trinh ean thiep v i ve sinh trudng hpc.
Cie ean thiep thay doi hanh vi su- dung nha vd sinh eua hpe sinh cin ddng bd tCr gia dinh tdi nhi trudng.
TAI LIEU THAM KHAQ
L Nguyin Vo Ky Anh (2006). Dinh gia ed sy tham gia dy an thi diem tai Viet Nam ve giao due ve sinh e i nhin va ve sinh trudng hpe do chinh phu Ha Lan tai trg nam 2000 - 2001.
2. Trjnh HCPU Vach (2006). Hieu qua sy t i i trg cua UNICEF v i cap nude va ve sinh mdi trudng cho eae trudng tieu hpc va nhi tre mau giao.
2006. 46.
3. IVIinistry of Health and UNICEF, (2006).
Summary of National Baseline Survey on Environmental Health, Vietnam, p. 34.
4. Social Republic of Vietnam (2005). National Target Program for rural water supply and sanitation (2006 2010). [cited; Available from: http://www.
isgmard.org.vn/lnformation%20Service/National%
20Program/NTPir/o20document%20-%20revised%
2027%20Oet2nd%20draft.%20EN2.pdf.
5. UNICEF and IRC. (1998). A mannual on School Sanitation and Hygiene.
6. World Health Organisation. (2009). Water, sanitation and hygiene standards in schools in low-cost settings.
7. VNS. (2009). School toilets inadequate. VNS (Population and Development).
Summary
SANITATION BEHAVIOR OF SCHOOL CHILDREN IN A RURAL AREA OF VIETNAM
Objective: to analyze how school children use latrine at school and at home in relation to urination and defecation. Subjects and methodology: In total, 707 child were interviewed by class with the student of grade 2, 3, 5, 6, 8 and 9 in 2 moutainous communes. Result: Children reported using latrine for urination and defecation the day before more common than in the open places. The percentage of children reported using school latrine to urinate and defecate was 50% and 32% respectively. The popularity for home latrine was 41% and 47%. The percentage of children reported to urinate and defecate in the open was 33% and 30%. There was a significant difference in latrine use by gender by ethnic groups , by level of grade.
However, the percentage of primary students reported using school latrine was far higher than that of secondary students (urination: 64% vs. 39%; defecation: 42% vs. 25%). Conclusion: the sanitation behavior of the sti.ident in this study was limited. The level of using latrine was increasing by age of children and differentiates by ethnic groups.
Key words: latrine behavior, school-age children, mountainous area
TINH TRANG SUY DINH OU'QNG CUA TRE EM DU'ai 5 TU6l
Nguyin Thj Thuy Hdng, Nguyin Thj Y§n Trwdng Dai hpc Y Ha Npi Nghidn cwu nhim dinh gii tinh trang suy dinh dwdng eua tre em dwdi 5 tudi va xic dnh ty Ip suy dinh dwang t^i cie khoa irong bpnh vipn Nhi Trung Wang. Bang piiwang phip md ta cit ngang nhirng bpnh nhin duvc dieu trj tpi 4 khoa phdng: Hd hip, Tieu hda, Tim mach, Diiu trj tw nguypn B ciia bpnh vipn. Kit qua che thiy hiu hit tre bj suy dinh dwdng diu khdng duxyc chan doin. Thdi gian aiu tri keo dii d nhdm tre suy dinh dwdng vira vi ning. Ty Ip suy dinh dwdng gap nhiiu nhit d nhdm tre mac bpnh tim bim sinh. Kit luin: suy dinh dwdng van cdn li vin di chwa duac quan tim trong Bpnh vien, dinh dwdng lam sang la van di cin duxyc nghien ciru.
Tie khoa: Suy dinh duo-ng, tre em du-ai 5 tuoi
I. DAT
V A N0 ^
Dinh dudng ddng mdt vai trd rit quan trpng trong sy tin tai v i phit trien toan dien eua ecn ngudi trpng suit cude ddi, die biet ddi vdi tre em, la ca thi dang Idn v i phit triin. Suy dinh dudng vin l i vin d i benh t i t eua c i e nude dang phit trien tren t h i gidi. Ty Id mie suy dinh dudng eua tre em nude ta d i giam nhung v i n edn cao so vdi cac nude khic. Suy dinh dudng l i nguyen nhin chinh v i eung l i hiu qua cua benh. SDD anh hu-o-ng din ehCrc ning v i sy hdi phuc cua he thong cie ca quan trong ca the, lam ting nguy ca nhiim trung, keo d i i thdi gian diiu trj. Tai benh vien Nhi Trung U'ang sd tre nhip vien vi cie benh lien quan din dinh dudng cdn k h i cao. Tuy nhien, s6 tre dugc chin doin suy dinh dudng edn thip va bo sdt nhieu. Oa sd benh nhin bj SDD khi nhip vien diu khdng duge chin doin hoac chf dugc quan tim diiu trj benh ehinh ma bd qua vin d i v i dinh duang.
De danh gia thuc trang suy dinh dudng cie b§nh nhin nhip vien, nghien eCru duge tien hinh nhim muc tieu: Md ta tinh trang suy dinh dudng cua tre em dudi 5 tuoi tai Benh vien Nhi Trung l/ong nam 2010. Xie djnh ty le suy dinh dudng tai cie khoa trong bdnh vien.
II.
D 6 |TU'QNG VA PHU'QNG
P H A P 1. Ddi tu'gng va dja diim nghien CIPUGdm 1000 benh nhin dugc diiu trj tai 4 khoa phong (Hd hip, Tieu hda, Tim mach, Oiiu trj ty nguyen B) eua benh vidn Nhi Trung Lfang tCr thing 1/1/2010 din 1/12/2010.
Tieu chuin chpn ddi tugng: cie benh nhin tuoi tip 0 den 60 thing tuoi nim diiu trj tai 4 khoa phdng benh vipn Nhi (Hd hip, Tieu hda, Tim mach, Oiiu
Bang 1. Ty le suy dinh du'd'ng theo nhdm tudi v i gid-i
trj ty nguyen B) dugc lya chpn ngiu nhien vio nhdm nghien eu-u.
2. Phu'ang phip nghien CCPU Nghien eCru md ta eit ngang.
Thu thip sd lieu theo mau benh i n nghidn cCru.
Sd lieu dugc xu- ly bing cie thuit toin thing ke y hpc tren phan mim Epi-info 6.04 va STADA 10.
Danh gia tinh trang dinh dudng v i ting trudng tre em theo tieu chuan WHO 2005.
III. KET QUA
1. Tinh trang suy dinh du'd'ng cua tre em du'd'i 5 tudi tai benh vien (bang 1)
Nhin xet bang 1: Cd 75,2 % tre gii v i 24,8%
tre trai tham gia nghien cCru. Nhiiu nhit d nhdm tuoi 0 - 12 thing (ehiim 61,6%) va it nhit d nhdm tuoi 49 60 thing (chiim 2,5%). Ty Id SDD giu-a nam v i nO- trong nhdm tudi 0 12 thing, 13 24 thing v i 37- 48 thing khac biet ed y nghTa thing ke vdi p < 0,05.
Nhan xet bang 2: Trong sd 1000 tre nhip vien cd 238 tre bj suy dinh dudng, nhung chf cd 7 tre dugc chan doan v i dinh dudng (chiim 0,7%).
Nhin xet bang 3:Thdi gian diiu tri trung binh eua 1000 tre nhip vien l i 7,5 ngiy. Trong dd thdi gian diiu trj keo d i i nhit l i d nhdm tre suy dinh dudng dp 2 (chiim 13,3%). Sy khic biet ed y nghTa thing ke vdi p < 0,05.
2. Ty le tre bj suy dinh du'd'ng tai cac khoa phdng trong benh vien (bang 4)
Nhin xet: Trong sd 238 tre bj suy dinh dudng ed18,1% sd tre nim diiu tri tai khoa Hd hip, 23,1% sd tre nim diiu trj tai khoa Tieu hda, 46,2%
sd tre nim diiu trj tai khoa Tim mach v i 12,6% sd tre nim diiu trj tai khoa Oiiu trj tu nguyen B.
Danh gia v i dinh du'd'ng Chan doin ve dinh du'd'ng
Cd Khdng
Nhdm tuoi
(thing) Gidi SDD dp 1 SDD dp 2 SDD dp 3 Khdng SDD
(%) (%) (%) (%)
0-12
Nu- Nam
446 170
13,2 17,7
4,5 8,8
3,1 1,2
79,2 72,3
Tpng 616 14,4 5,7 2,6 77,3
<0,05
Danh gii v i dinh du'd'ng Chan doan ve dinh du'd'ng
Cd Khong
Nhdm tuoi
(thing) Gidi SDD dp 1
(%)
SDD dp 2 (%)
SDD dp 3 (%)
Khdng SDD (%)
Nu- 182 20,3 3,3 3,9 72,5
13-24 Nam 48 16,7- 14,6 68,7
Tong 230 19,6 5,7 3,0 71,7 <0,05
Nir 69 13,0 1,5 1,5 84,0
25-36 Nam 18 16,6 5,6 77,8 >0,05
Tong 87 13,8 2,3 1,2 82,7
Nir 33 6,1 6,1 3,0 84,8
37-48 Nam 44,4 11,2 44,4
Tong 42 14,3 7,1 2,4 76,2 <0,05
Nir 22 22,7 4,6 4,6 68,1
49-60 Nam 33,3 66,7
Tdng 25 24,0 4,0 4,0 68,0 >0,05
Bang 2. Ty le tre bi suy dinh du'd'ng khdng dipgc chan doin Chin doan ve dinh du'ang
Danh gia ve dinh du'd'ng Cd Khdng
Khdng SDD CdSDD
n 1 7
% 12,5 87,5
n 761 231
% 76,7 23,3
p < 0,05
Tong sd 8 100 992 100
Bang 3. Mdi lien quan giipa thd'i gian diiu trj v i mipc do suy dinh du'd'ng MU'C dd SDD n (sd tre) Thd'i gian dieu trj trung binh
(ngiy) D p i
Op 2 Dps Khdng SDD
158 54 26 762
9,1 13,3 12,4 6,5
p < 0,05
Tong sd 1000 7,5
Bang 4. Ty le suy dinh du'd'ng tai cac khoa phdng Khoa dieu tri Suy dinh du'd'ng Khdng suy dinh du'd'ng Hd hip
Tieu hda Tim mach
Dieu trj ty nguydn B
n 43 55 110
30
% 18,1 23,1 46,2 12,6
n 207 195 140 220
% 27,1 25,6 18,4 28,9
p < 0,05
Tong sd 238 100 762 100
IV. BAN LUAN
Trong nghien eCru eua chung tdi tre bj suy dinh du-dng d nhdm tuoi 13 24 thing chiim ty Id cao nhit (28,3%). Kit qua nghidn eCru eua ehung tdi cung phii hgp vdi Nguyin Ngpc Sing v i Biii Viet Anh [1] khi nghien cCru ty Id suy dinh dudng theo tuoi thay ring ty le suy dinh duang cao nhit d nhdm tuoi 13-24 thing. Giai doan niy lien quan din che dO an bo sung va cai sO-a cua tre.
Hau hit tre bi suy dinh dudng d eae khoa phdng diu khdng duge chin doan, ma chf de cap den chin doin benh ehinh. Trong nghien eCru cua chiing tdi 238 tre bj suy dinh dudng, nhung chi cd 7 tre duge chan doan v i dinh dudng (ehiim 0,7%).
Kit qua niy eung tuang ty cac nghien eu-u cua cac tac gia trong v i ngoai nude [2, 3, 4].
Thdi gian diiu trj cua tre nhap vien trung binh la 7,5 ngay. Trong dd thdi gian dieu trj d nhdm tre suy dinh dudng dp 2 (13,3 ngay) v i suy dirih dudng do 3 (12,4 ngiy), cao han hin so vdi nhdm tre khdng bj suy dinh dudng (6,5 ngiy). Sy khic biet cd y nghTa thing ke vdi p < 0,05. Oiiu niy eung cho thiy tre bj suy dinh dudng kha nang miin djch bj suy giam lam ting nguy ea nhiim trung, keo dai thdi gian diiu trj. Kit qua niy eung phu hgp vdi nghien cu-u eua eic tie gia khic [4, 5].
- Kit qua nghien cCru eua ehung tdi cho thiy so tre diiu trj tai khoa Tim mach ed ty Id suy dinh dudng cao nhit (chiim 46,2%). Kit qua niy cung phu hgp vo-i nghien cCru khic tren the gidi [6] khi nghien CCPU
ve ty le suy dinh dudng d nhu-ng tre mie benh Tim bam sinh cho thiy ring, tre bj tim bim sinh dd bj suy dinh dudng do tre met nen bu kem, biing an them vao dd tinh trang nhiim trCing hd hap t i i phit nhiiu lan, sy dung nap thCrc i n kem han tre binh thudng trong khi nhu ciu ning lugng lai tang ndn niu khdng dupe chim sdc dinh dudng tdt.
V. K^T LUAN
Tir eic kit qua nghien eCru tinh trang suy dinh du-S-ng eua tre em dudi 5 tuoi tai benh vien Nhi Trung
U'ang nim 2010 ehung tdi rut ra mdt vai nhin xet sau:
Suy dinh dudng tre em dudi 5 tuoi tai Benh vien chiem 23,8%, cao nhit d nhdm 13-24 thing tuoi. Ty Id tre nhip vien bi suy dinh dudng dugc dk cip den chin doin ve dinh dudng edn khi thip (0,7%). Thdi gian diiu trj keo dii han d nhdm tre suy dinh dudng mCre dp vCra v i ning.
Ty Id tre bj suy dinh dudng nim diiu trj tai eae khoa la khac nhau, trong dd tai khoa Tim mach chiim ty le cao nhat (46,2%).
T A I LIEU THAM K H A O
1. Nguyin Ngpc Sang, Bui Viet Anh (2008).
Tinh trang suy dinh dudng va mdt so yiu to lien quan tdi suy dinh dudng the thip coi cua tre em dudi 5 tuoi tai tfnh Quang Ninh nam 2008. Tap ehi Nhi khoa, tap 3, sd 3 va 4, tr 247-253.
2. J p MeWhirter, C R Pennington (1994).
Incidence and recognition of malnutrition in hospital, 1994, 308:945.
3. Mike Lean, Martin Wiseman (2008).
Malnutrition in hospitals, 2008, 336: 290.
4. Cinda S. Chima, Kathy Barco, Marci L.A.
Dewitt, M.L.A Dewitt, Michelle Maeda, J.Carlos Teran, Kevin D. Mullen (1997). Relationship of nutrition status to length of stay, hospital costs, and discharge status of patients hospitalized in the medicine service. Journal of the American Dietetic Association, 975-978.
5. RL Weinsier, EM Hunker, CL Krumdieck and CE Butterworth Jr (1979). Hospital malnutrition. A prospective evaluation of general medical patients during the course of hospitalization. American Journal of Clinical Nutrition, 418-426.
6. Christy A N Okoromah, Ekanem N Ekure, Foluso E A Lesi, Wahab O Okunowo, Bolande O Tijani (2011). Prevalence, profile and predictors of malnutrition in children with congenital heart defects:
a case-control observational study. Arch Dis Child, 354-360.
Summary
MALNUTRITION STATUS IN CHILDREN UNDER 5 YEAR OLD
To determine incidence of malnutrition among patients under 5 on admission to National Hospital of Pediathcs and awareness of nutrition in different clinical units. By prospective study of consecutive admissions and 1000 patients admitted to hospital: 250 each from respiratory, gastrology, cardiology. Service Treating B.
Results: almost malnourished patients in hospital without the diagnosis appearing on their discharge summary.
Length of hospital stay is higher in groups of moderate and severe malnutrition. Malnutrition in children with congenital heart defects is highest. Conclusion: malnutrition remains a largely unrecognised problem in hospital.
Key words: Malnutrition, children under 5 years of age
TINH TRANG DINH DLPaNG VA MOT SO Y^U T 6 ANH HU'QNG cy SINH VIEN NAM THU' NHAT DAI HOC Y HA NOI
Pham Van Phii Trwdng Dai hpc Y Ha Noi
Nghien ciru nham dinh gia tinh trang dinh dwdng vi mdt sd yiu td chinh anh hwdng din sinh vien nim thir nhit Trwdng Dai hpc Y Hi Ndi. 962 sinh vien dwac aiu tra eat ngang md ta. Kit qua cho thiy, ty Ip thiiu nhiet Iwang trudng diin (TNL TD) dnam sinh vien la 30,9%; d nir la 33,8%; ty le thira ein vi beo phi d nam 9,0%; dnu'3,5%; ty le beo phi d nam 3,6%; d nir 0,4%; ty Ip thwa can boo phi a sinh vidn thanh phd gip gin 4 lin so vdi sinh vien ndng thdn. Chiiu cao nam 166,3 ± 5,5cm; nir 155,5 ± 5,2cm; cin nang nam 55,0 ± 7,6kg; nir 46,8 ± 4,9kg. Ty le TNLTD cd swkhic biet cd y nghTa thdng ke giCra nhdm cd kinh ti gia dinh tir khi trd len vi nhdm cd kinh ti gia dinh tw tmng binh trd xuong (p < 0,05), rd ret d nhdm sinh vien nam (p < 0,01). Chieu cao nam vi nCr thinh phd diu cao han sinh vien ndng thon (p < 0,05 vi p < 0,01). Cin ning eua sinh vien nam thinh phd hope cd kinh ti gia dinh tir khi trd len diu cao han cd y nghTa thdng ke so vdi nhdm ndng thdn hope ed kinh ti gia dinh tir trung binh trd xudng (p < 0,001).
Tir khoa: Sinh vien, tinh tr^ng dinh duo-ng, thiiu nhiet lu-gng triFong diln
I. DAT
VANDt
Trong nhu-ng nam gin day, eung vdi sy phit triin kinh te x i hdi eua d i t nude, tinh trang dinh dudng cua nhin d i n ndi ehung eung d i dugc cai thien ding k i . Tuy viy, vin edn mdt ty Id khdng nhd tre em bj suy dinh dudng v i ngudi trudng thinh bj thieu nhiet lugng trudng dien (TNLTD), ben canh dd l i mdt ty Id ding k i thCra c i n beo phi.
Sinh vien cie trudng dai hpe, cao dang l i mdt ddi tugng ein quan tam vi diy ehinh la lye lugng lao ddng tri de trong tuang lai, ICra tuoi 17-22 lai l i luc ca t h i tiip tub hoin thien va phit triin; d nhung nude dang phit triin nhu Viet Nam, dp tudi niy ed the vin ed hien tugng Idn bCi do d nhu-ng nim trude dd ea t h i ehua ting trudng hit tiim nang v i n ed eua nd. Chinh vi viy, mpi lech lac trong dinh duang diu ed t h i dan tdi nhung anh hudng khdng nhd va ed t h i de lai nhung hiu qua liu d i i cho su-e khde, the lye v i lim giam sut kha nang hpe t i p cua sinh vien, tCr dd din tdi giam sut kha ning lim vide, lao ddng sau niy.
Cho din nay, d i ed rit nhiiu cie nghien eu-u tip
trung v i o ddi tugng sinh vieri: Trin Thiit San va cs (1993) d i nghien eCru tren sinh vien nim thCr nhat Oai hpc y Ha Ndi; Trin Sinh Vuang (1996) nghidn
CCPU sinh vien cua Trudng Oai hpe The due The thao TCr San; Nguydn Ai Chiu v i cs (1997) nghien CCPU
tren sinh vien nam thCp tu, thCr nim eua 3 Trudng Oai hpe Y H i Ndi, Thii Binh, Bac Thii v i gin diy li eic nghien eCru eua Hoing Thu Soan v i cs (2007) d sinh vien trudng Oai hpe Y khoa Thii Nguyen; Trjnh Xuin D i n (2007) d sinh vidn mdi nhip vio trudng Oai hpe Thii Nguydn; Dd Hdng Cudng (2010) d sinh vidn giio due the chit Trudng Cao dang Su- pham H i Ndi [1, 2, 3, 5, 6, 7]. Nhung phin Idn eic nghien cCru tap trung vio hinh thii v i cie kich thude ea thi. Nghien eu-u niy nhim muc tieu:
Danh gia tinh trang dinh dudng cua sinh vien nam thCr nhat Trudng Oai hpc Y H i Ndi.
Dinh g i i mdt sd y i u to anh hudng chinh den tinh trang dinh duang eua sinh vidn.
II.
D 6 |TU'QNG VA PHU'QNG
PHAP I.Odi tu'gngSinh vien n i m thCr nhat n i m hpe 2010 - 2011,
