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“ALTERACIONES DEL SEDIMENTO URINARIO COMO FACTORES

ASOCIADOS A PERFORACIÓN EN PACIENTES CON APENDICITIS AGUDA EN

EL HOSPITAL REGIONAL DE CAJAMARCA, PERIODOD DICIEMBRE 2012-

DICIEMBRE 2015”

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ASESOR:

GLENN JAIME DIAZ GUTIRREZ

DOCENTE AUXILIAR DE LA FACULTAD DE MEDICINA HUMANA DE LA UNIVERSIDAD

NACIONAL DE CAJAMARCA.

CIRUJANO GENERAL ASISTENTE DEL DEPARTAMENTO DE CIRUGÍA DEL HOSPITAL

REGIONAL DE CAJAMARCA

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DEDICATORIA ! AGRADECIMIENTO

A Dios, por darme la vida, la fuerza

y la perseverancia para permitirme

 terminar esta carrera de

 Medicina Humana.

A mis padres, por su apoyo

incondicional, por su motivación y su

aliento cada día de mi vida hasta el día

de hoy ,en especial a mi madre, por su

fortaleza frente a la vida y a mis

hermanos que son la alegría de mi vida.

A mi abuelo orvil, que muchas

veces hace el papel de padre,

con su e!emplo conse!o y apoyo

incondicional me motiva a seguir

adelante.

A mi asesor Dr. "lenn #aime Díaz

"utierrez por guiarme durante

este $ltimo proceso de

aprendiza!e. "racias a todos

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"NDICE GENERAL

Ítem Pág.

RESUMEN…………………………………………………………………………….....06

 ASTRACT………………………………………………………………………………0!

INTRODUCCI"N………………………………………………………………………..0#

CAPITULO I: EL PROBLEMA DE IN#ESTIGACIÓN ! LOS OBJETI#OS

$.$ De%&'&(&)' * +e,&m&t-(&)' +e, /1,em-……………………………...

……………..02

$.3 F/m4,-(&)' +e, /1,em-…………………………………….…..

………………..02

$.5 J4t&%&(-(&)'………………………………………………………..……….

………..$0

$.5 O17et&8 +e ,- &'8et&g-(&)'…………………………………...

…………………..$0

$.5.$ O17et&8 ge'e/-,e…………………………………………..…………………..$0

$.5.3 O17et&8 ee(9%&(……………………………………….…………….………$$

CAPITULO II: MARCO TEÓRICO

3.$ A'te(e+e'te +e, /1,em-…………………………………..

…………………….$33.3 -e

te)/&(-……………………………………………………………………….$:

3.5 De%&'&(&)' +e t;/m&'…………………………………… …...……………………

$!

CAPITULO III: LA HIPÓTESIS: FORMULACIÓN DE HIPÓTESIS ! DEFINICIÓN

OPERACIONAL DE #ARIABLES

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5.$ H&)te&………………………………..…………………………………………....$#

5.3 De%&'&(&)' e/-(&'-, +e ,- 8-/&-1,e……………..………………..……………

$2

CAPITULO I#: METODOLOG"A

:.$ P1,-(&)'………………………………………………………………..…………...30

:.3 M4et/-……………………………………….…………………………..

……….....3$

:.5 D&e

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RESUMEN

OBJETI#OS:  Dete/m&'-/ & ,- &4/&-> * H 4/&'-/& +&m&'4&+ ' %-(t/e

-(&-+ - e/%/-(&)' e' -(&e'te (' -e'+&(&t& -g4+- e' e, H&t-,

Reg&'-, +e C-7-m-/(- D&(&em1/e 30$3 ? D&(&em1/e 30$=.

MATERIALES ! MTODOS: Se ,,e8) - (-1 4' et4+& -'-,9t&(> 1e/8-(&'-,>

/et/e(t&8 +e (- * ('t/,. L- 1,-(&)' et48 ('t&t4&+ / $30

-(&e'te@ 60 -(&e'te (' -e'+&(&t& -g4+- e/%/-+- * 60 -(&e'te ('

-e'+&(&t& -g4+- ' e/%/-+-.

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RESULTADOS: L- /ee'(&- +e &4/&- /e4,t) te'e/ /e,-(&)' (' ,- -e'+&(&t&

-g4+- e/%/-+- * e/ &g'&%&(-t&8 B3@ $0>!=5 8-,/ +e @ 0>00$&, /ee't-+

&4/&- 3$ +e, g/4 (- * 6 +e, g/4 ('t/, * 4' OR@ :>#:6. E, 4/&'-/&

/e4,t) te'e/ /e,-(&)' * e/ &g'&%&(-t&8 B3@ 32>00# 8-,/ +e @ 0>000>

/ee't-'+ 4/&'-/& +&m&'4&+ 52 +e, g/4 (- * $0 +e, g/4 ('t/, * 4'

OR@ 5>235'

CONCLUSIONES: L- &4/&- * e, 4/&'-/& +&m&'4&+ etá' /e,-(&'-+ -

-e'+&(&t& -g4+- e/%/-+-

PALABRAS CLA#ES: Ae'+&(&t& -g4+- e/%/-+-> &4/&-> 4/&'-/& +&m&'4&+.

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ABSTRACT

OBJECTI#ES:  T +ete/m&'e ete/ *4/&-> -'+ +e(/e-e+ 4/&'-/* H -/e

%-(t/ -(&-te+ &t +/&,,&'g &' -t&e't &t -(4te -e'+&(&t& &' te Reg&'-,

H&t-, % C-7-m-/(- &' De(em1e/ 30$3 ? De(em1e/ 30$=.

MATERIALS AND METHODS: A' -'-,*t&(-,> 1e/8-t&'-,> /et/e(t&8e (-e

('t/, t4+* - ('+4(te+. Te 4,-t&' ('&te+ % $30 -t&e't@ 60 -t&e't

&t -(4te e/%/-te+ -e'+&(&t& -'+ 60 -t&e't &t ''?e/%/-te+ -(4te

-e'+&(&t&.

RESULTS:  Te /ee'(e % *4/&- /8e+ t 1e /e,-te+ t -(4te e/%/-te+

-e'+&(&t& -'+ 1e &g'&%&(-'t B3@ $0.!=5 8-,4e@ 0.00$> te g/4 /ee'te+

3$ (-e &4/&- -'+ 6 &' te ('t/, g/4 -'+ OR@ :>#:6. Te 4/&'-/* H -

%4'+ t -8e /e,-t&'& -'+ 1e &g'&%&(-'t B3@ 32.00# 8-,4e@ 0.000>

/ee't&'g 4/&'-/* H +e(/e-e+ 52 (-e g/4 -'+ $0 &' te ('t/, g/4 -'+

OR@ 5>235.

CONCLUSIONS: P*4/&- -'+ +e(/e-e+ 4/&'-/* -/e /e,-te+ t e/%/-te+ -(4te

-e'+&(&t&

(E! )ORDS: A(4te Ae'+&(&t& e/%/-te+> *4/&-> 4/&'-/* H +e(/e-e+.

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INTRODUCCIÓN

L- -e'+&(&t& -g4+- e ,- 4/ge'(&- 4&//g&(- -1+m&'-, má (m' * 4/')t&( +ee'+e +e 4' +&-g')t&( /e(&> tem/-'.   N&'g' -e(t +e ,-

/ee't-(&)' (,9'&(- 4e+e /e+e(&/ (' /e(&&)' ,- /ee'(&- +e ,- e'%e/me+-+>

&' 4'- (m1&'-(&)' +e 8-/& &g' * 9'tm- 4e+e' -*-/ e, +&-g')t&(.

P/ +eg/-(&-> ,- -e'+&(&t& -g4+- e t+-89- +&%9(&, +e +&-g't&(-/ * +&-g')t&(

e//)'e ' e &'%/e(4e'te e' e, e/8&(& +e 4/ge'(&-. P/ t/- -/te> e, /et/- e'

e, +&-g')t&( /e(& 4e+e /e4,t-/ e' ,- e/%/-(&)' +e, -;'+&(e. 32

 A,g4'- t;('&(- +e &m-ge'> (m ,- e(g/-%9-> /-+&g/-%9- &m,e +e

-1+me'> tmg/-%9- (m4t-/&-+- * ,- g-mm-g/-%9-> 4e+e' -*4+-/ - ,

m;+&( - &+e't&%&(-/ -e'+&(&t& -g4+-. S&' em1-/g> et m;t+ +e

+&-g')t&( ' etá' +&'&1,e e' t+ , e't/' +e -te'(&)' /&m-/&-> *

-,g4' +e e,, ' (-/ * +ee'+&e'te +e ,- e('m9- +e, -(&e'te. #

Se -' /e-,&-+ m4( et4+& -/- -8e/&g4-/ & t/ -/ámet/ /e+&(t&8

e +/9-' 4t&,&-/ -/- e, +&-g')t&( +e -e'+&(&t& -g4+-. A,g4' et4+& -'

&'%/m-+ +e , /e4,t-+ +e, -'á,&& +e /&'- -'/m-,e e' -(&e'te ('

-e'+&(&t& -g4+-. 6>50

E' e, (- +e -e'+&(&t& -g4+- e/%/-+ e e'('t/) et-+9t&(-me'te

&g'&%&(-t&8 , 8-,/e +e g,)14, 1,-'(> e'('t/á'+e -4me't-+ * H

4/&'-/& +&m&'4&+ e' (m-/-(&)' (' -e'+&(&t& -g4+- ' e/%/-+-. =>#

P/ , t-'t> e' ete et4+&> '4et/ /)&t e +ete/m&'-/ & e, -'á,&& +e

/&'- +e /4t&'- 4e+e e/8&/ (m 4'- t&, e//-m&e't- -/- +&(/&m&'-/ e't/e *

-e'+&(&t& -g4+- e/%/-+ * -e'+&(&t& -g4+- ' e/%/-+-.

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CAPITULO I: EL PROBLEMA DE IN#ESTIGACIÓN ! LOS OBJETI#OS

1'1 D*+./ *34./ * 6789*3

L- -e'+&(&t& -g4+- e 4'- -t,g9- 1-t-'te %/e(4e'te * e, +&-g')t&( e -

me'4+ eB(,4&8> -9 e, m-'e7 +e -(&e'te (' +&-g')t&( e4&8(-+ e

('t/8e/&-, $. E' Et-+ U'&+ (4//e' 3=0>000 (- / -0 -/- ,- -e'+&(&t& tem/-'- -t- e,

!=>0 -/- ,- e/%/-+-> ,- &'(&+e'(&- +e e/%/-(&)' e - +ete/m&'-+ e't/e

$! * :0. L- (m,&(-(&'e -e'+&(4,-/e má %/e(4e'te +e1&+ - ,- ee/-

+e, -(t e/-t/& ' -;'+&(e 'e(/-+- e' 4' 50.= eg4&+- +e

e/%/-(&'e e' 4' $2.:  3. 

L- t-- +e -e'+&(&t& ' (m,&(-+- e' e, 3002 e' '4et/ -9 %4e +e 55>3= / 

$00>000 * 3>5= / $00>000 -/- -e'+&(&t& (m,&(-+- 5.

EB&te +&%e/e'(&- e't/e ,- et-'(&- &t-,-/&- -/- -4e,,- -;'+&(e

(m,&(-+- e' /e,-(&)' - ,- ' (m,&(-+- :.

1'2 F873./ * 6789*3

;S8 < 4*7.8*< *

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1'@ J 4'- &'%/m-(&)' +e 4t&,&+-+ -/- e, e4& m;+&( t/-t-'te 4&e'e

+/á' ,-'&%&(-/ (' -'te,-(&)' ,- et/-teg&- 4&//g&(- má ('8e'&e'te -/- ,-

/e,4(&)' e%e(t&8- +e, /1,em- +e -,4+ e' t-, e't&+ e - +(4me't-+ ,-

/e,-(&)' e't/e ,- /ee'(&- +e -'/m-,&+-+e e' e, eB-me' 4/&'-/& * ,- /ee'(&-

+e et-- -8-'-+- +e -e'+&(&t& -g4+- (m ,- e/%/-(&)' +e ete )/g-'

e' t-, e't&+ * -'te ,- -4e'(&- +e et4+& &m&,-/e e' '4et/ me+& e 4e

' ,-'te-m ,- &g4&e'te &'8et&g-(&)'@

1' O9>*48< * I**48 =**7

Dete/m&'-/ & ,- &4/&-> * 4/&'-/& +&m&'4&+ ' %-(t/e -(&-+ -

e/%/-(&)' e' -(&e'te (' -e'+&(&t& -g4+- e' e, H&t-, Reg&'-, +e

C-7-m-/(-.

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1''2 O9>*48< *

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CAPITULO II: MARCO TEÓRICO

2'1 A4*.**4*< * 6789*3

)* C, *4  C&'-> 300! ,,e8-/' - (-1 4'- &'8et&g-(&)' (' ,- %&'-,&+-+ +e

/e(&-/ ,- -(&-(&)' e't/e , -,,-g -'/m-,e +e, e+&me't 4/&'-/& e'

-(&e'te (' +&-g't&() +e -e'+&(&t& -g4+- e' /e,-(&)' (' e, /&eg +e

e/%/-(&)' -e'+&(4,-/ / me+& +e 4' +&e e/-+

+e -e'+&(&t& -g4+- 1e/8-'+ 4e 4' +e (-+- 5 -(&e'te /ee't) -,g'

9'tm- 4/&'-/& e, +,/ ,4m1-/ +e/e( * ,- +&4/&- %4e/' , má %/e(4e'te

/ee(t - , -,,-g -'/m-,e +e, e+&me't 4/&'-/& e e'('t/)

,e4((&t4/&- 4e/&/ - $0 (;,4,- / (-m e' $ +e (-+- ! e'%e/m> *

e/&t/(&t4/&- 4e/&/ - 5 (;,4,- / (-m e' $ +e (-+- 6. U' +e (-+- !

e'%e/m /ee't) /te&'4/&- t/--. L 9'tm- 4/&'-/& * ,- /te&'4/&- e

/ee't-/' (' m-*/ %/e(4e'(&- e' m-*/e +e =2 - e' e,

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g/4 +e $=?$2 - / me+& +e 4' et4+& +e (- * ('t/,e

/e(t&8 e' e, 4e e &'(,4*e/' - 5=! -(&e'te (' e(- (,9'&(- +e et-

-t,g9- 1e/8-'+ +&%e/e'(&- &g'&%&(-t&8- /ee(t - ,- --/&(&)' +e

-,te/-(&'e +e, e+&me't 4/&'-/& e't/e , g/4 +e -(&e'te (' -e'+&(&t&

-g4+- e/%/-+- * ' e/%/-+- &e'+ et- ,- /ee'(&- +e &4/&- K0.0= e,

4/&'-/& +&m&'4&+ K0.0= * ,- /ee'(&- +e (et'4/&- K0.0= e' /e,-(&)' -

ete ,t&m -,,-g e 1e/8) e' e, := +e -(&e'te (' -e'+&(&t& e/%/-+- *

, e' e, 3$ +e -(&e'te (' -e'+&(&t& ' e/%/-+-!.

(4 A, *4  I/-> 30$: ,,e8-/' - (-1 4'- &'8et&g-(&)' (' ,- %&'-,&+-+ +e

/e(&-/ ,- -(&-(&)' e't/e ,- /ee'(&- +e -,te/-(&'e +e, eB-me' +e

e+&me't 4/&'-/& e' -(&e'te (' +&-g't&() +e -e'+&(&t& -g4+- * ,-

/ee'(&- +e %/m- (m,&(-+-> / me+& +e 4' et4+& /e(t&8 +e (-

* ('t/,e e' e, 4e e &'(,4*e/' - 3$0 -(&e'te (' e(- (,9'&(-

eB4et - -e'+&(e(tm9- e'('t/-'+ +&%e/e'(&- &g'&%&(-t&8- /ee(t -

,- -,te/-(&'e 4/&'-/&- e't/e , -(&e'te (' -;'+&(e '/m-, * , -(&e'te

(' -e'+&(&t& * +e't/ +e ete g/4 +&%e/e'(&- e't/e ,- %/m- e/%/-+- *

' e/%/-+-> &e'+ , -,,-g /e,-(&'-+ (' e/%/-(&)' ,- /ee'(&- +e

14

http://www.ncbi.nlm.nih.gov/pubmed/?term=Chen%20CY%5BAuthor%5D&cauthor=true&cauthor_uid=24055480http://www.ncbi.nlm.nih.gov/pubmed/?term=Chen%20CY%5BAuthor%5D&cauthor=true&cauthor_uid=24055480

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(et'4/&- := * 50 K0.0= &4/&- 50 * $! K0.0= * 4/&'-/&

+&m&'4&+ K0.0=#.

2'2 B $0.

E, e8e't %&&-t,)g&( &'&(&-, e ,- 1t/4((&)' /B&m-, +e ,- ,4 -e'+&(4,-/ 

4e /8(- 4'- 1t/4((&)' e' -- (e//-+- * ,- ('t&'4- e(/e(&)' +e ,- m4(-

-e'+&(4,-/> ,- (4-, /8(- 4'- /á&+- +&te'&)'. L- +&te'&)' +e, -;'+&(e

et&m4,- te/m&'-(&'e 'e/8&- +e %&1/- 8&(e/-,e -%e/e'te +e et&/-m&e't *

(-4- +,/ /+> 8-g * +&%4 e' -1+me' me+& e&g-t/& 8-g $$.

L- +&te'&)' -4me't- /á&+-me'te / ,- -(e,e/-+- /e/+4((&)' 1-(te/&-'-

/e&+e'te e' e, -;'+&(e 4m-+ - ,- ('t&'4- e(/e(&)' m4(-> et +&t&e'+e

-' má ,- ,4 -e'+&(4,-/ +'+e e eB(e+e ,- /e&)' 8e'- * ,&'%át&(->

(,4*e'+ (-&,-/e * 8e'-> ,,e8-'+ - &'g4/g&t-(&)' * ('get&)' +e t&

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8-(4,-/. L- m4(- +e, t/-(t +&get&8 e 4(et&1,e - &4em&- * e'

('e(4e'(&- e -,te/- e' %/m- tem/-'- 4 &'teg/&+-+> , 4e /m4e8e 4'-

&'8-&)' 1-(te/&-'-. Cm ('e(4e'(&- +e e,, (4//e 4'- e/%/-(&)' $3> $5.

E't/e -,g4'- +e ,- (m,&(-(&'e e'('t/-m -;'+&(e 'e(/-+->

e/%/-+-> %/m-(&)' +e -1(e> e't/e t/-> ,- 4e ,,eg-' - e/ mt&8 +e

m-*/ et-'(&- &t-,-/&- * -,g4'- 8e(e +e /e&'te/8e'(&'e 4&//g&(->

ge'e/-'+ m-*/ (t -/- ,- e('m9- $:.

L- -e'+&(&t& -g4+- e 4'- +e ,- e'%e/me+-+e e' +'+e /e4,t- (m,&(-+

/e-,&-/ 4' +&-g')t&( (//e(t * eg4/> ete /1,em- /-+&(- e' ,- 8-/&e+-+ +e

,- %/m- (,9'&(- +e /ee't-(&)'. De -(4e/+ (' ,- ,&te/-t4/- m4'+&-,> -*

e't/e 4' 30 * 4' 55 +e -(&e'te (' e(- +e -e'+&(&t& -g4+- 4e

/ee't-' 9'tm- * &g' -t9&( $=>

 P-/- e, +&-g')t&( e /e('(e' (m 9'tm- má ('&te'te e, +,/ * ,-

-'/eB&-. Ot/ &g' ' 8-/&-1,e> (m ,- t-4&(-/+&- * ,- %&e1/e +e 1-7

g/-+. L- +e%e'- e' e, 4't +e M(4/'e* - &+ &em/e e, e,eme't ee'(&-,

e' ,- +e%&'&(&)' +e ,- e'%e/me+-+> e/ , &g' +e ,- t/9-+- +e, -> e, &g'

+e, 1t4/-+/ * e, &g' +e R8&'g t-, 8e e-' , me' (m4'e $!.

E' e, +&-g')t&( +&%e/e'(&-, eB&te' -,g4'- (-4- m;+&(-. Se +e1e' -(e/ 

t+ , e%4e/ -/- +e(-/t-/,-> / , 4e e +e1e /e-,&-/ 4'- -'-m'e&

(m,et-> 4' eB-me' %9&( /,&7> m-'te'e/ -, -(&e'te e' 4'- 1e/8-(&)'

-(t&8- * tm-/ eBáme'e +e ,-1/-t/& * /-+&,)g&( & e/&te' +4+-

/-'-1,e $#.

16

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E' 4' e%4e/ -/- /e+4(&/ e, /(e't-7e +e -e'+&(e(tm9- 'eg-t&8-> (m

t-m1&;' +e +&m&'4&/ e, t&em +e +&-g')t&( -/- ' &'(/eme't-/ e, /me+& +e

e/%/-(&'e -e'+&(4,-/e> e - me'(&'-+ e' ,- ,&te/-t4/- +&%e/e'te

&tem- +e (,-&%&(-(&)'> (,9'&(> -'-,9t&( e &m-ge',)g&( $2.

Se -' /e-,&-+ &'8et&g-(&'e -/- /e(&-/ & t/ -/ámet/ /e+&(t&8 e

+/9-' 4t&,&-/ -/- +ete/m&'-/ ,- e8e/&+-+ +e ,- -e'+&(&t& -g4+-. E' ete

e't&+ e - &+e't&%&(-+ 4e , /e4,t-+ -'/m-,e +e -'á,&& +e /&'-

4e+e' eB&t&/ e' , -(&e'te (' -e'+&(&t& -g4+-. S&' em1-/g> ,- (//e,-(&)'

e't/e -,,-g t-,e (m@ (et'4/&-> &4/&-> e/&t/(&t4/&- * +&m&'4(&)' +e,

4/&'-/& * ,- /ee'(&- +e -e'+&(&t& -g4+- e/%/-+-> -4' ' e +e, t+ (,-/-

30.

E' /e,-(&)' - ,- -,te/-(&'e 1e/8-+- e' e, e+&me't 4/&'-/& +4/-'te

-e'+&(&t& -g4+- e/%/-+- (-1e e 4e '

9'tm- (m4'e e' -(&e'te (' -e'+&(&t& -g4+- 3$.

L- +e'&+-+ 4/&'-/&- 8-/9- +ee'+&e'+ +e ,- /- +e, +9-> (-'t&+-+ +e -,&me't

* , ,94&+ ('4m&+> * ,- (-'t&+-+ +e e7e/(&(& /e(&e'te 4 e,e8-(&)' 4e+e

/e4,t-/ +e ,- +&m&'4(&)' e' e, ('4m +e -,&me't * ,94&+ ('e(4e'(&- +e,

m-,et-/ -1+m&'-, e(4'+-/& - ,- e'%e/me+-+. A9 m&m e, me'/ 8-,/ +e H

+e ,- /&'- e' , -(&e'te (' -e'+&(&t& -g4+- 4e+e et-/ -(&-+- (' ,-

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+&m&'4(&)' +e, -et&t * ,- &'get- /-, ('(m&t-'te (' ,- g/-8e+-+ +e ,-

-e'+&(&t& -g4+- 33.

2'@ D*+./ * 4738< 9 -e'+&(&t& %,em'-> -e'+&(&t& g-'g/e'-+- *

%&'-,me'te ,- -e'+&(&t& e/%/-+- 35.

A6*.4< 6*7+87: A;'+&(e (' 'e(/& t/- m4/-, +'+e e e8&+e'(&-

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(' ,- /ee'(&- +e P&4/&- t&e'e' :>#:6 8e(e má /&eg +e /ee't-/ 

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,e4((&t-/&-> g,)14, 1,-'( * g,)14, /7 e'('t/á'+e 4e e/-'

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(m-/-(&)' (' -e'+&(&t& ' e/%/-+-.!

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//(&)' e' -(&e'te (' Ae'+&(&t& -g4+- e/%/-+- (' H me'/ +e 6 6=

8 $6>!> m-'&%et-'+ 4e e, H me'/ +e 6 e +ee'+&e'te - ,- -e'+&(&t&

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('(,4&/ 4e , -(&e'te (' HK6 t&e'e' 2>3#6 8e(e má e, /&eg +e

/ee't-/ Ae'+&(&t& Ag4+- e/%/-+- 4e ,- e/'- (' H 6.

Re4,t-+ 4e (&'(&+e' (' e, et4+& /e-,&-+ / e& C> et -, 300!

+ete/m&'-/' e' T-&á' 3005 ?300= 4e , -(&e'te (' -e'+&(&t& -g4+-

te'9-' me'/ H 6>5=W0>02= +e ,- /&'- P0>00=. L m&m -4t/e &'+&(-'

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/ ,- +&m&'4(&)' +e, -et&t * ,- &'get- ('(m&t-'te (' ,- g/-8e+-+ +e ,-

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CONCLUSIONES

 

L- /ee'(&- +e &4/&- etá -(&-+ - e/%/-(&)' e' -(&e'te ('

-e'+&(&t& -g4+-.

 

E, H 4/&'-/& +&m&'4&+ HK6 etá -(&-+ - e/%/-(&)' e' -(&e'te

(' -e'+&(&t& -g4+-.

 

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-g4+-.

35

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RECOMENDACIONES

E' e, H&t-, Reg&'-, +e C-7-m-/(-> e +e1e /t(,&-/ ,- ,&(&t4+ +e

eB-me' +e /&'- 74't (' , eBáme'e +e /4t&'-> / ,- /e,-(&)' e't/e ,-

/ee'(&- +e -'/m-,&+-+e e' e, eB-me' 4/&'-/& (' ,- /ee'(&- +e et--

-8-'-+- +e -e'+&(&t& -g4+- (m ,- e/%/-(&)' +e ete )/g-'.

 Am,&-/ ,- /ee'te &'8et&g-(&)'> -/- 4e (' m-*/ (-49t&(- * ,- me+&(&)' +e

t/ -/ámet/ e' eB-me' +e /&'-> e e8-,e' t/ %-(t/e /e,-(&'-+ ('

-e'+&(&t& -g4+- e/%/-+- * e te'g- 4'- &'%/m-(&)' +e 4t&,&+-+ -/- e, e4&

m;+&( t/-t-'te 4&e'e +/á' ,-'&%&(-/ (' -'te,-(&)' ,- et/-teg&- 4&//g&(-

má ('8e'&e'te -/- ,- /e,4(&)' e%e(t&8- +e, /1,em- +e -,4+.

36

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REFERENCIAS BIBLIOGR$FICAS$. A'+e/' M> A'+e/' RE. Te -e'+&(&t& &'%,-mm-t/* /e'e

(/e@ - t, %/ te +&-g'& % -(4te -e'+&(&t& t-t 4te/%/m te

 A,8-/-+ (/e. /,+ J S4/g. 300# 53#@ $#:5$#:2.3. Ve,á4e C> Ag4&//e > V-,+&8&- C> R4& M> C/'e7 C> T//e M * et -,.

V-,/ +e, U,t/-'&+ e' e, D&-g')t&( * M-'e7 +e ,- Ae'+&(&t& Ag4+-.

Re8 G-t/e'te/, Pe/. 300! 3!5@ 3=2?365.5. R7- C. E&+em&,g9- +e ,- -e'+&(&t& -g4+- e' e, Pe/ 3002 ? 30$$.

30$5 $:?$=.:. Tm' NA. A(&-(&)' e't/e E(-,- +e A,8-/-+ * +&-g')t&( +e

-e'+&(&t& -g4+- (m,&(-+- * ' (m,&(-+- eg' -'-tm9- -t,)g&(-

e' Ce't/ M;+&( N-8-,. Re8 H/& Me+. 30$3 $33@ $3?$!.

=. e& C> 4 H> C-'g Y. R4t&'e U/&'-,*& &' P-t&e't &t A(4te

 Ae'+&(&t&. J Eme/g C/&t C-/e Me+. 300! $# 3@ !3?!6.

6. e& C> 4 H> C-'g Y. R4t&'e U/&'-,*& &' P-t&e't &t A(4te

 Ae'+&(&t&. J Eme/g C/&t C-/e Me+. 300! $# 3@ !3?!6.

!. T4'+&+/ A> Am-+ J> M'te +e O(- J. M-'&%et-(&'e 4/&'-/&- +e ,-

-e'+&(&t& -g4+-. A/(. E. U/,. 30$$ =5@ 30!?3$3.

#. Ce' C> - L> L&' Y. D&%%e/e't 4/&'-,*& -e-/-'(e &' (&,+/e' &t

&m,e -'+ e/%/-te+ -e'+&(&t&. Am J Eme/g Me+. 30$5 5$$$@$=60?5.

2. -t-' A> J--+ T> F4--+ M. A1'/m-, U/&'-,*& &' A(4te Ae'+&(&t&.

D&*-,- J. Me+. 30$: ! $@ 5?2.

$0.Se,t' T> M(&',-* R> S(-/t R. A(4te -e'+&(&t&@ (4//e't> +&-g'&

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37

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$$. -(4/ R> He''e,,* > C-,,--' M> Ce' C> M'4te-4B M@ D&-g't&(

Im-g&'g -'+ Neg-t&8e Ae'+e(tm* R-te &' C&,+/e'@ E%%e(t % Age -'+

Ge'+e/. Pe+&-t/&( 30$3 $32@ #!!?#:.

$3.A,'7-+-t I. A1+-,,- . A,8-/-+ 8e/4 RIPASA (/e &' +&-g'&'g -(4te

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30.S&m&4 T> I&4- M> 41t- . A ,e/ 'e4t/&, t ,*m(*te /-t& &

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ANE%OS

ANE%O N 01

 A,te/-(&'e +e, e+&me't 4/&'-/& (m %-(t/e -(&-+ - e/%/-(&)' e'

-(&e'te (' -e'+&(&t& -g4+- e' e, H&t-, Reg&'-, +e C-7-m-/(-.

FICHA DE RECOLECCION DE DATOS

Fe(-………………………… N\…………………………

I. DATOS GENERALES@

$.$. Nme/ +e &t/&- (,9'&(-@ ^^^^^^^^^^^^^^^

$.3. E+-+@ ^^^^^^^ -