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ȆǼȇǿǼīȋǼǿȇǾȉǿȀȅ ǹīȋȅȈ ȉȍȃ ȈȊīīǼȃȍȃ ȉȍȃ ȋǼǿȇȅȊȇīǿȀȍȃ ǹȈĬǼȃȍȃ ȂİȜȚįȠȞȚȫIJȘȢ Ǽ.,ȈȖȠȣȡȐțȘ Ȃ. 1, ȆĮIJİȜȐȡȠȣ ǹ., ȀĮȡȐIJȗȘ Ȃ. 1, ǻȚĮȝĮȞIJȐțȘ Ǽ. 1, ȈȠȣȕĮIJȗȒ Ȅ. 1 ȃȠıȘȜİȣIJȚțȒ ȊʌȘȡİıȓĮ, ǹȞĮȚıșȘıȚȠȜȠȖȚțȩ ȉȝȒȝĮ, ȆĮȞİʌȚıIJȘȝȚĮțȩ īİȞȚțȩ ȃȠıȠțȠȝİȓȠ ǾȡĮțȜİȓȠȣ, 1ȀȜȚȞȚțȒ ǹȞĮȚıșȘıȚȠȜȠȖȓĮȢ, ȆĮȞİʌȚıIJȘȝȚĮțȩ īİȞȚțȩ ȃȠıȠțȠȝİȓȠ ǾȡĮțȜİȓȠȣ ǼȚıĮȖȦȖȒ: Ǿ ʌİȡȚİȖȤİȚȡȘIJȚțȒ ʌİȡȓȠįȠȢ șİȦȡİȓIJĮȚ ȚįȚĮȓIJİȡĮ ıIJȡİıȠȖȩȞȠȢ IJȩıȠ ȖȚĮ IJȠȣȢ ȓįȚȠȣȢ IJȠȣȢ ȤİȚȡȠȣȡȖȚțȠȪȢ ĮıșİȞİȓȢ, ȩıȠ țĮȚ ȖȚĮ IJȠȣȢ ıȣȖȖİȞİȓȢ IJȠȣȢ1. ȆȡȠȘȖȠȪȝİȞİȢ ȝİȜȑIJİȢ ıIJȚȢ ǾȆǹ ȑȤȠȣȞ įİȓȟİȚ ȩIJȚ ȠȚ ıȣȖȖİȞİȓȢ ȤİȚȡȠȣȡȖȚțȫȞ ĮıșİȞȫȞ, ȠȚ ȠʌȠȓȠȚ ȑȜĮȕĮȞ įȚİȖȤİȚȡȘIJȚțȐ ȝȚĮ ʌȡȠijȠȡȚțȒ İȞȘȝȑȡȦıȘ ȖȚĮ IJȘȞ İȟȑȜȚȟȘ IJȘȢ İʌȑȝȕĮıȘȢ, İțįȒȜȦıĮȞ ȤĮȝȘȜȩIJİȡĮ İʌȓʌİįĮ ȐȖȤȠȣȢ ıİ ıȪȖțȡȚıȘ ȝİ İțİȓȞȠȣȢ ʌȠȣ įİȞ İȓȤĮȞ ȜȐȕİȚ țĮȝȓĮ İȞȘȝȑȡȦıȘ, ĮȜȜȐ İʌȓıȘȢ ıİ ıȪȖțȡȚıȘ ȝİ İțİȓȞȠȣȢ ʌȠȣ İȓȤĮȞ ȜȐȕİȚ ȝȩȞȠ ȖİȞȚțȑȢ ʌȜȘȡȠijȠȡȓİȢ ȖȚĮ IJȘ ȡȠȣIJȓȞĮ IJȘȢ İʌȑȝȕĮıȘȢ2,3. ȉĮ ĮȣȟȘȝȑȞĮ İʌȓʌİįĮ ȐȖȤȠȣȢ țĮȚ ıȣȞĮȚıșȘȝĮIJȚțȒȢ ijȩȡIJȚıȘȢ IJȦȞ ıȣȖȖİȞȫȞ įİȞ IJȠȣȢ İʌȚIJȡȑʌȠȣȞ ȞĮ įȚĮȤİȚȡȚıIJȠȪȞ IJȘȞ ʌȜȘȡȠijȠȡȓĮ ʌȠȣ IJȠȣȢ ʌĮȡȑȤİIJĮȚ ȩıȠȞ ĮijȠȡȐ IJȘȞ țĮIJȐıIJĮıȘ IJȘȢ ȣȖİȓĮȢ IJȠȣ ĮıșİȞȠȪȢ țĮȚ įȣıȤİȡĮȓȞȠȣȞ IJȘȞ ĮʌȠIJİȜİıȝĮIJȚțȒ ıȣȞİȡȖĮıȓĮ ȝİ IJȠ ȚĮIJȡȠȞȠıȘȜİȣIJȚțȩ ʌȡȠıȦʌȚțȩ. ȅ ıțȠʌȩȢ IJȘȢ ʌĮȡȠȪıĮȢ ȝİȜȑIJȘȢ ȒIJĮȞ Ƞ ʌȡȠıįȚȠȡȚıȝȩȢ IJȠȣ ȕĮșȝȠȪ IJȠȣ ȐȖȤȠȣȢ IJȦȞ ıȣȖȖİȞȫȞ IJȦȞ ȤİȚȡȠȣȡȖȚțȫȞ ĮıșİȞȫȞ țĮȚ Ș ıȣıȤȑIJȚıȒ IJȠȣ ȝİ IJĮ įȘȝȠȖȡĮijȚțȐ ıIJȠȚȤİȓĮ IJȦȞ ıȣȖȖİȞȫȞ. Ǿ ȣʌȩșİıȘ ʌȡȠȢ įȚİȡİȪȞȘıȘ ȒIJĮȞ ȩIJȚ IJȠ ȐȖȤȠȢ IJȦȞ ıȣȖȖİȞȫȞ șĮ ȝİȚȦȞȩIJĮȞ ȝİIJȐ IJȘȞ İʌȓıțİȥȘ IJȠȣ ĮıșİȞȠȪȢ ıIJȠ ȤȫȡȠ ĮȞȐȞȘȥȘȢ.

ȊȜȚțȩ – ȝȑșȠįȠȢ: ǼʌȡȩțİȚIJȠ ȖȚĮ ȝȚĮ ʌȡȠȠʌIJȚțȒ ȝİȜȑIJȘ ȝİ one-group quasi-experimental pretest/post-test design ıİ ıȣȖȖİȞİȓȢ Ȓ ıȣȞIJȡȩijȠȣȢ IJȦȞ ȤİȚȡȠȣȡȖȚțȫȞ ĮıșİȞȫȞ ȠȚ ȠʌȠȓȠȚ ȣʌȠȕȜȒșȘțĮȞ IJȘȞ ȓįȚĮ ȘȝȑȡĮ ıİ ȤİȚȡȠȣȡȖȚțȒ İʌȑȝȕĮıȘ. ȀȡȚIJȒȡȚĮ ĮʌȠțȜİȚıȝȠȪ ȒIJĮȞ Ș ȐȡȞȘıȘ ıȣȝȝİIJȠȤȒȢ ıIJȘ ȝİȜȑIJȘ țĮșȫȢ țĮȚ Ș ĮȞİʌȐȡțİȚĮ ȖȞȫıȘȢ IJȘȢ İȜȜȘȞȚțȒȢ ȖȜȫııĮȢ. ȅȚ ıȣȝȝİIJȑȤȠȞIJİȢ ıȣȝʌȜȒȡȦıĮȞ ȑȞĮ İȡȦIJȘȝĮIJȠȜȩȖȚȠ ıȤİIJȚțȐ ȝİ IJĮ įȘȝȠȖȡĮijȚțȐ IJȠȣȢ ıIJȠȚȤİȓĮ, țĮșȫȢ İʌȓıȘȢ İȡȦIJȒșȘțĮȞ ȖȚĮ ʌȠȚȩ Įʌȩ IJĮ IJȑııİȡĮ ʌȡȠțĮșȠȡȚıȝȑȞĮ șȑȝĮIJĮ - IJȘȞ ĮȞĮȚıșȘıȓĮ, IJȘ ȤİȚȡȠȣȡȖȚțȒ İʌȑȝȕĮıȘ, IJȘȞ ȣʌȠțİȓȝİȞȘ ȞȩıȠ țĮȚ IJȠ ȝİIJİȖȤİȚȡȘIJȚțȩ ʌȩȞȠ - ĮȞȘıȣȤȠȪıĮȞ ʌİȡȚııȩIJİȡȠ. ȉȠ İʌȓʌİįȠ IJȠȣ ȐȖȤȠȣȢ İțIJȚȝȒșȘțİ ȝİ IJȘȞ țȜȓȝĮțĮ ĮȟȚȠȜȩȖȘıȘȢ ȝİIJĮȕĮIJȚțȠȪ ȐȖȤȠȣȢ: STAI – Y (State-Trait Anxiety Inventory) țĮIJȐ Spielberger, ȣʌȠțȜȓȝĮțĮ Y-1 (state) ıİ İʌȓıȘȝȘ țĮȚ įȚİșȞȫȢ ĮȞĮȖȞȦȡȚıȝȑȞȘ ȝİIJȐijȡĮıȘ ıIJȘȞ İȜȜȘȞȚțȒ ȖȜȫııĮ IJȦȞ ȁȚȐțȠȢ & īȚĮȞȞȓIJıȘ. ȉĮ ȤȡȠȞȚțȐ ıȘȝİȓĮ IJȘȢ ĮȟȚȠȜȩȖȘıȘȢ IJȠȣ ȐȖȤȠȣȢ țĮȚ IJȦȞ țĮIJĮȖȡĮijȫȞ ȒIJĮȞ Į) ȝȩȜȚȢ Ƞ ĮıșİȞȒȢ İȓȤİ ȝİIJĮijİȡșİȓ ıIJȠ ȤİȚȡȠȣȡȖİȓȠ țĮȚ ȕ) ȝİIJȐ IJȠ IJȑȜȠȢ IJȘȢ ȤİȚȡȠȣȡȖȚțȒȢ İʌȑȝȕĮıȘȢ țĮȚ ĮijȠȪ Ƞ ıȣȖȖİȞȒȢ/ıȪȞIJȡȠijȠȢ İȓȤİ İʌȚıțİijIJİȓ IJȠȞ ĮıșİȞȒ ıIJȠ ȤȫȡȠ ĮȞȐȞȘȥȘȢ. ȉĮ İʌȓʌİįĮ IJȠȣ ȐȖȤȠȣȢ ıȣȖțȡȓșȘțĮȞ ʌȡȚȞ țĮȚ ȝİIJȐ IJȘ ȤİȚȡȠȣȡȖȚțȒ İʌȑȝȕĮıȘ ȝİ Wilcoxon signed ranks test. Ǿ

ıȣıȤȑIJȚıȘ IJȠȣ İʌȚʌȑįȠȣ IJȠȣ ȐȖȤȠȣȢ ȝİ IJĮ ȤĮȡĮțIJȘȡȚıIJȚțȐ IJȦȞ İȟİIJĮȗȩȝİȞȦȞ ȑȖȚȞİ ȝİ Spearman´s rank order

correlation, Kruskal Wallis test țĮȚ Mann Whitney test. ȍȢ İʌȓʌİįȠ ıIJĮIJȚıIJȚțȒȢ ıȘȝĮȞIJȚțȩIJȘIJĮȢ ȠȡȓıIJȘțİ IJȠ p<0,05. ȍȢ İʌȓʌİįȠ țȜȚȞȚțȐ ıȘȝĮȞIJȚțȠȪ ȐȖȤȠȣȢ ȠȡȓıIJȘțİ STAI • 46 ȖȚĮ ȖȣȞĮȓțİȢ İȞȫ • 44 ȖȚĮ ȐȞįȡİȢ4. ȉĮ įİįȠȝȑȞĮ İțijȡȐȗȠȞIJĮȚ ȦȢ įȚȐȝİıȠȢ [min-max] Ȓ ʌȠıȠıIJȐ. ǹʌȠIJİȜȑıȝĮIJĮ: Ȉİ įȚȐıIJȘȝĮ IJȡȚȫȞ İȕįȠȝȐįȦȞ, ıȣȝȝİIJİȓȤĮȞ ıIJȘ ȝİȜȑIJȘ 76 ıȣȖȖİȞİȓȢ (56 ȖȣȞĮȓțİȢ, 20 ȐȞIJȡİȢ), ȘȜȚțȓĮȢ 40 [19-71] İIJȫȞ. ȅ ȕĮșȝȩȢ IJȠȣ ȐȖȤȠȣȢ STAI ȒIJĮȞ ıIJĮIJȚıIJȚțȐ ıȘȝĮȞIJȚțȐ ȣȥȘȜȩIJİȡȠȢ ʌȡȚȞ IJȘȞ İʌȑȝȕĮıȘ (57 [23-80]) ıİ ıȪȖțȡȚıȘ ȝİ ȝİIJȐ IJȘȞ İʌȑȝȕĮıȘ țĮȚ IJȘȞ İʌȓıțİȥȘ IJȠȣ ĮıșİȞȠȪȢ ıIJȠ ȤȫȡȠ ĮȞȐȞȘȥȘȢ (51 [21-77], p = 0,000008). ȀȜȚȞȚțȐ ıȘȝĮȞIJȚțȩ İʌȓʌİįȠ ȐȖȤȠȣȢ ʌĮȡĮIJȘȡȒșȘțİ IJȩıȠ ʌȡȚȞ ȩıȠ țĮȚ ȝİIJȐ IJȘȞ İʌȑȝȕĮıȘ ıİ ʌȠıȠıIJȩ 77% țĮȚ 64% IJȦȞ ȖȣȞĮȚțȫȞ țĮȚ 75% țĮȚ 40% IJȦȞ ĮȞįȡȫȞ. ȅȚ ȖȣȞĮȓțİȢ İȝijȐȞȚıĮȞ İȜĮijȡȫȢ ȣȥȘȜȩIJİȡȠ İʌȓʌİįȠ ȐȖȤȠȣȢ ıİ ıȤȑıȘ ȝİ IJȠȣȢ ȐȞIJȡİȢ, ȤȦȡȓȢ ıIJĮIJȚıIJȚțȐ ıȘȝĮȞIJȚțȒ įȚĮijȠȡȐ, IJȩıȠ ʌȡȚȞ (60 [23-80] vs. 57 [30-71], p = 0,080) ȩıȠ ȝİIJȐ IJȘȞ İʌȑȝȕĮıȘ (51,5 [22-77] vs. 42 [21-70], p = 0,058). ǻİȞ ȣʌȒȡȤİ ıIJĮIJȚıIJȚțȐ ıȘȝĮȞIJȚțȒ ıȣıȤȑIJȚıȘ IJȠȣ ȕĮșȝȠȪ IJȠȣ ȐȖȤȠȣȢ ʌȡȚȞ țĮȚ ȝİIJȐ IJȘȞ İʌȑȝȕĮıȘ ȝİ IJȘȞ ȘȜȚțȓĮ IJȦȞ ıȣȖȖİȞȫȞ (p = 0,939, p = 0,199) Ȓ IJȠ ȝȠȡijȦIJȚțȩ IJȠȣȢ İʌȓʌİįȠ (p = 0,803, p = 0,224). ȉĮ șȑȝĮIJĮ ʌȠȣ ĮʌĮıȤȠȜȠȪıĮȞ ʌİȡȚııȩIJİȡȠ IJȠȣȢ ıȣȖȖİȞİȓȢ ȒIJĮȞ Ș ĮȞĮȚıșȘıȓĮ (37%), Ș ȣʌȠțİȓȝİȞȘ ȞȩıȠȢ (22%), Ș ȤİȚȡȠȣȡȖȚțȒ İʌȑȝȕĮıȘ (17%) țĮȚ Ƞ ȝİIJİȖȤİȚȡȘIJȚțȩȢ ʌȩȞȠȢ (11%). ȅȚ ıȣȖȖİȞİȓȢ IJȠȣȢ ȠʌȠȓȠȣȢ ijȩȕȚȗİ ʌİȡȚııȩIJİȡȠ Ș ĮȞĮȚıșȘıȓĮ İȝijȐȞȚıĮȞ ʌȡȠİȖȤİȚȡȘIJȚțȐ IJȠ ȝİȖĮȜȪIJİȡȠ ȕĮșȝȩ ȐȖȤȠȣȢ (61,5 [42-77], p = 0,002). ȈȣȝʌİȡȐıȝĮIJĮ: ȈIJȘȞ ʌĮȡȠȪıĮ ȝİȜȑIJȘ, ȠȚ ıȣȖȖİȞİȓȢ IJȦȞ ȤİȚȡȠȣȡȖȚțȫȞ ĮıșİȞȫȞ İȝijȐȞȚıĮȞ ȣȥȘȜȩ ȕĮșȝȩ ʌİȡȚİȖȤİȚȡȘIJȚțȠȪ ȐȖȤȠȣȢ, IJȠ ȠʌȠȓȠ įİȞ ıȤİIJȚȗȩIJĮȞ ȝİ IJȘȞ ȘȜȚțȓĮ Ȓ IJȠ ijȪȜȠ țĮȚ ĮijȠȡȠȪıİ ȐIJȠȝĮ ĮȞİȟĮȡIJȒIJȠȣ ȝȠȡijȦIJȚțȠȪ İʌȚʌȑįȠȣ. ȆĮȡȐ IJȠ ȖİȖȠȞȩȢ ȩIJȚ, ȩıȠȞ ĮijȠȡȐ IJȠ ȐȖȤȠȢ IJȦȞ ıȣȖȖİȞȫȞ, ıȘȝİȚȫșȘțİ ıIJĮIJȚıIJȚțȐ ıȘȝĮȞIJȚțȒ ȝİȓȦıȘ ȝİIJȐ IJȘȞ İʌȓıțİȥȘ IJȠȣ ĮıșİȞȠȪȢ ıIJȠ ȤȫȡȠ ĮȞȐȞȘȥȘȢ, Ș İʌȓįȡĮıȘ ĮȣIJȒ İȓȤİ ȝȚțȡȒ țȜȚȞȚțȒ ıȘȝĮıȓĮ, įİįȠȝȑȞȠȣ ȩIJȚ IJȠ ȐȖȤȠȢ İȟĮțȠȜȠȣșȠȪıİ ȞĮ ʌĮȡĮȝȑȞİȚ ıİ țȜȚȞȚțȐ ıȘȝĮȞIJȚțȐ ȣȥȘȜȐ İʌȓʌİįĮ. ȈȣȞİʌȫȢ, ʌȑȡĮ Įʌȩ IJȘȞ İʌȓıțİȥȘ IJȦȞ ĮıșİȞȫȞ ıIJȠ ȤȫȡȠ ĮȞȐȞȘȥȘȢ, țȡȓȞİIJĮȚ ıțȩʌȚȝȘ Ș ȝİȜȑIJȘ țĮȚ İijĮȡȝȠȖȒ țĮȚ ȐȜȜȦȞ ȝȑIJȡȦȞ İȞȘȝȑȡȦıȘȢ țĮȚ ȣʌȠıIJȒȡȚȟȘȢ IJȦȞ ıȣȖȖİȞȫȞ ʌȡȠțİȚȝȑȞȠȣ ȞĮ ʌİȡȚȠȡȚıIJİȓ IJȠ ʌİȡȚİȖȤİȚȡȘIJȚțȩ IJȠȣȢ ȐȖȤȠȢ. ǼʌȚʌȜȑȠȞ, țȡȓȞİIJĮȚ ıțȩʌȚȝȘ Ș İȣȡȪIJİȡȘ İȞȘȝȑȡȦıȘ IJȠȣ ȖİȞȚțȠȪ ʌȜȘșȣıȝȠȪ ıȤİIJȚțȐ ȝİ IJȚȢ ıȪȖȤȡȠȞİȢ İȟİȜȓȟİȚȢ IJȘȢ ĮȞĮȚıșȘıȚȠȜȠȖȓĮȢ țĮȚ IJȘȢ ĮıijȐȜİȚȐȢ IJȘȢ ʌȡȠțİȚȝȑȞȠȣ ȞĮ ȝİȚȦșȠȪȞ ȠȚ ıȤİIJȚțȠȓ ijȩȕȠȚ.

ǺȚȕȜȚȠȖȡĮijȓĮ: 1) Kathol DK. AORN J. 1984 Jul;40(1):131-7. 2) Leske JS. AORN J. 1996 Sep;64(3):424-5, 428-36. 3) Leske JS. Appl Nurs Res. 1995 Nov;8(4):169-73. 4)Tselebis A, et al. Ann Gen Psychiatry. 2010 Apr 14;9:16.

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ǿǹ-2 Ǿ ȋȇǾȈǾ ĭȊȉǿȀȍȃ ȈȀǼȊǹȈȂǹȉȍȃ Ȁǹǿ Ǿ ǹȊĬȅȇȂǾȉǾ ȆǹȇȅȋǾ ȉǾȈ ȆȁǾȇȅĭȅȇǿǹȈ ǹȆȅ ȉȅȊȈ ȋǼǿȇȅȊȇīǿȀȅȊȈ ǹȈĬǼȃǼǿȈ ȉȇǿȉȅǺǹĬȂǿȅȊ ȃȅȈȅȀȅȂǼǿȅȊ. ǹȞįȡȑȠȣ ǹ1, ȀȜȩțĮ Ȃ1, ȀȦıIJȠȪȜĮȢ ȃ2, ǺĮıȚȜȐțȘȢ Ĭ1 1ǹȞĮȚıșȘıȚȠȜȠȖȚțȩ ȉȝȒȝĮ, 2ǹ’ ȋİȚȡȠȣȡȖȚțȒ ȀȜȚȞȚțȒ, 251 īİȞȚțȩ ȃȠıȠțȠȝİȓȠ ǹİȡȠʌȠȡȓĮȢ, ǹșȒȞĮ ǼȚıĮȖȦȖȒ Ǿ ȤȡȒıȘ IJȦȞ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ țĮȚ IJȦȞ ıȣȝʌȜȘȡȦȝȐIJȦȞ įȚĮIJȡȠijȒȢ İȓȞĮȚ ȚįȚĮȓIJİȡĮ įȚĮįİįȠȝȑȞȘ. ȈIJȘ ȕȚȕȜȚȠȖȡĮijȓĮ ĮȞĮijȑȡȠȞIJĮȚ ʌȠıȠıIJȐ ĮȞȐȜȠȖĮ ȝİ IJȠ ȝİȜİIJȫȝİȞȠ ʌȜȘșȣıȝȩ Įʌȩ 4.8% ȑȦȢ țĮȚ 55%.1,2 ȀȪȡȚȠȢ ıțȠʌȩȢ IJȘȢ ȑȡİȣȞĮȢ ȒIJĮȞ ȞĮ įȚĮʌȚıIJȦșİȓ țĮIJȐ ʌȩıȠ ȠȚ ĮıșİȞİȓȢ ʌĮȡȑȤȠȣȞ ĮȣșȩȡȝȘIJĮ IJȘȞ ʌȜȘȡȠijȠȡȓĮ ȩIJȚ ȜĮȝȕȐȞȠȣȞ ijȣIJȚțȐ ıțİȣȐıȝĮIJĮ ȩIJĮȞ İȡȦIJȫȞIJĮȚ ȖȚĮ IJȘ ijĮȡȝĮțİȣIJȚțȒ IJȠȣȢ ĮȖȦȖȒ, İȞȫ İʌȚʌȜȑȠȞ ıIJȩȤȠȚ ȒIJĮȞ Ș țĮIJĮȖȡĮijȒ IJȠȣ ʌȠıȠıIJȠȪ IJȦȞ ĮıșİȞȫȞ IJȠȣ ȞȠıȠțȠȝİȓȠȣ ȝĮȢ ʌȠȣ țȐȞȠȣȞ ȤȡȒıȘ IJȦȞ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ, țĮIJȐ ʌȩıȠ İȓȞĮȚ İȞȒȝİȡȠȚ ȖȚĮ IJȘ ijȪıȘ IJȘȢ ȠȣıȓĮȢ ʌȠȣ ȜĮȝȕȐȞȠȣȞ, IJȚȢ ʌȚșĮȞȑȢ İʌȚʌȜȠțȑȢ țĮȚ IJȚȢ ʌĮȡİȞȑȡȖİȚİȢ țĮIJȐ IJȘȞ ʌİȡȚİȖȤİȚȡȘIJȚțȒ ʌİȡȓȠįȠ. ȊȜȚțȩ - ȂȑșȠįȠȢ Ǿ ȑȡİȣȞĮ ʌȡĮȖȝĮIJȠʌȠȚȒșȘțİ ȝİ IJȘ ȝȠȡijȒ İȡȦIJȘȝĮIJȠȜȠȖȓȠȣ İȞıȦȝĮIJȦȝȑȞȠȣ ıIJȘȞ ʌȡȠİȖȤİȚȡȘIJȚțȒ İțIJȓȝȘıȘ Įʌȩ IJȠȞ ĮȞĮȚıșȘıȚȠȜȩȖȠ ıİ 201 İȞȒȜȚțİȢ ĮıșİȞİȓȢ IJȡȚIJȠȕȐșȝȚȠȣ ȞȠıȠțȠȝİȓȠȣ (86 ȖȣȞĮȓțİȢ țĮȚ 115 ȐȞįȡİȢ) ʌȠȣ șĮ ȣʌȠȕȐȜȜȠȞIJĮȞ ıİ ʌȠȚțȚȜȓĮ ȤİȚȡȠȣȡȖȚțȫȞ İʌİȝȕȐıİȦȞ ʌȡȠȖȡĮȝȝĮIJȚıȝȑȞȦȞ Ȓ ȑțIJĮțIJȦȞ, ȤȦȡȓȢ ȠȚ ĮıșİȞİȓȢ ȞĮ ȖȞȦȡȓȗȠȣȞ ȩIJȚ ıȣȝȝİIJȑȤȠȣȞ ıİ İȡȦIJȘȝĮIJȠȜȩȖȚȠ ȑȡİȣȞĮȢ. ǹȡȤȚțȐ țĮIJĮȖȡĮijȩIJĮȞ Ș ijĮȡȝĮțİȣIJȚțȒ ĮȖȦȖȒ ȩʌȦȢ IJȘ įȒȜȦȞİ Ƞ ĮıșİȞȒȢ İȞȫ ıIJȘ ıȣȞȑȤİȚĮ ȖȚȞȩIJĮȞ ıȣȖțİțȡȚȝȑȞȘ İȡȫIJȘıȘ ȖȚĮ IJȘ ȤȡȒıȘ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ. ȂİIJȐ IJȠ ʌȑȡĮȢ IJȘȢ ʌȡȠİȖȤİȚȡȘIJȚțȒȢ İțIJȚȝȒıİȦȢ țĮȚ İij’ ȩıȠȞ ȠȚ ĮıșİȞİȓȢ İȓȤĮȞ ĮʌĮȞIJȒıİȚ șİIJȚțȐ ȖȚĮ IJȘ ȤȡȒıȘ ıțİȣĮıȝȐIJȦȞ, ıȣȞİȤȚȗȩIJĮȞ IJȠ İȡȦIJȘȝĮIJȠȜȩȖȚȠ ȖȚĮ IJȚȢ ʌȚșĮȞȑȢ ʌĮȡİȞȑȡȖİȚİȢ țĮȚ IJȘȞ İʌȓįȡĮıȘ ıIJȘȞ ʌİȡȚİȖȤİȚȡȘIJȚțȒ ʌİȡȓȠįȠ. ǹʌȠIJİȜȑıȝĮIJĮ ǹʌȩ IJȠȣȢ 201 ĮıșİȞİȓȢ ʌȠȣ İȡȦIJȒșȘțĮȞ ȠȚ 19 (9.5%) ĮȞȑijİȡĮȞ ȤȡȒıȘ İȞȩȢ Ȓ ʌİȡȚııȠIJȑȡȦȞ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ ıİ IJĮțIJȚțȒ ȕȐıȘ țĮȚ 4 (2%) ʌİȡȚıIJĮıȚĮțȐ. ȆĮȡȩȜȠ ȩȝȦȢ ʌȠȣ IJȠ 45% IJȦȞ ĮıșİȞȫȞ șİȦȡİȓ ȩIJȚ ȖȚĮ IJȘ ȤȡȒıȘ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ șĮ ʌȡȑʌİȚ ȞĮ İȞȘȝİȡȫȞİIJĮȚ Ƞ șİȡȐʌȦȞ ȤİȚȡȠȣȡȖȩȢ țĮȚ Ƞ ĮȞĮȚıșȘıȚȠȜȩȖȠȢ, ȀǹȃǼȃǹȈ ĮıșİȞȒȢ įİȞ ȑįȦıİ ĮȣșȩȡȝȘIJĮ IJȘȞ ʌȜȘȡȠijȠȡȓĮ ȖȚĮ IJȘ ȤȡȒıȘ IJȦȞ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ ȩIJĮȞ ȡȦIJȒșȘțİ ıIJȠȞ ʌȡȠİȖȤİȚȡȘIJȚțȩ ȑȜİȖȤȠ ȖȚĮ IJȘ ȜĮȝȕĮȞȩȝİȞȘ ĮȖȦȖȒ. ȅȚ ĮıșİȞİȓȢ ʌȠȣ ȑțĮȞĮȞ ȤȡȒıȘ, IJȠ ĮʌȠțȐȜȣȥĮȞ ȝȩȞȠ ȝİIJȐ Įʌȩ ıȣȖțİțȡȚȝȑȞȘ İȡȫIJȘıȘ IJȠȣ ĮȞĮȚıșȘıȚȠȜȩȖȠȣ ȖȚĮ IJȘ ȜȒȥȘ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ. ȉȠ ʌȠıȠıIJȩ ĮȣIJȫȞ ʌȠȣ IJȠ ȜȐȝȕĮȞĮȞ ȦȢ ıȣȝʌȜȒȡȦȝĮ ȖȚĮ IJȠȞ ȑȜİȖȤȠ țȐʌȠȚĮȢ ȤȡȩȞȚĮȢ ʌȐșȘıȘȢ (13.5%) İȓȞĮȚ ȣʌİȡįȚʌȜȐıȚȠ ıİ ıȤȑıȘ ȝİ ĮȣIJȠȪȢ ʌȠȣ IJȠ ȜȐȝȕĮȞĮȞ ȤȦȡȓȢ ȞĮ ȑȤȠȣȞ țȐʌȠȚĮ ȤȡȩȞȚĮ ʌȐșȘıȘ (5.8%). ȉȠ 45% IJȦȞ ĮıșİȞȫȞ įİȞ İȓȤĮȞ įȚĮȕȐıİȚ IJȠ ıȣȞȠįİȣIJȚțȩ ijȣȜȜȐįȚȠ ȠįȘȖȚȫȞ, İȞȫ ʌİȡȚııȩIJİȡȠȚ Įʌȩ IJȠȣȢ ȝȚıȠȪȢ (55%) IJȦȞ ĮıșİȞȫȞ įİȞ İȓȤĮȞ İȞȘȝİȡȫıİȚ IJȠȞ ȠȚțȠȖİȞİȚĮțȩ ȖȚĮIJȡȩ IJȠȣȢ ȖȚĮ IJȘȞ ʌĮȡȐȜȜȘȜȘ ȤȡȒıȘ ıțİȣĮıȝȐIJȦȞ ȝİ IJȘȞ IJĮțIJȚțȒ ijĮȡȝĮțİȣIJȚțȒ IJȠȣȢ ĮȖȦȖȒ. ȈȣȝʌȑȡĮıȝĮ ȆĮȡȩȜȠ ʌȠȣ ıȤİįȩȞ ȠȚ ȝȚıȠȓ ĮıșİȞİȓȢ ʌȠȣ țȐȞȠȣȞ ȤȡȒıȘ ijȣIJȚțȫȞ ıțİȣĮıȝȐIJȦȞ, șİȦȡȠȪȞ ȩIJȚ Ƞ șİȡȐʌȦȞ ȤİȚȡȠȣȡȖȩȢ țĮȚ Ƞ ĮȞĮȚıșȘıȚȠȜȩȖȠȢ ʌȡȑʌİȚ ȞĮ İȓȞĮȚ ȖȞȫıIJİȢ IJȘȢ ȤȡȒıȘȢ, İȞIJȠȪIJȠȚȢ ıIJȘȞ ȑȡİȣȞĮ ȝĮȢ, țĮȞȑȞĮȢ ĮıșİȞȒȢ įİȞ ȑįȦıİ ĮȣșȩȡȝȘIJĮ ĮȣIJȒ IJȘȞ ʌȜȘȡȠijȠȡȓĮ ȩIJĮȞ İȡȦIJȒșȘțİ Įʌȩ IJȠȞ ĮȞĮȚıșȘıȚȠȜȩȖȠ țĮIJȐ IJȘȞ ʌȡȠİȖȤİȚȡȘIJȚțȒ İțIJȓȝȘıȘ ȖȚĮ IJȘ ijĮȡȝĮțİȣIJȚțȒ ĮȖȦȖȒ ʌȠȣ ȜĮȝȕȐȞİȚ ıİ IJĮțIJȚțȒ ȕȐıȘ. Ȃİ įİįȠȝȑȞĮ IJĮ ʌȡȠȕȜȒȝĮIJĮ ʌȠȣ ȝʌȠȡİȓ ȞĮ ʌȡȠțȪȥȠȣȞ ıIJȘȞ ʌİȡȚİȖȤİȚȡȘIJȚțȒ ʌİȡȓȠįȠ3 șĮ ʌȡȑʌİȚ ȩȜȠȚ ȠȚ ĮıșİȞİȓȢ ȞĮ İȡȦIJȫȞIJĮȚ țĮȚ ıȣȖțİțȡȚȝȑȞĮ ȖȚĮ IJȘ ȤȡȒıȘ IJȠȣȢ țĮȚ ȩȤȚ ȞĮ șİȦȡİȓIJĮȚ ĮȣIJȠȞȩȘIJȘ Ș ʌĮȡȠȤȒ IJȘȢ ʌȜȘȡȠijȠȡȓĮȢ, ȩIJĮȞ İȡȦIJȫȞIJĮȚ ȖȚĮ IJȘ ijĮȡȝĮțİȣIJȚțȒ ĮȖȦȖȒ ʌȠȣ ȜĮȝȕȐȞȠȣȞ. Ǿ ıȪıIJĮıȘ ĮȣIJȒ İȟȐȜȜȠȣ ȑȤİȚ ıȣȝʌİȡȚȜȘijșİȓ ıIJȚȢ ȠįȘȖȓİȢ IJȘȢ ESA ȖȚĮ IJȠȞ ʌȡȠİȖȤİȚȡȘIJȚțȩ ȑȜİȖȤȠ4. ǺȚȕȜȚȠȖȡĮijȓĮ

1. Skinner CM, Rangasami J. Preoperative use of herbal medicines: a patient survey. Br J Anaesth 2002; 89:792–795

2. Heller J, Gabbay JS, Ghadjar K, et al. Top-10 List of herbal and supplemental medicines used by cosmetic patients: what the plastic surgeon needs to know. Plast Reconstr Surg 2006; 117:436–445

3. Kaye A D, Baluch A et al. Pharmacology of herbals and their impact in anesthesia. Curr Opin Anaesthesiol 2007; 20(4): 294-299

4. De Hert S et al. Preoperative evaluation of the adult patient undergoing non-cardiac surgery: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2011;28:684–72

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Ǿ «ǹȆǹȇǹǿȉǾȉǾ» ȆȇȅǼīȋǼǿȇǾȉǿȀǾ ǹȀȉǿȃȅīȇǹĭǿǹ ĬȍȇǹȀȅȈ: ȅǿ ȀǹȉǼȊĬȊȃȉǾȇǿǼȈ ȅǻǾīǿǼȈ Ȁǹǿ Ǿ ȀǹȉǼȈȉǾȂǼȃǾ ȆȇȅǼīȋǼǿȇǾȉǿȀǾ ȀǹĬǾȂǼȇǿȃȅȉǾȉǹ ȉȍȃ ǹȃǹǿȈĬǾȈǿȅȁȅīȍȃ Ȁǹǿ ȉȍȃ ȋǼǿȇȅȊȇīȍȃ. ȆĮʌĮıʌȪȡȠȢ ĭ, ȂȚȤĮȘȜȓįȠȣ Ǽ, ȀĮIJıĮȞȠȪȜĮȢ Ȁ, ĭȚȜȑȜȘ ǹ, ǹȞĮȖȞȦıIJȐȡĮ Ǽ. ǿʌʌȠțȡȐIJİȚȠ īȃĬ. ǼȚıĮȖȦȖȒ: Ǿ ȚĮIJȡȚțȒ ȕȐıİȚ įİįȠȝȑȞȦȞ ıȣȞȚıIJȐ ıȒȝİȡĮ IJȠȞ ĮȞIJȚțİȚȝİȞȚțȩ țĮȞȩȞĮ ıȪȝijȦȞĮ ȝİ IJȠȞ ȠʌȠȓȠ ĮȟȚȠȜȠȖİȓIJĮȚ Ș «ȣʌİȡȠȤȒ» ıȣȖțİțȡȚȝȑȞȦȞ țȜȚȞȚțȫȞ ʌȡĮțIJȚțȫȞ ȑȞĮȞIJȚ ȐȜȜȦȞ. ȆȡȠȧȩȞ ĮȣIJȒȢ IJȘȢ ȞȑĮȢ ĮȞIJȓȜȘȥȘȢ ȐıțȘıȘȢ ȚĮIJȡȚțȒȢ ĮʌȠIJİȜİȓ Ș İȟĮȖȦȖȒ țĮȚ įȘȝȠıȓİȣıȘ țĮIJİȣșȣȞIJȒȡȚȦȞ ȠįȘȖȚȫȞ (Ȁȅ) ȝİ ıIJȩȤȠ IJȘȞ İijĮȡȝȠȖȒ IJȦȞ țĮȜȪIJİȡȦȞ İʌȚıIJȘȝȠȞȚțȫȞ įİįȠȝȑȞȦȞ, IJȘ ȝİȓȦıȘ IJȘȢ ĮȞİȡȝȐIJȚıIJȘȢ ʌȠȜȣȝȠȡijȓĮȢ IJȘȢ țȜȚȞȚțȒȢ ʌȡȐȟȘȢ, IJȘ ȕİȜIJȓȦıȘ IJȘȢ șİȡĮʌİȣIJȚțȒȢ ĮʌȠIJİȜİıȝĮIJȚțȩIJȘIJĮȢ țĮȚ IJİȜȚțȐ IJȘȞ ĮȞĮȕȐșȝȚıȘ IJȘȢ ʌȠȚȩIJȘIJĮȢ ȣȖİȓĮȢ IJȦȞ ĮıșİȞȫȞ1. ȅȚ Ȁȅ ĮȞ țĮȚ İȟȠȡȚıȝȠȪ ıȣȞȓıIJĮȞIJĮȚ ıİ ʌȡȠIJȐıİȚȢ ʌȡȠȢ ĮȡȦȖȒ IJȠȣ ȚĮIJȡȠȪ țĮȚ IJȠȣ ĮıșİȞȠȪȢ ıIJȘ ȜȒȥȘ ĮʌȠijȐıİȦȞ ıȤİIJȚțȐ ȝİ IJȘȞ țĮIJĮȜȜȘȜȩIJİȡȘ ʌĮȡȠȤȒ ijȡȠȞIJȓįĮȢ ȖȚĮ ıȣȖțİțȡȚȝȑȞİȢ țȜȚȞȚțȑȢ țĮIJĮıIJȐıİȚȢ, ıȤİįȩȞ ʌȠIJȑ įİȞ ĮʌȠȜĮȝȕȐȞȠȣȞ IJȘȞ țĮșȠȜȚțȒ ĮʌȠįȠȤȒ IJȦȞ ȐȝİıĮ İȞįȚĮijİȡȩȝİȞȦȞ ȚĮIJȡȫȞ. īȚĮ ʌĮȡȐįİȚȖȝĮ ȚĮIJȡȠȓ ȓįȚĮȢ İȚįȚțȩIJȘIJĮȢ ȝʌȠȡİȓ ȞĮ įȚĮijȦȞȠȪȞ ȦȢ ʌȡȠȢ IJȘȞ İȡȝȘȞİȓĮ IJȦȞ «ĮȞIJȚțİȚȝİȞȚțȫȞ» ıIJȠȚȤİȓȦȞ ʌȠȣ șİȝİȜȚȫȞȠȣȞ IJȚȢ İȞ ȜȩȖȦ ȠįȘȖȓİȢ2. ǹțȩȝȘ ʌȚȠ ıȪȞȘșİȢ İȓȞĮȚ Ș ʌȡȠıʌȐșİȚĮ İijĮȡȝȠȖȒȢ ȞȑȦȞ Ȁȅ ȞĮ ıȣȞĮȞIJȐ ıșİȞĮȡȒ ĮȞIJȓıIJĮıȘ Įʌȩ IJȘȞ IJȡȑȤȠȣıĮ țĮIJİıIJȘȝȑȞȘ țȜȚȞȚțȒ ʌȡȐȟȘ3. ǺȐıİȚ ĮȣIJȠȪ IJȠȣ ıțİʌIJȚțȠȪ Ș ʌĮȡȠȪıĮ ȑȡİȣȞĮ İȓȤİ ȦȢ ĮijȠȡȝȒ IJȘȞ ȑțįȠıȘ Įʌȩ IJȘȞ ǼȣȡȦʌĮȧțȒ ǼIJĮȚȡİȓĮ ǹȞĮȚıșȘıȚȠȜȠȖȓĮȢ (ESA) IJȦȞ Ȁȅ ȖȚĮ IJȘȞ ʌȡȠİȖȤİȚȡȘIJȚțȒ İțIJȓȝȘıȘ İȞȘȜȓțȦȞ ĮıșİȞȫȞ ʌȠȣ ʌȡȩțİȚIJĮȚ ȞĮ ȣʌȠȕȜȘșȠȪȞ ıİ ȝȘ țĮȡįȚȠȤİȚȡȠȣȡȖȚțȑȢ İʌİȝȕȐıİȚȢ4. ȈȪȝijȦȞĮ ȝİ ĮȣIJȑȢ «Ș ʌȡȠİȖȤİȚȡȘIJȚțȒ ĮțIJȚȞȠȖȡĮijȓĮ șȫȡĮțĮ (ȆǹĬ) įİȞ ıȣıIJȒȞİIJĮȚ ȦȢ ȡȠȣIJȓȞĮ... İȞȫ ȑȤİȚ ʌȠȜȪ ʌİȡȚȠȡȚıȝȑȞȘ ĮȟȓĮ ıİ ĮıșİȞİȓȢ ȐȞȦ IJȦȞ 70 İIJȫȞ ȝİ İȖțĮIJİıIJȘȝȑȞȠȣȢ ʌĮȡȐȖȠȞIJİȢ țȚȞįȪȞȠȣ». Ȃİ įİįȠȝȑȞȘ IJȘȞ ʌȡĮțIJȚțȒ IJȠȣ ȞȠıȠțȠȝİȓȠȣ ȝĮȢ, ȞĮ ȣʌȠȕȐȜȜȠȞIJĮȚ ȩȜȠȚ ȠȚ ĮıșİȞİȓȢ ıİ ȆǹĬ įȚİȟȐȖĮȝİ ȑȡİȣȞĮ ȝİ ıIJȩȤȠ: i] IJȘȞ țĮIJĮȖȡĮijȒ IJȘȢ ȖȞȫȝȘȢ IJȦȞ ĮȞĮȚıșȘıȚȠȜȩȖȦȞ țĮȚ IJȦȞ ȤİȚȡȠȣȡȖȫȞ ıȤİIJȚțȐ ȝİ IJȘȞ ĮȞĮȖțĮȚȩIJȘIJĮ ĮȣIJȒȢ IJȘȢ İȟȑIJĮıȘȢ țĮȚ: ii] IJȘȞ ȑȞĮȡȟȘ įȚĮȜȩȖȠȣ ȖȚĮ ĮȜȜĮȖȒ IJȘȢ țĮșȚİȡȦȝȑȞȘȢ ʌȡĮțIJȚțȒȢ. ȂȑșȠįȠȢ: DzȡİȣȞĮ IJȪʌȠȣ İȡȦIJȘȝĮIJȠȜȠȖȓȠȣ ʌȠȣ ĮʌİȣșȪȞİIJĮȚ ıİ 50 ĮȞĮȚıșȘıȚȠȜȩȖȠȣȢ țĮȚ 50 ȤİȚȡȠȣȡȖȠȪȢ, İȚįȚțȠȪȢ țĮȚ İȚįȚțİȣȩȝİȞȠȣȢ, ʌȠȣ İȡȖȐȗȠȞIJĮȚ ıİ įȘȝȩıȚĮ ȞȠıȠțȠȝİȓĮ IJȘȢ ǺȩȡİȚĮȢ ǼȜȜȐįĮȢ. ǹʌȠIJİȜȑıȝĮIJĮ: Ǿ ȆǹĬ ĮʌȠIJİȜİȓ ȡȠȣIJȓȞĮ ıIJȠȞ ȑȜİȖȤȠ ȩȜȦȞ IJȦȞ İȞȘȜȓțȦȞ ĮıșİȞȫȞ (İțIJȩȢ İȖțȪȦȞ). ȅȚ ĮȞĮȚıșȘıȚȠȜȩȖȠȚ ıȣȝijȦȞȠȪȞ ȠȝȩijȦȞĮ ʌȦȢ Ș ıȣȖțİțȡȚȝȑȞȘ İȟȑIJĮıȘ įİȞ ʌȡȑʌİȚ ȞĮ ȖȓȞİIJĮȚ ıİ țȐșİ ʌȡȠİȖȤİȚȡȘIJȚțȩ ĮıșİȞȒ. ȅȚ ȤİȚȡȠȣȡȖȠȓ ijȑȡȠȞIJĮȚ ȝȠȚȡĮıȝȑȞȠȚ ıIJȚȢ ĮʌĮȞIJȒıİȚȢ IJȠȣȢ. ǻȚȤĮıȝȑȞİȢ țĮȚ ȝȐȜȜȠȞ ĮȕȑȕĮȚİȢ İȓȞĮȚ țĮȚ ȠȚ įȪȠ ȠȝȐįİȢ İȚįȚțȫȞ ȦȢ ʌȡȠȢ IJȠȣȢ ȜȩȖȠȣȢ ıIJȠȣȢ ȠʌȠȓȠȣȢ ȕĮıȓȗİIJĮȚ Ș IJȡȑȤȠȣıĮ ʌȡĮțIJȚțȒ. ȆȠȜȪ İȞįȚĮijȑȡȠȞ İȓȞĮȚ İʌȓıȘȢ IJȠ İȪȡȘȝĮ ȩIJȚ țĮȚ ȠȚ įȪȠ «țȠȚȞȩIJȘIJİȢ» ıȣȝijȦȞȠȪȞ ȖȚĮ IJȘȞ ĮȞĮȖțĮȚȩIJȘIJĮ IJȘȢ ıȣȗȒIJȘıȘȢ ȖȚĮ IJȘȞ ĮȜȜĮȖȒ IJȘȢ țĮșȚİȡȦȝȑȞȘȢ ʌȡĮțIJȚțȒȢ. ǹȞȐȜȠȖȘ ȠȝȩijȦȞȘ ıȤİįȩȞ, șİIJȚțȒ ʌȡȠįȚȐșİıȘ ȣʌȐȡȤİȚ țĮȚ ıIJȘȞ İȡȫIJȘıȘ ĮȞ șĮ İʌȚșȣȝȠȪıĮȞ ȞĮ įȚĮșȑIJȠȣȞ ıIJȠ ȞȠıȠțȠȝİȓȠ IJȠȣȢ ıȣȖțİțȡȚȝȑȞȠ ʌȡȦIJȩțȠȜȜȠ ıȤİIJȚțȐ ȝİ IJȘȞ ȤȡȒıȘ IJȘȢ ȆǹĬ. ȈȣȝʌİȡȐıȝĮIJĮ: ǻȚĮʌȚıIJȫıĮȝİ ʌȦȢ Ș ȆǹĬ ĮʌȠIJİȜİȓ țĮIJİıIJȘȝȑȞȘ ʌȡĮțIJȚțȒ ıIJĮ ȞȠıȠțȠȝİȓĮ ʌȠȣ ȑȜĮȕİ ȤȫȡĮ Ș ȑȡİȣȞĮ. ǼȝijĮȞȒȢ ȩȝȦȢ İȓȞĮȚ Ș ȕȠȪȜȘıȘ ȝİȖȐȜȠȣ ʌȠıȠıIJȠȪ IJȦȞ İȝʌȜİțȠȝȑȞȦȞ İȚįȚțȫȞ ȖȚĮ IJȘȞ İijĮȡȝȠȖȒ ıȣȖțİțȡȚȝȑȞȦȞ ȠįȘȖȚȫȞ ȖȚĮ IJȘȞ İȞįİįİȚȖȝȑȞȘ ȤȡȒıȘ ĮȣIJȒȢ IJȘȢ İȟȑIJĮıȘȢ. ȈȤİIJȚțȐ ȝİ IJȘȞ ȆǹĬ, ȠȚ ıȪȖȤȡȠȞİȢ ȠįȘȖȓİȢ IJȘȢ ESA, ʌȠȣ ıȣȝijȦȞȠȪȞ ȝİ ĮȞIJȓıIJȠȚȤȘ ʌĮȜĮȚȩIJİȡȘ ȠįȘȖȓĮ ıIJȠ ǾȞȦȝȑȞȠ ǺĮıȚȜİȓȠ5 İȓȞĮȚ ĮʌȩȜȣIJĮ ıĮijİȓȢ. ȆȜȘȡȠȪȞ įȘȜĮįȒ IJȠ ʌȡȫIJȠ Įʌȩ IJĮ ĮȞĮȖțĮȓĮ țȡȚIJȒȡȚĮ ʌȠȣ ĮʌĮȚIJȠȪȞIJĮȚ ʌȡȠțİȚȝȑȞȠȣ ȞĮ ĮȜȜȐȟİȚ Ș țĮIJİıIJȘȝȑȞȘ țȜȚȞȚțȒ ʌȡĮțIJȚțȒ6. ǼʌȚʌȜȑȠȞ IJĮ ıIJȠȚȤİȓĮ ıIJĮ ȠʌȠȓĮ ȕĮıȓȗİIJĮȚ Ș ȠįȘȖȓĮ İȓȞĮȚ İʌȚıIJȘȝȠȞȚțȫȢ ĮȟȚȩʌȚıIJĮ4,5 țĮȚ IJȠ ȩijİȜȠȢ Įʌȩ IJȘȞ İijĮȡȝȠȖȒ IJȘȢ ȝʌȠȡİȓ ȞĮ İȓȞĮȚ ʌȠȜȜĮʌȜȩ: ȆȡȦIJĮȡȤȚțȐ ȖȚĮ IJȘȞ ȣȖİȓĮ IJȦȞ ĮıșİȞȫȞ, ȖȚĮ ȝȚĮ IJĮȤȪIJİȡȘ ʌĮȡȠȤȒ ijȡȠȞIJȓįĮȢ Įʌȩ IJȠȣȢ İȝʌȜİțȩȝİȞȠȣȢ İȚįȚțȠȪȢ țĮȚ IJİȜȚțȐ ȖȚĮ IJȘȞ İȟȠȚțȠȞȩȝȘıȘ ʌȩȡȦȞ ȖȚĮ ȐȜȜİȢ ʌȚȠ İȞįİįİȚȖȝȑȞİȢ ʌȡȠİȖȤİȚȡȘIJȚțȑȢ İȟİIJȐıİȚȢ. ǺİȕĮȓȦȢ, ȝȚĮ ʌȚșĮȞȒ «ĮʌȠțĮșȒȜȦıȘ» IJȘȢ ȆǹĬ-ȡȠȣIJȓȞĮȢ Įʌȩ IJȠ «ʌȐȞșİȠȞ» IJȦȞ ȣʌȠȤȡİȦIJȚțȫȞ İȡȖĮıIJȘȡȚĮțȫȞ İȟİIJȐıİȦȞ IJȠȣ İȜȜȘȞȚțȠȪ įȘȝȩıȚȠȣ ıȣıIJȒȝĮIJȠȢ ȣȖİȓĮȢ, ȑȤİȚ ȞȩȘȝĮ ȝİ IJȘȞ ʌȡȠȨʌȩșİıȘ ȩIJȚ Ș ʌȜȒȡȘȢ țȜȚȞȚțȒ İȟȑIJĮıȘ țĮȚ Ș ȜȒȥȘ țĮȜȠȪ ȚıIJȠȡȚțȠȪ ĮʌȠIJİȜİȓ IJȘ ȡȠȣIJȓȞĮ IJȘȢ ʌȡȠĮȞĮȚıșȘIJȚțȒȢ ȝĮȢ İʌȓıțİȥȘȢ. ȅijİȓȜȠȣȝİ ȜȠȚʌȩȞ ȞĮ IJȠȜȝȒıȠȣȝİ ȞĮ ĮȜȜȐȟȠȣȝİ. ǼȓȞĮȚ ʌȡȠȢ ȩijİȜȠȢ ȩȜȦȞ ȝĮȢ.

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ǿǹ-4 ǹȃȉǿȁǾȌǾ, ȆȇȅȈǻȅȀǿǼȈ Ȁǹǿ ǼĭǾȈȊȋǹȈȂȅǿ īǿǹȉȇȍȃ Ȁǹǿ ȃȅȈǾȁǼȊȉȍȃ īǿǹ THN ǼȀȆǹǿǻǼȊȈǾ Ȁǹǿ ȉǾȃ ǼĭǹȇȂȅīǾ ǹȃǹǽȍȅīȅȃǾȈǾȈ ǹȘįȩȞȘ ǽ, ȀȠIJıȩȕȠȜȘȢ ī, ȆȠȣȡȗȚIJȐțȘ ȋ, ĭȣȞIJĮȞȓįȠȣ Ǻ, ǹȝĮȞȓIJȘ ǹ, DZȖȖȠȣ Ȃ, īȡȠıȠȝĮȞȓįȘȢ Ǻ, ǺĮıȚȜȐțȠȢ ǻ ȀȜȚȞȚțȒ ǹȞĮȚıșȘıȚȠȜȠȖȓĮȢ țĮȚ ǼȞIJĮIJȚțȒȢ ĬİȡĮʌİȓĮȢ ȆīȃĬ ǹȋǼȆǹ ĬİııĮȜȠȞȓțȘ ǼǿȈǹīȍīǾ – ȈȀȅȆȅȈ : ȉȠ ȞȠıȠțȠȝİȓȠ ǹȋǼȆǹ ȜİȚIJȠȣȡȖİȓ ȦȢ țȑȞIJȡȠ ʌĮȡȠȤȒȢ ʌȚıIJȠʌȠȚȘȝȑȞȘȢ İțʌĮȓįİȣıȘȢ ıIJȘ ǺĮıȚțȒ ȀĮȡįȚȠʌȞİȣȝȠȞȚțȒ ǹȞĮȗȦȠȖȩȞȘıȘ ȝİ ȤȡȒıȘ ǹȣIJȩȝĮIJȠȣ ǼȟȦIJİȡȚțȠȪ ǹʌȚȞȚįȦIJȒ. ǻȚĮșȑIJİȚ įȚțȩ IJȠȣ İțʌĮȚįİȣIJȚțȩ ȣȜȚțȩ, ȤȫȡȠȣȢ țĮȚ İțʌĮȚįİȣIJȑȢ, Ș İțʌĮȓįİȣıȘ ʌĮȡȑȤİIJĮȚ įȦȡİȐȞ, İȞIJȩȢ İȡȖȐıȚȝȠȣ ȤȡȩȞȠȣ, IJĮ IJİȜİȣIJĮȓĮ ȤȡȩȞȚĮ ȑȤȠȣȞ ʌȡĮȖȝĮIJȠʌȠȚȘșİȓ ʌİȡȚııȩIJİȡĮ Įʌȩ 80 ʌȚıIJȠʌȠȚȘȝȑȞĮ ıİȝȚȞȐȡȚĮ țĮȚ ȑȤİȚ İțʌĮȚįİȣIJİȓ IJȠ ıȪȞȠȜȠ ıȤİįȩȞ IJȦȞ İȡȖĮȗȠȝȑȞȦȞ. ǵȜİȢ ȠȚ țȜȚȞȚțȑȢ įȚĮșȑIJȠȣȞ țĮȡȩIJıȚ İʌİȚȖȩȞIJȦȞ țĮȚ ĮʌȚȞȚįȦIJȒ, ĮȣIJȩȝĮIJȠ Ȓ ȤİȚȡȠțȓȞȘIJȠ. Ǿ ȩȜȘ ȩȝȦȢ ʌȡȠıʌȐșİȚĮ, ıȪȝijȦȞĮ ȝİ IJȘȞ ȐʌȠȥȘ IJȦȞ ĮȞșȡȫʌȦȞ ʌȠȣ ĮȞIJĮʌȠțȡȓȞȠȞIJĮȚ ıIJȘȞ țȜȒıȘ ȖȚĮ țĮȡįȚĮțȒ ĮȞĮțȠʌȒ, įİȞ İțijȡȐȗİIJĮȚ ıİ İijĮȡȝȠȖȒ ȕĮıȚțȒȢ țĮȡįȚȠʌȞİȣȝȠȞȚțȒȢ ĮȞĮȗȦȠȖȩȞȘıȘȢ ȝȑȤȡȚ IJȘȞ ȐijȚȟȘ IJȘȢ İȟİȚįȚțİȣȝȑȞȘȢ ȠȝȐįĮȢ. ȈIJȘȞ ʌĮȡȠȪıĮ ȝİȜȑIJȘ șİȜȒıĮȝİ ȞĮ ĮʌȠIJȣʌȫıȠȣȝİ IJȘȞ ȐʌȠȥȘ ıİ ȗȘIJȒȝĮIJĮ ʌȠȣ ĮijȠȡȠȪȞ IJȘȞ İțʌĮȓįİȣıȘ ĮȜȜȐ țĮȚ IJȘȞ İijĮȡȝȠȖȒ țĮȡįȚȠʌȞİȣȝȠȞȚțȒȢ ĮȞĮȗȦȠȖȩȞȘıȘȢ IJȦȞ ĮȞșȡȫʌȦȞ ʌȠȣ ĮȞIJĮʌȠțȡȓȞȠȞIJĮȚ ʌȡȫIJȠȚ ıIJȠȞ ĮıșİȞȒ ʌȠȣ țĮIJĮȡȡȑİȚ. ȊȁǿȀȅ – ȂǼĬȅǻȅȈ : ȈȣȖțİțȡȚȝȑȞȠ İȡȦIJȘȝĮIJȠȜȩȖȚȠ ȝȠȚȡȐıIJȘțİ ıİ 130 ȖȚĮIJȡȠȪȢ țĮȚ ȞȠıȘȜİȣIJȑȢ IJȠȣ ȞȠıȠțȠȝİȓȠȣ ȝĮȢ. ǼʌȚıIJȡȐijȘțĮȞ ıȣȝʌȜȘȡȦȝȑȞĮ IJĮ 128. ǹʌȩ IJȠȣȢ ıȣȝȝİIJȑȤȠȞIJİȢ ȗȘIJȒșȘțİ Ș ȐʌȠȥȘ IJȠȣȢ, İȐȞ ʌȚıIJİȪȠȣȞ ȩIJȚ ıIJȠȞ İȡȖĮıȚĮțȩ IJȠȣȢ ȤȫȡȠ İijĮȡȝȩȗİIJĮȚ ıȦıIJȐ Ș ĮȞĮȗȦȠȖȩȞȘıȘ, İȐȞ ȖȞȦȡȓȗȠȣȞ IJȠ IJȘȜȑijȦȞȠ țȜȒıȘȢ ȕȠȒșİȚĮȢ IJȠȣ ȞȠıȠțȠȝİȓȠȣ ȝĮȢ, İȐȞ ȖȞȦȡȓȗȠȣȞ IJȠȞ ĮȜȖȩȡȚșȝȠ IJȠȣ ǼȣȡȦʌĮȧțȠȪ ȈȣȝȕȠȣȜȓȠȣ ǹȞĮȗȦȠȖȩȞȘıȘȢ, İȐȞ ȖȞȦȡȓȗȠȣȞ İȐȞ ȣʌȐȡȤİȚ ĮʌȚȞȚįȦIJȒȢ ıIJȠȞ ȤȫȡȠ IJȠȣȢ, ʌȠȚȩȞ ȖȚĮIJȡȩ șĮ țĮȜȑıȠȣȞ ıİ ʌİȡȓʌIJȦıȘ ĮȞĮțȠʌȒȢ țĮȚ ʌȩIJİ șİȦȡȠȪȞ ȦȢ țĮIJĮȜȜȘȜȩIJİȡȠ ȤȡȩȞȠ İțʌĮȓįİȣıȘȢ ıIJȘȞ ĮȞĮȗȦȠȖȩȞȘıȘ. ǹȆȅȉǼȁǼȈȂǹȉǹ : ǹʌȩ IJȘȞ ĮȞȐȜȣıȘ IJȦȞ įİįȠȝȑȞȦȞ ȕȡȑșȘțİ ȩIJȚ ıİ ıȪȞȠȜȠ 128 İȡȦIJȘȝĮIJȠȜȠȖȓȦȞ : 1. ȉȠ 53,9% IJȦȞ İȡȦIJȘșȑȞIJȦȞ ʌȚıIJİȪȠȣȞ ȩIJȚ ıIJȠȞ ȤȫȡȠ IJȠȣȢ İijĮȡȝȩȗİIJĮȚ ıȦıIJȐ ȀǹȇȆǹ İȞȫ IJȠ ȣʌȩȜȠȚʌȠ 46,1% ȩIJȚ įİȞ İijĮȡȝȩȗİIJĮȚ ıȦıIJȐ. ǹȞĮȜȣIJȚțȩIJİȡĮ IJȠ 37% IJȦȞ ȖȚĮIJȡȫȞ țĮȚ IJȠ 61,8% IJȦȞ ȞȠıȘȜİȣIJȫȞ ʌȚıIJİȪȠȣȞ ȩIJȚ İijĮȡȝȩȗİIJĮȚ ıȦıIJȐ. ȅȚ ȖȚĮIJȡȠȓ ıİ ȝİȖĮȜȪIJİȡȠ ʌȠıȠıIJȩ ʌȚıIJİȪȠȣȞ ȩIJȚ įİȞ İijĮȡȝȩȗİIJĮȚ ıȦıIJȐ ȀǹȇȆǹ, ȝİ ıIJĮIJȚıIJȚțȫȢ ıȘȝĮȞIJȚțȒ įȚĮijȠȡȐ Įʌȩ IJȠȣȢ ȞȠıȘȜİȣIJȑȢ(p<0,005). 2. ȉȠ 56,3% ʌȚıIJİȪȠȣȞ ȩIJȚ țĮIJȐȜȜȘȜȠȢ ȤȡȩȞȠȢ ȖȚĮ İțʌĮȓįİȣıȘ İȓȞĮȚ țĮIJȐ IJĮ ijȠȚIJȘIJȚțȐ ȤȡȩȞȚĮ, 18,8% țĮIJȐ IJȘȞ ʌȡĮțIJȚțȒ, 11,7% ıIJȠ ĮȖȡȠIJȚțȩ țĮȚ 13,3% țĮIJȐ IJȘȞ İȚįȚțȩIJȘIJĮ. 3. ȂȩȞȠ 36/128 (28,1%) ȒȟİȡĮȞ ıȦıIJȐ IJȠ IJȘȜȑijȦȞȠ țȜȒıȘȢ ȕȠȒșİȚĮȢ, 47/128 (36,7%) ȑįȦıĮȞ ȜȐșȠȢ IJȘȜȑijȦȞȠ țĮȚ 45/128 (35,2%) įİȞ IJȠ ȖȞȫȡȚȗĮȞ. ȂİIJĮȟȪ ȖȚĮIJȡȫȞ țĮȚ ȞȠıȘȜİȣIJȫȞ įİȞ ȣʌȒȡȤĮȞ įȚĮijȠȡȑȢ ıIJĮ ʌȠıȠıIJȐ. 4. ȉȠ 37,9% IJȦȞ ȞȠıȘȜİȣIJȫȞ țĮȚ IJȠ 10% IJȦȞ ȖȚĮIJȡȫȞ țĮIJȐ IJȘȞ ȀǹȇȆǹ įİȞ İijĮȡȝȩȗȠȣȞ ıȦıIJȐ IJȠȞ ĮȜȖȩȡȚșȝȠ ıȪȝijȦȞĮ ȝİ IJȚȢ țĮIJİȣșȣȞIJȒȡȚİȢ ȠįȘȖȓİȢ IJȠȣ ǼȣȡȦʌĮȧțȠȪ ȈȣȝȕȠȣȜȓȠȣ ǹȞĮȗȦȠȖȩȞȘıȘȢ. ȈIJȠȣȢ ȖȚĮIJȡȠȪȢ ȣʌȐȡȤİȚ ıIJĮIJȚıIJȚțȫȢ ıȘȝĮȞIJȚțȒ įȚĮijȠȡȐ (ȡ<0,005). 5. ȉȠ 96,6% IJȦȞ ȞȠıȘȜİȣIJȫȞ țĮȚ IJȠ 95,2% IJȦȞ ȖȚĮIJȡȫȞ ıİ ʌİȡȓʌIJȦıȘ țĮȡįȚĮțȒȢ ĮȞĮțȠʌȒȢ șĮ ijȦȞȐȟȠȣȞ ĮȞĮȚıșȘıȚȠȜȩȖȠ . 6. ȉȠ 90,6% ȖȞȦȡȓȗİȚ ȩIJȚ ȣʌȐȡȤİȚ ĮʌȚȞȚįȦIJȒȢ ıIJȠȞ ȤȫȡȠ IJȠȣȢ țĮȚ IJȠ 93,9% ȖȞȦȡȓȗİȚ ʌȠȣ ĮțȡȚȕȫȢ İȓȞĮȚ. 7. ȉȠ 91% ȖȞȦȡȓȗİȚ ȩIJȚ ıIJȘȞ țȜȚȞȚțȒȢ IJȠȣȢ ȣʌȐȡȤİȚ țĮȡȩIJıȚ İʌİȚȖȩȞIJȦȞ, ĮȜȜȐ ȝȩȞȠ IJȠ 46% ʌȚıIJİȪİȚ ȩIJȚ İȜȑȖȤİIJĮȚ ıİ țĮșȘȝİȡȚȞȒ ȕȐıȘ. ȈȊȂȆǼȇǹȈȂǹȉǹ – ȈȊǽǾȉǾȈǾ : ǹʌȩ IJĮ ĮʌȠIJİȜȑıȝĮIJĮ IJȘȢ ʌĮȡȠȪıȘȢ ȝİȜȑIJȘȢ ijĮȓȞİIJĮȚ ȩIJȚ ȖȚĮIJȡȠȓ țĮȚ ȞȠıȘȜİȣIJȑȢ ʌȠȣ įȠȣȜİȪȠȣȞ ıIJȠȞ ȓįȚȠ ȤȫȡȠ ȑȤȠȣȞ įȚĮijȠȡİIJȚțȒ ĮȞIJȓȜȘȥȘ ȖȚĮ șȑȝĮIJĮ ʌȠȣ ĮijȠȡȠȪȞ IJȘȞ ĮȞĮȗȦȠȖȩȞȘıȘ. ȆİȡȚııȩIJİȡȠȚ Įʌȩ IJȠȣȢ ȝȚıȠȪȢ įİȞ ȖȞȦȡȓȗȠȣȞ IJȠ IJȘȜȑijȦȞȠ țȜȒıȘȢ ȕȠȒșİȚĮȢ, İȞȫ ȑȞĮ ıȘȝĮȞIJȚțȩ ʌȠıȠıIJȩ įİȞ İijĮȡȝȩȗİȚ IJȘȞ ĮȜȜȘȜȠȣȤȓĮ İȞİȡȖİȚȫȞ ıİ ʌİȡȓʌIJȦıȘ țĮȡįȚĮțȒȢ ĮȞĮțȠʌȒȢ. ȉĮ ʌȠıȠıIJȐ ĮȣIJȐ ʌȚșĮȞȩȞ ȞĮ ȒIJĮȞ ȝİȖĮȜȪIJİȡĮ İȐȞ Ș ȑȡİȣȞĮ İȓȤİ IJȘȞ ȝȠȡijȒ İȟȑIJĮıȘȢ țĮȚ įİȞ ʌİȡȚȠȡȓȗȠȞIJĮȞ ıIJȘȞ ȝȠȡijȒ İȡȦIJȘȝĮIJȠȜȠȖȓȠȣ. ĭĮȓȞİIJĮȚ ȩIJȚ Ș ʌȚıIJȠʌȠȚȘȝȑȞȘ İțʌĮȓįİȣıȘ Įʌȩ ȝȩȞȘ IJȘȢ įİȞ Įȡțİȓ ȖȚĮ IJȘȞ ȕİȜIJȓȦıȘ țĮIJȐıIJĮıȘȢ. Ǿ ıȣıIJȘȝĮIJȚțȒ țĮIJĮȖȡĮijȒ IJȦȞ İȞįȠȞȠıȠțȠȝİȚĮțȫȞ țĮȡįȚĮțȫȞ ĮȞĮțȠʌȫȞ, Ș İijĮȡȝȠȖȒ ʌȡȠȖȡȐȝȝĮIJȠȢ İȜȑȖȤȠȣ ʌȠȚȩIJȘIJĮȢ ȖȚĮ IJȘȞ ĮȞIJȚȝİIJȫʌȚıȘ IJȦȞ ȞȠıȠțȠȝİȚĮțȫȞ İʌİȚȖȩȞIJȦȞ ʌİȡȚıIJĮIJȚțȫȞ țĮȚ Ș ȜȒȥȘ șİıȝȚțȫȞ ȝȑIJȡȦȞ șĮ ȝʌȠȡȠȪıİ ȞĮ ȑȤİȚ șİIJȚțȒ İʌȓįȡĮıȘ ıIJȘȞ ĮȞIJȚȝİIJȫʌȚıȘ IJȦȞ țĮȡįȚĮțȫȞ ĮȞĮțȠʌȫȞ. ǺǿǺȁǿȅīȇǹĭǿǹ

1. Soar J, Monsieurs K, Balance J et al. European Council Guidelines for Resuscitation 2010. Section 9 : Principales of education in resuscitation.

2. Cummins R, Chamberlain D, Hazinski M et al. Recommended guidelines for reviewing, reporting and conducting research on in hospital resuscitation the in hopsitan Utstein Style. Resuscitation 1997 ; 151-183.

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BUDGET IMPACT OF USING SUGAMMADEX FOR THE ROUTINE REVERSAL OF NEUROMUSCULAR BLOCKADE IN A GREEK HEALTH CARE SETTING

Insinga RP1, Konstantopoulou T2, Athanasakis K3, Argyris G2. 1Merck & Co, Inc., Upper Gwynedd, PA, USA

2MSD Greece, Alimos, Greece

3National School of Public Health, Department of Health Economics, Athens, Greece

Objective: To model the annual impact on hospital costs following the introduction of sugammadex for routine reversal of neuromuscular blockade.

Methods: An economic model reflecting resource use and costs associated with neuromuscular block and its reversal, and residual blockade, was constructed for a typical Greek hospital. Clinical trial data were used to estimate time savings relating to shortened reversal in the operating room (OR) for sugammadex compared to neostigmine and no reversal. Costs of OR time were derived from labor costs for different types of OR staff. Resource use associated with residual blockade sequelae (aspiration, hypoxemia, muscle weakness, upper airway obstruction) was estimated from the literature. Annual procedures, utilization of neuromuscular blocking and reversal agents, and uptake of sugammadex within a typical Greek hospital were estimated. Unit costs were based on public data sources or published literature.

Results: If all OR staff modeled (with average staff attendance across all procedures of 2.4 anesthetists, 3.5 surgeons and 3.7 nurses) can realize time savings with shortened reversal, use of sugammadex is estimated to save a typical Greek hospital, using sugammadex in 7,130 procedures annually, 23,717 € per year. This corresponds to an increase in drug costs of 358,963 €, which is more than fully offset by a decrease in costs of OR staff and clinical sequelae of residual blockade (-382,680 €). In a worst case scenario, if only one second degree anesthetist, one second degree surgeon and one nurse in attendance realize time savings, annual costs would be increased (198,404 €). Results were sensitive to OR staff costs and time savings.

Conclusion: Sugammadex for routine reversal of neuromuscular blockade can potentially lead to cost savings in the Greek healthcare setting. The degree to which costs may be saved depends upon which OR staff can realize time savings with shortened reversal.

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IA-6 ǼȀȆǹǿǻǼȊȈǾ ȈȉǾȃ ǹȃǹǽȍȅīȅȃǾȈǾ DZȖȖȠȣ Ȃ, ȆĮȖȚȩʌȠȣȜȠȢ Ȁ, ȂĮȞȦȜȒ Ǻ, ȆȐȞIJȠȣ Ǽ, ȀȠȣIJıȚĮȞIJȐ – ǽĮȝʌȩțĮ Ȁ, ĭȣȞIJĮȞȓįȠȣ Ǻ, īȡȠıȠȝĮȞȓįȘȢ Ǻ. ȆĮȞİʌȚıIJȘȝȚĮțȩ īİȞȚțȩ ȃȠıȠțȠȝİȓȠ ĬİııĮȜȠȞȓțȘȢ ǹȋǼȆǹ ǼǿȈǹīȍīǾ – ȈȀȅȆȅȈ : Ǿ İțʌĮȓįİȣıȘ ıIJȘ ȕĮıȚțȒ ȣʌȠıIJȒȡȚȟȘ IJȘȢ ȗȦȒȢ ĮʌİȣșȪȞİIJĮȚ ıİ ȣȖİȚȠȞȠȝȚțȠȪȢ țĮȚ ıİ ĮʌȜȠȪȢ ʌȠȜȓIJİȢ țĮȚ ȖİȞȚțȐ ıİ ĮȣIJȠȪȢ ʌȠȣ ʌȡȫIJȠȚ șĮ ĮȞIJĮʌȠțȡȚșȠȪȞ ıIJȠȞ ĮıșİȞȒ ʌȠȣ țĮIJĮȡȡȑİȚ. Ǿ İȜȜȘȞȚțȒ ʌȠȜȚIJİȓĮ ĮȞIJĮʌȠțȡȚȞȩȝİȞȘ ıIJȘȞ ĮȞȐȖțȘ ĮȣIJȒ ȑȤİȚ ȥȘijȓıİȚ IJȠ șİıȝȚțȩ ʌȜĮȓıȚȠ (ĭǼȀ 219/22-2-07) ȕȐıİȚ IJȠȣ ȠʌȠȓȠȣ ȩȜȠȚ ȠȚ İʌĮȖȖİȜȝĮIJȓİȢ ȣȖİȓĮȢ șĮ ʌȡȑʌİȚ ȞĮ İțʌĮȚįİȣșȠȪȞ ıIJȘȞ ĮȞĮȗȦȠȖȩȞȘıȘ. To ȞȠıȠțȠȝİȓȠ ǹȋǼȆǹ ȜİȚIJȠȣȡȖİȓ ȦȢ țȑȞIJȡȠ ʌĮȡȠȤȒȢ ʌȚıIJȠʌȠȚȘȝȑȞȘȢ İțʌĮȓįİȣıȘȢ ıIJȘȞ ǺĮıȚțȒ ȊʌȠıIJȒȡȚȟȘ IJȘȢ ǽȦȒȢ ȝİ ȋȡȒıȘ ǹȣIJȩȝĮIJȠȣ ǼȟȦIJİȡȚțȠȪ ǹʌȚȞȚįȦIJȒ (BLS/AED. Ȃİ IJȘ ȝİȜȑIJȘ ĮȣIJȒ șİȜȒıĮȝİ ȞĮ ĮȞĮȜȪıȠȣȝİ IJĮ İʌȚȝȑȡȠȣȢ ȤĮȡĮțIJȘȡȚıIJȚțȐ IJȦȞ ıȣȝȝİIJİȤȩȞIJȦȞ ıIJȠ ʌȡȩȖȡĮȝȝĮ ĮȣIJȩ. ȊȁǿȀȅ – ȂǼĬȅǻȅȈ : ȈIJȠ ȞȠıȠțȠȝİȓȠ ǹȋǼȆǹ Įʌȩ IJȠ 2007 ʌĮȡȑȤİIJĮȚ ʌȚıIJȠʌȠȚȘȝȑȞȘ İțʌĮȓįİȣıȘ ıIJȘ BLS/AED, Ș İțʌĮȓįİȣıȘ ĮʌİȣșȪȞİIJĮȚ țȣȡȓȦȢ ıIJȠȣȢ İȡȖĮȗȠȝȑȞȠȣȢ IJȠȣ ȞȠıȠțȠȝİȓȠȣ ĮȜȜȐ țĮȚ ıİ İȡȖĮȗȠȝȑȞȠȣȢ ȐȜȜȦȞ ȞȠıȠțȠȝİȓȦȞ, ijȠȚIJȘIJȑȢ țĮȚ ĮʌȜȠȪȢ ʌȠȜȓIJİȢ. Ȃİ ıIJȩȤȠ IJȘȞ İȟĮıijȐȜȚıȘ ȕȚȦıȚȝȩIJȘIJĮȢ Ș İțʌĮȓįİȣıȘ ʌĮȡȑȤİIJĮȚ įȦȡİȐȞ țĮȚ İȞIJȩȢ ʌȡȦȚȞȠȪ ȦȡĮȡȓȠȣ. ȅȚ İțʌĮȚįİȣIJȑȢ İȓȞĮȚ İȡȖĮȗȩȝİȞȠȚ IJȠȣ ȞȠıȠțȠȝİȓȠȣ ȝĮȢ, IJȠ İțʌĮȚįİȣIJȚțȩ ȣȜȚțȩ țĮȚ ȠȚ ȤȫȡȠȚ ĮȞȒțȠȣȞ ıIJȠ ȞȠıȠțȠȝİȓȠ İȞȫ Įʌȩ IJȘȞ įȚȠȓțȘıȘ IJȘȢ ȞȠıȘȜİȣIJȚțȒȢ ȣʌȘȡİıȓĮȢ įȩșȘțİ ĮʌĮȚIJȠȪȝİȞȘ ȣʌȠıIJȒȡȚȟȘ ȖȚĮ IJȘȞ ıȣȝȝİIJȠȤȒ IJȦȞ ȞȠıȘȜİȣIJȫȞ İȓIJİ ȦȢ İțʌĮȚįİȣIJȑȢ İȓIJİ ȦȢ İțʌĮȚįİȣȩȝİȞȠȚ. Ǿ ıȣȝȝİIJȠȤȒ ȖȚĮ IJȠȣȢ İțʌĮȚįİȣIJȑȢ ĮȜȜȐ țĮȚ ȖȚĮ IJȠȣȢ İțʌĮȚįİȣȩȝİȞȠȣȢ İȓȞĮȚ ʌȡȠĮȚȡİIJȚțȒ. ǹȆȅȉǼȁǼȈȂǹȉǹ : ȉȠ ıȪȞȠȜȠ IJȦȞ ıİȝȚȞĮȡȓȦȞ, IJȠȣ ĮȡȚșȝȠȪ IJȦȞ İțʌĮȚįİȣșȑȞIJȦȞ țĮȚ IJĮ İʌȚȝȑȡȠȣȢ ȤĮȡĮțIJȘȡȚıIJȚțȐ IJȠȣȢ ijĮȓȞȠȞIJĮȚ ıIJȠȞ ʌĮȡĮțȐIJȦ ʌȓȞĮțĮ

ȈİȝȚȞȐȡȚĮ 83 ǼȚįȚțȠȓ ǼȚįȚțİȣȩȝİȞȠȚ ǹʌȩ IJȠȣȢ İȚįȚțȠȪȢ ȖȚĮIJȡȠȪȢ ȝȩȞȠ įȪȠ ȒIJĮȞ ıIJȘȞ ȕĮșȝȓįĮ IJȠȣ įȚİȣșȣȞIJȒ. ȂȑȜȘ ǻǼȆ ȒIJĮȞ ȝȩȞȠ ȠįȠȞIJȓĮIJȡȠȚ – ȖȞĮșȠȤİȚȡȠȣȡȖȠȓ . ǹʌȩ IJȠȣȢ ȞȠıȘȜİȣIJȑȢ țĮȞȑȞĮȢ įİȞ ȒIJĮȞ ıİ ȕĮșȝȓįĮ ȝİȖĮȜȪIJİȡȘ IJȠȣ/IJȘȢ ʌȡȠȧıIJȐȝİȞȠȣ/ȞȘȢ. ȈȪȞȠȜȠ 2216 ȈȪȞȠȜȠ 49 390 ȃȠıȘȜİȣIJȑȢ 1100 ȆĮșȠȜȩȖȠȚ 11 90 ȆĮȡĮȧĮIJȡȚțȩ 127 ȀĮȡįȚȠȜȩȖȠȚ 1 10 ǿĮIJȡȠȓ 466 ȆĮȚįȓĮIJȡȠȚ 2 45 ĭȠȚIJȘIJȑȢ 344 ȃİȣȡȠȤİȚȡȠȣȡȖȠȓ 0 3 ǻȚȠȚțȘIJȚțȩ – ȉİȤȞȚțȩ 66 ǺȚȠʌĮșȠȜȩȖȠȚ 4 5 ȉȡĮȣȝĮIJȚȠijȠȡİȓȢ 26 ȋİȚȡȠȣȡȖȠȓ 3 36 ȆȠȜȓIJİȢ 22 ǹȚȝĮIJȠȜȩȖȠȚ 12 0 ȅįȠȞIJȓĮȞIJȡȠȚ 27 īȞĮșȠȤİȚȡȠȣȡȖȠȓ 7 0 ȂȑȜȘ ǼșİȜȠȞIJȚțȫȞ ȠȝȐįȦȞ 23 ȆȣȡȘȞȚțȠȓ ǿĮIJȡȠȓ 0 3 ǼșİȜȩȞIJȡȚİȢ 15 ǹțIJȚȞȠȜȩȖȠȚ 3 3 īİȞȚțȠȓ ǿĮIJȡȠȓ 2 67 ȃȠıȘȜİȣIJȑȢ İțIJȩȢ ǹȋǼȆǹ 247 ȅijșĮȜȝȓĮIJȡȠȚ 0 13 ǿĮIJȡȠȓ ǼțIJȩȢ ǹȋǼȆǹ 69 ǹȞĮȚıșȘıȚȠȜȩȖȠȚ 2 19 ǹȖȡȠIJȚțȠȓ ȚĮIJȡȠȓ 27 ȅȡșȠʌİįȚțȠȓ 1 2 ȆȡȠȧıIJȐȝİȞİȢ 12 ȃİȣȡȠȜȩȖȠȚ 0 1 ȆĮșȠȜȠȖĮȞĮIJȩȝȠȚ 0 7 ȌȣȤȓĮIJȡȠȚ 0 5 īȣȞĮȚțȠȜȩȖȠȢ 1 1 ȀĮȡįȚȠȤİȚȡȠȣȡȖȠȓ 0 3 ȈȊȂȆǼȇǹȈȂǹȉǹ – ȈȊǽǾȉǾȈǾ : ǹʌȩ IJȘȞ țĮIJĮȖȡĮijȒ IJȦȞ įİįȠȝȑȞȦȞ ijĮȓȞİIJĮȚ ȩIJȚ IJȠ ʌȡȩȖȡĮȝȝĮ ȑȜĮȕİ İȣȡİȓĮȢ ĮʌȠįȠȤȒȢ. Ǿ İȟĮıijȐȜȚıȘ ʌȩȡȦȞ ȖȚĮ IJȘȞ țȐȜȣȥȘ IJȠȣ țȩıIJȠȣȢ țĮȚ Ș ʌȡĮȖȝĮIJȠʌȠȓȘıȘ IJȘȢ İțʌĮȓįİȣıȘȢ ıİ İȡȖȐıȚȝȠ ȦȡȐȡȚȠ İȟĮıijȐȜȚıİ IJȘȞ ȕȚȦıȚȝȩIJȘIJĮ IJȠȣ. ǹʌȩ IJȘȞ İʌȚȝȑȡȠȣȢ ĮȞȐȜȣıȘ ijĮȓȞİIJĮȚ ȩIJȚ Ș ıȣȞIJȡȚʌIJȚțȒ ʌȜİȚȠȥȘijȓĮ IJȦȞ ıȣȝȝİIJİȤȩȞIJȦȞ ȒIJĮȞ ȞȠıȘȜİȣIJȑȢ, İȞȫ Įʌȩ IJȠȣȢ ȖȚĮIJȡȠȪȢ ȠȚ ʌİȡȚııȩIJİȡȠȚ ȒIJĮȞ İȚįȚțİȣȩȝİȞȠȚ. ȃȠıȘȜİȣIJȑȢ țĮȚ ȖȚĮIJȡȠȓ ıİ ȣȥȘȜȑȢ ȕĮșȝȓįİȢ įİȞ ıȣȝȝİIJİȓȤĮȞ, İȞȫ ȝȚțȡȒ ȒIJĮȞ țĮȚ Ș ıȣȝȝİIJȠȤȒ IJȦȞ IJȡĮȣȝĮIJȚȠijȠȡȑȦȞ. Ǿ İʌȚijȩȡIJȚıȘ ȝİ įȚȠȚțȘIJȚțȩ ȑȡȖȠ İȚȢ ȕȐȡȠȢ IJȠȣ țȜȚȞȚțȠȪ, țĮȚ Ș ȝȘ IJȠʌȠșȑIJȘıȘ IJȠȣ İĮȣIJȠȪ IJȠȣȢ ıİ ĮȣIJȠȪȢ ʌȠȣ ȑȤȠȣȞ țĮșȒțȠȞ ȞĮ ĮȞIJĮʌȠțȡȓȞȠȞIJĮȚ ıIJȠȞ ĮıșİȞȒ ʌȠȣ țĮIJĮȡȡȑİȚ șĮ ȝʌȠȡȠȪıĮȞ ȞĮ İȟȘȖȒıȠȣȞ IJȠ ijĮȚȞȩȝİȞȠ ĮȣIJȩ. Ȉİ țȐșİ ȩȝȦȢ ʌİȡȓʌIJȦıȘ ȤȡİȚȐȗİIJĮȚ İʌȚʌȜȑȠȞ ĮȞȐȜȣıȘ, ʌȡȠıʌȐșİȚĮ ȖȚĮ ĮȜȜĮȖȒ IJȠȣ IJȡȩʌȠȣ ıțȑȥȘȢ ĮȜȜȐ țĮȚ ȜȒȥȘ șİıȝȚțȫȞ ȝȑIJȡȦȞ ȖȚĮ IJȘȞ İijĮȡȝȠȖȒ IJȘȢ ȚıȤȪȠȣıĮȢ ȞȠȝȠșİıȓĮȢ. ǺǿǺȁǿȅīȇǹĭǿǹ

1. Soar J, Monsieursb K, Ballancec J et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 9. Principles of education in resuscitation. Resuscitation 2010 ; 81 : 1434–1444. 2. Chamberlain D, Hazinski M. Education in resuscitation. Resuscitation 2003;59:11–43.

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ȆȍȈ ȂǹȈ ǺȁǼȆȅȊȃ ȅǿ ǹȈĬǼȃǼǿȈ: ȉǿ ĭȅǺȅȊȃȉǹǿ Ȁǹǿ ȉǿ ȆǿȈȉǼȊȅȊȃ īǿǹ ȉȅ ȇȅȁȅ, ȉǹ ȀǹĬǾȀȅȃȉǹ, ȉǾȃ ǼȊĬȊȃǾ Ȁǹǿ ȉǾȃ ǼȆǿȀȅǿȃȍȃǿǹ ȉȅȊ ǹȃǹǿȈĬǾȈǿȅȁȅīȅȊ ȂǼ ȉȅȃ ǹȇȇȍȈȉȅ ȆĮʌĮıʌȪȡȠȢ ĭi ȂĮIJȚȐțȘ Ǽi ȂȚȤĮȘȜȓįȠȣ Ǽi ȀĮȝʌĮȡȠȪįȘ ȃii ȂȠȪIJıȚĮȞȠȢ īi ĭȚȜȑȜȘ ǹi ǹȞĮȖȞȦıIJȐȡĮ Ǽi īȃĬ ǿʌʌȠțȡȐIJİȚȠ (i), īȃ īȚĮȞȞȚIJıȫȞ (ii). ǼȚıĮȖȦȖȒ: Ǿ ĮȞIJȓȜȘȥȘ IJȠȣ țȠȚȞȠȪ ıȤİIJȚțȐ ȝİ IJȠ ȡȩȜȠ IJȠȣ ĮȞĮȚıșȘıȚȠȜȩȖȠȣ İȞIJȩȢ țĮȚ İțIJȩȢ ȤİȚȡȠȣȡȖİȓȠȣ ĮʌȑȤİȚ Įʌȩ IJȘȞ ʌȡĮȖȝĮIJȚțȩIJȘIJĮ1-6. ȅȚ İȖȖİȞİȓȢ ıȣȞșȒțİȢ ȕȐıİȚ IJȦȞ ȠʌȠȓȦȞ ĮıțİȓIJĮȚ ıȣȞȒșȦȢ Ș ĮȞĮȚıșȘıȚȠȜȠȖȓĮ İȟȘȖȠȪȞ ıİ țȐʌȠȚȠ ȕĮșȝȩ ĮȣIJȒ IJȘȞ țĮIJȐıIJĮıȘ. Ǿ ȐȖȞȠȚĮ ȦıIJȩıȠ ıȤİIJȚțȐ ȝİ IJȚȢ įȚĮijȠȡİIJȚțȑȢ țȜȚȞȚțȑȢ țĮIJĮıIJȐıİȚȢ ʌȠȣ ĮȞIJȚȝİIJȦʌȓȗİȚ Ƞ ĮȞĮȚıșȘıȚȠȜȩȖȠȢ įȣıȤİȡĮȓȞİȚ IJȘȞ ʌȡȠıʌȐșİȚĮ ȖȚĮ İȟĮıijȐȜȚıȘ ıȣȞșȘțȫȞ ĮıijĮȜȑıIJİȡȘȢ ĮȞĮȚıșȘıȚȠȜȠȖȚțȒȢ ijȡȠȞIJȓįĮȢ. ǼʌȓıȘȢ ʌİȡȚȠȡȓȗİȚ IJȠȣȢ įȚĮșȑıȚȝȠȣȢ ȠȚțȠȞȠȝȚțȠȣȢ ʌȩȡȠȣȢ țĮȚ IJȚȢ İȣțĮȚȡȓİȢ ȖȚĮ ʌİȡĮȚIJȑȡȦ ĮțĮįȘȝĮȧțȒ ĮȞȐʌIJȣȟȘ IJȘȢ İȚįȚțȩIJȘIJĮȢ. ǹȡȦȖȩȢ ıIJȘȞ ʌȡȠıʌȐșİȚĮ įȚĮijȫIJȘıȘȢ IJȠȣ țȠȚȞȠȪ İȓȞĮȚ Ș İʌȚțȠȚȞȦȞȓĮ IJȠȣ ĮȞĮȚıșȘıȚȠȜȩȖȠȣ ȝİ IJȠȞ ʌȡȠİȖȤİȚȡȘIJȚțȩ ĮıșİȞȒ7: ȈȣȝȕȐȜȜİȚ ıIJȘȞ ȝİȓȦıȘ IJȠȣ ʌȡȠ-ĮȞĮȚıșȘIJȚțȠȪ ȐȖȤȠȣȢ țĮȚ ıIJȘȞ İȞȘȝȑȡȦıȘ IJȠȣ ıȤİIJȚțȐ ȝİ IJȠ ȡȩȜȠ IJȠȣ ĮȞĮȚıșȘıȚȠȜȩȖȠȣ, ĮȜȜȐ įİȞ ĮȟȚȠʌȠȚİȓIJĮȚ ıIJȘȞ ĮȞĮȚıșȘıȚȠȜȠȖȚțȒ ȝĮȢ țĮșȘȝİȡȚȞȩIJȘIJĮ ıIJȠ ȝȑȖȚıIJȠ įȣȞĮIJȩ ȕĮșȝȩ. ȈțȠʌȩȢ IJȘȢ ʌĮȡȠȪıĮȢ ȑȡİȣȞĮȢ İȓȞĮȚ Ș ĮȞȐįİȚȟȘ IJȦȞ ĮʌȩȥİȦȞ IJȦȞ ĮıșİȞȫȞ ıȤİIJȚțȐ ȝİ IJĮ țĮșȒțȠȞIJĮ IJȠȣ ĮȞĮȚıșȘıȚȠȜȩȖȠȣ țĮȚ IJȘȢ ȝİȓȗȠȞȠȢ ıȘȝĮıȓĮȢ ʌȠȣ ȑȤİȚ Ș țĮȜȒ İʌȚțȠȚȞȦȞȓĮ IJȦȞ įȪȠ ʌȜİȣȡȫȞ ıIJȘȞ ȕİȜIJȓȦıȘ IJȘȢ įȘȝȩıȚĮȢ İȚțȩȞĮȢ IJȘȢ İȚįȚțȩIJȘIJĮȢ. ȂȑșȠįȠȢ: ȂİȜȑIJȘ IJȪʌȠȣ İȡȦIJȘȝĮIJȠȜȠȖȓȠȣ, 150 ĮıșİȞȫȞ ʌȠȣ İȓȤĮȞ ȣʌȠȕȜȘșİȓ ıİ IJĮțIJȚțȩ ȤİȚȡȠȣȡȖİȓȠ ȣʌȩ ȖİȞȚțȒ Ȓ IJȠʌȠʌİȡȚȠȤȚțȒ ĮȞĮȚıșȘıȓĮ ıİ 4 īİȞȚțȐ ȃȠıȠțȠȝİȓĮ IJȘȢ ǺȩȡİȚĮȢ ǼȜȜȐįȠȢ. ǹʌȠIJİȜȑıȝĮIJĮ: ȉĮ 2/3 ʌİȡȓʌȠȣ IJȦȞ ĮıșİȞȫȞ ĮȞȒțĮȞ ıIJȚȢ ȘȜȚțȚĮțȑȢ ȠȝȐįİȢ 19-35 (34,4%) țĮȚ 36-50 (29,1%). ȉȠ 62,4% ȒIJĮȞ ȖȣȞĮȓțİȢ țĮȚ IJȠ 37,6% ȐȞįȡİȢ. ȉȠ 62,8% ĮʌȐȞIJȘıĮȞ ʌȦȢ İȓȞĮȚ ĮʌȩijȠȚIJȠȚ įȘȝȠIJȚțȠȪ, ȖȣȝȞĮıȓȠȣ Ȓ ȜȣțİȓȠȣ. Ǿ ʌȜİȚȠȞȩIJȘIJĮ IJȦȞ ĮıșİȞȫȞ (82,9%) ĮʌȐȞIJȘıİ ʌȦȢ Ƞ ĮȞĮȚıșȘıȚȠȜȩȖȠȢ İȓȞĮȚ ȖȚĮIJȡȩȢ țĮȚ ʌȦȢ Ƞ ȡȩȜȠȢ IJȠȣ ıİ ȝȚĮ İȖȤİȓȡȘıȘ İȓȞĮȚ ȞĮ įȓȞİȚ IJĮ ijȐȡȝĮțĮ ȖȚĮ ȞĮ «țȠȚȝȘșİȓ» Ƞ ĮıșİȞȒȢ (28%). DZȜȜȠȚ ȡȩȜȠȚ ʌȠȣ IJȠȣ ĮʌȠįȓįȠȞIJĮȚ įȚİȖȤİȚȡȘIJȚțȐ ȕȐıİȚ IJȦȞ ĮʌĮȞIJȒıİȦȞ IJȦȞ ĮıșİȞȫȞ İȓȞĮȚ Ș İȟĮıijȐȜȚıȘ IJȘȢ ȠȝĮȜȒȢ ȜİȚIJȠȣȡȖȓĮȢ IJȦȞ ȗȦIJȚțȫȞ ȠȡȖȐȞȦȞ (25%) țĮȚ Ș ĮijȪʌȞȚıȘ (24,4%). ȂȩȞȠ IJȠ 13,3% ʌȚıIJİȪİȚ ʌȦȢ Ș ȝİIJİȖȤİȚȡȘIJȚțȒ ĮȞĮȜȖȘıȓĮ ĮijȠȡȐ IJȠȞ ĮȞĮȚıșȘıȚȠȜȩȖȠ. ǼʌȓıȘȢ ȝȩȞȠ IJȠ 6% ȖȞȦȡȓȗİȚ ʌȦȢ ȠȚ ĮȞĮȚıșȘıȚȠȜȩȖȠȚ İʌĮȞįȡȫȞȠȣȞ IJȠ ȚĮIJȡİȓȠ ʌȩȞȠȣ. ǹȞIJȓșİIJĮ IJȠ 27% ʌȚıIJİȪİȚ ʌȦȢ, İțIJȩȢ ȤİȚȡȠȣȡȖİȓȠȣ, ȠȚ ĮȞĮȚıșȘıȚȠȜȩȖȠȚ İȡȖȐȗȠȞIJĮȚ ıIJȘ ȂǼĬ, IJȠ 29,2% ʌȦȢ ĮʌĮıȤȠȜȠȪȞIJĮȚ ıIJȚȢ ȝĮȚİȣIJȚțȑȢ țȜȚȞȚțȑȢ țĮȚ IJȠ 21,1% ıIJĮ İʌİȓȖȠȞIJĮ ʌİȡȚıIJĮIJȚțȐ. ȂȚțȡȐ İȓȞĮȚ IJĮ ʌȠıȠıIJȐ IJȦȞ ĮıșİȞȫȞ ʌȠȣ ʌȚıIJİȪȠȣȞ ʌȦȢ Ƞ ĮȞĮȚıșȘıȚȠȜȩȖȠȢ İȡȖȐȗİIJĮȚ İȞIJȩȢ IJȠȣ ĮıșİȞȠijȩȡȠȣ (6.8%) țĮȚ ıIJȠ ĮțIJȚȞȠȜȠȖȚțȩ IJȝȒȝĮ (0,9%). ȈȤİIJȚțȐ ȝİ IJȠ ʌȠȚȠȢ İȓȞĮȚ ʌȚȠ ıȘȝĮȞIJȚțȩȢ ȖȚĮ ȝȚĮ İȖȤİȓȡȘıȘ, IJȠ 93,3% ĮʌȐȞIJȘıİ ʌȦȢ țĮȚ Ƞ ȤİȚȡȠȣȡȖȩȢ țĮȚ Ƞ ĮȞĮȚıșȘıȚȠȜȩȖȠȢ İȓȞĮȚ İȟȓıȠȣ ıȘȝĮȞIJȚțȠȓ, ĮȞ țĮȚ IJȠ 19,5% șĮ İʌȑȜİȖİ IJȠȞ ȤİȚȡȠȣȡȖȩ ĮȞ İȓȤİ ĮȣIJȒ IJȘ įȣȞĮIJȩIJȘIJĮ, ĮȞIJȓșİIJĮ ȝİ IJȠ 2,6% ʌȠȣ șĮ İʌȑȜİȖİ IJȠȞ ĮȞĮȚıșȘıȚȠȜȩȖȠ. ȅ ıȣȤȞȩIJİȡȠȢ ijȩȕȠȢ IJȠȣ ĮȡȡȫıIJȠȣ ıİ ıȤȑıȘ ȝİ ȑȞĮ İʌȚțİȓȝİȞȠ ȤİȚȡȠȣȡȖİȓȠ İȓȞĮȚ «ĮȞ șĮ ȟȣʌȞȒıȦ Įʌȩ IJȘȞ ĮȞĮȚıșȘıȓĮ». ȉȑȜȠȢ ıȤİIJȚțȐ ȝİ IJȘ ȕĮȡȪIJȘIJĮ ʌȠȣ İȓȤİ Ș ʌȡȠĮȞĮȚıșȘIJȚțȒ İʌȓıțİȥȘ ıIJȘȞ ʌȡȠİIJȠȚȝĮıȓĮ IJȦȞ ĮıșİȞȫȞ IJȠ 65,1% įȒȜȦıİ ʌȦȢ İȓȤİ șİIJȚțȒ ıȣȝȕȠȜȒ ıIJȘȞ ȥȣȤȠȜȠȖȓĮ IJȠȣȢ. ȈȣȝʌİȡȐıȝĮIJĮ: ǹȞ țĮȚ Ș ʌȜİȚȠȞȩIJȘIJĮ IJȦȞ ĮıșİȞȫȞ ĮʌȐȞIJȘıİ ʌȦȢ ȖȞȦȡȓȗİȚ ȩIJȚ Ƞ ĮȞĮȚıșȘıȚȠȜȩȖȠȢ İȓȞĮȚ ȖȚĮIJȡȩȢ, ȠȚ ʌİȡȚııȩIJİȡȠȚ ĮȖȞȠȠȪȞ IJȠ įȚİȖȤİȚȡȘIJȚțȩ IJȠȣ ȡȩȜȠ țĮȚ ʌȠȜȪ ʌİȡȚııȩIJİȡȠ IJĮ țĮșȒțȠȞIJĮ IJȠȣ İțIJȩȢ ȤİȚȡȠȣȡȖİȓȠȣ. ȆĮȡ’ȩȜĮ ĮȣIJȐ IJȠ ʌȡȠİȖȤİȚȡȘIJȚțȩ ȐȖȤȠȢ ıȤİIJȚțȐ ȝİ IJȘȞ ĮȞĮȚıșȘıȓĮ ĮʌĮȞIJȐIJĮȚ ʌȠȜȪ ıȣȤȞȩIJİȡĮ Įʌȩ IJȠ ȐȖȤȠȢ IJȘȢ İȖȤİȓȡȘıȘȢ țĮșİĮȣIJȒȢ. Ǿ ʌȡȠĮȞĮȚıșȘIJȚțȒ İʌȓıțİȥȘ ʌȡȑʌİȚ ȞĮ ĮʌȠIJİȜİȓ ĮijȠȡȝȒ ȖȚĮ țĮȜȪIJİȡȘ İȞȘȝȑȡȦıȘ IJȠȣ ĮȡȡȫıIJȠȣ ıȤİIJȚțȐ ȝİ IJȠȞ, įȚİȖȤİȚȡȘIJȚțȩ ȑıIJȦ, ȡȩȜȠ IJȠȣ ĮȞĮȚıșȘıȚȠȜȩȖȠȣ țĮȚ IJȘȞ ȝİȓȦıȘ IJȠȣ, ĮįȚțĮȚȠȜȩȖȘIJȠȣ ıȣȞȒșȦȢ, ijȩȕȠȣ IJȠȣ ȦȢ ʌȡȠȢ IJȘȞ ĮȞĮȚıșȘıȓĮ.

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ǼȣȡİIJȒȡȚȠ

ȈȣȖȖȡĮijȑȦȞ

ǹȖȖİȜȓįȘ

ǹ

.

Ǻ

-4

ǹȖȖİȜȓįȘ

Ȃ

.

Ǻ

-4, B-10

ǹȖȖİȜȓįȠȣ

I-11

ǹȖȖȑȜȠȣ

I-13

DZȖȖȠȣ

IA-6,

ǿǹ

-4

ǹȘįȩȞȘ

Ǻ

-14,

Ǻ

-21,

Ĭ

-9,

ǿǹ

-4

ǹșĮȞĮıȐțȘȢ

ǿǹ

-5,

ǻ

-3

ǹȚȝȠȞȚȫIJȠȣ

ǿ

-7, I-13

ǹȓıȦʌȠȢ

Ĭ

-6

ǹȜȕĮȞȠȪ

Ȉȉ

-7

ǹȜİȟȐȞįȡȠȣ

B-7

ǹȜİȟȚȠȣ

I-8

ǹȜİȟȠȪįȘȢ

Ǻ

-11

ǹȝĮȞȓIJȘ

Ǻ

-14,

Ǻ

-20,

Ĭ

-8,

ǿǹ

-4

ǹȝʌȠȣıȚțȑ

Ȉȉ

-1,

Ȉȉ

-4

ǹȞĮȖȞȦıIJȐȡĮ

B-19,

Ǻ

-15,

ǿ

A-7,

ǿǹ

-3,

Ȉȉ

-6

ǹȞĮȖȞȫıIJȘȢ

ī

-6,

Ĭ

-3,

Ĭ

-4

ǹȞĮȞȚȐįȠȣ

Z-3

ǹȞĮıIJĮıȚȐįȠȣ

ǿ

-40

ǹȞĮıIJĮıȓȠȣ

ǿ

-17,

ǿ

-19,

ǿ

-39

ǹȞįȡȑȠȣ

B-9,

Ǻ

-5,

ǿǹ

-2

ǹȞșȩʌȠȣȜȠȢ

10, 11,

I-12, I-9,

ǿ

-29,

Ǻ

-5

ǹȞȓıȠȖȜȠȣ

ǿ

-40

ǹȞIJȪʌĮ

ǹ

.

Ǻ

-2,

Ǻ

-3

ǹȞIJȪʌĮ

Ǽ

.

ǿ

-28

ǹȞIJȦȞȚȐįȠȣ

ǿ

-21,

ǿ

-28

ǹȞIJȦȞȓȠȣ

ǹ

. I-15

ǹȞIJȦȞȓȠȣ

ȋ

.

ǻ

-4,

ǻ

-5

ǹȞIJȫȞȠȖȜȠȣ

ī

-4

ǹȡĮȝʌĮIJȗȒȢ

ī

-6,

Ĭ

-3,

Ĭ

-4

ǹȡȕĮȞȚIJȐțȘ

Ǽ

-1

ǹȡȕĮȞȓIJȘ

ǹ

.

ǿ

-3

ǹȡȕĮȞȓIJȘ

Ȃ

.

ǿ

-28

ǹȡȖȪȡȘȢ

ǿǹ

-5

ǹȡȖȣȡȚȐįȠȣ

ǻ

-8

ǹȡȖȣȡȠʌȠȪȜȠȣ

ǿ

-29

ǹȡȞĮȠȪIJȠȖȜȠȣ

ǿ

-6

ǹıțȘIJȠʌȠȪȜȠȣ

ǻ

-3

ǹıȜĮȝȐȗȘ

Ǻ

-23

ǹıȜĮȞȓįȘȢ

ǿ

-17,

ǿ

-18,

ǿ

-19,

ǿ

-39

ǹıȠȣȤȓįȠȣ

Ǻ

-13, ī

-7, Ǿ

-2

ǹıIJȑȡȘ

Z-3

ǹıIJİȡȓȠȣ

ǿ

-40

ǺȐțĮȜȠȢ

I-1, I-2

ǺĮȜıĮȝȓįȘȢ

B-8

ǺĮȞȐțĮȢ

Ǻ

-13, ī

-7, Ǽ

-1,

Ǿ

-2,

Ĭ

-7

ǺĮıȚȜȐțȘȢ

Ǻ

-5,

ǿǹ

-2

ǺĮıȚȜȐțȠȢ

Ǻ

-14,

Ǻ

-17,

Ǻ

-18,

Ǻ

-22,

Ǻ

-23,

ǻ

-8,

ǽ

-1,

Ǿ

-1,

Ĭ

-8,

Ĭ

-9,

ǿǹ

-4

ǺĮıȚȜİȚȐįȠȣ

ǿ

-26,

ǺĮıȚȜȚȐȖțȠȣ

ǿ

-28

ǺİțȡȐțȠȣ

Ĭ

-3

ǺİȡȠȞȓțȘ

Ǻ

-18,

Ǻ

-21,

Ǻ

-22

ǺȚȠȜȐțȘ

ǿ

-20,

ǿ

-23,

ǿ

-31,

ǿ

-35

ǺȚIJȠȪȜĮ

ǿ

-16

ǺȜĮȤȠȖȚȐȞȞȘ

I-13,

ǿ

-7

ǺȜȐȤȠȢ

ī

-6,

Ĭ

-3

ǺȠȖȚĮIJȗȐțȘ

Ǻ

-11

ǺȠȖȚĮIJȗȒ

ǿ

-34,

ǿ

-35

ǺȩȜĮțȜȘ

ǿ

-20,

ǿ

-23,

ǿ

-31,

ǿ

-35

ǺȠȞIJȓIJıȠȣ

Ȉȉ

-3

ǺȠȣįȠȪȡȘȢ

ǿ

-5

ǺȠȣȜȚȫIJȘ

Ǻ

-3

ǺȡĮȞȐȢ

ǻ

-4

ǺȡȪȗĮ

Ǻ

-2

īĮȜĮȞȐțȘ

I-13

īĮȝʌȠʌȠȣȜȠȣ

B-12

īİȦȡȖȐțĮȢ

ǿ

-16,

ǿ

-25,

ǿ

-27

īİȦȡȖȚȐįȠȣ

ǿ

-36,

ǿ

-37

īİȦȡȖȓȠȣ

B-7

īİȦȡȖȠȖȚĮȞȞȐțȘ

Ȉȉ

-2

īİȦȡȖȠʌȠȪȜȠȣ

ī

. B-6

īİȦȡȖȠʌȠȪȜȠȣ

Ǽ

.

B-19,

Ȉȉ

-6

īȚĮȞȞȐțȘ

ī

-1,

ī

-2,

Ĭ

-1

īȚĮȞȞȐțȠȣ

ǿ

-17,

ǿ

-18,

ǿ

-19,

ǿ

-30,

ǿ

-39, Z-2

īȚĮȞȞȚIJȩʌȠȣȜȠȢ

B-6

īȚĮȞȞȠȪıȘȢ

I-1, I-2

īȚĮıȞȑIJıȠȕĮ

ǿ

-38

īȚȦIJĮțȘȢ

B-12

īțȑțĮ

ǿ

-17,

ǿ

-18,

ǿ

-19,

ǿ

-39

īțȓȞȘ

ǿ

-3

īțȜȚȞĮȕȠȣ

ǻ

-6

īțȝʌȐȞIJȚ

ǻ

-4,

ǻ

-5,

Ĭ

-5

īțȠȞİȗȠȣ

I-8,

ǿ

-24,

ǿ

-3,

ǿ

-32,

ǿ

-33

īțȩIJıȘ

Ȉȉ

-4

īțȠȣȞIJȒ

ǿ

-21,

ǿ

-28

īțȡȚIJȗȐʌȘ

Ǻ

-4

īȠȣȡȜȠȝȐIJȘ

ǿ

-16,

ǿ

-26,

ǿ

-25

īȠȪıȚĮ

ǻ

-1

īȡȓIJıȘ

ǿ

-36,

ǿ

-37,

ǿ

-38

īȡȠıȠȝĮȞȓįȘȢ

IA-6,

Ǻ

-17,

Ǻ

-18,

Ǻ

-20,

Ǻ

-21,

Ǻ

-22,

Ǻ

-23,

ǻ

-8,

ǽ

-1,

ǿǹ

-4

īȣijIJȠȞȚțȠȜȠȪ

Ȉȉ

-5

ǻĮȜĮȝʌȣȡĮ

ǻ

-2,

Ǽ

-2

ǻȐijĮ

ǿ

-20

ǻİȜȘĮıȜȐȞȘ

ǽ

-1

ǻİȝȚȡIJȗȩȖȜȠȣ

ī

-5

ǻİȡȝȚIJȗȐțȘ

Ȉȉ

-5

ǻȘȝȘȞȓțȠȢ

ī

-7, Ĭ

-7

ǻȘȝȘIJȡȚȐįȘȢ

Ǻ

-17

ǻȘȝȘIJȡȚȐįȠȣ

Ǻ

. I-13,

ǿ

-7

ǻȘȝȘIJȡȚȐįȠȣ

Ȃ

.

ǿ

-35

ǻȘȝȘIJȡȚȐįȠȣ

ȇ

.

ǿ

-20

ǻȘȝȘIJȡȓȠȣ

ǻ

-6

ǻȚĮȝĮȞIJȐțȘ

ī

-5,

ǿǹ

-1

ǻȚʌȜȐȡȘȢ

Z-3

ǻȠȣȝʌȐȡĮIJȗȘ

Ȉȉ

-7

ǻȡȩıȠȢ

Z-3

ǻȡȩıȠȣ

I-14

ǼȜİȣșİȡȚȐįȘȢ

Ǽ

-1,

Ĭ

-7

ǼȣșȣȝȓȠȣ

Z-2,

ǿ

-17,

ǿ

-19,

ǿ

-39

ǽȐȖțĮ

Ǻ

-17

ǽĮțȣȞșȚȞȩȢ

I-14

ǽĮȡĮȜȓįȠȣ

Ĭ

-8,

Ĭ

-9

ǽĮȡȗĮȕȐ

Ȉȉ

-7

ǽĮȤĮȡȚȐįȠȣ

ǻ

-1,

ǻ

-2,

Ǽ

-2

ǽȦȖȠȖȚȐȞȞȘȢ

ǻ

-6

ǽȫIJȠȣ

ǻ

-1

ǾȜȚȐįȠȣ

ǿ

-5

ĬİȠįȠıȚȐįȘȢ

Ǻ

-20

ĬȦȝȐ

Ĭ

-8,

ǿ

-39

Insinga P

ǿǹ

-5

ǿȠȡįĮȞȓįȠȣ

ǻ

-4,

ǻ

-5,

Ĭ

-5

ǿȦĮȞȞȓįȘȢ

ǹ

.

ǻ

-1,

ǻ

-2,

Ǽ

-2

ǿȦĮȞȞȓįȘȢ

ī

. Z-2

ǿȦĮȞȞȓįȠȣ

Ǻ

-2

ȀĮȚȝĮțȐȝȘȢ

ǿ

-27

ȀĮțĮțȚȠȪ

ī

-3

ȀĮțĮıȒ

ǿ

-4,

ǿ

-5

ȀĮȜȠȖİȡȚįȘȢ

ǻ

-1,

ǻ

-2

ȀĮȜȠȖȡȚįȐțȘ

Ȃ

ǻ

-3

ȀĮȝʌĮȡȠȪįȘ

ǿ

A-7

ȀĮȝʌİȡȓįȘȢ

ǻ

-8

ȀȐȞįȘȜĮ

Ǻ

-4

(10)

ȀĮȞȠȣʌȐțȘȢ

ǻ

-3

ȀĮȡĮșȐȞȠȣ

ǹ

. I-15

ȀĮȡĮșȐȞȠȣ

Ǽ

.

Ȉȉ

-1,

Ȉȉ

-4

ȀĮȡĮǸıțȠȢ

Z-3

ȀĮȡĮțȠȪȜĮȢ

Ǻ

-18,

Ǻ

-20,

ǽ

-1,

ǿ

-30

ȀĮȡĮȜȒ

ǿ

-26

ȀĮȡĮʌȐȞȠȢ

I-10, I-11, I-12,

I-9

ȀĮȡĮʌȚʌİȡȓįȘȢ

ǿ

-7

ȀĮȡȐIJȗȘ

ǿǹ

-1

ȀĮȡȣʌȓįȠȣ

I-8, I-8,

ǿ

-24,

ǿ

-3,

ǿ

-32,

ǿ

-33

ȀĮIJıĮȞȠȪȜĮȢ

ǿǹ

-3

ȀĮIJıȚțȐ

ǹ

.

ǿ

-12

ȀĮIJıȓțĮ

Ǽ

.

Ǻ

-15

ȀĮIJıȓțĮȢ

Ǻ

-3,

Ǻ

-2

ȀĮijĮȞIJȐȡȘȢ

ǿ

-17

ȀĮijȠȪIJȘȢ

ī

-6,

Ĭ

-3

ȀĮȤȡȚȝĮȞȓįȠȣ

ǻ

-5

ȀȐȥĮ

ǿ

-31

ȀĮȥȐȜȘ

B-1

ȀĮȥȠțĮȜȪȕĮȢ

Ǻ

-3

ȀİȝĮȞİIJȗȒ

ǿ

-25,

ǿ

-27

ȀİȣıİȞȓįȘȢ

B-19,

Ǻ

-15

ȀİȤĮȖȚȐȢ

ǿ

-21

ȀȚȞȣȠȣȐ

ǿ

-29

ȀȚȠȣȡIJȗȓİȕĮ

Ĭ

-9

ȀȜȒȝȘ

B-8

ȀȜȩțĮ

ǿǹ

-2

ȀȠȖțȩʌȠȣȜȠȢ

ǿ

-22,

ǿ

-4,

ǿ

-5

ȀȩțȠȡȘȢ

I-15

ȀȩȝȘ

Ǻ

-16

ȀȠȞIJĮțȚȫIJȘȢ

Z-3

ȀȠȞIJȠȕȓIJıȘȢ

ī

-1,

ī

-2,

Ĭ

-1

ȀȠȞIJȩȢ

ǿ

-17,

ǿ

-18,

ǿ

-19,

ǿ

-30,

ǿ

-39

ȀȠȞIJȠȪ

ǿ

-3

ȀȠȞIJȠȪȜȘ

I-13,

ǿ

-7

ȀȠȡȐțȘ

Ǽ

-1,

Ĭ

-7

ȀȠȡijȚȫIJȘȢ

B-19

ȀȩIJİȜȘ

ǿ

-4,

ǿ

-5

ȀȠIJȗĮʌĮȞĮȖȚȫIJȠȣ

ǿ

-35

ȀȩIJıĮ

Ȉȉ

-5

ȀȠIJıȩȕȠȜȘȢ

ǿǹ

-4

ȀȠȣȗȒȢ

Ĭ

-6

ȀȠȣțȠȣȜȚIJıȚȠȢ

ǻ

-7

ȀȠȣȡȒȢ

B-9,

Ǻ

-5

ȀȠȣȡȠȪȞȘ

Ĭ

-6

ȀȠȣIJıȚĮȞIJȐ

IA-6

ȀIJİȞȚĮįȐțȘȢ

Ǻ

-23

ȀȣįȫȞĮ

ǿ

-36

ȀȣʌĮȡȚııȐ

ǻ

-8

ȀȣȡȚĮȗȒȢ

ǻ

-3

ȀȦȜİIJıȘȢ

B-12

ȀȦȞıIJĮȞIJȩʌȠȣȜȠȢ

Ĭ

-2

ȀȦȞıIJĮȞIJȠʌȠȪȜȠȣ

ǿǹ

-5

ȀȦıIJȓįȠȣ

Ǻ

-3

ȀȫıIJȠȖȜȠȣ

Ǻ

-17,

ǻ

-1,

ǻ

-2

ȀȦıIJȠʌĮȞĮȖȚȫIJȠȣ

B-10

ȀȦıIJȠȪȜĮȢ

ǿǹ

-2

ȀȫIJıȚȠȣ

ǿ

-31,

ǿ

-34

ȀȫIJıȠ

Ǻ

-18,

Ǻ

-22

ȁĮȕȡİȞIJȓİȕĮ

ǿ

-16,

ǿ

-25,

ǿ

-26,

ǿ

-27

ȁĮșȪȡȘȢ

ǿ

-21

ȁȐʌʌĮȢ

Ȉȉ

-5

ȁȑȖȖĮ

ī

-4

ȁȚȐʌȘȢ

Ǻ

-5

ȁȚȠIJȘȡȘ

ǻ

-6

ȁȚȠȪʌȘȢ

Ĭ

-3

ȁȠȖȠșȑIJȘ

ī

-6,

Ĭ

-3

ȁȩȡIJȠȣ

ǿ

-34

ȁȠȣțȑȡȘ

B-8

ȁȣțȠȪıȘ

I-15

ȁȣȡȓIJȘ

Ǻ

-2

ȁȣıȓIJıțĮ

ǿ

-24

ȁȪIJȠȢ

Ǻ

-2

ȁȫIJȘȢ

Ȉȉ

-1

ȂĮįİȝȜȒ

Ǽ

-2

ȂĮȧįȐIJıȘ

Ĭ

-8,

Ĭ

-9

ȂĮțȡȒȢ

Ĭ

-2

ȂĮȜȚĮȤȩȕĮȢ

I-9

ȂĮȞĮIJȐțȘ

ǿ

-6

ȂĮȞIJȗĮijȜȑȡȘ

ǿ

-23,

ǿ

-31

ȂĮȞIJȗȠȣȡȐȞȘ

Ĭ

-6

ȂĮȞȦȜȒ

IA-6

ȂĮȡȖĮȡȓIJȘȢ

ǿ

-6

ȂĮȡțȩʌȠȣȜȠȢ

Ǻ

-15

ȂȐııĮ

ǿ

-36,

ǿ

-37,

ǿ

-38

ȂĮIJȚȐțȘ

B-19,

Ǻ

-15,

ǿ

A-7,

Ȉȉ

-6

ȂĮIJıȫIJĮ

B-10

ȂĮIJIJȐ

ǿ

-7

ȂĮȣȡȐțȘȢ

ǻ

-3

ȂĮȣȡȓįȠȣ

Ȉȉ

-4

ȂĮȣȡȠȝȐIJȘ

ī

-4

ȂĮȣȡȠȣįȒ

ǿ

-40

ȂİȜȐ

Ĭ

-2

ȂİȜȚįȠȞȚȫIJȘȢ

ǿǹ

-1

ȂȒIJȠȢ

Ǻ

-14,

Ǻ

-21,

Ǻ

-23,

Ǿ

-1,

Ĭ

-8

ȂȘIJȡȠȜȚȩȢ

ī

-6,

Ĭ

-4

ȂȘIJȡȠȪįȘȢ

Ȉȉ

-1,

Ȉȉ

-4

ȂȚȝȘIJȠȣ

Ǽ

-2

ȂȚȤĮȘȜȓįȠȣ

ǿ

A-7,

ǿǹ

-3

ȂȠȣȜȠȪįȘ

ǿ

-36,

ǿ

-37,

ǿ

-38

ȂȠȣȝIJȗȒ

Ȉȉ

-1

ȂȠȣȡȠȪȞȠȖȜȠȣ

ǿ

-33

ȂȠȣıIJȐțĮ

Ĭ

-2

ȂȠȪIJıȚĮȞȠȢ

Ǻ

-15,

ǿ

A-7

ȂʌĮțĮȜȠȪȜȘ

I-9

ȂʌĮȜȐıȘȢ

ī

-3

ȂʌĮȜȑȗȞIJȡȠij

ǿ

-19

ȂʌĮȜȒ

Ǻ

-11

ȂʌĮȞȚȐ

I-14

ȂʌĮȞIJȠȪȡ

Z-3

ȂʌĮȡįȐIJıȠȣ

Ȉȉ

-2

ȂʌĮȡȑțĮ

Ĭ

-7

ȂʌĮȡȝʌİIJȐțȘȢ

ǿ

-40

ȂʌİțȡȚįȑȜȘȢ

ǿ

-28

ȂʌȚIJȗȐȞȘ

ǿ

-16,

ǿ

-25,

ǿ

-26,

ǿ

-27

ȂʌȠȖȚĮIJȗȩʌȠȣȜȠȢ

B-19,

Ǻ

-15

ȂʌȡȐIJȗȠȣ

Ĭ

-5

ȂȣȜȦȞȐ

ǻ

-4

ȂȦȣıȚȐįȘȢ

ǿ

-27

ȃȚțȠȜȐȠȣ

B-7

ȃȚțȠȜȠʌȠȪȜȠȣ

ī

-3

ȃȩȜĮȢ

Ǻ

-5

ȃȠȪȡȘȢ

Ǿ

-1,

ǿ

-30

ȃȠȪıțĮ

ǿ

-7

ȃIJȐȕȜȘȢ

ǻ

-4,

ǻ

-5,

Ĭ

-5

ȃIJİȜȓțȠȣ

Ĭ

-6

ȃIJȗȐȞȘ

I-10, I-11, I-12, I-9

ȃIJȠȜȗȑȞțȠ

B-19,

Ǻ

-15

ȃIJȠȝȠȣȤIJıȒȢ

Ǻ

-2,

Ǻ

-3

ȃIJȠȣȝĮ

ǻ

-6

ȃIJȡȓIJıȠȣ

Ǻ

-17,

ǻ

-8,

Ǽ

-2

ȄĮȡȤȠȣȜĮțȠȢ

B-12

ȅȜȠțIJıȓįȠȣ

Ǻ

-21

ȅȣȡĮȒȜȠȖȜȠȣ

Ǻ

-18,

Ǻ

-22,

Ǻ

-23,

ǿ

-18,

ǿ

-19,

ǿ

-39

ȆĮȖȚȩʌȠȣȜȠȢ

IA-6

ȆĮȚįȠȞȠȝȠȢ

ǻ

-7

ȆĮȞȠȣIJıȩʌȠȣȜȠȢ

B-10

ȆȐȞIJȠȣ

IA-6

ȆĮʌĮȖİȦȡȖȓȠȣ

Ǽ

.

ǿ

-40

ȆĮʌĮȖİȦȡȖȚȠȣ

ȋ

. I-8,

ǿ

-24,

(11)

ȆĮʌĮȖȚĮȞȞȠʌȠȪȜȠȣ

Ǻ

-17,

ǻ

-1,

ǻ

-2,

Ǽ

-2

ȆĮʌĮįȐțȘȢ

ǿ

-21

ȆĮʌĮįȘȝȘIJȡȚȠȣ

ǻ

-7

ȆĮʌĮįȩʌȠȣȜȠȢ

ī

.

ǿ

-4

ȆĮʌĮįȩʌȠȣȜȠȢ

ī

.

ǿ

-6

ȆĮʌĮįȩʌȠȣȜȠȢ

Ȇ

.

Ĭ

-2,

Ȉȉ

-3

ȆĮʌĮįȩʌȠȣȜȠȢ

Ȉ

.

ǿ

-36,

ǿ

-37

ȆĮʌĮįȠʌȠȪȜȠȣ

E.

Ǻ

-2,

Ǻ

-3

ȆĮʌĮįȠʌȠȪȜȠȣ

ǹ

. I-8

ȆĮʌȐȗȠȖȜȠȣ

Ǻ

-3

ȆĮʌĮȧȦȐȞȞȠȣ

I-13

ȆĮʌĮțȓIJıȠȢ

B-1

ȆĮʌĮțȓIJıȠȣ

B-1

ȆĮʌĮȞĮıIJĮıȓȠȣ

B-6

ȆĮʌĮȞIJȦȞȐțȘ

ī

-4

ȆĮʌĮȞIJȦȞȓȠȣ

Ǻ

-11

ȆĮʌĮıʌȪȡȠȢ

B-19,

Ǻ

-15,

ǿ

A-7,

ǿǹ

-3,

Ȉȉ

-6

ȆĮʌĮıʌȪȡȠȣ

Ǻ

-5

ȆĮʌĮıIJİijȐȞȠȣ

Ĭ

-5

ȆȐIJĮ

ī

-6,

Ĭ

-4

ȆĮIJİȜȐȡȠȣ

ǿǹ

-1

ȆĮIJİȡȠȝȚȤİȜȐțȘȢ

ǻ

-3

ȆĮIJȡȫȞȘ

ī

-3

ȆĮIJıȠȪȡĮȢ

ǿ

-6

ȆĮȣȜȚȐȢ

I-10

ȆĮȣȜȓįȘȢ

ī

.

ǿ

-32,

ǿ

-33

ȆĮȣȜȓįȘȢ

Ȃ

.

Ȉȉ

-3

ȆĮȣȜȠʌȠȪȜȠȣ

I-10

ȆİȞIJȓȜĮȢ

ǻ

-6

ȆȑȡIJıĮȢ

ǿ

-22

ȆİIJțȓįȘ

I-11

ȆİIJțȠʌȠȪȜȠȣ

I-1, I-2

ȆȑIJȡȠȣ

Ĭ

-7

ȆȑIJıĮȢ

ǿ

-37

ȆȚʌİȡȓįȠȣ

ǿ

-36,

ǿ

-38

ȆȚʌİȡȩʌȠȣȜȠȢ

Ĭ

-2

ȆȓIJıȘȢ

Z-2,

ǽ

-1

ȆȜȚȐțȠȢ

ǻ

-8

ȆȞİȣȝĮIJȚțȩȢ

ǿ

-40

ȆȠȜȐțȘ

ī

-5

ȆȠȜȣȗȫȘ

ǻ

-2

ȆȠȜȣȗȫȘȢ

Ȉȉ

-1

ȆȠʌȓįȘȢ

Ǻ

-11

ȆȠȣȡȗȚIJȐțȘ

Ǿ

-1,

ǿǹ

-4

ȆȡĮ

I-12

ȆȣȡȖȚĮȞȞȐțȘȢ

Ȉȉ

-2

ȇȐȞIJȘȢ

B-9

ȇȐȞIJȠȣ

ǿ

-32

ȇİȝʌİȜȐțȠȢ

ǿ

-36,

ǿ

-38

ȇȑȞİıȘȢ

Ǻ

-4

ȇİȞIJĮ

ǿ

-21

ȇȑȤȠȕĮ

Ǻ

-11

ȇȚȝȐȡİȕ

Ǻ

-3

ȇȠȣȝİȜȚȦIJȘ

B-12

ȇȠȪıȠȢ

Ȉȉ

-1

ȇȫȚȝʌĮ

B-1

ȈĮȝĮȡȐȢ

Ǻ

-13, ī

-7, Ǿ

-2

ȈĮȝȐȡțȠȢ

Ĭ

-6

ȈĮȡĮțĮIJıȐȞȠȢ

ī

-3

ȈĮȡȐȞIJȘ

Ȉȉ

-7

ȈȖȠȣȡȐțȘ

ǿǹ

-1

ȈȖȠȣȡȠȪ

ǿ

-37,

ǿ

-38

ȈįȠȪȖțĮ

ǿ

-20,

ǿ

-23,

ǿ

-31,

ǿ

-34,

ǿ

-35

ȈȚįȘȡȠțĮıIJȡȓIJȘȢ

Ǻ

-16

ȈȚȫȘ

Ȉȉ

-1

ȈțȠȣȜȐțȘȢ

Ĭ

-3

ȈțȠȣȝȒȢ

ǿ

-20,

ǿ

-34

ȈțȠȪȡIJȘȢ

Ǻ

-20,

Ǻ

-21

ȈțȣIJȚȫIJȘ

ī

-1,

ī

-2,

Ĭ

-1

ȈȝȣȡȞȚȫIJȘȢ

ī

-6,

Ĭ

-4

ȈȠȣȕĮIJȗȒ

B-6,

ī

-5,

ǻ

-3,

ǿǹ

-1

ȈȠȣȜIJȐIJȘ

ǿ

-17,

ǿ

-19,

ǿ

-39

ȈȠijȚĮȞȠȣ

B-12

ȈʌȣȡȚįȦȞȓįȠȣ

Ǻ

-11

ȈʌȪȡȠȣ

Ǽ

.

Ǻ

-13,

Ĭ

-7

ȈʌȪȡȠȣ

Ȇ

.

ǻ

-7

ȈIJĮȝĮIJȐțȘ

Ǻ

-16

ȈIJĮȝĮIJȐțȘȢ

B-8

ȈIJĮȝʌȠȣȜȒ

ǿ

-23,

ǿ

-31

ȈIJĮȣȡȐțȘȢ

ǿ

-33

ȈIJĮȣȡȐIJȘ

Ǿ

-1,

Ĭ

-9,

ǿ

-30

ȈȣȝİȦȞȚįȠȣ

I-8,

ǿ

-33

ȈijȪȡĮ

Ǻ

-16

ȉĮȝȕȚıțȠȣ

I-8,

ǿ

-24,

ǿ

-3,

ǿ

-32,

ǿ

-33

ȉȗĮȞĮțȠʌȠȪȜȠȣ

Ȉȉ

-1,

Ȉȉ

-4

ȉȗȚȡȒȢ

Ǻ

-17

ȉȠʌȐȜȘȢ

I-15

ȉȠȣȡȓțȘȢ

Ǻ

-4

ȉȡȚĮȞIJȩʌȠȣȜȠȢ

ī

-3

ȉȡȚțȠȪʌȘ

Ǻ

-13, ī

-7, Ǽ

-1,

Ǿ

-2,

Ĭ

-7

ȉıĮțĮȜȓįȠȣ

Ĭ

-5

ȉıĮțȚȜȚȫIJȘȢ

Ȉȉ

-7

ȉıĮȠȪıȘ

Z-2,

ǽ

-1,

Ǿ

-1

ȉıȑțĮȢ

ǿ

-32,

ǿ

-33

ȉıȚțȡȓțȘ

I-15

ȉıȚȡȦȞĮȢ

ǻ

-7

ȉıȠȜȐțȘ

ǿ

-20,

ǿ

-23

ȉıȠȜİȡȓįȘȢ

Ĭ

.

Ȉȉ

-3

ȉıȠȜİȡȓįȘȢ

Ȉ

.

Ȉȉ

-3

ȉıȠȣȜȠȣ

ǻ

-7

ȉıȫȞȘ

Ĭ

-2

ȊȖȡȠʌȠȪȜȠȣ

ǿ

-6

ȊijĮȞIJȓįȘȢ

Ĭ

-4

ĭĮȡȝȐțȘȢ

Ĭ

-6

ĭȚȜȑȜȘ

ǿ

A-7,

ǿǹ

-3

ĭȚȜȚʌʌȓįȠȣ

Ǻ

-18,

Ǻ

-22

ĭȜȚȫȞȘ

ǿ

-4

ĭȡĮȞıȑȢ

ǿ

-26

ĭȡĮȞIJȗȑıțȠȢ

ī

-5

ĭIJȓțȠȢ

Ȉȉ

-3

ĭȣȞIJĮȞȓįȠȣ

IA-6,

Ǻ

-20,

Ǻ

-21,

Ǻ

-22,

Ǻ

-23,

ǿǹ

-4

ĭȣIJȐȢ

ǿ

-4,

ǿ

-5

ȋĮȜȠȪȜȘȢ

Ǻ

-2

ȋĮȡĮȜĮȝʌȐțȘȢ

B-6

ȋĮȡȚȗȠʌȠȪȜȠȣ

Ȉȉ

-7

ȋȐıȠȣ

ǿ

-28

ȋĮIJȗȘțȫıIJĮ

Ȉȉ

-2

ȋĮIJȗȘȜȓĮ

B-8

ȋĮIJȗȘȝʌĮȜȩȖȜȠȣ

Ǻ

-20

ȋĮIJȗȘȞȚțȠȜȐȠȣ

ǿ

-22

ȋĮIJȗȠȣįȘ

ǻ

-7

ȋĮȣIJȠȪȡĮ

Ĭ

-4

ȋĮȣIJȠȪȡĮȢ

Ĭ

-4

ȋȠȪȡȡȘȢ

B-7

ȋȠȪIJĮȢ

I-10, I-11, I-12, I-9,

ǿ

-29

ȋȡȘȕĮIJȐțȘȢ

ǿ

-30

ȋȡȚıIJȠįȠȪȜȠȣ

Ǻ

-11

ȋȡȚıIJȠijȐțȘ

ī

-4

ȋȡȣıȓįȘȢ

ǿ

-33

ȋȡȣıȠȪ

ǿ

-25

ȋȪIJĮȢ

ǿ

-17,

ǿ

-19,

ǿ

-39

ȌĮȡȠȪȜȘȢ

I-13

ȌȦȝȩʌȠȣȜȠȢ

ī

-4

References

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