KCH BN BI GING: CHC D DCH NO TY

K NNG O VNG UThs. Thanh HngMc tiu hc tp

Sau khi hc bi ny, hc vin c kh nng:

1.1. Trnh by c ngha ca vic o vng u

1.2. Thc hin ng cc bc o vng u1.3. Bit cch s dng c biu vng u 1.4. Lit k c cc nguyn nhn vng u to, vng u nh

1. i cng

nh gi s pht trin ca tr em bao gm: nh gi cn nng, chiu cao v vng u. Cc ch s ny phn nh: s pht trin, tnh trng sc khe, bnh tt, dinh dng v theo di din bin iu tr ca mt s bnh. Theo di nh k cc ch s ny cng c th gip pht hin sm mt s bnh no v bnh di truyn.Vng u tr mi sinh l 31-34 cm; mi thng tng 2-3 cm trong 3 thng u, tng 1 cm mi thng trong 3 thng tip, tng 0,5 cm mi thng trong 3 thng tip. S o vng u l 45-47 cm khi tr 1 tui v khi tr 15 tui l 52 cm.Ch s vng u hay chu vi chm trn gin tip nh gi th tch ca cc thnh phn cha trong hp s, bao gm: nhu m no, dch no ty v mch mu.

Tr khe mnh di 2 tui nn c o vng u t nht mi 3 thng. Vi tr c cc bnh l ca h thn kinh trung ng nn c o vng u mi ln ti khm. Tt cc cc ch s vng u nn c nh du vo biu tng trng trong s theo di hoc bnh n ca tr. 2. Nguyn nhn vng u to

-u to c tnh cht gia nh, di truyn gen tri trn nhim sc th thng

No ng thy

Bin dng xng s

Bnh i acid Glutaric Typ1

U x thn kinh Typ1, u nguyn bo hch,

Hi chng Sotos (ph i bn cu i no) Bnh di truyn: Alexander, Canavan

3. Nguyn nhn vng u nh

u nh c tnh cht gia nh

Cc bnh t bin 3 nhim sc th 13, 18, 21

Cc bnh di truyn: Prader-Willi, Rubinstein-Taybi

D tt thai do nhim c: ng c ru, Hydantoin, nhim tia bc x Nhim virus bm sinh: Cytomegalo, Rubella, Toxoplasmosis Cc nguyn nhn khc: di chng vim no, vim mng no, vng da nhn no, xut huyt no, bnh no thiu oxy, m b tiu ng thai k, m b tng phenylalanine.5. Cc bc o vng u5.1. Chun b bnh nhn

Cho hi bnh nhn v b m, bc s t gii thiu tn

Hi tn, ngy sinh v gii tnh ca tr

Gii thch mc ch ca vic o vng u cho b m ( nu phn i cng trn)5.2. Chun b dng c

Mt thc dy mm c chia vch milimet (thc c chiu di 60cm v khng chun gin)5.3. Yu cu b m b m hoc cc vt khc trn u tr (nu c)5.4. Yu cu b m b tr t th u thng ng (nu khng c b m, c th o vng u t th tr nm)5.5. Xc nh im trn cung my (im li cao nht trn cung my) v chm (im li cao nht vng chm)5.6. Thao tc o: dng thc dy o 2 ln vng quanh u trn cung my, qua chm (thy thuc ng bn cnh hoc sau bnh nhn )

5.7. c kt qu vi 1 s l sau du phy (ly s ln nht ca 2 ln o).5.8. Xc nh tui v nh du s o vng u theo tui trn biu vng u5.9. Nhn nh kt qu5.10. Kt thc thao tc khm. Cm n b m. 6. Bng kim dy-hcSTTNi dung tng bc ngha ca tng bcTiu chun phi t

1Cho hi, gii thiu tn bc s. Hi tn, gii tnh v ngy sinh ca tr. Lm quen vi bnh nhn v b m.

Xc nh ng bnh nhn. Bnh nhn v ngi nh hp tc vi bc s.

Xc nh ng bnh nhn

2Gii thch mc ch ca vic o vng uGip b m hiu r mc ch ca o vng uB m hiu mc ch ca o vng u v hp tc khi o.

3Yu cu b m b tr t th u thng ng v b m ca tr ( nu tr i m) thao tc o tin hnh thun li v chnh xcB m hp tc

4Xc nh chm v im trn cung my o vng u thun li v chnh xcXc nh chnh xc cc im mc

5Dng thc dy o vng u 2 lno ng qua cc mc nh du o ng v cho kt qu chnh xc

6c kt qu vi 1 s l (gi tr ln nht ca 2 ln o)c chnh xc kt quc chnh xc kt qu

7Xc nh tui, gii v nh du trn biu vng uXc nh chnh xc Xc nh chnh xc

8Nhn nh kt qu o vng uNhn nh chnh xcNhn nh chnh xc

9Kt thc thao tc khm. Cm n b m.B m hi lngB m hi lng

10Trnh by kt qu vi gio vinTrnh by y v chnh xcTrnh by y v chnh xc

Ti liu tham kho

1. Nguyn Gia Khnh (2013). c im h thn kinh tr em. Bi ging Nhi khoa. Tp 2. Nh xut bn y hc: 2442. John Gilroy (1982). Basic Neurology: 217-219.

3. Mayo Clinic Family Health Book. 4th edition.4. William E. DeMyer (1994). Technique of the Neurologic examination:14-22.5. Family Pratice Notebook (2014). Head Circumference.

6. William Demyer (2005). Small, large, or abnormally shaped head. Current management in child neurology. Third edition. 7. Clinical Guideline: measuring a child (2014). Head circumference. Great Ormond Street Hospital.PAGE 4