Ngjiien cmi Y hoc Y Hpc TP. Ho Chi M i n h * Tap 20 * So 4 * 2016
HIEU QUA CUA CAN THIEP TREN VAN DE HIEN THAN CHET NAO TAI M O T S O CONG DONG TAI THANH PHO HO CHI MINH
TrdnNggc Sinh* LiHodngNinh**, Hodng Thi Diem Thdy***
TOM
TATMuc tieu: ddnh gid hiiu qud ciia gido due trin kiih thiec, thdi dd tich cue zji iriec him th&n bdn thdn vd him th&n ngu&i thdn khi chii trin sirdi viin, nhiriig ngu&i theo dgo Thien Chda vd nhihig ngu&i theo dgo Ph&t tqi thdnh phd'Hd Chi Minh.
Doi tugng vd phuang phdp nghien ciiu- phdng vmi tru&c vd sau khi xem zrideo clip trin 864 ngu&i trin 18 tudi dua vdo bd eau hoi tu diin.
Kei qua: sau can thiep bang zrideo dip, cd su tdng cd y nghia thong ke cua cdng ddng lie him biii birih tfian id binh nang (24%); rihu cdu hieh ghep than cita xd hdi (19%); kim thiec chei ndo (21%). Thdi dd diing zie quan diem nhan dao tang 11%. Thdi do diing ve quan diem chia se tang 11%. Ti le ^ng y hieh than bdn tlmn khi chei tang 8%; ti li khdng Sng y gidm 2%; so ngu&i khdng cd chinh kie'n gidm 6%. Ti li dong y hieh than ngu&i than khi chii tdng 8%; ti li khong dongygidm 4%; sd'ngiari khdng co chinh kiih giam 6%.
Ket luan: Gido due Id phucmg phdp cd hiiu qud giiip ldm tang kiih thiec vd thai do tich cue cua cgng t^ong ve zriic hiin than khi diei.
Tic khod: kieh thuc, thai do, hien th&n, chet ndo ABSTRACT
EFFICACY OF EDUCATION INTERVENTION ON OPINIONS ON BRAIN-DEATH ORGAN DONOR FOR COMMUNTHES IN HO CHI MINH CTTY
Tran Ngoc Sinh, Le Hoang Ninh, Hoang Thi Diem Thuy
* Y Hoc TP. Ho Chi Minh * Vol. 20 - No 4 - 2016; 74 - 79 Objectives: to evaluate the efftcadty of education on the knowledges and positive attitudes about kidney Donation after death among studmts, catholics, buddhists at Ho Chi Minh dty.
Subjects and method, pre and post zrideo clip education interuiew on 863 people from 18 years old by questiontiaire, the interviewees filled in themselves.
Results: There were a significative augmentation after education of knowledges about kidney disease (24%), the need cf transplantation (19%) and brain death (21%). There were also a significative elevation of positive attitude about Donation: altruism attitude (11%), sharing attitude (11%). About Donation of thdr own kidney:
the agreed people increased 8%; the disagreed people decreased 2%; the undedded people decreased 2%. About Donation of thdr relative's kidney: the agreed people increased to 8%; the disagreed people decreased 4%; the undedded people decreased 6%.
Conclusion' Education is an effidmt way to ameliorate the knowledges and positizK attitudes of the community about Donation after death.
Key words: knowledge, attitude, kidney donation, brain death
DAT V A N DE ^^ phan: nang cao chat luong cham soc benh nhan ghep than va cai tao nguon than ghep.
Chien liroc de phat trien ghep Ihgn bao gom
• DHYD TP Ho Chi Minh, ** Vien ve sinh Y te cong cong, *** Truong DHYK Pham Ngpc Thach Tdc gid lien lgc: ThS. BS. Hoang Thi Diem Thuy, DT. 0908235287, Email: thuyd [email protected]
Y Hoc TP. H o Chi Minh * Tap 20 * So 4 * 2016 N g h i e n cmi Y hoc
Tai Hoa iO, chi c6 25% ngiioi suy than gjai doan CUOI dugc ghep trong nam dau tien, va gan 50% tie ngtroi cho songP'. Ngay ca tai Tay Ban Nha la quoc gia diing dau the gioi ve hien tang van CO 6-8% benh nhan da tir vong truoc khi ho dugc nhan than ghep tit chucmg trinh quoc giaf*).
R6 rang nguon thein ghep dang ngay cang khong dap ling kjp voi nhu cau. Nguon tang lay tu nguoi cho chet can dugc xem la nguon cung cap chii yeu de giam thieu ganh nang ve nguoi cho song. Tuy nhien, hanh vi hi&i tang khi chet van con khong on dinh theo khong gian va thoi gian.
Cac chuong trinh gjao due va tuyen truy&i rat can thiet de vugt qua rao can trong irien tang 6 ngucri chet.
Tai Viet Nam, con it chuong trinh giao due de nang cao iden thiic thai do Ken quan deh hi&i than chet nao trong cgng dong. Chung toi thuc hien nghien cihi nay nham danh gia hieu qua ciia giao due tren kien thiic va thai do ciia cong dong ve van de hieh than khi chet.
DdllUONG-PtlUtlNGFHAFNGHIENCLllJ Nghien ciiu can thigp truoc sau bang video- clip tren 864 nguoi tu ttiang 8 dan thang 11 nam 2013.
Mau nghien ciiu dugc chgn theo phuong phap thuan hen tren cac cong dan tit 18 tuoi sinh song tai TP Ho Chi Minh thugc 3 nhom doi tugng: sinh vien, Phat giao, Thien Chiia giao.
Co mau: 863 nguoi
Phuong phap thong ke: Tan so va ti le dugc sii dung cho bi&i so dinh tinh, trung binh va dp lech chuan dugc sir dung cho bien so tuoi. Chi binh phuong Mac Nemar dugc sii dung de xet su ket hgp giiia bi^i so kioi thiic, thai do, va viec hien than truoc va sau can thi^p.
Npi dung video clip dai 40 phiit bao gom:
- Hoan canh ciia cac benh nhan suy than giai doEin cuoi
- Cac chuyen gia n&u y kien ve khai niem chet nao va nhu cau ghep than.
- tfinh anh cupc song cac benh nhan sau khi
dugc ghep than.
- Tinh hinh hioi dian tren the- gioi va Viet nam.
- Cac dai dien Ton giao neu quan diem trong viec hien tang.
KETQUA
Dac diem doi tirpng nghien cihi So nguoi tham gia: 863.
Tuoi: trung vi 25 (25p= 23; 75p=48).
Gioi tinh: nam 314; nii 549 (36,4/ 63,6%).
Trinh dp hgc van: pho thong: 307 (37,39%);
dai hgc: 503 (61,27%); sau d ^ hgc: 11 (1,34%) Tmh trang kinh te: giau: 12 (1,4%); kha: 147 (17,19%); frung binh: 593 (69,36%); ngheo: 103 (12,05%)
Ng^e nghiep: lao dgng pho thong: 48 (5,7%);
chii doanh nghiep: 8 (0,9%) ; =n6ng dan: 29 (3,4%) ; hgc sinh- sinh vien: 509 (59,9%) ; cong nhan vien: 73 (8,6%); buon ban: 43 (5%); Ngi trg:
98 (11,6%); khac: 42 (4,9%).
Ton giao: Phat: 215(25%); Thien Chiia: 224 (26%); Tho ong ba-khac: 241 (28%); khong theo ton giao nao: 181 (21%)
Ket qua truoc va sau can thiep Kien thdc
Cau 8. Anh dij co biet ve benh suy than khong
Bdng 1: Kei qud truac vd sau can thiip eau 8 Sau can
thilp DCng Sai rtng
Truovcan ttil#p Sting
543 8 551 (68%)
Sai 211 61 262 (32%)
T6ng
754 (93%) 59 (?%(
813 OR (KTC95%) 26,38 (13,14- 61,89)
Gia tri P
<0,001
Cau 9. Suy ttian n|ng se chet neu khong dugc lgc mau hay ghep than
Bdng 2: Kei qud tne&c vd sau can thiep cdu 9 K^T QUA
Co
TnK>c N 1 % 654 1 80
Sau n 779 95
%
P
<0,001
75
N g h i d n c u u Y hpc Y H p c TP. H o CM M i n h * T a p 20 * So 4 * 2016
KfTQUA Ktiong Khong biit Tfing c6ng
Tnn>c N 16 148 819
%
218 Sau n 8 32 819
%
14 P
Cau 10. Nhiing nguoi bi suy than hien nay dang rat can co nhiing ngudi cho t h ^ de dugc ciiu song. Anh/chi ong / ba co biet ve thong tin nay:
Bdng 3: KH qud tne&c vd sau can thiip cdu 10
K £ T Q U A C6 Khong Kh6ng biet Tong cpng
Tnrvc N 623
32 166 821
76
%
4 20
Sau n 772
17 32 821
94
%
2 4
P
<0,001
Cau 11. Chet nao la tinh hang ttm con dap nhung nao hoan toan h u hai, khong con kha nang phuc hoi;
Bdng 4: Kil qud tne&e va sau can thiip cdu 11
K £ T Q U A
c«
Khong Khong biet Tong cpng
Tnf6v N 582 33 205 820
71
%
4 25
Sau n 741
16 63 820
90
%
2 8
P
<0,001
Cau 12. Chei: nao thuong xay ra trong nhiing cai chet "bat dac ky tii" nhu: tai nan, tai bieh mach mau nao,... Anh/chi co biet dieu nay khong?
Bdng 5: Kei qud tru&c vd sau can thiep cau 12 K£TQUA
C6 Khang Khong bi4t Tong cong
Tnroc N 614 63 140 817
75
%
8 17
Sau n 725 31 61 817
89
%
4 7
P
<0,001
Kien thdc ddng ve rihu mu ghep thaw khi trd lai CO cd 2 cdu 9 & 10
Bdng 6: Kieh thiec ddng vi nhu cdu ghep than tru&c vd sau can thiip
Sau can thifp IDOng Sai
Truvc can thiep Dung
574 11
Sai 181 60
Tdng 755 (93%) 61 (7%)
OR (KTC9S%) OR=16,46 (8,98-
G i i t i P
<0,001
Sau can thi#p T6ng
Tnjv^ccanthi^p DUng
685 (72%)
Sai 231 (28%)
TSng 816
OR (icrc9s%)
4
Kim thdc dung ue diei nao: Wii tra lai co cau 11 vd 12
Bdng 7: Kim thdc dung zie diet ndo tru&c vd sau can thiip
Sau can thiip Dicing Sai Tong
T n i ^ c a n thl#p DUng
470 29
Sai 199 104 499 303 (62,2%) (37,8%)
T6ng
669 (83,4%)
133 (16,6%)
802 OR (KrC95%) 6,86 (4,6-
10,5) P - 0,M1
Thai do
Cau 13. Ngiroi chet nao nen hioi tang cac tang trong co the vi muc dich nhan deio?
Bdng 8: Ket qud tru&c vd sau can thiep cau 13 KfiTQUA
RIt dong y Ddng;^
Khong dongy R^t I<h6ng
ddngy Tong cong
TnjDC n 206 484 121 7 818
25,1
%
59,2 14.8 0.9
Sau n 297 462 58 1 818
36.3
%
56.4 7.2 0,1
P'.'
<0,001
Cau 14. Viec cho than cho n g u o i b i benh la m o t nghia curnhan dao?
Bang 9: Kei qud tnmc va sau can thiip cm 14 K £ T Q U A
F?lt dong y D6ngy
KhSng i56ng^
Rit I(h6ng adng^
Tong cong TniOc n 270 603 46 4 823
32.8
%
61.1 5.5 0.6
Sau n 336 458 28 1 823
40,8
%
66,6 3,4 0,2
P '
<0,001
Cau 15. "Khi nguoi ta chet di nhung con mgt bp phiin tren ca the dem cho lai cho mot nguoi khac thi giong nhu than xac van con tren coi doi nay". Ong ba anh chj nghi sao ve quan diem nay?
Y H p c TP. H b C h i M i n h * T^p 20 * So 4 * 2016 N g h i d n c u u Y hpc
Bing 10: Kit qua K£TQUA R§t dSng y D o n g ^ Kheng dfing y Ftit Ichong d6ng ^
Tong c6ng
tntac va sau can thiep c&u 15 T n i w c
N 167 439 186 14 8 0 6
21
%
54 23 2
S a u n 208 448 145 6 8 0 6
25,8
%
66,5 18 0,7
P
<0,001
Cau 17. Viec tuyen truyen giao d\ic hieh t h ^ tren cac phuong ti|n thong tin dai chiing co can khong?
Bdng 11: Kit qud tne&c vd sau can thiip cau 17
Sau c a n t h i e p e i i n g Sai Tong
T n i ^ c a n t h i d p Bimg
736 8 744(91%)
S a i 62 2 4 76(9%)
T d n g
788(96%) 3 2 (4%) 820
O R ( K r C 9 5 % ) 6,5 (3-15,8)
G i ^ t r i P
<0,001
Cau 18. Ong ba anh chi co nghi rang minh se ban bcic voi ngiroi than khi quyet djnh hien than khong?
Bdng 12: KM qud tru&c vd sau can thiip c&u 18
K t T Q U A
C o Khong Khang biSt Tong cong
Tnj<dre N 6 6 6
87 67 820
81
%
11 8
S a u n 6 9 7
79 4 4 820
85
%
10 5
P 0,0045
Cau 19. Ong ba anh chi co nghi rang minh ding CO the co liic can dugc nguoi khac cho than khong
Bdng 13: KH qud tru&c vd sau can thiip c&u 19
K f T Q U A Co Khang Khang bi4t Tong cOng
T f l f 6 c N 6 2 0
75 127 . 8 2 2
75
%
9 16
S a u n 673
4 9 100 822
%
82 6 12P
<0,001
Thdi do diing ve quan diem rihdn d^o: khi trd loi ddng y hodc rat dong y 3 cdu 13,14,15 Bdng 14: kii qud thdi do dung zii quan diem nh&n dqo truac vd sau can thiip
Sau c a n t h l ^ p Dtjng Sai
T n r a v c a n t h i d p D i i n g
6 1 2 26
S a i 113 138
T 6 n g 625(79%) 164(21%)
OR (KTC95%)
(2,8-6,9) Gia t l i
P
<0,001 S a u c a n
t h i # p T6ng
T n f 6 c c a n t h i i p D i i n g
638 (68%)
Sai 251 (32%)
T f i n g OR ( K r C 9 5 % ) 789
G i i t h p
Thdi dd ddng ve quan dian chia se: fchi trd lai CO 3 cdu 17,18,19
Bdng 15: kei qud thdi dd dung zii quan di&n chia se tru&c vd sau can thiep
S a u c a n t h i e p
D i i n g Sai T i n g
T n j ^ c a n t h i i p D i i n g
449 52 501(62
%)
Sai 137 168 305(38
%)
T 6 n g OR (KTC95%) 586(73%) 2,6 (1,9-3,7) 220(27%)
806
< ^ t r i P
<0,001
Thdi do dong y hien thdn khi chet
Cau 24. Neu khong may qua doi, 6 n g ba anh chi CO dong y hi&i than ciia irunh cho mgt nguoi dang can ghep khong?
Bdng 16: Thdi dd ddng y hi^ than khi chit tru&c vd sau can thiip
K£TQUA
ca
Khong Khang b i i t T6ng cang
T n i - a ^ n 433
96 269 798
54
%
12 34
S a u n 492
77 229 798
6 2
%
10 28
P
<0,001
Cau 26. N ^ CO than nhan qua doi vi tai nan, 6 n g ba anh chi co dong y hien than ciia than nh&i minh cho mgt nguoi dang can ghep than khong?
Bdng 17: Thdi do ddng y hien than ngu&i thdn khi chit tru&c vd sau can thiip
KSTQUA
ca
Khang Khang b i i t Tong cOng
T r u 6 t : n 261 165 379 805
32
%
20 48
S a u n 338 132 336 805
%
4 2 16 4 2P
<0,001
BAN LUAN
Cau hoi ve rihsn thuc ve b^nh t h ^ va nhu cau ghep than trong nghien ciiu cua chiing toi cho thay cpng dong con it nhay cam truoc can thiep (72%). K S qua sau can thiSp cao dang ke (tang 21%) (bang 6). Ket qua aia chiing toi co the cao hon cac tac gia khac vi c^u h6i trong cac
77
Nghien ciiu Y hpc Y Hpc TP. H^ Chi Minh * T$p 20 * So 4 * 2016
nghien ciiu khac phiic tap hon vi du: binh than cd mmf giai doan, giai doqn ndo phdi thay thi'thdn, cdc tiinh tie ddnh gid chii nao, th&i gian sdng con cua than ghep... Hieu qua can thiep tren ki&i thiic chei nao cho thay ti le sau can thiep tang 21,2%
(bang 7). Ket qua ciia chiing toi gan giong voi tac gia Weaver<*t: ki&i thiic chet nao tang 18% sau buoi hgc 40 phiit cho 72 sinh vien dai hgc 6 Seattle (My). Tuong tu Donald^' khao sat truoc sau tren 100 dieu duong tai My ciing cho tiiay Id&i thiic diing ve chet nao tang len 17%. Theo Piccoli, sir Ihieu hut iden thiic chet nao la li do quan trgng lam giam tl le hi&i tang. Chinh suy nghi chet nao khong phai la chet that su tao ra tam li lo sg khong dugc "hoi siic d&i tan cung".
Chiing toi cho ring doi voi kien thiic chet nao, can CO mgt chuyen de rieng ve mat chuyen mon va xa hgi, ciing voi thoi gian moi thuyet phuc dugc cpng dong chap nhan. Theo Canterovich"*, nguoi dan kho chap nhan tim con dap la
"cheV'neu khong dugc thong tin nhieu Kn tnroc do. Hg CO the hieii mo ho la " khong con hi vpng" nhung hg ciing de nghj bac a "con nuoc con tat". Neu co kien thiic diing ttii ttiai do se khac.
Ti le thai do diing ve quan diam nhan dao sau can thiep teng 11% (bang 14). Dion thii vi la cac cau tra loi mo im:"kh6ng biii, khdng co y kieh"
deu giam sau can thiep (bang 8,9,10). Cac cau fra lai:"khong ^ng yvdrat khong ^ng y" tuy co ti le thap nhung thieii so nay co the co tac dong Ion den gia dinh va cpng dong. Sau can thi#p, ti 1^
nay giam 4-5% so voi 17% ciia PiccoliP'. Theo Rumsey'*', su chuyen bien thanh hanh vi diing tiiy thugc vao su hien dien ciia nhieu thai do diing va su xoa di cac thai do tieu cue.
Trong ca ba cau the hien quan diem chia se, ti le cac cau tra loi 'Tdiong biet" deu giam tvr 3- 4% sau can thiep (bang 11,12,13). Thai do diing ve quan di&n chia se khi tra loi diing ca 3 cau: "
COTi tuyen truyen gido due him than, bdn bgc v&i ngu&i thdn, bdn thdn cd thi'can dugc ngudi khac cho than". Ket qua sau can thiep ciia chiing ^ i tang 11% (bang 15) ciing la ket qua kha quan. Theo
nhieu tac gia, yeu to ban bac voi nguoi than la yeu t6 quan trpng de giam ti le nguoi than khong dong y hien tang khi chet Nghien cihi ciia Weaver**) cho thay ti le hai cau kien thiic co thay doi co y nghia th&ig ke sau can thiep la:
nhan thay su thieii hut than de ghep va trong tuong lai ban than co the la nguoi nhan than. Tac gia dong cho ihay day la 2 cau co tuong quan deh thai dp dong y cho tiian. Ket qua nay cung phu hpp voi ket qua ciia chiing toi. Dieu nay cho thay day la hai vaan de quan trgng can dugc ds cap trong cac chuong trinh tuyen truyen.
Tl 1? hien than ban than khi chet tang 8% sau can thiep, ti le khong dong y giam 2%, so ngu6i khong CO chinh kien giam 6%. Ti le dong y hi&i th^n nguoi than tang 8%, ti le khong dong y giam 4%, so nguoi khong co chinh iden giam 6%.
Ket qua ciia chiing toi gan giong voi can thiep ngan ciia DonaldP' ti le dong y hioi than ban tiian khi chet tang 5% sau can thiep. So voi tac gia Piccoli va Weaver, hieu qua nghien ciru ciia chiing toi tivap hon co le do thoi gian can thiep ngan hon. E)ieu nay cho thay chuong trinh can thiep cang cong phu, ^ so tac dgng cang cao va thoi gian cang hgp U thi hieu qua that cang cao.
Thiet ke nghien ciiu la nghien ctiu truoc- sau can thiep. Han che a i a loai nghien ctiu nay la phan cau hoi truoc can thiep da co ftie anh huong len ket qua ciia cau hoi sau du chira can thiep do nguoi tra loi tu nhay cam voi van de.
Trong nghien ciiu nay, thoi lugng can thiep la 40 phiit khong phai la ng3n nhung chi co mot lan, lam cho ket qua thu dupe chi co tinh nhat thoi. Cimg voi thoi gjan, ket qua nay co the tot hon neu co cac tac dgng tich cue cua xa hpi va ngugc lai.
Mac du CO nhieu ket qua khac nhau tiiy theo tinh chat ciia chuong trinh va dan so can thiep, nhung voi chuong trinh tuyen truyen h i & tang, thi chi can 1% tang len cung dugc cho la co hieu qua ciiu song. Van de la nhiing nguoi c6 trach nhiem phai duy tri ben viing cac chuong trinh tuyen truyen hi&i tangt". Theo To chiic Y te The
Y Hpc TP. H o Chi M i n h * T | p 20 * So 4 * 2016 N g h i e n cuu Y hoc
gi61(si, cac giai phap de cai thien tinh trang thieu tang doi hdi toan xa hgi cimg vao cupc.
K ^ T L U ^
Nghien ciiu can thiep truoc sau bang video- dip tren 863 nguoi tu thang 8 d m thang 11 nam 2013. Mau nghien a i u dugc chpn tren 3 nhom doi tugng: sinh vien, Phat giao, Thien Chiia giao tai thanh pho Ho Chi Minh.
Sau can thiep bang video dip, co su tang co y nghia thong ke cua cpng Sang ve hieu biet benh ih|n la b^nh nang (24%); nhu cau hi&i ghep th$n ciia xa hgi (19%); kioi. thiic diet nao (21%). Thai dp diing ve quan diem nhan dao tSng 11%. Thai dp diing ve quan diem chia se tang 11%. Ti le dong y hi&i than ban than khi diet tang 8%; ti le khong dong y gjam 2%; so nguoi khong co chinh kien gjam 6%. Ti le dong y hi&i than nguoi tiian khi diet tang 8%; ti le khong dong y giam 4%; so nguoi khong co chinh kim giam 6%.
Mac dii con han che trong thiet ke nghi&i ctiu va chpn mau nhung ket qua tiiu dugc la ket qua rat kha quan, la tien de thiic day cac chuong tiTnh van dgng h i m tang ve sau. Nguoi lam nghien ciiu khong ki vgng rang thong qua mgt chuong trinh can thi|p ngan, chiing ta co the Iam thay doi dang ke va nhanh chong kien thiic, thai do va hanh vi ciia Cei cgng dong. Viec tuy&n trayen him tang la mgt sii menh ciia nhieu ban
nganh: y te, van hoa, luait phap, dao diic, va can CO dli thai gian.
Ket qua nghien ciiu cho thay giao dgc la phuong phap co hieu qu^ giiip lam tang kim thiic va thai do tich circ ciia cgng dong ve viec h i m th|in khi chet.
TAI LIEU THAM KHAO
1 Cantarovich F (2002). "improvement in organ shortage through education" Tronsptoita/ibn, 73:1844-1846 2 M c Q a d e D, Pierscionek B (2014). "Can education alter
attitudes behavior knowledge about donation? A pretest- post-test study". BM/5:e003961. doi;10.1136
3 IRO Data httpyAvww.healthpolicyassodatesxonVservicesflro_data_mte
gnty__auditing,htinl
4 Piccoli GB, Giorgio Sorania (2006). "Efficacy of an educabonal programme for secondary school students on opinions on renal transplantation and organ donation: a randomized controlled tnal". N^hrd Diat tran^lant, 21:499 5 Rumsey S, Hutfond HD, Cole AK {2003)."Influence of
knowledge and reUgiousness on attitudes toward organ donation". Transplant Proc. (35). 2845-2850.
6 US Renal data 2010; http:/Avww.usrds.org/atla801,aspx, w w w . Transplaniorg
7 Weaver M, C. Spjgner, M Pinela, K G Rabun, M D Allen (2001). "l^iKiwIedge and opinions among uiban high sdiool students- pilot test of a health education". JAMA. 286.71-77 8 World health Assembly Resolution
hltp://www.who mt/gb/ebwha/pdL&les/WHA57/A57_R18- eapdf.
Ngdy nhgn bdi bdo: 9/11/2015 Ngdy phan bien nhgn xet bdi bdo: 25/11/2015 Ngdy bdi bdo dugc ddng: 15/05/2016
79
