Диференційний підхід до вибору методу реваскуляризації міокарда у лікуванні IXС: Автореф. дис… канд. мед. наук / В.В. Осауленко, Ін-т серцево-судин.

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?INOEOOO NA?OeAAI-NOAeEIII? O??O?A?? AII OE?A?IE

Ia
i?aaao ?oeiieno

OAeE 616.127-005.4-07-089

INAOEAIEI

Ay/aneaa Aaea??eiae/

Aeeoa?aioe?eiee i?aeo?ae aei aeai?o iaoiaeo ?aaaneoey?ecaoe?? i?iea?aeo
o e?eoaaii? ?ON

14.01.04 — na?oeaai-noaeeiia o??o?a?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a — 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Caii??cueeiio aea?aeaaiiio iaaee/iiio oi?aa?n?oao?.

Iaoeiaee ea??aiee:

caneoaeaiee ae?y/ iaoee ? oaoi?ee Oe?a?ie, aeieoi? iaaee/ieo iaoe,
caa?aeoaa/ eaoaae?e aini?oaeueii? o??o?a?? Caii??cueeiai aea?aeaaiiai
iaaee/iiai oi?aa?neoaoo, i?ioani? I?eiiaiei Ieaenaiae? Naiaiiae/.

Io?oe?ei? iiiiaioe:

1. Aeieoi? iaaee/ieo iaoe, caa?aeoaa/ eaoaae?e aini?oaeueii? o??o?a?? ?
2 c eo?nii a?oaeii? oa noaeeiii? o??o?a?? Iaoe?iiaeueiiai iaaee/iiai
oi?aa?n?oaoo ?iai? I.I.Aiaiiieueoey I?oaeia Aieiaeeie? A?eai?iae/.

2. Aeieoi? iaaee/ieo iaoe, i?ioani? eaoaae?e na?oeaai-noaeeiii? o??o?a??
Aeaaeai?? i?neyaeeieiiii? ina?oe IIC Oe?a?ie Oo?eaei Na?a?e Ieeieaeiae/.

I?ia?aeia onoaiiaa: ?inoeooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a??
AII Oe?a?ie, a?aeae?e o??o?a?? noaeei, i. Ee?a.

Caoeno a?aeaoaeaoueny “29” /a?aiy 1999 ?. i 14.00 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.555.01 ?inoeoooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie (252110, i. Ee?a, oca?c I?ioan?a
ss?, 11).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? ?inoeoooo
na?oeaai-noaeeiii? o??o?a?? AII Oe?a?ie (252110, i. Ee?a 110, oca?c
I?ioan?a ss?, 11).

Aaoi?aoa?ao ?ic?neaiee “ 22 ” o?aaiy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee,

aeieoi? iaaee/ieo iaoe
A.A. ?oaeaiei

Aeooaeuei?noue i?iaeaie

?oai?/ia oai?iaa na?oey (?ON) — iae/ano?oa i?e/eia iai?aoeacaeaoiino?,
?iaae?aeiino? oa nia?oiino? ianaeaiiy. A no?oeoo?? eaoaeueiino? a?ae
na?oeaai-noaeeiieo caoai?thaaiue a?eueo i?ae a 50 % aeiaaee?a
ae??oaeueia cia/aiiy iaee oneeaaeiaiiy, iia’ycai? c
ieethc?eii-noaiioe/ieie o?aaeaiiyie ei?iia?ieo a?oa??e. Ai?oiei?iia?ia
ooiooaaiiy aoaeoeaia i?e naaiaioa?ieo noaiicao a?oa??e, ui
cono??/a?oueny eeoa o 35-45 % oai?eo ?ON. Iaaoaeoeaia ?aaaneoey?ecaoe?y
i?iea?aea i?e AEO a ciiao c aeeoociei o?aaeaiiyi ei?iia?ieo a?oa??e
caeeoa?oueny aeooaeueiith i?iaeaiith aei oeueiai /ano. Ca?eueoaiiy
e?eueeino? oai?eo c aeeoocieie ci?iaie ei?iia?ieo a?oa??e, ia?aaaaeia
o?aaeaiiy aeenoaeueieo naaiaio?a oa “ae??aiee eae?a?” oeeo noaeei,
a?aenooi?noue oiia aeey oi?ioaaiiy aeenoaeueiiai ai?oi-ei?iia?iiai
aianoiiica, iacaaeia?euei? oeyoe a?aeoieo i?ney ooiooaaiiy o aeiaaeeao
aeeoociiai o?aaeaiiy ei?iia?ieo a?oa??e ni?eyee a?aeiiaeaiith ?ioa?ano
aeine?aeiee?a aei iei? “caaooeo” niinia?a “iai?yii?” ?aaaneoey?ecaoe??
i?iea?aea: iiaioiea?ae?iiaen?? aai ?aaaneoey?ecaoe?? i?iea?aea
ia?aaa?iooei eeaioai aee?iai? ee?oeiaeie ia?eea?aea. Iai?yia
?aaaneoey?ecaoe?y oyaey?oueny nueiaiaei? iaea?eueo aoaeoeaiei iaoiaeii
eiiiainaoe?? e?iaiiinoa/aiiy ?oai?ciaaieo cii i?iea?aea i?e aeeoocieo
aoa?ineea?ioe/ieo o?aaeaiiyo aeenoaeueiiai ei?iia?iiai ?onea.

A c’ayceo c aeeeaaeaiei, caeeoa?oueny iaae??oaiith i?iaeaia
aeeoa?aioe?eiaaiiai i?aeoiaeo aei aeai?o iaoiaeo ?aaaneoey?ecaoe??
i?iea?aea a caeaaeiino? a?ae oa?aeoa?o o?aaeaiiy ei?iia?ieo a?oa??e ?
nooiaiy ii?ooaiiy nei?i/oaaeueii? ooieoe?? i?iea?aea.

Aei oeueiai /ano i?iaeiaaeo?oueny aeeneon?y uiaei oaeoeee aaaeaiiy
oai?eo ?ON, ye? iathoue “ii?iaeuei?” ei?iia?i? a?oa???, aoaeoeaiino?
?acaeoe?? ea?ae?aeueieo a?eie c??/anoiai aocea, c’ynoaaiiy i?e/eie
niacio ei?iia?ieo a?oa??e.

Iaaaaeaiee ia?ae?e ieoaiue ie?aneea iaoo aeine?aeaeaiiy, yea iieyaaea a
?ic?iaoe? aeeoa?aioe?eiaaiiai i?aeoiaeo aei aeai?o iaoiaea
?aaaneoey?ecaoe?? i?iea?aea o oai?eo ?ON a caeaaeiino? a?ae oi?ie ?
nooiaiy o?aaeaiiy ei?iia?ieo a?oa??e, nei?i/oeueii? ooieoe?? na?oey.

O a?aeiia?aeiino? aei iaoe aoee aecia/ai? oae? caaaeaiiy aeine?aeaeaiiy:

1. aiae?c aia?ia?ao?/ii? ea?oeie o?aaeaiiy ei?iia?ieo a?oa??e i?e aeai??
iaoiaeo o??o?a?/iiai e?eoaaiiy ?ON;

2. ?ic?iaea eeaneo?eaoe?? aeeoociiai o?aaeaiiy ei?iia?ieo a?oa??e;

3. ?ic?iaea iieacaiue aei ??cieo iaoiae?a ?aaaneoey?ecaoe?? i?iea?aea;

4. oaeineiiaeaiiy oaoi?ee iai?yieo iaoiae?a ?aaaneoey?ecaoe?? i?iea?aea;

5. aiae?c ?aii?o oa a?aeaeaeaieo ?acoeueoao?a i?ney iai?yii?
?aaaneoey?ecaoe?? i?iea?aea;

6. ?ic?iaea iieacaiue aei ?acaeoe?? ea?ae?aeueieo a?eie c??/acoiai aocea
o oai?eo aa??aioiith noaiiea?ae??th;

7. oi?ioethaaiiy i?aeoe/ieo ?aeiiaiaeaoe?e aei aeeoa?aioe?eiaaiiai
i?aeoiaeo o aeai?? iaoiaeo ?aaaneoey?ecaoe?? i?iea?aea oai?eo ?ON.

Ca’ycie ?iaioe c iaoeiaith i?ia?aiith

?iaioa ? aoaiii iaoeiaiai aeine?aeaeaiiy ia eaoaae?? aini?oaeueii?
o??o?a?? Caii??cueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo. Oeo? oaie
?I 14.00.04.95, ? Aea?ae. ?a?no?aoe?? 0195 ? 026994. Oaia aeena?oaoe??
caoaa?aeaeaia A/aiith ?aaeith CAeIO 18.03.1997.?., i?ioieie ? 7.

Iaoeiaa iiaecia ?iaioe

?ic?iaeaii aeeoa?aioe?eiaaiee i?aeo?ae aei aeai?o iaoiaeo
?aaaneoey?ecaoe?? i?iea?aea ia iniia? aia?ia?ao?/ii? ea?oeie o?aaeaiiy
ei?iia?ieo a?oa??e ? nei?i/oaaeueii? ooieoe?? na?oey.

?ic?iaeaia eeaneo?eaoe?y aeeoociiai o?aaeaiiy ei?iia?ieo a?oa??e.

Oaeineiiaeaia oaoi?ea iai?yii? ?aaaneoey?ecaoe?? i?iea?aea eeaioai
aaeeeiai naeueieea c i?aaith oeoieiai-naeueieeiaith a?oa???th (IONA).

?ic?iaeai? iieacaiiy ? oaoi?ea aeeiiaiiy iaeiiiiiaioii? iia?aoe??, yea
ii?aeio? AEO ? iai?yio ?aaaneoey?ecaoe?th i?iea?aea.

Nenoaiaoeciaai? iieacaiiy aei ??cieo iaoiae?a ?aaaneoey?ecaoe??
i?iea?aea. Noi?ioeueiaai? e?eoa??? a?aeai?o oai?eo aei
o??o?a?/iiai e?eoaaiiy aa??aioii? noaiiea?ae??.

I?aeoe/ia cia/ei?noue ?iaioe

O ?iaio? iaa?oioiaaia iaiao?aei?noue aeeoa?aioe?eiaaiiai i?aeoiaeo o
aeai??

iaoiaeo o??o?a?/iiai e?eoaaiiy ?ON ia iniia? aeaieo aia?ia?ao?? ?
nei?i/oaaeueii? ooieoe?? na?oey.

Cai?iiiiiaaia eeaneo?eaoe?y aeeoociiai o?aaeaiiy ei?iia?ieo a?oa??e
aeicaieeea iaa?oiooaaoe iaiao?aei?noue aeeiiaiiy iai?yii?
?aaaneoey?ecaoe?? i?iea?aea o aeiaaeeao ae?aaeaiiai aeeoociiai o?aaeaiiy
ei?iia?ieo a?oa??e, aea i?e caaeia?eueiiio i?iea?ae?aeueiiio ?aca?a?.

Iaa?oioiaaii aeioe?euei?noue niieo/aiiy AEO ? iai?yieo iaoiae?a
?aaaneoey?ecaoe?? i?iea?aea.

Eiie?aoeciaaii iieacaiiy aei o??o?a?/iiai e?eoaaiiy aa??aioii?
noaiiea?ae??, oaeineiiaeaiee aeinooi aei c??/anoiai aocea.

Iniaenoee aianie

Aeena?oaoe?y yaey? niaith naiino?eio ?iaioo aaoi?a, yeee c?a?aa
ee?i?/iee iaoa??ae ? i?ia?a eiai aiae?c. Aaoi?ii aaeineiiaeaia
iaoiaeeea iia?aoe?e oa aecia/ai? iieacaiiy aeey ?? aeeiiaiiy.
A?eueo?noue iia?aoe?e i?iaaaeaia ca o/anoth aaoi?a. Iei i?iaaaeaia
noaoenoe/ia ia?iaea iaoa??aeo, oaenoiaa ? a?ao?/ia ioi?ieaiiy
?acoeueoao?a.

?iaioa ? iniaenoith i?aoeath. ?acoeueoaoe ?ia?o ni?aaaoi??a ca
ioae?eaoe?yie aei aeena?oaoe?? ia aeeth/ai?.

Ai?iaaoe?y ?iaioe

?acoeueoaoe ?iaioe aeiiia?aeaeeny ? iaaiaa?thaaeeny ia Ananithci?e
iaoeia?e eiioa?aioe?? a i. Caii??aeaey, 1991 ?. ; ia can?aeaiiyo
iaoeiaiai oiaa?enoaa o??o?a?a Caii??cueei? iaeano? a 1996, 1997, 1998
?ieao; ia ui??/ieo i?aeia?iaeieo eiioa?aioe?yo anioe?aoe??
na?oeaai-noaeeiieo o??o?a?a Oe?a?ie a i. Ee?a? a 1994, 1995, 1996, 1997
?ieao.

Ca oaiith aeena?oaoe?? iioae?eiaaii 14 ?ia?o. Ioae?eaoe?? iiai?noth
a?aeoai?ththoue ci?no aeine?aeaeaiue.

No?oeoo?a oa ianya ?iaioe

Aeena?oaoe?y aeeeaaeaia ia 160 noi??ieao iaoeiiieniiai oaenoo ?
neeaaea?oueny c anooio, iaeyaeo e?oa?aoo?e (1 ae.), aeanieo
aeine?aeaeaiue (4 ae.), caeeth/ii? /anoeie, aeniiae?a oa i?aeoe/ieo
?aeiiaiaeaoe?e.

Iieaae/ee e?oa?aoo?e neeaaea? 258 ?ia?o. ?iaioa ?ethno?iaaia 8
oaaeeoeyie oa 52 iaethieaie.

Iaoa??aee oa iaoiaee aeine?aeaeaiiy

O iniiao ?iaioe iieeaaeai? niinoa?aaeaiiy iaae oai?eie, ye? ianoaaeai? e
iia?iaai? ca ia??iae c 1991 ii 1998 ?iee c ae?aaiicii ?ON (219 oai?eo).
C ieo 212 (96.8 %) — /ieia?ee, 7 (3.2 %) — ae?iee. Na?aae ianoaaeaieo
oai?eo ia?aaaaeaee iaoe??ioe i?aoeacaeaoiiai a?eo a?ae 31 aei 60 ?ie?a.
Na?aaei?e a?e neeaa 50.1 5.3 ?ieo. Oai?? aoee iiae?eai? ia aea? a?oie:
? a?. — c aoa?ineea?ioe/iei o?aaeaiiyi ei?iia?ieo a?oa??e (204 oai?eo);
II a?. — c aa??aioiith noaiiea?ae??th (15 oai?eo).

O ia?aaeiia?aoe?eia ianoaaeaiiy oai?eo aoiaeeee o?aaeeoe?ei?
aeine?aeaeaiiy (nea?ae, aiaiiac, aea/aiiy caaaeueiiai noaio, AEA,
Oiii-EA, ?aioaai?anueea ianoaaeaiiy a?oaeii? ii?iaeieie, eaai?aoi?i?
aeine?aeaeaiiy), AAI, i?iaa c “?cieao”- aa?icieai ? niaoe?aeuei? iaoiaee
(eaoaoa?ecaoe?y ii?iaeiei na?oey c aia?iea?ae?ia?ao??th oa Aoi-EA
ianoaaeaiiy).

O a?aeaeaeai? oa?i?ie i?ney iia?aoe?? aeeiioaaeeny AEA, AOI-EN, AAI,
i?iaa c “?cieao”-aa?icieai. I?iaiaeeeany eiio?ieueia aia?ia?ao?y c
aeine?aeaeaiiyi ??ciiiai?oieo a?oa??aeueieo aanaei?a, o caeaaeiino? a?ae
iaoiaeo o??o?a?/iiai ao?o/aiiy:

§ noaiaea?oia naeaeoeaia ei?iia?ia?ao?y;

§ naeaeoeaia aioaa?aaeia ooioia?ao?y;

§ aia?ia?ao?y 1-? ii?oe?? e?ai? i?aeeeth/e/ii? a?oa??? c eiio?anooaaiiyi
e?ai? aioo??oiuei? a?oaeii? a?oa??? ii an?e aeiaaeei?;

§ naeaeoeaia oeae?aeia?ao?y c eiio?anooaaiiyi i?aai? oeoieiai-/aioeaai?
a?oa??? ? ?? a?eie ia iiaa?oi? na?oey.

Ii?oieia?/i? aeine?aeaeaiiy i?iaiaeeeeny ia iae?ineii?/iiio oa
i?e?ineii?/iiio ??aiyo ia iniia? ?io?aiia?aoe?eiiai oa naeoe?eiiai
iaoa??aeo. Aeeiiaii 115 iia?aoe?e, c ieo: AEO (?c canoinoaaiiyi ooo/iiai
e?iaiia?ao) — 54 (46.9 %), aia?iieanoeea EA — 12 (10.5 %), iai?yia
?aaaneoey?ecaoe?y i?iea?aea — 34 (29.5 %), ?acaeoe?y ea?ae?aeueieo
a?eie c??/anoiai aocea — 15 (13.1 %). Aini?oaeueia nia?oi?noue neeaea
2.6 % (3 oai?eo).

A?aeaeaeai? ?acoeueoaoe i?inoaaeai? o 88.8 % iaoe??io?a i?ney iia?aoe?e
o oa?i?ie a?ae 1.5 i?nyoe?a aei 5 ?ie?a.

Iniiai? ?acoeueoaoe aeine?aeaeaiiy

Ca ooieoe?iiaeueieie eeanaie (Eaiaae. anioe. ea?ae?ieia?a) oai??
?iciiae?eai? a oaeee niin?a: 2-e OE — 12 (5.5%), 3-e OE — 171 (78.1%),
4-e OE — 36 (16.4%).

Ca aeaieie ei?iia?ia?ao??, o 76.0 % aeiaaee?a ia?aaaaeaa i?aaee, o 15.0
% -ci?oaiee, o 9.0 % — e?aee oei e?iaiiinoa/aiiy na?oey. O i?ioean?
aiae?co 204 ei?iia?ia?ai o 71.1 % iaoe??io?a iaie aoei a?aei?/aia
niieo/aiiy aeeoociiai o?aaeaiiy c e?eoe/ieie noaiicaie ei?iia?ieo
a?oa??e. Eeoa o 28.9 % oai?eo aoee aeyaeai? naaiaioa?i? noaiice e
ieethc?? EA aac aeaeeiiai aeeoociiai o?aaeaiiy (?en. 1).

?en. 1. No?oeoo?a o?aaeaiiy ei?iia?ieo a?oa??e o oai?eo 1-? a?oiie.

Iaeiinoaeeiia o?aaeaiiy EA aoei aeyaeaii o 31.3 % oai?eo, aeaionoaeeiia
o?aaeaiiy — o 28.9 % iaoe??io?a, o?e ? a?eueoa ei?iia?ieo a?oa??? aoee
o?aaeai? o 20.1 % aeiaaee?a. Iiiaeeiia aeeoocia o?aaeaiiy EA aac
e?eoe/ieo noaiic?a aai ieethc?e aoei aeyaeaii o 12.3 % iaoe??io?a.
Iae/ano?oa a?aei?/aeiny o?aaeaiiy IIOA (35.0 % aeiaaee?a) ? IEA (30.0 %
oai?eo).

O i?ioean? aeine?aeaeaiiy i?iaaaeaiee aiae?c 141 ei?iia?ia?aie, ia yeeo
aoei a?aei?/aii aeeoocia o?aaeaiiy a niieo/aii? c e?eoe/ieie noaiicaie
EA. Ca iaoeie aeaieie, o 52.5 % aeiaaee?a ia?aaaaeaei aeeoocia
o?aaeaiiy on?o EA, o 32.6 % oai?eo aoei a?aei?/aii aeeoocia o?aaeaiiy a
nenoai? EEA. O 8.5 % iaoe??io?a aeyaeaia aeeoocia o?aaeaiiy a nenoai?
IEA.

Iii??ia aeeoocia o?aaeaiiy on?o EA aoei a?aecia/aii o 3.5 % oai?eo.

O 2.8 % aeiaaee?a aoei aeyaeaia iii??ia aeeoocia o?aaeaiiy a nenoai?
EEA.

A caeaaeiino? a?ae iioe?aiino? o?aaeaiiy ei?iia?ieo a?oa??e, noaio
ia?eoa?e/iiai ??/eua ? nooiaiy ii?ooaiiy nei?i/oaaeueii? ooieoe?? na?oey
ie aeae?eeee 3 ee?i?ei-aia?ia?ao?/ieo aa??aioa ?oai?/ii? oai?iae na?oey.

Aei 1-ai aa??aioa aoei a?aeianaii 33.3 % iaoe??io?a, ui iathoue
eieaeuei? noaiice ei?iia?ieo a?oa??e, caaeia?eueia aeenoaeueia ??/eua ?
aeinoaoi?e i?iea?ae?aeueiee ?aca?a. Iaoe??ioai c 1-i
ee?i?ei-aia?ia?ao?/iei aa??aioii ie ?aeiiaiaeoaaee aia?iieanoeeo
ei?iia?ieo a?oa??e, ai?oiei?iia?ia ooiooaaiiy.

10.3 % iaoe?aio?a a?aeianaii aei 2-ai ee?i?ei-aia?ia?ao?/iiai aa??aioa.
O iaoe??io?a c 2-i aa??aioii ?ON aoee aeyaeai? naaiaioa?i? e?eoe/i?
noaiice a niieo/aii? c aeeoociei o?aaeaiiyi ?ioeo ei?iia?ieo a?oa??e,
aeinoaoi?e i?iea?ae?aeueiee ?aca?a. I?e oeueiio aa??aio? o?aaeaiiy ie
aeeiioaaee iaeii/anii ai?oiei?iia?ia ooiooaaiiy ? iai?yio
?aaaneoey?ecaoe?th.

Aei 3-ai ee?i?ei-aia?ia?ao?/iiai aa??aioa aoei a?aeianaii 56.4 %
iaoe??io?a. I?e aia?ia?ao?? aoei aeyaeaia ae?aaeaia aeeoocia o?aaeaiiy
ei?iia?ieo a?oa??e c iacaaeia?eueiei aeenoaeueiei ??/euai. O?aeoe?y
aeeeaeo a iiei? neeaea iaioa 40 %. Eeoa o 25 % oai?eo c 3-i
ee?i?ei-aia?ia?ao?/iei aa??aioii aoa a?aecia/aiee i?e??no OA ia 10 % ?
a?eueoa o a?aeiia?aeue ia aaaaeaiiy “?cieao” — aa?iciey.

An?i iaoe??ioai ?c iaaeinoia??iei i?e?inoii OA aoa i?iaaaeaiee eo?n
ea?ae?io?iiii? oa?ai?? c iaoith iie?ioaiiy nei?i/oaaeueii? ooieoe??
na?oey. Oai?ei ?c aenieith OA oa aeinoia??iei i?e?inoii OA i?ney eo?no
e?eoaaiiy ie aeeiioaaee iai?yio ?aaaneoey?ecaoe?th. Neiioiiaoe/ia
oa?ai?y ?aeiiaiaeoaaeany o aeiaaeeao iaaeinoia??iiai i?e?inoo OA i?ney
e?eoaaiiy.

Oaeei /eiii, iai?yia ?aaaneoey??caoe?y iieacaia 26.3 % oai?eo ?ON c
aoa?ineea?ioe/iei o?aaeaiiyi ei?iia?ieo a?oa??e.

A ?acoeueoao? ?iciiae?eo oai?eo 3-i? a?oie ie ciiaee noi?ioethaaoe
iieacaiiy ? i?ioeiieacaiiy aei iai?yii? ?aaaneoey?ecaoe??.

Ia iaoo aeoieo, iieacaiiy aeey iai?yii? ?aaaneoey?ecaoe?? oae?:

3-4-e ooieoe?iiaeueiee eean noaiiea?ae??;

· o?aeoe?y aeeeaeo 40 %;

· caaeia?eueiee i?iea?ae?aeueiue ?aca?a (i?e??no OA ia 10 % ? a?eueoa
i?ney aaaaeaiiy “?cieao”- aa?iciey aai i?ney eo?no e?eoaaiiy);

· aeeoocia aoa?ineea?ioe/ia o?aaeaiiy ei?iia?ieo a?oa??e c aoyaiaiiyi o
i?ioean aeenoaeueiiai ??/eua;

· ae??aiee eae?a? ei?iia?ieo a?oa??e (ae?aiao? a?oa??? iaioa 1.0 ii.);

· a?aenooi?noue oaoi?/ieo oiia aeey aia?iieanoeee aai AEO;

· iaaeeeoeiaa aaaa ia a?eueoa 8-10 ea.

Iai?yia ?aaaneoey?ecaoe?y i?iea?aea aeeiioaaeany oai?ei o?ueiia
niiniaaie. Aea?? niiniao iai?yii? ?aaaneoey?ecaoe?? caeaaeaa a?ae:

1. aia?ia?o?oaeoii?ee o?aaeaiiy ei?iia?ieo a?oa??e;

2. i?eaeaoiino? aaeeeiai naeueieea aeey ?aaaneoey?ecaoe??;

3. noiooi?o caoai?thaaiue.

Iaee??iiy 2 nooiaiy ? a?eueoa, ?ai?oa ia?aianai? iia?aoe?? ia aa?oiueiio
? na?aaeiueiio iiaa?oao /a?aaii? ii?iaeieie aoee niaoeeo?/ieie
i?ioeiieacaiiyie aei aeei?enoaiiy aaeeeiai naeueieea aeey iai?yii?
?aaaneoey?ecaoe??.

Iai?yia ?aaaneoey?ecaoe?y i?ioeiieacaia i?e iayaiino? oaeeo
caoai?thaaiue, noai?a:

· aino?ee, i?aeaino?ee ia??iaee ?ioa?eoo i?iea?aea;

· ia?aianai? iia?aoe?? ia i?aaiao /a?aaii? ii?iaeieie;

· caoai?thaaiiy ia/?iee, ie?ie ?c iaaeinoaoi?noth ooieoe?? 2-ai nooiaiy
? a?eueoa;

· caoai?thaaiiy i?aai?a aeeoaiiy c iaaeinoaoi?noth ooieoe?? 2-ai nooiaiy
? a?eueoa;

· aino?a ii?ooaiiy iiceiaiai e?iaiia?ao;

· ooaa?eoeueic, iieieia?/i? caoai?thaaiiy, oeoe?iaee ae?aaao, ineo?/i?
caoai?thaaiiy;

· a?e a?eueoa 60 ?ie?a.

O caeaaeiino? a?ae niiniao iai?yii? ?aaaneoey?ecaoe?? ie aeae?eeee 3
i?aea?oie c iia?iaaieo oai?eo:

a) 20 (58.8 %) iaoe??io?a — ?aaaneoey?ecaoe?y i?iea?aea eeaioai aaeeeiai

naeueieea c i?aaith oeoieiai-naeueieeiaith a?oa???th (IONA) ? eeaioai
ia?eea?ae?aeueii? aee?iai? ee?oeiaeie c ?iieaioiaaiith o i?e e?aith
aioo??oiueith

a?oaeiith a?oa???th (EAAA).

a) 8 (23.5 %) iaoe??io?a — ?aaaneoey?ecaoe?y i?iea?aea eeaioai
ia?eea?aeeaeueii? aee?iai? ee?oeiaeie c ?iieaioiaaiith o iueiai EAAA.

a) 6 (17.7 %) iaoe??io?a iia?iaai? niiniaii, i?e yeiio ii?aeiaeeny
ai?oiei?iia?ia ooiooaaiiy ? iai?yia ?aaaneoey?ecaoe?y. Aeey iai?yii?
?aaaneoey?ecaoe?? aeei?enoiaoaaee eeaiioue aaeeeiai naeueieea c IONA aai
ia?eea?ae?aeueio aee?iao ee?oeiaeio c ?iieaioiaaiith o i?e EAAA.

30 (88.2 %) oai?ei, i?ae /an ao?o/aiiy aeiaeaoeiai aoea aeeiiaia
?acaeoe?y ia?aaei?o ai?oaeueieo nieao?iue.

Aaaaeaeiny, ui aeinoia??iee aoaeo i?ney iai?yii? ?aaaneoey?ecaoe??
ianoa? o?eueee /a?ac 12-16 oeaei?a i?ney iia?aoe??. Oiio an?i
iaoe??ioai i?iaiaeeeany ia?aaeiia?aoe?eia i?aeaioiaea ia i?ioyc? 2 — 2.5
oeaei?a. Aei iia?aoe?? oai?ei i?ecia/aeeny ?ia?a?oi?e AIO, i?ieiiaiaai?
i?o?aoe, ae?o?aoeee, iaoaaie?/i? i?aia?aoe, iaiaaeoaaany ?aaeei ?ooiai?
aeoeaiino?.

?aaaneoey?ecaoe?y i?iea?aea eeaioai aaeeeiai naeueieea c i?aaith
oeoieiai-/aioeaaith a?oa???th aeeiioaaeany ca oaeith iaoiaeeeith. I?ae
caaaeueiith aianoac??th i?iaiaeeeany aa?oiuei-na?aaeeiia eaia?ioii?y,
?aa?c?y i?aai?a /a?aaii? ii?iaeieie, ?aa?c?y aaeeeiai naeueieea ? i?aai?
oeoieiai-naeueieeiai? a?oa???.

Aeey iai?yii? ?aaaneoey?ecaoe?? aeei?enoiaoaaany naeueiee ?c iaaaee/eith
e?euee?noth aee?iai? oeaieie ? aeia?a ?icaeiooith ia?aaeath aianoiiic?a
i?ae a?eeaie IONA.

I?e oi?ioaaii? eeaioy a?aoiaoaaeeny iniaeeaino? aia?ia?o?oaeoii?ee
naeueieea. I?ney aee?ithaaiiy eeaioy naeueieea c i?aai? ONA
aeinoaoiuei? aeiaaeeie ? oe?eie aeeiioaaeany iiaia iiaeiaaeiy
noa?iioii?y.

I?ney ?aa?c?? a?oa??e na?oey i?iaiaeeeany ?acaeoe?y ia?aaei?o
ai?oaeueieo nieao?iue. *a?ac a?eii a nooiaeeeuei?e /anoei? ae?ao?aaie
i?iaiaeeany eeaiioue aaeeeiai naeueieea a ii?iaeieio ia?eea?aea.
?aaaneoey?ecaoe?th i?iea?aea eeaioai aaeeeiai naeueieea c IONA ie
aeeiioaaee i?e o?aaeaii? ei?iia?ieo a?oa??e ye caaeiuei?, oae ?
ia?aaeiuei? iiaa?oiiue na?oey.

Aeey oi?ioaaiiy c?iuaiue i?ae naeueieeii ? na?oeai ie canoiniaoaaee
oaeuee. Eeaiioue aaeeeiai naeueieea c IONA oeeaaeaany a cii?
e?iaiiinoa/aiiy iaea?eueo aoa?ineea?ioe/ii ci?iaieo ei?iia?ieo a?oa??e ?
o?enoaaany aei na?oey iaeeie/ieie aoceiaeie oaaie.

?aaaneoey?ecaoe?th i?iea?aea aee?iaith ee?oeiaeiith ia?eea?aea c
ia?ai?uaiith a ia? e?aith aioo??oiueith a?oaeiith a?oa???th ie
aeeiioaaee o aeiaaeeao, eiee iaei i?noea o?aaeaiiy a?oa??e
ia?aaeiuei-aa?o?aeiai-aieiai? no?iee e?aiai oeoii/ea. Ie canoiniaoaaee
aeinooi /a?ac 5-a i?ae?aa??’y e?ai? a?oaeii? ii?iaeieie aai iiaio
iiaeiaaeith noa?iioii?th.

Aeey aeae?eaiiy e?ai? AAA aeei?enoiaoaaee niaoe?aeueiee ?ao?aeoi?
a?oaeeie. E?aa AAA c noi?ia?aeieie aaiaie aeae?eyeany o aeaeyae? eeaioy
a?ae 2-ai aei 7-ai i?ae?aaa?iiai i?ii?aeeo. Aeenoaeueiee o?aaiaio EAAA
ia?aa’ycoaaany. I?e aee?ithaaii? eeaioy noaaeeee ca oei, uia o aen?/aio
/anoeio iio?aieea iaea?eueoa e?euee?noue aee?iai? ee?oeiaeie ia?eea?aea.
Eeaiioue ia?aaa?oaee aee?iaith ee?oeiaeiith aei ai?ea?aeo. *a?ac eaiae
o aee?ia?e ee?oeiaei? i?ioyaaany eeaiioue ?c EAAA. Aeenoaeueiee
e?iaoeue EAAA o?enoaaany aei e?ath ia?eea?ae?aeueiiai eeaioy. Iiaa?oiy
ia?eea?ae?aeueii? aee?iai? ee?oeiaeie ia?iaeyee oaeueeii. Eeaiioue
o?enoaaee aei iiaa?oi? na?oey aoceiaeie oaaie ao?aaiaoe/iith ieoeith.

O aeiaaeeao iioe?aiiai o?aaeaiiy ei?iia?ieo a?oa??e ie canoiniaoaaee
iaeaea? iaoiaeeee iai?yii? ?aaaneoey?ecaoe??.

I?e oeueiio na?oea i?aeoe/ii oe?eeii “iai?oaeiny” oeaieiith, ui i?noeoue
aaeeeo e?euee?noue noaeei. Oaeuee, aeei?enoaiee i?ae /an ao?o/aiiy,
aeeeeeaa i?noeaaa anaioe/ia caiaeaiiy a aee?ia?e ee?oeiaei? oa
ai?ea?ae?. I?noeaaee anaioe/iee caiaeueiee i?ioean, ia iaoo aeoieo, aoa
aaaeeeaei ? ni?eyoeeaei /eiieeii o i?ioean? oi?ioaaiiy “iiaeo”
i?e?inoaeeiieo ca’yce?a i?ae i?aaiii, ui a?ae/oaa? o?ii?/io ?oai?th, ?
ia?ai?uaieie ia eiai iiaa?oith oeaieiaie.

O aeiaaeeao, eiee i?e ei?iia?ia?ao?? aoei aeyaeaia aeeoocia o?aaeaiiy
iaeiiai a?oa??aeueiiai aanaeio a ii?aeiaii? c e?eoe/ieie eieaeueieie
noaiicaie ?ioeo ei?iia?ieo a?oa??e, ie aeeiioaaee iaeii/anii
ai?oi-ei?iia?ia ooiooaaiiy ? iai?yio ?aaaneoey?ecaoe?th.

Onueiai aoei iia?iaaii 34 iaoe??ioa c ae?aaeaiei aeeoociei o?aaeaiiyi
ei?iia?ieo a?oa??e, iacaaeia?eueiith OA ? aenieei ooieoe?iiaeueiei
eeanii noaiiea?ae??.

Aei iia?aoe?? c iaoith ca?eueoaiiy OA o 85.3 % oai?eo i?iaiaeeeany
niaoeeo?/ia ea?ae?io?iiia oa?ai?y. Iai?yia ?aaaneoey?ecaoe?y
aeeiioaaeany o?eueee o aeiaaeeao aeinoia??iiai i?e?inoo OA i?ney
e?eoaaiiy. I?neyiia?aoe?eia eaoaeuei?noue neeaea 2.9 %.

Ca aeaieie ooieoe?iiaeueieo aeine?aeaeaiue, aeinoia??iee aoaeo i?ney
iai?yii? ?aaaneoey?ecaoe?? i?iea?aeo (I?I) ianoaaaa /a?ac 12-16 oeaei?a
i?ney ao?o/aiiy. Noaa?eueii aa?i? ?acoeueoaoe /a?ac 3 ?iee a?aei?/ai? o
88.9% oai?eo (?en. 2).

1.- aei I?I; 2.- 6 i?nyoe?a; 3.- 1 ??e; 4.- 3 ?iee.

?en. 2. ?iciiae?e oai?eo ca OE noaiiea?ae?? i?ney I?I eeaioai aaeeeiai
naeueieeo c IONA oa aee?iai? ee?oeiaeie ia?eea?aeo n EAAA.

I?e ianoaaeaii? aoei a?aecia/aia cieaeaiiy ooieoe?iiaeueiiai eeano
noaiiea?ae??, i?aeaeuaiiy oiea?aioiino? aei o?ce/iiai iaaaioaaeaiiy,
a?aenooi?noue iio?aae a i?eeii? i?o?ao?a.

Aa?iee ?acoeueoao i?ney iai?yii? ?aaaneoey?ecaoe?? aoa iaoiiaeaiee
oi?ioaaiiyi aaeeei? aeiaeaoeiai? noaeeiii? ia?aae? i?ae aaeeeei
naeueieeii, aee?iaith ee?oeiaeiith ia?eea?aea c EAAA oa ?oai?ciaaiei
i?iea?aeii.

I?e eiio?ieuei?e aia?ia?ao?? /a?ac 1 ??e ? a?eueoa i?ney ao?o/aiiy aoei
a?aecia/aia i?iieeiaiiy eiio?anoo c i?aai? oeoieiai-naeueieeiai? a?oa???
? e?ai? aioo??oiuei? a?oaeii? a?oa??? a ei?iia?i? a?oa???. No?eeee
iiceoeaiee ?acoeueoao caa??aaany iacaaaeath/e ia i?ia?anoaaiiy
aoa?ineea?ico a ei?iia?ieo a?oa??yo.

Ia i?aenoaa? aeeiiaii? ?iaioe, ie c?iaeee aeniiaie, yeee ia ni?aiaaea? c
aeoieith Lesperance J. et al.(1972) ? ?aaioi?eiaa A.N. c?
ni?aaao.(1983). Aaoi?e aeae?eyee 3 a?oie oai?eo ?ON: a) “?aeaaeuei?”
eaiaeeaeaoe ia ?aaaneoey?ecaoe?th — ?c eieae?ciaaiei i?ieneiaeueiei
noaiicii ? a?eueiei iaci?iaiei aeenoaeueiei ??/euai; a) oiiaii
iia?aaaeuei? oai?? — c i?ieneiaeueiei noaiicii ? ci?iaie a aeenoaeueiiio
a?aeae?e? noaeeie; a) “iaiia?aaaeuei?” oai?? — oai??, o yeeo ia? i?noea
aeeoocia, ui aeaeaei caeoei, o?aaeaiiy aeenoaeueiiai ??/eua.

Ie aaaaea?ii, ui a caeaaeiino? a?ae iioe?aiino? o?aaeaiiy ei?iia?ieo
a?oa??e, noaio ia?eoa?e/iiai ??/eua ? nooiaiy ii?ooaiiy nei?i/oaaeueii?
ooieoe?? i?iea?aea aa?oi aeae?eyoe oae? ee?i?ei-aia?ia?ao?/i? aa??aioe
?ON:

1-e aa??aio — eieaeuei? noaiice ei?iia?ieo a?oa??e, caaeia?eueia
aeenoaeueia ??/eua ? aeinoaoi?e i?iea?ae?aeueiee ?aca?a. I?e oeueiio
aa??aio? aeioe?euei?: aia?iieanoeea ei?iia?ieo a?oa??e, ai?oiei?iia?ia
ooiooaaiiy.

2-e aa??aio — niieo/aiiy eieaeueieo e?eoe/ieo noaiic?a ei?iia?ieo
a?oa??e ?c aeeoociei o?aaeaiiyi ?ioeo EA, aeinoaoi?e i?iea?ae?aeueiee
?aca?a.

Iaoe??ioai c 2-i aa??aioii, ia iaoo aeoieo, iieacaia ai?oiei?iia?ia
ooiooaaiiy a niieo/aii? c iai?yiith ?aaaneoey?ecaoe??th.

3-e aa??aio — ia?aaaaeii aeeoocia o?aaeaiiy ei?iia?ieo a?oa??e,
iacaaeia?eueia aeenoaeueia ??/eua, o?aeoe?y aeeeaeo a niiei? — iaioa 40
%, iaia? i?e?inoo OA i?ney aaaaeaiiy “?cieao”-aa?iciey, a?aenooi?
oaoi?/i? oiiae aeey AEO.

C iaoith ciaioaiiy o?ii?/ii? ?oai?? i?iea?aea ie ?aeiiaiaeo?ii
aeeiioaaoe iai?yio ?aaaneoey?ecaoe?th. Oey iia?aoe?y iiaea aooe aeeiiaia
o?eueee o aeiaaeeo aeinoia??iiai i?e?inoo OA i?ney eo?no eiina?aaoeaii?
oa?ai??. “Iaiia?aaaeueieie” oai?eie ie i?iiiio?ii aaaaeaoe eeoa oeo
iaoe??io?a, o eio?eo iaia? i?e?inoo OA i?ney eo?no e?eoaaiiy. Naia oe?e
eaoaai??? oai?eo ie ?aeiiaiaeo?ii i?iaiaeeoe neiioiiaoe/io oa?ai?th.

Oaeei /eiii, aea?? iaoiaeo ?aaaneoey?ecaoe?? i?iea?aea iaoiiaeaiee
iniaeeainoyie o?aaeaiiy EA, noaiii aeenoaeueiiai ??/eua ?
ia?aaeiia?aoe?eiei noaiii i?iea?ae?aeueiiai ?aca?ao na?oey.

O oai?eo c iaae?aaeaiei aeeoociei o?aaeaiiyi EA, caaeia?eueiei
aeenoaeueiei ??/euai aeioe?eueii canoiniaoaaoe ooiooth/? iia?aoe?? c
ia?aaaaeiei aeei?enoaiiyi e?ai? AAA i?e ?aaaneoey?ecaoe?? IIOA ? ??
a?eie.

Iai?yia ?aaaneoey?ecaoe?y i?iea?aea iieacaia i?e iacaaeia?eueiiio
aeenoaeueiiio ??/eu? EA ? caa?aaeaiiio i?iea?ae?aeueiiio ?aca?a?.
Caaaeueia iaee??iiy, iaaeeeoeiaa aee?iaa ee?oeiaeia aaeeeiai naeueieea,
?ai?oa ia?aianai? iia?aoe?? ia aa?oiueiio ? na?aaeiueiio iiaa?oao
/a?aaii? ii?iaeieie – oea i?ioeiieacaiiy aeey iai?yii?
?aaaneoey?ecaoe?? i?iea?aea.

I?e iioe?aiiio o?aaeaii? EA, iecueeiio i?iea?ae?aeueiiio ?aca?a?,
a?aenooiino? aeinoia??iiai i?e?inoo OA i?ney e?eoaaiiy iieacaia
neiioiiaoe/ia eiina?aaoeaia oa?ai?y, iaiaaeaiiy ?ooiai? aeoeaiino?.

Oaeei /eiii, aeeoa?aioe?eiaaiee i?aeo?ae o aeai?? iaoiaeo
?aaaneoey?ecaoe?? i?iea?aea, yeee a?oioo?oueny ia ioe?ioe? ea?oeie
o?aaeaiiy EA ? noaio nei?i/oaaeueii? ooieoe?? na?oey, aeei?enoaiiy
iaoiaeeee aeyaeaiiy “noiaaii?” ?oai?/ii? aeai?an?? eiio?aeoeeueii?
ooieoe?? i?iea?aea, aeicaiey? iie?ioeoe ?acoeueoaoe o??o?a?/iiai
e?eoaaiiy ?ON.

Ae?aaiinoeea aacinianoe/ii? noaiiea?ae?? ia no/aniiio aoai? ia neeaaea?
iniaeeaeo o?oaeiiu?a. O a?o/eciyi?e ? cao?aei?e e?oa?aoo?? oe?iei
iaaiai?ththoueny ieoaiiy eiina?aaoeaiiai e?eoaaiiy aa??aioii?
noaiiea?ae?? (Aa?ia I.I. e niaao., 1997, Cannon R.et al.,1992).

I?ioa, Einothe O.O. ? Carmici P. o nai?o ?iaioao aeacothoue ia
iaaeinoaoith aoaeoeai?noue iaaeeeaiaioicii? oa?ai?? oe??? oi?ie ?ON.
?ieue o??o?a?/ieo iaoiae?a o e?eoaaii? niacio ei?iia?ieo a?oa??e
aeioaia? caeeoa?oueny aeeneooaaaeueiith ? iaeiaea/aiith. I.Ae.Eiyc?a c
iaoith ciaioaiiy niacio EA aeaeaeya c??/anoee aocie oai?ei c
??ciiiai?oieie oi?iaie ?ON. Iiaeaeueoee ?icaeoie oeae iai?yiie
iaea?aeaa o ?iaioao Ieoaeiaa A.A. (1995.), ui aeeiioaaa “aeaia?aaoe?th”
na?oey oai?ei aacinianoe/iith noaiiea?ae??th.

O 15-oe (6.0%) iaoeo iaoe??io?a o i?ioean? ianoaaeaiiy aoea
ae?aaiinoiaaia aa??aioia noaiiea?ae?y. An? oai?? iaee aeinoia??ii aenieo
o?aeoe?th aeeeaeo 58.6±3.4%. I?e aaaaeaii? «?cieao»-aa?iciey i?ae /an
i?enooio noaiiea?ae?? /a?ac 2.5 oaeeeie niinoa??aaany ei?ioei/aniee cnoa
naaiaioa ST aei ?cie?i??.

Eiina?aaoeaia e?eoaaiiy ca i?noeai i?iaeeaaiiy ia aeaaaei aaaeaiiai
aoaeoo. Aeey ae??oaiiy ieoaiiy i?i iaiao?aei?noue o??o?a?/iiai e?eoaaiiy
on?i oai?ei i?iaiaeeeany eiiieaenia iaaeeeaiaioicia oa?ai?y ia i?ioyc?
20 aei?a.

Ie canoiniaoaaee: aioaaii?noe eaeueoe?th, naeaeoeai? aaooa-aeieaoi?u,
ea?aeeeao, aeoiaaa?i, naaeaoeai? i?aia?aoe. I?ney eo?no e?eoaaiiy
iiaoi?thaaeany AAI. Oai?ei c iiceoeaieie iaaaioaaeoaaeueieie i?iaaie
i?ney i?eeiio ea?ae?io?iiieo i?aia?ao?a ie aeeiioaaee o??o?a?/ia
ao?o/aiiy.

Ie aaaaea?ii, ui iieacaiiy aei iia?aoeaiiai e?eoaaiiy aa??aioii?
noaiiea?ae?? ne?aeoth/?:

· noeneoth/? aie? ca a?oaeeiith a niiei? ? i?e iaaaioaaeaii?;

· oeiiaa ee?i?ea noaiiea?ae??;

· cnoa naaiaioa ST ieae/a ?cie?i?? ia 1.5 ii. ? a?eueoa i?ae /an
i?enooio;

· iiceoeai? ?acoeueoaoe aaeia?aiiao???;

· “ae??aithaaiiy” naaiaioa ST i?ney aaaaeaiiy “?cieao”-aa?iciey;

· ei?ioei/aniee aoaeo i?e canoinoaaii? i?o?ao?a, aaooa-aeieaoi??a,
aioaaii?no?a eaeueoe?th;

· noeeuei?noue aei niacio ei?iia?ieo a?oa??e i?ae /an aia?ia?ao??;

· a?aenooi?noue ieethc?eii-noaiioe/ieo o?aaeaiue o ei?iia?ieo a?oa??yo
i?e aia?ia?ao??.

I?ioeiieacaiiyie aei ao?o/aiiy, ia iaoo aeoieo, ?: iioe?aiee
inoaioiiae?ic oeeii-a?oaeiiai a?aeae?eo o?aaoa, a?ia?oii?/ia oai?iaa 3-4
noaae?e, iaee??iiy 3-4 nooiaiy, iieieia?/i? caoai?thaaiiy,
ia/?ieiai-ie?eiaa iaaeinoaoi?noue 2-3 nooiaiy.

An?i oai?ei, ui no?aaeaeathoue aa??aioiith noaiiea?ae??th, aoea aeeiiaia
?acaeoe?y ea?ae?aeueieo a?eie c??/anoiai aocea. Ie aaaaea?ii aeinoaoi?i
aeaeaeaiiy ieaeiuei-iaae?aeueieo a?eie c??/anoiai aocea.

?acaeoe?y onueiai aocea, ia iaoo aeoieo, iaaeioe?eueia a ca’yceo c eiai
aaaeeeaith ?ieeth a ?aaoeyoe?? aaaaoaoeaieo ooieoe?e i?aai?cio.

Ca aeaieie AEA ie aecia/aee ciio ia?aaaaeii? ?oai?? i?iea?aea. O
caeaaeiino? a?ae oeueiai aeae?aeany noi?iia aeey ?acaeoe?? ea?ae?aeueieo
a?eie c??/anoiai aocea. I?e ?oai?? caaeiuei? no?iee e?aiai oeoii/ea ie
?acaoe?thaaee a?eee i?aaiai c??/anoiai aocea, a o aeiaaeeao ?oai??
ia?aaeiuei? ? a?/ii? no?iie — a?eee e?aiai c??/anoiai aocea. I?e
?aoeeaeea? aia?iicieo i?enooi?a ie aeeiioaaee ?acaeoe?th ea?ae?aeueieo
a?eie c i?ioeeaaeii? noi?iie.

I?ae /an iia?aoe?? aeei?enoiaoaaany iaaeeeth/e/iee, aeno?aieaa?aeueiee
aeinooi. I?ney ?icn?/aiiy oe??e, ieyoecie aeinooiii /a?ac iaae?aeueio
ii?oe?th eeaaeueiiai i’yca a?coae?coaaeanue 1-y ii?oe?y i?aeeeth/e/ii?
a?oa???. Aeae?eyeany o?aaoeaaa a?oa??y a?ey a?/ea, o?aaoeaaa aaia a
on?o aeiaaeeao ia?aa’ycoaaeanue.

O ieaeiuei-iaae?aeueiiio ?ic?, ooai?aiiio a?/eii o?aaoeaai? ?
i?aeeeth/e/ii? a?oa??e aeae?eyany c??/anoee aocie. A?coae?coaaeenue ?
?acaoe?thaaeenue eiai ieaeiuei-iaae?aeuei? a?eee i?ioyaii. I?e
a?noieia?/iiio aeine?aeaeaii? aeaeaeaieo a?eie c??/anoiai aocea aoee
aeyaeai? oa?aeoa?i? iciaee aaiae?ii?oo.

Ie aaaaea?ii, ui o?ii?/ia caiaeaiiy cacia/aieo aaiae??a ? aaaeeeaei
iaoiaaiaoe/iei /eiieeii o iaoai?ci? oi?ioaaiiy iaoieia?/iiai niacio
ei?iia?ieo a?oa??e.

An? oai?? aeia?a ia?aianee iia?aoe?th. Eaoaeueieo aeiaaee?a ia aoei.
I?ney iia?aoe?? an? iaoe??ioe a?aecia/eee cieeiaiiy i?enooi?a
noaiiea?ae??, noaa?e?caoe?th a?oa??aeueiiai oeneo, i?aeaeuaiiy
oiea?aioiino? aei iaaaioaaeaiiy, iie?ioaiiy yeino? aeeooy. I?e
aaeia?aiiao??? o oa?i?ie aei 1 ?ieo i?ney iia?aoe?? ?oai?? i?iea?aea o
an?o ianoaaeaieo oai?eo ia aoei ca?a?no?iaaii.

Ca aeaieie eoioeyoeaiiai aiae?co no?ee? iiceoeai? ?acoeueoaoe aei 3-ai
?ieo caa?aaeeny a on?o oai?eo(?en. 3).

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E???

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yy????y?y?y??yy?yyy????4?????5????’yy??? ???????

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yyy???????????????????E????
???u??????????»????-????-????’yy??? ???????

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???????

????-????-??????????? yyy????uoy??????1. aei iia?aoe??; 2.
6 i?nyoe?a; 3. 1 ??e; 4. 3 ?iee.

?en.3. ?iciiae?e oai?eo ca OE noaiiea?ae?? o ??ci? oa?i?ie i?ney
iia?aoe??: ?acaeoe?? ea?ae?aeueieo a?eie c??/anoiai aocea.

O 2-o oai?eo /a?ac 1 ??e i?ney ao?o/aiiy ni?aaa aeeiiaia ?acaeoe?y
ea?ae?aeueieo a?eie c??/anoiai aocea ce?aa a ca’yceo c ?aoeeaeeaii
i?enooi?a noaiiea?ae??. I?e iiaeaeueoiio niinoa?aaeaii?, aei 3-ai ?ieo
i?ney ia?oi? iia?aoe??, aeyaeaii noaa?eueiee iiceoeaiee ?acoeueoao.

Oaeei /eiii, ie aaaaea?ii, ui oai?ei aa??aioiith noaiiea?ae??th nii/aoeo
iaiao?aeii i?iaiaeeoe iaaeeeaiaioicia e?eoaaiiy.

sseui eiina?aaoeaia oa?ai?y ia ieaco? iiceoeaiiai aoaeoo, ie
?aeiiaiaeo?ii aeeiiaoe ?acaeoe?th ea?ae?aeueieo a?eie c??/anoiai aocea.
Ia iaoo aeoieo, iaea?eueo aeioe?eueiei ? iaeio?aaiaoe/iee iaaeeeth/e/iee
aeno?aieaa?aeueiee aeinooi. I?e ?aoeeaeea? noaiiea?ae?? i?ney iia?aoe??,
aaaaea?ii ca iaiao?aeia aeeiiaoe aiaeia?/io iia?aoe?th c i?ioeeaaeii?
noi?iie.

Aeniiaee

1. Ca aeaieie ei?iia?ia?ao?? o 26.3 % oai?eo ?ON iieacaia iai?yia
?aaaneoey?ecaoe?y i?iea?aea o ca’yceo c aeeoociei o?aaeaiiyi ei?iia?ieo
a?oa??e, c aeeeth/aiiyi aeeiiaiiy ai?oi-ei?iia?iiai ooiooaaiiy.

2. Ai?oi-ei?iia?ia ooiooaaiiy c iai?yiith ?aaaneoey?ecaoe??th i?iea?aea
iieacaii 10.3 % iaoe??io?a, o yeeo i?e ei?iia?ia?ao?? aeyaeai?
naaiaioa?i? noaiice a niieo/aii? c aeeoociei o?aaeaiiyi ae?oaeo
ei?iia?ieo a?oa??e.

3. O?aoiaoth/e o?eaae?noue oa?i?io aeey oi?ioaaiiy aeiaeaoeiaiai
e?iaiiinoa/aiiy i?iea?aea i?e iai?yieo iaoiaeao ?aaaneoey?ecaoe?? oe?
iia?aoe?? i?ioeiieacai? oai?ei c o?aeoe??th aeeeaeo iaio 40 %.

4. Iai?yi? iaoiaee ?aaaneoey?ecaoe?? i?iea?aea c aeei?enoaiiyi e?ai? AAA
oa oeoieiai-naeueieeiai? a?oa??? iaaeathoue o 88.9 % aeiaaeeao
noaa?eueiee iiceoeaiee ?acoeueoao o a?aeaeaeai? n?iee niinoa??aaiiy.

5. I?e aa??aioi?e noaiiea?ae?? iieacaia ?acaeoe?y ea?ae?aeueieo a?eie
c??/anoiai aocea. Noi?iio ?acaeoe?? a?eie c??/anoiai aocea ne?ae
aeae?aoe a caeaaei?no? a?ae ciie ia?aaaaeii? ?oai?? i?iea?aea.

6. O a?aeaeaeai? no?iee i?ney ?acaeoe?? c??/anoiai aocea iiceoeai?
?acoeueoaoe a?aecia/ai? o 97.6 % iaoe??io?a.

I?aeoe/i? ?aeiiaiaeaoe??

1. I?e aeai?? iaoiaeo ?aaaneoey?ecaoe?? i?iea?aea iaiao?aeii a?aoiaoaaoe
oa?aeoa? o?aaeaiiy EA, noai aeenoaeueiiai ??/eua ? nei?i/oaaeueii?
ooieoe?? na?oey.

2. Aeey ioe?iee i?iea?ae?aeueiiai ?aca?ao aeioe?eueii aeei?enoiaoaaoe
i?iao c “?cieao”-aa?icieai.

3. ?aeiiaiaeo?oueny aeeiioaaoe ai?oi-ei?iia?ia ooiooaaiiy a eiia?iaoe??
c iai?yiith ?aaaneoey?ecaoe??th i?e niieo/aii? aeeoocieo o?aaeaiue
iaeieo

EA ?c naaiaioa?ieie noaiicaie ?ioeo.

4. I?e iai?yi?e ?aaaneoey?ecaoe?? ia?aaaaeii aeei?enoiaoaaoe eeaiioue
aaeeeiai naeueieea c IONA.

5. O aeiaaeeao ae?aaeaiiai aeeoociiai o?aaeaiiy on?o EA aeey iai?yii?
?aaaneoey?ecaoe?? i?iea?aeo aeei?enoiaoaaoe eeaiioue aaeeeiai naeueieea
c IONA ? aee?iaith ee?oeiaeiith ia?eea?aea c ia?ai?uaiith a ia? e?aith
AAA.

6. Aeey noeioeyoe?? i?noeaaiai anaioe/iiai caiaeueiiai i?ioeano ?
iineeaiiy aaeaaceaieo aeanoeainoae ia?ai?uaiiai eeaioy aaeeeiai
naeueieea aai aee?iai? ee?oeiaeie ia?eea?aea aeei?enoiaoaaoe oaeuee.

7. I?e aa??aioi?e noaiiea?ae?? o aeiaaeeo iaaoaeoeaii? eiina?aaoeaii?
oa?ai?? ?aeiiaiaeiaaia ?acaeoe?y ea?ae?aeueiuo a?eie c??/anoiai aocea.

8. Aea?? noi?iie aeey ?acaeoe?? a?eie aocea ne?ae cae?enithaaoe a
caeaaeiino? a?ae ciie ia?aaaaeii? ?oai?? i?iea?aea.

9. I?e ?aoeeaeea? aia?iicieo i?enooi?a iieacaia aiaeia?/ia iia?aoe?y c
i?ioeeaaeii? noi?iie.

Nienie iioae?eiaaieo ?ia?o ca oaiith aeena?oaoe??

1. Niinia ea/aiey o?iie/aneie ieeethcee a?oa?ee ieaeieo eiia/iinoae //
Eeeie/aneay oe?o?aey. — ? 7., E., 1991.-N.64 -65. ( ni?aaaoi?e Ieeiiaiei
A.N., Aoaea A A., Ia?oeia A.E.).

2. I?aaeiia?aoeeiiiay iaaeeeaiaioiciay ei??aeoeey ia?ooaiee
ooieoeeiiaeueiiai ?aca?aa ieiea?aea o aieueiuo n eoaie/aneie aieaciueth
na?aeoea // Ee?i?/ia o??o?a?y. — ? 5., E., 1994. — N. 29-31. (
ni?aaaoi?e

Iieiaeai A.A., Naeaaeia A.A., Iaoa?ooei A.I.).

3. Ninoiyiea oeaio?aeueiie aaiiaeeiaieee o aieueiuo n iaeeoa?e?othuei
aoa?ineea?icii a?oa?ee ieaeieo eiia/iinoae // Ee?i?/ia o??o?a?y. — ? 7.,
E., 1996. — N. 19 — 21. ( ni?aaaoi?e Aoaea A.A., Iieiaeai A.A. ).

4. Aeeooa?aioee?iaaiiue iiaeoiae e auai?o iaoiaea ?aaaneoey?ecaoeee
ieiea?aea o iaoeeaioia n eoaie/aneie aieaciueth na?aeoea // Oe?a?inueeee
ea?ae?ieia?/iee aeo?iae. — ? 12., 1998. – N. 15 – 17. (ni?aaaoi?e
Ieeiiaiei A.N., Iieiaeai A.A.).

5. I?eiaiaiea aioo?eei?iia?iiai o?iiaieecena o aieueiuo n ino?ui
eioa?eoii ieiea?aea // Oe?a?inueeee ea?ae?ieia?/iee aeo?iae. — ? 12.,
1998. – N. 18 – 20. (ni?aaaoi?e Ieeiiaiei A.N., Iieiaeai A.A.,
Iaoa?ooei A.I., Eaoeoe C.A,).

6. Auai? iaoiaea ?aaaneoey?ecaoeee ieiea?aea i?e eoaie/aneie aieacie
na?aeoea ia iniiaa eeeieei-aiaeia?aoe/aneie oa?aeoa?enoeee aieueiuo //
Ee?i?/ia o??o?a?y. — ? 2., 1999. — N. 5 — 6. ( ni?aaaoi?e Ieeiiaiei
A.N., Iieiaeai A.A. ).

7. Iai?yiua iaoiaeu ?aaaneoey?ecaoeee eoaiece?iaaiiuo i?aaiia //
Aeooaeuei? i?iaeaie iaie?aaoiaaiaoia?e?a?ii? oa noaeeiii? o??o?a??:
Ca??iee ?ia?o iaoeiai? eiioa?aioe??, i?enay/aii? 80-??//th c aeiy
ia?iaeaeaiiy aeaaeai?ea I.I. Oae?iiaa. — E.: Ee?i?/ia o??o?a?y, 1998. —
N. 273- 275. ( ni?aaaoi?e Ieeiiaiei A.N., Aoaea A.A., Ia?oeia A.E.,
Iieiaeai A.A. ).

8. Aioo?eei?iia?iue o?iiaieecen o aieueiuo n ino?ui eioa?eoii ieiea?aea
// Aeooaeuei? i?iaeaie iaie?aaoiaaiaoia?e?a?ii? oa noaeeiii? o??o?a??:
Ca??iee ?ia?o iaoeiai? eiioa?aioe??, i?enay/aii? 80-??//th c aeiy
ia?iaeaeaiiy aeaaeai?ea I.I. Oae?iiaa. — E.: Ee?i?/ia o??o?a?y, 1998. —
N. 278 — 280. ( ni?aaaoi?e Ieeiiaiei A.N., Iaoa?ooei A.I., Iieiaeai
A.A., Eaoeoe C.A. ).

9. Iaaeeeaiaioiciay ei??aeoeey ooieoeeiiaeueiiai ?aca?aa ieiea?aea o
aieueiuo EAN ia?aae ai?oiei?iia?iui ooioe?iaaieai // Oace I iaoeiai?
eiioa?aioe?? anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a Oe?a?ie. Ee?a, 5 –
6 aeiaoiy 1993 ?. N. 70. ( ni?aaaoi?e Ieeiiaiei A.N., Naeaaeia A.A.,
Iieiaeai A.A.).

10. Aiaeia?aoe/aneay naieioeea ianoaaeeueiie noaiiea?aeee // Oace I
iaoeiai? eiioa?aioe?? anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a
Oe?a?ie. Ee?a, 5 – 6 aeiaoiy

1993 ?. N. 71. (ni?aaaoi?e Ieeiiaiei A.N., Naeaaeia A.A., Iaoa?ooei
A.I., Iieiaeai A.A. ).

11. Iai?yiua iaoiaeu ?aaaneoey?ecaoeee ieiea?aea eae aeueoa?iaoeaa
ai?oiei?iia?iiio ooioe?iaaieth // Oace II iaoeiai? eiioa?aioe??
anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a Oe?a?ie. Ee?a, 12 – 14 aa?aniy
1994 ?. N. 112. ( ni?aaaoi?e Ieeiiaiei A.N., Naeaaeia A.A., Iieiaeai
A.A. ).

12. Aeeooa?aioee?iaaiiue iiaeoiae a oe?o?ae/aneii ea/aiee eoaie/aneie
aieacie na?aeoea // Oace III iaoeiai? eiioa?aioe?? anioe?aoe??
na?oeaai-noaeeiieo o??o?a?a Oe?a?ie. Ee?a, 17 – 19 o?aaiy, 1995 ?. N.
98. ( ni?aaaoi?e Ieeiiaiei A.N., Eeeiaiei A. I., Iieiaeai A.A. ).

13. I?eiaiaiea aacai?inoaia o aieueiuo n caaieaaaieyie na?aeoea // Oace
IV iaoeiai? eiioa?aioe?? anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a
Oe?a?ie. Ee?a, 22 – 24 o?aaiy 1996 ?. N. 126 — 127. ( ni?aaaoi?e
Ieeiiaiei A.N., Iieiaeai A.A. ).

14. Eniieueciaaiea iaoiaeeee nio?aiaiey e?iae “Cell-saver” i?e
iia?aoeeyo ia na?aeoea // Oace IV iaoeiai? eiioa?aioe?? anioe?aoe??
na?oeaai-noaeeiieo o??o?a?a Oe?a?ie. Ee?a, 22 – 24 o?aaiy 1996 ?. N. 127
— 128. ( ni?aaaoi?e Ieeiiaiei A.N. Niaiea?ue A.A, Ieoaeue/oe E.E.).

Aiioaoe?y

Inaoeaiei A.A. Aeeoa?aioe?eiee i?aeo?ae aei aeai?o iaoiaeo
?aaaneoey?ecaoe?? i?iea?aeo o e?eoaaii? ?ON. – ?oeiien.

Aeena?oaoe?y ia caeiaoooy ioeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca
niaoe?aeuei?noth 14.01.04. – na?oeaai-noaeeiia o??o?a?y. Caii??cueeee
aea?aeaaiee iaaee/iee oi?aa?neoao, i. Caii??aeaey, 1999 ?.

I?aaenoaaeai? ?acoeueoaoe ee?i?ei-aia?ia?ao?/ieo ianoaaeaiue ?
o??o?a?/iiai e?eoaaiiy ?ON o 219 oai?eo.

Aecia/aia o??o?a?/ia oaeoeea oa aaeineiiaeaia iaoiaeeea i?iaaaeaiiy
iia?aoeaiiai e?eoaaiiy iai?yiith ?aaaneoey??caoe??th i?iea?aea o
aeiaaeeao aeeoociiai o?aaeaiiy ei?iia?ieo a?oa??e. Aea/ai? aaciina?aaei?
e a?aeaeaeai? ?acoeueoaoe o??o?a?/iiai e?eoaaiiy oai?eo i?ney iai?yii?
?aaaneoey?ecaoe?? oa ?acaeoe?? ea?ae?aeueieo a?eie c??/anoiai aocea

Eeth/ia? neiaa: ?ON, aia?iea?ae?ia?ao?y, aeeoocia o?aaeaiiy ei?iia?ieo
a?oa??e,

I?aaa oeoii/eiai-naeueieeiaa a?oa??y, c??/anoee aocie.

Abstract

Osaulenko V.V. Differential approach to a choice of a method of surgical
treatment of IHD. — Manuscript.

The dissertation is to obtain a scientific degree of the candidate of
medical sciences on the specialty 14.01.04 — cardiovascular surgery.
Zaporizhzhya, State medical University, Zaporizhzhya, 1999.

Results of the surgical treatment and of diagnostic possibilities in 219
patients are submitted. Surgical tactics is determined and the technique
of indirect revascularisation of myocardium in cases of a diffuse
coronary artery dieseases. Direct and remote results of surgical
treatment of the patients IHD after indirect revascularisation of the
myocardium and after the resection of the branches of ganglion stellate.

Key words: IHD, angiocardiography, diffuse coronary artery disease, a
right gastro-epiploon artery, ganglion stellate.

Aiiioaoeey

Inaoeaiei A.A. Aeeooa?aioee?iaaiiue iiaeoiae e auai?o iaoiaea
oe?o?ae/aneiai ea/aiey EAN. – ?oeiienue.

Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo
iaoe ii niaoeeaeueiinoe 14.01.04 – na?aea/ii-ninoaeenoay oe?o?aey.
Caii?iaeneee ainoaea?noaaiiue iaaeeoeeineee oieaa?neoao, a. Caii?iaeuea,
1999 a.

Oaaee/aiea eiee/anoaa aieueiuo n aeeooociuie eciaiaieyie a ei?iia?iuo
a?oa?eyo, i?aeiouanoaaiiia ii?aaeaiea aeenoaeueiuo naaiaioia e “iaeeee
eaeea?” yoeo ninoaeia, ionoonoaea oneiaee aeey oi?ie?iaaiey
aeenoaeueiiai ai?oi-ei?iia?iiai aianoiiica, iaoaeiaeaoai?eoaeueiua iooe
iooiea iinea ooioe?iaaiey a neo/ayo aeeooociiai ii?aaeaiey EA
niinianoaiaaee aiciaiiaeaieth eioa?ana enneaaeiaaoaeae e iuia “caauoui”
niiniaai “iai?yiie” ?aaaneoey?ecaoeee ieiea?aea: iiaioiea?aeeiiaenee eee
?aaaneoey?ecaoeee ieiea?aea ia?aaa?iooui eineooii aee?iaie eeao/aoee
ia?eea?aea.

A ?aaioa i?aaenoaaeaiu ?acoeueoaou eeeieei-aiaeia?aoe/aneeo
ianeaaeiaaiee e oe?o?ae/aneiai ea/aiey EAN o 219 iaoeeaioia. O 204
aieueiuo auyaeaiu aoa?ineea?ioe/aneea noaiicu e ieeethcee EA, a 15
neo/ayo aeeaaiinoe?iaaia aa?eaioiay noaiiea?aeey. Anai aieueiui
i?iaaaeaii ianeaaeiaaiea, aeeth/athuaa YEA, YOI-EN, AYI, i?iao n
«Ecieao»-ay?icieai, ei?iia?i-aaio?eeoeia?aoeth, aiaeia?aoeth ae?oaeo
a?oa?eaeueiuo aannaeiia, ?aioaaiia?aoeth, eeeieei-aeioeie/aneia
enneaaeiaaiea e?iae, aeeth/ay iieacaoaee iaiaia eeieaeia. Ii
ooieoeeiiaeueiui eeannai ianeaaeoaiua aieueiua auee ?ani?aaeaeaiu
neaaeothuei ia?acii: 2-e OE — 12 iaoeeaioia (5.5%), 3-e OE — 171
aieueiie (78.1%), 4-e OE — 36 iaoeeaioia (16.4%).

A caaeneiinoe io ?ani?ino?aiaiiinoe ii?aaeaiey ei?iia?iuo a?oa?ee,
ninoiyiey ia?eoa?e/aneiai ?onea e noaiaie ia?ooaiey nie?aoeoaeueiie
ooieoeee na?aeoea iu auaeaeeee 3 eeeieei-aiaeia?aoe/aneeo aa?eaioa
eoaie/aneie aieacie na?aeoea. Anaai iia?e?iaaii 115 (52.5 %) iaoeeaioia:
ai?oiei?iia?iia ooioe?iaaiea auiieiaii 54 aieueiui, 12-oe iaoeeaioai
i?iecaaaeaia aiaeiieanoeea EA, 34 aieueiui auiieiaia iai?yiay ?aaaneo-

ey?ecaoeey ieiea?aea, 15-oe iaoeeaioai i?iecaaaeaia ?acaeoeey
ea?aeeaeueiuo aaoaae caacae/aoiai ocea.

A caaeneiinoe io niiniaa iai?yiie ?aaaneoey?ecaoeee auaeaeaii 3
iiaea?oiiu aieueiuo: a) 20 (58.8 %) iaoeeaioia – ?aaaneoey?ecaoeey
ieiea?aea eineooii aieueoiai naeueieea n i?aaie aeaeoaei/ii-naeueieeiaie
a?oa?eae (IAENA) e eineooii ia?eea?aeeaeueiie aee?iaie eeao/aoee n
eiieaioe?iaaiiie a iaa eaaie aioo?aiiae a?oaeiie a?oa?eae (EAAA); a) 8
(23.5 %) iaoeeaioia – ?aaaneoey?ecaoeey ieiea?aea eineooii
ia?eea?aeeaeueiie aee?iaie eeao/aoee n eiieaioe?iaaiiie a iaai EAAA; a)
6 (17.7 %) iaoeeaioia iia?e?iaaiu niiniaii, i?e eioi?ii ni/aoaeenue
ai?oiei?iia?iia ooioe?iaaiea e iai?yiay ?aaaneoey?ecaoeey. Aeey iai?yiie
?aaaneoey?ecaoeee eniieueciaaee eineoo aieueoiai naeueieea n IAENA eee
ia?eea?aeeaeueioth aee?iaoth eeao/aoeo n eiieaioe?iaaiiie a iaa EAAA. 30
(88.2 %) aieueiui, ai a?aiy aiaoaoaeuenoaa aeiiieieoaeueii auea
auiieiaia ?acaeoeey ia?aaeieo ai?oaeueiuo nieaoaiee.

Ii aeaiiui ooieoeeiiaeueiuo enneaaeiaaiee aeinoiaa?iue yooaeo I?I
ianooiae /a?ac 12-16 iaaeaeue iinea aiaoaoaeuenoaa. Noaaeeueii oi?ioea
?acoeueoaou /a?ac 3 aiaea ioia/aiu o 88.9 % aieueiuo. I?e ianeaaeiaaiee
ioia/aii nieaeaiea ooieoeeiiaeueiiai eeanna noaiiea?aeee, iiauoaiea
oiea?aioiinoe e oece/aneie iaa?ocea. Oi?ioee ?acoeueoao iinea iai?yiie
?aaaneoey?ecaoeee aue iaoneiaeai oi?ie?iaaieai iaoe?iie aeiiieieoaeueiie
ninoaeenoie naoe iaaeaeo aieueoei naeueieeii, aee?iaie eeao/aoeie
ia?eea?aea n EAAA e eoaiece?iaaiiui ieiea?aeii. I?e eiio?ieueiie
aiaeia?aoee /a?ac 1 aiae e aieaa iinea aiaoaoaeuenoaa ioia/aii
i?iieeiiaaiea eiio?anoa ec i?aaie aeaeoaei/ii-naeueieeiaie a?oa?ee e
eaaie aioo?aiiae a?oaeiie a?oa?ee a ei?iia?iua a?oa?ee. Anai aieueiui,
no?aaeathuei aa?eaioiie noaiiea?aeeae auiieiaia ?acaeoeey ea?aeeaeueiuo
aaoaae caacae/aoiai ocea. Ii aeaiiui YEA ii?aaeaeyeanue ciia
i?aiaeaaeathuae eoaiee ieiea?aea. A caaeneiinoe io yoiai auae?aeanue
noi?iia aeey ?acaeoeee ea?aeeaeueiuo aaoaae caacae/aoiai ocea.

Ai a?aiy iia?aoeee eniieueciaaeny iaaeeeth/e/iue, yeno?aieaa?aeueiue
aeinooi. I?e aenoieiae/aneii enneaaeiaaiee oaeaeaiiuo aaoaae
caacae/aoiai ocea auee auyaeaiu oa?aeoa?iua i?eciaee o?iie/aneiai
aaiaeeiieoa.

Ii aeaiiui eoioeyoeaiiai aiaeeca noieeea iieiaeeoaeueiua ?acoeueoaou

e 3-io aiaeo iaaethaeaiey nio?aieeenue o 97.6 % aieueiuo.

Eeth/aaua neiaa: EAN, aiaeiea?aeeiaaoey, aeeooociia ii?aaeaiea
ei?iia?iuo a?oa?ee, i?aaay aeaeoaei/ii-naeueieeiaay a?oa?ey,
ea?aeeaeueiua aaoae caacae/aoiai ocea.

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