TAP CHi NGHlfiN CO'U Y HQC
9. Kroon BK, Horenblas S, Nieweg OE. squamous cell carcinoma. Journal of surgical (2005). Contemporary management of penile oncology, 89, 43 - 50.
Summary
THE USE OF MOHS MICROGRAPHIC, RADICAL SURGERY FOR PENILE SQUAMOUS CELL CARCINOMA
The objective of this study was to assess the results of Mohs micrographie and radical surgery for penile squamous cell carcinomas Methods 55 penile squamous cell carcinoma patients whose tumors included 2(3 6%) Tis, 13(23.6%) T i , 31(56 4%) T;, 7(12 7%) Ta, 2(3 6%) T^ under- went the Mohs Micrographie, Radical Surgical procedure. Results There was no recurrent penile squamous cell carcinoma observed after months of postoperation Three patients died of visceral metastasis, another patient died of multiple organ failure 65 5% of patients unnated normally, 34.5% of patients had difficulty in urinating 25 5% of patients could make sexual intercourse as usual, 29 1 % of patients had some difficulty in performing sexual intercourse, 36-4% of patients expenenced completed impotent, 9 1 % of patients lost their sex dnve In conclusions, Mohs micrographie surgery is a good method in removing penile squamous cell carcinoma but preserved the function of the penis in a majority of patients .
Keywords: penile squamous cell carcinoma
R6I LOAN TAM THAN (y NHONG NGUOI SI> DUNG C H A T D A N G AMPHETAMINE DIEU TRj NQI TRU
TAI VIEN SLFC K H 6 E T A M T H A N
Trdn Thj Hdng T h u \ T r i n HO-u Binh^
'Bdnh vien Tam thdn Mai Hwang. ^Trwong Dai hoc Y Hd N91 Rdi loan tam than rat thudng gdp d nhung nguoi sw dung chdt dang amphetamine Nghien cuv nhdm mo td ddc diem Idm sdng cdc rdi loqn tdm thdn o nhung ngwdi sii' dqng chdt dang amphetamine didu tn n&
tm tai Vidn siK khoe Tdm thdn - bdnh viqn Bqch Mai Ket qud cho thay benh nhdn chu ydu Id nam gioi (91%). nhdm tudi sw dung phd bien Id 20 - 29 (70.5%) Tndu chung loan thdn chu yeu Id hoang ludng (68.2%,}. trong dd hoang twong bi hai 90%. hoang twdng bj theo doi 83.3%. Ao gidc bay gap nhdt Id do thanh • (56,8%,). ngodi ra con cd do thj (22,5%) va do xiic (5%) Tmh trang cdng thang do hoang twdng cd the din tdl kich dqng bao Iqc bao gdm ca khuynh hudng gidt ngudi vd tw sdt.
Tu khoa: rdi lo?n tam thAn, c h i t dgng amphetamine
I. DAT
V A N O £methamphetamine vd MDMA (ecstasy, thuoc Chat dang amphetamine (ATS) Id mdt ldc)[1]
nhdm chdt ma tuy tdng hop cd tde dung kich Loan than do s u dung ATS la hdu qua t*:
thich manh hd than kmh trung u o n g , Cde chat ddng trye tidp vd kdo ddi cua ATS len ndo phd bidn nhdt cua nhdm ndy Id amphetamine, Logn thdn xudt hidn khdng nhdng do ndng 36
^^S TCNCYH 82 (2)-2013
- TAP CHl NGHlfiN COU Y HpC ATS cao trong eo thd md ngay ea khi ngudi
bgnh dd ngdng sir dyng ATS [2], Logn than do su dung ATS cd the lien quan vdi edc hdnh VI bao luc, ddc bidt Id trong giai dogn bj nhidm ddc. Id ydu td d i n den tinh trang gia tdng lgi pham hinh s u , tdng nguy c o t u sdt hode t u gay Ihuong tich, tdng ly Id nhdp vi$n [3]
Hoang tudng vd ao thanh Id hai lri$u ehung phd bien nhdt eiia logn thdn do s u dyng ATS [4]
Tai vidn Sdc khde Tdm t h i n Bgch Mai cdc trudng hop rdi loan ldm than do s u dyng ATS ddn khdm vd didu In ngdy edng tdng. Ndm 2010 ehi cd 26/306 sd luot ngudi bdnh vdo didu In rdi logn tdm than do ma tiiy cd s u dung ATS (ehidm 8,5%); ndm 2011, ly Id ndy Id 59/348 (ehidm 17%) De ldm sdng td ddc diem lam sdng cde rdi loan ldm thdn do s u dung ATS, dd tdl "Ddc didm Idm sdng rdi logn tam thdn d nhung ngudi s d dung ATS didu tri noi tru tai vidn Sue khde tam thdn duae thue hidn vdi muc tieu:
1 Md la ddc didm tdm sdng rdi logn ldm thdn d nhung ngudi s u dung ATS didu tn ndi tru tai Vien sdc khoe Tdm than bdnh vien Bgch Mai
^ Nhdn xet kel qua dieu In nhung benh nhdn trdn
II. D 6 | TU'gNG VA PHU'aNG PHAP
I.Ddi tuang
Chitng tdl tien hdnh nghten c d u 44 bdnh nhdn duac chan dodn xdc dinh Id rdi loan tdm Ihdn lien quan s u dung cdc chat dang amphetamine theo ICD - 1 0 [5], didu tn ndi trii tgi vien Sue khde Tdm thdn, bdnh vidn Bach Oia Chilian he TrSn Thi Hong Thu, b§nh vi6n Tim thSn Mai Hwong
Email (lrthu91@yahoo com t^aynhan 06/01/2013 Ngay duuc chap thudn 26/4/2013
Mai t u thdng 8/2011 ddn thdng 8/2012 2. P h u a n g phap t
• Thidt ke nghidn edu: Nghidn cuu md ta edt ngang
- Tidu chuan lua chgn; Tat cd bdnh nhdn didu trj ndi tru tai vidn Sue khoe Tdm than Bgch Mai, d u o c chan dodn xdc dinh Id rdi loan ldm thdn hdn quan s u dyng cdc chat dang amphetamine theo ICD - 1 0 ,
- Tidu ehuan loai tru Bdnh nhdn s u dyng chdt ma tiiy (heroin, ATS) trong thdi gian didu tri Bdnh nhdn ed tdn Ihuong thue ton ndo, ed lidn s u mde bdnh ldm than trude khi sii- dung cdc chat dang amphetamine, dang mdc cdc bdnh CO thd ndng- tim mach, suy gan, suy thdn, tdm phd man, bdnh cdp tinh, n h i l m HIV/
AIDS, phu n d c o thai
3. Phuang phap thu thap thdng tin + Cbng cu nghien cuu Bdnh an nghien euu chuyen biet dung de nghidn cuu dac didm tndu chdng loan thdn Bd edu hdi ddnh cho benh nhdn va cho ngudi nhd bdnh nhdn Thang ddnh gid rdi loan tdm thdn BPRS ciia Overall J E , Gorham D R vd cdng s u (1962, 1988) Tidu chuan chan dodn rdi loan tdm thdn do su dung chdt kich thieh theo ICD - 1 0 [5] Tidu ehuan ehan dodn hdi chung cai chdt kieh thich theo ICD - 1 0 .
+ Ky thudt thu thdp thdng tin Phong vdn benh nhdn vd ngudi nhd benh nhdn Khdm ldm sdng, xel nghidm co ban Lam trdc nghidm ddnh gia tidn tndn ede rdi logn tdm thdn Iheo thang BPRS, ddng thdi ddnh gid hieu qua didu tri theo mdc dd thuyen giam tndu Chung Idm sdng theo thang CGI
- Cdc ehi sd, bien sd nghidn cuu Cac ehi sd ddc Idp (tudi, nghd nghidp, hoc vdn. ). Thdi gian sir dung ATS, dia diem s d dung ATS Chi sd vd ede tneu ehung rdi loan tdm Ihdn do
TCNCYH 82 (2)-2013 119
TAP CHi NGHIEN CO'U Y HQC • ATS Chi sd ve tri$u chdng hoang t u d n g , do gide theo lung ngdy didu In
- Xu ly sd lidu phuong phdp thdng kd y hgc, ung dyng phdn mdm SPSS 16 0.
4. Oao d u e nghien c u u
Dd tdl nghidn ciru theo phuong phdp md ta M O I chi dmh trong cdc lidu phdp didu tri hodn todn do cdc bde sT quydt dinh theo tinh trang bdnh nhdn,
Ddi tugng nghidn c u u vd ngudi nhd dd duoe thdng bdo vd mue dieh cua nghidn edu, l u nguyen tham gia vd khdng d u o c s u dyng bat c u dieh vu bat hop phdp ndo trong qud Irlnh nghien euu (heroin, chat gay nghidn khde) III. KtT Q U A
Nghidn c d u 44 bdnh nhdn s u dung ATS didu tri nOi tru tai vidn S u e khde Tdm Ih^n:
Tudi trung binh cua nhdm nghidn cdu 25,7 + 5,3, Ty 1$ nam (84%) gdp nhidu hon nQ- (16%), s u khde bidt cd y nghTa thdng ke So bdnh nhdn giam dan theo vdi Ida tudi. Hpc vdn trung hgc c o s d vd phd thdng trung hpc ehidm ehu ydu (25%, 64,6%) Thdi gian si>
dyng ATS trung binh 2,2 ± 0,3 ndm, it nhat 4 Ihdng, ddi nhdt 7 ndm, Tinh trang s u dung ti>
hai loai ma tiiy t r d ldn ciing mdt ldn hodc cdc Idn khdc nhau l u o n g ddi phd bien 38,6% s^
dyng vdi ruou, 20,5% s u dung vdi heroin, 15,9% eung vdi cdn sa, 13,6% vdi ketamin Da sd Id benh nhdn nhdp vi$n lan ddu 40/44 (91%)
2. Dac d i d m lam s a n g . Oac didm c h u n g cua n g h i e n c u u 2.1. Dac diem roi loan tam than
B a n g 1 . R d i l o a n h o a t d d n g
R6i loan hoat d o n g n
%
ROI loan hoat (Jong y chi - Khong - Giam hoat dong ' Tang hoat dong - Kich dong
1 10 11 22
2,3 22,7 25,0 50,0 ROI loan hoat dong ban nang
- Chan an - Kho ngu - Mat ngu
- Giam ham mu6n tinh due -T§ng ham mu6n
43 15 29 25 1
97 34.1 65,9 56,8 2,3
Bang 1 cho t h j y , ngu-CTi benh co tinh trang kich dong (60%), tang hoat dong (25%), Trong cic r6i loan hoat dong ban nang, chan Sn chiem ty le cao (97%), mat ngu (65,9%), tang ham muJn tinh due 2,3%
TCNCYH 82 (2) - 2013
• TAP CHl NGHIEN CLFU Y HQC
54,5%
13,2% 36.4%
I 29,
43%
43%
0
Aogiac
I i I I • 11,4% • 11,3%B *fi°'°
l i i i i l ^ ^
Hoang Liri noi Thai do Kich dong Hung tucrng bl khong thu dich cam theo ddi thich hop
• Nhe, rat nhe Trung binh
• Nang, ret nang
Bidu dd 1 . Cac trieu chu'ng d u a n g tinh theo thang BPRS
Bieu dd 1 cho thdy cde tndu ehung duong tinh d bdnh nhdn nghidn euu bidu hidn ram rd, cap tinh Cdc tridu chung ldi ndi khdng Ihich hop chidm ly Id cao (54,5%), do gidc mdc do trung binh (25%), do gidc mdc do ndng (47,8%), hoang ludng bi theo ddi 43,2% d muc do trung binh vd 36,4% muc dd ndng Tinh Irang kich ddng di kem vdi hoang tudng ao gidc lam cho benh canh lam sang cdng them phue tap, dd lien quan ddn vdn dd an ninh xa hoi [6]
• Nhe, rat nhe Trung bmh
• Nang rat nang
Thu rut cam xuc Cham chap tam t h i n vgn dpng
Bidu dd 2. Cac trieu c h u n g am tinh theo thang BPRS
Trdl nguae vdi mue dd ndng eua trieu ehung duong linh, bidu dd 2 eho thay phdn Idn cdc tndu Chung dm tinh d muc do t d nhe, rat nhe (29,5 — 34,2%) ddn trung binh (18,7% - 25%), chi CO 2,3% eb ehdm chap tdm thdn vdn ddng vd ludi vd smh cd nhdn mde dd ndng
TCNCYH 82 (2) - 2013
TAP CHl NGHIEN CU'U Y HpC 2.2. Dac diim h0i chifng cai A TS
Trl^u Chiang cai ATS 95,5%
c mDng TrSm cOm
Bieu dd 3. C4c trieu chipng cai ATS theo DSM - IV
Bieu do 3 cho thay tri^u chu'ng cai cOng gSp h^u het a cSc bSnh nhSn nh6m nghiSfi cii'u, ph6 bien li cau gat (77,7%), mSt moi (79,6%), mk ngu (95,6%) Dac bi^t c6 ty le cac bieu hi#n tram cam kha cao (61,4%)
Bang 3. Tiln triSn cac hoi chu'ng tam thin chti y6u trong qud trinh di^u trj
va mipc d o
Khi vao vien
n,
%
K h i v a o vien
n i
%
P
HOI Chung tram cam -Nhe - V u a -Nang HOI Chung )<ich thich
- N h e - V u a - Nang
suy nhtroc 4 6 6
16 21 5
9,1 11,4 13,6
36,4 47,7 11,4
0 7 0
19 1 0
15,9
43,2 2,3
Hoi Chung paranoid - N h e -vera -Nang
3 15 9
6,8 34,1 20,6
5 2 1
11,4 4,5 2,3 Hoi chi>ng cai
- N h e -VCfa - Nang
11 24 3
25,0 54,5 6,8
6 2,4,5
0
13,6
TCNCYH 82 (2) - 20«
—
• TAP CHi NGHIEN CCFU Y H p C Bang 3 eho thdy hdi chdng eai ATS Suae cai thidn rd rdt d thdi didm sau khi ra vidn so vdi khi vdo vidn, khdc nhau cd y nghia thdng kd vdi p < 0,05,
Bang 4. Tidn tridn cdc trieu c h u n g loan thdn chu ydu trong qud trinh didu trj
Tri§u
Hoang tu'ong Ao giac Kich dOng
Chiang
Khi n 30 32 22
vao vi^n
%
68,2 72,7 50,0
Khi n 8 . 9 2
ra vi^n
%
26,7 28,1 7,2
0,05 0,01 0,01 Kdt qua bang 4 eho thdy, hdu hel ede tridu ehdng loan than thuydn giam vd mat di trong vdng 1 tuan dieu tn d 2 thdi diem khde nhau, ed y nghia thdng kd (p < 0,05)
IV. BAN LUAN
Oac didm chung cua ddi t u a n g nghien cuu: Tudi trung binh cua nhdm nghidn cdu 25,7 + 5,3, day Id dd tudi lao ddng, chinh vi vdy hdu qua vd xa hdi rdt Idn Kdt qua nghien cuu eua chung tdi tuong ddng vdi kdl qua cua nghien cdu khae trdn thd gidi Id 27,11 ± 7,62 [6], Trinh Tdt Thdng (2012) lim thdy tudi trung binh 26,77± 5,81 Ty Id benh nhdn n u s u dung ATS Id 16%, tuong ddi nhidu so vdi cae chdt gdy nghidn khde nhu ruau, opiats Theo Trinh tdt Thdng ed tdi 22,8% Id ni>, Nguydn Manh Hiing Id 21,74%
Da sd nhung ngudi s u dung ATS ed hoc van thdp, t u edp 111 trd xudng vd khdng ed nghd hoac nghd l u do (63,6%) Chi 1 ddi tu'ong cd trinh do dai hoe vd dang Id cdng chuc nhd n u d c (2,3%). Nhidu benh nhdn trong nhdm nghidn cdu dd bd hpe khi dang hpc trung hoc phd thdng
Thdi gian s u dung ATS Ihudng gdp nhdt Id 1 - 3 ndm (54,5%), trdn 3 ndm (20,4%) Tuy nhidn, cd tdi 25% s u dung d u d i 1 ndm, ddy Id diem khac bidt vdi mdt sd nghien edu nude
ngodi Kdt qua nay ed thd do ATS mdi phd bien tai Vidl Nam Irong vdi nam gan ddy [3], mdt khdc trinh do hidu bidt vd ATS cua Idp Ire Viet Nam edn han chd (cho rdng ATS khdng gdy nghien) ddn tdi s u dung tan sudt cao, hdu cao. Tan sudl s u dung hang ngdy trong nghien edu cua chung tbi chiem da sd (56,8%), s u dung hang tudn 38,6% vd hang thdng Id 4,5% Theo Christian vd CS (2007) nghidn cdu tren ngudi nghien ATS tai My tan sudt s u dung ATS hien tai eao hon vd hen quan chdt che vdi loan thdn [7],
ATS thudng s u dung qua dudng udng, hill, hit hay tiem chich Tuy nhien, tai Vidt Nam, hinh thue s d dung phd bidn nhdt Id dudng hut hode nudt. Tdm quan trong cua edeh Ihuc s u dung khdng chi do sinh kha dung cua thude {ndng do ATS trong mdu), md edn do anh hudng eua ATS vdi hoat ddng eua ndo (Chesher 1993) Md hinh "ehai cho da - binge use" hodc "ehay ldc do - speed run" (tdn suat eao, hdu eao) Id md hinh s u dung ATS nguy hidm nhat Mdt cudc "ehay tde dd" vdi ATS ed the kdo ddi sudt ca ngdy hode hang ludn S u dung ATS ldp lai theo cdch ndy ddn den ndng do ATS qud cao trang ea the, ldm
TCNCYH 82 (2)-2013
TAP CHl NGHIEN CLKU Y H p C •
ldng nguy eo cdc hi$u dng ddc hgi vd logn than (Chesher 1993)
Ddc didm logn thdn' Da sd bdnh nhdn vdo vidn trong llnh trgng nhu mdt cdp c d u tdm thdn trong trgng thdi logn thdn rd rdt hodc trdm cam ed y ludng vd hdnh vi I d sdt Ngudi bdnh nhdp vidn vl ly do kfeh ddng gdp nhidu nhdt (22%), Ddc bidt trong giai dogn b| nhidm ddc, s u dung ATS rat d l lidn quan vdi cdc hdnh vi bgo Iyc Chinh vl vdy, logn thdn do s u dyng ATS cd thd Id ydu td dan den llnh trang gia tdng tOi phgm hinh s d [7]
Ket qua nghien edu eua ehung tdi cho thdy loan than do s u dung ATS ehu ydu Id hoang tudng ehidm ty Id 68,2 %, ao gidc 72,7% , Ao gide hay gdp nhat Id do thanh (56,8%), ngodi ra edn eb do th; (22,5%) vd ao xuc (5%) Kdl qua ndy phii hop vdi Ly Tran Tinh (2012) hoang ludng bj hai 63,63%, hoang tudng bi theo ddi 42,42%, ao gidc hay gdp nhat Id' ao thi 72,73%, do thanh 39,39% Theo Trinh Tat Thdng, 80,6% cdc Irudng hop cd hoang tudng Kdl qua nay khdng l u o n g ddng vdi kdl qua ctJa M Snsurapanonl va edng s u (2003, n = 168) vdi hoang tudng bi theo ddi 44,6%, ao thanh 22,8% cd le la do nghien cdu cua M Snsurapanonl dd danh gid tndu ehung sau nhidu ngay didu tn Tuy nhidn, kdl qua nghien cdu cua chiing tdi phii hop vdi da sd tdc gia khdc, theo Santo (1992) ed it nhat 75% bdnh nhan cd hoang tudng vd/hodc do gide do s u dung ATS Mdt sd nghien edu eho rdng dde diem ehinh eua loan thdn do s u dyng ATS Id hoang tudng bi hai, hoang tudng lidn hd, ao thanh vd ao Ihi (Ellinvi/ood, 1967) Loan than ATS rdt gidng vdi tdm than phdn hdt paranoid (Davis Schlemmer, 198b, Baker vd Davi/e, 2005)
Phdn ldn bdnh nhdn cd cde tridu ehdng loan than giam dan trong vdi ngdy Bang 4 eho thdy, cae trieu chdng thuyen giam nhanh irong tudn ddu didu tri, chi ed ty Id nhd cde trudng
hop hoang t u d n g vd do gidc thuydn giam khdng hodn todn (7,2%), Tuy nhidn mdt s6 nghidn c d u dd xdc dmh thdi gian hdi phyc Idu hon Iwanami (1994) nhdn xdt rdng edc roi logn ldm thdn mdt di Irong vdng mdi tuan (39%), 1 ddn 2 tudn (16%), 6% t u 2 tudn den mdt thdng vd 10% logn thdn t u 1 ddn 3 thdng, Khoang 1/4 sd n g u d i s u dung methamphetamine lai bdnh vidn ldm thdn d Ddi Loan vdn cdn bieu hidn loan than ldi hon mdt thdng sau khi ngung thude vd gan 13% bj logn thdn tdi hon 6 thdng (Chen, Lin Sham, 2003) Kdt qua cua ehiing ldi phii hop vdi cac nghidn c u u ' trdm cam ehidm 51 - 92%, lo du 60 - 76%, ao gidc 28 - 67%, hoang tudng 33 • 78%, khi sde khdng dn dmh 44 - 80%, bao lire 17 - 72%, kieh ddng hoang s o 9 - 35%, y tudng t y sdt 13 - 4 7 % (Kaamienieeki vd CS, 1998).
Bidu hidn ldm sang cdc tndu chung dm linh d u o e ddnh gid theo Ihang BPRS trong nghien c d u cua chung tdi eho thay, triSu chung dm tinh ehiu anh h u d n g eua linh trang bdnh cap tinh v d i ty Id rat thap, 2,3% d mi>c dd ndng vd l u d i vd sinh cd nhdn vd chdm chap vdn ddng, 2 5 % cam xue cun mdn va thu rut cam xuc m d c dd trung binh Tridu chirng dm llnh Irong nhdm nghidn euu ehidm ty le eao nhdt Id l u d i vd smh cd nhdn (34%) vdi mdc dd nhe vd rdt nhe
Meic dil ede tndu chdng am linh ktifing ndng ne n h u ede tndu ehung duong linh, nhung s u ed m^t cua cdc tridu chdng dm tinti chidm ly Id ddng kd trong sd 20% b§nh nhSn nghidn c d u (M, Snsurapanonl vd cdng su, 2003)
Ddc didm hdt chdng cai hdi chung cai ATS chu yeu la edc tneu chdng tdm thdn vdi cam gidc mdt mdi tdt do vd khd ehiu. Nghifen cdu eua chung ldi nhdn thay khi sdc tram budn (61,4), mdt moi, cam gidc kiet sCrc
TCNCYH 82 (2)'2013
• TAP CHi NGHIEN CU'U Y H p C (79,5%), mdt ngu (95,5%), ngu nhidu (4,5%),
bdn chdn, but rut khd chiu (77,3%), tdng cam gidc thdm dn (2,3%), nhdng giac m a ddng so vd sdng ddng (dc mdng) (34%) Ngodi ra ngudl bdnh edn ed cam gide bi theo ddi, hode cam xuc gidn d u Nghidn euu eua ehung tdi phu hop vdl cdc nghidn euu khde, theo Jenner & Saunders (2004), trieu ehdng eai ed thd gidng vdi trieu ehung nhiem dpc cap tinh, ddc biet Id kich ddng mgnh Theo Jenner Saunders (2004), thdi gian vd mde dd ndng cua hdi Chung eai ATS didn hlnh vdn edn chua rd rdng. Nghidn edu eua McGregor vd cdng su (2005) eho thay, phan ldn ede trieu ehdng cai thuyen giam vd het trong vdng mdt tudn sau dieu In, vdi s u eai thien eua giae ngO va su ngon mieng sau 1 den 2 luan
Nhdn xdt kdl qua didu In trong nghidn cuu cua ehiing tdi, an than kinh cd didn Halopendol d u a c s u dung nhidu nhdt (65,8%) dang tiem, vdi lidu giam dan trong ede ngdy tidp theo, khi tinh trang loan thdn cdp da hdt, chuyen diing ede thude an thdn kinh mdi Id Rispendone (38,5%), Olanzapine (38,5%) vd Seroquel (23%). Thudc Benzodiazepin chi cdn su dung trong mdt thdi gian ngdn Thdi gian didu In tmng binh d nhdm bdnh nhdn nghidn ciru Id 7,3 ± 2,5 ngdy Kdt qua nghien cuu eua chiing tdi thdp hon so vdi mdt sd tdc gia, theo Bill Quang Huy (2011) qud trinh didu tn cdn keo ddi trong 4 tudn, theo Ly Trdn Tinh Id 25,5
± 15,5 ngdy Didu ndy hen quan den s u phu thugc mdt phdn vdo quy dinh cua mdi co s d vd bdnh vien khac nhau
V. K^T LUAN
Tidn hdnh nghidn euu 44 bdnh nhdn ed rdi loan tdm thdn do s u dung ATS didu tri tai vien Sue khoe Tdm thdn, ehung tdi riit ra mdt sd kdt ludn-
Bdnh nhdn chu ydu Id nam gidi (91%), nhdm ludi hay g$p nhdt t u 20 29 tudi (70,5%) Ldm sdng do gide hay gdp nhdt Id ao thanh (56,8%), do Ihi (22,5%) vd do xuc (5%) Hoang tudng xuat hidn d 68,2%, trong dd hay gdp nhat Id hoang tudng bi hai (90%), hoang tudng b| theo ddi (83,3%),
Didu tri ede tridu ehdng loan than bdng an thdn kinh (92,2%), chu ydu Id Halopendol (65,8%)- Phdn Idn ede tndu chung loan than thuydn giam vd mdt hdn sau khi nhung anh hudng cdp tinh eua ATS giam xudng, Ihudng Id trong mdt vdi ngdy
Lo'i cam o>n
Nhdm tdc gia xin chdn thanh cam on vien Sue khde Tdm Ihdn Qudc gia da lao didu kien giup d d chiing tdi thye hien dd tdi nay
TAI LIEU THAM KHAO 1. Kathleen M. Grant, Tricia D. LeVan, Sandra M (2012). Methamphetamine- Associated Psychosis: J Neuroimmune PharmaeoL 7, 1 1 3 - 1 3 9 .
2. Sato, M., Chen, C C , Akiyama, K. &
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TAP CHi NGHIEN CU'U Y HQC —
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Summary
CLINICAL FEATURES OF PSYCHIATRIC SYMPTOMS AMONG AMPHETAMINE INDUCED PSYCHOSIS IN-PATIENTS AT NATIONAL
MENTAL HEALTH INSTITUTE
Mental disorders are common among amphetamme-type-stimulanl (ATS) users The objective of this study was to describe the psyehiatnc disorders among ATS users admitted to National Institute of Mental Health Methods 44 ATS-mduced mental disorders patients were admitted lo the MIMH for evaluation dunng August 2011 and August 2012. A cross sectional-sludy was applied Results Among the patients were 9 1 % are man and 9% are women with age ranging from 19 lo 20 years old Delusion is a common psychotic episodes observed Among these patients (68 2%), experience of delusion of persecutory was up to 90%, and suspicious delusion was raised to 83 3% The other commonly seen hallucination symptom among these patients was auditory hallucination (56 8%), visual delusion (22 5%) and touch delusion (5%) The slress state caused by these delusionary episodes often lead lo violent behavior problems, including both homicide and suicide tendency.
Keyword: Mental disorders, amphetamine-type-stimulant
TCNCYH 82 (2)-2013 ^
