"khoang trong" giaa nhu c iu vd thac trang khdm slpc

khoe tiin hbn nhdn, <56 Id nam na thanh nien “ngai” di khdm do cdc yeu to vdn hba, chu quan ve slp c khoe cua minh, sa tin taong trong tinh yeu, d iiu kien kinh te cung nhLP sa han che v i th6ng tin vd dich vu [6],

k £t lu a nSy khdc bibt Ibn giua nhu1 c iu daac cung cap

dich vu khdm s lp c khoe tiin h6n nhdn vd thac trang slp dyng dich vu dgt ra cdu hoi cho cdc nhd nghibn c lp u vd hoach dinh chinh sdch y t i de lap d a a c

khang tr6ng ndy.TAI LIEU THAM KHAO1. Thu tipong Chinh phu (2011). Quyet djnh so

2013/QB-TTg ngdy 14 thang 11 nam 2011 cua Thu tipong Chinh phu - Chien lu’Q,c dan so va slpc khoe sinh san giai dogn 2011-2020.

2. Qudc hbi ni/Oc Cbng hba *5 hpi chu n g hi a Vibt Nam (2000) Lu|t hdn nhdn v3 gia dinh

3. Luang Kim Phuc (2013) Nhu c iu cham soc sire khoe tiin hdn nhdn tai xd Kim Binh huy&n Kirn Bang tinh Ha Nam nim 2012

4. Oo Ngpc Tan (2004) Danh gia ket qua tri&n khai mo hinh kiim tra slpc khoe vd tu v in tien hon nhdn tai Hung Yen vd Hue Ddn sd va phat tn in

5. Nguyen Hai Yen (2013). Thi/c trang sir dung dich vy cham sdc sire khde tien hdn nhdn va mdt s6 y6u to lien quan cua phu nO ket hdn ndm 2009 - 2012 tai 4 xd huyen Kim Bang tinh Ha Nam

6. Le Thj Mg' (2013). Mot so yeu to khd khdn trong vi$c tiep c$n va sir dung dich vu cham sdc sue khde tien hdn nhan cua phy n ir tai xa Kim Binh huyen Kim Bang tinh Ha Nam nam 2012.

NGHltN CliU DAC DIEM CAN TH| HOC DlfftNG dl HOC SINH TIED HOC VA TRUNG HOC CO Sli HA Ndi NAM 2009

VU TH! THANH*, DOAN HUY HAU ", HOANG THj PHUC™* Bdnh viin Mat Hd Noi; ** Hqc vidn Quin y ; *** B$nh vi0n M it TW

t 6 m tAtMyc dich nghidn cuv: Khio sdt ty 10 tdt khuc xa

cua hoc sinh tai thdnh phd Ha N q i . Phuong phdp quan sdt phdn tich, cdt ngang. Nghidn cuv trdn 6.184 hoc sinh (3.222 nam vd 2.962 nCr) tieu hQC vd trung hoc co s& tir 6- 15 tudi 6 04 qudn, huy0n d Hd NQi ndm 2009. Ket qud nghien cuv cho th iy ty 10 cdn thi Id 33,7% (khuc xg c iu tuong duong: >- 0,75D). Ty 10 cdn thi d hoc sinh nir (35,0%) cao hon hqc sinh nam (32,5%), (p<0,05). Ty 10 cdn thj 6 hoc sinh qudn Ba Dinh (42,3%), qudn Thanh Xudn (41,0%) vd huy0n Tir Lidm (44,3%) cao hon so v&i huy0n Ddng Anh (18,8%), (p<0,001).

Tie khda: Tdt khuc xa, cdn thi.SUMMARYAim: to study the prevalence of refractive error of

school children at Hanoi. Methods: cross - sectional and prospective study in 2009. The study carry out on 6.184 children (3.222 males, 2.962 females) from primary and secondary schools, o f 4 districts in Hanoi, aged 7 -15 years. Results: the prevalence of myopia (SE at least - 0.75D): 33,7%. The rate of myopia in female children (35.0%) were than male children (32.5%), (p <0.05). The rate of myopia in Ba Dinh district (42.3%), Thanh Xuan district (41.0%) and Tu Liem (44.3%) were higher than the Dong Anh district (18.8%), (p<0.001).

Keywords: Refractive error, myopia.DAT VAN 0£T£t khuc xg n6i chung, can thi hoc dabng (CTHO)

n6i ribng dang ngdy cdng tang, Id mdi quan tdm cua tang gia dinh vd todn xd hbi [1], [9], [12]. Cdn thj hoc

dabng Idm anh huang d in sac khoe vd khd ndng hpc tdp, sinh hoat cua hpc sinh [2], [14], Cy Vi$t Nam, CTHD da dapc chu y ta nhang ndm 1960, nhang d in nay v in chiim ty 10 khd cao vd c6 xu habng tdng nhanh, khbng chi a khu vac thdnh thj md 6 ca khu vac nbng thbn [3], [4], [5], [7],

D i gbp phin ndng cao hibu qua cua chaang trinh phbng ching cdc b$nh hpc dubng, cbng trinh daac tiin hdnh nhdm muc tibu: “M6 t i ddc diem c$n thj hoc du&ng & hoc sinh tieu hoc vd trung hgc ca s&Hd Noi ndm 2009".

0 6 l TU’CXNG VA PHU’aNG PHAP NGHIEN Cl>U1. Dbi tu’ang nghien ci>uGim 6.184 HS (3.222 nam vd 2.962 nu’) tiiu hpc

vd trung hpc ca sa (THCS) tu- 6- 15 tu6i a 04 qudn, huybn a Hd Nbi Id Ba Dinh, Thanh Xudn, Ta Libm vd Dbng Anh.

2. Phaang phdp ngh iin ci>u- Thiet k i nghien clpu : Mb ta cdt ngang cb phdn

tich.- C& mdu nghibn clpu daac tinh theo cbng thipc

mb ta cdt ngang, abc tinh Id 5.780 HS. Thac t i dd nghibn clpu 6.184 HS.

- Khdm mdt, dc thj lac vd tha kinh xdc dinh TKX (cdn thi, vibn thj, logn thj) cho t i t ca HS thee danh sdeh dd chpn. Dc khuc xa bdng mdy khuc xg ta dpng.

- Mdt dapc coi Id cdn thi: Khi khuc xa c iu taang daang (KXCTO) 0.75D). Ngaih daac coi Id cdn thi khi cb mpt mdt hede ca hai mdt cdn thi

S6 ligu dapc xa ly theo phaang phdp th6ng kb y sinh hpc bing phin m im SPSS 13.0

92 Y HOC THUC HANH (90S) - SO 2/2014

k£t QUA ng h ien clpuBing 1. Ty Id cdn thj cua hpc sinh theo cdp hpc o- Ha Noi

Chi s6Tiiu hpc

(n= 3.177)THCS

(n= 3.007)T6ng s6

(n= 6 184)SL % SL % SL %

S6 HS mac can th| 811 25,5 1 272 42,3 2 083 33,7p<0,001

- Can thi 1 mat 190 23,4 251 19,7 441 21,2- Can thj 2 mSt 621 76,6 1.021 80,3 1 642 78,8- Da <Jeo kinh 204 25,2 592 46,5 796 38,2

Kit qua o’ bang 1 cho thdy ty le cdn thi d HS Hd Noi Id 33,7%. Ty le can thi o’ HS THCS (42,3%) cao hon HS Tiiu hpc (25,5%), sy khdc bidt cd y nghla thong ke vai p<0,001. Trong so 2.083 HS mdc cdn thi, ty Id cdn thj m$t mit Id 21,2%; cdn thi hai mdt Id 78,8% vd chi co 38,2% HS dd deo kinh.

Bang 2. Ty Id cdn thi cua hpc sinh theo gidi tinh

Chi s6Nam (n= 3 222) NO (n= 2 962)

SL % SL %S6 mac can thi 1047 32,5 1036 35,0

p<0,05- can 1 mat 234 22,3 207 20,0- C£n 2 mat 813 77,7 829 80,0- Deo kinh 372 35,5 424 40,9

Kit qua o’ bang 2 cho th iy ty Id cdn thi o’ HS nu* (35,0%) cao hon HS nam (32,5%), sy khdc bidt c6 y nghla th6ng kd vdi p<0,05.

Bing 3. Ty Id cdn thi cua hpc sinh cdc qudn/huyen

Chi s6Ba Dinh (A)(n=1.549) Thanh Xuan (B)

(n= 919) Ti> Liem (C) (n=1.376) DOng Anh (D) (n=2 340)

SL % SL % SL % SL %S6 mac c£n thj 656 42,3 377 41,0 609 44,3 441 18,8

Pa . b. c- o<0,001- Can 1 mat 92 14,0 92 24,4 137 22,5 120 27,2- C£n 2 mat 564 86,0 285 75,6 472 77,5 321 72,8- Deo kinh 441 67,2 117 31,0 147 24,1 91 20,6

Kit qua d bang 3 cho thdy ty le CTHD o’ HS qudn Ba Dinh (42,3%), Qudn Thanh Xudn (41,0%) vd huydn Tu1 Lilm (44,3%) cao hon so vdi huydn Dong Anh (18,8%), su1 khdc biet co y nghTa thong kd vdi p<0,001.

BAN LUAN1. Ty 1$ c$n thj hpc du’frng cua hpc sinh Hd Noi so v&i mot sd nirac tren thd gi&iSo vdi mdt so nu’dc khdc o’ chdu My, chdu Au, chdu Phi vd chdu A thi ty le cdn thi O’ HS Hd Ndi tu’ang d6i

cao, tu’ang du-ang vdi Trung Quoc, Malaysia, nhung th ip han Singapore (bang 4).Bing 4. So sdnh ty Id cdn thi vdi mpt so nu’dc khdc

Tac gia Quoc gia n Tuoi Can thj (%)Morgan I. va cs. (2005) [13] My 14.075 Ldp 4 4,5

Rushood A. A. va cs. (2013) [14] Sudan 671.119 6- 15 1,50Ghosh S. (2012) [9] An DO 2.570 6- 14 11,9

Khader Y. S. va cs. (2006) f12] Jordan 1.777 12-17 17,6GuoY. vacs. (2013) [11] Trung Quoc 681 33,0

Goh P. vd cs. (2005) [101 Malaysia 4.634 9-15 34,4Saw S. M. vd cs. (2002) [15] Singapore 11- 12 53,1

Kit qua nghien cuu (2009) Viet Nam 6.184 Ldp 1- 9 33,7

2. Ty 1$ cdn thj hoc du>&ng & hpc sinh Hd N6i so v&i mot s6 tinh vd thdnh phd khdc cua Vi£t NamKit qud nghidn ci>u cho th iy ty Id cdn thj chung cua 2 c ip (tieu hoc vd THCS) Id 33,7%. Ndu so vdi k it qua

nghidn cCru cua Trin Vdn D in (1978) ty le cdn thj cua HS Ha Ndi (7- 8%) thi ty Id ndy dd tdng Idn g ip trdn 4 lin v i so vdi nghidn am cua Hd Huy Tien (1980) (5%) thi tdng len g ip 6 lin.

So sdnh v&i cdc nghidn cim khdc chung tdi th iy ty le CTHD d HS Hd Ndi (ndm 2009) tdng cao so v&i cdc thinh ph6 khdc trong ca nu’&c (bang 5).

Y HOC THUC HANH (905) - S6 2/2014 93

Bang 5. So sdnh ty 16 can thj vfri mot s6 tinh/thdnh phA a viet NamT£c gia Oia phi/ang n Tu6i (I6p) CAn thi (%)

Lfe Thj Thanh Xuyfen (2009) [8] TP Ho Chi Minh 2 747 7- 15 38 88Ddng Anh Ngpc (2010) [41 Hai Phbng Ldrp 1- 12 16.42Nguyin VSn Lifen (1999) [3] Nam Dinh L6rp 1- 12 13.6

Phgm Hfenq Quang (2011) [6] BSc Ninh 757 L6p 6- 8 20,3Vu Quang Dung (2013) [11 Thai Nguyfen LPp 6- 9 16,8

Mai Quoc Tung vd cs. (2011) [7] B3c «gn 3.580 LPp 6- 9 5,9Trjnh Thi Bich Nqoc (2009) [5] Ha Nfei * Lap 6- 9 25,5Vu Thj Hodng Lan (2012) [21 Ha Npi 322 Lap 6- 9 50,3

Kit qua nghifen ci>u (2009) Ha Npi 6 184 Ldrp 1- 9 33,7

3. Ty l i cdn thj hoc dipfrng cua hpc sinh noi thdnh vd ngoai thdnh

Kdt qua nghibn cuu cho th iy ty 16 CTHO a HS qudn Ba Dinh (42,3%), Qudn Thanh Xudn (41,0%) vd huyfen Tu Lifem (44,3%) cao hon so vPi huyen B6ng Anh (18,8%), sy khdc bifet c6 y nghla thong kfe vdi p<0,001. Didu ndy cung tu’ang tu* nhu1 nhdn xfet cua nhieu nghifen cuu trong vd ngodi nu’d’c Id HS a thdnh thi c6 ty Ife cdn thi nhieu han vd muc dp ndng han so vdi HS a nfeng thfen [9], [10], [13], [14],

Cy Vifet Nam, nghifen cuu cua Nguyfen Vdn Lifen (1999) [3] a Nam Djnh cho th iy ty Ife CTHD a HS nfeng thfen th ip han so vPi HS thdnh ph6 (3,9% vd 13,3%). Nghifen ctm cua Lfe Thi Thanh Xuyfen vd cs. (2009) [8] a TP. Hd Chi Minh (7- 15 tudi) cho th iy ty Ife cdn thj theo vung Id 56,67% (trung tdm), 36,93% (cdn trung tdm), 38,88% (ven) vd 15,48% (ngoai thdnh). Pham Hdng Quang vd cs (2011) [6] nghifen cuu tai Bdc Ninh th iy HS I6p 6 ddn I6p 8 a nfei thdnh mdc cdn thj cao han ngoai thdnh (OR= 3,6; 95% Cl=2,3 - 5,6). T?i Bdc Kan, Mai Quoc Tung vd cs (2011)[7] cung th iy HS thdnh thj cfe nguy ca bj can thj cao han o’ nfeng thfen.

Chung tfei cho rdng ty Ife cdn thj u HS thdnh phd cao han a nfeng thfen Id do HS thdnh phd ddnh thfe-i gian doc vd vidt a ngodi trufeng hpc nhieu han so vPi HS nfeng thfen. Gia tdng hoat dfencj nhin gan Id nguyfen nhdn gfep phin vdo su1 phdt trien cdn thi.

k £t lu a nDieu tra 6.184 hpc sinh (3.222 nam vd 2.962 nu)

tieu hpc vd trung hpc ca sa tu 6- 15 tudi a 04 qudn, huyfen o’ Hd Nfei ndm 2009. Ket qua nghifen cuu cho th iy ty Ife cdn thj Id 33,7% (khuc xa cau tuang duang: > - 0,75D). Ty Ife cdn thj a hpc sinh nu (35,0%) cao han hpc sinh nam (32,5%), (p<0,05). Ty Ife cdn thj O’ hpc sinh qudn Ba Dinh (42,3%), qudn Thanh Xudn (41,0%) vd huyfen Tu Lifem (44,3%) cao han so vdi huyfen Dfeng Anh (18,8%), (p<0,001).

TAI LIEU THAM KHAO1. Vu Quang Dung (2013), Nghien ci>u thyc trang

vd mfet so giai phdp phong chdng can thj a hpc sinh trung hpc ca sa khu vyc trung du tinh Thai Nguyen, Luan dn Tien sT Y hpc, Dai hoc Y Dupe Thdi Nguyen.

2. Vu Thj Hodng Lan, Nguyin Thj Minh Thdi(2012), “Thyc trgng cfen thj hpc du’ong va mfet sd yeu td lien quan tai truang Trung hoc Ca sa Phan Chu Trinh, qudn Ba Dinh, Hd Nfei ndm 2010", Tap chi Y te Cfeng cfeng, 12.2012, So 26 (26), tr. 23

3. Nguyen Vdn Lien (1999), Danh gid tinh hinh cfen thj trong hoc sinh tinh Nam Dinh, Ludn vdn Thac syY hQC, Oai hQC Y Ha Nfei.

4. Dang Anh Ngoc (2010), Tdt can thj o' hoc sinh tieu hpc, trung hpc ca sa Hai Phong, yeu td anh huang va giai phap can thifep, Luan an Tien sT y hpc, Vifen Vfe sinh djch te Trung irang.

5. Trjnh Thj Bich Ngpc (2009), "Didu tra djch tfe hpc tfet khuc xa O’ hpc sinh Ha Npi nam 2009", Ky ydu Hpi nghj Nhdn khoa Toan quoc 2009, Od NSng 09- 12/9/2009, tr. 24.

6. Pham Hong Quancj, Pham Vdn Tin (2011), “Cfen thj d hpc sinh vd yeu to anh himng tai bdn trufeng trung hpc ca sa thanh phd Bdc Ninh nam 2010”, Tap chi Nghien cuu Y hpc, 73(2), tr. 112-116.

7. Mai Quoc Tung, Hoang Linh, Dinh Manh Cuang vd cs. (2011), “Tdt khuc xa a hpc sinh phd thfeng tinh Bdc Kan ndm 2007", Tap chi Nghifen cuu Y hpc, 72(1), tr. 100- 105.

8. Lfe Thj Thanh Xuyfen, Bui Thj Thu Huang, Phi Duy Tien va cs (2009), “Khao sat ty Ife tfet khuc xa vd kien thuc, thdi dfe, hdnh vi cua hoc sinh, cha me hpc sinh vd giao vifen ve tfet khuc xa tai TP. HCM’ , Tap chi Y Hpc TP. He Chi Minh, Tap 13, Phy ban cua Sd 1, tr. 5-12.

9. Ghosh S., Mukhopadhyay U.. Maji. D. et al(2012), “Visual impairment in urban school children of low-income families in Kolkata, India’ , Indian J Public Health, 56(2): 163-7.

10. Goh P. P., Abqariyah Y., Pokharel G. P. et al(2005), “Refractive error and visual impairment in school-age children in Gombak District, Malaysia", Ophthalmology, 112 (4): 678-85.

11. Guo Y„ Liu L. J., Xu L„ Lv Y. Y. et al. (2013), “Visual impairment and spectacle use in schoolchildren in rural and urban regions in Beijing", Eur. J Ophthalmol., 0. doi: 10.5301 /ejo.5000348.

12. Khader Y. S., Batayha W. Q„ Abdul-Aziz S. M. et al. (2006), “Prevalence and risk indicators of myopia among schoolchildren in Amman, Jordan", East Mediterr Health J„ 12(3-4): 434-9.

13. Morgan I., Rose K. (2005), "How genetic is school myopia?", Prog. Retin Eye Res., 24 (1), p. 1-38.

14. Rushood A. A., Azmat S.. Shariq M. et al.(2013), “Ocular disorders among schoolchildren in Khartoum State, Sudan", East Mediterr. Health J 19(3) 282-8.

15. Saw S. M., Andrew C., Kee S. C. et al. (2002), “Component dependent risk factors for ocular parameters in Singapore Chinese children", Ophthalmology, 109 (11), pp. 2065-2071

94 Y HQC THUC HANH (905) - SO 2/2014