ﺮﻬﺷﻮﺑ ﻥﺎﺘﺳﺍ ﺭﺩ ﻲﻋﺎﺨﻧ ﺕﺎﻌﻳﺎﺿ ﺎﺑ ﻥﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ *
ﺭﻮﭘ ﻲﻤﻴﻠﺳ ﻥﺎﻣﻮﻫ ﺮﺘﮐﺩ
١**
ﻉﺭﺍﺯ ﺮﻐﺻﺍ ﺮﺘﮐﺩ ، ﺕﺪﺣﻭ ﻥﻮﻳﺎﺘﮐ ﺮﺘﮐﺩ ،٢
۳
ﺮﻬﺷﻮﺑ ﻲﮑﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ ،ﻲﮑﺷﺰﭘ ﻩﺪﮑﺸﻧﺍﺩ ،ﻱﮊﻮﻟﻭﺭﻮﻧ ﺭﺎﻳﺩﺎﺘﺳﺍ١
ﺮﻬﺷﻮﺑ ﻲﮑﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ ،ﻲﮑﺷﺰﭘ ﻩﺪﮑﺸﻧﺍﺩ ،ﻲﮑﺷﺰﭘ ﻪﺘﺧﻮﻣﺁ ﺶﻧﺍﺩ٢
ﺳﺍ۳
ﺭﺎﻳﺩﺎﺘ ﻲﻧﻮﻔﻋ ﺮﻬﺷﻮﺑ ﻲﮑﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ ،ﻲﮑﺷﺰﭘ ﻩﺪﮑﺸﻧﺍﺩ ،
ﻩﺪﻴﻜﭼ :
،ﺪﺷﺎﺑ ﻲﻣ ﻲﻋﺎﺨﻧ ﺕﺎﻌﻳﺎﺿ ﺎﺑ ﻥﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻊﻳﺎﺷ ﺕﻼﮑﺸﻣ ﺯﺍ ﺖﻧﻮﻔﻋ ﺖﻧﻮﻔﻋ ﻪﻠﻤﺟ ﺯﺍ
ﻭ ﮒﺮﻣ ﻢﻬﻣ ﻞﻠﻋ ﺯﺍ ﻪﮐ ﺖﺳﺍ ﻱﺭﺍﺭﺩﺍ ﻱﺎﻫ ﺖﻧﻮﻔﻋ ﻊﻳﺎﺷ ﺭﺎﻴﺴﺑ ﻱﺎﻫ
ﺪﻨﺷﺎﺑ ﻲﻣ ﺰﻴﻧ ﻩﻭﺮﮔ ﻦﻳﺍ ﺭﺩ ﺮﻴﻣ .
ﺭﺍﺭﺩﺍ ﺖﻧﻮﻋ ﻉﻮﻴﺷ ﻲﺳﺭﺮﺑ ﺭﻮﻈﻨﻣ ﻪﺑ ﺍﺬﻟ ﻣ ﮏﻳ ﺭﺩ ،ﻱﺭﺎﻤﻴﺑ ﻞﻣﺎﻋ ﻊﻳﺎﺷ ﻡﺮﺟ ﻦﻴﻴﻌﺗ ﻭ ﻱ
ﺯﺍ ،ﻲﻌﻄﻘﻣ ﻪﻌﻟﺎﻄ ٩٧
ﻪﻌﻳﺎﺿ ﺭﺎﻤﻴﺑ
ﻧﻮﻤﻧ ،ﻲﻋﺎﺨﻧ ﻮﻴﺑ ﻲــﺘﻧﺁ ﻭ ﺰﻴﻟﺎﻧﺁ ،ﺖﺸﮐ ﺖﻬﺟ ﻱﺭﺍﺭﺩﺍ ﻪ
ﺪﺷ ﻪﻴﻬﺗ ﻡﺍﺮﮔ .
ﻥﺍﺭﺎﻤﻴﺑ ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ )
٣٥ ﻭ ﺚﻧﻮﻣ ﺮﻔﻧ ٦٢
ﺮﮐﺬﻣ ﺮﻔﻧ ( ٣١ /
±١٦ ٤٧ / ٢٦ ﻭ ﻝﺎﺳ
ﻝﻮﻃ ﻦﻴﮕﻧﺎﻴﻣ ﻱﺭﺎﻤﻴﺑ ﺕﺪﻣ
٣٦ /
±٦ ٥ / ٨ ﺩﻮﺑ ﻝﺎﺳ . ﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻉﻮﻴﺷ ،ﻱﺭ
٩ / ٦٣ ﺪﺻﺭﺩ ﺪﻣﺁ ﺖﺳﺪﺑ . ﻝﻮﺌﺴﻣ ﺎﻫ ﻢﺴﻴﻧﺎﮔﺭﺍﻭﺮﮑﻴﻣ ﻦﻳﺮﺘﺸﻴﺑ )
ﺭﺩ ٧ / ٧١ % ﺩﺭﺍﻮﻣ (
ﻪﮐ ﺩﻮﺑ ﻲﻠﮐﺎﻴﺷﺮﺷﺍ ﺎﻘﻣ ﻦﻳﺮﺘﺸﻴﺑ
ﻭ ﻣ ﻭﺮﺘﻴﻧ ﺭﺩ ﺍﺭ ﺖ ﻦﻴﺌﺘﻧﺍﺭﻮﻓ
) ٥ / ٦٠ (%
ﻦﻳﺮﺘﺸﻴﺑ ﻭ ﺳﺎﺴﺣ
ﺘﻔﺳ ﻪﺑ ﺍﺭ ﺖﻴ ﻭﺰﻴ
ﻢﻴﺴﮐ ) ١ / ٩٢ (%
ﺩﺍﺩ ﻲﻣ ﻥﺎﺸﻧ .
ﻞﺤﻣ ﻦﻳﺮﺗ ﻊﻳﺎﺷ
ﻝﺍﺮﮐﺎﺳﻮﺒﻣﻮﻟ ﻪﻴﺣﺎﻧ ﺰﻴﻧ ﻲﻋﺎﺨﻧ ﺐﻴﺳﺁ ﺭﺩ
١ / ٧٠ % ﺵﺭﺍﺰﮔ ﺩﺭﺍﻮﻣ ﻱﺭﺍﺭﺩﺍ ﻱﺎﻫ ﺖﻧﻮﻔﻋ ﺪﺻﺭﺩ ﻦﻳﺮﺘﺸﻴﺑ ﻪﮐ ﺪﺷ
ﺭﺩ ﺰﻴﻧ ﻦﻴﻤﻫ ﺪﺷ ﻩﺪﻫﺎﺸﻣ ﻩﻭﺮﮔ .
ﮏﻳ ﺭﺩ
ﺳ ﻲﻧﻻﻮﻃ ﻱﺭﺎﮔﺪﻧﺎﻣ ﺖﻠﻌﺑ ﻪﮐ ﺪﺳﺭ ﻲﻣ ﺮﻈﻧ ﻪﺑ ﻲﻠﮐ ﺵﺮﮕﻧ ﻮ
ﻱﺭﺍﺭﺩﺍ ﺪﻧ ﻭ
ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻱﻻﺎﺑ ﺪﺻﺭﺩ ﺵﻭﺭ ﺯﺍ ﻥﺎﮑﻣﺍ ﺕﺭﻮﺻ ﺭﺩ ﻪﮐ ﺖﺳﺍ ﺮﺘﻬﺑ
،ﺵﻭﺭ ﻦﻳﺍ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻡﺪﻋ ﺕﺭﻮﺻ ﺭﺩ ﺎﻳ ﻭ ﺩﻮﺷ ﻩﺩﺎﻔﺘﺳﺍ ﺏﻭﺎﻨﺘﻣ ﻥﻮﻴﺳﺍﺰﻳﺮﺘﺗﺎﮐ ﺗﺍﺮﺘﺳﺍ
ﻱﮋ ﺮﻈﻧﺪﻣ ﻲﻌﺿﻮﻣ ﻱﻮﺸﺘﺴﺷ ﺮﻴﻈﻧ ﺮﮕﻳﺩ ﻱﺎﻫ ﻗ
ﺩﺮﻴﮔ ﺭﺍﺮ .
ﻱﺪﻴﻠﻛ ﻥﺎﮔﮊﺍﻭ :
ﻲﻋﺎﺨﻧ ﺕﺎﻌﻳﺎﺿ ـ ﻱﺭﻮﻳﺮﺘﻛﺎﺑ ـ ﻱﺭﻮﻴﭘ ـ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ
ﺏﻮﻨﺟ ﺐﻃ ﻪﻣﺎﻨﻠﺼﻓ ﻭﺩ
ﺮﻬﺷﻮﺑ ﻲﻧﺎﻣﺭﺩ ﻲﺘﺷﺍﺪﻬﺑ ﺕﺎﻣﺪﺧ ﻭ ﻲﻜﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ
ﻩﺭﺎﻤﺷ ،ﻢﺘﻔﻫ ﻝﺎﺳ ٢
ﻪﺤﻔﺻ ، ۱۴۱
‐ ۱۴۶ ) ﺪﻨﻔﺳﺍ ١٣٨٣ (
ﻼﺳ ﻱﺎﻬﺸﻫﻭﮋﭘ ﺰﮐﺮﻣ ﺕﺎﻧﺎﮑﻣﺍ ﻭ ﻪﺟﺩﻮﺑ ﺎﺑ ﻩﮊﻭﺮﭘ ﻦﻳﺍ* ﺞﻴﻠﺧ ﺖﻣ
ﺱﺭﺎﻓ ﺮﻬﺷﻮﺑ ﻥﺎﺘﺳﺍ ﻲﺘﺴﻳﺰﻬﺑ ﻥﺎﻣﺯﺎﺳ ﻭ ﺖﺳﺍ ﻩﺪﻳﺩﺮﮔ ﻡﺎﺠﻧﺍ
.
ﻦﻔﻠﺗ ﻲﺸﻫﻭﮋﭘ ﺖﻳﺮﻳﺪﻣ ،ﻲﮑﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ ،ﻢﻠﻌﻣ ﻥﺎﺑﺎﻴﺧ ،ﺮﻬﺷﻮﺑ**
۲۵۲۸۵۸۷
‐ ۰۷۷۱ ﺹ . ﭖ : ۳۶۳۱
١٤٢ / ﺏﻮﻨﺟ ﺐﻃ
ﻩﺭﺎﻤﺷ ﻢﺘﻔﻫ ﻝﺎﺳ ٢
/ ﺪﻨﻔﺳﺍ
١٣٨٣
ﻪﻣﺪﻘﻣ
ﺳﺁ ﻴ ﻋﺎﺨﻧ ﺏﺎﻨﻃ ﺐ SCLﻲ
ﺎﻧﺍﻮﺗ ، ﻲﻳ ﺭﺍﺭﺩﺍ ﺰﮐﺮﻣ ﻭ ﺰﻧﻮﭘ ﺭﺩ
ﺮﻣ ﺍ ﺑ ﺯﺍ ﺍﺭ ﺮﺗﻻﺎﺑ ﺰﮐ ﻴ
ﻣ ﻦ ﻲ ﻐﺗ ﻭ ﺩﺮﺑ ﻴﻴ
ﺳﻭ ﺕﺍﺮ ﻴ ﻌ ﻲ ﺭﺩ
ﺩﺮﮑﻠﻤﻋ ﺍﺮﺠﻣ ﻱ ﻱﺭﺍﺭﺩﺍ ﻧﺎﺘﺤﺗ ﻲ ﺍ ﻳ ﻣ ﺩﺎﺠ ﻲ ﺪﻨﮐ . ﻌﻤﺟﺭﺩ ﻴ ﺖ
ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋSCL ﻱ
ﺑ ، ﻲ ﺘﺧﺍ ﻴ ﺭﺎ ﻱ ﺭ ،ﺭﺍﺭﺩﺍ ﻳ ﮓﻨﺳ ،ﺲﮐﻼﻔ
ﺩﺍﺪﺴﻧﺍ ﻭ ﺭﻮﻧ
ﮊﻮﻟﻭ ﻳ ﺎﺷ ﺭﻮﻄﺑ ﮏ ﻳ
ﻌ ﻲ ﺩ ﻳ ﻣ ﻩﺪ ﻲ ﺩﻮﺷ . ﺖﻧﻮﻔﻋ
ﺭﺩ ﺭﺍﺭﺩﺍ ﻣﻭﺩ ﻥﺍﻮﻨﻌﺑ ﻢﻫ ﺯﻮﻨﻫ SCL
ﻴ ﺍ ﮒﺮﻣ ﺖﻠﻋ ﻦ ﻳ
ﻦ
ﺑﻴ ﺖﺳﺍ ﻥﺍﺭﺎﻤ )
۱ ﻭ ۲ .(
ﺑ ﺭﺩ ﻴ ﺎﺿ ﻥﺍﺭﺎﻤ ﻳ
ﻋﺎﺨﻧ ﺕﺎﻌ ﻲ
، ۴ ﺑ ﺮﻫ ﺭﺩ ﻝﺎﺳ ﺭﺩ ﺐﺗ ﺭﺎﺑ ﻴ
ﺭﺎﻤ
،ﺩﺭﺍﺩ ﺩﻮﺟﻭ ۴۵
ﺪﺻﺭﺩ ﺖﻧﻮﻔﻋ ﺖﻠﻌﺑ ،ﺭﺍﺩ ﺐﺗ ﺩﺭﺍﻮﻣ ﺯﺍ
ﺭﺍﺭﺩﺍ ﻱ ﻘﺑ ﻭ ﺖﺳﺍ ﻴ
ﺴﻔﻨﺗ ﺖﻧﻮﻔﻋ ﺖﻠﻌﺑ ﻪ ﻲ
ﻟﻮﺒﻣﺁﻮﺒﻣﺮﺗ ﻭ ﻲ
ﺖﺳﺍ ) ۳ ﻭ ۴ .(
ﻣ ﻴ ﻠﮐ ﻥﺍﺰ ﻲ ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻱ
SCL ﺭﺩ ﺮﻘﺗ ﻳ ﹰﺎﺒ
۵ / ۲ ﺑ ﺮﻫ ﺭﺩ ﻝﺎﺳ ﺮﻫ ﺭﺩ ﺭﺎﺑ ﻴ
ﺖﺳﺍ ﺭﺎﻤ )
۵ .(
ﺎﻫ ﻪﻧﻮﮔ ﻱ
ﺮﺘﮐﺎﺑ ﻳ ﺍﺪﺟ ﻝﺎ ﺑ ﺯﺍ ﻩﺪﺷ ﻴ ﺎﺿ ﻥﺍﺭﺎﻤ ﻳ
ﺎﺨﻧ ﻪﻌ ﻋ ﻲ ﺎﺑ ،ﻩﺩﻮﺑ ﺕﻭﺎﻔﺘﻣ
ﺍﻳ ﺎﻘﻣ ﺭﺩ ﺩﻮﺟﻭ ﻦ ﻳ
ﻓﺍ ﺎﺑ ﻪﺴ ﺎﺿ ﻥﻭﺪﺑ ﺩﺍﺮ ﻳ
ﻋﺎﺨﻧ ﻪﻌ ﻲ ﺯﻭﺮﺑ ،
ﺒﺴﻧ ﻲ ﺮﺷﺍ ﻳ ﺸ ﻴ ﻠﮐﺎ ﻲ ﺴﺒﻠﮐ ﻭ ﻴ ﺶﻫﺎﮐ ﻼ ﻳ
ﺒﺴﻧ ﺯﻭﺮﺑ ﻭ ﻪﺘﻓﺎ ﻲ
ﺷﺍﺮﺳ ﻭ ﺱﻮﺌﺗﻭﺮﭘ ،ﺱﺎﻧﻮﻣﻭﺩﻮﺴﭘ ﻴ
ﺎﺿ ﺭﺩ ﺎ ﻳ
ﻋﺎﺨﻧ ﺕﺎﻌ ﻲ
ﺍﺰﻓﺍ ﻳ ﺶ ﻳ ﺖﺳﺍ ﻪﺘﻓﺎ )
۶ .(
ﺮﻘﺗ ﻳ ﹰﺎﺒ ۲۵
‐ ۲۰ ﺩﺭﺍﻮﻣ ﺯﺍ ﺪﺻﺭﺩ
ﺮﺘﮐﺎﺑ ﻳ ﻤ ﻲ ﺮﺘﮐﺎﺑ ﺪﻨﭼ ، ﻳﺎ
ﻲﻳ ) ﺮﺷﺍ ،ﮎﻮﮐﻭﺮﺘﻧﺍ ﻳ
ﺸ ﻴ ﻠﮐﺎ ﻲ ،
ﺴﺒﻠﮐ ﻭ ﺱﺎﻧﻮﻣﻭﺩﻮﺴﭘ ﻴ
ﻼ ( ﺖﺳﺍ ) ۷ .(
ﺮﻫ ﺭﺩ ،ﺕﺭﻮﺻ ﻳ
ﮑ ﻲ ﺑ ﻢﻬﻣ ﺕﻼﮑﺸﻣ ﺯﺍ ﻴ
ﺎﺿ ﻥﺍﺭﺎﻤ ﻳ
ﻪﻌ
ﻋﺎﺨﻧ ﻲ ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ، ﻱ
ﺎﻫ ﺖﻧﻮﻔﻋ ﺯﺍ ﻪﮐ ﺖﺳﺍ ﻱ
ﺎﺷ ﻳ ﻭ ﻊ
ﺪﻬﺗ ﻳ ﺪ ﺣ ﺓﺪﻨﻨﮐ ﻴ ﺍﺭﺩ ﺕﺎ ﻳ ﺑ ﻦ ﻴ ﻣ ﻥﺍﺭﺍﺮﻤ ﻲ ﺪﺷﺎﺑ . ﻤﻫ ﻪﺑ ﻴ ﻦ
ﺳﺭﺮﺑ ،ﺖﻬﺟ ﻲ
ﺭﺍﺭﺩﺍ ﻱ ﻧﺎﮔﺭﺍ ﻭ ﻴ ﺎﻫ ﻢﺴ ﻱ ﺭﺩ ﺖﻧﻮﻔﻋ ﻞﻣﺎﻋ
ﺑﻴ ﭘ ﺭﺩ ، ﻥﺍﺭﺎﻤ ﻴ
ﮕﺸ ﻴ ﺮ ﻱ ﺑ ﺭﺩ ﺖﻧﻮﻔﻋ ﻥﺎﻣﺭﺩ ﻭ ﻴ
ﺳﺁ ﺎﺑ ﻥﺍﺭﺎﻤ ﻴ
ﺐ
ﻋﺎﺨﻧ ﻲ ﺻﺎﺧ ﺵﺯﺭﺍ ﻲ
ﺩﺭﺍﺩ . ،ﺮﻬﺷﻮﺑ ﻥﺎﺘﺳﺍ ﺭﺩ ۱۱۰
ﺑ ﻴ ﺎﺑ ﺭﺎﻤ
ﺳﺁ ﻴ ﻋﺎﺨﻧ ﺐ ﻲ
ﺎﻤﺣ ﺖﺤﺗ ﻪﮐ ﺩﺭﺍﺩ ﺩﻮﺟﻭ ﻳ
ﻥﺎﻣﺯﺎﺳ ﺖ
ﺰﻬﺑ ﻳ ﺘﺴ ﻲ ﺸﺨﺒﻧﺍﻮﺗ ﺭﻮﻣﺍ ﻭ ﻲ
ﺪﻧﺭﺍﺩ ﺭﺍﺮﻗ ﺮﻬﺷﻮﺑ ﻥﺎﺘﺳﺍ .
ﺍﻳ ﻦ
ﻪﻌﻟﺎﻄﻣ ﻦﻳﺍ ﺭﺩ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻉﻮﻴﺷ ﻲﺳﺭﺮﺑ ﺭﻮﻈﻨﻣ ﻪﺑ
ﺪﺷ ﻲﺣﺍﺮﻃ ﻥﺍﺭﺎﻤﻴﺑ .
ﺭﺎﮐ ﺵﻭﺭ ﻭ ﺩﺍﻮﻣ
ﻲﻌﻄﻘﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳﺍ ﺭﺩ
، ﺳﺭﺮﺑ ﺖﻬﺟ ﻲ
ﻧﺍﻭﺍﺮﻓ ﻲ ﺖﻧﻮﻔﻋ
ﺍﺭﺩﺍ ﺭ ﻱ ﺎﺿ ﻥﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻋﺎﺨﻧ ﺕﺎﻌﻳ
ﻲ
،ﺮﻬﺷﻮﺑ ﻥﺎﺘﺳﺍ ٩٧
ﺯﺍ ﺮﻔﻧ
ﺪﻨﺘﻓﺮﮔ ﺭﺍﺮﻗ ﻲﺳﺭﺮﺑ ﺩﺭﻮﻣ ﻥﺍﺭﺎﻤﻴﺑ .
ﻪﻧﻮﻤﻧ ﻚﻳ ﺭﺎﻤﻴﺑ ﺮﻫ ﺯﺍ ﺪﺷ ﻪﺘﻓﺮﮔ ﻡﺍﺮﮔﻮﻴﺑ ﻲﺘﻧﺁ ﻭ ﺖﺸﻛ ﻭ ﺰﻴﻟﺎﻧﺁ ﺖﻬﺟ ﻱﺭﺍﺭﺩﺍ
.
ﻲﻧﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻪﻛ ﺩﻮﺑ ﺕﺭﻮﺻ ﻦﻳﺍ ﻪﺑ ﻱﺮﻴﮔ ﻪﻧﻮﻤﻧ ﻂﻳﺍﺮﺷ ﻪﻛ
ﺪﻧﺩﻮﺑ ﻥﺩﺮﻛ ﺭﺍﺭﺩﺍ ﻪﺑ ﺭﺩﺎﻗ
، ﻞﻳﺮﺘﺳﺍ ﻂﻳﺍﺮﺷ ﺖﻳﺎﻋﺭ ﺯﺍ ﺪﻌﺑ ﻭ
ﻥﺍﺭﺎﻤﻴﺑ ﻪﺑ ﺵﺯﻮﻣﺁ
، ﺴﻗ ـــ ﺳﻭ ﺖﻤ ـــ ﺪﺷ ﻲﻣ ﻪﺘﻓﺮﮔ ﺭﺍﺭﺩﺍ ﻂ
MID STREAM) (
ﺭﺎﻤﻴﺑ ﺭﺩ ﻭ ﻴﻧﺍ
ﻱﺭﺍﺭﺩﺍ ﺪﻧﻮﺳ ﻪﻜ
ﻂﺳﻮﺗ ﻪﻧﻮﻤﻧ ﺪﻨﺘﺷﺍﺩ ﻲﻠﺧﺍﺩ ﻝﺪﻴﻧ
ﻪﻟﻮﻟ ﻥﺎﻤﻳﺰﮔﻭﺮﭘ ﺖﻤﺴﻗ ﺯﺍ
ﻲﻣ ﻪﺘﻓﺮﮔ ﺪﺷ
ﺭﺎﻤﻴﺑ ﺭﺩ ﻭ ﻧﺍ
ﻲ ﻪﮐ ﻲﺟﺭﺎﺧ ﻱﺭﺍﺭﺩﺍ ﺪﻧﻮﺳ
ﻭ ﺪﺷ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﻱﺮﻴﮔ ﻪﻧﻮﻤﻧ ﺖﻬﺟ ﻥﻮﺗﻼﻧ ﺯﺍ ﺪﻨﺘﺷﺍﺩ ﺮﻇ ﺭﺩ ﺎﻫ ﻪﻧﻮﻤﻧ ﻩﺪﺷ ﻱﺭﻭﺁ ﻊﻤﺟ ﻑﺮﺼﻣ ﺭﺎﺒﻜﻳ ﻞﻳﺮﺘﺳﺍ ﻑﻭ
ﻥﺎﺘﺳﺭﺎﻤﻴﺑ ﻩﺎﮕﺸﻳﺎﻣﺯﺁ ﻪﺑ ﺖﻗﻭ ﻉﺮﺳﺍ ﺭﺩ ﻫﺎﮕﺸﻧﺍﺩ
ﻲ ﻪﻤﻃﺎﻓ
ﺍﺮﻫﺯ ) ﺱ ( ﻝﺎﻘﺘﻧﺍ ﻣ ﻲ ﺪﻨﺘﻓﺎﻳ ﺮﺜﻛﺍ ﺖﻓﺎﺴﻣ ﺪﻌﺑ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻭ
ﺦﻳ ﻪﺒﻌﺟ ﺭﺩ ﺎﻫ ﻪﻧﻮﻤﻧ ، ﻥﺍﺭﺎﻤﻴﺑ COLD BOX )
(
ﺪﺷ ﻲﻣ ﻩﺩﺎﺘﺳﺮﻓ ﺖﻋﺎﺳ ﺪﻨﭼ ﺽﺮﻋ ﺭﺩ ﻭ ﻱﺭﺍﺪﻬﮕﻧ .
ﻡﺯﻻ
ﻮﻤﻧ ﻦﺘﻓﺮﮔ ﺯﺍ ﻞﺒﻗ ﻪﻛ ﺖﺳﺍ ﺮﻛﺫ ﻪﺑ ﻑﺮﺼﻣ ﻡﺪﻋ ﺯﺍ ﺎﻫ ﻪﻧ
ﻴﻣ ﻞﺻﺎﺣ ﻥﺎﻨﻴﻤﻃﺍ ﻥﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻚﻴﺗﻮﻴﺑ ﻲﺘﻧﺁ ﺪﻳﺩﺮﮕ
ﻭﺭ ﺮﺑ ﻪﻧﻮﻤﻧ ﻱ
ﺤﻣ ﻴ ﺎﻫ ﻂ EMB ﻱ ﻧﻮﺧ ﺭﺎﮔﺁ ﻭ ﻲ
ﺖﺧﺎﺳ
ﺪﻧﺪﺷ ﻩﺩﺍﺩ ﺖﺸﮐ ﮎﺮﻣ ﺖﮐﺮﺷ .
ﺘﻧﺁ ﻲ ﻡﺍﺮﮔﻮﻴﺑ ﺵﻭﺭ ﻪﺑ
dis diffusion ﺑ
ـــ ﺍﺮ ﻱ ﻧﺁ ـــ ﺘ ـ ﻲ ﺑ ـــ ﻴ ـــ ﺗﻮ ـ ﻴ ـ ﻫ ﮏ ــ ﺎ ﻱ
ﻛﻮﻠﻓﻭﺮﭙﻴﺳ ـــ
ﺳﺎﺴ ــ ﻣﺁ ،ﻦﻴ ـ ﻴ ـ ﻜ ـ ﺳﺎ ـ ﻴ ـ
،ﻦ ﻝﻭﺯﺎﺴﻛ ﻮﻤﻳﺮﺗﻮﻛ
،
ﺪﻴﺳﺍ ﻚﻴﺴﻛﺪﻴﻟﺎﻧ
، ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ
، ﻦﻴﺋﻮﺘﻧﺍﺭﻮﻓ ﻭﺮﺘﻴﻧ
، ﻭﺰﻴﺘﻔﺳ
ﻥﻮﺴﻛﺎﻳﺮﺘﻔﺳ ﻭ ﻢﻴﺴﻛ ﻦﺗﺩﺎﭘ ﺖﮐﺮﺷ ﺖﺧﺎﺳ
ﻧﺍ ﺐﻃ ﺪﺷ ﻡﺎﺠ .
ﺕﺎﻋﻼﻃﺍ ﺭﺍﺰﻓﺍ ﻡﺮﻧ ﺔﺘﺴﺑ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﺎﺑ
ﻱ SPSSﺯﺍ ﺔﺘﺳﺍﺮﻳﻭ
ﻨﻌﻣ ﺢﻄﺳ ﺎﺑ ﻢﻫﺩ ﻲ
ﺭﺍﺩ ٠٥ / P<٠ ﺪﻳﺩﺮﮔ ﻡﺎﺠﻧﺍ .
ﺎﻫ ﻝﻮﺒﻠﮔ ﺩﻮﺟﻭ ﻱ
ﺭﺍﺭﺩﺍ ﺪﻴﻔﺳ ﻱ
ﺮﺗﻻﺎﺑ ۵ ﺮﻫ ﺭﺩ ﺩﺪﻋ ﻠﻴﻓ
ﺪ
ﻣ ﻴ ﻮﮑﺳﻭﺮﮑ ﺑ ﻲ ﻳﺎﻤﻨﮔﺭﺰﺑ ﺎﺑ ﻲ
ﺭﻮﻴﭘ ﻥﺍﻮﻨﻌﺑ ﻻﺎﺑ ﻱ
ﺭﻮﻀﺣ
ﺮﺘﮐﺎﺑ ﻱ ﺭﻮﻳﺮﺘﮐﺎﺑ ﻥﺍﻮﻨﻋ ﻪﺑ ﻪﻌﻟﺎﻄﻣ ﺩﺭﻮﻣ ﻪﻧﻮﻤﻧﺭﺩ ﻱ
ﻘﻠﺗ ﻲ
ﻨﻠﮐ ﺵﺭﺎﻤﺷ ﻭ ﻩﺪﺷ ﻲ
ﺯﺍ ﺮﺗﻻﺎﺑ ۱۰۵ ﺭﺍﺩﺮﺑ ﻪﻧﻮﻤﻧ ﺭﺩ ﻱ
ﻂﺳﻭ
ﺭﺍﺭﺩﺍ ﻱ ﮐ ﻭ ﻤ ﺎﻫ ﺵﻭﺭ ﺭﺩ ﻥﺁ ﺯﺍ ﺮﺘ ﻱ
ﻭ ﮏﻴﺑﻮﭘﺍﺮﭘﻮﺳ ﻳ
ﺪﻧﻮﺳ ﺎ
ﺭﺍﺬﮔ ﻱ ﺭﺍﺭﺩﺍ ﺖﺒﺜﻣ ﺖﺸﮐ ﻥﺍﻮﻨﻌﺑ ﻱ
ﺪﻧﺪﻳﺩﺮﮔ ﻒﻳﺮﻌﺗ .
ﺞﻳﺎﺘﻧ ﺩﺍﺪﻌﺗ ۹۷ ﺑ ﺭﺎﻤﻴ ) ۹ / ۶۳ ﻭ ﺮﮐﺬﻣ ﺪﺻﺭﺩ ۱
/ ۳۶ ﺚﻧﺆﻣ ﺪﺻﺭﺩ (
ﻋﺎﺨﻧ ﻪﻌﻳﺎﺿ ﺎﺑ ﻲ
ﺳﺭﺮﺑ ﺩﺭﻮﻣ ﻲ
ﺪﻨﺘﻓﺮﮔ ﺭﺍﺮﻗ .
ﻦﺳ ﻦﻳﺮﺘﻤﮐ ۲
ﻦﺳ ﻦﻳﺮﺘﺸﻴﺑ ﻭ ﻩﺎﻣ ۶۰
ﻦﻴﮕﻧﺎﻴﻣ ﺎﺑ ﻝﺎﺳ ۷۴
/ ۲۶ ﺩﻮﺑ ﻝﺎﺳ .
ﻧﺍﻭﺍﺮﻓ ﻲ ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻱ
ﺮﺘﮐﺎﺑ ، ﻱ ﺭﻮﻳ ﻱ ﺭﻮﻴﭘ ﻭ ﻱ ﺐﻴﺗﺮﺗ ﻪﺑ
۶ / ۵۳ ، ۹ / ۶۳ ﻭ ۹ / ۶۲ ﺩﻮﺑ ﺪﺻﺭﺩ .
ﺎﺷ ﻳ ﻞﻣﺎﻋ ﻢﺴﻴﻧﺎﮔﺭﺍ ﻦﻳﺮﺗ ﻊ
ﻥﺍﺭﺎﮑﻤﻫ ﻭ ﺭﻮﭘ ﻲﻤﻴﻠﺳ ﺮﺘﮐﺩ
ﻲﻋﺎﺨﻧ ﺕﺎﻌﻳﺎﺿ ﺭﺩ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ١٤٣
ﻧﻮﻔﻋ ـــ ﺍﺭﺩﺍ ﺖ ﺭ ﻱ ﻠـﮐﺎﻴـﺸﻳﺮﺷﺍ ـ
ﻲ ۳۸ ﺩﺭﻮﻣ ) ۷ / ۷۱ ﺪﺻﺭﺩ (
ﺎﻫ ﺏﻭﺮﮑﻴﻣ ﻭ ﺪﻳﺩﺮﮔ ﺵﺭﺍﺰﮔ ﻱ
،ﻼﻴﺴﺒﻠﮐ ،ﺱﺎﻧﻮﻣﻭﺩﻮﺳ
ﻡﺍﺪﮐ ﺮﻫ ﺮﺘﮐﺎﺑﻭﺮﺘﻴﺳ ۴
ﺩﺭﻮﻣ ) ۵ / ۷ ﺪﺻﺭﺩ ( ،ﺱﻮﺌﺗﻭﺮﭘ ﻭ
ﻴﺳﺍ ﻭ ﺱﻮﺋﺭﻭﺍ ﻑﺎﺘﺳﺍ ﻨ
ﺩﺭﻮﻣ ﮏﻳ ﻡﺍﺪﮐ ﺮﻫ ﺮﺘﮐﺎﺑ ﻮﺘ )
۹ / ۱
ﺪﺻﺭﺩ ( ﺪﻣﺁ ﺖﺳﺪﺑ .
ﻃﺎﺒﺗﺭﺍ ﻲ ﻦﻴﺑ ﻩﺪﻫﺎﺸﻣ ﻢﺴﻴﻧﺎﮔﺭﺍ ﻭ ﺲﻨﺟ
ﺪﺸﻧ ) ۰۵ / ۰ P>
.(
ﺳﺎﺴﺣ ﺖﺴﺗ ﺭﺩ ﻲﻜﻴﺗﻮﻴﺑ ﻲﺘﻧﺁ ﺖﻴ
، ﺭﺩ ﺖﻴﺳﺎﺴﺣ ﻦﻳﺮﺘﺸﻴﺑ
ﺑ ــ ﺑﺍﺮ ﺮــ ﺳ ـ ﻢﻴﺴﻛﻭﺰﻴﺘﻔ )
١ / ٩٢ ﺪﺻﺭﺩ (
، ﻥﻮﺴﻛﺎﻳﺮﺘﻔﺳ )
٢ / ٨٤
ﺪﺻﺭﺩ ( ﺎﺴﮐﻮﻠﻓﻭﺮﭙﻴﺳ ﻭ ﻦﻴﺳ
) ٩ / ٧٨ ﺪﺻﺭﺩ ( ﻦﻳﺮﺘﺸﻴﺑ ﻭ ﻧ ﺮﺑﺍﺮﺑ ﺭﺩ ﺖﻣﻭﺎﻘﻣ
ﻴﺘ ﻦﻴﺋﻮﺘﻧﺍﺭﻮﻓﻭﺮ )
٥ / ٦٠ ﺪﺻﺭﺩ ( ﺩﻮﺟﻭ
ﺖﺷﺍﺩ . ﻲﻋﺎﺨﻧ ﺕﺎﻌﻳﺎﺿ ﺢﻄﺳ ﺮﻈﻧ ﺯﺍ
، ﺭﺩ ﻪﻌﻳﺎﺿ ﻞﺤﻣ ﻦﻳﺮﺘﺸﻴﺑ
ﺩﻮﺑ ﻝﺍﺮﻛﺎﺳﻮﺒﻣﻮﻟ ﻪﻴﺣﺎﻧ )
١ / ٧٠ ﺪﺻﺭﺩ ( ﻪﻛ ﻱﺩﺭﺍﻮﻣ ﺭﺩ ﺎﻣﺍ
ﺩﻮﺑ ﻚﻴﺳﺍﺭﻮﺗ ﻪﻴﺣﺎﻧ ﺭﺩ ﻪﻌﻳﺎﺿ )
٤ / ١٤ ﺪﺻﺭﺩ ( ﺩﺭﺍﻮﻣ ﻦﻳﺮﺘﺸﻴﺑ
ﻱﺭﻮﻳﺮﺘﻛﺎﺑ ﻲﻨﻌﻳ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ )
٧ / ٨٥ ﺪﺻﺭﺩ (
، ﻴﭘ ــ ﻱﺭﻮ
) ٧ / ٨٥ ﺪﺻﺭﺩ ( ﺖﺒﺜﻣ ﻱﺭﺍﺭﺩﺍ ﺖﺸﻛ ﻭ )
٤ / ٧١ ﺪﺻﺭﺩ (
ﺖﺷﺍﺩ ﺩﻮﺟﻭ )
٠٠٣ / ٠ P = ( .
ﻝﻭﺪﺟ
١ ( ﻲﺒﺴﻧ ﻲﻧﺍﻭﺍﺮﻓ ﻊﻳﺯﻮﺗ )
ﺪﺻﺭﺩ ( ﻱﺭﻮﻴﭘ ،ﻱﺭﻮﻳ ﻱﺮﺘﮐﺎﺑ
ﻥﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻲﻋﺎﺨﻧ ﺐﻴﺳﺁ ﻞﺤﻣ ﮏﻴﮑﻔﺗ ﻪﺑ ﺖﺒﺜﻣ ﺭﺍﺭﺩﺍ ﺖﺸﮐ ﻭ
ﺮﻬﺷﻮﺑ ﻥﺎﺘﺳﺍ ﺭﺩ ﻲﻋﺎﺨﻧ ﻪﻌﻳﺎﺿﺎﺑ
ﻝﺎﮑﻳﻭﺮﺳ
ﮏﻴﺳﺍﺭﻮﺗ ﻝﺍﺮﮐ ﺎﺳﻮﺒﻣﻮﻟ
ﻞﮐ
ﻱﺭﻮﻳ ﻱﺮﺘﮐﺎﺑ
٧ / ٢٦ ٧ / ٨٥ ٦
/ ٧٦ ٩ / ٦٣
ﻱﺭﻮﻴﭘ ٧
/ ٢٦ ٧ / ٨٥ ٢
/ ٦٦ ٩ / ٦٢
ﺖﺒﺜﻣ ﺭﺍﺭﺩﺍ ﺖﺸﮐ
٠ / ٢٠ ٤ / ٧١ ٤
/ ٥٧ ٦ / ٥٣
١ / ٧١ ﺪﺻﺭﺩ ﺪﻴﺳﻼﻓ ﻪﻧﺎﺜﻣ ﻥﺍﺭﺎﻤﻴﺑ ﺯﺍ Flaccid )
( ﻭ ٩ / ٢٨
ﺻﺭﺩ ـ ﺪ ﻣ ـ ﺜ ـ ﭙﺳﺍ ﻪﻧﺎ ــ ﺘﺳﺎ ــ ﻚﻴ Spastic) (
ﻉﻮﻴﺷ ﻭ ﺪﻨﺘﺷﺍﺩ
ﺪﻴﺳﻼﻓ ﻪﻧﺎﺜﻣ ﺭﺩ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ٤
/ ٦٥ ﺪﺻﺭﺩ ﻪﻧﺎﺜﻣ ﺭﺩ ﻭ
ﻚﻴﺘﺳﺎﭙﺳﺍ ٦
/ ٣٤ ﺪﺻﺭﺩ ﺩﻮﺑ
؛ ٣ / ٩ ﺪﺻﺭﺩ ﻭ ﻲﻠﺧﺍﺩ ﺮﺘﺗﺎﻛ ﺯﺍ
٦ / ٢٥ ﺪﺻﺭﺩ ﻭ ﺪﻧﺩﺮﻛ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﻡﻭﺪﻧﺎﻛ ﺮﺘﺗﺎﻛ ﺯﺍ ١
/ ٧٠
ﺪﺻﺭﺩ ﺪﻧﺩﻮﺑ ﻥﺩﺮﻛ ﺭﺍﺭﺩﺍ ﻪﺑ ﺭﺩﺎﻗ ﺩﻮﺧ .
ﻉﻮﻴﺷ ﺖﻧﻮﻔﻋ
ﺐﻴﺗﺮﺗ ﻪﺑ ﻩﻭﺮﮔ ﻪﺳ ﻦﻳﺍ ﺭﺩ ﻱﺭﺍﺭﺩﺍ ٩
/ ٧٧ ﺪﺻﺭﺩ ﻭ ٧٠
ﺪﺻﺭﺩ ﻭ ٦ / ٤٥ ﺪﺻﺭﺩ ﺩﻮﺑ . ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺯ ﺕﺪﻣ ﺮﻈﻧ ﺯﺍ ﺭﺩ
ﻱﺩﺭﺍﻮﻣ ﺯﺍ ﺶﻴﺑ ﻪﻛ ١٠
ﺖﺷﺬﮔ ﻲﻣ ﻱﺭﺎﻤﻴﺑ ﺯﺍ ﻝﺎﺳ .
ﻧﺍﻭﺍﺮﻓ ﻲ
ﻱﺭﻮﻳﺮﺘﻛﺎﺑ )
٩ / ٤١ ﺪﺻﺭﺩ (
، ﻱﺭﻮﻴﭘ ) ٦ / ٤٢ ﺪﺻﺭﺩ ( ﺖﺸﻛ ﻭ
ﺖﺒﺜﻣ ﺭﺍﺭﺩﺍ )
٣ / ٤٢ ﺪﺻﺭﺩ ( ﺩﻮﺑ ﺮﺘﺸﻴﺑ ﺰﻴﻧ .
ﺚﺤﺑ ﺏﺎﻨﻃ ﺐﻴﺳﺁ ﻲﻋﺎﺨﻧ
ﻱﺍﺮﺠﻣ ﺩﺮﻜﻠﻤﻋ ﺭﺩ ﻲﻌﻴﺳ ﻭ ﺕﺍﺮﻴﻴﻐﺗ
ﺪﻨﻛ ﻲﻣ ﺩﺎﺠﻳﺍ ﻲﻧﺎﺘﺤﺗ ﻱﺭﺍﺭﺩﺍ .
ﺯﺎﻏﺁ ﺭﺩ ﻪﺑ ﻱﺍ ﻩﺭﻭﺩSCI
ﺲﭙﺳ ﺖﺳﺍ ﺲﻜﻠﻓﺭ ﻥﻭﺪﺑ ﻪﻧﺎﺜﻣ ﻭ ﻢﻳﺭﺍﺩ ﻲﻋﺎﺨﻧ ﻙﻮﺷ ﻡﺎﻧ ﻚﻳ ﺍ ﻪﻧﺎﺜﻣ ﺲﮑﻠﻓﺭ ﻱ
ﻝﺎﺘﻨﻤﮕﺳ –
ﻋﺎﺨﻧ ﻲ ﻢﻳﺭﺍﺩ ) ٨ ( . ﻋﺎﺨﻧ ﺏﺎﻨﻃ ﺐﻴﺳﺁ
ﻲ ﺮﺠﻨﻣ ﻪﺑ ﺰﻛﺮﻣ ﻲﻳﺎﻧﺍﻮﺗ ﻦﺘﻓﺭ ﻦﻴﺑ ﺯﺍ
ﺭﺩ ﺭﺍﺭﺩﺍ ﺰﻧﻮﭘ
ﺑ ﺰﻛﺍﺮﻣ ﻭ ﺪﺣﺍﻭ ﺖﻴﻟﺎﻌﻓ ﻪﻛ ﺮﺗﻻﺎ
ﺍﺭ ﻝﺍﺮﺗﺭﻮﻳﻮﻜﻳﺯﻭ ﺪﻨﻨﻛ ﻲﻣ ﮓﻨﻫﺎﻤﻫ ﻭ ﻝﺮﺘﻨﻛ ، ﺭﺎﻬﻣ
ﻲﻣ
ﺩﻮﺷ . ﻪﺟﺭﺩ ﻪﺑ ﻪﺘﺴﺑ ﻪﻧﺎﺜﻣ ـ ﺮﺘﻜﻨﻔﺳﺍ ﻲﮕﻨﻫﺎﻤﻫ ﻪﺟﺭﺩ SCI
ﺩﺭﺍﺩ
، ﻪﻧﺎﺜﻣ ﺖﻴﻟﺎﻌﻓ ﺯﺍ ﻞﻣﺎﻛ ﻚﻳﮋﻠﭘ ﻱﺭﺩﺁ ﻮﻛ ﺭﺎﻤﻴﺑ ﻚﻳ ﹰﻼﺜﻣ
ﺖﺳﺍ ﻩﺎﮔﺁﺎﻧ ﺩﻮﺧ .
ﻥﺪﺷ ﻞﺷ ﺎﺑ ﻪﻜﻨﻳﺍ ﻱﺎﺟ ﻪﺑ ﻪﻧﺎﺜﻣ ﺽﺎﺒﻘﻧﺍ
ﻟﺎﻌﻓ ﺎﺑ ﺩﻮﺷ ﻩﺍﺮﻤﻫ ﺮﺘﻜﻨﻔﺳﺍ ﻩﺍﺮﻤﻫ ﺮﺘﻜﻨﻔﺳﺍ ﮓﻨﻫﺎﻤﻫ ﺎﻧ ﺖﻴ
ﺖﻴﻌﺿﻭ ﻪﻛ ﺩﻮﺷ ﻲﻣ ﻔﺳﺍ ﺎﻳﮊﺮﻨﻴﺳ ﺲﻳﺩ
ﺍ ﻪﻧﺎﺜﻣ ﺮﺘﮑﻨ ﻱ
ﻡﺎﻧ
ﺚﻧﻮﻣ ﺭﺩ ﻲﻟﻭ ﺖﺳﺍ ﺩﺍﺪﺴﻧﺍ ﻚﻳ ﺮﻛﺬﻣ ﺲﻨﺟ ﺭﺩ ﻪﻛ ﺩﺭﺍﺩ ﺮﺘﻤﻛ ﻲﻠﻴﺧ ﺚﻧﻮﻣ ﺭﺩ ﺩﺍﺪﺴﻧﺍ ﻪﺟﺭﺩ ﺍﺮﻳﺯ ﺖﺴﻴﻧ ﻢﻬﻣ ﻪﺘﻓﺎﻳ ﺖﺳﺍ . ﻱﺩﺭﺍﻮﻣ ﺭﺩ SCI ﻪﻛ
ﺖﻤﺴﻗ ﺎﻳ ﻚﻴﺳﺍﺭﻮﺗ ، ﻲﻧﺩﺮﮔ ﻪﻴﺣﺎﻧ ﺭﺩ
ﺎﭘ ﺰﻛﺍﺮﻣ ﺖﺳﺍ ﺭﺎﺒﻣﻮﻟ ﻲﻳﻻﺎﺑ ﺝﺭﺎﺧ ﺮﺗﻻﺎﺑ ﺰﻛﺍﺮﻣ ﻝﺮﺘﻨﻛ ﺯﺍ ﻲﻨﻴﺋ
ﺯﺍ ﻪﻧﺎﮔﺍﺪﺟ ﺭﻮﻃ ﻪﺑ ﻪﻛ ﺪﻨﻛ ﻲﻣ ﺩﺎﺠﻳﺍ ﺖﻨﻤﮕﺳ ﻚﻳ ﻭ ﻩﺪﺷ ﺪﻨﻛ ﻲﻣ ﻞﻤﻋ ﻲﻋﺎﺨﻧ ﺏﺎﻨﻃ ﻪﻴﻘﺑ .
ﺖﻤﺴﻗ ﺭﺩ ﺐﻴﺳﺁ ﻪﭼ ﺮﻫ
ﻱﮊﺮﻨﻴﺳ ﺲﻳﺩ ﻱﻭﺭ ﻱﺮﺘﻤﻛ ﺮﺛﺍ ﺪﺷﺎﺑ ﻉﺎﺨﻧ ﺮﺗﻻﺎﺑ ﻱﺎﻫ ﻭ ﺩﺭﺍﺩ ﻪﻧﺎﺜﻣ ﺮﺘﻜﻨﻔﺳﺍ ﻪﺟﻮﺗ ﻞﺑﺎﻗ ﺭﻮﻄﺑ ﻞﻣﺎﻛ ﻱﺎﻫ ﺐﻴﺳﺁ ﻲﻟ
١٤٤ / ﺏﻮﻨﺟ ﺐﻃ
ﻩﺭﺎﻤﺷ ﻢﺘﻔﻫ ﻝﺎﺳ ٢
/ ﺪﻨﻔﺳﺍ
١٣٨٣
ﺍ ﻱ ﺮﺠﻣ ﺩﺮﻜﻠﻤﻋ ﻝﻼﺘﺧﺍ ﻪﺑ ﺍﺭﺩﺍ ﻱﺍ
ﺪﻧﺭﺍﺩ ﻁﺎﺒﺗﺭﺍ ﻲﻧﺎﻗﻮﻓ ﻱﺭ )
٩ ( . ﻲﻧﺎﺘﺤﺗ ﺖﻤﺴﻗ ﻡﺎﻤﺗ ﻝﺍﺮﻛﺎﺳ ﻉﺎﺨﻧ ﺭﺩ ﺐﻴﺳﺁ ﻚﻳ ﺎﺑ ﺖﻴﻟﺎﻌﻓ ﻭ ﺩﻮﺷ ﻲﻣ ﺞﻠﻓ ﻪﻧﺎﺜﻣ ﻭ ﻩﺪﺷ ﺐﻳﺮﺨﺗ ﻲﻋﺎﺨﻧ ﺏﺎﻨﻃ ﺭﺍﺪﺟ ﺲﻧﺎﻴﻠﭙﻤﻛ ﻥﺍﺪﻘﻓ ﺖﻠﻋ ﻪﺑ ﻭ ﺩﻮﺷ ﻲﻣ ﻢﻛ ﻥﺁ ﻲﺿﺎﺒﻘﻧﺍ ﻪﻧﺎﺜﻣ ﻥﺪﺷﺮﭘ ﻦﻴﺣ ﺭﺩ ﻪﻧﺎﺜﻣ
، ﻲﻣ ﺶﻳﺍﺰﻓﺍ ﻪﻧﺎﺜﻣ ﻞﺧﺍﺩ ﺭﺎﺸﻓ
ﺪﺑﺎﻳ . ﺭﺩ ﻱﺭﻮﻴﭘ ﺎﻨﺘﻣ ﺮﺘﺗﺎﻛ ﻭ SCI
ﺯﺎﺳ ﻪﻟﺎﺴﻣ ﺐﻠﻏﺍ ﻢﻳﺍﺩ ﺎﻳ ﺏﻭ
ﺖﺳﺍ . ﺭﺩ ﻪﻌﻟﺎﻄﻣ ﻚﻳ ﺭﺩ ﻧﺍﺭﺎﻤﻴﺑ
ﻲ ﮐ ﺪﻨﺘﺷﺍﺩ ﻢﻳﺍﺩ ﺮﺘﺗﺎﻛ ﻪ
ﺩﺍﺪﻌﺗ ﺎﻫ ﻝﻮﺒﻠﮔ ﺵﺭﺎﻤﺷ ﻱ
ﺪﻴﻔﺳ ﻥﺍﺭﺎﻤﻴﺑ ﻪﻴﻘﺑ ﻪﺑ ﺖﺒﺴﻧ
ﺩﻮﺑ ﺮﺘﺸﻴﺑ )
١٠ ( . ﺭﺩ ﻧﺍﺭﺎﻤﻴﺑ ﻲ ﻪﮐ ﻭ ﺪﻨﻨﻛ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﺮﺘﺗﺎﻛ
ﺖﺒﺜﻣ ﻱﺭﺍﺭﺩﺍ ﺖﺸﻛ )
١٠٥ CFU>
( ﻱﺭﻮﻴﭘ ﺎﺑ )
٥ ﻝﻮﺒﻠﮔ
ﮔﺭﺰﺑ ﺢﻄﺳ ﺮﻫ ﺭﺩ ﺪﻴﻔﺳ ـ
ﻻﺎﺑ ﻲﻳﺎﻤﻨ (
ﺮﻄﺧ ﻭ ﺖﺳﻻﺎﺑ ﺐﺗ
ﻛﺎﺑ ﻪﺟﻮﺗ ﻞﺑﺎﻗ ﻱﺭﻮﻴﭘ ﻲﻔﻨﻣ ﻡﺮﮔ ﻱﺎﻬﻳﺮﺘ ﺍ
ﻱ ﻲﻣ ﺩﺎﺠﻳﺍ
ﺪﻨﻛ ) ١١ ( . ﻝﺎﺳ ﻒﻳﺮﻌﺗ ﻖﺒﻃ ١٩٩٢
ﻂﺳﻮﺗ ﻩﺪﺷ ﻪﺘﻓﺮﮔ ﺭﺍﺭﺩﺍ ﻪﻧﻮﻤﻧ ﺭﺩ
ﺗﺎﻛ ـ ﺮﺘ
، ١٠٢ CFU>
ﺵﻭﺭ ﺭﺩﻭ ﻴﻣ
ـــ ﻳﺮﺟ ﻥﺎ ـــ ﺭﺍﺭﺩﺍ ﻥﺎ ﻱ
،
١٠٤ CFU>
ﻪﻧﻮﻤﻧ ﺭﺩ ﻥﮊﻮﺗﺎﭘ ﺯﺍ ﻲﺘﻈﻠﻏ ﺮﻫ ﻭ ﺮﺘﻴﻟ ﻲﻠﻴﻣ ﺭﺩ
ﺮﺘﻛﺎﺑ ﻢﻳﺍﺩﺮﺘﺗﺎﻛ ﺎﻳ ﻚﻴﺑﻮﭘﺍﺮﭘﻮﺳ ﻱﺭﻮﻳ
ﺖﻴﻤﻫﺍ ﺎﺑ ﻨﻴﻟﺎﺑ
ﻲ ﻩﺪﻴﻣﺎﻧ
ﺩﻮﺷ ﻲﻣ . ﺎﺑ ﻭ ﺩﺭﺍﺩ ﺖﻟﻻﺩ ﻲﺘﻓﺎﺑ ﻢﺟﺎﻬﺗ ﻪﺑ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ
١٠٥ CFU>
ﻢﺟﺎﻬﺗ ﻢﺋﻼﻋ ﻭ ﻲﻤﻳﺮﺘﻛﺎﺑ ﻭ ﺐﺗﺎﺑ ﻩﺍﺮﻤﻫ
ﺲﻳﺩ ـ ﻖﻳﺮﻌﺗ ﺩﺭﺩ ﻞﺜﻣ ﺖﻓﺎﺑ ﻒﻳﺮﻌﺗ ﻲﺘﻴﺳﺎﭙﺳﺍ ﻭ ﻲﺴﻜﻠﻓﺭ
ﺩﻮﺷ ﻲﻣ ) ٥ ( .
ﻪﻌﻳﺎﺿ ﺢﻄﺳ ،ﻪﻌﻳﺎﺿ ﺕﺪﺷ ﻭ
ﻱﺍﺮﺠﻣ ﺩﺮﻜﻠﻤﻋ ﻝﻼﺘﺧﺍ ﻉﻮﻧ
ﺘﻣ ﺍﺭ ﻲﻧﺎﺘﺤﺗ ﻱﺭﺍﺭﺩﺍ ﺮﺛﺎ
ﻣ ﻲ ﺩﺯﺎﺳ ) ٧ ( . ﻥﺍﺮﻈﻧ ﺐﺣﺎﺻ ﻲﻀﻌﺑ
ﻩﺩﺮﻛ ﺮﻛﺫ ﻢﻬﻣ ﺭﻮﺘﻛﺎﻓ ﻚﺴﻳﺭ ﻥﺍﻮﻨﻌﺑ ﺍﺭ ﻝﺎﻜﻳﻭﺮﺳ ﻪﻌﻳﺎﺿ ﺪﻧﺍ
ﻪﺟﺭﺩ ﻭ ﺮﺗﻻﺎﺑ ﻪﻌﻳﺎﺿ ﺢﻄﺳ ﻪﭼ ﺮﻫ ﻭ ﺕﺪﺷ
ﺮﺘﺸﻴﺑ ﻪﻌﻳﺎﺿ
ﺖﺳﺍ ﺮﺘﺸﻴﺑ ﺰﻴﻧ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﺮﻄﺧ ﺪﺷﺎﺑ )
١٢ ( .
ﺕﺎﻘﻴﻘﺤﺗ ﻖﺒﻃ
، ﻭ ﻱﺭﻮﻳﺮﺘﻛﺎﺑ ﺮﻄﺧ ﻦﻳﺮﺘﺸﻴﺑ ﻢﻳﺍﺩ ﺮﺘﺗﺎﻛ
ﻭ ﺏﻭﺎﻨﺘﻣ ﺮﺘﺗﺎﻛ ﻭ ﺩﺭﺍﺩ ﺍﺭ ﺖﻧﻮﻔﻋ ﻲﻬﺑﺎﺸﻣ ﻚﺴﻳﺭ ﻡﻭﺪﻧﺎﻛ
ﺩﺭﺍﺩ ﻲﻤﻛ ﺮﻄﺧ ﻚﻴﺑﻮﭘﺍﺮﭘﻮﺳ ﺵﻭﺭ ﻭ ﺪﻧﺭﺍﺩ )
١٢ ( . ﻩﺯﻭﺮﻣﺍ
ﺮﻄﺧ ﻢﻳﺍﺩ ﺮﺘﺗﺎﻛ ﻪﺑ ﺖﺒﺴﻧ ﺏﻭﺎﻨﺘﻣ ﺮﺘﺗﺎﻛ ﻪﻛ ﺪﻧﺍ ﻪﺘﻓﺮﻳﺬﭘ ﻧﻮﻔﻋ ــ ﺖ ﻱﺭﺍﺭﺩﺍ ﻫﺎﻛ ﺍﺭ ـ ﺖﻬﺟ ﺞﺣﺭﺍ ﺵﻭﺭ ﻭ ﺪﻫﺩ ﻲﻣ ﺶ
ﻱﺎﻣ ﻭﺮﺗ ﻞﻣﺎﺷ ﻲﺗﺍﺮﻄﺧ ﺰﻴﻧ ﺵﻭﺭ ﻦﻳﺍ ﺎﻣﺍ ﺖﺳﺍ ﻪﻧﺎﺜﻣ ﻪﻴﻠﺨﺗ ﺗﺭﻮﻳ ﻲﮕﻨﺗ ، ﺍﺮﺗﺭﻮﻳ ﻴﭘﺍ ﻭ ﻱﺭﻮﭼ ﺎﻤﻫ ،ﺍﺮ
ﺩﺭﺍﺩ ﺖﻴﻤﻳ ﺪﻳﺪ
) ١٣ ( . ﻲﻧﺍﺩﺮﻣ ﺭﺩ ﺮﺘﺗﺎﻛ ﻡﻭﺪﻧﺎﻛ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻲﺑ ﺮﻃﺎﺧ ﻪﺑ ﻪﻛ
ﺘﺗﺎﻛ ﻪﻴﺒﺷ ﺖﻧﻮﻔﻋ ﻥﺍﺰﻴﻣ ﺎﺑ ﺪﻧﺭﻮﺒﺠﻣ ﻱﺭﺎﻴﺘﺧﺍ ﺏﻭﺎﻨﺘﻣ ﺮ
ﺖﺳﺍ ﻂﺒﺗﺮﻣ )
١٢ ( ﻦﻜﻤﻣ ﻲﻟﻭ ﺖﺳﺍ
ﻩﺍﺭ ﺩﺍﺪﺴﻧﺍ ﻊﺒﻨﻣ ﺵﺩﻮﺧ
ﻞﺧﺍﺩ ﻪﺑ ﻼﻴﺴﺒﻠﻛ ﻭ ﺱﺎﻧﻮﻣ ﻭ ﺩﻮﺳ ﻞﺜﻣ ﺎﻫ ﻱﺮﺘﻛﺎﺑ ﺩﻭﺭﻭ ﺪﺷﺎﺑ ﺍﺮﺗﺭﻮﻳ )
٤ ( ﺮﺘﺗﺎﻛ ﺎﺑ ﻪﻧﺎﺜﻣ ﻪﻴﻠﺨﺗ ﺮﭘﻮﺳ
ﺵﻭﺭ ﻚﻴﺑﻮﭘﺍ
ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋﺮﻄﺧ ﻭ ﺖﺳﺍ ﻱﺮﺛﻮﻣ ﻱ
ﻲﻟﻭ ﺪﻨﻛ ﻲﻣ ﻢﻛ ﺍﺭ
ﮓﻨﺳ ﺩﺎﺠﻳﺍ ﻥﺁ ﮒﺭﺰﺑ ﺐﻴﻋ ﻁﺎﺒﺗﺭﺍ ﺭﺩ ﻪﻛ ﺖﺳﺍ ﻪﻧﺎﺜﻣ ﻱﺎﻫ
ﺎﺑ ٢٤ /
>٧ ﺖﺳﺍPH . ﻞﻳﺮﺘﺳﺍ ﻱﺭﻮﻴﭘ )
ﻱﺭﻮﻳﺮﺘﻛﺎﺑ ﺏﺎﻴﻏ ﺭﺩ (
ﻥﺎﺸﻧ ﻞﺜﻣ ﻱﺩﺎﻋ ﺮﻴﻏ ﻝﺎﻳﺮﺘﻛﺎﺑ ﻞﻣﺍﻮﻋ ﺎﺑ ﺖﻧﻮﻔﻋ ﻩﺪﻨﻫﺩ ﻞﺳ
ﭺﺭﺎﻗ ـ ﺖﺳﺍ ﺎﻳﺪﻴﻣﻼﻛ ﻭ ﺎﻤﺳﻼﭘﻭﺭﻮﻳ ـ .
ﺭﺩ ﻲﻓﺮﻃ ﺯﺍ ﺕﻻﺎﺣ
ﻭ ﮓﻨﺳ ﻞﺜﻣ ﻲﻧﻮﻔﻋ ﺮﻴﻏ )
ﺮﺗﺭﻮﻳ ﻪﺑ ﻪﻧﺎﺜﻣ ﺯﺍ ﺭﺍﺭﺩﺍ ﺲﻛﻼﻔﻳﺭ
( ﻲﻣ ﻩﺪﻳﺩ ﻞﻳﺮﺘﺳﺍ ﻱﺭﻮﻴﭘ ، ﻪﻴﻠﻛ ﻚﻴﺘﺴﻴﻛ ﻲﻠﭘ ﻱﺭﺎﻤﻴﺑ ﺎﻳ
ﺩﻮﺷ . ﻪﻌﻟﺎﻄﻣ ﺭﺩ ﻱﺍ
ﻂﺳﻮﺗ ﻪﻛ ﻦﻳﺭﻼﺳﺍ
ESELARIN ﻭ
ﻝﺎﺳ ﺭﺩ ﺶﻧﺍﺭﺎﻜﻤﻫ ٢٠٠٠
ﺪﺷ ﻡﺎﺠﻧﺍ
، ﻢﺴﻴﻧﺎﮔﺭﺍ ﻦﻳﺮﺘﻌﻳﺎﺷ
ﺷﺍ ﺸﻳﺮ ﻠﮐ ﺎﻴ ﻲ ) ٤٥ ﺪﺻﺩ ( ﻧﻮﻣ ﻭ ﺩﻮﺳ ﺎﻫ ﻢﺴﻴﻧﺎﮔﺭﺍ ﻪﻴﻘﺑ ﻭ ﺱﺎ
ﺪﻧﺩﻮﺑ ﺮﺘﮐﺎﺑ ﻮﺘﻴﻨﺳﺍ ﻭ )
١٢ ( .
ﻩﺎﮕﺸﻧﺍﺩ ﺭﺩ ﻱﺮﮕﻳﺩ ﻪﻌﻟﺎﻄﻣ ﺭﺩ ﮎﻮﮑﻠﺳ
SELCUK ﻪﻴﻛﺮﺗ
ﻝﺎﺳ ﺭﺩ ٢٠٠٤ ﻱﻭﺭ ٦٧ ﺭﺎﻤﻴﺑ ﻪﺟﻮﺗ ﺎﺑ ﺪﺷ ﺺﺨﺸﻣ SCI
ﻩﺍﺮﺑﺎﺸﻴﭘ ﺖﺸﻛ ﻪﻧﻮﻤﻧ ﺎﺑ ﻥﺁ ﻪﺴﻳﺎﻘﻣ ﻭ ﺭﺍﺭﺩﺍ ﺖﺸﻛ ﻪﻧﻮﻤﻧ ﻪﺑ ﻠﮐﺎﻴﺸﻳﺮﺷﺍ ﻲ
ﻭ ﺩﻮﺑ ﺎﻫ ﻪﻧﻮﻤﻧ ﺭﺩ ﺐﻟﺎﻏ ﻢﺴﻴﻧﺎﮔﺭﺍ ﻭﺮﻜﻴﻣ ٧٢
ﺪﺻﺭﺩ ﺑﺎﺸﻴﭘ ﻭ ﺭﺍﺭﺩﺍ ﻱﺎﻫ ﻪﻧﻮﻤﻧ ﻩﺍﺮ
، ﻭ ﻥﺯ ﺲﻨﺟ ﻭﺩ ﺮﻫ ﺭﺩ
ﺩﺮﻣ ﻠﮐﺎﻴﺸﻳﺮﺷﺍ ﻲ
ﻪﻛ ﺩﺍﺩ ﻲﻣ ﻥﺎﺸﻧ ﻪﻛ ﺪﻧﺩﻮﺑ ﺖﺒﺜﻣ
ﺵﺮﺘﺴﮔ ﻱﺍﺮﺑ ﻲﻤﻬﻣ ﻊﺒﻨﻣ ﻩﺍﺮﺑﺎﺸﻴﭘﺭﻮﻠﻓ ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ
ﻱ ﺭﺩ
ﻥﺍﺭﺎﻤﻴﺑ ﺖﺳﺍSCI
) ١٤ ( . ﻌﻟﺎﻄﻣ ﻚﻳ ـ
ﺷﺬﮔ ﻪ ــ ﻧ ﻪﺘ ــ ﺭﺩ ﺮﮕ
ﻩﺎﮕﺸﻧﺍﺩ GHENT ﺖﻧﮊ
ﻝﺎﺳ ﺭﺩ ﻚﻳﮋﻠﺑ ٢٠٠٣
ﺮﻈﻧ ﺯﺍ
ﻱﻭﺭ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ٧٤
ﺭﺎﻤﻴﺑ ﺘﻣ ﻩﻭﺮﮔ ﻪﺳ ﺭﺩSCI
ﺕﻭﺎﻔ
ﺎﻣﻭﺮﺗ ﻲﻟﻮﭘ ﻭ ﻚﻳﮋﻠﭘ ﺍﺭﺎﭘ ﻭ ﻚﻳﮋﻠﭘﺍﺮﺘﺗ )
ﻝﺮﺘﻨﻛ ( ﻡﺎﺠﻧﺍ
ﻥﺩﺮﻛ ﺭﺍﺭﺩﺍ ﺵﻭﺭ ﻪﻜﻨﻳﺍ ﻢﻏﺭ ﻲﻠﻋ ﻪﻛ ﺪﺷ ﺺﺨﺸﻣ ﻭ ﺖﻓﺮﮔ ﺩﺍﺪﻌﺗ ﺮﻈﻧ ﺯﺍ ﺩﻮﺑ ﻒﻠﺘﺨﻣ ﻥﺍﺭﺎﻤﻴﺑ ﻥﻮﻴﺳﺍﺰﻳ ﺮﺘﺗﺎﻛ ﻉﻮﻧ ﻭ ﻭ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻪﺑ ﻼﺘﺑﺍ ﺕﺎﻌﻓﺩ ﺍ ﻪﻧﻮﮔ ﺶﺧﺮﭼ
ﻱ ﺞﻳﺎﺘﻧ
ﻥﺎﻣﺭﺩ ﺭﺍﺭﺩﺍ ﻪﻧﻮﻤﻧ ﻦﺘﻓﺮﮔ ﺯﺍ ﺪﻌﺑ ﺖﺳﺍ ﺮﺘﻬﺑ ﻭ ﺖﺳﺍ ﻥﺎﺴﻜﻳ ﺗ ﻲﺑﺮﺠ EMPIRIC ﺖﺴﺗ ﻪﺠﻴﺘﻧ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻭ ﻩﺩﺮﻛ ﻉﻭﺮﺷ
ﺩﻮﺷ ﻲﺑﺎﻳﺯﺭﺍ ﻥﺎﻣﺭﺩ ﻪﻣﺍﺩﺍ ﻡﺍﺮﮔﻮﻴﺑ ﻲﺘﻧﺁ )
١٥ ( . ﻩﺪﻴﻘﻋ ﻖﺒﻃ
ﺿ ﻪﻜﻳﺩﺭﺍﻮﻣ ﺭﺩ ﻥﺍﺮﻈﻧ ﺐﺣﺎﺻ ـ
ﻳﺎ ـ ﻌ ـ ﺣﺎﻧ ﺭﺩ ﻪ ـ ﻴ ـ ﻝﺎﻜﻳﻭﺮﺳ ﻪ
ﺩﺭﺍﺩ ﺩﻮﺟﻭ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﺮﻄﺧ ﻦﻳﺮﺘﺸﻴﺑ ﺖﺳﺍ .
ﻥﻮﺴﮑﻳﺭﺍ
ﻥﺍﺭﺎﮑﻤﻫ ﻭ ﺭﻮﭘ ﻲﻤﻴﻠﺳ ﺮﺘﮐﺩ
ﻲﻋﺎﺨﻧ ﺕﺎﻌﻳﺎﺿ ﺭﺩ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ١٤٥
ERICKSON ﻝﺎﺳ ﺭﺩ ﺶﻧﺍﺭﺎﻜﻤﻫ ﻭ
١٩٨٢ ﺵﺭﺍﺰﮔ
ﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻪﻛ ﺪﻧﺩﺍﺩ ﺖﻤﺴﻗ ﺭﺩ ﻪﻌﻳﺎﺿ ﻪﻛ ﻚﻳﮋﻠﭘ ﻱﺭﺩﺁﻮﻛ ﻥ
ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﺮﻄﺧ ﺖﺳﺍ ﻲﻋﺎﺨﻧ ﺏﺎﻨﻃ ﻲﻳﻻﺎﺑ ﻱﺎﻫ ٥
/ ٢
ﺖﺳﺍ ﻚﻳﮋﻠﭘﺍﺭﺎﭘ ﻥﺍﺭﺎﻤﻴﺑ ﺯﺍ ﺮﺘﺸﻴﺑ ﺮﺑﺍﺮﺑ ﺖﻤﺴﻗ ﺭﺩ ﻪﻌﻳﺎﺿ ﻪﻛ
ﺖﺳﺍ ﺮﺗ ﻲﻧﺎﺘﺤﺗ )
١٦ ( .
ﻩﺎﮕﺸﻧﺍﺩ ﺭﺩ ﻱﺍ ﻪﻌﻟﺎﻄﻣ ﺭﺩ
ﻭ ﻳ ﺟﺮ ﻴﻨ VIRGINIA ﻴﺎ ﺎﻜﻳﺮﻣﺁ
ﻝﺎﺳ ﺭﺩ ٢٠٠٠ ﻱﻭﺭ ٨٩ ﺭﺎﻤﻴﺑ ) SCI ﻦﻴﺑ ﻦﺳ ٢٢
ﺎﺗ ٨٢
ﻝﺎﺳ ( ﻲﻧﺍﺭﺎﻤﻴﺑ ﻪﻛ ﺪﺷ ﻡﻮﻠﻌﻣ ﻭ ﺖﺒﺜﻣ ﺭﺍﺭﺩﺍ ﺖﻳﺮﺘﻴﻧ ﻪﻛ
WBC/HPF>6 ، ﻪﻌﻳﺎﺿ ﺢﻄﺳ ﺯﺍ ﺮﻈﻧ ﻑﺮﺻ ﺪﻧﺭﺍﺩ
ﻭ ﺖﺳﺍ ﻻﺎﺑ ﺖﺒﺜﻣ ﺭﺍﺭﺩﺍ ﺖﺸﻛ ﻭ ﻱﺭﻮﻳﺮﺘﻛﺎﺑ ﻪﺑ ﻼﺘﺑﺍ ﻚﺴﻳﺭ ﻪﺑ ﻼﺘﺑﺍ ﻝﺎﻤﺘﺣﺍ ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ
ﻱ ﻥﻭﺪﺑ ﻞﻴﻟﺪﺑ ﻱﺭﺎﻤﻴﺑ ﺩﻮﻋ ﻭ
ﺁ ﻪﺑ ﺖﻣﻭﺎﻘﻣ ﻭ ﻝﺎﻴﺑﻭﺮﻜﻴﻣ ﻲﻠﭘ ، ﻥﺩﻮﺑ ﺖﻣﻼﻋ ﺎﻫ ﻚﻴﺗﻮﻴﺑ ﻲﺘﻧ
ﻪﺘﻓﺎﻳ ﺶﻳﺍﺰﻓﺍ ﺖﺳﺍ
) ١٧ ( .
ﺮﮕﻳﺩ ﻲﻓﺮﻃ ﺯﺍ ،
ﻦﺘﮕﻨﻴﺷﺍﻭ ﻩﺎﮕﺸﻧﺍﺩ ﺭﺩ ﺶﻧﺍﺭﺎﻜﻤﻫ ﻭ ﻦﻤﻓﺎﻫ
ﻝﺎﺳ ﺭﺩ ﺎﻜﻳﺮﻣﺁ ٢٠٠٤
ﻭ ﺖﻴﺳﺎﺴﺣ ﺮﻈﻧ ﺯﺍ ﻪﻌﻟﺎﻄﻣ ﻚﻳ
ﻭ ﻳ ﮔﮋ ﻲ ﺭﺍﺭﺩﺍ ﺖﺴﺗ ﺭﺍﻮﻧ ﺯﺍﺮﺘﺳﺍ ﺖﻴﺳﻮﻛﻮﻟﻭ ﺖﻳﺮﺘﻴﻧ ﺶﻳﺎﻣﺯﺁ
DIPSTICK ) (
ﻱﻭﺭ ٥٦ ﺭﺎﻤﻴﺑ ﻪﺑ ﻚﺷ ﻪﻛSCI
ﺖﻧﻮﻔﻋ
ﺭﺍﺭﺩﺍ ﻱ ﺭﺍﺭﺩﺍ ﺖﺸﻛ ﻡﺎﺠﻧﺍ ﺯﺍ ﺪﻌﺑ ﻭ ﺪﺷ ﻡﺎﺠﻧﺍ ﺪﻨﺘﺷﺍﺩ
ﺷ ﺺﺨﺸﻣ ﺎﻫ ﺖﺴﺗ ﺖﻴﺳﺎﺴﺣ ﻪﻛ ﺪ
٦٤ ﺪﺻﺭﺩ ﺎﻬﻧﺁ ﺖﻗﺩ ﻭ
٥٢ ﺪﺻﺭﺩ ﻪﺑ ﺮﺠﻨﻣ ﺎﻫ ﺖﺴﺗ ﻦﻳﺍ ﻪﺠﻴﺘﻧ ﻪﺑ ﺩﺎﻤﺘﻋﺍ ﻭ ﺖﺳﺍ
ﺪﻳﺎﺑ ﹰﺎﻤﺘﺣ ﻭ ﺩﻮﺷ ﻲﻣ ﻥﺍﺭﺎﻤﻴﺑ ﺩﺭﻮﻣ ﻲﺑ ﻭ ﺪﺣ ﺯﺍ ﺶﻴﺑ ﻥﺎﻣﺭﺩ ﻴﻗﺩ ﻭ ﻞﻣﺎﻛ ﻥﺎﻣﺭﺩ ﻚﻳ ﻱﺍﺮﺑ ﻖ
، ﺭﺍﺭﺩﺍ ﺖﺸﻛ ﺎﺑ ﻥﺍﺭﺎﻤﻴﺑ
ﻲﺑﺎﻳﺯﺭﺍ ﺪﻧﻮﺷ ) ١٨ ( .
ﻟﻴ ﻨ ـ ﻣ ﻦﺴ ـ ﺎﻳ LINSEN MEYER ﺮ ﺳ ﺭﺩ
ـ ﻝﺎ ۲۰۰۳ ﺑ ــ ﺎ
ﻱﻭﺭ ﻪﻌﻟﺎﻄﻣ ۱۴۷
ﺭﺎﻤﻴﺑ ﺎﻜﻳﺮﻣﺁ ﻲﺳﺮﺟ ﻮﻴﻧ ﺖﻟﺎﻳﺍ SCI
ﻱﺭﺎﻤﻴﺑ ﻢﻳﻼﻋ ﻱﻭﺭ ﺯﺍ ﻖﻴﻗﺩ ﺭﻮﻃ ﻪﺑ ﻪﻛ ﺖﻓﺮﮔ ﻪﺠﻴﺘﻧ
، ﺩﻮﺟﻭ
ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻱ
ﻨﻨﻛ ﻲﻨﻴﺑ ﺶﻴﭘ ﻥﺍﻮﺗ ﻲﻤﻧ ﺍﺭ ﺪ
. ﻪﻌﻟﺎﻄﻣ ﻦﻳﺍ ﺭﺩ ﺩﻮﺟﻭﺮﺑ ﻝﺍﺩ ﻲﻤﺋﻼﻋ ﺎﺑ ﻥﺍﺭﺎﻤﻴﺑ ﻞﻛ
ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻱ
ﻪﻌﺟﺍﺮﻣ
ﺩﺍ ﺰﻴﻟﺎﻧﺁ ﺖﺤﺗ ﻭ ﻩﺩﺮﻛ ﺭ
ﻭ ﺪﻨﺘﻓﺮﮔ ﺭﺍﺮﻗ ﺭﺍﺭﺩﺍ ﺖﺸﻛ ﻭ ﺭﺍ
ﻂﻘﻓ ﻪﻛ ﺪﺷ ﺺﺨﺸﻣ ۶۱
ﺪﺻﺭﺩ ﻭ ﻩﺩﻮﺑ ﺢﻴﺤﺻ ﺺﻴﺨﺸﺗ
۳۹ ﺪﺻﺭﺩ ﻭ ﻳ ﮔﮋ ﻲ ﻪﺘﺷﺍﺪﻧ ﺍﺭ ﺺﻴﺨﺸﺗ ﻱﺍﺮﺑ ﻡﺯﻻ ﻭ ﺪﻧﺍ
۱۲
ﻦﻳﺍ ﺯﺍ ﺮﻔﻧ ۳۹
ﺪﺻﺭﺩ ﻱﺭﺎﻤﻴﺑ ﻥﺍﺭﺎﻤﻴﺑ ﻪﻴﻘﺑ ﻭ ﻱﺍ ﻪﻨﻴﻣﺯ ﻱﺎﻫ
ﻱﺭﻮﻴﭘ ﻥﻭﺪﺑ ﻱﺭﻮﻳﺮﺘﻛﺎﺑ ﺪﻨﺘﺷﺍﺩ
. ) ۱۹ (
ﻪﻧﺎﺜﻣ ﻥﺩﻮﺑ ﺪﻴﺳﻼﻓ ، ﻪﻌﻟﺎﻄﻣ ﻦﻳﺍ ﺭﺩ ﻪﻛ ﺪﺳﺭ ﻲﻣ ﺮﻈﻧ ﻪﺑ ﻊﻤﺠﺗ ﻭ ﺪﺷﺭ ﻱﺍﺮﺑ ﺍﺭ ﻪﻨﻴﻣﺯ ﻲﻣ ﺮﺗﺪﻋﺎﺴﻣ ﺎﻫ ﻢﺴﻴﻧﺎﮔﺭﺍ
ﺩﺯﺎﺳ
ﻤﺘﺣﺍ ﻭ ﺎ ﻝ ﻔﻋ ــ ﺭﺍﺭﺩﺍ ﺖﻧﻮ ﻱ
ﻲﻓﺮﻃ ﺯﺍ ﻭ ﺩﻮﺷ ﻲﻣ ﺮﺘﺸﻴﺑ
ﺭﺩ ﻲﻧﻻﻮﻃ ﺕﺪﻣ ﻪﻛ ﻲﻳﺎﻫﺮﺘﺗﺎﻛ ﻩﮋﻳﻭ ﻪﺑ ﺮﺘﺗﺎﻛ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻱﺍﺮﺑ ﺍﺭ ﻪﻨﻴﻣﺯ ﺪﻨﻧﺎﻣ ﻲﻣ ﻲﻗﺎﺑ ﻱﺭﺍﺭﺩﺍ ﻱﺍﺮﺠﻣ ﺩﺯﺎﺳ ﻲﻣ ﻢﻫﺍﺮﻓ .
ﺮﺘﺗﺎﻛ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻞﻴﻟﺩ ﻦﻴﻤﻫ ﻪﺑ ﻥﻮﻴﺳﺍﺰﻳ
ﻴﺟﺮﺗ ﺏﻭﺎﻨﺘﻣ ﺢ
ﻲﻣ ﻩﺩﺍﺩ ﺩﻮﺷ . ﺪﻣ ﻪﭼ ﺮﻫ ﻲﻓﺮﻃ ﺯﺍ ﻥﺎﻣﺯ ﺕ
ﺬﮔ ﻲﻋﺎﺨﻧ ﻪﻌﻳﺎﺿ ﺯﺍ ﻱﺮﺘﺸﻴﺑ ﺍ ﺖﻠﻋ ﻪﺑ ﺪﺷﺎﺑ ﻪﺘﺷ
ﻩﺩﺎﻔﺘﺳ
ﺰﻴﻧﻮﻠﻛ ﻭ ﺎﻫﺮﺘﺗﺎﻛ ﺯﺍ ﺭﺮﻜﻣ ﻣ ﻥﻮﻴﺳﺍ
ﺎﻫ ﻢﺴﻴﻧﺎﮔﺭﺍ ﺎﺑ ﻪﻧﺎﺜﻣ ﻡﻭﺍﺪ
ﺎﻤﺘﺣﺍ ﻝ ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻱ
ﺩﻮﺷ ﻲﻣ ﺮﺘﺸﻴﺑ .
ﻧ ﺭﺩ ﺩﺭﺍﻮﻣ ﺭﺩ ﻪﻛ ﺩﻮﺷ ﻲﻣ ﺩﺎﻬﻨﺸﻴﭘ ﺖﻳﺎﻬ ﻱ
ﺭﺎﻤﻴﺑ ﺎﺑ ﻪﻛ
ﺎﺑ ﻩﺍﺮﻤﻫ SCL ﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ
ﻱ ﺭﻮﻳﺮﺘﻛﺎﺑ ﺎﻳ ﻭ ﺐﺗ ﻭ ﻱ
ﺩﺎﺣ ﺕﺭﻮﺻ ﻪﺑ ﺪﻳﺎﺑ ﻢﻳﻮﺷ ﻲﻣ ﻪﺟﺍﻮﻣ ﻲﻤﻳﺮﺘﻛﺎﺑ ﻭ ﺯﻮﺘﻴﺳﻮﻜﻟ ﻲﻧﺍﺭﺎﻤﻴﺑ ﺭﺩ ﻭ ﻢﻴﻨﻛ ﻉﻭﺮﺷ ﺍﺭ ﻥﺎﻣﺭﺩ ﻱﺭﺍﺭﺩﺍ ﺖﻧﻮﻔﻋ ﻪﻛ
ﻪﻛ ﺩﺮﻛ ﻩﺩﺎﻔﺘﺳﺍ ﻲﻳﺎﻫ ﻚﻴﺗﻮﻴﺑ ﻲﺘﻧﺁ ﺯﺍ ﺪﻧﺭﺍﺩ ﺭﺍﺩ ﺖﻣﻼﻋ ﺍ ﻒﻴﻃ ﻦﻳﺮﺘﻜﭼﻮﻛ ﻭ ﻩﺩﻮﺑ ﺮﺗ ﻲﺻﺎﺼﺘﺧﺍ ﺕﺪﻣ ﻭ ﻪﺘﺷﺍﺩ ﺍﺭ ﺮﺛ
ﻲﻫﺎﺗﻮﻛ ﻥﺎﻣﺯ ﻟﻮﻨﻴﻛ ﻭ ﺎﻫ ﻦﻳﺭﻮﭙﺳﻮﻟﺎﻔﺳ ﻪﻛ ﺩﻮﺷ ﻡﺯﻻ
ﻥﻮ ﺎﻫ
ﺪﻨﺘﺴﻫ ﺐﺳﺎﻨﻣ .
ﻪﻴﺣﺎﻧ ﺖﺷﺍﺪﻬﺑ ﻭ ﻱﺰﻴﻤﺗ ﻆﻔﺣ ﺎﻫ ﻡﺍﺪﻧﺍ
ﻱ
ﻠﺳﺎﻨﺗ ﻲ ﻪﻴﺻﻮﺗ ﻞﻳﺮﺘﺳﺍ ﻂﻳﺍﺮﺷ ﺭﺩ ﺏﻭﺎﻨﺘﻣ ﻥﻮﻴﺳﺍﺰﻳﺮﺘﺗﺎﻛ ﻭ
ﺩﻮﺷ ﻲﻣ .
1. de-Droat WC. Mechanisms underlying the recovery of lower urinary tract function following spinal cord injury. Paraplegia 1995;33:493-505.
2. Pikov V, Wrathass JR. Coordination of the bladder detrousor and the external urethral sphincter in a rat model of spinal cord injury: effect of injury severity. J Neurosci 2001;21:559-69.
3. Baraldo PS, Neves EG, Alves CM, et al.
Pyrexia in hospitalized spinal cord injury patients.
Paraplegia 1993;31:186-91.
4 – Montgomerie JZ , Morrow JW . Long-term Pseudomonas colonization in spinal cord injury patients.Am J Epidemiul 1980;112:508-517.
5- Cardenas DD , Hooton TM. Urinary tract infection in persons with
spinal cord injury . Arch Phys Med Rehabil 1995;76:272-280.
6. Newman E, Price M. Bacteriuria in patients with spinal cord lesions: its relationship to urinary drainage appliance. Arch Phys Med Rehabil 1977;58:427-30.
References :
١٤٦ / ﺏﻮﻨﺟ ﺐﻃ
ﻩﺭﺎﻤﺷ ﻢﺘﻔﻫ ﻝﺎﺳ ٢
/ ﺪﻨﻔﺳﺍ
١٣٨٣
7- Waites KB , Canupp Kc , Devivo MJ . Epidermiology and risk factors for urinary tract infection following spinal cord injury . Arch Phys Med Rehabil 1993;74:691-695.
8- Yoshimura N . Bladder afferent pathway and spinal cord injury : possible mechanisms including hyperreflxia of the urinary bladder . Prog Neurobios 1999;57:583-606.
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