ࡱ> uxpqrstU 4bjbjnn 4aa`.... .'     &&(&(&(&(&(&(&$(+>L& L&  &!!! R  &&! &&!!$f$ g3!2$&&0':$,+3!R+f$+f$ ! L&L&! ' + B : BNG KIM QUY TRNH T NG THNG D DY QUA MhI Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay2Dng c: ng thng Levin ng c s ca NB, gc ming,  li, bt kn, cc ng nc chn, du nhn Parafin, kp Kocher Khay ht u, tm bng, bng dnh, tm nilon, khn bng ln, khn bng nh, ti nilon, dy thun, kim bng, gng tay, bm tim 20ml, ng nghe, thng ng rc thi y t, rc sinh hot Sp xp dng c ng, y xe dng c n cnh ging NB3Chun b ngi bnh: i chiu v cho hi NB, thng bo, gii thch cho NB bit th thut sp lm, ng vin v hng dn h nhng iu cn thit  hp tcTHC HIN4 NB  t th ph hp: nm u cao hoc nng cao u ging5Chong nilon v khn bng ln ngc ca NB, t khay ht u di cm hoc cnh m.6V sinh mii hoc ming NB7St khun tay v mang gng v khun8o ng thng, nh du: o t cnh mii  di tai  mii c NB9Bi trn ng thng bng du nhn parafin10a ng thng vo d dy ng k thut: Tay thun cm ng thng cch u ng 10cm, a ng thng vo qua mii NB, ni NB h ming th u nut ng thng, nh nhng y ng thng vo theo nhp nut ti v tr  nh du.(*)11Kim tra xem ng thng vo d dy bng 1 trong 3 cch sau:(*) Cch 1: nhng u ngoi ca ng thng vo nc, nu khng c bt kh ni ln l c; Cch 2: dng bm tim bm 15-20 ml kh qua u ngoi ng thoongvaof d dy, ng thi dng ng nghe t ln vng thng v, nu nghe c ting kh lu chuyn l c; Cch 3: Dng bm tim ht qua u ngoi ng thng thy c dch d dy hoc thc n cha tiu. 12C nh ng chc chn vo m13Nt kn u ngoi ca ng thng bng gc, cho u ngoi ng thng vo ti nilon c nh di gi bng kim bng14Lau ming cho NB v gip h tr v t th tha mi15Dn NB/ ngi nh nhng iu cn thit v cm n h16Thu dn dng c tr v ni quy nh, ra tay17Ghi h s/ phiu chm scTng cng36Gim kho im t BNG KIM QUY TRNH TRUYN DCH BNG TAY Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay2Dng c: Dng c v khun: B dy truyn dch, kp Kocher, gc ming, Catheter, gng tay, khn tri khay, khay ch nht, bnh tr, ko; Dch truyn, thuc theo y lnh Dng c khc: Gi nh, dy garo, hp thuc chng shock, hp bng cn, bng dnh, phiu truyn dch, gi treo, huyt p, ng nghe, nhit k, ng h bm dy, hp ng vt sc nhn. Sp xp dng c ng, y xe dng c n cnh ging NB3Chun b ngi bnh: Thc hin 5 ng, thng bo, gii thch cho ngi bnh yn tm; o du hiu sinh tn ( thy bt thng bo ngay cho bc s)) Kim tra y lnhTHC HIN4Kim tra dch truyn (ln 2), pha thuc ( nu c), st khun nt chai5St khun tay bng cn, cm dy truyn vo chai, kha li, treo chai dch ln cc, bp cho dch chy bu m git, ui kh kha li,  kim vo khay v khun, ct bng dnh. (*)6t Nb nm thun tin, chn v tr truyn, t gi k chi di vng truyn ( nu cn)7Mang gng v khun, buc dy garo trn v tr truyn 3-5cm.8St khun v tr chc kim theo hnh xon c t trong ra ngoi ti thiu 2 ln,  kh da, st khun li u ngn tay  mang gng bng cn (*)9Mt tay cng da di vng tim, tay kia m kim chch 15-300 so vi mt da lun kim vo t)nh mch, khi thy mu tro ra hoc kim tra kim vo ng t)nh mch th tho dy garo, m kha cho dch chy, rt hng kim lun, gn dy dch sau  mi m cho dch chy.(*)10Dng gc che kim, c nh kim v dy truyn, ly dy garo v gi k chi ra.11iu chnh tc  git ng theo y lnh.(*)12Gip Nb nm tha mi, dn d v theo st ton trng Khi truyn ht dch, rt kim, st khun ch tim, bng v khun.13Thu dn dng c, tho gng, ra tay.14Ghi phiu truyn dch, ghi h sTng cng36Gim kho im t BNG KIM QUY TRNH TIM BP SU Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay2Dng c: Bm v kim tim v khun, kp Kocher, khay ch nht v khun, hn vi v khun, dao ca  ca ng thuc, gc sch  b ng thuc, bng cn, khay ht u hoc ti giy ng bng bn v v thuc Thuc tim, hp chng shock, dung dch st khun (cn 700), phiu iu tr hoc n thuc Sp xp dng c ng, y xe dng c n cnh ging NB3Gii thch cho Nb cng vic sp lm, ng vin NB, thng bo thuc tim.(*)THC HIN4Xem y lnh iu tr v phiu cho thuc (thc hin 3 kim tra  5 i chiu)5Hi xem Nb c b phn ng loi thuc no khng.6 Nb nm hoc ngi theo t th thch hp v  l vng tim.7St khun nhanh bng cn 700, chun b bm kim tim thch hp, lp kim ly thuc vo bm tim.8Ly thuc vo bm tim ng y lnh.(*) Kim tra thuc ln 2 trc khi st khun ng thuc, b ng, pha thuc( nu c) v rt  lng thuc vo bm tim; Kim tra thuc ln 3trc khi b v l hoc ng thuc i.9Thay kim  bm tim, ui kh,  mt vt ca kim theo chiu ghi s ml trn thn bm tim, che y kim, t vo khay v khun.(*)10Xc nh v tr tim:  i: 1/3 gia mt trc  ngoi i;  mng: 1/3 trn ngoi mng.11St khun v tr tim: t trong ra ngoi theo hnh xon c rng 5cm ti thiu 2 ln,  da kh mi tim (*)12St khun li cc u ngn tay bng cn13m kim nhanh: ngn ci v ngn tr tay khng thun cng da  v tr tim, tay kia cm bm tim m kim nhanh qua da vo bp tht chch gc 900 so vi mt da v su khong 2/3 kim, tay khng thun bung khi da.(*)14Ko nh nng bm tim kim tra xem c mu theo ra hay khng.(*)15Bm thuc chm: nu khng c mu ra bm tim, tin hnh bm thuc t t, quan st sc mt NB.16Rt kim nhanh: sau khi  bm ht thuc, tay khng thun chuyn ln cng ch da tim, tay thun rt kim nhanh v nh nhng, n nh bng vo v tr tim.17Gip Nb tr v t th tha mi, dn d nhng iu cn thit.18Thu dn dng c, tho gng, ra tay.19Ghi h s, phiu chm scTng cng50 BNG KIM QUY TRNH THNG TIU N Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay2Dng c: Khay dng c v khun ng: 1 kp Kocher, 1 khay ht u, 1 sng c l, 2 vi ph , 1 ng thng Foley c ph hp vi Nb( s 14-19 cho ngi ln, s 8-10 cho tr em), 1 i gng v khun, ng nghim, bm tim 10-20ml, gc bng, du nhn; Khay ng dng c sch gm: 1 kp Kocher khng mu, 1 khay ht u, 1 ti ng nc tiu, 1 tm nilon, 1 tm bng cn st khun, 1 l Betadine, 1 l nc mui sinh l, gi ng ng nghim; Dng c khc gm: bnh phong, b dt, nc x phng long, nc ung si  ngui, s y lnh. Sp xp dng c ng, y xe dng c n cnh ging NB3Chun b ngi bnh: i chiu v cho hi NB, thng bo, gii thch cho NB bit th thut sp lm, ng vin v hng dn h nhng iu cn thit  hp tc ( v sinh b phn sinh dc ngoi nu c th; hng dn ngi bnh cch ht su v rn nh  gin c tht bng quang trong qu trnh thng tiu).THC HIN4NVYT ng ca, tt qut, che bnh phong, p vi ln ngi NB, tri tm nilon di mng NB.5NB ci qun, ph vi ln i cho NB (*),  NB nm chng chn ln6Nu NB khng t lm v sinh b phn sinh dc ngoi trc : NVYT t sn b dt di mng NB, ra b phn sinh dc ngoi ca Nb bng nc x phng long hoc nc un si  ngui, ra t trn xung di, t trong ra ngoi, khi xong  nc bn i.7NVYT st khun tay, mang gng v khun.8Tri sng c l, t khay ht u v khun gia hai i NB.9t 2 ming gc ln b phn sinh dc  NVYT t ngn ci v ngn tr ca tay khng thun, tay thun dng cp gp bng st khun theo trnh t: (*) Ln 1: St khun 2 bn mi ln; Ln 2: St khun 2 mi b; Ln 3: St khun l tiu ( st khun theo 1 chiu t trn xung di).10Bi du nhn vo u ng thng khong 5-7 cm, dng kp kp ng thng  trc ngnh i ca ng.11Dng 2 ngn tay bc l l tiu, nh nhng a ng thng qua l tiu khong 4-5 cm n khi c nc tiu chy ra.12Nu cn ly nc tiu xt nghim: b nc tiu u bi, ly nc tiu vo ng nghim; Nc tiu cn li cho chy vo khay ht u cho n ht; Ghi r thng tin ln ng nghim ( h tn NB, khoa iu tr, s ging, s bung), t ng nghim vo gi ng ng nghim.13Lu ng thng: a ng thng vo thm 3-5cm, kha kp li, ly nc mui sinh l vo bm tim ( s lng ty theo kch c ca ng thng Foley), b kp v tin hnh bm bng chn. Sau  ni u ng thng vi ti cha nc tiu, treo ti vo pha di thnh ging. (*)14Ghi h s/ phiu chm scTng cng34 BNG KIM QUY TRNH X TR SC SA Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101Cc dng c cp cu lun trong trng thi sn sng  s dng: Dng c ht nht ph hp ( my ht nht s sinh hoc ng ht nht c bu); Bng hi sc km mt n sch v ph hp vi cn nng ca tr; ng nghe.THC HIN2Xc nh ngay tnh trng sc sa  tr nh.3Ngay khi pht hin b b sc sa, t b nm sp trn cng tay v bn tay tri hoc trn i ca bn, u thp hn thn.(*)4Dng bn tay phi v vo lng tr ngay khong gia 2 vai5Nu cn tc `b~ & 4 n < F H J Z \ @yj[yj[j[j[j[j[j[j[jh@\h4$CJOJQJaJh@\hbCJOJQJaJhlhb5CJOJQJaJhlh4$5CJOJQJaJh4$CJOJQJaJhh@CJOJQJaJh4$h4$CJOJQJaJh4$hh@CJOJQJaJhlhh@5CJOJQJaJhh@hr 5CJ OJQJaJ hh@hh@5CJ OJQJaJ b z & n t $$Ifa$gdlgdh@ $xa$gdh@ ^SSSSS $Ifgd@\kd$$IflF! &t t06    44 lapyt@\ > .## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\> @ B D $Ifgd@\D F J \ .## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\\ @ "$ $Ifgd@\ & F$If^`gd@\@@&(*RdpNXZ\2<@B ַ֛֏֛֏֛֏֛֏֛֏֛֏֛֏t֛th1>CJOJQJaJh@\hCJOJQJaJhCJOJQJaJh ~CJOJQJaJ-$&*f.## $Ifgd@\kdM$$Iflr! X"$&t777 t0644 lap2yt@\fhjl $Ifgd@\lnp.## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\ $Ifgd@\ .## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\   $Ifgd@\.## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\ $Ifgd@\.## $Ifgd@\kdy$$Iflr! X"$&t777 t0644 lap2yt@\ $Ifgd@\P.## $Ifgd@\kdD$$Iflr! X"$&t777 t0644 lap2yt@\PRTV $Ifgd@\VX\.## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\ $Ifgd@\4.## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\468: $Ifgd@\:<B.## $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\ $Ifgd@\.## $Ifgd@\kdp $$Iflr! X"$&t777 t0644 lap2yt@\6vz>@HLNr|\fjl&*,.468;ܾܾܾylhl5CJOJQJaJh4$5CJOJQJaJh CJOJQJaJhp8PCJOJQJaJh1>CJOJQJaJh4$CJOJQJaJ)6>@BDF $Ifgd@\ & F$If^`gd1>FHN,!! $Ifgd@\kd; $$Ifle r! X"$&t777 t0644 lap2ytp8P $Ifgd@\t.## $Ifgd@\kd $$Iflr! X"$&t777 t0644 lap2yt@\tvxz $Ifgd@\z|.## $Ifgd@\kd $$Iflr! X"$&t777 t0644 lap2yt@\ $Ifgd@\^.## $Ifgd@\kd $$Iflr! X"$&t777 t0644 lap2yt@\^`bd $Ifgd@\dfl.## $Ifgd@\kdk $$Iflr! X"$&t777 t0644 lap2yt@\ $Ifgd@\.## $Ifgd@\kd6$$Iflr! X"$&t777 t0644 lap2yt@\   $Ifgd@\.# $Ifgd@\kd$$Iflr! X"$&t777 t0644 lap2yt@\&,.68:<PIIBBxgdA gdh@kd$$IflF! &t t06    44 lapyt#$$Ifa$gd @BDFHJLNPRTVXZ\^T& !t!!gdl $xa$gd?[xgdA 8^n !F!t!!!!!""#####N%P%%%%%&&&'''.':''':)H))*v*ŶŶŶŶŶtŶhhh3CJOJQJaJhlhRCJOJQJaJhRCJOJQJaJhlh/CJOJQJaJh/CJOJQJaJhlCJOJQJaJhlhlCJOJQJaJhlhl5CJOJQJaJhl5CJ OJQJaJ hlhl5CJ OJQJaJ h?[5CJ OJQJaJ (!!!!!!" "PEEE $Ifgdlkd$$IflF! &t t06    44 lapytu $$Ifa$gdl """"#kd:$$Iflr! X"$&t777 t0644 lap2ytu $Ifgdl"""""" $Ifgdl"""".## $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu "##P%%%%% $Ifgdl & F$If^`gdl%%%.# $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu %%x&&'''' $Ifgdl & F$If^`gd/ $Ifgd/'''.'.## $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu .'0'2'4' $Ifgdl4'6':''.## $Ifgdlkdf$$Iflr! X"$&t777 t0644 lap2ytu '''' $Ifgdl'''<).## $Ifgdlkd1$$Iflr! X"$&t777 t0644 lap2ytu <)>)@)B) $IfgdlB)D)H)).## $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu )))) $Ifgdl))*x*.## $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu x*z*|*~* $Ifgdl~***+.## $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu v***l+++$,&,,---b.r...>/@////0(0h0t000111ʹ񙍙~nnaQhh@h=v5CJ OJQJaJ h?[5CJ OJQJaJ hlhl5CJOJQJaJhlhu CJOJQJaJhlCJOJQJaJhu CJOJQJaJhZ8JheCJOJQJaJh)XCJOJQJaJhZ8JCJH*OJQJaJhZ8JCJOJQJaJhbCJOJQJaJh3CJOJQJaJhlhlCJOJQJaJ++++ $Ifgdl+++-.## $Ifgdlkd]$$Iflr! X"$&t777 t0644 lap2ytu ---- $Ifgdl---d..## $Ifgdlkd($$Iflr! X"$&t777 t0644 lap2ytu d.f.h.j. $Ifgdlj.l.r...## $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu .... $Ifgdl...,! $Ifgdlkd$$IflOr! X"$&t777 t0644 lap2ytu .@///// $Ifgdl & F$If^`gdu ///0.## $Ifgdlkd$$Iflr! X"$&t777 t0644 lap2ytu 000 0 $Ifgdl 0"0(0j0.## $IfgdlkdX$$Iflr! X"$&t777 t0644 lap2ytu j0l0n0p0 $Ifgdlp0r0t0.# $Ifgdlkd#$$Iflr! X"$&t777 t0644 lap2ytu t00001111PIIBBxgdA gdlkd$$IflF! &t t06    44 lapytu $$Ifa$gdl11111111111111111111122~3,4 5x5gd=v $xa$gd?[xgdA 122$2*4x55556J6N6`677"888888>99÷ҷҷqeXeIhGhGCJOJQJaJhGCJH*OJQJaJhGCJOJQJaJh2/h2/CJOJQJaJh2/CJOJQJaJhCJOJQJaJhhCJOJQJaJhh5CJOJQJaJh=vCJOJQJaJh4$h=vCJOJQJaJhlh=v5CJOJQJaJhh@h=v5CJ OJQJaJ h5CJ OJQJaJ x5566@6J6L6N6I> $Ifgdkd$$IflF! &t t06    44 lapytG$$Ifa$gdgd=vN6`6d6h6l6 $Ifgdl6n6r66.## $Ifgdkd\$$Iflr! X"$&t777 t0644 lap2ytG6666 $Ifgd6667.## $Ifgdkd' $$Iflr! X"$&t777 t0644 lap2ytG78>99999 $Ifgd & F$If^`gdG & F$If^`gd2/999P:\:p:|:; ;~;;<<<<J<L<<<<<<*=,=T=>:>>>>?֭֞⒆viZhh3CJOJQJaJh36CJOJQJaJh3h36CJOJQJaJhCJOJQJaJh3CJOJQJaJhI3hCJOJQJaJhI3CJH*OJQJaJh56CJOJQJaJhh5CJOJQJaJhI3CJOJQJaJhhCJOJQJaJhhGCJOJQJaJ999.# $Ifgdkd $$Iflr! X"$&t777 t0644 lap2ytG9R:T:V:X: $Ifgd & F$If^`gdX:Z:\:p:.## $Ifgdkd!$$Iflr! X"$&t777 t0644 lap2ytGp:r:t:v: $Ifgdv:x:|:;.## $Ifgdkd"$$Iflr! X"$&t777 t0644 lap2ytG;;;; $Ifgd;; ;;.## $IfgdkdS#$$Iflr! X"$&t777 t0644 lap2ytG;;;; $Ifgd;;;<.## $Ifgdkd$$$Iflr! X"$&t777 t0644 lap2ytG< < << $Ifgd<<<<.## $Ifgdkd$$$Iflr! X"$&t777 t0644 lap2ytG<<<< $Ifgd<<<,=.## $Ifgdkd%$$Iflr! X"$&t777 t0644 lap2ytG,=>>>>> $Ifgd & F$If^`gd3>>>?.## $Ifgdkd&$$Iflr! X"$&t777 t0644 lap2ytG???? $Ifgd???.# $Ifgd56kdJ'$$Iflr! X"$&t777 t0644 lap2ytG??????4@V@X@`@d@f@A.## $Ifgdkd($$Iflr! X"$&t777 t0644 lap2ytG>A@ABADA $IfgdDAFALA,! $Ifgdkd($$IflOr! X"$&t777 t0644 lap2ytGLAAAAA $Ifgd & F$If^`gdAAAXC.## $Ifgdkd)$$Iflr! X"$&t777 t0644 lap2ytGXCZC\C^C $Ifgd^C`CfCC.## $Ifgdkdz*$$Iflr! X"$&t777 t0644 lap2ytGCCCC $IfgdCCCC.## $IfgdkdE+$$Iflr! X"$&t777 t0644 lap2ytGCCCC $IfgdCCDD.## $Ifgdkd,$$Iflr! X"$&t777 t0644 lap2ytGDDDD $IfgdDDDE.## $Ifgdkd,$$Iflr! X"$&t777 t0644 lap2ytGDDDrEEEFF FFFFFFFFFFFG&G(G7y$$Ifa$gdKLLLL#kd@2$$Iflr! X"$&t777 t0644 lap2yt>7y $IfgdKL"LLLLL $IfgdKLLL.# $IfgdKkd 3$$Iflr! X"$&t777 t0644 lap2yt>7yLLN PP6Q8Q:QQBQS.## $IfgdKkd3$$Iflr! X"$&t777 t0644 lap2yt>7ySSSS $IfgdKSSSS.## $IfgdKkd4$$Iflr! X"$&t777 t0644 lap2yt>7ySSSS $IfgdKSSST.## $IfgdKkdl5$$Iflr! X"$&t777 t0644 lap2yt>7yTTTT $IfgdKTTTU.## $IfgdKkd76$$Iflr! X"$&t777 t0644 lap2yt>7yUUUU $IfgdKUU UW.## $IfgdKkd7$$Iflr! X"$&t777 t0644 lap2yt>7yVWWW WnWxWzW|WWWWX XY&Y(YfYhYY*Z,Z4Z8Z:ZZ[[[[[[[\\\]].]]^ٵ͵َvjhCJOJQJaJhm bCJOJQJaJhhCJOJQJaJh>tCJOJQJaJh@\hKCJOJQJaJh;CJOJQJaJhKCJOJQJaJhiCJOJQJaJhVeKCJOJQJaJhA CJOJQJaJh@\hA CJOJQJaJh>7yCJOJQJaJ(WWWW $IfgdKWW WpW.## $IfgdKkd7$$Iflr! X"$&t777 t0644 lap2yt>7ypWrWtWvW $IfgdKvWxW|WW.## $IfgdKkd8$$Iflr! X"$&t777 t0644 lap2yt>7yWWWW $IfgdKWWX(Y.## $IfgdKkdc9$$Iflr! X"$&t777 t0644 lap2yt>7y(YhYY,Z.Z0Z2Z $IfgdK & F$If^`gdK2Z4Z:ZZ.## $IfgdKkd.:$$Iflr! X"$&t777 t0644 lap2yt>7yZZZ[ $IfgdK[[[[.## $IfgdKkd:$$Iflr! X"$&t777 t0644 lap2yt>7y[[[[ $IfgdK[[[,! $IfgdKkd;$$Ifl~r! X"$&t777 t0644 lap2yt>t[\] ^ ^^^ $IfgdK & F$If^`gd>t^ ^^^^6_(`0`:`>`@`r`~`````````aaǻǯǓyl\O\?hlh;U5CJOJQJaJhgs5CJ OJQJaJ hh@h;U5CJ OJQJaJ h?[5CJ OJQJaJ h;U5CJ OJQJaJ hi5CJOJQJaJh 7y5CJOJQJaJhiCJOJQJaJh7{sCJOJQJaJhCJOJQJaJh@\h>7yCJOJQJaJh>7yCJOJQJaJh@\hA CJOJQJaJh@\hhCJOJQJaJ^^^2`.## $IfgdKkd<$$Iflr! X"$&t777 t0644 lap2yt>7y2`4`6`8` $IfgdK8`:`@`t`.## $IfgdKkd^=$$Iflr! X"$&t777 t0644 lap2yt>7yt`v`x`z` $IfgdKz`|`~`.# $IfgdKkd)>$$Iflr! X"$&t777 t0644 lap2yt>7y~`````````PFFFFF $xa$gd;Ukd>$$IflF! &t t06    44 lapyt>7y$$Ifa$gdK````````````aavb$cdpdd ee8eBe$$Ifa$gd#Ogd;U $xa$gd;Ua"cpdddd eBeFeXeje gg,g4g6g8gxggggggh8hhhhhiiii6idnpr:DFH~ƺƺƮƺƢƺƢƺƺƺƺƺƺ庑ƺh@\h mCJOJQJaJUhaVCJOJQJaJhx'CJOJQJaJh mCJOJQJaJh@\h;UCJOJQJaJhlh;U5CJOJQJaJh;UCJOJQJaJh4$h;UCJOJQJaJ5BeDeFeXe\e`ede^SSSSS $Ifgd#Okd?$$IflF! &t t06    44 lapyt#Odefejee.## $Ifgd#Okdb@$$Iflr! X"$&t777 t0644 lap2yt#Oe~ffgggg $Ifgd#O & F$If^`gd;Uggg,g.## $Ifgd#Okd-A$$Iflr! X"$&t777 t0644 lap2yt#O,g.g0g2g $Ifgd#O2g4g8gg.## $Ifgd#OkdA$$Iflr! X"$&t777 t0644 lap2yt#Ogggg $Ifgd#Ogggh.## $Ifgd#OkdB$$Iflr! X"$&t777 t0644 lap2yt#Ohhhh $Ifgd#Ohhhi.## $Ifgd#OkdC$$Iflr! X"$&t777 t0644 lap2yt#Oiiii $Ifgd#Oiii.## $Ifgd#OkdYD$$Iflr! X"$&t777 t0644 lap2yt#Onghn: kp b gia hai bn tay v hai cng tay, u thp hn thn  chuyn t sp sang nga, dng 2 ngn tay ( tr v gia) n 5 ln vo v tr di im ct ca ng ni 2 nm v vi ng gia c mt khot ngn tay.(*)6Quan st mii, hng thy c sa th lau sch, c th lp li bc 4,5 nu cn.7 Trong sut qu trnh cp cu phi nh gi tr, nu ngng tim ngng th th tin hnh hi sc ngay.8Tuyn x: chuyn tuy khi tr  th c; Tuyn huyn: x tr cc bin chng km theo v chuyn tuyn nu vt qu kh nng iu tr hoc tnh trng ca b khng ci thin sau 2 ngy iu tr; Tuyn tnh v trung ng: h tr h hp khi cn v iu tr cc bin chng nng km theo.9Thng bo cho b m v gia nh tnh hnh sc khe ca b v hng dn nhng iu cn thit  hp tc trong qu trnh theo di v chm sc tr.10Thu dn dng c, ra tay, ghi h s/ phiu chm sc.Tng cng24 BNG KIM QUY TRNH C NH GY KN XNG CNG TAY Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay. Cn chun b mt ngi ph.2Dng c: 2 np c chiu di ph hp; 3 dy buc bn to; Bng lt, bng tam gic hoc dy treo tay; Thuc cp cu; Phiu chuyn thng.3Nhn nh tnh trng ngi bnh, chi gy. Gii thch , ng vin, traansan v hng dn NB ngi tay lnh  tay au. Cng tay gp vung gc vi cnh tay.THC HIN4Hng dn ngi ph: ng i din, 1 tay  khuu, 1 tay  c tay, bn tay nga, va ko va quan st NB.5t 1 np t np gp khuu n ht lng bn tay.6t 1 np t qu khuu tay n ht mu bn tay.7n bng hp l: c tay, khuu tay, u np, vng xng li.8Buc 1 v tr trn  gy9Buc 1 v tr di  gy10Buc 1 v tr ngang bn tay11Treo tay Nb trc ngc bng khn tam gic hoc dy treo ( qua vng c)  t th c nng ( ngn tay cao hn khuu).12 Kim tra tun hon ca tay.13Thng bo s b tnh trng bnh v hng dn NB/ngi nh hng x tr tip theo.14Ghi h s/ phiu chm sc hoc phiu chuyn thng.Tng cng28 BNG KIM QUY TRNH C NH GY KN XNG I Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay. Cn chun b mt ngi ph.2Dng c: Np 3 ci (c chiu di,  cng ph hp vi NB); Bng cun to bn, bng hoc m lt, dy buc; Thuc cp cu; Phiu chuyn thng.3Nhn nh tnh trng ngi bnh, chi gy. Gii thch , ng vin, trn an v hng dn NB  hp tc.THC HIN4Nb nm trn mt phng cng. Hng dn ngi ph: Ngi ph 1: hai tay  trn v di  gy; Ngi ph 2: mt tay  gt chn, mt tay gi bn chn vung gc vi cng chn v ko lin tc theo trc ca chi bng 1 lc khng i trong sut thi gian tin hnh k thut.5t 3 np: 1 np di: t bn chn n gai chu trc trn; 1 np trong: t bn n qu gt chn; 1 np ngoi: t nch n qu gt chn.6n bng hp l: mt c chn, u np, vng xng li.7Buc 7 v tr bng dy to bn theo th t:(*) 1 v tr trn  gy; 1 v tr di  gy; 1 v tr ngang hng; 1 v tr ngang khp gi; 1 v tr ngang ngc; 1 v tr trn c chn 1 v tr bng s 8 c nh bn chn vung gc vi cng chn.8C nh 2 chn vo nhau ti 3 v tr (1 ngang 2 i, 1 ngang 2 u gi v 1 ngang 2 c chn).9Kim tra tun hon ca chi, tnh trng NB10Thng bo s b tnh trng bnh v hng dn NB/ ngi nh hng x tr tip theo.11Ghi h s/ phiu chm sc hoc phiu chuyn thngTng cng24 BNG KIM QUY TRNH S CU VT THNG PHN MM Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay. 2Dng c: Dng c v khun: khay ch nht, kp Kocher, kp phu tch, bt ng dung dch, bng, gng tay, gc; Dung dch st khun: Nacl 0.9%, Betadine Dng c khc: tm nilon, nc x phng, khay ht u, ko, bng dnh, bng cun, phiu chm sc, x ng rc thi.3Thng bo, gii thch cho NB bit cng vic sp lm v hng dn NB hp tc.4NB nm hoc ngi tha mi ty theo v tr vt thng, ng vin NB trong sut qu trnh lm th thut.THC HIN5 Quan st v nh gi tnh trng vt thng.(*)6 Tri nilon pha di v tr vt thng hoc t cnh vt thng.7 cc dung dch st khun ra cc, mang gng tay.8 Dng kp Kocher v kp phu tch kp gc nhng vo dung dch NaCl 0.9%, ra t trong ra ngoi, rng ra xung quanh, ra nhiu ln n khi sch vt thng.(*)9St khun xung quanh vt thng bng dung dch Betadine, dng gc thm kh vt thng v xung quanh.10p gc v khun che kn vt thng11Dng bng dnh hoc bng cun  bng li ( ty v tr v tnh trng vt thng).12Gip NB tr v t th tha mi, dn d nhng iu cn thit.13Thu dn dng c, tho gng, ra tay.14Ghi h s/ phiu chm scTng cng24 BNG KIM QUY TRNH BNG CNG TAY( bng ch nhn) Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIMCHUN B2101NVYT mang trang phc y t ( o, mi, khu trang), ra tay. 2 Dng c: khay ch nht, bng cun, gc ming3Nhn nh tnh trng vt thng, gii thch mc ch cng vic sp lm, ng vin NB v hng dn nhng iu cn thit  hp tc.THC HIN4  NB  t th thch hp: NB ngi tay lnh  tay au  t th c nng ( cng tay vung gc vi cnh tay).5 p gc ln vt thng (*)6Bng vng kha bt u t c tay.7 Bng ch nhn kn cng tay ( ng bng i chch ln trn nhng mi vng u phi gp li, ngn ci tay tri  ln ch gp, tay phi ko cun bng xung di bng kn ch cn bng).(*)8Ni di cun bng, tay phi lt cun bng ko xung v gp li. Vng sau  ln vng trc hoc 2/3, tip tc bng cho n khi che kn vt thng.9Kt thc bng 2 vng kha v c nh u bng.10Treo tay NB theo t th c nng.11Kim tra vt thng. Dn d NB nhng iu cn thit.12Thu dn dng c v ra tay.13Ghi h s/ phiu chm sc.Tng cng30 BNG KIM: K THUT HI SINH TIM PHI Cch ghi im: Ghi im theo ct, im cho mi bc thc hin c tnh nh sau: Lm ng v  theo chun mc hay hng dn : 2 Lm ng, cha  hoc lm , cha ng theo chun mc hay hng dn : 1 Lm sai hoc khng lm : 0 Nhng bc nh du (*) c nhn h s (2) H v tn th sinh:& & & & & & & & & & & & & & & & & & & & & & n v:& & & & & & & & & & & & & & & & & & & & & & & & & & .. TTCC BC THC HINIM210Tip nhn v nhn nh tnh trng nn nhn1a nn nhn ra khi ni b nn, quan st v nhn nh tnh trng nn nhn: Tri gic, mch, nhp th, ng tChun b dng c2Khay ch nht, hp thuc cp cu, gi3Km m ming, Canuyn Mayo,  li, kp ko li, gc, gc chn, bng Ambu (th tch 1600ml)K thut tin hnhK THUT THI NGT4t nn nhn nm nga trn nn cng, ni rng qun o,  nn nhn  t th nga c ti a5Ngi cu qu pha u nn nhn, dng km m ming6t gc chn vo gia 2 hm rng pha gc hm.7t u nn nhn nghing sang 1 bn, dng gc qun vo ngn tay, mc ht m ri, d vt trong ming nn nhn, t canuyn Mayo (trng hp nn nhn b tt li). B con chn,  u nn nhn v t th nga thng8Ngi cu qu ngang vai nn nhn, 1 tay t ln trn ngn tr v ngn ci bt mii nn nhn khi thi vo, 1 tay t trn cm  m ming nn nhn9Ngi cu ngm ming ht su ri p ming vo ming nn nhn thi mnh, quan st lng ngc nn nhn10Ngng u ly hi cho ln thi sau ng thi b tay bt mii ra11Tip tc thi nh trn vi tn s 16 - 18 ln/1pht cho ngi ln, 20 - 25 ln/1pht cho tr em12Thng xuyn theo di nhp th, sc mt, mch, ng t ca nn nhnK THUT BP BNG AMBU4t nn nhn nm nga trn nn cng, ni rng qun o,  nn nhn  t th nga c ti a5Ngi cu qu pha u nn nhn, dng km m ming6t gc chn vo gia 2 hm rng pha gc hm.7t u nn nhn nghing sang 1 bn, dng gc qun vo ngn tay, mc ht m ri, d vt trong ming nn nhn, t canuyn Mayo (trng hp nn nhn b tt li)8Nga c nn nhn ti a v nng hm ln9p cht mt n quanh ming v mii nn nhn (nu 2 ng: 1 ngi qu pha u nn nhn gi mt n, 1 ngi qu ngang u bp bng)10u tin bp bng nhanh 2 nhp lin tip, mi ln 2 giy  kp thi cung cp oxy cho nn nhn11Ch cho ngc xp hn xung bp bng tip vi tn s 10-12 ln/pht (bp bng vi th tch kh lu thng 400 - 600 ml, i vi ngi ln)12Thng xuyn theo di nhp th, sc mt, mch, ng t ca nn nhnK THUT P TIM NGOI LNG NGC4t nn nhn nm nga t th thun tin5Ngi cu qu ngang ngc bn phi nn nhn6t gc bn tay chng ln nhau  1/3 di xng c, dng sc n mnh ln ngc nn nhn, sau  nng nh tay cho lng ngc phng ln (vi tr em dng mt bn tay)7n nhp nhng nh trn vi tn s 60 - 80 ln/pht vi ngi ln, 90 - 100 ln/pht vi tr em8Thng xuyn theo di sc mt, mch, ng t ca nn nhnHI SINH TIM PHI (phi hp thi ngt v p tim) Phng php 1 ngi8Ngi cu qu ngang vai nn nhn, phi hp nhp nhng thi ngt 1 ln v p tim 15 ln hoc thi ngt 2 ln, p tim 30 ln9Thng xuyn theo di mch, nhp th, ng t ca nn nhn v kin tr thc hinPhng php 2 ngi8Ngi th nht qu bn cnh nn nhn, ngang vng u  thi ngt9Ngi th 2 qu bn i din ngang vi vng ngc thc hin k thut p tim ngoi lng ngc10Phi hp nhp nhng, thi ngt 1 ln p tim 15 ln hoc thi ngt 2 ln p tim 30 ln11Thng xuyn theo di mch, nhp th, ng t ca nn nhn v kin tr thc hin  $Ifgd#Of.## $Ifgd#Okd$E$$Iflr! X"$&t777 t0644 lap2yt#Ofhjl $Ifgd#Olnr.# $Ifgd#OkdE$$Iflr! X"$&t777 t0644 lap2yt#Or<>@B $Ifgd#O$If^gd mBDH.# $Ifgd#OkdF$$Iflr! X"$&t777 t0644 lap2yt#OH $Ifgd#O & F$If^`gd m.## $Ifgd#OkdG$$Iflr! X"$&t777 t0644 lap2yt#O$0DFHJLTd*P~ɼ墒ufuuVGVGh@\hYCJOJQJaJhlhY5CJOJQJaJh4$hgsCJOJQJaJhlhgs5CJOJQJaJhgs5CJ OJQJaJ hh@hgs5CJ OJQJaJ hY5CJ OJQJaJ h;U5CJOJQJaJhgs5CJOJQJaJh HLNP8BFHz噥hyVCJOJQJaJhCJOJQJaJh>CJOJQJaJh2bCJOJQJaJhlhY5CJOJQJaJhCJOJQJaJh@\hYCJOJQJaJhYCJOJQJaJ7 $Ifgd#O.# $Ifgd#Okd#L$$Iflr! X"$&t777 t0644 lap2yt#O&L $Ifgd#O & F$If^`gdY$If^gdY *.## $Ifgd#OkdL$$Iflr! X"$&t777 t0644 lap2yt#O*,.0 $Ifgd#O024H.## $Ifgd#OkdM$$Iflr! X"$&t777 t0644 lap2yt#OHJLN $Ifgd#ONPT,.## $Ifgd#OkdN$$Iflr! X"$&t777 t0644 lap2yt#O,.02 $Ifgd#O248.## $Ifgd#OkdOO$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O.## $Ifgd#OkdP$$Iflr! X"$&t777 t0644 lap2yt#O  $Ifgd#O  .## $Ifgd#OkdP$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O.## $Ifgd#OkdQ$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O.# $Ifgd#Okd{R$$Iflr! X"$&t777 t0644 lap2yt#O   $Ifgd#O $Ifgd> L,!! $Ifgd#OkdFS$$Ifl+r! X"$&t777 t0644 lap2yt>LNPR $Ifgd#ORTZ@.## $Ifgd#OkdT$$Iflr! X"$&t777 t0644 lap2yt#O@BDF $Ifgd#OFHN,! $Ifgd#OkdT$$Ifl~r! X"$&t777 t0644 lap2yt#ON $Ifgd#O$If^gd:.## $Ifgd#OkdU$$Iflr! X"$&t777 t0644 lap2yt#O:<>@ $Ifgd#O@BH.## $Ifgd#OkdzV$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O.# $Ifgd#OkdEW$$Iflr! X"$&t777 t0644 lap2yt#O8PFFFF $xa$gdyVkdX$$IflF! &t t06    44 lapyt#O$$Ifa$gd#O68TZ Dz~LZ,.tvƶƶ|||ppppa|UhTCJOJQJaJh@\hDCJOJQJaJhDCJOJQJaJh@\hyVCJOJQJaJhyVCJOJQJaJh4$hyVCJOJQJaJhlhyV5CJOJQJaJhh@hyV5CJ OJQJaJ hyV5CJ OJQJaJ h@\hYCJOJQJaJhyV5CJOJQJaJh  $Ifgd#O>@F,!! $Ifgd#Okdla$$Ifl+r! X"$&t777 t0644 lap2yt#O $Ifgd#O`.## $Ifgd#Okd;b$$Iflr! X"$&t777 t0644 lap2yt#O`bdf $Ifgd#Ofhj,! $Ifgd#Okdc$$Ifl~r! X"$&t777 t0644 lap2yt#Oj~PFFFFF $xa$gdMnkdc$$IflF! &t t06    44 lapyt#O$$Ifa$gd#O4("$$Ifa$gd#OgdMn $xa$gdMn"HRTVhlpPEEEE $Ifgd#Okdd$$IflF! &t t06    44 lapyt#O$$Ifa$gd#ORVh(*"$&"$&`jln6@DFս񽮽~~~~~~hXCJOJQJaJhsCJOJQJaJh=MCJOJQJaJhPCJOJQJaJh@\hCCJOJQJaJhCCJOJQJaJh CJOJQJaJhclCJOJQJaJhlhcl5CJOJQJaJh@\hclCJOJQJaJ0ptvz#kdCe$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#Oz $Ifgd#O $Ifgdcl.# $Ifgd#Okdf$$Iflr! X"$&t777 t0644 lap2yt#O* $Ifgd#O & F$If^`gd#O$If^gd#O.## $Ifgd#Okdf$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O.## $Ifgd#Okdg$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O.## $Ifgd#Okdoh$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O.# $Ifgd#Okd:i$$Iflr! X"$&t777 t0644 lap2yt#O  $Ifgd#O$If^gd=M "&.# $Ifgd#Okdj$$Iflr! X"$&t777 t0644 lap2yt#O& $Ifgd#O$If^gdP.## $Ifgd#Okdj$$Iflr! X"$&t777 t0644 lap2yt#O  $Ifgd#O "&.# $Ifgd#Okdk$$Iflr! X"$&t777 t0644 lap2yt#O&bdfh $Ifgd#O$If^gdPhjn8.## $Ifgd#Okdfl$$Iflr! X"$&t777 t0644 lap2yt#O8:<> $Ifgd#O>@F.## $Ifgd#Okd1m$$Iflr! X"$&t777 t0644 lap2yt#O $Ifgd#O@,!! $Ifgd#Okdm$$Ifl+r! X"$&t777 t0644 lap2yt#O>HLN(,.`jl  `     2 6 H ƹ嬜pdddUh@\h8rCJOJQJaJh8rCJOJQJaJh4$h8rCJOJQJaJhlh8r5CJOJQJaJh8r5CJ OJQJaJ hh@h8r5CJ OJQJaJ hV}5CJ OJQJaJ hcl5CJOJQJaJh  $Ifgd?[$If^gd?[> @ D .# $Ifgd?[kdu$$Iflr! X"$&t777 t0644 lap2yt?[D JLNP $Ifgd?[ $Ifgd8rPRTh.## $Ifgd?[kdu$$Iflr! X"$&t777 t0644 lap2yt?[hjln $Ifgd?[npt.# $Ifgd?[kdv$$Iflr! X"$&t777 t0644 lap2yt?[tLNPR $Ifgd?[ $IfgdBhRTX.# $Ifgd?[kdhw$$Iflr! X"$&t777 t0644 lap2yt?[X $Ifgd?[ $IfgdBh.# $Ifgd?[kd3x$$Iflr! X"$&t777 t0644 lap2yt?[ $Ifgd?[$If`gdBh.# $Ifgd?[kdx$$Iflr! X"$&t777 t0644 lap2yt?[bdfh $Ifgd?[ $IfgdBhhjn.## $Ifgd?[kdy$$Iflr! X"$&t777 t0644 lap2yt?[ $Ifgd?[.## $Ifgd?[kdz$$Iflr! X"$&t777 t0644 lap2yt?[ $Ifgd?[ R,!! $Ifgd?[kd_{$$Ifl+r! X"$&t777 t0644 lap2yt?[RTVX $Ifgd?[XZ`.## $Ifgd?[kd.|$$Iflr! X"$&t777 t0644 lap2yt?[ $Ifgd?[,!! $Ifgd?[kd|$$Ifl~r! X"$&t777 t0644 lap2yt?[ $Ifgd?[T,!! $Ifgd?[kd}$$Ifl~r! X"$&t777 t0644 lap2yt?[TVXZ $Ifgd?[Z\^,! $Ifgd?[kd~$$Ifl~r! X"$&t777 t0644 lap2yt?[^rxz|~PIIIIIgdh@kdf$$IflF! &t t06    44 lapyt?[$$Ifa$gd?[RL $d$Ifa$gd1d$d$Ifa$gd1dgd1d $a$gd1dgdh@zLr "$&(Ƨ|||gP?gP-#h1dB*CJOJPJQJaJph h1dh1dCJOJPJQJaJ,h1dh1d5B*CJOJPJQJaJph)h1dh1dB*CJOJPJQJaJphh1dCJOJQJaJh4$h1dCJOJQJaJhlh1d5CJOJQJaJ=h1dhl5B*CJOJPJQJaJfHphq =hCbh1d5B*CJOJPJQJaJfHphq 4h1dB*CJOJPJQJaJfHphq  "$6%$d$Ifa$gd1dkd$$If4+Fr- 'FFF  t0l(6    34B` ab pytV}$&*.248z~FfPFfFfx$d$Ifa$gd1dFf $d$Ifa$gd1d(*,.0248>HJ  !!D"F"########$$*%,%%%&&J'L'`(b(0)2)V*X****6+@+B+++ǰ,h1dh1d5B*CJOJPJQJaJph h1dh1dCJOJPJQJaJ#h1dB*CJOJPJQJaJph)h1dh1dB*CJOJPJQJaJphE  >BFHJNFfFfFf(Ff$d$Ifa$gd1dN z~ FfFfDFfءFfl$d$Ifa$gd1d      !!!!!!:">"B"D"F"L" ########Ff`FfFfFf$d$Ifa$gd1d###########$$$$$$ %$%(%*%,%0%%%%FfFfFf8Ff̹$d$Ifa$gd1d%%%%&&&&&&@'D'H'J'L'P'V(Z(^(`(b(h(&)*).)0)FfFfTFfFf|$d$Ifa$gd1d0)2)8)L*P*T*V*X*^*******6+:+>+@+B+F+++++FfxFfFf$d$Ifa$gd1dFf,++++,,,, ,P-T-X-Z-\-`-.".&.(.*.......Ff,FfFfP$d$Ifa$gd1dFf+,,Z-\-(.*..../// /"/&/L/X/Z/^0`0111<1H1J11122d3f3444®vvfh 1B1F1H1J1N1111111222222Z3^3b3d3FfFf,Ff$d$Ifa$gd1dFfTd3f3l3444444gdh@Ffp$d$Ifa$gd1dFf 21h:ph@/ =!n"n#n$n% $$If!vh#v#vt#v:V l t0655t5pyt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V le t0655t57p2ytp8P$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v7:V l t0655t57p2yt@\$$If!vh#v#vt#v:V l t0655t5pyt#$$If!vh#v#vt#v:V l t0655t5pytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V lO t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v7:V l t0655t57p2ytu $$If!vh#v#vt#v:V l t0655t5pytu $$If!vh#v#vt#v:V l t0655t5pytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V lO t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v7:V l t0655t57p2ytG$$If!vh#v#vt#v:V l t0655t5pytG$$If!vh#v#vt#v:V l t0655t5pyt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l~ t0655t57p2yt>t$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v7:V l t0655t57p2yt>7y$$If!vh#v#vt#v:V l t0655t5pyt>7y$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l~ t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l+ t0655t57p2yt>$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l~ t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l+ t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l~ t0655t57p2yt#O$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l+ t0655t57p2yt#O$$If!vh#v#vt#v7:V l t0655t57p2yt#O$$If!vh#v#vt#v7:V l~ t0655t57p2yt#O$$If!vh#v#vt#v7:V l~ t0655t57p2yt#O$$If!vh#v#vt#v7:V l~ t0655t57p2yt#O$$If!vh#v#vt#v:V l t0655t5pyt#O$$If!vh#v#vt#v:V l t0655t5pyt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l+ t0655t57p2yt?[$$If!vh#v#vt#v7:V l t0655t57p2yt?[$$If!vh#v#vt#v7:V l~ t0655t57p2yt?[$$If!vh#v#vt#v7:V l~ t0655t57p2yt?[$$If!vh#v#vt#v7:V l~ t0655t57p2yt?[$$If!vh#v#vt#v:V l t0655t5pyt?[T$$Ifr!vh#v#v#v:V 4+  t0l(6++,555/ / / / 34 B` apytV}$$Ifr!vh#v#v#v#v#v:V 4/  t20l(6?++,55555/ / / / 34 ` ap2yt1dkds$$If4/rr- "$'  t20l(6?34` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdY$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdŒ$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd1$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd $$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdu$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdM$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd%$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdi$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdջ$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdA$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd]$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd5$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1de$$Ifr!vh#v#v#v#v#v:V {  t20l(6?,55555/ 34 B` ap2yt1d kd$$If{rr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkdY$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1de$$Ifr!vh#v#v#v#v#v:V   t20l(6?,55555/ 34 B` ap2yt1d kd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1de$$Ifr!vh#v#v#v#v#v:V   t20l(6?,55555/ 34 B` ap2yt1d kd9$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd]$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd5$$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd $$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1da$$Ifr!vh#v#v#v#v#v:V  t20l(6?,55555/ 34 B` ap2yt1dkd $$Ifrr- "$'FFFF  t20l(6?34B` abp2yt1d s666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ OJPJQJ_HmH nH sH tH J`J 8rNormal dCJ_HaJmH sH tH DA`D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List jj 4$ Table Grid7:V0PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w<v `+@8v*19?DGV^aRH z(+45<Pat#,LTcm > D \ $fl PV4:Ftz^d<! """"%%'.'4'''<)B)))x*~*++--d.j..../0 0j0p0t01x5N6l666799X:p:v:;;;;<<<<,=>???^@>ADALAAXC^CCCCCDDEFFFFFG$G(GPGKLLLL`fj"pz & &h8>@F &bhl2 T    > D PhntRXhRXTZ^ $N #%0)+.1d346789:;=>?@ABCDEFGHIJKLMNOQRSTUVWXYZ[\]^_`bcdefghijklmnopqrsuvwxyz{|}~ !"$%&'()*+-./0123456789:;<=>?@ABCDEFGHIJKMNOPQRSUVWXYZ[\]^_`abdefghijklnopqrstuvwxyz{|}~8@0(  B S  ?_JaJPS+S,S4S5S$^%^N```_JaJPS+S,S4S5S$^%^N``` q#`^`OJPJQJ^Jo(-^`OJQJ^Jo(hHop^p`OJQJo(hH@ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoP^P`OJQJo(hH q#`8!.        edd mUyS yr r w$1dM^IV$5%x' -9- J-56K>=>1>h@v7CZ8JVeK=M#Op8PaV)X t>7y9izW{i>~C1deDbclTI3"#yVP`iaYK?[Os3;A ;U!2/lshu #=vqyXBr3R4$/L@V}eN8rCMn G``@aJaJaJaJ-  !0`XX XXX X2X6X<XFXJXUnknownG*Cx Times New Roman5Symbol3& *Cx Arial7&@Calibri?= .Cx Courier New;WingdingsA$BCambria Math"1ho'Cȇ m?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIKLMNOPQRSTUVWXYZ[\]^_abcdefgijklmnovwzRoot Entry Fp]gy@Data y1TableJ+WordDocument 4SummaryInformation(`DocumentSummaryInformation8hMsoDataStoreggVS1XUG4EMKGVN==2ggItem  PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q