Kết quả bước đầu tán sỏi niệu quản nội soi ngược dòng tại Khoa ngoại Bệnh viện Hữu Nghị

• TAI UI^U THAM KHAO

1. Berniee O. Adegbehingbe (2005), "Incidence of

ocular congenital anomalies in Nigerian teaching

hospitair. Orient Joumal of Medicine Vol.17 (3 & 4)

. . 2. Clare Gilbert & Allen Foster (2001), "Childhood

blindness in the context of vision 2020 - The right to

sighr. Bulletin of the World Health Organization,79:227-

232

3. Duke - Elder (1964), 'System of Ophthalmology",

Mosby company, volume II, part 2

4. Nguyen Vigt Hung vd Trinh Van Bdio (2006), "C/jin

doin cic dj tit bim sinh cua thai nhi bing siiu im sing

Igc vi xir tri lim sing cic dj tgt bim sinh tgi khoa sin

bgnh vign Bgch Mai", tgp ehi Nghien cuu Y hpe, sd 1

5. Nguyen Quang Huy, Le minh Thdng (2005),

"Khio sit cic yeu td inh hudng din sw sgp ml tii phit

theo phau thuit Bertie', tgp chi Y hpc thanh phd Hd Chi

Minh, tap 9, phg ban sd 1, tr. 27 - 32

6. Phgm Thj Chi Lan (2008), "Nh$n xit 30 tnrdng

hgp tgt khdng mdng mit tu 2000 - 2007 tgi BV. Mit

TP.HCM", Hdi nghj Nhan khoa toan qudc Vigt nam tgi

TP.HCM 11-13/9/2008

7. Le Do Thuy Lan (2008), "Dj tit bim sinh a mit vi

cic phwang phip diiu tn", NXB Y hpc CN. TPHCM, tap 1

8. Hodng Thj Luy (2003), "Thj giic cho mgi ngudi

nim 2020. Hudng phin diu tdi cua nginh mit chiing

ta", tgp chi Y hpc thanh phd Hd Chi Minh, t|ip 7, phg ban

sd3, tr.1 -5

9. M.G.Wirth (2002) , "Aetiology of congenital and

paediatric cataract in an Australian population", Br.J.

Ophthalmol, July:86(7): 782-786

10. Stella J. Hornby (2002), 'Enviromental risk

factors in congenital malformations of the eye", Ann Trop

Paediatr., Mar.22 (1)

KET QUA BUlOrC DAU TA N SOI NIEU QUAN Ndi SOI NGUVC DONG

c: TAI KHOA NGOAI BENH VIEN HO U NGHI in

__a￾NGUYEN H6NG LONG, TR|NH HdNG SON, NGUYIN TH^TRUdNG,

NGUY§N DLTC HOAN, od QUANG TH^', NGUYIN HI^NG,

HOANG VI^T DUNG, Lt PHU HANH. PHUNG XUAN TU

DAT VAN ^ i

Sdi nieu la benh kha phd bien tren the gidi, tan

suat mle tenh chung la 2-4%, trong sd dd sdi NQ

chiem khoang 30% trong tdng sd sdi nieu. De giai quyet

sd lUdng benh nhan rat Idn nay, tren the gidi da cd rat

nhieu nghien cifu ve eac phUdng phap dieu trj, luc dau la

cae phUdng phap md md de lay sdi. Nhung tU nhCltig

nam 1980, chuyen nganh tiet nieu the gidi da ed nhOfng

budc dot pha mdi trong viec ap dgng khoa hpe ky thuat

mdi tao ra eae phUdng phap dieu trj sdi tiet nieu tien tien,

hieu qua va it sang chan. Dd la phUdng phap tan sdi

ngoai ed the do Forssman va Chaussy de xUdng vao

nam 1980, tan sdi qua da do Aiken thUe hien nSm

1981, tan sdi nieu quan qua npi soi dng cifng do Petez

Catro vd Martinez - Pineixo tien hanh vao ndm 1980. TU

dd den nay nhieu tac gia da de xuat nhieu phUdng phap

tan sdi npi soi nieu quan khae nhau de pha vd vien

sdi nhU: thuy dien lUe (Raney va Handler), sieu am

(Huffman), laser (Vi^aston va Wickham), cd hpc

(Lopatkin). Hien nay vdi sU phat trien lien tue cua phau

thuat ndi soi dem lai rat nhieu thanh edng trong dieu tri

sdi nieu. Phau thuat md da dan dUde thay the bdi phau

thuat khdng xdm lan hode it xam lan. Dae biet sdi nieu

quan hau nhu da dUde dieu trj hoan toan bing cac

phUdng phap tan sdi.

6 Viet Nam tan sdi nieu quan qua npi soi da dUde

thUe hien tU nhifng nam 90 tgi mot sd benh vien Idn

trong ca nUde va da thu duoc ket qua tdt vdi eae loai

may tan sdi sif dung nang luong: sieu am, laser, thuy

dien life, xung hdi...

Tai khoa Ngoai Bv HOru Nghj tU thang 6/2008 da trien

khai thue hien ky thuat tan sol nieu quan npi soi ngUde

ddng. May tan sdi la may xung hdi Lithoclast va he thdng

camera va ngudn sang eua hang Karl-storz vdi dng soi

la dng soi cifng (Rigid) kich thUde dng soi 9,5Fr.

Nghien cifu nay ghi nhan ket qua Ludc dau 28 trudng

hdp tan sdi nieu quan ndi soi trong thdi gian tU 6/2008

den 11/2009 tai benh vien Hifu nghi.

D6\ TJpNG VA PHUONG PHA P NGHI§ N CLTU

1. Doi tUdng: 28 benh nhan dUde chan doan sdi

nieu quan dogn 1/3 giifa va 1/3 dudi dUde tan sdi trong

thdi gian tU 6/2008 den 11 /2009.

2. PhUdng phdp nghien cUu: tien cUu md ta. cac

benh nhan dua vao nghien cifu dUde thdng nhat ngay tU

dau ve ehi djnh; ehdng chi djnh;ehuan bj benh nhan

trUde md; phUdng phap gay me, gay te; ky thuat tien

hanh; ghi nhdn tai bien trong md va bien chimg sau md;

theo doi gan va xa de danh gia ket qua dieu trj.

2.1. Chi djnh: vj trf sdi: sdi 1/3dUdi va 1/3 giifa nieu

quan, kieh thudc 0,5-2 em. Vdi nhOng vien sdi <5mm: ehi

tan sdi khi benh nhan dau nhieu, dieu tri npi khoa* khdng

ket qua, sieu am va chup UIV thay dai be than gian.

2.2. Chong chi djnh:

2.2.1. Chong ch! djnh tuyet ddi: benh nhan c6

nhilm khuan nieu ehUa dUde dieu trj dn djnh; benh nhan

dang dieu tri benh rdi loan ddng mau hoac dang suf dung

heparin, aspirin, v.v...; phu nif dang mang thai; benh

nhan cd dj tat: gii veo cot sdng, cifng khdp hang nhat Id

dj tat tiet nieu khdng cd kha nang dat dtfde may.

2.2.2. Chong chi djnh tUdng ddi: hep nieu dao; phi

dai tuyen tien liet >50g; hep xd Id nieu quan; eac khdi u

dudng tiet nieu dUdi: u nieu dao, u bang quang v.v... gay

can trd dUdng vao nidu quan; cac khdi u chdn ep dUdng

di eCia nieu quan, hoac nieu quan bj xd cimg chit hep

sau chan thUdng, dieu tri tia xa v.v...

Ddi vdi cac trudng hdp ehdng ehi djnh tUdng ddi, ndu

van cd kha nang dat duoc may thi cd the tiep tue tien

hanh thu thuat, nhung can nhie than trpng.

Y HOC THUC HANH ^41) - S6 11/2010 51