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Transcription

1 # 1&#,(,( ,(( ((, ,((( (((, ",(8, :,8, % ;,& ; $,& ;, :,8( 8(, $,% $ $, $ ;, $$ <, $:,<,,/ $:,<,$,/ $: 1,- -./#**#((

2 #,8(( 8((, 6 = ;3,,#- # ; ;",$,-+ -+,$,, ;",$,$,( <$,;, <<,;,,& <<,;,$,& <",;,;,& <>,<, =1 6 = $,<,,& $,<,$,# ",<,;, >,<,<, - 7 % :,<,3,( 6 = :,<,, ,3,%- 6 =1 %- 6 = ,3,,& ,- -./#**#((

3 #,3,$,)-???????????,3,;,) ",3,<, ",3,3, "",3,, ":,8((( 8(((, >,,) 7 ) >,,,@ >,,$,)A >;,,;, >;,,;,,& >;,,;,$,& ><,,;,;,& >:,$,&7 &7 & :,;,& & & ::,<, ,3, 1 1?????????????,3,,% ,3,$, ,3,;, ,- -./#**#((

4 #,(B (B,1+ 1?????????????????2 :,B,9 7 1?? $$,B( B(,????????????????????222 $;,,( $<,$,) $<,;, ;,<,% <,B(( B((,. +????????????2 "<,B((( B(((,9 9?????????????????????2 ",B(8,&A7 &A7?????????????????????2 >,B8 B8,'- '-??????????????????? >< 4,- -./#**#((

5 # (,(94%/.(4 & -, = 1C = :D A "D -7C C = 1C 7 = D2&+ -7 = 6 C= 2 & ) ((( $3C 1 =A C + E= 2 #)C 62F7= 5C C 66 + A#' G + 7C 7 1 A= 2% 7C+ 6C C +-C A 12# C = C ,- -./#**#((

6 # ((,4'F.(*%&/% 4'F.(*%&/% #+C 56.A 1C66 2 % =12 9A +,-, -./ ((2 +2 & +, - (-67 1=*2, + 6A A+C A7C7+ 66 A +2, 7 H 1 I)#9.&)9(/B 2 6,- -./#**#((

7 # (((,(*49(/ (*49(/J K, % "C+ +L$M= C A 7 A A66 2, # :"C + A C6= - $= 2, :">C A='N7=5A7 2, :>$C ) O = + 2 6P E7C 7 7 #' =12, :><C , :>"C + 2, :>:C A = LEM2 7,- -./#**#((

8 #, ::C 7 - * 2, ::<C 6 (A/*#2, ::3C 6 -#%)2, ::3CAN='2F)+12, ::C )(2, :::C+ 6 ::32, $C+ )((2, $3C+ )(((2 8,- -./#**#((

9 # (8,9#11&*/9& *4)#. *4)#.J$C;K & A E C 6 C L8 (@2 M (@ 7-72,&76 &76 - C L+(@2$M, %=7+ -62, % = QC=2 9,- -./#**#((

10 #, % =6 - C 6 7.&C A6-2 & E 5 C + : D6 72( +R A E7 E6A7 C67 A 2 1,- -./#**#((

11 # 72 11,- -./#**#((

12 # $,&7 & C - 7 S@T =- C L8(@2;M (@;7 12,- -./#**#((

13 # 8, 9#11& */9 &# *.94(9 %/4%#& (,& -7 - J$C<,"K & -7 C H 5, =6-2 &- S@T C C = -72 * & 7 2 & 2 & -- 2 & 6-72 * = H -6C - -7C 7 -=;C+ 7 -= 2 % C C -- C C ,- -./#**#((

14 # & +& CA 6 V.& A 6 C C - 6 = S - +-, - 7T 7 5 H & 5 - H -7C 6C - C C C + C - A + C A7 6,+ A 7$ - 2 &66 E Q!WQ = C +,+C H Q WQ L8(@2<M 14,- -./#**#((

15 # 2 & - C - = C 6 + -, 7 C A2L8(@23M (@3 2 15,- -./#**#((

16 # &,7 C -7C - 7 C +6 C -7C C - C A? 7 C 6C=A A - 2 ) C 7-,7+ A, R C2)E)21N+ + 7 L- = - #M 2 $,&7- J;C>C:C C C $K & ,=,+ Q C :3<C ,5 2 1 :3:C 2 16,- -./#**#((

17 #,,&- 6 +,,,& ( + -, C A 7, & V 6 -C - = C Q A C - ; +6 C=" 672L8(@2M (@7-, 2,,$, & H + 7C ,- -./#**#((

18 #,$,&- 6,$,,& + 7 C 6 7-R = + 2 & ,$,$,&6A - 7A # A- A "C<C C C ,- -./#**#((

19 # ;, ;C <K &L'#4'#4M =7 7 = 5P C A 7CA,7+ 72 & C +-7L M - L 7+ M & A L)#4)A# 4M 7 - LX-!N-()*.M L<X-!N-*.M =7 E +A +=A + 2& & L1#4 1N# 4M A + 3 Y + C3 + 2 & = -72 * Z [ -, C & = ,- -./#**#((

20 # 8(,9#11&*/9& - -, & & I = 7 C L8 (M J 3C K 1944%/9 &*(4 #. )72 / ) /+ #'&#/( -7 J "K2 $,- & % AC = A C 7 + D 5 2,- -./#**#((

21 # C + C$D E C > +A C > 2L >C :M2&-7$=< C A -7 7$=; 6+ 2 & < 7 67 E55 2 & - A = 6-7= J 3C$C$ K2L8((M / /-7 1+ >D $D ( # >C3Q3! C3! *A ;! \ 1%7 <,3 33,3 ) D $C3D #'&#/((- J "K 21,- -./#**#((

22 # C$C$$C$;K & A - G C +- H C A2L8(((M #./9*%#@9**(42 #./9*%%*2 #72.=2 *2 ' - 7 A2 ) 2 ) A- 72 ) AEL= M2 (((. - -, J K2 22,- -./#**#((

23 # ;,,# JC$<K ;,,,#- 6- & 7 A + - 2( +7 2% C + LE;D AM2 7C -7 =A,7 + E A A2 & = A 7 A6- o #- A---72 o #- 2 o 9, -2 o # L 6 - M2 o #- +72 ;,,$,% 66 7 C66A - 7A2. = 6 - L - = A M 7 H 23,- -./#**#((

24 # N = 2 ;,$,#- -6A- A- J C;CC$3C$CK ;,$,,) & 7 +, C 66C o.a7-6 2 o.a , 6 ] L#(*MC ]C L - M2 ;,$,$, CC6 CC6 & 67 C C C A P = C 6A C 7 + I + C A C C #A 7 1 C C - + E 67 1<3 L.U12$.2 :M 7 (11 7C 7 C 24,- -./#**#((

25 # & A+ 6 I 7 --+= 62 ;,$,;,( ( 6 = & -7C H C -C - H 6A - 6 =2 ;,;,#6J$>C$:C;C; K ;,;,,- 7 & - -2# - 6A + = <D2. 2& <D % C - +E$!; I 7-7 A2 25,- -./#**#((

26 # ;,;,$,* / o & o &5A 75 2 ;,;,;, -7-7 & A *7 C A 6C A + +C A + - C 7 + A C -+C + 2 ;,;,<,* [ -,. C = C7- + L<$DMC L <DM 6C L:DM2 26,- -./#**#((

27 # C - + C ;,;,3,, 7 & + +C - C -? C 6-2 & 6- " ,- -./#**#((

28 # #7 1 #&9#(4%*%**%&#)///* A - 7A & +,66 Q MALADIE ULCEREUSE GASTRODUODENALE 9- #./9* *A 17 ) # (@/9" " + + J;3K J;3K2 28,- -./#**#((

29 # <, <,, 7J;$K & @%2,7C A -- = PC + C CC- V 2 & - 77 V + 2 <,$,& 7 <,$,, C @)/%L@^)/% M = $C3D J 3K2 #67C % &NJ;3KG - <D + A D ++2%A 5 J;K # J;"K A -7 = <3D = $D C - -+ ;"D=>:D672 29,- -./#**#((

30 #. = 6 2&7-- #(* &- I -+ 6+C I A & C 7 C C C7 -- J 3K2, &A= -- G7, 6L -, M2. < G A =--+7+= ;"C3D C:D 6 + 2J;;K, & A ,= C 77 - C3J< C<$K E 7 3,- -./#**#((

31 # - G - C3;C<2J<;K, 6 - A-7 6 J<<C<3K2 *( (-+ *(-+ 5C2 *( -7 2 *(( ((- *(( *((6 2 *(( *((( ((( --2 o / + + $ C A - -C ( (( ++-7J< C<C<"C<$C<>K2L. A(8M2 31,- -./#**#((

32 # * ( 33 ;3 (( <; ;< (( $$ " (( ; ((( 3 C3 $ #'&#/( *2 <,$,$,16 16 M 6 += DL;>M2 #67G +=$>D2L/-7 6 M <D= ;<D #672 & 6-7 S- TC66 = = C I -L3DM+ 2&A ,- -./#**#((

33 # 72&, %- A 2 & - L A 6 M + + C - - 2/ & -C C C L 6 MC,2 <,$,;,* & 7, # C 6 Z C3D 2% #6 C67 A C 6 C &N J;3K 5 J;K + 3D :D + C C<D2* C 3D=D 2 = _ C= 6C7 - = C -- +, A 6C A - -7 = 5 72& + 33,- -./#**#((

34 # N2 # + -7 C & 7C 1 L7 - M C I 7 7 C + H 7C + A 66 ="D A + =;D2 7 - = A C -J 3C;:C<K2 <,$,<,, A #67<A ,- -./#**#((

35 # 8((,/%%& /%%&(.(4 (.(41#9&(.4'#.91U&49( 1#9&(.4'#.91U&49(,#- - &- :66 2L88M -7 * LDM :>: 2 C ( :>< 26 ( :>< 2 :;C" A :> 26. C :<C" 1 :: 2 * ( :< & ::$ 2 * -7 ' :: & :"C3 ::; 2 A. CC : 49N ::$ (2 '7 Z-#9 *2A@ C J<:K 35,- -./#**#((

36 # -6 C + 6S/TS4TC;=3X - X2J<C<:C3,3;K2( - 7A- =6 G - C + A- A-,IC I + A A = C,=, A- DC ; = 3D A- C D -E 7C >3D E2& ;3. =;".C 7, =;. + = <$.C + +2& C: >2 ' 7 - C -7 I + 1C -R = + 7 C V = C - = 7 = 2 3="5 - -C CC-A 6C 72 E 7 7-7C 7 A + - C - C C E C CCJ<:C3<,3:K2&+A +- G7A + I2& 7C , C V A - 1C = 36,- -./#**#((

37 # - 7 AI J,;K $,-+ -+ $,,1+ &+ + 6 $,,,& --7 (@>1+ 6 =1L ::>MJ<K & 6 =1 + L8(@2>MC & = 1 +C 6 C+ #67C #7C7 C #7 #24 ++ C & + ;D 37,- -./#**#((

38 # C;<D # -;D/*#C " D)C:D.H+ ">D #-J3K2& 8( + 6 2JK # 1 # 1D 9 :: ;< :. $ > $: /*# :: 3$ "". /*# ::: $;:< < 95 ) $ 3 $ )EN F $ > 3 B -W - $ 3:: $ 4- $; "" :>C" #- $< >: # 9 $< ""3 >> 8( ,- -./#**#((

39 # $,,$,8 +R-C66 -C66 - % C R- A% - + 6C,- + R- 6 EC77 R-L8(@2:M2% 6 C + + R-C 6 AR-+ 2J"C>K.A 6 I 7C+ + A 66- G=R-- A+ - - A 5 C + = $D C = ++ C 7 - J:C"C" KC 67 = 72 39,- -./#**#((

40 # LA SEROPOSITIVITE DE L'HP SELON L AGE (%) AU BRESIL (REGION DE MATO GROSSO) % 5 SEROPOSITIVITE (%) < <7 AGE (ANS) (@: LA SEROPOSITIVITE DE L'HP SELON L AGE (%) AU BRESIL (REGION DE MATO GROSSO). J" K $,,;,&A &+ 6 - E7E62 J"$C";K2 $,,<,&, 7 % C + 7 = C # J"<K + 6 = 1 E 6-6+ <D + C7+ 2"DE 6-7C ,- -./#**#((

41 # #67 C + + E 57 + C 7 E A 7 7 H J"3K2/ 7 6 A C + 6 = 3 = J"KC 'C C L88((M 9+ 6 LDM La/*Mb $ :$2;D $,$< ><2>D $<,; "23D ;,<> "3D <>, D \ 3D 8(( 6 = 6 + 'L- )-MJ" K 41,- -./#**#((

42 # $,,3,- 7 * &#( A - &#%# +1CZ= - & - -&O(* + A 1CA 7+ ++G A - = 6 C 67 6= 2J""K $,,, 7 & = 1 - #C E L">MC I - C, [ - C? , 7 A + 6 C + I= 72J>C":K $,$,( $,$,,7 6 = 6 & 7 6 L+8(((M 42,- -./#**#((

43 # ( LDM J>K $CLb3 M F J> K $C"Lb3 M C"L\3 M 'J>C>;K ;C>Lb $ M. J>$K 3,;L3 M L\3 M$,<L M -J><K L, $ M" L M"3L3," M #'&#/8(((7 6 = 6 2 $,$,$,7 =R- - & 6 = 1 6C 5 6 = D2#A, C 5= $ C A + C<:D 2 C H A 7 C3D2J"C>$K2 43,- -./#**#((

44 # ;,- 7 ;,,&+ + ;,,,9+ &+ +& 1+C =C c17 I 7 7 V L1.9MC66 ++C"<D + 6 ' + C D. J>3C>K2 & C 7 1.9C +7 C J>"K c+ & +"3D C >D = ><DC + A67C+A+ D3D2J>"K c# *C5 -C J>>K / - ++E C 1 44,- -./#**#((

45 # +;A A< +16 2J>:K ( A 1 2% ' +AC1+ 7 $D & + +C & H +, 6 72 &1 E C 1 E ,2 & 76-7 A 1 I52 # -+ & N 2 45,- -./#**#((

46 # ;,,$,9+ & J>:K & & I 6 C 7 -J:KC57= & E 2J>:K ;,,;, + & 1 E +C + C C 7 + =+6W+1 3D 2& &A 6 +C +1.9 A = J: C:$K & 6 ] = C ,- -./#**#((

47 # + -C+ 1 C C C C H7 6 2J:;K % (-+6C ++ =<C 6+C J:<K & & ;,$,& ;,$,,( 1 6 % 6 12& = C3 C + 6 _ C C C C32% = 6 67 = 6 2J:3C:C:"K ;,$,$,&H &H % H ,- -./#**#((

48 # 6 6J:KC777 6 I C 7-62J:>C::K ;,$,;,&J C C $K / C I / E A 1 - H 2% AA A 2 ;,$,<,9H 6 & C = 62 ;,;,) & 6,, A 6 1 = ;,;,,& & 6, % ++ C65 H 1C - -72#1C+ 1E 7+E 48,- -./#**#((

49 # 7 + A 6 +C A7 6 C / + C H 6 =1J ;K2% - H 6 C ^= E C -657^= 2J <K% 7 6 =1 67 =+-#7 +,'C7 6+ = 6,2J 3C K ;,;,$,&, % C + C #67G + 7, 2*E EA +C +++ EC A 7C 7 -- C +, J "K2 1 C % C + J >K2 49,- -./#**#((

50 # ;,;,;,& -,. + + C J :C K2 ;,;,<,& -, C ;,;,3,# E.+ J K2 5,- -./#**#((

51 # & 6 =167 C Y+ 6 + ":D2 & + 6 = 1 + 6,&R-2,&A2,&2,& +, 72,& & C- + 6,, C = 6,2 51,- -./#**#((

52 # 1 <,,& &1 = - -, C,& 2,&)#&2,& -72 & 7 7 C ++ L MC A 7 C= <,,, 7-7 &IC C 7 - C <,,,,& &. E AC C 52,- -./#**#((

53 # 7 = 2$ = 1 = -7 72J C KC.+ 6C 7-72)H I =C C E<DJ $K2 /L.4$$MQ$$4QQ$<QQ.4;, / cccccccccc - 1ccccccccccccc & <Q.4;,2 <,,,$,* 7 6-J ;KL8(@2 M * =+ 2&<=6- - C - = A C A = (@2 1-R=6-53,- -./#**#((

54 # / 6 1 6A A C N > L67+ M2 <,,$,& J <C 3K &1 -R= &+72 & L&1*MC % E = + LAM2 & C7 6 +,=,+-72 & = C - 2 <,,;,& <,,;,,A AJ C "K &- = ,- -./#**#((

55 # & L&1*M A C 66C&1*A=6I &`C = 6 E C V - -7C,I6 21C&1* 6 - C 6 H - + =-72 & A + 8# - 8#C 3D1C+E:DA D AC H A J >K2& -I -# 7 = - + -= 7- )#&2 %-I + I + - -I #C' (( %A 6L+(BM2 55,- -./#**#((

56 # + / +-7 A#. N - )1 *A 9 =-. 9 =- 8#.A 8.-# &.A7+ # % )7 %- ) & ( - & 7 6 (B&6+ J >K 56,- -./#**#((

57 # <,,;,$,9 & =6- =H & = A7 2 & 1 +-7C 7AE A2 & A E J <K A L*4%MJ 3K A =1 =-C I <,$,# # <,$,, J :K &d & A A5 2 & = 2 57,- -./#**#((

58 # = <,$,$,9 9H H.EA 7 - ( - ((C = - (7 +72 <,$,;,9H 9H EACA + --7C 5 C7=- - 2 <,$,<,) C - = C <,;,+ - 7 &- = 1-6 C V C C C I'C6 I#C AI#'2 58,- -./#**#((

59 # <,<, - 7 & :D = - 7 = C + 2&76 E -= 2 <,3,( 6 =1-7 & 6 = 1 = C = / - E 5 62 & 6 =1.EA AC A+- -L@91M = 6 1C = - + I + 12 ( 6 = 1 & - 7 E 5 1C- 2 * - 6 & 6 - C ,- -./#**#((

60 # <,, 1 <,,,1 J<C ;C $K *1 7C :D A A - 7 C ="D2 * 7 C71 5 H - A 2& 1 -R A A -7 2 #67C &1 + E:3 = D A A E --7 AC 5= 6C>=:D2%C 7A & C & C 2 6,- -./#**#((

61 # / 5- H7 + AC & -= 6 C C 7 6 = 1 5 H 52. C C & 6 =V+ -C 6-72 <,,$,1- L L $, $<M + I = 7 + * - - :: L+ ::< $M <,,$,,&- &1 6 -'*N ) WC,=, - 7C C C C C7W ,- -./#**#((

62 # &A - ' " 7.+J $3C$<<K+ - AC$;$ 1C>;D2. C - = 17 C$>5-7C : 6 1C "D2* 3 + I C) + =%N > D E - C >;D 6 E -72 J $K2&A C = #67 72 <,,$,$,&-- &--J K % C A 2& C A L3> 6 $:C ; M2% C :C3D 6 7 C 3D 7 2( + C <,,$,;,& J $ C $3C $K & * A - 7 'C% ) + 6 = <D 3D - 62,- -./#**#((

63 # 6C 3 ><D #67 A + +2 &+- & =1C C :3D 33D 6 +2 % + 66 :D ";D :$D "D + 2J $3C $C $>K L $GcC $CC CC + M2 63,- -./#**#((

64 #.4.&/*(4 & 7 = 1 1 C C1 o 9 C 7 - <Q.4;, 7-72 o. 7-7-R = = 7 A7-72 o R== A,7 =-2 o A LL&1*MCA +?M 64,- -./#**#((

65 # 3,% # C 1 +6 LM +=L9/MC-C C6-7 +6L M- =7 ; <2 3,,. J $:C ;C ; K 3,,,1+ &-7 AGA + L=$ MC A + 6 A + -2 & + I 66 = L$ M 7C = C I +2 & A + Z = - 1 C + A2 3,,$, & <57= ,- -./#**#((

66 # 3,,;,. + 1 C + + = <.C -=,$.L + < M2 1-7CI- <=<.2 3,$,)- 7 4 V< +6 3,$,,= = L9/M L9/MJ $:C ;$C ;;C<C ;<C ;3K ( ++1C =$D2& -E 7 C V /L.4$$MQ MQ$$4Q $$4QQ$< $<QQ.4;, / cccccccccc - 1ccccccccccccccc & 6 A = = $ 6 C N I = ;".- 2. >D 6 :3D 3D J ;K2& = $< - 6J ;"KG7-6A62 66,- -./#**#((

67 # & 9/ 6-7C L 6 = M 7 A7 7 I H 1J ;"KC.&4,AC C -2# (11 $C J ;>KC I A I - 2 = I J ;>KC /C = C = + = $< 7 6A I E 7 J $:KC C = C C7W2 3,$,$, J $:C ;:K.- 76 C 6 D >=:3DG ,- -./#**#((

68 # =+ 7C7 + - C C E7C =75C7 7 2 & A A C 7C ,$,;,A -7 C 7 + 6A -7+ :3D+ V J ;K A 7-7J <C < KCA = 7C I J ;KC + O J <$K + - > DC C 7 7 )- J <;K + :3D &[ 7" A = 6A- <DJ <<KC 68,- -./#**#((

69 # + A C A 6 -<= I J <<K2 %66 C - LA, MC@6L1 6 MCO,L RMC + L1 6 C A M2& 6 66 = O,C 7 6A 6 A - 72 A C A, C 7LC M-1L6 ] - 66C -M2. A = 6 = C 7 6 -L77166=+MC) L16=+M L1 M2 += 7+- =66 1C 3= e - 7 1M J $<C $:K2 &A LC M - = C + - C C 7 C 7-72& C 69,- -./#**#((

70 # C I C + 6 = + - V 7+ I = 7 7 6,- 1C C + $D- 76-2J $:K2 3,$,<,& J $:C ;C ;"C ;>K & I -I 67 1 I 7 2 & 1. 9 L1.9M - = C I A C 1 I 6 7 = 6 2* 6 I C + C+= 1I - + C + 9/ C + I 7,- -./#**#((

71 # +J <3KC 7 6C6 +]C 7+ 2& I H 7 2J $:K 3,;,)- 7 3,;,,&- &- & E 6 CY- I 2 J $:K & 76 + (@@(@#,1C+ 2. A L>3,:3DM 67 L>,:3DM L& 6 +M2 * - H 1 C +66A+ C + L7-6+ A + 7 = > MC A+ 6 C=A 66 C I I C 6 - = 6 66 A 66 $3D =<DJ <C <"KC+ 6= D C 71,- -./#**#((

72 # 7 H 2-72 % 7 7 &(*# + I C 7 7,C -- A,6J $:K2 3,;,$,=7 =7L+(@2 M &7 +7A C - 7 ;.L <.M+ A ;.4$ C ;.4$ A + ; - 7C A 66 D. ; A + 2 /7. ;L ;.4$$MQ/9#* ;.4$Q$2. I + 7C C C C 6 * 7 7-2J <>K. =:D 6 :3DC + C <=3DC 67C ,- -./#**#((

73 # 6 C7+ LQ!, DM6 2& 6 7< C7 => 6J $:K =:3DL+BM2* :"C3D+ =>D H J <:C $:C 3C 3 K %L2M ( )6 * LDM *6LDM &- < < < 3 3 > < <. -Q > 3 * N > ;. -Q9/ >> :< 8 O` " " 3" <, <. -QQ9/ :$ "> > > >< ;. - : * : : $> ;. -Q Q > :".$ "> $ <. 9/=< : :: )-$ :" <, ;..9/Q- :$C$ C$ B* 6 H 12J 3$K 73,- -./#**#((

74 #. 6A 6 A C 6 C I " <: C J $:KC C - + 6A 6 = +71C- 6C L C3D +MC I 6+ - $ + -72JC $:C 3$K # +C 6A DG + -7,C6A -6 = 2% ;; C>D -6= + 6=C66 + ;.4$= = 66 2 &. < 7 C + +2 * C -PA2 74,- -./#**#((

75 # &=72 3,;,;,& - & *# L) - M + A % - E C 6+L ;M >:>C$D L : C>DM ""C> D L :$CDM2J $:CK 75,- -./#**#((

76 # & 6 H & 6 7 :$D C >> :$ D + 12 & 6A 6 + I = + 1 C <=> $ 6+ J 3;KC - 6A C6 H C 6 7C 6 7 J 3<K2 3,<, 66 - &+ A ) 1+ * *6 *- * :3D >3D *-&(*# * :3D :3D #A :3,:>D :3,:>D = '-7 :,:3D :>D '-7 :>D :>D - '-7 :,:3D D. '! :3D :3D 1.9 B(. 66-7J ;C 33K2 76,- -./#**#((

77 # 3,<, *-- 7 7JC $:C 3$K &A C PC G H C 7 6 7, 2* 7C + R- C H -6C A 7C A 5= 7612& C &- A-7-7 &(*# ++ 2.E 6 R- 7 C I 6 = / C E 6 C I 6C R A -7C -2 &-A = -+ 2 &A ,- -./#**#((

78 # &9/ & & - + 2&= ( + I C 7-7 I & C 6-2& = H -+C &- A A + 7 C A -7C )#& 7 72& 7 6 = - 2& - L*#M V 6 2 & - + A + = + 7 C H 66 - =7 CA2 78,- -./#**#((

79 # 3,,9-1J 3K & + L8B((M 9,& +67+ I N- - A+ + - I2,(11+ II $ + 12.( =A -2,&-I C C -7C-7C)#&C (11 72, C+ + I7 66 2,& H - C5 H ,- H - 6 =12,&6-1 5 H =12, AI2 2,& 1A 7+ I #+ - = = = 3,$D 3 $D - 2 #A , A 7I 66-2,= = #'&#/B(( )$32 79,- -./#**#((

80 # 8(((,9#%(.#(4%& 9#%(.#(4%&1 1 (,& 7,,@ J ;C ;<K &667 1 =,% ,( ,.+ 2,. 2 &AC- 2/ 66 + A +C C 7 + I 6 6+ C66 P2 & A 7 2 H AC C6 C 8,- -./#**#((

81 # < ="D 2& = A 76 Y 2 & = 7 + 2& "C = - -2 & - $ L 7 $M I66 =A 72 & 7 66 #A C,EC L M2 & 2 &B((( 66, 72 81,- -./#**#((

82 # ).7 ' ) #A ' + #+ 1,E E L EC EM A * 9 C =3D # 7$ # ( = / = $ B(((&66,2J ;<K 82,- -./#**#((

83 #,$,)A 7J 3"K & P 2 66C >DC I 66C, 6A = - 6 2( 6 A - 6 L M2 1 7 C + C 7 = 2&, 6A76 C7 = 62,;,1,,;,,&J 3>K % 7C I 6 2( +C + = CIC ,- -./#**#((

84 #,;,$,& 7 #,&#A J 3:C K,) &#A C I + 1&1 L A M2&+ C7+ V 2,1 7 &#A C I & 6 - C & 6 + C+ - E 66 2,( ( C + C662 % -, A C C - -= 2 & 72 84,- -./#**#((

85 #,., #-A 2 & 62 &] ,( ( # A #A 2 # ',& E EJ C $K,) & 6 A2. - E 6Z E7C 6+ 7 V A7A 7 2,1 7 &3 E +C E I + 2& 66 2& E =A AC + 85,- -./#**#((

86 # = 3 D 2& L3DM2& E62 & 6 + C ,( ( &66 2& A 6-7 C 7C C67 C + +-C6-C AC-P7CAIC C+ 2,. / AEC =+ - 2,( ( %666 C 6 2 #66 2 # - A7-2 86,- -./#**#((

87 #.,&J ;K,) & 7 2( += 3C 7 1 C A >*7 C ^ 7 + A7 A 2 +C 6 -, AC 66 2,1 7 #<- A C" 2& - 6C <,4, &+- = 2 & A 7-7C= A 7 2 & 72,( ( & -, QQQ C + C --C E E R ,- -./#**#((

88 # / - + = 72,. o o # + E C C E7C C EC C -72 %,& & J <K,) 7 6Z += ;2,1 7 ""D C A 3D ,- -./#**#((

89 #,( (. 2 % A CH AC C+ C2 7 A2 6C??2,. C-C C 6 > 2,( ( & & A6 C 7C+ I 72 # #- A7-A 2,;,;,& J 3C C "K #,(( I & C 7 72.A ,- -./#**#((

90 # 7C C & 7 = 2& 7 66 = 2& I ( & 66 A 67 L - M 2L. M ',& 7$ 7 $ ) C 9 C C E 2 ( & 7$ C IC - 6 $ -7+7 C - C C 72. = Q2 & 7$ % V C 7 $ C 9,- -./#**#((

91 # - +, 2 #A 7C. C 9-6 $< E 5 A 2 (,) * 6 C - C C 6 5C E5. 2 * CI+ A+E 2,) &+ $C;= D+. C & E2,) 6 & C 66 C ,- -./#**#((

92 #,) 6-7 % ,) % C N. ( #+ 7 -, A $2 ( = N E 82 ( = A7-7 2.,& = & = EE & I 1 - H 6+ C A EC EC EE2 92,- -./#**#((

93 # ) & = C EQ!WQ H-7C7 2. E = CA Q - WQ2 & Q A * EC 7 EE 2 ( + + Q!WQ 2 % + E C=I C = E & 7-7C 6 C C 6 = 7C + 5 = &66-7 3<Q!, $D2& 2 & EE && EE 2& ( C - & EE 6 2 &,+ 7 C< 93,- -./#**#((

94 # 2& AC=6+ 2& & EE 7 C= 2 1 E & E C + 6-2& A =C,+ 7 C+ C 3!N- C!!N-2&6A A 7:>D2 & E 7 A L>M2 ( 4E E % C C C C + C = - = 2 % & E & E - 2% C C 2% E ,- -./#**#((

95 # 1 E 4 C C C C + C C 7A I ( 66 + C 7C ( 4E # = + + -, AC C EE 2 & EE #+ C6 7 C 2L + WC C 6 AC C 6 C EE? 22M 7 & EE E72 95,- -./#**#((

96 # 1 E % 66 5C + + CEC-A C 6 C`6 C 6 6 2& E ((, = 1C 7 = D2& + -7 = 6 = C C+ A $,<D D + J >C :KC C C 66 +C+ = 2,&, J $:CC $C "C " C 3C :K,,& = = + +, #A -A$!F Q 3 A $!FQ(11 A $!F "5L'M2. A = >>DC A = >D = 2J 3K 96,- -./#**#((

97 #,. 3 A $!F Q E 3A$!FQ(11 A $!F "5L1.M2. A =:"DC A = 3D = C="$D EL7+ A $3DM2J 3K, #A - A $!F Q E 3A$!FQ (11 A $!F "5L#M2J 3K. A >:D EC A = <D E2, # +7 / ( E ;$ + E 3-5 ;5E< -!5 <5 E $3-6 <!5 "5 A "$C;D E L3 -!5 ;5ME<-!5L AM#A -e$!5 7E57 A : CD2,$,& , 9 ;-Q 3-Q#A -C$6 5 <52, 9 ;- Q 3- QE 3-C $6 5 <52 97,- -./#**#((

98 # & E E E2 $,& J 33C CC 3K. A >=>3D ' $< - Q $3- Q E <-C $6!5 5 ' $ - Q 3- Q E <-C <6!5 Q "5 9 L1U&49(%M<-Q 3-C $6!5 <52 / + ]-C $3-C E $ I PCA 66 5C$6! C+ 2 ) C A &E $3 -; 6!5 + $-<6!F 3-<6!5 <5C + A >;D+A+ I 62 98,- -./#**#((

99 # ;,&7 &7 J "$C 3C C K & 7 "5C C C E= = 2 & +,' $ - Q 3- Q E <-C <6!5 Q E$-C$6!5 "52,1U&49(%<- Q 3- Q 3-C $6!5 "52. 7 A :3= DC 72 P +C - L"5 M = A 7 = 2/ E$-Q E<-Q $3-Q#A -C$6!5 35C J ";K (((,% % & C )#. )#.$ + E2& 5 (11 <5 9'.J "<K2* ), &52J "3KC 99,- -./#**#((

100 # C I + 2 J "K 7 - < 5 + A '. - A 7 "= :DC 66 C 6 ZJ ""KC "5 <5C - I P 667 "5 5 < = $D$3=;3D J3K2 ( V - = " 5 2 ((( ((,& - & ) ((( $3C 1 J 3K & (11,,#A E = b 3,$DC E b<dc (11C E62 / <5 - $D2. "5 I 662 &7=' +72 &, C66 + I2 1,- -./#**#((

101 # (((,& & 1,%6 1 / C C H 12 $,6+ %+ ++ IC I = C I G I A7 72 & C C + = C 6 - I C E + CA I C (11Q#A (11Q C- 66 7C A J ">K2 7 C +'C #A 7 11,- -./#**#((

102 # - - EC-=A + 3D J ":K=> DJ >K2% I 7C A 3;D + 57^="D J > KC+ C6 C+67 C EC 7 J ">KL+(@2 ;M 7+# C - EC C - C + A + 57^= >D 2 J ">C K L8(@2 $M 12,- -./#**#((

103 # - IPP + amoxicilline + clarithromycine IPP + amoxicilline + métronidazole f $- IPP + amoxicilline + métronidazole IPP + amoxicilline + clarithromycine f Culture et antibiogramme IPP+ amoxicilline+clarithromycine ou métronidazole* 14j IPP+amoxicilline+rifabutine 14j (@2 $ H(11 667C C ( H 667JK2 & C + + C - C 7 6 E + E = C - I E7J ">K2 13,- -./#**#((

104 # & = - 5 J ">KC A 7 ++2% A 1 7 -= J >;K2 CA A- + 1A 7 C6 + C 7 6 C E + A E A 7 PC 57^= 5C 66+P66-7-J ><C 33K2, 1 7 )((($3, $- J 3K,/ 7 = ' C 2*,&(11,#A, E+ A <D2,&(11,, E+ A : D2 14,- -./#**#((

105 # & ;- J 3K & C +6A C 6 6 C + (11 #A C 2 L8B(8MJ ><K2 & I -2 # *7 % A LD:3D.(M )N 11(,#)B #)B < "L,>>M >>M. (11,'* '*,#)B #)B,.. " (11,#)B #)B,9( 9( < ":L<:,:3M :3M ' (11,#)B #)B,&8 &8 $ : L>$,::M (11,&8 &8,%[ %[ "L:,>$M (11,#)B #)B,&8 &8 " ><L:,:;M :;M O - (11,&8 &8,%[ %[ " ": (11,'* '*,..,/9 /9 " :L33, M (11,#)B #)B,/9 /9 " L$,>>M >>M. (11,#)B #)B,&8 &8 >; #)BCA G'*CG/9C6E G&8C+6A G(11C = G9(C6 G.C G%[C E2 E2 B(8A 7A J ><K 15,- -./#**#((

106 # ;, ;,,=1 =1 ;,,,9 A 7L L M,#,- % ::: - 7 3;$$> C + A ">2:D = >$2>D 6 J "3K2& L+, M2 ( 7 66 A7 + 2J KL+B8(M 16,- -./#**#((

107 # B8(9 A 7E --72J >3K 1 1+ = D 1+ ED 1+ = #A D 6. $ > ;; '- :,:: :: 3 ; C3 )- #- :3, $C$ $C$ O ( :>,$ $ $;C< ;C" C$ 1- :,:: :: $$ ;<C. )A7 :3,:" :" $3 "C; /*# :;,:: :: C $ C C> 4 (g, >C$ ;>C$ C: * -W - - :", <C3 $: C; & - - F :3, : C; 1E 17,- -./#**#((

108 # & A 7 7-5, 66 2 & -I 6, C 6 C -I 77 +A -I I2JK ', 7 + & 1A#'= + -I 67 C 7 Z- L7 -M + C I C 6 -I C 6 C = C7 C + + -I A 7 C - 7 L C 66 -C2M7 66C - 7L1.9,9&1C1.9,4&#C1.9,M7 2J >K.,& A#',& =#A * C 1=#A 6 J ">KC 66 57^= 6 ::"C < + J >"K2 / + 18,- -./#**#((

109 # $3 7 6 A + 7 #A J >>K2 1 = 7- C7= +-I C J >:KC 7 #A C - C 7-6 = 6 = #A 2 $,& & = & 7 1= L+ B8((MC 7 V 7 + (11Q#A Q (11Q = 3 -!5 JK2 66C - V - + 6A66 67 CI= & - 3-A$!5 C 66!66 2J 3K 19,- -./#**#((

110 # 96 A LDM * = 9 = W > C: W :$C :C; & >3C> :<C $; & > C > & <>C; > 3C3 & "$ >" )) " C >"C3 $; 1E <>C3 >; ; 1 >3 >" 3 N+ "C ": $ #'&#/B8((&A 1+ L(11Q#A Q M = J >3K2 K2 11,- -./#**#((

111 #. -- I C + 1C C6 7C ) 7 $3C H 1 = C C E A J 3K2 K2 & 1= C - C 3D J ">K2 2&- P = = +J :K2 & C - +-I 8#9$;* + -I 8( #9$;*2& A L M67 #$ <$@#$ <;@J >K2 K2 ;,& & = E & 1 E+5 ":D + + C ;D +C A ::<2 L8 B(((M2.++ =-A A C 7 E 2. C7 A 1 + ;>D$<DJ ">K2L8B8M2 111,- -./#**#((

112 # & "3D E I E2% C -6 C E A D7 (11Q EQ 2 & -6 7 #72JK2 &A E V A 7 ' 2( ++ -= C - E +73-A$!57 2% 4)9C A 7 E=<-A$!5C<-A;!5>-A$!5MC A 3"D >"D C + 7 E= - A 2L8B(((M 112,- -./#**#((

113 # 6 A LDM E E ' ;; > C3 >" 3" '66 : >> : "3 )N >3 :$C: :C> > C> 1 ;< >3C$ : 3 : >; >:C< <C< B8(((&A 1+ L(11Q#A Q EM EJ>3 >3K2 K2 # 7 +-I = E A7 2-I J >C :$K2 K2 & -I 9%A# L 9%A#MC + -I V +A =+2 113,- -./#**#((

114 # &-I A#75 H C + V + =+2 &-I A' 57 H AA-I 2,<,& = = & 1= + C A 3"DC =* -J :;K 7 + +=3:D2& =5 + $$C = -I #9 *C + #@#:3,:".2J >K 3,& % 12J :<KCA + 3D D+ #A Q EC 3D "D + Q E D3D+ #A 2% A I 7C + 1 E = 2 + C +C + 2 A : D L M+"3D - HI + JKC V ,- -./#**#((

115 # C+ I+A - 2 ;,$,+ 1.-#1.-#1 1 =66.-#1 667/ 6 #7 E$; 7.-# L49c$C$M J :3K A + +E 7.-#6JK2/ 7A E.-#6 "3DC 7 E +.-# -6 ="DJ ">K2&7E+.-#6 = #' C= 666 A +.-# 6C = A#' = 2JK ;,;, & J :KG I 7 6- C 6 -C - 7C 7 5= C 7 6-6Z - 6+A 2JK 115,- -./#**#((

116 # ;,<,=,&+ 7 &+ V 6 7C+ A :D + = :DC :D + 6=DLbC"MJ :"KC 6, 7 6Z J K & = C = $D C 7A I C 7 I = #A -P 7 E 67 C C 7-7 7, A I &6 + A77<D 7C 7 $3D 7 C + C A 7C J :>K2 116,- -./#**#((

117 # ;,3,- - & 6 7 JC ">C :C ::C $K2 & G A + 1-7J$K 21 C = 6 A A 1C A 7 + E A =>2<DJ$ $K2 ;,,*A ( 7 A E+E67E2. C + + E 6 E CA JC ">K2 ;,",#- & R- A % CA ER- <3 = + E 5 5 J :K ,- -./#**#((

118 # 7 A + 66 E 5 R- J$ KC 6 7I 7 6 Z - 2. A7 E5R-A 1 EJK2 118,- -./#**#((

119 # (B,&+ 6 =1J >< ><KCJ "$K h&-- & +C + +C - - C 7 C =12 $,* & 6 6 C C=+ C -C Z- C 6 Z-6 2 C / = C6 6A7 C EC + == 2 ;,8 1 &+ 6 =1C+ A2.E C & # & - 6 E 2 & 119,- -./#**#((

120 # + 1E V 6 A E C 6 E6-7C 6 - E I 72& = 2 & - C + + A & 7 Z- - - C = - 67C L1M C A 6 =-=+ - 2 % C C C i ++C 12,- -./#**#((

121 # = E / I 1C 7 A + I + 2 % = ,- -./#**#((

122 #,B,& 1 J 3K J 3K L8B(BM & ++ - & 16 )((C+ +A /- L6 C67M # &)#& # #-7 $ ' #--7 ; ' & 7 #.% ; ' & 16 )(((C+ +A ,&^ 1 #,&1 # 2,&^667 1 =6 + 12% 1-7A 72 $ ',&^ 1 6A #,% O C^ 1 ^66 7(11E6A # ,&1 ^ 6A $ #,.E+.E+ ^ = - =(111I 2 ', #CA A-- C 2 2 $ ',.E#(*= - =( # -2,&^ 1- +E 7#(* 66 + # A#(*2 A#(*2,& E ]6#(* # )#& B(B B(B & 1 6 ) (( (((C + +A ,- -./#**#((

123 # 49/% 123,- -./#**#((

124 # B,,(( + &5 H - -, C "= <5 A 7C 7 C )2.+ =A 1621 A +A7C66-7C C + - = 1 2 # $,) ) ( - + C +- $ C A 16C=P$C -, -./#**#((*2 #,& % AAC 16 9/!=A -7C ,- -./#**#((

125 # ',&A & Z 7 < = + 2 & -A CACA E=E2 & + 2 & 66 A-+2L. \$!M & & 66 72L1b3DM & ,& & & A 6Z A-7 & - # Z # L(11 Q #A -Q E3-M A5 "52 & - ' Z ' L(11 Q #A -Q 3M A5 "52 L8 (@ ;M %,& + L86A (@ <M,&+,7=5 7=5.+, - & C R-C AC 6 C - C C C = HC + 7C 2 125,- -./#**#((

126 # 7 /@%C C C #(*C LC= MC2 & C C 6 L A 7C 7 -C+ 7C6 M2 2,&A 7 &d 7C A 7 L -7C - = 5 C - C ) C M2,&4@%Q9/Q &4@%Q9/QA C 1 6C 6 = $ C = L. 9 M A A -7C + 7 6A C * + C - -+1CA A A 7 - +C C * 2,& / 7 C C ,- -./#**#((

127 # & = C 4E 7 - C ,f & II2 &+ 7 -C C 2 % I $,&+=5"5 &+=5"5 L6 M - A 7C7 +, + 7, 66 7 H, +-, + 66 %-6C C C2 A-6 C-P7CC2 ;,+ 6 =;& H 2 #+ -2 & H 127,- -./#**#((

128 # / 4@%Q; 9/A A -7 =7=12,& , = A -7 = 7C AC -6 *#%#9%MG + = A & + 2, & Z A - C - E # 7 C E ' 7 C + = A- H 7 & 6-, 62 & 7 6 C AC+ + 6 :3DC+ 6= C ,- -./#**#((

129 # BABABA AABABB BAABAB ABBAAB ABBAAB BBAAAB BBABAA BABABA AAABBB BAABBA BABABA AABBAB ABABAB ABBBAA BABBAA ABBBAA BAAABB BBABAA BAABAB ABBBAA ABBABA BAABBA AAABBB AABBAB ABABAB ABAABB BAABBA AABBBA AABABB BAAABB ABABAB AABBBA AABBAB BABABA BABAAB ABAABB ABBBAA BABABA ABABBA BBAAAB BAABAB AAABBB ABBAAB BBAAAB BABABA AABBBA ABAABB BBAAAB BBAAAB ABABAB BBBAAA ABABAB BBBAAA ABBBAA AAABBB AABBAB BBAAAB ABBBAA ABBBAA BBAAAB Protocole A : amoxicilline + flagyl + IPP Protocole B : amoxicilline + clarythromycine + IPP NB : La lecture se fera de gauche à droite et de haut en bas en commençant par la première ligne (@ ;&A7 129,- -./#**#((

130 # Service d hépato-gastro-enterologie Hôpital El Ghassani CHU Hassan II Fès LA CURE D HP DANS LE TTT DES ULCERES BULBAIRES : PROTOCOLE : A : PROTOCOLE : B : 1/ Identité : NE NO Nom & prénom :.. Age : ans Sexe : masculin Féminin Profession : Origine :.. adresse :. Milieu : U R Promiscuité : oui : non niveau économique: bon: moyen : mauvais Date d hospitalisation./../. Durée d hospitalisation :..j Malade externe : date : Tel :... Référé : non oui : II- Motif d hospitalisation : urgences autres 1- Syndrome ulcéreux non compliqué 2- Ulcère compliqué : - Hémorragie digestive - Vomissements chronique 3- Autres :. III -Facteurs de risque : 1- UGD 2- Tabac. 2- Alcool 3- AINS. 4- ATBttt : type : délais : 5- autres :.. IV- Examen physique : 1- EHD : stable instable 2- normal. 3- Sensibilité épigastrique. 4- Clapotage à jeun. 5- Plis de déshydratation. 6- Melena 7- Autres : V- transfusion : si oui : nb CG : VI/ Fibroscopie oesogastroduodénale / anapath N. de FOGD : 1- Ulcère bulbaire : - Siège : Face ant Face post - Taille : -nombre : base -Stade de Forrest : Ia I b sommet IIa IIb IIc 2- Sténose : franchissable Infranchissable. 3- Clotest HP + HP- 4- Anapath : n d anapath : VII - Traitement : 1- Protocol B : - Amoxicilline 1g * 2/j pd 7j - Clarytromicine 5mg * 2/j pd 7j - IPP 2 mg * 2/j pd 7 j 2- protocol A : - Amoxicilline 1g * 2/j pd 7j - metronidazol 5 * 2/ j pd 7 j - IPP2 mg* 2/j pd 7 j VIII - Effets secondaires : III HP + HP - - Digestif : diarrhée d+abd autres - Extra digestifs : éruption cutanée Goût métallique autres Autres: IX- Observance ttt : Bonne moyenne mauvaise X- FOGD de contrôle : après 3 mois : le Cicatrisation UB : oui non Clotest : HP+ HP Anapat: n : HP+ HP_ XI- Suivi psychologique : Bon moyen mauvais (@2 <A 2 13,- -./#**#((