vifin vd) k i t qua tdt. Theo nghifin cdu cOa Liang vd cflng s y trfin 261 bfinh nhdn ghfip gan todn bfl dOng vj tri d i o tiidy, ti Ifi chay mdu phai mfl Igi Id 8,4% vdi ti 1$ t d vong Id 4 1 % , nguyfin nhdn chO y l u lien quan A n kT thufit md, c h i l m 81,8% [0]. Cdc tafdng hap ghfip sau ndy, sau khi thyc hifin xong cac mifing ndi sfi cd mdt phdu thudt vifin nhieu kinh nghifim vdo kilm tra cdm mdu trydc khi ddng byng. K i t qua Id 18 ca d i n nay khdng cdn gfip tai b i l n chay mdu nda.
Biln chdng trdn djch mdng phdi Id mdt bien chdng phd biln trfin cdc benh nhdn sau ghep gan. Benh nhdn thydng co trdn djch mdng p h ^ ca 2 bfin, bfin phdi nhilu han bfin trdi. Sau md cd 1 tnfdng hyp bien chdng tdc TM gan gida, suy da tgng. Bilu hifin cua b$nh nhdn ndy Id lyang nydc tieu giam, thilu nifiu, men gan tdng cao, suy than, djch cd chydng tang nhanh, chdc ndng dflng mau giam. Bfinh nhdn du da dypc thd mdy, Ipc mdu lifin tuc nhung tinh trgng khflng cai thifin, bfinh nhdn t d vpng. Thai ghep cdp Id mdt biln chdng cdn dyp'c c^dn dodn vd d i l u trj sdm, trdnh gdy anh hydng d i n d i d c nang gan ghfip. Ngdy nay cCing vdi sy phdt t r i l n cOa thudc dc che miln djch, ti Ifi thdi ghfip da gidm di tuy nhifin ti Ifi thdi ghfip cap vdn cdn t d 15-25% [0]. Cl trong nghifin cdu ndy chOng tdi gdp 5 trudng hyp bfinh nhdn thdi ghfip cap, bleu hi§n gdm cd tdng bilirubin, tang nhg AST, ALT. Cd 2 bgnh nhdn duac chdn dodn xdc ^ n h bdng sinh thilt gan. Dilu tn thai ghfip cdp bdng cdch tang lieu dc c h l miln djch vd sd dung lilu caocorticosteroid.
Trong 19 bfinh nhdn, cd 18 bdnh nhdn ra vifin vdi chdc ndng gan binh thudng, cd 1 bfinh nhdn t d vong, tl Ifi 5,2%.
K £ T LUAN
Ghfip gan tai Bdnh vifin Hdu nghi Vifit Ddc theo cd 2 mfl hinh: Ghfip todn bfl t d ngydi cho c h i t ndo (16 tardng hyp) vd ghfip gan bdn phdn t d ngydi cho khoe mgnh (3 trydng hyp). Thdnh cflng cua ghfip gan phy thuflc vdo nhilu y l u td: trydc ghfip, trong ghfip, sau ghfip, phy thuflc vdo vific lya chpn ca ngydi cho vd ngydi nhfin gan cung nhy s y phdi hpp ddng bfl gida cdc kip chuyfin mfln
K i t qua sdm tai thdi d i l m ra vren cd 21,1% bfinh nhdn b i l n chdng dd 1, 15,8% bien chdng dfl 2, 57,9% b i l n chdng dfl 3, 5,2% b i l n chdng dfl 5. D i n khi ra vifin cfl 18 bfinh nhfin cfl k i t qua chdc ndng gan tdt.
T A I LIEU THAM K H A O
1. Nguyen T i l n Quyfit (2013). "Ghep gan ngydi ldn".
Sdch chuyfin khdo.
2. Nguyen Tien Quylt, Nguyin Quang NghTa, Trjnh Hdng Scrn, Do Mgnh Hiing (2012). "Ghep gan cho ngydi ldn tgi Bfinh vifin Vifit Ddc." Tap chi Y dygi: hpc Qudn sy 37:190-197.
3. Adam, R., V. Karam, et al. (2012). "Evolution of indications and results of liver transplantation in Europe.
A report from the European Liver Transplant Registry (ELTR)." J Hepatol 57(3). 675-688.
4. Clavien, P. A., M. Lesurtel, et al. (2012).
"Recommendations for liver transplantation for hepatocellular cardnoma: an intemational consensus conference report." Lancet Oncol 13(1): e l 1-22.
5. Dindo, D., N. Demartines, et al. (2004).
"Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey." Ann Surg 240(2): 205-213.
6. Gruttadauria, S., F. Vasta, et al. (2005).
"Basiliximab in a triple-drug regimen with tacrolimus and steroids in liver transplantation " Transplant Proc 37(6)' 2611-2613.
7. Liang, T. B., X. L. Bai, et al. (2007). "Eariy postoperative hemorrhage requiring urgent surgical reinten/ention after orthotopic liver transplantation."
Transplant Proc 39(5): 1549-1553.
8. O'Leary, J. G., R. Lepe, et al. (2008). "Indications for liver transplantation." Gastroenterology 134(6)' 1764- 1776.
9. Salizzoni, M., E. Ceaitti, et al. (2005). 'The first one thousand iiver transplants in Turin: a single-center experience in Italy." Transpl Int 18(12). 1328-1335.
10. Van der Meulen, J. H., J. D. Lewsey, et al.
(2007). "Adult orihotopic liver transplantation in the United Kingdom and Ireland between 1994 and 2005."
Transplantation 84(5): 572-579
THUC TRANG CONG TAC GIAO DUC PHONG, CHONG HIV/AIDS TAI MOT S6 CO SU GIAO OgC CONG LAP KHU VUC TAY BAC, NAM 2013
N G U Y £ N V A N HlJNG, B d HUTU THCIY, N G U Y E N HOANG LONG, D d THU THCJY Cue Phong, chdng HIV/AIDS, B<i Y tt
HA THj DUNG, Lt V A N T U A N Vi^ Cong tac Hgc sinh sinh viSn, S<i Gi^ d^ic vd Ddo tao Tfim T A T
Nghiin oCni mfl ti cSt ngang, kM hop nghiin ciiu dinh tlnh vi dlnh luvng duvc tiSn hinh nSm 2013 qua viic phdng vin cic cin bO quin ly giio diJc vi 421 tioc sinh cu6i cip Tmng hoc ca sd (THCS) vi Tning t<Oc phi thing (THPT) cua 03 ttnh khu vuc Tiy Bic nhim mi ti thi/c trang cing tic giio due phdng.
chdng HiV/AIDS tai mil s6 co s& giio due cing tip khu vi^ Tiy Bic. KM qui nghiin ciru cho thiy, s6 tiit hoc c6 nil dung vi HIV/AIDS ho$c liin quan 6 cip THCS ii a tiit vi THPT li 6 tiit. Nil dung duvc ldi cap tmng chuvng trinh don giin, chu yiu dimg (5"
muc cung dp thing tin. Hiu hit giio viin giing day vi HiV/AIDS nhimg chira timg duryc tham gia tip
Y HOC THirr HANH (916) - s 6 5/2014
huin vi phdng, ching HIV/AIDS. Hoc sinh cd kiin th&c dQng vi phdng, ching HlV/AlDS li 34,2%. thii dd ddng vi HIV/AIDS IS 30,3%. Ngudn thdng tin vi HIV/AIDS cic em nh$n du^ tir thay co vi b^n bd IS cao nhit (94,3%), tie tl vl li 91,4%; TO- intemet li 81,8%. Nghien cdu cQng dua ra cic khuyin nghi nhu dp nhdt cSc kiin th&c vi HIV/AIDS tmng sich glSo khoa sua doi, tang cu&ng t$p huin cho giio vidn giSng day vi HIV/AIDS, ting cu&ng cic hlnh th&c tmyin thdng ve HIV/AIDS cho hoc sinh.
T(F khoa: Giio duc phdng, chong HIV/AIDS, kiin th&c vi HIV/AIDS d hgc sinh.
SUMMARY
A cmss-sectional study in combining with qualitative and quantitative study has been conducted in 2013 by interviewing education management staff and 421 students at the last grade of Secondary schools and High schools in 3 pmvlnces In the North West In order to describe the curmnt status of training on HIV/AIDS in some public educational facilities in the North West area. The result shows that tmining units on HIV/AIDS in Secondary schools and High schools am 8 units and 6 units mspectively. The content is simply mentioned and mostly focuses on providing information. Most teachem teaching HIV/AIDS have not yet attended on tmining courses on HIV/AIDS. Students having correct knowledge and attitude about HIV/AIDS is 34.2% and 30.3%, respectively. Students is mostly received information on HIV/AIDS from teachem and friends (94.3%), TV (91.4%) and intemet (81.8%) The study also gives some recommendations such as: updating information on HIV/AIDS In the textbooks, enhancing tmining for teachers teaching on HlV/AlDS, pmmotlng communication on HIV/AIDS for students.
Keywords; Education on HIV/AIDS pmvention and contml, students' knowledge on HIV/AIDS.
DAT V A N Dt
Chiln lyyc Qudc gia v l phflng, chdng HIV/AIDS cQng nhy cdc chyang trinh hdnh dflng v l phdng, chdng HIV/AIDS cua ngdnh gido due ddu coi hpc sinh, sinh vifin Id ddi tuang quan trpng trong cac chyang trinh can thifip d y phdng lay nhifim HIV.
Nhieu hydng ddn cu the cua Bfl Gido duc vd Ddo tgo dd duac ban hdnti cung vdi khung chuang trinh chinh khda, cdc hoat dpng ngogi khda v l phdng, chdng HIV/AIDS dd d u y c hudng ddn vd t r i l n khai trpng fhdi gian qua dd giOp cho cdc hoat dflng phdng, chfing HIV/AIDS trong nhd trydng duac t r i l n khai thufin lyl han, k i l n thdc cua gido vifin vd hpc sinh ve phdng, chdng HIV/AIDS cung d y o c cai thifin theo hydng tich cyc han. Nhdm gdp phan cung cdp thflng tin cho vide xdy dyng chuang trinh, nfli dung gido dye ve phdng, chdng HIV/AIDS cho hpc sinh THCS vd THPT, Chung tfli t i l n hdnh nghifin cdu: Thyc trgng edng tde giao duc v l phdng, chdng HIV/AIDS tgi mflt sd ea s d gido due cflng lfip khu vyc Tdy Bde, ndm 2013 vdi muc tifiu sau:
1. Md ta vific t r i l n khai gido duc v l phflng, chdng HIV/AIDS tai ba tinh khu vyc Tdy Bdc.
2. Mfl ta kien thdc, thdi dfl, t h y c hdnh cOa gido vifin vd hpc sinh vd phdng, chdng HIV/AIDS tgi ba linh khu v y c Tdy Bac ndm 2013.
PHUprNG P H A P N G H l i N CCrU 1 . Dfli tV9>ng nghifin c d u
- Hpc sinh Idp 9 vd hpc sinh Idp 12 tgi cdc trudng lya chpn phdng vdn.
- Dgi difin Ban gidm hifiu, gido vifin gidng dgy cdc bp mfln cfl nfli dung Hfin quan d i n HIV/AIDS, cdn bfi y t l , cdn bfl phu trdch cflng tdc dodn, dfli tgi cdc trydng lya chpn.
- Cdn bfl Phu trdch cflng tde hpe sinh sinh vifin thuflc S d Gido due vd Ddo tgo,
2. Dja didm vd t h d i gian nghifin c d u - Dja didm: Nghifin edu tien hdnh tai 3 tinh Tfiy Bdc Id Difin Bien, San La vd Lai Chdu.
- TTidi gian nghien cdu: T d thdng 5-12/2013.
3. P h u v n g phdp nghifin c d u
3.1. Thiet ke nghiSn cihi: Md ta cat ngang, kit hyp nghifin cdu iSnh luang vd dinh tinh.
3.2. C&mau nghiSn cieu 3.2.1. Nghidn c&u dinh lugng
C d m i u nghifin cdu tdi thidu tinh theo cflng thdc:
_ .j2 P(1-P) Trong do: n Id c d mdu tdi thilu, Z: Hfi sd tin cfiy, vdi a = 0,05 thi 2 (i_ac) = 1,96; p: Id hidu bilt ddy dd cua hpc sinh ve HIV/AIDS, chpn p = 0,5 d l dgt cd mdu cap nhdt, q = 1 - p, d: Id sal sd chap nhdn dypc, d = 0,05. Sau khi tinh todn c d mdu thu duyc Id 384 hpc sinh.
D y kidn 10% ddi f y y n g t d chdi tham gia vl cdc ly do khde nhau. Do vfiy c d mdu dieu tra dy kiln khodng 420 hpc sinh.
3.2.2. NghiSn cuv djnh tlnh
- Phdng vdn sdu cdn bd qudn ly vd cdn bfl chu chdt (39 ngydi), trcng dfl:
+ Cdn bfl Phy trdch cflng tdc hpe sinh sinh vifin thuflc S d Gido duc vd Ddo tgo 3 tlnh: 1 ngydi/tlnh = 3 ngydi.
+ Dgi difin Ban gidm hifiu cOa cde trydng: 01 ngydi/trudng x 12 trydng = 12 ngydi.
+ Cdn bd phy trdch y t l tardng hpc: 01 ngydi/trydng x 12 trydng = 12 ngydi.
+ Cdn bd phy trdch cflng tde dodn, dfli: 01 ngydi/trydng x 12 trydng = 12 ngudi.
- Thao ludn nhdm vdi gido vifin gidng dgy cdc mfln cfl lifin quan den HIV/AIDS (96 ngydi): Gido vien THPT: Mdi trydng chpn n g i u nhifin mflt nhdm 8 gido vifin de thao lufin nhdm (6 trydng x 8 gido vifin = 48 ngydi), Gido vifin THCS: Mfii tm-dng chpn nglu nhifin mflt nhdm 8 gido vifin d l thao lufin nhdm (6 trydng x 8 gido vifin = 48 ngudi).
3.3. Phuvng phip chgn mau
- Tgi mdi tinh nghifin cdu, chgn dja bdn nghifin edu theo ehu dieh: Chpn thj xd h o l e thdnh phd vd 01 huyfin cd d i l u kifin kinh t l trung blnh.
- Tgi mdi dja bdn thj xfi/thdnh phd/huy$n dyyc chpn, lya chpn cd diO dich 1 tardng THCS vd 1 trydng THPT d l t i l n hdnh nghifin cdu. Cy t h l :
Y HOC THVC HANH (916) - s 6 5/2014
TT 1 2 3
B j a bdn nqhifin c d u TTnh
Lal C h d u e i f i n Bifin S a n La
T P / T h i xS/Huvfin T h j xd tai C h d u Huyfin T a m O u d n a
T P Difin Bifin PhO Huyfin e i f i n Bifin T P S o n La Huyfin T h u d n C h d u
Chpn t r u d n q nqhtfin c d u T H C S
T a f d n g THCS Dodn Kfit T n f & n g THCS Binh L y T n j d n g THCS M u d n g Thanh
T r y d n q T H C S Thanh Ludno T a f d n q T H C S S o n La T n / d n g THCS Chifing Ly
T H P T T n f d n q T H P T t h | xd Lai Chdu
Tniimg T H P T T a m D y d n g T n f d n q T H P T T P Oipn Bl6n P h u
T n f d n q T H P T Tfianh Chfin TnTdrng T H P T T 6 Hifiu T a r d n q T H P T T h u ^ n Chdu - Tai cdc trydng d y a c lya chon, trong sd cdc Idp
cull cdp, chpn n g i u nhifin 01 Idp di t i l n hdnh phdng vdn todn bfl sd hpc sinh cua Idp dd.
3^. Ky thuat thu thip thdng tin - Phdng vdn bdng bfl' cdu hdi t h i l t k l san - Phong vdn sdu vd thao lufin nhflm.
3.5. PhSn tich vi XLF ly so USu
- s d lifiu djnh tinh: G d bdng vd x d \'y theo phyang phdp nghifin cdu c^nh tinh.
- Sd lifiu djnh l y y n g d u y c nhdp, phdn tich vd x d Vi bdng phdn mem SPSS.
KtT QUA
1. T r i l n khai gido dgc vfi phflng, chdng HIV/AIDS tgi ba tinh khu v y c Tdy Bdc
Trong nhdng ndm qua, cdn c d hydng dan cua Bd Gidp dye vd Ddo tgo, S d Gido dye vd Ddo tgo cdc tinh Lai Chdu, Difiu Bifin vd San La dd ban hdnh k l hogch phdng, ehdng HIV/AIDS eua ngdnh d l ehf dao cdc Trydng, cdc Phflng Gido due vd Ddo tgo thyc hi$n gido dye phdng, chflng HIV/AIDS tgi cdc tafdng
100% cdc tardng nghifin cdu ddu triln khai gido dgc phdng, ehdng HIV/AIDS theo chuang trinh cua Gido due vd Ddo tgo, S d Gido dye vd Ddo tgo quy
^nh Hlnh thdc t r i l n khai nhu: Gidng day cho hpc sinh theo chuang trinh quy dmh chinh khfla, td chdc cdc hogt dflng ngogi khda nhy tuyfin truyin v l phdng, chdng HIV/AIDS cho hpc sinh.
v l chyang trinh gido dye vd HIV/AIDS chlnh khda'
- Ddi vdi cdp THCS, tdng sd giang day v l HIV/AIDS Id 8 t i l t Nfli dung giang dgy Bach cdu - Miln djch, Dich HIV/AIDS, Cdc bfinh Idy f a i y l n qua dydng tinh duc (05 t i l t - Mfln Sinh hpe Idp 8), Phdng, chdng Idy nhilm HIV/AIDS (02 t i l t - Mdn Gido dye cflng ddn); Ddn c y xd hfli Chdu Phi - cd d l cSp din tlnh hlnh nhiim HIV/AIDS d Chdu Phi (01 t i l t - M f l n Dja ly Idp 7)
- edi vdi cap THPT, tdng sd t i l t gidng day ve HtV/AIDS Id 6 t i l t Ndi dung giang day: Cdc bien phdp k l hogch hfla gia dlnh - cfl d l cap d i n bifin phdp trdnh thai cho phu n d nhiem HIV (02 t i l t - Mfln Sinh hpc Idp 11). Thflng difip Ngdy The gidi phdng, chdng AIDS (02 t i l t - Mdn Ngd vdn Idp 12), Cdng ddn vdi cdc vdn d l cua nhdn Ipgi - cd d l cfip d i n djch bfinh, trong dd cd HtV/AIDS (02 t i l t - Mdn Gidc duccdngddnldp12).
Da sd cdc 9 k i l n cdn bd nhd tardng ehe bidt Id dd c6 sy kilm tra gidm sdt ciia cdp trfin (Sd vd Phdng Gido dye vd Ddo tgo). Tuy nhifin, vific k i l m tra gidm sdt chll y l u dypc thye hifin thdng qua bdo cdo vd mang tlnh hlnh thdc
Cflng tdc phdng, chdng HIV/AIDS trong cdc nhd trydng dd nhfin dyac s y phdi hyp cOa cdc ban, ngdnh, dodn till, ddc bifit Id cua ngdnh y t l vd cdc c a quan phdng, ehdng HIV/AIDS i^a phyong. Tuy nhifin, vific phdi hyp ndy chi ddng Igi trong vific triln khai hogt dflng ^ e o cdc dot c h i l n djch, chya phdi hap
\Tong khdu lap k l hoadi hpat ddng.
Hdu h i t cdc trydng d i u cho rdng thilu kinh phi eho hogt dflng taiyln thflng v l HIV/AIDS eho hpc sinh Bfin cgnh dfl, edn bfl gido vifin gidng day tryc tiep chya dyac tham gia cdc khda ddo tgo k i l n thdc v l HIV/AIDS.
2. K i l n t h d c , thai d$, t h y c hdnh cua hpc sinh vfi phflng, chflng HlV/AIDS
2.1. Thdng tin chung vi doi twqng nghiSn cdu
Bl^u dd 1. Gldi tlnh h^c sinh theo c i p hgc K i t qud cho thdy, hpc sinh THPT (nam: 40,1%, nd.
59.9%), hpc sinh THCS (nam: 47,5%, nd: 52,5%).
Bdng 2. Ddn tflc cOa hpe sirih theo tlnh G l d l tinh
Kmh Thai H'lUlfing
Dao TSy i O l o M u
i<h4c l.ai Chdu
(n=140) SL 79 26 4 2 0 0 30
%
56,4 17,9 2,9 1,4 0 0 21.4
S o n i.a (n=141) SL 67 54 14 1 1 0 4
%
47,5 38,3 9,9 0,7 0.7 0 2.8
B i $ n BiSn (n=140) SL 97 38 0 0 0 1 4
%
69.3 27.1 0 0 0 0.7 2.9
Chung (n=421) SL 243 117 18 3 1 1 38
%
57.7 27.8 4.3 0.7 0.2 0.2 9.0 K i t qua nghifin cdu cho thdy. Ddn tflc Knh vdn chiem da sd (57,7%), ddn tflc Thdi cfl (27,8%), cdc dan tflc khdc cd t^ Ifi tuang ddl thdp.
2.2. Kiin thipc, thii dfy, thy-c hinh vi phdng, chong HIV/AIDS cua hgc sinh
40 0 H
llil
BI6u dd 2. Ki«n thdc dLing v6 HIV/AIDS cua h(fc sinh
Y HOC THVC H A N H (916) - S 6 5/2014
Kdt qua nghien cdu cho thdy, hpe sinh THCS tinh San La cfl k i l n thdc dCing ve HIV/AIDS (tra Idi dung 05 cdu hci) [5] cao nhdt (52,4%), thdp nhat la tinh Dien Bifin (19,7%); hpc sinh THPT tinh Lai Chdu cd k i l n thdc dung v l HIV/AIDS cao nhdt (40,0%), thap nhdt Id tinh Dien Bifin (30,4%). Tinh chung thi k i l n thdc dung ve HIV/AIDS d hpc sinh THPT vd hpc sinh THCS cua ba tinh khdng cao (hoc smh THCS: 33,3%, hpe sinh THPT: 35,0%).
40
l |
L i i Chau Son La Di^n Eien Chung
Bilu dd 3. Thai dp diing v l HIV/AIDS cua hpc sinh Trong nghien cdu ndy, chting toi cung dd tim hidu thai dd eua cac em vdi HIV/AIDS (thflng qua viec tra Idi 4 cdu hoi) [5]. Ket qua cho thdy, cht cd 30,3 % hpc sinh cfl thdi dfl dOng vdi HIV/AIDS. Ty le ndy d 3 tinh Id khdc
nhau, tuy nhien s y khdc nhau khdng cd y nghTa thong kfi (p>0,05}. .>
Bang 3 Ngudn thflng tin ve phdng, chdng HtV/AIDS Nguon thong tin
Tl vi lulanq internet Dai phat thanh. Loa truydn thanh
Sach bao, tap chi To qap, sach monq
Can b6 y t^
Trodng hoc. thay c6 giao
Lai Chau Cn=139) SL 128 108 85 106 75 100 134
%
92.1 77.7 61.2 76.3 64.0 71.9 96.4
Son La (n=139) SL 125 116 93 98 90 87 124
%
89,9 83.5 66.9 71.0 64.7 63.0 89.2
DiSn Bign (n=139) SL 129 118 98 116 55 119 136
%
92.1 84.3 70.0 82.9 39.3 86.0 97.1
Chung(n=417) SL 382 342 276 320 220 306 394
%
91.4 81.8 66.0 76.7 52.6 73.4 94.3
P
>0,05
>0.05
>0.05
>0.06
<0.05
<0.05
<0,05 Bang 3 cho thdy, thdng tin ve phflng, chdng
HIV/AIDS md hpc sinh nhdn d u y c t d rdt nhieu nguon khdc nhau vd rat phong phd Ngudn thdng tin cung cdp fy trydng hoc, thay cd gido Id cao nhdt (94,3%), fly' Ifi ndy khdc nhau gida cdc tinh, sy khdc biet nay cd
•) nghTa thdng ke vdi p<0,05. Ngudn thdng fin t d Ti vi vd mang infernef cijng ehllm mflt fy le cao (91,4% vd 81,8%). Nguon thflng tin f d T d gdp, sdch mdng chilm ty Id thap nhdt (52,6%).
B A N LUAN
1. Vi^c t r i l n khai gido duc phflng, chflng HIV/AIDS tai ba tinh Tdy Bdc
Nghien cdu cho thdy nganh gido dye cdc cdp da quan fam chi dao thyc hien gido due phflng, ciidng HIV/AIDS trong cdc nhd trydng. Hdng nam, Bd Giao due vd Dao tao da td chdc cac hdi nghj, hdi thao, khda tfip huan cho can bfl quan ly, cdn bd chuyen trach quan ly hoc sinh sinh vifin ve phdng, chdng HIV/AIDS hoac long ghfip trong cdtig tdc y t l hpc dudng vd ban hanh cdc hudng dan eu the. Tuy nhifin, fai ba tinh Lai Chau, San La vd Dien Bien viee trien khai vific giao due phdng, chdng HIV/AIDS v i n mang finh chung chung hodc cdn mang finh hinh thdc.
Hdu hef giao vien true tiep giang dgy cdc mdn hpc lifin quan d i n HIV/AIDS deu chya duac tham gia cac khda tdp hudn ve phdng, chong HIV/AIDS. Do dd, gido vien chua du fy tin khi td chdc cdc hoat ddng ngoai khda hoac thao lugn sdu cdc van de lifin quan den phdng, chdng HIV/AIDS cho hpe sinh. Ben canh dd, nhdng rao can ve vdn hoa, phong tyc la nhdng nguyen nhan khiln nhilu giao vifin khfing hdng thti de giang day ve HIV/AIDS va sdc khde tlnh due che hoc smh.
Nghien cdu cOng chp thay, dd ed s y phdi hyp lifin ngdnh trong edng tde gido dye v l phdng, chdng HIV/AIDS trong cdc nha trudng tgi 3 tinh Tdy Bdc Tuy nhien, vific phdi hap chi mang tinh vu viec, chya phdi hyp frong cflng tac lap ke hoach nen hifiu qud chua cao. Hogt dflng giam sat cdng tde gido due v l phflng, chdng HIV/AIDS trong cdc nhd trydng ciJa Sd Gido duc vd Ddo tap chya thye s y sfiu sdt, ehi tdng hyp tren ca s d bdo cdo eua ede trydng.
2. Kifin t h d c , thdi d f l , t h y c hdnh cua hoc sinh vfi phflng, ehdng HIV/AIDS
Trong nghifin cdu nay, 100% hpe sinh dypc phdng vdn d ca ba tinh dd tdng nghe ndi v l HIV/AIDS. D i l u ndy la phu hyp vdi mfli trudng gido dye hifin nay ngay ca khi cde trydng khdng triln khai chyang trinh gido dye ngoai khda v l phdng, chdng HIV/AIDS thi vdn d l HIV/AIDS dd d u y c idng ghfip vdo frong giao dye chinh khda d tdt cd ede cdp.
K i l n thde dtling ve HIV/AIDS (trd Idi diing 05 cdu hdi) [5] ctia hpe sinh ctia ca 2 cdp hpc ehl dgt 34,2%, thdp han vdi k i t qua nghien edu chung v l vj thdnh men va thanh men Vifit Nam ndm 2009 vdi tJ Ifi hilu bilt dung la 40,8% [7] vd thdp han nghien cdu cua Trudng Dai hpc Y t l cdng cdng trfin hpe sinh THPT Id 55,8% [6]. Ddy cOng Id vdn d l cdn luu y d l xdy dyng cac chyang trinh fruyin thdng phu hyp nhdm ndng cac k i l n thdc cho hpc smh v l HIV/AIDS vdi tinh hinh djch nhifim HIV cao d khu vye Tdy Bdc.
Ve thai do dting vdi ngydi nhifim HIV/AIDS {tri Idi diing 4 cfiu hoi) [5] cOa hoc sinh ba tinh khu vyc Tdy Bdc Id 30,3%, cao han so vdi nghifin cdu cOa Trudng Dgi hpc Y t l cflng cflng tgi Hdi Dyang trfin ddi t y y n g hoc sinh THPT Id 22,2% [6]
Thflng tin vd phflng, chdng HIV/AIDS md hpc anh
Y HOC THUC HANH (916)-S6 5/2014
n h ^ A i y c t d rdt n h i k i ngudn khdc nhau vd rdt phong phli. Ngudn thflng tin cung cdp t d trudng hpe, thdy cff gido Id cao nhdt (94,3%), ty lfi ndy khde nhau gida cdc Wn, sy khdc bifit ndy c6 'y nghTa thdng kfi ven p<0,05.
Ngudn thflng tin t d Ti vi vd mgng internet cung chilm mOt t j 1$ cao (91,4% vd 81,8%). Ngudn thflng tin t d t d g ^ , sdch mdng chiem t^ lfi thdp nhdt (52,6%). D i l u ( ^ rdt cd y nghTa trong wfic lya chpn kfinh truyin thdng v l phflng, chdng HIV/AIDS phCi hop cho ddi tiryng hpc sinh tgi khu vyc cdc tinh Tdy Bdc.
KtJ LUAN
Nfli dung aide dye v l phdng, ehdng HIV/AIDS dd dypc phdn bfl trong chuang trinh chinh khda d cdp THCS vd THPT. Tuy nhifin, mflt sd nfli dung chua phi^ hyp vd thflng tin chua d y y e cfip nhgt kjp thdi.
Nhilu gido vifin giang dgy v l HIV/AIDS nhyng chya tCmg dyye tham gia tap huan, kinh phi phuc vy cho cdc hogt dflng gido dye ngogi khoa thilu nfin anh hydng d i n chdt lyang t r i l n khai cdc hoat dflng gido duc phdng, chdng HIV/AIDS.
Kiln thde dting eiia hpc sinh ve phdng, chdng HIV/AIDS khu v y c Tdy Bac Id 34,2%. O cdp taing hoc phd thdng Id 33,3% vd cdp taing hpc ca sd Id 35,0%. Thdi dfl dCing ctia hpc sinh khu vye Tdy Bdc v l phflng, ehdng HIV/AIDS Id 30,3%. Ngudn thflng tin v i HIV/AIDS cdc em nhdn d y y e t d trydng hpc bao gdm ci thdy cd, ban bfi Id cao nhdt (94,3%), f y Tivi (91.4%). internet (81,8%), thdp nhdt Id f d gdp, sdch mdng (52,6%).
Nghifin cdu cQng dd dua ra cdc khuyin nghj nhu:
Cdn cfip nhfip ndi dung cd lifin quan d i n phdng,
chdng HIV/AIDS vdo gido trinh sdch gido khoa sda ddi; Tdng cydng bdl dyflrtg ndng cao ndng lyc cho gido vifin lam cflng tdc gido dye sdc khde sinh sdn, gidi tinh, k^ ndng sdng, phflng, chdng HMAIDS; Ddi mdi nfli dung vd phyang phdp taiyen thflng, trdnh hD dpa, tdng cydng giai thich de cdc em khflng ky thj vd phan bifit ddi x d vdi ngyfii nhifim HIV.
TAI LIEU THAM K H A O
1. Bp Giao dye vd Ddo tao (2008), 'Chi thj sd 61/2008 cua. Bfl Giio due va DSo t^o vi tang cu&ng phong, chong HIV/AIDS tmng ngSnh giao due', Hd Npi 2008,
2.- Bfl Giao dye va Dao tao (2012), Ki ho^ch hanh dgng ve phdng, ching HIV/AIDS cua ngSnh Giio due giaidosn 2012, Hd Nfli 2012.
3. Chinh phu (2009), 'Quyit dinh s6 84/QD-TTg ngay 04/6/2009 cda Thu tu&ng Chinh phu ve vide phe duy$t Ki ho^ch hSnh ddng Quic gia vi trd em bi inh hu&ng bdi HIV/AIDS din nam 2010 va tim nhin din nam 2020r, Ha Nfli 2009.
4. Chinh phii (2012): Quyef C^nh s6 711/<X>-TTg ngay 13/6/2012 cua Thu tu&ng Chinh phu : PhS duy$t 'Chiin lugc phit triin giSo due 2011 - 2020'.
5. Bfl Y te. Khung theo dfli. ddnh gia chyong trinh phdng, chdng HIV/AIDS Qudc gia, Hd Nfli 2007
6. Nguyen VO Tuyet Mai, La Ngpc Quang. Kiln thdc, thdi dp, thyc hdnh va tim hilu mflt sd yeu td lien quan trong phdng, chdng HIV/AIDS cua hpc sinh tnjng hpc phd thdng huyfin Thanh Mifin, tinh Hai Dyong, ndm 2012.
7. Tdng cyc Thdng k l - Dilu tra qudc gta ve vj thdnh nifin vd thanh nidn Vifit Nam nam 2009 (SAVY II).
SO SANH DAC DIEM LAM SANG VA CAN LAM SANG THOAT Vj C0 HOANH BAM SINH 01 TUOI S 0 SINH (TVHSS) VA NGOAI SO SINH (TVH NGOAI SS)
T R A N THANH TU
Vi^n nghiin ciiu stJK khoe tre em - BV Nhi Trung uang T 6 M T A T
Mjjc <Sch nghiin cieu: So sinh die diim iim sing vi cin lim sing thoit vi co hoinh bim sinh d tuii so sinh (TVHSS) vi thoit vi ca hoinh ngoii tuoi sa sinh (TVH ngoii SS) D6t tuvng vi phirang phip: Nghiin cuv hii aiu. Bdi tuvng t>inh nhin diiu tri TVH lin 1 tai BV Nhi TW tir nam 2001 din nim 2012. Kit qui nghiin ciru: 438 binh nhin (246 TVHSS vi 192 TVH ngoii SS). Ty li ngat sau di TVHSS r9356;cao han TVH ngoii SS (24%) Tin thuang trin X- quang cOa TVHSS ii md phii bin thiat vi. Tin thuvng tnn X quang TVH ngdai SS ii m * 2 M n phdt do viim. Chup luu thdng njtt cd hinh inh TV da diy vi nidi 57,3% d nhdm TVHSS, vi 26,6% TVH ngoii SS. Ting ALBMP cd d 45% binh nhin TVHSS chl ci 3% d nhdm TVH ngoii so sinh.
Kit lufn: Suy hd hip, ting ip iuc ding mach phdi li diu hiiu lim sing nii b$t d nhdm TVHSS, TVH
ngdai sa sinh thudng gip li tlnh trang nhiSm tning phdi tii diin.
Tir khda: Thoit vj co hoinh bim sinh, tudi sa sinh, ngoii tudi so sinh, BVNhl TW.
SUMMARY
COIUPARISON OF CDNiCAL AND LABORATORY FEATURES OF NEONATAL AND POST-NEONATAL
CONGENiTAL DiAPHRAGMATIC HERNIA Objectives: To compare ciinieai and laboratory featums of neonatal and post-neonatal congenital diaphragmatic hernia. Patients and methods:
Retrospective study. Patients who received treatment of congenital diaphragmatic hemia at NHP from 2001 to 2012. Results: Them wem 438 patients included 246 neonates and 192 post-neonates The rate of neonatal patients with congenital diaphragmatK hemia having postnatal mspiratory failure was 93%, higher than postnatal patients with diaphmgmatic
Y HOC THUC HANH (916) - SO S/2014