eficacia del lavado nasal isotónico

7/23/2019 Eficacia Del Lavado Nasal Isotnico

1/18

Hobfcfbc nhl Lcvcna Gcscl Bsatgbfa

(fag Cjuc nh Dcr) hg hl ^rctcdbhgta y Prhvhgfbgnh Ybgbtbs hg Gbas

Bva !lcpck, DN; Mcgc Vkaup, DN; Phtr Vtrgcn, DN; Pcvhl Eargk, DN

Aimhtbva=Hvclucr hl pathgfbcl nh lc cplbfcfbg gcscl nh salufbg sclbgc bsatgbfc pcrc prhvhgbr lc rhcpcrbfbg nhl

rhsorbcna y nh lc jrbph tbpa bgoluhgzc hg las gbas nurcgth hl bgvbhrga.

Nbsha=Prasphftbva, dultbfgtrbfa, nh jrupas pcrclhlas, cibhrta y nh fadpcrcfbg clhctarbzcnc.

Cdibhgth=Afea flgbfcs phnbtrbfcs nh cthgfbg cdiulctarbc.

Pcfbhgths=Xg tatcl nh >03 gbas (nh ?-30 cas) fag rhsorbcna a jrbph sbg fadplbfcfbaghs.

Bgthrvhgfbaghs=Vh csbjgcrag nh dcghrc clhctarbc c las pcfbhgths c 9 jrupas nh trctcdbhgta, uga sla fag

dhnbfcfbg hstgncr, y hl atra fag ug lcvcna gcscl fag salufbg nh cjuc nh dcr danbobfcnc (Peysbadhr) ds

lc dhnbfcfbg hstgncr, y sh aishrvcrag nurcgth 39 shdcgcs.

Dhnbfbaghs prbgfbpclhs nh las rhsultcnas=Las prbgfbpclhs pugtas obgclhs nh hobfcfbc ouhrag lc rhsalufbg nh

las sgtadcs gcsclhs nurcgth lc hgohrdhncn cjunc (vbsbtcs 3 y 9). cdibg sh aishrv lc rhcpcrbfbg nhl

rhsorbcna a nh lc bgoluhgzc, hl fagsuda nh dhnbfcdhgtas, lcs fadplbfcfbaghs, las ncs nh cushgtbsda hsfalcr, y

las ncs rhjbstrcnas nh hgohrdhncn nurcgth lcs shdcgcs sbjubhgths fucgna sh hvclu hl pathgfbcl nh

prhvhgfbg (vbsbtcs 6 y >).

Yhsultcnas=Hg lc vbsbtc 9, las pcfbhgths hg hl jrupa nh salufbg sclbgc nh cjuc nh dcr lajrcrag las prbgfbpclhs

pugtas obgclhs nh hobfcfbc (dhnbnas hg ugc hsfclc gudrbfc nh > pugtas hg lc fucl 3 bgnbfcic gbgjg sgtadc y

>, sgtadcs jrcvhs) hg las pcrdhtras nh shfrhfbg gcscl y aistruffbg (pugtucfbaghs pradhnba vs. hl jrupa sbg

salufbg nh cjuc nh dcr, 3,:2 vs 9,30 y 3,98 vs 3,85, rhsphftbvcdhgth) (P < 0,08 pcrc cdias). Nurcgth lc ocsh

nh prhvhgfbg (hg lc vbsbtc 6, 5 shdcgcs luhja nhl bgbfba nhl hstunba) las pcfbhgths hg hl jrupa nh lc salufbg

sclbgc bsatgbfc nh cjuc nh dcr dastrcrag rhsultcnas sbjgbobfctbvcdhgth dhgarhs hg hl nalar nh jcrjcgtc, tas,

aistruffbg gcscl y shfrhfbg (P < 0,08 pcrc tanas). Pcrc lc vbsbtc 6, sbjgbobfctbvcdhgth dhgas gbas nhl jrupa

nh salufbg sclbgc nh cjuc nh dcr hstcicg uscgna cgtbpbrtbfas (2% vs 66%), nhsfagjhstbagcgths gcsclhs (8%

vs >:%), dufaltbfas (30% vs 6:%), y cgtb-bgohffbasas sbstdbfas (?% vs 93%) (P < 0,08 pcrc tanas). Nurcgth hl

dbsda phrana las gbas hg hl jrupa nh lc salufbg nh cjuc nh dcr rhpartcrag sbjgbobfctbvcdhgth dhgas ncs nh

hgohrdhncn (63% vs :8%), cushgtbsda hsfalcr (3:% vs 68%), y fadplbfcfbaghs (5% vs 69%) (P < 0,08 pcrc

tanas). Yhsultcnas sbdblcrhs ouhrag hgfagtrcnas hg lc ltbdc vbsbtc.


2/18

Fagflusbg= Las gbas hg hl jrupa nh salufbg sclbgc nh cjuc nh dcr nhdastrcrag ugc rhsalufbg ds rpbnc

nh cljugas sgtadcs gcsclhs nurcgth lc ocsh cjunc nh lc hgohrdhncn y pasthrbardhgth ugc rhfurrhgfbc dhgas

orhfuhgth nh rbgbtbs .

Crfe Atalcrygjal Ehcn Ghfk Vurj. 9005;36>(3)=?:-:>

Coblbcfbaghs nh las Cutarhs= Flgbfc Phnbtrbfc nh Atarrbgalcrbgjalajc, Easpbtcl Nafhgth Irga (Nr. !lcpck),

Pecrdc Pramhfts Ltn (Nr. Vkaup), y Fhgtra nh Cthgfbg Cdiulctarbc nh Atarrbgalcrbgjalajc Phnbtrbfc (Nr.

Eargk), Irga, y lc Flgbfc Phnbtrbfc, Easpbtcl Xgbvhrsbtcrba nh Datal, Prcjc (Nr. Vtrgcn), Yhpilbfc Fehfc.

Lcs bgohffbaghs nhl trcfta rhspbrctarba suphrbar (B^YV) y las sgtadcs rbgasbgusclhs sag quhmcs

orhfuhgths,hsphfbcldhgth hg las gbas.3Lc prhvclhgfbc nh rbgasbgusbtbs hs tcg cltc fada ug 69% hg hsth jrupa

htcrba.9

Lc brrbjcfbg gcscl fag salufbaghs sclbgcs bsatgbfcs pcrhfh hohftbvc hg nbfecs fagnbfbaghs nh sclun yorhfuhgthdhgth hs uscnc hg ugc vcrbhncn nh bgnbfcfbaghs fada trctcdbhgta facnyuvcgth.6Cugquh hl lcvcna

gcscl sclbga hst cftucldhgth dhgfbagcna hg vcrbcs pcutcs, lc hvbnhgfbc fbhgtobfc nh su hobfcfbc hs icstcgth

pairh.>, 8

Xg gdhra nh crtfulas nagnh sh hvclcg nh 90 c 900 pcfbhgths fag rbgbtbs clrjbfc a rbgasbgusbtbs frgbfc ecg

sbna puilbfcnas.6Hg hllas sh fadpcrcrag salufbaghs nh nbohrhgth tagbfbncn?a nbspasbtbvas nh cndbgbstrcfbg: a

sh hvclu hl pathgfbcl nhl lcvcna gcscl pcrc prhvhgbr a rhnufbr las sgtadcs nh clhrjbc. 5Cugquh las rhsultcnas

sag fagtravhrsbclhs, lc brrbjcfbg gcscl dhmarc las sgtadcs y c dhguna nbsdbguyh lc fcgtbncn nh dhnbfcfbg

prhsfrbtc.2

Dhgas lbthrcturc hst nbspagbilh pcrc B^YV csafbcncs fag hl rhsorbcna fadg nurcgth hl bgvbhrga. Cncd ht cl.30hvclucrag lc hobfcfbc nh sprcys sclbgas ebphrtgbfas h bsatgbfas hg cnultas fag rhsorbcna a sgtadcs

rbgasbgusclhs y fadpcrcrag las rhsultcnas fag ug jrupa nh aishrvcfbg fagtral. Atra hstunba puilbfcna

rhfbhgthdhgth sh rhclbz pcrc hvclucr sb lc cplbfcfbg nbcrbc nh salufbg sclbgc gcscl puhnh prhvhgbr las

sgtadcs nhl rhsorbcna fadg hg cnultas scgas.33

Ga oubdas fcpcfhs nh hgfagtrcr gbgjg crtfula quh hvclucrc hl usa fadplhdhgtcrba nhl lcvcna gcscl hg gbas

nurcgth ug rhsorbcna fadg a quh hvclucrc su pathgfbcl prhvhgtbva. Vh tuva bgthrs hg hl jrupa nh hncn nh ? c

30 cas parquh las gbas hg hncn nh br cl falhjba tbhghg ug dcyar rbhsja nh fagtrchr B^YV y rbgasbgusbtbs quh

atras jrupas.39 Par la tcgta, llhvcdas c fcia ug hstunba prasphftbva fag las gbas quh vbgbhrag c lcs flgbfcs


3/18

phnbtrbfcs cdiulctarbcs pcrc hl trctcdbhgta nh ug

rhsorbcna cjuna a jrbph. Hl hstunba ouh rhclbzcna hg nas

ocshs= bgbfbcldhgth gas hgoafcdas hg hl clbvba nh las

sgtadcs nurcgth lc hgohrdhncn cjunc, y luhja

hvclucdas hl pathgfbcl prhvhgtbva hg lc dbsdc pailcfbg

nh pcfbhgths.

Las aimhtbvas prbgfbpclhs nh hsth hstunba ouhrag (3) praicr

lc hobfcfbc y shjurbncn nhl lcvcna gcscl sclbga bsatgbfa nh

cjuc nh dcr fada ug trctcdbhgta facnyuvcgth nurcgth lc

rbgbtbs cjunc ga fadplbfcnc pcrc lc rhsalufbg nh las

sgtadcs gcsclhs y (9) hvclucr su pathgfbcl pcrc prhvhgbr

lc rhfurrhgfbc nhl rhsorbcna y nh lc jrbph tbpa bgoluhgzc y nh

sus fadplbfcfbaghs. Las aimhtbvas shfugncrbas bgfluyhrag

lc hvclucfbg nh 9 ouhrzcs nh lcvcna gcscl nbohrhgths (ug

fearra dhnba y ug fearra sucvh hg rafa) y 9 ordulcs

bsatgbfcs fag nbohrhgths fadpasbfbaghs bgbfcs (ugc

ordulc nh lcvcna gcscl y ugc ordulc nucl uscnc pcrc

lcvcna afulcr y gcscl).

Hl hstunba ouh cpraicna par hl fadbt nh tbfc nhl Easpbtcl Nafhgth nh Datal hg Prcjc y hl fadbt nhl Easpbtcl

Nafhgth hg Irga. anas las pcfbhgths obrdcrag ug oardulcrba nh fagshgtbdbhgta nh bgoardcfbg y aituvbhrag lc

bgoardcfbg rhlhvcgth nhl hstunba, hl fucl ouh nbshcna fada dultbfgtrbfa, nh jrupas pcrclhlas, cibhrta, y nh

fadpcrcfbg clhctarbzcnc. Afea flgbfcs phnbtrbfcs cdiulctarbcs pcrtbfbpcrag hg hl hstunba; fcnc gba ouh

hvclucna par hl dbsda dnbfa hg fcnc vbsbtc. Las pcfbhgths hlhjbilhs thgcg hncnhs hgtrh ? y 30 cas y

hstcicg vbsbtcgna cl dnbfa par ug rhsorbcna fadg a jrbph. Las frbthrbas hsphfobfas nh hxflusbg ouhrag las

trcstargas cgctdbfas rbgasbgusclhs, bgduganhobfbhgfbc shvhrc fagafbnc, y lc dhnbfcfbg fagfadbtcgth fag

fartbfasthrabnhs.

Xg tatcl nh >03 gbas fudplbhrag fag las frbthrbas nh bgflusbg y ouhrag nbstrbiubnas cl czcr pcrc rhfbibr

trctcdbhgta hstgncr quh bgfluc cgtbpbrtbfas, nhsfagjhstbagcgths gcsclhs, dufaltbfas (hllas puhnhg ecihr

sbna ncnas hg icsh cl hstcna nhl pcfbhgth a c nbsfrhfbg nh las pcnrhs) y/a cgtbibtbfas sbstdbfas (g 4 303) sbg

lcvcna fag salufbg bsatgbfc nh cjuc nh dcr, a hsth dbsda trctcdbhgta hstgncr fag lcvcna fag salufbg

sclbgc bsatgbfc nh cjuc nh dcr. Lc salufbg sclbgc uscnc ouh ug pranufta fadhrfbcldhgth nbspagbilh

prafhscna c pcrtbr nhl cjuc nh dcr nhl Afcga Ctlgtbfa (Peysbadhr; Jahdcr Lciarctabrh nh lc Dhr, Vcbgt

Dcla, Orcgfbc). Fada lc hlhftranblbsbs hs uscnc pcrc hstcilhfhr lc bsatagbfbncn, las albjahlhdhgtas y dbghrclhs

Fucnra 3. Fadpasbfbg Sudbfc nh lc Valufbg

Vclbgc Bsatgbfc c

Bg Fagfhgtrcfbg

Hlhdhgtas, dj/L

Vanba (Gc+) 9>00

Flarura (Fl") 8580 Patcsba (K+) 83

Fclfba (Fc9+) 6?0

Dcjghsba (Dj+ +) 3600

Vuloctas (czuorh) (VA>- -) 9:88

Ebhrra (Oh+ +) ?

Albjahlhdhgtas, #j/L

]bgf (]g+ +) 9:.00

Vhlhgba (Vh+ +) 65.3:

Fairh (Fu+ +) 39.29

c (Peysbadhr; Jahdcr Lciarctabrh nh lc Dhr, Vcbgt

Dcla, Orcgfbc).


4/18

quhncg hg fagfhgtrcfbaghs sbdblcrhs c lcs quh sh hgfuhgtrcg hg hl cjuc nh dcr (Fucnra 3). Las pcfbhgths

csbjgcnas cl czcr cl jrupa nh salufbg sclbgc nh cjuc nh dcr ouhrag hvclucnas hg 6 suijrupas hg icsh c lc

ouhrzc nh cndbgbstrcfbg= (3) fearra dhnba (g 4 300), (9) fearra sucvh hg rafa(g 4 300), y (6) ugc ordulc nh

nailh lcvcna, afulcr y gcscl fag ug fearra sucvh hg rafa (g 4 300). C gbgjuga nh las bgvhstbjcnarhs sh lhs

bgoard sairh hl tbpa nh salufbaghs quh utblbzcicg.

Las pcfbhgths ouhrag aishrvcnas par ug tatcl nh 39 shdcgcs, nhsnh Hghra ecstc Cirbl nh 900?, phrana nurcgthhl fucl hl hstcna nh lc sclun, las sgtadcs y hl usa nh las dhnbfcdhgtas ouhrag hvclucnas hg > vbsbtcs nurcgth

hl trcgsfursa nhl hstunba. Lc hgohrdhncn cjunc ouh hvclucnc nurcgth lcs prbdhrcs 9 vbsbtcs (ecstc 6 shdcgcs),

y lc prhvhgfbg nurcgth lcs sbjubhgths 9 vbsbtcs (ecstc 39 shdcgcs). Lc thrfhrc vbsbtc, prajrcdcnc pcrc lc

shdcgc 5 luhja nhl bgbfba nhl hstunba, puna shr llhvcnc c fcia par thloaga.

Cl bgbfba nhl hstunba, las gbas hg hl jrupa nh lc salufbg sclbgc nh cjuc nh dcr y sus pcnrhs ouhrag bgstrubnas

cfhrfc nh su usa; hl gdhra nh iathllcs praparfbagcncs ouh rhjbstrcna hg hl pratafala; y sh lhs pbnb c las

pcfbhgths quh nhvalvbhrcg lcs iathllcs vcfcs, lcs fuclhs sh phscrag pcrc hvclucr hl fudplbdbhgta. Ga sh

ebfbhrag rhstrbffbaghs hg hl usa nh dhnbfcfbg fagfadbtcgth nurcgth lc hgohrdhncn cjunc, fag lc hxfhpfbg nh

cgtbebstcdgbfas sbstdbfas, las fuclhs sag uscnas c vhfhs pcrc rhnufbr lc bgolcdcfbg nh lcs dufascs. Hl usa clcrja plcza nh cgtbebstcdgbfas sbstdbfas pcrc atrcs bgnbfcfbaghs (h. j. clhrjbc) bgbfbcna cgths nhl fadbhgza nhl

hstunba ga ouh ug frbthrba nh hxflusbg.

Hl lcvcna gcscl fag salufbg sclbgc bsatgbfc nh cjuc nh dcr ouh cndbgbstrcna ? vhfhs cl nc nurcgth lc

hgohrdhncn cjunc y 6 vhfhs cl nc nurcgth lc ocsh nh prhvhgfbg. Pcrc hl fearra dhnba (jrupa nh salufbg

sclbgc 3) sh cndbgbstrcrag 2 dL nh salufbg sclbgc par cplbfcfbg y par oasc gcscl; pcrc las atras sprcys (jrupas

nh salufbg sclbgc 9 y 6), hl valudhg ouh nh 6 dL par cplbfcfbg y par oasc gcscl.

Lc nbstrbiufbg cl czcr nh las pcfbhgths ouh ehfec par hl dnbfa. Las pcfbhgths ouhrag csbjgcnas hg > jrupas

(sbg lcvcna a 3 nh las 6 tbpas nh lcvcna gcscl) hg icsh c su arnhg nh llhjcnc c lc flgbfc.

PCYDH^YAV H_CLXCNAV

Hg lc prbdhrc vbsbtc, sh hvclucrag las pcrdhtras nh rhohrhgfbc (shxa, hncn, nurcfbg nh lc hgohrdhncn,

hgohrdhncnhs y dhnbfcfbaghs fagfadbtcgths), y hl hstcna jhghrcl nh sclun (uscgna ug rcgja fuclbtctbva nhsnh

hxfhlhgth ecstc bgsctbsocftarba). Cl bgbfba y hg lcs vbsbtcs suishfuhgths, las pcrdhtras gcsclhs y vcrbas atras

quh rhprhshgtcg hl hstcna nhl trcfta rhspbrctarba suphrbar ouhrag hvclucnas par hl dnbfa uscgna ug rcgjafuclbtctbva prhnhobgbna (nhsnh 3, sbg sgtadcs, ecstc >, sgtadcs jrcvhs). Cljugas pcrdhtras tuvbhrag hsfclcs

nbohrhgths, lcs fuclhs hstg hsphfbobfcncs hg lcs Fucnras 9, 6, > y 8. Lc dhnbfcfbg fagfadbtcgth tcdibg ouh

rhjbstrcnc hg fcnc vbsbtc, ga par dcrfc a dalfulc sbga par jrupa (h. j. dufaltbfas). Hg tancs lcs vbsbtcs, sh lhs

prhjugt c las pcfbhgths cfhrfc nh las ncs nh hgohrdhncn y cushgtbsda hsfalcr. Nhsnh lc shjugnc vbsbtc, sh

hvclucrag c las pcfbhgths hg hl jrupa nh salufbg bsatgbfc nh cjuc nh dcr shjg su pasbfbg cfhrfc nh lc

talhrciblbncn y shgscfbaghs rhpartcncs nurcgth y nhspus nh lc cplbfcfbg, utblbzcgna ug rcgja fuclbtctbva. Las

hvhgtas cnvhrsas ouhrag rhjbstrcnas par shpcrcna, cs fada tcdibg lc susphgsbg nhl trctcdbhgta. Ga sh


5/18

hstcilhfb rhclbzcr pruhics nh lciarctarba. Lcs iathllcs vcfcs nhvuhltcs sh phscrag pcrc hvclucr hl

fudplbdbhgta nhl trctcdbhgta. Las pcfbhgths fag ug gnbfh nh fudplbdbhgta hstbdcna dhgar nhl :8% ouhrag

hxflubnas nh lc hvclucfbg. Pcrc obghs nh hvclucfbg, tanas las pcrdhtras fuclbtctbvas sh fagvbrtbhrag hg ugc

hsfclc gudrbfc.

Lc dcyarc nh las pcrdhtras (hstcna flgbfa) ouhrag hvclucnas par las dnbfas nurcgth lcs vbsbtcs

prajrcdcncs. Las pcfbhgths y/a las pcnrhs hvclucrag hl gbvhl nh sclun y las pcrdhtras rhlcfbagcnas fag lcshjurbncn y lc talhrcgfbc nh lc salufbg sclbgc.

CGLBVBV HV^CNV^BFA

Hl cglbsbs hstcnstbfa ouh llhvcna c fcia uscgna hl saotwcrh VtcrVaot Vtctbstbfc, vhrsbg :.3 (VtcrVaot Bgf, ^ulsc,

Aklceadc). Hl gbvhl nh sbjgbobfcgfbc hstcnstbfc sh obm hg 0,08 pcrc fcnc fadpcrcfbg.

Lcs hstcnstbfcs nhsfrbptbvcs sh praparfbagcg pcrc las pcrdhtras fucgtbtctbvas, fada dhnbc, nhsvbcfbg

hstgncr y dhnbcgc. Las nctas fuclbtctbvas sh prhshgtcg fada orhfuhgfbcs cisalutcs y parfhgtcmhs.

Las pcrdhtras bgnbvbnuclhs sh hvclucrag par shpcrcna hg fcnc vbsbtc. Pcrc las nctas dhnbnas hg ugc hsfclc

nh Lbkhrt, lc ebpthsbs nh gbgjugc nbohrhgfbc hg lcs dhnbcgcs hgtrh las > jrupas fadpcrcnas sh hvclu dhnbcgth

lc pruhic nh Kruskcl-Zcllbs nh vcrbcgzc icscnc hg jrcnas (farrhjbna hg ougfbg nh las lczas). Vb hstc pruhic

hvbnhgfbcic ugc nbohrhgfbc sbjgbobfctbvc hgtrh las jrupas, sh rhclbzcicg fadpcrcfbaghs dltbplhs hgtrh las

trctcdbhgtas (icscnc hg lc flcsbobfcfbg fagmugtc).

Pcrc las nctas nbfatdbfas, sh rhclbz ug cglbsbs nh rhjrhsbg lajstbfc, shjubna hg hl fcsa nh sbjgbobfcgfbc

dhnbcgth fadpcrcfbaghs nh las jrupas "trctcnas" vs. nh fagtral.Lc farrhffbg nh Iagohrragb pcrc

fadpcrcfbaghs dltbplhs ouh utblbzcnc pcrc hstas fagtrcsths.

Cnhds, sh ccnb ugc fadpcrcfbg hgtrh las pcfbhgths quh hstcicg uscgna lcvcna gcscl (trctcnas) vhrsus

fagtral (sbg trctcdbhgta), sbg nbohrhgfbcfbg nh las suijrupas trctcnas bgnbvbnucldhgth. Hg hsth fcsa sh

rhclbzcrag pruhics nh Dcgg-Zebtghy y U9.

Lcs quhmcs hspagtghcs y las hvhgtas cnvhrsas lafclhs rhpartcnas par las pcfbhgths ouhrag hgudhrcncs par

jrupas quh utblbzcg lcvcna gcscl.

Nh >03 pcfbhgths, 620 ouhrag obgcldhgth hvclucnas; 3 pcfbhgth ga hstuva nbspagbilh pcrc lc vbsbtc 6 y ouh

hxflubna nh lc hvclucfbg luhja nh lc shjugnc vbsbtc. Las 30 pcfbhgths rhstcgths a ga vbgbhrag c lc shjugnc

vbsbtc (g4>), ga fudplbhrag fag las frbthrbas nh bgjrhsa (g49), a las pcnrhs nhfbnbhrag ga fagtbgucr (g49); 3


6/18

pcfbhgth ouh cndbtbna hg hl easpbtcl, y 3 ouh hxflubna par thghr ug icma fudplbdbhgta. Lc nurcfbg pradhnba nhl

hstunba ouh nh 5? ncs. Lcs fcrcfthrstbfcs icsclhs hgtrh las jrupas ouhrag fadpcrcilhs cs fada hl gdhra

pradhnba nh ncs hgtrh lcs vbsbtcs nh las bgnbvbnuas (Fucnra 9).

OCVH NH HGOHYDHNCN CJXNC (_BVB^C 9)

Lc pugtucfbg rbgaljbfc sh us pcrc lc hvclucfbg nh lc hobfcfbc. Las sgtadcs bgnbvbnuclhs rhjbstrcnas hg hl

pratafala fada dhnbncs fuclbtctbvcs prhnhobgbncs ouhrag fagvhrtbnas c ugc hsfclc gudrbfc pcrc obghs nh

hvclucfbg (hsfclc nh pugtucfbg, 3 - >; 3, cushgfbc nh sgtadcs, c >, sgtadcs jrcvhs). Las pcrdhtras

hvclucnas bgfluyhrag lc shfrhfbg gcscl y su tbpa, lc aistruffbg gcscl, nalar nh jcrjcgtc, tas y hxphftarcfbg

bgfluyhgna lc gcturclhzc nh lc hxphftarcfbg, hstargunas, pbfczg y lc prnbnc nh las shgtbnas nhl alocta y hl

justa. C phscr nh quh lc jrcvhncn nh hstas sgtadcs ouh sbdblcr cl bgbfba nhl hstunba, sh vba ugc rhsalufbg ds

rpbnc nh cljugas nh las sgtadcs gcsclhs hg las jrupas nh salufbg bsatgbfc nh cjuc nh dcr. Lcs

pugtucfbaghs nh las sgtadcs quh nbobrbhrag sbjgbobfctbvcdhgth hgtrh las jrupas ouhrag lc shfrhfbg gcscl, hl tbpanh shfrhfbg gcscl, lc aistruffbg gcscl y hl nalar nh jcrjcgtc (Fucnra 6). Vh aituvbhrag rhsultcnas sbdblcrhs sb

sh fadpcrcicg las suijrupas bgnbvbnuclhs nh lcvcna gcscl y hl nh fagtral.

Cl fadpcrcr hl fagsuda nh pranuftas ocrdcfutbfas, sh aishrv quh hl fagsuda nh las nhsfagjhstbagcgths

gcsclhs y dufaltbfas ouh sbjgbobfctbvcdhgth dhgar hg las jrupas nh trctcdbhgta quh hg hl nh fagtral. Las atras

dhnbfcdhgtas hvclucnas ga fcdibcrag nh oardc sbjgbobfctbvc hg fcnc jrupa (Fucnra 6).

Hg lc vbsbtc 9, sh lhs pbnb c las dnbfas quh hvclucrcg hl fcdiba nhl hstcna nh sclun hg fadpcrcfbg fag lc

vbsbtc bgbfbcl. Hl rcgja fuclbtctbva utblbzcna ouh fagvhrtbna c ugc hsfclc gudrbfc pcrc prapsbtas nh hvclucfbg

(3, furcna; 9, dhmarc sbjgbobfctbvc; 6, dhmarc pcrfbcl; y >, sbg fcdibas). Hl hstcna nh sclun dhmar

sbjgbobfctbvcdhgth ds hg las jrupas quh uscrag salufbg sclbgc (Fucnra 6).

OCVH NH PYH_HGFBG (_BVB^CV 6 R >)

Pcrc lc hvclucfbg nh lc hobfcfbc nurcgth hl phrana nh prhvhgfbg, sh hlbjbhrag dhnbncs sbdblcrhs pcrc hvclucr

sb hl lcvcna gcscl rhjulcr (6 vhfhs cl nc) fag salufbg sclbgc bsatgbfc puhnh prhvhgbr lc rhcpcrbfbg nh B^YV.

Cnhds nh las pcrdhtras rbgaljbfas y lc bgjhstc nh dhnbfcdhgtas, sh rhjbstrcrag las ncs nh hgohrdhncn

rhpartcnas, ncs nh cushgtbsda hsfalcr, y hl rhparth nh fadplbfcfbaghs .

Las sgtadcs rbgaljbfas ouhrag fclbobfcnas bjucl quh pcrc lc hgohrdhncn cjunc y hvclucnas fhrfc nh 5

shdcgcs nhspus nhl bgbfba nhl hstunba. _crbas pcrdhtras, fada lc tas shfc, lc shfrhfbg gcscl, y lc

rhspbrcfbg gcscl, tuvbhrag ugc afurrhgfbc a jrcvhncn nh las sgtadcs sbjgbobfctbvcdhgth dhgar hg las jrupas

nh salufbg sclbgc bsatgbfc nh cjuc nh dcr (Fucnra > y Fucnra 8). Hl fucnra 8 rhsudh las rhsultcnas hg lc

vbsbtc obgcl (nurcgth lc shdcgc 39 nhspus nhl bgbfba nhl hstunba).


7/18

Fucnra 9. Fcrcfthrstbfcs shlhffbagcncs nh 620 pcfbhgths c

Hg fucgta c lc dhnbfcfbg utblbzcnc, hg lc vbsbtc 6, ug parfhgtcmh sbjgbobfctbvcdhgth dcyar nh pcfbhgths nh

fagtral quh nh pcfbhgths hg las jrupas nh salufbg sclbgc bsatgbfc nh cjuc nh dcr hstcic uscgna cgtbpbrtbfas,

dufaltbfas, nhsfagjhstbagcgths gcsclhs, y cgtbibtbfas sbstdbfas (Fucnra >). Las dbsdas rhsultcnas (fag lc

hxfhpfbg nh las cgtbibtbfas sbstdbfas) sh aituvbhrag hg lc vbsbtc obgcl (Fucnra 8).

Fcrcfthrstbfc

Fagtral(g 4 303)

FearraDhnba

(g 4 22)i

Fearra

Vucvh(g 4 28)i

OrdulcNucl

(g 4 28)i

^anas lasLcvcnas(g 4 952)f

Hncn, cas 5.> [3.8T 5.> [3.8T 5.3 [3.>T 5.9 [3.8T 5.9 [3.8T

Dcsfulbga 85 (8:.>) 86 (86.8) >: (>2.8) 83 (86.:) 383 (89.9)

Ohdhgbga >6 (>9.?) >? (>?.8) >5 (80.8) >> (>?.6) 365 (>:.5)

Nurcfbg nh las pugtas nhhstunba, nbcs

Vgtadcs cgths nhl bgjrhsa clhstunba.

?.6 [:.9T ?.9 [8.>T ?.5 [8.>T 8.2 [>.?T ?.6 [8.9T

Nhsnh _3 ecstc _9 30.: [6.2T 33.9 [8.6T 30.> [>.>T 30.3 [>.3T 30.8 [>.:T

Nhsnh _9 ecstc _6 6?.2 [:.>T 6?.5 [:.2T 6:.> [2.9T 6:.? [:.>T 6:.6 [5.3T

Nhsnh _6 ecstc _> 65.> [8.2T 65.> [:.6T 65.6 [:.2T 65.8 [?.:T 65.> [:.6T

_cfugcnas fagtrc lc jrbph 2 (5.2) 33 (33.3) 36 (36.:) 33 (33.?) 68 (39.3)

Clhrjbc 99 (93.5) 63 (63.6) 60 (63.?) 63 (69.?) 29 (63.5)

Xsa c lcrja plcza nh CE sbstdbfas 33 (30.2) 35 (35.9) 39 (39.?) 30 (30.8) >0 (36.5)

Pugtucfbg nh las sgtadcs

rbgaljbfas n

Jcrjcgtc brrbtcnc 3.5> [0.53T 3.:8 [0.53T 3.?5 [0.:6T 3.?9 [0.:8T 3.?2 [0.::T

as shfc 3.?0 [0.:?T 3.>9 [0.?:T 3.82 [0.::T 3.>: [0.:2T 3.>2 [0.:>T

as pranuftbvc 3.>6 [0.:>T 3.>6 [0.:6T 3.>3 [0.::T 3.63 [0.?8T 3.65 [0.:9T

Vhfrhfbg gcscl 9.:0 [0.?3T 9.58 [0.?6T 9.5> [0.?3T 9.56 [0.85T 9.5> [0.?0T

Hstargunas 3.80 [0.?:T 3.>0 [0.8:T 3.8? [0.?5T 3.8? [0.:8T 3.83 [0.?:T

Pbfczg 3.9: [0.88T 3.60 [0.8?T 3.69 [0.88T 3.95 [0.8>T 3.60 [0.88T

Prnbnc nhl alocta/justa 3.65 [0.5>T 3.69 [0.?9T 3.68 [0.?:T 3.9: [0.8>T 3.63 [0.?3T

^bpa nh shfrhfbg gcsclh 9.88 [0.?>T 9.82 [0.?9T 9.85 [0.?3T 9.8? [0.?3T 9.8: [0.?3T

Pugtucfbg nh lc rhspbrcfbg

gcsclo9.3? [0.?:T 9.9? [0.?2T 9.9> [0.:>T 9.9: [0.:5T 9.9? [0.:>T

Dhnbfcfbg uscnc

Cgtbpbrtbfas 9> (96.5) 9? (9?.6) 99 (96.9) 90 (93.3) ?5 (96.8)

Nhsfagjhstbagcgths gcsclhs >0 (62.?) 92 (92.6) 9? (9:.>) 60 (63.?) 58 (92.>)Dufaltbfas 90 (32.5) 38 (38.9) 36 (36.:) 3: (3:.2) >8 (38.?)

Cgtbibtbfas sbstdbfas 8 (8.0) ? (?.3) 3 (3.3) 9 (9.3) 2 (6.3)

Cirhvbcfbaghs= CE, cgtbebstcdgbfas; _, vbsbtcs nurcgth hl hstunba.

c. anas las nctas sag prhshgtcnas fada vclar dhnba [VNT [nhsvbcfbg hstgncrT a gdhra nh pcfbhgths

(parfhgtcmh).

i. Fadpcrcfbaghs dltbplhs nh las jrupas nh trctcdbhgtas vs. fagtral sb las rhsultcnas nhl Kruskcl-Zcllbs a

nh lc rhjrhsbg lajstbfc hrcg sbjgbobfctbvas.

f. Pruhics nh Dcgg-Zebtghy a nh U9.

n. Pugtucfbaghs nh las sgtadcs rbgaljbfas= 3, sbg sgtadcs; 9, sucvhs; 6, danhrcnas; y >, jrcvhs.

h. ^bpas nh shfrhfbg= 3, cushgth; 9 shrasc; 6, shrapurulhgtc; y >, purulhgtc.

Lcvcna Gcscl Vclbga Bsatgbfa


8/18

Fucnra 6. Pcrdhtras nh Hobfcfbc hg lc _bsbtc 9 (Ocsh Cjunc)

Las pcfbhgths quh utblbzcrag hl lcvcna fag salufbg sclbgc bsatgbfc nh cjuc nh dcr rhjbstrcrag

sbjgbobfctbvcdhgth dhgas ncs nh hgohrdhncn (hstg a ga csafbcnas fag lc cushgfbc c lc hsfuhlc), cushgtbsda

hsfalcr, y fadplbfcfbaghs (Fucnra 8). Lc dcyarc nh las hvhgtas rhjbstrcnas ouhrag atbtbs dhnbc,

ocrbgjacdbjnclbtbs, iragqubtbs y rbgasbgusbtbs.

Fcrcfthrstbfc

Fagtral(g 4 303)

FearraDhnba(g 4 22)

i

VprcyObga

(g 4 28)i

OrdulcNucl

(g 4 28)i


Pugtucfbg nh las

sgtadcs

rbgaljbfas n

Jcrjcgtc

Brrbtcnc 3.96 [0.>:T 3.05 [0.9:T 3.0: [0.9?T 3.33 [0.>6T 3.02 [0.66Th

as shfc 3.3> [0.65T 3.02 [0.68T 3.3> [0.>6T 3.39 [0.68T 3.33 [0.65T

as pranuftbvc 3.65 [0.?6T 3.93 [0.8>T 3.99 [0.>2T 3.98 [0.?9T 3.96 [0.88T

Vhfrhfbg gcscl 9.30 [0.:>T 3.:? [0.?:Th 3.5? [0.:2T 3.:> [0.?:Th 3.:2 [0.:3Th

Hstargunas 3.0? [0.9>T 3.03 [0.30T 3.0? [0.92T 3.0? [0.98T 3.0> [0.99T

Pbfczg 3.0? [0.9>T 3.03 [0.30T 3.06 [0.96T 3.0> [0.90T 3.06 [0.35T

Prnbnc nhl alocta/justa 3.02 [0.68T 3.03 [3.03T 3.00 [0.00T 3.00 [0.00T 3.00 [0.0?T

^bpa nh shfrhfbg gcscl o 9.0? [0.?2T 3.:> [0.?8Th 3.:> [0.?9Th 3.?2 [0.?8Th 3.:9 [0.?>Th

Pugtucfbg nh lc rhspbrcfbggcsclj 3.85 [0.?5T 3.9: [0.83Th 3.9: [0.8?Th 3.90 [0.80Th 3.98 [0.89Th

Dhnbfcfbg uscnc

Cgtbpbrtbfas 36 (39.2) 8 (8.3) : (:.>) 30 (30.8) 99 (:.?)

Nhsfagjhstbagcgthsgcsclhs

6? (68.?) 38 (38.9)h 36 (36.:)h 35 (35.2)h >? (38.2)h

Dufaltbfas 69 (63.:) 38 (38.9)h 3> (3>.:)h 93 (99.3) 80 (3:.6)h

Cgtbibtbfas sbstdbfas2 (5.2) : (:.3)

? (?.6)6 (6.9) 3? (8.8)

Pugtucfbg nhl

hstcna nh sclune

Bgbfba nurcgth hl

rhsorbcna9.?0 [3.09T 3.55 [0.55Th 3.26 [0.:2Th 3.50 [0.5>Th 3.5: [0.5>Th

Bgbfba nurcgth lc jrbph 9.00 [0.23T 3.?6 [0.:8T 3.85 [0.:2T 3.8: [0.?5T 3.82 [0.:>Th

c. anas las nctas sag prhshgtcnas fada pradhnba [VNT a gdhra nh pcfbhgths (parfhgtcmh).i. Fadpcrcfbaghs dltbplhs nh las jrupas nh trctcdbhgtas vs. fagtral sb las rhsultcnas nhl Kruskcl-Zcllbs a

nh lc rhjrhsbg lajstbfc hrcg sbjgbobfctbvas.



h. P < 0,08.

o. ^bpas nh shfrhfbg= 3, cushgth; 9 shrasc; 6, shrapurulhgtc; y >, purulhgtc.

j. Pugtucfbaghs nh lc rhspbrcfbg= 3, sbg gbgjugc nbobfultcn; 9, nbobfultcnhs dhgarhs; 6, nbofbl; y >, bdpasbilh.

e. Pugtucfbaghs nhl hstcna nh sclun= 3, furcna; dhmarc sbjgbobfcgth; 6, dhmarc pcrfbcl; y >, sbg fcdibas.



9/18

Fucnra >= Pcrdhtras nh Hobfcfbc hg lc _bsbtc 6 (Ocsh Prhvhgtbvc)c

H_CLXCFBG JLAICL NHL HV^CNA NH VCLXN

Cl obgcl nhl hstunba y hg lc ltbdc vbsbtc, sh lh pbnb c las pcnrhs quh hvclucrcg hl hstcna nh sclun nhl gba hg ugc

hsfclc fuclbtctbvc nh > pugtas, lc fucl ouh fagvhrtbnc c ugc hsfclc gudrbfc pcrc shr hvclucnc (3, hxfhlhgth; 9,

iuhga; 6, sctbsocftarba; y >, bgsctbsocftarba). Cl bgbfba nhl hstunba, lc pugtucfbg dhnbc ouh bngtbfc hg las jrupas

fagtral y salufbg sclbgc (pugtucfbg dhnbc, 9,>8), la quh rhprhshgt ug pradhnba nh hstcna nh iuhga c

Fecrcfthrbstbf

Fagtral(g 4 303)

FearraDhnba(g 4 22)

i

Vprcy Obga(g 4 28)i

OrdulcNucl

(g 4 2>)i


Pugtucfbg nh las sgtadcsrbgaljbfas n

Jcrjcgtc brrbtcnc 3.69 [0.?8T 3.02 [0.68Th 3.0: [0.60Th 3.06 [0.35Th 3.0: [0.92Th

as shfc 3.>0 [0.?5T 3.30 [0.6?Th 3.3: [0.80T 3.08 [0.9:Th 3.33 [0.62Th

as pranuftbvc GC GC GC GC GC

Vhfrhfbg gcscl 3.5? [0.5:T 3.9> [0.89Th 3.66 [0.?>Th 3.60 [0.?8Th 3.92 [0.?3Th

Hstargunas 3.93 [0.80T 3.0: [0.9?T 3.08 [0.99T 3.08 [0.9:T 3.0? [0.98T

Pbfczg 3.05 [0.9:T 3.00 [0.00T 3.06 [0.96T 3.09 [0.38T 3.09 [0.3?T

Prnbnc nhl alocta/justa 3.32 [0.>?T 3.09 [0.3>T 3.09 [0.3>T 3.0> [0.98T 3.06 [0.32T

^bpa nh shfrhfbg gcscl o GC GC GC GC GC


gcscl j3.?> [0.:6T 3.3? [0.>9Th 3.9> [0.85Th 3.93 [0.83Th 3.90 [0.80Th

Dhnbfcfbg

Cgtbpbrtbfas 66 (69.:) 2 (2.3)h 5 (5.>)h 30 (30.?)h 9: (2.>)hNhsfagjhgstbagcgths

gcsclhs>: (>?.8) ? (?.3)h ? (?.6)h 6 (6.9)h 38 (8.9)h

Dufaltbfas 6: (6?.?) 2 (2.3)h 2 (2.8)h 30 (30.?)h 95 (2.:)h

Cgtbibtbfas sbstdbfas 93 (90.5) > (>.0)h 8 (8.6)h : (:.>)h 3? (8.?)h

Hgohrdhncn y fadplbfcfbaghs

Hgohrdhncn rhpartcnc :? (:8.9) 9: (9:.6)h 66 (6>.:)h 92 (60.2)h 52 (60.2)h

Cishgtbsda hsfalcr

rhpartcna68 (6>.:) 3? (3?.9)h 36 (36.:)h 90 (93.6)h >2 (3:.0)h

Fadplbfcfbaghs 69 (63.:) 5 (5.3)h : (:.>)h 2 (2.?)h 9> (5.6)h


Cirhvbcfbg= GC, ga cplbfcilh

c. anas las nctas sag prhshgtcnas fada vclar dhnba [VNT a gdhra nh pcfbhgths (parfhgtcmh).

i. Fadpcrcfbaghs dltbplhs nh las jrupas nh trctcdbhgtas vs. fagtral sb las rhsultcnas nhl Kruskcl-Zcllbs

a nh lc rhjrhsbg lajstbfc hrcg sbjgbobfctbvas.



h. P < 0,08.


j. Pugtucfbaghs nh lc rhspbrcfbg= 3, sbg gbgjugc nbobfultcn; 9, nbobfultcnhs dhgarhs; 6, nbofbl; y >,

bdpasbilh.


10/18

Fucnra 8= Pcrdhtras nh Hobfcfbc hg lc _bsbtc > (Ocsh Prhvhgtbvc)c

sctbsocftarba. Hg lc vbsbtc >, luhja nh 39 shdcgcs nh hstunba, las pcnrhs nh las gbas fag salufbg sclbgc

bsatgbfc nh cjuc nh dcr fctclajcrag hl hstcna nh sclun nh sus ebmas fada sbjgbobfctbvcdhgth dhmar quh hl

dcgbohstcna par las pcnrhs nh las gbas hg hl jrupa fagtral (3,83 vs 9,3?) (Fucnra ?). Vh aituvbhrag rhsultcnas

sbdblcrhs cl fadpcrcr las suijrupas nh lcvcna gcscl bgnbvbnuclhs fag hl nh fagtral.

Fecrcfthrbstbf

Fagtral(g 4 303)

DhnbudMht

(g 4 22)i

Obgh Vprcy(g 4 28)i

NuclOardulc(g 4 2>)

i

Cll Zcse(g 4 955)f

Pugtucfbg nh las sgtadcs

rbgaljbfas n

Jcrjcgtc brrbtcnc 3.39 [0.>3T 3.0? [0.9>T 3.0> [0.98T 3.06 [0.96T 3.08 [0.9>T

^as shfc 3.0> [0.9>T 3.09 [0.3>T 3.0> [0.90T 3.06 [0.96T 3.06 [0.32T

^as pranuftbvc 3.36 [0.>?T 3.09 [0.90T 3.06 [0.96T 3.09 [0.38T 3.09 [0.32T

Vhfrhfbg gcscl 3.88 [0.:5T 3.90 [0.88Th 3.9> [0.80T 3.96 [0.80T 3.96 [0.89Th

Hstargunas 3.30 [0.60T 3.0> [0.90T 3.08 [0.99T 3.30 [0.6?T 3.0? [0.9:T

Pbfczg 3.33 [0.63T 3.0> [0.9>T 3.08 [0.9:T 3.0> [0.98T 3.08 [0.98T

Prnbnc nhl alocta/justa 3.33 [0.6:T 3.00 [0.30T 3.09 [0.3>T 3.03 [0.30T 3.03 [0.30T

^bpa nh shfrhfbg gcscl o 3.86 [0.53T 3.3? [0.83Th 3.96 [0.89T 3.96 [0.8>T 3.93 [0.89Th


gcsclj

3.62 [0.?0T 3.30 [0.6?Th 3.39 [0.69T 3.3: [0.>6T 3.36 [0.6:Th

Dhnbfcfbg

Cgtbpbrtbfas 90 (32.5) 5 (5.3)h 8 (8.6)h ? (?.>)h 32 (?.?)h

Nhsfagjhgstbagcgths

gcsclhs

>6 (>9.?) > (>.0)h : (:.>)h 0 (0.0)h 33 (6.5)h

Dufaltbfas 9> (96.5) > (>.0)h > (>.9)h ? (?.>)h 3> (>.2)h

Cgtbibtbfas sbstdbfas 2 (5.2) ? (?.3) 6 (6.9) 6 (6.9) 39 (>.9)

Hgohrdhncn y fadplbfcfbaghs

Hgohrdhncn rhpartcnc 86 (89.8) 99 (99.9)h 93 (99.3)h 93 (99.6)h ?> (99.9)h

Cishgtbsda hsfalcr

rhpartcna

98 (9>.5) : (:.3)h 5 (5.>)h 30 (30.?)h 98 (5.:)h

Fadplbfcfbaghs3> (36.2) ? (?.3) 6 (6.9)h 6 (6.9)h 39 (>.9)h


Cirhvbcfbg= GC, ga cplbfcilhc. anas las nctas sag prhshgtcnas fada vclar dhnba [VNT a gdhra nh pcfbhgths (parfhgtcmh).

i. Fadpcrcfbaghs dltbplhs nh las jrupas nh trctcdbhgtas vs. fagtral sb las rhsultcnas nhl Kruskcl-Zcllbs

a nh lc rhjrhsbg lajstbfc hrcg sbjgbobfctbvas.



h. P < 0,08.


j. Pugtucfbaghs nh lc rhspbrcfbg= 3, sbg gbgjugc nbobfultcn; 9, nbobfultcnhs dhgarhs; 6, nbofbl; y >,

bdpasbilh.


11/18

Fucnra ?. Fcdiba hg hl Hstcna nh Vclun Yhpartcna par las Pcnrhs cl Obgcl nhl Hstunba c


VHJXYBNCN R ÂLHYCGFBC

Pcrc hvclucr lc shjurbncn y talhrcgfbc, sh hvclucrag salcdhgth las suijrupas nh salufbg sclbgc bsatgbfc nh

cjuc nh dcr. Hdphzcgna nhsnh lc vbsbtc 9, sh lh prhjugt c las gbas cfhrfc nh sus shgscfbaghs nurcgth ycpraxbdcncdhgth 8 dbgutas nhspus nh lc cplbfcfbg nhl lcvcna gcscl. Lc hvclucfbg fuclbtctbvc ouh fagvhrtbnc

c ugc hsfclc gudrbfc nh 8 pugtas pcrc ugc hvclucfbg cnbfbagcl (3, duy cjrcncilh; 9, cjrcncilh; 6, sbg

quhmcs; >, bgfdanc; y 8, duy bgfdanc). Las gbas quh uscrag ug sprcy nh fearra sucvh hg rafa (jrupas 9 y

6) rhpartcrag ugc dcyar fadanbncn nurcgth y nhspus nh lc cplbfcfbg quh las usucrbas nhl fearra dhnba

(jrupa 3) (Objurc 3 y Objurc 9). Pcrc lc vbsbtc >, las rhsultcnas ecicg dhmarcna, phra shjucg sbhgna pharhs hg

hl jrupa 3 (fearra dhnba) quh hg las atras jrupas. Vbg hdicrja, hstc nbohrhgfbc ga ouh hstcnstbfcdhgth

sbjgbobfctbvc.

âncs lcs quhmcs nh las pcfbhgths ouhrag rhjbstrcncs hg hl pratafala nurcgth hl trcgsfursa nhl hstunba. Hg

jhghrcl, hl lcvcna gcscl fag salufbg sclbgc bsatgbfc nh cjuc nh dcr ouh ibhg talhrcna; lc dcyarc nh lcs

quhmcs cpcrhfb hg hl jrupa nhl fearra dhnba y sh csafbcrag fag hl oluma nh lcvcna ds ouhrth. Hl gdhra nh

quhmcs ouh nhdcsbcna icma pcrc su cglbsbs hstcnstbfa. Hg lc shjugnc vbsbtc, sla 98 pcfbhgths rhjbstrcrag

quhmcs par hl lcvcna gcscl (5,:%), y hg lc vbsbtc obgcl, hsth gdhra ecic nhsfhgnbna c : (9,>%). Lcs atrcs

dalhstbcs rhpartcncs ouhrag crnar y sciar cdcrja. ^rhs pcfbhgths nh 955 hxphrbdhgtcrag ehdarrcjbc gcscl.

_bsbtc Fagtral Fearra Dhnbai Fearra Vucvhi Ordulc Nucliânas lasLcvcnasf

3 9.>8 [0.8T 9.>5 [0.85T 9.>9 [0.8?T 9.>6[0.85T 9.>8 [0.8:T

> 9.3? [0.?>T 3.>6 [0.89Tn 3.8> [0.?:Tn 3.88 [0.85Tn 3.83 [0.82Tn

c. anas las nctas sag prhshgtcnas fada pradhnba [VNT. Pugtucfbaghs nhl hstcna

nh sclun= 3, furcna; 9, dhmarc sbjgbobfctbvc; 6, dhmarc pcrfbcl; y >, sbg fcdibas.

i. Fadpcrcfbaghs dltbplhs nh las jrupas nh trctcdbhgtas vs. fagtral sb las

rhsultcnas nhl Kruskcl-Zcllbs a nh lc rhjrhsbg lajstbfc hrcg sbjgbobfctbvas.f. Pruhics nh Dcgg-Zebtghy a nh U9.

n. P < 0,08.


12/18

6,9

6,3

6,0

9,2

9,5

9,:

9,?

9,8

9,>

Las rhsultcnas nhl hstunba duhstrcg quh hl lcvcna gcscl fag salufbg sclbgc bsatgbfc nh cjuc nh dcr dhmar

sbjgbobfctbvcdhgth las sgtadcs gcsclhs nhl rhsorbcna fadg hg gbas y nhduhstrc su pathgfbcl pcrc prhvhgbr lc

rhfurrhgfbc nh B^YV. Las rhsultcnas ouhrag slbnas, fagsbsthgths y hstcnstbfcdhgth sbjgbobfctbvas hg fagtrcsth

fag las pafas crtfulas puilbfcnas quh ga duhstrcg flcrcdhgth las ihghobfbas nhl lcvcna gcscl cl trctcr hl

rhsorbcna fadg.6Cljugcs lbthrcturcs nhsfrbihg hl pathgfbcl prhvhgtbva nh lc salufbg sclbgc.33

3 9 6

Pugtucfbaghs

Jrupa

_bsbtc 9 _bsbtc >

Objurc 3. Vhgscfbaghs nurcgth lc cplbfcfbg. Las pcfbhgths fclbobfcrag

sus shgscfbaghs nurcgth lc cplbfcfbg nhl lcvcna gcscl sclbga bsatgbfanh cjuc nh dcr uscgna ugc hsfclc fuclbtctbvc trcgsoardcnc hg ugc

fucgtbtctbvc pcrc su hvclucfbg (3, duy cjrcncilh; 9, cjrcncilh; 6, sbg

quhmcs; >, nhscjrcncilh; y 8, duy nhscjrcncilh).


13/18

Hg icsh c las ecllczjas bg vbtra, lc salufbg sclbgc bsatgbfc nh cjuc nh dcr tbhgh ugc cftbvbncn cgtb-bgolcdctarbc,

yc quh rhnufh lc pranuffbg y lbihrcfbg nh bgthrlhuqubgc 5 par hl hpbthlba rhspbrctarba.36Hgtrh atras dhfcgbsdas

nh cffbg, supagh ug hgtarga ocvarcilh pcrc hl davbdbhgta fblbcr, hsphfbcldhgth hg salufbaghs clfclbgcs.3> Vbghdicrja, atrc puilbfcfbg rhpart ugc nbsdbgufbg nh lc cftbvbncn fblbcr hg salufbg bsatgbfc sclbgc cl 0,2%. 38

Hstas gudhrasas rhsultcnas fagtrcnbftarbas sujbhrhg quh hl dhfcgbsda nh cffbg hxcfta cg sh nhsfagafh.

Ga hst flcra sb hl hohfta hs prhnadbgcgthdhgth dhfgbfa, icscna hg lc rhdafbg nhl dafa, a sb lcs sclhs y las

albjahlhdhgtas hg lcs salufbaghs nh cjuc nh dcr nhshdphcg ug pcphl bdpartcgth. Par atrc pcrth lc shrbh nh

pranuftas fadhrfbcldhgth nbspagbilhs nbobhrhg hg lc tagbfbncn, nblufbg, nbspasbtbva nh cplbfcfbg, y atras

csphftas. Hg guhstra hstunba, ehdas utblbzcna ug pranufta sbg nblubr pcrc hl fucl su bsatagbfbncn sh lajr

_bsbtc 9 _bsbtc >

9,2

9,5

9,:

9,?

9,8

9,>

9,6

9,9

Pugtucfbaghs

3 9 6

Jrupa

Objurc 9. Vhgscfbaghs luhja nh lc cplbfcfbg. Las pcfbhgths fclbobfcrag sus

shgscfbaghs 8 dbgutas nhspus nh lc cplbfcfbg nhl lcvcna sclbga bsatgbfa

uscgna ugc hsfclc fuclbtctbvc trcgsoardcnc c ug bgthrvcla fuclbtctbva pcrc

su hvclucfbg (3, duy cjrcncilh; 9, cjrcncilh; 6, sbg quhmcs; >,

nhscjrcncilh; y 8, duy nhscjrcncilh).


14/18

dhnbcgth hl usa nh hlhftranblbsbs. Hsth prafhsa nh ocirbfcfbg fagshrvc lcs fagfhgtrcfbaghs nh baghs y

albjahlhdhgtas c gbvhlhs fadpcrcilhs fag las nh cjuc nh dcr.

Nhsnh quh sh hvclu hl pathgfbcl nhl cjuc nh dcr fada ug trctcdbhgta facnyuvcgth y sh hvclu hg lc

prhvhgfbg, sh uscrag hgscyas flgbfas cibhrtas y lc aishrvcfbg pcrc fadpcrcr hl lcvcna gcscl fag hl

trctcdbhgta hstgncr. Las dnbfas hstuvbhrag fagsfbhgths nh fuclhs pcfbhgths uscrag lcvcna gcscl y su

csbjgcfbg c las jrupas pcrtbfulcrhs. Vbg hdicrja, ga sh lh bgoard c las dnbfas cfhrfc nh lc fadpasbfbg y hlnbspasbtbva uscna hg hstas jrupas; lcs iathllcs nhl lcvcna gcscl ga hstcicg htbquhtcncs.

Hsth csphfta cdplbcdhgth cibhrta hs ugc nhiblbncn nhl prhshgth hstunba. Vbg hdicrja, hl jrcg gdhra nh

pcrtbfbpcgths, hl nbsha dultbfgtrbfa, y lc fagsbsthgfbc nh rhsultcnas hgtrh las pcrcdhtras bgnbvbnuclhs

(hvclucnas par hl dnbfa, hl pcfbhgth y hl pcnrh) icmcg hl rbhsja nh quh ecyc pcrfbclbncn. Xgc fadpcrcfbg c

fbhjcs nh vcrbcs prhshgtcfbaghs (h. j. salufbg sclbgc obsbaljbfc cl 0,2 % y salufbg nh cjuc nh dcr sbg nblubr)

puhnh shr ug thdc pcrc ugc bg outurc bgvhstbjcfbg.

Atra bgfagvhgbhgth nhl prhshgth hstunba hs hl hslcig ocltcgth hgtrh lc sbjgbobfcfbg flgbfc y hstcnstbfc hg lc

fclbobfcfbg nh las sgtadcs. Vh us ugc hsfclc nh rhsultcnas cuta-nbshcnc sbg rhclbzcr gbgjg cglbsbs

cnbfbagcl pcrc hstcilhfhr ugc nbohrhgfbc flgbfc dgbdc sbjgbobfctbvc. Hsta rhprhshgtc ugc lbdbtcfbg

hsphfbcldhgth hg hl cglbsbs nh lc ocsh nh lc hgohrdhncn cjunc, nagnh lcs nbohrhgfbcs sag icstcgth phquhcs.

Vbg hdicrja, nurcgth lcs ocshs nh prhvhgfbg, ugc bgfbnhgfbc rhnufbnc nh atrcs dhnbncs rhlhvcgths (h. j. hl

tbhdpa nh hgohrdhncn rhjbstrcna, hl cushgtbsda hsfalcr, y hl usa nh dhnbfcfbg) cpayc lc vclbnhz nh las

ihghobfbas flgbfas nhl lcvcna gcscl. Cg lc nbohrhgfbc nh 0,25 hg lc fclbobfcfbg nh lc shfrhfbg gcscl y 0,2: hg

lc fclbobfcfbg nh lc rhspbrcfbg gcscl pcrhfh shr flbgbfcdhgth rhlhvcgth (c mubfba nh las dnbfas quh pcrtbfbpcrag

hg hl hstunba).

C las gbas sh lhs pbnb uscr hl lcvcna gcscl nh oardc orhfuhgth nurcgth lc hgohrdhncn cjunc. Ga sh ayhrag

quhmcs sustcgfbclhs cfhrfc nhl fudplbdbhgta, y pcrhfh fagobrdcna nh dcghrc duy sctbsocftarbc par hl phsa nh

lcs iathllcs vcfcs nhvuhltcs. Vh hxfluy salcdhgth 3 pcfbhgth par icma fudplbdbhgta.

HGOHYDHNCN CJXNC

Nurcgth lc hgohrdhncn cjunc, las gbas quh uscrag lc salufbg sclbgc bsatgbfc nh cjuc nh dcr hvbnhgfbcrag

ugc rhsalufbg dcs rpbnc nh lc shfrhfbg gcscl y lc aistruffbg, cs fada ugc rhnuffbg hg lc fcgtbncn nh

dhnbfcfbg uscnc; lc nbohrhgfbc hg hl usa nh dhnbfcfbg ouh sbjgbobfctbvc pcrc las nhsfagjhstbagcgths gcsclhs

(P < 0,003) y las dufaltbfas (P40,009). Hl usa rhnufbna nh nhsfagjhstbagcgths tpbfas hs bdpartcgth yc quh

hllas sag salcdhgth cprapbcnas pcrc shr uscnas c farta plcza. Hl usa c lcrja plcza nh las nhsfagjhstbagcgths

tpbfas, quh afurrh fadugdhgth, hsphfbcldhgth hg gbas, puhnh llhvcr c fadplbfcfbaghs, bgfluyhgna

rbgasbgusbtbs y fcdibas ebstaljbfas hg lc dufasc. Hstcs fadplbfcfbaghs ouhrag rhpartcncs hg cgbdclhs nh

hxphrbdhgtcfbg luhja nh ugc cplbfcfbg c lcrja plcza nh ohgblhorbgc y axbdhtczalbgc.3?Cnhds, hl flarura nh

ihgzclfagba, hl fucl hs uscna c dhguna fada ug prhshrvctbva hg las nhsfagjhgtbagcgths gcsclhs a

fartbfasthrabnhs gcsclhs, dastr hvhgtas cnvhrsas c lcrja plcza hg lc dufasc gcscl fucgna hs uscna hg

fadibgcfbg fag ugc sustcgfbc vcsacftbvc.3:


15/18

Cnhds nh ugc rpbnc rhsalufbg nh las sgtadcs, hl jrupa nh lcvcna fag salufbg sclbgc bsatgbfc nh cjuc nh

dcr hg hl prhshgth hstunba prhshgt ugc dhmarc sbjgbobfctbvc hg hl hstcna jhghrcl nh sclun ,suphrbar c la

hvbnhgfbcna hg hl jrupa fagtral, shjg la hvclucna par las dnbfas (P40,09).

Guhstras rhsultcnas ouhrag nbohrhgths c las puilbfcnas par Cncd ht cl.30 hg 3225, qubhghs ga hgfagtrcrag

nbohrhgfbcs hgtrh las cnultas trctcnas par rhsorbcna fadg y rbgasbgusbtbs fag lcvcna gcscl bsatgbfa a ebphrtgbfa

fadpcrcnas fag ug jrupa nh aishrvcfbg. Las rhsultcnas nbohrhgths panrcg shr hxplbfcnas par lc nbohrhgthpailcfbg nh hstunba (gbas vs. cnultas) y hl tcdca nh lc duhstrc (620 vs. 332). Hg lc nbsfusbg, las cutarhs

cndbtbhrag quh tcdca phquha nh lc duhstrc puna ecihr cohftcna las rhsultcnas. Guhstra hstunba ouh

fagnufbna nurcgth ug phrana nh tbhdpa dcs farta (nhsnh hghra ecstc cirbl nh 900?), fag ug phrana lbdbtcna

nh rhflutcdbhgta nh 5 shdcgcs pcrc cshjurcr ugc sbtucfbg hpbnhdbaljbfc fadpcrcilh. Hg hl hstunba rhclbzcna

par Cncd ht cl.30sh us ugc salufbg prhpcrcnc cdartbjucnc nh scl y ibfcriagcta nh sanba hg fadpcrcfbg fag

lc salufbg sclbgc bsatgbfc ga nblunc nh cjuc nh dcr utblbzcnc hg guhstra hstunba. Hsta plcgthc guhvcdhgth lc

prhjugtc cfhrfc nhl hohfta nh las albjahlhdhgtas nhl cjuc nh dcr hg lc hobfcfbc nh nbfec salufbg.

PYH_HGFBG NH BGOHFFBAGHV

YHVPBYC^AYBCV VXPHYBAYHV

Hg lcs vbsbtcs thrfhrc y fucrtc, las gbas quh hstcicg uscgna rhjulcrdhgth (6 vhfhs cl nc) hl lcvcna nh salufbg

sclbgc bsatgbfc nh cjuc nh dcr nhdastrcrag dhgas sgtadcs rbgaljbfas. Las sgtadcs rhjbstrcnas hrcg

fagsbsthgths fag lc dhnbfcfbg fagsudbnc; ug parfhgtcmh ds clta nh gbas nhl jrupa nh fagtral uscicg

cgtbpbrtbfas, dufaltbfas, nhsfagjhstbagcgths gcsclhs, y cgtbibtbfas sbstdbfas. Las cgtbibtbfas sh utblbzcg fag

orhfuhgfbc hg las gbas, y lcs fhpcs rhsbsthgths nh icfthrbcs rhsultcgths rhprhshgtcg ugc cdhgczc hg tanc

Hurapc.35 Hl lcvcna gcscl sclbga pcrhfh shr ug dhnba pcrc lajrcr ug dhgar fagsuda nh cgtbibtbfas c lc vhz

quh rhnufh lcs B^YV y sus fadplbfcfbaghs. Par atrc pcrth, las nhds pcrdhtras hvclucnas tcdibg cpaycg las

ecllczjas nh prhvhgfbg= lc rhnuffbg nh hgohrdhncnhs rhjbstrcncs hg lc vbsbtc 6 (sbg trctcdbhgta, hl :8% vs. las

trctcnas, hl 63%) y hg lc vbsbtc > (sbg trctcr, 89% vs. las trctcnas, hl 99%) hg fadpcrcfbg fag las fagtralhs; ug

83 % nh dhmarc nhl cushgtbsda hsfalcr hg lc thrfhrc vbsbtc (3:% vs 68%) y ugc rhnuffbg nhl ?>% hg lc vbsbtc

obgcl (2% vs 98%), cugquh cdias jrupas thgcg sbdblcrhs cushgfbcs nh lc hsfuhlc nurcgth hl phrana nh

hgohrdhncn cjunc (89% vs 80%). Lcs dbsdcs thgnhgfbcs sh aishrvcrag pcrc lcs tcscs nh fadplbfcfbg. ^anas

hstas rhsultcnas hstg cvclcnas par lc dcyar sctbsocffbg nh las pcnrhs fag hl trctcdbhgta.

Xg crtfula nh ^cga y ^cga33 bgoard sairh hl pathgfbcl nh prhvhgfbg nh lcvcna gcscl sclbga hg cnultas

mvhghs. Las pcfbhgths ouhrag nbvbnbnas nh dcghrc clhctarbc hg 9 jrupas pcrclhlas. Fcnc jrupa quh rhjbstrcic

sus sgtadcs rhclbz lcvcnas fag sprcy nh suhra obsbaljbfa cl 0,2 % a ga rhclbz brrbjcfbg gcscl. Nhspus nh

lcs prbdhrcs 30 shdcgcs, cdias jrupas fcdibcrag nh rhjdhghs y fagtbgucrag nurcgth atrcs 30 shdcgcs. Hl

hstunba hgfagtr ugc rhnuffbg sbjgbobfctbvc nhl gdhra nh ncs hg quh afurrbhrag las sgtadcs gcsclhs

(shfrhfbg y/u aistruffbg nh lc gcrbz) y ugc rhnuffbg nh las hpbsanbas nh B^YV nurcgth hl phrana nh lcvcna

gcscl. Cugquh ^cga y ^cga hstunbcrag cnultas y hvclucrag pcrdhtras ga bngtbfas c las guhstras, cdias

hgscyas nhdastrcrag lc hobfcfbc pcrc prhvhgbr las sgtadcs nh lc rbgbtbs.


16/18

VXIJYXPAV NH LC_CNA GCVCL

Ga ehdas hgfagtrcna nbohrhgfbcs sbjgbobfctbvcs slbncs nurcgth lc hgohrdhncn cjunc a hg lc ocsh nh prhvhgfbghgtrh las nbstbgtas suijrupas nh lcvcna gcscl, cugquh las jrupas nbohrcg hg lcs ouhrzcs nh lcvcna (fearra

dhnba y sucvh) y lc fadpasbfbg bgbfc nh lc salufbg sclbgc. Hg hsth jrupa nh hncn, ga ehdas hgfagtrcna

rhsultcnas quh cpayhg lc ebpthsbs nh quh ug oluma ds ouhrth shrc ds hobfcz quh ug fearra sucvh hg rafa.

Par atrc pcrth, ugc rhnuffbg hg lc fagfhgtrcfbg nh baghs nh sanba y dcyar fagthgbna nh patcsba ga ouh dhgas

hohftbva. Hstas rhsultcnas ga cpaycg fadplhtcdhgth lcs ebpthsbs sairh lc bdpartcgfbc nh flarura nh sanba fag

rhsphfta c lc hobfcfbc nh lcvcna gcscl.

Hg fagflusbg, hl prhshgth hgscya ec nhdastrcna lc hobfcfbc nh lcvcna gcscl nh salufbg sclbgc bsatgbfc

prafhscnc c icsh nh cjuc nh dcr nhl Afcga Ctlgtbfa hg lc rhsalufbg ds rpbnc nh las sgtadcs, lc

rhnuffbg nhl trctcdbhgta dnbfa, y ug hstcna nh sclun dhmarcna hg hl rhsorbcna fadg y lc jrbph tbpa bgoluhgzc.Nurcgth lcs shdcgcs sbjubhgths c lc hgohrdhncn cjunc, fucgna sh hvclu hl pathgfbcl nh prhvhgfbg, hl lcvcna

rhjulcr fag salufbg gcscl sclbgc bsatgbfc nh cjuc nh dcr nhdastr rhnufbr las hpbsanbas nh BY^V hg

fadpcrcfbg fag hl jrupa fagtral (sla aishrvcfbg). Las rhsultcnas quh hvbnhgfbcg lc rhnuffbg nh BY^V

ouhrag slbnas y fagsbsthgths hg ugc shrbh nh pcrdhtras, bgfluyhgna sgtadcs rbgaljbfas, fagsuda nh

dhnbfcdhgtas, hgohrdhncn rhpartcnc, cushgtbsda hsfalcr y lc tcsc nh fadplbfcfbaghs. Las gbas dastrcrag

ugc dcyar cfhptcfbg par hl lcvcna gcscl fag fearra sucvh hg oardc nh rafa (sprcy obga).

Hgvbcna pcrc su Puilbfcfbg=hl > nh ohirhra, 900:; rhvbsbg obgcl rhfbibnc hl ? nh shptbhdirh, 900:; cfhptcna

hl 3? nh shptbhdirh, 900:.

Farrhspagnhgfbc= Mcgc Vkaup, DN, Pan Vdukyrkau 9, 380 00 Prcjc 8, Yhpilbfc Fehfc

([email protected]).

Fagtrbiufbaghs nh las Cutarhs= Las Nrhs. !lcpck y Vkaup tuvbhrag cffhsa tatcl c tanas las nctas hg hl

hstunba y tadcg rhspagsciblbncn par lc bgthjrbncn nh las nctas y lc prhfbsbg nhl cglbsbs nh las dbsdas.

Fagfhpta y nbsha nhl hstunba= !lcpck, Vkaup, Vtrgcn, y Eargk. Cnqubsbfbg nh nctas=!lcpck, Vtrgcn, y

Eargk. Cglbsbs h bgthrprhtcfbg nh las nctas=!lcpck, Vkaup, Vtrgcn, y Eargk. Iasquhma nhl dcgusfrbta=

!lcpck, Vkaup, y Eargk. Yhvbsbg frtbfc nhl dcgusfrbta par hl fagthgbna bgthlhftucl bdpartcgth= !lcpck,

Vkaup, Vtrgcn, y Eargk. Cglbsbs hstcnstbfa= Vkaup y Vtrgcn. Obgcgfbcdbhgta aithgbna= !lcpck, Vkaup,Vtrgcn, y Eargk. Cpaya cndbgbstrctbva tfgbfa y dcthrbcl=!lcpck, Vkaup, Vtrgcn, y Eargk. Vuphrvbsbg nhl

hstunba=!lcpck, Vtrgcn, y Eargk.

Nbvuljcfbg Obgcgfbhrc= Hl Nr. !lcpck ec rhfbibna eagarcrbas nh arcnar nh JlcxaVdbteKlbgh y Vhrvbhr. Lc Nrc.

Vkaup ec rhfbibna eagarcrbas nh arcnar nh Yafeh, ]hgtbvc, Pobzhr, y JlcxaVdbteKlbgh; hllc hst trcicmcgna

cftucldhgth hg vcrbas prayhftas obgcgfbcnas par Pobzhr, JlcxaVdbteKlbgh, ]hgtbvc, Vfehrbgj CJ, Vcgaob-Cvhgtbs,

y Jhnhag-Ybfethr y trcicmcr hg ug outura fhrfcga hg prayhftas pcrc Hlb Lblly y Csthllcs. Hl Nr. Vtrgcn ec rhfbibna


17/18

eagarcrbas nh arcnar nh Dhrfk & Fa Bgf. Hl Nr. Eargk ec rhfbibna eagarcrbas nh arcnar nh Vfehrbgj-Plauje y

ec sbna a hs cftucldhgth ug bgvhstbjcnar hg las hstunbas flgbfas pctrafbgcnas par Pbhrh Ocirh y Crtu.

Obgcgfbcdbhgta/cpaya= Hsth hstunba ouh obgcgfbcna par Jhdcr Lciarctabrhs Lc Dcnhlhbgh, Cvhguh nu

Jhghrcl Pctrag, 68>00 Vcbgt-Dcla, Orcgfbc.

Pcphl nhl Pctrafbgcgth=Hl pctrafbgcgth pcrtbfbp hg hl nbsha nhl hstunba y fagtrbiuy dhnbcgth hl sudbgbstra

nhl pranufta pcrc hl lcvcna gcscl. Hl pctrafbgcgth ga nbrbjb, dcghm, a cgclbz las nctas y ga hstuva bgvalufrcna

hg lc bgthrprhtcfbg nh las rhsultcnas a hg lc prhpcrcfbg nhl dcgusfrbta.

Prhshgtcfbg Cgthrbar= Hsth crtfula ouh prhshgtcna cgth lc Yhugbg Cgucl nh Lc Vafbhncn Cdhrbfcgc nh

Atarrbgalcrbgjalajc Phnbtrbfc; hl 95 nh cirbl nh 900:, hg Vcg Nbhja, Fclboargbc.

Fagtrbiufbaghs Cnbfbagclhs= Peblbpph Fagthgfbg, DN, praparfbag nh ugc rhvbsbg frtbfc nh ug iarrcnar

cgthrbar c hsth crtfula.

3. Zcln HY, Juhrrc G, Iyhrs F. Xpphr rhspbrctary trcft bgohftbags bg yaugj feblnrhg= nurctbag ao cgn

orhquhgfy ao fadplbfctbags. Phnbctrbfs. 3223;5:(9)= 392-366.

9. _cgFcuwhgihrjhP, ZcthlhtMI. Hpbnhdbalajy ao feragbf rebgasbgusbtbs. ^earcx. 9000;88(suppl 9)=V90-V93.

6. Pcpsbg I, Df cvbse C. Vclbgh gcscl brrbjctbag= bts ralh cs cg cnmugft trhctdhgt. Fcg Ocd Peysbfbcg.

9006;>2=3?5-3:6.

>. OakkhgsZ, Lugn_, IcfehrtF, ht cl. HCCFB pasbtbag pcphr ag rebgasbgusbtbs cgn gcscl palyps. Cllhrjy.

9008;?0(8)=856-?03.

8. vcg Fcuwhgihrjh P, Icfehrt F, Pcssclcfquc J, ht cl. Fagshgsus stcthdhgt ag teh trhctdhgt ao cllhrjbf

rebgbtbs.Cllhrjy. 9000;88(9)=33?-36>.

?. Veashyav N, Ibib E, Vecb P, Veashyav G, Veczihrj J, Eurvbtz E. rhctdhgt wbte eyphrtagbf sclbgh vhrsus

gardcl sclbgh gcscl wcse ao phnbctrbf feragbf sbgusbtbs. M Cllhrjy Flbg Bddugal. 3225;303(8)=?09-?08.

:. Ehctlhy NJ, DfFagghll KH, Kbllh ^L, Lhvhrsag JH. Gcscl brrbjctbag oar teh cllhvbctbag ao sbgagcscl

sydptads. Atalcrygjal Ehcn Ghfk Vurj. 9003;398(3)=>>->5.

5. Jcrcvhlla Z, Yadcjgalb D, Varna L, Jcbgb YD, Nb Ihrcrnbga F, Cgjrbscga C. Eyphrsclbgh gcscl brrbjctbag

bg feblnrhg wbte sydptadctbf shcsagcl cllhrjbf rebgbtbs= c rcgnadbzhn stuny. Phnbctr Cllhrjy Bddugal.

9006;3>(9)=3>0-3>6.

2. Irawg FL, Jrcecd VD. Gcscl brrbjctbags= jaan ar icn1 Furr Apbg Atalcrygjal Ehcn Ghfk Vurj. 900>;39

(3)=2-36.


18/18

30. Cncd P, Vtboodcg D, Ilckh YL. C flbgbfcl trbcl ao eyphrtagbf sclbgh gcscl sprcy bg suimhfts wbte teh faddag

faln ar rebgasbgusbtbs.Crfe Ocd Dhn. 3225;:(3)= 62->6.

33. cga L, cga K. C ncbly gcscl sprcy wbte sclbgh prhvhgts sydptads ao rebgbtbs.Cftc Atalcrygjal. 900>;39>

(2)=3082-30?9.

39. Gcse NY, Ecrdcg M, Zcln HY, Khllhehr KM. Cgtbibatbf prhsfrbibgj iy prbdcry fcrh peysbfbcgs oar feblnrhg

wbte upphr rhspbrctary trcft bgohftbags.Crfe Phnbctr Cnalhsf Dhn. 9009;38?(33)=333>-3332.

36. cicry A, Dushlht F, Rvbg MF, Ecllhy-_cgeavh I, Pufehllh H, Mcfquat M. Peysb- adhr rhnufhs teh

fehdakbgh bgthrlhukbg-5 pranuftbag iy cftbvcthn eudcg rhspbrctary hpbtehlbcl fhlls. Hur Yhspbr M. 9003;35

(>)=??3-???.

3>. cliat CY, Ehrr ^D, Pcrsags NV. Dufafblbcry flhcrcgfh cgn iuoohrhn eyphrtagbf sclbgh salutbag.

Lcrygjasfaph. 322:;30:(>)=800-806.

38. Iahk ZD, Khlhs G, Jrccdcgs K, Eubzbgj HE. Peysbalajbf cgn eyphrtagbf sclbgh salutbag bdpcbr fblbcry

cftbvbty bg vbtra. Lcrygjasfaph. 3222;302(6)= 62?-622.

3?. Dbg RJ, Kbd EV, Vue VE, Mhag VR, Vag RB, Raag V. Pcrcgcscl sbgusbtbs cothr lagj-thrd ush ao tapbfcl

gcscl nhfagjhstcgts.Cftc Atalcrygjal. 322?;33?(6)= >?8->:3.

3:. Ecllg E, Jrco P. Ihgzclkagbud felarbnh bg gcscl nhfagjhstbvh sprcys ecs c lagjlcstbgj cnvhrsh hoohft ag

teh gcscl dufasc ao ehcltey valugthhrs. Flbg Hxp Cllhrjy. 3228;98(8)=>03->08.

35. Cjhgfh Orcgcbsh nh Vfurbt Vcgbtcbrh nhs Pranubts nh Vcgt. Vysthdbf cgtbibatbf trhctdhgt bg upphr cgn

lawhr rhspbrctary trcft bgohftbags= aoobfbcl Orhgfe jubnhlbghs. Flbg Dbfraibal Bgohft. 9006;2(39)=33?9-33:5.

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