TAP CHI Y PirgC HQC CXN THg - s611-12/2018
5. Tmdng Dai hpc Y tS cdng Cpng (2011), Gdnh ndng binh tdt va chdn thuang a Viet Nam, Nhi xudt ban y hpc, Ha Npi
6. Le Nam Tra (2006), Xdy dung vd ddnh gid phuang phdp nghien cuu md hinh benh tat vd tir vong ngudi Vi^t Nam nhung ndm ddu thi ky XXI, Bao cao tong kSt dS tai nghiSn cihi cdp Bp - Bo Y tS, Ha Npi, 2006.
7. WHO (2015), Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, Lancet Journal, 2015 Vol 5; 386: 2287-2323.
(Ngdy nhgn bdi: 15/11/2017 - Ngdy duyet ddng- 07/01/2018)
NGHIEN ClTU MO HINH B E N H T A T THEO ICD-10 TAI CAC BENH V l £ N TINH CA M A U T R O N G 5 N A M TlT 2010 £>EN 2014
Phgm Thi Tam', Li Minh Hitu', Huynh Qudc Vig^, Huynh Kim Hbn^
1. Trudng Dgi Hgc YDuac Cdn Tha 2. SaYtied Mau
*Email:pttam@ctump. edu. vn TOM T A T
Dgt v^n de: He thong benh viin cdc tuyin khdng ddng deu ve ea sd vgt chat, ky thugt va khd ndng chuyin mdn. Cdc nghien cdu md hinh binh tgt khdm chira benh tgi cdc binh vien dua tiin thdng tin sdn cd se gdp cung cdp dugc cdc bdng chung giup cdc binh viin to chuc lai cdc dich vg khdm chiia binh, ca cdu lgi giudng binh, bd tri nhdn luc di ddp ung tdt han nhu cdu chdm sdc sde khde cua nhdn ddn. Muc tiiu nghiin cuu: Xdc dinh ti li cdc chuang binh mac cao nhdt theo ICDIO eua cdc benh nhdn diiu tri ngi tru tir 2010 din 2014 tgi binh vi^n da khoa tinh Cd Mau, binh viin khu vuc da khoa Ddm Dai vd binh vi4n Da khoa huyin U Minh. tinh CdUau.
Doituffne vd phuang phap nghien cuu: Nghiin ciru dugc tiin hdnh bdng phirang phdp hoi cuu dir liiu hd sa b^nh dn luu trir tiin mdy tinh cua 226.206 b^nh nhdn ndi tru nhgp vi^n diiu tii trong thdi gian tir ngdy 1/1/2010 din 31/12/2014. Phdn logi b^nh dugc xip theo chuang dua theo cdch phdn logi hinh tgt theo ICD-10 theo bd md 3 ky tu cua td chuc y ti the gidi gdm 21 chuang. Ket qud: Ndm chuang binh ngi tid chiim ti I? cao la Chdn thuang ngg dgc 17,5%. Binh he tudn hoan 12.78%. Binh he tieu hda 12.13%, Binh nhiim trimg va ky sinh trung 11,45%, vd Binh hi hd hap 10,4%. d tre em dudi 16 tuoi chuang binh cao nhdt Binh nhiim trimg 34,4%, B?nh he hd hap 17,7%, Chdn thuang ngg dgc 16,8%, B^nh dudng tiiu hda 10.8%. Ngudi tu 16 tuoi. ti-d len.
Binh nhiim triing 33,6%, Chdn thuang ngd dgc 17,7%, Binh tuan hodn 15,4%, Binh tieu hoa 12.4%, b4nh hi ho hdp 8,9%. Kit lugn: Mo hinh binh tdt tgi cdc b^nh vi?n Cd Mau cho thdy chiim uu thi la cdc binh nhiim trimg vd chdn thuang ngd ddc.
Tir khda: ICD-10, ngi tiu. chirang b$nh, mo hinh binh tgt ABSTRACT
RESEARCH ON P A T T E R N S O F DISEASES O F HOSPITALIZED PATIENTS IN CA MAU P R O V I N C E IN F I V E YEARS FROM 2010 TO 2014
Pham Thi Tam, Le Minh Huu, Huynh Quoc Viet, Huynh Kim Hong 1. Can Tho University of Medicine and Pharmacy
392
TAP CHIY Dirge HQC CAN THff- s 6 11-12/2018
2. Ca Mau Department of Health Bacground: Hospitals at all levels are ununique in terms of facilities, techniques and expertise. Studies on health patterns at hospitals based on available information will contribute to the provision of evidence to help hospitals reorganize health services and treatment services, bed restructure and personnel placement to betier meet the health care needs of the people.
Objectives: To determine the highest rates of ICDIO cases among inpatient from 2010 to 2014 in Ca Mau provincial General Hospital. Dam Doi General Hospital and U Minh Distiiet Center.
Materials and methods: The study was conducted by retrospective data collection of computerized records of 226,206 inpatients admitted to inpatient clinics from 1/1/2010 to 31/12/2014. Diseases consisted of 21 chapters that were classified according to ICD-10 classification by three character code of the World Health Organization. Results: Injury of poisonings accounted for 17.5%.
Circulatory system 12.78%, Gastrointestinal disease 12.13% and Infectious diseases and parasites 11.45% and Disease of the respiratory system 10.4%. In children. Infectious diseases and parasites was 34.4%, Disease of the respiratory system 17.7%; Injury of poisonings 16.8% and respiratory 10.8%. To adults. Infectious diseases and parasites was 33.6%, Injury of poisonings 17.7%. Gastrointestinal diseasel2.4%. Disease of the respiratory system 8.9%. Conclusion: The disease pattern in hospitals basically shows that preveilenee of infections deseases and injuries.
AcjJ words: ICD-10, inpatient, outpatient, chapter of diseases, pattern of diseases
I. DAT VAN DE
He thdng bfnh vien cac tuyen khdng ddng dSu vS co sd v^t chdt, ky thuJit va kha nang chuyen mdn. Do do nghiSn ciiu md hinh bSnh tat kham chfta bfnh tai cac bfnh viSn dua ttSn thong tin sin co se gdp cung cap dugc cac bang chiing giiip cac bfnh viSn td chuc lai cac dich vu kham chua bfnh, co cau 1^ giudmg benh, bd tii nhan lire dS dap iing tdt hon nhu cau cham sdc siic khde ciia nhan dan [6], [7], Muc tieu: (J)Xac dinh ti If cac chuang bfnh mac cao nhdt theo ICDIO cua benh ndi tni tft 2010 den 2014 tai bfnh viSn da khoa tinh Ca Mau, benh vifn da khoa Dam Dai va benh vien da khoa U Minh (2) Md ta ty le chuong bfnh theo cac nhdm tudi.
II. PinrONG PHAP NGHIEN CUtJ
Thidt ki nghien CUTI: Nghien cihi dugc tiSn hanh bdng phuong phap hdi ciiu dft hSuhd so bfnh an luu tru tren may tinh ciia benh nhan diSu tri ndi tni va tir ngay 1/I/20I0 dSn 31/12/2014 tai bfnh vifn da khoa tmh Ca Mau (BVDKCM), benh vien da khoa khu vuc Ddm Doi (BVDKDD) va benh vifn da khoa U Minh (BVDK UM) ciia tmh Ca Mau.
Tiiu chuin chgn ddi tugrng: Hd so dugc chgn phai cd ddy dii cac thdng tin: Ten, tudi, gidi, dia chi, thdi gian nhap viSruchdn doan, ma bfnh thoe ICD-10.
C& mdu nghiin cihi: Tdt ca bfnh nhan du dieu kien bao gdm 226,206 benh nhan ndi tiii bao gdm 147600 tai BVDK CM, 62391 BVDK DD, va 16215 BVDK UM.
Ndi dung nghiin cim: BSnh dugc x^p theo chuong dua theo each phSn loai benh tat theo ICD-10 theo bd ma 3 kytii cua Td chiic ytethS gidi [3], [5], gdm 21 chuang nhu sau: Chuong I.-Bfnh nhilm triing; Chuong II- Budm tan sinh; Chuang III-Bfnh ciia mau;
Chuong IV-Ngi tiSt va chuyen hoa; Chuang V-Rdi l o ^ tam thdn va hanh vi; Chuang VI- Benh he thdn kinh; Chuang VII-Bfnh cua mdt; Chuong VHI-Bfnh Tai xuong chum;
Chuong DC-BSnh hS tudn hoan; Chuong X-Benh he hd hdp; Chuang XI-Bf nh hf tiSu hda;
Chuong XII-BSnh da va md dudi da; Chuong XIII (BSnh he co-xuong khdp va md Uen kSt; Chuang XIV-Benh hf sinh due tiSt nifu; Chuang XV-Thai nghen va smh de; Chuang XVI-BSnh thdi ky chu sinh; Chuong XVII-Di tat bam smh; Chuang XVIII-Cac benh
T»P CHi Y DLfQC HpC CAN THg - SO 11-12/2018
khong phto loai o phan khac; Chuong XlX-Chan thuong ng6 doc; Chucmg XX-Nguyen nhan ben ngoai; va Chuong XXI-YSu to anh huong toi sue khoe va tiSp xuc djch vu y tS.
III. KET QUA
Bang 1. S6 luong benh nhan noi tru t^i cac benh vien nghien cuu B?nh vi§n
BVBK Ca Mau BVDK Khu vuc DSm Doi b$nh vien da khoa Minh
Tong
n
%
n%
n%
n%
2010 27646
18,7 9506 15,2
(*)
37152 16,4
2011 31180
21,1 13867 22,2 2864 17,7 47911 21,2
2012 35181
23,8 13127 21,0 4516 27,9 52824 23,4
2013 19431
13,2 12038 19,3 4154 25,6 35623 15,7
2014 34162
23,1 13853 22,2 4681 28,9 52696 23,3
Tong 147600
100 62391 IOO 16215 100 226206 100 Tong so benh npi tni nghien ciiu la 226206 lugt benh nhan, trong do BVDKCM 147600 lugt, BVDKDD la 62391 lugt v a B V D K U M l a 16215 lugt.
Bang 2. Dac diem tuoi ciia benh nhan nghien cijru Dac diem
Nhom tuoi
< 6 tuoi 6 - 1 5 tuoi 16-59 tuoi
>= 60 tu6i T6ng
BVBK CM n 6938 5593 85541 49528 147600
%
4,7 3,8 58,0 33,6 100,0BVDK DD N 14494
5938 26720 15239 62391
%
23,2 9.5 42,8 24,4 100,0BVBKUM n 4925
710 6508 4072 16215
%
30,4 4,4 40,1 25,1 100,0Tong n 26357 12241 118769 68839 226206
%
11,7 5,4 52,5 30,4 100,0 Ngudi bfnh tudi 16 - 59 chiem ti If cao nhat, 52,5%, ke den la ngudi 60 tuoi trd ISn 30,4%. Trd em dudi 5 tudi va 6-15 tudi chiSm ti If ldn lugt la 11,7% va 5,4%. Tai BVDK DD va TTYTUM tre em duoi 5 tudi nhap vie diSu tri chiSm ti IS cao, lan lugt la 23,2% va 30,4%.Bang 3.Ti If chuang benh ngi tru phan loai theo ICD-10 Chinrng
XIX IX XI I X
xrv
XV II IV Khac
xm
TONG
BVDKCM n 36670 19035 19488 9864 11802 14667 128 9086 6152 4123 16585 147600
%
24,8 12,9 13,2 6,7
8 9,9 0,1 6,2 4,2 2,8 11,3 100
BVDKDD n 2693 7604 6893 13416 9076 1385 9574 355 1672 1492 8231 62391
%
4,3 12,2
11 21,5 14,5 2,2 15,3 0,6 2,7 2,4 13,2 100
BVDKUM n 243 2271 1060 2615 2653 124 4411 80 415 268 2075 16215
%
1,5 14 6,5 16,1 16,4 0,8 27,2 0,5 2,6 1,7 12,7 100
Tong n 39606 28910 27441 25895 23531 16176 14113 9521 8239 5883 26891 226206
17,51
%
12,78 12,13 11,45 10,4 7,15 6,24 4,21 3,64 2,6 11,9 IOO
T»P CHl Y Diriyc HOC CXN THg - so 11-12/2018
Nh^n xet: Muoi chuong benh ngi tni cao nhAt: chSn thuang, ngg dpc 17,51%; he tiian hoan 12,78%; h? tieu hoa 12,13%; nhiem triing vaky smh trimg 11,45%; benh he ho hap 10,4%; b6nh hp sinh due tiSt nieu 7,15%; thai san va sinh de 6,24%, ung buou 4,21%;
npi tiet dinh duOng vi chuyto hoa 3,64% va benh co xuong khop 2,6%.
Bang 4. Ti le chuang b8nh ngi tni phan loai theo ICD-10 g tre em diroi 16 tu6i Ten chirang (Chuang)
Nhiem trung (!) Ho hap (X) Chan thuang (XDC) Tieu hoa (XI) Benh chu sinh (XVI) SD-Tilt nieu (xrv) Benh Da (XII) Benh cua Mat (VII) Khac
Tong
BVDKCM n 910 873 6041 2214 9 818 386 394 886 12531
7,3
%
7,0 48,2 17,7 0,1 6,5 3,1 3,1 7,1 100
BVDKDD n 10210 4431
389 1727 2358 126 264 53 874 20432
50,0
%
21,7 1,9 8,5 11,5
0,6 1,3 0,3 4,3 100
TTYTUM n 2148 1521 49 242 1495
4 26 0 150 5635
38,1
%
27,0 0,9 4,3 26,5 0,1 0,5 0,0 2,7 100
Tong n 13268 6825 6479 4183 3862 948 676 447 1910 38598
34,4
%
17,7 16,8 10,8 10,0 2,5 1,8 1,2 4,9 100 0 tie em dudi 16 tudi chuong benh cao nhat BSnh nhiSm trung 34,4%, diing hang thit hai la Bfnh hS hd hdp 17,7%, Chdn thuong ngg dfc 16,8%, Bfnh dudng tiSu boa 10,8%. Va kS dSn la bfnh ly thdi ky chu sinh 10,0% T^ BVDKCM chiSm ti If cao nhdt la chdn tiiuong 48,2%. tai BVDKDD va BVDKUM, nhiem tiling chiSm ti If cao nhdt, 50,0% va 38,1%.
Bang 5. Ti IS chuong bfnh ndi tni phan loai theo ICD-10 o >16 tudi Ten chucmg
(Chucmg) Chk thuang (XDC) TuSn hoan (IX) Tieu hoa (XI) H6hap(X) SD-Ti6t nieu (XIV) Thai san (XV) Nhiem triing (I) Ung buou (II) Noi tiit (IV) Co xuong khdp (XIII) Khac
TSng
BVDKCM n 30629 18989 17274 10929 13849 128 8954 8853 6117 4068 15279 135069
22,7
%
14,1 12,8 8,1 10,3 0,1 6,6 6,6 4,5 3,0 11,3 100
BVDKDD n 2304 7572 5166 4645 1259 9574 3206 325 1556 1475 4877 41959
%
5,5 18,0 12,3 11,1 3,0 22,8 7,6 0,8 3,7 3,5 11,6 100BVDKUM n
194 2265 818 1132 120 4411 467 77 384 264 448 10580
%
1,8 21,47,7 10,7 1,1 41,7 4,4 0,7 3,6 2,5 4,2 100
T6n n 33127 28826 23258 16706 15228 14113 12627 9255 8057 5807 20604 187608
17,7
%
15,4 12,4 8,9 8,1 7,5 6,7 4,9 4,3 3,1 11,0 100 0 nguoi lon, c^c chuong benh cao la Benh nhiem trimg 33,6%, Chdn thuong 17,7%, Benh tuto hoto 15,4%, Benh tieu hoa 12,4%, b6nh hS ho hip 8,9%, benh sinh due - tiSt ni?u 8,1%. Tai BVDKCM chi6m ti le cao nhit la chin thuang 22,7%. Tai BVDKDD va BVDKUM chiSm ti le cao nhit la thai san sinh de (22,8% va 41,7%) va tuin hoan (18,0% v4 21,4%).
Bang 6. Ti le chuong benh ngoai tni phan loai theo ICD-10
T»P CHi Y DirpfC HpC CAN THg - SO 11-12/2018 Ten chuang (Chuang)
Ho hap: X Tuan hoan: IX Ti6u hoa: XI Co-Xuang-khop: XIII Thk kinh (VI) Npi t i k rv Nhiem trimg: I Chin thuong: XIX Benh ciia mat: VII Benh da: XII Khac
Tong
BVDKCM n 12591 17299 13097 10073 1609 9975 6152 8720 4218 3965 15898 103597
12,2
%
16,7 12,6 9,7 1,6 9,6 5,9 8,4 4,1 3,8 15,3 100
BVDK DD N 109222
53599 55728 31760 41931 14593 21344 13652 13151 10868 37836 403684
27,1
%
13,3 13,8 7,9 10,4 3,6 5,3 3,4 3,3 2,7 9,4 100
BVDK UM n 53849 32058 19139 14852 260 6621 3048 1363 3987 2849 10919 148945
36,2
%
21,5 12,9 10,0 0,2 4,5 2,1 0,9 2,7 1,9 7,3 100
Tong n 175662 102956 87964 56685 43800 31189 30544 23735 21356 17682 64653 656226
26,8
%
15,7 13,4 8,6 6,7 4,8 4,7 3,6 3,3 2,7 9,8 100 Mudi chuang benh ngoai tru hang dau tai cac bfnh vifn nghien ciiu: Benh hS ho hdp 26,8%; hf tudn hoan 15,7%; he tieu hda 13,4%; benh co xuong khdp 8,6%; bSnh hf thdn kinh 6,7%; ngi tiSt dinh duong va chuySn hda 4,8%; nhiem triing 4,7%; chdn thuong 3,6% va bfnh ctia mdt 3,3% va bfnh da 2,7%.
Bang 7. Ti IS chuong bfnh npi tni phan l o ^ theo ICD-10 d tie em <16 tudi Ten chuong (Chuang)
Ho hap: X Nhiem triing: I Tieu hoa: XI Benh da: Xn Chan thuong: XIX Benh cua mit: VII Khac
T^ng
BVDKCM n 459 218 888 426 1461 334 665 4451
10,3
%
4,9 20,0 9,6 32,8 7,5 14,9 100
BVDKDD n 46515 15943 10287 4819 3339 3012 6305 90220
51,6
%
17,7 11,4 5,3 3,7 3,3 7,0 100
BVDKUM n 20493
1494 3491 1367 506 883 1272 29506
69,5
%
5,1 11,8 4,6 1,7 3,0 4,3 100
Tong N 67467 17655 14666 6612 5306 4229 8242 124177
54,3
%
14,2 11,8 5,3 4,3 3,4 6,6 100 O tie em < 16 tudi, benh hd hap, nhiem triing va tieu hda chiem ti If cao nhat ldn lugt la 54,3%, 14,2% va 11,8%. Tai BVDKCMchiSm ti le cao nhdt la chdn tiiuong 32,8%.
Bang 8. Ti If chuang bfnh ndi tni phan loai theo ICD-10 d ngudi >= 16 tudi Ten chucmg
(Chuang) Ho hap: X Tuan hoan: IX Tieu hoa: XI Co-Xuong-khop: XlU Than kinh: VI Npi tiet: rv Chan thuang: XDC Benh cua mat :Vn
BVDKCM n 12132 17273 12209 10046 1505 9947 7259 3884
12,2
%
17,4 12,3 10,1 1,5 10,0 7,3 3,9
BVDKDD n 62707 53524 45441 31327 41521 13721 10313 10139
20,0
%
17,1 14,5 10,0 13,2 4,4 3,3 3,2
BVDKUM n 33356 31972 15648 14675 243 6303 857 3104
27,9
%
26,8 13,1 12,3 0,2 5,3 0,7 2,6
Tong N 108195 102769 73298 56048 43269 29971 18429 17127
20,3
%
19,3 13,8 10,5 8,1 5,6 3,5 3,2 396
T«P CHi Y Dl/iyc HpC CAN THOr - S6 11-12/2018 I'en chuang
(Chuang) SB-I'let niSu: XFV Nhigm triing: I Khac
Tong
BVDK CM n 4231 5934 14726 99146
%
4,3 6,0 14,9 IOOBVDKDD n 8081 5401 31289 313464
%
2,6 1,7 10,0 100BVDKUM n 2333
1554 9394 119439
%
2,0 1,3 7,9 100Tong N 14645 12889 55409 532049
%
2,8 2.4 10,4 100 O nguai >= 16 tudi trd ISn, benh hd hap, tuan hoan va tiSu hda chiem ti If cao nhdt ldn lugt la 29,3%, 19,3% va 13,8%. KS tiSp la co xuong khdp chiSm 10,5% va tiidn kinh 8,1%.IV. BAN L U ^
Mudi chuang benh ngi tni cao nhdt: chdn thuang, ngd ddc 17,51%; he tudn hoan 12,78%; he tieu hda 12,13%; nhiem triing va ky sinh trimg 11,45%; benh hf hd hap 10,4%; bfnh hf sinh due tiSt nifu 7,15%; thai san va sinh de 6,24%, ung budu 4,21%; ndi tiet dinh duang va chuySn hda 3,64% va benh ca xuong khdp 2,6%. KSt qua nghiSn ciiu nay tuong tu Nien giam thdng ke nam 2014 cua Bd y tS [1]. Theo niSn giam thdng kS Bd y tS nam 2014, trong toan qudc ty IS thai san va sinh de (chuong XV) 13,2%; benh he tudn hoan 10,46%, bfnh hf hd hdp 17,27%, bfnh hf tiSu hda 9,7% Bfnh nhiSm tining 8,7% va chdn thuong ngd dgc 7,9% [1], [2]. Ciing theo niSn giam thdng kS 2014 Bd y td, tai dong bang sdng cftu long, ty IS cac chuong benh nay ldn lugt la 11,02% thai san sinh de; 18,4%
bfnh hf tudn hoan; 17,07% benh hf hd hdp; 12,9% benh he tieu hda. 10,7% bfnh nhiem trimg; va 7,5% chan thuoi^ ngd ddc [4]. Mdt sd tac gia khac ciing tim thay kSt qua tuong hrp],[3]. , ' ' , ,
Co su khac nhau ve ty le 10 chuong bpnh mac cao nhat giiia benh vien tinh va benh vi$n tuyen huyen. Ti le chuong b^nh nhilm trimg chiem ti !$ 21,5% tai BVDKDD va 16,1% tai BVDKUM. Chan thugng ngd d6c chiem ti le cao g bSnh nhan npi tni tai BVDKCM 24,8%. Tai BVDK UM thai san smh de chiSm ti le cao nhit, 27,2%. Benh nhiem trimg chi6m ti Ie cao g tre em va nguoi lon v6i ti 16 lan lugt 34,4% va 33,6%.
Co su khac nhau giiia mo hinh benh tat o tre em va nguoi lon. 0 tre em dimg hang thll hai la Benh h^ ho hip 17,7%, Chin thuong ngg dgc 16,8%, BSnh dugng tiSu h6a 10,8%. VJ ki dSn la benh ly thgi ky chu smh 10,0% T?ii BVDKCM chito ti le cao nhit la chin thugng 48,2%. Tai BVDKDD va BVDKUM, nhilm trimg chiim ti le cao nhat, 50,0% v4 38,1%. d ngugi lon. Chin thuang ngp dpc 17,7%, Benh tuin hoan 15,4%, BSnh tieu hoa 12,4%, benh he ho hip 8,9%, benh sinh due - tilt nieu 8,1%. Tai BVDKCM chiim ti le cao nhit la chin thuong 22,7%. Tai BVDKDD va BVDKUM chiim ti le cao nhat la thai san sinh ii (22,8% vi 41,7%) va tuin ho&i (18,0% va 21,4%).
V. KET LUAN
Muoi chuang benh ngi tni cao nhit: chan thuang, ngg dpc 17,51%; he tuan hoan 12,78%; he tieu hoa 12,13%; nhilm tning va ky sinh triing 11,45%; benh he h6 hip 10,4%; benh hp sinh due tilt nieu 7,15%; thai san va smh de 6,24%, img buou 4,21%; npi tilt dinh du&ng va chuyin hoa 3,64% yk benh co xuong khop 2,6%.
Muoi chuong benh ngoai tni hang diu tai cJc hinh vien nghien cuu: BSnh he ho hip 26,77%; hS tuin hoan 15,69%; he tieu hoa 13,4%; bSnh co xugng khi^p 8,64%; benh
TAP CHf Y Dirge HQC C&N THO - s 6 11-12/2018
he thdn kinh 6,67%; ndi tiSt dinh duong va chuySn hda 4,75%; nhiem trimg va ky sinh trimg 4,65%; chdn tiiuong 3,62% va benh ciia mdt 3,25%.
Md hinh bfnh tat t^i cac bfnh vien ve ca ban cho thay "ganh nang kep" vdi bfnh khdng lay chiSm uu thS va cdc benh nhilm trimg van cdn chiem mgt ty trpng lon.
TAI L l £ U THAM K H A O
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khoa Tinh Ca Mau 5 nam 2007-2011, Luan an chuyen khoa cdp II chuyen nganh quan ly y tS, Tnrdng Dai hpc Y Dupe Cdn Tha.
4. NguySn Thi Thanh Hai (2005), Nghien cuu md hinh bfnh t^t va hoat dpng kham chiia benh tai cac bfnh vien da khoa tmh viing Dong bdng sdng cuu long, Lu|in van thac sT y te cong cdng, Tnrdng Dgi hpc Y Hi Noi, 2005.
5. Tnrdng Dgi hpc Y tS cdng Cpng (2011), Gdnh ngng binh tdt vd chan thuang d Viet Nam, Nha xuat ban y hpc. Ha Npi
6. Vien dao tao Y hoc Du phong va Y te cdng cpng Tnrdng Dgi hpc Y Ha Npi (2011), Y hoc dir phdng vd Y te cdng cdng thuc trang vd dfnh hudng a Viit Nam, Nhd xudt bdn y hgc, Hd Ndi, 2011.
7. WHO (2015), Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, Lancet Journal, 2015 Vol 5; 386: 2287-2323.
(Ngdynhdnbdi: 11/11/2017-Ngdy duyet ddng: 02/01/2018)
KET QUA LAU DAI C U A LIEU P H A P GEN T R O N G DIEU T R | BENH D O N G M A C H CHI D U d l GIAI BOJ^ II T H E O FONTAINE
Chervyakov Y. vJ, Ha H.N^
1. Trucmg Dgi Hoc Yaroslavl, Bd Y Ti Lien Bang Nga.
2. Trudng Dgi Hge Huu Nghi Cdc Ddn Tdc Nga TOM T A T
Dot van di: Benh dgng mgch chi dudi ed ty li luu hdnh ngdy cdng tdng vd cd tien lugng xdu. Muc tieu nghiin cti-u: ddnh gid kit qud Idu ddi tir 3 den 5 ndm ciia lieu phdp gen VEGF- 165 ddi vdi cdc h$nh nhdn PAD giai dogn II theo Fontaine. Boi tugng nghiin cdru : 83 binh nhdn PAD giai dogn II theo Fontaine duac dieu tij bang li^u phdp gen tir ndm 2009-2015.
Phuong phdp nghiin cuu: hdi edu md td cdc trudng hap. B^nh nhdn dugc chia ldm 2 nhom:
nhom A-17 binh nhdn PAD IIA. nhdm B -66 b?nh nhdn PAD IIB.Kit qua: Nhdm A tdng khodng cdch di bd khdng dau each hdi 100%. Nhdm B tdng PFWD 94%. Cdc chi sd ciia tiiu chudn phif cung ed kit qud tdt.Kit lugn: Lieu phdp gen cd hi^u qud cao trin benh nhdn PAD a hai giai dogn Avd B theo Fontaine sau 3 din 5 ndm theo doi.
Tir khda: Binh dgng mgch chi dudi. liiu phdp gen, Neovasculgen.
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