TAP CHfY D i r p t HQC CAN T H g - s 6 13-14/2018
9. Chamberlain M.B., Manning G.A., Morison I., et al(]984), "Ultrasound evaluation of amniotic fluid. I. The relationship of marginal and decreased amniotic fluid volume to perinatal outcomes", Am J Obstet Gynecol, 150, pp. 245-249.
10. Chauhan et al. (1999), "Perinatal outcome and amniotic fluid index in the antepartum and inttapartum periods: A meta analysis''. Am J Obstet Gynecol, 181(6), pp. 1473-1478.
11. Danon D., Ben-Haroush Avi, Yogev Yariv, Bar Jacob, Hod Moshe, Pardo Joshep (2007),"Prostaglandin E2 induction of labor for isolated oligohydramnios in women with unfavorable cervic at term". Fetal Dianogsis and Therapy, 22(1), pp.75-79.
12. Sultana J.C, F. Gary Cunnmgham, Kenneth J Lenevo et al (2010), William Obstetrics, 23rd edition, McGraw Hill Medical Publishshing.
13. Oz A.U., Holub B., Mehdilcioglu 1., Man G. ahd Bahado - Sihgh R.O.(2002), "Renal artery Doppler investigation of the etiology of oligohydramnios in posttemi piQpiancy", Am J Obstet Gynecol, 100, pp. 715-718.
(Ngay nhdn bdi: 13/11/2017-Ngdy duyit ddng: 04/01/2018)
NGHIEN c t r u TINH HINH THIEU KEM VA M O T SO YEU T 6 LIEN QUAN Of TRE TIEU CHAY T ^ I K H O A T R U Y E N N H l E M B ? N H VIENNHI
B O N G CAN T H O TlT 10/2014 D E N 11/2015
Nguyin Thi Thu Cue, Nguyin Thi Thu Ba, Nguyin Thi Nguyen Thao Trudng Dgi hgc Y Duac Cdn Tha
* Email: [email protected] TOM TAT
Bgt vdn de: thiiu kem dang Id vdn di phd bUn trong cgng ddng. dgc bijt Id a nhiing nude dangphdt triin, cd che dg dn chu yiu la ngu cdc, it thuc dn dgng vdt Mgc tiiu nghiin cd-u: xdc djnh ti le. ndng dg thieu kim vd mdt sd yeu td lien quan a tie tieu chdy tgi khoa Nhiem Binh vi?n Nhi dong Cdn Tha. Boi tugng va phuang phdp nghiin cd-u: nghiin ciru md td cdt ngang tien 481 bjnh nhi tiin I thdng den du&i 5 tudi mdc tiiu chdy tgi khoa Nhiem, Binh viin Nhi ddng Cdn Tha tir thdng 10/2014 din thdng ll/2015.Kit qud: ti Ij thiiu kem a tre tieu chdy Id 26,6%. Nong do thiiu kem trung binh: 8,77±1,67 pmol/l. Mgt sd yiu td lien quan din thiiu kem a tie tieu chdy:
giai nir (30.5%).sdng & vimg ndng thdn (27%), nhdm tudi tir 36 thdng din dirdi 60 thdng tuoi (43,8%), thiiu mdu (28%). Ket lugn: ti Ij thiiu kem a tie tieu chdy Id 26,6%. ndng dd thiiu kem trung binh: 8,77±1,67 pmol/l, mdt sdyiu td nguy ca thiiu kem a tiiu chdy Id tie cd thiiu mdu, sdng vung ndng thdn, gidi nir, suy dinh duong, nhdm tudi 24-36 thdng.
Td- khda: Thieu kem. tiiu chdy.
ABSTRACT
TO STUDY ZINC DIFIENCY A N D S O M E R E L A T E D FACTORS OF CHILDREN WITH D I A R R H E A A T T H E D E P A R T M E N T OF
INFECTIOUS, CAN T H O PEDIATRICS H O S P I T A L FROM 1 0 / 2 0 1 4 T O 11/2015
Nguyen Thi Thu Cuc\ Nguyen Thi Thu Ba, Nguyen Thi Nguyen Thao Cantho University of Medicine and Pharmacy Background: Zinc deficiency is a widespread problem in the community, especially w developing countiies where the diet is primarily cereal low animal feed. Objectives:
TAP CHf Y DirgfC HQC CAN THCT - SO 13-14/2018
Determination of ratio, concentration of zinc deficiency and some related factors in diarrhea children at Cantho Pediatrics Hospital Materials and methods: cross sectional description study, with 418 children from 1 month to under 5 years old with diarrhea at Department of Infectious Diseases, Cantho Children Hospital from 10/2014 to 11/2015. Result: the prevalence of zinc deficiency in diarrhea was 26.6%. Average zinc deficiency: 8.77^1.67 fimol/l. Some factors related to zinc deficiency in diarrhea children: female (30.5%), live in rural areas (27%), children aged 36 months to less than 60 months (43.8%), anemia (28%). Conclusion: the prevalence of zinc deficiency in diarrhea was 26.6%. average zinc deficiency: 8 77±1.67 pmol/l, some risk factors for zinc deficiency in children with diarrhea were anemia, rural living, female, malnutrition, age group 24-36 months.
Key word: Zinc deficiency, diarrhea.
I. D^T VAN DE
Thieu kem dang la vdn de phd bien ttong cdng ddng, dac bidt la d nhiing nude dang phat ttien, cd che dp an chii yeu la ngii cdc, it thiic dn dpng vdt. Tai Chdu A cd tdi 61% ddn sd thidu kem. Nghien ciiu tai Vidt Nam nam 2006 d tte em mien mii phia bac cho thdy ty Id tte em thidu kem Id 86,9%. Thidu vi chdt dinh duong hien nay la van dd dupe nhieu nude tten the gidi quan tdm [l].[4].Vidt Nam ciing nhu nhieu nude ttdn thd gidi da xdc dinh ro tam quan ttpng cua kem ttong qua trinh tang trudng d tte, Iam gidm ty Id mac bdnh va ban chd miic dp nang ciia tidu chdy d ttd em [7] .Do dd, vdi khao sat nay, chiing tdi mudn "Nghidn ciiu tinh hinh thidu kem vd mpt sd ydu td lien quan d tte tidu chay tai Khoa Nhidm Bdnh vien Nhi Ddng Cdn Tha tir thdng 10/2014 ddn tiiang 11/2015", vdi muc tidu nghien ciiu la xdc dinh ti Id, ndng dp thidu kem va mpt sd ydu td lidn quan d tte tieu chay tai khoa Nhidm Benh vien Nhi ddng Can Tha.
IL DOI TlTQfNG VA PHU'ONG PHAP NGHIEN ClTU 2.1. Boi tupng nghidn ciru
481 benh nhi tten 1 thdng ddn dudi 5 tudi mdc tidu chay tai khoa Nhidm, Bdnh vidn Nhi ddng Cdn Tha tir thang 10/2014 ddn thang 11/20I5
2.2. Phirong phap nghien cihi - Thiet kd nghidn cuu: md ta cat ngang.
- Cd mau: chpn tdt cd nhiing tte nhap vidn vi b?nh tidu chdy vd cd Iam xet nghidm kem huydt, thu thdp dupe 481 mdu. Phuang phap chpn mdu: chpn mau khdng xac suat (mau thuan tidn).
- Npi dung nghidn ciiu: d^c didm ddi tupng nghidn ciiu, ti Id thidu kdm, ndng dp thidu kem trung bmh, ti Id thieu kem iheo gidi, nhdm tudi, nai d, tinh trang dinh dudng, mpt sd ydu td lien quan thidu kem.
- Phuang phap thu thdp sd lieu: hdi bdnh theo bd cau hdi soan sdn, khdm ldm sdng ghi nhdn theo bp cdu hdi soan sdn, tidn hanh Idm cac xdt nghiem va ghi nhdn ket qua,cdng tinic mau: xac dinh Het, Hb, MCV, MCH, dinh lupng kgm huyet thanh, ghi cdc thdng tin vao phieu nghidn ciiu ddy du, chinh xac.
- Phuang phap xir li sd lieu: sd lieu thu thap duac da nhdp va xii li thdng kd cac sd lieu bang phdn mem SPSS 18.0
IIL KET QUA NGHIEN CU*U
TAP CHi Y DirqlC H Q C CXN IHOf - S 6 13-14/2018 Bang 1. Ti le thiSu kem a tre tieu chay (n=481)
Chi sd kem Thiiu kem (< 10,7 (imol/1) Binh thucmg (> 10,7 - 22,9 umol/l)
So Immg 128 353
Tile(%) 26,6 73,4 N6ng do thiiu kem trung binh: 8,77Mmol/l± 1,67, thSp nhSt 2,4nmol/l, cao nhat 10,5nmol/l
Vdi n ^ 481 tte tidu chay cd djnh lupng kem, ttong do kdt qua dinh lupng thieu kem Id 128 trudng hap, chidm 26,6%. Ndng dp thidu kdm tnmg binh ttong huydt thanh:
8,77pmol/l ± 1,67, thkp nhdt 2,4nmol/I, cao nhdt 10,5|imol/l
Bang 2.Ndng dp kem trung binh theo gidi, nhdm tudi, noi sdng, dinh duang d tte tidu chay CO thieu kem (n=128)
Dac diem Gidi tinh
Nam Nit Nhom tudi
<12 thang 12 thang - < 24 thang 24 thang-< 36 thang 36 thang-< 60 tiiang Nai song
Nong thdn Thanh thi Tinh tr^g dinh dudng Suy dinh dudng Binh thudng
Can nang cao han so vdi tuoi
So lupng(%) 74 (57,8) 54 (42,2) 67 (52,3) 40(31,3) 13(10,1) 8(6,3) 99 (77,3) 29 (22,7) 19(14,8) 102(79,7) 7(5,5)
N6ng dothieu k6m trung binh (umol/l) 8,93 ± 1,46 8,69 ±1,93 8,61 ± 1,82 8,89 ±1,49 8,83 ±1,91 9,30 ±0,50 8,77 ±1,52 8,76 ±2,10 9,10 ±0,60 8,72 ±1,74 Tre nam tidu chdy cd thidu kemchidm ti Id (57,8%) cao hon ttd ntt (42,2%),ndng dp thieu kdm tnmg binh d tte nam 8,89 ± 1,45 pmol/1 va ttd nii 8,61 ± 1,93 |amol/I.Thidu kemd nhdm tudi < 12 thang (52,3%) va nhdm 12 thang ddn dudi 24 thang (31,3%) chidm ti Id cao ban nhdm tu6i tir 24 thang ddn dudi 36 thang (10,1%), miic dd thieu kem trung binh d nhdm tu6i < 12 thdng 8,61 ± 1,82 pmol/1 va nhdm tudi tir 36 thang ddn dudi 60 thang 9,3 ± 0,5 pmol/1.- Tre co thieu kem song d ndng thdn 77,3% cao ban d thdnh thi 22,7%, miic dp thidu kdm trung binh d ndng thdn 8,77 ± 1,52 pmoI/1 va thanh thi 8,76 ± 2,1 |.iraoiyi.C6 14,8% tte bi suy sinh dudng va 5,5% tte cd can n ^ g cao hon so vdi tudi, miic dp thidu kem trung binh d tte suy dinh dudng 9,10 ± 0,6 pmol/1 va tte cd can ndng cao hon so vdi tudi 8,3 ± 2,4 pmol/I.
Bdng 3. Mdi lidn quan thidu kem vdi gidi, nhdm tudi, noi sdng, tinh ttgng dinh duang, thidu maud tte tieu chdy (n=48I)
Dac diem GiiH
Nam Nit
Kem Thieu n 74 54
CM 24,3 30,5
Binh thuang n 230 123
(%)
75,7 69,5
x'
2,17 P 0,14
OR
0,73 KTC 95% 0,5-1,1
TAP CHi Y D i r o c HOC CAN THO -
£)ac diem
<12 thang 12 thang - < 24 thing 24 thang - < 36 thang 36 thang - < 60 thang Noi soDg
Nong thon Thanh thi Tinh trang Dinh Duthig Binh thu6ng Suy dinh duong Can nang hon so voi tuoi Thieu mdu:
Co Khong
Kem Thieu n 64 43 14 7
99 29 10 8 13 7 50 78
24,2
(%)
27,0 33,3 43,8
27,0 25,4 26,4 26,0 31,8 29,4 25,1
Binh thuong n 200 116 28 9
268 85 301 37 15 120 233
(%)
75,8 73,0 66,7 56,273,0 73,7 73,6 74,0 68,2 70,6 74,9
SO 13-14/2018
X=
0,4 1,57 3,0 0,1
0,03 0,3 1,1
P 0,5 0,2 0,08
0,7
0,9 0,5 0,3
OR 0,8
0,6 0,4
1,1
0,98 1,3 1,24
KTC 95%
0,5-1,4 0,3-1,3 0,1-1,2
0,6-1,7
0,5-1,9 0,5-3,2 0,8-1,9 Tre tieu chay giai nam (24,3%) co nguy ca thieu kem it han so voi tre gioi nu (30,5%). Tre duoi 12 thang tu6i (24,2%) it co nguy ca thieu kem nhat so voi nhom moi tit 12 thang dSn duoi 24 thang (27,0% / ^ = 0,4p=0,5), tu 24 thang d6n duoi 36 thang (33,3%
y^ = l,57p=0,2), tit 36 thang d6n dudi 60 thang tu6i (43,8% x^= 3,0p=O,08). Tre tieu chay song a vimg nong thon (27,4%) co nguy ca thieu kem gap 1,1 lan so vai tre song a thanh thi (25,3%). Tre suy dinh duong (26,0%) co ti le thiSu kem gan gi6ng nhu tie binh thuong (26,4%). Tre CO can nang hon so VOT tu6i (31,8%) co nguy co thilu kem gdp 1,3 l^n so voi tre binh thuong (26,4%). Tre thiSu kem co nguy ca thieu mau (28,0%) nhieu hon so voi tre khong thieu mau (25,6%).
IV.BAN L U A N
4.1. Ti le va nong dd thieu kem a tre tieu chay
Theo ngiiien curu ciia chijng toi ti le thiSu kem cua tre tieu chay chiem ti le 26,6%, mirc do thiSu kem trung binh la 8,77 ± l,67)unoyi, kSt qua nay co thip hon so voi nghien cuu cua Luu Thi My Thvic (2013), ty 1$ tre tieu chay cjp co thiSu kem chiSm 71,7% [6] va nghien ciru ciia Edward Bitaiakwate va cpng su (2003), Theo nghien ciiu Edward Bitarakwate va cong su, ty le thiSu kem cr tre tieu chay cliiem 47,9% [8]. Dieu nay c6 the la do tre tieu chay duoc b6 simg kem theo khuyen cao cua WHO tai cac phong kham nhi talac khi tre bi tieu chay dpt nay, hon niia mot trS co thS mSc vai dot tiSu chay trong mpt nam. Mat khac, nghien cuu Lira Thi My Thuc (2013), ty le benh nhan co ham lupng kem huySt thanh thip duoi 10 (miol/1 la 77%, ciing gSn phii hpp nghien citu chung toi, ty Ie benh nhan co ham lupng kem huySt thanh thip duai 10 umol/l la 80,4% [6]
Tre gioi nam tieu chay co thi6u kemchiSm ti le cao (57,8%), nSng dp kem trong huyft thanh a tre nam la 8,93 ± 1,46 umol/l, nflng dp kem tnmg hiiyfe thanh otre nu la 8,69 ± l,93)miol/l. N5ng dp thiSu kem tmng binh cr nam 8,93±1,46 )mio!/l va nir 8,691:1,93 [imol/1, su khac biet nay khong nhiSu. K ^ qua n^y thip hon so v6i mpt nghiSn ciiu thuOc mien Bac Viet Nam cho thiy ty 1$ tre tiiieu
119
Ti?iP CHi Y D l / p t HOC C X N T H g - S O 13-14/2018
kem kba cao 87,2% d tre trai vd 86,5% d tre gdi [3].Tre tidu chay cd tMeu kemd nhom tudi dudil2thdr^ (52,3%) vd nhdm tudi tCr 12 thang dka dudi 24 thang (31,3%) chidm ti Id cao hon nhom tudi tir 24 t h ^ ddn dudi 36 tbang(IO,I%) vd nhom tudi tir 36 thdng i^n dudi 60 Ihdng. Ddngtiioi ndng dp kem trong huydt thanh d nhdm tudi dudiI2thang la 8,61 ± 1,82 ^unol/l, ndng dd kem trong hi^dt thanh d nhdm tudi tir 12 tfidng ddn dudi 24 thdng la 8,89 ± 1,49 ^unol4 ndng do kem trong huydt tiianh d nhom tudi tu 24 tiidi^ ddn dudi 36 tiiang la 8,83 ± 1,91 ^unol/1, nong dp kem trong huydt thanh d nhom tudi tir 36 tiiang ddn d i ^ 60 tiiang la 9,3 ± 0,5 (imol/l.
Phdn ldn cac tte tidu chdy co thidu kem sdng d khu vuc ndng thdn (77,3%), va ndng dp kem trong huydt thanh d khu vyic ndng thdn la 8,77 ± 1,52 ^mol/I, ndng dp kem ttong huydt thanh d khu vuc thanh thild 8,76 ± 2,1 ^imol/l. Cd 16,6% tte bi suy sinh dudng va ndng dp kem ttong huydt thanh d tte suy dinh dudng la 9,2±0,64 jimol/l. Tre co can nang cao han so vdi tuoi la 5,5% va ndng dp kem ttong huydt thanh d ttd co can n^ng cao ban so vdi tudila 8,3 ± 2,4 \imoVl.
4.2. Mot so yeu to lien quan den thi^u kem d tre tieu chay
Gidi: Tre tidu chdy d gidi nam (24,3%) nguy co thidu kem it ban so vdi tre gidi nii (30,5%). Sy khac bidt nay khdng cd y ngbia thdng kd vdi p. = 2,I7p=0,I4, OR = 0,73.
Kdt qua ndy c6 thdp ban theo mot nghidn cdu thupc midn Bac Viet Nam cho thdy ty Id tre thidu kem kha cao 87,2% d tte ttai vd 86,5% d tte gdi [4]. Mgc du cdc sd lieu vd tiitii tr^ng kem huyet thanh va ty Id thidu kem ttdn qudn thd cd nguy ca cao d Viet Nam cdn han che, nhung ty Id nay la rdt cao so vdi phdn logi cua IZNCG (ttdn 20%) [2], cd thd do khdc nhau vd vi tri dia Ii, tap quan tdng viing mien.
Nhom tuoi: Tidu chdy d nhom tudi tu 36 thang ddn dudi 60 thdng (43,8%) co nguy CO thidu kem nhidu ban so vdi tte dudi 12 thang tudi (24,2%). Su khac bidt nay khdng cd y nghia thdng ke vdi )(^ = 3,Op=0,08, OR = 0,4.
Noi if: Tre tidu chdy sdng d ndng thdn (27,0%) cd nguy co thidu kem gdp 1,1 ISn so vdi tte sdng d thanh thi (25,4%). Sy khdc biet nay khdng cd y nghia thdng kd vdi x^ = 0,Ip=0,7. Su khdc biet nay cd thd Id do ddi tuong nghidn cuu ciia chung tdi phdn ldn tre sdng d viing ndng thdn (76,3%) nhidu hon d thdnh thi (23,7%)
Tinh trang dinh du-dng: Tre suy dinh dudng cd thidu kdm (28,3%) chidm ti Ie cao it hon tte tte binh thudng (26,6%), ttd suy dinh dudng cd nguy ca thidu kem gdp 1,1 ldn so vdi tte binh thudng (/^ = 0,07p=0,78). Tre cd can nang cao hon so vdi tudi co thidu kdm (31,8%) chidm ti Id cao it ban tte binh thudng (26,4%), tte cd can ndng cao ban so vdi tuoi cd nguy ca tiiidu kdm gdp 1,3 ldn so vdi tte bmh thudng (x^ = 0,3p=O,5). Dieu ndy ciing cd the Id do nhdm nghidn cuu ciia chdng tdi, cd 29,4% ttd thidu mdu cd thidu kem.
Thieu m i u : Tre tieu chay thidu kem ma cd thieu mdu hdng cdu nhd nhirorc sac (29,4%) chidm ti le cao it hon tte thidu kem md khdng thidu mdu (25,1%), ttd tiiidu mau hdng cau nhd nhugc sac thi nguy ca thidu kem gdp 1,24 Idn so vdi tte khong thidu mau (X = I,I,p=0,3), su khac biet ndy ro rang hon, cd thd Id do ddi tupng nghidn cuu cua chiing tdi la tte tiiidu kem cd suy dinh dudng 14,8%. Theo nghidn cuu cua Ld Danh Tuydn (2009) vd tinh hinh thieu mau, thidu kem va mpt sd ydu td lidn quan d tte em dudi 5 tudi tai huyen Lac San, tinh Hda Binh cho thiy ty le thidu kem d tre em dudi 5 tudi ttong nghidn curu la 85,8% [5]. Ket qua nghien cttu cung cho thdy thidu kem lidn quan chat che vdi thidu mau, thidu vitamin A (OR = 2,66; p < 0,05).
T»p CHI Y Dl/grc HOC CAN T H a - SO 13-14/2018 IV. KET LUAN
- Ti id tiiidu kem d tre tieu chay la 26,6%, ndng dp tiiidu kem trung binh: 8,77±1,67 umol/l.
- Tidu chdy d gidi nir (30,5%) cd nguy co thidu kem nhieu hon d gidi nam (24,3%), p=0,l,OR = 0,73. Trd gidi nam sdng d viing ndng thdn (26,8%) thi nguy co thidu kem gdp 2,01 ldn so vdi tte gidi nam sdng d viing thanh thi (15,4%) (p=0,05). Trd tidu chdy sdng d vung ndng thdn (27%) thi nguy co thidu kdm hon tte sdng d viing tiianh thi (25,4%)(p-0,7, OR = 1,1). Tidu chdy d nhdm tudi tu 36 tiiang ddn dudi 60 tiiang tudi (43,8%) cd nguy co tiiieu kem hon so vdi tte < 12 thang tudi (25,3%), (p=0,08, OR=0,4).
Tre thidu kem cd nguy co tiiidu mdu (29,4%) (p-0,3, OR=I,24).
TAI LI|:U T H A M K H A O
1. Bp mdn dinh dinh dudng trudng dgi hoc Y Da(?c Ha Npi (2004), "Dinh du&ng vd vi sinh a7i/0fln//i«cpAdm",NhaxuitbanYhpc, Ha Npi, tt. 123 - 126.
2. Bp Y td (2011), "Tom tdt s6 lieu tfadng ke y td 2006-2010", Ha Noi.
3. Tdng cue thong ke (2011), "Dieu tra danh gia cac muc tieu tte em va phu nir 2011", Bdo cdo MICS Viit Nam.
4. Nguyen Xuan Ninh (2006), "Tmh ttang vi chat dinh duong va tang trudng d tre em Vi?t Nam", Tgp chi dinh dudng va th^K:phdm, s6 2(l),tt.29 -33.
5. Lgi Thi Thanh Thao va Suzanne MCB Thanh Thanh (2012), "Kham benh vd maulTriju chiing hgc ngi khoa, NXB Y hpc, tt. 198 - 204.
6. Luu Thi My Thgc (2013), "Ddnh gid hieu qud bd sung kem vd mgt sd vitamin a tre suy dinh duang cd tiiu chdy cdp do Rotavirus", Ludn an tiSn sT, chuyen nganh Dinh dudng.
7. Le Danh Tuyen (2009), 'T^ghien cuu tinh hinh thieu mau, thieu kem va mot so yeu td lien quan dtre em dudi 5 tudi tai huyen Lgc Son, tinh Hoa Binh", Tgp chi nghien ciru yhgc, so 79(2),tt.l38-143.
8. Edward Bitarakwate, Edison Mworozi, Addy Kekitiinwa (2003), "Serum zinc status of children with persistent diarrhoea admitted to the diarrhoea management unit ofMulago Hospital, Uganda", Department of Paedifrics and Child Health, Makerere University Medical School.
(Ngdy nhgn bdi: 13/11/2017 - Ngdy duyet ddng: 04/01/2018)
KHAO SAT B A C B I E M C A C TRlTCWG HOP BENH NHI IXS VONG B O S O C N H l i M K H U A N T A I B E N H V I E N NHI B O N G CAN T H O
Nguyen Phtrd^c Sang'*, Phiing Nguyen Thi NguySn 1. Trudng Dgi hgc YDugc Cdn Tha 2. Tru&ng Dgi hgc Y Dugc TP Hd Chi Minh
*Email: [email protected] TOM T A T
Bgt vdn de: Sdc nhiim khudn vdn cdn Id hdi chimg ldm sdng thu&ng gap tgi cdc dan vi Hdi sue cdp cuu nhi vd la mgt trong nhiing nguyen nhdn gdy td vong hdng ddu d tre em. Chdn dodn s&m, xir tri ban ddu hiju qud giiip gidm ty le tir vong. Muc tiiu nghiin cuu: xdc dinh cdc biiu hiin ldm sdng, cgn ldm sdng vd cdc biin phdp diiu tij ciia cdc tru&ng hgp benh nhi tir vong sdc nhiim khudn tgi Bjnh vijn Nhi Ddng Cdn Tha. Boi tugng vd Phuang phdp nghiin cuu:
Nghiin cuu md td hdi cuu 56 bjnh nhi sdc nhiim khudn tir vong tir 1 thdng -15 tudi nhdp khoa
