TAP CHf Y Dl/pC Hpc CAN THg - s6 11-12/2018
2. Dao Xuan Cudng (2015), "Dinh gia hieu qua cua ky thuat ndi soi mat-tyy ngugc dong ttong diiu tri cap cftu sdi dudng mat cd bien chftng", Tgp chi Y hgc Thdnh phd Hd Chi MnA, tgp 19, tr. 22-27.
3. Quach Trpng Dftc (2014), "HiSu qua ciia npi soi mgt tyy ngugc ddng vdi gay me npi khi quan ttong diiu tti sdi dng mat chu d ngudi cao tudi", Tgp chi Y hoc Thdnh phd Hd Chi Mn;i,tapl8,tt.4i8-423.
4. Tg Van Ngpc Dftc (2010), "Ket qua ldy sdi dudng mat qua ngi soi mat tyy ngugc dong ttong4 nam tgi BV Binh Dan", Tgp chi Yhgc Thdnh phd Hd Chi Minh, tgp 14, tt. 388.
5. Hd Van Han (2010), "Can thiep diiu tti qua npi soi mgt-tuy ngugc dong", Tgp chi Yhgc ThdnhphdHd Chi Minh, tap 14, tt. 67-73.
6. Nguyen Dinh Hdi (2012), "Dich te hpc benh sdi on%mM!\ Sdi du&ng mgt, Nha xuat ban Y hpc, tt. 45-55.
7. Nguyen Hoang Khai (2012), "Dac diem lam sang, cgn lam sang tten nhung b?nh nhan soi ong mat chu dugc dieu ttj bang phuang phap npi soi m|t tuy ngugc ddng tgi vien 103", Tgp chi Yhgc thuc hdnh, sd 855, tt. 137-138.
8. Duong Xuan Nhuong (2015), "Hi?u qua, tinh an toan cua npi soi mat tuy ngugc dong dieu tri sdi ong mgt chu d ngudi cao tuoi tgi bSnh vi?n QuSn Y 103", Hdi nghi khoa hoc Ngi A/)oo toan gudc/on iY", Tgp chi Npi khoa Viet Nam sd dgc bi^t,tt. 315-319.
9. La Van Phu (2015), "Jte? qud sam diiu tri soi duang mgt chinh bdng phdu thugt ngi soi tgi Binh vi4n Da Khoa Thdnh Phd Cdn Th(f\ De tai nghien cftu cSp thanh phd 2015.
I O.Nguyen Khanh Trgch (2009), "Sy phat ttiln ndi soi ttong b^nh Iy gan mat-gid tti cua no ttong chan doan-dieu tti tac mgt", Binh hgc ngi khoa tgp 1, Nha xuat ban Y hpc, tt. 70-80.
II .Nguyen Quang Trung (2012), "Nghien ciru ddc diem ldm sdng, can ldm sdng vd thdi do xu tri soi duang mgt chinh a ngu&i cao tudr, Luan in tiSn sf y hpc.
12.ASGE Guideline (2012), "Complications of ERCP", Gastrointestinal Endoscopy, Vol 75, No.3,pp.467-473.
13.ASGE Guideline (2010), "The role of endoscopy in the evaluation of suspected choledocholithiasis", Gastrointestinal Endoscopy, Vol 71.
H.Lee YT (2008), "Choledocholithiasis", ERCP, Elsevier Saunders, pp. 222.
(Ngdy nhgn bdi: 15/11/2017 - Ngdy duy$t ddng: 08/01/2018)
D A N H G I A KET QUA DIEU T R | C H A N THlTONG XOANG H A M TAI B f N H VIEN DA KHOA T R U N G l/OTVG C A N T H O N A M 2015-2017
Mai Vo Kim Thanh *, Duang Hitu Nghj Truang Bgi hgc Y Dugc Cdn Tho
*Email: [email protected] TOM T A T
Dgt vdn de: Chdn thuang xoang hdm khd phd biin, v&i nhiiu hinh thdi vd muc dg tdn thuang khdc nhau Chan dodn vd diiu trj chdn thuang xoang hdm cdn phdi kfp th&i vd dung dan, nhdm ddm bdo gidi phdu, chuc ndng vd thdm my cho b^nh nhdn. Mgc tiiu nghiin ciiu: Md td dgc diem ldm sdng, hinh dnh hgc vd ket qud diiu tri chdn thuang xoang hdm tgi Binh viin Da Khoa Trung Uang Can Tha. Boi tugng vd phuang phdp nghien cuu: Nghien cint mo td cdt ngang 66 truang hgp chdn thuang xoang hdm diiu tri ldn ddu dugc phdu thudt ndn chinh qua tiin dinh lgi mdi tir thdng 9/2015 den thdng 6/2017 tgi BVDKTVCdn Tha. Ket qud: Co 66 binh nhdn (nam gdp 5 ldn nii, tuoi trimg binh 30,65 tuoi). Triiu chirng ca ndng chu yiu la dau chdi vd dau nhiic tgi
TAP CHIY Dl/pfC Hpc CAN THP - SO 11-12/2018
VI tri chdn thuang. Trieu chiing thuc the gdm sung ne, bdm tim, mdt cdn ddi gd md vd chdy mdu mm Id cha yiu. Sai kh&p cdn 19,7% vd hd miing hgn chi 28.79%. Sau 3 thdng kit qud tdt dgt 51,52%, sau 6 thdng dgt 62,12%. Kit lu^n: Phdu thudt ndn chinh xoang hdm gd mdqua tien dinh lgi moi vdn cdn gid tri trong diiu trj chdn thuang xoang hdm.
Tirkhda: chdn thuang xoang hdm, chdn thuang hdm gd md, chdn thuang hdm mgt.
A B S T R A C T
T R E A T M E N T O U T C O M E S A M O N G P A T I E N T S W I T H M A X I L L A R Y SINUS T R A U M A I N C A N T H O C E N T R A L G E N E R A L H O S P I T A L
F R O M 2015 T O 2017
Mai Vo Kim Thanh, Duong Huu Nghi Can Tho University of Medicine and Pharmacy Background: Maxillary sinus fractures constitute a substantial proportion of cases of facial trauma. Accurate diagnosis and timely intervention are absolutely necessary to ensure the
anatomical structures and thefitnction of the sinus as well as the harmony of the face. Objective:
To assess the clinical features, imaging findings and the treatment outcomes among patiems with maxillary sini4S trauma in Can Tho Central General Hospital. Materials and method: A sectional descriptive study was conducted on 66 patients in Can Tho Central General Hospital from September 2015 to June 2017. Results: The ratio of males/female was 5 The mean age was 30,65.
The common symptoms were pain, swelling, bruising, assymmetry and nose bleeding. The percentage of malocclusion was 19,7% and the corresponding figure of trismus was 28,79%.The number of patients with good result accounted for 51.52% after three months of treatment and 62,12% after 6 months.Conclusion: Zygomatico-maxillary reduction with the oral vestibular cpproach has proven to be effective method in treating maxillary sinus trauma.
Keywords: Maxillary sinus trauma, zygomatico-maxillary fractures, maxillofacial injuries.
I. DAT V A N D E
Chdn thucmg xoang ham kha phd biSn ttong cac logi chdn thuong viing ham m^t, va cd xu hudng ngay cang tang. Chan thuang do nhieu nguySn nhan khac nhau va tfty tftng nguySn nhan va ca chS sS c6 nhilu hmh thai tdn thuang. Vdi vj tii giai phlu cfta xoang ham d vung tdng gjua mat, ndm ndng, cung vdi xuang go ma nam nhd ra trudc. Do dd rdt dS bi tdn tiiuong khi cd va cham. Vi xoang ham dugc cdu tgo bdi nhilu tiianh xucmg kl can nen nd cd lien he mat thilt vdi xuong gd ma va xuong d mat. Khi lyc chan thuang du mgnh cd thi lam tdn thuang cac cdu true nay, gay anh hudng nghiem ttpng den chftc nang va thdm my khudn mat. Viec chdn doan va diSu tri chan thuong xoang ham can phai dftng ddn va kip thdi, tranh dS lai di chftng cho benh nhan. Vi vay chftng tdi thyc hien de tai '"Bdnh gid ket qud dieu tri chdn thuang xoang hdm tgi Bfnh viin Ba Khoa Trung Vang cdn Tha ndm 2015-2017" vdi 2 myc tiSu:
1. Md ta dac diim lam sang va hinh anh hpc cfta chan thuang xoang ham.
2. Danh gia kit qua diiu tri chdn thuong xoang ham.
U. D O I T U ' O N G V A P H l T O N G P H A P N G H I E N ClTU
B^i tirgng nghien cuu: Tdt ca benh nhan chan thucmg xoang ham tgi benh vien Da khoa Trung Uang Cdn Tha nam 20I5-20I7.
Tieu chudn chgn mdu: Benh nhan chdn thuong xoang Imm dieu trj lan dau, dugc chi dinh phlu thu^t nan chinh hinh va ddng y tham gia nghiSn cftu.
TAP CHf Y Dl/pC Hpc CXN THP - SO 11-12/2018
TiSu chudn logi trir: BSnh nhan cd thang diem Glasgow dudi 9, cd kem chdn thuang sg nao, cot sdng, mgch mau, tft chi phai diSu tri cap cftu. Cd vd xuong mui, vd xuang ham dudi. Cd benh ly ndi khoa kem theo. Cd bat thudng vftng Imm mat, mui xoang hoac da phau thuat vftng ham mat, mui xoang trudc dd.
Bia diim vd th&i gian nghiin cuu: Nghien cftu dugc tiSn hanh tai BSnh vien Da khoa Trung Uang Cdn Tha. Thdi gian tijt 9/2015 - 6/2017.
Phirong phap nghien cuu
• Thiit ki nghien ciru: Md ta cdt ngang
• C& mdu: 66 benh nhan.
• Noi dung nghiin ciru:
- Dac diSm chung: Tudi, gidi.
- Trieu chftng ca nang va ttieu chtttig thuc the.
- Hinh anh tdn thuang ttSn Blondeau, Hirtz va Cat Idp vi tinh - Phuang phap phlu thuat
- Dien tiSn hau phdu ttong qua trinh ndm viSn.
- Tinh trgng Iftc ra vien.
- Danh gia ket qim diSu trj sau 3 thang va 6 thang dua ttSn giai phau, chftc nang va thdm my:
+ Giai phau: Danh gia lien xucmg: Tdt (xucmg liSn tdt, khdng cdn hinh anh thau quang gifta cac dau xuang gay), Kha (xuang di lech <3mm), KSm (Xucmg di lech >3mm)
+ Chftc nang:
Khdp can: Tdt (khdp can dftng), Kha (cdn hd hoac cham sdm I ben), Kem (Sai khdp cdn)
Ha ntieng: Tdt (>40mm), Kha (30-39mm), Kem (<30mm).
cam giac TK DOM: Tdt (HSt dau, tS), Kha (Cdn dau, te), Kem (Mdt cam giac).
Thi lyc: Tdt (Thi luc nhu trudc chan thucmg), Kem (Thi lyc giam so vdi trudc chan thucmg hogc cd song thi).
Mui xoang: Tdt (mui thdng, khdng chay miJi), Kha (Nghet miii khdng thudng xuySn, chay mui ttong), Kem (Nghet mui thudng xuyen, chay mui due).
+Tham m j ; Tdt (hai gd ma can ddi), Kha (quan sat kf mdi phat hien mat can doi, bd xuong khdng lien tiic), Kem (hai gd ma mdt can ddi).
- Danh gia chung
+ Tdt: tat ca tiSu chi tdt va khdng viSm xoang
+ Kha: cd it nhat 1 tieu chi kha, khdng cd tieu chi nao kem, khdng viem xoang.
+ KSm: cd it nhat 1 tieu chi kem hogc cd viSm xoang.
III. K E T Q U A N G H I E N ClTU Bac diem chung
Tudi vd gi&i: Tdng sd 66 ca. Nam 55 (83,33%), nft 11 (16,67%).
Bang 1. Phan bd benh nhan theo tudi 9 9 tuoi
Ty le %
16-40 tu6i 81,82
41-60 tudi 1 >60tu6i 18,18 0 Dp tudi tu 16-40 tudi chiim ty IS cao nhdt, khdng ghi nhgn dugc trudng hgp nao cd dd tudi tren 60 tudi.
TAP CHI Y Dl/pC Hpc CAN THtf - S6 11-12/2018 Bgc diem iam sang va can ISm sang
Cdc trifu chung ca ndng:
Bang 2. TriSu chftng ca nang Trieu chirng
Dau nhiic Dau choi Nghet miji Te mo! tren
Soca 53 58 17 7
Tv le % 80,3 87,88 25,76 10,61 Trieu chftng ca nang thudng gap la dau nhftc, dau chdi. TS mdi ttSn chiSm 10,61%.
Cdc trifu chung thtfc thi
90.00% 84.85%
75.75% 75.76%
80.00%
70 00%
60.00%
50 00%
40.00%
30.00%
20,00%
10.00%
0.00%
60,61%
1
19.70%I I
Srnig nl Bdm tim Mat can Chay Sai khdp Ha mieng Lao xgo Giam thi ddi mau mui cdn han chi xuang lyc Bieu do 1. Trieu chung thyc the
Cac dgc diim hinh anh hgc
Bang 3. Hinh anh tdn thuang tten phim Blondeau va cat Idp vi tinh EQnli auh ton thirong
Tu mau xoang ham Tu mau xoang ham don thuan Tu mau xoang ham+ton thuong xoang ham don
thuan
Ton thuomg xoang ham+gay XGM
Blondeau 59
0 11 55
89,39%
0%
16,67%
83,33%
CLVT 60
0 3 63
90,91%
0%
4,55%
95,45%
Bang 4. Hmh anh tdn thuang cung gd ma ttSn phim Hirtz Ton thuong cung go ma
Co Khong
Tong
SoTH 32 34 66
Ty 18 % 48,48 51,52 100 K i t qua dieu tri ^
Phuang phdp phdu thudt: Ndn chinh don thudn; 54 trudng hgp; Ndn chinh H djnh ham: 12 trudng hgp.
Th&i gian tir khi chdn thuang den khi phdu thugt Bang 5. Thdi gian tu khi chdn thuong den khi phau thugt
>14ngay 4,55 Thdi gian
Ty IS %
<3 ngay >3-7 ngay >7-14 ngay
31,82 13,63
TAP CH( Y Dl/pC Hpc CAN THP - S6 11-12/2018 Tai biin trong phau thugt: Khdng cd
Diin tien hgu phSu: Chay mau vlt md: 2 trudng hgp; cang tftc vftng mSit: 23 trudng hgp; khdng cd trudng hgp nao cang tftc d mat, giam thi lyc, dftt thun cd dinh ham hay dftt chi klmu ruem mgc.
Ftnh trgng ldc ra viin: Sung nS mat (12,12%), Bdm tim (36,36%), Dau vftng xoang chan thuang (10,61%).
Kit qud dieu trj sau 3 thdng
*Liin xuang: tdt 63,64%, kha 31,81 %, kein 4,55%
I*Chuc ndng: Cam giac va thi lyc phyc hdi 100%, cdn 16,67% ha mieng kha (30- 39mm), 9,09% khdp can hd nhe hoac cham sdm 1 ben. Tinh ttgng miii xoang kha 6,06%, kSm 4,55%. ViSm xoang 4,55%.
*Thdm my: Tdt 69,69%, kha 25,76%, kem 4,55%.
* Ddnh gid chung: Tdt 51,52%, kha 39,39%, kem 9,09%.
Ket qua dieu tri sau 6 thdng
*Lien xuang: tdt 68,18%, kha 31,82%, khdng trudng hgp nao cd ket qua kem.
PChuc ndng: Cam giac, thi lyc va khdp can phuc hdi 100%, cdn 6,06% ha mipng kha (30-39nim). Tinh trgng mui xoang kha 4,55%, kem 1,52%. Viem xoang 1,52%.
*Thdm my: Tdt 71,21%, kha 25,76%, kem 3,03%.
* Ddnh gid chung: Tdt 62,12%, kha 33,33%, kem 4,55%.
IV. BAN LUAN
KSt qim cfta chftng tdi cho thay nhdm tudi gap nhieu nhat ttong chdn thuong xoang ham la tft 16-40 tudi, chiem 81,82%, tuong ty nghiSn cuu cua Pham Nggc Anh va Nguyen Thi Quynh Lan [1], [3]. Day la nhdm tudi tham gia chft ySu vao cac hoat ddng ddi song va xa hgi, la nhdm sft dung phuong tiSn giao thdng nhilu va thudng xuySn. Nam gidi nhieu gap 5 ldn nft gidi. Ty IS rmy phft hgp vdi cac nghien ciru cfta Phgm Nggc Anh, Dd Thanh Tri va Shahzad M [I], [4], [7]. Do nam gidi tiiudng tham gia vao cac boat ddng mang tinh mgo hiSm va ty le dimg bia rugu ciing cao nSn de xay ra chdn thuang.
Trieu chftng ca nang thudng gap la dau nhftc va dau chdi khi dn vao xuang bi tdn thuong. Trieu chftng thyc the thudng gap la sung n l , bdm tim, mat can ddi gd mft va chay nmu miii. Ha mieng hgn chi cd 28,79% trudng hgp va sai khdp cdn 19,7% trudng hgp.
Chdn doan chan thuong xoang ham neu chi dua vao cac ttieu chftng ISm sang se khdng chinh xac vi cd nhftng trudng hgp phft nS, tu mau gay khd khan cho tham kham. Vi the, hinh anh hpc la phuong phap quan ttgng, giup xac dinh gay xuong, vj tti va kieu di lech cua tdn thuang [5]. Trong nghiSn cftu cfta chftng tdi, hinh anh tu mau xoang ham ttSn phim Blondeau la 89,39% tiudng hgp, va tten phim CLVT la 90,91% tiidng hgp. Hinh anh tdn tiiuong xoang ham kem gay XGM ttSn Blondeau la 83,33% va cdt Idp vi tinh la 95,45%. Huih anh tdn thuang tten 2 loai phim khdng khac biet nhilu, chftng td phim Blondeau van cdn gia tri trong chdn doan chdn thuong xoang ham gd ma.
Trong nghiSn cftu cfta chftng tdi, cd 54 trudng hgp dugc phau thuat imn chinh don thuan qua tien dinh lgi mdi, nhet meche ttong xoang c6 djnh va 12 trudng hgp phau thuat ndn chinh kit hgp cd dinh liSn ham.Thdi gian tu khi chdn tiiuong din khi phau ttiu^t ttong 3 ngay ddu chiim 50% va thdi gian txt ttSn 3-7 ngay chiim 31,82%. Theo tac gia Gentile MA thi khoang tiidi gian ly tudng dS can tiuep ngoai khoa la tii 7-10 ngay sau chdn thuang. Trong thdi gian nay, hien tugng phu n l da giam va cac xuong gay vln cdn kha nang di ddng de dang, rat thuan Igi cho nan chinh. N I U qim 10 ngay, xuong bat dau lanh 194
TAP CHI Y DI/pC Hpc CXN THP - SO 11-12/2018
lai, cd hiSn tugng hinh thanh md xa. Sau 3 tudn, qua tiinh can xuong sdm xay ra, rat khd khan dS can thiep ndn chinh 16].
Trong qua trinh phlu tiiuat, khdng cd ttudng hgp imo xay ra tai biSn. Trong qua trinh nam viSn sau phlu thugt, cd 3,03% trudng hgp cd chay mau vet md do mdi chi thua, xft tri bang khau tang cudng; 34,85% trudng hgp cang tftc vung mat va giam ddn sau khi rftt hSt meche ttong xoang.Khi ra vien, mgt sd tnrdng hgp cdn dau tftc, sung nS va bam tim vung mat, 100% trudng hgp cd vlt md dn.
Sau 3 tlmng, tat ca trudng hgp tai kham dugc chyp lgi phim Blondeau dS kiSm tra sy lien xuong va tinh trang xoang ham. Chftng tdi ghi nhgn chute nSng cam giac va thi lyc phyc hdi 100%. Tuy nhien, cdn 6 trudng hgp khdp can cdn hd nhp hogc chgm sdm 1 ben, 11 trudng hgp cd ha mi?ng hgn chS vdi bien dg 30-39nim. Nhiing trudng hgp cd nghet mfti, chay mui va X-quang cd hinh anh md xoang dugc chi dinh ndi soi miii xoang va xac dinh cd viem xoang hay khdng. Chui^ tdi ghi nhan cd 3 trudng hgp cd viSm xoang sau 3 thar^. KSt qua tdt ve thdm my dat 69,69%, kha 25,76%o va kem 4,55%. TiSn phim Blondeau, cd 63,64% tiudng hgp Uen xuong tdt, khdng cdn hinh anh than quang giiia cac dau xuong gay, cdn 4,55%
tiudng hgp cd bien dgng va di lech xuong nhieu. Danh gia chung kSt qim diSu tri sau 3 tiiang, chftng tdi ghi nhan tdt dat 51,52%, kha 39,39% va kem 9,09%.
Sau 6 thang, hdu hSt benh nhan dSu phyc hdi tdt ve chftc nang. Tuy nhiSn vln cdn 4 trudng hgp cd ha mieng han chi 30-39mm. Cd 1 trudng hgp cdn viSm xoang sau 6 thang phlu thugt. Day la trudng hgp chdn thuong xoang ham cd nhieu manh vd va dugc can thiep ttong tudn thft 2 sau chia thuang. KSt qua tdt ve thdm my dgt 71,21%, kha 25,76% va kem cdn 3,03%. Sau 6 thang, cac xuang hdu nhu liin tdt khdng cdn trudng hgp nao cd di ISch xuong nhieu. Danh gia chung ket qua diSu tri, chftng tdi ghi nhgn tdt dat 62,12%, kha 33,33%, kem 4,55%.
Kit qua diiu trj sau 3 thang va 6 thang vdi ty le dgt ket qua tdt kha cao, tuy nhiSn vln cdn mgt ty IS nhd cd ket qim kem. Trong nghiSn cftu cua Chau Chieu Hda tren nhung benh nhan chan thuang tang gifta mat cd tdn thuang mui xoang dugc can thiep bang phau tiiuat chinh hinh bdng nep vit vdi ty le kit qua tdt dat 80,95% va khdng cd tiudng hgp nao cd kit qua kem [2]. Tac gja Dd Thanh Tri nghien cftu tten nhiing bSnh nhan va xoang ham vdi phuong phap phlu thuat ndn chinh xoang ham ket hgp ndi soi mui xoang va cd djnh bang sonde Foley hoac nep vit, cho kit qua diSu tri gan nhu tuyet ddi d ca 3 phuang dien giai phlu, chftc nang vft thdm my [4].
V. KET LUAN
Chdn doan chdn thuang xoang ham khdng khd, nhung de chdn doan chinh xac tdn thucmg thi cdn phai cd sy kit hgp lam sang va hinh anh hpc, dS ttanh bd sdt tdn thuang.
Ben canh dd, phuang phap phlu thuat ndn chinh xoang ham gd ma qua ranh lgi mdi vln cdn uu thi ttong diiu ttj chdn thuang xoang ham, song d6i vdi nhimg trudng hgp chan thuang phftc tgp va gay vun nhilu manh cdn can nhdc ap dung them nhilu phuang phap tilp can d gay cung nhu kit hgp ngi soi mui xoang ttong phlu thuat de viec can thiep va ndn chinh dugc chinh x ^ hem. Tu dd cai thien dugc ket qim ve chftc nang, giai phau cung nhu tham my cho b?nh nlmn.
TAI LIEU THAM KHAO
1. Phgm Ngpc Anh (2009), Nghien ciiu dgc diim ldm sdng, can ldm sdng vd kit qud diiu trf chdn thuang xoang hdm kin, Lugn dn chuyen khoa cap II, Tnrdng Dai hoc Y Dugc Hue.
195
TAP CHI Y Dl/pC Hpc CAN THP - S6 11-12/2018
Chau Chieu Hda (2012), Nghien ciiu dgc diim ldm sdng. X quang chdn thuang tdng giwa khdi xitang mat co tdn thuang mSi xoang. ddnh gid kit qud phdu thugt chinh hinh bdng n^p vit, Luan an Tiin si Y hoc, Dai hoc Y Ha Ndi.
Nguyin Thi Quynh Lan (1998), Kit qud diiu tri v& xoang hdm - xuang go md do chdn thuang tgi Trung tdm Tai MSi Hgng Thdnh phd Ho Chi Minh (1991 - 1997), Lugn an Chuyen khoa Cdp II, Dai hoc Y dugc Thanh pho Hd Chi Minh.
D6 Thanh Tri (2013), Nghiin cuu diiu trf vd xoang ham trong chdn thuang tdng giOa mat bdng ngi soi kit hgp v&i ndn chinh xuang, Lugn an tien sT y hpc, Vien Nghien cftu Khoa hpc Y dugc Lam sang 108.
Ahmad K., Ansari S. etal (2013), Radiological Evaluation of Maxillofacial Trauma: Role of MDCT with MPR and 3-D Reconstruction, Indian Journal of Basic & Applied Medical Research 2 (8), p.1027-1034.
Gentile M. A., Tellington A. J. et al (2013), "Management of Midface Maxillofacial Trauma", Craniomaxillofacial Trauma - An Issue of Atlas of the Oral and Maxillofacial Surgery Clinics, 21, Elsevier Saunders, Philadelphia, p.69-96.
Shahzad M. , Hassan S. G., Memon M. R. (2012), Analysis of Maxillofacial Fractures in Patients Treated at Liaquat Medical Universi^ Hospital, Hyderabad, Pakistan Oral &
Dental Journal 32 (3), p.381-384.
(Ngdynhgn bdi: 10/11/2017-Ngdy duyet ddng: 02/01/2018)
DI C H U N G T H A N KINH V A C A C Y ^ U T O N G U Y C O O TRE NON T H A N G X U A T VIEN Ttr H O I StTC S O SINH BENH VIEN DA KHOA
TRUNG T A M T I E N GIANG
Nguyin Thi TiQ>itLoan*
Binh viin Ba khoa Trung tdm Tiin Giang
*Email: [email protected]
TOM T A T
Dgt vdn de: Di chung thdn kinh a tre non thdng thu&ng ndng ni, co thi gdy ton tgt cho tre. Nghien ciru thuc trgng di chimg thdn kinh cua tre giup dinh hu&ng cdc liiu phdp ho trg phii hgp. Mac tiiu nghiin cd-u: Khdo sdt ti li cdc di chung thdn kinh & tre non thdng trong 12 thdn§
theo doi. Xdc dfnh mdi liin quan giOa cdc yiu td nguy ca v&i cdc di chimg thdn kinh cua tre xudt vien tir Hdi stic sa sinh. Boi tugng vd phuang phdp nghiin ciia: Nghiin cdu dodn hi. tiin ciiu Chiing tdi tiin hdnh nghien cihi tren 2 nhdm tre sa sinh bao gdm: nhdm mgc tieu la nhdm tre non thdng vd nhdm chirng la nhom tre dii thdng trong th&i gian theo doi 12 thdng. Thdng qua thong ke phdn tich hdi qi^ da biin xdc dfnh cdc yiu to nguy ca lien quan di chirng thdn kinh. Ket qua nghiin cuu: Ti li di chiing thdn kinh & nhdm tre non thdng trong 12 thdng theo ddi la di chung mdt 9,5%, bgi ndo 2.1%, nao ung thiiy 4,2%. chdm phdt trien tdm thdn vgn dgng 11,6%. Cdcyeu td nguy CO lien quan v&i di chiing thdn kinh bao gdm suy dinh duang bdo thai, chi sd apgar < 7. co gigt sa sinh. vd bdt thu&ng nao trin sieu dm. Kit lugn: Cdn thdnh lap bg phgn qudn ly theo doi tre sa sinh non thdng, tre sa sinh du thdng cd yiu td nguy ca cao sau xudt viin tgi cdc binh vi^n tuyen tinh cd dan vj Hdi sue sa sinh v&i cdc quy trinh chuyin mon phii hgp.
TU khda: di chdng thdn kinh, tre non thdng.
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