Nhận xét về chỉ định mổ lấy thai trong tiền sản giật

TCNCYH 71 (SJ - 2010

Summary

RESULT OF TREATMENT ON THE ELDERLY MULTIPE MYELOMA PATIENTS

BY MP PROTOCOL IN THE DEPARTMENT OF HEMATOLOGY AND

BLOOD TRANSFUSION IN BACH MAI HOSPITAL

Objectives: (1) To study some changes of clinical features and laboratory tests in the elderly patients

with multiple myeloma treated by MP protocol. Method: 25 patients above 60 years elder diagndsed mul￾tiple myeloma and taken MP protocol. Results: rate of anemia reduced from 88% to 55% after 3"" course,

rate of bone pain reduced from 80% to 52% after 2"' course, Hb increased from 74.1 ± 29.7 g/l to 114.9 ±

.19.7 g/l after 3"^ course, all of total protein, globulin, paraprotein and creatinin reduced after 3"' and 4"'

courses of treatment, rate of patients with hypercalcinemia (> 2,6 mmol/l) reduced from 20% to 0% after

4"' course, rate of bone lesions reduced from 80% to 52% after 2''' course. Conclusions: MP protocol had

good outcome for the elderly patients with multipe myeloma: reduced anemia and bone pain, increased

Hb, reduced total protein, globulin, paraprotein, creatinin and bone lessions in radidlogieal investigation.

Keywords: multiple myeloma, melphalan and prcdnlslon

NHAN XET VE CHI DINH MO LAY THAI TRONG TIEN SAN GIAT • • •

Dao Thj Thanh Hfldng, Dang Thj Mlnh Nguyet

. Benh vien Pht^i san Trung (Jang

Muc tieu: nhan xet cic chi djnh mo lay thai tren thai phu tiin sin giat tai benh'vien Phu san Trung (Jang

nim 2008. Ddi tugng va phuang phap nghien ctfu: Cic thai phu cd tudi thai td 28 tdin trd len, ddac cha'n

doin bj TSC, SG; nhap vien, theo ddi vi diiu trj tai benh vien Phu san Trung uang trong nam 2008. Loai trd:

cac thai phu cd cic benh kem theo nhd: benh tim, benh gan, benh Basedow, benh dii thio dddng, thieu

miu, rau tien dao. Phifang phip nghien cdu li hoi cdu md ta cit ngang. Kit qua: T'y le md lay thai trong

nhdm thai phu bj TSC la 86,35%o. T'y 1$ mo liy thai cua nhdm chda chuyen da (89,44%o) cao han nhdm

chuyen da (80,22%o), trong dd chi djnh mo vl suy thai cao nhi't chiim 34%o, dieu tri ndi khdng kit qua 31 %o,

tien sin giat ning 16%o, biin chdng cua tiin san giat 12%o va vl cac nguyen nhan khac 7%o. Sd khic biet nay

cd y nghTa thdng ke (/ = 4,3628; p = 0,037 < 0,05). Chi djnh mo lay thai do TSC nang li 18,38%,, TSG cd

bien chdng la 8,97%o. Diy la nhdng chi dinh mo tuyet ddi de cdu me. Chi djnh md do diiu trj khdng ket qua

la 6,47%. Kit luan: Ty le mo liy thai ddi vdi cic thai phu bj TSG li: 86,35%o, mo lay thai khi chda chuyen

da (68,80%o). CM djnh mo liy thai khdng xuat phit td benh ly TSC trong nhdm thai phu chuyen da (54,05%o),

do TSC nang li 18,38%o, TSC cd biin chdng la 8,97%o, chi dinh mo do diiu tri khdng kit qua la 6,41%o. Chi

dinh mo liy thai d nhdm chda chuyen da cao nhi't li suy thai 34%o.

Tii khoa: md lay thai, tien san giat

I. DA T VA N D E tri trigu chflng, chfla dieu tri dflpe nguyen nhan va

Nguygn nhan va ed ehg' bgnh sinh cua TSG vige tien Ifldng gap nhieu khd khan. Khi thai c;dn

v i n chfla dfldc chflng minh va hig'u biet di y du. nam trong tfl eung, du dieu tri tieh cflc thi tinh

Vi vay, trong dieu tri mdi chi dflng d cap dp dieu trang me vi n ed thg' nang Ign, thai ed nguy eo

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