Laporan Pendahuluan Hemangioma Mifta

 

LEZK^EF ZCFAEGSLSEF GCOEF@MKOE

>.5.

ZCF@C^QMEF GCOEF@MKOE

Gcoef`mkoe eaeleg suetu tuokr bermf`ef lufei / tuokr vesiulcr bmfei eimnet prklmdcresm (pcrtuonugef yef` ncrlcnmg) aerm pconulug aereg yef` tmaei fkroel aef aepet tcrbeam peae sctmep bermf`ef pconulug aereg. Gcoef`mkoe scrmf` tcrbeam peae neym neru legmr aef peae efei ncrusme iuref` aerm 5 teguf (3-5:%). Nmesefye, gcoef`mkoe suaeg teopei scbei neym amlegmrief (8:%) eteu oufhul sctcleg ncncrepe omf``u sctcleg iclegmref (0:%). Gcoef`mkoe oufhul am sctmep tcopet peae pcrouieef tunug scpcrtm icpele, lcgcr, ouie, ieim eteu aeae. Gcoef`mkoe ocrupeief tuokr vesiuler bmfei tcrlezmo peae neym aef efei. Ocsimpuf tmaei ocfutup icouf`imfef aepet tcrbeam peae kref` tue, hkftkgfye eaeleg hgcrry gcoef`mkoe eteu ef`mkoe scfmlms yef` nmesefye  bmfei, ichml, rca-purplc pepulc peae iulmt kref` tue. Souofye gcoef`mkoe tmaei oconegeyeief iercfe scne`mef ncser iesus gcoef`mkoe aepet gmlef` acf`ef scfamrmfye ncncrepe nulef icouamef sctcleg iclegmref. Gerus amwespeaem nmle gcoef`mkoe tcrlctei am ne`mef tunug yef` vmtel, scpcrtm peae oete eteu oulut. Gel mfm amiercfeief, nmle ocfutupm scne`mef ncser tcopet tcrscnut eief ocf``ef``u prkscs oeief aef pcf`lmgetef, eteu nmle gcoef`mkoe tcrbeam peae kr`ef aeleo tunug (usus, kr`ef pcrfedesef, ktei) aepet

ocf``ef``u prkscs

icrbe kr`ef tcrscnut. Gcoef`mkoe lcnmg

ocf``ef``u ne`m pere kref` tue ictmie gcoef`mkoe tuonug peae ouie eteu icpele neym.

 

 

>.>.

CQMKLK@M

Gmf``e seet mfm epe yef` ocfbeam pcfycnen gcoef`mkoe oesmg ncluo amictegum, feouf ampcrimreief ncrgunuf`ef acf`ef ociefmsoc aerm ikftrkl  pcrtuonugef pconulug aereg. Ef`mk`cfcsms scpcrtmfye ocomlmim pcrefef aeleo iclcnmgef pconulug aereg. Hytkimfcs, scpcrtm Nesmh Dmnrknlest @rkwtg Dehtkr (ND@D) aef Teshuler Cfaktgclmel @rkwtg Dehtkr (TC@D), ocopufyem  pcrefef aeleo prkscs ef`mk`cfcsms. Zcfmf`ietef deitkr-deitkr pconcftuief ef`mk`cfcsms scpcrtm pcfurufef ieaer ef`mk`cfcsms mfgmnmtkr omselfye `eooe-mftcrdcrkf, tuokr fchrksms dehtkr   ‘   ncte, aef trefsdkromf` `rkwtg dehtkr   ‘   ncte ncrpcref aeleo ctmklk`m tcrbeamfye gcoef`mkoe.

>.8.

QEFAE AEF @CBELE

E.  Gcoef`mkoe iepmlcr

Qefae-tefae Gcoef`mkoe iepmlcr, ncrupe2

  Ncrhei ocreg tmaei ocfkfbkl aerm pcrouieef iulmt. “Xelokf



 pethg‟ ncrwerfe lcnmg ouae scaef` “Zkrt wmfc stemf‟ lcnmg `clep icnmru-nmruef,

ieaef`-ieaef`

 pcrouieef iulmt. N.  Gcoef`mkoe ievcrfksuo

 

oconcftui

ncfbklef

am

etes

 

  Qeopei scne`em suetu ncfbklef, icocregef, tcrese gef`et aef



“hkoprcssmnlc‟ (tuokr ocf`chml nmle amtcief aef nmle amlcpes aeleo ncncrepe weitu oconcser iconelm).

H.  Gcoef`mkoe Heopuref.

  Ameftere bcfms Gcoef`mkoe ievcrfksuo aef heopuref eae yef`



amscrtem dmstule ertcrmk-vcfkus (neweef). @cbele ilmfms Qcr`eftuf` oeheofye 2 5)  Gcoef`mkoe iepmlcr, “Zkrt wmfc stemf‟ tmaei eae ncfbklef iulmt. >)  “Xtrewncrry oeri‟, ocfkfbkl scpcrtm nueg ournem. 8)  Gcoef`mkoe ievcrfksuo, tcrene gef`et aef “hkoprcssmnlc‟.  “hkoprcssmnlc‟.   Zcocrmiseef aef ame`fksms 5)  Ouaeg feopei schere ilmfms, scne`em tuokr yef` ocfkfbkl eteu tmaei ocfkfbkl acf`ef werfe icocreg-ocregef >)  Quokr ncrsmdet “hkoprcssmnlc‟  “hkoprcssmnlc‟  8)  Ieleu pcrlu acf`ef pcocrmiseef ef`mk`redm.

 

 

>.1.

ZEQKDMXMKLK@M

Ocsimpuf ociefmsoc yef` bcles ocf`cfem ikftrkl aerm pcrtuonugef aef mfvklusm gcoef`mkoe tmaei nc`mtu amocf`crtm, pcf`cteguef ocf`cfem  pcrtuonugef aerm pconulug aereg yef` fkroel aef prkscs ef`mk`cfcsms aepet ambeamief pctufbui. Tesiulk`cfcsms ocfufbuiief suetu prkscs amoefe  prciurskr scl cfaktcl ocfmf`ietief pconcftuief pconulug aereg, ocf`mf`et ef`mk`cfcsms ncrgunuf`ef acf`ef pcriconef`ef aerm pconulug aereg neru yef` eae aeleo smstco vesiuler tunug. Xcleoe desc prklmdcresm, gcoef`mkoe ocf`uneg icpeaetef aerm scl-scl cfaktcl aerm iepmlcr-iepmlcr ichml. Xcl oericr aerm ef`mk`cfcsms, tcroesui prklmdcresm aerm eftm`cf mftm scl, hklle`cfesc tmpc MT, nesmh dmnrknlestmh `rkwtg dehtkr, veshuler cfaktgclmel `rkwtg dehtkr, urkimfesc, aef C-sclchtmf, aepet amicfelm klcg efelmsms moufkimomewm. Gcoef`mkoe supcrdmsmel aef aeleo, ocf`eleom desc pcrtuonugef hcpet amoefe uiuref aef vkluoc ncrteoneg schere hcpet. Desc mfm ammiutm acf`ef desc mstmreget, amoefe pcrunegef gcoef`mkoe sef`et scamimt, aef desc mfvklusm amoefe gcoef`mkoe ocf`eleom rc`rcsm schere spkftef. Xcleoe desc mfvklusm, gcoef`mkoe aepet gmlef` tefpe ncies. Gcoef`mkoe ievcrfkse yef`  ncser ocf`uneg iulmt scimterfye, aef ocsimpuf desc mfvklusm scopurfe, eigmrfye ocfmf``elief ncies peae iulmt yef` tcrlmget. Ncncrepe gcoef`mkoe iepmlcr aepet mfvklusm lcf`iep, tmaei ocfmf``elief ncies

 

 

Zetgwey ↘ `eoe mftcrdcrkf & trefsdkromf` `rkwtg N  N  ↘  ↕ veshuler cfaktcl `rkwtg dehtkr (outesm scl)  scl)   ↘  Gcoef`mkoe ↘  Ef`mk`cfcsms ↘  ↕ scl cfaktcl pconcftui veshuler ↕ vkl/buoleg  vkl/buoleg 

↘  ↕ uiuref tuokr   ↘ 

Zcfciefef bermf`ef

Zcfciefef aecreg vesiulermsesm & sered

 pcfmpmsef amfamf` vesiulcr

 Fycrm

↘  oete

rupturc spkftef vesiulcr ↘ 

Estm`oetmsoc & eonmkpme

fcirksms

 pcraeregef

↘  @`. Xcfskrm vmsuel

↕ icn. Futrmsm u/pcrnemief ber.  ber. 

smietrms

& icnutugef K> scrte futrmsm u/ Iuref` pcf`cteguef

Zcrtuonugef tuokr ↘ 

efxmctes

^upturc ulef`ef ulius

Oelfutrmsm (suplem mfeaciuet) ↘ 

``. mftc`rmtes iulmt

Icuseief bermf`ef Xcimter tuokr oesmd ↘   Futrmsm iuref` aerm icnutugef tunug

trkonksmtkpcfme

↘ vkl. hemref  hemref 

 

 

>.3.

ILEXMDMIEXM

5.  Gcoef`mkoe Iepmlcr (Xupcrdmhmel Gcoef`mkoe) Qcrbeam peae iulmt ne`mef etes. Gcoef`mkoe iepmlcr amscnut bu`e strewncrry gcoef`mkoe (gcoef`mkoe smoplci), tcrbeam peae weitu legmr eteu ncncrepe germ sctcleg legmr. Xcrmf` tcrbeam peae neym prcoetur aef  nmesefye eief ocf`gmlef` ncncrepe germ eteu ncncrepe omf``u icouamef. i couamef. @cbelefye eftere lemf teopei ncrhei ocreg yef` leoe-icleoeef oeimf  ncser. Leoe-icleoeef werfefye ocfbeam ocreg ocfyele, ncrnetes tc`es, icres peae pcreneef tc`ef` aef ncrncftui lknuler. Mfvklusm spkftef amtefaem klcg ocouhetfye werfe amaecreg scftrel, lcsm ocfbeam iuref` tc`ef` aef lcnmg ocfaeter. Xclemf strewncrry gcoef`mkoe (gcoef`mkoe smoplci), ncftui lemf gcoef`mkoe

iepmlcr

(supcrdmhmel

gcoef`mkoe)

eaeleg

`refulkoe

 pmk`cfmi. Lcsm mfm tcrbeam eimnet prklmdcresm iepmlcr yef` scrmf` tcrbeam scsuaeg treuoe, beam nuief klcg iercfe prkscs pcreaef`ef, weleupuf scrmf` amscrtem mfdcism sciufacr. Lcsm nmesefye sklmtcr, aepet tcrbeam peae scoue uour, tcruteoe peae efei aef tcrscrmf` peae ne`mef amstel tunug yef` scrmf` ocf`eleom treuoe. Oule-oule ncrncftui pepul crmtcoetkse acf`ef pconcseref yef` hcpet. Ncncrepe lcsm aepet ocfhepem uiuref 5 ho aef aepet ncrtef`iem, ouaeg ncraereg. >.  Gcoef`mkoe Ievcrfksuo Qcrbeam peae iulmt yef` lcnmg aeleo yemtu am ne`mef acroms aef suniutms (lepmsef peae iulmt). Gcoef`mkoe ievcrfksuo nmesefye tmaei ocomlmim netes tc`es ncrupe ncfbklef yemtu oeiule crmtcoetkse eteu fkaus yef`

ncrwerfe

ocreg

icuf`uef.

Nmle

amtcief

ocf`copms

aef

ocf``conuf` iconelm nmle amlcpes. Iclemfef mfm tcramrm aerm clcocf vesiuler (pconulug aereg) yef` oetef`. Gcoef`mkoe ievcrfksuo ieaef`-ieaef` tcraepet peae lepmsef bermf`ef yef` aeleo, peae ktkt eteu kr`ef aeleo. Ncftui ievcrfksuo beref` ocf`eaeief mfvklusm spkftef. Ncrncftui pepul crmtcoetkse acf`ef pconcseref yef` hcpet. Ncncrepe lcsm aepet ocfhepem uiuref 5 ho aef aepet ncrtef`iem, ouaeg ncraereg.

 

 

8.  Gcoef`mkoe Heopuref Zeae ncncrepe iesus, icaue bcfms gcoef`mkoe ametes aepet tcrbeam  ncrseoeef aef amfeoeief gcoef`mkoe heopuref. @eoneref ilmfmsfye  bu`e tcramrm etes `eoneref icaue bcfms gcoef`mkoe tcrscnut. Nefyei amtcouief peae cistrcomtes mfdcrmkr (elet `crei tunug ne`mef neweg, omselfye9 ieim, pege, all), ufmletcrel (setu smsm ne`mef tunug, omselfye9  pege imrm/iefef), sklmtcr (tuf``el) aef tcrbeam scbei legmr eteu peae oese efei-efei. Hmrm-hmrmfye eftere lemf tkfbklef ncrsmdet lufei aef ncrwerfe ocreg icnmruef yef` icouamef peae pcriconef`effye aepet oconcrm `eoneref icretktmi aef vcruikse. Lkiesm gcoef`mkoe heopuref peae lepmsef iulmt supcrdmsmel (pcrouieef) aef aeleo, eteu am kr`ef aeleo.

>.4.

ZCOC^MIXEEF LENK^EQK^MSO

Xchere ilmfms ame`fksms gcoef`mkoe tmaei suier, tcruteoe bmie `eoneref lcsmfye iges, tepm peae ncncrepe iesus ame`fksms gcoef`mkoe aepet ocfbeam suseg uftui amtc`eiief, tcruteoe peae gcoef`mkoe yef` lcteifye lcnmg aeleo. Ame`fksms gcoef`mkoe sclemf acf`ef `cbele ilmfms, bu`e aepet amtc`eiief

acf`ef

pcocrmiseef

pcfufbef`

lemf.

Zcf``ufeef

tcifmi

 pcfhmtreef oconeftu aeleo oconcaeief iclemfef pconulug aereg aerm  ncncrepe prkscs fckplesoe yef` e`rcsmd. Sltreskfk`redm acf`ef Akpplcr ocrupeief here yef` cdcitmd, iercfe tmaei ncrsmdet mfvesmd aef aepet ocfufbuiief `eoneref elmref aereg yef` tmf``m eftere gcoef`mkoe acf`ef tuokr sklma. Zeae pcf``ufeef W-rey, gcoef`mkoe bcfms iepmlcr, W-rey beref` am`ufeief iercfe tmaei aepet ocf``eonerief oese yef` lufei, scaef`ief  peae gcoef`mkoe ievcrfksuo nmesefye aepet tcrlmget iercfe tcraepet erce ielsmdmiesm. Ielsmdmiesm mfm tcrbeam iercfe pconciuef peae hevmtes hevcrfksuo (pglcnklmtgs). Msktkp shef peae gcoef`mkoe iepmlcr aepet ocfufbuiief  pcfmf`ietef ikfsmstcfsm i kfsmstcfsm acf`ef pcfmf`ietef suplem aereg, a ereg, tepm here mfm beref`

 

 

am`ufeief. Ef`mk`redm ocfufbuiief nemi tmaeifye pconulug aereg bu`e uftui ocf`ctegum pconcseref gcoef`mkoe iercfe fck-vesiulermsesm. Oe`fctmh ^cskfefhc Moe`mf` (O^M) ocfufbuiief iereitcrmstmi mftcrfel aerm suetu gcoef`mkoe aef lcnmg bcles oconcaeief aerm ktkt-ktkt yef` eae am scimterfye. Gcoef`mkoe aepet amame`fkse acf`ef pcocrmiseef dmsmi. Zeae iesus gcoef`mkoe aeleo eteu heopuref, HQ Xhef eteu O^M aepet amicrbeief uftui ocoestmief negwe struitur yef` aeleo tmaei tcrlmnet.

>.0.

IKOZLMIEXM

E.  Zcraeregef Ikoplmiesm mfm pelmf` scrmf` tcrbeam amnefamf`ief acf`ef ikoplmiesm lemffye. Zcfycnenfye meleg treuoe aerm luer eteu ruptur spkftef amfamf`  pconulug aereg iercfe tmpmsfye iulmt am etes pcrouieef gcoef`mkoe, scaef`ief pconulug aereg am newegfye tcrus tuonug. N.  Slius Slius ocfmonulief rese fycrm aef ocfmf`ietief rcsmik mfdcism,  pcraeregef, aef smietrmi. Slius ocrupeief gesml aerm fcirksms. Slius aepet bu`e tcrbeam eimnet ruptur. Gcoef`mkoe ievcrfkse yef` ncser aepet ammiutm acf`ef ulscresm aef mfdcism sciufacr. H.  Qrkonksmtkpcfme Beref` tcrbeam, nmesefye peae gcoef`mkoe yef` ncruiuref ncser. Aegulu amimre negwe trkonksmtkpcfme amscnenief klcg lmope yef` gmpcreitmd. Qcrfyete

icouamef

negwe

aeleo

bermf`ef

gcoef`mkoe

tcraepet

 pcf`uopulef trkonksmt yef` ocf`eleom sciucstcrmsesm. A.  @ef``uef Zcf`lmgetef Zeae rc`mk pcrmkrnmtel sef`et ocfmf`ietief rmsmik `ef``uef pcf`lmgetef aef gerus lcnmg scrmf` amokfmtkr. Eonlykpme aepet ocrupeief gesml aerm suonetef peae suonu pcf`lmgetef (vmsuel exms). Icnefyeief ikoplmiesm yef` tcrbeam eaeleg estm`oetmsoe yef` amscnenief tciefef tcrsconufym

 

 

aeleo nkle oete eteu acseief tuokr ic ruef` rctrknulner. Gcoef`mkoe  peae iclkpei oete nmse ocf``ef``u pcriconef`ef pcf`lmgetef fkroel aef gerus amtcrepm peae ncncrepe nulef pcrteoe icgmaupef.

>.7. ZCFEQELEIXEFEEF

 

E. OCAMX Zcfeteleisefeef gcoef`mkoe schere uouo eae > here, yemtu 2 5)  Here Ikfscrvetmd Zeae

pcrbelefef

eleomegfye

lcsm

gcoef`mkoe

eief

ocf`eleom

 pconcseref aeleo nulef-nulef pcrteoe, icouamef i couamef ocfhepem pconcseref oeismouo aef scsuaeg mtu tcrbeam rc`rcsm spkftef scimter uour 5> nulef, lcsm tcrus ocf`eaeief rc`rcsm seopem uour 3 teguf. Gcoef`mkoe supcrdmsmel eteu gcoef`mkoe iepmlcr eteu gcoef`mkoe strewncrry scrmf` tmaei amtcrepm iercfe gcoef`mkoe bcfms mfm nmle amnmerief eief gmlef` acf`ef scfamrmfye aef iulmt tcrlmget fkroel. >)  Here Eitmd Gcoef`mkoe yef` ococrluief tcrepm schere eitmd, eftere lemf eaeleg gcoef`mkoe yef` tuonug peae kr`ef vmtel, scpcrtm peae oete, tclmf`e, aef tcf``krkief9 gcoef`mkoe yef` ocf`eleom pcraeregef9 gcoef`mkoe yef`

ocf`eleom

mfdcism9gcoef`mkoe ocfmonulief

ulscresm9 yef`

acdkromtes

gcoef`mkoe

yef`

ocf`eleom

pcrtuonugef

(iclemfef)

bermf`ef.

ocf`eleom hcpet

aef

Zcfeteleisefeef

gcoef`mkoe schere eitmd, eftere lemf 2   N.  ZCONCAEGEF Mfamiesm 2 5)  Qcraepet tefae-tefae pcrtuonugef gcoef`mkoe yef` tcrlelu hcpet >)  Omf``u lcsm ocfbeam 8-1 ielm lcnmg ncser. 8)  Gcoef`mkoe reisese acf`ef trkonksmtkpcfme. 1)  Qmaei eae rc`rcsm spkftef-spkftef, omselfye tmaei tcrbeam pcf`chmlef gcoef`mkoe scsuaeg 4-0 teguf.

 

 

3)  Lcsm yef` tcrlctei peae webeg, lcgcr, tef`ef eteu vulve yef` tuonug hcpet, ouf`imf ococrluief cismsm lkiel uftui ocf`cfaelmieffye. H.  ^EAMEXM Zcf`knetef reamesm suaeg tmaei amleiuief le`m iercfe 2 5)  Zcfymferef ncreimnet iuref` nemi peae efei-efei yef` pcrtuonugef tulef`fye oesmg sef`et eitmd. >)  Ikoplmiesm ncrupe ic`efesef yef` tcrbeam peae bef`ie weitu leoe. 8)  Ocfmonulief dmnrksms peae iulmt yef` oesmg scget yef` eief ocfyulmtief nmle ampcrluief suetu tmfaeief. 1)  Icnefyeief gcoef`mkoe iepmlcr eief ncrc`rcsm. 3)  Ikrtmikstcrkma Irmtcrme pcf`knetef acf`ef ikrtmikstcrkma meleg 2

  Epenmle oclmnetief seleg setu struitur yef` vmtel.



  Quonug acf`ef hcpet aef ocf`eaeief acstruism iksoctmi.



  Xchere ociefmi ocf`eaeief knstruism seleg setu krmdmsmuo.



  Eaefye nefyei pcraeregef acf`ef eteu tefpe trkonksmtkpcfme.



  Ocfycnenief acikopcfsesmk ieramkvesiuler.



Ikrtmikstcrkma yef` ampeiem meleg eftere lemf prcafmskf yef` ocf`eimnetief gcoef`mkoe ocf`eaeief rc`rcsm, yemtu uftui ncftui strewncrry, ievcrfksuo, aef heopuref. Aksmsfye pcr krel >:-8: o`  pcrgerm scleoe >-8 omf``u aef pcrlegef-legef amturufief, leoe  pcf`knetef seopem 8 nulef. Qcrepm acf`ef ikrtmikstcrkma aeleo aksms ncser ieaef`-ieaef` eief ocfmonulief rc`rcsm peae lcsm yef` tuonug hcpet. Gcoef`mkoe ievcrfkse yef` tuonug peae iclkpei oete aef ocf``ef``u pcf`lmgetef uouofye amknetm acf`ef stcrkma mfbcism yef` ocfurufief uiuref lcsm schere hcpet, scgmf``e pcriconef`ef  pcf`lmgetef nmse fkroel. Gcoef`mkoe ievcrfkse eteu gcoef`mkoe heopuref aepet amknetm nmle stcrkma amncrmief schere krel aef mfbcism lef`suf` peae gcoef`mkoe.

 

 

Zcf``ufeef ikrtmikstcrkma pcrkrel aeleo weitu yef` leoe aepet ocfmf`ietief mfdcism smstcomi, tciefef aereg, amenctcs, mrmtesm leonuf`, scrte pcrtuonugef tcrgeonet. A.  KNEQ XILC^KQMI Zcfyuftmief negef silcrktmi peae lcsm gcoef`mkoe, omselfye acf`ef feokr gkhetc 3:%, GHl imfmf >:%, Fe-selmsmlet 8:%, eteu lerutef FeHl gmpcrtkfmi. Eief tctepm here mfm scrmf` tmaei amsuiem iercfe rese fycrm aef ocfmonulief smietrmi. C.  CLCIQ^KIKE@SLEXM Here mfm ampeiem uftui spmacr ef`mkoe uftui acsmiesm scftrel ertcrmfye,  bu`e uftui Gcoef`mkoe scfmlms aef `refulkoe pmk`cfmi. D.  ZCONCISEF Eplmiesm amf`mf acf`ef ocoeiem fmtrk`cf hemr. @.  EFQMNMKQMI Eftmnmktmi amncrmief peae gcoef`mkoe yef` ocf`eleom ulscresm. Xclemf mtu amleiuief pcrewetef luie schere stcrml.

 

 

DK^OEQ EXSGEF ICZC^EPEQEF ZEAE ILMCF ACF@EF @EF@@SEF XMXQCO MFQC@SOCF “GCOEF@MKOE‟ “GCOEF@MKOE‟  

8.5.ZCF@IEBMEF  Zcf`iebmef eaeleg tegep ewel aerm prkscs icpcrewetef aef ocrupeief suetu prkscs yef` smstcoetms aeleo pcf`uopulef aete aerm ncrne`em suoncr aete uftui ocf`cveluesm aef ocf`macftmdmiesm stetus icscgetef ilmcf ( Furseleo,  Furseleo, >::5) >::5)

  Aete sunycitmd



Aete yef` amaepetief aerm ilmcf scne`em suetu pcfaepet tcrgeaep suetu smtuesm aef icbeamef ( Furseleo, >::5) >::5)

  Aete knbcitmd



Aete yef` aepet amknscrvesm aef amuiur ( Furseleo,  Furseleo, >::5) >::5) 8.5.5.  Zcf`uopulef aete Ocrupeief upeye uftui ocfaepetief aete scne`em mfdkroesm tcftetef` pesmcf. Aete yef` amnutugief tcrscnut ocfheiup aete tcftef` nmkpsmiksksmel aef spmrmtuel eteu aete yef` ncrgunuf`ef acf`ef oeseleg pesmcf scrte aete tcftef` deitkr-deitkr yef` ocopcf`erugm oeseleg pesmcf (Gmaeyet, E. Ezmz Elmoul, >::4)  >::4)  E.  Macftmtes pesmcf oclmputm feoe pesmcf, tcopet aef tef``el legmr, suiu/nef`se, stetus pcriewmfef, e`eoe, pcfamamief, tef``el aef weitu aetef` ic ^uoeg seimt (Gmaeyet, E. Ezmz Elmoul, >::4 )  )  N.  Macftmtes pcfef``uf` bewen2 feoe, uour bcfms icleomf, eleoet,  pcicrbeef, gunuf`ef acf`ef ilmcf. 8.5.>.  ^mweyet icpcrewetef E.  ^mweyet icpcrewetef scieref` ^mweyet icpcrewetef scieref` eaeleg deitkr-deitkr yef` ocleterncleief`m eteu gel-gel ocopcf`erugm eteu ocfaegulum iclugef.

 

 

Oclmputm iclugef eteu `ef``uef yef` scgunuf`ef acf`ef  pcfyeimt yef` am reseief seet mfm. Acf`ef eaefye scsei fepes,  netui, fycrm aeae, icrmf`et oeleo, fedsu oeief ocfuruf aef sugu  neaef ocfmf`iet ocfakrkf` pcfacrmte uftui ocfherm pcf`knetef. N.  Iclugef uteoe Iclugef uteoe, epe yef` ocfycnenief pesmcf ncrknet eteu `cbele yef` pcrteoe tmonul seet pesmcf aetef` ic ^uoeg seimt yemtu iclugef ocf`cfem eaefye `ef``uef peae smstco pcrfedesef. H.  Leoe iclugef Leoe iclugef, scncrepe leoe pesmcf ocreseief iclugef.

A.  ^mweyet pcfyeimt seet mfm ^mweyet pcfyeimt seet mfm, ocrupeief pcfyeimt yef` amreseief  pesmcf peae seet amiebm (Gmaeyet, E. Ezmz Elmoul, >::4). C.  ^mweyet icpcrewetef scncluofye ^mweyet icpcrewetef scncluofye eaeleg rmweyet eteu  pcf`eleoef oese lelu tcftef` icscgetef eteu pcfyeimt yef`  pcrfeg am eleom (Gmaeyet, E. Ezmz Elmoul, >::4). D.  ^mweyet icpcrewetef icluer`e ^mweyet icpcrewetef icluer`e eaeleg rmweyet icscgetef eteu icpcrewetef yef` amomlmim klcg seleg setu ef``kte icluer`e, epeieg eae yef` ocfacrmte pcfyeimt yef` scpcrtm ameleom pesmcf (Gmaeyet, E. Ezmz Elmoul, >::4). Nmesefye icluer`e pcfacrmte eae yef` ocopufyem icsulmtef yef` seoe (pcfyeimt yef` seoe). Ocfherm ameftere ef``kte icluer`e peae tuncriulksms peru yef` ocfacrmte pcfyeimt tcrscnut scgmf``e scgmf``e amtcrusief pcfulereffye. @.  ^mweyet lmf`iuf`ef

 

 

Epeieg iceaeef lmf`iuf`ef icluer`e / ilmcf suaeg ococfugm syeret icscgetef.

8.5.8.  Zkle-pkle duf`sm icscgetef (Akc`kcs, >:::) E.  Eitmvmtes /Mstmreget 5.  Iclcoegef ktkt, fycrm aef ieiu. N.  Mftc`rmtes C`k 2 5.  Deitkr strcss 2 neru/leoe. >.  Zcreseef nutug pcrtklkf`ef 8.  Hcoes. H.  Oeiefef/Hemref 2 5.  Cacoe bermf`ef uouo. A.  Fyeoef/fycrm 2 5.  Ococ`ef` erce yef` seimt. C.  Zcrfepesef 2 5.  Qcrpebef leoe D.  Icoefef/Icscleoetef 2 5.  Eaefye acstruism bermf`ef @.  Mftcreism Xksmel 2 Zcreseef tcrmsklesm/amtklei. 8.>.AME@FKXE ICZC^EPEQEF  8.>.5   Fycrm n/a pcfciefef aecreg vesiulermsesm aef syered   8.>.>   Futrmsm iuref` aerm icnutugef tunug n/a mfteic mfeaciuet  8.>.8  Iciuref`ef vkluoc hemref aef clcitrklmt n/a pcraeregef  8.>.1  Icruseief mftc`rmtes iulmt n/a ulius  8.>.3  Efxmctes n/a iuref` pcf`cteguef tcftef` pfyeimt   8.8.MFQC^TCFXM ICZC^EPEQEF 

 

 

8.8.5   Fycrm n/a pcfciefef aecreg vesiulermsesm aef syered Qubuef

2 Xctcleg amncrmief pcrewetef fycrm aepet ncriuref` aef eigmrfye gmlef`.

Irmtcrme

2

e.  ilmcf tmaei ocf`clug seimt  n.  tmaei feopei ocrmf`ms h.  siele fycrm ncriuref` Mftcrvcfsm2 e.  Iebm lkiesm, iuelmtes aef mftcfsmtes fycrm ^/ Gesml iebmef aepet oconeftu pcfcftuef pcrewetef aef tcrepm  pcf`knetef.  n.  Zefteu QQT ^/ Sftui ocf`ctegum scbeug oefe pcf`erug fycrm tcrgeaep smstcoo tunuug lemf. h.  Efburief ilmcf uftui ocf`etur pksmsm tunugfye e`er aecreg luie tmaei tcrtcief. ^/ Sftui oclefherief vesiulermsesm a.  Eberief tcgfmi rcleisesm aef amstreismopeae ilmcf aef icluer`e. ^/ Qcgfmi fepes aeleo aepet ocomfmoelmsmr ocomfmoelmsmr fycrm yef` amreseief acf`ef tcrpcfugmfye icnutugef K> bermf`ef. c.  Efburief aef auiuf` uftui ocfhmpteief suesefe yef` fyeoef. ^/ iceaeef lmf`iuf`ei ncrpcf`erug peae scfsmtmdmtes scfsesm scsckref`. d.  Iklenkrsm pconcrmef knet pcf`gmlef`fycrm aef eftmnmktmi uftui ocfhc`eg pcfycnen luie lcnmg lefbut. 8.8.>   Futrmsm iuref` aerm icnutugef tunug n/a mfteic mfeaciuet Qubuef2 Icnutugef futrmsm tcrpcfugm, amtefaem acf`ef Irmtcrme Gesml2 e.  Ncret neaef ilmcf ncrtegef/ncrteoneg aerm iceaeef scncluoye  n.  Ilmcf ocfyeteief icmf`mfef ocf`miutm amct.

 

 

h.  Ilmcf ocfufbuiief tklcrefsm tcrgeaep amct yef` amfeburief a.   Fmlem lenkretkkrmuo (omselfye2 trefsdcrmf, elnuomf, aef clcitrklmt) aeleo rcftef` fkroel. c.  Ilmcf feopei sc`er aef tmaei lcoes. Mftcrvcfsm2  e.  Iebm stetus futrmsm ^/ Ocf`ctegum ikafsmsm pestm stetus futrmsm  n.  Iebm/hetet pkle aef pcoesuief amct ^/ Icnmeseef oeief ilmcf sef`et pcrlu uftui amictegum aeleo ref`ie pcfycsuemef aeleo pconcrmef amct. h.  Oktvesm ilmcf uftui ocf`uneg icnmeseef oeief ^/ Acf`ef oktmvesm, amgerepief ilmc tcrpehu uftui ocfmf`ietief esupef oeieffye. a.  Ncrmief oeiefef scamimt tepm scrmf` ^/ Xcne`em eftmsmpesm ouel oufteg yef` yef` ameleom ilmcf. c.  Ncrmief oeiefef aeleo ikfamsm gef`et ^/ Oeiefef yef` gef`et ocfmf`ietief feasu oeief oclelum ref`sef`et mfare pcfhmuoef aef pcf`chepef. d.  Ncrmief oeiefef scsuem icsuieef, ichuelm bmie ikftre mfamiesm. ^/ Oconeftu ocfmf`ietie esupef oeiefef. `.  Leiuief pcrewetef oulut, ncrmief pcfyc`er oulut. ^/ Icncrsmgef oulut eief ocfmf`ietief icfyeoefef aef ocf``u``eg feddsu oeief. g.  Qmonef` ncret ncret neaef ilmcf sctmep germ. ^/ Xcne`em okfmtkr pcriconef`ef stetus futrm futrmsm sm aef cdci tcrepm yef` tcleg amncrmief. m.  Iklenkresm pconcrmef bcfms amct acf`ef tceo `mzm ^/ Oesmf`-oesmf` ikfamsm pcfyeimt ocopuffyem bcfms icnutugef eief futrmsm yef` ncrncae-ncae.  b.  Iklenkresm pconcrmef tcrepm teonegef futrmhm aef hemref

 

 

^/ Ocfmf`ietief esupef icnutugef hemref. i.  Iklenkresm pcoefteuef gesml nmkimome stetus `mzm acf`ef tceo lenkretkkrmuo ^/ Ocf`ctegum pcriconef`ef icnutuge `mzm aerm sc`m nmkimome. l.  Iklenkresm pconcrmief knet scsuem mfamiesm 2 scameef ncsm9 Ielsmuo9 Tmteomf A aef N ikoplcis9 Eftmcoctmi ^/ Zcfef`efef pcfycnen `ef``uef futrmsm ncroefdeet uftui ocf`etesm/oconetesm oeseleg yef` oufhul eimnet iciuref`ef esupef futrmsm. 8.8.8  Iciuref`ef vkluoc hemref aef clcitrklmt n/a pcraeregef Qubuef2 Acdmsmt vkluoc hemref eief amhc`eg, amtefaem acf`ef Irmtcrme Gesml2 e.  Xtetus futrmsm eaciuet2esupef oeiefef aef hemref eftere mfteic aef kutput  n.  Icscmonef`ef clcitrklmt aef eseo-nese h.   Feam pcrmdcr tcrene a.  QQT aeleo netes fkroel Mftcrvcfsm2 e.  Knscrvesm QQT ^/ scne`em `eoneref iceaeef uouo ilmcf  n.  Siur mfteic aef kutput hemref, gmtuf` MPL yef` eiuret ^/ Zcoesuief krel yef` tmaei eaciuet aepet ocfycnenief gmpkvklcome. h.  Ncrmief hemref scsuem mfamiesm ^/ Iclcnmgef eteu iciuref` hemref, scrte icselegef pcomlmgef  bcfms hemref eief ocopcrncret ikfamam ilmcf. a.  Ewesm tciefef aereg, pcrunegef drciucfsm beftuf`, pcrgetmief tefae-tefae acgmaresm

 

 

^/ Qefae-tefae gmpkvklcome sc`cre amictegum acf`ef eaefye teimieram,

gmpktcfsm

aef

sugu

tunug

yef`

ocfmf`iet

 ncrgunuf`ef acf`ef acgmaresm.

c.  Hkftrkl esupef oeiefef tmf``m fetrmuo & sugu lmf`iuf`ef ^/ Zcfmf`ietef sugu lmf`iuf`ef eief ocfmf`ietief icgmlef`ef hemref, scgmf``e eief ocopcrpereg iciuref`ef hemref yef` tcrbeam. Zcfmf`ietef buoleg Fe+ eief ocfmf`ietief rctcfsm hemref scgmf``e ocopcrpereg tcrbeamfye cacoe. d.  Okfmtkr gesml len. ^/ Ocf`ctegum pcrunegef yef` tcrbeam aef cdci tcrepm. `.  Iklenkresm pconcrmef tcrepm hemref pcf``etm bmie ampcrluief ^/ Ococfugm icnutugef hemref yef` iuref`. 8.8.1  Icruseief mftc`rmtes iulmt n/a ulius Qubuef 2 luie oconemi aef mftc`rmtes iulmt oconemi. Irmtcrme

2

e.  Ilmcf tmaei le`m ocf`clug iulmtfye `etel-`etel  n.  Luie oconemi Mtcrvcfsm 2 e.  iebm lues aef iceaeef luie scrte prkscs pcfyconugef. ^/ Zcf`iebmef yef` tcpet tcrgeaep luie aef prkscs  pcfyconugef eief oconeftu aeleo ocfcftuief tmfaeief sclefbutfye.  n.  ^ewet luie acf`ef nemi aef ncfer acf`ef oconccrsmgief luie schere escptmi ocf``ufeief lerutef yef` tmaei mrmtetmd, ef`iet smse nelutef yef`f ocfcfpcl peae luie aef fcirktkom  besrmf`ef yef` oetm. ^/ Zcrewetef luie acf`ef tcgfmi escptmi aepet ocfbe`e ikfteomfesm luie aef smse nelutef bermf`ef fcirktmi f cirktmi

 

 

aepetocf`geonet `refulesm luie. 8.8.3  Efxmctes n/a iuref` pcf`cteguef tcftef` pfyeimt   Qubuef 2 ichcoesef ilmcf ncriuref` negief gmlef` Irmtcrme

2

e.  Ilmcf tmaur fycfyei  n.  Ilmcf ocf`crtm epe yef` ambclesief acf`ef dcca nehi nemi h.  Ilmcf feopei seftem Mftcrvcfsm2 e.  Iebm bchcoesef yef`f amreseief ilmcf ^/ Sftui oconeftu ocfcftuief tmfaeief pcrewetef yef` amncrmief.  n.  Ncrm pcfbclesef tcftef` pcfycnen tcrbeamfye luie aef here  pcfyconugeffye. ^/ Zcfbclesef ocf`cfem pcfyeimt aef luie yef` tmonul aepet oconcrmief `eoneref yef` tcrereg peae pesmcf scgmf``e eief ocf`uref`m hcoes aef ocfmf`ietief pertmsmpesm ilmcf aeleo prkscs pcf`knetef. h.  Leiuief pcfacietef tmep ocleiuief tmfaeief. ^/ Zcfacietef yef` amncrmief tmep ocleiuief tmfaeief  ncrtubuef e`er ilmcf lcnmg yeimf etes tmfaeief yef` amncrmief pcrewet. a.  Efburief aef auiuf` icluer`e uftui ocfhmptief suesefe aef lmf`iuf`ef yef` fyeoef ^/ Lmf`iuf`ef yef`f fyeoef aepet ncrpcf`erug peae psmims ilmcf. c.  Knscrvesm rese hcoes ilmcf scsuaeg amncrmief tmfaeief. ^/ Ncrtuuef uftui ocf`ctegum epeieg pcfbclesef aef tmfaeief yef` amnutugief oeopu ocf`uref`m hcoes. d.  Leiuief tcgfmi rcleisesm aef amstreism ^/ Qcgfmi rcleisesm aef amstreism aepet oconuet ilmcf i lmcf ocrese

 

 

lcnmg rmlcis aef seftem.

AEDQE^ ZSXQEIE 

5.  ^knnmfs,

X.L.

ct.ell.

^knnmfs

Nesmh

Zetgklk`yh

kd

Amscescs.1tg.ca.Zgmleaclpgme2 P.N Xeuacrs Hk.5==3 >.  Xeseim @G. Gcoef`mkoe, Ertcrmkvcfkus Oeldkroetmkf, efa Lyopgef`mkoes. mf2 Burimcwmhz OB, ct el. Zlestmh Xur`cry prmfhmplcs efa prehtmhc. 5st Ca.Xt.Lkums2 HT.Oksny Hk.5==:. 8.  Xocltzcr, Xuzeffc H. >::5.  Nuiu Eber Icpcrewetef Ocamiel Ncaeg aerm  Nruffcr & Xuaaertg, Xuaaertg, Camsm 7. C@H 2 Beierte. 1.  Xocltzcr, Xuzeffc H. >::>.  Nuiu Eber Icpcrewetef Ocamiel Ncaeg aerm  Nruffcr & Xuaaertg, Xuaaertg, Camsm 7. C@H 2 Beierte. 3.  Pmlimfskf, buamtg O. >::4.  Nuiu Xeiu Ame`fksms Icpcrewetef acf`ef mftcrvcfsm FMH aef Irmtcrme Gesml FKH . C@H 2 Beierte

 

 

4.  Xeftkse, Nuam. >::3.  Zefauef Am`fkse Icpcrewetef Fefae >::3->::4 . Zrmoe Ocamie 2 Beierte.