1, Cdi thifin ehdt tu'png tnjydn thfing glfio dgc vd vfi sinh ca nhan, vfi sinh mdi trudng vfi chdt lupng nydc va cac bifin phfip bdo vfi nhdm iam cho ngudi dan cd nhu edu su dgng nha[r]
Trang 1* Cac tripij c h d n g vfi x6t nghidm
Trong nghign cuu cua chung t6t, gSp tfing enzym
gan va Bilirubin vdt ll Ifi nhu' sau ALT: tang 25,9%,
AST tang 29,3%, GGT tflng 55,2%, Bilirubin todn
phdn tang 10,3%
Theo nghi&n ciiu cua chung tdi tSng ALT, AST va
Bilirubin toSn phdn \i dc tridu chung it gfip d bfinh
nhan (36ng nhidm HIV - HCV, tuy nhifin, ISng GGT lgi
nghi§n cuu ciia Kanxay Vernavong (2011), enzym
gan AST va ALT tSng c6 lifin quan ddn tinh trgng l6n
thu'ong cua gan Nghifin cu'u cho Ihdy ndng dO AST
trung binh la 216,58 ± 32.20 (U/l), ALT IS 147,15 ±
21.01 (U/l) Ndng 30 enzym gan cao ho'n mirc binh
thu'dng ddng nghla vdi tinh trgng gan dang b| ldn
thuong gap trong ddng nhidm HIV - HCV Vd chde
nSng 6^0 thai mgt d gan vdi Bilirubin toSn phdn \i
83,05 ± 12,23 (pmol/l) Bilirubin true lidp la 38,80 ±
5,59 (pmol/l), kdt qua x6l nghifim nay phan anh tinh
gan C Nhu' vSy, kdl qua nghifin ciiii ciia \ic gia phan
anh muc (56 Ion Ihuong gan d bfinh nhSn vi&m gan C
tren benh nhfln HIV, khong gap tdn thu'ong suy chii'C
nflng gan d bfinh nhfln viem gan C tren benh nhfln HIV
KET LUAN
Qua theo doi, dieu in trong 24 thang cho 198 bfinh
nhan nhidm HIV lgi khoa Truydn nhifim - Bfinh vifin
103, td thflng 1/2007 den Ihflng 5/2012 Chiing tdi
nhan thdy
- Ty le dong nhidm HCV d bfinh nhan nhiim HIV
la 29,3%
Ty le dong nhidm HIV - HCV d benh nhfin nam
gidl la 34,5%, cao han so vdi d n d g i d i la 15,1%
Ty le dong nhiem do chich ma tiiy 40,0% cao
hon so vdi nh6m quan hfi tinh due khOng an tofln
25,0%
- Kieu gen HCV chiem u'u the Ifl typ 1 (87,9%), lyp
6 chiem (12,1%), khdng gap cac kieu gen khac
- Ty le bfinh nhan e6 tnfiu chdng lfim sflng vd gan
d nhom dong nhidm HIV - HCV la thdp (Vflng da,
vang mflt, lidu vflng 13,8%, mfil moi 8,6%, chfln fln
3,4%, sp md 3,4%, gan to 3,4%) j Tflng ALT, AST vfl Bilirubin toan phdn Ifl tffl
chdng i! gap d nhdm ddng nhiem HIV - HCV, fl
Iuvt Ifl 25,9%, 29.3% vfl 10,3% Tuy nhifin, tflng GQ
lgi Ifl Irifiu chdng khfl phd bien (55.7%)
- Khdng cO su' khflc bidt c6 y nghTa thdng kfi j
eflc IriOu chirng Iflm sflng, xd\ nghiem enzym gaj
Bilirubin d nhdm cd vfl khdng ddng nhidm HCV TAI LIEU THAM K H A O
1 BO Y td, Cue phbng chdng HIV/AH
(04/03/2009), "Hudng din chin doin vi didu HIV/AIDS"
2 Bui Ogi (2008), -Vifim gan virus C", Vidm virul B vi D Nhfl xudi b^n y hoc Hfl NOi
3 H 6 Tdn Dgl, Pham Th| Thu Thuy vfl c^ng
(2005), "Kidu gen cua vifim gan sifiu vi C d \i
Nam", Tgp chi Y Hgc TP Hd Chi Mmh Tap 10, S4
Irang 28 - 34
4 Nguydn Tidn Hda (2012) Ttnh trgng r)t)i HIV HBV HCV vi ydu td lidn quan & mdt sd nl nguy ca cao tgi Hi N6i 2008 - 2010 Luan an Tidni
Y hoc Vifin vfi smh dich id trung u'ong Hfl NOi •
5 Andrew H Talal (2002), "The HCV and Hij Coinfected Patient What Have We Learned Abw Pathophysiology", Current Gastroenterology RepOfS
2002, 4 15-22 Current Science Inc ISSN 1522-8037J
6 Blatt LM el al (2000), 'Assessment D hepatitis C virus RNA and genotype from 66^
patients with chronic hepatitis C in the United Slated
J Viral Hepal 2000 May,7(3) 196-202
7 Cooper CL and others (2003 Hepatotoxicity associated with antiretroviral thera(
containing dual versus single protease inhibitors individuals coinfected with hepatitis C and hurni
immunodeficiency virus Clinical Infectious Diseaa
34(9) 1259-1263 May 1, 2002
8 Dl Martino V and others (2002), "H coinfection does not compromise liver histologic response to interferon therapy m patients with chrw
hepatitis C", AIDS 16(3) 441-445 February 15, 200
THin: TRANG DIEU KIEN NHA 0 VA VE SINH MOI TRlTOTNG HO GIA DINH
TAI BA XA VUNG NONG THON TINH HAI OUITNG NAM 2012
NGO TH! NHU - Dai hgc Y ThAi Binh
T 6 M TAT
Nghidn cuv dt ngang 1205 hd gia dinh vd •'Thgc
trgng nhi & vi didu kidn vd sinh mdi tnrdng hd gia
dinh tgi ba xi vung ndng thdn tinh Hai Dwong nim
2012" tu' thing Iddn thing 6/2012 kdt qui cho thiy:
Nhi d 1 ting chidm ty Id 59%; nhi d cip 4 chidm ty
1$ 14,9% Nhi d c6 didn tich trdn lOm'/ngwdi chidm
ty Id 84.6% Trong dd xi Thanh Timg chidm ty 1^ c nhit li 9 7.8% V$l hdu chlnh tmng xiy dwng nhi 6 ggch nung cd trdt vwg li 63.3% Cdn 22.2% ftfli dinh sw dung ram rg vi 12,4% sir dung than trz dun niu sinh hogt hing ngiy.Ty 1$ ngudi dii\
dung nwdc sgch li 47% nwdc miy; 33% nwdc gii
Trang 2cic ngudn nwdc dwgc gia dinh cho li hgp vd sinh
chidm tir 49,8% ddn 57,4% Tj? Id hd gia dinh cd nhi
tidu li 99.2%; vin cdn 30,3% nhi tidu khdng dim
bio vd sinh
Td" khda: nhi &, vd sinh mdi trwdng
SUMMARY
A cross-sectiongi study among 1205 people about
the condition of household and environmental
hygiene at 3 rural communes in Haiduong province
fmm January to June 2012 showed that: concrete
house condition accounted for 59 0%, level IV house
condition accounted for 14.9% About 84.6% of all
which Thanhtung communes accounted for highest
proportion (97.8%) The main materials for
construction were concrete (61.5%) and brick with
mortar (63.3%) About 22.2% of all the household
used rice stmw and 12.4% used coal in daily cooking
Neariy haff of people (47%) used tap-water, about
33% of them used well-water There was still 3.8% of
people used water in pool for daily activities About
49.7% to 57.4% of all the water soumes were
considered as hygienic ones, finest of household
(99.2%) had WC in which 30.3% WC were not
hygienic
Keywords: household, environmental
DAT VAN o e
6 nhidm mdi tru'dng nfing thdn dang la tinh trang
chung d hdu hdt cdc ^ a phu'ang, nhdt ifi vOng ddng
bdng, do dat dai chfit h|p nfin ngudi dan dang ddi
• mat vdi tinh trang 6 nhiem mdi tru'dng nang nd S6
< lupng rac thdi sinh boat ngay mdt tang lfin Ngudi
i dan vdt rac thai ra k h l p nffi nhu t d ven nha, du'dng
, iang, ngd xdm ddn kfinh muang, ao hd Tai Vifit
1 Nam, cd tdi ban 80% cae bfinh cd lien quan den
ngudn nu'dc nhu tieu chay, thuang ban, ta, [y, giun
J san, vifim gan Nguyfin nhfin chu ydu do nhifim b i n
f t d cfic chat hdu co va vi sinh vfit, qua dd tac dpng
gia va tre em [13] Mdt vdn dd ddng ndi dd la tinh
trang tdn tai nha vfi sinh khdng dam bao, hay khdng
ndng thdn Tai Viet Nam, Tbeo bfio cao Chu'ong trinh
I 2005- 2010 chi ed 55% hfi gia dinh ndng thfin ed nha
tieu dgt tifiu chudn vfi sinh cOa Bd Y td Thdp nhdt la
Nam Bfi (69%), Trong khi dd myc tifiu chinh vd vfi
sinh eua chuong trinh nfiy la phdn ddu ddn nam 2015
"cd 65% s6 hfi gia dinh, 100% tardng hpc va trgm y td
ed nha tifiu hp'p vfi sinh Phdn ldn ngudi dfin chu'a
thdy hdt moi nguy hai khi mfii tru'dng bj fi nhidm, suy
'Ithofii Ttnh trang thidu J thdc vd vfi sinh lfim cho mfii
^'trudng ngay cfing 6 nhidm hen
fi Giai quydt tdt vdn dd nba d va 6\ku kifin vfi sinh
3mditnrdngxung quanh se ban chd du'pctinh trgng 6
Moan mfit s6 bfinh darig lifin quan nhdm nfing cao tinh
tru'dng sdng Xudt phat t d y nghTa thi,i'c tifin dd chCing
tfii tidn hfinh nghifin cdu dd tfii' "Thirc trying dieu
kidn nhi & vi v$ sinh mdi trwdng hd gia dinh tai
ba xi vung ndng thdn tinh HAi Duxmg nim 2012"
D O I T U - Q N G V A PHU-aNG P H A P NGHIEN CU'U
1 Ddi lu'Q'ng nghifin c d u : Hd gia dinh Tgi cac hfi ehiing tfli tidn bflnh didu tra va quan sdt vd Didu kifin nha d, md hinh nhfi tifiu va tinh trgng vfi sinh, ngudn nu'dc, rfic thdi
2 Oja bfin nghifin c u u Nghifin cdu du'pc tidn hdnh tgi 3 xa vCing ndng
thfln Tinh Hi\ Duong d6 la: Xa Cdm Phiic thu$e
huyfin cdm Giflng, xfl Thanh TCing thuOc huyfin
Ldc
3 Thdi gian nghifin c u u : Nghifin cdu dupe thu'c hifin t d thang_1/2012 ddn thang 6/2012
4.Thidt kfi nghifin c d u : Nghifin cdu djch td hpc mfl ta dua trfin cudc didu tra cdt ngang
5 C d mdu vfi chpn mfiu
- Chgn miu: Chii djnh chpn 3 xfl dd ifl Cdm Phuc
thufie huyfin Cdm Gidng, xa Thanh Tung thuflc huyfin Thanh Mifin vfi xa Phu'ang Hu'ng thuflc huyfin Gia Lfle, Day la cfic xa dgi difin cho viing ndng thfln tinh
ddi lu'O'ng nghifin cdu theo phuang phdp chon ngiu
gia dinh, sau dd tidn hanh 6iku tra theo phuang phap
"cdng lidn cdng" cho Qkn khi du c_d mdu nghifin cdu
- Cd m i u ; Ap dung tinh cd mfiu
n = ^(a!2) ' .P^-P)
Du'a vao cflng thde tren tinh n=400 Vay ea mau can cho nghifin cdu la 1205 Hfi gia dinh
6 Phu'ang phfip, ky thufit thu th^p sd li^u Quan sat true tidp vfl sd dung bang kiim da xay dM'ng sdn dd xac dinh cac ydu to nguy ca d nhifim nguon nu'dc, tinb trgng vfi sinh nhfl tifiu, thu gom va
nang lu'png sd dgng trong dun ndu, )
7 Tjfiu chudn ddnh gid Dua theo tifiu chuln quy dinh tgi Quydt djnh 08/2005/QB-BYT va 09/2005/QD-BYT
Didu kifin vfi sinh nha d dya vao tifiu chudn c h i t
lypng vfi sinh mfli trudng nydc, nhfi tifiu, thu va x d Yj
djnh hifin bfinb [0], [2]
8 PhSn tich vfi x u ly s6 li^u cac phidu didu tra (Snh lupng, sau khi thu thfip ddu dup'C ifim sgch trude khi nhfip vao may tlnb
phdn mdm SPSS 16.0
Cfic s6 lieu dypc trinh bay dudi dang bang vfi bidu dd
Sy dgng cfic test tbdng kfi trong phfin tfch s6 Iifiu
Trang 3Bdng 1, Cfic loai hinh nha d tgi cac xS didu tra
L09i
nhS 0'
Nhd 1
Nhd 2
Idnq
Nhd 3
t^ng trp
T6ng
C i m Phuc
S i
35
212
148
6
401
8.7
52,9
36,9
1,5
100
T h a n h
T u n g
SL
3 6
166
174
35
401
%
9,0
38,9
43,3
8,8
100
P h i f o n g
H u n g
SL
6 0
238
9 9
6
403
%
14,9
59,0
24,5
1,6
100
C h u n g
SL
131
606
421
47
701
%
10,9
50,2
34.9
3,9
58,2
Ty Ifi ehung ca 3 xa nhd 1 tdng chidm cao nhdt Id
50,2% vdn cfln 10,9% nha cdp 4 Nha d cua ngudi dan
ddn 59% ddi vdi nhfi d xfiy 1 tdng vfi td 24,5% ddn
43,3% vdi nha xay 2 tdng va ed sy khae nhau gida cfic
xa theo Chung tdi la hpp ii* bdi IS kmh td cua m6i xa la
10,9% hd gia dinh cd nha cdp 4; didu nay cOng hoan
toan phCi hpp vdi didu kifin kmh td eua eac xS
Bdng 2 Difin tich nhfi d d dja bfin nghifin cdu
D[$n
t i c w
ngirdri
<10
m '
>10
e l m Phuc
( n = 4 0 1 ) ( 1 )
SL
4 6
355
%
11,5
88.5
T h a n h
T a n g
( n = 4 0 1 ) ( 2 )
SL
9
392
%
2.2
97.8
P h i / o n g
H i f n g (n=403) (3)
SL
103
300
%
25.6
74.4
T i n g (n=1205)
SL
156
867
%
15.4
84.6
p (1.2vi3)<0,05
Difin tich nhfi d cua cfic hfl gia dinh t u
lOm^/ngu'di trd lfin cbidm ty Ifi eao (84,6%); trong 3
xfi nghifin edu cho tbdy xS Thanh Tung cbidm ty Ifi
cao nbdt ifi 97,8% va thdp nhdt la xa Phyang Hyng
chidm t^ Ifi 74,4% S y khfic bifit cd 9 nghTa tbdng kfi
vdi p<0,05
Bang 3 Cfic loai vfit Iifiu chlnh s d dung lfim tudng
nha
Loai v$t
ll$U
TLffrng
d i t t r i t
vdch
B& tdng
G a c h
khdng
nung, c d
trdt v & a
G 9 c h
n u n g c d
e l m Phiic
(n=401)
SL
2
180
5
6
208
%
0,6
44.9
1.2
1.5
61,9
T h a n h
TCing
(n=401)
SL
12
6 7
20
2 3 3
%
3,0
16,7
4,9
58,2
P H i f ng (n=403)
S I
0
0
12
387
%
1,0
2.9
96.1
T d n g (n=1205)
SL
14
247
7 8
38
828
%
1.4
24,0 7,6
3,7
63,3
ggch (63,3%) ddm bdo yfiu edu chde chdn nhung khS nfing chdng ndng cho nha d d^c bifit vd milia hfi rdt hgn chd
Bang 4 c a c logi vfit Iifiu chinh sd dung lfim mdi nba
Loai vdt li$u
G5
Fibre XI mang
N B 6 I luldi
b i n g Khac
e l m PhUc (n=401)
SL
2
34
76
288
1
%
0,5
8.6
18,9
71.9
0.2
T h a n h
T u n g ( n = 4 0 1 )
S I
4
3 6
150
2 0 8
3
%
1.0
8.9
37,4
52.1
0.6
P Hi^ng (n=403)
SL
0
4
6 8
314
17
%
1.0
16,7
77.9
4 , 4
Tfing J
SL
6
74
294
21
%i
m
7,2 J
28,71'
8'fl
2:0*
cac logi v$t Iifiu cbinb duprc ngudi dfin sd dyr^
ifim mai nha chd ydu la mai bdng chidm 61,5%; m | ngdi chidm ty Ifi 28,7%; cac logi khac chidm t? 1$
thdp Trong 3 xfi nghifin cdu, xfi Phuang Hung c6 If
lfi nha mai bdng cao nhdt (77,9%) '-^
Bdng 5 Ngudn nfing lyprng chinh su dyng duft ndu ^
Loai v | t il«U
D i $ n Binh g a Bioqa
D I u hoa
T h a n
c d c icai
C i j i ,
r o m ra
d m P h u c (n=401)
S L
6
318
11
3
16
4 7
%
1,5 79.3 2,7
0.7
3.9
11,9
T h a n h
T i i n g ( n = 4 0 1 )
S L
128
2 0
5
103
6 6
%
19.7 31.9 5,0
1,2
2 5 , 8
16.4
P H l / n g (n=403)
S L
5
9 6
2
0
8
2 9 2
%
1,2 23,8 0,5
2,0
72.5
T i n g t
SL
542
33
8
127
405
»
8,7
S 2 « 3,2;
0,8
"7?
'1
!3
c a c hfi gia dinh s u dgng ga trong dun ndu 52,8%; tuy nhifin, d xfi C i m phdc t9 ifi cao^MH chidm 79,3% vfi xS Phyang Hung chf cd 2 3 ^
song t^ Ifi ngudi ddn s d di,jng cui va ram rg dd dun
ndu chidm 72,5%, cdc nguyfin Iifiu khdc It dypc sur dgng nbu v$y It nhidu cOng gfiy dnb hydng d d n ^ khde con ngudi
Bfing 6 Ngudn nu'dc dang sd dung chlnh
N g u d n
n i ^ d c
N i / d c mSv
N i f d c m i f a
G i l n q k h a i
G i ^ n g khoan
S d n g , sudi
a o h d
e l m PhOc (n=401)
SL
167
72
6
152
4
%
4 1 5
1 5
38.0
1,0
T h a n h
T u n g ( n = 4 0 1 )
SL
2 3 2
6 4
8 2
2
%
57 8
1 6 0
5 ?
2 0 , 5
0,5
P- H i / n g (n=403)
SL
164
2 2
12
165
4 0
%
4 0 6 5,5
41
9,9
T i n g (n=1206)
SL
563
39
399
46
%
47,0
3,2
33,0
3,S
K & q u i Cho thily 93% c i c hO gia Oinh c6 iJCi nu«c
dCing trong sinh hogt; ngu6n nu-iic chlnh du'^c sii
r a n g c h i j m t) 1$ cao nhSt 67,8%, xS Phtrang Hwi§
chiSm 33,0%; c4c ngu6n nirdc khSc It Surge sO dgrg,
Trang 4DC Phiic (1)
DT, TOng (2)_
• P Hiyng (3) C Phuc(1) T Tling {2)_ P Hipng
IUtl>ci3d
nguy
ca
RSt cao
Cao
Trung
binh
ThSp
Cim Phuc
(n=401}
SL
12
180
149
%
3.0
15.0
44.8
37.2
Thanh
TUng
(n=401)
SL
9
73
161
158
%
2.3
18.2
40,1
39,4
P Hirng (n=403)
SL
10
193
119
%
2,5 20,1 47.9 29,5
Ting (n=1205)
SL
31
214
534
426
%
2,6 17.7 44.3 35.4
lyidc dp nguy co d nhidm cac ngudn nu'dc tgi 3
xa Nguy co d nhifim mdc dd trung binh chung d 3 xa
chidm t^ le cao nhdt 44,3%; trong dd xa Phycng
Hyng chidm ty Ifi cao nhdt 47,9% Nguy ca 6 nhidm
chidm 39,4% v a n cdn 17,7% nguy CCT d nhifim mdc
dfi eao va 2,6% nguy eo d nhidm mdc dd rdt cao Kdt
qud nghifin cdu eua ehung tfii so vdi cae nghifin cdu
Theo chCing tfii, kdt nhu vfiy la ph£j hpp bdi ie dd la
kdt qua thye td cua nfing thdn Vifit Nam vd nude
sach trong sinh hoat, tuy cd sy khae nhau gida cac
xa ndng thdn eua cac dja pbucng trong nude
Hdu hdt cfic hp gia dinb ddu cd nhfi tifiu, cbidm t f
Ifi 99,2%; tuy nhifin v l n cdn mfit s6 bfi khdng cd nha
tifiu ehidm t^ le 0,8% Kdt qua nfiy ifi cao ban rdt
nhidu so vdi nhidu noi trong khu vyc Tuy nhifin kdt
qud nghifin cuu cua chCing tdi tyo'ng du'ong vdi kdt
qud nghifin edu eOa Vi Vfin Thuydt (2009) [18] vd tf
lfi hfi gia dinh cd nhfi tifiu Kdt qui nfiy cung phdn
Bdc coi nha vfi sinb la mfit phdn khdng thd thidu cua
cfic thanb vien trong gia dinh, nhyng nd cQng gdp
phdn cung cdp mdt ngudn dinb dudng cbo cfiy trong
cua gia dinh
QC.phuc(l) QT.TiJng(2)
P P.HLfng (3)
P,i.2.3)<0.05
Bidu dd 1 Ty Ifi hfi gia dinh cd ngudn nu'dc chlnh
dyp'c danh gia cam quan la hpp vfi smh
Ty Ifi hfi gia dinh cd ngudn nude ehinh dupc danh
gia cdm quan id hp-p vfi sinh ehidm t / Ifi cao nhdt d
xa Thanh Tung la 57,4%; xa Cdm PhOc 56,1%, thdp
nhdt la d xa Phuang Hyng 49,8% vdi p<0,05
sang 7 Mdc dd nguy ca fi nhifim cdc ngudn
nudc tai cac xa
C.phijc T.Tung P.Hu'ng (1) (2) (3)
K , P(i.2.3)<0.p5
Bifiu dd 2 Ty Ifi nhd tifiu dat tifiu chudn vfi sinh vd
xfiy dyng d 3 xS
D^t xdy d^rng D^t si> dung mt utu
Bidu dd 3 Ty Ifi nha tifiu h$ gia dinh dgt tifiu chudn
vfi sinh d 3 xfi Kdt qua bidu dd 2 va 3 cho thdy nha tifiu dgt tifiu chudn vfi sinh vd xfiy dyng d xfi Phuong Hu-ng chidm ty Ifi cao nhdt 94,8%; xfi Cdm Phuc 89,7%,
cd y nghta thdng kfi Ty Ifi hfi gia dinh c6 nhfi tifiu dgt chudn vd sd dung d ca 3 xfi la 70,1%
KfiT LUAN
- Nha d 1 tang chidm ty Ifi 59%; nhfi d cdp 4 chidm ty lfi 14,9%, Nha d cd difin tich trfin lOm^gu-di cbidm ty Ifi 84,6%, Trong dd xa Thanh Tung chidm ty Ifi cao nhdt lfi 97,8% Vfit Iifiu chinh trong xfiy dyng nha d la mai bdng bfi tdng chidm t / Ifi 61,5% vfi tydng bdng ggch nung cd trdt vQ'a lfi 63,3%
- Cdn 22,2% vfi 12,4% hd gia dinh sy dyng rom
rg, than trong dun ndu, sinb hogt hdng ngay
- Ty Ifi ngudi dan sd dyng nude sach la 47% nu'dc may, 33% nu'dc gidng khoan va cdn 3,8% cdn
gia dinh cho la hpp vfi sinh chidm t d 49,8% ddn 57,4%
- Ty Ifi hfi gia dinh cd nhfi tifiu la 99,2%; vdn cdn 30,3% nha tifiu khdng ddm bdo vfi smb
KHUYDN NGHI
1, Cdi thifin ehdt tu'png tnjydn thfing glfio dgc vd vfi sinh ca nhan, vfi sinh mdi trudng vfi chdt lupng nydc va cac bifin phfip bdo vfi nhdm iam cho ngudi dan cd nhu edu su dgng nha tifiu, s u dung nudc sgch va cdi thifin hfinh vi vfi sinh ca nhfin Elfic bifit lfi
vd vai trd vfi yfiu cdu nha d hp'p vfi sinh
2 T u van dd ngudi dSn bidt Iya chpn logi nhfi
tifiu pbCi hp'p vdi Adu kifin dia If cua Ct\a phuang vfi
didu kifin kinh td cua gia dinh, d | c biet hydng ddn dd
Trang 5cac tidu chudn vfi smh
T A I L I E U THAM K H A O
1 Hoang Anh (2009), Hd thdng v8n bin mdl vd
bio vd mdl tmdng 2009 quy chuin lidu chuin Vidt
Nam vd mdl trwdng, nxb Thdng kfi
2 Bd Y td (2005), Tidu chuin vd sinh nudc sgch
vi tidu chudn vd smh ddi v&i cic logi nhi tidu Hd
NOi-2005, tr 12-13
3 Cyc Qudn ly mfii trudng, Bfi Y td (2011),
Hudng din vd sinh hd gia dinh Hfi NOi 2011
4 Nguydn Duy Dang (2006), Dinh gii hidu qui
cgn thidp cii tgo xiy dgng, sd' dijng nhi tidu hgp vd
sinh tinh Thii Binh Lufin vfin thgc s f Y hpc, Trydng
Dgi hpc Y Thai Binh,
5 Trdn Thj Khuyfin (2004), Dinh gii mdt sd chl
tidu vd chdt lugng nudc sinh hogt vi ydu td lidn qugn
ddn chit Iwgng nudc tgi 3 x8 thudc huydn Kidn
Xwgng tinh Thii Binh Lufin van thgc sf Y bpc,
Tru'dng Ogi hpc Y Thai Binh,
6 Phgm Trung Kifin, Nguydn Gia Khfinh (2010),
Hidu qui chwang trinh cung cip nw&c sgch vd sinh
tudi Igt x8 Hoing Tiy Kim Bing Hi Nam Tgp chl Y
7 Ngfl Thj Nhu (2008), Nghidn cCru mdt sd yiu chit Iwgng nw&c sinh hogt vi bdnh lidn quan &6x5 ndng thdn Ddng Hwng Thii Binh Hidu qui bidn phip can thidp Lufin an tidn s f y hpc, Hpc Vifin Qufin Y
8 Trdn Ddc Phu vfi CS (2010), Nghidn cOv m6i lidn quan giO-a vd sinh mdi trwdng, ngudn nwdc hd gia dinh vi hinh vi vd sinh chim sdc trd cOa bi m$ vdi tinh trgng dmh dudng cua trd dw&i 5 tu& tgi Vi^ Nam Bao cao kdt qud dd tai cdp Bfi
9 UNICEFT Vifit Nam, Nwdc sgch, mdi tnj&ng vd
vd sinh
http//www.unieef.orq/vietnam/vi/wes.blml NgSy truy cfip 5/8/2009
10 VO Khanh Vfin (2010), Thi/c trgng xiy difl)g sir dung nhi tidu hd gia dinh, xir 1^ phin ngwdi t^i m^t sd xi vOng ndng thOn Nam Djnh, Lufin vSn tiigc
s f Y bpc, Trudng Dgi hpc Y Thfii Binh
11 Vi v a n Thuydt (2009), Nghidn cim nhin thtic, thii dd thwc hinh cua ngwdi din vd quin ly s&dijng phin ngwdi tgi Bi Thwdc, ttnh Thanh Hda Lufin v&i
thgc s f Y bpc, Tnj'dng Dai hpc Y Thfii Binh
NGHIEN CUfU XAY DUNG MO HJNH CAN THIEP NHAM HAN CHE TAI BIEN DO LAN
CHD NGITDAN KHANH HDA
PHUNG TH! THANH T l i \ VlfiN CHINH CHlfeV, T R A N T H | QUYNH CHI',
Lt HONG MINH* , HOANG TI^N THANH' NGUYEN V A N T U Y S N ' , T H i i U LONG'
Vi^n Pasteur Nha Trang\ Vi^n Vd sinh Dich (S TAy Nguydn', Vidn Y hgc Biin Vi^t Nam', Bdnh vi^n 175 BO QuSc phdn^, B^nh vi^n Y hgc C6 truydn vA Phyc h6i chirc nSng KhAnh Hda'
T6M TAT
Di/a trdn kdt qui didu tra vi nghidn cdu vd
nguydn nhin tai bien do l$n, md hinh bdnh tdt vi tai
biin do lin cua ngw din Khinh Hoi, nhdm tic gii di
tiin hinh nghidn cuv can thidp trdn 200 ngw ddn
Khinh Hoi: - Tnrd-c khi can thidp Kiin thwc vi
thgc hinh cda ngw din vi an toin lin vi sd cip cdu
lin 1,8%; sa cip cOv tai ngn trdn biin 33%) - Tidn
hinh can thidp: Tip huin cho ngw din vd an toin
lin vi so cip cuv tai ngn trdn bidn 2 lin; dinh gii
kidn thdc thi/c hinh vd an toin l$n vi so cip cOv tai
ngn trdn bidn 2 lin - Sau can thi^p: kidn thirc vi
thi/c hinh cua now din vd an toin tin vi sa cdp cdu
tai ngn trdn bien ting Idn: t$p huin an toin l$n
98,5%; bidt bing hwdng din l$n 98.5%; thudc bing
hwdng din lin 98% cip ciru tai bidn l$n khi ngn
nhin cdn tinh 98%, cip ciru tai biin l$n khi ngn nhin
bit tinh 95%; sO- dgng binh oxy an toin 93%; so dp
cOv tai ngn trdn bidn 96% Sau can thidp, l<idn thOc
thi/c hinh vd an toin lin vi so cip cdu tai n$n trdn
biin cOa ngw din ting idn rO rdt, v&i p<0,005
• CAc tic gii dS dd xuit m6 hinh can thi$p
nhim hgn chd tai bidn do l$n cho ngtr dSn tOiinfi HoA MO hinh di/a trdn cic vin bin vi chl thj cOa 6$
Y td vi Bd Ndng nghidp - Phit triin ndng thdn UBND tinh Khinh Hda iXn cic S&, Ban, Nginh lidn quan iM
•Qudn ly an toin nghd lin bidn & Vidt Nam"
TOF khda: tai bien do tin ngw din fOiinh Hoi
SUMMARY Research to set up the model of intervention
to limit the diving accidents of Khanh Hoa's fishermen
Based on (be investigating and researching the cause of diving accidents, disease model and diving accidentst of Khanh Hoa's fishermen, conda(^nQ inten/ention studies on 200 fishennen Khanh Hoa • fishermen for safe diving and first aid accidents at sea have very low rate: training on safe diving (1.8%); fire(
aid accidents at sea 33% - Cany out the intervention: safe diving tmining for fishermen: 2
times and assessing knowledge about safe diving and first aid accidents at sea practices: 2 times •
After intervention: safety knowledge and practice of
emergency diving accident and first aid accidents ei