Nghiên cứu đặc điểm dịch tễ, lâm sàng, cận lâm sàng của bệnh nhân hen phế quản điều trị tại bệnh viện 175

NGHIEN CQU DAC DIEM DjCH TE, LAM SANG, CAN LAM SANG

CUA BENH NHAN HEN PHE QUAN DIEU TRj TAI BENH VIEN 175

MAI VAN OIEN

Benh vien 175

TOM TAT

Nghien ciru tren nhom 42 benh nhan hen phe

quan dieu tn tai benh vien 175, ket qua cho tha'y: da

so cac benh nhan la nam gidi, song trong thanh phd

va d tuoi trung nien, cd nghe nghiep lien quan den bui

va hoa chat vdi t^ le kha cao. Mot nda so benh nhan

mic benh tren 10 nim. Da so benh nhan co tien sSr

ban than va gia dmh di img nha viem mui di Ong, me

day, cham, dj img thdc in, va bo me hay anh chi em

bi hen phe quan. Can hen thadng xuat hien khi thay

doi thdi tiet, viem dadng ho hap tren, tiep xuc vdi bui.

Cac benh nhan cd dac diem lam sang va can lam

sang taang doi dien hinh vdi trieu chimg: ho, khd khe,

khd tha, trong can hen cd ran rit, ran ngay. Da so

benh nhan cd cac cd trieu chi/ng bao trade can hen

va can hen chd yeu d mac trung binh va nhe. Hen

bac 2 chiem chQ yeu, nhi/ng d tat ca cac bac hen, khi

dang cd can hen, thi can cd thi la can nhe, trung binh

hay can nang. T^ le benh nhan cd roi loan thdng khi,

so lagng bach cau ai toan, va nong dd khang thi IgE

toan phan ting cao chiem da so. Trong dieu tn, doi

vdi can hen ning: 100% phai phoi hap ca 3 nhdm

thuoc cit can, can hen trung binh: hau het phai dung

phoi hgp a2 giao cam va corticoid, can hen nhe; cd

42,86% chi dung a2 giao cam. Hau het cac benh

nhan cit can trong 1 tuan dieu tri.

Tdkhda; hen phe quan, benh vien 175

SUMMARY

STUDYING ON THE CHARACTERS OF THE

ETIOLOGY, CLINICAL AND PARACLINICAL

SYMPTOMS OF THE ASTHMA PATIENTS

TREATED IN 175 HOSTITAL

Studying on 42 asthma patients treated in 175

hospital, the result showed that: the majority of that

patients are males, living in the city and at the middle￾aged, and occupation related with dust and chemical.

A half of that patients suffer from asthma over 10

years. These patients with allergic history (both their

self and family) are high ratio such as: allergic rhinitis,

urticaria, eczema, food allergy, and their parents or

brothers with asthmas. The asthma exacerbation

often appears in the conditions such as: weather

change, upper respiratory infections, exposure of dust.

The clinical and paraclinical characters are quite

typical with symptoms; cough, wheezing, dyspnea,

rhonchus and sibilance rales within exacerbation. The

majority of researched patients have previous

symptoms and most of exacerbations are mild and

moderate. The number of mild persistent asthma

patients are mainly, however, in all steps, there has

all exacerbation with different levels. There has the

increased proportion of patients with high ventilation

dysfunction, amount of eosinophils and total IgE

concentration. In treatment: 100% severe asthmas

exacerbations have to combine 3 relief groups,

almost moderate asthmas exacerbation used a2

agonist and coticoids, while there is 42.86% of mild

exacerbations treated only by a2 agonist. Almost of

patients have relief within one week.

Keywords; asthma, 175 hospital

DAT VAN DE:

Benh hen phe quan (HPQ) c6 xu hi/6ng ngay

cang gia tang khong nhiimg d Viet Nam ma ci tat ca

cac ni/dc tren the gidi. Nguyen nhan chinh la do mirc

dp 6 nhilm moi tri/dng tang nhanh ciing vdi cong

cuoc cong nghiep hoa va do thi hda. Viec chan doan,

dieu tri va dU phong doi liic gap nhieu khd khan do

khong xac djnh difdc cac yeu to' lam khcii phat cdn

hen, khong co si/ ttfdng ximg giOra mifc dp cdn hen

vdi cac ket qua xet nghiem, nha't la khi benh nhan lai

CO them cac benh 1^ ho hap khac di kem. Vi vdy,

chiing toi tien hanh nghien ciru de tai: " Nghien cifu

dac diem lam sang, can lam sang cua benh nhan hen

phe quan dieu tri tai benh vien 175" nham muc dich:

Tim hieu dac diem djch t l cua benh nhan HPQ

dieu tri tai benh vien 175

Tim hieu dac diem lam sang, can lam sang va

dap ifng dieu tri cua cac benh nhan nay.

OOI Tl/QNG vA PHl/ONG PHAP NGHIEN CQU

1. Ooi tu'dng nghien ciiru:

Gom 42 benh nhan dUdc chan doan hen phe quan

(theo GINA 2006) dieu tri tai khoa Lao va Benh phdi,

Benh vien 175 tif 05/2008 - 06/2009.

2. Phirdng phap nghien ciiru:

Nghien curu diidc tien hanh theo phiTdng phap tien

eiru, md ta cat ngang c6 so sanh, dd'i chimg.

Cac benh nhan diTdc true tiep hoi benh, khai thac

benh sur, tien sCr, tham kham lam sang theo mau benh

an thong nhat, lap bang hoi, dieu tra ti mi ve nghe

nghiep, dieu kien song, tien si!rd| Cmg, tien si!ftiep xuc

vdi cac yeu to kich thi'ch, hoan canh xuat hien cdn

hen, thoi quen hut thuoc la, uong rUdu cOa benh nhan

cung nhir tien sCf cua gia dinh, tien hanh day du cac

xet nghiem;

Huyet do, toe do lang hong cau, glucose mau,

chifc nang gan (AST, ALT), chUc nang thSn (are,

creatinin), dinh li/dng IgE toan phan, dem $6 lifdng

bach cau ai toan trong mau ngoai vi.

^ Xet nghiem thong khi phdi va lam test phuc h6i

phe quan, do dien tim, chup X-quang tim phoi.

- So lieu dUdc xijf \'y bang phirdng phap thong ke y

hoc, sCf dung phan mem SPSS for Windows 12.0.

34 Y HOC THVC HANH (755) - s 6 S/ZOlf