Chẩn đoán và điều trị phẫu thuật ung thư đại trực tràng tại Bệnh viện Hữu Nghị (giai đoạn 2008-2009)

phu thudc vao che do an hoac nhCfng thay ddi sinh ly

ma ehi phu thupc vao kha nang dao thai cua than. Khi

cau than bi tdn thUdng, ndng dp creatinin mau tang

sdm hdn ure.

Trong nghien cifu cua chiing tdi, urea va creatinin

trong mau thd sau 4 tuan udng vien nang Nao thong

lac d ca 2 lieu 0,28g/kg va 0,84g/kg khdng cd sU thay

ddi so vdi trUde khi dung thudc vd so vdi 16 chUng,

chifng td vien nang Nao thong lac vdi cae lieu tren

khong anh hudng tdi chUe nang Ipc eua cau than.

KET LUAN

Vien nang Nao thdng lac vdi lieu 0,28g/kg/ngay

(lieu tUdng dUdng vdi lieu dung tren ngUdi) va

0,84g/kg/ngay (gap 3 lan lieu dung tren ngudi) udng

lien tue 4 tuan: Ta't ca cac chi sd theo ddi ve chUc

nang gan (hoat dp SGPT, SGOT, ndng dp Bilirubin

todn phan. Protein toan phan) vd chUe nang than

(Urea vd Creatinin huye't thanh) deu nam trong gidi

han binh thudng, khdng cd sU khde biet rd ret so vdi

16 chifng.

TAI LIEU THAM KHAO

1. Bo y te (1996), Hudng din kem theo quyet djnh

sd 371/BYT-QD ngay 12/3/1996 ve xdc djnh dp an toan

eho thudc ed truyen Bo Y te.

2. Giang Khac Minh, Bao Minh Hue. Gian minh

phUdng te tU dien (Tai ban lan 2). NXB Khoa hoe ky

thudt Thupng Hai, 2002: 649 (tilng Trung).

3. Cau Bdi Nhien. Tuyen tap phUdng thudc Tmng y

ndi tieng cdc trieu dai. NXB TU thu ThUdng Hai, 1998:

483 (tieng Trung).

CHAN DOAN VA DIEU TRj PHAU THUAT UNG THlTDAI TRlA; TRANG

TAI BENH VIEN HOU NGHj (GIAI DOAN 2008 - 2000)

HOANG VIET DONG , NGUYI N QUOC DUNG

Benh Vien HQu Nghi

TOM TAT:

Dat van de: UTDTT dUng hang dau trong ung thu

dudng tieu hda. Trieu chifng khdng rd ring trif khi cd

bien chifng. Chan doan bing ndi soi dai trang va sinh

thiet. Dieu trj phau thuat la chij ye'u, hda xa trj cai

thien thdi gian song sau mo. NC rut ra mdt so kinh

nghiem trong chan doin vi dieu trj phiu thuat

UTDTT. Doi tupng va phuang phap: NC tien cifu tat

ca cic trudng hgp phiu thuat UTDTT tit 1/2008 de'n

12/2009 tai Benh vien Hutu Nghi. Kei qua: 114 trudng

hgp UTDTT duac phiu thuat: nam 78,9Vo, nO 21,1%o;

t^ le nCf/nam: 1/3,75. Tuoi trung binh 65,75 ±12,53,

nho nhat 22, Idn nhat 88. Ye'u to nguy ca: hiit thuoc li

23,7%,, viem dai tring 12,3%,. Phoi hgp: ting huyet

ip 37,7%,, benh phoi man tinh 14%,, u xa tien liet

tuye'n 14%,, dii dudng 9,6%,, benh ly tim mach

7%,...Lam sing: dau bung va RLTH 48,2%,, la miu

42,1%%, tic rudt 12,3% %,, thieu miu 34,7%o, CEA

va CAI9-9 tang 55,7%o. Ndi soi dai trang 86,8%o. Md

benh hgc: UTBM tuyen 85,9%o, ung thu tuyen nhay

12,3%,, u lympho 0,9%, di cin khdng biet hda tU

dudng tieu hda 0,9%. Giai doan benh: Dukes A

15,8%o, Dukes B 29,8%o, Dukes C vi D 54,4%,. Mo

cap cifu 13, •?%, md' cd chuan bj 86,9%o, cd hd trg ngi

soi 7,9%,. Vj tri u: dai trang phai 14,9%,, dai tring

ngang 11,4%, dai trang trii 32,5%o, true tring 37,7%o,

u dong thdi 3,5%. Phau thuat cit u noi ngay thi dau

63,•/%, caf u iam HMNT 16,7%,, phiu thuat Hartmann

14,9%o, khdng cit u chi lam HMNT4,4%o, noi tat 0,9%,.

Bien chifng sau mo 12,3%o, t^ le tCf vong 1,7yo. Phoi

hgp hda xa tri sau mo 52,6%o. Kit luan: UTDTT vin

la mdt thach thUc trong chan doin sdm va dieu tri.

Dieu tri phau thuat phu thudc vao giai doan benh vi

tinh trang toin than. Phiu thuat ket hgp vdi hda chat

sau mo la md hinh phii hgp tai Benh vien HOu Nghj.

Tif khda: UTDTT, Benh vien HCfu Nghj.

SUMMARY:

Background and aims: colorectal cancer is the

most common malignancy in the gastrointestinal tract. It

does not have any eariy signs. Unless a patient

presents with a tumor complication. Diagnosis is

typically made by colonoscopy and biopsy. Surgery is

the most common fonv of colorectal cancer treatment.

Postoperative chemoradiotherapy was shown to

improve survival rates. The aim of this study was to

report our experience in diagnosis and management

Material and Method: A prospective study of all

surgical cases due to colorectal cancer in our institution

from 1/2008 to 12/2009. Results: 114 patients who

have been surgery for colorectal cancer, males 78.9%,

and females 21.1%o, female/male ratio: 1/3.75. These

patients, aged from 22 to 88 years, mean age: 65.75

±12.53. Risk factors included: smoking history 23.7Vo,

ulcerative colitis 12.3%,. Associated with: hypertension

37.7%,, chronic obstructive pulmonary disease 14%,,

benign prostatic hypertension 14%o, diabetes 9.6%,,

cardiovascular diseases 7%... Signs and symptoms:

abdominal pain and bowel habits is highest rate

(48.2%o), lower gastrointestinal bleeding 42.1%,

obstructive signs 12.3%,, anemia 34.7%,, increased CEA

and CA19-9 level

55.7%,. Colonoscopy with biopsy 86.8%o.

Histologic classification: adenocarcinoma 85.9%o,

mucinous carcinoma 12.3%,;' lynphoma 0.9%o,

undifferentiated metastasis from gastrointestinal tract

0.9%,. Stage I (Dukes A) 15.8%o, stage II (Dukes B)

29.8%, stage lll-IV (Dukes C & D) 54.4%o. Urgent

surgery was performed in 13.1%,; selective surgery:

86.9%<,, iaparoscopy-assisted colectomy 7.9%o. Side

tumor: the right colon 14.9%o, the transverse colon

28 Y HOC THVC HANH (727) - SO 7/2010