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DAU DANH GIA THUC TRANG
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VAT CHAT KY THUAT CHAN DOAN
VA
DIEU
TRI CUM A TAI
6
BENH VIEN
TUYIN
HUYEN TINH QUANG NINH
TOM
TAT
Kiim soat mdt
each
hieu qui cum dai dich khdng
nhi/ng ddi hdi viec hiiu biet sau vi cum dai dich mi
cdn can cd day
dCi
ca sd vat chat trang thiit
bi.
Nghien
cifu xac dinh tht/c trang ca sd vat chat ky thuat chan
doan va
diiu
tn cum A tai cac bdnh vien huyen thugc
tinh
Quing Ninh td dd lam ca
?5 ciio
cac nghien eifu
can thiep nhim ting cadng ca sd vat chat ky thuat can

the
real instruments
and
essentlons drugs
for
diagnosing
and
treating
Influenza pandemic
In
some district- hospital
in
Quang Ninh province thereby
to
make basements
to
interfere
for the
purposes
of
Improving
the
ability
for
diagnosing
and
treating patients with influenza
A.
Results;
The two

thanh
dai
djch tren toan
the
gidi,
nhieu nude djch
da lay lan ra
cpng ddng, trong
dd cd
Vtet
Nam.
Tai
tinh
Quang Ninh tinh hinh cung diln
ra
tUPng
tu. De
phdng, chdng
dai
dich
eiim
A, ben
canh
viec nang
cao
kien thifc, thuc hanh phdng, chdng
benh
cua can bd y te,
viec trang
bj co sd vat

nay
nham
muc
tieu:
"Budc
dau
danh
gia
thUc trang
co sd
vat chat
ky
thuat chan doan
va
dieu
trj
ciim
A tai mdt
sd benh vien tuyen huyen eiia
tinh
Quang Ninh".
OOI TUONG
vA
PHUONG
PHAP
NGHIEN CLfU
1.
Ddi
tuong nghien
cufu.

Van
Don, Benh vien
da
khoa
khu
vuc Tien
Yen.
VU TH! THU
THUV
-
Bac sy va dieu dudng vien
true
tiep dieu trj
ciim
A tai 06 khoa
cOa
benh
vien:
Khoa Hdi sii'C
c^p
eifu,
Khoa Npi nhi, Khoa truyen
nhilm,
Khoa Kham benh,
Khoa Xet nghiem, Khoa Chdng nhilm khuan.
2.
Phuong phap nghien cufu.
2.1. Thiet
ke
nghien CUV

thiet
cho
viec dieu
tri
tich
cifc,
dieu
tri
benh nhan
cum.
- Thude thiet
yeu: cae
thudc dieu
trj cum
hien
tai
va thude
can
thiet
cho
dieu
tri bd trp cho
benh nhan.
- Nhan
luc
ciia
cae
khoa, phdng
ban
trong benh

chan
doan
va
dieu
tri
eiim
A.
2.3.
Xuly sd
lieu
-
Sd
lieu dupe nhap
va xuf
ly
bang SPSS
16.0
KET
QuA
vA
BAN
LUAN
1.
Thirc trang
cO sd vat
chait, nhan
lUc
phuc
vu
chan doan

ly
Hd thdng thdng
khi
Budng each
ly
nay cd budng ddm
Budng cdch ly cd nhd tam
& vd sinh ridng bidt
NhOng budng
each
ly
hoan toan
each
bidt
vdi cdc budng khac
Budng
each
ly cd didu hda khdng
khi
Budng
each
ly
nay cd
d§
ddng lam
vd
sinh/khir khuan
Nhdm
A
(n

va sd
giudng
tir
9-li2
giudng,
dl
dang
lam
v^
sinh khii khuan,
each
biet
vdi cac
budng khac, deu c6
nha
tam va nha ve
sinh
rieng biet nhung nhifng
khu
vUc each
ly va cac
phdng chUa
dat
tieu chuin
ptiii
hop
cho
cdng
tac
chan doan

khu vUc
each
ly can phai di qua nhieu khu vUc khac.
ThUe te dd cho tha'y, tuy cd khu vUc each ly nhUng
yeu cau thUc te xay ra tiii benh vien se bj dpng, lung
tuing
trong viec bd tri khu vUe each ly va khdng dap
Cmg dupe yeu eau, khdng dam bao dung dupc chirc
nang va yeu cau ciia khu vUc each ly.
Bang 2. Kha nang dap umg vdi
eiim
dai djch ciia 2
nhdm benh vien tuyen huyen
Kha nang dap Ong
Ndu cd dodi 10 b6nh nhdn cung nhap
vidn
Ndu cd to 10-50 bdnh nhdn cung nhap
vidn
Ndu cd nhidu hon 50 bdnh
nhan
cung
nhap vi6n
Nhdm A
3/3
2/3*
0/3
NhdmB
3/3
2/3'
0/3

thidt bi
Mdy thd
Hd thdng d xy trung tdm ddn
cdc
khoa
phdng
Mdy tao d xy
Binh d
xy
Monitor
theo
ddi
Mdy do bao hod d xy
Bom truydn
dich
Bom tidm
didn
Mdy chup X quang lou
ddng
Mdy sidu dm xdch
tay
Mdy sidu dm cd xe
day
Nhom A
2,6,2
2/3
2,3,8
2,13,0
4,9,2
1,7,2

hoac
binh oxy deu khdng cd
thudng xuyen tai cac phdng dieu trj cum, cd benh
vien cdn khdng cd may do dp bao hda oxy. Oac biet
nhiimg may mde nhu may chup X- quang
luu
ddng,
may sieu am xach tay, may sieu am cd xe day la
nhifng may moc hien dai, thich hpp cho viee eo ddng,
thuan tien eho viec hd trp trong chan doan va dieu trj
benh niian cum dai djch thi ed benh vien edn khdng
cd.
Nhu the, thuc trang trang thiet bj cO sd vat chat
ciia cac benh vien tuyen huyen tai
tinh
Quang Ninh
cdn thieu thdn rat nhieu, dae biet la trang thiet bi hd
trd cho viee chan doan va dieu trj
ciim
dai
djch,
va
nhu
nhau d ca 2 nhdm benh
vien.
Khdng nhufng the, khi dieu tra cac khoa can lam
sang trong viec hd trp va chan doan cum dai
djch,
chiing tdi xem xet cac
khoanhu

nhu vay
mac
dii
nhdm B cd cae khoa xet
npliiem
tren hdn han
nhdm A nhUng
thUe
te kha nang hd trp chan doan
ciia
ca 2 nhdm benh vien trong phdng chdng cum dai djch
deu nhu nhau. Ca 2 nhdm benh vien deu cd 2 benh
vien ed may X- quang va sieu am tai giudng benh.
NliU
vay, thuc trang cd sd vat chat cua cac benh vien
tuyen huyen tinti Quang Ninh cdn rat thieu
thdn,
dac
biet la viec thuc hien cac xet nghiem ho trd chan doan
eiim
dai
dich.
Ve td dpi chdng nhilm khuan cua benh
vien,
khi
dieu tra chung tdi tha'y ca 2 nhdm benh vien deu cd hdi
ddng hoac ban chdng nhilm khuan, deu cd khoa hoac
td dpi chdng nhiem khuan. Khdng nhiimg the, ca 2
benh
vien deu cd xay dung ke hoach kiem soat nhilm

luu giiif
chat thai y te ca 6 benh vien
thupc 2 nhdm deu cd, vdi noi
lifu
giiif chat thai y te,
dupe bd tri xa noi chuan bj dd an, xa Idi di chung, cd
noi luu
giOr
cha't thai y te nguy hai rieng biet, va tieu
chuan ve xuf
ly
chat thai y te deu theo quy djnh
phii
hop vdi he thdng cung cap nUdc, rufa tay chdng nhilm
ktiuan,
he thdng thoat
nUde phii
hpp. Cimg vdi dd cac
benh vien deu cd quy djnh ve quan
ly
chat thai y te,
eae
quy trinh phan
loai,
xuf
ly
chat thai y te day du.
Tuy nhien, khi kiem tra thUc dja mdt each
sau
sat va

cap dien nude cua cac benh vien thi chimg tdi nhan
tha'y da sd cac benh vien thude ca 2 nhdm deu thieu
thdn trong van de thUe hien chirc nang cua cac khoa
tren,
cae benh vien cdn thudng xuyen bj ma't
dien.
Day cung la thuc trang chung
ciia
cac benh vien
tuyen huyen khi dieu kien trang thiet bi cho cae khoa
cdn han che, trang bi chUa ddng bd hoac khdng dupc
chii
trpng.
Khi dieu tra cac thiet bj chuyen dung cho dieu trj
benh nhan
ciim
A, dac biet ia cae loai may thd da nang
ehufe nang cao, may thd xach tay, va cac loai may thd
cao cap khac cuing vdi cac loai may chuyen dung khac
dimg cho hdi sifc ca'p cufU benh nhan benh ly
phdi,
da
sd cac benh vien deu khdng cd, hoac cd it, hoac khdng
ddng bp, dae biet la he thd'ng oxy trung tam, tidm tiem
dien,
may truyen dich tU dpng, cac loai may hut, khi
dung deu khdng cd d nhdm A, hoac it hon so vdi nhdm
B,
dii
nhdm B cd mpt sd benh vien cd cac dung cu dd

cum A
Thudc dieu
tri
cum A
Tamiflu
Thudc
thiet
yeu
Nhdm A
2/3
3/3
NhdmB
2/3
3/3
Ca 2 nhdm benh vien
chi
cd 2/3 sd benh vien cd
Tamiflu,
vdi sd lupng khdng nhieu. Theo khuyen cao
cua Bd y te, Tamiflu la loai thudc cd ban nha't cho
viec phdng chdng va dieu tri
ciim
dai
djch,
la loai
thudc khdng the thieu. Cac loai
thudj;
thiet yeu trong
hdi sire cap
ciJli nhu

khoa truyen nhilm, khoa npi, khoa hdi sifc
cap
cifu dac
biet chu trpng vao cac cau hoi ve co
sd vat chat lien quan tdi chan doan va dieu trj
ciim
A, chung tdi deu nhan dUdc cau tra Idi chung
cQa
ea
2 nhdm benh vien dd la
tliUc
trang cd sd vat chat
cdn nhieu thieu
thdn,
ngudn kinh phi cdn han hep,
dac biet la ngudn nhan
lUc
cdn thieu, trong do phai
ke den ngudn nhan
lUc
cd trinh dp chuyen mdn cao,
cd trinh dp trong chan doan va dieu trj cum A. Thirc
trang nay xay ra d hau het cac benh vien tuyen
huyen trong ca nUdc.
KET LUAN
1.
Cd sd vat chat va trang thiet bj trong cac benh
vien tuyen huyen thupc 2 nhdm
ciia tinh Quarig
Ninh

dai djch cho cac
benh vien tuyen huyen
ciia tinh
Quang Ninh ndi rieng
va cac
tinh
khac trong ca nUdc ndi chung la rat can
thiet, nham tang cUdng
cO
sd vat chat ky thuat, nang
eao nang
lUc
chan doan, dieu tri va dU phdng cum dai
djch trong thdi gian tdi mdt
each
tdt hOn.
TAI
LIEU THAM
KHAO
1.
Vien Ve sinh Dich tl Trung UOng,
Tinh
hinh
cum
A/H5N1 tai Viet Nam. 2003-2005. 2005, Vien Ve sinh
Djch te Trung Udng: Ha Npi.
2.
Tran HiTu
Bich,
La Ngpc Quang, and B.V. TrUdng,

cam,
Bdnh cum gia cim vi bidn phap plidng
chong.
2005,
Ha Npi: Nha xuat ban Ndng nghiep.
6. The Academy of Education Development, Avian
Flu Baseline
Sun/ey
Backyard Poultry Farmers of
Viel
Nam. 2005, The Academy of Education Development:
Hanoi.
56
Y HOC THUC HANH (751) - SO
2/2011