Laporan Kasus CHF Ec Peripartum Kardiomiopati

 

Gkparko Mksus

IKIKG FKO^UOI KMU^ E^ BKURK MKSNLAHLAPK^L MKSNLAHLA PK^L PESLPKS^UH

Nlsusuo Agej6

Krld Skjhko Jkmlh, R.Men. 9; 30;< 02;

Pehclhcloi6

nr. Ol Hkne Egvk Hkykskrl, Rp. Fp

NEPKS^EHEO LGHU PEO\KML^ NKGKH SUHKJ RKML^ HUJKHHKNL\KJ PKGEHCKOI DKMUG^KR MENAM^ESKO UOLTESRL^KR HUJKHHKNL\KJ PKGEHCKOI 303;

 

JKGKHKO PEOIERKJKO

Gkparko mksus ykoi Cerfunug6

Ikikg Fkotuoi Kmut et Bkusk Mkrnlahlapktl Perlpkrtuh Agej Krld Skjhko Jkmlh, R.Men. 9; 30;< 02; ^egkj nlterlhk seckikl skgkj sktu sykrkt nkgkh heoilmutl Mepkolterkko Mglolm Reolar  (MMR) nl Ckilko Lghu Peoykmlt Nkgkh Suhkj RkmltHujkhhknlykj Pkgehckoi Dkmugtks Menamterko Uolversltks Hujkhhknlykj Pkgehckoi perlane Fkoukel 303;.

Pkgehckoi,

Fkoukrl 303;

Pehclhcloi,

nr. Ol Hkne Egvk Hkykskrl, Rp. Fp

l

 

MK^K PEOIKO^KS  Pufl syumur mepknk ^ujko Rehestk Kgkh, Kggkj RY^, ktks olmhkt nko mkruolk-Oyk. mkruo lk-Oyk. Rjagkwkt Rjagkwkt cerlrloi cerlrloi skgkh segkgu terburkj terburkj mepknk mepknk fuofuoiko fuofuoiko Okcl Hujkhhkn RKY. Peougls Peoug ls heoiubkpmko heoiubkpmko terlhk mkslj ktks clhcloiko clhcloiko segkhk peoierfkko peoierfkko gkparko mksus, sus, ykoi cer erffunug ‗I ‗Iki kikg kg Fkot Fkotuo uoi i Kmut Kmut et bkus bkusk k Mkrn Mkrnla lahl hlap apkt ktll Perlpkrt Perl pkrtuh‘ uh‘ lol mepknk nr. Ol Hkne Egvk Hkykskrl, Rp. Fp, nko terkmjlr, terkmjlr, ckil

sehuk pljkm ykoi terglckt, cklm sebkrk gkoisuoi hkupuo tlnkm gkoisuoi, regk hkupuo hku puo tlnkm tlnkm regk, regk, ykoi ykoi tlnkm tlnkm nkpkt nkpkt peougl peouglss secutm secutmko ko sktu-p sktu-persk ersktu, tu, peougl peouglss jktu jkturm rmko ko terl terlhk hk mksl mkslj j ktks ktks ckot ckotuk ukoo ooyk yk jl jloi oiik ik gk gkpa park rko o mk mksu suss lo loll nk nkpk pktt terseges ters egesklm klmko. ko. Rehaik Rehaik ckotuk ckotuko o ykoi ykoi tegkj tegkj nlcerlm nlcerlmko ko heonkp heonkpktm ktmko ko lhckgko lhckgko setlhpkg nkrl Kggkj RY^. Peou Peougl glss heoy heoykn knkrl krl ck ckjw jwkk nlnk nlnkgk gkh h gk gkpa parko rko mk mksu suss lo loll hkslj hkslj ck ckoy oykm  km  memurkoiko cklm nkgkh peouglsko hkupuo lsl gkparko mksus. Mkreok ltu, Peougls heoijkrkpmko mrltlm nko skrko ykoi hehckoiuo nehl sehpurokoyk rederkt lol. Peougls cerjkrkp rederkt lol nkpkt cerhkodkkt ckil mltk sehuk.

 

Pkgehckoi, Fkoukrl 303;

Peougls

ll

 

NKD^KS LRL

JKGKHKO FUNUG JKGKHKO PEOIERKJKO........................... PEOIERKJKO................................................. ............................................ ........................... ..... ll MK^K PEOIKO^KS

.......................................... ................................................................ ........................................... ..................... lll

NKD^KS LRL .......................................... ................................................................ ............................................ ..................................... ............... lv CKC L. PEONKJUGUKO.......................... PEONKJUGUKO................................................ ............................................ ................................... ............. CKC LL. GKPASKO MKRUR

3.;

Lneotldlmksl......................................... Lneotldlmksl............................................................... ........................................................ .................................. 2

3.3

Kokhoesls. Kokhoesls...... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ......... ......... .......... .......... .......... ......... .... 3

3.2

Peherlmskko Peherlmskko dlslm...... dlslm........... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... ......... ......... .......... ............. ........ >

3.>

Peherlmskko Peherlmskko peouofkoi. peouofkoi...... .......... .......... .......... .......... .......... .......... .......... ......... ......... .......... ............. ................. .............. ..... 4

3.5

Nlkioasls..................................... Nlkioasls........................................................... .............................................................. ........................................ :

CKC LLL. ^LOFKUKO PUR^KMK

2.;.

Koktahl... Koktahl........ ......... ......... .......... .......... .......... .......... .......... .......... .......... ......... ......... .......... .......... .......... .............. ................... ............... ..... ;;

2.3.

Rlsteh Maonumsl Maonumsl Fkotuoi... Fkotuoi........ .......... .......... .......... .......... .......... .......... .......... ............ ................ .................. .............. ..... ;2

2.2.

Nehkh Sehktlm Sehktlm Kmut..... Kmut.......... ......... ......... .......... .......... .......... .......... .......... .......... .......... ......... ............ ................. ............ ... ;4

2.>.

Peoykmlt Peoykmlt Fkotuo Fkotuoi i Mktup..... Mktup.......... .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... ............... ................. ....... ;:

2.5. Nlkioasls Nlkioasls Hltrkg Rteoasls... Rteoasls........ .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... ........... ............... ........... .. 32 2.4. Mktup Kartk Clmuspln.. Clmuspln....... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... ......... ......... ............. ............... ....... 34

CKC LT. KOKGLRLR MKRUR.........................................................................

3<

CKC T. PEOU^UP.........................................................................................

24

NKD^KS PUR^KMK ..................................................................................... 29

lll

 

CKC L PEONKJUGUKO

;.;.

Gktkr Cegkmkoi

Peoykmlt Peoykm lt mkrnla mkrnlavks vksmug mugkr kr herupk herupkmko mko peoyec peoyeckc kc peotlo peotloi i hartkg hartkgltk ltkss nko ; harclnltks segkhk mejkhlgko.   Remltkr 0,3 ‒ >% mejkhlgko nl oeikrk hkfu nlsertkl nlsert kl

mahpglmksl mahpglmksl

peoykmlt peoykmlt

mkrnlavksm mkrnlavksmugkr. ugkr. Peoykmlt Peoykmlt mkrnlavksmu mkrnlavksmugkr gkr lol

heru he rupk pkmk mko o pe peoy oyec eckc kc tloi tloiil iloy oykk ko koim imkk me mehk hktl tlko ko hkte hktero rokg kg segkh segkhkk hksk hksk mejkhlgko terutkhk nl oeikrk hkfu. Rkgkj sktu peoykmlt mkrnlavksmugkr ykoi nkpkt nkp kt terfknl terfknl pknk pknk perlan perlanee mejkhl mejkhlgko gko knkgkj knkgkj mkrnla mkrnlahla hlapkt pktll perlpk perlpkrtu rtuh. h.3 Cernkskrmko Oktlaokg Cernkskrmko  Oktlaokg Jekrt kon Cgaan Lostltute nko Addlbe ad Skre Nlsekses nkrl Oktlaokg nkrl  Oktlaokg Lostltute ad Jekgtjy, Jekgtjy, ikikg fkotuoi pknk mkrnlahlapktl perlpkrtuh nlseck nls eckcmk cmko o agej agej nlsduo nlsduoisl isl slstagl slstaglm m veotrl veotrlmeg meg mlrl mlrl ykoi ykoi terfknl terfknl segkhk segkhk kmjlr  kmjlr  mejkhlgko nko glhk cugko setegkj pastpkrtuh tkopk peoyeckc gklo nkrl ikikg  fkotuoi nko peoykmlt seceguhoyk.2  Mkrnlahlap Mkrnla hlapktl ktl perlpkrtuh perlpkrtuh knkgkj ceotum ceotum mkrnlahlapk mkrnlahlapktl tl lnlapktlm lnlapktlm ykoi  pkrkj, ykoi heoyerkoi wkoltk hunk ykoi seceguhoyk sejkt segkhk kmjlr  mejk mejkhl hlgk gko o ktku ktku pksb pksbkp kpkr krtu tuh, h, ykoi ykoi nk nkpk pktt heoi heoiko kobk bkh h oy oykw kwk. k. Lo Losl slne neo o Mkrnlahlapktl perlpkrtuh reonkj ykltu 0,;% pknk mejkhlgko, tetkpl harclnltks nko hartkgl hartkgltks tks bumup bumup tloiil tloiil kotkrk kotkrk 5-23%. 5-23%. Loslne Loslneo o kmtukg kmtukg Mkrnla Mkrnlahla hlapkt pktll  perlpkrtuh tlnkm nlmetkjul nko gkparko ykoi skoikt cervkrlksl knk nl cerckikl oeikrk, neoiko ;6 3 >< jloi loiik >. >.00 000 0 me megk gkj jlrko lrko jl jln nup nl KR. Mkrnlahlapktl perlpkrtuh fkrkoi nlnkpkt, okhuo herupkmko mahpglmksl serlus mejkhlgko. Rkoikt senlmlt ykoi nlmetkjul teotkoi Mkrnlahlapktl perlpkrtuh, meckoykmko peoegltlko nlgkmumko nl URK, Kdrlmk Regktko, nko Erapk. > Dkmtar  rlslm rlslma a Mkrn Mkrnla lahl hlap apkt ktll pe perlp rlpkrt krtuh uh terh terhksu ksum m us uslk lk lc lcu u gk gkof ofut ut,, hugt hugtlp lpkrl krltk tks, s, mejkhl mej khlgko gko hugtlp hugtlpeg, eg, jlperte jlperteosl osl iestksl iestkslaok aokgg ktku preemg preemgkhs khslk, lk, nko tamagl tamaglsls sls  cermepkofkoiko. Mkreok wkoltk hegkjlrmko kokm nl uslk ykoi geclj tuk, mefknlko Mkrnlahlapktl perlpkrtuh nkpkt heoloimkt.>  Nlkioasls Nlkio asls Mkrnlahlap Mkrnlahlapktl ktl perlpkrtuh perlpkrtuh serloimkgl serloimkgl tergkhckt tergkhckt mkreok iefkgk Mkrnlahlapktl perlpkrtuh tlnkm spesldlm, terutkhk pknk mejkhlgko gkofut. Pknk ;

 

 cecerkpk wkoltk, mglols nko emamkrnlairkdl clsk hehcklm jloiik mehckgl me maonlsl oarhkg, okhuo pknk cecerkpk wkoltk gklo clsk cermehckoi heofknl ikikg fkotuoi nko mehktlko fkotuoi heonknkm. Agej mkreok ltu mewkspknkko termklt iefkgk mkrnlahlapktl perlpkrtuh pergu nltloimktmko. Nlkioasls nlol nko terkpl terckru uotum ikikg fkotuoi hehlglml perko peotloi nkgkh heouruomko hart ha rtkg kgltk ltkss

nk nko o

Mkrnlahlapktl

harc harcln lnlt ltks ks perl rlp pkrt rtu uh

Mkrn Mkrnla lahl hlap apkt ktll knkgk kgkj

pe perl rlpk pkrt rtuh uh.. 2

hehper erc cklml

^ufu ^u fuko ko

te terkp rkpll

amsli slieoksl

nko

hehper heh pertkj tkjkom komko ko bkrnlkb bkrnlkb autput autput,, sejloi sejloiik ik praioa praioasls sls detkg detkg nko hktero hkterokg kg heofkn heo fknll geclj geclj cklm. cklm. Loterv Loterveos eosll nlpergu nlpergumko mko uotum uotum heouru heouruomk omko o pregak pregakn n nko kdtergakn, sertk hehpercklml maotrkmtlgltks fkotuoi. >

3

 

CKC LL GKPASKO MKRUR

3.; Lneotltks  Okhk

6

 Oy. Z

Uhur 

6

>2 ^kjuo

Feols Megkhlo

6

Perehpuko

Kgkhkt

6

Kikhk

6

Rumu

6

 Oa. Sei

6

3 .3

Kokhoesls

Megujko Utkhk

Reskm okdks (nyspoek)

Slwkykt Perfkgkoko Peoykmlt

Rearkoi wkoltk ceruslk >2 tkjuo nktkoi me LIN heoieguj seskm okdks (nyspoek), enehk tuoimkl nko ksltes. Megujko certkhckj cerkt nkgkh glhk cugko terkmjlr. terkmj lr. Pksleo heoieguj heoieguj hunkj hunkj gegkj skkt cerkmtlvltks, cerkmtlvltks, cktum cktum nko terckoiuo terckoiuo skkt tlnur mkreok seskm. Pksleo 5 cugko ykoi gkgu hegkjlrmko sebkrk sebtla sebkrk  sebtla bkeskrek nl bkeskrek nl ruhkj skmlt. Regkhk jkhlg skhpkl trlhester terkmjlr tlnkm knk tkonk-tkonk pksleo hehlglml  preemgkhslk, nko jkoyk heoieguj seskm rloiko sepertl megujko clksk nl  peoijufuoi mejkhlgko., Receguh aperksl, temkoko nkrkj oklm heofknl ;50/

Pehe Peherl rlms mskk kko o Peou Peouof ofko koi i

Peherlmskko Peherlmskk o Gkcarktarluh Peherlmskko Jehaigaclo

Jkslg

Rktuko

;5,2

i/ng

Olgkl Sufumko ;>-;:

Geumaslt ^rahcaslt Jehktamrlt  Oktrluh Mkgluh Mgarlnk Kgcuhlo Ureuh nkrkj Mrektlolo mglreos

:000 302.000 >5,; ;>9,: 2 ,5 ;0:,9 2 ,9 9 ,< 0,9:

;022 µG  µ G ;0  µG  µG % heq/G heq/G heq/G i/ng hi/ng hi/ng

>,3-;; ;50->>0 >3-53 ;25-;>: 2,5-5,5 -;;; 2,5-5,< 4-3; 0,40-;,50

Peherlmskko Peherlmskk o EMI

Mesko 6 slous tkmlmkrnl, nevlksl kmsls mlrl

Peherlmskko Saotieo ^jarkx

Mesko 6 mkrnlaheikgl neoiko maoiestld pughaokg nko edusl pgeurk

Peherlmskko Peherlmskk o Emjamkrnlairkdl Emjamkrnlairkdl

Mesko 6 sehuk rukoi nlgktksl, jlpamloetlm veotrlmeg mlrl seiheotkg igackg neoiko drkmsl efemsl veotrlmeg mlrl 23,4:%

3 .5

Nlkioasls

Ikikg Fkotuoi kmut et bkusk mkrnlahlapktl perlpkrtuh

3 .4 -

^ktkgkmskok

Pksleo heofkgkol terkpl ikikg fkotuoi kmut neoiko amslieoksl jlnuoi 2 gph A3, 0, fkh, nko mkteter urlo.

-

^erkpl dkrhkmagails nlcerlmko pahpk Durasehln 5 hi / fkh, Oltrkt 5 hi nlhlouh tlik mkgl sejkrl, nko Bkoneskrtko nlhlouh > hi nuk mkgl sejkrl.

-

Jkrl pertkhk peoiacktko pksleo hkslj heoieguj nlspoeu tetkpl sunkj hugkl  cermurkoi, enehk tuoimkl nko ksltes fuik cermurkoi. Hehkotku pranumsl pranumsl urlo

4

 

450bb / 3> fkh. Uotum terkpl, nluretlm nlikotl neoiko nluretlm lotrkveok tlik mkgl sejkrl. -

Jkrl menuk tlnkm knk megujko nlspoeu, ceoimkm pknk tuoimkl nko ksltes. Pehkotkuko pranumsl urloe >50 bb / 3 fkh, pksleo nlcerl tkhckjko terkpl arkg Bkrven Bkr venlga lgagg 4,35 4,35 hi pknk pknk hkgkh hkgkh jkrl. jkrl. Pknk Pknk jkrl jkrl metlik metlik pksleo pksleo stkclg nko hehcklm.

-

Pksleo pugkoi setegkj tlik jkrl nlrkwkt nl ruhkj skmlt neoiko terkpl ruhkj Durasehln >0 hi pkil jkrl, Bkoneskrtko > hi nuk mkgl sejkrl, Oltrkt 5 hi tlik mkgl sejkrl, Rplraoagkmtao 35 hi pkil jkrl, Bkrvenlgag 4.35 hi hkgkh jkrl.

9

 

CKC LLL ^LOFKUO PUR^KMK

2.;. Koktahl Koktahl nko Dlslagail Dlslagail

Fkotuoi knkgkj secukj ariko ceratat neoiko ehpkt rukoi ykoi tergetkm nl raoiik nknk nlckwkj perglonuoiko tugkoi lik, senlmlt me secegkj mlrl sterouh. Umurko fkotuoi murkoi geclj seceskr ieoiikhko tkoiko mkoko nko cerktoyk 350200 irkh. Fkotuoi hehpuoykl ehpkt rukoiko ykltu ktrluh mkoko, ktrluh mlrl, veotrlmeg mkoko nko veotrlmeg mlrl. Ktrluh knkgkj rukoiko secegkj ktks fkotuoi nko  cernlonloi tlpls, senkoimko veotrlmeg knkgkj rukoiko secegkj ckwkj fkotuoi nko hehpuoykl nlonloi geclj teckg mkreok jkrus hehahpk nkrkj me seguruj tucuj. 5 Ktrluh mkoko cerduoisl seckikl peokhpuoi nkrkj reonkj amslieo nkrl seguruj tucuj. Ktrluh mlrl cerduoisl heoerlhk nkrkj ykoi mkyk amslieo nkrl pkru-pkru nko heoikglrmko nkrkj 3 tersecut me veotrlmeg mlrl. Teotrlmeg mkoko cerduoisl heoerlhk nkrkj nkrl ktrluh mkoko nko hehahpkmkooyk me pkru-pkru. Teotrlmeg mlrl cerduoisl uotum hehahpkmko nkrkj ykoi mkyk amslieo meseguruj tucuj. Fkotuoi fuik ternlrl nkrl tlik gkplsko ykltu gkplsko tergukr ykoi herupkmko segkput  pehcuoimus nlsecut eplmkrnluh, gkplsko teoiko herupkmko gkplsko lotl nkrl  fkotloi ternlrl nkrl atat-atat fkotuoi nlsecut hlamkrnluh nko gkplsko ternkgkh ykoi ternlrl fkrloiko eonateg nlsecut eonamkrnluh.5

:

 

Ikhckr 3.;. Koktahl Fkotuoi

Dlslagail Fkotuoi4 k. Duoisl uhuh atat fkotuoi ykltu6

;. Rldkt rlthlsltks/atahktls6 sebkrk pateoslkg cermaotrkmsl tkopk knkoyk rkoiskoiko nkrl gukr. 3. Heoilmutl jumuh ikikg ktku tuotks6 lhpugs nlgepks heobkpkl khckoi rkoiskoi atat fkotuoi hkmk seguruj fkotuoi kmko k mko cermaotrkmsl hkmslhkg. 2. ^lnkm nkpkt cermaotrkmsl tetkolm. >. Memuktko maotrkmsl nlpeoikrujl pkofkoi kwkg atat. c. Hetkcaglshe Atat Fkotuoi

Repe Repert rtll atat atat me merko rkoim imk, k, atat atat fkot fkotuo uoi i fuik fuik heoi heoiiu iuok okmk mko o eo eoeri erill ml mlhl hlkk uo uotu tum  m   cermaotrkmsl. Eoeril terutkhk te rutkhk cerkskg nkrl hetkcaglsh kskh gehkm nkgkh fuhgkj

<

 

ykoi geclj meblg nkrl hetkcaglshe zkt ilzl terutkhk gkmtkt nko igumask. Prases hetkcaglsh fkotuoi knkgkj keraclb ykoi hehcutujmko amslieo b. Peoikruj Lao Pknk Fkotuoi

;. Peoikruj lao mkgluh 6 megecljko lao mkgluh pknk BER heoyeckcmko  fkotuoi nlgktksl, gehkj nko dremueosl gkhckt. 3. Pe Peoi oikr kruj uj lao lao mkgs mkgslu luh6 h6 mege megecl cljk jko o la lao o mk mkgs gslu luh h heoy heoyec eckc kcmk mko o fk fkot otuo uoi i  cermaotrkmsl spkstls. 2. Peoikruj Peoikruj lao oktrluh oktrluh66 heoemko heoemko duoisl fkotuoi. fkotuoi.

n. Egemtradlslagail Reg Atat fkotuoi

Kmtldlt Kmt ldltks ks gls glstrlm trlm fkotuo fkotuoi i herup herupkmk kmko o kmlckt kmlckt peruck peruckjko jko perhek perhekclg clgltk ltkss hehcrkoe seg. Reguruj prases kmtldltks glstrlm fkotuoi nlokhkmko pateoslkg kmsl ykoi nlseckcmko agej rkoiskoiko glstrlm, mlhlk, hemkolmk, nko terhls. Glhk dkse kmsl pateoslkg ykltu6 lstlrkjkt6 Ckilko Ckilko nkgkh cerhuktko cerhuktko oeiktlve(p oeiktlve(pagkrlsks agkrlsksl) l) nko ckilko ckilko gukr  - Dkse lstlrkjkt6  cerhuktko pasltld.

- Dkse nepagkrlsksl(bepkt)6 Nlseckcmko heoloimktoyk perhekclgltks hehcrkoe terjknkp oktrluh sejloiik oktrluh heoikglr nkrl gukr me nkgkh.

- Dkse pagkrlsksl pkrslkg6 Retegkj nepagkrlsksl ternkpkt senlmlt peruckjko kmlckt hksumoyk hksum oyk mkgsluh me nkgkh seg, sejloiik huktko pasltld nkgkh seg heofknl  cermurkoi.

- Dkse pgkta(meknkko stkclg)6 Dkse nepagkrlsksl nllmlutl meknkko stkclg kikm gkhk sesukl hksk redrkmtar kcsagute hlamkrn.

- Dkse Dkse repag repagkr krlsk lsksl sl(be (bepk pkt)6 t)6 Mkgsl Mkgsluh uh nk nko o ok oktr trlu luh h ce cerk rkoi oisu sur-k r-koi oisu surr tlnk tlnkm  m  heoikglr nko perhekclgltks terjknkp mkgluh skoikt heoloimkt. e. Rlsteh Maonumsl Fkotuoi

Rlsteh maonumsl fkotuoi heglputl6

-

RK oane6 ^uhpumko ^uhpumko fkrloiko oeurahusbug oeurahusbugkr kr ykoi meblg cerknk cerknk nl nkgkh nlonloi ktrluh mkoko nl ufuoi Mrlstk terhlokgls.

-

KT oane6 Rusuokooyk skhk neoiko RK oane cerknk nl nkgkh septuh ktrluh nemkt hukrk slous maraokrl.

;0

 

-

Cuonge ktrlaveotrlmuger6 nkrl cuonge KT cerfkgko me krkj nepko pknk tepl  pasterlar nko tepl ckwkj pkrs hehcrkoksek septuh loterveotrlmugkre.

-

Rerkcu Rer kcutt peoiju peoijucuo cuoi i terhlo terhlokg( kg(pur purmlo mlofe)6 fe)6 Koykhk Koykhko o ykoi ykoi cerknk cerknk pknk pknk eonamkrnluh heoyeckr pknk menuk veotrlmeg.

d. Rlmgus Fkotuoi Ehpkt Ehp kt pahpk pahpk ykoi ykoi terplskj terplskj ykltu6 ykltu6 nuk pahpk prlher prlher ktrluh ktrluh nko nuk

 pahpk teokik veotrlmeg. Perlane kmjlr maotrkmsl fkotuoi skhpkl maotrkmsl  cerlmutoyk nlsecut slmgus fkotuoi. i. Duoisl fkotuoi seckikl pahpk

Glhk duoisl fkotuoi seckikl pahpk ykltu6 ;. Duoisl ktrluh seckikl pahpk 3. Duoisl veotrlmeg seckikl pahpk 2. Perlane efemsl >. Nlkstage 5. Perlane regkmsksl lsahetrlb Nuk bkrk nkskr peoikturko merfk pehahpkko fkotuoi ;. Kutareiugk Kutareiugksl sl lotrloslb lotrloslb pehahpkko pehahpkko kmlckt peruckjko peruckjko vaguhe nkrkj ykoi heoikglr me fkotuoi. 3. Sedgex heoikwksl heoikwksl mebepktko nko memuktko memuktko maotrkmsl fkotuoi hegkgul skrkd  ataoah j. Burkj fkotuoi

 Oarhkg, fuhgkj nkrkj ykoi nlpahpkmko veotrlmeg mlrl nko mkoko skhk  ceskroyk. Fuhgkj nkrkj ykoi nlpahpkmko veotrlmeg segkhk sktu heolt nlsecut burkj fkotuoi (bkrnlkb autput). Dkmtar-dkmtar utkhk ykoi hehpeoikrujl atat fkotuoi6 ;. Cecko kwkg 3. Maotrkmtlgltks 2. Cecko kmjlr  >. Dremueosl fkotuoi Perlane pemerfkko fkotuoi ykltu6 ;. Perlane systage 3. Perlane nlkstage

;;

 

2. Perlane lstlrkjkt l. Cuoyl Fkotuoi

^kjkpko cuoyl fkotuoi6 ;. Cuoyl pertkhk6 gup 3. Cuoyl menuk 6 Nup 2. Cuoyl metlik6 gehkj nko reonkj ;/2 fkgko nlkstaglb lonlvlnu hunk >. Cuoyl Cuoyl meehp meehpkt6 kt6 mknkoi mknkoi-mkn -mknkoi koi nkpkt nkpkt nlneoi nlneoikr kr seierk seierk secegu seceguh h cuoyl cuoyl  pertkhk

2.3. Ikikg Ikikg Fkotuoi Fkotuoi Kmut Kmut 2.3.;. Nedlolsl

Ikik Ik ikgg fkot fkotuo uoi i kmut kmut knkg knkgkj kj te terh rhlo loag agai aill yk ykoi oi nl nliu iuok okmk mko o uo uotu tum  m  heonesmrlpslmko mefknlko ktku peruckjko ykoi bepkt nkrl tkonk nko iefkgk ikikg fkotuoi. Maonlsl lol heoikobkh mejlnupko nko jkrus nltkoikol neoiko seierk, nko clkskoyk cerufuoi pknk jaspltkglsksl. Knk 3 feols perseotksl ikikg  fkotuoi kmut, ykltu ikikg fkotuoi kmut ykoi ckru terfknl pertkhk mkgl ( ne oava ) nko ikikg fkotuoi nemahpeosksl kmut pknk ikikg fkotuoi mraols ykoi sece secegu guho hoyk yk stkcl stkclg. g. Peoy Peoyec eckc kc terse terserl rloi oi nk nkrl rl ik ikik ikgg fk fkot otuo uoi i km kmut ut kn knkg kgkj kj jlpervaguh ktku jlperteosl pknk pksleo neoiko ikikg fkotuoi nlkstaglm.9 2.3.3.Eplnehlagail

Ikikg fkotuoi kmut tegkj heofknl hkskgkj mesejktko nl seguruj nuolk semkgl sem kglius ius peoyec peoyeckc kc sliold slioldlmk lmko o fuhgkj fuhgkj perkwk perkwktko tko nl ruhkj ruhkj skmlt skmlt neoiko neoiko heoijkclsmko clkyk ykoi tloiil. Prevkgeosl mksus ikikg fkotuoi nl mahuoltks heoloimkt selrloi neoiko heoloimktoyk uslk6 0,9 % (>0->5 tkjuo), ;,2 % (55-4> tkjuo), nko :,> % (95 tkjuo me ktks). Geclj nkrl >0% pksleo mksus ikikg fkotuoi hehlglml efemsl drkmsl geclj nkrl 50%. Pknk uslk >0 tkjuo, rlslma terfknloyk ikikg fkotuoi semltkr 3;% uotum gegkml nko 30.2 % pknk  perehpuko.:  Nkrl survey reilstrksl ruhkj skmlt nlnkpktmko nlnkpktmko koimk perkwktko perkwktko nl SR, perehpuko >,9% nko gkml-gkml8 5,;% knkgkj cerjucuoiko neoiko ik ikik ikgg fkot fkotuo uoi. i. Reck Reckil ilko ko nk nkrl rl ik ikik ikgg fko fkotu tuoi oi lo loll kn knkg kgkj kj nk nkgkh gkh ce ceot otum  um  hkolde hko ldestks stksll mglols mglols cerupk cerupk ikikg ikikg fkotuo fkotuoi i kmut, kmut, nko seckil seckilko ko ceskr ceskr cerup cerupkk :

emsksercksl emskser cksl kmut ikikg fkotuoi fkotuoi mraolm. mraolm.   Pksleo neoiko ikikg fkotuoi kmut

;3

 

hehlglml praioasls ykoi skoikt curum. Nkgkh sktu rkonahlzen trlkg ykoi  ceskr, pknk pksleo ykoi nlrkwkt neoiko ikikg fkotuoi ykoi heoikgkhl nemahp nem ahpeos eosksl, ksl, hartkg hartkgltks ltks 40 jkrl jkrl knkgkj knkgkj .

Pktadlslagail

;2

 

Meikikgko pknk fkotuoi nkpkt nlseckcmko agej ; ktku geclj nkrl cecerkpk hemkolshe utkhk nl ckwkj lol6;0

-

Meikikgko pahpk ^erfkn ^er fknll kmlckt kmlckt maotrk maotrkmsl msl atat atat fkotuo fkotuoi i ykoi ykoi gehkj, gehkj, tlnkm tlnkm knemuk knemukt, t, ktku ktku mkreok regkmsksl atat fkotuoi ykoi tlnkm bumup uotum terfknloyk peoilslko veotrlmeg.

-

Acstrumsl kglrko Acstrumsl nkpkt nlseckcmko knkoyk gesl ykoi heobeikj tercumkoyk mktup ktku meknkko gklo ykoi nkpkt heoyeckcmko peoloimktko veotrlmeg fkotuoi, sepertl steoasls kartk nko jlperteosl slstehlm.

-

Seiuriltksl Seiuriltksl nkpkt heoloimktmko kglrko ckglm nko cecko merfk veotrlmeg, sepertl ykoi terfknl pknk meknkko reiuriltksl kartk sertk pknk reiuriltksl

-

hltrkg. Ikoiiuko maonumsl ykoi heoyeckcmko maotrkmsl hlamkrnluh ykoi tlnkm  hkmslhkg nko tlnkm edlsleo.

Cecerkpk meknkko nl ktks nkpkt heoyeckcmko avergakn vaguhe nko temkoko sertk nlsduoisl reilaokg pknk fkotuoi sejloiik kmko heoloimktmko cecko merfk  fkotuoi nko heoyeckcmko rehanegloi strubturkg fkotuoi. Flmk cecko merfk  fkotuoi sehkmlo prairesld, hkmk kmko sehkmlo hehpercerkt rehanegloi sejloiik kmko heolhcugmko ikikg fkotuoi.;0 

2.3.5.

Mgksldlmksl

Mgksldl Mgk sldlmks mksll mglols mglols ikikg ikikg fkotuo fkotuoi i kmut kmut nlcukt nlcukt cernks cernkskrm krmko ko perdus perdusll nko maoiestl, nlmegahpammko heofknl ehpkt tlpe. ^lpe jkoikt nko ckskj (perdusl  cklm nko maoiestl) herupkmko tlpe terckoykm, tlpe nloilo nko ckskj (jlpaperdusl nko maoiestl), tlpe nloilo nko merloi (jlpaperdusl tkopk maoiestl) sertkk tlpe sert tlpe jkoikt jkoikt nko merloi merloi (mahpe (mahpeosks osksl, l, perdus perdusll cklm cklm tkopk tkopk maoie maoiestl) stl)..5,4 ^ernkp ^er nkpkt kt glhk glhk suctlp suctlpee IFK, IFK, ykltu ykltu ikikg ikikg fkotuo fkotuoi i mraols mraols nemahp nemahpeos eosktk ktk kmut kmut (KNJD), enehk pkru kmut, syam mkrnlaieolm, ikikg fkotuoi jlperteosld, nko ikikg fkotuoi mkoko. ;;,;3 

;>

 

-

KNJD terserloi nltehumko nltehumko nl lostkgksl lostkgksl ikwkt nkrurkt neoiko neoiko percurumko percurumko iefkgk nko tkonk ikikg fkotuoi, pknk pksleo neoiko duoisl veotrlmeg mlrl reonkj (ED 7 >0%).

-

Enehk pkru kmut nltkonkl nltkon kl neoiko neoiko nlstre nlstress ss perokp perokpksko ksko cerkt cerkt nlsertk nlsertkll peouru peouruoko oko skturksl skturksl amslieo (RkA3 70%, setegkj maonlsl stkclg, uotum uotum heoiurkoil heoiurkoil rlslma mehktlko, mehktlko, lodkrm hlamkrn  cerugkoi nko perkwktko agej mkreok ikikg fkotuoi

-

Peoyem Peo yemkt kt γ nlrema nlremaheo heonks nkslmk lmko o ckil ckil pksleo pksleo neoiko neoiko drkmsl efemsl efemsl 7 >0 %, setegkj maonlsl stkclg, uotum uotum heoiurkoil heoiurkoil rlslma mehktlko, mehktlko, lodkrm hlamkrn  cerugkoi nko perkwktko agej mkreok ikikg fkotuoi

-

Aplkt Apl kt (LT) (LT) jkrus jkrus nlpert nlpertlhc lhckoi koimko mko uotum uotum heoiur heoiurkoi koill oy oyerl erl lsmehl lsmehlm m ykoi ykoi jeckt jec kt (nko (nko hehper hehpercklm cklmll seskm seskm okdks). okdks). Mesknkr Mesknkrko ko nko uskjk uskjk okdks okdks jkrus jkrus nlhaoltar sebkrk metkt mkreok aplkte nlhaoltar aplkte nkpkt heoyeckcmko heoyeckcmko nepresl nepresl perokdksko perokdksko tlnkm stkclg

-

Kotkiaols Kotki aols hloerkgama hloerkgamartlma rtlmaln ln nlremaheon nlremaheonkslmko kslmko uotum heouruomk heouruomko o rlslma mehktlko nko perkwktko mkreok hkskgkj bkrnlavksbugkr pknk pkselo neoiko drkmsl efemsl 7 >0%

-

KBE (KSC) (KSC) nlrema nlremaheo heonksl nkslmko mko ckil ckil pksleo pksleo neoiko neoiko drkmsl drkmsl efemsl efemsl 7 >0%, >0%, setegkj maonlsl stkclg, uotum uotum heoiurkoil heoiurkoil rlslma mehktlko, mehktlko, lodkrm hlamkrn  cerugkoi nko perkwktko agej mkreok ikikg fkotuoi

-

Peoyem Peo yemkt kt γ nlrema nlremaheo heonks nkslmk lmko o ckil ckil pksleo pksleo neoiko neoiko drkmsl efemsl efemsl 7 >0 %, setegkj maonlsl stkclg, uotum uotum heoiurkoil heoiurkoil rlslma mehktlko, mehktlko, lodkrm hlamkrn  cerugkoi nko perkwktko agej mkreok ikikg fkotuoi

-

Aplkt Apl kt (LT) (LT) jkrus jkrus nlpert nlpertlhc lhckoi koimko mko uotum uotum heoiur heoiurkoi koill oy oyerl erl lsmehl lsmehlm m ykoi ykoi jeckt jec kt (nko (nko hehper hehpercklm cklmll seskm seskm okdks). okdks). Mesknkr Mesknkrko ko nko uskjk uskjk okdks okdks jkrus jkrus nlhaoltar sebkrk metkt mkreok aplkte nkpkt heoyeckcmko nepresl perokdksko

Pksleo neoiko Dlcrlgksl Ktrlkg nko gkfu veotrlmuger ykoi bepkt9 

39

 

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Pksl Pksleo eo jk jkru russ heon heonkp kpkt kt ko kotl tlma maki kiug ugko ko (hls (hls.j .jep epkr krlo lo)) segkh segkhkk tlnk tlnkm m kn knkk maotrklonlmksl, seierk setegkj nlnetemsl lrkhk dlcrlgksl ktrlkg, uotum heoiurkol rlslma trahcaehcagl

-

Mkrnlaversl Mkrnl aversl egemtrlm egemtrlm nlremaheo nlremaheonkslmk nkslmko o pknk pksleo neoiko neoiko jehanlokh jehanlokhlm  lm  ykoi tlnkm stkclg ykoi nljkrusmko uotum seierk mehckgl me lrkhk slous, uotum  hehpercklml maonlsl mglols neoiko bepkt

-

Mkrn Mk rnla lav ver ersl sl

egem egemtr trlm lm

ktku ktku

dk dkrh rhkm kma aga gai ilm

neo neoik iko o

khla khlan nkr kra ao

jkr kru us

nlpertlhckoimko pknk pksleo ykoi nlputusmko uotum mehckgl me lrkhk slous tetkpl( strkteil‚maotrag lrkhk“ ). Rtreteil lol jkoyk nltufumko ckil pksleo ykoi  ckru pertkhk mkgl heoikgkhl dlcrlkgsl ktrlkg neoiko nurksl 7 >: fkh (ktku  pknk pksleo tkopk tjrahcus nl kppeonlms ktrluh mlrl pknk emamkrnlairkdl trkosesadkius)

-

Pehcerlko iglmaslnk mkrnlkm jkrus nlpertlhckoimko uotum heoiaotrag gkfu

-

veotrlmeg Kotl Ko tlkr krlt lthl hlkk

megk megkss

L,

tlnk tlnkm m

nlre nlrema mahe heon onks kslm lmko ko

mk mkre reok ok

pe pert rtlh lhck ckoi oimk mko o

mekhkokooy mekhk okooykk (heoloimktm (heoloimktmko ko rlslma mehktlko nlol), terutkhk terutkhk pknk pksleo neoiko nlsduoisl slstaglm 

2.2. Mkrnlahla Mkrnlahlapktl pktl Perlpkr Perlpkrtuh tuh 2.2.;. Nedlolsl 

Nedlolsl perlpkrtuh mkrnlahlapktl ykoi uhuh nliuokmko nkrl Oktlaokg  nkrl  Oktlaokg   Jekrt kon Cgaan Lostltute nko nko Addlbe  Addlbe ad Skre Nlsekses nkrl nkrl Oktlaokg  Oktlaokg Lostltute ad Jekgt Jekgtjy jy   knkgkj knkgkj ikikg ikikg fkotuo fkotuoi i ykoi ykoi nlseck nlseckcm cmko ko agej agej nlsduo nlsduoisl isl slstagl slstaglm  m  ve veot otrl rlme megg mlrl mlrl yk ykoi oi terf terfkn knll segkh segkhkk km kmjl jlrr me mejk jkhl hlgk gko o nk nko o 5 cu cugk gko o hksk hksk  pastpkrtuh tkopk peoykmlt mkrnlavksmuger gklo.;  Nedlols Nedlolsll terckru terckru ykoi ykoi nlskhpklmko nkrl megahpam merfk pknk Kssablktlao ad Eurapeko Rablety ad  Bkrn Bk rnla laga gaiy iy

gecl geclj j

se sene nerj rjko kokk

neoi neoiko ko

heoi heoijl jlgk gkoi oimk mko o

ck cktk tksk sko o

wkmt wkmtu. u.

Mkrnlahlapktl perlpkrtuh knkgkj mkrnlahlapktl lnlapktlm ykoi heouofummko knkoyk knk oyk ikikg ikikg fkotuo fkotuoi i kmlckt kmlckt nlsduo nlsduoisl isl slstagl slstaglm m veotrl veotrlmeg meg mlrl mlrl pknk pknk kmjlr  kmjlr  mejkhlgko ktku cecerkpk cugko setegkj hegkjlrmko, nl hkok tlnkm nltehumko  peoyeckc ikikg fkotuoi gklo. Lol knkgkj mrlterlk peoiebukglko. Teotrlmeg mlrl 3

tlnkm nkpkt cernlgktksl tetkpl drkmsl efemsl jkhplr segkgu turuo nl ckwkj >5%.

3:

 

2.2.3. Eplnehlagail

Loslne Los lneo o PPBH PPBH bumup bumup reonkj reonkj ykltu ykltu 0,;% 0,;% pknk pknk mejkhl mejkhlgko gko,, okhuo okhuo harclnltks nko hartkgltks bumup tloiil kotkrk 5-23%. Pknk cecerkpk wkoltk, mglols nko emamkrnlairkdl nkpkt hehcklm jloiik mehckgl me maonlsl oarhkg, okhuo pknk cecerkpk wkoltk gklo nkpkt cermehckoi heofknl ikikg fkotuoi nk nko o me mehk hktl tlko ko fkot fkotuo uoi i heon heonkn knkm km.. Lo Losl slne neo o mk mkrn rnla lahl hlap apktl ktl pe perl rlpk pkrt rtuh uh  cervkrlksl, ykoi tegkj nlgkparmko nl Jkltl6 ; nkrl 30 >000 00 me megk gkjl jlrk rko o jl jlnu nup p nl Kherlmk Rerlmkt. Tkrlksl ykoi guks lol nlseckcmko agej percenkko ieairkdl nko nko

pagk pagk

pegk pegkpa park rko, o,

se segk gklo lo

ltu ltu

km kmse sess

em emam amkr krnl nlai airk rkdl dl

heoy heoyec eckc kcmk mko o

averestlhksl mksus lol. Cecerkpk dkmtar rlslma ykoi nkpkt heoyeckcmko lcu jkhlg heoikgkhl PPBH kotkrk gklo peoloimktko uslk lcu, hugtlpkrltks nko mejkhlgko neoiko preemgkhslk ktku jlperteosl iestkslaokg. 2  Nehkmlos et kg nko Crkr et kg heoehumko ckjwk wkoltk Kdrlmk Kherlmk 3,< mkgl geclj  ckoykm termeok PPBH. nlckonloimko neoiko wkoltk muglt putlj nko 9 mkgl geclj ckoykm nkrl wkoltk jlspkolm. Loslneo jlperteosl ykoi geclj ceskr nl Kdrlmk-Kherlmk nkpkt heoyeckcmko jkg lol.

2.2.2. Etlagail nko Pktadlslagail

Mkrnla Mkr nlahla hlapkt pktll perlpk perlpkrtu rtuh h knkgkj knkgkj ceotum ceotum peoykm peoykmlt lt hlamkr hlamkrn n prlher  prlher  ln lnla lapk pktl tlm m

yk ykoi oi ce cerj rjuc ucuo uoik iko o

ne neoi oiko ko me mejk jkhl hlgk gko. o.

Hesm Hesmlp lpuo uo ce cece cerk rkpk pk

hemk he mkol olsh shee etla etlaga gail il te tegk gkj j nlkf nlkfum umko ko te tetk tkpl pl tlnk tlnkm m sk sktu tupu puo o nk nkrl rl here heremk mk 4

herupkmko etlagail herupkmko etlagail ykoi pkstl.   Mkrnlahlap Mkrnlahlapktl ktl perlpkrtuh perlpkrtuh nlcenkmko nkrl mkrnlahlapktl gklo mkreok mefknlkooyk termklt neoiko mejkhlgko. Dkmtar reslma mkrnlahlapktl perlpkrtuh knkgkj hugtlpkrltks, uslk lcu ykoi tuk, mejkhlgko ikonk, pre-emgkhpslk, jlperteosl iestkslaokg, nko rks Kdrl Kd rlmk mk-Kh -Kher erlm lmk. k. Rkhp Rkhpkl kl skkt skkt lo lol, l, etlag etlagai aill pk pkstl stloy oykk ce cegu guh h nl nlte tehu humk mko, o, nlpermlrkmko mkreok hlamkrnltls, respao lhuo kcoarhkg terjknkp mejkhlgko, respao hkgknkptld terjknkp stress jehanlokhlm skkt jkhlg, kmtlvksl sltamlo kmlckt kml ckt stress, stress, nko terkpl terkpl tamagl tamagltlm tlm ykoi ykoi cermep cermepkof kofkoi koiko. ko. Ckoykm Ckoykm prases prases etlaga etlagail il ykoi ykoi nlnuik nlnuik heofkn heofknll peoyec peoyeckc kc Mkrnlah Mkrnlahlap lapktl ktl perlpk perlpkrtu rtuh, h, ykltu ykltu hlam hl amkrn krnltl ltlss vlrk vlrkg, g, respa respao o lhuo lhuo kc kcoa oarh rhkg kg yk ykoi oi ce cerj rjuc ucuo uoik iko o ne neoi oiko ko

3<

 

mejkhlgko, respao hkgknkptld terjknkp stres jehanlokhlm segkhk mejkhlgko, slta sltaml mlo o yk ykoi oi heoi heoikm kmtl tldm dmko ko st stres res,, em emsp spre resl sl pr prag agkm kmtl tlo o yk ykoi oi ce cerg rgec eclj ljko ko,,  peoiiuokko tamagltlm nko hkgoutrlsl ykoi cermepkofkoiko. Eurapeko Rablety ad Bkrnlagaiy heoimgksldlmkslmko Mkrnlahlapktl perlpkrtuh seckikl ceotum  2

oaodkhlglkg, oao-ieoetlm nkrl mkrnlahlapktl nlgktktld.   Hlam Hl amkr krnl nltl tlss vlru vlruss kn knkg kgkj kj hemk hemkol olsh shee ut utkh khkk yk ykoi oi nl nlnu nuik ik secki seckikl kl  peoyeckc Mkrnlahlapktl perlpkrtuh nko pertkhk mkgl nlgkparmko agej Iauget nko Hegvlo, ykoi heoehumko hlamkrnltls pknk clapsl hlamkrn pknk 2 wkoltk neoiko Mkrnlahlapktl perlpkrtuh. Okhuo sebkrk mglols tlnkm clsk nlcenkmko kotkrk wkoltk neoiko ktku tkopk hlamkrnltls. 9 Sespao lhuo ykoi kcoarhkg terjkn ter jknkp kp hlmrab hlmrabjlh jlherls erlshe he fkolo fkolo (seg fkolo fkolo nkgkh nkgkh slrmugk slrmugksl sl lcu) lcu) nlnui nlnuikk heofknl skgkj sktu peoyeckc Mkrnlahlapktl perlpkrtuh. ^earl lol nlnumuoi mkreok segkhk mejkhlgko seg fkolo nlgepksmko me nkgkh kglrko nkrkj lcu nko tlnkm knk rekmsl peoagkmko kmlckt peoemkoko memeckgko kgkhl ykoi terfknl segkhk mejkhlgko. Okhuo, setegkj hegkjlrmko, metlmk seg fkolo heoehpeg  pknk

fkrloiko

hlamkrn,

respaos

kutalhuo

pktagails

nkpkt

terfknl,

heoyeckcmko Mkrnlahlapktl perlpkrtuh pknk lcu setegkj hegkjlrmko.9  Regkhk mejkhlgko, vaguhe nkrkj nko burkj fkotuoi heoloimkt. Atat  pagas pehcuguj nkrkj heoikgkhl regkmsksl sejloiik kdtergakn cermurkoi. Jkg lo loll heoy heoyec eckc kcmk mko o jlpe jlpert rtra radl dl ve veot otrl rlme megg ml mlrl rl re reve vers rslc lceg eg uo uotu tum m hehe heheou oujl jl mecutujko lcu nko ckyl. Nlsduoisl veotrlmeg mlrl seheotkrk segkhk trlhester  metlik nko kwkg perlane pastpkrtuh, nkpkt mehckgl oarhkg setegkj hegkjlrmko  pknk mejkhlgko oarhkg. Mkrnlahlapktl perlpkrtuh nlnuik terfknl mkreok  peouruoko duoisl veotrlmeg ykoi nrkstls clgk terfknl peruckjko jehanlokhlm  segkhk seg khk mejkhl mejkhlgko gko..>  Peo Peoloi loimkt mktko ko maoseo maoseotrks trksll pgkshk pgkshk sltaml sltamlo o lodgkh lodgkhksl ksl terhksum tuhar oebrasls dkbtar λ (^OD-λ= ( ^OD-λ= B-rekbtlve pratelo (BSP)= nko Dks / Kpa-;, peokonk pgkshk kpaptasls, tegkj nllneotldlmksl nkgkh Mkrnlahlapktl  perlpkrtuh. Dks / Kpa-; mknkr gliko ykoi ternkpkt pknk perhumkko seg pratelo ykoi yko i cerper cerperko ko muobl muobl nkgkh nkgkh kpapta kpaptasls, sls, geclj geclj tloiil tloiil pknk pknk wkoltk wkoltk peoner peonerltk ltk Mkrnlahlapktl perlpkrtuh nlckonloimko wkoltk sejkt. 2  Jlgdlmer-Mgelo Jlgdlm er-Mgeloer er nmm heoehumko heoehumko hemkolshe hemkolshe pktaieoesls pktaieoesls ckru pknk Mkrnlahlap Mkrnl ahlapktl ktl perlpkrtuh perlpkrtuh,, ykltu peoloimktko peoloimktko pranumsl pranumsl pragkmtlo. pragkmtlo. Fuhgkj Fuhgkj

20

 

 pragkmtlo nlmkltmko neoiko peoloimktko vaguhe nkrkj, peouruoko temkoko nkrkj, peouruoko respao koilateoslo nko peouruoko fuhgkj klr, oktrluh nko mkgluh. Peoegltlko heouofummko ckjwk Mkrnlahlapktl perlpkrtuh pknk tlmus hehlgl heh lglml ml peoijk peoijkpu pusko sko spesldl spesldlm m R^K^2 R^K^2 pknk pknk mkrnla mkrnlahla hlaslt. slt. Pknk Pknk wkoltk wkoltk neoiko Mkrnlahlapktl perlpkrtuh, mknkr pratelo R^K^2 reonkj nl fkotuoi nko fuhgkj seruh bktjeplo N nko pragkmtlo ;4-mN heoloimkt. Peoiiuokko tamagltlm tama gltlm cermepkofk cermepkofkoiko oiko knkgkj peoiiuokko peoiiuokko kieo slhpktahlhe slhpktahlhetlm tlm segkhk geclj gec lj nkrl nkrl > hloiiu hloiiu.. Gkhper Gkhper nmm heoehu heoehumko mko knkoyk knkoyk jucuo jucuoiko iko kotkrk kotkrk  peoiiuokko terkpl tamagltlm nko permehckoiko permehckoiko enehk pkru pknk wkoltk jkhlg nko jucuoiko kotkrk peoiiuokko slhpktahlhetlm cetk nko Mkrnlahlapktl  perlpkrtuh.

2.2.>. Hkoldestksl Mglols

Peruckjko pknk mejkhlgko oarhkg sepertl peoloimktko vaguhe nkrkj,  peoloimktko mecutujko hetkcaglm, koehlk rloiko, peruckjko reslsteosl vksmugkr ykoi cerjucuoiko neoiko nlgktksl veotrlmeg rloiko nko peoloimktko bu burkj rkj fkot fkotuo uoi. i. Rehu Rehukk ma maon onlsl lsl lo loll yk ykoi oi hehc hehcuk uktt ao aose sett mk mkrn rnla lahl hlap apkt ktll  perlpkrtuh nkpkt neoiko hunkj nltutup-tutupl nko tlnkm nlmetkjul, mkreok meskhkkooyk. Ykoltk Yko ltk neoiko neoiko mkrnla mkrnlahla hlapkt pktll perlpk perlpkrtu rtuh h serloi serloi nltehu nltehumko mko seskm, seskm, gegkj gegkj skkt cerkmt cerkmtlvl lvltks, tks, pusloi pusloi,, oy oyerl erl nknk, nknk, cktum, cktum, enehk enehk tuoimk tuoimkl, l, veok veok  fuiugkrls heoloimkt, raoml pkru, nko sukrk fkotuoi R2. ^loimkt mepkrkjko iefkgk cervkrlksl nkrl O\JK L jloiik LT. Okhuo megks LLL nko LT knkgkj ykoi yko i pkgloi pkgloi serloi. serloi. Mahpgl Mahpglmksl mksl ykoi ykoi heoiko heoikobkh bkh flwk flwk terhksu terhksum m ikikg ikikg  fkotuoi redrkmter, syam mkrnlaieolm, krlthlk veotrlmeg cerkt, meikikgko hugtlariko, trahcaehcagl, nko mehktlko.;0 Nkgkh mksus lol pksleo nktkoi me LIN neoiko megujko nyspoeu, mkml  ceoimkm, hunkj gegkj skkt kmtld nko cktum sertk seskm flmk cerckrloi. Peoner Peo nerltk ltk ykoi ykoi nktkoi nktkoi sunkj sunkj nkgkh nkgkh meknkk meknkko o ikikg ikikg fkotuo fkotuoi i ykoi ykoi sehkml sehkmlo o  pkrkj ykltu nltehumko tkonk-tkonk fkotuoi mlrl tersuhckt nko fkotuoi mkoko. Pknk peherlmskko dlslm terfknl peoloimktko temkoko veok fuiugkrls, raomjl

2;

 

 ckskj nl menuk pkru, enehk emstrehltks nko ksltes. Pksleo nktkoi sunkj nkgkh meknkko ikikg fkotuoi megks O\JK LLL-LT. Nlkioasls mkrnlahlapktl perlpkrtuh serloimkgl tergkhckt mkreok iefkgk mkrnlahla mkrnl ahlapktl pktl perlpkrtuh perlpkrtuh tlnkm spesldlm, terutkhk terutkhk pknk mejkhlgko gkofut. gkofut. Mkrnlahlapktl Mkrnlahlap ktl perlpkrtuh perlpkrtuh jkrus nlpertlhcko nlpertlhckoimko imko pknk wkoltk wkoltk perlpkrtuh perlpkrtuh neoiko tkonk nko iefkgk ikikg fkotuoi ktku pksleo ykoi sunkj gkhk sehcuj. Slwkykt megukrik pergu nlmehckoimko geclj gkofut uotum heoietkjul pagk megukrik meguk rik pknk mkrnlahlap mkrnlahlapktl. ktl. Cecerkpk Cecerkpk egemtramkrn egemtramkrnlairkh lairkh oaospesldlm oaospesldlm nl mkrnlahla mkrnl ahlapktl pktl perlpkrtuh perlpkrtuh heouofumm heouofummko ko megkloko megkloko oao-spesldl oao-spesldlm, m, lotervkg lotervkg [^ ykoi cermepkofkoiko cermepkofkoiko,, nlgktksl nlgktksl [SR, jlpertradl jlpertradl veotrlmeg veotrlmeg mlrl, nko dlcrlgksl dlcrlgksl ktrluh.. Cecerkpk ktrluh Cecerkpk tes gkcarktarluh gkcarktarluh fuik peotloi tetkpl tlnkm mjusus uotum  mkrnlahlapktl perlpkrtuh.;; Nkgkh Nkg kh mksus mksus lol, lol, megujk megujko o kwkg kwkg past past pkrtuh pkrtuh pksleo pksleo jkoyk jkoyk nlspoe nlspoeu u rloiko, nko mkml ceoimkm fuik nlkoiikp megujko oarhkg pknk lcu pastpkrtuh. Jkg lol hehcukt pksleo heoikcklmko megujkooyk. Mesknkrko kmko tkonk nko iefkgk sertk mepktujko terjknkp terkpl nkpkt hehpeoikrujl praioasls pksleo. Megu Me gujk jko o

em emam amkr krnl nlai airk rkdl dl

kw kwkg kg

heou heouof ofum ummk mko o

nl nlgk gktk tksl sl

ve veot otrl rlme megg

ml mlrl rl,,

oarhamloetlm veotrlmeg mlrl seiheotkg nko Drkmsl Efemsl 40%. Glhk cugko tkopk terkpl nko pehkotkuko pksleo fktuoi nkgkh maonlsl ykoi geclj pkrkj. Nlhkok mltk nkpkt heoehumko sehuk nlgktksl rukoi, igackg seiheotkg GT jlpamloetlm neoiko Drkmsl Efemsl 723,4:%. Rtun Rtunll terc terckr kru u heoi heoieo eokl kl clah clahkrm krmer er yk ykoi oi huoi huoiml mlo o mj mjus usus us uo uotu tum  m  mkrnla mkr nlahla hlapktl pktl perlpk perlpkrtu rtuh h terhksu terhksum m pragkm pragkmtlo tlo ;4-mNk ;4-mNk,, hlbraS hlbraSOKOK-;>4 ;>4k, k, tlraslo mlokse ; ykoi heoyerupkl gkrutko tegkj nltehumko, hesmlpuo olgkl nlkioastlm nkgkh prkmtlm mglols hkslj hehergumko verldlmksl. ^loimkt COP ktku O^-pra COP (O-terhlokg pracrklo oktrluretlb peptlne). Maoseotrksl COP  pgkshk ktku COP O^-pra hehlglml seosltlvltks tloiil terjknkp lomgusl, nko spesldlsltks spesldl sltks tloiil tloiil uotum uotum heoyloiml heoyloimlrmko rmko ikikg fkotuoi. Hesmlpuo Hesmlpuo ternkpkt ternkpkt stres jehanlokhlm ykoi slioldlmko, COP ktku O^ pra-COP tlnkm heoloimkt segkhk mejkhlgko oarhkg. COP nko O^ pra-COP heoloimkt tlnkm slioldlmko  pknk preemgkhslk senkoimko nl mkrnlahlapktl perlpkrtuh heoloimkt ;;

slioldlmko.

23

 

Sao aoti tieo eo nkn nknk

jkr kru us

nlgkm lgkmu umk mko o

pkn knkk

pks ksle leo o

neo neoik iko o

nu nuik ikko ko

mkrnlahla mkrnl ahlapktl pktl perlpkrtuh. perlpkrtuh. Saotieo lol nkpkt hehckotu hehckotu flmk ternkpkt enehk  pkru, mkrnlaheikgl, maoiestl pkru, nko edusl pgeurk. Emamkrnlairkdl knkgkj  peherlmskko oao-lovksld nko peherlmskko evkguksl serlkg nlpergumko pknk wkoltk wkol tk jk jkhl hlg. g. Pknk Pknk wkol wkoltk tk pe peon oner erlt ltkk mk mkrn rnla lahl hlap apktl ktl pe perl rlpk pkrt rtuh uh sebkrk sebkrk maoslsteo maosl steo nltehumko ikikg fkotuoi fkotuoi ykltu peouruoko peouruoko drkmsl efemsl, nlgktksl nlgktksl igac igackg kg,, nk nko o pe peol olpl plsko sko nlon nlonlo loi i fkot fkotuo uoi. i.2  Mrl Mrlterl terlkk emamkr emamkrnla nlairk irkdl dl pknk pknk mkrnlahlapktl perlpkrtuh ykltu nlheosl nlkstaglm ufuoi GT 73,9 bh / h3 nko H-hane Drkbtlaokg sjarteoloi 720% ktku drkmsl efemsl veotrlmeg mlrl 7>5%. Emamkrnlai Emam krnlairkdl rkdl nkpkt nliuokmko nliuokmko uotum uotum heoiebukgl heoiebukglmko mko cecerkpk cecerkpk nlkioasls nlkioasls  ckonloi.;0  Peoblt Peobltrkko rkko resaoko resaokosl sl hkioet hkioetlm lm fkotuo fkotuoi i (HSL) (HSL) nkpkt nkpkt heofkn heofknll  pegeoimkp emamkrnlairkdl, e mamkrnlairkdl, terutkhk neoiko dltur emamkrnlairkdl ykoi murkoi aptlhkg.

2.2.5. ^ktkgkmskok

Hkokfe Hko kfeheo heo mkrnla mkrnlahla hlapkt pktll perlpk perlpkrtu rtuh h hlrlp hlrlp neoiko neoiko ceotum ceotum ikikg ikikg  fkotuoi gklooyk. Okhuo, perjktlko mjusus nlpergumko uotum mesegkhktko wkoltk wko ltk nko emsmre emsmresl sl ac ackt kt ktku ktku hetkca hetkcaglt glt segkhk segkhk perskg perskglok loko o jloiik jloiik prases prases heoyusul setegkj hegkjlrmko. ^ufuko utkhk peokoikoko ikikg fkotuoi knkgkj uotum uotu m heoloimktm heoloimktmko ko stktus jehanlokhlm, jehanlokhlm, heoiurkoil heoiurkoil tkonk nko iefkgk, iefkgk, nko heoi he oiap aptl tlhk hkgm gmko ko

jk jkslg slg fkoim fkoimkk

pk pkof ofko koi. i.

Heoi Heoiur urko koil il

pr preg egak akn n

ne neoi oiko ko

vksanlgktar sepertl oltrkt peotloi ykoi seckilko ceskr khko uotum mejkhlgko nko heoyus heoyusul. ul. Nluret Nluretlm lm fuik fuik peotlo peotloi i uotum uotum heoiur heoiurkoi koill pregak pregakn, n, tetkpl tetkpl  perjktlko jkrus nlcerlmko uotum heoiurkoil vaguhe lotkvksmuger, sejloiik heoiurkoil supgkl nkrkj me uterus nko fuik me fkolo. Hkokfeheo kmko damus  pknk peoiurkoiko pregakn nko kdtergakn sertk heoloimktmko loatraplm. Peoktk Peo ktkgkm gkmsko skokko kko uhuhoy uhuhoykk nlckil nlckil heofkn heofknll peoktk peoktkgkms gkmskok kokko ko clgk clgk pksleo pksleo neoiko ikikg fkotuoi mahpeosksl nko ikikg fkotuoi kmut. Peoktkgkmskokko ykoi yko i lnekg lnekg knkgkj knkgkj jlnrkgk jlnrkgkzlo zloe, e, oltrkt oltrkt,, nliam nliamslo slo,, nko nluret nluretlm. lm. Peoijk Peoijkhck hcktt eozlh peoiuckj koilateoslo (KBE-l) nlmaotrklonlmkslmko segkhk perskgloko mkreok terktaieolsltksoyk tetkpl terkpl lol knkgkj terkpl PPBH utkhk setegkj

22

 

hegkjlrmko uotum peouruoko kdtergakn. Kotkiaols kgnasterao edemtld clgk KBE tlnkm nltagerkosl tetkpl tlnkm nkpkt nlcerlmko segkhk mejkhlgko. 2 Kotkia Kot kiaols ols knreoe knreoeril rilm m cetk cetk sepert sepertll hetapr hetapraga agagg nko bkrvenl bkrvenlgag gag nkpkt nkpkt nlcerl nlc erlmko mko pknk pknk mkrnla mkrnlahla hlapktl pktl perlpk perlpkrtu rtuh h nko nkpkt nkpkt heoloi heoloimkt mktmko mko koimk koimk jkrk jkrkpk pko o jlnu jlnup. p. Cetk Cetk cgab cgabme merr tl tlnk nkm m ca cage gej j nl nlce cerl rlmk mko o pk pknk nk tk tkjk jkp p kwkg kwkg mkrnla mkr nlahla hlapktl pktl perlpk perlpkrtu rtuh h mkreok mkreok nkpkt nkpkt heoiur heoiurkoi koill perdus perdusll pknk pknk ikikg ikikg  fkotuoi kmut. Nliaxlo seckikl kieo loatraplm fuik khko nliuokmko segkhk mejkhlgko, nlkofurmko uotum lcu jkhlg neoiko nlsduoisl slstaglm sls taglm veotrlmeg mlrl nko drkmsl efemsl murkoi nkrl >0% neoiko meikikgko. Cerlmut penahko uotum  ikikg fkotuoi mahpeosksl pknk mkrnlahlapktl perlpkrtuh. Cerlmut penahko  peoktkgkmskokko ikikg fkotuoi termahpeosksl nl mkrnlahlapktl mkrnlahlapktl perlpkrtuh.2 ^kceg ^kc eg 3.:. 3.:. Hkokfe Hkokfeheo heo Mkrnla Mkrnlahla hlapkt pktll perlpk perlpkrtu rtuh h neoiko neoiko ikikg ikikg fkotuo fkotuoi i termahpeosksl Oao Pjkrhkbeutlbkg ^jerkples Gaw-sanluh nlet6 glhlt ad 3 i sanluh per nky Dguln restrlbtlao restrlbtlao6 3 G/nky Glijt nklgy kbtlvlty6 ld tagerkten (ei, wkgmloi) Kotepkrtuh Hkokieheot ad PPBH Cetk cgabmer 6 Bkrvenlgag, Hetapragag Tksanlgktar6 Jynrkgkzloe Nliamslo ^jlkzlne nluretlb6 Jlnramgaratlkzlne Koilateoslo-baovertloi Koilateoslo-b aovertloi eozyhe (KBE) lojlcltar  Bkptaprlg, Eokgkprlg, Skhlprlg, Glsloaprlg Koilateos Koila teoslo-r lo-rebe ebeptar ptar cgabmer cgabmer (clgk KBE-L KBE-L tlnkm hkhpu hkhpu heoagerk heoagerkosl) osl) Bkoneskrtko, Tkgskrtko Tksanlgktar  Jynrkgkzloe, Lsasarcln Nloltrkt Kgnasteraoe kotkiaolst  Rplraoagkbtao, Epgereoaoe Cetk cgabmer  Bkrvenlgag, Hetapragag Ykrdkrlo  (flmk drkmsl efemsl 725%)

  Peo Peoktk ktkgkm gkmsko skokko kko pksleo pksleo mkrnla mkrnlahla hlapkt pktll perlpk perlpkrtu rtuh h neoiko neoiko ikikg ikikg  fkotuoi kmut nlhugkl nkrl fkgko okdks, perokdksko nko slmgus. Peolgklko fkgko okpks skoikt peotloi mkreok vaguhe lotrkvksmugkr mejkhlgko ykoi cergecljko. Perokdksko Perok dksko pergu nlckotu neoiko neoiko amslieoksl amslieoksl tkhckjko tkhckjko uotum uotum heoiurkoil heoiurkoil tkonk nko iefkgk jlpamsehlk sertk heoiumur skturksl amslieo sebkrk terus heoerus. heoer us. Pehkotkuko Pehkotkuko temkoko nkrkj nko pehkotkuko pehkotkuko fkolo pergu nlgkmumko. nlgkmumko.

2>

 

Rebkrk dkrhkmagails dkrhkmagails nkpkt nlcerlmko nluretlm lotrkveok lotrkveok neoiko neoiko perjktlko, perjktlko, vksanlgktar nko kieo loatraplm. Durasehln nlcerlmko neoiko pertlhckoiko  pehcersljko mrektlolo nko oltraiglserlo nlcerlmko sesukl neoiko stktus mglols nko temkoko nkrkj. Nkgkh mksus lol, pksleo heofkgkol terkpl ikikg fkotuoi kmut neoiko amslieoksl amsli eoksl jlnuoi jlnuoi 2 gph A3, 0, fkh, nko mkteter  mkteter  urlo. ^erkpl dkrhkmagails nlcerlmko pahpk Durasehln 5 hi / fkh, Oltrkt 5 hi nlhlouh tlik mkgl sejkrl, nko Bkoneskrtko nlhlouh > hi nuk mkgl sejkrl. Jkrl pertkhk peoiacktko pksleo hkslj heoieguj nlspoeu tetkpl sunkj hugkl  cermurkoi, enehk tuoimkl nko ksltes fuik cermurkoi. Hehkotku pranumsl pranumsl urlo 450bb / 3> fkh. Pahpk durasehln nlikotl neoiko nluretlm lotrkveok tlik mkgl sejkrl. Pehkotkuko jkrl menuk pranumsl urloe >50 bb / 3> fkh, pksleo nlcerl tkhckjko terkpl arkg Bkrvenlgag 4,35 hi pknk hkgkh jkrl. Pksleo pugkoi seteg setegkj kj tlik tlik jk jkrl rl nlrk nlrkwk wktt nl ru ruhk hkj j skmlt skmlt ne neoi oiko ko te terkp rkpll nl nlck ckwk wk pu pugk gkoi oi Durasehln >0 hi pknk pkil jkrl, Bkoneskrtko > hi nuk mkgl sejkrl, Oltrkt 5 hi tlik mkgl sejkrl, Rplraoagkmtao 35 hi pknk pkil jkrl, Bkrvenlgag 4,35 hi  pknk hkgkh jkrl. Pksleo lol heouofummko respao terkpl ykoi cklm nko iefkgk mglols heoijlgkoi segkhk 2 jkrl peoiacktko. 2.2.4. Praioasls

Praioa Pra ioasls sls mkrnla mkrnlahla hlapkt pktll perlpk perlpkrtu rtuh h cerjuc cerjucuoi uoiko ko pasltl pasltldd neoiko neoiko  peoloimktko duoisl veotrlmeg. Meikikgko umurko fkotuoi uotum mehckgl me umurko oarhkg nlmkltmko neoiko hartkgltks nko harclnltks. Ykoltk neoiko nlsduoisl veotrlmeg perslsteo geclj suglt uotum certkjko jlnup nko mehckgl me duoisl duo isl fkotuo fkotuoi i oarhkg oarhkg nlckon nlckonloi loimko mko neoiko neoiko wkoltk wkoltk neoiko neoiko peoloi peoloimkt mktko ko duoisl veotrlmeg mlrl. Rglwk et kg heoiktkmko drkmsl efemsl knkgkj kgkt ckotu ykoi mukt nkrl jkslg pknk wkoltk neoiko PPBH.;3  Kccaun nmm. hegkparmko 50% wkoltk neoiko PPBH mehckgl me duoisl veotrlmeg oarhkg nkgkh 4 cugko setegkj hegkjlrmko. ;2 ^erkpl henls heourut  penahko KBBD / KJK secklmoyk nlgkofutmko flmk duoisl fkotuoi ceguh mehckgl oarhkg. Nlkioasls nlol nko terkpl terckru ikikg fkotuoi hehlglml  perko peotloi nkgkh heouruomko hartkgltks nko harclnltks PPBH. Perjktlko  fuik jkrus nlcerlmko pknk mejkhlgko cerlmutoyk pknk pksleo neoiko PPBH

25

 

ykoi hehcklm. Percklmko duoisl veotrlmeg mlrl herupkmko prenlmtar uotum  mejkhlgko cerlmutoyk.;>

CKC LT KOKGLRLR MKRUR

Mksus lol hehckjks searkoi wkoltk uslk >2 tkjuo nktkoi me LIN neoiko neo iko megujk megujko o seskm seskm okdks. okdks. Megujk Megujko o nlsertk nlsertkll enehk enehk tuoimk tuoimkll nko ksltes. ksltes. Megujko certkhckj cerkt nkgkh glhk cugko cugko terkmjlr. Pksleo heoieguj hunkj hunkj gegkj skkt cerkmtlvltks, cktum nko terckoiuo skkt tlnur mkreok seskm. Pksleo 5  cugko gkgu hegkjlrmko nko jkoyk heoieguj seskm rloiko sepertl megujko clksk nl peoijufuoi mejkhlgko, setegkj nlterkpl megujko pksleo hehcklm nko tlnkm   perokj maotrag gkil. 5 cugko mehunlko megujko seskm okdks certkhckj pkrkj nlsertkl megujko enehk tuoimkl nko ksltes. Heourut Hkouruoi (30;>), Ykoltk neoiko mkrnlahlapktl perlpkrtuh serloi nltehumko seskm, gegkj skkt cerkmtlvltks, pusloi, oyerl nknk, cktum, enehk tuoimkl, veok fuiugkrls heoloimkt, raoml pkru, nko sukrk fkotuoi R2. ^loimkt mepkrkjko iefkgk cervkrlksl nkrl O\JK L jloiik LT. Okhuo megks LLL nk nko o LT kn knkg kgkj kj yk ykoi oi pk pkgl gloi oi serlo serloi. i. Mahp Mahpgl glmk mksl sl yk ykoi oi heoi heoiko kobk bkh h flwk flwk terhksum ikikg fkotuoi redrkmter, syam mkrnlaieolm, krlthlk veotrlmeg cerkt, meikikgko hugtlariko, trahcaehcagl, nko mehktlko. Peoner Peo nerltk ltk ykoi ykoi nktkoi nktkoi sunkj sunkj nkgkh nkgkh meknkk meknkko o ikikg ikikg fkotuo fkotuoi i ykoi ykoi sehkml seh kmlo o pkrkj pkrkj ykltu ykltu nltehu nltehumko mko tkonktkonk-tko tkonk nk fkotuo fkotuoi i mlrl mlrl tersuhc tersuhckt kt nko  fkotuoi mkoko. Pknk peherlmskko dlslm terfknl peoloimktko temkoko veok  fuiugkrls, raomjl ckskj nl menuk pkru, enehk emstrehltks nko ksltes. Pksleo nktkoi sunkj nkgkh meknkko ikikg fkotuoi megks O\JK LLL-LT. Nkgkh Nkg kh mksus mksus lol, lol, megujk megujko o kwkg kwkg past past pkrtuh pkrtuh pksleo pksleo jkoyk jkoyk nlspoe nlspoeu u rloiko, nko mkml ceoimkm fuik nlkoiikp megujko oarhkg pknk lcu pastpkrtuh. Jkg lol hehcukt pksleo heoikcklmko megujkooyk. Mesknkrko kmko tkonk nko iefkgk sertk mepktujko terjknkp terkpl nkpkt hehpeoikrujl praioasls pksleo. Megu Me gujk jko o

em emam amkr krnl nlai airk rkdl dl

kw kwkg kg

heou heouof ofum ummk mko o

nl nlgk gktk tksl sl

ve veot otrl rlme megg

ml mlrl rl,,

oarhamloetlm veotrlmeg mlrl seiheotkg nko Drkmsl Efemsl 40%. Glhk cugko tkopk terkpl nko pehkotkuko pksleo fktuoi nkgkh maonlsl ykoi geclj pkrkj.

24

 

Nlhkok mltk nkpkt heoehumko sehuk nlgktksl rukoi, igackg seiheotkg GT jlpamloetlm neoiko Drkmsl Efemsl 723,4:%. Heourut Paolmawsml, nmm (30;4) Nlkioasls mkrnlahlapktl perlpkrtuh serloimkgl tergkhckt mkreok iefkgk mkrnlahlapktl perlpkrtuh tlnkm spesldlm, teru terutk tkhk hk pknk pknk mejk mejkhl hlgk gko o gk gkof ofut ut.. Mkrn Mkrnla lahl hlap apkt ktll pe perl rlpk pkrt rtuh uh jk jkru russ nlpert nlp ertlhc lhckoi koimko mko pknk pknk wkoltk wkoltk perlpk perlpkrtu rtuh h neoiko neoiko tkonk tkonk nko iefkgk iefkgk ikikg ikikg  fkotuoi ktku pksleo ykoi sunkj gkhk sehcuj. Slwkykt megukrik pergu nlme nlmehc hcko koim imko ko

gecl geclj j

gkof gkofut ut

uotu uotum m

heoi heoiet etkj kjul ul

pa pagk gk

me megu gukr krik ik

pk pknk nk

mkrnlahlapktl. Pknkk peherl Pkn peherlmsk mskkh kh dlslm dlslm nlnkpk nlnkpktmk tmko o temkok temkoko o nkrkj nkrkj ;30/90 ;30/90 hhJi, hhJi, ne neoy oyut ut ok oknl nl ;3 ;30 0 x/he x/heol olt, t, su suju ju 24 24,3 ,3 B, skt sktur urksl ksl A3 5 hh), drkbtlaokg sjarteoloi (heouruo 735%) = umurko ktrluh mlrl (heoloimkt (heoloimkt ?>0 hh), meteckgko meteckgko veotrlmeg mlrl (jlpertradl (jlpertradl (?;;-;3 hh) = strumtu stru mturr nko duoisl duoisl mktup mktup (steoas (steoasls ls ktku ktku reiuri reiuriltk ltksl sl mktup) mktup) = pradlg pradlg kglrko kglrko nlksta nlk staglb glb hltrkg hltrkg (kcoar (kcoarhkg hkgltk ltkss pagk pagk peoils peoilslko lko nlksta nlkstaglb glb nlol nlol nko gkofut gkofut)) =  perlbkrnluh (edusl, jehaperlmkrnluh, peoeckgko perlbkrnluh) = kartb autgaw vegablty (heouruo 7;5 bh), veok bkvk loderlar (nlgktksl, retrairkne dgaw).   Pknk wkoltk peonerltk peonerltk mkrnlahlap mkrnlahlapktl ktl perlpkrtuh perlpkrtuh sebkrk maoslsteo maoslsteo nltehumko ikikg fkotuoi ykltu peouruoko drkmsl efemsl, nlgktksl igackg, nko  peolplsko nlonloi fkotuoi. Mrlterlk emamkrnlairkdl pknk mkrnlahlapktl  perlpkrtuh ykltu nlheosl nlkstaglm ufuoi GT 73,9 bh / h3 nko H-hane Dr Drkb kbtl tlao aokg kg sj sjar arte teol oloi oi 720% 720% ktku ktku drkm drkmsl sl ef efem emsl sl ve veot otrl rlme megg ml mlrl rl 7>5% 7>5%.. Emamkrnlai Emam krnlairkdl rkdl nkpkt nliuokmko nliuokmko uotum uotum heoiebukgl heoiebukglmko mko cecerkpk cecerkpk nlkioasls nlkioasls  ckonloi. Nkgkh mksus lol, pksleo heofkgkol terkpl ikikg fkotuoi kmut neoiko amslieoksl amsli eoksl jlnuoi jlnuoi 2 gph A3, 0, fkh, nko mkteter  mkteter 

2:

 

urlo. ^erkpl dkrhkmagails nlcerlmko pahpk Durasehln 5 hi / fkh, Oltrkt 5 hi nlhlouh tlik mkgl sejkrl, nko Bkoneskrtko nlhlouh > hi nuk mkgl sejkrl. Jkrl pertkhk peoiacktko pksleo hkslj heoieguj nlspoeu tetkpl sunkj hugkl  cermurkoi, enehk tuoimkl nko ksltes fuik cermurkoi. Hehkotku pranumsl pranumsl urlo 450bb / 3> fkh. Pahpk durasehln nlikotl neoiko nluretlm lotrkveok tlik mkgl sejkrl. Pehkotkuko jkrl menuk pranumsl urloe >50 bb / 3> fkh, pksleo nlcerl tkhckjko terkpl arkg Bkrvenlgag 4,35 hi pknk hkgkh jkrl. Pksleo pugkoi seteg setegkj kj tlik tlik jk jkrl rl nlrk nlrkwk wktt nl ru ruhk hkj j skmlt skmlt ne neoi oiko ko te terkp rkpll nl nlck ckwk wk pu pugk gkoi oi Durasehln >0 hi pknk pkil jkrl, Bkoneskrtko > hi nuk mkgl sejkrl, Oltrkt 5 hi tlik mkgl sejkrl, Rplraoagkmtao 35 hi pknk pkil jkrl, Bkrvenlgag 4,35 hi  pknk hkgkh jkrl. Pksleo Pks leo lol heouof heouofumm ummko ko respao respao terkpl terkpl ykoi ykoi cklm cklm nko iefkgk iefkgk mglols mglols heoijlgkoi segkhk 2 jkrl peoiacktko. Heourut Reptl (30;:) Peoktkgkmskokko  pksleo mkrnlahlapktl perlpkrtuh neoiko ikikg fkotuoi kmut nlhugkl nkrl fkgko okdks, perokdksko nko slmgus. Peolgklko fkgko okpks skoikt peotloi mkreok vaguhe lotrkvksmugkr mejkhlgko ykoi cergecljko. Perokdksko pergu nlckotu neoiko amslieoksl tkhckjko uotum heoiurkoil tkonk nko iefkgk jlpamsehlk sertk heoiumur skturksl amslieo sebkrk terus heoerus. Pehkotkuko temkoko nkrkj nkr kj nko pehkot pehkotkuk kuko o fkolo fkolo pergu pergu nlgkmu nlgkmumko mko.. Rebkrk Rebkrk dkrhkma dkrhkmagai gails ls nkpkt nkpkt nlcerlmko nluretlm lotrkveok neoiko perjktlko, vksanlgktar nko kieo loatraplm. Durase Dur asehln hln nlcerl nlcerlmko mko neoiko neoiko pertlh pertlhcko ckoiko iko pehcer pehcerslj sljko ko mrektl mrektlolo olo nko oltraiglserlo nlcerlmko sesukl neoiko stktus mglols nko temkoko nkrkj. Heourut PESML Heourut PESML (30;4) (30;4) Pehcerlko Pehcerlko Nliaxlo Nliaxlo tlnkm nlpergumko nlpergumko pknk mksus lol. Nliamslo nlcerlmko uotum pksleo slhptahktlm neoiko ikikg fkotuoi nlsduo nls duoisl isl slstagl slstaglm m veotrl veotrlmeg meg mlrl mlrl nko terutk terutkhk hk ykoi ykoi neoiko neoiko dlcrlg dlcrlgksl ksl ktrlkg, ktrlkg, nliuokmko cerskhk skhk nluretlm, KBE lojlcltar, cetk cgabmer. Pknk pksleo tlnkm ternkpkt dlcrlgksl ktrlkg, hkmk tlnkm nlpergumko pehcerlko nliamslo. Heou He ouru rutt Rykr Rykrld ld (3 (30; 0;3) 3) Rete Retegk gkj j dkse dkse km kmut ut te terkt rktks ksl, l, pk pksl sleo eo nk nkpk pktt nltkhckjmko pehcerlko Bkptaprlg hugkl nkrl 4.35 hi nkpkt nloklmmko jloiik heobkpkl nasls aptlhkg. Bkptaprlg knkgkj iagaoiko Koilateoslo Baovertloi Eozyhe Eozy he Lojlcltar Lojlcltar (KBE), (KBE), cerperko cerperko seckikl seckikl vksanlgkta vksanlgktarr uotum uotum heoiurkoil heoiurkoil  cecko pregakn pknk ikikg fkotuoi. Ackt iagaoiko lol cemerfk neoiko bkrk

2<

 

heoi he oijk jkhc hckt kt me merf rfkk eo eozl zlh h

pe peoi oiuc uckj kj ko koil ilat ateo eosl slo o

se sejl jloi oiik ik pe peru ruck ckjk jko o

koilateoslo L heofknl koilateoslo LL nkpkt nlcgam. Koilateoslo LL herupkmko vk vksa sama maos ostr trlm lmta tarr mu mukt kt nk nko o fuik fuik heos heostl tlhu hugk gksl sl semres semresll kg kgna nast stera erao. o. Flmk Flmk  pehceotumko koilateoslo LL nljkhckt hkmk vksamaostrlmsl (peoieblgko  pehcuguj nkrkj) tlnkm terfknl, semresl kgnasteraoe heouruo, kglrko nkrkj me ilof ilofkg kg heol heoloi oimk mktt se sejl jloi oiik ik se semr mres esll ok oktr trlu luh h heol heoloi oimk mkt. t. Jkg Jkg te ters rsec ecut ut heoiurkoil cecko pregakn fkotuoi. Durase Dur asehln hln knkgkj knkgkj iagaoi iagaoiko ko gaap gaap nluretl nluretlb. b. Durase Durasehln hlnkk herupk herupkmko mko suktu nerlvkt kskh kotrkolgkt ykoi edemtld seckikl nluretlm. Edem merfkoyk bepkt bep kt nko nkgkh nkgkh wkmtu wkmtu ykoi ykoi sloimkt sloimkt.. Hemkol Hemkolshe she merfk merfk durase durasehln hln knkgkj knkgkj heoijkhckt peoyerkpko mehckgl oktrluh agej seg tucugl ilofkg. Durasehlnk heol he oloi oimk mktm tmko ko

peoi peoieg eguk ukrk rko o

hehp he hpeo eoik ikru rujl jl temk temkok oko o

klr, klr,

oktr oktrlu luh, h,

mg mgar arln lnk, k,

nkrk nkrkj j ykoi ykoi oa oarh rhkg kg..

mk mkgl gluh uh

nk nko o

tlnk tlnkm  m 

Pk Pknk nk pe peoi oiiu iuok okko ko ar arkg kg,,

durasehlnk nlkcsarpsl seckilko sebkrk bepkt nko nlemsmreslmko cerskhk urlo nko deses. Rplr Rp lrao aoag agkm kmta tao o heru herupk pkmk mko o ko kotk tkia iaol olss spesl spesldl dlm m kg kgna naste stera raoe oe,, yk ykoi oi  certonkm terutkhk heggul peoilmktko sebkrk mahpetltld pknk reseptar ykoi  cermklrko eoiko kgnasteraoe, tehpkt pertumkrko oktrluh-mkgluh nl nlstkg tucugus ilofkg. Rplraoagkmtao heoyeckcmko peoloimktko fuhgkj nko klr uotum  nlsemresl, senkoimko mejlgkoiko mkgluh nlhlolhkgmko. Kotkiaols kgnasterao terhksum splraoagkmtao nko lojlcltar maonumtko oktrluh oktrlu h numtus numtus magemtldus magemtldus (trlkhtereo nko khlragln). khlragln). Ackt-ackt lol skoikt skoikt murkoi edemtld clgk nliuokmko seonlrl tkopk mahcloksl neoiko ackt gklo uotum   peoktkgkmskkokko ikikg fkotuoi. Hesmlpuo nehlmlko, clgk nliuokmko nkgkh mahcloksl neoiko tlkzln ktku gaap nluretlb, ackt-ackt iagaoiko lol edemtld  nkgkh hehpertkjkomko mknkr mkgluh ykoi oarhkg nkgkh seruh.

CKC T PEOU^UP Pksleo pknk mksus lol heoikgkhl ikikg fkotuoi kmut ykoi nlseckcmko agej  perlpkrtuh mkrnlahlapktl. Pksleo hehlglml rlwkykt setegkj hegkjlrmko pksleo

>0

 

heoieguj heoie guj nlspoeu, setegkj heonkpkt heonkpkt terkpl pksleo tlnkm perokj mehckgl mehckgl maotrag. maotrag. Glhk cugko mehunlko pksleo nktkoi neoiko megujko nlspoeu ykoi geclj pkrkj, enehk tuoimkl nko ksltes sertk jkslg emamkrnlairkdl heouofummko drkmsl efemsl geclj reonkj ykltu 23,4:%. Jkslg peherlmskko dlslm nltehumko permusl renup nl menuk gkpkoi pkru, raoml ckskj nl pkru mkoko nko mlrl, lmjtus marnls terkck nl LBR TL gloek kxlggkrls koterlar koterl ar slolstrk, slolstrk, kcnaheo kcnaheo ksltes, nko enehk menuk tuoimkl. Peherlmskko Peherlmskko EMI nlnkpktmko slous tkmlmkrnl, JS ;30 x/heolt, nevlksl kmsls mlrl. Jkslg peherlmskko Z-rky tjarkms nlnkpktmko ikhckrko mkrnlaheikgl neoiko maoiestld pughaokg nko edusl pgeurk. Jkslg peherlmskko peherlmskko emam emamkrnlai krnlairkdl rkdl nlnkpktmko nlnkpktmko sehuk rukoi nlgktksl, jlpamloetlm jlpam loetlm veotrlmeg veotrlmeg mlrl seiheotkg igackg neoiko drkmsl efemsl veotrlmeg veotrlmeg mlrl 23,4:%.  

NKD^KS PUR^KMK

;.

Rglwk Rgl wk M, Cajh Cajh H. Loblne Loblneobe obe kon prevkg prevkgeob eobee ad preiok preiokoby oby-reg -regkte kten n jekrt jekrt nlsekse. Bkrnlavksb Ses 30;>=;0;655>-540. 30;>=;0;655>-540.

>;

 

3.

Ruglstykot Rugls tykotll N & Ruryaoa Ruryaoa C. Pktadlslaga Pktadlslagail il nko Peokoikoko Peokoikoko Mkrnlahlap Mkrnlahlapktl ktl Perlpkrtuh. Furokg Koestesl Acstetrl Lonaoeslk. 30; 6 Pkon Pkonuk uko o Prkm Prkmtl tlm m Mg Mglo lols ls Ckil Ckil Namt Namter er nl Dkslgltks Pegkykoko Mesejktko Prlher, 30;>.

6 ;5;5-:4-50>. ;2. Kc Kcca caun un F, Hurkn Hurkn \, Bjeo Bjeo-R -Rbk bkrkc rkceg eggl gl B, Rk Rkrkv rkvag agkt ktzz G, Rb Rbkr krkc kceg eggl gl ^H. ^H.

Perlpkrtuh Perlp krtuh Bkrnlahyapktj Bkrnlahyapktjy6 y6 k bahprejeosl bahprejeoslve ve revlew. revlew. Lot F Bkrnlag. Bkrnlag. 3009. 3009. ;;:(2)63. Cr nlddereobes nldder eobes lo perlpkrtuh perlpkrtuh bkrnlahyapktjy bkrnlahyapktjy.. Kh F Bkrnlag. Bkrnlag. 3009. 3009. ;00(3)6203 ;00(3)6203-20>. ;5. PESML. Pkonuko Prkmtlm Mglols (PPM) nko Bglolbkg Pktjwky (BP) Peoykmlt

Fkotuoi nko Pehcuguj Nkrkj Fkmkrtk. PESML. 30;4. ;4. Rykrld, Khlr et kg. Dkrhkmagail nko ^erkpl6 Enlsl meglhk. Fkmkrtk6 Dkmugtks

Menamterko Uolversltks Lonaoeslk 30;3.

>2