Helicobacter pylori та інша мукозна мікрофлора шлунка при хірургічному лікуванні виразкової хвороби дванадцятипалої кишки: Автореф. дис… канд. мед.

AeI?I?IIAO?IANUeEA AeA?AEAAIA IAAeE*IA AEAAeAI?ss

AOEAANUeEEE NA?A?E IEEIEAEIAE*

OAeE:616.33+616.342:-002.44-089-06-036.4:-072.1-08.

HELICOBACTER PYLORI OA ?IOA IOEICIA I?E?IOEI?A OEOIEA I?E O??O?A?*IIIO

E?EOAAII? AE?ACEIAI??

OAI?IAE AeAAIAAeOessOEIAEI??EEOEE

14.01.03. – O??O?A?ss

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Aei?i?iiao?ianuee – 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia o Caii??cueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? IIC
Oe?a?ie.

Iaoeiaee ea??aiee:

eaiaeeaeao iaaee/ieo iaoe, aeioeaio A?ooea Aaiaaeeeo Aenaio?eiae/,
caa?aeoaa/ eo?no aiaeineii?? eaoaae?e aini?oaeueii? o??o?a??
Caii??cueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo.

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, i?ioani? Oa?/aiei Aieiaeeie? A?eai?iae/,
i?ioani? eaoaae?e o??o?a?/ieo oai?ia Aei?i?iiao?ianueei? aea?aeaaii?
iaaee/ii? aeaaeai??

aeieoi? iaaee/ieo iaoe, aeioeaio Eeeiaiei Aieiaeeie? Ieeeoiae/,
caa?aeoaa/ eaoaae?e oaeoeueoaonueei? o??o?a?? Caii??cueeiai aea?aeaaiiai
iaaee/iiai oi?aa?neoaoo.

I?ia?aeia onoaiiaa:

?inoeooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie,
eaoaae?a oi?aei-aaaeii?iaeueii? oa noaeeiii? o??o?a??, i. Ee?a.

Caoeno a?aeaoaeaoueny “ 25 “ o?aaiy 1999 ?. i 11-00 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 08.601.01 o
Aei?i?iiao?ianuee?e aea?aeaai?e iaaee/i?e aeaaeai?? (320044, i.
Aei?i?iiao?ianuee, aoe. Aeca?aeeinueeiai, 9).

C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? Aei?i?iiao?ianueei?
aea?aeaaii? iaaee/ii? aeaaeai?? (320044, i. Aei?i?iiao?ianuee, aoe.
Aeca?aeeinueeiai, 9).

Aaoi?aoa?ao ?ic?neaiee “ 21 “ ea?oiy 1999 ?.

A/aiee nae?aoa?

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

eaiaeeaeao iaaee/ieo iaoe, aeioeaio
A.I.Oea/aiei

— 1 —

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

AEOOAEUeI?NOUe I?IAEAIE. Ae?aceiaa oai?iaa ia nueiaiaei?oi?e aeaiue ?
iaea?eueo ?iciianthaeaeaiei oa iaaacia/iei aeey aeeooy oai?eo
caoai?thaaiiyi oeoieiai-eeoeiaiai o?aeoo /a?ac iiaeeea?noue ?icaeoeo
oyaeeeo oneeaaeiaiue. Iacaaaeath/e ia oa, ui a oaia??oi?e /an c’yaeeeny
iia? aenieiaoaeoeai? i?ioeae?aceia? i?aia?aoe, oneeaaeiaiiy, ui
aeieeathoue i?e oeueiio caoai?thaaii?, iio?aaothoue o??o?a?/iiai
ao?o/aiiy ye “inoaiiueiai e?eoaaeueiiai caniao” o 20-30% oai?eo (Eoc?i
I.?., 1981). I?ioa ?acoeueoaoe iia?aoeaiiai e?eoaaiiy ia caaaeaee
caaeiaieueiythoue ee?i?oeeno?a, oiio ui o /anoeie oai?eo aeieeathoue
??ci? i?neyiia?aoe?ei? oneeaaeiaiiy oa ?aoeeaeeae ae?acee.

Iaei??th c i?e/ei oeeo oneeaaeiaiue aeaye? aaoi?e aeciathoue iayai?noue
o neecia?e iaieiioe? aio?aeueiiai a?aeae?eo oeoiea ? iaaeieiae?aceia?e
cii? aae?eiaaeoa??e oa ??cieo ?ioeo i?e?ii?aai?ci?a. *anoa aeyaeaiiy
Helicobacter pylori (I?) i?e ae?aceia?e oai?ia? aeaaiaaeoeyoeiaei? eeoee
oa caiaeueieo caoai?thaaiiyo oeoiea aeicaiey? aaaaoueii aeine?aeieeai
noaa?aeaeoaaoe, ui oeae aeae aaeoa??e aaciina?aaeiuei i?e/aoiee aei
ooai?aiiy ae?acie oa ?aoeeaeea?a ae?aceiai? oai?iae (A?o?i E.?., 1990;
Aeoaea?ue E.A., 1995; I?o?io?ia O.A., 1996; Eioaeoeueeee N.A.,1998). Aea
oea ia ?aeeiee i?e?ii?aai?ci, ui aeyaey?oueny a neecia?e iaieiioe?
oeoiea (NIO). ?io? aaoi?e a?aei?/athoue iayai?noue a NIO eieiai? oa
aaoeeey?ii? oei?e ? i?e/aoi?noue naia oeeo i?e?ii?aai?ci?a aei
oneeaaeiaiue caiaeueiiai oa?aeoa?o oa ?aoeeaeea?a ae?acee i?ney ??cieo
aeae?a iia?aoe?e (Neoi?e N.?., 1980; Ni??iiaa O.A., 1982; Aiueinueeee
A.A., 1997).

A?aoiaoth/e iiaeeea?noue caeaoiino? ye I?, oae ? ?ioi? ioeicii?
i?e?ioei?e ni?e/eiyoe caiaeuei? noaie a oeoieo, ui iaaaoeaii
a?aeaeaa?oueny ia ia?aa?ao i?neyiia?aoe?eiiai ia??iaeo, iaiao?aeii
aea/eoe aanue oii i?eno?iii? i?e?ioei?e, a ia o?eueee ?? ie?ai? aeaee ye
aei, oae ? i?ney ??cieo aeae?a iia?aoe?e a caeaaeiino? a?ae aeeaeie
ii?oieia?/ieo ci?i neeciai? iaieiiee oa ii?ooaiiy ooieoe?iiaeueiiai
noaio oeoiea. Oea aeicaieeoue anoaiiaeoe ca’ycie i?ae iayai?noth I?
oa ?ioi? i?e?ioei?e ? aeieeiaiiyi caiaeueieo oneeaaeiaiue oa ?aoeeaeea?a
ae?acee i?ney o??o?a?/iiai e?eoaaiiy ae?aceiai? oai?iae
aeaaiaaeoeyoeiaei? eeoee.

CA?ssCIE ?IAIOE C IAOEIAEIE I?IA?AIAIE, IEAIAIE, OAIAIE. Aeeiiaia
?iaioa ? o?aaiaioii ieaiiai? iaoeiai-aeine?aeii? ?iaioe eaoaae?e

-2-

aini?oaeueii? o??o?a?? Caii??cueeiai aea?aeaaiiai iaaee/iiai
oi?aa?neoaoo “Iaoiaee

e?eoaaiiy ae?aceiai? oai?iae oeoiea oa aeaaiaaeoeyoeiaei? eeoee”, oeo?
i?iaeaie 01.850012.016.

IAOA ? CAAeA*? AeINE?AeAEAIIss. Iie?ioeoe ?acoeueoaoe o??o?a?/iiai
e?eoaaiiy ae?aceiai? oai?iae aeaaiaaeoeyoeiaei? eeoee ia iniia?
aeine?aeaeaiiy i?e?iaiiai oiio neeciai? iaieiiee oeoiea i?ae /an
aiaeineii?? aei oa i?ney iia?aoe?? ? aeei?enoaiiy iio??eii?
aioeaaeoa??aeueii? oa?ai?? a eiiieaen? c eaca?iei ii?ii?ithaaiiyi NIO o
ia?aae- oa i?neyiia?aoe?eiiio ia??iae?.

I?e oeueiio ia?aaeaa/a?oueny ae??oeoe oae? caaaeaiiy:

1) Aea/eoe I? oa aeaeiaee neeaae ioeicii? i?e?ioei?e neeciai? iaieiiee
oeoiea a ii??aiyii? c? noaiii eeneioiooai?thth/i? oa
iioi?ii-aaaeoaoi?ii? ooieoe?e oeoiea, a oaeiae ii?oieia?/ieie ci?iaie
NIO o oai?eo ia ae?aceo aeaaiaaeoeyoeiaei? eeoee aei iia?aoe??.

2) Aeine?aeeoe I? oa aeaeiaee neeaae ioeicii? i?e?ioei?e oeoiea caeaaeii
a?ae oeio iia?aoeaieo ao?o/aiue, noaio eeneioiooai?thth/i? ooieoe??,
ii?oieia?/ieo ci?i NIO o oai?eo ia ae?aceo aeaaiaaeoeyoeiaei? eeoee a
??ci? no?iee i?ney iia?aoe??.

3) Anoaiiaeoe aieea I? oa ?ioi? ioeicii? i?e?ioei?e ia aeieeiaiiy
i?neyiia?aoe?eieo oneeaaeiaiue caiaeueiiai oa?aeoa?o a ?aiiueiio
i?neyiia?aoe?eiiio ia??iae? oa ?aoeeaeea?a ae?acee o a?aeaeaeai? no?iee
i?ney iia?aoe??.

4) Ia iniia? io?eiaieo aeaieo ?ic?iaeoe iaoiae eiiieaeniiai aieeao ia
neeciao iaieiieo oeoiea a aei- oa i?neyiia?aoe?eiiio ia??iaeao iio??eii?
aioeaaeoa??aeueii? oa?ai?? a niieo/aii? c eaca?iei ii?ii?ithaaiiyi ?
ioe?ieoe eiai aoaeoeai?noue.

IAOEIAA IIAECIA. Aia?oa aea/aiee aanue niaeo? i?eno?iii? i?e?ioei?e ye
I?, oae ? ?ioeo aeae?a ioeicii? i?e?ioei?e o ni?anoaaeaii? c? noaiii
iniiaieo ooieoe?e oa ii?oieia?/ieo ci?i neeciai? iaieiiee oeoiea o
oai?eo ia ae?aceo aeaaiaaeoeyoeiaei? eeoee aei oa i?ney iia?aoe??.

Eiie?aoeciaaii aieea ??cieo aeae?a i?e?ii?aai?ci?a ia ia?aa?a
i?neyiia?aoe?eiiai ia??iaeo a caeaaeiino? a?ae oeio iia?aoe??, noaio
ii?oieia?/ieo ci?i neeciai? iaieiiee oa eeneioiooai?thth/i? ooieoe??
oeoiea.

Iaa?oioiaaia aeioe?euei?noue eiiieaeniiai aieeao ia neeciao iaieiieo
oeoiea iio??eii? aioeaaeoa??aeueii? oa?ai?? oa iecueeiaia?aaoe/iiai
eaca?iiai aei?ii?ithaaiiy i?e iia?aoeaiiio e?eoaaii?
ae?aceiai? oai?iae

-3-

aeaaiaaeoeyoeiaei? eeoee.

I?AEOE*IA CIA*AIIss. Ia iniia? iaea?aeaieo aeaieo anoaiiaeaia
caeaaei?noue iacaaeia?eueieo ?acoeueoao?a o??o?a?/iiai e?eoaaiiy
ae?aceiai? oai?iae aeaaiaaeoeyoeiaei? eeoee a?ae iayaiino? a neecia?e
iaieiioe? oeoiea I? oa ?ioi? ioeicii? i?e?ioei?e, aeeaeie ii?oieia?/ieo
ci?i NIO oa ii?ooaiue ooieoe?iiaeueiiai noaio oeoiea.

Aeyaeaiiy I? oa ?ioi? ioeicii? i?e?ioei?e a NIO ia oii? ii?ooaiue
?aaaia?aoi?ieo i?ioean?a o oai?eo ia ae?aceo aeaaiaaeoeyoeiaei? eeoee,
yeei ieaio?oueny iia?aoeaia e?eoaaiiy, iio?aao? canoinoaaiiy iio??eii?
aioeaaeoa??aeueii? oa?ai?? a eiiieaen? c eaca?iei ii?ii?ithaaiiyi NIO
aei, a a ?ac? iaiiaii? naiaoe?? neeciai? iaieiiee oa aeieeiaiiy
oneeaaeiaiue caiaeueiiai oa?aeoa?o ? i?ney iia?aoe??.

Canoinoaaiiy iio??eii? aioeaaeoa??aeueii? oa?ai?? a eiiieaen? c eaca?iei
ii?ii?ithaaiiyi NIO aea? cia/iee naioth/ee aoaeo o a?aeiioaii?
i?eno?iii? i?e?ioei?e, ui cieaeo? nooi?iue caiaeueieo ci?i oa ?ecee
?icaeoeo aianoiiiceo?a i?e ?acaeoe?yo ? ae?aioth/eo iia?aoe?yo, nei?i/o?
/an ?oaoethaaiiy ae?acee i?e i?aaiicaa??aath/eo iia?aoe?yo, ciaioo?
e?euee?noue ?aoeeaeea?a ae?acee oa no?iee ?aaa?e?oaoe?? iaoe??io?a.
Cai?iiiiiaaiee iaoiae ? aeinooiiei ? aea? cia/iee e?eoaaeueiee oa
aeiiii?/iee aoaeo.

AI?IAAAeAEAIIss IAeA?AEAIEO ?ACOEUeOAO?A. Eiiieaenia iaoiaeeea iio??eii?
aioeaaeoa??aeueii? oa?ai?? ? eaca?iiai ii?ii?ithaaiiy NIO c o?aooaaiiyi
aeae?eaii? i?e?ioei?e ? ii?oieia?/ieo ci?i neeciai? iaieiiee a aei- oa
i?neyiia?aoe?eiiiio ia??iaeao ai?iaaaeaeaia ? aeei?enoiao?oueny a
o??o?a?/iiio a?aeae?eaii? Caii??cueei? iaeanii? ee?i?/ii? e?ea?i?
(aeo ai?iaaaeaeaiiy ?1 a?ae 16 eenoiiaaea 1998 ?.), a o??o?a?/iiio
a?aeae?eaii? IN* caaiaeo “Caii??aenoaeue” (aeo ai?iaaaeaeaiiy ?2
a?ae 18 eenoiiaaea 1998 ?.), o??o?a?/iiio a?aeae?eaii? i?nueei? e?ea?i?
?1 i.Iae?oiiiey (aeo ai?iaaaeaeaiiy ?3 a?ae 2 a?oaeiy 1998 ?.).

INIAENOEE AIANIE CAeIAOAA*A. Aeena?oaoe?y ? iniaenoith i?aoeath aaoi?a,
yeee i?ia?a aiae?c iaoeiai? e?oa?aoo?e ca oaiith ?iaioe, aeeiiaa
aeeaieee ?ioi?iaoe?eiee iiooe, i?ia?a aiae?c ee?i?/iiai iaoa??aeo. On?
aiaeineii?/i? aeine?aeaeaiiy c acyooyi ii?oieia?/iiai iaoa??aeo,
aeine?aeaeaiiy iioi?ii-aaaeoaoi?ii? ooieoe?? oeoiea ca aeiiiiiaith
aoioiiineii??, i?noeaaa oa eiina?aaoeaia e?eoaaiiy oai?eo, noaoenoe/io
ia?iaeo ?acoeueoao?a aeine?aeaeaiue

-4-

aeeiiaii naiino?eii caeiaoaa/ai. Aeni?an-ae?aaiinoeea I? oa
aeine?aeaeaiiy eeneioiooai?thth/i? ooieoe?? oeoiea i?iaaaeai? ni?eueii c
iaoeiaei ea??aieeii e.i.i., aeioeaioii A?ooea A.A. A?noieia?/i? oa
ii?oieia?/i? aeine?aeaeaiiy a?iin?eiiai iaoa??aeo a eiiieaen? c
aaeoa??ineii??th i?iaaaeai? noi?nii c ni?a?ia?oieeaie
iaoieiai-aiaoii?/iiai a?aeae?eaiiy (caa?aeoaa/ Caoaethe A.I.).
Oeeoieia?/i? aeine?aeaeaiiy iace?a-a?aeaeoe?a a eiiieaen? c
aaeoa??ineii??th aeeiiai? ia eaoaae?? ee?i?/ii? eaai?aoi?ii?
ae?aaiinoeee Caii??cueeiai ?inoeoooo oaeineiiaeaiiy e?ea??a e.i.i.,
aeioeaioii E?eaioaonueeith TH.I. Aaeoa??ieia?/i? aeine?aeaeaiiy
ioeicii? i?e?ioei?e aeeiiai? ia aac? aaeoa??ieia?/ii? eaai?aoi???
Caii??cueei? iaeanii? ee?i?/ii? e?ea?i? e?ea?ai Iiaeue/aiei O.A.
Iia?aoeaia e?eoaaiiy oai?eo aeeiioaaeinue ia aac? o??o?a?/iiai
a?aeae?eaiiy Caii??cueei? iaeanii? ee?i?/ii? e?ea?i? (caa?aeoaa/
a?aeae?eaiiy e.i.i., aeioeaio Aieiaei I. A.) oa eaoaae?? aini?oaeueii?
o??o?a?? Caii??cueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (caa.
eaoaae?ith – ae.i.i., i?ioani? Ieeiiaiei I.N.). Aaoi? i?ia?a aeaoaeueiee
aiae?c oa noaoenoe/io ia?iaeo ee?i?/iiai iaoa??aeo, aeaieo
aiaeineii?/iiai, ii?oieia?/iiai ? aaeoa??ieia?/iiai aeine?aeaeaiue.

AI?IAAOe?ss ?ACOEUeOAO?A AeINE?AeAEAIIss. Iniiai? ?acoeueoaoe
iaoa??ae?a aeena?oaoe?? aeiiia?aeaeenue: 1) ia VI ?anioae?eainuee?e
iaoeiai-i?aeoe/i?e eiioa?aioe?? “I?eiaiaiea eaca?ia a iaaeeoeeia e
aeieiaee” (i.Oa?e?a, 1996?.); 2) iaoeiai-i?aeoe/i?e eiioa?aioe??
aiaeineii?no?a Oe?a?ie “Aeooaeuei? i?iaeaie ae?aaiinoe/ii? oa
e?eoaaeueii? aiaeineii??” (i.Ee?a, 1996?.); 3) ia 57 –e eiioa?aioe??
iieiaeeo a/aieo Caii??cueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo oa
C?OE (i.Caii??aeaey, 1996?.), ia can?aeaiiyo Caii??cueeiai iaeaniiai
iaoeiaiai oiaa?enoaa o??o?a?a (1995 – 1997?.?.), ia oaoiaiio nai?ia?? c
o??o?a?? o niaoe?aae? Ae 08.601.01 o Aei?i?iiao?ianuee?e aea?aeaai?e
iaaee/i?e aeaaeai??.

IOAE?EAOe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 12 iaoeiaeo ?ia?o.
C ieo o oaoiaeo aeo?iaeao – 6 noaoae, a ca??ieeao, i?aoeyo c’?cae?a oa
eiioa?aioe?e – 6 ?ia?o o aeaeyae? oac aeiiia?aeae.

IANssA OA NO?OEOO?A ?IAIOE. Aeena?oaoe?y neeaaea?oueny c anooio, iaeyaeo
e?oa?aoo?e, o?ueio ?icae?e?a aeanieo aeine?aeaeaiue, aiae?co oa
ocaaaeueiaiiy ?acoeueoao?a aeine?aeaeaiiy , aeniiae?a, i?aeoe/ieo
?aeiiaiaeaoe?e oa nienea aeei?enoaieo aeaea?ae. Aeeeaaeaia ia 149
noi??ieao iaoeiiieno. Oaeno ?ethno?othoue 20 oaaeeoeue oa 5 iaethie?a,
ye? caeiathoue 24 noi??iee. A?ae?ia?ao?y ai?uo? 198 aeaea?ae.

— 5 —

INIIAIA *ANOEIA

IAOA??AEE OA IAOIAeE AeINE?AeAEAIIss. Aeey iinoaiiaee inoaoi/iiai
ae?aaiico, ioe?iee oyaeeino? caoai?thaaiiy oa eiai oi?ie, a oaeiae aeey
aeai?o iaoiaeo e?eoaaiiy, on?i oai?ei i?iaiaeeeinue aiaeineii?/ia
aeine?aeaeaiiy ca caaaeueiii?eeiyoith iaoiaeeeith i?e aeiiiiic?
acioaaiaano?iaeoiaeaiineiio AAe-A-AI-4-“EIII”. Ioe?ieo a?coaeueieo
aeaieo i?iaiaeeee ca nooiaiai aeoeaiino? caiaeueiiai i?ioeano neeciai?
iaieiiee aano?iaeoiaeaiaeueii? ciie ca eeaneo?eaoe??th I.ss.A?eai?’?aa
(1986).

C iaoith ii?oieia?/iiai aea/aiiy neeciai? iaieiiee oeoiea oa
aeaaiaaeoeyoeiaei? eeoee a on?o iaoe??io?a i?iaiaeeee i?eoe?eueio
a?iin?th ca ?aeiiaiaeaoe?yie 9-ai I?aeia?iaeiiai eiia?ano
aano?iaioa?ieia?a (N?aeiae. Aano?ae?y. 1990).

Oeeoieia?/ia aeine?aeaeaiiy iace?a-a?aeaeoe?a i?iaiaeeee ca?aeii c
iaoiaee/ieie ?aeiiaiaeaoe?yie Aooiiiaa E.A., I?aea?ae?aa A.?. (1992).
Oeeoia?aio ioe?ithaaee ia iniia? e?eoa???a I?aeia?iaeii? a?noieia?/ii?
eeaneo?eaoe?? iooeei ? 17 AIIC (1982).

Aeine?aeaeaiiy eeneioiooai?thth/i? ooieoe?? oeoiea i?iaiaeeeinue ia
iniia? aeaeo?iiao?e/iiai iaoiaeo aecia/aiiy aeoeaiino? aiaeiaaeo ?ii?a o
oeoieo – aioo??oiueioeoieiaa ?I-iao??y. Aeine?aeaeaiiy i?iaiaeeeiny
aeaiaeaeo?iaeiei ciiaeii O?yc?inueeiai III “?NOIE” c ?a?no?aoe??th
i?eno?iii? ?I ii oeae? “?I-iao?ai?i?aieueoiao?a ?I-121” ca iaoiaeeeith
E?ia?a ?.TH. (1968) oa i?ae /an aiaeineii?/iiai aeine?aeaeaiiy ca
aeiiiiiaith iaeiiaeaeo?iaeiiai ciiaea Eai’yiaoeue-Iiae?euenueeiai NEA
IAO c ?a?no?aoe??th i?eno?iii? ?I ii oeeo?iaiio ?iaeeeaoi?o
?I-iao?a AEO-2 ca iaoiaeeeith *a?iia?iaiai A.I. (1991).

Iioi?ii-aaaeoaoi?ia ooieoe?y oeoiea aeine?aeaeoaaeany ia
oeueo?acaoeiaiio aia?ao? “Sonoline SL-1” o??ie “SIEMENS” (O?I) c
naeoi?aeueiei aoiaeao/eeii 3,5 IAoe. Ioe?ieo iaea?aeaieo ?acoeueoao?a
i?iaiaeeee ca aeaniith iaoiaeeeith. Aea/aeenue aoioiiia?aie oeoiea a ?
oaco aaaeoaoe??. Nooue iaoiaeo iieyaa? a ii??aiyii? caeeoeiaiai ia’?io
oeoiea ca ia?o? 20 oaeeei aaaeoaoe?? o aeaiiai oai?iai c ii?iith.
Ciaioaiiy caeeoeiaiai ia’?io a?eueoa i?ae ia 60% ioe?ithaaee ye
i?enei?aiiy aaaeoaoe??, a ciaioaiiy caeeoeiaiai ia’?io iaioa
i?ae ia 40% — ye oiia?eueiaiiy aaaeoaoe??.

Helicobacter pylori aeyaeyee iacaeaaeii aeaiia niiniaaie. I?e?ineii?/iei
— i?ae /an ii?oieia?/iiai oa oeeoieia?/iiai aeine?aeaeaiiy ca
aeiiiiiaith ?ia?n?eii?

— 6 —

oaoi?ee o630. A?io?i?/iei – ca aeiiiiiaith iaeiioaeeeiiiai o?aaciiai
oanoo (Arvind, 1988) ? Aea-iie-oanoo o??ie ssiaio/? TH?ii. Nooue oanoo
iieyaa? a caeaoiino? aae?eiaaeoa??e a?ae?ie?coaaoe na/iaeio, a
?acoeueoao? /iai ooai?ththoueny ?a/iaeie, ci?ithth/? ?I ?ic/eio a
eoaeiee a?e, ui i?iyaey?oueny ci?iith eieuei?o ?iaeeeaoi?a.

Ioeicio i?e?ioei?o a neecia?e iaieiioe? oeoiea aeyaeyee ca iaoiaeeeith
I?naooiai? I.I.. Acyooy iaoa??aeo neeciai? iaieiiee aeeiioaaeinue ca
iaoiaeeeith Neoi?e N.?. (1982), ui aeicaiey? aecia/aoe iaoiaaiio
i?e?ioei?o i?ae oa?ii neeco oa a nai?e neecia?e iaieiioe?.

Ioe?ieo a?aeaeaeaieo ?acoeueoao?a iia?aoeaiiai e?eoaaiiy cae?enithaaee
ca iiaeeo?eiaaiith eeaneo?eaoe??th Visink — Iaioee??a (1991).

Iaoiaeieia?y i?aoe? iieyaa? a aeyaeaii? I? oa ?ioi? i?e?ioei?e o oai?eo
ia ae?aceo aeaaiaaeoeyoeiaei? eeoee a ni?anoaaeaii? c? noaiii iniiaieo
ooieoe?e, aeeaeiith ii?oieia?/ieo ci?i neeciai? iaieiiee oeoiea aei oa
i?ney iia?aoe?? ? ni?anoaaeaii? ?acoeueoao?a iia?aoeaiiai e?eoaaiiy c?
noaiii i?e?iaiiai oiio neeciai? iaieiiee oeoiea aei oa i?ney iia?aoe??.

A iniiao oeueiai aeine?aeaeaiiy iieeaaeaii niinoa?aaeaiiy ca 162 oai?eie
ia ae?aceo aeaaiaaeoeyoeiaei? eeoee c oyaeeei oeiii ia?aa?ao oai?iae oa
caa?icith ?icaeoeo oneeaaeiaiue. A?e ianoaaeaieo iaoe??io?a eieeaaany
a?ae 21 aei 70 ?ie?a ? neeaaeaa o na?aaeiueiio 42±13,5 ?ie?a, /ieia?e?a
aoei 129 (79,6%), ae?iie – 33 (20,4%).

Ca oyaee?noth iaoieia?/iiai i?ioeano oai?? ?iciiae?eyeeny oaeei /eiii:
ae?aceiaa oai?iaa c? ni?eyoeeaei ia?aa?aii — 48 (30,0%) aeiaaee?a,
ae?aceiaa oai?iaa c oyaeeei ia?aa?aii oa caa?icith ?icaeoeo oneeaaeiaiue
— 65 (40,0%) aeiaaee?a, ae?aceiaa oai?iaa aeaaiaaeoeyoeiaei? eeoee,
oneeaaeiaia eiiiainiaaiei oa noaeiiiainiaaiei noaiicii — 36 (31,6%)
aeiaaee?a, iayai?noth aaeeeeo eaeueicieo ae?acie c iaiao?aoe??th — 13
(11,4%) aeiaaee?a. C oeueiai /enea 114 oai?eo aoei i?iiia?iaaii. O 41
(36,0%) iaoe??ioa c /enea i?iiia?iaaieo niinoa??aaeeny noiooi?
caoai?thaaiiy. Iae/ano?oa cono??/aeenue caoai?thaaiiy aaiaoia?e?a?ii?
nenoaie, i?aeoeoieiai? caeice, eeoeiaiai o?aeoo, aoa?ineea?ic. Iniiaia
e?euee?noue c oeeo oai?eo aoee ethaee noa??oa 50 ?ie?a.

Caeaaeii a?ae eieae?caoe?? ae?acee, oa?aeoa?o oneeaaeiaiue, noiooi?o
caoai?thaaiue oa ??aiy oeoieiai? nae?aoe?? aoee aeeiiai? ??ci? aeaee
iia?aoeaieo ao?o/aiue. I?e i a o n e e a ae i a i ? e aeoiaeaiaeuei?e
ae?acoe? o oai?eo c aeiaai iacaaithaaieie ae?aceaie oa
aacia?a?aii ?aoeeaeeaoth/ei ia?aa?aii

-7-

caoai?thaaiiy iieacaia naeaeoeaia i?ieneiaeueia aaaioii?y (NIA),
yea aoea aeeiiaia 63 (55,3%) oai?ei. I?e i ? e i ? i ae o i ae a i a e
ue i i i o n o a i i c ? a noaae?? eiiiainaoe?? oa noaeiiiainaoe??
iaea?eueo iieacai? aaaioii?? c ae?aioth/eie iia?aoe?yie ca Finney, Judd
oa Heineke-Mikulicz, ye? aoee aeeiiai? 32 (28,1%) oai?ei. I?e aaeeeeo
eaeueicieo ae?aceao aeaaiaaeoeyoeiaei? eeoee c iaiao?aoe??th oa
aeoiaeaiinoacii canoiniaoaaeanue aaaioii?y c aio?oiaeoii??th ii oeio
Billroth-II, ye? aoee aeeiiai? 19 (16,7%) oai?ei.

On? i?iiia?iaai? oai?? aoee ?iciiae?eai? ia aea? a?oie: iniiaio (58
/ieia?e) neeaaeaee iaoe??ioe, yeei aei iia?aoe?? ii?yae c aaceniith
i?ioeae?aceiaith oa?ai??th i?iaiaeeee iio??eio aioeaaeoa??aeueio
oa?ai?th, ? eiio?ieueio a?oio (56 /ieia?e), yeei aioeaaeoa??aeueii?
oa?ai?? ia i?iaiaeeeinue. Ee?i?/ia oa aiaeineii?/ia aeine?aeaeaiiy a
eiio?ieuei?e ? iniiai?e a?oiao i?iaiaeeeiny aei eiina?aaoeaiiai
e?eoaaiiy, ia?aae iia?aoe??th, i?ney iia?aoe?? o ?aiiueiio
i?neyiia?aoe?eiiio ia??iae? a?ae 10 aei?a aei 2 i?nyoe?a oa o
a?aeaeaeai? no?iee i?ney iia?aoe?? a?ae 6 i?nyoe?a aei 2 ?ie?a.

?ACOEUeOAOE AEANIEO AeINE?AeAEAIUe. Aeey aea/aiiy neeaaeo i?e?ioei?e,
/anoioe aeyaeaiiy oeo /e ?ioeo i?e?ii?aai?ci?a a neecia?e iaieiioe?
oeoiea oa ia??oeueoea?ici?e cii? o 162 oai?eo ia ae?aceo
aeaaiaaeoeyoeiaei? eeoee aeine?aeaeoaaany a?iin?eiee iaoa??ae neeciai?
iaieiiee aio?aeueiiai a?aeae?eo oeoiea ? e?ath ae?acee ia iayai?noue
i?e?ioei?e aei iia?aoe??. O ca’yceo c oei, ui aaaaoi aeine?aeiee?a o
oe?e aaeoc? i?ia?aeio ?ieue a ao?iiaoiaaiac? ae?aceiai? oai?iae
aeaaiaaeoeyoeiaei? eeoee a?aeaeathoue Helicobacter pylori, a aeai?e
?iaio? oeae i?e?ii?aai?ci aiae?coaaany ie?aii a?ae ?ioeo i?aaenoaaiee?a
i?eno?iii? i?e?ioei?e, eio?? iicia/aeeny ye ?ioa ioeicia i?e?ioei?a.

I?e i?e?ineii?/iiio ? i?e?ia?ieia?/iiio aeine?aeaeaii? a?iin?eiiai
iaoa??aeo c neeciai? iaieiiee oeoiea oa e?ath ae?acee aoea c’yniaaia
ea?oeia i?e?ia?ieia?/iiai noaio. C 69 oai?eo ia ae?aceo
aeaaiaaeoeyoeiaei? eeoee a e?a? ae?acee oa ia??oeueoea?ici?e cii? I?
aeyaeyany o 28 (40,5%) oai?eo, a ioeicia i?e?ioei?a cono??/aeanue
/ano?oa ? aoea aeyaeaia o 40 oai?eo, ui neeaaeaei 58,0%. O aeaeyae?
anioe?aoe?e i?e?ii?aai?ci?a I? oa ?ioa ioeicia i?e?ioei?a cono??/aeenue
o 18 (26,0%) oai?eo. Iiiieoeueoo?e ye I?, oae ? ?ioi? ioeicii?
i?e?ioei?e aoee aeyaeai? o 37 (53,6%) oai?eo. C ieo aae?eiaaeoa???
aeyaeyeenue o

15 (21,7%), a ioeicia i?e?ioei?a — o 22 (31,9%) oai?eo.
A?aenooi?noue

-8-

i?e?ii?aai?ci?a anoaiiaeaia o 14 (20,3%) oai?eo.

I?ioa i?e aeine?aeaeaii? 162 oai?eo ae?aceith aeaaiaaeoeyoeiaei? eeoee
ia iayai?noue i?e?ii?aai?ci?a a neecia?e iaieiioe? oeoiea aae?eiaaeoa???
aeyaeyeeny o 144 oai?eo (89,0%), a oie /an ye ?ioa ioeicia i?e?ioei?a
aeyaeyeany o 76 (47,0%) oai?eo. O 68 (42,0%) aeiaaeeao ioeicia
i?e?ioei?a cono??/aeany a anioe?aoe?? c I?. O aeaeyae? iiiieoeueoo? I?
cono??/aany o 76 (47,0%), a ioeicia i?e?ioei?a — o 8 (5,0%) aeiaaeeao. O
10 (6,0%) oai?eo i?e?ii?aai?ci?a aeyaeaii ia aoei.

Oaeei /eiii, iiaeia a?aei?oeoe, ui i?e?iaiee oii o e?a? ae?aceiaiai
aeaoaeoo ? a neecia?e iaieiioe? aio?aeueiiai a?aeae?eo oeoiea
a?ae??ciy?oueny ca nai?i neeaaeii. A e?a? ae?acee ioeicia i?e?ioei?a
noaoenoe/ii aeinoia??ii ia?aaaaeaea I?. ? iaaiaee, o neecia?e iaieiioe?
oeoiea aae?eiaaeoa??? a iiiieoeueoo?ao ia?aaaaeaee iaae ioeiciith
i?e?ioei?ith.

Aiaeineii?/ia ianoaaeaiiy oai?eo ia ae?aceo aeaaiaaeoeyoeiaei? eeoee ia
iaiaaeoaaeinue o?eueee aeyaeaiiyi ae?aceiaiai aeaoaeoo, oaeiae
i?iaiaeeeanue ioe?iea noaio neeciai? iaieiiee ??cieo a?aeae?e?a oeoiea.
Caaaeueiia?aeiii, ui ae?aceiaee i?ioean caaaeaee noi?iaiaeaeo?oueny
??cieie ii?oieia?/ieie oi?iaie aano?eo?a. Oiio i?e a?noieia?/iiio
aeine?aeaeaii? a?iioao?a neeciai? iaieiiee oeoiea 162 oai?eo aoee
aeyaeai? oae? ?o oi?ie: iiaa?oiaaee aano?eo – 33 (20,4%);
?ioa?noeoe?aeueiee aano?eo (c o?aaeaiiyi caeic) – 20 (12,3%); ao?io?/iee
aano?eo aac ia?aaoaeiae caeic – 54 (33,3%); ao?io?/iee aano?eo c
ia?aaoaeiaith caeic – 40 (24,7%); ao?io?/iee a?ia?ieanoe/iee aano?eo –
15 (9,2%).

A?aoiaoth/e, ui o?eaaeee ia?aa?a caiaeueieo i?ioean?a a neecia?e
iaieiioe? oeoiea i?e ae?acoe? aeaaiaaeoeyoeiaei? eeoee
noi?iaiaeaeo?oueny ?aaaia?aoi?ieie ii?ooaiiyie o aeaeyae? ao?io??,
eeoeiai? iaoaieac??, iaoieia?/ii? i?ie?oa?aoe?? oa ia?aaoaeiae caeic,
iaie aea/aeenue ii?oino?oeoo?i? ci?ie ia o?eueee ia i?aaiiiio, a e
ee?oeiiiio ??ai?. Aea ei?enooaaoeny oeeie iieacieeaie aeey
oa?aeoa?enoeee i?ioean?a ?aaaia?aoe?? iac?o/ii. Oiio aeey i?aeoe/iiai
canoinoaaiiy aoea aeei?enoaia iiaeeo?eiaaia eeaneo?eaoe?y o?ii?/ieo
aano?eo?a ca nooiaiai aaaeeino? ?aaaia?aoi?ieo ii?ooaiue (Iao?ia A.I.,
1994). A?aeiia?aeii aei oe??? eeaneo?eaoe?? an? oai?? ia ae?aceo
aeaaiaaeoeyoeiaei? eeoee c noiooi?ie aano?eoaie ?iciiae?eeeeny oaeei
/eiii:

1. O?ii?/iee aano?eo aac ii?ooaiiy ?aaaia?aoi?ieo i?ioean?a — 27 (16,7%)
oai?eo.

-9-

2. O?ii?/iee aano?eo c ia??cei ae?aaeaieie ii?ooaiiyie ?aaaia?aoi?ieo
i?ioean?a — 70 (43,2%) oai?eo.

3. O?ii?/iee aano?eo c ??cei ae?aaeaieie ii?ooaiiyie ?aaaia?aoi?ieo
i?ioean?a — 39 (24,1%) oai?eo.

4. O?ii?/iee aano?eo c ii?aeiaieie aeenieanoe/ieie oa ?aaaia?aoi?ieie
ci?iaie — 26 (16,0%) oai?eo.

5. O?ii?/iee aano?eo c ?cieueiaaieie aeenieac?yie — aeyaeaii ia aoei.

O aeine?aeaeoaaii? a?oie oai?eo aea/aeany caeaaei?noue i?e?iaii?
eiioai?iaoe?? I? oa ?ioi? ioeicii? i?e?ioei?e a?ae nooiaiy ae?aaeaiiy
ii?ooaiue ?aaaia?aoi?ieo i?ioean?a neeciai? iaieiiee oeoiea. A
?acoeueoao? i?iaaaeaiiai aiae?co aoei anoaiiaeaii, ui o oai?eo c?
c?inoaiiyi nooiaiy ii?ooaiue ?aaaia?aoi?ieo ? aeenieanoe/ieo i?ioean?a
/anoioa aeyaeaiiy I? a iiiieoeueoo?? cieaeo?oueny a?ae 55,6% i?e
o?ii?/iiio aano?eo? aac ii?ooaiiy ?aaaia?aoi?ieo i?ioean?a aei 38,5% i?e
o?ii?/iiio aano?eo? c ii?aeiaieie aeenieanoe/ieie ? ?aaaia?aoi?ieie
ii?ooaiiyie, a a anioe?aoe?yo c?inoa? a?ae 26,0% aei 50,0%
a?aeiia?aeii aei iaaaaeaieo oi?i aano?eo?a. Noiniaii ioeicii? i?e?ioei?e
iiaeia a?aei?oeoe i?aeaeuaiiy /anoioe aeyaeaiiy oeeo i?e?ii?aai?ci?a
o?eueee o neeaae? anioe?aoe?e.

Oaeei /eiii, c iaea?aeaieo aeaieo aeaeii, ui i?e ae?aaeaiiio nooiai?
?aaaia?aoi?ieo ii?ooaiue a ii?aeiaii? c aeenieanoe/ieie ci?iaie neeciai?
iaieiiee oeoiea /anoioa aeyaeaiiy ye I?, oae ? ?ioi? ioeicii? i?e?ioei?e
c?inoa? o aeaeyae? anioe?aoe?e oeeo i?e?ii?aai?ci?a.

A caeaaeiino? a?ae noaio eeneioiooai?thth/i?, eoaeii?,
iioi?ii-aaaeoaoi?ii? ooieoe?e oeoiea, ?aaaia?aoi?ieo ii?ooaiue eiai
neeciai? iaieiiee oa i?e?ioei?e a i?e oeei oai?ei aoee aeeiiai? oae?
oeie iia?aoe?e: ?cieueiaaia naeaeoeaia i?ieneiaeueia aaaioii?y o 63
(55,3%) oai?eo; ??ci? oeie aaaioii?e c ae?aioth/eie iia?aoe?yie o 32
(28,1%) oai?eo; ?acaeoe?? ii Billroth-II o 19 (16,7%) oai?eo.

On? i?iiia?iaai? oai?? aoee iiae?eai? ia aea? a?oie. A iniiaio a?oio
aa?eoei 58 /ieia?e, eio?ei aei oa i?ney iia?aoe?? i?iaiaeeeany iio??eia
aioeaaeoa??aeueia oa?ai?y o eiiieaen? c eaca?iei ii?ii?ithaaiiyi
neeciai? iaieiiee. Eiio?ieueio a?oio neeaaeaee 56 oai?eo, eio?ei
aioeaaeoa??aeueia oa?ai?y ia i?iaiaeeeany.

A eiio?ieuei?e a?oi? aea/aany i?e?iaiee noai neeciai? iaieiiee
oeoiea

a ?aiiueiio i?neyiia?aoe?eiiio ia??iae? caeaaeii a?ae
oeio iia?aoe?? oa

-10-

eeneioiooai?thth/i? ooieoe??, a oaeiae caeaaei?noue ?acoeueoao?a
iia?aoe?? a?ae iayaiino? o??? /e ?ioi? i?e?ioei?e.

C 31 iaoe??ioa a ?aiiueiio ia??iae? i?ney naeaeoeaii? i?ieneiaeueii?
aaaioii?? i?e?ioei?a oeoiea aoea i?aaenoaaeaia i?e?ii?aai?ciaie
i?aeueiiai oeio o 11 (35,5%) oai?eo, a?eaeiaith oei?ith — o 7
(22,6%)oai?eo. *anoioa aeyaeaiiy I? cinoaaaeanue ia oiio ae ??ai?, ui e
aei iia?aoe?? – 23 (74,2%) aeiaaeee, i?ioa nooi?iue ian?iai?iiy iaa
oaiaeaioe?th aei cieaeaiiy. I?e?ii?aai?ci?a eeoeiaiai oeio i?e oeeo
iia?aoe?yo aeyaeaii ia aoei. I?ney iia?aoe?? cia/aiiy ii?iaeieiiiai ?I
oeoieiaiai ai?noo o oeeo oai?eo eieeaaeiny a?ae 1,9 aei 4,8. Iayai?noue
iaeieo ? oeo naieo aeae?a i?e?ii?aai?ci?a ioeicii? i?e?ioei?e aei oa
i?ney iia?aoe?? o iaeieo ? oeo naieo oai?eo neeaaeaea 19,6%, a I? –
74,2% aeiaaee?a.

O 15 oai?eo, eio?ei aoea aeeiiaia aaaioii?y c ae?aioth/eie iia?aoe?yie,
aaeoa??aeueiee oii a i?neyiia?aoe?eiiio ia??iae? iaa ?ioee aeaeyae.
I?e?ii?aai?cie eeoeiaiai oeio cono??/aeeny o 5 (33,3%) oai?eo,
i?aeueiiai – o 3 (20,0%) oai?eo, a?eae Eaiae?aea – o 4 (26,6%)
oai?eo, i?e/iio o 3 aeiaaeeao — a anioe?aoe?? c I?. E?euee?noue
aeiaaee?a aeyaeaiiy I? cieceeany ia 20% o ii??aiyii? c aeiiia?aoe?eiei.
Iayai?noue a neecia?e iaieiioe? oeoiea i?ney iia?aoe?? eeoa/ii? iaee/ee,
eeaan??ee oa oaeaeueiiai no?aioieiea aeicaiey? noaeeoe i?i ?o
?ao?ia?aaeia i?a?oaaiiy aei oeoieo /a?ac ciio aeoiaeaiiieanoeee. On?
iaoe??ioe oe??? a?oie c iayai?noth i?e?ia?a iaee cia/aiiy ?I oeoieiaiai
ai?noo a?ae 2,5 aei 5,5. Iaei? e o? ae nai? i?aaenoaaieee ioeicii?
i?e?ioei?e aei oa i?ney iia?aoe?? aeyaeyeenue o 26,6%, a I? – o 73,3%
oai?eo.

C 10 oai?eo, eio?ei aoea aeeiiaia ?acaeoe?y oeoiea ii niiniao
Billroth-II, ioeicia i?e?ioei?a a iiiieoeueoo?ao oa anioe?aoe?yo
aeyaeyeany o 6 oai?eo: a 5 aeiaaeeao — eeoeiaiai oeio, o 1 aeiaaeeo —
i?aeueiiai. I? a iiiieoeueoo?? oa anioe?aoe?yo aeyaeyany o 5 oai?eo, ui
ia 30% iaioa, i?ae aei iia?aoe??. Aioo??oiueiii?iaeieiia ?I oeoieiaiai
ai?noo o oeeo oai?eo i?ney iia?aoe?? eieeaaeanue a?ae 4,0 aei 6,5.
I?aaenoaaieee iaeiiai e oiai ae aeaeo ioeicii? i?e?ioei?e aei oa i?ney
iia?aoe?? aeyaeyeenue o 30,0% oai?eo, I? – o 50,0% oai?eo.

I?e aeine?aeaeaii? oa?aeoa?o oneeaaeiaiue a ?aiiueiio i?neyiia?aoe?eiiio
ia??iae? o oai?eo eiio?ieueii? a?oie aianoiiiceoe ??ciiai
nooiaiy aoee

ae?aaiinoiaai? o 7 (12,5%) oai?eo i?ney ae?aioth/eo iia?aoe?e oa o 4
(7,1%) -i?ney ?acaeoe?e, iacaai?i? ae?acee i?ney NIA i?e
aiaeineii?/iiio ianoaaeaii? /a?ac

-11-

1 i?nyoeue i?ney iia?aoe?? aoee ae?aaiinoiaai? o 7 (12,5%) oai?eo. A
on?o aeiaaeeao caiaeuei? oneeaaeiaiiy noi?iaiaeaeoaaeeny cia/iei
canaeaiiyi NIO oa ciie caiaeaiiy ioeiciith i?e?ioei?ith iaeiiai aeaeo ye
aei, oae ? i?ney iia?aoe??, a i?e aeiaai iacaaithaaieo ae?aceao i?ney
NIA — iayai?noth ae?aaeaii? eiioai?iaoe?? neeciai? iaieiiee
aae?eiaaeoa??yie.

O a?aeaeaeai? no?iee i?ney iia?aoe?? o oai?eo eiio?ieueii? a?oie
iiceoeai? ?acoeueoaoe a?aei?/aeeny o 71,4% oai?eo, caaeia?euei? c
aeeniaine/ieie i?iyaeaiiyie — o 17,8% oai?eo, iacaaeia?euei? o aeaeyae?
?aoeeaeeao ae?acee oa a?iceaiiai i?ioeano — o 10,7% oai?eo. O an?o
iaoe??io?a ?aoeeaeea caoai?thaaiiy noi?iaiaeaeoaaany ae?aaeaiith
?io?eiaai?noth neeciai? iaieiiee oeoiea I? ye a iiiieoeueoo??, oae ? a
anioe?aoe?? c ioeiciith i?e?ioei?ith, a aeeniaine/i? yaeua ia oii?
i?neyiia?aoe?eiiai aano?eoo noi?iaiaeaeoaaeeny canaeaiiyi NIO ia?aaaaeii
ioeiciith i?e?ioei?ith eeoeiaiai oeio.

I?e/aoi?noue aae?eiaaeoa??e oa ?ioi? ioeicii? i?e?ioei?e aei caiaeueieo
oneeaaeiaiue ?aiiueiai i?neyiia?aoe?eiiai ia??iaeo oa iacaaeia?eueieo
?acoeueoao?a o a?aeaeaeai? no?iee na?ae/eoue i?i iaiao?aei?noue
canoinoaaiiy i?e o??o?a?/iiio e?eoaaii? ae?aceiai? oai?iae
aeaaiaaeoeyoeiaei? eeoee aaeaeaaoii? aioeaaeoa??aeueii? oa?ai??.

Aoaeoeai?noue eiiieaenii? aioeaaeoa??aeueii? oa eaca?ioa?ai??
aea/aeanue ia i?eeeaae? 58 oai?eo, i?iiia?iaaieo ia ae?aceo
aeaaiaaeoeyoeiaei? eeoee, ui neeaaeaee iniiaio a?oio. Oeei oai?ei
ii?yae c o?aaeeoe?eiith i?ioeae?aceiaith oa?ai??th a aei- oa
i?neyiia?aoe?eiiio ia??iaeao c iaoith naiaoe?? canoiniaoaaeanue iio??eia
aioeaaeoa??aeueia oa?ai?y (aea-iie, aii?oeee?i, iao?ii?aeacie ca
noaiith). O ?ac? aeyaeaiiy o ianoaaeaieo oai?eo ae?aaeaieo ii?ooaiue
?aaaia?aoi?ieo i?ioean?a, a oaeiae ?icaeoeo a i?neyiia?aoe?eiiio
ia??iae? oneeaaeiaiue caiaeueiiai oa?aeoa?o, iaiiaii? naiaoe?? aai
iacaaithaaii? ae?acee, e?eoaaiiy aeiiiaithaaeiny canoinoaaiiyi
iecueeiaia?aaoe/iiai eaca?iiai ii?ii?ithaaiiy.

I?iaiaeeee ii??aiyeueiee aiae?c iieaciee?a nooiaiy canaeaiiy NIO
i?eno?iiith i?e?ioei?ith oa oa?aeoa?o ?? ii?oieia?/ieo ci?i o oai?eo,
ye? io?eioaaee ? ia io?eioaaee eiiieaenio aioeaaeoa??aeueio oa eaca?io
oa?ai?th, a aoaeoeai?noue iaoiaeo ioe?ithaaeany ca
ee?i?ei-aiaeineii?/ieie aeaieie ?aiiueiai oa a?aeaeaeaiiai
i?neyiia?aoe?eieo no?ie?a. ?acoeueoaoe ii??aiyeueiiai aiae?co noaio

i?eno?iii? i?e?ioei?e a iniiai?e oa eiio?ieuei?e a?oiao iaaaaeai? a
oaaeeoe? 1.

Aiae?c io?eiaieo aeaieo o oai?eo iaio a?oi iieacaa, ui e?euee?noue
in?a c

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canaeaiiyi NIO aae?eiaaeoa?iith ?ioaeoe??th a iniiai?e a?oi? aei
iia?aoe?? ciaioeeanue ia 60,3% a ii??aiyii? c aeo?aeiei ??aiai. Aenieee
??aaiue naiaoe?? o oai?eo iniiaii? a?oie aoa a?aecia/aiee noiniaii
ioeicii? i?e?ioei?e. A 2 ?ace ciaioeany ?? oii a ii??aiyii? c aeo?aeiei
??aiai. *iai ia iiaeia neacaoe i?i oai?eo eiio?ieueii? a?oie. O oai?eo
oe??? a?oie a aeiiia?aoe?eiiio ia??iae? i?e?iaiee oii ia o?eueee ia
ciaioeany, a iaa?oue i?aeaeueany — noiniaii aae?eiaaeoa?o aei 82,3%, a
noiniaii ioeicii? i?e?ioei?e oa a?ea?a caeeoeany i?aeoe/ii ia oiio ae
??ai?, ui e aei e?eoaaiiy.

Oaaeeoey 1.

Noai i?e?iaiiai oiio o oai?eo iniiaii? oa eiio?ieueii? a?oi aei ? a
??ci? no?iee i?ney iia?aoe?? a caeaaeiino? a?ae canoiniaaiiai e?eoaaiiy

A?oieI?e?ioei?aAei eiina?-aaoeaiiai e?eoaaiiyI?ney eii-na?aaoeaii-ai
e?eoaaiiyI?ney iia?aoe??

1 – 2 i?nyoeyI?ney iia?aoe??

6 i. – 2 ?.E?euee?noue aeiaaee?a, (%)Eii-o?i-eueia
n=56Iiii-eoeue-oo?aHelicobacter pylori33 (59,0%)29 (51,9%)19 (34,0%)26
(46,4%)II

(iaeei c aeae?a)7 (12,5%)7 (12,5%)14 (25,0%)5 (9,0%)Anioe?-aoe??
i?e?i-i?aa-i?ci?aHelicobacter pylori c II12 (21,4%)17 (30,4%)17
(30,4%)20 (35,7%)II

(??ci? aeaee)2 (3,5%)3 (5,3%)5 (9,0%)3 (5,3%)I?e?ioei?a

ia aeyaeaia2 (3,5%)-1 (1,8%)2 (3,5%)In-iiaia
n=58Iiii-eoeue-oo?aHelicobacter pylori30 (51,7%)5 (8,6%)-6 (10,3%)II

(iaeei c aeae?a)5 (8,6%)-2 (3,4%)2 (3,4%)Ani-oe?aoe??
i?e?i-i?aa-i?ci?aHelicobacter pylori c II19 (32,7%)9 (15,5%)6 (10,3%)9
(15,5%)II

(??ci? aeaee)1 (1,7%)5 (8,6%)2 (3,4%)3 (5,1%)I?e?ioei?a

ia aeyaeaia3 (5,1%)39 (67,2%)48 (82,7%)38 (65,6%)

Aiae?coth/e aeai? ii?oieia?/ieo ci?i neeciai? iaieiiee oeoiea, io?eiaieo
i?ney iia?aoe?? o oai?eo eiio?ieueii? oa iniiaii? a?oi
a ii??aiyii? c

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aeiiia?aoe?eieie aoa a?aei?/aiee aeia?ee aoaeo iiiiaeaiiy ii?iaeueieo
?aaaia?aoi?ieo i?ioean?a ? ciaioaiiy /enea aano?eo?a c ii?aeiaieie
aeenieanoe/ieie oa ?aaaia?aoi?ieie ci?iaie a iaio a?oiao oai?eo i?ney
canoinoaaiiy eaca?iiai ii?ii?ithaaiiy NIO. Aea a ii??aiyii? c
?acoeueoaoaie eiio?ieueii? a?oie, i?ioeane iiiiaeaiiy ii?iaeueii?
?aaaia?aoe?? o oai?eo iniiaii? a?oie aoee a?eueo ae?aaeai?.

E?eoa??yie aoaeoeaiino? canoiniaaii? iaoiaeeee o ?aiiueiio
i?neyiia?aoe?eiiio ia??iae? aoee: oa?i?i caai?iiy ae?acee i?ney NIA oa
oneeaaeiaiiy caiaeueiiai oa?aeoa?o a cii? iia?aoe??, a?aeaeaeai?
?acoeueoaoe -ioe?iea ee?i?/iiai noaio oai?eo ii Visick. Ai?iaaaeaeaiiy a
eo?n o??o?a?/iiai e?eoaaiiy ii?aeiaii? iio??eii? aioeaaeoa??aeueii?
oa?ai?? c iecueeiaia?aaoe/iei eaca?iei ii?ii?ithaaiiyi o in?a c
ae?aaeaiei nooiaiai ?aaaia?aoi?ieo ii?ooaiue oa ci?oaiith i?e?ioei?ith
ciaioeei e?euee?noue caiaeueieo oneeaaeiaiue i?ney iia?aoe?? a 2 ?ace,
iacaai?ieo ae?acie i?ney NIA — o 3 ?ace, a oaeiae e?euee?noue
?aoeeaeea?a ae?acee oa i?neyiia?aoe?eieo aano?eo?a c
ae?aaeaieie aeeniaine/ieie ?iceaaeaie oeoieiai-eeoeiaiai o?aeoo o
a?aeaeaeai? no?iee. I?e oeueiio ia?aaoaaiiy oai?eo ia o??o?a?/iiio
e?aeeo a iniiai?e a?oi? neeaaeaei 17±4 aeiae (eiio?ieueia a?oia — 26±7
ae?a).

Canoinoaaiiy iio??eii? aioeaaeoa??aeueii? oa?ai?? a eiia?iaoe?? c
aiaeineii?/iei eaca?iei ii?ii?ithaaiiyi aei oa i?ney iia?aoe?? o oai?eo
c ae?aaeaieie ii?ooaiiyie ?aaaia?aoi?ieo i?ioean?a oa ?ioaineaiith
?io?eiaai?noth NIO i?eno?iiith i?e?ioei?ith i?eaiaeeoue aei iiaii?
naiaoe?? neeciai? iaieiiee a?ae aaeoa??e ? aeinoia??ii ca?eueoo?
e?euee?noue iiceoeaieo ?acoeueoao?a iia?aoeaiiai e?eoaaiiy ae?aceiai?
oai?iae.

AENIIAEE

1. A e?a? ae?aceiaiai aeaoaeoo iacaeaaeii a?ae eieae?caoe?? ae?acee
ioeicia i?e?ioei?a ia?aaaaea? iaae aae?eiaaeoa?ii. A neecia?e iaieiioe?
aio?aeueiiai a?aeae?eo oeoiea i?e aeoiaeaiaeueieo ae?aceao
ia?aaaaeath/ei o niaeo?? i?e?ioei?e ? aae?eiaaeoa?, eio?ee aeyaeyany o
89,0% oai?eo a ii??aiyii? c ioeiciith i?e?ioei?ith (47,0% oai?eo). O
42,0% oai?eo i?e?ioei?a NIO i?aaenoaaeaia anioe?aoe?yie i?e?ii?aai?ci?a
c I? oa ioeicii? i?e?ioei?e.

2. Helicobacter pylori ia?nenoo? a na?aaeiaeu? c a?eueo
aenieeie

iieacieeaie eeneioiino? oa i?enei?aiiyi iioi?ii-aaaeoaoi?ii? ooieoe??
oeoiea.

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Ioeicia i?e?ioei?a, iaaiaee,- o na?aaeiaeu? c a?eueo iecueeeie
iieacieeaie eeneioiino? ? oiia?eueiaiiyi aaaeoaoe?? oeoiea.

3. I?e i?aeaeuaii? nooiaiy ii?ooaiue ?aaaia?aoi?ieo i?ioean?a o
niieo/aii? c aeenieanoe/ieie ci?iaie neeciai? iaieiiee oeoiea /anoioa
aeyaeaiiy aae?eiaaeoa??e oa ioeicii? i?e?ioei?e c?inoa?.

4. Aeaeiaee neeaae i?e?ii?aai?ci?a a i?neyiia?aoe?eiiiio ia??iae?
caeaaeeoue a?ae oeio i?iaaaeaii? iia?aoe??. I?ney NIA a neeaae?
i?eno?iii? i?e?ioei?e i?aaaeththoue aae?eiaaeoa??? (75,0% aeiaaee?a),
i?ney ae?aioth/eo iia?aoe?e c aaaioii??th a?aei?/a?oueny ia?aaaaa
anioe?aoe?e aae?eiaaeoa??e c ?ioith ioeiciith i?e?ioei?ith (45,5%
aeiaaee?a), a i?ney ?acaeoe?? oeoiea a i?e?iaiiio oii? /ano?oa
cono??/athoueny i?aaenoaaieee ioeicii? i?e?ioei?e (63,6% aeiaaee?a), c
ia?aaaaith i?e?ii?aai?ci?a eeoa/iiai oeio.

5. Ae?aaeaia canaeaiiy neeciai? iaieiiee oeoiea aae?eiaaeoa??yie o
iaeieo e oeo naieo oai?eo aei oa i?ney iia?aoe?? c iacaaithaaieie ?
?aoeeaeeaieie ae?aceaie i?ney NIA, a oaeiae ioeiciith i?e?ioei?ith i?e
caiaeueieo oneeaaeiaiiyo a cii? iia?aoe?? o ?aiiueiio i?neyiia?aoe?eiiio
ia??iae?, na?ae/eoue i?i i?e/aoi?noue oeeo i?e?ii?aai?ci?a aei aeaieo
i?ioean?a, ui iio?aao? i?iaaaeaiiy aioeaaeoa??aeueii? oa?ai??.

6. Canoinoaaiiy iio??eii? aioeaaeoa??aeueii? oa?ai?? a ii?aeiaii? c
eaca?iei ii?ii?ithaaiiyi o oai?eo c ae?aaeaieie ii?ooaiiyie
?aaaia?aoi?ieo i?ioean?a oa ?ioaineaiei canaeaiiyi neeciai? iaieiiee
oeoiea i?eno?iiith i?e?ioei?ith aei oa i?ney iia?aoe?? i?eaiaeeoue aei
iiaii? naiaoe?? NIO aei iia?aoe?? o 67,2% oai?eo, a iiaoi?iee eo?n
oaei? oa?ai?? i?ney iia?aoe?? — aei 82,7%, ui aeinoia??ii ca?eueoo?
e?euee?noue iiceoeaieo ?acoeueoao?a iia?aoeaiiai e?eoaaiiy ae?aceiaai?
oai?iae aei 83,0% o oai?eo iniiaii? a?oie o ni?anoaaeaii? c 69,0%
iiceoeaieo ?acoeueoao?a o oai?eo eiio?ieueii? a?oie.

I?AEOE*I? ?AEIIAIAeAOe??

1. A?aoiaoth/e ca?ycie i?eno?iii? i?e?ioei?e neeciai? iaieiiee oeoiea c
aeieeiaiiyi ?aii?o i?neyiia?aoe?eieo oneeaaeiaiue caiaeueiiai oa?aeoa?o
oa i?iaeiaaeaii?noth caai?iiy aeoiaeaiaeueieo ae?acie i?ney
i?aaiicaa??aath/eo iia?aoe?e, iaiao?aeii i?iaiaeeoe i??ii?e?inoaa
iai?aaeai? ia ae?i?iaoe?th aeaieo i?e?ii?aai?ci?a. C oe??th iaoith
a aeiiia?aoe?eiiio ia??iae? ?aeiiaiaeo?oueny

aeei?enoiaoaaoe ne?aeoth/o noaio aioeaaeoa??aeueii? oa?ai??: Aea-iieii
ii 120 ia 3

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?ace ia aeaiue ca 30 oaee. aei ?aee oa 1 ?ac iaouana?oea oaa/a?? ia?aae
niii; aii?oeee?i ii 0,5 a 4 ?ace ia aeaiue aei ?aee; iao?ii?aeacie ii
250 ia 4 ?ace ia aeaiue i?ney ?aee. O?eaae?noue aeiiia?aoe?eiiai eo?no
10 aei?a. I?e iayaiino? a neecia?e iaieiioe? oeoiea a?ea?a aei e?eoaaiiy
ne?ae aeiaeaaaoe i?noao?i o aeic? 250 oen. IAe. 4 ?ace ia aeaiue, ia
i?ioyc? 7 aei?a.

2. A i?neyiia?aoe?eiiio ia??iae? oai?ei, yeei aei iia?aoe?? ia aaeaeiny
iiai?noth naioaaoe neeciao iaieiieo oeoiea, ia 3 – 5 aeaiue i?ney
iia?aoe?? iaiao?aeii i?iaeiaaeeoe i?iaaaeaiiy iio??eii?
aioeaaeoa??aeueii? oa?ai?? ua ia i?ioyc? 7 – 14 aei?a, a a ?ac?
caa?aaeaiiy aeniei? eeneioiino? aeiiiaieoe ?? i?eeiiii aeieaoi??a
a?noai?iiaeo ?aoeaioi??a (?ai?o?ae?i ii 150 ia a?aioe? ? aaa/a??), aai
?ia?a?oi??a i?ioiiii? iiiie (iiai?acie ii 20 ia ia aeiao).

3. Oai?ei c i?neyiia?aoe?eieie oneeaaeiaiiyie caiaeueiiai oa?aeoa?o
(i?neyiia?aoe?eiee aano?eo, aianoiiiceoe ??ciiai nooiaiy ae?aaeaiiy)
iaiao?aeii i?iaiaeeoe iio??eio aioeaaeoa??aeueio oa?ai?th a eiiieaen? c
ii?ii?iaiiyi neeciai? iaieiiee aio?aeueiiai a?aeae?eo oeoiea
iecueeiaia?aaoe/iei eaca?iei aei?ii?iaiiyi.

4. Oai?ei, o yeeo i?ney i?aaiicaa??aath/eo iia?aoe?e iathoueny iacaai?i?
ae?acee, iaiao?aeii i?iaiaeeoe eiiieaenio oa?ai?th, ui aeeth/a?:
aeieaoi?e a?noai?iiaeo ?aoeaioi??a (?ai?o?ae?i ii 150 ia, oaiio?ae?i ii
20 ia 2 ?ace ia aeiao iaouana?oea), aai ?ia?a?oi?e i?ioiiii? iiiie
(iiai?acie ii 20 ia a?aioe? aai aaa/a??) oa iio??eio aioeaaeoa??aeueio
oa?ai?th a eiiieaen? c eaca?iei ii?ii?iaiiyi ca noaiith, aei iiaiiai ?o
caaithaaiiy.

NIENIE ?IA?O, IIOAE?EIAAIEO CA OAIITH AeENA?OAOe??

1. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N. I?eiaiaiea yiaeineiie/aneie
iaaeeeaiaioiciie aeieaaeu aeoaeaeathuaai ia?aa a ea/aiee ycaaiiie
aieacie. //Eeeie/aneay oe?o?aey. –1996 a. -?8. –N. 12–13.

2. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N., Aaneeueaaa I.A. Iee?ioei?a
aeaeoaeea i?e ycaaiiie aieacie e o?iie/aneii aano?eoa. // A?a/aaiia
aeaei. –1998. -?1. –N. 52–58.

3. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N. Yiaeineiie/aneea iaoiaeu
ea/aiey ycaaiiie aieacie. //A?a/aaiia aeaei. –1998. -?2. –N. 8-13.

4. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N. Yiaeineiie/aneay
iaaeeeaiaioic-iay aeieaaea aeoaeaeathueo ia?aia e e?eioa?aiey a ea/aiee
aeeeoaeueii iacaaeeaa-

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thueo yca aeaeoaeea e aeaaiaaeoeaoeia?noiie eeoee. //Aanoiee i?iaeai
aeieiaee e iaaeeoeeiu. –1998. -?22. –N. 105-109.

5. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N. Helicobacter pylori e
ioeiciay iee?ioei?a aeaeoaeea i?e oe?o?ae/aneii ea/aiee ycaaiiie
aieacie. //Aanoiee i?iaeai aeieiaee e iaaeeoeeiu. –1998. -?23. –N.
140-143.

6. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N. Helicobacter pylori e
ioeiciay iee?ioei?a aeaeoaeea i?e ycaaiiie aieacie. //Aanoiee i?iaeai
aeieiaee e iaaeeoeeiu. –1998. -? 25. –N. 16-20.

7. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N. Aeieiae/aneia aeaenoaea
ieceiyia?aaoe/aneiai eaca?iiai eceo/aiey e e?eioa?aiee ia neecenooth
aeaeoaeea i?e ianoiii ea/aiee ycaaiiie aieacie. //Iaoa?eaeu VI
?anioaeeeaineie iao/ii-i?aeoe/aneie eiioa?aioeee “I?eiaiaiea eaca?ia a
iaaeeoeeia e aeieiaee”. –Oa?ueeia, 1996a., n. 64-65.

8. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N., Ieeiiaiei O.I. Aeeyiea
yiaeineiie/aneie eaca?ioa?aiee ia caaeeaeaiea aeoiaeaiaeueiie ycau e
iee?ioei?o aeaeoaeea iinea naeaeoeaiie i?ieneiaeueiie aaaioiiee.
//Iaoa??aee iaoeiai-i?aeoe/ii? eiioa?aioe?? aiaeineii?no?a Oe?a?ie
“Aeooaeuei? i?iaeaie ae?aaiinoe/ii? oa e?eoaaeueii? aiaeineii??”. -i.
Ee?a, 23-24 o?aaiy, 1996 ?., n. 16-17.

9. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N., Oeiea?aiei A.E., Caoaethe
A.I. *anoioa auyaeaiey Helicobacter pylori a niiinoaaeaiee n
yiaeineiie/aneeie aeaiiuie i?e aano?eoao e ycaaiiie aieacie. //Iaoa??aee
iaoeiai-i?aeoe/ii? eiioa?aioe?? aiaeineii?no?a Oe?a?ie “Aeooaeuei?
i?iaeaie ae?aaiinoe/ii? oa e?eoaaeueii? aiaeineii??”. — i.Ee?a, 23-24
o?aaiy, 1996 ?., n. 19-20.

10. A?ooea A.A., Aoeaaneee N.I., Caoaethe N.A., Eaciy N.N. Ii?aaeaeaiea
yaaeoaoi?iie ooieoeee aeaeoaeea i?e yoioiiineiiee. //Nai?iee iao/iuo
o?oaeia, Caii?iaeuea, 1996a., –n. 126-127.

11. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N. Yiaeineiie/aneay
iaaeeeaiaioiciay aeieaaea aeoaeaeathuaai ia?aa e e?eioa?aiey a ea/aiee
ycaaiiie aieacie. //Nai?iee iao/iuo o?oaeia, Caii?iaeuea, 1996a., -n.
127.

12. A?ooea A.A., Aoeaaneee N.I., Eaciy N.N., Caoaethe A.I., E?eaioaoeeay
TH.A., Aa?aaiaay I.A. *anoioa auyaeaiey Helicobacter pylori a
niiinoaaeaiee n yiaeineiie/aneeie aeaiiuie i?e ainiaeeoaeueiuo
caaieaaaieyo aano?iaeoiaeaiaeueiie ciiu. //Nai?iee iao/iuo o?oaeia,
Caii?iaeuea, 1996a., -n. 128.

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AIIOAOe?ss

Aoeaanueeee N.I. Helicobacter pylori oa ?ioa ioeicia i?e?ioei?a oeoiea
i?e o??o?a?/iiio e?eoaaii? ae?aceiai? oai?iae aeaaiaaeoeyoeiaei? eeoee.

— ?oeiien.

Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe
ca niaoe?aeuei?noth 14.01.03 — O??o?a?y. – Aei?i?iiao?ianueea aea?aeaaia
iaaee/ia aeaaeai?y, i.Aei?i?iiao?ianuee, 1999.

Aeena?oaoe?th i?enay/aii ieoaiiyi iie?ioaiiy ?acoeueoao?a o??o?a?/iiai
e?eoaaiiy ae?aceiai? oai?iae. Caoeua?oueny ?oeiien, yeee i?noeoue
?acoeueoaoe eiiieaeniiai aeine?aeaeaiiy i?eno?iii? i?e?ioei?e o 162
oai?eo ia ae?aceo aeaaiaaeoeyoeiaei? eeoee a caeaaeiino? a?ae noaio
eeneioiooai?thth/i?, iioi?ii-aaaeoaoi?ii? ooieoe?e oa ii?oieia?/ieo ci?i
neeciai? iaieiiee oeoiea, a oaeiae o 114 oai?eo c oe??? a?oie aei oa
i?ney iia?aoe??. Ae?aaeai?noue nooiaiy canaeaiiy neeciai? iaieiiee
oeoiea i?eno?iiith i?e?ioei?ith oa ?? niaeo? ciaoiaeyoueny o caeaaeiino?
a?ae noaio eeneioii?iaeoeoe??, ae?aaeaiino? ii?oieia?/ieo ci?i neeciai?
iaieiiee oa oeio canoiniaaiiai iia?aoeaiiai e?eoaaiiy. *anoa aeyaeaiiy
aae?eiaaeoa?ii? ?ioaeoe?? i?e aeiaai iacaaithaaieo ae?aceao i?ney
i?aaiicaa??aath/eo iia?aoe?e oa ?aoeeaeeaao ae?acee, a oaeiae iayai?noue
ioeicii? i?e?ioei?e i?e caiaeueieo oneeaaeiaiiyo a ?aiiueiio
i?neyiia?aoe?eiiio ia??iae? na?ae/aoue i?i i?e/aoi?noue oeeo
i?e?ii?aai?ci?a aei aeaieo i?ioean?a. Canoinoaaiiy iio??eii?
aioeaaeoa??aeueii? oa?ai?? a eiiieaen? c iecueeiaia?aaoe/iei eaca?iei
ii?ii?ithaaiiyi aea? iaeneiaeueiee naioth/ee aoaeo, ui ni?ey? ciaioaiith
e?eueeino? i?neyiia?aoe?eieo oneeaaeiaiue.

Eeth/ia? neiaa: ae?aceiaa oai?iaa, o??o?a?/ia e?eoaaiiy, oneeaaeiaiiy,
i?e?ioei?a, aioeaaeoa??aeueia oa?ai?y.

AIIIOAOeEss

Aoeaaneee N.I. Helicobacter pylori e ae?oaay ioeiciay iee?ioei?a
aeaeoaeea i?e oe?o?ae/aneii ea/aiee ycaaiiie aieacie
aeaaiaaeoeaoeia?noiie eeoee.- ?oeiienue.

Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe
ii niaoeeaeueiinoe 14.01.03 — Oe?o?aey. — Aeiai?iiao?ianeay
ainoaea?noaaiiay iaaeeoeeineay aeaaeaiey, a. Aeiai?iiao?iane, 1999.

Aeenna?oaoeey iinayuaia aii?inai oeo/oaiey ?acoeueoaoia oe?o?ae/aneiai
-18-

ea/aiey ycaaiiie aieacie. Caueuaaony ?oeiienue, eioi?ay niaea?aeeo
?acoeueoaou eiiieaeniiai enneaaeiaaiey i?enoaii/iie iee?ioei?u o 162
aieueiuo ycaaiiie aieaciueth aeaaiaaeoeaoeia?noiie eeoee a caaeneiinoe
io ninoiyiey eeneioiia?acothuae, iioi?ii-yaaeoaoi?iie ooieoeee e
ii?oieiae/aneeo eciaiaiee neecenoie iaiei/ee aeaeoaeea, a oaeaea o 114
aieueiuo ec yoie a?oiiu aei e iinea iia?aoeee. Au?aaeaiiinoue noaiaie
ianaiaiaiiinoe neecenoie iaiei/ee aeaeoaeea i?enoaii/iie iee?ioei?ie e
aa iee?iaiue niaeo? iaoiaeyony a caaeneiinoe io ninoiyiey
eeneioii?iaeoeoeee, au?aaeaiiinoe ii?oieiae/aneeo eciaiaiee neecenoie
iaiei/ee e oeia i?eiaiyaiiai iia?aoeaiiai ea/aiey. Oae i?e
aeia?aoeeaeiii eeneioiia?aciaaiee i?aiaeaaeathueie a niaeo?a
i?enoaii/iie iee?ioei?u yaeythony aaeeeiaaeoa?ee, eioi?ua auyaeythony o
89,0% aieueiuo. I?e oia?aiii au?aaeaiiii eee ii?iaeueiii
eeneioiia?aciaaiee a niaeo?a i?enoaii/iie iee?ioei?u ia?yaeo n
aaeeeiaaeoa?eyie iiyaeythony i?aaenoaaeoaee ?acee/iuo aeaeia eieeiaie
iee?ioei?u e a?eaia a aeaea annioeeaoeee i?eia?ii o 42,0% aieueiuo.
Auyaeaiea iaeeiaeiauo aeaeia iee?ii?aaieciia, ioiinyueony a 25,4%
neo/aaa e i?aaenoaaeoaeyi ioeiciie iee?ioei?u e a 65,8% neo/aaa e
aaeeeiaaeoa?eyi, o iaeieo e oao aea iaoeeaioia eiio?ieueiie a?oiiu aei e
iinea iia?aoeee, a oaeaea aieaa /anoia aicieeiiaaiea iineaiia?aoeeiiiuo
ineiaeiaiee eiaiii o yoeo aieueiuo, naeaeaoaeuenoaoao i
i?e/eiii-neaaenoaaiiie nayce i?enoaii/iie iee?ioei?u n aeaiiuie
ineiaeiaieyie. *anoia iaia?oaeaiea aaeeeiaaeoa?iie eioaeoeee i?e
aeeeoaeueii ia?oaoeothueony ycaao iinea i?aaiinio?aiythueo iia?aoeee e
iaee/ea ioeiciie iee?ioei?u i?e ainiaeeoaeueiuo ineiaeiaieyo a ?aiiai
iineaiia?aoeeiiiii ia?eiaea iinea ae?aie?othueo e ?aaeeeaeueiuo
iia?aoeee, iicaieyao ooaa?aeaeaoue i?e/anoiinoue eiie?aoii yoeo
iee?ii?aaieciia e aeaiiui ineiaeiaieyi. Au?aaeaiiua ia?ooaiey
?aaaia?aoi?iuo i?ioeannia a ni/aoaiee n aeenieanoe/aneeie eciaiaieyie
neecenoie iaiei/ee ia oiia aaeoa?eaeueiie eiioaieiaoeee oaaee/eaatho
?ene aicieeiiaaiey ineiaeiaiee ainiaeeoaeueiiai oa?aeoa?a a ?aiiai
iineaiia?aoeeiiiii ia?eiaea e aa?iyoiinoue ?aoeeaeeaa ycau a ioaeaeaiiua
n?iee. A nayce n yoei ea/aaiua ia?ii?eyoey aeieaeiu iineoue eiiieaeniue
oa?aeoa?, /oi aeinoeaaaony i?eiaiaieai ni/aoaiey aioeaaeoa?eaeueiie
oa?aiee n eaca?iui iaeo/aieai ciiu ycaaiiiai aeaoaeoa e neecenoie
iaiei/ee i?aieei?e/aneiai ioaeaea aeaeoaeea. Aeey oneeaiey naie?othuaai
yooaeoa eniieuecoaony ni/aoaiea ianeieueeeo aioeaaeoa?eaeueiuo

-19-

i?aia?aoia, eiathueo ?acee/iue iaoaieci aaeoa?eoeeaeiiai aeaenoaey, ii a
eiiieaena aunooiathuea eae neia?aenou.

I?eiaiaiea o?ieiie aioeaaeoa?eaeueiie oa?aiee (aea-iie, aiieoeeeeei,
iao?iieaeacie) niaianoii n ieceiyia?aaoe/aneei eaca?iui iaeo/aieai aeaao
iaeneiaeueiue naie?othuee yooaeo. Yoi iicaieeei nieceoue i?ioeaio
iineaiia?aoeeiiiuo ineiaeiaiee a iniiaiie a?oiia aieueiuo aei 10,2% ii
n?aaiaieth n eiio?ieueiie – 32,1% neo/aaa, a eiee/anoai
iaoaeiaeaoai?eoaeueiuo ?acoeueoaoia a aeaea ?aoeeaeeaia ycau e
y?iceaiiai ainiaeeoaeueiiai i?ioeanna n au?aaeaiiuie aeeniaine/aneeie
?anno?ienoaaie a ioaeaeaiiii ia?eiaea aei 17.2% a iniiaiie a?oiia ii
n?aaiaieth n eiio?ieueiie 28,5% neo/aaa.

Eeth/aaua neiaa: ycaaiiay aieaciue, oe?o?ae/aneia ea/aiea, ineiaeiaiey,
iee?ioei?a, aioeaaeoa?eaeueiay oa?aiey.

SUMMARY

Gulevsky S.N. Helicobacter pylori and Other Mucous Microflora of the
Stomach on Surgical Treatment of Duodenal Ulceration. – Manuscript.

The thesis for the degree of Candidate of Medicine by speciality
14.01.03 — The Surgery. – Dnepropetrovsk State Medical Academy,
Dnepropetrovsk, 1999.

The thesis is designed to improve the results of surgical treatment of
duodenal ulceration. The manuscript is defended which contains the
results of complex investigation of parietal microflora in 162
ulcerative patients depending on the condition of acid-forming and
motor-evacuating functions and the morphological alterations of gastric
mucosa as well as in 114 patients of this group before and after
operation. The semination degree of gastric mucosa by parietal
microflora and its spectrum depend upon the condition of acid products,
the expressed morphological alterations of mucosa and the kind of
operative treatment. The frequent detection of Helicobacter infection on
protracted non-scarred ulcer after organ-preserving operations and ulcer
recurrence as well as the presence mucous microflora on inflammatory
complications in early post-operative period give evidence of these
microorganisms involvement in the processes. The use of the triple
antibacterial therapy along with low-energetic laser radiation gives the
maximum sanative effect contributing to the reducing of the number of
postoperative complications.

Key words: ulceration, surgical treatment, complications, microflora,
antibacterial therapy.

I?aeienaii aei ae?oeo 4.03.99 ?. Oi?iao 60*90/16.

Oi. ae?oe. a?e. 1,0. Oe?aae – 100 i?ei. Cai. ? 48

Aeaeaaie/ee oeaio? “Oiiac”

i. Caii??aeaey, i?. Eai?ia, 92-a.

Oae. 13-84-96

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