Tìm hiểu mối liên quan giữa một số yếu tố xã hội, môi trường và sức khỏe với ung thư cổ tử cung ở phụ nữ 12 tỉnh Việt Nam

TIM HIEU MO I LIEN QUAN GIQA MOT SO YEU TO XA Hdl, MO I TRU&NG VA SllC KHOE

von UNG THircd TUT CUNG O PH U NGf 12 TiNH VIET NAM

TOM TAT

Nghien cOv bgnh - chimg nham tim hieu mdi lien

quan giira mgt sd yiu td xi hgi, mdi tnrdng va sire khde

vai tinh trgng ung thw cd tir eung d phu nw 12 tinh miin

Bic Vigt Nam. Ddi twgng nghien cuv bao gdm 611 ea

bgnh (ung thw CTC) va 1833 ea chwng (khdng bj ung

thw CTC). Kit qua cho thiy: 1) Nguy ea mic ung thw

CTC cao ban a nhdm phg nir lam mdng, ed thdi gian

phai nhiim vdi khdi thudc li eua chdng tren 100 diiu vi

tren 5 nam, thdi gian phai nhiim vdi khdi thudc lao cua

chdng tren 1000 dieu vi tren 5 nam, ed tiin sir bj viem

nhiem dwdng sinh dgc, viem im dgo do triing roi, da

timg thgt rira im dgo va phau thugt eat budng trimg. 2)

Khdng ed mdi lien quan giira ung thw CTC vdi cic yiu td

li: trinh dd vin hda, phg nir ed tien sw hut thudc la/thude

Iio tren 100 dieu, viem im dgo do lgu ciu vi sd ben

budng trimg bj dt. 3) Cin cd them nhung nghien ciru

khac vai quy md rgng han di gdp phin tim hieu nguyen

nhin mac bgnh, tu dd giup phat hign sdm vi dieu tri kjp

thdi cho ngwai bgnh.

Tw khda: xa hgi, mdi trwdng, sire khde, ung thw ed

tir eung, phu nir

SUMMARY

The case-control study aims to define the

mlationship between the social factors, envimnment,

health and the situation on cervical cancer in women in

12 Northem pmvinees of Vietnam. The study subjects

included 611 disease cases (cervical cancer) and 1833

contml cases (non-cervical cancer). The msults show

that: 1) The cervical cancer risk was found a higher rate

in the women who were fanners with the time of

exposum to tobacco smoke s 5 years and s 100

eigamttes and to pipe tobacco smoke ^ 5 years and s

1000 eigamttes from their husbands, the history of

genital tmet infection, vaginitis due to trichomonas,

vaginal douching and ovariotomy; 2) Them is no

relationship between the cervical cancer with the factors

of education, history of women in tobacco/pipe tobacco

smoke s 100 eigamttes, gonococcal, ''aginitis and the

number of ovary sides; 3) It should have further other

studies with the larger scale to expose the causes of

cervical cancer, then to help the eariy detection and

timely tmatment for the patients.

Keywords: social factors, envimnment, health,

cervical cancer, women

OAT VAN O^

Theo du bgo ciia Td chuc Y t l Thi gidi, trong md

hinh bgnh tgt ciia thi ky 21, cae bgnh khdng nhiem

triing, trong dd cd bpnh ung thu, lg nhdm bpnh chu ylu

de dpa sue khde eon ngudi. Tgi Vipt Nam, udc tinh

hang ngm cd khoang 100.000-150.000 trudng hpp mle

mdi ung thu va cd khoang 70.000 ngudi chit vi can

bgnh nay [2]. Trong dd, dang chu y la ty Ig tir vong cao d

nir gidi bj ung thu cd tir cung, ehi sau ung thu vu [4].

Vdi muc dich tim hilu nguyen nhan mle bpnh, d l tgi

DOAN TRONG TRUNG, D?/hpc y TW/B/nh

"Nghien cuu mpt sd ylu td xa hpi, mdi trudng va sue khde

lien quan din ung thu ed tir cung d phy nO' 12 tinh Vigt

Nam" da dugc tien hanh. Kit qua nghien cuu cd thi se

gdp phin tim ra eac giai phap kha thi d l hgn ehl ty Ig mle

mdi, phat hipn sdm va dilu tri kip thdi cho ngudi bgnh.

D 6 I TU'P'NG VA PHU'CNG PHAP NGHIEN Cl/U

1. odi tirgng nghien ciru

Ddi tugng nghien cuu la nhttng phu nii' sinh vgo giai

dogn tu diu nam 1947 din hit nam 1966, dupe chia

thanh 2 nhdm:

- Nhdm bgnh: Lg tit ca nhung trudng hgp bj ung thu

CTC nguyen phat, duge xae djnh thdng qua chin doan

t l bao hpc hogc md hpc dang sinh sdng tgi 12 tinh cua

Miln Blc Vigt Nam: Nam Djnh, Ha Nam, Thai Binh, Hai

Duang, Hung Yen, Ha Tay, Blc Giang, Blc Ninh, VTnh

Phiie, Phu Thp, Ninh Binh, Nghp An.

- Nhdm chung: La nhirng phu nu khdng bj ung thu

CTC dugc lua chpn ngau nhien tu nhUng ngudi sdng ciing

thdn/ban, eung nhdm tudi vdi ddi tugng bj ung thu CTC. -

2. Dja ban vi tho'i gian nghien eu'u

Nghien cuu dupe tien hanh tgi 12 bgnh vign d Ha

Npi la Bpnh vipn K Trung uang, Bpnh vign Phy san

Trung uang, Bgnh vipn Vipt Dire, Bgnh vign Bgch Mai,

Bgnh vipn Qugn y 108, Bgnh vign Qugn y 103, Bgnh

vign phu san Ha Npi, Bgnh vign Giao thdng, Bgnh vign

Buu dign, Bpnh vipn U budu Hg Npi, Bpnh vign Thanh

Nhan, va Bgnh vipn E va 15 bpnh vign tuyln tinh lg

Bpnh vipn da khoa eac tinh Nghp An, Ha Nam, tinh

Hung Yen, Ha Tay, khu vuc San Tay, Blc Ninh, VTnh

Phue, Phu Thp, khu vuc Phii Thp, Hai Duong, Trudng

Dgi hpe Y Thai Binh va bgnh vign phy san cae tinh Nam

Djnh, Tliai tiin.\, Blc Giang. Day la cae bgnh vign cd du

kha nang kham lgm sgng, cgn lam sgng, liy mau va co

dinh bgnh phim ung thu phu khoa dgt tieu chuin qui

djnh eiia Bp Y tl . Chin doan xae djnh la ung thu CTC

dupe thuc hign tgi bgnh vign K trung uang.

Thdi gian nghien cuu: bit diu tU 9/2001 - 8/2006.

3. Thilt k l nghien eu'u

Lg mpt nghien cuu bgnh - ehung.

4. Cd" mau vg phifcrng phap chpn mlu

- Ap dyng edng thuc tinh cd mau cho nghign cuu

bpnh Chung:

n=Z2(a^){1/[pi(1-pi)] +1/[p2(1-P2)]}/ [ln(1-€)]^

_^ Cd mau xgc djnh duge che nhdm bgnh la 608; cd

mau che nhdm chung dugc liy gIp 3 lin cd mlu nhbm

bpnh. Thue tl , nghien cuu da tiln hanh tren 611 ca

bgnh (ung thu CTC) vg 1833 ea chung (khdng bj ung

thu CTC).

- Chpn mau: Cac ca bpnh dugc lua chpn tu tit ea

cae bpnh vign ciia cua cac tinh thupe dja ban nghien

cuu va 12 bgnh vign d Ha Npi. Chpn ea ehung: vdi mdi

mpt ddi tugng ung thu CTC dugc xae djnh thi cd ba doi

tugng ehung duge lua chpn ngau nhien tu nhung phy

nu song cimg thdn ban vi sinh cung nhdm thdi gian vdi

ddi tugng bj ung thu.

86 Y HOC THUC HANH (741) - SO 11/2010