nghi khoa hge VSATTP lin thir 5, N h i xult ban Y hpc, tr, 101-113.
5 Dfng Oanh v i CS (2009), "Tinh trgng d nhilm VSV thyc pham luu thdng tren ^ a ban c i c tinh T i y Nguyen tir nam 2005-2007" Ky yiu Hdi nghi khoa hgc an toan v$ smh thgc pham lan thd 5. Nhi xuit ban Y hpe. tr 31^2-329.
6. Trin Huy Quang va cfng sy(2009), "Khao sit tinh hinh fi nhiem thdc an dudng phd v i yeu td lidn quan tgi thinh phd Thanh Hda (2006-2007)", Kfyiu Hdi nghi khoa hgc vg smh an todn thgc phim tin thw 5. NXB Yhpc. H i N f i . t r . 197.
7. Tran Vidt Thing. Phgm Thj Ngpc v i CS (2007),
"Dinh gii tinh hinh v f sinh an l o i n thyc phim tinh Ydn Bai nam 2005 - 2006" Kf yiu hdi nghj khoa hgc Vi smh an toan thgc phim lin thw 4-2007. tr 75-86.
8. Tran V i n Thp, Phan Trpng Khinh. Vu Thj Trung (2005). "Dinh g i i thye trgng v i de xult mfit so giai phip quan ly chu yeu dam bao v f sinh an toin Ihyc pham d Hai Phdng". Kf yiu h0i nghj khoa hgc VSATTP tin thir
3, N h i xuit ban Y hpc, tr. 36 - 42,
9, Truang Thj Thanh V i n (2010), Nghien eifu thyc trgng fi nhiem vi khuin thuc i n dudng phd v i mft sd ydu id lidn quan tgi thinh phd L i o Cai ndm 2010, Lufn vin thgc sT. Trudng Dgi hpe Y H i Nfl,
10, Bohayehuk VM, Checkley SL, Gensler GE, Barrios PR (2006). Microbiological baseline study of poultry slaughtered in provincially inspected abattoirs in Alberta, Canada, J Food Prot, 69(9), pp.2176-82.
11, Ghosh M, Wahi S, Kumar M, Ganguii A. (2007), Prevalence of enterotoxigenic Staphylococcus aureus and Shigella spp. in some raw street vended Indian foods, InlJ Environ Health Res, 17(2), pp,151-6.
12, Mosupye FM, von Holy A (1999), Microbiological quality and safety of ready-to-eat street-vended foods in Johannesburg, South Africa, J Food Prol. 62(11), pp.1278-84.
13, WHO (2003). Phuang phip lly mau v i cd mau, Phuang phip nghien ciru sue khde, W/id xuit bdn Y hgc. tr, 63-72 (tii lifu djch).
NGHIEN CQtJ VAI TRO TRAC NGHIEM THAN KINH TAM LY TRONG SUY GIAM NHAN THOC SAU NHOI MAU NAO
TOM T A T
Trac nghigm thin kinh tam if ddng vat trd quan tmng giiip chin doan suy giam chirc nang nhgn thirc sau tai bien nhdi mdu n§o (NMN). Myc tiiu. Nghiin cuv gid tq eua m0t sd trie nghigm than kinh tam If trong chan dodn rdt loan nhgn thirc sau NMN Doi twgng 40 bgnh nhan NMN dwac chin doan theo tieu chuin lam sang cung nhw hinh anh hgc cOa WHO va 40 ngudl khde mgnh.
Tat ca deu dwac khdm lam sang Ngi khoa, Thin kinh va lam Trie nghigm than kinh tam If. Kit qua: Diim tmng binh cua trie nghiim tam than tdi thieu (MMSE) cOa nhdm bgnh thap han nhom chimg (p<0.05). Diem tmng binh cua cdc trie nghigm ve tri nhd d nhdm chung cao han nhdm bgnh (p<0.05). Doi vdi cac chuc nang nhdn thirc khac (ngon ngw. chirc nang thiiy tran. danh gia tdc dp van dgng thi giac), diem tmng binh cda nhdm hgnh thap han nhdm chung (p<0,05) trir trac nghigm xdy dwng hinh dnh qua thj giac thi khdng khac nhau gtwa hai nhom (p>0,05). Kit lu$n: Da sd cdc chOc nang nhdn thirc deu suy giam rdrgtd cdc bgnh nhdn sau NMN va cdc trac nhigm than kmh tam If cd gia trj cao tmng chin doan suy giam nhgn thiic sau NMN.
Twkhda: Suy gidm nhgn thuc sau nhdi mdu nao. trie nghigm thin kinh tam If.
STUDY THE ROLE OF NEUROPSYCHOLOGICAL TESTS IN PATIENTS POST ISCHEMIC STROKE.
SUMMARY
The neuropsychological batteries play an important role to diagnose cognitive impainnent after stroke.
Objectives. To study the mie of neuropsychological tests in the diagnosis of cognitive impairment apter Ischemic stmke. Patients & Methods-40 ischemic stmke patients according to clinical and paraclinical criteres of the WHO and 40 healthy were pertormed
NGUYEN TRQNG Ht/NG, N G U Y I N DUY MANH Dgi hgc YHd Ngi
medical, neumloglcal examination and neumpsychological tests. Results: The average of MMSE score in patients less than control group (p<0.05). Average score of the memory tests higher than placebo gmup (p<0.05). Forother cognitive functions (language, fmntal lobe function, visuomotor speed), the average score of patients group was lower than contmi group (p<0 05) except for visuocotmction test was not different between two groups (p>0 05) Conclusion.
Most cognitive functions were significantly reduced in patients post ischemic stmke and psychological tests are valuable in the diagnosis of cognitive impainnent after ischemic stmke.
Td khda: Cognitive impairment post stmke, Neumpsychological tests.
DAT V A N Dt.
Bfnh sa siit tri tuf (SSTQ do mgch l i mfit dgng eua suy giim nhfn thirc do eae o nhdi miu nao (NMN) nho hogc Idn gay ra [4],[6].[7],[10]. Tai bien NMN cd khdi bgnh dft ngpt, tilp theo I i sy thoii tnen din cic hogt dfing nhfn Ihirc lidn quan tdi cic tdn thuyng than kinh trung uang lien quan den eic d NMN. Theo mft sd nghidn ciru cho thay ti If mie SSTT chiem tir 13,6% den 31,8% trong thdi gian ba thing sau lai biln NMN [4],[8].
Vifc phit hifn sdm roi logn nhgn thue sau NMN (suy giam nhfn thue nhg va SSTT do mgch miu) cd y nghia quan trpng bdi vife dieu trj dy phdng cic yeu to nguy ca cd the giiip bgnh nhan suy giam nhfn thue nhg cd the hdi phye,
Hifn nay, vdi sy tiln bf cua y hpc v i khoa hpc cdng nghf, vifc chin doin bfnh phit triln hyn rat nhilu nhy nhii'ng xdt nghifm can lam sang bd try nhung ehin doin rdi logn nhfn thirc van phai dya tren lam sing la chinh, trong do cic trac nghifm thin kinh tam i^ ddng
Y HOC THUC HANH (820) - SO 5/2012
mft vai trd quan trpng giiip d i n h g i i , phit hifn, chin doin v i theo ddi tiln triln SSTT [2].[7}. Vdi mong mudc gdp phin giup cde n h i l i m sing cd thdm mft phuang tifn ehin doin hiru hifu i p dyng trong thyc hinh, ehung tdi tien hinh dd t i l niy nhim myc tidu' Nghl§n cdu vai trd cua m^t sd trie nghiim thin kinh tdm If trong chin dodn roi logn nh$n thdc sau nhoi mdu nao.
D6I TU'O'NG VA PHU-ONG PHAP NGHIDN Cl>U.
40 bfnh nhin tu- 60 tudi trd Idn, duyc chin doin l i tai blln NMN theo tidu chuin l i m sing v i hinh i n h hpc ciia WHO, chin doin suy giim nhfn thCre nhg theo lidu chuin ciia Peterson 2001 [8] v i chin doin SSTT theo tidu ehuin DSM IV [1]. 40 ngudl thufic nhdm chirng duyc lya chpn ciing dfi ludt, cimg gidi vdi bfnh nhin v i
khdng bj tai bidn mgeh n i o v i eic y i u td nguy cy mgch m i u khic.
T i l e i bfnh nhin v i nhfim chung dwac khim Idm sing Nfi khoa. T h i n kinh v i l i m trie nghifm thin kinh t i m ly theo m l u bfnh i n nghidn cii'u thdng nhll (gdm dinh g i i nhfn thi>c tdng quit MMSE, dinh gii tri nhd, dinh g i i sy chO y. dinh g i i tinh trgng ngdn ngfr, dinh g i i chuc ning thye hifn nhifm vy, x i y dyng hinh anh qua thj giic, tde d f vfn dfng thj giic, dinh gii hogt dfng hing ngiy v i dinh g i i trim cim).
K t T QUA.
Bing 1, Dinh g i i chue ning nhfn thdc chung (Iric nghifm t i m thin tdi thilu - MMSE)
Nhflm b f n h (n=40) Trunq binh 1 Khoanq tin c i y 95%
20,7e±4,67 1 19,3-22,3
Nh6m chLcng (n=AO) Trunq binh 1 K h o i n g tin e f y 9 5 % 25,43±3,24 | 24,4-26,5
t -5,177
P 0,001 Nhfn xdi- Dilm trung binh dinh g i i chuc ning nhfn thii'c ting quit eua nhdm chirng cao han nhdm bfnh, sy khic bift cfi y nghia thing kd vdi p<0,05
Bing 2. Trie nghifm dinh g i i tri nhd Test
Nhd lir nqav NhdtCrsau N h i n bidt tCf Kd lai nqay Kd Igi sau Nhd hinh nqay
Nhd hinh sau Nh^n biet hinh
Nhdm b f n h (n=40) Trung binh
9,5t3,79 2,08±2,2 7,13±3,17 4,5±2,23 3,2a±2,53 4,33±1,89 2,93±2,09 8,3a±2,7B
Khodng tin c&v 95%
8,28-10,71 1,37-2,76 6,11-8,14 3,79-5,21 2,47-4,08 3,72-4,93 2,26-3,59 7,48-9,27
Nhdm chunq {n=40) Trung binh 13,8±5,43 4,68±2,37 8,35*2,45 6,69±2,56 5,23±2,82 6,21±2,00 4,56±1,85 9,00±1,64
KhoSng tin c$y 95%
12,1-15.56 3,92-5,43 7,57-9,13 5,86-7,52 4,32-6,15 5,56-6,85 3,97-5,16 847-9,53
t 4,131 5,087 1,935 3,959 3,121 4,297 3,701 1,218
P 0.000 0,001 0,057 0,OOQ 0,003 0,002 0,001 0,228 Nhfn xdt Diem trung binh ciia nhdm chung da sd d i u cao han nhdm bfnh (p<0,05), trir c i c trie nghifm nhfn biet hinh v i nhfn biet tif.
Bang 3. Dinh g i i trie nghifm v l chirc ning ngdn ngir Test
Gpl ldn Boston Ndi luu Iodt tir
Nhdm bdnh (n=40) Trunq binh 13,25±2,06 11,15±4,59
Khoanq hn cdy 9 5 % 12,58-13,92 9,68-12,62
Nhdm chifng (n=40) Trunq binh 14,95±0,22 13,28±3,45
Khoanq tin cdy 9 5 % 14,88-15,02 12,17-14.38
I 5,129 2,341
P 0,001 0,022 Nhfn xdt, D i l m trung binh cua c i c trie nghifm v l ngdn ngir cua nhdm chung cao ban nhdm bfnh (p<0,05) Bang 4. Trie nghifm dinh g i i ve sy ehu y
Test Doc xudi
Nhdm b Trung binh
8,35±2,33 Docnqu-yc | 3,00±1,4
nh {n=4D) Khoanq tin cdy 95%
7,61-9,09 2,55-3,45
Nhdm chd'ng (n=40) Trunq binh 10,23±2,5 4,13±2,89
Khoang tin cdy 9 5 % 9,42-11.03 3,20-5,05
t 3,468 2,215
P 0,001
0.03 Nhfn xdt: Trj gia eae trie nghifm dinh g i i v l sy chu y cua nhdm chirng d i u cao ban nhdm bfnh (p<0,05) Bing 5. Dinh g i i chuc ning thyc hifn nhifm vy (chUc ning IhUy trin).
Nhdm bdnh (n=40) Trung binh 1 KtioSng tm c$Y 95%
10,08±3,9 1 8.83-11,32
Nhdm chunq (n=40) Trunq binh 1 Khoing lin C$Y 95%
12,3±4.32 1 10.92-13,68 I 2,416
P 0,018 Nhgn xel: Trie nghifm dinh g i i chirc ning thuy trin cua nhdm chirng ddu cao han nhdm bfnh, sy khic bigt co y nghTa thdng kd vdi p<0.05.
Bang 6. Trie nghifm danh g i i ve x i y dyng hinh anh qua thj g i i c Nhdm b f n h ( n = 4 0 )
Trunq binh 1 Khoanq hn cdy 95%
3,9±4.08 1 2,6-5,2
Nhdm chunq (n=40) Trunq binh 1 Khoanq lin c | y 9 5 %
5,3±3,91 1 4.05-6,55 1 1,566
P 0,121 Nh^n xet: Khong khac nhau giua nhom b^nh va nhom Chiang ve trSc nghi$m xay dg'ng hinh dnh qua thj giSc (p>0,05).
Y HOC THVC HANH (820) - S6 5/2012
Bang 7. Trie nghifm dinh g i i tdc d f vfn dfng thj giic (ggch bd so) Nhdm benh (n=40)
Trunq bmh 1 Khoinq hn c^y 95%
15,23±a,4 1 12,54-17,91
Nhdm chi>nq (n=40) Trung binh 1 Khoanq tin cdv 95%
28,93±9,5 1 25,89-31,96 t 6,834 0,001 Nhfn xet: Trie nghifm ggch sd eua nhdm chirng cao hyn nhdm bfnh (p<0,05).
BAN LUAN.
Chifc nang nhfn thirc chju t i c dfing cua nhilu ydu td nhu: tudi, gidi, trinh dp hpc v i n , mfii trudng sdng,.,vi vfy bfnh nhan trong nhdm bfnh v i ngudi khde mgnh cua nhdm chung cd sy tuang duang ve c i c ydu td trdn.
Ket qua diem trun^ binh cua trie nghifm dinh g i i trgng thii tam than toi thieu (MMSE) eua nhdm bfnh (20,78±4,67) thip han nhdm chifng (25,43±3,24) cd y nghTa, Kit qua niy thip han kit qua Nguyin Dgi Chiln [3] vdi kit qua trung binh l i 26,3±3,2. Nhu vfy trie nghifm dinh gia t i m t h i n tdi thieu MMSE ngoii l i c dyng sing Ipc rdi logn nhfn thyc edn cd t i c dyng phin logi duyc ba nhdm bfnh nhin SSTT, suy giam nhfn thifc nhg v i binh thudng [2],[7],[9].
Theo tieu chuin eiia DSM IV, suy giam tri nhd ddng mpt vai trd rat quan trpng trong chan doin SSTT [1]
Trong nghidn cUu niy, chung tdi thiy tn sd trung binh cic trie nghifm danh gia chirc ning tri nhd cua nhdm chung deu cao hyn nhdm bfnh mfit each cd y nghTa thdng ke, ngogi trir c i c trie nghifm nhfn biet tir v i nhfn bill hinh (bang 2). Cae trac nghifm dinh g i i tri nhd duyc chia thanh hai logi' tri nhd ngan hgn v i tri nhd dii hgn, c i hai logi niy d i u b[ giam mfit each cfi y nghTa d nhdm bfnh nhin so vdi nhdm chirng. Dilu niy I h l hifn kha ning luu tru, tai hifn v i xu ly thfing tin deu bj anh hudng rd rft d nhdm benh. Nhu vfy. trac nghifm dinh g i i tri nhd cd t i c dyng sang Ipc rdi logn nhfn Uiirc, tuy nhien nd khfing cd kha nang phdn bift mft cich rfi ring giua cae nhdm Vi vfy cac trie nghigm v l tri nhd chi la cic trac nghifm cin chir chua du d l dinh gii v i phan logi tinh trgng rdi logn nhfn thifc v i can phai cd cic trac nghifm danh gia cae chuc nang nhgn thuc khic bo xung|1].[2],[9]. ^
Rot loan ngdn ngu' gap d hau h i t cac bfnh nhan cfi rdi logn nhan thirc. Cac bieu hifn rdi logn ngdn ngu khac nhau tiiy tifng giai dogn bfnh, Chiing tdi thay: trj sd trung binh cua nhdm bfnh d ca hai trie nghifm deu giam so vdi nhdm chirng mft eieh cfi y nghTa thdng ke vdi p<0.05 (bang 3.3). Vdi trie nghifm gpi tdn cua Boston, k i t qua l i 13,25±2,06 thip han so vdi kit qua cua t i c gia Nguyen Thanh Van I i 14,1±2,1 [10], ly' do vi nghien cifu nay duyc tien hinh d Bfnh vifn Lao khoa TW vdl cic bfnh nhin d mpi thanh phin va trinh dfi khic nhau, eon nghien cuu cua Nguyen Thanh Van fien hanh d bfnh vifn Hu-u nghj la nyi bfnh nhan cd trinh d f hpc van tuyng ddi cao. Ket q u i trie nghifm ndi luu loat tif trong trac nghifm nay a nhdm bfnh l i 11,15±4,59 v i nhom chifng l i 13,28±3,45 thap hon so vdi ket qua cua t i c gia Nguydn Thanh Van l i 15,4±4,6 [10], sy khac nhau niy chinh l i do each lya chpn mau nghien cuu gidng nhu each giai thich tren.
Trong nghien ciru niy, trj g i i cCia trie nghifm dpc xufii day sd l i 8,35±2,33 v i trie nghifm dpe ngupc day sd l i 3,00±1,4, kit qua niy deu thap hyn so vdi k i t qua cua nhdm chung mft cich cd J nghTa thdng ke vdi
p<0,05 K i t q u i cua trie nghifm dpc xufii diy sd trong nghien cuu niy d trdn mi>c tdi thilu m i tie gia Nguyin Dgi Chiln [3] dd cdng bd l i 6, dilu dd cho thiy l i trong giai dogn d i u ciia SSTT ehde ning chu i/ ca bin chua bj i n h hudng nhidu. luy nhidn khi so vdi nhdm chifng cimg dieu kifn thi thiy rfi dupe sy suy giim niy d bfnh nhinNMN. Vdi trie nghifm dpc nguye ddy sd, kit qua d dOng ngudng tdi thilu m i t i c gia Nguyin Dgi Chiln d i cdng bd l i 3 [3], nhu vfy bfnh ly NMN d5 anh hudng adn sy chu y chpn Igc.
Trie nghifm ve ddng hd l i mft trie nghifm thudng diing trong dinh g i i chuc ning kiln true thj giic. Day l i mft trie nghifm cd g i i tq trong dinh g i i chuc ning nhfn thue, d f nhgy v i df dfc hifu cao trong vifc phit hifn v i chin doin bfnh Alzheimer. Dilm trung binh ciia trie nghifm niy trong nghidn cuu l i 3,9 v i dfi Ifch ehuin l i 4,08 so vdi ket qua cua nhdm chirng l i 5,3±3,91, thip han nhdm chung tuy nhien sy khac bift khdng ed y nghTa thdng kd vdi P>0,05. L^ giai eho dilu niy ed the l i vl kha ning thj giic khdng gian khi phifc tgp v i lien quan den nhieu hf thdng trong nao dfc bift l i bin c i u ndo phai. Xet v l mft giac quan, kha nang thj giac ddng vai trd quan trpng trong thye hifn trie nghifm nay, m i ngudi cao tuoi cd nhung hgn ehl ve mft thj giac dan den try nggi trong vifc thyc hifn trie nghifm.
Hon nCfa do hoin canh sdng v i tgp quan sinh hogt m i nhilu ngudi g i i cung khdng cd thdi quen xem gid. Nhgn xdt ciia chung tfii cung tuang t y nhu nhfn xdt ciia eac t i c gia khac [2].[4],[6].
Gia trj cua trac nghifm danh g i i chdc nang thye hifn nhifm vy trong nghidn cifu d nhdm bfnh giam so vdi nhdm chifng mfit each cd y nghTa vdi p<0,05 (bang 3,5). Diem trung binh cua trie nghifm l i 10,08 ±3,9.
tuyng tu kit qua cua tac g i i Nguyen Dgi Chien [3] dua ra nguo'ng diem tdi thilu la 12, nhu vfy tai bien NMN da anh hudng ding ke den chirc ning thyc hifn nhifm vy.
C i c lac gia ngoii nudc cung dua ra cie kel qua tuang ty[9].
K t T LUAN.
Trir trie nghifm dinh gii xiy dyng hinh anh qua thj giic, da sd cic chifc nang nhfn thuc deu suy giam ro rft y eae bfnh nhin sau tai biln NMN nhu chirc nang nhgn thifc chung MMSE, danh gia tri nhd. dinh gii sy chu y, chifc nang ngfin ngu, ehUc ning thyc hign nhifm vy. toe dfi vgn dfing thj giic. va danh gia hogt dfng hing ngiy.
T A I L I $ U THAM K H A O .
1. American Psychiatric Association (2000).
Diagnostic and Statistical manual of Mental Disorders.
DSM-IV-TR, 4'" ed Washington.
2. Censori B, Manara 0, Agnostinis C El al (1996).
Demenha after strocke Stroke 27, pp. 1205-1210.
3. Nguyen Dgi Chidn (2006), Oinh gii chuc nang nhfn thirc a ngudi Vift Nam tu 60 tudi trd len bang mft so trie nghifm than kinh tam ly. Lufn van Thgc sy y hpc, trudng Dgi hpe Y H i Nfi,
Y HOC THirC HANH (820) - SO 5/2012
4 Desmond DW, Joan T, Moroney, Mary Sano el al (2002) incidence of Dementia After Ischemic Stroke:
Results of a Longitudinal Study Editorial Comment.
Stmke. 33, 2254-2262.
5, Nguyen Ngpc Hda (2006) Nghidn ciru ty if hifn mic v i m f l sd ydu id lidn quan d i n sa siit tri tuf d ngudi cao tudi tgi huyfn Ba Vi, H i T i y 2005-2006, LuSn vdn Thgc sf Y hgc, trudng Dgi hpc Y H i Nfii.
6. Lin J H. Lin R,T, Tai C-T et al (2003). Prediction of poststrocke dementia, Neumlogy. 61, 343-348,
7 Patel, Coshall C, Rudd AG, et al (2002) Cognihve impairment after stroke: clinical determinants
and its associations with long-term stroke outcomes, J Am GeriatrSoc, 50: 700-706.
8, Petersen RC, Smith GE, et al (2001). MCI.
Clinical and characterization and outcome. Arch Neurolgy. 56(3): 303-308,
9, Pohjasvaara T, Erkinjuntti T, Ylikoski R, et al (1998), Clinical determinants of poststroke dementia.
Stroke. 1998;29:75-81.
10, Nguyin Thanh V i n (2008), Nghidn cuu dfc dilm l i m sing roi logn nhfn thifc sau nhoi m i u nao d bfnh nhin trdn 60 tu6i, Ludn v&n Tiin si Y hgc. trudng Dgi hpc Y H i Nfi,
BOAC D A U D A N H GIA THOC T R A N G M A N G LUlQfl CONG TAG MOI T R U A N G Y TE
TAI MOT SO TUYEN
DAT V A N D ^ .
Cdng t i c bao v f mdi trudng d i duye khing djnh l i sy nghifp cua l o i n x3 hfii, l i quyin v i trich nhifm ciia c i c ca quan nhi nude, eic td chuc. h f gia dinh, c i nhin. Vdi chifc ning, nhifm vy, quydn hgn v i ca elu td ehirc cua Bf Y td, Cye Quan ly mdi trudng y te thufc Bfi Y t l dd Ihyc hifn chirc ning quan ly mfii trudng trong nginh y te va to chuc thanh lfp mfit mgng ludi thyc hifn cfing l i c mdi trudng y t l tren phgm vi toin qudc, D l d i p ung duyc nhirng van dd dgt ra, chiing tdi tien hanh nghien cuu^
"Budc dau ddnh gia thgc trgng mgng ludi cdng tdc moi trudng y ti tgi m0t sd tuyen"
Muc tieu nghien ciru:
- Md la thyc trgng mgng ludi cfing tac mfii trudng y t l tif Trung uang tdi d|a phuang.
- Tim hiiu, danh gia nhu cau l i n g cudng mgng ludi cdng l i e mdi trydng y te tgi mfit sd tuyen
- Dua ra giai phip de nang cao hifu qua ciia mgng ludi cdng l i c mdi trydng y te
PHU-aNG PHAP NGHIEN CLTU.
1. Phuang phap khao sat thyc dja
Dieu tra lay sd lifu thyc te mgng ludi quan ly mfii trudng y t l tir Trung uang tdi mfit so dja phuong trong phgm tgi: Trung t i m Y t l dy phdng tinh Thil Nguydn,
BUI KHANH TOAN Cgc Quin If mdi trwdng yte-BgYte Trung t i m Y t l dy phdng tinh H i Tinh, Sd Y t l tinh Hda binh Tiln hinh phdng v i n ln,rc tiep cin bf Linh dgo cua Sd Y t l v i Trung t i m Y le dy phdng.
2. Phuyng p h i p chpn m l u nghien ciru Trong khufin k h i eua d l t i i , chung tfii Ihyc hifn dieu tra cac ddi tuyng nghidn cuu theo vung mien, dfc thti eiia tirng dja phuang. lya ehpn cac doi tuyng nghidn cuu va c i c bien nglu nhidn nhung v i n dam bao so doi tuyng duyc nghidn ciru dgi difn eho tdng the toan bf mgng ludi.
3. Phuang p h i p thu thgp thdng tin qua philu didu tra
X i y dyng 06 philu dilu tra cho 06 ddi tuyng nghien cifu la Vifn chuydn nginh, Sd Y id. Trung tam Y te di/
phdng, Trung tam Sire khde lao dfng va mfii tardng cac tinh/TP, Trung lam Y t l huyf n/thj.
4. Phuang p h i p phan tich va xir ly sd lifu -Thu t h f p sd l i f u :
+ Su dyng sd lifu theo 06 m l u phieu dilu tra dupc gifl xudng c i c dan vj.
+ Thu thfp sd lifu thdng kd theo myc nfi dung Igi phieu dieu tra.
-Xd ly so ligu:
So lifu duyc l i m sgeh tnrdc khi nhfp v i o miy tinh va duyc xif ly bing phin mem Microsoft Excel.
KtT QUA VA B A N L U A N 1. Kdt qua cdng t i c quan ly n h i nudc.
Bang 1; Ket qua kiem tra. giim sit chuyen mdn tgi cac Vifn Vi$n chuydn ngdnh Quan ly MTCSYT
[Xu ly chll thai, an todn biic xg)
SKMTCD (Nirdc sgch, vf sinh mdi trudng, blln doi khi hfu)
Cdng tac chuydn rndn
SKMTLD QLHC, CP DCTDK dCing trong gia dgng
vdy Id
Danh giS tac ddng mdi Injorig
yte Vidn Y hpc lao ddng vd
VSMT Vign Pasteur Nha
Trang Vign VSYTCC
TP HCM
Y HOC THtJC HANH (820) - SO 5/2012
