Nội soi phế quản ống cững chẩn đoán ung thư phế quản tại khoa hô hấp bệnh viện Bạch Mai

T A I LIEU THAM KHA O

1. Ta Van Binh (2006), "Bpnh Oai Thao Dudng tang

glucose mau" tr.11 -14.

2. Le Thj Thanh Nhon (2002), " Nhan xet tinh trang

quanh rang tren benh nhan Oai thao dudng", Luan an

thae sTy hgc - Tnedng Dai hgc Y Hi Ngi.

3. Academy Report (2000), " Diabetes and

periodontal disease" J. periodontol 2000; 71: 664 - 678.

4. Gugliemo Campus va CS (2005), " Diabetes and

periodontal disease: A case

control study" J. periodontol 2005; 76: 418 - 425,

5. Steven P, Egebretson (2004), " Gingvival

crevicular fluid levels of interleukin - 1 beta and glycemic

control in patients with chronic periodontitis and type 2

diabetes" J, periodontol 2004; 75: 1203 -1208.

6. Sergio Guzman (2003), " Association between

interieukin - 1 genotype and periodontal disease in a

diabetic populatoin" J. periondontol 2003; 74: 1183 -

1190.

NQI SOI PHE QUAN ONG CUfNG CHAN DOAN ONG THO PHE QUAN

TAI KHOA HO HAP BENH VIEN BACH MAI

TOMTAT

Ngl soi phi quan la mgt ky thuat tham dd c§n thiit

trong benh ly cua ca quan hd hap. Ndi soi phi quan cd

hai logi ong so (dng cirng va dng mim). Ong ndi soi phi

quan cung b ang kim loai da cd tu han 100 nam nay.

1967 ong soi mim do S. Ikeda (Nhat ban) phat minh da

dugc ung dung rdng rai a nhiiu nude. Mac du da ed ong

soi mim ong soi phi quan bang kim vin khing djnh

dugc gia tri cua nd trong chin doan va diiu tri bgnh phoi

Muc tieu: danh gia higu qua chin doan cua ky thuat ngi

soi phi quan ong cirng trong chin doan ung thu phi

quan tgi khoa Hd hap Bgnh vign Bach mai. Doi tugng:

142 trudng hgp ed lam sang, Xquang, ehan doan md

bgnh te bio hgc xac djnh ung thu phi quan dieu tri tai

khoa trong nam nam 1996-2000. Phuang phap: Ngi soi

phi quan bang ong soi cimg Fridel (CHDC Diec). Quy

trinh ehuan bj soi va cae dung eg kem theo nhu vdi mgi

cudc soi thiedng quy. Tiin hanh sol phi quan va thue

hign cae ky thugt liy bgnh pham chin doan. Dung eg

gom kim sinh thiit eung, kim chgc hut tu tao ca kim 21

G, dai 3 cm, lam kinh dan bgnh pham. Dgc va djnh typ

tai khoa Hd hap Benh vien Bach mai.Kit qua: 142

tnedng hap nghien cieu (127 nam, 15 nie), cd 111 tnedng

hap tren 50 tuoi. Dau nguc, khd thd, ho mau la 3 trigu

chimg quan trgng, hay gap. Ton thieang ngi soi phi

quan: u thiy rd trong Idng khi phi quan 28 trudng hgp,

tham nhiim niem mac phi quan chiim hang thu 2 vol

24 trudng hgp. Cua phi quan gian rgng 66 trudng hgp

(48%). Cac ky thugt ap dung trong ngl sol phi quan sinh

thiet phoi hgp vdi cac ky thuat khac 76 tnedng hgp.

Chgc hut bang kim 66 tnedng hgp. Chan doan md benh

te bao: 76 (53,5%o) trudng hgp ung thu biiu md vay, 27

trudng hgp(19%,) ung thu bieu md tuyin 16 (11%,)

tliudng hgp ung thu ti bao nhd. Kit luan: soi phi quan

dng cirng chan doan tren 142 trudng hgp ung thu phi

quan sinh thiit phi quan chin doan cho tren 53,5%, sd

trudng hgp.Chgc hut bing kim ehin doan dugc 128

trudng hgp(>90%,) so bgnh nhan. Ky thuat an toan

khdng cd tai biin nao cin phai can thigp.

Tu khda: Ndi soi phe quan, Chgc hut kim nho xuyen

thanh phi quan, ung thu phi quan

SUMMARY

Bronchoscopy is one of many neccesary technic for

the diagnosis in praetic in Pulmonary disease.Ojective:

HOANG HONG THAI

Bo mon Ngi - Dai hgc Y Ha Ngi

evaluation of the result of transbronchial Needle

Aspiration on bronchoscopy by rigid tube for the

diagnosis and staging in patients who had

bronchogenic carcinoma

Material and method: Bronchoscope tube rigid of

Fridel (Germany). Cross -sectional retospectif study.

Subjects: Transbronchial needle aspiration by tube rigid

for the diagnosis and stging of bronchogenic carcinoma

was pertormed in 142 patients of Respiratory

Department of Bach Mai hospital from 3/1991 to 8/1996.

All patients who had malignant disease on clinic, chest

radiography.Results Endoscopic and both histologic and

cytologic specimens demontrating malignancy. 76

patients with squamous cell carcinoma (53.53%,) and 27

with adenocarcinoma (19.01%,). 16 patients with small

cell carcinoma (11.26%,). 9 patients with

adenosquamous (6.33%), 7 patients with large cell

(4.94%) and 5 patients were difficult to typage (3.52%,).

Conclusion: transbronchial needle aspiration is a safe,

and effective procedure to obtain a deep specimens of

extrinsic compression or submucosal tissue for the

diagnosis and staging of bronchogenic carcinoma. This

technic is low risk.

Key words: Bronchoscopy, carcinoma.

DAT VA N DE

Npi soi phe quan ehin doan trong ITnh vuc hd hip la

ky thuat da dupc su' dung tCr hon th l ky nay. Cung vdi

lam sang Xquang, nd tao thanh bp ba chin doan quan

trpng ddi vdi eae thay thudc

Ngoai cac tripu ehCrng lam sang, Xquang giup chin

doan t l bao hpc, md hpc ed y nghTa quylt djnh.

K l tCr khi S. Ikeda (Nhat Ban) la ngudi di u tien phat

minh ra loai dng soi mim . Nd dupe sCr dung rdng rai

trong tham kham khi ph i quan. Tuy nhien dng soi ph i

quan bing kim loai vi n edn nguyen gia tri cua nd trong

chin doan, trong dilu tri bpnh ly phi quan hipn nay.

Npi soi dng eCrng, tai khoa Hd hap benh vien Bach

Mai da dong gdp phin Idn trong chin doan xae dinh eho

nhilu bpnh nhan nhd vao ap dung mpt sd ky thuat phdi

hpp lay benh phim trong khi soi.

Vi vay, chung tdi dgt vi n d l nghien eCru gia tri eua

eae ky thuat phdi hpp liy benh phim qua ndi soi dng

eCrng d nhQ'ng bpnh nhan ung thu phi quan qua d l tai:

"Ngi soi phi quan ong cung va hieu qua cua eac ky thuat

Y HOC THVC HANH (667) - SO 7/2009 61