,VAN PHONG CHINH PHU ~EN THONG TULIEN TICHdatafile.chinhphu.vn/file-remote-v2/DownloadServlet?filePath=vbpq/2… · sf>:16/2016/TTLT-BYT-BQP BQYTE-BQQu6c PHONG CQNG HOA xXHQI CHU

sf>: 16/20 16/TTL T-BYT -BQP

BQ Y TE - BQ Qu6c PHONG CQNG HOA xX HQI CHU NGHiA VI~T NAMDQc l~p - T\f do - H~nh phtic

Hit Nl}i, ngity 30 thang 6 nam 2016eoN6 THONG TIN {)I$N Til cHiNH PHU :

,VAN PHONG CHINH PHU DENGi~: ( .CONG VAN ~EN THONG TULIEN TICH Ngay:.S11f./.lQ16..: ..

1~~....1.. Ngay ~.I.tQ.~Y...~inhvi~c Imam suc khoe thl}'c hi~n nghia vI} qua~'sl}'

IKinh chuyen: :mr.r:r.?). 1

Can cu Luqt Nghza v¥ Quan Sl:fnam 2015,'

Can cu Nghj ajnh s6 63/2012/ND-CP ngay 31 tJuing8 nam 2012 cUaChinhphu Quy ajnh chuc nang, nhi?m v¥, quy~n h(m va co cdu t6 chuc cua B(J Y ti;

Can cu Nghj ajnh s6 35/2013/ND-CP ngay 22 thimg 4 nam 2013 cua Chinhphu Quyajnh chuc nang, nhi?m v¥, quy~n hgn va co cdu t6 chuc cua B(J Qu6cphong;

Thea a~ nghj cua C¥c truirng C¥c Quem if; Kham, chua b?nh - B(J Y ti vaC¥c truirng C¥c Quan y - B(J Qu6c phong,

B(J truirng B(J Y ti va B(J truirng B(J Qu6c phong ban hanh Thong tu lientjch quy ajnh vi?c kham suc kh6e thlfc hi?n nghza v¥ quan Sl:f.

ChtfO'ng INHUNG QUY DJNH CHUNG

Di~u 1.Ph~m vi di~u chinh va d8i ttfgng ap d1}ng1. Thong tu lien tich (sau day vi~t t~t la Thong tu) nay quy dinh kham suc

khoe thlJc hi~n nghla V\l quan SlJ, bao g6m: KiSm tra suc khoe, sa tuySn suckhoe, kham suc khoe, kham phuc tra suc khoe, giam dinh suc khoe, quan ly suckhoe va phan lo~i suc khoe ddi v6i cong dan Vi~t Nam trong dQ tu6i duQ'c g<)ilam nghla V\lquan SlJt~i ngfi, quan nhan dlJ bi va cong dan dang ky dlJ thi tUYSnsinh quan SlJ.

2. Thong tu nay ap d\lng ddi v6i:a) Cong dan Vi~t Nam trong dQtu6i duQ'cg<)ilam nghla V\lquan SlJt~i ngfi,

quan nhan dlJ bi va cong dan dang ky dlJ thi tuySn sinh quan SlJ;b) CO'quan quan slJ cac clip, cO'quan y t~, quan y cac clip;c) Cac cO'quan, dan vi, t6 chuc va ca nhan co lien quan d~n vi~c kham suc

khoe thlJc hi~n nghla V\lquan SlJ.Di~u 2. Ghii thich tir ngfrTrong Thong tu nay, cac til ngu du6i day duQ'chiSu nhu sau:

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1. Kiim tra sue khoe nghia v¥ quan S1! la vi~c th\fc hi~n kiSm tra, phan lo~i,k@tlu~n suc khoe d6i vai quan nhan d\f bi.

2. Sa tuyin sue khoe nghia v¥ quan S1! la vi~c th\fc hi~n kiSm tra, danh giasa b9 suc khoe d6i vai cong dan duQ'c gQi kham suc khoe th\fc hi~n nghia V\lquan S\ftruac m6i dqt tuySn chQn va gQicong dan nh~p ngl1.

3. Kham sue khoe nghia v¥ quan S1! la vi~c th\fc hi~n kham, phan lo~i, k@tlu~n suc khoe d6i vai cong dan duQ'cgQi lam nghia V\l quan S\f dff qua sa tuySn<::::Lsuc khoe va cong dan dang ky d\f thi tuySn sinh quan S\f, do H9i d6ng kham suckhoe nghia V\lquan S\fhuy~n th\fc hi~n.

4. H(Ji a6ng kham sue khoe nghia v¥ quan S1! la H9i d6ng chuyen mon ho~td9ng theo ch@d9 kiem nhi~m do Chu tich Uy ban nhan dan huy~n quy@tdinhthanh l~p theo dS nghi cua Phong Y t@huy~n; m6i huy~n co thS thanh l~p til m9td@nhai h9i d6ng tuy theo dia ban va s6 cong dan c~n kham.

5. Kham phue tra sue khoe nghia v¥ quan S1! la vi~c th\fc hi~n kham, phanlo~i, k@tlu~n l~i suc khoe d6i vai chi@nsy mai nh~p ngl1 vao Quan d9i, do H9id6ng kham cua dan vi nh~n quan th\fc hi~n.

6. H(Jia6ng kham phue tra sue khoe la H9i d6ng chuyen mon ho~t d9ng theoch@d9 kiem nhi~m do Thu truOng dan vi (d.p trung doan va tuang duang tra len)quy@tdinh thanh l~p theo dSnghi cua Chu nhi~m Quan y dan vi.

7. Giam ainh sue khoe nghia v¥ quan S1! la vi~c su d\lng phuang ti~n, kythu~t, nghi~p V\ldS kham, k@tlu~n vS tinh tr~ng suc khoe cua cong dan duQ'cgQilam nghia V\lquan S\f, cong dan dang ky d\f thi tuySn sinh quan S\fva quan nhand\f bi trong truOng hQ'Pco khi@un~i.

8. H6 sa sue khoe nghia v¥ quan S1! la tai li~u vS tinh hinh suc khoe cuacong dan duQ'c gQi lam nghia V\lquan S\ft~i ngl1, cong dan dang ky d\f thi tuySnsinh quan S\f va quan nhan d\f bi, bao g6m phi@usuc khoe nghia V\l quan S\fvacac tai li~u lien quan d@nsuc khoe.

9. Phiiu sue khoe nghia v¥ quan S1! la tai li~u y khoa t6ng hQ'Pnhfrng thongtin cO'ban vS suc khoe cua cong dan lam nghia V\lquan S\f.

Di~u 3. Kinh phi th\fc hi~n kham suc khoe nghia vy. quan S\f

Kinh phi bao dam cho vi~c kham suc khoe, sa tuySn suc khoe, kiSm tra suckhoe, giam dinh suc khoe, lam cac xet nghi~m cho cong dan th\fc hi~n nghia V\lquan S\f duQ'c su d\lng til ngan sach dia phuang bao dam cho cong tac qu6cphong - an ninh theo quy dinh hi~n hanh. Dinh muc v~t tu tieu hao va kinh phicho ho~t d9ng kiSm tra suc khoe, kham suc khoe th\fc hi~n Nghia V\l quan S\ftheo quy dinh t~i Ph\ll\lc 2 ban hanh kem theo Thong tu nay.

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ChU'O'ng IIKHAM SUC KHOE THlfC HI~N NGHiA Vl) QUAN Slf

Di~u 4. Ki~m tra suc khoe nghia Y\I quan s1}'

1. T6 kiSm tra suc khoe

a) T6 kiSm tra suc khoe do Trung tam y tS qu~n, huy~n, thi xa, thanh phdtr\fc thuQc tinh, thanh phd tr\fc thuQc Trung uang (sau day gQi chung la Trungtam y tS huy~n) ra quySt dinh thanh l~p. T6 kiSm tra suc khoe g6m it nhfit 3thanh vien: 01 bac sy lam t6 truOng va 2 nhan vien y tS khac thuQc tr<;tmy tS xa,khi c~n thiSt co thS duQ'cdi@udQng til' Trung tam Y tS huy~n;

b) T6 kiSm tra suc khoe co nhi~m V\l t6 chuc kiSm tra suc khoe, l~p phiSukiSm tra suc khoe va t6ng hQ'P,bao cao kSt qua theo quy dinh.

2. NQi dung kiSm tra suc khoe

a) KiSm tra v@thS l\fc;

b) Lfiy m<;tch,huySt ap;

c) Kham phat hi~n cac b~nh ly v@nQi khoa, ngo<;tikhoa va chuyen khoa;

d) Khai thac ti@nsu b~nh t~t ban than va gia dinh.

3. Quy trinh kiSm tra suc khoe

a) Can cu vao kS ho<;tchhufin luy~n quan nhan d\f bi cua quan S\f diaphuang, l~p danh sach cac ddi tugng duQ'c tri~u t~p tham gia hufin luy~n d\f bidQng vien tren dia ban duQ'cgiao quan ly;

b) Thong bao thai gian, dia diSm t6 chuc kiSm tra suc khoe;

c) L~p phiSu kiSm tra suc khoe nghia V\lquan S\ftheo M~u 1 Ph\ll\lc 4 banhanh kern theo Thong tu nay;

d) T6 chuc kiSm tra suc khoe theo cac nQi dung quy dinh t<;tiKhoan 2 Di@unay;

d) T6ng hQ'P,thdng ke, bao cao kSt qua kiSm tra suc khoe theo Mftu 1a vaM~u Sa Ph\ll\lc S ban hanh kern theo Thong tu nay.

J)i~u 5. SO' tuy~n suc khoe nghia Y\I quan s1}'

1. Sa tuySn suc khoe do Tr<;tmy tS xa tiSn hanh du6i S\f chi d<;tov@chuyenmon, nghi~p V\lcua Trung tam y tS huy~n.

2. NQi dung sa tuySn suc khoe

a) Phat hi~n nhfrng truang hQ'Pkhong du suc khoe v@thS l\fc, di t~t, di d<;tngva nhung b~nh ly thuQc di~n miSn dang ky nghia V\lquan S\f;

b) Khai thac ti@nsu b~nh t~t ban than va gia dinh.

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3. Quy trinh sa tuy~n suc khoe

a) Can cu vao k@ho~ch tuy~n ch(.m va g9i cong dan nh~p ngu cua HQid6ng nghia V\l quan S\f dia phuong, l~p danh sikh cac d6i tuqng la cong danthuQc di~n g9i kham suc khoe th\fc hi~n nghia V\l quan S\f tren dia ban duqcgiao quan ly;

b) T6 chuc sa tuy~n suc khoe theo nQidung quy diM ~i Khoan 2 DiSunay;

c) Hoan chinh va xac nh~n tiSn su b~nh t~t bim than va thong tin cua congdan duqc g9i kham suc khoe nghia V\l quan S\f theo quy dinh t~i M\lc IM~u 2 J

Ph\ll\lc 4 ban hanh kern theo Thong tu nay;

d) L~p danh sach nhung cong dan mic cac b~nh thuQc Danh m\lc b~nhmiSn dang ky nghia V\l quan S\f theo Bang s6 3 Ph\l l\lc 1 ban hanh kern theoThong tu nay, bao cao HQi d6ng Nghia V\lquan S\fxa;

d) T6ng hqp, th6ng ke, bao cao k@tqua sa tuy~n suc khoe theo M~u 2 vaM~u 5b Ph\ll\lc 5 ban hanh kern theo Thong tu nay.

Di~u 6. Kham sue khoe nghia V1}.quan s1!

1. HQi d6ng kham suc khoe nghia V\lquan S\f

a) Thanh ph~n HQi d6ng kham suc khoe nghia V\lquan S\f

- HQi d6ng kham suc khoe nghia V\lquan S\fhuy~n g6m: bac sy, nhan vieny t@thuQCTrung tam Y t@huy~n, can bQ chuyen mon Phong Y t@,quan y BanChi huy quan S\fhuy~n va cac don vi co lien quan.

- HQi d6ng kham suc khoe nghia V\lquan S\fg6m:

+ 01 Chu tich: do Giam d6c Trung tam Y t@huy~n dam nhi~m;

+ 01 Pho Chu tich: Pho giam d6c ph\l trach chuyen mon;

+ 01 Uy vien Thucmg tnJc kiem Thu ky HQi d6ng do can bQ chuyen monPhong Y t@dam nhi~m;

+ Cac uyvien khac.

- 86 luqng uy vien HQi d6ng, tuy thuQc vao diSu ki~n C\l th~ cua tUng diaphuong, nhung phai bao dam du s6 luqng va trinh dQ th\fc hi~n kham suc khoetheo quy dinh t~i Khoan 2, du bQ ph~n theo quy dinh t~i Khoan 5 DiSu nay,trong do phai co t6i thi~u til 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 th~ b6trl bac sy ho~c y sy, ky thu~t vien thuQCchuyen khoa do dam nhi~m.

b) Nguyen tic lam vi~c cua HQid6ng kham suc khoe nghia V\lquan S\f

- HQid6ng lam vi~c theo nguyen t~c ~p th~, quy@tdinh cac vfuIdS theo da s6;

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- TruOng hQ'Pcac thanh vien cua HQi d6ng khong th6ng OOfttv@phan lo~iva kSt lu~n suc khoe thi Chu tich HQi d6ng ghi vao phiSu suc khoe kSt lu~n theoy kiSn cua da s6. TruOng hQ'PbiSu quySt ngang nhau thi quySt diOOtheo ben cobiSu quySt cua Chu tich HQi d6ng. Nhfing y kiSn khong th6ng OOfttphai duQ'cghi dfiy du vao bien ban, co chu ky cua tung thanh vien trong HQi d6ng, gui HQid6ng Nghia V\l quan S\fhuy~n.

c) Nhi~m V\l cua HQi d6ng kham suc khoe nghia V\l quan S\f

- Chiu trach OOi~mtruac HQi d6ng Nghia V\l quan S\f huy~n v@vi~c triSnkhai kham suc khoe, phan lo~i va kSt lu~n suc khoe cho tUng cong dan duQ'cg<;>inh~p ngu;

- T6ng hQ'Pbao cao kSt qua kham suc khoe gui HQi d6ng Nghia V\l quan S\fhuy~n va So' Y tS tiOO,thanh ph6 tr\fc thuQc Trung uang (sau day g<;>ichung latinh) theo quy diOO;ban giao toan bQ h6 sa suc khoe cho HQi d6ng Nghia V\l

quan S\fhuy~n (qua Phong Y tS huy~n).

d) Nhi~m V\l cua cac thanh vien trong HQi d6ng Kham suc khoe nghia V\l

quan S\f

- Chu tich HQi d6ng:

+ Di@uhaOOtoan bQ ho~t dQng cua HQi d6ng; chiu trach OOi~mtruac HQid6ng Nghia V\l quan S\fhuy~n v@chftt lUQ'llgkham suc khoe cong dan thuQc di~nduQ'cg<;>ilam nghia V\l quan S\f;

+ Quan tri~t, ph6 biSn kS ho~ch kham suc khoe nghia V\l quan S\f;huang dfulcac quy diOOv@tieu chu&nsuc khoe, chuc trach, OOi~mV\l, nguyen t~c lam vi~c vaphan cong OOi~mV\l C\l thS cho cac thaOOvien trong HQid6ng kham suc khoe;

+ Tri~u t~p va chu tri h<;>pHQi d6ng dS kSt lu~n d6i vai nhung truanghQ'pco y kiSn khong th6ng nhftt v@kSt lu~n suc khoe;

+ T6 chuc hQi ch&n va ky gifty giai thi~u cho cong dan kham suc khoenghia V\l quan S\fdi kiSm tra a cac ca So'y tS khi cfin thiSt;

+ Tr\fc tiSp kSt lu~n phan IO(;lisuc khoe va ky vao phiSu suc khoe nghiaV\l quan S\f;

+ T6 chuc h<;>prut kinh nghi~m cong tac kham suc khoe nghia V\l quan S\l'va bao cao vai HQi d6ng Nghia V\l quan S\fhuy~n.

- Pho Chu tich HQi d6ng:

+ Thay m~t Chu tich HQi d6ng khi v~ng m~t;

+ Tr\fc tiSp kham suc khoe, tham gia hQi ch&nkhi cfin thiSt;

+ Tham gia h<;>pHQi d6ng kham suc khoe nghia V\l quan s\!'.

- Uy vien ThuOng tr\fc, kiem Thu ky HQi d6ng:

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+ L~p d\f tru, t6ng hQ'Pva quySt toan kinh phi, thu6c, v~t tu tieu hao ph\lcV\lcho cong tac kham suc khoe nghi'a V\lquan sV';

+ Chufin bi phuong ti~n, cO'sa v~t chfrt, h6 sa suc khoe va cac tai li~u c~nthiSt khac dS H9i d6ng kham suc khoe nghi'a V\lquan SV'lam vi~c; tham gia hQpH9i d6ng kham suc khoe nghi'a V\lquan sV';

+ Tham gia kham suc khoe, h9i chfin khi c~n thiSt;

+ ThV'chi~n dang ky, th6ng ke va giup Chu tich H9i d6ng lam bao cao lenH9i d6ng Nghi'a V\lquan SV'huy~n va Sa Y tS theo M~u 3a va M~u 5c Ph\ll\lC 5ban hanh kern theo Thong tu nay.

- Cac uy vien H9i d6ng:

+ TrV'ctiSp kham suc khoe va tham gia h9i chfin khi c~n thiSt;

+ Chiu trach nhi~m vS chfrt lUQ'llgkham va kSt lu~n suc khoe trong ph~m viduQ'cphan cong;

+Tham gia hQpH9i d6ng kham suc khoe nghi'avv quan SV'khi duQ'ctri~u~p.

2. N9i dung kham suc khoe

a) Kham vS thS lV'c;kham lam sang cac chuyen khoa theo cac chi tieu quydinh t~i M\lc II, M~u 2 Ph\l l\lc 4 ban hanh kern theo Thong tu nay; trong quatrinh kham, truang hQ'Pcong dan duQ'ckham co m9t trong cac chuyen khoa xSpdiSm 5 ho?c diSm 6 thi nguai kham chuyen khoa do co trach nhi~m baa cao Chutich H9i d6ng kham suc khoe xem xet, quySt dinh vi~c co tiSp t\lC kham cacchuyen khoa khac;

b) Truang hQ'Pc~n xet nghi~m c~n lam sang ph\lc vv cho kSt lu~n suc khoetheo yeu cfiu cua H9i d6ng kham suc khoe nghi'a V\l quan S\f, baa g6m ca xetnghi~m phat hi~n rna tuy;

c) Phan lo~i suc khoe theo cac quy dinh t~i DiSu 9 Thong tu nay.

3. Quy trinh kham suc khoe

a) L~p danh sach cac d6i tUQ'llgla cong dan thu9C di~n duQ'c gQi nh~p ngilda:qua sa tuySn suc khoe tren dia ban duQ'cgiao quan ly;

b) Thong bao thai gian, dia diSm t6 chuc kham suc khoe;

c) T6 chuc kham suc khoe theo cac n9i dung quy dinh t~i Khoan 2 DiSu nay;

d) T6 chuc tu vfrn va xet nghi~m HIV theo quy dinh cua Lu~t Phong, ch6ngHIV/AIDS d6i v6i cac truang hQ'Pd~t tieu chu~n suc khoe gQi nh~p ngil hingnam theo huang d~n cua B9 truang B9 Qu6c phong;

d) Hoan chinh phiSu suc khoe thea quy dinh t~i M\lc II M~u 2 Ph\l l\lc 4ban hanh kern theo Thong tu nay;

e) T6ng hQ'P,bao cao kSt qua kham suc khoe nghi'a V\lquan S\fthea M~u 3aPh\ll\lc 5 ban hanh kern thea Thong tu nay.

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4. Thai gian kham suc khoe: ill ngay 01 thang 11 d@nh@tngay 31 thang 12h~ngnam.

5. TfJ chuc cac phong kham suc khoe

a) Vi~c b6 tri cac phong kham phai theo nguyen tAc mQt chiSu, khep kin,thu~n IQ'i cho nguai kham va bao dam du diSu ki~n t6i thiSu dS kham d6i vaitUng chuyen khoa.

b) 86 IUQ'llgcac phong kham can cu vao s6 IUQ'llgnhan vien y t@cua HQid6ng kham suc khoe va tinh hinh th\fC t@dS b6 tri:

- Phong kham thS l\fc;

- Phong do m~ch, Huy@t ap;

- Phong kham thi l\fc, MAt;

- Phong kham thinh l\fc, Tai - Mili - H<;mg;

- Phong kham Rang - Ham - M~t;

- Phong kham NQi va Tam thc1nkinh;

- Phong kham Ngo~i khoa, Da lieu;

- Phong xet nghi~m;

- Phong k@tlu~n.

Truang hQ'P co kham tuySn cong dan nu th\fc hi~n kham san phv khoa theohuang d~n t~i M\lc IV Ph\ll\lc 1 ban hanh kern theo Thong tu nay.

c) Trang bi, d\lng C\l y t@t6i thiSu cua HQi d6ng kham suc khoe theo Danhm\lc quy dinh t~i Ph\ll\lc 3 ban hanh kern theo Thong tu nay.

6. D6i 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 Y\l quy dinh t~i DiSu nay.

Di~u 7. Kham phuc tra suc khoe nghia vt} quan Sl}'

1.HQi d6ng kham phuc tra suc khoe

a) Thanh phc1n HQi d6ng kham phuc tra suc khoe, g6m: can bQ, nhan vienquan y cua trung doan va tuong duang tra len. Khi cc1n thi@t, HQi d6ng duQ'ctang cuang them l\fc IUQ'ngchuyen mon cua quan y tuy@n tren;

b) Nhi~m V\l cua HQi d6ng kham phuc tra suc khoe

- TfJ chuc, triSn khai kham, phan lo~i va k@t lu~n l~i suc khoe cho toan bQchi@n sy mai theo k@ho~ch dff duQ'c phe duy~t;

- T6ng hQ'Pbao cao k@tqua kham phuc tra suc khoe.

2. NQi dung kham phuc tra suc khoe

a) Theo quy dinh tuySn ch<.mva g<;>icong dan nh~p ngfi cua BQ Qu6c phong;

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b) Phan IOl;lisue khoe theo quy dinh tl;lif)i~u 9 Thong tu nay.

3. Quy trinh kham phue tra sue khoe

a) Thong bao thai gian, dia di@mkham phue tra sue khoe;

b) T6 ehue kham phue tra sue khoe theo quy dinh tl;liKhoan 2 f)i~u nay; d6iv6i cae truang h9]J, phiSu sue khoe co ghi ehfr "T" (tl;lmthai), HQi d6ng khamphue tra sue khoe phai kSt lu~n:

- NSu b~nh khoi thi bo ehfr "T" va ehuy@nIOl;lisue khoe;

- NSu khong khoi ho?e co ehi~u huang tiSn tri~n x~u, e~n phai t6 ehue khamll;liva co kSt lu~n du sue khoe ho?e khong du sue khoe g9i nh~p ngu phai tra v~dia phuong.

c) T6ng h9]J bao eao kSt qua kham phue tra sue khoe theo M~u 4d Ph\ll\le 5ban hanh kern theo Thong tu nay.

Di~u 8. Ghim dinh suc khoe nghia V\I quan s\f

1. HQi d6ng giam dinh y khoa tinh t6 ehue giam dinh sue khoe nghia V\lquan SlJkhi co cae khiSu nl;lilien quan dSn sue khoe eua eong dan duqe g9i lamnghia V\l quan S\!, eong dan dang ky d\! thi tuy@nsinh quan S\!va quan nhan d\!bi, do HQi d6ng Nghia V\lquan S\!huy~n d~ nghi.

2. Yeu e~u giam dinh: Giam dinh tinh trl;lngb~nh t~t theo d~ nghi eua HQid6ng Nghia V\l quan S\! huy~n; kSt lu~n giam dinh phai xae dinh ra tinh trl;lngb~nh t~t va phan IOl;lisue khoe theo Bang s6 1, Bang s6 2 va Bang s6 3 tl;liPh\ll\le 1 ban hanh kern theo Thong tu nay.

3. Trong yang 7 - 10 ngay lam vi~e, k@ill ngay nh~n du h6 sa d~ nghi giamdinh sue khoe, HQi d6ng giam dinh y khoa tinh phai co kSt lu~ giam dinh suekhoe eong dan th\!e hi~n nghia V\lquan S\!va gui h6 sa, kSt qua giam dinh eho HQid6ng Nghia V\lquan S\!huy~n.

4. QuySt dinh eua HQi d6ng giam dinh y khoa tinh la kSt lu~n eu6i cling v~khiSu nl;lisue khoe eua eong dan th\!e hi~n nghia V\lquan SlJva tuy@nsinh quan S\!.

Di~u 9. Phan lo~i suc khoe th\fc hi~n nghia V\I quan s\f

1. Can eu phan IOl;lisue khoe

Theo tieu ehu~n sue khoe tl;liBang s6 1, Bang s6 2 va Bang s6 3 Ph\l l\le 1ban hanh kern theo Thong tu nay.

2. Caeh eho di~m

M6i chi tieu, sau khi kham bae sy eho di~m ehfu1ill 1 - 6 vao eQt"f)i~m", e\l

a) f)i~m 1: Chi tiOOtrl;lngsue khoe r~t t6t;

b) f)i~m 2: Chi tiOOtrl;lngsue khoe t6t;

8

c) DiSm 3: Chi tinh tr~ng suc khoe kha;

d) DiSm 4: Chi tinh tr~ng suc khoe trung binh;

d) DiSm 5: Chi tinh tr~ng suc khoe kern;

e) DiSm 6: Chi tinh tr~ng suc khoe rat kern.

3. Cach ghi phiSu suc khoe nghTaV\l quan S\f

a) M6i chuyen khoa, sau khi kham xet, bac sy se cho diSm vao cQt "DiSm";a cQt "Ly do" phai ghi tom t~t ly do cho s6 diSm do; a cQt "KY", bac sy khamphai ky va ghi ro h<;>ten;

b) Ph~n kSt lu~n, Chu tich HQi d6ng kham suc khoe din cu vao diSm dacho a tUng chi tieu dS kSt lu~n, phan lo~i suc khoe theo dung quy dinh, ghi b~ngs6 va chu (ph~n b~ng chu dS a trong ngo~c don);

c) Chu tich HQi d6ng kham suc khoe co trach nhi~m ky vao phiSu suc khoenghTaV\l quan S\f sau khi kSt lu~n;

d) Chu ky cua Chu tich HQi d6ng kham suc khoe duqc dong dau cua coquan Chu tich HQi d6ng; chu ky cua Chu tich HQi d6ng kham phuc tra suc khoeduqc dong dau cua don vi quySt dinh thanh l?p HQi d6ng kham phuc tra suc khoe.

4. Cach phan lo~i suc khoe

Can cu vao s6 diSm cham cho 8 chi tieu ghi trong phiSu suc khoe nghTaV\l

quan S\f dS phan lo~i, C\l thS nhu sau:

a) Lo~i 1: 8 chi tieu dSu d~t diSm 1;

b) Lo~i 2: Co it nhat 1 chi tieu bi diSm 2;

c) Lo~i 3: Co it nhat 1 chi tieu bi diSm 3;

d) Lo~i 4: Co it nhat 1 chi tieu bi diSm 4;

d) Lo~i 5: Co it nhat 1 chi tieu bi diSm 5;

e) Lo~i 6: Co it nhat 1 chi tieu bi diSm 6.

5. MQt s6 diSm c~n chli y

a) Truang hqp dang m~c b~nh cap tinh' b~nh co thS thuyen giam hay tanglen sau mQt thai gian ho~c sau diSu tri, thi diSm do phai kern theo chu "T" benc~nh (nghTa la "t~m thai"). Nguai kham phai ghi tom t~t b~ng tiSng Vi~t tenb~nh ben c~nh (co thS ghi b~ng danh tu qu6c tS giua hai ngo~c don). Khi kStlu?n, nSu chu "T" a chi tieu co diSm 100 nhat, phai viSt chu "T" vao ph~n phanlo~i suc khoe;

b) Truang hqp nghi nga chua thS cho diSm ngay duqc, HQi d6ng kham suckhoe co thS gui cong dan t6i kham t~i mQt b~nh vi~n dS kSt lu?n chinh xac hon;

9

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c) Truang hQ'p chua kSt lu~n duQ'c thi gui cong dan do dSn b~nh vi~nchuyen khoa g~n nh~t dS kham va kSt lu~n ch~n doan. Thai gian t6i da til 7 -10 ngay phai co kSt lu~n va chi th\fChi~n trong truang hqp c~n thiSt;

d) Nhfrng truang hQ'p phiSu suc khoe co ghi chfr "T", H9i d6ng khamsuc khoe nghia V\l quan S\f co tnich nhi~m huang d~n cong dan dSn cac coSo' y tS dS di@utrio

Di~u 10. Yeu cAu dai v6i cong dan khi di ki~m tra, SO'tuy~n, kham suckhoe thl}'c hi~n nghia vy. quan sl}'

1. Ph~tixu~t trinh

a) L~nh gQi kham suc khoe ho~c kiSm tra suc khoe cua Chi huy truangBan chi huy quan S\f huy~n;

b) Gi~y chung minh nhan dan;

c) Cac gi~y ta lien quan dSn suc khoe ca nhan (nSu co) dS giao cho H9id6ng kham suc khoe ho~c T6 kiSm tra suc khoe nghia v\l quan S\f.

2. Khong u6ng ruQ'U,bia ho~c dung ch~t kich thich.

3. Ch~p hanh n9i quy khu V\fCkham suc khoe, kiSm tra suc khoe.

4. C~m cac hanh vi IQ'id\lng vi~c kham suc khoe dS tr6n, tranh th\fc hi~nnghia V\lquan S\f.

ChuO'ng IIIPHIEU sue KHOE NGHiA VV QUAN SV

vA QUAN LY sue KHOE QUAN NHAN nV BJ

Di~u 11. Phi~u suc khoe nghia vy. quan sl}'

1. N9i dung phiSu suc khoe nghia V\lquan S\f

a) Ph~n I-So ySu Iy ljch va ti@nsu b~nh t~t:

- Ph~n so ySu Iy ljch do Ban chi huy quan S\fxa ghi;

- Ti@nsu b~nh t~t: do Tr?m y tS xa ghi va chiu trach nhi~m.

b) Ph~n II-Kham suc khoe: do H9i d6ng kham suc khoe nghia V\lquan S\fhuy~n ghi a nua ben trai va H9i d6ng kham phuc tra suc khoe cua don vi quand9i ghi a nua ben phai.

2. Quan Iy phiSu suc khoe nghTaV\lquan S\f

a) Khi chua nh~p ngfi, phiSu suc khoe nghia V\l quan S\f do Ban Chi huyquan S\fhuy~n quan Iy;

b) Khi cong dan nh~p ngfi, phiSu suc khoe nghTaV\lquan S\fduQ'cgiao chodon vi nh~n quan, quan Iy t?i quan y tuySn trung doan va tuong duong;

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I

c) Ra quan, ban giao l~i Ban Chi huy quan S\1huy~n quim ly.3. PhiSu sue khoe nghla V\lquan S\1chi co gia tri khi:a) Theo dung mfiu qui dinh;b) ViSt b~ng but m\1e ho~e but bi, khong duge viSt b~ng but chi;c) Chu viSt r5 rang, khong tciyxoa, khong viSt t~t;d) Ghi d~y du cae nQi dung quy dinh trong phiSu sue khoe nghla V\l

quan S\1;d) Khong qua 06 (sau) thang kS tir ngay HQi d6ng kham sue khoe nghla V\l

quan S\1co kSt lu~n vS tinh tr~ng sue khoe, trir truang hgp co di@nbiSn d~e bi~tvS sue khoe.

Di~u 12. Giao, nh~n phi~u suc khoe nghia vy. quan st]' cua cong dannh~p ngii

1. Truae khi HQi d6ng Nghla V\l quan S\f huy~n phat l~nh gQi eong dannh~p ngfi, Phong Y tS huy~n phai hoan thanh vi~e l~p danh saeh nhfrng eong dandu sue khoe theo quy dinh, hoan ehinh phiSu sue khoe nghla V\l quan S\1va bangiao eho Ban Chi huy quan S\1huy~n.

2. Can eu vao kS ho~eh hi~p d6ng giua dan vi nh~n quan va dia phuong,Ban Chi huy quan S\f huy~n ban giao phiSu sue khoe nghla V\l quan S\1eua caeeong dan du tieu ehucin sue khoe eho quan y don vi nh~n quan.

3. Quan y dan vi nh~n quan t6 ehue nghien elru truae h6 sa sue khoe eongdan duge gQi nh~p ngfi. Truang hgp phat hi~n co nghi vc1nvS sue khoe, dS nghiHQi d6ng Nghla V\lquan S\1huy~n kiSm tra kSt lu~n l~i.

4. T6ng hgp bao eao kSt qua theo mfiu t~i Ph\l l\le 5 ban hanh kern theoThong tu nay (dia phuong giao quan theo Mfiu 4a, 4b; quan y don vi nh~n quantheo Mfiu 4e).

5. Don vi nh~n quan phai t6 ehue kham phue tra sue khoe eho ehiSn sy maingay sau khi vS don vi dS phan lo~i, kSt lu~n l~i sue khoe, phat hi~n nhfrngtruang hgp khong du sue khoe tra vS dia phuong va co traeh nhi~m thong baoeho Ban Chi huy quan S\1huy~n biSt:

a) 86 eong dan du tieu ehucin sue khoe;b) 86 eong dan khong du tieu ehucin sue khoe e~n tra vS dia phuong (do sai

sot trong qua trinh kham chua tim ra b~nh ho~e b~nh mai phat sinh trong quatrinh huc1nluy~n ehiSn sy mai).

6. Quy dinh vS vi~e tra l~i nhung eong dan khong du tieu ehucin suekhoe vS dia phuang

a) Nhfrng eong dan khong du tieu ehucin sue khoe tra vS dia phuong khi kStqua kham phue tra sue khoe duge Chu nhi~m Quan y ec1ptrung dmln va tuongduong tra len xae dinh va ec1ptren tr\1e tiSp phe duy~t.

1 1

,----I,

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b) H6 sa sue khoe eua eong dan khong du tieu ehu~n sue khoe tnl v@diaphuang phai eo du phiSu sue khoe nghla V\l quan Sl)' eua HQi d6ng kham suekhoe nghla V\l quan Sl)'dia phuang eo ph~n ghi kSt qua kham, kSt lu~n sue khoeeua HQi d6ng kham phue tra sue khoe dan vi.

e) Vi~e tra eong dan khong du sue khoe v@dia phuang thl)'e hi~n theo quydinh eua BQ Qu6e phong. TruOng hQ'p e~n thiSt, eO'quan y tS dia phuang t6 ehuekiSm tra It;li(thai ht;ln tu 7 - 10 ngay, kS tu khi dan vi ban giao eong dan khongdu sue khoe eho dia phuang). TruOng hQ'P khong th6ng nh<1tvai kSt lu~n euaHQi d6ng kham phue tra sue khoe eua dan vi, HQi d6ng Nghla V\l quan Sl)'huy~nehuySn h6 So' eua eong dan len HQi d6ng giam dinh y khoa tinh dS t6 ehue giamdinh sue khoe.

Di~u 13. QmlD If sue khoe qUaD DhaD d1}'hi1. MQi quan nhan truae khi tra v@ dia phuO'ng (xu<1t ngu, ph\le vi en,

ehuySn nganh), quan y dan vi eo traeh nhi~m t6 ehue kham, phan lot;li suekhoe, ghi vao phiSu sue khoe quan nhan. Khi vS dia phuO'ng, quan nhan eontrong dQ tu6i dl)' bi phai nQp h6 So' sue khoe eho Ban Chi huy quan Sl)'huy~ndS quan ly.

2. Quan nhan dl)' bi dUQ'ekiSm tra sue khoe truae m6i dqt t~p trung hu<1nluy~n theo kS hot;leh eua HQi d6ng Nghla v\l quan sl)' dia phuO'ng. Nhung quannhan dl)' bi eon du sue khoe theo tieu ehu~n dUQ'e tiSp t\le b6 tri vao eae danvi dl)' bi dQng vien. Truang hQ'p khong du tieu ehu~n sue khoe, Phong Y tShuy~n thong bao b~ng van ban dSn Ban Chi huy quan Sl)'huy~n dS dua ra khoidanh saeh dl)' bi dQng vien eua dia phuO'ng.

3. Trong eae dqt hu<1nluy~n va t~p trung kiSm tra s~n sang dQng vien quannhan dl)' bi, quan y eua eae dan vi dl)' bi dQng vien eo traeh nhi~m theo doi eh~tehe vS m~t sue khoe eua quan nhan dl)' bi.

4. Khi eo l~nh dQng vien, Ban Chi huy quan Sl)' huy~n eo traeh nhi~mban giao toan bQ h6 So' sue khoe eua quan nhan dl)' bi eho dan vi tiSp nh?nquan nhan dl)' bi quan ly.

ChU'O'Dg IVNHI~M Vv eVA co QUAN Y TE cAe cAp

TRONG KHAM sue KHOE THve HI~N NGHiA VV QUAN sV

Di~u 14. Tr~m y t~ xa1. Cli' ean bQ tham gia T6 kiSm tra sue khoe nghla V\l quan Sl)'.

2. T6 ehue kiSm tra sue khoe, l?p h6 So' sue khoe eho eong dan thuQe di~nthl)'e hi~n nghla V\l quan Sl)'theo kS hot;leh eua HQi d6ng Nghla V\l quan Sl)'diaphuang. Qulm ly, theo doi tinh hinh sue khoe eong dan (thuQe di~n quan ly)trong dQ tu6i lam nghla V\l quan Sl)',phat hi~n kip thai nhung truOng hQ'P m~eb~nh mt;ln tinh, eae b~nh thuQe danh m\le b~nh miSn dang ky nghla V\l quan Sl)'.

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-------- ~.~~~_~ __ ~<~_,.~ ••_~~~=~~======d

3. Can cu V~lOkS ho?ch cua HQi d6ng NghTa V\l qufm S\f xa, ph6i hQ'pv6i Ban chi huy quan S\f xa t6 chuc sa tuySn suc khoe cho cong dan duQ'cg<)i kham suc khoe th\fc hi~n nghTa V\l quan S\f.

4. Sau khi sa tuySn, l~p danh sach cong dan du tieu chuAn suc khoe lamnghTa V\l quan S\f va nhfing cong dan m~c b~nh thuQc Danh m\lC cac b~nh miSndang ky nghTa V\l quan S\f quy dinh t?i Bang s6 3 Ph\l l\lc 1 ban hanh kern theoThong tu nay, thong qua HQi d6ng NghTa V\l quan S\f xa.

5. Xac nh~n va chiu trach nhi~m v@ti@nSlr b~nh t~t cua cong dan duQ'c g<)ilam nghTa V\l quan S\f va dang ky d\f thi tuySn sinh quan S\f; ban giao h6 sa suckhoe, phiSu suc khoe nghTa V\l quan S\f cua cac cong dan di kham suc khoe choHQi d6ng kham suc khoe nghTa V\l quan S\f huy~n.

6. Th\fc hi~n sa kSt, t6ng kSt, rut kinh nghi~m v@ cong tac sa tuySn suckhoe, kiSm tra suc khoe nghTa Y\l quan S\f sau m6i dqt tuySn ch<)n va g<)i congdan nh~p ngil ho~c t~p trung huc1n luy~n quan d\f bi.

Di~u 15. Phong Y t~ huy~n

1. Tham muu cho Dy ban nhan dan va HQi d6ng NghTa V\l quan S\f huy~nv@cong tac kham suc khoe th\fc hi~n nghTa V\l quan S\f.

2. TiSp nh~n, hoan chinh phiSu suc khoe nghTa V\l quan S\f cua cac congdan duQ'c g<)i lam nghTa V\l quan S\f, t6ng hQ'P danh sach cong dan m~c cac b~nhthuQc di~n miSn dang ky nghTa V\l quan S\f do HQi d6ng NghTa V\l quan S\f xabao cao, trinh HQi d6ng NghTa V\l quan S\f huy~n xem xet, quySt dinh.

3. Can cu van kS ho?ch tuySn ch<)n va g<)i cong dan nh~p ngfi cua HQi d6ngNghTa V\l quan S\f huy~n, ph6i hQ'P v6i Trung tam Y tS huy~n l~p kS ho?ch, d\ftru kinh phi kham suc khoe cho cong dan duQ'c g<)i lam nghTa V\l quan S\f va t6chuc triSn khai th\fc hi~n.

4. £)@xuc1t thanh l~p HQi d6ng kham suc khoe nghTa V\l quan S\f, d@nghiDy ban nhan dan huy~n xet duy~t, ra quySt dinh; bao cao So Y tS tinh.

5. Ph6i hQ'P v6i Ban Chi huy quan S\f huy~n ban giao d~y du, kip thai h6 sasuc khoe cua cong dan duQ'c g<)inh~p ngil cho dan vi nh~n quan.

6. Chu tri, ph6i hQ'P v6i Ban Chi huy quan S\f huy~n giai quySt khiSu n?icua cong dan lien quan dSn vi~c kham suc khoe th\fc hi~n nghTa V\l quan S\f vatuySn sinh quan S\f.

7. Chu tri, ph6i hQ'P v6i Trung tam y tS huy~n chi d?o vi~c kiSm tra suckhoe cho quan nhan d\f bi theo kS ho?ch cua HQi d6ng NghTa V\l quan S\f huy~n.

8. T6ng hQ'P kSt qua cong tac kham suc khoe th\fc hi~n nghTa V\l quan S\f,bao cao HQi d6ng NghTa V\l quan S\f huy~n va So Y tS tinh theo Mfiu s6 1b, 3b,4a, 5c Ph\ll\lc 5 ban hanh kern theo Thong tu nay.

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9. ThlJc hi~n SO'kSt, t6ng kSt, rut kinh nghi~m v@cong tilC kham suc khoecho cong dan lam nghla V\l quan SlJ sau m6i dqt tuyen ch<;mva gQi cong dannh~p ngii.

Di~u 16. Trung Him y t~ huy~n

1. QuySt dinh thanh l~p T6 kiem tra suc khoe nghla V\l quan SlJ cua cac xii.

2. Chi d?o v@chuyen mon, giam sat vi~c thlJc hi~n kiem tra suc khoe, SO'tuyen suc khoe nghla V\l quan SlJ.

3. Tang cuemg can bQ chuyen mon tham gia kiem tra suc khoe, SO'tuyensuc khoe nghla V\l quan SlJ cho cac xii khi co d@nghi.

4. T6 chuc t~p hufin, b6i du5ng v@ chuyen mon, nghi~p V\l v@ cong tackiSm tra suc khoe, SO'tuySn suc khoe nghla V\l quan SlJ cho can bQ y tS xii.

5. Chu tri, ph6i hgp v6i Phong Y tS va Ban Chi huy quan SlJ huy~n xaydlJng kS ho?ch kham suc khoe cho cong dan duQ'c gQi lam nghla V\l quan SlJ vat6 chuc thlJc hi~n.

6. Ph6i hgp v6i Phong Y tS huy~n thanh l~p HQi d6ng kham suc khoe nghlaV\l quan SlJ; clI can bQ chuyen mon cung cac trang thiSt bi y tS tham gia HQid6ng kham suc khoe nghla V\l quan SlJ cho cong dan duQ'c gQi lam nghla V\lquan SlJ tren dia ban huy~n.

7. Ph6i hgp v6i Ban chi huy quan SlJ huy~n t6 chuc kham suc khoe chocong dan dang ky dlJ thi tuySn sinh quan SlJ.

Di~u 17. B~nh vi~n huy~n

D6i v6i cac huy~n co B~nh vi~n huy~n thi B~nh vi~n huy~n thlJc hi~n cacnhi~m V\l quy dinh cho Trung tam Y tS huy~n t?i cac Khoim 5, 6 va 7 Di@u 16Thong tu nay.

Di~u 18. SO'Y t~ tlnh1. Chi d?o cac CO'sa y tS thuQc thc1mquy@n:

a) ThlJc hi~n cac huang d~n cua cO' quan co thc1m quy@n v@cong tac y tStrong thlJc hi~n Lu~t Nghla V\l quan SlJ;

b) Di@u dQng IlJC lugng, phuang ti~n tham gia kham suc khoe nghla V\lquan SlJ theo KS ho?ch cua HQi d6ng Nghla V\l quan SlJ cac huy~n khi co d@nghi.

2. Ph6i hgp v6i BQ Chi huy quan SlJtinh:

a) Tham mUll cho HQi d6ng Nghla V\l quan SlJ tinh l~p kS ho?ch, chi d?o,huang d~n y tS huy~n t6 chuc, triSn khai cong tac kham suc khoe thvc hi~nnghla V\l quan sv va tuySn sinh quan sv;

b) T6 chuc, hi~p d6ng v@y tS v6i cac dan vi nh~n quan v@vi~c giao, nh~nquan.

14

3. T6 chuc t~p hu&n v@chuyen mon, nghi~p V\l cho can bQ, nhan vi en y tStham gia kham suc khoe nghi'a V\l quan S\f cua cac huy~n.

4. T6 chuc kiSm tra vi~c kham suc khoe nghi'a V\l quan S\f t~i cac diaphuang trong tinh.

5. Xem xet va giai quySt nhfrng vuOng m~c, khiSu n~i v@cong tac khamsuc khoe th\fc hi~n nghi'a V\l quan S\f va tuySn sinh quan S\f.

6. Bao cao Dy ban nhan tinh va BQ Y tS kSt qua kham suc khoe nghi'a V\lquan S\f theo M~u 3c Ph\ll\lc 5 ban hanh kern theo Thong tu nay.

7. Th\fc hi~n sa kSt, t6ng kSt, rut kinh nghi~m v@cong tac kham suc khoeth\fc hi~n nghi'a V\l quan S\f sau m6i dq1:tuySn chQn va gQi cong dan nh~p ngu.

ChuO'ng VNHI~M vv eVA eo QUANQUANsveAe eAp

TRONGKHAM sue KHOETHve HI~N NGHiA Vl) QUANSV

Di~u 19. Ban Chi huy quan Slf xa

1. Chu tri, ph&i hQ'P v6i Tr~m y tS xa t6 chuc sa tuySn suc khoe; l~p danhsach nhfrng cong dan du suc khoe th\fc hi~n nghi'a V\l quan S\f, cong dan m~cb~nh thuQc danh m\lc cac b~nh miSn dang ky nghi'a V\l quan S\f da qua sa tuySn,thong qua HQi d6ng Nghi'a V\l quan S\f xa, bao cao len HQi d6ng Nghi'a V\l quanS\f huy~n. Hoan chinh ph~n thu t\lC hanh chinh phiSu suc khoe nghi'a V\l quan S\f.

2. KiSm tra, don d&c cong dan thuQc di~n duQ'c gQi lam nghi'a V\l quan S\f dikham suc khoe theo kS ho~ch cua HQi d6ng Nghi'a V\l quan S\f huy~n.

3. Thong bao kSt qua kham suc khoe theo kSt lu~n cua HQi d6ng kham suckhoe nghi'a V\l quan S\f huy~n. Thu th~p nhfrng y kiSn th~c m~c lien quan dSnvi~c kham suc khoe va kSt lu~n suc khoe nghi'a V\l quan S\f cua cong dan (nSuco), bao cao len Ban Chi huy quan S\f huy~n va HQi d6ng Nghia V\l quan S\fhuy~n nghien CUll, giai quySt.

Di~u 20. Ban Chi huy quan Slf huy~n

1. Ph&i hQ'Pv6i Phong Y tS huy~n va Trung tam Y tS huy~n ho~c B~nh vi~nhuy~n (theo quy dinh t~i Khoan 6, Di@u 6) l~p kS ho~ch kham suc khoe chocong dan thuQc di~n duQ'c gQi lam nghia V\l quan S\f.

2. Tri~u t~p cac cong dan thuQc di~n duQ'c gQi lam nghia V\l quan S\f dikham suc khoe ho~c kiSm tra suc khoe theo kS ho~ch cua HQi d6ng Nghia V\lquan S\f huy~n.

3. Ph&i hQ'P v6i cac ca quan chuc nang cua huy~n tham gia cong tac t6chuc kham suc khoe nghia V\l quan S\f theo kS ho~ch; theo d5i s& IUQ'llg, ch&tIUQ'llgsuc khoe cua cong dan cac dia phuang dSn kham.

15

••• •• '."41 un

4. Quim ly phiSu suc kh6e nghla V\l quan SlJdo H9i d6ng kham suc kh6enghla V\l quan SlJhuy~n b~mgiao. Thai h~n lUll tru cho dSn khi cong dan hSt h~ntu6i ph\lc V\la ng~ch dlJ bi theo quy dinh cua Lu~t Nghla V\lquan SlJ.

5. Chu tri, ph6i hqp v6i Phong Y tS huy~n t6 chuc ban giao h6 so suc kh6econg dan duQ'cgQinh~p ngu cho cac don vi nh~n quan theo kS ho~ch.

6. Chu tri, ph6i hqp v6i Trung tam Y tS huy~n ho~c B~nh vi~n huy~n (theoquy dinh t~i Khmln 6, DiSu 6) l~p kS ho~ch va t6 chuc kham suc kh6e cho congdan dang ky dlJ thi tuy~n sinh quan SlJ.

7. Ph6i hqp v6i Phong Y tS va cac don vi, co quan chuc nang lien quan cuahuy~n giai quySt cac khiSu n~i lien quan dSn kham suc kh6e thlJc hi~n nghla V\lquan SlJva tuy~n sinh quan SlJ.

8. T6ng hqp, bao cao tinh hinh giao nh~n chiSn sy m6i vS B9 Chi huy quanSlJtinh sau m6i dQ'ttuy~n chQn va gQi cong dan nh~p ngu theo M~u 4b Ph\ll\lc 5ban hanh kern theo Thong tu nay.

J)i~u 21. Bi}Chi huy quan Sl]' tinh

1. Ph6i hqp v6i Sa Y tS tinh chi d~o, t6 chuc tri~n khai va ki~m tra don d6cvi~c kham suc kh6e thlJc hi~n nghla V\l quan SlJ cua cac dia phuong theo kSho~ch cua HQi d6ng Nghla V\lquan SlJtinh'

2. T6 chuc hi~p d6ng v6i tUng don vi nh~n quan vS tieu chu~n suc kh6e, s6IUQ'llg,thai gian, dia di~m va phuong thuc giao nh~n quan.

3. Chi d~o vi~c kham suc kh6e cho cong dan dang ky dlJ thi tuy~n sinhquan SlJ.

4. Ph6i hqp v6i Sa Y tS tinh xem xet, giai quySt nhUng vuang m~c, khiSun~i lien quan dSn cong tac kham suc kh6e thlJc hi~n nghla V\l quan SlJva tuy~nsinh quan SlJ.

5. T6ng hqp, bao cao kSt qua cong tac kham suc kh6e thlJc hi~n nghla V\l

quan SlJva tuy~n sinh quan SlJtheo quy dinh.

ChU'O'ngVINHI~M Vl) eVA co QUANQUANY cAe cAp

TRONGKHAM sue KHOETHlfe HI~N NGHiA Vl) QUANslf

J)i~u 22. Quan y Ban Chi huy quan Sl]' huy~n

1. Chu dQng n~m kS ho~ch kham suc khoe thlJc hi~n nghla V\lquan SlJh~ngnam cua dia phuong minh, ph6i hQ'Pv6i Phong Y tS huy~n theo doi cong tackham suc khoe, ki~m tra suc khoe cong dan lam nghla V\l quan SlJ. Tham giaHQi d6ng kham suc khoe nghla V\lquan SlJhuy~n.

16

2. Ph6i hQ'pv6i quan IlJc Ban Chi huy quan SlJhuy~n n~m k@tqua khamsuc khoe cho cong dan duQ'c gQi lam nghla V\l quan SlJ tren dia ban huy~n;ph6i hQ'pv6i quan y cac dan vi nh~n quan kiSm tra h6 So' suc khoe cong danduQ'c gQi nh~p ngil.

3. Tham gia kham suc khoe d6i v6i cong dan dang ky dlJ thi tuySn sinhquan SlJtheo k@hOlilChcua Ban TuySn sinh quan SlJhuy~n.

4. Bao cao k@tqua cong tac kham suc khoe thlJc hi~n nghla V\l quan SlJvatuySn sinh quan SlJ, sau m6i dQ't tuySn chQn va gQi cong dan nh~p ngil, tuySnsinh quan SlJ.

Ili~u 23. Quan y B{)Chi huy quan S1! tinh

1. Tham muu cho BQChi huy quan SlJtinh v~ cong tac kham suc khoe thlJchi~n nghla V\lquan SlJva tuySn sinh quan SlJ.

2. Tham muu cho So' Y t@tinh trong cong tac chi dlilO,t6 chuc, ph6i hQ'Pgifra cac Co'quan y t@,quan SlJva quan y dan vi nh~n quan thlJc hi~n cong tackham suc khoe cong dan lam nghla V\lquan SlJva cong tac giao, nh~n quan.

3. Ph6i hQ'p v6i So' Y t@tlnh xem xet, giai quy@t nhfrng vu6ng m~c,khi@u nlili v~ cong tac kham suc khoe thlJc hi~n nghla V\l quan SlJ va tuySnsinh quan SlJ.

4. Bao cao k@tqua cong tac kham suc khoe thlJc hi~n nghla V\l quan SlJvatuySn sinh quan SlJv~ Phong Quan y quan khu theo quy dinh cua BQQu6c phong.

Ili~u 24. Quan y quan khu

1. Tham muu cho Dang uy, BQ Tu l~nh Quan khu trong chi dlilOcong tackham suc khoe thlJc hi~n nghla V\lquan SlJ,tuySn sinh quan SlJva cong tac quanly suc khoe quan nhan dlJ bi theo k@hOlilchh&ngnam cua BQQu6c phong.

2. Ph6i hQ'Pv6i cac So' Y t@chi dlilOcong tac kham suc khoe thlJc hi~nnghla V\lquan SlJva tuySn sinh quan SlJ.

3. Chi dlilOBan Quan y cac tinh trong cong tac kham suc khoe, kiSm tra suckhoe, giam dinh suc khoe thlJc hi~n nghla V\lquan SlJva tuySn sinh quan SlJ.

4. D6i v6i cac khu VlJCkh6 khan v~ IlJc IUQ'ngy t@,Chu nhi~m Quan yquan khu di~u dQng can bQ nhan vien quan y cua quan khu tham gia HQid6ng kham suc khoe nghla V\l quan SlJtheo d~ nghi cua So' Y t@,Ban quan -dan y cac tinh.

5. Bao cao k@tqua cong tac kham suc khoe thlJc hi~n nghla V\l quan S\fvatuySn sinh quan SlJsau m6i dQ'ttuySn chQn va gQi cong dan nh~p ngil, tuySn sinhquan SlJtheo quy dinh.

17

Zf ea

L_

Di~u 25. Cye Quan y

1. Ph6i h9]J v6i cac ca quan chuc nang thuQc BQ Qu6c phong tham mUllcho BQ Qu6c phong v~ vi~c quy dinh tieu chufin suc khoe cong dan nh~p ngucho tUng khu V\lC,cac quan chung, binh chung va chi d~o, huang d~n quan y cacdan vi triSn khai th\lc hi~n.

2. H~ng nam, can cu vao yeu c&uxay d\fllg Quan dQi, ph6i h9]J v6i cac caquan chuc nang lam tham mUll cho BQQu6c phong ban hanh tieu chufin suc khoetrong tuySn sinh quan S\l va chi d~o, huang d~n quan y cac dan vi th\lc hi~n.

3. Chi d~o quan y cac dan vi nh~n quan nfun ch~c h6 sa suc khoe cong danduQ'cgQinh~p ngu va t6 chuc kham phuc tra suc khoe chiSn sy m6i theo quy dinh.

4. Chi d~o, t6 chuc kiSm tra cong tac kham suc khoe th\lc hi~n nghia vl)quan S\l va giao, nh~n quan a cac dia ban trQng diSm.

5. Bao cao kSt qua cong tac kham suc khoe th\lc hi~n nghia Vl) quan S\l,

tuySn sinh quan S\l theo quy dinh.

ChU'O'ng VIITO CHUC THVC HI~N

Di~u 26. Traeh nhi~m eua BQ Quae phong

1. Can cu vao s6 luqng cong dan nh~p ngu trong nam cua Chinh phu vayeu c&uxay d\fllg Quan dQi, ban hanh quy dinh Cl)thS v~ tieu chufin suc khoecho phil h9]J d6i v6i cong dan gQi nh~p ngu th\lc hi~n cho tUng khu V\lC,timgquan chung, binh chung.

2. Chi d~o ca quan quan S\l cac c~p co trach nhi~m ph6i h9]J v6i ca quan ytS dia phuang trong vi~c l~p kS ho~ch va triSn khai th\lc hi~n kham suc khoecong dan thuQc di~n duQ'cgQi lam nghla Vl)quan S\l, cong dan d\l thi tuySn sinhquan S\l va quan nhan d\l bi theo dung quy dinh.

3. Cac ca quan chuc nang co trach nhi~m chi d~o, huang d~n, cac dan vitrong toan quan triSn khai th\lc hi~n kS ho~ch kham suc khoe th\lc hi~n nghia Vl)quan S\l, tuySn sinh quan S\l va quan nhan d\l bi h~ng nam.

4. Cac dan vi nh~n quan co trach nhi~m ph6i h9]J v6i ca quan quan S\l cacc~p va ca quan y tS dia phuang th\lc hi~n vi~c giao, nh~n phiSu suc khoe nghiaVl)quan S\l d6i v6i cong dan duQ'cgQinh~p ngu theo dung quy dinh.

Di~u 27. Traeh nhi~m eua BQ Y t~

Chi d~o ca quan y tS cac c~p quan tri~t, t6 chuc th\lc hi~n cac quy dinh,hu6ng d~n h~ng nam cua Chinh phu, cac BQ, nganh lien quan v@cong tac khamsuc khoe th\lc hi~n nghia Vl)quan S\l.

18

Bi~u 28. Hi~u Il}'c thi hanh

1. Thong tu nay co hi~u h,rcthi 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 B<)Y te - B<)Qu6c phong hu6ng ddn vi~c kham suc kh6e thlJChi~nnghia V\l quan SlJhet hi~u IlJck~ illngay Thong tu nay co hi~u h,rc.

Trong qua trinh thlJc hi~n, neu co kho khan, vuOng m~c, d~ nght co quan,t6 chuc, ca nhan phan anh kip thai v~ B<)Y te va B<)Qu6c phong d~ xem xet,gi:Hquyeu.

*Trung tlf6'ng Tr~n BOll

Nui nh~n:- Cac Bi}, Ca quan ngang Bi}, Co' quan thui}c Chfnh phti;- HDND, UBND cac tinh, thanh ph5 tr1,Ccthui}c TW;- Van phong Trung lIang va cac Ban ctia Dang;- Van phong Chti tich nlIoc;- HQi dang Dan ti}c va cac Uy ban ctia Qu5c hQi;- Van phong Qu5c hi}i;- Van phong Chfnh phu;- Ca quan Trung lIang ctia cac doan th~;- Cac co quan, dan vi tr1,CCthuQc BQ Y t~,Bi} Qu5c phong;- C6ng TIDT CP, C6ng bao;- C6ng TTDT BYT, BQP;- Cl;!CKi~m tra van ban-Bi} TII phap;- LI!U: VT, Cl;!CQLKCB, Vl;!PC - Bi} Y t~;

VT, Cl;!CQuan Y, Vl;!PC - Bi}Qu5c phong.

19

rPhD IDc 1

PHAN LOAI SUC KHOE THE.O THE LUC vA BENH TAT(Ban hanh k~m theo Thong ill lien tich s6 16/2016/TTLT:BYT-BQP

ngay 30 thang 6 nam 2016 cua B<)tru6ng B<)Y t€ - B<)tru6ng B<)Qu6c phongQuy dinh vi~c Kham suc kh6e thlJc hi~n nghla V\lqUlinslJ)

I. TIEU CHuAN PHAN LO~I THEO THE LTfC (Bang sa 1)LO~I NAM NUSUC Cao dung Can n~ng Vong ng\fc Cao dung Can n~ngKHOE (cm) (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 ::;; 152 ::;;39 ::;;70 ::;; 146 ::;;37

Cac truOng hQ'P qua beo ho~c qua g~y se xem xet dSn chi s6 BMI (xem ph~n chlid~n kham tuySn).

II. TIEU CHuAN PHAN LO~I THEO B~NH T~T (Bang sa 2)1. Cac b~nhv~ m~t

TT B~NHT~T DIEM1 Thi l\fc1.1 Thi l\fc khong kinh

Thi l\fc m~t phai T6ng thi l\fc 2 m~t10/10 19/10 110/10 18/10 29/10 17/10 38/10 16/10 46,7/10 13/10 - 15/10 51,2,3,4,5/10 6/10-12/10 6

1.2 Thi l\fc sau chinh kinh Cho diSmtheo m\lc1.1 va tanglen 1 diSm

2 C~n thi:- C~n thi du6i -1 ,5D 2

1

TT BtNHT~T DIEM- C~n thi til -1 ,5D dSn du6i -3D 3

- C~n thi ill -3D dSn du6i -4D 4

- C~n thi ill -4D dSn du6i -5D 5

- C~n thi ill -5D tra len 6

- C~n thi da:phftu thu~t Cho diSmtheo m\lc1.1 va tanglen 1 diSm

3 Thoai hoa hAc vang m~c do c~n thi n~ng (til -3D tra len) 6

4 Vien thi:

- Vien thi du6i + 1,5D 3

- Vien thi ill + 1,5D dSn du6i + 3D 4

- Vien thi til + 3D dSn du6i + 4D 5- Vien thi ill + 4D dSn du6i + 5D 6

- Vien thi da:phftu thu~t Cho diSmtheo m\lc1.1 va tanglen 1 diSm

5 Cac lo~i lo~n thi 66 MQng thit:

- MQng thit dQ 1, dQ2 2- MQng thit dQ 3 4- MQng thit che d6ng ill 5- MQng thit da:m6 tai phit, gay dinh 5

7 B~nh giac m~c:

- S~o giac m~c dan thuAn, m6ng, nh6 a ngoai vung trung tam Cho diSmtheo m\lc1.1 va tanglen 1 diSm

- S~o giac m~c co dinh m6ng mAt 6- Dang viem giac m~c:

+Nh~ 3T+ Vila 4T

8 MAt hQt:

- Chua biSn chUng:+ NSu dang (; giai do~n tiSn triSn Cho diSm

theo m\lc

2

TT BtNHT~T DIEM1.1 va tanglen 1 di€m

+NSu a giai do~ da lanh SyO Gift nguyenphan lo~itheo thi l\fc

- Co biSn chUng (mang mau, SyO giac m~c) 5

9 Long sieu (qu~m) a mi m~t:- Khong anh huang dSn thi l\fc 2- Co anh huang dSn thi l\fc Cho di€m

theo m\lc1.1 va Hinglen 1 di€m

10 Viem kSt m~c (mang tiSp hqp):- cfip 2T- Viem kSt m~c mua xuan 4

11 L~ d~o:- Viem t~c l~ d~o cfip tinh 3T- Viem t~c l~ d~o m~n tinh ho~c da nhi~u Ian di~u tri khongkh6i:+NSu a 1 ben m~t 5+NSu a 2 ben m~t 6

12 B~nh cac co v~n nhan:- Lac co nang:+Khong anh huang dSn chuc nang 3+ Co anh huang chuc nang 5- Lac do li~t 1 hay nhi~u co v~n nhan (lac trong, ngoai, len, 6xu6ng)

13 T~t rung gi~t nhan cau (b~nh ly ho~c bfim sinh) 514 Nhfrng b~nh a mi m~t va h6c m~t:

- Cac vSt SyO lam hu mi m~t: m~t nh~m khong kin, dinh mi 6cau, l~t mi, 19nmi- S\lPmi m~t bfim sinh ho~c b~nh ly cac muc d9 6- Nhfrng b~nh a h6c m~t 6

15 Mu mau (mu 1mau ho~c toan b9) 616 Thoai hoa bi€u mo s~c t6 (quang ga) 617 D\lc thuy tinh th€ bfim sinh 6

3

TT B~NHT~T DIEM, ,

18 Nhfing b~nh khac ve mat:

- Tang nhan ap, d\Jc thuy tinh thS 2 m~t, l~ch thS thuy tinh, viem 6mang b6 dao, dinh bit d6ng ill, bong yang m~c, teo gai thi 1 ho~c 2ben

- Cac t6n h~i yang m~c do b~nh ly (viem yang m~c do b~nh 6tang huySt ap, viem yang m~c s~c t6) ho~c bAm sinh (thoai hoa

?

yang m~c bam sinh)

2. Cae b~nh v~ ding, ham, m~t

TT B~NHT~T DIEM

19 Rang sau:- Chi co rang sau dQ 1 - 2, khang ho~c it anh hu6ng suc nhai 2- Co :s 3 rang sau dQ 3 2- Co 4 - 5 rang sau dQ 3 3- Co 6 rang sau dQ 3 4T- Co 7 rang sau dQ 3 tr6 len 5T

20 MAt rang:- Con du 28 rang (khang kS rang khan) 1

- MAt rang da: co ph\Jc hinh dam bao chuc nang va thAm my 2

- MAt :s 3 rang, trong do co 1 rang ham IOn ho~c rang cua, suc 2nhai con 85% tr6 len- MAt 4 rang, trong do co :s 2 rang ham IOn ho~c rang cua, suc 3nhai con 70% tr6len- MAt 5 - 7 rang, trong do co :s 3 rang ham IOn ho~c rang cua, 4suc nhai con 50% tr6 len- MAt tren 7 rang, trong do co > 3 rang ham IOn ho~c rang cua, 5suc nhai con < 50%

21 Viem lqi:- Viem lqi 6 :s 5 rang, chua co tui mu sau 1- Viem lqi 62: 6 rang, chua co tui mu sau 2

22 Viem quanh rang (nha chu viem):- Viem quanh rang da:diSu tri 6n dinh v~n con llii lqi sau 3- Viem quanh rang 6 < 5 rang, rang lung lay dQ2 - 3 - 4 3- Viem quanh rang til 6 - 11 rang tr6 len, rang lung lay dQ 2- 3 4-4- Viem quanh rang til 12 rang tr6len 5

23 Viem tuy, tuy ho~i ill, viem quanh cu6ng rang:- 1 - 2 rang bi viem my, my ho~i ill ho~c viem quanh cu6ng rang:+ Dang con viem 2T

4

TT B~NHT~T DIEM

+ Da diSu tri an diOO 2- 3 - 4 rang bi viem my, my ho~i ill ho~c viem quanh cu6ng rang:+ Dang con viem 3T+ Da diSu tri an diOO 3- 5 - 6 rang bi viem my, my ho~i ill ho~c viem quanh cu6ng rang:+ Dang con viem 4T+ Da diSu tri an diOO 4- <:;6 tren 6 rang bi viem my, my ho~i ill ho~c viem quaOO 5cuong rang

24 BiSn chUng rang khon:- BiSn chUng da diSu tri t6t 1 - 2- BiSn chUng dang chua 2T

25 Viem loet niem m~c 6 mi~ng, luai:- Viem loet c~p tiOO 3T- Viem loet m~n tiOOda diSu tri OOiSuIAnkhong kh6i 4

26 Viem tuySn nuac bQt:- Viem tuySn mang tai:

+ Da diSu tri kh6i 2

+ Viem tuySn mang tai c~p 3T

+ Vi em tuySn mang tai m~n tiOO1 ben da an diOO 3

+ Vi em tuySn mang tai m~n tiOO2 ben da an diOO 4

+ Viem tuySn mang tai m~n tiOO1 ho~c 2 ben chua an diOO 5

- Viem tuySn nuac bQt duai ham:+ Da diSu tri kh6i 2

+ Viem c~p 4T

+ Viem m~n, XO' hoa, chua an diOO 5

+ S6i 6ng Wharton 5

27 Viem kh6p thai duang ham:

- Viem c~p tiOO 3T

- Viem m~n tiOO 4

28 Xuang ham gay:

- Da liSn t6t, kh6p c~n khong di I~ch ho~c di I~ch it 2- Kh6p c~n di I~ch OOiSu,aOOhuang tai sue nhai 4

29 Khe h6 moi, khe h6 yom mi~ng:

- Khe h6 moi 1 ben, khong toan bQ:

5

TT BtNHT~T DIEM

+ Da phfiu thu~t, khong anh huemg t6i thfun my va chuc nang 2

+ Chua phfiu thu~t 3

- Khe ha moi 1ben toan bQho~c khe ha moi khong toan bQ2 ben:

+ Da phfiu thu~t 4lo hinh, anh huemg it dSn thfun my va phcit fun 3

+ Chua phfiu thu~t 4T

- Khe ha moi toan bQ 2 ben:

+ Da phfiu thu~t t~o hinh 4

+ Chua phfiu thu~t 5T

- Khehavom:

+ Khe ha vom mSm 3

+ Khe ha vom toan bQ 5

- Khe ha moi kern theo khe ha vom 6

30 B~nh 1yva u vung m~t

- Cac b~nh 1y 1anh tinh da diSu tri 6n dinh (nang chan rang, 2nang nhAy... )

- U 1anh da phfiu thu~t 6n djnh khong anh huemg dSn chuc 3nang (torus, u 1qi XD' ••• )

- U 1anh da phfiu thu~t 6n djnh c6 biSn d~ng vung m~t (u men, 5u xuang XD', u mau, u b~ch m~ch ... )

3. Cae b~nh v~ tai, mlii, hQng

TT BtNHT~T DIEM

31 Suc nghe (do b~ng tiSng n6i thuOng):

- MQt ben tai 5m (nghe binh thuemg) 1- MQt ben tai 4m (nghe kern nh~) 2- MQt ben tai 3m (nghe kern trung binh nh~) 3- MQt ben tai 2m (nghe kern trung binh n~g) 4- MQt ben tai 1m (nghe kern n~ng) 5- MQt ben tai du6i 1 m (nghe kern sau) 6Tinh timg tai, sau 1ftytrung binh cQng va lam tron dS duqc kStqua chung.Vi d\l: Tai phai 1, tai tnii 6, t6ng 1a(6+1)/2 = 3,51am tron 1a4

32 Tai ngoai:

6

TT B~NHT~T DIEM

- Ong tai ngoai

+ Hyp mQt ph~n 6ng tai ngm\i 3+ Hyp toan bQ 6ng tai ngoai 4+ Tit 6ng tai ngoai 5- VaOOtai

+ Khong co vaOOtai 5

+ Khong con c~u truc vanh tai (chi co n\l thit) 4

+ M~t mQt s6 c~u truc giai phau 3

+ C~u truc d~y du OOung 006 han tai ben biOOthuang 2

- Viem tai ngoai c~p tiOO 3T

33 Tai giua:

- Vi em tai giua c~p tiOO 4T

- Viem tai giua thaOOdich 4T

- Viem tai giua m~n tiOOhom 001 kho, s~ch

+ Mang 001 thung 006 ho~c trung biOO 4

+ Mang 001 thung rQng 5

- Viem tai giua m~n tiOOco thung mang 001, co chay ch~t OO~yho~c mu, muc dQ thung:

+ Thung 006 ho~c trung biOO 5

+ Thung rQng 6

Viem tai .- tiOO co thung, co chay mu th6i 6- gma m~n(Cholesteatome)

34 XUO'llgchum:

- Viem tai XUO'llgchum cAp tinh 5T

- Viem tai XUO'llgchum m~n tiOO 5

- Viem tai xuang chum dff phau thu~t rna hang chum - thuQTIg001 co va mfmg 001, n~u:+ Mfmg 001 dong kin 4+ Mfmg 001 thung, day 001 s~ch 5+ Mfmg 001 thung, con chay mu 6- Viem tai XUO'llgchum dffm6 ti~t din, n~u:

+H6cm6kho 5+ H6c m6 con chay mu 6

35 Tai trong:

- Chong m~t me 001 (r6i lo~n tiSn diOO) 5

7

TT BtNHT~T DIEM

36 Mlii:

- Mlii, h6 mlii, vach ngan bi l~ch v~o, di d~ng, nSu:

+ Khong co r6i lo~n ho hApva phat am 3

+ Dfi co r6i lo~n ho hAp, phat am, nu6t milc dQnh~ 4-5

+ Co r6i lo~ chilc nang ho hAp quan trQng, r6i lo~n phat am 6

- Viem mlii m~n tinh don thuftn:

+ Khong co r6i lo~n chilc nang ho hAp 2

+ Co r6i lo~n chilc nang ho hAp ra ho~c mAt ngui 4

+ R6i lo~n chilc nang ho hAp 5

- Polip mlii:

+ DQ I - II 4

+ DQ III - IV 5

+ Polip ca 2 ben dQI - II 5+ Polip ca 2 ben dQ III - IV 6

37 HQng:

- Viem hQng cAp tinh 2T- Viem hQng m~n tinh don thuftn, th~ tr~ng t6t 2- Viem hQng m~n tinh hay ho, 86t gay kho thO' anh huang dSn 4th~ tr~ng

38 Amidan:

- Viem amidan cAp tinh 2T

- Viem amidan m~n tinh, khong qua phat ho~c qua phat dQ I 2

- Viem Amidan m~ tinh qua phat dQ11-ill chua co r6i lo~ chilc 3nanghohAp

- Viem Amidan m~n tinh qua phat dQ III co r6i lo~n chilc nang 4ho hAp (ngimg thO'khi ngu, kho thO'...)

- Viem Amidan m~n tinh qua phat dQ IV 5- Amidan viem m~n tinh dfi dugc c~t b6 2

39 Chay mau cam:- Chay mau cam tai phat chua co thiSu mau ho~c thiSu mau 4nh~- Chay mau cam tM phat gay thiSu mau trung binh 5- Chay mau cam tai phat gay thiSu mau n~ng 6

40 Thanh quan:- Viem thanh quan c~p tinh 2T- Viem thanh quan m~n tinh, nSu:

8

TT B~NHT~T DIEM

+ Khong co r6i lo~n phat am quan trQng nhu ti6ng noi con 3phan bi~t dugc, thS tr~ng t6t+ Co r6i lo~n phat am quan trQng nhu ti6ng noi khong phan 4bi~t dugc ho~c phan bi~t kho, thS tr~ng kern- Li~t cac co khep - rna day thanh va li~tday th~n kinh h6i qui 5- Khan ti6ng dan thUlin, khong li~t day thanh, khong co t6n 3thuang ho~c chi t6n thuang nh~ a niem m~c day thanh- Khan ti6ng do cac kh6i u lanh tinh a day thanh nhu: polip, h~t 5xa day thanh, u nang, u nhli (papilloma) day thanh ...- Noi l~p:+ L~p til (Vi dV:Con bo bo ... bo sua) 3+ Keo dai ill (Vi dV:C....o....n bo sua) 4+Mftt til (Vi dV:Con ..... sua) 5- Noi ngQng:+Nguai nghe hiSu 75% d6n du6'i 100% ill 3+Nguai nghe hiSu 50% d6n du6'i 75% ill 4+Nguai nghe hiSu 20% d6n du6'i 50% ill 5+Nguai nghe hiSu du6'i 20% ill 6- Chftn thuang hay b~nh ly gay t6n thuang cftu truc thanh qmin+ Khong co r6i lo~n giQng 5+ Co r6i lo~n giQng 6

41 Xoang m~t:- Viem mlii cftp tinh 3T- Viem xoang cftp tinh 4- Viem xoang ham m~n tinh 4- Viem xoang tran, xoang sang m~n tinh 5- Viem mlii di tmg 3

42 Li~t m~t khong h6i phvc do viem tai xuang chum 643 Kh6i u v-ungmlii xoang, hQngthanh quim, tai ngoai, tai giua

- Khong nghi nga ac tinh 5- Co nghi nga ac tinh 6

4. Cae benh v~ thin kinh, fiim thin

TT B~NHT~T DIEM

Thin kinh44 Nhuc d~u thanh can, dai d~ng, keo dai, anh hUOng d6n lao

9

TT B:f:NH T~T DIEM

d(mg:

- Do b~OOly cQt s6ng c6 (HQi chUng giao cam c6 sau) 4

- Bi ill 006, khong lien quan dSn cQt s6ng c6 4

45 Suy OOuQ'cthAn kiOO:

- Nh~, da h6i ph\lc 3

- N~ng, khong h6i ph\lc hoa~ toan (giam tri 006, giam kha 6nang lao dQng ho~c tai phat 2 Ian tr61en)

46 DQng kiOO:

- Da hSt con (lam sang va c~n lam sang) 5- Con con 100 ho~c 006 6

47 Ra m6 hoi ban tay ho~c ca ban tay, ban chan:

- Muc dQoo~ 2- Muc dQvua 4

- Muc dQ n~ng 548 Phan x~ gan xuong:

- Tang dSu ca hai ben:

+ Khong r6i lo~n v~n dQng cam giac 4+ C6 r6i lo~n v~n dQng cam giac 6- Giam dSu ca hai ben:

+ Khong r6i lo~n v~n dQng cam giac 3+ C6 r6i lo~n v~n dQng cam giac 6- Tang ho~c giam mQt ben:

+ Khong r6i lo~n v~n dQng cam giac 3+ C6 r6i lo~n v~n dQng cam giac 6

49 Dai dAm thuemg xuyen 550 Di tiOOOOiSu,aOOhuang t6i suc kh6e 451 Ch6ng m~t c6 h~ th6ng:

- R6i lo~n kiSu tiSn diOO(trung uong va ngo~i vi) 4- R6i lo~n ph6i hqp v~ dQng va thang b~ng kiSu tiSu nao 5

52 Li~t thAn kiOOm~t ngo~i vi:- Con di chUng mea mi~ng khi cuai, m~t OO~mkin 3- Con di chUng mea mi~ng thuang xuyen, m~t ook khong kin 5

53 Li~t thAn kiOOngo~i vi:- Li~t 1 trong cac day thftn kiOOquay, gifra 5- Li~t day thftn kinh tf\l 4

10

TT B~NHT~T DIEM

- Li~t day thftn kinh hong to 6- Li~t 1 trong cac day thftn kinh hong khoeo trong, hong khoeo 5ngoai

- M~t ho~c giam kha nang v~ dQng a mQt phftn chi the:+ it anh huang t6'i lao dQng, sinh ho~t 4

+AM huang nhiSu d~n lao dQng, sinh ho~t 5

- M~t hoan toan kha nang lao dQng a 1 chi ho~c mxa nguai 654 Di chUng t6n thuang SQ nao, my s6ng: Li~t chan tay, h~n ch~ 6

kha nang lao dQng ra r~t

55 Dau rS thftn kinh va cac dam r6i thftn kinh (dam r6i c6, canhtay, th~t lung, dmg):

- it anh huang d~n v~n dQng 4

- H~n ch~ ra r~t kha nang v~n dQng 556 B~nh co (Myopathie):

- C6 teo co n~ng, anh huang ra d~n kha nang lao dQng 6

- Teo co nhy, anh huang it d~n v~n dQng 4

57 NhU'<!cco (Myasthenia): 658 T~t may co (TIC):

- Khong gay dau a m~t 3

- Gay dau a m~t 5

59 Dau lung do:

- Gai doi cQt s6ng 4

- Thoai hoa cQt s6ng:

+Muc dQ nhy 3

+Muc dQvua 4

+Muc dQ n~ng 5- Thoat vi ma d~m:

+Muc dQnhy 4

+Muc dQ vua 5+Muc dQ n~ng 6

60 Dau vai gay do:

- Thoai hoa cQt s6ng c6:

+Muc dQ nhy 3+Muc dQvua 4

+Muc dQn~ng 5

11

IL_

TT B~NHT~T DIEM

- Thmit vi rna d~m CQts6ng c6:

+Mirc dQoo~ 4

+Mirc dQ vila 5+Mirc dQn~ng 6

61 Chful thuang SQ nao:

- Chfin thuang SQ nao, vSt thuang cli khong thfiu nao dS l~i dichUng suy OOuQ'cth~n kiOOoo~:+ NSu di~n nao d6 khong biSn d6i 4

+ NSu di~n nao d6 co biSn d6i 5

- Chful thuang SQ nao cli, vSt thuang thfiu nao cli con dS l~i di 6chUng ra r~t vS th~n kiOOho~c tam th~n

Tam thAn62 Lo~n th~n do:

- ThiSu nang tam th~n:

+Mirc d9 n~ng 6+Mirc dQ trung biOO 5+Mirc d9 oo~ 5- Cac b~OOlo~ thk co lien quan dSn cac b~nh cua cO'thS OOu:r6i lo~n nQi tiSt, chuySn hoa diOOduOng, OOiSmtrung, OOiSmdQc:

+ Da ph\lc h6i 4+ Ph\lc h6i khong hofm tofm 5+ Khong ph\lc h6i 6- Lo~ tam thk phan Ung:

+ Khong h6i ph\lc 6+ H6i ph\lc khong hofm tofm 6+ H6i ph\lc hofm toan 5- Cac tr~ng thai hoang tu6ng va lo~n th~n khong d~c hi~u 6- Cac r6i lo~n tri giac 4- Cac r6i lo~n ao giac 5- Nhfrng l~ch l~c vS r6i lo~n tiOOd\lc: Lo~n dam d6ng gi6i, suc

4v~t, tre em, pho truong, lanh d(;lm,rbi lO(;lntinh d\lc kha.c63 Tam th~n phan li~t (cac thS) 664 Lo~n th~n do ruQU:

- B~OO Corxacop sa sut tri nang, ao giac, hoang tu6ng, say 6

12

TT B~NHT~T DIEM

ruqu b~nh ly

- HQi chUng l~ thuQc fUqu 665 Nghi~n rna tuy (opiate) 666 Lo~n thfin do thu6c:

- HQi chUng cai cac thu6c gay nghi~n, tr~ng thai hoang tu6ng, 6ao giac, lo~n thfin do ngQ dQc thu6c

- L~ thuQc thu6c gay nghi~n 5

67 Lo~n thfin cam xuc:

- ThS diSn hinh, cUOng dQm~nh, con keo dai, mau tai phat 6

- ThS trung binh, con thua 1 - 3 nam/lfin ho~c thS nh~ chu ky 6can 3 - 5 nam

68 R6i lo~n nhan cach:

- ThS n~ng, mfit bu thuOng xuyen 6

- Con bu nhung da tai phat 2 lfin tr6' len 5

69 R6i lo~n hanh vi 6' thanh thiSu nien:

- ThS n~ng va c6 dinh 6

- Trung binh 5

70 R6i lo~n gific ngu:

- Ba h6i ph\lc 4

- Khong h6i ph\lc 5

71 R6i lo~n 10 au:- Ba h6i ph\lc 4

- Bang tiSn triSn 5- Hay tai phat (tu 2 lfin tr6' len) 6

72 R6i lo~n phan Ii (Hysteria):

- Ba h6i ph\lc sinh ho~t binh thuOng 4

- Bang tiSn triSn 5

- Hay tai phat (tM phat ill 2 lfin tr6' len) 673 Lo~n thfin co lien quan dSn t6n thuong S9 nao do:

- Viem nao - mang nao:

+ Ba h6i ph\lc 5+ Khong h6i ph\lc 6- Lao nao:

+ Ba h6i ph\lc 5+ Khong h6i ph\lc 6

13

TT B¥NHT~T DIEM

- Giang mai nao:

+ Da h6i ph\lc 5

+ Khong h6i ph\lc 6

- Cac r6i lo~n m~ch mau nao, xo cUng dQng m~ch nao, u nao, 6thoai hoa h~ thftn kinh

74 Lo~n thftn do chan thuong:

- Da h6i ph\lC 5

- Khong h6i ph\lc 6

5. Cae b~nhv~ tieD hoa

TT B¥NHT~T DIEM75 B~nh thlJC qwin:

- Viem th\fc quim cap 5T

- Viem th\fc quim m~n, loet th\fc quim 1<inhtinh 4- Gian th\fc quim 5- H~p th\fc qwin 5- Gian tInh m~ch th\fc qmin 6- Ung thu th\fc quim 6

76 B~nh d~ day, ta trang:

- Viem d~ day cap 2T- Viem d~ day, ta trang m~n tinh 4- Loet d~ day, ta trang chua co biSn chUng 4- Loet d~ day, ta trang co biSn chUng (h~p mon vi, chay mau ... 6,chua dieu tri kh6i)

- Loet d~ day, ta trang da diSu tri lanh b&ng nQi khoa 4- Loet d~ day, ta trang da diSu tri lanh b&ng ph~u thu~t 5- Ttii thira d~ day anh hu6ng t6i suc kh6e it hay nhiSu 4

- Ung thu d~ day 677 RUQtnon:

- Thung ruQt non do cac nguyen nhan phai m6:

+ KSt qua khong anh hu6ng t6i tieu hoa 4+ Co anh hu6ng t6i tieu hoa va sinh ho~t 5- Tic ruQt co gi6i da m6:

+ KSt qua t6t 4+NSu v~n con r6i lo~n tieu hoa 5

14

TT B~NHT~T DIEM- Tui thua, polip ru<)tnon 5- U ru(>tnon 6

78 Viem ru(>tthua:

- Viem ru(>tthua dff m6, kSt qua t6t 2- Co biSn chUng, bim t~c, s6 thanh bvng 5

79 Thoclt vi byn cac lo~i:

- Dff dugc phfiu thu~t t6t, 6n dinh tren 1 nam 2

- Chua dugc phfiu thu~t 4T80 Cac dUOng m6 bVng tham do (khong can thi~p vao n(>it~ng):

- Li@nSyOt6t va tren 1 nam, khong co tri~u chUng dinh t~c 4

- NSu SyOnhan nhum ho~c s6 thanh bVng 5- Co dAu hi~u dinh t~c ho~c ban t~c 6

81 Cac dUOng n(>i soi qua thanh bVng, khong can thi~p t~ng trong 26 bVng, dff lanh SyO

82 B~nh d~i, tf\IC trang:

- Viem d~i trang ho~c viem tf\IC trang cAp 3T

- H(>ichUng d~i trang tang kich thich:

+ Muc d(>nhy 3+ Muc d(>vua 4

+ Muc d(>n~ng 5

- Viem loet tr\fc, d~i trang xuAt huySt:

+Nhy 5T+ Vua, n~ng 6- Cac b~nh lanh tinh cua d~i trang phai can thi~p phfiu thu~t 5- Lao h6i trang 5- Ung thu d~i trang 6- Tui thua d~i, tr\fc trang 5- Polip tr\fc, d~i trang (Polypose Rectocolique) 6- Polip tr\fc trang (Polype rectal) co cu6ng nh6 di@u tri hStdugc:

+ Dff c~t b6 2+ Chua c~t b6 5T- Polip tr\fc trang chay mau 5

83 B~nh h~u mon - tr\fc trang:

- Ro h~u mon:

15

TT B~NHT~T DIEM+ Don gian da diSu trj kh6i 2

+ Don giim chua diSu trj 3T

+ Ro h~u man phuc t~p 5

- Sa tr\fc trang 5

- NUt h~u man:

+ Da diSu trj t6t 3+ NhiSm trung OOiSuIAn 4

84 TrI:

- TrIngo~i:

+ 1 bui kich thuac duai 0,5 cm 2+ 1 bui kich thuac ill 0,5 cm dSn 1 cm 3- TrI nQi ho~c trI kSt hQ'P1 bui 006 duai 0,5 cm 3

- TrI nQi, trT ngo~i, ho~c trI kSt hQ'POOiSubui (2 bui tra len) 4kich thuac til' 0,5 cm dSn 1 cm

- TrI da mE>t6t 3

- TrI OOiSubui, co bui to tren 1cm, bui trI 16i ra khong t\f co len 5TduQ'c

- TrI da th~t, nay co bui trTtai phcit 5T85 B~OOgan:

- Viem gan c~p 5T- Viem gan c~p da laOOtren 12 thang, suc kh6e h6i ph\lc t6t 3- Viem gan c~p da laOOtren 12 thang OOung h6i ph\lc chua t6t, 5thu HBsAg (+)

- Nguai laOOmang vi rut viem gan B ho~c C 3- Viem gan m~n tiOOthS t6n t~i 4- Viem gan m~n tiOOthS ho~t dQng 6- Dng thu gan nguyen phcit ho~c thu phcit 6- San la gan 4T- Gan to chua xac djnh duQ'c nguyen OOan 5T- HQi chUng vimg da chua ra nguyen OOan 5T- Xo gan giai do~n con bli 5- Xo gan giai do~n m~t bu 6- D\lng gi~p gan da duQ'c diSu tri bao t6n, kSt qua t6t 3- Ap xe (abces) gan da diSu tri E>ndiOO 4- Ap xe gan da va gay biSn chUng tuy da diSu tri kh6i 5- S6i trong gan 4

16

TT B~NHT~T DIEM- Nang gan

+ <2 cm 3+~2 cm 4-5- Umaugan 5- Ung thu gan 6

86 B~nh m~t, ttii m~t:

- S6i tui m~t, gay viem duemg m~t 5T

- S6i duang m~t trong va ngoai gan, gay viem nhiSm ho~c t~c 6m~t

- Ap xe duang m~t 5T

- S6i ttii m~t don dQc, chua m6 4T

- S6i ttii m~t da c~t ttii m~t:

+ Khong anh huang t6i sinh ho~t 4

+ Co anh huang t6i sinh ho~t 5

- Viem tui m~t, viem duemg m~t, viem tui m~t c~p do s6i don 4dQCda m6 tren 1 nam, 6n dinh

- Viem duang m~t do s6i ho~c do nguyen nhan khac 5T

- S6i 6ng m~t chli 687 T\lY

- Viem t\lY c~p th@phu nS:

+ Ua h6i ph\lc 3+ Tai phat 5

- Viem t\lY c~p th@ho~i tu, xu~t huy€t 6

- Viem t\lYm~n 5-6- Viem tl,ly c~p da diSu tri ngo~i khoa 6n dinh 4- Nang t\lY 4- S6i tl,ly 5

- Ung thu t\lY 688 Lach

- Lach to do cac nguyen nhan 4- Nang lach 4- Ap xe lach 5- Va lach do ch~n thuO'ng phai ph~u thu~t c~t lach 5

89 Uao nguQ'c phli t~ng 5

17

L

6. Cae b~nh v~ ho hip

TT B~NHT~T DIEM90 HQi chUng va tri~u chUng b~OOho hip:

- Khai huySt khong ra nguyen OOfm 4T

- Khai huySt tii diSn keo dai kern theo ho kh~c dam, dau ngvc 6

- TiSng CQ mang ph6i ra, kern theo dau ng\fc (viem mang ph6i 5kho)

- Ran Amho~c ran n6 OOiSua 1 ho~c 2 day ph6i kern theo khai 5ThuySt ho~c kh~c dam OOiSu

- HQi chUng 3 giam (day diOOmang ph6i) 5

- Gu, V(fOcQt s6ng, biSn d~ng xuong lic va xuang 16ng ng\fc 6aOOhuang dSn chlic nang ho hip

- Di chUng S(fO16ng ng\fc do m6 tim, ph6i ho~c sau chk 6thuong ng\fc cli, aOOhuang d~n khi ph6i

91 Cac b~OOphS qulin:

- Viem phS quan cip 3T- Viem phS quan cip tai diSn:

+ Co cac ySu t6 nguy ca co thS chua kh6i 4T+ Cac ySu t6 nguy ca khong thS chua kh6i 4- Gian phS quan OO(fco chAn doan ra, chua co biSn chUng 5- Viem phS qulin m~n tiOOdon thu5.n, giai do~n d5.u 5

- Viem phS qulin m~ tiOOb~t d5.u co biSn chUng tam phS m~n 6tinh, suy ho hip, khi phS thling (COPD + tam phS m~n)

- Khi phS thfing type A 6- Hen phS quan:

+ Hen OO(fkhong co biSn chUng 5+ Hen trung biOO va n~ng, hen co biSn chUng; hen phS quan 6kern theo viem xoang ham m~n ho~c polip mlii

92 Cac b~OOOOumo ph6i:

- Viem ph6i cip do vi khuAn, virus, Mycoplasma Pneumoni 3T- Viem ph6i m~n tiOO 6- San la ph6i, amip ph6i 5T- Ken khi ph6i 5- HQi chUng Loffler 3T- B~OObl,liph6i 6- Xa ph6i ho~c xa ph6i ke Ian toa 6

93 Cac b~OOmang ph6i:

18

TT B~NHT~T DIEM- Phe mc;tcviem tran dich to' huyet (Sero 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 mc;tcviem, tran dich mc;tntinh (keo dai tren 2 thang) phe 6mc;tcviem tran dich mau (mau hut ra khong dong), du5ng chfip16ngng1Jc- Voi hoa mang ph6i:+ft 3+ Nhieu, di~n rQng 5- XO'hoa 16ngng1Jcho~c day dinh rQng toan bQmQtben mang 6ph6i

94 B~nh lao ph6i:- Nghi lao ph6i (co hQi chUng nhiem dQc lao, co tien su tiep 4Txuc va tien su lao)- Khai huyet do lao 5T- Lao ph6i nh~ m6i m~c (lao tham nhiem, lao huy~t BK am 5Ttinh (-) trong dam b~ng soi tr1Jctiep, khong co hang lao)- Lao ph6i m6i m~c nhung co BK (+) trong dam b~ng soi tr1Jc 6tiep, co hang lao- Lao ph6i dffdieu tri 6n dinh va khoi dugc tren 3 nam, neu:+ Tru6c day khong co hang, hi~n tc;tiX-quang ph6i binh 4thuang, BK (-), suc khoe khong bi anh huang

+ Hi~n nay co biSn chUng lao, xO'ph6i, suy ho h~p mc;tntinh, 6tam phS mc;tntinh, giffnphS quan

95 Lao ngoai ph6i:- Lao hc;tchngoc;tivi dffkhoi 4- Lao hc;tchc6 mc;tntinh ho~c ra mu 5- Lao thanh quan dffkhoi 4- Lao mang b\lng, lao XUO'llg 5- Lao tinh hoan dffm6, khoi 4

7. Cae b~nh v~ tim, m~eh

TT B~NHT~T DIEM96 HuySt ap (tinh trc;tngHA khi nghi, thuang xuyen, tinh b~ng

mmHg):

19

TT B:E:NH T~T DIEM- HuySt 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

- HuySt ap t6i thiSu:+ ::s 80 1

+ 81 - 85 2

+ 86 - 89 3

+ 90 - 99 4

+ ~ 100 5

97 B~OOtang huySt ap:- Tang huySt ap dQ 1 4

- Tang huySt ap dQ2 5

- Tang huySt dQ 3 6

98 M;;tch (tiOO tr;;tng m;;tch khi nghi, thuCmg xuyen dSu, tiOOb~ngl~n/phut):- 60 - 80 1

- 81 - 85 ho~c 57 - 59 2

- 86 - 90 ho~c 55 - 56 3

- 50 - 54 3 - 4 (dlJavao nghi~mphap Lian)

- 91 - 99 4

- ~ 100 ho~c < 50 5,6

99 R6i lo;;tndfin truySn va OOiptim:- Block 001 thftt dQ I 4

- Block 001 thAt dQ II 5

- Block 001 thftt dQ III 6

- Block OOanhph.E:+ Khong ho~m toan 2

+ Hoan toan 4

- Block OOaOOtrai:+ Khong hoan toan 5

20

r

TT B~NHT~T DIEM+ Hoan toan 6- Block nhanh ph<ii+ block nhanh trai 6- L01ilnnhjp ngo1ilitam thu thfit:

+ Cac NTT mfit ho~c gi<imdi sau v~n dQng 2

+NTT thfit thua (1 - 9 nhjp/gia) 3+NTT thfit trung binh (10 - 29 nhjp/gia) 4

+NTT thfit day (~ 30 nhjp/gia) 5+NTT thfit da 6 6

+NTT thfit tung chum ho~c R1T 6

+NTT thfit trong cac b~nh tim th\Ic th~ 6

- L01ilnnhjp ngo1ilitam thu nhl 5- Rung cu6ng nhl, I01ilnnhjp hoan toan 6

- HQi chUng nut xoang b~nh ly 5- Can nhjp nhanh kjch phat 6

100 B~nh h~ th5ng m1ilchmau:

- Viem t~c dQng m1ilchcac I01ili 6

- R5i I01ilnv~n m1ilch(b~nh Raynaud) 6- Viem t~c ti'nh m1ilchnang ho~c sau chi duai 5

101 B~nh tim:

- B~nh tim bAm sinh:

+ Chua gay r5i I01ilnhuySt dQng dang k~ 5+ C6 r5i I01ilnv6 huySt dQng 6

+ Da duqc can thi~p ho~c ph~u thu~t truac 16 tu6i 4

- B~nh van tim 6- Viem nQi tam m1ilcnhi~m khuAn 6- Suy tim 6- Viem cO'tim va cac b~nh cO'tim 6- Thfip tim (thfip kh6'p cfip) va b~nh tim do thfip 6- Cac b~nh mang ngoai tim 6- Cac kh5i u tim 6

21

"" di4Wlitlitt!f+ uUf •• ""-W in '- it ~1nI •• ,_ ••

8. Cac b~nh v~ coo,xU'O'ng, kh6'p

TT B~NHT4.T f>IEM

102 B~nhkh6p:

- Cac b~nh kh6p nhiSm khuAn 5T

- Lao kh6p, lao cQts6ng 5

- Viem kh6p nhiSm khuAn,hQi chUngReiter, viem kh6p Lyme, 5Tcac b~nhnay m6i kh6i chua qua 6 thang

- Cac b~nh viem kh6p do thfip, viem kh6p d~ng thfip, viem cQts6ng dinh kh6p (Bechterew):

+ N@uchua gay teo ho~c bi@nd~ng kh6p, c(mg kh6p, chuc 4nang kh6p chua h~n ch@,suc kh6e toan than t6t+N@udffgay teo cO',cUngkh6p, bi@nd~ng kh6p, h~n ch@chucnang kh6p, anh huang t6i suc kh6e toan than:• Muc dQnhy va vua 5

• Muc dQn~ng 6

103 Ban chan byt:

- Di l~i khong gay dau nh6i 2

- Di l~i dau nh6i, anh huang mang vac, ch~y nhay 4

104 Chai chan, m~t ca, r6 chan:

- Chai chan (Durillon) day sUng nhung n~n con mSm, di l~i 2khong anh huang

- Chai day sUnggay cQmc(mg, di l~i anh huang 4

- M~t ca long ban chan (Corpolantaire):

+ Chi c6 1 cai, dUOngkinh ::;1cm, di l~i khong anh huang 2

+ C6 2 cai, dUOngkinh::; 1cm, di l~i khong anh huang 3

+ C6 ~ 3 cai, ho~c c6 1- 2 cai nhung dUOngkinh tren 1cm, 4ho~c m~t ca gay anh huang d@ndi l~i- R6 chan (Porokeratose):

+ C6 1- 2 diSm 15mtrong 1cm2, dUOngkinh cac diSm 15mdu6'i 22 mm, di l~i khong anh huang

+ C6 tren 2 diSm 15m trong 1cm2, ho~c dUOngkinh cac diSm 315mtren 2 mm, di l~i khong anh huang+ C6 tren 2 diSm 15mtrong 1cm2 va duang kinh cac diSm 15m 4tren 2 mm, di l~i khong anh huang

22

---- ." ..,~•.•,,~-rm~••-""_.-mm-.._---- -,c_-, .••..-_._-_.~,._d,.'.. ,~_~~~.WI&mll--.'"-tU".~" .-., .•-,.• __-,_,~-,~.,~-,_,,-.. _.-">.,,.-w

TT B~NHT~T DIEM

+ R6 chan anh huemg dSn di hili 5105 Dinh ke ng6n tay, ng6n chan:

- Chua xu tri phftu thu~t:

+ it anh huemg dSn ho~t dQng 3T

+ Anh huemg dSn ho~t dQngCllaban tay, ban chan 4T

- Va xu tri phftu thu~t:

+Khong ho~c r~t it anh huemg dSn v~n dQng 2

+ Co keo, anh huemg dSn v~n dQngCllaban tay, ban chan 4

106 Thua ng6n tay, ng6n chan:

- Chua c~t bo 3T

- Va c~t bo, nSu:

+ Khong anh huemg dSn ho~t dQngCllaban tay, ban chan 1

+ it anh huemg dSn ho~t dQngCllaban tay, ban chan 2

+Anh huemg nhiSu dSn ho~t dQngCllaban tay, ban chan 4

107 Mfit ng6n tay, ng6n chan:

- M~t 1 d6t:

+ Clla 1 ng6n tay cai 4

+ Clla ng6n tro ban tay phai 4

+ Clla 1 ng6n chan cai 4

+ Clla 1 ng6n khac Cllaban tay ho~c ban chan 3

- M~t 2 d6t:

+ Clla ng6n tay tro Cllaban tay phai 5



- M~t 1 ng6n:

+M~t 1 ng6n cai Cllaban tay 5

+M~t 1 ng6n cai Cllaban chan 5

+M~t 1 ng6n tro Cllaban tay phai 5

+M~t 1 ng6n khac Cllaban tay ho~c ban chan 4

23

TT B~NHT~T DIEM

- M~t 2 ngon:

+ M~t 2 ngon trong do khong m~t ngon tay cai, ngon chan cai 5va ngon tr6 ban tay phai

+ M~t 2 ngon trong do co m~t ngon tay cai, ngon chan cai, 6ngon tr6 ban tay phai

- M~t 3 ngon tra len 6

108 Co rut ngon tay, ngon chan:

- Co rut tu 1 - 2 ngon tay ho~c ngon chan 5

- Co rut tu 3 ngon tay ho~c ngon chan tra len 6

109 L~ch vt(o ngon chan cai van trong (Hallux varus) hay ra ngoai(Hallux valgus):

- N~u khong anh hu6ng t6i di giay, dep va mang vac, ch~y, 4nhay

- N~u anh huang t6i mang vac, ch~y, nhay 5

110 Ch~n thuong, v~t thuong kh6p (vua va Ian):

- Chua diSu tri kh6i 4T

- Da diSu tri kh6i, khong dS l~i di chUng 3

- Da diSu tri, dS l~i di chUng anh hu6ng v~n dQng 4

111 Sai kh6p xuong:

- Sai kh6p nh6, vua:

+ Chua diSu tri kh6i 3T

+Da diSu tri kh6i, khong dS l~i di chUng 1

- Sai kh6p vua da diSu tri nhung dS l~i di chUng thanh c6 t~t 4can tra d~n lao dQngva sinh ho~t- Sai kh6p Ian:

+ Da n~n chinh khong dS l~i di chUng 4

+ Da n~n chinh dS l~i di chUng 5

+ Da duQ'cphftu thu~t n~n chinh:

• N~u khong dS l~i di chUng, da duQ'ctheo d5i 1 nam tra len, 4lao dQng sinh ho~t binh thuemg

• DS l~i di chUng nht( 5

24

TT B~NHT~T 11IEM

• D6 l~i di chUng dau, h~n ch€ v~n dQng, thmii hmi bi€n d~ng 6ho~c cUng kh6p

- Sai kh6p IOn kh6ng n~n chinh thanh c6 t~t can trO' d€n lao 6dQng va sinh ho~t

- Sai kh6p b~nh ly a cac kh6p IOn 6

- Sai kh6p tai phat nhiSu lfin 6

112 Gay xuang:

- Gay xuang nho:

+ Chua liSn xuang 3T

+ Da liSn xuang, kh6ng anh huang v~n dQng 1

+ Da liSn xuang, co anh huang v~n dQng 2

- Gay xuang vila va IOn:

+ Chua liSn xuang 5T

+ Da liSn xuang vfrng a tu th€ binh thuemg, kh6ng d6 l~i di 2chUng dau moi ho~c h~n ch€ v~n dQng (thai gian til khi gayxuang d€n khi ki6m tra 1 nam trO' len)

+ Da liSn xuang vfrng, cong l~ch tf\lC kh6ng quan tr9ng, h~ 3ch€ v~n dQng kh6p, kh6ng gay dau moi, kh6ng gay thoai hoabi€n d~ng kh6p, kh6ng anh huang dang k6 t6'i sinh ho~t, ho~tdQng cua chi

+ Da liSn xuang nhung tf\lc l~ch v~o, h~n ch€ v~n dQng 5

+ Co dau moi h~n ch€ v~n dQng nhiSu 5

+ Co dau moi, thoai hoa bi€n d~ng kh6p nhiSu 6

+ Da phfiu thu~t nhung con phuang ti~n k€t xuang 5T

113 Kh6p gia xuang dai ill chi:

- Kern theo mAt do~n xuang lOn, ng~n chi tU 5 cm trO' len d6i 6v6'i chi tren va til 3 cm trO' len d6i v6'i chi du6'i

- Kh6ng kern theo ng~n chi 5

114 Di d~ng bAm sinh:

- Sai kh6p lOn, mAt do~n xuang, mAt dfiu xuang. 6

115 CUng, dinh cac kh6p IOn:

25

TT BtNHT~T DIEM

- CUng, dinh cac khap vai, khu)ru, g6i, hong 6

116 Cung, dinh khap c6 tay, c6 chan:

-a tu thS co nang 5

- Khong a tu thS co nang 6

117 Chenh l~ch chiSu dai chi:

- Til 2 cm tra xu6ng, khong gay dau m6i trong sinh ho~t, lao 4dQng

- Til 3 - 4 cm, it nhiSu anh huang t6'i thfim my va dau m6i khi 5lao dQng, sinh ho~t

- Tren 5 cm, dff anh huang t6'i thfim my va dau m6i khi lao 6dQng, sinh ho~t

118 Hai chan vang kiSng hinh chfr 0, chfr X:

- Nh~, khong anh huang t6'i di l~i, ch~y nhay (5 -10 dQ) ho~c 4anh huang khong dang kS

- Vila (du6'i 15 dQ) di l~i, ch~y nhay it anh huang 5

- N~g (tren 15 dQ) thuemg kern theo biSn d~g a cimg chan, 6ban chan, anh huang dSn chuc nang v~n dQng

119 Cong gil cQt s6ng:

- Dff 6n diM (khong tiSn triSn, khong gay viem ra, dau m6i) 4

- AM huang t6'i mang vac, v~ dQng, ch~y nhay 5

- N~ng: do di chung b~i li~t, di chUng chfin thuong ho~c do lao 6cQt s6ng pha huy d6t s6ng

120 Raxuong:

- Don gian, co xuong viem khu trU, khong pha huy xuong rQng 5T

- Ra cac xuong 100, ra lien tl,lc, hay tai phat 6121 B~nh u xuong, s\ln lanh tinh a nhiSu xuong:

- Dff m6 d\lc b6 u, khong anh huang t6'i chuc nang 4

- Chuam6 5122 6 khuySt xuong a xuong dai:

- Anh huang dSn dQvfrng cua xuong 5- Khong anh huang dSn dQvfrng cua xuong 4

123 Ho~i ill vo khufin ch6m xuong dili 5124 Viem vo khufin 16i cu tru6'c xuong chay 3125 Ho~i ill vo khufin mao xuong chay:

26

TT B:f:NHT~T DIEM

- Ba rn6 d\lc xuang, kSt qua t6t 4- Chua rn6, dau tM phat nhi€u Ian 5T

126 Ho~i tU vo khuAn 16i cau xuang canh tay 4T127 Ban chan thu6ng:

- Khong ng~n chi ho~c co ng~n chi til 1 - 3crn 5- Co ng~n chi tren 3crn 6

128 BUt gan got (gan Achill) 5129 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 6 chi thS:- Muc dQ n~ng 6- Muc dQvila 5

131 Di chUng b~i nao, li~t cUng 6 chi thS 6132 Ban tay kheo 6133 Dj t~t bAm sinh thiSu xuang 6 chi thS (xuang quay, xuang 6

chay ...)134 S~o bong va cac lo~i s~o do cac nguyen nhan khac:

- Nho, da lanh, khong anh huang dSn v~n dQng, sinh ho~t va 1 - 2lao dQng- Nho, da lanh, co anh huang dSn thArn my (6 rn~t, c6):

+ft 3+ Nhi€u 4- Co keo gay biSn d~ng:+ Anh huang it dSn chuc ph~n, sinh ho~t va lao dQng 4+ Anh huang nhi€u dSn thArn my, lao dQng, sinh ho~t 5

135 Gian tTnh rn~ch chan (Varice):- Chua thanh bui 3- Ba thanh bui, ch~y nhay di l~i nhi€u thi d\ng, mc 4

136 Cac lo~i u:

- U lanh tinh (u rna, u XO', nang nhay, u xuang), khong anhhuang t6'i suc khoe, lao dQng, luy~n t~p, sinh ho~t:

+ NSu duemg kinh kh6i u du6'i 1crn: I

+ NSu duemg kinh kh6i u til I - 2crn: 2

+ NSu duemg kinh kh6i u til 3 - 4crn: 3

27

TT BtNHT~T DIEM

-U lanh tinh (u rna, u XO', nang nhay, u xuang) dff anh hUOng t6i 4sinh ho~t, lao dQng, luy~n t~p, ho~c kich thu6c 2: 5cm

- Cac lo~i u ac tinh 0 cac vi tri 6

9. Cac b~nh v~ th~n, ti~t ni~u, sinh d1}c

TT BtNHT~T DIEM

137 Th~n, ti~t ni~u:

- B~nh th~ c~p tinh nhu: Viem c~u th~n c~p, viem bS th~n 5c~p, viem 6ng th~n d.p do cac nguyen nhan m6i kh6i b~nhchua qua 6 thang

- B~nh th~n m~n tinh: Viem c~u th~n m~n tinh co hQi chUng 6th~n hu, suy th~n m~n tinh do cac nguyen nhan

- S6i th~n chua co bi~n chUng:

+ Chi co 0 1 ben, dff m6 k~t qua t6t tren 1 nam 4

+ Chua m6 ho~c co s6i 0 2 ben 5

- S6i th~n co bi~n chUng phai c~t 1 ben th~n 6

- U th~n dffm6 6

- Nang th~n:

+ Chi co 1 nang, dUOng kinh du6i O,5cm, khong chen ep dai, 3bSth~

+ Co ill 2 nang tro len ho~c dUOng kinh tren O,5cm, khong 4chen ep dai bS th~n

+ Kich thu6c 100, chen ep dai bS th~n 6

- S6i ni~u quan dan thu~n, 1 ben:

+ f)ff l~y s6i khong qua ph~u thu~t 3

+ f)ff phfiu thu~t l~y s6i (kS ca phfiu thu~t nQi soi) 4

+ Chua l~y s6i 5T

- S6i ni~u qufm dan thu~n, 2 ben (kS ca dff phfiu thu~t) 5

- S6i ni~u quan dff phfiu thu~t co bi~n chUng (ro nu6c tiSu, chit 6hyp gay giffn th~n ho~c viem th~n)

- S6i bang quang, ni~u d~o:

28

TT B:E:NHT~T DIEM

+ Chua lfiy soi 4T

+ Dff lfiy soi khong qua ph~u thu~t, kSt qua t6t 3

+ Dff ph~u thu~t lfiy soi, kSt qua t6t 4

+ Dff ph~u thu~t nhiSu IAn 5

138 Cac hQi chUng tiSt ni~u:

- Dai r~t, dai bu6t, dai kho 4

- Can dau qu~m th~n hay tai di€n 5T

- Dai ra mau chua ra nguyen nhan, deli ra mu, duang chfip 5

139 Viem duemg tiSt ni~u:

- Viem bS th~n - th~n cfip, viem ni~u d~o do l~u, viem tuySn 5TtiSn li~t

- Viem ni~u d~o thuemg, viem bang quang cfip 3T

140 Cac b~nh th~n bAm sinh:

- Sa th~n (1 ho~c 2 ben) 5T

- Th~n mong ng\la 6

- Th~n kep 1 ben co biSn chUng 6

- Th~ kep ca 2 ben 6

- Th~n l~c ch6 (1 - 2 ben) ho~c 1 th~n 6

141 Kh6i u sau phuc m~c:

- U th~n dffm6 ho~c chua m6 6

- U tuySn thugng th~n (huySt ap cao) 6

- U rna, u quai, u th~n kinh, u h~ch 6

142 Lao duemg tiSt ni~u, sinh d\lc:

- Lao th~ dff m6 ho~c chua m6 6

- Lao th~n dS l~i di chUng h~p ni~u quan 6

- Lao bang quang, lao tuySn tiSn li~t 6

- Lao mao tinh hoan (u C\lCho~c ra) 6

143 Cac di t~t 6 ni~u quan:

- Ni~u quan nAm sau tinh m~ch chu 6

29

TT B~NHT~T DIEM

- Ni~u qufmn~m sau dQngmt;tchch~u 6

- Ni~u qmin kep 1 ben 6

- Ni~u qmin kep 2 ben 6

- Ni~u qUIDIt;tcch6 6

144 Cac b~nh 6 bang quang:

-Unh6 bang quang 5

-Unh6 bang quang dffm6, h6i ph\lc t6t 4".

-U ac tinh bang quang 6

- Tlii thua bang quang, hyp c6 bang quang 5

145 Sinh d\lc:

- Hyp bao quy dftu khong anh huang tiSu ti~n, ho~c dff phftu 1thu~t kSt qua t6t

- Hyp bao quy dftu anh huang tiSu ti~n 3T

- Hyp ni~u dt;todo di chUng l~u, ch~n thuong ra va hyp ni~u 5dt;tokhac

146 Cac di t~t duong v~t:

- L6 dai l~ch th~p (hypospadias) 5

- L6 dai l~ch cao 6

- C\lt duong v~t 6

- Ni~u dt;tokep 6

147 Di t~t 6 biu:

- ThiSu 1 ben tinh hoan 3

- Tinh hoan finho~c It;tcch6 1 ben chua gay biSn chUng 3T- Tinh hom finho~c It;tcch6 1 ben dffgay biSn chUng 4T- ThiSu ho~c finca 2 ben tinh hoan 6

- Ai nam, ai nfr 6

-U tinh hoan don thuftn 5

-Umao tinh hoan (khong phai lao) 4T

- Tran dich mang tinh hoan dffm6 t6t 4

- Tran dich mang tinh hoan chua m6 5

30

TT B~NHT~T DIEM

- Viem day da tinh hoan 5

- Tran mau mang tiOOhoan 5

- Viem loet da biu. 5T

- U nang thung tiOO:

+ Chua m6. 5

+ Ba m6 tren 6 thang, dien biSn t6t 4

- Teo tiOOhoan:

+ Teo ca 2 ben do quai bi 6

+ Teo 1 ben do b~OOkhac, nSu b~OOda 6n diM 4

- Teo mao tiOOho~m 1 - 2 ben 5

- U OOilqui dAu va raOOqui dAu 5T

148 Ung thu duong v~t 6

149 Viem tiOOhoan, viem mao tiOOhoan 4T

150 Gian tiOOm~ch thU'ng tiOO(Varicocel):

-Nhy 2

- Vua 3

- N~ng 4

10. Cae b~nh v~ nQi ti~t, ehlly~n hoa, h~eh, mall

TT B~NHT~T DIEM

151 B~OOtuySn giap:

- Viem tuySn giap cap tiOO 3T

- Viem tuySn giap tv mien 5

- B~OOBasedow 5

- BuOu laOOtiOO006, sa thay, chua aOOhUOng t6i ho hap 3

- BuOu laOOtiOOto, c6 aOOhUOng t6i ho hap, n6i, nu6t 5

- Ung thu tuySn giap 6152 B~OO1:9" tuySn thuQ'Ilg th~n 6

153 B~OO1:9" tuySn yen 6

154 B~OO1:9" chuy@nh6a

31

TT BtNH T!.T DIEM

- B~OOdai thao duemg 5

- B~OOGoutte m~n tiOO 5

- R6i lo~n chuySn hoa Lipid 4T

155 H9i chUngn9i tiSt c~n u 6

156 Phi d~i tuySn vu a nam gi6i (1 ho~c 2 ben), aOOhuang thAm 4my

157 Cac b~OOh~ch va b~OOmau ac tiOO 6

158 ThiSu mau n~ng thuemg xuyen do cac nguyen OOan 5

11. B~nh da li~u

TT BtNH T!.T DIEM

159 Nfim da, nfim b~n (hic lao):- ThS diSn hinh, chua co biSn chung, di~n tich du6i 50cm2 2T- Nfim da di~n tich tlr 50 - 100cm2 chua co biSn chUng, ho~c 3Tnfim da di~n tich du6i 50cm2 OOungco biSn chUng cham hoa,OOiSmkhuAn...- Nfim da di~n tich tren 100cm2

, ho~c rili rac toan than, ho~c co 4TbiSn chUng n~ng (cham hoa, OOiSmkhuAn...)

160 Nfimmong:- Co tu 1 - 2 mong bi nfim 2- Co tlr 3 - 4 mong bi nfim 3- Co tlr 5 mong tra len bi nfim 4

161 Nfim ke:- Chi bQttring tlr 1 - 2 ke 2T- Chi bQttring tlr 3 - 4 ke 3T- BQt tring tu 5 ke tra len, ho~c co m\ln nu6c tu 3 ke tra len 4T

162 Lang ben:- ThS khu tm ,(m~t ho~c vai ho~c lung ...), di~n tich du6i 1/3 2Tdi~n tich cO'the- ThS Ian toa chiSm tren 1/3 di~n tich cO'thS 3T- ThS Ian toa chiSm tren 1/3 di~n tich cO'thS, aOOhuang dSn 4Tthc1mmy (bi OOieuvung m~t, c6, gay)

163 Nfim toc, f\lng toc do cac nguyen OOan:- Muc d9 oo~ 3- Muc d9 vua 4- Muc d9 n~ng 5

164 Bi mic tu 2lo~i nAmneu tren tra len (tlr m\lc 158-162) L~ydi~m cua

32

TT B~NHT~T DIEM

nhi€m lo<;ti,nam n~ngnhdt va tanglen 1 di~m

165 Ghe:

- Th8 gian dan, khu trU, chua co biSn chUng: Viem da nhiSm 2Tkhufin, cham hoa ...- Th8 co biSn chUng: Viem da nhiSm khufin, cham hoa ..., 3Tnhung con khu tru- Ghe rai rac toan than va co biSn chUng: Viem da nhiSm 4Tkhufin, cham hoa ...

166 Viem da dj Ung

- Viem da dj Ung/kich thich 3

- Cham vi khufin 3T

- Cham hoa do b~nh da khac (nfrm, tiSp xuc ... ) 4T

- A simg lien c~u, a simg vung d~u (cham khong ra nguyen 2nhan)

- Viem da ca dja 6

- Viem da d~u 4

- T6 dia 5

- Viem da th~n kinh

+ Khu trli 4T

+ Lan toa (nhiSu nai) 5

167 B~nh da b<;mgnuac (Pemphigus, Pemphigoid, Duhring Brocq) 6

168 B~nh t6 chuc lien kSt:

- Lupus ban do:

+ Lupus ban do mt;ln (khu trli) 5

+ Lupus ban do h~ th6ng 6- Xa cung bi:

+ Khu trli 4+ Lan toa 6- Viem bi ca 6- Viem nut quanh dQng mt;lch 5

169 B~nh da co vay:

- B~nh vay nSn cac th~ 4-5-6

33

TT B~NHT~T DIEM

- A yay nSn 3

- Vay ph5.nh6ng Gibert 3T

- Lichen ph~ng 5

- Vay ph5.ndo nang long 3

170 B~nh r6i lo~n s~c t6:

- B~nh b~ch biSn:

+ ThS khu tru, dill do~n 3

+ ThS Ian toa 4

- S~m da

+ Khu tru vung rna (nam rna) 2

+ Rai rac (nguyen nhan nQitiSt) 5

171 Cac t~t bAmsinh ada, b61cac lo~i:

- Di~n tich duai 3cm2, khong a vung m~t - c6 1

- Di~n tich tich tir 3 - 9cm2 khong a vung m~t - c6, ho~c di~n 2tich duai 3 cm2 a vung m~t - c6- Di~n tich tir 10 - 20 m2 khong a vung m~t - c6, ho~c di~n tich 3tir 3 - 4cm2 a vung m~t - c6- Di~n tich tren 4 cm2 a vling m~t - c6, ho~c di~n tich tren 420cm2

, ho~c co rai rac nhiSu nO'i172 B~nh phong t5.tca cac thS: 6

173 B~nh lay theo duemg tinh d\lc:

- Giang mai:

+ Giang mai giai do~n 1 va 2 sam, dffdiSu trj dung, du phac d6 3va xet nghi~m TPHA am tinh

+ Giang mai giai do~n 2 mUQn,dffdiSu trj dung, du phac d6 va 4xet nghiem TPHA am tinh.

+ Giang mai giai do~n 3 6

+ Giang mai chua diSu trj 6n djnh 5

- L~u:

+ L~u c5.pdffdiSu trj khoi 2

+ L~u c5.pchua diSu trj 4

+ L~u m~n co t6n thuoog bQph~n tiSt ni~u, sinh d\lc 5

- B~nh h~ cam (Chancremou):

34

TT B:~NHT~T DIEM

+ Btl diSu tri khoi 3

+ Chua diSu tri 4

- Sui mao ga (Papyloma) 4

- B~nh Nicolas-Favre 5

- Nhiem HIV 6174 Day simg long ban chan cO'dia 5175 TrUng ca va mQt s6 b~nh khac:

- TrUng ca thuemg (chi tinh vung m~t):+ Du6i 100 sAn, khong co m\ln mil 1+ Til' 100 - 200 sAnvaJho~c < 5 m\ln mil 2T+ > 200 sAnvaJho~c 2: 5 m\ln mil 3T- TrUng ca ho~i tir, trUng ca m~ch luan, trUng ca s~o 16i 4- TrUng ca do 5

176 SAnngua C\lCdo con trung d6t (ru6i yang, bQ cho, din ...):+ S6 IUQ'ngdu6i 10 n6t 2T+ Til' 10 - 30 n6t 3T+ Til' 30 - 50 n6t 4T+ Tren 50 n6t 5

177 May day m~n tinh 6178 Lao da cac lo~i 5179 Cac b~nh u da:

- UXO'thAn kinh (b~nh di truySn) 5- Cac loe;tiu lanh tinh khac 4

180 C~y di v~t vao duang v~t 4T

12. B~nhph...•khoa

TT B:E:NHT~T DIEM

181 Kinh nguy~t:

- Kinh nguy~t nhiSu, hay xu~t hi~n va khong dSu 4

- V0 kinh, thi@ukinh, hiSm kinh 5

- Chay mau b~t thuemg khac cila tir cung, am de;to 5182 U cO'tran ill cung (dtl ph~u thu~t boc u ho~c chua ph~u thu~t) 4T

35

- -~~-----------------------------------_ ..._-_ ...._--_ ..

TT BtNHT~T DIEM

183 UUmhbu6ng trung (da phfiu thu~t boc u ho~c chua phfiu thu~t) 4184 U lanh cua cac co quan sinh d\lc khac khong xac dinh (da phfiu 4

thu~t boc u ho~c chua phfiu thu~t)

185 Lo~n san vu lanh tinh 4186 VUphi d~i 4187 BiSn d6i khac a vU 4188 Viem voi tu cung va viem bu6ng trtrng 4189 Viem voi tu cung tnl c6 tu cung 2-3190 Viem c6 ill cung 4T191 Cac b~nh cua tuySn Bartholin 4T192 Cac b~nh khac cua am d~o va am hQ 4193 L~c nQim~c ill cung 4194 Polyp duemg sinh d\lc nft 4T195 Nhf'rngdi t~t bAmsinh cua bu6ng trtrng, voi trung va day chAng 4

rQng

196 Di t~t bAmsinh cua ill cung va c6 ill cung 4197 Cac di t~t bAmsinh cua co quan sinh d\lc nft

- Am d~o doi 4T- Di t~t bAmsinh am v~t 4-6- Mang trinh khOng thung 3T- Di t~t bAmsinh cua vu 4- Cac di t~t bAmsinh khaCcua ca quan sinh d\lc nft 4

198 Co thai (nhung chua duQ'cchAndoan khAngdinh) 4T199 Sui mao ga (Papyloma) a h~u mon, sinh d\lc 4

36

III. DANH Ml}C cAc B~NH MIEN DANG KY NGHiA Vl} QUAN 81]'(Bang sA 3):La nhiing b~nh thuQC di~n miSn dang ky nghla Y\l quan S\f, khong nh~n vao quanthuOng tf\IC, g6m:

" MAB~NHTT TENB~NHICDIO

1 Tam th~n F20-F29

2 DQng kinh G40

3 B~nh Parkinson G20

4 MumQtm~t H54,4

5 Di~c H90

6 Di chung do lao xuong, kh6p B90.2

7 Di chung do phong B92

8 Cac b~nh ly ac tinh COOd~n C97;DOO d~n D09;

D45-D47

9 Nguai nhiSm HIV B20 dSn B24,Z21

10 Nguai khuy~t t~t muc dQ d~c bi~t n~ng va n~ng

37

IV. Chu d~n kham tuy~n

1. Kham th~ ll}'c:

a) Cach quy trim s6 1i~u:ChiSu cao, yang ng\fc, can n~ng til 0,5 tn] len ghi 1a 1don vi; til' 0,49 tra xu6ng thi khong l~y ph~n Ie.Vi d\J:- Cao: ..+ 152,50cm ghi 1a 153cm+ 158,49cm ghi 1a 158cm- Can n~ng:+ 46,50kg ghi 1a47kg+ 51,49kg ghi 1a51kg- Vang ng\fc:+ 82,50cm thi ghi 1a83cm+ 79,49cm thi ghi 1a79cmb) Kham th@l\fc: Khi kham th@l\fc, nguai duQ'ckham phai bo mil, non, khong digiay ho~c dep (chan d~t, d~u tr~n): N@u1anam giai phai cai h@tqu~n ao dai, aolot, chi m~c 1 qu~n dui. N@ula nfr giai m~c qu~n dai, ao mongo- Do chiSu cao: Nguai duQ'c do phai dUng a tu th@th~ng, 2 got chan ch~m vaonhau, 2 tay buong thong t\f nhien, m~t nhin ngang, t~m nhin la 1 duang th~ngn~m ngang song song vai m~t d~t.+ Thuac do: N@udo chiSu cao b~ng thuac a ban can thi phai chu y keo ph~ntren cho h@tcO',sau do diSu chinh d@l~y k@tqua ph~n duai cua thuac.+ N@udung tuang, cQt ke thuac d@do thi tuang ho~c cQt phai th~ng dUng, nSnd@dUng khong g6 ghS, phai vuong goc vai tuang ho~c cQt lam thuac do.+ Nguai dUng vao vi tri do, got chan, mong, xuO'ng ba vai ch~m tuang. Thuacd~t l~y k@tqua do ch~m dinh d~u phai vuong goc vai tuang.- Do yang ng\fc (d6i vai nam giai): Vang do qua ng\fc vuong goc vai tr\Jc thandi qua num vu a phia truac, qua 2 ba duai xuong ba vai a phia sau. Dung thuacday do, nguai duQ'cdo hit thO'binh thuang. D@chinh xac ta do khi hit vao t6i dava thO'ra t6i da, l~y 2 gia tri do cQng l~i chia trung binh, tinh nhu sau:

Vang ng\fC trung binh=Hit vao t6i da + thO'ra t6i da

2- Chi s6 BMI (Body Mass Index) la chi s6 kh6i cO'th@danh gia m6i tuong quangifra chiSu cao va can n~ng:

BMI = Can n~ng (kg){ChiSu cao (m)}2

38

Chi s6 BMI duQ'c xem xet trong truemg hQ'Pdu tieu chu~n vS th~ 19c, OOungcosg m~t can d6i gifra chiSu cao va can n~ng: khong OO~nOOfrngtruang hQ'Pco chis6 BMI ~ 30.

2. Kham m~t:

86 1: Thi 19c: Thi 19c la tieu chu~n cO'ban d~ danh gia suc OOincua tUng m~t,mu6n do thi 19c chiOOxac, yeu c~u:- Nhan vien chuyen mon: Phai trgc tiSp huang dftn cach dQc va tiSn hanh dungky thu~t quy diOO.Chu y phat hi~n OOfrngtruang hQ'Pnguai dQc khong trungthgc ho~c khong biSt dQc theo huang dftn.- Bang thi 19c phai:+ Chfr den, nSn tr~ng, hang 7/10 dSn 8/10 phai treo ngang t~m m~t OOin.+ £>ud<)aOOsang c~n thiSt d~ dQc (khoang 400 - 700 lux) traOOmQi hi~n tuqnggay loa m~t, qua sang ho~c sang dQi vao m~t nguai dQc ho~c t6i qua aOOhuemgt6'i suc OOincua nguai dQc.+ Cg ly gifra bang t6'i ch6 dUng cua nguai dQc la Sm.+Nguai dQcphai che m~t 1 ben b~ng 1 miSng bia cung (khong che b~ng tay) vakhi dQCca 2 m~t dSu rna (1 m~t rna sau bia che).+ Nguai do dung que chi vao du6'i tUng chfr, nguai dQc phai dQc xong chfr dotrong khoang du6'i 10 giay. Hang 8/10, 9/10, 10/10 m6i hang chi duQ'cdQc sai 1chfr rn6'i tiOOkSt qua hang do.- Cach tiOOt6ng thi 19c 2 m~t: nSu thi 19c cao han 10/10 vftn chi tiOOla 10/10Vi d\l: M~t phai 12/10, rn~t trai 5/10 thi t6ng thi 19c 2 m~t la 15/10.Khi tiOOt6ng thi 19c d~ phan lo~i thi chu y thi 19c cua rn~t phai. Thi 19c cua m~ttrai khong th~ bu cho m~t phai duQ'Crna thi 19c cua m~t phai vftn phai nhu tieuchu~n dffquy dinh.

3. Kham rang:

86 19: Rang sau:Quy dinh ky hi~u sau ding b~ng chfr "8".- 81: sau rang £><)1 (sau men);- 82: sau rang £><)2 (sau nga nong);- 83: sau rang £><)3 (sau nga sau).Vi d\l: Rang 46 bi sau d<)3 thi ghi la: R468386 20: M~t rang.a) Quy diOOvS ky hi~u rang: M6i rang dSu co ky hi~u b~ng hai chfr s6:- Chfr s6 d~u la ky hi~u cua ph~n tu ham cua d6i tuqng:

39

PhiaTrenDu6i

Phai14

Tnii23

+Nhfrng ding ham tren ben phai co ky hi~u s6 1.+Nhfrng ding ham tren ben tnii co ky hi~u s6 2.+Nhfrng ding ham du6i ben tnii co ky hi~u s6 3.+Nhfrng ding ham du6i ben phai co ky hi~u s6 4.Chu s6 thu hai ky hi~u cua timg rang:+Rang cua giua: S6 1+Rang khan trong cung: S6 8

Vi dV:+Rang nanh ham tren tnii ky hi~u 23+Rang ham s6 5 du6i phai ky hi~u 45Rang 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 khan).b) Cach tinh suc nhai:Rang bi viem tuy ho~c tuy bi ho;;titu chi coi nhu la m~t suc nhai t;;tmthaiRang bi lung lay dSn muc d9 khang diSu tri dugc c~n phai nh6; ho~c m~t hSt thanrang can chan thi coi OOum~t rang.NSu m~t 1 rang thi coi OOum~t ca rang cung s6 d6i di~n v6i m~t OOai.Vi dV;M~t rang 16 thi coi OOum~t ca rang 46 va tinh m~t 10% suc nhai.NSu m~t 4 rang khan ham tren va du6i thi khang tinh la m~t suc nhai (vi co

nhiSu nguai khang co rang khan).

Cach tinh suc nhai:

%suc2 5 5 3 3 4 1 2 2 1 4 3 3 5 5 2

Ham nhaifren 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2

Rang8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8

%suc3 5 5 3 3 4 1 1 1 1 4 3 3 5 5 3

Ham nhaidum 4 4 4 4 4 4 4 4 3 3 3 3 3 3 3 3

Rang8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8

Rang gia: M~t rang da:lam rang gia t6t dugc tiOO50% suc nhai cua rang.S6 21, 22:Phan bi~t giua viem 19i va viem quaOOrang:

40

Viem lQi

- LQ'icuang do, co thS viem 2 - 3 dingdSn tmln bQ2 ham- Khong co tui mu 0 sau

it ho~c khon

- Co cao fan

Viem quanh rang

- LQ'i co thS viem do, chay mau, t\1tlQ'i,ho c6 din- Co tui mu 0 sau 0 nhiSu ding dSntoan bQ2 ham, mu cha thuan xu en- Ran lun la tu dQ 1 dSn dQ4- Hai tho ffit hoi- NhiSu cao fan tfen lQ'iva duai lQ'i- Xuang 6 fang tieu d<;>cho~c ngang

S6 23: Viem tuy, tuy ho~i tu, viem quanh cu6ng fang:Viem quanh cu6ng fang khac viem quanh fang la viem day ch~ng quanh fang,tieu xuang 6 fang, viem lQ'i.- Viem cu6ng fang: La viem vung t~n cung cua fang nai cac m~ch mau va thclnkinh di vao nuoi du5ng fang (thuang do tuy ho~i tu) dau e ~m, fang co cam giactf6i len, go d<;>cdau, hai ham ch~m vao dau, lQ'ivung cu6ng hai nS. Viem cu6ngfang cfip: dau khu tm lQ'iho~c rna tuang ung fang viem sung nS.- Viem tuy fang: Rang tv nhien dau, dau nhiSu vS dem, dau Ian toa, dau diI dQithanh tUng can tuy thuQc vao viem tuy cham phat hay viem tuy cfip, go ngangdau han d<;>c.Quy dinh ky hi~u viem tuy fang b~ng chiI "T", cach ghi tuang tv nhu chu d~nm\1cfang sau.- Viem tuy ho~i tu: Rang khong dau, thuang fang d6i mau xam ho~c yang d\1c.S6 26: Viem tuySn mang tai: BiSu hi~n sung 0 vung tuySn mang tai. NSu chua6n dinh, khi kham, n~n vao vung tuySn mang tai se thfiy chay mu fa 0 6ngStenon.S6 28: Kh6p c~n binh thuang: Nguai duQ'ckham ng~m mi~ng 0 tu thS tInh, nu6tnuac b<;>t,hai ham fang khit l~i, khong bi ho, khong di l~ch sang phai ho~c trai.Kh6p c~n di l~ch la khi 0 tu thS tfen rna hai ham bi ho ho~c l~ch sang mQtben.

4. Kham tai - mtii - hQng:

S6 31: Do suc nghe.a) Noi thclm:- Nguai kham tho fa hSt f6i noi thclm dS thu. Phai thu tung tai fieng bi~t (taikhong thu phai duQ'c bit kin b~ng cach de ngon tay len n~p 16 tai do nguaiduQ'cthu lam).- TiSng noi phat fa th~ng goc vai tai thu. Nguai duQ'c thu cclmmiSng bia clingche m~t dS khong nhin duQ'cmi~ng nguai thu.

41 I

---~----~

- Trong diSu ki~n kham dong nguai, khong co nai yen Hnh, co thS dung tiSngnoi thuang. Truang hQ'P tai bi giam suc nghe phai dung cach thu tiSng noith~m vai diSu ki~n cho phep. NSu nghi nga c~n cho kiSm tra ky t~i ca So'chuyen khoa. Do b~ng am m~u: am tr~m (128), am cao (2096).b) Noi thuang: Suc nghe t6t han noi th~m 10 l~n khoang cach do.S6 35: Chong m?t me nhI, biSu hi~n.a) Cam giac chu quan tv quay theo cac chiSu khong gian khac nhau ho?c m<)iv~t xung quanh minh.b) Cac r6i lo~n thvc v~t kern theo (xanh tai, toat m6 hoi, non, m~ch nhanh ho?cch~m l~i). Cac r6i lo~n khach quan mAtthang b~ng.c) Thuang co dQng m~t tv phat.S6 37: Viem h<)ngm~n tinh.- NSu thanh sau h<)ngchi co t6 chuc lympho tang sinh, day len, thS tr~ng t6t thiv~n xSp lo~i 2.- NSu t6 chuc lympho day len lam h~p khoang sau h<)ng,ho?c tren dam t6 chuclymho tang sinh co nhfrng chAm nuac ho?c mu gay ho, s6t luon ho?c lam thStr~ng suy nhu<)'cthi xSp lo~i 4.

5. Kham dim thAn va thAn kinh:

S6 47: Ra m6 hoi tay, chan: Chia lam cac muc dQ:- Nh~: So' vao ban tay chi hai Am,nhin vao ke duang chi ban tay thAy lAmtAm,ong anh m6 hoi khong thanh v~t dai Lau kho, tren 10 phut mai xuAt hi~n tral~i nhu cu ho?c sau thai gian v~n dQng m6 hoi ban tay khong thanh v~t daiho?c thanh gi<)t.- Vila: BiSu hi~n n?ng han cac dAuhi~u tren va thuang co ca m6 hoi chan.- N?ng: Mua he cung nhu mua dong, ban tay luon nhap nhap m6 hoi, So'vaod~u ngon tay thAy l~nh, cac ke duang chi ban tay ong anh m6 hoi thanh v~t daiva thanh gi<)t. Sau khi lau m6 hoi, dS 5 - 6 phut m6 hoi l~i tiSt ra g~n nhu cu.Lo~i nay cung thuang kern theo ra m6 hoi toan than, nhAt la khi cam xuc.S6 56: B~nh ca (Myopathie): BiSu hi~n teo ca a g6c chi. B~nh nhan dang ng6ix6m rna tv dQng dung d~y khong du<)'cho?c rAtkho khan.S6 57: B~nh nhu<)'cca (Myasthenia): Thuang biSu hi~n b~ng S\lPmi m~t, bu6isang m~t con rna du<)'c,vS chiSu S\lP cang roo Cac co khac luc d~u v~n dQngcon kha, sau 1 thai gian v~n dQng va cang vS chiSu thi co ySu d~n.S6 58: T~t may ca (TIC): BiSu hi~n nhay m~t, nhay m6m, nhay mep.

6. Kham nQi khoa:

S6 82: B~nh d~i, trvc trang.

42

a) HQi chUng d~i trang kich thich: La r6i lo~n vS v~n dQng va xu~t tiSt clla d~itrang. Thucmg dau b\lng dQc theo khung d~i trang, r6i lo~n d~i ti~n, khong coviem ho~c viem r~t nhy, phan khong co a mip. Chia lam cac muc dQ:- Nhy: M6i nam chi 1 - 2 dqt ng~n, dau it va nhy. R6i lo~n d~i ti~n nhy, it anhhuang t6'i sinh ho~t va suc kh6e chung.- Vira: M6i nam 3 - 4 dqt, cuang dQdau dang kS han, r6i lo~n tieu hoa keo daico anh huang t6'i sinh ho~t va suc kh6e chung.- N~ng: M6i nam tren 4 dqt, ho~c dau keo dai hang thang, cuang dQ dau dangkS, anh huang nhiSu dSn suc kh6e chung va sinh ho~t, tam thfin kinh.b) Viem loet tr\fc, d~i trang xu~t huySt: Thuang co nhiSu 6 loet to, chay maurai rac a tr\fc trang, d~i trang.86 85: B~nh gan.a) Viem gan m~n tinh t6n t~i: La lo~i viem gan m~n tinh thS nhy va khong tiSntriSn, it anh huang t6'i suc kh6e chung va cac chuc nang Clla gan, do do khongtra thanh xa gan. Tuy nhien cfin giu gin va theo doi.b) Viem gan m~n tinh ho~t dQng: La lo~i viem gan m~n tinh thS n~ng, tiSn triSnthanh nhiSu dqt, cac chuc nang gan bi anh huang ro, suc kh6e chung bi anhhuang dS tiSn dSn xa gan.8688: Lach.Tinh dQ lach to: Ke 1 duang th~ng til dinh nach t6'i r6n, I~y do~n th~ng til ba s-uan trai t6'i r6n clla do~n th~ng tren chia lam 3 phfin dSu nhau. Phfin sat suan ladQ 1, phfin sat r6n la dQ3, til r6n tra xu6ng la dQ4.86 91: Cac b~nh phS quan.- Viem phS quan c~p tM diSn: La b~nh tai diSn nhiSu lfin, lien quan dSn cac ySut6 thu~n Iqi nhu hut thu6c la, hit phai khi dQc (do moi truang s6ng, lam vi~c),nhiSm khu~n rang mi~ng, suy tim tnii, xa ph6i ken, suy giam miSn dich ...;trong do cac ySu t6 nguy ca co thS chua kh6i nhu: nhiSm khu~n rang mi~ng,hut thu6c la, hit phai khi dQc...- Hen phS quan:+ Muc dQ nhy: Can kho thO'nhy, thinh thoang xu~t hi~n nhiSu vS mila ret, vSban dem, chua anh huang t6'i thS tr~ng, lao dQng binh thuang, khong phai di,

nam vi~n.+Muc dQtrung binh: Thai gian m~c 10 - 15 nam, can hen xu~t hi~n vS dem vasang. Tai phat it, ph\! thuQc vao thai tiSt, suc kh6e toan than con t6t.+Muc dQn~ng: M~c b~nh 15 - 20 nam, can hen xu~t hi~n ca ngay va dem, keodai dai d~ng, dii co biSn chung khi phS thCing, tam phS m~n, viem phS quanm~n, trong 3 nam gfin day, nam nao cling co can hen xu~t hi~n lien t\lC phai di,

nam vi~n.

43

86 96: HuySt ap.- Th6ng nh~t cach do huySt ap: Theo Quy trinh do huySt ap dung (Ban hanhkern theo QuySt djnh s6 3192/QD-BYT ngay 31/8/2010 clla BQ truang BQY tSv@huang dftn chfin dmin va di@utrj tang huySt ap):1.Nghi ngai trong phong yen tlnh it nh~t 5 - 10 phut truac khi do huySt ap.2. Khong dung ch~t kich thich (ca phe, hut thu6c, ruQU,bia) truac do 2 gia.3. Tu thS do chufin: Nguai duQ'c do huySt ap ng6i ghS tva, canh tay du6ithing tren ban, nSp khuyu ngang muc vai tim. Ngoai ra, co th@do a cac tu thSnAm, dung. D6i vai nguai cao tu6i ho~c co b~nh dai thao duang, nen do themtu th~ dung nhAm xac djnh co h~ huy~t ap tu th~ khong.4. 8u dVng huy~t ap k~ thuy ngan, huy~t ap k~ d6ng h6 ho~c huy~t ap k~ di~ntu (lo~i do a canh tay). Cac thi~t bi do c~n duQ'c ki@mchufin dinh kyo B@daibao do (nAm trong bang cu6n) t6i thi@ubAng 80% chu vi canh tay, b@rQng t6ithi@ubAng 400/0chu vi canh tay. Qu~n bang qu~n dll ch~t, ba duai Clla bao doa tren n~p IAn khuyu 2cm. D~t may a vj tri dam bao may ho~c m6c 0 Cllathang do ngang muc tim.5. N~u khong dung thi~t bi do tv dQng, truac khi do phai xac dinh vi tri dQngm~ch canh tay d@d~t 6ng nghe. Bam hai them 30mmHg sau khi khong conth~y m~ch d~p. Xa vai t6c dQ 2 - 3mmHg/nhip d~p. Huy~t ap tam thu tuangung vai luc xu~t hi~n ti~ng d~p d~u tien (ph a I clla Korotkoff) va huy~t aptam truang tuang ung vai khi m~t hin ti~ng d~p (pha V CllaKorotkoff).6. Khong noi chuy~n khi dang do huy~t ap.7. L~n do d~u tien, c~n do huy~t ap a ca hai canh tay, tay nao co con s6 huy~tap cao han se dung d@theo d5i huy~t ap [email protected]. Nen do huy~t ap it nh~t hai l~n, m6i l~n cach nhau it nh~t 1 - 2 phut. N~us6 do huy~t ap gifra 2 l~n do chenh nhau tren 10 mmHg, c~n do l~i vai phutsau khi da:nghi tren 5 phut. Gia trj huy~t ap ghi nh~n la trung binh clla hai l~ndo cu6i cung.9. Truang hQ'p nghi nga, co th@theo d5i huy~t ap bAng may do tv dQng t~inha ho~c bAng may do huy~t ap tv dQng 24 gia (Holter huy~t ap).10. Ghi l~i s6 do theo dan vi mmHg duai d~ng huy~t ap tam thu/huy~t ap tamtruang (vi dv 126/82mmHg), khong lam tron s6 qua hang dan vi va thong baok~t qua cho nguai duQ'c do.- Th6ng nh~t cach phan lo~i: N~u huy~t ap tam thu va hUYStap tam truang khongcung mQtmuc phan lo~i, thi chQnmuc cao han d@k~t lu~n phan lo~i (vi dv: huy~tap tam thu lo~i 2, huy~t ap tam truang lo~i 1, k~t lu~n la lo~i 2 vS huYStap).86 97: B~nh tang hUYStap.Phan dQ theo huang dftn Clla BQ Y t~ (QuYSt dinh s6 3192/QD-BYT ngay31/8/2010):

44

_________ ~ =~" ~m~m~==. =~~_,,_ii=,..,.••~=_=_:a"'_=""=_.;;mr~_m_W::~ __ "'''''''''''.._:''''£i"",,'''''J .•.••••••<;g,~m__ =z__

Phan dQ huy~t ap

< 120120 - 129130 - 139140-159160 - 179~ 180~ 140

vava;ho~cva;ho~cva;ho~cva;ho~cva;ho~c

va

< 8080 - 8485 - 8990 - 99100 - 109~ 110<90

S6 98: M~ch.- Kham m~ch: Chu ySu b~t m~ch quay, phai b~t 2 ben d6ng thm. ,Khi ~hfiy"m~chsinh doi", "m~ch sinh ba" (ngo~i tam thu) thi phai nghe tim va dem so ngo~i tamthu trong 1phut.+NSu phat hi~n ngo~i tam thu thi th\fc hi~n nghi~m phap v~n dQng(chi ap d\lng chonguai khong m~c b~nh tim): cho v~ dQng~i chB (dUng len ng6i xu6ng nhanh 20 -30 lfinho~c ch~y cao chan ~i chBtrong 5 phut). NSu ngo~i tam thu giam ho~c mfit dithi ghi nh~ la ngo~i tam thu cO"nang, nSu ngo~i tam thu khong giam ho~c tang lenthi ck dua dSn kham chuyen khoa ~i b~nh vi~n va lam di~n tim.+NSu b~t m~ch thfiy lo~n nhip ho£mtoan thi phai nghe tim va dSm nhip.+M~ch thuang xuyen khi nghi ~ 90 lfinJphut cfin kham chuyen khoa tim m~ch vanQitiSt t~i b~nh vi~n.- Cach lam nghi~m phap Lian:+Nguai duQ'cthu a tu thS dUng lfiym~ch truac khi ch~y.+ Ch~y ~i chB vai t6c dQ 10-12 buac trong 5 giay, ch~y trong 5 phut. Khi ch~y,c~ng chan gfip th~g goc vai dili. Sau khi ch~y 1 phut lfiy m~ch 15 giay dfiu cuatimg phut 1,2,3,4, 5. Trong khi do, nguai duQ'cthu phai dUng im, khong cu dQng,khong noi.- KSt qua:+NSu dfiu phut thu nhfit m~ch da len tai 140 lfin /phut ho~c cao han la xfiu khongxSp tlr lo~i 1 - 3 duQ'c.+NSu dfiuphut thu 2 - 3 tral~i nhu Cll ho~c gfinnhu Cll thi coi nhu binh thuang.+ NSu dfiu phut thu 4 - 5 m~ch mai tra l~i nhu Cll la xfiu khong xSp tlr lo~i 1 dSnlo~i 3 duQ'crna phai xSp tlr lo~i 4 tra di.+NSu t~n dfiuphut thu 6 m~ch mai tra l~i nhu Cll la xfiu, xSp lo~i 4.- M~ch thuang xuyen khi nghi < 50 lfinJphut, cfin duQ'c tiSn hanh nghi~m phapAtropin:

45

mr•. meWMft

+ Tiem tIOOm~ch Atropin 1/4 mg x 04 6ng (nSu ham IUQ1lg1/2mg thi dung 026ng). Truac do ghi di~n tim d~o triOODII, sau do tiSp 1\lcghi timg do~n DII ngaysau tiem, sau 1 - 3 - 5 - 7 phut.+Danh gia: NSu nhip tim d~t 2: 90 l~n/phut thi m~ch ch~m do cuang pho giao cam.NSu nhip tim < 90 l~n/ phut thi m~ch ch~m co thS do b~nh ly nut xoang, c~ duadSn kham chuyen khoa tim m~ch t~i b~nh vi~n.S6 101: B~nh tim.- Khi nghe tim c~n mo ta ro tiSng thu nh~t (T1) va tiSng thu hai (T2) a cac vi trlmom tim, lien suan II va III c~nh uc trai, mili uc. Khi ph::ithi~n tiSng th6i tam thuc~ mo ta cuang dQ, thai gian va am s~c; phan bi~t ro tiSng th6i tam thu cO'nanghay th\1c thS. TiSng th6i tam thu cO'nang thuang nho, ng~n va khong tho rap, m~tdi khi v~n dQng ho~c thay d6i tu [email protected]@ngthu nh~t va thu hai phan doi xay ra anguai tre tu6i (hay xuc dQng),khong m~c b~nh tim m~ch la sinh ly.S6 102: B~nh khap.- B~nh khap nhi@mkhu~n: Day la truang hqp viem khap sau 1 b~nh nhi@mkhu~nnhu lien c~u khu~n va khong sinh mu. VS lam sang co viem ro r~t mQt vai khapvua va nho nhu: g6i, c6 chan, ngon chan, khu)ru tay, ngon tay ... thuang viem khongd6i xUng, khong di chuySn, khong gay teo cO'nhiSu va khong co biSu hi~n tim kerntheo.- HQi chUng Reiter: La mQt lo~i viem khap phan Ung xu~t hi~n sau khi b~nh nhanbi mQthQi chUng ly,ho~c bi di long. D~c diSm cua b~nh la ngoai tri~u chUng viemkhap con co cac tri~u chUng viem k@tm~c va viem ni~u d~o. Tuy cac tri~u chUngco am~t va ni~u d~o co thS chi amuc dQnh~ va thoang qua.S6 158: Thi@umau n~ng thuang xuyendo cac nguyen nhan.- H6ng c~u 2.500.000/mm3

, huy@ts~c t6 <80g/1 x@plo~i 6.- H6ng c~u 2.500.000 - 3.000.000/mm3 mau, huy@ts~c t6 ill 80 - 100g/1x@plo~i 5.

7. Kham da li~u:

S6 159: N~m da.ThS diSn hinh: NSn da hO'ido, co viSn ba ro, nSn khong cQm, chua bi bi@nchUngcham hoa (do nhiSu, ngua nhiSu va cQm day) ho~c nhi@mkhu~n (sung t~y, comu, xu~t ti@t).S6 160: N~m mongoMong bi sui mau vang d\lc, 16ch6, mun mong, t6n thuang di ill ba t\1do vao trong.S6 167: B~nh da b<;mgnuac.a) B~nh Duhring Brocq: Tung dQ1:n6i m\ln nuac cang thanh c\lm, co tri~u chUngngua bao truac khi t6n thuang, khong co t6n thuang niem m~c, suc khoe toimthan 6n dinh.b) B~nh Pemphigus: N6i nhUng b<;mgnuac nheo, d@va, khi va dS l~i trQ1:rQngdau nit, kern t6n thuO'ng niem m~c, toan than suy S\lPd~n, tien lUQ1lgde d~t.

46

4 ; &&mLia .a;u

86 168: B~nh t6 chuc lien kSt.B~nh Lupus ban do:- Th~ khu tm: ThuOng n6i a m~t thanh dam do, ranh gi6i ro, co yay simg g~nch~t, xen ke SttO,teo da (hinh canh bu6m).- Th~ h~ th6ng: TiSn tri~n n~ng dftn, kern theo t6n thuang nQi t~ng, tien luqng ded~t.86 169: B~nh da co yay.B~nh yay nSn:Bi~u hi~n b~ng cac dam do, cQm, co yay tr~ng nhu xa ell', d8 bong, co khi thanhchclm, giQt, d6ng tiSn ho~c thanh mang m~n tinh. D6i v6i th~ do da bong yaytoan than, viem da kh6p yay nSn m\ln mu co th~ dfin t6i tan phS, tu vong.86 171: T~t belm sinh cua da, g6m nhfrng lo~i nhu:- Bat s~c t6 (vSt den, mau nau, xanh la).- Bat s~c t6 co lOng.- U gian m~ch.-Uxa thftn kinh.86 173: B~nh lay theo dUOngtinh d\lc.Giang mai: Chia cac giai do~n:- Giang mail: Chi co vSt trQi:nong trim ho~c bftu d\lc, ranh gi6i ro, nSn cQmcling nhu d~m bia kern theo h~ch bttn, khong viem, xet nghi~m tr\1'ctiSp tim T.P(Treponema pallidum) duang tinh (+).- Giang mai II: Bi~u hi~n thanh dao ban, selnhQt, sftn sui mang niem m~c viem,h~ch rai rac. Xet nghi~m huySt thanh, phan ling TPHA duang tinh. Xet nghi~mtf\l'c tiSp TP duang tinh m~nh.- Giang mai III: Bi~u hi~n b~ng gom, cu, mang, b~ch san co khi kern theo t6n th-uang phu t~ng ho~c thftn kinh.- Giang mai bc1m sinh mUQn, viem giac m~c kho, tran do, mfii tttt, dingHutchinson ho~c co t6n thuang nhu trong giai do~n III.86 174: Day simg long ban chan ca dja.Co cac dam to nho a vung ti de cua ca 2 gan ban chan. T6n thuang phat tri~nnhiSu gay cQm, dau khi di l~i. DiSu trj rcit kho khan (khong khoi). B~nh co ySut6 gia dinh.

8. Kham ngo~i khoa:

86 84: TrI.- Cach kham: Kham tung nguai mQt a nai du anh sang, nguai dugc kham ch6ngmong, t\1'banh rQng h~u mon va r~n m~nh.- Phan lo~i: Lclyduang lugc cua h~u mon lam chuc1n(ca th~t h~u mon):+NSu bui trTa trong ca th~t la tfTnQi.

47

II

+ NSu blii trI a ngoai ca th~t 1atrI ngo~i.+NSu blii trI a duemg 1uQ'c1atrI h6n hQ'P.- Tri~u chung: ia ra mau tuai (co thS ra tung giQt sau khi d~i ti~n chui m6i th~ymau tuai):+ TrI loi ra ngoai t\1'co duQ'chay khong t\1'co duQ'c(phai d~y len).+ Blii trI 106tram mau.+Da co t~c tinh m~ch trl.- each ghi vi tri blii trI:Vi d1,1:TrI nl)i 5 gia 0,8 cm; trI ngo~i 7 gia 0,5 cm (phia xuang cung 1a6 gia, d6idi~n 1a 12 gia).S6 150: Gian tInh m~ch thirng tinh (Varicoce1).- Dung vS phuang di~n giai ph~u, gian tinh m~ch thirng tinh thuemg a vS bentrai. NSu sa th~y to han ben phai chlit it thi chua gQi 1ab~nh 1y.- Nhy: So' th~y tinh m~ch to, th~ng, chua qu~n vao nhau thanh blii.- N~ng: So' th~y tinh m~ch to, qu~n vao nhau thanh blii nhU blii giun va thuemglam sa biu. Khi kham khong c~n cho ch~y rna kham 1licbinh thuemg.S6 103: Ban chan byt.Binh thuemg ban chan in tren nSn g~ch, d~u chan bi khuySt a vung vom banchan. Ban chan byt d~u in khong th~y khuySt it a vung vom.

9. Kham san ph\l khoa:

- Phong kham phai kin dao, nghiem tlic.- Khi kham ph1,1khoa c6 g~ng b6 tri can bl) chuyen mon 1ailll. D6i v6i nu thanhnien, mang trinh chua rach thi chi kham n~n b1,1ng,khong kham rna vit, khongtham am d~o, chi kham qua h~u mon nhUng tfUemghQ'Pc~n thiSt. D6i v6i nguaimang trinh da rach Cll, khi co nghi nga b~nh ph1,1khoa thi kham b~ng d1,1ngC1,1qua am d~o dS xac dinh chftn doan.- NSu khong co can bl) chuyen khoa ph1,1san thi chi dinh bac sy ngo~i khoa thaythS, nhung phai co nhan vien nu tham d\1'.Khong su d1,1ngy sy dS kham, phan10~ib~nh t~t.- KSt qua kham san ph1,1khoa duQ'cghi vao ph~n kham ngo~i khoa, da 1i@u.

48

Phu luc 2BINH Mire VAT TUTIEU HAO VA KINH PHI eHO HOAT BONG KIEMTRA sire KHOE, KHAM sire KHOE THve HI~N NGHIA VV QUAN sV

(Ban hanh kern thea Thong tu lien tich s6 16/2016/TTLT-BYT-BQPngay 30 thang 6 nam 2016 cua BQ truOng BQY t~ - BQtruong BQQu6c phong

Quy dinh vi~c Kham suc kh6e thvc hi~n nghla V\l quan sv)

I. Binh muc mot s8 vat tu tieu hao. ..1. Binh muc v~t tu tieu hao cho ho~t d{)ngki~m tra, SO' tuy~n suc khoe/IOOngum

TT Ten v~t ttl' Boonvi tinh Binh mac Ghi chu

1 C6n 70 dQ ml 300-500••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• H ••••• _ ••••••••••••••••• __ •••••••••••••••••••••• _ •••••• ,. ••••••• _ ••

2 Bong hut gam 200.............. ,.,.,.,. .

3 Gang tay caa su (ng~n) d6i 05......................... ,., , .

4 Pin den 1,5 V doi 03................................................................................................................................................... ,......... .. .

5 Xa phong gi~t gam 300............................................................................................................................................ - , ~ .

6 Xa phong thorn nia tay banh 01............................................................................................................................................... ,. _ .

7 Khan m~t lau tay chi~c 03................................................................... ,. ,. , .

8 Gidy tr~ng A4 t~p 0,25,. .

9 But bi chi~c 05......................................................................................................................................................................................................................................................................................................................................... _ _ .

10 Chdt d6t Thea thvc dung............................. , .

11 V~t tu khac (nSu co) Thea thvc dung

2. Binh muc v~t tu tieu hao cho ho~t dQng kham suc khoe/IOO ngum

TT Ten v~t ttl' Boonvi tinh Binh mac Ghi chu

1 C6n 70 dQ ml 1000.................................................... _ - .

2 Bong hut gam 1000............................................................................................................................................................................................................................................................................................................................................................................................................................. - _ .

3 Gang tay caa su (ng~n) doi 20.......................................................................................................................................................................................................................................................................................... _ - .

4 Pin den 1,5 V doi 05...................................................................................................................................................................................................................................................................................................................................................................................................................................................................

5 Xa phong gi~t gam 500..................................... , ,. _ , .

6 Xa phong thorn 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 Chdt d6t Thea thvc dung......... .. _. .. _..... .. _.................... . ~.... . ~~ .

11 Boa chdt, v~t tu xet nghi~m Thea thvc dung....... ,., ~ ~~................................................................ ...,........... . _...... . - , _ ..

12 V~t tu khac (n~u co) Thea thvc dung

1

3. Ghi v~t to' tieu haoBugc tinh theo m~t b&nggia clla dja phuong t~i thai diSm do.

II. Dinh muc kinh phi

1. Kinh phi b6i duang cho mQt ngay lam vi~c Clla m6i thanh vien trongdoan kham suc khoe ho~c t6 kiSm tra suc khoe (g6m: kham suc khoe, t~p hu&n,sa kSt, t6ng kSt v.v ...):

a) Bugc tinh b&ngmQt ngay cong tac phi trong tinh Clla can bQ cong nhanvien chuc theo quy djnh hi~n hanh CllaNha nuac;

b) Rieng thanh vien HQi d6ng kham suc khoe nghia V\l quan SlJ,ngoai tieuchu~n nhu thanh vien doan kham suc khoe noi tren con dugc b6i duang themkhoan ti@nb&ng ph\l c&p trlJc 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\lp X-quang va lam cac xet nghi~m c~n thiSt khac.

3. Kinh phi chi cho v~n chuySn d\lng C\l, phuong ti~n ph\lc V\l cho doankham suc khoe.

2

Ph1} 11}c 3DANH Ml)C TRANG BI, Dl)NG Cl) Y TE TOI THIEU CVAH<)I DONG KHAM SUC KHOE NGHiA Vl) QUAN sTf

(Ban himh kern theo Thong tu lien tich s6 16/2016/TTLT-BYT-BQPngay 30 thang 6 narn 2016 cua B9 tru6ng B9 Y t~ - B9 tru6ng B9 Qu6c phong

Quy dinh vi~c Kharn suc kh6e th\lc hi~n nghla V\l quan S\l)

TT Ten trang hi, dl}ng cl}Don vi salU'Qllgtinh

1 Can co thuac do chiSu cao ' . 01Cal

2 Thuac day,.

01Cal

3 Ong nghe hai tai cai 03

4 HuySt ap kS ' . 03Cal

5 Nhi~t kS nach ' . 02Cal

6 Bua phim x~ ' . 01Cal,

7 Den soi day mat cai 01

8 HQP kinh thu thj hJc bQ 01

9 Bang kiSm tra thj IlJc ' . 01Cal

10 Bang thj IlJc mim cai 01

11 BQ kham rang ham m~t bQ 01

12 BQ kham tai mlii h<,mg bQ 01

13 BQ d\lng C\l, ban kham ph\l khoa (nSu co nil) bQ 01

14 N6i IUQckhu trung d\lng C\ly tS ' . 01Cal

15 Ttl s~y d\lng C\l ' . 01Cal

16 Ttl dlJng h6 sa suc kh6e cai 01

17 Ban ghS t~i cac phong kham (1 ban + 2 ghS) bQ 05

18 Giuemg kham b~nh ' . 04Cal

19 GhS cha kham t~i m6i phong kham ' . 03Cal

20 Ttl thu6c co dtl thu6c c~p cUu ' . 01CalTAng cQng: 20 (hai muO'i) khmin.

1

Phy. ly.e 4eAe MAu PHIEU sue KHOE

(Ban hanh kem thea Thong tu lien tjch s8 16/2016/TTLT-BYT-BQPngay 30 thang 6 nam 2016 cua Bi) truong Bi} Yd-Bi} truong Bi} Qu8c phimg

Quy tljnh vi?c Kham suc khoe th1lc hi?n ngh'ia v~ quan S1l)

M~u 1. PhiSu kiSm tra sue khoe nghia v\l quan s\f

M~u 2. PhiSu sue khoe nghia V\l quan S\f

Huang d~n ghi ehep m~u phiSu kiSm tra sue khoe nghia v\l quan S\fva m~uphiSu sue khoe nghia V\l quan S\f.

1

M~u 1. Phi~u ki~m tra SIfe khoe nghia vl}. quan Sl}.'

Huy~n .XA .

CONG HOA xA HOI CHU NGHiA VIET NAM. . .Dt)c l~p - T1}' do - H~nh phuc

Nam sinh:

Sinh ngay:

Nam sinh:

Phi~u ki~m tra suc khoe nghia v\l quan S1}'

I. SO' y~u ly lich

HQva ten:

HQva ten b6:

HQva ten m~:

Nguyen qmln:

Tru qmln:

Gifry chung minh nhfm dan s6:

Da ph\lc V\ltl;lingii til (thcing/nam) d~n (thcing/nam)

II. K~t qua ki~m tra suc khoe:Cao: cm; N?ng: kg; Yang ng\fc trung binh: cm.

MI;lCh: lftn/phut; Huy~t ap: mmHg.

B~nh nQikhoa: .

B~nh ngol;likhoa: .

B~nh chuyen khoa (m~t, T-M-H, R-H-M): .

Ti~n su b~nh t~t:

Gia dinh: .

Ban than: .

Phan IOl;lisuc khoe sa bQ: .

N' h' vgay.. .. tang .....nam...

Ta trU'O'ngta ki~m tra suc khoe

2

Miu 2. Phi~u suc khoe nghia vl} quan sl}'

Huy~n .Xa .

Anh 4 x 6em

CQNG HOA xA HQI CHU NGHiA VI~T NAMDQc 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, Nil: .

N he;" h'" t ' kh' h" - G':" CMND :..g ng H;P mac 1n ~p ngu:.................................... laY so: .

HQva ten b6: Nam sinh: Ngh€ nghi~p: .

HQva ten m~: Nam sinh: Ngh€ nghi~p: .

Nguyen qulin: .

Tru qulin: .

Ti€n su b~nh:

Gia dinh: .Ban than: .

Tai xin cam doan khai dung ly lich va ti€n su b~nh cua taL

Xae nh~n Iy lieheua dia phuong

Xae nh~n ti~n sif b~nheua y t~ coosO'

Ngay thimg. nam .Ngum khai ky ten

II. Kham suc khoe:

Cao : ./ cm; N~ng: ./ kg; Yang ng\Ic TB: ./ cm.

Huy~t lip: ./ mmHg; M~ch: ./. .IfrnJphut.

Thi l\Ic: - Kh6ng kfnh: M~t phai: ./ ; M~t trai: ./ .

- C6 kfnh:

Thinh l\Ic: - N6i thuimg:

- N6i tham:

M~t phai: ./ ;

Tai phai: ./ m;

Tai phiii: ./ m;

,Mat trai: ./......... .. .

Tai trai ./ m.

Tai trlii ./.......... m.

3

K~t qua kham tuy~n t~i dia phuong K~t qua kham phuc tra t~i don vi

Chi tieu Y,BS kham Y,BSkhamDi~m Lydo Di~m Lydo

(ky, hQ ten) (ky, hQ ten)

Th~ hJc

M~t

Tai miii hQng

Ranghamm~t

NQi khoa

Tam th~n kinh

Ngoi;likhoa

Da li~u

KQ xet nghi~m(n€u co)

K€t lu~

N ' h ' ~ N ' h' ~gay. ......... t ang. ...... nam ............. gay. .......... t ang. .......... nam ...............Chil tjch HQidAng KSK ~VQS huy~n Chil tjch HQi dAng kham ~huc tra SK

(IcY ten, dong ddu) (IcY ten, dong ddu)

4

HUONG DAN GHI CHEP

1. Phi~u ki~m tra suc khoe Dghia V\l qUaD Sl}':

- PhiSu duQ'c in tren gi~y tr~ng kh6 A4 dUng, phong chfr 13.

- PhiSu g6m 02 phAn:

+ PhAn 1 g6m sa ySu ly lich.

+ PhAn 2 la kSt qua kiSm tra, sa tuySn suc khoe, do y tS xa tiSn hanh.

- KSt qua kham co ghi tri trong yang 6 (sau) thang kS tu ngay kiSm tra, satuySn suc khoe.

2. Phi~u suc khoe Dghia V\l qUaD Sl}':

- Mfiu phiSu suc khoe nghIa V\l quan S\f duQ'c in tren gi~y tr~ng kh6 A4,phong chfr 13.

- PhiSu g6m 02 trang:

+ Trang 1 in theo chiSu dUng cua to' gi~y A4, g6m: sa ySu ly lich, tiSn sub~nh t~t; kSt qua kham chiSu cao, can n~ng, yang ng\fc trung binh, m~ch, huyStap, thi l\fc, thinh l\fc. Rieng phAn kSt qua kham, t~i m6i chi tieu duQ'c chia lam 2phAn cach nhau b~ng net s6 (I), phAn ben trai net s6 do HQi d6ng kham sue khoenghIa V\l quan S\f huy~n ghi, phAn ben phai net s6 do HQi d6ng kham phuc trasuc khoe cua dan vi nh~n quan ghi.

+ Trang 2 in theo chiSu ngang cua to' gi~y A4: la phAn kham cac chuyenkhoa va kSt qua xet nghi~m (nSu co), duQ'c chia lam 2 phAn rieng cach nhau 1TIQtv~ch dQc kep, phAn ben trai cho HQi d6ng kham suc khoe nghIa V\l quan S\fhuy~n va phAn ben phai cho HQi d6ng kham phuc tra suc khoe cua dan vi nh~nquan.

Khi kham cac chuyen khoa, sau khi cho diSm, yeu cAu cac y, bac sIkham ky va ghi ra hQ ten.

- KSt qua kham co gia tri trong yang 6 (sau) thang kS tu ngay kham (ngayky, dong d~u kSt lu~n cua Chu tich HQi d6ng kham suc khoe).

5

Phn Inc 5. .cAc LO~I MAu BAo cAo vA MAu s6 THONG KE

(Ban hanh kern theo Thong tu lien tich s6 16/2016/TTLT-BYT-BQPngay 30 thang 6 nam 2016 cua B9 tru6ng B9 Y t€ - B9 tru6ng B9 Qu6c phong

Quy dinh vi~c Kh<irnsuc kh6e thlJc hi~n nghla V\l quan slJ)

M~u la. Bao cao kiSm tra suc khoe nghia V\l quan S1)'(Ta kiSm tra suc khoe).M~u lb. Bao cao kiSm tra suc khoe nghia V\l quan S1)'(Phong Y tS huy~n).M~u 2. Bao cao kSt qua sa tuySn suc khoe nghia V\l quan S1)'.M~u 3a. Bao cao kSt qua kham suc khoe nghia V\l quan S1)'(HQi d6ng Kham suckhoe nghia V\l quan s1)').M~u 3b. Bao cao kSt qua kham suc khoe nghia V\l quan S1)'(Phong Y tS huy~n).M~u 3c. Bao cao kSt qua kham suc khoe nghia V\l quan S1)'(So' Y tS tinh).M~u 4a. Bao cao tinh hinh giao nh~n chiSn sl m6i (Phong Y tS huy~n).M~u 4b. Bao cao tinh hinh giao nh~ chiSn sl mm (Ban chi huy quan S1)'huy~n).M~u 4c. Bao cao tinh hinh giao nh~n chiSn sl m6i (Dan vi nh~n quan).M~u 4d. Bao cao kSt qua suc khoe chiSn sl m6i sau kham phuc tra va giam satHIV, ma tuy (Dan vi nh~n quan).M~u 5a. sa th6ng kS kiSm tra suc khoe nghia V\l quan S1)'(tuySn xa).M~u 5b. sa th6ng kS kham sa tuySn suc khoe nghia V\l quan S1)'(tuySn xa).M~u 5c. S6 th6ng kS kham suc khoe nghia V\l quan S1)'(tuySn huy~n).

I

Miu la. Bao cao k~t qua ki~m tra suc khoe nghia vI}. quan sl}'

Huy~n .Xft .

CQNG HOA xA HQI CHU NGHiA VI~T NAMDQc l~p - Tlf do - H~nh phuc

s6: / ..........(Dia danh), ngay thang nam

Bao cao k~t qua ki~m tra suc khoe nghia vI}. quan sl}'

DQ1 nam .

TT NQidung K~t qua Ghi chu

1

2

3

s6 luQ'Ilge~n kiSm tra theo kS ho?eh........... _ _ _- __ .

s6 luQ'IlgdffkiSm tra••••••••••• M ••••••••••••• __ •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• __ ••••••••

Phan lo?i sue khoe

Lo?! 1

Lo?i 2

Lo?i 3

Lo?i 4

Lo?i 5

Lo?i 6

T8 trtro-ngT8 ki~m tra suc khoe

(Ky ten)

NO'i nhljn:- HQi d6ng NVQS xiI;- Phong Y tS hlly~n;- Trung tam Y tS hlly~n;- Lull .....

2

. !

Mau 1b. Bao cao k~t qua ki~m tra suc khoe nghia vy. quan sl}'

UBND huy~n .Phong y t~

CQNG HOA xA HQI CHU NGHiA VI~T NAMDQc I~p - TV do - H~nh phuc

86: / .............( Dia danh), ngay thang nam

Bao cao k~t qua ki~m tra suc khoe nghia vy:quan s,!

DQi nam .


1 86 IUQ'ng c~n ki@m tra theo kS hO(;l.ch............................................................................................................................................................................................................................................................................................................................................................................... - _-_ .

2 86 IUQ'ng dil ki@m tra............................................................................................................................................................................................................................................................................................................................................................................................................................................... _._ .

3 Phan IO(;l.isue khoe

LO(;l.i 1

LO(;l.14...... _ _ .

LO(;l.i5

LO(;l.i6

TruOng phong(Ky ten va dong ddu)

Nui nh~n:- HQi d6ng NVQS huy~n;- Ban CHQS huy~n;- SaY t~;- Luu .....

3

M~u 2. Bao cao k~t qua SO'tuy~n suc khoe nghia Vl}.quan sl}'

Huy~n .Xi .

CQNG HOA xA HQI CHU NGHiA VItT NAMDQc l~p - T\f do - H~nh phuc

s6: / ..........(fJja danh), ngay thang nam

Bao cao k~t qua SO'tuy~n sue khoe nghia vy. quan sl}'

Nam .

TT NQi dung K~t qua Ghi chu

1 s6 luqng phai sa tuySn sue khoetheo kS ho~ch

s6 luqng dfi sa tuySn2

3.................................. ,.•..•....•.............•. _ - ,._._- " .

s6 luqng du diSu ki~n kham t~ituySn huy~n

......................................................................................................... - .

4 T6ng s6 dfi lo~i ra•••••••••••••••••••••••••••••••• _ •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• N ••••••••••••••••••••••••••••• _ •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• _ ••••••••••••••••••••••••

Trong do................................................................................................................................. - .

- s6 luqng dS nghi miSn hImNVQS

...- .

- Ly do khac....................................................................................... _- _ .

T8 trmyngT8 sO' tuy~n suc khoe

(Ky ten)

NO'i nhq.n:- HQi d6ng NVQS xii;- PhOng Y t~ huy~n;- Trung tam Y t~ huy~n;- Luu .....

4

Miu 3a. Bao cao k~t qua kham suc khoe nghia vI} quan Sl!

Huy~n .HQid6ng KSK NVQS

CONG HOA xA HOI CHU NGHiA VIET NAM. . .DQc l~p - TV do - H~nh phuc

S6: / ............. (Dja danh), ngay thang nam

Bao cao k~tqua kham suc khoe nghia vI} quan Sl!

Nam .

TT NQidung K~t qua Gh. chu

1 S6 lUQ11gkham theo kS ho~ch•••••••••••••••••••••••••••••• •••••••••••••••••••••••••••••••••••••••• •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• • •••••••••••••••••••••••• w ••••••••••••••••••••••• __ ••••••••••••••••• _ •• ~ ••••••••••••••• _ •••••••••••••••••• __ •• _ ••••••••

2 S61uQ11gdfi kham.._._ . _ _. __ M._ .. _ ..............•.......

3 Phan lO~l suc khoe

Lo~i 1

Lo~i 2......•_-- . _ .

Lo~i 4

Lo~i 6

Chu tjch HQi d6ng kham suc khoe(Ky ten va dong ddu)

Nui nh~n:- H9i d6ng NVQS huy~n;- Phong Y t€ huy~n;- So' Y t€;- Luu.....

5

Mfiu 3b. Bao cao k~t qua kham suc khoe nghia vl} quan Slf

CQNG HOA xA HQI CHU NGHiA VI:E:TNAMD(}c l,p - TIf do - H~nhphtic


86: /.............. (Dia dan h), ngay thang nam

Bao cao k~tqua kham suc khoe nghia vl} quan Sl!

Nam .


1 86 luQTIg khaffi theo k@ho~eh..................................................................................................................... . .

2 86 luQTIg da khaffi....................................................................................................................................................................... _ .

3 Phan lo~i sue khoe

Lo~i 1

Lo~i 2

Lo~i 3

LO~l 4

LO~l 5

Lo~i 6

Trmyng phong(Ky ten va dong ddu)

Nu; nhlin:- H9i de;ng NVQS hlly~n;- Ban CHQS hlly~n;- So' Y tS;- Lull .....

6

r

M~u 3c. Bao cao k~t qua kham suc khoe nghia vI} quan SI}'

UBND tinh .S6' y t~

CQNG HOA xA HQI CHU NGHiA VI~:TNAMDQc l~p - Tt,r do - H~nh phuc

S6: / .............. (Dia danh), ngay thcmg nam

Bao cao k~t qua kham suc khoe nghia vI} quan SI}'

Nam .

TT NQI dung K~t qua Ghi chu

1 S6 lUQ11gkham theo kS ho~eh••••• __ •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• _ •• _........ •••••••••• • •••••••••••• , •••••••••• _ •••••••• ., •• n •••••••• n ••••••••

2 S61uQ11gda kham•......~ _ .., _ .

3 Phan lO~l sue khoe

LOl;li 1

LO~12

LO~l 3

LO~l 5

Giam oBc(Ky ten va dong ddu)

Not nhljn:- UBND tinh;- B9 Y t€;- Luu.....

I

7

M~u 4a. Bao cao tiob blob giao ob~o cbi~o si m6'i


CQNG HOA xA HQI CHU NGHiA VI~T NAMDQc l~p - T., do - H~oh phuc

s6: / .............( Dia danh), ngay thang nam

Bao cao tlob blob giao nb~n cbi~o si mooNam .

1 TA J." d" .. oog so cong an glao:Sue khoe lo~i 1:Sue khoe lo~i 2:Sue khoe lo~i 3:

2 TA J." d" , ".".'". oog so cong an van quan uQI :Sue khoe lo~i 1:Sue khoe lo~i 2:Sue khoe lo~i 3:

3 TA J." d" t" I . d ' kh". oog so coog an ra ~I 0 suc oe:

Nguyen nhlin tra [{Ii:

Lo~i b~nb

Th~n kinh - tam th~n............................................................................................................................................................................................................................

Ngo~i khoa.........................................................................

NQi khoa..................................................................................................

Da liSuM~t

sa nguO'i

Tai - mfii - h<;mg....................................................... _ ~ .

Rang - ham - m~t....................... - - .

ThSI\Ie

TruOng phimg(Ky ten va dong ddu)

Nui nhan:- HQi d6~g NVQS huy~n;- So' Y t~;-Luu .....

8

M~u 4b. Bao eao tinh hinh giao nh~n ehi~n si mm

B(>CHQS tinh .Ban CHQS huy~n .

CONG HOA xA HOI CHU NGHiA VIET NAM. . .DQc l~p - TI}' do - H~.mhphuc

S6: / ............. (Dia danh), ngay thimg nam

Bao eao tinh tinh hinh giao nh~n ehi~n si mmNam .

1 TA A" d" .. ong so eong an gmo:Sue khoe lo~i 1:Sue khoe lo~i 2:Sue khoe lo~i 3:

2 TA A" d" , "d'". ong so eong an vao quan QI:Sue khoe lo~i 1:Sue khoe lo~i 2:Sue khoe lo~i 3:

3. TBng sa eong dan tnt l~i do sue khoe:

Nguyen nhan Ira [{Ii:

Lo~i b~nh sa nguO'i

Th~n kinh - tam th~n................................................................................................................................................................................................................... - - _ _ .

NgO~lkhoa•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• ••••• ••••••••••••••••••••••••••••••••••••••••••• ••••••••• • •••••••••••••••••••••• _ ••••••••••••••• ~ ••••••••••••••••••••••••••••••••••••••••••••• H ••• H ••••••••••••••••••••••••••••••••••••••••••• __ •••••••••••••••• ._ •••••••••••

NQl khoa................................................... __ - _- " _ " _ .

Da heuM~tTat - mUl - h<;mg

................................................................................................................................................................................................................................................................................................................................................................................................................. _ _.-Rang - ham - m~t

............................................................................................................................................................................................................................................................................................................................................................................................................... _ _._.Th~ h,re

Chi huy trU'Ong(Ky fen dong ddu)

Nui nhljn:- B9 CHQS tinh;- Luu .....

9

Mfiu 4c. Bao cao tinh hinh giao nhin chi~n si mm

(Don vi c~p tren tf\rc tiSp) .

(DO'nvi bao cao) .

C(>NG HOA xA HQI CHiT NGHiA VlE:T NAMDQc lip - Tl}' do - H~nh phuc

S6: / . (Dta danh), ngay thcmg nam

Bao cao tinh hinh giao nhin chi~n si mmNam .

A ).A. Tuyen chQn qua ho sO' SK

1 T6ng s6 h6 sa SK giao

- Sue kh6e lo:;ti 1

- Sue kh6e lo:;ti2

- Sue kh6e lo:;ti3

- Sue kh6e lo:;ti4

- Sue kh6e lo:;ti5-6

Dia phuO'ng giao quan TA "ong cQng

sf> Ti WTSIUQl1g h6 sa

•••••••••••••••••••••••••••••••••••• _ ••••••• " •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• _ ••••••••••••• _ •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• _ ••••••••••••••••••••••• _ ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• H •••••••

2. s6 h6 sa SK phai tra It;li

- Do thu t\le phap ly- Do sue kh6e

................................................................................... __ . _ _ - . _- ............................••.......

B. Giao nh,n chi~n si mOl

1 Phat hi?n b?nh t(it phai tra If;li............................... _........ . - ...•••.....•.•..•..... ..•.....•..•.....•.•..••••..... .. _ .

2. T6ng s6 nh(in v€ dan vi+ Sue kh6e lo:;ti 1

+ Sue kh6e lo:;ti2

+ Sue kh6e lo:;ti3

10

CI} th~ cae b~nh phai tra l~i

Dia phaO'D g gia0 quanTen b~nh CQng GhichU

•••••••••••••••••••••••••••• H ..................................... ...................................................... ..._- ........................ .................................... .................................... .................................... •••••••• H ..................... ............ .................... .............. _- ........... ..._- ............. .,... ... .m •••••••••••••••••••••••••••••••••••••••••••••••• ..........- .......... - ..............

............................................................. .......... .................................................. .....- ........................ .................................... ................................... .................................... ......- ..................... .................................... ................................... ........................ - ...... ..................................... - ........... ............ ........ ........ _ ........

............................................... ............................... ........................................ ....................... - .... .................................... ............... ................... .................................... ................................... .................................... ................................. .................................... ................................... ............... ........................ _--_ ........

........... .................................. ................... .................................................... .................................... .............................. ..... .................................... .................................... .................................... .................................... ...... ............ ............ - .................. ............. ................................ .................. ......................... _ .................

.................................................................. _ ... .................•... .......................... ................................... ._ ...- ........................ .................................... .................................... .................. ... ....... ..... .•..............•...••.••...•...... ................ ................ ...................................................... ......... ....................................

............ ,., .... ,' ,............................................................ - .................. ................ ................................... .................................... ........................ ,.......... .................................... ..................... ........... .................................... .................................... .................................... ...................................................... ......... ..._ .._ ............. _ ..................

...................................................... _ ... ................................. .......................... ..... ................ ... ..... .................................... ................................... .................................... .................... ............. .......... ..... ............... ................. .................................... ...................................................... ................... ......... _ ....... ...........................

............ ,., ............................................ ....... .................................................... ............................. ................. ............... .................... ......".... ........ ,........................... ................................... .................................... ......... ...................... .......................... ...... ................ .................................. ......... __ ...- ........._ ..........

Nh~n xet

Nui nh~n:- Nhu tren;................ ,

- Luu .....

N ' h' vgay tang nam .Chti nhiem quan y(Ky,d6~g d6u)

11

Mftu 4d. Bao cao suc khoe chi~n si moo sau kham phuc tra va giam sat HIV, rna tuy

(Dan vi c~p tren tr\fc tiSp) .(DO'nvi bao cao) .

CONG HOA xA HOI CHU NGHiA VIET NAM. . .DQc l~p - TV do - H~nh phuc

86: / .............. (Dja danh), ngay

Bao cao suc khoe chi~n si moosau kham phuc tra va giam sat HIV, rna tuy

Nam .

thang nam

Dia phU'O'Dg TA "ong cQng

s6 IUQ'ng Ti l~

!~~?!~9:~J~~_~f..~~ .- Sue kh6e lo~i 1

................................................. __ , - .

- Sue kh6e lo~i 2.......... __ _ _ .

- Sue kh6e lo~i 3

2. K~t qua kham phuc tra SK

y.~..~~~g!9.~!!!:.Y'.~~~.~y. . .~)~~q'!~'.!:'!.~~'!!~~~~f!..... ................................mm. ......._ ..

.~.~~~~?~!?~~1... ........................._ ..........................mm. ..

+ Sue .~~~ !?~~?_. _ .~~~~~?~}<?~~}..... .......................................................................-.

b) sa khong au sue khoe

!!.?~g~?4?.:. -......................................................................................................................................................................................................................................................................................................................................................................................................................................

........:1= !h~}¥em.................................................................................................. ~

..................::~2~~?~ _ .+ Tam thful kinh...................................... .. _ _...... .. - .. - _.. ..••.••...... _ .

...:1= ..~g<?'t!..~?~_+ Da li€u+M~t

.mm.:1=!~~.!??:.~~h9~g . _ .....:1=~~g~~!??:JP.:~~__mm.. .................................._.......mm......... . mm.._..

+ HIV duong tinh

............:1=M~.~~Y4.:t.!~K!~!l:h . _....... . .3. Cood~~i~~~~~~~~~..~~ ..mm..... ........................• ................................• ................................................•

~)~~'.!:g'!:i!~!.!!4.~~f.'.!:~'.!:p.J.- B~nh tim m~eh

12

- B~nh h6 ~~P.m_ mm __ mm.. mm .. _ _ ...=~~1?:?!~~~ ~.~.~ mm mm.. _ _ _ _._ ......_ .- B~nh nQi khoa khae

........... _ ~ , - . ., _. "-" _._ •.......•.•... _- .

b) ~~I!JI~i!f~4c bfn.h ngo{l( mm._ ....._ mm.mm._.__ .

..=g~_~uOT1.~...mm........ __ . mm._ _=!?!n..!~1?:?~~~~.~~~~..... mm. .................................mm..__ __..- Dan ..!~~ m~eh thimg ti~ _ __- Chan b~t, ehai ~~.~~................................................................. __ ................................_mm. __. ......___ .

....=~~1?:?~~~.................................._ __.. ..................................._ _ __ . ..........._ .c) sa_l1gwi(i miic bfnh ngoai d.~.. ................................H..mm._ ___._ ......______ _.

- Ghe

- N~mda........................................................................................................................................................................................................................................................................................................................................................................ - - _ .,...•..•.. - ~ .

- B~nh khae......................................... - .

..t!)~~_'!-c.~i!!.~4~~?'!:~~:~:!i _ __ __ _.__ _._._::}3~1?:?_.y~.!ai...................................................................... _ _ . _ _ ................................._...._ ..._ ..=~~1?:?y.~_I?~i.................................... .__ _. . . m.__ _...

_:: ~~1?:?y.th9ng..............................................................._........_ . __ . _ _ _ .___ m_if) sa nc.,!i1imiic.bfnh v~'!!4~. __ m _ mm._ ............_._.___ __.e) sa nguiJi miic bfnh vi riing

Nh~n xet

Nui nh~n:- Nhu tren;

................ ,- Lull .....

Chti nhi~m quan y(Ky, dong d6u)

13

Mfiu Sa. sA thBng ke ki~m tra suc khoe nghia v.•••quan sl}'(eho tuy~n xli)

a) Bia:Huy~n: .

Xii .

sa thBng keki~m tra sue khoe nghia vl} quan s1!

Beit adu ngay ./ ./ K~t thue ngay ./ ./ .

b) N(>idung ghi ehep:

86 Th6ng kS kiSm tra sue khoe nghla V\l quan S\f

A AQuyen so: .

Th~ hrc Phan loai suc khoeTT HQ va ten Ngay Dia chi Cao Can Yang Tinh tr~ng suc khoe

sinh n~g nglJCTB va b~nh t~t Ll L2 L3 L4 L5 L6(cm) (kg) (cm)

Ghi ehu:- Th6ng ke kham sue khoe NVQS sau m6i ngay c(mg d6n cae c(jt phdn !o(;lisuc khoe;- Sau m6i ar;rtco t6ng kit vi?c phdn !ogi suc khoe.

t • " • 14

M~u Sb. sA th8ng ke kham SO' tuy~n sue khoe nghia vt}.quan s\f (eho tuyin xii)

a) Bia:Huy~n: .

Xii .

sA th8ng kekham sO' tuy~n sue khoe nghia V1}.quan sl}'

Bbi ddu ngay ./ / Kit thue ngay ./ ./ .

b) N{ji dung ghi ehep:sf> Th6ng kS kiSm tra sue kh6e nghla V\l quan S\f

Q A :..uyen so: .

1

Th~ lue K~t luan

TT HQ va ten Ngay Dia ehi Cao Can Yang Tinh tr~ng sue khoe Dudik SK Kh6ng du DK kham t~i huy~nsinh (cm) ni;ing ng\fc TB va b~nh t~t kham ~i ThuQCdi~n mi~n Lydo

(kg) (cm) huy~n hlmNVQS khac

Ghi cluJ.:- Th6ng ke kham sue kh6e NVQS sau m6i ngay e(mg dim eae e{jtphan IO(lisue kh6e;- Sau m6i a(1t eo t6ng kit vi?e phan IO(lisue kh6e.

•• It' Q i l J15

Mfiu 5c. sa thang ke kham suc khoe nghia vt] quan S\f (eho tuyin huy?n)

a) Bia:Tinh: .

Huy~n .

sa thflng kekham sue khoe nghia vI}.quan sl}'

Bat ildu ngay .! .! Kit thue ngay .! .

b) N(Jidung ghi ehep:

S6 Th6ng kS kiSm tra sue khoe nghla V\l quan SlJ

Quy~n sa: .

Th~ luc Phan lo~i suc khoeTT Hq va ten Ngay Bfa chi Cao Can Yang Tinh tr~ng suc khoe

sinh (cm) n~g ng\Ic TB va b~nh t~t Ll L2 L3 L4 L5 L6(kg) (cm)

Ghi ehu:- Th6ng ke kham sue kh6e NVQS sau mJi ngay c(mg dfm cac c()tphan loqi suc kh6e;- Sau mJi aclt co tang kit vi?c phan loqi suc kh6e va ca cdu b?nh t(it cong dan suc kh6e loqi 4, 5 va 6.

16• ') J ••

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