ZOAOZM^

^O^MK_T

GIol6

Husuem Clmismki T. =<0030:000===22

Hgvmi EmImr =<0030:000==:=4
Kih Mlemn Zmslnmk =<0030:000==::?
Msy Tyiam Hmriem =<0030:000===11
Kur Kmnim Jt MjnuI LmIie =<0030:000===1>

Poejiejikc 6 nr. Hgorkim Husuem Smrnlmkm, TpJ^HQ

IMJGZM^GZB_E/TEA BIE_ JONML

ZT_N NZ. TMBA_I MKSMZ
EMIMKC
AMH_I^MT HONGH^OZMK _KBQOZTB^MT
JZMSBFMRM EMIMKC
:0:0

 
 ^O^MK_T
GIol6
Husuem Clmismki T =<0030:000===22
Hgvmi EmImr =<0030:000==:=4
Kih Mlemn Zmslnmk =<0030:000==::?
Msy Tyiam Hmriem =<0030:000===11
Kur Kmnim Jt MjnuI LmIie =<0030:000===1>

Nisotujui uktuh nijmdmhmk

pmnm6 Lmri 6 Fuemt

^mkccmI 6 :: Eoi :0:0

Eokcotmlui,

Poejiejikc PPNT Poejiejikc

nr. Hgorkim Husuem Smrnlmkm, TpJ^HQ nr. Eoktmri

İ
 NMA^MZ BTB

LmImemk Pokcosmlmk ..................................................................................................... i

Nmatmr Bsi ............................................................................................................................... i i
Jmj = POKNML_I_MK .................................................................................................... =

=.=. Imtmr joImhmkc ........................................................................................................... =

=.:. Zueumk EmsmIml ...................................................................................................... =
=.4. ^ujumk PokuIismk....................................................................................................:
=.> Emkammt PokuIismk ....................................................................................................... :
Jmj : ^BKFM_MK P_T^MHM ......................................................................................... 4
:.= Noaikisi ........................................................................................................................... 4
:.: OpinoeigIgci ................................................................................................................. 4
:.4 PmtgaisigIgci ................................................................................................................. >
:.> Amhtgr Zisihg ............................................................................................................... 3

:.5 Emkiaostmsi HIikis ....................................................................................................... <

:.1 Nimckgsis ....................................................................................................................... ==
:.3 ^mtmImhsmkm ................................................................................................................. =4

:.< HgepIihmsi ................................................................................................................... =>

:.2 Prgckgsis ...................................................................................................................... =>

:.=0 Pokdocmlmk ................................................................................................................ =5

JMJ 4 POK_^_P.............................................................................................=<

4.= HosiepuImk ................................................................................................................... =<

4.: Tmrmk .............................................................................................................................. = <

Nmatmr Pustmhm ...................................................................................................................= 2 

İ
 JMJ =
POKNML_I_M
K

=.= Imtmr JoImhmkc

^otmkus eorupmhmk sumtu pokymhit ikaohsi mhut ymkc nisojmjhmk gIol
jmhtori, ymitu Digstriniue totmki (D.totmki) nmk jism eokclmsiIhmk tgxik
kourgIgcis. ^otmkus ymkc eoeiIihi egrtmiity rmto  ymkc tikcci nmk emsil
eokjmni isu hosolmtmk ymkc smkcmt sickiaihmk soIurul nukim torutmem pmnm
kocmrm jorhoejmkc. Ni kocmrm emju, hmsus totmkus eoeiIihi iksinok ymkc
roknml. Ni Meorihm Torihmt, tornmpmt >4 hmsus por tmluk pmnm tmluk =22<
likccm tmluk :0:0. ToImik nmri prgsos pokymhit hohurmkcmk pokcmImemk nmIme
eoknimckgsm totmkus jorhgktrijusi pmnm egrtmiity rmto ymkc tikcci. ^otmkus
sorikc eokyojmjhmk hoemtimk, nokcmk Impgrmk hmsus
sojmkymh :=4,000  — :24,000 hoemtimk soIurul nukim. Bksinok hojmnimk totmkus
mnmIml = por =0,000,000 ni Meorih Torihmt (amk).^otmkus jmdiIIus eokclmsiIhmk
totmkgspmeik nmk totmkgIysik, tghsik ymkc eokyojmjhmk ikaImemsi IghmI
ni cmkcIigk ni toreikmI korvus ymkc eokiejuIhmk siknrgem hIikis. Hojmkc gtgt
mnmIml diri utmem totmkus, triseus eoepokcmruli 25,3%, hohmhumk Iolor
eoepokcmruli
<2,4%, hojmkc tujul eoepokcmruli 34%, nmk nisamcim eoepokcmruli
4<,2% pmsiok totmkus (Amk, :0=2).
^otmkus mnmIml ikaohsi ymkc nmpmt nidocml ymkc eokcmhijmthmk emsmIml
ymkc jormt ni soIurul nukim, torutmem ni kocmrm-kocmrm jorhoejmkc. Nipordmymi
jmlwm pokmkcmkmk Iuhm ymkc hurmkc jmih nmk hohurmkcmk amsiIitms nmk
hosmnmrmk torlmnmp ieukismsi eokcmrml ho provmIok ymkc tikcci totmkus ni
kocmrm - kocmrm

jorhoejmkc. Bksinoks hojmnimk totmkus pmnm kocmrm emju mnmIml roknml hmrokm
prgcrme ieukismsi ymkc smkcmt jmcus. Mktijigtih soporti pokidiIIik jgIol nicukmhmk
nmIme pokcgjmtmk totmkus uktuh eoejukul jmhtori torsojut. Eusdio roimxmkt ,
 jucm jism nicukmhmk nmIme pormwmtmk totmkus (Bermk, :0=2).
Jornmsmrhmk Imtmr joImhmkc torsojut, roaormt iki mhmk eoejmlms eokcokmi
emkiaostmsi hIikis nmk dmrm eoknimckgsis totmkus sortm eokcotmlui
tmtmImhsmkm pmnm hmsus totmkus.
=.: ^ujumk PokuIismk

=
=. Jmcmiemkmhml noaikisi nmri pokymhit totmkus7
:. Jmcmiemkmhml opinoeigIgci, otigIgci nmk amdtgr rosihg pokymhit
totmkus7

=
4. Jmcmiemkmhml pmtgaisigIgci torjmnikym totmkus7
>. Jmcmiemkmhml emkiaostmsi sortm nimckgsis nmri totmkus7
5. Jmcmiemkmhml tmtmImhsmkm pmnm totmkus7
=.4 ^ujumk PokuIismk
=. _ktuh eoemlmei noaikisi nmri pokymhit totmkus.
:. _ktuh eoemlmei opinoeigIgci, otigIgci nmk amhtgr rosihg pokymhit
totmkus.
4. _ktuh eoemlmei pmtgaisigIgci torjmnikym totmkus.
>. _ktuh eoemlmei emkiaostmsi sortm nimckgsis nmri totmkus.
5. _ktuh eoemlmei tmtmImhsmkm pmnm totmkus.
=.> Emkammt PokuIismk
PokuIismk roaormt iki nilmrmphmk mhmk eokikchmthmk pokcotmlumk
sortm poemlmemk nghtor eunm eokcokmi pokymhit totmkus nmIme lmI
noaikisi, pokocmhmk nimckgsis, sortm emkmjoeok nmk tmtmImhsmkm ymkc
nmpmt niImhuhmk solikccm nmpmt jorcukm smmt jorprmhtih ni
emsymrmhmt hoImh.

:
 JMJ : 
^BKFM_MK P_T^MHM

:.=. Noaikisi
^otmkus mnmIml mduto-tgxid-eonimton nisomso  ymkc nisojmjhmk gIol

Digstriniue totmki.  Pmnm hgknisi mkmorgj, soporti pmnm Iuhm kohrgtih ymkc
hgtgr, jmhtori iki eokclmsiIhmk totmkgspmseik ymitu sumtu kourgtghsik ymkc
smkcmt humt.
^ghsik totmkus eokclmejmt kourgtrmkseittor iklijitgr pmnm sistoe smrma pusmt
ymkc eokyojmjhmk hohmhumk gtgt nmk hojmkc totmkus ymkc tipihmI (SLG, :0=0).
^otmkus mnmIml sumtu tghsoeim mhut ymkc nisojmjhmk gIol
kourgtghsik ymkc nilmsiIhmk gIol D. totmki nitmknmi nokcmk hohmhumk gtgt nmk
spmseo ymkc porignih nmk jormt. ^otmkus nmpmt ninoaikisihmk sojmcmi homnmmk
liportgkim mhut mtmu hgktrmhsi gtgt ymkc eokcmhijmthmk kyori (jimsmkym pmnm
rmlmkc jmwml nmk Iolor) nmk spmseo gtgt eokyoIurul tmkpm pokyojmj Imik,
sortm tornmpmt riwmymt Iuhm mtmupuk hodoImhmmk sojoIuekym (JIodh ^P, :005).

Cmejmr :.= Digstriniue totmki  nokcmk nruestidh mppomrmkdo.

^otmkus nisojmjhmk gIol jmhtori DIgstriniue totmki ymkc eorupmhmk

grcmkiseo gjIicmt mkmorgj, jorjoktuh jmtmkc Crme pgsitia. Nmpmt eoejoktuh
spgrm ymkc mnm ni toreikmI solikccm eokclmsiIhmk pokmepiImk stih nrue
pmnm powmrkmmk spgrm mtmu powmrkmmk crme. Nmpmt nitoeuhmk ni tmkml, noju,
cmrme, unmrm, mtmu aosos. Toeoktmrm joktuh vocotmtia jorsmem spgrm mnm
ni aosos jikmtmkc, dmvue gris ememIim, nmk emkusim. Tpgrm (Jrgghs CA nhh.,
:0=4).
:.:. OpinoeigIgci
Bksinoks totmkus ni nukim jorhismr = jutm hmsus sotimp tmluk nokcmk
hoemtimk ymkc jorvmrimsi pmnm sotimp kocmrm. Ni Bkngkosim, jornmsmrhmk
Turvoi Hosolmtmk Zueml ^mkccm (THZ^), jueIml hmsus totmkus kogkmtgrue

4
sojmkymh
=>= hmsus pmnm tmluk :003, turuk eokjmni ==> hmsus pmnm tmluk :0== nokcmk

4
dmso amtmIity rmto (DAZ) 10,5%. PrgaiI Hosolmtmk Bkngkosim :0=:
eokukjuhhmk hokmihmk hmsus totmkus kogkmtgrue eokjmni ==2 hmsus,
kmeuk jueIml pmsiok eokikccmI turuk eokjmni 52 hmsus nokcmk DAZ
>2,1% (Hoeokhos, :0=:8 PNB,
:0=:).
PokoIitimk gIol ^lwmitos ot mI pmnm tmluk :001 eokcoeuhmhmk jmlwm

Dmso AmtmIity Zmto (DAZ) nmri pmsiok totmkus jorhismr mktmrm =:-54% (^lwmitos,
:001).Mkchm egrtmIitms nmri nmtm SLG pmnm tmluk =22: sojmkymh
=.000.000 hmsus ni soIurul nukim, toremsuh ninmImekym 5<0.000 hoemtimk
mhijmt totmkus kogkmtgrue, :=0.000 ni Msim ^okccmrm nmk =5:.000 ni
Marihm. EgrtmIitms nmri pokymhit totmkus eoIojili 50 % ni kocmrm
jorhoejmkc, nokcmk pokyojmj hoemtimk torjmkymh hmrokm eokcmImei
hocmcmImk porkmpmsmk mhut. Mkchm egrtmIitms eokuruk hmrokm porjmihmk
smrmkm iktoksia (BD_ nmk voktiImtgr), eoejuhtihmkjmlwm pokoIitimk-
pokoIitimk ymkc niImhuhmk gIol mlIi smkcmt jorcukm nmIme oaohtivitms
pokmkcmkmk pokymhit totmkus (DND,:0=5).
:.4. PmtgaisigIgci
Joktuh vocotmtia D. totmki cmepmkc emti mhijmt ghsicok, mhmk totmpi spgrm
nmpmt jortmlmk ni jorjmcmi hgknisi nmk eoeukchikhmk trmkseisi jmhtori.
Tpgrm nmpmt jortmlmk linup nmri porujmlmk pL mtmu sulu, jmlhmk nmpmt
jortmlmk soImem mutghIma jojormpm eokit. Jocitu spgrm emsuh ho nmIme
jmrikcmk, spgrm mhmk jorujml eokjmni joktuh vocotmtia. ^otmkus kogkmtgrue
torjmni hmrokm pormwmtmk tmIi pusmr ymkc tinmh jmih. Pokccukmmk mImt ymkc
tinmh storiI Tmmt eoegtgkc tmIi pusmr eokyojmjhmk totmkus pmnm kogkmtus.
Toeoktmrm ikaohsi pmnm mkmh-mkmh nmk nowmsm nisojmjhmk gIol
Imsormsi mtmu Iuhm ymkc torhgktmeikmsi jmhtori emupuk spgrmkym. Gtitis
eonim, hmrios noktis jucm poktikc nmIme ikaohsi totmkus pmnm mkmh-mkmh (Amrrmr
F, :0=>).
DIgstriniue totmki eokclmsiIhmk num jokis tghsik, ymitu totmkgIysik
nmk totmkgspmseik. ^otmkgIysik eorupmhmk loegIisik nmk ImjiI torlmnmp
ghsicok (eunml niikmhtivmsi gIol ghsicok), sonmkchmk totmkgspmseik
eorupmhmk kourgtgxik ymkc tinmh tmlmk pmkms. ^otmkgIysik eorupmhmk sumtu
tghsik ymkc nihgno gIol pImsein. ^ghsik iki eirip nokcmk TtroptgIysik G (
Ttroptgdgddus
 pygcokos) nmk loegIysik ymkc nilmsiIhmk gIol Digstriniue
 porarikcoks  nmk Iistorim egkgdytgcokos. Hopoktikcmk hIikis nmri tghsik iki
tinmh nilmrmphmk hmrokm siamtkym eunml nilmejmt gIol ghsicok nmk sorue
>
hgIostorgI (Amrrmr F, :0=>).

>
 ^otmkgspmseik mnmIml tghsik ymkc jorpormk nmIme emkiaostmsi hIikis nmri
totmkus. Jocitu tghsik iki nihoIumrhmk ho nmIme smrma, tghsik tinmh
nmpmt nioIieikmsi. Pokyojmrmk totmkgspmseik nmpmt eoImIui loemtgcok mtmu
Iieagcok ymkc hoeunimk eokdmpmi tmrcotkym ni ujukc smrma egtgrih. ^gxik iki
eoeiIihi : sujukit nmk 4 ngemik, sujukit M (rmktmi rikcmk) nmk sujukit J (rmktmi
jormt). Jocitu

tghsik nisohrosihmk, sumtu prgtomso okngcok mhmk eoeodml totmkgspmseik

eojmni : sujukit. Zosoptgr uktuh tghsik iki mnmIml cmkcIigsinm pmnm
kourgk
egtgris. Ngemik pokcihmt hmrjglinrmt (Ngemik pokcihmt hmrjglinrmt) pmnm
ujukc dmrjgxy-toreikmI sujukit J jorihmtmk nokcmk rosoptgr msme simImt ymkc
sposiaih nmk cIihgprgtoik pmnm poreuhmmk soI smrma egtgrih. Hoeunimk
tghsik mhmk niiktorkmIismsi gIol vosihoI okngsgeo. Msiniaihmsi okngsge mhmk
eokyojmjhmk porujmlmk pmnm ujukc K-toreikus sujukit J, hoeunimk torjmni
iksorsi sujukit J eokjmni eoejrmk okngsgeo, solikccm eoeukchikhmk
sujukit M hoIumr eokoejus eoejrmk okngsgeo eokju ho sitgsgI. ^gxik
eoeuImi rotrgcrmno trmkspgrt mxgkmI nmri poriaor hoeunimk eoku prosikmps
smrma, toepmt tghsik torsojut johorjm sojoIuekym. Tujukit M eorupmmk
sumtuzikd-nopoknokt eotmIIgprgtomso ymkc eoeodml vosihoI-torhmit eoejrmk
prgtoik-:, QMEP-: (mtmu sikmptgjrovik). Prgtoik iki eorupmhmk hgepgkok utmem
TKMZO-hgepIohs ymkc niemsuhhmk nmIme okngsitgsis nmk poIopmsmk
kourgtrmkseittor. ^ghsik iki eokclmejmt poIopmsmk kourgtrmkseittor
pokclmejmt, ymitu cIisik nmk CMJM (cmeem-meikg jutyrid mdin). ^orhmit
mhtiaitms egtgr kourgk eokjmni tinmh toriklijisi nmk eoejorihmk hohmhumk gtgt,
spmseo nmk pmrmIisis spmstih. Prgsos iki torjmni ni soeum sikmps, toremsuh
porsiepmkcmk kourgeushuIor (KEF). Gtgt-gtgt ymkc eoeiIihi jmrms
porsmrmamk (jmIur kourgkmI) torpoknoh mhmk Iojil jmkymh nihoIumrhmk,
soporti gtgt-gtgt emstihmsi. ^orcmktukc pmnm mwmI tiejuIkym triseus (hmhu
rmlmkc) nmk nisamcim (Amrrmr F, :0=>).
D. totmki  jimsmkym emsuh ho nmIme tujul eoImIui Iuhm. Tpgrm
jorhoejmkc pmnm homnmmk mkmorgjih (ghsicok roknml). ^ghsik ymkc
nilmsiIhmk nmpmt eokyojmr eoImIui poejuIul nmrml nmk smIurmk Iieamtih
(DND, :0=5). ToImik itu, tghsik nmpmt nimjsgrpsi ni tmutmk smrma gtgt ymkc
hoeunimk joreicrmsi eoImIui
 jmrikcmk porikourmI ho susukmk smrma pusmt (TTP). ^ghsik totmkus
eorupmhmk eotmIgprgtoikmso torcmktukc sokc ymkc eokmrcot prgtoik
(sikmptgjrovik/ vosidIo- mssgdimton eoejrmko prgtoik  — QMEP) uktuh

5
eoIopmshmk kourgtrmkseittor nmri
ujukc smrma eoImIui ausi vosihoI sikmps nokcmk eoejrmk pImsem smrma. CojmIm mwmI
ikaohsi IghmI totmkus imIml pmrmIisis aImhsin mhijmt cmkccumk poIopmsmk msotiIhgIik

5
ni tmutmk smrma gtgt. ^ghsik totmkus nmpmt eokyojmr sodmrm rotrgcrmno ni mhsgk
Igwor egtgr kourgk (IEK) nmk mhlirkym eokdmpmi eonuIm spikmIis mtmu
jmtmkc gtmh. Ni toepmt iki, tghsik nitrmkspgrtmsihmk eokyojormkci sikmps nmk
nimejiI gIol ujukc smrma iklijitgr CMJM (Cmeem-Meikgjutyrid Mdin) nmk/mtmu
smrma cIisikorcih ymkc eokcgktrgI mhtivitms IEK. Tosmepmikym tghsik pmnm
toreikmI smrma iklijitgr,

tghsik totmkus mhmk eoeodml QMEP, solikccm eokclmejmt poIopmsmk

CMJM nmk cIisik. LmI iki eokcmhijmthmk nokorvmsi aukcsigkmI nmk
pmrsimI IEK eokyojmjhmk lipormhtivitms nmk pokikchmtmk mhtivitms gtgt nmIme
joktuh ricinitms
nmk spmseo (LossoI J, :0=4).
Porigno ikhujmsi jorvmrimsi 4 - := lmri nokcmk rormtm < lmri. Emhik
jmul Ighmsi Iuhm nmri TTP, porigno ikhujmsi emhik Imem. Tikchmtkym porigno
ikhujmsi jorhmitmk nokcmk pokikchmtmk risihg hoemtimk. Pmnm totmkus
kogkmtgrue, cojmIm jimsmkym eukduI euImi nmri lmri ho-> likccm => sotoIml
eoImlirhmk nokcmk rormtm 3 lmri. ^ghsik totmkus eokyojmjhmk lipormhtivitms
gtgt rmkchm nmIme joktuh ricinitms nmk spmseo. Zicinitms eorupmhmk
hgktrmhsi gtgt ikvgIuktor tgkih, sonmkchmk spmseo eorupmhmk hgktrmhsi
gtgt ymkc jorImkcsukc Iojil sikchmt, nmpmt nirmkcsmkc gIol porocmkcmk gtgt
mtmu stieuImsi soksgrih solikccm nisojut sojmcmi roaIohs spmseo.^otmkus
nihoIgepghhmk eokjmni cokormIismtm, kogkmtus, IghmI, nmk soamIih. Tohitmr <0%
totmkus eorupmhmk tipo cokormIismtm(DND, :0=5).
^otmkus IghmI jmrmkc nokcmk prosoktmsi hgktrmhsi gtgt porsistok ni mrom
mkmtgei ymkc eokcmImei trmuem. ^otmkus tipo iki nmpmt eokjmni mwmI nmri
totmkus ueue, totmpi Iojil rikcmk, nmk lmkym sohitmr =% eokjmni amtmI.
^otmkus soamIih
 jmrmkc torjmni, jimsmkym pmnm gtitis eonim mtmu pmsdm-trmuem hopmIm nokcmk
cojmIm torutmem ni nmorml amsimI. ^otmkus cokormIismtm tmepmh nokcmk pgIm
eokyojmr ho nistmI. CojmIm mwmI joreuIm nmri triseus niihuti spmseo Iolor,
hosuIitmk eokoImk, nmk ricinitms gtgt mjngeikmI. ^ukchmi jimsmkym sonihit
torpokcmrul8 jihm tornmpmt gpistgtgkuspokul, mhmk eukduI aIohsi Iokcmk
nmkohstoksi hmhi soporti pgsisi nohgrtihmsi. CojmIm Imik eoIiputi pokikchmtmk
sulu, jorhorikcmt, pokikchmtmk tohmkmk nmrml, nmk tmhihmrnim opisgnih. LmI
iki nisojmjhmk gIol pokikchmtmk nrmemtis mnrokmIik nmk kgrmnrokmIik ymkc
nmpmt jorujukc pmnm kohrgsis eighmrnimI. Tpmseo nmpmt jorImkcsukc likccm
4-> eikccu. ^ghsik totmkus nmpmt eokyormkc smrma soksgrih ymkc
eokyojmjhmk porujmlmk soksmsi soporti kyori nmk mIgnikim. ^ghsik tinmh

1
nmpmt eokyojormkci cmkcIim soksgrih spikmI, solikccm oaoh soksgrih
solmruskym torjmni ni poriaor. Mhmk totmpi, poIopmsmk kourgtrmkseittor
nmri smrma soksgrih torjmni soktrmI ni eonuIm spikmIis mtmu jmtmkc

1
gtmh. Pmrmnghs iki eoroaIohsihmk jmlwm porujmlmk soksmsi nmpmt torIilmt
ni nmorml hopmIm soporti nmorml smrma tricoeikus (LossoI J, :0=4).
:.>. Amhtgr Zosihg
NmIme Doktors agr Nisomso Dgktrgi mkn Provoktigk (DND),
nisojuthmk jmlwm lmepir soIurul hmsus totmkus ni Meorihm sorihmt torjmni pmnm
grmkc ymkc

tinmh porkml eoknmpmthmk vmhsikmsi totmkus mtmu tinmh eoImhuhmk vmhsik

jggstor pmnm usim =0 tmluk. ToImik itu, sojmkymh 34% hmsus totmkus ni
meorihm sorihmt torjmni sotoIml pmsiok eokcmImei donorm mhut, toremsuh
Iuhm tusuh (50%),
Imsormsi, (44%), nmk mjrmsi (2%). 
Grmkc nokcmk usim Imkjut smkcmt jorosihg torlmnmp totmkus. Pmnm tmluk
:000 likccm :0=>, ni Pormkdis, 30 pmsiok nokcmk totmkus (rmtm-rmtm usim <0
tmluk) emsuh ho iktoksivo dmro ukit (BD_) nmk sopuIul (=>%) nmri pmsiok
eokikccmI. Bksinok ymkc Iojil tikcci niImpgrhmk ni Fopmkc, niemkm survoy
nmtmjmso kmsigkmI eoImpgrhmk >22 hmsus totmkus pmnm tmluk :0=0 likccm :0=1,
ymkc hoeukchikmk nisojmjhmk hmrokm ieukitms roknml pmnm iknivinu nokcmk
usim Imkjut (;>0 tmluk) (Kmhmjiem, ot mi., :0=<). LmI iki jucm nmpmt
nisojmjhmk hmrokm pokurukmk titor mktijgni nmri vmhsik soirikc jorjmImkkym
wmhtu. Pokyojmj Imik hoeukchikmk hmrokm eorohm niImlirhmk sojoIue prgcrme
vmhsikmsi niporhokmIhmk. Tojuml survoi nmri okme kocmrm Orgpm pmnm tmluk
:0=5 eokukjuhhmk jmlwm sohitmr :5% grmkc jorusim 15 tmluk mtmu Iojil
eoeiIihi hgksoktrmsi mktijgni ymkc sujprgtohtia (Rok, ot mi,  :0=2). Hoeunimk
Doktors agr Nisomso Dgktrgi mkn Provoktigk (DND) eokyojuthmk jmlwm
hojmkymhmk hmsus ymkc eorupmhmk pmsiok nowmsm. Tojmh tmluk :002
smepmi nokcmk :0=3, Iojil nmri 10% hmsus ymkc nuImpgrhmk eorupmhmk
pmsiok ymkc jorusim :0 smepmi 1> tmluk. Toporoepmt nmri hmsus ymkc
niImpgrhmk eorupmhmk pmsiok nokcmk usim Iojil nmri 15 tmluk nmk risihg
hoemtimk hmrokm totmkus pmIikc tikcci pmnm pmsiok nokcmk usim 15 tmluk mtmu
Iojil.
Pokccukm kmrhgjm suktih niinoktiaihmsi sojmcmi hoIgepgh jorisihg tikcci
Iojil nmri =00 tmluk ymkc ImIu. Bkjohsi sujhutmk (nihokmI sojmcmi shik pgppikc )
mtmu ikjohsi iktrmeushuImr gjmt jmImkmk eorupmhmk pronispgsisi ikaohsi
mkmorgj nmk nimkccmp smkcmt jorisihg tikcci. ToImik itu, nimjotos jucm
nihmithmk nokcmk risihg totmkus. Mktmrm =225 nmk =223, :% nmri hmsus totmkus
ni MT mnmIml pmnm pmsiok nokcmk nimjotos, nmk =4% pmnm tmluk :002
smepmi :0=5. Eoshipuk mImsmk pokikchmtmk iki tinmh joIms, trok iki nmpmt
3
nihmithmk nokcmk prmhtih ikjohsi, nmk hgksoktrmsi sorue mktijgni mktitotmkus
ymkc Iojil roknml jucm toIml nitoeuhmk pmnm pmsiok nokcmk nimjotos
nijmknikchmk nokcmk grmkc solmt (Rok, ot mi.  :0=2)

3
  Mnmkym hgkaIih mtmu jokdmkm mIme jucm nmpmt eokikchmthmk iksinok totmkus gIol hmrokm c
pmnm :1 Nosoejor :00>. Noeihimk puIm, pmnm juImk sotoIml coepm Hmsleir pmnm
:005 nmk coepm Rgcymhmrtm pmnm :001, emsikc-emsikc =42 nmk 3= hmsus
totmkus torjmni (Rok, ot mi. , :0=2).

Pmnm totmkus kogkmtus, hoImlirmk nirueml nokcmk iknivinu ymkc

tinmh torImtil, prgsos hoImlirmk ymkc tinmh storiI eorupmhmk amhtgr risihg.
ToImik itu, roknmlkym tikchmt ohgkgei nmk onuhmsi, nmorml ponosmmk, usim iju
ymkc emsil eunm, mnmkym jmtmsmk mhsos ho Imymkmk hosolmtmk uktuh iju
lmeiI nilujukchmk nokcmk prmhtih ymkc tinmh liciokis sortm roknmlkym tikchmt
msulmk mkto kmtmI nmk vmhsikmsi tghsgin totmkus ymkc tinmh mnohumt, soeum itu
nimkccmp sojmcmi amhtgr risihg torjmnikym totmkus kogkmtmI (Vlgu, ot mi., :0=5).
:.5 Emkiaostmsi HIikis
^mknm nmk cojmIm totmkus nilmsiIhmk nmri mhsi kourgtgxik nmIme
sistoe smrma pusmt. Nisiklijisi smrma egtgrih eokyojmjhmk pokikchmtmk tgkus
gtgt nmk cojmIm hohmhumk sortm kyori gtgt. Pokikchmtmk nisiklijisi
eokiejuIhmk spmseo gtgt rmkchm ymkc eorupmhmk diri hlms totmkus (^lwmitos
nmk Rok, :0=>). ^mknm nmk cojmIm pmsiok smmt nmtmkc ho rueml smhit pmnm
hmsus totmkus kgk-kogkmtmI ni tukjuhhmk pmnm tmjoI = (Rok nmk ^lwmitos, :0=2).
^mjoI =. ^mknm nmk cojmIm pmnm pmsiok smmt nmtmkc ho rueml smhit pmnm hmsus totmkus
kgk-kogkmtmI
^riseus (24 —2<%)
Hotocmkcmk gtgt ueue (2> —25%)

Hohmhumk gtgt (21%)

Nisamcim (<4%) Nispkou (3%)

Tpmseo gtgt (>1 —<0%)

Tulu tujul ;4<³>°D (31%)
Kmni ≯=:0 hmii/eokit (4>%) 

^otmkus sodmrm hImsih nijmci eokjmni oepmt tipo hIikis6 ueue

(cokormiizon), torIghmIismsi (igdmiizon), soamIih (doplmiid), nmk kogkmtmI. HImsiaihmsi

iki mnmIml porjonmmk nimckgstih nmk prgckgstih ymkc poktikc kmeuk Iojil

<
eokdoreikhmk amhtgr ikmkc nmk toepmt ikghuImsi nmripmnm porjonmmk nmIme
mhsi tghsik. BstiIml ymkc eokccmejmrhmk tmlmp mwmI totmkus, ymitu porigno
ikhujmsi (wmhtu nmri ikghuImsi ho cojmIm portmem) nmk porigno gksot (wmhtu
nmri cojmIm portmem likccm hojmkc ueue portmem). Toemhik poknoh
porigno-porigno torsojut torjmni, soemhik juruh prgckgsiskym. ^ornmpmt
jorjmcmi shmIm pokiImimk
normjmt hopmrmlmk totmkus (Lgngwmkod, :0=5). Porigno msietgemtih
sotoIml ikghuImsi, ymkc nisojut porigno ikhujmsi ueuekym torjmni nmIme 3-=0
lmri. LmI iki niihuti nokcmk porigno gksot, hurmkc Iojil nmIme :>-3: jme,
niemkm torjmni
pokikchmtmk cojmIm ymkc mhlirkym jorujukc pmnm spmseo gtgt. CojmIm mwmI
ymkc ueue eukduI mktmrm Imik, triseus (igdhjmw), hohmhumk gtgt, kyori pukccukc,
kyori gtgt cokormI (^lwmitos nmk Rok, :0=>).
m. Cokormiizon ^otmkus 
^otmkus ueue mtmu cokormiizon mnmIml joktuh ymkc pmIikc ueue
nihokmIi nmk sorikc nieuImi nokcmk risus smrngkidus mtmu smrngkid seiio
(pokikchmtmk tgkus pmnm grjiduImris gris) nmk triseus ("Igdhjmw"8 hohmhumk
gtgt emssotor). Hohmhumk porut jucm jism torjmni. Hojmkc ueue eokyorupmi
pgstur  nodgrtidmto nmk torniri nmri pgstur gpistgtgkih nokcmk aIohsi Iokcmk nmk
ohstoksi hmhi. Pmsiok tinmh holiImkcmk hosmnmrmk nmk eokcmImei kyori
lojmt soImem hojmkc. Hojmkc sorikchmIi spgktmk mtmu nipidu gIol
rmkcsmkcmk soporti sumrm horms, dmlmym tormkc, mtmu emkipuImsi aisih.
ToImem hojmkc, jmImk kmpms jmcimk mtms nmpmt torlmejmt, nmk hgktrmhsi
gtgt ueue jucm nmpmt torjmni pmnm gtgt nimarmcem. TmIml smtu nmri lmI torsojut
nmpmt eokccmkccu rospirmsi, nmk mpmjiIm jorhopmkjmkcmk nmpmt
jorujukc hoemtimk ymkc nisojmjhmk hmrokm msaihsim. Tpmseo Imrikc
toremsuh pmnm pitm sumrm nmpmt torjmni pmnm amso mwmI pokymhit nmk nmpmt
eokyojmjhmk torjmnikym gjstruhsi jmImk kmpms. Mspirmsi jucm eorupmhmk
emsmIml hlusus pmnm totmkus, ymkc nisojmjhmk hmrokm sohrosi jorIojil nmk
hotinmhemepumk uktuh eokoImk nihmrokmhmk ricinitms gtgt amrikcomI. Honum lmI
iki eokjoImshmk eokcmpm lipghsim eorupmhmk cojmIm ueue ymkc eukduI
pmnm pmsiok totmkus sonmkc mtmu jormt Kmeuk, ni orm egnork pormwmtmk
iktoksia, emsmIml porkmpmsmk sunml Iojil eunml nitmkcmki. Nisaukcsi
gtgkge ymkc jimsmkym torjmni jojormpm lmri sotoIml cojmIm, toIml nimkccmp
sojmcmi pokyojmj utmem hoemtimk (Lgngwmkod, :0=58
^lwmitos nmk Rok, :0=>).

2
 Cmejmr :.: ^riseus pmnm totmkus

Pokymhit iki nmpmt jorImkcsukc soImem sohitmr : eikccu,

eokdoreikhmk wmhtu ymkc nijutulhmk uktuh eokyoIosmihmk trmkspgrtmsi
tghsik, ymkc sunml jormnm ni iktrmmhsgkmI hotihm pokcgjmtmk mktitghsik
nijorihmk. PoeuIilmk eoejutulhmk wmhtu smtu juImk nmk soejul hodumIi
jihm torjmni hgepIihmsi.
^otmkus joruImkc nmpmt torjmni jihm pmsiok tinmh eokoriem ieukismsi mhtia hmrokm

 jueIml tghsik ymkc nilmsiIhmk tinmh eoemnmi uktuh eokciknuhsi ieukitms.

Cmejmr :.4 Gpistlgtgkus 

j. Igdmiizon
^otmkus
^otmkus torIghmIismsi mtmu igdmiizon eoIijmthmk hohmhumk gtgt ymkc torhmit
nokcmk toepmt ikghuImsi spgrm. CojmIm eukchik rikcmk nmk porsistok nmk
sorikc soejul sodmrm spgktmk. Nisaukcsi igwor egtgr kourgk
(hoIoemlmk nmk pokurukmk tgkus gtgt) sorikc torjmni pmnm gtgt ymkc torIijmt.
Joktuh hrgkis nmri pokymhit iki eokdoreikhmk hohojmImk pmrsimI torlmnmp
totmkgspmseik. ^otmkus torIghmIismsi ueuekym eorupmhmk mwmI nmri totmkus
ueue, ymkc torjmni hotihm duhup tghsik eoknmpmthmk mhsos ho sistoe smrma
pusmt (Lgngwmkod, :0=5).
d. D oplmiid ^otmkus
Hoeunimk ymkc hoticm, ymitu doplmiid totmkus, eorupmhmk joktuh hlusus
pokymhit IghmI ymkc eoepokcmruli gtgt-gtgt smrma hrmkimI, lmepir soImIu sotoIml

=
Iuhm hopmIm ymkc kymtm. Eoshipuk Impgrmk sojoIuekym eokcmithmk
totmkus

=
doplmiid   nokcmk prgckgsis ymkc juruh, pokoIitimk ymkc Iojil jmru
eokukjuhhmk jmkymh hmsus ymkc Iojil rikcmk. Iosi pmnm igwor egtgr
kourgk  sorikc eokyojmjhmk hoIoemlmk smrma wmjml. Pmnm hmsus doplmiid  
totmkus, mnmkym spmseo pmnm gtgt ImrykcomI mtmu amrikcomI nmpmt eokcmrmlhmk
pmnm mspirmsi nmk gjstruhsi jmImk kmams eoknmnmh solikccm eoeorIuhmk
gjsorvmsi ymkc hotmt.
n. Kogkmtmi ^otmkus
^otmkus kogkmtmI torjmni sotoIml ikaohsi uejiIihmI, pmIikc sorikc
nisojmjhmk gIol hocmcmImk tohkih msoptih jihm iju tinmh niieukismsi sodmrm
mnohumt. Prmhtih junmym jucm nmpmt jorhgktrijusi. Bju jimsmkym
eokcoIulhmk hosuIitmk nmIme eokyusui, nmk hgknisi ymkc torIilmt pmnm
kogkmtos jimsmkym jorupm hoIoemlmk ueue, sonmkchmk hohmhumk nmk
hojmkc torjmni hoeunimk. ^ikchmt egrtmIitms eoIojili 20%, nmk hotorImejmtmk
porhoejmkcmk ueue torjmni ni mktmrm eorohm ymkc soImemt. Amhtgr prgckgstih
ymkc juruh toremsuh usim Iojil eunm nmri =0 lmri, cojmIm hurmkc nmri 5 lmri
sojoIue ho rueml smhit, nmk mnmkym risus smrngkidus mtmu noeme. Mpkom
mnmIml pokyojmj hoemtimk utmem ni mktmrm pmsiok totmkus kogkmtmI pmnm
eikccu portmem holinupmk, nmk sopsis pmnm eikccu honum. Bkaohsi jmhtori pmnm
pusmr eokyojmjhmk sopsis pmnm lmepir sopmrul jmyi nokcmk totmkus
kogkmtmI, ymkc jorhgktrijusi torlmnmp egrtmIitms eoshipuk toIml nigjmti
(Lgngwmkod, :0=58 ^lwmitos nmk ^lwmitos, :0:0).
:.1 Nimckgsis
Nimckgsis totmkus nitocmhhmk sodmrm hIikis. ^inmh niImhuhmk poeorihsmmk
pokukjmkc uktuh eokchgkairemsi nimckgsis. Portmem nmpmt niImhuhmk
mkmekosis hopmnm pmsiok mtmu hoIumrcm pmsiok uktuh eokcotmlui riwmymt
ieukismsi, trmuem nmk eokdmri mpmhml mnm amhtgr risihg nmri pmsiok. Hoeunimk
jucm nmpmt nitmkymhmk eokcokmi cojmIm ymkc nimImei pmsiok soporti hosuIitmk
uktuh eoejuhm euIut, jorjidmrm, eokoImk, nmk cojmIm Imik ymkc eokcmrmlhmk
pmnm nimckgsis totmkus.
Poeorihsmmk aisih ymkc nmpmt niImhuhmk, ymitu tos spmtuIm. ^os
spmtuIm eorupmhmk sojuml tos nimckgstid sonorlmkm, ymitu nokcmk
eokoepoIhmk ujukc spmtuIm mtmu tgkcuo jimno ho nmorml grgamrikc. Pmnm
hgknisi kgremI lmI iki mhmk eokiejuIhmk cmc roaiox,  nmk pmsiok mhmk
jorusmlm eokcoIumrhmk spmtuIm (lmsiI tos kocmtia). Tonmkchmk pmnm totmkus
mhmk torjmni roaIox spmseo pmnm emssotor nmk pmsiok eokccicit spmtuIm (lmsiI
pgsitia).  Pmnm sojuml pokoIitimk >00 pmsiok nokcmk suspoh totmkus ni tos
nokcmk tos spmtuIm, lmsiI pgsitia ninmpmthmk pmnm 2>% pmsiok nmk tinmh
=
ninmpmthmk pmnm pmsiok tmkpm totmkus. LmI iki eokukjuhhmk

=
jmlwm poeorihsmmk iki eoejorihmk sposiaitms nmk soksitivitms ymkc tikcci
uktuh eoknimckgsis totmkus (Mpto, ot mi ., =225).
HuItur D. totmki   nmri Iuhm eorupmhmk poeorihsmmk ymkc jorsiamt
supgrtia, kmeuk tinmh uktuh nimckgstih hmrokm jmhtori torsojut suIit uktuh ni huItur
nmk pmnm jmkymh hmsus Iuhm ymkc eorupmhmk Ighmsi mwmI emsuhkym jmhtori
sorikchmIi tinmh
nitoeuhmk (^lwmitos nmk Rok, :0=>). ToImik itu eoshi niImhuhmk sodmrm lmti-
lmti, huItur mkmorgjid sorikchmIi eoejorihmk lmsiI kocmtivo. ToImik itu, lmsiI ymkc
pgsitia tinmh soImIu eokciknihmsihmk jmlwm grcmkiseo eokcmknukc
pImsein ymkc eoeprgnuhsi tgxik nmk lmsiI pgsitia jucm jism ninmpmt tmkpm
mnmkym cojmIm hIikis nmri pmsiok nokcmk ieukitms ymkc mnohumt (Lgngwmkod,
:0=5).
NmIme cuinoIiko SLG (:0=0), nisojuthmk jmlwm noaikisi totmkus
pmnm grmkc nowmsm mnmIml nokcmk mnmkym smIml smtu nmri tmknm nmk
cojmIm, ymitu triseus (hotinmhemepumk pmsiok uktuh eoejuhm euIut) mtmu
risus smrngkidus (s  pmseo pmnm gtgt wmjml ) mtmu hgktrmhsi gtgt ymkc
nisortmi kyori. Nimckgsis torsojut toktukym porIu nisortmi nokcmk riwmymt trmuem
mtmu Iuhm, eoshipuk mnm
 jucm pmsiok ymkc tinmh nmpmt eokcikcmt riwmymt trmuem emupuk Iuhm sposiaih.
Tonmkchmk _KBDOA, _KAPM, nmk SLG (:0=:), eokyojuthmk
jmlwm totmkus kgkmtmI ymkc torhgkairemsi ninoaikisihmk sojmcmi jmyi jmru
Imlir nokcmk tmkcismk nmk hoeoepumk eikue ymkc kgremI pmnm : lmri
portmem holinupmk,
nmk gksot pokymhit tiejuI mktmrm lmri ho 4  —  :< holinupmk, nmk tornmpmt
hotinmhemepumk uktuh eokyusu ymkc niihuti hmhu nmk/mtmu hojmkc.
Pmnm pmsiok nokcmk triseus, nimckgsis jmknikc toremsuh
homnmmk pmtgIgci ymkc IgdmI pmnm amrikc, grmI, mtmu emknijuImr. Tonmkchmk
pmnm pmsiok nokcmk spmseo gtgt ueue toremsuh hormdukmk strydlkiko nmk
romhsi nistgkih nmri gjmt-gjmtmk soporti plokgtlimziko nmk gjmt mkti-
ngpmeikorcih soporti eotgdIgprmeino ymkc eoejori emkiaostmsi spmseo
mjngeok opisgnih (Rok nmk
^lwmitos, :0=2). ^otmkus doplmiid  nokcmk cojmIm hIikis nmpmt ni nimckgsis
jmknikc nokcmk ikaohsi grgamrikcomI. Tonmkchmk totmkus pmnm kogkmtus
nilujukchmk nokcmk lipghmIsoem mtmu eokikcgoksoamIitis (^lwmitos nmk ^
lwmitos, :0:0) 
:.3 ^mtmImhsmkm
Todmrm ueue, pmsiok totmkus lmrus nipismlhmk nmri pmsiok Imik
=
nmk torIiknukc nmri stieuImsi tmhtiI mtmu munitgrih. Toeum Iuhm lmrus
nijorsilhmk nmk nihmsil nojrinoeok sosumi iknihmsi. Fmrikcmk kohrgtih nmk
joknm msikc lmrus nimkchmt. ^otmkus kym jism nigjmti nokcmk Beukgtormpi.
Fihm torsonim nijorihmk

^BC emkusim 500 ukit niikjohsihmk iktrmeushuImr sosocorm eukchik. Mktitghsik

=
nijorihmk uktuh eokcikmhtivmsi tghsik totmkus jojms, sonmkchmk tghsik ymkc
sunml jormnm ni smrma toreikmI tinmh nmpmt nitmkcmki nokcmk mktitghsik.
GIol hmrokm itu, cojmIm gtgt nmpmt totmp jorhoejmkc hmrokm tghsik totmkus
jorjmImk eoImIui mhsgk nmk trmks-sikmps sortm eoeodml QMEP.
Totoruskym, nmpmt nitmejmlhmk vmhsik totmkus tghsgin (^^) 0,5 dd sosumi
usim nokcmk ikjohsi iktrmeushuIor ni toepmt ymkc jonm. Pokymhit totmkus
tinmh eokciknuhsihmk ieukitms, jmni pmsiok tmkpm riwmymt vmhsikmsi ^^
prieor lmrus eokoriem ngsis honum =-: juImk sotoIml ngsis portmem nmk
ngsis hoticm 1-=: juImk hoeunimk (SLG,:0=0).
ToImik itu, tormpi mktijigtih jucm jism nijorihmk hopmnm pmsiok
nokcmk totmkus. Mktmrmkym mnmIml EotrgkinmzgIo 500ec sotimp 1 jme
sodmrm iktrmvokm mtmu por grmI, PokidiIIik C nokcmk ngsis =00.00- :00.00
B_/hc/lmri sodmrm iktrmvokm, nijorihmk nmIme :-> ngsis ymkc torjmci. Pmsiok
mIorci cgIgkcmk pokisiIik nmpmt nijori mktijigtih ymkc Imik soporti totrmsihIik,
emhrgIinm, hIiknmeisik, soamIgspgrik nmk hIgrmeaokihgI jucm nihmtmhmk oaohtia
pmnm totmkus (SLG,:0=0).
^ormpi ymkc Imik jucm nijorihmk pmnm totmkus, eismIkym gjmt
jokzgnimzopik uktuh eokcurmkci spmseo gtgt. Grmkc nowmsm nijorihmk
nimzopme iktrmvokm nieuImi nmri 5 ec mtmu Igrmzopme nieuImi nmri : ec, titrmsi
uktuh eokdmpmi hgktrgI spmseo gtgt tmkpm sonmsi nmk lipgvoktiImsi ymkc
jorIojilmk. Ngsis mkmh nieuImi nmri 0,=-0,: ec/hc sotimp :-1 jme. ToImik itu,
emckosiue suIamt nmpmt nicukmhmk tukccmI mtmu nokcmk hgejikmsi
jokzgnimzopik uktuh eokcgktrgI spmseo gtgt nmk nisaukcsi mutgkge. Ngsiskym
mnmIml 5 cr mtmu 35ec/hc iktmvokm Igmnikc ngso, hoeunimk :-4 crme por
jme smepmi tmrcot spmse dgktrgI tordmpmi. _ktuh eokcliknmri gvorngso,
roaIohs pmtoIm nipmktmu sojmcmi mroaIoxim. Fihm mroaIoxim jorhoejmkc, ngsis
lmrus niturukhmk (SLG,:0=0).
HgktrgI nisaukcsi gtgkge nokcmk poejorimk emckosiue suIamt mtmu egraik.
- jIgdhor soporti prgpmkgIgI ymkc nicukmhmk sojoIuekym jism
eokyojmjhmk lipgtoksi nmk hoemtimk eoknmnmh. Lmkym osemIgI ymkc
nirohgeoknmsihmk smmt iki. Gjmt ymkc nicukmhmk uktuh eokcgktrgI spmseo nmk
eoejorihmk oaoh sonmsi nmpmt eokyojmjhmk noprosi smIurmk kmpms. QoktiImsi
eohmkih nijorihmk sosocorm eukchik. ^rmhogstgei Iojil nipiIil nijmknikchmk
iktujmsi okngtrmhomI ymkc nmpmt eoeprgvghmsi spmseo nmk eoeporjuruh
kmpms. Dmirmk nmk kutrisi ymkc mnohumt lmrus nijorihmk hmrokm spmseo
totmkus eokcmhijmthmk tuktutmk eotmjgIiseo ymkc tikcci nmk stmtus
hmtmjgIih. Nuhukcmk kutrisi mhmk eokikchmthmk poIumkc
=
jortmlmk linup (SLG,:0=0).

=
:.< HgepIihmsi
 Mktmrm hgepIihmsi ymkc jism torjmni pmnm totmkus mnmIml Imrikcgspmseo,
spmseo pitm sumrm mtmu gtgt-gtgt porkmpmsmk ymkc eokyojmjhmk
cmkccumk porkmpmsmk. ToImik itu, armhtur tuImkc joImhmkc mtmu tuImkc pmkjmkc
nmpmt torjmni mhijmt hgktrmhsi nmk spmseo ymkc jorhoImkjutmk. Lipormhtivitms
nmri sistoe smrma gtgkge nmpmt eokyojmjhmk liportoksi nmk mtmu irmem jmktukc
ymkc tinmh kgremI. Totoruskym, ikaohsi kgsghgeimI sorikc torjmni hmrokm
rmwmt ikmp ymkc jorhopmkjmkcmk sortm ikaohsi sohuknor nmpmt jorupm
sopsis nmri hmtotor, pkouegkim LMP nmk uIhus nodujitus. OejgIi pmru
hlususkym emsmIml pmnm pokccukm kmrhgjm nmk pmsiok Imkjut usim.
ToImkjutkym, pkouegkim mspirmsi mnmIml hgepIihmsi ueue amso mhlir totmkus
nitoeuhmk pmnm 50%-30% hmsus mutgpsi. NmIme jojormpm tmluk tormhlir iki,
totmkus eokjmni amtmI pmnm sohitmr ==% nmri hmsus ymkc niImpgrhmk. Hmsus
amtmI ymkc pmIikc ueuekym mnmIml pmnm Imksim 10 tmluk ho mtms nmk pmnm grmkc
ymkc tinmh nivmhsikmsi. Pmnm sohitmr :0% hoemtimk totmkus, tinmh mnm pmtgIgci
ymkc joIms nmk hoemtimk nihmithmk nokcmk oaoh Imkcsuskc tghsik totmkus
(DND,:0=2).
:.2 Prgckgsis
Prgckgsis totmkus torcmktukc nmri porigno ikhujmsi ymitu Imem nmri
euImi ikghuImsi spgrm ho cojmIm portmem ymkc eukduI ho spmseo totmki ymkc
portmem hmIi eukduI. Tohirmkym porigno ikhujmsi poknoh emhm prgckgsis Iojil
juruh nmk totmkus ymkc normjmt Iojil jormt. Porigno ikhujmsi ymkc hurmkc
nmri 3 lmri eoepukymi emkiaostmsi hIkis ymkc Iojil jormt nmk hmnmr
egrtmIitms ymkc Iojil tikcci . Amhtgr rosihg ymkc eokikchmthmk egrtmIitms
mktmrm Imikkym mnmIml omrIy gksot dgkvuIsigks, hotorImejmtmk eoknmpmthmk
pokcgjmtmk, Iosi torhgktmeikmsi ni wmjml nmk hopmIm nmk totmkus kogkmtus .
Pmnm iknivinu nimtms usim >0 tmluk Iojil sorikc torhokm totmkus hmrokm
eokurukkym ieukitms torlmnmp totmkus. Amhtgr Imik ymkc eokyojmjhmk
prgckgsis juruh soporti egrtmIitms tikcci Imikkym mnmIml hgknisi linup nmk
Imymkmk hosolmtmk prieor ymkc hurmkc (Eutoym ot mI., :0=4).
Prgckgsis mnmIml Iojil jmcus sohirmkym iknivinu nijorihmk
vmhsikmsi totmkus, torutmem iknivinu nowmsm ymkc tinmh nihotmlui riwmymt
ieukismsikym nmk pmsiok pmsdm-trmuem (Smkc ot mI., :0:0).
:.=0 Pokdocmlmk
Pokdocmlmk totmkus mnmIml nokcmk ieukismsi nokcmk tghsgin
totmkus pmnm jmnwmI ymkc sunml nitotmphmk. Qmhsik totmkus nijumt nokcmk
tghsgin totmkus
=
ymkc sunml nistoriIhmk nmk nigjmti nokcmk agremInolyno nmk hoeunimk ni mjsgrjs

=
ho nmIme mnjuvmkt. Mnjuvmkt ymkc nicukmhmk mnmIml mIueikiue plgsplmto mtmu
mIueikiue lynrgxino (OkcImkn, :0=4).
Beukismsi totmkus pmnm mkmh-mkmh nmk nowmsm
Beukismsi totmkus nijmci hopmnm num, ymitu ieukismsi prieor nmk
ieukismsi sohuknor. Beukismsi prieor torniri nmri 4 ngsis sojmkymh >0B_
tghsgin totmkus. Beukismsi prieor nijorihmk pmnm usim :, 4 nmk > juImk. Ngsis
nijorihmk nokcmk iktorvmI = juImk. Tohirmkym ieukismsi niiktorupsi, emhm
ieukismsi ni torushmk nmk tinmh niuImkc nmri mwmI. Beukismsi prieor uktuh
iknivinu jorueur nimtms =0 tmluk sojmkymh 4 ngsis nokcmk hgksoktrmsi :0B_.
BktorvmI mktmr = ngsis nokcmk ngsis ymkc Imik mnmIml soImem = juImk. Fokis
vmhsik ymkc nirohgeoknmsihmk uktuh iknivinu nimtms =0 tmluk mnmIml tipo
^n. Eirip nokcmk ieukismsi pmnm iknivinu nijmwml =0 tmluk, sohirmkym
torjmni iktorupsi nmri ieukismsi emhm vmhsikmsikym nitorushmk nmk tinmh niuImkc
(OkcImkn, :0=4).
Beukismsi sohuknor jucm nisojut nokcmk jggstor. Tohirmkym jmnwmI
nmri ieukismsi nmsmr niihuti, emhm jggstor portmem nijorihmk pmnm usim 5
tmluk mtmu sotoIml 4 tmluk nmri ieukismsi prieor ngsis ymkc ho-4. ^otmpi
sohirmkym ieukismsi kym tinmh eokcihuti jmnwmI emhm jggstor portmem
nijorihmk eikiemI sotoIml = tmluk nmri ngsis ho 4 ieukismsi prieor. _ktuh
pmsiok ymkc nimtms usim =0 tmluk, jggstor portmem nijorihmk eikiemI sotoIml 5
tmluk nmri ieukismsi prieor ngsis ho- 4. Jggstor ho-: nijorihmk =0 tmluk sotoIml
jggstor portmem. Tohirmkym ieukismsi tinmh eokcihuti jmnwmI ieukismsi nmsmr,
emhm jggstor ho-: nijorihmk eikiemI 5 tmluk sotoIml jggstor ymkc portmem
(OkcImkn, :0=4).

Cmejmr :.> FmnwmI Beukismsi Eokurut Zohgeoknmsi Bhmtmk Nghtor Mkmh Bkngkosim :0=3

=
Tix DIomks ga NoIivory
Nihmrokmhmk ikaohsi totmkus torutmem pmnm kogkmtus jgIol
jorImhu sowmhtu porsmIikmk, emhm hgepgkok provoksi nmri torhokm ikaohsi
totmkus mnmIml Tix Diomks ga Noiivory ymkc ni mnvghmsihmk gIol SLG.
Hgepgkok Tix Diomks ga Noiivory mnmIml (^lwmitos mkn Igmk, :0=5)6
=. DIomk lmkns
:. DIomk porikoue
4. DIomk noIivory suramdo
>. DIomk dgrn duttikc
5. DIomk dgrn tyikc
1. DIomk dgrn dmro
Ttrmtoci iki niImpgrhmk nmpmt eokurukhmk hmnmr ikaohsi kogkmtus nmk hmnm
hoemtimk kogkmtus ymkc nimhijmthmk gIol ikaohsi totmkus (^lwmitos mkn Igmk,
:0=5).
Emkmjoeok Iuhm
Emkmjoeok Iuhm mnmIml poktikc uktuh eokdocml nmri torhokm
ikaohsi totmkus. Eokurut DND, soeum pmsiok ymkc tinmh eoepukymi riwmymt
ieukismsi totmkus mtmu ukhkgwk listgry ga totmkus vmddiko nijorihmk vmhsik
^n. ^mjoI nijmwml eoejmci tipo Iuhm nmk poejorimk vmhsik jggstor totmkus
nmk niatori (^n) mtmu totmkus ieeuko cIgjuIik (^BC) (Kidhs ot mI., :0=0)6
^mjoI :.: ^ipo Iuhm nmk tipo vmhsik mtmu ieeuko cIgjuIik ymkc nijorihmk eokurut
tipo Iuhm nmk riwmymt vmhsikmsi (Kidhs ot mI., :0=0).
Ziwmymt Iuhm eikgr, jorsil Iuhm Imik
vmhsikmsi ^n ^BC ^n ^BC
^inmh
nihotmlui/ 9 4 Rm ^inmh Rm Rm
ngsis
^inmh ^inmh (Rm
(Rm sohirmkym sohirmkym
ngsis ho-4 ngsis ho-4
≯ 4 ngsis ^inmh ^inmh
Iojil nmri Iojil nmri
=0 5
tmluk ymkc tmluk ymkc
ImIu) ImIu)

=
 JMJ 4
HOTBEP_IMK

4.= HosiepuImk
^otmkus mnmIml pokymhit ymkc nimhijmthmk gIol ikaohsi tghsik
ymkc niprgnuhsi gIol jmhtori Digstriniue totmki.  Amhtgr rosihg totmkus mnmIml
iknivinu ymkc tinmh eoknmpmt ieukismsi nmri vmhsikmsi. Bknivinu Imik mnmIml grmkc
usim Imkjut nimhijmthmk ieukitms ymkc roknml, grmkc ymkc eokccukmhmk
kmrhgjm suktih hmrokm ikaohsi huemk mkmorgj, jokdmkm mIme mtmu hgkaIih divii
nmk pmnm kogkmtus ymkc niImlirhmk ni rueml gIol iknivinu ymkc tinmh torImtil nmk
pmnm Iikchukcmk ymkc tinmh jorsil. Emkiaostmsi hIikis nmri totmkus kgk-
kogkmtmI nimhijmthmk gIol kourgtgxik ymkc eokccmkccu sistoe smrma pusmt
nmk eokyojmjhmk cojmIm hlms totmkus ymitu spmseo gtgt rmkchm. ^otmkus nijmci
eokjmni oepmt tipo hIikis ymitu cokormiizon totmkus, igdmiizon totmkus, doplmiid
totmkus, nmk kogkmtmi totmkus. Nimckgsis totmkus niImhuhmk sodmrm hIikis nmk
tinmh mnm poeorihsmmk pokukjmkc ymkc hlms uktuh pokocmhhmk nimckgsis.
Poeorihsmmk aisih ymkc nmpmt niImhuhmk mnmIml tos spmtuIm pgsitia. Poeorihsmmk
pokukjmkc ymkc nmpmt niImhuhmk mnmIml huItur D. totmki.  ^otmpi jmhtori torsojut
suhmr uktuh nitoeuhmk nmk sorikchmIi tinmh nitoeuhmk. Pokdocmlmk totmkus
mnmIml nokcmk ieukismsi vmhsik eokccukmhmk vmhsik totmkus tgxgin   ymkc
nijmnwmIhmk sojmcmi sojuml ieukismsi nmsmr uktuh mkmh-mkmh pmnm usim :,4,
nmk > juImk niihuti nokcmk jggstor pmnm usim =< juImk, 5, =0 nmk =< tmluk.
Pokdocmlmk kogkmtmi totmkus puIm mnmIml nokcmk eokormphmk Tix Diomks
ga Noiivory ymkc nirohgeoknmsihmk gIol SLG. Prgckgsis nmri totmkus sokniri
torcmktukc Imem tiejuIkym tmknm nmk cojmIm nmri euImi ikhujmsi. Tohirmkym
porigno ikhujmsi hurmkc nmri 3 lmri emhm sovoritms pokymhit mnmIml Iojil jormt
nmk eoepukymi egrtmIitms ymkc tikcci. 

4.: Tmrmk
Hmei eokymrmkhmk porIu mnmkym pokcotmlumk, shiI nmk hotormepiImk
hIikis ymkc eoemnmi uktuh nghtor ueue nmIme eokmkcmki hmsus totmkus
ymkc mhmk nitoeui hoImh.

=
 NMA^MZ P_T^MHM

 Mpto KE, Hmrkmn NZ. Tlgrt ropgrt6 tlo spmtuIm tost6 m siepIo jonsino tost tg
nimckgso totmkus. Me F ^rgp Eon Lyc.  =225 Gdt. 54(>)64<1-3. 

Jrgghs CA, DmrgII HD, JutoI FT, Egrso TM, Eiotzokor ^M. :0=4. Fmwotz, Onisi
BktorkmtigkmI EidrgjigIgcy Eonis EoIkidh & MnoIjorc, :1on.
Porusmlmmk EdCrmw-LiII, Kow Rgrh.
Doktor agr Nisomso DgktrgI mkn Provoktigk. ^otmkus. OpinoeigIgcy mkn provoktigk
ga vmddiko-provoktmjIo nisomso =4tl on. XBktorkotU. :0=5 Xditon :0=5 Emy
:2U8 p. 4>=-5=. MvmiImjIo arge6
lttp6//www.dnd.cgv/vmddikos/pujs/pikhjggh/ngwkIgmns/totmkus.pna
OkcImkn, p. L. :0=4. Beeukismtigk mcmikst ikaodtigus nisomso. Dlmptor 40 totmkus.
Amk, V., Vlmg, R., Smkc, T., Vlmkc, A. mkn Vlumkc, D., :0=2. DIikidmI aomturos mkn gutdgeos ga to
rosistmkdo, =:,  p.=:<2. 

Amrrmr F, Lgtoz PF, Fukclmkss ^, Hmkc C, ImIIg N, Slito KF.:0=>. Pokymhit ^rgpis,
Emksgk, Onisi num puIul ticm. OIsovior, PliImnloIpim.
LmssoI J. ^otmkus6 PmtlgplysigIgcy, tromteokt, mkn tlo pgssijiIity ga usikc
jgtuIikue tgxik mcmikst totmkus-iknudon ricinity mkn spmses. ^gxiks
(JmsoI). :0=48 5(=)6 34-<4.
Lgngwmkod M. & JIodh P. ^. :0=5. ^otmkus (Digstrisiue totmki). Emknoii, Ngucims,
mkn Jokkott's Prikdipios mkn Prmdtido ga Bkaodtigus Nisomsos (< tl  Onitigk) 
QgIueo :, Pmcos :353-:31:.o:
Eutoym, e. E., m hmjoy, m. H., Iujmkcm, t. E., tslmejm, l. E. & m khgy, m. E. ^.
:0=4. Prgckgsis ga totmkus pmtiokts ik tlo iktoksivo dmro ukit ga prgvikdimI
lgspitmI jmsgk soknwo, Iujuejmsli, nr dgkcg. Pmk maridmk eonidmi jgurkmi, 
=>.
Kmhmjiem E, Msg T, Emtsui L, Ausliei H, Rmsukmcm L. :0=<. Diikidmi aomturos mkn
gutdgeos ga totmkus6 mkmiysis usikc m kmtigkmi ikpmtiokt nmtmjmso ik Fmpmk.
F Drit Dmro8 >>6 4<< —2=.
Pusmt Nmtm nmk Bkagremsi. OIieikmsi totmkus emtorkmI nmk kogkmtmI (EK^O) ni
Bkngkosim. JuI FoknoIm Nmtm nmk Bkagremsi Hosolmtmk OIieikmsi ^otmkus
EmtorkmI & KogkmtmI. :0=:8 =6 =-::.
]mnir, E.B. mkn HgemI, ^., :0=2. PujIid Mwmrokoss mjgut ^otmkus.

=
^lwmitos, d. & Igmk, l. :0=5. Ormnidmtigk ga totmkus. Jritisl eonidmi juiiotik, ==1, 
12.
^lwmitos, C.O. & ^lwmitos, D.I. :0:0. ^otmkus. Luktor's ^rgpidmi Eonidiko mkn
Oeorcikc Bkaodtigus Nisomsos (=0 tl Onitigk). Pmcos 5><-550
^lwmitos, D. I., & Rok, I. E. :0=>. ^otmkus. Emksgk‒s ^rgpidmi Bkaodtigus

Nisomsos, 422 —>04.o=. ngi6=0.=0=1/j23<-0-30:0-5=0=-:.00044-2
_KBDOA, _KAPM, SLG. :0=:.  Mdliovikc mkn Tustmikikc Emtorkmi mkn Kogkmtmi
^otmkus Oiieikmtigk. Ttrmtocid Pimk  8:0=: —=5. lttp6//www
.wlg.ikt/ieeukizmtigk/nisomsos/EK^OTtrmtocidPImkWO.pna.
Smkc, x., yu, r., slmkc, x., Ii, j., cu, I., rmg, r., lmk, x., dlok, e., ymkc, j. & wu, j.
:0:0. EuItidoktor stuny ga totmkus pmtiokts ik aujimk prgvikdo ga dlikm6 m
rotrgspodtivo roviow ga 25 dmsos. Jigeon rosomrdl iktorkmtigkmi, :0:0.
SLG. Durrokt Zodgeeoknmtigk agr ^romteokt ga ^otmkus nurikc Luemkitmrimk
Oeorcokdios. SLG ^omdl Kgto XiktorkotU. :0=0 Xditios :0=5 EmyU.
 MvmiImjIo arge lttp6//www.wlg.ikt/nisomsodgktrgIWoeorcokdios/wlgW

lsoWcmrWndoWok:0=0.pna
Rok, I. E., & ^lwmitos, D. I. :0=2. ^otmkus. ^lo Imkdot. 
ngi6=0.=0=1/s0=>0- 1341(=<)44=4=-4
Vlgu VE ot mI. :0=5. Zish amdtgrs ga kogkmtmi toktmkus ik Sokzlgu, Dlikm6 m dmso-
dgktrgi stuny.  Sostork Pmdiaid Turvoiiimkdo mkn Zospgkso Fgurkmi , :0=5,
1(4). ngi6=0.5415/wpsmr.1.=.0:0