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Y HOC VIET NAM THANG 9 SO 1/2010 Co 3 benh nhan bi tac catheter, 1 benh nhan co dau hieu xuat huyet xung quanh vi tri catheter di qua va khong cd benh nhan nao cd bieu hien viem nao th|t sdm trong 26[.]
Y HOC VIET NAM THANG - SO 1/2010 Co benh nhan bi tac catheter, benh nhan co dau hieu xuat huyet xung quanh vi tri catheter di qua va khong cd benh nhan nao cd bieu hien viem nao th|t sdm 26 benh nhan dUdc dieu tri - Bien chutig sau da rut dan lull nao that Cd benh nhan sau rut dan lull tuan sau quay lai vdi chan doan la viem mang nao Benh nhan cd dd dich nao ngoai sau rut din lUu Ve ky thuat neu nhu khau da tot sau rut dan lull thi cd the han che du'dc bien chUng dextran solution on increased intracranial pressure after brain injury Crit Care Med.;33(l): 196-202; discussion 257-8 Francony G; Fauvage B; Falcon D; Canet C; Dilou H; Lavagne P; Jacquot C; Payen JF (2008); Equimolar doses of mannitol and hypertonic saline in the treatment of increased intracranial pressure Crit Care Ato/,36(3):795-800 Mayhall CG; Archer NH; Lamb VA; Spadora AC; Baggett JW; Ward JD; Narayan RK (1984), Ventriculostomy-related infections A prospective epidemiologic study., N Engl J /Veo;310(9):553-9 IV KET LUAN Dan lull nao that ngoai ngoai viec true hep lam Suarez JI; Qureshi Al; Bhardwaj A; Williams MA; Schnitzer MS; Mirski M; Hanley DF; giam ALNS thong qua dan luU dich nao tarn thdi thi la mot phu'dng phap tot de theo ddi ALNS tren Ulatowski JA (1998); Treatment of refractory intracranial hypertension with 23.4% saline Crit lam sang Ti le bien chutig ciia thu thuat (chu yeu la Care A/e^26(6):1118-22 tac dan luu) chi vao khoang tren 10% Vialet R; Albanese J; Thomachot L; Antonini F; Bourgouin A; Alliez B; Martin C (2003); TAI LIEU THAM KHAO Adams, RA, Ropper, AH (1997) Principles of Isovolume hypertonic solutes (sodium chloride or mannitol) in the treatment of refractory neurology, 6th ed, McGraw Hill, New York posttraumatic intracranial hypertension: mL/kg Battison C; Andrews PJ; Graham C; Petty T 7.5% saline is more effective than mL/kg 20% (2005); Randomized, controlled trial on the effect mannitol Crit Care Afetf.;31(6): 1683-7 of a 20% mannitol solution and a 7.5% saline/6% DANH GIA CHUDNG TRINH VA THI/C TRANG GIANG DAY VE HIV/AIDS CUA TRUONG DAI HOC Y HAI PHONG Nguyen Thi Tham*, Nguyen Van Hung*, Pham Van Han* TOM TAT mot so bp mdn Nhieu ndi dung va cac dich vu mdi lien Nghien citu danh gia chudng trinh va viec thitc quan den HIV chua dUdc de cap chUdng trinh hien dao tao ve HIV/AIDS: ndi dung, cau true chUdng dao tao ChUa cd tai lieu dUdc xuat ban phuc vu giang trinh dao tao, to chut giang day, phUdng phap giang day va nhieu thong tin chUa cap nhat PhUdng phap day, tai lieu giang day va hpc tap Cac phUdng phap giang day ly thuyet chu yeu la thuyet trinh, chUa cd nghien cu'u dinh lUdng va dinh tinh da dupe sir dung ndi dung thut hanh tai cac cd sd cham soc va dieu tri vdi sit tham gia ciia 225 sinh vien nam thir va nam thirnhiem HIV tai cdng dong Da so sinh vien nam thir 6, giang vien va can bp quan ly, ket qua cho thay: va nam thU cho rang kien thirc ve du phong Cac npi dung lien quan den HIV/AIDS dupe giang dayHIV/AIDS dUdc hpc trudng Dai hpc dap itng nhieu bp mon khac tir nam thir nhat den nam thir cdng viec sau d mUc dp thap va trung binh sau, kien thirc dUdc giang day phan tan va triing lap d * Tn/dng Dai hoc Y Hai Phong 23 Y HOC VIET NAM THANG - SO 1/2010 chUdng trinh dao tao ve HIV/AIDS cho sinh vie SUMMARY: Evaluating curriculum and the implementation y khoa ciia TrUdng dai hgc Y Hai Phong nam hg 2007-2008 of HIV/AIDS program-Haiphong Medical University The study aims to evaluate the existing HIV/AIDS II OOI TUONG VA PHUONG PHAP NGHIEN 2.1 Doi tudng va cd mau nghien cu'u curriculum, teaching/learning materials and 120 sinh vien nam thd va toan bp 105 methodology of Haiphong Medical University for sinh vien nam the? medical students Contents, structure, materials, Toan bp giang vien cac bp mon dang giang teaching methodology of related departments day cac chu de ve HIV/AIDS (7 giang vien) Qualitative and quantitative methods have been used 01 can bp quan ly phong dao tao with the participation of 225 students at the and 6* 2.2 Phu'dng phap nghien ciiu year, faculty members, resutlts showed that: Thiet ke nghien cu'u cat ngang phoi hdp HIV/AIDS related contents mentioned and phUdng phap: integrated in different departments for thefirstto the Nghien cu'u djnh lu'dng: Nghien cUu sU sixth years students, some are scattered and dung phUdng phap so sanh cat ngang dUa vao duplicated and not updated New services available bang cau hoi phat van true tiep dieu tra danh gia relating to HIV/AIDS at community level is not yet chUdng trinh dao tao ve HIV/AIDS addressed Most of subjects have been conducted as Nghien cu'u djnh tinh: theory based, traditional teaching methods There is Nghien cUu cac tai lieu san cd: bai giang, no official published teaching/learning materials on bao cao, tai lieu hpc tap HIV Most of students rated their own knowkedge Thao luan nhdm vdi sinh vien nam thU gained in the university at low and average level nam, thU sau I OAT VAN OE" Phong van sau giang vien, can bp phong Cung vdi sU gia tang so luting ngUdi nhiem dao tao HIV/AIDS, cac cd sd y te thdi diem hien 2.3 Phan tich va sd ly so lieu: va tUdng lai phai tiep nhan, phuc vu va So lieu dinh lUdng td bp cau hoi dUdc nhap cham sdc cang nhieu benh nhan HIV/AIDS tai tat ca cac tuyen tif trung Udng den dia va xU ly tren phan mem SPSS 15.0 So lieu dinh tinh nhu thong tin tU thao luan phUdng Cac sinh vien sap tot nghiep cd dUdc nhom dUdc dpc, ma hoa, phan tich va xd ly theo trang bi du kien thud va ky nang can thiet de doi phudng phap nghien cu'u xa hpi hpc thong vdi dai dich HIV/AIDS ChUdng trinh dao tao thudng tai TrUdng dai hpc y hien cd phu hdp vdi nhu 2.4 Van de dao diTc nghien cfru : cau ve kien thud va ky nang lien quan den cong Nghien cUu vien giai thi'ch ro muc tieu nghien tac phong chong HIV/AIDS, nhUng van de nao cud cho doi tUdng dUdc phong van, dUdc sU can sua doi, bo sung, cap nhat dap Ung nhu cau dong y va tu nguyen tham gia ciia ddi tUdng thut te De tra Idi nhUng cau hoi tren chung toi nghien ciiu NgUdi dUdc phong van cd quyen ti/ tien hanh nghien cu'u vdi muc tieu: Danh gia chdi tra Idi hoac ddng tra Idi bat cif nao chUdng trinh va thuc trang viec thuc hien KET QUA NGHIEN CLfU Bang Ndi dung lien quan den HIV/AIDS chUdng trinh chi tie : So tiet Chu de lien quan HIV/AIDS, Bp mon giang nghien va lam dung chat kich thich day Ly thuyet ThUc hanh 1 HIV Vi sinh SKMT Nghien rUdu va ma Tarn than Nghien ma th 24 Y HOC VIET NAM THANG - SO 1/2010 Tarn than Lam dung rudu va nghien rUdu YTCC Nhiem HIV/AIDS/ Dich te hoc du phong HIV/AIDS Noi Bieu hien AIDS noi khoa San-Phu Nhiem HIV/AIDS doi vdi ba me tre em Truyen nhiem Nhiem HIV/AIDS Lao Lao va HIV/AIDS Rang ham mat 10 HIV/AIDS vung rang mieng Da lieu 11 Nhiem trung qua dudnq tinh due (HIV) Tong cong 19 23 Nhan xet: Trong chUdng trinh dao tao cho sinh vien he bac sT da khoa chinh quy ciia trudng Dai hgc Y Hai Phong, cac chu de lien quan den HIV/AIDS gom tong so 19 tiet ly thuyet va 23 tiet thUc hanh dUdc giang day d 11 bp mon khac Mot so npi dung trung lap giua cac bp mon Y te cong cong, Truyen nhiem, Tarn than Mot sd ndi dung chUa dUdc de cap nhu giam hai phong chong HIV, nhiem trung cd hpi, cham soc giam nhe, dieu tri ngoai tru cho benh nhan, tu van xet nghiem HIV tU nguyen Phu'dng phap giang day: Bai giang dUdc thUc hien theo phUdng phap thuyet trinh la chinh Viec hpc thUc hanh ve HIV/AIDS da dUdc dieu chinh tai mot so bp mon, nhu Truyen nhiem, Lao va benh phd'i Sinh vien chUa dupe tiep can cac dich vu mdi nhU tU van xet nghiem tU nguyen, cham soc cho ngUdi benh ngoai tru, dieu tri bang methadone Bang : Ket qua tra Idi cua sinh vien ve phUdng phap giang day ma giang vien da giang cho hp — — — M i r e ThUdng xuyen Khong thu'dng Thinh thoang ChUa bao PhUOng phap —-— (%) xuyen (%) (%) gid (%) 57.2 35.1 Thuyet trinh 7.8 Nghien cuu trUdng hdp 3.6 20.9 34.2 41.3 Thao luan nhdm nhd 4.9 14.3 40.4 40.4 Day hoc bang ddng vai 5.2 7.6 25.3 61.8 Cd cac phUdnq tien nghe nhin 27.1 20.0 34.7 18.2 Hoc tren md hinh 8.4 3.6 16.0 72.0 Day tU van HIV/AIDS 15.6 10.7 47.6 26.2 Day Lam sang 49.8 17.8 25.8 6.7 Nhan xet: Sinh vien Y5, Y6 la cac sinh vien da hpc qua tat ca cac bp mon danh gia, hpc thuyet trinh, day lam sang va cd cac phUdng tien nghe nhin thudng xuyen (57,2%, 49,8%, va 27,1%) Tai lieu giang day ve HIV: Bang 3: Tai lieu day hpc theo danh gia cua giang vien — — B T N Tai lieu giang day - Handout/tai lieu phat tay -Sach giao khoa - Tap bai giang - Tranh/anh/ video C So lu'dng (n=7) 7/7 1/7 2/7 2/7 25 Y HOC VIET NAM THANG - SO 1/2010 Nhan xet: Ve tai lieu giang day, cd 7/7 giang vien da phat cho sinh vien handout/tai lieu phat tay, tap bai giang va tranh anh (2/7), cd 1/7 giang vien cd gidi thieu sach giao khoa Cho den thdi diem nghien cu'u, cac bai giang du'dc soan va phat tay theo bo mon, chu'a cd tai lieu du'dc xuat ban cho giang day ve HIV, ma Kha nang dap d'ng cong viec: jo 40 • — , ; 302 29X Hinh 1: Ket qua tra Idi cua sinh vien ve kha nang dap d'ng dUdc cdng viec sau trUdng Nhan xet: Sinh vien danh gia ve kien thud d 11 bp mon va moi bp mon chi giang mot vai dU phong dUdc hpc trUdng dap Ung cdng tiet, cd mot so ndi dung lai lap lai nhieu viec sau d cac mUc dp: chUa dap Ung la lan da lam giam hieu qua dao tao ciia chUdng 40%; dap Ung la 30,2% va dap Ung tot 29,8% trinh giang day Ly khong dap Ung dUdc sinh vien giai Nhieu noi dung ly thuyet chda du'dc cap thich cac cupc thao luan nhdm: nhat, cac dich vu cham soc va ho trd ngudi "Chung em khong biet kien thifc ve HIV du'dc nhiem HIV tai cdng dong chua dddc gidi thieu, chua cd tai lieu xuat ban ve HIV: Phan tich tai hoc tru&ng cd du de dap d'ng cdng viec lieu hpc tap hien dang ap dung giang day tai sau khong vi HIV chi la mot rat nhieu ndi dung ma chung em dddc hoc Cd luc ditngtrUdng va so vdi yeu cau ve Kien thirc, Thai dp trddc benh nhan HIV thay khong du'dc td tin mac va Ky nang (KAS) can dat tot nghiep bac sT dii sap trd bac si" da khoa, cd nhieu ndi dung lien quan den Tom tat thao luan nhdm giang vien trUdng HIV/AIDS de cap yeu cau, nhUng thud te Dai hpc Y Hai Phong: "nhieu giang vien co be chUa dUdc de cap chUdng trinh giang day kinh nghiem, yeu nghe va cd trach nhiem day vdi va tai lieu day hpc nhU: anh hudng ciia cdng viec ciia minh"; "so lu'dng giang vien HIV/AIDS cd den gia dinh va xa hpi; phUdng phap hitu cua cac bd mon dii dieu kien de giang day tU van, giao due sire khoe cho benh nhan nhiem cac chu de lien quan den td van di/ phong HIV/AIDS; ky thi va phan biet ddi xU; tuyen HIV/AIDS, nghien ma tuy, nghien rtfdu va lam truyen giao due cdng dong ve HIV/AIDS, tu van dung rddu" xet nghiem tu nguyen, cham soc giam nhe, cham soc ngoai tru, cac chUdng trinh giam hai Tai lieu IV BAN LUAN giang day chUa cap nhat d nhieu npi dung: dich Qua nghien cifu cho thay, cac ndi dung lien te hpc ve HIV/AIDS; cd che benh sinh, chien lUdc quan den HIV dddc giang day tai nhieu bd mon, phong chong lay truyen tU me sang [l, 3] kha phan tan va chong cheo nhieu ndi dung chu'a dddc de cap: sinh vien dUdc hpc cac Ve phu'dng phap giang day: Trong tai' lie chu de lien quan den HIV/AIDS vdi 19 tiet ly hgc tap chda dddc hoan thien, viec giang day ly thuyet va 23 tiet thUc hanh Mot sd kien thuc ve thuyet chu yeu van theo each thuyet trinh truyen dU phong lay nhiem nhu dU phong lay nhiem HIV thong Viec hpc thuc hanh chUa theo kip sU phat nghe nghiep va tU van noi chung, tU van trien nhanh chong ciia cac dich vu du phong, HIV/AIDS, giam hai chUa dUdc de cap d bp cham soc va dieu tri HIV/AIDS Trong nhieu mon nao Hdn nUa vdi sd lUdng thdi gian hpc ly dich vu y te da xuat hien va van hanh tai khu vUc thuyet va thUc hanh khong nhieu nhUng lai rai Hai Phong [4] nhUng sinh vien van chUa cd cd hpi dUdc hpc tap, tim hieu ve cac dich vu 26 Y HOC VIET NAM THANG - SO 1/2010 Day la nhutig dich vu het site quan trgng, vdi V KET LUAN nhutig can bo y te da dUdc dao tao cd ky nang ChUdng trinh dao tao ve HIV/AIDS cd npi tot, cd tiem nang Idn viec hd trd sinh vien dung triing lap va phan tan d nhieu bp mon phat trien cac kien thcVc va ky nang cho cdng tac Nhieu npi dung lien quan trite tiep den du phong, cham soc site khoe ndi chung va cho ngudi cham soc va dieu tri nhiem HIV chUa dUdc de nhiem HIV ndi rieng cap d bp mon nao Tai lieu hoc tap hien tai chu yeu la tai' lieu ChUa cd tai lieu dUdc xuat ban phuc vu phat tay cua giang vien Khao sat cac chUOng giang day mot each toan dien ve HIV va nhutig trinh va tai lieu hgc tap ciia cac trudng dai hpc y chu de sUc khoe lien quan trite tiep, nhu ma tuy, ca nUdc cho thay, chUa cd tai lieu giang cham sdc giam nhe, giam hai day dUdc xuat ban theo hudng mot chuyen de cd Sinh vien chUa dUdc thUc hanh va gidi tinh toan dien Hdn nUa, nhieu bp mon cirng thieu ve cac dich vu du phong, cham sdc va dieu tham gia giang day nhUng chUa cd sU phoi hop, tri ngUdi nhiem HIV/AIDS tai cdng dong nhu tu viec chong cheo ve ndi dung la khd tranh khdi van xet nghiem tit nguyen (VCT), dieu tri ngoai La mot ITnh vitc sUc khoe quan trong, da cd tru cho benh nhan (OPC), giao due ddng dang nhieu van ban phap ly, cac chUdng trinh hanh Khuyen nghi : ddng qudc gia de cap den cdng tac phong chong Can cd chUdng trinh toan dien de giang HIV, viec xay ditng mot chUdng trinh va tai lieu day ve HIV theo hudng mot chu de sire khoe: hoan chinh ve HIV/AIDS la het sUc can thiet dam bao dap Ung kien thUc, thai dp cung nhu ky Qua phong van sinh vien y da khoa nam thU nang cham sdc va dieu tri benh nhan nam, thU sau ve mUc dp dap Ung nhu cau cdng HIV/AIDS va cac van de lien quan dUdc de cap viec sau ciia kien thiic da dupe hpc Xay ditng tai lieu giang day va hpc tap trudng dai hpc ve cac chu de lien quan den dap irng nhu cau thut te cdng tac phong chong HIV/AIDS Ket qua cho thay mire dp dap irng HIV Cac npi dung lien quan den cac qui dinh trung binh va thiip rat cao (70,2% ), hien tai Luat phong chong HIV, nhu van de mUc dap Ung td't theo quan niem ciia sinh vien chong phan biet ky thi, bao mat thong tin can chi dat 28,8% Ly khong dap Ung la "kien dUdc gidi thieu thtic ve HIV/AIDS du'dc hoc d nhieu bo mon va Viec hpc tap ve kien thirc va k9 nang tu khong lien tuc nen kien thut khong he thong",van, giao tiep, y dire cd the dUdc tang cUdng "noi dung hpc tap qua nhieu; dieu kien thut thong qua gidi thieu cac djch vu mdi cho sinh hanh kern, thieu cd hpi thut hanh cac ky nang vien nhu TU van xet nghiem tu nguyen, cham can thiet" va cd nhieu sinh vien cd tarn ly sdc giam nhe, dieu tri ngoai tru cho benh nhan "ngai tiep xuc vdi benh nhan HIV/AIDS" vi chUdng trinh dao tao "5d"benh nhan HIV/AIDS nen cang lam cho sinh TAI LIEU THAAA KHAO vien cd it cd hpi thud hanh ky nang dUdc hpc Bo Y te (2006) Kien thUc - Thai dp - Ky nang Van de ky thi ddi vdi benh nhan HIV/AIDS da trd can dat td't nghiep bac si da khoa Nha xuat rao can ddi vdi sinh vien viec hieu, ban Y hpc thong cam, chia se cung nhu thut hanh cac ky Le Hong Phudng (2008) Kien thirc, thai dp ciia nang dUdc hpc trUdng Qua dd cung cho hpc sinh dieu dudng, hp sinh ve HIV/AIDS Khoa thay hieu qua ciia chUdng trinh dao tao ve luan td't nghiep cU nhan Y te cdng cdng TrUdng HIV/AIDS ciia trUdng chUa thUc sU dat hieu qua, Dai hpc Y Ha Ndi nhieu han che Ket qua nghien ciru ciia Trudng Dai hoc Y Hai phong (2001) ChUdng chiing tdi ve kha nang dap irng cdng viec sau trinh Dao tao Bac si da khoa he dai han thap hdn ciia Le Hong PhUOng cd 65% hpc Uy ban phong chong AIDS Hai Phong Bao sinh cho rang kien thUc hpc trUdng dap cao cdng tac phong chong HIV/AIDS nganh Y te Ung tot cdng viec sau [2] Hai Phong 1998-1999-2000-2007 27 ... ly hgc tap chda dddc hoan thien, viec giang day ly thuyet va 23 tiet thUc hanh Mot sd kien thuc ve thuyet chu yeu van theo each thuyet trinh truyen dU phong lay nhiem nhu dU phong lay nhiem HIV. .. di/ phong HIV/ AIDS; ky thi va phan biet ddi xU; tuyen HIV/ AIDS, nghien ma tuy, nghien rtfdu va lam truyen giao due cdng dong ve HIV/ AIDS, tu van dung rddu" xet nghiem tu nguyen, cham soc giam nhe,... Nghien ma th 24 Y HOC VIET NAM THANG - SO 1/2010 Tarn than Lam dung rudu va nghien rUdu YTCC Nhiem HIV/ AIDS/ Dich te hoc du phong HIV/ AIDS Noi Bieu hien AIDS noi khoa San-Phu Nhiem HIV/ AIDS doi vdi