Header Page of 166 B GIO DC V O TO TRNG I HC THNG LONG KHOA KHOA HC SC KHE B MễN IU DNG PHM TH TUYT NHUNG Mó Sinh viờn: B00240 ĐáNH GIá CHấT LƯợNG CUộC SốNG CủA BệNH NHÂN Bị HộI CHứNG MạCH VàNH CấP TRƯớC Và SAU CAN THIệP ĐộNG MạCH VàNH QUA DA Sử DụNG Bộ CÂU HỏI SEATTLE ANGINA QUESTIONNAIRE TI TT NGHIP C NHN H VLVH H Ni Thỏng 11 nm 2013 Footer Page of 166 Header Page of 166 B GIO DC V O TO TRNG I HC THNG LONG KHOA KHOA HC SC KHE B MễN IU DNG PHM TH TUYT NHUNG Mó Sinh viờn: B00240 ĐáNH GIá CHấT LƯợNG CUộC SốNG CủA BệNH NHÂN Bị HộI CHứNG MạCH VàNH CấP TRƯớC Và SAU CAN THIệP ĐộNG MạCH VàNH QUA DA Sử DụNG Bộ CÂU HỏI SEATTLE ANGINA QUESTIONNAIRE TI TT NGHIP C NHN H VLVH Ngi hng dn khoa hc: THS PHAN TUN T H Ni 2013 Footer Page of 166 Thang Long University Library Header Page of 166 LI CM N Trong sut quỏ trỡnh hc i hc v lm lun tt nghip, tụi ó nhn c s quan tõm, giỳp ca rt nhiu ca cỏc Thy Cụ, cỏc anh ch, cỏc bn ng nghip v gia ỡnh Qua õy, tụi xin by t lũng bit n sõu sc ti: GS TS Phm Th Minh c - Trng B mụn iu Dng - Trng i hc Thng Long, Cụ ó truyn t cho tụi kin thc v chuyờn mụn, ch dy cho tụi phng phỏp hay tip cn vi mụi trng hc mi; Cụ rt nhit tỡnh ging dy v ó hỡnh thnh cho tụi mt tỏc phong lm vic v hc nghiờm tỳc, cú trỏch nhim Khụng nhng vy, tụi cũn hc c Cụ cỏch i nhõn x th, cỏch giao tip vi bnh nhõn v ng nghip Nhng iu ny s l hnh trang giỳp tụi vng vng cuc sng sau ny PGS TS Phm Mnh Hựng - Trng phũng Tim Mch can thip-Vin Tim Mch Quc Gia- Bnh vin Bch Mai Thy ó ch bo cho tụi kin thc v kinh nghim chuyờn mụn, ng thi cng to mụi trng hc tớch cc y hng cho tt c hc viờn; thy ó tn tỡnh hng dn, giỳp v ng viờn tụi quỏ trỡnh hon thnh lun ny ThS Phan Tun t, ngi ó ht lũng dy bo tụi quỏ trỡnh hc v trc tip hng dn tụi thc hin lun v ó giỳp tụi rt nhiu viờc la chn bnh nhõn nghiờn cu cho ti tt nghip ca tụi cng nh chia s v giỳp tụi nhng khú khn quỏ trỡnh hc v lm ti Cỏc anh, ch, bn bố ca tụi, c bit l BS Hong Phi ip, ngi ó giỳp v ng viờn tụi rt nhiu quỏ trỡnh thc hin lun Tp th cỏc ng nghip bỏc s, iu dng, k thut viờn ca cỏc phũng ban Vin Tim Mch Quc Gia Vit Nam ó ch bo cng nh to iu kin giỳp tụi sut quỏ trỡnh hc v thc hin lun Ban giỏm hiu, Phũng o to v cỏc B mụn c bit l B mụn iu Dng - Trng i hc Thng Long v cụ giỏo ch nhim H Th Huyn ó Footer Page of 166 Header Page of 166 to iu kin tt nht giỳp tụi thi gian hc ti trng v hon thnh lun ny Tụi xin by t lũng bit n n nhng bnh nhõn ti h chớnh l nhng ngi thy, giỳp tụi hon thnh lun tt nghip Cui cựng, tụi xin dnh tỡnh cm v li cm n sõu sc ti gia ỡnh tụi, b m, anh ch em gỏi tụi, nhng ngi ó luụn bờn, quan tõm, ng viờn v chia s nhng nim vui cng nh ni bun hc v cuc sng H Ni, ngy 15 thỏng 11 nm 2013 Phm Th Tuyt Nhung Footer Page of 166 Thang Long University Library Header Page of 166 LI CAM OAN Tụi xin cam oan cụng trỡnh nghiờn cu bn lun ny l bn thõn tụi thc hin, nhng s liu lun ny l trung thc H Ni, thỏng 11 nm 2013 Tỏc gi Phm Th Tuyt Nhung Footer Page of 166 Header Page of 166 DANH MC CC CH VIT TT ACC American College of Cardiology (Trng mụn tim mch Hoa K) AHA American Heart Association (Hip hi tim mch Hoa K) BN Bnh nhõn CCS Canadian Cardiovascular Society (Hi tim mch Canada) CLCS Cht lng cuc sng MV ng mch vnh T ỏi thỏo ng TNKễ au tht ngc khụng n nh TNễ au tht ngc n nh EF Ejection Fraction: Phõn s tng mỏu HCMVC Hi chng mch vnh cp NMCT Nhi mỏu c tim NMCTST Nhi mỏu c tim cú ST chờnh lờn NMCTKST Nhi mỏu c tim khụng ST chờnh lờn SAQ Seattle Angina Quesionnaire: B cõu hi SAQ THA Tng huyt ỏp Footer Page of 166 Thang Long University Library Header Page of 166 DANH MC HèNH V Hỡnh 1.1: Hi chng mch vnh cp Footer Page of 166 Header Page of 166 DANH MC BNG Bng 1.1 Phõn au tht ngc theo Hi tim mch Canada (CCS) Bng 3.1 c im chung ca i tng nghiờn cu 20 Bng 3.2 im SAQ trung bỡnh trc v sau can thip thỏng 21 Bng 3.3 T l thay i cú ý ngha lõm sng sau thỏng 21 Bng 3.4 Tng quan gia kh nng gng sc, tn s au ngc v tui vi cht lng cuc sng trc can thip 22 Bng 3.5 Mi quan h gia gii tớnh v im SAQ trc can thip 22 Bng 3.6 Quan h gia mc kinh t t ỏnh giỏ v im SAQ trc can thip 23 Bng 3.6 Quan h gia mc kinh t t ỏnh giỏ v im SAQ trc can thip (tip)23 Bng 3.7 Quan h gia tin s tng huyt ỏp v im SAQ trc can thip .23 Bng 3.8 Quan h gia tin s ỏi thỏo ng v im SAQ trc can thip 24 Bng 3.9 Quan h gia tin s can thip MV v im SAQ trc can thip 24 Bng 3.10 Quan h gia tin s nhi mỏu c tim v im SAQ trc can thip 25 Bng 3.11 Quan h gia tỡnh trng hp thõn ng mch vnh v im SAQ trc can thip .25 Bng 3.12 Quan h gia tỡnh trng hp thõn ng mch vnh v im SAQ trc can thip (Tip) 26 Bng 4.1 So sỏnh im SAQ trc can thip ng mch vnh nghiờn cu ca chỳng tụi v cỏc tỏc gi khỏc 29 Bng 4.2: So sỏnh s ci thin cú ý ngha lõm sng 31 Footer Page of 166 Thang Long University Library Header Page of 166 MC LC T VN CHNG 1: TNG QUAN 1.1 Tng quan v hi chng mch vnh cp 1.2 Tng quan v cht lng cuc sng 10 1.3 Tng quan v b cõu hi SAQ 12 1.4 Tỡnh hỡnh nghiờn cu v cht lng cuc sng Vit Nam v th gii 14 CHNG 2: I TNG V PHNG PHP NGHIấN CU 15 2.1 a im v thi gian nghiờn cu 15 2.2 i tng nghiờn cu 15 2.3 Thit k nghiờn cu 16 2.4 Cỏc bc tin hnh nghiờn cu 16 2.5 Bin s nghiờn cu 16 2.6 Phõn tớch thng kờ 19 2.7 o c nghiờn cu 19 CHNG 3: KT QU 20 3.1 c im chung ca i tng nghiờn cu 20 3.2 Cht lng cuc sng trc can thip v sau can thip thỏng 21 3.3 Mi quan h gia mt s yu t vi cht lng cuc sng trc can thip 22 CHNG 4: BN LUN 27 4.1 c im chung 27 4.2 Cht lng cuc sng trc v sau can thip ng mch vnh 28 4.3 Mi quan h gia mt s yu t v cht lng cuc sng trc can thip 32 KT LUN 34 KHUYN NGH 35 TI LIU THAM KHO PH LC Footer Page of 166 Header Page 10 of 166 T VN Thut ng hi chng mch vnh cp (HCMVC) dựng ch nhúm triu chng lõm sng thiu mỏu cp ca c tim [3] Trong HCMVC phõn nhúm: nhúm cú ST chờnh lờn biu hin ca nhi mỏu c tim cú ST chờnh lờn (NMCTST) v nhúm khụng cú ST chờnh lờn bao gm NMCT khụng cú ST chờnh lờn (NMCTKST) v au tht ngc khụng n nh (TNKễ) Nu nh trc õy, NMCTST c c bit chỳ ý n chn oỏn v iu tr õy l bnh lý cp tớnh cú tiờn lng nng n v nguy c gõy t vong cao thỡ cho n nhng nm gn õy, s chỳ ý ny ang dn chuyn sang NMCTKST v TNKễ s tng lờn nhanh chúng ca hai th bnh ny n nm 2003, cỏc bỏo cỏo cho thy Hoa K, 1/3 s 5,3 triu ca cp cu vỡ au ngc hng nm l NMCTKST/ TNKễ Theo thi gian, t l ny ngy cng gia tng, NMCTST ang gim dn [10] T nm 1999 n 2008, s cỏc ca chn oỏn HCMVC, t l NMCTKST/TNKễ tng t 51,5% lờn 73% [38] v tr thnh nguyờn nhõn chớnh gõy t vong [11] Chớnh vỡ vy, Trng mụn tim mch Hoa K (ACC) v hip hi tim mch Hoa K (AHA) ó khụng ngng a cỏc khuyn cỏo mi v chn oỏn v iu tr NMCTKST/TNKễ c bit, khuyn cỏo mi nht nm 2012, ch nh can thip tỏi thụng mch vnh, mt gõy nhiu tranh cói iu tr NMCTKST/TNKễ ó c m rng rt nhiu so vi khuyn cỏo nm 2007 V vi nhng u im vt tri hn so vi m bc cu ni ch vnh, can thip MV qua da ó tr thnh phng phỏp c s dng thng xuyờn chin lc tỏi thụng mch vnh [22, 23] Trc õy, t l t vong, bin chng v cỏc thụng s chc nng l yu t c s dng nh nhng ch s o lng hiu qu mt phng phỏp iu tr bnh MV [8] Tuy nhiờn, nhng nm gn õy, cht lng cuc sng (CLCS) ca ngi bnh ang ngy cng tr thnh mt yu t quan trng vic ỏnh giỏ v sc khe ca nhng BN cú bnh lý tim mch Trờn th gii, lnh vc CLCS ó c nghiờn cu rng rói qun th nhng ngi cú bnh MV núi chung v nhng bnh nhõn (BN) cú can thip MV núi riờng [15, 24, 50, 51] Footer Page 10 of 166 Thang Long University Library Header Page 45 of 166 TI LIU THAM KHO Ti liu Ting Vit: Phm Gia Khi, v CS.,(2006), "Khuyn cỏo ca hi tim mch hc Vit Nam v chn oỏn, iu tr au tht ngc khụng n nh v nhi mỏu c tim khụng cú ST chờnh lờn", Khuyn cỏo v cỏc bnh lý tim mch v chuyn húa giai on 2006-2010, Tr: 107-141 NXB y hc H Vn Phc,(2006), Nghiờn cu mt s yu t nh hng n chc nng thn sau can thip mch vnh qua da, Lun tt nghip thc s tim mch, Vin Tim mch quc gia Vit Nam, i hc y H Ni Nguyn Lõn Vit,(2007), "Cn au tht ngc khụng n nh v nhi mỏu c tim khụng cú ST chờnh lờn", Thc hnh bnh tim mch, Tr: 17-34 NXB y hc Nguyn Lõn Vit, v CS.,(2008), "iu tr cn au tht ngc khụng n nh", iu tri hc ni khoa, Tr: 92-105 NXB y hc Ngụ Hu Vinh, Nguyn Cu Li, and Hunh Vn Minh,(2010), Nghiờn cu t l, hỡnh thỏi tỏi hp v cỏc yu t liờn quan trung hn thỏng sau can thip ng mch vnh bng stent, Lun bỏc s chuyờn khoa II, Bnh vin Trung ng Hu, i hc Y Hu Phm Nguyn Vinh, Th Kim Chi, and Phm Thu Linh,(2003), "Hi chng ng mch vnh cp khụng ST chờnh lờn: Cn au tht ngc khụng n nh v nhi mỏu c tim khụng ST chờnh lờn", Bnh hc tim mch, Tr: 85-96 NXB y hc, Thnh ph H Chớ Minh Ti liu ting Anh: Bennett, S.J., et al.,( 2003 ), "Comparison of quality of life measures in heart failure", Nursing Research 52(4): p 1-10 Benzer, W., Hửfer S., and Oldridge N.B.,(2003), "Health-related quality of life in patients with coronary artery disease after different treatments for angina in routine clinical practice." Herz, 28: p 421-428 Borkon, A.M., et al.,( 2002), "A Comparison of the Recovery of Health Status After Percutaneous Coronary Intervention and Coronary Artery Bypass", Ann Thorac Surg, 74: p 1526-1530 Footer Page 45 of 166 Header Page 46 of 166 10 Braunwald E (2003), " Application of Current Guidelines to the Management of Unstable Angina and Non-ST-Elevation Myocardial Infarction" Circulation, 2003;108: p.III 28-37 11 Braunwald, E., et al.,(2007), "ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-STElevation Myocardial Infarction): Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine", Circulation, 116: p e148e304 12 Braunwald, E., et al.,(2012), "2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non-STElevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines" Circulation, 2012;126: p 875-910 13 Brorsson, B., et al.,(2001), "Quality of life of chronic stable angina patients years after coronary angioplasty or coronary artery bypass surgery", Journal of Internal Medicine, 249: p 47-57 14 Coelho, R and Prata J., Handbook of Disease Burdens and Quality of Life Measures, in Quality of life measures in acute coronary syndromes: The evaluation of predictors in this field of research, V.R Preedy and R.R Watson, Editors 2010 p 3016-3032 15 Dempster, M and Donnelly M.,(2000), "Measuring the health related quality of life of people with ischaemic heart disease", Heart 83: p 641-644 16 Derek, G., Ron J., and Geraldine P., Quality of Life, in Dictionary of Human Geography, W Blackwell, Editor 2009, Oxford Footer Page 46 of 166 Thang Long University Library Header Page 47 of 166 17 Dougherty, C.M., et al.,(1998), "Comparison of three quality of life instrumentts in stable angina pertoris: Seattle Angine Questionnaire , Short Form Health Survey (SF-36), and Quality of life Index- Cardiac Version III", J Clin Epidemiol, 51(7): p 569-575 18 Durmaz, T., et al.,(2009), "Factors affecting quality of life in patients with coronary heart disease", Turk J Med Sci 39(3): p 343-351 19 Emery, C.F., et al.,(2004), "Gender diffirences in quality of life Among Cardiac patients", Psychosomatic medecine, 66: p 190-197 20 Eurich, D.T., et al.,(2006), "Assessing responsiveness of generic and specific health related quality of life measures in heart failure", Health and Quality of Life Outcomes 4(89): p 1-14 21 Garratt, A.M., Hutchinsonb A., and Russell I.,(2000), "The UK version of the Seattle Angina Questionnaire (SAQ-UK) Reliability, validity and responsiveness", journal of clinical epidemiology, 54(9): p 907-915 22 Grech, E.D.,(2004), ABC of Interventional Cardiology:Percutaneous coronary intervention I: History and development, BMJ, ed london 23 Grech, E.D.,(2004), ABC of Interventional Cardiology: Percutaneous coronary intervention II: The procedure BMJ, ed london 24 Guyatt, G.H., Feeny D.H., and Patrick D.L.,(1993), "Measuring HealthRelated Quality of Life", Annals of Internal Medicine, 118: p 622-629 25 Hayward Group, What is quality of life?, in What is ? Series 2009: London 26 Kim, J., et al.,(2005), "Health-related quality of life after interventional or conservative strategy in unstable angina (RITA-3) infarction: One-year results of the third randomized intervention trial of patients with unstable angina or nonST-segment elevation myocardial", Journal of the American College of Cardiology, 45(2): p 221-228 27 Kong, D.F., Blazing M.A., and O'Connor C.M.,(1999), "The health care burden of unstable angina ", Cardiology Clinics, 17(2): p 247-261 28 Lowry, F Seattle Angina Questionnaire predicts mortality and hospitalization in outpatients with CAD 2002; http://www.theheart.org/article/271149/print.do Footer Page 47 of 166 Available from: Header Page 48 of 166 29 Maddox, T.M., et al.,(2007), "One year health status outcomes of unstable angina versus myocardial infarction: a prospective, observational cohort study of ACS survivors", BMC Cardiovascular Disorders 7: p 1-28 30 Mayou, R and Bryant B.,(1993), "Quality of life in cardiovascular disease", Heart, 69: p 460-466 31 Morie, G., et al.,(2010), "Quality of Life in Patients with Severe and Stable Coronary Atherosclerotic Disease ", Arq Bras Cardiol 32 Nainggolan, L CHD patients have poor quality of life 2008; Available from: http://www.theheart.org/article/881623.do 33 Norris, C.M., et al.,(2004), "Women with coronary artery disease report worse health related quality of life outcomes compared to men", Health and Quality of Life Outcomes 2: p 1-21 34 Norris, C.M., et al.,(2004), "Systematic review of statistical methods used to analyze Seattle Angina Quetionnaire scores", can j cardiol, 20(2): p 187-193 35 Norris, C.M., et al.,(2008), "Sex and Gender Discrepancies in Health-Related Quality of Life Outcomes Among Patients With Established Coronary Artery Disease", Circ Cardiovasc Qual Outcomes 1: p 123-130 36 Pischke, C.R., et al.,( 2006), "Comparison of Coronary Risk Factors and Quality of Life in Coronary Artery Disease Patients With Versus Without Diabetes Mellitus ", The American Journal of Cardiology, 97: p 12671273 37 Rumsfeld, J.S., et al.,(2001), "Predictors of quality of life following acute coronary syndromes", The American Journal of Cardiology 88: p 781-784 38 S.Go Alan, et al (2012), Heart Disease and Stroke Statistics 2013 Update A Report From the American Heart 2013 Update A Report From the American Heart" Circulation, 2012 39 Seki, S., et al.,(2010), "Validity and Reliability of Seattle Angina Questionnaire Japanese Version in Patients With Coronary Artery Disease", Asian Nursing Research 4: p 57-63 40 Simpson, E and Pilote L.,(2005), "Quality of life after acute myocardial infarction: A comparison of diabetic versus non-diabetic acute myocardial infarction patients in Quebec acute care hospitals", Health and Quality of Life Outcomes 3(80) Footer Page 48 of 166 Thang Long University Library Header Page 49 of 166 41 Smith, H.J., Taylor R., and Mitchell A.,(2000), "A comparison of four quality of life instruments in cardiac patients: SF-36, QLI, QLMI, and SEIQoL", Heart 84: p 390-394 42 Souza, E.N., et al.,(2008), "Predictors of Quality of Life Change after an Acute Coronary Event", Arq Bras Cardiol 91(4): p 229-235 43 Spertus, J.A.,(2001), "Testing the Effectiveness of Treatment", American Heart Journal, 141(4): p 1-9 44 Spertus, J.A., et al.,(2002), "Health status predicts long term outcome in outpatients with coronary disease", Circulation 106: p 43-29 45 Spertus, J.A., et al.,(2004), "Predictors of quality of life benefit after percutaneous coronary intervention", Circulation, 110: p 3789-3794 46 Spertus, J.A., et al.,(1995), "Development and Evaluation of the Seattle Angina Questionnaire: A New Functional Status Measure for Coronary Artery Disease", JACC 25(2) 47 Tajvar, M., Arab M., and Montazeri A.,(2008), "Determinants of healthrelated quality of life in elderly in Tehran, Iran", BMC Public Health 8(323) 48 The Epimetrics Group, L The Seattle Angina Questionnaire Available from: http://cvoutcomes.org/saqs/new 49 The Epimetrics Group, L The Seattle Angina Questionnaire Available from: http://myhealthoutcomes.com/faqs/3001#3004 50 Thompson, D.R and Martin C.R., Handbook of disease burdens and quality of life measures: Measurement issues in the assessment of quality of life in patients with coronary heart disease, in Measurement issues in the assessment of quality of life in patients with coronary heart disease, V.R Preedy and R.R Watson, Editors 2010, Springer p 2988-2997 51 Thompson, D.R and Yu C.M.,(2003), "Quality of life in patients with coronary heart disease-I: Assessment tools", Health and Quality of Life Outcomes, 1: p 1-5 52 Weintraub, W.S., et al.,(2008), "Effect of PCI on quality of life in patients with stable coronary disease", The new england journal of medicine, 359: p 677-87 Footer Page 49 of 166 Header Page 50 of 166 53 Wong, M.S and Chair S.Y.,(2007), "Changes in health related quality of life following percutaneous coronary intervention: A longitudinal study", International Journal of Nursing Studies 44: p 1334-1342 54 Wyrwich, K.W., et al.,(2007), "Triangulating Patient and Clinician Perspectives on Clinically Important Differences in Health-Related Quality of Life among Patients with Heart disease", Health Services Research, 42(6): p 2257-2274 55 Wyrwich, K.W., et al.,(2005), "A Comparison of clinically important differences in health related quality of life for patients with chronic lung disease, asthma, or heart disease", Health Services Research, 40(2): p 577-591 56 Xie, J., et al.,(2008), "Patient-Reported Health Status in Coronary Heart Disease in the United States: Age, Sex, Racial, and Ethnic Differences ", Circulation, 118: p 491-497 57 Yu, C.M., et al.,(2004), "A Short Course of Cardiac Rehabilitation Program is Highly Cost Effective in Improving Long-Term Quality of Life in Patients With Recent Myocardial Infarction or Percutaneous Coronary Intervention", Arch Phys Med Rehabil, 85: p 1915-1922 58 Zhang, Z., et al.,(2006), "The impact of acute coronary syndrome on clinical, economic, and cardiac-specific health status after coronary artery bypass surgery versus stent-assisted percutaneous coronary intervention: 1-year results from the stent or surgery (SoS) trial." American Heart Journal, 150(1): p 175-181 Footer Page 50 of 166 Thang Long University Library Header Page 51 of 166 PH LC BNH N NGHIấN CU S nghiờn cu: H v tờn: Mó h s a ch: S in thoi: Chn oỏn Ngy nhp vin7 Ngy vin Ngy can thip A c im cỏ nhõn Tui Gii: Tỡnh trng hụn nhõn : Nam N c thõn , li d, chng/ v cht Cú v/chng Trỡnh giỏo dc: ht lp Vic lm: ang lm vic V hu Tht nghip Kinh t gia ỡnh (t ỏnh giỏ): Khú khn Va phi Khỏ gi B Tin s: 7.Hỳt thuc lỏ Tng huyt ỏp ỏi thỏo ng 10 ó lm can thip MV 11 ó lm cu ni ch vnh Footer Page 51 of 166 Cú Cú Cú Cú Cú Khụng Khụng Khụng Khụng Khụng Header Page 52 of 166 12.Nhi mỏu c tim Cú Khụng C Lõm sng v cn lõm sng ti vin: 13 Troponin T: ng\ml 14 Hp thõn 15 T vong ti vin: Khụng lm Cú Khụng Cú Khụng D Sau thỏng can thip: 16 Tỏi nhp vin 17 Can thip li 18 T vong Cú Cú Cú Khụng Khụng Khụng E B cõu hi (Xem tip trang sau) Footer Page 52 of 166 Thang Long University Library Header Page 53 of 166 Phiu t ỏnh giỏ tỡnh trng au ngc ễng/ b hóy ỏnh du (X) vo MT ụ thớch hp biu hin mc KHể KHN m tỡnh trng au tc hay nng ngc gõy i vi cỏc hot ng, i sng sinh hot ca mỡnh khong thi gian thỏng tr li õy: Tụi gp Tụi gp Tụi gp Tụi Tụi Tụi gp Tỡnh RT KH khú T gp KHễNG khú khn trng NHIU NHIU khn khú gp khú khú khú VA khn khn NGUYấN khn khn PHI NHN KHC Hot (khụng ng phi au ngc, tc ngc) hoc tụi khụng lm hot ng ú T mc qun ỏo i b nh V sinh cỏ nhõn Leo cu thang liờn tc, khụng ngh Lm vn, dn nh,mang vt nh Footer Page 53 of 166 Header Page 54 of 166 Tụi gp Tụi gp Tụi gp Tụi T Tụi Tụi gp Tỡnh RT KH khú gp khú KHễNG khú khn trng NHIU NHIU khn khn gp khú khú khú VA khn NGUYấN khn khn PHI NHN KHC Hot (khụng ng phi au ngc, tc ngc) hoc tụi khụng lm hot ng ú i nhanh t ngừ nh mỡnh n ngừ bờn cnh Chy b B tr hoc nõng, di chuyn vt nng Tham gia cỏc hot ng th thao (cu lụng, bi, tennis, ) Footer Page 54 of 166 Thang Long University Library Header Page 55 of 166 So vi thỏng trc, ụng\ b lm vic nng nht cú th, thỡ s ln ụng/ b b au ngc - tc hay nng ngc thay i nh th no? So vi thỏng trc tụi au-tc ngc: Nhiu hn Nhiu hn Cng nh t hn t hn Tụi KHễNG RT MT vy thụi MT RT au-tc nng NHIU CHT CHT NHIU ngc tun qua Trong tun qua, ụng \b b au au ngc - tc hay nng ngc TRUNG BèNH khong bao nhiờu ln? ln tr lờn 1-3 ln ln tr lờn 1-2 ln t hn ln KHễNG ln no trong trong trong MT MT MT TUN MT MT bn tun NGY NGY nhng khụng TUN TUN thng xuyờn Trong tun qua, ụng\ b ung thuc chng au ngc (viờn nitroglycerin) TRUNG BèNH bao nhiờu ln KHI AU NGC ? ln tr lờn 1-3 ln ln tr lờn 1-2 ln t hn ln KHễNG Tụi ch trong trong ln no ung thuc MT MT MT TUN MT MT theo n NGY nhng khụng TUN TUN tun ca bỏc s NGY thng xuyờn Footer Page 55 of 166 Header Page 56 of 166 ễng/ b cú cm thy khú chu dựng thuc cha au ngc - tc ngc theo n ca bỏc s khụng? Tụi cm thy: RT KH HI HU NH HON TON Bỏc s ca khú chu khú chu khú chu KHễNG KHễNG tụi khụng khú chu khú chu kờ n ễng/ b cú hi lũng vi mi th ó v ang c lm iu tr chng au - tc ngc ca mỡnh? Tụi cm thy: RT KHễNG KHễNG THT S KH hi lũng hi lũng hi lũng HI LềNG RT hi lũng ễng\b cú hi lũng vi nhng li t ca bỏc s v au ngc - tc ngc ca mỡnh khụng? Tụi cm thy: RT KHễNG KHễNG THT S KH hi lũng hi lũng hi lũng HI LềNG RT hi lũng ễng\b cú hi lũng vi vic iu tr hin ti vi au ngc - tc ngc ca mỡnh khụng? Tụi cm thy: RT KHễNG KHễNG THT S KH hi lũng hi lũng hi lũng HI LềNG RT hi lũng Footer Page 56 of 166 Thang Long University Library Header Page 57 of 166 Trong vũng thỏng qua, tỡnh trng au ngc - tc hay nng ngc cú cn tr vic tn hng cuc sng ca ụng/ b khụng? Cn tr Cn tr Cn tr T KHễNG RT NHIU KH NHIU MT PHN cn tr cn tr 10 Nu t bõy gi n ht cuc sng ụng\b phi sng chung vi tỡnh trng au ngc - tc hay nng, ụng\b s cm thy th no? Tụi cm thy: RT KHễNG KHễNG THT S KH hi lũng hi lũng hi lũng HI LềNG RT hi lũng 11 ễng/ b cú thng xuyờn lo lng rng mỡnh cú th cú nhng cn au tim hoc b t t khụng? KHễNG THNG ễI KHI HIM KHI KHễNG NGNG XUYấN lo lng lo lng BAO GI lo lng lo lng v iu ú v iu ú lo lng v iu ú v iu ú Footer Page 57 of 166 v iu ú Header Page 58 of 166 PH LC DANH SCH BNH NHN NGHIấN CU TI VIN TIM MCH QUC GIA VIT NAM BNH VIN BCH MAI STT H V TấN TUI NGY NGY M VO VIN RA VIN BNH NHN Nguyn Th S 53 29-08-13 07-10-13 130034471 Nguyn Vn V 56 10-09-13 14-09-13 130213682 Phm Vn T 54 25-08-13 03-08-13 130221208 Tng Th K 62 01-10-13 04-10-13 130290128 Nguyn Xuõn T 61 08-10-13 10-10-13 130228702 ng c T 67 08-10-13 12-10-13 130039183 Phm Th N 54 23-09-13 06-10-13 130029603 Nguyn i L 58 21-08-13 25-08-13 131601518 Phm c T 68 22-09-13 29-08-13 130012985 10 Nguyn H 81 06-09-13 15-09-13 130037260 11 inh Xuõn T 73 20-09-13 29-09-13 130207646 12 Trn c H 59 02-10-13 06-10-13 130215864 13 Nguyn Vn T 50 28-08-13 05-09-13 130026357 14 Nguyn Hu T 73 04-09-13 10-09-13 130213802 15 ng Xuõn T 74 27-09-13 01-10-13 130034562 16 inh Vn D 64 27-08-13 03-09-13 130034294 17 Giang Cụng B 61 29-08-13 05-10-13 130033974 18 Lờ Vn L 59 10-10-13 18-10-13 130037756 19 Nguyn Minh T 61 09-10-13 15-10-13 130038462 20 Phm ỡnh T 62 27-08-13 03-09-13 130037496 21 Nguyn Vn T 49 27-09-13 02-10-13 130215025 22 Trn Minh S 48 10-09-13 15-09-13 130033808 23 Phan Th T 74 27-08-13 03-09-13 130207356 24 Trn Th Lờ A 72 03-09-13 09-09-13 130213890 Footer Page 58 of 166 Thang Long University Library Header Page 59 of 166 25 Nguyn Vn T 53 03-09-13 07-09-13 130212197 26 Ngụ Ngc S 48 20-09-13 27-09-13 131601510 27 Phựng Quang T 71 23-08-13 29-08-13 130036274 28 Lờ Ngc A 70 30-09-13 05-10-13 130214231 29 Nguyn Tin T 71 08-10-13 13-10-13 130021423 30 Nguyn Hu S 64 02-10-13 07-10-13 130215753 31 Lờ Hng V 78 30-08-13 10-09-13 130213883 32 Nguyn Th H 70 05-09-13 11-09-13 130213952 33 Nguyn inh L 68 26-08-13 30-08-13 130212423 34 on Vn V 83 03-09-13 08-09-13 130031200 35 Nguyn inh T 84 05-09-13 15-09-13 131601455 36 Nguyn Hu V 57 03-09-13 10-09-13 131601428 37 Phựng Th B 65 26-09-13 05-10-13 130215897 38 V Vn H 62 20-09-13 29-09-13 130207655 39 Nguyn Xuõn D 80 26-09-13 04-10-13 130215932 40 Nguyn c T 37 23-08-13 26-08-13 130027650 41 Trn Vn P 64 07-08-13 05-09-13 131601103 42 Trn Th T 80 23-08-13 26-08-13 130035507 43 Trinh Th M 63 12-09-13 15-09-13 130037460 44 Nguyn Th Y 67 22-08-13 30-08-13 131601418 45 Phm Th O 63 10-09-13 17-09-13 131601583 46 Phm Vn N 67 31-08-13 04-09-13 130212618 47 Nguyn ỡnh T 84 08-08-13 11-08-13 130204322 48 Phan Quang D 91 18-08-13 22-08-13 130213373 49 Phan Th H 67 03-09-13 06-09-13 130212624 50 Nguyn Nh T 80 08-10-13 13-10-13 130215506 51 ng Quang V 53 20-09-13 05-10-13 130206540 52 Trng Vn T 68 08-10-13 12-10-13 130214275 Footer Page 59 of 166 ... Mó Sinh viờn: B00240 ĐáNH GIá CHấT LƯợNG CUộC SốNG CủA BệNH NHÂN Bị HộI CHứNG MạCH VàNH CấP TRƯớC Và SAU CAN THIệP ĐộNG MạCH VàNH QUA DA Sử DụNG Bộ CÂU HỏI SEATTLE ANGINA QUESTIONNAIRE TI TT... tht ngc khụng n nh trc v sau can thip ng mch vnh qua da s dng b cõu hi Seattle Angina Questionnaire nhm mc tiờu: So sỏnh cht lng cuc sng trc v sau can thip mch vnh qua da ca BN nhi mỏu c tim khụng... thin tt hn nhúm can thip MV qua da [9] Nm 2004, Man Sin Wong v cng s nghiờn cu trờn 65 BN c can thip MV sau thỏng v thỏng vi ti: Theo dừi dc s thay i CLCS sau can thip mch vnh qua da bng vic s