Nhận xét một số đặc điểm thực trạng điều trị trầm cảm ở người bệnh rối loạn cảm xúc lưỡng cực

TAP CHl Y HOC VigT NAM TAP 463 - THANG 2 - SO 1 - 2018

aiang diem VAS tai viing ed mat la 4,33 ± 2,08;

tai viing khdp thai dUdng ham la 7,0 ± 2,0;

100% benh nhan nao cd tieng keu khdp; 100%

benh nhan co dudng ha ngam mieng khong

Biang vdi bien dp ha mieng toi da trung binh la

13,33 ± 2,89.

Trong cac trudng hdp sai vj trf dTa khdp ra

tnidc khdng hoi phuc, mUc do dau trung binh

theo tiiang diem VAS tai viing'cd mat la 5,8 ±

1,48; tai viing khdp th^i dUdng harn la 6,2 ±

1,1; khdng ed benh nhan nao ed tieng keu khdp

tai thdi diem kham; 100% benh nhan cd dUdng

ha ngam mieng khdng thaiig vdi bien dp ha

mieng toi da trung binh la 19 ± 7,4.

NhU the CO the thay eac dau hieu nhU dau,

han che ha mieng khong phai la trieu chiing dae

hieu dio sai vj trf dTa khdp ra trUdc, ke ca cac

tnidng hdp vi trf dTa khdp binh thudng ta van ed

the gap eae trieu chu'ng nay, tham chf cae trieu

chirng nay cdn bieu hien rd ret hdn (miic dp dau

Idn hdn, han che ha mieng hdn). Tuy nhien,

trieu ehirng tieng keu khdp lai la dac hieu eho

ton thUdng sai vj trf dTa khdp ra trUdc cd hoi

phuc khi ma 100% benh nhan ed sai vj trf dTa

khdp ra trUdc cd hoi phuc dBu cd tieng keu khdp

6 ca hai thi, con cac trifdng hdp vj trf dTa khdp

binh thudng hoac sai vj tri dta khdp ra trUde

khong hoi phuc thi khong xuat hien tieng keu

khdp. Nhu vay, MRI chi phat hien dUdc cac ton

thUdng eiia dTa khdp, tuy nhien, loan nang TDH

bao gom cae rdi loan d ea he thong ed va viing

khdp TDH, vi vay, lieu chi sir dung MRI de chan

doan loan nang TDH la khdng thuyet phuc va de

bo sdt tdn thUdng.

V. KET LUAN

TMD gay anh hUdng len benh nhan nii nhieu

hdn la benh nhan nam.

Cae trieu chimg lam sang ed the gap ciia

TMD la dau vimg cd mat hoae vung TMJ, han

ehe ha mieng, tieng keu l<hdp bat tJiUdng va leeh

dudng ha ngam mieng...

Cae hinh anh ed the gap tren MRI cua TMD la

sai leeh vi trf dTa khdp ra trUde, tran dieh khdp,

bien dang dTa khdp...

MRI ehi phat hien diidc eae ton thUdng eua

dTa khdp, neu ehi suf dung MRI de chan doan

loan nang TDH la chUa thuyet phue va d l bd sdt

ton thUdng.

TAI UEU THAIVl KHAO

1. Okeson J.P. (1996). Orofacial pain: Guilines for

assessment, diagnosis and management. Chicago:

Quintessence Publishing Co, 113-184.

^. De Leeuw R. (2008). American Academy of

Orofacial Pain: Guilines for Assessment, Diagnosis,

and Management, fourth ed. Chicago:

Quintessence Publishing, 131-141.

3. Dworkin S.F., Muggins K.H., Leresche L et al.

(1990). Epideminology of signs and symptoms in

temponDmandibular disorders: clinical signs in case and

contrals. J. Am. DentAssodabon, 120(3), 273-281.

4. Kamisaka M., Yatani H., Kuboki T. et al

(2000). Four year longitudinal course of TMD

symptoms in an adult population and the

estimation of risk factors in relation to symtoms. J

OrofacPam, 14(3), 224-232.

5. Jake E, Robert JG (2000). Coping Profile Differences

in the Biopsydiosoaal Functioning of Pateits With TMD.

PsydKisomatic Medidne, 62,69-75,

D. R. Tallents, R. Katzberg, W. Murphy et al

(1996). Magnetic resonance imaging findings in

asymptomatic volunteers and symptomatic

pabents with temporomandibular disorders. The

Journal of prosdietic dentistry, 75 (5), 529-533.

/ . Hoang Thj Dien Thao, Hoang Tir Hung

(2000). Rdi loan thai dUdng ham. Tap chf Y hoc

Ho Chi Minh, 8(4), 23-30.

NHAN XET MOT SO DAC DIEM THITC TRANG DIEU TRI TRAM CAM

dr NGirai BENH ROI LOAN CAM XUC LU-ONG eye

Le Thi Thu Ha*, Nguyen Kim Viet*,

TrSn Hull Binh*, Nguyen Thanh Long*, Pham Xuan Th^ng*

TOM TAT

^ Myctieu: NhanxetmgtsodacdiemthuCtrangdleutn

Cram cam d ngudi benh rS toan cam xuc luQnp cUc Dot

tiling: 71 benh nhan dUdc chan doan xac djnh roi

loan cam xiic lu^ng cUe hien giai doan tram cam theo

*Trudng dai hoc YHa Noi

Oliu frach nhilm chinh: Le Thj Thu Ha

Eniail: lethuha@hmu. edu. vn

Ngay nhan bai: 11.11.2017

Ng^yphan bien khoa hoe: 23.12.2017

Ngay duyet bai: 30.12.2017

tieu ehuan chan doan ciia ICD-10 dieu tri noi tru tai

Vien Si^c khde Tam than tU thancj 1/2011 den

12/2017. Phu'dng phap: Nghien eUu mo ta cat

ngang. Ket qua: Trong khoang thdi gian nghien ciru

tren, ehiing tdi thu dUde 1 so ket qua sau: cac benh

nhan dUdc dieu tri phae do da hda tn chiem > 90%.

Thuoc chinh khi sac diidc ehi dinh d 67,6% benh

nhan, j)ho bien nhat la valproat. thudc^an than Idnh

va chong tram cam dUdc sU dyng phd bien d hdn

75% benh nhan; an than kinh thUdng dUdc chi dinh

la quetiapin va olanzapin, cac thuoc an than kinh

the he mdi sU dung dai ngay hdn so vdi an than

kinh the he eu (halopendol); sertralin va mirtazapln la