Nghiên cứu một số đặc điểm lâm sàng, cận lâm sàng và chỉ định điều trị khi xuất viện ở bệnh nhân đặt stent động mạch vành tại bệnh viện Chợ Rẫy và Bệnh viện Đại học Y Dược TP HCM năm 2007-2008

NGHIEN CUU MOT SO DAC DIEM LAM SANG, CAN LAM SAN G VA CHI DjNH DIEU TR!

KHI XUAT VIEN Of BENH NHAN DAT STENT DONG MACH VANH TAI BENH VIEN CHO RAY

VA BIN H VIE N DAI HOC Y DUUC TP HCM NAM 2007-2008

T6M TAT:

Qua nghien ciru 327 benh nhin dat stent ddng

mach vanh tai benh vien Cho Riy (BVCR) vi benh

vien Dal hgc Y dwgc thanh phd Ho Chi Minh

(BVDHYD), Chung tdi riit ra 1 sd kit luin sau:

1. Dae diem lam sing, can lam sing:

- Da sd benh nhan Idn tudi va cd benh einh lim

sing ning; Idn hon 45 tudi ehiem ty le 93%,, ehu yeu

li >60 tudi; Nam nhieu hon nw; Cd 71,43%, la hgi

ehirng ddng mach vinh cip, 28,57%, li con dau that

ngire dn dinh hay eae dang benh dgng mach vinh

man tinh khie, trong dd nhdi miu eo tim cip chiem

56%,.

- Da sd benh nhan ed nhieu yeu td nguy eo benh

tim mach, trong dd ed 74%, benh nhan ed tir 2 yeu td

nguy eo trd len; 58,33%, benh nhin nam edn dang

hut thudc li tai thdi diem bi benh; 72,48%, cd ting

huyet ip; 77,92 %> ed rdi loan lipid miu.

- Hon 2/3 benh nhin ed it nhit 2 nhinh ddng

mach vinh bi tdn thwong.

2. Toa thuoc xuat vien: Da sd toa thudc liie xuit

vien BVCR vi BVDHYD phu hgp khuyen do hidn tai.

Trong toa ed Aspirin 99,02%,; elopidogrel 100%,; ire

ehi men chuyen: 96,10 %,; ire ehe beta 91,56%,;

statin 93,83%,; thudc ha lipid miu 98,70%,.

Tir khda: dat stent dgng mach vinh, benh vien

Cho Riy, lim sing, cin lim sing

SUMMARY

From the study on 327 patients on Stent

placement in coronary arteries in Cho Ray Hospital

and Ho Chi Minh City Medical and Pharmaceutical

University's Hospital, the following conclusion are

drawn:

1. Clinical and para-clinical features:

- The majority of patients at old age have more

serious para-plinieal diseases; patients who are over

45 years old account for 93% and among these

patients, most of them are over 60 years old. There

are more male patients than female ones. 71.43%o of

the patients' diseases are acute coronary syndromes,

28,57%o are stable angina or other types of chronic

cardiac diseases. Among these diseases, heart

attacks account for 56%,.

• Most of the patients possess a number of risks

of cardiac diseases. Among these patients, 74% of

them have 2 or more than 2 risk factors; 58.3%, of the

male patients still smoke cigarettes during having

such diseases; 72,48%o have high blood pressure;

and 77,92 %, have blood lipid disorder

- X- rays manifestations: Most of the patients have

had at least 2 injured branches of coronary arteries.

VO TH! oe

2. Discharge prescription: Most discharge

prescriptions are in accordance with the current

recommendations. At discharge time, aspirin were

prescribed for 99,35%, patients, elopidogrel for 100%

patients; beta blocker for 91,56%, patients, ACE for

96,10%, patients, lower lipid drugs'for 98,70%

patients.

Keywords: Clinieai and X-rays manifestations,

coronary artery disease, stent. Discharge

prescription.

DAT VAN D^

Benh mach vanh IS mpt benh rit trim trpng vS

phd bien, benh nSy da trd thSnh mpt trong nhu'ng

nguyen nhan tCr vong hSng diu d eSc nude phSt

trien, benh cOng dang trd thSnh phd bien d cSc nude

dang phSt trien. Trong nhu'ng nam gin dSy, nhieu

phuang phSp chan doan va dieu trj mdi, hien dai da

duac Sp dung vS dem lai nhu'ng cai thien ro net trong

phSt hien vS dieu trj benh dpng mach vSnh (DMV).

Trong dd dat stent dpng mach vSnh chiem ban 80%

nhQ'ng trud'ng hap duac can thiep mach vSnh. Sau

stent phai nghiem ngat diing thudc chdng ket tap tieu

cau ph6ng ngira thuyen tie trong stent va vin phai

tiep tue eSc dieu tri npi khoa khSc de tiep tue cit giam

yeu td nguy ca, tSc dpng vSo cSe tdn thuang chua

duac can thiep va toan bp giudng DMV ndi ehung.

Toa xuit vien IS het sue quan trpng cho khdi diu qua

trinh dieu trj lau dai sau stent. Do vay chiing toi tien

hSnh nghien ciru "Nghien ciru mpt sd dae diem lam

sSng, can lam sSng vS chi djnh dieu tri khi xuit vien d

benh nhSn dat stent dpng mach vSnh tai benh vien

Cha Riy vS benh vien Dai hoc Y duac nam 2007-

2008" vdi cSc muc tieu nghien ciru nhu sau:

- Md ta mdt sd die diem lam sang, can lim sang

eiia benh nhin dat stent dgng mach vinh.

- Md ta dae diem toa thudc xuit vien eiia binh

nhan sau dat stent ddng mach vanh.

D 6 I TU'O'NG VA PHU'ONG PHA P NGHIEN CU'U

1. Ddi tiFcyng nghien CIFU: Ddi tuang nghien ciru

eua ehiing tdi gdm 327 benh nhSn dang khSm vS dieu

trj tai benh vien Cha Riy vS b$nh vien Dai bpc Y

duac TPHCM, sdng tai thanh phd Hd Chi Minh vS 8

tfnh ISn can, duac chin doSn benh dpng mach vSnh

qua chup mach vSnh vS dupe dat it nhat 1 stent d6ng

mach vSnh trong 2 nam 2007-2008.

2. Phu'O'ng phSp nghien CIFU: Nghien cii'u ve

dSe diem ISm sSng, cSn ISm sSng: qua xem hd sa

benh Sn, ket hop phdng vin benh nhSn bang b6 eSu

hdi thiet ke sin. Ghi nhan dieu^trj khi xuit vien: xem

hd sa benh Sn, toa thudc liie xuit vien.

3. XLF ly sd lieu: bing phin mem STATA 8.0

56 Y HOC THVC HANH (729) - SO 8/2010