Hình thái lâm sàng viêm xoang trán mạn tính và chỉ định phẫu thuật

TCNCYH 68 (3)-2010

Summary

DIAGNOSIS AN D TREATMENT OF GASTRIC ESOPHAGEAL REFLUX (GERD)

Assessing clinical symptoms and endoscopy is highly reliable in diagnosis and treatment of GERD.

Objective: study of clinieai symptoms, endoscopy before and after treatment. Methods: 58 patients with

clinical symptoms, endoscopy and was treated with Esomeprazole in 4 weeks. Results: The typical

clinical symptoms before and after treatment: hot burning (87.9% and 25.5%), in tomato (72,4 % and

26.2%), chest pain (84.5 % and 26.5%), cough (81.0% and 36.2%). Oesophagitis before and after

treatment: grade A (67.4% and 1 8.9%), grad B (28.2% and 8.6%), grad C (4.4% and 1.7%) . Conclusion:

The main clinical symptom is hot burning after sternum, chest pain, heartburn, in the steam. Esophagitis

grad A is the majority. After treatment, clinical symptoms and inflammation are reduced.

Keywords: gastric esophageal reflux

HINH THAI LAM SANG VIEM XOANG TRAN MAN TINH

VA CHI DINH PHAU THUAT

Phan Ngpc Minh', Nguyen Tan Phong''

'Benh vien Viet Tri - Phu Tho; 'Trddng Dai hoc Y Eld Noi

Mac du phdu thudt noi soi xoang trdn dd thay the gan nhd hodn todn phdu thuat xoang trdn qua dddng

ngoai nhdng ty le tai phdt viem xoang tran do loai phau thudt nay van cdn kha cao. Muc tieu: nghien cdu

cdc hinh thdi viem xoang trdn man tinh qua neii soi vd chup cdt lap vi tinh dd'i chieu vdi ket qua phau thudt

nhdm tim ra nguyen nhan that bai cua phdu thudt de de xudt bien phdp can thiep thich help. Ddi tugng va

phuang phap nghien cdu: (1) Nghien cdu cdc hinh thdi lam sang cua viem xoang trdn mdn tinh qua ndi soi

vd chyp est Idp vi tinh. (2) Ddi chieu hinh thai lam sdng viem xoang trdn vd chup cat Idp vi tinh vdi ke't qud

phau thudt. Ke't qua: 3 hinh thdi viem xoang trdn ddac phat hien: viem xoang trdn dan thuan mot ben, viem

xoang trdn mot t)en phdi hap vdi viem xoang sang ~ hdm vd viem xoang trdn ddi xdng. Viem xoang trdn dan

thuan mot ben lien quan chu yeu den cdc di hinh cua chinh xoang trdn vd quanh Id thdng xoang. Viem

xoang tran mot ben phdi hap vdi viem xoang sang-hdm thi nguyen nhdn chinh Id td viem xoang sdng hdm.

Viem xoang trdn ddi xdng lien quan den nhieu nguyen nhan todn than. Ke't luan: (1) Viem xoang trdn dan

thuan (17%) thi phdu thudt phdi trong tdm xd ly di hinh quanh Id thdng xoang. (2) Loai viem xoang trdn mot

ben phoi hgp vdi viem xoang sang - hdm (59%) thi phau thudt phai triet de ddi vdi xoang sdng - hdm. (3)

Loai viem xoang trdn ddi xdng (27%) phdi tim vd dieu tri phd'i hap nguyen nhan todn than.

Tii khoa: phiifc hpp Id ngach, ngach xoang tran

1. DA T VA N D E can trd dddng dan lull xoang trdn sau phlu thuat.

Viem xoang tran man tinh Id loai benh ly khd Mdt trong nhiTng ly do can bi n la khdng din h gia

dieu tri ke e l phau thuat eung tdi phdt vdi ty le rat hit ddde benh tich, nhifng hinh thai va eau true

eao. Theo Zhou Bing [6| nguyen nhan gay tha't gil i phau bd't thddng d vung Id thdng xoang

bai chd phlu thuat xdang tran dd la sd ti c hep Nguyen Ta'n Phong [3] td dd chi djnh ky thuat md

lai Id thdng xoang sau phdu thuat. Cd nhilu yeu td khdng thieh dang. V l mat ca'u true giai phlu

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