So sanh sy phdt triln long mu gida nam ngudi Kinh, ngudi Thdi vd ngudi Hmdng d tinh Didn Bidn nhan thdy: nam ngudi Hmdng cd thdi dilm xudt hien Idng mu sdm nhdt, ty Id da phdt trien Idng
Trang 1D^C mtU DAY THI CUA HQC SINH 9 - 17 TU6l Of
CAC D A N T O C K I N H , T H A I VA H M O N G
TAI TiNH BIEN BIEN
DAO HUY KHU£, NGUYEN BAO e6NG
1 Dat van de
Q Viet Nam, trong vdi chyc ndm gdn
ddy, khdng cd nhilu cdng trinh nghien cuu,
dieu tra, ddnh gid ve sy tdng trudng vd phdt
triln cda tre em, nhdt Id doi vdi tre em ddn
tdc thilu sd (DTTS) vd cdng viec ndy khdng
dugc tien hanh thudng xuyen Tuy nhien, cd
the kl din nhftng diln hinh vl cac nghien
cdu phdt triln thi chdt trd em nhu mOt so
cdng trinh cua Dinh Ky va Nguyen Vdn
Khoa (1974), Dao Huy Khue (1991), Mai
Vdn Thin (1991), Thdm Thj Hodng Diep
(1992), Cao Qudc Viet vd Nguyen Phii Dat
(1997), Nguyln Yen vd cdng sy (1997),
Nguyen Thj Lan (1998), Ddo Mai Luyln
(2001), Trdn Thj Loan (2002), Do Hong
Cudng (2009) Cdc cdng trinh ciia nhthig
tac gia neu tren dd sd dyng phuang phdp
nghien cdu truyln thdng trong nhdn trdc hpc,
sd lugng ddi tugng dieu tra tuong doi Idn,
nghien cuu cdt ngang hodc nghien cdu theo
chilu dpc, cac kfch thudc do dac vd md td
tuemg ddi nhilu chd ylu ddi vdi d trd em
khu vyc do thi vd viing ddng bdng, nhung
cdn hilm nhftng nghien ciru v l vdn dl ndy d
miln nui va ngudi DTTS
Nghien cdu ddc dilm day thi d ngudi
Id mOt ndi dung rdt quan trpng trong nghien
cdu phdt triln thi chdt bdi thdi ky day thi
danh dau sy thay dii Idn cd vl hinh thai va sinh ly con ngudi Q nude ta, trong nhthig ndm 60 vd nda ddu thap ky 70 ciia thi ky trudc, nhieu tdc gid da nghidn cdu vl tuli c6 kinh idn ddu cua cdng nhfin, ndng dfin, hpc sinh ndng thdn va thanh thj Nhftng kit qud ndy da dugc thong ke trong "Hdng sd sinh hpc ngudi Vidt Nam" (1975) Cac kit qua nghien cdu cho thdy tuli cd kinh idn dfiu ngay cang din sdm qua cdc thap ky ciia thi
ky trudc, vi du thdp kj" 50 Id 15,8 tuli, thap
ky 60 la 15,53 mdi, thdp ky 70 Id 14,9 tuli, thap ky 80 Id 15,27 tudi vd thfip ky 90 Id 13,5 tudi Ddo Huy Khud tu kit qua nghien cuu ve tuli cd kinh idn ddu ciia nft sinh Ha Ddng (1989) Id 13 ndm 8,6 thdng, da suy ra tudi trung binh ddy thi chfnh thdc khoang 14 ddi vdi nft vd 15-16 ddi vdi nam d Hd Ddng Trong cudn "Cdc gia hj sinh hgc ngudi Viet Nam binh thudng tiifip ky 90 - thd ky XX" (2003), cdc tdc gid cho rdng tudi cd kinh idn ddu d trd gdi thay ddi theo vdng miln, d nOi thanh Hd Ndi la 13 ndm 3 thdng, d ndng thdn Id 14 nSm, d ndi thdnh Hue Id 13 ndm 7 thdng, d thj xd Ddng Hd Id 14 ndm 5 thang,
d ndng thdn Thda Thidn Id 15 ndm 3 thdng,
d miln niii Thua Thien Id 14 ndm 7 thdng Kit qud td cdc cdng trinh nghidn cuu cho thdy c6 su khdc biet vl mOt so chi s l chdc ndng gifta cdc dan tOc, sy khdc biet vl
Trang 2phdt triln CO thi ciia hgc sinh DTTS so vdi
hgc sinh ngudi Kinh Tuy nhidn, v§n rdt cdn
nhftng nghidn cdu c^p nh$t tren tre em cdc
DTTS dang sinh sing tgi mien nul, viing
sdu viing xa trong cd nude Vdi djnh hudng
dd, bdi vilt ciia chiing tdi l$p trung vdo d$c
dilm d§y Ihl ciia hgc sinh ngudi Thdi, ngudi
Hmdng vd ngudi Kinh d tinh Di^n Bidn Id
mOt phdn trong kit qud dl tdi nghidn cdu
phdt triln thi chdt ciia hgc sinh 9 - 17 tuli d
mOl so lOc ngudi tinh Di?n Bien' Kit qud
nghidn cdu ndy nhdm gdp phdn b l sung s l
liOu cho h? thing dft li?u vl phdt triln ihl
chdt tre em nude la, ding thdi cung cdp cdc
ludn cd cho vi^c hogch djnh cdc chfnh sdch
bdo ve, chdm sdc vd gido dye tre em ndi
chung vd phdt triln thi chdt ndi ridng d viing
Tdy Bdc nude ta
2 Vdi net v l tinh Dien Bien
Didn Bien Id tinh miln niii, bien gidi,
nam d phfa Tdy Bdc nude la, gidp vdi tinh
Lai Chau vd cd dudng bien gidi tiep gidp vdi
hai qudc gia ddi 398,5km; trong do bien gidi
vdi Ldo ddi 360km, vdi Trung Quoc ddi
38,5km Din ndm 2009, tong dien lich ty
nhien ciia tinh Dien Bien Id 9.562,9km^
\xon% do didn tich ddt ndng nghiep ft
(I08.158ba, ehilm 11,3% dien tfch ty nhien)
va dat chua sd dyng cdn nhilu (528.370ha,
chiem 55,3%)
Dien Bien cd 9 don vi hdnh chfnh gom:
Thdnh phd Di§n Bien Phu, thj xfi Mudng Lay
va 7 huyen (cd 4 huy?n nghdo dugc hudng
chinh sdch theo Nghj quylt 30a); 112 xd,
phudng, thj trdn Ty 1? hg ngheo cda tinh Id
34,6% (6/2009) Ndm 2009, dan so ttaing
' D^ tai cap tinh Di^n Bien, Nghien cuusvphat triin
thi chdt cua hgc sinh tir 9 din 17 tudi & mdt sS tdc
binh todn tinh Id 491.172 ngudi, trong
dd thdnh thj 75.059 ngudi, ndng thdn -416.113 ngudi Todn tinh cd 21 dfin tOc, trong
dd dfin tOc Thdi chilm 40,4%, dfin tpc Hmdng - 28,8%, ddn tOc Kinh - 19,7% dfin
sl, cdn Igi Id cdc ddn tOc khdc (Xinh Mun, Kho-mu, Khdng, Ldo Tdy Mudng ) Sy da dgng ddn lOc d DiOn Bifin cQng di liln vdi
sy da dgng, phong phd v l vdn hda lOc ngudi, d^c biOl Id dii vdi cdc dfin tOc cd dfin s l Idn trong tfnh nhu Thdi, Hmdng, Kinh, thudng
cd dnh hudng Idn dii vdi cdc dfin lOc khdc sing trdn ciing dja bdn Ting s6 trd em dudi
16 tuli dong tinh Id 147.141 ngudi, dong dd 2.575 tre cd hodn cdnh ddc b i ^ khd khdn
Tinh Di^n Bien d& dugc cdng nh$n dgt
chudn quIc gia vl phi c§p gido dye THCS; 102/112 xd, phudng, thj trdn dgt chuan pho c|p gido dye tilu hgc dung dO tuli Di^n Bien vdi nhftng ddc dilm ch&ih ve
ty nhien, xd hOi neu ddn, chdc chdn dfi vd s2 cd
tdc dOng khdng nhd tdi sy phdt trien thi chdt
cua Ihl he trd trong cgng ddng cdc dfin tOc
3 Dja bdn, doi t i r ^ g vk phinrag
phdp nghien cihi Nghien cdu dugc tiln hdnh tai
22 trudng phi thdng gIm tilu hgc, THCS
vd THPT d cdc huyOn Di^n Bien, Tudn Gido
vd Tiia Chda Hpc sinh dugc chpn khdo sdt hdu hit dang hgc phi thdng gom 2.807 ngudl (1.392 nam vd 1.415 nft), trong
dd cd 949 em nguin Kinh (463 nam va
486 nft), 893 em ngudi Thdi (442 nam va
451 nft) va 965 em ngudi Hmdng (487 nam
vd 478 nft) M5i Ida tuol, gidi tfnh vd dfin tOc dlu cd s l lugng dii Idn d l tfnh todn thong
kd, ft nhdt Id 43 vd nhilu nhat Id 54 em Phuong phdp nghien cdu v l d§y thi:
Trang 3vd nft, ddng phuang phdp phdng vdn hdi c l
d l hdi ngdy thdng ndm cd bilu hidn xuat
tinh idn ddu (vdi nam) hodc ngay thdng ndm
cd kinh Idn ddu (vdi nd) Cdc ddu hieu sinh
dye phu (thd cdp) nhu sy phdt triln tuyin
vu (d nft), ldng mu va Idng ndeh (d cd nam
vd nd) dugc ddnh gid lam sdng tiieo chudn
cua cdc nhd nhan chdng hpc Lien Xd (cu),
trich dan theo ludn vdn Phd Tiln sy ciia
Dao Huy Khud (1991)
4 Ddc diem dgy thi cua hpc sinh
9 - 17 t u l i d cdc dfin tOc Kinh, Thdi vd
Hmdng tai tinh Dien Bien
4,L Vdi net vi dgc diim ddy thi cua
tri em ViitNam
Day thi Id giai doan biet hda gidi tfnh
Idn nhat, bien ddi co quan sinh dye, phdt
triln dac tinh sinh due phu, thay ddi kfch
thudc hinh thdi co thi Thudng day thi d
nam dien ra cham hon so vdi d nu Tdng thi
tich tinh hodn la ddu hidu ddu tien, nd bdt
dau khoang 1 nam trudc khi xuat hien x:dc
dau hidu sinh due phy, trung binh khodng
12 tudi vd phdt trien nhanh trong 2 ndm ddu
ciia day thi, sau do cham ddn nhung keo ddi
trong 5 ndm Sau khi phdt trien tinh hoan,
ducmg vat bat ddu phat diln trung binh d
13 tudi (sdm Id 10,5 tudi, muOn la 16,5 tudi),
chua ddy 2 ndm sau c6 thi dgt kfch tiiudc culi cdng Ldng mu bdt ddu phdt triln sau khi duang vdt vd blu phdt triln dugc vdi thdng,
nd phdt triln cham ban, trong 2 - 3 ndm ddu ciia day thi long mu hinh tam gide, sau lan rpng dan vd sau 4 - 5 ndm trd tiidnh hinh thoi Ldng ndch cdn chfim ban, chdnh l^ch so vdi ldng mu ti-ung binh 1 nSm Xudt linh Id ddu hidu sinh due chfnh ddnh ddu thdi ky day thi chinh thdc d nam Thudng tuli xudt tinh trung binh khodng 14 tuli 3 thdng ± 9 thdng Dii vdi nft, phdt triln tuyin vu Id ddu hidu ddu tidn ciia ddy thi vd khdc nhau tiiy timg ngudi, nd phdn dnh hoat tinh Estrogen ciia budng trdng Ddu tien id niim vti nli len,
d dp tuli hung binh 10,5 -11 tuoi Sau do vti
to Idn ro, nhOng thdng ddu cd thi chi mOt ben, khdng ddi xung Num vii to Idn, qudng vii rOng vd thdm mau hon Vii phdt diln day du trong 2 - 3 nam Ldng mu thudng xudt hidn sau khi vu phdt-trien vai thang, ddng thdi d
mu vd cac mdi Idn, nd phdt triln ddy du trong vdng 2 ndm va cung trai qua 5 giai doan phdt trien (PO - P4) tuong tu Idng mu ciia nam Ldng ndch phat triln sau long mu khodng
1 2 - 1 8 thang, sau 2 - 3 nam thi dgt muc nhu ngudi Idn K^' kinh nguyet lan ddu la mdc chac chdn nhat ciia day thi nu, trung binh sau khi phdt diln tuyen vu khoang 2 nam
Ldng trong ho ndch: Quan sat thuc trang long trong ho nach va khoanh tron vao cac rnijc duoi day:
AO: Chua co long; AI: Co long roi nhung la long to, thira; A2: Long da sam mau, ram hem, nhung con thay phdn da dudi chan cac long; A3: Long sam mau, ram, phu kin, khong con nhin thay chan long, dat muc ciia ngudi trudng thanh
Ldng tren mu: Quan sat thyc tr^g long tren mu va khoanh tron vao cac rniJc dudi day: PO: Chua co
long; PI: Co ldng rdi nhung la ldng to, thua; P2: Long da sam mau, rdm Hon, nhung cdn nhin thay
p h ^ da dudi ch§n Idng; P3: Ldng sIm mau, rim, phu kin, khong con nhin thdy chdn ldng, dat mdc cua ngudi trudng thanh; P4: Ldng r|m, phat trien rdng hon phan mu, tham chi mpc ISn ron, nguc •
Tuyin vu: Quan sat thyc trgng tuyin vii va khoanh tron vao cdc mdc duoi day: MaO: Tuyin vu chira
phdt triln; Mai: Bdu vu bdt ddu phat triln, co hi?n tugng simg d qudng thdm num vii, trong nhu chiim cau; Ma2: Bau vii phat trien hem, nhS cao tr6n ling ngyc; Ma3; Bau vu phat trien Icm, tuy nhiSn bdu vii chua du Idn de tgo thanh dudng gly net gifta chdn bdu vii vdi be mat ngyc; Ma4: Bau
vd phat triln Idn hon, tgo thanh dudng gay net gifta ch§n bdu vu vdi bl m3t ngirc, dat mdc ciia nguoi
Trang 4Tuli d^y thl chju dnh hudng ciia cdc
yeu to ben trong nhu gidi tfnh, ylu l l di
truyln, chiing lOc, gilng ndi, bOnh t§l, vfin
hda, mdi trudng sing ho^c cdc dilu ki§n
bdn ngodi bao gIm ddi sing kinh te, dinh
dudng khf hau thdi tilt, dja 1^ Trd d viing
cao dfiy thi muOn hon so vdi cdc viing khdc,
giai doan dfiy thl keo ddi hon (trong dilu
ki?n dinh dudng giong nhau)
4.2 D^y thi cua hgc \inh 9 - !7 tu6i a
cdc ddn tpc Kinh, Thdi vd Hmdng tgi tinh
Di^n Bien
4.2 i Dii)' thi cm hpc sinh nam 9-17 tuoi
Day thl chinh thuc is nam dya vdo thdi
dilm xudt tinh idn ddu Liic 9 - 1 1 tuli chua
thdy hpc sinh nam d cd 3 dan tOc day thl
chinh thdc 6 tuoi 12 dd cd nam ngudi
Hmdng day thi chfnh thdc, cdn nam ngudi
Kinh vd nam ngudi Thdi tuong ung d 14 tudi
Ty Id hpc sinh nam day thl chfnh thdc d cd
3 dan tOc tdng dan theo tudi Luc 1 4 - 1 7 ludi
ty le hpc sinh nam ddy thi chfnh thdc d ngudi
Hmdng ddu cao hon ngudi Kinh vd ngudl
Thai; cdn d ngudi Thdi vd ngudi Kinh gan
nhu nhau Ddn tuli 17 ty le nam day thi
chfnh tilde d cd 3 dfin tOc gdn nhu nhau vd dgt
cao nhfit, d ngudi Hmdng Id 98,1%, ngudi
Kinh - 95,3% vd ngudi Thdi - 91,7%
Ldn xudt linh ddu tien (thudng Id mpng
tinh) Id mdc chdc chdn nhdt ciia day thl
chfnh thdc d nam Theo kit qua nghien
cdu thyc ll, tudi dgy thi chfnh ftidc ciia hgc
sinh nam ngudi Hmdng la 14 nam I thdng
± I nam 2 thdng, ngudi Kinh - 14 ndm
7 tiidng ± I nam 9 thdng, ngudi Thdi
-14 ndm 8,4 thdng ± I ndm 1,4 thdng Nhu
vdy, tuli day tiii chinh tiiuc cua nam ngudi
ngudi Kinh vd nam ngudl Thdi, sy khdc nhau
cd ^ nghTa thing ke (p<0,05) Cdn d ngudi Thdi vd ngudi Kinh, tuli d§y tiii chfnh thdc ciia hpc sinh nam gdn nhu nhau Kit qud ndy
cd thl do ylu t l di truyln chiing tOc khdc nhau, ngodi ra cdn do dilu ki§n vdn hod, xd hOi ciia ngudi Hmdng khdc ngudi Kinh vd ngudi Thdi: chdng hgn ngudi Hmdng cd Idp qudn idy vg vd yeu sdm ban; bdn cgnh dd, nam sinh ngudi Hmdng da s l sing nOi trd, dS g$p gd, giao luu vdi bgn nft hem Tuli d§y thl chfnh thdc d nam ngudi Kinh tinh Di§n Bien (2010) tuong duong vdi nam ngudi Kinh d Hd NOI, nhung sdm hon so vdi nam ngudi Kinh d cdc tinh Thdi Binh, Hd Tfiy (eu), Bdc Thdi (cu) hong nghien cdu cua Cao Quoc ViOl va Nguyen Phu Dgt (1997)
Cdc ddu hi4u dgy thi thu cdp
Nghien cuu hIi c l cho thdy: Thdi
diem xudt hien myn trdng cd tren mdt nam
ngudi Hmdng Id 13 lull 2 thdng ± 1 ndm
9 thdng, d ngudi Kinh Id 13 tuli 4 tiidng + 1 ndm 6 tiidng, d ngudl Thdi Id 13 tuli
5 thdng ± 1 ndm 8 thdng, sy khde bl^t khdng
cd i' nghTa thong ke (p>0,05)
- Sy phdt triln long mu ciia nam sinh:
d ludi 10, ngudi Hmdng dd cd Idng mu (1,8%) Trong tiidi ky 10 - 17 hili, chudn do trung binh vd ty 10 nam phdt trien Idng mu tang ddn theo tuli, mdc tdng cao nhdt d lull
14 Din 16 17 tudi 100% nam ngudi Hmdng da cd Idng mu, chudn dd hung binh
Id 3,6 vd cd 66,5% nam sinh dat mdc phdt trien long mu cua ngudi trudng thdnh Nam sinh ngudi Kinh d dO tudi 12 mdi
cd ngudi bdt ddu mgc ldng mu, chilm 1,8%
Trang 5binh vd ty Id nam cd long mu tdng ddn
tiieo tudi, mdc tdng cao nhdt d tudi 14 Din
16 - 17 ludi, 100% nam sinh ngudi Kinh cd
long mu phdt triln, d tuoi 17 cd 60,5% nam
sinh dat mdc ldng mu d ngudi trudng thanh,
ehufin do hung binh Id 3,5
Nam sinh ngudi Thdi d dO tuli 9 - 1 2
chua phdt triln ldng mu; d dO tuli 13 mdi cd
ngudi mpc ldng mu, ehilm 8,3% Trong thdi
ky 13 - 17 tuli, chudn dO trung binh vd IT^ 10
nam phdt triln ldng mu tSng ddn theo tuli,
mdc ldng cao nhdt d tuoi 14 Din 17 tuli,
97,9% nam ngudi Thdi dS cd Idng mu, chuan
do trung binh Id 3,0 vd cd 41,2% nam dat
- mdc Idng mu cda ngudi trudng thdnh
So sanh sy phdt triln long mu gida
nam ngudi Kinh, ngudi Thdi vd ngudi
Hmdng d tinh Didn Bidn nhan thdy: nam
ngudi Hmdng cd thdi dilm xudt hien Idng
mu sdm nhdt, ty Id da phdt trien Idng mu cao
nhfit, ly le dgt mdc phdt triln long mu d
ngudi trudng thanh vd chuan dO trung binh
ciing cao nhdt, tilp theo la nam sinh ngudi
Kinh, cdn nam sinh ngudi Thai cd thdi dilm
xudt hien ldng mu mudn nhdt, ty le da phdt
triln Idng mu thfip nhdt, tj- le dat muc dO
phdt trien Idng mu d ngudi trudng thdnh vd
chudn dO trung binh cung thdp nhat
Hien tugng nay la phii hgp vdi quy lugt
phdt trien cac ddu hieu day thi Nguyen nhan
do dnh hudng cda tuoi day thi chfnh thdc d
nam sinh ngudi Hmdng sdm nhdt, cdn nam
sinh ngudi Thdi cd lull day thi chinh thdc
muOn nhdt So vdi nam sinh ngudi Kinh d
Hd Ddng (1989), t^ le nam sinh da phdt triln
Idng mu va ty le nam sinh co Idng mu dat
muc dO ngudi trudng thdnh d Dien Bien
(2010) cao hon, dilu nay phu hgp vi ngudi
Kinh, Thdi vd Hmdng d Di$n Bidn d^y thi chfnh thdc sdm hon
- Ldng ndch Id mOt trong 3 ddu hifu phy de ddnh gid mdc dO d§y thi, nd thudng xuat hidn sau khi phdt friln long mu Ket qud nghien cdu d DiOn Bien (2010) cho thdy: Q
dO tuoi 11, nam sinh ngudi Hmdng da cd ngudi mpc ldng ndch, chilm 18,2% Trong thdi ky 11 - 17 tuoi, chudn dO trung binh vd
ty le nam bdt ddu phdt triln Idng ndch tdng ddn theo lull, mdc tdng cao nhdt d tuli 14 Den 17 tuli, cd 96,3% nam sinh ngudi Hmdng phdt trien long ndch, chudn dd trung binh la 2,0 vd 33,3% dgt mdc ldng ndch ciia ngudi trudng thdnh
Vdi nam ngudi Kinh vd ngudi Thdi tinh Dien Bidn (2010), d t u l i 13 mdi bat dau mpc ldng ndch (ngudi Kinh: 13,2% vd ngudi Thai: 6,2%) Liic 13 17 tuli, chudn dp trung binh va ty le nam bdt dau phat triln ldng ndch tdng ddn theo lull Ddn 17 tudi, d nam ngudi Kinh, 93,0% cd ldng ndch phdt triln, chudn dd trung binh Id 1,9 vd 27,9% nam dgt mdc ngudi trudng thanh; nam ngudi Thai cd 66,7% da phat triln Idng ndch, ehufin dO trung binh Id 1,3 vd 12,5% dat muc ngudi trudng thdnh
So sdnh gifta nam sinh 3 ddn lOc d Didn Bidn cho thdy: nam ngudi Hmdng cd thdi diem xudt hien ldng ndch sdm nhdt, ty
le da phdt triln long ndch cao nhfit, ty I? dat mdc dp phdt triln long ndch d ngudi trudng thanh va chudn dO trung binh cung cao nhdt, tilp theo Id nam ngudi Kinh; nam ngudi Thdi cd thdi dilm xudt hien Idng ndch mudn nhdt, ty Id dgt mdc dp phat triln ldng ndch d ngudi trudng thdnh vd chudn dp trung binh cung thdp nhdt Hidn tugng ndy cd thl do
Trang 6nam ngudi Hmdng d§y thi sdm nhdt, cdn
nam ngudi Thdi d§y thi muOn nhdt
So sdnh vdi nghien eihi ciia Ddo Huy
Khue vd cpng sy trdn hgc sinh ngudi Kinh d
Hd Ddng (1991), thdy t^ 10 nam ngudi Kinh
vd Hmdng d Difn Bidn (2010) dd phdt triln
long ndch vd cd chudn dO trung binh cao
hon, phii hgp vdi ddu hi^u d^y thl chfnh thdc
sdm hon, chdng td sy phdt triln cdc ddu hiOu
sinh dye phy ciia nam sinh d Di^n Bidn
(2010) sdm hem, lien quan tdi ddy thi chfnh
thdc cua hgc sinh d Di^n Bidn sdm ban
4 2.2 Dgy thi cua hpc sinh nir9-17 tuoi
ngu&i Kinh, Thdi vd Hmdng
Ddu hi$u day tin chinh thuc: 0 9 - 1 1 tuli
nft sinh cd 3 ddn tOe dlu chua cd trudng hgp
nao day thi chfnh thdc MOt sd nft ngudi
Hmdng, ngudi Thai vd ngudi Kinh ciing bdt
ddu day thi chinh thdc d lua tuli 12 Sau dd
ty le nu day thi chfnh thdc tdng ddn theo hioi
td 12 din 17 Ty Id nft da day thi chinh thuc
cua ngudi Kinh, ngudi Thdi vd ngudi Hmdng
d Dien Bien (2010) khdng gilng nhau Liic
9 - 1 1 tudi nd d cd 3 dan tOc ddu chua cd
trudng hgp ndo day thi chfnh thuc Din
12 tudi, nft sinh cd 3 ddn tOc dd bdt ddu dfiy
thi chfnh thuc: ngudi Hmdng dgt 20,7%,
ngudi Kinh dgt 11,1% trong khi d ngudi
Thdi chi 2,0% Luc 12 - 15 tuli, cd sy chdnh
lech ldn vl ty le day thi chfnh tiiuc ciia nft
cdc dan lOc, nhung d 13 - 17 tuoi ly I? nft da
dgy thi chinh thdc cua ngudi Kinh Idn nhfit
tiep theo Id ngudi Hmdng, thdp nhdt Id
ngudi Thdi Din 17 tudi, khdng cd sy khde
biet vl ty Id dfiy thi chinh thdc gifta 3 dfin
tOc(dludal 100%)
Nhin chung, ty Id day thi chinh thdc
Hmdng vd nft ngudi Thdi, cy thl d 13 - 17 tuli t^ 10 nft d^y thl chfnh thdc d ngudi Kinh dlu cao hem ngudi Hmdng vd ngudl TTidi Din tuli 17, t:;-10 nft sinh d§y thi chfnh tiiirc
d cd 3 dfin tOc dlu dgt 100% Kit qud ndy ngodi ylu l6 di truyln cdn do mdi trudng sing ciia ngudi Kinh lit hon Ty 1? nft d§y thl chfnh ihuc tdng ddn theo tuli liic 12 - 17 tuli
6 tuli 12 nft ngudi Kinh, ngudi Thdi vd ngudi Hmdng d DiOn Bien (2010) da bdt ddu xudt hiOn d$y thl chfnh thdc Ket qud ndy tuong ty kit qud ciia Nguyln Quang Mai vd cOng sy (1998), Dinh Ky vd Cao QuIc Vi?t (1986), nhung muOn hem 1 ndm so vdi nghi^ cdu cua Ddo Huy Khue vd cOng sy (1993),
Do Hing Cudng (2009)
Kit qud nghien cihi hIi c l cho thdy: Tuoi day thl chfnh thdc d nft ngudi Hmdng
Id 12 tuli 11 thdng ± I ndm 3 thdng, d ngudi Kinh Id 13 tuol 2 thdng ± I ndm 4 thdng, d ngudi Thdi Id 13 ndm 8.8 tiidng ± 1 ndm 0,4 thdng Nhu vdy, tuoi d§y tiii chfnh tiiuc cua nft ngudi Thdi mugn nhdt, nft ngudi Hmdng sdm nhdt, sdm ban khodng 3 tiidng
so vdi nd ngudi Kinh vd 9 tiidng so vdi nft ngudi Thdi Sy khdc biOl hili d§y thi gifta nft ngudi Hmdng vd ngudi Kinh khdng cd y nghTa tiidng kd (p>0,05), nhung gifta nft ngudi Hmdng vd nft ngudi Thdi thi sai khdc
cd y nghTa thing kd (p<0,05)
So sdnh vdi nhihig nghidn cdu trong va ngodi nude cho tiidy: tudi cd kinh ldn ddu ciia nft ngudi Kinh, ngudi Thdi vd ngudi Hmdng
is Dipn Bien (2010) sdm ban so vdi nft tiidnh
phi, ndng thdn trong Hdng so sinh hgc nguW Viet Nam (1975) vd cung sdm hon hgc sinh
Hd NOi, Thdi Binh, Hd Tfiy trong mOt sl nghien cdu nhihig nam 1978 - 1990 Tuy v4y,
Trang 7ngudi Thai va ngudi Hmdng d Dien Bien
(2010) Igi tuong duong vdi niT ngudi Thdi vd
Kinh d Hda Binh (Do Hdng Cudng, 2009)
Kdt qud nay theo chiing tdi Id phii hgp, vi sau
mdy chyc ndm qua dilu kien sing dd cdi
thien nhieu, ddt nude hOi nb^p vdi ndn kinh t l
the gidi, dieu kien vdn hod, x§ hOi lot han nen
tudi day tiii ngdy cdng sdm hon Nhilu
nghien cdu dd khdng dinh rdng dilu kipn
sdng, chdt lugng cugc sing, khu vyc dja ly cd
dnh hudng ldn din tudi cd kinh ldn dfiu
Cdc ddu hiiu dgy thi thu cdp
- Ket qud nghidn cdu hoi c l cho thdy:
Thdi dilm xudt hien myn tning cd tren mdt
nft ngudi Hmdng la 11 lull 5 thdng ± 1 ndm
7 thdng, d ngudi Kinh td 11 tuoi 8 thdng
± ! ndm 5 thang, sy khdc biet khdng cd y
nghTa thing kd (p>0,05) Thdi dilm xudt hien
mun trdng ca tren mdt nft ngudi Hmdng sdm
nhfit, tilp theo id ngudi Thai va culi ciing la
ngudi Kinh, kit qud ndy cd thd do ngudi
Hmdng day thi chinh thirc sdm hon
- Kit qud nghien cuu d tinh Dien Bien
(2010) cho thdy; 0 dO tudi 10, nft sinh ngudl
Hmdng dd mgc Idng mu, chiem 1,9% Thdi
ky 10 - 17 tudi, chudn do trung binh phat
triln vd ty le nft cd long mu tang ddn theo
tuli Din 17 tuli, 100% nft sinh ngudi
Hmdng phat triln ldng mu, chuan dO trung
binh la 2,4 vd cd 49,1 % sd nft dat mdc long
mu d ngudi trudng thanh
Nu smh ngudi Kinh d 9 tudi da cd em
mgc long mu, chilm 1,8% Trong thdi ky
1 1 - 1 7 tudi, chuan dO trung binh phdt trien
P vd ty Id nu cd ldng mu tdng ddn theo tudi,
mdc tang cao nhfit d tuoi 14 Den 17 tudi,
100% nd sirih ngudi Kinh cd Idng mu
phdt triln, chudn dO hung binh la 2,7 va cd
81.5% s6 nft dgt mdc long mu ciia ngudi trudng thdnh
Nft sinh ngudi Thdi d dO tuli 9 - 1 0 ddu chua phdt triln Idng mu Din tuoi 11, cd 1,8% bdt ddu cd ldng mu vd din 16 - 17 tudi hau nhu todn bO nft cd ldng mu d cdc mdc
dO khdc nhau Ty le nft cd ldng mu tang ddn theo tuli; mdc tang cao nhdt d lull 14 Ddn
17 tuli 100% nft sinh ngudi Kinh cd long
mu phdt triln, chudn dO trung binh Id 2,7 va 71,4% nft sinh ngudi Thdi cd Idng mu dat mdc ngudi trudng thdnh
So sdnh sy phdt triln long mu gifta hpc sinh nft ngudl Kinh, ngudi Thdi vd ngudi Hmdng d tinh Dien Bien (2010) cho thfiy: nft sinh ngudi Kinh cd thdi diem xuat hien Idng
mu sdm nhdt, ty le dd phdt triln long mu cao hon, chudn dO trung binh va ty le dat muc dp cua ngudi trudng thanh cung cao ban nu sinh ngudi Hmdng va nu sinh ngudi Thdi
So sdnh vdi nghien cuu ciia Ddo Huy Khue va cOng sy trdn nft sinh ngudi Kinh d
Ha Ddng (1989) thdy ty Id nft sinh ngudi Kinh, ngudi Thdi va ngudi Hmdng d tinh Dien Bien (2010) da phat trien ldng mu vd chudn dp trung binh cao hon Dilu dd chdng
Id theo thdi gian sy phdt tridn cdc ddu hieu sinh due thd cdp ciia nd sdm ban, phii hgp vdi dau hieu d$y thi chfnh thdc sdm hem vd
sy d^y thi ciia Ire cung sdm hem
- Ket qua nghidn ciiTi sy phdt trien long ndeh ciia hpc sinh nft cho thay: 0 dO tudi 11, nft sinh ngudi Hmdng dd bdt dau mgc Idng ndch, chilm 1,9% Trong tiidi ky 11 -17 tudi, chudn do trung binh vd ty le nft bdt dau phdt triln long ndch ldng ddn theo tuoi, tdng nhanh nhdt d tuoi 17 Ddn tudi 17, cd 92,4% nft sinh ngudi Hmdng phat trien Idng ndeh, chudn dd
Trang 8trung binh Id 1,7 vd cd 9.4% dgt mdc ldng
ndch ciia ngudi trudng thdnh
Nft sinh ngudi Kinh d 10 tuli da bat
ddu mgc ldng ndeh, ehilm 1,8% Trong thdi
ky 11 - 17 tuli, chudn dO trung binh vd t j 1$
nft cd ldng ndch tfing ddn theo tuli mdc
tdng cao nhdt d tuli 14 Din 17 tuli dd cd
98.1% nft sinh ngudi Kinh phdt triln Idng
ndch, chuan dO trung binh Id 1.9 vd cd
16.7% so em dgt muc Idng ndch ciia ngudi
trudng thdnh
Nft sinh ngudi Thdi d 11 tuli d3 cd
mgc Idng ndch, chilm 1.8% Ty 10 nft cd
long ndch tdng ddn theo lull; mdc ldng
cao nhdt d tuli 14 Den 17 tuoi, cd gdn 90%
nu sinh ngudi Thdi cd long ndch nhung chi
cd 18,4% dgt mdc phdt triln eQa ngudi
trudng thanh
So sdnh nft sinh ngudi Kinh, ngudi
Thai va ngudi Hmdng d tinh Dien Bidn
(2010) vdi nhau cho thdy: nftngudi Kinh cd
thdi diem xudt hien Idng nach sdm nhdt ty
le phat triln ldng ndch cao hon, ehufin dO
trung binh vd ty le dgt mdc phdt triln ciia
ngudi trudng thdnh cao hon nft sinh ngudi
Hmdng vd nft sinh ngudi Thdi Ket qud ndy
Id do d nft sinh ngudi Kinh cd ty Id day thi
chfnh thdc ldn hem nft sinh ngudi Hmdng
So vdi nft sinh ngudi Kinh d Hd Ddng
(1989), nft sinh ngudi Kinh ngudi Thdi vd
ngudi Hmdng d linh Didn Bien (2010) xudt
hidn long ndch sdm hem 1 - 2 nam chudn dO
trung binh cao hon Dilu ndy dugc giai thfch
tuemg ty nhu vdi ddu hieu long mu
- Phdt diln tuyen vii Id ddu hieu ddu
lien phdn dnh hogl tfnh Estrogen ciia budng
trdng, bdo hieu em gdi da budc vdo tiln day
vii (Ma) cCia hgc sinh nft ngudi Kinh, ngudi Thdi vd ngudi Hmdng d tinh DiOn Bien (2010) cho thdy: 6 9 tuli, da cd nft sinh ngudi Hmdng phdt triln luyln vu, t^ I? Mal chilm 17,0%, Ma2 chilm 1.9%, sau dd tdi nft cdc dfin tOc khdc
Trong giai dogn 9 - 1 7 tuli, chudn dO trung binh vd ty 1$ hgc sinh nft cd luyln vu phdt trien tdng ddn theo lull; din Ida tuli 17, dfi cd 100% nft sinh ngudi Hmdng phdt triln tuyin vii, chudn dO trung binh Id 3,5 vd cd 50,9% nft phdt triln luyln vii dat mdc ciia ngudi Irudng thdnh
Nft sinh ngudi Kinh d 9 tuli da cd em phdt triln tuyin vu, ehilm 8,9% Trong giai dogn 9 - 1 7 tuoi, chudn dp trung binh vd ty le nft cd luyln vii phdt triln tdng ddn theo tuli; din 17 tudi, da cd 100% nft sinh ngudi Kinh phdt triln tuyin vii, chudn dO trung binh Id 3,1 vd CO 25,9% nft phdt trien tuyen vii dgt mdc cua ngudi trudng thdnh
Nft sinh ngudi Thdi tu 9 tuli, mdt so
da phdt trien tuyin vu vd din 16 tudi todn bp nft dd phdt triln luyln vu d cdc mdc dO khdc nhau Ty le nft dfi phdt triln tuyin vii tdng ddn theo ludi, mdc tdng cao t^p trung d dO tuli 11 - 16 Din 17 tuli, cd gdn 50% niJ sinh phdt triln luyln vu dgt mdc dO ngudi trudng thanh, chudn dO hung binh Id 3,4
So sdnh sy phdt triln tuyin vii gifta nft ngudi Kinh, ngudi Thdi vd ngudi Hmdng d linh Dien Bien (2010) vdi nhau cho tiifiy: d
9 tuli nft sinh cd 3 dfin tOe dlu da cd em phdt triln tuyin vu, nhung t^ Id nft sinh dd phdt trien luyln vii, chudn dp trung binh vd
ty le dgt mdc dO phdt triln cda ngudi trudng thdnh d nft sinh ngudi Hmdng cao ban so
Trang 9So sdnh gifta nft sinh ngudi Kinh vd nft
sinh ngudi Thdi cho thdy nft sinh ngudi
Kinh cd su phdt triln tuyin vu sdm hem, cu
the Id thdi dilm phdt triln ddy du cdc mdc
dO cua nft sinh ngudi Kinh sdm hem nft sinh
ngudi Thai Tuy vdy, luc 16 - 17 lull, t j le
phdt triln tuyin vu dgt mdc dO ngudi trudng
thdnh cda nft sinh ngudi Thdi lai cao ban nft
sinh ngudi Kinh
So sdnh gifta nft ngudi Kinh, ngudi
Thdi vd ngudi Hmdng d tinh DiOn Bien
(2010) vdi nhau cho thdy; nft sinh phdt triln
tuyen vii rtr 9 tuli, ty Id nft sinh da phdt triln
tuyin vQ, chudn dO trung binh vd ty le dgt
muc dO tuyen vd cua ngudi trudng thdnh d
nft sinh cd 3 dfin tpc tuong duong nhau
So sanh vdi nghien cdu cda Ddo Huy
Khue va cdng sy tren nft sinh ngudi Kinh d
Hd Son Binh (1989) cho thay ty le nu sinh
ngudi Kinh, ngudi Thdi vd ngudi Hmdng d
tinh Dien Bien (2010) da phdt triln Idng
mu vd ehufin dO trung binh tuong duong
nhau, su khde biet khdng cd y nghTa thing
kd (p>0,05)
5 K i t luan v^ khuyen nghi
5.L Bgc diim dgy thi
Tuli ddy thi chfnh thdc d nft ngudi
Hmdng Id 12 tuli 11 thdng ± 1 ndm 3 thdng,
d nft ngudi Kinh Id 13 mdi 2 thang ± 1- ndm
4 thdng va d nft ngudi^Thdi Id 13 nam 8,8
thang ± 1 ndm 0,4 thdng Sy khdc nhau vl
tudi day tiii giu^ nft ngudi Hmdng vd ngudi
Kinh khdng cd y nghTa thing ke (p>0,05),
hong khi gifta nft ngudi Hmdng vd nft ngudi
Thai cd y nghTa thing kd (p<0,05) Nhu vdy,
cd thl ndi nft sinh ngudi Hmdng va ngudi
Kinh d$y thi chfnh thdc sdm nhdt hong
chinh thdc d ngudi Kinh ldn hem so vdi nft ngudi Hmdng vd nft ngudi Thdi, tdp trung vdo nhdm 1 3 - 1 7 tuoi, d dd t j Ifi nft dgy thi chfnh thuc d ngudi Kinh dlu cao hem ngudi Hmdng va ngudi Thdi Din tuoi 17, t>' le nft ddy thi chfnh thdc d cd 3 dan tOc Kinh, Hmdng va Thdi dlu dgt 100%
Tuli dgy thl chfnh thdc cua nam ngudi Hmdng Id 14 tuli 1 thdng ± 1 ndm 2 tiidng, nam ngudi Kinh Id 14 tuoi 7 thdng ± 1 ndm
9 thdng vd nam ngudi Thdi Id 14 ndm 8,4 thdng ^ 1 ndm 1,4 thdng Tuoi ddy thi chinh thdc ciia nam ngudi Hmdng sdm hon
6 - 7 thdng so vdi nam ngudi Kinh vd nam ngudi Thai, cd y nghTa thong ke (p<0,05) Cdn d nam ngudi Thdi vd nam ngudi Kinh, tudi d$y thi chfnh tiidc gdn nhu nhau Trong ciing dan tpc, lull dgy ciia nu bao gid cung sdm ban cua nam, vi du
d ngudi Hmdng sdm hon khodng 1 nam
1 thang, d ngudi Thdi sdm han gdn 1 ndm vd
d ngudi Kinh sdm hem 1 ndm 5 thdng Hien tuong ndy ciing phii hgp quy lugt d nude ta
Id nam day thi chinh thudng mudn hon nft khoang 1 - 2 ndm
Cdc ddu hieu sinh dye thd cdp d hpc sinh cd 3 dfin tOc nhu phdt hien tuyin vu (d nft), mun trdng ca, Idng mu, Idng nach (d cd nam vd nu) dlu bdt dfiu tu trudc khi day thi chinh thuc va tudn theo thu ty thdi gian nhdt djnh, ddng tiidi cdch nhau khdng Ifiu (3 nam: Idng mu - long nach - mun trdng cd; d nft: tuyin vd ldng mu long ndeh -mun dimg cd Nft thudng xuat hidn cdc ddu hidu sinh dye thd cdp sdm hon nam
5.2 Cdc yeu tS tdc ddng
Sy phdt triln thl chdt va ddy tiii cua
Trang 10vd ngudi Hmdng chju sy tdc dOng cua nhilu
ylu to nhu: di truyln, dinh dudng, kinh tl
gia dinh, t§p qudn vdn hda, l§p luyOn gido
dye Ihl chdt trong trudng hpc, chdm sdc y tl
vd chfnh sdch phdt trien kinh t l - xd hOi ciia
nhd nude trung uong, dja phuong Tuy
chua cd sy ddnh gid chuydn biet, nhung cd
thl dy dodn tdc dOng ciia ylu to di truyln
mang tinh quylt djnh, bdn cgnh dd tdc dOng
ciia dinh dudng vd vdn hda cung rat quan
trpng, sau dd Id cdc yeu to khdc ciing gdp
phdn vdo sy phdt triln thl chdt vd dgy thl
ciia hpc sinh D^c bipt trong 1 0 - 1 5 ndm Ird
lai ddy, tdm vdc, thl luc cda ngudi ViOt Nam
dugc cdi thiOn mgnh thl hien quy lugt gia
toe vl ldm vdc co the vd cd ve lull day thi
do dieu kien mdi trudng vd kinh le - xd hOi
cua nude ta bao gdm cd Dien Bien phdt
triln hon trudc
5.3 Khuyin nghi
Qua dieu tra, khdo sdt thyc tl vl d^c
diem sinh ly day thi ciia hpc sinh 9 - 1 7 tuoi
cac dfin lOc Thdi, Hmdng vd Kinh d tinh
Didn Bidn cho thdy tudi day thi cua cdc em
dang cd chilu hudng sdm ldn, dong thdi
cung cd sy khdc nhau vl day thi gifta hpc
sinh cdc dan tOc ndy Vi vay, gia dinh va nha
Irudng is Dien Bien cfin cd ke hoach nOi
dung gido dye gidi tfnh phii hgp vol lua tudi
dfin tdc, gidi tinh; cdc cdp chinh quyln vd
cac CO quan chdc ndng cung can nghidn cuu
hoach djnh cdc chfnh sdch phii hgp dl can
thiep kip thai trong qua trinh phdt triln thl
chdt ciia tre, giup trd ddm bao phdt triln tit
chilu cao trong dilu kien tudi day thl cd xu
hudng sdm len Cdn ddc biet tdng cudng
tuyen truyln, van ddng ldm thay ddi ddn lap
qudn yeu duong va kit hdn sdm, dan din dd
ddy, dd nhilu con d ngudi Hmdng vd mpt sl DTTS khdc tren dja bdn linh
Tdi liOu tham khdo
1 D 3 Hing Cudng (2009), Nghien
cuu mpi s6 chi so sinh hgc cua hgc sinh Trung hgc ca sa cdc ddn tgc a tinh Hod Binh, Lu^n dn Tiln sT Sinh hpc, Dai hgc Sir
phgm Hd NOi
2 Thdm Thj Hodng DiOp (1992), £)ac
diim hinh thdi the lycc hpc sinh mgt so tntdng phd thdng ca sd Hd Npi, Lu$n dn
Phd Tien sT Y dugc, Dai hgc Y khoa HdNOi
3 Dinh Ky vd Nguyen Vdn Khoa (1974), "Nghien cdu mOt sd kfch thudc hinh thdi vd thl lyc ciia hpc sinh phd thdng tir 7
den 18 tuli d Thdi Binh", Hinh thdi hgc,
Tong hOi Y dugc hpc ViOt Nam, Sd 7
4 Dinh Ky (1983), "Vl hili day thi
ciia hpc sinh pho thdng", Tgp chi Nghien cuu
Gido due, BO Gido dye vd Dao tao, Sd 5
5 Dinh Ky, Cao Quoc Viet (1986),
Bdn vi tudi dgy thi a tri em nude ta nhung ndm 1978 - 1980, Tdm tdt cdng hinh nghidn
cdu khoa hgc ciia ViOn Bdo ve Bd me va Tre
so sinh, 1980-1985, Nxb Y hgc Ha NOi
6 Ddo Huy Khue (1991), Ddc diim
vi kich thudc hinh thdi, vi su tdng trudng vd phdt then ca the cua hpc sinh phd thdng tu 6-17 tudi, Luan dn Phd Tiln sT Sinh hoc,
Dai hpc Tdng hgp Hd
NOi-7 Ddo Huy Khud, Nguyln Thj Tan, Nguyen Ddc NghTa (1993), "Ddc dilm chfn sinh dye ciia hgc sinh pho tiidng ihj xd Ha
Ddng", Hinh thdi hpc, Tdp 1, Hd NOi, tr 23-31
8 Trdn Thj Loan (2002), Nghiin cuu
mgt sd chi so thi ly:c vd tri tui cua hoc sinh