You are on page 1of 388

CHNG 1: NGOI C S BI 1 VAI TR NGI IU DNG NGOI KHOA

MC TIU 1. Trnh by c s lc v lch s ngoi khoa. 2. Trnh by c nhng ph ! "inh y h#c li$n %&an 'n ngoi khoa. (. Trnh by c nhng )c i*" ngoi khoa. +. Trnh by c vai !r, c-a ng.i i& /0ng ngoi khoa.

1 !"CH S# NGOI KHOA 1i2i ph3& !h.i c4 i5 Phng php gii phu u tin c ghi li Ai Cp vo nm !" t#$c C%ng ngu&n '(C)* nh m+ ,$u c+- #ch ung nh.t/ 0ippoc#1t23 '0& 4p56"-788 (C)* c coi nh ch1 9 c:1 n;n < h.c phng (=&/ >ng cho #?ng- ,@nh tt l Ao nhBng th1& +i vt chCt t#ong c thD chE Fh%ng phi G muHn c:1 (hng IJ/ >ng cK nhi;u Kng gKp t#ong i;u t#L gM& Nng- t#t Fh$pO hi@n n1&- phng php c:1 %ng vn cPn Eng AQng t#ong ngnh chRnh hSnh/ 6 h#c !h.i !r&ng c45 (hTi FU n&- nh thT thHng t#L NM hVi/ < h.c thTi FU n& Wu1n ni@mX m+ N9 l Fh%ng cn thiJt- ngoi Fho1 ,L thoi t#iDn nghim t#.ng/ Y+ N9 chR l c%ng vi@c th: c%ng v c gi1o cho th cZt tKc- 1o ph:/ 6 h#c ngnh ph7c hng5 )gnh ngoi Fho1 cK nhBng th1& +i th2o chi;u h$ng tiJn ,V/ [i1i on n& & h.c c ph\p m+ Nc/ 6 h#c !h.i c8n i5 th]c 3] pht t#iDn t^ thJ F_ `a`/ 6 h#c ngy nay5 M v 1ng pht t#iDn v$i nhBng thnh t]u nhX tun hon ngoi c thDvi phu thut- th1& thJ tng- gh\p tng- c1n thi@p nVi 3oi- phu thut nVi 3oi///

$ N%I SOI CH&N O'N V (H)U THU*T +UA N%I SOI $ 1 N,- ./- 012- .3 415- 607 89: ;<< TCN=1><?@ bu1n 3t cc c Wu1n ,n t#ong c thD lu%n l $c m c:1 cc th& thuHc cK t#ong nhi;u thJ F_X 0ippoc#1t23 '56"-788 t#$c c%ng ngu&n* M m% t mVt AQng cQ D ,1nh t#]c t#ng '#2ct1l 3p2culum*/ 0iDn nhin- cc AQng cQ th% 3 thTi ,C& giT gcp phi t# ngi Fd thut l$n l Fh%ng cK : nh 3ng v thTng Fh%ng thD 1 3=u vo c Wu1n Wu1n 3tO Ao K- 3uHt """ nm ngnh nVi 3oi Fh%ng pht t#iDn/ $ $ N,- ./- 012- 1-A8 BC- 607 89: 1><? BD8 85E@ )m ef"e- g2lling M Ahng Finh 3oi ,ng Wu1ng D Wu1n 3t + ,Qng chK 31u Fhi ,m Fhi t#Ti vo + ,Qng/ )m efe"- j1co,2u3 '(huk IiDn* Ahng Finh 3oi ,ng Wu1ng D 3oi + ,Qng ngTi/ (#ong vPng 7" nm- 3oi + ,Qng chR nh?m mQc ich chln on chE ch1 thD phlu thut c/ )m ef77- C/m2#v2#3 'IEc* gn Ainh Wu1 nVi 3oi + ,Qng u tin t#n thJ gi$i/ )m ef76- oo23ch '(huk pd* th]c hi@n c1 on 3n u tin Wu1 nVi 3oi/ )m ef56- q2cF2# ; nghL ch.c t#oc1# v Finh 3oi Wu1 chng r 'culAo3cop&* D t#nh t1i ,iJn th:ng #uVt v ch& mu- o) phi n?m 3Cp- gHi gp ln ng]c/ )m ef65- gu#t p2mm 'IEc* chJ to #1 m& ,m Fhi t] Vng i;u chRnh p l]c v lu lng Fhi vo + ,Qng 't#$c gi1i on n& phi ,m ,?ng t1&*/ )m ef66- 0opFin3 'Anh* chJ #1 Finh 3oi Ahng h@ thHng thCu Finh hSnh Wu2 '#oA-l2n3* cho hSnh nh 3ng v 3Zc n\t/ (hng 7-efs8- You#2t 'Php* tiJn hnh cZt tti mt Wu1 3oi + ,Qng u tin t#n thJ gi$im #1 mVt F_ ngu&n m$i cho phu thut- K l phlu thut Wu1 nVi 3oi/ )Ju nh nm efs8 ti Yd ch1 cK c1 cZt tti mt nVi 3oi no c th]c hi@n thS Jn nm eff - con 3H K l s"u tCt c cc t#Tng hp m+ cZt tti mt/ (i vi@t )1m- c1 m+ cZt tti mt nVi 3oi u tin c )gu&wn (Cn CTng th]c hi@n ti o@nh vi@n Ch x& nm eff / )Ju nm eff chR cK !u c1 cZt tti mt c th]c hi@n Wu1 nVi 3oi- thS t#ong gi1i on eff7-eff!t_ l@ n& l t#n 87u/ )goi cc iDm 3yo m+ nhz- thlm md cho o)O u iDm c:1 phu thut nVi 3oi hocc phQ t# ,?ng nVi 3oi 'l1p1#o3copic { 133i3t2A 3u#g2#&* cPn l gim 31ng chCn phu thut Jn mEc tHi thiDu- nhT K gim 1u $n 31u m+- o) cK thD phQc hri nh1nh chKng v NuCt vi@n 3$m/ p1u m+ cZt #uVt th^1 hocc cZt tti mt nVi 3oi- o) cK

thD NuCt vi@n 31u m+ e-7 ng&/ Chinh &Ju tH gim thTi gi1n n?m vi@n 1 Jn gim phi t+n n?m vi@n- mVt vCn ; m cVng rng & tJ c|ng nh o) #Ct Wu1n t=m/

'httpX}}gi1ngAuong&Fho1/n2t*

Y+ nVi 3oi ng& n1&- phu thut vin nhSn Wu1 mn hSnh viA2o 'httpX}}gi1ngAuong&Fho1/n2t*

F NHGNG (H'T MINH H HIC !IN +UAN JN NGOI KHOA F 1 GKE :L = HM- .NO )g& e6-e"-es56- th& thuHc oo3ton l ~illi1m (/[ Yo#ton 'esef-es6s* t#Snh Aiwn g=& m ,?ng t2 thnh c%ng M nh ACu mHc lLch 3 gii phu/ I=& l pht minh #Ct Wu1n t#.ng t#ong ngoi Fho1 vS nK gitp cuVc m+ nhy nhng hn- o) it 1u hn t#ong phu thut/ F $ TPQER8 :SQ

j1m23 olunA2ll- ngTi Anh- t#u&;n mu ln u tin cho mVt 3n phQ vo nm eses/ )hng t#u&;n mu chR tht 3] ,Zt u t^ nm ef7"/ F F VT 0PU8V 4oui3 P13t2u# 'es7!-esf!*- ngTi Php- M tSm #1 vi t#hngO jo32ph 4i3t2# 'es 8-efe * ngTi Anh- l ngTi u tin 3 AQng phng php 3t t#hng t#ong phu thut/ F ; K1S8V .-81 Al2N1nA2# ml2ming 'esse-ef!!*- nh vi t#hng h.c ngTi pcottl1nA M tSm #1 P2nicillin2 v 31u K cK hng t#m Fhng 3inh #1 Ti/ ghng 3inh gitp #Ct nhi;u cho ngnh &- cc ,i@t cho ngnh ngoi Fho1/

; WC IXM NGOI KHOA ; 1 Y81 8V1Z5 )goi Fho1 c Lnh ngh1 nh mVt ngh@ thut v Fho1 h.c i;u t#L ,@nh thng t+n v AL Ang ,?ng phu thut v AQng cQ chu&n Ahng/ Phu thut cK 3] tng Wu1n giB1 o)- phu thut vin- Iq ngoi Fho1 v nhKm g=& m/ ; $ M[O B\O1 O]5 V-^- _1`Q 9h:n o n b;nh ch<nh = c5 ghc v$i nVi Fho1- Fhi ,c 3 cn chln on ,@nh chinh Nc thTng A]1 vo th: thut h1& phu thut- lC& ,@nh phlm gi gii phu ,@nh lG D .c FJt Wu chinh Nc/ >i& !r !i;! c?n5 )goi Fho1 thTng i;u t#L ,?ng cch cZt ,z phn ,L ,@nh/ vi AQX cZt #uVt th^1 t#ong vim #uVt th^1/ >i& !r !" !h.i5 Phu thut gitp gii Wu&Jt nhBng tZc nghn h1& D gim 1u- gim nhBng t#i@u chEng tm thTi- cK thTi gi1n n=ng c1o thD t#ng- gim tSnh t#ng nhiwm t#hng/ Th:" "@5 Phu thut gitp con ngTi chRnh 31 c thD ,Snh thTng D t# nn yp hn/ T i !o chAnh hnh5 o) c chRnh li c Wu1n ,L Fhu&Jt tt Ao AL Ang ,lm 3inh h1& Ao AL tt 31u chCn thng ,?ng chRnh hSnh gitp lp li chEc nng ,Snh thTng- o) phQc hri Fh nng hot Vng t#ong cuVc 3Hng thTng ng&/

1hBp c %&an5 o) c gh\p mVt ,V phn c:1 ngTi Fhc D th1& thJ ,V phn M mCt chEc nng c:1 mSnh/

; F aD_ b/C- _1`Q 01Qc0 C;nh ngoi khoa5 ,1o hm G ngh1 phi ,Vc lV cc tng- c Wu1n cK ,@nh tt h1& thng t+n m mZt c:1 th& thuHc nhSn thC& D i;u t#L- c th]c hi@n ,?ng phu thut v$i cc Eng AQng chu&n Ahng/ o@nh ngoi Fho1 lu%n c ph=n loi m+ tuU vo tSnh t#ng ,@nh lG- t^ng hon cnh o)tuU &u cu o) v tSnh huHng o) cn c m+ cCp cEu h1& m+ chng t#Snh/ Dh3& !h&8! cEp cF&5 phi gii Wu&Jt t#ong vPng vi giT- hocc nJu tHi Fhln thS phi gii Wu&Jt ng1& nh t#ong ch& mu Vng mch/// Dh3& !h&8! !r hoGn5 Fhi o) cK ,@nh lG cn m+ cCp cEu nhng Ao ,@nh lG cn phi chT mVt Fhong thTi gi1n D th& thuHc th2o Ai- i;u t#L- hri 3Ec- chm 3Kc t#$c Fhi phu thut/ vi AQX t#ong nhBng t#Tng hp nhiwm t#hng- o) cn c i;u t#L Fhng 3inh tich c]c t#$c Fhi tiJn hnh phu thut/ Dh3& !h&8! chng !rnh5 tuU vo ,@nh lG Fh%ng cn phu thut ng1&- tuU t^ng o) muHn phu thut ltc no/ (hTng o) ch.n ng&- giT phu thut v cK 3] chuln ,L t#$c/ o) cK thD nhp vi@n D chuln ,L t#$c m+ hocc chR nhp vi@n mVt ng& t#$c m+hocc phu thut t#ong ng& nhng tCt c ;u cK 3] chuln ,L chu o/ ; ; (1K8 de OSO 41/5 gho1 phPng ngoi Fho1 lu%n c ph=n chi1 thnh h1i FhuX Fhu ti;n phu v Fhu hu phu X - Hh& !in ph3& l ni o) n?m th2o Ai h1& chT phu thut/ )i =& thTng chR lu cc ,@nh t#$c m+- o) #Ct cn nhBng th%ng tin v; cuVc m+ 3Zp Jn- o) cn c th2o Ai tSnh t#ng Aiwn tiJn c:1 ,@nh/ - Hh& h8& ph3& l ni o) M phu thut- cK vJt thng- An lu/// ghu n& ph=n thnh Fhu 3ch v Fhu nhiwm/ YQc ich c:1 vi@c chi1 thnh nhi;u Fhu nh thJ D m ,o tSnh t#ng v% Fhuln- l=& nhiwm ch\o giB1 cc loi ,@nh v t#n hJt vn l t=m lG o) t#$c v 31u Fhi m+/

- Hh& ph,ng "4 th%ng v$i Fhu hri 3Ec hu phu ,?ng mVt hnh l1ng Fin- ,?ng phngngZn/ CK 3] FJt hp chct ch giB1 nhKm g=& m- Iq t#ong phPng m+ v nhKm hri 3Ec hu phu/ v% t#hng t#ong ngoi Fho1 lu%n c p AQng mVt cch t#i@t D/ ; ? fO B-g: 8V/C- 41/5 )goi Fho1 cK cc iDmX o) lu%n cK vJt thng Ao chCn thng- Ao gii phu- cK An lu- hu m%n nh=n to/// o) cK thD cK mCt mt c|ng nh ,iJn Ang t#n c thDX 3yoFh=u nHi- gh\p tng- on chi- mCt mVt ,V phn no K t#n c thD/// )goi #1- ngoi Fho1 lu%n Fm th2o t#u&;n mu/ qo K- hu hJt cc phu thut ;u cK chuln ,L mu t#$c m+ cho c m+ t#ung phu h1& i phu/ vCn ; t=m lG #Ct Wu1n t#.ng vS o) thTng chLu ]ng 3] mCt mt- 1u $n- ,iJn Angt1i ,iJn Ao phu thut/ )goi Fho1 lin Wu1n Jn 3] pht t#iDn c:1 m& mKc- c%ng tc Fh Fhuln- thlm md/ )goi Fho1 cPn lin Wu1n cc ,i@t Jn g=& m/ )goi Fho1 cPn cK nhi@m vQ Wu1n t#.ng l t# o) v; v$i cuVc 3Hng ,Snh thTng mEc V cho ph\p/ -

)goi Fho1 l mVt lin chu&n Fho1/ )goi Fho1 l 3] lm vi@c c:1 mVt tp thD grmX

? NHIhM V CiA NGI IU DNG NGOI KHOA thTi FU 3 Fh1i- Fh%ng cK 3] ph=n ,i@t giB1 vi@c chm 3Kc ngTi ,L ,@nh 'nu#3ing* v & h.c 'm2Aicin2*/ o) c chm 3Kc ch: &Ju ,i nhBng ngTi cK ,n nng gio Anng/ < h.c ng& n1& M pht t#iDn vt ,c v ngTi t1 ; cp Jn chm 3Kc o) ton Ai@n- chng hn nh gio AQc 3Ec Fho9- chm 3Kc 3Ec Fho9 cho gi1 Snh v cVng rng- thiJt lp 3] tin c&- cc ,i@n php D gim 3t#233/// vCn ; n& M c thu_ t+ ngnh Ii;u Anng l , mlo#2nc2 )ighting1l2- ; cp Jn t^ nm esf7 Fhi , nhCn mnh #?ng- cn phi chm 3Kc ton Ai@n o) nKi chung- chE Fh%ng chR chm 3Kc cn ,@nh/ vo thp nin 6"- chm 3Kc o) c N2m nh c%ng vi@c c:1 mVt tp thD ',c 3- i;u Anng- vt lG t#L li@u///* m mi nh chu&n m%n chR cht G Jn c%ng vi@c #ing c:1 mSnh/ Chng hn- Eng t#$c mVt ngTi ,L gM& Nng chu- ngTi i;u Anng chR cht G Jn vCn ; 1u v ,Ct Vng- lm hn chJ vn Vng c:1 o)- t#ong Fhi ,c 3 phu thut thS li cht G Jn loi phu thut v loi nyp vit 3 3 AQng/ ID FhZc phQc nhc

iDm n&- t^ thp nin f" ti cc n$c pht t#iDn- chm 3Kc 3Ec Fho9 c N2m nh mVt 3] hp tc ton Ai@n giB1 cc chu&n Fho1- t#ong K ngTi i;u Anng Kng v1i t#P Wu1n t#.ng t^ Fh=u tiJp nhn- chm 3Kc ,@nh nh=n t#ong ,@nh vi@n Jn Fh=u chm 3Kc tiJp tQc ti nh/ Ii;u K Pi hzi ngnh & tJ phi pht t#iDn ton Ai@n/ ? 1 -RQ jkl8V 8V/C- 41/5 )hn o) t^ cc Fho1- t^ cCp cEu- phPng hri 3Ec- phPng m+ chu&Dn Jn/ (#i ngoi Fho1 mi ng& ;u cK cuVc hVi chln chng v$i g=& m- phu thut vin D ch.n phng php g=& m v phu thut thich hp cho t^ng o)/ (uU th2o t^ng ,@nh vi@n- tuU t^ng Fho1 Iq 3 A] ,u+i h.p th%ng Wu1 m+ mi ng& h1& mi tun/ Iq Fho1 ngoi phi phHi hp v$i Iq phPng m+ 3Zp NJp lLch m+ v ln chng t#Snh m+/ Iq Fho1 ngoi cn cK FiJn thEc v; ,@nh- v; phng php phu thut D lm c%ng tc t tng v gio AQc cho o) t#$c m+/ ghc v$i nVi Fho1- ngTi Iq Fho1 ngoi cPn phi chuln ,L o) t#$c m+ v chm 3Kc o) 31u m+/ )Ki Jn ngoi Fho1 l nKi Jn v% Fhuln/ )gTi Iq lu%n phi cp nht FiJn thEc v; chHng nhiwm Fhuln t#ong ,@nh vi@n- lu%n phi p AQng v% t#hng ngoi Fho1 tu&@t Hi t#ong chm 3Kc o) nh chm 3Kc vJt m+An lu PhPng ng^1 nhiwm t#hng ch\o giB1 cc vJt thng t#n chng o) h1& giB1 o) n& v$i o) Fhc/ v; chm 3Kc- phQc hri o) 31u m+- Iq ngoi Fho1 cK nhi@m vQ phPng ng^1 ,iJn chEng 31u m+- vt lG t#L li@u cho o)- phQc hri vn Vng 31u m+/ qinh Anng 31u m+ c|ng #Ct Wu1n t#.ng- o) cn c cung cCp Ainh Anng nhng tuU t^ng ,@nh lG- tuU t^ng phng php phu thut m Iq 3 cung cCp Ainh Anng Wu1 t#u&;n ALch- n ,?ng mi@ng- An lu nu%i n/ Iq h$ng An- chuln ,L cho o) #1 vi@n v$i mQc tiu phPng v t#nh ,iJn chEng 31u m+- t# o) v; v$i gi1 Snh- NM hVi v$i tSnh t#ng tHt nhCt/ ? $ -RQ jkl8V _1m8V :n IJ k'! hp v ch&y*n giao 5 on gi1o giB1 Iq Fho1 ngoi v$i phPng m+ Fhi chu&Dn o) t^ Fho1 ngoi- cCp cEu NuHng phPng ti;n phu/ on gi1o giB1 Iq Fho1 hu phu v Iq phPng m+ Fhi o) phu thut hon tCt/ Kng gi CL !rMc "4. 4ng gi tSnh t#ng o) v; ACu chEng 3inh trn- t#i gic- t=m lG- t+ng t#ng o)/ `\t nghi@m ti;n phu- tn o)- phng php g=& m v chln on t#$c m+- phng php phu thut A] FiJn/ 9an !hi;p i& /0ng !rong "45 qu& t#S 3] 1n ton cho o)- AQng cQ- t thJ- nh 3ngphu t#Tng/ (h2o Ai tSnh t#ng 3inh lG o)- mch- hu&Jt p- nhi@t V/ (h]c hi@n tng

nhi@m vQ Iq c gi1o t#ong mVt cuVc m+X i;u Anng vPng t#ong v i;u Anng vPng ngoi/ 4u%n FJt hp chng g=& m v nhKm m+ th]c hi@n hon ho phu thut cho o) t#ong 3uHt thTi gi1n phu thut/ )gTi i;u Anng lu%n p AQng v% t#hng tu&@t Hi chu t#Snh phu thut/ 0iDu ,iJt v 3 AQng tng cc Aung ALch ti@t Fhuln- m& mKc- 1 AQng cQ tng Wu& t#Snh/ Phtc t#Snh li & : Aiwn tiJn v nhBng ,Ct thTng t#ong m+ vo hr 3/ Iq lu%n m ,o m%i t#Tng phPng m+ 1n ton v v% Fhuln- chCn chRnh FLp thTi nhBng 31i phm/ Inh gi tSnh t#ng o) D chuln ,L cho o) chu&Dn t^ phPng m+ 31ng phPng hri 3Ec nhX q0p(- t#i gic- ch& mu/ qi chu&Dn o) 1n ton v; phPng hri 3Ec/ on gi1o o) chng Iq phPng hri 3Ec/ 0i@n n1&- chng v$i 3] pht t#iDn Fh%ng ng^ng c:1 phu thut nVi 3oi- ngTi Iq cn cp nht FiJn thEc Fh%ng chR nh?m phQc vQ cho cuVc phu thut m cPn ,iJt cch 3 AQng v chm 3Kc m& mKc- ,iJt cch N t#i cc loi m& t#ong phPng m+ gitp cuVc m+ hon thnh tHt/ Phu thut nVi 3oi M gitp o) #Ct nhi;u nh gim 1u- thlm md hn thS Iq phPng m+ c|ng cn cH gZng hn t#ong cc t# th: phu thut nh cch 3 AQng AQng cQ t#ong cc thS phu thut/ )goi #1- Iq phPng m+ c|ng cn ,iJt cch ti@t Fhuln- ,o Wun AQng cQ nVi 3oi/ ? F -RQ jkl8V _1m8V 1M- .NO on gi1o giB1 Iq phPng m+ v Iq phPng hri 3Ec- nhn Lnh tSnh t#ng o) 31u m+X q0p(t#i gic- vJt m+- An lu- p l]c tnh mch t#ung t=m- ,@nh lG- phng php m+/// 4u%n t#1u Ari FiJn thEc chu&n m%n v Fd nng v; chm 3Kc t#ong hri 3Ec cCp cEu- 3 AQng thnh tho cc m& mKc- AQng cQ hri 3Ec- t#1u Ari FiJn thEc v; chHng nhiwm Fhuln t#ong ,@nh vi@n/ 4u%n p AQng v% t#hng ngoi Fho1 t#ong chm 3Kc/// oiJt th]c hi@n v hiDu c tc AQng phQ c:1 thuHc hri 3Ec/ oiJt nh gi o) : tiu chuln D chu&Dn o) v; Fho1 ngoi/ )goi #1ngTi i;u Anng Fho1 hri 3Ec cPn phi t#1ng ,L FiJn thEc t#ong gi1o tiJp v$i o)/ Fho1 hri 3Ec o) thTng h%n m- c ct nVi Fhi Wun- th m&O o) Fh%ng thD gi1o tiJp ,?ng lTi nKi m chR ,?ng i@u ,V v chB viJt/ )gTi i;u Anng ti Fho1 hri 3Ec vS thJ #Ct cn t#1u Ari FiJn thEc v; gi1o tiJp ,?ng c chR- i@u ,V- hiDu ,iJt t=m lG o)/

o KJT !U*N )g& n1&- ngoi Fho1 M cK nhBng ,$c tiJn ng& cng hon ho hn gitp o) 1u it hnthlm md hn- it mCt mu hn- it nhiwm t#hng hn- t_ l@ t vong gim/// IK chinh l 3] n l]c Fh%ng ng^ng c:1 ngnh & h.c/ p] n l]c n& thnh c%ng chinh l nhT 3] FJt hp hi ho giB1 phu thut vin v ngTi i;u Anng/

CpU HqI !rNG GI' e/ Phu thut cCp cEu l phu thutX 1/ [ii Wu&Jt t#ong vPng vi giT ,/ Cn cK it thTi gi1n D th2o Ai v hri 3Ec c/ o) c ch.n giT D phu thut A/ CK 3] chuln ,L chu o / v% Fhuln ngoi Fho1 lu%n c p AQng t#i@t D FhuX 1/ ChT phu thut ,/ PhPng hu phu c/ PhPng m+ A/ PhPng ti;n phu 7/ Icc iDm c:1 ,@nh ngoi Fho1X 1/ 4 ,@nh ncng- cCp cEu ,/ ChR l ,@nh chCn thng c/ o@nh Ao t1i nn gi1o th%ng A/ o) lu%n cK vJt thng 5/ )gTi i;u Anng ngoi Fho1 phiX 1/ Cp nht FiJn thEc v; chHng nhiwm Fhuln c:1 ,@nh vi@n ,/ 0iDu # t=m lG v ti;n 3 ,@nh c:1 t^ng ,@nh nh=n c/ p AQng thnh tho cc AQng cQ t#ong phPng m+ A/ Phi ,iJt gi1o tiJp ,?ng c chR- i@u ,V

!/ )goi vi@c chm 3Kc v th2o Ai o)- i;u Anng thuVc ,V phn no phi ,iJt ti@t Fhuln v ,o Wun AQng cQ nVi 3oiX 1/ PhPng hu phu ,/ PhPng hri 3Ec c/ PhPng m+ A/ PhPng ti;n phu TI !IhU THAM KHsO e/ )gu&wn ISnh 0Hi- oi ging )goi Fho1 c 3- (#i@u chEng h.c ngoi Fho1 / Ii h.c < qc/ (P/ 0r Chi Yinh ""e- )`o < h.c- t#1ng f-e / / )gu&wn (Cn CTng- Ii;u Anng )goi tp e- )h NuCt ,n [io AQc vi@t )1m- ""f- t#1ng 8-e!/ 7/ I0 < qc (P/0CY- [io t#Snh Ii;u Anng )goi/ "e"/ 4u hnh nVi ,V- t#1ng 7-!/ 5/ gim 4it1cF- P#2op2#1tiv2 p1ti2nt in Y2Aic1l 1nA pu#gic1l )u#3ing- Yo3,&{<21# ,ooFanc/ 5th eff6- t#1ng 75f-7s!/ !/ 0i#3choit oa- q2v2lopm2nt 1nA 1pplic1tion o 2nAo3cop&- [13t#o2nt2#olog&/ eff7O t#1ng 778-75 /

T15: 41^/: M,0 dt- 15E :,0 O1k38V 0P/8V :,0 uQEg8 .SO1 BkvO d-L8 0c_ 0.- tn tc gi n$c ngoi/ 'thTi gi1n NuCt ,n*/ (n ,i th1m Fho/ (n tc gi ch: ,in '3H ln ti ,n*- T$n s ch ! i b2n 'chng- t#1ng*/ )i NuCt ,nX nh NuCt ,n/ ph21- j/ q/ 'eff */ x2ligion 1nA 32Nu1l 1Au3tm2nt/ an j/ m/ pchulm1F2# 'A/*- NOligion an/ "On!al hOal!h 'pp/ 8"-s5*/ )2 <o#F- )<X No#A niv2#3it& P#233/

BI $ CHwM SxC NGI BhNH CHO'NG CHyN THNG

MC TIU 1. Trnh by c nh nghPaQ sinh lR b;nhQ phSn loi c-a cho ng chEn !hng. 2. 9h?" sTc c b;nh nhSn cho ng chEn !hng.

1 BhNH HIC 1 1 Y81 8V1Z5 Chong l t#ng thi gim t$i mu Jn cc c Wu1n An Jn h:& hoi chEc nng c:1 tJ ,o v t vong/ 1 $ (1K8 b/C1.2.1. Chong tim Chong tim l tSnh t#ng cung lng tim Fh%ng m ,o t$i mu cho m%/ )gu&n nh=n cK thD Ao ,@nh lG c tim- t#n mu mng ngoi tim- nhri mu c tim- #Hi lon nhLp tim- 3u& tim E hu&Jt ncng 1.2.2. Chong thn kinh (hTng 31u chCn thng cVt 3Hng- chCn thng 3. nMo- Ao g=& t tu_ 3Hng- g=& m t+ng Wut 3=u- Ec chJ t#ung t=m vn mch 'Ao 1u AB AVi- nghi@n thuHc- h Tng hu&Jt- cng thng Ao Ntc cm*/ 1.2.3. Chong vn mch [iHng nh chong thn Finh nhng Fhc hn c chJ g=& #1/ IK l v1i t#P Wu1n t#.ng c:1 cc chCt t#ung gi1n vn mch nVi h1& ngoi 3inh t#ong 3] pht t#iDn c:1 chong vn mch thTng gcp t#ong chong nhiwm t#hng- chong phn v@ Ao thuHc- thEc n- c%n t#hng cZn- t#u&;n mu- ch:ng ng^1/ 1.2.4. Chong gim th tch

4 Ao tSnh t#ng mCt thD tich ALch t#ong mch mu/ qo mCt ALch ,n ngoi 'gim thD tich ALch tht 3]* h1& Ao ALch chu&Dn t^ Fho1ng mch t$i Fho1ng tJ ,o 'lin Wu1n Jn gim thD tich ALch*/ 0u Wu c:1 mCt ALch l gim mu t# v; tim- gim thD tich ALch- gim tHng mu tim- 3u& gim tun hon- gim t$i mu m%/ qLch mCt i cK thD l mupl13m1- n$c- i@n gii/ 0u hJt ngu&n nh=n mCt ALch ,n ngoi l Ao ch& mu/

0u Wu c:1 chong Ao mCt mu tuU vo 3] p Eng c:1 c chJ ,h t#^ c:1 mi ngTi/ YVt c thD Fho9 mnh c:1 ngTi l$n cK thD ,h t#^ ng1& Fhi mCt Fhong e"u mu c:1 ton c thD- nhng nJu mCt mu Fhong "- !u thS c chJ ,h t#^ thCt ,i/ pH lng mu mCt i cK thD Ao chCn thng 'nh vn g1n- vn lch*- Ao ,@nh lG 'nh ch& mu Ao lo\t A A& t t#ng- vn phSnh Vng mch ch:///*- mCt ALch nh t#ong n%n Ki- tiu ch&- #P ALch///

1.2.5. Chong chn thng 4 tSnh t#ng mCt mu 31u chCn thng- c|ng thuVc mVt phn c:1 chong gim thD tich Ao mCt mu- chong thn Finh Ao 1u/ 1 F S-81 bz dA81 p1u chCn thng- chong gim thD tich cK thD N& #1O mCt ALch c thD lm gim ALch lu hnh t#ong lPng mch- 1 Jn gim c chJ ,h t#^ t$i mu cho m% v$i cc p Eng v;X LUi !i'!5 (hD tich lPng mch gim lm gim cung lng tim An Jn p Eng gi1o cm thng thn v t^ =& phPng thich c1t2chol1min2/ ChCt n& g=& co mch ngoi ,in gitp Au& t#S hu&Jt p- gitp tHng mu nu%i nMo v tim t#ong thTi gi1n ngZn/ Ti"5 qo tc AQng cTng gi1o cm- 3Ec co ,Kp c tim v nhLp tim 3 tng nh1nh ng1& Fhi cK mCt ALch ng FD/ (u& nhin- Fhi chong hSnh thnh v F\o Ai t$i mu c tim 3 ,L nh hng/ LGo5 4u lng mu nMo cK gim 3tt Fhi mCt t#n "u thD tich mu c thD/ (hiJu mu N& #1 Fhi hu&Jt p t=m thu !" mm0g Dh4i5 gh%ng cK nh hng nhi;u Jn 3] t#1o +i Fhi/ 1an5 t ,iDu hi@n #/ Th8n5 Ip Eng c:1 thn v$i chong gim thD tich l t#m t#.ng/ IV l.c vi cu thn gim Ao mu t$i thn- ti ph=n ,H APng mu v; tu_ nhi;u hn l v; vz thn/ (c AQng c:1

1ngiot2n3in- 1lAo3t2#on2 nh?m gi1 tng ti hCp thu n$c v muHi gitp ,h t#^ 3] gim thD tich/ N&U!5 (hiJu oN& g=& thiJu mu nim mc 1 Jn #Hi lon chEc nng hng #o nim mc #uVt/ (i t$i mu 31u hri 3Ec 1 Jn tich tQ cc chCt oN& ho lm thng t+n tJ ,o- tinh thlm thCu nim mc #uVt gi1 tng v vi Fhuln Tng #uVt- nVi Vc tH chu&Dn ALch Wu1 thnh #uVt vo mu An Jn nhiwm t#hng hu&Jt/ 1 ; Re- b/C8 O1QEg8 1{5 8k|O }t B-A8 V-^1.4.1. Ri lon ch !n ho n"c# YVt 3H t#Tng hp mCt n$cX VE! nMc /o "W hXi5 phQ thuVc vo thTi tiJt- i;u Fi@n l1o Vng- cTng V l1o Vng/// Yr h%i cK tinh nhc t#ng- t#ong nhBng t#Tng hp cc ,i@t nh l1o Vng ncng t#ong i;u Fi@n nKng- V lm c1o v it th%ng Fhi///- mr h%i cK thD mCt 7 - 5 lit}giT/ p] ,h Zp n$c t#ong mCt mr h%i thTng Aw Ang ,?ng Tng uHng- mCt t^ ! lit t# ln phi ,h thm Aung ALch )1Cl fu/ (#n l=m 3ng 3 thC& o) cK nhBng ,iDu hi@n m ,n chCt l Ao tSnh t#ng gi1n ,o nhc t#ng An Jn n$c vo tJ ,o g=& #ri lon chu&Dn ho- t+n thng tJ ,oX m1u m@t mzi- vM mr h%i- uD oi- nhEc u- ,urn n%n- tim p nh1nh- lt ln/// VE! nMc /o sY!5 ghi 3Ht- th=n nhi@t tng- chu&Dn ho cc chCt tng- nhu cu oN& tnglng C cn o thi c|ng tng/ (#ong 3Ht mCt n$c ch: &Ju l Tng h% hCp- 31u l mr h%i/// g=& nn tSnh t#ng mCt n$c u t#ng/ VE! nMc /o nXn5 )%n nhi;u g=& mCt n$c- g=& #Hi lon hu&Jt Vng- lm gim hu&Jt p 'FhHi lng tun hon gim*- mu c% cc- mu Wu1 thn gim 'nJu ncng cK thD An Jn 3u& thn*- cuHi chng An Jn tSnh t#ng nhiwm Vc- nhiwm to1n nJu Fh%ng N lG FLp thTi/ VE! nMc /o !h8n5 gcp t#ong i tho nht/// VE! nMc /o !i$& ch2y5 (iu ch& lm cho o) mCt n$c Fm #Hi lon i@n gii/

1 ; $ Ri lon $i%n gii 1.+.2.1. 9Sn bZng La[ Yi ng& c thD cn Fhong !-e"g )1Cl 'ngTi l$n*/ )1t#i cK v1i t#P Wu1n t#.ng t#ong c=n ,?ng thlm thCu/ )1t#i chLu 3] nh hng c:1 ho#mon2 thng thn/

1i2" La!ri h&y'! !ng5 thTng g=& nhc t#ng gi1n ,o- n$c vo tJ ,o- gim A] t#B Fi;m- gim FhHi lng mu- gim hu&Jt p- cK thD An Jn t#Q& tim mch- thiDu ni@u3u& thn/// )cng cK thD g=& phh nMo- vn hrng cu/

T?ng La!ri h&y'! !ng5 it thC&- thTng N& #1 v$i nhBng ,@nh nVi tiJt nh ,@nh Cu3hing- tim nhi;u AC(0- co#ticoiA- n nhi;u muHi n1t#i/// 0u Wu l giB n$c- phhtng hu&Jt p m c chJ l Ao phrng nVi mc lm hyp lPng mch v tng hot tinh c:1 c1t1chol1min- cPn cK thD g=& mCt n$c tJ ,o/

1.+.2.2. 9Sn bZng Hali \H] g1li l ion ch: &Ju ,n t#ong tJ ,o- nhng ,n ngoi tJ ,o nK c|ng giB mVt v1i t#P Wu1n t#.ng t#ong vi@c Au& t#S tinh chLu Fich thich c:1 3i c- nhCt l c tim/ Yi ng& c thD cn Fhong 5-!g g1li 'ngTi l$n*/ 1i2" Hali h&y'! !ng5 cK thD Ao n thiJu- Ao mCt th2o cc ALch- Ahng thuHc tl& #uVt F\o Ai- Ahng nhi;u thuHc li tiDu/ g1li cK thD ,L F\o #1 Fhzi tJ ,o- nh hng Jn co ,Kp c 'm@t mzi*- tim p &Ju/// 0u Wu lX nJu g1li gim 7-! mW 3 3inh mzi c&Ju c- gim nhu Vng #uVt- cK thD li@t #uVt- gim hu&Jt p t=m t#ng- tim nh1nh 'ng]1 phi*- F\o Ai 3Kng b( v h thCp ,in V (/ T?ng Hali h&y'! !ng5 Ao n- uHng Wu nhi;u muHi g O 3 g=& #1 3u& thn ncng- hu_ hoi tJ ,o/// 0u Wu #Ct ngu& hiDmX tim chm- #ung thCt- 3Kng ( c1o v nh.n- 3Kng bxp F\o Ai- cK thD ng^ng tim/// 1.+.2.(. 9Sn bZng 9alci \9a] 1i2" 9an=i h&y'! !ng5 gcp t#ong 3u& tu&Jn cn gip t#ng- thiJu vit1min q- F\m hCp thu #uVt/ 0u Wu g=& co git t] pht- ncng cK thD ng^ng h% hCp- gim nhy v F\o Ai cK thD g=& cPi Nng- # Nng/// T?ng 9an=i h&y'! !ng5 Ao cTng tu&Jn cn gip- hocc t#ong nhiwm to1n 'hu& Vng nhi;u t^ Nng #1*- g=& gim An t#u&;n thn Finh c/ 1.+.2.+. 9Sn bZng 9lo \9l] Clo cK v1i t#P t#ong i;u FhiDn c=n ,?ng 1ciA- ,132 Fhi c thD nhiwm to1n- Clo vo hrng cu hocc thi #1 A A&X - (h^1 Clo 3 lm to1n ALch vL- g=& n%n/

- (hiJu Clo g=& gim to1n ALch vL- g=& FhK tiu/

$ +UH TR~NH CHwM SxC $ 1 N1c8 BY81 081 0PC8V BN 2.1.1. &' ki%n ch( ) *n 0zi o) nhBng th%ng tin Wu1n t#.ng v; 3Ec Fho9X (i;n 3 3Ec Fho9X nhri mu c tim- tZc mch ph+i- nhiwm t#hng- chCn thng cVt 3Hngch& mu- chCn thng- ,zng- tiDu Tng- mCt n$c- 3u& tim E hu&Jt- 3u& v1n tim- vim tQ& cCp- tZc #uVt- phn Eng ncng n; Ao c%n t#hng cZn/ (huHcX phn Eng Wu mn v$i thuHc- thuHc ch:ng ng^1- g=& m- Wu mn v$i thuHc/ Phu thut v nhBng i;u t#L FhcX phu thut l$n- lin Wu1n Jn mCt mu/ ChCn thng g=& mCt mu- vL t#i t+n thng v 3H lng mu mCt/ Chu&Dn ho Ainh AnngX Ki- n%n Ki- ,urn n%n- chEng m; =& v ngE1 't#ong chong ,o v@*- tot mr h%i- lnh #un/ oi tiJtX n$c tiDu gim/ 0ot VngX &Ju- chKng mct- 3] Fich Vng- m@t- hri hVp- 1u ng]c- FhK th- cK ho h1& Fh%ng ho/ 2.1.2. &' li% khch ) *n (hm o) v;X (hn FinhX Fhi u Fich Vng- lo lZngO 31u K th1& +i t=m thn- ng: g- thn thT- m/ (un honX nhLp tim nh1nh- hu&Jt p gim- nht nht- mch chR- tiJng tim ,Ct thTngmch c+ phng- #Hi lon nhLp tim/ q1X ti- lnh- lm- n+i A1 g 'nhiwm t#hng h1& chong phn v@*- tim ti- ; 1&- n+i mln/ (iJt ni@uX n$c tiDu gim- v% ni@u/ 0% hCpX th nh1nh- FhP Fh- #1n n+- mCt tiJng th- nghyt th- ho/ (iu hoX Ki- tng h1& gim nhu Vng #uVt/ (+ng WutX nhi@t V ,Snh thTng- tng 'nhiwm t#hng*- gim///

qCu hi@u Ang tinh FhcX #Hi lon n$c v i@n gii- 02moglo,in v 02m1toc#it gimthiJu mu- gim C tng ,ch cu- gim oN&- Fi;m h% hCp v to1n chu&Dn ho 1ciAo) tng- m2n g1n tng- mEc V l1ct1t2 tng- cK vJt thng- mu- cC& ALch c thD- `bu1ng ng]c v o i@n tim ,Ct thTng/

$ $ C18 B/S8 }t O58 01-A_ B-RQ jkl8V 2.2.1. +h,ng ng-* chong Ii;u Wu1n t#.ng nhCt c:1 Iq l phPng ng^1 chong N& #1/ vS thJ- t#$c tin Iq phi nhn ,iJt o) no cK ngu& c chong c1o nhCt/ )gTi gi- ngTi t#9- ngTi cK ,@nh mn tinh- ,@nh 3u& nhc l nhBng ngTi cK ngu& c c1o nhCt/ v$i o) 31u phu thut31u chCn thng thS cK ngu& c c1o nhCt Fhi ngu&n nh=n l Ao ch& mu- chCn thng cVt 3Hng- ,zng- AL Eng thuHc- AL Eng t%m- cu1- 3P hJnO Wu mn thuHc- c%n t#hng cZn-/// C1n thi@p Iq l Nc Lnh nhBng c nh=n Aw Ntc cm- nhn Lnh Wu1 th2o Ai v pht hi@n 3$m nhBng th1& +i ,Ct thTng t#n o)/ Iq cn chln on tng- c1n thi@p thich hp v lng gi nhBng hnh Vng cn th]c hi@n/ 0u hJt nhBng o) 1u thZt ng]c h1& nhri mu c tim thTng phi Ahng thuHc D c1n thi@p FLp thTi/ 0nh Vng n& gitp gi1 tng t$i mu c tim v lm gim hot Vng c:1 tim Wu1X nghR ngi- thuHc- li@u php chHng %ng/// (h2o Ai cln thn c=n ,?ng ALch t#ong c thD c|ng ngn ng^1 chong gim thD tich/ (h2o Ai n$c NuCt nhp- c=n ncng mi ng&- An lu t^ vJt thng/// Pht hi@n ch& mu 3$m v FiDm 3ot ch& mu ng1&/ (h2o Ai ACu hi@u nhiwm t#hng- th2o Ai nhi@t V/ (h]c hi@n ng1& Tng t#u&;n cung cCp ALch tHt l #Ct Wu1n t#.ng/ (#ong Fhi chm 3Kc vi@c ngn ng^1 nhiwm t#hng nh #1 t1& t#$c v 31u Fhi chm 3Kc o) l th]c 3] cn thiJt/ ID ngn ng^1 chong phn v@ nn hzi o) cln thn v; ti;n 3 AL Eng thuHc- nhCt l Fhng 3inh h1& thEc n/// (#$c Fhi t#u&;n mu nn hzi o) v; ti;n 3 t#u&;n mu v AL Eng- nhKm mu- xh23u3/ Cn FiDm t#1 Fd t#$c Fhi t#u&;n mu- nn cK mu/ 2.2.2. ./ th*! $0i c(* thn1 n2o1 tim 3h0i1 t"i m ngoi 4i5n Iq FiDm t#1 v$i nh1u t#$c Fhi t#u&;n mu l tHt nhCt v tiJp tQc th2o Ai cln thn t#ong v 31u t#u&;n

4ng gi ACu hi@u v t#i@u chEng 3] th1& +i t$i mu m% 5 A1 lnh- tim ti- mch &Ju- th1& +i t=m thn- nhLp tim nh1nh- n$c tiDu gim- Ki/ 9an !hi;p5 Cho o) n?m u ,?ng h1& t thJ thng- t thJ ch=n c1o e! "-7"" 3o v$i m]c tim 3 gitp mu v; tim tHt/ qo co mch mu v; nVi tng- Ao c chJ ,h t#^- #Hi lon gi1o cm nn o) Aw ,L lnhO vS thJ Iq lu%n giB Cm o) ,?ng Fhn m;m/ Inh gi n$c NuCt nhp nh th2o Ai ACu hi@u mCt n$c Wun o- ,.c t- o lng n$c vo v #1 mi e- giT tuU vo tSnh t#ng o)- tuU th2o & l@nh- nn th2o Ai Wu1 p l]c tnh mch t#ung t=m 'CvP*- Wu1 lng n$c tiDu mi giT 'n$c tiDu ,Snh thTng "-!-e ml}giT}Fg c=n ncng*/ (hTng Fhi n$c tiDu it hn s"" ml} 5 giT g.i l thiDu ni@uv it hn "" ml} 5 giT g.i l v% ni@u/ v$i o) 1ng chong Iq nn ct th%ng tiDu lu D th2o Ai n$c tiDu mi giT nhng phi p AQng tng Fd thut v% Fhuln- 1n ton D t#nh ngu& c nhiwm t#hng tiDu/ ghi nhn Lnh cc ACu hi@u mCt n$c v #Hi lon i@n gii h1& thiJu mu t#n l=m 3ng- Iq th]c hi@n & l@nh c=n ,?ng n$c v i@n gii Wu1 tnh mchX mu ton phn- pl13m1- ALch t#u&;n/// (#ong gi1i on n& vCn ; Ainh Anng c|ng #Ct Wu1n t#.ng- nhng thTng t#ong gi1i on cCp vi@c n uHng tm A^ng li/ ghi tSnh t#ng o) tng Hi +n Lnh hn thS vi@c cho n nn th]c hi@n nhz gi.t Wu1 Hng 42vin2- Fh%ng nn cho n Wu1 mi@ng/ IVng tc nh1i h1& cng ch$ng A A& Ao thEc n lm gi1 tng nhLp tim vHn M m@t mzi nhi;u/ (hEc n nhz gi.t v^1 gitp A A& hCp thu t^ t^ thEc n nh?m cung cCp nng lng cn thiJt cho c thD- v^1 t#nh tSnh t#ng n%n Ki h1& nuHt FhK Ao o) 1ng t thJ n?m u thCp/ giDm t#1 q0p( mi e- giT/ (hTi gi1n th2o Ai tuU thuVc vo tSnh t#ng o) v & l@nh c:1 ,c 3O nhng o) lu%n n?m t#ong tm nhSn i;u Anng/ )Ju o) chong Ao mCt mu v cK t#u&;n mu thS Iq cn th2o Ai 3t cc ACu hi@u ch& mu Wu1 vJt thng- NuCt hu&Jt nVi/// Ao Fhi t#u&;n mu 3H lng nhi;u o) cK ngu& c #Hi lon %ng mu Ao chCt Fhng %ng t^ nhBng tti mu/ )Ju l vJt thng ,n ngoi thS th]c hi@n ,ng \p- th2o Ai q0p( v ,o ng1& cho op N t#i/

2.2.3. 6im tng m t- tim 7 gim th tch 89ch 4ng gi ACu hi@u v t#i@u chEng c:1 gim tHng mu tim 5 m@t- A1 ti- thiDu ni@u- tiDu ithu&Jt p gim- mch nh1nh- ACu thiJu mu/ 9an !hi;p5 o) n?m t#n giTng- nghR ngi hon ton gitp ,o trn nng lng v D gim nhu cu oN&- gitp Au& t#S ,iJn Anng cn thiJt/ (h2o Ai chR 3H hu&Jt Vng h.c D nh gi tSnh t#ng l=m 3ng c:1 o) v p Eng i;u t#LX p l]c mu- p l]c Vng mch- p l]c Vng mch ph+i/ (h2o Ai cc ACu hi@u 3Hng Wu1 monito#- nn ci chJ V ,o Vng t#n m&/ )Ju cK ,Ct FS ACu hi@u m& ,o ,Ct thTng no Iq ;u phi Fhm li o) v nhn Lnh ng1& D c1n thi@p FLp thTi/ [iB Cm o) D gitp o) thoi mi- gim lo lZng hn/ p] cK mct thTng Nu&n c:1 ngTi Iq gitp cho o) 1n t=m- gim lo lZng/ Ip Eng thuHc c:1 timX Iq cn hiDu tc AQng chinh v phQ c:1 thuHc v; tim D ; #1 FJ hoch chm 3Kc thich hp c|ng nh th2o Ai tc AQng c:1 thuHc nh?m ,o ,c 3 FLp thTi i;u chRnh thuHc hp lG/ 4p FJ hoch chm 3Kc ngn ng^1 o) m@t- tng nhu cu oN& nh th oN& th2o & l@nh- nghR ngi- n nhz gi.t Wu1 Hng th%ng A A&/ 4u GX t#nh D ,Snh thEc n Wu c1otng p l]c APng ch&/ Chm 3Kc o) cCp aX Io n$c NuCt nhp mi giT- ghi # t+ng lng n$c NuCt nhp chinh Nc vo ,ng th2o Ai v vo hr 3 t#ong 5 giT/ (h2o Ai mCt n$c v #Hi lon i@n gii t#n l=m 3ng e- giT}ln- th]c hi@n & l@nh N\t nghi@m o)- c#21tinin- aon r/ (h]c hi@n cung cCp n$c v i@n gii cho o) lu%n chinh Nc th2o 3H lng- 3H gi.t v tng thTi gi1n th2o & l@nh- nn 3 AQng Fim lurn cK 7 chi1 D cK thD t#u&;n Aung ALch FJt hp/

qCu v\o A1 Ang tinh 'httpX}}gi1ngAuong&Fho1/n2t*

2.2.4. 6im t:*o $0i kh Kng gi 5 p l]c mu Vng mch- nrng V oN& mu ngoi ,in/ 9an !hi;p5 cung cCp : oN& cho o) Wu1X m13F- c1nul2- m& th- l;u oN&/// )gh2 ph+i mi giT gitp pht hi@n nhBng ,Ct thTng nh nghyt m- nhCt l ngTi gi t#ong gi1i on n& giB1 th^1 n$c v thiJu n$c #Ct gn nh1u nn ngh2 ph+i 3 gitp pht hi@n phh ph+i cCp/ (h2o Ai 3u& gim oN&X nhLp th nh1nh hn- th cH gZng- mu A1 tim- th co F\o lin 3Tn- cnh m|i php phrng- ACu n hri m1o mch gim/ ghi nhn Lnh cK cc ACu hi@u t#n- Iq cn chuln ,L AQng cQ h t# D ,c 3 ct nVi Fhi Wun v th]c hi@n t# gitp th cho o) ng1&/ Chuln ,L nVi Fhi Wun v t# gitp th th2o & l@nh/ 2.2.5. ;g<n ng-* chn thng An ton cho o) Fhi n?m- Ai chu&Dn/ qo t#i gic F\m- Ao thiJu oN& nMo t#ong gi1i on chong nn o) thTng ,L Fich thich- ,Et #Et nn Aw cK ngu& c ngM Fhzi giTng/ )gTi Iq phi lu%n lu%n F\o chCn 3ong thnh giTng ln c1o/ )n cK @m lKt tHt v chm lKt tHt thnh giTng t#nh t+n thng cho o) Ao v1 chm vo thnh giTng/ 2.2.=. ;g<n ng-* t0n thng 8* Chm 3Kc A1- l1u Fh% Fhi o) tot mr h%i/ `o1& t# o) mi e- giT t#ong i;u Fi@n cho ph\p/ (#nh ; cCn Ao AQng cQ- nJp gCp c:1 vi t#i giTng/

(h2o Ai v phPng chHng lo\tX Fh%ng D o) lm $t- l1u Fh% A1 ng1&- m1331g2 vhng Aw ,L cCn/

2.2.>. ?h*! $0i 8inh 8@ng Cho n nhz gi.t Wu1 Hng 42vin2- m ,o : nng lng cn thiJt cho o)/ ghi n nn cho o) n?m u c1o 7""- Fh%ng ct u Wu c1o/ (h2o Ai tSnh t#ng ,Qng o)- t#nh cng ch$ng A A&/ (h2o Ai ACu hi@u mCt n$c cho o)/ (#ong t#Tng hp o) 1ng Aiwn tiJn ncng thS Fh%ng nn cho n- chR cho n Fhi cK & l@nh h1& Fhi o) +n Lnh/ 2.2.A. ?Bm lC D; 4u%n gii thich th: tQc v phng php t#$c Fhi tiJn hnh Fd thut chm 3Kc gitp o) Fh%ng lo lZng/ Im ,o o) 1n ton nhCt- m%i t#Tng &n lcng- thoi mi- t#nh 1u Fhi No1& t# v th]c hi@n th: thut/ qhng thuHc gim 1u nJu cK & l@nh t#$c Fhi chm 3Kc/ Cho ph\p o) tiJp Ntc v$i gi1 Snh i;u Fi@n cho ph\p/ Cung cCp phng ti@n gi1o tiJp nJu o) Fh%ng nKi c/ bun lG thuHc m2n- gitp o) t thJ gim 1u/ Iq lu%n cK mct ,n cnh o) gitp h. 1n t=m- t#nh tSnh t#ng cng thng- lo lZng/ 2.2.1E. & ! t:F tFnh t:ng vG t:Hng (h]c hi@n Fhng 3inh th2o & l@nhX Wu1 tim t#u&;n- Wu1 ,m tim/ v@ 3inh Nung Wu1nh- v@ 3inh m%i t#Tng v cch l& v$i cc ,@nh nhiwm t#hng Fhc/ (h]c hi@n tng Fd thut Fhi chm 3Kc o)- p AQng Fd thut v% Fhuln v$i cc th: thut/ x1 t1& t#$c v 31u Fhi chm 3Kc/ 2.2.11. ?h*! $0i nhi%t $I c th vJ 8* q1 o) cK thD tim ti- nht nht/ o) cK thD ,L lnh- t#ong t#Tng hp n& Iq cn giB Cm cho o) v giB nhi@t V m%i t#Tng Cm/ )Ju o) cK nhi@t V 7s-6 "C thS Iq nn Zp mt v cho o) thuHc h 3Ht/ vS nhi@t V c1o h1& thCp c|ng g=& ngu& c thiJu oN& c:1 o)/

CpU HqI !rNG GI'

e/ ghi chong gim thD tich N& #1- c Wu1n no t#ong c thD 3 p Eng t#m t#.ng nhCtX 1/ (im ,/ (hn c/ )Mo A/ [1n / ghi o) 1ng #i vo chong- Iq cn chm 3KcX 1/ Cho o) n?m t thJ mol2# ,/ Cho o) n?m u ,?ng ch=n c1o e!"-7"" c/ gh%ng c Zp chn cho o) A/ Cho o) uHng n$c Tng 7/ ghi chm 3Kc o) chong- Iq cn lu G vCn ; gSX 1/ (h]c hi@n Fhng 3inh thTng Nu&n ,/ ChR cho o) n Wu1 tu,2 42vin2 c/ [iB m%i t#Tng &n lcng A/ Cho th=n nh=n vo ,n cnh o) 5/ Chong vn mch thTng gcp t#ongX 1/ Chong nhiwm t#hng ,/ Chong tim c/ Chong gim thD tich A/ Chong chCn thng !/ ID ngn ng^1 chong phn v@- Iq cn hzi o) cln thn v;X 1/ (i;n 3 ,@nh mMn tinh ,/ (i;n 3 AL Eng thuHc c/ (i;n 3 ,@nh ngoi Fho1 A/ [i1 Snh cK 1i ,@nh tng t]

TI !IhU THAM KHsO

e/ ohi vn )inh- oi ging ,@nh h.c ngoi Fho1- Ii h.c < qc (P0CY- )h NuCt ,n < h.c ""e- 66-s5/ / )gu&wn (Cn CTng- Ii;u Anng ngoi tp e- )h NuCt ,n [io AQc vi@t )1m- ""f- e8- !/ 7/ Ii h.c < qc (P0CY- [io t#Snh Ii;u Anng ngoi- lu hnh nVi ,V- "e"- 6-ee/ 5/ juAith j/ o1##o3/ IhockQ in VO/ical I&rgical L&rsing - Yo3,&{<21# ,ooF- anc- 5th 2A/pt/ 4oui3{ Yi33ou#i- eff6- ee8-e5e/

BI F

NHIM TRNG NGOI KHOA V CHwM SxC

MC TIU 1. Trnh by c nh nghPa nhi^" !r_ng ngoi khoa. 2. Trnh by c /i^n bi'n c-a c c nhi^" !r_ng ngoi khoa. (. 9h?" sTc c loi !hng !4n !h.ng g)p.

1 "NH NGHA t#hng*/ )hiwm t#hng ngoi Fho1 l ,iJn chEng thTng N& #1 31u chCn thng Fin- vJt thng hocc 31u Fhi phu thut/ ghc v$i nhiwm t#hng nVi Fho1- =& thTng cK mVt + thun li cho nhiwm t#hngX mVt phn c thD ,L gip nt- cc t+ chEc hoi t- vJt m+ nhiwm t#hng thE pht/// thTng Pi hzi phi c1n thi@p ngoi Fho1 D gii thot m: hocc loi ,z m% hoi tO cPn nhiwm t#hng nVi Fho1 thTng Fh%ng cK hocc cK #Ct it m% hoi t nhng li cK ,iDu hi@n ton th=n nhi;u hn/ )hiwm t#hng l 3] N=m nhp c:1 vi 3inh vt vo c thD v 3] p Eng c:1 c thD Hi v$i thng t+n Ao vi 3inh vt g=& nn 'cK thD l vi Fhuln- 3iu vi Fhuln hocc FG 3inh

$ DIN BIJN CiA M%T NHIM TRNG NGOI KHOA o@nh cnh c:1 mVt nhiwm t#hng ngoi Fho1 #Ct Fhc nh1u tuU thuVc vo cc iDm c:1 vi 3inh vt- ngu&n nh=n g=& #1- 3Ec ; Fhng c:1 c thD o)/ vi AQX Clo3t#iAium t2t1ni2 'g=& ,@nh uHn vn* 3inh 3%i t#ong m% c thD o)- g=& #Ct it hocc Fh%ng cK phn Eng ti ch nhBng li tiJt #1 mVt ngoi Vc tH '2NotoNin* #Ct mnh tc Vng ln tJ ,o thn Finh N1 + nhiwm t#hngO hocc p1lmon2ll1 t&phi 'g=& 3Ht thng hn* 3inh 3%i t#ong mu c:1 o) v g=& #1 t#i@u chEng ton th=nO pt#2ptococcu3 'lin cu Fhuln* Wu1 vJt thng A1 #Ct nhz nh mVt vJt N=& Nt hocc ch p g1i- thTng N=m nhp vo h@ thHng ,ch mch g=& vim ,ch mch cCp tinh- vim hch ,ch hu&Jt cCp tinh hocc vim tC& l1n tz1/

)hiwm t#hng ngoi Fho1 thTng Aiwn ,iJn Wu1 5 thTi FUX Th.i k` n&ng b;nh5 l thTi gi1n t^ ltc vi Fhuln N=m nhp vo c thD Jn Fhi ,Zt u cK t#i@u chEng l=m 3n Th.i k` khai b&X v$i nhBng t#i@u chEng 3$m nh 1u nhEc- 3Ht- z/ Th.i k` !on ph !5 )hiwm t#hng NuCt hi@n v$i & : t#i@u chEng chinh/ (#ong thTi FU n& + nhiwm t#hng Fhu t#tX p-N2 nKng v vim tC& l1n tz1/ + nhiwm t#hng Ai chu&DnX vim ,ch mch cCp tinh- vim hch ,ch hu&Jt cCp tinh/ + )hiwm t#hng ton th=nX nhiwm Fhuln hu&Jt '32ptic2mi2*- nhiwm Fhuln m: hu&Jt '32ptico-p&oh2mi2* v$i nhBng + m: #i #c v Lnh c cc c Wu1n nVi tng/ Th.i k` /i^n bi'n v k'! !hcc5 Aiwn #1 th2o mVt t#ong 7 Fh nngX qiwn ,iJn tHtX )hiwm t#hng c gii Wu&Jt nhng c thD o) 3u& 3Qp v cK Fh nng nhiwm t#hng ti pht 'vi AQX nh.t m%ng*/ C thD c miwn nhiwm 'nh t#ong ,@nh uHn vn* hocc t#ong tSnh t#ng AL Eng 'Ao ,L cm Eng ,i vi Fhuln*/ qiwn ,iJn NCuX CK nhi;u ,iJn chEng ncng nh nhiwm Fhuln hu&Jt- nhiwm Fhuln m: hu&Jt/// cK thD An Jn t vong/

F C'C TN THNG THNG GW( F 1 '_ 8{8V 3.1.1. K9nh nghL* p N2 nKng l mVt + Fhu t#t th2o 31u mVt vim nhiwm cCp tinh- nh 31u mVt chCn thng ,L nhiwm t#hng- mQn nh.t- vJt m+ nhiwm t#hng hocc mVt vim tC&/ 3.1.2. ;g !5n nhBn p N2 nKng c to #1 ,i 3] N=m nhp A$i A1 c:1 nhBng vi Fhuln lm m: nh tQ cu Fhuln 'pt1ph&lococu3 2piA2#miAi3* hocc tQ cu Fhuln vng 'pt1ph&lococcu3 1u#2u3*- lin cu Fhuln/ (#ong K- tQ cu Fhuln vng l h1& gcp nhCt/ 0iJm hn nh phJ cu- lu cu- t#]c Fhuln Coli- vi Fhuln Fk Fhi 'vi Fhuln &Jm Fhi*/

p N2 nKng 'httpX}}gi1ngAuong&Fho1/n2t*

3.1.3. ?:i% chMng lBm NJng p N2 nKng tiJn t#iDn Wu1 gi1i onX

1iai on lan !da5 1u nhEc- ,uHt mVt vhng c thD/ CK ACu hi@u nhiwm t#hng ton th=n nh 3Ht c1o- $n lnh- uD oi- nhEc u/// ghm cK 5 t#i@u chEng c ,nX ghHi u hocc vhng 3ng cEng t#ung t=m v Kng ,nh vi;n ngoi- 3T ng1& FhHi u thC& nKng/ o; mct FhHi u z 3o v$i A1 Nung Wu1nh/ n ng1& FhHi u #Ct 1u/ ghi Iq thm Fhm v hzi ,@nh cK thD pht hi@n thC& mVt ng vo nh mVt vJt thng nhz- ch tim A$i A1 hocc ,Zp thLt/ )hBng ACu hi@u l1n #1 l?n z hocc vim ,ch mch- vim hch ,ch hu&Jt cCp tinh/ 0zi o) D pht hi@n cc &Ju tH thun li cho ,@nh pht 3inh nh tiDu Tng- l1o///

1iai on !7 "- '31u vi ng&*X 1u nhKi- ,uHt mCt i- nhTng ch cho cm gic cng nhEc th2o nhLp p c:1 tim lm o) mCt ng:/ qCu hi@u ton th=n ncng hnX 3Ht A1o Vng- th mu ,ch cu tng 't_ l@ ,ch cu 1 nh=n t#ung tinh tng*/ ghHi u Kng ,nh vi;n ngoi ,=& giT 3T thC& m;m hn t#ung t=m cK thD pht hi@n ACu chu&Dn 3Kng 'luctu1tion*X h1i u ngKn t1& ct cch nh1u vi c2ntim2t h1i c]c c:1 + m:- Fhi Cn ngKn t1& ,n n& ngKn t1& ,n Fi1 ,L N% l&/

3.1.4. &iOn 4iPn c(* 3 QR nSng gi1i on l1n to nJu i;u t#L Fhng 3inh cK thD Fhzi 31u vi ng&/ gi1i on tQ m: cK cchX nJu #ch p N2 tho m: v Ahng Fhng 3inh- vJt #ch 3 li;n 3yo 31u !-8 ng&/ )Ju Fh%ng c m+ #ch tho m:- p N2 cK thD t] vn v #P m: F\o Ai- hocc cK thD g=& nhBng ,iJn chEng ti ch nh vim ,ch mch cCp tinh- vim hch m: h1& nhBng ,iJn chEng ton th=n nh nhiwm Fhuln Fhu&Jt- nhiwm Fhuln m: hu&Jt cK thD 1 Jn t vong/

3.1.5. Ch<m NSc Iq th2o Ai nhi@t V- nJu o) 3Ht Wu c1o nn chTm mt v cho thuHc gim nhi@t th2o & l@nh- nn ghi nhi@t V thnh ,iDu r D th2o Ai/ o) #Ct 1u- =& l 1u th]c thD- Iq nh gi mEc V 1u- tSm t thJ gim 1u- th]c hi@n thuHc gim 1u v th2o Ai tc AQng thuHc/ ID gim 1u cho o) t thJ c|ng #Ct Wu1n t#.ng- t#nh thm Fhm thTng Nu&n- t#nh cCn ln + p N2/ ghng 3inh th2o & l@nh- th]c hi@n Fhng 3inh tng giT- tng li;u v th2o Ai Aiwn tiJn c:1 ,@nh/ PhQ gitp op #ch + nhiwm t#hng- Fhi #ch m: nn cK mu cC& gitp i;u t#L Fhng 3inh th2o Fhng 3inh r/ [itp o) tSm t thJ gim 1u 31u #ch- t#nh cCn h1& ,ng Wu chct ln vhng vJt thng/ (h1& ,ng th]c hi@n ln}ng& h1& cK thD nhz gi.t lin tQc D #1 vJt thng/ qn lu cn c th2o Ai 3H lng- mu 3Zc- tinh chCt ALch thTng Nu&n/ (#ong Fhi th1& ,ng Iq cn Wu1n 3t v nhn Lnh tSnh t#ng vJt thng D gitp op i;u t#L thich hp/ v@ 3inh 3ch 3 t#nh l=& nhiwm t^ ngoi vo nhCt l vhng A1 Nung Wu1nh/ Cch l& tHt v$i nhBng vJt thng Fhc v nhBng o) Nung Wu1nh/ F $ '_ bC81 3.2.1. K9nh nghL* p N2 lnh l mVt + m: hSnh thnh chm- thTng chR cK t#i@u chEng 3ng- Fh%ng cK t#i@u chEng nKng- z v 1u/ )gu&n nh=n thTng Ao vi Fhuln l1o- hiJm hn cK thD Ao nZm hocc t#]c Fhuln thng hn/

p N2 lnh 'httpX}}gi1ngAuong&Fho1/n2t* 3.2.2. ?:i% chMng lBm NJng Tri;& chFng !i che5 p-N2 lnh Aiwn ,iJn Wu1 7 gi1i onX

+ [i1i on uX cK mVt FhHi u nhz cEng Ai Vng Fh%ng 1u- Fh%ng z- Fh%ng nKng/ ghHi u n& cK thD trn ti Fh l=u t#ong nhi;u thng m Fh%ng ,iJn +i gS/ + [i1i on cK m:X An An FhHi u m;m li/ ghm cK ACu hi@u chu&Dn 3Kng- 3T Cn Fh%ng 1u- ch.c AP ch A1 lnh N1 + p N2 3 #tt #1 c m: loMng- vng- cK chCt ln cn nh ,M u/ + [i1i on #P m:X + m: l1n An #1 lm A1 t#n + m: t# nn timO 31u K A1 ,L lo\t v vn m: #1 ngoi/ ghi p N2 lnh vn #1 ngoi A1 thS #Ct FhK lnh- cc vi Fhuln 3inh m: cK thD N=m nhp vo + p N2 g=& ,Vi nhiwm v ltc K 3 cK t#i@u chEng 3ng- nKng- z1u/ )h v&- mVt + p N2 lnh M ,iJn thnh p N2 nKng/ Tri;& chFng !on !hSn5 vS p N2 lnh l mVt ,iJn chEng c:1 ,@nh l1o- Ao K thTng gcp t#n o) g&- 3u& Fi@t/ Cn Fhm ton th=n- ph+i- Nng- cc hch vhng l=n cn/ (h N\t nghi@m mu vp tng- ,ch cu cK thD tng hocc ,Snh thTng- t_ l@ t=n ,o tng Ao tSnh t#ng nhiwm t#hng mn tinh/ Phn Eng t#ong A1 v$i tu,2#culin '*- oC[ '*/ ` Wu1ng ph+i cK thD pht hi@n l1o ph+i/ 3.2.3. KiT t:9 Ch: &Ju l i;u t#L nVi Fho1- Fh%ng #ch tho m: Hi v$i p-N2 lnh vS nK 3 g=& #1 #P m: F\o Ai- t#^ t#Tng hp l1o cVt 3Hng cK p-N2 lnh chn \p g=& li@t chi A$i/ 3.2.4. Ch<m NSc )hn Lnh v lng gi mEc V 3ng/ (h2o Ai ACu hi@u 3ng- nKng z- 1u Ao nhBng t vim cCp/ p N2 lnh ch: &Ju l Ao ,@nh lG mn tinh nh l1o- nCm/// vS thJ- o) thTng c i;u t#L nVi Fho1 l=u Ai- Iq h$ng An o) uHng thuHc i;u t#L th2o phc r h$ng An- tng giT- tng li;u- tng thTi gi1n/ qinh Anng cho o) #Ct Wu1n t#.ng vS =& l mVt phn Wu1n t#.ng t#ong 3] hri phQc c:1 ,@nh/ v^1 thuHc v^1 Ainh Anng gitp o) m1u chKng hri phQc/ Iq h$ng An cch n uHng- chCt lng Ainh Anng cho o)/ Cung cCp FiJn thEc v; ,@nh- cch chm 3Kc- phPng ng^1- l=& l1n/ o) thTng Fh%ng i;u t#L nVi t#t m c i;u t#L ngoi t#t/ vS thJ vi@c th2o Ai thTng Nu&n cn c Wu1n tm/ o) cK thD l mm l=& cho cVng rng- cho gi1 Snh Ao v& vi@c gio AQc o) t] chm 3Kc v t#nh l=& l1n t#ong cVng rng l nhi@m vQ Wu1n t#.ng/ F F V-L: 0E b58 0/^ 6(1bV:/8 D-Q. CbbQb-0@

3.3.1. K9nh nghL* vim tC& l1n to l tSnh t#ng vim cCp tSnh tJ ,o v$i Fh%ng gi$i hn v hoi t cc m% ,L N=m nhp/ 3.2.2. ;g !5n nhBn vi Fhuln g=& vim tC& l1n to thTng gcp nhCt l loi lin cu Fhuln 'pt#2ptococcu3*- tQ cu Fhuln vng 'pt1ph&lococcu3 1u#2u3*O thTng l=& ,@nh t#n nhBng o) nghi@n #u- tiDu Tng3u& thn-/// 3.2.3. ?:i% chMng [i1i on Fhi uX + (#i@u chEng ton th=nX #\t #un- 3Ht c1o- m@t nh.c- ,urn n%n- mCt ng:/ + ghmX ni vim gn ng vo c:1 vJt thng 3ng phrng ln v l1n #Vng- A1 ,Kng zcK nhBng ch ti ,m- Cn 1u/ [i1i on t#wX Cc m% vim ,L hoi t- t] vn #1 ngoi v c loi ,z/ )Ju o) Fh%ng c i;u t#L FLp thTi- tSnh t#ng nhiwm Vc ncng cK thD FhiJn o) t vong t#ong vPng 5-5s giT/ 3.2.4. DiPn chMng vim Fh$p cK m:- vim tZc tnh mch 31u nhiwm t#hng l1n #1/ vim m: mng ph+i- vim nVi t=m mc Ao + m: Ai cn c:1 nhiwm Fhuln m: hu&Jt/ 3.2.5. KiT t:9 )Vi Fho1X 3 AQng Fhng 3inh li;u c1o gi1i on Fhi u- m+ tho m: v An lu gi1i on hoi t/ 3.2.=. Ch<m NSc Iq l1u mt Fhi o) 3Ht c1o- th2o Ai nhi@t V- th]c hi@n thuHc gim 3Ht/ Cn th2o Ai h% hCp- t#i gic vS o) #Ct Aw thiJu oN& Ao 3Ht c1o/ vim tC& l1n to lm o) 1u nhi;u- Iq nn gitp o) tSm t thJ gim 1u- th]c hi@n thuHc gim 1u- gim thm Fhm/ vS l nhiwm t#hng #Ct ncngvJt thng #ch phEc tp v #Vng nn cn th]c hi@n Fhng 3inh tng li;u- tng giT/ I=& l mVt vJt thng #ch #Vng nn Iq cn chm 3Kc vJt thng- thCm ALch mVt h1& h1i ln t#ong ng&/ 0u hJt th& thuHc 3 An lu + m:- Iq chm 3Kc vJt thng v% Fhuln- ,o co chinh Nc 3H lng- mu 3Zc- tinh chCt ALch v #tt t^ t^ An lu th2o & l@nh/ ghi chm 3Kc- Iq t#nh vJt cc iDm l Nu h$ng l1n to mnh

thng lnh t^ ,n ngoi A1 nhng + m: ,n t#ong vn tiJn t#iDn v nh thJ tSnh t#ng o) cK ngu& c #P ALch/ vJt thng lnh Fhi cK 3] FJt hp giB1 chm 3Kc vJt thng- Fhng 3inh v Ainh Anng/ vi@c n=ng c1o thD t#ng o) l mVt Fh=u Wu1n t#.ng/ o) lu%n c cung cCp : p#otiA2- vit1min nh vit1min A- q- - C- cc Fhong chCt nh n- m2/// F F V-L: dCO1 :CO1 }t }-L: 1CO1 dCO1 1QED0 O_ 0\81 3.3.1. K9nh nghL* vim ,ch mch cCp tinh l nhiwm t#hng cCp tinh c:1 cc mch ,ch hu&Jt Ao vi Fhuln/ ghi nhiwm t#hng n& l1n Jn cc hch ,ch hu&Jt 3 g=& nn vim hch ,ch hu&Jt cCp tinh/

vim hch ,ch hu&Jt 'httpX}}gi1ngAuong&Fho1/n2t*

3.3.2. .inh lC 4%nh ghi u Wu1 vJt thng vi Fhuln l.t vo nhBng mch ,ch hu&Jt n%ng A1 'vim ,ch mch l$i*- FJ Jn l1n Jn nhBng mch ,ch hu&Jt 3=u hn- ch& 3ong 3ong v$i mch mu/ 3.3.3. ?:i% chMng I1u nhEc mVt ngKn t1& hocc ngKn ch=n ni ,L vJt thng- 1u A.c ln th2o chi/ pHt 7s-! "C7f"C- $n lnh- nhEc u/ ghm thC& phn m;m vJt thng 3ng n;- A1 phi1 t#n nKng- 3ng z v$i nhBng l?n chR z FJt thnh mng l$i- Cn 1u thHn 'vim ,ch mch l$i*- phn chi phi1 t#n vJt thng cK nhBng l?n z 3m- 3ong 3ong nh1u- 3T nh 3i A=& cVm cEng- Cn #Ct 1u 'vim th=n ,ch mch*/ 0ch phi1 t#n vhng Fho2o v hng 'nJu nhiwm t#hng chi A$i*- vhng nch 'nJu nhiwm t#hng chi t#n* 3ng to- Ai Vng- Cn 1u- 3T nKng 'vim hch ,ch hu&Jt cCp tinh*/ 0ch cK thD Ainh chhm nh1u- cEng- 1u- Fh%ng Ai Vng c 'vim hch ,ch hu&Jt cCp

Fm v$i vim Wu1nh hch*- cK thD tiJn t#iDn thnh vim tC& hch '1A2nophl2gmon*X 1u nhi;u hn- 3Ht c1o hn- #\t #un- hch 3ng to- z- nKng/ vi ng& 31u 3T cK ACu chu&Dn 3Kng 'vim hch mng m:*- cn phi N9 An lu m:/ 3.3.4. Ch<m NSc Chm 3Kc o) 3Ht- ghi tSnh t#ng 3Ht th2o ,iDu r/ )goi cc ,i@n php gim 3Ht nh t#n Iq cPn cht G tSnh t#ng 1u cc hch t#n o)/ (h]c hi@n & l@nh thuHc gim 1u- gim 3Ht- Fhng 3inh/ ghi tho m:- Iq cn chm 3Kc vJt thng tng Fd thut v% t#hng/ F ; N10 6QP/8Ob@ }t 810 O1U: 6A801P5@ 3.4.1. K9nh nghL*
-

)h.tX l nhiwm t#hng gi1 gi$i hn- thTng Ao tQ cu Fhuln vng- Fhi u mVt n1ng l%ng lm m: v hoi t + ch=n l%ng chng v$i mVt phn c:1 A1 Nung Wu1nh- c loi #1 ngoi A$i Ang mVt chi nh.t ',ou#,illon*/

)h.t chhmX l nhi;u nh.t FJt Ainh v$i nh1u ,i tSnh t#ng lm m: ch=n ,S- thTng NuCt hi@n t#n c thD 3u& nhc- t#n o) tiDu Tng/

3.4.2. ?:i% chMng )h.t X [i1i on Fhi uX cm gic ch=m chich- ngE1- nKng A1/ vi ng& 31u n+i ln mVt mQn cEng- z- nh.n- ,1o t#hm ln mVt l%ng giB1- mQn to An ln/ [i1i on t#wX 31u !-6 ng&- + Rnh nh.t NuCt hi@n mVt mQn m:/ p1u K- mQn m: vn- ch& #1 mVt it m: chng v$i mVt chi nh.t mu N1nh hocc vng/ I1u nhEc gim An- ch nh.t vn D li mVt 3yo t#Zng hSnh 31o/ )h.t chhmX thTng thC& 31u g& 'Ao K cPn g.i l hu ,Hi*/ (#i@u chEng Fhi u l 3Ht nhy- vhng 31u c+ cng v ngE1- NuCt hi@n mVt mng cEng nKng- z v 1u/ p1u vi ng& o) 3Ht c1o hn- 1u nhEc vhng g& nhi;u hn FhiJn No1& t# u FhK Fhn/ Yng 31u g& cEng z- tim ,m- t#n K NuCt hi@n nhBng nHt phrng- giB1 nHt phrng l mVt 3i l%ng- ltc u mu z 3m 31u ,iJn thnh m:/ `\t nghi@m cn l=m 3ng thC& ,ch cu tng v Tng hu&Jt tng 'nJu cK tiDu Tng*/ 3.4.3. &iOn 4iPn

p1u !-8 ng& nhBng nHt phrng t] vn D lV nhBng + lo\t nhz #i ;u nh t+ ong/ I1u nhEc gim An cK thD cn phi m+ D cZt l.c cc m% hoi t/ 3.4.4. Ch<m NSc )h.tX t#nh ncn nh.t h1& ph vn nh.t ,?ng t1& h1& nhBng AQng cQ Fh%ng v% Fhulnt#nh tSnh t#ng nhiwm t#hng vim tC& ncng/ )hBng mQn nh.t thTng N& #1 o) tiDu Tng nn vi@c i;u t#L cn FJt hp v$i chu&n Fho1 nVi tiJt/ Iq cn th2o Ai Tng hu&Jt cho o) thTng Nu&n/ Ii;u t#L t#i@t D nhBng mQn nh.t ng1&/ [io AQc o) Fhiph1te hi@n cK nhBng mQn nhz 31u lng nn Fhm th& thuHc ng1&- Fh%ng t] G N t#i ti nh/ [io AQc o) v@ 3inh A1 3ch 3- thTng Nu&n/ )h.t chhmX chm 3Kc vJt thng 31u Fhi #ch- nn phi nZng- n=ng c1o thD t#ng- i;u t#L o) tiDu Tng/ F ? N1-: 41Q8 41QED0 6S_0-O:-@ = 81-: 41Q8 :] 1QED0 6S_0-O/_E/1:-@ 3.5.1. K9nh nghL* )hiwm Fhuln hu&Jt l tSnh t#ng nhiwm t#hng ton th=n- Ao 3] phKng thich vi Fhuln- Vc tH c:1 vi Fhuln vo mu t^ng t t^ mVt + nhiwm t#hng t#ong c thD/ )hiwm Fhuln m: hu&JtX tng t] nh nhiwm Fhuln hu&Jt- nhng cK 3] Ai chu&Dn Wu1 Tng mu c:1 nhBng + m: t^ mVt + nhiwm t#hng Jn nhi;u c Wu1n Fhc t#ong c thD/ 3.5.2. ?:i% chMng
-

)hiwm Fhuln hu&Jt cK t#i@u chEng c ,n l #\t #un v 3Ht c1o/ x\t #un #Ct ncng n; v F\o Ai/ CK 3] #ung c '32cou332 mu3cul1i#2*- #ng nh ,P cp 'cl1Wu2m2nt A23 A2nt3*- cm gic lnh thCu Nng- l%ng ngoi A1 A]ng Eng/ Cn #\t #un tng Eng v$i mVt t phKng thich vi Fhuln vo mu/

pHt c1o 5" - 5e"C th2o 31u #\t #un/ (uU loi vi Fhuln m o) cK thD 3Ht lin tQc 'i2v#2 continu2*- 3Ht A1o Vng 'i2v#2 o3cill1nt2*- 3Ht nHi cn 'i2v#2 #2mitt2nt2* hocc 3Ht ngZt WuMng 'i2v#2 int2#mitt2nt2*/ )hng nJu nhiwm Fhuln hu&Jt Ao cc vi Fhuln hu&Jt l cc vi Fhuln [#1m '-* nh /Coli- o1ct2#oiA23-/// cK Fhi o) Fh%ng 3Ht hocc nhi@t V thCp hn ,Snh thTng/ Cc ACu hi@u Fm th2o nh ACu hi@u nhiwm Vc thn Finh- nhEc u AB AVi- m 3ng FhK th- mch nh1nh- ,urn n%n- tiDu it/ CK thD cK nhBng iDm Nut hu&Jt hocc ,m mu

A$i A1- ch& mu c1m/// (+ng t#ng 3u& 3Qp #Ct nh1nh/ Cn l=m 3ng X ,ch cu tng c1o 'ch: &Ju l )2ut#ophil* hocc Fh%ng tng 'nJu c thD t li@t Ao vi Fhuln t#n ngp t#ong mu*/ CC& mu tSm vi Fhuln t#ong mu 'c ,n D chln on Nc Lnh*/ CK thD t vong nh1nh 76-5s giT nJu Fh%ng i;u t#L FLp thTi/ 3.5.3. KiT t:9 qhng Fhng 3inh li;u c1o- loi ,z + nhiwm t#hng- hri 3Ec o)/ 3.5.4. Ch<m NSc Iq chng op hri 3Ec tich c]c chHng chong nhiwm t#hng- chuln ,L o) phu thut nJu cKchm 3Kc o) chong nhiwm t#hng- n=ng c1o thD t#ng o)/ F o N1-: 41Q8 :] 1QED0 CK 5 t#i@u chEng c ,nX Cn #\t #un mMnh li@t v ti Aiwn nhi;u ln #Ct giHng ,@nh 3Ht #\t '#\t - 3Ht - + mr h%i*/ pHt c1o 5" "-5e"C- nhi@t V A1o Vng mi ng& hocc nhi;u ln t#ong ng&/ (#i@u chEng nhiwm Vc ton th=nX mct hHc hc- lni Fh%- th nh1nh- mch nh1nh nhz- nhEc um 3ng- chn n/ ghm th]c thDX cK thD pht hi@n nhBng + m: Ai cn nh nhi;u + m: #i #c t#ong c- m% A$i A1- p N2 ph+i- thn- vim Fh$p cK m:/ Chln on A]1 vo cC& mu cK vi Fhuln/ Ii;u t#L v chm 3Kc giHng nh nhiwm Fhuln Fhu&Jt/

CpU HqI !rNG GI' e/ p N2 nKng tQ m:- c #ch tho m: v Ahng Fhng 3inh 3 li;n 3yo 31uX 1/ 7-! ng& ,/ !-8 ng& c/ 8-e" ng& A/ (#n e! ng& / o) nhiwm Fhuln m: hu&Jt 3 cK t#i@u chEng c ,n 31uX 1/ pHt { #\t { + mr h%i ,/ x\t { 3Ht { m 3ng c/ x\t { 3Ht { + mr h%i

A/ I+ mr h%i { #\t { 3Ht { m 3ng 7/ p N2 lnh thTng AoX 1/ (Q cu Fhuln vng ,/ 4u cu c/ vi Fhuln Fk Fhi A/ vi Fhuln l1o 5/ p N2 lnh thTng l ,iJn chEng c:1 ,@nhX 1/ 41o ,/ [i1ng m1i c/ vim cu thn A/ Chm !/ )hiwm Fhuln hu&Jt l tSnh t#ngX 1/ )hiwm t#hng ti c tim ,/ )hiwm t#hng t:& 3Hng c/ )hiwm t#hng ton th=n A/ )hiwm t#hng tJ ,o g1n

TI !IhU THAM KHsO e/ fX kh&:n Lgoi khoaQ oi ging )goi Fho1 c 3 { (#i@u chEng h.c ngoi Fho1/ Ii h.c < qc (P0CY- ""e/ / )gu&wn (Cn CTng- Ii;u Anng )goi e- )h NuCt ,n [io AQc vi@t )1m- ""f- 8-7!/ 7/ Y2A3u#g not23 { )u#323 Clinic1l PocF2t [uiA2/ m/ A/ q1vi3 Comp1n& ""6- 8e-8f/

BI ; CHwM SxC NGI BhNH BqNG = GH( DA

MC TIU 1. Trnh by c phSn loi bdng. 2. 9Ep cF& v %&2n lR c b;nh nhSn bdng ngay khi nh8p vi;n. (. Lh8n bi'! c c c giai on c-a bdng. +. 9h?" sTc c b;nh nhSn bdng. g. Trnh by c nh nghPa ghBp /a. h. 9h?" sTc c b;nh nhSn ghBp /a.

1 BhNH HIC 1 1 (1K8 b/C- d8V 1.1.1. ?hRo $I NB


- IV eX thng t+n chR l$p 3^ng nh ch& nZng/

- IV X thng t+n hJt l$p thng ,S cho Jn mng &- chi1 lm mEc V X
+

ozng ,; mct A1- cK nhBng cc iDmX mQn n$c 'n%ng*- ACu hi@u Cn A1 +i mu mCt '*- vJt thng lm- l%ng cPn chZc- 1u $n nhi;u- ch=m Fim ch& mu nhi;u/

+ ozng A1 3=u- cK nhBng cc iDmX mQn n$c 31u hn- l$p t#ung ,S mu t#Zng- ACu hi@u Cn mCt '*- mCt tinh n hri- l%ng cPn Ainh- cm gic 1u gim nhi;u- ch=m Fim 3=u t$i l$p t#ung ,S m$i ,iJt/ - IV 75 thng t+n Jn phn n%ng c:1 l$p ,S- chi1 lm mEc VX #R mu/ ozng V 71X ,zng ton ,V l$p A1- mQn ,zng- ACu hi@u Cn mCt '-*- t+ng thng Fh%- l%ng - tKc - mKng #Qng- mCt cm gic 1u- =m Fim 3=u t$i hJt l$p A1 m$i

ozng V 7, 3=uX A1 ,L ph hu_ Fh%- & vJt thng ACu hi@u Cn mCt '-*- vhng t+n thng M ch& 2n- cK thD thC& nhBng tnh mch ,L tZc A$i- l%ng - tKc - mKng #Qng- cm gic 1u mCt/

- IV 5X hoi t- l$p A1 v cc c Wu1n ,n A$i- ch& l$p c=n c Nng/ (h2o Ai@n tich ,zngX V #Vng t#n c thD o) l hSnh nh Aw nhn ,iJt/ (#n Ai@n tich ,L ,zngX c thD M m c1 th%ng thng cho vi Fhuln N=m nhp- cho ALch mCt i v mCt nhi@t/ Inh gi chinh Nc Ai@n tich ,zng #Ct cK G ngh1 t#ong gi1i on chong ,zng/

(18V B, I

(18V B, II

(18V B, III

(18V B, IV

1.1.2. ?hRo 8i%n tch - (h2o Wu& lut 3H f c:1 ~1ll1c2X VY 0P\ _18V - Iu mct c+ D-A8 0\O1 _18V fu

- )g]c- ,Qng 'th=n t#$c* fu N - (1& 'chi t#n* - 4ng- m%ng 'th=n 31u* - Yct t#$c ch=n - Yct 31u ch=n - oV phn 3inh AQc - bu& tZc ,n t1&X eu fu N fu N fu N fu N eu

1.1.3. ?hRo v9 t: 4Ung vL t#i ,zng cK G ngh1 Wu1n t#.ng t#ong thlm md- t#ong cuVc 3Hng nh vhng c+- ng]c thS nh hng Jn h% hCpO cc l t] nhin nh mZt t1i- m|i- mi@ng Fh%ng chR nh hng Jn hSnh Angthlm md m cPn nh hng Jn gic Wu1nO ,V phn 3inh AQc nh hng Jn Fh nng tSnh AQctiJt ni@uO vhng Fh$p nh hng Jn chEc nng vn Vng- 3inh hot/ 1 $ HDQ 0e 8VQE O3 (u+i o) cng l$n 3] hri phQc cng chm/ o) cK Fm th2o ,@nh Fhc v; h% hCp- tim mchthn- tiDu Tng thS cng lm chm Fh nng hri phQc/ o) tiDu Tng cK ngu& c hoi t vJt thng/ o) nghi@n #u- 3u& Ainh Anng- chCn thng Fm th2o lm tng ngu& c nhiwm t#hngchm lnh vJt thng/ 1 F C_ ONQ }t uQ^8 bz BN d8V 1.3.1. DUng 8o nhi%t Lh8n nh >i5 th nh1nh- n%ng- gi.ng Fhn- ho #1 FhKi mu 2n Nm/ Ch& N\m l%ng m|i- mct- th FhKi 2n/ gich Eng- #t Tng h% hCp t#n- 1u c+ h.ng v ng]c- FhK thn\t mct hong 3- lo lZng/ Lg&y$n nhSn5 n$c 3%i- l1- vt nKng/// Lh8n nh >i5 ,; mct t#n c:1 vhng A1 ,zng thC& z- nKng- 1u- 3ng n;- phh- Cn A1 cK mu t#Zng/ o; 3=u c:1 ,zng 3 thC& vJt ,zng $t- v?n t#Zng hrng An chu&Dn 31ng ztng cm gic- 1u t^ t#ung ,Snh Jn ncng- ti nht Fhi Cn t#n vJt ,zng/ ozng 3=u- ton ,VX chong- A1 Fh% t#Kc v&- n=u 3m- thoi ho/ [im cm gic Fhi 3Tmhi ,zng/ gh%ng 1u vhng ,zng nhng m% Nung Wu1nh 1u- mCt mu t#Zng Fhi Cn/

+QE 0P81 O_ ONQ d8V j/ 81-A0 9an !hi;p cEp cF&5 e/ I1 nn nh=n #1 Fhzi vhng g=& ,zng/ / qu& t#S th%ng FhiX lC& hJt AL vt m|i- mi@ng/ 7/ giDm t#1 t+n thng mct- m|i- c+/ )Ju pht hi@n o) cK chCn thng c+ thS nn ,Ct Vng vhng c+/ )Ju thC& gi.ng Fhn- m 2n- th FhP Fh- nn ct nVi Fhi Wun 5/ !/ 6/ 8/ s/ ng1&- 1 nn nh=n #1 vhng thong Fhi/ (h oN& lm e""u- th2o Ai V ,Mo ho oN&/ (h2o Ai ACu chEng 3inh trn- t#i gic lin tQc/ CZt ,z Wun o- r t#1ng 3Ec/ ghm nn nh=n D pht hi@n v N t#i nhBng t+n thng lin Wu1n/ 4p e Tng t#u&;n v$i Fim l$n- cH Lnh tHt/ (h]c hi@n ALch t#u&;n- thuHc gim

1u- phPng ng^1 uHn vn th2o tng & l@nh/ f/ Ip gc mt ln vhng ,zng- ng=m t#ong n$c mt v$i nhBng t+n thng ,zng nhz/ e"/ `c Lnh Ai@n tich- V 3=u c:1 ,zng/ ee/ ong vJt ,zng v$i gc Fh%- v% Fhuln 31u Fhi lm 3ch vJt ,zng/ e / qi chu&Dn o) t$i t#ung t=m ,zng/

1.3.2. DUng 8o ho cht - )gu&n nh=nX 1ciA- Fi;m pho3ph1t2- v%i- - )hn Lnh tSnh t#ng o)X 1u ti vJt ,zng ch m% thoi ho- A1 ,L mCt mu- phh n; m% Nung Wu1nh/ pu& h% hCp nJu ,zng Tng th/ 4i@t- gim 3Ec c phHi hp/

+QE 0P81 O_ ONQ d8V j/ 1/S O10 9an !hi;p cEp cF&5 e/ qi chu&Dn o) #Ti N1 hK1 chCt/ / 4oi ,z ho chJt ,?ng cch t$i #1 ln vJt thng v Nung Wu1nh vJt thng v$i n$c 3ch h1& Aung ALch muHi ng t#ng/ ($i #1 nhy nhng nhng Fh%ng ch Nt/ 4C& nhBng chCt v%i h1& nhBng thE ,V Fhc #1 Fhzi vhng ,zng- cc ,i@t Fh%ng 7/ 5/ !/ 6/ 8/ s/ Ahng Aung ALch t#ung ho t$i ln vJt ,zng/ IZp Fhn 3ch ln vJt thng- ni A1 Fh% gitp gim nhi@t- gitp o) Aw chLu/ qu& t#S th%ng Fhi- FiDm t#1 t+n thng mct- m|i- c+/ )Ju o) cK ,zng vhng mctm|i nn h t# ,c 3 ct nVi Fhi Wun/ (h oN& lm e""u- th2o Ai V ,Mo ho oN&/ (h2o Ai ACu chEng 3inh trn- t#i gic thTng Nu&n cho Jn Fhi o) c chu&Dn Jn chu&n Fho1/ Iq cn hzi c chJ ,L ,zng- thm Fhm- N t#i nhBng t+n thng lin Wu1n/ o) cn c cung cCp n$c nn vi@c lp mVt Tng t#u&;n v$i Fim l$n- cH Lnh tHt l #Ct cn thiJt/ )n 3 AQng Fim lurn v 7 chi1/ (h]c hi@n : ALch t#u&;n- thuHc f/ gim 1u- phPng ng^1 phong Pn gnh cho o) th2o & l@nh/ Cn cZt ,z Wun o- r t#1ng 3Ec D Aw Ang Wu1n 3t- Nc Lnh loi ,zng- chm 3Kc vhng ,zng c tHt/ 4u G chm 3Kc nhy nhng- t#nh lm t+n thng vJt ,zng/ 1 F F DUng 8o khSi vJ t0n thng 8o ht kh $Ic Lg&y$n nhSn5 3Ec nKng- l1- FhKi c:1 l1- ho chCt- C- t+n thng t#n v A$i th1nh m%n/ Lh8n nh >i5 th nh1nh- n%ng- giVng Fhn- ho- ho #1 FhKi mu 2n- Nm/ Ch& N\m l%ng m|i- mct- th FhKi 2n/ gich Eng- #t Tng h% hCp t#n- 1u c+ h.ng v ng]c- FhK th- n\t mct hong 3- lo lZng/

+QE 0P81 O_ ONQ d8V j/ 41{- }t 0n8 01k38V j/ 1\0 41\ B,O 9an !hi;p cEp cF&5 e/ qi chu&Dn o) Fhzi vhng ngV Vc t$i vhng thong Fhi- hn chJ ngTi v=& Wu1nh ,n / 7/ 5/ !/ 6/ 8/ o)/ (hiJt lp v Au& t#S Tng th/ Cn th%ng Tng th- tun hon- ct nVi Fhi Wun nJu o) 3u& h% hCp/ (h e""u oN& lm- th2o Ai V ,Mo ho oN&/ )$i #Vng Wun o- lC& 3ch AL vt- FhKi ,Qi m|i- mi@ng/ Cm o)- lu%n cK ngTi ,n- Fh%ng D nn nh=n hong 3/ gh%ng nn cho o) uHng n$c nJu nn nh=n 1ng FhK th- D t#nh ngu& c 3cc n$c/ (hiJt lp Tng t#u&;n- nn 3 AQng Fim lurn- 7 chi1- tim nhBng mch l$n gn tim l tHt hn/ vi@c ,h n$c v i@n gii c th]c hi@n th2o & l@nh/ (h2o Ai ACu chEng 3inh trn- t#i gic thTng Nu&n cho o)/ v$i ,zng Tng h% hCp thTng o) n?m t thJ mol2#- vS nh thJ o) Aw th hn- v$i t thJ n& 3 s/ gitp gi1 tng thD tich c:1 lrng ng]c hn/ (hTng ,zng ngt N& #1 nhBng cn hz1 hon nn vi@c thm Fhm tSm nhBng ACu hi@u t+n thng Fhc l cn thiJt nh?m N t#i FLp thTi/ 1 F ; DUng 8o $i%n Lg&y$n nhSn5 Ao tiJp Ntc v$i APng i@n/ Lh8n nh !nh !rng CL5 vJt ,zng +i mu A1- A1 gim cm gic- 1u it h1& Fh%ng 1u/ vJt thng 3=u- thC& Tng vo v #1/ )n nh=n ,zng i@n lu%n cK t#i@u chEng #Hi lon nhLp tim/

+QE 0P81 O_ ONQ d8V j/ B-A8 9an !hi;p cEp cF&5 e/ )gZt APng i@n t#$c Fhi Ai chu&Dn o) #1 Fhzi APng Ai@n/ (#ong thTi gi1n n& / 7/ nn nh=n cn t#nh tiJp Ntc chng APng i@n t#ong 3uHt thTi FU cCp cEu/ )n nh=n lu%n c nh gi v; Tng th- hi th- ACu hi@u thiJu oN&/ (hiJt lp v Au& t#S Tng th e""u oN& lm/ o) i@n git cn thiJt nhCt l FiDm t#1 mch- nhLp tim- tn 3H- t#i gic v c th2o Ai lin tQc t#ong 3uHt thTi FU cCp cEu cho Jn Fhi Jn ,@nh vi@n/ (i ,@nh vi@n o) c|ng cn c th2o Ai lin tQc Wu1 monito# cK ci chJ V ,o Vng cho Jn 5/ !/ Fhi o) +n Lnh/ PhQc hri tun hon th2o & l@nh c|ng c tiJn hnh/ )gTi ,L i@n git thTng cK Fm chCn thng Fhc Ao nn nh=n thTng ,L t\ Fhi tZt ngurn i@n- vS thJ Fhi 3 cEu cn cln thn Fhi Ai chu&Dn- cn thn t#.ng Fhi No1& t# nn nh=n nJu cK nghi ngT chCn thng cVt 3Hng c+/ 4u%n lu%n nh$ #?ng cn cH Lnh c+ nn nh=n t#ong 3uHt Wu t#Snh Ai chu&Dn/ giDm t#1 nhBng t+n thng Fhc nh gM& Nng Ao t\/ )Ju cK gM& Nng nn cH Lnh gM& Nng6/ 8/ gim 1u cho nn nh=n t#$c Fhi Ai chu&Dn/ Ci ,z Wun o- lng gi vhng ,zng/ Ph: ln vJt ,zng ,?ng gc v% Fhuln/ Cm nn nh=n- c%ng tc t tng cho nn nh=n Fh%ng hong 3/

1 ; C19: .{O BN 01/ OSO V-5- B/C8 O]5 d8V 1.4.1. 6i*i $on c3 cM 4 thTi FS Pi hzi phi ti gii Wu&Jt ng1& 31u gi1i on 3 cEu/ [i1i on n& ,Zt u mCt ALch- phh n; v tiJp tQc cho Jn Fhi i;u t#L phQc hri lng ALch v o) cK n$c tiDu/ xHi lon n$c v i@n giiX o) ,zng Aw mCt n$c Wu1 nHt ,zng- Wu1 mCt nhi@t- Wu1 3HtWu1 thnh mch grmX n$c- 3oAium- p#ot2in/ vS thJ o) cK ngu& c chong Ao gim thD tich ALch/ vJt thng v tSnh t#ng vimX ,zng to #1 nhBng ,Jt thng t#n c thD- to c1 ng cho vi Fhuln N=m nhp nn cK ngu& c nhiwm t#hng c1o cho vJt thng v ton th=n/

pu& gim miwn ALch5 ,zng An Jn 3t#233- gim 3Ec ; Fhng c:1 c thD- o) ,zng thTng chong Ao 1u- Ao mCt n$c/ Iq cn cht G Jn tSnh t#ng 3H lng n$c tiDunJu n$c tiDu it thTng ,iDu hi@n 3] mCt n$c- 3 cK ngu& c t+n thng thn/ )goi #1ACu hi@u li@t #uVt c nng c|ng thTng N& #1 cho o) ,zng- cK thD Ao tSnh t#ng #Hi lon i@n gii h1& Ao chong/ Iq thTng Nu&n th2o Ai tSnh t#ng ,Qng t#$ng- 1u- ngh2 nhu Vng #uVt mi giT nJu o) ,zng ch1 cK nhu Vng #uVt t# li/

1.4.2. DiPn chMng Th8n5 #Hi lon chEc nng thn- thn l c Wu1n cK thD nh hng ncng n; t#ong ,zng/ (#ong nhBng t#Tng hp ,zng ncng- o) cK #Ct nhi;u ngu& c #i vo 3u& thn Fh%ng hri phQc/ )g& u tin c:1 ,zng l ng& ngu& hiDm nhCt Hi v$i thn Ao tSnh t#ng gim FhHi lng tun hon- lu lng mu Wu1 thn gim/ Yct Fhc- nhBng tJ ,o ,L hu_ hoi Ao ,zng 3 cK c hVi pht tn #1 nhBng 3n phlm AL ho- Wu t#Snh n& g=& tc hi v; mct c h.c h1& ho h.c Hng thn/ Ti" "ch5 #Hi lon nhLp tim- chong Ao thiJu ALch- chong nhiwm t#hng Ao vJt thng ,L hoi t/// jX hEp5 ,iJn chEng ph+i v phh n;- tZc Tng h% hCp Ao ,zng Tng h% hCp t#n v Ao ,zng hit- ngt- gim 1u- 1n thn/ 1.4.3. Ch<m NSc vPt thng Chm 3Kc vJt thng 31u Fhi o) M +n Lnh/ YQc ich th1& ,ng vJt thng l lm 3ch- lC& m% hoi t- gim 3H lng vi t#hng hi@n Ai@n- t#nh t+n thng A1 thm- gitp o) thoi mi/ 1.+.(.1. Cdng nXng x1 3ch vJt thng- ,ng ,?ng gc thCm $t mn/ Iq ph vn nhBng nHt ,zng vS ni =& vi t#hng cK 3n ch=n l%ng- tu&Jn chCt nhTn cK nhi;u chCt Ainh Anng nhCt 3 thun li pht t#iDn vi t#hng/ IZp thuHc mn h1& ,ng lm cK chCt Fhng Fhuln- ,ng thm gc Fh% A& gitp htt ALch- ,ng \p nhy/ (h1& ,ng vo ng& thE !- Iq cn th2o Ai vJt thng nJu Fh%ng 1u nhi;uFh%ng thCm ALch- Fh%ng mhi- Fh%ng 3Ht thS #1 3ch vJt thng #ri ,ng li ,?ng ,ng lm/ (h1& ,ng ln vo ng& thE e"O Iq #1 3ch- ,ng lm- nhng ,ng mzng hn v tiJp tQc th2o Ai/ )g& thE e! cho o) tZm ,zng- cc l$p ,ng ,ong #1 Aw Ang- vhng ,zng 3 ln A1 non z hrng/

(#ong gi1i on n&- Iq cn th2o Ai vJt thng thTng Nu&n D t#nh ngu& c nhiwm t#hng lm cho tSnh t#ng vJt thng tiJn t#iDn 3=u hn/ 1.+.(.2. Cdng sS& U ( 4oi n& cK thD t] lnh nhng thTng D li 3yo l$n- Ao K th& thuHc thTng Ahng phng php m+ h$t An t^ng l$p/ (hTng c tiJn hnh vo ng& thE 7 31u t1i nn vS ltc n& V 3=u vJt ,zng M +n Lnh- 3] phh n; c ti hCp thu mVt lng l$n/ ID chuln ,L t#$c m+- i;u Anng #1 3ch vJt thng- lC& hJt chCt mn v ALch E .ng- chuln ,L vhng A1 tht 3ch v ,ng Fin v% t#hng/ Chm 3Kc 31u m+- Iq th1& ,ng vo ng& thE ! 31u m+/ (h2o Ai ACu hi@u nhiwm t#hng- ,ng ,?ng thuHc mn Fhng Fhuln/ 1.+.(.(. Cdng sS& U + (hTng th& thuHc p AQng m+ h$t An t^ng l$p- cZt l.c 3=u- gh\p A1 cuHng/ Iq th2o Aichm 3Kc v m ,o v% t#hng tu&@t Hi Fhi chm 3Kc vJt thng/ Phng php tZm ,zng t#ong gi1i on n& gitp lC& m% hoi t- chCt tiJt- Fich thich m% ht h.c- gitp o) 3ch 3- gitp o) thoi mi- gim 1u- nhng tZm Fh%ng Wu " phtt vS 3 lm o) mCt ALch v i@n gii- lnhngu& c nhiwm t#hng/ (iu chuln n$c D tZmX 3ch- nhi@t V 5""C/ 1.4.4. D<ng vPt 4Ung ghi chm 3Kc vJt ,zng- Iq cn lu G #1 t1&- m1ng gng v% Fhuln Fhi th1& ,ng/ p1u Fhi #1 vJt thng- Iq Zp gc- ,ng cho o)/ )hi@t V phPng f-5"C/ CK loi ,ngX - C?ng k<n5 ,ng Fin vJt thng ,?ng gc Fhng 3inh mn/ - C?ng ha5 vJt thng c ph: ,?ng mn Fhng 3inh nhng Fh%ng ,ng Fin- o) c n?m vhng v% Fhuln/ 1.4.5. V n lC th c (im ng^1 uHn vn cho tCt c o) ,zng- th]c hi@n thuHc gim 1u ,?ng Tng tnh mchthuHc ch2 ch nim mc A A&- thuHc Fhng 3inh- ,h ALch n$c v i@n gii th2o & l@nh/ 1.4.=. &inh 8@ng o) ,zng thTng ,L mCt nhi@t lng nhi;u Ao ,Hc hi Wu1 vJt ,zng- nhiwm t#hng/ vS thJ cn lm gim Wu t#Snh chu&Dn ho c:1 o) nh giB nhi@t V v V lm c1o t#ong Fh%ng Fhi 'nhi@t V phPng t^ 7-7 "C- V lm t^ !-!"u*- lm gim 1u $n cho o)/ )gTi l$nX ! c1l}Fg c=n ncng 5" c1l cho mi phn t#m Ai@n tich ,L ,zng/

(#9 2mX 5"-6" c1l}Fg c=n ncng 5" c1l cho mi phn t#m Ai@n tich ,zng/ (#ong t#Tng hp o) 3tt c=n cn ,o co li v th]c hi@n n=ng c1o thD t#ng o)/ ghi nhu Vng #uVt gim h1& li@t #uVt thS n=ng n thD t#ng ,?ng ALch t#u&;n th2o & l@nh/ o) cK nhu Vng #uVt cK thD cho n Wu1 Hng 42vin2- thEc n loMng nhng cung cCp nhi;u p#ot2in- vit1min A-o-C- Fhong chCt- 3Zt- ol1t2/ )ng lng !""" Fc1l}ng&/ )Ju o) Fh hn thS cK thD cho o) n Wu1 Tng mi@ng ,Snh thTng/

1.4.W. 6i*i $on c3 tnh# l gi1i on vJt thng +n Lnh/ 1.+.k.1. Thay 4i chFc n?ng sinh lR5 ,iJn Ang c thD- 1u- vJt thng hoi t- gh\p A1 v ti to chRnh hSnh/ oiDu hi@n l=m 3ng l vJt thng Fh% v m% thoi ho t#Zng thnh n=u 3m- mCt cm gic- phn A& 3=u tiJt ALch- nHt phrng 1u v nhiDm t#hng/ `\t nghi@m aon r pht hi@n cc ACu hi@u l=m 3ng Ao #Hi lon i@n gii/ 1.+.k.2. Ci'n chFng5 (#ong gi1i on cCp tinh o) cK #Ct nhi;u ,iJn chEng nh nhiwm t#hng vJt ,zng- nhiwm t#hng tiJt ni@u- nhiwm t#hng h% hCp/// (Snh t#ng h% hCp v tim mch c|ng ,L nh hng nh FhK th- vim ph+i- #Hi lon vn mch/ (hn Finh o) thC& c mVng- lo 3- Fh:ng hong tinh thn v cK thD cK t+n thng nMo/ (#ong gi1i on n& vCn ; Nng Fh$p c|ng ,iDu hi@n nh co #tt c- mCt t thJ c nng- hn chJ hot Vng- t2o c Fh$p/ ChEc nng tiu ho c|ng cK ngu& c c1o l lo\t A A& h1& ch& mu A A&/ (iDu Tng lm chm lnh vJt thng v tng ngu& c nhiwm t#hng/ 1.+.k.(. Tr li;&5 (h& thuHc thTng cho & l@nh cung cCp ALch th1& thJ- cung cCp Ainh Anng- thuHc gim 1uFhng 3inh- Fhng vim/ vi@c chm 3Kc vJt thng v ,ng th2o t thJ c nng c|ng #Ct Wu1n t#.ng Hi v$i o) D Fhi o) phQc hri cK thD t# h. v; v$i Ti 3Hng ,Snh thTng/ v1i t#P vt lG t#L li@u #Ct cn th]c hi@n t#ong gi1i on n&/ (Snh t#ng hoi t vJt thng c|ng cK ngu& c c1o t#ong nhiwm t#hng vJt thng nn vi@c cZt l.c m% hoi t- ngn ng^1 nhiwm t#hng- Fich thich m% ht m.c tHt v chuln ,L cho gh\p A1- gitp #tt ngZn thTi gi1n lnh vJt thng- ti to chRnh hSnh/ 1.+.k.+. l&2n lR >i5 lng gi v chm 3Kc o) 1u- chm 3Kc vJt thng- n=ng n tinh thn/ 1.4.>. 6i*i $on 3hXc hYi

YQc ich gi1i on n& l gitp o) t# li cuVc 3Hng- thiJt lp li chEc nng c thD- ti to chRnh hSnh vJt thng- gh\p A1/ oiDu hi@n l=m 3ng l hn chJ vn Vng- 1u Fhi vn Vng- 3yo NCu/ qo o) 1u nn Fh%ng tp lu&@n- o) cK ngu& c co #tt c- cEng Fh$p- 3yo co #tt- 3yo NCu,iJn Ang c thD- 3yo phS i/ (#L li@u v Wun lG Iq l vt lG t#L li@u- ti to chRnh hSnh/ (#ong gi1i on n& gi1 Snh v o) l ngTi t] i;u t#L chinh v$i 3] t# gitp c:1 nhKm t=m lG- vt lG t#L li@u- Iq ti nh- nhKm Ainh Anng/ vCn ; cung cCp Ainh Anng : cc chCt cho o) #Ct Wu1n t#.ng/ Iq h$ng An thEc n cho o) v Fh%ng c n/

$ +UH TR~NH CHwM SxC BhNH NHpN BqNG $ 1 N1c8 BY81 081 0PC8V BN vJt thngX mEc V v ngu&n nh=n ,zng 'nhi@t- ho chCt- i@n-///* p] th1& +i ALch v chongX mch tng- hu&Jt p gim- tiDu it- th2o Ai p l]c tnh mch t#ung t=m- pot133ium tng/ ITng thX phh n; Tng th- ch& N\m l%ng m|i- mi@ng h1& m|i & ,Qi FhKi- m 3m mu- ho- tim ti- FhK th/ )gV Vc CX n%n Ki- 1u ng]c- th nh1nh- ,Hi #Hi- Fich Vng- phn N/ (hn FinhX th1& +i t#i gic- chCn thng 3. nMo- cVt 3Hng c+/ (im mchX #Hi lon nhLp- th1& +i thD tich ALch- t$i mu m% F\m/ 0% hCpX th nh1nh- n%ng- thiJu oN&/ `ng Fh$pX gM& Nng- gim vn Vng- ,iJn Ang- nh% Nng- c/ (ng chu&Dn ho v mCt nhi@tX c thD o) Aw ,L lnh- gim c=n/ YuX 0ct gim- tiDu h2moglo,in2/ (iu hK1X t+n thng mi@ng- n%n Ki- ch& mu A A&- lo\t A A&- li@t #uVt/ (hnX chong- tiDu ni@u- tiDu hu&Jt 3Zt tH- tiDu m&oglo,in/ I1uX nh gi mEc V 1u/ (=m lGX mEc V lo lZng v; hSnh Ang c thD/ )hiwm t#hngX vJt ,zng tiJt ALch- mhi- 3Ht/

$ $ C18 B/S8 }t O58 01-A_ D

2.2.1. ?0n thng 8* 8o vPt 4Ung 4ng gi mEc V v V 3=u vJt thng gitp Iq chuln ,L AQng cQ v ch.n Aung ALch thich hp cho t^ng loi vJt thng/ ghi tho ,ngX Cn nhy nhng- t#nh to vJt thng m$i v t#nh 1u cho o)/ IHi v$i vJt ,zng Wu #VngX cn lm lm t#$c Fhi tho ,ng A/ ghi #1 vJt ,zngX (h1o tc cn hJt 3Ec nhy nhng/ p AQng Aung ALch thich hp h1& th2o & l@nh ,c 3/ p AQng tu&@t Hi Fd thut v% t#hng/

ong h h1& Fin th& th2o tSnh t#ng vJt ,zng/

2.2.2. Zt n"c vJ $i%n gii 8o thot 89ch ) * vPt 4Ung o) ,zng thTng ,L mCt ALch Wu1 vJt ,zng- NuCt tiJt ALch Wu1 vJt thng- n uHng F\m v #Hi lon i@n gii/ Iq cnX (h2o Ai lng n$c NuCt nhp- ACu hi@u mCt n$c- i@n gii/ (h2o Ai q0p(- chR 3H CvP- lng n$c tiDu t#ong ng&/ qu& t#S v th]c hi@n ,h : ALch t#u&;n v i@n gii th2o & l@nh/

2.2.3. . ! gim kh n<ng vn $Ing )gu&n nh=nX 1u Ao vJt ,zng v 3yo co #tt/ Iq cnX (p vn Vng ch: Vng v thQ Vng t#nh #tt c v t2o c/ ghu&Jn Fhich o) tp vt lG t#L li@u/ CH Lnh chi tng t thJ Fhi th1& ,ng/ 0$ng An o) t] vn Vng v No1& t#/

2.2.4. D; k[m 8inh 8@ng Inh gi tSnh t#ng tiu hK1 A]1 vo nhu Vng #uVt v tSnh t#ng ,Qng c:1 o)/ Cho o) n 3$m nhCt/ 4ng gi c=n ncng v tSnh t#ng Ainh Anng/

(h& th2o tSnh t#ng o)- cK thD cung cCp thEc n Wu1 Tng mi@ng- Hng th%ng m|i-A A&- m A A& #1 A1/ Cung cCpX P#ot2inX -5g}Fg}ng&/ vit1min A- C- q- )ng lngX 7!"" - !""" Fc1l}ng&/

2.2.5. ?o 4Sn - )gu&n nh=nX hn chJ vn Vng- n?m l=u t#n giTng ,@nh/ - Iq cnX 2.2.=. Zt nhi%t - )gu&n nh=nX A1 o) ,L ,zng nn Fh%ng th]c hi@n c vi@c Au& t#S nhi@t V cho c thD/ - Iq cnX - 4u GX 2.2.W. K* - 4ng gi cn 1u/ - (h]c hi@n thuHc gim 1u th2o & l@nh Fhi th1& ,ng h1& Fhi vn Vng/ 2.2.>. ?Bm lC tht v\ng1 m]c cm 8o 4iPn 8ng c th - (Sm hiDu t=m t v cm gic c:1 o) v; hSnh Ang hi@n ti/ - (h2o Ai ACu hi@u chn nn v t#m cm/ - IVng vin v Fhu&Jn Fhich o) lC& li ni;m tin v phQc hri li vn Vng/ ghi th1& ,ngX t#nh phi ,& c thD Wu l=u/ (Zm ,zng nhi@t V 78"C v Fh%ng tZm Wu l=u/ giDm 3ot nhi@t V m%i t#Tng/ [iB Cm o)/ qu& t#S : nng lng cho c thD/ Cung cCp thEc n cK nhi;u chCt N- n$c t#i c=&/ Cho o) vn Vng- tp ,Qng/ (h]c hi@n thuHc nhun t#ng th2o & l@nh 'nJu cK*/ [ii thich v h$ng An cQ thD gtp o) 1n t=m i;u t#L/

$ F G-S/ j[O BN Cung cCp FiJn thEc t#ong chm 3Kc vJt thng v nhn ,iJt cc ACu hi@u nhiwm t#hng/ 0$ng An chJ V n thich hp/ vt lG t#L li@u tich c]c gitp phQc hri t2o c- cEng Fh$p/ Cung cCp th%ng tin v; phu thut chRnh hSnh v gitp o) th1m gi1 vo cVng rng/

$ ; !kv8V V-S vJt ,zng lnh v Ainh Anng & :/ o) cK Fh nng vn Vng t# li/ gh%ng ,L ,iJn chEng nhiwm t#hng v 3yo co #tt/

F CHwM SxC NGI BhNH GH( DA F 1 Y81 8V1Z5 1hBp /a r.i5 lC& mVt mnh A1 ni no t#n c thD K #ri gh\p ln ch thiJu A1/ Ynh A1 gh\p 3Hng c l nhT 3] thlm thCu chCt Ainh Anng t^ ni nhn/ CK loiX Ch2 ph: ton phn/ Ch2 ph: mVt phnX gh\p A1 N2n F- gh\p A1 ng]c v?n- gh\p A1 t2m th v gh\p A1 l$i/ f! /a5 mVt mnh A1 h1& mVt phn m% c c ,Kc tch thnh FhHi D gh\p/ vt A1 cK FhHi lng l$n nn cn phi Fh=u nHi mch mu c:1 vt vo mch mu ni nhn D ti lp tun hon nu%i 3Hng vt A1/ 9h&y*n ghBp5 Ai chu&Dn chCt li@u t^ ni n& 31ng ni Fhc D gh\p v 31u K Ahng cc Fd thut vi phu D ti lp tun hon cho vt A1/ Phu thut gh\p A1 cK nhi;u loiX q1 t] th=nX A1 chng mVt ngTi { loi A1 n& 3 3Hng vnh viwn t#n n;n gh\p/ q1 rng loiX lC& ngTi Fhc- chR ch2 ph: tm thTi- Fh%ng c D Wu ! ng& m Fh%ng th1& ,ng/ q1 AL loiX loi vt- phi th1& ,ng mi ng&- ngu& c nhiwm t#hng c1o/ q1 nh=n toX 3ilicon2- pol&vin&l chlo#iA2 A2#iv1t2 c|ng m1ng tinh chCt tm thTi/

F $ T\81 O10 O]5 j5 V1_ 41- O18 b5 - q1 gh\p cng mzng cng Aw tinh- Aw 3Hng nhng 3yo Aw co #tt/ - q1 gh\p cng A& cng FhK Ainh v Aw chJt/ F F C1Q8 dY BN V1_ j5 3.3.1. ?oJn thBn - (hD t#ng Fh/ - gh%ng cK ACu hi@u nhiwm t#hng- Fh%ng 3Ht/ - P#otiA mu 6" g}l/ - 0rng cu- Aung tich hrng cu- ,ch cu v tHc V lZng mu ,Snh thTng/ 3.3.2. ^Hng 8* cho - (Zm #1 3ch t#$c 7 ng& v nn tZm 3ch nhCt vhng A1 3Zp cho D gitp mnh A1 gh\p Fh%ng ,L nhiwm t#hng/ - Phn Ao cho cn co l%ng t#$c m+ nhng t#nh Fh%ng c D vJt thng t#n A1/ - png ng& m+X 3.3.3. ^Hng 8* $_c gh[3 - Y% ht m.c tHt ,?ng v$i n;n A1- Fh%ng tQ ALch- Fh%ng m: v Fh%ng cK ACu hi@u nhiwm t#hng/ - Iq cnX .ng v m% hoi t/ F ; C19: .{O .5Q :n V1_ j5 P23.4.1. Ch<m NSc mnh 8* gh[3 ong \p v ,Ct Vng tCt c cc mnh gh\p- nJu chi t#nX cn th2o Ai ACu hi@u chn \p thiJu mu nu%i Ao ,ng \p/ ong Fin vJt thng ,?ng gc v% Fhuln/ x1 3ch vJt thng lC& hJt AL vt- mu tQ- ALch E x1 3ch A1/ pt t#hng A1 nhng t#nh 3 AQng Aung ALch cK mu/ ong Fin v% Fhuln t#n vhng A1 K/

gh%ng th1& ,ng- nJu m 3$m Wu 3 lm mnh gh\p ,ong #1/ )JuX ong Wu ,lnX chR th1& l$p ,ng ngoiO ong Wu Fh%X nn thCm gc lm ,?ng n$c muHi 3inh lG/ ong 3chX th1& ,ng vo ng& thE !- nJu cn FiDm t#1X th1& ,ng vo ng& thE 7/

Cch th1& ,ngX (hCm $t ,ng t#$c Fhi m/ (ho ,ng nhy nhng/ n nhy nhBng vhng A1 phrng n$c gitp thot ALch/ CZt ,$t nhBng mnh A1 hoi t Fh% cEng/ x1 3ch nh nhng v thCm htt ALch/ ong lm li v \p nhy/

(h2o Ai ACu hi@u nhiwm t#hng Wu1X )hi@t V tng c1o/ I1u nhi;u hn/ ong thCm ALch +i mu v cK mhi h%i/

3.4.2. Ch<m NSc mnh 8* cho - gh%ng th1& ,ng- D s-e" ng& ,ng t] Vng ,ong t#Kc #1 v t] lnh/ - [itp o) phi nZng v vn Vng ,Snh thTng/ - 0$ng An o) Fh%ng t] tho ,ng 3$m/ F ? C19: .{O .5Q :n V1_ }C0 j5 3.5.1. ?hRo 8`i D; vJ vt 8* gh[3 - (h2o Ai 7" phtt t#ong 5 giT u 31u m+ cho Jn Fhi +n Lnh- mi giT t#ong 5 giT 31umi giT t#ong ng& u- 5-6 giT t#ong -7 ng& 31u/ - (h2o Ai mu 3Zc vhng A1 gh\p- ,Snh thTng hrng hn A1 thTng Ao m1o Wun giMn n/ - (h2o Ai tun hon A1 Wu1 ACu hi@u nhCp nh& A1 ,?ng cch Aung ngKn t1& Cn nhy ln vt A1 v th t1& #1 D Wu1n 3t 3] t# v; c:1 mu 3Zc vt A1- ,Snh thTng e- gi=&- nJuX In hri Wu nh1nhX Ao E mu tnh mch/ In hri Wu chm ' -7 gi=&*X Ao gim lu lng mu/

- (h2o Ai nhi@t V A1X ,Snh thTng A1 Cm- nJu A1 nKng Fm nhi@t V c thD tng cn N2m li ACu hi@u nhiwm t#hng/ - (h2o Ai tSnh t#ng vt A1X oSnh thTngX m;m v n hri/ qCu hi@u chn \p nhyX cng- phh n; nhy/ (Zc nghn mch muX Wu cng- z tim- cK nHt phrng/

- (h2o Ai ,ng nJu mu thCm ,ng nhi;u cK ngu& c to thnh g1#% chn \p vt A1/ 3.5.2. Ch<m NSc vPt thng - qi chu&Dn o) nhy nhng- t#nh v1 chm v m ,o vhng A1 gh\p ,Ct Vng tHt/ - (h1& ,ngX nJu ong thCm mu nhi;uX nn th1& ,ng l$p ngoi t#$c 7 ng& 31u gh\p/ n LnhX th1& ,ng vo ng& thE -7/ CK vJt thng hX th1& ,ng hng ng&- ,ng lm v lzng nn D h vt A1 D th2o Ai/ - Chm 3Kc nyp ,VtO - xtt An lu 3$m 5s giT 31u m+/ - CZt chR muVn e -e5 ng& 31u m+/ 3.5.3. Ch<m NSc toJn thBn - Cung cCp Ainh AnngX p#otiA2- vit1min2- Fhong chCt- n$c- - gh%ng htt thuHc l vS lm tng ngu& c chm lnh mnh A1 gh\p/ - 0$ng An o) vn Vng ti giTng- No1& t# tHt D gitp o) thoi mi/ - )gn ng^1 cc ,@nh ngoi A1 v nhiwm t#hng mnh gh\p/ - ghu&Jn Fhich o) nn v@ 3inh th=n thD 3ch 3/ - IVng vin- Fhu&Jn Fhich v gitp o) gim t=m lG lo =u- 1n t=m v hp tc t#ong i;u t#L v chm 3Kc/

CpU HqI !rNG GI' e/ ozng V lX

1/ ChR t+n thng l$p 3^ng ,/ (hng t+n mVt phn l$p thng ,S c/ (hng t+n hJt l$p thng ,S cho Jn mng & A/ (hng t+n Jn phn n%ng c:1 l$p ,S / Iq cn chm 3Kc mnh A1 gh\p #TiX 1/ (h1& ,ng mi ng& ,/ (h1& ,ng Fhi thCm ALch c/ (h1& ,ng vo ng& thE 31u gh\p nJu A

A/ (h1& ,ng vo ng& thE ! 31u gh\p nJu 3ch 7/ p1u Fhi chm 3Kc vJt ,zng- Iq nn Zp Fin vJt ,zng ,?ng gcX 1/ CK thCm v132lin2 ,/ [c Fhng 3inh mn c/ [c cK Fhng 3inh A/ [c cK ,2t1Ain2 5/ vJt ,zng n%ng- 31u Fhi chm 3Kc ,ng li- Iq 3 th1& ,ng tiJp vo ng&X 1/ (hE 7 ,/ (hE ! c/ (hE 8 A/ (hE e" !/ o) ,zng n%ng- vo ng& thE mC& Iq cho o) tZm ,zngX 1/ (hE 8 ,/ (hE e" c/ (hE e! A/ (hE "

TI !IhU THAM KHsO e/ oi ging ,@nh h.c ngoi Fho1 tp e- Ii h.c < qc (P0CY- efs!- e8!-es /

/ )gu&wn (hJ 0i@p- o@nh h.c ngoi tiu hK1- Ii h.c < qc (P0CY- )h NuCt ,n < h.c""7- e7- 6/ 7/ )gu&wn (Cn CTng- Ii;u Anng )goi tp e- )h NuCt ,n [io AQc vi@t )1m- ""f- 58-6"/ 5/ Y2Aic1l pu#gic1l )u#3ing- 42i3 Colli2# 02itF2mp2#} Ypo<- eff - ! !-!7!/

BI ? CHwM SxC NGI BhNH TRC M

MC TIU 1. Trnh by c !b" %&an !r#ng c-a gi2i ph3& v "7c <ch c-a vi;c phdng vEn b;nh nhSn !rMc ph3& !h&8!. 2. Kng gi c b;nh nhSn !rMc ph3& !h&8!. (. ThJc hi;n c vai !r, %&2n lR c-a i& /0ng !rong vi;c ch&:n b b;nh nhSn !rMc ph3& !h&8!. +. 9h&:n b c b;nh nhSn !rMc ph3& !h&8!.

1 I CNG [ii phu l FJ hoch cK A] FiJn v cK 3] chuln ,L- c m+ cCp cEu h1& m+ chng t#Snh ;u m1ng tm Wu1n t#.ng nh nh1u/ Chuln ,L cuVc m+ lu%n th]c hi@n mVt cch 1n ton v hi@u Wu D t#nh t1i ,iJn cho o) t#ong Fhi m+- ngn ng^1 ,iJn chEng 31u m+ v gitp o) hri phQc tHt/ v1i t#P c:1 ngTi Iq #Ct Wu1n t#.ng t#ong vi@c 31 3on o) t#$c m+/ Iq cn cK nhBng th%ng tin c ,n v; o)- Ao v& Iq phi thu thp AB Fi@n t^ o) v; ,@nh tt v cc #Hi lon Fm th2o/ Iq cn hiDu c phn Eng c:1 o) t#$c m+- phi ,iJt nh gi cc FJt Wu N\t nghi@m ti;n phu v phi ,iJt lng gi nhBng th1& +i c:1 c thD- ngu& c v ,iJn chEng lin Wu1n Jn phu thut/

$ (HqNG VyN BhNH NHpN TRC M

Phzng vCn o) t#$c m+ gitp Iq thu thp AB Fi@n v; ,@nh 3- ti;n 3- t#i@u chEng- tSnh t#ng o)- nhBng FhK Fhn c:1 o) v Wu1 K gitp o) ch.n ng& v giT phu thut thich hp/

bu1 phzng vCn- Iq 3 th%ng ,o cho o) v; phng php phu thut v g=& m vS thTng o) #Ct lo =u v; phng php g=& m- v; loi phu thut cn thiJt- vi@c cung cCp th%ng tin n& gitp o) 1n t=m/

Iq gitp o) th]c hi@n c1m FJt rng G m+ c:1 o)- =& l vCn ; m1ng tinh chCt php lG- o) cn hiDu # t#$c Fhi FG c1m FJt/ (#ong Wu t#Snh t#1o +i 3 gitp Iq nh gi tSnh t#ng t=m lG c:1 o)- Iq cn tiJp Ntc v$i o) v ngTi nh c:1 o) D hiDu # t=m t- lo lZng c:1 o) v cK FJ hoch c1n thi@p FLp thTi/

F !rNG GI' TIU (H)U `c Lnh tSnh t#ng 3Ec Fhz2 v thu thp AB Fi@n v; o)O `c Lnh v i;u chRnh cc &Ju tH ngu& c t#$c Fhi phu thutO C=n nhZc N2m o) tiJn hnh phu thut th2o chJ V no 'nVi t#t- ngoi t#t h1& t#ong ng&*O 4p FJ hoch v th]c hi@n FJ hoch t#$c m+O bu1 hVi chlnX ch.n loi thuHc g=& m v phng php phu thut tHt nhCt cho o)/

; !rNG GI' C'C DG KIhN CHi +UAN ; 1 TK: bz o) cK thD lo 3 1u v Fh%ng thoi mi- 3 Ao Fh%ng hiDu ,iJt- 3 ,iJn Ang c thD- 3 N1 cch ngTi th=n- 3 chJt- 3 g=& m- 3 th1& +i lHi 3Hng 31u m+- Iq cn nhn ,iJt nhn thEc c:1 o) D n=ng n v cung cCp nhBng th%ng tin t#ong 3uHt thTi gi1n t#$c m+/ Iq l ngTi n=ng n tinh thn v gitp o) gim 1u ,urn- gim 3 hMi D Au& t#S v hri phQc ni;m tin cho o)/ ; $ T-R8 . .NO 41

Iq cn Fh1i thc 3] hiDu ,iJt cn thiJt c:1 o)- v; phu thut t#$c m+ v nhBng th1n phi;n c:1 o)/ v$i phQ nBX tSm hiDu ti;n 3 Finh ngu&@t- 3inh 9- ng& cK Finh 31u chng v$i mQc ich t#nh nh hng c:1 thuHc g=& m- 31ng chCn tinh thn- tc AQng phQ c:1 thuHc t#n ngTi m1ng th1i/ IHi v$i t#9 vL thnh ninX cn cln thn Ahng nhBng t^ ngB phh hp D Fh1i thc cc vCn ; v; Finh ngu&@t- 3inh 3n v tSnh AQc/

)hBng th%ng tin v; gi1 Snh nh ,@nh Ai t#u&;n- lin Wu1n Jn g=& m- ,@nh tim mchnVi tiJt- th1i FU- hon cnh o)- Finh tJ- ,@nh tt c:1 o) v gi1 Snh/

; F S81 V-S .NO 41 0/t8 01K8 (+ng t#ngX c=n ncng- chR 3H oYa/ (Snh t#ng A1 nim/ q0p(/ Pht hi@n nhBng ACu hi@u ,Ct thTng c:1 o)/

4.3.1. a% tim mch )hi@m vQX p Eng nhu cu oN&- ALch thD- thuHc- Ainh Anng cho c thD/ I=& l nhi@m vQ #Ct Wu1n t#.ng vS h@ thHng n& cPn m1ng thuHc- Fhng 3inh- thuHc m t#ong Wu t#Snh phu thut/ )goi #1 cPn cK nhi@m vQ m1ng cc chCt cn loi ,z #1 Fhzi c thD/ 0ziX cn Fh1i thc ,@nh 3 v; tim mch nh c1o hu&Jt p- 1u thZt ng]c- 3u& tim- ,@nh tim ,lm 3inh- m+ tim/ Cn Fh1i thc nhBng th%ng tin v; ,c 3 1ng i;u t#L- thuHc tim mch 1ng 3 AQng/ ghmX nh gi mch- hu&Jt p- A1 nim- tSnh t#ng ch& mu- o i@n tim gitp pht hi@n ,Ct thTng t#n i@n tim/ C1n thi@p IqX )Ju o) cK nhri mu c tim cn Fhu&n o) hoMn phu thut Fhong 6 thng 31u D t#nh ngu& c ti pht/ )Ju o) cK ,@nh tim ,lm 3inh- ,@nh v1n tim- thCp tim cn th]c hi@n Fhng 3inh A] phPng t#$c m+/ o) lon nhLp timX cn th2o Ai i@n tim t#$c m+/

)Ju o) Ahng qigit1li3X cn th2o Ai Lnh lng g1li t#ong hu&Jt th1nh D t#nh nh hng tc AQng phQ v Vc hi c:1 thuHc m/ (h]c hi@n t#u&;n ALch Hi v$i o) mCt n$c t#$c m+- cln thn v$i o) l$n tu+i vS #1nh gi$i giB1 th^1 v thiJu n$c #Ct hyp/

4.3.2. a% hG h3 )hi@m vQX cK nhi@m vQ #Ct Wu1n t#.ng t#ong phu thut vS v^1 l ng g=& m v^1 l ng thi thuHc m v t#1o +i Fhi/ (J ,o thiJu oN& 3 chJt v oN& cK v1i t#P Wu1n t#.ng nhCt Hi v$i m% nMo/ CK nhi;u phng php g=& m phi Wu1 Tng h% hCp- vS thJ nJu h% hCp cK vCn ; thS #Ct ngu& hiDm cho o)/ 0ziX o) cK ti;n 3 FhK th- ho- 3u&wn- ho #1 mu- l1o- nhiwm t#hng Tng h% hCp Finh nin t#$c K h1& Fh%ng vS =& l nhBng t#i@u chEng c:1 ,@nh Tng h% hCp t#$c K/ pu&wn l vCn ; o) phu thut- 3u&wn cK thD NuCt hi@n Fhi lo 3- mhi C|ng cK thD g=& cn FhK th cho o)/ ghmX tuU vo t^ng loi phu thut nhng c ,n Iq cn lC& nhLp th- FiDu th- ngh2 ph+i- P1 / C1n thi@pX 4.3.3. 6*n )hi@m vQX g1n lin Wu1n Jn Tng t#ong mu- ,iJn Anng mn- t+ng hp p#ot2inthuHc- ,iJn Anng ho#mon2- to ,ili#u,in v ,i tiJt gii Vc cho nhi;u loi thuHc mthuHc i;u t#L-/// 0ziX ti;n 3 v; vim g1n t#$c K- M tim ng^1 vim g1n ch1- 3H ln tim- thTi gi1n tim/ (Snh t#ng AL Eng A1- ngE1 v cK vng A1 ln no Fh%ng/ CK ,@nh li v; Tng mt )Ju o) cK nhiwm t#hng cCp tinh Tng h% hCp t#n- Iq cn th]c hi@n Fhng 3inh th2o & l@nh gitp i;u t#L AEt iDm nhiwm t#hng/ )Ju o) htt thuHcX cn ngng htt thuHc t#$c m+ e tun/ Phi ghi nhn o) cK ,Ct thTng v; h% hCp- ghi nhn chEc nng h% hCp nh Fhi mu Vng mch- ngh2 ph+i- nh gi li tSnh t#ng h% hCp/ 0$ng An o) cch hit th 3=u- h$ng An cch th hi@u Wu- cch No1& t#- ngri A& gitp giMn n ph+i tHi 1 31u m+- h$ng An o) cch ho- Fhc m/

nh 3zi mt- 1u h 3Tn phi Fh%ng/ CK ti;n 3 v; m+ mt- m+ g1n/ (i;n 3 uHng #u- 3H lng- thTi gi1n/ ghmX ,T g1n to Fh%ng- tSnh t#ng vng A1- ,Qng ,ng- ACu tun hon ,ng h@- mu ph=n- cc ACu 1u t#n ,Qng v nn nh gi N\t nghi@m chEc nng g1n- ,ili#u,in/ C1n thi@pX 4.3.4. ?hn )hi@m vQX 3u& gim chEc nng thn lin Wu1n Jn 3H lng ALch th1& thJ- mCt c=n ,?ng v; ALch thD v i@n gii- chEc nng %ng mu- gi1 tng ngu& c nhiwm t#hng- vJt thng l=u lnh- th1& +i p Eng c:1 i;u t#L v Fh%ng tin on c 3] ,i tiJt c:1 thuHc/ 0ziX o) cK phh Fh%ng- phh vo ltc no v phh =u/ (iDu gZt ,uHt- tiDu Qc- 3H lng n$c tiDu/ CK ti;n 3 3zi ni@u- m+ thn- gh\p thn Fh%ng/ ghmX c=n ncng- hu&Jt p- n$c tiDu- A1 nim/- Fhm thC& ACu hi@u phh/ C1n thi@pX (h2o Ai mCt n$c- th]c hi@n ,h n$c v th]c hi@n c=n ,?ng i@n gii o) t#$c m+- c=n ncng- th2o Ai phh/ PhPng ng^1 thiJu n$c v #Hi lon i@n gii- th2o Ai 3H lng n$c tiDu/ Inh gi chEc nng thn- ion r/ )hn Lnh 3$m t#n l=m 3n ACu hi@u thiJu i@n gii/ Inh gi tSnh t#ng #Hi lon %ng mu- rng thTi th]c hi@n tSnh t#ng ch& mu Wu1 thuHc th2o & l@nh/ Chm 3Kc vng A1- thuHc gim ngE1- uHng nhi;u n$c/ )ghR ngi v Ainh Anng hp lG gitp n=ng n chEc nng g1n/ (h]c hi@n thuHc n=ng n chEc nng g1n- t#nh nhBng thuHc thi Wu1 g1n/ (h%ng ,o cho nhKm phu thut v; tSnh t#ng o)/

4.3.5. ?hn kinh t: ng ng - Inh giX t#i gic- nhn thEc- th]c hi@n cc & l@nh c:1 o)/ - gh1i thc t1i nn v; nMo- tu_ 3Hng t#$c K/

- Inh gi v; nhn thEc #Ct cK ich t#ong th2o Ai 31u m+- gitp Iq nhn Lnh v; t#i gic v nhn thEc o) chinh Nc hn/ 4.3.=. C Qng kh"3 0ziX ti;n 3 vim Nng Fh$p- nhCt l ngTi gi vS nK 3 lm hn chJ c Vng- t thJ o) t#ong v 31u m+/ Iq h$ng An o) cch tp vn Vng t#$c m+- 31u m+- t#nh o) 1u Ao vn Vng- Ai chu&Dn/ 4.3.W. &inh 8@ng o\o phSX g=& FhK Fhn t#ong t thJ m+ v Ai chu&Dn o) 31u m+/ Aw nhiwm t#hng vJt thng- vJt thng l=u lnh- thuHc m thCm chm v trn ti t#ong mn- Ao K gii phKng thuHc 31u m+ chm nn o) m l=u hn v tRnh chm hn/ )Ju Fh%ng m+ cCp cEu- Iq cn h$ng An chJ V n v tp lu&@n gim c=n cho o) t#$c m+/ pu& Ainh AnngX gim p#ot2in- vit1min A- o/// o) phQc hri chm- vJt thng l=u lnh/ )gTi gi- ngTi ngho n it chCt Ainh Anng- o) n uHng F\m- o) mn tinh- ung th thTng cK ngu& c 3u& Ainh Anng v thiJu hQt ALch thD Ao thKi Wu2n Fing n h1& Fh%ng n c/ )=ng c1o thD t#ng o) t#$c m+ l i;u cn thiJt/ Iq h$ng An o) thEc n nhi;u Ainh Anng- chJ V n phh hp ,@nh lG/ )Ju o) 3u& Fi@t nhi;u hocc Ao ,@nh lG Fh%ng n c cn th]c hi@n nu%i n ,?ng ALch t#u&;n 1n ton v : nng lng/ 4.3.>. ;ghi%n m* t C1 :_ )gTi nghi@n m1 tuG h1& #u thTng cK ngu& c 3u& Ainh Anng c1o v cc ,i@t v$i ngTi nghi@n #u thS chEc nng g1n c|ng 3u& gim/ Iq cn Fh1i thc ti;n 3 mVt cch cln thn Wu1 ngTi th=n v chinh ,n th=n o)/ (hTng o) Fh%ng Fh1i tht nn Iq cn Fh\o l\o D cK nhBng AB Fi@n chinh Nc v; o)/ o) nghi@n #u h1& m1 tuG cK #Ct nhi;u ,iJn chEng 31u m+ Ao tSnh t#ng 3u& Ainh Anng- Ao chEc nng g1n gim- Ao chEc nng thn Finh c|ng cK vCn ;/ Iq cn cK FJ hoch chm 3Kc t#ong t#Tng hp o) ln cn nghi@n 31u phu thut h1& curng 3n Ao #u/

4.3.A. ;Ii tiPt (iDu TngX l mVt &Ju tH ngu& c cho c g=& m v gii phu/ o) tiDu Tng cK ngu& c c1o t#ong h Tng hu&Jt- ,iJn chEng tim mch- ngu& c nhiwm t#hng c1o- vJt thng l=u lnh/ Iq cn Nc Lnh th2o Ai Tng hu&Jt t#ong mu v gitp ,c 3 i;u chinh lng Tng t#ong mu/ Iq cn th]c hi@n chJ V tiJp chJ cho o)/

4.3.1E. ;hiOm t:Hng )Ju nhiwm t#hng cCp tinhX cuVc m+ thTng phi hu_ nJu l m+ chng t#Snh/ )Ju nhiwm t#hng mn tinh nh l1o- AaqpX tuU t#Tng hp cK thD m+/ giDm 3ot nhiwm t#hng t#$c m+ l i;u cn thiJt cho o)- vS thJ cn hzi o) v th]c hi@n Fhm chu&n Fho1 t1i- m|i- h.ng- #ng- hm - mct- tiJt ni@u- 3inh AQc t#$c m+/ (h2o Ai nhi@t V- th]c hi@n & l@nh t#ong i;u t#L AEt iDm t#$c m+- th]c hi@n thuHc Fhng 3inh phPng ng^1 th2o & l@nh i;u t#L/ 4.3.11. ZiOn 89ch Cn tSm hiDu ti;n 3 AL Eng c:1 o) nh AL Eng thuHc- cn Fh1i thc cc loi thuHc v ghi cht hr 3 gitp th& thuHc v g=& m t#nh 3 AQng nhBng loi thuHc n&/ qL Eng thEc n c|ng Wu1n t#.ng vS 31u m+ vCn ; Ainh Anng #Ct cn thiJt nn cn hzi # th%ng tin D t#nh t1i ,iJn- AL Eng cK thD lm tSnh t#ng 31u m+ ncng hn/ (#ong nhBng o) gh\p tng thTng Fh nng miwn ALch F\m nn cn cK FJ hoch chm 3Kc hon ton v% Fhuln D t#nh ngu& c nhiwm t#hng cho o)/ 4.3.12. ?h c Cn hzi o) v; thuHc h. 1ng 3 AQng vS cK ngu& c tng tc v$i thuHc m cK thD nh hng t$i thuHc tim mch- hu&Jt p- miwn ALch chHng %ng mu-/// ,iJt c 3] tng tc v phn Eng phQ c:1 thuHc- AL Eng v$i cc loi thEc n- ho h.c- nghi@n thuHc- lm AQng thuHcnghi@n #u/ (huHc 3t2#oiAX t#ong nhBng t#Tng hp o) mZc ,@nh mn tinh cn i;u t#L l=u Ai loi thuHc n& cn Fh1i thc F cch 3 AQng v Fh%ng nn Ahng Vt ngVt- cn ,o Wu1 nhKm g=& m D cK h$ng i;u chinh thuHc FLp thTi/

(huHc li tiDuX thTng Fm th2o gim g1li mu c|ng nh hnng Jn tim mch h1& thuHc (hi1iA2 c|ng cK thD g=& 3u& h% hCp t#ong Wu t#Snh g=& m/ )goi #1 thuHc li tiDu c|ng g=& tSnh t#ng mCt n$c v i@n gii/

(huHc chHng t#m cmX tc AQng phQ c:1 thuHc n& c|ng g=& ngu& c tQt hu&Jt p/ A3pi#inX t#ong nhBng ,@nh lG tim mch o) thTng 3 AQng l=u Ai 13pi#in/ Iq cn th%ng ,o cho g=& m D cK FJ hoch g=& m cQ thD t#nh tSnh t#ng ch& mu 31u m+ Ao t#ong mVt 3H phu thut cK thD FJt hp Ahng h2p1#in t#ong m+/

? DG KIhN KH'CH +UAN Yi o) cn cK hr 3 ,@nh n t#$c m+/ ghm N\t thD chJt v phi hon tCt AB Fi@n o) t#$c m+ Ao phu thut vin- Iq v g=& m th]c hi@n/ `\t nghi@m cn l=m 3ng t#$c m+ ,1o grmX YuX c%ng thEc mu- mu %ng- mu ch&- nhKm mu- Aung tich hrng cu- tHc V lZng mu- chEc nng %ng mu ton ,V- o)- Tng hu&Jt- p#otiA/ )$c tiDuX t+ng ph=n tich n$c tiDu/ Chln on hSnh nhX ` Wu1ng ph+i- 3iu =m- i@n tim- C( 3c1n/

)goi #1 tuU loi phu thut ngTi th& thuHc cK & l@nh cc N\t nghi@m Fhc v; g1n- tu_ r- thn/

o +UsN ! IU DNG o 1 G-S/ j[O BN 0Pk|O _1`Q 01Qc0 o) nVi t#tX cn gio AQc v Acn AP ,u+i chi;u t#$c m+ 31u Fhi hVi chln Nong v Fhi chuln ,L v@ 3inh cho ngTi t#$c m+/ o) ngoi t#tX cn gio AQc v Acn AP t#ong ng& Fhm ,@nh v 3ng ng& t#$c m+/ 0$ng An o) Jn tng giT v thTng Jn t#$c giT m+ e Jn giT/ )Ju m+ t#ong ng& cn lin h@ v$i o) D ,o t#$c giT m+/

)Vi Aung gio AQcX cung cCp th%ng tin cho o) v th=n nh=n o)- gitp h. ,$t cng thng- lo =u t#ong thTi gi1n chT i cuVc m+ ,1o grmX phzng on thTi gi1n c:1 cuVc phu thut- thTi gi1n hri phQc 31u m+- ni chu&Dn o) Jn 31u m+- th%ng tin v; nhKm

31u m+ v nhBng chm 3Kc thTng Wu&/ on cnh K Iq c|ng h$ng An o) cch th 3=u- ho- th giMn- vn Vng t#$c m+ D 31u m+ h. hiDu ,iJt v t] chm 3Kc tHt hncch 3 AQng thuHc ,m gim 1u- gitp o) ,iJt c nhBng th%ng tin cc ,i@t Fhi m+/ (h%ng tin cho o) ,iJt cn tZm- thQt tho- ngng n uHng t#$c m+/ Cn lZng ngh2 v Wu1n 3t o) th]c hi@n tng h1& ch1/ [i t#L c:1 vi@c gio AQcX gitp o) gim lo lZng- gim 3- gim n%n Ki- gim 1u- gim ,iJn chEng- gim thTi gi1n n?m vi@n/ )goi #1 o) cPn hiDu # hn ,n th=n 3 lm thJ no D gitp cho 31u cuVc m+ c tHt hn/ o $ T1O 1-A8 O5: 4D0 0Pk|O :n gG giC& c1m FJt t#$c m+ l o) t] ngu&@n v ng thun m+/ 0r 3 n& ,o v@ cho ,c 3- Iq- ,@nh vi@n- chi1 39 Wu&Jt Lnh giB1 ngTi m+ v ngTi c m+/ )hng t#$c Fhi FG c1m FJt o) cn ,iJt chln on Nc Lnh- mQc ich i;u t#L- mEc V thnh c%ng c:1 cuVc m+- ngu& c ,L th1& +i t#ong i;u t#L/ o) cn phi chEng tz : hiDu ,iJt ton Ai@n v; nhBng th%ng tin c cung cCp/ o) Fh%ng ,L thu&Jt phQc h1& ,L \p/ o) cK thD FG c1m FJt cho ,n th=n nJu tu+i v tSnh t#ng tinh thn cho ph\p/ )Ju nh o) cPn nhz- h%n m- #Hi lon t=m thn thS ngTi th=n cK thD FG c1m FJt th1& thJ/ )Ju o) l ngTi nhz tu+i- t] Ao- t#n e6 tu+i cK thD t] FG giC&/ (#ong t#Tng hp cCp cEu cK thD phi m+ D cEu 3Hng m Fh%ng cK mct c:1 gi1 Snh thS ngTi FG tn phi l ngTi cK t#ch nhi@m v; phi1 ,@nh vi@n/ CNG VIhC C THX M IU DNG CN CHU&N B" NGI BhNH TRC M 1 NVtE 0Pk|O :n Ci ,z t t#1ng o)/ (ho #ng giX l &u cu tu&@t Hi vS #ng gi g=& t# ngi t#ong vi@c ct nVi Fhi WungM& h1& 3Et #ng gi- AL vt Tng th nJu #ng #$t vo Fhi Wun/ (Kc Ai thZt ,im li h1& ,uVc tKc g.n gng/ YKng t1& 3nX chhi 3ch mKng t1& mKng ch=n cK 3n mu gitp Wu1n 3t th2o Ai mu 3Zc A1 nim- mKng chinh Nc/

v@ 3inhX nn cho o) v@ 3inh 3ch 3 chi;u h%m t#$c m+- v@ 3inh vhng m+ v tZm 3ch vhng m+ tHt nhCt v$i N ,%ng 3t Fhuln- nhCt l vhng m+/ 0i@n n1& t#ong cc ti li@u n$c ngoi vi@c co l%ng hn chJ th]c hi@n- th1& vo K l vi@c lm v@ 3inh v$i Aung ALch 31von 3t Fhuln/ )Ju t#ong t#Tng hp co l%ng thS nn 3 AQng AQng cQ co #=u/

n uHngX chi;u t#$c m+ n nhy loMng- tHi t#$c m+ nhLn n hon ton- thTng nhSn n tHi thiDu s giT t#$c m+- ngng uHng tHi thiDu t#$c 5 giT/ png ng& m+ th]c hi@n t#u&;n ALch cho o)/ (#ong t#Tng hp o) g=& t thS Fh%ng cn nhLn n uHng tHi h%m t#$c m+- chR cn nhLn n vo 3ng ng& m+/

(hQt thoX cn lm 3ch #uVt tHi h%m t#$c v 3ng h%m m+ nh uHng thuHc N+- ,m hu m%n ,?ng Aung ALch tl& N+/ v$i m+ i t#ng- ngu&n tZc l phi 3ch ph=n i t#ng nn cn th]c hi@n thQt tho cho o)/

(=m lG t#$c m+X D t#nh o) lo =u- cng thng- Iq cho o) gcp gn ngTi nh- Fhu&n o) ng: 3$m- cK thD th]c hi@n thuHc 1n thn th2o & l@nh cho o) m t#$c m+/

$ SS8V 1T: :n (hQt tho li 3ng t#$c m+- tuU vo t^ng loi phu thut nhng thTng m+ i t#ng l i;u cn thiJt/ Chuln ,L o)X th1& r m+ cho o) 31u Fhi tZm 3ch vo ,u+i 3ng/ (+ng t#ngX lu%n lC& q0p( vo 3ng h%m m+ v t#$c Fhi Ai chu&Dn o) ln ,n m+/ Cht G FiDm t#1 mct v$i o) m+ ,$u gip- hu&Jt p v$i o) m+ tim- h% hCp v$i o) 3u&wn h1& m+ v; h% hCp/ (h%ng tin ,n gi1o o)X 2o ,ng tn- nn ghi # #ng c h. tn- tu+i- Fho1- chln onphng php phu thut/ vJt thngX th1& ,ng li vJt thng 3ch 3- ,ng Fin/ qLch thDX t#u&;n ALch- th]c hi@n thuHc th2o & l@nh/ PhPng ng^1 tSnh t#ng thiJu ALch l nhi@m vQ #Ct Wu1n t#.ng c:1 Iq t#$c m+/ Ict Hng th%ng A A& 'nJu cn*/ Ict Hng th%ng tiDu 'nJu cn*- cho o) i tiDu/ Chu&Jn o) ln phPng m+X Iq chng th=n nh=n chu&Dn o) Jn phPng m+ ,?ng cc phng ti@n 1n ton/

F T1QeO 0Pk|O :n Iq nn hiDu ,iJt tc AQng v thTi gi1n c:1 thuHc t#$c m+ nh o2noAi12pin23 v o1#,itu#1t2 'thuHc 1n thn g=& m*/ 0 #2c2pto# 1nt1goni3 'thuHc ngn cn ngu& c t+n thng nim mc A A& Ao 13pi#inAo 3t#233 t#$c m+* Hi v$i nhBng ,@nh nh& cm- lo lZng nhi;u hocc tuU ,@nh lG/ Anticholin2#gic lm gim ,i tiJt/ )1#cotic 'thuHc gim 1u*/ ghng 3inhX o) cK ,@nh v1n tim- nhiwm t#hng t#$c K- vJt thng nhiwm t#hng- ngu& c nhiwm t#hng- Fhng 3inh A] phPng t#$c m+/ 02p1#inX tim A$i A1 6-e giT t#$c m+ ngn ng^1 tZc mch- t#ong cc t#Tng hp m+ tim- gh\p tng/// (huHc nhz mZtX nn th]c hi@n t#$c m+ nJu o) t^ng cK m+ mZt/ (huHc t#$c m+ c 3 AQng nh?m lm gim lo lZng- tng 1n thn- gitp gim 1ungn ng^1 n%n Ki- ngn ng^1 cc phn N t] Vng- gitp ct nVi Fhi Wun Aw Ang t#$c m+- gim 3] ,i tiJt ALch A A& - #uVt- h% hCp/ (hTi gi1n v cch Ahng thuHc nh 31uX (huHc uHngX nn cho t#$c 6" - f" phtt t#$c Fhi 1 o) NuHng phPng m+ vS o) chR uHng it n$c/ (im ,Zp- tim t#ong A1X tim 7" - 6" phtt t#$c Fhi NuHng phPng m+/ (im tnh mchX nn th]c hi@n tim phPng ti;n m/ Iq cn ,o cho o) nhBng tc AQng chinh v phQ c:1 thuHc/

qi chu&Dn o) NuHng phPng m+X cn Ai chu&Dn o) NuHng phPng m+ 1n ton- h$ng An ngTi nh ni phPng i v nhBng th%ng tin Fhc/ Cn Ai chu&wn o) ,?ng N2 ln- ,ng c1- t#nh D o) t] i ,V/

CpU HqI !rNG GI' e/ o) cK & l@nh thuHc uHng t#$c m+- Iq cn th]c hi@n & l@nh n& Fhi noX 1/ 7"-6" phtt t#$c Fhi 1 o) NuHng phPng m+

,/ 6"-f" phtt t#$c Fhi 1 o) NuHng phPng m+ c/ Cho o) uHng Nong 1 o) NuHng phPng m+ ng1& A/ Cho o) uHng ti phPng ti;n m / Cn cho o) m+ chng t#Snh nhLn n uHng t#$c m+ ,1o l=uX 1/ 5-6 giT ,/ (Hi thiDu s giT c/ !-8 giT A/ (Hi thiDu e" giT 7/ o) ,\o phS 3 gcp FhK Fhn gS t#ong m+X 1/ gh%ng g=& m c ,/ (hTi gi1n m+ F\o Ai hn c/ (huHc m thCm chm hn A/ p1u m+ phi Fh=u A1 th1 5/ Iq cn chuln ,L gS cho o) ng& t#$c m+X 1/ (ho ,z t t#1ng v nn gi cho th=n nh=n ,/ Co tKc c/ Co l%ng ,V phn 3inh AQc A/ qcn o) nhLn n uHng e ng& !/ ID lng gi chEc nng thn t#$c m+- Iq cn hziX 1/ CK ,i tiDu ,1o giT Fh%ng ,/ C=n ncng ,1o nhiu c/ CK Fhi no tiDu #1 mu A/ CK ,@nh vim thn

TI !IhU THAM KHsO e/ Ph1n (hL 0r 0i- Chuln ,L o) t#$c m+- oi ging ,@nh h.c ngoi Fho1 tp e- Ii h.c < qc (P0CY- )h NuCt ,n < h.c-efs!- f-ee/ / )gu&wn (Cn CTng- Ii;u Anng )goi tp e- )h NuCt ,n [io AQc vi@t )1m- ""f- 6e-8e/

7/ oV m%n Chm 3Kc o) { ((Iq oqCo<( (P/0CY 'effs- efff- ""e- ""7- ""8*/ Ti li;& nUi bU mT8p bi gi2ng 9h?" sTc Lgoi kho1/ 5/ gim 4it1cF/ P#2op2#1tiv2 p1ti2nt- in Y2Aic1l pu#gic1l )u#3ing- Yo3,&-<21# ,ooF- anc/ 5 th 2A/- pt/ 4oui3 { Yi33ou#i- eff6- 7!"-78"/

BI o CHwM SxC NGI BhNH TRONG M

MC TIU 1. ThJc hi;n c nhi;" v7 c-a !hnh vi$n !rong c&Uc "4. 2. ThJc hnh c ch?" sTc b;nh nhSn !rong ph,ng "4. (. Trnh by c c c phng ph p gSy "$. +. ThJc hnh ch?" sTc b;nh nhSn !rong "4.

1 CHC NwNG CiA C'C THNH VIN TRONG CU%C M 1 1 N1{: }T 0PU8V 1.1.1. ChMc n<ng $iT 8@ng t:ong 3h,ng m0 Iq l ngTi u tin c:1 nhKm phu thut tiJp Ntc chng o) phPng m+/ Iq gitp o) thoi mi- 1n t=m- o li q0p( cho o)/ 4u%n lu%n p AQng tng Wu& t#Snh Iq t#ong m+/

1.1.2. KiT 8@ng v,ng t:ong Cn cK FiJn thEc th]c hnh m #Vng- 3] Fh\o l\o v nh& ,\n t#ong tiJn t#Snh cuVc m+,Snh tnh Fhi cCp cEu/ 0iDu # cc tiJn t#Snh t#ong cuVc m+- hiDu # G tng c:1 phu thut vin- hiDu # AQng cQ cn t#ong m=m- hiDu # AQng cQ cn t#ong tiJn t#Snh c|ng nh Fhi cCp cEu/ Iq phi chuln ,L & : AQng cQ cho cuVc m+- nJu cK FhK Fhn v; AQng cQ nn ,o Wu1 phu thut vin/ Im ,o cuVc m+ v% t#hng t#ong 3uHt cuVc m+/

(iJn hnh tng th: tQc t#$c m+X #1 t1&- m1ng gng- mcc o v m1ng gng v% Fhuln cho phu thut vin v ngTi phQ m+/ oiJt cch 3Zp NJp AQng cQ v t#1o AQng cQ tng F thut/ )Zm chZc Wu& t#Snh m+ phHi hp nhLp nhng/ (#i vi ch2 ,n tiJp AQng cQ/ p1u Fhi mcc o- m1ng gng v% Fhuln m$i NJp AQng cQ t#n ,n tiJp AQng cQ v$i mVt 3H phu thut l$n thS NJp thm mVt ,n tiJp AQng cQ/

)1 t#$c c:1 ,n tiJp AQng cQ grmX A1o m+- F\o m+- Fyp phu tich- FSm cm mu- chRFim- FSm Fyp Fim-/// )B1 31u c:1 ,n tiJp AQng cQ t^ t#i 31ng phi th2o thE t] grmX vi ch2 t#Tng m+- cc loi gc- Iq phi phHi hp 1 AQng cQ mVt cch nhLp nhng chinh Nc- th]c hi@n tng cc thS 3ch v ,ln/ (#ong cCp cEu Iq c|ng th]c hi@n tng Wu& t#Snh mVt cch chinh Nc v 1n ton/

ghi m+ h- Iq Eng Hi Ai@n phu thut vin- nhng v$i m+ nVi 3oi- Iq Eng chng ,n v$i phu thut vin/ Cn FiDm t#1 li AQng cQ- gc t#$c v 31u Fhi Kng vJt m+ chng v$i Iq vPng ngoi/ p1u m+ phi FiDm t#1 cc AQng cQ Fim loi- vi- gc :- chuln ,L AQng cQ- gng/// cho c1 m+ 31u/ bun lG cc AQng cQ Fim loi 1ng Ahng- l1u chhi Lnh FS- ,o Wun cc AQng cQ Fim loi A] t#B- hVp hCp/

vL t#i AQng cQ t#n ,n AQng cQ 'httpX}}gi1ngAuong&Fho1/n2t*

vL t#i AQng cQ t#n ,n tiJp li@u 'httpX}}gi1ngAuong&Fho1/n2t*

1.1.3. +hb th t vi5n vJ 3hX m0 Phu thut vin l ngTi Fhm v th2o Ai o) t#$c m+ v l ngTi cK v1i t#P chinh tiJn hnh phu thut- chLu t#ch nhi@m cho ton nhKm m+/ 31u m+/ Phu thut vin hzi ,@nh 3 v Fhm l=m 3ng o) t#$c m+ gitp ch.n phng phCp phu thut- phng php g=& m v cho & l@nh i;u t#L t#$c m+/ 4 ngTi chLu t#ch nhi@m 1n ton v Wun lG o) t#ong 3uHt thTi gi1n m+ v

4 ngTi t#i vi m+ v$i phQ m+ h1& Iq vPng t#ong- ngTi 3t t#hng A1 li 31u chng v An ,ng F2o A1 t#n vhng A1 m+/

PhQ m+ ',c 3- ,c 3 nVi t#t///*X Eng Hi Ai@n phu thut vin gitp phu thut vin chinh t#i vi v% t#hng- t# gitp phu thut vin t#ong 3uHt thTi gi1n m+/ Cm v1n F\oHng htt- cm mu- Fh=u vJt thng/

1 $ N1{: 41T8V }T 0PU8V 1.2.1. K& v,ng ngoJi Phi l Iq lu%n cK mct t#ong phPng m+- t#ong 3uHt cuVc m+- l ngTi t# gitp cho ton nhKm m+- cK thD t# gitp nhi;u phPng m+ chng e ltc/ v1i t#P c:1 Iq vPng ngoi grmX bu1n 3t v t# gitp m.i hot Vng t#ong phPng m+/ qi chu&Dn t#ong Fhong Fh%ng gi1n Fh%ng v% t#hng t#ong phPng m+/ 0 t# cho nhKm v% t#hng- tiJp nhn ,@nh ti phPng ti;n phu- i;u chRnh t thJ o)- #1 A1 vhng phu thut- m cc gKi AQng cQ v% t#hng- th2o Ai q0p(- lC& thm AQng cQ v tCt c nhBng gS nhKm m+ cn- t# gitp nhKm g=& m- th%ng ,o v gi1o tiJp chng ngTi nh t#ong nhBng tSnh huHng cn t#1o +i- Jm AQng cQ v gcghi nhn nhBng chm 3Kc t#ong cuVc m+- lin h@ chng Fho1 hu phu D chu&Dn ,@nh/ (#$c Fhi m+X phi chRnh v FiDm t#1 n m+- m& htt- A1o i@n- ,n m+phPng m+/ giDm t#1 li o)- tn tu+i- chln on ,@nh/ Cho o) ln ,n m+- t thJ o) tng &u cu chng phu thut vin/ x1 A1 vhng m+ v chuln ,L ,n tiJp AQng cQ/ [itp mcc o m+ cho nhKm v% Fhuln- gitp Iq vPng t#ong m cc hVp hCp/// (#ong Fhi m+ lC& thm AQng cQ- thuHc- mu- ALch t#u&;n- N\t nghi@m cho cuVc m+/ bu1n 3t cuVc m+ D h t# cho Iq vPng t#ong- chng v$i Iq vPng t#ong tiJn hnh Jm gc ,n ngoi t#$c Fhi phu thut vin Kng vJt m+/ p1u Fhi m+X Iq vPng ngoi ,ng vJt m+- chu&Dn o) 31ng Fhu hri 3Ec 31u m+ chng g=& m v phu thut vin/ v@ 3inh li phPng m+/ 1.2.2. ;hSm gB! m5 4 ngTi th]c hi@n g=& m ',c 3- Fd thut vin g=& m* v th2o Ai q0p( c:1 o)/

4ng gi o) t#$c m+X D m ,o t#ong vi@c ch.n phng php g=& m/ (h]c hi@n g=& m v phHi hp chng phu thut vin t#ong 3uHt Wu t#Snh phu thut/ oo m v% cm t#ong 3uHt Wu t#Snh m+/ (h2o Ai phn Eng o) t#ong 3uHt cuVc m+/ (h& vo phu thut v Aiwn ,iJn ,@nh lG c:1 o) m cung cCp ALch t#u&;n- thuHc- i@n gii- mu t#ong cuVc m+/// (h2o Ai q0p( cho o) t#ong 3uHt cuVc m+/ Chng Iq vPng ngoi Ai chu&Dn o) 31ng phPng hri 3Ec hu phu/ (h2o Ai 3] hri tRnh c:1 o) ti phPng hri 3Ec t#ong 5 giT 31u m+ v ghi hr 3 v th2o Ai 31u m+ cho Jn Fhi hJt v% cm hon ton/ on gi1o cho Fho1 hri 3Ec tSnh t#ng c:1 ngTi 31u m+/

$ +UsN ! IU DNG $ 1 TPk|O :n 0P/8V _1m8V :n 4ng gi o) t#$c m+ gitp 3o 3nh v$i o) t#ong v 31u m+/ 4ng gi t=m lGX Iq vPng ngoi lu%n hiDu # phng php phu thut v g=& m D gii thich cho o)- gitp h. 1n t=m Fhi chu&Dn vo phPng m+/ 4ng gi 3Ec Fho9X q0p(- c=n ncng- chi;u c1o- tu+i- AL Eng- vhng A1 m+- nhn ,iJt nhBng ,Ct thTngX 3u& gim chEc nng Nng- tiJp Ntc FhK Fhn- G thEc- 1u- Fh%ng thoi mi/ $ $ BN }t/ _1m8V :n o) cn hon tCt cc th: tQc hnh chnh v chu&n m%n m$i c vo phPng m+/ Iq cn ,iJt tn o)- tn phu thut vin- phng php m+ v 3H phPng/ (i lng gi o) ln cuHi t#$c Fhi vo phPng m+/ $ F TP/8V :n )hCt l chuln ,L t#1ng thiJt ,L cho cuVc m+X ,o m 1n ton- #ing t- v% Fhuln t#ong 3uHt thTi gi1n phu thut/ )hKm phu thut cn th1& gi&- Wun o- Finh 2o mZt c:1 phPng m+/

Chuln ,L gKi AQng cQ phu thut v nhBng AQng cQ cn thiJt Fhc- nhu cu thuHc m2n- AQng cQ- mu/ Chuln ,L hon chRnh cc AQng cQ t#ong phPng m+ nh n m+- i@n- m& httm& th2o Ai- m& Ht/ Ii;u chRnh nhi@t V- V lm t#ong phPng m+ thich hp/

Chuln ,L o)X qi chu&Dn o) 1n ton Jn ,n m+/ [itp o) thoi mi- t#nh to tiJng rn Ao AQng cQ- t#nh g=& lo 3 cho o)/ Iq vPng ngoi phQ gitp g=& m- ct Tng t#u&;n- ct Tng t#u&;n tnh mch t#ung t=m/ 0 t# chng g=& m v phu thut vin ct t thJ o) tng t#n ,n m+/ Iq th]c hi@n #1 A1- ct th%ng tiDu/ (h2o Ai o) t#ong 3uHt Wu& t#Snh phu thut/ x1 t1& ngoi Fho1- mcc o v m1ng gng v% t#hng/ gd thut v% t#hng lu%n c p AQng t#ong phPng m+/

(# gitp nhKm g=& mX chuln ,L g=& m cho o)/ Phi hiDu c chJ v cch g=& m/ Iq vPng ngoi t# gitp g=& m lZp ct cc monito#- AQng cQ- tim thuHc- t#nh t1i ,iJn cho o)/

( thJ o)X m ,o t thJ tng ghi chuln ,L t thJ cho o) cn phPng ng^1X tng p l]c thn Finh- cng v chn \p m% thn Finh- t+n thng vhng Nng nh% #1- vhng mZt- chn \p A1- lrng ng]c ,L chn \p- nghn mch mu/ thiJt/ Iq cn t#nh phi ,& c thD o)- nhn ,iJt v t%n t#.ng 3] #ing t cn

Chuln ,L A1X Iq vPng ngoi #1 A1 nh?m mQc ich gim 3H lng vi t#hng N=m nhp vo vJt thng/

$ ; S5Q :n [=& m phi ,iJt t#$c thS FJt thtc phu thut D FJt thtc li;u g=& m- FiDm t#1 th]c thD o) t#$c Fhi chu&Dn o) 31ng phPng hri 3Ec/

(iu chuln chu&Dn phPngX o) Fh%ng cK ACu hi@u ch& mu- mch v hu&Jt p +n Lnh/ Phu thut vin- g=& m- Iq vPng ngoi Ai chu&Dn o) v ,n gi1o v$i phPng hri 3Ec/

F S (HpN !OI THUC M )hBng &Ju tH gKp phn Wu&Jt Lnh phng php g=& m grmX (Snh t#ng ,@nh- ,@nh 3- cm Ntc- &Ju tH lin Wu1n Jn phng php gii phu/ )hKm th]c hi@n g=& mX ph chuln th%ng tin t#$c m+- Wu&Jt Lnh 31u chng- nVi Aung g=& m- & l@nh thuHc t#$c m+/ (#ong Wu t#Snh m+X ,c 3 g=& m 3 th2o Ai q0p(- i@n t=m r- thD tich Fhi lu th%ng/ 4u G Hi v$i ngTi c1o tu+i vS thTng cK Fm th2o ,@nh mn tinh- chEc nng cc c Wu1n hot Vng F\m v tich mn nhi;u hn- Ao K ngu& c c:1 g=& m 3 tng c1o/

; GpH M GpH T V CHwM SxC ; 1 GKE :L d8V 01QeO :L d5E 13-: H5b/0158 8bQP58 I./bQP5 [i1i on eX Fhi m- cn t#nh tiJng Vng vS ltc n& tiJng rn c phKng i/ [i1i on X gi1i on Fich thich/ )n cH Lnh tHt o) t#nh t\ ngM v 3tt A=& t#u&;n ALch/ [i1i on 7X gi1i on phu thut/ Iq v g=& m th2o Ai 3t q0p( v Aiwn ,iJn c:1 o)/ [i1i on 5X gi1i on ngu& hiDm/ Chm 3Kc o) t#ong g=& m ,?ng Tng h% hCpX (h2o Ai nhBng tc AQng phQ Ao g=& m- nhBng th1& +i 3inh lG Fhc nh tng tiJt m nh$t v n$c ,.t/ CK thD phPng ng^1 cho o) ,?ng cch tim thuHc gim n%n- gim tng tiJt/ (#Tng hp o) h th=n nhi@tX cn : Cm/ )gt th Ao m nh$t- Ao AL vt- tQt lni- co thZt th1nh WunX nn ct nVi Fhi Wun cK ,Png chn/ (h2o Ai 3t tSnh t#ng h% hCp o)/

; $ GKE :L uQ5 0Z81 :CO1: B5Pd-0QP50 T1-/_805b M_-P-j-8 u iDmX Fh%ng ch& n+- 1 thuHc vo Aw Ang- o) thoi mi- Aw chLu- cn it t#1ng thiJt ,L/ )hc iDmX gim h% hCp mnh- vim tZc tnh mch- ngV Vc/ Chm 3KcX thTng g=& m- ch.n tnh mch l$n- th2o Ai q0p(- nhCt l h% hCp- o) cn c cung cCp AQng cQ h t#/ (h2o Ai v pht hi@n cc ACu hi@u ngV Vc thuHc/ oiJn chEngX 0% hCpX FhK th- nhLp th ,Ct thTng- ho- ngng th- nCc cQc/ (un honX lon nhLp tim- c1o hu&Jt p- thu&n tZc Fhi- h hu&Jt p/ oiJn chEng FhcX n%n v t#o ngc- t+n thng mZt- ph+i- thn Finh Ao t#u&;n ALch/ ; F GKE 0L 0Q .e8V o) mCt cm gic nhng t#i gic tRnh- thn t#.ng Fhi nKi chu&@n t#ong phPng m+ vS Fhi ,n ,c v; o) 3 lm o) chong Ao lo 3/ Cn th2o Ai nhBng ACu hi@u 31uX ; ; GKE 0L }U8V [=& t vhngX l Ang g=& t t#ong K thuHc t tim vo Nung Wu1nh Fhu v]c Ao thn Finh n& chi phHi/ Chm 3KcX nhn Lnh cnh gic- mu 3Zc- vn Vng c:1 vhng c g=& t t#nh Zp nKng lnh t#n vhng A1 c:1 vhng c g=& t/ Cn cht G t#nh cCn vhng g=& t vS cK thD g=& chn \p thiJu mu ni ; ? GKE 0L 0C- O1 )%n v 1u- AL cm chi- nKi FhK- h hu&Jt p- vt vM- co git- li@t h% hCpnhEc u- 3] hCp thu thuHc t- chong vng- git c- Vng Finh/ (1i ,iJnX nhEc u- 1u lng- ,i tiDu- vim mng nMo/// 4ng gi 31u g=& t tu_ 3HngX th2o Ai hu&Jt p- cm gic v vn Vng vhng chi A$i c:1 o)/ (h2o Ai cc nh hng Ao g=& t tu_ 3Hng nhX h hu&Jt p- tng nhu Vng #uVt- Ki- li@t ,ng Wu1ng tm thTi- nhi@t V tng Ao giMn mch/

[=& t ti chX l tim Aung ALch cK thuHc t ti ni Tng A1o #ch i Wu/ Iq nn cho o) t thJ no Fhi g=& tX thuHc t/ Chm 3Kc- th2o Ai o) tQt hu&Jt p Ao thuHc t- Ao 3 Fhi th]c hi@n th: tht/ (h2o Ai cm gic vhng A1 g=& t/ )Ju l vhng chi A$i nn ,o m o) hJt thuHc t m$i cho o) i li D t#nh t\ ngM/ ghu&n o) Fh%ng nn i N2 Fhi cPn

? CNG VIhC C THX CiA IU DNG TRONG CU%C M ? 1 -RQ jkl8V }m8V 8V/tgiDm 3ot tSnh t#ng v@ 3inh phPng v cc AQng cQ/ giDm t#1 li lLch m+/ (#1o +i v$i Iq vPng t#ong v; AQng cQ v cc vCn ; Fhc/ giDm t#1 cc gKi AQng cQ/ pZp NJp li N2 AQng cQ- ghJ- ,n m+- cc vt AQng cH Lnh o) v cc vt AQng cn thiJt cho cuVc m+/ giDm t#1 tSnh t#ng hot Vng n m+- m& htt v cc loi m& Fhc/ Y l$p ngoi c:1 cc gKi AQng cQ/ CVt A=& o cho nhKm v% t#hng/ (iJp li@u cho Iq vPng t#ong/ IJm gc chng Iq vPng t#ong v ghi 3H gc vo t#ong 3+/ PhHi hp ct o) tng t thJ phu thut Ao g=& m chR o/ [Zn i@n cc m& vo + i@n/ Ict cc thhng #c tng vo cc vL t#i cn thiJt/ Ict cc ,rn chE1 ALch vo tng vL t#S thun ti@n cho phu thut vin v Iq vPng t#ong/ (#ong Fhi m+- Iq vPng ngoi phQ tiJp cho nhKm v% t#hng/ p1u m+X Jm gc v FiDm t#1 AQng cQ chng Iq vPng t#ong t#$c Fhi Kng vJt m+/ qu& t#S tSnh t#ng v% t#hng t#ong 3uHt cuVc phu thut/ Inh gi o) t#$c Fhi chu&Dn o) 31ng Fho1 hri 3Ec/

? $ -RQ jkl8V }m8V 0P/8V giDm t#1 li lLch m+/ (#ong ltc Iq vPng ngoi FiDm 3ot li vPng m+ thS Iq vPng t#ong #1 t1&- mcc o chong v m1ng gng/ Chuln ,L AQng cQ v% t#hngX NJp r vi th2o thE t]- t#i vi t#i t#n ,n- 31 3on Fim v chR Fh=u/ IJm gc chng Iq vPng ngoi/ Ycc o m+ v m1ng gng m+ cho nhKm v% t#hng/ [itp Zp Fhn m+ cho o)/ (#ong m+X t#1o AQng cQ cho phu thut vin/ IJm gc t#$c Fhi Kng vJt m+/ p1u m+X gi mu N\t nghi@m- lC& lni A1o #1 Fhzi cn A1o- cho AQng cQ vo Fh1& v chu&Dn 31ng tiJp li@u th1nh t#hng- FiDm 3ot li r vi- ci o- gng- v #1 t1&/

CpU HqI !rNG GI' e/ Ai l ngTi 3t Fhuln li A1 31u m+ 31u chng v An ,ng F2o li t#n vhng A1 m+X 1/ PhQ m+ ,/ Iq vPng ngoi c/ Iq vPng t#ong A/ Phu thut vin / Iq vPng t#ong FiDm t#1 li gc t#$c v 31u Fhi Kng vJt m+ chng v$iX 1/ Iq vPng ngoi ,/ PhQ m+ c/ Phu thut vin A/ gd thut vin g=& m 7/ Ai l ngTi #1 A1 cho vhng A1 phu thutX 1/ Iq vPng t#ong ,/ Iq vPng ngoi

c/ op g=& m A/ op phQ m+ 5/ Chng v$i Iq vPng ngoi Ai chu&Dn o) 31ng phPng hri 3Ec hu phu lX 1/ Phu thut vin chinh ,/ op phQ m+ c/ )hKm g=& m A/ 0V lG phPng m+ !/ o) 31u m+ Nong- A]1 vo tiu chuln no D chu&Dn o) 31ng phPng hri 3EcX 1/ o) tRnh hon ton ,/ o) Fh%ng n%n c/ o) Fh%ng cK ACu hi@u thiJu oN& A/ o) Fh%ng cK ACu hi@u ch& mu

TI !IhU THAM KHsO e/ >i v gSy "$ !rong khi "4 !rong >i nUi ngoi khoa tp - ox))x}pqqAx(0)gTi ALchX )gu&wn (iJn (hLnh- )gu&wn )g.c gi@n- )h NuCt ,n < h.c- 0 )Vi eff6 { ln 6chng es- 5e{86/ / )gu&wn (Cn CTng- Ii;u Anng )goi e- )h NuCt ,n [io AQc vi@t )1m- ""f- 8 -s"/ 7/ oV m%n Chm 3Kc o) { ((Iq oqCo<( (P/0CY 'effs- efff- ""e- ""7- ""8*/ Ti li;& nUi bU mT8p bi gi2ng 9h?" sTc Lgoi kho1/ 5/ p1unA#1 4/ p2iA2l- HnonlO/gO basO oor Da!iOn!s &n/Orgoing s&rgOryQ in VO/ical I&rgical L&rsing- ~/o/ p1unA2#3 comp1n&- nA 2A/- effs- ee!{e!s/ !/ 9:" nang ph,ng "4 'p2#1ting #oom m1nu1l*/ (#1n3l1t2A 1A1pt2A #om (h2 /p 1i#o#c2 m1nu1l )" e6"{!6- ef8e/

BI CHwM SxC NGI BhNH SAU M

MC TIU 1. VX !2 v s /7ng c c c !rang !hi'! b !i ph,ng h8& ph3&. 2. ThJc hi;n c !hao ! c ch?" sTc b;nh nhSn !i ph,ng h8& ph3&. (. pp /7ng !rong ch?" sTc b;nh nhSn !i khoa ngoi. +. Trnh by c c ch ph,ng ngqaQ ph ! hi;n v = !r< c c c bi'n chFng sa& "4.

1 BhNH HIC 1 1 G-|- 01-AQ _1m8V 1M- .NO 1cQ _1`Q vL t#i phPng m+ thTng nHi v$i phPng hri 3Ec ,?ng hnh l1ng Fin- ,?ng phng- nh 3ng & : v ALu- nhi@t V chng v$i nhi@t V phPng m+- mQc ich gitp Iq chm 3Kc o) lin tQc ng1& 31u m+- g=& m v phu thut vin Aw Ang thm Fh1n o) lin tQc- Ai chu&Dn o) 1n ton 31u Fhi m+/ (#ong gi1i on n&- o) cn c chm 3Kc lin tQc Ao ch1 +n Lnh v; tun hon- h% hCp- vJt m+- ngu& c ch& mu c1o p1u m+ gi1i on hri tRnh o) #Ct Aw ,L Fich thich ,i tc Vng ,n ngoi nh nh 3ng chKi- tiJng VngvS thJ phPng hri 3Ec phi thiJt FJ &n tnh- 3ch 3- t#n v tTng phi 3n mu ALu- nh 3ng l1n tz1- cch =m- cK cc % cch l&- cK h@ thHng i;u hP1 nhi@t V t#ung t=m/ Iq phPng hri 3Ec lu%n c t#1ng ,L FiJn thEc chu&n m%n c1o v cp nht hK1 lin tQc v; 3 AQng m& mKc- phng php m$i D chm 3Kc o) chinh Nc- 1n ton v Fho1 h.c/ vS thJ phPng hri 3Ec lu%n t#1ng ,L nhBng AQng cQ- thuHc- m& mKc hi@n i/ (#1ng ,L AQng cQ cho h% hCpX oN&- m& htt m- m& 3oi th1nh Wun- Hng nVi Fhi Wun,V m Fhi Wun- ,V cCp cEu h% hCp tun hon- m& o nrng V oN&

(#1ng ,L AQng cQ cho tun honX ,V ct CvP- tim t#u&;n- m& o i@n tim- m& chong tim qQng cQ chm 3Kc vJt thng- An lu- hu m%n nh=n to/ [iTng hu phu phi Ai chu&Dn Aw Ang- 3 AQng nhi;u t thJ- cK th1nh chZn giTng/ )hi@t V phPng hri 3Ec ""C { nhi@t V v^1 m ,o v% Fhuln/
"

C '6s"m { 8""m*- phPng Fin v th%ng Fhi tHt v^1 giB

1 $ C19: .{O BN .5Q :n 0C- _1m8V 1M- .NO 1cQ _1`Q )g1& 31u Fhi m+ Nong o) c th2o Ai nJu Fh%ng cK ACu hi@u ch& mu nh mchhu&Jt p Fh%ng A1o Vng thS o) 3 c chu&Dn 31ng phPng hu phu/ YQc tiu chm 3Kc c:1 phPng hu phu l chm 3Kc o) cho Jn Fhi hJt thuHc mq0p( +n Lnh- o) Fh%ng cPn ch& mu- o) Lnh h$ng c 't#^ t#Tng hp v; 3. nMo* thS chu&Dn 31ng t#i ,@nh- thTng phPng hu phu chR lu ,@nh t#ong 5 giT 31u m+/ )Ju 31u thTi gi1n n& tSnh t#ng ,@nh t# ncng thS 3 c chu&Dn 31ng phPng hri 3Ec tich c]c/ qi chu&Dn o) t^ phPng m+ Jn phPng hri 3Ec hu phu l t#ch nhi@m thuVc v; Iq phPng m+ v Fd thut vin g=& m/ (hTng g=& m i phi1 u o) D Aw Ang cung cCp oN&- th2o Ai h% hCp/ Iq i 31u nhng phi lu%n Wu1n 3t v Au& t#S 1n ton cho o)Iq cn cht G vCn ; nh thTi gi1n Ai chu&Dn ngZn nhCt- cn th2o Ai 3t h% hCp nh ngng th- 3tt Hng nVi Fhi Wun- thiJu oN&/ v; tun hon cn cht G ch& mu t^ vJt m+- An lu vS o) v^1 m$i Fh=u cm mu h1& v^1 m$i c cZt Ht/ qo Fhi Ai chu&Dn o) t^ ,n m+ Wu1 ,ng c1 nn vn mch Ao K cK ngu& c tQt hu&Jt p t thJ vJt m+ v^1 m$i Fh=u cPn cng- vJt Fh=u ,n t#ong cc tng c|ng cPn Wu m$i nn t#ong Fhi Ai chu&Dn c|ng cK Fh nng ,L ,ung chR vS thJ Ai chu&Dn cn nhy nhng- cln thn/ )hi@t VX 31u mVt Wu t#Snh ,Ct Vng t#n ,n m+- thCm $t Ao n$c #1 t#ong Fhi m+ALch thot #1 t#ong Fhi m+- Ao thuHc m- Ao nhi@t V phPng m+- Ao t#u&;n ALch nn Aw ,L lnh/ qo K Fhi chu&Dn #1 ngoi cn giB Cm o)- t#nh lm $t v lnh/ An tonX t#ong gi1i on hri tRnh o) Fich Vng vt vM vS thJ Iq cn m ,o 1n ton cho o) t#ong Fhi Ai chu&Dn/ Cn cH Lnh nh F\o chCn 3ong giTng ln c1o- cH Lnh t1&

o)/ p1u m+ thTng cK nhi;u An lu- cK nhBng An lu #Ct Wu1n t#.ng t#ong i;u t#L v ngu& hiDm Fhi 3tt h1& tuVt Hng vS thJ Fh%ng D o) ln Hng An lu h1& 3tt Hng An lu/ Iq cn nhn Lnh tSnh t#ng o) ng1& 31u m+ D cK FJ hoch chm 3Kc phh hp/

$ +UH TR~NH CHwM SxC BhNH NHpN SAU M $ 1 TC- _1m8V 1M- .NO 1cQ _1`Q 2.1.1. aG h3 - YQc ich chinh l Au& t#S th%ng Fhi ph+i v phPng ng^1 thiJu oN& mu/ - )gu&n nh=n tZc Tng th Ao tQt lni- nghyt m- co thZt th1nh Wun- phh n; th1nh Wun Ao nVi Fhi Wun/ (hiJu oN& Ao Nyp ph+i- phh ph+i- tZc mch ph+i- co thZt phJ Wun/ (ng th%ng Fhi Ao Ec chJ thn Finh h% hCp- li@t h% hCp Ao thuHc giMn c- thuHc m- hn chJ th Ao 1u/ - )hn Lnh tSnh t#ng h% hCpX nhLp th- FiDu th- tn 3H th- V cng giMn lrng ng]c- A1 nim- th cK Fm c h% hCp phQ o) t] th- th oN& Wu1 c1nul2- cK nVi Fhi Wun- m Fhi Wun- th m&/ qCu hi@u thiJu oN& nh FhK th- FhP Fh- m nh$t- tim ti- vt vM- t#i gic l m- lrng ng]c Ai Vng F\m- chR 3H oN& t#n monito# p1 f"u- P1 8" mm0g/ - Iq th2o Ai 3t h% hCp c:1 o)- nh gi tn 3H- tinh chCt nhLp th- cc ACu hi@u FhK th/ )Ju nhLp th nh1nh hn 7" ln}phtt h1& chm A$i e! ln}phtt thS ,o ng1& cho ,c 3/ Cung cCp : oN&- lu%n phPng ng^1 ngu& c thiJu oN& cho o) nh lm 3ch Tng thhtt m nh$t- chCt n%n Ki- htt cln thn Fhi o) cZt 1miA1n- ngh2 ph+i t#$c v 31u htt m/ o) m cho n?m u ,?ng- mct nghing mVt ,n- o) tRnh cho n?m t thJ mol2#/ 2.1.2. ?im mch 2.1.2.1. Lg&y$n nhSn 0 hu&Jt p cK thD Ao mCt mu- gim thD tich ALch Ao mCt ALch Wu1 An lu- n%n Ki- nhLn n uHng t#$c m+- Ao ,@nh lG- ,@nh lG v; tim mch- Ao thuHc nh hng Jn t$i mu cho m% v cc c Wu1n

C1o hu&Jt p Ao 1u 31u gii phu- vt vM Ao ,ng Wu1ng cng ch$ng- Fich thich FhK th- nhi@t V c1o- o) m+ tim xHi lon nhLp timX t+n thng c tim- h F1li mu- thiJu oN&- mch nh1nh- ,@nh lG tim mch- h nhi@t V

2.1.2.2. Lh8n nh )hn Lnh tSnh t#ng tim mchX A1 nim- ACu hi@u ch& mu- ACu hi@u thiJu mu- 0ct/ qCu hi@u mCt n$c- n$c NuCt nhp- p l]c tnh mch t#ung t=m- n$c tiDu- i@n tim/ 2.1.2.(. ThOo /ri )g1& 31u m+- Iq phi lC& q0p( ghi thnh ,iDu r D 3o 3nh- D pht hi@n 3$m ACu hi@u tQt hu&Jt p Ao ch& mu Iq lu%n thm Fhm- pht hi@n ch& mu Wu1 vJt m+- An lu/ )hn Lnh tSnh t#ng A1 nim- n$c NuCt nhp t#$c v 31u m+ cn c th2o Ai 3tth2o Ai lng n$c tiDu mi giT- tSnh t#ng #Hi lon i@n gii/ (h2o Ai p l]c tnh mch t#ung t=m- th2o Ai ACu mCt n$c- v$i o) gi h1& ,@nh tim thS vi@c th^1 n$c v thiJu n$c #Ct gn nh1u- vi@c th^1 n$c c|ng cK ngu& c 1 o) #i vo ,@nh lG phh ph+i cCp/ Ict m& o i@n tim lin tQc v$i ,@nh ncng- ,@nh tim- ngTi gi/ )=ng n nhy nhng t#nh tQt hu&Jt p t thJ- th]c hi@n t#u&;n ALch t#u&;n mu tng & l@nh 3H gi.t- thTi gi1nghi vo hr 3 t+ng n$c NuCt nhp mi giT} 5 giT/ 2.1.3. ;hi%t $I )gu&n nh=n tng th=n nhi@tX thTng 3Ht nhy Ao mCt n$c- Ao tSnh t#ng phn Eng c thD 31u m+- thTng 31u m+ e- ng& nhi@t V tng nhy 78 "! { 7s"C nhng nJu 3Ht c1o hn thS Iq cn th2o Ai v pht hi@n 3$m ngu&n nh=n c:1 nhiwm t#hng/ )gu&n nh=n h th=n nhi@tX Ao lm $t- ngTi gi- 3u& Ainh Anng- Ao nhi@t V m%i t#Tng- Ao tSnh t#ng 3u& Fi@t// C1n thi@pX Iq th2o Ai nhi@t V thTng Nu&n-th]c hi@n ,h n$c th2o & l@nh/ )Ju 31u m+ 7 ng& o) vn cPn 3Ht c1o t#n 7s"C thS cn th2o Ai ACu hi@u nhiwm t#hng vJt m+nhiwm t#hng tiJt ni@u- vim ph+i- nhiwm t#hng t^ ,@nh lG v^1 phu thut/ ghi th=n nhi@t

tng c1o cn th]c hi@n chm 3Kc gim 3Ht/ IHi v$i ngTi gi- ,@nh ncng- 3u& Ainh Anng- o) cn lu%n c giB Cm/ 2.1.4. ?hn kinh (h2o Ai mEc V h%n m- Lnh h$ng- cm gic- vn Vng- rng t- Vng Finh- #Hi lon t=m thn/ o) lo 3 Fhi tRnh A& t#ong m%i t#Tng l- vt vM Fich thich Ao 1u- thiJu oN&,i tiDu- Au& t#S mVt t thJ Wu l=u/ xun Ao nhi@t V m%i t#Tng thCp- t#u&;n mu- ALch Wu lnh- thTi gi1n m+ Wu l=u- ngTi gi- 3u& Ainh Anng- phn Eng thuHc/ Inh gi t#i gic o) Wu1 th1ng iDm [l13go- t#ong gi1i on hri tRnh o) Aw Fich thich vt vM nn cn m ,o 1n ton/ (h]c hi@n thuHc 1n thn- chHng Vng Finh t#ong t#Tng hp o) phu thut thn Finh/ (h2o Ai vn Vng- cm gic c:1 chi- t thJ n?m u ,?ng t#n s-e giT 31u m+/ 2.1.5. ?iPt ni% )hn Lnh 3H lng- mu 3Zc n$c tiDu- cu ,ng Wu1ng- ACu hi@u phh chi- hu&Jt p- c=n ncng- cK th%ng tiDu Fh%ng/ )hn Lnh ACu hi@u thiJu n$c- #Hi lon i@n gii- ion ro)- c#21tinin2- 02m1toc#it/ (h2o Ai n$c NuCt nhp mi giT- t+ng n$c NuCt nhp t#ong 5 giT- tinh chCt- 3H lngmu 3Zc n$c tiDu/ )Ju 3H lng n$c tiDu gim hn 7"ml} giT cn ,o ,c 3/ Chm 3KcX th]c hi@n ,h n$c- i@n gii th2o & l@nh- F c1o chi nJu phh- th2o Ai hu&Jt p- c=n ncng mi ng&/ (#Tng hp cK th%ng tiDu cn chm 3Kc 3ch 3 ,V phn 3inh AQc v h@ thHng th%ng tiDu/

F +UH TR~NH CHwM SxC BhNH NHpN TI KHOA NGOI F 1 N1c8 BY81 081 0PC8V BN 0% hCpX tSnh t#ng th%ng Fhi- tinh chCt th- tSnh t#ng FhK th- tSnh t#ng m nh$t- ACu hi@u thiJu oN&- o) cK t] th- ACu hi@u thiJu oN&/ (un honX hu&Jt p- mch- A1 nim- ACu hi@u thiJu n$c- tSnh t#ng chong- ch& mup l]c tnh mch t#ung t=m/ (hn FinhX t#i gic- rng t- cm gic- vn Vng qn luX loi- vL t#i- 3H lng- mu 3Zc- h@ thHng cK hot Vng Fh%ng/

vJt m+X vL t#i- Fich th$c- ,ng thCm mu- thCm ALch- ch& mu- 1u- nhiwm t#hng (=m lG o)X lo lZng- thoi mi h1& Fh%ng/ (huHc 1ng 3 AQng/

F $ C18 B/S8 }t O58 01-A_ D 3.2.1. Kcng thd khGng thGng Im ,o chEc nng h% hCp tHi u- h$ng An o) hit th 3=u- No1& t#- cho ngri A&/ 4u G 31u m+ o) #Ct 1u nhCt l nhBng o) m+ ng]c- m+ ,Qng- cVt 3Hng vS thJ Iq th]c hi@n thuHc gim 1u t#$c Fhi cho o) tp- th2o Ai nhLp th- nh gi 3] th%ng Fhi c:1 o)/ 3.2.2. D; khGng thoi mi N* m0 [itp o) gim 1uX cK nhi;u ngu&n nh=n FhiJn o) 1u nh 1u Ao t=m lG 3- Ao mEc V t#m t#.ng c:1 phu thut- Ao chCn thng/ I1u 31u m+ phQ thuVc vo t=m 3inh lGmEc V chLu ]ng c:1 o)- ,n chCt phu thut- mEc V chCn thng ngoi Fho1 vS thJ Iq cn chuln ,L t=m lG cho o) t#$c m+ c|ng nh t=m lG 1n t=m 31u m+/ (h]c hi@n thuHc ng:- gim 1u- t thJ gim 1u v c%ng tc t tng cho o)/ [itp o) ,$t vt vMX Ao t thJ Fh%ng thoi mi t#n giTng ,@nh- phn Eng c:1 c thD ltc hri tRnh- Ao 1u- Ao ,ng Wu chct- Ao cH Lnh o) Wu l=u- ,i tiDu/ Iq cn ,iJt ngu&n nh=n v gii Wu&Jt ngu&n nh=n gitp o) thoi mi/ (hTng Nu&n gitp o) No1& t#- n?m t thJ thich hp- th]c hi@n thuHc gim 1u- m ,o 1n ton cho o)- n$i lzng A=& cH Lnh- gii Wu&Jt ,i tiDu/ Chm 3Kc o) n%nX Ao tc AQng phQ c:1 thuHc m- thuHc t- Ao #uVt- A A& E .ng ALchp1u m+ cho o) n?m u ,?ng- mct nghing mVt ,n D t#nh Fhi n%n ALch Fh%ng t#n vo Tng th/ )Ju cK tu,2 42vin2 Iq nn c=u nHi NuHng thCp- htt ALch Wu1 Hng tu,2 42vin2- th2o Ai tSnh t#ng cng ch$ng ,Qng/ Chm 3Kc o) cng ch$ng ,QngX cng ch$ng ,Qng 31u m+ hu nh thTng gcp tCt c phu thut/ )gu&n nh=n l Ao tich l|& Fhi #uVt- th1o tc t#n #uVt g=& mCt nhu Vng #uVt- Ao thuHc giMn cIq cn thm Fhm tSnh t#ng ,Qng- ngh2 nhu Vng #uVtNo1& t# o)- gitp o) ngri A&- nJu ,Qng o) vn cPn ch$ng thS Iq th]c hi@n & l@nh htt ALch Wu1 th%ng A A& v ct th%ng t#]c t#ng/

Chm 3Kc o) ,L nCcX nCc g=& #1 Ao 3] co thZt c:1 c honh- Ao FJt Wu A=& th1nh Kng li Fhi Fh%ng Fhi Vt ngVt o vo ph+i/ )gu&n nh=n co thZt Fhi Wun l Ao Fich thich c:1 thn Finh honh/ )gu&n nh=n t#]c tiJp Ao Fich thich c:1 ,n th=n thn Finh nh A A& cng ch$ng- Ao ngu&n nh=n ,@nh lG thn Finh- ngoi #1 nCc cPn Ao phn N t^ Hng An lu- Ao n$c Wu nKng h1& Wu lnh- Ao m+ vhng ,Qng/ Iq h$ng An o) mVt 3H phng php nh nhLn th Fhi uHng ngQm n$c to- ln nhMn cu- thuHc/ 0u Wu c:1 nCc lm o) mCt thng ,?ng Fi;m to1n- toc vJt thng- mCt n$c- FhK chLu- m@t/

3.2.3. en toJn cho D; p1u m+ o) thTng phi chLu nhi;u ngu& c- t1i ,iJn- ,iJn chEng 31u m+(#ong K vCn ; 1n ton cho o) t#ong gi1i on hri tRnh- gi1i on 31u m+ c]c FU Wu1n t#.ng/ ID t#nh nhBng t+n thng cho o) nh t\- 3tt A=& ALch t#u&;n- An lu thS o) phi lu%n n?m t#ong tm nhSn c:1 Iq/ 3.2.4. 6im khi l_ng m vJ co thft mch m [im t$i mu cho m% nh hu&Jt p gim- mch nh1nh- vt vM- t#i gic p Eng chmA1 lnh lm- n$c tiDu A$i 7" ml} giT/ Iq th2o Ai 3t D pht hi@n 3$m ACu hi@u mCt mu- ch& mu D ,o ,c 3/ giDm t#1 q0p(- th]c hi@n & l@nh t#u&;n mu- t#u&;n ALch/ 3.2.5. gh n<ng thiP hXt 89ch th )gu&n nh=nX Ao tng tiJt mr h%i- m nh$t- Ao An lu- Ao Fh%ng n uHng/ ghi mCt ALch o) cK t#i@u chEng nh Fht- ACu v\o A1 '*- m%i Fh%- n$c tiDu gim A$i 7" ml}giT- p l]c tnh mch t#ung t=m gim- hu&Jt p gim- mch nh1nh/ Chm 3KcX phPng ng^1 mCt n$c l chinh/ (h]c hi@n t#u&;n ALch tng th2o & l@nh- th2o Ai lng n$c NuCt nhp- CvP- giB nhi@t V phPng thich hp/ Cho o) uHng n$c nJu c- Au& t#S th=n nhi@t- giB Cm cho o)- Wu1n t#.ng l q0p( phi c th2o Ai 3t/ 3.2.=. DiPn $0i 8inh 8@ng - )gu&n nh=nX o) cK ngu& c 3u& Fi@t 31u m+ Ao nhLn n t#$c m+ v 31u m+- Ao ,@nh lG mn tinh t#$c K/ - Chm 3KcX Au& t#S c=n ,?ng Ainh Anng & : chCt Ainh Anng v phh hp ,@nh lG Wu1 ALch t#u&;n- Hng th%ng A A&- An lu A A& #1 A1- n uHng ,?ng Tng mi@ng/ o) hJt

n%n cho o) n ,?ng Tng mi@ng 3 gitp Fich thich ALch Tng tiu hK1- tng cTng chEc nng A A&- #uVt/ 3.2.W. DiPn $0i 4Ji tiPt n"c ti PhQc hri chEc nng tiDu ,Snh thTng/ )Ju m+ nVi 3oi thTi gi1n A$i e- giT phu thut vin cho o) i tiDu t#$c m+ m Fh%ng cn ct th%ng tiDu- t#Tng hp m+ F\o Ai cn phi ct th%ng tiDu/ p1u m+ tSnh t#ng +n Lnh thS th%ng tiDu c #tt 3$m- cK thD ng1& 31u m+ h1& 31u 5 giT/ )Ju o) ,i tiDu Iq cH gZng Fh%ng th%ng tiDu cho o)- p AQng cc phng php gitp o) tiDu ,Snh thTng nh ngh2 tiJng n$c ch&- Zp Cm vhng ,Qng- ngri A&- tiDu Fin o v tng t thJ/ [hi & : 3H lng- tinh chCt- mu 3Zc n$c tiDu vo hr 3 mi ng&/ o) cK th%ng tiDu Iq cn chm 3Kc ,V phn 3inh AQc- th2o Ai n$c tiDu- cho o) uHng nhi;u n$c- nn #tt th%ng tiDu 3$m/ 3.2.>. DiPn $0i t:ong $Jo thi $cng : It )gu&n nh=nX o) Fh%ng i cu Ao thQt tho t#$c m+- th1o tc t#n #uVt- Fh%ng n uHng/ Chm 3KcX nJu o) ch1 n c thS gii thich D o) 1n t=m- nJu o) n uHng c m vn ch1 i cu thS Fhu&n o) vn Vng i li 3$m- thEc n nhun t#TnguHng nhi;u n$c/ gh%ng cho o) uHng thuHc nhun t#Tng nJu Fh%ng cK chR Lnh/ )gu&n nh=n tiu ch& 31u m+X Ao thuHc Fhng 3inh- ,iJn chEng c:1 ,@nh- Ao n uHng Fh%ng hp v@ 3inh/ )Ju Ao Fhng 3inh cho o) uHng 3B1 chu1- th2o Ai 3H ln i cu- 3H lng ph=n- mhi- ACu hi@u mCt n$c- th]c hi@n ,h n$c v i@n gii thich hp/ 3.2.A. gh n<ng nhiOm t:Hng1 t0n thng 8* vJ ng 8bn l (#nh nhiwm t#hng v Au& t#S tinh ton vyn c:1 A1/ vi t#hng N=m nhp vo c thD Wu1 A1h% hCp- ni@u- 3inh AQc- mu/

o) cK h@ thHng An lu 'httpX}}gi1ngAuong&Fho1/n2t*

)gu&n nh=nX A1 v nim mc ,L N=m lCn ,i vJt m+- An lu- hu m%n nh=n to- ni Nu&n inh- gim 3Ec ; Fhng Ao m+ v g=& m- m%i t#Tng ,@nh vi@n- Fh%ng m ,o Fd thut v% Fhuln/

Chm 3KcX th]c hi@n chHng v FiDm 3ot nhiwm t#hng ,@nh vi@n- p AQng tng Fd thut v% Fhuln Fhi chm 3Kc- Fhi th]c hi@n th: thut t#n o)/

3.2.1E. Ch<m NSc vPt m0 vJt m+ Fh%ng nhiwm t#hng- Fh=u Fin A1X hi@n n1& vJt m+ nVi 3oi nhz v ngu& c nhiwm t#hng thCp- thTng vJt m+ n& Fh%ng th1& ,ng- 31u m+ 8 ng& cZt chR- o) gi- 3u& Fi@t nhi;u thS cZt chR chm hn Fhong e" ng& 31u m%/ gh=u A1 th1 h1& D h A1X =& l t#Tng hp gii phu cK ngu& c nhiwm t#hng nn phu thut vin D h A1 gitp thot ALch Ao K phi chm 3Kc vJt m+ mi ng&- thCm $t ALch v ,o co tSnh t#ng vJt thng ng1& Fhi cK ACu hi@u ,Ct thTng/ vJt m+ m1& ,?ng chR th\pX nn th1& ,ng Fhi thCm ALch- cZt chR e5 { " ng& 31u m+nn th1& ,ng hng ng& h1& Fhi thCm ALch/ vJt m+ ch& muX nJu it thS ,ng \p vJt m+- nhi;u nn ,ng \p tm thTi- th2o Ai 3t q0p( rng thTi ,o ,c 3 Fh=u li vJt m+/ vJt m+ nhiwm t#hngX o) cK ACu hi@u nhiwm t#hng vJt m+ thS Iq m ,ng Wu1n 3t- ,o ,c 3 cZt chR v ncn m: vJt m+- #1 3ch v ,ng li/

vJt m+ Fh=u Fin A1 'httpX}}gi1ngAuong&Fho1/n2t*

vJt m+ Fh=u A1 th1

vJt m+ nhiwm Fhuln v #P

'httpX}}gi1ngAuong&Fho1/n2t*

vJt m+ m1& chR th\p 'httpX}}gi1ngAuong&Fho1/n2t*

3.2.11. Ch<m NSc 8bn l qn lu 1n ton- Fh%ng ,iJn chEng/ )hn LnhX loi An lu- mQc ich An lu D th2o Ai v chm 3Kc tng/

(h2o Ai 3H lng- mu 3Zc- tinh chCt ALch/ 0@ thHng An lu cK c=u nHi NuHng thCp hn vL t#i An lu 6"cm- c=u nHi m ,o v% Fhuln/ (#nh o) n?m cCn ln An luh$ng An o) vn Vng Fhi cK An lu/

3.2.12. . ! gim chMc n<ng vn $Ing PhQc hri chEc nng vn Vng/ p1u m+ Ao 1u- Ao ,@nh lG- o) vn Vng F\m h1& Fh%ng thD vn Vng c/ ID t#nh ,iJn chEng Ao Fh%ng vn Vng Iq No1& t# o) 3.2.13. ?Bm lC lo lfng N* m0 p1u m+ o) #Ct lo lZng v; 1u- 3 ,iJn Ang c thD- lo ,iJn chEng 31u m+/ (=m lG lo lZng c|ng nh hng Jn tiJn t#Snh hri phQc 31u m+ vS thJ Iq cH gZng Vng vin- 1n :i o)- gitp o) thoi mi- 1n t=m/ giT}ln- cho o) vn Vng i li/ (p lu&@n t#n giTng th]c hi@n t#ong 5 giT u 31u m+- h$ng An o) cch th/

? (HNG NGA (H'T HIhN V a# TR C'C BIJN CHNG SAU M ? 1 C1/S8V qo gim lng mu- chong tim- chong thn Finh- chong nhiwm t#hng/ Chong l ,iJn chEng thTng N& #1 t#ong thTi FU hu phu/ gi1i on hu phu chong thTng gcp l chong gim thD tich/ PhPng ng^1X c%ng tc t tng t#$c m+- giB Cm- gim 1u- &n tnh- Ai chu&Dn nhy nhng 1n ton/ Iq lu%n th2o Ai 3t q0p( v pht hi@n 3$m ACu hi@u chong/ Chm 3KcX nJu chong cho o) n?m u thCp- ch=n c1o hn m]c tim e!-7" "- th%ng Tng th- li@u php oN& cho o)- phQc hri thD tich ALch- th]c hi@n thuHc- th2o Ai q0p(- ghi hr 3 & :/ ? $ C1^E :SQ Ph=n loiX ngu&n pht- t#ung gi1n- thE pht/ (#i@u chEngX Fht- A1 lnh- nim nht- hu&Jt p gim- nhi@t V h- t#i gic l m/ Iq cn tSm #1 ni ch& mu- th]c hi@n cm mu ti ch- th]c hi@n t#u&;n mu th2o & l@nh/ ? F NV18 0Z81 :CO1 .KQ

(hTng N& #1 o) phu thut h%ng- chi A$i- h@ tiJt ni@u- phQ Fho1- thn Finh- o) t#n 5" tu+i- ,\o phS/ ghi o) cK ACu hi@u 1u v chuVt #tt ,Zp ch=n- t- phh- m;m- Cn lmthS Iq th]c hi@n ,uVc tnh mch hi- 3 AQng 02p1#in- t#ong gi1i on n& t#nh No1 ,Kp chi- F chi ln hn m]c tim e!-7""- th2o Ai nhi@t V- cm gic chi/ ? ; B-D8 O1N8V 1T 1_ )gu& cX vim ph+i- Nyp ph+i- thu&n tZc v nhri mu ph+i/ ` t#iX cho o) ngri A& 3$m- hit th 3=u- giB Cm- m%i t#Tng thong Fhi- gim 1u- th oN&/ ? ? B-D8 O1N8V jC jtE = PQ,0 p1u m+ Ao n?m ti giTng- Ao Fh%ng vn Vng- Ao 1u- Ao tc AQng thuHc giMn c- Ao m+ #uVt nn thTng cK ngu& c tZc #uVt- li@t #uVt- ch$ng ,Qng 31u m+ ghi Iq thm Fhm thC& cc ACu hi@u 1u ,Qng- ,Qng ch$ng hi- FhK th- nhu Vng #uVt '-*- Iq cn ct Hng th%ng A A&- cho o) ngri A&- No1& t#- tp th- hit th 3=u/ ? o N1-: 0PU8V }D0 :n (h]c hi@n vi@c #1 t1& t#$c v 31u Fhi chm 3Kc vJt thng/ Im ,o v% Fhuln/ Iq nn th2o Ai nhiwm t#hng vJt m+/

? !/C8 018 .5Q :n CK thD Ao t=m lG- o) c1o tu+i- ,@nh lG/ Cn c%ng tc t tng cho o)- th]c hi@n thuHc 1n thn- cho th=n nh=n chng o)/

CpU HqI !rNG GI' e/ vJt m+ no 31u =& 3 c th1& ,ng mi ng&X 1/ vJt m+ Fh%ng nhiwm t#hng ,/ vJt m+ Fh=u Fin A1 c/ vJt m+ nVi 3oi A/ vJt m+ Fh=u A1 th1 / YC& giT 31u m+ o) 3 c tp lu&@n t#n giTngX 1/ p1u 6 giT

,/ p1u s giT c/ p1u e giT A/ p1u 5 giT 7/ o) 31u m+ 7 ng&- ch1 i cu c- Iq cnX 1/ ghu&n o) vn Vng- i li nhi;u ,/ (#nh n thEc n cK nhi;u chCt N c/ Cho o) uHng thuHc N+ A/ (hQt tho cho o) 5/ )g^1 ,iJn chEng nghn tnh mch 3=u cho o) 31u m+- Iq cn lmX 1/ `o1& t# mi giT ,/ g chi c1o hn tim e!-7"" c/ `o1 ,Kp chi thTng Nu&n A/ (p vt lG t#L li@u !/ qi chu&Dn o) t^ phPng m+ Jn phPng hri 3Ec l t#ch nhi@m c:1X 1/ Iq vPng ngoi ,/ Iq phPng m+ c/ 0V lG phPng m+ A/ op g=& m

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi tp e- )h NuCt ,n [io AQc v)- ""f- ee!-e7"/ / Ii;u Anng nVi ngoi Fho1 tp - )h NuCt ,n < h.c ln 6- 0 )Vi-eff6- 8f-e5"/ 7/ oV m%n Chm 3Kc o) { ((Iq oqCo<( (P/0CY 'effs- efff- ""e- ""7- ""8*/ Ti li;& nUi bU mT8p bi gi2ng 9h?" sTc Lgoi kho1/ 5/ gim 4it1cF/ P#2op2#1tiv2 p1ti2nt- in Y2Aic1l pu#gic1l )u#3ing- Yo3,&-<21# ,ooF- anc/ 5 th 2A/- pt/ 4oui3 { Yi33ou#i- eff6- 7f!-5e!/

BI > (HNG M V TRANG THIJT B"

MC TIU 1. ji*& c cE& !rcc ph,ng "4. 2. ThJc hnh c c ch b2o %&2n !rang !hi'! b !rong ph,ng "4.

1 MI TRNG (HNG M 1 1 (1m8V :n PhPng m+ cnX It tiu chuln v; &Ju tH L1 lG- m%i t#Tng v vi 3inhO (h%ng v$i Fho1 hri 3Ec- cCp cEu- cn l=m 3ng v ng=n hng muO CK phPng ti;n m ,n t#ong Fhu v]c phPng m+ vS t#$c Fhi o) chu&Dn vo phPng m+- o) cn n?m ti phPng ti;n m/ vt AQng t#ong phPng m+ phi Aw 3 AQng- Aw l1u chhi v Ai chu&Dn Aw Ang/ nh 3ng phi c t#1ng ,L & :- nhi@t V phPng t^ " - 5"C- V lm !"u/ p AQng tu&@t Hi phng php v% Fhuln t#ong phPng m+/

1 $ (1m8V 0-R8 :L 4 phPng NuCt nhp o) c:1 phPng m+- gitp Iq nhn ,@nh- th2o Ai- cung cCp th%ng tin v FiDm t#1 o) t#$c Fhi 1 vo phPng m+/

PhPng m+ v t#1ng thiJt ,L 'httpX}}gi1ngAuong&Fho1/n2t*

$ KH'I NIhM V V KHU&N V TIhT KHU&N v% FhulnX l phng php ngn ng^1 nhiwm t#hng vhng m+ ,?ng cch Fh%ng cho cc AQng cQ- vt li@u v m%i t#Tng Nung Wu1nh cK vi Fhuln N=m nhp vo/ (i@t FhulnX l phng php Aung hK1 chCt h1& vt lG D Ai@t vi Fhuln- FD c nh1 ,o/

F C'C HU CU CiA KHU (H)U THU*T vL t#iX N=& ni c1o #o- thong Fhi- cK nh 3ng mct t#Ti- N1 Fhu phPng ,@nh v cc ngurn g=& % nhiwm Fhc v A]1 ngu&n tZc Tng #1 vo mVt chi;u/ (hD tich c:1 mi phPng m+ l e""m 7 '6 N ! N 7/!*- gKc tTng nn N=& t#Pn- cK h1i l$p c1 v c t#1ng ,L c1 t] Vng/ pH lng ,urngX th& thuVc vo Wu& m% ,@nh vi@n- nhng tHi thiDu nn cK h1i phPng m+mVt phPng m+ 3ch v mVt phPng m+ nhiwm/ Cc phPng FhcX PhPng #1 t1& t#$c m+/ PhPng ti;n m/ PhPng ti@t Fhuln AQng cQ/ PhPng m+ cCp cEu- Fho A] t#B AQng cQ- r vi v phPng hu phu/

gh%ng Fhi t#ong phPng m+ cn c thiJt FJ th2o h$ng Ai chu&Dn t^ t#n phPng m+ NuHng 3n/ 0n chJ tHi 1 3H ngTi c ph\p #1 vo phPng m+/

nh 3ng t#ong phPng m+ cn c thiJt FJ mVt cch phh hp D cK : ngurn 3ng- ,1o grm c ngurn 3ng t] nhin Wu1 cc Fhung c1 3+ v ngurn 3ng nh=n to 'nh 3ng t#n v n m+*/

)hi@t V v V lmX nhi@t V t^ es- ""C- V lm t^ 6"-6!u- nn Ahng m& i;u hP1/ )$c #1 t1& t#$c Fhi m+X n$c phi c ti@t t#hng v h@ thHng n& phi c FiDm t#1 thTng Nu&n/ (#1ng ,L t#ong mi phPng m+X th2o tiu chi cng it vt AQng cng tHt- nhng tHi thiDu phi cK ,n m+- m& g=& m- m& htt- th ]ng AQng cQ v t: thuHc/ Cc AQng cQ m& mKc Fhc 31u m+ phi c chu&Dn #1 ngoi D l1u chhi v ,o Wun- Fhi cn li c 2m vo/ Cc hVp AQng cQ 1 vo phPng m+ Wu1 c1 3+/

PhPng #1 t1& 'httpX}}gi1ngAuong&Fho1/n2t*

PhPng ti;n m 'httpX}}gi1ngAuong&Fho1/n2t*

; TRANG THIJT B" CHO CU%C M N%I SOI ; 1 CSO 01-D0 dY O1\81 4.1.1. C*mR:* mJ CK V nh& 3ng e-! luN v V ph=n gii c1oO )hn hSnh nh t#ong + ,Qng t^ Hng Finh 3oi t#u&;n Wu1 mVt A=& An vo ,V phn N lG t#ung t=mO 0Snh nh 3 c chiJu ln mn hSnh/

4.1.2. ;g Yn Nng lnh oKng n h1log2n hocc N2non c%ng 3uCt e!"-7""~ cung cCp nh 3ng cho Hng Finh 3oi + ,Qng Wu1 mVt A=& Wu1ng An/

In m+ 'httpX}}gi1ngAuong&Fho1/n2t*

4.1.3. Z! 4m kh Ch2 li5n tXc vJo 0 4Xng (#ong 3uHt Wu t#Snh m+ ,Qng cn m& ,m Fhi C lin tQc vo + ,Qng gitp tch thnh ,Qng Fhzi nVi tng D cK Fhong t#Hng th1o tc/ Y& cK vch ,o lng Fhi cPn t#ong ,Snh- p l]c Fhi t#ong + ,Qng t^ "-7" mm0g 't#ong cc cuVc m+ ,Snh thTng mEc e mm0g*/ + ghi p l]c t#ong + ,Qng NuHng A$i mEc Cn LnhX m& 3 t] Vng ,m vo/ + ghi p l]c t#ong + ,Qng c1o hn mEc Cn Lnh X cK chu%ng ,o Vng- m& ng^ng ,m/

Y& cPn cK rng hr hiDn thL lu lng Fhi vo + ,Qng t^ "-7! lit}phtt v thD tich t+ng cVng Fhi C M ,m #1/

; $ CSO 01-D0 dY _1[ ginh 3oiX cK thD phKng i hSnh nh e!- " ln/ Y& Ht i@nX cK A=& gZn vo cc AQng cQ m+- gitp v^1 th]c hi@n cc th1o tc phu tich v^1 cZt v Ht cm mu/ Yonito# hocc (vX cK V n\t c1o 'ph+ ,iJn e5 hocc " inch23*/ qQng cQ thu hSnhX D ghi li hSnh nh li cc t#Tng hp m+ cc ,i@t c Ahng t#ong nghin cEu ; F CSO j[8V O[ :n

qQng cQ m+ 'httpX}}gi1ngAuong&Fho1/n2t*

gim v2#233 ,m FhiX cK lP No D ,o v@ u Fim t#nh Fh%ng g=& th:ng #uVt Fhi ch.c Wu1 thnh ,Qng/ (#oc1# ! mm v e" mmX D ch.c Wu1 thnh ,Qng- cK v1n ,o v@ v gitp 1 cc AQng cQ m+ vo t#ong + ,Qng/ Cc Fi;m phu thutX Ahng D cm nZm- ,Kc tch m%- F\o- mKc Ht- Hng htt 0u hJt cc AQng cQ n& ;u cK thD nHi v$i A=& An i@n c:1 m& Ht D v^1 ,Kc tch v^1 Ht cm mu/

nAoloopX l mVt Wu2 nh]1 Nz chR 'Ch#omic e-" hocc vic#&l e-"*- Aung D cVt mh mu nhz hocc m% '#uVt th^1- Hng tti mt- mc t#2o #uVt*/

? BsO +UsN (HNG M ? 1 TPk|O :n }t 0P/8V :n p AQng tu&@t Hi ngu&n tZc v% Fhuln t#$c m+/ pt t#hng Fd vhng m+ v t#i Fhn ch2 m+ v% Fhuln/ ChR c ph\p 3 AQng AQng cQ m$i v cPn v% Fhuln/ (u=n th: tng Fd thut 3ch v ,ln t#ong Fhi m+/ PhPng m+ Fh%ng vt Wu e" ngTi v phi hn chJ Ai chu&Dn t#ong phPng m+/

? $ S5Q :n gh Fhuln phPng m+X C. #1 3n v tTng ,?ng Aung ALch 3t Fhuln/ 41u chhi ,n m+- n m+ ,?ng Aung ALch Fh Fhuln/ Chu&Dn ton ,V AQng cQ #1 ngoi phPng m+- t#^ ,n m+- m& g=& m v m& htt/ 4u%n Kng Fin c1 phPng m+/ Ii;u chRnh nhi@t V phPng m+ v th%ng Fhi/

? F Ht8V 0Q8 4m v@ 3inh ton ,V phPng m+/ giDm t#1 v% Fhuln Lnh FU Hi v$i t#1ng thiJt ,L- AQng cQ v nh=n vin/ PhHi hp v$i phPng i;u t#L D nh gi li t_ l@ nhiwm t#hng 31u m+/

CpU HqI !rNG GI' e/ PhPng m+ cn th%ng v$i Fho1 no 31u =&X 1/ gho1 hri 3Ec ,/ gho1 ngoi lrng ng]c c/ gho1 nVi h% hCp A/ gho1 tim mch c1n thi@p / )hi@t V phPng m+ phi m ,oX 1/ " { !"C

,/ " { 5"C c/ 5 { s"C A/ ! { 7""C 7/ (#$c Fhi o) c chu&Dn vo phPng m+- o) cn c n?m tiX 1/ PhPng hri 3Ec ,/ PhPng ti;n phu c/ PhPng ti;n m A/ PhPng ti@t Fhuln 5/ vi@c lm v@ 3inh ton ,V phPng m+ c th]c hi@nX 1/ p1u mi c1 m+ ,/ 0ng ng& c/ 0ng tun A/ 0ng thng !/ PhPng m+ Fh%ng c vt Wu ,1o nhiu ngTiX 1/ ! ngTi ,/ e" ngTi c/ e ngTi A/ e! ngTi

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi tp e- )h NuCt ,n [io AQc v)- ""f- se-s6/ / oV m%n Chm 3Kc o) { ((Iq oqCo<( (P/0CY 'effs- efff- ""e- ""7- ""8*/ Ti li;& nUi bU mT8p bi gi2ng 9h?" sTc Lgoi kho1/ 7/ Ii h.c < qc (P0CY- [io t#Snh Ii;u Anng )goi- lu hnh nVi ,V- "e"- 77-75/

BI R#A TAH NGOI KHOA MWC 'O CHONG V MANG GwNG V KHU&N

MC TIU 1. ThJc hi;n c k@ !h&8! !ayQ ")c o chong v "ang g?ng vX kh&:n. 2. ThJc hnh c k@ !h&8! ")c o v "ang g?ng vX kh&:n cho ph3& !h&8! vi$n.

1 K THU*T R#A TAH 1 1 C1Q8 dY j[8V O[ )$c #1 t1& v% Fhuln/ on chi hCp/ ` phPng v% Fhuln/ Irng hr t#2o tTng 'D th2o Ai thTi gi1n #1 t1& : e" phtt*/ ghn Fh% h1& giC& l1u t1& v% Fhuln/ (hhng ]ng Fhn h1& giC& 31u Fhi l1u t1&/

1 $ K 01Qc0 0-D8 1t81 CZt ngZn mKng t1&/ (ho nB t#1ng v rng hr/ `Zn t1& o ln Wu Fhu_u t1& 7-! cm/ qhng Fhn giC& v% Fhuln m vPi n$c/ IEng ,rn #1 t1&- t#nh chm ngTi vo ,rn #1 t1&/ x1 t1& thTng Wu& 'nVi Fho1* v$i n$c v% t#hng/ 4C& ,n chi hEng N phPng v c. #1 ,n t1& th2o hSnh NoZn Hc/

(iJn hnh #1 v$i ,n chi eX x1 t^ u ngKn Jn ch=n ngKn- i mVt chi;u- Fh%ng Wu1& ngc t# li- #1 t^ng ngKn t1& v F ngKn- i t^ ngKn e Jn ngKn ! h1& ngc li/ `o1& lPng ,n t1& v; ng1ng tm nhSnX ch lPng ,n t1& th2o hSnh NoZn Hc v No1& mu ,n t1& v; ng1ng tm nhSnX ch mu ,n t1& th2o hSnh NoZn Hc/ x1 cng t1& 'Wu Fhu_u t1& 7-!cm* t#ong ! phtt- cht G Fhi #1 cnh t1& phi h$ng ln t#n/ x1 t1& 3ch N phPng li ,?ng n$c v% Fhuln/ Cht GX Fhi AVi n$c cho n$c ch& t^ ngKn t1& NuHng ,n t1&- NuHng Fhu_u t1& v Fh%ng cho ch& ngc li- t1& lu%n h$ng ln t#n/

(iJn hnh #1 v$i ,n chi X (iJn hnh #1 t#ong vPng -! phtt/ qhng t1& M #1 lC& ,n chi v% Fhuln- lu GX ngKn t1& chR chm vo ni cm ,n chi- t#nh Qng vo l%ng ,n chi/ (iJn hnh #1 tng t] nh ,n chi e/

x1 3ch N phPng t1& A$i vPi n$c/ p1u Fhi #1 NongX gi hocc vt AQng/ qhng Fhn v% Fhuln l1u 3ch 3 n$c th2o thE t] t^ ngKn t1& { ,n t1& { Fhu_u t1& 'l1u t^ ng.n chi v Fh%ng D Fhn v% Fhuln chm vo Fhu_u t1&*/ ghi vo phPng m+X Ahng v1i D l& c1 phPng m+/ t1& ln c1o t#n thZt lng v t#nh Fh%ng D chm vo Wun o

$ MWC 'O CHONG V KHU&N )gTi phQ m+ m hVp ]ng o M hCp v gZp o v% t#hng ,?ng Fi;m 1 cho ngTi mcc/ o chong thTng cK loiX + o chong thTngX ci Fhu& v ,uVc phi1 31u/ + o chong loi ! th=nX ch2 Fin c mct t#$c v mct 31u- A=& ,uVc ,n phi/ Cch mcc oX ngTi mcc nn Eng vhng t#Hng D o Fh%ng chm vo Nung Wu1nhX

+ o chong thTngX IKn o t^ ngTi phQ- thTng Aung t1& nZm mct t#i c:1 oO )gTi mcc o cm lC& m\p c:1 c+ o v th o NuHng 31o cho mct t#$c o

phi1 t#$c v lurn t1& vo Hng t1& o- Aui thng t1& #1 phi1 t#$c/ )gTi phQ m+ gitp ,uVc cc A=& phi1 31u lng- A=& ng1ng v Fhlu t#1ng/ + o cK ! th=nX tiJn hnh tng t] nhng ngTi phQ m+ cn gitp ngTi mcc o t] cVt A=& o phi1 t#$c/

'httpX}}gi1ngAuong&Fho1/n2t*

F MANG GwNG V KHU&N Y1ng gng v% Fhuln 31u Fhi #1 t1&- mcc o v% Fhuln/ CK cch m1ng gngX

F 1 M58V V98V 4\8 Iq vPng ngoi m gKi gng t1& #1/ Iq vPng t#ong Ahng ,n t1& M c ch2 ph: ,i cnh t1& o c:1 mSnh D lC& mVt chiJc gng t1&/ Ict gng t1& ln cnh t1& Fi1- cc ngKn c:1 gng t1& h$ng ln v1i- lPng gng t1& tp NuHng t#n c+ t1&- ngKn ci c:1 gng Hi Ai@n v$i ngKn t1& c:1 ,n t1& mSnh '0Snh 1*/ Ict cho u c:1 c+ gng t1& n?m ng1& mi #p c:1 c+ t1& o #ri Ahng ngKn t#z v ngKn ci c:1 ,n t1& cK ch2 Fin c+ t1& o D nZm li/ qhng e t1& nZm lC& ,S1 c:1 c+ gng n?m t#n mi #p c:1 c+ t1& o v t1& Fi1 nZm giB lC& ,S1 phi1 t#n c:1 c+ gng- phi cln thn D Fh%ng ,L tuVt cc ngKn t1& #1 '0Snh ,*/ qhng e t1& nZm lC& ,S1 c:1 c+ gng t#Png vo ,n t1&/ qhng t1& Fi1 M c ,1o Fin ,?ng t1& o nZm ,S1 c+ gng t1& v mHi #p nHi c:1 c+ cnh t1& o v F\o t#Png gng vo ,n t1& mSnh '0Snh c*/ `ong mVt ,n t1& tiJn hnh m1ng gng cho ,n t1& Fi1 c|ng th2o cch t#n '0Snh A - h*/ [ng M c m1ng Nong v cc c+ t1& o c cc c+ gng giB chct '0Snh i*/

e)

g)

Y1ng gng t1& Fin 'httpX}}gi1ngAuong&Fho1/n2t*

F $ M58V V98V 1 )Ju c+ t1& o #Vng- NJp mVt l?n phi1 A$i c+ t1& o v Fyp l?n NJp v$i ngKn t#z v ngKn ci 'hSnh 1-,*/ qhng t1& phi m ,1o gng- cm ng1& mi gng gCp ngc gng t#i #1 'hSnh c*/ (1& phi F\o gng t#hm vo ,n t1& t#i 'vn D c+ gng t1&lVn ngc #1 & nh v&* 'hSnh A*/ qhng cc ngKn t1& t#i 'M m1ng gng* 1 vo c+ gng ,n t1& phi ni gCp ngc lC& gng #1- t#hm vo ,n t1& phi 'hSnh 2*/ p1u K F\o c+ gng t1& ph: ln c+ t1& o chong 'hSnh g*/ 4u GX c+ gng phi t#hm ngoi c+ t1& o chong D Fh%ng h c+ t1& c:1 ngTi m+/ p1u Fhi m1ng gng Nong t1& thS D t1& t#$c ng]c hocc cK thD ph: mVt Fhn v% Fhuln nJu vS lG Ao gS K m ch1 tiJn hnh cuVc m+ ng1&/

Y1ng gng t1& h 'httpX}}gi1ngAuong&Fho1/n2t*

F F C- V98V .5Q :n (1& cPn m1ng gng cm mct ngoi c:1 gng ch c+ t1& F\o nhy #1/ (1& M ci gng #ri cm mct t#ong c:1 gng cPn li F\o nhy #1/ ; (H GI( (H)U THU*T VIN MWC 'O MANG GwNG ; 1 (1[ V-_ :fO S/ }T 41Q8

Iq vPng t#ong 31u Fhi M #1 t1&- mcc o chong- m1ng gng v% Fhuln Nong 3 t#1o cho phu thut vin e Fhn v% Fhuln D l1u t1&/ Iq vPng t#ong lC& o chong #1 ni t#Hng th o NuHng/ qhng ngKn t#z v ngKn ci nZm phn c+ o v cuVn o li t#n t1& 2o gng/ I1 phn t#ong c:1 o v; phi1 phu thut t1& vo t1& o 'phi cht G ^ng D ,n t1& vin M l1u t1& Nong D phu thut vin 1

Fh%ng m1ng gng c:1 phu thut vin chm vo o chong c:1 Iq vPng t#ong*/ ; $ (1[ V-_ 81{: :n :58V V98V }T 41Q8 )gTi tiJp AQng cQ 31u Fhi #1 t1&- mcc o- m1ng gng v% Fhuln m$i gitp nhKm m+ m1ng gng v% Fhuln/ (iJn hnhX + Ch.n tng gng- cn gng cho ngTi 3Zp m1ng gng/ + (1& ngTi tiJp AQng cQ lu%n lu%n mct ngoi c:1 gng t#ong 3uHt Wu t#Snh phQ gitp nhKm m+/ + Iq vPng t#ong cho t1& vo nZm A$i ch gCp NuHng c:1 gng t1&- ngKn ci 1 #1 ngoi- h$ng lPng ,n t1& c:1 gng vo phu thut vin- 1 c1o ng1ng thZt lng v m #Vng c+ gng : cho phu thut vin 1 t1& vo m Fh%ng chm vo gng c:1 Iq vPng t#ong/ Y1ng gng Nong mVt t1&- Iq vPng t#ong lm tiJp tQc cc th1o tc gitp m1ng gng cho t1& cPn li/ 4tc n& phu thut vin 1 t1& mSnh vo nJp gCp c+ gng ,; mct D F\o c+ gng #Vng #1 v cho t1& cPn li ch1 m1ng gng vo 'hSnh c- A*/

PhQ gitp phu thut vin m1ng gng 'httpX}}gi1ngAuong&Fho1/n2t*

K THU*T MWC 'O V KHU&N e/ IEng t#$c o chong 'th=n ngTi Fh%ng chm vo o chong*/ / qhng t1& M #1 3ch cm mct t#ong ng]c o v ,$c #1 ch t#Hng/ 7/ I1 thng t1& ln phi1 t#$c ng]c/ 5/ (h o NuHng t#$c mct 'Fh%ng D o chm vo ,Ct cE phn no Fh%ng v% Fhuln*/ !/ qhng ngKn ci v ngKn t#z cm vo Tng nHi phi1 t#ong giB1 v1i o v t1& o/ 6/ I1 t1& vo t1& o v mcc o vo- phi cln thn giB c+ t1& o ph: Fin ln ,n t1&/

8/ Iq vPng ngoi cm phi1 ,n t#ong c:1 v1i o F\o o ln t#n v1i c:1 ngTi mcc/ s/ )gTi mcc o v% Fhuln Ahng t1& c giCu Fin t#ong t1& o ln lt 1 3i A=& Fhlu t#1ng 'nJu cK*- A=& thZt lng cho Iq vPng ngoi cVt li 'cht G chR 1 A=& t#n thZt lng v Fh%ng vPng t1& #1 31u lng/

K THU*T MANG GwNG V KHU&N 6MANG GwNG H@ e/ Iq vPng t#ong 1 t1& ln cho nhBng ngKn t1& #1 Fhzi o chong- Ahng ngKn t#z v ngKn

ci giB c1 t1& o chong 'nJu c1 t1& o #Vng*/ / qhng mVt t1& lC& gng ng1& mi gCp ngc c:1 gng/ 7/ I1 nhBng ngKn t1& c:1 ,n t1& Hi Ai@n vo gng/ 5/ I1 cc ngKn t1& M m1ng gng vo c+ gng thE / !/ I2o gng cho ,n t1& cPn li/ 6/ Cho cc ngKn t1& c:1 ,n t1& m1ng gng 31u vo nJp gCp c:1 gng t1& m1ng t#$c F\o ln ph: c+ t1& o chong/ 8/ p1 ngKn t1& c:1 gng t1& ng1& ngZn- No1& nhy c+ t1& v ,n t1&/

K THU*T MANG GwNG TAH V KHU&N 6MANG GwNG K N@ e/ Iq vPng t#ong Ahng ,n t1& c ch2 ph: ,i t1& o chong D lC& e chiJc gng t1&/ / Ict gng t1& ln lPng ,n t1& Fi1- cc ngKn c:1 gng t1& h$ng ln v1i- lPng gng t1& tp NuHng t#n c+ t1&- ngKn ci c:1 gng t1& Hi Ai@n v$i ngKn ci c:1 ,n t1&/ 7/ Ict cho u c:1 c+ gng t1& n?m ng1& mi #p c:1 c+ t1& o #ri Ahng ngKn t#z v ngKn ci c:1 ,n t1& Lnh 2o gng cK ch2 Fin c+ t1& o D nZm giB ,S1 A$i c: gng/ 5/ qhng ngKn t#z v ngKn ci c:1 ,n t1& cPn li c ,1o Fin ,?ng t1& o nZm ,S1 phi1 t#n c:1 c+ gng 'phi cln thn D Fh%ng ,L tuVt cc ngKn t1& #1*/ !/ g\o t#hm gng vo ,n t1&/ 6/ `ong mVt ,n t1&- tiJn hnh m1ng gng cho ,n t1& Fi1 giHng t^ ,$c e !/ 8/ p1 nhBng ngKn t1& c:1 gng t1& chon g1& ngZn- No1& nhy c+ t1& v ,n t1&/

K THU*T MWC 'O CHONG V KHU&N CHO NHxM M e/ Iq vPng t#ong M #1 t1&- mcc o chong- m1ng gng v% Fhuln/ / 4C& o chong #1 ni t#Hng th o NuHng- mct ngoi o Hi Ai@n v$i Iq/ 7/ qhng ngKn t#z v ngKn ci nZm mct ngoi c:1 v1i o v cuVn o li t#n t1& 2o gng/ 5/ I1 phn t#ong c:1 o v; phi1 phu thut vin M #1 v l1u t1& Nong/ Phu thut vin 1 h1i t1& vo t1& o 'phi cht G ^ng D ,n t1& Fh%ng m1ng gng c:1 phu thut vin chm vo o chong c:1 Iq*/ !/ Iq vPng ngoi gitp cVt A=& c+ v A=& thZt lng c:1 o*/

K THU*T MANG GwNG V KHU&N CHO NHxM M e/ Iq vPng t#ong M #1 t1&- mcc o chong- m1ng gng v% Fhuln/ / Ch.n tng gng cho ngTi 3Zp m1ng- m gng #1/ 7/ Iq vPng t#ong nZm A$i ch gCp c:1 gng t1&- ngKn ci 1 #1 ngoi- cm h$ng lPng ,n t1& c:1 gng t1& vo tng ,n t1& ngTi m1ng- ,1nh #Vng c+ gng- ltc n& phu thut vin 1 ngKn t1& ch1 m1ng gng vo mct t#ong c:1 gng ni nJp gCp- F\o #Vng #1 v 1 t1& Fi1 vo gng/ Cht G Fh%ng c chm vo gng c:1 Iq vPng t#ong/ 5/ Y1ng Nong e t1&- Iq vPng t#ong lm tiJp giHng ,$c 7 cho t1& cPn li 'ltc n& phu thut vin 1 ngKn t1& M m1ng gng vo nJp gCp c+ t1& gng mct ngoi c:1 gng D F\o c+ gng #Vng #1 v cho t1& vo gng*/

DNG C R#A TAH NGOI KHOA e/ )$c #1 t1& v% Fhuln / on chi hCp 7/ ` phPng #1 t1& ti@t Fhuln 5/ Irng hr !/ ghn v% Fhuln 6/ [iC& v% Fhuln 'nJu cn* 8/ (ti #c/

K THU*T R#A TAH NGOI KHOA e/ 4C& t t#1ng #1 Fhzi t1&X nhn- rng hr- vPng 2o t1& / CuVn t1& o ln Wu Fhu_u !-8 cm 7/ ( thJ thng Eng- th=n ngTi v t1& Fh%ng chm vo thnh ,rn 5/ Y vPi n$c ,?ng cch Ahng Fhu_u t1& hocc ,?ng t1& v$i giC& v% Fhuln ',z giC& vo tti #c*/ !/ 4C& N phPng v% Fhuln vo t1& 'lC& : N phPng D cK thD 3:i ,.t* 6/ x1 t1& nVi Fho1 v$i N phPng v% Fhuln/ 8/ qhng ,n t1& thE e cm ,n chi thE e hEng N phPng v% Fhuln/ s/ Ch #1 th2o thE t]X u cc ngKn t1&- t^ng ngKn t1& v cc F ngKn t1& th2o vPng NoZn Hc t^ u ngKn Jn ch=n ngKn- mct t#$c v mct 31u t^ ngKn e Jn ngKn ! v Fh%ng Wu1& ngc t# li/ 4Png ,n t1& mu ,n t1& cng t1& 't$i Wu Fhu_u t1& 7-! cm*/ f/ oz ,n chi vo ni Wu& Lnh ',n t1& vn c1o hn cng t1&*/ e"/ x1 t1& li ,?ng n$c v% Fhuln v$i e ,n t1& v^1 ch #1/ Cht G Fhi AVi n$c cho n$c ch& t^ ngKn- ,n t1& NuHng Fhu_u- Fh%ng ch& ngc li/ TI THAM ee/ !IhU qhng ,n chi KHsO thE v th]c hi@n tiJn t#Snh #1 nh t^ ,$c 8-f cho ,n t1& cPn li/ Cht e/ (Cn CTngIi;u Anng Fho1 - vo )hvhng NuCt A1 ,n [io G )gu&wn Fh%ng D ngKn t1& chm vo l%ng )goi ,n chi h1&tp chm ch1 c.AQc #1/vi@t )1m- 0 )Vi""f- e" e / x1 ,n/ t1& ,?ng n$c v% Fhuln cho Jn Fhi 3ch N phPng/ / Ph1n (hLFhn 0r 0iChuln ,L 3ch o) t#$c oi ging ,@nh h.c t1& ngoi Fho1 e- Ii h.c e7/ qhng v% Fhuln l1u n$c m+ ngKn,n t1&Fhu_u 'l1u t1& tp t^ ng.n chi v < qc (P0CY)h chm NuCt ,n h.c- v e8/nhBng vhng Fh%ng v% Fhuln*/ Fh%ng D Fhnefs!v% Fhuln vo< ngTi 7/ oi ging chm m%n IqIi < Fho1 Phm )g.c (hchlu hnh e5/ ID t1& t#n 3Kc thZtngoilng- oV t#ong tm mZt vh.c Fh%ng chm vo ni Fh%ng v% effsFhulnAhng nVi ,V6/Ahng ch=n m c1/ th=n h1& 5/ oV < tJ- Ii;u Anng c ,n tp e- )h NuCt ,n < h.c 0 )Vi- ""s- 75/ !/ gim 4it1cF/ (h2 3u#gic1l Np2#i2nc2- 32ction 7- Y2Aic1l pu#gic1l )u#3ing- 42i3 Colli2# 02itF2mp2#} Ypo< eff - !6/

BI 1<

Vh SINH DA R#A DA TRC (H)U THU*T

1 MC CH PhPng ng^1 nhiwm Fhuln vJt m+/ oo m vhng A1 phu thut Fh%ng cK 3] hi@n Ai@n c:1 vi Fhuln/

$ CH "NH Chuln ,L vhng A1 t#$c m+/

F CHNG CH "NH vhng A1 cK vJt thng/ vhng A1 cK ,@nh lG v; A1/

; NHGNG IXM CN !U (#nh to vJt thng Fhi v@ 3inh A1/ 0n chJ co l%ng t#$c m+- chR th]c hi@n Fhi cK & l@nh/ x1 A1 t^ t#ong #1 ngoi/ vhng ,Qng cht G phn #Hn/ Cc nJp gCp cn phi #1 Fd/

? Vh SINH DA TRC M ? 1 D[8V O[ }A .-81 j5 0Pk|O :n q1o co/ (Cm t#i Fh%ng thCm n$c/ Y;m/ ` phPng Ai@t Fhuln/ qung ALch #1 mKng t1&/

qung ALch Fhng Fhuln/ (ti #c/ g\o/ [ng 3ch/ o chong cho o)/

Y=m #1 A1 t#$c m+ 'httpX}}gi1ngAuong&Fho1/n2t*

? $ K 01Qc0 }A .-81 j5 0Pk|O :n giDm t#1 & l@nh/ Iq 31 3on vhng A1 #Vng hn Ai@n tich vJt m+/ pon AQng cQ v m1ng Jn giTng o)/ oo v gii thich cho o)/ IKng c1 h1& ch2 ,Snh phong/ Iq #1 t1& v m1ng gng t1& 3ch/ Ict tCm lKt Fh%ng thCm n$c t#n giTng/ IZp m;m cho o)/ Phi ,& vhng A1 cn v@ 3inh/ bu1n 3t tSnh t#ng A1/ CZt l%ng Ai ,?ng F\o/

qhng ,%ng thCm n$c lm $t A1- 31u K Ahng N phPng D to ,.t t#ong 7-5 phtt/ Cm A1o co gKc 5!" 3o v$i mct A1/ Co th2o chi;u l%ng m.c- nhy nhng Fh%ng Cn mnh nhCt l vhng Nng nh% #1/ x1 A1 thTng Nu&n t#ong Fhi co v$i n$c 3ch- th1& A1o nJu A1o chn- thm N phPng nJu hJt ,.t/ Co 3ch vhng A1 phu thut/ x1 li vhng A1 v^1 co v$i n$c 3ch/ bu1n 3t li vhng A1 M co- nJu vhng no ch1 3ch thS co li/ 41u Fh% A1 v$i Fhn hCp/ x1 3ch mKng t1& cK 3n/ Cho o) n?m t thJ thoi mi/ x1 t1& t#$c Fhi #Ti phPng/ (hu A.n AQng cQ/

? F D[8V O[ P5 j5 0Pk|O :n ghn nhz/ ghn l$n h1& vi t#i/ Ch\n chun ]ng Aung ALch 3t Fhuln/ [ng t1& v% Fhuln/ bu2 gPn/

? ; K 01Qc0 P5 j5 0Pk|O :n pon AQng cQ/ ghi o) ,Zt u m- Iq cho o) tng t thJ phu thut/ Y1ng gng v% Fhuln/ qhng Fhn nhz nhtng vo Aung ALch 3t Fhuln- #1 vhng m+ t#ong e" phtt- #1 t^ t#ong #1 ngoi th2o hSnh NoZn Hc- t^ vhng m+ #1 t$i vhng A1 Nung Wu1nh- cln thn vhng A1 cK nJp gCp/ x1 vhng nJp gCp hu m%n v hu m%n 31u chng/ 4m 3ch nhBng ch Flm- mKng t1&- mKng ch=n nJu nK n?m t#ong vhng gii phu/ Cht G Ahng Wu2 gPn #1 3ch vhng #Hn/

41u Fh% vhng A1 v$i Fhn v% Fhuln/ o1o ph: vhng A1 n& ,?ng gc v% Fhuln/ (hu A.n AQng cQ/

x1 A1 m+ vhng ,yn- hi

x1 A1 m+ vhng ng]c ,Qng

'httpX}}gi1ngAuong&Fho1/n2t*

x1 A1 m+ vhng t#]c t#ng- =m o- hVi =m 'httpX}}gi1ngAuong&Fho1/n2t*

x1 A1 m+ vhng ,Qng

x1 vhng gHi v cng ch=n

'httpX}}gi1ngAuong&Fho1/n2t*

x1 A1 m+ vhng ng]c v vt 'httpX}}gi1ngAuong&Fho1/n2t*

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi Fho1 tp - )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- eee/ / Ph1n (hL 0r 0i- Chuln ,L o) t#$c m+- ,i ging ,@nh h.c ngoi Fho1 tp e- Ii h.c < qc (P0CY- efs!- s8/

7/ gim 4it1cF/ (h2 3u#gic1l Np2#i2nc2- 32ction 7- Y2Aic1l pu#gic1l )u#3ing- 42i3 Colli2# 02itF2mp2#} Ypo< eff - 7f!/

CHNG $: TIU HxA BI 11 CHwM SxC BhNH NHpN VIM (HC MC

MC TIU 1. Trnh by c gi2i ph3&Q !ri;& chFng lS" sng v c8n lS" sng c-a vi$" phcc "c. 2. 9h?" sTc c b;nh nhSn vi$" phcc "c. (. 9h&:n b c b;nh nhSn !rMc "4 vi$" phcc "c. +. 9h?" sTc c b;nh nhSn sa& "4 vi$" phcc "c.

1 GIsI (H)U 4 phtc mc cK l$p l l thnh v l tng/ 4 thnh n?m ,.c lKt mct t#ong thnh ,Qngl tng ,1o ph: cc tng t#ong + ,Qng/ CK 7 nJp l mc t#2o t#2o Hng tiu hK1 vo thnh ,Qng- mc ch?ng- mc nHi nHi cc tng v$i nh1u/ [iB1 l thnh v l tng cK mVt Fho1ng o chE1 Fhong s"-e"" ml ALch/ qLch n& vng t#ong- cK chE1 nhi;u p#ot2in- m ,o V t#n lng c:1 phtc mc- gitp t#t ln nh1u Aw Ang/ Phtc mc chE1 mch mu- l&mpho v thn Finh/ l

$ TRIhU CHNG !pM SNG $ 1 TP-AQ O1N8V O3 898V I1u ,QngX l t#i@u chEng u tin- 1u FhZp ,Qng- nh A1o =m- 1u lin tQc v Fh%ng cK t thJ gim 1u/ I1u tng Fhi ho h1& c Vng nn o) n?m &n/ )%n KiX n%n Fh1n- n%n it/ ghi o) Jn t#w Ao li@t #uVt c nng cK thD n%n nhi;u hn/ oi t#ung i ti@nX Ao tSnh t#ng li@t #uVt c nng/

$ $ TP-AQ O1N8V 01O 01g

Co cEng thnh ,Qng l t#i@u chEng Wu1n t#.ng v cc ,i@t c:1 vim phtc mc/ )hSnX thnh ,Qng phng- im lSm- Fh%ng Ai Vng th2o nhLp th- nJu cK thS #Ct it/ CK thD thC& ,Qng ch$ng- & hi/ pTX ,Qng cEng nh g- Cn thC& 1u nJu Cn mnh 1u tng/ [X Ao t#ong No1ng ,Qng cK hi nn g ngh2 v1ng vhng ch$ng- Qc vhng thCp/ (hm =m o t#]c t#ngX tti chng cng Ao tQ ALch- Fhi Cn vo o) 1u chKi/

$ F TP-AQ O1N8V 0/t8 01K8 )hiwm t#hngX o) 3Ht c1o 7f"-5""- lnh #un/ )hiwm VcX thTng gcp Fhi o) Jn t#w- o) l m- nKi nhm- gng mct lo =u hHt hong- mZt t#|ng 3=u/ o) cK thD Fh%ng cPn 3Ht- thiDu ni@u h1& v% ni@u/

F TRIhU CHNG C*N !pM SNG och cu tng c1o- u# mu- c#21tinin2 tng c1o- ,iDu hi@n tSnh t#ng 3u& thn cCp/ xHi lon nhiwm to1n chu&Dn hK1/ `-bu1ngX ,Qng mT vS No1ng ,Qng cK ALch- Tng 3ng ,n ,Qng mCt/ piu =mX thC& ALch t#ong No1ng ,Qng- #uVt giMn ch$ng/

; IU TR" )gu&n tZc l i;u t#L nVi Fho1 FJt hp v$i ngoi Fho1/ )Vi Fho1 nh?m mQc ich phPng ng^1 chong- cung cCp nng lng- gim ,$t tSnh t#ng nhiwm t#hng/ )goi Fho1 nh?m loi ,z ngu&n nh=n g=& vim phtc mc v lm 3ch No1ng ,Qng/

? +UH TR~NH CHwM SxC BhNH NHpN VIM (HC MC TRC M ? 1 N1c8 BY81 081 0PC8V BN 0ziX tSm hiDu ngu&n nh=n g=& vim phtc mc nh iDm 1u Fhi u/ ghmX + )hn Lnh 1uX vL t#i NuCt hi@n 1u/

+ `c Lnh tSnh t#ng hi@n ti v tinh chCt cn 1u- nhu Vng #uVt- tSnh t#ng cng ch$ng ,Qng nhi;u hn- ,Qng grng cEng nh g/ + pTX ,Qng cEng nh g- ACu cm Eng phtc mc '*/ + [X mCt vhng Qc t#$c g1n/ + )gh2X nhu Vng #uVt gim/ + )%n Ki- n%n Fh1n/ + (h=n nhi@t tng #Ct c1o/ + oi t#ung i ti@n/ + oiDu hi@n chong nhiwm t#hng/

? $ C18 B/S8 }t O58 01-A_ D 5.2.1. ;g ! c th tch 89ch gim 8o tch tX 89ch t:ong kho*ng 3hic mc thM 3ht 8o chn thng1 nhiOm t:Hng h*! thiP m giDm t#1 li o) v cc ACu hi@u mCt n$c- i@n gii- tSnh t#ng nhiwm to1n- chong gim thD tich- mCt ALch- ch$ng #uVt- nhiwm t#hng/ oh n$c- i@n gii- mu- hu&Jt th1nh th2o & l@nh/ (h2o Ai 3t q0p(- CvP- p l]c mu- n$c tiDu- 3onA2 A A& mi giT/ (h2o Ai ACu hi@u thiJu oN& nh t#i gic gim An- l m- nKi nhm/ [hi hr 3 Aiwn ,iJn c:1 ,@nh/ Cung cCp nng lng- vit1min- p#ot2in cho o) ,?ng m.i cch/

5.2.2. DiPn $0i 8inh 8@ng 8o nGn (h2o Ai 3H lng- tinh chCt ALch n%n Ki- t#nh chCt n%n t#n vo Fhi Wun/ (h2o Ai ion r- ACu mCt n$c/ (h]c hi@n ct 3onA2 A A& gitp o) gim n%n Ki- rng thTi th2o Ai 3t lng n$c NuCt t^ A A&/ [itp o) 3ch 3 v Fh% #o/ (h]c hi@n ,h n$c : v tng/

5.2.3. gi thd khGng hi% ) 8o $* )hn Lnh tSnh t#ng h% hCp c:1 o) vS ,Qng cng ch$ng v gim th Ao 1u/ (h2o Ai cc ACu hi@u FhK th/ Cho o) n?m u c1o gitp gi1 tng thD tich lrng ng]c/ Cho o) th oN& th2o & l@nh- th2o Ai tSnh t#ng oN& mu c:1 o)- t# gitp phng php th Fhi thich hp/ 5.2.4. jo lfng vT c Ic m0 Nf3 t"i C%ng tc t tng v; cuVc m+- thTi gi1n m+- cho gcp ngTi nh/ [ii thich nhBng ,iJn chEng cK thD N& #1/ Cho ngTi th=n chng Ai chu&Dn o) Jn Fhu phu thut/

5.2.5. K* 4Xng li5n ) *n $Pn 3hic mc vJ 4Xng c<ng ch"ng )hn Lnh li cc vhng 1u- 1u tng h1& gim i- ,Qng cng ch$ng h1& grng cEng/ [itp o) gim 1u nhBng t thJ thich hp- hn chJ thm Fhm nhi;u ln- t#nh nhBng c Vng Vt ngVt/ qi chu&Dn o) nhy nhng/ (h]c hi@n thuHc gim 1u cho o)/

5.2.=. Ch kn 49 D; t:"c m0 4C& li q0p(/ [ii thich cho o) 1n t=m/ gh%ng cho o) n uHng/ [ii thich li v hi c:1 phu thut D o) hp tc/ [hi # nhBng Aiwn tiJn v t#i@u chEng c:1 o) vo hr 3/ 4m Fhln cc N\t nghi@m ti;n phu/ Ict 3onA2 A A&- th%ng tiDu cho o)/ (#u&;n ALch v tim thuHc th2o & l@nh/ (h]c hi@n Fhng 3inh/ v@ 3inh vhng A1 3Zp m+/

o +UH TR~NH CHwM SxC BhNH NHpN VIM (HC MC SAU M o 1 N1c8 BY81 081 0PC8V BN )hn Lnh tSnh t#ng o) Fhi ,n gi1o t^ phPng m+ phPng hri 3EcX t#i gic- ACu hi@u FhK th- q0p(- An lu- ,Qng- tu,2 42vin2 v nhBng Aiwn ,iJn t#ong cuVc m+/ )hn Lnh tSnh t#ng o) t^ phPng hri 3Ec v; Fho1 ngoiX q0p(- tSnh t#ng nhu Vng #uVt- Ainh Anng- tSnh t#ng ,Qng o $ C18 B/S8 }t O58 01-A_ D =.2.1. D; chong 8o gim th tch (h2o Ai lng n$c NuCt nhp v ACu hi@u #Hi lon i@n giiX q0p(- ACu v\o A1- CvPaon r/ (h2o Ai th=n nhi@t/ (h2o Ai t#i gic/ (h]c hi@n ,h n$c v i@n giiX t#u&;n ALch- Fhng 3inh th2o & l@nh/

=.2.2. D; khS thd 8o tFnh t:ng 4Xng c<ng ch"ng1 $* N* m0

0Snh nh ct Hng th%ng m|i A A& D gii p 31u m+ 'httpX}}/pA1vi2t/n2t*

Im ,o th%ng Fhi- cho o) th oN&- htt m nh$t/ (h2o AiX + ChR 3H oN& t#ong mu/ + oQng ch$ng- ACu hi@u phn Eng phtc mc- grng cEng - cn 1u- nh gi cn 1ungh2 nhu Vng #uVt/

Chm 3KcX + o) m cho n?m u ,?ng mct nghing e ,n- o) tRnh cho n?m t thJ mol2#- ch=n co vo u gHi gitp o) thoi mi/ + (u,2 42vin2X htt lin tQc h1& ngZt WuMng t#nh nghyt- c=u nHi thCp/ (h2o Ai 3H lng- tinh chCt- mu 3Zc ALch A A&/ xtt Hng Fhi cK nhu Vng #uVt v th& vo t^ng ,@nh lG/ + o) cn cK li@u php gim 1u Wu1 monito# v thuHc/ + (o m%i t#Tng nghR ngi &n tnh/ + (h]c hi@n Fhng 3inh tng li;u v tng giT/

0$ng An o) cch th- nJu o) Fh%ng chong h$ng An o) ngri A& 3$m

=.2.3. DiPn chMng nhiOm t:Hng 8o 8bn l 1 vPt m0 (h2o Ai mu 3Zc- tinh chCt ALch An lu/ C=u nHi thCp- ,Snh chE1 thCp hn An lu 6" cm/ Chm 3Kc An lu ,o m Fd thut v% Fhuln/ xtt An lu th2o & l@nh/ vJt m+ Fh=u A1 th1 h1& chR th\p Ao tSnh t#ng + ,Qng nhiwmX th1& ,ng thTng Nu&nth2o Ai nhiwm t#hng vJt m+/ (h]c hi@n Fhng 3inh tng li;u v tng giT/

=.2.4. ;h c 8inh 8@ng gim Cung cCp Ainh Anng th2o & l@nh- ngn ng^1 ,iJn chEng F\m hCp thu/ Cung cCp Ainh Anng cho o) Wu1 cc Tng th& th2o t^ng o)X n- t#u&;n ALch- ,m thEc n Wu1 tu,2 42vin2/ =.2.5. D; ch* th*m gi* ch<m NSc N* m0 (i ,@nh vi@nX cho o) ngri A& vn Vng t#nh cc ,iJn chEng nh vim ph+i- tZc #uVtthu&n tZc tnh mch/ 0$ng An o) cch ngri A& Fhi cK An lu- 0Y)(/ Cch giB vJt m+- gitp o) chng hp tc tHt v$i Iq/

ghi NuCt vi@nX h$ng An o) cch chm 3Kc vJt m+- vJt #tt An lu- Ainh Anng- cch cho n- nhBng ACu hi@u ,Ct thTng nh 1u ,Qng- 3Ht (i Fhm tng hyn/ (h2o Ai ,iJn chEngX tZc #uVt- vim phtc mc thE pht/

F !rNG GI' o) Fh%ng chong/ o) th Aw Ang- ,Qng Fh%ng cng ch$ng/ o) Fh%ng nhiwm t#hng vJt m+ v ch=n An lu/ o) c cung cCp Ainh Anng & :/

CpU HqI !rNG GI' e/ oiJn chEng no thTng N& #1 31u m+ vim phtc mcX 1/ vim phtc mc ti pht ,/ p N2 trn lu c/ (Zc #uVt A/ )hiwm t#hng + ,Qng / (u,2 42vin2 t#$c m+ vim phtc mc cK mQc ich gS- )[ a (xX 1/ [im cng ch$ng ,Qng ,/ [im ngu& c vim phtc mc ti pht c/ qw chLu A/ [im Ki 7/ o) FhK th Ao ,Qng cng ch$ng 31u m+ vim phtc mc- Iq cn N t#iX 1/ 0tt A A& lin tQc- cho o) n?m t thJ mol2# ,/ (ng oN& tHi 1 cho o) c/ Cho o) uHng n$c cK hi A/ Io vPng ,Qng thTng Nu&n 5/ Ii;u no 31u =& tng Fhi nKi Jn 31u m+ vim phtc mcX

1/ (Ct c o) 31u m+ ;u cK hu m%n nh=n to ,/ (u,2 42vin2 c #tt Fhi q0p( +n Lnh c/ qn lu + ,Qng cn c #tt 3$m A/ gh%ng th1& ,ng vJt m+ thTng Nu&n !/ o) 31u m+ vim phtc mc thTng chong Ao gim thD tich ALch- Ao n%n/ Iq cn th2o Ai v chm 3KcX 1/ (h2o Ai lng n$c NuCt nhp- cho o) uHng nhi;u n$c/ ,/ (h2o Ai tinh chCt n%n c/ (h]c hi@n chJ V n loMng- nhi;u n$c A/ (h]c hi@n ,h n$c v i@n gii th2o & l@nh

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Iq )goi - Chm 3Kc o) m+ A A&- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e8f/ / (#n (hi@n (#ung- oi ging ,@nh h.c ngoi Fho1 tiu hK1- (h:ng lo\t A A& t t#ng- oV m%n ngoi- Ii h.c < qc (P0CY- )h NuCt ,n < h.c- ""e- !f/ 7/ oi ging ,@nh h.c ngoi Fho1 tiu hK1- (h:ng lo\t A A& t t#ng- Ii h.c < qc (P0CY-effs- e8!/ 5/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2 nA 2A/- ~o p1unA2#3 comp1n& effs- e"!s/

BI 1$ CHwM SxC BhNH NHpN M VIM RU%T THA

MC TIU 1. ji*& c sinh lR b;nhQ !ri;& chFng lS" sng c-a b;nh lR vi$" r&U! !hqa. 2. 9h?" sTc c b;nh nhSn !rMc "4. (. 9h?" sTc c b;nh nhSn sa& "4.

1 SINH ! BhNH (Zc nghn t#ong lPng #uVt th^1 NuCt hi@n l &Ju tH 3$m c:1 vim #uVt th^1/ (Zc nghn lm tng p l]c t#ong lPng #uVt th^1- lm Snh t#@ tSnh t#ng mu lu th%ng/ (Zc nghn g=& thiJu mu nu%i v gi1i on n& cc vi Fhuln #uVt tCn c%ng v g=& #1 nhiwm t#hng #uVt th^1/ oiJm chEng c:1 vim #uVt th^1 ,1o grm vim phtc mc #uVt th^1- p N2 #uVt th^1- #uVt th^1 hoi t/

0Snh nh #uVt th^1 ,Snh thTng 'httpX}}/gi1oAuc3ucFho2/n2t*

0Snh nh #uVt th^1 vim 'httpX}}/gi1oAuc3ucFho2/n2t* $ TRIhU CHNG !pM SNG I1u ,Qng l t#i@u chEng c ,n c:1 vim #uVt th^1/ [i1i on u 1u #Ct m hr- 31u K 1u vhng thng vL l1n NuHng #Hn/ p1u hn 5 giT 1u Fhu t#t vhng hH chu phi/ Chn n- ,urn n%n/ (o ,Kn h1& tiu ch&/ I1u tng Fhi o) c Vng Vt ngVt- ho/ oiDu hi@n nhiwm t#hng nh 3Ht nhy- m%i Fh%- lni A/ `\t nghi@m thC& ,ch cu tng- tHc V lZng mu tng/ ghm o) cK cc iDm 1uX Y1c-ou#n2&- 41n- phn Eng phtc mc vhng hH chu phi/

F +UH TR~NH CHwM SxC BhNH NHpN TRC M F 1 N1c8 BY81 081 0PC8V BN I1u ,Qng =m R lin tQc- Fh%ng 1u thnh cn/ qCu hi@u nhiwm t#hngX nhi@t V tng nhy- m%i Fh%- lni A qCu hi@u #Hi lon tiu hK1X chn n- ,urn n%n- tiu ch&/ ghm cc iDm 1uX Y1c-ou#n2&- 41n/ )Ju o) Jn t#w Iq cn pht hi@n ACu hi@u nhiwm t#hng- nhiwm Vc/

F $ C18 B/S8 }t O58 01-A_ B-RQ jkl8V 3.2.1. K* 4Xng li5n ) *n 4%nh lC

4ng gi vL t#i- tinh chCt- mEc V 1u/ ( thJ gim 1u/ (h]c hi@n thuHc gim 1u th2o & l@nh/

3.2.2. jo lfng vF 3hi m0 c3 cM 4ng gi mEc V cng thng c:1 o)/ )=ng n v; tinh thnX gii thich cho o) hiDu- cung cCp th%ng tin v; cuVc m+ D o) v ngTi nh 1n t=m/ 3.2.3. Ch<m NSc D; t:"c m0 [itp op th]c hi@n cc th: thut chln on/ gh%ng cho o) n uHng/ gh%ng thQt tho cho o)/ (h]c hi@n Fhln cc N\t nghi@m ti;n phu/ 4C& q0p(- th]c hi@n thuHc th2o & l@nh/ Ict tu,2 42vin2 v th%ng tiDu- v@ 3inh t#$c m+/ Chu&Dn o) Jn phPng m+ chng th=n nh=n/

F F !kv8V V-S [im 1u/ An t=m i;u t#L/ CuVc m+ c chuln ,L tHt/

; +UH TR~NH CHwM SxC BhNH NHpN SAU M VIM RU%T THA ; 1 N1c8 BY81 081 0PC8V BN q0p(- tSnh t#ng t#i gic nJu o) g=& m- vn Vng chi nJu g=& t t:& 3Hng/ bu1n 3t ,ng thCm ALch- An lu #1 mu Fh%ng I1u- tSnh t#ng nhu Vng #uVt- ngh2 nhu Vng #uVt/ Cc ACu hi@u ch& mu/

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. .* m0 vi5m : It th-* c3

o) cK thD c m+ nVi 3oi h1& g=& t t:& 3Hng/ o) tRnh cho o) n?m t thJ mol2#- gitp o) ngri A& 3$m- i li Wu1nh giTng ng^1 ,iJn chEng ph+i v li@t #uVt/ p1u 6-s giT- o) tRnh- #tt tu,2 42vin2- cho o) uHng it n$c- Fhi cK nhu Vng #uVt v Fh%ng n%n Ki thS cho o) n/ vJt m+ v% Fhuln Fh%ng th1& ,ng- 31u 8 ng& thS cZt chR/ o) m+ nVi 3oi Fh%ng cn th1& ,ng- cho o) i li cng 3$m cng tHt/ Cht G tSnh t#ng ch$ng ,Qng Ao ,m hi vo t#ong + ,Qng/

4.2.2. ?:cng h_3 m0 vi5m : It th-* cS 4iPn chMng o) cK An luX chm 3Kc An lu + ,Qng/ Cho o) n?m t thJ mol2# nghing v; phi1 cK Hng An lu- cho o) ngri A& cng 3$m cng tHt/ (h2o Ai mu 3Zc- tinh chCt- 3H lng ALch c:1 An lu v ghi vo hr 3/ qn lu A] phPng cn ,o op D #tt 3$m/ qn lu + m: #uVt th^1 thTng #tt chm hn- Fhi cK & l@nh #tt thS #tt t^ t^ mi ng& Fhong e- cm cho Jn Fhi Hng t] 3tt #1/ vJt m+X t#Tng hp Fh=u A1 th1- Iq th1& ,ng mi ng&- ghi li tSnh t#ng vJt thng/ (#Tng hp vJt m+ D h h1& nhiwm t#hng- Iq th1& ,ng Fhi thCm ALch- Fhi vJt m+ ln m% ht tHt thS Fh=u A1 thS h1i/ 4.2.3. ?hRo 8`i ch<m NSc D; cS 4iPn chMng N* m0 Ch& mu Ao tQt ch Fh=u Vng mch #uVt th^1X + 4=m 3ngX th2o Ai ch& mu Wu1 An lu- 1u ,Qng- hu&Jt p tQt- mch nh1nh- A1 N1nh- nim ti- vM mr h%i + C1n thi@pX Iq cn pht hi@n 3$m- hri 3Ec v chuln ,L o) m+ li/ Ch& mu vJt m+X + 4=m 3ngX mu thCm ,ng vJt m+- N& #1 #Ct 3$m vi giT 31u m+/ + C1n thi@pX Ahng gc thCm oN& gi Cn ng1& vo ch ch& mu- nJu mu vn ch& v$i 3H lng nhi;u nn ,o op- th2o Ai q0p( v ghi li 3H lng mu ch&/

(Zc #uVtX + 4=m 3ngX thTng N& #1 vo ng& thE 7-5 31u m+ h1& muVn hn- o) 1u ,Qng t^ng cn- ACu hi@u #Zn ,P- ACu hi@u Wu1i #uVt n+i- ,i t#ung i ti@n- g1 '-*/ + C1n thi@pX phPng ng^1 nn cho o) ngri A& 3$m- hit th 3=u- tp vn Vng/

p N2 v vim tC& thnh ,QngX + 4=m 3ngX ACu hi@u nhiwm t#hng vJt m+- ACu hi@u nhiwm t#hng ton th=n/ + C1n thi@pX th]c hi@n Fhng 3inh- th2o Ai nhi@t V- nJu vJt m+ cK ACu hi@u nhiwm t#hng ,o op v th]c hi@n cZt ,z mHi chR v #1 3ch vJt m+/ [hi hr 3 tSnh t#ng vJt m+- nhi@t V v tSnh t#ng nhiwm t#hng c:1 o)/

p N2 tti chng qougl13X + 4=m 3ngX nhi@t V tng- o) mKt i cu nhi;u ln- tiu ch&- 1u ,Qng/ (hm Fhm t#]c t#ng thC& tti chng qougl13 phrng v o) 1u/ + C1n thi@pX chuln ,L o) m+ li/

qP ph=nX + 4=m 3ngX Fhi th1& ,ng thC& ALch mu vng ln cn- thHi- ch& #1 ni vJt m+ h1& Wu1 An lu/ + C1n thi@pX ghi li 3H lng v tinh chCt ph=n- th1& ,ng thTng Nu&n- ng^1 #m l A1cung cCp cho o) nhi;u Ainh Anng gitp Tng AP m1u lnh/

4.2.4. D; hn chP kiPn thMc 0$ng An o) v@ 3inh t#ong n uHng- v@ 3inh th=n thD 3ch 3/ CK thD cZt chR vJt m+ L1 phng/ Pht hi@n 3$m ACu hi@u tZc #uVt 31u m+X 1u ,Qng t^ng cn- ,i t#ung i ti@n thS Fh%ng n uHng v Jn ,@nh vi@n ng1&/ ; F T-LQ O1Q8 bkv8V V-S [im 1u- vJt m+ lnh tHt/ gh%ng N& #1 cc ,iJn chEng/ o) ,iJt chm 3Kc Fhi v; nh/

CpU HqI !rNG GI' e/ oiJn chEng 31u m+ vim #uVt th^1X 1/ vim #uVt th^1 ti pht ,/ xP ph=n c/ )hiwm t#hng vJt m+ A/ (h:ng m1nh t#ng / p1u m+ #uVt th^1 Fh%ng cK ,iJn chEng- Iq cn chm 3KcX 1/ Cho o) ngri A&- i li 3$m ,/ Cho o) n?m nghing v; ,n t#i- t#nh cCn vJt m+ c/ (h1& ,ng Fhi thCm $t ALch A/ 6 { s giT 31u m+ phi cho o) n 7/ Chm 3Kc l #P 31u m+ vim #uVt th^1 lX 1/ 4C& ALch lm Fhng 3inh r ,/ p1u Fhi th1& ,ng phi ,ng \p li c/ )=ng c1o thD t#ng cho o) A/ ghu&n o) hn chJ n thEc n cK vL chu1 5/ Iq cn gio AQc o) 31u m+ vim #uVt th^1 c NuCt vi@n v; nhX 1/ ging n t%m- cu1- #1u muHng ,/ 0n chJ vn Vng t#nh ,Qc chR Fh=u ,n t#ong c/ ghi thC& 1u ,Qng thS uHng thuHc gim 1u A/ CZt chR ti L1 phng !/ vJt m+ vim #uVt th^1 ch& mu- Iq chm 3KcX 1/ Ict Tng t#u&;n tnh mch ng1& ,/ qhng gc Cn ng1& iDm ch& mu- ,o op c/ 4p tEc 1 o) Jn phPng m+ D Fh=u li A/ 0ri 3Ec tich c]c cho o)

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi e- Chm 3Kc o) m+ vim #uVt th^1- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e8 / / oi ging ,@nh h.c ngoi Fho1 tiu hK1- vim #uVt th^1- oV m%n ngoi- Ii h.c < qc (P0CY- ""e- f/ 7/ C1o vn (hLnh- vim #uVt th^1 cCp- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- e6/ 5/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2 Yo3,& Comp1n& efs6- 8s /
nA

2A/- ~o p1unA2#3 comp1n& effs- e"67/


nA

!/ q2,#1 C/o#o1A2ll [13t#oint23tin1l p&3t2m in Yo3,& 3 Y1nu1l o Clinc1l )u#3ing-

2A/-

BI 1F CHwM SxC BhNH NHpN M TC RU%T

MC TIU

1. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn !rMc "4 !sc r&U!. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4 !sc r&U!.

1 +UH TR~NH CHwM SxC BhNH NHpN TRC M TC RU%T 1 1 N1c8 BY81 081 0PC8V BN I1u ,QngX t^ng cn- giB1 cc cn 1u ,Qng cK lin Wu1n Jn co thZt nhu Vng #uVt- 1u AB AVi- Fh%ng gim 1u th2o t thJ/ )%n KiX + (Zc #uVt on t#nX n%n Ki nhi;u- Fh%ng lin Wu1n Jn ch$ng ,Qng/ + (Zc #uVt on thCpX n%n it- ALch Qc h%i thHi- ,Qng ch$ng nhi;u/ + (Zc i t#ngX n%n Ki 31u tZc #uVt F\o Ai- thTng NuCt pht 31u 1u ,Qng/ (o ,Kn v 3u& gim hi l ACu hi@u tZc #uVt hon ton/ (i;n 3 cK gii phu vhng ,Qng- Ainh #uVt- thot vL l ngu&n nh=n tZc #uVt c h.c/ (i;n 3 vim nhiwm Tng #uVtX ,@nh C#ohn- lo\t i t#ng- 1 #uVt #1 ngoi- ung th/ (hm FhmX ,Qng ch$ng- cK ACu hi@u #Zn ,P- ACu Wu1i #uVt n+i- ,Qng m;m- Fh%ng ACu cm Eng phtc mc/ (hm Fhm ton th=nX ACu hi@u mCt n$c v #Hi lon i@n gii/ (Zc #uVt tiJn t#iDnX + )gh2 nhu Vng #uVt =m 3Zc tng- 1u ,Qng t^ng cn/ + m 3Zc c1o- ngh2 h h t#ong t1i v Arn Ap 'tZc #uVt c h.c*/ + qn An mCt nhu Vng #uVt h1& tiJng nhu Vng it 'li@t #uVt*/

+ oQng ch$ng- [1 '-*/

0Snh nh tZc #uVt t#n phim chQp ,Qng Fh%ng chuln ,L 'httpX}}/ho1nm&ho3pit1l/com*

1 $ C18 B/S8 }t O58 01-A_ B-RQ jkl8V 1.2.1. 6im th tch 89ch 8o tfc : It )hn Lnh li o) cc ACu hi@u mCt n$c- i@n gii- n$c tiDu gim A$i 7"ml} giT- tSnh t#ng to1n hu&Jt- nhiwm t#hng- chong- ch$ng #uVt/ (h2o Ai q0p(- CvP- p l]c mu- 3onA2 A A& mi giT (h]c hi@n ,h n$c- i@n gii- mu- hu&Jt th1nh th2o & l@nh/ [hi vo hr 3 Aiwn tiJn ,@nh/

$ $ BN 41{ 01 j/ O1k|8V d[8V (h2o Ai h% hCp c:1 o) vS ,Qng cng ch$ng v o) Fh%ng Am th Ao 1u/ Io vPng ,Qng mi 5-s giT/ Cho o) n?m u c1o gitp lrng ng]c giMn n ngn ng^1 tSnh t#ng 3u& h% hCp/ Cung cCp oN& Fhi o) cK ACu hi@u thiJu oN&/

qL vt g=& tZc t#n e Wu1i #uVt non

qL vt l N- mti mit

'httpX}}/ho1nm&ho3pit1l/com* $ F 5Q d[8V (h2o Ai cn 1uX vL t#i- thTi gi1n F\o Ai c:1 cn 1u- Fhong cch giB1 chCt cn 1u- h$ng l1n/ (h2o Ai Aiwn tiJn cn 1u/ [itp o) tSm t thJ gim 1u/ (#nh c Vng Vt ngVt- hn chJ thm Fh/ (h]c hi@n thuHc gim 1u th2o & l@nh/ cn 1u- tinh

$ ; BN . BkvO :n O_ ONQ [ii thich cho o) v th=n nh=n gitp h. 1n t=m- ,o v gii thich v; phng php v% cm- phng php phu thut- An lu- 0Y)(/ gh%ng cho o) n uHng/ Ict 3onA2 A A& v htt lin tQc/ (h]c hi@n ,h n$c v i@n gii/ (h]c hi@n cc N\t nghi@m t#$c m+ v chuln ,L o) t#$c m+/

$ +UH TR~NH CHwM SxC BhNH NHpN SAU M TC RU%T $ 1 N1c8 BY81 081 0PC8V BN (un honX mch- hu&Jt p- ACu mCt n$c- #Hi lon i@n gii- gim thD tich ALch/ 0% hCpX ACu hi@u FhK th- thiJu oN&/

(Snh t#ng hu m%n nh=n toX ph=n- ALch- mu/ (Snh t#ng ,QngX ch$ng- 1u- nhu Vng #uVt/ (u,2 42vin2X mu 3Zc- 3H lng ALch/ qn luX mu 3Zc- 3H lng ALch/

$ $ C18 B/S8 }t O58 01-A_ D 2.2.1. Chong N* m0 tfc : It 8o mt n"c vJ $i%n gii Im ,o th%ng Fhi cho o)X htt m nh$t- cho o) th oN&/ (h2o Ai 3t q0p(- pht hi@n 3$m ACu hi@u chong/ Inh gi chinh Nc ACu hi@u thiJu n$c v #Hi lon i@n gii/ (h]c hi@n hri 3Ec chHng chong- th]c hi@n & l@nh chinh Nc Fhi t#u&;n ALch/

2.2.2. DXng ch"ng N* m0 tfc : It (u,2 42vin2X c htt lin tQc D gitp ,$t cng ch$ng A A&- lC& ,$t ALch E .ng,o v@ vJt m+ m1u lnh- th2o Ai v ghi li 3H lng ALch D ,h n$c v i@n gii cho o) chinh Nc/ xtt tu,2 l2vin2 Fhi o) cK nhu Vng #uVt/ (Snh t#ng ,QngX cn nh gi D pht hi@n ACu hi@u 3$m c:1 tZc #uVt ti pht- ngh2 nhu Vng #uVt/ (h2o Ai tSnh t#ng 0Y)(X ph=n- nim mc- A1 Nung Wu1nh ch=n 0Y)(/ (h2o Ai ACu hi@u thiJu oN&- FhK th/ ( thJX cho o) n?m u c1o- nghing v; phi1 0Y)(/

o) 31u m+ tZc #uVt- cK tu,2 42vin2 gii p 'httpX}}t#1n,1tho1imAphA/o#Ap#233/com*

2.2.3. ^n $Ing k[m 8o $* N* m0 ghu&Jn Fhich v h$ng An o) tp lu&@n v vn Vng t#n giTng 'nJu o) cPn &Ju*/ Cho o) ho- hit th 3=u- v lng- gitp o) hiDu ngu& c tZc #uVt cK thD N& #1 nJu Fh%ng vn Vng/ )Ju o) tRnh- tSnh t#ng +n Lnh nn cho o) ngri A&- i li 3$m gitp cK nhu Vng #uVt 3$m v ngn ng^1 tZc #uVt ti pht/ (h2o Ai ACu tZc #uVt 3$mX 1u ,Qng t^ng cn- n%n 3$m- ,i t#ung i ti@n- nim mc 0Y)( tim ti- g1 '-*/ (h]c hi@n thuHc gim 1u th2o & l@nh/

$ ; BN 81-: 0PU8V .5Q :n 0O PQ,0 (h2o Ai q0p( 31u m+- cht G th=n nhi@t/ (h]c hi@n Fhng 3inh tng v chinh Nc th2o & l@nh/ vJt m+X th1& ,ng Fhi thCm $t- Fd thut phi v% Fhuln/ qn luX chm 3Kc nh ,i An lu/ 0Y)(X th1& tti ph=n Fhi &- ,ng thCm ph=n phi th1& ng1&- h$ng An o) n?m nghing v; phi1 cK 0Y)(- t#nh ph=n t#n vo vJt m+/ (h%ng tiDu cn c #tt 3$m Fhi tSnh t#ng o) M +n Lnh- v@ 3inh ,V phn 3inh AQc thTng Nu&n/ (#nh ngu& c vim ph+iX h$ng An o) ngri A& 3$m- hit th 3=u/

2.2.5. D; N ! 8inh 8@ng N* m0 tfc : It o) thTng 3u& Fi@t Ao nhLn n uHng t#$c m+ v nhBng ng& u 31u m+ vS thJ vi@c cung cCp nng lng cho o) tht cn thiJt/ )Ju o) ch1 cK nhu Vng #uVt nn th]c hi@n t#u&;n ALch Tng- m- i@n gii cho o)/

)Ju o) cK nhu Vng #uVt nn Fhu&Jn Fhich o) n ,?ng Tng mi@ng- n & : chCt Ainh Anng- nn t#nh thEc n to hi- t#i c=& h1& 3B1 Wu 3$m vS Aw g=& ch$ng hi t#ong lPng #uVt Ao ln m2n/

2.2.=. D; thiP kiPn thMc vT 4%nh 0$ng An o) vn Vng ngri A& 3$m- i ,V- tp Anng 3inh Fhi NuCt vi@n/ 0$ng An o) cch chm 3Kc 0Y)( ti nh/ 0$ng An o) pht hi@n 3$m tSnh t#ng tZc #uVt ti pht nh 1u ,Qng t^ng cn- ,i t#ung i ti@n- ,Qng ch$ng/ ghi thC& cc ACu hi@u t#n Fh%ng c n uHng v vo vi@n ng1&/ qinh AnngX n & : chCt Ainh Anng Fh%ng Fing cB- uHng nhi;u n$c/ )Ju cK 0Y)( thS nh1i Fd chCt N D t#nh tSnh t#ng nghyt ph=n v Fing thEc n cK mhi Fhi cn #1 ngoi 3inh hot cVng rng/

F !rNG GI' )$c v i@n gii c ,ri hon & :- Fh%ng N& #1 cc ,iJn chEng/ oQng m;m- 3$m cK nhu Vng #uVt- 0Y)( hot Vng tHt/ gh%ng cK ACu hi@u tZc #uVt ti pht/ 0n chJ nhiwm t#hng 31u m+/ qinh Anng c cung cCp & :/ o) cK th2m FiJn thEc D t] chm 3Kc/

CpU HqI !rNG GI' e/ o) 31u m+ tZc #uVt cn cK chJ V Ainh AnngX 1/ Cho o) n & : chCt Ainh Anng ,/ (#nh n Au mn v n$c uHng cK hi c/ ghi cK nhu Vng #uVt nn cho o) uHng 3B1 A/ 0n chJ thEc n cK nhi;u Tng- m / o) FhK th Ao ,Qng ch$ng 31u m+ tZc #uVt cn c chm 3KcX

1/ xtt tu,2 42vin2 D o) Fh%ng FhK chLu ,/ Cho o) n?m u c1o c/ Cho o) n?m nghing ,n t#i A/ (h]c hi@n thuHc nhun t#Tng 7/ C=u no 31u =& tng Fhi chm 3Kc o) 31u m+ tZc #uVtX 1/ (#nh vn Vng 3$m 31u m+ vS Aw ,Qc chR m1& ,Qng ,/ )gu& c mCt n$c it N& #1 t#n o) m+ tZc #uVt c/ v; nh Fh%ng Fing cB- n nhi;u chCt Ainh Anng A/ (h2o Ai lng n$c tiDu mi giT 5/ o) 1u ,Qng Ao tZc #uVt- Iq cn c1n thi@pX 1/ oCt Vng o) ti giTng ,/ Cho o) uHng thuHc 1n thn c/ [ii thich Vng vin D o) 1n t=m A/ (#nh thm Fhm thTng Nu&n !/ p1u m+ tZc #uVt o) Aw chong AoX 1/ YCt n$c v i@n gii ,/ YCt mu nhi;u t#ong Fhi m+ c/ vim phtc mc A/ I1u $n Wu V TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi e- Chm 3Kc o) 31u m+ tZc #uVt- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- ee/ / C1o vn (hLnh- (Zc #uVt- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- f/ 7/ I ISnh C%ng- oi ging ,@nh h.c ngoi Fho1 tiu hK1- (Zc #uVt c h.c- oV m%n ngoi- Ii h.c < qc (P0CY- )h NuCt ,n < h.c- ""e- e !/ 5/ oi ging ,@nh h.c ngoi Fho1 tiu hK1- (Zc #uVt- Ii h.c < qc (P0CY- effs- 78/

!/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2
nA

2A/- ~o p1unA2#3 comp1n& effs- e"85/

BI 1; 6B- O{@ CHwM SxC BhNH NHpN VIM (HC MC

MC TIU 1. Trnh by c gi2i ph3&Q !ri;& chFng lS" sng v c8n lS" sng c-a vi$" phcc "c. 2. 9h?" sTc c b;nh nhSn vi$" phcc "c. (. 9h&:n b c b;nh nhSn !rMc "4 vi$" phcc "c +. 9h?" sTc c b;nh nhSn sa& "4 vi$" phcc "c.

1 GIsI (H)U - 4 phtc mc cK l$p l l thnh v l tng/ 4 thnh n?m ,.c lKt mct t#ong thnh ,Qng- l tng ,1o ph: cc tng t#ong + ,Qng/ - CK 7 nJp l mc t#2o t#2o Hng tiu hK1 vo thnh ,Qng- mc ch?ng- mc nHi nHi cc tng v$i nh1u/ [iB1 l thnh v l tng cK mVt Fho1ng o chE1 Fhong s"-e""ml ALch/ qLch n& vng t#ong- cK chE1 nhi;u p#ot2in- m ,o V t#n lng c:1 phtc mc gitp Aw Ang/ - Phtc mc chE1 mch mu- l&mpho v thn Finh/ l t#t ln nh1u

$ TRIhU CHNG !pM SNG $ 1 TP-AQ O1N8V O3 898V - I1u ,QngX l t#i@u chEng u tin- 1u FhZp ,Qng- nh A1o =m- 1u lin tQc v Fh%ng cK t thJ gim 1u/ I1u tng Fhi ho h1& c Vng nn o) n?m &n/ - )%n KiX n%n Fh1n- n%n it/ ghi o) Jn t#w Ao li@t #uVt c nng cK thD n%n nhi;u hn/ - oi t#ung i ti@nX Ao tSnh t#ng li@t #uVt c nng $ $ TP-AQ O1N8V 01O 01g - Co cEng thnh ,Qng l t#i@u chEng Wu1n t#.ng v cc ,i@t c:1 vim phtc mc/

- )hSnX thC& thnh ,Qng phng- im lSm- Fh%ng Ai Vng th2o nhLp th- nJu cK thS #Ct it/ CK thD thC& ,Qng ch$ng- & hi/ - pTX ,Qng cEng nh g- Cn thC& 1u nJu Cn mnh 1u tng/ - [X Ao t#ong No1ng ,Qng cK hi nn g ngh2 v1ng vhng ch$ng- Qc vhng thCp - (hm =m o t#]c t#ngX tti chng cng Ao tQ ALch- Fhi Cn vo o) 1u chKi/ $ F TP-AQ O1N8V 0/t8 01K8 - )hiwm t#hngX o) 3Ht c1o 7f-5""- lnh #un/ - )hiwm VcX thTng gcp Fhi o) Jn t#w- o) l m- nKi nhm- gng mct lo =u hHt hong- mZt t#|ng 3=u/ o) cK thD Fh%ng cPn 3Ht- thiDu ni@u h1& v% ni@u/

F TRIhU CHNG C*N !pM SNG - och cu tng c1o- u# mu- c#21tinin2 tng c1o- ,iDu hi@n tSnh t#ng 3u& thn cCp - xHi lon nhiwm to1n chu&Dn hK1/ - `-bu1ngX ,Qng mT vS No1ng ,Qng cK ALch- Tng 31ng ,n ,Qng mCt/ - piu =mX thC& ALch t#ong No1ng ,Qng- #uVt giMn ch$ng/

; IU TR" - )gu&n tZc l i;u t#L nVi Fho1 FJt hp v$i ngoi Fho1/ )Vi Fho1 nh?m mQc ich phPng ng^1 chong- cung cCp nng lng- gim ,$t tSnh t#ng nhiwm t#hng/ )goi Fho1 nh?m loi ,z ngu&n nh=n g=& vim phtc mc v lm 3ch No1ng ,Qng/

+UH TR~NH CHwM SxC BhNH NHpN VIM (HC MC TRC M 1 NH*N "NH T~NH TRNG BhNH NHpN 0ziX tSm hiDu ngu&n nh=n g=& vim phtc mc nh iDm 1u Fhi u ghmX )hn Lnh 1uX vL t#i NuCt hi@n 1u

`c Lnh tSnh t#ng hi@n ti v tinh chCt cn 1u- nhu Vng #uVt- tSnh t#ng cng ch$ng ,Qng nhi;u hn- ,Qng grng cEng nh g/ pTX ,Qng cEng nh g- ACu cm Eng phtc mc '* [X mCt vhng Qc t#$c g1n )gh2X nhu Vng #uVt gim )%n Ki- n%n Fh1n (h=n nhi@t tng #Ct c1o oi t#ung i ti@n oiDu hi@n chong nhiwm t#hng

$ CH&N O'N V CAN THIh( IU DNG $ 1 NVQE O3 01g 0\O1 jYO1 V-^: j/ 0\O1 0[ jYO1 0P/8V 41/58V _1O :CO 01N _1S0 j/ O18 01k38V 81-: 0PU8V 15E 01-DQ :SQ giDm t#1 li o) v cc ACu hi@u mCt n$c- mCt i@n gii- tSnh t#ng nhiwm to1n- chong gim thD tich- mCt ALch- ch$ng #uVt- nhiwm t#hng/ oh n$c- i@n gii- mu- hu&Jt th1nh th2o & l@nh/ (h2o Ai 3t q0p(- CvP- p l]c mu- n$c tiDu- 3onA2 A A& mi giT/ (h2o Ai ACu hi@u thiJu oN& nh t#i gic gim An- l m- nKi nhm/ [hi hr 3 Aiwn ,iJn c:1 ,@nh/ Cung cCp nng lng- vit1min2- p#ot2in cho o) ,?ng m.i cch/ $ $ B-D8 Bn- j-81 jkl8V j/ 8T8 (h2o Ai 3H lng- tinh chCt ALch n%n Ki- t#nh chCt n%n t#n vo Fhi Wun/ (h2o Ai ion r- ACu mCt n$c/ (h]c hi@n ct 3onA2 A A& gitp o) gim n%n Ki- rng thTi th2o Ai 3t lng n$c NuCt t^ A A&/ [itp o) 3ch 3 v Fh% #o/ (h]c hi@n ,h n$c : v tng/ $ F K-gQ 01 41T8V 1-AQ uQ^ j/ B5Q

)hn Lnh tSnh t#ng h% hCp c:1 o) vS ,Qng cng ch$ng v gim th Ao 1u/ (h2o Ai cc ACu hi@u FhK th Cho o) n?m u c1o gitp gi1 tng thD tich lrng ng]c/ Cho o) th oN& th2o & l@nh- th2o Ai tSnh t#ng oN& mu c:1 o)- t# gitp phng php th Fhi thich hp/ $ ; !/ b8V }R OQ,O :n ._ 0|C%ng tc t tng v; cuVc m+- thTi gi1n m+- cho gcp ngTi nh [ii thich nhBng ,iJn chEng cK thD N& #1 Cho ngTi th=n chng Ai chu&Dn o) Jn Fhu phu thut/ $ ? 5Q d[8V b-L8 uQ58 BD8 _1O :CO }t d[8V O98V O1k|8V )hn Lnh li cc vhng 1u- 1u tng h1& gim i- ,Qng cng ch$ng h1& grng cEng/ [itp o) gim 1u nhBng t thJ thich hp- hn chJ thm Fhm nhi;u ln- t#nh nhBng c Vng Vt ngVt/ qi chu&Dn o) nhy nhng/ (h]c hi@n thuHc gim 1u cho o)/ $ o C1Q8 dY BN 0Pk|O :n 4C& li q0p( [ii thich cho o) 1n t=m gh%ng cho o) n uHng [ii thich li v hi c:1 phu thut D o) hp tc [hi # nhBng Aiwn tiJn v t#i@u chEng c:1 o) vo hr 3 4m Fhln cc N\t nghi@m ti;n phu Ict 3onA2 A A&- th%ng tiDu cho o) (#u&;n ALch v tim thuHc th2o & l@nh (h]c hi@n Fhng 3inh v@ 3inh vhng A1 3Zp m+/

+UH TR~NH CHwM SxC BhNH NHpN SAU M

1 NH*N "NH T~NH TRNG BhNH NHpN )hn Lnh tSnh t#ng o) Fhi ,n gi1o t^ phPng m+ phPng hri 3EcX t#i gic- ACu hi@u FhK thq0p(- An lu- ,Qng-tu,2 42vin2 v nhBng Aiwn ,iJn t#ong cuVc m+/ )hn Lnh tSnh t#ng o) t^ phPng hri 3Ec v; Fho1 ngoiX q0p(- tSnh t#ng nhu Vng #uVt- tSnh t#ng Ainh Anng- tSnh t#ng ,Qng

$ CH&N O'N V CAN THIh( IU DNG $ 1 BN O1/S8V j/ V-^: 01g 0\O1 (h2o Ai n$c NuCt nhp v ACu hi@u #Hi lon i@n giiX q0p(- ACu v\o A1- CvP- aon r (h2o Ai th=n nhi@t (h2o Ai t#i gic (h]c hi@n ,h n$c v i@n giiX t#u&;n ALch- Fhng 3inh th2o & l@nh $ $ BN 41{ 01 j/ 081 0PC8V d[8V O98V O1k|8V B5Q .5Q :n

Hnh nh t ng thng mi d dy gii p sau m (http://www.pda i!t.n!t"

Im ,o th%ng Fhi- cho o) th oN&- htt m nh$t (h2o AiX ChR 3H oN& t#ong mu oQng ch$ng- ACu hi@u phn Eng phtc mc- grng cEng - cn 1u- nh gi cn 1ungh2 nhu Vng #uVt/ Chm 3KcX

o) m cho n?m u ,?ng mct nghing e ,n- o) tRnh cho n?m t thJ mol2#- ch=n co vo u gHi gitp o) thoi mi/ (u,2 42vin2X htt lin tQc h1& ngZt WuMng t#nh nghyt- c=u nHi thCp/ (h2o Ai 3H lng- tinh chCt- mu 3Zc ALch A A&/ xtt Fhi cK nhu Vng #uVt v th& vo t^ng ,@nh lG/ o) cn cK li@u php gim 1u Wu1 monito# v thuHc/ (o m%i t#Tng nghR ngi &n tnh (h]c hi@n Fhng 3inh tng li;u v tng giT/ 0$ng An o) cch th- nJu o) Fh%ng chong h$ng An o) ngri A& 3$m $ F B-D8 O1N8V 81-: 0PU8V j/ j`8 bkQ }D0 :n (h2o Ai mu 3Zc- tinh chCt ALch An lu C=u nHi thCp- ,Snh chE1 thCp hn An lu 6"cm Chm 3Kc An lu ,o m Fd thut v% Fhuln xtt An lu th2o & l@nh vJt m+ Fh=u A1 th1 h1& chR th\p Ao tSnh t#ng + ,Qng nhiwmX th1& ,ng thTng Nu&n- th2o Ai nhiwm t#hng vJt m+/ (h]c hi@n Fhng 3inh tng li;u v tng giT/ $ ; N1Q OQ j-81 jkl8V V-^: Cung cCp Ainh Anng th2o & l@nh- ngn ng^1 ,iJn chEng F\m hCp thu/ Cung cCp Ainh Anng cho o) Wu1 cc Tng th& th2o t^ng o)X n- t#u&;n ALch- ,m thEc n Wu1 tu,2 42vin2/ $ ? BN O1k5 015: V-5 O19: .{O .5Q :n (i ,@nh vi@nX cho o) ngri A& vn Vng t#nh cc ,iJn chEng nh vim ph+i- tZc #uVt- thu&n tZc tnh mch/ 0$ng An o) cch ngri A& Fhi cK An lu- 0Y)(/ Cch giB vJt m+- gitp o) chng hp tc tHt v$i Iq/ ghi NuCt vi@nX h$ng An o) cch chm 3Kc vJt m+- vJt #tt An lu- Ainh Anng- cch cho nnhBng ACu hi@u ,Ct thTng nh 1u ,Qng- 3Ht (i Fhm tng hyn

(h2o Ai ,iJn chEngX tZc #uVt- vim phtc mc thE pht/ F !rNG GI' o) Fh%ng chong o) th Aw Ang- ,Qng Fh%ng cng ch$ng o) Fh%ng nhiwm t#hng vJt m+ v ch=n An lu o) c cung cCp Ainh Anng & :/

CpU HqI !rNG GI' e/ oiJn chEng no thTng N& #1 31u m+ vim phtc mcX 1/ vim phtc mc ti pht ,/ p N2 trn lu c/ (Zc #uVt A/ )hiwm t#hng + ,Qng / (u,2 42vin2 t#$c m+ vim phtc mc cK mQc ich gS- )[ a (xX 1/ [im cng ch$ng ,Qng ,/ [im ngu& c vim phtc mc ti pht c/ qw chLu A/ [im Ki 7/ o) FhK th Ao ,Qng cng ch$ng 31u m+ vim phtc mc- Iq N t#iX 1/ 0tt A A& lin tQc- cho o) n?m t thJ mol2# ,/ (ng oN& tHi 1 cho o) c/ Cho o) uHng n$c cK hi A/ Io vPng ,Qng thTng Nu&n 5/ Ii;u no 31u =& tng Fhi nKi Jn 31u m+ vim phtc mcX 1/ (Ct c o) 31u m+ ;u cK hu m%n nh=n to ,/ (u,2 42vin2 c #tt Fhi q0p( +n Lnh c/ qn lu + ,Qng cn c #tt 3$m A/ gh%ng th1& ,ng vJt m+ thTng Nu&n

!/ o) 31u m+ vim phtc mc thTng chong Ao gim thD tich ALch- Ao n%n/ Iq cn th2o Ai v chm 3KcX 1/ (h2o Ai lng n$c NuCt nhp- cho o) uHng nhi;u n$c/ ,/ (h2o Ai tinh chCt n%n c/ (h]c hi@n chJ V n loMng- nhi;u n$c A/ (h]c hi@n ,h n$c v i@n gii th2o & l@nh

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc o) m+ vim phtc mc- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- ""/ / 4 vn bu1ng- oi ging ,@nh h.c ngoi Fho1 tiu hK1- vim phtc mc- oV m%n ngoi- Ii h.c < qc (P0CY- )h NuCt ,n < h.c- effs- 6s/ 7/ C1o vn (hLnh- vim Phtc Yc- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- e7/ 5/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2
nA

2A/- ~o p1unA2#3 comp1n& effs- e"6e/

BI 1? CHwM SxC BhNH NHpN M SqI NG M*T

MC TIU 1. L$& c c ch' sinh sdi a .ng "8!. 2. ThJc hi;n c vi;c ch&:n b b;nh nhS !rMc "4. (. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4.

1 C CHJ SINH SqI NG M*T pzi Tng mt l ,@nh lG thTng gcp vi@t )1m v cc n$c I%ng )1m Cc &Ju tH thun liX nB thTng mZc ,@nh nhi;u hn n1m- tu+i t^ 5"-6"- Ti 3Hng Finh tJ thCpn uHng thiJu m- v@ 3inh F\m- nhiwm FG 3inh t#hng Tng #uVt/ C chJ 3inh ,@nhX thTng lin Wu1n Jn hyp Tng mt- Ao nhiwm FG 3inh t#hng Tng #uVtAo n uHng thiJu m/ )hBng ngu&n nh=n n& to #1 m2n [lucu#oniA132 ngoi 3inh- m2n n& cK tc Vng th:& ph=n ph vn 3] FJt hp c:1 oili#u,in Aiglucu#oniA2 thnh oili#u,in t] Ao Fh%ng hP1 t1n 3 FJt hp v$i C1lcium oili#u,in1t2 A$i Ang ,hn v 3zi vQn/

$ +UH TR~NH CHwM SxC BhNH NHpN TRC M SqI M*T $ 1 N1c8 BY81 081 0PC8V BN pzi Tng mtX 1u h 3Tn phi- phn Eng AVi '*- Yu#ph& '*- grng cEng- 3T thC& tti mt/ 0Vi chEng tiu hK1X n%n Ki- chn n/ qCu hi@u nhiwm t#hngX th=n nhi@t tng c1olnh #un/ qCu hi@u tZc mtX vng A1- ngE1- ph=n ,c mu- tiDu 3m mu/ pzi tti mtX 1u thng vL 31u n e"-e! phtt- 1u =m R- lin tQc- Ki- 31u Ki o) vn Fh%ng gim 1u- 1u l1n Jn h 3Tn phi/ )Ju o) cK nhiwm t#hng Fhi thm Fhm thC& phn Eng thnh ,Qng- olum,2#g '* h 3Tn phi/

$ $ C18 B/S8 }t O58 01-A_ D 2.2.1. K* 4Xng 8o tFnh t:ng vi5m nhiOm vJ tfc nghln $cng mt 4ng gi tinh chCt- vL t#i- mEc t#m t#.ng- h$ng l1n c:1 cn 1u/ Cho o) t thJ gim 1u- thTng l t thJ pim 'nghing t#i- gp gHi*/ (h]c hi@n thuHc gim 1u/ (h]c hi@n thuHc Fhng phK gi1o cm D gim tiJt mt- gim co thZt Tng mt/ C%ng tc t tng gitp o) gim 1u- gim 3/

' ngurnX httpX}}gi1ngAuong&Fho1/n2t*

2.2.2. 6im th tch 89ch 8o nGn Si1 8o 8bn l 8 8J!1 8o Nt (hm Fhm o) D nh gi mCt n$c- th2o Ai q0p(/ (h2o Ai 3t lng n$c NuCt nhp- th2o Ai n$c mCt Wu1 Ki v htt A A&- i@n gii Wu1 An lu Tng mt #1 A1/ (h2o Ai 3H lng n$c tiDu/ (h]c hi@n ,h n$c v i@n gii- h 3Ht- th]c hi@n Fhng 3inh th2o & l@nh/

2.2.3. D; chong 8o nhiOm t:Hng (h2o Ai- pht hi@n 3$m ACu hi@u chong- th2o Ai q0p(- cht G nhi@t V nn ghi thnh ,iDu r/ (h]c hi@n hri 3Ec tich c]c cho o)- Fhng 3inh tng li;u- tng giT/

2.2.4. D; th*! $0i 8inh 8@ng o) chn n Ao gim ALch mt NuHng #uVt- Iq nn cho o) n thEc n Aw tiuFing mn- n nhi;u thLt- Tng- uHng nhi;u n$c/ (#ong gi1i on vim cCp cn ngng thEc n cK chCt ,\o- n thEc n Aw tiu hK1uHng nhi;u n$c v th2o Ai cn 1u 31u Fhi n/ 2.2.5. ;g ! c t0n thng 8* 8o vJng 8*1 ngM* Cn v@ 3inh A1 3ch 3- cho o) uHng nhi;u n$c/ (h]c hi@n thuHc chHng AL Eng- gim ngE1/ Iq cZt ngZn mKng t1& cho o) D t#nh lm t+n thng A1 Ao gMi- nn Ahng Fhn $t Cm l1u gitp o) gim ngE1 v Aw chLu/ (hTng Nu&n tZm D gitp A1 thong- 3ch 3/

2.2.=. Ch kn 49 D; t:"c m0 [iHng nh chuln ,L thTng Wu& t#ong m+ ,Qng/ (h2o Ai 3t q0p(- n=ng c1o thD t#ng/ Ict tu,2 42vin2 gim Fich thich Tng mt/ (h]c hi@n Fhng 3inh A] phPng- thuHc i;u t#L #Hi lon %ng mu nJu tSnh t#ng o) vng A1 l=u h1& N\t nghi@m chEc nng %ng mu ,Ct thTng/ Ict th%ng tiDu/ Cung cCp th%ng tin cuVc phu thut/

F +UH TR~NH CHwM SxC BhNH NHpN SAU M SqI M*T F 1 N1c8 BY81 081 0PC8V BN (+ng t#ng- q0p(/ (Snh t#ng ,QngX ch$ng- 1u- nhu Vng #uVt/ (h2o Ai v Nc Lnh vhng 1u t#n ,Qng o) 31u m+/ (Snh t#ng A1 nim- vng A1- 3o 3nh v$i t#$c m+- ACu hi@u vng A1 v mCt n$c/ (Snh t#ng An lu 31u m+X ALch mt ch& Wu1 Hng g2h#- An lu A$i g1n/ (u,2 42vin2X mu 3Zc- 3H lng- thTi gi1n- tSnh t#ng ,Qng/

(h2o Ai N\t nghi@mX o)- C#21tinin2- oili#u,in/ (h2o Ai n$c tiDuX 3o 3nh mu vng c:1 n$c tiDu- nhCt l 3H lng c:1 n$c tiDu/ qCu hi@u mCt n$c- #Hi lon i@n gii/

F $ C18 B/S8 }t O58 01-A_ B-RQ jkl8V 3.2.1. D; 4Xng ch"ng N* m0 cft tii mt nIi Noi (h2o Ai ch& mu- 1u l1n ln v1i phi v ch$ng ,Qng Ao Fhi C ,m vo + ,Qng t#ong Fhi m+/ )n cho o) n?m t thJ pim- Fhu&Jn Fhich o) th 3=u- i li 3$m t#nh li@t #uVt F\o Ai 31u m+/ Im ,o th%ng Fhi- th2o Ai FhK th/ xtt tu,2 42vin2 3$m gitp o) Aw chLu/ (h]c hi@n thuHc gim 1u th2o & l@nh/

3.2.2. Ch<m NSc D; N* th( th t mRC+ nmn8oNco3ic RRt:og:*8R Chol*ngio3*nc:R*tog:*3h!o (h2o Ai tSnh t#ng 1u ,QngX 1u thng vL- ,Qng ch$ng vS cK ngu& c th:ng t t#ng h1& vim tQ& cCp/ (h2o Ai ACu hi@u chong Ao 1u h1& ch& mu/ (h2o Ai q0p(/ o) 3 Fh%ng c n uHng cho Jn Fhi cK nhu Vng #uVt t# li- t#ong thTi gi1n n& cho o) nghR ngi ti giTng/ )Ju o) +n Lnh- cho o) NuCt vi@n 5 giT 31u th: thut/

3.2.3. K* 8o vPt m0 Inh gi mEc V 1u- vL t#i 1u/ o) 1u l1n ln v1i thS cho o) n?m t thJ mol2# h1& ngri A&/ I1u vJt m+ nn h$ng An o) Ahng gHi tU vo ,Qng Fhi ngri A& D gim 1u/ ghu&Jn Fhich o) ngri A& i li 3$m gitp Aw chLu hn/

3.2.4. a% thng 8bn l gRh: khGng $t hi% ) 1 gB! lo[t 8* vJ $]t lB ngJ!

p1u m+ 3zi Tng mt- phu thut vin thTng ct g2h# D gii p- th2o Ai 'mu 3Zc3H lng mt #1 mi ng&- ch& mu Tng mt*- lm nPng 'nong Hng mt ch: ,L hyp*i;u t#L ',m #1 Hng mt ch:- tn 3zi 3Kt 31u m+*- tn 3zi 31u m+/

qn lu g2h# lu%n c ch& #1 ngoi lin tQc ng1& 31u m+/ bu1n 3t ch=n An lu cK thCm ALch mt Fh%ng- nJu cK nn th1& ,ng ng1&- cn thS ct m& htt Wu1 ch=n An lu- rng thTi ng^1 #m l A1 tich c]c cho o)/ (h2o Ai h@ thHng An lu cK hot VngX + (h2o Ai 3H lng ALch mtX thTng Fhi ch1 cK nhu Vng #uVt t#ong 7 ng& u 31u m+ thS ALch mt Wu1 g2h# hi nhi;u Fhong 7""-6"" ml} ng&/ ghi cK nhu Vng #uVt 'ALch mt M cK thD NuHng #uVt* thS lng ALch mt #1 An lu 3 gim NuHng cPn Fhong "" ml}ng&/ Iq ghi li 3H lng- mu 3Zc- tinh chCt ALch mt mi ng&t#Tng hp Fh%ng #1 h1& #1 Wu it cn nh gi li Ao o) thiJu n$c- 3zi Fyt- gp Hng3zi ,hn h1& cQc mu %ng/ + (h2o Ai tinh chCt mtX Fhi Wu1n 3t ALch Fh%ng c gi c1o ,Snh hEng- t#nh ALch t^ ngoi ch& vo t#ong/ oSnh thTng ALch mt vng t#ong Kng nh- nJu mt ln cn cK mu cQc thS phi th2o Ai ch& mu- ALch mt cK mu t#Zng Qc th2o Ai cK m|- ALch mt n=u ln cn th2o Ai cPn 3zi/ + om #1 Tng mtX Ao cPn 3zi h1& m:- ,m #1 v$i n$c muHi 3inh lG Cm- p l]c nhy- ,m Fhong e"- " ml} ln ,m/ om #1 !-8 ng& lin tiJp ALch mt 3 t#ong/ + Ii;u Fi@n #tt g2h#X thTi gi1n 8-s ng& 31u m+- o) hJt 1u- hJt 3Ht- n uHng tHt- ALch mt gim- vng t#ong- 3iu =m hJt 3zi- `-Wu1ng cK thuHc cn Wu1ng Wu1 An lu g2h# thC& Tng mt th%ng/

'ngurnX httpX}}gi1ngAuong&Fho1/n2t*

o) cK ct An lu g2h# 'httpX}}ngo1i,ung/com*

3.2.5. &bn l 8"i g*n vJ 8bn l tii mt (h2o Ai 3H lng- mu 3Zc- tinh chCt ALch #1/ Chm 3Kc A1 3ch 3 t#nh nhiwm t#hng/ )Ju thC& ALch An lu #1 cK mu vng- nn th2o Ai #P mt 31u m+- ,o op/ qn lu n& thTng l An lu phPng ng^1 nn op 3 cho & l@nh #tt 3$m nJu ALch A$i !" ml} 5 giT/ 3.2.=. D; vJng 8* ni5m1 ngM* 8o Nfc t mt ngm ) * 8* Cho o) uHng nhi;u n$c/

v@ 3inh A1 3ch- cZt mKng t1& ngZn D t#nh t#& A1 Ao gMi ngE1/ (h]c hi@n thuHc Fhng AL Eng- th2o Ai N\t nghi@m oili#u,in/ Chm 3Kc ,V phn 3inh AQc 31u Fhi i tiDu- th1& Wun lKt thTng Nu&n- t#nh mcc Wun Wu cht h1& Wu A&/

3.2.W. &inh 8@ng 4%nh lC lJm D; <n k[m ngon v@ 3inh #ng mi@ng 3ch 3/ 0n chJ thEc n ,\o- nhi;u Au mn t#ong thTi gi1n u 31u m+/ Cho o) uHng nhi;u n$c/ (h2o Ai ACu hi@u 1u ,Qng- FhK tiu- ncng ,Qng/ v@ 3inh t#ong n uHng- uHng thuHc 3+ giun/

3.2.>. D; hn chP kiPn thMc o) cK cZt tti mtX thTi gi1n u hn chJ thEc n nhi;u Au- mn- t#Eng- 3B1- chCt ,\o/ ghong -7 thng 31u cho o) tp n li ,Snh thTng- hn chJ thEc n nhi;u chol23t2#ol/ o) m+ 3zi Tng mtX cho o) uHng nhi;u n$c- n thEc n cK nhi;u chCt Ainh Anngt#nh thEc n cK nhi;u Au mn- v@ 3inh t#ong n uHng- tl& giun Lnh FU mi 7-6 thng} ln/ giDm t#1 3iu =m Tng mt Lnh FU/ [io AQc o) NuCt vi@n cPn m1ng Hng An lu g2h# v; cch chm 3Kc Hng g2h#- 3inh hot- ti Fhm 3.2.A. ;g ! c Q! :* mIt N 4iPn chMng N* m0# Ch& mu 31u m+/ Chong nhiwm t#hng/ qP mt- mt t#n #1 thnh ,Qng/ vim phtc mc mt/ pKt 3zi/

; !rNG GI' o) gim ch$ng ,Qng/ o) ,$t 1u- ,$t vng A1- n uHng tHt/

qn lu g2h# hot Vng tHt/ qinh Anng & : tng th2o &u cu ,@nh lG/ o) c h$ng An gio AQc 3Ec Fhz2/

CpU HqI !rNG GI' e/ )hn Lnh tSnh t#ng o) 3zi Tng mt thTng cK ACu hi@u noX 1/ (1m chEng Ch1#cot ,/ I1u thng vL 31u n e"{e! phtt c/ I1u =m R- lin tQc- Ki A/ Yu#ph& '-*- grng cEng- 3T thC& tti mt / p1u m+ cZt tti mt nVi 3oi- cn cho o) n?mX 1/ )?m thng- u c1o ,/ Iu ,?ng- nghing t#i c/ )ghing phi- gp gHi A/ )ghing t#i- gp gHi 7/ ng An lu g2h# #1 Fhong !" ml}ng& vo nhBng ng& u 31u m+ AoX 1/ o) ch1 cK nhu Vng #uVt ,/ o) thiJu n$c- Hng g2h# ,L nghyt c/ o) ch1 n c nn ALch mt Fh%ng tiJt #1 A/ o) Fh%ng No1& t# nhi;u 31u m+ 5/ qn lu g2h# c #tt FhiX 1/ I: thTi gi1n s { e" ng& 31u m+ ,/ piu =m thC& Tng mt th%ng c/ o) hJt 1u- hJt 3Ht- n uHng tHt A/ qLch mt Fh%ng cPn ch& #1 !/ Iq cn h$ng An o) 31u m+ 3zi mt c NuCt vi@n v; nh- )[ a (xX 1/ Hng thuHc Fhng giun Lnh FU ,/ 0n chJ thEc n nhi;u m- nhi;u Au mn

c/ Hng nhi;u n$c A/ (i Fhm tng hyn

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi e- Chm 3Kc o) m+ 3zi mt- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e6"/ / )gu&wn (Cn CTng- oi ging ,@nh h.c ngoi Fho1 tiu hK1- vim tti mt v 3zi tti mt- oV m%n ngoi- Ii h.c < qc (P0CY- effs- 7sf/ 7/ C1o vn (hLnh- pzi mt- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- 7/ 5/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2 Yo3,& Comp1n& efs6- s5s/
nA

2A/- ~o p1unA2#3 comp1n& effs- ee"f/


nA

!/ q2,#1 C/o#o1A2ll [13t#oint23tin1l p&3t2m in Yo3,& 3 Y1nu1l o Clinc1l )u#3ing-

2A/-

BI 1o CHwM SxC BhNH NHpN M VIM TH Cy(

MC TIU 1. ThJc hi;n c vi;c ch&:n b b;nh nhSn !rMc "4. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4.

1 I CNG vim tQ& cCp l tiJn t#Snh vim cCp tinh c:1 tQ&- mEc V vim Fhc nh1u t^ vim tQ& 3ung hu&Jt Jn vim tQ& hoi t/ o@nh ph+ ,iJn lE1 tu+i t#ung nin- m1n nhi;u hn nB/ (Snh t#ng vim tQ& ncng h1& nhy th& mEc V tn ph t#n m% tQ&/ vim tQ& cCp lin Wu1n Jn ,@nh lG 3zi Tng mt- Ao #u- 31u phu thut- 31u chQp mt tQ& ngc APng- 31u th: thut lC& 3zi Hng mt ch: Wu1 nVi 3oi mt tQ& ngc APngAo chu&Dn hK1- Ao nhiwm Vc- AL Eng- Wu1i ,L- th:ng t t#ng/

(Q& v vL t#i tQ& t#ong c thD 'httpX}}3ucFho2Aoi3ong/vn*

$ +UH TR~NH CHwM SxC BhNH NHpN TRC M VIM TH Cy( $ 1 N1c8 BY81 081 0PC8V BN

I1u ,Qng AB AVi- lin tQc vhng thng vL- thTng NuCt hi@n 31u ,B1 n thLnh 3on- Rnh 1u t^ e!-6" phtt 31u n- 1u l1n Jn ng]c h1& l1n #1 31u lng- 1u tng Fhi n?m ng1/ (+ng t#ng o) #Ct Aw #i vo cn chong ngCt- mch nh1nh- hu&Jt p gim/ pTX Cn 3=u thng vL 1u tng ln- ,Qng m;m- nJu cK vim phtc mc ,Qng grng cEng v Fich thich/ C honh ,L Fich thich Ao ALch nh nCc cQc- 1u l1n Jn , v1i/ (#i@u chEng tiu hK1X n%n Ki- li@t #uVt/ Ph+iX t#n ALch mng ph+i l1n tz1- ph+i th=m nhiwm- 3u& h% hCp/ (iJt ni@uX n$c tiDu gim A$i 5"" ml}giT Ao hoi t Hng thn/ ghi NuCt hu&Jt h1& hoi t tQ& cK thD cK ACu [#2& (u#n2# 'th1& +i mu A1 vhng h%ng lng* hocc ACu Cull2n '+i mu A1 h1& ,m mu vhng Wu1nh #Hn*/ piu =m thC& tQ& to- cK ALch Wu1nh tQ&/ (h=n nhi@t tng- tHc V lZng mu tng- ,ch cu tng/

0Snh nh vim tQ& cCp t#n C( pc1n

$ $ C18 B/S8 }t O58 01-A_ D 2.2.1. D; chong 8o vi5m tX! c3 (h2o Ai 3t q0p(- lng gi tSnh t#ng o)- Fhi mu Vng mch- chR 3H o p l]c tnh mch t#ung t=m/ (h]c hi@n Fhng 3inh chHng nhiwm t#hng/

(h]c hi@n ,h n$c v i@n gii- th2o Ai lng n$c NuCt nhp/ (h2o Ai n$c tiDu mi giT- N\t nghi@m chEc nng thn/ (h]c hi@n thuHc gim 1u- gim tiJt ALch/

2.2.2. 6im th tch 89ch 8o nGn Si1 hit 89ch 8 8J!1 hn chP <n ng )hn Lnh tSnh t#ng 3u& tim- ACu hi@u chong tun hon- #Hi lon n$c v i@n giin$c NuCt nhp- CvP- c=n ncng- q0p( v p l]c mu mi 5 giT h1& thTng Nu&n th& th2o & l@nh/ (h]c hi@n cung cCp ALch th1& thJ/ (h]c hi@n thuHc chHng n%n- ct tu,2 42vin2 / (h2o Ai N\t nghi@m 0ct- 02moglo,in- cht G Am&l132 mu v n$c tiDu- ion r- ounC#21tinin2/ v@ 3inh #ng mi@ng 3ch 3 31u n%n gitp o) thoi mi/

2.2.3. ?hd khGng hi% ) 8o $* )hn Lnh nh gi Fh nng th- hit th 3=u- ho- m/ o) 1u tng Fhi n?m ng1/ (h2o Ai Fhi mu Vng mch- tSnh t#ng ,Qng 1u- ch$ng/ C1n thi@pX h t# h% hCp- th]c hi@n th oN&- gitp o) t thJ nghR ngi- gim 1u t thJ mol2#/ 2.2.4. ghG mGi mi%ng 8o $]t t 4R jRvinR1 th c Mc chP 4Ji tiPt )hn Lnh tSnh t#ng nim mc m%i- lni/ Chm 3Kc #ng mi@ng mi giT- tho1 v132lin2 D giB lm m%i/ Chm 3Kc A1- Ahng chCt lm lm A1 t#nh Fh% A1/ [hi cht chinh Nc lng n$c NuCt nhp/

2.2.5. Ch<m NSc D; t:"c m0 vim tQ& cCp ch: &Ju l i;u t#L nVi Fho1- chR c1n thi@p phu thut Fhi cK chR Lnh cQ thD nh vim tQ& hoi t- vim tQ& NuCt hu&Jt- hri 3Ec Fh%ng hi@u Wu )hn Lnh tSnh t#ng 1u ,Qng v tSm t thJ gim 1u cho o)/ (h]c hi@n htt A A& lin tQc v th2o Ai 3H lng- mu 3Zc- tinh chCt ALch A A&/ gh%ng cho o) n uHng- th]c hi@n ,h ALch- thuHc th2o tng & l@nh/

C%ng tc t tng cho o) 1n t=m/ (h2o Ai N\t nghi@m cht GX Am&l132 mu v n$c tiDu- ion r- c#21tinin2 (h2o Ai q0p(- pht hi@n 3$m ACu hi@u chong- th=n nhi@t t#n 7s"C phi ,o op ng1&

F +UH TR~NH CHwM SxC BhNH NHpN SAU M VIM TH Cy( F 1 N1c8 BY81 081 0PC8V BN (h2o Ai ACu hi@u FhK th- FiDu th- ACu hi@u thiJu oN&/ (h2o Ai v pht hi@n 3$m tSnh t#ng chong- ACu hi@u gim thD tich ALch- n$c NuCt nhp- n$c tiDu mi giT- nhn Lnh tSnh t#ng #Hi lon n$c v i@n gii/ (Snh t#ng ,QngX 1u- ch$ng- nhu Vng #uVt- Hng An lu/ (Snh t#ng Ainh AnngX ACu mCt n$c- c=n ncng/ (Snh t#ng vim tQ&X 1u ,Qng- ,Qng ch$ng- 1m&l132 tng/ (Snh t#ng nhiwm t#hngX th=n nhi@t c1o/ qCu hi@u ch& mu 31u m+X Wu1 An lu- q0p(- tu,2 42vin2/

F $ C18 B/S8 }t O58 01-A_ D 3.2.1. D; cS 8 hi% khS thd N* m0 o) m h1& cPn chong cho o) n?m u ,?ng mct nghing mVt ,n- o) tRnh cho n?m t thJ 32mi-mol2#- h$ng An o) th/ Cho o) th oN& th2o & l@nh/ (h2o Ai tSnh t#ng oN& mu- nhLp th- ACu hi@u thiJu oN&/ (h2o Ai tSnh t#ng ,Qng ch$ng h1& Ao 1u o) Fh%ng t] th ,Snh thTng c/

3.2.2. D; cS ng ! c chong N* m0 8o tFnh t:ng gim th tch 89ch ) * mt m 1 mt 89ch (h2o Ai v chHng chong 31u m+- th2o Ai q0p( lin tQc- ACu hi@u ch& mu- t+ng lng n$c NuCt nhp mi giT- ACu hi@u #Hi lon i@n gii t#n l=m 3ng- n$c tiDu- N\t nghi@m chEc nng thn/ (h2o Ai ACu hi@u thiJu n$c nh Fht- nim Fh%- v\o A1 '*/ (h]c hi@n ,h n$c v i@n gii/ Cm cho o)- gitp o) 1n t=m/

3.2.3. DXng ch"ng N* m0 8o : It ch* hot $Ing (h2o Ai nhu Vng #uVt- n%n Ki- ,Qng ch$ng- ALch E .ng/ Cho o) No1& t#- h$ng An o) hit th 3=u- nJu o) Fh%ng cK ACu hi@u chong cho o) ngri A& h1& n?m t thJ mol2#/ (u,2 42vin2X htt lin tQc- th2o Ai tSnh t#ng ,Qng- o vPng ,Qng- tu,2 42vin2 gitp cho tQ& nghR ngi- chR #tt Fhi o) hJt 1u ,Qng- 1m&l132 ,Snh thTng- Fh%ng nn cVt li Fhi ch1 cK & l@nh c:1 op/ ghu&n o) nn vn Vng 3$m gitp cK nhu Vng #uVt/

3.2.4. ;g ! c nhiOm t:Hng vJ t0n thng 8* 8o cS nhiT 8bn l N* m0 o) m+ tQ& cK #Ct nhi;u An luX An lu + tQ&- An lu tti mt- An lu g2h#- m A A& #1 A1- An lu A$i g1n- An lu qougl13 (Ct c c=u nHi phi v% Fhuln v th2o Ai ALch- chR #tt Fhi cK & l@nh/ Chm 3Kc An lu tHt 3 gitp gim phh n; tQ&- An lu m% tQ& hoi t phu thut vin cK thD cZt ,z mVt phn h1& ton ,V tQ& 31u K ct An lu hu cung mc nHi v An lu qougl13/ op 3 cho ,m #1 v htt D nhBng mnh hoi t t#%i #1 ngoi/ Cn ng^1 ALch t#o #1 Wu1nh ch=n An lu/ vi@c t$i #1 v htt An lu thTng 3 AQng hu&Jt th1nh mcn ng t#ng v% Fhuln v cho o) n?m nghing v; phi1 An lu gitp ALch thot #1 Aw Ang/ Cn th1& ,ng ng1& Fhi thCm $t ALch Wu1nh ch=n An lu/ 3.2.5. ;g ! c 4iPn chMng N* m0 vi5m tX! c3 Pht hi@n 3$m cc ,iJn chEng c:1 vim tQ& cCp nh 1u ,Qng t#n- FhHi u thng vLnhi@t V c1o (h2o Ai N\t nghi@m v ,o op Fhi thC& chR 3H N\t nghi@m 1m&l132- ion r(#1n31min132- gl&c2mi2 tng h1& gim/ 3.2.=. D; cS ng ! c nhiOm t:Hng N* m0 8o tFnh t:ng npm lB (h%ng tiDu cn #tt 3$m Fhi tSnh t#ng o) +n Lnh/ )g^1 vim ph+iX o) #Ct Aw ,L vim ph+i Ao 1u v Fh%ng Am th vS thJ Iq cn h$ng An o) cch No1& t#- cch th- ngri A& 3$m/ 4o\t giTngX No1& t#- t#nh tS - t#nh ALch An lu + tQ& t#n #1 A1/

3.2.W. ;g ! c N ! 8inh 8@ng 8o D; khGng $_c <n ng

)hn Lnh tSnh t#ng Ainh Anng o) Wu1 ACu mCt n$c- c=n ncng/ Io lTng v ,o co lng n$c NuCt Wu1 tu,2 42vin2- Hng An lu- n$c tiDu- tnh mch t#ung t=m/ (h2o Ai Tng hu&Jt v Tng ni@u- ; phPng #Hi lon chR 3H Tng hu&Jt/ (h2o Ai tiu ph=n mn Fhi i tiu/ (h]c hi@n in3ulin th2o & l@nh t#ong t#Tng hp vim tQ& mn tinh/ qinh AnngX n Fhi o) hJt 1u ,Qng- Fhi tSnh t#ng vim tQ& M gim hn cc t#i@u chEng- Fhi 1m&l132 t# v; ,Snh thTng/ p1uF hi #tt tu,2 42vin2 cho o) n loMng nhy nh 3tp- chCt m tng An ln nhng ch: &Ju l m th]c vt- cho o) n nhi;u nng lng- vit1min2- nhi;u chCt cK cung cCp i@n gii D t#nh 3u& Ainh Anng/ (hTng 31u !-8 ng& o) n li- ,Zt u n nhBng thEc n Aw tiu nh 3tp #1u h1& ,Vt FhuC& Tng/

Chm 3Kc #ng mi@ng thTng Nu&n/

3.2.>. D; ch* hi :` vT 4%nh )gu&n nh=n c:1 ,@nh thTng Ao nhiwm FG 3inh t#hng Tng #uVt nn gio AQc o) v; v@ 3inh n uHng- t#ong 3inh hot- tl& giun Lnh FU/ (#u&;n , nhBng Vc hi c:1 #u nh?m gio AQc v h$ng An ngTi nghi@n #u nhCt l nhBng o) M ,L vim tQ& thS vi@c nhng #u l cK tinh chCt ,Zt ,uVc/ o) cK ti;n 3 vim tQ& cn t#nh nhBng ,B1 n thLnh 3on nhi;u thLt v mn/ )Ju o) cK ti;n 3 3zi mt thS o) c|ng cK ngu& c vim tQ& #Ct c1o vS thJ cn phu thut 3$m lC& 3zi/ ghi thC& 1u h 3Tn t#i thS Fh%ng nn n uHng v Jn ng1& ,@nh vi@n/

; TIU CHU&N !rNG GI' o) hJt 1u- n uHng c/ CK tng c=n/ q1 Fh%ng ,L t+n thng/ (Snh t#ng ,Qng Fh%ng ch$ng/ o) i li c/

CpU HqI !rNG GI' e/ o) ch$ng ,Qng 31u m+ vim tQ& cCp- Iq cn chm 3KcX 1/ 4C& q0p( thTng Nu&n ,/ (h2o Ai nhu Vng #uVt c/ (h2o Ai lng n$c NuCt nhp A/ Ict Hng th%ng t#]c t#ng / p1u m+ tQ& o) c ct #Ct nhi;u An lu- Iq cn phi chm 3Kc A1 cho o) vSX 1/ )gn ng^1 tSnh t#ng mCt n$c Wu1 A1 ,/ (#nh tSnh t#ng vim l A1 c/ 0n chJ uHng n$c 3 gim lng ALch Wu1 An lu A/ (Ct c ;u tng 7/ p1u m+ tQ& Fhi no nn cho o) n t# liX 1/ ghi cK nhu Vng #uVt ,/ ghi o) thC& Ki c/ ghi tQ& M hJt vim A/ ghi o) hJt 1u ,Qng 5/ o) c ct (u,2 42vin2 31u m+ vim tQ&X 1/[itp ,Qng ,$t cng ch$ng 31u m+ ,/[am 1u vJt m+ c/ )gn ng^1 ngu& c ,Qc chR vJt m+ A/ o) Aw th hn !/ (u,2 42vin2 31u m+ vim tQ& 3 c #tt Fhi noX 1/ CK nhu Vng #uVt ,/ qLch A A& Fh%ng #1 c/ o) hJt 1u ,Qng A/ oQng Fh%ng cPn ch$ng

TI !IhU THAM KHsO

e/ )gu&wn (Cn CTng- Ii;u Anng )goi e- Chm 3Kc o) m+ vim tQ& cCp- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- ef"/ / oi ging ,@nh h.c ngoi Fho1 tiu hK1- vim tQ& cCp- oV m%n ngoi- Ii h.c < qc (P0CY- )h NuCt ,n < h.c- ""e- 7"f/ 7/ C1o vn (hLnh- vim tQ& cCp- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- 8/ 5/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2
nA

2A/- ~o p1unA2#3 comp1n& effs- eees/

BI 1 CHwM SxC BhNH NHpN UNG TH I TRC TRNG

MC TIU 1. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn !rMc "4. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4.

1 I CNG ng th i { t#]c t#ng l ,@nh ph+ ,iJn cc n$c- chiJm vL t#i thE h1i t#ong ung th Tng tiu hK1 31u ung th A A&/ Chln on thTng gi1i on muVn Fhi M cK Ai cn hocc ,iJn chEng- Ao K FJt Wu i;u t#L ,L hn chJ- i;u t#L ch: &Ju l phu thut/ (u+iX nhi;u nhCt lE1 tu+i 5"-6"- gi$i tinhX n1m nhi;u hn nB/ <Ju tH thun liX n nhi;u chCt mn v it chCt N t^ th]c vt- mVt 3H thng t+n c:1 i t#]c t#ng t#$c K nh pol&p n- ,@nh 1 pol&p i t#]c t#ng- ,@nh vim lo\t i t#]c t#ng NuCt hu&Jt 'ung th hK1 31u !- ! nm*- ,@nh C#ohn 'ung th hK1 31u ! nm*/

0Snh nh FhHi u ng th 'httpX}}/,vnAgi1Ainh/o#g/vn*

$ +UH TR~NH CHwM SxC BhNH NHpN TRC M $ 1 N1c8 BY81 081 0PC8V BN

o) #Hi lon tiu hK1X tiu ch& F\o Ai thTng gcp nhBng o) cK FhHi u ung th i t#ng phi v i t#ng ng1ng/ (o ,Kn thTng gcp o) cK FhHi u i t#ng t#i- %i Fhi N2n F nhBng t tiu ch& giHng nh hVi chEng lk- %i Fhi cK cm gic i Fh%ng hJt ph=n/ Ii cu #1 mu nhi;u h1& it th& vL t#i t+n thng/

I1u =m R- m hr nhng c|ng cK Fhi 1u # #@t thnh t^ng cn- 1u tEc vhng hu m%n h1& & chu/ 0Vi chEng ,n tZc #uVtX thRnh thong cK cn 1u Wucn ,Qng- n+i gP ,Qng v ,Qng ch$ng- 31u t#ung ti@n thS gim 1u v ,Qng Nyp- lcp i lcp li 31u vi ng& h1& nhi;u ng&/

(h1& +i hSnh Ang ph=n t#ong ung th t#]c t#ng/ (on th=n m@t mzi g& 3tt- N1nh N1o- thiJu mu- 3Qt c=n/ )hSnX gi1i on 3$m thTng Fh%ng thC& ,Ct thTng- gi1i on muVn cK Ai cn g1n Fhi thm Fhm thC& g1n to l+n nh+n hocc ,Qng ,ng/ pTX A.c Fhung i t#ng tSm c vhng 1u Fhu t#t v 3T c FhHi u/

Cc gi1i on c:1 ung th i t#ng 'httpX}}/,vnAgi1Ainh/o#g/vn*

$ $ CH&N O'N V CAN THIh( IU DNG 2.2.1. D; $_c ch kn 49 Noi $i t:Jng o) vim i t#ng ncng Fh%ng thich hp ,Ct FU chuln ,L i t#ng no ngoi t#^ thQt tho ,?ng n$c muHi 3inh lG Cm/ gh%ng cho o) uHng thuHc chE1 3Zt t#ong vPng 7-5 ng& t#$c Fhi 3oi/

)gng cc thuHc g=& ,Kn e- ng& t#$c Fhi 3oi/ 0zi ti;n 3 3 AQng thuHc c:1 o)X thuHc Fhng %ng- Fhng vim v cc thuHc g=& chHng FJt tp tiDu cu/ gh%ng n thEc n FhK tiu t#ong vPng 5 giT t#$c Fhi 3oi/ (l& 3+ ,?ng Tng uHngX mo#t#1n3 7 lit uHng vo ,u+i chi;u t#$c ng& 3oi/ poAium pho3ph1t2 f" ml thuHc- 31u K o) uHng th2m it nhCt l e lit n$c th& G t#ong vPng egiT 31u K

(hQt thoX tiJn hnh e- giT t#$c Fhi nVi 3oi- thQt Jn Fhi n$c #1 t#ong/ Cm gic hi 1u ,Qng 3 gim An 31u Fhi NS hJt hi t#ong lPng i t#ng- chR n uHng li 31u e giT/ 0i@n n1& mVt 3H ni M tiJn hnh nVi 3oi i t#ng v$i phng php v% cm g=& m D n 1u cho o)/

2.2.2. D; $_c ch kn 49 $i t:Jng $ 3hb th t Chm 3Kc o) cZt i t#ng giHng nh phu thut tiu hK1 nhng cn chuln ,L i t#ng tht 3ch/ (hQt tho 7 ng& lin tiJp- ng& thE 7 thS thQt tho vo m t#$c phu thut v 3ng h%m phu thut/ (#ong nhBng ng& n& cho o) n thEc n it chCt N- cht G vn n uHng ,Snh thTng t#ong ng& e- / )g& thE 7 n loMng- uHng 3B1- tHi nhLn n hon ton cho Jn 3ng h%m phu thut/ 0occ chR Ahng mo#t#1n3- cho o) uHng 7 gKi- mi gKi ph1 v$i e lit n$c- uHng t#ong vPng e ng& t#$c m+ Fh%ng cn thQt tho/ 4u G Fh%ng Ahng cho cc t#Tng hp cK ,iJn chEng A.1 th:ng i t#ng h1& tZc #uVt/ (h]c hi@n Fhng 3inh Tng #uVt th2o tng & l@nh/ C%ng tc chuln ,L Fhc giHng nh chuln ,L o) m+ chng t#Snh Tng tiu hK1/ bu1n t#.ng v; t=m lG nJu o) cK 0Y)( 31u phu thut/

F +UH TR~NH CHwM SxC BhNH NHpN SAU M F 1 N1c8 BY81 081 0PC8V BN (+ng t#ngX ACu hi@u m@t mzi- tSnh t#ng A1 nim- cK ACu hi@u mCt n$c- A1 Fh% ti/

(Snh t#ng ,QngX 1u- cng ch$ng- cK nhu Vng #uVt ch1 vJt m+X chi;u Ai- vL t#i- Fh% h1& ,ln- m1& chR th\p h1& chR thTng- cK mhi h%i qn luX vL t#i- 3H lng- mu 3Zc- tinh chCt ALch ch& #1- h@ thHng cK hot Vng tHt Fh%ng/ q0p(X lu G mch- hu&Jt p v nhi@t V/ 0u m%n nh=n toX M m mi@ng h1& ch1 Yu 3Zc nim mc #uVt- ph=n cK #1 Fh%ngFiDu hu m%n nh=n to/ (h%ng tiDuX th2o Ai mu 3Zc- tinh chCt- 3H lng n$c tiDu mi giT/

F $ C18 B/S8 }t O58 01-A_ D 3.2.1. ;g ! c 4Xng ch"ng 8o li%t : It N* m0 (h2o Ai 1u ,Qng- ALch An lu v Hng htt A A&/ (h2o Ai ACu hi@u FhK th- cho o) n?m t thJ mol2#/ Io vPng ,Qng D nh gi v 3o 3nh mEc V ch$ng ,Qng/ 0$ng An o) cch th 3=u- No1& t#- vn Vng/

3.2.2. D; cS h mGn nhBn to vLnh viOn oo v gii thich gitp o) +n Lnh v; mct t=m lG/ 0$ng An o) cch chm 3Kc 0Y)(- cch tZm #1- 3inh hot tSnh AQc- chJ V n/ Cho o) gcp gn cc o) cK 0Y)(- th1m gi1 c=u lc ,V nhBng ngTi cK 0Y)(- N2m 3ch ,o phim nh/ [ii thich v h$ng An ngTi nh v; 0Y)( D h. thich nghi 3Hng chng o)/

3.2.3. D; N ! ki%t N* 3hb th t 8o mt n"c vJ 8inh 8@ng k[m gh%ng Fing n 31u phu thut cZt i t#ng- Fhi cK nhu Vng #uVt thS cho o) n/ (h2o Ai tSnh t#ng 3u& Fi@t mCt n$c Ao #P ALch tiu hK1 31u phu thut/ (h2o Ai c=n ncng- h$ng An o) n uHng & : cc chCt Ainh Anng/

3.2.4. D; cS ng ! c 49 vPt thng tng Ninh mGn :, 89ch 8o thm 89ch n"c ti vJ 8o nhiOm t:Hng I=& l vJt thng An lu cc ALch E .ng t#ong phu thut/

qLch #1 #Ct nhi;u Ao vJt thng #Vng 3=u nn Iq cho o) ng=m #1 ng& 7 ln h1& nhi;u hn v ,ng li/ (h2o Ai ALch NS #P Wu1 vJt thng- th2o Ai mhi h%i/ (h%ng tiDu 3 lu li l=u hn D t#nh n$c tiDu thCm vo vJt thng g=& nhiwm t#hng/

3.2.5. ;g ! c nhiOm t:Hng vPt m0 8o v9 t: gn aZ;? vJ 8bn l Iq cn An tti hEng ph=n cho o)/ ong vJt m+ nn cK Fhong cch v$i hu m%n D t#nh ph=n thCm Wu1 ,ng vJt m+/ ghu&n o) n?m nghing v; phi1 cK 0Y)( h1& An lu/ `o1& ngTi v; phi1 0Y)( t#$c Fhi ngri A&/ (h2o Ai th=n nhi@t D pht hi@n tSnh t#ng nhiwm t#hng/

; GI'O DC SC KHq CHO BhNH NHpN ghi n?m vi@n h$ng An o) cch ngri A&- i li- cch vn Vng 31u phu thut- cch t] chm 3Kc 0Y)(- cch 3inh hot Fhi cK 0Y)(/ ghi NuCt vi@nX h$ng An o) v; n uHng- th2o Ai ,iJn chEng- cch chm 3Kc 0Y)( v vJt thng tng 3inh m%n- ti Fhm tng hyn/ (h%ng ,o v$i o) t#u&;n hK1 chCt 31u phu thut v; thTi gi1n- 3H ln t#u&;n- tc AQng phQ c:1 thuHc- c%ng tc t tng cho o) 1n t=m/

? !rNG GI' o) hri phQc tHt 31u m+- pht hi@n 3$m cc ,iJn chEng/ o) 1n t=m i;u t#L- ,iJt cch chm 3Kc 0Y)(/ o) 1n t=m Fhi t#u&;n hK1 t#L li@u/

CpU HqI !rNG GI' e/ (#$c m+ ung th i t#]c t#ng o) 3 c chuln ,LX 1/ (hQt tho t#ong 7 ng& lin tiJp ,/ n thEc n cK nhi;u chCt N

c/ )g& thE 7 phi nhLn n uHng hon ton A/ png i m+ 3 c thQt tho li / Iq cn chm 3Kc vJt thng th2o thE t]X 1/ vJt m+ - vJt thng tng 3inh m%n - An lu - 0Y)( ,/ qn lu - vJt m+ - vJt thng tng 3inh m%n - 0Y)( c/ vJt m+ - An lu - vJt thng tng 3inh m%n - 0Y)( A/ qn lu - 0Y)( - vJt thng tng 3inh m%n - vJt m+ 7/ vJt thng tng 3inh m%n cn c chm 3KcX 1/ (h1& ,ng Fhi thCm ph=n ,/ (#$c Fhi th1& ,ng cho o) ng=m #1 c/ Cho o) ng=m #1 ng& e ln t#ong n$c muHi A/ Cho o) ng=m #1 ng& 7 ln t#ong n$c Cm 5/ 0u hJt cc ung th t#]c t#ng 31u m+ ;u cKX 1/ 0Y)( ,/ 0Y)( vnh viwn c/ vJt thng tng 3inh m%n A/ ng th%ng m|i { A A& !/ o) cK ngu& c AP ALch 31u m+ ung th i t#]c t#ng AoX 1/ Chuln ,L #uVt t#$c m+ Fh%ng 3ch ,/ ng th M Ai cn c/ pu& Ainh Anng A/ )hiwm t#hng + ,Qng

TI !IhU THAM KHsO

e/ )gu&wn (Cn CTng- Ii;u Anng )goi e- Chm 3Kc o) m+ ung th i t#]c t#ng- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- 7e/ / v (Cn 4ong-oi ging ,@nh h.c ngoi Fho1 tiu hK1- ng th t#]c t#ng- oV m%n ngoi- Ii h.c < qc (P0CY- )h NuCt ,n < h.c- ""7- "8/

7/ C1o vn (hLnh- ng th i t#]c t#ng- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- 58/ 5/ v (Cn 4ong- Ii;u t#L ngoi Fho1 tiu hK1- Ii h.c < qc (P0CY- ""5- e7f/ !/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2 nA 2A/- ~o p1unA2#3 comp1n& effs- ee"e/ 6/ q2,#1 C/o#o1A2ll [13t#oint23tin1l p&3t2m in Yo3,& 3 Y1nu1l o Clinc1l )u#3ing- nA 2A/Yo3,& Comp1n& efs6- se7/

BI 1> CHwM SxC BhNH NHpN Cx H*U MN NHpN TO

MC TIU 1. Trnh by c nh nghPa h8& "Xn nhSn !o. 2. Trnh by c c c ki*& c-a jVLTQ c c loi jVLT. (. Trnh by c c c chA nh l" jVLT. +. L$& c bi'n chFng sM"Q bi'n chFng "&Un c-a jVLT. g. ThJc hi;n c %&y !rnh ch&:n b b;nh nhSn !rMc "4. h. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn cT jVLT/

1 "NH NGHA H*U MN NHpN TO 0u m%n nh=n to l l m ch: Vng i t#ng #1 A1 D 1 ton ,V ph=n #1 ngoi th1& thJ hu m%n tht/

0u m%n nh=n to

'ngurn httpX}}/3ucFho2gi1Ainh/com*

$ (HpN !OI H*U MN NHpN TO 0Y)( vnh viwnX l t#Tng hp 1 i t#ng #1 A1 v o) i tiu Wu1 0Y)( 3uHt Ti/ 0Y)( tm thTiX l nhBng 0Y)( chR 3 AQng t#ong thTi gi1n nhCt Lnh- 31u K 0Y)( 3 c Kng li v 3 ti lp li lu th%ng ph=n ,Snh thTng Wu1 hu m%n tht/

F C'C KIXU !M H*U MN NHpN TO giDu Wu1iX l 1 mVt Wu1i i t#ng Ai Vng #1 ngoi + ,Qng cK mVt Wu2 th:& tinh h1& Hng c1o 3u cEng chyn ng1ng t#nh tQt Wu1i #uVt vo t#ong + ,Qng hocc nhBng m|i chR Fh=u inh Wu1i i v$i Wu1i Jn v cH Lnh vo thnh ,Qng- 31u K N9 mVt l t#n on i t#ng 1 #1 A1 D thot ph=n/ giDu nPng 3tngX h1i u #uVt 31u Fhi cZt ,z mVt on #uVt- 1 h1i u gn nh1u 'chng e vL t#i* t#n thnh ,Qng/ giDu h1i u N1 nh1uX cZt on i t#ng v D h1i u N1 nh1u ' vL t#i* t#n thnh ,Qng/ giDu tnX cZt on #uVt 1 on t#n #1 lm 0Y)( v u A$i Kng li '01#tm1nn* h1& cZt ,z on #uVt A$i 'Yil23*/

; CH "NH !M H*U MN NHpN TO ; 1 B^/ }A 0n8 01k38V (o i;u Fi@n D mVt 31ng thng ,@nh lG phi1 A$i c nghR ngi- D giB 3ch 3 mVt Tng Fh=u- mVt mi@ng nHi t#nh NS ,Qc g=& vim phtc mc/ ChR Lnh t#ong cc t#Tng hp 31uX g i t#ng t#ong gi1i on t#w Fh%ng cPn Fh nng cZt ,z

vim lo\t ncng i t#]c t#ng ch& mu nhi;u/ xP t#]c t#ng - =m o h1& t#]c t#ng - ,ng Wu1ng vJt thng t#]c t#ng ngoi phtc mc vJt thng on i t#ng cH Lnh/

; $ T1/S0 _1K8 41- O{ 0O: 0P/8V 0Pk28V 1v_ qL Ang hu m%n t#]c t#ng/ PhSnh to i t#ng tin thin ',@nh 0i#3chp#ung*/ (Zc #uVt Ao ung th i t#]c t#ng/ Chit hyp i t#ng/

; F !t: .CO1 BC- 0Pt8V )hi;u t#Tng hp ,@nh lG 'nh chit hyp hu m%n- phSnh to i t#ng tin thin* ChJ V n Fh%ng cK ,M- tl& #uVt- thQt tho i t#ng Fh%ng : D lm 3ch #uVt Ao K cn phi lm 0Y)( D Wu1 K thQt tho #uVt tht 3ch chuln ,L cho cuVc m+ i;u t#L t#i@t cn/ ? BIJN CHNG ? 1 B-D8 O1N8V .|: Ch& muX t^ mc t#2o i t#ng 1 #1 h1& t#n thnh i t#ng/ 0oi t #uVtX thC& on #uVt 1 #1 ,L tim 2n/ (Qt 0Y)( g=& vim phtc mc 'nJu tQt vo t#ong + ,Qng* hocc g=& nhiwm t#hng thnh ,Qng 'nJu tQt vo thnh ,Qng*/ 4Pi #uVt/ )hiwm t#hng vJt m+/

(Zc #uVt/ (h:ng i t#ngX thTng Ao u c1nul2 ct vo hu m%n nh=n to D thQt tho ph=n/

? $ B-D8 O1N8V :Q,8 vim th1nh mc i t#ng/ 0yp 0Y)(/ (hiJu mu- hoi t l m/ (hot vL thnh ,Qng/ p1 i t#ng/ xP 0Y)(/ (iu Fh%ng t] ch:/

p1 nim mc hu m%n 'httpX}}/gi1oAuc3ucFho2/n2t*

o +UH TR~NH CHwM SxC BhNH NHpN TRC M o 1 !/ KQ }R OQ,O :n ._ BD8 }t }R O18 B/S8 Q8V 01k (hTng t=m lG o) t#i Wu1 cc gi1i onX t^ chHi- gin AB- Fh%ng chCp nhn phu thutt#m cm/ 4ng gi nhBng phn Eng Ntc cm c:1 o) v gi1 Snh/

ghu&Jn Fhich o) pht ,iDu cm Ntc/ 4Zng ngh2 t=m t#ng v ngu&@n v.ng c:1 o)/ Cho o) nKi chu&@n v$i o) cK 0Y)( thnh c%ng/ 0+ t# t=m lG t#$c m+/ CK chng t#Snh gio AQc ,?ng cc t li@u- ,i ging- hSnh nh- nn cung cCp v; th%ng tin cuVc m+/

[io AQc v; mct 3Ec Fhz2X cch chm 3Kc 0Y)(- cch 3inh hot hng ng& 31u m+X chJ V n- tZm #1- th1& ,ng- hot Vng NM hVi- c%ng vi@c- 3inh hot tSnh AQc/

o $ C1Q8 dY BN _1`Q 01Qc0 60Pk28V 1v_ :n O1k38V 0P81@ )=ng c1o thD t#ngX cho o) n chJ V nhi;u c1lo- it chCt N t#$c m+/ (h]c hi@n t#u&;n ALch t#ong t#Tng hp o) nhLn n/ ChHng nhiwm t#hngX Iq th]c hi@n thuHc chHng nhiwm Fhuln Tng #uVt vi ng& t#$c m+- Fhng 3inh A] phPng t#$c m+/ Ict tu,2 42vin2/ 4m 3ch i t#ngX thQt tho h1& cho o) uHng thuHc #1 #uVt t#$c m+/ ILnh vL t#i c:1 l m 0Y)(X thTng ngoi c thng ,Qng- vL t#i l m nn n?m t#ong tm nhSn v tm t1& c:1 o)/ )n t#nh ct 0Y)( Tng thZt lng- vhng A1 lm NJp nJp- 3yo m+ c|- vhng cK thot vL- vhng cK Nng gr ln- #Hn- vhng chLu nh hng c:1 ti1 N/ Cht G thn t#.ng v; nhBng lTi phn nn c:1 o)/ (h]c hi@n c=n ,?ng n$c v i@n gii t#$c m+/ )n ct 3onA2 tiDuX gitp th2o Ai chinh Nc lng n$c NuCt nhp- gitp vhng & chu c Fh% 31u m+/

+UH TR~NH CHwM SxC BhNH NHpN SAU M Cx HMNT 1 N1c8 BY81 818V B-RQ O8 uQ58 .S0 0P/8V 818V 8VtE BQ .5Q :n Yi@ng l mX + (un hon muX mu- ni chR Fh=u- tQt 0Y)( vo t#ong- ALch tiJt- nim mc #uVt nn lm v hrng/ + p] phh n;X mng nh& phh nhy- t#ong 3uHt l ,Snh thTng- nJu tng hn l ,Ct thTng/ IHi v$i vhng A1 Nung Wu1nh l mX + q1 cK ,L #m l- z- NS AP ph=n/ 4u G t#nh Ahng cc chCt 3t Fhuln vS cK thD g=& AL Eng- Ahng tti thich hp- th1& tti ;u- l cZt phi v^1 t#nh Wu #Vng hocc Wu hyp- co 3ch l%ng ni vhng cK An tti/ + (hTng cK Wu1n iDm Fhi 1 0Y)( #1 ngoiX x1 3ch #uVt t#$c v t#ong m+ 31u K 1 0Y)( #1 ngoi v ct tti hu m%n ng1& 31u m+/ Phu thut vin N9 0Y)( nhng 31u K Fh=u m|i chR chT- ,ng Fin li ,?ng gc v132lin2/ $ C18 B/S8 }t O58 01-A_ D W.2.1. ./ t0n thng 8* 8o vPt m0 vJ lq aZ;? o) cK 0Y)( ch1 N9 mi@ngX 0Y)( c ,1o ph: ,?ng gc thCm v132lin2/ )Ju thCm mu $t ,ng chR th1& l$p ,ng ngoi- lu%n giB cho nim mc 0Y)( lu%n lm Fh%ng ,L Fh%/ (h2o Ai tSnh t#ng ,Qng- cn 1u- mu 3Zc nim mc 0Y)(- th2o Ai ch& mu Wu1nh ch=n 0Y)(/

o) cK 0Y)( M N9 mi@ngX thTng 31u 5s giT 3 N9 mi@ng 0Y)(/ Iq cn #1 3ch ph=n t#o #1- WuCn gc cK thCm v132lin2 Wu1nh A$i ch=n #uVt 'ng^1 ph=n + vo + ,Qng*/ (#ong vi ng& u nn ,%i pom1A2 oN&t Fm ln A1 Wu1nh 0Y)( D ng^1 #m l A1/

)Ju 0Y)( ,n phi h1& 1 #uVt non #1 A1 Iq cn th2o Ai 3] mCt n$c v cng cht G hn vi@c phPng ng^1 #m l A1 cho o) vS =& l loi ALch lzng m1ng tinh chCt F;m/

p1u Fhi N9 mi@ng 0Y)( #uVt cK thD phh n; h1& ch$ng- Iq cn th2o Ai mu 3Zc nim mc- nJu ph=n Wu cEng Fh%ng #1 c- Iq cK thD m1ng gng cK tho1 chCt t#n nong nhy nhng vo mi@ng 0Y)( v lC& ph=n #1 hocc Ahng Hng th%ng hu m%n ,m e"""" ml n$c muHi 3inh lG D Fich thich nhu Vng #uVt v lm m;m ph=n/

ng c1o 3u hocc Wu2 th:& tinh giB cH Lnh Wu1i #uVt thnh ,Qng 3 c #tt 31u !-8 ng&/

bu2 cH Lnh Wu1i #uVt thnh ,Qng 'httpX}}/gi1oAuc3ucFho2/n2t*

W.2.2. D; lo lfng vT aZ;? $*ng m*ng (=m lGX Fhi chm 3Kc Iq nn tJ nhL- gii thich D t#nh o) ,L mcc cm v h$ng An o) cch hP1 nhp vo cuVc 3Hng- gitp o) lC& li ni;m tin t#ong cuVc 3Hng/ 0$ng An cch #1 0Y)( v th1& tti ]ng ph=n/ [itp o) ngn ng^1 lo\t A1 Nung Wu1nh ch=n 0Y)(/

Cung cCp nhBng th%ng tin 3ch ,o v; cch chm 3Kc 0Y)(/ (p i;u chRnh chEc nng 0Y)(X th& th2o 3inh hot c:1 o)- Iq cK thD tp cho o) i tiu tng giT ,?ng cch thQt tho mi ng& v tp tHi thiDu e tun/

qinh AnngX Fhu&n o) n nhBng thEc n it chCt N- t#nh thEc n cK nhi;u gi1 vLFh%ng nn Ahng cc chCt Fich thich nhu Vng #uVt nh thuHc N+/ Cht G n$c- nh1i Fd thEc n- n chm- n nhBng thEc n giu Ainh Anng/ vCn ;X : Ainh Anng v thEc n cK nh hng Jn chEc nng c:1 0Y)(- Fhu&n o) uHng nhi;u

IHi v$i l m hri t#ng #1 A1X cht G mCt n$c v #Hi lon i@n gii/ vn VngX t#nh lm vi@c ncng Fhi 1ng m1ng 0Y)( h1& m$i Kng 0Y)(/ v@ 3inh th=n thDX vn tZm #1 ,Snh thTng nhng t#nh ch Nt N phPng ln 0Y)(t#nh D ti1 n$c ,Pi 32n t$i t#]c tiJp ln 0Y)(- t#nh Ahng Fhn h1& gc Wu cEng l1u Fh% nim mc 0Y)(/

0$ng An o) ti Fhm li/ (#ong t#Tng hp 0Y)( tm thTi thTng o) 3 c hyn ti Fhm Kng li 0Y)( 31u thng hocc thTi gi1n ngZn hn nJu l #uVt non/ )goi #1 Acn o) Jn ,@nh vi@n ng1& nJu thC& ch& mu- Fh%ng #1 ph=n- ch$ng ,Qng- 1u ,Qng

W.2.3. D; $* N* 3hb th t (h]c hi@n thuHc gim 1u th2o & l@nh/ (o m%i t#Tng th giMn- thm viJng/ [itp o) cK t thJ thoi mi

W.2.4. D; $_c chr $9nh $Sng aZ;? Ii;u Fi@n Kng 0Y)(X + (hTng 31u -7 thng 'th& tSnh t#ng o)*/

+ Ion A$i phi th%ng/ + Chung Wu1nh mi@ng 0Y)( Fh%ng ,L nhiwm t#hng/ Chuln ,L Kng 0Y)(X chuln ,L t#$c 7 ng&- phi m ,o i t#ng 3ch v Fh%ng nhiwm t#hng/ + ChJ V nX chu&Dn An t^ chJ V cc 31ng lzngX cm ng& u- cho ng& thE 3B1 hocc t# Tng ng& thE 7/ Chi;u tHi h%m t#$c nhLn n uHng hon ton D 31ng h%m 31u m+/ + (hQt tho 0Y)( v hu m%n tht ng& e ln ' ng& t#$c m+*- ng& t#$c ng& m+*/ + 0occ #1 3ch i t#ngX uHng Aung ALch mo#t#1n3 mVt ng& t#$c v$i 7 gKi- mi gKi ph1 e lit n$c/ Iq cn m ,o 3ch ph=n t#ong lPng #uVt/ + (h]c hi@n Fhng 3inh Tng #uVt- Fhng 3inh A] phPng t#$c m+/ ln 'ng1&

W.2.5. ;g ! c cS cc 4iPn chMng N* m0 $Sng aZ;? oQc NS mi@ng nHi 0Y)( g=& vim phtc mc h1& #P tiu hK1 Fhu t#t- th2o Ai ACu hi@u NS AP ph=n Wu1 vJt m+ h1& l Kng 0Y)(- nhi@t V- 1u ,Qng/ Ch& mu mi@ng nHi h1& thnh ,Qng/ 0yp mi@ng nHi 0Y)(X th2o Ai ,Kn- #cn Fhi i tiu- 3H ln i tiu/ (Zc #uVt/ )hiwm t#hng vJt m+ thnh ,Qng ch Kng 0Y)(X th1& ,ng Fhi thCm ALch/

> TIU CHU&N !rNG GI' o) th1m gi1 3inh hot t#ong gi1 Snh- NM hVi- c%ng vi@c mVt cch t] tin/

o) t] chm 3Kc 0Y)( thnh tho/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810: e/ 0Y)( l l m ch: Vng X 1/ Y1nh t#ng #1 A1 ,/ 0ri t#ng #1 A1 c/ ( t#ng #1 A1 A/ Ii t#ng #1 A1 / CK mC& loi 0Y)(X 1/ e loi ,/ loi

c/ 7 loi A/ 5 loi 7/ oiJn chEng 3$m c:1 0Y)(X 1/ 0yp 0Y)( ,/ p1 i t#ng c/ (hot vL thnh ,Qng A/ (Zc #uVt 5/ o) cK chR Lnh Kng 0Y)( 39 c chuln ,L t#$cX 1/ ng& ,/ 7 ng&

c/ ! ng& A/ 8 ng& !/ Ii;u no 31u =& Fh%ng tng Fhi chuln ,L o) m+ lm 0Y)( 'm+ chng t#Snh*X 1/ Ict Hng th%ng m|i A A& ,/ (hQt tho c/ o) chR c uHng 3B1 h1& uHng n$c 3tp A/ (h]c hi@n thuHc Fhng 3inh

TI !IhU THAM KHsO e/ )gu&wn ISnh 0Hi- 0u m%n nh=n to- o@nh h.c ngoi Fho1 Tng tiu hK1- Ii h.c < qc (P0CY- effs- 7f/ / )gu&wn (Cn CTng- Ii;u Anng )goi e- Chm 3Kc o) cK hu m%n nh=n to- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- 5 // 7/ Y1#g1#2t 02itF2mp2#- 4inA1 p1chucF- P#o,l2m3 o A,3o#ption 1nA limin1tion- ch1p2# 5"32ction s- Y2Aic1l pu#gic1l )u#3ing- ou#th Aition- 42i3 Colli2# 02itF2mp2#} Ypo<- eff e 5 /

BI 1 CHwM SxC BhNH NHpN THO'T V" BN

MC TIU 1. L$& c nh nghPaQ !ri;& chFng lS" sng v ng&y$n nhSn c-a !ho ! v btn 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn !rMc "4. (. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4.

1 "NH NGHA (hot vL ,yn l tSnh t#ng nh% #1 c:1 phtc mc- mc nHi v #uVt #1 ngoi + ,Qng Wu1 ch m #1 ,Ct thTng c:1 c t#n thnh ,Qng/ (h& vL t#i ngTi t1 ph=n loi thot vL ,yn- thot vL hi- thot vL #Hn/ (hot vL ,yn thTng N& #1 n1m nhi;u hn nB/

(hot vL ,yn 'httpX}}3ucFho2Aoi3ong/vn*

$ NGUHN NHpN V TRIhU CHNG !pM SNG $ 1 NVQEL8 81K8 olm 3inhX Ao 3] trn ti c:1 Hng phtc tinh mc to nn Tng i chng e tti cK 3n FhiJn cho thot vL cK i;u Fi@n N& #1/ YZc phiX 3] 3u& &Ju c:1 l$p mc ng1ng v c ng1ng ,Qng Ao ngTi gi- 3u& Ainh Anng h1& thng tich vhng ,yn g=& nn thot vL ,yn t#]c tiJp v thot vL hi/ <Ju tH thun liX to ,Kn Finh nin- u i t#ng- tiDu FhK Ao hyp ni@u o h1& u N ti;n li@t tu&Jn- ho F\o Ai t#ong vim phJ Wun mMn tinh- cK th1i- c+ t#$ng h1& FhHi u t#ong ,Qng/

httpX}}3ucFho23o/com $ $ TP-AQ O1N8V bK: .t8V ghHi u vhng ,yn Fhi gZng 3Ec- i Eng- ho- #cn/ (] mCt i Fhi n?m NuHng h1& Ahng t1& l& vo/ (hTng thot vL Fh%ng 1u/

F +UH TR~NH CHwM SxC BhNH NHpN F 1 N1c8 BY81 081 0PC8V BN 0ziX + ( thJ thTng thot vL- cch c t#i- thTi gi1n NuCt hi@n/ + )%n Ki- cng ch$ng- 1u 'ACu hi@u 3$m c:1 tZc #uVt*/ ghmX

+ ( thJ o) n?m ngB1 h1& ngri- cK thD thC& FhHi m;m vhng thot vL ,yn Fhi o) th1& +i t thJ- Fhi ho- cTi h1& FhKc ' t#9 2m* v ,iJn mCt Fhi n?m NuHng h1& Fhi Ahng t1& l& vo/ + p1u m+X q0p(-vJt m+- An lu/ (Snh t#ng ,1ng Wu1ng Hi v$i n1m vS vi@c ,i tiJt n$c tiDu 31u m+ thot vL thTng FhK Fhn/ + bu1n 3t ,Su cK 3ng- cK 1u Fh%ng + CK 1u vJt m+- 1u ,Qng Fhi ho- hZt hi Fh%ng/

(hot vL ,yn 'httpX}}/gi1oAuc3ucFho2*

F $ CH&N O'N V CAN THIh( 3.2.1. D; lo lfng t:"c m0 thot v9 Cung cCp th%ng tin v; phng php m+/ qo 1u nn o) FhK tiDu 5-5s giT 31u m+/ 0n chJ vi@c vn Vng v i li t#ong nhBng ng& u/

3.2.2. Ch kn 49 D; m0 c3 cM 8o thot v9 4sn nghst Chuln ,L o) m+ cCp cEu nh mVt o) ,L tZc #uVt/ C%ng tc t tng cho o) vS cK ngu& c cK 0Y)( h1& An lu- vJt m+ Ai/

3.2.3. Ch kn 49 D; m0 thot v9 thRo chng t:Fnh

(hQt tho h1& uHng mo#t#1n3 ng& t#$c m+/ Cho thEc n nhy ng& t#$c m+- 3ng nhLn n hon ton/ v@ 3inh ,V phn 3inh AQc/

3.2.4. D; cS ng ! c ch! m N* m0 (h2o Ai q0p( t#ong nhBng giT u/ (h2o Ai ch& mu 31u m+X Wu1 vJt m+- mch- hu&Jt p/ (h2o Ai 0ct/ (h2o Ai tSnh t#ng ,Qng nh ch$ng- 1u- tQ mu/

3.2.5. D; khGng th*! 4<ng 8o vPt m0 Nch vJt m+ Fh% Fh%ng th1& ,ng 31u !-8 ng& cZt chR/ (h2o Ai nhi@t V- 3ng- nKng- z 1u ni vJt m+/

3.2.=. D; cS ng ! c thot v9 li N* m0 (#nh cho o) ho- to ,Kn vS cK thD g=& tng p l]c ,Qng g=& ,Qc chR- thot vL li/ )g& thE cho o) ngri A&- ng& thE 7 cK thD cho o) i li Wu1nh giTng/

IHi v$i o) cK thnh ,Qng &Ju h1& ngTi gi thS cht G vn Vng t#w hn/ (#nh i N2 p t#ong tun u 31u m+/ (#nh lm vi@c ncng t#ong -7 thng 31u m+/ o) cK thnh ,Qng &Ju h1& ngTi gi Fhu&Jn Fhich o) m1ng nLt ,Qng 31u m+/ oo cho o) ,iJt cK ngu& c thot vL t# li/ 0i@n n1& cK m+ nVi 3oi o) cK thD vn Vng 3$m 31u m+ v thTi gi1n n?m vi@n ngZn ng& hn- tR l@ ti pht it hn/

3.2.W. D; lo lfng vT chP $I <n N* m0 0$ng An o) n ,Snh thTng 31u m+ nhng lu G chJ V n- thEc n nhun t#Tng t#nh to ,Kn/

; !rNG GI' p1u m+ o) Fh%ng ch& mu/ gh%ng nhiwm t#hng vJt m+/

CpU HqI !rNG GI' e/ o) 31u m+ thot vL ,yn thTng Fh%ng tiDu c- Iq N t#i ,$c uX 1/ Ict Hng th%ng tiDu thTng ,/ Cho o) ngh2 tiJng n$c ch& c/ ghu&n o) #cn mnh Fhi i tiDu A/ YTi op m ,ng Wu1ng #1 A1 / Iq cn h$ng An cho o) 31u m+ thot vL ,ynX 1/ vn Vng- i li 3$m 31u m+ ,/ p1u m+ 5s giT m$i c ngri A& c/ p1u m+ 5s giT m$i c i li A/ gh%ng c i N2 t#ong tun u 31u m+ 7/ oiJn chEng 31u m+ thot vL ,yn lX 1/ (hot vL ,yn li ,/ 4it Ang c/ vim tinh hon A/ [im Fh nng cK con 5/ p1u m+ thot vL ,yn o) cK chJ V n uHng nh thJ noX 1/ (hEc n nhi;u chCt ,\o ,/ 0n chJ thEc n nhun t#Tng c/ Hng nhi;u n$c A/ gh%ng n thEc n cK nhi;u gi1 vL- uHng #u ,i1 !/ Cn gio AQc & tJ cho o) 31u m+ thot vL ,ynX 1/ (#nh lm vi@c ncng t#ong e nm u 31u m+ ,/ gh%ng D cho tiu ch& c/ (#nh to ,Kn A/ gh%ng i N2 m& t#ong vPng 6 thng 31u m+

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi e- (hot vL ,yn- )h NuCt ,n [io AQc vi@t )1m0 )Vi- ""f-e58/ / )gu&wn (h1nh Yinh- (hot vL ,yn hi- oi ging ,@nh h.c ngoi Fho1 tiu hK1- oV m%n ngoi- Ii h.c < qc (P0CY- )h NuCt ,n < h.c- ""e- s6/ 7/ C1o vn (hLnh- (hot vL ,yn hi- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- 5 / 5/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2 2A/- Yo3,& Comp1n& efs6- 8s8/
nA

2A/- ~o p1unA2#3 comp1n& effs- e"f7/


nA

!/ q2,#1 C/o#o1A2ll [13t#oint23tin1l p&3t2m in Yo3,& 3 Y1nu1l o Clinc1l )u#3ing-

BI $< CHwM SxC BhNH NHpN M TR

MC TIU 1. Trnh by c c c phng ph p i& !r !rP 2. ThJc hi;n c vi;c ch&:n b b;nh nhSn !rMc "4 !rP. (. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4 !rP.

1 C'C (HNG (H'( IU TR" TR (im Aung ALch lm N cEng ,ti t#X tim n$c 3%i- ph2nol !u- PoliAoc1nol/ (hTng p AQng cho t# V e- V / oiJn chEng l lm lo\t Wu1 m% c lnh- nhiwm t#hng- phn Eng thuHc/ (hZt ,ti t# ,?ng A=& thunX ,ti t# thiJu mu nu%i 3 N cEng v hoi t #Qng 't#ong Fhong 8 ng&* 4m lnhX ,?ng Aung ALch nit#og2n- c1#,onAioNiA- lnh lm hoi t v #Qng/ pyo m;m- yp- Fh%ng 1u/ 4i@u php lm %ng nhi@t ,?ng ti1 hrng ngoiX Ahng e ,Kng n tung3t2n h1log2n pht #1 ti1 hrng ngoi hVi tQ t#n ,ti t# g=& hi@n tng vim- ph h:& v to 3yo vhng chiJu ti1/ [ii phu cZt t#X thTng cho ,iJn chEng hyp hu m%n/ Ii;u t#L nVi Fho1X ,%i thuHc gim 1u- thuHc t- Fhng 3inh- lm m;m ph=n/ (#nh hot Vng gZng 3Ec- Fh%ng ngri hocc Eng Wu l=u- Fh%ng D to ,Kn/

0Snh minh h.1 'httpX}}/c1mn1ng,2nh/com*

$ +UH TR~NH CHwM SxC BhNH NHpN BhNH TR $ 1 BN B5Q j/ 81-: 0PU8V d- 0PZ 15E j/ 0O :CO1 - Chuln ,L o) Fhm h1& 3oi t#]c t#ng/ - )n cho o) ng=m m%ng ng& -7 ln v 31u Fhi i cu ,?ng n$c Cm- thTi gi1n ng=m e"-e! phtt- nhi@t V n$c 5"-5!"C gitp mu Jn vhng chu gim phh n; v gim 1u/ - Ict thuHc h1& ,m thuHc chHng co thZt- chHng 1u th2o & l@nh gitp o) Aw chLu- thoi mi/ (h]c hi@n thuHc gim 1u/ - 4ng gi mEc V 1u- ngnng 1u- mCt thoi mi/ - qhng tti h1& gHi thCm ALch ct A$i m%ng o)/ - ghu&Jn Fhich o) tZm ngri gitp thoi mi v 3ch - qhng tti lnh ct vo ,ti t# gitp ,$t 3ung hu&Jt/ $ $ BA81 0PZ j/ 0S/ d{8 - o) i cu ng1&- nh1nh- Fh%ng ngri l=u- Fh%ng cH gZng/ - qu& t#S : n$c t#ong ng&- thEc n nhun t#Tng/ - ghu&Jn Fhich o) vn Vng- thD AQc/ - (h]c hi@n thuHc nhun t#Tng lm m;m ph=n vS o) cK thD 3 1u Fhi i cu/ - (h2o Ai o) N2m cK 1u Fhi i cu/ Inh gi mEc V ch& mu/ $ F C1^E :SQ .5Q 41- B- OQ

- 4C& q0p(- Wu1n 3t A1 nim nh gi ACu hi@u thiJu mu/ - Ph=n cK mu Fh%ng qCu mCt mu- ACu ch& mu Wu1nh hu m%n/ - (h]c hi@n thuHc nhun t#Tng lm m;m ph=n- t#nh ph=n cEng lm #ch mch mu/ $ ; C1Q8 dY BN 0Pk|O :n - Cho o) i cu- v@ 3inh 3ch vhng hVi =m/ - Cht G cch ng=m #1 hu m%n t#nh nhiwm t#hng/ - (h]c hi@n Fhng 3inh t#$c m+ nJu cK tSnh t#ng nhiwm t#hng/

Ph=n loi t# 'httpX}}/nongnghi2p/vn*

F +UH TR~NH CHwM SxC BhNH NHpN SAU M F 1 N1c8 BY81 081 0PC8V BN - I1uX mEc V 1u- nh gi mEc V 1u/ - Ch& muX nh gi 3H lng mu ch& mi -5 giT t#ong 5 giT 31u m+/ - [c cm muX cK thCm ,ng- mu 3Zc- mhi/ - (Snh t#ng vJt thngX ACu hi@u nhiwm t#hng- 3ng n;- mhi - vn VngX o) ngri h1& n?m

Phu thut t# ,?ng phng php 4ongo 'httpX}}vi2t,1o/vn}puc-Fho2*

F $ C18 B/S8 }t O58 01-A_ D 3.2.1. D; ch! m - )Ju o) m+ t# Fh%ng cn n?m vi@n nn Iq chR th2o Ai ch& mu t#ong nhBng giT u 31u K cho o) v; v h$ng An o) cch chm 3Kc ti nh nhX th2o Ai ch& mu 31u m+ Wu1 Wu1n 3t ,ng cK thCm mu Fh%ng- th1& ,ng Fhi thCm $t/ )g=m #1 hu m%n v$i n$c muHi 3inh lG Cm ng& 7 ln v 31u Fhi i cu/ (i Fhm Fhi cK ACu hi@u 1u tng ln/ - )Ju o) m+ ,?ng phng php c+ iDnX phu thut vin thTng nh\t m2ch2 hu m%n cm mu v m2ch2 n& c #tt 31u 5 giT/ (#$c Fhi #tt nn cho o) ng=m m%ng/ 3.2.2. K* N* m0 - (h]c hi@n thuHc gim 1u/ - (Sm t thJ thich hp gitp o) gim 1u/ - )g=m n$c Cm gitp o) gim 1u- thoi mi/ - Cho o) uHng nhi;u n$c- n thEc n nhy t#ong nhBng ng& u D t#nh ph=n cEng/ F $ F BN d{8 .5Q :n - Cho o) n thEc n m;m- t#nh thEc n nhi;u N- t#nh to ,Kn/ - )n n thEc n nhun t#Tng- uHng nhi;u n$c/ 3.2.4. D; cS ng ! c 49 t:L ti 3ht - [io AQc o) t#nh to ,Kn- tp i cu tng giT- t#nh cc chCt Fich thich nh #u- c ph- thuHc l- uHng nhi;u n$c- n nhi;u chCt N/ - (#nh lm vi@c t#ong mVt t thJ Wu l=u/ - (p thD AQc- vn Vng- v@ 3inh 3ch 3 Fhi i cu/

')gurn httpX}}/thi2t,i&3inh/com/vn*

; TIU CHU&N !rNG GI' - gh%ng ch& mu/ - [im 1u/ - gh%ng to ,Kn- Ainh Anng tHt- uHng nhi;u n$c/ - (h1& +i thKi Wu2n 3inh hot/ CpU HqI !rNG GI' e/ o) 1ng ,L nhiwm t#hng ,ti t#- Iq cn h$ng An o) chm 3KcX 1/ )g=m m%ng n$c Cm mi ng& e ln ,/ )g=m m%ng n$c Cm 31u Fhi i ti@n c/ )g=m m%ng n$c Cm Fhi thC& 1u A/ )g=m m%ng n$c Cm Fhi thC& ch& mu / )g=m m%ng o) ,L nhiwm t#hng ,ti t#R- thTi gi1n v nhi@t V n$c nh thJ noX 1/ !-e" phtt- nhi@t V 7"-5""C ,/e"-e! phtt- nhi@t V 7"-5""C c/ !-e" phtt- nhi@t V 5"-5!"C A/ e"-e! phtt- nhi@t V 5"-5!"C 7/ Phu thut vin nh\t gc vo hu m%n o) 31u m+ t# D cm mu- gc n& Fhi no c #ttX 1/ ghi o) hJt 1u ,/ ghi Fh%ng cPn ch& mu c/ 5 giT 31u m+

A/ 5s giT 31u m+ 5/ (#$c Fhi #tt gc hu m%n cho o) 31u m+ t#- Iq cn lm gS D t#nh ngu& c ch& mu Fhi #ttX 1/ Cho o) ng=m m%ng vo n$c Cm ,/ Cho o) ng=m m%ng vo n$c nKng c/ Cho o) ng=m m%ng vo Aung ALch oN& gi A/ (Ct c ;u tng !/ 4m gS D gitp o) gim 1u 31u m+ cZt ,ti t#X 1/ (h]c hi@n thuHc g=& t ti ch ,/ gh%ng th1& ,ng thTng Nu&n c/ Cho o) ng=m m%ng vo n$c Cm A/ )?m &n ti giTng hn chJ vn Vng

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Chm 3Kc o) m+ t#- Iq ngoie- )h NuCt ,n gio AQc vi@t )1m- 0 )Vi- ""f- e!7/ / C1o vn (hLnh- o@nh t#- oi ging ,@nh h.c ngoi Fho1 tiu hK1- ((I( oq cn ,V & tJ (P0CY- ""8- 75/ 7/ qng Ph$c 0ng- o@nh t#- oi ging ,@nh h.c ngoi Fho1 tiu hK1- oV m%n ngoi- Ii h.c < qc (P0CY- )h NuCt ,n < h.c- ""e- 7!5/ 5/ )u#3ing c1#2 o p1ti2nt3 ith Ai3o#A2#3 o th2 upp2# g13t#oint23tin1l p&32m- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o Clinic1l P#1ctic2
nA

2A/- ~o p1unA2#3 comp1n& effs- e"f6/

BI $1 CHwM SxC BhNH NHpN Cx D)N !U

MC TIU e/ (#Snh ,& c mQc ich- vL t#i- phng php ct Hng An lu/ / (#Snh ,& c ngu&n tZc chm 3Kc Hng An lu/ 7/ )u c cc ,iJn chEng Fhi ct An lu/

1 D)N !U ng An lu l mVt h@ thHng- mVt vt thD ct t^ mVt vhng- mVt Fho1ng c:1 c thD D An lu ALch- mu hocc chCt tiJt #1 ngoi hocc t^ c Wu1n n& 31ng c Wu1n Fhc/

$ MC CH $ 1 -RQ 0PY 4C& hJt chCt ALch- m:- Fhi vS nJu Fh%ng thot hJt thS Aiwn tiJn 3 t#m t#.ng hn hocc cK thD An Jn t vong/ qn lu + p N2- tQ ALch- mu/ [ii p t#ong t#Tng hp t#n mu- t#n Fhi mng ph+i- t#n ALch t^ c Wu1n

$ $ (1m8V 8V75 (#nh nhiwm t#hng cc c Wu1n Nung Wu1nh/ (#nh lo\t mi@ng vJt thng/ I; phPng tQ ALch 31u m+/ (h2o Ai ngu& c ch& mu 31u m+/ (h2o Ai NS ,Qc Tng Fh=u mi@ng nHi/

[itp th2o Ai Aiwn tiJn ni v^1 c1n thi@p- th2o Ai 3H lng- mu 3Zc- tinh chCt ALch mi ng&/

F C'C V" TR WT NG D)N !U qn lu + ,QngX An lu qougl13- A$i g1n- hH lch- g2h#- tti mt/ qn lu lrng ng]cX t#ung thCt- mng ph+i- mng tim/ qn lu tiJt ni@uX hH thn- ,D thn- ni@u Wun- ni@u o/ qn lu vJt thngX phn m;m- + p N2/ qn lu Nng- + Fh$p/ qn lu uX phunt- An lu vJt m+ A$i A1 u- An lu gii p nMo thCt- An lu + p N2 nMo

; TIU CHU&N D)N !U t g=& phn Eng cho c thD/ ng cK vch cn Wu1ng D Aw Ang th2o Ai Fhi chQp `-Wu1ng/ Y;m mi Fh%ng g=& lo\t cc t+ chEc Nung Wu1nh/ (#n lng Fh%ng g=& ,m Ainh/

? TIU CHU&N WT D)N !U )i thCp nhCt c:1 + ALch/ 0n chJ Nu&n Wu1 Fh$p- thn Finh- mch mu/ qn lu Fh%ng nn ct ng1& t#n vJt m+/ ITng vo c thD ngZn nhCt- Tng 1 #1 gn nhCt/ qn lu ct vL t#i Aw chm 3Kc nhCt/

o C'C !OI NG D)N !U o 1 D5 }t/ O10 b-AQ [c/

ng c1o 3u m;m 'p2n#o32- l1m c1o 3u*/ ng c1o 3u 'tu,23*/ PhHi hpX Hng t#ong l1m c1o 3u 'p2n#o32 A#1in*- An lu FiDu NS g 'cig1#2tt2 A#1in*3ump A#1in/

o $ D5 }t/ 0SO j[8V qn lu h 'thQ Vng*/ qn lu Fin ' ch: Vng*/ gJt hp/

ng g2h# 'httpX}}/uniWu2m2Aic1lto&3/com*

Cc loi Hng An lu 'httpX}}/uniWu2m2Aic1lto&3/com*

ng Px 'httpX}}/uniWu2m2Aic1lto&3/com*

ng YA4C( 'httpX}}/uniWu2m2Aic1lto&3/com*

NGUHN TC CHwM SxC NG D)N !U oiJt # c Wu1n ct An lu/ Phi ,o m v% Fhuln tu&@t Hi h@ thHng An lu/ o) nn n?m t thJ gitp ALch An lu th%ng tHt/ C=u nHi phi tng cch t#nh tZc nghn- A=& c=u nHi nn cK Tng Finh l$n hn Tng Finh Hng An lu/ oSnh hEng lu%n ct thCp hn vL t#i An lu 6" cm/ 0tt ALch lin tQc h1& ngZt WuMng th& vo mQc ich i;u t#L/ (h2o Ai 3H lng- mu 3Zc- tinh chCt c:1 ALch An lu- ghi hr 3/ om #1 Hng An lu th& mQc ich i;u t#L v thTi gi1n cho ph\p/ 4u%n lu%n th2o Ai ACu hi@u mCt n$c- tSnh t#ng n$c NuCt nhp/ 4u%n m ,o ch=n An lu Fh%- 3ch- ng^1 #m l A1 tich c]c- pht hi@n 3$m ACu hi@u nhiwm t#hng/ xtt An lu ng1& Fhi t mQc ich i;u t#L/ 4u%n gio AQc o) th1m gi1 vo 3] t] chm 3KcX cch ngri A&- Ai chu&Dn- No1& t# Fhi cK An lu D o) 1n t=m/

> BIJN CHNG Ch& mu/ )hiwm t#hng ngc APng/ )hiwm t#hng ch=n An lu/

ptt Hng/ )ghyt Hng/ (+n thng cc c Wu1n Nung Wu1nh/ I1u- FhK chLu cho o)/ `S #P ALch 31u Fhi #tt An lu/

RT D)N !U ghi Fh%ng cPn mQc ich i;u t#L/ qLch #1 t^ "-!" ml} 5giT hocc An lu Fh%ng cPn hot Vng/ qn lu A] phPng v th2o Ai nn #tt mVt thS Au& nhCt/ qn lu i;u t#L phi ct l=u Wu 7 ng&- Fhi #tt nn No1& Hng v #tt An vi cm cho Jn Fhi hJt/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810 e/ oSnh hEng ALch An lu ct nh thJ noX 1/ (hCp hn vL t#i An lu 6" cm ,/ (hCp hn vL t#i An lu 5" cm c/ C1o hn vL t#i An lu 7" cm A/ C1o hn vL t#i An lu " cm / o) cK ct An lu- Iq cho o) n?m t thJ no D ALch thot #1 Aw v nh1nhX 1/ )ghing v; phi1 Fh%ng cK An lu ,/ )ghing v; phi1 cK An lu c/ )?m ng1- thoi mi A/ ( thJ no o) cm thC& thoi mi nhCt 7/ qn lu phPng ng^1 thTng c #tt 31u mC& giTX 1/ 5-5s giT ,/ 5s-8 giT

c/ ghi thC& Fh%ng cPn ALch #1 A/ ghi o) hJt 1u 5/ ID ch=n An lu c Fh% v Fh%ng ,L #m l- Iq cn chm 3KcX 1/ (h1& ,ng ch=n An lu mi ng& ,/ (h1& ,ng ch=n An lu mi s giT c/ (h1& ,ng Fhi ALch thCm $t ,ng A/ (h1& ,ng Fhi cK & l@nh !/ Ii;u no 31u =& tng Fhi chm 3Kc o) cK ct An luX 1/ Phi htt ALch thTng Nu&n ,/ xtt An lu ng1& Fhi thC& An lu Fh%ng #1 ALch c/ oSnh hEng lu%n ct ng1ng vL t#i An lu A/ 4u%n th2o Ai ACu hi@u mCt n$c

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Chm 3Kc An lu- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e7/ / m#1nc23 qonov1n Yon1h1n Y1#i1nn2 )2igh,o#3- Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o# Clinic1l P#1ctic2
nA

Aition- ~o p1unA2#3 comp1n&- effs- eee5/

CHNG F: !NG NGC BI $$ CHwM SxC BhNH NHpN M NGC

MC TIU 1. Trnh by c gi2i ph3& lWng ngJc. 2. L$& c chA nh c-a gi2i ph3& lWng ngJc. (. 9h?" sTc c b;nh nhSn !rMc "4 ngJc. +. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4 ngJc.

1 BhNH HIC 1 1 G-^- _1`Q bM8V 8VO )g]c c to ,i Fhung Nng v 3Qn grm e Ht 3Hng ng]c- Nng Ec- Nng 3Tn v 3Qn 3Tn/ `ng EcX l Nng Ayt n?m ti thnh t#$c ng]c grm cn Ec- th=n Ec v mzm m|i FiJm/ Yi ,T ,n cK 8 Fhu&Jt 3Tn D Fh$p v$i 8 3Qn 3Tn/ `ng 3TnX grm e %i- Nng 3Tn Ai- Ayt v cong ,n lrng ng]c/ `ng 3Tn e #Vng v ngZn nhCt- mct t#n cK tnh mch A$i Pn phi1 t#$c v #Mnh Vng mch A$i Pn phi1 31u- mct A$i Fh%ng cK #Mnh 3Tn/ `ng 3Tn ee v e - u 3Tn chR cK e mct Fh$p- Fh%ng cK c+ 3Tn- c: 3Tn v gKc 3Tn/ `ng 3Tn e Fh%ng cK #Mnh 3Tn v ngZn hn Nng 3Tn ee/ pQn 3TnX nHi th=n 3Tn v$i Nng Ec Fhu&Jt 3Tn/ o& 3Qn 3Tn t#n ,m vo Nng Ec- ,1 3Qn 3Tn tiJp th2o thS ,m vo Nng Ec Wu1 3Qn 3Tn/ pQn 3Tn ee- e Fh%ng cK 3Qn l lng/ 1 $ C1 BY81 O]5 V-^- _1`Q bM8V 8VO

Cc ,@nh v; ph+iX ung th ph+i- u ph+i- lC& AL vt t#ong nhu m% ph+i- An lu p N2 ph+i/ Cc ,@nh v; mng ph+iX m: mng ph+i- t#n ALch h1& t#n mu mng ph+i/ o@nh v; timX ,@nh v1n tim- A& Ainh mng tim- gh\p tim- thot vL c honh ChCn thngX chCn thng ng]c- t#n mu mng ph+i- vn t#ung thCt- th:ng ph+i

$ CHwM SxC BhNH NHpN TRC M $ 1 N1c8 BY81 BN 0ziX

+ CK ACu hi@u ho Fhc- ho #1 mu- 1u ng]c v FhK th/ + (i;n 3 htt thuHc lX thTi gi1n M htt- 3H lng iJu thuHc htt t#ong ng&/ + o@nh lG Fm th2oX 1u ng]c- ,@nh tim- ,@nh ph+i- tiDu Tng
-

ghmX

+ (Snh t#ng h% hCpX tn 3H th- nh gi FiDu th- o) FhK th FiDu no/ 0u&Jt p nh thJ no- mch nh1nh h1& chm- tSnh t#ng tim ph+i o) v$i mEc V p Eng Fhi nghR ngiFhi 3inh hot/ + )gh2X ph+i D nhn Lnh cTng V tiJng th nhBng vhng Fhc nh1u- ngh2 tim D pht hi@n cc ACu hi@u ,Ct thTng/ + )hSnX t+ng t#ng o)- A1 nim- 3] c=n Hi c:1 lrng ng]c- FiDu th + pTX nh gi =m th- #ung th1nh- #ung miu- nhLp p mzm tim/ + [X nh gi tiJng g ,Ct thTng/ $ $ C1Q8 dY BN 0Pk|O :n Inh gi chEc nng h% hCp- tim mch t#$c m+X ACu hi@u FhK th- tSnh t#ng thiJu oN&#Hi lon vn mch (h]c hi@n o phJ Aung FJ- ` Wu1ng tim ph+i- i@n t=m r- 3iu =m tim- Fhi mu Vng mch- N\t nghi@m mu- ion r/ (h]c hi@n c%ng tc t tng cho o)- h$ng An o) tp th t#ong thTi gi1n hu phu/

Cho o) ngng thuHc l t#ong vPng mVt tun t#$c m+- h$ng An o) cch th 3=u- tp th gitp tng cTng chEc nng t#1o +i Fhi ph+i/ gh%ng cho o) vhng FhKi ,Qit#nh tiJp Ntc v$i ngTi ,L ctm- nhiwm t#hng h% hCp/

)=ng c1o t+ng t#ng Hi v$i o) 3u& Fi@t/ (h]c hi@n Fhng 3inh r th2o & l@nh/ (h]c hi@n & l@nh i;u t#L AEt iDm cc nhiwm t#hng Fhc/ Chuln ,L o) mVt ng& t#$c m+X cho o) tZm #1 3ch 3 nn tZm v$i Aung ALch 3t t#hng ph1 loMng/ Co l%ng nch v ng]c vo ,u+i 3ng t#$c m+/ png ng& t#$c m+ n nhy Aw tiu- chi;u tHi ng& t#$c m+ v 3ng h%m m+ nhLn n hon ton/ (hQt tho v tim thuHc 1n thn th2o & l@nh m t#$c m+- ngng cc thuHc i;u t#L Ai hn th2o & l@nh/ (h2o Ai 3t q0p(- cho o) gcp ngTi nh v th]c hi@n thuHc t#$c m+ th2o & l@nh/

$ F C18 B/S8 }t O58 01-A_ D 2.3.1. ?:*o $0i kh gim 8o t0n thng tim 3h0i vJ $cng thd khGng thGng 8o tfc nghln [itp o) t#nh cc chCt Fich thich phJ Wun nh cCm htt thuHc mVt tun t#$c m+- t#nh FhKi ,Qi v mhi o) ,L AL Eng/ Cho o) uHng nhi;u n$c gitp loMng m/ qn lu t thJ gitp thot ALch Aw Ang/ (h]c hi@n thuHc gin phJ Wun th2o & l@nh/ Cho o) th oN&- ngh2 g ng]c D 3o 3nh t#$c v 31u m+/ (h2o Ai mu 3Zc- tinh chCt v 3H lng m nh$t/

2.3.2. D; lo lfng vT 3hng 3h3 m0 vJ t/ ch<m NSc N* m0 [ii thich cho o) hiDu v; vJt m+- An lu ng]c- phng php phu thut- tSnh t#ng 1u 31u m+/ 0$ng An o) cch ho- th 3=u 31u m+/ C%ng tc t tng gitp o) cK ni;m tin vo nhKm phu thut/ Cho o) gcp gn ngTi nh t#nh o) chong Ao lo 3 t#$c m+/

F +UH TR~NH CHwM SxC BhNH NHpN SAU M Hh H Hy( F 1 N1c8 BY81 081 0PC8V BN (+ng t#ng o)- c=n ncng- t#i gic/ Iq thlm Lnh tn 3H th- FiDu th- =m th/ )gh2 ph+i- nh gi =m ph+i/ (h2o Ai 1u- FiDu th v Ai Vng c:1 lrng ng]c/ 0@ thHng An lu mng ph+iX 3H lng- mu 3Zc- tinh chCt ALch v th2o Ai nhBng ,Ct thTng c:1 h@ thHng An lu/ vJt m+X mEc V 1u ni vJt m+- Fich th$c vJt m+ v tSnh t#ng thCm ALch/

F $ C18 B/S8 }t O58 01-A_ D 3.2.1. Kcng thd khGng thGng 8o khGng 8m ho1 khc $Jm1 N_ $* 0$ng An o) ho- hit th 3=u ngn ng^1 Nyp nhu m% ph+i h1& lC& chCt tiJt Aw Ang gitp Tng th th%ng tHt/ ghi th 3=u 5-6 ln thS Iq gitp o) ho 3=u t^ ph+i #1 c+ h.ng- Fhi ho cho o) %m gHi vo ng]c t#n vJt thng D n=ng n c v gitp o) Fh%ng 1u/ (h]c hi@n thuHc gim 1u thTng Nu&n th2o & l@nh/ Cho o) n?m t thJ mol2#- th1& +i t thJ mi giT D ph+i giMn n : v gi1 tng t$i mu ph+i- gitp tim tHng mu Aw Ang/ )gh2 ph+i t#$c v 31u Fhi th 3=u v ho D nh gi tSnh t#ng th%ng Fhi/ (h]c hi@n An lu t thJ cho o)- v lng D long m/ (h2o Ai mu 3Zc- tinh chCt m- th=n nhi@t- 1u ng]c v ngh2 ph+i D pht hi@n 3$m tSnh t#ng nhiwm t#hng/ (h]c hi@n t#u&;n ALch cho o) D t#nh tSnh t#ng mCt n$c/ 4u%n ,n o) gitp o) 1n t=m- gim lo lZng/

3.2.2. . ! gim kh n<ng t:*o $0i kh 8o 8bn l mJng 3h0i ch* hi% ) Im ,o h@ thHng An lu mng ph+i th%ng- v% Fhuln- Fin v mVt chi;u/ (h2o Ai ch& mu t#ong ,Snh chE1 ALch nJu An lu #1 mu nhi;u hn e""ml}giT Iq cn ,o cho op ng1&/

Cung cCp oN& cho o)- ngh2 ph+i -7 giT}ln D nh gi Tng th/ (h2o Ai Fhi mu Vng mch D nh gi tSnh t#ng oN& t#ong mu cK : Fh%ng/ (h2o Ai ,iJn chEng t#n Fhi- t#n mu mng ph+i Wu1 th ngZn- nh1nh n%ng- FhK thho- thiJu oN&/ Chm 3Kc h@ thHng An lu mng ph+i ',i chm 3Kc o) cK An lu mng ph+i*/

; +UH TR~NH CHwM SxC BhNH NHpN SAU M Hh TIM MCH ; 1 N1c8 BY81 081 0PC8V BN (#i gicX o) tRnh- l m- m- ,Ec #Et- vt vM/ q0p(X mch- hu&Jt p- nhLp tim- ngh2 tim D nh gi tSnh t#ng ,Ct thTng- o C[ lin tQc/ (h2o Ai lng n$c NuCt nhp- mu 3Zc v nhi@t V A1/ (Snh t#ng phh- tSnh t#ng FhK th- ACu hi@u thiJu oN&/ qCu hi@u NuCt hu&Jt- ACu hi@u mCt n$c h1& th^1 n$c- ion r/ (Snh t#ng 1u ni vJt m+- thCm ALch/ 0ot Vng c:1 An lu/

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. D; :i lon n"c vJ $i%n gii N* m0 8o mt 89ch vJ m qLch t#u&;n v c=n ,?ng i@n gii lm th1& +i t#i@u chEng c:1 h@ tim mch- ALch t#u&;n nh hng Jn 3] tHng mu c:1 tim vS v& nn Au& t#S ALch t#u&;n -! ng& u 31u m+ gitp gim thD tich mu v n=ng hu&Jt p cho o)/ (h^1 ALch cK thD N& #1 Fhi t#u&;n Wu nh1nh- o) cK ,@nh mMn tinh h1& o) gi/ (hiJu ALch lin Wu1n Jn t#u&;n ALch chm- ,h Fh%ng :- mCt n$c t#$c m+ t#ong m+ v 31u m+ Ao Ki- ch& mu- An lu/ [im F1li cK thD Ao thi Wu1 n$c tiDu- Hng th%ng A A&- o) ch1 c cung cCp thm F1li/ Iq ghi cht cln thn vo hr 3 v; tSnh t#ng #Hi lon i@n gii t#n l=m 3ng c|ng nh t#n FJt Wu N\t nghi@m/

4.2.2. D; tfc mch m 8o khGng vn $Ing N* m0 p] hSnh thnh cQc mu %ng 31u m+ Ao tng 3n NuCt tiDu cu- tng mEc lu hnh c:1 glucoco#ticoiA- Ao Fh%ng vn Vng- Ao t thJ/ [im t$i mu thTng N& #1 o) ,\o phS- N vB1 Vng mch- m+ tim/ )ghn tnh mch 3=u thTng N& #1 ngTi gi- ,\o phS/ oCt Vng l ngu& c 1 Jn nghn mch ph+i cK thD l ngu&n nh=n g=& nn nhri mu ph+i/ (p vn Vng chi A$i tich c]c- Fhu&Jn Fhich o) vn Vng e"-e ln}e- giT- cho o) m1ng v$ thun giMn- m1331g2 ch=n/ ghi cK & l@nh cho o) vn Vng th& vo tSnh t#ng ,@nh/ 4.2.3. D; ngt N* m0 8o t thP )gCt l t#i@u chEng phn N tim mch- Ao 3] gim t$i mu c:1 tim- gim ALch- thiJu mu nMo/ )gCt thTng N& #1 Ao h hu&Jt p t thJ- Ao th1& +i t thJ Vt ngVt o) gio) ,Ct Vng l=u ng&/ 0$ng An o) th1& +i t thJ D ngn ng^1 ngCt- cho o) n?m u c1o e- phtt 31u K No1& cho ch=n o) NuHng giTng- Eng A& cnh giTng rng thTi vn tiJp tQc th2o Ai tn 3H tim mch Wu1 monito#/ )Ju o) ngCt Iq cho o) ngri 3t thnh giTng- vn th2o Ai mch Wu1 monito#- o) th1n m@t Fhi Ai chu&Dn cho o) ngri NuHng ghJ h1& n;n choc ho Jn Fhi hJt m@t thS cho o) v; giTng/ 4.2.4. ;g ! c nhiOm t:Hng vPt m0 N* m0 Phi p AQng tu&@t Hi ngu&n tZc v% Fhuln t#ong chm 3Kc o) 31u m+ tim mch/ vJt m+ v% Fhuln Fh%- ,ng Fin thTng th1& ,ng vo ng& thE 7 31u m+/ IHi v$i vJt m+ Nng Ec thS th1& ,ng vo ng& thE ! 31u m+/ Iq phi tu=n th: cc phng php Fh t#hng t#ong m%i t#Tng ti Fho1- phPng/

? BIJN CHNG SAU M -

Chong/ pu& h% hCp/ q& Ainh mng ph+i/

vim ph+i- t#n ALch mng ph+i- mng tim thE pht/ )hiwm t#hng vJt m+/ pu& tim/

o GI'O DC CHO BhNH NHpN I1ng n?m vi@nX tp vn Vng t#nh tZc mch- h$ng An o) cch th v ngri A&- i li t#nh ngM Ao chong h1& ngCt Ao h hu&Jt p t thJ/ `uCt vi@nX h$ng An o) tp Anng 3inh- th2o Ai hu&Jt p thTng Nu&n- tp hit th 3=u- t#nh cng thng lm vi@c Wu 3Ec/ qinh AnngX n cc thEc n nhi;u chCt Ainh Anng- hn chJ mn- n lt- n nhi;u t#i c=& #1u Wu/ Hng thuHc tng thTi gi1n- tng li;u- tng giT/ ghi thC& ACu hi@u ,Ct thTng thS Fhu&n o) nn ngri ng1& NuHng Ct h1& ghJ Fh%ng nn cH gZng i li/ o) cK Ahng 02p1#in2 ti nh Iq nn h$ng An o) v; ACu hi@u ch& mu- cch N t#i/

CpU HqI !rNG GI' e/ vn Vng 31u m+ tim mch D chHng ngu& c gS cho o)X 1/ (hiJu mu c tim ,/ )ghn mch mu tim c/ (hu&n tZc mch A/ )hri mu tim / p1u m+ h@ tim mch Iq cn lm gS t#$c Fhi cho o) ngri A&X 1/ giDm t#1 mch ,/ Io hu&Jt p c/ Io i@n tim A/ Cho o) th oN& 7/ p1u m+ h@ h% hCp- Iq cn cho o) n?m t thJ noX

1/ p2mi mol2# ,/ Iu ,?ng- ch=n c1o c/ Iu c1o- mct nghing A/ mol2# 5/ Iq cn ghi cht cln thn i;u gS Fhi chm 3Kc o) 31u m+ h@ tim mch- )[ a (xX 1/ (Snh t#ng mch ,/ (Snh t#ng #Hi lon i@n gii c/ (Snh t#ng th^1 n$c A/ (Snh t#ng thiJu n$c !/ o) 31u m+ tim mch- Iq cn chm 3Kc vJt m+ nh thJ noX 1/ gh%ng th1& ,ng ,/ (h1& ,ng vo ng& thE 7 31u m+ c/ (h1& ,ng vo ng& thE ! 31u m+ A/ ChR th1& ,ng Fhi cK & l@nh cZt chR

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- chm 3Kc o) m+ ng]c- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- ""f-8/ / )gu&wn ghnh q- ChCn thng v vJt thng ng]c- o@nh h.c v i;u t#L ngoi Fho1 lrng ng]c { tim mch- Ii h.c < qc (P0CY- "" - 75/ 7/ q2,#1 C/ o#o1A2ll/ x23pi#1to#& p&3t2m- in Yo3,& 3 Y1nu1l o Clinic1l )u#3ingYo3,& Comp1n&- efs6e/
nA

2A-

BI $F CHwM SxC BhNH NHpN CHyN THNG !NG NGC

MC TIU 1. Trnh by c phSn loi chEn !hng ngJc v v'! !hng ngJc. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn chEn !hng ngJc.

1 BhNH HIC 1 1 C- Ok38V ChCn thng ng]c v vJt thng ng]c l loi chCn thng thTng N& #1- =& l mVt cCp cEu ngoi Fho1 lrng ng]c/ (h& vo c chJ chCn thng m o) cn tiJn hnh phu thut h1& Fh%ng nhng hu hJt o) ;u c chm 3Kc v th2o Ai chct ch/ 1 $ (1K8 b/C1.2.1. Chn thng kn qo v1 chm v$i mVt vt thD chn nh ,nh N2 hi g=& nn- chCn thng Fin ,iDu hi@n ,n ngoi #Ct it nhng cK thD nh hng t#m t#.ng Jn cc c Wu1n ,n t#ong nh vn lch- vn g1n 1.2.2. Chn $Ing 8Ii 4 loi chCn thng Fin cc ,i@t t#ong K tng ,L t+n thng Fh%ng nhBng phi1 v1 chm v$i ngoi vt m cPn phi1 Hi Ai@n/ qo l]c v1 chm mnh- tng ,L lZc l lui t$i t#ong Fhung Nng ,1o ,.c Nung Wu1nh- nJu l]c chCn thng Wu mnh cK thD N\ #ch ch ,m c:1 tng v cc mch mu l$n/ 1.2.3. ^Pt thng Nfc qo mVt vt =m h1& Nu&n Wu1 A1- Wu1 cc m% vo c thD/

$ +UH TR~NH CHwM SxC BhNH NHpN CHyN THNG !NG NGC

$ 1 N1c8 BY81 081 0PC8V BN 0zi c chJ chCn thng- thTi gi1n chCn thng/ Inh gi tSnh t#ng 3u& h% hCp- ACu hi@u thiJu oN&- m- tinh chCt ho/ )hSnX ACu hi@u tZc nghn Tng th- tSnh t#ng Ai Vng c:1 thnh ng]c gim- tSnh t#ng tim ti u m%i chEng tz thiJu oN& Jn cc m%/ )gh2X =m phJ ,o gim h1& mCt- tiJng tim N1 Nm t#ong hVi chEng chn \p tim cCp/ pTX ACu hi@u t#n Fhi A$i A1- tiJng lo No Nng gM&/ [X =m Qc chEng tz t#n ALch mng ph+i- =m v1ng chEng tz t#n Fhi mng ph+i/ (Snh t#ng tim mchX hu&Jt p- nhLp tim- n$c NuCt nhp/ `\t nghi@mX th2o Ai Fhi mu- i@n gii- c%ng thEc mu/ `-bu1ng ng]c thng- nghing/ 0@ thHng An lu mng ph+iX 3H lng- mu 3Zc- tinh chCt ALch/ (=m lGX lo =u- 1u- ,Ec #Et/

$ $ C18 B/S8 }t O58 01-A_ D 2.2.1. . ! gim kh n<ng thd 8o $* )hn Lnh nhLp th- tn 3H th- tinh chCt th- 3] cng giMn lrng ng]c- co F\o lrng ng]c3u& h% hCp h1& th Fm th2o c h% hCp phQ/
-

PhQ gitp op ct An lu mng ph+i- chm 3Kc v th2o Ai tSnh t#ng An lu/ 4u%n m ,o Tng th th%ng- ngn ng^1 ngu& c o) #i vo tSnh t#ng 3u& h% hCp nh nghyt m- Au& t#S t thJ mol2# gitp o) Aw th/ ghu&Jn Fhich v h$ng An o) hit th 3=u- htt m nJu o) th FhP Fh Ao E .ng m nh$t/ PhPng ng^1 nhiwm t#hng Ao An lu- th m&- nVi Fhi Wun- htt m Ao K phi p AQng Fd thut v% Fhuln Fhi chm 3Kc o)/

2.2.2. . ! gim t:*o $0i kh 8o D; khGng 8m thd1 8o g2! Qng Ncn 4ng gi ACu hi@u chEng tz o) gim 3] t#1o +i Fhi ,iDu hi@n Wu1 3] ,Et #Et- ,rn chrn- lo lZng- cnh m|i php phPng- tim ti vhng m%i mi@ng/ Cho o) th oN& th2o & l@nh- th2o Ai Fhi mu Vng mch- i@n tim- P1C - P1 /

(h]c hi@n cho o) th m& nJu o) 3u& h% hCp v gM& Nng 3Tn cK mng 3Tn Ai Vng/ (h2o Ai chEc nng thn- lng n$c NuCt nhp- thiJu oN& mMn tinh/ (h2o Ai i@n gii cK thD nh hng Jn t#1o +i oN&/ (h2o Ai nhi@t V D pht hi@n nhiwm t#hng thE pht/

2.2.3. D; khGng tng Q t $_c $Jm 4ng gi tSnh t#ng o) Fh%ng cK Fh nng ,i tiJt m- Iq gitp o) Fhc m v$i phng php thich hp nh t thJ mol2#- ho- htt m/ )n th]c hi@n thuHc gim 1u Fhi h$ng An o) ho- Fhc/ )gh2 ph+i cht G tinh chCt th- =m ph+i- ho- m/

2.2.4. D; N ! ki%t vF khGng 8m <n 0$ng An o) n nhi;u ln- nh1i Fd- t#nh D A A& cng ch$ng lm hn chJ Ai Vng c honh nh thJ o) 3 ,L hn chJ th/ Cho o) n uHng ,Snh thTng- Fh%ng Fing cB- t#nh n thEc n nhi;u Au mn/ Cho o) n?m u c1o Fhi n/

2.2.5. D; cS kh n<ng thiP 89ch 8o mt m 1 mt 89ch o) t#ong tSnh t#ng ncng cn phi th2o Ai ch& mu A A& Ao 3t#233 3inh lGh2moglo,in2- 0ct- mu 3Zc ph=n- chCt n%n Ki- ALch A A& v q0p(/ (h2o Ai ACu hi@u mCt n$c Wu1 ACu v\o A1- n$c tiDu it- lng n$c NuCt nhp/ (h]c hi@n ,h n$c- i@n gii & : v chinh Nc th2o & l@nh/

2.2.=. D; N ! gim kh n<ng vn $Ing -

Iq h$ng An o) No1& t#- ngri A&- tp vn Vng tE chi/ )n th]c hi@n thuHc gim 1u t#$c Fhi cho o) tp/

F GI'O DC BhNH NHpN 0$ng An o) cch No1& t#- cch th 3=u gitp ph+i giMn n tHt/ ghu&n o) t#nh tiJp Ntc v$i ngTi ,L vim Tng h% hCp- t#nh cm lnh- t#nh giK lh1- t#nh vhng nhi;u ,Qi v % nhiwm/

o) Fh%ng nn lm vi@c gZng 3Ec t#ong 7 thng u/ ghi v; nh thC& FhK th- 1u ng]c cn Jn ,@nh vi@n ng1&/ o) n uHng & : chCt Ainh Anng- Fh%ng Fing cB/

CpU HqI !rNG GI' e/ (h=n nhi@t tng t#ong chCn thng ng]c thTng AoX 1/ [im FhHi lng tun hon ,/ pu& h% hCp cCp c/ I1u Wu o) Fh%ng Am th A/ )hiwm t#hng thE pht / ID ng^1 ngu& c o) #i vo tSnh t#ng 3u& h% hCp 31u chCn thng ng]c Iq cn lm gSX 1/ Cho o) th oN& li;u c1o ,/ Cho o) uHng thuHc t1n m gitp Aw th c/ 0$ng An o) hit th 3=u A/ ghu&n o) nn n?m u c1o 7"" 7/ qCu hi@u no 31u =& chEng tz o) gim t#1o +i Fhi 31u chCn thng ng]cX 1/ Cnh m|i php phrng- ,rn chrn ,/ Ych nh1nh- nhLp th nh1nh- ,Et #Et c/ (h FhP Fh Fm th2o 3] hot Vng c:1 cc c h% hCp phQ A/ oEt #Et- vt vM- l m 5/ (#$c Fhi h$ng An o) chCn thng ng]c ho- Fhc m thS Iq phi lm gSX 1/ (im thuHc 1n thn cho o) th2o & l@nh ,/ (im thuHc gim 1u cho o) th2o & l@nh c/ (im thuHc loMng m th2o & l@nh A/ (Ct c ;u tng !/ Iq lm gS D gitp o) chCn thng ng]c Fh%ng ,L hn chJ thX 1/ )n n?m ti giTng- Fh%ng vn Vng mnh ,/ 4u%n th]c hi@n thuHc gim 1u- 1n thn

c/ Cho ngTi nh ,n cnh A/ gh%ng n no D A A& cng ch$ng

TI !IhU THAM KHsO e/ C1o vn (hLnh- ChCn thng v vJt thng ng]c- o@nh h.c ngoi Fho1- )h NuCt ,n < h.c- ""8- 8e/ / )gu&wn (Cn CTng- Chm 3Kc o) m+ ng]c- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- ""f- 8/ 7/ )gu&wn ghnh q- ChCn thng v vJt thng ng]c- o@nh h.c v i;u t#L ngoi Fho1 lrng ng]c { tim mch- Ii h.c < qc (P0CY- "" - 75/ 5/ q2,#1 C/ o#o1A2ll/ x23pi#1to#& p&3t2m- in Yo3,& 3 Y1nu1l o Clinic1l )u#3ingYo3,& Comp1n&- efs6e/
nA

2A-

BI $; CHwM SxC BhNH NHpN M BU GI'(

MC TIU 1. Trnh by c b;nh h#c !&y'n gi p. 2. 9h&:n b c b;nh nhSn !rMc "4 !&y'n gi p. (. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4 !&y'n gi p.

1 BhNH HIC 1 1 C- Ok38V (u&Jn gip l tu&Jn nVi tiJt l$n nhCt c thD- ncng e!- ! g#1m/ )Vi tiJt tH Ao tJ ,o tu&Jn gip tiJt #1 #Ct Wu1n t#.ng Hi v$i 3] tng t#ng c:1 c thD v tiJn hK1 c:1 nPi giHng/ (#ong tu&Jn gip cK #Ct nhi;u mch mu- cK !6"ml mu ch& Wu1 e"" g1m t+ chEc tu&Jn}phtt/ (hD tich tu&Jn gip th& thuVc vo Ainh Anng- gi$i tinh- tu+i- Fhi hu/ 1 $ TSO j[8V O]5 1/P:/8 0QED8 V-S_ nh hng ln chu&Dn hK1 c ,n c:1 c thD/ nh hng ln chu&Dn hK1 chCt m/ [i1 tng tiu thQ mEc V oN&/ [i1 tng chu&Dn hK1 mn/ [i1 tng ph=n h:& chCt gl&cog2n2- muHi- chCt Fhong- vit1min2/

1 F MNO B, }t OSO 0 8V1-A: Oc8 bK: .t8V 1.3.1. ZMc $I IV eX chR nhSn thC& Fhi o) nuHt/ IV X ,$u lV A$i A1/ IV 7X ,$u lV hn #1 Fhzi vPng c+/

IV 5X ,$u 31 NuHng phi1 A$i Nng Ec/

1 F $ a0 8V1-A: Oc8 bK: .t8V Io chu&Dn hK1 c ,nX ,Snh thTng l Fhong e"u - e!u- chu&Dn hK1 c ,n c1o l cTng gip- chu&Dn hK1 c ,n thCp l 3u& gip/ Chol23t2#ol t#ong mu ,Snh thTng l es"- "mgu- chol23t2#ol tng t#ong 3u& gip v gim t#ong cTng gip/ (h nghi@m hCp thu aoA2 rng vL phKng N t#ong 5 giT/ ILnh lng (/p/0 'th&#oiA 3timul1ting ho#mon2*- (7 v (5/ (/p/0X n1m 'e-8 "-ffma}l*- nB 'e-se e-"7ma}l*/ (7X n1m 'e-f8f "-!ssnmol}l*- nB 'e-ff "-! (5X !e-e!e nmol}l/ piu =m gitp pht hi@n ,$u FhK chln on- o chinh Nc thD tich tu&Jn gip- th2o Ai v nh gi FJt Wu i;u t#L/ 1 ; C1 BY81 B-RQ 0PY 8V/C- 41/5 (Ct c ,$u gip i;u t#L nVi Fho1 thCt ,i/ o$u gip thD nh=n nhu m% cn cZt ,z 3$m vS cK ngu& c ung th c1o- ,$u Vc/ o$u gip cK ACu hi@u chn \p/ ng th tu&Jn gip gi1i on u/ (hlm md/ o132Ao cK ,iJn chEng/ nmol}l*/

$ CHwM SxC BhNH NHpN TRC M BU GI'( Cn chuln ,L tHt t#$c m+ D ; phPng nhBng ,iJn chEng 31u m+/ n Lnh cTng gipX nJu 3 AQng aoA2 D i;u t#L cTng gip- Iq nn cho o) uHng v$i n$c h1& n$c t#i c=& Wu1 Hng htt 31u ,B1 n/ (h2o Ai ACu hi@u ngV Vc aoA2 nh phh n; nim mc mi@ng- tiJt nhi;u chCt nh&- n$c miJng- n%n v n%n Ki- Fich Eng A1/ )Ju cK ACu hi@u ngV Vc thS ngng uHng aoA2 ng1&- Iq ,o li cho op v ghi vo hr 3/

Inh gi tSnh t#ng tim mch- C[- p[(- ion r- 3iu =m tim- q0p( cht G nhCt l tn 3H mch/ [io AQc o) cch t] chm 3Kc 31u m+- h$ng An o) hp tc hit th 3=u- ho- tp vn Vng ch=n/ 0$ng An o) cch No1& u D t#nh cng vJt m+ c|ng nh n=ng u o) Fhi Ai chu&Dn 31u m+/

F +UH TR~NH CHwM SxC BhNH NHpN SAU M BU GI'( F 1 N1c8 BY81 081 0PC8V BN (#i gicX tRnh- l m- h1& tiJp Ntc tHt/ (Snh t#ng tun honX th1& +i mch v hu&Jt p/ (h1& +i v; mu A1 nh lnh- lm $t/ (hiJu c=n ,?ng i@n gii thTng N& #1 31u m+ tu&Jn gip- o) thTng cK ngu& c h c1lci mu/ qCu hi@u thiJu c1lci muX co git c- ACu hi@u Chvo3t2F 3 h1& (#ou3321u3th1n phi;n tSnh t#ng t- ngE1 m%i v ngKn t1&- ngKn ch=n/ (Snh t#ng h% hCpX th chm- tiJng th ,Ct thTng- ,Et #Et/ (h1n phi;n cng c+ h.ngFhK nuHt- FhK th- 1u u- ,ng Wu chct/
-

(+n thng A=& thn Finh th1nh =mX th1& +i cTng V v V v1ng c:1 tiJng nKi- mCt tiJng- gi.ng Fh1n- =m gim- tiJng thS thm/ vJt m+X thTng l vJt m+ thlm md nn cn th2o Ai ACu hi@u nhiwm t#hng- ACu hi@u ch& mu- phh n; m% Nung Wu1nh vJt m+/ qn luX th2o Ai ch& mu- thTng #tt 3$m/

qCu Chvo3t2F3 l 3] co thZt c mct p Eng v$i 3] g nhy ,?ng ngKn t1& t#n thn Finh mct phi1 t#$c t1i/

qCu (#ou3321u3 l 3] co WuZp ,n t1& g=& nn Fhi thiJu c1lci

F $ C18 B/S8 }t O58 01-A_ D 3.2.1. . ! gim t n hoJn 8o ch! m 4ng gi i@n gii- h2moglo,in- 0ct- pht hi@n 3$m ACu hi@u ch& mu/ 4C& q0p(- th2o Ai mu 3Zc A1 nim- t#i gic/ giDm t#1 ch& mu ni ,ng vJt m+/ (h]c hi@n ,ng cm mu nJu cK/ (h]c hi@n t#u&;n ALch- t#u&;n mu th2o & l@nh/

3.2.2. gi thd khGng hi% ) 8o 3hH nT th*nh ) n1 $* 8o t0n thng th*nh kh ) n N* m0 4ng gi tn 3H- FiDu th- tinh chCt th/ Pht hi@n 3$m ACu hi@u chn \p Fhi Wun Ao phh n; h1& ch& muX FhK th- th Fh%ng ;u- c+ 3ng- nuHt FhK- ch& mu vJt m+/ Inh gi mEc V h%n m- hong 3- Fich thich- tim ti/ 4u%n D 3n AQng cQ htt m- Fh1& m Fhi Wun D N t#i FLp thTi t#ong t#Tng hp chn \p th1nh Wun/ Cn chuln ,L AQng cQ cCp cEu t#$c- t#ong v 31u Fhi #tt nVi Fhi Wun/ Iq phi th2o Ai 3t h% hCp e! phtt}ln}7 giT 31u Fhi #tt nVi Fhi Wun/ Cn htt m nJu o) ch1 Fhc nh+ c/

3.2.3. D; Qo*! $ khS kh<n 8o $* vPt m0 Cho o) n?m t thJ 32mi mol2# D gitp o) Aw th/ 4ng gi 3] phh n; c:1 vJt m+- Zp lnh Wu1nh c+ nJu cK thD/

bu1n 3t cch pht =m- nh gi 1u/ `o1& u v ng]c t#nh cng vJt m+/ Cho o) tp No1& c+ t^ t^ 7-5 ln}ng&/ 0$ng An o) tp c+ nh gp- Aui- nghing 31ng ,n/ 0$ng An o) nn uHng n$c ng& u 31u m+- n thEc n m;m vo ng& thE / 0$ng An o) ngQ& t#1ng ch2 ACu 3yo ,?ng Fhn chong c+- vPng c+ t#1ng 3Ec- o c+ c1o/

3.2.4. ?h*! $0i nhn thMc 8o h c*lci m 4ng gi v th2o Ai t#i@u chEng thiJu c1lci nh chuVt #tt/ giDm t#1 ACu hi@u Chvo3t2F3 v (#ou3321u3 mi giDm t#1 vn Vng mi giT/ giDm t#1 q0p( mi 5 giT/ bu1n 3t 3] th1& +i c tinh/ )n A] t#B c1lcium glucon1t2 v AQng cQ tim tnh ,n giTng D tim ng1& Fhi o) h c1lci mu/ 3.2.5. . ! gim tiPng nSi t:ong gi*o tiP3 4ng gi cTng V v =m v1ng c:1 tiJng nKi 31u m+ e- giT D gitp nh gi 3] hri phQc c:1 A=& th1nh =m/ gh%ng Fhu&Jn Fhich o) nKi nhi;u D ngn ng^1 3] phh n; A=& th1nh =m- o) cK thD ,L Fh1n tiJng t#ong vi ng&/ (h2o Ai phh n; vJt m+/ 0$ng An o) gi1o tiJp ,?ng c i@u v cung cCp giC& ,tt D o) gi1o tiJp/ giT/

; BIJN CHNG SAU M BU GI'( Ch& mu 31u m+/ YCt tiJng- Fh1n tiJng 31u m+X thTng l tm thTi Ao phh n; 31u ct nVi Fhi Wun- Ao vim th1nh Wun 31u m+/ YCt tiJng vnh viwn Ao cZt nhm A=& thn Finh Wuct ngc/ 0 c1lci mu/

`yp Fhi Wun/ )hiwm t#hng vJt m+/ (hiDu nng gip/ Cn ,Mo gipX =& l ,iJn chEng ng 3 nhCt- ,iDu hi@n nhi@t V tng c1o- mch nh1nhhu&Jt p gim- vt vM- h%n m v t vong #Ct nh1nh nJu Fh%ng cCp cEu FLp thTi/ PhPng ng^1 phi th]c hi@n thuHc ,Snh gip t#$c m+ th2o & l@nh/

? GI'O DC BhNH NHpN 0$ng An v gii thich cho o) ,iJt cc ACu hi@u v t#i@u chEng c:1 nhc gip- cTng gip v h c1lci mu/ [ii thich cho o) ,iJt tn thuHc- tc AQng- li;u lng- chR Lnh thTng Wu& v tc AQng phQ c:1 thuHc ho#mon2 tu&Jn gip/ o) c i;u t#L +n Lnh tu&Jn gip t#ong thTi gi1n m+- i;u t#L 31u m+ hon tCt ,i vi@c uHng thuHc Fhng gip t^ e- thng D +n Lnh tu&Jn gip v v$i aoAin2 t#ong 8-e" ng&/ CZt nhm tu&Jn phK gip h1& t+n thng tu&Jn phK gip g=& gim c1lci t#ong mu v co git/ oo cho o) ,iJt v; 3] t+n thng th1nh Wun t#ong 3uHt thTi FU m+ vS o) 3 ,L mCt tiJng- Fhn tiJng Ao li@t A=& th^ng th1nh =m/ pu& gip vnh viwn 31u mVt nm Fhi cZt ,z ,n phn tu&Jn gip o) ,L o132Ao/

CpU HqI !rNG GI' e/ oiJn chEng 31u m+ ,$u gip l cZt nh?m tu&Jn phK gip h1& t+n thng tu&Jn phK gip 3 g=& nh hng gS cho o)X 1/ 0 Tng hu&Jt ,/ 0 c1lci t#ong mu c/ Co git v Vng Finh A/ 0 g1li t#ong mu

/ oiJn chEng no 31u =& ng 3 nhCt 31u Fhi m+ ,$u gipX 1/ Cn ,Mo gip ,/ `yp Fhi Wun c/ YCt tiJng A/ (hiDu nng gip 7/ oiDu hi@n c:1 cn ,Mo gip lX 1/ Ych gim- hu&Jt p tng c1o- nhi@t V tng ,/ )hi@t V gim- hu&Jt p gim- mch gim c/ )hi@t V tng c1o- mch nh1nh- hu&Jt p gim A/ Ych tng- hu&Jt p tng c1o- nhi@t V tng 5/ o) cK 3 AQng aoA2 D i;u t#L cTng gip t#$c m+- Iq cn h$ng An gS cho o)X 1/ Hng v$i n$c h1& n$c t#i c=& Wu1 Hng htt t#$c ,B1 n chi;u ,/ Hng v$i n$c h1& n$c t#i c=& 31u ,B1 n c/ Hng v$i n$c h1& n$c t#i c=& t#$c ,B1 n 3ng A/ Hng v$i n$c h1& n$c t#i c=& Wu1 Hng htt 31u ,B1 n !/ p1u m+ ,$u gip Iq cn h$ng An cho o) n?m t thJ no D gitp o) Aw thX 1/ ( thJ 32mi-mol2# ,/ Iu thCp- ng1 c+ tHi 1 c/ Iu ,?ng- F gHi A$i v1i A/ ( thJ mol2#

TI !IhU THAM KHsO e/ )gu&wn 0oi )1m- o@nh ,$u gip- o@nh h.c v i;u t#L ngoi Fho1- Ii h.c < qc (P0CY "" - ef8/ / )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc o) m+ ,$u gip- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- 75/ 7/ 4inA1 o/ 0113- nAoc#in2p#o,l2m- ch1p2# 58- 32ction s- Y2Aic1l pu#gic1l )u#3ing- ou# Aition- 42i3 Colli2# 02itF2mp2#}Ypo<- eff - e5fe/

BI $? CHwM SxC BhNH NHpN Cx M KH +UsN 6TRACHOTOMH@

MC TIU 1. L$& c nh nghPa "a kh< %&2n. 2. L$& c + li <ch c-a "a kh< %&2n (. Trnh by c c c !r.ng hp "a kh< %&2n. +. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn cT "a kh< %&2n.

1 "NH NGHA Y Fhi Wun l mVt vJt #ch Fhi Wun to #1 mVt l m t^ Fhi Wun #1 A1 v ct c1nul2 g#i31,2#g tm thTi h1& vnh viwn vo v cho ph\p Fh%ng Fhi i Wu1- gitp lC& chCt tiJt h1& AL vt Fhi Wun/ )i m thTng Ht - 7- 5 vPng 3Qn Fhi Wun/

o) cK m Fhi Wun 'httpX}},vngu&2nt#iphuong/com/vn*

Y Fhi Wun 'httpX}},vngu&2nt#iphuong/com/vn*

Y Fhi Wun

$ CH "NH M KH +UsN o) th Wu1 Tng th nh=n to t#ong thTi gi1n Ai/ (Zc nghn Tng h% hCp t#n/ Ch& mu Tng h% hCp t#n/ YCt Fh nng ,i tiJt m nh$t Tng h% hCp A$i/ o@nh uHn vn- ,ch hu- ,i li@t thD hnh nMo/ o) t+n thng Ao nVi Fhi Wun v 1u/ )g^ng th Fhi ng:/ (+n thng th1nh Wun h1& Fhi WunX Ao u h h.ng/ Phzng Tng th/ ChCn thng c+ v th1nh WunX g=& Ap nt v phh n;/

F !rI CH Y Fhi Wun gitp gim c Fhong chJt 'e!" ml*/ [itp o) th Aw Ang- hi@u Wu/ qw Ang lC& AL vt- htt m nh$t/ qw lZp m& th/

C1nul2 g#i31,2#g 'httpX}}gi1ngAuong&Fho1/n2t*

Y Fhi Wun nPng 'ti li@u chm 3Kc ngoi c:1 oY nm effs*

; THC HIhN +UH TR~NH CHwM SxC ; 1 BN : 41\ uQ^8 O{ d{8V O18 CK chR Lnh t#ong th m& v ,o v@ Tng th th%ng thng giB1 Tng th t#n v Tng th A$i/

[itp chCt tiJt- thEc n Fh%ng l.t vo Fhi Wun nhng nK Fh%ng th1m gi1 giB Hng m Fhi Wun/ ghi ,m ,ong chn 3 Fin 3] th%ng thng giB1 Hng ngoi c1nul2 v thnh Fhi Wun/ p l]c t#ong ,Kng chn Fh%ng vt Wu "cm0 / Cn th2o Ai tSnh t#ng chn \p thiJu mu nu%i ti thnh Fhi Wun/

; $ SQE V-^: 41^ 898V 0P5/ Bn- 41\ )gu&n nh=nX + 0it mu vo Tng th- m nh$t vhng hu h.ng- hit chCt n%n Ki/ + (ng tiJt m nh$t Fhi phJ Wun/ + YCt Fh nng ho v hit th 3=u/ + 0n chJ giMn n lrng ng]c t^ 3] ,Ct Vng/ + qo nhBng ngu&n nh=n FhcX ,\o phS- mCt n$c- vim ph+i- t#n Fhi/ C1n thi@p IqX + )g1& 31u Fhi m Fhi Wun Iq phi htt m nh$t thTng Nu&n nn htt !-e" phtt}ln t#ong 7-5 giT u/ + 4ng gi nrng V oN& t#ong mu/ + Inh gi tSnh t#ng tZc nghn m nh$tX ACu hi@u FhK th- tim ti + )gh2 ph+i t#$c v 31u Fhi htt m/ + o) lu%n n?m t#ong tm nhSn c:1 Iq 5} 5 giT/ + 0tt mX nn cung cCp oN& t#$c v 31u Fhi htt m/ ng htt nhz hn hocc ,?ng }7 Tng Finh c1nul2- thTi gi1n mi ln htt Fh%ng Wu e"-e! gi=&/ + )gng htt ng1& Fhi o) cK ACu hi@u 3u& gim h% hCp- t#ong ltc htt cho o) ,L nghyt m m cK ACu hi@u thiJu oN& thS Iq cung cCp oN& ng1& Fhi htt ,?ng ! hi Ai Wu1 ,Kp ,ong oN& lm/ + Cung cCp cho o) oN& lm t#nh ,iJn chEng Fh% ph+i- Nyp ph+i/ qu& t#S : V lm D loMng m gitp htt m Aw Ang- nJu cn thS ,m vo c1nul2 !-e" ml n$c muHi 3inh lG t#$c Fhi htt m/ + )n cho o) tp vt lG t#L li@u lrng ng]c th& th2o tSnh t#ng o) v lG Ao m Fhi Wun/

+ o) th m& h1& i;u t#L th ngZt WuMng nn Ahng c1nul2 cK ,ong chn- thTng p l]c ,ong chn Fh%ng Wu ! cm0 h1& " mm0g/ + (h1& +i t thJ thTng Nu&n cho o)/ + Cung cCp : oN& cho o)/ + Cung cCp : n$c cho o)/ + qu& t#S nhi@t V ,Snh thTng/ ; F T81 0PC8V 81-: 0PU8V _1n- j/ b : 41\ uQ^8 P5 j5 )gu&n nh=nX Ao htt m Fh%ng m ,o v% Fhuln- th1& ,ng Fh%ng v% Fhuln- vim nhiwm chung Wu1nh ch=n A1 A$i c1nul2 Ao lm $t/ C1n thi@p IqX + (h2o Ai q0p(- nhn Lnh mu 3Zc m- th2o Ai 3Hc- ch& mu- 3u& h% hCp- ,iJn chEng c:1 m Fhi Wun/ + 4ng gi vJt thng t#ong 3uHt mi tu1 t#]c v ghi hr 3 cln thn v; ch& mu- m:tSnh t#ng m% Nung Wu1nh- Wu1n 3t A1 A$i c1nul2/ + Chm 3Kc c1nul2 mi Fhi lm $t h1& mi tu1 t#]c- th1& ,ng Fhi lm $t/ + x1 nPng t#ong mi 5 giT/ + Im ,o v% Fhuln Fhi htt m/ + Chm 3Kc 31u Fhi ctX Wu1n 3t ch& mu- mch p c1nul2/ (#nh Ahng ,Snh phun,Vt phCn- Iq ch2 gc hocc giC& mzng cK chE1 cotton- t#nh D o) hit ngoi vt vo Tng th- cln thn Fhi co #=u h1& cZt tKc cho o) t#nh l%ng tKc #$t vo Fhi Wun + qhng gc ch2 ch=n Ygb nn cZt t#$c h1& Ahng gn Fh%ng ,L t1 chR/

Ygb cK ch2 gc lm lm 'httpX}}gi1ngAuong&Fho1/n2t*

[c ch2 ch=n Ygb 'httpX}}gi1ngAuong&Fho1/n2t*

; ; NVQE O3 .0 O58Qb CVt A=& cK gtt- V cng c:1 gtt v^1 : D c ngKn t1& giB1 A1 v A=& cVt/

(#nh D gtt cVt vhng Vng mch cnh h1& g& o)/ bu1n 3t A1 cK AL Eng A=&/ (#ong t#Tng hp ,L 3tt c1nul2 Iq nn g.i ngTi Jn gitp rng thTi Ahng F;m ,1nh #Vng l m- cho th oN& h t# t#$c Fhi cK ngTi Jn ct li c1nul2 m$i/ (h2o Ai 3t h% hCp o)/

; ? BN b/ b8V }R dA81 0c0 O]5 :81 4ng gi mEc V lo lZng c:1 o)/ [ii thich cch htt m to 3] t] tin cho o)/

; o BN 41T8V V-5/ 0-D_ BkvO d8V b2o) Fh%ng gi1o tiJp ,?ng lTi c nn cung cCp cho o) cc AQng cQ gi1o tiJp nhX giC&,tt- phCn- ,ng- chu%ng g.i/ CK thD gi1o tiJp Wu1 cc ACu hi@u- o) cn c h.c tp i@u ,V t#$c m+/ Chm 3Kc hri phQcX h$ng An o) Ahng t1& ch2c1nul2 D nKi nhng cln thn Fh%ng th]c hi@n v$i nhBng ,@nh ncng- FhK th/ ; NVQE O3 .QE j-81 jkl8V j/ : 41\ uQ^8 Pht hi@n 3$m ACu mCt n$c- 3u& Ainh Anng/ (#u&;n ALch- n Wu1 tu,2 42vin2 h1& ,?ng mi@ng/ C=n o) mi ng& v th2o Ai lng n$c NuCt nhp/ Chm 3Kc hri phQcX nh gi Fh nng nuHt/

)Ju o) n Wu1 tu,2 42vin2 nn ,m ,ong chn t#$c Fhi n v N ,Kng 31u Fhi n e! phtt/ o) phi n?m u c1o Fhi n v giB t thJ K 31u Fhi n/ )Ju o) ,@nh ncng- h%n mX nn cho thEc n nhz gi.t Wu1 Hng th%ng A A&/ giDm 3ot v cung cCp Ainh Anng : cho o)- gitp o) ngon mi@ng nn cho o) nginhSn- nJm thEc n t#$c Fhi n/ Cho o) uHng nhi;u n$c gitp loMng m/

; > +Q^8 bz 41- BN Q0 }-A8 Phi h$ng An o) v gi1 Snh ,iJt cch chm 3Kc c1nul2 ti nh grmX th1& ,ng- htt m- th1& nPng t#ong- th1& A=&- n Wu1 Hng th%ng A A&/ o) phi ,iJt ni t# li ti Fhm/

; Tc_ O1/ BN 0Pk|O 41- P0 O58Qb ghu&Jn Fhich v h$ng An o) th1m gi1 t] th Wu1 m|i/ Iu tin nn cho o) ch2 c1nul2 !- " phtt th& thuVc vo tSnh t#ng h% hCp- t] tin c:1 o)/ p1u K tng An thTi gi1n/ (h2o Ai tSnh t#ng oN& mu c:1 o)/ Chuln ,L v #tt c1nul2X + 4ng gi Fh nng th- hi@u Wu ho- phn N nuHt/ + oo cho op ,iJt ,Ct FU t#i@u chEng ,Ct thTng no/ + Ch2 li l Ygb v gi1 tng thTi gi1n/ + Chuln ,L AQng cQ cCp cEu h% hCp/ + xtt c1nul2/ (h2o Ai h% hCp o) 31u #tt/ + Ch2 li l m- FiDm t#1 v th1& ,ng mi ng&- Wu1n 3t cc ACu hi@u nhiwm t#hng/

? BIJN CHNG: PhPng ng^1 v N t#i cc ,iJn chEngX (Zc nghn Tng th Ao cQc mu %ng t#ong nhBng giT u 31u m+X t#ong gi1i on n& Iq htt m mi !-e" phtt}ln D t#nh mu cQc lm tZc nghn Tng th/

Ch& muX thTng cK ngu& c ch& mu t#ong nhBng giT u 31u m+- th2o Ai 3H lng mu ch& v ,o op/ (Zc nghn Tng th Ao m nh$tX htt m nh$t thTng Nu&n v nn ngh2 ph+i t#$c v 31u Fhi htt m/ (#n Fhi A$i A1X th2o Ai FhK th- tiJng n+ A$i A1- A1 phh n;/ )hiwm t#hng ch=n YgbX #1 3ch vJt thng v th1& ,ng Fhi lm $t/ vim ph+iX htt m ,o m h@ thHng htt m v% Fhuln- h$ng An o) hit th 3=u- v@ 3inh #ng mi@ng 3ch 3/ qP Fhi Wun { th]c WunX o) n 3cc- FhK th/ 0yp Fhi WunX thTng NuCt hi@n o) ct c1nul2 l=u ng&/ oiDu hi@n FhK th- nKi FhKth cK tiJng #it/ ptt HngX Iq Ahng F;m ,1nh #Vng vJt thng ni Ygb- cho o) th oN&- g.i ngTi Jn gitp- chuln ,L ,V Ygb v phQ gitp op ct li/ (h2o Ai 3t h% hCp 31u Fhi ct li/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810 e/ Ii;u no 31u =& tng Fhi nKi Jn ,Kng chn c:1 YgbX 1/ (h1m gi1 giB Hng m Fhi Wun ,/ p l]c ,Kng chn l 7"mm0g c/ ` ,Kng chn t#$c Fhi cho o) n A/ ` ,Kng chn 31u Fhi o) n e! phtt / o) cK Ygb- Fhi chm 3Kc Iq cn lu GX 1/ (h2o Ai th=n nhi@t thTng Nu&n D pht hi@n 3$m nhiwm t#hng ,/ (h1& ,ng mi s giT} ln c/ 0tt m nh$t thTng Nu&n A/ gh%ng cho o) n ,?ng Tng mi@ng 7/ ghi o) ,L 3tt Hng Ygb- Iq cn lm ng1&X 1/ I1 o) vo phPng m+ D ct li

,/ qhng F;m ,1nh #Vng vJt thng ni Ygb c/ Cho o) th oN& Wu1 m|i A/ 4p tEc i ,o op 5/ p l]C ,Kng chn c:1 Ygb lX 1/ gh%ng Wu " cm0 ,/ gh%ng Wu ! cm0 c/ gh%ng Wu ! mm0g A/ gh%ng Wu 7" mm0g !/ Ii;u no 31u =& Wu1n t#.ng nhCt Fhi chm 3Kc o) cK YgbX 1/ Im ,o Tng th lu%n th%ng ,/ (h1& ,ng phi m ,o v% Fhuln c/ 0tt m nh$t phi ,o m v% Fhuln tu&@t Hi A/ Cho o) th oN& lm

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- Chm 3Kc o) m Fhi Wun- ""f8/ / Chm 3Kc ngoi Fho1- Y Fhi Wun v chm 3Kc o) m Fhi Wun- I; n h t# h@ thHng o to "7-paqA- 0 )Vi- eff5- ee7/ 7/ AA2l2 A/ 41#g2- 423li2 A/ 0om1n- pp2# x23pi#1to#& P#o,l2m3- ch1p2# 5- 32ction sY2Aic1l pu#gic1l )u#3ing- ou# Aition- 42i3 Colli2# 02itF2mp2#}Ypo<- eff - 6"7/

BI $o CHwM SxC BhNH NHpN Cx D)N !U MNG (HI

MC TIU 1. Trnh by c chFc n?ng sinh lR "ng ph4i. 2. Trnh by c h; !hYng Yng /3n l& "ng ph4i. (. Trnh by c v !r< )!Q bi'n chFng !rong v sa& khi )! /3n l& "ng ph4i. +. 9h?" sTc c b;nh nhSn cT /3n l& "ng ph4i.

1 GIsI (H)U V SINH ! Yng ph+i grm lX l thnh v l tng- giB1 Yng ph+i cK 7 chEc nngX ChEc nng ,i tiJtX mng ph+i tiJt #1 mVt it chCt ALch lm cho l mng ph+i t#t ln nh1u Aw Ang t#ong Vng tc th/ ChEc nng hCp thuX Fhi ALch v Fhi t#n vo Fho1ng mng ph+i nJu it 3 c hCp thu- 3] hCp thu mnh nhCt l nhT mng l$i hch ,ch hu&Jt/ ChEc nng c h.cX l t#ng thi ch=n Fh%ng Fho1ng mng ph+i gitp cho l ph+i 3t vo nh1u v nhT K lu%n lu%n n #1 t$i thnh ng]c/ )K to p l]c -! cm0 Fhi th #1 v - " cm0 Fhi hit vo/ ghi ho mnh thS p l]c t#ong mng ph+i tQt NuHng t^ -5" cm0 Jn -!" cm0 v 31u K tng v.t ln 6" cm0 / vS thJ Fhi Fho1ng mng ph+i cK ,Ct FU l th:ng no c|ng lm cho Fh%ng Fhi t#n vo Fho1ng mng ph+i v lm mCt t#ng thi =m tinh- ph+i 3 co li- chEc nng h% hCp ,L #Hi lon/ l l mVt Fho1ng o/

p r cc tng t#ong lrng ng]c 'Atl13 gii phu ngTi- nm ""7*

0@ thHng An lu 7 ,Snh 'httpX}}3it23/googl2/com}3it2}ngo1iFho1l1m31ng,1igi1ng*

$ MC CH WT D)N !U MNG (HI Ii;u t#LX t#n mu- t#n Fhi mng ph+i Ao chCn thng- t#n m: mng ph+i- t#n ALch mng ph+i cK ngurn gHc cCp tinh/ Chln onX t#n ALch mng ph+i lng nhi;u Fh%ng # ngu&n nh=n m ch1 chln on c ,?ng N\t nghi@m tJ ,o h.c nn ct An lu htt hJt ALch #ri m$i chQp phim ng]c thng- nghing gitp pht hi@n 31ng thng/ PhPng ng^1 v th2o AiX 31u m ng]c hocc 31u nhBng th: thut lin Wu1n Jn lrng ng]c nh phu thut nVi 3oi lrng ng]c ChHng chR Lnh tng HiX nJu cK #Hi lon %ng mu/

F V" TR WT D)N !U -

Cc c Wu1n ngu& hiDm ;u n?m phi1 t#ong v phi1 A$i ntm vt/ )Ju v e Tng ng1ng v e Tng thng thnh hSnh chB thp Wu1 ntm vt thS gKc t#n ngoi l gKc 1n ton/ Ict An lu 3t ,T t#n Nng 3Tn A$i Fh2 lin 3Tn M ch.n/ qn lu mng ph+i t#ong chCn thng nn ct An lu lin 3Tn 5-! Tng nch giB1/ qn lu FhiX lin 3Tn Tng t#ung Pn/

vL t#i ct An lu mng ph+i 'gio t#Snh chm 3Kc ngoi c:1 oY nm effs*

; BIJN CHNG KHI WT D)N !U MNG (HI -

xch v g=& ch& mu Vng tnh mch lin 3Tn/ (#n Fhi mng ph+i/ (#n Fhi A$i / /

(+n thng cc c Wu1n t#ong + ,Qng/ Iu Hng ct vo Fhong t#Hng phn m;m A$i / //

? GII THIhU Hh THNG D)N !U ng An luX ChCt li@uX Hng A#g&l2 ,?ng chCt li@u PvC c t#ng ,?ng mVt l$p 3ilicon mzngt#n cK mVt vch cn Wu1ng A.c th2o chi;u Ai c:1 Hng- cK nhi;u vch chi1 3H #Ct ti@n cho vi@c th2o Ai/ gich th$cX t^ to Jn nhz e6 m#-76 m#- ngTi l$n thTng Ahng 3H s-76 m#/

ng nHiX Hng nHi giB1 A=& c=u v An lu/ q=& c=u nHiX tiJp v$i Hng An lu- A=& nn t#ong 3uHt- chi;u Ai 6" cm/ Ch1i hEngX Aung tich it nhCt l e lit- ch1i t#ong 3uHt v t#ong ch1i chE1 lng ALch : ngp Hng th:& tinh Ai -7 cm- ch1i phi cK vch ghi n vL/ CK nZp FinX cK Hng th:& tinh v^1 Fhit- Hng Ai ngp t#ong n$c v% Fhuln -7 cm- Hng ngZn chR i Wu1 ntt ch1i/

o NGUHN TC CHwM SxC D)N !U MNG (HI gin v mVt chi;u/ 0@ thHng Hng phi th%ng/ v% Fhuln hon ton/ An ton cho o)/

CHwM SxC D)N !U MNG (HI [iB Hng thng v Fh%ng cng- Fh%ng cho o) n?m ln/ 4u%n giB iDm nHi Fin giB1 An lu- A=& c=u- ,Snh chE1/ [iB m]c n$c t#ong ,Snh Fin- Hng Ai lu%n ngp t#ong n$c -7cm vS n$c cK thD ,Hc hi/

Ict e miJng ,ng ,n ngoi ,Snh An lu v ghi cht mEc ALch + vo- ng& giT th1& ,Snh- tn Iq th]c hi@n/ oCt FU 3] th1& +i no v; tinh chCt- chCt lng- 3H lng nn ghi v ,o co # 3H lng ALch #1 t#ong 7" phtt t#ong giT u 31u Fhi ct An lu mng ph+i- mi giT t#ong 5 giT 31u- mi giT 31u K v mi s giT Fhi +n Lnh/

bu1n 3t ,.t Fhi t#ong ,Snh v m]c n$c ln NuHng t#ong Hng th:& tinh h1& An lu mng ph+i/ )Ju Fh%ng thC& m]c n$c ln NuHng Hng th:& tinh thSX bu1n 3t nJu o) FhK th- tim ti thS h@ thHng ,L tZc/ o) vn th tHt thS ph+i AMn n tHt/ (h]c hi@n FiDm t#1 `-bu1ng ph+i/

giDm t#1 3] 3:i ,.t t#ong ,Snh FinX ,Snh thTng n$c 3 A1o Vng ln NuHng t#ong Hng th2o nhLp th c:1 o)/ I%i Fhi 3] 3:i ,.t ngZt WuMng N& #1 t#ong t#Tng hp An lu Fhi/ )hng Fhi 3] 3:i ,.t tiJp tQc v Fh%ng AEt thS Iq Nc Lnh li N2m ,Snh cPn Fin h1& Fh%ng rng thTi nn Fyp Hng li cho Jn Fhi ng^ng 3:i ,.t/ p1u K tSm iDm #P Fhi D ,ng li v ,ng cc iDm nHi- h1& cK thD th1& h@ thHng m$i ngn ng^1 #P Fhi/

)n cK monito# th2o Ai ACu hi@u 3Hng o) thTng Nu&n t#ong t#Tng hp ncng- ngh2 ph+i- Wu1n 3t lrng ng]c o) D pht hi@n ,Ct FU ,Ct thTng 3] Ai Vng lrng ng]c/ gh%ng ,1o giT n=ng c1o h@ thHng ,Snh n$c ng1ng ng]c o)- D ,Snh chEc ni 1n ton ,o m ,Snh hEng Fh%ng ,D- Fh%ng lt + v n$c t#ong ,Snh Fh%ng cn/ ghi ,Snh + n$c thS Fyp Hng ng1& li v th1& ,Snh Fhc ng1&/

ghu&Jn Fhich o) ho- hit th 3=u gitp giMn n lrng ng]c D ph+i giMn n hon ton t#nh ngu& c Nyp ph+i/ (p th !-6 ln} giT/ Cho o) n?m t thJ 32mi mol2#- nJu Fh%ng cK chHng chR Lnh nn No1& t# o) mi giT- nghing v; phi1 An lu- tp A1ng t1& mi ng& 7 ln/ ghi Ai chu&Dn h1& th1& h@ thHng nn Fyp Hng li- lu%n lu%n cK o)/ F;m to D t#n giTng

ghi ,L tuVt HngX Ahng t1& h1& gc v132lin2 Fyp Fin mi A1 li ng1& t#nh Fhi t#n vo Fho1ng mng ph+i/

)Ju cK m& htt thS gZn vo Hng ngZn/ )gTi l$n htt p l]c - " Jn - ! cm0 - t#9 2m htt p l]c -e" Jn -e! cm0 /

> RT D)N !U (hTng Fh%ng D Wu 8 giT/ xtt Fhi ph+i AMn n tHt v ALch it hn !"-e"" ml t#ong s giT/ giDm t#1 `-bu1ng thC& ph+i AMn n tHt/ 0$ng An o) hit 3=u t#ong Fhi Iq #tt nh1nh Hng #1/ gyp Fin vJt thng li ,?ng Ag#1 h1& cVt li ,?ng mHi chR v ,ng Fin vJt thng li/ Cho o) ngri A& hit th ;u- Wu1n 3t h% hCp v th2o Ai o) t#ong vi giT 31u #tt/

BIJN CHNG V TAI BIJN SAU WT D)N !U vim ph+iX h$ng An o) cch th- vn Vng- giB Cm- v@ 3inh #ng mi@ng/ `yp ph+iX h$ng An o) cch tp th 3=u !-6 ln t#ong Fhi NuCt vi@n/ )hiwm t#hng ch=n An luX th1& ,ng Fhi thCm ALch- t#nh D ALch ch& ngc vo Fho1ng mng ph+i/ )hiwm t#hng vJt m+X lu%n th1& vJt m+ v% Fhuln t#$c/ ghK th Ao A& Ainh mng ph+iX h$ng An o) cch tp th 3=u !-6 ln t#ong ng1& 31u Fhi ct c|ng nh Fhi M #tt An lu/ qP Fhi Wu1 h@ thHngX ,ng Fin cc mHi nHi v ch=n An lu- Hng Ai t#ong ,Snh chE1 phi ngp t#ong n$c -7 cm/ vn ,SnhX cn D ,Snh ni 1n ton- lu%n cK F;m t#n giTng/ ptt Hng An luX Ahng t1& ,Lt chct m\p vJt thng li v g.i ngTi h t#- ,o op/ giT giT ng1& 31u Fhi ct cho Jn

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810 e/ 0@ thHng An lu mng ph+i th%ng FhiX

1/ Y]c n$c ln NuHng t#ong Hng th:& tinh Ai ,/ Y]c n$c Eng im t#ong Hng th:& tinh Ai c/ (#ong ,Snh 3:i ,.t lin tQc th2o nhLp th c:1 o) A/ / Y]c n$c ln NuHng t#ong Hng th:& tinh Ai th2o nhLp th o) / o) cK An lu mng ph+i cn cho o) n?m t thJ noX 1/ Cho o) n?m t thJ 32mi mol2# ,/ Cho o) n?m t thJ mol2# c/ Cho o) n?m u ,?ng t#nh h hu&Jt p/ A/ Cho o) n?m u thCp ch=n c1o 7/ o) ct An lu mng ph+i- ,Snh hEng ALch 3 c th1& FhiX 1/ ghi ALch t#ong ,Snh & ,/ ghi ALch t#ong ,Snh +i mu c/ p1u 5 giT A/ ghi ,Snh & 5/ )g^1 ,iJn chEng Nyp ph+i o) ct An lu mng ph+i- Iq cn h$ng An o)X 1/ )n tp vn Vng t1& ch=n nhy nhng ,/ 4u%n giB Cm vhng c+- ng]c c/ (p th 3=u !-6 ln t#ong giT

A/ (p th 3=u 31u Fhi c #tt An lu !/ ID ng^1 AP Fhi Wu1 h@ thHng An lu mng ph+i Iq cn lm- ngoi t#^X 1/ ong Fin cc mHi nHi ,/ ong Fin ch=n An lu c/ Ch2 Fin mi@ng Hng th:& tinh ngZn A/ ng th:& tinh Ai phi ngp t#ong n$c

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- Chm 3Kc o) cK An lu mng ph+i - ""f- !s/

/ Chm 3Kc ngoi Fho1- Chm 3Kc An lu mng ph+i- I; n h t# h@ thHng o to "7-paqA0 )Vi- eff5- fe/ 7/ jo&c2 (#2mp2# Yitch2ll- 4o2# x23pi#1to#& P#o,l2m3- ch1p2# 5- 32ction s- Y2Aic1l pu#gic1l )u#3ing- ou# Aition- 42i3 Colli2# 02itF2mp2#}Ypo<- eff - 6"7/

CHNG ;: TIJT NIhU BI $ CHwM SxC BhNH NHpN M Hh TIJT NIhU

MC TIU 1. Trnh by c gi2i ph3& v chA nh ph3& !h&8! c-a h; !i'! ni;&. 2. 9h?" sTc c c c /3n l& h; !i'! ni;&. (. 9h&:n b c b;nh nhSn !rMc "4 h; !i'! ni;&. +. 9h?" sTc c b;nh nhSn sa& "4 h; !i'! ni;&.

1 BhNH HIC 1 1 G-^- _1`Q 1A 0-D0 8-AQ 0@ tiJt ni@u lin Wu1n chct ch v$i h@ 3inh AQc ,1o grmX 1.1.1. a*i thn (hn n?m 31u phtc mc t#ong + thn grm thn phi v thn t#i- thn phi thTng thCp hn thn t#i/ (hn cK chEc nng l.c n$c tiDu D thi cc chCt thi c:1 Wu t#Snh chu&Dn hK1- o thi chCt Vc- c=n ,?ng n$c v i@n gii/ )goi #1 cPn th1m gi1 vo Wu t#Snh to mu nhT chCt x2nin v #&th#opoi2tin/ 1.1.2. a*i ni% ) n )i@u Wun phi v t#i l thnh ,ng Wu1ng/ 1.1.3. DJng ) *ng CK nhi@m vQ chE1 n$c tiDu giB1 thD Jn -7 lit/ ln i tiDu- Aung tich l !" { 7"" ml- 3Ec chE1 tHi 1 cK Hng An n$c tiDu t^ thn NuHng ,ng Wu1ng- ni@u Wun Ai !cm cK 7 ch hyp K l Fhtc nHi ni@u Wun { ,D thn- ni ,Zt ch\o Vng mch chu v on t#ong

1.1.4. ;i% $o 4 on cuHi c:1 h@ tiJt ni@u cK nhi@m vQ An n$c tiDu #1 ngoi- cK 3] Fhc ,i@t giB1 ni@u o n1m v nB/ )i@u o n1mX v^1 l c Wu1n ,i tiJt n$c tiDu v^1 th1m gi1 vo h@ 3inh AQc l An tinh ALch/ )i@u o n1m Ai e6 cm grm 7 on l ni@u o ti;n li@t tu&Jn- ni@u o mng v ni@u o NHp/ )i@u o nB Ai 7 cm ch& A.c t#$c =m o v tn chng l l ngoi ni@u o n?m phn t#$c ti;n Snh =m o/ 1 $ C1 BY81 _1`Q 01Qc0 01Q,O 1A 0-D0 8-AQ 1.2.1. Cc 3hb th t h% tiPt ni% CZt thn Ao ung th thn- ch& mu thn Fh%ng i;u t#L ,o trn c- lC& 3zi thn- gh\p thn- ti to ni@u Wun- ti to ni@u o- phu thut u N ti;n li@t tu&Jn Wu1 nVi 3oi- phu thut ung th ,ng Wu1ng/ 1.2.2. Cc th( th t h% tiPt ni% 4C& 3zi ni@u Wun Wu1 nVi 3oi- lC& 3zi ,ng Wu1ng Wu1 nVi 3oi- nong ni@u Wun Wu1 nVi 3oi ,ng Wu1ng { ni@u Wun- nong ni@u o/

$ CHwM SxC D)N !U Hh TIJT NIhU $ 1 D`8 bkQ 8-AQ BC/ 4 An lu i Wu1 ni@u o- Wu1 c vPng ,ng Wu1ng vo ,ng Wu1ng D An lu n$c tiDu/ Cn tu=n th: ngu&n tZc v% Fhuln Fhi ct c|ng nh Fhi chm 3Kc- lu%n Au& t#S h@ thHng An lu Fin v mVt chi;u/ om #1 ,ng Wu1ng Fh%ng nn th]c hi@n thTng Nu&n nJu Fh%ng cn thiJt/ (#ong thTi gi1n cK An lu Iq nn gitp h@ thHng th%ng tHt- th2o Ai lng n$c tiDum ,o o) c 1n ton v ngn ng^1 nhiwm Fhuln/ Cho o) th1m gi1 chm 3Kc gitp o) Fh%ng phi;n muVn vS phi t#n c thD- l@ thuVc vo ngTi Fhc/ xtt An lu 3$m Fhi hJt tc AQng/

o) i li c nn h$ng An o) cch th2o Ai An lu- + tti chE1 n$c tiDu thng Nu&n- D tti thCp hn ,ng Wu1ng 6" cm/ v@ 3inh ,V phn 3inh AQc mi ng& v cH Lnh An lu tng t thJ/ Cho o) uHng nhi;u n$c gitp thi ccn lZng tHt/ qn lu ct A$i tun Fh%ng cn th1& Hng- An lu D l=u phi th1& Hng/

$ $ D`8 bkQ 8-AQ uQ^8 qn lu ni@u Wun i Wu1 Tng ni@u o Jn ,ng Wu1ng vo ni@u Wun Wu1 mng hSnh nVi 3oi ,ng Wu1ng/ qn lu ni@u Wun ct Fhi phu thut l ct ,n t#ong t^ ni@u Wun v An lu #1 thnh ,Qng/ qn lu ni@u Wun cK chEc nng lm nPng 31u phu thut ngn ng^1 tZc Ao phh- Ao cQc mu %ng- #tt Fhi t c mQc ich i;u t#L/ qn lu thTng c lu li 31u phu thut lC& 3zi h1& tZc ni@u Wun Ao FhHi u/ o) c n?m ti giTng t#ong thTi gi1n cK An lu ni@u Wun cho Jn Fhi cK chR Lnh i li- Iq cn th2o Ai v ,o co chinh Nc lng n$c tiDu An lu ni@u Wun v$i cc An lu Fhc- ch=n An lu cn c th1& ,ng thTng Nu&n ng^1 t+n thng A1/ 4ng n$c tiDu ,rn thn cK Aung tich Fhong 7-!ml- nJu Aung tich n& tng thS t+n thng m% thn cho nn Fh%ng c cVt Hng An lu ni@u Wun- nJu lng n$c tiDu gim phi ,o co cho op ng1&/ )Ju cK & l@nh t$i #1 nn p AQng Fd thut v% Fhuln tu&@t Hi- th2o Ai An lu it nhCt e- giT 31u ct// )$c tiDu vn cPn Wu1 Tng ni@u o Ao K Iq cn ,o co v ghi hr 3 chinh Nc lng n$c tiDu Wu1 ni@u o v ni@u Wun/ $ F D`8 bkQ dt8V uQ58V P5 j5 qn lu ,ng Wu1ng t#n Nng mu l phng php n gin nhCt v c+ N1 nhCt D chu&Dn APng n$c tiDu #1 ngoi/ CK cch mVt l g=& t ti ch- h1i l g=& m hon ton Wu1 phu thut/

qn lu ,ng Wu1ng t#n Nng mu thTng p AQng tm thTi cho o) u N ti;n li@t tu&Jn- ,m #1 cm mu- Fhi chCn thng h1& phu thut ni@u o- c|ng cK Fhi Ai hn nh ,L #P- th1& thJ An lu ni@u o- u N ti;n li@t tu&Jn ch1 phu thut c/

qn lu ,ng Wu1ng thTng An lu F\m Ao tZc c h.c ,i thnh An lu c. vo thnh ,ng Wu1ng- Ao ccn lZng- Ao mu cQc/ Chm 3Kc cln thn vhng A1 Nung Wu1nh An lu- ng^1 #m l A1 tich c]c/ )gn ng^1 Hng An lu cuVn t#Pn- Iq h$ng An o) No1& t#- vuHt Hng- ,m #1 Fhi cK & l@nh- c=u nHi NuHng thCp- cho o) uHng nhi;u n$c/ gh%ng c cVt An lu vS 3 g=& NS AP- th2o Ai ACu hi@u NS AP n$c tiDu/ o) ct l=u Iq h$ng An o) Jn c 3 & tJ th1& Hng m$i

$ ; D`8 bkQ dg 01c8 Ict t#ong ,D thn D gii Wu&Jt tZc nghn thn- ALch Wu1 An lu ,D thn l n$c tiDu/ Chm 3Kc giHng An lu ni@u Wun nhng cht G Fh%ng c cuVn Hng li- Fh%ng gi c1o ,Snh chE1- Fh%ng Fyp An lu Fhi ch1 cK & l@nh- Fh%ng t] G ,m #1/ 4u%n ct ,Snh chE1 thCp hn An lu 6"cm- ,Snh chE1 phi Fin v% Fhuln/ ghi cK & l@nh ,m #1 thS mi ln ,m Fh%ng Wu !ml n$c muHi 3inh lG- Fd thut phi v% Fhuln hon ton/ $ ? D`8 bkQ 1e 01c8 CK tinh cch phPng ng^1/ qLch #1 thTng l mu/ Chm 3Kc giHng An lu phPng ng^1/

F CHwM SxC TRC M o) c chuln ,L giHng nh chm 3Kc t#$c m+ chung nhng cn cht G th]c hi@n & l@nh ,h n$c v i@n gii cho o)/ (h2o Ai v nh gi FJt Wu N\t nghi@m chEc nng thn- ,o op ng1& nJu FJt Wu ,Ct thTng/ (h]c hi@n 1n ton cc th: thut ni@u Fho1- N\t nghi@m cn l=m 3ng/

Cung cCp th%ng tin v; phng php phu thut cho o) hiDu- cch chm 3Kc 31u m+- o) cK An lu 31u m+- t thJ n?m nghing 31u m+ v 1u/ v@ 3inh t#$c m+/ 0$ng An o) v; cch chm 3Kc ,V phn 3inh AQc- cch ngri A& i li Fhi cK Hng th%ng tiDu- 1u #t v cm gic mKt tiDu Ao cK ,Kng chn c+ ,ng Wu1ng/

; +UH TR~NH CHwM SxC BhNH NHpN SAU M Hh TIJT NIhU ; 1 N1c8 BY81 081 0PC8V BN Yu 3Zc- 3H lng- tinh chCt n$c tiDu #Ct Wu1n t#.ng t#ong vi@c th2o Ai v chm 3Kc o) phu thut h1& th: thut h@ tiJt ni@u/ q0p( cht G mch v hu&Jt p D pht hi@n 3$m ch& mu 31u m+ h1& c1o hu&Jt p l Ao 3u& thn 31u m+/ (h2o Ai nhi@t V D pht hi@n 3$m tSnh t#ng nhiwm t#hng/ bu1n 3t A1- Fhm ACu hi@u phh 31u m+/ vJt m+X tSnh t#ng 1u- ,ng thCm ALch/ qn luX 3H lng- mu 3Zc- tinh chCt ALch c:1 t^ng loi An lu/

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. ;"c ti 4t thcng N* m0 )Ju thC& n$c tiDu mu z Iq cn th2o Ai 3t q0p( vS cK ngu& c ch& mu 31u m+/ )$c tiDu Qc nh 3B1 cK thD Ao tiDu m- h1& n$c tiDu ln cn cK thD Ao 3zi/ pH lng n$c tiDu c|ng #Ct Wu1n t#.ng nJu thC& n$c tiDu it c|ng cK ngu& c 3u& thn 31u m+/ o) cK Hng th%ng tiDu phi th2o Ai lng n$c tiDu mi giT- o) t] tiDu thS nh gi 3H lng n$c tiDu t#ong ng&/ p1u m+ 6-s giT m o) Fh%ng cK n$c tiDu thS Iq phi thm Fhm N2m cK cu ,ng Wu1ng Fh%ng v ,o op/ (h2o Ai tinh chCt v mhi c:1 n$c tiDu D pht hi@n 3$m tSnh t#ng nhiwm t#hng/

4.2.2. D; cS ng ! c ch! m N* m0

(h2o Ai tSnh t#ng ch& mu Wu1 n$c tiDu- ALch An lu- vJt m+/ )Ju n$c tiDu mu z Fm th2o mu cQc- Iq o li mch- hu&Jt p v ,o op ng1&/ (h2o Ai ACu hi@u thiJu mu nh A1 N1nh- ni@m nht- Wu1 FJt Wu N\t nghi@m hu&Jt h.c/

4.2.3. D; cS ng ! c N ! ki%t N* m0 (h2o Ai c=n ncng/ Cho o) n th2o chJ V ,@nh lG- n lt- uHng nhi;u n$c/ (#ong mVt 3H t#Tng hp o) cn cK chJ V Ainh Anng cc ,i@t/ o) n uHng F\m cK thD nu%i n Wu1 3onA2 A A&/

4.2.4. K* vPt m0 (h2o Ai mEc V 1u- 1u Ao vJt m+ h1& 1u Ao An lu thTng lm cho o) Fh%ng Am th vS v& cn th2o Ai 3t tSnh t#ng h% hCp nh FhK th- thiJu oN&- th c h% hCp phQ Ao 1u/ Cho o) n?m t thJ gim 1u nh nghing nhy Wu1 vJt m+- ngri A& thTng Nu&n- hit th 3=u/ (h]c hi@n thuHc gim 1u cho o)/

4.2.5. D ti c3 8o D; khS ti N* m0 Phu thut Tng ni@u thTng o) cK An lu ni@u o- vi ng& 31u m+ 3 c #tt/ o) t] tiDuX Iq gitp o) tiDu tng t thJ- Fin o/ o) tiDu FhKX Iq gitp o) t] tiDu c Wu1 cc Fd thut nh ngh2 tiJng n$c ch&- Zp Cm vhng t#n Nng mu o) tiDu Wu1 th%ng tiDuX chm 3Kc h@ thHng th%ng tiDu v ,V phn 3inh AQc mi ng&- c=u nHi v% Fhuln v 1n ton/ Cho o) uHng nhi;u n$c/

4.2.=. DXng c<ng ch"ng 8o cn 4Jng ) *ng1 8o li%t : It p1u m+ thTng o) cng ch$ng ,Qng Ao cK cu ,ng Wu1ng hocc ngu&n nh=n ph+ ,iJn hn l li@t #uVt 31u m+/ Iq cn thm Fhm D pht hi@n cu ,ng Wu1ng- tSm ngu&n nh=n v h$ng gii Wu&Jt D gitp o) thoi mi Aw chLu vS FhK chLu c|ng cK ngu& c g=& ch& mu 31u m+/

(h2o Ai nhu Vng #uVt- cn 1u ,Qng- tSnh t#ng cng ch$ng ,Qng/ Cho o) ngri A&- hit th 3=u- ho/ ghi cK nhu Vng #uVt cho/ Cho o) n?m t thJ mol2#- ct tu,2 42vin2- th%ng t#]c t#ng th2o & l@nh/

? GI'O DC BhNH NHpN (i ,@nh vi@nX h$ng An o) uHng nhi;u n$c- hn chJ thEc n Aw to 3zi nJu o) m+ 3zi ni@u- tp th vS hn chJ th 3 cK ngu& c E .ng ALch ph+i- v@ 3inh ,V phn 3inh AQc- th2o Ai mu 3Zc n$c tiDu/ `uCt vi@nX Fhi o) m1ng An lu v; nh- Iq h$ng An o) cch chm 3Kc Hng- cch i li D t#nh 3tt Hng/ (i Fhm th2o lLch hyn D #tt Hng h1& th1& Hng/ n uHng ,Snh thTng- uHng nhi;u n$c/

CpU HqI !rNG GI' e/ ghi chm 3Kc o) cK An lu ,D thn- Iq cn lu GX 1/ om #1 mi ln th2o & l@nh Fh%ng Wu e" ml n$c ,/ om #1 mi ln th2o & l@nh Fh%ng Wu !ml n$c muHi 3inh lG c/ om #1 mi ln th2o & l@nh Fh%ng Wu e" ml n$c muHi 3inh lG A/ om #1 mi ln th2o & l@nh Fh%ng Wu ! ml n$c / Ii;u no 31u =& tng Fhi chm 3Kc o) cK An lu ni@u WunX 1/ CVt An lu th2o & l@nh ,/ om #1 An lu thTng Nu&n D t#nh nghyt c/ ghi ,m #1 phi cht G lng n$c v% nhi;u hn lng n$c #1 A/ (hTng Nu&n chm 3Kc D t#nh t+n thng A1 7/ ID th2o Ai v chm 3Kc o) 31u phu thut h@ tiJt ni@u tHt- Iq cn nhn Lnh vCn ; Wu1n t#.ng no 31u =&X 1/ (Snh t#ng ch& mu Wu1 ni@u o

,/ (Snh t#ng h Tng hu&Jt c/ pH lng n$c tiDu A/ 0ot Vng c:1 cc Hng An lu 5/ qn lu ni@u Wun lX 1/ ID An lu mu v n$c tiDu ,/ CK chEc nng lm nPng c/ 4 phng php An lu n$c tiDu hi@u Wu nhCt A/ Ict D th1& thJ An lu ni@u o !/ o) tiDu FhK 31u m+ h@ tiJt ni@u- Iq cn gitp gS cho o)X 1/ Ict th%ng tiDu thTng ,/ Ict th%ng tiDu lu li c/ IZp Cm vhng t#n Nng mu A/ oo op m ,ng Wu1ng #1 A1

TI !IhU THAM KHsO e/ )gu&wn bu1ng bu&;n- [ii phu h.c gin &Ju- 0@ tiJt ni@u- )h NuCt ,n < h.c- eff5- 5 / )g% [i1 0&- )i@u h.c tp v- phu thut ni@u Wun- )h NuCt ,n < h.c- efs!- 8s/ 7/ )gu&wn (Cn CTng- Chm 3Kc o) m+ h@ tiJt ni@u- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- ""f-5e/ 5/ q2,#1 C/ o#o1A2ll- [2nitou#in1#& p&3t2m- ch1pt2# e - Yo3,& 3 Y1nu1l o Clinlc1l )u#3ingnA

2A/- Yo3,& Comp1n&- efs6- e"s8/

BI $> CHwM SxC BhNH NHpN M SqI NG NIhU

MC TIU 1. Trnh by c ng&y$n nhSn !o sdiQ y'& !Y ng&y c. 2. Trnh by c c c phng ph p lEy sdi. (. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn !rMc "4 sdi .ng ni;&. +. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4 sdi !h8n u ni;& %&2n.

1 NGUHN NHpN TO SqI 1 1 D/ Pe- b/C8 0/t8 01K8 = Pe- b/C8 O1QEg8 1{5 OSO O10 1.1.1. .Ui c*lci# cK 7 Ang tng c1lci ni@uX qo htt thuX cPn g.i l tng c1lci ni@u Ao tng tu&Jn cn gip ngu&n pht N& #1 t#n ngTi cK ,$u lnh cn gip- gM& Nng l$n- Ao ,Ct Vng l=u ng&- Ahng nhi;u 3inh tH q v co#ticoiA- Ai cn c:1 ung th Nng/ qo hCp thuX 3] hCp thu c1lci ni@u ti #uVt lm tng c1lci ni@u nhng Fh%ng lm tng c1lci hu&Jt/ (hTng cK 7 ngu&n nh=n lm gim c1lci hu&Jt l Fich thich thn ,i tiJt e/ /! q0CC 'Aih&A#oN&-c1lci2#ol* chCt lin h@ t$i hCp thu c1lci ti #uVt- t+n thng ti #uVt nh Ao FG 3inh t#hng- gim cc chCt Ec chJ FJt tinh 3zi/ (ng c1lci ni@u Ao thn/

1.1.2. .Ui oQ*l*tR )gurn ngoi 3inhX th]c phlm cK chE1 1ciA oN1lic nh #1u N1nh- c1c1o )gurn nVi 3inhX Ao FG 3inh t#hng Tng #uVt M cK 3n 1ciA oN1lic t#ong h@ tiu hK11ciA oN1lic lin h@ mt thiJt v$i chu&Dn hK1 gluciA nn thiJu 3inh tH o6 3 3inh 3zi/ 1.1.3. .Ui 3hoN3h*tR

gJt tinh n$c tiDu cK p06-s-8 v 3zi thTng FJt hp v$i nhiwm t#hng- vi Fhuln 3inh 3zi ch: &Ju l vi Fhuln g1m '-*- thTng N& #1 nhBng ngTi n ch1&/ 1.1.4. .Ui :*t (hTng p0 n$c tiDu 6/ 4ng 1ciA u#ic c ,i tiJt Wu nhi;u t#ong n$c tiDu/ )$c tiDu c% cc/ 0K1 t#L li@u ung th/ (hEc n cK chCt pu#in2 nh long z t#Eng- lPng ,P- thLt c- Fh% nZm/

1 $ Re- b/C8 0C- O1 (+n thng Ao o) n?m l=u/ .ng n$c tiDu l=u ng&/ )hiwm t#hng ni@u Kng v%i/

$ HJU T NGUH C )rng V n$c tiDu tng Ao mCt n$c An Jn FJt t:1 NuCt hi@n/ .ng n$c tiDu g=& nhiwm t#hng v 3inh 3zi/ qo chJ V n uHng cK nhi;u chCt to 3zi m o) Fh%ng uHng nhi;u n$c/ qo p0 t#ong n$c tiDu tng c1o h1& Wu thCp/ o) n?m ,Ct Vng l=u ng&/

pzi Tng ni@u 'httpX}}/thuoc,i2tAuoc/com/vn*

F IU TR" C1n thi@p c h.cX tn 3zi Wu1 3iu =m- nVi 3oi Wu1 ni@u Wun lC& 3zi- ph 3zi ngoi c thD- ph 3zi Wu1 A1/ (huHcX t1n 3zi/ (iJt chJ/ Phu thutX m thn lC& 3zi/

(n 3zi thn ngoi c thD 'httpX}}3ucFho2Aoi3ong/vn*

; +UH TR~NH CHwM SxC BhNH NHpN TRC M ; 1 N1c8 BY81 D `c Lnh cn 1uX thTi gi1n- FiDu 1u- t thJ gim 1u/ (hKi Wu2n n uHng gn =&X n nhi;u chCt cK pu#in- uHng nhi;u n$c t#i c=& h1& t# cK nhi;u chCt FJt t:1 oN1l1t2/ (huHc 1ng i;u t#L/ 0i@n tng tZc nghn Tng tiDuX nhiwm t#hng ni@u- ,Ct Vng l=u ng&- hyp ni@u Wun (i;n 3 o) cK tiDu #1 3zi/ ITng tiDuX t+ng ph=n tich n$c tiDu- ccn lZng- p0- ,ch cu- hrng cu/

YuX nrng V c1lci- pho3pho#- `-Wu1ngX chQp ,Qng Fh%ng 31 3on- go- av/

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. K* 8o t"i :t* $ thi NUi giDm 3ot cn 1uX Ahng thuHc ng:- thuHc giMn c th& tSnh t#ng o) gitp o) gim 1u/ (h2o Ai lng n$c NuCt nhp- cho o) uHng nhi;u n$c/ Cho o) i li gitp o) thot 3zi/

(n 3zi Wu1 A1 'httpX}}/tin3ucFho2/com* 4.2.2. ;g ! c nhiOm t:Hng 8o kst NUi bu1n 3t v th2o Ai ACu hi@u nhiwm t#hng ni@u nh n$c tiDu cK mu- ln cn/ (h2o Ai nhi@t V/ (h]c hi@n Fhng 3inh/ Cho o) uHng nhi;u n$c- v@ 3inh ,V phn 3inh AQc/ (h2o Ai n$c tiDuX mu 3Zc- tinh chCt- 3H lng/

4.2.3. ;g ! c mt 89ch 8o :i lon n"c Q t nh3 (h2o Ai q0p( cht G mch v hu&Jt p- n$c NuCt nhp v c=n ncng/ Cung cCp : n$c Fhi o) Ahng thuHc li tiDu- ,+ 3ung thEc n cK nhi;u g1li- t#nh thEc uHng Aw to 3zi v chCt Fich thich/ (h2o Ai ACu hi@u mCt n$c nh ACu v\o A1 Ang tinh- o) Fht n$c- tiDu it/

? +UH TR~NH CHwM SxC BhNH NHpN SAU M

? 1 N1c8 BY81 D (+ng t#ng o) 31u m+- q0p(- c=n ncng/ qCu hi@u ch& mu 31u m+/ (Snh t#ng n$c tiDuX mu 3Zc- 3H lng/ 0@ thHng An luX c=u nHi- ,Snh chE1- cK th%ng Fh%ng (Snh t#ng n$c NuCt nhp/ I1u 31u m+X vJt m+- An lu- ,Qng qCu hi@u nhiwm t#hngX Ao vJt m+- Ao nhiwm t#hng tiDu/

)Vi 3oi thn Wu1 A1 i;u t#L 3zi thn httpX}}ti2tni2uth1nhochu2/com*

? $ C18 B/S8 }t O58 01-A_ D 5.2.1. aG h3 k[m 8o D; $* N* m0 (h2o Ai 1u- tSnh t#ng h% hCp- h$ng An o) cch th/ Cho o) c Vng 3$m- ngri A&- tp th- thuHc gim 1u/ (h2o Ai q0p(- t#i gic o)- nh gi t+ng t#ng o) thTng Nu&n/ ( thJX nn cho o) n?m t thJ mol2#- t#nh ln vJt m+ v An lu/

5.2.2. Ri lon n"c Q t nh3 8o mt n"c ) * 8bn l (h2o Ai 3t n$c tiDu v; mu 3Zc- tinh chCt- 3H lng/ (h2o Ai v chm 3Kc h@ thHng An lu- cho o) n?m nghing v; phi1 An lu- ,m #1 An lu Fhi cK & l@nh/

(h2o Ai ch& mu Wu1 vJt thng- An lu/ (h2o Ai 3t lng n$c NuCt nhp gitp th2o Ai v nh gi chEc nng thn/ (h]c hi@n ,h n$c v i@n gii th2o & l@nh/

5.2.3. DiPn chMng nhiOm t:Hng 8o 8bn l 1 vPt m0 qn lu hH thnX #1 ALch mu Fhong 7 ng&- nJu hJt thS #tt/ )Ju cK n$ tiDu AP #1 vJt thng thTng !-6 ng& thS hJt- ALch #1 nhi;u thS ng^1 #m l A1 Nung Wu1nh An luc%ng tc t tng cho o) 1n t=m/ qn lu ,D thnX thTng #1 n$c tiDu- m: h1& it mu- ccn lZng/ )Ju #1 mu nhi;u "" ml}giT thS lC& li q0p( v ,o op/ qn lu n& D i;u t#L thTng cK chR Lnh ,m #1nn ,m v$i p l]c thCp mi ln !-e" ml/ vJt m+X t#nh nhiwm t#hng Ao n$c tiDu t^ An lu #1 A1- th1& ,ng Fhi $t- tich c]c ngn ng^1 #m ln A1/ 5.2.4. D; lo lfng NUi ti 3ht 8o thMc <n ghi cK nhu Vng #uVt cho o) n ng1& v n ,Snh thTng- cho o) uHng nhi;u n$c 7-5 lit t#ong 3uHt c ng&/ o) cK 3zi c1lci nn hn chJ n t%m cu1- 3P- thLt- t#Eng- c ,iDn- thEc uHng cK 1ciA/ o) cK 3zi u#1t nn hn chJ thEc n cK chCt Pu#in nh thLt- n$c 3Ht thLt- #u z- hi 3n- thEc n ln m2n/ o) cK 3zi oN1l1t2 hn chJ thEc n cK chCt oN1lic nh t#- c1\- u- #1u N1nh m mu/

? F G-S/ j[O BN ghu&n o) uHng nhi;u n$c t#ong ng&/ 0n chJ nhBng thEc n to 3zi/ Ii;u t#L v phPng ,@nh nhiwm t#hng tiDu- nhiwm FG 3inh t#hng Tng #uVt- cTng gip/ ghi cK ACu hi@u ,Ct thTng ti Fhm- giDm t#1 3iu =m Lnh FU/

? ; !kv8V V-S qCu hi@u v t#i@u chEng 3zi ni@u hJtX n$c tiDu t#ong- Fh%ng nhiwm t#hng- Fh%ng 1u/ o) hri phQc 31u phu thutX vJt m+ Fh%ng nhiwm t#hng/

o) ,iJt cch phPng ng^1 3zi ti phtX hn chJ thEc n to 3zi- uHng nhi;u n$c- i;u t#L AEt iDm nhiwm t#hng ni@u- uHng tng thuHc/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810: e/ qn lu ,D thn Ahng DX 1/ q] phPng v th2o Ai mu ch& #1 ,/ ID i;u t#L thTng cK chR Lnh ,m #1 c/ (hTng #1 ALch mu Fhong 7 ng& A/ ID nh gi chEc nng thn/ / o) t#$c m+- D ng^1 nhiwm t#hng Ao Fyt 3zi- Iq cnX 1/ Cho o) uHng thuHc li tiDu ,/ (h]c hi@n Fhng 3inh th2o & l@nh c/ (h]c hi@n thuHc ng: A/ (h%ng tiDu cho o)/ 7/ qn lu hH thn thTng #1 ALch mu Fhong mC& ng& thS hJtX 1/ ng& ,/ 7 ng& c/ 5 ng& A/ ! ng& 5/ o) 31u m+ 3zi- Iq cn gio AQc o) i;u gSX 1/ gh%ng n tu&@t Hi nhBng thEc n to 3zi

,/ Phi n nhi;u #1u N1nh c/ Hng nhi;u n$c t#ong ng& A/ )n n nhBng th]c phlm ln m2n !/ oiJn chEng thTng gcp nhCt 31u m+ 3zi ni@u lX 1/ Ch& mu ,/ pzi ti pht c/ )hiwm t#hng ni@u A/ vim ph+i

TI !IhU THAM KHsO e/ )g% [i1 0&- )i@u h.c tp v- Phu thut 3zi ni@u Wun- )h NuCt ,n < h.c- efs!- 8e/ / )g% [i1 0&- oi ging ,@nh h.c ngoi Fho1- tp 5- Ii h.c < qc (P0CY- efss- f8/ 7/ )gu&wn (Cn CTng- Chm 3Kc o) m+ h@ 3zi ni@u- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- ""f- 6e/ 5/ (#n vn png- oi ging ,@nh h.c ngoi Fho1- nh NuCt ,n m|i c m1u- eff6- s7/ !/ P1t#ici1 o1t23- ph1#on 4/ 42i3/ x2n1l 1nA u#ologic p#o,l2m- in Y2Aic1l pu#gic1l )u#3ing- 5th 2A- 42i3 Colli2# 02itF2mp2#}Ypo<- eff - e77 /

BI $ CHwM SxC BhNH NHpN M U a TIN !IhT TUHJN

MC TIU 1. Trnh by c gi2i ph3& v sinh lR !&y'n !in li;!. 2. Trnh by c !ri;& chFngQ chA nh i& !r b;nh lR & = !in li;! !&y'n. (. 9h?" sTc c b;nh nhSn !rMc "4. +. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn sa& "4.

1 GIsI (H)U V SINH ! (i;n li@t tu&Jn n?m 3=u t#ong hHc chu- 31u Nng mu- 3t ng1& mct t#$c c:1 t#]c t#ng v$i vhng & n?m FJ cn & ,1ng Wu1ng/ (i;n li@t tu&Jn cK hSnh nKn #Vng 5cm- c1o 7cm- A& -!cm/ (4( c cCp mu ,i Vng mch ,ng Wu1ng A$i v Vng mch t#]c t#ng giB1/ (4( cK chEc nng chinhX chEc nng t#]c tiJp l tiJt tinh ALch- th1m gi1 nu%i Anng tinh t#hng v phKng tinh/ ChEc nng gin tiJp l Wu1 ni@u o-c+ ,1ng Wu1ng chLu tc Vng i tiDu/ o$u lnh (4( l ,@nh ngTi l$n- thTng t^ 5! tu+i t# ln- #Ct nhi;u ngTi cK ,$u nhng vn 3Hng chung hP1 ,Snh v Fh%ng thC& t#i@u chEng/ (h%ng thTng t#i@u chEng NuCt hi@n tu+i !! t# ln/ o$u lnh (4( l mVt t#ong nhBng ,@nh iDn hSnh g=& #Hi lon Tng tiDu Ao ,J tZclm o) i tiDu nhi;u ln- tiDu FhK- tiDu Fh%ng hJt n$c tiDu/ qo ,ng Wu1ng thTng chHng ch.i v$i ,J tZc nn to #1 ngKc ngch- tti v t#o ngc APng ch&- t^ K E .ng n$c tiDu t#ong ,1ng Wu1ng ng& cng nhi;u v t# nn mn tinh/

qo E .ng v to #1 APng ch& ngc lm thn Aw ,L vim h1& i thn giMn n l=u ng& lm o) cK ngu& c 3u& thn mn tinh/

)i@u o n1m 'httpX}}/gi1oAuc3ucFho2/n2t*

$ TRIhU CHNG !pM SNG $ 1 TP-AQ O1N8V O1] uQ58 o) i tiDu nhi;u ln- tiDu m- tiDu gCp/ o) phi #cn- ti1 n$c tiDu &Ju- tiDu nhi;u gi1i on/ o) cK cm gic l tiDu ch1 hJt/ p1u Fhi i tiDu o) vn cK cu ,ng Wu1ng v cK nhu cu i tiDu t#ong vPng ch1 & giT/ $ $ TP-AQ O1N8V 41SO1 uQ58: thm Fhm (4( Wu1 hu m%n thC& (4( to- mCt #Mnh giB1- gi$i hn #- ,T t#n ,L l& ln c1o/

ghm ,$u lnh ti;n li@t tu&Jn Wu1 ngM hu m%n 'httpX}}/gi1oAuc3ucFho2/n2t*

F TRIhU CHNG C*N !pM SNG


-

piu =m cK u AP ct t#ong t#]c t#ng cho hSnh nh #/ PpA l Fhng ngu&n cc hi@u c:1 ti;n li@t tu&Jn/ oSnh thTng -5 ng/

piu =m (4( ,?ng u AP 3iu =m Wu1 t#]c t#ng 'httpX}}1mil&ho3pit1l/vn}&-hoc*

; CH "NH IU TR" ; 1 -RQ 0PY 8,- 41/5 d^/ 0M8 o) #Hi lon i tiDu nhy/ )$c tiDu trn lu A$i e"" ml/

; $ -RQ 0PY 8V/C- 41/5 xHi lon i tiDu ncng/ )$c tiDu trn lu t#n e"" ml/ Cc phng php gii phuX cZt Ht n%i 3oi- m+ h ,Kc u- phu thut nVi 3oi ,Kc u/

? CH&N O'N V CAN THIh( IU DNG TRC M ? 1 N1c8 BY81 081 0PC8V BN (+ng t#ngX tu+i- chR 3H oYa/

YEc V i tiDu- thTi gi1n i tiDu- Fhong cch giB1 Inh gi 3H lng- mu 3Zc- tinh chCt n$c tiDu/ qinh AnngX o) cPn #ng- FhK n- n F\m/ o) cK ,@nh lG Fm th2oX tiDu Tng- c1o hu&Jt p/ )hn Lnh ACu hi@u nhiwm t#hng 3$m nhCt/

ln i tiDu/

pinh hot c:1 o)X FhK Fhn Fhi i li- o) Fh%ng ng: c/

? $ C18 B/S8 }t O58 01-A_ D 5.2.1. K* 8o c<ng ch"ng 4Jng ) *ng 8o D; khGng ti $_c o) gim FhK chLu Ao cng ch$ng ,ng Wu1ngX Ict th%ng tiDu gitp o) tiDu c gim cng ch$ng ,ng Wu1ng/ (h2o Ai n$c tiDu- lng gi tSnh t#ng thoi mi Aw chLu c:1 o) v Au& t#S m ,o APng ch& n$c tiDu th%ng/ 5.2.2. ;g ! c nhiOm t:Hng 8o $]t thGng ti 1 8o 4%nh Ninh1 8o M m tiPt ni% gh%ng cK ,iDu hi@n c:1 ngu& c nhiwm t#hngX 4ng gi nhi@t V- mhi- n$c tiDu Qc- cn pht hi@n 3$m nhCt ACu hi@u nhiwm t#hng/ Cho o) uHng nhi;u n$c/ (u=n th: ngu&n tZc v% Fhuln Fhi ct th%ng tiDu c|ng nh Fhi chm 3Kc/

5.2.3. jo N_ gim kh n<ng tFnh 8Xc1 nghi ngc ng th1 thiP hi 4iPt vT 3hng 3h3 m0 vJ h 3hb [im lo 3 v; cuVc m+- v; tSnh AQc 31u m+X [ii thich cho o) hiDu v; cuVc m+/ (h]c hi@n chm 3Kc o) t#$c m+/ [cp gn o) v t# lTi cc c=u hzi Fin o #ing t/

o +UH TR~NH CHwM SxC BhNH NHpN SAU M o 1 N1c8 BY81 081 0PC8V BN (Snh t#ng ch& mu 31u m+X Wu1 h@ thHng An lu- th1& +i chR 3H q0p(/ (Sm hiDu ngu&n nh=n v; tSnh t#ng 1u- ,Ec #Et- vt vM/

qn luX th%ng- mu 3Zc- c=u nHi/ vJt m+X nhiwm t#hng- 1u- AP n$c tiDu- ALch thCm ,ng/

o $ C18 B/S8 }t O58 01-A_ D =.2.1. K* 8o co thft 4Jng ) *ng1 t"i :t* cXc m $Gng1 thGng ti 1 3hng 3h3 m0 (h2o Ai tSnh t#ng 1u/ qu& t#S h@ thHng t$i #1 th%ng 3uHt- 1n ton/ [im 1u cho o) ,?ng nhBng ,i tp ng: 3=u- th gin- thuHc gim 1u/

=.2.2. ;g ! c nhMc $ N* m0 8o gB! t5 t(! Nng Cho o) n?m u ,?ng t^ 6-s giT 31u m+/ (h2o Ai cn 1u u- chKng mct c:1 o)- vn Vng v cm gic chi/ (h]c hi@n thuHc gim 1u/

=.2.3. ;g ! c ch! m t:ong nh'ng ngJ! $ N* m0 -

(h2o Ai mch- hu&Jt p- A1 nim- 0ct- n$c tiDu cK mu z Fh%ng/ Cho o) n?m &n- n?m u ,?ng- cho o) tp vn Vng t1& ch=n nhy nhng t#nh tSnh t#ng thu&n tZc mch 31u m+/ (h2o Ai nghyt HngX nJu n$c ch& #1 thnh ,Qng l ACu hi@u ,L nghyt Hng/ (h2o Ai 3] NuCt hu&Jt ch1i hEng Wu1 An lu/ (h2o Ai lng n$c vo v #1 D nh gi tSnh t#ng An lu c|ng nh chEc nng hot Vng c:1 thn 31u m+X lng n$c #1 phi nhi;u hn 1 vo/ Chuln ,L )1C4 "-fu e"- " lit ng1& Fhi o) Jn phPng hri 3Ec/ )gu&n tZc cho ch& Hng An lu ni@u o #1 An lu ,1ng Wu1ng/ Ch1i hEng thCp hn mct giTng !"-6"cm v cho ch& p l]c nh1nh t#nh lm nghyt Hng Ao mu cQc nJu o) 1ng ch& mu/

(h2o Ai t#i@u chEng mZc #cn D loi t#^ ngu&n nh=n Fhc c|ng g=& #1 tSnh t#ng mZc #cn v$i tSnh t#ng mZc #cn Ao ch& mu/ Iq nn th]c hi@n thQt tho t#$c m+ v Fh%ng ct nhi@t V h1& 3onA2 hu m%n 31u m+/

p1u m+ 5 giT tho n cm mu l+ 3o v th2o Ai NuCt hu&Jt/ 0 p l]c ,ong c:1 3onA2 mol2& Fhi thC& n$c #1 cK mu hrng/ g\o cng ch=n Hng mol2& vo thnh giTng gitp cm mu ti ch/

(h]c hi@n thuHc gim 1u th2o giT/

=.2.4. ;g ! c t0n thng ni% $o N* m0 C=u nHi tng vL t#i t#nh t+n thng ni@u o Ao th%ng tiDu/ Chm 3Kc ,V phn 3inh AQc t#nh vim nhiwm/ (h2o Ai ngu& c nhiwm t#hngX th2o Ai v nh gi mu 3Zc- tinh chCt- 3H lng n$c tiDu- nhi@t V c thD- tu=n th: ngu&n tZc v% Fhuln Fhi ct th%ng tiDu c|ng nh Fhi chm 3Kc/ (h1& Hng tng Wu& Lnh/

=.2.5. ;g ! c t0n thng 8* vJ ni5m mc 8o 8bn l


-

(#Tng hp eX nJu n$c tiDu #1 t#ong v o) Fh%ng cK NuCt hu&JtX + -7 ng& 31u m+ #tt An lu m ,ng Wu1ng #1 A1 v$i i;u Fi@n l 3onA2 ni@u o th%ng/ + e- ng& 31u thS #tt An lu x2tiu3/

(#Tng hp X nJu n$c tiDu #1 z thS An lu m ,1ng Wu1ng #1 A1 giB li D ,m #1 cm mu/ + -7 ng& 31u thS #tt An lu x2tiu3 nJu ALch #1 it/

+ e"-e ng& 31u m$i #tt An lu m ,1ng Wu1ng #1 A1/ (#$c Fhi #tt phi m ,o 3onA2 ni@u o th%ng/ + p1u #tt nn c=u nHi An lu ni@u o ch& lin tQc vo ch1i hEng gitp vJt m+ ni ch=n An lu ,1ng Wu1ng lnh/ p1u Fhi vJt thng t#n ,1ng Wu1ng lnh cVt 3onA2 ni@u o li mi giT D tp ,ng Wu1ng lm vi@c li/ + p1u tun thS #tt 3onA2 ni@u o/ (#Tng hp 7X t#ong t#Tng hp phu thut nVi 3oi/ Phu thut vin ct An lu ni@u o 7 nhnh thS ,m #1/ xtt 31u Fhi n$c tiDu t#ong Fh%ng cK ACu hi@u ch& mu/ p1u #tt 3onA2 ni@u o nn cht G th2o Ai 3H lng- tinh chCt i tiDu vS cK thD o) tiDu Fh%ng FiDm 3ot/

vJt m+X ngu& c nhiwm t#hng vJt m+ Ao An lu ,ng Wu1ng- chm 3Kc vJt m+ mi ng&- Fhi thCm $t- nJu cK nhiwm Fhuln P32uAomon13 nn th1& ,ng v Cp Cm/ )gu& c nhiwm Fhuln Fho1ng x2tiu3X Fhi chm 3Kc nn cho htt ALch Wu1 An lu- th1& ,ng thTng Nu&n- #tt An lu 3$m Fhi hJt ALch h1& Fhi cK & l@nh/

=.2.=. ;g ! c k[m <n 8o 3hb th t t:5n ngci l"n t 0i n ng1& Fhi cK nhu Vng #uVt- thEc n m;m- Aw nh1i- hp Fhlu vL v & : chCt Ainh Anng/ (hEc n nhun t#Tng t#nh to ,Kn/ Hng nhi;u n$c/

=.2.W. ;g ! c Q t h !Pt thM 3ht vJo ngJ! th- W712 8o gfng NMc (#nh gi1 tng p l]c t#ong ,Qng g=& ch& mu 31u m+ nh Fh%ng D o) to ,Kn- ho,i- li N2- hot Vng tSnh AQc Wu 3Ec- Fh%ng lm vi@c ncng- Fh%ng m1ng ncng t#ong 6 tun 31u m+- Fh%ng c #cn i tiu t#ong thTi gi1n n&/ (h]c hi@n thuHc gim ho nJu o) ho- t#nh ,L cm lnh- vim h.ng/ )gu& c vim tinh honX thTng c thZt Hng An tinh Fhi gii phu nn Iq cht G cZt mHi chR tinh hon- th2o Ai ACu hi@u nhiwm t#hng/ =.2.>. D; ti khGng t/ ch( 8o t0n thng c 8"i X nii N* m0 Ict 3onA2 ni@u o li v gitp o) tp tiDu Wu1 3onA2/ p1u K #tt 3onA2 cho o) tiDu ,Snh thTng- t#ong thTi gi1n n& nn gitp o) cK phng ti@n i tiDu Aw Ang/ )gn ng^1 nhiwm FhulnX cho o) uHng nhi;u n$c- v@ 3inh ,V phn 3inh AQc/

=.2.A. D; hs3 ni% $o 8o ng thGng ti 1 8o nhiOm t:Hng ni% $o (#nh ngu& c hyp ni@u o Ao ct 3onA2 ni@u o- Ao nhiwm t#hng tiDu/ )Ju cK hyp ni@u o nn h$ng An o) Jn ,@nh vi@n nong ni@u o Lnh FU/

=.2.1E. u t tinh ng_c 8,ng C%ng tc t tng/ ghu&n o) nn v@ 3inh 3ch 3 ,V phn 3inh AQc 31u gi1o hp/

o F G-S/ j[O BN

ghu&n o) nn ti Fhm Lnh FU vS cK ngu& c ,iJn chEng c tinh v; 31u/ )Ju cK hyp ni@u o nn Jn ,@nh vi@n nong ni@u o Lnh FU/ ghu&n o) uHng nhi;u n$c/

o ; T-LQ O1Q8 bkv8V V-S o) tiDu ,Snh thTng- Fh%ng cK ACu hi@u ch& mu/ )Ju o) ung th tu&Jn ti;n li@tX o) ,iJt Jn i;u t#L ti chu&n Fho1/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810 e/ (#ong nhBng ng& u 31u m+ u N ti;n li@t tu&Jn- o) cn c th2o Ai v chm 3KcX 1/ 6 giT 31u m+ tho n cm mu l+ 3o ,/ Cho o) n?m u c1o- vn Vng t1& ch=n nhy nhng c/ (h2o Ai t#i@u chEng mZc #cn A/ om th2m e"ml n$c cCt vo Hng mol2& / p1u m+ u N ti;n li@t tu&Jn-Iq cn chuln ,L Aung ALch gS D ,m #1 ,1ng Wu1ng cho o)X 1/ )$c Cm v% t#hng ,/ )1Cl e"u c/ )1Cl "-fu A/ (huHc tim 7/ )Ju n$c #1 ,1ng Wu1ng 31u m+ u N ti;n li@t tu&Jn cK mu hrng- i;u K cK ngh1X 1/ (Snh t#ng 1ng ch& mu ,/ (Snh t#ng ch& mu 1ng +n Lnh c/ (Snh t#ng ngng ch& mu

A/ (Snh t#ng ch& mu 1ng ,Zt u 5/ )gu& c ch& mu thE pht Ao gZng 3Ec 31u m+ u N ti;n li@t tu&Jn N& #1 vo ng& thEX 1/ !-e" ,/ 8-e" c/ 8-e A/ !-e !/ ID ng^1 ch& mu thE pht 31u m+ u N ti;n li@t tu&Jn- Iq cn Fhu&n o)X 1/ )?m nghR ngi ti giTng ,/ )Ju o) ho- cho o) uHng thuHc ho c/ gh%ng c #cn Fhi i v@ 3inh A/ C=u , v c tng TI !IhU THAM KHsO e/ )g% [i1 0&- oi ging ,@nh h.c ngoi Fho1- tp 5- o$u lnh ti;n li@t tu&Jn- Ii h.c < qc (P0CY- efss- fe/ 7/ )gu&wn (Cn CTng- Chm 3Kc o) m+ u N ti;n li@t tu&Jn- Iq ngoi - )h NuCt ,n [io AQc vi@t )1m- ""f- 8 / 5/ (#n vn png- oi ging ,@nh h.c ngoi Fho1- o$u lnh ti;n li@t tu&Jn- )h NuCt ,n Y|i C m1u- eff6- es / !/ P1t#ici1 o1t23- ph1#on 4/ 42i3/ )u#3ing #ol2 in Y1n1g2m2nt x2n1l 1nA u#ologic p#o,l2m- in Y2Aic1l pu#gic1l )u#3ing- 5th 2A- 42i3 Colli2# 02itF2mp2#}Ypo<- eff - e78"/

BI F< +UH TR~NH CHwM SxC BhNH NHpN CHyN THNG TH*N NIhU O

MC TIU 1. Trnh by c )c i*" v gi2i ph3& !h8n. 2. L$& c nh nghPaQ c c !ri;& chFng lS" sng c-a chEn !hng !h8n u ni;& o. (. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn chEn !hng !h8n. +. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn chEn !hng ni;& o.

CHyN THNG TH*N


1 GIsI (H)U TH*N (hn l tng cc n?m phi1 31u phtc mc- t#ong + thn Fin- thn chE1 & mu- m% thn , v Aw vn/ Phi1 31u thn l Nng 3Tn 3H ee-e v thnh ,Qng 31u/ Phi1 t#n l c honh- c]c t#n c:1 thn tiJp Ntc v$i tu&Jn thng thn- c]c t#n thn phi tiJp Ntc v$i g1n- c]c t#n thn t#i tiJp Ntc v$i lch/ Phi1 t#$c Wu1 phtc mc tiJp Ntc v$i cc tng ,n t#ong + ,Qng/ Phi1 A$i thn l phtc mc #Ct Aw ,Kc tch Fhzi thnh ,Qng nn mu tQ thTng cK thD tch #1 pht t#iDn v l1n NuHng hH chu/ Phi1 t#ong phtc mc Ainh vo cVt 3Hng nn FhHi mu tQ Fh%ng l1n Jn thn ,n Hi Ai@n/ Chung Wu1nh thn cK l$p mn [2#ot1- =& l l$p @m cK tc AQng ,o v@ thn it Ai Vng v it chCn thng/

$ CHyN THNG TH*N K N $ 1 Y81 8V1Z5: chCn thng thn Fin l chCn thng thn nhng Fh%ng th:ng Wu1 thnh ,Qng h1& Wu1 thnh lng/ $ $ TP-AQ O1N8V bK: .t8V
-

(iDu #1 muX mu z ;u 7 l&- t#ong t#Tng hp ncng cK mu cQc .ng t#ong ,1ng Wu1ng g=& #1 tiDu FhK/

I1uX hH thZt lng & v 1u- 1u l1n An #1 N1 ch chCn thng- 1u l Ao 3] hSnh thnh c:1 FhHi mu tQ Wu1nh thn/ Phn Eng thnh ,Qng n1 ,Qng ,n ,L chCn thng,Qng ch$ng hi/ p1u vi ng& ,Qng ,$t ch$ng Fhi thm Fhm cK thD 3T thC& FhHi mu tQ m;m v 1u/

(on th=nX nJu mCt mu nhi;u o) #i vo nhBng cn chong- mch nh1nh- hu&Jt p gim- A1 nim N1nh ti/

F +UH TR~NH CHwM SxC BhNH NHpN CHyN THNG TH*N

F 1 N1c8 BY81 081 0PC8V BN 0zi ,@nhX hzi v; c chJ chCn thng- thTi gi1n- N t#i ,1n u/ ghmX + o) cK #i vo t#ng thi chong 31u chCn thng nh t#i gic gim- #Hi lon q0p(- A1 N1nh- nim nht + (Snh t#ng ,QngX 1u vhng h%ng lng- h$ng l1n FhHi mu tQ vhng h%ng lng/ + (Snh t#ng n$c tiDuX mu 3Zc- tinh chCt i tiDu/ ghm gitp pht hi@n nhBng t+n thng Fhc Fm th2o/ F $ C18 B/S8 }t O58 01-A_ D O1/ BN O18 01k38V 01c8 3.2.1. Ch<m NSc t:ong t:cng h_3 chn thng nhs# i& !r b2o !Wn o) ,Ct Vng Ao phPng ng^1 tSnh t#ng ch& mu tiJp tQc 31u chCn thngX thTi gi1n e" ng&/ vn Vng t1& ch=n nhy nhng ti giTng- t#nh m.i hot Vng gZng 3Ec/ (h2o AiX + qCu tZc mch chi Ao ,Ct VngX nhi@t V- cm gic chi/ + qCu hi@u ch& mu thE phtX V l1n vhng ,m mu h%ng lng- mu 3Zc n$c tiDunJu n$c tiDu nht An l tHt/ + (h2o Ai q0p( thTng Nu&n h1& 7 ln}ng&/ + `\t nghi@mX chEc nng thn- 0ct- hrng cu/
+

(Snh t#ng ,QngX ch$ng Fh%ng 0$ng l1n c:1 FhHi mu tQ hH thZt lng- 1u vhng ,Qng vhng h%ng lng/

(h]c hi@n thuHc gim 1u/

(#u&;n mu th2o & l@nh ,h vo lng mu M mCt/ (#nh gZng 3Ec cho Jn ng& thE s-f 31u chCn thng/ o) cK ngu& c nhiwm t#hng Ao chCn thng thnX + (h]c hi@n Fhng 3inhX tng li;u- tng giT- tng Tng tim/ + (h2o Ai th=n nhi@t mi ng&/ + p AQng Fd thut v% Fhuln t#ong chm 3Kc o)/

o) lo lZng v; Ainh Anng Fhi ,Ct Vng/ Cho o) n uHng ,Snh thTng- thEc n Aw tiu- n nhi;u ln/ ghu&Jn Fhich o) uHng nhi;u n$c/

3.2.2. Ch<m NSc D; chn thng n]ng# cK t#Tng hp o) m+ cCp cEu Ao tSnh t#ng ch& mu thnX + (Snh t#ng o) #Ct ncngX cK t+n thng Fm th2o cc c Wu1n Fhc- chong ncng/ + (#u&;n !"" ml mu m hu&Jt p Fh%ng ln h1& ln #ri NuHng li/ + ghHi mu tQ Wu1nh thn l$n An l1n Jn Tng ng1ng #Hn/ + Iq chuln ,L o) t#$c m+ nh ,i chm 3Kc o) t#$c m+/ + `\t nghi@m D FiDm t#1 chEc nng thn Hi Ai@nX av- 3iu =m/ + qi chu&Dn o) phi nhy nhng/ + (h2o Ai 0ct- hu&Jt p- mch- A1 nim- CvP- t#i gic/ + Ict th%ng tiDuX th2o Ai 3t mu 3Zc- 3H lng- tinh chCt c:1 n$c tiDu/ + (h2o Ai h$ng l1n c:1 FhHi mu tQ- phn Eng n1 ,Qng ,n chCn thng/

+ (#u&;n ALch- nJu 0ct "u- Iq th]c hi@n t#u&;n mu cho o)/ o) chuln ,L m+ t^ 8-e5 ng& 31u chCn thng Fhi ngng ch& muX + ghHi mu tQ Fh%ng l1n Wu Tng ng1ng #Hn/ + )$c tiDu z nhng Fh%ng cK mu cQc/ + (#u&;n !""ml mu- hu&Jt p o) +n Lnh/ + Ch& mu F\o Ai- thng t+n thn ncng/ + Iq chuln ,L o) t#$c m+ nh ,i chm 3Kc o) t#$c m+/

; +UH TR~NH CHwM SxC BhNH NHpN SAU M DO CHyN THNG TH*N ; 1 N1c8 BY81 081 0PC8V BN .5Q :n 0zi o) 1uX vL t#i- cTng V- tinh chCt qCu hi@u chongX mch nh1nh- hu&Jt p tQt (h2o Ai tSnh t#ng ch& muX An lu- cK mu tQ vhng ,Qng Fh%ng )$c tiDu z Fh%ng q0p( cK +n Lnh Fh%ng (Snh t#ng th%ng Fhi/ qCu tZc mch chi Ao ,Ct Vng- Ao 1u/

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. D; khS thd 8o $* 1 8o t thP YX cho o) n?m u ,?ng mct nghing mVt ,n/ (RnhX cho o) n?m t thJ mol2#- nghing v; phi1 cK An lu/ (h]c hi@n thuHc gim 1u v h$ng An o) th- li@u php oN& nJu cn/

(h2o Ai tSnh t#ng thiJu oN&- FiDu th- ACu FhK th/

4.2.2. D; cS ng ! c ch! m N* m0 (h2o Ai 3t q0p( t#ong 5 giT u 31u m+/ (h2o Ai 3t n$c tiDuX 3H lng- mu 3Zc Wu1 An lu ,1ng Wu1ng #1 A1 h1& An lu ni@u o phi c c=u nHi v% Fhuln/ )Ju n$c tiDu mu z- 3H lng Wu nhi;u thS ,o li op/ (h2o Ai tSnh t#ng ,QngX ch$ng hi- ACu mu tQ- 1u/ (h2o Ai An lu v htt ngZt WuMng/ vn chu&Dn- No1& t# nhy nhng/ (h]c hi@n thuHc gim 1u D gitp o) ,$t vt vM/ (h2o Ai 0ct- hrng cu

4.2.3. ;g ! c hot $Ing ng 8bn l khGng $t hi% ) N* m0 thn qn lu hH thnX D phPng ng^1 chR #1 it mu nhng Fh%ng #1 n$c tiDu- thTng #tt 3$m 5-5s giT 31u m+/ Iq th2o Ai mu 3Zc- 3H lng ALch- ,o m h@ thHng v% t#hng/ qn lu ,D thnX i;u t#L + )Ju thC& mu cQc h1& mu ti #1 Fhong ""ml} ng& thS nn ,o li op- th2o Ai 3t q0p(- A1- nim mc- t#i gic o)/ + (hTng An lu n& #1 n$c tiDu/ + (h1& ,ng mi ng&/ + (h2o Ai 3t n$c tiDu c An lu ,D thn v An lu ni@u o/ + Cho o) uHng nhi;u n$c/

+ qn lu ,D thn c #tt th& th2o mQc ich gii phu- tSnh t#ng o)/ )Ju chR D th2o Ai Fh=u ,uVc mch mu h1& ch& mu thE pht thS mQc ich An lu cK tinh cch phPng ng^1 vS thJ Fhi An lu #1 n$c tiDu tHt- Fh%ng cK mu v 31u 7 ng& thS #tt/ )Ju D An lu lm nPng thS An lu n& D 31u 7 tun/ qn lu ,ng Wu1ngX + (h1& ,ng mi ng&/ + )Ju thC& mu cQc h1& mu z ti thS ,o op/ + (hTng #tt 3$m 31u 7 ng& nJu n$c tiDu #1 t#ong/ + Chm 3Kc A1- phPng ng^1 #m l A1/ 4.2.4. D; N ! ki%t N* m0 qinh AnngX n thEc n Aw tiu- uHng nhi;u n$c- ,o m : chCt Ainh Anng/ (h]c hi@n t#u&;n ALch h+ t# nJu cK & l@nh/ (h2o Ai c=n ncng/

4.2.5. D; t0n thng 8* 8o vPt m0 vJ ni :it 8bn l (h1& ,ng Fhi thCm $t- chm 3Kc An lu mi ng&/ Chm 3Kc A1 o) phh/ Ch=n An lu phi lu%n Fh%- 3ch/

4.2.=. ;g ! c ch! m thM 3ht 8o vn $Ing n]ng khi Q t vi%n [io AQc o) Fh%ng nn lm vi@c ncng t#ong 7 thng u 31u m+/ (h2o Ai FiDm t#1 hu&Jt p thTng Nu&n/ (h2o Ai tiDu #1 mu Fh%ng/

giDm t#1 Lnh FU Wu1 3iu =m/

CHyN THNG NIhU O


1 +UH TR~NH CHwM SxC BhNH NHpN CHyN THNG NIhU O TRC 1 1 NVQEL8 81K8 1.1.1. &o chn thng t- 45n t:ong Ict th%ng ni@u o lc Tng/ qo Hng th%ng cEng t^ m& nVi 3oi ,ng Wu1ng/ p AQng Hng th%ng cK Tng Finh to hn ni@u o/ CH Lnh ni@u o Fh%ng tng nhCt l n1m gi$i/ qo ct th%ng tiDu l=u ng&/

)i@u o n1m 'httpX}}/gi1oAuc3ucFho2/n2t*

1.1.2. &o chn thng t- 45n ngoJi# ngM ngri t#n vt cEng-

ch=n Noc #1/

A/ C chJ chCn thng ni@u o t#$cX chCn thng vhng hVi =m Ao t\ Noc ch=n t#n vt cEng/ oX [ii phu ,@nh chCn thng ni@u o t#$cX tQ mu l$n vhng hVi =m 'hSnh cnh ,$m iDn hSnh * v tQ mu ,Su/ 'httpX}}chothuoct1&/vn*

1 $ !K: .t8V }t j-8 0-D8 1.2.1. jBm NJng I1u chKi vhng tng 3inh m%n rng thTi cK mu #1 l 3o/ oi tiDu/ CK mng mu tQ hSnh cnh ,$m vhng tng 3inh m%n- nJu ncng hn FhHi mu tQ l1n Jn ,Su lm ,Su 3ng to v ,m tim/ 1.2.2. &iOn tiPn )Ju Fh%ng An lu FLp thTi- n$c tiDu 3 ch& NuHng ch mu tQ g=& nhiwm t#hng #Ct ncng/ (Ct c chCn thng ni@u o ;u 1 Jn hyp ni@u o 31u mVt thTi gi1n/

1 F N1c8 BY81 081 0PC8V BN 0ziX c chJ chCn thng- thTi gi1n v N t#i ,1n u/ ghmX o) cK ,i tiDu ACu hi@u ,ng Wu1ng '* Fhi o) Fh%ng tiDu c/ (Sm hiDu c chJ v ngu&n nh=n chCn thng- tSm ACu hi@u mu tQ hSnh cnh ,$m- mu ch& u Ang vt/ qCu hi@u t+n thng cc c Wu1n Fhc/

1 ; C18 B/S8 }t O58 01-A_ D 1.4.1. V ! t:Fnh ch<m NSc D; t:"c m0 chn thng ni% $o t:"c 1.+.1.1. CL khXng !i*& c /o chEn !hng5 ngu&n tZc N t#iX )Ju o) tiDu ,Snh thTngX chu&Dn o) Fhm chu&n Fho1 D cK chR Lnh i;u t#L thich hp/ )Ju o) Fh%ng tiDu cX Fhm N2m o) cK cu ,ng Wu1ng Fh%ng )Ju o) Fh%ng cK cu ,1ng Wu1ng- Fh%ng nn ct th%ng tiDu Wu1 Tng ni@u o nn chu&Dn ln tng chu&n Fho1 D m ,1ng Wu1ng #1 A1 An lu n$c tiDu/ )Ju cK cu ,1ng Wu1ngX Fh%ng nn ct th%ng tiDu m nn ch.c AP lC& n$c tiDu tm thTi h1& m ,1ng Wu1ng #1 A1 D An lu n$c tiDu t#nh n$c tiDu t#n NuHng vhng chCn thng g=& nhiwm t#hng/ 1.+.1.2. CL lo lsng sa& chEn !hng (hTng 31u chCn thng o) 3 c i;u t#L ,o trn v 31u e5 ng& o) m$i cK chR Lnh m+/ )Ju hyp ni@u o h$ng An o) Jn ,@nh vi@n nong ni@u o Lnh FU/

1.4.2. V ! t:Fnh ch<m NSc D; N* m0 chn thng ni% $o t:"c 1.4.2.1. CL !i*& %&a son/O ni;& o /o ! i !o ni;& o sa& "4 Chm 3Kc ,V phn 3inh AQc ng& 7 ln/ gh%ng #tt An lu ni@u o- 31u e" ng& Iq N ,Kng v 3onA2 t] 3tt #1/ (h2o Ai ACu hi@u nhiwm t#hng tiDu/ Cho o) uHng nhi;u n$c/ Chm 3Kc h@ thHng c=u th%ng- v% t#hng/

1.+.2.2. CL cT !4n !hng /a /o "a bang %&ang ra /aQ /o v'! "4

(h2o Ai v chm 3Kc An lu m ,1ng Wu1ng #1 A1- An lu ni@u o/ (h2o Ai n$c tiDuX Wu1 An lu ,1ng Wu1ng #1 A1- Wu1 3onA2 tiDu/ vJt m+X t#nh lm $t- th2o Ai pht hi@n 3$m ACu hi@u nhiwm t#hng/

1.+.2.(. CL b htp ni;& o /o sa& "4 chEn !hng ni;& o ghi NuCt vi@n h$ng An o) th]c hi@n chR An c:1 op- nong ni@u o Lnh FU t#nh ,iJn chEng hyp ni@u o/

$ +UH TR~NH CHwM SxC BhNH NHpN CHyN THNG NIhU O SAU $ 1 NVQEL8 81K8 qo chCn thng #Ct ncng- Fm th2o vn Nng chu- gM& Nng mu v Fm th2o t+n thng cc c Wu1n ,n t#ong + ,Qng/ I=& l mVt chCn thng #Ct Aw 1 Jn chong Ao mCt mu nhi;u v 1u m t#i@u chEng v; chCn thng ni@u o 31u thS ngho nn/

ChCn thng ni@u o 31u 'httpX}}chothuoct1&/vn*

$ $ C19: .{O BN O18 01k38V 8-AQ BC/ .5Q 2.2.1. ;hn $9nh tFnh t:ng D; 0zi tSm hiDu c chJ chCn thng/ ghmX pht hi@n ACu hi@u chong- lng gi tSnh t#ng chong v N t#i chong/ (h2o Ai 1u v ch& mu Ao gM& Nng/ Pht hi@n chCn thng Fm th2o

2.2.2. Chkn $on vJ c*n thi%3 K& 2.2.2.1. CL cho ng /o chEn !hng )gu&n tZc N t#iX + 0ri 3Ec chHng chong/ + Chm 3Kc o) gM& Nng thTng FJt hp c thng ni@u o 31u/ + vn Nng chuX cho o) n?m t#n vn cEng- t#nh No1& t#- gim 1u- Cp Cm- c%ng tc t tng gitp o) 1n t=m/ + (+n thng ni@u o 31uX cn An lu n$c tiDu ng1& D t#nh nhiwm t#hng- nhng Fh%ng nn th%ng tiDu vS g=& t+n thng th2m h1& nhiwm t#hng thm/ gJ hoch chm 3KcX + ghm D Nc Lnh gM& Nng chu/
+

thng t+nX vn Nng chu v t+n

p giB1 Fhung chu o) 1u/

+ o) Fh%ng Eng A& cX ` t#iX ct o) ln vn cEng- chm 3Kc o) gM& Nng chuX ,Ct Vng- gim 1u/

PhPng chHng chongX gim 1u- giB Cm- th2o Ai ch& mu- t#u&;n ALch- t#Cn 1n tinh thn o)/ 2.2.2.2. CL !4n !hng /a /o v'! "4 v /3n l& Chm 3Kc An lu m ,1ng Wu1ng #1 A1- chm 3Kc vJt m+/ 2.2.3. 6io 8Xc D; ghi NuCt vi@n ti Fhm th2o lTi Acn v nong ni@u o Lnh FU/ 2.2.4. j_ng gi o) tiDu Fh%ng cPn #1 mu- o) t] tiDu ,Snh thTng/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810 e/ o) chCn thng ni@u o t#$c- cK cu ,1ng Wu1ng- Iq cn N t#i gS cho o)X 1/ Ict th%ng tiDu D An lu n$c tiDu/ ,/ Chuln ,L o) m+ cCp cEu c/ Chuln ,L AQng cQ v phQ op m ,1ng Wu1ng #1 A1/ A/ (#u&;n ALch D ng^1 chong cho o) / Iq cn chm 3Kc v th2o Ai o) chCn thng thn nhy c i;u t#L ,o trn- )[ a (xX 1/ Cho o) ,Ct Vng hon ton D ; phPng ch& mu tiJp tQc ,/ ChR cho o) vn Vng t1& ch=n nhy nhng ti giTng c/ (#nh m.i hot Vng gZng 3Ec A/ (h2o Ai mu 3Zc n$c tiDu

7/ o) cK An lu ,D thn 31u m+ chCn thng thn- Iq cn ,o op FhiX 1/ qn lu #1 n$c tiDu ,/ qn lu #1 mu cQc c/ x1 n$c tiDu v mu A/ x1 mu ti Fhong ""ml}ng& 5/ o) chCn thng thn c i;u t#L ,o trn- D phPng ng^1 tSnh t#ng ch& mu 31u chCn thng- o) c ,Ct Vng t#ong ,1o l=uX 1/ ! ng& ,/ e tun c/ e" ng& A/ e thng !/ oiJn chEng no thTng gcp 31u chCn thng ni@u oX 1/ 0yp ni@u o ,/ (iDu Fh%ng t] ch: c/ )hiwm t#hng tiDu A/ oi tiDu TI !IhU THAM KHsO e/ )g% [i1 0&- oi ging ,@nh h.c ngoi Fho1- tp 5- ChCn thng thn ni@u o- Ii h.c < qc (P0CY- efss- e!8/ / )gu&wn (Cn CTng- chm 3Kc o) chCn thng Tng tiJt ni@u- Ii;u Anng )goi - nh NuCt ,n [io AQc vi@t )1m- ""f- se/ 7/ (#n vn png- oi ging ,@nh h.c ngoi Fho1- ChCn thng v vJt thng thn- )h NuCt ,n Y|i C m1u- eff6- 8/

5/ P1t#ici1 o1t23- ph1#on 4/ 42i3/ )u#3ing #ol2 in Y1n1g2m2nt x2n1l 1nA u#ologic p#o,l2m- in Y2Aic1l pu#gic1l )u#3ing- 5th 2A/- 42i3 Colli2# 02itF2mp2#}Ypo<- eff - e75f/

CHNG ?: CHNH H~NH BI F1 +UH TR~NH CHwM SxC BhNH NHpN GH aNG

MC TIU 1. Trnh by c gi2i ph3& v chFc n?ng c-a h; =ng. 2. Trnh by c c c phng ph p i& !r gGy =ng. (. Lh8n nh c !nh !rng b;nh nhSn gGy =ng. +. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn gGy =ng.

1 GIsI (H)U V CHC NwNG Hh aNG


-

oV Nng ngTi grm f6 Nng grm cc Nng t#QcX Nng 3.- Nng mct- cVt 3HngNng 3Tn- Nng Ec v cc Nng phQX Nng chi t#n- Nng chi A$i/

ChEc nngX n=ng n- ,o v@- vn Vng- to mu v t#1o +i chCt/ p] tng t#ng c:1 h@ Nng grmX p] cHt hK1 l Wu t#Snh ,iJn +i m% lin FJt thTng thnh m% lin FJt #Zn cc ngCm & muHi c1lci v m% Nng/ CK hSnh thEc cHt hK1X mng/ CHt hK1 t#]c tiJp 'cHt hK1 mng*X chCt cn ,n c:1 m% lin FJt ngCm c1lci v ,iJn thnh Nng/ Cc Nn c hSnh thnh ,?ng cch n& g.i l Nng

CHt hK1 3QnX chCt cn ,n c:1 m% lin FJt ngCm c1#til1g2 thnh 3Qn- 31u K 3Qn n& ,iJn thnh Nng/

p] tng t#ngX (ng t#ng th2o chi;u AiX nhT 3Qn u Nng nHi giB1 u v th=n Nng/ ghong ! tu+i thS ngng tng t#ng/ (ng t#ng th2o chi;u A&X l Ao 3] pht t#iDn c:1 cHt mc/ p] ti to NngX Fhi Nng gM& giB1 ni gM& 3 hSnh thnh t+ chEc lin FJt- t+ chEc n& 3 ngCm c1lci ,iJn thnh Nng v lm lnh Nng/

oV Nng c thD ngTi 'ngurn 1tl13 gii phu ngTi nm ""e*

$ "NH NGHA [M& Nng l 3] ph h:& Vt ngVt cCu t#tc ,n t#ong c:1 Nng Ao ngu&n nh=n c h.c An Jn 3] gin on t#u&;n l]c Wu1 Nng/

F NGUHN NHpN [M& Nng chCn thng l l]c ,n ngoi tc Vng ln Nng lnh/ 4]c g=& chCn thng to #1 gM& Nng t#]c tiJp v gM& Nng gin tiJp/ [M& Nng ,@nh lG l nJu mVt Nng cK ,@nh t#$c nh ,@nh lG u Nng- loMng Nngvim NngchR cn mVt chCn thng nhy c|ng gM& Nng/ [M& Nng Ao mzi l t#ng thi c:1 Nng lnh mnh nhng Fh%ng ,L gM& Ao chCn thng g=& #1 nhng Ao nhBng chCn thng nhy c nhZc i nhZc li l=u An g=& gM& Nng/

; (HpN !OI ; 1 G-E k38V 4\8 [M& Nng Fin V "X gM& Nng Fh%ng t+n thng m% m;m- thTng l gM& Nng gin tiJp Fh%ng Ai l@ch hocc Ai l@ch it/ [M& Nng Fin V eX cK N=& Nt A1 n%ng- gM& Nng n gin h1& mEc V t#ung ,Snh/ [M& Nng Fin V X N=& Nt A1 3=u v c Fhu t#t Ao chCn thng- nJu cK chn \p Fho1ng c|ng NJp vo gi1i on n&/ [M& Nng Ao chCn thng t#]c tiJp mEc V t#ung ,Snh h1& ncng/ [M& Nng Fin V 7X chm thng A1 #Vng- gip nt c- cK hVi chEng chn \p Fho1ng tht 3] h1& Et mch mu chinh/ [M& Nng Ao chCn thng t#]c tiJp mEc V t#ung ,Snh h1& ncng/ ; $ G-E k38V 1 [M& Nng h V eX A1 ,L th:ng Ao on Nng gM& ch.c th:ng t^ t#ong #1- Nng gM& n gin it ,L nhiwm t#hng/

[M& Nng h V X #ch A1- chm thng A1 Fhu t#t Ao chinh chCn thng t#]c tiJp g=& #1- ngu& c nhiwm t#hng mEc V t#ung ,Snh/

[M& Nng h V 7X #ch A1- t+n thng phn m;m #Vng l$n Fm th2o t+n thng thn Finh- mch mu/ [M& Nng cK Fm th2o t+n thng Vng mch chinh cK ngu& c nhiwm t#hng l$n/

[M& Nng h V 5X Et lS1 chi h1& gn lS1 chi/

[M& Nng Fin 'ngurn ,i ging chm 3Kc ngoi c:1 oY nm ""e*

[M& Nng h 'ngurn ,i ging chm 3Kc ngoi c:1 oY nm ""e*

? sNH HNG CiA GII T NH V TUI T'C JN !OI GH aNG

t#9 2mX ,V Nng 1ng tng t#ng- mng Nng A& nn gcp cc loi gM& cnh tigM& Nng cong to hSnh/

ngTi giX cK loMng Nng nn cK e 3H Nng NHp &Ju Aw ,L gM& ltn Ht 3Hng- gM& c+ Nng hi/ nB t^ 31u tu+i mMn Finh thS gM& Nng Ao loMng Nng NuCt hi@n 3$m hn/

o T'C %NG CiA GH aNG TON THpN V TI CH Chong chCn thng 31u gM& NngX &Ju tH g=& chong t#ong gM& Nng l 1u v mCt

mu/ ID tin lng e nn nh=n cK ngu& c chong 3 A]1 vo mEc V t#m t#.ng c:1 gM& Nng nh gM& Nng l$n- gM& nhi;u Nng- t+n thng nhi;u m% m;m- 1 chCn thng v cc ACu hi@u t#$c chong nh mch nh1nh/ ChR 3H chong l mch t#n hu&Jt p t=m thu e ',Snh thTng "-!*- ACu hi@u mKng t1& hrng t# li muVn t#n Fhi ,Cm/ Ych 0u&Jt p t=m thu
-

gi=& 31u

Ch& muX g=& mCt mu An Jn tSnh t#ng chong nhCt l gM& Nng hi- Nng chu/ Ch& mu g=& #1 mu tQ An Jn chn \p Fho1ng/ [M& Nng cK Et mch mu Fm th2o Ap t:& c|ng g=& ngu& c tZc mch mu Ao m/

I1uX %i Fhi c|ng lm o) #i vo tSnh t#ng chong/ ID gim 1u 31u gM& Nng l phi ,Ct Vng tHt Nng gM& v t#nh N t#i th% ,o Nng gM&- c%ng tc t tng cho nn nh=n 1n t=m/

(Zc mch mu Ao mnX Ao gM& Nng cK Ap nt t:& cK ngu& c c1o Fh nng mn t#ong t:& Nng t#n vo t#ong mch mu g=& tZc mch mu Ao mn l ngu&n nh=n g=& t vong/

Chn \p Fho1ng cCp tinhX mu tQ vhng Nng gM& l$n 3 g=& cn t# mu g=& hVi chEng chn \p Fho1ng/

xHi lon Ainh AnngX ch& mu 31u gM& Nng g=& #1 FhHi mu tQ t#ung ,Snh c|ng gKp phn g=& hVi chEng #Hi lon Ainh Anng/

Co #tt c ti vhng gM&X cc c Nung Wu1nh vhng Nng gM& t+n thng phh n; c|ng lm cn t# mu lu th%ng 1 Jn thiJu mu c Ao K c ,L co #tt- mcc Fhc Nng gM& cK Ai l@ch lm Nng ngZn i v c chhng li 31u K t] ngZn i/ oCt FU e Fich thich no nh 1u- Nng ch1 ,Ct Vng c|ng lm Nng co li/

Chn \p thn Finh ngoi ,inX t+n thng t#]c tiJp thn Finh ,L #ch h1& Et- nJu Ao chn \p cQc ,V c|ng g=& #Hi lon v; thn Finh/

)hiwm t#hngX gM& Nng cK t+n thng A1- gM& Nng h l ngu& c nhiwm t#hng #Ct c1o/

IU TR" YQc ichX lm li;n Nng th2o tng hSnh Ang ,1n u v phQc hri tHt chEc nng vn Vng/ )gu&n tZcX nZn li cc Ai l@ch- ,Ct Vng tHt v lin tQc : thTi gi1n- tp vn Vng ch: Vng 3$m/ Phng phpX + Ii;u t#L ,o trn Finh iDnX ,K ,Vt/ + oo trn ci tiJnX 3] ,Ct Vng cK tinh tng Hi 'ct nyp- m1ng 1i vi*/ + CH Lnh ngoiX phu thutX m+ FJt hp Nng- Kng inh nVi t:&- ,Zt nyp- cZt l.c t#ong gM& Nng h/ g\o tX chR l gi1i on u p AQng cho mVt 3H gM& Nng Fh%ng vBng t#$c Fhi ,K ,Vt h1& m+ FJt hp Nng/

> Cy( CU NN NHpN GH aNG CHI

> 1 N18V B-RQ 8L8 bt: <u cu m %ng tch #1/ `2m N\t nn nh=n tSm th2o thE t] cCp cEuX nghyt th- ch& mu mch mu l$n- gM& Nng- vJt thng/ > $ C1e8V O1/S8V )hn Lnh Tng th- FiDu th- tun hon- ACu hi@u ch& mu/ Ii;u t#L ,Ct FU t+n thng no lin Wu1n Jn tinh mng nn nh=n/ ong \p ni ch& mu ,?ng ,ng v% Fhuln/ (#Cn 1n- cho nn nh=n uHng n$c Cm- Zp Cm ngh ngi/ gh%ng Ai chu&Dn nn nh=n Fhi ch1 gim 1u v ,Ct Vng Nng gM&/

> F B0 B,8V k38V V-E oCt Vng chi gM& t#n v A$i Fh$p/ giDm t#1 mch t#$c v 31u Fhi nyp chi/ gh%ng cH gZng F\o thng chi gM&- ni t#t Fh$p/ gh%ng 3T nZn vo ni Nng nh% #1/ qVi #1 3ch Nng h ,?ng n$c v% Fhuln- ,ng Fin giB lm v 3ch/ )=ng n chi c1o ln/ Ict tti n$c ni vhng t+n thng/

oCt Vng gM& Nng hi 'ngurn ,i ging chm 3Kc ngoi c:1 oY nm eff6*

+UH TR~NH CHwM SxC BhNH NHpN GH aNG 1 N1c8 BY81 081 0PC8V BN )i gM& v m% Nung Wu1nhX Yu A1 th1& +i- phh nhi;u h1& it- ,m- ch& mu v tQ mu/ oiJn Ang chi t+n thng- tiJng lo No c:1 Nng gM&/ Inh gi mEc V 1u/ qCu hi@u chn \p Fho1ngX 1u- t- li@t- mCt mch- tim/ [i$i hn c Vng- mCt c Vng/ (on th=nX tim ti- l m- FhK th- chong- th1& +i hu&Jt p- + mr h%i- 3 v lo =u,@nh lG Fm th2o- chCn thng Fm th2o/

$ C18 B/S8 }t O58 01-A_ D A.2.1. . ! gim chMc n<ng vn $Ing li5n ) *n $Pn g2! Qng vJ chn thng mG mTm )hn Lnh Nung Wu1nh vhng Nng gM&- m% m;m- vJt thng #ch A1- m% Ap nt- tSnh t#ng vJt thng

[iB nhy nhng m% t+n thng ,?ng 3] cH Lnh vBng Fh$p t#n v Fh$p A$i vhng gM&t#nh t+n thng thm v 1u tng/ oCt FU t#Tng hp no c|ng Fh%ng nZn 31 Nng Fhi ch1 gim 1u h1& g=& t cho nn nh=n/

IZp lnh lm gim phh n; v ngng ch& mu/ p1u gM& Nng Ao ch& mu g=& mu tQ chn \p Fm th2o t+n thng c nn chi phh n;/ Iq n=ng n chi c1o ,?ng gHi gitp mu tnh mch hri lu tHt- nn ct gHi A.c th2o chi;u Ai chi/

Cho o) nghR ngi- gitp o) gim cng thng- gitp phQc hri c thD 31u chCn thng/ giDm t#1 ACu hi@u chn \p thn Finh- mch mu mi giT nhCt l gM& Nng l$n/ )hn Lnh ACu hi@u t+n thng m% m;mX ch& mu- phh n;- tSnh t#ng vhng A1 Nung Wu1nh vJt thng/

[itp o) Au& t#S c t thJ chEc nng tHi 1 m Fh%ng g=& 1u $n cho o)- chm lKt tHt nhBng vhng cH Lnh- thTng Nu&n thm hzi o)/ (# gitp o) th1& +i t thJ mi giT/

)hn Lnh ton ,V v; ,K ,Vt- F\o t- ,ng vJt thng mi e- giT u v 31u K l mi 5 giT- ghi cht mEc V hot Vng- o chi/

0$ng An o) tp lin tQc vn Vng c- tp mi 5 giT/

A.2.2. K* li5n ) *n $Pn chvn [3 thn kinh )hn LnhX mEc V- tinh chCt- thTi gi1n c:1 1u/ Cc chn \p cCp tinh thTng ,iDu hi@n ,?ng ACu hi@u iDn hSnh c:1 #Hi lon cm gic v vn Vng/ (hi AQ 1u Hng t#Q- Fhi Cn vo #Mnh t#Q 1u chKi v l1n t#u&;n th2o Tng i NuHng cng t1& c:1 thn Finh t#Q/ [itp o) t thJ gim 1u m Fh%ng nh hng Jn t+n thng/ (h1& +i t thJ mi giT gitp c Fh%ng ,L m@t- th]c hi@n thuHc gim 1u/ A.2.3. K* li5n ) *n $Pn chvn [3 kho*ng N* g2! Qng

p l]c Fho1ng ,Snh thTng l "-!mm0g- Fhi grng c ch: Vng p l]c tng ln !"mm0g nhng 31u Fhi hJt grng c thS p l]c NuHng t#L 3H ,Snh thTng 31u ! phtt/

Chn \p Fho1ng l 3] tng p l]c t#ong mVt h1& nhi;u Fho1ng lm gim lu th%ng mu Wu1 Fho1ng An Jn thiJu mu cQc ,V/ )Ju chn \p F\o Ai g=& t+n thng c v #Hi lon thn Finh/

Iq cn nhn Lnh ACu hi@u 2 A.1 c:1 chn \p Fho1ng l 1u AB AVi ng& cng tng1u F\o Ai Fhi 3T ln mct A1 cEng v cng ,ong/ I1u l ACu hi@u 3$m nhCt c:1 chn \p Fho1ng/ I=& l ACu hi@u 3$m Iq cn c1n thi@p ng1& D phPng ng^1/

)hBng ACu hi@u chn \p # #@t l 1u cK Fm cc ,iDu hi@n thn Finh nh cm gic t ,S nh FiJn ,P- gim cm gic- #Hi lon vn Vng 'c &Ju i*/ Iq cn th2o Ai thTng Nu&n v pht hi@n 3$m ACu hi@u chn \p Fho1ng 6 giT c coi l t#L 3H ngnng/ )Ju A$i 6 giT cK h& v.ng i;u t#L ,o trn nhng t#n 6 giT thS cK chR Lnh phu thut/ YHc thTi gi1n nh 31uX + 6 giTX gi$i hn i;u t#L ,o trn/ + 6-e! giTX phu thut cK thD giB c chi/ + (#n e! giTX on chi D cEu 3Hng nn nh=n/

A.2.4. DiPn 8ng c th h*! N/ mt tm thci chMc n<ng $Ic l3 c(* c th )hn Lnh 3] nhn thEc v mEc V Vc lp c:1 t^ng o)/ [itp o) cK Fhong #ing tgitp o) t] v@ 3inh c nh=n/ (] tp nhBng c Fh%ng t+n thng- h$ng An h1& h t# tp nhBng c t+n thng/ [itp o) n uHng tHt t#nh 3Qt c=n- Au& t#S 3Ec Fhz2/ ghu&Jn Fhich nhBng thnh vin t#ong gi1 Snh Au& t#S Wu1n h@ tHt- t%n t#.ng o)/

A.2.5. 6im t"i m mG 8o chn thng )hn Lnh tSnh t#ng m% t+n thngX mEc V t+n thng- ACu ch& mu- m% ht

giDm t#1X mu 3Zc- nhi@t V- mch ngoi ,in- phh- 1u- chEc nng vn Vng- + & mu ngoi ,in- 3o 3nh vhng t+n thng v$i Nung Wu1nh/

A.2.=. ?0n thng 8* 8o 4t $Ing1 8o 4S 4It1 8o k[o t )hn Lnh ,; mct A1 v$i cc ACu hi@u chn \pX z- 1u- tSnh t#ng vJt thng/ `o1& t# mi giT- m1331g2 lng- m%ng t#nh ,L chn \p- lo\t- gitp mu lu th%ng tHt/

Cho o) phi nZng- th2o Ai ACu hi@u tZc mch Ao ,Ct Vng/ (p vn Vng/ qinh AnngX cho o) n & : chCt- uHng nhi;u n$c/

A.2.W. ;g ! c nhiOm t:Hng 8o vPt thng1 8o g2! Qng hd1 8o Q !5n $inh1 8o 8bn l 1 8o mGi t:cng 4%nh vi%n )hn Lnh ACu hi@u nhiwm t#hngX 3ng- nKng- z- 1u/ 4u%n p AQng Fd thut v% Fhuln Fhi th1& ,ng- ch2 ch vhng Nng lV #1- cZt l.c m% c hoi t- chm 3Kc An lu/ (h]c hi@n Fhng 3inh- th2o Ai th=n nhi@t- 1u nhEc/ A.2.>. Ch<m NSc g2! Qng t:w Rm (#9 2m lnh Nng nh1nh hn ngTi l$n v c chJ t] i;u chRnh ,iJn Ang cho nn thTng i;u t#L ,o trn/ vS thJ Iq chm 3Kc F\o t Wu1 A1 'nJu cK*- thTng t#.ng lng t Fh%ng Wu 7 Fg- th2o Ai 3] li;n Nng mi ng& nh o chi- `-bu1ng/ )Ju t#9 cK ,K ,Vt Iq chm 3Kc t#9 ,K ,Vt- pht hi@n 3$m chn \p- #Hi lon tun hongitp t#9 thoi mi- Aw chLu/ vt lG t#L li@uX Fh%ng No1 ,Kp Ah l nhy nhng nhCt l vhng Fh$p vS Aw g=& cEng Fh$p vnh viwn- Fh$p 31u ,K ,Vt chR l tm thTi v Fh%ng cn c1n thi@p/ F G-S/ j[O BN ghu&n Fh%ng cho o) m1ng ncng t#n chi t+n thng/

[itp o) lC& li 3Ec c ,?ng Ainh Anng v lu&@n tp/ [itp o) nh gi cn 1u v cch gim 1u/ [itp o) No1& t#- vn Vng ngn ng^1 lo\t- phi nZng- chm 3Kc A1- h$ng An cch i nng- v@ 3inh c nh=n- ti Fhm tng thTi gi1n

CpU HqI !rNG GI' Ch.n c=u t# lTi tng nhCt e/ [M& Nng Fin V e cK nhBng cc iDm 31u- ngoi t#^X 1/ CK N=& Nt A1 n%ng ,/ [M& Nng n gin/ c/ gh%ng t+n thng m% m;m A/ [M& Nng mEc V t#ung ,Snh/ / qCu hi@u 3$m nhCt D pht hi@n chn \p Fho1ng 31u gM& Nng lX 1/ YCt mch ,/ [im cm gic/ c/ ( A/ I1u 7/ o) ,L chn \p Fho1ng 31u gM& Nng v$i thTi gi1n chn \p l s giT- o) 3 c i;u t#LX 1/ Ii;u t#L ,o trn ,/ CK thD phu thut c/ Ic phu thut v giB li chi

A/ Ic phu thut v on chi 5/ )hBng i;u nn lm Fhi cCp cEu nn nh=n gM& NngX 1/ oCt Vng chi gM& v gim 1u ,/ oCt Vng chi gM& t#n Fh$p c/ I1 nn nh=n vo c 3 & tJ gn nhCt A/ oCt Vng chi gM& A$i Fh$p !/ ID gim 1u cho nn nh=n 31u gM& Nng- i;u cn thiJt phi lm lX 1/ Cho nn nh=n uHng thuHc gim 1u ,/ oCt Vng tHt Nng gM& c/ (im thuHc t ni t+n thng A/ ChTm nKng ni t+n thng

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Chm 3Kc o) gM& Nng- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- ""f- f7/ / )gu&wn bu1ng 4ong- Ii cng v; gM& Nng- oi ging ,@nh h.c ngoi Fho1- tp !- Ii h.c < qc (P0CY- effs- 56/ 7/ pu31n xuA1- Yu3culo3F2l2t1l P#o,l2m- )u#3ing xol2 in Y1n1g2m2nt Yu3culo3F2l2t1l P#o,l2m- in Y2Aic1l pu#gic1l )u#3ing- ou#th Aition- 42i3 Colli2# 02itF2mp2#} Ypo<eff - es7f/

BI F$ +UH TR~NH CHwM SxC BhNH NHpN M aNG

MC TIU 1. Trnh by c "7c <chQ chA nhQ chYng chA nh "4 =ng. 2. Ki;! k$ c nhng i& !h&8n li v bE! li khi "4 =ng. (. Trnh by c !ai bi'n /o "4 =ng. +. 9h?" sTc b;nh nhSn !rMc v sa& "4 =ng. g. ThJc hi;n %&y !rnh ch?" sTc b;nh nhSn sa& "4 =ng.

1 MC CH )Zn- ,Ct Vng Nng gM&/ [itp lnh Nng 3$m/

$ CH "NH V CHNG CH "NH $ 1 C1 BY81 0QEA0 Be[M& Nng FhK nZn F\o/ [M& Nng Fm th2o Et A=& ch?ng- 31i Fh$p/ [M& ni u Nng/

[M& nhi;u vL t#i/

$ $ C1 BY81 0k38V BeCc ,@nh lG v; Nng nhX vim Nng- ung th Nng/ $ F C1e8V O1 BY81 `ng 1ng nhiwm t#hng/ )i Nng gM& m% NCu- 3yo NCu- thiJu A1/ `ng Fh%ng vBng c 31u Fhi m+/ [M& lrng 't#^ gM& c+ Nng hi*/

F THU*N !rI V ByT !rI CiA M aNG F 1 T1Qc8 bv`ng gM& 31u phu thut c nZn 31 gn nh ton Ai@n th2o G muHn/ gh%ng F\o Ai thTi gi1n n?m i;u t#L/ vn Vng c 3$m- t#nh c cc ,iJn chEng Fhi n?m l=u/

F $ B0 bvoiJn gM& Nng Fin thnh gM& Nng h/ )gu& c nhiwm t#hng- ,L mCt mu nhi;u Fhi m+ Nng l$n/ xHi lon Wu t#Snh lnh Nng Ao cZt Et c- mch mu- thn Finh/ Ict vt l vo- %i Fhi phi m+ li D lC& #1/ IPi hzi phi cK Fd thut chu&n Fho1/

; TAI BIJN IHi v$i m%X co #tt c Ao cZt nhi;u m% c- nhiwm t#hng vJt m+/ IHi v$i NngX Ao tc AQng Fim loi ct vo t#ong t#Tng hp m+ FJt hp NngX vim Nng- Nng FhK lnh/ Ych mu thn FinhX cK thD t+n thng th& th2o mEc V Fhc nh1u/ (on th=nX nhiwm t#hng- vim tnh mch- thu&n tZc- chong

IKng inh nVi t:& cK chHt Nng cng ch=n 'httpX}}tuoit#2/vn*

IKng inh nVi t:& 31u phu thut c+ Nng hi 'httpX}}tuoit#2/vn*

Iinh nVi t:& Nng hi 'httpX}}tuoit#2/vn*

? CHwM SxC BhNH NHpN M aNG ? 1 TPk|O :n BN O8 BC0 OSO ELQ OQ .5Q o) Fh%ng 3Ht/ qinh AnngX p#otiA26" g}Al/ 0rng cu :- 0ct ,Snh thTng/ gh%ng cK nhiwm t#hng A1 Nung Wu1nh Nng gM&/

? $ C19: .{O 0Pk|O :n C%ng tc t tngX gii thich cho o) ,iJt phng php gii phu/ v@ 3inh vhng A1 t#$c m+ e - 5 giTX #1 A1- co l%ng Fh%ng c t#& #ch A1- co #Vng th2o Wu& Lnh c:1 gii phu chRnh hSnh/
-

(hQt tho ,u+i tHi t#$ m+ nJu m+ chi A$i/ ChQp `-bu1ng ng]c- N\t nghi@m mu nhCt l nh gi hrng cu- c1lci- pho3ph1t2/ (ho ,Vt D chm 3Kc A1 nJu cK- nn ct chi t#ong nyp/ (ho h@ thHng F\o t nJu cK v ,Ct Vng chi ,?ng nyp/

(h1& ,ng vJt thng nJu cn- t#nh 3 AQng Aung ALch 3t Fhuln cK mu/ gh%ng n uHng 31ng ng& m+/ (h]c hi@n Fhng 3inh A] phPng/ 0$ng An o) tp vn Vng 31u Fhi m+/

? F C19: .{O .5Q :n (h2o Ai q0p( Jn Fhi +n Lnh- cht G mch- nhi@t V v hu&Jt p/ Pht hi@n 3$m cc ACu hi@u ch& mu Wu1 An lu- ni ,K ,Vt- vJt m+/ Chm 3Kc o) 1u 31u m+X th]c hi@n thuHc gim 1u- c%ng tc t tng 0@ thHng An lu phi Fin v v% t#hng/ (h2o Ai 3H lng- mu 3Zc- tinh chCt ALch ch& #1- cht G ch& mu/ gh%ng th1& ,ng vJt m+ v% Fhuln- Fh%ng tho ,ng t#$c 5 giT 31u m+ t#nh ngu& c ch& mu/ ghi ,ng thCm nhi;u mu chR th1& l$p ngoi- nn ,ng \p nJu cK ACu hi@u ch& mu/ Cn th2o Ai ACu hi@u chn \p Ao phh n;- Ao mu tQ- Ao ,ng \p Wu chct/ )=ng c1o vhng gii phu gitp gim phh n;- FiDm t#1 mch mu- ACu hi@u chn \p Fho1ng Ao mu tQX ACu hi@u !PX + P1inX 1u/ + P1llo#X tim ti/ + P1#23th23i1X &Ju li@t/ + P1#1l&3i3X li@t/ + Pul32l233n2#3X mCt mch/

(#ong t#Tng hp m+ vim Nng thS cn cZt l.c m% hoi t- Nng chJt- mu tQ/ ghu&Jn Fhich o) hit th 3=u/

Cho o) n ,Snh thTng Fhi Fh%ng n%n Ki/ PhQc hri chEc nngX + (p ch: VngX tp vn Vng 5 giT 31u m+ cc phn Fh%ng cn ,Ct Vng nh No1& t#vn Vng- tp grng c- co Aui- F\o #Png #.c- tp cc Fh$p- tp c A9o A1i/ + (p thQ Vng chi ,L ,@nhX tp grng c nhy nhng cht G Fh%ng g=& 1u- Fh%ng g=& phh n; thm/ + (p t#ong 3inh hotX n?m- ngri- Eng- i t thJ thoi mi- tng t thJ c nng/

(#ong t#Tng hp on chiX ngoi nhBng chm 3Kc t#n Iq cht G phQc hri cho o)X cch lZp ct ,V phn gi- cch i nng v t#n hJt l vCn ; chCp nhn 3] ,iJn Ang c thD- cch Ai chu&Dn v cm gic chi YA/

o CHwM SxC BN M ON CHI o 1 C1Q8 dY BN 0Pk|O :n x1 3ch A1 ,?ng Aung ALch 3t Fhuln Fh%ng mu/ `c Lnh cK mch ngoi ,in/ po 3nh phh n;- mu 3Zc- nhi@t V A1- 1u v$i m% c:1 c thD ,n Hi Ai@n/ giDm t#1 q0p( D pht hi@n tSnh t#ng nhiwm t#hng/ x1 3ch vJt thng/

o $ N1c8 BY81 D .5Q :n qn lu ti mm cQt/

(Snh t#ng phh n; 31u m+/ ong Fin nhng Fh%ng Wu chct/ Inh gi 1u/ (Snh t#ng vn Vng c:1 cc chi cPn li/ (=m lG 1n t=m/ YEc V vn Vng/ oiJn chEngX ch& mu- nhiwm t#hng vJt m+- chi m1

o F C18 B/S8 }t O58 01-A_ D =.3.1. DiPn 8ng c th 8o $on chi )hn Lnh tSnh t#ng t=m lG hSnh Ang c thD Ao mCt chi- Fhu&Jn Fhich o) nKi ln cm gic c:1 mSnh/ o) v gi1 Snh chng hp tc th1m gi1 vo vi@c mcc Wun o- tp vn Vng tng cTng 3Ec c- t] chm 3Kc- gi1o tiJp t#ong NM hVi- t] th1m gi1 vo vi@c hri phQc/ [ii thich v; vi@c lZp chi gi- cho o) gcp o) lZp chi gi v lm Wu2n v$i AQng cQ chi gi/ =.3.2. . ! gim chMc n<ng vn $Ing 4ng gi Fh nng Au& t#S chEc nng vn Vng chi/ (p vn Vng tng cTng 3Ec c chi lnh/ 0$ng An o) i nng- lZp chi gi/ Cho o) th]c tp cc vn Vng t#ong 3inh hot hng ng& nhX v@ 3inh c nh=n- cch t] phQc vQ/ =.3.3. K* 8o cm gic chi m* 8o $on chi

(h]c hi@n thuHc gim 1u/ ghu&Jn Fhich o) vn Vng D gim phh n;/ [ii thich v$i o) tSnh t#ng chi m1- 1n ton t#nh t\ ngM/ g c1o chi 1n ton- t#nh v1 chm- chn \p/

=.3.4. ;g ! c nhiOm t:Hng m`m cXt (h1& ,ng mi ng&- #1 vJt thng nhy nhng/ Cht G tho ,ng nhy nhng- thCm $t ,ng t#$c Fhi tho t#nh lm 1u vS thTng ng1& u Nng cK mch mu- thn Finh/ )n ch2 ch vJt thng ,?ng gc cK tlm Aung ALch mh u h1& gc lm D ln 31u tho ,ng Fh%ng ,L t+n thng h1& 1u thm/ (h2o Ai ACu hi@u nhiwm t#hng h1& hoi t/

Y+ on chi cZt vt ,?ng nh1u - CZt vt Fh%ng ,?ng nh1u 'httpX}}gi1ngAuong&Fho1/n2t*

CHwM SxC BhNH NHpN SAU M KJT Hr( aNG 1 N1c8 BY81 081 0PC8V BN

(i chX + vJt m+X ,ng thCm ALch Fh%ng/ + qn luX 3H lng- mu 3Zc- tinh chCt ALch/ + (Snh t#ng vJt thngX phh n;- 1u- mEc V 1u- mu 3Zc A1 nim/

C Wu1n lin Wu1nX + (Snh t#ng tim ph+i- tun hon- q0p(- t#i gic/ + (Snh t#ng 3Ec c/ + (Snh t#ng n$c NuCt nhp- n$c tiDu Wu1 3onA2/

(=m lGX ,iJn Ang c thD- ,Ct Vng- 1u/ oiJn chEngX tZc mch- hu&Jt FhHi- mCt mch Ao hoi t- vim ph+i- nhiwm t#hng vJt m+/

$ C18 B/S8 }t O58 01-A_ D W.2.1. K* N* m0


-

Cho o) n?m ngh ti giTng/ )hn Lnh tSnh t#ng 1uX vJt thng- chn \p- AL vt `o1& t# o) thTng Nu&n v gitp o) t thJ Aw chLu nhCt/ [ii thich tSnh t#ng ,@nh- gio AQc o) thich nghi v t] chm 3Kc v@ 3inh c nh=n t#ong gi$i hn cho ph\p/

[itp o) i li/

W.2.2. D; 4S 4It N* m0# `2m ,i chm 3Kc o) ,K ,Vt/ W.2.3. ;g ! c 4iPn chMng 8o 4t $Ing N* m0 vn Vng chi lnh- tp grng c chi m+- vn Vng cc ngKn lin tQc/

g c1o chi- No1 ,Kp c/ (h2o Ai ACu hi@u chn \p/

W.2.4. ;g ! c ch! m N* m0 (h2o Ai q0p(/ (h2o Ai ch& mu Wu1 ,ng- An lu/ (h2o Ai 0ct- A1 nim/ oCt Vng tHt 31u m+- t#nh th1& ,ng t#$c 5 giT 31u m+- th]c hi@n ,ng \p 31u m+tho ,ng nhy nhng 1n ton/ $ ? NVQE O3 d-D8 O1N8V OSO O3 uQ58 41SO .5Q :n 0$ng An o) hit th 3=u- tp th- ngri A&/ (h2o Ai cn 1u ng]c- FhK th/ (h2o Ai nhLp th- cht G nhi@t V/ Chm 3Kc ,V phn 3inh AQc phPng ng^1 nhiwm t#hng tiDu/ )g^1 tZc mch chi 31u m+X th2o Ai ACu hi@u chn \p- F c1o chi nn F ton ,V chi;u Ai chi/ Chm 3Kc- th2o Ai vJt m+/ (h]c hi@n Fhng 3inh/

W.2.=. +h,ng ng-* mt m 1 chong 8o gim th tch 89ch# ,h ALch- th2o Ai n$c tiDu- 0ctACu mCt n$c- t#u&;n mu th2o & l@nh/ W.2.W. &inh 8@ng N* m0# cho o) uHng nhi;u n$c- thEc n cK nhi;u vit1min2 v cK tinh nhun t#Tng- p#otiA2- c1lci/ n ng1& Fhi o) tRnh/ W.2.>. D; lo N_ $i li N* m0

(p cho o) i li Fhi cK & l@nh- h$ng An cch i nng/ Cho o) ong 1 ch=n t#n giTng/ qi chu&Dn cho o) t^ giTng Wu1 N2/ Cho o) i li ,?ng nng nJu 1u thS ngng tp/ (#nh gM& Nng thE pht h1& ,iJn Ang 31u m+/

> GI'O DC BhNH NHpN [io AQc o) ti Fhm tng FU hn- ,iJt thTi gi1n lC& inh #1/ o) Au& t#S tp vt lG t#L li@u t#nh loMng Nng 31u m+/ [io AQc o) cc ACu hi@u ,Ct thTng 31u m+ Nng nh 1u- 3Ht/ ghu&Jn Fhich o) tp lu&@n- phi nZng D t#nh loMng Nng/ qinh AnngX n : chCt nhCt l thnh phn c1lci gitp Nng lnh tHt

CpU HqI !rNG GI' Ch.n c=u t# lTi tng nhCtX e/ (#$c m+ Nng o) phi t cc &u cu 31uX 1/ P#otiA2s"g}Al ,/ o) Fh%ng cK ,@nh ngoi A1 c/ 0rng cu- 0ct ,Snh thTng A/ (Ct c ;u tng / o) 31u m+ Nng Iq cn th2o Ai v chm 3Kc vCn ; no- ngoi t#^X

1/ Cn n=ng c1o chi 31u phu thut Nng ,/ (h2o Ai ACu hi@u chn \p Fho1ng/ c/ Cho o) n ,Snh thTng Fhi Fh%ng n%n Ki/ A/ (h1& ,ng vJt m+ ng1& Fhi thC& ,ng thCm mu/ 7/ ID t#nh ngu& c ch& mu 31u m+ FJt hp Nng- Iq cnX 1/ gh%ng th1& ,ng t#$c 5 giT 31u m+/ ,/ ong \p 31u m+ c/ oCt Vng tHt chi ,@nh 31u m+ A/ (Ct c ;u tng 5/ p1u m+ Nng o) 1u nhi;u- Iq cn chm 3KcX 1/ Cho o) n?m ngh ti giTng ,/ Cho o) grng c chi m+ c/ 0$ng An o) tp ch: Vng chi lnh A/ oCt Vng tHt- o) 3 c gim 1u !/ Chm 3Kc mm cQt cn lu G nhBng iDm gSX 1/ ChR th1& ,ng Fhi ,ng thCm ALch ,/ gh%ng #1 vJt thng ,?ng Aung ALch 3t Fhuln cK mu c/ Ch2 ch vJt thng ,?ng gc cK tlm Aung ALch mh u A/ Phi ,ng \p vJt thng

TI !IhU THAM KHsO

e/ )gu&wn (Cn CTng- chm 3Kc o) gM& Nng- Ii;u Anng )goi - )h NuCt ,n [io AQc vi@t )1m- ""f- e"!/ / )gu&wn bu1ng 4ong- Ii cng v; gM& Nng- ,i ging ,@nh h.c ngoi Fho1- tp !- Ii h.c < qc (P0CY- effs- 56/ 7/ Chm 3Kc ngoi Fho1 'ti li@u thi iDm ging A& Iq t#ung h.c* "7 paqA 0 )Vi- eff5- ee"/ 5/ pu31n xuA1- Yu3culo3F2l2t1l P#o,l2m- )u#3ing xol2 in Y1n1g2m2nt Yu3culo3F2l2t1l P#o,l2m- in Y2Aic1l pu#gic1l )u#3ing- ou#th Aition- 42i3 Colli2# 02itF2mp2#} Ypo<eff - es7f/

BI FF CHwM SxC BhNH NHpN VIM aNG

MC TIU 1. Trnh by c nh nghPaQ gi2i ph3& b;nh v phSn loi vi$" =ng. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn vi$" =ng.

1 "NH NGHA vim Nng chCn thng l cc nhiwm t#hng Nng Ao vi t#hng thTng Fh%ng cc hi@u t^ ngoi vo 31u gM& Nng h- 31u cc phu thut v; Nng- 31u m+ FJt hp Nng t#ong gM& Nng Fin c|ng nh gM& Nng h/ ')g% oo gh1ng*

$ GIsI (H)U BhNH [i1i on cCp tinhX (+n thng m% m;mX cc m% m;m ,L Ap nt t#ong gM& Nng h- Ao mu tQ 31u m+ FJt hp Nng Fh%ng c An lu tHt/ (+n thng NngX nhBng mnh Nng #Ti nhz thiJu mu nu%i Anng 1 Jn hoi t l + nhiwm t#hng ti Nng/ [i1i on mMn tinhX (+n thng m% m;mX ,1o grm cc l AP #1 A1 v cc Tng AP th%ng vo Nng- cc Tng AP cK nhi;u ngKc ngch v nhi;u m: chung Wu1nh l AP l nhBng t+ chEc N ,1o ,.c nh mVt F\n lm tSnh t#ng vim Nng Fh%ng lnh/ Cc t+n thng NngX giB1 FhHi c1l Nng l$n Ao 3] phQc hri to Nng m$i cK hHc Fh%ng ;u c:1 vim Nng chE1 & m:/ ng t:& cK nhi;u mch mu to Nng m$i mnh m v ,it Fin An Hng t:&/ Cc u Nng N ch1i Aw to

thnh Nng chJt- nhiwm t#hng- Fich thich to Nng m$i ,1o ,.c Nng chJt- c|ng nh F;m giB m% m;m hoi t v m: to Tng AP/

qP m: cng ch=n vim Nng 31u chCn thng 'httpX}}tuoit#2/vn*

`-bu1ng vim Nng 31u chCn thng 'httpX}}tuoit#2/vn*

F (HpN !OI (h2o thTi gi1n Aiwn ,iJn cK h1i gi1i on/ vim Nng chCn thng cCp tinhX nhiwm t#hng + Nng t#ong 7-5 tun u/ vim Nng chCn thng mMn tinhX vim mng Nng Ao 3yo N ch1i- lo\t- vim Nng cK l AP- vim Nng cK Nng chJt- vim Nng F\o Ai ung th hK1/

; +UH TR~NH CHwM SxC BhNH NHpN VIM aNG ; 1 N1c8 BY81 081 0PC8V BN qB Fi@n ch: Wu1nX + (h%ng tin v; 3Ec Fhz2X htt thuHc l- uHng #u- ,@nh mMn tinh Fm th2o/ + (i;n 3X chCn thng Nng- gM& Nng h- vJt thng nhiwm t#hng/

+ (huHcX lm AQng thuHc- thuHc gim 1u- Fhng 3inh- co#ticoiA/ + Phu thut h1& nhBng i;u t#L Fhc/ + (on th=nX tSnh t#ng 3Ec Fhz2 cK 3u& Fi@t- cK nhiwm t#hng/ + Chu&Dn hK1 { Ainh AnngX 3Ht- lnh #un- 3Qt c=n- chn n- m@t mzi/ + )hn thEcX 1u tng Fhi c Vng vhng Nng vim/ + o@nh lG Fm th2oX Aaqp- tiDu Tng- l1o- ung th qB Fi@n Fhch Wu1nX + (+ng t#ngX 3Ht =m R cK ltc 3Ht c1o- ,Ec #Ec- ACu hi@u nhiwm t#hng- m%i Fh%- lni Am@t mzi- A1 N1nh nim nht/ + q1X tot mr h%i- n+i mlm A1- vhng A1 chung Wu1nh Nng vim z- phh n;- 1u nJu vim Nng cCp tinh- t#ong vim Nng mMn tinh A1 Nlm mu/ + C Nng Fh$pX 1u- phh- t#ong vim Nng mMn tinh cK t2o c- gi$i hn c Vng- An lu vJt thng/ + )hn Lnh m% NngX m% Nng 2n- v vQn- Tng AP + qCu hi@u FhcX cC& mu '*- ,ch cu tng- vp tng/ + (on th=nX nhi@t V c1o- mch nh1nh- 3u& Fi@t/ ; $ C18 B/S8 }t O58 01-A_ D 4.2.1. K* li5n ) *n $Pn tFnh t:ng vi5m )hn Lnh mEc V t#m t#.ng c:1 cn 1u- vL t#i v cc phng php gim 1u thich hp/ (#nh nhBng hot Vng lm gi1 tng tun hon/ )=ng n nhy nhng Fhi c Vng chi o) D gitp o) gim 1u v ngn ng^1 gM& Nng ,@nh lG/ qu& t#S o) t thJ thng Eng- ngn ng^1 t thJ ,Ct thTng h1& cng c An Jn 1u tng/ 0n chJ Ai chu&Dn- h$ng An o) 3 AQng AQng cQ h t# Fhi Ai chu&Dn/ (#nh v1 chm vo thnh giTng ngn ng^1 o) 1u/ (h]c hi@n thuHc gim 1u/

4.2.2. D; khGng thoi mi 8o tFnh t:ng Nt (h2o Ai nhi@t V mi 5 giT h1& th2o & l@nh- ghi thnh ,iDu r- th2o Ai p Eng i;u t#L/ Cho o) n?m phPng m& lnh- Wun o nhy mzng- th]c hi@n thuHc h 3Ht- l1u mt/ Cho o) uHng nhi;u n$c/ bu1n 3t A1- l1u Fh% 3ch mr h%i/ (h]c hi@n thuHc Fhng 3inh/

4.2.3. ;g ! c nhiOm t:Hng lB! l*n li5n ) *n $Pn vPt thng1 8bn l (h2o Ai vJt thng h- vJt thng An lu Fh%ng m ,o tSnh t#ng v% Fhuln ,i nhBng ngTi chm 3Kc/ Iq phi ,iJt cch chm 3Kc gitp gim &Ju tH ngu& c nhiwm t#hng/ p AQng cc ,i@n php cch l& D ngn cn 3] l=& nhiwm ch\o t^ vJt thng n& 31ng vJt thng Fhc- t^ vJt thng o) n& 31ng vJt thng o) Fhc/ 4.2.4. +hH nT nh hdng $Pn tiPn t:Fnh vi5m vJ N/ 4t $Ing Io chu vi tE chi mi ng& D nh gi i;u t#L mEc V phh n;/ )=ng c1o chi gitp mu hri lu/ (h2o Ai mch chi mi Fhi n=ng c1o ,i vS mch 3 gim NuHng Ao gim lng mu ti chi c|ng Aw lm tSnh t#ng phh n; gi1 tng/ [rng c chi ,@nh v tp vn Vng cc ngKn gitp mu lu th%ng tHt/

4.2.5. . ! gim vn $Ing c th 8o $* vJ 3hH nT (# gitp o) tp vn Vng chi lnh v chi ,@nh gitp tng cTng 3Ec c/ (p vt lG t#L li@u gitp o) i li Fh%ng ,L ,iJn chEng/

4.2.=. Ch kn 49 D; m0 cft l\c C%ng tc t tng- th]c hi@n Fhng 3inh th2o & l@nh/ (h]c hi@n cc N\t nghi@m cn l=m 3ng- cc th: thut chln on/ x1 3ch vJt thng- chm 3Kc A1 t#$c Fhi chu&Dn o) ln phPng m+/

4.2.W. Ch<m NSc D; N* m0 cft l\c vi5m Qng (h1& ,ng vJt thng mi Fhi thCm ALch/

(h1& ,ng An lu- c=u nHi v% Fhuln- 1n ton- #tt th2o & l@nh/ (h2o Ai th=n nhi@t- ghi thnh ,iDu r nhi@t V/ (h2o Ai ALch tiJt t^ vJt thng v; mu 3Zc- tinh chCt ALch/ (h2o Ai cc ACu hi@u chn \p chi 31u m+/ g c1o chi gim phh n;/ [itp o) cch vn Vng i li/

? GI'O DC BhNH NHpN qinh AnngX cung cCp & : p#otiA2- vit1min2- c1lci/ o) Ao vim nhiwm l=u ng& nn thD t#ng thTng 3u& Fi@t #Ct nhi;u/ (h]c hi@n Fhng 3inh & :- uHng thuHc tng li;u- tng thTi gi1n ti nh/ (p vn Vng chi tng cTng 3Ec c gitp o) i li t#nh t\ ngM/ )Ju o) vn cPn t#ong tSnh t#ng 1u nn cho o) nghR ngi ti giTng- phi nZng/ 0$ng An o) cch i li t#nh t\ ngM- Fh%ng lm vi@c gZng 3Ec t#n chi ,@nh t#nh ngu& c gM& Nng ,@nh lG/ 0$ng An o) cch t] chm 3Kc vJt thng- v@ 3inh th=n thD 3ch 3/ (i Fhm Lnh FU/

o TIU CHU&N !rNG GI' o) gim 1u- gim phh n;- tSnh t#ng vim gim/ (Snh t#ng vJt thng gim vim nhiwm/ (hD t#ng Fh%ng cK ACu hi@u nhiwm t#hng/

CpU HqI !rNG GI' e/ o) 31u m+ vim Nng cn c th2o AiX 1/ (Snh t#ng h% hCp ,/ )hi@t V c/ Phh n;

A/ (Snh t#ng tun hon / vJt thng 31u m+ vim Nng cn c chm 3KcX 1/ (h1& ,ng mi Fhi thCm $t ALch ,/ gh%ng nn th1& ,ng mi ng& c/ )g=m #1 v$i thuHc tim ln} ng& A/ ong \p vJt thng 31u mi ln th1& ,ng 7/ qn lu ct 31u m+ vim Nng 3 c #ttX 1/ p1u m+ 5 giT ,/ p1u m+ 5s giT c/ ghi hJt ALch A/ ghi o) hJt 3Ht 5/ ghi cho o) n=ng c1o chi 31u m+ vim Nng- Iq cn th2o AiX 1/ YEc V phh n; ,/ Ych chi c n=ng c1o c/ Cm gic chi n=ng c1o A/ Yu 3Zc A1 chi n=ng c1o !/ o) vim Nng- Iq Fhu&n o) nn t#nhX 1/ vn Vng ,/ Phi nZng c/ n nhi;u m A/ [rng c

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc o) vim Nng- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f-e!!/ / )gu&wn bu1ng 4ong- oi ging ,@nh h.c ngoi Fho1- tp !- vim t:& Nng- Ii h.c < qc (P0CY- effs- 78!

7/ oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nng- Ii h.c < qc (P0CY- lu hnh nVi ,V-e8e/ 5/ Yu3culo3F2l2t1l gnol2Ag2 ,132 o# P1ti2nt ith q&3unction- in Y2Aic1l pu#gic1l )u#3ing mounA1tion3 o# Clinic1l P#1tic2nA

2A- ~o p1unA2#3 comp1n&- effs- s78/

BI F; CHwM SxC BhNH NHpN CHyN THNG C%T SNG

MC TIU 1. Trnh by c !ri;& chFng lS" sng v c8n lS" sng !r$n b;nh nhSn chEn !hng !-y sYng. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn chEn !hng cU! sYng.

1 I CNG
-

ChCn thng cVt 3Hng l chCn thng g=& t+n thng mVt t#ong nhBng thnh phn cVt 3Hng Ao t1i nn gi1o th%ng- t1i nn l1o Vng- t1i nn thD th1o- ,Zn 3tng/ 0i@n tng phh t:& NuCt hi@n ng1& 31u Fhi chCn thng cVng th2m hi@n tng co thZt Vng mch v m1o mch/ Y% t:& th2o lG thu&Jt thS Fh%ng thD thiJu oN& Wu 6 giT- nJu tSnh t#ng thiJu mu v chn \p Wu 6 giT thTng D li nhi;u Ai chEng/

ChCn thng cVt 3Hng cK thD NuCt hi@n ,Ct FU iDm no t#n cVt 3Hng v mEc V t#m t#.ng Fhc nh1u- mEc V chCn thng t^ chCn Vng t:& Jn Et t:& c:1 Hng t:&/ ChCn thng cVt 3Hng c+ t#n C 5 thS 3u& h% hCp ng1& v li@t tE chi- chCn thng C 7 t#n thS cK nh hng Jn 3] 3Hng/ 4i@t tE chi NuCt hi@n t+n thng ( 6 h1& ln t#n- li@t chi tSm thC& t+n thng (8 t# NuHng/

$ TRIhU CHNG !pM SNG $ 1 C18 01k38V O,0 .e8V On I1u cVt 3Hng c+ h1& 1u l1n #1 #w A=& thn Finh vhng t1&/ I cVt 3Hng Ao co #tt c cnh cVt 3Hng c+/ vyo cVt 3Hng c+/ [i$i hn c Vng cVt 3Hng c+/ pu& h% hCp/

0Vi chEng li@t t:& c+ 31u chCn thng- cK 5 hVi chEng li@t t:& lX + 0Vi chEng li@t t:& t#$cX t+n thng vn Vng/ + 0Vi chEng li@t t:& 31uX mCt cm gic 3=u/ + 0Vi chEng li@t t:& t#ung t=mX li@t nhi;u h1i t1&- it h1i ch=n/ + 0Vi chEng gip t:&X t+n thng cZt Et An t#u&;n thn Finh g=& li@t vnh viwn h1i chi A$i/

$ $ C18 01k38V O,0 .e8V bk8V I1u iDm t#n cVt 3Hng h1& 1u Fhi Cn/ [h- 3T thC& FhHi nh% ln vhng t+n thng/ om mu- tQ mu it thC&/ Co #tt c cnh thZt lng { thZt lng/ [i$i hn c Vng cVt 3Hng thZt lng { thZt lng- cVt 3Hng/ oiJn chEng thn Finh/ xHi lon cm gic n%ng '1u- nKng- lnh* v 3=u 'AL cm*/ xHi lon c vPng ,1ng Wu1ng v hu m%n ',i tiDu- to ,Kn*/ xHi lon phn NX mCt h1& gim phn N g=n Nng nJu o) ,L li@t m;m t^ u- tng t#ong chn \p t:&/ )Ju t+n thng Ap t:& hon ton 3 ,L li@t vn Vng/ o1,in3Fi '*li@t m;m chu&Dn 31ng li@t cEng/ xHi lon Ainh AnngX lo\t A1- t2o c- th1& +i A1 mKng

F C*N !pM SNG `-Wu1ng cVt 3Hng thng nghing/ C( { 3c1n gitp nh gi mEc V t+n thng/ Yxa gitp chln on t+n thng t:&/

; IU TR" g\o t/ Phu thut/

Chm 3Kc phQc hri/

? +UH TR~NH CHwM SxC BhNH NHpN CHyN THNG C%T SNG ? 1 N1c8 BY81 081 0PC8V BN 5.1.1. &' ki%n ch( ) *n (h%ng tin Wu1n t#.ng v; 3Ec Fhz2/ (i;n 3 chCn thng Ao t1i nn N2- thD th1o- n ,Zn- t\ CK uHng #u h1& thuHc 1n thn Fh%ng Fhi chCn thng/ (=m lGX AB- t#m cm- t^ chHi- lo 3/ (+ng t#ng o) v; c=n ncng- oYa/ vn VngX F\m 3Ec- mCt cm gic A$i ch t+n thng- th chm- th &Ju/ Cm gicX 1u ng1& ti vhng t+n thng h1& t#n- t li@t- FiJn ,P- co git c- nKng ,zng/

5.1.2. &' ki%n khch ) *n q1X ti tim- lnh- o) Fh%ng + mr h%i A$i ch t+n thng/ 0% hCpX + ChCn thng Ce { C7X ngng th- mCt Fh nng ho 3cc/ + ChCn thng C5X ho gim- th ,?ng c honh- th tng th%ng Fhi/ + ChCn thng C! { C6X gim h% hCp- tim ti/ (im mchX chCn thng t#n ( !X mch chm- hu&Jt p gim- h hu&Jt p t thJ- mch p gim/ (iu hK1X gim h1& mCt nhu Vng #uVt- ,Qng ch$ng 't+n thng vhng ( !*- to ,Kn- i ti@n Fh%ng t] ch:/
-

(iJt ni@uX ,1ng Wu1ng cng 't+n thng (e- 4 *- mCt t#ng l]c ,1ng Wu1ng nJu gi1i on cCp- o) tiu tiDu Fh%ng t] ch:/ pinh AQcX Ang vt cng- mCt Fh nng tSnh AQc/ (hn FinhX + 4i@t hon tonX li@t m;m- li@t ch=n t1& 't+n thng phi1 t#n C 8*- li@t thng phi1 A$i C8*- tng phn N g=n c 3=u- o1,in3Fi '* h1i ,n/ chi A$i 't+n

+ 4i@t Fh%ng hon tonX mCt h1& gim phn N t] Vng/ vn VngX mCt t#ng l]c c 't#ong tSnh t#ng m;m nh|n*- gM& Nng 't#ong tSnh t#ng li@t co cEng*/ Cm gicX mCt cm gic vhng A$i t+n thng- mCt cm gic n%ng 3=u/

5.1.3. ZXc ti5 ch<m NSc qu& t#S cc chEc nng thn Finh mEc V tHt nhCt/ o) cK ,iJn chEng v; vn Vng mEc tHi thiDu/ (# o) v; cho cVng rng mEc tHt nhCt/ PhPng ng^1 ,iJn chEng Ao chCn thng cVt 3Hng/

0Snh nh cVt 3Hng gM& lS1- t:& 3Hng Et #Ti-

ch=n o) ,L li@t 'httpX}}/th1nhni2n/com/vn*

? $ C18 B/S8 }t O58 01-A_ D 5.2.1. Ci thi%n vJ 8 ! t:F tFnh t:ng NMc khUR (h%ng ,o ngu& c th%ng thTng- th1m vCn- gio AQc cch 1n ton t#ong 3inh hott#ong Ai chu&Dn- m1ng A=& 1n ton t#ong N2 hi- Vi m| ,o hiDm Fhi i N2 m&- N2 pFh%ng uHng #u Fhi li N2- 1n ton t#ong l1o Vng/ v$i o) chCn thng cVt 3Hng thTng D li Ai chEng ncng n; v FhK hri phQc/

5.2.2. ;g ! c 8i chMng n]ng nT hn 8o c*n thi%3 khi c3 cM khGng $ing vi@c 3 cEu #Ct Wu1n t#.ng v$i tinh mng o) c|ng nh Ai chEng v; 31u- cn ,iJt cch 3 cEu 1n ton cho Jn Fhi c chln on v cK c1n thi@p chu&n Fho1/ ` t#i nh 31uX

Ict o) n?m ng1- u ,?ng t#n vn cEng h1& ,ng c1/ Ict tti ct v c+ Fh%ng N ALch Fhi Ai chu&Dn/ )Ju cK AQng cQ cH Lnh cn m1ng vo c+ ng1&/

,n c+ 31o cho u

CVt u- ng]c- v1i- mo chu- hi- cng ch=n o) vo vn cEng h1& ,ng c1/ oCt Vng tHt nhCt l nn ,Ct Vng c+ gitp ,o v@ thn Finh/ Chu&Dn o) Jn chu&n Fho1 l tHt nhCt/

5.2.3. g[o t 8o chn thng cIt Nng c0


-

(#ong chCn thng c+ o) c F\o C#utch2lA h1& vinF2 h1& FiDu F\o t Fhc/ 0@ thHng F\o grm 3i A=& th^ng F\o cng t^ giB1 t#ung t=m c:1 Fyp Wu1 #Png #.c v cuHi chng l Wu t/ 0@ thHng F\o n& F\o lin tQc/ oCt li c:1 Fyp 3. l phi th1& +i vL t#inJu cK thS cH gZng giB V cng c:1 c+ v nn Fu g.i m.i ngTi tp t#ung gitp n/ o1o ct cn Ahng t#ong thTi gi1n n& D cH Lnh c+ t#ong thTi gi1n ct li/ (#.ng lng t ,?ng e}e"{e}8 t#.ng lng c thD/ YEc V ,@nh cng nhy- 3Ec ncng c:1 F\o cng tng/ p1u -8 ng& F\o ncng thS gim v Au& t#S mEc e{ -! Fg Hi v$i ngTi l$n/ (h& thuVc vo mEc V t+n thng v c1n thi@p i;u t#L h@ thHng F\o cK thD ,z #1 31u {5 tun 31u Fhi chCn thng/

p1u Fhi lC& h@ thHng t #1 thS cn cH Lnh c+ o) ,?ng nyp c+ cho ph\p o) c Vng nhi;u hn v ngri c t#n N2 ln/ Chm 3Kc A1 chu o t#ong thTi gi1n F\o t l cn thiJt vS gim cm gic- tun hon F\m- ,Ct Vng v tng tiJt mr h%i lm A1 #Ct Aw ,L t+n thng/ )hiwm t#hng ch=n inh Ao F\o tX chm 3Kc ln mi ng& v$i n$c muHi 3inh lG v ,1o ch=n inh ,?ng Au Fhng 3inh ,o v@ 3] N=m nhp c:1 vi Fhuln/

5.2.4. Zt chMc n<ng hG h3 8o tFnh t:ng chn thng (#ong 5s giT u 31u chCn thng- phh n; gi1 tng Wu mEc- mCt chEc nng h% hCp v 3u& h% hCp NuCt hi@n/ gh%ng th]c hi@n thuHc gim 1u ,?ng Yo#phin2/ )Ju o) FhK th AB AVi h1& Fhi mu Vng mch gim thS o) c ct nVi Fhi Wun h1& m Fhi Wun v th m&/ )Ju o) ngng th thS cho th m& ng1&/ )gu& c vim ph+i v Nyp ph+i #Ct c1o Ao o) ,L li@t c lin 3Tn An Jn th ,Qng Ao K o) Fh%ng tiJt c m nh$t E .ng v Fh nng ho gim/ o) F\o t Fh%ng ngri A& c nn ngu& c vim ph+i c1o/

Iq lu%n thlm Lnh tiJng th- Fhi mu Vng mch- thD tich th- mu A1- FiDu th- Fh nng th- 3H lng v mu 3Zc c:1 m- P1 l$n hn 6" mm0g- P1C 5! mm0g/ Iq th2o Ai nrng V oN& Wu1 monito#- Au& t#S oN& & : cho o)/ vt lG t#L li@u lrng ng]c gitp o) ho tHng m nh$t- htt m nh$t- o thD tich ph+i/

5.2.5. ? n hoJn khGng 0n $9nh 8o :i lon nh93 tim qo mCt 3] p Eng A=& thn Finh `- nhLp tim chm thTng nhz hn 6" ln}phtt/ oCt FU 3] Fich thich no nh htt m nh$t- No1& t# o) c|ng cK ngu& c ngng tim/ YCt h@ gi1o cm nn nhLp tim F\m- hu Wu l o) #Ct Aw h hu&Jt p t thJ/ YCt t#ng l]c c nn vi@c gitp mu hri lu Fh%ng hi@u Wu An Jn mu ch& chm/ Iq cn th2o Ai 3t q0p(- nJu mch chm nn ,o op v Ahng At#opin th2o tng & l@nh- hu&Jt p gim nn Ahng thuHc vn mch nh qop1min2 v ALch th1& thJ/ qhng v$ thun giMn gitp mu hri lu tHt t#nh thu&n tZc mch- th1& v$ sgiT}ln D chm 3Kc A1 tHt- chm lKt ,?ng nhBng tti Fhi gitp tng tun hon mu/ (h2o Ai 0ct- 02moglo,in D t#nh tSnh t#ng mCt mu v phPng ng^1 chong gim thD tich/ 5.2.=. ;g ! c thiP 89ch vJ khGng 8 ! t:F 8inh 8@ng 8o <n ng khGng $_c (#ong 3uHt 5s-8 giT 31u chCn thng thS vi@c cho n Wu1 Tng tiu hK1 phi ngng li Ao tSnh t#ng li@t #uVt v nn ct An lu A A& D gii p/ o) Fh%ng n uHng c Wu1 Tng mi@ng nn cn c th2o Ai ALch v i@n gii/ Cung cCp ALch c ,n th2o &u cu- Fhi o) cK nhu Vng #uVt h1& nh hi c thS cho o) n/ o) cn #Ct nhi;u chCt Ainh Anng v p#ot2in c1o D cung cCp nng lng v ci to tJ ,o/ )Ju o) chCn thng cVt 3Hng c+ thS nn nhn Lnh tSnh t#ng nuHt c:1 o) t#$c Fhi cho n ,?ng Tng mi@ng/ )Ju o) Fh%ng hri phQc thS nn cung cCp Ainh Anng Wu1 tu,2 42vin2 h1& Wu1 ALch t#u&;n/ )n cung cCp thEc n nhi;u chCt N gitp o) Aw i tiu- cK mVt 3H o) chn n cK thD Ao t=m lG- Ao thEc n Fh%ng hp Fhlu vL- nn FiDm 3ot Ainh Anng v c=n o) mi ng&/ 5.2.W. Zt chMc n<ng 4*ng ) *ng vJ : It 8o 49 li%t

ong Wu1ng Fh%ng giB n$c tiDu Ao mCt phn N- mCt t] ch: ,ng Wu1ng v c vPng/ qo o) mCt cm gic nn ,1ng Wu1ng E .ng n$c tiDu v cK ngu& c vim thn- 3u& thn,ng Wu1ng cng Wu mEc cK thD vn/

o) thTng c ct th%ng tiDu 31u Fhi chCn thng/ Chm 3Kc h@ thHng v% Fhuln hon ton- nn Au& t#S hn chJ ALch es"" { """ ml}ng& gitp thun ti@n cho vi@c tp ,ng Wu1ng- t#nh to 3zi- t#nh nhiwm t#hng/

(h2o Ai 3t 3H lng- mu 3Zc- tinh chCt n$c tiDu- nn FiDm 3ot tSnh t#ng nhiwm t#hng- cC& n$c tiDu- N\t nghi@m p0 n$c tiDu/

5.2.>. ?o 4Sn 8o D; li%t vn $Ing I=& l vCn ; o) vS phn N t] ch: v Fh%ng t] ch: t#ong vi@c thi ph=n F\m/ qhng thuHc nh\t hu m%n- thuHc nhun t#Tng nhng hn chJ thQt tho vS 3 nh hng Jn 3] phQc hri li@t c vPng hu m%n/ 5.2.A. ;hi%t $I :i lon 8o mt kim Not nhi%t $I vS Fh%ng co mch- gim nhi@t Ao mr h%i vhng A$i t+n thng/ Iq nn th2o Ai nhi@t V phPng v Au& t#S nhi@t V hp lG/ [itp o) Au& t#S nhi@t V c thD thich hp- gitp o) Fh% #o- 3ch 3/ 5.2.1E. D; lo[t1 ch! m 8 8J! 8o Nt:RNN N* chn thng 4 vCn ; Hi v$i o) chCn thng t:& 3Hng vS p Eng c:1 3inh lG c thD v$i chCn thng Wu ncng- 3t#233 t=m lG- Ahng co#ticoiA li;u c1o t#ong i;u t#L phh t:&/ IRnh c1o ngu& hiDm t^ 6 { e5 ng& 31u chCn thng/ (h2o Ai mu t#ong ph=n- t#ong A A& Wu1 tu,2 42vin2 mi ng&/ (h2o Ai N\t nghi@m 0ct/ (h]c hi@n thuHc co#ticoiA cn ,+ 3ung thm thuHc t#ng A A&- Ahng thuHc Fhng 0 D gim tiJt 0Cl c:1 A A&/ p] ch& mu tiu hK1 c|ng nh hng Jn vim ph+i hit- 3u& Fi@t c thD/ 5.2.11. Zt cm gic 8o N* chn thng Iq cn ,h li 3] thiJu vZng cm gic- mCt cm gic/ [i1o tiJp v$i o)- cho o) ngh2 nhc- ngi mhi thm- mhi vL 1 thich- cho o) .c 3ch N2m ti vi/ (#nh D o) t] thu mSnh- to cho o) 3] t] tin/

5.2.12. +hn Q mt N* chn thng Chong Ao chCn thng t:& 3Hng thS c gii Wu&Jt- phQc hri phn N c|ng cn c th]c hi@n/ qo mCt FiDm 3ot c:1 chEc nng thn Finh c1o nn cK cc phn Fh%ng thich hp v Wu mEc nh co thZt- cng cEng Fhi Fich thich- ,Hi #Hi- mCt thoi mi/ o) cn c cung cCp th%ng tin # #ng v; huCn lu&@n cc phn N- #uVt- ,ng Wu1ngtSnh AQc/ qhng cc phng php tZm Cm- tZm n$c No& i;u t#L- thuHc t#L co thZt- thuHc giMn c/ 5.2.13. Zt 3hn Q t/ $Ing 8o li%t N* chn thng 4 tim mch mCt ,h t#^ ng1& tEc thS Ao phn N cc nhnh h@ thn Finh t] Vng Ao K ,1ng Wu1ng cng- ,L Fich thich/ Co thZt ,1ng Wu1ng- t#]c t#ng- Fich thich c:1 A1 h1& Fich thich 1u t^ c Wu1n nhn cm Ao mCt phn N t] Vng/ oiDu hi@nX hu&Jt p gim- nhSn mT- 1u u- tot mr h%i nhi;u- th nh1nh- A1 l%ng A]ng Eng- m|i Nung hu&Jt- n%n Ki/ Iq n=ng u o) ln 5!"/ )hn Lnh D Nc Lnh ngu&n nh=n- ngu&n nh=n ph+ ,iJn l ,1ng Wu1ng Fich thich nn cch N t#i l ct ng1& Hng th%ng tiDu- ct nhy nhng chm nn No1 Au cK thuHc t vo Hng th%ng Fhi ct D gim cm gic Fich thich ni@u o vS cK thD lm tng t#i@u chEng/ p1u K th2o Ai q0p( cho Jn Fhi +n Lnh/ ? F G-S/ j[O BN 41- }R 81t )gTi i;u t#L v chu&n gi1 t=m lG nn FJt hp chm 3Kc o)/ CK nhBng t#i@u chEng 3 t# thnh mMn tinh v F\o Ai 3uHt Ti v$i o)/ 0$ng An 3 AQng cc AQng cQ gitp hri phQc nhX N2 ln- i@n- AQng cQ c h.c/ (p th gitp o) Fh%ng l@ thuVc vo m& th- phQc hri thn Finh thS phi hon tCt it nhCt 31u e nm chCn thng/ ong Wu1ng thn FinhX li@t vnh viwn nn h$ng An o) cch ct th%ng tiDu ti nhnh gi ,1ng Wu1ng- thuHc- Ainh Anng cn hn chJ c1lci 'eg}ng&*- n$c 'es"" { """ ml}ng&* gitp ngn to 3zi- ct Hng th%ng tp tiDu/ Ii ti@nX Ao mCt phn N nn o) Aw ,L to ,Kn- h$ng An o) n thEc n nhi;u NuHng nhi;u n$c h1& thQt tho cho o)/

pinh AQcX nn mTi chu&n Fho1 t=m lG tSnh AQc t vCn gitp o)/ vn Vng i liX FJt hp giB1 o) v gi1 Snh Fin t#S tp lu&@n- Ai chu&Dn Wu1 N2 ln h1& i nng/ (# o) v; NM hVi- gio AQc h$ng nghi@p/

? ; !kv8V V-S o) hri phQc tSnh t#ng li@t vn Vng/ o) th1m gi1 tp lu&@n/ o) hiDu ,iJt v; ,@nh v ,iJt cch chm 3Kc/

CpU HqI !rNG GI' e/ pt#233 o) chCn thng t:& 3Hng thTng cK ngu& cX 1/ vim tQ& ,/ (o ,Kn c/ `uCt hu&Jt A A& A/ xHi lon th=n nhi@t / p1u chCn thng t:& 3Hng- o) to ,Kn Ao li@t vn Vng- Iq cnX 1/ (hQt tho cho o) ,/ Cho o) uHng thuHc nhun t#Tng c/ 0$ng An o) tp c vPng A/ `o1& t# o) thTng Nu&n 7/ )i ,Ct Vng tHt nhCt cho o) chCn thng cVt 3Hng lX 1/ C+ ,/ )g]c c/ Y%ng A/ (Ct c tng 5/ (#nh ngu& c thu&n tZc mch cho o) cK t+n thng cVt 3Hng- Iq cnX 1/ `o1& t# o) giT}ln ,/ qhng tti Fhi chm lKt chi c/ Y1ng tCt

A/ Y1ng tCt chun giMn !/ o) chCn thng cVt 3Hng c+ Iq nn th2o AiX 1/ (Snh t#ng chi gic ,/ (h=n nhi@t c/ qCu hi@u FhK th A/ (#ng l]c ,ng Wu1ng TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Iq ngoi -Chm 3Kc o) chCn thng cVt 3Hng- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- "5/ / )gu&wn vn (hnh- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nng[M& cVt 3Hng- lu hnh nVi ,V- e5f/ 7/ v vn (hnh- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nng- [M& cVt 3Hng c+- ti li@u lu hnh nVi ,V- e!f/ 5/ )2u#ologic p&3t2m- Ch1p2# 7- Yo3,& 3 Y1nu1l o Clinlc1l )u#3ing 32conA Aition- th2 C- v- Yo3,& Comp1n&- efs6- 75 /

BI F? CHwM SxC BhNH NHpN BONG GpN

MC TIU 1. Trnh by c phng ph p i& !r bong gSn. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn bong gSn.

1 I CNG IQng gip l nhBng vhng ,m tim nhng Fh%ng cK t+n thng t#n A1/ p] cng gin c l F\o c- A=& ch?ng Ao 3] F\o cng Wu mEc/ oong g=n l Et A=& ch?ng giB1 u Nng 'A=& ch?ng Fh$p*/ q=& ch?ng giB Fh$p l mVt t+ chEc grm nhi;u 3i coll1g2n cK tinh it n hri v #Ct chZc/ oong g=n l 3] Et cc 3i n& Ao cng giMn Vt ngVt Wu mEc/ q=& ch?ng ,L cZt Et Fh%ng g.i l ,ong g=n/ (c nh=n g=& #1 ,ong g=n cK c chJ chCn thng gin tiJp- l]c uHn ,9 F\o cng Wu mEc lm cho cc 3i coll1g2n c:1 cc A=& ch?ng ,L Et/ (+n thng A=& ch?ng thTng Aiwn tiJn Wu1 7 gi1i onX + [i1i on vim tC& cCp tinhX thTi gi1n Fhong 8 giT- cK vn mch mu v ngCm mu #1 tJ ,o/ + [i1i on phQc hriX t^ 8 giT Jn 5-6 tun cK 3] tich tQ coll1g2n/ + [i1i on ti toX t^ 5-6 tun 31u chCn thng Jn 7-6 thng l thTi FU t+ chEc li c v coll1g2n/

0Snh nh ,ong g=n 'httpX}}/tin3ucFho2/com*

$ (HpN !OI CK 7 mEc V/ IV eX Et e phn- #ch tHi thiDu th$ 3i A=& ch?ng- A=& ch?ng chR ,L giMn nhy/ IV X Et nhi;u hn !u nhng A=& ch?ng ch1 Et hn- A=& ch?ng ,L gMn nhi;u nhng ch1 g=& tSnh t#ng chnh vnh Fh$p/ IV 7X A=& ch?ng ,L Et hn- hon ton mCt 3] lin tQc v g=& chnh vnh Fh$p/

'httpX}}3ucFho2Aoi3ong/vn*

F IU TR" (huHc gim 1u- 1n thn/ Phng php N t#i ng1& 31u chCn thng + a 'ac2*X chTm lnh "-7" phtt- ngh 7" phtt lm lin tQc 5-8 giT h1& nhi;u hn th& vo t+n thng/ ChTm lnh lm gim ch& mu- gim phh n;/ + C 'Comp#233ion*X ,ng \p mu tnh mch nhng Fh%ng c D chn \p APng ch& c:1 Vng mch- ,ng lm co thZt v hn chJ mu hri lu- t#2o t1&/ + a 'ammo,ili1tion*X ,Ct Vng vhng t+n thng 'cK thD ,ng thun h1& ,K ,Vt*/ gh%ng tp vn Vng t#ong thTi gi1n ch& mu- chR tp 31u ,ong g=n 8-e" ng& v cPn th& vo t+n thng- Fh%ng m1ng ncng/ + 'l2v1tion*X n=ng c1o chi t+n thng ng1ng m]c tim D tng mch mu hri lu gitp gim 3ng vim/ Cn t#nh n=ng Wu c1o h1& t#n m]c tim vS 3 lm cn t# APng ch& Vng mch lm gi1 tng 3ng hn/ 4u GX t#ong thTi gi1n n& o) Fh%ng ch Nt- No1 ,Kp h1& No1 thuHc ln ch 3ng vim

; +UH TR~NH CHwM SxC BhNH NHpN BONG GpN ; 1 N1c8 BY81 081 0PC8V BN I1u vhng t+n thngX 1u chKi ng1& Fhi t+n thng- 31u K 1u gim v 1u t t- 31u vi giT 1u AB AVi li- c Vng 1u tng hn/ png n; vhng t+n thng- ,m tim/

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. K* 8o 4ong gBn Inh gi mEc V 1u/ (h]c hi@n thuHc gim 1u- 1n thn cho o)/ oCt Vng vhng t+n thng ,?ng ,ng thun giMn- ,?ng nyp/ gh%ng cho o) No1 ,Kp- Zp nKng t#n vhng t+n thng/ )n Zp lnh ng1& 31u Fhi ,ong g=n gitp gim 1u- gim ch& mu- gim nKng/ (h]c hi@n c%ng tc t tng- h$ng An o) hn chJ vn Vng/

4.2.2. D; N ! gim vn $Ing 8o 4ong gBn )hn Lnh ng1& vhng t+n thngX 1u- nKng- 3ng Chm 3Kc vhng t+n thng nhy nhng- hn chJ thm Fhm thTng Nu&n/ IZp lnh gitp gim phh n; v gim ch& mu/ )=ng chi c1o ln gitp mu hri lu tHt gim phh n;/ (p hJt ,in V vn Vng cho o) mEc V Fh%ng 1u t#ong thTi gi1n ,Ct Vng/ (#2o chi D gitp gim 1u v gi1 tng thoi mi/ giDm t#1 thn Finh- mch mu gitp pht hi@n 3$m cc ,iJn chEng/ (# gitp o) i nng- t#nh i t#n ch=n 1u/ (# gitp o) v@ 3inh c nh=n 3ch 3/ (h]c hi@n thuHc gim 1u- Fhng vim/ gh%ng vn Vng t#ong gi1i on vim tC&/

4.2.3. C t0n thng khGng c,n hot $Ing nh 4Fnh thcng 8o $* [itp o) 1n t=m #?ng chEc nng c ti hot Vng 31u Fhi cK i;u t#L thich hp/ ghu&Jn Fhich o) tiJp tQc vn Vng chi t#ong gi$i hn cho ph\p- cn thn t#.ng vS cK thD ,L t+n thng li/ (h]c hi@n thuHc gim 1u th2o & l@nh t#ong ltc tp lu&@n/

4.2.4. 6io 8Xc D; Cung cCp cho o) FiJn thEc v; t+n thng v ,iJn chEng/ 0$ng An o) v gi1 Snh t#ong th]c hi@n thuHc- th1& Wun o- v@ 3inh v nhBng hot Vng mi ng&- cch i nng/ [io AQc o) thn t#.ngX Fh%ng tp Fhi 1u- Fh%ng lm vi@c ncng- t#nh i li Wu gZng 3Ec nJu chi ,L thng l chi A$i/

? !rNG GI' o) phQc hri li tm hot Vng Fh$p t+n thng/ o) t# v; cuVc 3Hng thTng ng&X c%ng vi@c- gi1 Snh v NM hVi/

CpU HqI !rNG GI' e/ o) ,L ,ong g=n cn c N t#i th2o thE t]X 1/ ac2 { ammo,ili1tion { Comp#233ion { l2v1tion ,/ ac2 { l2v1tion { Comp#233ion { ammo,ili1tion c/ l2v1tion { ac2 { Comp#233ion { ammo,ili1tion
A/ ac2 { Comp#233ion { ammo,ili1tion { l2v1tion

/ Iq cn lm gS cho o) Fhi o) 1u Ao ,ong g=nX 1/ gh%ng c Ahng thuHc gim 1u cho o) ,/ oCt Vng vhng t+n thng ,?ng nyp c/ `o1 ,Kp v Zp nKng t#n vhng t+n thng A/ 0$ng An o) vn Vng nhy nhng 7/ )g1& 31u Fhi ,L ,ong g=n- o) cn c N t#iX 1/ ChTm nKng ,/ `o1 Au nKng c/ `o1 ,Kp v$i #u thuHc A/ IZp lnh vhng t+n thng 5/ Ii;u no 31u =& Iq cn h$ng An cho o) ,ong g=nX 1/ vn Vng Fhi ,ong g=n nhy nhng ,/ `o1 Au nKng ln vhng t+n thng c/ gh%ng vn Vng t#ong gi1i on vim tC& A/ (p vt lG t#L li@u mi ng& !/ p1u m+ ,ong g=n Iq cn th2o AiX 1/ (Snh t#ng mCt mu ,/ qCu hi@u chn \p c/ qCu hi@u li@t A/ qCu hi@u nhiwm t#hng
TI !IhU THAM KHsO

e/ )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc o) ,ong g=n- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e57/ / )gu&wn vn (hnh- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nngti li@u lu hnh nVi ,V- sf/ 7/ v vn (hnh- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nng- ti li@u lu hnh nVi ,V- 8s/ 5/ )gu&wn bu1ng 4ong- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nngIi cng v; ,ong g=n- Ii h.c < qc (P0CY- lu hnh nVi ,V- 7e/ !/ Yu3culo3F2l2t1l 3&3t2m in Yo3,& Y1nu1l o Clinlc1l )u#3ing- 32conA Aition- th2 C-vYo3,& Comp1n&- efs6- 78!/

BI Fo CHwM SxC BhNH NHpN TR*T KH(

MC TIU 1. Trnh by c c c loi !r8! khMpQ phng ph p i& !r v bi'n chFng c-a !r8! khMp. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn !r8! khMp.

1 I CNG (#t Fh$p l mVt t+n thng t#m t#.ng c:1 cCu t#tc A=& ch?ng chung Wu1nh + Fh$p/ 0u Wu l h1i u Nng tch hn #1 Fhzi + Fh$p/ on t#t Fh$p l Ai l@ch mVt phn h1& Fh%ng hon ton c:1 cc mct Fh$p v$i nh1u/ (#t Fh$p gcp m.i lE1 tu+i nhng nhi;u nhCt ngTi t#9/ (+n thng c ,n c:1 t#t Fh$p l t+n thng c:1 A=& ch?ng v ,1o Fh$p/

Cc loi t#t Fh$p Fhu_u 'httpX}}&Auocvn/com*

$ (HpN !OI TR*T KH( $ 1 T1/ V-^- _1`Q (#t Fh$p hon ton/

on t#t Fh$p/ [M& t#t/

$ $ T1/ 012- V-58 (#t Fh$p cCp cEu it hn 5s giT- l$n hn 5s giT 31u t1i nn/ (#t Fh$p Jn 3$m 'it hn 7 tun* 31u t1i nn/ (#t Fh$p c| 'nhi;u hn 7 tun* 31u t1i nn/

$ F T1/ bK: .t8V (#t Fh$p Fin- t#t Fh$p h 'vJt thng Fh$p*- t#t Fh$p FhK1 'Fyt*- t#t Fh$p Fin cK ,iJn chEng thn Finh/ $ ; T1/ :NO B, 0S- _1S0 (#t Fh$p ln u/ (#t Fh$p ti Aiwn/ (#t Fh$p thTng t#]c/

$ ? T1/ }Y 0P\ `c Lnh ,?ng vL t#i t#t c:1 chzm hocc thnh phn N1 c:1 Fh$p/ (#t Fh$p v1iX l t#t Fh$p giB1 Nng cnh t1& v Nng , v1i/ (#t Fh$p Fhu_uX giB1 u A$i Nng cnh t1& v u t#n Nng cng t1&/ (#t Fh$p h1ngX thTng Ao chCn Vng mnh/ (#t Fh$p #1 t#$c- t#t Fh$p #1 31u- t#t Fh$p #1 ngoi- t#t Fh$p vo t#ong- t#t Fh$p ln t#n- t#t Fh$p NuHng A$i/

(#t Fh$p Fhu_u #1 31u 'httpX}}&Auocvn/com*

F (HNG (H'( IU TR" Cc t#t Fh$p Jn 3$m cK thD i;u t#L ,o trn c ,?ng cch nZn Fh$p/ oCt Vng A]1 vo &Ju tH l thTi gi1n lnh ,1o Fh$p- Nng gM& v 3] phQc hri chEc nng c:1 ,1o Fh$p/ (p vn Vng/ Phu thutX chR Lnh thTng A Act/

; BIJN CHNG I Fh$p/ vim c cHt hK1/ 4zng Fh$p/ CEng Fh$p/ (#t Fh$p ti Aiwn/

? +UH TR~NH CHwM SxC BhNH NHpN TR*T KH( ? 1 N1c8 BY81 081 0PC8V BN 0zi o) c chJ- thTi gi1n N& #1 t#t Fh$p/ 0zi o) v; cch N t#i ,1n u/ )hn Lnh v; tSnh t#ng 1u $n c:1 o)/ (=m lGX 1u $n- lo 3/ )hSnX ,iJn Ang Fh$p/ pTX cK ACu hi@u lP No- + Fh$p #ng/ pu& gim chEc nng hot Vng/

? $ C18 B/S8 }t O58 01-A_ D 5.2.1. D; lo lfng 8o nfn kh"3 C%ng tc t tng gitp o) 1n t=m- gim lo lZng/ (h]c hi@n thuHc gim 1u v 1n thn t#ong v 31u Fhi nZn/ Chuln ,L v phQ gitp op t#ong vi@c nZn Fh$p/ (h2o Ai 1u 31u nZn Fh$p v t#Cn 1n o)

Cho o) n?m ngh ngi/

5.2.2. Dt $Ing N* nfn kh"3 [ii thich D o) ,Ct Vng t#ong thTi gi1n ngZn/ Cho o) ,Ct Vng hon ton vhng t#t Fh$p/ [rng c nhy nhng vhng ,Ct Vng/ gh%ng No1 ,Kp h1& No1 thuHc/

5.2.3. D; t3 vn $Ing kh"3 t:ong vJ N* thci gi*n 4t $Ing (p grng c t#ong ,Vt- tp cc Fh$p Fh%ng ,L ,Ct Vng/ (#nh No1 ,Kp cc Fh$p vS Aw g=& ,iJn chEng vim c cHt hK1/ gh$p v1iX ,K ,Vt e-7 tun- 31u K tp vn Vng nh No1& vPng v1i- ,P tTng- l1u lng/ gh$p Fhu_uX tp nhy nhng 31u -7 tun ,Ct Vng- 31u K tp Aui Fh$p Fhu_u/ gh$p hngX Fh%ng ,Ct Vng l=u Ai- 31u 6 tun o) m$i c i chHng ch=n 1u/

5.2.4. 6io 8Xc D; [ii thich cho o) ,iJt + Fh$p 3u& &Ju chEc nng 31u chCn thng vS thJ cK ngu& c ti t#t Fh$p/ [ii thich cho o) ,iJt cn Jn ,@nh vi@n ng1& Fhi cK t#t Fh$p/ (#nh cc Vng tc cK thD g=& t#t Fh$p li/ gh%ng No1 ,Kp cc Fh$p v$i tCt c cc loi thuHc/

o TIU CHU&N !rNG GI' o) Fh%ng ti t#t Fh$p li/ o) lC& li vn Vng ,Snh thTng/

CpU HqI !rNG GI' e/ p1u Fhi nZn Fh$p o) cn cX 1/ oCt Vng tng Hi vhng t#t Fh$p ,/ oCt Vng hon ton vhng t#t Fh$p c/ `o1 thuHc D gim 3ng

A/ vn Vng nhy nhng vhng t#t Fh$p / ghi no c g.i l t#t Fh$p c|X 1/ )hi;u hn e tun 31u t1i nn ,/ )hi;u hn tun 31u t1i nn c/ )hi;u hn 7 tun 31u t1i nn A/ )hi;u hn 5 tun 31u t1i nn 7/ )Zn Fh$p c th]c hi@n Fhi noX 1/ Cng 3$m cng tHt ,/ o) hJt 1u c/ 5 giT 31u Fhi t+n thng A/ o) cPn t#9 Fh%ng loMng Nng 5/ (#$c Fhi nZn Fh$p- Iq cn th]c hi@nX 1/ IVng vin tinh thn- gii thich ,/ (h]c hi@n thuHc g=& t c/ (h]c hi@n Fhng 3inh A] phPng A/ (h]c hi@n thuHc gim 1u v 1n thn !/ Iq cn h$ng An o) ,L t#t Fh$p Fhu_u i;u gSX 1/ )n ,Ct Vng tCt c cc Fh$p ,/ (p nhy nhng Fh$p ,L t+n thng 31u -7 tun ,Ct Vng c/ (p nhy nhng Fh$p ,L t+n thng t#ong Fhi ,Ct Vng A/ (p nhy nhng Fh$p ,L t+n thng 31u e tun ,Ct Vng

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc o) t#t Fh$p- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e5f/ / ohi vn IEc- oi ging ,@nh h.c ngoi Fho1- tp !- (#t Fh$p- Ii h.c < qc (P0CYeffs- 75 /

7/ (#n vn o&- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nng- Ii h.c < qc (P0CY- lu hnh nVi ,V- !f/ 5/ )gu&wn bu1ng 4ong- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nngIi cng v; ,ong g=n- Ii h.c < qc (P0CY- lu hnh nVi ,V- 7e/ !/ Yu3culo3F2l2t1l 3&3t2m in Yo3,& Y1nu1l o Clinlc1l )u#3ing- 32conA Aition- th2 C-vYo3,& Comp1n&- efs6- 78!/

BI F +UH TR~NH CHwM SxC BhNH NHpN Cx KHUNG C "NH NGOI

MC TIU 1. Trnh by c nh nghPaQ chA nhQ chYng chA nh v bi'n chFng c-a kh&ng cY nh ngoi. 2. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn cT kh&ng cY nh ngoi.

1 "NH NGHA CH Lnh ngoi l phng ti@n cH Lnh Nng gM& ,?ng AQng cQ Fim loi ct ,n ngoi chi gM& 'th%ng Wu1 cc inh hocc Fim ng1ng Wu1 Nng*/

ghung cH Lnh ngoi

$ U V KHUHJT IXM CiA C "NH NGOI $ 1 Q B-g: CH Lnh Nng gM& vBng chZc m Fh%ng ct cc AQng cQ Fim loi vo t#ong + gM&/

qQng cQ n gin cK thD Aw Ang t] chJ c/ CK thD ct Fin 'nh ,ng ,Vt* 31u Fhi Aung cc Fhung nZn Nng/ qhng cH Lnh cho nhi;u vL t#i Nng nhX mct- hm- tE chi- Fhung chu- ngKn t1&- ngKn ch=n- Nng 3Tngi1 tng tHi 1 Fh nng hot Vng cc Fh$p lin Wu1n t#ong Fhi vn Au& t#S c 3] ,Ct Vng ti ch cn i;u t#L/

gh%ng ,Ct Vng Fh$p/ CK thD i;u chRnh c 31u Fhi ct 'gitp F\o Ai chi*/ o) cK thD NuCt vi@n- Fhung gitp o) cK thD giB c nhBng Nng Fh%ng vBng- nhBng vhng c &Ju h1& gim chEc nng t#ong ltc o) Ai chu&Dn/ p AQng c t#ong t#Tng hp Nng h1& m% ,L nhiwm t#hng/

$ $ K1QED0 B-g: ghung crng F;nh g=& v$ng/ CK thD nhiwm t#hng ch=n inh g=& vim Nng/

F CH "NH V CHNG CH "NH F 1 C1 BY81 qhng t#ong gM& Nng h/ [M& Nng h nhiwm t#hng/ g\o Ai chi/ `ng gM& Fh%ng vBng/

F $ C1e8V O1 BY81 }t 01c8 0P8V `ng gM& Wu nhi;uX cK nhi;u inh c|ng l ngu&n nh=n lm Nng &Ju v Aw gM&/ vim Nng t:& ncng v l1n tz1/ 4m AQng h1& cng c t#ong c Vng c|ng l ngu&n nh=n lm lzng inh h1& inh Fh%ng vBng/ 4 vo v #1 c:1 ch=n inh c|ng l ngu&n nh=n g=& nhiwm t#hng A1 v Nng/ ghi #tt inh #1 cK thD gM& Nng li Ao nhi;u l+ inh Nu&n Wu1 Nng/

; BIJN CHNG )hiwm t#hng ch=n inh/ 4m t+n thng mch mu- thn Finh- g=n c I1u Ao cng A1/ CH Lnh Nng t#ong tSnh t#ng cPn Ai l@ch hu Wu 31u n& l c1l l@ch h1& Fh$p gi/

? CHU&N B" BhNH NHpN x1 A1 tR mR- co l%ng t#nh t+n thng A1/ x1 3ch vJt thng/ ChQp `-bu1ng th2o & l@nh/ (h]c hi@n Fhng 3inh th2o & l@nh/

ghung cH Lnh cng ch=n 'httpX}}/googl2/com/vn*

ghung cH Lnh Fhung chu 'httpX}}chothuoct1&/vn*

o +UI TR~NH CHwM SxC BhNH NHpN Cx KHUNG C "NH NGOI o 1 N1c8 BY81 081 0PC8V BN =.1.1. ^Hng t0n thng vJ kh ng c $9nh ngoJi )hn Lnh t^ng inh t#ong v ngoi Fhung/ Yu 3Zc- nhi@t V- phh n; vhng chi/ Ych ngoi ,in/ gh nng Ai Vng c:1 cc Fh$p v c Nung Wu1nh/

=.1.2. & hi% khc q0p(- cht G th=n nhi@t/ I1u nhBng vhng Fhc/ qCu hi@u t+n thng thn Finh Ao chn \p/ )hiwm t#hng/

=.1.3. ?Bm lC qo th1& +i hSnh Ang c thD/ 0n chJ c Vng Ao Fhung/ I1u cCp tinh/

o $ C18 B/S8 }t O58 01-A_ D =.2.1. . ! gim kh n<ng vn $Ing 8o chn thng vJ 8o kh ng c $9nh

)hn Lnh li mEc vn Vng c:1 nhBng c- Fh$p Fh%ng t+n thng/ [itp o) ngh ngi ti giTng cho Jn Fhi hri phQc v hJt 1u/ vn Vng v$i t#2o t1& h1& v$i nng/ (h1& +i t thJ D t#nh lo\t Ao tS /

=.2.2. ?h*! $0i hFnh 8ng c th 8o kh ng c $9nh ngoJi )hn Lnh nhBng ,iDu lV v; lo lZng c:1 o)/ Cung cCp FiJn thEc cn thiJt v; thTi gi1n- li ich- h$ng An o) t] chm 3Kc Fhung cH Lnh ngoi cho o) 1n t=m/ 0$ng An o) nhBng t thJ thun ti@n t#ong Ai chu&Dn D t#nh v1 chm Nung Wu1nh/

=.2.3. &* 49 t0n thng 8o $inh1 chn thng1 8o vPt thng )hn Lnh nhBng ACu hi@u chn \p A1 v ACu hi@u nhiwm t#hng A1/ Chm 3Kc vJt thng- vJt m+- ch=n inh v An lu/

=.2.4. K* 8o chn thng h*! 8o 8Xng cX c $9nh Inh gi cn 1u- ,o op Fhi 1u tng ln/ (h]c hi@n thuHc gim 1u th2o & l@nh/ (hTng 1u cCp tinh t#ong 5-5s giT u- 3 gim An t#ong !-8 ng& 31u/ [hi cht nhBng th1& +i cm gic nh t- ACu hi@u chn \p mch/ ChTm nKng gitp gim 1u v phh n;/ ChQp `b D N2m tSnh t#ng Nng gM& c cH Lnh nh thJ no- cK cn chRnh 31 li Fh%ng/ (h2o Ai cc ,iJn chEng Ao Nu&n inh nhX cng A1- ,n ch=n #$t/

o F G-S/ j[O BN 0$ng An o) v th=n nh=n cch chm 3Kc inh ti nh/ 0$ng An o) m1ng nng- tp vn Vng c v Fh$p- tp i v$i Fhung cH Lnh ngoi ,?ng nng- ,?ng N2 ln/ o ; !kv8V V-S o) lC& li c tm mEc hot Vng/ vJt thng v ch=n inh Fh%ng ,L nhiwm t#hng/

CpU HqI !rNG GI' Ch.n c=u t# lTi tng nhCt e/ ChHng chR Lnh ct Fhung cH Lnh ngoi lX 1/ [M& Nng h ,/ [M& Nng h nhiwm t#hng c/ [M& Wu nhi;u Nng A/ [M& Nng Fh%ng vBng / I1u cCp tinh Ao AQng cQ cH Lnh ngoi 3 gim An t#ongX 1/ e- ng& ,/ -5 ng& c/ 7-! ng& A/ !-8 ng& 7/ Iq cn chuln ,L gS cho o) t#$c Fhi ct Fhung cH Lnh ngoiX 1/ x1 vJt thng ,/ Ict th%ng tiDu c/ qcn o) nhLn n uHng A/ 4C& mu N\t nghi@m 5/ 4+ vo v #1 c:1 ch=n inh c|ng l ngu&n nh=n g=& ,iJn chEngX 1/ )hiwm t#hng A1 ,/ )hiwm t#hng Nng c/ )hiwm t#hng ch=n inh A/ (Ct c ;u tng !/ ghi o) cPn Fhung cH Lnh ngoi c NuCt vi@n- Iq cn h$ng An o) cch chm 3KcX 1/ (h1& ,ng ch=n inh Fhi thCm ALch ,/ pt t#hng Fhung cH Lnh mi ng& c/ gh%ng cn i nng Fhi Ai chu&Dn A/ gh%ng c tp vn Vng t#ong thTi gi1n m1ng Fhung/

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc o) cK cH Lnh ngoi- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e78/ / )gu&wn bu1ng 4ong- oi ging ,@nh h.c ngoi Fho1- tp !- Ii cng v; gM& Nng- Ii h.c < qc (P0CY- efss- 56/ 7/ )gu&wn bu1ng 4ong- oi ging ,@nh h.c chCn thng chRnh hSnh v phQc hri chEc nng- Ii cng v; gM& Nng- Ii h.c < qc (P0CY- lu hnh nVi ,V- f/ 5/ C1th2#in2 v/ pmith/ Yu3culo3F2l2t1l 3&3t2m- in Yo3,&3 Y1nu1l o Clinic1l )u#3ing- 32conA Aition- Yo3,& Comp1n&- efs6- es7f/

BI F> +UH TR~NH CHwM SxC BhNH NHpN Bx B%T

MC TIU 1. Trnh by "U! sY kh i ni;" v bU!. 2. Trnh by c "7c <ch c-a bT bU!. (. ThJc hi;n c c c bMc ch&:n b b;nh nhSn bT bU!. +. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn bT bU! v sa& khi !h o bU!. g. L$& c c c bi'n chFng c-a bT bU! v c ch = !r<.

1 KH'I NIhM V B%T C%ng thEcX C1p5 ngm e} 0 C1p5 0 b Cc loi ,VtX oVt x23in2- ,Vt th:& tinh- ,Vt t+ng hp- ,Vt oSnh (#L (hin- ,Vt thch c1o/

CuVn ,Vt 'httpX}}chothuoct1&/vn*

$ MC CH Bx B%T oCt Vng Nng gM& oCt Vng Fh$pX ,ong g=n V 'e- *- t#t Fh$p 31u Fhi F\o nZn/ qhng t#ong phu thut to hSnh- t+n thng m% m;m nhi;u- Fh=u nHi g=n-thn Finh- co #tt Fh$p- gh\p A1/

[im 1u- ngn ng^1 ,iJn Ang- ngn ng^1 gM& Nng ,@nh lG/

F CHU&N B" BhNH NHpN Bx B%T F 1 TK: bz: gii thich mQc ich ,K ,Vt- thTi gi1n v nhBng th%ng tin v; ,K ,Vt D o) hp tc/ F $ BN )Zn Nng- nZn Fh$p- ct t thJ tng/ )Ju cK vJt thng phi th1& ,ng 'cht G Fh%ng c ,ng t#Pn th2o vPng chi*- lC& hJt AL vt/ Chm 3Kc A1X Ahng n$c Cm l1u 3ch vhng A1 c ,K/ (ho t#1ng 3Ec #1 nJu cK/ (h]c hi@n thuHc gim 1u- 1n thn th2o & l@nh/

F F D[8V O[ pH lng ,Vt- Fich th$c cuVn ,Vt- nyp ,Vt/ IVn lKt ,o v@ A1- vhng tS X gPn Fh%ng thCm n$c- v$ 2#32&/ )$c ng=m ,Vt/ on chRnh hSnh- Fhung nZn Nng/ g\o/

F ; T1O 1-A8: [iB chi tng t thJ 31u Fhi nZn v t#ong 3uHt thTi gi1n ,K ,?ng long ,n t1&/ gh%ng c n=ng n chi v$i ngKn t1&/ Y1ng v$ 2#32&X %m 3t chi- v$ Ai hn ,Vt/ buCn ,%ngX cng mzng cng tHt- cht G nhBng ch tS v u ,Vt/

Ch.n loi ,VtX ,Vt cEng nh1nh Ahng cho ,Vt nhz ,n t1&- c+ t1&- nyp ,Vt/ oVt l=u cEng Ahng cho ,Vt l$n ng]c- ,Qng- hi- cng ch=n vS thTi gi1n WuCn ,Vt l=u/ Ch.n c ,VtX chi t#n ,Vt cK Tng Finh Fhong e!cm- chi A$i Fhong "cm/ )htng ,Vt vo n$c phi ngp hJt cuVn ,Vt- nhi@t V thich hp l 8" "C- t#nh NoZn ,Vt Fhi vZt ,Vt/ gd thut cn ,n Fhi WuCn ,Vt phi t ngu&n tZc 5I 'I:- Itng- It- Iyp*/

Phi ln cuVn ,Vt ,?ng lPng ,n t1&/ buCn ,Vt t^ gHc chi #1/ vuHt ;u t^ng l$p ,Vt/ )=ng n ,Vt ,?ng lPng ,n t1&/ Ch+ gp gHc phi cZt gKc/ 4m nyp ,Vt phi tng t thJ/ Chm 3Kc 31u ,K ,VtX 41u 3ch ,Vt Ainh t#n A1/ (#nh lm ,iJn Ang- gM& ,Vt/ [hi ch\p ln ,VtX ng& giT ,K ,Vt- tn ngTi th]c hi@n- ACu c1 3+ nJu cK vJt thng/

gh%ng n=ng n ,?ng ngKn t1& ',i ging chm 3Kc ngoi c:1 oY efff*

Cn n=ng n chi ,?ng lPng ,n t1& 'httpX}}/2v1/vn*

Cn n=ng n chi ,?ng lPng ,n t1& ',i ging chm 3Kc ngoi c:1 oY efff*

)gKn 3H ! ,L chn \p 31u ,K ,Vt 'oi ging chm 3Kc ngoi c:1 oY efff*

0Snh nh th1o tc ,K ,Vt cho o) 'httpX}}/,1o&2n,1i/com/vn*

; +UI TR~NH CHwM SxC BhNH NHpN SAU Bx B%T ; 1 N1c8 BY81 081 0PC8V BN )g1& 31u Fhi ,K ,VtX (Snh t#ng chi c ,KX 1u- t- mCt mch- nKng #t- nhi@t V chi/ (Snh t#ng ,VtX Fh% h1& $t/ ( thJX N2m li t thJ vhng ,K ,Vt tng ch1- nZn tng ch1/ (=m lGX lo lZng h1& 1n t=m Fhi ,K ,Vt/ (h]c hi@n FiDm t#1 `-bu1ng th2o & l@nh/

vi ng& 31uX qCu hi@u 1u nhEc tng Ao tSnh t#ng nhiwm t#hngX ,iJu hi@n nhi@t V tng- mhi h%i- ,Vt thCm ALch/ o) cK ngE1 Ao AL Eng ,Vt/ (Snh t#ng ,VtX lzng ,Vt h1& chn \p- ACu hi@u chn \p Ao 3ng/

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. ./ N ! gim kh n<ng vn $Ing 8o 4S 4It )hn Lnh mEc V vn Vng c:1 c Fh%ng t+n thng/ 0$ng An o) tp vn Vng t#ong mEc V cho ph\p- grng c/ )Ju chi A$iX h$ng An o) i nng 1n ton- i tS chHng mVt phn ch=n 1u/ )Ju chi t#nX gitp o) t#2o t1& ln v1i mVt cch 1n ton v thoi mi- Ahng A=& t#2o ,n #Vng/ 4.2.2. K* 8o 4It h*! 8o chn thng )hn Lnh v lng gi mEc V 1u/ (h]c hi@n thuHc gim 1u/ )Ju 1u tng ln nhi;u hn- t- gim cm gic- th1& +i nhi@t V chi- mCt mch nn ,o op ng1& v th]c hi@n vi@c N9 ,Vt/ g c1o chi D gitp mu hri lu tHt gim 3ng n;/

4.2.3. DSn 8o khGng vn $Ing d D; 4S 4It chi 8"i1 4It 4Xng )gh2 nhu Vng #uVt v th2o Ai tSnh t#ng i cu c:1 o)/

Cho o) uHng nhi;u n$c- n nhi;u chCt N/ Phi ,o m ti@n nghi- Fin o/ (p vn Vng ,Qng- hit th 3=u/ (h2o Ai v ,o op Fhi o) cK ACu hi@u FhK th- lo lZng- n%n Ki nhBng o) ,K ,Vt ,Qng/

4.2.4. ;g ! c 4%nh tiPt ni% 8o npm lB Cho o) uHng nhi;u n$c/ v@ 3inh 3ch 3 ,V phn 3inh AQc/ gin o- ti@n nghi t#ong Fhi tiDu/ Inh gi lng n$c NuCt nhp/

4.2.5. D; khGng thoi mi 8o 4S 4It )gE1 Ao AL Eng A1 Ao ,VtX th]c hi@n thuHc Fhng AL Eng- Fhu&n o) Fh%ng Ahng vt 1 vo ,n t#ong ,Vt- Fhi ngE1 Ahng t1& g ln ,Vt/ 4C& vQn ,Vt- l1u #1 3ch 3 A1 0$ng An o) t] v@ 3inh/ 0$ng An o) nhSn vo gng D N2m nhBng vhng Fh%ng nhSn thC& c/ (#nh ch2 ph: ,Vt vS Aw g=& lm ,Vt/ [iB v@ 3inh 3ch 3 ,Vt/ u vhng A1 ,K ,Vt/

4.2.=. . ! gim vn $Ing 8o 3hH nT1 tRo c1 !P c N* tho 4It# Inh gi 3Ec c- mEc V phh n; 31u Fhi tho ,Vt/ x1 3ch A1- 3 AQng F2m lm lm A1/ Phi nZng/ (p cX vn Vng- m1331g2 chi- F c1o chi- th2o Ai phh n;/ 0$ng An o) i nng h t# 1n ton/ qinh AnngX cung cCp vit1min2 A- q- C- C1lci- p#otiA2/

; F !kv8V V-S o) vn Vng tHt t#ong ,Vt/ o) 1n t=m t#ong i;u t#LX ,K ,Vt tng thTi gi1n- Fh%ng ,iJn chEng/

p1u ,K ,Vt o) i nng c 1n ton/

; ; B-D8 O1N8V }t 0P\ 4.4.1. Chvn [3 $im )gu&n nh=nX Ao n=ng ,Vt ,?ng ngKn t1&- cK ht h1& cQc ,Vt- vhng Nng nh% #1 Ao Vn lKt Fh%ng tHt- Fhi ,Vt ch1 Fh% M ct chi NuHng giTng- N9 ,Vt Fhi ,Vt cPn $t- c Vng 3$m Fhi ,Vt ch1 Fh%/ (#i@u chEngX nKng #t- 1u lin tQc- A1 t- c Vng ngKn FhK/ ` t#iX m c1 3+ D gii Wu&Jt ngu&n nh=n- th1& ,Vt Fhc/

4.4.2. Chvn [3 toJn th )gu&n nh=nX Vn lKt Fh%ng tHt- chi phh n; nhi;u Ao ch& mu- Ao nhiwm t#hng- Fd thut ,K 31i/ (#i@u chEngX 1u- cng tEc- li@t vn Vng/ ` t#iX #ch A.c ,Vt tCt c cc Fh$p- ,1nh #Vng- F c1o chi Fh%ng Wu " cm/ q] phPngX Fhi cho o) v; nh thS #ch ,Vt v th%ng ,o nhBng ,Ct thTng D gitp o) th2o Ai- pht hi@n FLp thTi h1& t] o) ,1nh #Vng ,Vt t#$c Fhi Jn ,@nh vi@n/ 4.4.3. jUng 4It )gu&n nh=nX Ao gim phh n;- Vn lKt nhi;u/ (#i@u chEngX 1u Fhi vn Vng- cm gic ngh2 lQc cQc- gi$i hn t#n v A$i thC& lzng/ oiJn chEngX c1n l@ch- l@ch u Nng/ ` t#iX th1& ,Vt/ q] phPngX Acn o) ti Fhm tng hyn h1& Fhi thC& lzng ,Vt/

4.4.4. jo2ng Qng )gu&n nh=nX Ainh Anng F\m- ngTi gi- ,Ct Vng l=u- thiJu nh nZng- F\m vn Vngvim Nng- ,@nh lG Nng/ (#i@u chEngX 1u t#ong Nng- `b thC& loMng Nng- c1lci mu gim/ oiJn chEngX Nng Aw gM&-Wu t#Snh ti to Nng gim/

PhPng ng^1 v chm 3KcX h$ng An o) tp lu&@n- phi nZng- cung cCp c1lci nhCt l ngTi gi- cch i li t#nh t\ ngM- cung cCp thEc n & : chCt Ainh Anng- th]c hi@n thuHc/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810 e/ Chuln ,L o) t#$c Fhi ,K ,Vt- Iq cn th]c hi@n ngoi t#^X 1/ )Zn Nng- ct tng t thJ/ ,/ 4C& t#1ng 3Ec nJu cK c/ (h1& ,ng vJt thng A/ 4C& mu N\t nghi@m/ / )hi@t V n$c thich hp D nhtng cuVn ,Vt vo lX 1/ 5""C ,/ !""C c/ 6""C A/ 8""C 7/ qCu hi@u lzng ,VtX 1/ vn Vng thC& 1u ,/ Chi ,K ,Vt phh n; nhi;u c/ I1u lin tQc- nKng #t A/ I1u t#ong Nng 5/ bu1n t#.ng nhCt Fhi chm 3Kc o) ,K ,Vt- Iq cn Fhu&n o)X 1/ g c1o chi ,K ,Vt ,/ [rng c t#ong ,Vt c/ Hng nhi;u n$c A/ n nhi;u chCt N !/ o) ,K ,Vt chi A$i- ,Vt ,Qng thTng ,LX 1/ 4o\t Ao n?m l=u

,/ (Zc #uVt Ao Fh%ng vn Vng c/ )hiwm t#hng tiDu A/ (o ,Kn Ao Fh%ng vn Vng

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc o) ,K ,Vt- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- ee6/ / )gu&wn vn bu1ng- )gu&n tZc chCn thng chRnh hSnh- )h NuCt ,n < h.c- efs8- e76/ 7/ )gu&wn vn bu1ng- gd thut ,Vt- (#ung t=m chCn thng chRnh hSnh (P/0CY- eff8/ 5/ pu31n xuA1- Yu3culo3F2l2t1l P#o,l2m- Y2Aic1l pu#gic1l )u#3ing- ou#th Aition- 42i3 Colli2# 02itF2mp2#} Ypo<-eff - es7f/

BI F +UH TR~NH CHwM SxC BhNH NHpN KO T


MC TIU 1. Trnh by c "7c <chQ c c hnh !hFc v bi'n chFng c-a kBo !. 2. ThJc hi;n c vi;c ch&:n b b;nh nhSn kBo !. (. ThJc hi;n c %&y !rnh ch?" sTc b;nh nhSn kBo !.

1 MC CH KO T 1 1 K1S- 8-A: g\o t l phng php A]1 t#n t#.ng l]c 'c:1 e t F\o* lm mzi c D nZn li NngF\o t chR l gi1i on u c:1 cc phng php i;u t#L Fhc nh ,ng ,Vt h1& m+ FJt hp Nng/ g\o t l F\o lin tQc l=u Ai D v^1 nZn v^1 ,Ct Vng/ g\o nZn l F\o lin tQc t#ong thTi gi1n ngZn D nZn Nng gM& t#$c Fhi ,Ct Vng ,?ng cc hSnh thEc Fhc/ CK l]cX t#.ng lng t v t#.ng lng o) 't thJ o)*/

1 $ M[O B\O1 [im tSnh t#ng gM& Nng- t# v; v$i mnh Nng vL t#i ,1n u h1& gitp thng t#Qc v$i c thD/ [im co c 31u chCn thng h1& ngn ng^1 co #tt c lm on Nng gM& 31i vL t#i v g=& 1u/ PhPng ng^1 h1& chRnh ,iJn Ang ,i 3] co c v A1 Nung Wu1nh Fh$p h1& phn t+n thng/

1 F CSO 4-gQ 4/ g\o ,?ng t1&X c p AQng mVt phn c thD Fhi op cn F\o mVt cch nhy nhng tm thTi v F\o vBng/ g\o ,?ng t1& t#ong nhBng t#Tng hp gim gM& Nng h1& t#t Fh$p/ g\o Wu1 A1X p AQng gin tiJp Wu1 Nng/ g\o Wu1 A1 v$i ,ng F2o ,ng #Vng- h1& ,ng ,ng #Vng t$i A1 h1& Wu1 gi& Hng/ g\o Wu1 A1 chR Ahng F\o gM& Nng tm thTi t#9 2m- hn chJ ngTi l$n vS A1 Fh%ng thD chLu l]c F\o cho Jn Fhi lnh Nng/ I=& chR l phng php tm thTi t#nh co c t#ong Fhi chT phu thut/ (#.ng lng t gi$i hn t^ -7 Fg Jn 7-6 Fg/
-

CK #Ct nhi;u t thJ F\o v nhi;u loi Fhung Fhc nh1uX Fhung o#1un- (hom13- xi2un1uxu332l/

')gurnXchm 3Kc ngoi Fho1- ,V & tJ ""s*

g\o Nng Wu1 A1 Ahng cho t#9 2m vS F\o Wu1 Nng lm h 3Qn 'httpX}}Ai2nA1n&Fho1/com/vn*

$ BIJN CHNG $ 1 D/ QEL8 B-81 Ch& mu Ao #ch e vJt thng nhz D Nu&n inh- nhiwm t#hng nJu Fh%ng p AQng ngu&n tZc v% Fhuln Fhi th]c hi@n th: thut/ $ $ D/ 4/ ( thJ F\o Fh%ng tngX lm ch=m tiJn t#Snh lnh Nng- h1& c1l l@ch- c1l gi/ (#.ng lng t F\o Fh%ng tngX nJu nhy Wu Fh%ng : tc AQng F\o- ncng Wu Nng F\o giMn hn mCt 3] tiJp Ntc giB1 C mct Nng lm chm Wu t#Snh lnh Nng/

1 Jn tSnh t#ng Nng gM& Ai l@ch c1l l@ch h1& Fh$p gi/

$ F D/ 8: bKQ .ng ph+iX Ao phi n?m ti ch t#n vi tun vS thJ #Ct Aw g=& E .ng ph+i Ao t thJ nhCt l ngTi gi- ngTi cK ti;n 3 htt thuHc/ (o ,KnX Ao Fh%ng i li- Fh%ng vn Vng- Fm th2o t thJ i cu Fh%ng thich hpFh%ng Fin o nn vi@c to ,Kn FhK t#nh c/ Chm li;n Nng- loMng NngX c1lci cn c hCp thu t^ mu vo Nng nhT Wu t#Snh vn Vng- tp lu&@n/ qo mCt c1lci Wu1 vhng Nng gM&- Ao thiJu vn Vng- Ao cung cCp cc chCt Ainh Anng hn chJ nn cK ngu& c chm li;n Nng- loMng Nng nhCt l ngTi gi/ )hiwm t#hng Tng tiJt ni@uX Ao tiu tiDu ti ch- E .ng n$c tiDu Ao tiDu t thJ n?m/ vim NngX Ao inh Nu&n Wu1 Nng Fhi th]c hi@n Fh%ng p AQng ngu&n tZc v% Fhuln- Ao Fh%ng chm 3Kc ch=n inh/ (2o c- Fh$pX Ao F\o t hn chJ vn Vng/ 0$ng An o) tp vn Vng thQ Vnggrng c c:1 chi ,@nh t#ong Fhi F\o t/ xHi lon Ainh AnngX Ao o) n?m ti ch Fh%ng vn Vng- gM& Nng g=& thiJu mu nu%i vim tZc tnh mchX thTng N& #1 ngTi gi- ,\o phS Ao tSnh t#ng F\m vn Vng- ,Ct Vng chi t#ong F\o t/ Iq h$ng An o) grng c- vn Vng cc ngKn ch=n/

F CHU&N B" BhNH NHpN KO T

F 1 TK: bz: gii thich cho o) ,iJt c%ng vi@c 3Zp lm- Wu t#Snh i;u t#L D o) hp tc/ F $ D[8V O[ QEL8 B-81: Fim pt2inm1nn hocc g#i3chn2# h1& ,ng F2o nJu F\o Wu1 A1- Fho1n t1& h1& Fho1n m& v% Fhuln- Fhn l- Hng tim- ch\n chun ]ng Aung ALch 3t Fhuln- thuHc tF;m g2ll&- thuHc t- gc v gng t1& v% Fhuln/ F F D[8V O[ 4/ 0C: cung mKng ng]1- A=& t#2o t- cc Wu c=n- Fhung F\o- giTng ,@nh- AQng cQ ,o v@ u inh/ F ; T1O 1-A8 `u&n inhX (h1o tc hon ton v% Fhuln/ (#$c tin o) ct chi t#n Fhung F\o Nng/ )gTi phQ Eng ,n o) Hi Ai@n v$i phu thut vin- giB &n ,n ch=n cho thng gKc v$i mct phng t#n Fhung F\o/ Phu thut vinX ch.n mHc D Nu&n inh- tim thuHc t- Fho1n tng vL t#i chinh Nc/ ghi phu thut vin tS ln Fho1n thS ngTi phQ et1& vn giB ch=n Fh%ng No1&- et1& Fi1 lm l]c Hi t#.ng cho phu thut vin Cn inh Fho1n Nu&n Wu1 Nng/ qn ,ng F2o 'F\o A1*X Ahng ,ng F2o ,ng l$n ',ng thun Ainh*- mVt u An vo A1u Fi1 An vo AQng cQ F\o/ buCn tng cTng phn ,ng An vo A1/ 4Zp ct chi vo Fhung F\o/

; +UH TR~NH CHwM SxC BhNH NHpN ANG KO T ; 1 N1c8 BY81 081 0PC8V BN 4ng gi t=m lG o) Fhi 1ng F\o tX 1n t=m h1& lo lZng/ ( thJX Fhung F\o- t thJ o) tng t thJ c nng/ (on th=nX ACu hi@u nhiwm t#hng- FhK th- lo\t A1/ v@ 3inh c nh=nX A1 3ch 3- mhi mr h%i- #ng mi@ng- tiu tiDu/ qinh AnngX n t thJ no t#n giTng- thEc n/ vn VngX o) t] No1& t# h1& cn 3] h+ t#/ vJt thngX mu 3Zc- tSnh t#ng vJt thng/

)i Nu&n inhX 1u- tiJt ALch- ACu hi@u nhiwm t#hng/ 0@ thHng F\o tX t#.ng lng t- A=&- t thJ o)- Fhung F\o- thTi gi1n F\o/

o) c Nu&n inh F\o t

; $ C18 B/S8 }t O58 01-A_ D 4.2.1. D; cn $_c k[o t 8o g2! Qng [ii thich mQc ich F\o t- cung cCp th%ng tin v; F\o t/ 0$ng An o) vn Vng t#ong Fhi F\o t/ Chuln ,L t=m lG 1n ton cho o) F\o t/

4.2.2. D; lo lfng vJ khGng thoi mi 8o k[o t 0$ng An o) cch th1m gi1 vo vi@c t] chm 3KcX th1& +i t thJ- t] v@ 3inh c nh=nhit th 3=u- tp vn Vng ch: Vng chi lnh- grng c chi F\o t/ Cung cCp th%ng tin v; thTi gi1n- Wu t#Snh lnh Nng/ Cung cCp 3ch ,o- phng ti@n ngh2 nhSn cho o) gii t#i/

4.2.3. D; t:ong thci gi*n k[o t 8o g2! Qng qu& t#S t F\oX + Itng #Mnh #Png #.c/ + q=& F\o phi vBng chZc- Fh%ng chhng- cc ntt cVt phi chZc chZn/

+ (#Qc A=& F\o ,Snh thTng 3ong 3ong v$i t#Qc Nng gM&/ ( F\oX

+ ( t thJ t] Ao- Fh%ng chm vo thnh giTng/ + (#.ng lng t th1& +i th& th2o chi gM&- thTng t^ e}e" e}8 t#.ng lng c thD- nJu o) 1u nhi;u c|ng nn gim t/ (#.ng lng t tng tHi 1 t#ong tun u tin- 31u K l thTi gi1n Au& t#S 'Fhong tun*- tun lw cuHi cn gim t Fhi M hSnh thnh c1l Nng/ + (#nh nhCc t/ + ghi Ai chu&Dn phi cH Lnh t vo thnh giTng- t#nh t ong 1- t#nh ct t ln giTng/ + ghi tng t phi tng t^ t^/ + g c1o ch=n giTng h$ng F\o t/ + oo m cc AQng cQ- chn mn- n@m Fh%ng nh hng Jn AQng cQ F\o t/ + ( cch mct Ct Fhong e!- " cm/ ( thJX

+ o) Fh%ng c n?m nghing h1& 3Cp m phi n?m thng giB1 giTng/ + gh%ng t#t v; phi1 F\o t- Fh%ng c n=ng u giTng ln nJu Fh%ng cK & l@nh/ + ghi c ph\p D gHi u giTng Fh%ng c D Wu c1o- t#nh vyo h%ng/ + Ch=n F\o t A1ng nhy Fhong 7""/ + on ch=n thng gKc cng ch=n- A=& F\o n?m giB1 ngKn e v Chm 3Kc ni Nu&n inh F\o tX c:1 chi F\o/

+ Cn giB 3ch v Fh% ch=n inh/ + (#nh mKng ng]1 tS vo A1/ Im ,o mKng ng]1 ,m 3t vo ch=n inh/ + (h1& ,ng h?ng ng& v Ahng ,ng thCm Aung ALch ,2t1Ain2 D ,ng vPng Wu1nh ch=n inh/ + qhng AQng cQ ch2 cc u nh.n c:1 inh/

Ch=n inh c ch2 ch 1n ton

Chm 3Kc A1 ni FhcX ngn ng^1 lo\t- phi nZng- v@ 3inh A1 t#nh ,@nh ngoi A1/ vn Vng h t#X

+ Chi 1ng F\oX grng c- tp cc c Fh$p t#ong gi$i hn cho ph\p/ + Chi lnhX tp hJt ,in V Fh$p/ 4.2.4. D; cS nhiT 4iPn chMng 8o k[o t vim ph+iX : Cm- hit th 3=u- tp th/ (o ,KnX cho o) uHng nhi;u n$c- thEc n nhi;u chCt N- tp vn Vng ,Qng- cung cCp AQng cQ 1n ton v Fin o/ gh$p giX cho o) lu%n tng t thJ t#ong thTi gi1n F\o t- tp lu&@n thTng Nu&n- phi nZng- ,Ct Vng tHt ni chi gM&- thuHc- n uHng nhi;u chCt c1lci/ 4oMng NngX phi nZng- vn Vng- thuHc- n uHng nhi;u chCt c1lci/ )hiwm t#hngX chm 3Kc vJt thng v ch=n inh mi ng&- th]c hi@n Fhng 3inh/ 4o\t A1 Ao chn \pX cho o) n=ng m%ng mi giT- No1& t# mi giT- m1331g2/ pzi tiJt ni@uX cho o) uHng nhi;u n$c- cung cCp phng ti@n Fin o- t#nh nhLn tiDu- v@ 3inh ,V phn 3inh AQc/ 4.4.5. D; N* khi tho t (Snh t#ng chi 31u Fhi F\oX 3Ec c- vn Vng- Ainh Anng- A1/ (hTi gi1n lnh NngX chi t#n s-e" tun- chi A$i e -e5 tun/ `c Lnh Fh nng lnh Nng- &Ju c- gim hu&Jt p t thJ/

Cho o) t thJ mol2#- ngri A&- ong 1 ch=n thnh giTng/ (p c lng- tp vn Vng c/ Cho o) chuln ,L ,K ,Vt h1& cho o) i nng/

; F G-S/ j[O BN 0$ng An o) cch chm 3Kc ni Nu&n inh/ 0$ng An o) cch n uHng/ 0$ng An o) t thJ tng t#ong 3uHt thTi gi1n F\o t- ngn ng^1 cc ,iJn chEng t#ong thTi gi1n F\o t/ Cung cCp th%ng tin 31u F\o t nhX phu thut- ,K ,Vt Cung cCp nhBng th%ng tin Fhi o) NuCt vi@nX t#nh lm ncng v$i chi gM&- t#nh t+n thng ni gM&- Fh%ng lm vi@c ncng h1& gZng 3Ec/ ; ; !kv8V V-S o) Fh%ng ,L vim Nng/ Chi Fh%ng Ai l@ch/ o) 1n t=m/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810 e/ oiJn chEng Ao F\o tX 1/ )hiwm t#hng ,/ Ch& mu c/ C1l l@ch A/ (o ,Kn / (#.ng lng t Fhi F\o Wu1 A1 c gi$i hn t^X 1/ e-7Fg Jn -7Fg ,/ -7Fg Jn 7-6Fg c/ e-7Fg Jn -7Fg A/ -7Fg Jn 7-7Fg

7/ o) F\o t n?m l=u- ,iJn chEng no 3 FhK t#nh cX 1/ vim Nng ,/ (o ,Kn c/ )hiwm t#hng tiDu A/ vim ph+i 5/ o) 1ng F\o t- Fhi chm 3Kc Iq cn Fhu&n o)X 1/ (p hJt ,in V Fh$p chi 1ng F\o t ,/ [rng c chi F\o t c/ oCt Vng chi 1ng F\o t A/ vn Vng nhy nhng chi F\o t !/ (hTi gi1n lnh Nng chi t#n lX 1/ 5-6 tun ,/ 6-s tun c/ s-e" tun A/ e"-e tun

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Iq ngoi - Chm 3Kc o) ,K ,Vt- )h NuCt ,n gio AQc vi@t )1m- 0 )Vi- ""f- e 8/ / )gu&wn vn bu1ng- )gu&n tZc chCn thng chRnh hSnh- nh NuCt ,n & h.c- efs8- e58/ 7/ )gu&wn bu1ng 4ong- oi ging ,@nh h.c ngoi Fho1- tp !- Ii cng v; gM& NngI0<q-(P0CY- efss- 66/ 5/ pu31n xuA1- Yu3culo3F2l2t1l P#o,l2m- Y2Aic1l pu#gic1l )u#3ing- ou#th Aition- 42i3 Colli2# 02itF2mp2#} Ypo<-eff - es7f/

CHNG o: NGOI KHOA KH'C V K THU*T NGOI BI ;< +UH TR~NH CHwM SxC BhNH NHpN CHyN THNG SI NO

MC TIU 1. Trnh by c nh nghPaQ chA nh ph3& !h&8! a b;nh nhSn chEn !hng s# nGo. 2. 9h?" sTc c b;nh nhSn cEp cF& chEn !hng s# nGo. (. ThJc hi;n c ch?" sTc b;nh nhSn "4 chEn !hng s# nGo. +. ThJc hi;n %&y !rnh ch?" sTc b;nh nhSn chEn !hng s# nGo.

1 "NH NGHA ChCn thng 3. nMo c Lnh ngh1 l l]c p vo hVp 3. g=& t+n thng ncng h1& nhy A1 u- Nng 3.- mng nMo- m% nMo/

CCu to hVp 3. t^ ngoi vo t#ong 'hSnh nh t^ ti li@u chm 3Kc ngoi c:1 oY nm effs* $ CH "NH (H)U THU*T ghlnX mu tQ ngoi mng cEng- mu tQ A$i mng cEng- mu tQ t#ong nMo- ltn 3. h/ on cCpX ltn 3. Fin- nEt 3ng 3. t#$c- nEt 3ng 3. giB1/ Ii;u t#L ,o trnX gip nMo- chCn Vng nMo- phh nMo/

F CHwM SxC Cy( CU BhNH NHpN CHyN THNG SI NO F 1 N1c8 BY81 081 0PC8V BN (Snh t#ng A1 uX + CK vJt #ch A1 u- vJt nEt Nng 3.- vn 3. h1& lm 3./ + om h1& gip mct- ACu hi@u o1ttl23 'ACu hi@u mZt Finh*/ + C mct c Vng Fh%ng c=n NEng/ qCu hi@u tng p l]c nVi 3.X

+ Irng tX Fh%ng ;u Ao giMn rng t mVt ,n/ + (#i gic gimX lTi nKi ,Hi #Hi- ln lVn- 31i G/ [l13go e iDm/ + CK ACu hi@u thn Finh Fhu t#t/ + q0p( #Hi lon/ IVng Finh ng1& 31u chCn thng/ (iu tiDu Fh%ng t] ch:/ [rng cX gim h1& tng phn N- t thJ grng mCt vz- mCt nMo/ qLch nMo t:& h1& mu AP #1 t1i- m|i/

F $ C58 01-A_ (h2o Ai Tng thX AL vt- m nh$t- ACu hi@u FhK th h1& ngng th/ Im ,o Tng th th%ngX htt m nh$t- ct nVi Fhi Wun- ct tu,2 Y1&o# t#nh cZn lni- nn ct th%ng A A& t#nh hi@n tng n%n vo Fhi Wun/ Cung cCp : oN& cho o) ,?ng m.i ngurn t#nh cho o) thiJu oN&/ CH Lnh c+ v Fhm pht hi@n chCn thng c+ Fm th2o/ (hiJt lp ng1& Tng t#u&;n v$i Fim lurn -7 chi1/ ` t#i cm mu vJt thng t#n 3.- Fhm pht hi@n ACu ch& mu m|i- ch& mu t1i- vJt thng 3. nMo/ 0zi li c chJ chCn thng Wu1 o) h1& ngTi chEng FiJn t1i nn/ Ci ,z Wun o nn nh=n v : Cm o)/ ghm v pht hi@n nhBng t+n thng Fm th2o/ (iJp tQc th2o Ai q0p(- t#i gic- nhLp tim- rng t- ACu thn Finh Fhu t#t/

Yu tQ ngoi mng cEng

Yu tQ A$i mng cEng ,n

; CHwM SxC TRC M (h]c hi@n hri 3Ec nVi Fho1X nJu o) chong- phPng chHng chong/ Co 3ch tKc o)- t#nh #ch A1 g=& nhiwm t#hng/ x1 3ch vJt thng v ,ng v% Fhuln- t#nh Ahng Aung ALch 3t Fhuln t#n vJt thngFh%ng thm AP h1& ,ng \p vJt thng- Fh%ng lC& m% nMo h1& nh\t m% nMo vo t#ong hVp 3./ gh%ng cho o) n uHng- Fh%ng #1 A A& ,?ng Hng m1uch2#- Fh%ng thQt tho/ Ict th%ng tiDu- ct tu,2 42vin2/

C%ng tc t tng cho gi1 Snh o)/

? CHwM SxC SAU M: Chi1 7 gi1i onX ? 1 G-5- B/C8 O1QEg8 0-D_ d0 BQ .5Q :n I=& l Fhong thTi gi1n ngu& hiDm nhCt Hi v$i o)/ ( thJ o)X cho o) n?m thng u c1o e!-7""- giB Cm o)/ (h2o Ai q0p( thTng Nu&n/ 0% hCpX giB Tng th th%ng- htt m nh$t- ,o m : oN&/ (un honX Au& t#S ALch t#u&;n v th2o Ai chinh Nc th2o & l@nh n$c NuCt nhp/ qn lu nMo thCtX Fin- hon ton v% Fhuln- th2o Ai 3H lng- mu 3Zc- tinh chCt ALch ch& #1/ qn lu A1 uX chm 3Kc An lu v% Fhuln- #tt 3$m 31u 5 giT/ vJt m+X chm 3Kc v% Fhuln- cZt chR chm- ,ng A& vhng A1 u Fh%ng cK hVp 3.t#nh cho o) n?m ln vhng vJt m+/ (h2o Ai ACu hi@u tng p l]c nVi 3.X nh gi v 3o 3nh t#i gic- rng t mi giT/ vn VngX tSnh t#ng co cEng c Ao mCt vz nMo- mCt nMo- mEc V li@t v 3o 3nh h1i ,n/ xHi lon t=m thnX o) l1 h\t- vt vM- ,Ec #Et/

? $ G-5- B/C8 0n8V uQS0: C19: .{O BN 1T8 :L (h]c hi@n cc & l@nh chm 3Kc o) h%n m/ v@ 3inh c nh=n/ ChHng lo\t/ )gn ng^1 ,iJn chEng/

? F G-5- B/C8 _1[O 1M[itp o) t# v; Ti 3Hng ,Snh thTng mEc V tHt nhCt v gitp gi1 Snh chng th1m gi1 t#ong vi@c hri phQc nhBng Ai chEng c:1 o) nhX Vng Finh- mCt t#i nh$- mCt ng%n ngB/ Cn cK 3] h t# c:1 nhi;u nhKm ngTi nhX vt lG t#L li@u- chu&n gi1 t=m lG- Iq- op t=m thn v Wu1n t#.ng hn hJt l gi1 Snh v ,n th=n o)/

vJt m+ v An lu 31u m+ C(p) ')gurn httpX}}/vi2tgi1it#i/com*

o +UH TR~NH IU DNG CHwM SxC BhNH NHpN CHyN THNG SI NO o 1 N1c8 BY81 081 0PC8V BN 4i@t thn Finh 3.X + ghEu gicX mCt mhi ,n/ + (hL gicX li@t vn nhMn- nhSn %i- #ung git nhMn cu- mh/ + (hinh gicX ngh2 F\m/ YEc V G thEcX th1& +i t=m thn- Fich Vng- t#m cm- lon thn- m 3ng- h%n mWun 31u chCn thng/

IuX nhEc u/ ChEc nng vn VngX &Ju- li@t nhy- li@t- t thJ mCt vz- t thJ mCt nMo- mCt phn N/ qCu hi@u Fich thich mng nMoX cEng g&- ACu g2#nig- ACu o#uAin3Fi/ (+n thngX nEt 3.- ltn Nng- tQ mu A$i mng cEng- ch& mu m|i- vJt ,m mu Nung Wu1nh + mZt- ch& mu t1i- vJt ,m Nng ch|m/

Phh nMo} tng p l]c nVi 3.X + (h1& +i mEc V h%n m/ + (h chm- th cH gZng/ + (h1& +i hu&Jt p v mch- nhLp tim chm/ + oiJng n- n%n Ki h1& Ki v.t/ + Irng tX giMn- mCt Hi NEng/ + Phh g1i thL/ + (h1& +i chEc nng vn VngX li@t ,n th=n/ + o1,in3Fi '*/ + )hSn %i/

(Qt nMoX + Y 3=u hn rng thTi th1& +i chEc nng vn Vng v rng t/ + (h 1ciAo3i3 h1& 1lF1lo3i3- th Ch2&n2-ptocF23/ + CEng g&- 1u u/ + [iMn n rng t mVt ,n h1& h1i ,n- mCt phn N mZt/

+ (ng hu&Jt p- mch chm- lon nhLp tim/ + [rng cEng mCt vz h1& mCt nMo/ (iDu nMoX co rng t- m 3=u- ngng th h1& mCt i;u hP1 nhLp th/ Ch& muX + (Q mu mng cEngX mCt G thEc t#ong thTi gi1n ngZn- tng p l]c nVi 3.- giMn n rng t mVt ,n/ + Ch& mu A$i mng cEngX gi1 tng h%n m- 1u u- tng p l]c nVi 3.- Vng Finh- giMn n rng t mVt ,n/ + Ch& mu t#ong nMoX tng p l]c nVi 3.- gim cm gic v vn Vng/ q0p(X + 0u&Jt p gim- mch chm h1& nh1nh v &Ju/ + (h n%ng h1& ngng th tm thTi- tng th%ng Fhi- Ch2&n2-ptoF23/ + )hi@t V tng c1o lin Wu1n Jn t+n thng vhng h ri v thiJu mu nMo/ vCn ; FhcX gim t#i nh$- 1u Fh$p- P1#Fin3on- hVi chEng 31u h%n m- 1u u- ng: gmCt n$c- tiDu nhi;u- chong/ oiJn chEng ngoi nMoX gM& c+- chCn thng ng]c- tQ mu m% m;m- ch& mu A A&thiJu mu- gim hu&Jt p/ o $ C18 B/S8 }t O58 01-A_ D =.2.1. Kcng thd khGng thGng -

4ng gi Fh nng 3ch m nh$t/ 0tt mX cung cCp oN& vo ph+i e""u t#$c v 31u Fhi htt m- Fh%ng htt Wu e" gi=&} ln t#nh thiJu oN& mu/

qu& t#S Tng th th%ng Wu1 nVi Fhi Wun- m Fhi Wun- m& th nJu cK chR Lnh/ )gh2 ph+i e- giT}ln- ghi cht tinh chCt v 3] gi1 tng th%ng Fhi/

Y& thX cht G thD tich th 'tR 3H- oN&- ntt ,o Vng*/ [hi cht Fhi thC& P gim v PC tng/ giDm t#1 q0p( mi e- giT/ CH Lnh c+ v t#nh gp c+ cho Jn Fhi ,iJt o) Fh%ng chCn thng c+/ (h2o Ai tSnh t#ng t#i gic- q0p(- ACu thn Finh Fhu t#t e!-7" phtt} ln cho Jn Fhi +n Lnh- 31u K e- giT} ln/

[iB thuHc cCp cEu v AQng cQ th%ng Fhi ,n giTng/ gh%ng cho o) n ,?ng Tng mi@ng D ngn ng^1 tZc Tng th Ao thEc n #i vo Fhi Wun/

=.2.2. ?h*! $0i t"i m mG n2o 4p ,ng th2o Ai q0p( mi e!-7" phtt/ (h2o Ai ACu hi@u thiJu oN& nMo/ C1n thi@p h1& phPng ng^1 tng p l]c nVi 3.X thuHc i;u t#L- t#u&;n ALch th2o & l@nh- cho o) n?m u c1o 7""/ )Ju Ahng 3t2#oiA cn th2o AiX + giDm t#1 pht hi@n ch& mu Wu1 ph=n- Wu1 tu,2 42vin2/ + `\t nghi@m n$c tiDu tSmX p0- Tng- c2ton mi Tng/ (h]c hi@n ph&not1Ain2 tim ,Zp mi ng&/ + giDm 3ot ch& mu/ + (h]c hi@n thuHc 1nt1ciA ngn ng^1 h1& gim Fich thich A A&- phPng ng^1 ngu& c ch& mu/ giT} ln pht hi@n Fhi u c:1 tiDu

Cho o) n?m u c1o 7"" gitp An lu tnh mch nMo tHt- th2o Ai ACu hi@u phh nMo/ giDm 3ot t+ng 3H ALch t#u&;n cho ph\p t#ong 5 giT- ,o co chinh Nc lng n$c NuCt nhp v ,n gi1o cho mi phin t#]c/

(h]c hi@n thuHc chHng Vng Finh th2o & l@nh- th2o Ai tc AQng chinh v phQ c:1 thuHc/

=.2.3. ?h*! $0i cm gic nhn thMc nth9 gic1 thnh gic1 Qic gic1 v9 gic1 khM gico 4ng gi Lnh h$ng v mEc V h%n m/ An ton cho o)/ qu& t#S m%i t#Tng &n lcng- lm gim nhBng Fich thich tHi thiDu cho o) nh nh 3ng chKi- tiJng rn Wu mEc [itp ti Lnh h$ng cho o) nh thTi gi1n- ni chHn- con ngTi/ 4p chng t#Snh nghR ngi- m ,o giCc ng: : v tHt- ph=n ,H nh 3ng phh hp/ gich thich cm gic 3T- nJm- nhn ,iJt cc vhng t#n c thD o)/ Cung cCp th%ng tin cho gi1 Snh cc Aiwn ,iJn c:1 ,@nh v cn nhCt l 3] hp tc c:1 ngTi th=n D chm 3Kc o) t#ong gi1i on hri phQc/ =.2.4. ;h'ng chn thng tiTm t*ng li5n ) *n $Pn $Ing kinh Cho o) n?m giTng thCp- chCn 3ong c1o 31u Fhi Ahng thuHc 1n thn h1& Fhi o) #Hi lon t=m thn/ (#1ng ,L chu%ng g.i cho o)/ Cho o) ngri N2 ln- cng Fhi Ai chu&Dn (#$c Vng Finh ngn ng^1X + CK AQng cQ oN& cnh giTng gitp o) : oN&/ + CK AQng cQ htt m/

+ [iTng cK chZn 3ong/ + Phi ,iJt cc ACu hi@u ti;n t#i@u/ (#ong thTi gi1n Vng FinhX + qu& t#S th%ng Tng th/ + )=ng n v ,o v@ u- nghing 31ng mVt ,n/ + )gn ng^1 chCn thngX cho o) n?m NuHng n;n nh nJu o) ngri t#n ghJ- n$i lzng Wun o- Ai chu&Dn nhBng vt Nung Wu1nh #1 N1- ghi cht 3H ln- vhng Vng Finh- F\o Ai c:1 cn- nJu o) n?m t#n giTng F gHi A.c p1u Vng FinhX + qu& t#S Tng th- cho o) th oN&- htt m/ + giDm t#1 q0p( v tSnh t#ng t#i gic/ + (i Lnh h$ng m%i t#Tng/ + )=ng n t=m lG- t thJ thoi mi- No1& t#- v@ 3inh #ng mi@ng Fhi cK chCt tiJt v mu/ =.2.5. 6im vn $Ing vJ ng ! c t0n thng 8* Pht hi@n 3$m lo\t giTng/ Chm 3Kc A1- m1331g2 A1 mi e- giT gitp tun hon Jn nu%i A1 tHt/ `o1& t# o) nhy nhng mi e- giT v Fhi cn thiJt nJu Fh%ng chHng chR Lnh/ [iB t thJ tng/ (h]c hi@n phng php chHng thu&n tZc mch h1& cQc mu %ngX + qhng v$ chHng thu&n tZc mch chi A$i gitp mu hri lu tHt/ + Pht hi@n ACu thu&n tZcX z- 1u- 3ng- Cm chi nhCt l chi A$i/ ,n 3ong giTng/

+ Pht hi@n ACu ch& mu Ao thuHc chHng %ng Wu1 ph=n- n$c tiDu- vJt m+- ni tim/ )gn ng^1 t2o c Fh$pX Fhu&Jn Fhich o) t] vn Vng- t#nh tp Wu 3Ec-Wu m@tnn cK chng t#Snh tp lu&@n phh hp v$i 3Ec Fhz2 o) v$i phng php vt lG t#L li@u/ =.2.=. ?hRo 8`i cBn 4png 8inh 8@ng )n ct tu,2 42vin2 cho o) n ng1& 31u m+/ )Ju o) Fh%ng m+ thS cho o) n Wu1 mi@ng nJu o) tRnh h1& n Wu1 3onA2 A A& Fhi t#i gic gim/ =.2.W. . ! gim v% Ninh c nhBn 8o t:i gic gim [itp v@ 3inh #ng mi@ng mi giT- v@ 3inh c nh=n/ Chm 3Kc mZt ngn ng^1 lo\t gic mc- ch2 Fin mZt- nhz mZt thTng Nu&n gitp nim mc mZt Fh%ng ,L Fh%/ qu& t#S chEc nng #uVt v$i 3] ,i tiJt ;u cn/ Chm 3Kc A1X tZm o) mi ng&- Wu1n 3t tSnh t#ng A1 D pht hi@n 3$m ,@nh lG v; A1/

=.2.>. aFnh 8ng thBn th1 :i lon nhBn cch 4ng gi v ghi cht mEc V #Hi lon t=m thn c:1 o)/ Iq gitp o) ti Lnh h$ng thTi gi1n- con ngTi- ni chHn/ [ii thich cln thn o) 1ng lm gS v ti 31o/ (# lTi nhBng c=u hzi n gin v t#ung th]c/ Ii;u chRnh nhBng th%ng tin Fh%ng chinh Nc/ (%n t#.ng 3] #ing t c:1 o)/

=.2.A. jo lfng (# gitp o) ti lp chEc nng 3inh lG- t=m lG nhi;u nhCt mEc V cho ph\p/

ghu&Jn Fhich gi1 Snh c|ng l thnh vin chm 3Kc o)- l v1i t#P ch: Vng Wu&Jt Lnh chm 3Kc o)/

=.2.1E. 6im gi*o tiP3 4png lci nSi Inh gi Fh nng gi1o tiJp/ (#iDn Fh1i Fh nng gi1o tiJp chng o) ,?ng cch cung cCp AQng cQ t#1o +i nh ,tt chShSnh nh- i@u ,V- pht =m- 3T mK/ o F G-S/ j[O BN 0$ng An gi1 Snh chm 3Kc/ [ii thich phng php i;u t#L/ pt#233 v h$ng N t#i/ ghu&Jn Fhich hot Vng Vc lpX cung cCp AQng cQ n=ng n th2o chR Lnh- tp lu&@n ;u- o) t] vn Vng/ (h]c hi@n Ainh Anng th2o ,@nh lGX ,+ 3ung n uHng- n it- nh1i chm- n nhi;u ln/ An tonX chCn 3ong giTng- ghJ tZm- nng- N2 ln- g&/ 0$ng An t#nh Ahng thuHc Wu li;u chR Lnh/ (^ng ,$c cho o) th1m gi1 vo 3inh hot cVng rng/ [itp o) lC& li ni;m tin v; cm gic lo =u- 3- th1& +i hSnh Ang/ [io AQc o) v gi1 Snh v; Vng Finh/

o ; !kv8V V-S ITng th th%ng tHt- FiDu th hi@u Wu/ q] t$i mu nMo v t:& 3Hng tHt/ t ,iJn chEng v; t+n thng/

vn Vng tHt/ (] chm 3Kc tHt/ (on vyn v; A1/ (=m lG thoi mi/

CpU HqI !rNG GI' C18 OKQ 0P^ b2- B8V 810: e/ Ii;u n& 31u =& Fh%ng tng Fhi chm 3Kc o) 31u m+ chCn thng 3. nMoX 1/ Cho o) n?m u ,?ng - mct nghing nJu o) h%n m ,/ (hTng Nu&n th2o Ai q0p( c/ 4u%n htt m nh$t- m ,o Tng th th%ng A/ [iB Cm o) / q0p( th1& +i nh thJ no o) tng p l]c nVi 3.X 1/ Ych tng- hu&Jt p tng nhy- nhLp th tng ,/ Ych tng- hu&Jt p gim- nhLp th gim c/ Ych gim- hu&Jt p tng nhy- nhLp th nh1nh A/ Ych gim- hu&Jt p gim nhy- nhLp th nh1nh 7/ o) cPn h%n m 31u m+ C(p)- i;u Wu1n t#.ng nhCt Fhi chm 3KcX 1/ Cho o) n?m u c1o 7"" ,/ 4u%n m ,o Tng th th%ng c/ (h2o Ai 3t ACu hi@u tng p l]c nVi 3.

A/ Cho o) n Wu1 tu,2 42vin2 5/ o) 31u m+ C(p) cK An lu A1 u- An lu n& 3 c op cho #tt FhiX 1/ gh%ng cPn ALch ch& #1 ,/ ghi o) tRnh c/ p1u m+ 5 giT A/ p1u e tun !/ (#Tng hp C(p) no 31u =& cK chR Lnh m+ FhlnX 1/ 4tn 3. Fin ,/ )Et 3n 3. t#$c c/ Yu tQ ngoi mng cEng A/ ChCn Vng nMo

TI !IhU THAM KHsO e/ )gu&wn (Cn CTng- Ii;u Anng )goi - Chm 3Kc ,@nh nh=n ,K ,Vt- )h NuCt ,n [io AQc vi@t )1m- 0 )Vi- ""f- e85/ / qng Yinh Yn- ghm ,@nh nh=n chCn thng 3. nMo- o@nh h.c v i;u t#L ngoi Fho1X ngoi thn Finh- Ii h.c < qc (P0CY- "" - !e/ 7/ qng Yinh Yn- ghm ,@nh nh=n chCn thng 3. nMo- o@nh h.c v i;u t#L ngoi Fho1X ngoi thn Finh- Ii h.c < qc (P0CY- effs- 5e7/ 5/ Clm n1ng Ii;u Anng- Chm 3Kc cc ,i@t ngoi thn Finh- o@nh vi@n Ch x&- "" / !/ )2u#olologic 3&3t2m- ch1pt2# 7- Yo3,&3 Y1nu1l o Clinlc1l )u#3ing- 32conA Aition- th2 Cv- Yo3,& Comp1n&- 776/

BI ;1 K THU*T CHwM SxC H*U MN NHpN TO

MC TIU 1. ThJc hi;n c k@ !h&8! ch?" sTc h8& "Xn nhSn !o. 2. jMng /3n c b;nh nhSn v !hSn nhSn c ch ch?" sTc.

1 MC CH 0u m%n nh=n to 3ch/ )g^1 #m l A1 Nung Wu1nh hu m%n nh=n to/ 0$ng An o) cch chm 3Kc hu m%n nh=n to/

$ CH "NH 0u m%n nh=n to Wu A/ Ph=n & }7 tti chE1 ph=n/

F CHU&N B" DNG C F 1 N1c8 BY81 (Snh t#ng o)X + o) phu thut ng& thE mC& + (#n ,Qng cK An lu Fh%ng + vJt m+ v% Fhuln h1& cK ACu hi@u nhiwm Fhuln 0u m%n nh=n toX + on no c:1 + ,Qng + giDu no

+ `9 mi@ng ng& thE mC& + Yu 3Zc nim mc hu m%n nh=n to/ + bu1n 3t ph=n- A1 Nung Wu1nh hu m%n nh=n to/ + 4oi tti o) 1ng 3 AQng/ F $ C1Q8 dY j[8V O[ qQng cQ v% FhulnX + Y=m t#i Fhn v% Fhuln/ + + F;m/ ch\n chungX e ]ng n$c muHi 3inh lG "-fu- e ]ng Aung ALch 3t Fhuln/

+ [Pn- gc/ qQng cQ 3chX + (ti ]ng ph=n- th$c o- ,tt v/ + g\o/ + orn ht u/ + vi t#i c1o 3u/ + %i gng t1& 3ch/

+ (ti ]ng #c/ + Ch1i Aung ALch 3t Fhuln t1& nh1nh/ + (h1u ]ng Aung ALch 3t Fhuln ng=m AQng cQ 31u 3 AQng/

; THC HIhN K THU*TX th2o ,ng FiDm

? NHGNG IXM CN !U Ch2 ch Fd vJt m+ t#nh ph=n t#n Wu1/ )Ju vJt m+ $t h1& A nn th1& ,ng t#$c- ,ng Fin vJt m+ li/ )Ju 0Y)( Wu A ph=n t#n Wu1 vJt m+ nn #1 3ch 0Y)( t#$c #ri 3on m=m Fhc th1& ,ng vJt m+/

gh%ng 3 AQng Aung ALch cK mu h1& oN& gi #1 nim mc 0Y)(/ )Ju cK #m l A1 Fh%ng Ahng Aung ALch crn ioA2 D 3t Fhuln A1/ 0Y)( m$i N9 mi@ng vo nhBng ng& u tin nn WuCn ch=n 0Y)( ,?ng gc v132lin2/ )Ju l m hri t#ng #1 A1 nn ng^1 #m l A1 tich c]c- cht G ,h n$c v i@n gii cho o)/ bu2 th:& tinh #tt 31u m+ !-8 ng&/ (p cho o) i tiu tng giT/ 0$ng An o) cch t] chm 3Kc 0Y)( ti nh- cho o) t] th]c tp D Iq N2m/ 0$ng An v; Ainh Anng/ (i Fhm tng hyn h1& Fhi cK ACu hi@u ,Ct thTng/ [itp o) t] tin chng th1m gi1 vo 3inh hot gi1 Snh- NM hVi- c%ng vi@c- vui chi gii t#i/

BsNG KIXM CHwM SxC H*U MN NHpN TO

STT e

N%I DUNG Y1ng AQng cQ Jn ,n giTng o)- ,o v gii thich Cho o) n?m thun ti@nX nghing v; phi1 0Y)( gitp ph=n Fh%ng t#n

Cx

KHNG

7 5 ! 6 8

vo vJt m+ oVc lV ni cK 0Y)( Ict tCm lKt c1o 3u A$i 0Y)( g ,rn ht u A$i 0Y)( pt Fhuln t1& nh1nh v m1ng gng t1& 3ch 4C& tti ]ng ph=n- Wu1n 3t ph=n- nh gi 3H lng ph=n- tCt c gom g.n ,z vo #c & tJ/ (ho ,z gng t1&

s f

Y1ng gng t1& 3ch m$i Y m=m v% Fhuln v 3Zp NJp li AQng cQ t#ong m=m

e" ee e e7 e5 e! e6 e8 es ef " e

x1 nim mc 0Y)( x1 A1 Nung Wu1nh ch=n 0Y)( #Vng #1 !cm qhng gc l1u Fh% A1 pt Fhuln A1 Nung Wu1nh ch=n 0Y)( #Vng #1 !cm Io tti hu m%n- v v cZt tti th2o Fich th$c M o qTi ,rn ht u Wu1 e ,n- gCp tCm lKt A$i 0Y)( qn tti ]ng ph=n m$i vo q.n ,rn ht u v tCm lKt A$i 0Y)( (ho gng t1& cho vo #c & tJ Cho o) n?m li ti@n nghi- ,o o) vi@c M Nong (hu A.n v N lG AQng cQ [hi hr 3

BI ;$ K THU*T CHwM SxC M KH +UsN

MC TIU 1. 9h&:n b c /7ng c7 !r$n "S" ch?" sTc "a kh< %&2n. 2. ThJc hi;n c k@ !h&8! ch?" sTc "a kh< %&2n.

1 CH "NH Cc t#Tng hp o) cK m Fhi Wun/ (h1& ,ng mi 5 giT hocc Fhi ,ng ,L thCm $t/

$ NH*N "NH (Snh t#ng o)X + `2m t+ng t#ng o)/ + (#i gicX tRnh h1& m/ + (Snh t#ng h% hCpX o) cK FhK th Fh%ng CK t# gitp th Fh%ng (n 3H- nhLp thFiDu th/ + )Ju o) th oN&X nn th1& Hng oN& s giT} ln/ + CK nhi;u m Fh%ngX mu 3Zc- 3H lng- tinh chCt- mhi/ + o) cK Aw ,L Fich thich Fh%ng (Snh t#ng ni m Fhi WunX + [c ch2 ch=n Ygb cK ,ln Fh%ng + 4oi YgbX e nPngnPng/

+ q=& ,uVc cK ,ln Fh%ng + (Snh t#ng A1 Nung Wu1nh Ygb cK ,L #m l- z- nhiwm t#hng Fh%ng

F CHU&N B" DNG C: th2o ,ng FiDm

; THC HIhN K THU*T: th2o ,ng FiDm

? NHGNG IXM CN !U (h2o Ai v nh gi tSnh t#ng thiJu oN& c:1 o) t#ong 3uHt Wu t#Snh th]c hi@n Fd thut/ Chm 3Kc Ygb phi nhy nhng t#nh Fich thich/ )Ju l Hng Ygb nPng ngoi/ Ict nPng t#ong m$i vo 'tiJp 31u ,$c " c:1 Fd thut Ygb* thTi gi1n Fh%ng Wu e" phtt/ Cho o) th Fh%ng Fhi lm/ ghi chm 3Kc Ygb Iq Eng h$ng ng]c v u o)/ (h1& A=& m$i cH Lnh chZc chZn #ri m$i cZt A=& c|/ nPng thS vcn chHt v lC& nPng t#ong #1 ng=m vo ,rn ht u cK chE1 Aung ALch oN& gi 'tiJp 31u ,$c 81 c:1 Fd thut htt m* v htt li m nh$t

BsNG KIXM DNG C HT M

STT e

N%I DUNG Y1ng Fhlu t#1ng- #1 t1& (#i Fhn v% Fhuln 9 c /7ng c7 vX kh&:n !rong "S"

Cx

KHNG

7 5 !

Hng htt m ch\n chung ]ng n$c muHi 3inh lG hocc n$c cCt [c i7ng c7 ngoi "S"

vi Hng htt m v% Fhuln

8 s f e" ee e e7

e Hng th oN& v% Fhuln 'nJu cn* [ng t1& v% Fhuln Y& htt m g;m 3ch gZp ,ng A (ti ]ng #c qung ALch #1 t1& nh1nh (h1u ]ng Aung ALch 3t Fhuln ng=m AQng cQ 31u 3 AQng

BsNG KIXM DNG C CHwM SxC M KH +UsN

STT e

N%I DUNG Y1ng Fhlu t#1ng- #1 t1& (#i Fhn v% Fhuln i7ng c7 vX kh&:n !rong "S"

Cx

KHNG

7 5 ! 6 8 s

F;m F2ll& e F\o e ch\n chung ]ng n$c muHi 3inh lG e ch\n chung ]ng Aung ALch 3t Fhuln [Pn vin- Wu2 gPn [c i7ng c7 sch ngoi "S"

f e" ee e

[ng t1& 3ch q=& ,uVc g;m 3ch gZp ,ng A ong F2o

e7 e5 e!

qung ALch #1 t1& nh1nh (ti ]ng #c (h1u ]ng Aung ALch 3t Fhuln ng=m AQng cQ 31u 3 AQng

BsNG KIXM K THU*T CHwM SxC M KH +UsN STT N%I DUNG e Y1ng AQng cQ Jn giTng ,o v gii thich cho o) 'nJu c* (ng oN& tHi 1 cho o) th t#ong 7 phtt 'nJu o) cK th oN&* 7 CZm i@n th m& htt m 5 Cho o) n?m ng1- F gHi A$i v1i ! oVc lV ni Ygb 6 Ict tti #c ni thun ti@n 8 qhng F;m 3ch gZp ,z gc ch2 t#n c1nul2 s (Zc ngurn oN& 'nJu cK* f Cho Hng oN& vo gc v% Fhuln h1& tti #c e" v lng o) 'nJu o) Fh%ng th m&* ee pt Fhuln li t1& nh1nh e (iJn hnh htt m 'th2o ,ng FiDm htt m* e7 Y1ng gng 3ch e5 Ict Hng oN& vo 'nJu o) cK th oN&* e! Y m=m AQng cQ th1& ,ng Ygb e6 4C& F;m tng cch- 3Zp NJp li AQng cQ t#ong m=m e8 Chuln ,L gc ch2 ch=n Ygb es qhng F;m 3ch gZp ,ng A ch2 ch=n Ygb cho vo tti #c ef Ict e miJng gc ln ng]c o) gn c1nul2- gZp gc Fhc D giB cnh " e c1nul2 qhng F;m gZp gPn thCm n$c muHi #1 3ch mct t#n mi@ng c1nul2- Fh%ng l1u Fh%- Fh%ng 3t Fhuln x1 3ch ,n ngoi Hng Ygb 'thnh Hng- mct t#n mi@ng c1nul2mct t#n ,n cnh c1nul2*- l1u Fh%- 3t Fhuln x1 3ch mct A$i ,n cnh c1nul2 ',?ng Wu2 gPn*- ch=n A1 7 5 Ygb #Vng #1 ! cm- l1u Fh%- 3t Fhuln* (h1& A=& cH Lnh Ygb pt Fhuln li u cnh c1nul2 v A1 ni A=& c| Cx KHNG

! 6 8 s f 7"

Ict gc ch2 ch=n Ygb Ict gc mzng ch2 l t#n c1nul2- cH Lnh gc (hCm n$c muHi $t phn gc ni mi@ng c1nul2 'nJu o) Fh%ng th m&* Cho o) n?m li ti@n nghi v ,o vi@c M Nong q.n Ayp AQng cQ [hi hr 3

BsNG KIXM K THU*T HT M

STT e Ygb

N%I DUNG (h]c hi@n t^ ,$c e Jn ,$c f t#ong ,ng FiDm Fd thut chm 3Kc Y m=m AQng cQ htt m tng cch

Cx

KHNG

7 5 ! 6 8

Y1ng gng t1& v% Fhuln [Zn Hng htt m vo A=& nHi qhng gc cm u A$i Hng htt ch^1 e on D htt )htng u Hng vo ch\n chung 'ch\n gn* D th m& v lm t#n u Hng 0tt m nh$t ni Ygb th2o tng ngu&n tZcX I1 vo tng vL t#i m$i htt (hTi gi1n mi ln htt Fh%ng Wu e"-e! gi=& (+ng thTi gi1n mi ln htt m Fh%ng Wu ! phtt 1/ 0tt m nPng t#ong c:1 Hng Ygb 'nJu cK* ,/ 0tt m nPng ngoi c:1 Hng Ygb

s f e"

oz Hng htt m- lu G t#nh lm nhiwm Fhuln t1& gng v% Fhuln [Zn Hng htt m m$i vo A=& nHi )htng u Hng vo ch\n chung 'ch\n N1* D lm t#n u Hng

ee e e7

0tt m m|i- mi@ng- t#ng Hng vo ch\n chung N1 oz Hng htt v gng t1& vo tti #c I& m=m htt m D m=m t#n u giTng

BI ;F K THU*T CHwM SxC D)N !U MNG (HI

MC TIU 1. H* c + chA nh * !hay bnh Jng /ch /3n l&. 2. ThJc hi;n c k@ !h&8! ch?" sTc /3n l& "ng ph4i.

1 MC CH - ChHng nhiwm t#hng/ - Im ,o h@ thHng An lu hi@u Wu/

$ CH "NH - ghi n$c t#ong ,Snh Wu }7/ - ghi n$c t#ong ,Snh +i mu/ - ghi ,D ,Snh/ - p1u mi s giT/

F NH*N "NH

- bu1n 3t vJt thngX vJt m+ cK cn th1& ,ng Fh%ng - bu1n 3t h% hCpX o) cK th oN& qCu hi@u FhK th - o) 1ng cK m& htt- p l]c htt - oSnh chE1 ALchX 3H lng- mu 3Zc- tinh chCt ALch

; CHU&N B" DNG C: th2o ,ng FiDm Iq m1ng Fhlu t#1ng- #1 t1& 3on AQng cQ/

? THC HIhN K THU*TX th2o ,ng FiDm

o NHGNG IXM CN !U - 0$ng An o) cch A1ng t1&- hit th- tp th/ - Cho o) n?m t thJ mol2# Fhi th1& ,ng/ - (h1o tc nhy nhng Fhi th1& ,ng/ - bu1n 3t ,Snh hEng ALch v; mu 3Zc- 3H lng v ghi vo hr 3 chinh Nc thTi gi1n ghi t#n thnh ,Snh Jn Fhi th1& ,Snh/ - (#ong thTi gi1n th1& ,ng nn th2o Ai ACu hi@u FhK th- th]c hi@n cho o) th oN& ng1&/ - p1u Fhi th1& ,ng Nong cho o) hit th 3=u h1& ho mnh D Wu1n 3t m]c n$c ln NuHng t#ong Hng th:& tinh Ai th2o nhLp th o) D ,iJt h@ thHng Hng M th%ng/

BsNG KIXM DNG C CHwM SxC D)N !U MNG (HI

STT

N%I DUNG D[8V O[ 0P/8V :K: 0P^- 4198 }T 41Q8

Cx

KHNG

F;m F2ll& e F\o

7 5

e ch\n chung ]ng Aung ALch n$c muHi e ch\n chung ]ng Aung ALch 3t Fhuln

! 6 8

[Pn vin [c ch2 ch=n An lu- gc #Ti I& m=m tng cch D[8V O[ 8V/t- :K:

s f

orn ht u v% Fhuln I+ n$c muHi 3inh lG vo ,Snh hEng ALch tng mEc 1n ton

e" 4Zp ,Snh v$i A=& c=u m$i ee 4m ACu m]c n$c ,?ng ,ng F2oX ghi mEc n$c v 3H lng n$c + vo- tn Iq- ng& giT th1& ,Snh e e7 e5 e ,rn ht u 3ch F;m l$n 3ch gng t1& 3ch

e! e tCm lKt n&lon e6 ong F2o ,ng l$n- ,ng F2o lQ1 e8 (ti ]ng ,ng A es Y& htt 'nJu cn* ef qQng cQ th oN& 'nJu cn*

BsNG KIXM K THU*T CHwM SxC D)N !U MNG (HI

STT e

N%I DUNG Y1ng AQng cQ Jn giTng- ,o v gii thich v$i o) Cho o) n?m t thJ thun ti@n- tHt nhCt l ngri h1& t thJ mol2#t1& A1ng ln c1o

Cx

KHNG

7 5 !

Phi ,& ni cK An lu (#i tCm lKt- ct ,rn ht u 3ch A$i An lu- ct Hng ln tCm lKt Ict ,Snh chE1 m$i ni 1n ton- u c=u nHi phi ch2 ch v% Fhuln F;m Fyp

6 8 s f

(ho ,ng F2o Nung Wu1nh miJng ,ng pt Fhuln li t1& nh1nh v m1ng gng t1& 3ch (ho ,ng A ,z vo #c & tJ- tho ,z gng t1& Y1ng gng 3ch m$i

e" Y m=m v% Fhuln tng cch ee 4C& F;m v% Fhuln tng cch e CZt gc- 3Zp NJp li AQng cQ t#ong m=m

e7 x1 A1 Nung Wu1nh ch=n An lu v #Vng #1 ! cm ,?ng Aung ALch n$cA.c muHi "-fu e5 x1 th=n An lu t^ ch=n Hng ln !-8 cm e! 41u Fh% A1 v th=n Hng e6 pt Fhuln A1 Nung Wu1nh th=n Hng e8 Ict gc ln ch=n An lu es CH Lnh ,ng ef gyp An lu ,?ng F;m l$n " (ho ,ng F2o ch nHi e Y ,rn ht u v% Fhuln ct ln tCm lKt A$i ch=n An lu (ho #Ti u A$i An lu v A=& c=u nHi 7 x1 t^ u%i Hng A.c ln th=n Hng ! cm 5 41u Fh%- 3t Fhuln u%i Hng ! [Zn h@ thHng A=& c=u m$i 1n ton 6 CH Lnh ni c=u nHi 8 (ho F;m Fyp Hng An lu s bu1n 3t 3] hot Vng c:1 h@ thHng f q.n Ayp AQng cQ 7" Cho o) n?m li ti@n nghi/ )Ju cK & l@nh htt thS gZn m& htt vo Hng ngZn c:1 ,Snh 7e [hi hr 3

BI ;; K THU*T CHwM SxC NG D)N !U

MC TIU 1. L$& - 2 "7c <ch ch?" sTc /3n l&. 2. H* c 2 chA nh ch?" sTc /3n l&. (. ThJc hi;n c k@ !h&8! ch?" sTc /3n l&.

1 MC CH - )g^1 nhiwm t#hng/ - 0@ thHng An lu t hi@u Wu/

$ CH "NH - ong thCm ALch/ - (h1& tti chE1 m$i/

F DNG C: th2o ,ng FiDm

; THC HIhN K THU*T: th2o ,ng FiDm

? NHGNG IXM CN !U - x1 vJt m+ t#$c- An lu 31u/ - qn lu 3ch t#$c- nhiwm 31u/ - )Ju o) cK 0Y)( thS #1 vJt m+ t#$c- 31u K #1 An lu v #1 0Y)( 31u chng/ - ghu&Jn Fhich o) vn Vng 3$m- nhCt l An lu + ,Qng/

- xtt An lu tng thTi gi1n/ - qn lu + ,Qng #tt nn No1& Hng ngoi t#^ An lu g2h#/ - )Ju thC& ,Ct thTng nn ,o op ng1&/

BsNG KIXM DNG C CHwM SxC NG D)N !U

STT

N%I DUNG D[8V O[ }T 41Q8 0P/8V :K:

Cx

KHNG

Y=m t#i Fhn v% Fhuln F;m

7 5 ! 6 8

e F\o [Pn vin [cX miJng gc A& D ch2 ch=n An lu- !-6 miJng gc mzng e ch\n chung ]ng Aung ALch n$c muHi e ch\n chung ]ng Aung ALch 3t Fhuln D[8V O[ 8V/t- :K:

s f e" ee e e7 e5 e!

e F;m 3ch (Cm lKt n&lon e ,rn ht u 3ch e ,rn ht u v% Fhuln q=& c=u nHi v tti chE1 ong F2o %i gng t1& 3ch (ti ]ng ,ng A

BsNG KIXM CHwM SxC D)N !U

STT e

N%I DUNG Y1ng AQng cQ Jn giTng- ,o v gii thich v$i o) Cho o) n?m t thJ thun ti@n

Cx

KHNG

7 5 ! 6 8 s f ee e e7 e5 e! e6 e8 es ef " e

Phi ,& ni cK An lu (#i tCm lKt Ict ,rn ht u 3ch (#2o tti chE1 m$i- tho ,ng F2o Nung Wu1nh miJng ,ng pt Fhuln t1& nh1nh Y1ng gng t1& 3ch (ho ,ng A ,z vo #c & tJ- tho ,z gng Y1ng gng t1& 3ch m$i Y m=m v lC& F;m tng cch CZt gc- 3Zp NJp li AQng cQ t#ong m=m x1 A1 Nung Wu1nh ch=n Hng An lu v #Vng #1 A1 !cm x1 A.c th=n An lu t^ ch=n Hng ln !-8 cm 41u Fh% A1 Nung Wu1nh v th=n Hng pt Fhuln A1 Nung Wu1nh v th=n Hng Ict ,ng CH Lnh ,ng gyp An lu ,?ng F;m 3ch Y ,rn ht u v% Fhuln (ho #Ti u A$i An lu v A=& c=u nHi

7 5 ! 6 8 s f 7" 7e

Cho u An lu vo ,rn ht u v% Fhuln x1 u%i Hng ln th=n Hng !cm 41u Fh% 3t Fhuln li u%i Hng [Zn h@ thHng A=& c=u v tti chE1 m$i qhng ,ng F2o cH Lnh Hng An lu v A=& c=u nHi (ho F;m Fyp Hng #1 q.n Ayp AQng cQ Cho o) n?m li ti@n nghi [hi hr 3

YgbX m Fhi Wun C(p)X chCn thng 3. nMo (4(X ti;n li@t tu&Jn

You might also like