139 (AA() DVC VA DAO 7'iN0 TRU 6NG DiN1 119C THANG LONG Khoa Dieu DtriTrng THANG LONG Lt HOANG 'Fill TUYkt MAI Ma sinh len: 130008 TAM LY CAC OH MIN DIEU TRI 110 SINH BANG PHUUNG PHAP THU TINH THONG ONG NGHIEM TAI BENH VIEN PHU SAN TRUNG UUNG DE TAI TOT N( HIFP DAI HOC He dao tao vita hoc N ira lam Giang vien Inr(ing dan: I lis Ho Sy lung HA NOI-2012 WI CAM ON! fle hoan chivy luan van nay, toi xin bay to long biet an chan va sau sac MI - Ban giam hieu ba mon dieu clueing, cac phong ban tryOng dai hoc Thi Long, Hang ziy, ban Giam dac, cac khoa phong benh Wen Phu san Trung trang, da tao dieu kien cho toi diro.c hoc tap va hoan luan van - GS TS Pham Thi Minh Dar, trzrang ba mon dieu chrang trwOrng Dal hoc Thang Long, nguoi thay da 1,6 nhieu cong say ciao tao, luthng dan, tan tinh day boo, tao 1110i dieu kien thuan lyi cho toi dray hoc tap va hoan luan van - Thac sj," Ha S9 fThng, giang vien trzferng Dai hoc Y Ha Nal, nguoi thay del gizip da, truc tiep huang cian, clang vien toi suet qua trinh nghien ctiu va hoan luan van - Toi xin bay to Mng biet an sau sac toi qu.} they co ba mon dieu &rang truorg Dai hoc Thang Long, da tao dieu kien thuan lyi cho toi &roc hoc tap suet thol gian qua - Toi xin bay to long biet an sau sac ten tap the bac sr, can ba, nhan vien Trung tam try sinh san Benh Wen Phu san Trung wcrng, del tao dieu kien giap der raj rat nhieu qua trinh !lac tap va hoan !win van - Cuai cUng, tc; r khong the Ice het long biet an sau sac ten Cha Mc, Chang, Con va nhting nguOi than gia dinh va cac ban lop KCT2 del luan ben toi, Bang vien gizip c1a toi viral qua nhang kilo khan tren du-Ong hoc tap Toi xin tran cam an! Ha Alai, 23 thong 02 nom 2012 Hoang Thi Tuy6I Mai DANH MVC cifti CAI VIET TAT Viet tit mot ngit y hgc duvc vie't tit IUI Intrauterine Insemination IVF in vitro fertilization WHO World Health Organization TTTON Thu tinh 6ng nghi'm VBVBMTSS Wen bao vg ba mg tre so, sinh se; TT MI,JC LI,JC DAT VAN DE Chuang 1: TONG QUAN TAI LIEU 1.1 Dinh nghia, tS, le va nguyen nhan vo sinh 1.1.1 Dinh nghia vo sinh 1.1.2 Tinh hinh va nguyen nhan vo sinh 1.2 Dieu tri vo sinh bang thu tinh nhan tao va thu tinh 6ng nghiem 1.2.1 Phucrng phap bum tinh vao bung tir cung 1.2.2 Thu tinh 6ng nghiem 1.2.3 Cac bien cluing cua thu tinh 6ng nghiem 1.3.Yeu t6 tam V, anh huomg den ket qua c6 thai 1.4 Khia canh tam V, lam sang Chtrcmg 2: DOI TIJQNG VA PHU'ONG PHAP NGHIEN CfrU 2.1 Doi Wang nghien ciru 9 2.1.1 Tieu chuAn lua churl 2.1.2 Tieu chuAn loai trir 2.1.3 CO' mAu nghien ciru 2.2 Phucmg Oar) nghien ciru: nghien ciru tien ciru, mo to 10 2.3 Phan tich s6 lieu 11 2.4 VAn de dao dirc nghien ciru 11 Chuang 3: KET QUA NGHIEN CO 3.1 D4c diem benh nhan tham gia nghien ciru 3.1.1 Tu6i benh nhan 12 12 12 3.2 Nghe nghiep d6i Wang nghien ciru 13 3.2.1 Dia chi d6i Wang nghien ciru 14 3.2.2 Loai vo sinh 15 3.2.3 Nguyen nhan vo sinh 16 3.2.4 Cac phucmg phap da dieu tri 17 3.3 Tam V, cua cac benh nhan Bang dieu tri vo sinh bang phuang phap thu tinh 18 6ng nghiem 19 3.4 Cac yeu t6 anh htr(Mg den tam V, benh nhan 3.4.1 Tu6i benh nhan anh htromg tam V/ benh nhan 19 3.4.2 Loai vo sinh anh huemg tam ly benh nhan 20 3.4.3 Tam ly cua benh nhan lien quan den cac phuung phap da" dieu tri 21 3.4.4 Th&i gian vo sinh va tam ly benh nhan 22 3.4.5 Lien quan ket qua c6 thai va tam ly benh nhan 22 Chuang 4: BAN LUAN 23 4.1 Thiet ke b6 cau hoi 23 4.2 D4c diem benh nhan nghien dru 24 4.2.1.Tu6i benh nhan tham gia nghien ciru 24 4.2.2 Dia chi va nghe nghiep benh nhan nghien cfru 24 4.2.3 Loai v6 sinh va nguyen nhan vo sinh 25 4.2.4 Cac phucmg phap dA dieu tri tien sir 25 4.3 Mc diem tam ly cac benh nhan dang dieu tri v6 sinh bang thy tinh 6ng 25 nghiem 4.4 Cac yeu t6 anh hiring den tam ly benh nhan 26 4.4.1 Tu6i anh htrerng den tam ly benh nhan 26 4.4.2 Loai vo sinh 27 4.4.3 Cac ping:mg phap da dieu tri anh huemg den tam ly berth nhan 27 4.4.4 Theri gian v6 sinh va tam ly benh nhan 27 4.4.5.Lien quan IC& qua c6 thai va tam ly benh nhan 28 Chuang 5: KET LUAN 29 5.1 D'a'c diem benh nhan vo sinh dieu tri bang phtrung phap thy tinh 6ng Error! Bookmark not defined nghiem 5.2 Tam ly cac benh nhan dieu tri vo sinh bang phucmg phap thy tinh 6ng 29 nghiem 5.3 Cac yeu t6 anh huemg den tam ly benh nhan dieu tri vo sinh bang phucmg 29 phap thy tinh 6ng nghiem KIEN NG1-11 TAI LIEU TRAM KHAO 30 DANH MVC CAC BANG Bang Tu6i benh nhan tham gia nghien ciru Bang Nguyen nhan vo sinh 16 Bang Cac phuang phap da diau tri 17 Bang Kat qua bang diem danh gia tam 1y cua benh nhan 18 Bang Lien quan tu6i va tam ly benh nhan 19 Bang Lien quan loci vo sinh den tam 1Y benh nhan 20 Bang Lien quan cac phwmg phap diau tri va tam 1y benh nhan 21 Bang Lien quan thei gian vo sinh va tam 1y benh nhan 22 Bang Lien quan kat qua có thai va tam 1y benh nhan 22 DANH MI,JC BIEU DO Bleu Nghe nghiep 6i tugng nghien cun 13 Bieu Dia chi do' i tugng nghien art' 14 Bieu Loai v8 sinh 15 DAT VAN BE Vo sinh la mot vAn de dm xa h8i va cac gia Binh, la ganh Ong kh8ng chi ve chi phi ma IA ganh Ong ve tam ly cho cac cap vo chOng Bang chimg cho thAy ty le cong ctia cac phucrng phap dieu tri vo sinh ky thuat cao cling chi dAt 30 den 40% Mat khac, m51 phucrng phap dieu tri co chi phi va hieu qua khac DOi vo i phuang phap barn tinh trung vao bung tir cung, chi phi thAp nhung hieu qua toi da ding chi dAt 15-16 % Vori phtrung phap thy tinh 6ng nghiem, hieu qua cao gAp den lAn nhtmg chi phi co the tang horn gAp den 10 !An CO rAt nhieu yeu to anh htremg den ket qua dm mOt chu ky dieu tri vo sinh Nh&ng anh htrang tam ly cua benh nhan dang dtrgc dieu tri cling la mot nhang yeu to Hien tai, co rAt it cac nghien dru ve linh vyc Yeu to tam ly cua benh nhan vAn chua dugc quan tam den nhieu vi cac thAy thuOc mai chi quan tam den vAn de dieu tri la chinh GAn day, mot so trung tam ho trg sinh san tren the gieri da de cap den yeu to tam ly viec cong cira cac phtrung phap dieu tri vo sinh Do vay, khu vtrc dieu tri cua nhfrng trung tam 1u8n co cac khu vtic giai tri kern theo nhu vuem hoa, nai nghe nhac, xem phim va thu gian, tharn chi co ca mat xa hoac vat ly tri lieu XuAt phat tir thyc tin chung toi titt hanh nghien ci.ru de tai "Nghien ccuu phtrowg phap thu tinh ang tarn IS, cac benh nhlin ctiu tri vo tzghiem" v6ri ba myc tieu sau: MI,JC TIEU NGHIEN CUU Danh gia tinh trang tam IS, dm cac bfnh nhan dieu tri vti sinh bing phuromg Oat) thu tinh tong nghifm Mc Binh cac yeu to anh htrerng den tinh trang tam 1j , cfia cac bfnh A nhan dieu tri A sinh bang phtrcrng phi') thu tinh ong nghifm Chuang TONG QUAN TAI LIEU sinh 1.1 Dinh nghia, is le va nguyen nhan 1.1.1 Dinh nghia vfi sink Theo WHO, vo sinh la tinh trang c5p vo chOng 'thong c6 thai sau mot nam chung song ma khong dung mOt bien phap tranh thai nao [2] Doi vai nhang trithng hop ma nguyen nhan v8 sinh d5 tuang dOi CO rang thi viec tinh thoi gian khong dugc d5t Vi du: ngtrai phu nit bi vo kinh, nguOi dan 6ng bi liet thi dugc xem la vo sinh ngay; hoc vo i cac c5p vo chOng ma vg tren 35 tuOi, sau thang mong muOn c6 ma khong co thai cling da dugc coi la vo sinh, can dugc kham va dieu tri son Vo sinh nguyen phat (vo sinh I) la chua c6 thai lan nao, vo sinh thu Oat (vo sinh II) la tien sir d5 tong c6 thai it nhAt 1&'n V6 sinh nam la vo sinh co nguyen nhan hoan toan nguai chOng, vo sinh nil la nguyen nhan hoan toan nguai vg Vo sinh khong rO nguyen nhan la tnrang hap khan' va lam cac xet nghiem tham ma kh8ng phat hien dugc nguyen nhan nao c6 the giai thich dugc 1)', v8 sinh 1.1.2 Tinh hinh v71 nguyin nhan vo sinh Teen the giai t-S, le vo sinh thay dOi tir 10-18%, tong nuoc, co not len tai 40% [2] Tai Phap vo sinh chiem khoang 1/6 cac c5p vg chOng, a my nam 1999 tS, lenay15%[3] Ve nguyen nhan v8 sinh, theo WHO (1985), 80% larO nguyen nhan (trong vo sinh nil chiem 40%, v8 sinh nam 40% va ca hai la 20%), khoang 20% la 4.2.3 Loai vo sinh va nguyen nhan tiv, sinh si6u d6 cho thAy 51,7% benh nhan vo sinh nguyen phat, 48,3% benh nhan vo sinh thin phat, tS, le cling khac vOi so voi mot so nghien ciru khac cling vi dac ditm tat ca dau la benh nhan thy tinh 6ng nghiem can cac nghien ciru khac nghien dm berth nhan ditu tri bang phtrcmg phap IUI Cling lining tir tren, bang cho thAy nguyen nhan vo sinh ngubi vci chitin 55%, khong ro nguyen nhan chitm 17,8%, chemg chitm 14,8% va khong ro nguyen nhan la 12,8% ; 4.2.4 Cac phtrong phap da di eu tri lien su Bang cho thAy co tai 88% benh nhan da timg dugs ditu tri hoac bang phtrcrng phap bum tinh vao bung tir cung hoac bang phircrng phap thu tinh 6ng nghiem Chi c6 12 % cac tn.r?mg hop chtra timg dieu tri gi PhAn lan cac berth nhan bi tic voi tir cung nen phai chi dinh lam "I ION Ytu t6 da timg ditu tri tin sir cling g6p phan lam tam ly benh nhan cang thing hon vi mot mat ban than benh nhan da ditu tri thCri gian lau, mat khac ho cling da tong bi thAt bai nhitu lAn nen de nan chi .A 4.3 Bac diem tam IS, cac bent) titian clang (lieu tri sip sinh bing thy tinh ong nghiOn Bang cho thAy ditm trung binh cua cac berth nhan ditu tri vo sinh la 27,21 ± 6,2 ditm, nhu vay nam tong thing ditty' tir 21 dtn 29 ditm va xtp vao mirc di) tam 1/ hui lo lang theo danh gia cua chimg toi Phan tich ky chimg toi thAy c8 12% s6 benh nhan c6 tong ditm tit 12-20 ditm xep vao mire d8 khong lo lang, 54% ski benh nhan c6 s6 ditm tir 21 — 29 ditm xtp vao mire hui lo ling, 32,7% se) berth 25 nhan co s6 diem tir 30 — 38 diem xep vao mire dq tucrng c1 6i to ling va 1,4% so benh nhan c6 s6 diem tir 39-48 diem xep vao mirc (10 rat to Fang Tom lai se) cac benh nhan dieu tri vo sinh nghien ciru thi c6 teri 88% cac benh nhan co tam ly to lang du it hay nhieu dO co 34,1% cac truimg hop to lang nhieu (bao gam twang dal va rat lo tang) Wichman va ceng str cling sir dung be.) cau hOi dm Beck de nghien ciru tam 1y cac cap vo ch6ng chuAn bi lam thu tinh 6ng nghiem thi thAy ngtr•;:ri vo c6 tam ly Ong thing Ilan ngtthi ch'Ong [11] Trong nghien ciru oh chimg toi khong tap trung nghien ciru vao ngueri ching vi ly qua trinh dieu tri ngtr6i chikig it den benh vien nen kho ph6ng van horn Hy \tong nghien ciru sau chimg Col co the tien hanh ph6ng van clucfc ea ngtthi ch6ng de tir dO co nhang khuyen nghi hop ly nhtr ngtthi vo can co str chic se tir phia ngtrai chemg 4.4 Cac yeu to anh htriimg den t a m h 1)01l) Whin 4.4.1 Tuiii anh haying diti tam 11' 1)171th 'than Bang cho thAydiem trung binh cua cac nhom tuOi cluai 29 tu6i la 24,70 ± 4,5 diem, nhom 30-34 tue)i la 28,49 ± 6,9 diem va nhom tren 35 tue)i la 27,9 ± 5,2 diem Khi so sanh diem trung binh gicra cac nh6m tu6i chUng Col thy co str khac biet ro ret giira nhom benh nhan duai 29 tulii vii hai nhOm 30-34 tu6i va nh6m tren 35 Weil vc7i p < 0,05 Dieu chimg t6 benh nhan cang kin tu6i cang to lang hon, tam lY cang thing ham Dieu cling de hieu vi Ito ton tue)i thi theyi gian vo sinh cling lau hon, dieu tri cang nhieu hon nen nhieu stress hon 26 4.4.2 Logi vo sinh Bang cho thay diem trung binh cua nhOm benh nhan vo sinh nguyen Oat la 27,62 + 4,5 diem so v6i 26,90 ± 5,7 diem dm nhom vo sinh did Oat, sir khac biet khong coy nghia thOng ke yeti p • 0,05 4.4.3 Ctic ph:tong pluip da diem tri rink huyi'ng din tam 11" benh nhan Bang cho thy diem trung binh cua nh6m benh nhan chua ducrc dieu tri gI 23,94 + 4,7 diem, ni'un da dieu tri IUI la 27,32 ± 5,6 diem va nhom da dieu tri TTTON la 29,00 ± 7,9 diem Va so sanh cac gia tri trung binh chfing toi thAy co sty khac biet coy nghia thOng ke giira nhom chua dieu tri gi v6i hai nhOm da dieu tri bang IUI hay bang TTTON Dieu ding tucrng to nhu ve de) tuOi cua benh nhan vi IT* cac benh nhan di dieu tri bang cac phircmg phap khac bi thAt bai rOi bay giO chuyen sang lam TTTON chic chan ho se cang thong va lo rang hon Ket qua cua chang toi ding tucrng ta ket qua nghien dru cua Vahratian va cong sir vao nam 2011 [10] 4.4.4 Theri gian vo sinh vd tam ly benh nhan Theo ket qua bang diem trung binh nhOm vo sinh du6i nam la 25,47 ± 5,7 diem va cua nhom tren nam la 28,41 ± 6,1 diem Su khac Net ding c6 , nghia thong ke vOi p < 0,05 NIur vay th6i gian vo sinh cling anh huong tai tam 15, cua benh nhan cua benh nhan lam thu tinh 6ng nghiem Theo Boivin va cong ski thi cac benh nhan lam thu tinh 6ng nghiem thu6ng rat de bi Stress va c6 toi 30% cac cap vor chOng bo dieu tri son vi 15 ganh nang tam 15 , [12] 27 4.4.5.Lien quan klit qua có thai viz tam ly benh nhan Bang cho thAy nhOm berth nhan có thai diem trung binh la 25,31 ± 5,8 thap horn so vai 29,24 ± 5,7 diem cua nhom benh nhan kh8ng có thai Nhis vay có the yeu to tam lY ding anh hutrng den ket qua có thai cCia benh nhan Mac clit dieu kilo 1/ giai nhung ngutri to thay có rat nhieu tn.itmg hop có thai mot each ttr nhien sau mot ky nghi, du lich hay mot s6 cap vg ch6ng sau mot theYi gian dieu tri khong ket qua, di xin nu8i ve 14i có thai tir nhien duoc, hay nhu ban than trung tam Ht; try sinh san benh vin Phu san Trung trcrng có mot so benh nhan Ian dau phai lam thu tinh 't;ng nghiem nhung ran sau lai co thai ttr nhien chrgc MOt nghien dru phong van cac phu nu ding rat nhiL nguOi tin ttrang yeti tam lY anh twang rat nhieu den lcha nang có thai cua ho [10] 28 to Chtrang KET LUAN 5.1 Tam 1Y cac benh [than diet' tri yO sinh hang ! ► mong phap Ulu tinh (rung Ong nghiem — 12% so Nnh nhan diL tri khong lo ling gi —54% so Nnh nhan to hai lo ling —32,7% so Nnh nhan tucmg dui to Fang —Va 1,4% so Nnh nhan rat lo ling 5.2 Cac yeu hiriimg den tam 15, bent) ntuin diet' tri yO sinh bang phirceng phap thu tinh Ong nghiem — Do tu6i co anh Wang den tam ly Nnh nhan —Thai gian vo sinh có anh lurang den tam 15, ciia Nnh nhan — Da timg dieu tri IUI hoac IVF có anh den tam 15/ ciia Nnh nhan — Cac Nnh nhan co thai it lo ling hurl cac Nnh nhan dieu tri khosng có thai 29 MEN NGH! Nghi'en cau yen ca mAu lem ham, phan tich chi tiet hon mix dO lo ling dm - benh nhan - Dao tao dOi ngti nhan vien y to co trinh dO tu yin tot d tu van cho benh nhan dieu tri vo sinh, giup ho bat cang thing hon de CO ket qua dieu tri tot - Benh vien can co khu vui choi giai tri cho benh nhan thu gian 30 TAI LIEU THAM KHAO Tai Lieu Tham MIA° Tieng Viet Benh vie') Phu san Tir Dii (1999), Hiem muan- Vo sinh va kj ," thudt ho try sinh san, Soy Y Te Thanh pile Ho Chi Minh, Thanh pile He Chi Minh Nguyen Thi Duvc (2002), "Met se nhAn xet ye nguyen nhan vo sinh tren nhang benh nhan den kham tai phong kham san Tnrerng Dai hoc Y Thai Binh tiff 6/1999 den 6/2001", Ni san San Phu Khoa nam 2002, tr.101-2 Nguyen Van Hue, "Danh gia ket qua kich thich phong noan bang Clomiphen Citrat dieu tri vo sinh", Luan van thac si- 2000, tr 46-47 Nguyen Klfic Lieu (1999), "Dai cucmg ye vo sinh", Bai giang san phu khoa, Be mon Phu san, Truerng Dai hoc Y Ha Nei, Nha xuat ban Y hoc, Ha Nei, tr.311-6 Trin Thi Ph‘romg Mai, Nguyen Thi Nguc Phurgng, Nguyen Song Nguyen, HO Mani' Ttrirng, Vircrng Thi Nguc Lan, Tai ban Ian thd nhAt (2007) "Hiem muon- ye sinh va ky- thot ho trq sinh san", Nha xuAt ban y hoc Nguyen Dim Manh, Nghien cfru tinh hinh tac voi trang tren 1000 benh nhan vo sinh tai Wen BVSKBMVTSS, Ulan van thac si Y hoc (1998), trang 37- 48 Pham Nhv Thao (2004), Tim hieu mat so ddc diem, yeu to lien quan va nhiing bin phap dieu tri vo sinh tai Benh vien Phu san Trung trang nein] 2003, Luan van thac sy Y khoa, Tn.rerng Dai hoc Y Ha Nei Vin Bio ve Bi mg va Tre so sinh (2003), Chan doan va dieu tri va sinh, Nha xuAt ban Y hoc Ha Nei Nguyen Thi Xiem, Nguyen Khic Lieu (1978), NO/ tiet phu khoa thyv hanh Tai Li0 Tham Khao Tieng Anh 10 Boivin 1, Takefman JE (1995) Stress level across stages of in-vitro fertilization in subsequently pregnant and non-pregnant women Fertil Steril 1995 ;64:802-10 11 Lord S , Robertson N (2005) The role of patient appraisal and coping in predicting distress in I VF J Reprod Infant Psycho! 20 05;23:319 -32 12 Vahratian A, Smith YR, Dorman M, Flynn HA (2011) Longitudinal depressive symptoms and state anxiety among women using assisted reproductive technology Fertil Steril 2011 Mar 1;95(3):1192-4 Epub 2010 Nov 13 Wichman CL, Ehlers SL, Wichman SE, Weaver AL, Coddington C (2011) Comparison of multiple psychological distress measures between men and women preparing for in vitro fertilization Fertil Steril 2011 Feb;95(2):717-21 Epub 2010 Nov 10 So tht'r Ngay phong vein: / BO chu hal nghien cult tam benh nhon v6 sinh /2011 PHIEU NGHIEN CtrU TAM Li? Ho \fa NHAN ten: Dia chi: Nghe nghiep- Dien thoai• u Thir phat Nguyen phat Loai vo sinh: Cu the PARA: 0000 Nguyen nhan vo sinh: u Do vg u Do Chang u Khong ro nguyen nhan u Do ca vg chOng nam So nam vo sinh nam Thefi gian dieu tri• Da- tirng dieu tri: u IUI ( Ket qua có thai: u Co thai Dang dieu tri: u IUI ( chu Icy) chu Icy) u Chua dieu tri u Khong có thai u IVF u Chua dieu tri SO nang SO nang• (14-18mm) Thulic sir u Clomiphen Citrat (CC) Lieu - So - Lieu So ngay• u FSH Lieu S6 ngay• FSH+LH Lieu SO ngay• ch.mg nay: CC + FSH K.& qua CO thai: u CO thai SO diem the4rac nghirn: iv diem - Khong có thai SO thin Ur Ngay phong van Mir u nghien ciru tam 1j, bC:nh When vo sinh Thang tkr danh gia tare di) to au — State Trait nxiety Inventory Ten Huang dAn: Dtreti day la 12 Cali hoi -Cau di:cc &mg' de ma to thai tam lY cue bgn.Xin bgn hay doc kj7 titng adz', sau khoanh tron vao mat so thich hop (tit di.n 4) bieu thj thai tinh cam sclia bgn veto hic nay.Khong c6 cau tra 161 dung hoc sai.Khang sir dung qua nhieu thai gian de suy nghT ve mat cau hoi.flay tra lei bang chinh nhiing y nghi den 6c minh dciu tien STT Tali cam thiy binh tinh Toi dang cang tiring Toi cam thy met mei va to au Toi cam thay bin tire Toi dang lo ling ve nh&ng bit hanh riti ro A Toi cam thy dexchin thoiti mai Toi cam they tkr tin Tel cam tick, phan van, khong the quyet djnh ducic Toi cam thay them man Toi cam thay tu bi nhim lan,len xen Toi cam thay viing tam Toi cam thay vui mirng Mirc dO Trang thai Vic cam,tinh cam 10 11 12 Tong se diem Hwang dim tinh 39-48 diem: Rat to au 30-38 diem: Tucmg del to au 21-29 diem: Hai lo au 12-20 diem: Khong lo au Killing c6 1 1 NW chat 2 2 Turing diii 3 3 fat nhieu 4 4 4 3 2 1 4 2 4 3 2 1 DANH SACH BENH NHAN NGHIEN COU Stt Ho ten Dia Chi Tu6i S6 HS Nguyen Thi Kim A 31 Hai Phong 1291/11 Nguyen Thi L 35 Ha NOi 1094/11 Nguyen Thi Minh H 33 Phti Tho 1581/11 Doan Thi Hong H 35 Ha NOi Thang Nguyen Thi B 28 Hai Ducrng 8191/11 Le thi B 37 Ha NOi 547/10 Nguyen Thi H 30 Ha NOi 1155/10 Nguyen thi Thu H 32 Ha NOi 1429/10 Tran 1e Kh 34 HA NO 686/11 10 Nguyen thi ThuS, D 24 HA NO 965/11 11 DO Thu Tr 31 Ha NO 1258/09 12 D6 Thi L 28 Quang Ninh 154/08 13 Nguyen Thi D 23 HA NO 659/11 14 Nguyen Thi H 35 HA NOi 774/08 15 Nguyen Thi Thu H 31 Hai Phong 769/09 16 Dao thi L 38 Vinh Phdc 1209/11 17 Doan HOng H 30 HA NOi 365/11 18 Nguyen Thi D 29 Quang Ninh 1637/10 19 Pham Thi H 42 Ha NOi 1109/08 20 Nguyen Thi N L 29 Quang Ninh 968/09 21 DO Thi L 36 Ha Giang 1217/11 22 Nguyen Thi T 33 Bac Ninh 569/09 23 Dinh Thi H 31 With Phtic 678/11 24 Hoang Thi H 31 Ha NOi 807/09 25 DO Wing H 29 Vinh Finic 109/11 26 Bin Thi Thu H 32 HA NOi 1040/11 27 DO Thi Th 32 HA Nam 2321/11 28 Nguyen ngoc L 37 HA NOi 986/09 29 Pilling Thi V 28 HA NOi 1265/11 30 Bui Thi Thug Ng 39 Ha NOi 598/09 31 Nguyen Thi Thanh H 28 HA NOi 467/09 32 Nguyen Thi Oa 33 Thai Binh 376/11 33 Kim Thi Thanh G 28 Vinh Pink 1063/11 34 Nguyen Thi Ph 29 HA NO 1236/11 35 Nguyen Thi M 27 HA NOi 685/09 36 Dinh 'Thi L 27 Thai Binh 1211/11 37 Nguyen Thi A 29 Bac Ninh 04/11 38 Mai Thi V 27 Thai Binh 991/11 39 Biti Thi H 31 Hai Ducmg 506/11 40 Vii Thi Th 34 HA NOi 1014/11 41 Hoang Thi Hong T 37 Lao Cai, 155/11 42 Dang Thi Ph 31 HA NOi 256/11 43 Nguyen Thi H 32 HA NO 872/11 44 Vitcmg Ngoc L 28 Ha NO 658/11 45 Tang Thi Ng 38 Hai Duong 689/09 46 Nguyen Thi A 34 Yen Bai 335/11 47 Nguyen Thi D 34 Scm La 230/11 48 Nguyen Thi Thu Ng 34 HA NOi 950/11 49 Nguyen Thi D 32 13ac Giang 51/08 50 NO Thi Ph 34 Ha NO 988/11 51 Nguyen Thi D 32 HA NOi 1002/11 52 Nguy6n Thi Thu H 33 HA NO 1023/11 53 Nguyen Thi M 43 Vinh Phtic 156/11 54 Nguy6n QuSmh Tr 26 HA NO 1630/10 55 NO Thi Thanh Th 41 HA NO 1359/09 56 Vii Thi M 38 HA NOi 269/09 57 Vii Thi Th 27 HA NOi 1205/11 58 Ltrong Thi S 44 Nam Dinh 112/08 59 Trail Thi Thanh H 28 HA NOi 664/09 60 Bui Minh H 36 Hai Duang 571/10 61 Doan Thi Y 27 Hai Phong 1478/11 62 Vii Thi Ph 33 Bac Giang 781/10 62 Iran Phtrong Th 30 HA NO 354/11 63 Nguyen Thi Ch 28 Bac Ninh 488/10 64 Hoang Thi Thu Tr 27 Phti Tho 1251/11 65 Nguyen Phtrong A 37 HA NOi 952/09 66 Nguyen Thi H 28 Thanh Hoa 659/11 67 Nguyen Thi Thu H 36 HA NOi 72/09 68 Le Thi H 40 HA NOi 1070/11 69 Pham Thi L 40 HA NOi 1301/11 70 Pham Thi M 30 Hung Yen 947/11 71 Nguyen Thi C 32 Phu Tho 535/11 72 La Thi L 33 HA NOi 900/11 73 Nguyen Thi H 28 HA NO 852/10 74 Vii Thi Y 33 Quang Ninh 33/07 75 Nguyen Thi Th 39 Ha NOi 311/11 76 [Yang Thi H 23 HA NOi 1372/11 77 Dang Thanh H 31 HA NO 987/09 78 Trail thi thu$, H 33 HA NOi 1313/10 79 Trail Le K 34 Ninh Binh 686/11 80 Nguyen Thi B 30 HA NO 1150/11 81 Doan Thanh H 35 Ha NOi 1065/11 82 Trail Thi Lan H 35 HA NO 987/11 83 Hoang Thi M 31 Ninh Binh 231/09 84 Tran pinion T 32 HA NOi 234/09 85 Nguyen Thi C 39 Ric Ninh 489/10 86 Hoang Thi Thu T 37 Phil Tho 1251/11 87 Nguyen Phtrang T 35 Ila NOi 1524/11 88 Nguyen Lam H 28 Thanh Hod 1352/11 89 Nguyen T H 36 HA NOi 895/11 99 Nguyen T M 36 Quin Ninh 879/11 100 Ld Thi T 29 HA NO 897/11 101 Van Thi H 33 HA NOi 1055/10 102 Trait thi T 30 HA NO 130/11 103 Nguyen Thi T 32 Ha NO 1139/11 104 Nguyen Thi M 36 HA NO 929/07 105 Trait Phircmg A 28 Ha NOi 858/11 106 Dinh Thi N 36 Phti Tho 569/11 107 DO Thi H 31 Hai Ducmg 1059/11 108 Nguyen thi B N 32 Ha NO 503/10 109 Nguyen Thi Ng 33 Ha NOi 66/10 110 Nguyen Thi H 27 Nam Dinh 1195/11 111 NO Thi Kim D 42 Quang Ninh 169/10 112 Nguyen Thi Van A 32 HA NO 767/2011 113 Chu Wing Nh 26 Ha NOi 906/11 114 Pham Thi T H 36 Ninh Binh 119/09 115 Tran 'Thi T 36 Yen BM 1037/11 116 Nguyen Thi H 39 Ha Tinh 1022/08 117 Nguyen Thi H 32 HAI Dtrcmg 949/11 118 Nguyen Thi T N 37 Hai Ducrng 875/11 119 Dinh Lan P 37 Nam Dinh 1178/11 120 Dao Hong Ng 29 HA NOi 994/07 121 Vii Thi M 27 Ha NO 139/09 122 Nguyen Thi L 31 Ha NO 876/11 123 Ha Thi H 25 Ha NOi 1128/11 124 throng Hoai T 37 Tuyen Quang 248/07 125 Nguyen Thi T6 Y 31 Ninh Binh 617/11 126 Lii Thi T 33 Lao Cai 911/I I 127 Vii Thi Anh D 31 Ha NO 370/11 128 NgO Thi S • 26 Bac Ninh 1413/11 129 Pham Thi C 38 Hai Dtrung 1438/11 130 Lai Thi T 32 Nam Dinh 04/10 131 Nguyen Thi Van C 30 Ha NOi 1264/11 132 Mai Thi T 35 Ha NOi 599/08 133 Tran Thi Tuya M 38 HA NOi 801/11 134 Le Thi H 30 Lao Cai 531/10 135 Dinh Thi M 25 HA NOi 1027/11 136 Ta Hoang A 38 Ha NOi 176/07 137 Nguyen Thi H 45 Ha NOi 156/09 138 Nguyen Thi Th 27 Ninh Blush 303/08 139 Nguyen Thi H 30 Ha NOi 1363/11 140 Biii Thi H 36 Ha NO 1181/11 141 Nguyen Thi H 29 Hung Yen 1252/11 143 Nguyen Thi T 23 Ninh Binh 1410/10 144 Vii Thi N 28 Ninh Binh 1850/10 145 Le Thi T 30 Ha NOi 520/08 146 Nguyen Thi T 29 Ha NOi 1067/11 147 Trinh Hoang Y 33 Ha NOi 787/11 148 Ha Thi Thanh N 33 VIM Phtic 1015/11 149 VII Thi N 36 Ha NOi 1072/10 150 Dinh Thi Bich H 37 Ha NOi 803/10 Xac nhin cua phong KHTH vien Phu sin Tti NA 05c o SiNH VIEN -, Pill1 SAN MING lla 'lk, s _ T.S 24._ ' :Mzi-Oity/