qu6c phong cqng hoa xa hqi chir nghiavi~t...
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----BQ Y TIt - DQ Qu6c PHONG CQNG HOA xA HQI CHir NGHiAVI~T NAM
Bqc I,p - Til do - H,nh phuc
s6: 16/20 16/TTLT-BYT-BQP Ha NQi, ngay 30 thang 6 nam 2016
. eON@ fliONG TIN £l1$N Ttl CHINH PHU..•. ' Gi' SDEN d.: .•••••••••••••••
Ngay: . D.tWl.t1tb .. " '.THONG Ttr LIEN TJCH
Quy dinh vi~c kham SIfC khoe th1}'chi~n nghia VI} quan S1}'
Can CU- Luqt Ngh'la v~ Quan S1!nam 2015;
Can cu Nghi ainh s6 63/2012/ND-CP ngily 31 thang 8 nam 2012 cUa Chinhphil Quyainh chu-cnang, nhi?m v¥, quyJn hq.nva co cciu t6 chu-ccua B9 Y ti;
Can cu-Nghi ainh s6 35/2013/ND-CP ngay 22 thang 4 nam 2013 cua Chinhphil Quy ainh chu-c nang, nhi?m v¥, quyJn hq.n va co cciu t6 chuc cua B9 Qu6cphimg; ..
Theo aJ nghi cua C¥c truimg C¥c Quem If Kham, chiia b?nh - B9 Y ti vaC~c truirng C~c Quan y - B9 Qu6c phdng,
B9 trur}ng B9 Y ti va B9 truirng B9 Qu6c phdng ban hanh Thong tu lientich CJ.uyainh,vi?c kham su-ckhoe' th1!c'hi?n nghia v¥ quan St!..
Chllo-ng INHUNG QUY BINH CHUNG
J)i~u 1.Ph,m vi di~u chinh va d8itU'Q'ng ap dl}ng
1. Thong tu lien tich (sau day vi~t t~t la Thong tu) nay quy dinh kham suckhoe th1)'chi~n nghia V\l quan S1)',bao g6m: Ki8m tra suc khoe, sa tuy8I?-suckhoe, kham suc khoe, kham phuc tra suc khoe, giam dinh suc khoe, quan ly suekhoeva phan lo~i suc khoe d6i vai cong dan Vi~t Namtrong dQ tu6i dugc g<;>ilam nghia V\l quan s1)'t~i ngil, quan nhan dg bi va cong dan dang ky dg thi tuy8n. h " .sm {,quansg.
'2. Thong tu nay ap d\lng d6i vai:
:a) Cong dan Vi~t Nam trong dQtu6i duQ'c gQi lam nghia V\lquan sg t~i ngil,quan nhan d1)'bi va cong dan dang ky dg thi tuy8n sinh quan S1)';
b) CO'quan quan sg cae c~p, cO'quan y t~, quan y cae c~p;
c) Cac cO'quan, dan vi, t6 ehuc va ca nhan co lien quan d~n vi~c kham suckhoe th\l'c hi~n nghia V\l quan sg.
J)i~u 2. Giai thich tir ngfr
,!,rong Thong tu nay, cae til' ngfr du6'i day dugc hi8u nhu sau,:
, 1. Kidm tra suS kh6e nghia v~ qulin S1! la vi~c th\1c hi~n ki~m tra, phan lo~i,ket lu?n suc khoe doi v6i quan nhan d\l bi.
2. Sa tuydn s~e khoe nghia v~ qulin S1! la vi~c thl)'c hi~n ki~m tra, danh giasa bQ suc khoe doi v6'i cong dan dugc gQi kham sue khoe thl)'c hi~n nghia vuquan SlJtru6c m6i dgt tuy~n chQnva gQicong dan nh?P ngfi. .
3. Kham sue kh6e nghia v~ qulin S1! la vi~c thl)'e hi~n kham, phan lo~i, kStlu~n suc khoe d6i v6i eong dan dugc gQi lam nghia V\lquan S\l da:qua sa tuYSnsuc khoe va cong dan dang ky d\l thi tUYSnsinh quan S\l, do HQi d6ng kham suekhoe nghia V\lquan S\l huy~n th\lc hi~n.
4. H(Jid6ng kham sue khoe nghia v~ qulin S7! la HQi d6ng ehuyen mon ho~tdQng theo chS dQ ki~m nhi~m do Chu tich Uy ban nhan dan huy~n quySt djnhthanh l~p theo d~ nghi cua Phong Y tS huy~n; m6i huy~n co thS thanh l?p tir mQtdSn hai hQi d6ng my theo dia ban va s6 eong dan cAnkham.
S. Kham phue tra sue kh6e nghia v~ qulin S7! la vi~c th\lc hi~n kham, phanlo~i, kSt lu~ l~i suc khoe d6i v6i chiSn sy m6i nh~p ngfi vao.Quan dQi, do H<)id6ng kham cua dan vi nh~n quan th\lChi~n.
6. H(Jid6ng khtim phue tra sue khoe la HQid6ng ehuyen mon ho~t dQng theochS d<)kiem nhi~m do Thu truOng dan vi (cAptrung doan va tuahg duang tra len)quySt dinh thanh l~p theo d~nghi cua Chu nhi~m Quan y dan vi.
7. Giam djnh sue kh6e nghia v~ quiin S1! la vi~c sir d\lng phuong ti~n, kythu~t, nghi~p V\ldS kham, kSt lu~n v~ tinh tr~g suc khoe cua cong dan dugc gQilam nghia V\lquan S\l, eong dan dang ky d\l thi tuySn sinh quan S\l va quan nhand\l bi trong truOng hgp co khiSu n~i.
8. H6 sa sue kh6e nghia v~ qulin S1! la tai li~u v~ tinh hinh suc khoe euaeong dan dugc gQi lam nghia V\lquan S\l t~i ngfi, cong dan dang ky d\l thi tuySnsinh quan S\l va quan nhan d\l bi, bao g6m phiSu sue khoe nghia V\lquan S\l vacae tM li~u lien quan dSn sue khoe.
9. Phiiu sue kh6e nghia v~ qulin S1! la tai li~u y khoa tfmg hgp nhiingthongtin co ban v~ sue khoe eua eong dan lam nghia V\lquan S\l.
Di~u 3. Kinh phi thl}'Chi~n kham StfCkhoe nghia v1} quan sl}'
Kinh phi bao dam eho vi~c kham suc khoe, sa tuySn sue khoe, kiSm tra suekhoe, giarn dinh sue khoe, lam cae xet nghi~m eho eong dan th\le hi~n nghia V\lquan S\l duQ'c sir d\lng tu ngan saeh dia phuang bao dam cho eong me qu6ephong - an ninh theo quy dinh hi~n harm. Dinh rnuc v~t tu tieu hao va kinh phicho ho~t d<)ngkiSm tra suc khoe, kham suc khoe th\lc hi~n Nghia V\lquan S\l
theo quy dinh t~i Ph\ll\le 2 ban h~mhkern theo Thong illnay.
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. Chuong IIKHAM sire KHOE THlfC HI~N NGHiA VlJ QUAN SV
f)i~u 4. Ki~m tra sue khoe nghia v\I quan slJ'
1. T6 ki~m tra sue khoe
a) T6 ki~m tra sue khoe do Trung tam y tS qu~, huy~n, thi xii, thanh phdtIve thuQe dnh, thanh ph6 trge thuQe Trung uong (sau day gQi chung la Trungtam y tS huy~n) ra quySt dinh thanh l~p. T6 ki~m tra sue khoe g6m it nhfit 3thanh vien: 01 bae sy lam t6 truang va 2 nhan vien y t~ khae thuQetr~ y tS xii,khi e~n thiSt co th~ dUQ'ediSu dQngtil'Trung tam Y tS huy~n;
b) T6 ki~m tra sue khoe co nhi~rn V\l t6 ehue ki~m tra sue khoe, l~p phiSuki~m tra sue khoe va t6ng hQ'P,bao eao k~t qua theo quy dinh.
2. NQidung ki~m tra sue khoe
a) Ki~m tra vS th~ 1ge;
b) Lfiym~eh, huyStap;
c) Kham phat hi~n cae b~nh ly vS nQikhoa, ngo~i khoa va ehuyen khoa;
d) Khai thae tiSn su b~nh t~t ban than va gia dinh.
3. Quy trinh ki~m tra sue khoe
a) Can eu vao k~ ho~eh hufin luy~n quan nhan dg bi eua quan sg djaphuong, l~p danh saeh cae d6i tugng dUQ'etri~u t~p tham gia hufin luy~n dg bidQng vien tren dia ban dUQ'egiao quan ly;
b) Thong bao thai gian, dia di~rn t6 ehue kiSm tra sue khoe;
c) L~p phi~u kiSm tra sue khoe nghia V\1 quan S\f theo M~u 1 Ph\! l\!e 4 banhooh kern theo Thong tu nay;
d) T6 ehue kiSm tra sue khoe theo cae nQi dung quy dinh t~i Khoan 2 DiSunay;
d) T6ng hQ'P,th6ng ke, bao eao k~t qua kiSm tra sue khoe theo M~u 1a vaM~u 5a Ph\!l\!e 5 ban hanh kern theo Thong tu nay.
f)i~u 5. SO' tuy~n sue khoe nghia vl} quan sl}'
1. Sa tuySn sue khoe do Tr~rn y t~ xii tiSn harih du6'i sg chi d~o vS ehuyenmon, nghi~p V\l eua Trung tam y t~ huy~n.
2. NQidung sa tuySn sue khoe
a) PhM hi~n nhilng truang hgp khong du sue khoe vS th~ 1ge,di t~t, dj d~gva nhilng b~nh ly thuQe di~n miSn dang ky nghia V\l quan sg;
b) Khai thae tiSn su b~nh t~t ban than va gia dinh.
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3. Quy triOOsa tuySn suc khoe
, a) Can cu vao kS ho~ch tuySn chQn va gQi cong dan OO~pngii cua HQidong nghia Vl) quan sg dia phuang, l~p daOOsach cac dBi tuqng la c0ng danthuQc di~n gQi kham suc khoe thgc hi~n nghia Vl) quan sg tren dia ban duQ'cgiao qUlm ly;
b) T6 chuc sa tuySn suc khoe theo nQidung quy dinh ~i Khoan 2 DiSu nay;c) Hom chinh va xac nh~ tiSn sir b~nh t~t ban than va thong tin cua cong
dan dugc gQi kham suc khoe nghia Vl)quan S\l theo quy dinh t~i Ml)c I M~u 2Ph\ll\!c 4 ban hanh kern theo Thong tu nay;
d) L~p danh sach nhUng cong dan m~c cac b~OOthuQc Danh m\lC b~nhmi~n dang ky nghia V\! quan S\l theo Bang sB 3 Ph\! l\lc 1 ban hanh kern theaThong tu nay, bao cao HQi d6ng Nghia V\lquan Sl)'xa;
d) T6ng hgp, thBng ke, bao cao kSt qua sa tuySn suc khoe theo M~u 2 vaM~u 5b Ph\ll\lc 5 ban hanh kern thea Thong tu nay.
Di~u 6. Kham sue khoe Dghia V\1 qUaDSl}'~
1. HQi d6ng kham suc khoe nghia V\lquan S\l
a) Thanh ph~n HQi d6ng kham suc khoe nghia V\lquan S\l
- HQi dang kham suc khoe nghia V\lquan S\l huy~n g6m: bac sy, nhan vieny tS thuQc Trung tam Y tS huy~n, can bQ chuyen mon Phong Y tS, quan y BanChi huy quan s\lhuy~n va cac dan vi co lien quan.
- HQi d6ng kham suc khoe nghia V\lquan S\l g6m:
+ 01 Chu tich: do Giam dBc Trung tam Y tS huy~n dam nhi~m;
+ 01 Pho Chu tich: Pho giam d6c ph\l trach chuyen mon;
+ 01 Uy vien Thuang tl'\l'ckiem Thu ky HQi d6ng do can bQ chuyen monPhong Y tS dam nhi~m;
+ Cac uy vien khac.
- s6 lugng uy vien HQi d6ng, tuy thuQc vao diSu ki~n C\l thS cua timg diaphuong, nhung phai bao dam du s6 lugng va trinh dQ th\lc hi~n kham suc khoetheo quy dinh t~i Khoan 2, du bQ ph~ theo quy diOOt~i Khoan 5 DiSu nay,trong do phai co t6i thiSu tu 3 - 5 bac sy. Kham vS nQi khoa, ngo~i khoa phai docac bac sy nQi khoa va ngo~i khoa dam nhi~m; cac chuyen khoa khac, co thS b6trl bac sy ho~c y sy, ky thu~t vien thuQc chuyen khoa do dam OOi~m.
b) Nguyen t~c lam vi~c cua HQi d6ng kham suc khoe nghia V\lquan Sl!
- HQi d6ng lam vi~c theo nguyen t~c~p thS, quySt dinh cac vfu1dStheo da s6;
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- TruOng hQ'Pcac th8.11hvien cua HQi d6ng khong th6ng nhAtv8 phan lo~iva k~t lu~ suc khoe thl Chu tich HQid6ng ghi vao phi~u suc khoe k~t lu~ theoj ki~n cua da s6. TruOng hQ'Pbi~u quy~t ngang nhau thl quy~t djnh theo ben cobi~u quy~t cua Chu tich H9i d6ng. Nhfrng y ki~n khong th6ng nhdt phai dugcghi dAydu vao bien ban, co chit kYcua tung thanh vien trong HQid6ng, gui HQid6ng Nghia V\!quan S\fhuy~n.
c) Nhi~m v.\!cua HQi d6ng kham suc khoe nghia V\lquan S\f
- Chiu trach nhi~m truac HQi d6ng Nghia V\!quan S\l huy~n ve vi~c tri~nkhai kham suc khoe, phan lo~i va kSt lu~ suc khoe cho tirng cong dan duQ'cgQinh~p ngil;
- Tdng hQ'Pbao cao k~t qua kham suc khoe gui H9i d6ng Nghia V\lquan S\fhuy~n va Sa Y tS tinh, thanh ph6 tr\fc thuQc Trung uang (sau day gQi chung latinh) theo quy dinh; ban giao toan b9 h6 sa suc khoe cho HQi d6ng Nghia V\lquan sg huy~n (qua Phong Y t~ huy~n).
d) Nhi~m V\!cua cac thanh vien trong HQi d6ng Kham suc khoe nghTaVl) .quan Sl)'
- Chu tich H9i d6ng::,;.
+ Dieu hanh tom bQho~t dQng cua HQi d6ng; chiu trach nhi~m truac HQid6ng Nghia V\lquan S\fhuy~n ve chdt IUQIlgkham suc khoe cong dan thuQc di~nduqc gQilam nghia V\l quan sg;
+ Quan tri~t~phd biSn kS ho~ch kham suc khoe nghia V\lquan S\f;huang dfutcac quy diM v8 tieu chufuIsuc khoe, chuc trach, nhi~m V\l,nguyen tic lam vi~c vaphan cong nhi~m V\lC\!thS cho cac th3.nhvien trong HQid6ng kham suc khoe;
+ Tri~u t~p va chu tri h9P HQi d6ng d~ kSt lu~n d6i vai nhfrng truanghQ'Pco y kiSn khong th6ng nhdt ve kSt lu~n suc khoe;
+ Td chuc hQi chAn va ky gidy giai thi~u cho cong dan kham suc khoenghia V\!quan Sg di kiSm tra a cac ca sa y t~ khi cAnthiSt;
+ Tr\fc tiSp k~t lu~n phan lo~i suc khoe va ky vao phi~u suc khoe nghiaV\lquan S\f;
+ Td chuc h9P rut kinh nghi~m cong tac kham suc khoe nghia V\lquan S\fva bao cao vai H9i d6ng Nghia V\lquan sg huy~n.
- Pho Chu tich H9i d6ng:+ Thay m~t Chu tich H9i d6ng khi v~ng m~t;+ Trgc ti~p kham suc khoe, tham gia hQichAnkhi cAnthi~t;+ Tham gia h9P H9i d6ng kha.msuc khoe nghia V\lquan Sl)'.- Dy vien Thucmg t~vc, kiem Thu ky H9i d6ng:
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+ L~p d\l tm, t6ng hgp va quySt tom kinh phi, thu6c, v~t tu tieu hao ph\lcV\lcho cong tac kham suc khoe nghia V\lquful S\l;
+ ChuAn bi phuong ti~n, cO'sa v~t chAt,hA sO'suc khoe va cac tai li~u cAnthiSt ~ac dS HQi dAng kharn suc khoe nghia V\lquan s\llam vi~c; tharn gia hQpHQidong kharn suc khoe nghia V\lquan sv;
+ Tharn gia kharn suc khoe, hQi chAnkhi cAnthiSt;.. + Th\lc hi~n dang ky, th6ng ke va giup Chu tich HQidAng lam bao cao len
HQidAng Nghia V\lquan sg huy~n va So' Y tS theo Mftu 3a va Mftu 5c Ph\ll\lc 5ban hanh kern theo Thong tu nay.
- Cac uy vien HQi dAng:.+ Tn,rc tiSp kharn suc khoe va tham gia hQi chAnkhi cAnthiSt;+ Chiu trach nhi~m "..8chAtluQ'Ilgkham va kSt lu~ suc lG10etrong ph~m vi
duQ'cp~an cong;+ Tharn gia hQpHQidAngkham suc khoe nghia V\lquan sg khi duQ'ctri~u ~p.2. NQi dung kharn suc khoea) Kharn v8 thS 19c; kham lam sang cac chuyen khoa theo cac chi tieu q~
dinh t~i M\lc II, Mftu 2 Ph\l l\lc 4 ban hanh kern theo Thong tu nay; trong quatrinh kham, tfuang hQ'Pcong dan duQ'ckharn co mQt trong cac chuyen khoa xSpdiSm 5 ho~c diSm 6 thi nguai kham chuyen khoa do co tnlch nhi~rn bao cao Chutich HQi dAng kham suc khoe xelrt xet, quySt dinh vi~c co tiSp t\lC kham cacchuyen khoa khac; .
b) Truang hgp cAnxet nghi~m c~ lam sang ph\lc V\lcho kSt lu~ suc khoetheo yeu cAu cua HQi dAng kham suc kh6e nghia V\l quan S\l, bao gAm ca xetnghi~m phat hi~n rna tuy;
c) Phful lo~i suc k~~theo cac quy:djnh t~i Di8u 9 Thong tu nay.3. Quy trinh kham suc khoea) L~p danh sach cac dBi tUQ'Ilgla cong dan thuQc di~n duqc gQi nh~p ngii
da:qua sO'tuySn suc khoe tren dja ban duQ'cgiao quan ly;b) Thong bao thai gian, djadiSm t6 chuc kham suc khoe; .c) TB chuc khallls_l1ckhoe theo cac nQidung quy djnh t~i Khoan 2 Di~u nay;d) TB chuc tu vAnva xet nghi~m HIV theo quy dinh cua Lu~t Phong, chBng
HIV/AIDS d6i v6i cactruang hQ'Pd~t tieu-chuAn suc khoe gQi nh~p ngl1 h~ngnam theo hu6ng dftn clla BQtruOng BQQu6c~phong; .
d) Hoan chinh 'ph~:Susuc khoe theo quy djnh t~i M\lc II Mftu 2 Ph\ll\lc 4ban hanh kern theo Thong tu nay;. ___ e) T6ng hgp, bao.-c~9kSt qua kham suc khoe nghia V\lquan sg theo Mftu 3aPli\l'I~cS.ban h~mhkern theo Thong tu nay.
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4. Thai gian kham suc khoe: tir ngay 01 thang 11 d~n h~t nga,y31 thang 12hfutgnam.
5. Tc3chuc cac phong kham suckhoe
a) Vi~c b6 tri cac phong kham phai theo nguyen t~c mQt chiSu, khep kin,thu~n 19i cho nguai kham va bao dam dll diSu ki~n t6i thiSu dS kham dBi vaitung chuyen khoa.
b) S6 lugng cac phong kham can cu vao s6 lugng nhan vien y t~ eua HQid6ng kham suc khoe va tinh hinh th\fc t~ d~ b6 tri:
- Phong kham thS l\fc;- Phong do m~ch; Huy~t ap;- Phong kham thi l\fc, M~t;- Phong kham thinh l\fc, Tai - Miii - HQng;- Phong kham Rang - Ham - M~t;- Phong kham NQi va Tam thfut kinh;
~- Phong kham Ngo~i khoa, Da lieu;- Phong xet nghi~m;- Phong k~t lu~n.
Truang hQ'Pco kham tuy~n cong dan nu th\fc hi~n kham san ph\! khoa theohuang ddn t~i M\lc IV Ph\ll\lc 1 ban hanh kemtheo Thong tu nay.
c) Trang bi, d\lllg C\ly t~ t6i thiSu cua HQi dang kham suc khoe theo Danh:"m\lc quy dinh t~i Ph\ll\lc 3 ban hanh kern theo Thong tu nay.
6. f>6i vai cac huy~n co B~nh vi~n thi B~nh vi~n da khoa huy~n chiu trachnhi~m th\fc hi~n cac nhi~m V\lquy djnh ~i E>iSunay.
f)i~u 7. Kham phuc tra suc khoe nghia vI} quan sl}'
1. HQi d6ng kham phuc tra suc khoe.
a) Thanh phful HQi d6ng kham phuc tra suc khoe, g6m: can bQ, nhan vienquan y cua trung doan va tuang duong tr& len. Khi c~n thi~t, HQi dang duQ'ctang cuang them l\fc lugng chuyen mon cua quan y tuy~n tren; .
b) Nhi~m V\lCllaHQi d6ng kham phuc tra suc khoe
- Tc3chuc, triSn khai kham, phan lo~i va k~t lu~n l~i suc khoe cho toan b9chi~n sy m6i theo k~ ho~ch dii dugc phe duy~t;
- T6ng hgp bao cao k~t qua kham phuc tra suc khoe.
2. NQidung kham phuc tra suc khoe
a) Theo quy dinh tuy~n chQnva gQicong dan nh~p ngfi CllaB9 Qu6c phong;
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b) Phan lo~i suc khoe theo quy dinh t~i f)i~u 9 Thong tu nay.
3. Quy triOOkham phuc tra suc khoe
a) Thong bao thai gian, dia diSm kham phuc tra suc khoe;
b) T6 chuc kharn phuc tra suc khoe theo quy dinh ~i Khoan 2 DiSu nay; d6iv6i cac twang hQ'P,phi8u suc khoe co ghi chfr "T" (t~m thai), HQid6ng khamphuc tra suc khoe phai k8t lu~n:
- N8u b~nh khoi thi bo chfr "T" va chuySn lo~i suc ldioe;
- N8u khong khoi ho~c co chiSu hu6ng ti8n triSn xAu,cftn phai t6 chuc kharnl~i va co k8t lu~ du suc khoe ho~c khong du sue khoe gQiOO~pngii phai tra v~dia phuong.
c) T6ng hQ'Pbao cao k8t qua kharn phuc tra suc khoe theo Mfiu4d Ph\ll\lc 5ban hanh kern theo Thong tu nay.
f)i~u 8. Ghim djnh suc khoe nghia v1}qU3n s'11. HQi d6ng giarn dinh y khoa tiOOt6 chuc giam dinh suc khoe nghia Vl)
quan S1)' khi co cac khi8u n~i lien quan d8n suc khoe eua cong dan duQ'cgQi lamnghia V\l qufu1sg, cong dan dang ky dg thi tuySn sinh.quan sg va quan nhan dgbi, do HQi d6ng Nghia Vl)quan sg huy~n d~nghi.
2. Yeu cAugiarn dinh: Giarn dinh tinh tr~ng b~nh t~t theo d~ nghi cua HQid6ng Nghia V\l quan sg huy~n; kSt lu~n giarn diOOphfli xac diOOro tinh tr~gb~nh t~t va phan lo~i suc khoe theo Bang s6 1, Bang s6 2 va Bang s6 3 t~i Phl)l\lc 1 ban hftnh kern theo Thong tu nay.
3. Trong vong 7 - 10 ngay lam vi~c, kS tU ngay nh~ du h6 sa d~ nghi giamdinh sue khoe, HQi d6ng giam diOOy khoa tiOOphai co k8t lu~ giam dinh suekhoe cong dan thgc hi~n nghia V\lquan sg va gui h6 sa, k8t qua giam djnh cho HQid6ng Nghia V\lquan sg huy~ri.
4. Quy8t dinh cua HQid6ng giam dinh y.khoa tinh la k8t lu~ cu6i cimg v~khiSu n~i suc khoe cua cong dan thgc hi~n nghia V\lquan sg va tuySn sinh quan sg.
f)i~u 9. Phan lo,i suc khoe th'1c hi~n nghia V1}quan s1!1. Can cu phan lo~i suc khoe
Theo tieu chuan suc khoe t~i Bang s6 1, Bang s6 2 va Bang s6 3 Ph\lll)c 1ban hanh kern theo Thong tu nay.
2. Caeh cho diSrnM6i chi tieu, sau khi kharn bac sy eho diSrn chful til' 1 - 6 vao cQt"f)iSrn", Cl)
thS:
a) DiSrn 1: Chi tiOOtr~ng suc khoe d.t t6t;
b) DiSrn 2: Chi tioo tr~ng suc khoe t6t;8
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c) Di~rn 3: Chi tiOOtr~ng suc khoe kha;
d) Di~rn 4: Chi tiOOtr~g suc khoe trung biOO;
d) Di~rn 5: Chi tiOOtr~ng suc khoe kern;
e) Di~rn 6: Chi tiOOtr~ng suc khoe d.t kern.
3. Cach ghi phi~u suc khoe nghia V\lquan SlJ
a) M6i chuyen khoa, sau khi kharn xet, bac sy se cho di~m vao cQt "E>i~rn";a CQt "Ly do" phili ghi tom t~t ly do cho s6 di~m do; a cQt "KY", bac sy khamphai ky va ghi ro hQ ten;
b) Phfut kSt lu~n, Chu tjch HQi d6ng kham sue khoe din cu vao di~rn diicho a timg chi tieu d~ kSt lu~, pharr lo~i suc khoe theo dung quy djOO, ghi b~ngs6 va chfr (phdn b~ng chfr d~ a trong ngo~c dan); .
c) Chil tjch HQi d6ng kharn suc khoe co trach nhi~rn ky vao phi~u suc khoenghia V\l quarr S\f sau khi k~t lu~;
d) Chfr ky cila Chu tjch HQi d6ng kharn suc khoe duQ'c dong d~u cua cO'quan Chu tjch HQi d6ng; ehfr ky cua Chu tjch HQi d6ng kham phlic tra sue khoeduQ'c dong d~u eua dan vjquySt djOOthanh l~p HQi d6ngkham phue tra suc khoe.
4. Caeh phan lo~i suc khoe
Can eu vao s6 di~m eh~rn eho 8 chi tieu ghi trong phi~u sue khoe nghia V\lquan SlJ d~ pharr lo~i, C\lth~ nhu sau:
a) Lo~i 1: 8 chi tieu d8u d~t di~f!11;
b) Lo~i 2: Co it OO~t1 chi tieu bi di~m 2;
c) Lo~i 3: Co it nh~t 1 chi tieu bi di~m 3;
d) Lo~i 4: Co it nh~t 1 chi tieu bi di~m 4;
d) Lo~i 5: Co it nh~t 1 chi tieu bi di~m 5;
e) Lo~i 6: Co it OO~t1 chi tieu bj di~m 6.
5. MQt s6 di~rn cdn chli y
a) TruOng hgp dang rn~c b~nh e~p tiOO,b~OOco th~ thuyen giam hay tanglen sau rnQt thai gian ho~c sau di8u tri, thi di~rn do phai kern theo chli "T" benc~nh (nghia la "t~rn thai"). Nguai kham phili ghi tom t~t b~g ti~ng Vi~t tenb~nh ben e~h (co th~ ghi b~ng danh tu qu6c tS gifra hai ngo~e dan). Khi k~tlu~n, n~u ehfr "T" a chi tieu co di~m Ian nh~t, phili vi~t chfr "T" vao phdn phanlo~i suc khoe;
b) TruOng hgp nghi nga chua th~ eho di~rn ngay duQ'c, HQi d6ng kham suckhoe co th~ giri cong dan t6i kharn t~i rnQt b~nh vi~n d~ k~t lu~ ehinh xac han;
9
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c) Truang hgp chua kSt Iu~n dUQc thi gui cong dan.do dSn b~nh vi~nchuyen khoa g~n nhdt d~ kham va k~t Iu~n chAn doan. Thai gian t6i da til 7 -10 ngay phai co kSt Iu~ va chi th\lc hi~n trong wang hgp c~ thi~t;
d) Nhiing truang hqp phi~u suc khoe co ghi chii "T", HQi d6ng khamsuc khoe nghia V\l quan S\f co trach nhi~m huang dan cong dan d~n cac cO'sa y t~ d~ di~u trj.
f)i~u 10. Yeu ciu dai vOi cong dan khi di kiSm tra, sO'tuySn, kham suekhoe th1}'chi~n nghia vI} quan s1}'
1. Phai xudt trinha) L~nh gQi kham suc khoe ho~c ki~m tra suc khoe cua Chi huy truang
Ban chi huy quan S\l huy~n;b) Gidy chUng minh nhan dan;c) Cac gidy to lien quan d~n suc khoe ca nhan (nSu co) d~ giao cho HQi
d6ng kham suc khoe ho~c T6 ki~m tra suc khoe nghia v\l quan SlJ.2. Khong u6ng ruqu, bia ho~c dung chdt kich thich.3. Chdp hanh nQiquy khu \'\IC kham suc khoe, ki~m tra suc khoe.4. cAm cac hanh vi lqi d\lng vi~c kham suc khoe d~ tr6n, tranh th\fc hi~n
nghia V\l quan S\l.
Ch1f00ng IIIPHIEU sue KHOE NGHiA VV QUAN SV
vA QUAN LYsue KHOE QUAN NHAN nV BJ
f)i~u 11. PhiSu suc khoe nghia vI} quan s1}'
1. NQi dung phi~u suc khoe nghia V\lquan SlJ
a) Ph~n I - Sa y~u Iy Iich va ti~n su b~nh t~t:
- Phful sa y~u Iy Iich do Ban chi huy quan S\fxa ghi;
- Ti~n sir b~nh t~t: do Tr~m y tS xa ghi va chiu trach nhi~m.
b) Ph~n II - Kham suc khoe: do HQid6ng kham suc khoe nghia V\l quan S\fhuy~n ghi 6 mia ben trai va HQi d6ng kham phuc tra suc khoe cuadan vi quandQi ghi a nua ben phai.
2. Quan Iy phiSu suc khoe nghia V\l quan S\f
a) Khi chua nh~p ngii, phi~u suc khoe nghia V\l quan S\f do Ban Chi huyqwln S\fhuy~n quan Iy;
b) Khi cong dan nh~p ngii, phiSu suc khoe nghia V\l quan S\fdugc giao chodan vi nh~n quan, quan Iy t~i quan y tuySn trung doan va tuang duang; ,
10
, I
.. "
c) Ra quan, ban giao l~i Ban Chi huy quan S\l huy~n quan ly.3. Phi~u suc khoe nghia V\lquan S\l chi co gia tri khi:a) Theo dung m~u qui dinh;b) Vi~t b~ng but m\lc ho~c but bi, khong duQ'cvi~t b~g but chi;c) Chii'vi~t ra rang, khong tftyxoa, khong vi~t cit;d) Ghi dfty dli cac nQi dung quy dinh trong phi~u suc khoe nghia V\!
quan S\l; .
d) Khong qua 06 (sau) thang k~ tir ngay HQid6ng kham suc khoe nghia V\l
quan S\l co k~t lu~n vS tinh tr~ng suc khoe, trir truOng hQ'Pco diSn bi~n d~c bi~tvS suc khoe.
Di~u 12. Giao, nh~n phi~u StfC khoe nghia V1} quan Sl}' Clla cong dannh~p ngo
1. Truac khi HQi d6ng Nghia V\l quan Sl! huy~n phat l~nh gQi cong dannh~p ngu, Phong Y t~ huy~n phai hoan thanh vi~c l~p danh sach nhiing cong dandli suc khoe theo quy dinh, hoan chinh phi~u suc khoe nghia V\lquan Sl! va.bangiao cho Ban Chi huy quan Sl! huy~n.T 2. Can cu vao k~ hOl;lChhi~p d6ng gifra dan vi nh~n quan va dia phuong,Ban Chi huy quan S\l huy~n ban giao phi~u suc khoe nghia V\lquan S\f cua caccong dan dli tieu chuful suc khoe cho quan y dan vi nh~n quan.
3. Quan y don vi nh~ quan t6 chuc nghien CUutruac h6 So' suc khoe congdan duQ'cgQinh~p ngu. TruOng hgp phat hi~n co nghi vfuI vS suc khoe, dS nghjHQi d6ng Nghia V\lquan S\I huy~n ki~m tra k~t lu~ ll;li.
4. T6ng hQ'Pbao cao k~t qua theo m~u t~i Ph\! l\lc 5 ban hanh kern theaThong tu nay (dja phuang giao quan theo Mftu 4a, 4b; quan y don vi nh~ quantheo M~u 4c).
5. Ban vi nh~n quan phili t6 chuc kham phuc tra suc khoe cho chiSn sy maingay sau khi vS dan vi de phan lo~i, kSt lu~n ll;lisue khoe, phat hi~n nhfingtruOng hgp khong dli sue khoe tra vS dia phuong va co traeh nhi~m thong baocho Ban Chi huy quan Sl! huy~n bi~t:
a) 86 eong dan dli tieu chudnsuc khoe;b) 86 eong dan khong dli tieu ehudn sue khoe eftn tra vS dia phuong (do sai
sot trong qua trinh kham chua tim ra b~nh ho~c b~nh mai phat sinh trong quatrinh hufin luy~n ehiSn sy mai).
6. Quy dinh vS vi~e tra l~i nhii'ng eong dan khong dli tieu chudn suekhoe v~ dia phuong
a) Nhfing eong dan khong dli tieu ehudn suc khoe tra vS dia phuong khi kStqua kham phue tra sue khoe duQ'cChli nhi~m Quan y efip trung doan va tuongduong tra len xae dinh va efip t~entr\le tiSp phe duy~t.
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b) H6 sa suc khoe cua cong dan khong du tieu chufuI suc khoe tni v~ diaphuong phai co du phiSu suc khoe nghia V\l quan S\l cua HQi dang kham s~ckhoe nghia V\l'quan SlJdia phuong co phAnghi kSt qua kham, kSt lu~ suc khoecua HQi d6ng kham phuc tra suc khoe don vi.
c) Vi~c tni cong dan khong du suc khoe v~ dia phuong thlJc hi~n theo quydinh cua BQ QuBc phong. TruOng hgp cAnthiSt, cO'quan y tS dia phuong t6 chuckiSm tra l~i (thai h~ tir 7 - 10 ngay, kS tir khi don vi ban giao cong dan khongdu suc khoe cho dia phuong). Truang hgp khong thBng nhftt vai kSt lu~ CllaHQi dang khaffi phuc tra suc khoe Clla dan vi, HQi dang Nghia V\lquan SlJhuy~nchuySn h6 So'Cllacong dan len HQi d6ng giam dinh y khoa tinh dS t6 chuc giamdinh suc khoe.
Di~u 13. Quan ly sue khoe quan nhan d1}' bi1. MQi quan nhan truac khi tra v8 dia phuong (xuftt ngfi, ph\lc vi en,
chuySn nganh), quan y dan vi co trach nhi~m t6 chuc kham, phan lo~i suckhoe, ghi vao phiSu suc khoe quan nhan. Khi v~ dia phuong, quan nhan controng dQ tu6i dlJ bi phai nQp h6 so suc khoe cho Ban Chi huy quan SlJhuy~ndS quan ly.
2. Quan nhan dlJ bi duQ'ckiSm tra suc khoe truac m6i dqt t~p trung huftnluy~n theo kS ho~ch cua HQi d6ng Nghia v\l quan s\l dia phuong. Nbfrng quannhan d\f bi con du suc khoe theo tieu chufuI duQ'c tiSp t\lC bB trf vao cac donvi d\l bi dQng vien. Truang hgp khong du tieu chudn suc khoe, Phong Y tShuy~n thong bao bfulg van ban dSn Ban Chi huy quan SlJhuy~n dS dua ra khoidanh sach d\l bi dQng vien Clladia phuong.
3. Trong cac dqt huftn luy~n va t~p trung kiSm tra sfuIsang dQng vien quannhan d\f bi, quan y.cua cac don vi d\l bi dQngvien co trach nhi~m theo doi ch~tche v8 m~t suc khoe cua quan nhan d\l bi. .
4. Khi co l~nh dQng vien, Ban Chi huy quan SlJ huy~n co traeh nhi~mban giao toan bQ h6 so suc khoe clla quan nhali d\f bi eho dan vi ti~p nh~nquan nhan dlJ bi quan ly.
ChU'ang IVNHI:E:M Vl} eVA eo QUAN Y TE eAe eAp
TRONG KHAM sue KHOE THlfe HI:E:NNGHiA Vl} QUAN sT!
Di~u 14'-Tr,m y t~ xa
1. Cll can bQtham gia T6 kiSm tra sue khoe nghia v\l quan S\f.
2. T6 chuc kiSm tra suc khoe, l~p h6 sa suc khoe cho cong dan thuQc di~nth\fc hi~n nghia V\l quan S\f theo kS ho~ch eua HQi dang Nghia V\l quan SlJ diaphuong. Qu{m ly, theo doi tinh hinh suc khoe cong dan (thuQc di~n qu{m ly)trong dQ tu6i lam nghia V\l quan SlJ,phat hi~n kip thai nhfrng truOng hgp m~cb~nh m~n dnh, cac b~nh thuQc danh m\lc b~nh miSn dang ky nghia V\lquan S\I.
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II
3. Can cu vao k8 ho~ch ~ua Hi)i d6ng .Nghia V\l quan S\l'xa, ph6i hgpvoi Ban chi huy quan S\l'xa to chuc sO'tuyen suc khoe. cho cong dan duQ'cgQi kham suc khoe th\l'c hi~n nghia V\l quan S\l'.
4. Sau khi sa tuy~n, l~p danh sach cong dan du tieu chuAn suc khoe lamnghia V\lquan S\l'va nhiing cong dan rn~c b~nh thuQc Danh m\lC cac b~nh mi~ndang ky nghia V\lquan s\l' quy dinh t~i Bang s5 3 Ph\ll\lc 1 ban hanh kern theoThong tu nay, thong qua HQid6ng Nghia Y\lquan sg xa.
5. Xac nh~n va chiu trach nhi~m vS tiSn sir b~nh t~t cua cong dan duQ'cg9ilam nghia V\lquan sg va dang ky dg thi tuy8n sinh quan sg; ban giao hB sa suckhoe, phi8u suc khoe nghia V\lquan S\f cua cac cong dan di kham suc khoe choHQidBngkham suc khoe nghia V\lquan S\l'huy~n.
6. Th\l'c hi~n sa k8t, t6ng k8t, rut kinh nghi~m vS cong tac sa tuy~n suckhoe, ki8m tra suc khoe nghia Y\lquan sg sau m6i dgt tuy~n chQn va gQi congdan nh~p ngii ho~c t~p trung hu~n luy~n quan dg bi.
f)i~u 15. Phong Y t~ huy~n
1. Tham mUll ch~ Uy ban nhan dan va HQi dBng Nghia V\l quan S\l huy~n~~ c6ng tac kham suc khoe thgc hi~n nghia V1;1quan s\l'.
2. Ti8p nh~, hoan chinh phi8u suc khoe nghia V\l quan S\l'cua cac c6ngdan duQ'cgQi lam nghia V\lquan S\l, t6ng hgp danh sach cong dan m~c cac b~nhthuQc di~n mi~n dang kY nghia V1;1quan S\l do Hi)i dBng Nghia Y\lquan S\f xabao cao, trinh HQid6ng Nghia V\lquan sg huy~n xem xet, quy8t dinh.
3. Can cu vao k8 ho~ch tuy~n chQn va gQicong dan nh~p ngii cua Hi)i dangNghia V1;1quan s\l huy~n, ph5i hgp voi Trung tam Y t8 huy~n l~p k8 ho~ch, dvtril kinh phi kham suc khoe cho cong dan duQ'cgQi lam nghia Y\lquan S\l'va t6chuc trien khai th\lChi~n.
4. as xuftt thanh l~p HQi dBng kham suc khoe nghia Y\l quan s\l, dS nghiUy ban nhan dan huy~n xet duy~t, ra quy8t djnh; bao cao Sa Yt8 tinh.
5. Ph5i hgp voi Ban Chi huy quan S\l huy~n ban giao ddy du, kip thai hB sasuc khoe cua cong dan duQ'cgQinh~p ngii cho dan vi nh~n quan.
6. Chu tri, ph5i hgp v6i Ban Chi huy quan S\l'huy~n ghii quy8t khi8u n~icua cong dan lien quan d8n vi~c kham suc khoe th\lc hi~n nghia V\lquan sv:vatuy~n sinh quan S\l.
7. Chu tri, ph5i hgp voi Trung tam y t8 huy~n chi d~o vi~c kiem tra suckhoe cho quan nhan d\l bi theo k8 ho~ch cua HQidBng Nghia V\lquan s\l huy~n.
8. T6ng hqp k8t qua c6ng tac kham suc khoe th\lc hi~n nghia V\lquan S\l,bao cao HQidBng Nghia V\lquan S\l huy~n va Sa Y t8 tinh theo M~u s5 1b, 3b,4a, 5c Ph1;1l\lc5 ban hanh kem theo Thong tu nay.
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9. Thgc hi~n sO'k8t, t6ng kSt, rut kinh nghi~m v8 cong tac kham suc khoecho cong dan lam nghla V\l quan S\f sau m6i dQ't:tuy8n chQn va gQi cong dannh~p ngii.
Di~u 16. Trung tam y t~ huy~n1. QuySt dinh thanh l~pT6 ki8m tra suc khoe nghla V\l quan SlJcua cac xa.2. Chi d~o v8 chuyen mon, giam sat vi~c thgc hi~n ki8m tra suc khoe, sa
tuy8n suc khoe nghla Vl)quan SlJ.3. Tang cu6ng can bQchuyen mon tham gia ki8m tra suc khoe, sa tuy8n
suc khoe nghla V\lquan SlJcho cac xa khi co d8 nghi.4. T6 chuc t~p hufuI, bAi du5ng v8 chuyen mon, nghi~p V\l v8 cong tac
ki8m tra suc khoe, sa tuy8n suc khoe nghia V\l quan SlJcho can bQYt~ xa.5. Chu tri, ph6i hQ'Pvai Phong Y t8 va Ban Chi huy quan SlJhuy~n xay
d\fIlg kS ho~ch kham suc khoe cho cong dan dugc gQi lam nghla V\lquan SlJvat6 chuc thgc hi~n.
6. Ph6i hQ'Pvai Phong Y t~ huy~n thanh l~p HQidAngkham suc khoe nghlaV\l quan sg; Cll can bQ chuyen mon cimg cac trang thi8t bi y t8 tham gia HQidAng kham suc khoe nghia V\l quan SlJcho cong dan dugc gQi lam nghla Vl)quan SlJtren dia ban'huy~n.
7. Ph6i hQ'Pvai Ban chi huy quan SlJhuy~n t6 chuc kham suc khoe chocong dan dangley dlJ thi tuy8n sinh quan SlJ.
f)i~u 17. B~nhvi~n huy~nfl6i vai cac huy~n co B~nh vi~n huy~n thi B~nh vi~n huy~n thlJc hi~n cac
nhi~m Vl) quy dinh cho Trung tam Y t~ huy~n t~i cac Khmin 5, 6 va 7 fli8u 16Thong tu nay.
Di~u 18. Sa Y t~doh1. Chi d~o cac cO'So' y t8 thuQc thdm quy8n:a) Thgc hi~n cac huang d~n cua cO'quan co thdm quy8n v8 cong tac y t8
trong thlJc hi~n Lu~t Nghia V\l quan sg;b) Di8u dQng 19c IUQ'Ilg,phuong ti~n tham gia kham suc khoe nghla Vl)
quan SlJ theo K8 ho~ch cua HQi dAng Nghia Vl) quan SlJ cac huy~n khi co d8nghi.
2. Ph6i hQ'Pv6'i BQChi huy quan sg tinh:a) Tham muu cho HQi dAng Nghla V\l quan SlJtinh l~p k8 ho~ch, chi d~o,
huang dftn y t~ huy~n t6 chuc, tri8n khai cong tac kham suc khoe thgc hi~nnghla V\l quan sg va tuy8n sinh quan S\l';
b) T6 chuc, hi~p d6ng v8 y tS vai cac dan vi nh~ quan v8 vi~c giao, nh~quan.
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3. T6 chuc t~p huAnv~'chuyen mon, nghi~p V\lcho can bQ, nhan vien y t@tham gia kham suc khoe nghia V\lquan SlJcua cac huy~n.
4. T6 chuc kiSm tra vi~c kham suc khoe nghia Y\l quan SlJ t~i cae diaphuong trong tinh.
5. Xem xet va giai quy@tnhUng vuong m~c, khi@un~i v~ cong tac khamsuc khoe thlJc hi~n nghia V\lquan SlJva tuySn sinh quan SlJ.
6. Bao cao Uy ban nhan tinh va BQY t@k@tqua kham suc khoe nghia V\lquan SlJtheo Mftu 3c Ph\ll\lc 5 ban hanh kern theo Thong tu nay.
7. Th\lc hi~n sO'k@t,t6ng k@t,rut kinh nghi~m v~ cong tac kham suc khoethlJc hi~n nghia Y\lquan SlJsau m6i dgt tuy~n chQnva gQi cong dan nh~p ngil.
ChlfO'DgVNHI~M \TV CUA COQUAN QUAN sT/ cAc cAP
TRONGKHAM SUC KHOE THT/CH~N NGHiA Vl) QUAN sT/
Di~u 19.BaD Chi huy qUaD SIf xi
1i 1. Chu tri, ph6i hgp voi Tr~m y t@xa t6 chuc so tuySn suc khoe; l~p danhsach nhfrng cong dan du suc khoe th\lc hi~n nghia V\l quan SlJ,cong dan m~cb~nh thuQc danh m\lc cac b~nh mi~n dang ky nghia V\lquan sg da qua sO'tuySn,thong qua HQidang Nghia Y\lquan S\l xa, bao cao len HQi dang Nghia Y\lquanSlJhuy~n. Hoan chinh phful thu t\lc hanh chinh phiSu suc khoe nghia V\lquan S1)'.
2. KiSm tra, don d6c cong dan thuQcdi~n duQ'cgQilam nghia V\lquan S¥ dikham suc khoe theo k@ho~ch cua HQidang Nghia V\lquan sg huy~n.
3. Thong bao kSt qua kham suc khoe theo k@tlu~ cua HQi dang kham suekhoe nghia V\lquan SlJ huy~n. Thu th~p nhiing y ki@nth~c m~c lien quan dSnvi~c kham suc khoe va kSt lu~ suc khoe nghia V\l quan SlJ cua cong dan (nSuco), bao cao len Ban Chi huy quan SlJhuy~n va HQi dang Nghia V\l quan svhuy~n nghien cUu,giai quySt.
Di~u 20. Ban Chi huy quan SIf huy~n1. Ph6i hqp v6i Phong Y tS huy~n va Trung tam Y tS huy~n ho~c B~nh vi~n
huy~n (theo quy dinh t~i Khoan 6, f)i~u 6) l~p kS ho~ch kham suc khoe chocong dan thuQcdi~n duQ'cgQilam nghia V\lquan SlJ.
2. Tri~u t~p cac cong dan thuQc di~n dugc gQi lam nghia V\l quan S\f dikham suc kh6e ho~c ki~m tra suc kh6e theo kS ho~ch cua HQi dang Nghia vvquan SlJhuy~n.
3. Ph6i hgp v6i cac cO'quan chuc nang cua huy~n tham gia cong tac t6chuc kham suc kh6e nghia V\lquan SlJ theo k@ho~ch; theo d5i 86 luqng, ch~tluqng suc khoe cua cong dan cac dia phuong d@nkham.
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4. Quan ly phi~u sue kh6e nghia V\lquan sg do HQi d6ng kham sue khoenghia V\l quan sv huy~n ban giao. Thai h?n lUlltrii eho d€n khi eong dan h~t h?lltu6i ph\le V\la ng?eh dg bi theo quy dinh ella Lu~t Nghia V\lquan sg.
5. Chu tri, ph6i hqp vai Phong Y t~ huy~n t6 ehue ban giao h5 sa sue khoeeong dan dUQ'egQinh~p ngil eho cae don vi nh~n quan theo k~ ho?eh.
6. Chu tri, ph6i hqp vai Trung tam Y t~ huy~n ho~e B~nh vi~n huy~n (theoquy dinh t?i Kholm 6, Bi@u6) l~p k~ ho?eh va t6 ehue kham sue khoe eho eongdan dang ky dVthi tuy~n sinh quan sv.
7. Ph6i hqp vai Phong Y t€ va cae don vi, co quan ehue nang lien quan ellahuy~n giai quy~t eae khi~u n?i lien quan d~n kham sue khoe thge hi~n nghia V\lquan Sl! va tuy~n sinh quan sv.
8. T6ng hQ"P,bao eao tinh hinh giao nh~n ehiSn sy mai v@BQChi huy quansg tinh sau mBi dqt tuy~n ehQnva gQieong dan nh~p ngil theo Mau 4b Ph\ll\le 5ban hanh kern theo Thong tu nay.
f)i~u 21. B(j Chi huy qUaD SI}'tinh
1. Ph6i hqp vai Sa Y t~ tinh ehi d?o, t6 ehue tri~n khai va kic3mtra don d6evi~e kham sue kh6e thve hi~n nghia V\l quan sv eua cae dia phuong theQ kSho?eh ella HQid6ng Nghia V\lquan sg tinh.
2. T6 ehue hi~p d6ng vai tUng dan vi nh~ quan v@tieu ehuAnsue kh6e, s6IUQ'ng,thai gian, dia dic3mva phuong thue giao nh~ quan.
3. Chi d?o vi~e kham sue khoe eho eong dan dang ky dg thi tuyc3nsinhquan Sl!.
4. Ph6i hQ'Pvm Sa Y tS tinh xem xet, giai quy~t nhUng vuang m~e, khi~un?i lien quan dSn eong tae kham sue khoe thge hi~n nghia V\lquan sv va tuy~nsinh quan sg.
5. T6ng hQ'P,bao eao k~t qua eong tae kham sue khoe thge hi~n nghia V\lquan sv va tuyc3nsinh quan sv theo quy dinh.
Chuang VINHltM VlJ CUA CO QUANQUANy cAe cAp
TRONGKHAM sue KlIOE TH1/e HltN NGHiAVV QUANs1/
f)i~u 22. Quan y Ban Chi huy quan SI}' huy~n
1. Chu dQng n~m k~ ho?eh kham sue khoe thge hi~n nghia V\lquan sg hfulgnam ella dia phuong minh, ph6i hQ'Pvai Phong Y tS huy~n theo dOi eong taekham sue khoe, ki~m tra sue khoe eong dan lam nghia V\l quan sg. Tham giaHQi dAng kham sue khoe nghia V\lquan sg huy~n.
16
r
I •
i ""
I'
2. Ph6i hgp vai quan l\fc Ban Chi huy quan S\f huy~n n~m k~t qua khamsuc khoe eho cong dan dugc gQi lam nghia V1)quan S\f tren dia him huy~n;ph6i hgp vai quan y cae dan vi nh~n quan kiSm tra hB sa sue khoe cong dandugc gQi nh~p ngu.
3. Tham gia kham suc khoe d6i vai cong dan dang ky d\f thi tuySn sinhquan S\f theo k~ ho~ch cua Ban TuySn sinh quan S\fhuy~n.
4. Bao cao k~t qua cong tac kham suc khoe th\fc hi~n nghia V1)quan S\f vatuySn sinh quan S\f, sau m6i dgt tuySn ehQn va gQi eong dan nh~p ngu, tuySnsinh quan S\f.
f)i~u 23. Quan y BQ Chi huy quan S,! tinh
1. Tham muu cho BQ Chi huy quan 811tinh vS cong tac kham suc khoe thgchi~n nghia V\l quan S\f va tuySn sinh quan S\f.
2. Tham muu cho So' Y tS tinh trong c6ng mc chi d~o, t6 chuc, ph6i hgpgifra cac ca quan y t~, quan S11va quan y dan vi nh~ quan th\fc hi~n cong mckham suc khoe cong dan lam nghia V1)quan S\f va cong tac giao, nh~n quan.
3. Ph6i hgp vai So' Y t~ tinh xern xet, giai quy~t nhfrng vuong m~c,khiSu n~i vS cong bic kham suc khoe th\fc hi~n nghla V1)quan S\f va tuySnsinh quan S\f.
4. Bao cao k~t qua cong tac kham suc khoe thgc hi~n nghia V\l quan S\f vatuySn sinh quan S11vS Phong Quan y quan khu theo quy dinh cua BQQu6c phong.
f)i~u 24. Quan y quan khu
1. Tham muu cho Dang uy, BQ Tu l~nh Quan khu trong chi d~o cong mckham suc khoe th\fc hi~n nghia V\lquan S\f, tuySn sinh quan S\fva cong tac quanly suc kh6e quan nhan d\f bi theo kS ho~ch h~ng nam cua BQ Qu6c phong.
2. Ph6i hgp vai cac So' Y tS chi d~o cong tac kham sue khoe th\fc hi~nnghia V\l quan sg va tuySn sinh quan S\f.
3. Chi d~o Ban Quan y cac tinh trong cong tac kham suc khoe, kiSmtra suekh6e, giarn dinh suc kh6e th\fc hi~n nghia V\l quan S\f va tuySn sinh quan S\f.
4. D6i vai cac khu V\fCkh6 khan vS l\fc lugng y tS, Chu nhi~m Quan yquan khu diSu dQng can bQ nhan vien quan y cua quan khu tham gia HQid6ng kharn suc kh6e nghia V1;1quan S\f theo dS nghi cua So' Y tS, Ban quan -dan y cae tinh.
5. Bao cao kSt qua cong tac kham suc khoe th\fc hi~n nghia V1)quan S\f vatuySn sinh quan sg sau rn6i dgt tuySn chQn va gQi cong dan nh~p ngU, tuySn sinhquan S\f theo quy dinh.
17
Di~u 25. C\le Quan y
1. Ph6i hgp v6i cac cO'quan chuc nang thuQc BQ Qu6c phong tham moocho BQ Qu6c phong ve vi~c quy dinh tieu chuAnsuc khoe cong dan nh~p ngiicho timg khu V\lC,cac quan chung, binh chung va chi d~o, huang d~n quan y cacdon vi tri~n khai thvc hi~n.
2. Hfulg nam, din cu vao yeu du xay d\lI1gQuan dQi,ph6i hgp v6i cac coquan chuc nang lam tham muu cho BQQu6c phong ban hanh tieu chudn suc khoetrong tuy~n sinh quan sv va chi d~o,huang d~ quan y cac dan vi thvc hi~n.
3. Chi d~o quan y cac dan vi nh~ quan nfun ch~c hB sO'suc khoe cong danduQ'cgQinh~p ngil va t6 chuc kham phuc tra suc khoe chi~n sym6i theo quy dinh.
4. Chi d~o, t6 chuc kiSm tra cong tac kham suc khoe thvc hi~n nghia V\l
quan Sl!va giao, nh~n quan a cac dia ban trQngdiSm.5. Bao cao k~t qua cong tac kham suc khoe th\lC hi~n nghia V\l quan Sl!,
tuySn sinh quan sv theo quy dinh.
ChU'O"ng VIITO CHUC THVC HI:E:N
Di~u 26. Traeh nhi~m eua Bq Quae phong1. Can cu vao s6 IUQ'llgcong dan nh~p ngil trong nam eua Chinh phu va
yeu cftu xay dt;rngQuan dQi, ban hanh quy dinh Cl)th~ ve tieu chuAn suc khoecho phil hQ'Pd6i v6i cong dan gQinh~p ngil thvc hi~n cho timg khu vvc, timgquan chung, binh chUng.
2. Chi d~o cO'quan quan sv cac cdp co trach nhi~m ph6i hQ'Pv6i cO'quan yt~ dia phuO'ng trong vi~c l~p k~ ho~ch va tri~n khai thvc hi~n kham suc khoecong. dan thuQc di~n duQ'cgQi lam nghia V\lquan sv, cong dan dv thi tuy~n sinhquan Sl!va quan nhan dv bi theo dung quy dinh.
3. Cac cO'quan chuc nang co trach nhi~m chi d~o,huang d~, cac don vitrong tom quan tri~n khai thvc hi~n k~ ho~ch kham suc khoe thvc hi~n nghia V\lquan sv, tuy~n sinh quan Sl!va quan nhan dv bi h&ngnam.
4. Cac don vi nh~ quan co trach nhi~m ph6i hgp v6i cO'quan quan sv caccAp va co quan y t~ dia phuong thvc hi~n vi~c giao, nh~n phi~u suc khoe nghiav\lquan sv d6i v6i cong dan duQ'cgQinh~p ngfi theo dung quy dinh.
Di~u 27. Traeh nhiem eua Bo Y t~. .Chi d~o cO'quan y t~ cac cdp quan tri~t, t6 chuc thvc hi~n cac quy dinh,
huang ddn h&ngnam.cua Chinh phu, cac BQ,nganh lien quan ve cong tac khamsuc khoe thvc hi~n nghia V\lquan sv. .
18
fli~u 28. Hi~u ll)'c thi himh
1. Tho.ng tu nay co hi~u h:IC thi hanh k~ illngay 15 thang 8 nam 2016.
2. Thong tu lien tich s6 36/2011/TTLT-BYT-BQP ngay 17 thang 10 nam2011 cua BQ Y t~ - BQ Qu6c phong hu6ng dful vi~c kham suc kh6e thlJc hi~nnghia V\l quan sv h~t hi~u Ivc k~ illngay Thong tu nay co hi~u IlJc.
Trang qua trinh thlJc hi~n, n~u co kho khan, vuOng m~c, d€ nght co quan,t6 chuc, ca nhan phan anh kip thai v€ BQ Y t~ va BQ Qu6c phong d~ xem xet,giai quy~t./.
*Trung tmlng Tr~n flO'll
KT. BQ TRUONG BO Y TETmJTRUONG
NO'inh~n:- Cac BQ, CO quan ngang BQ, CO"quan thuQc Chfnh pM;- HDND, UBND cac tinh, thanh pha trl,CcthuQc TW;- Van phong Trung trOilg va cac Ban cua Dang;- Van phOng Chu tich ntraC;- HQi d6ng Dan tQc va cac Uy ban cua Quac hQi;- Van phOng Quac hQi;- Van phOng Chinh phil;- Co quan Trung trong cua cac doan th~;- Cac co quan, d011 vi trl,CCthuQc BQ Y t~, BQ Quac ph6ng;- C3ng TTDT CP, C6ng bao;- C3ng TTDT BYT, BQP;- Cl,lCKi~m tra van ban-BQ Ttr phap;- LtrU: VT, el,lC QLKCB, Vv. PC - BQ Y t~;
VT, CI,lCQuan Y, Vl,l PC - BQ Quac phong.
19
Phu lue 1PHAN LOAI SUC KHOE THE.O THE LUC vA BENH TAT(Ban hanh k~m theo Th6ngtu lien tich s616/2016/TTLT-BYT-BQP
ngay 30 thang 6 nam 2016 cua BQtwang Be)Y t€ - Be) twang Be)Qu6c phongQuy dinh vi~c Khfun suc khoe th\Ic hi~n nghia V\l quan s\I)
I. TIEU CHuAN PHAN LO~I THEO THE LVC (Bang sa 1)LOAI NAM NU
sue Cao dung Can ning Vong ng'1e Cao dung Can n,ng?
KHOE (em) (kg) (em) (em) (kg)
1 ~ 163 ~ 51 ~ 81 ~ 154 ~48
2 160 - 162 47 - 50 78 - 80 152-153 44 - 47
3 157 - 159 43 - 46 75 -77 150-151 42 - 43
4 155 - 156 41 - 42 73 -74 148 - 149 40 - 41
5 153 - 154 40 71 -72 147 38 - 39
6 ~ 1-52 ~ 39 ~ 70 ~ 146 ~ 37
Cac tWOng hgp qua beo ho~c qua gfty se xem xet d~n chi s6 BMI (xem phftn chtidful kham tuyen).
II. TIEU CHuAN PHAN LO~I THEO Bl:NH T~ T (Bang sa 2)1. Cae benh v~mit.TT B~NHT~T DIEM
1 Thj h,rc1.1 Thj 19c kh6ng kinh
Thi 19c mit phai T6ng thj 19c 2 mit
10/10 19/10 1
10/10 18/10 2
9/10 17/10 3
8/10 16/10 4
6,7/10 13/10 - 15/10 5
1,2,3,4, 5/10 6/10 - 12/10 6
1.2 Thj l\l'c sau chinh kinh Cho diemtheo fi\lC1.1 va Hinglen 1 difun
2 c~ thj:- C~n thj du6'i -1 ,5D 2
1
IIl!l!lIl!l!!!rDe:l!!"'''"II!m•••• ------llI:CI:1. =,,~.~=!.•! •••=" ... -"77='''~''''''''.'""'=! •• 'I3'U=...-=,,-"'••••••.=="" "="'=!l!n"-"""",!'"='._=mIT"'~' ....=..-.-,.=....==-.'~...,-.~_.
;
TT B~NH T~T DIEM
- C~n thi ill -1,5D den du6'i -3D 3,
- C~ thi ill -3D den du6i -4D 4
- C~n thi ill -4D den du6i -5D 5
- C~ thi ill -5D tr6len 6
..- C~n thi da:ph~u thu~t Cho di~mtheo m\lc1.1 va tanglen 1 di~m
3 Tho~iihoa h~c vong m~c do c~n thi n~g (til -3D tr6len) 6
4 Vien thi:- Vien thi du6'i + 1,5D 3
- Vien thi tir + 1,5D den du6'i+ 3D 4
- Vien thi tir + 3D den du6'i + 4D 5
- Vien thi ill + 4D den du6'i + 5D 6
- Vien thi da:ph~u thu~t "Cho diemtheo m\lc1.1 va tanglen 1 di~m
5 Cac lo~i lo~n thi 6
6 MQng thit:- MQng thit dQ1, dQ2 2
- MQng thit dQ3 4
- MQng thit che d6ng ti'r 5- MQng thit da:m6 tai phat, gay dinh 5
7 B~nh giac m~c:- St;Ogiac m~c don thudn, mong, nho a ngoai vimg trung tam Cho diem
.. theo m\lC1.1 va tanglen 1 diem
- St;Ogiac m~c co dinh m5ng m~t 6
- Dang viem giac m~c:+Nht; 3T
+Vua 4T
8 M~t hQt:- Chua bien chlmg:+ N~u dang a giai do~ tien trien Cho diem
theo m\lc
2
, ,
TT B$NHT~T DIEM1.1 va tanglen 1 di~m
,+ Neu a giai do~n dii lanh s~o Gift nguyen
pharr lo~itheo thj 19c
- Co bi~n chUng (mang mau, s~o giac m~c) 5
9 Long sieu (qu~) a mi m~t:- Khong arm huang d~n thj 19c 2
- Co arm huang d~n thj hrc Chodiemtheo m\lc1.1 va tanglen 1 diSm
10 Viem k~t m~c (mang ti~p hgp):,
-Cap 2T
- Viem k~t m~c mila xuan 4
11 L~ d~o:- Viem t~c l~ d~o cAptinh- Viem t~c l~ d~o m~n tinh ho~c dii nhieu leln dieu trj khongkh6i:+ N~u a 1 ben m~t+ N~u a 2 ben m~t
12 B~nh cac cO'v~ nhan:- Lac cO'nang:+ Khong arm huang d~n chuc nang+ Co arm huang chuc nang- Lac do li~t 1 hay nhieu cO'v~n nhan (lac trong, ngoai, len,xu6ng)
13 T~t rung gi~t nhan celu (b~nh ly ho~c b~m sinh)14 Nhiing b~nh ami m~t va h6c m~t:
- Cac v~t s~o lam hu mi m~t: m~t nh~m khong kin, dinh micelu, l~t mi, le)nmi- S\lP mi m~t bftm sinh ho~c b~nh ly cac muc dQ- Nhiing b~nh a h6c m~t
15 Mil mau (mil 1 mau ho~c toan be))16 Thoai hoa bi~u mo s~c t6 (quang ga)17 D\lc thuy tinh th~ bftm sinh
3T
56
3
56
5
6
66666
3
TT BtNHT~T DIEM18 Nhfrng b~nh khac v8 m~t:
- Tang nhan ap, dl)c thuy tinh the 2 m~t, l~ch the thuy tinh, viem 6mang b6 dao, dinh bit d6ng ill, bongyang m~c,teo gai thi 1 ho~c2ben- Cac t6n h~i yang m~c do b~nh ly (viem vong m~c do b~nh 6tang huySt ap, viem vong m~c s~c t6) ho~c bfun sinh (thoai hoayang m~c bAmsinh)
2. Cae b~nhv~rang, ham, mtt
TT B~NHT~T DIEM
19 Rang sau:- Chi co rang sau dQ 1 - 2, khong ho~c it arm huang suc nhai 2
- Co ~ 3 rang sau dQ3 2
- Co 4 - 5 rang sau dQ3 3- Co 6 rang sau dQ3 4T
- Co 7 rang sau dQ3 tra len 5T
20 Mdt rang:- Con du 28 ding (khong ke rang khon) 1
- Mdt rang dffco phl)c hinh dam bao chuc nang va thdm my 2,
- Mat ~ 3 rang, trong do co 1 rang ham IOnho~c rang cua, suc 2nhai con 85% tra len
,- Mat 4 rang, trong do co ~ 2 rang ham Ian ho~c rang cua, suc 3nhai con 70% tra len
,- Mat 5 - 7 rang, trong do co ::;3 rang ham Ian ho~c rang mia, 4suc nhai con 50% tra len- Mdt tren 7 rang, trong do co > 3 rang ham Ian ho~c rang cua, 5suc nhai con < 50%
21 Viem lqi:- Viem lqi a ~ 5 rang, chua co tui'mu sau 1
- Viem lqi a ~ 6 rang, chua co wi mu sau 2
22 Viem quanh rang (nha chu viem):- Viem quanh rang dffdi8u tri 6n dinh vfu1con wi lqi sau 3- Viem quanh rang a < 5 rang, rang lung lay dQ2 - 3 - 4 3- Viem quanh rang til 6 - 11 ding tra len, rang lung lay dQ2- 3 4-4- Viem quanh rang ill 12 rang tra len 5
23 Viem my, my ho~i tu, viem quanh cu6ng ding:- 1 - 2 rangbi viemmy,my ho~ tUho~cviemquanh cu6ngrang:+ Dang con viem 2T
4
,..
DIEM2
TT+ Da diSu tri 6n diOO- 3 - 4 rang bi viem my, my ho?i tir ho~c viem quaOOcu6ng rang:+ Dang con viem+ Da diSu tri 6n diM- 5 - 6 rang bi viem my, my ho?i ill ho~c viem quanh cu6ng rang:+ Dang con viem+ Da diSu tri. 6n diOO- <:;6 tren 6 rang bi viem my, my ho?i t1i ho~c viem quanhcuong rang
24 Bi8n chUng rang khon:- Bi8n chtmgda diSu tri t6t- Bi8n chUng dang chua
25 Viem loet niem m?c 6 mi~ng, lucri:- Viem loet cftp tiOO- Viem loet m?ll tiOOda diSu tri nhi8u IAnkhong kh6i
26 Viem tuy8n nuac bQt:- Viem tuy8n mang tai:+ Da diSu tri kh6i
+ Viem tuy8n mang tai cftp
+ Viem tuy8~ mang tai m?n tinh 1 ben da 6n dinh
+ Viem tuy8n mang tai m?ll tinh 2 ben da 6n dinh
+ Viem tuy8n mang tai m?n tiOO 1 ho~c 2 ben chua 6n dinh
- Viem tuy8n nuac bQt duai ham:
+ Da diSu tri kh6i+ ViemcAp+ Viem m?ll, xa hoa, chua 6n dinh
+S6i 6ng Wharton27 Viem kh6p thai duong ham:
- Viem cAp tinh
- Viem m?n tinh
28 Xuang ham gay:
- Da liSn t6t, kh6p c~n khong di l~ch ho~c di l~ch it- Kh6p c~n di l~ch nhiSu, cinh huang taisuc OOai
29 Khe h6 moi, khe h6 yom mi~ng:
- Khe h6 m6i 1 ben, khong tofm be):
..
3T3
4T45
1-22T
3T4
2
3T
3
4
5
2
4T
5
5
3T
4
24
.-
5
TT B~NHT!T I>IEM
+Dffphfruthu~t, khong arm huang t6i thfunmy va chuc nang 2
+ Chua phfru thu~t 3
- Khe h6 moi 1ben toan bQho~ckhe ha moi khong toan bQ2 ben:+Dffphfruth~t ~o hinh, arm huang it d6n thfun my va phat fun 3
+ Chua phfru thu~t 4T
- Khe h6 moi toan bQ2 ben:+Dff phdu thu~t tl;lohinh 4
+ Chua phfru thu~t 5T
- Khehavom:+ Khe ha vom m8m 3
+ Khe h6 vom tow bQ 5
- Khe ha moi kern theo khe ha vorn 6
30 B~nh ly va u vung m?t- Cac b~nh ly lanh tinh dff di8u tri 6n dinh (nang chan rang, 2nang nhay ... )- U lanh dff phdu thu~t 6n dinh khong arm hUOng d6n chuc 3nang (torus, u lQ'ixO'... )- U lanh dffphfru thu~t 6n dinh co bi6n dl;lllgvung m~t (u men, 5u xuang XO',u mau, u bl;lChml;lch... )
3. Cae b~nh v~ tai, miii, hQng
TT DIEM
31 Suc nghe (do b~ng ti6ng noi thuOng):- MQt ben tai 5m (nghe binh thuOng) 1- MQt ben tai 4m (nghe kern nhy) 2- MQt ben tai 3m (nghe kern trung binh nhy) 3- MQt ben tai 2m (nghe kern trung binh n~ng) 4- MQt ben tai 1m (nghe kern n~g) 5- MQt ben tai du6i 1 rn (nghe kern sau) 6Tinh timg tai, sau lAytrung binh cQngva lam tron de duQ'Ck6tqua chung.Vi dl): Tai phai 1, tai trai 6, t6ng la (6+ 1)/2 = 3,5 lam tron la 4
32 Tai ngoai:
6
TT DIEM
- Ong tai ngoai+HypmQtphful6ng tai ngoai 3+Hyptoan bQBngtai ngoai 4+ Tit Bngtai ngoai 5- Vanh tai+Khong co vanh tai 5+Khong con d.u trUcvanh tai (chi co n\l thit) 4+MdtmQtsB cdu trUcgilii phdu 3+ cAu truc ddy dil nhung nhc>hon tai ben binh thuOng 2- Viem tai ngoai cAptinh 3T
33 Tai gifra:-~~~~~ ~
- Viem tai giiia thanh dich 4T- Viem tai giiia m~ tinh hom nhi kho, s~ch+Mang nhi thimg nhc>ho~c trung binh 4+Mang nhi thung rQng 5- Viem tai giiia m~n tinh co thimg mang nhi, co chay chAtnhdyho~cmu, milc dQthung:+ Thung nh6 ho~c trung binh 5
~ .+ Thling rQng 6- Viem tai giiia m~n tinh co thling, co chay mil thBi 6(Cholesteatome)
34 Xuong chum:- Viem tai xuong chum cAptinh 5T- Viem tai xuong chum m~ntinh 5- Viem tai xuong chum da:phftuthu~t rna hang chum - thuQ11gnhi co va mang nhi, n~u:+Mang nhi dong kin 4+Mang nhi thung, day nhi s~ch 5+Mang nhi thling, con chay mu 6- Viem tai xuong chum da: rna ti~t din, n~u:+~~~ 5+HBcrna con chay mu 6
35 Tai trong:- Chong m~t me nhi (rBilo~nti~n dinh) 5
7
TT BtNHT!T DIEM
36 Mfii:- Miii, hBmui, vach ngan bi l~ch v~o, di d~ng, n€u:+Kh6ng co rBi lo~ h6 hdp va phat am 3
+ Dff co rBi IOlilnh6 hdp, phat am, nuBt muc dQoo~ 4-5
+ Co rBi lo~n chuc nang ho hdp quan trQng, rBi lo~ phat fun 6
- Viem mlii m~ tiOOdon thufin:+Khong co rBi lo~ chuc nang ho hdp 2
+ Co rBi lo~ chuc nang ho hdp ro ho~c mdt ngui 4
+ RBi lo~ chuc nang h6 hdp 5
= Polip mlii:+ DQ I-II 4
+DQ III - IV 5
+ Polip ca 2 ben dQI - II 5
+ Polip ca 2 ben dQIII - IV .. 6
37 HQng:- Viem hQng cdp tiOO 2T
_Viem hQng m~n tinh don thufin, thS tr~g tBt 2
_ yiem hQng m~ tiOOhay ho, sBt gay kho thO' aM huang d€n 4
the tr~g38 Amidan:
- Viem amidan cdp tiOO 2T
_Viem amidan mlilntinh, khong qua phat ho~c qua phat dQI 2
_ Viem ~dan mlillltinh qua phat dQII- ill chua cO rBi IOlilllchuc 3
nanghohap_ Viem Amidan m~ tinh qua phat dQIII co rBi lo~ chuc nang 4ho hdp (ngirng thO'khi ngu, kho thO'...)- Viem Amidan m~n tiOOqua phat dQIV 5
- Amidan viem m~ tiOOdff duQ'c c~t b6 2
39 Chay mau cam:_ Chay mau cam tai phat chua co thi€u mau ho~c thi€u mau 4
nh~- Chay mall cam tai phat gay thi€u mau trung biOO 5
- Chay mau ~am tai phat gay thi€u mau n~ng 6
40 Thanh quan:- Viem thaOOquan cdp tiOO 2T
- Viem thanh quan mlilntiOO,n€u:
." ••. "'_ .•••• ,., •••••~.•.•,,•• ,•••••••••••••~_,",.IQ_, •. j •...••• ,' ,::t,', .•.:z.~••••_ ..•...,.mr=m mmr:dLW..L ....•.•......L ....:::::::::a:::::-. ,.;
8
I
9 & ••••••• , •• j
r .
4. Cae benh ve than kinh, tam than
TT BtNHT~T DIEM
+ Khong c6 r6i IO?11phat am quan trQng nhu ti~ng n6i con 3phan bi~t duqc, thS tr?11gtdt+ Co r6i IO?11phat am quan trQng nhu ti~ng n6i khong phan 4bi~t duqc ho~c phan bi~t kh6, thS tr~ng kern- Li~t cac cO'khep - rna day thanh va li~t day thAnkinh hc3iqui. 5
- Khan ti~ng don thu~n, khong li~t day thanh, khong c6 t6n 3thuang ho~c chi t6n thuang nh~ & niem m~c day thanh- Khan ti~ng do cac kh6i u Umhtinh & day thanh nhu: polip, h~t 5XO'day thanh, u nang, u nhil (papilloma) day thanh ...- N6i l~p:+ L~p ill (Vi dV: Con bo bo ... bo sua) 3
+Keo dai ill (Vi dl): C....o ....n bo sua) 4
+MAtill (Vi d\l: Con ..... sua) 5
- N6i ngQng:+Nguai nghe hiSu 75% den du6i 100% ill 3
+Nguai nghe hiSu 50% den du6i 75% ill 4
+Nguai nghe hiSu 20% d~n du6i 50% til 5
+Nguai nghe hiSu du6i 20% tir 6
- Ch~ thuang hay b~nh ly gay t6n thuong du trUc thanh quan, .
5+ Khong c6 roi IO?11giQng+ Co rdi IO?11giQng ~ 6
41 Xoang m~t:- Viem miii cfrp tinh 3T
- Viem xoang cfrp tinh 4
- Viem xoang ham m~n tinh 4
- Viem xoang tran, xoang sang m?11tinh 5
- Viem miii dj (rng 3
42 Li~t m~t khong h6i phl)c do viem tai xuang chum 6
43 Khdi u vung miii xoang, hQng thanh quan, tai ngoai, tai giua- Khong nghi nga ac tinh 5
- C6 nghi nga ac tinh 6, A " . . " A"
TT DIEM
ThAnkinh44 Nh(rc d~u thanh con, dai d5ng, keo dai, acit huang den lao
9
TT
k""'P! ,., .. ,.",. .. ~r,,'~ --.•' " ...••'. ",,,,n."",' .'~ ..' .-._,.'_~~ . '., <
BENHTAT. . DIEM
.52
dQng:- Do b~OOIy cQt s6ng c6 (HQi chUng giao cam c6 sau)- Bi ill 006, khong lien quan den CQts6ng c6
45 Suy OOuQ'cthfuI kinh:- Nht;, da h6i ph\lc- N~ng, khong h6i ph\lc hoan toan (giam tri 006, giam khanang lao dQng ho~c tai phat 2 IAntra len)
46 DQng kiOO:- Da het can (Him sang va c~ lam sang)- Con can 100 ho~c 006
47 Ra m6 hoi ban tay ho~c ca ban tay, ban chan:- Mirc dQOOt;- Muc dQ vua-MircdQn~g
48 Phim x~ gan xuang:- Tang deu ca hai ben:+ Khong r6i lo~n v~ dQng cam giac+ Co r6i lo~ v~ dQng cam giac- Giam deu ca hai ben:+ Khong r6i lo~ v~ dQng cam giac+ Co r6i lo~ v~ dQng cam giac- Tang ho~c giam mQt ben:+Khong r6i lo~ v~ dQng cam giac+ Co r6i lo~ v~ dQng cam giac
49 Dai dam thuOng xuyen50 Di tiOOOOieu, anh huang t6i suc kh6e51 Chong m~t co h~ th6ng:
- RBi lo~ ki~u tien dinh (trung uong va ngo~i vi)- RBi lo~ ph6i hQ'Pv~n dQng va thang bfutg kl~u ti~u naoLi~t than kiOOm~t ngo~i vi:- Con di chUng mea mi~ng khi cuai, m~t nhfun kin- Con di chUng mea mi~ng thuemg xuyen, m~t nhfun khong kin
53 Li~t than kiOOngo~i vi:- Li~t 1 trong cac day thdn kinh quay, giua- Li~t day thfuI kiOOtf\l
4
4
3
6
56
24
5
4
6
3
6
3654
45
35
54
10
TT BtNHT~T DIEM
- Li~t day thAnkinh hong to 6
- Li~t 1 trong cac day thAn kinh hong khoeo trong, hong khoeo 5,.ngoal
- MAtho~c gifun kha nang v~ dQng 6mQtphAn chi th~:,
+ It anh huang t6'i lao dQng, sinh ho~t 4
+Anh huang nhieu dSn lao dQng, sinh ho~t 5
- MAthoan toan kha nang lao dQng 6 1 chi ho~c mia nguoi..-
6
54 Di chUng t6n thuong S9 nao, my sang: Li~t chan tay, h~ chS 6kha nang lao dQng ro r~t
55 Dau rS thAn kinh va cac dam rai thAn kinh (dam rBi c6, canhtay, thAt lung, cung):- it anh huang dSn v~ dQng 4
- H~ chS ro r~t kha nang v~ dQng 5
56 B~nh co (Myopathie):- Co teo co n~g, anh huang ro den kha nang lao dQng 6
- Teo co nh~, anh huang it den v~ dQng 4
57 Nhugc co (Myasthenia): 6
58 T~t may co (TIC):- KhoIlg gay dau 6 m~t 3
- Gay dau & m~t 5
59 Dau lung do:- Gai doi CQtsang 4
- Thmii hoa cQt sang:+Muc dQ nhy 3
+Muc dQvua 4
+Muc dQn~g 5
- Thoat vi rna d~m:+Muc dQnh~ 4
+Muc dQ vua 5
+Muc dQ n~g 6
60 Dau vai gay do:- Thoai hoa CQtsang c6:
..-
+Muc dQ nhy 3
+Muc dQ vua 4
+Muc dQ n~ng 5
11
TT BtNHT4T DIEM
- Thoat vi rna d~m CQts6ng c6:
+ Muc dQnh~ 4
+ Muc dQvila 5
+ Muc dQn~ng 6
61 ChAn thuong S9 nao:- Chdn thuang S9 nao, vet thuang ell khong thdu nao d€ l~i dichUng suy nhugc thfut kinh nh~:
+ NSu di~n nao dB khong bien d6i 4
+ N Su di~n nao dB co bien d6i 5
- Chdn thuong S9 nao Cll, vet thuang thdu nao Cll con d€ l~i di 6chUng ra r~t vS thfuI kinh ho~c tam thAn
Tam thin62 Lo~n thAn do:
- Thi€u nang tam thAn:.
+MucdQn~g 6
+ Muc dQ trung binh 5
+ Milc dQnh~ 5
- Cac b~nh lo~ thAn coHen quan_dSn cac b~nh cua cO'thS nhu:rBi lo~ nQi tiSt, chuySn hoa dinh duOng, nhiSm trUng, nhiSmdQc:+ Da ph\lc hBi 4
+ Ph\lc h6i khong hoan toan 5
+ Khong ph\lc h6i 6
- Lo~n tam thfuI phan lIng:+ Khong h6i ph\lC 6
+ H6i ph\lc khong hoim toim 6
+ H6i ph\lc hoim toan 5
- Cac tr~ng thai hoang wOng va lo~n thAnkhong d~c hi~u 6
- Cac r6i IOl;Ul tri ghk 4
- Cac r6i lo~n ao giac 5
- Nhihlg l~ch l~c vS rBi lo~n tinh dlfC:Lo~ dam d6ng gi6'i, suc 4v~t, tre em, phDtruO'ng, Hlnhd~m, rBi lo~ntinh d\lc khac
63 Tam thdn pharr li~t (cac the) 6
64 Lo~ thdn do ruQ'U:- B~nh Corxacop sa sut tri nang, ao giac, hoang moog, say 6
12
1T DIEM
nrqu b~nh Iy- HQi chUng I~ thuQc ruqu
65 Nghi~n rna tuy (opiate)66 Lo~ thAn do thu6c:
- HQi chUng cai cac thu6c gay nghi~n, tr~ng thai hoang wOng,8.0 giac, lo~n thAn do ngQ dQCthu6c- L~ thuQc thu6c gay nghi~n
67 Lo~ thfin cam xuc:- ThS diSn hinh, cuemg dQm~, can keo dai, mau tai phat- ThS trung binh, can thua 1 - 3 namllfin ho~c thS nhy chu kycan3-5nam
68 R6i lo~ nhan cach:- ThS n~g, mAt bil thuemg xuyen- Con bu nhung da tai phat 2 lfin tro len
69 R6i lo~ hanh vi 0 thanh thieu nien:- ThS n~ng va c6 dinh- Trung binh
70 R6i lo~ giAc ngu:- Da h6i ph\lc- Khong h6i ph\lC
71 R6i lo~n 10 au:- Da h6i ph\lc- Dang tien triSn- Hay tai phat (m 2 IAntro len)
72 R6i lo~n phan li (Hysteria):- Da h6i ph\lc sinh ho~t binh thuemg- Dang tien triSn- Hay tai phat (tai phat ill 2 lfin tro len)
73 Lo~ thAn co lien quan den tan thuang SQ nao do:- Viem nao - mang nao:+Da h6i ph\lc+Khong h6i ph\lc- Lao nao:+Da h6i ph\lc+ Khong h6i ph\lc
66
6
5
6
6
65
65
4
5
4
5
6
4
56
56
56
13
'TJm"Mre""W.AMMR
TT DIEM
,,
.
- Giang mai nao:+ Ba h6i ph\lc+ Khong h6i ph\lc- Cac r6i lo~ mlilch mall nao, xo cUng dQng mlilch nao, u nao,thoai hoa h~ thAn kinh
74 LOlilllthful do chAn thuong:- Ba h6i ph\lc- Khong h6i ph\lc
5. Cae b~nhv~tieu boa
TT B~NHT!T
75 B~nh thgc qmin:- Viem th\l'c qufm cAp- Viem th\l'c quan mliln, loet th\l'c quan lanh tinh- Gitin th\l'c quim- Hyp th\l'c quan- Gian tinh mlilch th\l'c quim- Dng thu thgc quan
76 B~nh dlilday, ta trang:- Viem dlilday cAp- Viem dlilday, ta trang mliln tiOO- Loet dlilday, ta trang chua co bi~n chUng- Loet dlilday, ta trang co bi6n chUng (hyp mon vi, chay mau ...chua diSu tri khoi)- Lbet dlilday, ta trang da diSu tri lanh bfutg nQi khoa- Loet dlilday, ta trang da diSu tri lanh bAng phftu thu~t- T\ii thira dlilday anh huemg t6i suc khoe it hay nhiSu
- Dng thu dlilday77 RUQtnon:
- Thung ruQt non do cac nguyen nhan phai mc3:+ K6t qua khong anh huemg t6i tieu hoa+ Co anh huang t6i tieu hoa va sinh hOlilt- T~c ruQt co gi6i da m6:+ K6tqua t6t+ N6u vftn con r6i lOlilntieu hoa
566
56
DIEM
5T
4
5566
2T4-
46
4
546
45
4
5
14
~~ ~ =~." "=,._._aLi,.=•••••••••=•••..••=O::'.•~_=",J::..;~~"'"',=. ~.,.,...."."...".="'.....=,"< .. =..I.. ••=..'",._rm_l:".",u== z:z::::::•••• ~••••n.~."",~".~••••••,
TT
>. 82
BtNHT~T
- Tufthira, polip ruQt non- U ruQtnon
78 Viem ruQt thua:- Viem ruQt thua da mB, kSt qua tM- Co biSn chUng, ban t~c, sa thanh b\lng
79 Thmit vi byn cac lo~i:- Da dugc phdu thu~t t6t, Bn dinh tren 1 nam- Chua duQ'cphdu thu~t
80 Cae dUOngrna b\lng tharn do (khong can thi~p vao nQi t~g):- LiSn SyOt6t va tren 1 nam, khong co tri~u chUng dinh t~c- NSu SyOnhan nhum ho~c sB thanh b\lllg- Co dAuhi~u diOOt~c ho~e ban t~c
81 Cae dUOngnQi soi qua thanh b\lng, khong can thi~p t~g trongBb\lng, da lanh SyOB~nh dlili,trvc trang:- Viem dlilitrang ho~c viern trgc trang cAp- HQi chUng d~i trang tang kich thich:+MucdQOOy+ Muc dQvua+MucdQn~ng- Viem loet trgc, d~i trang xufit huySt:+Nhy
+ Vira, n~g- Cae b~OOlanh tiOOcua d~i trang phai can thi~p phdu thu~t- Lao h6i trang- Ung thu dlilitrang- Tui thira d~i, trgc trang- Polip trlf'c, d~i trang (Polypose Rectocolique)- Polip trgc' trang (Polype rectal) co cu6ng 006 diSu tri hStduQ'c:+Da c~tbe+ Chuac~tbe- Polip tr\fc trang chay rnau
83 B~nh h~u mon - tr\fc trang:- Roh~urnon:
DIEM56-'-
2
5
2
4T
45
62
3T
345
5T65
5
65
6
2
5T5
15
"-=Z=""";-C-' 'T' _."-,, -'''CY' ,'••~..••.q"""-"-'''-7'g_'_'_ .''''~''.''''-'-'''"- - ..• , .
TT --...,.~... ..,- ," BtNHT~T f>utM+ Don gian dft di~u tri kh6i 2
+ Don gian chua di8u tri 3T
+ Ro h~u mon phuc tc;lP 5
- Sa tIVc trang 5
- NUt h~u mon:+ Dft di8u tri t6t 3
+ Nhi~m trung nhi~u IAn 4
84 Tri:- Tringo~i:+ 1 bili kich thuac duai 0,5 cm 2
+ 1 bili kich thuac til 0,5 cm dSn 1 cm 3
- Tri nQi ho~c trTkSt hqp 1 bili nh6 duai 0,5 cm 3
- Tri nQi, tri ngoc;li,ho~c tri kSt hQ'P nhi~u bili (2 bili tra len) 4kich thuac tit 0,5 cm dSn 1 cm- Tri dft rnB t6t 3
- Tri nhi8u hili, co bili to tren 1cm, bili tri 16i ra khong tg co len 5TduQ'c- Tri dft th~t, nay co bili trTtai phat 5T
85 B~nh gan:- Viem gan cAp 5T
- Viem gan cAp dft lanh tren 12 thling, suc kh6€ h6i ph\lc t6t 3
- Viem gan cAp dft lanh tren 12 thling nhung h6i ph\lc chua t6t, 5thli HBsAg (+)- Nguai lanh mang vi rut viem gan B ho~c C 3
- Viem gan m~ tiOOthe t6n t~i 4
- Viem gan m~ tiOOthe ho~t dQng 6
- Ung thu gan nguyen phat ho~c thu phat 6
- Slin la gan 4T
- Gan to chua xac dinh duQ'c nguyen oo~ 5T
- HQi chUng yang da chua ro nguyen nhful 5T
- Xa gan giai dOc;lncon bit 5
- Xa gan giai dOc;lnmAt bit 6
- D\lng gi~p gan dft duQ'c di~u tri baD t6n, kSt qua t6t 3
- Ap xe (abces) gan dft di8u tri fin diM 4
- Ap xe gan dft va gay biSn chUng tuy dft di~u tri kh6i 5
- S6i trong gan 4
16I
II
im_ ...m" .. f.
TT DIEM- Nang gan+<2cm+~2 cm- Umaugan- Ungthu gan
86 B~nh m~t, tUi m~t:- Soi tUi m~t, gay viem duang m~t- Soi duang m~t trong va ngoai gan, gay viem nhiBm ho~c t~cm~t- Ap xe duang m~t- Soi tUi m~t dan dQc, chua m6- Soi tUi m~t dff c~t tui m~t:+Khong anh huang t6i sinh ho~t+ Co anh huang t6'i sinh ho~t- Viem tUi m~t, viem duang m~t, viem tui m~t cftp do soi dandQc da:m6 tren 1 nam, 6n dinh- Viem duang m~t do soi ho~c do nguyen nhan khac- Soi dng m~t chu
87 T\lY- Viem tvy cftp the phu n~:+ Bff h6i ph\lC+ Tai phat- Viem tvy cftp the ho~i tir, xuftt huySt- Viemtvym~- Viem tvy cftp dff di~u tri ngo~i khoa 6n dinh- Nangtvy- Soi tvy- Ung thutvy
88 Lach- Lach to do cac nguyen nhan- Nang lach- Ap xe lach- Va lach do chAn thuang phai phdu thu~t c~t h:ich
89 Bao nguQ'c phu t~g
34-5
56
5T6
5T4T
454
5T6
356
5-644
56
4
4555
17
6. Cae b~nh v~ ho hip
TT B:f:NHT!T I>IEM90 HQi chUng va tri~u chUng b~nh ho hAp:
- Khai huy8t khong ro nguyen nhan 4T- Khai huy8t tAidi~n keo dai kern theo ho khl;lCdam, dau nglJc 6
- Ti8ng CQrnang ph6i ro, kern theo dau nglJc (viem mang ph6i 5kh6)- Ran Amho~c ran n6 OOi€u& 1 ho~c 2 day ph6i kern theo khai 5Thuy8t ho~c khl;lCdam OOi€u- HQi chUng 3 giam (day dinh rnang ph6i) 5- Gil, vc;;ocQt s6ng, bi8n dl;lllgxuang lIC va xuong IBng nglJc 6imh huang d8n chuc nang ho hAp- Di chUng sc;;o16ng nglJc do rn6 tim, ph6i ho~c sau chAn 6thuang nglJc Cll,aOOhuang dftn khi ph6i
91 Cac b~nh ph8 quan:- Viem ph8 quan cAp 3T ..- Viem ph8 quan cAptai di~n:+ Co cac yeu t6 nguy cO'co th~ chua khoi 4T+Cac ySu t6 nguy cO'khong th~ chiia khoi 4- Giful ph8 quan oo~co chAndom ro, chua co bi8n chfrng 5
- Viem ph8 quan ml;lntinh dan thuful, giai dOl;llldAu 5- Viem phe quan ml;lntinh b~t dAuco bien chfrng tam ph8 ml;lll 6tinh, suy ho hAp,khi phe thiing (COPD + tam ph8 ml;ln)- Khi phe thiing type A 6
- Hen ph8 quan:+Hen nhC;;khong co bien chUng 5+ Hen trung biOOva n~g, hen co bi8n chUng; hen ph8 quan 6kern theo viem xoang ham rnl;lnho~c polip mlii
92 Cac b~OOnhu rno ph6i:. - Viem ph6i cApdo vi khuAn, virus, Mycoplasma Pneurnoni 3T- Viem ph6i rnl;lntiOO 6
- San la ph6i, arnip ph6i 5T- Ken khi ph6i 5- HQi chUng Loffler 3T- B~nh b\li phc3i 6
- XO'ph6i ho~c XO'phc3ike Ian toa 6
93 Cac b~nh rnang phc3i:
18
TT BtNHT~T DIEM
- Phe m~c viem tnm djch to' huyet (Sera fibrineuse):+ Khong do lao, khong co di chUng day dinh mang ph6i 3T
+ Do lao, co di chUng day dinh mang ph6i 5T
- Viem mu mang ph6i khong co di chUng day dinh mang ph6i 6nhieu- Phe m~c viem, tran djch m~n tinh (keo dai tren 2 thang) phe 6~~c viem tran djch mau (mau hut ra khong dong), dUOng ch~plong nglJc- Voi hoa mang ph6i:+it 3
+ Nhieu, di~n rQng 5
- Xa hoa 16ng nglJc ho~c day dinh rQng toan bQmQt ben mang 6ph6i
94 B~nh lao ph6i:- Nghi lao ph6i (co hQi chUng nhiSm dQc lao, co tien su tiep 4T
~" xuc va tien su lao)- Khai huyet do lao 5T
- Lao ph6i nhy m6i m~c (lao tham nhiSm, lao huy~t BK am 5Ttinh (-) trong dam bfug soi trlJc tiep, khong co hang lao)- Lao ph6i m:6i m~c nhung co BK (+) trong dam bfulg soi trlJc 6tiep, co hang lao- Lao phili dli dieu trj 6n djnh va kh6i duQ'Ctren 3 nam, neu:+ Tru6c day khong co hang, hi~n t~i X-quang ph6i binh 4thUO'ng,BK (-), suc kh6e khong bj anh huang
+ Hi~n nay co bien chUng lao, xa ph6i, suy ho hdp m~n tinh, 6tam ph~ m~ tinh, gian phe quan
95 Lao ngoai ph6i:- Lao h~ch ngo~i vi dli kh6i 4
- Lao h~ch c6 m~n tinh ho~c ro mu 5
- Lao thanh quan dli kh6i 4
- Lao mang b\lIlg, lao xuang 5
- Lao tinh hoim dli m6, kh6i 4
7. Cae b~nh v~ tim, m~eh
TT BENHTAT J>IEM. .96 Huyet ap (tinh tr~ng HA khi nghi, thuang xuyen, tinh b&ng
mmHg):
19
..•.....-
TT B~NHT~T DIEM
- Huy~t ap t6i da:
+ 110 - 120 1
+ 121 - 130 ho~c 100 - 109 2
+ 131 -139 ho~c 90 - 99 3
+ 140 - 149 ho~c < 90 4
+ 150 -159 . 5
+ > 160 6
- Huy~t ap t6i thi8u:
+<80 1
+ 81 - 85 2
+ 86 - 89 3
+ 90 - 99 4
+ > 100 5
97 B~OOtang huy~t ap:
- Tang huy~t ap d9 1 4
- Tang huy~t ap d9 2 5
- Tang huy~t d9 3 6
98 M~ch (tioo tn;mg m~ch khi nghi, thuOng xuyen deu, tinh bfu1gIftnJphut):
- 60 - 80 1~ - 81 - 85 ho~c 57 - 59 2
- 86 - 90 ho~c 55 - 56 3
- 50 - 54 3 - 4 (dgaVaGnghi~mphap Lian)
- 91 - 99 4
- > 100 hoac < 50 5,6- .99 R6i lo~n dful truyen va nhip tim:
- Block nhi thdt d9 I 4
- Block nhithdt d9 II 5
- Block nhi thdt d9 III 6
- Block nhanh phai:
+ Khong hoan toan 2
+ Hoan toan 4
- Block nhanh trai:
+ Khong hoan toan 5
20
TT BENHTAT DIEM. .+Hoan toan 6
- Block nhanh phai + block nhanh trai 6
- Lo~ nhjp ngo~i tam thu that:
+ Cac NTT mat ho~c giam di sau v~ dQng 2
+NTT that thua (1 - 9 nhjp/gi6') 3
+NTT that trung binh (10 - 29 nhjp/gia) 4
+NTT that day (2:: 30 nhjp/gia) 5
+NTT that da 6 6
+NTT that timg chUm ho~c RlT 6..-
+NTT that trong cac b~nh tim th\fc th~ 6
- Lo~ nhjp ngo~i tam thu nhi 5
- Rung cu6ng nhi, lo~ nhjp hoan toan 6
- HQi chUng nut xoang b~nh ly 5 ._--- Con nhjp nhanh kich phat 6
100 B~nh h~ thBng m~ch mau:
- Viem t~c dQng m~ch cac lo~i 6
- R6i lo~ v~n m~ch (b~nh Raynaud) 6
- Viem t~c tinh m~ch nang ho~c sau chi du6'i 5
101 B~nh tim:
- B~nh tim bAm sinh:+ Chua gay r6i lo~ huy~t dQng dang ke 5
+ Co r6i lo~ ve huy~t dQng 6
+ Dff duQ'ccan thi~p ho~c ph~u thu~t tru6'c 16 tu6i 4
- B~nh van tim 6
- Viem nQi tam m~c nhiem khuAn 6
- Suytim 6
- Viem cO'tim va cac b~rih cO'tim 6
- Thap tim (thfip khD'p cap) va b~nh tim do thap 6
- Cac b~nh mang ngoai tim 6
- Cac khBi u tim 6
21
8. Cac b~nhv~coo,xU'O'ng, kh6'p
TT BtNHT!T DIEM
102 B~nh khap:
- Cae b~nh kh6'pnhi8m khu~n 5T
- Lao khap, lao eQts6ng 5
- Viem khap nhi8m khuful,hQichUngReiter, viem khap Lyme, 5Tcae b~nhnay mm khoi chua qua 6 thang- Cae b~nh viem kh6p do thAp,viem khap d~g thAp,viem eQts6ng dinh khap (Beehterew):+ Neu chua gay teo ho~c bien d~g kh6'p, cUng kh6'p, ehue 4nang khap chua h~ che, sue khoe toan than t6t+ Neu da:gay teo cO',eung kh6'p, bien d~g kh6p, h~ che ehuenang khap, anh huang t6i suc khoe toimthan:• Muc dQoo~va vita 5
• Muc dQn~ng 6
103 Ban chan b~t:
- Di l~i khong gay dau OOoi 2
- Di l~i dau nhoi, aOOhuang mang vae, eh~y OOay 4
104 Chai chan, m~t Cel, r6 chan: ~
- Chai chan (Durillon) day simg nhung nfut con mSm, di l~i 2khong anh huang
- Chai day simg gay cQmeUng,di l~ianh huang 4
- M~t ca long ban chan (Corpolantaire):
+ Chi co 1 cai, dUOngkinh :51em, di l~ikhong anh huang 2
+ Co 2 cai, dUOngkinh:5 1em, di l~ikhong aOOhuang 3
+ Co ~ 3 cai, ho~c co 1- 2 eai nhung dUOngkiOOtren1cm, 4ho~c m~t ca gay anh huang dell'di l~i- R6 chan (Porokeratose):
+ Co 1- 2 diSm lorn trong 1cm2, duang kiOOcac diSmlorn du6i 22 mm, di l~i khong anh huang+ Co tren 2 diSm lorn trong 1em2, ho~e dUOngkiOOcae diSm 310m tren 2 rom, di l~i khong anh huang+ Co tren 2 diSm lorn trong 1cm2 va duang kiOOcae diSm lorn 4tren 2 mm, di l~i khong anh huang
r" ,'""-",=-_,wTW,,W_'.U"'T""'"''
I!
22
.'
TT B:tNHT~T BIEM
+ R6 chan anh huemg d~n di l~i 5
105 Dinh ke ng6n tay, ng6n chan:
- Chua xu tri phfiu thu~t:
+ it anh hUOngd~n ho~t dQng 3T
+Anh huang d~n ho~t dQng cua ban tay, bim chan 4T
- Da xu tri phfiu thu~t:
+Kh6ng ho~c rdt it anh huemg d~n v~ dQng 2
+ Co keo, anh huemg d~n v~ dQng cua bim tay, ban chan 4
106 Thira ng6n tay, ngon chan:
- Chua c~t bo 3T
- Da c~t bo, n~u:
+Kh6ng anh huang d~n ho~t dQng cua ban tay, ban chan 1
+ it anh.hu6ng dSn ho~t dQng cua bim tay, bim chan 2
+ Anh huang nhieu d~n ho~t dQng cuaban tay, ban chan 4
107 Mdt ng6n tay, ngon chan:
- Mdt 1 dBt:
+ Cua 1 ng6n tay cai 4
+ Cua ng6n tro ban tay phai 4
+ Cua 1 ng6n chan cai 4
+ Cua 1 ng6n khae cua bim tay ho~c ban chan 3--
- Mdt 2 dBt:
+ Cua ngon tay tro cua ban tay phai 5
+ Cua 1 ng6n khae cua ban tay ho~e ban chan 4
+ Cua 2 ng6n khae cua ban tay ho~e ban chan 5
- Mdt 1 ng6n:
+Mdt 1 ng6n cai eua ban tay 5
+Mdt 1 ng6n cai eua ban chan 5..-
+MAt 1 ng6n tro eua ban tay phai 5
+Mdt 1 ng6n khae cua ban tay ho~c ban chan 4
23
TT BtNH T~T DIEM
- Mfit 2 ngon:
+ Mat 2 ngon trong d6 kh6ng mfit ng6n tay cai, ngon chan cM 5va ng6n tro ban tay phai
+ Mfit 2 ngon trong do co mfit ngon tay cai, ng6n chan cai, 6ngon tro ban tay phai
- Mfit 3 ngon tra len 6
108 Co rut ngon tay, ngon chan:
- Co rut ill 1 - 2 ngon tay ho~c ngon chan 5
- Co rut ill 3 ngon tay ho~c ngon chan tra len 6
109 L~ch Vyongon chan cai vao trong (Hallux varus) hay ra ngoai(Hallux valgus):
- Neu khong anh huang tai di giay, dep va mang vac, ch~y,nhay
- Neu anh huang tai mang vac, ch~y, nhay
110 Chfin thuang, vet thuong kh6'p (vua va 100):
- Chua diSu trj khoi
- Dii diSu trj khoi, kh6ng de l~i di chUng
- Dii diSu trj, de l~i di chUng anh huang v~ dQng
111 Sai khap xuang:
- Sai khap nho, vua:
+ Chua diSu tri khoi
4
5
4T
3
4
3T
+ Dii diSu tri khoi, khong de l~i di chUng 1
- Sai kh6p vua dii diSu tri nhung de l~i di chUng thanh c6 t~t 4can tra den lao dQng va sinh ho~t- Sai kh6'p 1611:
+ Dii nful chinh kh6ng de l~i di chUng 4
+ Dii nful chinh de l~i di chUng 5
+ Diidugc phftu thu~t nful chinh:
• Neu kh6ng de l~i di chUng, dff dugc theo d5i 1.nam tro len, 4lao dQng sinh ho~t binh thuemg
• De l~i di chUng nhy 5
24
TT BENHTAT. . DIEM
1
3T
• BS l~i di chUng dau, h~ che v~ dQng, thmii hmi bien d~ng 6ho~c cUng kh6p
- Sai kh6p IOn khong n~n chinh thanh cd t~t can tra den lao 6dQngva sinh ho~t
- Sai kh6p b~nh ly a cac kh6p 100 6
- Sai kh6p tai phat nhieu IAn 6
112 Gay xuong:
- Gay xuong nho:
+ Chua lien xuang
+ Btl lien xuang, khong anh huang v~n dQng
+ Btl lien xuang, co aM huang v~ dQng 2
- Gay xuong vira va 100:
+ Chua lien xuang 51
+ Btl lien xuang vfmg a tu the binh thuOng,khong de l~i di 2chUng dau moi ho~c h~ che v~ dQng (thai gian tir khi gayxuang den khi kiem tra 1 nam tra len)
+ Btl lien xuang vfmg, cong l~ch tIvc khong quan trQng, h~ 3che v~n dQng kh6p, khong gay dau rnoi, khong gay thoai hoabien d~ng kh6p,- khong aM huang dang ke tai sinh ho~t, ho~tdQng cua chi
+ Btl lien xuang nhung ttvc l~ch VyO, h~ chS v~ dQng 5
+ Co dau moi h~n che v~n dQngnhieu 5
+ Co dau moi, thoai hoabien d~g kh6p nhieu 6
+ Btl phdu thu~t nhung con phuong ti~n ket xuong 51
113 Kh6p gia xuang dai ill chi:
- Kern theo mAt do~n xuang 100, ng~ chi ill 5 cm tra len ddi 6vai chi tren va ill 3 cm tra len ddi vai chi duai
- Khong kern theo ng~n chi 5
114 Di d~g bfun sinh:
- Sai kh6p lOn, mAtdo~n xuang, mAtdAuxuang.
115 Cung, dinh cac kh6p Ian:
6
25
, - zm", _
TT B~NHT~T DIEM
- C(mg, dinh cac khOp vai, khu)ru, g5i, hong . 6
116 Cung, dinh khOp c6 tay, c6 chan:
-a tu th6 co nang 5
- Khong a tu th6 co nang 6
117 Chenh l~ch chi~u dai chi:
- Tu 2 cm tra xu6ng, khong gay dau rnai trong sinh ho~t, lao 4dQng
- Tu 3 - 4 cm, it nhi~u anh huang t6'i thfun my va dau mai khi 5lao dQng, sinh ho~t- Tn3n 5 cm, dli anh huang t6'i thfun my va dau mai khi lao 6dQng, sinh ho~t
118 Hai chan vong ki~ng hinh chft 0, chft X:- Nh~, khong anh huang t6i di l~i, ch~y nhay (5 -10 dQ) ho~c 4anh huang khong dang kS- Vua (du6i 15 dQ) di l~i, ch~y nhay it anh huang 5
- N~g (tren 15 dQ) thuOng kern theo bi6n d~g a c~ng chan, 6ban chan, anh huang den chuc nang v~ dQng
119 Cong gil cQt s5ng:- Vii 6n djnh (khong tien triSn, khong gay viem ro, dau mai) 4
- AM huang t6i rnang vac, v~n dQng, ch~y nhay 5
- N~g: do di chUng b~i li~t, di ch(mg chAnthuang ho~c do lao 6CQts6ng pha huy d6t s6ng
120 Roxuang:- Dan gian, co xuong viem khu trU, khong pha huy xuang rQng 5T
- Ro cac xuang lan, fO lien tlfc, hay rei phcit 6
121 B~nh u xuang, s\lllianh tinh a nhi~u xuang:- Dii m6 d\lc ba u, khong anh huang t&ichuc nang 4
- Chuam6 5
122 6 khuyet xuang a xuang dai:- Anh huang den dQwng cua xuong 5- Khong anh huang den dQvftng cua xuong 4
123 Ho~i ill vo khudn cham xuong dili 5124 Viem va khudn 16ieu tru6c xuang chay 3125 Ho~i ill vo khudn mao xuang chay:
26
TT BENHTAT DIEM. .- Bft m6 dl)c xuong, ket qua t6t 4
- Chua rn6, dau tai phat nhi~u Ifill 5T
126 Ho~i til' vo khufin 16i cdu xuang canh tay 4T
127 Ban chan thu6ng:- Khong ng~n chi ho~c co ng~ chi ill 1 - 3crn 5
- Co ng~ chi tren 3cm 6
128 BUt gan got (gan Achill) 5
129 Dj t~t ban chan kheo:- Ca 2 ban chan 6
- 1 ban chan 5
130 Di chUng b~i li~t, li~t rn~rn a chi thS:-MircdQn~g 6
- Mirc dQvua 5
131 Di chUng b~i nfto, li~t cirng a chi thS 6
132 Ban tay kheo 6
133 Dj t~t bfun sinh thieu xuang a chi thS (xuO'ng quay, xuong 6chdv...)
134 S~o bong va cac lo~i s~o do cae nguyen nhan khac:- Nho, dft lanh, khong anh huang den v~ dQng, sinh ho~t va 1 - 2lao dQng -- Nho, dft lanh, co anh hUOngden thfun my (0 rn~t, c6): ~,
3+ It,
+Nhieu 4
- Co keo gay bien dang:+AM hUOng it d€n chirc ph~, sinh ho~t va lao dQng 4
+AM huang nhi~u d€n thfun my, lao dQng, sinh ho~t 5
135 Giftn tinh m~ch chan (Varice):- Chua thanh btii 3
- Bft thanh btii, ch~y OOaydi l~i nhi~u thi ding, mc 4
136 Cac lo~i u:
- U lanh tiOO(u rna, u XO',nang nhay, u xuong), kh6ng aOOhuang t6i suc khoe, lao dQng, luy~n t~p, sinh ho~t:, ,
+Neu dUOngkiOOkh6i u duai 1cm: 1
+Neu dUOngkinh kh6i u ill 1 - 2cm: 2
+Neu dUOngkinh kh6i u ill 3 - 4cm: 3
27
"1""-." ..". "",," ,..... '71'; -~~-'~'-C'IT"~~c',~"mI
TT B~NHT~T DIEM
-U lanh tinh (u rna, u XO, nang nhay, u xuang) da:8.nhhuang tai 4sinh ho~t, lao dQng, luy~n ~p, ho~c kich thuac 2: 5cm
- Cac lo~i u ac tinh a cac vi tri 6
9. Cae b~nh v~ th~n, ti~t ni~u, sinh dye
TT B~NHT~T DIEM
137 Th~, ti~t ni~u:
- B~nh th~ cAp tiOO OOu: Viem cAu th~n cAp, viern be th~ 5cAp, viem Bng th~ cAp do cae nguyen OOan rnai kh6i b~OOchua qua 6 thang
- B~OO th~ m~n tiOO: Viern cAu th~ m~ tinh co hQi chUng 6th~ hu, suy th~ m~ tiOOdo cac nguyen OOan
- S6i th~n chua co bi~n chUng:
+ Chi co a 1 ben, da:mB k~t qua t6t tren 1 narn 4
+ Chua mB ho~c co s6i a 2 ben 5
- S6i th~ co bi~n chUng phai c~t 1 ben th~ 6
- U th~n dam6 6
- Nangth~: ~
+ Chi co 1 nang, duemg kiOOduai O,5cm, khong chen ep dai, 3beth~
+ Co tir 2 nang tra len ho~c duang kiOO tren O,5cm, khong 4chen ep dai be th~+ Kich thuac lan, chen ep dai be th~ 6
- S6i ni~u quan dan thudn, 1 ben:
+ Dii lAy s6i khong qua phdu thu~t 3
+ Dii phdu thu~t lAy s6i (k~ ca phdu thu~t nQi soi) 4
+ Chua lAys6i 5T
- S6i ni~u quan dan thuAn, 2 ben (k~ ca da:phdu thu~t) 5
- S6i ni~u quan da: phdu thu~t co bi~n chUng (ro nuac tieu, chit 6h~p gay gian th~n ho~c viern th~n)
- S6i bang quang, ni~u d~o:
28
6
6
6
6
6
6
6
6
5T
6
6
6
6
5T
3T
4
5T
5
DIEM
4T
3
4
5"
TT
- Th~ m6ng ng\la
- Th~ kep 1 ben co bien chUng
- Th~ kep ca 2 ben
- Th~ l~c ch6 (1 - 2 ben) ho~c 1 th~
141 Kh6i u sau phuc rn~c:
- U th~n dffrn6 ho~c chua m6
-U tuyen thugng th~n (huyet ap cao)
-U rna, u quai, u thfrn kinh, u h~ch
142 Lao duemg tiet ni~u, sinh d\lc:
- Lao th~ dii rn6 ho~c chua rn6
- Lao th~ de l~i di chUng hyp ni~u qmin
- Lao bang quang, lao tuyen ti~n li~t
- Lao mao tinh hoan (u C\lCho~c ra)
143 Cac dj t~t a ni~u quim:- Ni~u quan n&rnsau tinh rn~ch chil
+ Chua lAysoi+ Dff lAysoi khong qua phdu thu~t, ket qua t6t+ Dffphdu thu~t lfty soi, ket qua t6t
+ Dffphdu thu~t nhiSu IAn138 Cac hQi chUng tiet ni~u:
- Bai r~t, dai bu6t, dai kh6
- Con dau qu~n th~n hay tai di~n
- Bai ra mau chua ro nguyen nhan, dai ra mil, dUOngchftp
139 Viem duemg tiet ni~u:
- Viern be th~n - th~n cftp, viern ni~u d~o do l~u, viern tuyentiSn li~t
- Viern ni~u d~o thuOng, viem bang quang cAp
"140 Cac b~nh th~n bAm sinh:
- Sa th~ (1 ho~c 2 ben)
29
TT B~NHT~T
- Ni~u qulin nb sau dQng rn~ch ch~u
- Ni~u qulin kep 1 ben
- Ni~u qu{mkep 2 ben
- Ni~u qulin l~c chB
DIEM
6
6
6
6
144 Cae b~nh a bang quang:
-Unh6 bang quang 5
-Unh6 bang quang dii rn6, h6i ph\lc t6t 4
-U ac tinh bang quang 6
- Tui thira bang quang, h~p e6 bfmg quang 5
145 Sinh d\lc:
- H~p bao quy dAu khong anh huang ti@uti~n, ho~c dii phau 1thu~t k8t qua t6t
- H~p bao quy dAu anh huang ti@uti~n 3T
- H~p ni~u d~o do di chung l~u, chfuI thuang fa va h~p ni~u 5d~o khac
146 Cae dj ~t duang v~t:
- L6 dai l~ch thdp (hypospadias) 5
- L6 dai l~ch cao 6
- C\lt duang v~t 6
- Ni~u d~o kep 6
147 Di t~t a biu:- Thi8u 1 ben tinh hoan
- Tinh hoan fin ho~c llilCchB 1 ben chua gay bi8n chUng- Tinh hoan fin ho~c llilCchB 1 ben dii gay bi8n chUng
- Thi8u ho~e dn ca 2 ben tinh hoan
- Ai nam, ai nu-U tinh hoan dan thudn
-Umao tinh hoan (khong phai lao)
- Tran djch rnang tinh hoan dii rn6 t6t
- Tran djch rnang tinh hofm chua rn6
3
3T4T6
6
5
4T
4
5
30
TT BENHTAT DIEM. .- Viem day da tinh hoan 5
- Tran m{mmang tinh hoan 5- Viem 10etda biu. 5T- U nang thung tinh:
+Chuam6. 5+ Ba m6 tren 6 thang, di~n biSnt6t 4- Teo tinh hoan:
+ Teo ca 2 ben do quai hi 6
+ Teo 1ben do b~nh khac, nSub~nh da 6n dinh 4- Teo mao tinh hom 1-2 ben 5- U nhil qui dAuva ranh qui dAu 5T
,)48 Ung thu duang v~t~ 6
149 Viem tinh hoan, viem mao tinh hoan 4T,--
150 Gian tinh m~ch thUng tinh (Varicocel):
- Nh~ 2~Vua 3
"
~-N~g 4
10. Cae b~nb v~ nQiti~t, eblly~n boa, b,eb, mall
TT B~NHT~T DIEM[
151 B~nh tuySn giap:- Viem tuySn giap cap tinh 3T- Viem tuySn giap nr mi~n 5- B~nh Basedow 5- BuOu lanh tinh nho, sa thay, chua anh huang t6'i h6 hap 3- Bmw lanh tinh to, c6 anh huang t6'i h6 hap, n6i, nu6t 5- Ung thu tuySn giap 6
152 B~nh ly tuySn thugng th~ 6--
153 B~nh ly tuySn yen 6
154 B~nh ly chuySn h6a
31
TT B~NHT~T flIEM
- B~nh dai thao duang 5
- B~nh Goutte m~ tinh 5
- RBi lo~ chuyen hoa Lipid 4T
155 HQi chUng nQi ti~t c~n u 6
156 Phi d~i tuy~n wa nam gi6i (1 hoij.c 2 ben), arm hUOng thAm 4my
157 Cac b~nh h~ch va b~nh mau ac tinh 6
158 Thi~u mau nij.ngthuemg xuyen do cac nguyen nhan 5
11. Benh da Ii~u.TT B~NHT~T
159 Ndm da, nb b~n (h~c lao):- ThS dien hinh, chua co bi~n chUng, di~n tich du6'i 50cm2
- Ndm da di~n dch til 50 - 100cm2 chua co bi~n chUng., hoij.cnfim da di~n dch du6'i 50cm2 nhung co bi~n chUng cham hoa,nhiSm khuftn ...- Nb da di~n tich tren 100cm2, hoij.cnii rac toan than, hoij.c cobi~n chUng nij.ng(cham hoa, nhiSm khufuJ...)
160 Nb mong:- Co ill1-2 mong hi nb- C6 ill 3 - 4 mong bi ndm- C6 ill 5 m6ng tra len bi ndm
161 Nb ke:- Chi bQ1:tr~ng ill 1 - 2 ke- Chi bot tr~g ill 3 - 4 ke- BQ1:tr~ng ill 5 ke tra len, hoij.cco m\ln nu6c til 3 ke tra len
162 Lang ben:- ThS khu tru (mij.t hoij.c vai hoij.c lung ...), di~n tich du6'i 1/3di~n tich co the- The Ian t6a chi~m tren 1/3 di~n tich co the- ThS Ian t6a chi~m tren 1/3 di~n tich cO'th8, anh hUOng d~nthfun my (bi nhi€u vimg mij.t,c6, gay)
163 Ndm toc,f\lng toc do cac nguyen nhan:- Muc dQnh~- Muc dQvua- Muc dQnij.ng
164 Bj m~c til' 2 lo~i ndm neu tren tra len (ill m\lc 158-162)
flIEM
2T ~3T
4T
234
2T3T4T
2T
3T4T
345
Ldy di€m cua -
32
TT BtNHT~T DIEMnhi€m lo~i
;.namn~gnhAtva tanglen 1diSm
165 Ghe:- Th~ giim don, khu tnl, chua co bi~n chUng: Viem da nhi8m 2T,khuan, cham hoa...- Th~ co bi~n chUng: Viem da nhi8m khudn, cham hoa..., 3Tnhung con khu trU- Ghe nii rac toan than va co bi~n chUng: Viem da nhi8m 4Tkhudn, cham hoa...
166 Viem da dt tmg- Viem da dt Ung/kich thich 3
- Cham vi khudn 3T- Cham hoa do b~nh da khac (nfun, ti~p xuc ... ) 4T- A simg lien cAu, a sung vimg dAu (cham khong ro nguyen 2nhan)
- Viem da co dia 6
- Viem dadAu 4
- T6 dia 5
- Viem da thAnkinh
+Khu trU 4T+ Lan tDa (nhieu nai) 5
167 B~nh da b<;mgnuO'c(pemphigus, Pemphigoid, Duhring Brocq) 6
168 B~nh t6 chuc lien ket:- Lupus ban do:+ Lupus han do miiln(khu trU) 5.+ Lupus han do h~ th6ng 6
- XO' cUng hi:+Khu trU 4
+Lan toa 6
- Viem hi co 6
- Viem nut quanh dQngm~ch 5169 B~nh da co yay:
- B~nh vay nen cac thS 4-5-633
--,
TT B~NHT~T DIEM
- A vayn~n 3
- Vay phdn hBngGibert 3T
- Lichen ph~ng 5
- Vay phftndo nang long 3
. 170 B~nh r6i lo~ sic t6:
- B~nh b~ch bi~n:
+ The khu trU, dUt:do~ 3
+ The Ian toa 4
- S~m da
+Khu trU vung rna (mimrna) 2
+Rai rac (nguyen nhan nQiti~t) 5
171 Cac t~t bAmsinh 6 da, bOicac lo~i:
- Di~n tich du6i 3cm2, khong 6 vung rn~t- c6 1
- Di~n tich tich til J - 9crn2 khong 6 vimg rn~t - c6, ho~c di~n 2tich du6i 3 cm2 6 vung m~t - c6- Di~n tich ill 10 - 20 rn2 khong 6 vimg rn~t- c6, ho~c di~n tich 3ill 3 - 4cm2 6 vung m~t - c6- Di~n tich tren 4 cm2 6 vung m~t - c6, ho~c di~n tich tren 420cm2, ho~c co rai rac nhiSunai ~
172 B~nh phong tfttca cac the: 6
173 B~nh lay theo duemgtinh d\lc:
- Giang mai:
+Giang mai giai do~ 1 va 2 s6m, da:diSutri dung, dli phac dB 3va xet nghi~rnTPHA am tinh
+ Giang mai giai do~n 2 rnuQn,da:diSutri dung, dli phac d6 va 4xet nghiem TPHA am tinh.
+Giang mai giai do~n 3 6
+ Giang mai chua diSu tri 6n dinh 5
-L~u:+ L~u cftpda:diSu tri khoi 2
+L~u cftpchua diSu tri 4
+L~u m~nco t6n thuang bQph~ ti~tni~u, sinh d\lc 5
- B~nh h~ cam (Chancremou):
34
TT BENHTAT DIEM. .+Dli diSu trj khoi 3
+ Chua diSu trj 4
- Sui mao ga (Papyloma) 4
- B~nh Nicolas-Favre 5
-Nhi~rnHIV 6
174 Day sUng long ban chan co dja 5
175 Trtrng ca va mQt s6 b~nh khac:- Trtrng ca thuang (chi tinh vimg m~t):
+Du6i 100 sAn,khong co m\ln mil 1.+ Til' 100 - 200 san vaJho~c < 5 m\lll mil 2T
+ > 200 sAnvaJho~c ~ 5 m\ln rnu 3T
- Trirng ca ho~i tU, trirng ca m~ch luan, trtrng ea Syo 16i 4
- Trtrng ca do 5..
176 San ngua C\lCdo con trung d6t (ru6i vang, b9 cho, dIn ...):
+ s6 hrQ'Ilgdu6i 10 n6t 2T,
+ Til' 10 - 30 not 3T
+ Til' 30 - 50 n6t 4T
+ Tren 50 n5t"-5..-
177 May day m~ tinh 6
178 Lao da cac lo~i 5..-
179 Cac b~nh u da:-U xo thdn kinh (b~nh di truySn) 5
- Cac lo~i u lanh tinh khac 4
180 Cfty dj v~t vao duong v~t 4T
12. B~nh phI} khoa
TT B~NHT~T DIEM
181 Kinh nguy~t:
- Kinh nguy~t nhiSu, hay xuftt hi~n va khong dSu 4
- VO kinh, thi~u kinh, hiem kinh 5
- Chay mau bftt thuang khac eua tir cung, am d~o 5
182 U co trOll tir cung (dli phau thu~t boc u ho~c chua phau thu~t) 4T
35
TT BtNHT!T DIEM
183 U lanh hu6ng trimg (da:phfiu thu~t boc u ho~c chua phfiuthu~t) 4184 U lanh cua cac cO'quan sinh d\lc khac khong xac diM (da:phfiu 4
thu~t hoc u ho~c chua phfiu thu~t)185 Lo~ san vu tanh tinh 4186 VUphi d~i 4187 Bien d6i khac a vU 4188 Viem voi ill cung va viem hu6ng trfulg 4189 Viem voi tit cung tm c6 ill cung 2-3190 Viem c6 tUcung 4T191 Cac b~nh cua tuy~n Bartholin 4T192 Cac h~nh khac cua am d~o va fun hQ 4193 L~c nQim~c ill cung 4194 P~lyp duang sinh d\lc nfr 4T195 Nhfing di t~t hfun sinh cua hu6ng trung, voi trimg va day chAng 4
rQng196 Oi t~t bAmsinh cua tUcung va c6 ill cung 4197 Cac dj t~t bAmsinh cua cO'quan sinh d\lc nu
- Am d?o doi 4T- OJ t~t hAmsinh fun v~t 4-6- Mang trinh khong thung 3T- OJ t~t hAmsinh cua vu 4- Cac dj t~t hAmsinh khac cua CO'quan sinh d\lc nu 4
198 Co thai (nhung chua duQ'cchAndoan khftngdjnh) 4T199 Sui mao ga (Papyloma) a h~umon, sinh d\lC 4
36
III. DANH Ml}C cAc B~NH MIEN BANG KY NGHiA VV QUAN 81/(Bang sa 3):La nhfing b~nh thuQCdi~n miSn dang ky nghia V\l quan S\f, khong OO~nvao qUIDthuemg trvc, g6m:
TT TENB~NH MAB~NHICDIO
1 Tam thfrn F20-F29
2 DQngkinh- G40
3 B~OOParkinson G20
4, H54.4MumQtmat
,5 Diec H90
6 Di chung do lao xuong, kh6p B90.2
7 Di chUng do phong B92,
8 Cac b~OOly ac tiOO COOden C97;,DOOdenD09;
D45-D47
Nguai nhiSm mv,
9 B20 denB24,Z21
10 Nguai khuyet t~t muc d(fd~c bi~t n~g va n~g
37
IV. Chu din kham tuySn
1. Kham thS Il}'c:
a) Cach quy trcm s6 li~u: ChiSu cao, vang nggc, can n?ng tu 0,5 tra len ghi la 1don vi; tir 0,49 tra xu6ng thi khong Idyphftn Ie.Vi d\l:- Cao:+ I52,50cm -ghi la 153cm+ 158,49cm ghi la 158cm- Cann~g:+ 46,50kg ghi la 47kg+ 51,49kg ghi la 51kg- Vang ng\fc:+ 82,50cm thi ghi Ia 83cm+ 79,49cm thi ghi la 79cmb) Kham th~ Igc: Khi kham th~ l\I'c,nguai dugc kham phai bo mil, non, khong digiay ho~c dep (chan dftt, dau tran): NSu lit nam gim phai cai hSt quan aGdai, ao16t, chi m~c 1 quan dui. NSu la nil' giai m~cquan dai, ao mongo_ Do chiSu cao: Nguai dugc do phai dung a tu th~ thfulg, 2 got chan chlilmvaonhau, 2 tay buang thong t\l' nhien, m~t nhin ngang, tam nhin Ia 1 duang th~ngn&mngang song song vai m?t dftt.+ Thuac do: NSu do chiSu cao b&ngthuac a ban can thi phai chu y keo phantren cho h~t cO',sall d6 diSu chinh de IftykSt qua phan duai cua thuac.+ NSu dung tuang, cQt ke thuac de do thi tuang ho?c cQt phai th~ng dUng, nSnde dUng khang g6 ghS, phai vuong goc vm tuang ho?c cQt lam thuoc do.+ Nguai dUng vao vi tri do, got chan, mong, xuong ba vai chlilIDmang. Thuacd~t Ifty k~t qua do chlilmdinh dau phai vuong g6c vai mango_Do vong nggc (d6i vai nam gioi): Vang do qua nggc vuong goc vai tf\lC thandi qua num vu a phi a truac, qua 2 ba duai xuong ba vai a phia sau. Dung thuacday do, nguai dugc do hit thO'binh thuO'ng.D~ chinh xac ta do khi hit vao t6i dava tho ra t6i da, Idy 2 gia tri d6 cQng llilichia trung binh, tinh nhu sau:
Vong ng\fCtrung binhHit vao t6i da + thO'ra t6i da2
- Chi s6 BMI (Body Mass Index) la chi s6 kh6i co the danh gia m6i tuongquangiil'a chiSu cao va can n~ng:
BMI =Can n~ng (kg)
{ChiSucao (m)}2
38
Chi s6 BMI duQ'cxem xet trong truOng hgp du tieu chuful vS thS l\fc, nhung coS\fmAtcan d6i giiia chiSu cao va can n~g: khong nh~ OOiingtruOng hQ'Pco chis6 BMI ~30.
2. Kham mit:
S6 1: Thi l\lc: Thi l\lc la tieu chuAnco bim dS danh gia suc OOincua timg m~t,mu6n do thi l\lc chiOOxac, yeu cAu:_Nhan vien chuyeri. mon: Phai tf\lc tiSp hu6ng ddn cach dQc va tiSn hanh dungky thu~t quy dinh. Chu y phat hi~n OOiingtruOng hQ'Pnguai dQc khong trungth\fc ho~c khong biSt dQctheo huang ddn.- Bang thi l\fc phai:+ Chfr den, nSn tr~ng, hang 7/10 dSn 8/10 phai treo ngang tfimm~t OOin.+ UUdQaM sang cfin thiSt dS dQc(khoang 400 - 700 lux) tfaM mQihi~n tuqnggay loa m~t, qua sang ho~c sang dQivilOm~t nguai dQc ho~c t6i qua aOOhuemgt6'i suc nhin cua nguai dQc.+ C\lly giua bang t6i ch6 dUng cua nguai dQc 1a5m.-+ Nguai dQcphai che m~t 1 ben b~ng 1miSng bia Clrng(khong che bfuIg tay) vakhi dQCca 2 m~t dSu rna (1 m~t rna sau bia che).+ Nguai do dung que chi van du6'i tUng chii, nguai dQc phai dQcxong chfr dotrong khoang du6'i 10 giay. Hang 8/10, 9/10, 10/10 m6i hang chi duQ'cdQc sai 1chii m6'i tiOOkSt qua hang do._Cach tiOOtang thi l\lC2 m~t: nSu thi hrc cao han 10/10 vdn chi tiOOla 10/10Vi d\l: M~t phai 12/10, m~t tnii 5/10 thi t6ng thi l\fc 2 m~t la 15/10.Khi tinh tang thi l\fc d~ phan 10l;lithi chu y thi l\lc cua m~t phai. Thi l\fc cua miittrai khong thS bi! cho rn~t phiii duQ'Crna thj l\fCcua rn~t phai vdn phai nhu tieuchufrn dli quy dinh.
3. Kham rang:
sa 19: Rang sau:Quy dinh ky hi~u sau rang b~ng chfr "S".- 8 1: sau rang UQ 1 (sau men);- 82: sau rang UQ 2 (sau nga nong);- 83: sau fang UQ 3 (sau nga sau).Vi d\l: Rang 46 bi sau dQ3 thi ghi IS.: R46S3sa 20: MAtrang.a) Quy dioo vS ky hi~u fang: M6i rang dSu co ky hi~u b~ng hai chfr s6:- Chii s6 dfiu la ky hi~u cua phdn tu ham eua d6i tuqng:
39
rnm=_-I,
Phia Phii Trai
Tren I 2
Du6i 4 3
+Nhiing rang ham tren ben phai co ky hi~u s6 1.+ Nhiing rang ham tren ben tnii co ky hi~u s6 2.+ :Nhiing rang ham du6i ben tnii co ky hi~u s6 3.+Nhfrng rang ham du6i ben phai co ky hi~u s6 4.
- Chfr s6 thu hai ky hi~u cua timg rang:+ Rang cua gifra: S6 I+ Rang khon trong cling: 86 8
Vi d\l:+ Rang nanh ham tren tflii ky hi~u 23+ Rang ham s6 5 du6i phiii ky hi~u 45
- Rang ham co:+ Rang ham nho.(rang c6i nho): g6m rang s6 4 va 5;+ Rang ham Ian (rang c6i Ian): g6m rang s6 6, 7 va 8 (rang khon).b) Cach tinh sue nhai:- Rang bi viem my ho~c my bi ho~i tu chi coi nhu la mAt sue OOai~m thai.- Rang bi lung lay d~n muc dQ khong di8u tri dugc cdn phai 006; ho~c mAt h~t thanrang con chan thi coi OOumAt rang.- NSu mAt I rang thi coi nhu mAt ca rang cung s6 d6i di~n v6i m~t nhaLVi dl): MAt rang 16 thi coi nhu mAt ca rang 46 va dnh mAt 10% sue nhai. ~- N ~u mAt 4 rang khon ham tren va du6i thi khong tinh Ia mAt sue nhai (vi conhi8u nguai khong co rang khon).
Cach tinh sue nhai:
% sue 2 5 5 3 3 4 I 2 2 1 4 3 3 5 5 2Ham nhaitrcn I I I I I I I I 2 2 2 2 2 2 2 2
Rang8 7 6 5 4 3 2 I I 2 3 4 5 6 7 8
% sue 3 5 5 3 3 4 I I I 1 4 3 3 5 5 3Ham nhaidU'm 4 4 4 4 4 4 4 4 3 3 3 3 3 3 3 3
Rang8 7 6 5 4 3 2 I I 2 3 4 5 6 7 8
Rang giii: MAt rang dff lam rang gia t6t dugc tiOO50% sue nhai cua rang.8621,22: .Phan bi~t gifra viem Igi va viem quaOOrang:
40
•
- Co cao rang
- Rang lung lay it ho~c khong lung lay
- Hai tho hoi
Viem lQi- LQ'icuang do, co th~ viem 2 - 3 rangd@ntoan bQ2 ham- Khong co tui mu a sau
Viem quanh rang- LQ'i co th~ viem do, chay mau, t\lt19i,ha c6 ding- Co tui mu a sau 0 nhiSu rang d@ntoan bQ2 ham, mu chay thuOng xuyen- Rang lung lay tu dQ1 d@ndQ4
- Hai tho rAthoi- NhiSu cao rang tren 19iva duai lQ'i- Xuang 6 rang tieu dQCho~c ngang
S6 23: Viem tuy, tuy ho~i tu, viem quanh cu6ng rang:Viem quanh cu6ng rang khac viem quanh rang la viem day ch~ng quanh rang,tieu xuang 6 rang, viem 19i._Viem cu6ng rang: La viem vung t~n cung cua rang nai cac m~ch mau va thfrnkinh di vao nuoi duang rang (thuOng do tuy ho~i tu) dau e dm, rang co cam giactr6i len, go dQc dau, hai ham ch~m vao dau, lQ'ivUng cu6ng hai nS. Viem cu6ngrang d.p: dau khu trli lQ'iho~c rna tuang ung ding viem sung nS._Viem tuy rang: Rang tg nhien dau, dau nhiSu v@dem, dau Ian toa, dau dli dQithanh tUng can tuy thuQc vao viem tuy cham phat hay viem tuy cAp,go ngang
dau han dQc.Quy dinh ky hi~u viem tuy rang b~ng chfr "T", cach ghi tuang tg nhu chit d~
m\lc rang sau._Viem tuy ho~i tu: Rang khong dau, thuong rang d6i mau xam ho~c yang d\lc.S6 26: Viem tuy@nmang tai: Bi~u hi~n sung a vung tuy@nmang tai. N@uchua6n dinh, khi kham, n~n vao vung tuy~n mang tai se thfty chay mu ra 0 6ng
Stenon.S6 28: Khap c~n binh thuOng: Nguoi duQ'ckham ng~m mi~ng 0 tu th@tinh, nu6tnuac bQt,hai ham rang khit l~i, khong bi ha, khong di l~ch sang phai ho~c 1rai.Kh6p c~n di l~ch la khi 0 tu th~ tren rna hai ham bi ha ho~c l~ch sang mQtben.
4. Kham tai - mfii - hqng:
S6 31: Do suc nghe.a) Noi thAm:_ Nguoi kham thO'ra h~t r6i n6i thAmd~ thu. Phai thu tung tai rieng bi~t (taikhong thu phai duQ'c bit kin b~ng cach de ngon tay len n~p 16 tai do nguoidugc thu lam)._ Ti@ngnoi phat ra th~ng goc v6i tai thu. Nguoi dugc thu cAmmi@ngbia c(mgche m~t d~ khong nhin dugc mi~ng nguoi thu.
41
_ Trong diSu ki~n kham dong nguai, khong co nO'iyen Hnh, co thS dung ti~ngnoi thuemg. Truang hQ'p tai bi giam suc nghe phai dung cach thu ti~ng noithAm vai diSu ki~n cho phep. N~u nghi nga cAn cho kiSm tra ky tl;li cO' sachuyen khoa. Do b~ng am mdu: am trAm(128), am cao (2096).b) Noi thuO'ng: Suc nghe t6t han noi thAm 10 IAnkhoang cach do.S6 35: Chong m~t me nhi, biSu hi~n.a) Cam giac chit quan tv quay theo cac chiSu khong gian khac nhau ho~c mQiv~t xung quanh minh.b) Cac rBi IOl;lnthgc v~t kern theo (xanh tai, toat md hoi, non, ml;lchnhanh ho~cch~m ll;li).Cac r6i lo~n khach quan mftt thang b~ng.c) ThuO'ng co dQngm~t tv phat.S6 37: Viem hQng m~n tinh._N~u thanh sau hQngchi co t6 chuc lympho tang sinh, day len, thS trl;lngt6t thivftn x~p 10l;li2._N~u t6 chuc lympho day len lam h~p khoang sau hQng, ho~c tren dam t6 chuclymho tang sinh co nhfrng chdm nuac ho~c mit gay ho, s6t luon ho~c lam thStr~ng suy nhuQ'c thi x~p lo~i 4.
5. Kham tam thin va th~n kinh:
S6 47: Ra md hoi tay, chan: Chia lam cac muc dQ:_Nh~: SAvao ban tay chi hO'iAm,nhin vao ke duO'ng chi ban tay thdy ldm tftrn,ong anh md hoi khong thanh v~t dai. Lau kho, tren 10 phut mai xuftt hi~n trall;linhu cli ho~c sau thai gian v~n dQng md hoi ban tay khong thanh v~t daiho~c thanh giQt._Vira: BiSu hi~n n~ng han cac ddu hi~u tren va thuO'ng co ca md hoi chan._ N~ng: Mila he ding nhu mua dong, ban tay luon nh6p nhap rnd hoi, So' vaodAungon tay thdy l~nh, cac ke duang chi ban tay ong anh md hoi thanh v~t daiva thanh giQt. Sau khi lau md hoi, dS 5 - 6 phut md hoi ll;liti~t ra gAnnhu cu.LOl;linay cling thuO'ngkern theo ra md hoi toan than, nhdt la khi cam xuc.SB 56: B~nh Co'(Myopathie): BiSu hi~n teo Co'a g6c chi. B~nh nhan dang ngdix6rn rna tg dQng dung d~y khong dugc ho~c rftt kho khan.SB 57: B~nh nhugc Co'(Myasthenia): Thuang biSu hi~n b~ng S\lP mi m~t, bu6isang rn~t con rna duQ'C,vS chiSu S\lP cang rooCac Co'khac luc dAuv~n dQngcon kha, sau 1 thai gian v~n dQngva cang vS chiSu thi Co'y~u dAn.S6 58: T~t may Co'(TIC): BiSu hi~n nhay m~t, nhay rndm, nhay mep.
6. KhaID DQi khoa:
S6 82: B~nh dl;li,trgc trang.
42
••
a) HQi chUng d~i trang kich thich: La r6i lo~n v8 v~n dQng va xudt ti~t cua d~itrang. Thucmg dau b\lng dQc thea khung d~i trang, r6i lo~n d~i ti~n, khong coviem ho~c viem rdt nh~, phan kh6ng co amip. Chia lam cac muc dQ:- Nh~: M6i nam chi 1 - 2 dqt ng~n, dau it va nh~. R6i lo~n d~i ti~n nh~, it anhhUOngtai sinh ho~t va suc khoe chung.- ViIa: M6i nam 3 - 4 dqt, cuong dQdau dang kS han, r6i lo~n tieu hoa keo daico anh huang t6'i sinh ho~t va suc khoe chung.- N~ng: M6i nam tren 4 dQ't,ho~c dau keo dai hang thang, cuong dQdau dangkS, anh huang nhi8u d~n suc khoe chung va sinh hmJt, tam thftn kinh.b) Viem loet tr\lc, d~i trang xudt huy~t: ThuO'ng co nhi8u (, loet to, chay maurai rac a trgc trang, d~i trang.86 85: B~nh gan.a) Viem gan mlJn tiOOt6n t~i: La lo~i viem gan m~n tinh thS oo~va kh6ng ti~ntriSn, it anh huang tai suc khoe chung va cac chuc nang cua gan, do do khongtra thanh xa gan. Tuy nhien cAngiu gin va theo doLb) Viem gan m~n tiOOho~t dQng:La I~i viem gan m~n tinh thS n~ng, tiSn tri~nthanh nhi8u dqt, cac chuc nang gan bi imh huang ro, suc khoe chung bi imhhuang d8 tien den xa gan.8688: Lach.Tinh dQlach to:Ke 1 duong th~ng til dinh nach tai r6n, Idy do~n th~ng tiI ba s-uon tnii tai r6n cua do~n th~g tren chia lam 3 phAnd8u OOau.Phftn sat suan ladQ 1, phftn sat r6n la dQ3, til r6n tra xUQngla dQ4.86 91: Cac b~nh phe quan._Viem phS quan cdp tai di8n: La b~nh tai di8n nhi8u IAn,lien quan den cac y~ut6 thu~n Igi nhu hut thu6c la, hit phai khi dQc (do m6i truang s6ng, lam vi~c),OOi8mkhuAn rang mi~ng, suy tim trai, xa ph{,i ken, suy giam mien dich ... ;trong do cac yeut6 nguy ca co thS chua khoi OOu:OOiemkhuAn rang mi~ng,hut thu6c la, hit phai khi dQc...- Henphe quan:+Muc dQ nh~: Can kho tho nh~, thinh thoang xudt hi~n nhi8u v8 mila ret, v~ban dem, chua anh huang taithS tr~g, lao dQng binh thuang,. khong phai di,
nam vi~n.+ Muc dQtrung binh: Thai gian m~c 10 - 15 nam, can hen xudt hi~n v8 dem vasang. Tai phat it, ph\! thuQc vao thai ti~t, suc khoe toan than con t6t.+ Muc dQn~ng: M~c b~nh 15 - 20 nam, can hen xudt hi~n ca ngay va dem, keodai dai d~ng, da co biSn chung khi phS thling, tam phe m~n, viem phe qUIDm~n, trong 3 nam gAnday, nam nao cling co can hen xudt hi~n lien 1\lcphai di,
nam vi~n.
43
""2"J!P7TV===_
S6 96: HuySt ap._ Th6ng nhAt cach do huySt ap: Theo Quy trinh do huySt ap dung (Ban hanhkern theo QuySt diOOs6 3192/QD-BYT ngay 31/8/2010 cua BQ truang BQY tSvS hu6ng ddn ch~n doan va diSu trt tang huy~t ap):1.Nghi ngai trong phong yen tiOOit nhAt5 - 10phut truac khi do huySt ap.2. Khong dung chAtkich thich (ca phe, hut thu6c, ruqu, bia) truac do 2 gio.3. Tu thS do chu~n: Ngucri duQ'c do huySt ap ng6i ghS t\1'a, canh tay du6ith~ng tren bim, nSp khuyu ngang muc v6i tim. Ngoai ra, co thS do a cac tu thSn~m, dung. D6i vai nguoi cao tu6i ho?c co b~nh dai thao duong, nen do themtu thS dung nh~m xac dinh co h~ huySt ap tu thS khong.4. Sir dVng huySt ap kS thuy ngan, huy~t ap kS dang h6 ho?c huy~t ap kS di~ntil (lo~i do a canh tay). Cac thiSt bi do cfin duQ'c kiSm chu~n dinh kyoBS daibao do (n~m trong bang cu6n) t6i thiSu b~ng 80% chu vi canh tay, bS rQng t6ithiSu b~ng 40% chu vi c~nh tay. QuAn bang quAn du ch?t, bo du6i Cllabao doa tren nSp l~n khuyu 2cm. D~t may a vi tri dam bao may ho~c m6c 0 Cllathang do ngang muc tim.5. NSu khong dung thiSt bi do t\1'dQng, truac khi do phai xacdfnh vi tri dQngm~ch canh tay dS d~t 6ng nghe. Bam hoi them-30mmHg sau khi khong conthAy m~ch d~p. Xa vai t6c dQ 2 - 3mmHg/nhip d~p. Huy~t ap tam thu tucmgung vai luc xuAt hi~n tiSng d~p dfiu tien (pha I cua Korotkoff) va huySt aptam truang tuang ung vai khi mAth~n tiSng d~p (pha V cua Korotkoff).6. Khong noi chuy~n khi dang do huySt ap.7. Lfin do dfiu tien, cfin do huy~t ap a ca hai canh tay, tay nao co con s6 huyStap cao han se dung dS theo doi huySt ap vS sau.8. Nen do huySt ap it nhAt hai lfin, m6i lfin cach nhau it nhAt 1 - 2 phut. NSus6 do huySt ap gifra 2 lfin do chenh nhau tren 10 mmHg, cfin do I~i vai phutsau khi da nghi tren 5 phut. Gia tri huy~t ap ghi nh~n 1atrung blnh cua hai lfindo cu6i cung.9. Truong hQ'Pnghi ngo, co thS theo doi huySt ap b~ng may do t\1'dQng t~inh~ ho~c b~ng may do huy~t ap t\1'dQng24 gio (Holter huySt ap).10. Ghi l~i s6 do theo dan vi mmHg duai d~ng huySt ap tam thu/huySt ap tamtruang (vi d\l126/82mmHg), khong lam tron s6 qua hang dan vi va thong baokSt qua cho nguoi duQ'cdo.- Th6ng nhAt cach phan lo~i:N~u huy~t ap tam thu va huySt ap tam truang khongcung mQt rnuc phan lo~i, thi chQnmuc cao han dS kSt lu~ phan lo~i (vi d\l: huyStap tam thu lo~i 2, huySt ap tam truang lo~i 1,kSt lu~n la lo~i 2 vS huyStap).S6 97: B~nh tang huySt ap.Phan dQ theo huang ddn clla BQ Y tS (QuySt diOO s6 3192/QD-BYT ngay31/8/2010):
44
I, .
Phan dQ huy~t ap
< 120, <80va
120 - 129 vaJho~c 80 - 84130 - 139 vaJho~c 85 - 89140 - 159 vaJho~c 90 - 99160 -179 vaJho~c 100 - 109
~ 180 vaJho~c ~ 110tam ~ 140 va <90
S698:MlilCh.- Kham mlilch:Chli y~u b~t rnlilchquay, phai b~t 2 ben d6ng thai ,Khi !hAy"mlilchsinh doi", "rnlilchsinh ba" (ngolilitam thu) thi phai nghe tim va dern so ngo~i tamthu trong 1 phut.+NSu phat hi~n ngolilitam thu thi th\fc hi~n nghi~m phap v~n dQng(chi ap d\Ulgchonguoi khong m~c b~nh tim): cho v~ dQng~i ch6 (dUng len ng6i xu6ng nhanh 20 -:30lfuIho~c chlilYcao chan ~i ch6 trong 5 phut). NSu ngo~ tam thu giam ho~c m~t dithi ghi nh~n la ngolilitam thu co nang, n~u ngo~i tam thu khong giam ho~c tang lenthi cful dua d~n kham chuyen khoa ~i b~nh vi~n va lam di~ntim.+NSu b~t mlilchthAyIOlilllnhip hoan tom thi phai nghe tim va dSm nhip.+ M~ch thuOng xuyen khi nghi ~ 90 lfuvphut cfuI kham chuyen khoa tim rn~ch vanQiti~t tlilib~nh vi~n.- Cach lam nghi~m phap Lian:+Nguai duQ'cthir a tu th~ dUnglAymlilchtru6c khi chlilY.+ ChlilYtlilich6 v6i t6c d<)10-12 bu6c trong 5 giay, chlilYtrong 5 phut. Khi chlilY,cfuIg chan gdp thfuIg g6c v6i diIi. Sau khi ChlilY1 phut Idy mlilch 15 giay dflu cuatlmg phut 1,2,3,4,5. Trong khi do, nguai duQ'cthu phai dUng im, khong cu dQng,khongn6i.- KStqua:+ NSu dau phut thu nhAt rnlilchdii len t6i 140 Ian /phut ho~c cao hon Ia xAu khongx~p tir IOlili1 - 3 duQ'c.+NSu dau phut thu 2 - 3 tr61lilinhu Cllho~c gannhu cllthi coi nhu binh thuang.+ NSu dau phut thu 4 - 5 rnlilchm6i tr6llili nhu Cll la xdu khong x~p ill IOlili1 dSnIOlili3 duQ'Crna phai xSp tir IOlili4 tra di.+ NSu t~n dfluphut thu 6 rnlilchrn6i tra llilinhu Cllla xAu,xSp lo~i 4.- M~ch thuOng xuyen khi nghi < 50 lfuvphut, can duQ'cti~n hanh nghi~m phapAtropin:
45
't ..,."-,, "",., ",'-""""'1,. Q r",,:'-''tZJ
+ Tiem tinh m~ch Atropin 1/4 mg x 04 6ng (nSu ham IUQIlg1/2mg thi dung 026ng). Truac do ghi di~n tim d~o trinh DII, sau do tiSp t1)cghi timg do~ DII ngaysau tiem, sau 1 - 3 - 5 - 7 phut.+ Banh gia: NSu nhip tim d~t~ 90 lfuvphutthi m~ch ch~ do cUOngpho giao cam.NSu OOiptim < 90 I~n/ phut thi m~ch ch?m co the do b~nh Iy nut xoang, c~ duad~n kham chuyen khoa tim m~ch t~i b~nh vi~n.S6 101: B~nh tim.- Khi nghe tim c~ mo ta ro ti~ng thu nh~t (Tl) va ti~ng thu hai (T2) & cac vi trimom tim, lien suOn II va III c~nh uc trai, miii uc. Khi phat hi~n ti~ng th6i tam thucAnmo ta cUOngdQ, thai gian va fun s~c; phan bi~t ro tiSng th6i tam thu co nanghay thgc the. TiSng th6i tam thu co nang thuOng 000, ngful va khong tho rap, m~tdi khi v?n dQngho~c thay d6i tu thS. TiSng thu OO~tva thu hai phan doi xay ra &nguai tre tu6i (hay xuc dQng),khong m~c b~nh tim m~ch hi sinh Iy.S6 102: B~nh khOp.- B~OOkhap nhiSm khufut: Bay la truang hqp viem kh6p sau 1 b~nh nhiSm khufu1nhu lien cAukhuful va khong sinh mu. v~lam sang co viem ro r~t mQt vai kh6pvila va 006 nhu: g6i, c6 chan, ngon chan, khu)rutay, ngon tay... thuang viem khongd6i xUng, khong di chuyen, khong gay teo co nhi~u va khong co bieu hi~n tim kerntheo.- HQi chUng Reiter: La mQtlo~i viem kh6p phan lIng xu~t hi~n sau khi b~nh nhanbi mQt hQi chUng Iy'ho~c bi di long. B~c di8m cua b~nh la ngoai tri~u chUng viemkhOp con co cac tri~u chUngviem kSt m~c va viem ni~u d~o. Tuy cac tri~u chUngco & m~t va ni~u d~o co the chi & muc dQnh~ va thoang qua.S6 158: ThiSu mau n~g thuO'ngxuyendo cac nguyen nhan.- H6ng c~u 2.500.000/mm3
, huySt s~c t6 <80g/1 xSp lo~i 6.- H6ng c~u 2.500.000 - 3.000.000/mm3 mau, huySt s~ct6 ill 80 - lOOg/1xSp lo~i 5.
7. Kham da Ii~u:
S6 159: N~m da.The dien hiOO:NSn da hoi do, co vi~n ba ro, nSn khong cQm, chua bi biSn chungcham hoa (do nhi~u, ngua nhiSu va cQm day) ho~c nhiSm khuful (sung t~y, comu, xu&t tiSt).S6 160: Nb mongoMong bi sui mau vang d\lc, 16ch6, mun rnong,t6n thuang di ill ba tl! do VaGtrong.S6 167: B~nh da b<;>ngnuac.a) B~OODuhring Brocq: Timg dgt n6i rn\ln nuoc cang thaOOc\lm, co tri~u chUngngua bao truac khi t6n thuang, khong co t6n thuang niem m~c, suc khoe toanthan 6n dinh.b) B~nh Pemphigus: N6i nhfing b<;>ngnuac nheo, dS va, khi va de I~i trgt rQngdau rat, kern t6n thuO'ng niem m~c, toan than suy S\lPd~n, tien luqng de d~t.
46
S6 168: B~nh t6 chuc lien k~t.
B~nh Lupus ban do:_ ThS khu tm: Thuemg n6i 6 m~t thanh dam do, ranh gi6i ro, co yay sung g~nch~t, xen ke s~o, teo da (hinh canh bu6m)._ ThS h~ th6ng: Ti~n triSn n?ng dan, kern theo tBn thuang nQi t~g, tien lugng ded?t.S6 169: B~nh da co yay.
B~nh yay n8n:BiSu hi~n bfulg cac dam do, cQm, eo yay tr~ng nhu xa cu, dS bong, co khi thanhcham, giQt, d6ng tiSn ho?c thanh mang m~n tinh. B6i v6i the do da bong yaytoan than, viem da kh6p yay n~n m\ln mu co the d~n t6i tan ph~, tii vong.S6 171: T~t bAm sinh cua da, g6m nhung lo~i nhu:
- BOt s~c t3 (v~t den, mau nau, xanh 10').- BOt s~c t6 co long.
- U gian m~ch.- UXO'than kiOO.S6 173: B~nh lay theo dUOng tiOOd\lc.
Giang mai: Chia cac giai do~n:_ Giang mail: Chi co v~t trgt nong tron ho~c bfiu d\lc, ranh gi6i ro, nBn eQmcU'ng nhu d~m bia kern theo h~ch b~n, khong viem, xet nghi~m trgc ti~p tim T.P(Treponema pallidum) duang tinh (+)._ Giang lllai II: Bieu hi~n thanh dao ban, sAn hQt, sftn sui mang niem m~c viem,h~ch rai rac. Xet nghi~m huy~t thanh, phan U'ng TPHA duang tinh. Xet nghi~mtrgc ti8p T.P duang tinh m~h._ Giang mai III: BiSu hi~n b&ng gom, CU, mang, b~ch san co khi kern theo t6n th-uang phu t~ng ho~c than kiOO._ Giang mai bAm sinh mUQn, viem giac m~c kho, tran do, mlii t~t, rangHutchinson ho~c co t6n thuO'ng nhu trong giai do~ III.S6 174: Day sung long ban chan cO'dja.Co cac dam to nho 6 vungti de eua ca 2 gan ban chan. T6n thuO'ng phat triennhiSu gay cQm, dau khi di l~i. Bi8u trj rfit kho khan (khong khoi). B~nh co y~u
.. t6 gia dinh.
8. Kham ngo~i khoa:
S6 84: Tri._ Cach kham: Kham tUng nguo-i mQt 6 nO'idu anh sang, nguai duQ'c kham chBngmong, t\1'banh rQng h~u mon va r?il m~nh .._ Phful lo~i: Lfiy duo-ng luQ'c cua h~u mon lam chuAn (cO'th~t h~u mon):
+NSu bili tri 6 trong cO'th~t la tri nQi.
47
+ N8u bui trI a ngoai co th~t la tri ngo~i.+ N8u bui trI a dUOngluQ'cla trI h6n hQ'P._ Tri~u chUng: ia ra m{mtuoi (co thBro tung gic;>tsau khi d~i ti~n chui m6i thdymau tuoi):+ Tri loi ra ngoai tv co duQ'chay khong tv co duQ'c(phai dAylen).+ Bui tri loet r6m mau.+ Ba co t~c tinh m~ch trio- each ghi vi tri bui tri:Vi d\l: Tri nQi 5 gia 0,8 cm; tri ngo~i 7 gia 0,5 cm (phia xuong cung la 6 gia, d6idi~n la 12 gia).S6 150: Gian tinh m~ch thimg tinh (Varicocel)._ BUng vS phuong di~n giai ph~u, gian tinh m~ch thimg tinh thuOng a vS bentrai. N8u SO' thdy to hon ben phili chut it thi chua gc;>ila b~nh ly._Nh~: Sa thdy tinh m~ch to, th~ng, chua quAnvao nhau thanh bui._N~ng: Sa thdy tinh m~ch to, qudn vao nhau thanh bui nhu bui giun va thuanglam sa biu. Khi khl:imkhong c~n cho ch~y rna kham luc binh thuang.S6 103: Ban chan b~t.Binh thuOng ban chan in tren nSn g~ch, dAu chan bi khuy8t a vung vom banchan. Ban chan b~t dAuin khong thAykhuy8t it a vung vom.
9. Kham sao phI}khoa:
- Phong kham phai kin dao, nghiem tuc._Khi kham ph\l khoa cB g~g bBtri can bQchuyen mon la nit. B6i-v6i nft thanhnien, mang trinh chua rach thi chi kham n~n b\lng, khong kham mo vit, khongtham am d~o, chi kham qua h~u mon nhiing twang hQ'Pdn thi8t. B6i v6i nguaimang trinh da rach Cll,khi co nghi nga b~nh ph\! khoa thi kham b~ng d\lng C\lqua am d?o de xac dinh chAndoan._N8u khong co can bQchuyen khoa ph\! san thi chi dinh bac sy ngo?i khoa thayth8, nhung phai co nhan vien nft tham d\T.Khong su d\lTIgy syde kham, phanlo?i b~nh t~t._K8t qua kham san ph\! khoa duQ'cghi vao ph~ kham ngo?i khoa, da liSu.
48
••
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Phl}Il}C 2DlNH Mue V~T TU TIEU HAO vA KINH PHi eHO HO~T DQNG KIEMTRA sue KHOE, KHAM sue KHOE THve HItN NGHiA VV QUAN SV
(Ban hanh kern theo Thong tlllien tich s6 16/2016ITTLT-BYT-BQPngfly30 thang 6 nam 2016 cua B9 tru6ng BQ.Y t~ - BQtruemg BQQu6c phong
Quy dinh vi~c Kharn suc khoe th\Ic hi~n nghia V1,l quan s\I)
I. Binh muc mot sa vat tlr tieu hao. ..1. Binh muc v~t ttl tieu hao cho ho~ltd90g ki~m tra, sO'tuy~o suc khoe/IOO ogU'oo
TT Ten v~t ttl Dan vi tinh Dioh mile Ghiehu
1 C6n 70 d9 ml 300-500---- ---_ ..__ .__._-_. .- -----_._--2 Bong hut gam 200
-_ ..- r----~M -- _._--_.-3 Gang tay cao su (ngAn) d6i 05
~-._-
4 Pin den 1,5V d6i 03-- --I-- .. ---- ._..-
5 Xfl phong gi~t gam 300- ------- ._-------
6 Xfl phong tharn rna tay banh 01_.---- _ .._-- -'--,--- -- -
___ M •••
7 Khan m~t lau tay chiec 03------ --_ ..._---- -_._---_ ..-
8 Gidy tr~ng A4 t~p 0,25..__ ..- --_ ..__ ._._--_._ .._-_ ... - ____ ••• ___ M_ ••
9 But bi chi~c 05_._-_. -'-"'-'---'.__ . .._--_._-
10 ChAtdbt Theo th\Ic dung--'
_ .. ..,_M-
Il V~t tu khac (n~u co) Theo th\Ic dung
2. Bioh muc v~t ttl tieu hao cho hmJtdQng kham suc khoe/lOO ng«Oi
"-"'-
---
._"-
.._-_._-
Ghi ehoDinh mile10001000
---'--- 2005
mlgamdoi
Dan vi tinhTT Ten v~t ttl
1 C6n 70 do--"'- .._ .._' _.__ ._------_.2 Bong hut---- _.3 Gang tay cao su(ng~n)_._---------_.-4 Pin den 1,5 V doi.._---- ------_. __ .._ _-_._--_ .
5 Xflphong gi~t gam 500._.._---1--- .--.-.------------ ..--------6 Xflphong tharn rua tay banh 05-_.- ..
7 Khan m~t lau tay chi~c 10--- ----- --_.- -- _._-_ .._---8 Gidy tr~ng A4 t~p 0,5--..--_. ---_.__ ._..._------- ---_._----------_ ..-.9 - But bi chi~c 20------ ._-_._------_ ..._-_ ...__ .. ---_.
. 10 ChAtdbt Theo th\Ic dung1-,-..----- ------.--.----- ----.-.-- ---.--.---- ----------=-- ----..---..---11 Hoa chdt, v~t tu xet nghi~m Theo thgc dung.--_ .._-_._----_._._._---_._.-12 V~t tu khac (n~u co) Theo th\Ic dung
1
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,.J.J.J..t •••..••• _'''' ••,~~" ,1 ."j~~.-, ..,CJ"'",'''''~'''''' •••••••••=•.". _.~.~~"'""-"••-.c.. •••.•.•J....l..i<u
3. Gia vat to' tieu hao.Dugc tinh theo m~t b~ng gia clla dia phuong t~i thai diem do.
II. Bjoh IDtfC kioh phi1. Kinh phi b6i du5ng cho mQt ngay lam vi~c clla m6i thanh vien trong
doan kham suc khoe ho~c t<3kiem tra suc khoe (g6m: kham suc kh6e, t~p hu~n,SO' kSt, t<3ngkSt v.v...):
a) Dugc tinh b~ng mQt ngay cong tac phi trong tinh clla can bQc6ng nhanvien chuc theo quy dinh hi~n hanh CllaNha nuac;
b) Rieng thanh vien HQid6ng kham suc kh6e nghia V\l quan S\l, ngmli tieuchuful nhu thanh vien doan kham suc kh6e noi tren con dugc b6i duang themkhmin ti~n b~g ph\! c~p trgc clla bac si t~i b~nh vi~n huy~n theo chS dQ hi~nhanh CllaNha nuac.
2. Kinh phi chi cho vi~c gui cong dan di kham chuyen khoa, chiSu, ch\!p X-quang va lam cac xet nghi~m cAnthiSt khac.
3. Kinh phi chi cho v~n chuyen d\lng C\!,phuong ti~n ph\!c V\l cho doankham suc kh6e. ..
2
f'" f~ '~ ~l"'C ',"'f"'l'~\!'r'.T"""'''I'''' T_ - f--~ ~~=,..."'#' !I'~"'~l"'r"!""'- .•.....""....""" "!'lI'J'I'.••••...•.••" •• ,."' ••""'l'....,..,."..~r ....'!JT 'I''lI''I''.-'W......,...-,~.<.,. •.•.• ,."""., l".•••••"'''''~ '~~lI!"Il'llI'r '''i'"",,'''f~~'''~
I •
.'
Phu luc 3'\ DANH MlJC TRANG BJ, DVNG ClJ Y TE TOI THIEU CUA
HQI DONG KHAM SUC KHOE NGHiA Vl) QUAN S11(Ban hanh kern theo Thong illlien tich s6 16/2016/TTLT-BYT-BQP
ngay 30 thang 6 nam 2016 cua BQ tru6ng BQY t~ - BQ tru6ng BQQu6c phongQuy dinh vi~c Kharn suc kh6e th\Ic hi~n nghia V\l quan s\I)
TT Ten trang hi, dl}ngCl}
1 Can co thuac do chiSu cao
2 Thuac day
3 Ong nghe hai tai
4 HuySt ap kS
5 Nhi~t kS nach
6 Buaphanx~
7 Ben soi day m~t
8 HQpkinh thu thi hJc
9 Bang kiSm tra thi hJc
10 Bang thi l\Ic mau
11 BQkham rang ham m~t
12 BQkham tai mlii h<;mg
13 BQd\illg C\l,ban kham ph\l khoa (nSu co nfr)
14 N6i IUQckhu trung d\lng C\ly tS
15 Tli s~y d\lng C\l
16 Tli dlJllg h6 so suc khoe
17 Ban ghS t~i cac phong kham (1 ban + 2 ghS)18 Giuemg kham b~nh
19 GhS cha kham t~i m6i phong kham
20 Tli thu6c co dli thu6c c~p CUuTAng cQng: 20 (hai IDU'O'i) khmin.
Bon vitinh
cMcai
cai
cai
cai
cai
cai
bQcai
cai
bQbQbQcai
cMcai
bQcai
cMcai
01
01
03
03
0201
01
01
01
01.-
01
01
01
01
01
01
05
04
03
01
1
,"
Ph1]I1]C 4eAe MAu PHIEU sue KHOE
(Ban hemh kem thea Thong tu lien tich sc516/2016/TTLT-BYT-BQPngay 30 thang 6nam 2016 cua BrJ truo'ng BrJ Y d-BrJ tru6'J1gBrJQuc5cphong
Quy ainh vi?c Kham suc khoe thvc hi?n nghfa v~ quan sv)
M~u 1. PhiSu kiSm tra sue khoe nghla v\l quan S\f
M~u 2. PhiSu sue khoe nghla V\l quan S\f
Huang d~n ghi ehep m~u phiSu kiSm tra sue khoe nghla V\l quan S\f va m~uphiSu sue khoe nghla V\l quan S\f.
1
M~u 1. Phi~u ki~m ira SITe khoe nghia vl}. quan sl}.'
Huy~n .Xa .
CQNG HOA xA HQI CHU NGHiA VI:E:TNAMDQc l~p - Tl}'do - H~nh phuc
Nam sinh:
Nam sinh:
Sinh ngay:
Phi~u ki~m tra suc khoe nghia V1] quan sl}'
I. SO' y~u ly lich
HQva ten:
HQva ten b6:
HQva ten my:
Nguyen quan:
Tru quan:
Gi~y chung minh nhan dan s6:
Da: ph\lc V\lt~i ngu til (thang/nam) dSn (thang/nam)
II. K~t qua ki~m tra suc khoe:Cao : cm; N~ng: kg; Yang ngl,l'ctrung binh: cm.
M~ch: lfuvphut; HuySt ap: mmHg.
B~nh nQikhoa: .
B~nh ngo~i khoa: .
B~nh chuyen khoa (m~t, T-M-H, R-H-M): .
TiSn su b~nh t~t:
Gia dinh: .
Ban than: .
Phan lo~i suc khoe sa bQ: .liT ' J r v1 Vgay. ... t 'lang.....nam...
TA tnfcrngtA ki~m tra suc khoe
2
.'
M~u 2. Phi~u sue khoe nghia vl} quan sl}'
Huy~n .Xli .
Anh 4 x 6em
CONG HOA xA HOI CHU NGHiA VIET NAM. . .DQc I~p - TV do - H~nh phuc
Phi~u suc khoe nghia vl} quan sl}'
I. SO' y~u Iy Itch:HQva ten: Sinh ngay: ./ ./ Nam, Nft:. .
Ngh~ gh'e~ twa' kh' h~ - G' ~ CMND ~en I.P e I n ~p ngu:.................................... laY so: .
HQva ten b6: Nam sinh: NghS nghi~p: "..
HQva ten m~: Nam sinh: NghS nghi~p: .
Nguyen quan: .
TrU quan: : .
TiSn su b~nh:Gia dinh: .Ban than: .
T6i xin cam doan khai dung 1y1iehva tiSn su b~nh eua t6i.
Xac nh~n ly lieheua dia phuong
Xae nhan ti~n Slf benheu~y t~ coo SO' •
Ngay thang nam .NguOl khai ky ten
II. Kham sue khoe:Cao : ./ em; N~ng: ./ kg; Yang ng\Ic TB: ./ cm.
Huy~t ap: ./ mmHg; M~ch: ./ .llln/phut.
Thi 1\Ic: - Kh6ng kinh: M~t phai: ./ ; M~t trai: ./ .
- C6 kinh:
Thinh 1\Ic: - N6i thucmg:
- N6i tlulm:
M~t phai: ./ ;
Tai phai: ./ m;
Tai phai: ./ m;
,Mat trai: ./......... .. .
Tai trai ./ m.
T. ,. /al tral In.
3
K~t qua kluim tuy~n t~i dia phU'o'ng K~t qua lduim phuc tra t~i dO'nvi
Chi tieu Y, BS khamDi~m
Y, BS ldlamDi~m Lydo
(ky, h9 ten)Lydo
(ky, 119ten)
Th~l\Xc
Mit
Tai mUi 11911g
Ranghamm~t
NQi khoa
Tfun th<111kinh
Ngo<;tikhoa
Da 1i~u
KQ xet 11ghi~m(nSu c6)
KSt 1U~11
N ' h ' ~ N ' h ' ~gay .......... t ang. ...... nam ............. gay ........... tang ........... nam ...............Chii tjch HQi dBng KSK NVQS huy~n Chii tjch HQi dBng kham ~huc tra SK
(kY ten, dong dJu) (kY ten, dong dau)
4
..
HU<1NG nAN GHI CHEP
1. Phi~u ki~m tra suc khoe nghia vl}. quan s1!:
- Phi@uduQ'c in tren gi~y tr~ng kh6 A4 dUng, ph6ng chfr 13.
- Phi@ug6m 02 ph~n:
+ Ph~n 1 g6m sa y@u1y1ich.
+ Ph~n 2 1ak@tqua kiSm tra, sa tuySn suc khoe, do y t@xa ti@nhanh.
- K@tqua kham co gia tri trong vang 6 (sau) thang kS til ngay kiSm tra, satuySn suc khoe.
2. Phi~u suc khoe nghia vl}. quan s1!:
- M~u phi@usuc khoe nghia V\l quan S\f duQ'c in tren gi~y tr~ng kh6 A4,ph6ng chfr 13.
- Phi@ug6m 02 trang:
+ Trang 1 in theo chi@udung cua to' gi~y A4, g6m: sa y@u1y lich, ti@nSlrb~nh t~t; k@tqua kham chi@ucao, can n~ng, vang ng\fc trung binh, m~ch, huy@tap, thi l\fc, thinh l\fc. Rieng phk k@tqua kham, t~i m6i chi tieu duQ'cehia liun 2ph~n caeh nhau b~ng net s6 (I), ph~n ben trai net s6 do HQi d6ng kham sue 1dl0enghia V\l quan S\f huy~n ghi, ph~n ben phai net s6 do HQi d6ng kham phuc trasue khoe cua don vi nh~n quan ghi.
+ Trang 2 in theo ehi@ungang eua to' gi~y A4: 1a ph~n kham cae chuyenkhoa va kSt qua xet nghi~m (nSu co), dUQ'eehia lam 2 ph~n rieng each nhau mQtv~ch dQc kep, ph~n ben trai cho HQi d6ng kham suc khoe nghia V\l quan S\fhuy~n va ph~n ben phai eho HQi d6ng kham phuc tra suc khoe eua dan vi nh~nquan.
- Khi kham cae ehuyen khoa, sau khi eho diSm, yeu c~u cae y, bae sikham ky va ghi ro hQten.
- KSt qua kham co gia tri trong vang 6 (sau) thang kS til ngay kham (ngayky, dong d~u kSt 1u~ncua Chu tieh HQi d6ng kham suc khoe).
5
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Phu Iuc 5. .cAe LO~I MAu BAo cAo vA MAu s6 THONG KE
(Ban hanh kern theo Thong ill lien tieh s6 16/2016fITLT-BYT-BQPngay 30 thang 6 nam 2016 elia BQ twang BQY t~ - BQtruang BQ Qu6e phong
Quy dinh vi~e Kharn sue khoe th\l'e hi~n nghia V\l quan S\l')
Mfiu la. Bao eao kiSm tra sue khoe nghIa V\l quan s\f (T6 kiSm tra sue khoe).Mfiu 1b. Bao eao kiSm tra sue khoe nghIa V\l quan S\f(Phong Y t~ huy~n).Mfiu 2. Bao eao k~t qua sa tuySn sue khoe nghIa v\l quan s\f.Mfiu 3a. Bao eao k~t qua kham sue khoe nghIa V\l quan S\f(HQi d6ng Kham suekhoe nghIa V\l quan S\f).Mfiu3b. Bao eao k~t qua kham sue khoe nghIa V\l quan S\f(phong Y t~ huy~n).Mfiu 3e. Bao eao k~t qua kham sue khoe nghIa V\l quan S\f(SO'Y t~ tioo).Mfiu 4a. Bao eao tioo hinh giao OO~nehi~n sI m6'i (Phong Y t~ huy~n).Mfiu4b. Bao eao tiOOhinh giao nh?n ehi~n sI rnm (Ban chi huy quan S\fhuy~n).Mfiu 4e. Bao eao tiOOhinh giao nh~n ehi~n sI m6'i (Ban vi oo~ quan).Mfiu 4d. Bao can k~t qua sue khoe ehi~n sI rn6'i sau kharn phue tra va giam satmv, rna tuy (Ban vi nh~n quan).Mfiu 5a. 86 th6ng kS kiSm tra sue khoe nghIa V\l quan S\f(tuy~n xa).Mfiu 5b. 86 th6ng kS kham sa tuySn sue khoe nghIa V\l quan S\f(tuy~n xa).Mfiu 5e. 86 th6ng kS kham sue khoe nghia V\l quan S\f(tuy~n huy~n).
1
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Miu 1a. Bao cao k~t qua ki~m tra suc khoe nghia vI} quan SI}'
Huy~n .Xa .
CONG HOA xA HOI CHU NGHiA VIET NAM. . .DQcl~p - Tv do - H~nh phuc
S6: / .......... (Dja danh), ngay thang nam
Bao cao k~t qua ki~m tra StfC khoe nghia vI} quan sl}'DQ1 nam .
TT N{)idung K~tqua Ghi chu
------
.._ ....._-----1 S6 lUQ11gc~n ki~m tra theo kS ho~ch_._--_ .. -----_._---_._ ..__ .._.__ ..._-_._._--- ..-._ .._ .._._----- ._------_ .._.__ ._._-_ ..__ .- _._.
2 S6 lUQ11gda: ki~m tra.._, ...__ ._-_._--_._----_ ..__ ..
3 Phan loai suc khoe:---_. _ ..._:_-------_ .._._ ..__._.._--- .._._--_ ..__ ._._- -_.__ ._-_ ...._ .._---_ ...__.-
Lo~i 1Lo~i 2
...._--- ..__ ._ __ __ _._------_ .._---_.- ---_._-_ •..._- .._ _---- _-_._--- ----_ .._ __ _-_._ _ _ ..__ _ .._--_ .._ ..__ ._-_.- .._ _--_._---_ __ - _ .._---_._ ..__ ..-
Loai 3_._--_ ..__...__ .__ ...:.._._._ ....._-_ ....__ .._ .._---._._--_ ....__ ....__ .__ ..- ---'-'-'--"-"-- --------_ ....._ ..-Lo~i 4._---- _._-----_ ..__ ._-----_._-----_ .._---_ ..._ ..._----- --------_ .._-_. ------_._----_ .._-_ ...•_--Loai 5
1---..----- -.--....:.----.- ....- ..- ..---.----_ .._ ...._ ..... .. ._ . .__ ._ .. . ....__ .. ..__ ....__ ..._
Lo~i 6
Noin~~n:- HQi dong NVQS xii;- Phong Y t8 huy~n;- Trung tam Y t8 huy~n;- Luu .....
_ .._-------._-_ .._ ...._-- _._-_ .._ ..._--
T8trU'O'ogT8 ki~m tra S1fC khoe
(Ky ten)
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Miu lb. Bao cao k~t qua ki~m tra suc khoe nghia vy quan S\f
UBND huy~n .Phongy t~
CONG HOA xA HOI CHiT NGHiA VIET NAM. . .DQc I~p - T\f do - H~nh phuc
86: / .............( Dia danh), ngay thang nam
Bao cao k~t qua ki~m tra suc khoe nghia vy quan S\f
DQ1 nam .
TT N(}idung K~tqua Ghi chu
1 86 IUQ11g cftn kiSm tra theo kS ho~ch" ' __ M_M , __ ,,_~ •• _ _ __ M_" '_""_
2 86 IUQ11g dii kiSm tra.-- •• _- ••• --.--,,-----_._._ •• __ • • _ ••••• __ .M __ ~_ ••• ••• •• _.
3 Phan lo~i suc khoe:
Lo~i 1
Lo~i 2-----I-- M __ •• M. • ,, ,, __ •• , W H. ••••• _. •••• _ ••
Lo~i 3Lo~i 4
Lo~i 5Lo~i 6
TrU'Ong phong(Ky ten va dong ddu)
Nui nh8n:- HQi dt;ng NVQS huy~n;- Ban CHQS huy~n;- SO'Y t€;- Luu .....
3
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Mau 2. Bao eao k~t qua sO' tuy~n sue khoe nghia Y\l quan sl}'
Huy~n .Xa .
CONG HOA xA HOI cHiJ NGHiA VIET NAM. . .DQc l,p - TV do - H~nh phuc
S6: / ..........(Dta danh), ngay thang nam
Bao cao k~t qua sO' tuy~n StfC khoe nghia Y\l quan sl}'
Nam .
TT NQi dung K~tqua Ghi ehu
1 S6 IUQllgph,H sa tuySn sue khoetheo k8 ho~eh
2
3
S6 IUQllgdii sa tuySn_. M_ •••• __ .N •__ •__ M_._ .. ... •. __
S6 IUQllg du diSu ki~n kham t~ituy8n huy~n
___ ._. • •__ .R •• __ R•• _ •• M_ ••• _._. •••• _ •••• ••• _._._
4 T6ngs6 dii lo~i ra'-''''--'-'''''-- _._,_-_ __ .._._~.__ ._-_ _.__ __ ..__ .__ ._.._-_._ __ ._._.__ .._.__ ._- _ .._-_ _--_.
Trong do:----_ .._- -_ ...._-------_ ....._ ...._-_._-_._---_. __ ...._----_ ..__ .. ---_ ..._._ ..
- S6 IUQ'ng dS nghi miSn lamNVQS
_ •• __ ,. __ ._. __ •• • •• _. • __ •• __ • __ • •• .H •••• _.
- Ly do khae
T6 truOllgT6 SO' tuy~n StfC khoe
(Ky ten)
NO'; nhlin:- HQi d6~g NVQS xii;- PhOng Y t~ huy~n;- Trung tam Y t~ huy~n;- Lull .....
4
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Miu 3a. Bao cao k~t qua kham suc khoe nghia v1} quan Slf
Huy~n .HQi d6ng KSK NVQS
CONG HOA xA HOI CHU NGHiA VIET NAM" . "
BQc l~p - TV do - H~nh phuc
86: / ............. (tJta danh), ngay thang nam
Bao cao k~t qua kham sue khoe nghia v1} quan SlfNitm .
TT NQi dung K~tqua Ghi chu
1 86 lUQ'llgkham theo k~ho~eh_' __ M_ •• •__ • •• _. • •• •• ._ ••• _._ •• _ ------.-.-.-.-- •••
2 86 lUQ'llgda: kham--- ---_._ .._ ----_ __ .._-_._ ....•...__ - ----_ .._ .._._-_._._ -----_._----3 Phan lo~i sue khoe:
Lo~i 1Lo~i 2Lo~i 3
Lo~i 4
Lo~i 6
Chii tjch HQi d6ng kham suc khoe(Ky ten va dong ddu)
N(fi nhfin:- HQi d6"ngNVQS huy~n;- Phong Y tS huy~n;- Sa Y tS',- Luu.....
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M~u 3b. Bao cao k~t qua kham suc khoe nghia vI} quan sl}'
CONG HOA XX HOI CHU NGHIA VIET NAM. . .DQc l~p - TV do - H,nh phuc
UBND huy~n .PhongY t~
86: /.............. (Dia danh), ngay thimg nam
Bao cao k~tqua kham suc khoe nghia vI} quan sl}'
Nam .
TT Nqidung K~t qua Ghi chu
1 86 luqng kham theo kS ho~eh--- .----.- ..-.---.-- ....----.-- ---.----.--.--- ..-e- ..-.-.------ ..
2 86 luqng dffkham--.- .-.- -- -- ..- -- ..-.-- ..---- - ..--.-.-.-1-----.-- ..-- --- .
3 Phan lo~i sue khoe:..- --.-.- - - ..----- -- --- ..--.--.-.-1--- -- ..----- -.- ..
Lo~i 1
Lo~i 2_.__ ...-----_._ .._ ....__._ .•.•__ ._-_.__ •..- _ ..._._ .._ .._---- ._.__ .._.__ .._-._-_ ..•...-.
Lo~i 3--_ ..._--------_ ...__ .._-_./--_ ..__ .__ .._ ..__ ..__ .....- ---_.Lo~i 4
..-.-.-- •.- ..---.------- •.•....-.-.- ..-- •.•..•- ••.•- ..•- ..1"--.- ...- ...-------- ...- .•- ...
.---- --.-.-- ...-.- ..-...-.----- ..-- ..-.-.-..-.- ...- ..-.-----.----- ..-t--.- ....----.---.-.
TrU'O'ng phong(Ky ten va dong ddu)
Nui n~~n:- HQi dong NVQS huy~n;...Ban CHQS huy~n;- Sa Y tS;- Luu .....
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Miu 3c. Bao cao k~t qua kham suc khoe nghia vl} quan S1}'
UBND tinh .so-y t~
CONG HOA xA HOI CHU NGHiA VIET NAM. . .DQc l~p - Tv do - H~nh phuc
s6: / .............. (Dia danh), ngay thang nam
Bao cao k~t qua kham suc khoe nghia vl} quan S1}'
Nitm .
TT NQidung K~t qua Ghi chu
1 s6 IUQ'Ilg kham theo k~ ho?ch----.._ .._._-_._-----_._._ ...._--- ._--,-_._--_.-2 sa IUQ'Ilg dii kham---------_ .._--_._ ..---_._-_ .._---------_._--3 Phan lo?i suc khoe:
'Lo?i 1
Lo?i 2
Lo?i 3
Lo?i 4
Lo?i 5
Lo?i 6
Giam d8c(Ky ten va dong d6u)
N(fi nh~n:- UBND tinh;- Be} Y t~;- Luu .....
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Min 4a. Bao cao tinh hinh giao nh~n chi~n si mOi
,
UBND huy~n .PhongY t~
CQNG HOA xA HOI cHiT NGHiA VIET NAM. . .Dqe lip - Tv do - H~nh phuc
s6: / .............(Diadanh),ngay thang nam
Bao cao tinh hinh giao nh~n chi~n si mOiNam .
1. TAng sa cong dan giao:Sue khoe lo~i 1:Sue khoe lo~i 2:Sue khoe lo~i 3:
2. TAng sa cong dan vao quan tlQi:Sue khoe lo~i 1:Sue khoe lo~i 2:Sue khoe lo~i 3:
3. TAng sa cong dan tra l~i do sue khoe:Nguyen nhiin tra f{li:
Loai benh. . sa ngU'O'iThan kinh - tam .than--_._--_."'._-_.__._---_._---_ .._._._-_ _-------_ _ _--_._-_ _ .._-_ _ _-Ngo~i khoa
__ •• ._. __ ._ •• •• __ ••••• N _ •• ••••• _ •• ._ •• __ ••••
N9i khoa_._-- .._.__ _-_ _ __ ._. __ __ .._--_ .._---- .._ _._._----------Da liSuM~tTai - mlii - h9ng.._--------_ __ ._.._-_._----_ _ __._-_._------_._. __ ..__ _--Rang - ham - m~t-_._---_ ..-.....---_ ....._._-_ .._---_._---_ ..__ .._._-----------ThSlgc
TruOng phong(Ky ten va dong ddu)
Nui nhfin:- H(>id6'ng NVQS hlly~n;- Sa Y t~;- Lull .....
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Mdu 4b. Bao cao tinh hinh giao nh~n chi~n si mOi
Be)CHQS tinh .Ban CHQS huy~n .
CONG HOA xA HOI CHU NGHiA VIET NAM. . .D{)cI,p - TV do - H~nh phuc
S6: / ............. ( D;a danh), ngay thang nam
Bao cao tinh tinh hinh giao nh~n chi~n si m6'iNam .
1. TBng sa cong dan giao:Sue khoe lo?i 1:Sue khoe lo?i 2:Sue khoe lo?i 3:
2. TBng sa cong dan vao quan dQi :Sue khoe lo?i 1:Sue khoe lo?i 2:Sue khoe lo?i 3:
3. TBng sa cong dan tra I~i do suc khoe:Nguyen nhan tra IfJi:
Lo~ib~nh
Th~n kinh - tam th~n_._---_._-_._-_ ..._---------_._-_._-Ngo~i khoa. .. __ .M.__ .. __ ... . ._.
NQikhoaDa liSu
sa nguiti
----------_._----------_._--_._ .._-----------_._-_.M~t--_ .._----_._._--_._._-_ ....._----------_.---------_.-_ .._----Tai - miii - hQng---_._ .._--_ ..__._..__ ...__ ._-----_ ..- -'Rang - ham - m~t_._---_._ _._--------- .._-_._ ..__._--------_. __ ._.-_.ThSl\le
Chi huy trU'Ong(Ky ten dong ddu)
N(fi nh~n:- BQ CHQS dnh;- LUll .....
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Mftu 4c. Bao cao tinh hinh giao nhin chi~n si m6'i
(Bon vi cAptren tf\lC ti~p) .
(DO'nvi bao cao) .
CQNG HOA XX HQI CHU NGHiA VItT NAMDQc lip - Tt}' do - H,nh phuc
86: / .. (Dta danh), ngay
Bao cao tinh hinb giao ohin chi~n si moo
Nam .
thang nam
Ilia phuong giao quan TBng cQng
S6 Til~rrsIUQ11g h6 sa
A. Tuy~n chQnqua h6 sO' SK' . ._.M.._._ ..~..__ . ,_ __,_ __ ...._ -- --- -.------,----
1. T6ng s6 h6 sa SK giao~
- Sue khoe IOi;li 1
- Sue khoe IOi;li 2
- Sue khoe IOi;li 3
- Sue khoe IOi;li 4
- Sue khoe IOi;li 5-6
2. s6 h6 sa SK phai tra If;zi
- Do thu tvc phap Iy- Do sue khoe
B. Giao nh~n chi~n si mOi1. Phat hi?n b?nh ttJtphai tra If;li--------~_.__._---,--,--- -_ ..- _ .._._,--
2. T<5ngs6 nhtJn v€ aO'nvi+ Sue khoe IOi;li 1
+ Sue khoe IOi;li 2
+ Sue khoe lOi;li 3
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C1]. th~ cae b~nh phai tra l~i
Ten b~nhDja phuong giao quan
Ghi chu
__ MM •• •• __ • •••••• •••• __ ••• '._'_ •• • ••• N ••••• ------ ------- --- ------ •• --
•• _._. • • __ •••• ••••••• __ ._ •••• •• N ••• _._. __ • __ •••••• __ ••••• _-- -_._ •• -_ ••• -- •• _ •••• ------.-- •
....._ ..__ ._-_ _-_ _ .._---_. _._ .._-............. .._ _--_ -_._ -_ .._- ---_ _-_ .._- _- ----_ _.-------- - --_.__ .__ .-
Nh~n xet••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• u ••••••••••••••••••••••••••••••
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N ' h' ~gay tang nam .ChiI nhi~m quan y(Ky, dong ddu)
Nui nh~n:- Nhutren;.................. ,
-Lull .....
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Miu 4d. Bao cao suc khoe chi~n si moo sau kharn phuc tra va giam sat HIV, ma tny
(Ban vi d.p tren tr\fc ti~p) .(BO'n vi bao cao) .
CQNG HOA xA HQI CHU NGHiA VItT NAMDQcI~p - T\f do - H~nh phue
S6: / .............. (Dta danh), ngay thang nam
Bao eao sue khoe chi~n si rn6'isan kharn phuc tra va giarn sat HIV, rna tuy
Nitro .
Dia phU'O'ng TAng eQng
S6 luqng Ti I~
-!:.._sa ..!U'Q'ng_~~~n: __ _.._ .. _ _. __._.. _- Sue kh6e lo~i 1
___ ._._ •• R. __ ._ ••••• ~. _. __ M ••• _ ••• _ •••••••••••••• __ •• __ ••• _. • •• _._ -_ •••• -
- Sue kh6e lo~i 2......_----_._ ...._~-- ..__ ..._._ .... --- .._-_ ..__ ... _.- -_ ..__ .
- Sue kh6e lo~i 3-_._-_._----_ _. -_.- _ _.. _._" _ _._ .._ _ .._ __ __ ..- __ .. __ _.__ .__ -_ _ ..-
2. Kit qua kham phiic tra SKva sang lQ~H"~!..Da t~y _ _.. _.. ._ ___ ._._..... .__ ._..__ ._ .
...!!:L~aq_uanau s.ue kh0e.._ _. .. _ ..__ __ _.. ._ ... __ _ _
._ ..::!::...-~frekh6~ lo~i.._l _ __ . ._ __ _ _ .._ _ ..__ _ ._ __ __ ._ .._ .._._.._ :!= Sue kh6e l~~i2_.._ _.._._. ....__ .. . ..__ .__ ___ . _ _. __ _ __ ._ ___ .. ._ __ .._
+ Sue kho...~o~i 3 _. __ _..__ . ..__ __ __ __ _._ __ __ __ .. _ .b) sa khong au sue khoe
._ _--_ .._-_._--_ _--_ _---_ _._-_ .. -~-__ - ~--------_ - .__ - ----_ __ .---_ _ -_ __ .
_.Trang d~ do: .. .._ _. _ __ ..__ _.._ _ _ .._. __ . ..__ __ . .. ___~. Th~h!~ . __.__._ _.__. ..__ ..___ _ . ---- -
+NQi khoa _ . . __ ._ _._ _ ."_._. _ __.._..__ __ ._+ Tam thfuI kiOO_ .. ._ .. _ .._ _ ._N _ __ _ _'''_' _' _.", ..- '---"---'''-- _ - "'-"'--'-'- _ , - _-
......_+ Ngo~i khoa __ _ _. _. _ ._... _.__ __ __ . ...._. _ _._ __ .._+Da li~u+M~t._---_ .._~.---_.._-_._ ..---_ _-- __ .. _._- ._--'-'--'--' --_.- -_ __ _.. _ _--- --"._- --------_._.
+ Tai mili h<;mg _ .._. ._....... _ _ _.._ _.._ _ _._ _. ...___ _ _. .._ ..._. __ =,=- Rang ham ..!U~~ _____.__..__ _._.._..._ _. _,_. _.__ ._.._.__ ..__ .__--- .
+ HIV duang tiOO+Ma tuy duang tiOO
-i~(Y..c~u b~~hchiin si~_~=.~_-':~=~=~=::::..~~=-'=:~==.~__ _._:=- =:-.~===~==..==:~=...a) ~angU'ui mA£...!!..f.!,h..~2.L .._ .. _ __ __ ._.__ . _._._ _ _ .._ ..__ . _ .._.._ _._.....: ~_~?h~~ ~~.~h._..__.__..___, _._-..- - -..- ---- -..-- --.-.._.-- -..--.---.........---..- --.--......------- - --
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_:._B~nh_ho h~2 ...__ ._.. ._. __..__...._..._:~~nh ti~uh~_~ .. . __ .._~B~~ nQi !<!t0B:.khac . _!!l sa ngU'ui 'n.Ac b~'.'h'!:G0{li__._.. __:_CO' ~._U_O'll~g . ._
_- D_an_t_Inh__ m_?c_~_ch_an_.__ . ..__ ..__ ._.__:_Dan tInh m?ch.. thin.!.g.!}nh_.._. ._- Chan b¥t, chai chan.._-------_._-_._--~-~-_.._ .._._- _._--_ .._. -----=~~nh khac . _._._..~) S~J!gU'uim4c bfnh ~goiii t!..~ _- OM---,,---------_ .._---- ..- __ ..__ '-- Nfun da _._----_._ ....__ ...__ .._--_ ...---=-B~~ kha~ . . .. . __. . '....d)sa ngU'ui '!.!#c b~nh !-M:!! "' ' __:._~~~~€tai. ._.... .__ ._..... _ ...__ .._.-...:Btnh v~mUi .__ . .__ __-=-l3.~nh_v€ h~~ .. .. .__...'!J S~ ngU'ui1!!...4.cbf'!...~vJ miit .__ .__
e) Sa ngirui miic bfnh vJ ding
Nh~nxet....................................................................................................................................................................................................................................................................
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Nui nh~n:- Nhutren;................ ,
-Luu .....
Chu nhi~m quan y(Ky, dong ddu)
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Miu Sa. sA th8ng ke ki~m tra StfC khoe nghia Vl}. quan s1}'(cho tuyin XQ)
a) Bia:Huy~n: .
Xa .
S6 th8ng keki~m tra sue khoe nghia VI} quan Slf
Bdt adu ngay .! .! Kit thuc ngay I. .! .
b) N9i dung ghi chep:
sa ThBng kS kiSm tra sue khoe nghia V\l quan s\f
Q A I..uyen so: .
A Phan loai suc khoeThe hrc
TT HC} va ten Ngay Dia chi Cao Can Yang Tinh tr~ng suc khoesinh n~g ngve TB va b~nh t~t Ll L2 L3 L4 L5 L6
(em) (kg) (em)
,
Glzi elzu:_ Th6ng ke kham sue khde NVQS sau mJi ngay cQng d6n cac cQtphdn lot;lisuc khde;- Sau mJi G(1tco tt5ng kit vi?c phdn lot;lisuc khde.
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Mau Sb. sA thBng ke kham SO' tuy~n suc khoe nghia VI} quan sl}'(cho tuyin XQ)
a) Bia:Huy~n: .
Xii .
sa th6ng kekham sO' tuyin sue khoe nghia v1}.quan sl}'
BAt ildu ngay I. I. Kit thuc ngay I. .I. .
A ~Quyen so: .
. ,"
.. ..
b) N(Ji dung ghi chep:SB Th6ng kS.kiSm tra sue khoe nghTa V\l quan S\f
Th~ lU'c K~t luan
TT HC} va ten Ngay Dia chi Cao Can Yang Tinh tr~ng suc khoe Dudik SK Khong du DK khlim t:;tihuy~nsinh n~g ng\Ic TB va b~nh t~t khlim t:;ti ThuQC di~n miSn(cm) Lydo
(kg) (cm) huy~n lfunNVQS khac
Ghi chu:- Th6ng ke kham suc khoe NVQS sau m6i ngay c(jng d6n cac c(jf phon 10(li suc khoe;- Sau m6i Q(1tco t6ng kit vi?c phon 10(lisuc khoe.
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M~u Sc. sa th8ng ke kham StrC khoe nghia vI} quan st}'(eho tuyin huy?n)
a) Bia:Tinh: .
Huy~n .
sa th8ng kekham sue khoe nghia v1} quan sl}'
Bilt ildu ngay .! .! Kit thue ngay .! .
b) N9i dung ghi ehep:
S6 Th6ng kS kiSm tra sue khoe nghia V\l quan SlJ
A ~Quyen so: .
Th~ hrc Phan I03i StrC khoe
TT HQ va ten Ngay Dia chi Cao Can Yang Tinh tr~ng StrC khoesinh n~g ngl,l'cTB va benh tat L1 L2 L3 L4 L5 L6
(cm) . .(kg) (cm)
Ghi chu:- Th6ng ke kham sue kh6e NVQS sau m6i ngay cQng d6n eac cQtphan /ogi suc kh6e;_Sau m6i a(Jt eo t6ng kit vi?c phan /ogi sue kh6e va ca cdu b?nh tq,t eong dan suc kh6e /ogi 4, 5 va 6.
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