N g h i e n c d u n d y k h o n g c h o b i d t t} l e m d c b d n h n h i l m t n l n g t r o n g c d n g d d n g b j l u t d o d d , n h i J n g n g h i d n c d u d j c h t l h o c d u a t r d n d i d u t r a h d g i a d i n h s e c h o t h d n g t i n v d t j I d m a c b d n h s a u ID l u t c h f n h x a c h o n .
T A I L 1 $ U T H A M K H A O
1. B a n c h i d a o p h d n g e h d n g lut b a o t m n g u o n g (2009), B d o c a o t d n g h o p thidt h a i d o b a o s d 9, tinh d d n ngay 15 t h a n g 10 n a m 2 0 0 9
2. B d Y t e ( 2 0 1 1 ) , Nifin G i a n t h d n g k d y t d 2 0 1 0 3. H a v a n N h u ( 2 0 1 1 ) . T i n h hinh khSm chCfa b § n h tai tram y t d x a t h u d c h u y f i n V a n C h d n , ttnh Y d n bai s a u lu q u e l t h a n g 9 n a m 2 0 0 5 , T a p c h i Y h o c d U p h d n g , t a p X X I , s d 6(124), tr, 2 9 8 - 3 0 6
4 . H a v a n N h U ( 2 0 1 1 ) , T i n h h i n h b 6 n h n h a n m d c b e n h n h i l m t r i i n g d d n k h a m tai t r a m y t d x a A n P h u d c , h u y e n T i n H o n g , tinh D d n g T h S p t r o n g m i i a lu nSm 2 0 0 7 , T a p ch( Y h o c d u p h d n g , t a p X X I , s d 4 ( 1 2 2 ) , tr, 8 5 - 9 2
5. A h e m , M , K o v a t s , R S , W i l k i n s o n , P, F e w , R a n d Matthies, F 2 0 0 5 , ' G l o b a l h e a l t h i m p a c t s of f l o o d s : Epidemiologic e v i d e n c e ' . Epidemiologic Reviews, v o l . 2 7 , pp, 36-46,
6. F e d e r a l Ministry o f H e a l t h , G o v e r n m e n t of Pakistar a n d W o r l d H e a l t h O r g a n i z a t i o n ( W H O ) , P a k i s t a n 2 0 1 0 F l o o d R e s p o n s e in P a k i s t a n , Epidemiological Bulletin, vol I , i s s u e 2 M o n d a y 3 0 A u g u s t 2 0 1 0
7. G u h a - S a p i r , D, W i l l e n Gijsbert v a n P a n h u i s anc Joet L a n g o u t t e 2 0 0 7 , 'Pattern of c h r o n i c a n d acute d i s e a s e after n a t u r a l disasters - a s t u d y from the i n t e m a t i o n a l C o m m i t t e e of t h e R e d C r o s s field hospital ir B a n d a A c e h after the 2 0 0 4 Indian o c e a n t s u n a m i s ' Tropical Medicine and International Health, v o l . 12, No, I I , pp, 1338-1341
8. Hisayoshi K o n d o e l a l , , ( 2 0 0 1 ) , •Infectious D i s e a s e s d u r i n g t h e F l o o d Disaster in M o z a m b i q u e 2 0 0 0 ' , Prehospital Disaster M e d i c i n e , v o l , 16, S u p p l e m e n t 2 , pp.
3 8 - 3 9
9. Ivers, L o u i s e , C a n d R y a n , E d w a r d , T (2006) 'Infectious d i s e a s e s of s e v e r e w e a t h e r - r e l a t e d a n d flood- related natural disasters', C u n e n t o p i n i o n in infectious d i s e a s e s , v o l . 19, n o . 5, p p , 4 0 8 - 4 1 4
10,Nishikiori N , A b e T , C o s t a D G . D h a r m a r a t n e S D , Kunll 0 a n d Moji K 2 0 0 6 , ' W h o d i e d a s a result of t h e t s u n a m i ? Risk factor of mortality a m o n g intemally displaced p e r s o n s in Srilanka: a retrospective c o h o r t analysis", BMC Public Health 6, 73.
mSC TRANG NGUdN NHAN USC Y HOC c£ TRUYEN CUA TINH U N G SON NAM 2010 - 2011
H O A N G T H j H O A L t P H A M P H O V I N H , P H A M V I ^ T H O A N G
DAT VAN DE
L a n g S o n la m d t t i n h m i e n nOi b i e n g i d i t h u d c k h u vUC O d n g B a c eOa T o Q u d c . D d y l a v i i n g d a t e d n g a p n h i e u k h d k h a n , nUI n o n h i e m t r d t u y n h i e n n d i d a y l a vCing e h i ^ d u n g n h i e u t i e m n S n g , n g u d i d a n c d n h i e u k i n h n g h i e m t r o n g n u d i t r o n g , s i j f d u n g c a c e a y e o n l a m t h u d c v a e a e p h u o n g p h a p chO'a b e n h b a n g Y H C T . H i e n n a y m a n g l u d i y t e e o s d t i n h L a n g S o n c h u a t h u c s U d a p Lfng d u d c n h u c a u C S S K b a n g Y H C T eOa n h a n d a n , s d n g u d i d a n d e n k h a m ehOa b e n h b a n g Y H C T t a i c a c t r a m y t d ch? e h i e m t y l e < 1 0 % . D a y la m d t t f Id c d n r d t t h d p s o v d i c h ( t i e u ciia C h i n h s a e h q u d e g i a v e Y D H C T d e n n a m 2 0 1 0 . D o v a y , d e g d p p h d n t h u c h i e n t d t h o n nO)a n h i e m v u e h S m s d c sijic k h o e n h d n d a n b a n g Y H C T c h o d d n g t i a o c a e d a n t d c , t h u c h i d n t d t e a c chii t r u o n g , e h i n h s a c h eOa D a n g v a N h a n u d c v d p h a t t r i e n Y H C T t a i t i n h L a n g S d n , t m d c h d t p h a i h i e u r d t h i f c t r a n g n g u d n n h a n l i f e v e Y H C T h i e n n a y n h u t h d n a o , t i r d o c d k e h o a c h p h a t t r i e n n g u d n n h a n lUC Y H C T m d t e a c h ^ n g t h e v a p h u h p p v d i t i n h h i n h thUC t i d n cOa d i a p h U d n g , g d p p h d n n a n g e a o c h a t l u p n g C S S K B D c h o n h a n d a n t i n h L a n g S o n d u p c t d t h o n .
Muc tidu nghidn cOu: M d t ^ t h u c t r a n g n g u d n n h a n l u c Y H C T t r o n g c a c e o s d y t e c d n g I d p v a n g o d i c d n g l a p cQa t i n h L a n g S o n ; O d x u d t m o t s d g i a i p h a p n h a m t a n g c u d n g n g u d n n h a n lift; Y H C T c D a " f i n h
D 6 I T L / O N G V A P H U O N G P H A P N G H | £ N C C T U 1. Doi tupng nghien cthj.
3487 can bd y td cda eac cd sd y te cdng lap va 116 can bp y te ci^a cac co sd y te ngoai cdng lap e^a tinh Lang Son.
2 . P h U d n g p h a p n g h i e n c U u .
M d t a c a t n g a n g k e t h p p v d i d j n h t i n h v d d i n h l u p n g 3. Phuong phap thu thap so lieu,
Thu thap thdng qua bang eau hoi, sd lieu thdng kd cQa nganh y td Lang son, phdng van sau.
4 . T h d i g i a n v a d j a d i e m n g h i e n c u t j . N g h i e n c i f u d u p e t h u d h i e n n a m 2 0 1 0 va 6 t h a n g d a u n a m 2 0 1 1 t a i t i n h L a n g s o n .
K£'T QUA NGHI£N CQU
1. Nhan I^rc YHCT tai c a c CSYT c d n g lap t r o n g toan t i n h .
Ket qua nghien eifu tir 3487 can bd y t d (CBYT) cho thay t j le can bd Y hoc cd tmydn / can bd y t d Chung la 333/3487 = 9,5% v a can bd YHHO /CBYT Chung la 3154 /3487 = 90,5% dupe phan b d eu the tai bang sau:
Bang 1. C o eau nhan luc YHCT v a YHHD trong CSYT cdng Idp
Otitumc SDH
BH
Khic . ^ ^ s d y t g
TS Th.s BSCKII BSCKI BSCK BSCKDH
BSeK YSCK YSDK KW LuDaqv flfifl
YHCT n 0 0 0 5 10 1 3 175 87 52 0 333
%
0,0 0.0 0,0 1.5 3,0 0.3 0.9 52.55 26,12 15.63 0.0 100,0
YHHB n 1 26 10 204 215 90 64 0 756 1788 0 3154
%
0.03 0,82 0,34 6,46 6,69 2.85 2,0 0.0 23,96 56.66 0.03M
vmm
YHOC THUC H A N H (843) - S6 10/2012
s d c a n b o Y H C T / C B Y I c h u In. i n ti l e t h d p 9 5 % , s d c a n b o Y h o c h i e n d.ii g . i j i i 4 7 l a n :.u c a n b d Y H C T CD c i i n g trinh d o , s d c a n b o c o trinh d o s a u d a i h o c ( S D H ) c u a n h o m Y H H O n h i e u l i d n n h o m Y H C T T r o n g n h o m c a n b o Y H C T , s d c a n b o y I d c o I r i n h d o y sy c h u y e n k h o a Y H C T ( C K Y H C T ) c h i e m l y l e n h i e u n h a t 5 2 5 5 % , tiep d e n la b a c sT c h u y e n k h o a ( B S C K ) 3 % , k h d n g c d c a n b d n a o c 6 Irinh d o l i d n sy v a c h u y e n i<hoa II, I h a c sy
2 . N h a n l u c Y H C T t a i c a c C S Y T n g o a i c d n g l a p B a n g 2, C o c a u n h S n lUc Y H C T v a Y H H D tai c a c c d s d n g o a i c o n g lap
^ ^ " ^ ^ ^ CosdylC OOi li/tjng
SDH
DH
Khac
~ —-_
TSThs BSCKtl BSCKI
escK
BSCKDH BSOK YSCK YSOK KTV LuonqV T6ng
Y n 0 ""
0 0 0 4 0 0 5 0 0 24 33
HCT 0,0 0,0 0,0 0,0 12,12 0,0 0,0 15,15
0,0 0,0 72,73 100,0
YHHD n 0 4 0 1 32 2 21 4 11 8 0 83
0,0
%
4 ^ 0,0 1,2 '36,6 2,4 25,3 4,8 13,3 9,6 0,0 100,0 V d i 2 2 c d s d h a n h n g h e y d U d c l U n h a n I r o n g l i n h v u c Y H C T CO t d n g s d 3 3 ngUdi t h a m g i a (dUdc c a p c h i f n g c h i h a n h n g h e & g i a y c h i m g n h a n c d s d dCi d i e u kien h a n h n g h e ) . S o c o b a n g c a p c h u y e n m d n v e Y H C T la 9 ( 2 7 . 2 7 % ) ,
C o c h i m g c h i c h u y e n m o n v e Y H C T (lUdng y. l u o n g dUdc) ia 8 ( 2 4 , 2 4 % ) , c 6 c h i f n g n h a n b a i t h u d c g i a Injyenla13(39,39%)
+ Ngoai ra phan tdn Irong hdn 3000 hdi vien hdi Dong Y cac cap trong tinh cung hoat dong kham chua benh YDHCT t u nhan nhUng chua cd thdng ke chinh xac.
+ Sd lUdng nhan luc YHCT&YHHD tai cac CSYT ngoai cdng lap chenh lech nhau kha Idn 33/83=28,44%
tdng sd nhanluc,
+ Sd ean bd YHHD cd trinh do DH&SDH cd ti le rat cao (72,3%) trong khi do sd can bd YHCT ed trinh do DH rat thap (12,12%) trong cd can bd YHCT cd trinh dp SDH,
+ So can bd la luang y tai CSYHCT ngoii cdng lip chiem t^ le cao nhat (72.73%)
3 . P h a n b d ' n h a n l y c Y H C T t h e o t u y e n B a n g 3, C o e a u n h a n l u c Y H C T t h e o t u y e n lai C S Y T e o n g l a p
^ s d y l £ D S t i r o n g ^ ^ ^
SDH
DH
KhSc TS Th.s BSCKII BSCKI BSCK BSCKDH
BSDK YSCK
Tinh n 0 0 0 5 4 1 1 27
urn %
0.00 0,00 1,50 1,2U 0,3 0,3 8,10 1.8
HuyCh n 0 0 0 0 _5j
0 2 25 12
%
0,0 0.0 0,0 0,0 1,50 0,0 0,6 /,bO 3,6
xa
n 0 0 0 0 1 0 0 123 69
%
0,00 0,00 0,00 0,00 0,3 0,00 0,00 3693 20,/2
Tfinq n 0 0 0 5 10 1 3 175 87
0,00
%
0,00 0.00 1,50 3.0 0,3 08 52,55 26,15
- Tai tuydn tinh, so ean bd YHCT ed trinh dd SDH va OH nhldu hdn cac tuyen khac (3,3%)
- T a i t u y d n h u y e n , c h i i y e u l a y s y c h u y e n k h o a , y s y d a k h o a ( 1 1 , 1 % ) ' . S d B S C K rat it (1 5 % ) .
T a i t u y e n x a , c a c b d Y H C T c h u y e u l a y sy c h u y e n k h o a 3 6 9 3 %
B a n g 4 . CO c a u n h d n l i f e Y H C T t h e o t u y d n tai C S Y T n g o a i c d n g l a p .
Co s6 y 16 D(5i tL/ong~^^-^^
SDH
DH
KhSc TS Th.s BSCKII BSCKI BSCK T S C K D H "
BSDK YSCK YSOK KTV Luang y TAg
Tinh n 0 0 0 0 3 0 0 2 0 0 10 15
%
0,00 0,00 0,00 0,00 9,09 0,00 0,00 6,06 0,00 0,00 30,3 45,45
Huyen n 0 0 0 0 1 0 0 1 0 0 5 7
%
0,00 0,00 0,00 0,00 3,03 0,00 0,00 3,03 0,00 0,00 15,15 21,21
X3 n 0 0 0 0 0 0 0 2 0 0 9 11
%
0,00 0,00 0,00 0,00 0,00 0,00 0,00 6,06 0,00 0,00 27.27 33.23
*!S n 0 0 0 _ 0 ,
4 0 0 5 0 0 24 33
%
0,01 0,00 0,00 0,00 12,12 0,00 0,00 15.15 0,00 0.00 72,73 100,[O T a i t u y e n t i n h , c d 3 lUe lUOng t h a m g i a K C B bang Y H C T d d i a '
BSCK YHCT nhung ehi ehiem ti Id la (9,09%), chu yeu la luong y vdi ti le (30,3%), cdn lai Id YSCK vdi ty le (6,06%)
- Tai tuyen huyen. BSCK (3.03%). y sy chuyen khoa (3,03%), sd cdn lai la luong y chiem ty le (15,15%)
- Tai tuyen xa, so luong y t h a m gia K C B tUOng ddi cao (27,27%), so y sy chuyen khoa rat it (6,06%)
5. T u d i d d i v a t h a m n i e n c o n g t a e c u a c a n bo YHCT.
Bang 5. Tudi ddi va tham men c d n g tac c u a can bo YHCT
J s S y l j
& 5 t u a r ^ ^ ^
SDH
DH
Khac TS Ttis BSCKII BSCKI BSCK BSCKDH
BSDK YSCK YSDH KTV LuDngy T^g
CSYTcfifX n 0 0 0 5 10 1 3 175 87 52 0 333
T B T u * 0 0 0 47,61
5.9 41,7±
8,8 38 35,5t 4,3 32,5i
11,1 31,5±
8,6 33,6±
12,3 0 36,24±
9,9 lap TBnSm
nqh6 0 0 0 22,3±
4,8 18,6±
9,5 9 13,5±
10,3 12,6±
8,2 10,9±
5,8 13,5±
6.4 0 10.1±
8.3
CSYT nqoaicflnq lap n 0 0 0 0 4 0 0 5 0 0 24 33
I B ludi 0 0 0 0 38,0±
5,0 0 0 40,6±
9,7 0 0 58,61 23,7 48,t±
12,3 TBnam
nghS 0 0 0 0 16,01
4,0 0 0 18.51
5.9 0 0 33,01
14,9 25,71 9.1 N h i n c h u n g
n g h d c i i a c a n
t m n g b i n h t u d i n g h e v a t m n g b i n h n S m b p Y H C T n g o a i c d n g I d p d e u e a o h o n
Y HOC THi;C HANH (843) - S 6 10/2012
can bd YHCT trong cdng lap. Doi vdi can bd y te edng lap, ddi tuong TB cd tudi cao nhat la 44,8 va sd nam hanh nghd TB eao nhat la 19,5 trong khi dd ddi vdi can bd ngoai cdng lap Idn lupt la 56.5 va 32.2.
BANLUAN
Ngudn nhSn luc y td tal eac eo sd y td ddng vai trd quan trpng trong vide cung cap eac loai hinh d[ch vu y td tai edng ddng. Tien hdnh khSo sat hai ngudn nhan luc y te chinh tai co sd y te edng lap va co sd y td ngoai edng lap tai tinh Lang Son, ehiing tdi nhan thdy rang:
sU thidu hut ve ngudn nhan luc YHCT cd ^nh hudng rat Idn tdi viec silr dung YHCT trong cham sdc sifC khoe cdng ddng. Su thidu hut nhan lut YHCT xudt hidn c^ d ca mang ludi cd sd y td cdng Idp va co sd y td ngoai cdng lap, thidu ea ve sd lUdng vd ehdt lupng.
TJ le can bd YHCT cd trinh do chuydn sdu d ca 2 khu vuc edng lap va ngoai cdng tap ddu thap, ddc biet can bp YHCT la tidn sy va bae sy chuydn khoa 2 ehus ed ai. Ddy la mdt sU bdt cdp ddi vdi mdt chuydn ngdnh khoa hpc d tuydn tinh, chi cdch Trung uong cd hOn 100 km, ma chua cd thac sy YHCT, sd bac sy cd trinh dd chuyen khoa I vd YHCT todn tinh chi cd 05 ngudi chiem t j Id (1,5%). So sdnh vdi YHHO thi t? Id cilia YHCTA'HHD cung rat khiem tdn (vi du BSCK I t j Id la 5/204 = 2.4%).
So sanh g\ita CSYT ngoai cdng lap / CSYT cdng lap, t} Id cdn bd sau dai hpc cung rdt thdp. Tai cdc eo sd YHCT ngoai cdng lap khdng cd can bp cd trinh dp sau dai hpc.
Ca tinh chi cd 14 cdn bd cd trinh dd dai hoe lam YHCT tai CSYT cdng Idp chiem tf Id (4,2%). Trong khi dd YHHO sd can bd ndy la 369, mCfc chenh ve nhan lite YHCT/YHHD la 14/369 = 3,8% ^
Tai cae CSYT ngoai cdng lap sd cdn bd ed trinh dp dai hoc thudc ffnh vut YHCT cung rat thdp chi cd 4 BSCK chieni t j Id (12.12%), trong khi dd tai cac CSYT tu nhan YHHD sd can bd ed trinh dp DH cd tdi 55 ngudi chidm t } Id 66,3%, miifc chenh lech giG^
YHCT/YHHO Id 4/55 = 7,2%,
Hai ddi tUpng can quan tam la y sy YHCT va ludng y. Ve y sy YHCT tai cae CSYT edng lap chidm tf le tuong ddi cao (52,55%), va day cung la mdt tifc lupng ddng vai trd quan trpng trong viee phat trien YHCT d tuyen y te cd sd, hau het ddi tupng nay d dp tudi tren, dudi 30 vdi tham nien cdng tae trung binh Id 10 nam.
Day la mot dau hieu kha quan vi so vdi nghien ciru tmdc day tai tinh Hung Ydn nam 2002 cDa Oang Thj PhCic thi tai cac tram y td x a c d n trang vd can bd YHCT, hay nghien ciiiu cda Od Thi Phuong tai edng ddng dan cu Bac bd nam 1996 cho thdy trong sd 25 tram y te xa khao sat, thi chi cd 2/25 tram cd luong y;
3/i25 tram c6 can bd YHHO kdt hpp YHCT trong dieu tn, cdn lai hoat ddng kham chu^ benh chf) ydu bang YHHO va nghien ciilU cOa Hoang Thj Hoa L]^ nam 2006 cd 78/126 tram y te sCi" dung YHCT trang khdm va chua bdnh.
Qua dieu tra thifc td chiing tdi thdy tCr khi cd Chinh sdch Qudc gia vd STHCT va Quyet flnh 370 cOa Bd Y td ban hanh chudn Qudc gia y te xa, tai tinh Lang Sdn da quan tam hon ddn van 36 dao tao, bdi dudng can bp YHCT tai tuydn y td xa, phudng cung nhiT dau tu cd
sd vat chdt cho bd phan kham chCfa I-., i. • tai tram. Tuy nhien sd can bd lam cong t-'t tram v l n phai kiem nhiem nhieu viec khac do tn-rr, • ciia y td CO sd qua it so vdi chde nang nhiem vu M J . khae do mdl ehi dupe dao tao dinh hudng hoac bd luc chuyen khoa YHCT do do mot sd xa cd hoat ddng YHCT nhung chat lUOng cdn thap, hau nhu tai cac CSYT ehUa cd chinh sach dai ngd thoa dang ddi vdi nhiing ngudi lam cong tac YHCT va chua cd kinh phi danh rieng eho hoat ddng YHCT.
Vi vSy vdn de dat ra b day la cdn cd cd che phii hpp dd lUe luong Y sy lam edng tae YHCT tai tuyen y td CO sd, vifa lam vide lai vira ed dieu kien de hoc tap vuWn len, vifa giai quyet dUOc nghTa vu va quyen Ipi ciia ngudi Iao ddng. Mat khdc Nha nudc can cd chinh sach dai ngp thoa dang ddi vdi nhiJng ngudi lam YHCT dac bidt la tai tuydn y td cd sd va tai tram y te phai co djnh bidn YHCT on dinh. Qua tim hieu chiing Idi dupe phan anh rang: vai nSm gan ddy, Nha nudc cd chieu sinh Y sy YHCT hoc bae sy chuyen tu YHCT. Day la mot CO chd chinh sach hoan toan dung dan. Tuy nhien, cd didu chua phii hpp d day la ehi tieu tuyen sinh hang nam qua thap so vdt nhu cau dao tao. Mat khae eae ddi tuong nay la nhCmg ngudi true tiep ISn Ion vdi y td CO sd do do sau khi ra tn/dng ho it cd co hoi dupc bdi dudng, dao tao, nen ehang can cd cO ehe ehinh saeh phii hpp trong thi tuyen de dam bao quyen loi cho lut lupng nay. cd nen chang la ap dung ed ehe cd tuyen, vi nhu thd dam bao dupe sU cdng bang va phan t)d ddu cho cae khu vut.
Tai cac cO sd YHCT ngoai cong lap, lUdng y la lUc lupng ddng dao nhat chiem ty le 72,73% va day la lUC luong chii yeu cung cap cae loai hinh dieh vu YHCT tai edng ddng. Cac eO sd YHCT ngoai edng lap ddng mot vai trd quan trpng trong edng tae CSSKCD, gdp phan lam giam bdt sU qua tai cho cac CSYT cdng lap.
Qua phan tich d tren ehung ta tiiay ve sd lupng nhan lut YHCT cCia tinh Lang Sdn la thap chi ehidm ty le 9,5 % (d ea can bp chuyen sau, eung nhU can bd phd cap). SU phan bd' cung khdng ddng deu, hau hdt can bd dai hoc vd sau dai hpc d tuyen tinh, y sy va luong y d tuydn huyen, xa. Qua thdng ke tong hpp chung ta thay luc lupng ludng y d khu vUC edng lap khdng cd ai. Mot eau hdi duoe dat ra la tai sao khdng cd luong y nao lam tai cae cO sci y te edng lap, phai Chang do hp khdng cd dii trinh dp, dieu kien hay vi co chd ehinh saeh khdng tuyen dung ho vao lam.
K§T L U A N
- Nhan luc ve y hoc cd tmyen / tong sd can bd y td chidm ti Id ttidp 9.5%.
- Can bd cd trinh dp sau dai hpc cDa nhdm Y hpc cd tnjydn chidm t j le ttidp, sd can bd cd trinh dp Y sy chuydn khoa Y hoc ed tmydn ehiem t j Id nhidii nhat 52.55%
- Nhan luc Y hpc cd tmydn phin bd khdng ddng deu, hdu hdt cdn bd cd trinh dd chuydn sau ddu tap trung tai tuydn tinh va tuyen huySn.
- Tai tuydn xa cdn bp lam cdng tac Y hpc cd tmyen cdn phai kidm nhidm them rdt nhidu cac chudng trinh muc tieu qudc gia khac.
Y HOC rayc HANH (843) - S6 10/2012
- Tf le kham chua bdnh bang YHCT tai tuydn y td CO sd chi dat dudi 10%
SUMMARY
Through the research results from the 3487 medical staff and 116 pnvate hoealtheare in Lang Son province, we have noticed that.
- Human resources of traditional medicine / total number of health workers low rate of 9.5%.
- Personnel qualified graduate of the traditional medicine group low proportion of Qualified staff specialist doctors of Traditional Medicine largest percentage 52,55%
- Human resources for traditional medicine distribution is not uniform, most qualified staff specialized focus at the provincial and district levels.
- At the commune level ofTieials working in traditional medicine have to concurrently add a lot of other national target programs
- Percentage of health care with traditional medicine in the health district and commune levels are low < 10%
T A I L I $ U THAM K H A O
1. Dang Thj Phiic (2002), Thi/c ir^ng s&di^ng YHCT t^i tinh Hung ydn, Lu^n van Ihac s j y hpc
2. Dfl Thi Phuong (1996), Nghiin cOu vi hi$n b^ngsi) dung YHCT vi tic dung diSu trj cia 8 chi phim thuSc nam d m(it sic0ng ding ndng thdn. Luan van phd tidn s?
khoa hpc Y Dupc, trudng dai hoe Y Ha Npi.
3. VD van Hoang (2006), t h u t trang md hinh td chifc va ngudn nhan luc tal 3 bdnh vidn Y hpc cd tmydn Hod Binh, son La. DlSn BlSn.
4. Phpm VQ khanh (2007), Thpc trang si^ dung YHCT tal cac tuydn khu vUC y td khu vuc y td edng lap b dc ^nh phfa Bdc.
5. Quydt djnh 370/2002/QD-BYT ngdy 07/02/2002 dia Bd trudng Bp y td vd vi$e ban hanh ehudn qudc gia y i^
xa giai doan 2001 -2010.
6. Quydt djnh 2166/QD-TTg ngay 30/11/2010 ciia ThCi tudng chinh phO ban hanh k§ hoach hanh ddng dia Chfnh phO vd phat tridn y, duoc cd tnJydn Viet Nam din nam 2020.
RONG KINH RONG HUYET VA CHI DINH NAO BUdNG TUT CUNG
T 6 M TAT
Nghidn ciiU 100 phu nit bi rang kinh rang huyit duoc hut nao bu6ng TC d PK 56 BVPSTU tit thing 11/2011 din thing 2/2012. Kit qui cho thiy 72% si phu nO duac dm miu nhanh sau thO thuit. Phit hi$n duac 2%, trudng hap ung thuniem mac TC, 65% do rii loan ndi tiet, 25% nidm mac qua sin linh linh, 4% thai ngitng phit triin, 2% vidm nidm mac TC.
RESUME
Etudier 100 femmes atteintes menometrorragie, qui sont ete aspirees de biopsie de Tendometre dans le sendee de consultasion 56 de I'hopital gyneco- obstetrique nationale de novembre 2011 a fevrier 2012. Les resuHats montent: 72% des femmes arretees d'hemorragie. 2% cancer de Tendometre, 65% disoder hormonal, 25% hyperplasia benign de I'endometre, 4% grossesse d' aritees, 2%
endometrite.
DAT VAN
oi
Rong kinh, rong huydt la mdt bdnh ly rdt hay gap d phu nQ. Hanh kinh tren 7 ngay gpi la rong kinh. Ra mdu khdng lidn quan den ky kinh va kdo dai trdn 7 ngay la rong huyeL Hanh kinh keo dai trdn 15 ngay thi gpi la rong kinh rong huydt.
^Rong kinh rong huydt cd nhidu nguydn nhSn, cd the nguydn nhdn thifc thd nhif u xo tCr eung, polip budng tit cung, ung thu cd lit cung, ung thu nidm mac tfrcung va nguydn nhSn rong kinh rong huydt co nang.
HCit nao budng tijf cung nham muc dfch lam sach buong tit cung cdm mau va giM td chClc nao lam gl^i phau benh 1;^ la mot phuong phap vita chdn doan dudc nguyen nhSn vifa didu trj rong kinh, rong huyet. Tuy nhien day la mdt th^ thudt can thidp vao niem mac budng tt!^ cung, nen phSi cdn nhac tCing tnJdng hpp cu the, dac bidt ddi vdi nhOng phu niir chu^ sinh d4 hay mdi cd mdt con.
DINH BfCH THUt, K l i U THj HUONG LOAN Nghidn cdu nay nhdm muc dich tim hidu hlSu qua ciia nao budng tdcung trong rong kinh, rong huydt
D 6 I Tl/pNG VA PHl/ONG P H A P NGHIDN CCfU 100 phu nCf bj rang kinh, rong huyet den kham va duoc hiit nao budng tiJrcung b PK 56 bdnh vien PSTU tir thang 11/2011 ddn thang 2/2012. Tnidc khi lam thii thuat cae phu nQ' niy ddu dupc kham F^U khoa, sieu am tijf cung vd 2 phdn phu, do dd day nidm mac bi' cung, xet nghidm HCG trong nudc t i l u am tinh hoac djnh lupng aHCG trong huydt thanh dUdi 5 UI/1. Loai khdi nghidn eCfu nhOhg phu nu* nghi ngd chiJia ngoai bi eung. u xo t d eung, polip budng tit cung, polip cd tii cung, nhung phu nd chua cd quan hd tinh due.
Hilt nao budng tCf cung la mdt ti^u thii ttiuat lam tai phdng kham. Bdnh nhdn dupc gay ti tat ch6 d cd t^
cung, diing dng hOt sd 5 de hut niem mac tiJr cung ra.
Mdt sd trudng hop nidm mac tro thi diJng thia sac manh dua vao budng tCf cung dd nao Idy manh niem mac ra ngodi lam giai p h i u benh ly. Benh nhdn dupc udng khang sinh trong 7 ngay sau nao hut Qe chdng nhiSm trung.
cac phu niJf dupc tai kham sau 1 tu&i danh gid sJ ra mau va xae dinh kdt qua giai phau benh ly ciia to chde hilt nao tir niem mac budng tijf cung dd cd hudng dieu tri tidp theo.
KCT QUA NGHICN cCru vA BAN LUAN Bang 1: Tudi bdnh nhan
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6 100 - V ^Y HOC THVC HANH (843) - S610/2012
