1. Thm 50 l mu ton phn hay 25 l dch lng hng cu, lc nh. 2. !ho"ng 10 ph#t $ nh%&t '( ph)ng.

. o Quy trnh xt nghim. *h+ng ,- d.ng cc /0 1 2a3d c4 d5u h%&u !h+, c4 67t !h8 hay t5m !%m lo9% 6 h:. 1. nh d5u /0 1 2a3d 6;ng tn hay ,< c=a 6&nh nh>n, 64c 6? t5m nh+m 3a !h?% @ <ng 'u t%n. 2. Thm 10 l dch pha loAng tB 6o hng cu 5C. @. Dy t>m /0 1 2a3d t3ong 10 ph#t. E. 7c F 6o co !Bt Gu". *h% Hc 'nh nh4m mu thIc h%&n !J thuKt LMl t3:Nc FO n4 m5t thP% g%an hQn, t3ong l#c ly t>m LMl 2a3d ta dRng !J thuKt ant%. Sau '4 F+ ,T !Bt Gu" dRng ant%, chP LMl 2a3d !% m t3a l9% !Bt Gu". Uh"% lu+n !% m t3a tn t3n <ng mu F LMl 2a3d ' t3nh ,I nhm lVn.

2.1.1. TM,t nhanh W/X, WY,Zg, X0[D

Ya H\t ngh%&m th:Png ':]c thIc h%&n '<% FN% tha% ph.. ^uay ly t>m <ng mu_ 24 th cho mu ton phn Fo tM,t nh:ng ' d` '7c !Bt Gu" nn ta dRng huyBt thanha. X%Bt tn 6&nh nh>n ln tM,t. W#t 50 l huyBt thanh cho Fo tM,t _ *% m t3a tn 6&nh nh>n t3n <ng mu F t3n tM,ta.

Thb tI cho huyBt thanh Fo tM,t X0[D c W/X c W6,Zg. ]% !ho"ng 101 15 ph#t F '7c !Bt Gu". *Bt Gu" ph"% ':]c F+ ,T F tM,t ':]c !% m t3a md% ngy.

2.1.2. Uht mu
ThIc h%&n chbng ngh%&m phR h]p _ T3ong m+% t3:Png n:Nc mu<% F m+% t3:Png ant%glo6ul%na. 1. Thu<c th-e 0ung dch fa2l 0,gC huyBt thanh Znt%glo6ul%n, huyhn dch hng cu 21 EC c=a 6&nh nh>n F t#% mu, my Guay l% t>m. 2. iVu th-e 2ml mu !hng '+ng j0TZ. @. *J thuKte T%Bn hnh t3n @ phne Uhn ch8nh _ia, phn ph. _ma F phn tI chbng c=a cha% mu F 6&nh nh>n. Uha huyhn dch hng cu 21 EC c=a mu 6&nh nh>n F cha% mu. T3n @ <ng ngh%&m ':]c !8 h%&u i, m, Tc 3% t%Bn hnh nh: ,aue o L%a% 'o9n m+% t3:Png mu<%e

Y&nh nh>n WuyBt

Uhn ch8nh i 2 g%7t

Uhn ph. m

TI chbng Tc 2 g%7t

2ha% mu

t:Qng Wng cu Wng cu WuyBt t:Qng

1 g%7t 1 g%7t 2 g%7t

1 g%7t

Dc 'hu, Guay ly t>m 1000 F)ng t3ong 1 ph#t. 7c !Bt Gu" nBu !h+ng ng:ng !Bt thO Gua g%a% 'o9n ,au. o L%a% 'o9n m+% t3:Png ant%glo6ul%n. [-a Wng cu cc <ng i, m, Tc @ ln FN% dung dch fa2l 0,gC 3% nh? Fo cc <ng ngh%&m 1 g%7t huyBt thanh. Znt%glo6ul%n Guay ly t>m 1000 F)ng t3ong 1 ph#t, '7c !Bt Gu". 7c !Bt Gu"e 1. Y5t !O g%a% 'o9n no m ph"n bng d:Qng t8nh _ ng:ng !Bt hokc tan mua $ phn ch8nh _ia thO t#% mu !h+ng t3uyhn cho 6&nh nh>n. 2. fBu $ phn ph. _ma H"y 3a ph"n bng d:Qng t8nh nh:ng phn ch8nh _ia ph"n bng >m t8nh thO t#% mu '4 c4 th t3uyhn cho 6&nh nh>n nh:ng ,< l:]ng t3uyhn mu 8t _*h+ng Gu 25C th t8ch mu ng:P% nhKna. T<t hQn hBt l dRng hng cu lng nh4m mu '4. *J thuKt ph"n bng h)a h]p mu. _0nh cho t% u cu 'Km 'kc, huyBt t:Qng t:Q% '+ng l9nha. o 10 l hng cu 6&nh nh>n pha loAng FN% 1g0 l fa2l 0,gC _ Uha loAng 5Ca. o D5y 100 l t% u cu 'Km 'kc _ hokc huyBt t:Qng t:Q% '+ng l9nha pha FN% 50 l hng cu 6&nh nh>n 'A pha loAng 5C $ t3n. o ^uay ly t>m hdn h]p ny 15 g%>y. o 7c !Bt Gu"e *h+ng ng:ng !Bte Uh"n bng h)a h]p. fg:ng !Bte Uh"n bng !h+ng h)a h]p. ^uy t3Onh thIc h%&n t3uyhn mu. 1. nh nh4m mu h& ZYl mVu mu c=a ng:P% nhKn F tmng 'Qn F mu, thnh phn mu ,n t3uyhn 6;ng ph"n bng huyBt thanh mVu F hng cu mVu _ant%a.

2. nh nh4m mu h& [hM,u, mVu mu c=a ng:P% nhKn. @. ThIc h%&n H\t ngh%&m h)a h]p. @.1. T3uyhn mu ton phn, !h<% hng cu _hng cu lnga, !h<% 69ch cu, lm H\t ngh%&m h)a h]p t3ong <ng ngh%&m $ m+% t3:Png n:Nc mu<% ,%nh lo, nh%&t '( ph)ng, 6ao gme @.2. png 1e L%qa hng cu c=a 'Qn F mu, thnh phn mu FN% huyBt thanh ng:P% nhKn. png 2e L%qa huyBt t:Qng c=a 'Qn F mu, thnh phn mu FN% hng cu ng:P% nhKn. T3uyhn thnh phn t% u cu, huyBt t:Qng. Dm H\t ngh%&m h)a h]p g%qa huyBt t:Qng c=a 'Qn F mu, thnh phn mu FN% hng cu ng:P% nhKn t3ong <ng ngh%&m $ m+% t3:Png n:Nc mu<% ,%nh lo, nh%&t '( ph)ng. E. *% m t3a t#% mu t3:Nc !h% pht mu. *% m t3a t#% mu, thnh phn mue Uht h%&n cc d5u h%&u ,aue Tan mu, c4 c.c mu '+ng, Frn, FKt l9, t#% mu 6 3ch, th=ng, h%&n t:]ng 'T% mu ,c l9. *% m t3a '<% ch%Bu cc th+ng t%n Fh ng:P% cho F ng:P% nhKn, !Bt Gu" nh4m mu ZYl, [h, !Bt Gu" ph"n bng ch\o t3n ph%Bu dI t3R mu, nhAn t#% mu, ,< !Bt Gu" ph"n bng ch\o, ph%Bu t3uyhn mu. 5. W ,Q c5p pht mu. Uh%Bu t3uyhn mu g-% !hoa '%hu t3. W ,Q gh% !Bt Gu" 'nh nh4m mu, ph"n bng h)a h]p l:u t9% !hoa H\t ngh%&m.

2.2. ng mu ( Thi gian t 18/4/2011 n 29/4/2011)

:]c h:Nng dVn cch ,- d.ng my '+ng mu, my 'o t<c '( lng mu F thIc hnh t3n my.

2.2.1. iy '+ng mu STZ 2liUZ2T.

ThIc h%&n cc H\t ngh%&m T^, T2*, s%63%nogMn, 01 0%mM3

TQ:
*h"o ,t con ':Png '+ng mu ngo9% ,%nh _ta F con ':Png chung _10, 2, 1, 5a. 2hu ,< 6Onh th:Png t0 1 100C. L%"me L%"m m(t ,< hokc m(t yBu t< '+ng mu _ U3oth3o6%n, U3oconFM3t%n, yBu t< Stua3ta, g%"m nh%hu s%63%nogMn, Hu5t h%&n WMpa3%n.

TCK:
*h"o ,t ':Png '+ng mu n(% ,%nh _12, 11, g, va F ':Png chung _10, 5, 2, 1a. 2hu ,< 6Onh th:Png 2w 1 @5C. Txnge L%"m s%63%nogMn huyBt, t%u s%63%n.

Fibrinog n!
D m(t U3otM%n huyBt t:Qng ':]c tTng h]p $ gan, 6 ph>n ct 6$% Th3om6%n thnh nhqng ,]% s%63%n cn cho ,I t9o thnh c.c mu '+ng. Th%Bu h.t s%63%nogMn g>y 3a ch"y mu.

s%63%nogMn ch= yBu do gan t9o 3a. fng '( s%63%nogMn huyBt t:Qng th5p c4 th do ,I '+ng mu n(% m9ch 3"% 3c do ch5n th:Qng nkng hokc 6%Bn chbng ,"n !hoa.

YOnh th:Qnge 2,0 y E,0 gz l Txnge fh% m t3Rng, txng 69ch cru, th5p !hNp c5p. L%"me Y&nh gan nkng_ {Q gan, ng( '(c pho,phoa, lao phT%, '+ng mu n(% m9ch 3"% 3c.

"#$ ( "nt rnationa% #orma%i& ' $atio! T( )* b+nh th,ng h-a .u*/ t)
| ngh}ae nh g% h%&u Gu" ,- d.ng c=a ~a3a3%n F ,- d.ng cc thu<c !hng '+ng u<ng _S%nt3oma. TRy thMo 6&nh, m.c t%u /f[ !hc nhaue Xan '(ng m9ch ch= cQ h7c cn /f[ tm 2 1 @ t3ong !h% Fan 2 l cQ h7c cn /f[ tm 2,5 1 @,5. fBu /f[ !h+ng '9t tN% ng:ng m.c t%u ,n d` 6 c.c mu '+ng lm !t Fan, nBu cao Gu m.c t%u thO d` 6 ch"y mu_ fkng nh5t l ch"y mu nAoa.

01 0im r
2hrn 'on huyBt !h<% t}nh m9ch ,>u. 24 th ':]c lm cRng H\t ngh%&m !hc ' chrn 'on '+ng mu lan t?a n(% m9ch. 01 0%mM3 ':]c lm !h% 6&nh nh>n c4 t3%&u chbng c=a 6&nh huyBt !h<% t}nh m9ch ,>u nh: 'au ch>n, 'au 'Nn, ,:ng, 'T% mu da, cc t3%&u chbng c=a nghnn m9ch phT%, !h4 th$, ho, 'au ngIc do phT%. 2hu ,< 6Onh th:Pnge 0,001 0,50gz ml. D ph:Qng php ch8nh Hc F h%&u Gu" t3ong chrn 'on lo9% t3m huyBt !h<% t}nh m9ch ,>u t3n 6&nh nh>n n(% !hoa c5p t8nh.

234 T$5#6 78# 69#6 :;4 <T= >?:@=>T

1. >huAn bB mC YKt n#t ?# / ?FF $ cu<% h+ng $ 6n t3% c=a my, 'n !h$% '(ng ,n 6Kt ,ng t3n my %n, mon%to3 F 6n t3ong my STZ 2liUZ2T.

in hOnh h% n th DE?F=E 7G$"F">=T"?# 0?#G FN% con t3? t+ 'Km $ d)ng chq >?#T"#3G , nh5n G#TG$ .

2. >huAn bB thu*/ thH m$ !hay chba thu<c th- tm mn hOnh TjST UZfjD nh5n F2 hokc dRng ph8m m% tn d% chuy n 'Bn E?=0"#D ch7n @$?03>T< nh5n G#TG$. i$ np t5t c" cc l7 thu<c 'A churn 6 'kt Fo my. ThIc h%&n cc H\t ngh%&m Sc3MMn%ng TM,t thO cn churn 6 cc l7 thu<ce STZ 2* U[jST 5 STZ 2Z2D 2 STZ s/Y[/ U[jST 5 STZ l~jf *lDDj[ STZ 2lZL 2lfT[lD f U Uh.c h% cc l7 thu<c th- 6;ng cch t3(n l7 dung m+% ,ang l7 6(t !h+ '<% FN% thu<c th- STZ fjl UDZST/fj 2/5, STZ 2* U[jST 5 hokc 6;ng cch 6T ,ung n:Nc c5t 2 ln thMo '#ng th t8ch gh% ch# ,n t3n l7 thu<c th- '<% FN% cc thu<c th- s/Y[/ U[jST 5, STZ 2lZL 2lfT[lD f U lc nh l7 thu<c ' yn t3ong ph)ng 101 15 ph#t. ^u\t YZ[2l0j c=a l7 thu<c STZ fjl UDZST/fj 2/5, nh5n G#TG$ ' d% chuy n con t3? chu(t 'Bn c(t @?<"T"?# 'kt l7 thu<c STZ fjl UDZST/fj 2/5 Fo F t38 c4 !8 h%&u !hu5y tm _ F8 d.e F t38 2@a. ThIc h%&n t:Qng tI FN% cc l7 thu<c !hc. E,u Ie 2c l7 thu<c STZ fjl UDZST/fj 2/ 5 F STZ 2* U[jST ph"% ' Fo F t38 c4 !8 h%&u !hu5y tm. fh5n G<> 3% nh5n G#TG$ ' '4ng !hay chba thu<c. m$ !hay chba mVu th- tm mn hOnh TjST UZfjD nh5n F1 hokc dRng ph8m m% tn d% chuy n 'Bn E?=0"#D ch7n <amL% nh5n G#TG$. J. >huAn bB mKu o

L tn 6&nh nh>n F nh5n G#TG$ ' d% chuy n con t3? 'Bn c(t @?<"T"?# 'kt tu6M pla,ma c=a 6&nh nh>n '4 Fo F t38 65t !O, nh5n G#TG$ F nh5n F10, lkp l9% thao tc t:Qng tI '<% FN% cc mVu 'o c)n l9%.

Sau cRng nh5n G<> 3% nh5n G#TG$ '4ng !hay chba mVu. iy ,n h%&n th+ng 6o FN% con t3? $ d)ng 23"T nh5n 4 'Bn l&nh 6t 'u 'o mVu F !Bt Gu" ,n tI '(ng %n 3a my %n.

"n %Mi Nt .uO hoP/ o %Mi Nt .uO /Qa mRt mKu Tm mn hOnh TjST UZfjD dRng ph8m m% tn ' dP% con t3? 'Bn %lM 6&nh nh>n cn tOm 3% nh5n G#TG$ F FS ' %n l9% !Bt Gu" hokc nh5n G#TG$ F FJ ' 3a l&nh 'o l9% !Bt Gu". fh5n G<> ' t3$ Fh mn hOnh TjST UZfjD. E,u Ie T3ong Gu t3Onh 'o mVu nBu hBt thu<c th- thO my ,n !u FT@ F h% n th th+ng 6o. fh5n G<> ' my hon t5t 'o cc H\t ngh%&m !hc. Sau '4 thao tc thMo X.2 ' l5y l7 thu<c 'A c9n F thao tc thMo // ' 'kt l9% l7 thu<c mN%. iy ,n tI '(ng thIc h%n t%Bp t.c cc tM,t c)n l9% hokc c4 th 3a l&nh 'o l9% thMo h:Nng 'Vn $ t3n. 4. TUt mC i$ !hay chba mVu, ln l:]t l5y cc l7 thu<c th- 3a ngo%. E,u Ie T3ong !hay chba mVu chu c)n l9% l7 thu<c l~jf *lDDj[. i$ !hay chba thu<c th-, ln l:]t l5y cc l7 thu<c 3a ngo%. E,u Ie T3ong !hay chba mVu chu c)n l9% l7 STZ 2Z2D 2 F l7 STZ 0jSl[Y. Tm mn hOnh TjST UZfjD, nh5n G<> 6 4 hokc dRng ph8m m% tn d% chuy n con t3? 'Bn 6=ET G#TG$. *h% mn hOnh h% n th d)ng chq l >=# <V"T>6 ?FF T6G :=>6"#G thO tt n#t ?#/ ?FF c=a my.

2.2.2. iy 'o t<c '( lng mu DjfZ

ThW/ hiXn YZt nghiXm mu %Ung

a) Mc ch:
ThMo d% tOnh t39ng F%m hay thMo d% 1 6&nh c t8nh no '4, ,<t c5p th5p, cQn nh% mu cQ t%m c5p. {\t ngh%&m mang t8nh th:Png Guy, tm ,ot nh:ng 35t cn th%Bt t3ong F%&c pht h%&n F thMo d% 6&nh lao, thMo d% Gu t3Onh ho9% t- m+ cQ th F nhqng 3<% lo9n 6&nh lo Fh th5p h7c _ Y&nh lo c=a !hNp, gan, cQ F>n, d>y ch;ng,a F nhqng c5u t3#c l%n Guan. L%#p 6c ,} pht h%&n 3a nhqng 6&nh lo m t3%&u chbng l>m ,ng !h mQ h, !h+ng 3 3ng.
6a

TSBT: L%P 1 _ 15mma

L%P 2 _ 20 mma

c) Tr s tng:
Y&nh thKn. iang tha%. Y&nh th5p c5p. X%m !hNp d9ng nkng.

Th%Bu mu nkng. Y&nh g%ang ma%. Y&nh tuyBn g%p. Y&nh lao. Y&nh F%m '(ng m9ch do tB 6o !hTng l. au t=y. Y&nh txng s%63%nogMn. Y&nh F%m m9ch mu ho9% t-. au cQ d9ng th5p. Suy t%m Hung huyBt. iu txng '( nhNt. L%"m s%63%nogMn mu. L%"m U3otM%n huyBt t:Qng _ Y&nh lo gan, thKna. Y&nh 'a hng cu. Y&nh th%Bu mu hng cu hOnh l%hm. X%m m9ch mu d bng. nhy nh} t3%. nhy nh} ph"%. X%m gan tI m%`n. X%m n(% m9c t- cung. X%m Gung da do nh%hu St3Mptococu, UypgMn. X%m FRng chKu. X%m t=y H:Qng. X%m tuyBn g%p 6n c5p.

Txng 3 3ng t3onge

) Tr s gi!m

") #h$ng y%u t !nh h&'ng %n (%t )u! xt nghim:

234 T$5#6 78# 69#6 :;4 ? T[> \ E]#D :;3 EG#=

1. >huAn bB mKu o. D5y mu t}nh m9ch cho Fo <ng 'o tu6M TapFal 2ml. T3(n 'hu mVu 'o 6;ng cch '"o ng:]c <ng nh nhng tm 10 y 15 ln. {\t ngh%&m ph"% ':]c thIc h%&n t3ong F)ng 2h ,au !h% l5y mVu.

2h# oe o D5y mu cho Fo tu6M ph"% '#ng F9ch t3n <ng 'o _ ,a% ,< cho ph\p l 5mm F y 11mma. o fBu mu cho Fo Gu nh%hu hokc Gu 8t, my ,n 6o ld% E.G DMFMl j33o3. o Uh"% t3(n 'hu mu t3:Nc !h% 'o

2. >huAn bB mC o. YKt c+ng tc '%&n $ ph8a ,au my _ fgun '%&n ,- d.ng l 1001 2E0 Xolt,a, nBu !hu FIc c4 ngun '%&n !h+ng Tn 'nh ph"% c4 thm Tn p ' 6"o F& my. iy c4 ha% chB '( lm F%&ce il0j 1 Wl[ chu 'o t<c '( lng mu g%P thb nh5t. il0j Wl[ 'o t<c '( lng mu g%P thb nh5t F g%P thb ha%. chuy n 'T% g%qa ha% chB '( lm F%&c ny thO nh5n g%q ph8m 1 !h% 6Kt c+ng tc '%&n. iy ,n tI '(ng ch9y ch:Qng t3Onh !% m t3a tmng 6( phKn c=a my, mn hOnh h% n th t%u 'h g%P F chB '( lm F%&c. *h% ch:Qng t3Onh !% m t3a !Bt th#c, mn hOnh ,n h% n th th+ng 6o

$G=04 1 @< ^^^^^^ 8 @<

$G=04 9 @< ^^^^^^^^^^^^ 1S @< iy 'A ,n ,ng Gu t3Onh 'o mVu. 2% 'kt /0 c=a mVu 'o_ nBu !h+ng c% 'kt thO 6? Gua 6:Nc nya. o Tm mn hOnh ch8nh, nh5n ph8m ,< 1 mn hOnh h% n th "#T$?03>T"?# <=:@EG "0_` o {c nhKn 6;ng cch nh5n "# , mn hOnh h% n th #GV <G2a ?$ 0GFG>T <G2 _ o 2% 'kt ,< /0 _ fn ,- d.ng /0 @ !o tIa c=a mVu 'o 3% nh5n "#. fBu mu<n H4a /0 thO dRng ph8m G<> / 0GE. J. ThW/ hiXn YZt nghiXm 7<

kt <ng 'o Fo F t38 'o, 6t 'u tm F t38 ,< 1 thIc h%&n tun tI 'Bn F t38 1w, !h% 'o hBt 1w F t38 thO 6t 'u l9% F t38 ,< 1. iy ,n tI '(ng thIc h%&n 'o mVu !h% 'kt <ng Fo F t38.

*Bt Gu" ':]c Hu5t 3a. in hOnh h% n th , nh5n ph8m ,< 2 ,au '4 nh5n "# ' Hc nhKn, nhKp ,< thb tI c=a mVu cn HMm !Bt Gu", thot 3a 6;ng ph8m G<> / 0GE. in hOnh h% n th nh: ,aue

4. E,u I! *h+ng l5y <ng 'o 3a !h?% F t38 'o !h% my 'ang thIc h%&n Gu t3Onh 'o. fBu l5y <ng 3a my ,n 6o ld% <.G SamplM j33o3. *h+ng 'kt 65t !O FKt d.ng !hc $ !hu FIc 'o mVu c=a my FO c4 th g>y c"n t3$ ,I d% chuy n c=a mVu 'o. 2u<% ngy 6ao ph= my, t3nh FKt l9 3Q% Fo !hu FIc 'o mVu. *h+ng ,- d.ng Zlcohol t0C ' lau chR% my, 6( nhN c=a my 2E0 !Bt Gu". 2c !Bt Gu" l:u t3q c ,n tI '(ng H4a 6? !h% c% 'kt l9% ngy g%P c=a my. Won chunh !Bt Gu".

Tm mn hOnh ch8nh, nh5n ph8m 2, mn hOnh h% n th $G<3ET< >?$$G>T"?# . L%N% h9n 6Onh th:Pnge L%P 1e 0 y 5mm $ nq, 0 y tmm $ nam, g%P 2 20 mm. fguyn nh>n lm XS g%" t9oe iVu !h+ng lc 'hu !J l:ng, 6& my !h+ng 6;ng phng, th t8ch mu d: do FN% ch<ng '+ng.

2.J. T/h m n ( Ebn 1 t 2/c/2011 n 1J/c/2011 Ebn 2 t 2c/d/2011 n 29/d/2011)

D nQ% Guay ly t>m mVu mu lm H\t ngh%&m ,%nh h4a, nQ% thIc h%&n tM,t nhanh ,<t Hu5t huyBt _S{Wa F H\t ngh%&m ~%dal

png Hanh d:Qng lm H\t ngh%&m fW@, <ng Hm lm H\t ngh%&m ':Png, lactat Guay ly t>m t3ong F)ng 2 ph#t. png '? Guay 2 ph#t ,au '4 !% m t3a HMm mu c4 '+ng !h+ng, nBu mu '+ng thO dRng txm GuKy $ thnh <ng ,au '4 Guay t%Bp cho 'Bn !h% tch ':]c huyBt thanh.

Sau !h% Guay ly t>m Hong chuy n mu F g%5y ,ang 'nh ,< ' ':a Fo my ,%nh h4a. 24 2 my ,%nh h4a Z E00 F Z w00 _ iy Z w00 6t 'u tm 1 y 100, c)n my Z E00 6t 'u tm 101a.

<% FN% H\t ngh%&m c4 %on ' ch9y my Z E00. fgo% 3a c)n ':]c h:Nng dVn F thIc h%&n tM,t nhanh S{W.

2.@.1. ^uy t3Onh H\t ngh%&m tM,t nhanh S{W

1.

:Ku thH: huyBt thanh hokc huyBt t:Qng.

fBu !h+ng H\t ngh%&m ngay thO ph"% ' t= l9nh 2 1 vl2. iVu huyBt thanh hokc huyBt t:Qng chba !Bt t=a, tn huyBt Fng ,n cho !Bt Gu" ,a%.

2. 2uC tr+nh YZt nghiXm.

fh? 5l huyBt thanh hokc huyBt t:Qng Fo g%Bng Fu+ng S. fh? @ y E g%7t dung m+% Fo g%Bng t3)n. 7c !Bt Gu" t3ong F)ng 15 y 20 ph#t. *h+ng '7c !Bt Gu" ,au 20 ph#t FO ,n cho !Bt Gu" ,a%.

@. #hen Bnh Nt .uO.

m t8nhe 2hu c4 F9ch chbng 2. *h+ng pht h%&n *T /gi F /gL. 0:Qng t8nh /gie 24 F9ch 2 F F9ch /gi. fh%`m F%3u, S{W t%n pht. 0:Qng t8nh /gL c4 F9ch 2 F F9ch /gL. fh%`m F%3u, S{W t3:Nc '4 hokc nh%`m F%3u, S{W thb pht. 0:Qng t8nh /gi F /gLe 24 F9ch 2 F F9ch /gi, /gL. fhqng F%3u, S{W t%n pht mu(n hokc thb pht ,Nm.

2.@.2. ~%dal.
1. Thu<c th-e $ nh%&t '( 21 vo2, !h+ng ' nQ% c4 nh nng mkt t3P% F nh%&t '( cao. 2. Y&nh phrme WuyBt t:Qng !h+ng t%u huyBt, huyBt t:Qng 6"o Gu"n Ev g%P $ nh%&t '( 21 vo2. @. T%Bn hnh e Uha loAng huyBt t:Qng 1zv0 6;ng cch. 2ho 15,v ml fa2l 0,g C Fo <ng ngh%&m _15ml v00la 2ho t%Bp Fo 0,2ml huyBt t:Qng, t3(n 'hu _200l huyBt t:Qng fa2la D5y v <ng Zl ZW Yl YW 2l 2W 0l 0W

id% <ng 1l huyBt t:Qng 'A pha loAng 1zv0 $ t3n 2ho Fo md% <ng 1 g%7t thu<c th- _*fa tRy lo9%. T3(n 'hu, = $ 50l2. *f *f E. *Bt Gu"e png ngh%&m no c4 !Bt t=a _fg:ng t.a c d:Qng t8nh 1zv0 pha loAng huyBt t:Qng 1zv0 thnh huyBt t:Qng 1zw0 F lm t%Bp cho c !h% hBt d:Qng ngh%&m. Zl ZW Yl YW 2l 2W 0l 0W e E g%P. e 2 g%P.

2.4. fhg mu ( Thi gian t J0/c/2011 n 10/S/2011)

D nQ% lm H\t ngh%&m !h8 mu F pha loAng mu lm W6Z12. f6T :;3

2.E.1. i.c '8ch c=a H\t ngh%&m !h8 mu

L%#p 6c ,} 6:Nc 'u Hc 'nh ':]c cc 3<% lo9n th+ng !h8 mu, 3<% lo9n c>n 6;ng aH%t 6a,M ' Hc 'nh nguyn nh>n F chqa t3.

2.E.2. 2c t3:Png h]p lm H\t ngh%&m !h8 mue

1. Suy h+ h5p m7% nguyn nh>ne T9% phT% hay ngo% phT%. 2. Suy tun hon, chong, nh%`m t3Rng mu. @. Suy thKn F 6&nh lo <ng thKn. E. f(% t%Bte % tho ':Png nh%hu toan cMton, 6&nh F? th:]ng thKn. 5. W+n m, ng( '(c. w. T%u h4ae %, t%u ch"y, d) t#% mKt hokc 3u(t non, t.y t9ng. t. [<% lo9n '%&n g%"%e Txng !Bt t=a *al% mu, 2holo3 mu. v. ThMo d% '%hu t3e lHy l%&u php, th$ my, nu+% xn Gua ':Png t}nh m9ch, l7c thKn, t3uyhn dch hokc t3uyhn mu l:]ng lNn, '%hu t3 l]% t% u.

2.E.@. 2hu ,< 6Onh th:Png.

pW '(ng m9ch e t,@t y t,E5. p2l2e fam e @5 y Ew mmWg. fq W2l@ churn *%hm d: e @2 y E@ mmWg. e 21 y 2w mmolzD. e 12 'Bn @ mmolzD.

pl2 '(ng m9ch e t1 y 10E mmWg.

2.E.E. iy ph>n t8ch !h8 mue S- d.ng my jZS YDll0LZS

a) Quy trnh *+n h,nh m-y: 1. fhhi Rng mC YKt c+ng tc ngun _220X z 50Wa, !% m t3a g%5y t3n my %n. 2hP my !h$% '(ng _*ho"ng 2 ph#t a t3n mn hOnh h% n th Ga)C F%oo'Da) 7 ri : 'i/a >oi L6 / L>?2/ L?2. 0at / :onth / 4 ar. >onjirm _ fBu ngy thng '#ng thO nh5n 4G< z *h+ng thO nh5n #? F h%&u chunh Ga)C F%oo'Da) ^^ 7 ri : 'i/a >oi <o%ution @a/N i) out )i' a "n)ta%% )o%ution La/N. >onjirm_ 2ho 6Onh thu<c th- Fo my, my ,n cho th+ng t%n Fh 6Onh thu<c. ^ 6om : nu ^

1. ^^^ 2. ^^^ J. >a%ibration. 4. 0ai%C >% an r. c. < /on' m u. fh5n g%q ph8m 4 0ai%C >% an r, nh5n <amL% @rob tN% F t38 <Cring F ':a dung dch Fo !%m h#t F nh5n 4G< ' my h#t dung dch Fo 3-a my, !h% my h#t Hong Hu5t h%&n th+ng 6o >%o) <amL% @rob , l5y dung dch 3-a 3a F '4ng <amL% Lrob . iy t%Bn hnh 3-a F tI '(ng 2al%63at%on. *h% my 2al%63at%on Hong, mn hOnh h% n th cc th+ng ,< pWz p2l 2z pl2. fBu my h% n th !h+ng '= @ th+ng ,< t3n thO ta ph"% t%Bn hnh 3-a my F 2al%63at%on l9% my, nBu !h+ng thO ch#ng ta ph"% thay '%&n cIc g7% 6( phKn SM3F%cM. E,u I! T3ong Gu t3Onh ch9y !h+ng ':]c m$ np my, thMo d% Gu t3Onh ph>n t8ch mVu t3n thanh t39ng th%, c4 nhqng ,I c< ld% Hu5t h%&n t3n mn hOnh ch#ng ta c4 th can th%&p, H- lo cho my t%Bp t.c ho9t '(ng, nhqng ld% th:Png gkp nh:e XaluM j33o3, Z%3 %n 2al%6 Zz Yz [%n,M, 03%t fo%,M. *h% '4, ch#ng ta cn HMm H\t tOnh t39ng XaluM, d>y Uum6, 6Onh thu<c, '%&n cIc. 2. >hMC mKu!

*h% my 2al%6 hon thnh _ 'y '= @ '%&n cIc pWz p2l 2z pl2a c4 th t%Bn hnh ch9y mVu, churn 6 mVu, nh5n <amL% @rob , ':a mVu Fo F nh5n 4G<, my h#t Hong l5y mVu 3a F '4ng <amL% @rob l9%, nhKp th+ng t%n 6&nh nh>n, nh%&t '(, W6, F nh5n 4G<.

iy ph>n t8ch Hong ,n cho !Bt Gu" t3n mn hOnh F %n 3a g%5y. E,u I! iy !h8 mu thP% g%an 2al%6 _ iy c4 chB '( 2al%6 tI '(nga my mN% t%Bp t.c 'o mVu ':]c.

@6= E?k#D 6b=1>! | ngh}a H\t ngh%&m W6Z12e 'o l:]ng glycohMmoglo6%n t3ong hng cu.*Bt Gu" !h+ng "nh h:$ng 'Bn F%&c 6.ng '4% hay 'A xn 3%.0o '4 c4 th l5y 65t cb l#c no t3ng ngy. *Bt Gu" W6Z12 cho 6%Bte :Png huyBt t3ung 6Onh t3ong !ho"ng thP% g%an tm 2 'Bn @ thng. ^ua '4 6c ,} c4 th 'nh g% !Bt Gu" '%hu t3 t3ong !ho"ng thP% g%an '4.

nh g% !B hoach !% m ,ot t% u ':Png. fBu W6Z12 FVn $ mbc cao ph"% HMm H\t l9% !B ho9ch '%hu t3.

24 nh%hu ph:Qng php 'o W6Z12. Uh:Qng php th:Png dRng l t8nh phn t3xm l:]ng LlycohMmoglo6%n t3ong ton th WMmoglo6%n. T3 ,< 6Onh th:Png l E y w.2C. Th- ngh%&m W6Z12 !h% pht h%&n 6 t% u ':Png. W6Z12 !h+ng ph"n nh txng hay g%"m ':Png huyBt c5p t8nh. fBu 6&nh nh>n th%Bu mu tn huyBt hokc Hu5t huyBt nkng !Bt Gu" c4 th th5p g%". fBu 6&nh nh>n 'ang th%Bu ,t thO W6Z12 ,n txng. fBu 6&nh nh>n t3uyhn mu gn '>y, W6Z12 ,n txng g%" F !h+ng ph"n nh ch8nh Hc F%&c !% m ,ot ':Png huyBt t3ong 2 y @ thng. 2uC tr+nh YZt nghiXm 6b=1>! 1. Uha loAnge iu j0TZ _Tu6M Hanh d:Qnga 2ho Fo 2uFMttM _iy ,%nh h4a tI '(ng llympu,ae wl ton phn _j0TZa o 250 l dung dch WMmoglo6%nM 0Mnatu3ant _ 0ung dch ph hng cua 10 ph#t cho dung dch chuy n mu Hanh. 2. :a cuFMttM ny Fo my ,%nh h4a tI '(ng. @. 2h7n 2 ch:Qng t3Onh e TW6 F W6Z12 ' lm H\t ngh%&m W6Z12. E. 2u<% ngy, c5t cha% dung dch WMmoglo6%nM 0Mnatu3ant Fo t= l9nh 6"o Gu"n 2 y vo2.

2.c. film bXnh LhAm ( Thi gian t 2d/S/2011 n 8/d/2011)

D nQ% nhKn 6&nh phrm tm cc !hoa ' lm H\t ngh%&m t9% !hoa F 6&nh phrm 'Mm g$% ngo%, l nQ% t3" lP% !Bt Gu" cho cc !hoa t3ong nhqng t3:Png h]p cn !Bt Gu" g5p.

*h% nhKn 6&nh phrm ph"% !% m t3a tn, tuT% 6&nh nh>n t3n 6&nh phrm F t3ong ph%Bu H\t ngh%&m. o <% FN% cc <ng mu c4 ch<ng '+ng ph"% !% m t3a HMm mu c4 '+ng !h+ng. [%ng cc <ng mu lng F '+ng mu ph"% HMm c4 '#ng th t8ch !h+ng. o T3:Png h]p mu '+ng hokc !h+ng c4 6&nh phrm ph"% 6o ln *hoa F yu cu l5y l9%.

Sau !h% !% m t3a 6&nh phrm Hong chuy n g%5y H\t ngh%&m ,ang nhKp my F mang 6&nh phrm Fo t3ong. >y cng l nQ% cung c5p <ng 'Ing mu, l7 'Ing n:Nc t% u cho cc *hoa. 2*, 2* 1 iYe D nhqng H\t ngh%&m Fh mMn t%m. sUe ThMo d% ung th: t%nh hon F ung th: gan. 2Z 125 //e ThMo d% ung th: 6ung t3bng. 2Z 151@e ThMo d% ung th: F#. 2Z 1g1g {[e ThMo d% ung th: '9% t3Ic t3ng, ung th: t.y, ung th: d9 dy. 2jZe ThMo d% ung th: t3Ic t3ng, phT%, F#. Total USZe Uht h%&n ,Nm F thMo d% ung th: t%hn l%&t tuyBn.

fhqng H\t ngh%&m mN% Fh ,%nh h4a1 m%`n dch.

T3 ,< 6Onh th:Png c=a cc H\t ngh%&m ,%nh h4ae 3 Lluco,M 23Mat%n%n Y%l%3u6%n TU Y%l%3u6%n TT Y%l%3u6%n LT U3otM%n TU Zl6um%n Llo6u6%n Tu l& Zz L s%63%nogMn 2holM,tM3ol T3%glycM3%d 2,5 y t,5 mmolzD @,g y w,E mmolzD fame w2 y 120 lzD fqe 150 y @w0 lzD 1t molzD E,@ molzD 12,t molzD w5 y v2 gzD @5 y 50 gzD 2E y @v gzD 1,@ y 1,v 2 y E gzD @,g y 5,2 mmolzD 0,Ew y 1,vv mmolzD

W0D 2ho D0D 2ho fa * 2l1 2alc% 2alc% %on h4a Uho,pho St iag% ZST _LlTa ZDT _LUTa 2* 2*1 iY D0W LLT 2hol%nM,tM3a,M

0,g molzD @,E molzD 1@5 y 1E5 mmolzD @,5 y 5 mmolzD gv y 10w mmolzD 2,15 y 2,w mmolzD 1,1t y 1,2g mmolzD Tje 1,@ y 2,2 mmolzD fDe 0,g y 1,5 mmolzD fame 11 y 2t molzD fqe t y 2w molzD 0,v y 1,00 mmolzD @t zD y @to2 E0 zD y @to2 fame 2E y 1g0 zD y @to2 fqe 2E y 1wt zD y @to2 2E zD y @to2 2@0 y Ew0 zD y @to2 fame 11 y 50 zD y @to2 fqe t y @2 zD y @to2 5@00 y 12g00 zD y @to2

2hu ,< 6Onh th:Png c=a TY mu ngo9% F% S< l:]ng hng cu WuyBt ,c t< WMmatoc3%t i2X i2W i2W2 Wng cu c4 nh>n Wng cu l:N% S< l:]ng t% u cu S< l:]ng 69ch cu fam _ E,0 y 5,v 1012 zD a fq _ @,g y 5,E 1012 zD a fam _ 1E0 y 1w0 gzD a fq _ 125 y 1E5 gzD a fam _ 0,@v y 0,50 lzD fq _ 0,@5 y 0,E5 lzD a v@ y g2 l 2t y @2 pg @20 y @5w gzD _ 0 10g zD a _ 0,1 y 0,5C a _ 150 y E00 10g zD a E y 10 10g zD

@6m# """! Tn#D foT

Y&nh F%&n fguy`n T3% Uh:Qng l m(t 6&nh F%&n t3Ic thu(c S$ TB thnh ph< W 2h8 i%nh, 'ng thP% cng l 6&nh F%&n 'a !hoa h9ng nh5t. Y&nh F%&n ':]c t3ang 6 'y '= cc lo9% my m4c F t3ang th%Bt 6 h%&n '9%. %hu '4 g4p phn n>ng cao ch5t l:]ng !hm F chqa 6&nh, 'Mm l9% ,bc !h?M cho m7% ng:P%. [%ng !hoa {\t ngh%&m md% ngy t%Bp nhKn 35t nh%hu 6&nh phrm tm cc *hoa !hc g-% 'Bn cRng FN% l:]ng 6&nh nh>n 'Bn lm H\t ngh%&m 35t '+ng, '%hu ny chbng t? ch5t l:]ng !hm F chqa 6&nh c=a 6&nh F%&n 35t ':]c ,I t%n cKy F t8n nh%&m c=a m7% ng:P%. :]c thIc tKp t9% !hoa {\t ngh%&m c=a 6&nh F%&n, ':]c lm F%&c cRng 2v thnh F%n t3ong *hoa, md% ng:P% c4 nhqng n\t 3%ng, nh:ng $ h7 lu+n c4 ,I tKn tOnh chu 6"o h7c ,%nh thIc tKp, h7 lu+n th>n th%&n F h)a 'ng. Sau thP% g%an h7c tKp $ 6( m+n, thIc tKp g%#p Mm c=ng c< l9% !%Bn thbc 'A h7c, 6n c9nh '4 c)n g%#p Mm 6T ,ung thm nhqng !%Bn thbc mN%, ':]c t%Bp cKn F lm GuMn FN% cc lo9% my m4c h%&n F nhqng H\t ngh%&m mN%. ThP% g%an thIc tKp g%#p Mm chqng ch9c hQn, t3:$ng thnh hQn F cng c4 t3ch nh%&m FN% c+ng F%&c. *Bt th#c thP% g%an thIc tKp Mm h7c ':]c 35t nh%hu '%hue :]c lm GuMn FN% m+% t3:Png 6&nh F%&n, ':]c 3n luy&n !J nxng g%ao t%Bp FN% 6&nh nh>n, thnh th9o t3ong !J thuKt l5y mu, 6%Bt cch l5y cc <ng mu phR h]p FN% cc H\t ngh%&m t:Qng bng, ch9y cc my tI '(ng, F+ ,T !Bt Gu" 'Bn F%&c t3" !Bt Gu" cho 6&nh nh>n. :]c lm F%&c d:N% ,I thMo d% F h:Nng dVn c=a nh>n F%n t3ong *hoa, '+% l#c cng c4 nhqng '%hu ,a% ,4t, ch8nh nhqng ,a% ,4t '4 m Mm 6%Bt ':]c tc h9% c=a n4, ,I "nh h:$ng

c=a n4 'Bn !Bt Gu" H\t ngh%&m c=a 6&nh nh>n F ,au ny ,n !h+ng mc ph"% nhqng ,a% lm '4. Tuy nh%n, lch thIc tKp c=a nhqng thnh F%n t3ong nh4m ':]c !hoa ,p HBp ,n nn 6n c9nh F%&c ':]c thIc tKp nh%hu $ nQ% ny nh:ng l9% !h+ng ':]c thIc tKp $ nQ% !hc. Y"n th>n Mm !h+ng ':]c thIc tKp $ phne WuyBt ', m%`n dch, n:Nc t% u. :]c thIc tKp nh%hu $ ph)ng F% ,%nh, huyBt h7c F h9n chB $ ph)ng ,%nh h4a. T3ong ph)ng ,%nh h4a chu ':]c tch huyBt thanh ' ':a Fo my ,%nh h4a tI '(ng. jm hy F7ng lch thIc tKp ':]c ,p HBp h]p l8 hQn ' h7c ,%nh c4 th thIc tKp $ t5t c" cc nQ% t3ong *hoa ' !%Bn thbc ':]c c=ng c< F 6T ,ung nh%hu hQn. jm H%n ch>n thnh c"m Qn T3:Png 9% h7c 0:]c Thnh Uh< W 2h8 i%nh, *hoa %hu 0:ng y *J ThuKt W7c F Y( i+n {\t fgh%&m 'A t9o '%hu !%&n thuKn l]% ' Mm ':]c thIc tKp t9% Y&nh F%&n. jm ch>n thnh c"m Qn cc Znh, 2h F ton th '(% ng nh>n F%n *hoa {\t fgh%&m c=a Y&nh X%&n fguy`n T3% Uh:Qng 'A g%#p Mm h7c h?%, FKn d.ng F c=ng c< !%Bn thbc 'A h7c. Yn c9nh '4, Mm cng H%n c"m Qn g%o F%n h:Nng dVn 'A g%#p Mm hon thnh t<t 6% 6o co thIc tB t<t ngh%&p.