SU DUNG THANG DO VAS THONG DANH CIA MU DO DAU SAU PHAU THUAT KET HOP XUUNG DUI TAI DOH VIEN VIET Bit NGUYEN THI NGOC MAI, NGUYEN HUY PHUONG, IRAN TRUNG DUNG Dai hoc Y Ha NOi TOM TAT Mu
Trang 1SU DUNG THANG DO VAS THONG DANH CIA MU DO DAU SAU PHAU THUAT
KET HOP XUUNG DUI TAI DOH VIEN VIET Bit
NGUYEN THI NGOC MAI, NGUYEN HUY PHUONG, IRAN TRUNG DUNG
Dai hoc Y Ha NOi TOM TAT
Muc tieu: MO te tinh trang dau sau phau thuat kat
xuong a benh nhan gay xuceng theo thang
di m VAS Nhan xet cac yeti t6 lien quan tai tinh trang
dau sau phau thuat
Doi tuong va phuong phap nghien ciru: Gam 50
benh nhan duor chin (loan gay xikyng va /for
pilau thuat ket hop xuung tai benh vien Viet Dix
Diem dau VAS duoc phan loai mUc CIO theo Salley
L.Collens Xcy ly s6 lieu bang phan mem SPSS 16.0
Ket qua nghien cthi: Diem dau cc:La benh nhan
duoc danh qia bang Mang diem VAS tai cac thdei diem
0 — 12 gia, 12 — 24 gia, ngay ther hai, ngay thin ba sau
phau thuat MUc dO dau giam den theo thai gian
Ket luan: Tinh trang dau ctia benh nhan sau phau
thuat Aei livp Awing Jul co tne itiong gia va theo dal
bang thang diem VAS Dau sau pilau thuat ket hop
xuonq crOi nang nhat trong thai diem 24 gia dau sau
mO, cho yeu /à dau vela tai dau Ong, VAS 4 — 9 cfiem
Cac you to hen quan den tinh trang dau sau and bao
gOm tool gay xuung, vi tri, tinh chat 6 gay, phuong
phap ket hop xuong va tu6i benh nhan
Tir khda: Phau thuat ket hop xuong dui, thang
diem VAS, muc da dau
SUMMARY
USING VAS PAIN CLASSIFICATION SCALE TO
ASSESS LEVEL OF PAIN AFTER FEMUR
FRACTURE SURGERY AT VIET DUC HOSPITAL
Objectives: Assessing the level of pain after femur
fracture surgery by using VAS scale Assessment the
factors that related with pain postoperative
Methods: 50 patients with femur fracture were
operated atVict ho.3pital VAS pal Jwies
categorized according to Salley
processing using SPSS 16.0 software
Results: Distribution on the pain VAS scale at the
()nit), of tim p 0 - 1 2 hours, 12-24 hoc - 2 scccnd and
third postoperative day Pain postoperative decreases
along the time
Conclusions: Level of pain after femur fracture
sugery can fully assessed and followed up by VAS
scale Pain level in the first 24 hours postoperative
were the most severe, mainly moderate and severe
pain, VAS at 4-9 points The factors that is related with
pain postoperative include: type of fracture, local of
fracture, level of fracture, fixated method and patient's
years old
Keywords: Femur fracture surgery, VAS scale,
level of pain
DAT VAN DE
Dau la mot li do ph6 bien nhat khien nguai benh
tim den sir cham sac cua y te tinh cd khoang
80% benh nhan (BN) den kham lien quan tai yeu to dau Dua theo ket qua dia mdt cudc dieu tra ve dau sau ph5u thuat tai M9 Lrac tinh c6 khoang 80% BN trai qua can dau cap tinh sau ph5u thuat, trong s6 nhCrng
BN nay 86% la dau vCra va dau nang
Gay xuang dui la mdt char) thuang thLranggap, CO the xay ra moi hoan canh vai nhieu tu6i khac nhau Theo Janos P S thi hang ngay a M9 co trung binh 01 ngLyai gay xuang dui Van 100.000 dan
Dieu tri thin thu gay wang dui thuteng sir dung bien phap phau thuat ket hop xuong (PTKHX) Tuy nhien PTKHX dOi la mdt ph5u thuat Ian, doi hdi st,r chuan bi ki ludeng khOng chi & nhan vien y te ma con BN.Va van de dau sau PTKHX dOi la mdt trona ,Thrr,,3
io lang hang dau cita nhieu BN, tra thanh An a can quan tam cho nhan vien y te Do do vied danh gia va giarn dau cho BN sau phau thuat, giup rut ngan qua trinh phuc hdi va tranh nhirng ben chirng c6 the xay ra
la quan trong Vi nhung li do ten chUng tdi tien hanh ngnien cL:ru de tai val hai muc tieu la m6 to min dd dau sau PTKHX dOi theo thang phan loai dau VAS va nhan xet cac yeu t6 lien quan tai tinh trang dau sau
md
DOI TU'O'NG VA PHU'O'NG PHAP NGHIEN D6i ttran9 nghien
Tieu chuan lua chop:
BN gay xuang dui &roc PTKHX tai Vien Chan thiyang Chinh hinh — Benh vien Viet Dire, tren 6 tu6i
Tieu chuAn lc* trck
KhOng CO chi dinh hoar co chOng chi dinh PTKHX,
BN s 6 tu6i, CO da char) thuang va cac rOi loan then
k iii/ rigoai vi Vi a du n, iir en6i [ham gia ngnien cu'u
50 Bri phu hop tieu chuan Iva chon Phiyang phap nghien ciru
Ngher cth: rrid td, tier khong nhom chi.mg Dia di4m
Khoa Chan thuang Chinh hinh I va khoa Chan thuang Chinh hinh II - Vien Chan thLiang Chinh hinh - Benh vien Viet DC/c
Thai gian
Tir ngay 15/11/2014 den ngay 28/2/2015
Bi6n s6 nghien ciru
Tudi, giai tinh, nghe nghiep, nguyen nhan chan thuang, loai gay Arcing, tinh chat gay xuang, phiyang phap PTKHX, thai gian: vac) vien, phAu thuat va ra vien, tinh trang dau truck m6, tinh trang dau sau m6
Cong cy va phwang phap thu thap sO lieu
COng cu ihu Chap
Thuac phan loai dau VAS:
Cui too: La mdt thirac dai 10cm co hai mat:
Trang 2Mirc dO dau cua benh nhan sau phSu thuOt ket
Tan so
40
30
20
10
[
KhOng Kho Dau at Dau Dau PAtit as dau Oita Vv n3ng
25
20
15
10
0 - :iatair - Khong Kho ()au it
dau chiu
Dau Mire dO naafi
Dau VIJJ
Tin 46
„ -
-Mur dQ
Dau it Dau Dau
35
30
25
70
15
10 r
LL.1111
/Chong dau
Khanga Kta6 Dau it Dau Dau Mirc dij
Tin:4
30
"
,
25 ,
20
15 r
10 1",
MOt mat kh6ng s6 danh cho BN bieu thi cac dau ttr
khOng dau tai dau tot Binh nhat, khong the chiu dog
Cuvc
Mt con lai quay ye phia they thu6c du'oc chia 11
vach vai 10 MCYC d6 dau, krang Ong vai mat quay ye
phia BN tir khOng dau tai kh6ng the chiu dog &roc
Thanh truvt co the di chuyen de chon d6 dau
Cach ser dung: De BN tu, so sanh va nhan xet rnt:rc
60 dau sau CIO di chuyen thanh truvt_tir dau khOng dau
tai vi tri tulang Ong dau cua minh They thu6c se biet
duvc diem dau cua BN qua mat so, diem VAS la
khoang cach tir 0 den diem BN danh dau
benh an nghien ci:ru thong nhat Diem dau VAS tai cac
thai diem: 0 - 12 gide, 12 - 24 gia, ngay thin hai, ngay
thin ba va Nay ra vien
- Diem dau VAS dt.rac phan loaf theo Salley
L.Collens:
• VAS - KhOng
• VAS 1 - 2: Cam giac khO chiu
• VAS 3 -4: Dau nhe
• VAS 5 - Rt Dal, virs
• VAS z 7 Oat, neng
Xt/ Li SO LIEU
Bang phan mem SPSS 16.0
KET QUA NGHIEN
D4c diem chung cua mAu nghien ctru
Bang 1: flac diem Chung cua mau nghien ciru
so Penh nhancn = 50)
Loai gay xtrang (110i Gay kin: 43 BN (86%)
Gay her 7 BN (14%) Tinh chat gay
xuang dui
Phirc tap: 38 BN (76%) Dan gian: 12 BN (24%) Dau tren xtrang dui 13 BN (26%) Than xuang dui: 28 BN (56%) Dau dirtri nrcmg dui: 9 BN (18%)
Si : dung nep vit 37 BN (74%) Dinh nc)i tuy Kuntscher: 7 BN (14%) Dinh SIGN co ma 6 gay:, 3 BN (6%)
billi 11(,)1 it.iy Kt long m& o Tay @inn
RUSH): 3 BN
Vi tri gay xaang
CIO
Phan b6 phaang
phap ph5u thuat
ket hp.p xirang
Biku d61: Phan b6 min de dau CCM benh nhan
vao thai diem 0 -12 gia sau m6 Nhon xet: Tai thai diem 0 - 12 gia sau m6, diem
VAS phan bo tir 4 - 9 diem Phan Ian cac BN a MCYC
dO dau neng, chiem 68%
Bieu dO 2: Phan bO mu'c 6) dau cua benh nhan vao thai diem 12 - 24 gio , sau mo
Nhan xet: Tai thai diem 12 - 24 gib, sau m6: 48%
sO BN dau Ong, 46% s6 BN dau viva, 06% s6 be nhan dau it
Bleu do 3: Phan bo In CPC de dau cua benh nhan vao than diem ngay thu , nal sau mo
Nhan xet Tai ngay thir hai sau mo: phan Ion BN they dau viva (chiem 62%), dau nang con 12% va 26%
BN dau it
Bi4u des 4: Phan b6 mt"pc de dau cua benh nhan vao thol diem ngay thu ba sau mo
Nhan xet: Ngay thin ba sau m6, khOng co BN nao dau nang, 14 BN dau vira (28%) 28 BN dau it (56%),
8 BN chi they kho chiu
Tan so
20
.0 e Marc do
Iwo
0 - Khonu 10%6 Oau t Oeu ()au
Bi6U (16 5: Phan 136 min dc;) dau cua benh nhan
vao thai diem ra vien
NW xet: Den ngay ra vien, 60% BN de khOng con dau (n = 30), co 12 BN yen con cam giac kho chiu va 8
BN con dau it
8 VAS , 3:
;3
3.82
0 84
0 12 it.0 12 24 Nitay tht‘Nguy II, t Noy ra
KIC'Theiht;a11 I" v'i 'n
Bi6U di 6: Phan b6 diem VAS trung binh
tai cac thai diem sau phau thuat
10
6
2
46
Trang 3VAS
tudi
- ein enAs
4.14
5 - 15
-
1 5
Nhan xet: Diem VAS trung binh giam den theo thai
gian
50
35
30
1 4c
20
15 1
10
4
0
0- 12
CA0
BiAu d6 7: Phan b6 tinh chAt dau cua benh nhan
theo thai gian
veti p < 0,05
Bang 2: Thu6c giarn dau benh nhan da SO' dung
Thu6c
Om dau
0-12 gia
12-24 gia
Ngay thi", hai
Ngay thir ba
Ngay ra vien
Faicicetainui
dang truyen 50 50 49 29 0
Paracetamol
Nhan xet: Phan Ion cac BN deu duvc sir dyng
Paracetamol clang truy4n de Om dau sau m6, co 5
BN can dung them Morphin giam dau trong 12 gia deu
sau mo SO luvng BN can dung thu6c giam dau giam
den theo thai gian Ngay thir ba con 29 BN, ngay ra
vien khong BN nao can sip dung
Cac yeti to lien quan tai tinh trang dau sau m6
A 0.25 (I - 12 nib 12 - 24 NstAy thir Ngay Mit Noy to
Bleu d6 Lien quan giipa tuig
va tinh trang dau sau phiu thuat
Nhan xet Tai cac (nal diem nghien cu'u, diem VAS
deu cao han cac nhom tu6i khac Sir khac biet co
nghia thong ice tai theri diem tt:r 0 — 12 giO sau pheu
thuat vai p < 0,05 (p= 0,015)
14,
9 5 86
6 35
3 - 2 1
0
hai gi:ut
0- 1Z 12 - 24 NI.L.1 ilatil5L4a) that Nsca■ I 1
2I 2141 Itas La % tett
Bieu do 9: Lien quan giCra loci gayxu,ceng dui
va tinh trang dau sau ma
Nhan xet: Tai cac thai diem nghien cVu thi diem dau trung binh sau pheu thuat cua cac BN gay ha deu cao han so v6i cac BN gay kin Si,, khac biet co nghia thong ke tai thai diem 0 — 12 gibs sau pheu thuat
(p < 0,05)
WAS
10
2.4 3 3
S
•Zi
4
•
j)34, treat
7 3 -{ MB TltAtt xi 44,444,t
7C/P0111,14t11
<tut
£1iiitt at roi
3 68
1 11
0 68
- 2 12 - 24 1.31:eny /51s4c1r, - Nutty a.n 4I• • 44144 11114 14.14 11441 1 5 1.61
BiAu do 10: Lien quan giCi,a 6 gay xtrolig dui va tinh wog
dau sau m6
Nhan xet: Tai cac the?' diem nghien city, diem dau trung binh cua nhom gay dau dual xuang dui deu cao han hai nhom doi twang con lai Min chart tech diem
trung binh cao nhat la 1,26 diem tai theyi diem 0 — 12
gia sau phAu thuat Sir khac biet coy Conghia thong ke hau het cac thai diem (p< 0,05), trir ngay ra vien
J
V
:pan
Phirc tap
6 6 n
4 - 4 7 5 3 9"
76
0 - 12 gio 12 - 24 Ngay Hai Nay thir Ngay ra
BiAti d6 11: Lien quan girra tinh chit gay wang
va tinh trang dau
Nhan xet: Diem dau trung binh tai cac thai diem cua cac BN bi gay xuang phirc tap deu cao han nhom
BN gay xtfung don gian Thai diem chenh lech !an nhat le 0 — 12 giO• sau mo (0,97 diem), su, khac Wet co
\"/ nghia th6ng ke vai p < 0105 (p= 0,028)
Bang 3: Lien quan giCya phvang phap PTKHX vhi
tinh trang dau sau mo
Prayong Diem VAS trur9 binh
p1-1,:ip Ki-IX 0-12
gig"
12-24 gia
Ngay Ngay thCr hai thir ba
Ngay ra
vien
Nap '.dt 7.52 5,65 5,32 3,35 1
Dinh nti ttly
Kuntscher
6,29 5,71 4,57 3,14 0,57
r Dinh SIGN
co ma 6 gay
7,5 6,67 5,25 3,5 0
Dinh nOi tuy khong mar 6 gay (RUSH)
5,67 5,1 4,67 3,67 0
Nhan xet: Tai cac thai diem nghien ciru, diem VAS
trung binh cua nh6m BN duvc PTKHX bang nep vit cao han ba nhom can lai khac biet CO y nghia thong ke tai thai diem 0 — 12 gia sau ma vOi p < 0,05 (p= 0,009)
BAN LUAN
nglEA bent) do do cam nhan dau cang kho dinh Itiong
It
17
.12
gian
12 - 24 Ngny Ngny Noy t a Sub Mil hat thu b a vier)
Trang 4va phu thuec vao scr danh gia cua BN cung nhu, kinh
nghiem cua nhan vien y te Dau sau mO la dau cap
.tinh, hien nay van de giam dau sau m6 Clang duac
quan tam nhieu Tuy nhien each danh gia ph6 bien van
la hoi BN dau nhieu hay dau it ma van chua ap dung
.he thong thang diem de danh gia cuang de dau cua
BN sau PTKHX dui Trong nghien ciru len nay, chiing
tei Op dung thang diem VAS de danh gia dau hang
diem VAS co Liu diem la the tao va sir dung de dang,
khach quan hoe cam giac dau cua BN, ph5n anh duac
sir thay d6i min de dau sat han (10 mire de) giCip
quan-ly dau tot han Nhu'ng VAS co nhirac diem la BN
phai khOng co riOi loan nhan thirc hay khuyet tat ye thi
glad, y thtrc tinh tao va kheng thich hap cho tre em
duti 6 tuoi Do de trong nghien ciru nay chUng tOi chi
chon nhCyng BN co de tu6i tir 7 - 85 tu6i co y third tinh
tao, chin nang thi giac binh thuang
Sau phau thuat ket hap xuang dui, chUng tOi
huVno dhn BN tu, nhan xet tinh traria dau cua minh
theo thang diem VAS
CO 5 min de dau theo VAS: Kheng dau (VAS = 0
diem), cam g:ac khe chiu (VAS: 1-2), dau it (VAS:
3-4), dau viva (VAS: 5-6) va dau nang (VAS z 7)
Muc d6 dau theo VAS a 0 - 12 gia sau PTKHX
Trong so 50 BN duac nhan xet dau trong 12 gib'
deu sau ph5u thuat diem VAS phan 66 tap trung tCy 4
- 9 diem tren thang phan loai VAS Gia tri phe bien
nhat la 8 diem (n = 15) Diem VAS trung binh a thai
diem 0 12 gia sau m6 la 7,32 ± 1,35 diem, & mirc
dau nang Trong d6 co tai 34 BN dau nang (78%), 14
BN dau viva (28%), chi co 2 BN (4%) dau it Nhu vay,
trong 12 gia elk sau PTKHX mire de dau chu yeu tir
dau viva den nang Tai then diem nay, co 9 BN dau
Min nang diem ,VAS tir 8 - 9 diem can sir dung
Morphin tiem bap de giam dau va ket hop vai
Paracetamol truyen tinh mach Nhiyng BN con at deu
phai SCI' dung Paracetamol truyen tinh mach vai s6
luang tir 2 - 3 gam /24 gia
Mire d6 dau theo VAS a 12 - 24 gia sau PTKHX
Trong so 50 BN duac nhan xet Min de dau trong
12-24 giu dau sau NI Ou thut, diem dau phan b6 tap
trung tir 4-8 diem tren thang ph5n loai VAS Gia tri phO
bien nhat la 7 diem (n=14) Diem VAS trung binh &
thai diem 12 - 24 gia sau m6 la 6,46 ± 1,18 diem,
mu c dau viva Trong d6 co tai 24 BN dau nang (48%),
23 BN dau viva (46%), chi co 3 BN (4%) dau it Ty le
BN co mire de dau nang va dau viva xap xi ngang
nhau Nhu'ng s6 luong BN a mirc de dau nang van
con nhieu Nhu vay, sau 12 - 24 gia PTKHX tY le BN
dau nang da giam di re ret Tai theri diem nay kh6ng co
BN nao can sir dung morphin de giam dau Tat ea BN
deu s& dung Paracetamol truyen tinh mach
Min de dau theo VAS a ngay thin hai sau
PTKHX
Trong ngay thin hal sau phAu thuat, 50 BN co diem
dau phan le6 tap trung tir 3 - 7 diem tren thang phan
loai VAS Gia tri pho bien nhat la 5 diem (n = 16) Diem
VAS trung binh a thdri diem ngay thti hai sau m6 la 5,2
± 1,09 diem & mire dau viva Tai thai diem nay, da s6
BN they dau a Min d¢ dau viva, chiem 62% (n = 31),
a Min de dau nang co 6 BN (12%) va 13 BN (26%) & mirc de dau it
Nhu' vay, ngay thin hai sau PTKHX, mirc de dau cua BN d5 Om hart hOn so vai hai theri diem tuft Tai theri diem nay co 01 BN da sir dung giam dau bang paracetamol duang uOng, cac BN con lai van can giam dau bang truyen Paracetamol tinh mach_ Tuy nhien s6 luang da gi5m han thai diem truck
Min de dau theo VAS a ngay th& ba sau PTKHX
0' ngay thin ba sau ph5u thuat, diem dau cua 50
BN phan b6 tap trung tir 1 - 6 diem tren thang phan bpi VAS Gia tn ph6 bien nhat la 4 diem (n = 19) Diem VAS trung binh & thai diem ngay thir ba sau m6 la 3,82 ± 1,19 diem, & mirc de dau it Kheng co BN nao dau nang, 14 BN dau vim (28%), 38 BN dau It (76%),
co 8 BN chi con they kh6 chiu
Nhu vay, sau ba ngay duac dieu to diem dau cua
BN da clam h6n Vi vav da co 21 BN khena can su
dung giam dau Con lai 29 BN dau & mirc de viva van duac cham sac giam dau bang Paracetamol hap Mire de dau theo VAS vao ngay benh nhan ra vign
Vao that diem ngay ra vien, 50 BN &An danh gia min de dau met len nCra Diem VAS trunq binh & thai diem ngay ra vien la 0.84 ± 1,01diem Diem VAS cao nhat tai thai diem nay la 4 diem Da s6 cac BN deu da het dau (60%), co 8 BN con dau it va 12 BN cam they con kh6 chiu vai vet mO
Nhu vay qua 50 BN duac danh gia dau tir ngay thin nhat sau PTKHX den ngay ra vien, chung toi nhan they rang phan b6 diem dau theo VAS Om den theo thai gian
Bleu d6 cho they sO BN dau lien tuc Om den theo thai gian, va sO BN dau ngat quang tang len theo thai gian tit' 0-72 gia sau mO Sy khac biet giCra cac thin diem coy nghia thong ke vai p < 0,05 Dieu nay cho they mire de dau gi6m den theo theri gian tiv 0 - 72 gib sau mO
Cac yeu tO lien quan tai tinh trang dau sau mo: Diem VAS :rung binh tang cac hen O nhorn EN co,
do tuOi tren 60 tai cac theri diem nghien ciru Sty khac biet coy nghia thong ke tai theyi diem tir 0-12 gib sau m6 vai p = 0,015
O' nhOrn BN gay ha xuang dui, ton thuang xuang phiyc tap diem VAS trung binh cung cao han nhorn BN gay kin va co Min da ton thuang xuang Clan gian khac biet coy nghia thong ke vai p < 0,05 tai theri diem 0-12 gia deu sau mO Dieu nay cung la hap ly bai vi gay ha, gay xuang phirc tap thuang kern theo sang chan phan mem nang ne han so veri gay kin va gay xuang don gian
Phtrang phap PTKHX di-mg la yeu to anh twang tai ML:n de dau cua BN NhOm BN duac PTKHX bang nap vit, do vet m6 dal, bac tech phan mem va mang xuang nhieu han nen diem VAS trung binh cao han cac nhem den lai khac biet coy COnghia thong ke tai thai diem tir 0 - 12 gib deu sau m6 vai p<0,05
KET LUAN
Dau sau ph5u thuat ket hop xuang dui c6 the duvc
Trang 5quart li bang thang diem VAS Dau sau phau thuat ket
hap xu'ang dbi nang nhat vac) ngay dau tien sau m6 va
giam dan theo thai gian Trong d6 thai diem 0-12gia
dau sau m6 BN cam nhan dau nang ne nhat Diem
VAS tiy 4-9 diem (trung binh la 7,32±1,5 diem)
Trong thai diem 0-12 gia dau, tinh trang dau sau
m6 co lien quan vai tu6i, loci gay xuang dui, tinh chat
gay xuang, vi tri gay xuang va phuang phap ket hap
xuang
KHUYEN NGHI
De nang cao chat luting cham soc BN sau phau
thuat ket hap xuang dui nen huang dan dOi ng0 dieu
duang vien by dung mot cach co he thong thang diem
VAS de quan ly dau sau PTKHX (bao gom danh gia va
theo doi mtk do dau) cho BN gay xuang dui Nen tip
dung mot so phtyang phap giam dau sau m6 chu dOng
trong 48 gia dau sau n16 cno BN nhu' dat Catheter
giam dau ngoai mang Chu y dac bet han
nhCing BN cao tuOi, the trang yeu, gay xu'ang hey, ton
thuang xu'ang phuc tap gay dau xuang, PTKHX
bang nep vit de giup BN giam dau tot, nhat la trong
thai diem 12 gice dau sau m6
TAI LIEU TRAM KHAO
1 ThOilid riddjtudvlupuUlOS & Nennern u Craig
(2004), Pain Psychological Perspectives, Lawrence
Ertbaumm Associates, Inc, publishers 10 industrial
Avenue Mahwah, New Jersey, USA
2 Jeffry Lapfelbaum, Connie Chen, Shilpa S, Mehta
and Tong J.Gan (2003), Postoperative pain experience: Results from a National survey suggest postoperative pain continues to be undermanaged, Anesth Analg, 97: 534-540
3 Pham Gia Curing (2005), Dau, Nha xuat ban Y hoc
4 Trinh HON Ctyang (2011), Sinh ii hd than kinh cam giac, Sinh li hoc, tnyang Dai hoc Y Ha Ni,O Nha xuat ban Y hoc
5 Mai Trung Dung (2006), Dieu tri dau, Google Books,
http://books.google com.vn/books?id=JLkZec63H4UC
6 Trinh Binh Di va cac tac gia (2000), Cam giac
Sinh li hoc tap II, Nha xuat ban Y hoc
7 An Thi Thanh Van (2009), Nghien cua anh hating :am ti nguoi benh den cani giac dau trong va sau pnau thuat Benh vier) Mat Trung wring
8 Pham Thi Van Anh, Nguyen Van Gal, DO Gia Phirc, , Pham Dirt Muc Danh gia hidu qua giam dau sau me3 bang phuong phap dUng thudc day theo
Et(E„.hh vien Btyu dien, KY yeu Nghien clru khoa hoc toan dirk Ian thtY III
9 United States department of veterans affairs (2000), Pain as the 5 vital toolkit, Health care
IL Nguyen Tien El lit C2UU/), Vann gia bleu qua wain
dau sau ma ung thu , truc trang bang hOn hop Buoivacain - Fentanyl qua catheter nqoai nang cUng do henh nhan dieu khien va truyen lien Luc , Luan van Thac si Y hoc,
Truang Dal hoc Y Ha N'Oi
DANH GIA WET QUA DIED TRI PHUC HINH RANG BANG PHUTIN PHAP CAY GHEP IMPLANT NHA KHOA VII Slc HO TRU at PHAN MEM 3D
TAI BENH VIEN RANG HAM MAT TRUNG RING HA NOI
TRINH DINH HAI, PHAM THANH HA, DAM VAN VIET
BOnh vien Rang Ham Mat Trung uting Ha NOi
TOM TAT
Myr; heti caa nghien ctiu nay la nharn danh gia ket
qua dieu phuc hinh rang bang phuong phap cay
gliep inipiant nria knoa voi sit n6 tro ctia phan mem
3D D6i luting va phirong pnap - so lieu di roc Thu (hap
tit 30 bent) nhan lien 18 tudi dutc cay ghat) Implant vat
tong s6 Implant duce cay thanh cOng /à 49 Cac heti
chi dutc danh gra bat.; g6m 1;1e thaiiii Gang kik; tidny
khdi phuc than my va chdt nang cua rang gia tier)
Implant, cac Bien cluing xay ra trong va sau qua trinh
dieu tri Kat qua: Ty le thanh cOng coa nghien citu la
98% Sau khi lap phuc hinh 6 thang stir; nhai cCia rang
gia tren Implant &roc khdi phuc tot chiem 83,7% va
trung binh chiem /6,3% TY/10 nay tuOng ring la 85,7%
va 14,3% sau 12 (hang con sau 18 (hang tuong Ong /à
83,7 va 16,3% Sau khi lap phuc hinh 6 (hang thdm my
du'oc khdi phuc tot chiem 91,8% va trung binh chiem
8,2% Ty re nay tilling Ling la 89,8% va 10,2% sau 12
(hang con sau 18 thang mitt tot là 87,8%, mut kha la
10.2% va intro kern la 2% Trong va ngay sau khi ph5u
thuat CO 1 trutng hop bi chay mac' (chiem 2%) va 3
trutng hop bi ha vet throng (chiem 6,1%), 2 truOng
hop sung n4 (chiem 4,1%) va 1 trutng hop dau keo dal
(chidm 2%) Sau khi phuc hinh 18 thang co 2 truOng
hop bi long 6c lien kdt abutment lchidm 4.1%1, 4
truOng hop bi vd sri (chidm 8.2%) va 6 trutng hop hi ha tiep xuc vci rang kd ben (chiem 12,2%) Sau 18 thang
ke tti khi phuc hinh, tj't 10 vien and mem quanh Implant
la 14,3% va ty 10 vien quanh Implant /à 4,1%
tcet ivan: Ky thuat phuc hinh rang gia fro n Implant
co tj't 10 thanh cOng rat cao, kha nang khei phuc chrfc nang an nhai va thdm iny rat tot Cac bien chCmg xay
ra chiem tY 10 rat nho va deu trong pham vi co the' seta cht - ta
Takhba: Implant, pilaf. ) mem 3D
SUMMARY
PROSTHETIC OUTCOMES ASSESSMENT OF PATIENT TREATED WITH OSSEOINTEGRATED DENTAL IMPLANTS USING 3D SOFTWARE PLANNING AT THE NATIONAL HOSPITAL OF ODONTO-STOMATOLOGY HANOI
The goal of this study was to evaluate prosthetic outcomes of 49 dental implants, successfully placed for 30 patients at National hospital of Odonto-stomatology Hanoi Materials and methods: Data were