Actualización ITU SOCHIPE 2016

Educación Médica Continua SAVAL Curso nefrología pediátrica SOCHIPE 2016

Dra. Angélica Rojo Lozano

!"#$%&'(%"')* ,* ,& -'%.*)/#'"0 1 2%*,30 -, &% '*4,""')* $5'*%5'% 65%7 !*.8&'"% 9030 :0(%*0 ;,45)&0.% <*4%*#'& =&>*'"% :%/ =0*-,/ ?0/@'#%& AB,C$',& D0*(E&,( =05#8/

AF0&$"')* -,& ,*45,*#%2',*#0 "&>*'"0 -, &% '*4,""')* $5'*%5'% G
M'*'2'(%"')* -, 5',/.0/ •H5%#%2',*#0 %.5,/'F0 •N,.$'2',*#0 ,BO%$/#'F0 •ABE2,*,/ •P50Q&%B'/

9',/.0 -, -%L0 5,*%& 0 "'"%#5'",/ 5,*%&,/

?'@0R-'/@&%/'% 5,*%& "0*.8*'#% @5'*"'@%& "%$/% -, A9=S -'E&'/'/ 1 #5%/@&%*#,S %T* ,* %$/,*"'% -,
1



2



3



H,2%/ % "0*F,5/%5 ! ! !

6,Q*'"'0*,/ W'/'0@%#0&0.>% 6'%.*)/#'"0 !

! ! ! ! ! !

H02% -, 2$,/#5%

=5'#,5'0/ -, O0/@'#%&'(%"')* H5%#%2',*#0 A/#$-'0 -, '2E.,*,/ P50Q&%B'/ N,.$'2',*#0 6,5'F%"')* %& ,/@,"'%&'/#%

4



6,Q*'"'0*,/ <;WA==% "&>*'"% F%5'%K&, !

!"# %&'( )"*'+,- ./0.1 23 4356 .789.:2

6,Q*'"'0*,/ !

!"#$"$"# & '() *+,+ !

!

!

'*4,""')* &'2'#%-% % &% F,3'.% 1 % &% $5,#5% />*#02%/ &'2'#%-0/ % '*Y%2%"')* &0"%& "020 -'/$5'%S @0&%C$'$5'%S $5.,*"'%S 05'*% #$5K'%S 1 20&,/#'%/ %K-02'*%&,/ K%3%/

'() +-$+ & ."/-&0/12"$"# +345+ 6789: !

!

'*4,""')* K%"#,5'%*% -,& #5%"#0 $5'*%5'0 /$@,5'05 C$, "02@502,#, ,& @%58*C$'2% 5,*%& />*#02%/ /'/#82'"0/ !"# %&'( )"*'+,- ./0.1 23 4356 .789.:2

5



6,Q*'"'0*,/ !

'() +$;."<+ & <&=.-"<+5+ !

!

% $5'*%5'% #%&,/ "020Z !

!

!

!

!

!

[%30 -8K'#0 $5'*%5'0 M%/% %K-02'*%& 0 F,/'"%& !$2,*#0 -, "5,%#'*'*% I50/,@/'/ N'* 5,/@$,/#% %& #5%#%2',*#0 %*#'K')#'"0 %@50@'%-0 ,* &%/ @5'2,5%/ \] O05%/ <*4,""')* @05 K%"#,5'% *0 ;<=>(' !"# %&'( )"*'+,- ./0.1 23 4356 .789.:2

6,Q*'"'0*,/ !

>+<$/2"42"+ +#"0$&=?$"<+ !

!

P5,/,*"'% -, K%"#,5'%/ ,* 05'*% ,* /$3,#0/ C$, *0 @5,/,*#%* /'*#02%#0&0.>%

'() 2/<422/0$/ !

^ 0 2E/ '*4,""'0*,/ $5'*%5'%/ K%3%/S _ 0 2E/ @',&0*,45'#'/ 0 ` @',&0*,45'#'/ 2E/ ` '*4,""')* $5'*%5'% K%3%7

!"# %&'( )"*'+,- ./0.1 23 4356 .789.:2

6



W'/'0@%#0&0.>% !

!

!

!

U>% $5'*%5'% ,/ %/8@#'"% :% .5%* 2%105>% -, &0/ "%/0/S &% "0&0*'(%"')* -, &% F>% $5'*%5'% ,/ /,"$*-%5'% % %/",*/0 -, K%"#,5'%/ -,5'F%-0/ -, &%/ -,@0/'"'0*,/ W&$30 -, 05'*% @50#,., a&%F%*-0b A& -,/%550&&0 -, K%"#,5'$5'% %/'*#02E#'"%S ( 4./075 3060.A3B0.7A

W'/'0@%#0&0.>% W!=HV9AN 6A: ?IcNPA6 !*052%&'-%-,/ %*%#)2'"%/R4$*"'0*%&,/ -, &% F>% $5'*%5'% !

!

!

!

!

!

!

9,Y$30 F,/'"0$5,#,5%& M,.%$5,#,5 U,3'.% *,$50.8*'"% 6'/4$*"')* 2'""'0*%& 6'/'*,5.'% F,/'"0,/Q*#,5'%*% =0*/#'@%"')*R,*"0@5,/'/ )"*'+,- ?"@&->( 4./075 3060.A3B0.7A

7



W'/'0@%#0&0.>% W!=HV9AN 6A: M<=9VV9D!;
!

!

!

!

!

!

!

M,"%*'/20/ %-'"'0*%&,/ -, -,4,*/% C$, 4%"'&'#%* &% "0&0*'(%"')* 9,/'/#,*"'% % &% 5,/@$,/#% '*2$*, '*2,-'%#% )"*'+,- ?"@&->( 4./075 3060.A3B0.7A

W'/'0@%#0&0.>% <*#,5%""')* -'*E2'"% ,*#5, &% '*F%/')* -, &% IPA= 1 ,& O$8/@,- -$5%*#, $*%
AB40&'%"')* -, "8&$&%/ /$@,5Q"'%&,/

N'/#,2%/ -, %-C$'/'"')* -, Q,550

P5,/,*"'% -, @'&' <*F%/')* -, "8&$&%/ ,@'#%&'%&,/S 4052%"')* -, K'0Q&2/ ;C@ D>( )+,&>(< .//2 1 2A4056 00B08

8



W'/'0@%#0&0.>%

)"*'+,- ?"@&->( 4./075 3060.A3B0.7A

A@'-,2'0&0.>% !

!

`R`d *'L0/ 1 `R^d *'L%/ @5,/,*#%* ` ,@'/0-'0 -,
!

dk^ 2,/,/ jSlg ^ki 2,/,/ lSjg ik`_ 2,/,/ ]S^g m`_ 2,/,/ _S`g

G_S\g "'5"$*"'-%-0/ F/ _dS`g *0 "'5"$*"'-%-0/J

_e`f %L0/ />*#02%/ $5'*%5'0/ K%30/ jS]g 0 )"* EFG H'I .//2J .:1 3/.93/2

9



A@'-,2'0&0.>% !

9',/.0 -, 5,"$55,*"'% Gêi 2,/,/J !

h` %L0 !

!

`]g 2$3,5,/ _ig O02K5,/

;'L0/ 2%105,/ !

^de\dg 2$3,5

? ;FK( L D"* .//81 3706 0:M29A8

6'%.*)/#'"0 1 2%*,30 @'()9!'A8B@ !CD8'!9@ C+<$+0$/ 1/*2"8"E&F+ <&0 #;0$&=+# 42"0+2"&# *+,&#

10



6'%.*)/#'"0 -, P;! ,* ,& &%"#%*#, 4,K5'& M%*,30 -,& &%"#%*#, "0* P;!

6'%.*)/#'"0Z &%"#%*#, 4,K5'& !

P5,F%&,*"'% !

!

!

h` %L0 jg G2%105 ,* *0 "'5"$*"'-%-0/S 5',/.0 f F,",/ 2%105J m` %L0 2% →

→

V#50/ />*#02%/ ! ! ! ! ! !

U)2'#0/ ^lg` <*%@,#,*"'% \lg` :,#%5.'%R'55'#%K'&'-%P%&'-,( V5'*% -, 2%& 0&05RO,2%#$5'% ^g` 60&05 %K-02'*%& 0 )"* EFG H'I .//2J .:1 3/.93/2

11



6'%.*)/#'"0Z &%"#%*#, 4,K5'& !

9,"02,*-%"')*Z !

!

!*#, &% @5,/,*"'% -, &%"#%*#, 4,K5'& "0* 2E/ -, _\ O5/S /'* 0#50 40"0 %@%5,*#,S /, 5,"02',*-% 5,%&'(%5 $* ,B%2,* -, 05'*%R$50"$&#'F0 @%5% -,/"%5#%5 *'"0/

H02% -, 2$,/#5% @%5% ,& -'%.*)/#'"0 -,
A#%@% "5$"'%& @%5% ,& -'%.*)/#'"0 -,
!

!

!

→

→

6,K, /,5 5,%&'(%-0 ,* $*% '*/#'#$"')* -, /%&$-S @05 @,5/0*%& -, /%&$- "%@%"'#%-0 6,K, /,5 @50",/%-0 ,* 4052% '*2,-'%#% !

!

AF%&$%"')* 2'"50/")@'"% 1 I50"$&#'F0

U0&$2,* %-,"$%-0 _leld 2& G2>* ^ 2&J 9,%&'(%5 %-,"$%-0 %/,0 -, (0*% @,5'*,%&

12



n=$E& ,/ ,& 28#0-0 %-,"$%-0 -, 5,"0&,""')* -, 05'*%o !

P$*"')* /$@5%@TK'"% F/ =%#,#,5'/20 #5%*/$5,#5%& !

!

M8#0-0/ -, ,&,""')* @%5% ,& -'%.*)/#'"0 -, *#,5 PNP D0&- /#%*-%5- @%5% -'%.*)/#'"0 -,
!

!

!

M8#0-0 '*F%/'F0S *0 ,B,*#0 -, 5',/.0/S @,5/0*%& 28-'"0 "%@%"'#%-0 H%/%/ -, 8B'#0 F%5'%K&,/ _êfdg

=HI !

!

!

H%/%/ -, 8B'#0 -, PNP F/ =HI idg F/ ]^g A/"%&%/ -, -0&05 4%F05%K&,/ @%5% =HI A* "02@%5%"')* "0* PNP sensibilidad 95%, especificidad 99% →

→

)"*'+,-'=IJ ./001 0.26 ":M89"::/

n=$E& ,/ ,& 28#0-0 %-,"$%-0 -, 5,"0&,""')* -, 05'*%o !

[0&/% 5,"0&,"#05% !

!

!

!

!

!

M8#0-0 -'4>"'& -, '*#,5@5,#%5 N,*/'K'&'-%- `ddgS ,/@,"'Q"'-%- `\e]\g H02%*-0 ,* "$,*#% $*% @5,F%&,*"'% -, lg -,
13



)"*'+,-'=I ./001 0.2 4356 A8A970/

)"*'+,-'=I ./001 0.2 4356 A8A970/

14



!*E&'/'/ -,& ,B%2,* -, 05'*% ='*#%/ 5,%"#'F%/ !

:,$"0"'#0e,/#,5%/% !

!

!

N,*/'K'&'-%- f\g "0* "&>*'"% /$.,5,*#,S 4%&/0/ @0/'#'F0/

;'#5'#0/ !

M'"50/"0@>%

;0 ,/ 2%5"%-05 %-,"$%-0 @%5% &%"#%*#,/S #'@0 -, K%"#,5'%

P5,/,*"'% -, &,$"0"'#0/ !

!

!

V5'*% ",*#5'4$.%-% l r[=/ @05 "%2@0 G _l r[=/Rs:J !

P5,/,*"'% -, K%"#,5'%/ ,* #'*"')* -, .5%2 !

:% @5,/,*"'% -, K%"#,5'%/ ,* #'*"')* -, .5%2 -, 05'*% *0 ",*#5'4$.%-% `dl IW=R2: !

)"*'+,-'=IJ ./001 0.26 ":M89"::/

<*#,5@5,#%"')* -,& ,B%2,* -, 05'*% !

N' ,& %*E&'/'/ "0* "'*#% 5,%"#'F% ,/ GpJ @%5% &,$"0"'#0e ,/#,5%/% 0 *'#5'#0/ !

!

N' ,& %*E&'/'/ "0* "'*#% 5,%"#'F% ,/ GpJ @%5% &,$"0"'#0e ,/#,5%/% 1 *'#5'#0/ !

!

AB%2,* 2'"50/")@'"0 -, 05'*% 1 $50"$&#'F0S %*#,/ -, #02%5 &% -,"'/')* -, '*'"'0 -, #5%#%2',*#0 %*#'K')#'"0

H02%5 2$,/#5% @%5% $50"$&#'F0S /, @$,-, '*'"'%5 #5%#%2',*#0 %*#'K')#'"0

N' ,& %*E&'/'/ "0* "'*#% 5,%"#'F% ,/ GeJ !

N, @$,-, -,/"%5#%5 *'"% 2$1 /$.,5,*#, )"*'+,-'=I ./001 0.2 4356 A8A970/ !"# %&'( )"*'+,- ./0.1 23 4356.789.:2

15



=5'#,5'0/ 2'"50K'0&).'"0/ @%5% -'%.*)/#'"0 -,
8J 5/ ="<2& &23+0"#=&#

8J <&-&0"+# .&2 =-K

8J <&-&0"+# .&2 =-

P$*"')* /$@5%@TK'"%

`

m`

m`dd "0"E",%/ .5%2 GpJ_

N0*-,0 #5%*/$5,#5%&

`

m`d7ddd

N,.$*-0 "O0550

`

m`dd7ddd

m`7ddd ,* *'L%/ 1 *'L0/ "'5"$*"'-%-0/_ m`dd7ddd *'L0/ *0 "'5"$*"'-%-0/_ mld7ddd_S^

9,"0&,"#05

`

m`dd7ddd 0 !"# %&'( )"*'+,- ./0.1 23 4356.789.:2 . !"# %&'( EFG"=,>( .//01 306MA09M73 3 )"*'+,-'=I ./001 0.2 4356 A8A970/

6'%.*)/#'"0Z &%"#%*#, 4,K5'& !

9,"$,*#0 -, &,$"0"'#0/ !

!

;0 O%1 ,/#$-'0/ "0*"&$1,*#,/ C$, -,#,52'*,* ,& 2,*05R2%105 5',/.0 -, P;!

P50#,>*% = 5,%"#'F% !

!

U%&05,/ /0K5, _d 2.R: N]lg A`feidg A/#$-'0/ O%* 5,&%"'0*%-0 *'F,&,/ 2%105,/ -, P=9 "0* 2%105 -%L0 @%5,*C$'2%#0/0 ,* 6MN!

16



6'%.*)/#'"0Z &%"#%*#, 4,K5'& !

P50"%&"'#0*'*% !

!

!

!

U%&05,/mdSl *.R2: V9 `\ G<=flg \e\^J P=HmdS]l *.R2& 1 P=9m^l 2.R: #',*, Nj]g 1 A`ddg M,#%%*E&'/'/ *0 -,2$,/#5%* /$ $#'&'-%-

U,&0"'-%- -, /,-'2,*#%"')* !

A/ '2@50K%K&, #,*,5 $*% P;! /' U?Nh`d

6'%.*)/#'"0Z &%"#%*#, 4,K5'& !

V/20&%5'-%- $5'*%5'% 2EB'2% 5,-$"'-% !

!

]lg @%"',*#,/ @05#%-05,/ -, P;!

<:iS <:]S ;!D ,#" !

;0 O%* -,20/#5%-0 $#'&'-%- "&>*'"%

17



6'%.*)/#'"0Z &%"#%*#, 4,K5'& !

?,20"$&#'F0/ !

!

!

;0 ,B'/#,* -%#0/ "&%50/ -, '*"'-,*"'% -, O,20"$&#'F0/ GpJ _dg %-$�/ O0/@'#%&'(%-0/ W%"#05,/ -, 5',/.0 !

!

!

!

h^ 2,/,/ !/@,"#0 #)B'"0 !*02%&>%/ F>% $5'*%5'% !&#,5%"')* /'.*'Q"%#'F% -, @%5E2,#50/ -, 4%/, %.$-%

=5'#,5'0/ -, O0/@'#%&'(%"')* ! !

! !

! ! !

h^ 2,/,/ N,@/'/ "&>*'"% 0 @0#,*"'%& K%"#,5,2'% G=ADS %/@,"#0 #)B'"0S -,/O'-5%#%"')*S 2%&% @,54$/')*J U)2'#0/ 0 '*#0&,5%*"'% % &% F>% 05%& M%&4052%"')* -,& /'/#,2% $5'*%5'0 G9UI -, %� .5%-0S $50@%#>% 0K/#5$"#'F%S -'/@&%/'% 5,*%&S %&#,5%"')* -, &% 4$*"')* 5,*%&S 5'L)* T*'"0J <*2$*0-,Q"',*"'% @5'2%5'% 0 /,"$*-%5'% W%&#% -, "0*#50& %-,"$%-0 %2K$&%#05'0 W%&#% -, 5,/@$,/#% % #,5%@'% %2K$&%#05'% -,/@$8/ -, \] O05%/

18



H5%#%2',*#0Z n05%& F/ ,Fo !

!

!

!

UV m^ 2,/,/S %$/,*"'% -, />*#02%/ -, '*4,""')* .5%F, AU h^ 2,/,/ 1R0 /'.*0/ -, /,@#'",2'%S F)2'#0/S 6?S /0/@,"O% -, $50@%#>% 0K/#5$"#'F% 1 9UI *'"0 -,& &0 @,52'#% I*% F,( '*'"'%-0 ,& !H[S ,& @%"',*#, /,5E ,F%&$%-0 "&>*'"%2,*#, ,* $* @&%(0 %@50B'2%-0 -, \] O05%/

H5%#%2',*#0Z n05%& F/ ,Fo !

!

A* @%"',*#,/ "0* ,F0&$"')* 4%F05%K&, 1 /' ,& $50@%#).,*0 ,/ /,*/'K&,S *0 5,C$',5, "0*#50& -, 05'*% \] O5/ N' ,& !H[ @5,/,*#% /,*/'K'&'-%- '*#,52,-'% 0 9 %& $50@%#).,*0S 0 *0 /, -'/@0*, -, /,*/'K'&'-%- /, -,K, 5,%&'(%5 "0*#50& % &%/ \] O05%/

19



H5%#%2',*#0Z ,&,""')* -,& !H[ !

h^ 2,/,/ !

!

!2'*0.&'")/'-0/ 0 ",4%&0/@05'*% ^,5% .,*,5%"')* p %2@'"'&'*% 6$5%"')* `de`\ ->%/

H5%#%2',*#0Z ,&,""')* -,& !H[ !

!

m^ 2,/,/ U>% 05%& !

=,4%&0/@05'*%/ n`,5%S _-% 0 ^,5% .,*,5%"')*o !

!

!

U>% ,F !

!

!

=,4,B'2% ]2.Rt. ` -0/'/ -'%5'% =,4@0-0B'2% `d2.Rt. _ -0/'/ -'%5'%/

=,4%&0/@05'*%/ ^,5% .,*,5%"')* G*,450@%#>%/J !2't%"'*% `l 2.Rt.S -0/'/ -'%5'%S *'F,&,/ @&%/2E#'"0/

6$5%"')* je`d ->%/

20



H5%#%2',*#0Z ,&,""')* -,& !H[ !

!

!

=%2K'0 -, #,5%@'% % &%/ \] O5/ K%/%-% ,* %*#'K'0.5%2% V#50/ %*#'K')#'"0/ -,K,5E* /,5 5,/,5F%-0/ @%5% "'5"$*/#%*"'%/ ,/@,"'%&,/ ,* &%/ C$, O%1% '*4052%"')* 2'"50K'0&).'"% G",4#%('-'2%S C$'*0&0*%/S "%5K%@,*82'"0/J ;0 $/%5 %.,*#,/ C$, *0 %&"%*(%* "0*",*#5%"'0*,/ %-,"$%-%/ ,* @%58*C$'2% 5,*%&

6'%.*)/#'"0 -, *#02%/ $5'*%5'0/ K%30/ M%*,30 -, &%
21



6'%.*)/#'"0 !

P5,F%&,*"'% -, *#02%/ $5'*%5'0/ K%30/ jS]g N',2@5, /, 5,C$',5, "0*Q52%"')* -'%.*)/#'"%S 1% C$, &% @50K%K'&'-%- @0/#@5$,K%S %T* #,*',*-0 F%5'0/ /'.*0/R/>*#02%/S *$*"% /$@,5% ,& ^dg V#5%/ "%$/%/ -, />*#02%/ $5'*%5'0/ K%30/Z -'/4$*"'0*,/ 2'""'0*%&,/S F$&F0F%.'*'#'/S K%&%*'#'/S "0*/#'@%"')*S &'#'%/'/ ,#" →

!

!

n=$E& ,/ ,& 28#0-0 %-,"$%-0 -, 5,"0&,""')* -, 05'*%o !

N' ,& @%"',*#, *0 "0*#50&% ,/4>*#,5

!

<*'"'%&2,*#, 5,"0&,"#05o N, -,K, "0*Q52%5 "0* ,B%2,* '*F%/'F0 =0*#50& -, ,/4>*#,5 s,.$*-% 2'""')* !/,0 %-,"$%-0 -, (0*% @,5'*,%& "0* %.$% 1 3%K)* N,*/'K'&'-%- jle`ddgS ,/@,"'Q"'-%- lje`ddg !

!

→

!

!

NOP+ *" )-Q=,'=+ %(PF'=+ I>R-" EST "F (+ )>R(+='UF )"*'Q,-'=+J V?V ;I@+W+J ./00

22



H5%#%2',*#0Z ,&,""')* -,& !H[ !

!

!

A* ,& 202,*#0 %"#$%& ,* *$,/#50 2,-'0S /, 5,"02',*-% ",4%&0/@05'*% -, @5'2,5% 0 /,.$*-% .,*,5%"')* 0 *'#504$5%*#0>*% 6$5%"')* -,& #5%#%2',*#0 %*#'K')#'"0 -, ,*#5, ^ 1 \ ->%/ P%"',*#,/ C$, 5,"'K,* #5%#%2',*#0 @50Q&E"#'"0 1 -,/%550&&%*
6'%.*)/#'"0 @05 '2E.,*,/

23



6'%.*)/#'"0 @05 '2E.,*,/ !

!

VK3,#'F0 KT/C$,-% -, %*02%&>%/ -,& #5%"#0 $5'*%5'0 C$, @$,-%* @5,-'/@0*,5 %& @%"',*#, % *$,F%/ '*4,""'0*,/ 1 C$, /0* /$/",@#'K&, -, #5%#%2',*#0/ 28-'"0/ 0 C$'5T5.'"0/ :% 2%105>% -, &%/ 5,"02,*-%"'0*,/ /, K%/%* ,* &% @5,2'/% -, C$, ,& 9UI -,/,2@,L% $* @%@,& '2@05#%*#, ,* &% @%#0.8*,/'/ -, &% % @5,F,*'5 /$ %@%5'"')* 0 @50.5,/')* →

6'%.*)/#'"0 @05 '2E.,*,/Z P;!R
!

!

!

9UI .5%-0 5',/.0 -, -%L0 5,*%&S @0"0 45,"$,*#,S @50@05"')* /'.*'Q"%#'F% -, &0/ -,4,"#0/ -,& @%58*C$'2% 5,*%&S /0* @5,*%#%&,/ 1 *0 /0* /$/",@#'K&,/ -, @5,F,*'5 A& #'@0 -, #5%#%2',*#0 *0 20-'Q"% &% ,F0&$"')* -,& -%L0 5,*%& ;0 /, O% -,20/#5%-0 ,& K,*,Q"'0 -, &% @50Q&%B'/ %*#'K')#'"% ,* &% @5,F,*"')* -, 5,"$55,*"'%/ →

→

)"*'+,-'=IJ ./001 0.26 ":M89"::/

24



6'%.*)/#'"0 @05 '2E.,*,/Z P;!R
)"*'+,-'=IJ ./001 0.26 ":M89"::/

6'%.*)/#'"0 @05 '2E.,*,/Z P;!R
)"*'+,-'=IJ ./001 0.26 ":M89"::/

25



6'%.*)/#'"0 @05 '2E.,*,/Z P;!R
)"*'+,-'=IJ ./001 0.26 ":M89"::/

6'%.*)/#'"0 @05 '2E.,*,/Z P;!R
)"*'+,-'=IJ ./001 0.26 ":M89"::/

26



6'%.*)/#'"0 @05 '2E.,*,/ !

!

A/#$-'0 -, '2E.,*,/ *0 ,/#E &'K5, -, 5',/.0 1R0 "0/#0/ AB'/#, ,F'-,*"'% /$Q"',*#, @%5% 5,"02,*-%5 C$, #'@0 -, @5$,K% ,&,.'5 !

!

!

!

A"0#020.5%4>% 5,*%& %*%#02>%S -'&%#%"')* -, F>% $5'*%5'% =IMN 9UI 6MN! -,4,"#0/ -,& @%58*C$'2% 5,*%& →

→

→

;0 ,B'/#,* ,F'-,*"'% /$Q"',*#, @%5% 5,"02,*-%5 ,/#$-'0 %*#, #0-0/ &0/ *'L0/ "0*
6'%.*)/#'"0 @05 '2E.,*,/Z 9,"02,*-%"')* !

A& ,/#$-'0 "02@&,#0 1% /,% @5,"0( 0 -'4,5'-0 /, -,K, 40"%&'(%5 ,* &0/ .5$@0/ -, 5',/.0 -, -%L0 5,*%& !

!

!

hi 2,/,/ 2%105 5',/.0 -, 2%&4052%"'0*,/ 1 0K/#5$""')* -, &% F>% $5'*%5'% C$, *'L0/ 2%105,/ @'"% %� 5',/.0 -, -,4,"#0/ @%5,*C$'2%#0/0/ 5,*%&,/ /'.*'Q"%#'F0/ 1 %*02%&>%/ ,/#5$"#$5%&,/ /'.*'Q"%#'F%/
→

→

27



6'%.*)/#'"0 @05 '2E.,*,/Z A"0.5%4>% 5,*%& !

!

!

!

H0-0 @%"',*#, #5%/ $*% @5'2,5% @'"% ;0 /, 5,"02',*-% 5,@,#'5&% 45,*#, % *$,F0/ ,@'/0-'0/ -, *-502, -, ,&'2'*%"')* -'/4$*"'0*%& A* *'L0/ "0* "0*#50& -, ,/4>*#,5 -,K, /,5 "0* F,3'.% &&,*%S 2'-',*-0 ,& F0&$2,* F,/'"%& %*#,/ 1 -,/@$8/ -, &% 2'""')*

6'%.*)/#'"0 @05 '2E.,*,/Z I5,#50"'/#0.5%4>% !

!

;0 /, 5,"02',*-% -, 5$#'*% N, 5,"02',*-% 5,%&'(%5 ,* !

!

!

!

!

!

M,*05 -, ` %L0 @'"% % 0 6MN!

28



6'%.*)/#'"0 @05 '2E.,*,/Z ='*#'.5%2% 5,*%& ,/#E#'"0 6MN! !

!

W%/, %.$-% G_ /,2J .0&- ,/#E*-%5 @%5% ,& -'%.*)/#'"0 -, P;! N' /, -'/@0*, -, 8&S /, 5,"02',*-% /$ 5,%&'(%"')* ,* 4%/, %.$-%S 1% C$, @,52'#, "0*Q52%5 ,& -'%.*)/#'"0 1 "0*-'"'0*%5 &0/ ,BE2,*,/ "02@&,2,*#%5'0/ →

!

N' 45,*#, % $* @5'2,5 ,@'/0-'0 -,
6'%.*)/#'"0 @05 '2E.,*,/Z ='*#'.5%2% 5,*%& ,/#E#'"0 6MN! !

!

6'4,5'-0 Gmi 2J .0&- ,/#E*-%5 @%5% ,& -'%.*)/#'"0 -, "'"%#5'( 5,*%& 9,%&'(%5 6MN! -'4,5'-0 #5%/ $*% @5'2,5% *'"0/ 0 5%-'0&).'"0/ C$, '*-'C$,* $*% %&#% @50K%K'&'-%- -, ,B'/#,*"'% -, -%L0 5,*%& →

!

!

!

@'"% N'.*0/ -, -'/4$*"')* -,& #5%"#0 $5'*%5'0 '*4,5'05 ?%&&%(.0/ @%#0&).'"0/ ,* ,/#$-'0/ -, '2E.,*,/ @5,F'0/ GA=VS "'/#0.5%4>%S 6MN!J

29



6'%.*)/#'"0 @05 '2E.,*,/Z ='*#'.5%2% 5,*%& ,/#E#'"0 6MN! !

N, 5,"02',*-% &% 5,%&'(%"')* -, 6MN! ,* &0/ @%"',*#,/ C$, @5,/,*#%*
30



)"*'+,-'=I ./001 0.2 4356 A8A970/

)"*'+,-'=I ./001 0.2 4356 A8A970/

P50Q&%B'/S /,.$'2',*#0 1 -,5'F%"')*

31



P50Q&%B'/ !

!

;0 /, 5,"02',*-% ,* 4052% 5$#'*%5'% <*-'"%-% ,* !

!

!

!

`h%L0 "0* % 0K/#5$"#'F%
!

m _ 2,/,/

!

h _ 2,/,/

→ →

;HW 0 HMeNMu ",4%-50B'&0

N,.$'2',*#0 !

;0 ,/#E* 5,"02,*-%-0/ &0/ %*E&'/'/ -, 05'*% 5$#'*%5'0/ #5%/ ,& #5%#%2',*#0 %*#'K')#'"0S 0 -, 4052% @,5')-'"% -$5%*#, ,& /,.$'2',*#0 !

!

!

!/'*#02E#'"0/ !*02%&>%/ ,/#5$"#$5%&,/

?%1 ,F'-,*"'% /$Q"',*#, C$, -,2$,/#5% C$, ,& #5%#%2',*#0 %*#'K')#'"0 -, &% K%"#,5'$5'% %/'*#02E#'"% *0 #',*, ,4,"#0 ,* &% @5,F,*"')* -,
32



N,.$'2',*#0 !

!

N, 5,"02',*-% %-F,5#'5 % &% 4%2'&'% &% @0/'K'&'-%- -, 5,"$55,*"'%/ , '*4052%5 /0K5, />*#02%/ 05',*#%-05,/ @%5% 5,"0*0"'2',*#0 -, *#02%/ 2'""'0*%&,/JS ,* "$10 "%/0 -,K, "0*/$&#%5 @50*#%2,*#, %& 28-'"0 ;0 /, 5,"02',*-% ,& /,.$'2',*#0 ,* *'L0/ "0* [!

N,.$'2',*#0 !

9',/.0 -, -,/%550&&%5 "'"%#5'",/ 5,*%&,/ ,/ F%5'%K&, -,@,*-',*-0 -,& .5$@0 %*%&'(%-0 Glei\gJ !

!

9UI -, %� .5%-0S
33



6,5'F%"')* %& ,/@,"'%&'/#% !

!

!

!

@'"% !*02%&>%/ ,/#5$"#$5%&,/S 5'L)* T*'"0 1R0 %*02%&>%/ 4$*"'0*%&,/ *,450$50&).'"%/ G-'/4$*"')* F,/'"%&J 1R0 %*02%&>%/ -, &% 5,.')* -05/0&$2K%5

6,5'F%"')* %& ,/@,"'%&'/#% !

!

!

!

!

6%L0 5,*%& @,52%*,*#, "0*Q52%-0 ,* ,/#$-'0/ -, '2E.,*,/ 0 2,-'%*#, 2%5"%-05,/ -, /%*.5, G[I;S "5,%#'*'*%J 0 ,* 05'*% G@50#,'*$5'%S 2'"50%&K$2'*$5'%J ?'@,5#,*/')* %5#,5'%& 9,#5%/0 -, "5,"'2',*#0 !*#,",-,*#,/ 4%2'&'%5,/ -, ,*4,52,-%-,/ *,450$50&).'"%/ 1R0 A9= !*/',-%- 4%2'&'%5 1R0 "0*Q52%"')* -'%.*)/#'"%7

34



;0 0&F'-%5 ,* #0-0 *'L0 "0*
!

!

!

!

!

!

!

!*#,",-,*#,/ 4%2'&'%5,/ -, 9UIS -%L0 5,*%&S 2%&4052%"'0*,/ -, &% F>% $5'*%5'% A"0.5%4>%/ @5,*%#%&,/ D&0K0 F,/'"%& AF%&$%"')* -, .,*'#%&,/ AF%&$%"')* -, &% 5,.')* -05/0&$2K%5 P%#5)* 2'""'0*%& P%#5)* -,4,"%#05'0 M%/%/ @%&@%K&,/ %K-02'*%&,/

['K&'0.5%4>% !

!

!

!"$#, @1,&0*,@O5'#'/ '* "O'&-5,*7 M05,&&0 ,# %&7 P,-'%#5 ;,@O50& G_dìJ ^`Z`_l^k`_il !"#$%&'(%"')* ,* ,& -'%.*)/#'"0 1 2%*,30 -, &% <*4,""')* I5'*%5'% ,* @,-'%#5>%7 N%&%/ ,# %&7 9,F =O'& P,-'%#5 _d`_w ]^ G^JZ _ife_j] I5'*%51 H5%"# <*4,"#'0*Z =&'*'"%& P5%"#'", D$'-,&'*, 405 #O, 6'%.*0/'/ %*- M%*%.,2,*# 04 #O, <*'#'%& IH< '* W,K5'&, <*4%*#/ %*- =O'&-5,* _ #0 _\ M0*#O/7 !!P7 P,-'%#5'"/ _d``w `_] G^JZ lflei`d

35

Actualización ITU SOCHIPE 2016

Recommend Documents