Y HOC VIET NAM THANG 2 - SO
2/2014
mg/ngay. Tan suat sff dyng heroin hang ngay
eua benh nhan giam di rd ret: tru'dc dieu tri 1,24
lan/ngay;
giai
doan dd lieu 1,07 lan/ngay sau 7
ngay, 0,33 lan/ngay sau 30 ngay va sau 3 thang
dieu tri la 0,08 lan/ngay. Ty te benh nhan dffdc
chuyen girl den cac
dich
vu y te khac nhff: Dieu
trj ARV la 44,5%, dieu tn nhiem triing cd
hdi
30,8%,
cung cap BKT sach 21,3%, tff van xet
nghiem HIV ty nguyen 8,3%, Oa sd benh nhan
dang dffdc
dieu
trj tai cac cd sd deu cho biet hp
rat hai Idng, hai Idng vdi cac djch vy ddn tiep
benh nhan, thai dp bac sy lam viec, thai dp nhan
vien tff van cung nhff hai Idng vdi thai dp
eiia
cae
nhan vien cdng tac tai
cd
sd dieu trj Methadone.
TAILlgUTHAM
KHAO
1.

Methadone
,yi5
Noi, tr, 5- 24.
Bp Y te (2010), Hudng dan dieu tri thay the
nghien cac chit dang thudc phien bang thuoc
methadone,
Ha Noi, tr, 3- 25.
Trung tam phong chong
HIV/AIDS
Ha Npi
(2013),
Bao cao ket qua hoat dong phong chong
HIV/AIDS 5 thang dau va phUOng
hUdng
nhiem
vu 6 thang
cuoi
nam 2013,
Thu tu'dng Chinh phu
(2012),
Chien
\Mc
qudc
gia
phong chdng HIV/AIDS
d
Viet
Nam den nam
2020 va tam nhin 2030,
NGHIEN

tffdng
va phu'dng
phSp
nghien
cffu:
hoi cffu ket
hijp
tien
ciru,
mo ta, cat ngang
dUdc
thyc hien d
BVrWQD
108
ty
2008-2013, Ket qua: 400 trUdng hpp
giam tieu
au
mau ngoai
vi
ddn thuan hoac kem
giam
HC Tuoi trung binh la
53,2
tuoi
{14-94
tudi),
Oa so
cic BN nhom
tuoi

lu^n:
Tiiy
do la xet nghiem quan trong de chan
do^n
xac djnh nguyen nhan giam tieu cau.
Titldida:
Giam
teu
cau,
Chpc
hiit
bjy
xUOng
(tiiy
do)
•
Khoa
huyet
hpc lam
sang
Benh
vi$n
TWQD108
PhAn
bl$n
khoa hgc: PGS.TS Nguyen Lieu
Nguyen Thj Minh
Phuong*
SUMMARY
STUDY OF CHANGES IN NUMBER

acute leukaemia respectively. Most patients increased
number of megacaryocyte
with
immature form is ITP.
Conclusion: bone marrow aspiration
is
an important
diagnostic modality to determine the aetiology of
thrombocytopenia.
Keywords: Thrombocytopenia, bone marrow
aspiration
YHOC
VIET
NAM
THANG 2 - SO 2/2014
I.
BAT VAN DE
Tieu cau (TC) ddng mpt vai trd quan trpng
trong ddng mau va cam mau khi thanh maeh bi
ton thffdng. Giam so iffdng tieu cau
(thrombocytopenia) se tang nguy ed ehay mau.
Giam TC thffdng gap trong thyc hanh lam sang.
Mae
dii
ed rat nhieu nguyen nhan gay giam tieu
cau nhffng cd the chia ra lam 4 nhdm
chinh:
Suy
giam kha nang sinh tieu cau, tang
hiiy

(Kibria et
al.,
2010) [2]. Mue tieu
eiia
nghien cffu
nay la danh gia vai trd cua
tiiy
xffdng trong cac
trffdng hdp giam tieu cau.
II.
OOI TU'ONG
VA
PHt/CTNG PHAP NGHIEN OJM
2.1.
Doi tu'dng nghien cu'u: 400BN giam
tieu cau mau ngoai vi dieu trj tai Benh
vienTWQO
108.
Loai trff cac trffdng hdp Iffdng dich hut
tiiy
xffdng khdng
dii
de dpc xet nghiem hoac
tiiy
kho
khd hilt
djch,
benh nhan dang sff dung cae thuoc
cd kha nang gay
giam

SPSS 18.0
. KET QUA
Bang 1: Dac diem chung cua cac
BN
nghien cffu
Tuoi
Gidi
<15
16-30
31-45
46-60
>60
Nam
NO-
Sot
Xuat huyet
Da
xanii,
niem mac
ntidt
Gan
to
Lach to
Hach to
Dau xu'dng
Cac trieu
chCrnq
khac
So
lu'dng BN

11,8
20,5
400 BN giam
tliu cau du tliu
chuan d&dc chpn vao nghien
c&V.
Tudi
trung btnh ia 53,2
tuoi (14-94
tudi).
Nhdm
tudi
th&dng
gap nhit la >45 tudi
(69,25%,
trong sd
400
binh
nhan).
62,8% la
nam
g'i&
37,3% la
n&gidi
vdi ty li
nam:n&la
1,6:1.
Trieu ch&ng
lam sang
th&dng

rq/il
Tonq
so
iu'dnq
bach cau
(G/L)
So
iydnq
tuyet doi BC
hat
(G/L)
So
iu'Onq
tieu cau
(G/i)
Hinh thai
te bao
Hinh thai hong
cau
HC Binh thu'dng dang
sac
HC Nho, nhu'dc sac
HCto
Te bao
bat
thu'dng mau ngoai
vi
Gia
tri
trunq binh (Mean

dang sac chiem 81.5%.
Bang
3:
Mat
do te
bao
tuy
xi/dnq
d
cac BN nqhien ciru
Sd tlTdng
te
bao
tuy (G/L)
So iu'dng binh thu'dng (30-100
G/L)
Tuy tang
so
luang
te
bao (>100
G/L)
Tuy qiam
so
lu'dnq
te
bao
(<30
G/L)
Tong

2725%
Bang
4:
So
iu'dng mau tieu
car
Chan doan
Bach cau lympho cap
Bach cau
tuy
cap
Giai doan cap
ciJa
bach cau
tijy
man
H6I chu'ng thu'c bao
Cu'dng lach
Giam san
tuy
Xuat huyet giam tieu cau
vo
can (FTP)
Roi ioan sinh
tuy
Thieu mau HC
i<h6ng
io
Di can ung thu vao
tuy

0
0
52
:ac Chan doan khac nhau
3
Mau tieu cau
(n=
Binh
thu'dng
4
2
3
5
2
21
22
4
5
0
0
7
11
10
96
Giam
9
27
2
3
1

53
6
11
9
85
89
19
37
25
5
13
15
13
400
Tyl?
(%)
5
13,25
1,5
2,75
2,25
21,75
22,25
4,75
9,25
6,25
1,25
3,25
3.75
3,25

xddng (6,25%),
roi
loan sinh
tuy
(4,75%), tang sinh
ac
tinh ddng piasmocyte
(3,25%) va nhiem trung
gay
giam TC(3.25%).
Y HOC VIET NAM THANG
2 -
SO 2/2014
Bang
5:
Moi
lien quan giffa so iffdng va hinh
thai
mau tieu cau d
tiiy
dd cac
BN
giam TC
Hinh thai
Khonq gap
Hinh thai roi ioan
Hinh thai binh thu'dnq
Dang te bao non
Tdng
sd

400
Sdl&dng
va
hinh
thai
mau
tiiu
cau
trong tuy do
cd
mdi liin
quan
vdi
benh.
229/400
BN
chiim
57,25%
CO
so
l&dng
mau tieu cau trong tuy binh
thwdng hoac giam nh&ng
hinh that van binh
th&dng.
Co
97
tr&dng
hdp co
tang

loan sinh
tuy.
IV. BAN
LU^N
Giam tieu eau thffdng gap trong cac rdi loan
huyet hpe khac nhau bao gom ed rdi loan sinh
tiiy
hoae khdng ed rdi loan
(MeKenzie,
1996) [5].
Mpt so benh huyet hpc ehi bieu hien giam tieu
eau ddn thuan hoac kem theo giam 2 ddng khac.
Chpc hilt tuy xffdng de lam
tiiy
do la mdt xet
nghiem an toan va hffu
leh
nham xac djnh ehan
doan cudi cung [6]. Trong nghien cffu
eiia
chung
tdi dp tudi hay gap nhat la >45 tudi
(59,25%,
trong sd 400 BN). Trong mdt nghien cffu
ciia
Muhury
va es (2009), da sd eae BN dffdi 10 tudi
[6].
Tudi trung binh trong nghien cffu
ciia

bi§n
nhat thay d 89 BN (22,25%). Cac nghien effu
khae eae ty le nay lan Iffdt la
6.21%,
14.5%,
6,8% va 5%
kibria
va es 2010 [2]; Ahmad va cs
2011;
Pudasaini va cs 2002;Knodke va es 2001)
[3],
[7]. Nguyen nhan phd' bien thff 2 gay giam
tieu eau la giam san
tiiy
(85/400 BN chiem
21,75%) sau dd la bach eau
tiiy
cap (53 BN,
13,25%). Trong 53 trffdng hdp AML, the phd
bien la AML-M2 (22 BN), sau do la
AML-Ml
(8
BN) va AML-M4 (7 BN). Tffdng tff nhff nghien
cffu cua chiing tdi thi bach cau cap cung la
nguyen nhan phd bien thff 3 gay giam tieu cau
trong nghien cffu
ciia
Savage va cs (1999) va
tffdng tff nhff nghien cffu
ciia

Chiing tdi cung gap tang sinh ac tinh piasmocyte
nhffng vdi ty le thap (3,25 %) va rdi loan
sinh tiiy
(4,75%).
Cac nghien effu khac nhff cua Kibria va
cs 2010; Laishram va cs 2008) thay
t/
Ie
da u
tiiy
xffdng tff 0.94% tdi
4.1%
va rdi loan sinh
tiiy
tff 2% to 7.9%. Ve so Iffdng va hinh thai mau
tieu cau thi tang sd Iffdng va dang non dffdc thay
trong hau het cae trffdng hdp FTP. George va cs
(1994) va Levine va es (1999) cung cho ket qua
tffdng tff.
V. KET LUAN
Ciing vdi cac trieu
chiffig
lam sang thi xet
nghiem
tiiy
do la mdt bffdc quan trpng de chan
doan xac djnh cac benh ly huyet hpc cd giam tieu
cau.
Xuat huyet giam tieu cau vd can la nguyen
nhan pho bien nhat gay giam tieu cau trong

R.
C,
Panta, D.,
Jha,
R.
(2008). Bone marrow examination
in
cases
of pancytopenia. 3 Nepal Med
Assoc,
47, 12-17.
2.
Kibria, S. G., Islam, M. D. U. (2010).
Prevalence of Hematological Disorder: A Bone
MantJW
Study of
177
Cases In a Private Hospital
at Fandpur.
Farldpur
Med.
Coll J, S, 11-13.
3.
Knodke,
K.,
Marwah,
S (2001). Bone marrow
examination in cases of pancytopenia. J Academy
QinMed,!,
55-59.

bone marrow
aspirabon
study. Indian J
PatholMlcrobioi,
52,
490^94.
Pudasaini, S., Prasad, K. B. R (2002).
Interpretation of bone marrow aspirabon
in
hematological
disorder.
Journal of Pathology of
Nepal, 2, 309-312.
THirC
TRANG AN TOAN VE SINH THITC PHAM TAI
BEP
AN TAP THE
COA
MOT
"SO
DOANH
NGHIEP
-
THANH
PHO HAI
DiraNG
NAM 2013
TbM
TAT
Nghien

khdng mang day
dii
bao hp lao dpng
khi
lam
viec;
20%
NPV khong sff dung dung
cy
sach khi che
bien;
Tren cac mau xet nghiem deu thay co ty le nhiem
vi
sinh vat (VSV): tren
thi/c
pham
chin,
dung cu chira
(Jyhp
thu'c pham
chin,
ban tay NPV, Trong do ty le
nhiem VSV tren ban tay NPV la cao nhat: Coliform
(72,5%);
E.coli
(25,0%); S.aureus(32,0%).
SUMMARY
SAFETY
SITUAHON
IN FOOD HYGIENE AT

khoa hgc: GS.TSKH Nguyen VSn Hien
Dinh Huy
Hung*,
Vu
Due
Long**
unsatisfactorily on administrative procedures;
17.5%
is
unsatisfactorily on infrastructure, 20% waiters do not
carry adequate labor protection at work; 20% waiters do
not use clean utensils when processing; In the
specimens founded microorganism ratio on cooked
food,
containers of cooked food , hands of waiters. In which
the infection rates on the waiters' hands is the highest;
Coliform (72.5%), E,
coli
(25,0%), S, aureus (32,0%),
I.
OAT VAN
OE
An toan ve
sinh
thffc pham(ATVSTP) hien
dang la mdi quan tam
Idn
ciia
nhieu Qudc gia
tren the

12,7 den 20,6% tong sd vu moi nam, Tuy nhien
day chi la sd iieu thdng ke chu'a day du
,thffc
te
con sd ngd dpc thffe pham hang nam cdn eao
hdn rat nhieu[2]. Theo ffdc tinh
eiia
WHO, d Viet
Nam con sd ngd dpc thffe pham hang nam
khoang tren 8 trieu ngffdi [5]. Hai Dffdng la mdt