CHN ON TRC SINH BNH THALASSEMIA TRN 290 TRNG HP THAI

Nguyn Khc Hn Hoan1, Phm Vit Thanh1, Trng nh Kit2, Lm Th M2

1

Bnh vin T D, 2 i hc Y Dc TPHCM

- v -thalassemia l bnh thiu mu di truyn ph bin ti Vit Nam. Chn on trc sinh nhm pht hin sm v can thip cc trng hp thai mang gen bnh ng hp t l bin php phng nga tch cc v hiu qu. Mc tiu: Phn tch c im phn b t bin gen thalassemia trn cc trng hp chn on trc sinh ti Bnh vin T D t 1/12/2007 n 31/3/2010. i tng v phng php: Tt c cc trng hp thai ca cc cp v chng mang t bin gen - hoc -thalassemia c chc i v chn on tm alen t bin bng k thut ARMS, gap-PCR, enzyme hn ch v MLPA. Kt qu: 290 thai c chn on trc sinh, pht hin 207 thai c t bin (207/290; 71,4%). Trong s , 128 thai b t bin -thalassemia (128/290; 44%) cao hn 2 ln so vi s thai b t bin -thalassemia (59/290; 20,3%), 20 thai (20/290; 6,9%) mang ng thi t bin v -thalassemia. C 62 thai (62/290; 21,4%) mang kiu gen nng gm: Hb Barts (38/290; 13,1%), Hb H (9/290; 3,1%), -thalassemia nng (15/290; 5,2%). T l alen t bin -thalassemia (67,2%) hn gp i -thalassemia (32,8%) trong tng s 287 alen c pht hin. t bin --SEA v Hb E chim a s, tip theo l -3.7, codon 41/42 TCTT v codon 17 +A. C 59 trng hp ng chm dt thai k (59/290; 20,3%). 100% kt qu kim nh sau sinh u ph hp vi chn on trc sinh. Kt lun: T l -thalassemia cao hn 2 ln so vi thalassemia. t bin --SEA, - 3.7, Hb E, codon 41/42 TCTT v codon 17 +A l cc t bin ph bin nht. Chc i v chn on trc sinh bng k thut multiplex ARMS, multiplex gap-PCR chnh xc v an ton. T kha: thalassemia, chn on trc sinh, t bin gen globin

Summary PRENATAL DIAGNOSIS OF THALASSEMIA ON 290 FETUSES

- and -thalassemia are common inherited anemia disorders in Vietnam. Prenatal diagnosis in order to early detect and terminate fetuses with homologous genotype is an active and effective prevention method. Objective: to investigate the distribution of thalassemia mutations among prenatal diagnosis pregnancies at Tu Du Hospital in 1/12/2007 to 31/3/2010. Method: Amniocytes of all pregnancies of - or -thalassemia carrier couples had prenatal diagnosis for mutation alleles with ARMS, gap-PCR, restriction enzyme and MLPA. Result: There were 207 out of 290 fetuses having mutation (207/290; 71.4%). Among those, 128 fetuses (128/290; 44%) had -thalassemia mutations that were more than twice to 59 fetuses with -thalassemia (59/290; 20.3%) and 20 fetuses (20/290; 6.9%) inherited both - and -thalassemia simultaneously. Sixty two fetuses (62/290; 21.4%) had severe genotypes including Hb Barts (38/290; 13.1%), Hb H (9/290; 3.1%) and -thalassaemia major (15/290; 5.2%). -thalassemia allele rate (67.2%) was higher than thalassemia twice (32.8%) in 287 detected alleles. --SEA and Hb E alleles were most common; 3.7 then were - , codon 41/42 TCTT and codon 17 +A alleles. There were 59 cases accepting TOP. All postnatal confirmations were consitent with prenatal diagnosis results. Conclusion: Rate of -thalassemia was more common than -thalassemia. Mutation SEA, -3.7, Hb E, codon 41/42 TCTT and codon 17 +A were most common. Amniocentesis and prenatal diagnosis with ARMS and gap-PCR were precise and safe. Key words: thalassemia, prenatal diagnosis, globin gene mutation, prevention

C TNH CA SHELLAC F I VI DNG T BO L929

Hong o Bo Trm1,2, Hong T Hng1, Imad About2
1

i hc Y Dc Thnh ph H Ch Minh, Vit Nam. 2 i hc Mditerrane, Marseille, Php.

nh gi c tnh ca Shellac F i vi dng t bo L929. Phng php: Phng php th c tnh vi t bo qua cht tit t vt liu theo chun chu u ISO 10993-5. T bo c nui cy trong cc mi trng tip xc vi vt liu th, cc nng khc nhau (pha long theo t l 1:1, 1:2, 1:10, 1:100, 1:1000, 1:10000). Mt t bo c nh gi bng th nghim MTT, s dng my quang ph k E 960 (Bioblock, Strasbourg, France) bc sng 550nm. Kt qu: Shellac F khng cn c tnh mc pha long mi trng l 1:10 (t l t bo sng trung bnh l 92,36%), tng ng vi Duraphat (93,09%), trong khi Isodan khng c pha long 1:100 (t l t bo sng trung bnh l 96,85%). Kt lun: i vi dng t bo L929, mc c tnh vi t bo ca Shellac F tng ng vi Duraphat v thp hn Isodan. T kha: Shellac F, c tnh vi t bo, t bo L929

Summary CYTOTOXICITY OF SHELLAC F ON L929

Objective: To evaluate the cytotoxicity of Shellac F on L929. Methods: The cytotoxicity test was performed on L929 according to the Europe Standard ISO 10993-5. Cells were incubated in material-contacted medium with different dilutions (1:1, 1:2, 1:10, 1:100, 1:1000, 1:10000). A succinyl dehydrogenase (MTT) assay was performed and the absorbance of each 96-well dish was determined using an automatic microplate spectrophotometer (E 960, Bioblock, Strasbourg, France) at 550nm. Results: Shellac F and Duraphat were non-toxic at the dilution of 1:10 (average cell viability: 92.36% and 93.09%) and Isodan at 1:100 (96.85%). Conclusions: Using 929 as test cell, Shellac F showed a toxicity which was similar than that of Duraphat and lower than that of Isodan. Key words: Shellac F, cytotoxicity, L929

HO M MIN DCH U BIU M BUNG TRNG GIP BIN V UNG TH BUNG TRNG
L Quang Vinh
Bnh vin Ph sn Trung ng Nhn xt s bc l mt s du n min dch trong cc u biu m gip bin v ung th bung trng. i tng v phng php: chn on hi cu cc tiu bn m bnh hc v thc hin nhum ho m min dch ti Trung tm Gii phu bnh - T bo bnh hc Bch mai v Khoa Gii phu bnh - Bnh vin K H Ni vi 4 du n (CK7, CK20, p53, Ki67) 102 trng hp u biu m bung trng (bao gm 87 trng hp ung th biu m bung trng v 15 trng hp u biu m gip bin) c iu tr ti Bnh vin Ph sn Trung ng t 1/2000 n 12/2007. Kt qu v kt lun: nhum ha m min dch cho thy: 100% cc u gip bin v 88,5% u c tnh dng tnh vi CK7; 80% u gip bin v 86,2% u c tnh m tnh CK20. CK7 v CK20 cng dng tnh chim 10,8%, cng m tnh ch c 4,9%. Ch c 20% cc u biu m gip bin dng tnh vi p53. Cc ung th thanh dch, UT dng NMTC, UT TB sng c t l bc l p53 cao nht (t 50% n 64,7%). Cc UTBM khng bit ho, ung th ch nhy v u Brenner c tnh c t l bc l du n p53 thp (t 20% n 37,5%). Cc ung th thanh dch, ung th ch nhy, UTBM khng bit ho, u Brenner c tnh v ung th dng ni mc t cung u bc l du n K67 vi t l rt cao (t 81,8% -100%). T kho: U biu m gip bin, ung th biu m, ho m min dch

Summary A IMMUNOHISTOCHEMICAL STUDY ON BORDERLINE TUMOURS AND CARCINOMAS OF OVARY

Objective: To evaluate immuno markers of ovarian epithelial tumours. Subject and method: we reviewed histologic slides and stained immunohistochemically to CK7, CK20, p53 and Ki67 at Pathology department of K hospital and Bachmai hospital of 102 ovarian epithelial tumours (including 87 carcinomas and 15 borderline tumours) admitted to National hospital of obstetrics and gynecology from 1/2000 to 12/2007. Results and conclusion: CK7 stained in borderlin tumours (100%), in carcinomas (88.5%); CK20 stained in borderlin tumours (20%), in carcinomas (13.8%); p53 stained in borderlin tumours (20%), in serous carcinoma, endometrioid carcinoma, clear cell carcinoma (50% - 64.7%); undfferentiated carcinoma, mucinous carcinoma and malignant Brenner tumour (20%-37.5%). Ki67 stained in borderlin tumours (86.7%), in carcinomas (81.8%- 100%). Keywords: Epithelial borderline tumours, carcinoma, immunohistochemical

CHN ON HNH NH U NG BI XUT H TIT NIU CAO

Bi Vn Lnh
Trng i hc Y H Ni U ng bi xut tit niu cao (i b thn v niu qun) chim khong 5% cc u biu m ng niu (1-2 trng hp/ 100000 dn/nm). Chn on xc nh v phn bit cc u ny thng da vo siu m, chp niu tnh mch v/hoc chp ct lp vi tnh. Mc tiu: Tm hiu cc du hiu hnh nh ca u ng bi xut tit niu cao v xc nh gi tr chn on ca cc phng php chn on hnh nh. i tng v phng php: 62 bnh nhn c chn on l u ng bi xut tit niu cao t 1/2006 n 9/2009 ti bnh vin Vit c. Cc d liu chn on hnh nh c so snh i chiu vi phu thut v gii phu bnh. Kt qu: nhy ca chp ct lp vi tnh: 93,50 %, gi tr d bo dng tnh: 82,69 % v gi tr d bo m tnh l 50%. Siu m l k thut c chn u tin trong thm d bnh l ny. Kh nng chn on u ng bi xut ca chp niu tnh mch cn hn ch. Kt lun: Chp ct lp vi tnh chn on tt bnh l ny. Chp ng bi xut tit niu cao ngc dng l rt cn thit trong trng hp chp niu tnh mch tht bi. Chi ra tm t bo c tnh trong soi niu qun hoc hng dn di mn tng sng chn on sm. T kho: Chp niu tnh mch, chp dng bi xut tit niu cao ngc dng, soi niu qun, u ng bi xut

Summary DIAGNOSTIC OF HIGH URINARY FRACT TOMORS

High urinary tract tumors (HUTT) consist of 5% urinary tract carcinomas (1-2 cases/100 000 people/year). Diagnosis of this disease is usually based on ultrasound, intra-venous urography (IVU) and/or computed tomography (CT). Objective: To find out the imaging characteristics of the HUTT and determine the diagnostic value of imaging models. Subject and method: There were 62 patients diagnosed with HUTT from Jannuary 2006 to September 2009 at Viet Duc Hospital. This was a observational study comparing the imaging finding with the results from surgery and pathology. Result: The sensitivity of the urinary tract CT was 93.5%, its positive predictive value was 82.69% and the negative predictive value was 50%. Urinary tract ultrasound was the first choice for exploring this disease. Nevertheless the role of IVU was still limited. Conclusion: The urinary tract CT was the good method on diagnosing the HUTT. The retrograde urography was the alternative technique if the IVU failed to find the diagnostic. Brushing the urinary tract wall on uroscopy or radioguided procedure to discovery the malign cells should be used to diagnose early the HUTT. Key words: Diagnosis, HUTT, IVU, ultrasound, CT.

GI TR CHN ON V THEO DI SAU M CA CA19-9 I VI UNG TH TY NGOI TIT

Trng Sn
Trng i hc Y H Ni nh gi hiu qu ca cht ch im khi u CA19-9 trong chn on v theo di sau m ung th ty ngoi tit (UTTNT). i tng v phng php: Nghin cu m t, kho st nng CA19-9 trn nhng BN nghi ng l UTTNT, xc nh nhy (Se), c hiu (Sp), chnh xc (Acc.) ca BN trc m (chun vng: adenocarrcinome trn kt qu GPBH) v sau m. Kt qu: 132 BN trn lm sng v siu m c du hiu nghi ng ung th tu c nh lng CA19-9 huyt thanh, sau i chiu vi kt qu phu thut v GPBH. xc nh c 76 trng hp l ung th biu m tuyn ng tu (adenocarcinoma) v 56 trng hp khng phi l ung th tu. Nng CA19-9 trung bnh ca 76 BN ung th tu l 3609,1 10178,6 (n=76). Nu ly gi tr ngng (cut-off value) l 75 UI/ml th nhy ca xt nghim l 69,7%, c hiu l 67,8% v gi tr tin on dng tnh l 74,6%. Sau m ct u, CA19-9 gim mnh t 90 - 93% so vi mc trc m (p < 0,05). Kt lun: Nng CA19-9 trc m BN UTTNT trung bnh l kh cao so vi bnh thng (3609 U/ml). Xc nh CA199/huyt thanh l bin php tt gip chn on UTTNT trc m vi nhy 70%, c hiu 68%. Vai tr cnh bo ti pht sau m UTTNT nghin cu ny cha c chng minh mt cch thuyt phc. T khoa: CA 19 - 9, ung th ty ngoi tit

Summary THE CLINICAL RELEVANCE OF THE TUMOR MARKER CA19-9 IN THE DIAGNOSING AND MONITORING OF PANCREATIC CANCER
To evaluate the role of tumor marker CA19-9 in diagnosing and monitoring of pancreatic cancer. Patients and method: Descriptive study evaluating the role of tumor marker CA19-9 in the serum of suspected pamcreatic cancer patients through its sensitivity, specificity, positive and negative predictive value before operative (gold standard: adenocarcinome) and postoperative monitoring. Results: 132 patients suspected from pancreatic cancer had been evaluated CA19-9 concentration in serum before operation and confirmed thereafter by pathological examination as if pancreatic cancer or not. 76 cases have been confirmed as pancreatic cancer and 56 cases as others. The mean value of CA19-9 from serum samples pre-operation of 76 pancreatic cancer patients is 3609.1 10178,6. If taking the cut-off value of CA19-9 as 75UI/ml, sensitivity (Se) would be 69.7%, specificity (Sp) 67.8% and the positive predictive value (PPV) 74.6%. The concentration of CA19-9 decreased largely from 90-93% in comparison before and after pancreatic cancer resection (p<0.05). Conclusion: The mean concentration of CA19-9 beore operation in pancreatic cancer patients is rather high in comparing with normal value (3609U/ml). Detect the serum content of CA19-9 in suspected pancreatic cancer patients is a useful measure for diagnosing pancreatic cancer before operation with sensitivity 70%, spacificity 68%. The role of postoperative monitoring for warning the cancer recurrence is not yet demonstrated by this study. Keyword: CA19-9, pancreatic cancer.

NG DNG K THUT MULTIPLEX LIGATION-DEPENDENT PROBE APLIFICATION (MLPA) XC NH T BIN XA ON GEN DYSTROPHIN TRN BNH NHN LON DNG C DUCHENNE
T Thnh Vn, Nguyn Th Thanh Hi, Trn Vn Khnh
Trng i hc Y H Ni K thut Multiplex Ligation-dependent Probe Amplification (MLPA) c cc nh khoa hc ng dng rng ri trong nghin cu pht hin chnh xc v nhanh t bin gen mt s bnh l di truyn. Mc tiu: ng dng k thut MLPA xc nh t bin xa on gen dystrophin trn bnh nhn lon dng c Duchenne (DMD). i tng v phng php: 13 bnh nhn c chn on b bnh DMD da trn cc triu chng lm sng v cn lm sng in hnh, k thut tch chit DNA t t bo mu ngoi vi, k thut MLPA. Kt qu: 7/13 bnh nhn c t bin xa on gen dystrophin. Kt lun: K thut MLPA c ng dng thnh cng xc nh t bin xa on gen dystrophin vi kt qu chnh xc v trong thi gian ngn. T kha: t bin xa on, MLPA

Summary ANALYSIS OF DELETED MUTATION OF DUCHENNE MUSCULAR DYSTROPHY USING MULTIPLEX LIGATION DEPENDENT PROBE AMPLIFICATION
Multiplex Ligation-dependent Probe Amplification (MLPA) has been used commonly to detect mutation in inherited diseases because MLPA is rapid and accurate technique. Objective: Application of MLPA for analysis of deleted mutation of dystrophin gene on patients with Duchenne Muscular disease (DMD). Subjects and methods: analysis of deletion of dystrophin gene were performed for 13 patients with DMD; DNA extraction; MLPA were performed. Results: Seven out of 13 patients have been detected deletion of dystrophin gene. Conclusions: MLPA have been quickly and accurately applied for analysis of deletion of dystrophin gene. Key words: Deletion, MLPA

P DNG QUY TRNH XC NH T BIN GEN M HA YU T VIII GY BNH HEMOPHILIA A

T Minh Hiu, Trn Vn Khnh, T Thnh Vn
Trng i hc Y H Ni Bnh ri lon ng mu di truyn Hemophilia A hay bnh a chy mu do t bin gen F8 m ha cho yu t VIII. Dng t bin gen F8 chim t l cao nht l t bin im (47,5 %), t bin o on intron 1 v intron 22 (36,7 %). Cho n nay Vit Nam cha c nghin cu ton din v phn tch t bin gen F8, gip cho vic phn tch pht hin ngi lnh mang gen bnh v chn on trc sinh bnh Hemophilia A. Mc tiu: (1) p dng quy trnh k thut sinh hc phn t pht hin t bin gen F8 gy bnh Hemophilia A, (2) Thc hin quy trnh xc nh ngi mang gen v chn on trc sinh cho ngi c nguy c cao. i tng v phng php: Mt thai ph c con trai c chn on b bnh Hemophilia A da trn tiu chun lm sng v cn lm sng in hnh. DNA bnh nhn c tch chit v phn tch t bin bng k thut PCR v gii trnh t. Thai ph c phn tch xc nh l ngi mang gen t bin v chn on trc sinh. Kt qu: Pht hin t bin del2605C bnh nhn Hemophilia A, thai ph (ngi m bnh nhn) l ngi lnh mang gen bnh, thai nhi mang t bin del2605C, em gi ca bnh nhn l ngi lnh khng mang gen bnh. Kt lun: (1) p dng thnh cng quy trnh xc nh t bin gen F8 gy bnh Hemophilia A; (2) p dng thnh cng quy trnh xc nh ngi mang gen v chn on trc sinh cho thai ph (ngi lnh mang gen bnh). T kha: Hemophilia A, yu t VIII, t bin gen

Summary MUTATION DETECTION OF F8 GENE CAUSING HEMOPHILIA A

Hemophilia A is the most severe inherited bleeding disorder to affect human and is among the most common disorders of this kind. Hemophilia A is caused by F8 gene mutations which reduced levels of VIII coagulation factor. Point mutations account for as much as 47.5 % whereas inversion intron 1 and 22 cause 36.7 % of all Hemophilia A cases. In Vietnam, so far there has been no full studies of mutation analysis for hemophilia A patients as well as carriers and prenatal diagnosis. Objectives: Construcing of mutation analyis procedure of hemophilia A. Methods: This study based on analysis of a Hemophilia A familys genetic profile. Genomic DNA was extracted from venous blood collected in EDTA using phenol procedure. The 26 exons of F8 gene were amplified and checked for mutations by using Long PCR and Sequencing procedure. Results: The Hemophilia A patient and unborn fetus were found to have del2605C mutation. His mother is a carrier whereas his sister has a normal status. Conclusion: Successfully contructed a procedure to detect muations in F8 gene. Keywords: Hemophilia A, F8 mutation

NGHIN CU PHT HIN NGI LNH MANG GEN BNH V CHN ON TRC SINH BNH THOI HA C TY
Trn Vn Khnh, T Thnh Vn
Trng i hc Y H Ni

Bnh thoi ha c ty (spinal muscular atrophy: SMA) l bnh l di truyn ln trn nhim sc th thng. Bnh gy nn do t bin gen SMN1 nm trn nhim sc th s 5. Bnh chia lm 3 th khc nhau tu vo mc biu hin bnh trn lm sng. Pht hin ngi mang gen bnh v chn on trc sinh s lm gim t l mc bnh. Mc tiu: Xy dng quy trnh pht hin ngi mang gen bnh v chn on trc sinh bnh thoi ha c ty (SMA). i tng v phng php nghin cu: 10 gia nh v 2 thai ph c tin s sinh con b bnh SMA; DNA c tch chit t mu v t bo i ca cc thnh vin gia nh v thai ph; S dng k thut MLPA, STR, RFLP. Kt qu: 48% cc thnh vin gia nh ngi bnh SMA c pht hin l ngi mang gen bnh; 02 thai nhi c chn on khng mc bnh SMA. Kt lun: Bc u thnh cng trong vic pht hin ngi lnh mang gen bnh v chn on trc sinh bnh thoi hoa c ty Vit Nam. T kha: Bnh thoi ha c ty, ngi lnh mang gen bnh, chn on trc sinh.

Summary CARRIER DETECTION AND PRENATAL DIAGNOSIS OF SPINAL MUSCULAR ATROPHY

SMA is recessive autosomal chromosome which caused by SMN1 mutation. SMA is divided to 3 types depending on the degree of clinical features. Objectives: Molecular biological techniques were applied for prenatal diagnosis and carrier detection of SMA in Vietnam. Materials and Methods: members of 10 SMA families and 2 high risk pregnant women were selected, DNA was extracted from blood and aminotic fluid, MLPA, STR RFLP techniques were used. Results: 48% of family members were detected as carrier; the two fetuses were fortunately confirmed not to receive the mutation from their mothers and their father. Conclusions: the present investigation was the first to be carried out in Vietnam and this result were demonstrated the potential application in clinical settings in Vietnam. Keywords: Spinal muscular atrophy, carrier detection, prenatal diagnosis

DIN BIN LM SNG V CN LM SNG CA BNH NHN NG C CP NNG TRONG QU TRNH LC MU LIN TC TI TRUNG TM CHNG C BNH VIN BCH MAI
Ng c Ngc1, Nguyn Th D2, Phm Du3
1

Trng i hc Y H Ni; 2Hi Hi sc Cp cu v Chng c H Ni 3 Bnh vin Bch Mai

Lc mu lin tc l mt phng php mi c trin vng iu tr bnh nhn ng c cp mc nng. Mc tiu: (1) nh gi tin trin lm sng ca bnh nhn ng c cp trong lc mu lin tc v (2) nh gi tin trin cn lm sng ca bnh nhn ng c cp trong lc mu lin tc. i tng v phng php: 21 bnh nhn ng c cp, iu tr ti Trung tm Chng c - Bnh vin Bch Mai, c tin hnh 28 ln lc mu lin tc. Kt qu: 57,1% nguyn nhn ng c do t t, trong khi bnh 14 (67,3%), t vong 7 (33,3%), thi gian t khi nhim c ti khi c lc mu 72 gi, thi gian trung bnh ca qu lc 27,1 gi, sau lc 12 gi thc ci thin r rt, khng c ri lon huyt ng trong qu trnh lc, nng gardenal trong mu gim nhanh trong 12 gi u, creatinin mu gim dn trong qu trnh lc. Kt lun: Lc mu lin tc ci thin nhanh thc ca bnh nhn, gip thi tr c cht, gim thi gian th my, h tr tt chc nng thn v khng lm ri lon huyt ng. T kha: Lc mu lin tc, ng c cp nng, CVVH

Summary CLINICAL AND LABORATORY PROGRESSION OF ACUTE POISONED PATIENT UNDER TREATMENT OF CONTINUOUS VENO-VENOUS HEMOFILTRATION AT POISON CONTROL CENTRE OF BACH MAI HOSPITAL
Continuous veno-venous hemofiltration (CVVH) is a new hopeful therapy of acute severe poisoned patients. Objectives: (1) To evaluate the clinical courses of acute severe poisoned patients during CVVH and (2) to detect the changes of laboratorial investigation during CVVH. Patients and methods: 22 acute severe poisoning patients were treated at Poison Control Center of Bach Mai hospital, 28 times of CVVH were performed. Results: 57.1% suicidal patient, 14 (66.7%) patients totally recovered, 7 (33.3%) died, the time from being intoxicated to hemofiltrated was 72 hours, median time of a filter was 27,1 hours, 12 hours after hemofiltration, patients consciousness clearly got better, no hemodynamic disorder happened all the time of CVVH, serum Gardenal concentration decreased rapidly during first 12 hours, serum creatinine decreased during CVVH. Conclusion: CVVH improved patient consciousness, effectively eliminated toxins, decreased ventilations time, assisted renal function and didnt cause hemodynamic disoders. Keywords: Continuous veno-venous hemofiltration, CVVH, acute severe poisoned patients

S DNG VT MCH XUYN NG MCH NGC LNG TRONG PHU THUT TO HNH
Trn Thit Sn v CS
Trng i hc Y H Ni Vt mch xuyn ca ng mch ngc lng thuc th loi mi trong phu thut to hnh v c p dng trn lm sng t hn mt thp k nay. Mc tiu: 1. M t qui trnh phu tch vt da nhnh xuyn ng mch ngc lng. 2. Nhn xt mt s ch nh ca vt trong phu thut to hnh. i tng v phng php: T thng 9/2008 n thng 1/2011, 5 bnh nhn c cc khuyt tn phn mm rng c bn, thnh ngc, bn tay v bn chn c phu thut to hnh bng vt mch xuyn ng mch ngc lng. Kt qu: Kch thc vt ln (rng nht 10cm, di nht 18cm). Cung mch nui vt bao gm nhnh xuyn trong c, nhnh ngoi v thn ng mch ngc lng di trung bnh 14,2 cm. Cc dng vt c s dng: 2 vt cung mch lin, 3 vt t do. Thnh phn ca vt: 3 vt da n thun, 2 vt da c km mt phn c lng rng. Cc vt che ph 100% khuyt phn mm cn to hnh. Tt c cc vt u sng v cho kt qu thm m tt ni cho vt v nhn vt. Ni ly vt khng c hin tng ng dch tt c cc trng hp. Kt lun: Vt nhnh xuyn ng mch ngc lng l mt cht liu ng tin cy v linh hot cho mc ch to hnh che ph cc khuyt ln trn c th. T kho: phu thut to hnh, vt da nhnh xuyn ng mch ngc lng

Summary TECHNICAL AND INDICATIVE ASSESSEMENT ON THORACODORSAL ARTERY PERFORATOR FLAP IN RECONSTRUCTION.
Thoracodorsal artery perforator flap (TDAP) represent the latest descendant in a line of evolution of plastic surgery and now it is a popular material for plastic surgeons. Objective: to report our clinical experience (on technical procedures and indications) with TDAP aps in reconstruction. Material and methods: Between September 2008 and January 2011, TDAP aps were used in 5 patients. The indications were immediate coverage reconstruction for soft tissue defects of the neck, thorax and extremities. Results: The ap dimensions were from 10 to 18cm. The mean lenght of flap vascular pedicle was 14.2cm. The pedicled TDAP ap was harvested in two cases and the free TDAP ap in three cases. In addition, there were two aps with a variable amount of muscle. A successful ap transfer was achieved in all patients. Seroma was not encountered at the donor sites of the perforator aps. Conclusion: Our results show that TDAP ap is safe and extremely versatile technique with a long pedicle and a large flap cutaneous territory. It may be used in forms of free or pedicled flap for many goals in reconstructive and plastic surgery. Key word: perforator, thoracodorsal artery, soft tissue defect, plastic surgery

NHN MT TRNG HP GIM THIU THAI CHN LC TRN THAI PH SONG THAI C MT THAI BT THNG
Nguyn Vit Tin, H S Hng
Trng i hc Y H Ni Gim thiu thai chn lc c p dng cho cc trng hp a thai c km theo thai bt thng, a thai sau iu tr bng h tr sinh sn. Trc y cc trng hp a thai c km theo thai bt thng hoc phi gi li tt c hoc l nh ch tt c cc thai. T khi c phng php gim thiu thai chn lc gii quyt c cc trng hp ny gip cho cc cp v chng c c hi sinh con c bit l nhng cp v chng him mun, iu tr v sinh nhiu nm. Chng ti bo co mt trng hp gim thiu mt thai bt thng (nang bch huyt vng c - hygroma kistique) trn ph n song thai 12 tun. Kt qu hy c thai bt thng, thai bnh thng cn li pht trin bnh thng. Kt lun: phng php gim thiu thai chn lc c th p dng hy thai bt thng trong trng hp a thai. T kha: gim thiu thai chn lc, song thai, nang bch huyt vng c

Summary SELECTED EMBRYO REDUCTION IN TWIN PREGNANCY BUT ONE ABNORMAL EMBRYO
Selected embryos reduction is applied to treat the case of multi-pregnancy but contain abnormal embryo(s) or in case of multi-pregnancy in assissted reproductive technology. Before those cases the women have to chose to keep pregnancy or to terminate all include normal embryo. This procedure has helped the couple a chance to have baby, especially who are treated infertility for long time. We report one case selected embryo reduction in twin pregnancy but one abnormal embryo hygroma kistique. After procedure the pregnancy develope normally. Conclusion: selected embryo reduction can be method to apply in case of twin but one abnormal embryo. Key words: selected embryo reduction, twin, hygroma kistique

NG DNG CH S MANNING NH GI SC KHO THAI THAI PH B TIN SN GIT NNG TI BNH VIN PH SN TRUNG NG
Trn Danh Cng1, Vng Vn Khoa2
1

Trng i hc Y H Ni; 2Bnh vin a khoa tnh Bc Ninh

nh gi tnh trng sc khe ca thai trong t cung, nht l ph n b tin sn git, lun l mt vn quan trng c thi x tr ng n trnh tai bin cho m v cho thai. Mc tiu: l nh gi gi tr tin on tnh trng sc khe ca thai bng ch s Manning. Phng php: m t ct ngang tin cu, nghin cu tin hnh trn 92 thai ph tin sn git nng. Kt qu cho thy ch s Manning khng c ngha trong tin on thai chm pht trin trong t cung ngng 6 im. Cng ngng ny ch s Manning rt c ngha tin on suy thai vi nhy 82%, c hiu 92%, gi tr tin on (+) 56% v gi tr tin on (-) 98%. Kt lun: ch s Manning c gi tr tin on suy thai ngng 6 im v khng c gi tr tin on thai chm pht trin trong t cung cng ngng ny. T kha: Ch s Manning, tin sn git, suy thai, thai chm pht trin trong t cung

Summary STUDY ON MANNING SCORE FOR EVALUATION OF FETAL HEATH AT PREECLAMPSIA PREGNANCIES AT NATIONAL HOSPITAL OF GYNECOLOGY AND OBSTETRIC
One of the best tests for assessment of fetus is biophysical profile test (Manning score) and performance of this has significant effects in fetus heath and outcome of pregnancy. Objective: To evaluate the relationship if any, between Manning score and fetus wellbeing. Methods: This study was a prospective observational. Manning score consists of five parameters: fetal breathing movements, fetal movements, fetal tone, qualitative amniotic fluid volume, and non - stress test, were measured in the same observation period in 96 patients with several preeclampsia pregnancies of gestation age from 32 to 40 week. All delivered within 48 hours of the last observation. This study is worked at Obstetric I department of national obstetric and gynecology hospital. Determining the relationship between in fetal Manning score to the out come of pregnancy as judged by five - minute Apgar score, intra uterine fetus. Results: Manning score has been demonstrated to be and accurate predictor of fetal out come as low Apgar score. The cut off is 6 with sensitivity, specificity, positive predictive, negative predictive are: 82%, 92%, 56%, 98%. Conclusion: Manning score accurately predicts fetus wellbeing. Keys words: Manning score, preeclampisia, intrauterine grow retarded

THI X TR SN KHOA I VI SN PH I THO NG THAI K TI BNH VIN PH SN TRUNG NG

Trn Thy Linh, ng Th Minh Nguyt
Trng i hc Y H Ni Nhn xt thi x tr sn khoa vi sn ph i tho ng thai k ti Bnh vin ph sn trung ng t thng 1-2008 n ht thng 6-2009. Phng php: Hi cu m t, vi i tng l cc sn ph c thai t 28 tun tr ln sinh ti Bnh vin Ph sn Trung ng (BVPSTW) v c chn on TTK theo tiu chun ca WHO 1999. Kt qu: thng l 14,67 %, m ly thai l 85,33 %, trong m ly thai v thai to 29,69 %,v suy thai 21,88 % v cc yu t sn khoa khc i km 37,5 %, m ly thai vi l do T n thun 10,93 %. C 1 trng hp sn ph b t cung, do thai to v a i. Cn nng trung bnh ca tr s sinh l 3,421g, nng nht l 4600g, tr c cn nng 3600g chim 34,67 %. H glucose huyt thanh con (< 3,6 mmol/l) 80,95 %. Kt lun: TTK lm tng nguy c m ly thai. thng chim 14,67%, m ly thai 85,33%. T kha: i tho ng thai k, m ly thai

Summary ATTITUDE OF OBSTETRIC TREATMENT FOR THE PREGNANT WOMEN WHO HAVE GESTATION DIABETES AT OBSTETRICAL CENTRAL HOSPITAL FROM JANUARY 2008 TO JUNE 2009
Survey the attitude of obstetric treatment for the pregnant women who have gestation diabetes at Obstetrical Central Hospital from January 2008 to June 2009. Subjects and method: looking back and description, with object: the pregnant women from 28 weeks upward, they had childbirth at Obstetrics Central Hospital and they were diagnosed gestation diabetes with the criterion of WHO 1999 in this pregnancy. Results: Normal childbirth: 14.67 %, Caesarean section: 85.33 %, in which due macrosomia: 29.69 %, due fetal distress: 21.88 %, due obstetric elements another: 37.5%, due merely gestation diabetes: 10.93 %. One pregnant woman had uterus which didnt pulsate because macrosomia and much amniotic fluid. Conclusion: Gestation diabetes was increased rate of caesarean section. Caesarean section: 85.33 %. Keywords: Gestation diabetes, caesarean

NHN HAI TRNG HP CHN THNG KN VNG C TCH RI THANH - KH QUN DO VNG DY NGANG NG
Quch Th Cn
Bnh vin Tai Mi Hng Trung ng Chn thng kn thanh - kh qun gy tch ri thanh, kh qun l bnh l him gp, tuy vy nguy him do ng th b hp ngay lp tc. Nguyn nhn thng do ngi i xe my b vng dy phi, t t bng tht c. Trong bo co ca chng ti, c hai trng hp u do ngi i xe my ang i th b vng dy in chng xung, ging ngang ng. B ngoi nh nhng nhng tn thng bn trong li nng n. Ni soi v chp ct lp vi tnh l hai phng tin cn lm sng rt gi tr chn on. Tn thng gp l v cung trc sn nhn vn nt, v t sn kh qun 1, 2. Mng nhn - kh qun rch, nim mc lng thanh - kh qun bong, rch ton b. Phn kh qun cn li b ko v pha ngc. Phng php phu thut iu tr l ni kh qun - thanh qun tn - tn kt hp t ng nong. T kho: chn thng kn thanh kh qun

Summary CASE REPOT: LARYNGOTRACHEAL SEPARATION AFTER BLUNT TRAUMA TO THE NECK
Laryngotracheal separation due to blunt baryngotracheal trauma is rare event, but the air way can be immediately obstruction and it is life-threatening. In our cases report blunt trauma to the larynx and trachea is caused mainly by motorbike accidents, victims were stuck on a electric wire hang over on the road when the used motorbike. Endoscopic and cervical CT scan are useful for diagnosis. The injuries were severe with fracture of cricoid ring and the fist - second tracheal rings. The retraction of the lower part of the trachea into the mediastinum. The treatment was: tracheotomy then laryngo-tracheal resection and end-to-end anastomosis with stenting. Keywords: Laryngotracheal separation

T TH THY TINH NHN TO TRN MT CN TH THY TINH IU TR CN TH NNG

Nh Hn, Nguyn Thanh Thy
Bnh vin Mt Trung ng nh gi kt qu bc u ca phu thut t th thy tinh nhn to (TTTNT) trn mt cn th thy tinh (TTT) iu tr cn th nng. Phng php: Nghin cu th nghim lm sng, tin cu, 60 mt cn th nng c iu tr theo phng php t TTTNT hu phng trn mt cn th thy tinh (phakic ICL) ti Bnh vin Mt Trung ng t 05/2007 n 10/2008. Kt qu: Kt qu v gii phu: Sau m TTTNT yn, cn, vng at yu cu, cc mt khng thy c thay i g ng k v mt gii phu, cha c trng hp no lon dng gic mc (t bo ni m gic mc gim 2,1% sau mt nm), cha gp c TTT, bong vng mc, vim mng b o...Kt qu v chc nng: Khc x cu trung bnh sau m gim t - 11,88 D n -13,00 D, khc x tr trung bnh sau m gim t -1,38 D n -1,78 D, khc x tng ng cu sau m gim t -12,28 D n -13,89 D. 36,2 % mt t th lc 20/20, 84,5% mt t th lc 20/40,58% th lc khng knh sau m tng hn 2 hng so vi th lc chnh knh tt nht trc m. Th lc khng knh sau m tng trung bnh t 2,34 n 4,3 hng so vi th lc chnh knh tt nht trc m 81,67% bnh nhn thy hi lng, 18,33% bnh nhn rt hi lng. Kt qu chung: Kt qu tt t t 60 - 77%, kh t 11-23%, trung bnh t 3- 6%, km t 6-9% ty thi im theo di. Bin chng: 6,7% mt thy la sau phu thut, 6,7% mt c tng nhn p, s lng t bo ni m gic mc gim 2,1% sau 1 nm. Kt lun: Kt qu ban u cho thy t TTTNT hu phng trn mt cn TTT l mt phng php mang li hiu qu cao v an ton cho bnh nhn cn th nng. T kha: TTTNT hu phng, cn th nng, khc x tn d, khc x cu

Summary THE RESULTS OF IMPLANTABLE COLLAMER LENS (ICL) FOR HIGH MYOPIA IN VIETNAM NATIONAL INSTITUTE OF OPHTHALMOLOGY
To assess the result of the Implantable Collamer Lens (ICL) for high myopia correction. Method: Prospective nonrandomized clinical trial, 60 eyes of 32 patients with high myopia were treated in the VNIO from 05/2007 to 10/2008. Main outcomes: Evaluated Uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), adverse event, operative and postoperative complications, subjective sastifaction and symptoms. Results: 36.2 % of patients has a visual acuity 20/20; 84.5% of patients has a visual acuity 20/40. The main spherical equivalent (SE) of refraction reduced from -12.28D to -13.89D. Patients averaged a 2.34 to 4.3 line improvement in UCVA. The mean difference between the last follow-up UCVA and pre-operative BSCVA was a gains of 2 or more lines in 58%. Patient satisfaction reported by 87.61%; very satisfaction reported by 18.33%. 6.7% patient was reported with high intraocular pressure, 6.7% with haloz. Corneal endothelial cell loss 2.1% at 1 year after ICL implantation. Conclusions: the results confirmed the safety, efficacy of ICL implantation for high myopia. Keywords: Implantable Collamer Lens (ICL), high myopia, correction, visual acuity, main spherical equivalent

P DNG PHNG PHP MICHELET - CHAMPY TRONG IU TR PHU THUT GY GC XNG HM DI

Nguyn Quang Hi1, Nguyn Bc Hng2, Nguyn Mnh H3
1

Trng i hc Y Dc Hu, 2,3 Trng i hc Y H Ni

M t c im lm sng, X quang cc bnh nhn gy gc xng hm di v nh gi kt qu iu tr phu thut theo phng php Michelet - Champy. Vt liu v phng php: 42 bnh nhn vi 43 ng gy gc hm c iu tr theo phng php Michelet Champy ti Khoa Phu thut Hm mt Bnh vin Rng Hm Mt Trung ng v bnh vin Vit Nam Cu Ba H Ni, t 03/2009 n 03/2010. nh gi kt qu iu tr khi ra vin v 6 thng sau phu thut da vo t l iu tr thnh cng v 7 tiu chun nh gi sau m ca Rudolf Seemann (nm 2010). Kt qu: chn thng ch yu nam gii (85,7%), tui 19 39 (81,0%). Gy gc hm thng nm cng pha vi v tr ca lc tc ng (78,6%), hay phi hp vi cc ng gy khc ca xng hm di (61,9%) trong ch yu vng cm (76,9%) (khp cm v cn gia cm); a s gy gc hm khng thun li (97,7%) v di lch (65,1%). Triu chng lm sng thng gp gm sng au, h ming hn ch, sai khp cn v n au chi. Phim ton cnh v mt thng thng c s dng v c gi tr ln trong chn on. T l iu tr thnh cng ca phng php Michelet Champy l 100%; 4 bnh nhn (9,5%) c bin chng sau m: 2 nhim trng (4,8%), 1 ri lon lin thng (2,4%) v 1 sai khp cn (2,4%). Kt lun: phng php Michelet Champy trong iu tr phu thut gy gc xng hm di n gin, d s dng, c t l thnh cng cao v t bin chng. T kha: gy gc xng hm di, phng php Michelet Champy

Summary APPLICATION STUDY OF MICHELET - CHAMPYS TECHNIQUE IN SURGICAL TREATMENT OF MANDIBULAR ANGLE FRACTURE
Objective: to describe the clinical and radiographic features of patients who had suffered mandibular angle fractures and evaluate the postoperative outcome in patients treated for the Michelet Champys technique. Materials and methods: 42 patients with 43 fractures of the mandibular angle were treated by the Michelet - Champys technique at the department of maxillo facial surgery of National Hospital of Odonto-Stomatology and VietnamCuba Hospital in Ha Noi, from March 2009 to March 2010. Evaluating of results when patients were discharged from hospital and 6 months after surgery, based on the treatment success rate and 7 standard of postoperative evaluation were classified by Rudolf Seemann. Results: the majority of the patients were males (85.7%), 19 - 39 years of age (81.0%). The angle fractures usually occurred on same side with position of impact forces (78.6%), often associated with other mandibular fractures (61.9%) mostly included symphyseal and parasymphyseal regions (76.9%), the majority of angle fractures had the unfavorable fractures (97.6%) and displaced fractures (64.3%). The most common symptoms were pain swelling, mouth limited opening, malocclusion and throbbing pain. The posterior - anterior and panoramic radiographs were often used and were of great value in diagnosis (97%). The treatment success rate of this technique was 100%; complications occurred in 4 patients (9.5%); 2 were infections (4,8%), 1 were wound-healing disturbance (2.4%) and 1 were dis-occlusion (2.4%). Conclusions: The Michelet Champys technique for surgical treatment of mandibular angle fractures was simple, easy to use, had high success rates and few complications. Key words: mandibular angle fracture, Michelet Champys technique

GI TR CA CNG HNG T TRONG CHN ON U NGUYN BO TU H SAU

Nguyn Th Hng1, Nguyn Duy Hu2
1

Bnh vin i hc Y H Ni; 2B mn CHA Trng i hc Y H Ni

Nhn nh gi tr ca cng hng t trong chn on u nguyn bo tu (UNBT) h sau. i tng v phng php: nghin cu m t ct ngang c so snh 324 bnh nhn chn on trn phim CHT l u h sau c phu thut v c kt qu GPB ti bnh vin Vit c t nm 2005 -2008. Kt qu: UNBT tui 3-8 tui chim 41,5 %, v tr thu nhng 85,5%. Cng hng t chn on xc nh u nguyn bo tu vi nhy Se = 90,2%, c hiu Sp = 97,5%. Chn on ng v tr l 100%. Gi tr chn on phn bit UNBT vi u mng no tht IV da trn du hiu hp gc hoc mt gc trn no tht IV c nhy Se = 87,8 %, c hiu Sp = 85,7. Kt lun: U nguyn bo tu h sau l loi u no ph bin tr em, v tr ch yu thu nhng tiu no. CHT ng vai tr quan trng trong chn on xc nh UNBT h sau v chn on phn bit vi u mng no tht IV. T kha: u nguyn bo ty, cng hng t

Summary THE VALUE OF MRI IN THE DIAGNOSIS OF MEDULLOBLASTOMA

Access the value of MRI in the diagnosis of Medulloblastoma. Methods and materials: A cross sessional descriptive study of 324 patients diagnosed posterior fossa tumor and perated in Viet Duc hospital from 2005 to 2008, including 41 patients who had their histological results of Medulloblastoma. Results: In the group of medulloblastoma patients, the age from 3 to 8 years accountel for 41.5% and the position in the vermis 85.5%. The accuracy of MRI in the diagnosis of medulloblastoma was 100%, the sensitivity 90.2%, the specificity 97.5%. The sensitivity of the differential diagnosis between medulloblastoma and ependymoma was 87,8%, the specificity 85.7%. Conclustion: Medulloblastoma is the most counmon in the childrens posterior fossa tumors, especially in the vermis. MRI plays an very important role in the diagnosis of medulloblastoma in the regard of diffinitive diagnosis and differential diagnosis from Ependymoma. Keywords: Medulloblastoma, MRI

MI TNG QUAN GIA LM SNG V MT S DU N SINH HC LIN QUAN N TNH TRNG BNH NNG TR S SINH
Khu Th Khnh Dung, Trng L Thi
Bnh Vin Nhi Trung ng T l t vong tr s sinh vn cn cao ti Bnh vin Nhi Trung ng do bnh c pht hin v can thip mun. Mc tiu: Tm hiu mi tng quan gia tnh trng bnh nng vi cc ch s LDH huyt thanh, lactate, v magi tr s sinh lc nhp vin v 24 gi sau khi nhp vin. i tng v phng php: Tt c cc bnh nhn nhp vin vo khoa iu tr tch cc s sinh, Bnh vin Nhi trung ng t 2 - 4/2010; Thm khm lm sng; Xt nghim ng mu, LDH, lactate, AST, ALT, v Mg lc nhp vin v 24 gi sau khi nhp vin; Phng vn gia nh bnh nhn s dng bng cu hi v thu thp thng tin t h s bnh n ca bnh nhn. Kt qu: Tng s 359 i tng nghin cu (65,2% nam v 38,4% n), trong , 44,8% l tr non v 42,9% phi th oxy. Trong cc ch s nghin cu, ch s LDH, lactate, v AST l c bit khc nhau (p < 0,001) gia thi im nhp vin v 24 gi sau khi nhp vin, trong khi s khc bit ca ALT v Mg ln lt l p = 0,214 v p = 0,73. Khng c s khc bit ng k i vi glucose, LDH, lactate, AST, v Mg gia tr non v thng. Tuy nhin, c s khc bit kh r gia glucose, LDH, lactate, v AST nhm tr phi th oxy, v c sc (p < 0,01). Kt lun: C s thay i ng k v nng LDH, lactate, AST ti thi im nhp vin v 24 gi sau khi nhp vin. C mt s khc bit r rt nng mt s ch s trong huyt thanh nhng tr b bnh nng nh sc v suy h hp, nhng khng c s khc bit no gia cc tui thai khc nhau. T kha: iu tr tch cc, ch s huyt thanh, tng quan lm sng

Summary CHANGES IN SERUM LACTATE AND MAGNESIUM UPON ADMISSION TO THE NEONATAL INTENSIVE CARE UNIT AT THE NATIONAL HOSPITAL OF PEDIATRICS
The newborn mortality rate remains high at the National Hospital of Pediatrics (NHP). One reason is because diseases are discovered late and only newborns with severe signs and symptoms receive interventions and are brought to the hospital. This research project has been conducted to assist clinical decision-making for doctors when newborns are brought to the hospital. Objectives: To investigate serum LDH, lactate, and magnesium concentrations of newborns at and 24 hours after admission. To correlate severe clinical conditions with serum markers. Subjects and Methods: All admitted patients to the NICU at the NHP from February to April 2010; Investigate a correlation of clinical signs/symptoms and biomarkers in serum of babies at and after 24 hours after admission. Interviews were carried out using questionnaire and patient records. Blood test results were collected on glucose, LDH, lactate, AST, ALT, and Mg.Values were subtracted and underwent logarithmic transformation to resemble a normal distribution. Results: A total of 359 subjects were enrolled (65.2% male, 38.4% female) including 44.8% were premature and 42.9% were on supplemental oxygen. Biomarkers including LDH, lactate, and AST were significantly different (p < 0.001) at and 24 hours after admission, while ALT and Mg were not (p = 0.214 and p = 0.73, respectively). There were no significant differences for glucose, LDH, lactate, AST, and Mg when controlling for prematurity. However, there significant differences between glucose, LDH, lactate, and AST for newborns requiring supplemental oxygen were observed (p<0.01). Conclusions: There were significant changes in LDH, lactate, and AST concentrations at and 24

hours after admission. There were great differences in serum biomarkers for severe illnesses like including shock and respiratory distress, but no differences existed in prematurity. Key words: Intensive care, serum markers, clinical correlation

NGHIN CU TNH HNH NHIM VIRUS VIM GAN C (HCV) BNH NHN CHY THN NHN TO TI BNH VIN BCH MAI
V Th Tng Vn
Khoa Vi sinh, Bnh vin Bch Mai Xc nh t l nhim virus vim gan C (HCV) bnh nhn chy thn nhn to ti bnh vin Bch Mai ng thi tm hiu mi lin quan gia thi gian chy TNT vi t l nhim HCV trn nhm i tng ny. i tng v phng php: Nghin cu c tin hnh trn 469 bnh nhn chy thn nhn to ti bnh vin Bch Mai trong thi gian 2 nm (2006 - 2008). Phng php nghin cu: iu tra ngang, xc nh t l nhim HCV bnh nhn chy thn nhn to ti bnh vin Bch Mai v tm hiu mi lin quan gia t l nhim HCV vi thi gian lc mu v truyn mu. K thut s dng trong nghin cu: KT ELISA th h 3 pht hin anti-HCV trong huyt thanh, k thut Real time RT PCR nh lng HCV-RNA bng b sinh phm COBAS AmpliPrep/ COBAS TaqMan HCV Test (Roche) xc nh HCV-RNA. Kt qu v kt lun: T l nhim HCV bnh nhn chy thn nhn to l 31,77%, trong 91,3% bnh nhn c HCV-RNA (+), T l nhim HCV bnh nhn chy TNT chu k tng t l thun theo thi gian lc mu. Truyn mu c nguy c nhim HCV cao. T kha: Virus vim gan C (HCV), bnh nhn chy thn nhn to (chy TNT), bnh vin Bch Mai.

Summary RESEARCH ON HEPATITIS C VIRUS INFECTION (HCV) IN HEMODIALYSIS PATIENTS AT BACH MAI HOSPITAL
Objective: To determine prevalence of hepatitis C virus (HCV) in hemodialysis patients at Bach Mai hospital and exploring the relationship between the duration on dialysis with HCV infection. Subjects and methods: The study was conducted on 469 hemodialysis patients at Bach Mai hospital during 2006-2008. The study was conducted by the description of cross-sectional progressive study.HCV antibody and HCV-RNA were measured in the maintenance hemodialysis patients before hemodialysis by 3rd generation ELISA and Real time RT PCR. Results and concludsion: The results showed that the prevalence of HCV infection in hemodialys patients in Bach Mai hospital (2006 - 2008) were 31,77%. There were a significant correlation between the duration on dialysis (over five years), history of blood transfusion and the prevalence of anti-HCV and the prevalence of anti-HCV positive patients (p < 0,001). Key words: HCV (hepatitis C virus), hemodialysis patients, Bach Mai hospital.

BC U NH GI HIU QU IU TR SUY TNH MCH MN TNH CHI DI BNG PHNG PHP LASER NI TNH MCH TI BNH VIN LO KHOA TRUNG NG
Phm Thng, Nguyn Trung Anh
Bnh vin Lo khoa Trung ng Suy tnh mch mn tnh chi di (STMMTCD) l bnh thng gp, gy tn km, tn ph v nh hng n cht lng sng ca ngi bnh. Mc tiu: nh gi hiu qu ca phng php laser ni tnh mch trong iu tr STMMTCD. i tng v phng php nghin cu: 20 bnh nhn c chn on STMMTCD theo tiu chun v phn loi CEAP, c siu m Doppler v v bn tnh mch. Cp quang ELVeS c lun ti cch ch tnh mch hin vo tnh mch i chung khong 3-4 cm. Bt my phng laser, rt dn cp quang ra. Qun bng chun p lc 30-40mmHg trong vng 7-10 ngy. Kt qu: Phng php loi b on tnh mch hin b suy vi t l thnh cng ln n 100%, c hiu qu cao trong vic lm gim nh hoc mt hn cc triu chng lm sng ca bnh nh: au mi bp chn, gin TM, ph, vim v thay i mu sc da, lot. Phng php an ton, khng c trng hp no b cc bin chng nng. Kt lun: Laser ni tnh mch l mt bin php iu tr hiu qu v an ton STMMTCD. T kho: suy tnh mch mn tnh, laser ni tnh mch

Summary PRELIMINARY EVALUATION OF ENDOVENOUS LASER ABLATION METHOD IN TREATMENT OF CHRONIC VENOUS INSUFFICIENCY
Chronic venous insufficiency (CVI) is a common disease, affected on patients quality of life of. Objective: to evaluate the effectiveness of endovenous Laser Ablation (AVLA) method in treatment of CVI. Research methods: 20 patients diagnosed CVI by criteria and classification of CEAP. All patients were explored with Doppller ultrasound and venous mapping. Elves fiber is threaded to the site of 3-4 cm before saphenous vein enter into the common femoral vein. Turn on the laser machine and threaded the fiber out slowly. Elastic bandage with 30-40 mmHg pressure was kept in 7-10 days. Results: Endovenous Laser Ablation allows removing the veins with reflux with the success rate of up to 100%. AVLA were effective in reducing or erasing the clinical symptoms such as pain, varicose, edema, lipodermasclerosis and ulcers. No serious complications were reported. Conclusion: AVLA was effective and safe method in treatment of CVI. Key words: Chronic venous insufficiency, endovenous Laser Ablation

KHO ST MNG X VA NG MCH CNH ON NGOI S BNH NHN TNG HUYT P

Hong Quc Ha
Bnh vin Nhn dn Gia nh, Bnh Thnh, Thnh ph H Ch Minh Tng huyt p li bin chng nng n trn mch vnh v mch no, siu m ng mch cnh gip pht hin mng x va, c gi tr d bo nhi mu c tim v t qu. Mc tiu: tm hiu tn sut v v tr thng gp mng x va, mi tng quan cc yu t nguy c x va vi mng x va ng mch cnh. i tng v phng php nghin cu: Nghin cu m t ct ngang thc hin trn 126 bnh nhn tng huyt p mi pht hin. S dng siu m kiu B xc nh mng x va ng mch cnh. Kt qu: Tn sut mng x va ng mch cnh 26%, v tr thng gp l ch chia i ng mch cnh 64,7%. Kt lun: C mi tng quan gia tui, gii, ht thuc l, i tho ng v tng hsCRP vi mng x va ng mch cnh. Cc yu t tui, ht thuc l, i tho ng l yu t nguy c c lp mng x va ng mch cnh. T kha: Tng huyt p, mng x va, ng mch cnh

Summary ASSESSMENT OF CAROTID ARTERY PLAQUES IN HYPERTENSIVE PATIENTS

Hypertension leaves severe complications on coronary and cerebral arteries. Carotid ultrasound helps to detect carotid artery plaques which are valuable to predicted myocardial infarction and stroke. The aims of this study are: to evaluate frequency, common location of carotid plaques and correlation of atherosclerotic risk factors for atherosclerotic carotid plaques. Subjects and methods: Cross-sectional descriptive study was performed on 126 patients with new- onset of hypertension.B mode ultrasound determined carotid artery plaques. Results: The frequency of carotid artery plaques is 26%, carotid bifucation is common location of carotid plaques (64.7%). Conclusions: There are correlation between age, gender, smoking, diabetes, increased hs-CRP and carotid artery plaques. Age, smoking, diabetes mellitus are independent risk factors for carotid artery plaques. Keywords: Hypertention, carotid artery plaques

HIU QU IU TR V AN TON CA IVABRADIN VI NITROGLYCERIN TC DNG KO DI TRONG IU TR AU THT NGC N NH

Nguyn Thu Giang, Phm Thng
Bnh vin Lo khoa Trung ng Bc u nh gi hiu qu iu tr v an ton ca ivabradin vi nitroglycerin tc dng ko di trong iu tr au tht ngc n nh. i tng v phng php: nghin cu tin hnh t thng 9/2008 n ht thng 8/2010 trn 107 bnh nhn au tht ngc n nh c chia lm 2 nhm: 49 bnh nhn iu tr bng nitroglycerin tc dng ko di (nhm 1), 58 bnh nhn dng ivabradin (nhm 2). Kt qu: sau 4 thng iu tr, ch cn 1 bnh nhn nhm 2 au ngc v ch au 1 cn/thng, trong khi nhm 1 vn au trung bnh 1 cn/tun, s ln dng nitrat tc dng ngn nhm 1 gim t 1,77 ln/tun xung 0,82 ln/tun, trong khi nhm 2 gim t 1,83 ln/ tun n khng phi dng thuc tc dng ngn na. Kt lun: phn ln bnh nhn nghin cu khng cn au sau 4 thng iu tr. Nhm dng nitroglycerin tc dng ko di gp nhiu bin c bt li trong qu trnh nghin cu hn nhm dng ivabradin. T kho: ivabradin, nitroglycerin tc dng ko di, au tht ngc n nh

Summary EFFECT AND SAFETY OF TREATMENT REGIME OF IVABRADIN AND LONG-ACTING NITROGLYCERIN IN STABLE ANGINA PATIENTS
To evaluate effect and safety of ivabradin and long-acting nitroglycerin in stable angina patients. Subjects and methods: 107 stable-angina patients divided into two groups to receive long-acting nitroglycerin (group 1) and ivabradin (group 2). Results: After 4 months, only one patient of group 2 had chest pain with 1 time/month, while the patients of group 1 had still average 1 time/week. The using number of short-acting nitrate in group 1 decreased from 1.77 time/weeks to 0.82 time/weeks, while this number in group 2 decreased from 1.83 time/weeks to not using. Conclusion: Most of patients had not pain after 4 months of treatment. The long-acting nitroglycerin treated group had more adverse problems during the research period than ivabradin treated group. Key words: ivabradin, nitroglycerin, stable angina patients

VAI TR CA PROCALCITONIN TRONG CHN ON PHN BIT TNH TRNG NHIM KHUN BNH NHN LUPUS BAN H THNG
Trn Th Minh Hoa1, Nguyn Th Bch Ngc2
1

Bnh vin Bch Mai; 2Trung tm Y t Qun ng a

Bc u tm hiu vai tr ca procalcitonin trong chn on phn bit tnh trng nhim khun bnh nhn lupus ban h thng. i tng v phng php: nghin cu m t ct ngang, tin cu c nhm chng. 54 bnh nhn lupus ban h thng v 35 bnh nhn nhm chng c chn on v iu tr ti khoa C Xng Khp bnh vin Bch Mai t thng 11/2009 n thng 12/2010. Cc bnh nhn (nhm lupus v chng) c chia lm hai nhm c nhim khun v khng c nhim khun v u c khm lm sng v lm cc xt nghim nh lng procalcitonin, protien C phn ng, tc mu lng. Kt qu: Hm lng procalcitonin bnh nhn lupus c nhim khun 0,457 + 0,125ng/ml cao hn hn nhm lupus khng nhim khun 0,132 + 0,015 ng/ml khc bit c ngha thng k vi p < 0,01. Hm lng procalcitonin tng khng c mi lin quan tuyn tnh vi protein C phn ng (r = 0,23) v tc mu lng (r = 0,17) bnh nhn lupus ban h thng. Kt lun: Hm lng procalcitonin tng trong trng hp lupus ban h thng c nhim khun. T kho: lupus ban h thng, procalcitonin, protein C phn ng

Summary THE ROLE OF PROCALCITONIN FOR DIFFERENTIATION DIAGNOSIS BACTERIAL INFECTION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
To determine the value of procalcitonin in diagnosis infection in patients with systemic lupus erythematosus. Patients and methods: 54 lupus patients and 35 control patients were devised in to groups infection and no infection who were diagnosed and treated in Rhematology department, Bach mai Hospital from November, 2009 to December, 2010. Examination and laboratory (PCT, CRP) have done for all patients. Result: High level of procalcitoin in lupus patients with infection (0.457 + 0.125 ng/ml) compared with those without infection (0.132 + 0.015 ng/ml) with p < 0.01. No correlation between level of PCT compared with CRP (r = 0.23) and erythrocyte sedimentation rate (r = 0.17). Conclusion: high level of procalcitonin might has an important role in differentiating diagnosed infection in patients with systemic lupus erythematosus. Key words: Systemic lupus erythematosus, Procalcitonin, C protein reactive

MI TNG QUAN GIA HNH VI TNG CNG SC KHE V MC NG HUYT NGI BNH I THO NG TYP 2 BNH VIN BCH MAI, H NI
Nguyn Th Hoa Huyn1, Triu nh Tuyt2, Phm Ngc Thng2
1

Trng Cao ng Y t H Ni, 2 Bnh vin Bch Mai

M t hnh vi tng cng sc kho v tnh trng kim sot ng huyt ngi bnh i tho ng type 2, bnh vin Bch Mai, H Ni. (2) M t mi tng quan gia hnh vi tng cng sc kho v tnh trng kim sot ng huyt ngi bnh i tho ng type 2, bnh vin Bch Mai, H Ni. i tng v phng php: Nghin cu m t ct ngang trn 92 ngi bnh. Kt qu: im trung bnh ca vic thc hin hnh vi tng cng sc khe ngi bnh i tho ng type 2 l 2,8 0,2. 55,4% ngi bnh khng kim sot c ng huyt. C mi tng quan gia hnh vi tng cng sc khe v mc ng huyt. Kt lun: Hnh vi tng cng sc khe ngi bnh i tho ng type 2 c thc hin khng u n, trn 50 ngi bnh khng kim sot c ng huyt mc cho php. Ngi bnh thc hin hnh vi tng cng sc khe tt s kim sot c ng huyt tt hn T kha: i tho ng type 2, hnh vi tng cng sc khe, kim sot ng huyt

Summary CORRELATE OF HEALTH PROMOTING BEHAVIORS AND BLOOD GLUCOSE LEVEL OF PATIENTS WITH TYPE 2 DIABETES, BACH MAI HOSPITAL, HANOI
(1) To determine health promoting behaviors and blood glucose control of patients with type 2 diabetes, Bach Mai Hospital, Hanoi. (2) To examine the correlation of health promoting behaviors and blood glucose level of patients with type 2 diabetes, Bach Mai Hospital, Hanoi. Subjects and Method: A cross sectional study design was used in this study on 92 patients. Results and Discussion: The score of health promoting behaviors in patients with T2D was 2.8 0.2. 55.4% participants were uncontrolled blood glucose level. The correlation between health promoting behaviors and blood glucose level was found. Conclusion: Health promoting behaviors was not often practiced; over a half of patients did not control their blood glucose level. The more practicing health promoting behaviors of patients with T2D, the better blood glucose level is controlled. Keywords: type 2 diabetes, health promoting behaviors, blood glucose control

NGHIN CU C IM DCH T, LM SNG V IU TR UI NC TR EM TI BNH VIN NHI TRUNG NG

L Thanh Hi, Khu Th Khnh Dung
Bnh vin Nhi Trung ng ui nc l mt tai nn thng gp trong i sng hng ngy. Mc tiu ca ti: nh gi mt s c im dch t hc, triu chng lm sng, cc bin chng v iu tr ui nc tr em nm iu tr ti Bnh vin Nhi trung ng. i tng v phng php: i tng l 47 bnh nhi, tui 2 thng - 13 tui vo vin iu tr v ui nc t 2003 n 2009. Nghin cu hi cu da trn cc bnh n ca bnh nhn. Kt qu: Tui trung bnh ca tr vo iu tr l 5,7 4,5 tui. T l nam/n 1,3:1. Phn ln cc trng hp ui nc xy ra vo cc thng ma h t thng 5 n thng 9. 63,8% trng hp ui nc xy ra trong khong thi gian 12 - 16 gi. 72,3% (34/47) cc trng hp ui nc xy ra ao, h. S cu ban u c thc hin ch yu bi gia nh v hng xm, nhng ngi khng c chuyn mn y t. 42,6% bnh nhn c vn chuyn n bnh vin Nhi Trung ng bng xe ca y t c h tr cp cu trn ng vn chuyn. Ba yu t quan trng quyt nh tin lng ca nn nhn l cht lng v thi gian cp cu nn nhn ti ni b nn, tnh trng bnh nhn nng i hi hi phc chc nng h hp tun hon v im Glassgow di 4. Kt lun: ui nc l vn quan trng ca y t cng ng do cn c cc bin php gio dc tch cc hn h tnh trng ny xy ra. Tuy nhin nu ui nc xy ra th cp cu c bn chnh xc v nhanh gn l iu kin tin quyt cho mt tin lng tt T kha: ui nc, tai nn, cp cu

Summary DROWNING IN CHILDREN AT NATIONAL HOSPITAS OF PEDIATRICS

Drowning is a common cause of accident in children. The aim of the present study was to study demographic features, clinical characteristics, treatment and outcome of drowning in National Hospital of Pediatrics. Material and methods: A retrospectively review of records from 2003 to 2009 for cases of drowning was performed. 47 consecutive cases of drowning were identified. Results: The average age of admitted patients was 5.7 4.5 years (ranged from 2 months to 13 years patients). Male: female ratio was 1.3 : 1 and most cases occurred in summer time. Children drowning during the period of time from 12 to 16 oclock was 68.4%. The most common sites of drowning were ponds and lakes (72.3%). Resuscitation performed by family members and neiboughers was 98%. Only 42.6% of drowning cases were transpoted to national Hospital of Pediatrics with the supports from health care givers. A poor prognosis after drowning is associated with several factors such as efective immidiate resuscitation after submersion, the need for cardiopulmonary resuscitation in the emergency department and the initial Glassgow score less than 4. Conclusion: Since drowning is an important public health issuse, the education and support of rescure services and public awareness campaigns are very important. However, if drowning happens, effective immediate resuscitation is crucial for the better outcome. Key words: Drowning, accident, emergency

T L T VONG DO TAI NN THNG TCH VIT NAM NM 2007

Nguyn Phng Hoa
Trng i hc Y H Ni M hnh bnh tt ca Vit Nam hin trong giai on chuyn i dch t hc, tai nn thng tch v cc bnh khng ly nhim ang tr thnh nhng nguyn nhn hng u gy t vong. Mc tiu: xc nh t l t vong do tai nn thng tch ti Vit Nam. i tng v phng php nghin cu: nghin cu m t ct ngang, phng vn ngi trc tip chm sc i tng b t vong trong t m cui cng (phng php VA). Kt qu: trong s 6805 trng hp t vong, t l t vong do tai nn thng tch chim 14,3%. Nam gii c nguy c b t vong do tai nn thng tch cao hn n gii (OR = 2,3; p < 0,05). Nhm tui 15 - 49 c t l t vong do tai nn thng tch cao nht (36,3%). T vong do ui nc gp nhiu nht (12,1%) tr em t 0 - 14 tui. 18,4% l t l t vong do tai nn giao thng nhm tui 15 - 49. Kt lun: tai nn thng tch l mt trong nhng nguyn nhn hng u gy t vong Vit Nam, c bit l la tui tr em v thanh nin. Cn c cc chng trnh can thip gim thiu t vong do tai nn thng tch. T kha: tai nn thng tch, xc nh nguyn nhn t vong bng phng php phng vn (VA)

Summary MORTALITY RATE OF INJURY IN VIETNAM IN 2007

The epidemiological transition is occurring in Vietnam. Injury and non-communicable diseases are leading causes of death. Objective: to identify mortality rate of injury in Vietnam. Methods: a cross-sectional study was conducted by using verbal autopsy method to interview the person who was directly care of the patient before die. Results: mortality rate of injury was 14.3% among 6805 cases. Males had a significantly higher injury rate than females (OR = 2.3; p < 0.05). Drowning was the most common cause (12.1%) among children with aged 0-14. Traffic injury was common cause of death (18.4%) among people with aged 15 - 49. Conclusions: injury is one of the leading causes of death in Vietnam, especially among the children and young. Prevention programs are needed to implement for the benefit of public health. Key words: injury, Verbal Autopsy (VA)

T L HIN MC V T L MC MI TT KHC X HC SINH KHI LP 6 TRNG TRUNG HC C S CT LINH H NI NM 2010

Nguyn Ch Dng
Bnh vin Mt Trung ng Tt khc x (TKX) tr em nc ta c xu hng tng nhanh, v vy iu tra t l mc v t l mc mi TKX hc sinh l cn thit c k hoch can thip. Mc tiu: (1) Xc nh t l mc v t l mc mi TKX sau 1 nm hc sinh lp 6 trng THCS Ct Linh, H Ni. (2) Kho st cc yu t lin quan n t l mc TKX. i tng v phng php: nghin cu ct ngang trn 225 hc sinh lp 6 trng THCS Ct Linh, nh gi tt khc x sau lit iu tit. Kt qu: T l mt mc cn th l 42,2%, mt vin th l 2,2%, mt lon th l 13,6%. Hc sinh lp chuyn c t l mc TKX cao hn (68,7% nm u v 78,3% nm th 2) so vi lp khng chuyn (tng ng 58,5% v 67,6%) T l mc mi TKX sau 1 nm (tnh theo ngi) l 9,3%. T l mc mi cn th (tnh theo mt) sau 1 nm l 2,2%. Cc yu t lin quan: hc sinh lp chuyn c nguy c mc TKX cao hn lp khng chuyn 1,6 ln, b m c TKX mc cao hn 1,5 ln. Kt lun: T l mc TKX nm 2010 hc sinh lp 6 trng Ct Linh: 71,6%, trong cn th 42,2%, vin th 2,2%, lon th 3,6%.T l mc mi cn th l 2,2%/ nm. T kho: nh gi TKX tr em

Summary CURRENT PREVALENCE AND INCIDENCE OF REFRACTIVE ERROR AMONG THE 6 GRADE PUPILS OF THE SECONDARY CATLINH SCHOOL IN HANOI IN 2010
Objectives: Prevalence of refractive error (RE) in children in Vietnam has been rapidly increased so it is necessary to make an assessment of RE prevalence and incidence in children. 1. To evaluate RE prevalence and incidence/year in 6th grade pupils of the CatLinh School in Hanoi. 2. To describe some risk factors related to RE in children. Methods: Cross-sectional prescriptive study on 225 children aged from 11 to 12 years old. Results: Current prevalence (per eyes) of Myopia is 42.2% , Hypermetropia is 2.2%, and Astigmatism is 13.6 %. Pupils in the special class have a higher prevalence of RE (68.7% in the 1st year and 78.3% in the 2nd year) than the pupils of normal class (58.5% in the 1st year and 67.6% in the 2nd year). The incidence of RE (per person) is 9.3% /year. The incidence of Myopia (per eyes) is 2.2 /year. Risk factors related to RE are children learning in the special class OR=1.6 [0.9 - 2.8], having parents suffered from RE OR=1,5 [0,8- 3,1]. Conclusion: Current prevalence (per eyes) of RE of the 6th grade pupils of CatLinh School in Hanoi in 2010 is rather high (71.6 ). Incidence of Myopia is 2.2 /year. Key words: assessment of refractive error in children

NGUYN NHN B CUC V TC DNG PH KHNG MONG MUN CA THUC TIM TRNH THAI PH N HUYN A LI TNH THA THIN HU GIAI ON 2006 -2009
Phan ng Tm1, V Vn Thng2
1

Chi cc Dn s - KHHG, tnh TT-Hu; 2i hc Y Dc Hu

M t cc yu t lin quan n vic b cuc thuc tim trnh thai. i tng v phng php: nghin cu nh lng v nh tnh, thit k m t ct ngang, tin hnh phng vn 525 ph n trong tui sinh 15 - 49 tui v ang s dng thuc tim trnh thai t 01/07/2006 n 31/06/2009. Kt qu: L do b cuc ca 97 i tng (18,5%) thay i rt ln, vi nhiu l do. L do chim t l cao nht l do tc dng ph ca thuc tim nh hng ln sc khe. Mt s yu t lin quan n b cuc thuc tim trnh thai C mi lin quan c ngha thng k (p < 0,05): chng thiu quan tm ng h th t l b cuc cng cao; Mc tc dng ph cng nng th t l b cuc cng cao. T l b cuc cng thp khi khong cch t nh n im cung cp dch v cng gn. Kh khn v giao tip khi tim thuc lm tng t l b cuc. Thi gian ch i lu lm tng t l b cuc. i tng khng c p ng dch v kp thi v c iu tr khi gp tai bin tc dng ph th t l b cuc tng. Kt lun: T l b cuc thuc tim trnh thai ti A Li l 18,5%. L do b cuc chim t l cao nht l do tc dng ph ca thuc tim nh hng ln sc khe. Mt s yu t lin quan n b cuc thuc tim trnh thai (p < 0,05): S quan tm ca chng, tc dng ph ca thuc tim trnh thai, khong cch t nh n ni cung cp thuc tim trnh thai, kh khn v giao tip khi tim thuc, thi gian ch i v p ng dch v v tn sut cung cp dch v. T kha: Nguyn nhn, t l b cuc, tc dng ph, thuc tim trnh thai

Summary REASONS OF DROP-OUT AND UNEXPECTED SIDE EFFECTS OF INJECTABLE CONTRACEPTIVES AMONG WOMEN IN A LUOI DISTRICT, TT-HUE PROVINCE IN 2006-2009
In order to have an insight into the factors relating to the drop-out of DMPA injectable contraceptive users. Methods: combination of quantitative and qualitative research methods, using cross sectional design, doing interviews with 525 married women aged from 15 - 49 years who have used injectable contraceptives from 01/07/2006 to 31/06/2009. Results: The reasons for dropout in 97 of DMPA users varies considerably, including a lot of reasons. The most popular reason is the influence of side effects on health. A number of factors statistically significant relating (p < 0.05) to the dropout of DMPA injectable contraceptive injections are: the support from husband, the serious the side effects, the distance from home to service provision location. The other factors are difficulties in communication when women having DMPA injectable contraceptives and waiting time of users to have consultancy. There is a high withdrawing rate among subjects who do not receive timely service provision and timely treatment when suffering from side effects. Conclusion: The drop- out rate of DMPA users in A Luoi district is 18.5%. The main reason of DMPA drop out is side effect of DMPA. There are some factors statistically significant influencing drop-out rate of DMPA users (p < 0.05) as husbands concern, side effect of DMPA, distance between users home and health service locations, communication barriers, waiting time and DMPA services response and DMPA service provision frequency. Key words: DMPA, causes, drop-out rate, side effects, injectable contraceptives

NGHIN CU NNG RU TRONG MU V C IM TN THNG CA NHNG NGI CHT DO TAI NN GIAO THNG NG B
Nguyn Hng Long1, inh Gia c2
1

Vin Php y Quc gia, 2 Trng i Hc Y H Ni

Nghin cu c im dch t nn nhn b t vong do tai nn giao thng (TNGT) c nng cn trong mu v xc nh hnh nh tn thng thng gp nhng nn nhn ny. i tng v phng php: nghin cu m t ct ngang c thc hin trn 572 nn nhn t vong b Tai nn giao thng trong thi gian t 30/8/200730/8/2009 tm ra c 100 nn nhn c nng cn trong mu. Kt qu: T l c nng cn trong mu nam gii l 97% v n 3%. tui t 15 - 29 chim t l 59%, t 30 - 44 l 24%. Tai nn gia xe my - t chim 64%, t gy l 14% v xe my - xe my l 10%. Thi gian thng xy ra tai nn t 20 gi m - 3 gi sng (60%). Chn thng s no chim 70%, v xng s chim 59%, chy mu mng mm chim 49%. Kt lun: T l nam gii c nng cn trong mu b Tai nn giao thng l 97%, tui hay gp t 15 - 29, thi gian thng xy ra Tai nn giao thng ngi ung ru bia t 20 gi m - 3 gi sng. Chn thng s no chim 70% v chy mu mng mm chim 49%. T kho: Tai nn giao thng, chn thng s no, chy mu mng mm.

Summary STUDIES IN BLOOD ALCOHOL CONCENTRATION AND INJURY CHARACTERISTICS OF THE DECEASED BY ROAD TRAFFIC ACCIDENT
To study characteristics of Epidemiology at the victims died of traffic accidents have blood alcohol levels and identify common image lesions in these victims. Methods: Cross-sectional descriptive study was conducted on 572 deaths were from traffic accidents during the period 30/8/2007 - 30/8/2009 found the 100 victims with blood alcohol concentrations. Results: The rate of blood alcohol concentrations in men is 97%, 3% female. Aged 15 - 29 account for 59%, from 30 44 for 24%. Accidents between motor vehicles account for 64%,14% and caused himself a motorcycle and motorcycles is 10%. Regular time since the accident and from 20 oclock 3 am (60%). Brain injury accounts for 70%, 59% broken skull, soft membrane bleeding 49%. Conclusion: The proportion of men of with a blood alcohol concentration in traffic accidents is 97%, from the 15 - 29 age or experience, often times traffic accidents occur in people who drink alcohol from 20 oclock 3 am. Cranial trauma 70% and 49% soft membrane bleeding. Keywords: Traffic accidents, brain injury, soft membrane bleeding

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