Y HOC VIET NAM THANG 9 - S 6 1/2013
Nhan xet: KCB ngoai tru tai tuyen xa dung binh khoang 40 nghin ddng/ mot lan kham, len tuyen huyen tang 2,5-3 lan, len tuyen tinh tang 5-6 lan va len trung ddng tang khoang 15 lan. KCB npi tru tai benh vien huyen khoang nu& triSu dong, len tuyen tinh tang len 3-4 lan va len tuyen trung ddng tang len 8-10 lan.
Dieu nay cho thay, gia ciia gdi djch vy KCB npi trii va ngoai trii cd sff chenh lech nhau rat nhieu giffa cac tuyen dieu tri tff xa, huyen den tinh, trung ffdng.Vay gdi djch vu nay dffdc xac djnh gom nhutig gi de dam bao dau ra BHYT?
Nhu" vay, BHYT vdi vai trd trung gian la ngffdi thff 3 chu^ thffc sff khach quan bdi le: Dau vao BHYT la nhff nhau nhffng dau ra khac nhau; NSNN bao cap gan 5 0 % sd the BHYT nhffng hdn 50% ngffdi dan phai tra them tien cho cac dich vu y te (Theo GSO, 2010); BHYT ket dff tang lien tuc nhieu nam (nhat la quy ngffdi ngheo, dan tdc)...
IV. KET LUAN
BHYT Viet Nam da cd the hien dffdc tinh cdng bang, tinh chia se nhffng chffa cao, chffa khach quan vi:
- Ngan sach Nha nu'dc bao cap gan mot nii^ so the BHYT trong ca nffdc nhffng mffc bao phii BHYT mdi chi dat gan 7 0 % va toe dp tang bao phii rat cham (2%/nam).
- BHYT cd xu the quan ly quy chi tra cho benh vien theo djnh xuat nhutig khdng xac dinh dffdc
gdi djch vu, nen cd sff ch^nh lech nhieu ve gia tien KCB npi trii va ngoai trii giffa cac tuyen.
- Ty le ket dff quy BHYT t§ng lien tuc 2010 - 2012.
- Hdn 50% ngffdi dan phai tra them tien cho cac DVYT, cao hdn so vdi cac nffdc (Theo GSO, 2010).
- Cd hien tffdng bao cap ngffdc, Iffa chon ngffdc va lam dung BHYT.
V. KHUYEN NGHj
Oe BHYT Viet Nam thffc sff cdng bang hdn, chia se cao hdn, can phai cd bien phap dot pha dd la thffc hien BHYT bat budc vdi gdi djch vy y te dffdc xac dinh va hdp dong Bao hiem y te minh bach giffa ba ben (Ben ban, ben mua va ben chi tra)
TAI U | U T H A M KHAO
1. Bao cao so 1163/BC-BHXH ngay 29/3/2013 ciia Bao hiem xa hpi Viet Nam ve ket qua thUc hien chfnh sach va phap luat ve BHYT giai doan 2009- 2012
2. P Braveman, S Gruskin (2003), Defining Equity in Health. J Epidemiol Community Health 2003; 57:
254-258
J. WHO (2008), Key concepts. Commission on Social Determinants of Health
4. Ruth Barnes (2003), Glossary of Terms Used inHealth Impact Assessment.
5. GSO (2010), dieu tra mffc song hp gia dinh
THyC TRANG DAY/HOC MON HOC MO - PHOI TAI TRirO-NG DAI HOC Y THAI BINH NAM 2 0 1 2
T O M TAT
Nghien ciru dUpc tien hanh tren 906 sinh vien viTa hpc xong hpc phan Mo - Phoi tai Tru'dng Oai hoc Y [Thai Binh. I*1uc tieu: Mo ta thu'c trang day/iipc mon hoc Mo - Phoi qua phieu danh gia ciia sinh vien va thao luan nhom giii^ cac can bp Bp mon. Ket qua: Hau het smh vien deu cho ring mon hpc la rat can thiet va can thiet (63,7% va 35,1%). So sinh vien co chuan bi bai tru'dc khi hpc thffc tap la 93,3% va biet diing
: Tru'dng OH Y Thai Binh
Phan bien khoa hoc: PGS. TS VUiOig Thj Hoa
Nguyen Xuan B
nhiem vy nghi§n ciTu ciia mon hpc la 85,1%; biet cac ki§n thffc cd ban ve ky thuat md hpc la 81,0%. Ty le tham dy tff > 80% thdi lupng hpc ly thuyet chiem 98,7%. Cd 99,8% sd smh vien cho rang cac trang thiet bi tai bp mon dap irng dUpc nhu cau hpc tap. Ty le sinh vien hai long vdi phyong phap giang d^y va hinh thffc to chffc thi thyc tap la 93,6%. Ty le sinh vien co ket qua thi het hpc phan dat loai gidi va xuat sac; kha va trung binh kha; yeu va kem lan lyot la: 22,7%;
69,2%; 8,0%; hai long vdi ket qua thi la 76,5%.
Y HQC VigT NAM THANG 9 • S6' 1/2013
SUMMARY
CURRENT S I T U A T I O N OF TEACHING/LEARNING THE SUBJECT OF
HISTOLOGY A N D EMBRYOLOGY I N T H A I B I N H MEDICAL UNIVERSITY I N 2 0 1 2
The study was conducted on 906 students who have completed learning the unit of histology - Embryology In Thaibinh Medical University. Objective:
To describe the current situation of teaching/learning the subject of histology through students' assessments and group discussions between the Department staff.
Results; Most students agreed that the subject was very essential and necessary (63.7% and 35.1%).
Number of students prepanng lessons before learning histology practice was 93.3% and number of those who knew properly the research task of the subject was 85.1%; number of students who knew the basic knowledge of histological techniques was 81.0%. The participation rate of > 80% of theory time accounted for 98.7%. 99.8% of the students said that the equipment in the department could meet their leaming needs. Percentage of students satisfied with the teaching methods and organizational forms of practical exam was 93.6%. Percentage of students with good or excellent results, pretty and pretty average, weak and poor at the final term were 22.7%, 69.2%, 8.0%, respectively. 76.5% students were satisfied with the test result.
I . DAT VAN DE
Md - Phoi la mdn Y hoc cd sd nghien cffu sff phdt sinh, phat trien, each cau tao va sff hoat ddng ciia cac md, cac cd quan, cac bp may ciia cd the ngudi, ddng vat binh thffdng, bat thffdng tff giai doan trffng, trong bung me, giai doan cd the dd trffdng thanh. Md - Phoi hpc la mdn hpc dang phat trien manh va dang sff dung nhieu thanh tffu ciia cac nganh khoa hpc khac nhff sinh hpc phan tff, sinh hpc di truyen, vat ly hoc, hoa hpc va nhd mdi quan he mat thiet vdi cac nganh khoa hpc khac trong y hpc nhff giai phau hpc, sinh ly hpc, ly sinh hoc, hoa sinh hpc, giai phau benh, sinh ly benh va cac mdn lam sang khac ma ngay nay nhffng irng dung cua mdn hpc Md - Phdl thai hpc hien dai da gdp phan rat Idn trong cdng tac kham chffa benh va cham sdc sffc khde.
Trong thdi dai ngay cac cd sd dao tao ve y hpc dang phai dam dffdng vol nhCJtig nhiem vu rat nang ne de dap ffng nhu cau thffc tien ve cham sdc sffc khde, v! vay doi hoi viec day va hpc phai khdng ngutig cai tien de cd hieu qua hdn. Nham dap img tot hdn yeu cau nhiem vu dao tao va nghien cffu khoa hpc, gdp phan nang
cao chat Iffdng dao tao d | c biet la kiem dmh chSt Iffdng dao tao, chung tdi tien hanh khao sat t h ^ m dd lay y kien tff cac ddi tffdng la sinh vien da hpc xong mon hoc Mo - Phoi tai Trffdng Dai hpc Y Thai Binh vdi muc tieu: Md ta thut trang day va hoc mon hpc Mo - Phoi Isi Trddng Dai hoc Y Thai Binh qua phieu danh gia cua sinh vien ra thao luan nhom giOla cac can bp cua Bp mon.
II. D d i TUiTNG VA P H U a N G PHAP NGHIEN COtJ 2 . 1 . D6il t i r i n g nghiSn cu'u ( D T N 6 )
Gom toan bp sinh vien n3m thff hai nganh Bac sy da khoa, nganh Y hpc Off phdng; nam Uiii' nhSt nganh Y hpc co truyen, nganh Dieu duQng;
nam thff nhat he lien thong, da hpc xong mon hpc Md - Phoi tai Trffdng Dai hpc Y Thai Binh va toan bp Giang vien, Ky thuat vien ctia Bp mon.
2 . 2 . Phu'dng p h a p n g h i e n cu'u 2.2.1. Thiet ke nghien cu^
De tai dffdc thffc hien theo thiet ke ngtiien cffu md ta vdi cudc dieu tra ngang. Ket hdp viS thao luan nhdm g i u ^ cac giang vien, ky thuat vien trong Bp mdn Mo - Phoi.
2.2.2. Chi tieu nghien cii'u
- Dac diem chung ve DTNC: tudi, gidi, nganh, he dao tao.
- Kien thffc, thai dp, ky nang ciia DTNC vdi m m hpc - Danh gia ciia can bp Bo mon we: tinh than thai do, ket qua hpc tap ciia DTNC; cd sd vat chat tra"9 thiet bj, dieu ki6n phuc vu giang day tai Bp mon.
2.2.3. Phu'dng phap xii" ly so'ffeu So lieu du'dc nhap bang phan mem Epidata 3.1 va dffdc xff ly, phan tich bang chffdng tiinh SPSS 16.0.
III. KET Q U A NGHIEN CLTU 3 . 1 . M o t so t h o n g t i n c h u n g
Bang 3.1: Phan loai OTT^C theo gidi va ndi dang ky hd khau
Noi dung Gidi Nam Nu- Tong Kliu viTc Khu vlTc 1 Khu virc 2
So lu'dng
414 492 906
354 114
Ty 16 (%)
45,7 f?
54,3 »•
100,0 "'
<4.
39,1 J
12,6 „£
Y HOC VigT NAM T H A N G 9 - s 6 1/2013
Khu vlTc 2-NT Khu Vl/c 3
TSng
383 55 906
42,3 6,1 100,0 Vdi tong so 906 sinh vien dude dieu tra, so sinh vien nff chlim 51,3%, nam chiem 15,7%.
Doi tudng thuoc KV2 nong thon chlim ty le cao nhat (12,3%), tlip den la doi tu'dng thuoc KVl (39,1%), it nhat la KV3(6,1%)
Bang 3.2: Phan bo OTNC theo he dao tao, dan t6c
HSd^otao Chfnh quy Lien thong DSntdc Kinh Khac
Sd iU0ng 633 273
621 285
Ty le »/o 69,9 30,1
68,5 31,5 K^ qua cho thay doi tiTdng nghien c&u chu yeu la he dao tao chfnh qui chiem 69,9%, he lien thong chf chiem mot nu^ so vdi he chfnh qui (30,1%). Sinh vien la ngddi dan toe Kinh chiem 68,5%, thuoc dan tgc ktiac chiem 31,5%
3.2. Kien thu'c, thai Ho, ky nang cua DTNC vdi mon hoc
Bang 3.3: Ty le DTTMC biet ten mdn hpc qua timg moc thdi gian
Moc thdi gian Tru'dc khi hoc dai hoc Y
Ngay sau l<hi nhap hpc Khi nhan du'dc iich hpc Khi bat dau hpc mon
hoc Khong nhd
Tong
So lu'dng 137 233 321 189 26 906
Ty le »/o 15,1 25,7 35,4 20,9 2.9 100,0 cd 15,1% so sinh vien biet ten cua mon hoc trddc khi vao Trddng, sau khi nhap hoc cd 25,7%. Nhdm chf bi& den ten mdn hoc khi nhan dddc iich hoc chiem ty ie cao nhat (35,4%)
Bang 3.4: Quan diem ciia DTNC ve sff can thiet cua mdn hpc
Ml^cdo Rat can thiet
So lu'dng 577
Ty IS % 63,7
C3n thiet Khong can thiet
Khong biet Tong
318 2 9 906
35,1 0,2 1,0 100,0 Nghien cffu nay tien hanh sau khi sinh vien da thi het mdn hpc, da sd hp cho rSng Mo phoi la mdn hpc rat can thiet (63,7%), chi 2 trong sd cac sinh vien dff^c hdi cho rang mdn hpc nay khdng ran thiet.
Bang 3.S: Ty le DTNC biet nhiem vu nghien ciiU ciia mdn hpc Mo phoi
Nhi^m vg nghien cd'u Cau tao dai the Cau tao vi the Cau tao sieu vi the
I^LTC dp phan tiiTong
So lu'dng 135 670 248 68 906
Ty l# % 14,9 74,0 27,4 7,5 100,0 Khi dddc hdi, hau het cac sinh vien deu biet dddc chuyen nganh Md phdl cd nhiem vu nghien edit cau tao vi the (74%); tuy nhien van cd 14,9% cho rang day la mon hoc nghien cuV cau tao dai the
Bang 3.6: Mifc dp chuyen can cua DTNC ithi hoc V[b phoi
Thdi gian tham dir mdn hoc Tliam du" 100% so tiet Tham du' > 80% so tiet Tliam dl/ < 80% so tiet
Tong
So lu'dng 622 272 12 906
Ty 14 "/o 68,7 30,0 1,3 100,0 Tmng sd906 sinh vien tham gia nghien cut/, cd 622 sinh vien tham dd du tat ca cac tiet hoc ly thuyet chiem 68,7%, chf cd 12 sinh vien hpc ft hdn 80% so tiet hoc chiem 1,3%
Bang 3.7: Danh gia ciia DTNC ve trang thiet bj phuc vu dao tao tai bp mon
Oanh gici Dap LTng du'dc
Khong dap
Solu^ng 901
2
T* le »/o 99,8
0, I
Y HpC VigT NAI« THANO 9 - s g 112013
Ltng du'dc Khong biet Tfing
3 906
0, 1 100,0 Da so sinh vien cho la trang thiet bi cua bp mdn dap dtig dude nhu cau cho viec hoc (99,8%), chf cd 2 sinh vien (0,1%) cho ik khong dap utig dddc.
Bang3.8:T\f \k DTNC chuan b! bai trffdc khi den phdng thffc tap va biet dff(?c cac phffdng
ChuSn b| bai Co Khong Phu'dng phap
nhuom HE (Hematoxyiin -
Eosin) Giem sa Cazan ngam bac
Khong biet
Sd lu'dng 845
61
466 379 371 180
Ty 1$ »/o 93,3
6,7
54, 1 48, 1 35,0 19,9 thut tap chlim 93,3%, khong chuan bi bai tru'dc la 6,7%. Ty le sinh vien biet tieu ban ma ho xem da nhugm tiSng phu'dng phap nhuqm H.E la 51,1%, khong biet ten phudng phap nhuom tieu ban la 19,9%.
Bang 3.9: Danh gia cua sinh vien ve su' hai iong vdi phu'dng phap giang day va hinh thiJc to chu'c thi thu'c tap tai bp mon
Su* hai long Co Khonq Khonq biet
Tong
So lu'dng 848
Ty 16 "/o 93,6
1,8 100,0 Co SIB sinh vien hai long vdi phu'dng phap giang day va each to chu'c thi thu'c tap tai bo mon chlim 93,6%, con 1,6% khong hai long.
Bang 3.10: Phan ioal ket qua thi va su' hai lonq ve ket qua thi Mo phoi
Ph3n loal ket qua thi Gioi, xuat s8c (>= 8)
Kha, trung binh kha (5-7,9)
Sd lu'dng Ty le o/o 22,7 69,2
Yeu, kem (< 5) SM'hiMongvdiket
qui thi Co Khdng
41
390 120
8,0
76,5 23,5 Sau khi thi hit hgc phan cd 116 sinh viin ^ kit qui gidi, xuat sSc chiim 22,7%. Cao nhatk nhom kha va trung binh kh^ chi&n 69,2%. Nhm CO diem yeu kem chiim 8,0%. Ty le sinh vien Mi 'ong vdi kit qua thi la 76,5% va khong hai long 'a 23,5%
3.3. Ket qua thao luin nhom cira giant 'ISn vii ky thu^t vien vig thu'c trang day hgi .Id-Ph6ih9c
Trudc het phai ra soat iai chut^ng binh, chinli SL'a sach gi^o khoa, giam tai nhiJtig kien tfiij'c kh )ng can thiet, nang cao tinh hap dan, phu iiop vd doi tu'dng, cai tien phu'dng phap day lipc.
"niLT hai, cung vdi cai each chu'dng trinfi va sacl. giao khoa, phai tiep tuc phat trien dpi ngu giant vien va k9 thuat vien; dam bao 100% Uily CO gic 3 ap dung phu'dng phap giang day h'ch cifc, tao ra mot phong each giang day sinh dong, ti3p dan trcng Idp hpc. Gan ket giang day vdi ngliiSn ciiti khi a hpc, Tru'dng dai hpc muon trd thai*
mot trui g tam dao tap tot phai dong thdi cOng li mot trur g tam nghien ciili khoa hpc tot.
/iec ap dung cac phu'dng phap giang day mdi doi hoi phai co nhifng tai li?u day/hoc m*.
NiiOhg tai iieu nay phai gan vdi cac pliu'dng pliap kiem tra mdi nhSm khuyen khich khong ctii Idia nSngnhd lai ma ca kha nang phan tich van &, cac ky nlng thu'c hanh va sang tao cua sinh viSn.
Vdi nhutig doi tu'dng la cac em sinh vien he ciJ tuyen hoac lull hpc sinh, nen phan bo Si vao cacjdp va hinh thanh cac nhdm nho ti/li?i trong moi Idp de cac em cung thi dua va giip S nhau tien bp.
Ngoai ra yeu to cd sd vat chat cua nhi trifOng cDng co anh hi/dng den ket hoc qua li«
tap. Vi vay, nha tru'dng nen tang cu'dng nliDlis trang thiet b| phu'dng tien day hoc tot nhat d»
sinh vien trong dieu kien co ttie.
IV. BAN LUAN
4.1. Oac diem chung vS dSi tu'dng nghien cut!
TTiong thu'dng vdi nhifng nganh co thdi gSn
dao tap tren S nSm thi chu yeu la cac em nan
smh vien theo hpc, tuy nhien trong nghien aU
Y HOC VigT NAM THANG 9 - S6 1/2013
nay ty le sinh vien nff cao hdn sinh vien nam (54,3% va 45,7%), dieu nay cho thay nganh Y dang dffdc nhieu sinh vien cijng nhff cac gia dinh, xa hpi quan tam va yeu thich [ 3 ] .
Ddi tffdng thupc khu vffc 2 nong thon chiem ty le cao nhat (42,3%), dieu nay cung hocin toan phu hdp trong dieu kien thffc te d nffdc ta chii yeu van la mot nffdc nong nghiep, phan Idn dan so sdng d nong thon, hdn nO^ Trffdng Dai hpc Y Thai Binh CO tru sd dat tai Thai Binh, mot tinh thupc viing dong trang Bac Bp.
Doi tffdng nghien cffu thupc he lien thong chi chiem mot nu^ (30,1%) so vdi he chinh quy, dieu nay phii hdp vdi thffc te tuyen sinh ciia trffdng theo chi tieu dffdc Bp Giao due va Oao tao giao hang nam.
Sinh vien la ngffdi dan toe thieu sd (chii yeu d nhffng Idp cff tuyen) chiem 31,5% tffdng dffdng mot phan hai sd Iffdng sinh vien la ngffdi dan tdc Kinh. Dieu nay chffng td tinh ffu vlet ciia chii trffdng, dffdng ldi ciia dang va nha nffdc ta rat quan tam tdi cdng tac dao tao nguon nhan Iffc y te cho cac viing khd khan va ddng bao dan tdc thieu sd. Dong thdi qua dd cijng the hien rd vi tri va sff mang ciia Trffdng Dai hpc Y Thai Binh trong cdng tac dao tao nguon nhan lu'c.
4 . 2 . Kien thu'c, thai d o , ky nang cua doi tu'dng nghien cu'u vdi mon hoc
Md - Phdl la mot trong nhffng bp mon y hpc cd sd, cung cap nhffng kien thffc ve cau true vi the, sieu vi the va qua trinh hinh thanh con ngu'di cho cac the he sinh vien nganh khoa hpc sffc khde [1],[2],[4J. Tuy nhien da sd sinh vien dffdc hdi chi biet den mon hoc khi nhan du'dc Ijch hpc (chiem 35,4%), mac dii khi nhap hpc vao trffdng, sinh vien da dffdc gidi thieu ve chffdng trinh dao tao khi tham dff khda hoc tuan sinh hoat cdng dan. Qua day cho thay ITnh viTc Md - Phdl hpc cung nhff nhffng thanh tffu ve y hpc lien quan tdi Md - Phoi thai hoc chu^ thffc sff dffdc xa hpi quan tam, chffa co nhieu cd hpi dffdc gidi thieu qua cac phffdng tien thong tin dai chung.
Song, sau khi da hpc xong hpc phan Md - Phoi, dffdc hdi ve quan diem cua sinh vien ve sff o n thiet cua mon hpc, da sd sinh vien cho rang I^d Phoi la mdn hpc rat can thiet (63,7%), can thiet (35,1%). Dieu nay chffng td chffdng trinh dao tao dam bao b'nh phu hdp vdi myc tieu chung, dong thdi phffdng phap giang day da cd hieu qua, chat lu'dng, sinh ddng, hap dan, giup sinh vien xac t^nh dffdc tam quan trpng ciia mdn hpc.
Khi dffdc hdi ve mffc dp chuyen can ciia sinh vien khi hpc mdn Md phdl, cd 622 sinh vien tham dff dii tat 'ca cac tiet hpc ly thuyet (chiem 68,7%), Chi cd 12 sinh vien hpc it hdn 80% sd tiet hpc'chiem 1,3%. Dieu nay chii yeu xay ra d ddi tffdng lien thong, phii hdp vdi thffc te do mot vai sinh vien he lien thong xin nghi ve giai quyet viec cd quan hoac mot sd nff sinh vien lien thong xin nghi tam thdi vi ly do thai san.
Khi hdi ve viec trang thiet bl tai phdng thffc tap ciia bp mdn cd dap ffng nhu cau hpc tap cua sinh vien, da sd sinh vien danh gia trang thiet bj ciia Bp mdn dap irng dffdc (99,8%), chi cd 2 sinh vien (0,1%) cho la khong dap ffng.
Vdi thdi Iffdng 3 ddn vj hpc trinh cho moi hpc phan, bp mdn to chffc thi thffc tap va thi ly thuyet cho cac sinh vien. Diem hpc phan la diem tong hdp ciia diem thi thffc tap va diem thi ly thuyet (d3 nhan he sd vdi diem thi ly thuyet). Ket qua thi da the hien rd theo phan phdl chuan, danh gia khach quan, chinh xac nang Iffc hpc tap ciia sinh vien.
Nhdm sinh vien xep loai gidi, xuat sac chiem 22,7%, nhdm kha va trung binh kha chiem 69,2%.
Nhdm cd diem yeu kem chiem 8%. Cd 390 em hai Idng vdi ket qua thi (76,5%), 120 em chu^ hai Idng vdi ket qua ma ho dat 6dcic (23,5%). Ket qua nghien cirtJ ciia chiing tdi cung phii hdp vcfi nhan dinh ciia cac tac gia [5], [6], [7].
Qua phieu tham dd, lay y kien danh gia ciia sinh vien, chiing tdi muon du'a ra mot so kien nghi de gliip cho bd mdn cd nhffng ke hoach, chffdng trinh giang day cung nhu* la nhffng hoat ddng ngoai khoa thu hut sinh vien tham gia, tren cd sd dd vffa nang cao chat lu'dng dao tao vita thiic day sinh vien hpc tap nhd xay dffng dffdc he thong ddng cd hpc tap dung dan.
V. KET LUAN
Qua nghien cffu, chung tdi rut ra mot so ket luan sau:
- Ty !e sinh vien nff nhieu hdn sinh vien nam (54,3% va 45,7%). Cd 69,6% sinh vien thupc he chinh quy va 3 0 , 1 % thupc he lien thong. So sinh vien la ngffdi dan tdc thieu so chiem 31,5%.
- Chii yeu sinh vien biet ten mon hpc khi nhan 6iScic lich hoc (35,4%). hoac sau khi nhap trffdng (25,70/0).
- Hau het cac ddi tffdng nghien cffu deu cho rang mdn hoc Md phoi la rat can thiet va can thiet (63,7% va 35,1%).
Y HpC VigT NAM THANG 9 . s 6 1/2013
- Ba so cac doi tu'dng nghien CIHJ deu chuan bi bai tru'dc khi hpc ttii/c tap (93,3%) va biet dung nhiem vu nghien cii'u cua men hpc (85,1%), biet cac kien thCrc cd ban ve ky thuat mo hpc nhu' phu'dng phap nhupm m6 hpc (81,0%).
- Ty ie sinh vien tham dlf t i r 8 0 % thdi iUdng hpc ly thuyet trd ien chiem 9 8 , 7 % .
- Co 99,8% so sinh vien cho rSng cac trang thiet bi tai bp mon da dap irng diTdc nhu cau hoc tap.
- T9 le sinh vien hai long vdi phu'dng phap giang day va each to chu'c thi thUc tap tai bp mon cliiem 93,6%.
- Ty le sinh vien c6 ket qua thi het hpc phan d j t ioai gioi va xuat sac; kha va trung binh kha; yeu va kem ian ludt ia: 22,7%; 69,2%; 8,0%.
- Co 76,5% so doi tu'dng nghien ciru hai iong vdi ket qua thi het hpc phan l>1c - Phoi.
T A I L I E U T H A M KHAO , 1 Trinh Binh (2004), Mo hoc, NhJ xuat ban Y hpc.
2. TrSn van Hanh (2006), 1^6 hpc, Nha xuat ban QuSn dpi nhan dan.
3. Nguyin Thj Lan Hu'dng (2011), "Phong c i d i hpc tSp trong sinh vien truSng Dai hpc Y IHa Npi va m6t so yeu to lien quan", Y hpc thUc hanh s6 818 - 819, tr 714 - 719.
4 Oo Kinh (2008), Phoi thai hpc, Nha xuat ban Y hoc.
5, Engels PT, de Gara C ( 2 0 1 0 ) , Leaming styles of medical students, general surgery residents, and general surgeons; implications for surgical education. BMCMedEduc; 10:51.
6. Gurpinar E, Bati H, Tetik C (2011), teaming styles of medical students change in relation to time. Adv Physiol Educ. (3): 307-11.
. Gurpinar E. e t al (2010), Can learning style predict student satisfaction with different instruction methods and academic achievement in medical education'. Adv Physiol Educ. Vol.34 no.4 pp 192-196.
DAC DIEM PHAU THUAT CAT KHOI TA TUY SU" DUNG PHU'aNG P H A P NOI TUY DA DAY TAI BENH VIEN VIET D O - C
Pham The Anh', Trjnh Hong Son', Nguyen Tien Quyet' T O M TAT
Qua nghien cirtj 60 tru'dng hdp c3t khoi ta trang dau tuy, lap lai lUu thong tieu hoa tuy - da day tai Benh vien Viet Dire tir 15/09/2009 den 31/03/2012 ctiung toi nhan thay: day la phau thuat phiTc tap vdi thdi gian phau thuat trung binh tuonci doi dai 308,3±61,6 phut. Tai bien chinh trong phau thuat la chay mau chii yeu d giai doan giai phong va c3t rcJi khoi ta trang dau tuy. Di dong mom tuy phai dii dai tren 2,5cm. Mieng noi tuy - da day phai de each mieng noi da day hong trang tir 5cm trcl len. Viem tyy man ia yeu to nguy co gay chay mau trong mo.
SUiVlMARY
CHARACTERISnCS OF PANCREATICODUODENECTOMY W I T H
PANCREATICOGASTROSTOMY ANASTOMOSIS I N V I E T DUC HOSPITAL
' Binh vien Viet Otic
Phan bipn khoa hoc: PGS.TS. Nguyen Di^c Tien
Over 60 cases of pancreaticoduodenectomy witti panaeaticogasbtKtomy anastomosis in Viet Due Hospital from 15/09/2009 den 31/03/2012 we noticed:
surgical time is relatively iong average 308.3 ± 61.6 minutes. Major surgical complications are bleeding pnmariiy in liberabon period and cut the pancreatic duodenal head. Pancreatic remnant mobilization at least 2,5 cm. The distance between Pancreabcogastrostomy anastomosis and gastrojejunostomy at least 5 cm or more. Chronic pancreatitis are risk factors for bleeding dunng surgery.
I. OAT VAN OE
Phau thuat cat khoi ta trang dau tiiy (CICTTOT) la phau thuat bao gom cat ca khS gom ta trang, dau tuy, du'dng mat chinh, tui mat, mot phan da day va doan dau hong trtng dUiK Whipple thuc hien thanii cong lan dau tien tren ngu'di vao nam 1935. Phau thuat de dieu tn cac benh ly lanh ti'nh, ac tinh viing dau tuy nhi/: ung thu dau tuy, ung thu bong Vater, viem tuy
