Mô tả cơ cấu bệnh, kết quả điều trị và một số yếu tố liên quan của người bệnh tại khoa nội thần kinh, bệnh viện trung ương quân đội 108 trong giai đoạn 2017 2021

DOI: 10.31276/VJST.64(12).15-18

Khoa hoc Y - DuOc I Y hoc lam sang

r

r

r

Mo ta co cau benh, ket qua dieu trj va mot so yeu to lien quan
cua ngiroi benh tai Khoa Noi than kinh, Benh vien Trung irong Quan doi 10$
trong giai doan 2017-2021
Le Thj Que*, Nguyen Thanh Tung, Dao Th| Thuy Ngoc, Nguyen Bi'ch Phuong, Phan Khanh Ly, Nguyen Thi Kim Ngoc

B enh vien Trung ucm g Q uan doi 108
N g a y n h a n b a i 1 2 /9 /2 0 2 2 ; n g a y c h u y e n p h an b ie n 1 6 /9 /2 0 2 2 ; n g a y n h an p h an b ie n 1 4 /1 0 /2 0 2 2 ; n g a y ch a p n h a n d a n g 1 9 /1 0 /2 0 2 2

T om tat:
Nghien ciiu diroc thyc hien nham mo ta etc cau benh, ket qua dieu trj va mot so yeu to lien quan cua ngiroi benh (NB) tai Khoa
Noi than kinh, Benh vien Trung mmg Quan doi 108 trong giai doan 2017-2021. Nghien ciru sir dung phirong phap mo ta cat ngang
trSn 9.401 NB. Ket qua cho thay, ty le NB vao dieu tri dupe phan if 3 nhom tuoi, trong do 2 nhom tuoi co ty le cao la 16-59 va >60
tuoi. Tuy nhien, tap trung chu y£u o’ nhom >60 tuoi, voi ty le lan luot cac nam tir 2017 den 2021 d£u >50. Ty le mac benh it nam
gioi qua cac nam deu cao hon nu gioi va chiem >50%. Ty le ngiroi dieu trj sir dung the bao hiem y te co xu hirong tang dan qua
cac nam (deu >90%), dac biet trong nam 2020 dat to'i 96,61%. Ty le NB thuoc nhom co chi dinh dieu trj noi khoa chiem c h u y e u
(>95%). Ngay dieu trj trung binh o’ nhom >10 ngay co xu hirong giam qua cac nam. Ty Ie NB vao Benh vien d ie u t r i c h n y e u «r
nhom tuoi tren 60. Ty le khoi, d& giam khi co chi djnh ra vien trong 5 nam nay deu dat >97% va ty le tir vong <0^% .

T irk h o a : Benh vien Trung vong Quan doi 108, Khoa Noi than kinh, mo hinh benh tat, tinh hinh dieu trj, V ie n

T h a u k in k .

C h i so p h a n loai: 3.2
flat van ffe

o ii

m in

v i p H N i pfeap a g U M pm

Doi tuemg

K h o a N o i th a n k in h th u o c V ie n T h a n k in h , B e n h v ie n T r u n g
u o n g Q u a n d o i 1 0 8 la c o s o d a o ta o t ie n s y c h u y e n n g a n h th a n

Tieu c h u d n lu a c h o n :

N B m a c b e n h l y th u o c c h u y e n n g a n h

k in h v a c a c lo p b a c s y c h u y e n k h o a 1 v a 2 c u a B e n h v ie n v o i

n o i th a n k in h d ie u tri n o i t n i, b a o g o m c a c t r u a n g h a p c o v a

b ie n c h e 5 6 g i u o n g b e n h (k h a n a n g g iu c m g b e n h c o th e th u

k h o n g c a n th ie p p h a u th u a t ta i K h o a N o i th a n k in h t h u o c V ie n

d u n g la 7 5 g i u o n g ) . K h o a d a n g tr ie n k h a i th irc h ie n c o h ie u

T h a n k in h , B e n h v ie n T r u n g u a n g Q u a n d p i 1 0 8 c o m a I C D - 1 0

q u a c a c k y th u a t c h u y e n k h o a n h u : c h u p d ia d e m c a n q u a n g , d o

tr o n g 5 n a m tir 2 0 1 7 d e n 2 0 2 1 .

Tieu c h u d n lo a i trie:

d ie n th a n k in h , c a n th ie p c h o c c a t d ia d e m q u a d a tr o n g d ie u tri

C a c b e n h k h o n g th u o c c h u y e n n g a n h

c o t s o n g th a t lu n g , b a m n a n k e o g ia n c o t s o n g c o v a c o t s 6n g

n o i th a n k in h , k h o n g c o c h a n d o a n m a b e n h tr o n g I C D - 1 0 v a

th a t lu n g , p h o n g b e d e d ie u tri c a c b e n h l y c o t s o n g ... B a c b ie t

N B t u y b o d ie u tri [2 ],

P h u c m g tien n g h ie n cwu:

g a n d a y , K h o a rat c h u y u n g d u n g c a c k y th u a t g e n tr o n g c h a n
d o a n P a r k in s o n , b ie n d o i v i p h a n t u tr o n g c a c b e n h t u m i e n n a o
t u y ... [1 ] , N g a y tut n h u n g n g a y d a u th a n h la p , d o i n g u b a c s y v a

h e t h o n g p h a n m e m q u a n l y b e n h v ie n .

Phiromg phap nghien cieu

d ie u d u o n g tr o n g K h o a d a lu o n h o a n th a n h to t n h ie m v u k h a m

ch u a b en h v a ch am so c su e k h o e ch o b o d o i v a nh an dan, dap
u n g d u p e n h u n g y e u c a u n g a y c a n g c a o c u a n g a n h y te .
V i e c x a c d in h t h u c tr a n g c a c a u b e n h , k e t q u a d ie u tri v a

1 0 0 % h o s a b e n h an lu u trir c u a

N B d ie u tri n o i tru ta i K h o a tr o n g 5 n a m tir 2 0 1 7 d e n 2 0 2 1 tren

ho

T h ie t k e n g h ie n c m : N g h i e n c u u
s o b e n h an lu u tr u tr e n h e th o n g

m o ta c a t n g a n g , h o i cixu
p h a n m e m q u an ly

benh

v ie n .

P huom g p h a p chon m au va c o m au:

m o t s o y e u t o li e n q u a n c u a N B la c a s a g iu p d in h h u a n g v a

A p d u n g p h u o n g phap

kinh

x a y d u n g k e h o a c h p h a t tr ie n c u a K h o a tr o n g g ia i d o a n b e n h

c h o n m a u to a n b o N B d ie u tri n o i tru ta i K h o a N o i th a n

v i e n t u c h u h ie n n a y . C a c ta c g ia t h u c h ie n n g h ie n c u u v a i m u c

t h u o c V ie n T h a n k in h , B e n h v i e n T r u n g u a n g Q u a n d p i 1 0 8

tie u : m o ta

co

c a u b e n h , k e t q u a d ie u tri v a m o t s o y e u t o lie n

q u a n c u a N B ta i K h o a N o i th a n k in h , B e n h v i e n T r u n g u a n g

tr o n g 5 n a m ( 2 0 1 7 - 2 0 2 1 ) , d u t ie u c h u a n v a o n g h ie n c u u
t h o n g p h a n m e m q u a n l y b e n h v ie n .

T h a i g ia n :

Q u a n d p i 1 0 8 tr o n g g ia i d o a n 2 0 1 7 - 2 0 2 1 .
‘T ac g i a lie n he: E m a il: q u e le th il0 8 @ g m a il.c o m

IttKNGHtViil Nam 64(,2) 12-2022

15

T h a n g 6 -7 /2 0 2 2 .

tren he

Khoa hoc Y - Dupe I Y hoc lam sang

tin h to a n d a m b a o c h in h x a c . K h o n g t ie t 16 t h o n g tin N B c h o

Description of the disease patterns,
treatment results and some related factors
of patients at the Department of Neurology,
Military Central Hospital 108 from 2017 to 2021
Thi Que Le*, Thanh Tung Nguyen, Thi Thuy Ngoc Dao,
Bich Phuong Nguyen, Khanh Ly Phan, Thi Kim Ngoc Nguyen

b at c u to c h u c ,

co q u a n

n a o k hac.

Ket qua
K e t q u a b i 6u d o 1 c h o th a y . N B v a o d ie u tri d u g c p h a n
th a n h 3 n h o m t u o i , tr o n g d o 2 n h o m c o ty le c a o la 1 6 - 5 9 v a
> 6 0 tu 6 i, ta p tr u n g c h u y e u cr n h o m > 6 0 tu o i. c o t y le la n l u g t
c a c n a m tir 2 0 1 7 d e n 2 0 2 1 d e u > 5 0 % .

108 M ilitary C entral H o spital
R e c e iv e d 12 S e p te m b e r 2 0 2 2 ; a c c e p te d 19 O c to b e r 2 0 2 2

Abstract:
This study aimed to describe the disease patterns,
treatment results and some related factors of patients at the

Department of Neurology, Central M ilitary Hospital 108 in
05 years from 2017 to 2021. The descriptive cross-sectional
method was used to study 9,401 patients. Results showed
the rate of patients entering treatment was classified into 3
age groups, in which 2 groups had a high rate of 16-59 and
over 60 years old. However, it is mainly in the age group
from over 60 years old, whose rates from 2017 to 2021 are
>50, respectively. The incidence in men over the years is
higher than in women and accounts for over 50%. The
percentage of patients using health insurance cards tends
to increase gradually over the years, all >90%, especially
in 2020, reaching 96.61%. The percentage of patients in
the group with indications for internal medicine treatment
accounted for the main percentage (>95%). The average
treatment day in the group >10 days tended to decrease
over the years. The percentage of patients admitted to
hospital for treatment is mainly in the age group over 60
years old. The rate of cure and reduction when indicated
for hospital discharge in 5 years reached >97% and the
mortality rate <0.5%.

T y le m a c b e n h

6 n am g io i q u a c a c n a m d e u c a o h o n n u g io i v a

c h ie m ty le > 5 0 % (b ie u d o 2 ).

N h o m N B d ie u tri s u d u n g th e b a o h ie m y t e c o x u h u o n g
ta n g d a n q u a c a c n a m v a d e u d a t > 9 0 % , d a c b ie t tr o n g n a m
2 0 2 0 d a t t o i 9 6 ,6 1 % ( b ie u d o 3 ).

96,61

Keywords: Central M ilitary Hospital 108, Department of
Neurology, disease model, Institute o f Neurology, treatment
situation.

Classification number: 3.2

■ Bao hiem
■ Dich vu

D ia d iem :

K h o a N o i th a n k in h t h u o c V ie n T h a n k in h , B e n h

v ie n T r u n g uxrng Q u a n d p i 1 0 8 .

X u ly so lieu:

S o lie u d ir g e x ir l y b a n g p h a n m e m E x c e l v a

Bieu do 3. Hinh thirc chi tra cua NB.

S P S S 2 0 .0 .

Dao dire nghien ciru
N g h ie n ciim d u g c t h u c h ie n n h a m m u c d ic h k h o a h o c v a d e
\ u a t c a i tie n c h a t lir g n g . C a c s o li e u d u g c th u th a p tr u n g th u c ,

KM OAHOC

\ ..

w m w sm m

\

Nam 64( 12) 12.2022

D a c d i 6m p h a n lo a i c h i d in h d ie u tri c u a N B g ia i d o a n 2 0 1 7 2 0 2 1 d u g c th 6 h ie n a b a n g 1. T r o n g 9 .4 0 1 N B , c h i d in h d ie u
tri n o i k h o a c h ie m t y le c h in h ( > 9 5 % ) . k e t q u a n a y p h u h g p v a i
d a c d ie m c u a c h u y e n n g a n h n o i th a n k in h .

16


Khoa hoc Y - DUtic I Y hoc lam sang

Bang 1. Phan loai chi djnh dieu trj cua NB.
\

- Nam

2017

2018

T ru n g b in h n h o m N B c o n g a y d ie u tri > 1 0 n g a y c o x u h u d n g
g ia m q u a c a c n a m , v d i t y le la n lu g t la 7 4 ,1 7 , 6 8 ,5 6 , 6 3 ,5 2 , 6 9 ,1 3

2019

2020

2621

v a 6 9 ,0 4 % (b a n g 2 ).

Diediem

n

%

n

%

n

%

n

%

n

%

Ngoai khoa

122

4,78

56

2,46

58

2,86

39

2,4

28

3,02

Noi khoa

2.431

95,22

2.217

97,54

1.968

97,14

1.584

97,6

898

96,98

Tong

2.553

100

2.273

100

2.026

100

1.623

100

926

100

K e t q u a b i l u d d 4 c h o th a y , N B c o d o t u o i 1 6 - 5 9 v a > 6 0 c o
c h i d in h d ie u tri n o i k h o a h o a n t o a n c u a c a c n a m d e u c a o h o n

Bang 2. Thai gian dieu trj.

y 8? * . , .
■ U iv ip M ig ijr )

2017

2018

2019

2020

2021

1-5

5 3

5,14

6,60

4,99

6,46

6-10

20,57

2630

29,88

25,88

24,50

>10

74,17

68,56

63,52

69,13

69,04

s o v d i c h i d in h c a n th ie p n g o a i k h o a d u g c c h u y e n s a n g d ie u trj
K e t q u a b a n g 3 c h o th ay, ty le k h o i, d o g ia m k h i c o c h i d jn h ra

n o i k h o a t i e p ta i K h o a N o i th a n k in h , B e n h v i e n T r u n g u o n g

v ie n tro n g 5 n a m tir 2 0 1 7 d i n 2 0 2 1 d l u d a t > 9 7 % . C u th e l l n lu g t

quan d o i 108.

dat: 9 8 ,2 4 ,9 7 ,9 8 , 9 7 ,4 4 ,9 8 ,7 v a 9 7 ,7 3 % , ty le tu v o n g d l u < 0 ,5 % .
B a n g 3 . K e t q u a d i e u tr j.

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Ill
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2017

|2018 |2019 j

2020

Noi khoa hoan toan

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2017

2018

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%

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K

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2.553

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100

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m

us

m

m

m

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|2021

2017

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dm
1 2019

2020

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2020

Ket qua .
* Nhom 6-15
■ Nhom I6-59

2019

2021

Da tirng can thi$p ngoai kboa
dirp’c chuyen sang noi khoa dieu
tri tiep

Bieu do 4. Moi lien quan gitra tuoi v&i chi di.nh dieu tri cua NB.
T r o n g c a c b e n h d ie u tri d u g c m a h o a t h e o m a I C D - 1 0 , c o
5 m a b e n h d u g c d ie u tri n h ie u n h a t, b a o g d m : R 5 1 ( d a u d a u ),
G 4 0 ( d o n g k in h ) , M 4 7 ( t h o a i h o a c o t s o n g ) , H 8 1 (r o i lo a n c h u c

Ban luftn

n a n g t ie n d in h ) , 163 ( n h o i m a u n a o ) ( b i e u d o 5 ). T r o n g d o , to n g

Dae diem chung

s o N B m a c c a o n h a t la m a 163 ( n h o i m a u n a o ) v o i 3 7 ,8 3 % v a
H 8 1 (r o i lo a n c h u c n a n g t ie n d in h ) v d i 3 6 ,4 8 % .

S o l u g t N B d ie u trj ta i K h o a N o i th a n k in h , B e n h v ie n
T r u n g u c m g Q u a n d o i 1 0 8 tr o n g 5 n a m t u 2 0 1 7 d e n 2 0 2 1 la
9 .4 0 1 . N B v a o d ie u trj d u g c p h a n d 3 n h o m t u o i , tr o n g d o 2
n h o m c o t y le c a o la 1 6 - 5 9 v a > 6 0 t u o i , ta p tr u n g c h ii y e u or
n h o m > 6 0 t u o i, t y l e la n l u g t c a c n a m d e u > 5 0 % . T y le

mac

b e n h d n a m g id i q u a c a c n a m d e u c a o h o n n u g id i v a

deu

c h ie m t y l e > 5 0 % . K e t q u a n a y t u o n g d o n g v d i m o t s o n g h ie n
c u u t r u d e d a y [ 3 - 5 ] . T y le N B d ie u trj n o i t n i c o s u d u n g th e
b a o h ie m y te c o x u h u d n g t a n g d a n q u a c a c n a m v a d a t c a o
n h a t la n a m 2 0 2 0 v d i 9 6 ,6 1 % . K e t q u a n a y c h o t h a y d u g c m u c
d o b a o p h u c u a th e b a o h ie m y t e td i to a n d a n . D a y la m o t

xu

h u d n g tr o n g q u a tr in h t h u c h ie n b a o h ie m y te , n g u d i b e n h

va

g i a d in h s e d u g c g ia m b d t g a n h n a n g v e c h i p h i. n h i t la

Bieu do 5. Ty le 5 benh thirong gap nhat theo ma ICD-10.

64( 12) 12.2022

b e n h d o i h o i c h i p h i ld n , k e o d a i.

17

vdi cac


Khoa hoc Y - Dupe I Y hoc lam sang

Ve tilth hinh ctieu tri

Ket lu$n

T r o n g 9 .4 0 1 N B d ir g e d ie u tri ta i K h o a N o i th a n k in h , B e n h
v i e n T r u n g u o n g Q u a n d o i 1 0 8 , n h o m ta c g i a n h a n th a y s o N B
d ie u tri n o i k h o a c h ie m t y le c h in h v a d e u d a t > 9 5 % . K e t q u a

K 6t q u a n g h ie n c u u 9 .4 0 1 N B c h o th a y , t y le N B v a o d ie u
trj c h u y 6u a n h o m tu o i 1 6 - 5 9 v a > 6 0 , tr o n g d o ta p tr u n g c h u
y 6u a n h o m tu 6 i tren 6 0 . T r o n g 5 n a m , c h ie m t y le c a o n h a t la

n a y p h u h o p v a i d a c d ie m c u a c h u y e n n g a n h n o i th a n k in h . T y
n h o m c o c h i d in h d ie u tri n o i k h o a . v a i b e n h l y h a y g a p n h a t la
le k h o i, d a , g ia m k h i c o c h i d in h ra v i e n tr o n g 5 n a m d e u d a t
> 9 7 % , Mn l u o t la 9 8 , 2 4 , 9 7 ,9 8 , 9 7 ,4 4 , 9 8 ,7 v a 9 7 ,7 3 % , t y l e tii

n h 6 i m a u n a o v a ro i lo a n c h u c n a n g t ie n d in h . T h a i g ia n d ie u
tri tr u n g b in h a n h o m >

v o n g d e u < 0 ,5 % .

10 n g a y c o x u h u a n g g ia m q u a c a c n a m .

T y le k h o i, d a , g ia m k h i c o c h i d jn h ra v ie n tr o n g 5 n a m d e u d a t
V e th d i g ia n d ie u tr i, n h o m N B ta p tr u n g c h u y e u a n h o m tir

10 n g a y tr a le n , tu y n h ie n c o x u h u a n g g ia m q u a c a c n a m v a i

> 9 7 % v a ty le tir v o n g d e u < 0 ,5 % .

t y l e la n l u o t la 7 4 , 1 7 , 6 8 , 5 6 , 6 3 ,5 2 , 6 9 ,1 3 v a 6 9 ,0 4 % . S u k h a c
b ie t b n h o m n g a y d ie u tri c o y n g h la t h o n g k e ( p < 0 ,0 5 ) .

Ve co' cau benh tat theo ICD-10
T a i V ie t N a m , v a i s u p h a t tr ie n n h a n h c h o n g c u a g i a o th o n g ,

T ir k e t q u a n e u tr e n , c h u n g t o i k h u y e n n g h i t a n g c u c m g g ia o
d u e h o t r g t u y e n tr u a c d u p h o n g v a d ie u tri b e n h l y m a 163
(n h 6 i m a u n a o ) v a H 8 1 (r o i lo a n c h u c n a n g t ie n d in h ) . D o n g
t h a i . t ie p tu c n g h ie n c u u tr o n g k h o a n g t h a i g ia n d a i h a n v a t im

c o n g n g h ie p h o a v a d o th i h o a , m o i tru em g d a n g p h a i c h iu lie n

c a c m o i lie n q u a n k h a c v a i c a c d a c d ie m d o i t u g n g n g h ie n c u u

tie p n h u n g ta c d o n g t i e u c u e . T a t c a d e u a n h h u o m g k h o n g n h o

d e c o h u a n g t o c h u c c h u y e n k h o a v a c h i d a o t u y e n v e c o n g ta c

d e n s u e k h o e v a g a y ra c a c h e lu y tr o n g c u o c s o n g . T r o n g c a c

d ir p h o n g b e n h .

b e n h d ie u tri d u g c m a h o a t h e o I C D - 1 0 , c a c ta c g ia n h a n t h a y
c o 5 m a b e n h d u g c d ie u trj n h ie u n h a t b a o g o m : R 5 1 (d a u d a u ),

TKl I lC l H U M KHA0

G 4 0 ( d o n g k in h ) , M 4 7 ( t h o a i h o a c o t s o n g ) , H 8 1 ( r o i lo a n c h ii c

[1] https:^enhvienl08.vn/gioi-thieu-khoa-noi-than-kinh.htm.

n a n g tie n d in h ) v a 163 ( n h o i m a u n a o ) . T r o n g d o , t o n g s o N B

[2] Bo Y tg (2020),

m a c c a o n h a t la m a 163 ( n h o i m a u n a o ) v a i t y l e la 3 7 ,8 3 % v a
H 8 1 (r o i lo a n c h u c n a n g tie n d in h ) veri t y le la 3 6 ,4 8 % .

Q u y i t d in h 4 4 0 0 /Q D -B Y T , n g a y 2 3 /1 0 /2 0 2 0 v i v ie c

b a n h a n h " B a n g p h a n lo a i q u d e te m a h o a b e n h ta t, n g u y e n n h a n t i t v o n g
I C D - 1 0 ’’ v a “H u o n g d a n m a h o a b e n h ta t th e o I C D - 1 0 ” ta i c a c c o s o k h a m

Mot so yeu to lien quan

T r o n g m o i li e n q u a n g iu a c a c a u b e n h c u a 5 n h o m m a c c a o
n h a t t h e o I C D - 1 0 : R 5 1 (d a u d a u ), G 4 0 ( d o n g k in h ) , M 4 7 (t h o a i
h o a c o t s o n g ) , H 8 1 (r o i lo a n c h u c n a n g t i e n d in h ) v a 163 ( n h o i

ben h , c h u a b en h .

[3] Trin Trung Dung (2007), “Tinh hinh chan thuong chi do tai nan giao
thong tai Benh vien Viet Due tir nam 2000-2004”, T a p c h i N g o a i k h o a , 1,
tr.97-102.

m a u n a o ) th i ty le m a c b e n h a n a m c a o g ia i h a n n u g ia i. S u
k h a c b ie t c o m u c y n g h ia t h o n g k e v a i p < 0 ,0 5 .
T r o n g m o i li e n q u a n g i u a c a c a u b e n h c u a 5 n h o m m a c c a o

[4] Le Ngan (2016), N g h ie n

k h o n g c o y n g h la t h o n g k e ( p > 0 ,0 5 ) .

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khoa I, Truong Dai hoc Y Dugc Can Tho.
[5] Nguyen Van Xang, Ngo Nhat Vu, Vo Dinh Hoa (2012), “Nghien cuu

n h a t t h e o I C D - 1 0 v a h in h t h u c c h i tra v i e n p h i th i a n h o m b a o
h ie m y te c a o h a n n h o m d ic h v u y te . T u y n h ie n , s u k h a c b ie t

c im tin h h in h c h a n th u o n g c o q u a n v a n d o n g

tq i K h o a C h a n th u o n g c h in h h in h B en h v ie n D o n g N a i 2 0 1 6 ,

cong tac cip cuu va dieu trj tai nan giao thong tai Khanh Hoa”, T a p
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