Nhận xét một số thay đổi điện tâm đồ ở bệnh nhân suy tim lớn tuổi tại Tiền Giang

NHAN XET MOT S6 THAY DOI DIEN TAM Dd or BENH NHAN SUY TIM LOTN TUOI

TAI TIEN GIANG

T6MTAT

Qua cic nghien cuv djch ti tren thi giai cho thiy

suy tim dang de dga sire khde cgng ddng, khdng eh! vi

sw gia ting tan suit bgnh mi cdn li nhung inh hwdng

ning ne cua suy tim len sinh hogt ngwdi bgnh cung nhu

chi phi xi hgi. Hien nay, du cd nhiiu phuang tign chin

doin suy tim, nhung dign tim dd van ed mgt gia tri nhit

dinh tmng chin doin, theo ddi diiu tri, tien Iwgng bgnh.

SUMMARY

COMMEMT ON SOME CHANGES OF

ELECTROCARDIOGRAM ON AGED HEART FAILURE

PATIENTS IN TIEN GIANG PROVINCE

Epidemiological investigations in the worid indicate

that heart failum is thmatening public health not only

because of its incmasing proportion but also its negative

effects on patients daily life and social expenses.

Nowadays, there am a lot of equipment used for

diagnosing heart failum, but eleetmcardiogram still has

its definte value in diagnosis, following, and pmgnosis of

the disease

OAT VAN Dt

Suy tim xay ra khi tim khdng dgp ung cung lupng d l

duy tri kha ngng chuyin hda eiia ca thi . [8]

Tgi Chau Au vdi tren 500 trigu dan, udc lupng ti n

suit suy tim tu 0,4-2%, do dd cd tu 2 trigu di n 10 trigu

ngudi bj suy tim, vdi 400.000 ca mdi mdi ngm. [2]

Tgi Vigt Nam theo sd lipu tu 1991-1996 eiia Vign tim

mgch qudc gia, suy tim chilm khoang 50% sd bgnh

nhgn nhgp vign. Tgi bgnh vign Chp Riy trong thdi gian

tu thgng 6/1999 di n thang 3/2000 ed khoang 500 bgnh

nhgn suy tim nhgp vign, ti Ig tir vong trong sd ngy lg

5,2%. [3]

Phan Idn cgc bgnh nhgn suy tim tgi cgc nude tien

tiln la do bgnh dpng mgch vanh, bgnh tang huylt ap,

bgnh CO tim dan nd vi mpt sd bgnh tim khae. Tgi Vigt

Nam, do ti n suit bgnh van tim do thip cdn cao, su

phgn phdi nguyen nhgn ed th i khgc. Tuy nhien, cgc

nguygn nhgn ehinh eiia suy tim van lg tang huylt ap,

bgnh dgng mgch vanh, bgnh van tim ...[8]

Ngay nay, mgc dii cgc phuang tign chin doan y

khoa phat tien cao, nhung dign tam dd vi n cd gia trj

trong chin doan va theo ddi bgnh tim mgch.

Dign tam dd khdng giiip chin doan suy tim, tuy nhien

dign tgm dd thudng bit thudng d bgnh nhgn suy tim

ngng, ddng thdi ed th i gai y nguyen nhgn suy tim. j9]

0 6 l TU'Q'NG VA PHU-QNG PHAP NGHIEN CU-U

Thiet k l nghien cuu: Bgnh chung.

Ddi tupng nghign cuu:

Din so mgc tieu: Bgnh nhgn suy tim tU 60 tudi trd

Ign tgi tinh Tiln Giang.

Din so chgn mau:

cac bgnh nhan tu 60 trd ldn nhgp khoa tim mgch

(Bgnh vign da khoa trung tgm Tiln Giang) tu 07/2004-

07/2005 dupe chin dogn xae djnh suy tim.

Tieu chuau logi trir. Nhdi mau ca tim d p tren bgnh

nhgn suy tim.

PHAN VAN TUAN

Camau:

[z^-aJ2 ^^p?r'pT+z,-p\^PuT^^p;riT^rr^^p?f

N=

(P.-P2)'

N = 125

Phwang phip lay mau: Chpn ngau nhign.

Tieu chuan chin doin suy tim cua Framingham

Phuang phgp do dign tgm dd

- Chiing tdi do dign tgm dd bing may Cardisumy

501B - III mpt ein, do cdng ty Fukuda (Nhgt Ban) san

xuit ngm 2001.

- cac bgnh nhan nghign cuu, sau khi nhgp khoa tim

mgch (Bgnh vign da khoa Tien Giang) dupe nl m nghi

15 phiit, sau dd tgc gia do dign tgm dd theo diing

phuang phgp.

K^T QUA

1. Gidi tinh

Nhdm NC: Nu: 56,8%; Nam: 43,2%

Nhdm Chung : NU: 59,2%; Nam: 40,8%

Trong 125 bgnh nhgn suy tim Idn tudi, ed 71 bgnh

nhan nu (ti Ig 56,8%), 54 bgnh nhgn nam (ti Ig 43,2%).

Ti Ig mac bgnh suy tim nam/nir = 1/1,3.

2. Tudi: lUa tudi ml e bgnh suy tim thip nhat 60 tudi,

cao nhit 94 tudi, tudi trung binh lg 75,26 ± 8,71. LUa tudi

tren 80 chilm ti lg eao nhat (39,2%).

3. Nai cu ngg: bpnh nhgn d dja ban ndng thdn

khoang 75,6%, dja ban thanh thj chiem khoang 24,4%.

4. Phan dp suy tim: suy tim ngng (dp III, IV) chiem ti

Ig eao 63,2%.

5. Ti n sd: ti n sd tim d bgnh nhgn suy tim Idn tudi lg

104,26±26,5.

6. Nhjp tim: Logn nhjp tim chiem ty Ig 84% d bgnh

nhan suy tim Idn tudi, trong dd nhilu nhit la nhjp nhanh

xoang ty Ig 18,4%, k l den lg rung nhT 16,8%.

Mdi iua.ig quan giira nhip va 2 nhdm nghien cuu

Nhip

Nhip xoang binh thudng

Nhip Chgm xoang

Nhip nhanh xoang

Ngogi tgm thu nhi

Ngogi tgm thu that

Block AV dp 1

Rung nhT

Block nhgnh trai

Block nhanh phai

Logn nhip khgc

Tong cgng

Nhbm NC

N (%)

20(16,0)

6(4,8)

23(18,4)

10(8,0)

11 (8,8)

12(9,6)

21 (16,8)

13(10,4)

9(7,2)

0

125(100,0)

Nhbm chirng

N (%)

60 (48,0)

8(6,4)

21 (16,8)

9(7,2)

6 (4,8)

3(2,4)

4(3,2)

8 (6,4)

6 (4,8)

0

125(100,0)

X2 = 40.65, P < 0.001

7. Sdng P: Dgy nhT trai trgn dign tgm dd (P d DII >

0,12 gigy) d bgnh nhgn suy tim Idn tudi chiem ti Ig

57,7%, dgy nhT phai la 11,6%.

8. Khoang PR: PR dai 11,6%, PR ngln 3,8%.

9. Phue bp QRS: Thdi gian QRS trung binh la

0,089 ± 0,023 giay, QRS dan chilm 15,2%, day that trai

tren dign tgm dd d bgnh nhan suy tim Idn tudi khoang

Y HOC THUC HANH (741) - S 6 11/2010 75