ꯅꯍꯥꯛꯀꯤ ꯑꯉꯥꯡꯒꯤ ꯐꯨꯗ ꯄꯥꯏꯞ ꯑꯃꯁꯨꯡ ꯅꯨꯡꯁꯤꯠꯀꯤ ꯃꯔꯛꯇꯥ ꯑꯆꯝꯕꯥ ꯃꯔꯤ ꯑꯃꯥ ꯂꯩꯕ꯭ꯔꯥ? (Tracheoesophageal Fistula)ꯒꯤ ꯃꯔꯃꯗꯥ ꯄꯨꯝꯅꯃꯛ ꯈꯪꯖꯤꯅꯁꯤ!

ꯅꯍꯥꯛꯀꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯅꯥ ꯁꯉ꯭ꯒꯣꯝ ꯊꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯆꯥꯅꯕꯥ ꯆꯤꯟꯖꯥꯛ ꯆꯥꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯈꯪꯍꯧꯗꯅꯥ ꯀꯣꯛ ꯅꯣꯟꯖꯔꯤꯕ꯭ꯔꯥ? ꯃꯍꯥꯛ ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯗꯥ ꯑꯋꯥꯕꯥ ꯃꯥꯌꯣꯛꯅꯔꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯅꯤꯜ ꯈꯣꯡꯕꯥ ꯎꯕꯥ ꯐꯪꯂꯕ꯭ꯔꯥ? ꯃꯃꯥ-ꯃꯄꯥ ꯑꯃꯥ ꯑꯣꯏꯅꯥ ꯅꯍꯥꯛꯅꯥ ꯌꯥꯝꯅꯥ ꯋꯥꯅꯥ ꯑꯃꯁꯨꯡ ꯋꯥꯈꯜ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯐꯥꯎꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯅꯣꯔꯃꯦꯂꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ, ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ, ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯂꯨꯝꯂꯕꯥ, ꯑꯗꯨꯕꯨ ꯂꯥꯌꯦꯡꯕꯥ ꯉꯝꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯥ ꯂꯩꯕꯥ ꯌꯥꯏ, ꯃꯗꯨꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯉꯁꯤ ꯋꯥꯔꯤ ꯁꯥꯒꯗꯧꯔꯤꯕꯅꯤ꯫ ꯃꯗꯨꯗꯤ ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯌꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ , ꯅꯠꯠꯔꯒꯥ ꯊꯣꯏꯗꯣꯛꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ ꯇꯤ.ꯏ.ꯑꯦꯐ., ꯑꯃꯁꯨꯡ ꯃꯔꯤ ꯂꯩꯅꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯑꯦꯠꯔꯦꯁꯤꯌꯥ , ꯅꯠꯠꯔꯒꯥ ꯏ.ꯑꯦ. ꯋꯥꯈꯜ ꯋꯥꯕꯥ ꯂꯩꯔꯣꯏꯗꯕꯅꯤ, ꯃꯁꯤ ꯏꯆꯝ ꯆꯝꯅꯥ ꯊꯃꯁꯤ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ? ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯂꯧꯁꯤꯅꯁꯤ!

ꯑꯣꯀꯦ, ꯍꯧꯖꯤꯛ ꯃꯁꯤꯒꯤ ꯇꯤ.ꯏ.ꯑꯦꯐ. ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯑꯩꯈꯣꯌꯒꯤ ꯀꯣꯀꯊꯛꯇꯒꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯈꯣꯡꯗꯥ ꯆꯤꯟꯖꯥꯛ ꯄꯨꯕꯥ ꯇꯤꯎꯕ ꯑꯁꯤꯕꯨ "ꯏꯁꯣꯐꯦꯒꯁ" ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯃꯇꯧ ꯑꯁꯨꯝꯅꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯥ ꯃꯇꯃꯗꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯂꯪꯁꯇꯥ ꯅꯨꯡꯁꯤꯠ ꯄꯨꯊꯣꯀꯄꯥ ꯇꯤꯎꯕ ꯑꯁꯤꯕꯨ "ꯇ꯭ꯔꯦꯀꯤꯌꯥ" ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯅꯥ, ꯍꯀꯁꯦꯜ ꯐꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯗꯥ, ꯇꯤꯎꯕ ꯑꯅꯤ ꯑꯁꯤ, ꯏꯁꯣꯐꯦꯒꯁ ꯑꯃꯁꯨꯡ ꯇ꯭ꯔꯦꯀꯤꯌꯥ ꯑꯁꯤ ꯑꯃꯒꯥ ꯑꯃꯒꯥ ꯃꯔꯤ ꯂꯩꯅꯗꯅꯥ ꯇꯣꯉꯥꯟꯅꯥ ꯂꯩ꯫ ꯃꯁꯤ ꯂꯝꯕꯤ ꯑꯅꯤꯒꯨꯝꯕꯅꯤ, ꯑꯃꯅꯥ ꯆꯥꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯑꯇꯣꯞꯄꯥ ꯑꯃꯅꯥ ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯅꯤ꯫

ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯀꯧꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯥ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯗꯥ, ꯃꯔꯨꯑꯣꯏꯅꯥ ꯑꯄꯤꯀꯄꯥ ꯑꯉꯥꯡ ꯑꯃꯗꯥ, ꯐꯨꯗ ꯄꯥꯏꯞ (esophagus) ꯑꯃꯁꯨꯡ ꯋꯥꯏꯟꯗꯄꯥꯏꯞ (trachea)ꯒꯤ ꯃꯔꯛꯇꯥ ꯃꯍꯧꯁꯥꯒꯤ ꯑꯣꯏꯕꯥ ꯃꯔꯤ ꯑꯃꯥ ꯂꯩ, ꯅꯠꯠꯔꯒꯥ ꯍꯣꯜ (fistula) ꯑꯃꯥ ꯂꯩ꯫ ꯃꯁꯤ ꯏꯁꯤꯡꯒꯤ ꯄꯥꯏꯞ ꯑꯅꯤꯒꯤ ꯃꯔꯛꯇꯥ ꯑꯄꯤꯀꯄꯥ ꯂꯤꯛ ꯑꯃꯒꯨꯝꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫ ꯃꯁꯤꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯀꯔꯤ ꯑꯣꯏꯔꯤꯕꯒꯦ? ꯐꯨꯗ ꯄꯥꯏꯄꯀꯤ ꯃꯈꯥꯗꯥ ꯆꯦꯟꯊꯔꯀꯄꯒꯤ ꯃꯍꯨꯠꯇꯥ, ꯑꯉꯥꯡ ꯑꯗꯨꯅꯥ ꯆꯥꯔꯤꯕꯥ ꯑꯃꯁꯨꯡ ꯊꯀꯄꯥ ꯌꯥꯕꯥ ꯆꯤꯟꯖꯥꯛ ꯑꯃꯁꯨꯡ ꯂꯤꯛꯌꯨꯏꯗꯁꯤꯡ ꯑꯗꯨꯅꯥ ꯃꯍꯧꯁꯥꯒꯤ ꯑꯣꯏꯕꯥ ꯃꯔꯤ ꯑꯗꯨꯒꯤ ꯃꯅꯨꯡꯗꯒꯤ ꯅꯨꯡꯁꯤꯠꯀꯤ ꯈꯣꯡꯖꯦꯂꯗꯥ ꯑꯃꯁꯨꯡ ꯃꯐꯃꯗꯨꯗꯒꯤ ꯂꯪꯁꯇꯥ ꯆꯠꯄꯥ ꯍꯧꯏ꯫ ꯑꯩꯈꯣꯌꯅꯥ ꯃꯁꯤꯕꯨ "ꯑꯦꯁ꯭ꯄꯤꯔꯦꯁꯟ" ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯃꯁꯤ ꯈꯔꯥ ꯈꯨꯗꯣꯡꯊꯤꯅꯤꯉꯥꯏ ꯑꯣꯏ, ꯃꯔꯃꯗꯤ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯆꯤꯟꯖꯥꯛ ꯑꯁꯤ ꯂꯪꯁꯇꯥ ꯆꯪꯂꯕꯗꯤ, ꯏꯅꯐꯦꯛꯁꯟ ꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫

ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ, ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯑꯇꯣꯞꯄꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯎꯕꯥ ꯐꯪꯏ꯫ ꯍꯥꯌꯕꯗꯤ ꯏꯁꯣꯐꯦꯖꯤꯌꯜ ꯑꯦꯠꯔꯦꯁꯤꯌꯥ (ꯏ.ꯑꯦ.) . ꯏ.ꯑꯦ.ꯅꯥ ꯏꯁꯣꯐꯦꯒꯁ (ꯐꯨꯗ ꯄꯥꯏꯞ) ꯑꯁꯤ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯁꯦꯃꯖꯤꯟ-ꯁꯥꯖꯤꯅꯕꯥ ꯉꯃꯗꯕꯥ, ꯁ꯭ꯇꯣꯃꯥꯀꯀꯥ ꯁꯝꯅꯗꯕꯥ ꯑꯃꯁꯨꯡ ꯇꯉꯈꯥꯏ ꯑꯃꯥ ꯊꯤꯡꯖꯤꯅꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯏꯁꯣꯐꯦꯒꯁ ꯑꯁꯤ ꯁꯔꯨꯛ ꯑꯅꯤ ꯊꯣꯛꯅꯥ ꯈꯥꯌꯗꯣꯀꯏ, ꯑꯃꯁꯨꯡ ꯁꯔꯨꯛ ꯑꯅꯤꯃꯛꯀꯤ ꯃꯊꯛꯇꯥ ꯀꯨꯄꯁꯤꯜꯂꯤ (ꯕ꯭ꯂꯥꯏꯟꯗ ꯄꯥꯎꯆꯦꯁꯤꯡ)꯫ ꯃꯔꯛꯇꯥ ꯆꯦꯟꯊꯔꯀꯄꯥ ꯄꯥꯏꯞ ꯑꯃꯒꯨꯝꯅꯥ꯫

ꯐꯤꯚꯝ ꯑꯁꯤꯅꯥ ꯀꯅꯥꯕꯨ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯍꯦꯟꯅꯥ ꯁꯣꯀꯍꯜꯂꯤꯕꯅꯣ?

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯑꯁꯤ ꯑꯌꯥꯝꯕꯗꯤ "ꯀꯣꯟꯖꯦꯅꯤꯑꯦꯜ ꯀꯟꯗꯤꯁꯟ" ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯑꯉꯥꯡꯁꯤꯡ ꯑꯁꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯄꯣꯀꯏ ꯍꯥꯌꯕꯅꯤ꯫ ꯃꯁꯤ ꯃꯤꯔꯣꯜꯂꯤꯉꯩ ꯃꯇꯃꯗꯥ ꯐꯤꯇꯁꯀꯤ ꯗꯤꯚꯦꯂꯄꯃꯦꯟꯇꯗꯥ ꯑꯄꯤꯀꯄꯥ ꯑꯍꯣꯡꯕꯥ ꯑꯃꯥ ꯂꯥꯀꯄꯗꯒꯤ ꯊꯣꯀꯏ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ, ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯀꯦꯁ ꯑꯌꯥꯝꯕꯗꯤ ꯑꯉꯥꯡ ꯑꯗꯨ ꯄꯣꯀꯄꯥ ꯃꯇꯨꯡꯗꯥ ꯃꯇꯝ ꯁꯥꯡꯅꯥ, ꯑꯉꯥꯡ ꯑꯣꯏꯔꯤꯉꯩꯗꯥ ꯂꯥꯌꯦꯡꯏ ꯑꯃꯁꯨꯡ ꯂꯥꯏꯌꯦꯡꯏ꯫

ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯌꯥꯝꯅꯥ ꯇꯥꯡꯅꯥ ꯊꯣꯛꯂꯕꯁꯨ, ꯃꯄꯨꯡ-ꯃꯔꯩ ꯐꯥꯔꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯁꯨ ꯇꯨꯡꯗꯥ ꯄꯨꯟꯁꯤꯗꯥ ꯇꯤ.ꯏ.ꯑꯦꯐ. ꯃꯁꯤꯕꯨ "ꯑꯦꯛꯕꯤꯌꯔ ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ" ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯃꯁꯤ ꯏꯁꯣꯐꯦꯖꯤꯌꯜ ꯀꯦꯟꯁꯔ, ꯂꯪꯁ ꯀꯦꯟꯁꯔ, ꯇ꯭ꯌꯨꯕꯔꯀꯨꯂꯣꯁꯤꯁꯒꯨꯝꯕꯥ ꯁꯥꯊꯤꯕꯥ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯅꯠꯠꯔꯒꯥ ꯃꯦꯗꯤꯀꯦꯜ ꯄ꯭ꯔꯣꯁꯤꯗ꯭ꯌꯨꯑꯣꯔ ꯑꯃꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯑꯦꯛꯁꯤꯗꯦꯟꯇ ꯑꯃꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯑꯁꯤ ꯀꯌꯥꯝ ꯀꯃꯟ ꯑꯣꯏꯕꯒꯦ?

ꯌꯨꯅꯥꯏꯇꯦꯗ ꯁ꯭ꯇꯦꯇꯁꯀꯤ ꯁ꯭ꯇꯦꯇꯤꯁ꯭ꯇꯤꯀꯦꯂꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ, ꯄꯣꯀꯄꯥ ꯑꯉꯥꯡ 3,000ꯗꯒꯤ 5,000 ꯐꯥꯎꯕꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯑꯃꯗꯥ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯅꯥ ꯁꯣꯀꯍꯜꯂꯤ ꯍꯥꯌꯅꯥ ꯄꯥꯅꯔꯤ꯫ ꯃꯁꯤꯒꯤ ꯃꯊꯛꯇꯥ, TEF ꯅꯠꯠꯔꯒꯥ EA ꯂꯩꯕꯥ ꯑꯉꯥꯡꯁꯤꯡꯒꯤ ꯆꯥꯎꯔꯥꯛꯅꯥ 50%ꯗꯤ ꯑꯇꯣꯞꯄꯥ ꯀꯣꯟꯖꯤꯅꯤꯑꯦꯜ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯥ ꯂꯩꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯀꯤꯗꯅꯤ, ꯍꯥꯔꯠ ꯅꯠꯠꯔꯒꯥ ꯁ꯭ꯀꯦꯂꯦꯇꯜ ꯁꯤꯁ꯭ꯇꯦꯃꯒꯨꯝꯕꯥ ꯑꯇꯩ ꯃꯐꯃꯁꯤꯡꯗꯥ ꯄ꯭ꯔꯣꯕ꯭ꯂꯦꯝ ꯂꯩꯕꯥ ꯌꯥꯏ꯫

ꯃꯤꯔꯣꯜꯂꯤꯉꯩ ꯃꯇꯃꯗꯥ ꯊꯣꯀꯄꯥ "ꯑꯦꯛꯕꯤꯌꯔ ꯇꯤ.ꯏ.ꯑꯦꯐ." ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯀꯃꯟ ꯑꯣꯏꯗꯦ꯫ ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ, ꯃꯄꯨꯡ-ꯃꯔꯩ ꯐꯥꯔꯕꯥ ꯃꯤꯑꯣꯏ ꯈꯔꯗꯤ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯅꯥ ꯄꯣꯀꯄꯥ ꯌꯥꯏ ꯑꯃꯁꯨꯡ ꯄꯨꯟꯁꯤꯗꯥ ꯇꯨꯡꯗꯥ ꯂꯥꯀꯄꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯂꯩꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯃꯈꯣꯌꯗꯥ ꯄꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯂꯩ, ꯑꯗꯨꯕꯨ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤ ꯇꯨꯡꯗꯥ ꯂꯥꯀꯏ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF)ꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯈꯂꯁꯤꯡ ꯑꯁꯤ ꯀꯔꯤꯅꯣ?

ꯍꯧꯖꯤꯛ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯈꯂꯁꯤꯡ ꯌꯦꯡꯁꯤ꯫ ꯃꯍꯧꯁꯥꯅꯥ ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯃꯁꯤ ꯃꯈꯜ ꯃꯉꯥꯗꯥ ꯈꯥꯌꯗꯣꯀꯏ꯫ ꯃꯁꯤ ꯈꯔꯥ ꯑꯀꯨꯞꯄꯥ ꯃꯔꯣꯂꯅꯤ ꯑꯗꯨꯕꯨ ꯂꯧꯁꯤꯟꯅꯕꯥ ꯍꯣꯠꯅꯁꯤ꯫ ꯏꯁꯣꯐꯦꯒꯁ (E) ꯑꯁꯤ ꯇꯤꯎꯕ ꯑꯃꯅꯤ, ꯑꯃꯁꯨꯡ ꯇ꯭ꯔꯦꯀꯤꯌꯥ (T) ꯑꯁꯤ ꯑꯇꯣꯞꯄꯥ ꯇꯤꯎꯕ ꯑꯃꯅꯤ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫

• ꯃꯈꯜ A: ꯃꯁꯤ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯅꯤ, ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯑꯦꯕꯅꯣꯔꯃꯦꯜ ꯀꯅꯦꯛꯁꯟ ꯑꯃꯠꯇꯥ ꯂꯩꯇꯦ꯫ ꯑꯗꯨꯕꯨ ꯏ.ꯑꯦ.(ꯏꯁꯣꯐꯦꯖꯤꯌꯜ ꯑꯦꯠꯔꯦꯁꯤꯌꯥ) . ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯏꯁꯣꯐꯦꯒꯁ ꯑꯁꯤ ꯁꯔꯨꯛ ꯑꯅꯤ ꯊꯣꯛꯅꯥ ꯈꯥꯌꯗꯣꯀꯏ, ꯑꯃꯁꯨꯡ ꯁꯔꯨꯛ ꯑꯅꯤꯃꯛꯀꯤ ꯃꯊꯛ ꯑꯃꯁꯨꯡ ꯃꯈꯥ ꯊꯪꯕꯥ ꯁꯔꯨꯛ ꯑꯅꯤꯃꯛ ꯊꯤꯡꯖꯤꯜꯂꯤ (ꯕ꯭ꯂꯥꯏꯟꯗ ꯄꯥꯎꯆꯦꯁꯤꯡ)꯫ ꯃꯁꯤ ꯃꯔꯛꯇꯥ ꯆꯦꯟꯊꯔꯀꯄꯥ ꯄꯥꯏꯞ ꯑꯃꯒꯥ ꯃꯥꯟꯅꯩ ꯑꯃꯁꯨꯡ ꯆꯦꯟꯊꯔꯀꯄꯥ ꯄꯣꯠꯁꯀꯁꯤꯡꯒꯤ ꯃꯊꯛ ꯑꯅꯤꯗꯨ ꯊꯨꯒꯥꯏꯔꯀꯄꯒꯨꯝꯕꯅꯤ꯫ ꯃꯁꯤꯕꯨ "ꯄ꯭ꯌꯨꯔ ꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯑꯦꯠꯔꯦꯁꯤꯌꯥ" ꯍꯥꯌꯅꯥꯁꯨ ꯀꯧꯏ꯫ ꯇꯤ.ꯏ.ꯑꯦꯐ./ꯏ.ꯑꯦ.ꯒꯤ ꯑꯅꯥꯕꯥ ꯄꯨꯝꯅꯃꯛꯀꯤ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯸%ꯗꯤ ꯃꯈꯜ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡ ꯆꯜꯂꯤ꯫

• ꯇꯥꯏꯞ B: ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯇꯣꯏꯅꯥ ꯊꯣꯀꯏ, ꯃꯁꯤꯅꯥ ꯄꯦꯁꯦꯟꯇ ꯄꯨꯝꯅꯃꯛꯀꯤ 2% ꯈꯛꯇꯗꯥ ꯁꯣꯀꯍꯜꯂꯤ꯫ ꯃꯐꯝ ꯑꯁꯤꯗꯥ, ꯏꯁꯣꯐꯦꯒꯁꯀꯤ ꯃꯊꯛꯀꯤ ꯁꯔꯨꯛ ꯑꯗꯨ ꯇ꯭ꯔꯦꯀꯤꯌꯥꯒꯥ ꯁꯝꯅꯩ (TEF ꯑꯃꯥ ꯂꯩ), ꯑꯗꯨꯕꯨ ꯏꯁꯣꯐꯦꯒꯁꯀꯤ ꯃꯈꯥ ꯊꯪꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨꯗꯤ ꯀ꯭ꯂꯣꯖꯗ ꯑꯦꯟꯗ (blind pouch) ꯑꯃꯗꯥ ꯂꯣꯏꯁꯤꯜꯂꯤ꯫

• ꯃꯈꯜ ꯁꯤ: ꯃꯁꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯀꯃꯟ ꯑꯣꯏꯕꯥ ꯃꯈꯂꯅꯤ꯫ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯀꯦꯁ ꯸꯵%ꯗꯤ ꯀꯦꯇꯦꯒꯣꯔꯤ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡ ꯆꯜꯂꯤ꯫ ꯃꯐꯃꯁꯤꯗꯥ ꯊꯣꯛꯂꯤꯕꯥ ꯑꯁꯤꯗꯤ ꯏꯁꯣꯐꯦꯒꯁꯀꯤ ꯃꯊꯛ ꯊꯪꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨ ꯀ꯭ꯂꯣꯖꯗ ꯑꯦꯟꯗ (ꯕ꯭ꯂꯥꯏꯟꯗ ꯄꯥꯎꯆꯦ) ꯑꯃꯗꯥ ꯂꯣꯏꯁꯤꯜꯂꯤ, ꯑꯗꯨꯕꯨ ꯏꯁꯣꯐꯦꯒꯁꯀꯤ ꯃꯈꯥ ꯊꯪꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨ ꯇ꯭ꯔꯦꯀꯤꯌꯥ (TEF)ꯒꯥ ꯁꯝꯅꯩ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯁ꯭ꯇꯣꯃꯥꯀꯀꯥ ꯁꯝꯅꯒꯗꯕꯥ ꯏꯁꯣꯐꯦꯒꯁꯀꯤ ꯁꯔꯨꯛ ꯑꯗꯨ ꯇ꯭ꯔꯦꯀꯤꯌꯥꯒꯥ ꯁꯝꯅꯔꯦ ꯍꯥꯌꯕꯅꯤ꯫

• ꯃꯈꯜ D: ꯃꯁꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯌꯥꯝꯅꯥ ꯊꯣꯀꯄꯥ ꯃꯈꯂꯅꯤ, ꯃꯁꯤ ꯀꯦꯁ 1%ꯗꯒꯤ ꯇꯥꯅꯥ ꯊꯣꯀꯏ꯫ ꯃꯐꯝ ꯑꯁꯤꯗꯥ, ꯏꯁꯣꯐꯦꯒꯁꯀꯤ ꯃꯊꯛ ꯑꯃꯁꯨꯡ ꯃꯈꯥ ꯊꯪꯕꯥ ꯁꯔꯨꯀꯁꯤꯡ ꯑꯁꯤ ꯇ꯭ꯔꯦꯀꯤꯌꯥꯒꯥ ꯇꯣꯉꯥꯟꯅꯥ ꯁꯝꯅꯍꯜꯂꯤ (ꯇꯤ.ꯏ.ꯑꯦꯐ. ꯑꯅꯤ ꯂꯩ)꯫

• ꯃꯈꯜ E: ꯃꯈꯜ ꯑꯁꯤꯗꯥ, ꯏꯁꯣꯐꯦꯒꯁ ꯑꯁꯤ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯁꯦꯝꯃꯤ ꯑꯃꯁꯨꯡ ꯁ꯭ꯇꯣꯃꯥꯀꯀꯥ ꯁꯝꯅꯩ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯏ.ꯑꯦ. ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯏꯁꯣꯐꯦꯒꯁ ꯑꯃꯁꯨꯡ ꯇ꯭ꯔꯦꯀꯤꯌꯥꯒꯤ ꯃꯔꯛꯇꯥ ꯑꯦꯕꯅꯣꯔꯃꯦꯜ ꯀꯅꯦꯛꯁꯟ (TEF) ꯑꯃꯥ ꯂꯩ꯫ ꯃꯁꯤꯕꯨ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ H-ꯇꯥꯏꯞ ꯐꯤꯁ꯭ꯇꯨꯂꯥ ꯍꯥꯌꯅꯥ ꯀꯧꯏ, ꯃꯔꯃꯗꯤ ꯀꯅꯦꯛꯁꯟ ꯑꯁꯤ "H" ꯍꯥꯌꯕꯥ ꯑꯛꯁꯔꯒꯨꯝꯅꯥ ꯃꯑꯣꯡ ꯁꯦꯝꯕꯥ ꯌꯥꯏ꯫ ꯄꯦꯁꯦꯟꯇ ꯄꯨꯝꯅꯃꯛꯀꯤ ꯆꯥꯎꯔꯥꯛꯅꯥ 4%ꯗꯤ ꯃꯈꯜ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡ ꯆꯜꯂꯤ꯫

ꯃꯁꯤꯒꯤ ꯀ꯭ꯂꯥꯁꯤꯐꯤꯀꯦꯁꯟ ꯑꯁꯤ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯂꯨꯝꯂꯕꯁꯨ, ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯂꯥꯌꯦꯡꯕꯒꯤ ꯊꯧꯔꯥꯡ ꯇꯧꯕꯥ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF)ꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤ ꯀꯔꯤꯅꯣ?

ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤ ꯏ.ꯑꯦ.(ꯏꯁꯣꯐꯦꯖꯤꯌꯜ ꯑꯦꯠꯔꯦꯁꯤꯌꯥ)ꯁꯨ ꯂꯩꯕ꯭ꯔꯥ ꯑꯃꯁꯨꯡ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯃꯑꯣꯡ ꯃꯇꯧꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫

EA ꯌꯥꯎꯗꯕꯥ TEF (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯇꯥꯏꯞ E) ꯈꯛꯇꯃꯛ ꯂꯩꯕꯥ ꯑꯉꯥꯡꯁꯤꯡꯅꯥ ꯄꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯂꯥꯏꯑꯣꯡ ꯎꯠꯄꯥ ꯉꯃꯗꯕꯥ ꯌꯥꯏ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯃꯇꯃꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ, ꯃꯈꯣꯌꯅꯥ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯥ ꯋꯥꯐꯃꯁꯤꯡ ꯑꯁꯤ ꯈꯪꯖꯤꯅꯕꯥ ꯌꯥꯏ:

• ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯂꯪꯁꯀꯤ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯊꯣꯀꯏ ꯃꯔꯃꯗꯤ ꯐꯨꯗ ꯄꯥꯔꯇꯤꯀꯦꯂꯁꯤꯡ ꯑꯁꯤ ꯑꯦꯌꯔꯋꯦ (airways)ꯗꯥ ꯆꯦꯟꯊꯔꯀꯄꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯊꯣꯀꯏ꯫
• ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯃꯈꯣꯌꯅꯥ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯈꯣꯝꯂꯥꯡ ꯏꯅꯕꯒꯤ ꯃꯑꯣꯡ ꯐꯥꯎꯏ꯫

ꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯑꯦꯠꯔꯦꯁꯤꯌꯥ (EA) ꯑꯃꯁꯨꯡ ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) (ꯍꯦꯟꯅꯥ ꯀꯃꯟ ꯑꯣꯏꯕꯥ ꯃꯈꯜ, ꯇꯥꯏꯞ C) ꯑꯅꯤꯃꯛ ꯂꯩꯕꯥ ꯑꯉꯥꯡꯁꯤꯡꯅꯥ ꯃꯍꯧꯁꯥꯅꯥ ꯄꯣꯀꯄꯥ ꯄꯨꯡ ꯈꯔꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯎꯕꯥ ꯐꯪꯏ꯫ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯀꯃꯟ ꯑꯣꯏꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡꯗꯤ:

• ꯃꯔꯨꯑꯣꯏꯅꯥ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯛꯅꯕꯥ ꯍꯣꯠꯅꯕꯗꯥ ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯀꯣꯛ ꯆꯤꯀꯄꯥ꯫
• ꯂꯧꯅꯒꯅꯕꯥ ꯍꯣꯠꯅꯕꯗꯥ ꯆꯣꯀꯊꯕꯥ꯫
• ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯒꯤ ꯁꯃꯁ꯭ꯌꯥ ꯂꯩꯕꯥ꯫
• ꯃꯤꯠꯇꯒꯤ ꯍꯦꯟꯅꯥ ꯃ꯭ꯌꯨꯀꯁ ꯗꯤꯁꯆꯥꯔꯖ ꯇꯧꯕꯥ꯫
• ꯑꯦꯕꯗꯣꯃꯤꯅꯦꯜ ꯗꯤꯁꯇꯦꯟꯁꯟ (ꯃꯔꯨꯑꯣꯏꯅꯥ ꯇꯥꯏꯞ Cꯗꯥ, ꯃꯔꯃꯗꯤ ꯏꯅꯍꯦꯜ ꯇꯧꯔꯕꯥ ꯅꯨꯡꯁꯤꯠꯅꯥ TEFꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯁ꯭ꯇꯣꯃꯥꯛꯇꯥ ꯆꯦꯜꯂꯤ)꯫
• ꯑꯉꯥꯡ ꯑꯗꯨꯅꯥ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯕ꯭ꯂꯨ (cyanosis) ꯑꯣꯏꯔꯀꯏ꯫

ꯈꯅꯕꯤꯌꯨ, ꯅꯧꯅꯥ ꯄꯣꯀꯄꯥ ꯑꯉꯥꯡ ꯑꯃꯥ ꯂꯩꯔꯤ꯫ ꯃꯃꯥ ꯑꯗꯨꯅꯥ ꯁꯉ꯭ꯒꯣꯝ ꯈꯔꯥ ꯄꯤꯖꯅꯕꯥ ꯍꯣꯠꯅꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯑꯉꯥꯡ ꯑꯗꯨꯅꯥ ꯂꯦꯡ-ꯑꯣꯠꯄꯥ ꯍꯧꯔꯀꯏ, ꯁꯣꯀꯄꯥ ꯍꯧꯔꯀꯏ, ꯑꯃꯁꯨꯡ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯃꯀꯣꯀꯊꯣꯡꯕꯗꯥ ꯅꯤꯜ ꯑꯣꯏꯔꯀꯏ꯫ ꯃꯆꯤꯟ-ꯃꯅꯥꯑꯣꯗꯒꯤ ꯃꯩꯁꯥ ꯌꯥꯝꯅꯥ ꯊꯣꯀꯏ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯥ ꯎꯔꯕꯗꯤ ꯈꯨꯗꯛꯇꯥ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯄꯥꯎꯇꯥꯛ ꯂꯧꯕꯥ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯑꯁꯤ ꯀꯔꯤꯅꯥ ꯊꯣꯀꯍꯅꯕꯒꯦ?

ꯃꯁꯤ ꯑꯌꯥꯝꯕꯗꯤ ꯐꯤꯇꯁ ꯗꯤꯚꯦꯂꯄꯃꯦꯟꯇꯒꯤ ꯃꯇꯃꯗꯥ ꯊꯣꯀꯏ, ꯃꯗꯨꯗꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯅꯥ ꯃꯤꯔꯣꯜꯂꯤꯉꯩ ꯃꯇꯃꯗꯥ ꯗꯤꯚꯦꯂꯞ ꯇꯧꯕꯥ ꯃꯇꯃꯗꯥ ꯊꯣꯀꯏ꯫ ꯃꯍꯧꯁꯥꯅꯥ, ꯃꯤꯔꯣꯜꯂꯤꯉꯩ ꯃꯇꯨꯡꯗꯥ ꯅꯨꯃꯤꯠ 4 ꯑꯃꯁꯨꯡ 8ꯒꯤ ꯃꯔꯛꯇꯥ, ꯏꯁꯣꯐꯦꯒꯁ ꯑꯃꯁꯨꯡ ꯋꯥꯏꯟꯗꯄꯥꯏꯄꯀꯤ ꯃꯔꯛꯇꯥ ꯋꯥꯜ ꯑꯃꯥ ꯁꯦꯝꯃꯤ, ꯃꯈꯣꯌꯗꯨ ꯑꯍꯥꯅꯕꯗꯥ ꯇꯤꯎꯕ ꯑꯃꯈꯛꯇꯃꯛ ꯑꯣꯏꯅꯥ ꯍꯧꯏ꯫ ꯋꯥꯜ ꯑꯁꯤ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯁꯦꯃꯒꯠꯄꯥ ꯉꯃꯗꯕꯥ ꯃꯇꯃꯗꯥ, ꯅꯠꯠꯔꯒꯥ ꯇꯣꯈꯥꯌꯕꯥ ꯑꯗꯨ ꯃꯄꯨꯡ ꯐꯥꯗꯕꯥ ꯃꯇꯃꯗꯥ, ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯀꯧꯕꯥ ꯑꯦꯕꯅꯣꯔꯃꯦꯜ ꯀꯅꯦꯛꯁꯟ ꯑꯁꯤ ꯊꯣꯀꯏ꯫ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯒꯤ ꯑꯆꯨꯝꯕꯥ ꯃꯔꯝ ꯑꯁꯤ ꯍꯧꯖꯤꯛ ꯐꯥꯑꯣꯕꯥ ꯈꯉꯕꯥ ꯉꯃꯗ꯭ꯔꯤ, ꯑꯗꯨꯕꯨ ꯃꯁꯤ ꯖꯤꯅꯦꯇꯤꯛ ꯑꯃꯁꯨꯡ ꯑꯦꯅꯚꯥꯏꯔꯅꯃꯦꯟꯇꯀꯤ ꯐꯦꯛꯇꯔꯁꯤꯡꯅꯥ ꯊꯣꯀꯍꯅꯕꯅꯤ ꯍꯥꯌꯅꯥ ꯂꯧꯅꯩ꯫

ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯃꯇꯧ ꯀꯔꯝꯅꯥ ꯇꯤ.ꯏ.ꯑꯦꯐ.

ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ, ꯑꯉꯥꯡ ꯑꯗꯨ ꯄꯣꯀꯄꯥ ꯃꯃꯥꯡꯗꯥ ꯑꯂꯠꯔꯥꯁꯥꯎꯟꯗ ꯁ꯭ꯀꯦꯅꯗꯥ ꯎꯕꯥ ꯐꯪꯂꯤꯕꯥ ꯑꯦꯕꯅꯣꯔꯃꯦꯂꯤꯇꯤꯁꯤꯡꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯅꯥ ꯇꯤ.ꯏ.ꯑꯦꯐ. ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯑꯀꯣꯌꯕꯗꯥ ꯑꯦꯝꯅꯤꯑꯣꯇꯤꯛ ꯐ꯭ꯂꯨꯏꯗ (polyhydramnios) ꯌꯥꯝꯅꯥ ꯂꯩꯔꯕꯗꯤ, ꯅꯠꯠꯔꯒꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯃꯀꯣꯛ ꯑꯗꯨ ꯃꯌꯦꯛ ꯁꯦꯡꯅꯥ ꯎꯕꯥ ꯐꯪꯗ꯭ꯔꯕꯗꯤ, ꯗꯣꯛꯇꯔ ꯑꯗꯨꯅꯥ ꯆꯤꯡꯅꯕꯥ ꯂꯩꯕꯥ ꯌꯥꯏ꯫

ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ, ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯆꯤꯡꯅꯕꯥ ꯑꯁꯤ ꯄꯣꯀꯄꯥ ꯃꯇꯨꯡ ꯄꯨꯡ ꯈꯔꯒꯤ ꯃꯅꯨꯡꯗꯥ, ꯃꯃꯥꯡꯗꯥ ꯄꯅꯈ꯭ꯔꯤꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ (ꯃꯌꯥꯏ ꯑꯣꯏꯕꯥ ꯃꯍꯤꯛ-ꯃꯇꯥꯏ ꯂꯩꯕꯥ, ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯥ ꯋꯥꯕꯥ, ꯊꯀꯄꯥ ꯉꯃꯗꯕꯥ) ꯎꯠꯄꯥ ꯍꯧꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯊꯣꯀꯏ꯫

ꯃꯁꯤꯒꯤ ꯑꯀꯤꯕꯥ ꯑꯁꯤ ꯀꯅꯐꯤꯗ ꯇꯧꯅꯕꯥ ꯃꯦꯗꯤꯀꯦꯜ ꯇꯤꯃꯅꯥ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯥ ꯇꯦꯁ꯭ꯇꯁꯤꯡ ꯑꯁꯤ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯌꯥꯏ:

• ꯆꯦꯁ꯭ꯠ ꯑꯃꯁꯨꯡ ꯑꯦꯕꯗꯣꯃꯤꯅꯦꯜ ꯑꯦꯛꯁ-ꯔꯦ: ꯃꯁꯤꯅꯥ ꯏꯁꯣꯐꯦꯒꯁ, ꯂꯪꯁꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯁꯨꯡ ꯁ꯭ꯇꯣꯃꯥꯀꯇꯥ ꯅꯨꯡꯁꯤꯠ ꯂꯩꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯆꯦꯛ ꯇꯧꯕꯥ ꯉꯝꯃꯤ꯫ ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯏ.ꯑꯦ.ꯅꯥ ꯅꯥꯕꯥ ꯑꯉꯥꯡ ꯑꯃꯒꯤ ꯏꯁꯣꯐꯦꯒꯁꯇꯥ ꯊꯝꯂꯤꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯇꯤꯎꯕ (nasogastric tube) ꯑꯃꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛꯇꯥ ꯌꯧꯗꯅꯥ X-ꯔꯦꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯇꯪꯈꯥꯌ ꯑꯃꯥ ꯊꯃꯖꯤꯅꯕꯥ ꯌꯥꯏ꯫
• ꯑꯦꯟꯗꯣꯁ꯭ꯀꯣꯄꯤ ꯅꯠꯠꯔꯒꯥ ꯕ꯭ꯔꯣꯉ꯭ꯀꯣꯁ꯭ꯀꯣꯄꯤ: ꯇꯦꯁ꯭ꯇꯁꯤꯡ ꯑꯁꯤꯗꯥ ꯀꯦꯃꯦꯔꯥ ꯑꯃꯥ ꯌꯥꯎꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯇꯤꯎꯕ ꯑꯃꯥ ꯃꯤꯠ ꯅꯠꯠꯔꯒꯥ ꯅꯥꯀꯣꯡꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯊꯥꯗꯨꯅꯥ ꯏꯁꯣꯐꯦꯒꯁ (endoscopy) ꯅꯠꯠꯔꯒꯥ ꯋꯥꯏꯟꯗꯄꯥꯏꯞ (bronchoscopy)ꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯍꯀꯊꯦꯡꯅꯅꯥ ꯌꯦꯡꯏ꯫ ꯃꯁꯤꯅꯥ ꯑꯦꯕꯅꯣꯔꯃꯦꯜ ꯀꯅꯦꯛꯁꯟ (ꯐꯤꯁ꯭ꯇꯨꯂꯥ) ꯑꯗꯨꯒꯤ ꯑꯀꯛꯅꯕꯥ ꯃꯐꯝ ꯑꯗꯨ ꯈꯪꯗꯣꯀꯄꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫

ꯑꯉꯥꯡ ꯑꯃꯕꯨ ꯇꯤ.ꯏ.ꯑꯦꯐ. ꯅꯠꯠꯔꯒꯥ ꯏ.ꯑꯦ . ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯍꯥꯔꯠ ꯁ꯭ꯀꯦꯟ (ꯏꯀꯣꯀꯥꯔꯗꯤꯑꯣꯒ꯭ꯔꯥꯐ) ꯑꯃꯁꯨꯡ ꯀꯤꯗꯅꯤ ꯁ꯭ꯀꯦꯟ ꯇꯧꯕꯥ ꯌꯥꯏ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯑꯁꯤ ꯀꯔꯝꯅꯥ ꯂꯥꯏꯌꯦꯡꯕꯒꯦ?

ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯑꯃꯠꯇꯥ ꯉꯥꯏꯔꯕꯥ ꯏꯐꯦꯛꯇꯤꯕ ꯑꯣꯏꯕꯥ ꯂꯥꯌꯦꯡꯗꯤ ꯁꯔꯖꯔꯤꯅꯤ꯫ ꯁꯔꯖꯔꯤ ꯑꯁꯤꯗꯥ ꯁꯔꯖꯔꯤꯅꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯏꯁꯣꯐꯦꯒꯁ ꯑꯃꯁꯨꯡ ꯇ꯭ꯔꯦꯀꯤꯌꯥꯒꯤ ꯃꯔꯛꯇꯥ ꯂꯩꯕꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯑꯗꯨ ꯂꯧꯊꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯍꯨꯔꯥꯅꯕꯥ ꯑꯗꯨ ꯊꯤꯡꯏ꯫ ꯃꯗꯨꯒꯤ ꯃꯇꯨꯡꯗꯥ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯏ.ꯑꯦ.ꯁꯨ ꯂꯩꯔꯕꯗꯤ, ꯏꯁꯣꯐꯦꯒꯁꯀꯤ ꯑꯁꯣꯀꯄꯥ ꯁꯔꯨꯛ ꯑꯅꯤ ꯑꯗꯨ ꯑꯃꯒꯥ ꯑꯃꯒꯥ ꯁꯝꯅꯍꯟꯗꯨꯅꯥ ꯆꯤꯟꯖꯥꯛ ꯑꯗꯨ ꯆꯠꯄꯥ ꯌꯥꯍꯜꯂꯤ꯫

ꯃꯁꯤꯒꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯇ꯭ꯔꯦꯗꯤꯁꯅꯦꯜ ꯑꯣꯄꯟ ꯁꯔꯖꯔꯤ ꯑꯃꯥ ꯑꯣꯏꯅꯥ ꯅꯠꯠꯔꯒꯥ ꯑꯄꯤꯀꯄꯥ ꯏꯅꯁꯤꯁꯟ ꯈꯔꯥ ꯁꯤꯖꯤꯟꯅꯗꯨꯅꯥ ꯃꯤꯅꯤꯃꯝ ꯏꯅꯚꯦꯁꯤꯚ ꯁꯔꯖꯔꯤ (ꯊꯣꯔꯥꯀꯣꯁ꯭ꯀꯣꯄꯤꯛ ꯁꯔꯖꯔꯤ) ꯑꯣꯏꯅꯥ ꯇꯧꯕꯥ ꯌꯥꯏ꯫ ꯁꯤꯖꯤꯟꯅꯔꯤꯕꯥ ꯃꯦꯊꯗ ꯑꯁꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯐꯤꯚꯝ, ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯃꯈꯜ, ꯑꯃꯁꯨꯡ ꯁꯔꯖꯔꯤꯒꯤ ꯑꯦꯛꯁꯄꯔꯤꯌꯦꯟꯁꯒꯨꯝꯕꯥ ꯐꯦꯛꯇꯔꯁꯤꯡꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫

ꯁꯔꯖꯔꯤ ꯑꯁꯤꯒꯤ ꯔꯤꯁ꯭ꯛ ꯂꯩꯕ꯭ꯔꯥ?

ꯁꯔꯖꯔꯤ ꯑꯃꯍꯦꯛꯇꯒꯥ ꯃꯥꯟꯅꯅꯥ, ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯀꯣꯔꯔꯦꯛꯁꯟ ꯁꯔꯖꯔꯤꯗꯥ ꯀꯃꯞꯂꯤꯀꯦꯁꯟ ꯈꯔꯗꯤ ꯂꯩꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯁꯤꯡ ꯑꯁꯤ ꯌꯥꯑꯣꯔꯤ:

• ꯑꯦꯅꯥꯁ꯭ꯇꯣꯃꯣꯇꯤꯛ ꯂꯤꯀꯁꯤꯡ: ꯃꯁꯤꯅꯥ ꯐꯤꯗꯤꯡ ꯇꯨꯕꯀꯤ ꯑꯦꯅꯥꯁ꯭ꯇꯣꯃꯣꯁꯤꯁ (ꯀꯅꯦꯛꯁꯟ)ꯗꯒꯤ ꯐ꯭ꯂꯨꯏꯗꯁꯤꯡ ꯂꯤꯛ ꯇꯧꯕꯕꯨ ꯈꯪꯅꯩ꯫
• ꯏꯁꯣꯐꯦꯖꯤꯌꯜ ꯁ꯭ꯠꯔꯤꯀꯆꯔꯁꯤꯡ (Esophageal strictures): ꯃꯁꯤ ꯃꯇꯃꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ ꯐꯨꯗ ꯄꯥꯏꯄꯀꯥ ꯃꯔꯤ ꯂꯩꯅꯕꯥ ꯀꯅꯦꯛꯁꯟ ꯑꯗꯨ ꯍꯦꯟꯅꯥ ꯀꯨꯄꯁꯤꯜꯂꯀꯄꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯅꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯕꯨ ꯂꯧꯅꯒꯅꯕꯥ ꯂꯥꯌꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
• ꯂꯦꯔꯤꯟꯖꯦꯜ ꯅꯔꯚꯇꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯄꯥ: ꯃꯁꯤꯅꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯈꯣꯟꯖꯦꯂꯗꯥ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
• ꯐꯤꯁ꯭ꯇꯨꯂꯥ ꯔꯤꯀꯣꯚꯔꯤ: ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯁꯨ, ꯑꯦꯕꯅꯣꯔꯃꯦꯜ ꯀꯅꯦꯛꯁꯟ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯂꯥꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯁꯤ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯀꯦꯁ 3%ꯗꯒꯤ 14% ꯐꯥꯎꯕꯗꯥ ꯊꯣꯀꯏ꯫
• ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡ ꯂꯩꯕꯥ꯫
• ꯒꯦꯁ꯭ꯠꯔꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯔꯤꯐ꯭ꯂꯛꯁ ꯗꯤꯖꯤꯖ (GERD): ꯃꯁꯤ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯦꯁꯤꯗ ꯑꯁꯤ ꯏꯁꯣꯐꯦꯒꯁꯇꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯆꯦꯟꯊꯔꯀꯄꯥ ꯃꯇꯃꯅꯤ꯫ ꯃꯁꯤ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯀꯃꯟ ꯑꯣꯏ꯫

ꯃꯦꯗꯤꯀꯦꯜ ꯇꯤꯃꯅꯥ ꯑꯗꯣꯃꯒꯥ ꯈꯨꯗꯣꯡꯊꯤꯕꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯅꯒꯅꯤ꯫ ꯋꯥꯈꯜ ꯋꯥꯕꯥ ꯂꯩꯔꯣꯏꯗꯕꯅꯤ, ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯃꯁꯤ ꯄꯨꯝꯅꯃꯛ ꯑꯁꯤꯒꯤꯗꯃꯛ ꯁꯦꯝ ꯁꯥꯗꯨꯅꯥ ꯂꯩꯔꯤ꯫

ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯂꯥꯌꯦꯡꯕꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯐꯒꯠꯂꯀꯄꯗꯥ ꯃꯇꯝ ꯀꯌꯥ ꯆꯪꯕꯒꯦ?

ꯔꯤꯀꯣꯚꯔꯤꯒꯤ ꯃꯇꯝ ꯑꯁꯤ ꯑꯉꯥꯡ ꯑꯃꯗꯒꯤ ꯑꯉꯥꯡ ꯑꯃꯗꯥ ꯈꯦꯠꯅꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ, ꯁꯔꯖꯔꯤꯒꯤ ꯃꯑꯣꯡ-ꯃꯇꯧ ꯑꯃꯁꯨꯡ ꯑꯉꯥꯡ ꯑꯗꯨꯅꯥ ꯂꯥꯏꯌꯦꯡꯕꯗꯥ ꯀꯔꯝꯅꯥ ꯔꯦꯁꯄꯣꯟꯁ ꯇꯧꯕꯒꯦ ꯍꯥꯌꯕꯗꯨꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫ ꯑꯌꯥꯝꯕꯥ ꯀꯦꯁꯁꯤꯡꯗꯗꯤ, ꯃꯄꯨꯡꯐꯥꯅꯥ ꯐꯒꯠꯂꯀꯄꯗꯥ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯅꯨꯃꯤꯠ 12ꯅꯤ, ꯅꯠꯠꯔꯒꯥ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯊꯥ ꯑꯍꯨꯝ ꯆꯪꯂꯝꯕꯥ ꯌꯥꯏ꯫ ꯃꯇꯝ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ, ꯑꯉꯥꯡ ꯑꯗꯨꯕꯨ ꯑꯈꯟꯅꯕꯥ ꯄꯤꯖ-ꯄꯤꯊꯛ ꯇꯧꯕꯥ ꯌꯥꯕꯥ ꯇꯤꯎꯕ ꯑꯃꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯄꯤꯖꯕꯥ ꯌꯥꯏ, ꯅꯠꯠꯔꯒꯥ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯑꯣꯔꯦꯜ ꯄꯤꯖꯕꯗꯥ ꯌꯥꯎꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯗꯣꯛꯇꯔꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯅꯔꯁꯤꯡ ꯁ꯭ꯇꯥꯐꯁꯤꯡꯅꯥ ꯃꯁꯤ ꯄꯨꯝꯅꯃꯛ ꯑꯁꯤ ꯑꯗꯣꯃꯗꯥ ꯁꯟꯗꯣꯛꯅꯥ ꯇꯥꯛꯀꯅꯤ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯑꯁꯤ ꯊꯤꯡꯕꯥ ꯉꯃꯒꯗ꯭ꯔꯥ?

ꯍꯧꯖꯤꯛꯀꯤ ꯑꯣꯏꯅꯥ ꯄꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯂꯩꯕꯥ ꯇꯤ.ꯏ.ꯑꯦꯐ. ꯃꯁꯤꯒꯤ ꯃꯔꯃꯗꯤ ꯃꯁꯤ ꯐꯤꯇꯁ ꯁ꯭ꯇꯦꯖ ꯃꯅꯨꯡꯗꯥ ꯊꯣꯀꯏ꯫ ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯏꯅꯈꯠꯂꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯊꯣꯀꯄꯥ ꯑꯦꯛꯕꯤꯌꯔ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯅꯥ ꯑꯌꯥꯝꯕꯅꯥ ꯀꯦꯟꯁꯔ ꯅꯠꯠꯔꯒꯥ ꯁꯥꯊꯤꯕꯥ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡꯅꯥ ꯊꯣꯀꯍꯅꯕꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯃꯁꯤ ꯊꯤꯡꯅꯕꯒꯤ ꯑꯀꯛꯅꯕꯥ ꯃꯑꯣꯡ ꯑꯃꯠꯇꯥ ꯂꯩꯇꯦ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯍꯀꯁꯦꯜ ꯐꯕꯥ ꯄꯨꯟꯁꯤ ꯃꯍꯤꯡ ꯑꯃꯥ ꯏꯅꯕꯅꯥ ꯀꯦꯟꯁꯔ ꯑꯃꯁꯨꯡ ꯏꯅꯐꯦꯛꯁꯅꯁꯤꯡꯗꯒꯤ ꯉꯥꯀꯊꯣꯀꯄꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯩꯒꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯗꯥ TEF ꯂꯩꯔꯕꯗꯤ ꯑꯩꯅꯥ ꯀꯔꯤ ꯑꯥꯁꯥ ꯇꯧꯒꯗꯒꯦ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯑꯉꯥꯡ ꯑꯗꯨ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯅꯥ ꯅꯥꯔꯦ ꯍꯥꯌꯅꯥ ꯈꯪꯂꯕꯗꯤ, ꯃꯦꯗꯤꯀꯦꯜ ꯇꯤꯃꯅꯥ ꯈꯨꯗꯛꯇꯥ ꯁꯔꯖꯔꯤ ꯇꯧꯅꯕꯥ ꯄꯥꯎꯇꯥꯛ ꯄꯤꯒꯅꯤ꯫ ꯃꯁꯤ ꯄꯨꯟꯁꯤ ꯃꯥꯡꯍꯅꯕꯥ ꯌꯥꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ, ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯊꯨꯅꯥ ꯂꯥꯏꯌꯦꯡꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯈꯜ ꯑꯁꯤ ꯇꯤ.ꯏ.ꯑꯦꯐ.ꯀꯤ ꯃꯈꯂꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯗꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯀꯃꯞꯂꯤꯀꯦꯁꯟ ꯑꯃꯥ ꯂꯥꯀꯄꯥ ꯇꯥꯔꯕꯗꯤ, ꯃꯦꯗꯤꯀꯦꯜ ꯇꯤꯃꯅꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯕꯨ ꯅꯨꯃꯤꯠ ꯈꯔꯅꯤꯒꯤ ꯑꯣꯏꯅꯥ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯂꯗꯥ ꯊꯃꯒꯅꯤ ꯑꯃꯁꯨꯡ ꯃꯍꯥꯛꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨ ꯅꯤꯡꯊꯤꯅꯥ ꯌꯦꯡꯁꯤꯅꯒꯅꯤ꯫ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯇꯣꯏꯅꯥ ꯀꯃꯞꯂꯤꯀꯦꯁꯅꯁꯤꯡ ꯂꯥꯀꯄꯥ ꯑꯉꯥꯡꯁꯤꯡꯗꯥ ꯇꯨꯡꯗꯥ ꯇꯤ.ꯏ.ꯑꯦꯐ. ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯀꯃꯞꯂꯤꯀꯦꯁꯅꯁꯤꯡ ꯑꯁꯤ ꯂꯥꯛꯂꯕꯗꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯕꯨ ꯃꯈꯥ ꯇꯥꯅꯥ ꯌꯦꯡꯁꯤꯅꯒꯅꯤ (ꯐꯣꯂꯣ-ꯑꯄꯁꯤꯡ)꯫

ꯑꯁꯤꯒꯨꯝꯕꯥ ꯃꯇꯝ ꯑꯁꯤꯗꯥ, ꯃꯃꯥ-ꯃꯄꯥ ꯑꯣꯏꯅꯥ, ꯅꯍꯥꯛꯅꯥ ꯋꯥꯈꯜ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯐꯥꯎꯔꯀꯄꯥ ꯌꯥꯏ꯫ ꯅꯍꯥꯛꯅꯥ ꯋꯥꯈꯜ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯐꯥꯎꯔꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯗꯨ ꯅꯣꯔꯃꯦꯂꯅꯤ꯫ ꯗꯣꯛꯇꯔꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯅꯔꯁꯁꯤꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯋꯥꯍꯪꯁꯤꯡ ꯍꯪꯕꯤꯌꯨ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯑꯀꯤꯕꯥ ꯑꯗꯨ ꯁꯦꯡꯗꯣꯀꯄꯤꯌꯨ꯫ ꯃꯈꯣꯌꯅꯥ ꯑꯗꯣꯃꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯒꯅꯤ꯫

ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯑꯁꯤ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯐꯍꯅꯕꯥ ꯉꯃꯒꯗ꯭ꯔꯥ?

ꯍꯣꯏ! ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯑꯁꯤ ꯁꯔꯖꯔꯤꯅꯥ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯐꯍꯅꯕꯥ ꯉꯝꯃꯤ꯫ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯋꯥꯐꯃꯗꯤ ꯃꯁꯤ ꯇꯣꯏꯅꯥ ꯈꯪꯗꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯈꯨꯗꯛꯇꯥ ꯂꯥꯏꯌꯦꯡ ꯍꯧꯕꯅꯤ, ꯃꯔꯃꯗꯤ ꯃꯁꯤ ꯄꯨꯟꯁꯤꯗꯥ ꯈꯨꯗꯣꯡꯊꯤꯅꯤꯉꯥꯏ ꯑꯣꯏꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤ ꯇꯧꯕꯅꯥ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤ ꯏꯁꯣꯐꯦꯒꯁ ꯑꯃꯁꯨꯡ ꯋꯤꯟꯗꯄꯥꯏꯄꯀꯤ ꯃꯔꯛꯇꯥ ꯂꯩꯕꯥ ꯑꯁꯣꯀꯄꯥ ꯃꯔꯤ ꯑꯗꯨ ꯆꯨꯃꯊꯣꯀꯄꯥ ꯉꯃꯒꯅꯤ, ꯆꯤꯟꯖꯥꯛ ꯑꯗꯨ ꯂꯪꯁꯇꯥ ꯆꯪꯂꯀꯄꯥ ꯊꯤꯡꯕꯥ ꯉꯃꯒꯅꯤ (ꯑꯦꯁ꯭ꯄꯤꯔꯦꯁꯟ) ꯑꯃꯁꯨꯡ ꯑꯉꯥꯡ ꯑꯗꯨꯕꯨ ꯍꯀꯁꯦꯜ ꯐꯕꯥ ꯄꯨꯟꯁꯤ ꯑꯃꯥ ꯍꯤꯡꯅꯕꯒꯤ ꯈꯨꯗꯣꯡꯆꯥꯕꯥ ꯄꯤꯕꯥ ꯉꯃꯒꯅꯤ꯫

ꯑꯔꯣꯏꯕꯗꯥ, ꯃꯁꯤ ꯅꯤꯡꯁꯤꯡꯕꯤꯌꯨ (ꯇꯦꯛ-ꯍꯣꯝ ꯃꯦꯁꯦꯖ)

ꯅꯍꯥꯛꯀꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯗꯥ ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ (TEF) ꯂꯩꯔꯦ ꯍꯥꯌꯕꯥ ꯈꯪꯂꯕꯥ ꯃꯇꯃꯗꯥ ꯋꯥꯈꯜ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯐꯥꯎꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯅꯣꯔꯃꯦꯂꯅꯤ꯫ ꯑꯗꯨꯕꯨ ꯅꯤꯡꯁꯤꯡꯕꯤꯌꯨ, ꯃꯁꯤ ꯂꯥꯏꯌꯦꯡꯕꯥ ꯌꯥꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫

• ꯉꯟꯅꯥ ꯈꯪꯗꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯈꯨꯗꯛꯀꯤ ꯑꯣꯏꯕꯥ ꯂꯥꯏꯌꯦꯡ ꯑꯁꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯅꯥ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯆꯥꯕꯥ ꯃꯇꯃꯗꯥ ꯂꯦꯞꯇꯅꯥ ꯀꯞꯄꯥ, ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯗꯥ ꯑꯋꯥꯕꯥ ꯃꯥꯌꯣꯛꯅꯔꯤꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ, ꯅꯠꯠꯔꯒꯥ ꯅꯤꯜ ꯂꯥꯎꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ, ꯈꯨꯗꯛꯇꯥ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯃꯇꯦꯡ ꯂꯧꯒꯗꯕꯅꯤ꯫
• ꯃꯁꯤꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯂꯥꯏꯌꯦꯡꯗꯤ ꯁꯔꯖꯔꯤꯅꯤ꯫ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯑꯉꯥꯡ ꯑꯗꯨꯒꯤꯗꯃꯛ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯆꯨꯅꯕꯥ ꯂꯥꯏꯌꯦꯡ ꯄꯤꯒꯅꯤ꯫
• ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯁꯨ ꯗꯣꯛꯇꯔꯁꯤꯡꯒꯤ ꯏꯅꯁ꯭ꯠꯔꯛꯁꯅꯁꯤꯡ ꯉꯥꯛꯅꯥ ꯆꯠꯄꯥ ꯑꯃꯁꯨꯡ ꯑꯉꯥꯡ ꯑꯗꯨꯕꯨ ꯃꯇꯝ ꯆꯥꯅꯥ ꯐꯣꯂꯣ-ꯑꯄꯀꯤꯗꯃꯛꯇꯥ ꯂꯧꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫
• ꯑꯗꯣꯝ ꯈꯛꯇꯅꯥ ꯅꯠꯇꯦ꯫ ꯃꯇꯝ ꯑꯁꯤꯗꯥ ꯑꯗꯣꯃꯒꯤ ꯃꯦꯗꯤꯀꯦꯜ ꯇꯤꯝ, ꯏꯃꯨꯡ ꯃꯅꯨꯡ ꯑꯃꯁꯨꯡ ꯃꯔꯨꯄꯁꯤꯡꯒꯤ ꯃꯇꯦꯡ ꯑꯁꯤ ꯃꯃꯜ ꯌꯥꯝꯃꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯄꯨꯛꯅꯤꯡꯒꯤ ꯋꯥꯈꯜ ꯑꯗꯨ ꯁꯦꯌꯔ ꯇꯧꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯃꯇꯦꯡ ꯄꯥꯡꯅꯕꯥ ꯍꯥꯌꯖꯕꯗꯥ ꯋꯥꯈꯜ ꯋꯥꯕꯥ ꯂꯩꯔꯣꯏꯗꯕꯅꯤ꯫

ꯏꯅꯐꯣꯔꯃꯦꯁꯟ ꯑꯁꯤꯅꯥ ꯑꯗꯣꯃꯗꯥ ꯑꯔꯨꯕꯥ ꯐꯤꯚꯝ ꯑꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯔꯥ ꯂꯧꯁꯤꯅꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯒꯅꯤ ꯍꯥꯌꯅꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯥꯁꯥ ꯇꯧꯔꯤ꯫ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯗꯣꯃꯒꯤ ꯑꯉꯥꯡ ꯑꯗꯨ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯐꯒꯠꯂꯛꯅꯕꯥ ꯌꯥꯏꯐ-ꯄꯥꯎꯖꯦꯜ ꯄꯤꯖꯔꯤ!

` ꯇ꯭ꯔꯦꯀꯤꯑꯣꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯐꯤꯁ꯭ꯇꯨꯂꯥ, ꯏꯁꯣꯐꯦꯖꯤꯑꯦꯜ ꯑꯦꯠꯔꯦꯁꯤꯌꯥ, ꯀꯣꯟꯖꯤꯅꯤꯑꯦꯜ ꯀꯟꯗꯤꯁꯟ, ꯄꯣꯀꯄꯗꯥ ꯉꯥꯏꯔꯤꯕꯥ ꯑꯉꯥꯡꯒꯤ ꯍꯀꯁꯦꯜ, ꯄꯦꯗꯤꯑꯦꯠꯔꯤꯛ ꯁꯔꯖꯔꯤ, ꯑꯦꯁ꯭ꯄꯤꯔꯦꯁꯟ꯫