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KRUPRQDO75+HDQWLFRQFHSFLRQDLVRUDLV$&2VtQGLFH
GH PDVVD FRUSRUDO ,0& ! H DEGRPLQRSODVWLD FLUFXQ
IHUHQFLDO1RSURWRFRORGH6DQGULHVWiLQGLFDGDDSURIL
OD[LD IDUPDFROyJLFD QD PHVPD GRVH TXH QR GH 'DYLVRQ-­
&DSULQLQRVULVFRVPRGHUDGRHDOWR8PDGLIHUHQoDVLJQL-­
ILFDWLYDHQWUHRVGRLVSURWRFRORVpTXHRGH6DQGULSRVVXL
DOJXQVIDWRUHVGHULVFRWtSLFRVGHFLUXUJLDVHVWpWLFDVFRPR
SRVLomRGH)RZOHUGHUPROLSHFWRPLDDEGRPLQDORXFUXUDO
LPSODQWHV JO~WHRV H SDQWXUULOKDV FLUXUJLDV HVWpWLFDV DVVR-­
FLDGDVHOLSRDVSLUDomR-iRSURWRFRORGH6DQGULPRGLIL
FDGR DFUHVFHQWD WUrV IDWRU HV GH ULVFR DQHVWHVLD JHUDO
PDOLJQLGDGHUHVWULomRQROHLWR!KRUDVFRPRXVRGH
SURILOD[LDIDUPDFROyJLFDVRPHQWHQRJUXSRGHDOWRULVFRH
VHPSUH LQLFLDQGR KRUDV DSyV R SURFHGLPHQWR SDUD GL
PLQXLUDRFRUUrQFLDGHVDQJUDPHQWRV ,QWHUHVVDQWHQRWDU
TXHWRGRVHVVHVSURWRFRORVWrPJUDXGHUHFRPHQGDomRH
QtYHOGHHYLGrQFLD&DPDLRUSRQWXDomRTXHSRGHVHUGDGD
DHVWXGRVTXHQmRVmRUDQGRPL]DGRVHFRQWURODGRV
$DEGRPLQRSODVWLDWHPtQGLFHGHPRUWDOLGDGHEDL[RHD
SULQFLSDOFDXVDGHyELWRUHODFLRQDGDDHVVDFLUXUJLDpD7(3
1R HQWDQWR D UHODomR HQWUH 7(3 H DEGRPLQRSODVWLD DLQGD
QmRHVWiPXLWRFODUDSDUDRVFLUXUJL}HV(PFRPSDUDomR
D RXWUDV FLUXUJLDV SOiVWLFDV DOJXQV SURFHGLPHQWRV HVSHFt-­
¿FRVGDVDEGRPLQRSODVWLDVSRGHPVHUFRQVLGHUDGRVIDWRUHV
GHULVFRDGLFLRQDLVHFRQGX]LUDPDLRULQFLGrQFLDGH7(3
FRPRDSOLFDWXUDGDPXVFXODWXUDDEGRPLQDOFRPDXPHQWR
GDSUHVVmRLQWUDDEGRPLQDORXGHVHQYROYLPHQWRGDVtQGURPH
GHFRPSDUWLPHQWRDEGRPLQDO7DOHIHLWRWDPEpPSRGHULD
VHU SURYRFDGR SHOR XVR GH PDOKDV HOiVWLFDV FRPSUHVVLYDV
PXLWRDSHUWDGDV
&RQVLGHUDQGRVHDHVFDVVDOLWHUDWXUDDFHUFDGHVVHDVVXQ
WRRSUHVHQWHWUDEDOKRWHPFRPRREMHWLYRVDQDOLVDUDVFDUDFWH
UtVWLFDVGDSRSXODomRVXEPHWLGDDDEGRPLQRSODVWLDQRSH
UtRGRGHPDUoRGHDDEULOGHVXDVFRPSOLFDo}HV
HPHVSHFLDOFRPSOLFDo}HVWURPERHPEyOLFDVHVHXVHYHQWXDLV
IDWRUHVGHULVFRHFRPSDUDUDLQFLGrQFLDGHWDLVFRPSOLFDo}HV
80
FRP D XWLOL]DomR GH GRLV SURWRFRORV GH SUHYHQomR WURP
ERHPEyOLFDGLVWLQWRVRSURWRFRORIDUPDFROyJLFRLVRODGRHR
SURWRFRORFRPXVRGH&3,LVRODGDPHQWH
MÉTODO
)RLUHDOL]DGRHVWXGRUHWURVSHFWLYRSRUPHLRGDDQiOLVHGH
SURQWXiULRVGHWRGRVRVSDFLHQWHVVXEPHWLGRVDDEGRPLQR-­
SODVWLD FRQVHFXWLYDPHQWH H RSHUDGRV HQWUH PDUoR GH H DEULO GH )RUDP FRQVLGHUDGDV FLUXUJLDV LVRODGDV GH
DEGRPLQRSODVWLDRXDVVRFLDGDVDRXWURVSURFHGLPHQWRV1mR
IRLH[FOXtGRQHQKXPSDFLHQWHVXEPHWLGRDDEGRPLQRSODVWLD
QRSHUtRGR
)RUDP FRQVWLWXtGRV GRLV JUXSRV GH HVWXGR GLVWLQWRV HP
UHODomR DR WLSR GH SUR¿OD[LD WURPERHPEyOLFD XWLOL]DGD R
JUXSRFRPSUR¿OD[LDIDUPDFROyJLFDHRJUXSRFRPSUR¿OD[LD
PHFkQLFDFRPHPSUHJRGH&3,
&RPRRVSDFLHQWHVVXEPHWLGRVDDEGRPLQRSODVWLDVmRQR
PtQLPR GH ULVFR PRGHUDGR SDUD IHQ{PHQRV WURPERHPEy-­
OLFRVVHJXQGRDFODVVLILFDomRGH$QJHUHWDO SRQWXDomR
!WRGRVRVSDFLHQWHVLQFOXtGRVQRHVWXGRUHFHEHUDPDOJXP
WLSRGHSUR¿OD[LD
2V SDFLHQWHV RSHUDGRV HQWUH PDUoR GH H DEULO GH
FRQVHFXWLYDPHQWHUHFHEHUDPVRPHQWHWHUDSLDIDUPD-­
FROyJLFDHDTXHOHVHQWUHPDLRGHHDEULOGHXWLOL-­
]DUDPVRPHQWHWHUDSLDSUR¿OiWLFDPHFkQLFDFRP&3,
3DUDDSUR¿OD[LDPHGLFDPHQWRVDIRLXVDGDHQR[DSDULQD
&OH[DQH®QDGRVHGHPJNJGRSDFLHQWHLQLFLDQGR
KRUDVDSyVRWpUPLQRGRSURFHGLPHQWRHQDIUHTXrQFLDGHXPD
YH]SRUGLDDWpGHDPEXODomRGRSDFLHQWH3DUDDSUR¿OD[LD
PHFkQLFD FRP &3, IRL XVDGR FRPSUHVVRU SQHXPiWLFR GH
SpVHSDQWXUULOKDV'973KOHERSUHVV®FRPSUHVVmRHQWUH
PP+JHPP+JLQLFLDGRDQWHVGDLQGXomRDQHVWpVLFD
HPDQWLGRFRQWLQXDGDPHQWHDWpDGHDPEXODomRGRSDFLHQWH
$ WpFQLFD FLU~UJLFD HPSUHJDGD IRL D DEGRPLQRSODVWLD
FOiVVLFDFRPLQFLVmRKRUL]RQWDODFLPDGRVSHORVSXELDQRV
GHVFRODPHQWRGDDSRQHXURVHDWpDSrQGLFH[LIRLGHSOLFDWXUD
GRVP~VFXORVUHWRVDEGRPLQDLVUHSRVLFLRQDPHQWRGDFLFDWUL]
XPELOLFDO GUHQDJHP FRP VLVWHPD IHFKDGR D YiFXR OLSHF-­
WRPLDGHUHWDOKRDEGRPLQDOHVtQWHVHGHSHOHSRUSODQRV(P
FDVRVVHOHFLRQDGRVFRQIRUPHLQGLFDomRHVWpWLFDUHDOL]RXVH
OLSRDVSLUDomRGHUHJLmRHSLJiVWULFDHÀDQFRV
$DQiOLVHHVWDWtVWLFDIRLUHDOL]DGDFRPDX[tOLRGRsoftware
,%0 6366 )RUDP HPSUHJDGRV WHVWHV ELFDXGDLV FRP
QtYHOGHVLJQL¿FkQFLDGH3
2SUHVHQWHWUDEDOKRIRLVXEPHWLGRjDSURYDomRGR&RPLWr
GHeWLFDGRVKRVSLWDLVRQGHIRUDPUHDOL]DGDVDVFLUXUJLDV
RESULTADOS
1RSHUtRGRGHPDUoRGHDDEULOGHSDFLHQWHV
IRUDP VXEPHWLGRV D DEGRPLQRSODVWLD 'R WRWDO SD
FLHQWHVHUDPGRVH[RPDVFXOLQRHGRVH[RIHPLQLQR
Rev Bras Cir Plást. 2012;;27(1):77-­86
3UR¿OD[LDWURPERHPEyOLFDIDUPDFROyJLFDHSRUFRPSUHVVmRSQHXPiWLFDLQWHUPLWHQWHHPDEGRPLQRSODVWLD
'DGRVUHODWLYRVDLGDGHSHVRDOWXUD,0&SHVRGRUHWDOKR
DEGRPLQDOUHPRYLGRHWHPSRGHFLUXUJLDHVWmRDSUHVHQWDGRV
QD7DEHOD
2VSDFLHQWHVRSHUDGRVQRSHUtRGRGHPDUoRGHD
DEULO GH TXH WRWDOL]DUDP SDFLHQWHV UHFHEHUDP
VRPHQWH SUR¿OD[LD WURPERHPEyOLFD IDUPDFROyJLFD -i RV
SDFLHQWHVRSHUDGRVHQWUHPDLRGHHDEULOGHTXH
WRWDOL]DUDP SDFLHQWHV UHFHEHUDP VRPHQWH SUR¿OD[LD
PHFkQLFDFRP&3,$DQiOLVHHVWDWtVWLFDGHVFULWLYDGRVGRLV
JUXSRVHQFRQWUDVHQDV7DEHODVH
$DQiOLVHHVWDWtVWLFDGRVGDGRVGDV7DEHODVHGHPRQVWUD
TXHVXDVSRSXODo}HVWrPGLVWULEXLomRQmRSDUDPpWULFD1D
FRPSDUDomRHQWUHDVGXDVSRSXODo}HVFRPSUR¿OD[LDIDUPD-­
FROyJLFDHFRP&3,REVHUYDVHTXHHVWDVVmRVHPHOKDQWHV
VHJXQGRRWHVWHUGH0DQQ:KLWQH\LGDGH3 SHVR
3 DOWXUD3 SHVRUHWLUDGR3 WHPSR
GHFLUXUJLD3 )RUDPHVWXGDGRVHYHQWXDLVIDWRUHVGHULVFRGHVVDVSRSX-­
ODo}HVTXHSXGHVVHPSUHGLVSRUDRVXUJLPHQWRGHFRPSOLFD-­
o}HV HP HVSHFLDO DRV IHQ{PHQRV WURPERHPEyOLFRV FRPR
Tabela 1 ±'DGRVFOtQLFRVHGHPRJUi¿FRVGRVSDFLHQWHV
n = 563
Variáveis
Mínimo
Máximo
Média
Desvio padrão
3HVRNJ
$OWXUDFP
,0&NJPð
3HVRGRUHWDOKRJ
7HPSRGHFLUXUJLDPLQ
55
,GDGHDQRV
,0& tQGLFHGHPDVVDFRUSRUDOQ Q~PHURGHSDFLHQWHV
Tabela 2 ±'DGRVFOtQLFRVHGHPRJUi¿FRVGRVSDFLHQWHVVXEPHWLGRVDSUR¿OD[LDIDUPDFROyJLFD
Variáveis
n = 357
Mínimo
Máximo
Média
Desvio padrão
,GDGHDQRV
3HVRNJ
$OWXUDFP
,0&NJPð
3HVRGRUHWDOKRJ
7HPSRGHFLUXUJLDPLQ
55
,0& tQGLFHGHPDVVDFRUSRUDOQ Q~PHURGHSDFLHQWHV
Tabela 3 ±'DGRVFOtQLFRVHGHPRJUi¿FRVGRVSDFLHQWHVVXEPHWLGRVDSUR¿OD[LDSRUFRPSUHVVmRSQHXPiWLFDLQWHUPLWHQWH
Variáveis
,GDGHDQRV
n = 206
Mínimo
Máximo
Média
Desvio padrão
3HVRNJ
$OWXUDFP
,0&NJPð
3HVRGRUHWDOKRJ
7HPSRGHFLUXUJLDPLQ
55
,0& tQGLFHGHPDVVDFRUSRUDOQ Q~PHURGHSDFLHQWHV
Rev Bras Cir Plást. 2012;;27(1):77-­86
81
3RQWHOOL(3HWDO
SUHVHQoDGHFLUXUJLDVFRPELQDGDVWHPSRGHFLUXUJLDREHVL-­
GDGH,0&!HWDEDJLVPRHQWUHRXWURV,QWHUHVVDQWHQRWDU
TXHGRVSDFLHQWHVVRPHQWHIRUDPVXEPH-­
WLGRV D DEGRPLQRSODVWLD LVRODGD HQTXDQWR SDFLHQWHV IRUDP VXEPHWLGRV D DEGRPLQRSODVWLD DVVRFLDGD
DDOJXPRXWURSURFHGLPHQWR7DEHOD$GLVWULEXLomRGRV
WLSRVGHFRPELQDomRGHFLUXUJLDVWDPEpPIRLVHPHOKDQWHHP
DPERVRVJUXSRV)LJXUDVH
$GLVWULEXLomRGRVIDWRUHVGHULVFRQDSRSXODomRHPJHUDO
HQRVGRLVVXEJUXSRVpDSUHVHQWDGDQD7DEHOD
(PUHODomRDRVIDWRUHVGHULVFRQmRKRXYHGLIHUHQoDVLJ
QL¿FDWLYDHQWUHRVJUXSRVTXLTXDGUDGRWDEDJLVPR3 FLUXUJLDEDULiWULFDSUpYLD3 WUDQVWRUQRVPHQWDLV
3 WUDQVWRUQRVHQGyFULQRV3 +$63 QHRSODVLD3 7937(3SUpYLRV3 H[FHWR
TXDQWRDRXVRGH$&2VFRPPDLRUIUHTXrQFLDQRJUXSRVXE
PHWLGRDSUR¿OD[LDSRU&3,TXLTXDGUDGR3 Tabela 4 ±$EGRPLQRSODVWLDLVRODGDRXFRPELQDGD
Cirurgia
n
Porcentagem
,VRODGD
0DVWRSODVWLD
3UyWHVHGHPDPD
/LSRDVSLUDomRRXWUDViUHDV
LiftingGHEUDoRVRXSHUQDV
&LUXUJLDVIDFLDLV
2XWUDV
563
7RWDO
Q Q~PHURGHSDFLHQWHV
Figura 1±'LVWULEXLomRGDSRSXODomRVXEPHWLGDDSUR¿OD[LD
farmacológica conforme cirurgia combinada.
82
1HQKXPSDFLHQWHDSUHVHQWRXLQVX¿FLrQFLDYHQRVDLPR
ELOL]DomRSUpYLDVXSHULRUDKRUDVUHFRQVWUXomRGHPDPD
RXXWLOL]DomRGHSUyWHVHVGHJO~WHRRXSDQWXUULOKDIDWRUHVGH
ULVFRFOiVVLFRVSDUDRGHVHQYROYLPHQWRGHIHQ{PHQRVWURP-­
ERHPEyOLFRVVHJXQGRRVHVWXGRVGH$QJHUHWDO
6RPHQWH HP SDFLHQWHV R WHPSR GH FLUXUJLD IRL PLQXWRV QR JUXSR FRP SUR¿OD[LD IDUPDFROyJLFD H QR
JUXSRFRPSUR¿OD[LDSRU&3,SRUpPWRGDVID]LDPXVRGH
$&2VHXPDGHODVHUDWDEDJLVWDRTXHDVFRORFRXFRPRULVFR
PRGHUDGRVHQGRLQGLFDGDDSUR¿OD[LDGH7937(3
6RPHQWH QR JUXSR FRP SUR¿OD[LD PHGLFDPHQWRVD IRL
REVHUYDGD D SUHVHQoD GH GRLV IDWRUHV GH ULVFR PXLWR JUDYHV
SDUDRVXUJLPHQWRGHIHQ{PHQRVWURPERHPEyOLFRVHPDOJXQV
SDFLHQWHVQHRSODVLDH7937(3SUpYLDVHQWUHWDQWRQHQKXP
GHVVHV SDFLHQWHV GHVHQYROYHX QRYRV IHQ{PHQRV WURPERHP
EyOLFRVDSyVDFLUXUJLDRTXHFRPSURYDDH¿FiFLDGDSUR¿OD[LD
$GHPDLVIRUDPHVWXGDGRVDOJXQVIDWRUHVGHULVFRTXHQmR
VmR FRQKHFLGRV FODVVLFDPHQWH SRU DXPHQWDU D FKDQFH GH
7937(3)RLDQDOLVDGDDSUHVHQoDRXQmRGH+$6FLUXUJLD
EDULiWULFDSUpYLDWUDQVWRUQRVPHQWDLVGHSUHVVmRDQVLHGDGH
HSLOHSVLDHWUDQVWRUQRVHQGyFULQRVGLDEHWHVPHOLWRKLSRWL
UHRLGLVPR 'HQWUH RV IDWRUHV GH ULVFR HVWXGRV DQWHULRUHV
DVVRFLDUDPVRPHQWHDSUHVHQoDGHFLUXUJLDEDULiWULFDDQWHULRU
DULVFRDXPHQWDGRSRUIHQ{PHQRVWURPERHPEyOLFRV
$LQFLGrQFLDGHFRPSOLFDo}HVSyVRSHUDWyULDVQDSRSX-­
ODomRHPJHUDOHQRVJUXSRVFRPSUR¿OD[LDPHGLFDPHQWRVD
HFRPSUR¿OD[LDSRU&3,SRGHVHUREVHUYDGDQD7DEHOD
&RPUHODomRjLQFLGrQFLDGHFRPSOLFDo}HVQmRIRLRE
VHUYDGD GLIHUHQoD VLJQLILFDWLYD HQWUH RV JUXSRV FRP SUR
ILOD[LD IDUPDFROyJLFD H SRU &3, QRV TXDLV D GLVWULEXLomR
IRL PXLWR VHPHOKDQWH$SyV D DQiOLVH GR WHVWH HVWDWtVWLFR
TXLTXDGUDGR IRUDP REVHUYDGRV RV VHJXLQWHV UHVXOWDGRV
LQIHFomR3 VHURPD3 7937(33 Figura 2±'LVWULEXLomRGDSRSXODomRVXEPHWLGDDSUR¿OD[LDSRU
compressão pneumática intermitente conforme cirurgia combinada.
Rev Bras Cir Plást. 2012;;27(1):77-­86
3UR¿OD[LDWURPERHPEyOLFDIDUPDFROyJLFDHSRUFRPSUHVVmRSQHXPiWLFDLQWHUPLWHQWHHPDEGRPLQRSODVWLD
Tabela 5 ±'LVWULEXLomRGHIDWRUHVGHULVFR
Fatores de risco
3UR¿OD[LDPHGLFDPHQWRVD
(n = 357)
3UR¿OD[LDSRU&3,
(n = 206)
População total
(n = 563)
n
%
n
%
n
%
$&2RX75+
7DEDJLVPR
&LUXUJLDEDULiWULFD
5
7UDQVWRUQRVPHQWDLV
5
–
–
5
7UDQVWRUQRVHQGyFULQRV
5
+$6
1HRSODVLD
–
–
7937(3SUpYLDV
3
–
–
3
,0&!
,GDGH!DQRV
6
&LUXUJLDVFRPELQDGDV
$&2 DQWLFRQFHSFLRQDORUDO&3, FRPSUHVVmRSQHXPiWLFDLQWHUPLWHQWH+$6 KLSHUWHQVmRDUWHULDOVLVWrPLFD,0& tQGLFHGHPDVVDFRUSRUDOQ Q~PHURGHSDFLHQWHV
7(3 WURPERHPEROLDSXOPRQDU75+ WHUDSLDGHUHSRVLomRKRUPRQDO793 WURPERVHYHQRVDSURIXQGD
Tabela 6 ±'LVWULEXLomRGHFRPSOLFDo}HV
Complicações
3UR¿OD[LDPHGLFDPHQWRVD
(n = 357)
3UR¿OD[LDSRU&3,
(n = 206)
População total
(n = 563)
n
%
n
%
n
%
&LFDWUL]KLSHUWUy¿FDRXTXHORLGH
+HPDWRPD
6HURPD
5
,QIHFomR
5
'HLVFrQFLD
7937(3
3
$WHOHFWDVLDJUDYH
–
–
,QWXVVXVFHSomRHYROYRGHFHFR
–
–
&3, FRPSUHVVmRSQHXPiWLFDLQWHUPLWHQWHQ Q~PHURGHSDFLHQWHV7(3 WURPERHPEROLDSXOPRQDU793 WURPERVHYHQRVDSURIXQGD
GHLVFrQFLD 3 FLFDWUL] KLSHUWUyILFD RX TXHORLGH
3 $~QLFDFRPSOLFDomRTXHWHYHIUHTXrQFLDPDLRU
QRJUXSRGHSURILOD[LDSRU&3,IRLDLQFLGrQFLDGHKHPD-­
WRPDSRUpPHVVDGLIHUHQoDWDPEpPQmRIRLHVWDWLVWLFDPHQWH
VLJQLILFDQWHTXLTXDGUDGR3 (QWUHWDQWRQRVFDVRVHPTXHKRXYHKHPDWRPDDJUDYL-­
GDGHQRVSDFLHQWHVFRPSUR¿OD[LDPHGLFDPHQWRVDIRLPDLRU
'HQWUHRVFDVRVGHKHPDWRPDQDSRSXODomRFRPSUR¿OD[LD
IDUPDFROyJLFDQHFHVVLWDUDPGHUHDERUGDJHPFLU~UJLFDH
GHWUDQVIXVmRGHVDQJXH-iGRVFDVRVGHSUR¿OD[LDSRU&3,
VRPHQWHQHFHVVLWDUDPGHUHDERUGDJHPFLU~UJLFDHQHQKXP
QHFHVVLWRXGHWUDQVIXVmRGHVDQJXH
+RXYHGXDVLQWHUFRUUrQFLDVSRXFRKDELWXDLVREVHUYDGDV
VRPHQWHQRJUXSRFRPSUR¿OD[LDIDUPDFROyJLFDDWHOHFWDVLD
Rev Bras Cir Plást. 2012;;27(1):77-­86
SXOPRQDUJUDYHHLQWXVVXVFHSomRHYROYRGHFHFR1RSUL
PHLURFDVRRTXDGURIRLWmRGUDPiWLFRTXHDSDFLHQWHSUH
FLVRXVHULQWHUQDGDHP8QLGDGHGH7HUDSLD,QWHQVLYDSDUD
FRPSHQVDomRFOtQLFDSXOPRQDU$SRVVLELOLGDGHGH7(3Vy
IRL H[FOXtGD DSyV D UHDOL]DomR GH YiULRV H[DPHV FRPSOH-­
PHQWDUHVHDDYDOLDomRSHODVHTXLSHVGHFLUXUJLDWRUiFLFDH
SQHXPRORJLDHDSDFLHQWHIRLWUDWDGDDSHQDVSDUDDWHOHFWDVLD
SXOPRQDU JUDYH FRP UHYHUVmR FRPSOHWD GR TXDGUR 8PD
SDFLHQWH DSUHVHQWRX VLQDLV GH DEGRPH DJXGR GLDV DSyV
D DEGRPLQRSODVWLD VHQGR UHDOL]DGRV H[DPHV GH LPDJHP
TXHVXJHULUDPRGLDJQyVWLFRGHLQWXVVXVFHSomRHYROYRGH
FHFR$ SDFLHQWH IRL VXEPHWLGD D ODSDURWRPLD H[SORUDGRUD
SHOD LQFLVmR SUpYLD GH DEGRPLQRSODVWLD FRP FRQ¿UPDomR
GD VXVSHLWD GR H[DPH GH LPDJHP H ERD HYROXomR (VVD
83
3RQWHOOL(3HWDO
FRPSOLFDomR DSHVDU GH PXLWR UDUD Mi IRL DVVRFLDGD QD OL
WHUDWXUD j DEGRPLQRSODVWLD 3HOD UDULGDGH GH DPEDV DV
VLWXDo}HVQmRpSRVVtYHOID]HUTXDOTXHUFRPSDUDomRGHVVDV
FRPSOLFDo}HVHQWUHRVJUXSRV
1RVFDVRVHPTXHKRXYH793RX7(3WRGRVRVSDFLHQWHV
HYROXtUDPEHP7RGDVDVSDFLHQWHVTXHDSUHVHQWDUDPIHQ{-­
PHQRV WURPERHPEyOLFRV IRUDP VXEPHWLGDV D DEGRPLQR-­
SODVWLD DVVRFLDGD D RXWUD FLUXUJLD HVWpWLFD 7RGRV WDPEpP
DSUHVHQWDUDPSRQWXDomRGHQRPtQLPRSDUDRVIDWRUHVGH
ULVFRGHWURPERHPEROLDRXVHMDWRGRVGHULVFRDOWR1RV
FDVRVGRJUXSRFRPSUR¿OD[LDIDUPDFROyJLFDXPDSDFLHQWH
DSUHVHQWRX793LVRODGDHRXWUD793VHJXLGDGH7(3PR
GHUDGD QHFHVVLWDQGR GH PHGLGDV GH WHUDSLD LQWHQVLYD 1R
~QLFR FDVR GR JUXSR FRP SUR¿OD[LD SRU &3, KRXYH 793
VHJXLGDGH7(3OHYHVHPQHFHVVLGDGHGHWHUDSLDLQWHQVLYD
1HQKXPSDFLHQWHGHVHQYROYHX6371mRKRXYHQHQKXPFDVR
GHyELWRHPWRGDDFDVXtVWLFD
DISCUSSÃO
$WXDOPHQWH D FLUXUJLD SOiVWLFD WHP VLGR DOYR IiFLO GD
PtGLDHGHEDWDOKDVMXUtGLFDV0XLWRVFRQVLGHUDPTXHSRUVHU
XPDFLUXUJLDHVWpWLFDHOHWLYDGHYHVHULVHQWDGHFRPSOLFDo}HV
GHYHKDYHUFRPSURPLVVRFRPRUHVXOWDGRHQmRFRPRPHLR
XWLOL]DGR H GHYH VHPSUH VDWLVID]HU R ³UHVXOWDGR HVSHUDGR´
SHORSDFLHQWHVHQGRIUHTXHQWHPHQWHHQTXDGUDGDQR&yGLJR
GH 'HIHVD GR &RQVXPLGRU (VVDV LQWHUSUHWDo}HV DOpP GH
HTXLYRFDGDV FRORFDP HP [HTXH WRGRV RV FRQKHFLPHQWRV
PpGLFRV H FLHQWt¿FRV QR TXDO VH EDVHLD D HVSHFLDOLGDGH H
WDPEpPWRUQDRFLUXUJLmRSOiVWLFRSUHVDIiFLOGDPtGLDHGH
DGYRJDGRV 7RGD FLUXUJLD HVWi VXMHLWD D FRPSOLFDo}HV DR
LQHVSHUDGRHDRLQIRUWXLWRFRPRGHPRQVWUDGRSHODOLWHUDWXUD
PpGLFDPXQGLDO(QDFDVXtVWLFDDSUHVHQWDGDQHVWHWUDEDOKR
QmRIRLGLIHUHQWH
2V IHQ{PHQRV WURPERHPEyOLFRV VmR FRP H[FHomR GR
yELWRRVFDOFDQKDUHVGH$TXLOHVGRFLUXUJLmRSOiVWLFR$¿
VLRSDWRORJLDGHVVHVIHQ{PHQRVIRLGHVFULWDSRU9LUFKRZHP
TXHDWULEXLXFRPRIDWRUHVSULPRUGLDLVSDUDVHXVXUJL-­
PHQWRDHVWDVHVDQJXtQHDRGDQRGRHQGRWpOLRHRVHVWDGRV
GH KLSHUFRDJXODELOLGDGH (P XPD FLUXUJLD HP HVSHFLDO D
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Clínica Vital – Av. Costabile Romano, 1.301 – Ribeirânia – Ribeirão Preto, SP, Brasil – CEP 14096-380
E-mail: [email protected]
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