ﺑﺮﺭﺳﻲ ﺗﻐﻴﻴﺮﺍﺕ ﺍﻟﻜﺘﺮﻭﻛﺎﺭﺩﻳﻮﮔﺮﺍﻡ ﺩﺭ ﺳﮓ ﭘﺲ ﺍﺯ ﺗﺰﺭﻳ

(1)

ﻡﺍﺮﮔﻮﻳﺩﺭﺎﮐﻭﺮﺘﮑﻟﺍ ﻥﺍﺭﺎﮑﻤﻫ ﻭ ﻪﺠﻳﺭﻮﺷ ﻱﺮﻔﻌﺟ ﺮﺘﮐﺩ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﮓﺳ ﺭﺩ

٩

ﻒﻠﺘﺨﻣ ﻱﺎﻫﺯﻭﺩ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﮓﺳ ﺭﺩ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺕﺍﺮﻴﻴﻐﺗ ﻲﺳﺭﺮﺑ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﺏﺮﻘﻋ ﻢﺳ

ﻪﺠﻳﺭﻮﺷ ﻱﺮﻔﻌﺟ ﺭﺍﺩﺮﺳ ﺮﺘﻛﺩ

١*

، ﺩ ﻲﻣﺮﻬﺟ ﻲﻧﺍﺮﻔﻏ ﻦﺴﺣ ﺪﻤﺤﻣ ﺮﺘﻛ ٢

ﺸﻧﺍﺩ١

ﻲﻜﺷﺰﭙﻣﺍﺩ ﻩﺪﻜﺸﻧﺍﺩ ﻲﻫﺎﮕﻧﺎﻣﺭﺩ ﻡﻮﻠﻋ ﻲﺷﺯﻮﻣﺁ ﻩﻭﺮﮔ ﻲﻠﺧﺍﺩ ﺶﺨﺑ ﺭﺎﻴ

، ﺯﺍﺮﻴﺷ ﻩﺎﮕﺸﻧﺍﺩ

ﻲﻜﺷﺰﭙﻣﺍﺩ ﻪﺘﺷﺭ ﻪﺘﺧﻮﻣﺁ ﺶﻧﺍﺩ٢

، ﺸﻧﺍﺩ ﺯﺍﺮﻴﺷ ﻩﺎﮕ

ﻩﺪﻴﮑﭼ :

ﻡﻮﻤـﺳ ﺩﺮـﮑﻠﻤﻋ ﺩﺭﻮـﻣ ﺭﺩ ﻲﻓﺎﮐ ﺕﺎﻋﻼﻃﺍ ﺍﺮﻳﺯ ،ﺪﻳﺁ ﻲﻣ ﺭﺎﻤﺸﺑ ﻥﺎﻣﺭﺩ ﻦﺌﻤﻄﻣﺎﻧ ﺩﺭﺍﻮﻣ ﺯﺍ ﻲﮑﻳ ، ﻥﻮﮔﺎﻧﻮﮔ ﺽﺭﺍﻮﻋ ﺩﺎﺠﻳﺍ ﺖﻠﻋ ﻪﺑ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﻥﺎﻣﺭﺩ ﺪﺷﺎﺑ ﻲﻤﻧ ﺩﻮﺟﻮﻣ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﺐﻗﺎﻌﺘﻣ ﻲﻨﻴﻟﺎﺑ ﻢﺋﻼﻋ ﺯﻭﺮﺑ ﻲﮕﻧﻮﮕﭼ ﻭ ﻒﻠﺘﺨﻣ ﻱﺎﻬﻣﺍﺪﻧﺍ ﻱﻭﺭ ﺎﻫ ﺏﺮﻘﻋ .

ﻲـﺒﻠﻗ ﺕﺍﺮـﺛﺍ ﻲـﺳﺭﺮﺑ ﻱﺍﺮـﺑ ﺏﺮـﻘﻋ ﻢـﺳ

،ﮓﺳ ﯼﻭﺭ ﺮﺑ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﻦﺳ ﻂﺳﻮﺘﻣ ﺎﺑ ﻥﺍﺮﻳﺍ ﻲﻣﻮﺑ ﻁﻮﻠﺨﻣ ﺩﺍﮋﻧ ﺯﺍ ﻢﻟﺎﺳ ﮓﺳ ﻩﺩﻼﻗ ﻩﺩﺰﻧﺎﺷ

٢ ﻥﺯﻭ ﻭ ﻝﺎﺳ ٥

/ ١٨ ﻭ ﺏﺎـﺨﺘﻧﺍ ﺲﻨﺟ ﻭﺩ ﺮﻫ ﺯﺍ ﻡﺮﮔﻮﻠﻴﻛ

ﺪﻧﺪﺷ ﻢﻴﺴﻘﺗ ﻱﻭﺎﺴﻣ ﻩﻭﺮﮔ ﺭﺎﻬﭼ ﻪﺑ ﻲﻓﺩﺎﺼﺗ ﺭﻮﻄﺑ .

ﻩﺯﺍﺪﻧﺍ ﺎﻬﮕﺳ ﻡﺎﻤﺗ ﻲﺗﺎﻴﺣ ﻱﺎﻫﺭﻮﺘﻛﺎﻓ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﻞﺒﻗ ﻧﺁ ﺯﺍ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﻭ ﻱﺮﻴﮔ

ﺪﻳﺩﺮﮔ ﻪﻴﻬﺗ ﺎﻬ .

ﻩﻭﺮﮔ ﻱﺎﻬﮕﺳ ﻪﺑ ﻭ ﻱﮊﻮﻟﻮﻳﺰﻴﻓ ﻡﺮﺳ ﺮﺘﻴﻟ ﻲﻠﻴﻣ ﻚﻳ ﺭﺍﺪﻘﻣ ﺪﻫﺎﺷ ﻩﻭﺮﮔ ﻱﺎﻬﮕﺳ ﻪﺑ ﺪﻌﺑ ١

، ٢ ﻭ ٣ ﺮﻳﺩﺎﻘﻣ ﺐﻴﺗﺮﺗ ﻪﺑ ١

/ ٠ ، ٠٥ / ٠ ﻭ ٠١ / ٠ ﻚﺸﺧ ﺭﺩﻮﭘ ﻡﺮﮔ ﻲﻠﻴﻣ

ﻧ ﺭﺩ ﻱﺪﻠﺟ ﻞﺧﺍﺩ ﻖﻳﺮﻃ ﻪﺑ ﻭ ﻩﺩﻮﻤﻧ ﻞﺣ ﻱﮊﻮﻟﻮﻳﺰﻴﻓ ﻡﺮﺳ ﺮﺘﻴﻟ ﻲﻠﻴﻣ ﻚﻳ ﺭﺩ ﻥﺪﺑ ﻥﺯﻭ ﻡﺮﮔﻮﻠﻴﻛ ﺮﻫ ﺀﺍﺯﺍ ﻪﺑ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﺏﺮﻘﻋ ﻢﺳ ﻲﺘﺸﭘ ﺢﻄﺳ ﺎﻳ ﻢﻜﺷ ﻪﻴﺣﺎ

ﺪﺷ ﻖﻳﺭﺰﺗ ﺎﻬﮕﺳ ﻥﺍﺭ .

ﻱﺎﻬﻧﺎﻣﺯ ﺭﺩ ﺲﭙﺳ ٥

، ١٥ ، ٣٠ ، ٦٠ ، ٩٠ ﻭ ﻪﻘﻴﻗﺩ ٢ ، ٣ ، ٦ ﻭ ٢٤ ﻢـﺋﻼﻋ ،ﻱﺮـﻴﮔ ﻩﺯﺍﺪﻧﺍ ﻲﺗﺎﻴﺣ ﻱﺎﻫﺭﻮﺘﻛﺎﻓ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﺖﻋﺎﺳ

ﺪﻳﺩﺮﮔ ﻪﻴﻬﺗ ﺶﻳﺎﻣﺯﺁ ﺖﺤﺗ ﻱﺎﻬﮕﺳ ﻡﺎﻤﺗ ﺯﺍ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺭﺍﻮﻧ ﻭ ﺖﺒﺛ ﻱﺭﺎﺘﻓﺭ .

ﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﻱﺎﻫﺭﺍﻮﻧ ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ ﻩﻭﺮﮔ ﻱﺎﻬﮕﺳ ﺭﺩ ﻩﺪﻣﺁ ﺖﺳﺪﺑ ﻡﺍ

١ ﻭ ٢ ﻙﻮـﻠﺑ ،ﺪﻳﺪـﺷ ﻱﺩﺭﺎـﻛ ﻲﻛﺎﺗ ،ﺪﻳﺪﺷ ﻱﺩﺭﺎﻜﻳﺩﺍﺮﺑ ،ﻲﺳﻮﻨﻴﺳ ﻒﻗﻮﺗ ،ﻱﺰﻴﻠﻫﺩ ﻲﺳﻮﻨﻴﺳ ﻙﻮﻠﺑ ،ﻪﺘﻓﺮﺸﻴﭘ ﻲﺳﻮﻨﻴﺳ ﻲﻤﺘﻳﺭﺁ ﺮﻴﻈﻧ ﻲﺗﺍﺮﻴﻴﻐﺗ ﻩﺪﻨﻫﺩ ﻥﺎﺸﻧ

ﻪﺟﺭﺩ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ١

ﻭ ٢ ﺪﺷﺎﺒﻴﻣ ﻲﻨﻄﺑ ﻥﻮﻴﺳﻼﻳﺮﺒﻴﻓ ﻭ ﻲﺳﻮﻨﻴﺳ ﻱﺩﺭﺎﻜﻳﺩﺍﺮﺑ ،ﻲﻨﻄﺑ ﺱﺭﺩﻭﺯ ﻱﺎﻬﺿﺎﺒﻘﻧﺍ ، .

ﻭﺮﮔ ﻱﺎﻬﮕﺳ ﺭﺩ ﻩ

٣ ﻲـﺳﻮﻨﻴﺳ ﻲـﻤﺘﻳﺭﺁ ﻂـﻘﻓ

ﺪﺷ ﻩﺪﻫﺎﺸﻣ ﻱﺩﺭﺎﻛ ﻲﻛﺎﺗ ﻭ ﻪﺘﻓﺮﺸﻴﭘ ﻲﺳﻮﻨﻴﺳ ﻲﻤﺘﻳﺭﺁ ،ﻲﺳﻮﻨﻴﺳ ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ،ﻲﺳﻮﻨﻴﺳ ﻒﻗﻮﺗ ،ﻲﺋﺰﺟ .

ﺏﺮﻘﻋ ﻢﺳ ،ﻦﻳﺍﺮﺑﺎﻨﺑ ﺕﺍﺮﻴﻴﻐﺗ ﺪﻧﺍﻮﺗ ﻲﻣ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ

ﺭﺩ ﻲﻔﻠﺘﺨﻣ ﺷ

ﺩﺎﺠﻳﺍ ﻝﺎﻧﺭﺩﺁ ﻩﺪﻏ ﻭ ﮏﻴﺗﺎﭙﻤﺳ ،ﮏﻴﺗﺎﭙﻤﺳﺍﺭﺎﭘ ﻢﺘﺴﻴﺳ ﺮﺑ ﺕﻭﺎﻔﺘﻣ ﺕﺍﺮﺛﺍ ﻞﻴﻟﺪﺑ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﮐﻭﺮﺘﮑﻟﺍ ﻞﮑ ﺪﻨﮐ

.

ﻱﺪﻴﻠﻛ ﻥﺎﮔﮊﺍﻭ :

ﺍ ،ﺏﺮﻘﻋ ،ﻢﺳ ﮓﺳ ،ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ،ﺱﻮﺗﻮﺑﻮﺘﻧﺩ

ﺏﻮﻨﺟ ﺐﻃ ﻪﻣﺎﻨﻠﺼﻓ ﻭﺩ

ﺮﻬﺷﻮﺑ ﻲﻧﺎﻣﺭﺩ ﻲﺘﺷﺍﺪﻬﺑ ﺕﺎﻣﺪﺧ ﻭ ﻲﻜﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ

ﻝﺎﺳ ﻢﺘﻔﻫ ﻩﺭﺎﻤﺷ ، ٢

ﻪﺤﻔﺻ ، ۱۱۳

‐ ۱۲۱ ) ﺪﻨﻔﺳﺍ ١٣٨٣ (

ﺯﺍﺮﻴﺷ ﻩﺎﮕﺸﻧﺍﺩ* ﻲﻜﺷﺰﭙﻣﺍﺩ ﻩﺪﻜﺸﻧﺍﺩ–

ﻲﻫﺎﮕﻧﺎﻣﺭﺩ ﻡﻮﻠﻋ ﻩﻭﺮﮔ– ﻲﺘﺴﭘ ﻕﻭﺪﻨﺻ–

١٧٣١ ﻲﺘﺴﭘ ﺪﻛ ٧١٣٤٥ ﻦﻔﻠﺗ ، ٣ ‐ ٦٢٨٠٧٠١ ٠٧١١–

ﺮﺑﺎﻤﻧ ٣

‐ ٦٢٨٠٧٠٧ ‐ ٠٧١١

(2)

/١١٤ ﺏﻮﻨﺟ ﺐﻃ

ﻩﺭﺎﻤﺷ ﻢﺘﻔﻫ ﻝﺎﺳ

۲ / ﺪﻨﻔﺳﺍ ۱۳۸۳

ﻪﻣﺪﻘﻣ : ،ﻲﻳﺍﻮﻫ ﻭ ﺏﺁ ﺖﻴﻌﺿﻭ ﻅﺎﺤﻟ ﻪﺑ ﻥﺍﺮﻳﺍ ﺭﻮﺸﻛ

ﻭ ﻱﺰﻛﺮﻣ ﻪﻘﻄﻨﻣ ﺭﺩ ﻩﮋﻳﻮﺑ ﺎﻬﺑﺮﻘﻋ ﺯﺍ ﻲﻌﻴﺳﻭ ﻒﻴﻃ ﻱﺍﺭﺍﺩ ﻲﻣ ﺭﻮﺸﻛ ﻲﺑﻮﻨﺟ ﻖﻴﻘﺤﺗ ﻥﻮﻨﻛﺎﺗ ﺩﻮﺟﻭ ﻦﻳﺍ ﺎﺑ ﻲﻟﻭ ﺪﺷﺎﺑ

ﻉﺍﻮﻧﺍ ﺵﺰﮔ ﻱﺎﻫﺪﻣﺎﻴﭘ ﻭ ﺽﺭﺍﻮﻋ ﺩﺭﻮﻣ ﺭﺩ ﻱﺪﻨﺘﺴﻣ ﻭ ﻞﻣﺎﻛ ﺑﺮﻘﻋ ﺖﺳﺍ ﻩﺪﺸﻧ ﻡﺎﺠﻧﺍ ﻥﺍﺮﻳﺍ ﻱﺎﻬ .

٦٥٠ ﺭﺩ ﺏﺮﻘﻋ ﻪﻧﻮﮔ

ﺎﻬﻧﺁ ﻦﻴﺑ ﺯﺍ ﻪﻛ ﺖﺳﺍ ﻩﺪﺷ ﻪﺘﺧﺎﻨﺷ ﻥﺎﻬﺟ ٢٣

ﻥﺍﺮﻳﺍ ﺭﺩ ﻪﻧﻮﮔ

ﺪﻨﻨﻛ ﻲﻣ ﺪﻴﻟﻮﺗ ﻢﺳ ﺎﻬﻧﺁ ﻪﻤﻫ ﻭ ﺪﻧﺍ ﻩﺪﺷ ﻲﺋﺎﺳﺎﻨﺷ )

۳

‐ ۱ .(

ﻪﻧﻮﮔ ﺯﺍ ﻲﻜﻳ ﻩﺮﻴﺗ ﺯﺍ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﻪﻧﻮﮔ ،ﺎﭘﺪﻨﺑ ﻦﻳﺍ ﻢﻬﻣ ﻱﺎﻫ

ﻲﻣ ﺖﻓﺎﻳ ﻲﻧﺍﻭﺍﺮﻓ ﻪﺑ ﺎﻣ ﺭﻮﺸﻛﺭﺩ ﻪﻛ ﺖﺳﺍ ﻩﺪﻴﺗﻮﺑ ﺩﻮﺷ

. ﻩﺮﻴﺗ

ﻮﺑ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﻪﻧﻮﮔ ﻲﻜﻳ ﺖﺳﺍ ﻪﻧﻮﮔﻭﺩ ﻞﻣﺎﺷ ﻩﺪﻴﺗ ﺯﺍ ﻪﻛ ﻪﻳﻭﺭ ﻭﺩ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﻪﻧﻮﮔ ﻱﺮﮕﻳﺩ ﻭ ﺱﻭﺭﻮﺘﻧﺩﺍ

ﺖﺳﺍ ﻩﺪﺷ ﺪﻴﺻ ﻥﺍﺮﻳﺍ ﻁﺎﻘﻧ ﺮﺘﺸﻴﺑ .

ﺯﺍ ﻲﻀﻌﺑ ﺭﺩ ﺎﻬﺑﺮﻘﻋ ﻦﻳﺍ

ﻱﺍﻮﻫ ﻭ ﺏﺁ ﺭﺩ ﻭ ﻑﻭﺮﻌﻣ ﻩﺭﺍﺮﺟ ﺏﺮﻘﻋ ﻪﺑ ﻥﺍﺮﻳﺍ ﻁﺎﻘﻧ ﻱﺎﻬﺑﺮﻘﻋ ﺯﺍ ﻭ ﺪﻧﻮﺷ ﻲﻣ ﺖﻓﺎﻳ ﺭﻮﺸﻛ ﻝﺪﺘﻌﻣ ﻭ ﻚﺸﺧ ﻚﺸﺧ ﺪﻨﺷﺎﺑ ﻲﻣ ﻱﺯ )

۴ .(

ﻈﻧ ﺯﺍ ﻲﻘﻓﺍ ﻲﮔﺪﻨﻛﺍﺮﭘ ﺮ )

ﺭﺩ ﺎﻬﺑﺮﻘﻋ ﻲﻠﻛ ﺭﺎﺸﺘﻧﺍ

ﺭﻮﺸﻛ ﺢﻄﺳ (

ﺱﻮﻧﻮﺘﻛﺭﺪﻧﺁ ﻭ ﺱﻮﺗﻮﺑﻭﺰﻣ ﻱﺎﻬﺑﺮﻘﻋ ﺯﺍ ﺲﭘ

ﺩﺭﺍﺩ ﺭﺍﺮﻗ . ﻩﮋﻳﻮﺑ ﻥﺍﺮﻳﺍ ﻁﺎﻘﻧ ﺮﺘﺸﻴﺑ ﺯﺍ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﻱﺎﻬﺑﺮﻘﻋ

ﻦﻳﺍ ،ﺖﺳﺍ ﻩﺪﺷ ﺪﻴﺻ ﻲﻗﺮﺷ ﺏﻮﻨﺟ ﻭ ﻲﺑﻮﻨﺟ ﻲﺣﺍﻮﻧ ﻢﻛ ﺕﺎﻋﺎﻔﺗﺭﺍ ﺭﺩ ﻥﺎﺑﺎﻴﺑ ﻭ ﺖﺷﺩ ﺭﺩ ﻭ ﺪﻨﺘﺴﻫ ﺭﺎﻔﺣ ﺎﻬﺑﺮﻘﻋ ﺪﻨﻨﻛ ﻲﻣ ﻲﮔﺪﻧﺯ .

ﻱﺎﻫ ﻩﺮﻔﺣ ﺎﻬﺑﺮﻘﻋ ﻦﻳﺍ ﻂﺳﻮﺗ ﻩﺪﻣﺁ ﺩﻮﺟﻮﺑ

ﺩﻭﺪﺣ ٤٠ ﻩﺮﻔﺣ ﻦﻳﺍ ﻱﺎﻬﺘﻧﺍ ﺭﺩ ﺭﻮﻧﺎﺟ ﻭ ﺪﺳﺭ ﻲﻣ ﺮﺘﻤﻴﺘﻧﺎﺳ

ﺪﻳﺎﻤﻧ ﻲﻣ ﻲﮔﺪﻧﺯ )

۴ .(

ﺯﺍ ﻍﻮﻠﺑ ﺖﻟﺎﺣ ﺭﺩ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﺏﺮﻘﻋ ﻩﺯﺍﺪﻧﺍ ٥

ﻲﮔﺪﻣﺁﺮﺑ ،ﺭﺪﻛ ﺩﺭﺯ ﻥﺁ ﮓﻧﺭ ،ﺪﻨﻛ ﻲﻣ ﺯﻭﺎﺠﺗ ﺮﺘﻤﻴﺘﻧﺎﺳ ﮓﻧﺮﻤﻛ ﺩﺭﺯ ﺎﻫﺎﭘ ﻭ ﺎﻬﻛﺮﺒﻧﺍ ﻭ ﻩﺮﻴﺗ ﺶﻴﻧ ﻱﺎﻬﺘﻧﺍ ﻭ ﻲﻤﺸﭼ ﺖﺳﺍ ) ﺮﻳﻮﺼﺗ ١ ( ﺯﺍ ﻭ ﻲﻣ ﺰﻳﺎﻤﺘﻣ ﺎﻬﺑﺮﻘﻋ ﺮﻳﺎﺳ ﺯﺍ ﺖﻬﺟ ﻦﻳﺍ

ﺩﻮﺷ ) ۴

‐ ۲ .(

ﺕﻼﻜﺸﻣ ﺕﺎﻧﺍﻮﻴﺣ ﻭ ﻥﺎﺴﻧﺍ ﺭﺩ ﺏﺮﻘﻋ ﻦﻳﺍ ﺵﺰﮔ

ﺩﻮﺷ ﻲﻣ ﮒﺮﻣ ﺐﺒﺳ ﻲﺘﺣ ﻭ ﻩﺩﺮﻛ ﺩﺎﺠﻳﺍ ﻱﺪﺟ .

ﺏﺮﻘﻋ ﺯﺍ

ﺵﺭﺍﺰﮔ ﻲﮔﺪﻳﺰﮔ ﻥﺎﻬﺟ ﻒﻠﺘﺨﻣ ﻖﻃﺎﻨﻣ ﺭﺩ ﻱﺩﺎﻳﺯ ﻱﺎﻫ

ﺩﺭﺍﺩ ﺩﻮﺟﻭ .

ﺵﺭﺍﺰﮔ ﻦﻳﺍ ﺮﺘﺸﻴﺑ ﻲﻘﻃﺎﻨﻣ ﻭ ﺎﻫﺭﻮﺸﻛ ﺯﺍ ﺎﻫ

ﺎﺣ ﺎﻳ ﻭ ﻡﺮﮔ ﻱﺍﻮﻫ ﻭ ﺏﺁ ﻱﺍﺭﺍﺩ ﻪﻛ ﺖﺳﺍ ﺪﻨﺘﺴﻫ ﻱﺍ ﻩﺭ

. ﺯﺍ

،ﻥﺍﺮﻳﺍ ﺪﻨﻧﺎﻣ ﻪﻧﺎﻴﻣﺭﻭﺎﺧ ﻱﺎﻫﺭﻮﺸﻛ ،ﻚﻟﺎﻤﻣ ﻦﻳﺍ ﻪﻠﻤﺟ ﺰﻴﻧ ﻭ ﻲﻟﺎﻐﺷﺍ ﻦﻴﻄﺴﻠﻓ ،ﻞﻴﺋﺍﺮﺳﺍ ،ﺮﺼﻣ ،ﻥﺎﺘﺴﺑﺮﻋ ،ﻥﺎﺘﺴﻛﺎﭘ

ﺪﺷﺎﺑ ﻲﻣ ﻞﻳﺯﺮﺑ ﻭ ﻚﻳﺰﻜﻣ ،ﻥﺎﺘﺳﻭﺪﻨﻫ ﺪﻨﻧﺎﻣ ﻲﻳﺎﻫﺭﻮﺸﻛ )

۵

ﻭ ۶ .(

،ﺏﺮﻘﻋ ﻉﻮﻧ ﻪﺑ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﻲﻨﻴﻟﺎﺑ ﻱﺎﻫ ﻪﻧﺎﺸﻧ

ﺳ ﺖﻴﻌﻗﻮﻣ ﺰﻴﻧ ﻭ ﺵﺰﮔ ﻞﺼﻓ ،ﻩﺪﺷ ﻖﻳﺭﺰﺗ ﻢﺳ ﺭﺍﺪﻘﻣ ﻭ ﻲﻨ

ﺩﺭﺍﺩ ﻲﮕﺘﺴﺑ ﻩﺪﺷ ﻩﺪﻳﺰﮔ ﺩﺮﻓ ﻲﻧﺎﻤﺴﺟ .

ﺯﺍ ﻲﻨﻴﻟﺎﺑ ﻱﺎﻫ ﻪﻧﺎﺸﻧ

ﻲﻧﻮﮔﺮﮔﺩ ﺎﺗ ﻲﺋﺰﺟ ﺶﻨﻛﺍﻭ ﻚﻳ ﺎﻫ

ﻚﻳﮊﻮﻟﻮﻳﺰﻴﻓ ﺪﻳﺪﺷ ﻱ

ﺩﻮﺷ ﻲﻣ ﻩﺪﻳﺩ )

۱ ، ۷ ﻭ ۸ .(

ﺎﺑ ﻲﻨﻴﺌﺗﻭﺮﭘ ﺖﺳﺍ ﻱﺍ ﻩﺩﺎﻣ ﺏﺮﻘﻋ ﻢﺳ ﻲﺜﻨﺧpH

ﻉﻮﻧ ﻪﺑ ﻥﺁ ﺭﺍﺪﻘﻣ ﻭ ﻩﺪﻨﻫﺩ ﻞﻴﻜﺸﺗ ﺮﺻﺎﻨﻋ ﻪﻛ ﻲﻳﺎﻴﻠﻗ ﺎﺗ ﺭﻮﻧﺎﺟ ﺖﺴﻳﺯ ﻂﻴﺤﻣ ﻲﺳﺎﻨﺷ ﻡﻮﺑ ﻂﻳﺍﺮﺷ ﻭ ﺏﺮﻘﻋ ﻲﮕﺘﺴﺑ

ﺩﺭﺍﺩ . ،ﻦﻴﺴﻛﻮﺗﻭﺭﻮﻧ ﺪﻨﻧﺍﻮﺗ ﻲﻣ ﺏﺮﻘﻋ ﻢﺳ ﻱﺎﻫ ﻦﻴﺌﺗﻭﺮﭘ ﺍﺬﻟ

ﺪﻨﺷﺎﺑ ﺎﻬﻧﺁ ﺯﺍ ﻲﻃﻮﻠﺨﻣ ﺎﻳ ﻭ ﻦﻴﺴﻛﻮﺗﻮﻳﺩﺭﺎﻛ ،ﻦﻴﺴﻛﻮﺗﻮﻤﻫ .

،ﺯﺍﺪﻴﻧﻭﺭﻮﻟﺎﻴﻫ ،ﺯﺎﻨﺘﻴﺴﻴﻟ ﺪﻨﻧﺎﻣ ﻲﻳﺎﻬﻤﻳﺰﻧﺁ ﺩﻮﺟﻭ ﻦﻴﻨﭽﻤﻫ ﻭ ﻱﺩﺎﻘﻌﻧﺍ ﺕﺍﺮﺛﺍ ﺎﺑ ﻲﻳﺎﻬﻤﻳﺰﻧﺁ ﺎﻳ ﻭ ﺯﺎﻨﻴﺌﺗﻭﺮﭘ ،ﺯﺎﭙﻴﻟﻮﻔﺴﻓ ﻩﺪﺷ ﺪﻴﻳﺄﺗ ﻒﻠﺘﺨﻣ ﻱﺎﻬﺑﺮﻘﻋ ﻢﺳ ﺭﺩ ﻱﺩﺎﻘﻌﻧﺍ ﺪﺿ ﺖﺳﺍ ) ۴ .(

،ﻲﻜﺷﺰﭘ ﺶﻧﺍﺩ ﺭﺩ ﺮﻴﮕﻤﺸﭼ ﻱﺎﻬﺘﻓﺮﺸﻴﭘ ﺩﻮﺟﻭ ﺎﺑ

ﺽﺭﺍﻮﻋ ﺩﺎﺠﻳﺍ ﺖﻠﻋ ﻪﺑ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﻥﺎﻣﺭﺩ ﻢﻫ ﺯﻮﻨﻫ ﻲﻣ ﺭﺎﻤﺸﺑ ﻥﺎﻣﺭﺩ ﻦﺌﻤﻄﻣﺎﻧ ﺩﺭﺍﻮﻣ ﺯﺍ ﻲﻜﻳ ﻥﻮﮔﺎﻧﻮﮔ ﺪﻳﺁ

. ﺍﺮﻳﺯ

ﻱﻭﺭ ﺎﻬﺑﺮﻘﻋ ﻡﻮﻤﺳ ﺩﺮﻜﻠﻤﻋ ﺩﺭﻮﻣ ﺭﺩ ﻲﻓﺎﻛ ﺕﺎﻋﻼﻃﺍ ﺐﻗﺎﻌﺘﻣ ﻲﻨﻴﻟﺎﺑ ﻢﺋﻼﻋ ﺯﻭﺮﺑ ﻲﮕﻧﻮﮕﭼ ﻭ ﻒﻠﺘﺨﻣ ﻱﺎﻬﻣﺍﺪﻧﺍ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﻤﻧ ﺩﻮﺟﻮﻣ

ﺪﺷﺎﺑ ﻲ ) ۱ ﻭ ۳ .(

ﻦﻳﺍ ﺭﺩ ﻡﺯﻻ ﻱﺎﻬﺸﻳﺎﻣﺯﺁ ﻡﺎﺠﻧﺍ ﻪﻜﻨﻳﺍ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ

ﻥﺎﻜﻣﺍ ﻲﻟﺎﻤﺘﺣﺍ ﺕﺍﺮﻄﺧ ﺖﻠﻋ ﻪﺑ ﻥﺎﺴﻧﺍ ﻱﻭﺭ ﺮﺑ ﻪﻨﻴﻣﺯ ﺮﻳﺬﭘ

ﺖﺴﻴﻧ . ﺐﺳﺎﻨﻣ ﻱﻮﮕﻟﺍ ﻚﻳ ﻥﺍﻮﻨﻌﺑ ﺕﺎﻧﺍﻮﻴﺣ ﺯﺍ ﻥﺍﻮﺗ ﻲﻣ ﺍﺬﻟ ﺎﻬﻧﺁ ﺯﻭﺮﺑ ﻲﮕﻧﻮﮕﭼ ﻭ ﻲﻨﻴﻟﺎﺑ ﻥﻮﮔﺎﻧﻮﮔ ﻢﺋﻼﻋ ﻲﺳﺭﺮﺑ ﺖﻬﺟ

ﻳﺎﺳ ﻭ ﺐﻠﻗ ،ﻥﻮﺧ ﺭﺩ ﻪﻠﺻﺎﺣ ﺕﺍﺮﻴﻴﻐﺗ ﻭ ﻩﺩﺎﻔﺘﺳﺍ ﺎﻬﻣﺍﺪﻧﺍ ﺮ

ﻩﻮﻴﺷ ﻱﺮﻴﮔﺭﺎﻜﺑ ﺖﻬﺟ ﺍﺭ ﻩﺪﻣﺁ ﺖﺳﺪﺑ ﻱﺎﻫ ﻪﺘﻓﺎﻳ ﻭ ﺩﻮﻤﻧ ﺩﺍﺩ ﻢﻴﻤﻌﺗ ﻥﺎﺴﻧﺍ ﻪﺑ ﺐﺳﺎﻨﻣ ﻲﻧﺎﻣﺭﺩ ﻱﺎﻫ .

ﺕﺍﺮﻴﻴﻐﺗ ﻲﺳﺭﺮﺑ

ﻢﺳ ﻖﻳﺭﺰﺗ ﻝﺎﺒﻧﺩ ﻪﺑ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﻭ ﺐﻠﻗ ﻥﺎﺑﺮﺿ ﻱﺎﻫﺪﻣﺎﻴﭘ ﻭ ﻲﺒﻠﻗ ﺽﺭﺍﻮﻋ ﺯﻭﺮﺑ ﻲﮕﻧﻮﮕﭼ ﺪﻧﺍﻮﺗ ﻲﻣ ﺏﺮﻘﻋ ﻭ ﺪﻳﺎﻤﻧ ﺺﺨﺸﻣ ﺍﺭ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﺐﻗﺎﻌﺘﻣ ﻒﻠﺘﺨﻣ ﻮﻴﺷ ﻩ ﺍﺭ ﺎﻬﻧﺁ ﻥﺩﻮﻤﻧ ﻑﺮﻃﺮﺑ ﺖﻬﺟ ﺐﺳﺎﻨﻣ ﻲﻧﺎﻣﺭﺩ ﻱﺎﻫ

ﺪﻫﺩ ﻥﺎﺸﻧ .

(3)

١١٥

ﺮﺘﺸﻴﺑ ﻥﺪﺑ ﺭﺩ ﻡﻮﻤﺳ ﺮﺛﺍ ﻢﻴﻧﺍﺩ ﻲﻣ ﻪﻛ ﺭﻮﻄﻧﺎﻤﻫ

ﻲﺳﺭﺮﺑ ﺖﻬﺟ ﻦﻳﺍ ﺯﺍ ﻭ ﺖﺳﺍ ﺏﺎﺼﻋﺍ ﻭ ﺪﺒﻛ ،ﺐﻠﻗ ﻱﻭﺭ ﺮﺑ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺭﺍﻮﻧ ﻪﻌﻟﺎﻄﻣ ﻭ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﺕﺍﺮﻴﻴﻐﺗ ﺪﺷﺎﺑ ﻲﻣ ﻥﺪﺑ ﺭﺩ ﻢﺳ ﺮﻴﺛﺄﺗ ﻙﺭﺩ ﻱﺍﺮﺑ ﻱﺪﻨﻤﺷﺯﺭﺍ ﻱﺎﻤﻨﻫﺍﺭ .

ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺭﺩ ﻲﻤﻛ ﻲﮔﺪﻨﻛﺍﺮﭘ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﺏﺮﻘﻋ ﻪﻜﻨﻳﺍ

ﻱﺎﻫﺪﻣﺎﻴﭘ ﻭ ﺽﺭﺍﻮﻋ ﺩﺭﻮﻣ ﺭﺩ ﻲﻧﺍﺪﻨﭼ ﺕﺎﻘﻴﻘﺤﺗ ،ﺩﺭﺍﺩ ﺎﻴﻧﺩ ﺖﺳﺍ ﻪﺘﻓﺮﮕﻧ ﺕﺭﻮﺻ ﻥﺍﺮﻳﺍ ﺭﺩ ﻙﺎﻧﺮﻄﺧ ﺭﻮﻧﺎﺟ ﻦﻳﺍ ﺵﺰﮔ .

ﻪﺑ ﻪﻛ ﺖﺳﺍ ﻲﻘﻴﻘﺤﺗ ﻦﻴﺘﺴﺨﻧ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺭﻮﻈﻨﻣ ﻦﻴﻤﻫ ﻪﺑ ﺕﺍﺮﻴﻴﻐﺗ ﻭ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﺕﺍﺮﻴﻴﻐﺗ ﻲﺳﺭﺮﺑ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﮓﺳ ﺭﺩ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﻒﻠﺘﺨﻣ ﻱﺎﻫﺯﻭﺩ

ﺭﻮﻧﺎﺟ ﻦﻳﺍ ﻥﺍﻭﺍﺮﻓ ﻱﺎﻫ ﻪﻧﻮﮔ ﺯﺍ ﻪﻛ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﺏﺮﻘﻋ ﻢﺳ ﺖﻓﺮﮔ ﻡﺎﺠﻧﺍ ﺖﺳﺍ ﺭﻮﺸﻛ ﻁﺎﻘﻧ ﺐﻠﻏﺍ ﺭﺩ .

ﺭﺎﻛ ﺵﻭﺭ ﻭ ﺩﺍﻮﻣ :

ﻱﻭﺭ ﺮﺑ ﻖﻴﻘﺤﺗ ﻦﻳﺍ ١٦

ﻲﻣﻮﺑ ﻁﻮﻠﺨﻣ ﮓﺳ ﻩﺩﻼﻗ

ﻦﺳ ﻂﺳﻮﺘﻣ ﺎﺑ ﻢﻟﺎﺳ ﻥﺍﺮﻳﺍ ٢

ﻥﺯﻭ ﻦﻴﮕﻧﺎﻴﻣ ﻭ ﻝﺎﺳ ٥

/ ١٨

ﺖﻓﺮﮔ ﻡﺎﺠﻧﺍ ﺲﻨﺟ ﻭﺩ ﺮﻫ ﺯﺍ ﻡﺮﮔﻮﻠﻴﻛ .

ﺕﺎﻨﻳﺎﻌﻣ ﺯﺍ ﺲﭘ

ﻨﻴﻟﺎﺑ ،ﺎﻬﻧﺁ ﻲﺘﻣﻼﺳ ﺯﺍ ﻥﺎﻨﻴﻤﻃﺍ ﻭ ﺶﻳﺎﻣﺯﺁ ﺩﺭﻮﻣ ﻱﺎﻬﮕﺳ ﺯﺍ ﻲ

ﻲﻳﺍﺩﺯ ﻞﮕﻧﺍ ﻭ ﻖﻳﺭﺰﺗ ﻱﺭﺎﻫ ﻦﺴﻛﺍﻭ )

ﺪﻳﺎﻣﻭﺯﻮﻠﻜﻴﻧ ﺱﻮﻟﻮﺑ

١٢٥ ﻝﻭﺰﻴﻣﺍﻮﻟ ﻭ ٥

/ ٧ ﻥﺯﻭ ﻡﺮﮔﻮﻠﻴﻛ ﺮﻫ ﻱﺍﺮﺑ ﻡﺮﮔ ﻲﻠﻴﻣ

ﻥﺪﺑ ( ﺖﺤﺗ ﻪﺘﻔﻫ ﻭﺩ ﺕﺪﻣ ﻪﺑ ﻭ ﺖﻓﺮﮔ ﻡﺎﺠﻧﺍ ﺎﻬﮕﺳ ﻡﺎﻤﺗ ﺭﺩ ﻱﺎﻣﺩ ﻪﺘﻔﻫ ﺭﺩ ﺯﻭﺭ ﻪﺳ ﻭ ﺪﻧﺪﺷ ﻱﺭﺍﺪﻬﮕﻧ ﻪﺑﺎﺸﻣ ﻂﻳﺍﺮﺷ

ﺮﺿ ﺩﺍﺪﻌﺗ ،ﻥﺪﺑ ﺖﻋﺎﺳ ﺭﺩ ﺲﻔﻨﺗ ﻭ ﺐﻠﻗ ﻥﺎﺑ

٧ ،ﺢﺒﺻ ١٢

ﻭ ﺮﻬﻇ ٥ ﺕﺪﻣ ﻪﺑ ﺮﺼﻋ ١٤

ﻩﺯﺍﺪﻧﺍ ﺯﻭﺭ ﺪﻳﺩﺮﮔ ﺖﺒﺛ ﻭ ﻱﺮﻴﮔ

.

ﻱﺪﻌﻘﻣ ﻲﻜﺷﺰﭘ ﺞﻨﺳﺎﻣﺩ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﺎﺑ ﻥﺪﺑ ﻱﺎﻣﺩ

ﻩﺯﺍﺪﻧﺍ ﻲﻜﺷﺰﭘ ﻲﺷﻮﮔ ﻥﺩﺍﺩ ﺭﺍﺮﻗ ﺎﺑ ﺲﻔﻨﺗ ﺩﺍﺪﻌﺗ ،ﺪﺷ ﻱﺮﻴﮔ ﺮﺑﺍﺮﺑ ﺭﺩ ﺖﺳﺩ ﺖﺸﭘ ﻥﺩﺍﺩ ﺭﺍﺮﻗ ﺎﺑ ﻦﻴﻨﭽﻤﻫ ﻭ ﻱﺎﻧ ﻱﻭﺭ

ﺐﻠﻗ ﻥﺎﺑﺮﺿ ﺩﺍﺪﻌﺗ ﻭ ﻲﻨﻴﺑ ﻱﺎﻫ ﻩﺮﻔﺣ ﻲﺷﻮﮔ ﻥﺩﺍﺩ ﺭﺍﺮﻗ ﺎﺑ

ﻦﻴﻨﭽﻤﻫ ﻭ ﻩﺪﻧﺩ ﻦﻴﻤﺸﺷ ﺎﺗ ﻦﻴﻣﻮﺳ ﻪﻠﺻﺎﻓ ﺭﺩ ﻲﻜﺷﺰﭘ ﺪﻳﺩﺮﮔ ﺵﺭﺎﻤﺷ ﻲﻧﺍﺭ ﮒﺮﺧﺮﺳ ﺲﻤﻟ .

ﺩﺭﻮﻣ ﺎﻬﮕﺳ ﻩﺭﺎﺑﻭﺩ ﺶﻳﺎﻣﺯﺁ ﻉﻭﺮﺷ ﺯﺍ ﻞﺒﻗ

ﺺﺧﺎﺷ ﻭ ﻪﺘﻓﺮﮔ ﺭﺍﺮﻗ ﻲﻨﻴﻟﺎﺑ ﺕﺎﻨﻳﺎﻌﻣ ﻱﺎﻣﺩ ،ﺮﻈﻧ ﺩﺭﻮﻣ ﻱﺎﻫ

ﻩﺯﺍﺪﻧﺍ ﺐﻠﻗ ﻥﺎﺑﺮﺿ ،ﺲﻔﻨﺗ ﺩﺍﺪﻌﺗ ،ﻥﺪﺑ ﺯﺍ ﻭ ﺪﺷ ﺖﺒﺛ ﻭ ﻱﺮﻴﮔ

ﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺭﺍﻮﻧ ﺎﻬﻧﺁ ﺪﻳﺩﺮﮔ ﻪﻴﻬﺗ ﻡﺍﺮﮔ

. ﺩﺭﻮﻣ ﻱﺎﻬﮕﺳ

ﻪﺑ ﻲﻓﺩﺎﺼﺗ ﺭﻮﻄﺑ ﺶﻳﺎﻣﺯﺁ ٤

ﻞﻣﺎﺷ ﻩﻭﺮﮔ ﺮﻫ ﻭ ﻩﻭﺮﮔ ٤

ﺪﻳﺩﺮﮔ ﻢﻴﺴﻘﺗ ﮓﺳ .

،ﻝﻭﺍ ﻩﻭﺮﮔ ﻱﺎﻬﮕﺳ ﻪﺑ ﻪﺑ ﻡﻮﺳ ﻭ ﻡﻭﺩ

ﺐﻴﺗﺮﺗ ١ / ٠ ، ٠٥ / ٠ ﻭ ٠١ / ٠ ﻢﺳ ﻚﺸﺧ ﺭﺩﻮﭘ ﻡﺮﮔ ﻲﻠﻴﻣ

ﻡﺮﺳ ﺮﺘﻴﻟ ﻲﻠﻴﻣ ﻚﻳ ﺭﺩ ﻥﺪﺑ ﻥﺯﻭ ﻡﺮﮔﻮﻠﻴﻛ ﺮﻫ ﻱﺍﺮﺑ ﺏﺮﻘﻋ ﻲﺘﺳﻮﭘ ﻞﺧﺍﺩ ﻖﻳﺮﻃ ﺯﺍ ﻭ ﻩﺩﺮﻛ ﻞﺣ ﻱﮊﻮﻟﻮﻳﺰﻴﻓ (Intra

dermal) ﺪﺷ ﻖﻳﺭﺰﺗ

. ﻥﺍﻮﻨﻋ ﻪﺑ ﻡﺭﺎﻬﭼ ﻩﻭﺮﮔ ﻱﺎﻬﮕﺳ ﻪﺑ

ﻲﺘﺳﻮﭘ ﻞﺧﺍﺩ ﻩﺍﺭ ﺯﺍ ﻱﮊﻮﻟﻮﻳﺰﻴﻓ ﻡﺮﺳ ﺮﺘﻴﻟ ﻲﻠﻴﻣ ﻚﻳ ﺪﻫﺎﺷ ﺪﻳﺩﺮﮔ ﻖﻳﺭﺰﺗ .

ﺭﺩ ﮓﺳ ﻩﺩﻼﻗ ﻭﺩ ﺭﺩ ،ﻢﺳ ﻖﻳﺭﺰﺗ ﻩﻭﺮﮔ ﺮﻫ ﺭﺩ

ﺖﺳﻮﭘ ﺭﺩ ﺮﮕﻳﺩ ﮓﺳ ﻩﺩﻼﻗ ﻭﺩ ﺭﺩ ﻭ ﻲﻤﻜﺷ ﻪﻴﺣﺎﻧ ﺖﺳﻮﭘ ﺪﺷ ﻡﺎﺠﻧﺍ ﻥﺍﺭ ﻲﺘﺸﭘ ﻪﻴﺣﺎﻧ .

ﻩﺯﺍﺪﻧﺍ ﻱﺎﻫ ﺺﺧﺎﺷ ﻱﺮﻴﮔ

ﭘ ﻲﺗﺎﻴﺣ ﻲﻧﺎﻣﺯ ﻞﺻﺍﻮﻓ ﺭﺩ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲ ٥

، ١٥ ، ٣٠ ، ٦٠

ﻭ ٩٠ ﻭ ﻪﻘﻴﻗﺩ ٢ ، ٣ ، ٦ ﻭ ٢٤ ﺖﻓﺮﮔ ﻡﺎﺠﻧﺍ ﺖﻋﺎﺳ .

ﺭﺩ

ﺖﺷﺍﺩ ﺭﺍﺮﻗ ﺮﻈﻧ ﺖﺤﺗ ﺖﻗﺩ ﻪﺑ ﻥﺍﻮﻴﺣ ﻕﻮﻓ ﻲﻧﺎﻣﺯ ﻞﺻﺍﻮﻓ ﺪﺷ ﺖﺒﺛ ﻥﺁ ﻱﺭﺎﺘﻓﺭ ﻭ ﻲﻜﻳﺰﻴﻓ ﺕﺍﺮﻴﻴﻐﺗ ﻡﺎﻤﺗ ﻭ .

ﻢﺳ ﻪﻴﻬﺗ ﺵﻭﺭ :

ﻱﺯﺍﺭ ﻮﺘﻴﺘﺴﻧﺍ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﺩﺭﻮﻣ ﻚﺸﺧ ﻢﺳ

ﺪﻳﺩﺮﮔ ﻪﻴﻬﺗ ﻙﺭﺎﺼﺣ .

ﺩﺭﻮﻣ ﻢﺳ ﻪﺟﻮﺗ ﺎﺑ ﮓﺳ ﺮﻫ ﻱﺍﺮﺑ ﺯﺎﻴﻧ

ﻥﺯﻭ ﻩﺎﮕﺸﻳﺎﻣﺯﺁ ﻱﻭﺯﺍﺮﺗ ﺎﺑ ﻲﻘﻳﺭﺰﺗ ﻢﺳ ﺯﻭﺩ ﻭ ﮓﺳ ﻥﺯﻭ ﻪﺑ ﺪﺷ . ﻭ ﻩﺩﻮﻤﻧ ﻞﺣ ﻱﮊﻮﻟﻮﻳﺰﻴﻓ ﻡﺮﺳ ﺮﺘﻴﻟ ﻲﻠﻴﻣ ﻚﻳ ﺭﺩ ﺪﻌﺑ ﺭﺩ ﻭ ﻩﺪﻴﺸﻛ ﺖﻗﺩ ﻪﺑ ﻱﺮﺘﻴﻟ ﻲﻠﻴﻣ ﻚﻳ ﻱﺎﻬﮕﻧﺮﺳ ﻂﺳﻮﺗ

ﺪﻳﺩﺮﮔ ﻖﻳﺭﺰﺗ ﺮﻈﻧ ﺩﺭﻮﻣ ﻞﺤﻣ .

ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺖﺒﺛ ﺵﻭﺭ :

ﺎﻬﮕﺳ ،ﻲﻓﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﻡﺎﺠﻧﺍ ﻱﺍﺮﺑ ﺖﻤﺳ ﻪﺑ

ﻲﻜﻴﺘﺳﻻ ﻖﻳﺎﻋ ﺎﺑ ﹰﻼﺒﻗ ﻪﻛ ﻱﺰﻴﻣ ﻱﻭﺭ ﻮﻠﻬﭘ ﻪﺑ ﺖﺳﺍﺭ ﺪﺷ ﻲﻣ ﻩﺩﺍﺩ ﺭﺍﺮﻗ ﺩﻮﺑ ﻩﺪﺷ ﻩﺪﻧﺎﺷﻮﭘ .

ﺞﻧﺭﺁ ﻞﺼﻔﻣ ﺱﺃﺭ ﺪﻌﺑ

ﻭ ﻩﺪﻴﺷﺍﺮﺗ ﻲﻓﺍﺮﮔﻮﻳﺩﺭﺎﻛ ﻱﺎﻫﺩﻭﺮﺘﻜﻟﺍ ﻞﺻﻭ ﻱﺍﺮﺑ ﻪﺳﺍﺮﮔ ﻭ ،ﺹﻮﺼﺨﻣ ﻝﮊ ﺎﺑ ﻥﺪﺷ ﻪﺘﺸﻏﺁ ﺯﺍ ﺲﭘ ﻭ ﺰﻴﻤﺗ ﻞﻜﻟﺍ ﺎﺑ ﻱﺎﻫﺩﻭﺮﺘﻜﻟﺍ ﻭ RA

ﻭ ﺞﻧﺭﺁ ﻞﺼﻔﻣ ﺱﺃﺭ ﻱﻻﺎﺑ LA

ﻱﺎﻫﺩﻭﺮﺘﻜﻟﺍ ﻭ RL

ﻪﺳﺍﺮﮔ ﻞﺼﻔﻣ ﻱﻻﺎﺑ ﺖﻤﺴﻗ ﻪﺑ LL

ﺪﻳﺩﺮﮔ ﻞﺻﻭ .

ﻱﺎﻬﻗﺎﻘﺘﺷﺍ ﻱﻭﺭ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺖﺴﺨﻧ

ﺎﻬﻣﺍﺪﻧﺍ ﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻲﺒﻄﻗ ﻭﺩ ،I

ﻭ II ﻚﻳ ﻱﺎﻬﻗﺎﻘﺘﺷﺍ ﻭ III

ﻩﺪﺷ ﺖﻳﻮﻘﺗ ﻲﺒﻄﻗ ،aVR

ﻭ aVL ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﺎﺑ aVF

ﻉﻮﻧ ﺯﺍ ﻪﻟﺎﻧﺎﻛ ﻚﻳ ﻑﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﻩﺎﮕﺘﺳﺩ Hewlett

(4)

١١٦ / ﺏﻮﻨﺟ ﺐﻃ

ﻩﺭﺎﻤﺷ ﻢﺘﻔﻫ ﻝﺎﺳ ۱

/ ﺭﻮﻳﺮﻬﺷ ۱۳۸۳

packard ﻝﺪﻣ

١٥٠٠ ﺖﻋﺮﺳ ﺎﺑ ٥٠

ﺘﻣ ﻲﻠﻴﻣ ﻭ ﻪﻴﻧﺎﺛ ﺭﺩ ﺮ

ﺖﻴﺳﺎﺴﺣ ١٠

ﻭ ﺪﻳﺩﺮﮔ ﺖﺒﺛ ﺖﻟﻭ ﻲﻠﻴﻣ ﻚﻳ ﺮﺑﺍﺮﺑ ﺮﺘﻣ ﻲﻠﻴﻣ

ﻱﺪﻨﻠﺑ ﺭﺍﻮﻧ ﻥﺎﻳﺎﭘ ﺭﺩ ﺲﭙﺳ (Long lead)

ﻕﺎﻘﺘﺷﺍ ﻱﻭﺭ

ﻲﺳﺭﺮﺑ ﻱﺍﺮﺑ ﺖﺳﺍ ﻚﭼﻮﻛ ﻱﺎﻬﻣﺍﺩ ﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻪﻛ II ﺪﺷ ﻪﺘﻓﺮﮔ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ )

۹ .(

ﻭ ﺲﻧﺎﻳﺭﺍﻭ ﺰﻴﻟﺎﻧﺁ ﻱﺭﺎﻣﺁ ﻥﻮﻣﺯﺁ ﺯﺍ ﻲﺳﺭﺮﺑ ﻦﻳﺍ ﺭﺩ

ﻦﻴﮕﻧﺎﻴﻣ ﻪﺴﻳﺎﻘﻣ ﻥﻮﻣﺯﺁ ﺘﺳﺍ ﺎﻫ

ﺪﻳﺩﺮﮔ ﻩﺩﺎﻔ .

ﺘﻧ ﺞﻳﺎ : ﻩﻭﺮﮔ ﻱﺎﻬﮕﺳ ١

ﻪﻛ ١ / ٠ ﺏﺮﻘﻋ ﻢﺳ ﻡﺮﮔ ﻲﻠﻴﻣ

ﻖﻳﺎﻗﺩ ﺭﺩ ﺪﻧﺩﻮﺑ ﻩﺩﺮﻛ ﺖﻓﺎﻳﺭﺩ ﻥﺪﺑ ﻥﺯﻭ ﻡﺮﮔﻮﻠﻴﻛ ﺮﻫ ﻱﺍﺮﺑ ٦٥ ، ٧٨ ، ١٠٥ ﻭ ١٨٠ ﻒﻠﺗ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﻪﻘﻴﻗﺩ

ﺪﻧﺪﻳﺩﺮﮔ . ﻦﻳﺍ ﺭﺩ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﮒﺮﻣ ﻥﺎﻣﺯ ﻞﻗﺍﺪﺣ

ﻩﻭﺮﮔ ٦٥ ﺮﺜﻛﺍﺪﺣ ﻭ ﻪﻘﻴﻗﺩ ١٨٠

ﺩﻮﺑ ﻪﻘﻴﻗﺩ .

ﮓﺳ ﺔﻤﻫ ﻩﻭﺮﮔ ﻱﺎﻫ

٢ ﻛ ﻪ ٠٥ / ٠ ﻢﺳ ﻡﺮﮔ ﻲﻠﻴﻣ

ﺭﺩ ﺪﻧﺩﻮﺑ ﻩﺩﺮﻛ ﺖﻓﺎﻳﺭﺩ ﻥﺪﺑ ﻥﺯﻭ ﻡﺮﮔﻮﻠﻴﻛ ﺮﻫ ﻱﺍﺮﺑ ﺏﺮﻘﻋ

ﻖﻳﺎﻗﺩ ٨٦ ، ٩٧ ، ١٢٥ ﻭ ١٨٩ ﻒﻠﺗ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﻪﻘﻴﻗﺩ

ﺪﻧﺪﺷ . ﻩﻭﺮﮔ ﻦﻳﺍ ﺭﺩ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﮒﺮﻣ ﻥﺎﻣﺯ ﻞﻗﺍﺪﺣ

٨٦ ﺮﺜﻛﺍﺪﺣ ﻭ ﻪﻘﻴﻗﺩ ١٨٩

ﺩﻮﺑ ﻪﻘﻴﻗﺩ .

ﮓﺳ ﻩﻭﺮﮔ ﻱﺎﻫ ٣

ﻪﻛ ٠١ / ٠ ﻢﺳ ﻡﺮﮔ ﻲﻠﻴﻣ

ﻠﻴﻛ ﺮﻫ ﻱﺍﺮﺑ ﺏﺮﻘﻋ ﺪﻧﺩﻮﺑ ﻩﺩﺮﻛ ﺖﻓﺎﻳﺭﺩ ﻥﺪﺑ ﻥﺯﻭ ﻡﺮﮔﻮ

ﺭﺍﺮﻗ ﺮﻈﻧ ﺖﺤﺗ ﻪﺘﻔﻫ ﻚﻳ ﺕﺪﻣ ﻪﺑ ﻭ ﺪﻧﺪﻧﺎﻣ ﻩﺪﻧﺯ ﻲﮕﻤﻫ ﺪﺸﻧ ﻩﺪﻫﺎﺸﻣ ﺎﻬﻧﺁ ﺭﺩ ﻲﺗﺎﻔﻠﺗ ﻲﻟﻭ ﺪﻨﺘﺷﺍﺩ .

ﺎﺑ ﺮﻴﻴﻐﺗ ﻪﻧﻮﮕﭽﻴﻫ

ﮓﺳ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺭﺩ ﻪﻌﻟﺎﻄﻣ ﺕﺪﻣ ﻝﻮﻃ ﺭﺩ ﻲﺘﻴﻤﻫﺍ ﺪﺸﻧ ﻩﺪﻳﺩ ﺪﻫﺎﺷ ﻩﻭﺮﮔ ﻱﺎﻫ .

ﻲﺳﺭﺮﺑ ﻪﺑ ﻲﻜﻳﺰﻴﻓ ﻪﻨﻳﺎﻌﻣ ﺭﺩ

ﭘ ﺐﻠﻗ ﻥﺎﺑﺮﺿ ﺩﺍﺪﻌﺗ ﺕﺍﺮﻴﻴﻐﺗ ﺪﺷ ﻪﺘﺧﺍﺩﺮ

. ﻩﺩﺎﻔﺘﺳﺍ ﺎﺑ ﻪﭼ ﺮﮔﺍ

ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ﻢﻫ ﻭ ﻱﺩﺭﺎﻜﻳﺩﺍﺮﺑ ﻢﻫ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺭﺍﻮﻧ ﺯﺍ ﻱﺎﻬﻫﻭﺮﮔ ﺭﺩ ١

ﻭ ٢ ﻩﻭﺮﮔ ﺭﺩ ﻭ ﺪﻳﺩﺮﮔ ﻩﺪﻫﺎﺸﻣ ٣

ﺰﻴﻧ

ﺪﺷ ﻩﺪﻳﺩ ﻱﺩﺭﺎﻜﻴﻛﺎﺗ .

ﻥﺎﺑﺮﺿ ﺩﺍﺪﻌﺗ ﺭﺩ ﻦﻴﮕﻧﺎﻴﻣ ﺕﺍﺮﻴﻴﻐﺗ ﺎﻣﺍ

ﻱﺎﻬﻫﻭﺮﮔ ﺭﺩ ﻢﺳ ﻖﻳﺭﺰﺗ ﺯﺍ ﺲﭘ ﻭ ﻞﺒﻗ ﻱﺎﻬﻧﺎﻣﺯ ﺭﺩ ﺐﻠﻗ ﻲﻨﻌﻣ ﻪﻧﺎﮔﺭﺎﻬﭼ ﺩﻮﺒﻧ ﺭﺍﺩ

) ٠٥ / ٠ P › .(

ﺝﺍﻮﻣﺍ ﻞﻜﺷ ﻭ ﻲﺒﻠﻗ ﻲﻤﺘﻳﺭﺁ ﺕﺍﺮﻴﻴﻐﺗ :

(5)

١١٧

(6)

١١٨ / ﺏﻮﻨﺟ ﺐﻃ

ﻱﺎﻬﻫﻭﺮﮔ ﺭﺩ ﻲﻧﻮﮔﺎﻧﻮﮔ ﻱﺎﻬﻤﺘﻳﺭﺁ ١

، ٢ ﻭ ٣ ﻲﺳﺭﺮﺑ ﺩﺭﻮﻣ

ﺪﺷ ﻩﺪﻫﺎﺸﻣ .

ﻲﺳﻮﻨﻴﺳ ﻲﻤﺘﻳﺭﺁ ﻪﻛ ﻲﺋﺎﺠﻧﺁ ﺯﺍ ﻚﻳ ،ﻲﺴﻔﻨﺗ

ﮓﺳ ﺮﺘﺸﻴﺑ ﺭﺩ ﻲﻌﻴﺒﻃ ﻲﻤﺘﻳﺭﺁ ﻲﻣ ﻢﻟﺎﺳ ﻱﺎﻫ

ﺪﺷﺎﺑ ) ﺮﻳﻮﺼﺗ

٢ .(

ﮓﺳ ﻡﺎﻤﺗ ﺭﺩ ﻦﻳﺍﺮﺑﺎﻨﺑ ﺪﺷ ﻩﺪﻳﺩ ﺎﻫ

. ﻤﺘﻳﺭﺁ ﻲ ﻲﻳﺎﻫ ﻪﻛ ﺭﺩ

ﺯﺍ ﺲﭘ ﻖﻴﻘﺤﺗ ﻦﻳﺍ ﺭﺩ ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ ﺏﺮﻘﻋ ﻢﺳ ﻖﻳﺭﺰﺗ ﺮﺛﺍ ﺪﻨﺗﺭﺎﺒﻋ ﺪﻳﺩﺮﮔ ﺺﺨﺸﻣ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﻱﺎﻫﺭﺍﻮﻧ ﻲﺳﺭﺮﺑ ﺯﺍ : ﻪﺟﺭﺩ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻙﻮﻠﺑ ٢

ﻲﻨﻄﺑ ﺍﺮﻓ ،

(Ventricular escape) ﻪﺟﺭﺩ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻙﻮﻠﺑ ﻭ

٢ ،ﺪﻳﺪﺷ ﻱﺩﺭﺎﻜﻳﺩﺍﺮﺑ ،ﻲﻨﻄﺑ ﻱﺩﺭﺎﻜﻳﺩﺍﺮﺑ ،ﻲﻨﻄﺑ ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ،

ﺽﺎﺒﻘﻧﺍ ﺑ ﺱﺭﺩﻭﺯ ﻱﺎﻫ ﻲﻨﻄﺑ ﻥﻮﻴﺳﻼﻳﺮﺒﻴﻓ ﻭ ﻲﻨﻄ

. ﻪﻴﻠﻛ

ﻞﻣﺎﺷ ﺝﺍﻮﻣﺍ ﻞﻜﺷ ﺕﺍﺮﻴﻴﻐﺗ ﻩﺍﺮﻤﻫ ﻪﺑ ﻲﺒﻠﻗ ﻲﻤﺘﻳﺭﺁ ﺕﺍﺮﻴﻴﻐﺗ ﺝﺍﻮﻣﺍ ﻞﻜﺷ ﺭﺩ ﻩﺪﺷ ﺩﺎﺠﻳﺍ ﺕﺍﺮﻴﻴﻐﺗ ﺲﻜﻠﭙﻤﻛ ،P

ﻭQRS

ﺪﺷ ﻩﺪﻫﺎﺸﻣT )

ﺮﻳﻭﺎﺼﺗ ٣ ، ٤ ، ٥ ، ٦ ، ٧ ﻭ ٨ .(

ﺤﺑ ﺚ : ﻩﺪﻳﺰﮔ ﺩﺮﻓ ﺭﺩ ﻲﻔﻠﺘﺨﻣ ﺕﺍﺮﻴﻴﻐﺗ ﺩﺎﺠﻳﺍ ﺐﺒﺳ ﺏﺮﻘﻋ ﻢﺳ

ﻲﻣ ﻩﺪﺷ ﺩﺩﺮﮔ . ﺖﻴﻤﻫﺍ ﺯﺍ ﻪﭽﻧﺁ ﻩﮋﻳﻭ

ﺖﺳﺍ ﺭﺍﺩﺭﻮﺧﺮﺑ ﻱﺍ

ﺖﺳﺍ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ﺯﻭﺮﺑ ﻲﮕﻧﻮﮕﭼ .

ﺍﺪﺘﺑﺍ ﺭﺩ ﺏﺮﻘﻋ ﻢﺳ ﻲﻣ ﻚﻴﺗﺎﭙﻤﺳﺍﺭﺎﭘ ﺏﺎﺼﻋﺍ ﻢﺘﺴﻴﺳ ﺮﺑ ﺍﺭﺬﮔ ﻱﺮﺛﺍ

ﻭ ﺩﺭﺍﺬﮔ

ﻲﻣ ﻲﻜﻳﮊﺮﻨﻴﻠﻛ ﻱﺎﻬﺘﻴﻟﺎﻌﻓ ﺐﺒﺳ ﺩﺩﺮﮔ

. ﻚﻳﺮﺤﺗ ﺎﺑ ﻪﻣﺍﺩﺍ ﺭﺩ

ﻲﻣ ﺐﺒﺳ ﺍﺭ ﻚﻳﮊﺮﻧﺭﺩﺁ ﺕﺍﺮﺛﺍ ﻚﻴﺗﺎﭙﻤﺳ ﺏﺎﺼﻋﺍ ﻲﻧﻻﻮﻃ ﺩﻮﺷ . ﺩﺎﻳﺩ ﺯﺍ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﺯﺍ ﻱﺭﺎﻴﺴﺑ ﺩﺭﺍﻮﻣ ﺭﺩ ﺢﺷﺮﺗ

ﻲﭘﺍﺭﻮﻧ ﻞﻣﺎﺷ ﺎﻬﻨﻴﻣﻵﻮﻜﺗﺎﻛ ﻲﭘﺍ ﻭ ﻦﻳﺮﻔﻧ

ﻱﺎﻬﺘﻴﻟﻮﺑﺎﺘﻣ ﻭ ﻦﻳﺮﻔﻧ

ﺖﺳﺍ ﻩﺪﺷ ﻩﺪﻫﺎﺸﻣ ﻥﻮﺧ ﺭﺩ ﻥﺁ ﺯﺍ ﻞﺻﺎﺣ .

ﻥﺍﺰﻴﻣ ﺩﺎﻳﺩﺯﺍ

ﺏﺎﺼﻋﺍ ﻢﺘﺴﻴﺳ ﺮﺑ ﺏﺮﻘﻋ ﻢﺳ ﺮﺛﺍ ﺔﺠﻴﺘﻧ ﺍﺭ ﺩﺍﻮﻣ ﻦﻳﺍ ﺢﺷﺮﺗ ﻲﻣ ﻱﻮﻴﻠﻛ ﻕﻮﻓ ﺩﺪﻏ ﻱﺰﻛﺮﻣ ﺖﻤﺴﻗ ﻭ ﻚﻴﺗﺎﭙﻤﺳ ﺭﺎﻛﺩﻮﺧ ﺪﻨﻧﺍﺩ . ﻪﻛ ﺪﻧﺭﺍﺩ ﻲﻧﻮﮔﺎﻧﻮﮔ ﺹﺍﻮﺧ ﻒﻠﺘﺨﻣ ﻱﺎﻬﺑﺮﻘﻋ ﻢﺳ

ﻦﻜﻤﻣ ﺎﻳ ﻚﻴﺴﻛﻮﺗﻮﻳﺩﺭﺎﻛ ،ﻚﻴﺴﻛﻮﺗﻭﺭﻮﻧ ﺖﺳﺍ

ﺪﻨﺷﺎﺑ ﻚﻴﺴﻛﻮﺗﻮﻤﻫ .

ﻪﻌﻟﺎﻄﻣ ﻦﻳﺍ ﺭﺩ ﺮﻈﻧ ﺩﺭﻮﻣ ﺏﺮﻘﻋ ﻢﺳ

) ﺱﻮﺗﻮﺑﻮﺘﻧﺩﺍ (

ﺹﺍﻮﺧ ﻚﻴﺴﻛﻮﺗﻭﺭﻮﻧ ﻭ ﻚﻴﺴﻛﻮﺗﻮﻳﺩﺭﺎﻛ

ﺩﺭﺍﺩ ) ۳

‐ ۲ ، ۶ ، ۱۷

‐ ۱۰ .(

ﻢﺳ ﻚﻳﮊﺮﻨﻴﻠﻛ ﺕﺍﺮﺛﺍ :

ﺪﻨﻧﺎﻣ ﻚﻴﺗﺎﭙﻤﺳﺍﺭﺎﭘ ﺏﺎﺼﻋﺍ ﻚﻳﺮﺤﺗ ﺎﺑ ﺍﺪﺘﺑﺍ ﺏﺮﻘﻋ ﻢﺳ ﻳﺍ ﻱﺎﻬﺘﻧﺍ ﺯﺍ ﻦﻴﻟﻮﻛ ﻞﻴﺘﺳﺍ ﺢﺷﺮﺗ ﺚﻋﺎﺑ ﮒﺍﻭ ﺐﺼﻋ ﻦ

ﻲﻣ ﺏﺎﺼﻋﺍ ﺯﻭﺮﺑ ﺐﺒﺳ ﺩﻮﺧ ﻪﺑﻮﻧ ﻪﺑ ﻦﻴﻟﻮﻛ ﻞﻴﺘﺳﺍ ﻪﻛ ﺩﺩﺮﮔ

(7)

١١٩

ﺩﻮﺷ ﻲﻣ ﻲﻜﻳﮊﺮﻨﻴﻠﻛ ﻱﺎﻬﺘﻴﻟﺎﻌﻓ )

۱۶ ﻭ ١۸ .(

ﻲﻗﻭﺮﻋ ﻲﺒﻠﻗ ﺕﺍﺮﻴﻴﻐﺗ :

ﻩﺪﻳﺩ ﮒﺍﻭ ﺐﺼﻋ ﻚﻳﺮﺤﺗ ﺮﺛﺍ ﺭﺩ ﻲﻗﻭﺮﻋ ﻲﺒﻠﻗ ﺕﺍﺮﻴﻴﻐﺗ ﺪﺷ . ﻦﻳﺍ ﻱﺎﻫ ﻪﺧﺎﺷ ﻱﺎﻬﺘﻧﺍ ﺯﺍ ﮒﺍﻭ ﺐﺼﻋ ﻚﻳﺮﺤﺗ ﺎﺑ

ﺩﻮﺷ ﻲﻣ ﺩﺍﺯﺁ ﻦﻴﻟﻮﻛ ﻞﻴﺘﺳﺍ ﺏﺎﺼﻋﺍ .

ﺐﺒﺳ ﻦﻴﻟﻮﻛ ﻞﻴﺘﺳﺍ

ﻮﻳ ﺶﻳﺍﺰﻓﺍ ﻪﺠﻴﺘﻧ ﺭﺩ ﻩﺪﻳﺩﺮﮔ ﺐﻠﻗ ﻪﻠﻀﻋ ﺖﻓﺎﺑ ﺭﺩ ﻢﻴﺳﺎﺘﭘ ﻥ

ﻱﺰﻴﻠﻫﺩ ﻲﺳﻮﻨﻴﺳ ﻩﺮﮔ ﻥﺪﺷ ﻩﺰﻳﺭﻼﭘﻮﭙﻴﻫ ﺶﻳﺍﺰﻓﺍ ﺐﺒﺳ ﺶﻫﺎﻛ ﻥﺁ ﺯﺍ ﻩﺭﺩﺎﺻ ﻱﺎﻬﺴﻟﺎﭙﻤﻳﺍ ﺖﻠﻋ ﻦﻴﻤﻫ ﻪﺑ ،ﻩﺪﺷ ﻲﻣ ﺪﺑﺎﻳ . ﻚﻳﺮﺤﺗ ﺶﻫﺎﻛ ﺐﺒﺳ ﻦﻴﻟﻮﻛ ﻞﻴﺘﺳﺍ ﻦﻴﻨﭽﻤﻫ ﻩﺮﮔ ﻭ ﺎﻫﺰﻴﻠﻫﺩ ﺔﻠﻀﻋ ﻦﻴﺑ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻱﺎﻫﺮﺒﻴﻓ ﻱﺮﻳﺬﭘ

ﻝﺎﻘﺘﻧﺍ ﻪﺠﻴﺘﻧ ﺭﺩ ،ﻩﺪﺷ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻞﺧﺍﺩ ﻪﺑ ﺲﻟﺎﭙﻤﻳﺍ

ﺪﺑﺎﻳ ﻲﻣ ﺶﻫﺎﻛ ﺰﻴﻧ ﺎﻬﻨﻄﺑ .

ﺶﻳﺍﺰﻓﺍ ﻞﻴﻟﺩ ﻪﺑ ﺮﮕﻳﺩ ﻱﻮﺳ ﺯﺍ

ﻪﺑ ﺀﺎﺸﻏ ﻱﺮﻳﺬﭘﺫﻮﻔﻧ K⁺

ﻊﻳﺮﺳ ﺖﺸﻧ ﺐﺒﺳ K⁺

ﺝﺭﺎﺧ ﻪﺑ

ﺩﺩﺮﮔ ﻲﻣ .

ﺐﺒﺳ ﺰﻴﻧ ﺍﺭ ﺎﻬﺘﻓﺎﺑ ﻱﺮﻳﺬﭘ ﻚﻳﺮﺤﺗ ﺶﻫﺎﻛ

ﻲﻣ ﺩﻮﺷ . ﻱﺎﻬﺴﻟﺎﭙﻤﻳﺍ ﺶﻫﺎﻛ ﺐﺒﺳ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ﻪﻋﻮﻤﺠﻣ

ﺩﺩﺮﮔ ﻲﻣ ﺐﻠﻗ ﻲﺿﺎﺒﻘﻧﺍ ﺕﺭﺪﻗ ﺶﻫﺎﻛ ﻭ ﻲﺒﻠﻗ .

ﻦﻳﺍ ﻪﻴﻠﻛ

ﺮﻴﻴﻐﺗ ﻪﻛ ﺩﻮﺷ ﻲﻣ ﺐﻠﻗ ﺭﺩ ﻒﻠﺘﺨﻣ ﻱﺎﻬﻤﺘﻳﺭﺁ ﻪﺑ ﺮﺠﻨﻣ ﺕﺍ

ﺖﺳﺍ ﻱﺭﺎﻜﻳﺩﺍﺮﺑ ﺎﻬﻧﺁ ﺓﺪﻤﻋ .

ﺰﻴﻧ ﻪﺘﻓﺮﺸﻴﭘ ﻲﺳﻮﻨﻴﺳ ﻲﻤﺘﻳﺭﺁ

ﺪﻫﺩ ﻲﻣ ﺥﺭ ﮒﺍﻭ ﺐﺼﻋ ﻚﻳﺮﺤﺗ ﺮﺛﺍ ﺭﺩ .

ﺐﺼﻋ ﻪﭽﻧﺎﻨﭼ

ﻩﺮﮔ ﺭﺩ ﺎﻬﺿﺎﺒﻘﻧﺍ ﻞﻣﺎﻛ ﻒﻗﻮﺗ ﺩﻮﺷ ﻚﻳﺮﺤﺗ ﺕﺪﺷ ﻪﺑ ﮒﺍﻭ ﻩﺮﮔ ﺯﺍ ﺲﻟﺎﭙﻤﻳﺍ ﻝﺎﻘﺘﻧﺍ ﻞﻣﺎﻛ ﺩﺍﺪﺴﻧﺍ ﺎﻳ ﻭ ﻱﺰﻴﻠﻫﺩ ﻲﺳﻮﻨﻴﺳ ﺐﺒﺳ ﺍﺭ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﺩﻮﺷ ﻲﻣ

) ١۹ ( . ﻪﻛ ﻲﺗﺭﻮﺻ ﺭﺩ

ﺩﺍﺪﺴﻧﺍ ﺎﻳ ﻭ ﻱﺰﻴﻠﻫﺩ ﻲﺳﻮﻨﻴﺳ ﻩﺮﮔ ﺭﺩ ﺎﻬﺿﺎﺒﻘﻧﺍ ﻞﻣﺎﻛ ﻒﻗﻮﺗ ﺕﺪﻣ ﻱﺍﺮﺑ ﺎﻬﻨﻄﺑ ﻥﺎﺑﺮﺿ ،ﺪﻫﺩ ﺥﺭ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻩﺮﮔ ﻞﻣﺎﻛ ٤ ﺎﺗ ١٠ ،ﻱﺍ ﻪﻄﻘﻧ ﺕﺪﻣ ﻦﻳﺍ ﺯﺍ ﺲﭘ ﺎﻣﺍ ،ﻩﺪﺷ ﻒﻗﻮﺘﻣ ﻪﻴﻧﺎﺛ

ﮋﻨﻴﻛﺭﻮﭘ ﻱﺎﻫﺮﺒﻴﻓ ﺭﺩ )

ﻪﺘﺷﺭ ﺭﺩ ﹰﻻﻮﻤﻌﻣ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻱﺎﻫ

(

ﻣ ﺪﻴﻟﻮﺗ ﺍﺭ ﺹﻮﺼﺨﺑ ﻢﺘﻳﺭ ﻚﻳ ﻲ

ﺪﻨﻛ . ﻪﺑ ﻡﻮﺳﻮﻣ ﻩﺪﻳﺪﭘ ﻦﻳﺍ

ﻲﻨﻄﺑ ﺭﺍﺮﻓ (Ventricular escape)

ﺖﺳﺍ ﻲﻨﻄﺑ ﺰﻳﺮﮔ ﺎﻳ

) ١۹ ( . ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺝﺍﻮﻣﺍ ﻞﻜﺷ ﺭﺩ ﻲﻔﻠﺘﺨﻣ ﺕﺍﺮﻴﻴﻐﺗ

ﻲﻣ ﻩﺪﻳﺩ ﻲﮔﺪﻳﺰﮔ ﺏﺮﻘﻋ ﻝﺎﺒﻧﺪﺑ ﺩﻮﺷ

. ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ﻲﺳﺭﺮﺑ

ﺪﻨﻛ ﻲﻣ ﻢﺳ ﺕﺍﺮﺛﺍ ﻱﺮﻴﮕﻫﺭ ﻪﺑ ﻲﻧﺍﻭﺍﺮﻓ ﻚﻤﻛ .

ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺕﺍﺮﻴﻴﻐﺗ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺭﺩ

ﺘﻣ ﻪﻛ ﺪﻳﺩﺮﮔ ﻩﺪﻫﺎﺸﻣ ﺶﻳﺎﻣﺯﺁ ﺩﺭﻮﻣ ﻱﺎﻬﮕﺳ ﺭﺩ ﻱﺩﺪﻌ ﻒﻗﻮﺗ ﺎﻳ ﻱﺰﻴﻠﻫﺩ ﻲﺳﻮﻨﻴﺳ ﻙﻮﻠﺑ ﺯﺍ ﺪﻧﺩﻮﺑ ﺕﺭﺎﺒﻋ ﺽﺎﺒﻘﻧﺍ ﻭ ﻲﺳﻮﻨﻴﺳ ﻱﺩﺭﺎﻜﻳﺩﺍﺮﺑ ،ﻱﺩﺭﺎﻜﻳﺩﺍﺮﺑ ،ﻲﺳﻮﻨﻴﺳ ﻲﻨﻄﺑ ﺱﺭﺩﻭﺯ

(Premature ventricular

contraction) .

ﺕﺍﺮﻴﻴﻐﺗ ﻢﻴﺳﺎﺘﭘ ﺪﻳﺪﺷ ﺶﻳﺍﺰﻓﺍ ﻞﻴﻟﺩ ﻪﺑ

ﻲﻣ ﺩﻮﺟﻮﺑ ﺝﺍﻮﻣﺍ ﻞﻜﺷ ﺭﺩ ﻱﺪﻳﺪﺷ ﺪﻨﺗﺭﺎﺒﻋ ﻪﻛ ﺪﻳﺁ

ﺯﺍ

ﻪﻠﺻﺎﻓ ﺶﻳﺍﺰﻓﺍ ﺝﻮﻣ ﻥﺪﺷ ﻚﻳﺭﺎﺑ ﻭ ﺪﻨﻠﺑ ،P-R

ﻦﻬﭘ ،T

ﻪﻌﻄﻗ ﻥﺪﺷ ﺝﻮﻣ ﻥﺪﺷ ﻦﻬﭘ ،S-T

ﺖﻳﺎﻬﻧ ﺭﺩ ﻭ QRS

ﺝﻮﻣ ﻥﺪﺷ ﺪﻳﺪﭘﺎﻧ ﺝﻮﻣ ﻥﺪﺷ ﮒﺭﺰﺑ ﻭP

ﻪﺑS )R ﺮﻳﻭﺎﺼﺗ

٣ ﻲﻟﺍ ٨ .(

ﺵﺭﺍﺰﮔ ﺍﺭ ﻕﻮﻓ ﺕﺍﺮﻴﻴﻐﺗ ﻱﺩﺪﻌﺘﻣ ﻥﺍﺮﮕﺸﻫﻭﮋﭘ

ﺪﻧﺍ ﻩﺩﺮﻛ ) ۱ ، ۷

‐ ۵ ، ۱۵

‐ ۱۰ ، ۱۸ ، ۲۵

‐ ۲۰ .(

ﺍ ﻢﺳ ﻚﻳﮊﺮﻧﺭﺩﺁ ﺕﺍﺮﺛ :

ﺳ ﻪﻣﺍﺩﺍ ﺭﺩ ﺏﺎﺼﻋﺍ ﻱﻭﺭ ﺮﺑ ﺮﻴﺛﺄﺗ ﺎﺑ ﺏﺮﻘﻋ ﻢ

ﺎﻫﺭ ﺐﺒﺳ ﻱﻮﻴﻠﻛ ﻕﻮﻓ ﺓﺪﻏ ﻱﺰﻛﺮﻣ ﺶﺨﺑ ﻭ ﻚﻴﺗﺎﭙﻤﺳ ﺯﺎﺳ

ﻝﻮﻜﺗﺎﻛ ﻱﺯﺎﺳ ﺎﻬﻨﻴﻣﺁ

) ﻲﭘﺍ ﻲﭘﺍﺭﻮﻧ ﻭ ﻦﻳﺮﻔﻧ ﻦﻳﺮﻔﻧ

( ﺩﻮﺷ ﻲﻣ .

ﻝﻮﻜﺗﺎﻛ ﺩﺮﻜﻠﻤﻋ ﻞﻴﻟﺩ ﻪﺑ ﻢﺳ ﺕﺍﺮﻴﺛﺄﺗ ﺓﺪﻤﻋ ﺪﺷﺎﺑ ﻲﻣ ﺎﻬﻨﻴﻣﺁ

.

ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ،ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ﻞﻣﺎﺷ ﻪﻠﺣﺮﻣ ﻦﻳﺍ ﺭﺩ ﻲﺒﻠﻗ ﺕﺍﺮﻴﻴﻐﺗ ﻫﺩ ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ،ﻲﺳﻮﻨﻴﺳ ﻭ ،ﻲﻨﻄﺑ ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ،ﻱﺰﻴﻠ

ﺩﻮﺑ ﻲﻨﻄﺑ ﻥﻮﻴﺳﻼﻳﺮﺒﻴﻓ )

ﺮﻳﻭﺎﺼﺗ ٣ ﻲﻟﺍ ٨ .(

ﻝﻮﻜﺗﺎﻛ ﻪﻛ ﺖﺳﺍ ﻦﻳﺍ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ﻞﻴﻟﺩ ﻱﺎﻬﻨﻴﻣﺁ

ﻩﺪﻧﺮﻴﮔ ﻱﻭﺭ ﺮﺑ ﺮﺛﺍ ﺎﺑ ﻚﻴﺗﺎﭙﻤﺳ ﺏﺎﺼﻋﺍ ﻱﺎﻬﺘﻧﺍ ﺯﺍ ﻩﺪﺷ ﺩﺍﺯﺁ ﺮﺑ ﻱﺮﻳﺬﭘﺫﻮﻔﻧ ﺶﻳﺍﺰﻓﺍ ﺐﺒﺳ ﺐﻠﻗ ﻚﻳﮊﺮﻧﺭﺩﺁﺎﺘﺑ ﻱﺎﻫ ﺶﻳﺍﺰﻓﺍ ﺐﺟﻮﻣ ﻪﺠﻴﺘﻧ ﺭﺩ ﻩﺪﺷ ﻢﻳﺪﺳ ﻭ ﻢﻴﺴﻠﻛ ﻱﺎﻬﻧﻮﻳ ﺖﻋﺮﺳ ﺩﻮﺷ ﻲﻣ ﻱﺰﻴﻠﻫﺩ ﻲﺳﻮﻨﻴﺳ ﻩﺮﮔ ﺯﺍ ﺲﻟﺎﭙﻤﻳﺍ .

ﻝﻮﻜﺗﺎﻛ ﻡﺎﻤﺗ ﻱﺮﻳﺬﭘ ﻚﻳﺮﺤﺗ ﺶﻳﺍﺰﻓﺍ ﺐﺒﺳ ﻦﻴﻨﭽﻤﻫ ﺎﻬﻨﻴﻣﺁ

ﺩﺩﺮﮔ ﻲﻣ ﺐﻠﻗ ﻱﺎﻬﺘﻤﺴﻗ .

ﺶﻳﺍﺰﻓﺍ ﺐﺒﺳ ﻪﻠﻤﺟ ﺯﺍ

ﻚﻳﺮﺤﺗ ﺩﻮﺷ ﻲﻣ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻩﺮﮔ ﺭﺩ ﻱﺮﻳﺬﭘ .

ﻱﻮﺳ ﺯﺍ

ﻝﻮﻜﺗﺎﻛ ﺮﮕﻳﺩ ﺩﺭﺎﻛﻮﻴﻣ ﺎﻳ ﺐﻠﻗ ﺔﻠﻀﻋ ﺮﺑ ﺮﻴﺛﺄﺗ ﺎﺑ ﺎﻬﻨﻴﻣﺁ

ﻻﺎﺑ ﺍﺭ ﻲﻧﻼﻀﻋ ﺖﻓﺎﺑ ﺭﺩ ﻢﺴﻴﻟﻮﺑﺎﺘﻣ ﺶﻫﺎﻛ ﺐﺒﺳ ﻭ ﻩﺩﺮﺑ

ﻱﺩﺎﻳﺯ ﻱﺎﻬﺘﻈﻠﻏ ﻊﻤﺠﺗ ﻭ ﺐﻠﻗ ﺭﺩ ﺰﻧﮊﻭﺪﻧﺁ ﻱﺎﻬﻨﻴﻣﺁ ﺮﻳﺎﺧﺫ ﺐﻠﻗ ﺖﻓﺎﺑ ﺭﺩ ﺎﻫﺪﻴﭙﻴﻟﻮﻔﺴﻓ ﻭ ﺩﺍﺯﺁ ﺏﺮﭼ ﻱﺎﻫﺪﻴﺳﺍ ﺯﺍ ﻲﻣ ،ﺩﻭﺭ ﻲﻣ ﻻﺎﺑ ﺩﺭﺎﻛﻮﻴﻣ ﺭﺩ ﻥﮋﻴﺴﻛﺍ ﻑﺮﺼﻣ ﻪﺠﻴﺘﻧ ﺭﺩ ﺩﻮﺷ ﻞﻴﻟﺩ ﻪﺑ ،ﻥﮋﻴﺴﻛﺍ ﻱﺍﺮﺑ ﻑﺮﺼﻣ ﺶﻳﺍﺰﻓﺍ ﻦﻳﺍ ﻲﺗﺪﻣ ﺯﺍ ﺲﭘ

ﻲﺴﻛﻮﭙﻴﻫ ﺩﺎﺠﻳﺍ ﺐﺒﺳ ﺱﺮﺘﺳﺩ ﺭﺩ ﻥﮋﻴﺴﻛﺍ ﻥﺩﻮﺒﻧ ﻲﻓﺎﻛ ﺭﺩ

ﺮﺠﻨﻣ ﺖﻟﺎﺣ ﻦﻳﺍ ﻦﺘﻓﺎﻳ ﻪﻣﺍﺩﺍ ﺕﺭﻮﺻ ﺭﺩ ﻭ ﻩﺪﺷ ﺐﻠﻗ ﺖﻓﺎﺑ ﻲﻤﻜﺴﻳﺍ ﻪﺑ )

١١ ﻭ ١٥ ( ﺩﺩﺮﮔ ﻲﻣ ﺱﻮﺘﻛﺭﺎﻔﻧﺍ ﺖﻳﺎﻬﻧ ﺭﺩ ﻭ )

١١ ، ٥ ﻭ ١٦ .(

ﺩﺎﺠﻳﺍ ﺐﺒﺳ ﻪﻳﻮﻧﺎﺛ ﺭﻮﻃ ﻪﺑ ﺰﻴﻧ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ

(8)

١٢٠ / ﺏﻮﻨﺟ ﺐﻃ

ﺩﻮﺷ ﻲﻣ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺭﺩ ﻲﺗﺍﺮﻴﻴﻐﺗ ) .

ﺮﻳﻮﺼﺗ ٧ ( ﻪﺑ

ﻥﻮﻴﺳﻻﻭﺮﺒﻴﻓ ﻲﻠﺻﺍ ﻞﻴﻟﺩ ،ﺩﺭﺎﻛﻮﻴﻣ ﻲﻤﻜﺴﻳﺍ ﻪﻧﻮﻤﻧ ﻥﺍﻮﻨﻋ ﺖﺳﺍ ﻲﻨﻄﺑ )

١٩ ( ﺯﻭﺮﺑ ﺐﺒﺳ ﻲﻌﺿﻮﻣ ﻲﻤﻜﺴﻳﺍ ﻦﻴﻨﭼ ﻢﻫ

ﺩﺩﺮﮔ ﻲﻣ ﺎﺠﺑﺎﻧ ﻱﺎﻬﻧﻮﻧﺎﻛ ﻞﻴﻜﺸﺗ ﻭ ﺱﺭﺩﻭﺯ ﻱﺎﻬﺿﺎﺒﻘﻧﺍ .

ﻲﺒﻠﻗ ﺖﺴﻳﺍ ﻭ ﺐﻴﺳﺁ ﺐﺒﺳ ﺰﻴﻧ ﺐﻠﻗ ﻲﺴﻛﻮﭙﻴﻫ

ﺩﻮﺷ ﻲﻣ . ﺝﻮﻣ ﻥﺪﺷ ﺱﻮﻜﻌﻣ ﻞﻣﺎﺷ ﺝﺍﻮﻣﺍ ﻞﻜﺷ ﺕﺍﺮﻴﻴﻐﺗ

ﺝﻮﻣ ﻥﺪﺷ ﻪﻧﻭﺭﺍﻭ ،ﻱﺰﻴﻠﻫﺩ ﻱﺩﺭﺎﻜﻴﻛﺎﺗ ﺭﺩ P ﺭﺩ ،T

ﻪﻌﻄﻗ ﻪﻣﺍﺩﺍ ﺭﺩ ﻪﻛ ﺩﺭﺎﻛﻮﻴﻣ ﻲﻤﻜﺴﻳﺍ ﺝﻮﻣ ﻭ ﻪﺘﻓﺭ ﻻﺎﺑ S-T

ﺖﻳﺎﻬﻧ ﺭﺩ ،ﻩﺪﺷ ﻮﺤﻣ ﻭ ﻪﻧﻭﺭﺍﻭ T ﺩﻮﺷ ﻲﻣ ﻪﻧﻭﺭﺍﻭQRS

.

ﻪﻌﻄﻗ ﻪﻛ ﻲﺗﺭﻮﺻ ﺭﺩ ﺝﻮﻣ ﺎﺑ ﻭ ﻩﺪﺷ ﻲﻘﻓﺍ S-T

ﻪﻳﻭﺍﺯ T

ﺖﺳﺍ ﺩﺭﺎﻛﻮﻴﻣ ﻲﻤﻜﺴﻳﺍ ﻪﻧﺎﺸﻧ ﺩﺯﺎﺴﺑ .

ﺝﻮﻣ ﺱﻮﺘﻛﺭﺎﻔﻧﺍ ﺭﺩ

ﻪﻨﻣﺍﺩ ﺶﻳﺍﺰﻓﺍ ﺕﺭﻮﺻ ﺭﺩ ﻭ ﺩﻮﺷ ﻲﻣ ﻪﺧﺎﺷ ﻭﺩ ﺎﻳ ﺰﻴﺗ T ﻢﻳﺮﺑ ﻲﻣ ﺩﺭﺎﻛﻮﻴﻣ ﺖﻓﺎﺑ ﺮﻴﮔﺍﺮﻓ ﺐﻴﺳﺁ ﻪﺑ ﻲﭘ ،QRS

) ﻭﺎﺼﺗ ﺮﻳ ٣ ﻲﻟﺍ ٨ .(

ﻪﺠﻴﺘﻧ ﻱﺮﻴﮔ :

ﻝﻭﺍ ﻪﻠﺣﺮﻣ ﺭﺩ ،ﻲﺒﺼﻋ ﻢﺘﺴﻴﺳ ﻱﻭﺭ ﺮﺑ ﺮﻴﺛﺄﺗ ﺎﺑ ﺏﺮﻘﻋ ﻢﺳ ﺭﺩ ﻚﻴﺗﺎﭙﻤﺳ ﻡﻭﺩ ﻪﻠﺣﺮﻣ ﺭﺩ ﻭ ﻚﻴﺗﺎﭙﻤﺳﺍﺭﺎﭘ ﻱﻭﺭ ﺮﺑ ﺮﺛﺍ ﺎﺑ ﺩﺩﺮﮔ ﻲﻣ ﻲﺗﻭﺎﻔﺘﻣ ﺕﺍﺮﻴﻴﻐﺗ ﺐﺒﺳ ﺩﺭﺍﻮﻣ ﻲﻀﻌﺑ .

ﻲﻠﺻﺍ ﻞﻠﻋ

ﻦﻴﻟﻮﻛ ﻞﻴﺘﺳﺍ ﺢﺷﺮﺗ ﻭ ﮒﺍﻭ ﺐﺼﻋ ﻚﻳﺮﺤﺗ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ) ﻲﻠﻛ ﻱﺎﻬﺸﻨﻛﺍﻭ ﻚﻳﮊﺮﻧ

( ﺄﺗ ﺎﺑ ﻪﻣﺍﺩﺍ ﺭﺩ ﻭ ﻱﻭﺭ ﺮﺑ ﻢﺳ ﺮﻴﺛ

ﻱﺯﺎﺳﺎﻫﺭ ،ﻱﻮﻴﻠﻛ ﻕﻮﻓ ﻩﺪﻏ ﻭ ﻚﻴﺗﺎﭙﻤﺳ ﺏﺎﺼﻋﺍ ﻝﻮﻜﺗﺎﻛ

ﺎﻬﻨﻴﻣﺁ ) ﻚﻳﮊﺮﻧﺭﺩﺁ ﻱﺎﻬﺸﻨﻛﺍﻭ (

ﻱﺯﺎﺳﺩﺍﺯﺁ ﻦﻴﻨﭽﻤﻫ ،

ﺪﺷﺎﺑ ﻲﻣ ﻥﺁ ﺶﻫﺎﻛ ﻭ ﻦﻴﻟﻮﺴﻧﺍ ﺮﺛﺍ ﺭﺎﻬﻣ ﻭ ﻝﻭﺰﻴﺗﺭﻮﻛ .

ﻑﺪﻫ ﻱﺎﻬﺘﻓﺎﺑ ﺮﺑ ﺮﺛﺍ ﺎﺑ ﺎﻬﻧﻮﻣﺭﻮﻫ ﻦﻳﺍ ﺯﺍ ﻡﺍﺪﻛ ﺮﻫ

ﺪﻨﻨﻛ ﻲﻣ ﺮﻫﺎﻇ ﺍﺭ ﻥﺎﺷﺮﺛﺍ .

ﺯﺍ ﻒﻠﺘﺨﻣ ﻝﺎﻜﺷﺍ ﻪﺑ ﺕﺍﺮﻴﺛﺄﺗ ﻦﻳﺍ

ﻪﻠﻤﺟ ﻲﻔﻠﺘﺨﻣ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻴﻨﭽﻤﻫ ﻭ ﻲﻗﻭﺮﻋ ﻲﺒﻠﻗ ﺕﺍﺮﻴﻴﻐﺗ

ﺏﺮﻘﻋ ﻝﺎﺒﻧﺩ ﻪﺑ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺝﺍﻮﻣﺍ ﻞﻜﺷ ﺭﺩ ﻲﮔﺪﻳﺰﮔ

ﻪﺑ ﻲﻧﺍﻭﺍﺮﻓ ﻚﻤﻛ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ﻲﺳﺭﺮﺑ ﻪﻛ ﺪﻳﺁ ﻲﻣ ﺪﻳﺪﭘ ﺪﻳﺎﻤﻧ ﻲﻣ ﻢﺳ ﺕﺍﺮﺛﺍ ﻱﺮﻴﮕﻫﺭ .

ﻲﻧﺍﺩﺭﺪﻗ ﻭ ﺮﻜﺸﺗ :

ﻲﻧﺎﺒﻴﺘﺸﭘ ﺮﻃﺎﺨﺑ ﺯﺍﺮﻴﺷ ﻩﺎﮕﺸﻧﺍﺩ ﻲﺸﻫﻭﮋﭘ ﻡﺮﺘﺤﻣ ﻱﺍﺭﻮﺷ ﺯﺍ ﻦﻳﺍ ﻱﺍﺮﺟﺍ ﻱﺍﺮﺑ ﻲﻟﺎﻣ ﻡﺮﺘﺤﻣ ﺖﻳﺮﻳﺪﻣ ﺯﺍ ﻦﻴﻨﭽﻤﻫ ﻭ ﻖﻴﻘﺤﺗ

ﺯﺍ ﻭ ﺕﺎﻧﺎﻜﻣﺍ ﻥﺩﺭﻭﺁ ﻢﻫﺍﺮﻓ ﺮﻃﺎﺨﺑ ﻲﻜﺷﺰﭙﻣﺍﺩ ﻩﺪﻜﺸﻧﺍﺩ ﺭﺩ ﻞﻴﻟﺩ ﻪﺑ ﻱﺯﺍﺭ ﻱﺯﺎﺳ ﻡﺮﺳ ﻭ ﻦﺴﻛﺍﻭ ﺕﺎﻘﻴﻘﺤﺗ ﻮﺘﻴﺘﺴﻧﺍ ﺩﻮﺷ ﻲﻣ ﻲﻧﺍﺩﺭﺪﻗ ﻭ ﺮﻜﺸﺗ ﺯﺎﻴﻧ ﺩﺭﻮﻣ ﻢﺳ ﻥﺩﺍﺩ ﺭﺍﺮﻗ ﺭﺎﻴﺘﺧﺍ .

ﻪﻴﻬﺗ ﺭﺩ ﻪﻛ ﻲﻠﺧﺍﺩ ﺶﺨﺑ ﺱﺎﻨﺷﺭﺎﻛ ﻱﺮﻴﻣﺍ ﺮﺻﺎﻧ ﻱﺎﻗﺁ ﺯﺍ ﻫ ﻡﺍﺮﮔﻮﻳﺩﺭﺎﻛﻭﺮﺘﻜﻟﺍ ﺐﻠﻗﺭﺍﻮﻧ ﺯﺍ ﻭ ﺪﻧﺩﻮﻤﻧ ﻱﺭﺎﻜﻤ

ﭗﻳﺎﺗ ﺮﻃﺎﺨﺑ ﻲﻫﺎﮕﻧﺎﻣﺭﺩ ﻩﻭﺮﮔ ﻲﺸﻨﻣ ﺭﻮﭙﻔﻳﺮﺷ ﻢﻧﺎﺧﺭﺎﻛﺮﺳ ﺩﻮﺷ ﻲﻣ ﻲﻧﺍﺩﺭﺪﻗ ﻭ ﺮﻜﺸﺗ ﻪﻧﺎﻤﻴﻤﺻ ﺰﻴﻧ ﻪﻟﺎﻘﻣ .

۱ . ﻥﺍﺯﺮــﻓ ﺭ ﻲــﭘ ، ﻪﻣﺎﻨﻠــﺼﻓ ،ﻥﺁ ﻱﺎﻫﺪــﻣﺎﻴﭘ ﻭ ﻲﮔﺪــﻳﺰﮔ ﺏﺮــﻘﻋ

،ﻲﮔﺪﻧﺯﺎﺳ ﻭ ﺶﻫﻭﮋﭘ ﻢﺘـﻔﻫ ﻝﺎـﺳ

) ﺭﺎﻤـﺷ ﻩ ٢٥ :(

١٣٧٢

، ٢١٥

‐

٢١٣.

2. Fowler ME. Veterinary zootoxicology. CRC Press. Inc. Boca Racton, 1993, 81-87.

3. Sherman MA. Venom Disease. Springfield, Illinois, Charles, Thomas, Pub, 1974, 27-37.

٤ . ﻥﺍﺯﺮــﻓ ﺭ ﻲــﭘ

، ﻲﻫﺎﮕــﺸﻧﺍﺩ ﺮــﺸﻧ ﺰــﻛﺮﻣ ،ﺖﺧﺎﻨــﺷ ﺏﺮــﻘﻋ ،

١٣٦٦

، ﺹ ٧ ، ١٠٣

‐ ٩٢ ، ١٥٤

‐ ١٥٥ ، ١٨٥

‐ ١٨٤ ، ٩٨

‐ ٢٠٠ .

5. Dehesa-Davila, M. Possani LD. Scorpionism and serothrapy in Mexico. Toxicon 1994; 32: 1015- 1018.

6. Radmanesh M. Androctonus Crassicauda sting and its clinical study in Iran. J Trop Med Hyg 1990;

93: 323-326.

7. Parrish HM. Analysis of 460 fatalities from venomous animals in the United States. Am J Med Sci 1963; 245: 129-141.

8. Tiwary AK, Deshpande S B. Toxicity of scorpion (Buthus tamulus) venom in

mammals is influenced by the age and species.

Toxicon 1993; 31: 1619-1622.

۹ . ﭖ ﻝ ﻲــﻠﺗ

، ﮓــﺳ ﻲﻓﺍﺮﮔﻮﻳﺩﺭﺎــﻛﻭﺮﺘﻜﻟﺍ

، ﻲــﻠﻋ ﺮــﺘﻛﺩ ﺔــﻤﺟﺮﺗ

ﻲﻧﺎﺧﺎﺿﺭ

،

،ﺯﺍﺮﻴﺷ ﻩﺎﮕﺸﻧﺍﺩ ،ﺮﺸﻧ ﺰﻛﺮﻣ

، ١٣٧٠ ﺹ ٧٥

‐ ٢٧ .

10. Amaral CFS, Barbosa AJA, Leite VH. R, et al.

Scorpion sting-induced pulmonary oedema:

evidence of increased alveolocapillary membrane permeabiltiy. Toxicon 1994; 32: 999-1003.

11. Bawaskar HS, Bawaskar PH. Cardiovascular manifestations of severe scorpion sting in India (review of 34 children). Ann Trop Paediat 1991;

11: 381-387.

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١٢١

12. Bawaskar HS, Bawaskar PH. Treatment of cardiovascular manifestations of human scorpion envenoming: is serotherapy essential? J Trop Med Hyg 1991; 94: 156-158.

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14. Bawaskar HS, Bawaskar PH. Management of the cardiovascular manifestations of poisoning by the Indian red scorpion (Mesobuthus tamulus). Br Heart J 1992. 68: 478-480.

15. Ismail M, Fatani AJY, Dabees TT.

Experimental treatment protocols for scorpion envenomation: a review of common therapies on effect of kallikrein-Kinin inhibitors. Toxicon 1992;30:1257-1279.

16. Kumar EB, Al.-Hamdani A, El. Shimy N.

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