Tgp chl Tai MQi Hpng Vigt Nam - Volume (57-12). N°6- Dec., 2012
TH^TC TRi^NG BfNH TAI MUI HQNG CUA HQC SINH TRUdNG TifeU HQC CAM GIA T H A N H P H 6 THAI NGUYEN
Trin Duy Ninh vd CS.
T6M TAT
DC' gdp phdn bd sung nhiing s6 liiu cgp nhdt vi dich ti hgc binh tai mUi hgng trong cgng ddng. di tdi dd tien hdnh tham khdm n^i soi cho toan bg 325 hgc sinh tru&ng tiiu hgc Cam Ciui thdnh phS Thdi Nguyin. Ket qud cho thdy: ty li mdc binh ly tai mUi hgng cua hgc sinh a ddy khd cao (63,7%). Dimg hdng ddu la cdc binh ly a hgng (60,3%). sau do den cdc binh ly & tai giita (12,9%) vd mdi xoang (12.0%). Trong cdc binh ly & tai giiia, dung ddu Id binh viim tai giUa tict dfch (8.0%), viem tai giira cQ c6 thiing, s^o, xa nht (2.5%) Cdc binh ly & hgng chu yeu ^dp viem V A (57,7%) vd viim amidan (35,4%). Kit qud nghien ciru cdng cho thdy co moi liin quan rd rit giita viim V.A. viem amidan v&i viem tai giita (p<0.001). Phuang phdp khdm tai mHi hgng bdng ngi soi cho thdy ty li mdc cdc binh & tai giUa. binh V.A deu cao han so v&i nhirng kit qud nghien ctiu tru&c day v&i phucmg phdp khdm tai mui hgng thdng thu&ng. Vi vdy phucmg phdp khdm tai mdi hgng bdng noi soi cdn dugc dp dung rgng rdi trong cgng dong.
ABSTRACT
For updates of current epidemiological data on community ear nose throat (ENT) diseases, M-e conducted endoscopic examination on 325 school children ofthe Cam Gia Primary School in Thai Nguyen city. We found a high incidence of ENT diseases (63.7%), mainly throat diseases (60.3%) followed by middle ear diseases (12.9%) and sino-nasal diseases (12.0%). In terms of middle ear diseases, otitis media with effitsion was seen with the highest incidence (8.0%) followed by chronic otitis media with tympanic membrane perforation, tympanic scar, and tympanosclerosis (2.5%). Adenoiditis and tonsillitis accounted for (57.7%) and (35.4%), respectively. We also found a significant correlation between adenoiditis and tonsillitis and otitis media (p<0.001). This study showed that endoscopic examination provided better view and more accurate diagnosis of ENT diseases. Therefore, this method should be used more widely in community-based studies.
1. DAT V A N Bt. '^^"^ 'y ^^ TMH [3]. Tre em mpt sd ddn t^c
^ , . - , ,. X . . . . ,-T^»„,^ miln nui pbia Bdc Vipt Nam tir 7- 15 tudi Cac bpnh ly ve tai mm hpng (TMH)
,. ^-. , . - \ * I. . . - cdtyl^ mdc bpnh TMH tir 47,18-77,78%
la nhung bpnh rat thuong gdp trong cpng ddng, ddc bipt d trd em. Theo ket qud nghien cuu eiia Tran Duy Ninh vd cpng sy tir ndm 1993 din ndm 1998 cd 48,49% tre em Ilia tudi nhd tr6 - mau giao mdc cdc
* Dai hQC Y Thdi Nguyfin Nhan Mi 15/10. Duy^t in 25/10/2012
[4]. M$c dii bpnh TMH it gdy tir vong nhung thudng dnh hudng tdi su phdt hiln ve tinh thdn, thi chdt ciia tre vd cd the de Igi nhihig di chiing, bien chung nang ne.
Tgp chl Tai MOi Hpng Vigt Nam - Volume (57-12). N°6 - Dec, 2012
Lira tuoi hpc sinh chiem m^t ty Ip tir tren 1/4 tdi gdn 1/3 trong co c^u dan so.
Liia tudi nay chinh Id tuong lai cua mpt dan tpc, mpt qudc gia sau ndy. Trong dieu kipn xa hpi dang phdt trien nhu hipn nay, quyen Ipi hpc tap ciia cdc em thudng dupe cdc bgc phu huynh dat I6n vj tri im tien hdng dau, viec khdm chita benh cho tre thudng chua duoc quan tam mpt cdch diing miic.
Trong nhimg ndm qua da cd mpt so dieu tra ve dich te hpc benh TMH tgi cpng ddng, trong dd cd ddi tucmg hpc sinh. Tuy nhien cdc kit qud cd dupfc chua mang tinh chdt he thdng vd cap nhgt. Mdt khde trong cdc nghien cuu nay chu yeu su dung cdc dung cu thdm khdm TMH thdng thudng do do vipc phdt hipn benh vd chdn dodn cd the cdn gap nhtmg khd khan. Cho din nay viec dp dung npi soi trong tham khdm benh TMH tgi cpng ddng cdn rat han che.
Vi vdy trong khudn khd cua de tdi nay da dp dyng tham khdm ndi soi cho 100%
ddi tuong nghien ciiu nhdm dgt dupe cdc muc tieu sau:
- Xac diab dugv tb^ trang bfnh tai mui bgog ciia bgc sinb tni&ng tiiu bgc Cam Gia tbanbpbo TbaiNguyin namlOlZ.
- Tim hiiu moi lien quan giOa cdc binh ly trong tai mUi hgng,
2. D 6 I TU'gfNG VA PHlTONG P H A P NGHIEN c t r u
2.1. Thiet kl nghien cuu
Nghien ciiu djch te hpc md td cdt ngang cd phan tich.
2.2. Doi tirgmg, dja diem va thdi gian nghien ciru
- Doi tupng nghien cihi: todn bp hpc sinh trudng tilu hpc Cam Gid thdnh phd Thdi Nguyen.
- Dia dilm nghien ciiu: trudng tieu hpc Cam Gia thanh phi Thdi Nguydn.
Thdi gian nghien cuu: 9/2012 11/2012.
2.3. Cor mSu nghien cihi
So mau nghien ciiu dupe dua tren ket qua ciia nhimg nghien ciiu trudc va dupe tinh theo cdng thiic:
n^
. zf-a/2^P(l-P) Trong do:n: S5 lupng hoc sinh t6i thi6u can nghien cuu.
ZiK^: Gia tri diSm Z tai mile y nghia o, vcria = 0,05^Zi.„n=l,96.
d: Dp sai lech mong muon giua ty le thu dupe tit mau va ty le thue cua quin the, chpn d = 0,05.
p: Ty le hpc sinh mic benh TMH udc lupng theo nghien ctiu cua Trin Duy Nmh til nam 1993 -1998 la 70% (p = 0,7) [4].
Voi cac thong s6 da dupe xac dinh, CO mau t6i thi^u tiong nghien cuu la 323 doi tupng.
Tai truong tiSu hpc Cam Gii c6 325 hpe smh (xip xi ca mlu nghien cira toi thiSu), d^ tai da tiSn hanh nghien cira tren toan bp s6 hpc sinh nay.
61
Tgp chl Tai Mui Hpng Vi^t Nam - Volume (57-12). N^S - Dec., 2012 2.4. Ky thuat chpn mSu nghien cihi
Chpn mau cd chu dfch, chpn todn b0 hpc sinh dang theo hpc tgi trudng tilu hpc Cam Gid thdnh phi Thdi Nguydn.
2.5. Npi dung nghien cihi Dieu Ira dich te hpc bpnh TMH.
Tim hilu mli licn quan giiJa cdc bpnh ly Irong TMH.
2.6. (dc chi sl nghien cihi
Cue chi so ve ddc diem chung cua doi tupng nghien cim: dp luoi, khoi Idp, gidi tinh, dan tpc, nghe nghipp ciia bo mp.
Cdc chi sd md ta thyc trgng bpnh TMH.
Cdc chi sd md Id moi lien quan gii^a cdc bpnh TMH.
2.7. Phucmg phdp thu thap va ddnh gid thong tin
Phdng van true tiep hpc sinh nhimg thdng tin lien quan den cac trieu chiing d TMH trong 01 nam trd lgi ddy vd tai thdi diem nghien cihi. Cdc ket qua phdng van dupe ghi tren phieu phdng van da thiet ke sdn.
Thdm khdm Idm sang bdng phucmg phdp npi soi nhdm phdt hipn bpnh ly TMH.
Ddi vdi cac trudng hprp nghi ed bpnh ly d tai dupe do thinh luc vd do nhT lupmg. Cdc ket qua tham khdm dupe ghi tren phieu khdm dd thiet ke sdn.
Chdn dodn vd phdn logi benh theo tieu chuan phdn loai bpnh Quoc te.
Can cii vao kich thudc ciia V.A, amidan vd chia ra cdc mirc dp nhu sau:
V.A dd thodi triln: khdng cdn V.A ho$c chi cdn d^u vlt V.A trfin ndc vdm.
V.A do 1: khli V.A nhd, gpn map m6 cira mfli sau, khdng vuprt qud 1/4 sau trfin cira mui sau.
V.A d$ 2: khoi V.A khd to, che lap 1/2 cira mOi sau.
V.A dp 3: khoi V.A qud phdt to, che ldp 3/4 cira miii sau.
V.A dO 4: khoi V.A qud phdt rat to, che kin hodn todn ciia mui sau.
Amidan dd thodi triln: khdng cdn amidan hodc ehi cdn rat nhd tiong hoc amidan.
Amidan dp 1: khoi amidan nhd, gpn, khdng vupt qud 1/4 khodng cdch tir try trudc amidan tdi dudng trung vi.
Amidan dp 2: khdi amidan khd to nhung khdng vu<?t qud 1 /2 khodng cdch tu try trudc amidan tdi dudng trung vj.
Amidan dp 3: khdi amidan to nhung khdng vuprt qud 3/4 khodng cdch tir try trudc amidan tdi dudng trung vj.
Amidan dp 4: khoi amidan qua phdt to, tien sdt tdi dudng trung vj, hai amidan che kin eo hpng.
2.8. Phinmg phdp phan tich va xir ly so lipu So lipu duprc nhgp, kilm sodt hen chuong trinh Epidata vd xd ly tren chuong trinh SPSS 13.0.
Su dyng test x^ <ie so sdnh 2 ty 1? %.
Tgp chl Tai MOI Hpng Vi^t Nam - Volume (57-12). N°6 - Dec, 2012 3. KET QUA NGHIEN CVV
Phan tich kSt qua tren t6ng s6 325 hpc sinh tit lop 1 dSn lop 5 (trong d6 c6 171 nam va 154 nu), dS tai da thu dupe nhOng ket qua nhu sau:
Bang 1. Ty 1^ mSc b$nh tai mui hgng x6p theo khoi l&p
Bdng 3. Ty 1$ mSc b$nh tai mQi hpng x^p theo dan tflc
Kh6i ldp 1 2 3 4 5 Tong
so Khflng
b^nh SL 23 27 17 32 19 118
%
33.3 44,3 27.0 42,7 33,3 36,3
C6 b$nh SL 46 34 46 43 38 207
%
66,7 55,7 73,0 57,3 66,7 63,7
T6ng s6 SL 69 61 63 75 57 325
%
100,0 100,0 100,0 100,0 100,0 100,0
Nhdn xet: Trong mdu nghien cim cd so lupng hpc sinh tuong ddi ddng deu giiia cac khdi ldp. Ty le mac benh TMH ciia hpc sinh tilu hpc hi 55,7% - 73,0%, trung binh Id 63,7%, khdng cd su khac biet giGa cdc khdi Idp (p>0,05).
Bang 2. Ty Ip mic benh tai mui hpng xep theo gidi tinh
Gidl tinh Nam NO T6ng
s6 Khflng
benh SL 60 58 118
%
35,1 37,7 36,3
Cfl bSnh SL 111 96 207
64,9
%
62,3 63,7
T6ng so SL 171 154 325
100,0
%
100,0 100,0
Nhdn xet: S6 luong hpc sinh nam va nii la tuong duong va ty le mac benh TMH khong CO su khac biet giua hai gicji {P>0,05).
Dan tflc
Kinh r a y NCjng Khac
T6ng s6 Khflng
b$nh SL 98 5 6 9 118
%
35,5 62,5 66,7 28,1 36,3
Cfl b^nh SL 178 3 3 23 207
%
64,5 37,5 33,3 71,9 63,7
Tfing s6 SL 276 8 9 32 325
%
100,0 100,0 100,0 100,0 100,0
Nhgn xet: Trong mau dieu tra, hpc sinh thudc dan tdc kinh Id chii yeu (64,5%), ngodi ra cdn cd hpc sinh thupc dan tdc Tay, Nung va mdt sd dan tdc khac. Ket qud so sanh chua thay su khac biet ve ty le mac benh TMH gQa cdc dan tpc nay (p>0,05).
Bang 4. Ty 16 m^c b$nh tai mOi hong x6p theo ngh^ nghiep ciia bo me Nghe
bo me c a n bfl, nhan Vi6n Cflng nhan Nflng dan c a c nghe khac
Tong so Khong
benh SL
2 39 57 20 118
%
40,0 37,9 33,3 43,5 36,3
Cfl bSnh SL
3 64 114 26 207
%
60,0 62,1 66,7 56,5 63,7
Tong so SL
5 103 171 46 325
%
100,0 100,0 100,0 100,0 100,0
Nhdn xet: Trong mdu dieu ha, hpc sinh thupc con em cdng nhan vd ndng dan la chii yeu, ngodi ra cdn cd con em can bp va mpt sd lam nghi khac. So sdnh ty le mac benh TMH khdng thdy su khdc biet giita cac ddi tugng nay (p>0,05).
63
T^p chl Tai MOI Hgng Vi^t Nam -Volume (57-12), N°6- Dec, 2012 BSng 5. Co ciu b^nh lal mOi hgng
Co quan Tai giOa Mui xoang Hgng
T6ng sA Khflng
b$nh SL 283 286 129 118
%
67,1 88,0 39,7 36,3
Cfl bSnh SL 42 39 196 207
%
12,9 12,0 60,3 63,7
T6ng s6 SL 325 325 325 325
%
100,0 100,0 100,0 100,0 Nhgn xet: Trong cdc bpnh iy d TMH nhdm bpnh vc hpng chilm ly Ip cao nh^t (60,3%).
sau dd Id cdc bpnh ly d lai giOa (12.9%) vd miii xoang (12,0%).
Bdng 6 Cdc b$nh ly d lai giOa cac b$nh tai
Tac vfli nhT ViSm tai giOa ti^t djch Viflm tai giOa cQ cfl thung, seo, xa nhT
Tong s6
SL 8 26 8 42
2,4
%
8,0 2,5 12,9 Nhdn xet: Trong cdc benh ly ciia tai giiia, diing ddu la benh viem tai giira tiet djch (8,0%), sau do Id viem tdc vdi nhT (2,4%) va dac biet viem tai giGa cu dd de lai di chiing (2,5%).
Bang 7. Cdc b§nh ly d mQi xoang cac b$nh mQI xoang
Viflm mOI xoang c^p tinh.
d| Ong
Vi6m mQI xoang man tinh T6ng s6
SL 32 7 39
%
9,8 2,2 12,0 Nhdn xet: Trong cdc b$nh ly cua mui xoang, dung dau la viem mui xoang cap tinh, di ling (9,8%), sau do la viem miii xoang man tinh (2,2%).
Khi tim hieu ve su ton tai, kich thuac
ciia V.A vi amidan 6 lita tuoi niy, chung toi nh^n th4y; c6 17,9% hpc sinh V.A dl thoii triln v4 82,1% V.A c6n thn tai. Boi vdi amidan: 37,5% hpc sinh amidan d3 thoii triln v4 c6n t6n t?ii 62,5%.
Bang 8. Phan dfl VA Bfl V.A
B f l l Bfl 2 Bfl 3 Bfl 4 T6ng s6
SL 91 146 29
1 267
%
28.0 44,9 8,9 0,3 82,1 Nhgn xet: 0 lua tuoi hpc sinh tieu hpc, V.A d$ 2 chilm ty 1? cao nhdt (44,9%), tuy nhien cd tdi 9,2% trd cd V.A dp 3 vd dp 4.
Bang 9. Phdn d4 amidan Bfl amidan
B f l l Bfl 2 Bfl 3 Bfl 4 TAnq s6
SL 90 85 27 1 203
%
27.7 26,2 8.3 0,3 62,5 Nhdn xet: Ci lira tudi hpc sinh tieu hpc, chil yeu cd amidan d dp I (27,7%) vd dp 2 (26,2%), tuy nhien cd tdi 8,6% tre cd amidan dp 3 vd dp 4.
Bdng 10, Cdc b$nh ty d hpng cac b$nh ly d hgnq
Viflm hgnq c ^ tinh ViflmVAmantlnh ViflmVAmantlnhdgt Vi6m amidan man tinh Vifim amidan mgn tinh dglcelp
T6ng s6 doi tupng m6c b^nh v^ hgnq
SL 2 176
12 113 2 196
%
0,6 54,2 3,7 34,8
0,6 60,3
T^p chl Tai MOi Hpng Vi^t Nam - Volume (57-12). N°6 - Dec., 2012 Nhgn xet: Trong cdc bdnh I;^ ciia hpng,
diing dau Id V.A (viem V.A mgn tinh vd man tinh dang trong dpt viem cap) Id 57,9%, sau dd Id bpnh amidan (viSm amidan man tinh va mgn tfnh dang trong dot viem cap) Id 35,4%.
De tim hieu mdi li€n quan giua cdc bpnh ly trong TMH, chdng tdi thilt I§p cdc bang tir 11 -15 dudi ddy:
Bdng 11. Mdi lidn quan giifa cdc b$nh ly d hpng vdi b$nh tai giOa
Bdng 13. M6i lidn quan giOa b$nh amidan vdi b$nh tai gi&a
B$nh tai glOa Cfl b$nh Khflng
b$nh SL
%
SL
%
B$nh hgng Cfl b«nh
37 88,1 159 56,2
Khflng b«nh 5 11,9 124 43,8
P
<a,ooi
Nhdnxer. 88,1% nhilng doi tucmg co benh ly cr tai giira la co benh ly a hpng, chi co 11,9% nhiing d6i tupng co benh tai giiia nhung khong CO benh ly a hpng (p<0,001).
Bang 12. Moi lifln quan glOa b^nh V A vfl'i b#nh tai giOa
B$nh tai giOa Cfl b$nh Khflng
b$nh SL
%
SL
%
B«nh V.A Cfl b$nh
34 81,0
142 50,2
Khflng b$nh 8 19,0 141 49,8
P
<0,001
Nhdn xer. 81,0% nhiing d6i hipng cfl benh ly a tai giiJa la co benh V.A, chi co 19,0% nhiing d6i tuong co b?nh tai giiia nhung khong co b^nh V.A (p<0,001).
B$nh tai giOa Cfl b$nh Khflng b#nh
SL
%
SL
%
B$nh amidan Cfl b«nh
25 59,5
88 31,1
Khflng b$nh 17 40,5 196 68,9
P
<0,001
Nhdn xit. 59,5% nhiing ddi tuong cd benh Iy d tai gitta la cd bpnh V.A, chi cd 40,5%
nhimg doi tupng co bpnh tai giiia nhung khdng cd bpnh V.A (p<0,001).
Bang 14. Moi IJdn quan giOa b$nh mQi xoang vdl b^nh lal gi&a
B$nh tai giOa Cfl b$nh Khflng b^nh
SL
%
SL
%
B$nh mui xoang Cfl benh
8 19,0
31 11,0
Khflng b$nh 34 81,0 252 89,0
P
>0,05
Nhdn xet: Chua co su lien quan ro ret giua benh viem miii xoang voi benh viem tai giua (p>0,05).
sang 15. Moi Il6n quan giOa b$nh vi6m V A va b$nh viflm amidan
B$nh vlflm VA Cfl b^nh Khflng b«nh
SL
%
SL
%
B$nh vlflm amidan Cfl b^nh
93 62,8
20 13,4
Khflng b^nh
83 47,2 129 86,6
P
<0,001
65
Tgp chl Tai MQi Hpng Vi^t Nam - Volume (57-12). N°6- Dec., 2012 Nhgn xet: Cd svr lien quan rd r?t giOa b^nh
viem V.A vdi b^nh viem amidan (p<0,001).
4. BAN LUAN
Kit qud nghidn cdru tir cdc bdng 1 - 4 cho thiy ty 1$ mdc bpnh TMH ciia hpc sinh trudng tieu hpc Cam Gia khd cao (63,7%), ty ip ndy ciing tuofng duong vdi cdc kit qud nghidn ciiu vl b^nh TMH d Ida tuli hpc sinh cua con em cac ddn tpc viing Ddng Bdc vd Tdy Bdc tCr 1993 - 1998 (47,18% - 77,78%) [3], [4], [5]. Vd ciing phii h(?p vdi kit qua nghidn ciiu ciia Phiuig Minh Luang tren cpng ddng ddn tpc fi De ndm 2010 (58,9%) [2]. Diiu dd chimg td rdng ty 1$
mdc bpnh ly TMH cua hpc sinh ludn ludn d miic cao.
Ket qud nghien ciiu t^ cdc bdng I - 4 cdn cho thay khdng cd s\r khdc bipt vl ty Ip mdc cac benh TMH giiia cdc gidi, khoi ldp, ddn tdc hay nghi n ^ e p cua bd mp. Tuy nhien vdi sd mau cdn nhd, de tai cdn tiep tyc nghien cim de cd nhiing ket luan ddy du hem.
Nghien ciiu ve co cdu cua cdc bpnh TMH, ket qua tai bdng 5 cho thay: trong cdc benh ly d TMH nhdm bpnh ve hpng chiem ty le cao nhdt (60,3%), sau dd Id cdc bpnh ly d tai giira (12,9%) vd mui xoang (12,0%). Ket qua nay cho thdy ca cau bpnh TMH dd khdng hoan todn phii hpp vdi nhihig ket qua nghien ciiru trudc day khi thdm kham TMH thdng thudng cho hpc smh viing Ddng Bdc vd Tay Bac: dung ddu Id cdc bpnh ve hpng, sau dd den nhdm benh ve miii xoang vd sau ciing Id cac bpnh tai [3], [4], [5]. Dieu do phai chdng ca cdu benh TMH da th\re s\r thay ddi hay do phucmg phdp thdm khdm npi soi hipn nay dd giiip cho viec chdn dodn dupe chinh xdc hon, vi vdy van de nay ciing can dupe tiep tyc nghien ciru.
Khi tim hieu sau ve cac bpnh d tai, kit qua tai bdng 6 cho thay: trong cde bpnh ly
ciia tai giQ-a, dOmg dAu Id vi6m tai gi&a tiet djch (8,0%), sau dd Id vidm tdc vdi nhi 2,4% vd d$c bi^t vidm tai giCta cu dd dl lai di chiing (2,5%). Diiu dd phii hprp vdi nhdn djnh ciia T r k Vilt Ludn [I]: "Viem tai giiia tilt djch chilm khodng 10 - 20% d tr6 em chua din tuli di hpc, thudng nhat Id 6 thdng din 4 tuoi vd gidm thap ban d tre em lira tuli hpc dudng". M^t ty 1? cao hpc sinh bj viem tai gitJa vd di chiing cua viem tai giiia Id v4n dl rit ddng duprc quan tam vi diiu dd cd thi gdy dnh hudng den siic nghe cua trd.
Khi tim hilu sdu vl co cau ciia bpnh mui xoang, kit qud t^ bdng 7 cho thay: trong cdc bpnh ly ciia mui xoang, diing dau Id viSm miii xoang cap tinh, dj ling (9,8%), sau dd Id viem miii xoang m ^ tinh (2,2%). So sdnh vdi cdc kit qud nghien cuu trudc day thi ty le vd ca cau bpnh miii xoang ca bdn chua cd su khdc bipt [3], [4], [5].
Tim hilu sau vl cdc benh ly d hpng, ket qua nghien cuu tai cac bdng tu 8 - 10 cho diay: d lua tuli ndy cd 17,9% hpc smh V.A da thodi triln, 82,1% V.A cdn tin tai, trong do tren 50% V.A qud phdt. Ddi vdi ami(!^:
37,5% hpc sinh amidan dd thodi triln va 62,5% cdn tin t^, trong dd tren 30%
amidan qua phdt. Trong cdc bdnh !y cua hpng, diing ddu la VA (viem V A mgn tinh va man tinh dang trong dprt viem c ^ ) Id 57,9%, sau dd Id b^nh amidan (vian amidan man tinh vd m ^ tinh dang trong dprt viem dp) la 35,4%. Ty Ip ndy rat eao so vdi nhirng ket qud nghien ciiu cua Tran Duy Ninh vd cpng svr ndm 1993 d tre em tii 0 - 13 tudi t^ mot so dja phuong thupc Bdc Thdi: viem VA cap 5,57%; viem VA mgn 17,17%; viem amidan cap 3,94% vd viem amidan man 9,28% [3]. Day Id nhung vdn dl rit ddng du^c ^uan tam vi viem V.A vd amidan d Ilia tudi nay ngoai vipc dnh hudng den sinh
Tgp cht Tai MQi Hpng Vi^t Nam - Volume (57-12). N°6 - Dec.. 2012
hogt vd hpc tgp ciia hpc sinh cdn c6 nguy CO gay biln chiing thap tim...
Khi tim hieu mdi lien quan giira bpnh Iy trong TMH, cdc kit qud nghien CIJU tir bdng 11-15 cho fliay: cde bpnh Iy d hpng, ddc bi^t bpnh VA vd amidan cd moi lien quan rS rpt vdi bpnh vi&n tai gjiia. Hdu het cdc tre viem tai giua deu cd cdc bpnh d V.A va amidan, dieu dd khdng chi phu hprp vdi ca chl bpnh sinh cua viem tai giihi ma qua dd g^iip cdc nhd TMH ludn lidn hp den cdc b^nh Iy d tai tren nhihig hpc sinh viem V.A vd amidan.
5. KET L U ^
Ty le mdc bpnh tai miii hpng ciia hpc sinh trudng tieu hpc Cam Gid cao (63,7%).
Dung hang ddu Id cdc bpnh Iy d hpng (60,3%), sau do din cdc bpnh ly d tai giita (12,9%) vd mui xoang (12,0%). Trong dd cdc bpnh cd ty le mdc cao: viem V.A (57,7%), viem amidan (35,4%) vd viem tai giira tilt dich 8,0%. Cd mli lien quan ro ret gi&a viem V.A, viem amidan vdi viem tai gi&a(p<0,001).
5. KHUYEN NGHI
Cdn phdt huy ban nua vai trd ciia nhd tmdng, gido vien thi chat vd cdn bd Y te trudng hpc trong cdng tdc truyin thdng gido due siic khde, qudn ly va chdm sdc siic khde ban ddu vl tai miii hpng tgi ca sd.
Nganh y tl cdn cd nhimg ke hoach cu thi diiu trj bpnh tai miii hpng cho hpc sinh vi ty Id mdc benh tai miii hpng cua cdc em khd cao trong khi chiing ta hoan todn ed khd ndng kilm sodt duac.
TAI Lifu THAM KHAO 1. Tran Vilt Ludn (2008), "Viem tai giita
tiit dfch", Tai miii hpng quyen I, Nhd xuit bdn Y hpc, Thdnh pho Hd Chi Minh, Tr. 515-531
2. Phiing Minh Luang {2Q\Q\"Nghien cuu mo hinh binh tai mUi hgng & cgng dong ddn tgc £ Di Tdy Nguyen, ddnh gid hiiu qud cua mgt so biin phdp can thiip phii hgp & tuyin thon bdn", Ludn dn tiln sT Y hpc, Dai hpc Y Hd Npi.
3. Tran Duy Ninh, Nguyen Minh Hdng, Nguyen Thuy Vdn, VO Minh (1993),
"77n/i hinh binh Tai mui hong vd mgt so yiu td lien quan den benh tai mUi hgng cita tre em tgi mgt sd dia phuang thuoc Bdc Thdi" Ky ylu cdng trinh nghien ciiu khoa hpc (1991-1992), Trudng Dai hpc Y Bdc Thai - Bdnh vien da khoa Thdi Nguyen, Nhd xuit ban Y hpc. Ha Npi, QuyIn V, Tr. 236-241.
4. TrinDuyNinh vd cpng sir (1998), "Md hinh benh tai mdi hgng cua mgt so ddn tgc mien nui phia Bdc Viet Nam ". Ky yeu cdng trinh nghien ciiu khoa hpc, trudng Dgi hpc Y Khoa Thai Nguyen, QuyIn DC, Nhd xuit bdn Y hpc, Hd Ndi, Tr. 174-179.
5. Trin Duy Ninh, Nguyen Minh Hdng vd cpng sir (1998), "Tinh hinh mdc binh tai mUi hgng cua ddn tgc Tdy huy^n Bdc San tinh Lang San ", Ky ylu cdng trinh nghien ciiu khoa hpe, trudng Dgi hpc Y Khoa Thdi Nguyen, QuyIn IX, Nhd xuit ban Y hpe. Ha Npi, Tr. 187-191.
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