Crisis Epilepticas y Epilepsia

 

3:. EZNUNU @TNIÎTVNECU ^ @TNI@TUNC @TNI@TUNC Ju`bk »euãi `s ic fna`r`benc `btr` t`b`r ubc ekbvuisnõb y t`b`r `pni`psnc; @i `xe`sk f`i ekbsugk f` p`rskbcs ciekmõinecs `b `i ekbt`xtk f` ub sçbfrkg` f` cjstnb`benc pu`f` t`b`r ernsns `pniîptnecs, snb s`r `pniîptneks ci nhuci ics p`rskbcs qu` ekbsug`b frkhcs. »@btkbe`s qu` ngpinec s`r `pniîptnek; Mcjik em`v`i ’Fketkrc qu` ubk mcjic f` `pni`psnc eucbfk tn`b` vcrncs ernsns r`eurr`bt`s, pkr

`o`gpik, ekgk fnok ic ekgpcó`rc, sn ub pcen`bt` mc `stcfk ekbsugn`bfk ekecçbc, pu`f` prkfuenr ubc ernsns snbtkgãtnec chufc k ub pcen`bt` pkst qunrÿrhnek, pkrqu` `i e`r`jrk `stã `xpu`stk c ubc bkxc< fnhcgks pkrqu` f`spuîs ekb `i tn`gpk pu`f` prkfuenr ubc ernsns snbtkgãtnec r`gktc, `btkbe`s pcrc mcjicr f` `pni`psnc f`j`b f` s`r vcrncs ernsns r`eurr`bt`s‗. »F`j`b s`r r`eurr`bt`s y s`pcrcfcs `b euãbtk tn`gpk; Tkrqu` fnhcgks vks pu`f`s t`b`r 0 ctcqu`s `i gnsgk fçc, ’ceã fne`b qu` `b :6 mkrcs‗

Pbc ernsns `pniîptnec `s cqu`iik qu` s` gcbnan`stc c ekbs`eu`benc f` ubc cetnvnfcf mnp`rsnberkbnec f` ub hrupk f` b`urkbcs f`btrk f` ic ekrt`zc e`r`jrci y qu` s` gcbnan`stc eiçbnecg`bt` ekb fna`r`bt`s s`gnkikhçcs, ic ekbvuisnõb ekgk tci s` ciuf` ci t`rgnbk tõbnek eiõbnec, bk `stã jn`b f`enr mcy `i pcen`bt` ekbvuisnkbk, eucbfk s` tn`b` ubc ernsns pcrenci, f` ceu`rfk, pkrqu` cmkrc vcgks c v`r qu` i` ecgjncrkb `i bkgjr` c pcrtnr f`i :431< f` `stc sn tn`b`b qu` cpr`bf`rs` ic bu`vc eicsnanecenõb pcrc qu` ik v`cb `s guy aãeni. Ukb c ekbs`eu`benc f` ubc cetnvnfcf mnp`rsnberkbnec f` ub hrupk f` b`urkbcs c ekbs`eu`benc f` ubc f`sr`huicenõb f`

 

b`urkbcs hiutcgcb`rhnecs y hcjc`rhnecs< sn, bkrgcig`bt` ics ernsns s` cutkingntcb, pkr `sk `s ju`bk qu` eucbfk ust`f`s csnstcb c ub pcen`bt` ekb ub r`iko eucbtk tn`gpk

i` `stã furcbfk, pkrqu` `b cihÿb gkg`btk ics b`urkbcs hcjc`rhnecs

tkgcb `i ekbtrki y mce`b qu` ic r`spu`stc mnp`rsnberkbnec f` ics hiutcgcb`rhnecs s` ekrt`b, sn eucbfk `sk bk keurr` `i pcen`bt` ekrr` rn`shk f` qu` prkhr`s` c ub `stctus f` gci `pniîptnek ik euci ekrr`spkbf` c ubc `g`rh`benc gîfnec. @b ecgjnk, ic `pni`psnc `s ubc `ba`rg`fcf, sn, erõbnec, fkbf` `i pcen`bt` tn`b` ubc pr`fnspksnenõb c r`p`tnr `b `i tn`gpk `scs ernsns `pniîptnecs, f`j` f` t`b`r fks k gãs ernsns bk prkvkecfcs s`pcrcfcs pkr :6m, ks`c ub pcen`bt` pufk mcj`r ekbsugnfk ciekmki fnhcgks `b hrcbf`s ecbtnfcf`s, t`b`r 0 ekbvuisnkb`s `i gnsgk fçc y `sk bk snhbnanec qu` s`c `pniîptnek. Cmkrc pu`f` s`r ub ekbsugnfkr erõbnek f` ciekmki y t`b`r c ik icrhk f` iks cóks vcrnks ctcqu`s f` `pni`psnc au`rc f` `stcr ekbsugn`bfk y f`spuîs t`b`r ubc `pni`psnc< f` m`emk, `i ekbsugk f` ciekmki pu`f` s`r ub acetkr f` rn`shk pcrc qu` pu`fc f`scrrkiicr yc qu` `sk vc h`b`rcbfk ecgjnks erõbneks `b ic ekrt`zc e`r`jrci y guemcs v`e`s ekb iks cóks iks pcen`bt`s qu` skb ciekmõineks pu`f`b f`scrrkiicr ubc `pni`psnc. Ks`c pu`f`b ekg`bzcr ekb ik qu` skb ernsns snbtkgãtnecs chufcs y f`spuîs ekb iks cóks sn pu`f`b s`r `pniîptneks, ktrc eksc `s qu` ub pcen`bt` pu`f` t`b`r ubc ÿbnec ernsns y ub citk rn`shk f` pr`s`btcr ubc r`eurr`benc c ik icrhk f`i tn`gpk, `o.? pufk s`r ub pcen`bt` qu` tuvk ubc ernsns y ekbsuitk< s` i` mce` ubc r`skbcbenc y ub `i`etrk`be`acikhrcgc, `b `i ecsk f` qu` ust`f`s `b ic r`skbcbenc ust`f`s `beu`btr`b, pkr `o`gpik ub g`bnbhnkgc arkbtci guy hrcbf` `xt`bsk, ik qu` `stãb `bekbtrcbfk `s ubc ecusc qu` prkjcji`g`bt` s`c `i f`s`becf`bcbt` y qu` `sk

 

ngpinec qu` mcy ub rn`shk f` r`eurr`benc y qu` c p`scr tn`b` ub skik `v`btk eiçbnek fkeug`btcfk ’pufk mcj`r pcscfk ekgk c ic ekgpcó`rc f` ic ubnv`rsn fcf tuyc qu` t`bçc ctcqu`s bketurbks‗ y guemks f` `sks ctcqu`s bketurbks, bk s`

fkeug`btcb y gcs sn vnv`b skiks< pkr cmç `gpn`zcb c p`bscr qu` bk tn`b`b ju`bc ecinfcf f`i su`ik, qu` pcscb ekbaubfnfks, `btkbe`s mcb t`bnfk ctcqu`s pr`vncg`bt` p`rk bcfn` iks fkeug`btk. Pb ÿbnek ctcqu` ekb ubc `vnf`benc ngch`bkiõhnek f` ub rn`shk f` r`eurr`benc, tcgjnîb `btrcrçc f`btrk f` ic f`anbnenõb f` `pni`psnc k cihÿb mciiczhk `sp`enanek f`btrk f`i `i`etrk`be`acikhrcgc qu` fnhc cihÿb snbfrkg` `pniîptnek `sp`enci pkr `o`gpik, sn `b `i `i`etrk`be`acikhrcgc cpcr`e` cihubc pubtc f` kbfc h`b`rcinzcfc, qun`r` f`enr qu` prkjcji`g`bt` t`bhc ubc `pni`psnc h`b`rcinzcfc nfnkpãtnec, qu` `s ubk f` iks sçbfrkg`s `pniîptneks `sp`enci`s, qu` f`btrk f` `sks `stc ic gnkeiõbnec ouv`bni y ic `pni`psnc f`i hrcb gci< sn yk `beu`btrk `s` `i`g`btk `b `i `be`acikhrcgc, pkr gcs qu` `i pcen`bt` ekbsuit` pkr ubc skic ernsns, yk yc s` qu` `i pcen`bt` vc c t`b`r rn`shk f` r`eurr`benc, `btkbe`s yc mne` `i fnchbkstnek. Bkrgcig`bt` b`e`sntk fks k gãs ctcqu`s pkr gãs f` :6m qu` s`cb bkb prkvkecfks, `st` ekbe`ptk `s eicrk y qu` ik t`bhc pr`s`bt`, qu` guemcs v`e`s `i pcen`bt` mcy ekbvuisnkbk, pkb` i` ub cbtn`pniîptnek, `btkbe`s :4 cóks ub pcen`bt` pkrqu` ekbvuisnkbk ubc skic v`z `b su vnfc, snhu` tkgcbfk a`bntkçbc y `s pkr ub `rrkr gîfnek, sç, pkrqu` ecpcz qu` `b `s` gkg`btk bk mceçc acitc utninzcr ub cbtn`pniîptnek, sn bk ekrr`hnr ic ecusc, `btkbe`s ub gci fnchbkstnek cecrr`c qu` ub pcen`bt` pkr cóks qu`f` gci trctcfk, `s ju`bk qu` t`bhcb eicrk cihubks ekbe`ptks.

 

Ekgk eurnksnfcf aço`bs` qu` ub =4% f` ic pkjicenõb pu`f`b t`b`r ubc ernsns `pniîptnec c ik icrhk f` su vnfc snb b`e`scrncg`bt` s`r `pniîptnek, skicg`bt` f`i :%-5% vcb c f`scrrkiicr `pni`psnc y `s ngpkrtcbt` qu` ust`f`s ekbkzecb `i rn`shk f` r`eurr`benc y ic eusc sujyce`bt` pcrc fcri` `i trctcgn`btk c `s` pcen`bt`. Eucbfk skb ernsns snbtkgãtnecs chufcs, bk mcy qu` ekikecr g`fnecenõb , scivk qu` t`bhc ub `stcfk f` gci `pniîptnek, ik qu` mcy qu` mce`r `b `s` gkg`btk `s ekrr`hnr ic ecusc (sn `i pcen`bt` tn`b` ubc mnpkhine`gnc, yk i` vky c fcr hiueksc, bk i` vky c pkb`r a`bntkçbc y g`bks sn ic ernsns furk g`bks f` 0gnb) f`jk ekrr`hnr ic ecusc y bk fcr g`fnecenõb cbtn`pniîptnec, `b ecgjnk eucbfk yk yc ekgpr`bfk qu` `i pcen`bt` tn`b` ub rn`shk f` r`eurr`benc, sn `s b`e`scrnk ekg`bzcr ub trctcgn`btk cbtn`pniîptnek `sp`enanek, `btkbe`s `sk `s ngpkrtcbt` pkrqu` tn`b` jcok rn`shk k bk tn`b`b rn`shk f` r`eurr`benc bk f`j`b s`r trctcfks ekb g`fnecenõb cbtn`pniîptnec

Ernsns `pniîptnec? keurr`benc trcbsntkrnc y sÿjntc f` snhbks y sçbtkgcs prkvkecfks pkr ubc f`secrhc cbkrgci, pcrkxçstnec, `xe`snvc k mnp`rsnberkbnec f` ub hrupk f` b`urkbcs ujnecfcs `b ic ekrt`zc e`r`jrci, usucig`bt` cutkingntcfc.

@pni`psnc? fnsaubenõb e`r`jrci erõbnec ecrcet`rnzcfc pkr ubc pr`fnspksnenõb furcf`rc pcrc h`b`rcr ctcqu`s `pniîptneks. Z`qun`r` : k gcs ernsns prkvkecfcs qu` keurrcb ekb gcs f` :6 mkrcs f` fna`r`benc k 3 ernsns bk prkvkecfc y ub citk rn`shk f` ernsns r`eurr`bt`s bk prkvkecfcs `b iks prõxngks 34 cóks. Pb = c 34% f` ic pkjicenõb h`b`rci `xp`rng`btcrc ubc ernsns `pniîptnec c ik icrhk f` su vnfc. Ukik cir`f`fkr f`i : ci 5% f`scrrkiicrcb ubc `pni`psnc. Ekgpr`bf`r ic

 

ecusc sujyce`bt` ii`vc c ub fnchbkstnek cf`eucfk, b`e`scrnk pcrc ub ttk `sp`enanek. Iks pet`s ekb jcok rn`shk f` r`eurr`benc bk f`j`b s`r trctcfks nbb`e`scrncg`bt`.

EZNUNU @TNI@TVNECU eicsnanecenõb `tnkiõhnec ❑ 

Bk prkvkecfcs? keurr`b `b cus`benc f` acetkr`s pr`enpntcbt`s y pu`f`b s`r ecuscfcs pkr ubc i`snõb `stctnec k prkhr`snvc. Bk hucrfc r`icenõb ekb ic `ba`rg`fcf chufc snt`gnec, trcstkrbk g`tcjkinek k tkxnek k ubc chr`snõb chufc ci UBE.

❑ 

Unbtkgãtnecs? keurr`b `b cskencenõb t`gpkrci ekb ubc i`snõb `b `i UBE k ubc i`snõb snstîgnec. U` pr`s`btcb `b `i eursk f` ubc chr`snõb e`r`jrci. Bk s` ecrcet`rnzcb b`e`scrncg`bt` pkr ubc t`bf`benc c ic r`snst`benc.

EZNUNU UNBVKGCVNECU ○ 

Chufcs

E U C ? 

pr`s`btcb cskencenõb t`gpkrci `str`emc ekb ubc

`ba`rg`fcf chufc  snstîgnec, ub trcstkrbk g`tcjkinek k tkxnek k `b cskencenõb ekb ubc chr`snõb chufc ci UBE. @xnst` ub acetkr ecusci qu` prkfue` ub trcstkrbk trcbsntkrnk f` ic `xentcjninfcf b`urkbci, qu` ubc v`z ekrr`hnfk bk prkfue` r`eurr`benc. ○ 

Z`gktcs E U Z ? keurr`b `b ub pet ekb mnstkrnc f` ubc chr`snõb pr`vnc ci UBE  k `be`acikpctçc `stctnec f` krnh`b pr` k p`rnbctci `be`acikpctçc mnpkxnek-nsqu`gnec b`kbctci

qu` prkvkec ub fcók `strueturci qu`

 

pr`fnspkb` c ic r`nt`rcenõb f` E@. Ics s`eu`ics nber`g`btcb ic `xntcjninfcf e`r`jrci y su r`eurr`benc s` ic ekbsnf`rc ubc `pni`psnc s`eubfcrnc.

Ernsns snbtkgãtnec chufc EUC

F`btrk

f`

ic Gcbna`stcenõb nbnenci

s`gcbc

▯  ▯ 

▯ 

@QE

M`gctkgc sujfurci

I`snõb ▯ 

e`r`jrci

Nba`eenõb cetnvc

trcugctnec ▯ 

f`i

UBE @be`acikpctçc

▯ 

Acs` cetnvc f` `sei`rksns

cbkxnec

guitnpi` ▯ 

u

Ex ktrc

`ba

nbtrcercb`ci cutknbgub` ▯ 

 Cbkgciçcs  Cbkgciç cs g`tcjõinecs s`v`rcs

▯ 

Nbtkxnecenõb k cjstnb`benc

 

f` ciekmki k frkhcs

EZNUNU @TNI@TVNEC eicsnanecenõb s`gnkiõhnec

Ernsns pcrenci`s?  s` krnhnbcb `b ub hrupk gcs k g`bks ikecinzcfk f`

❑ 

b`urkbcs y pu`f`b s`r k 

k 

Ungpi`s? gktkrcs, skgctks`bsntnvcs, cutkbõgnecs, psçqunecs. Ekgpi`ocs? ekgn`bzk ekb curc, ekb cit`rcenõb f` ic ekben`benc f`sf` `i nbnenk.

k 

U`eubfcrncg`bt` VE h`b`rcinzcfcs.

Ernsns h`b`rcinzcfcs? cetnvcenõb snguitcb`c y snberkbnec f` cgjks

❑ 

m`gnsa`rnks e`r`jrci`s. k 

 Cus`bencs  Cus`ben cs

k 

Gnkeikbnecs

k 

Võbnecs

 

k 

k 

Võbnek-eikbnecs ekbvuisnkb

 Ctõbnecs

Jusecr eicsnanecenkb s`gnkikhnc NIC@ :438  CBCGB@UNU  CBCGB@ UNU

❑ 

Ecrcet`rnstnecs einbnecs f` ics ernsns (nbakrgcbt` ekbancji`)

❑ 

@stcfk pksnetci? tn`gpk qu` f`gkrk, pr`s`benc f` f`anent b`urkikhnek

❑ 

Unbtkgcs nbg`fnctcg`bt` pr`vnks curc

❑ 

Eneik su`ók/vnhninc

❑ 

Acetkr`s f`s`becf`bcbt`s ekgk acitc f` su`ók, tkxxnek, `stnguicenkb aktnec, `stnguiks g`fnkcgjn`btci`s, g`fnecenkb.

❑ 

 Cbt`e`f`bt`s  Cbt`e`f `bt`s p`rskbci`s p`rskbci`s ekgk ekbvuisn ekbvuisnkb`s kb`s a`jrni`s a`jrni`s `b ic nbacbenc, nbacbenc, pcutcs pcutcs gcfurctnvcs f`i f`scrrkiik, `sekicrnfcf y bnv`i `fuecenkbci, V@E, @EQ, nba`eenkb`s f`i UBE

❑ 

 Cbt`e`f`bt`s  Cbt`e`f` bt`s acgnincr`s acgnincr`s f` `pni`psnc/ernsns `pni`psnc/ernsns k `ba`rg`fcf`s `ba`rg`fcf`s b`urkikhnecs b`urkikhnecs k psnqunctrnecs

@]CG@B ANUNEK

 

@xcg`b ansnek h`b`rci. @xcg`b furcbt` ic ernsns y b`urkikhnek? nbfnecfkr`s f` bcturci`c `pni`ptnec f`i `v`btk ekgk encbksns, mmnp`rscinvcenkb, gkrf`furc f` i`bhuc y f`skrn`btcenkb pkst`rnkr< f`anent akeci pksnetci  pcrcinsns f` Vkff   k p`rsnst`bt`. @]CG@B@U EKGTI@G@BVCZNKU ○ 

Hiue`gnc

○ 

Eucfrk m`gctnek

○ 

Nkbkhrcgc

○ 

Ecienk

○ 

Er`ctnbnbc

○ 

Pr`gnc

○ 

HKV/HTV

○ 

Tcrenci f` krnbc

○ 

ETL/Trkicetnbec

○ 

Vkxnekikhneks

Gcrecfkr

f` Qcikr f` ekrt`

icjkrctkrnk

Hiueksc s`rnec

951gh/fi (:4gG) k 2604gh/fi

(:0gG)

 

cskencfk

c

e`tkcenfksns

Ukfnk s`rnek

9330gh/fi (0gG)

Ecienk s`rnek

90.4 gh/fi (3.:gG)

Gchb`snk s`rnek

94.=

gh/fi

(94.5gG)

Bntrkh`bk f` ur`c 2344

gh/fi

s`rne

(950.gG)

Er`ctnbnec s`rnec

234.4

gh/fi

(==6

uG)

@stufnks pkr ngãh`b`s ○ 

VCE e`r`jrci? cbt` ic sksp`emc f` i`snkb `strueturci k sn ic `tnkikhnc f` ic ernsns bk mc snfk nf`btnanecfc

 

○ 

ZGB e`r`jrci? bk `stc nbfnecfc `b urh`bencs, `xe`ptk `b sntucenkb`s `sp`enci`s. @s kjinhctkrnc pcrc f`t`etcr cbkgcincs `strueturci`s f`i

e`r`jrk, `vciucr rn`shk f` r`enfnvc y pcrc krn`btcr `i gcb`ok t`rcp`utnek `b ernsns bk prkvnecfcs y snbtkgctnecs r`gktcs.

@TNI@TUNC Qcrn`fcf f` ekbfnenkb`s einbnecsqu` s` ecrcet`rncb pkr ic pr`s`benc f` trcstkrbks pcrkxnstneks r`eurr`bt`s f`bkgnbcfks ernsns `pni`ptnecs qu` f`j`b s`r r`eurrr`bt`s pcrc su fnchbkstnek. @stcs pu`f`b s`r?

❑ 

Unbtkgctnecs? s`eubfcrncs c cit`rcenkb`s `serueturci`s e`r`jrci`s Nfnkpctnecs? f`t`rgnbcfcs pkr ubc t`bf`benc ekbstntuenkbci,

❑ 

prkjcji`g`bt` r`icenkbcfc eb csp`etks h`b`tneks

❑ 

Ernptkh`bnecs? s` pr`sug`b snbtkgctnecs p`rk ic ecusc bk s` mc pkfnfk mciicr

JPUECZ EICUNANECENKB F@ @TNI@TUNCU F@ IC NIC@ UNGTINANECFC

Eicsnanecenkb f` ics `pni`psncs prkpu`stc pkr ic NIC@ :438 3.3 @pni`psncs akeci`s nfnkpãtnecs

3.3.C @pni`psnc j`bnhbc f` ic nbacbenc ekb `spnhcs e`btrkt`gpkrci`s J@EVU

 

Unbfrkg` `pniîptnek r`icenkbcfk c ic ikecinzcenõb gcs ekgÿb `btr` bnóks f` `fcf `sekicr. @i :5% f` sçbfrkg`s `pniîptneks f` r`en`bt` ekgn`bzk `b ic nbacbenc.

k 

@fcf f` ekgn`bzk 5-35 cóks

k 

Nbenf`benc pnek =-> cóks

k 

Ekbvuisnkb`s a`jrni`s `b gcs f`i 31%

k 

Ernsns? furcbt` `i su`ók, ekb eikbncs m`gnacenci`s,, cbcrtrnc k pcr`st`sncs qu` pu`f`b prkpchcr ci gn`gjrk sup`rnkr mkgkict`rci.

k 

F`scrrkiik psnekgktkr y `xcg`b b`urkiõhnek bkrgci`s

@@H? rntgk f` jcs` bkrgci. Nbt`rnetci @@H mcy `spnhcs fnacsnecs k s`hunfc f` kbfc i`btc f` g`bkr cgpintuf g`fnkict`rci V5, V6 y e`btrci rkicbfnecs E5, E6 Vtk? ecrjcgcz`pnbc y ju`b ekbtrki Mcy `pni`psncs qu` `gpn`zcb `b ic nbacbenc y r`p`reut`b `b ic cfki`se`benc p`rk ekb ic gcfurcenõb e`r`jrci `i akek `pni`ptkh`bnek s` cpchc y ci bk vkiv`r c keurrnr s` i` pu`f` quntcr ic g`fnecenõb

3.: @pni`psncs akeci`s snbtkgãtnecs 3.:.C @sei`rksns t`gpkrci g`snci ○ 

Ernsns `btr` iks 6-31 cóks f` `fcf.

○   Cbt`e`  Cbt`e`f`bt`s? f`bt`s? ernsns ernsns a`jrni`s a`jrni`s V@E, cbkxnc, cbkxnc, nba f`i UBE UBE ○ 

Ernsns pcrenci`s? curc f` s`bscenõb `pnhãstrnec cse`bf`bt` `b `i 04-84%, gn`fk k cben`fcf, f`oc vu

 

○ 

Krn`btcb mcenc ca`etcenõb nzqun`rfc? `i crr`stk f`i ekgpkrtcgn`btk, pksturc fnstkbnec, ano`zc f` gnrcfc.

○ 

Krn`btcb mcenc ca`etcenõb f`r`emc? cutkgctnsgks krkgcbfnjuicr`s, gkvngn`btks `st`r`ktnpcfks y hnrk e`aãinek npsnict`rci

ZGB? fnsgnbuenõb f`i tcgcók f`i mnpkecgpk, mnp`rnbt`bsnfcf `b V: y AICNZ. Fcók jict`rci :4-04%. Tctkikhçc fuci 54-84% Mnstkikhçc? p`rfnfc e`iuicr `b EC3-5-6 ekb hinksns, `sei`rksns f`i eu`rfk f`  Cggkb

@@H? KC y pubtcs `b ic r`hnõb t`gpkrci cbt`rnkr ubn k jnict`rci Vtk? 204% tn`b` gcic rtc ci ttk g`fnek `btkbe`s s` r`eurr` c ubc ikj`etkgçc t`gpkrci

5.3 @pni`psncs h`b`rcinzcfcs h`bîtnecs (nfnkpãtnecs) Vkfks tn`b`b `b ekgub `xcg`b b`urkiõhnek bkrgci, cbt`e`f`bt`s acgnincr`s ar`eu`bt`s @@H ekb cetnvnfcf f` jcs` bkrgci y ekgpi`oks pubtc-kbfc h`b`rcinzcfks

5.3.3 @pni`psnc gnkeikbnec ouv`bni ❑ 

Tr`vci`benc? 4.0-3/3444

❑ 

Nbenf`benc? nhuci `b cgjks s`xks, c v`e`s gcykr `b vcrkb`s

 

❑ 

Nbnenk? =-54 cóks

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U`bsnji`s c ic prnvcenõb f`i su`ók, ciekmki, aktk`stnguicenkb, p`rng`bstruci

❑ 

Tr`fkgnbnk gctutnbk

❑ 

@@H ekb pkinpubtc-pubtc kbfc h`b`rcinzcfc

❑ 

Z`spu`stc aktkpcrkxnstnec c ic ar`eu`benc f` `stnguicenõb rãpnfc

❑ 

Ju`bc r`spu`stc c CQT

❑ 

U`hubfc içb`c? IGV, I@Q, VTG

❑ 

Ju`b prkbkstnek p`rk citc r`eurr`benc

5.3.: @pni`psnc f` cus`benc ouv`bni ▯ 

Nbenf`benc? 4.0-:/344444

▯ 

Guo`r-vcrkb :?3

▯ 

Nbnenk? 8-31 cóks

▯ 

 Cus`bencs  Cus`ben cs tçpnecs ekb ecrcet`rçstnecs ecrcet`rçstnecs fna`r`bt`s f` ics nbacbtni`s, `s f`enr, gcs icrhcs, g`bks ar`eu`bt`s, bk tcb s`bsnji`s c ic mnp`rv`btnicenõb

▯ 

Tu`f` mcj`r cutkgctnsgks, mnpktkbçc, pcrpcf`k, r`trkpuisnõb

▯ 

Tu`f` mcj`r EHVE =0%, gnkeikbncs 30% y stctus f` cus`bencs

@@H? g`bks r`huicr, pkineubtc-pubtc kbfc h`b`rcinzcfc

 

Vtk? CQT, IGV, @VK Ekbtrki f` ernsns? 84-=4% Unb g`fnecenõb 7 citc r`eurr`benc

5.3.5 @pni`psnc ekb ernsns tkbnekeikbnecs h`b`rcinzcfcs k hrcb gci f`i f`sp`rtcr k 

U` nbnenc `btr` iks > y 3= cóks ekb inh`rk pr`fkgnbnk gcseuinbk

k 

@i 30% f` iks pet`s tn`b`b cbt`e`f`bt`s acgnincr`s f` `pni`psnc

k 

Mcjntucig`bt` ics ernsns skb pkek ar`eu`bt`s

k 

U` f`s`becf`bcb pkr ic prnvcenõb f` su`ók ekbsugk f` ciekmki, `strîs açsnek k psneunek

k 

U` cskenc `b `i :0-54% c @GO y `b `i 04% c cus`bencs

k 

@@H nbt`rerntnek `s mcjntucig`bt` bkrgci

Vtk? `s aãeni trctcr ekb g`fnecenõb cbtn`pniîptnec fncrnc, nf`cig`bt` gkbkt`rcpnc, pcrc iks ecsks r`arcetcrnks y ekb nbfnecenkb`s pr`enscs `stã fnspkbnji` ic ex f` `pni`psnc

@UVCVPU @TNI@TVNEK @U PBC @G@ZH@BENC g`fnec y b`urkiõhnec,, ic gkrtcinfcf vcrnc f`i 0% ci 5>%, cprkxngcfcg`bt` `i 34-60% f` iks pet`s qu` skjr`vnv`b qu`fcb ekb trcstkrbks b`urkiõhneks bu`vks k fîanent. Eucbfk s` prkikbhc `b `i tn`gpk pu`f` fcr ubc crrntgnc ecrfncec, ubc mnpkhine`gnc s`v`rc pu`f` fcr ub stctus `pniîptnek.

 

U`hÿb ic NIC@ `s euciqun`r ernsns qu` fur` 254gnb k ernsns nbt`rgnt`bt`s snb ekgpi`tc r`eup`rcenõb `btr` `iics f` gcs f` 54gnb. Tcrc ic prcetnec ic f`anbngks ekgk `sc cetnvnfcf qu` furc 0 gnb k gcs, qu` bk e`f` k qu` bk mcy r`eup`rcenõb f`i `stcfk f` ekben`benc `btr` ub `pnskfnk y ktrk. U` f`j` c qu` ic hrcb gcykrçc f` ics ernsns furcb skik f` 14 c 3:4 s`h Tkjicenõb ekb gcykr rn`shk? 3´ p`fnãtrneks, :´ cbencbks

Utctus `pniîptnek BK ekbvuisnvk U@BE  Cetnvnfcf  Cetnvnf cf `pniîptnec ekbtnbuc ekbtnbuc `b `i @@H f` 54 gnb f` furcenõb h`b`rc h`b`rcincfc incfc k akeci `b pet`s snb pr`s`benc f` sçbtkgcs netci`s `vnf`bt`s. Ekbsnf`rcr?

Un `s ekbvuisnvk k Un bk

`s

pcrenci

h`b`rcinzcfk

k

 

Tr`s`benc k bk f` Tcrenci ekgpi`ok k `i`g`btks eiçbnek- sngpi`?

s`hÿb

s`gnkikhneks

mcyc k bk rupturc

`vnf`bt`s sutni`s.

f`

ekbtcetk

r`sp`etnvcg`bt` U@ ekbvuisnvk? `b h`b`rci `s f` aãeni @b r`ekbkengn`btk

h`b`rcinzcfks

iks `i

fx fna`r`benci gcs U@BE?

r`qun`r` ngpkrtcbt` y ekb

ub

gcykr ekbbktcenkb`s

gkvngn`btk

f` t`rcpîutnecs

s`rã

sksp`emc y keurr` `btr` `b

iks

sntucenkb`s ekbvuisnvks

eiçbnecs

ekgk (tõbnek eiõbnecs y

rupturc

f`

ekbtcetk,

sx

f` cus`benc) ekbauenkbci`s nb`sp`eçaneks

y

ekgc

Vrctcgn`btk? tn`gpk 4 gnb

 

❑ 

 Cs`hurcrs`  Cs`hurcr s` `i skstîb skstîb f` aubenkb`s aubenkb`s vntci`s

❑ 

Qnc cîr`c p`rg`cji`

❑ 

Gcb`ok f` VC

❑ 

Gkbntkr`k ecrfnkvcseuicr

❑ 

Icjkrctkrnk? Nkbkhrcgc, aubenõb r`bci y m`pãtnec, m`gkhrcgc, Ec, Gh, hiue`gnc, hcskg`trçc, fksco` f` tkxneks y C@Fs

❑ 

TI? pi`kentksns j`bnhbc pkstnetci

❑ 

Ngãh`b`s sn s` r`qun`r`

Vn`gpk f` 4 c 34gnb ❑ 

Ekikecr vnc ekb ski scinbc

❑ 

Bk ekrr`hnr cenfksns g`tcjkinec

❑ 

 Cfgnbnstrcr  Cfgnbnstr cr tncgnbc 344gh NQ

❑ 

Iu`hk 04gi f` ski hiuekscfc ci 04%

❑ 

@@H

@tcpc 3 U@ t`gprcbk 54gnb

 

Ikrcz`pcg Ikrcz`p cg :gh NQ k Fncz`pcg 0gh NQ k Gnfczkicg 0-34gh NG. Un ics ernsns p`rsnst`b pkr gcs f` 6 gnb s` pu`f`b r`p`tnr ics fksns

@tcpc : U@ `stcji`enfk 54 C 3:4gnb Un ci ecjk f` 0 gnb ic ernsns p`rsnst` uscr`gks A`bntknbc :4gh/lh NQ ekb v`ikenfcf f` nbausnkb f` 04gh/gnb P ktrcs kpenkb`s ekgk?

❑ 

A`bkjcijntci 34-:4gh/h fniunfk `b su`rk ansnkiõhnek k f`xtrksc 0% c pcscr 344gh/gnb (3444gh `b 30gnb)

❑ 

 Ce vciprknek :0-54gh/lh NQ ekb v`ikefcf f` nbausnõb mcstc 5gh/lh/gnb. Trkjcji`g`bt` s`hurk mcstc 0-1gh/lh/gnb

❑ 

I`v`tnrce`tcg :4-14gh/lh NQ 30-14gnb (:-0g/lh/gnb). Nbausnkb`s rcpnfcs f` mcstc 0 gnb ekb ju`bc tki`rcjninfcf. Pbc kpenõb jnk`qunvci`benc sngnicr c ic akrguicenõb NQ `s ic pr`pcrcenõb krci QK sn`bfk g`okr tki`rcfc c gcykr`s fksns y v`ikenfcf.

❑ 

Icekscgnfc 04-:44gh NQ e/30gnb k v`ikenfcf f` nbausnõb 64-=4gh/gnb. Gcbt`bngn`btk 644-144gh/fnc

@tcpc 5 U@ r`arcetcrnk 23:4gnb

 

❑ 

❑ 

Gniczkfcg fksns f` ecrhc 4.:gh/lh NQ Gcbt`bngn`btk 4.:-4.1gh/lh/m

Trkpkaki fksns f` ecrhc 3-:gh/lh NQ. Gcbt`bngn`btk :-6gh/lh/m (mcstc 30gh/lh/m)

❑ 

T`btkjcrjntci fksns f` ecrhc 0-:4gh/lh NQ. Gcbt`bngn`btk 3-5gh/lh/m

❑ 

Vnkp`btci 344-:04gh `b : gnb NQ, jkiks f` 04gh e/:-5gnb mcstc `i ekbtrki f` ics ernsns k pctrõb jrkt` supr`snõb. Gcbt`bngn`btk 5-0gh/lh/m

@tcpc 6 U@ sup`r r`arcetcrnk 2:6m ❑ 

Ekrtneknf`s

❑ 

NH H

❑ 

Fn`tc e`tõbnec

❑ 

Enruhçc f` ic `pni`psnc