Tỷ lệ nhiễm HIV ở các nhóm đối tượng nguy cơ tại Hà Nội trong 10 năm (1996-2005)

Sui tai vCing mep trudc: 2 ca 6,25%, dinh tai phat 15

ea (46,88%).

BAN LUAN

1. Dac diem lam sang cua dinh mep tru'dc DT 2

ben

- Tudi va gidi: Ti le mac benh cua nii' (87,5%) nhilu

gip 7 lin nam (12,5%). Sd dT nir mie nhilu hon nam vi

nip CO ti le phau thuat u lanh tinh DT nhieu hon nam [1],

[2]. Tudi ed ti le mic benh cao nhit la tip 36-55 tudi

(68,75%).

- Nguyen nhan: Do ehin thuong ehilm 50% trong dd

chu ylu la do thiy thudc gay ra, sau phau thuat u nhu 4

ea (12,5%), sau cat hat xo 8 ca (25%), 2 ca do dat ndi

khi quan, 2 ea do tai nan giao thdng. Nhu vay, nen than

trpng hon trong viee can thiep vao DT va dat npi khi

quan.

- Nguyen nhan do viem nhiem gap 4 ca sau cum

(12,5%), cdn 3 trudng hpp sau dilu tri lao TQ (9,38%).

- Nguyen nhan bim sinh gap 6 trudng hop, tit ca ehi

cd dj dang TQ don thuan khdng phdi hpp vdi cac dj

dang khae eCia eo thl [4].

+ Lam sang

-Khan tilng la trieu ehCrng quan trpng nhit gap d

100% trudng hop, chu ylu la khan nang, mit tilng [5].

-Khd thd TQ dp II (8/32 ea-25%) phai tiln hanh md

khi quan trudc khi phau thuat, khd thd TQ dp I

(21,88%).

- Thuc thl dua vao kham TQ: dinh dp 1 cd ti Ip eao

nhit 40,63%, mCre dp nay ehu ylu gap d nhCrng benh

nhan co can thiep tren day thanh [3], Dp 4 cd ti le cao

thu 2: 25%, gap 2 benh nhan chin thuong TQ do tai

nan giao thong, sau eat u nhu TQ 2 ea, mang dinh bim

sinh 3 ea, va sau lao TQ 1 ea. Day la nhQ'ng trudng hop

see dinh kha day, can thiep rit khd khan. Dinh dp 3:

21,88%, dp 2 cd tlje thip nhit 12,5%,

2. Danh gia kit qua phiu thuat

- Kit qua dilu tri: Kit qua tdt: 53,13%, tuy vpy, ti Ip

thanh cong nay cao hon nhilu so vdi phiu thuat tach

dinh don thuin trudc day, kit qua tdt chi dat 20% [5].

Kit qua trung binh 25%, gipng van cdn khan nhung da

giao tilp duoc, khdng phai deo canuyn. Kit qua xiu:

21,87%, cd 3 ea dinh tai phat dp 3 vin phai deo canuyn,

cdn 4 benh nhan gipng khan nang, giao tilp khd khan do

dinh hit chilu cao DT nen bd tu do tdn thuong nhilu.

- Tai biln, biln chCrng

- Sui tai vimg mep trudc: 2 ca 6,25%, day la mpt

trong nhirng biln ehung thudng gap trong cac can thiep

tren DT [3], vi vay, viec phau thuat DT phai hit sire than

trpng nhit la d nhtpng bpnh nhan cd co dia spo ldi.

- Dinh mep trudc tai phat (46,88%) mac dii da sii'

dung thudc uc ehi tang sinh TB: Mitomycin C, cho thiy

mirc dp khd khan cua phau thuat.

KST LUAN

1. Dac diem lam sang dinh mep tru'dc DT 2 ben:

- Khan tilng la tripu chung quan trpng nhit gap 6

100% trudng hpp.

- Khd thd TQ dp II (8/32 ca-25%) phai tiln hanh mo

khi quan trudc khi phiu thuat, khd thd TQ do I

(21,88%).

- Thuc thl dua vao kham TQ: dinh dp 1 ed ti Ip cao

nhit 40,63%, Dp 4 cd ti le cao thu 2: 25%, dinh do 3:

21,88%, do 2 cd tijp thip nhit 12,5%

2. Danh gia ket qua phlu thuat

- Kit qua phau thuat: Ndi soi cit- tach dinh cho ket

qua tdt: 53,13%, kit qua trung binh 25%, kit qua xiu:

21,87%. Vi vay, d l tranh dinh mep trudc DT cac nha

TMH ein rat than trpng khi can thiep tren DT, khi viem

TQ do cung nen dilu tri triet d l phdng dinh mep truoc

DT.

TAI LIEU THAM KHAO

1. Trin Viet Hdng, Huynh Khac Cudng (2000), Crng

dyng kT thuat npi soi dng cung vao vi phau TQ, Y hoc

thanh phd Hd Chi Minh, sd dae biet hpi nghj KHKT

Trudng Dai hpcY DuocTP. HCM lin thCr 19,1.69-72

2. Truong Ngpe Hung, Huynh Ba Tan (2005), Vi

phau thuat TQ qua npi soi tai khoa Tai Mui hpng Bpnh

vien Oa Nlng, Ki yiu cae edng trinh nghien cieu khoa

hgc hdi nghj khoa hgc nganh Tai Mui Hgng, tr. 216-22

3. Trin Phan Ctiung Thuy, Pham Thanh Son (2005)

Dilu tri lipt eo md thanh quan tai khoa Tai Mui Hpng

bpnh vien Chp Riy, ki ylu cdng trinh nghien eCru khoa

hpc, hpi nghj khoa hpc nganh TMH nam 2005, T.223-30

4. M. Hardingham and G.P, Walsh-Waring, (1975)

The treatment of a congenital laryngeal web. The

Journal of Laryngology & Otology, Cambridge University

Press 89:273-280

5. Tip Fakultesi Hastanesi, Kulak Buain Bogaz

Hastaliklari AD, Zeytinlibahee cad., (2004), The successful

management of congenital laryngeal web with endoscopic

lysis and topical mitomycin-C, international journal of

pediatric otortiinolaryngology, volume 68, issue 2, p. 231-

235

TY LE NHIEM HIV 0 CAC NHOM DOI TOONG NGUY CO

TAI HA NOI TRONG 10 NAM (1996 - 2005)

NGUYEN DLTC CHUNG - Trung tam Y te Du phdng Ha Ngi

TRAN THj BfCH TRA - Cue phdng chong HIV/AIDS,Bg Yte

TOM TA T

Human Immunodeficiency Virus (HIV) dang la dai

dich lam anh hudng den sire khoe cgng ddng, nen

kinh te ciia moi qudc gia, moi dan toe. Giam sat djch

te hgc HIV de du bao dien bien cCia djch la rat can

thiet. Muc tieu: Mo ta t^ le nhiem HIV d cac nhdm

nguy ca trong 10 nam 1996 -2005 va nhan xet dac

diem lay nhiem HIV tai Ha Ndi. Ddi tugng va phuang

phap: 3200 mau huyet thanh cOa 6 nhdm nguy cO

khac nhau duac xet nghiem phat hien khang the

khang HIV theo phuang each ll cCia bd Y te, ket qua

giam sat HIV tir nSm 1996-2004. Ke't qua: nSm 2005

t^ le nhiem HIV d nhdm chich ma tuy (CMT) la 27,5%,,

gai mai dam (GMD) la 13%o, phu nu" mang thai

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