Y HOC
VIET
NAM
THANG 2
-
SO 2/2014
VAI TRO CUA
Y
TE
TIT
NHAN
TRONG HOAT DONG PHONG CHONG
HIV/AIDS TAI 4 TINH BUOC HO
TRO*
CUA
DIT
AN QUY
TOAN
CAU
TOM TAT
Nghien cffu cat
npang
nham
6anh
gia vai tro cua
y
te
tif
nhan trong cong
tac
phong chong HIV/AIDS

du'Oc thu'c
tiien
tai
252
cd
s6
y
te
tif
nhan
6 8
huyen
thuoc
4
tinh
tren_toan
quoc
di/a
tren
cac chi so
va
thang
do ve
sif
sin co va
sin
sang
die
dich
vy

Y
te
(SARA) cua WHO. Ket qua cho thay cac dich
vu
phong
chong
HIV
du'Oc cung
cap
la
chuyen benh nhan
co
nguy ca cao (47,3%),
tu
van HIV
ti/
nguyen (34,5%),
dieu
tri
STI
(18,6%)
va
dieu
tn
nhiem trung
cO hpi
(14,4%);
tu"
van dieu
tri

ARV (10,3%)
va xet
nghiem
test nhanh
HIV
tif
nguyen (8,3%).
Tu"
van
va xet
nghiem phong chong lay truyen
tif
me sang con du'Oc
cung cap
d
89,1%
va 28,3% cac phong kham San/nha
hp
sinh.
Vai
tro
cua
y te
tu"
trong phong chong
HIV/AIDS con han che. Can tang cu'dng dao tao, giam
sat ho trd chuyen mon ky thuat cho
y
te
tu'

nhan tham
gia phong chong HIV/AIDS.
TiJ'khoa:
Y
te
tu' nhan, phong chong HIV/AIDS,
tif
van
va xet
nghiem
tif
nguyen,
lay
truyen
tCf
me
sang con.
SUMMARY
PARTICIPATION
OF
PRIVATE HEALTH
SECTOR
IN
HIV/AIDS
CONTROL
IN
4
PROVINCES SUPPORTED BY GLOBAL FUND
This
cross-sectional study which aims

to
assess
the role
of
pnvate health care facilities
in
the
prevention
of
HIV/AIDS was conducted
at
252 private
health facilities
in
8
districts
in
4
provinces using
the
WHO tool about
the
availability
and
availability
of
health services (SARA).
The
results showed that
the

HIV prevention services that were provided were
referral
of
high
nsk
patients (47.3%), voluntary
HIV
counseling
(34.5%),
STI
treatment (18,6%)
and
treatment
of
opportunistic infections (14.4%);
ARV
treatment counseling (10.3%) and rapid HIV voluntary
testing (8.3%). Counseling and testing
for
prevention
of mother
to
child transmission were provided
in
89.1%
and 28.3%
of
obestrict clinics/maternity wards.
The role
of

private health care
in
HIV/AIDS
is
still
limited.
It is
necessary
to
strengthen trainning,
technical
and
professional support
to
pnvate health
sector in participating
in
HIV/AIDS control.
Keywords: Private health sector, HIV/AIDS
control,
voluntary counseling
and
testing, mother
to
child HIV
transimission.
*
Cgcphdng
chdng HIV/AIDS, Bd
Yte;

Tru'dng Dai
hoc
YHa
Ngi
** Bg mdn Y
htpc
gia dinh, Dai hgc
Y
Ha
Ngi
Phan
bign
khoa hgc: PGS.TS Nguyin Thj Kim Chuc
Nguyen Hoang Long*, Tran Khanh Toan**
L
DAT
VAN DE
Viet Nam
da
dat du'dc nhieu thanh
tiTu
trong
phong chong HIV/AIDS,
ca
ve trien khai cac hoat
dpng
tu"
van,
xet
nghiem HIV

tu"
nguyen, phong
chong lay truyen
tif
me sang con; giam thieu tac
hai,
dieu
tri
ARV cung
nhu*
giam
ty le
mac va
tii
vong do HIV/AIDS
[1,3].
Hien
co hdn
55.000
cd sd y
du'dc
tif
nhan
tren toan quoc dang cung
Cfng
43,5% dich
vu
ngoai
tru va
2,1%

dich
vu
npi tru, gop phan lam
giam
tai cho cac
c6
sd y te
cong.
Y te
tu' cung
du'dc
ky
vpng
gop
phan tang cu'dng hieu
qua
trien khai cac chu'dng trinh
y
te, trong do co cong
tac phong chong
HIV/AIDS.
Tuy nhien, hien
chu^
CO
cac nghien cu'u danh gia day du ve vai tro
cija
y te tu' nhan trong cac chu'dng trinh
y
te quoc gia
nhu'cong

tac phong chong
HIV/AIDS
[1,2].
Nghien
cu'u
nay
du'dc
thyc hien trong
khuon
kho Dl/ an Ho trd he thong
y te
do Quy Toan cau
tai
trd
trong
5 nam
(2012-2016)
nhkm
ho trd
tang cu'dng nang lu'c he thong
y
te, gop phan cai
thien
va duy tri cac
thanh
qua cua cac
chu'dng
trinh
y te
quoc

gia
khac,
ca
trong ITnh
vi/c
y te
cong va tu'.
Muc
tieu:
Mo
ta
hoat dpng cua
y te
tu"
nhan
trong phong chong HIV/AIDS
tai 4
tinh thu'c
hi?n
dy
an
ho trd he thong
y
te do Quy toan cau tai trd.
II.
DOI
TU'pWG
VA PHU'aNG
PHAP
NGHIEN

CUU
2.1.
Dja ban va doi
tu'dng nghien
cthi:
Nghien cifu thu'c hien
tai 4
tinh Quang Ninh,
Khanh Hoa, Binli
Phu'dc
va Soc Trang
tLf
thang
6-
9/2013,
moi
tinh chpn
mpt
huyen nong thon
va
mpt
thi
xa, thanh
plip
tru'c thupc
tinh.
Toan
bp
252 cd sd
y te

(CSYT)
tu"
bao gom
ca
cac phong
kham
da
khoa
va
chuyen khoa Npi, Nhi, San va
nha
hp
sinh tren
dja ban
du'dc chpn tham
gia
nghien cifu.
2.2.
Phu'dng phap nghien cu'u: Thiet
ke
nghien cii'u
mo ta cat
ngang, thu'c hien
qua
phong van bang
bp
cau
hoi
cau
true

ve
cac loai
hinh
cd sd,
nhan
lyc, to
chu'c, trang thiet
bj,
thdng
tin, cac
loai dich
vu
t\f
van,
dy
phong va
dieu
tri
san
co tai
cac cd sd
y te
tu".
Danh gia
s;/
san
CO
cua cac djch
vu y te
theo hu'dng dan cua

WHO (SARA)
[7]. So
lieu du'dc
xy
ly
bSng phan
68
Y HQC VlgT NAM THANG 2
-
SO 2/2014
mem SPSS 11.5 vdi cac test thong ke mo ta d
mii'c y nghTa thong ke
a=
0,05.
III.
KIT
QUA
NGHIEN cCrU
3.1.
Thong tin ve doi tu'dng nghien cii'u
Trong so 252 cd sd y te
tU
tham gia nghien
cinj,
CO
168 phong kham npi (66,7%); 46 phong
kham San/nha hp sinh (18,2%); 23 phong kham
da khoa (9,1%) va 15 phong kham
Nhi
(6,0%).

Tat ca cac cd sd deu co bac
sT
lam viec
tai
cac cd
sd y te nha nu'dc dang ky kham
chya
benh ngoai
gid hoac can bp y te ve hu'u
phy
trach vdi nhan
lyc
tu"
mpt den tren mu'di ngu'di. Doi tu'dng tra Idi
chu yeu la bac
sT
chiem 91,6%,
vCra
lam quan ly
vya
kiem luon nhiem
vy
kham chu'a benh, Tuoi
trung binh doi tu'dng tra Idi phdng van la 48, thdi
gian trung binh lam viec cho cac cd sd y te cong
la 22 nam va
cac cd sd y te
tu"
la 12
nam.

3.2. Hoat dong cung cap dich vu phong
chong
HIV/AIDS
Bieu
do 1 cho thay cac dich vu du'dc cung
cap chu yeu la chuyen
g(f\
benh nhan c6 nguy
c6
cao (47,3%), tu' van HIV
tu-
nguyen (34,5%),
dieu
tri benh lay truyen qua du'dng sinh
due
(18,6%) va nhiem trung cd hoi (14,4%). Cd
10,3%
cd sd
tL/
van dieu trj ARV va chi 8,3% so
cd sd cd xet nghiem test nhanh HIV.
Bieu
do 1. Ty le cac
CSYT
cd cung cap cac djch vu phong chdng HIV
Test
nhanh
HIV ty
nguyen
Tir

van dieu tri ARV
Cap phit bao cao su
Dieu trj nhiem triing co
hpi
Digu
tri STI
Tu van HIV
tir nguyen
Chuyen giri
bpnh
nhan
0
10
20 30 40 50
Tinh chung
cd
34,5%
CSYT
t&
co cung
cip
dich
vu t& vin HIV
va
8,3%
th&c hien
xet nghiim
nhanh
HN; ty
le nay

d
cac PKDK cao
hdn
so vdi
cac
phdng kham Ngi va Nhi
vdi p
<0,05 (Bieu do
2).
Bieu
do 2. Ty le cac CSYT cd cung cap djch vu
tu'
van
va xet nghiem HIV
36.4 34 9 Tir vkve HIV AIDS
I
PK
Nhi
PKSK PKN'pi
22,7% cac
PKBK
cung cap dich vu dieu
tri
nhiim trung cd
hoi
va sang
Ipc
Lao cho benh nhan
HIV/AIDS,
caohdnso

vdicac
phdng
kham
Noi,
Nhi
(p<0,05).
Cung cap djch vu
td
van
dieu tri
ARV
d
cac lOfil CSYT
la tddng
du'dng
nhau.
Y HOC VIET NAM THANG 2 • SO 2/2014
Bleu do 3. Ty le cac CSYT co dich vu cham soc, dieu tri cho BN
HIV/AIDS
Dieu
tri iiluem
triing co
hoi
I
Sana lpc Lao cho BN
I Tu vin
di^u
tn
AR\'
-0

PKNoi
PK
Nhi
Co
89,1% phdng kham
San/nha
hg sinh
va
31,8%
PKBK cung
cap dich vu td
van
phdng
chong lay
truyen
td me
qua
con,
Ty
le cd sd
co
lam xet
nghiem HIV cho
phu niT mang thai
lan
Iddt
la
28,3%
va
9,1%.

Cd
73,9%
phdng kham
san va
54,5%
PKBK
gidi
thieu
phu
nO
den
CSYT khac
lam xet
nghiem
(Bleu
do 4).
Bleu do
4. Ty le cung cap
dich
vu phong lay truyen HIV tir me sang con
:l00 "" \
""y^
" S9,l
Tu vin lav
tniyin HIV
me - con
73.9 :
• Xel nghi?m HIV
cho
PNMT

:m
HIV
cho
PNMT MHH
J J
PKBK PK
San/Nha hp
sinh
Bang
1 cho thay
khoang
50% so cd sd dddc tap
huan ve phdng chong
HIV/AIDS;
hdn 60% cd sd co
tii
lieu hddng dan dd
phdng lay
truyen
me
con va
dddi
30%
cd tai
lieu
hddng dan td
van td
nguyen.
Ty
le dddc

cung cap
bleu
mau bao
cao,
dddc phan hoi
thong
tin
va
dddc ho trd
chuyen mon
rat
thap,
nhat la vdi
td
van
HIV
td
nguyen.
Bang
1.
Ty le CSYT du'dc ho tra, giam sat hoat
dpng
phong chSng
HIV/AIDS
Chi
so
Du'Oc tap huan
Co san tai lieu
Dtroc
cung cap bleu mau

Du'dc phan
hoi
thong
tin
Du'dc giam sat chuyen mon
Tu*
van
tir
nguyen
48,8
28,9
2,0
7,3
5,4
Du*
phong lay truyen me con
53,3
61,0
10,4
22,7
11,3
IV. BAN LUAN
Y te tu' nhan
d Viet
Nam hinh thanh tu' cuoi
nhu'ng nam 1980 va da du'dc luat hoa thong qua
Phap lenh hanh nghe y te tu' nhan ban hanh lan
dau nam 1993, lan
thi?
hai nam 2003

[3].
Ngoai
ra Dang va Nha nu'dc cung co nhieu chu
trifdng,
chinh sach
dUdc
the
hien
trong cac van ban cu
the nham tao dieu
l<len
phat trien mang
lUdi
y te
tir
nhan.
Trong
bol
canh do y te
tu"
nhan da phat
trie'n
tu'dng doi nhanh chong. Y te tu' nhan da trd
thanh mpt bp phan khpng the tach rdi trong
h§
thong y te Viet Nam va co nhu'ng dong gop quan
trpng trong cung cap djch vu chSm soc
sik
khoe
cho ngu'di dan [2]. Tuy nhien

sir
tham gia
dia
Y HQC
VIET
NAM THANG 2 - SO 2/2014
cac Cd sd y te
tu"
nhan hien nay chu yeu chi mdi
tap trung trong viec cung cap cac djch vu dieu tn.
Chu:a
co cac nghien
CLTU
danh gia ve vai trn cua y
te
tu"
nhan trong cong tac y te
diT
phong va cac
chudng trinh y te quoc gia. Trong khi do, d nhieu
nu'dc tren the
gidi,
y te
tu*
nhan cung tham gia
tich
cue
trong cong tac
du*
phong va hdp tac cong tu'

d^
gop phan quan trpng trpng viec thu'c hien cong
tac cham soc
SLTC
khoe
di/
phong noi chung va
tnang
phong chong HIV/AIDS noi chung [5].
Ket qua nghien
CCTU
cho thay vai tro cua y te
tu"
nhan trong phong chong HIV/AIDS tai cac dja
phu'dng tham gia nghien
CLTU
con han che, chu
yeu tap trung vao mang
du"
phong.
Vi
hoat dpng
tu"
van va xet nghiem chi mdi co 34,5% cac cd sd
CO
cung cap djch vu
tu"
van va chi cd 8,3% cac cd
sd CO
thi/c

hien xet nghiem test nhanh HIV. Mpt
ly do khien viec lam xet nghiem test nhanh HIV
tu"
nguyen
it
du'dc cac phong kham quan tam bdi
djch vu nay da du'dc trien khai d nhieu cd sd y te
cong
[1],
Hdn
nuci
cac cd sd y te tu' hoat dpng
vdi muc dich ldi nhuan thong qua thu
phi
dich vu
trong cac djch vu nay rat kho thu
phi.
Cac cd sd
y te
tu"
nhan co nhieu thuan ldi hdn trong viec
thu hut doi tu'dng den
tU
van HIV ty nguyen bdi
tfnh thuan tien va kha nang
bi
mat [5]. Neu tang
cu'dng cac djch vu nay tai cac cd sd y te
tif
se

t5ng
kha
nSng
tiep can cua khach hang va gdp
phan dang ke cho cong tac phong chong
HIV/AIDS [4].
Cong tac phong chong lay truyen tir me sang
con cung du'dc trien khai tai cac
cti
sd y te tu",
trong do chu yeu la hoat dong tu' van
(31,8%
cac
phong kham da khoa va 89,1% cac phong kham
san).
Mac
du thupc cac dja ban du'dc ho trd
ciia
Quy
To^n
cau song
chi
co 9,1% cac
PKOK
va
28,3%
cac phong kham san khoa thifc hien viec
xet nghiem sang Ipc cho phu nu' mang
thai.
Con

s6 nhy
rat thap so vdi ty le 43,4% phu nu' mang
thai d khu
vi/c
thanh thj va 69,6% d khu vu'c
ndng thon trong mpt nghien cu'u gan day co di
kham thai tai cac cd sd y te tu' nhan [6]. Trong
khi 66 muc tieu cua chu'dng trinh la tat ca phu nu'
mang thai phai du'dc sang Ipc HIV tru'dc sinh va
trong
nSm
2012 co hdn mpt trieu lu'dt phu
nQ'
mang
thai
du'dc sang Ipc HIV.
Bii
lai, cd 54,5%
cac phong kham da khoa va 73,9% cac phong
kham san gidi thieu phu
nu*
den cac cd sd y te
khac de lam xet nghiem.
Vdi dich vu
dieu
trj va ch3m sdc benh nhan
HIV/AIDS,
c^c'cd
sd y te
t\f

nhan cung chi mdi
tham gia
chii
yeu vao
viec
chuyen
gul
benh nhan
(47,3%
so cd sd). Cong tac dieu tri tap trung
chii
yeu vao dieu tri cac benh lay truyen qua
dUdng
sinh
due (18,6%)
va dieu trj nhiem
trijng
cd hpi
(14,4%).
So phong kham co sang loc benh lao
cho benh nhan nhiem HIV/AIDS chi chiem
t/
le
thap (cao nhat cung chi la 22,7% d cac PKOK).
Mac du
CO
khoang 10% so cd sd cd tu' van ve
dieu tri ARV song chu'a co phdng kham nao tham
gia dieu tn do hoat dpng nay chi
mdi

du'dc trien
khai
d cac cd sd y te cong vdi khoang 70.000
ngu'di du'dc dieu trj tfnh den cuoi nam 2012
[1],
Mac
dii
SI/
tham gia
ciia
cac cd sd y te
ti/
trong phong chong HIV/AIDS dang timg bu'dc
dddc quan tam, song cac hoat dpng giam sat ho
trd hien van het sii'c han che. Ket qua nghien
cirtj
cho thay chi mdi co khoang tren du'di mpt nira so
cd sd du'dc tap huan ve phong
ch6ng_
HIV/AIDS
va chi mdi co 28,9% so cd sd co san tai lieu
hu'dng dan
tu*
van HIV
tiX
nguyen va 61,0% co tai
lieu hu'dng dan tu' van lay truyen tir me sang
con.
Chu'dng trinh phong chong HIV/AIDS doi hdi
cac

cC
sd y te tham gia phai bao cao ket qua
hoat dpng ca ve
tif
van va dieu trj song sd cd sd
du'dc cung cap bieu mau
ciia
chu'dng trinh cung
chi mdi dat 2,0% vdi tu' van HIV
tir
nguyen va
10,4%
vdi tu' van lay truyen tir me sang con. Mac
dii
ty le cd sd thu'c hien viec chuyen giri benh
nhan la 47,3% tuy nhien chi co 7,3% du'dc phan
hoi thdng
tin
vdi tu' van
tir
nguyen va 22,7% vdi
tu"
van lay truyen tir me sang con. Oac biet, ty le
du'dc ho trd, giam sat ve chuyen mon ky thuat
dat cao nhat trong tu' van lay truyen HIV tir me
sang con cijng chi la 11,3%. Cac chi so nay
dcac
dia phUdng khac khong du'dc ho trd
ciia
Quy

Toan cau chac chan con thap hdn. Oieu nay doi
hoi cac cd quan chirc nang can tang cu'dng hoat
dpng giam sat, ho trd chuyen mon ky thuat cho
cac cd sd y te tu' de hp tham gia ti'ch
ci/c
va co
hieu qua hdn
nUa
trong cac hoat dpng
ciia
chu'dng
trinh.
Tru'dc het can phai cd cac quy dmh
ve vai tro, chirc nang nhiem
vy ciia
cac cd sd y
te tu' nhan trong chu'dng
trinh;
xay
duTng
mo hinh
to chirc chuan, dao tao can bp, cung cap bieu
mau,
tang
cu'dng
phoi hdp
cong-tu,
ho trd ky
thuat va giam sat de dam bao cac hoat dpng
dien ra theo dung yeu cau.

V. KET LUAN
Sir
tham gia
ciia
cac cd sd y te
tU
vao hoat
dpng phong chdng HIV/AIDS tai cac tinh tham
gia
nghien cu'u van con han che. Cac cd sd y te
Y HOC VIET NAM THANG 2 - SO 2/2014
tif
nhan
chii
yeu tham gia
tiX
van HIV
tu"
nguyen
(34,5%) va tu' van dy phong lay truyen HIV
tCr
me sang con
(89,1%
so phdng kham san). Chi
8,3%
cac cd sd thyc hien dirpc viec xet nghiem
ty nguyen va 29,1% cac phong kham san xet
nghiem sang Ipc HIV cho phu
ny
mang

thai.
Cong tac dieu tri
chii
yeu la
dieu
tri nhiem triing
qua du'dng sinh
due
(18,6%) va nhiem triing cd
hpi (14,4%), cac tru'dng hdp khac du'dc chuyen
giri (47,3%) va chu'a tham gia dieu tri ARV. Chi
mdi khoang tren du'di 50% cac cd sd y te
tu"
du'dc tap huan ve phong chdng HIV/AIDS va cd
san tai lieu hu'dng dan. Ty le cd sd du'dc cung
cap bieu mau, phan hoi thong tin va du'dc giam
sat ho trd ky thuat chi dat
myc
rat thap.
VI.
KHUYEN NGH!
Can tang cu'dng vai tro va nang lyc cua cac
cd sd y
tu
nhan trong phdng chong HIV/AIDS
thong qua viec quy djnh ve
chye
nang, nhiem vu,
xay dyng mo
hinh,

cung cap thong tin, cap nhat
kien
thyc
ve sang Ipc,
tu"
van ve HIV/AIDS, xay
dyng he thong bieu mlu bao cao, phdi hdp cong-
tu"
va tang cu'dng giam sat ho trd ky thuat.
TAI LIEU THAM
KHAO
1.
Bg
Y te
(2013),
Bao cao chung tong quan nganh
y te nam 2013. Nha xuat ban y hoc.
£
Tran Thj Mai Oanh va cong su' (2013), Danh
gia thyc trang va de xuat giai phap nham
tSng
cu'dng phoi
hop cong
tiT
trong
ITnh
vyc y te.
Viln
Chien
luoc

va chinh sach y te.
J.
Uy ban thu'dng vu Quoc hoi, Phap lenh ve
hanh nghe y
dUtfc
tu"
nhan. 2003.
4. Harvard School of Public Health (2009). An
Overview of Public Private Partnerships in Health.
5. Sheikh, K., et al. (2005). Urban private
practitioners; potential partners in the care of
patients with HIV/AIDS.
Natl
Med J India,18(l); p.
32-5.
6. Toan K Tran et al. (2012). Factors associated
with
antenatal care adequacy in rural and urban
contexts - results from two health and
demographic surveillance sites in Vietnam. BMC
Health Services Research,
12:40
7. UNAIDS (2013). UNAIDS report on the global
AIDS epidemic 2013.
RAN DOC VA DOC TO CUA CAC LOAI RAN DOC TAI VIET NAM
Trinh Xuan Kiem*, Tran Thj Ngan**, Le KhSc Quyen*
TOM TAT
RSn
dpc gay nan cho ngu'di van dang la van de y
hoc ton tai d cac

nirdc
nhiet ddi dang phat trien
nhU
Viet Nam. Tuy nhien, ran dgc
d5c trung
cho moi viing
dja ly khac nhau. Can du'dc nghien
ciru,
phan
loai,
xac
djnh chirc nang sinh hpc, dpc hpc cac loai
rSn
dpc co
tam quan trpng y hpc tai moi quoc gia. Theo hu'dng
dan
ciia
To
chye
Y te
tlie
gidi (WHO) va cac chuyen
gia hang dau the
gidi,
ket qua nghien ciru da xac lap
thanh cong 2 hp ran dpc (Hp
r§n
ho va hp ran luc gom
10 loai) la nguyen nhan thu'dng xuyen gay nan cho
ngu'di tai Viet Nam, Lao va Campuchia

(Sangl).
Dong
thdi
dSc
ti'nh sinh hpc, doc hpc, dac biet lieu doc gay
chet 50%
(LDso)
cua noc
tyng
loai ran dpc da dirpc
xac djnh (Bang 2).
06 clifnh
la cO sd khoa
hgc eiia
cae
chiTdng
tnnh tiep theo, dac biet che tao huyet thanh
khang nge dac
hieu,
thiet thyc phuc vu cap
cyu
tren
lam sang.
Tu'khda:
RSn dpc va
LD50
SUMMARY
VENOMOUS SNAKES AND THEIR
TOXINSIN VIETNAM
Venomous snakes of medical importance and

snake bites are a
big
medical problem, but
it
was
neglected in tropical countries such as Vietnam.
However, snakes are characterized for each different
geographical region of the World. The method for
research was applied by WHO guidelines and
techniques of the famous international specialists. The
results,
Elapidae
and Viperidae families, content 10
species (Table 1) and their venom's biological and
toxicologica! functions
with LD50
for each venom were
established. (Table 2). The research for recognition of
the particular species of greatest medical importance is
* Vien
nghien c&u phat trien cdng nghe ndng thdn
** bai
hoc
Y
Hal phdng
*** Benh
vien Viet - Phap
TP
Hd
Chi

Minh
Phan
bi$n
khoa hgc: GS.TS Hoang VSn Lu'dng