Поперекова симпатектомія у хворих на облітеруючий атеросклероз при хронічній критичній ішемії нижніх кінцівок: Автореф. дис… канд. мед. наук / В.І.

3

I?i?noa?noai ioi?iie caei?ia’y Oe?a?ie

Oa?e?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao

AEAAeAIIA Aieiaeeie? ?ee?/

OAeE 617;616.13-004.6-036.12-056-24

IIIA?AEIAA NEIIAOAEOII?ss

O OAI?EO IA IAE?OA?OTH*EE AOA?INEEA?IC I?E O?II?*I?E E?EOE*I?E ?OAI??
IEAEI?O E?IOe?AIE

14.01.03 — O??o?a?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Oa?e?a, 1999?.

Aeena?oaoe?th ? ?oeiien.

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

Iaoeiaee Aeieoi? iaaee/ieo iaoe i?ioani? OI?

ea??aiee: Iaoi Aiaoie?eiae/, caa?aeoaa/ eaoaae?ith o?- ?o?a?? oa
aianoac?ieia??, ?aai?iaoieia?? oa-

eoeueoaoo i?neyaeeieiiii? ina?oe Eoaainue- eiai aea?aeaaiiai
iaaee/iiai oi?aa?neoaoo.

Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe, i?ioani?

Eoiaeueoeia Aieiaeeie? ?aaiiae/, Oa?e?anue- eee aea?aeaaiee oi?aa?neoao
caa?aeoaa/ eaoaae-

?ith o??o?a??.

aeieoi? iaaee/ieo iaoe, i?ioani?

Ieeiiaiei Ieaenaiae? Naiaiiae/, Caii??aenue-

eee aea?aeaaiee oi?aa?neoao caa?aeoaa/ eaoaae-?ith o??o?a??.

I?ia?aeia onoaiiaa – Aeiiaoeueeee aea?aeaaiee iaaee/iee

oi?aa?neoao ?i. I.Ai?ueeiai

eaoaae?a caaaeueii? o??o?a??

Caoeno aeena?oaoe?? a?aeaoaeaoueny » 28 » aeiaoiy 1999 ?. i 14-00 aiae.

ia can?aeaii? niaoe?ae?ciaaii? A/aii? ?aaee Ae.64.600.01 i?e
Oa?uee?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? (310022, i.Oa?e?a,
i?. Eai?ia, 4).

C aeena?oaoe??th iiaeia iciaeiieoenue o iaoeia?e a?ae?ioaoe?
Oa?e?anueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo. (310022, i.Oa?e?a,
i?. eai?ia, 4).

Aaoi?aoa?ao ?ic?neaiee » 25 » aa?aniy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? A/aii? ?aaee

eaiaeeaeao iaaee/ieo iaoe, aeioeaio Oaiueei I.I.

Caaaeueia oa?aeoa?enoeea ?iaioe.

Aeooaeuei?noue i?iaeaie. A inoaii? ?iee iae?oa?oth/? caoai?thaaiiy
noaeei ieaei?o e?ioe?aie iathoue oe?iea ?iciianthaeaeaiiy ?
cono??/athoueny o 2-3% ianaeaiiy (A.N.Naa?eue?a oa ni?aaaoi?e., 1996).
Na?aae oeeo caoai?thaaiue ia?aaaaeathoue aoa?ineea?ioe/i? o?aaeaiiy
noaeei, /anoioa yeeo aeinyaa? 90% (A.A.Oae?iia oa ni?aaao., 1979).

O e?eoaaii? oai?eo ia iae?oa?oth/? caoai?thaaiiy noaeei ieaei?o
e?ioe?aie a inoaii? ?iee aeinyaiooi cia/ieo oni?o?a, ui coiiaeaii
oe?ieei canoinoaaiiyi o e?eoaaii? ?aeiino?oeoeaieo iia?aoe?e. Aea o
aaaaoueio oai?eo, o ca’yceo c iiaaiei noaiii aeenoaeueiiai noaeeiiiai
?onea aai caaaeueiei aaaeeei noaiii aeeiiaoe ?aeiino?oeoeaio iia?aoe?th
iaiiaeeeai. Oae, ca aeaieie O.I.Coniaiiae/a (1996), i?e iae?oa?oth/iio
aoa?ineea?ic? aeeiiaoe ?aeiino?oeoeaio iia?aoe?th ia noaeeiao aaea?oueny
eeoa o 17-20% oai?eo. Naia oiio a a?naiae? o??o?aa i?e iaaoaeoeaiino?
eiina?aaoeaiiai e?eoaaiiy oa iaiiaeeeaino? aeeiiaiiy ?aeiino?oeoeaii?
iia?aoe?? caeeoa?oueny iaeio?aaiaoe/ia oa aeinoaoaiuei aoaeoeaia
iia?aoe?y — iiia?aeiaa neiiaoaeoii?y.

A?eueo?noue o??o?a?a noaaeueii ioe?iththoue ?acoeueoaoe oe??? iia?aoe??
a ii/aoeiaeo noaae?yo caoai?thaaiiy ye i?e iae?oa?oth/ei aiaea?oa???o?,
oae ? i?e iae?oa?oth/ei aoa?ineea?ic? (?.I.Eioai oa ni?aaao., 1986,
A.I.Aa/aa oa ni?aaao., 1996).

I?ioa, i?e iayaiino? III-IVnooiaith ?oai?? (ii eeaneo?eaoe??
A.A.Iie?ianueeiai-Oiioaia), yea a iao /an a?eueo?noth o??o?a?a
aecia/a?oueny ye o?ii?/ia e?eoe/ia ?oai?y, ?acoeueoaoe iiia?aeiai?
neiiaoaeoii?? a oe?eiio iacaaeia?euei? (A.A.Aa?aen?i, 1994).

A oie aea /an, i?iaeaia e?eoaaiiy o?ii?/ii? e?eoe/ii? ?oai?? e?ioe?aie
i?e iae?oa?oth/iio aoa?ineea?ic? yaey?oueny aeooaeueiith, ai oai?? c
oaeith ?oai??th cono??/athoueny o 35% aeiaaee?a, i?e /iio 30% c ieo
iio?aaothoue ia?aeiii? aiiooaoe?? (TH.A.A?eia oa ni?aaao., 1997,
A.E.Aonae oa ni?aaao., 1992, A.A.Iie?ianueeee 1994, ?.?.Nooa??a oa
ni?aaao., 1992).

A?eueo?noue o??o?a?a aaaaeathoue, ui a oeueiio ?ac? eeoa
?aeiino?oeoeai? iia?aoe?? ia noaeeiao aeicaieythoue oieeiooe aiiooaoe??
e?ioe?aee (TH.A.A?eia oa ni?aaao., 1997, A.E.Aonae oa ni?aaao., 1992,
A.A.Iie?ianueeee 1994, ?.?.Nooa??a oa ni?aaao., 1992, A.A.Aiai?oiia,
1995).

Aea ? oaeiae ? ie?ai? iia?aeiieaiiy, ui o oai?eo ia iae?oa?oth/ee
aoa?ineea?ic ieaei?o e?ioe?aie i?e iayaiino? o?ii?/ii? e?eoe/ii? ?oai??
iiaeeeai io?eiaoe iiceoeai? ?acoeueoaoe a 50-70% aeiaaee?a ? i?ney
aeeiiaiiy iiia?aeiai? neiiaoaeoii?? (A.E.Aai?aaaeca oa ni?aaao., 1997,
O.?.Ea??iia oa ni?aaao., 1994, ?.I.Eioai oa ni?aaao., 1996).

Iacaaeia?euei? ?acoeueoaoe iiia?aeiai? neiiaoaeoii?? coiiaeai?
a?aenooi?noth iaa?oioiaaieo e?eoa???a i?iaiicoaaiiy ?? ?acoeueoao?a, ui
aeene?aaeeoo? oeae iaoiae o??o?a?/iiai e?eoaaiiy (A.A.Aiai?oiia oa
ni?aaao., 1995, A.I.Caoa?iaa oa ni?aaao., 1984).

Ca’ycie caaaeaiue aeine?aeaeaiiy c i?iaeaiiei ieaiii ?icaeoeo iaaee/ii?
iaoee. Aeena?oaoe?eia ?iaioa aeeiioaaeanue ca ieaiii iaoeiai-aeine?aeieo
?ia?o Eoaainueeiai aea?aeaaiiai iaaee/iieai oi?aa?neoaoo, caoaa?aeaeaiei
IIC Oe?a?ie – iiia? aea?aeaaii? ?a?no?aoe?? 01970009505.

Iaoa ? caaea/? aeine?aeaeaiiy. Iaoith ?iaioe aoei aecia/aiiy
iiaeeeaino? aeeiiaiiy iiia?aeiai? neiiaoaeoii?? o oai?eo ia
iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? o?ii?/ii? e?eoe/ii? ?oai??
ieaei?o e?ioe?aie.

A?aeiia?aeii aei oeueiai aoee iinoaaeai? oae? caaea/? aeine?aeaeaiiy:

· O oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? a ieo o?ii?/ii?
e?eoe/ii? ?oai?? ieaei?o e?ioe?aie ca aeiiiiiaith no/anieo iaoiae?a
aeine?aeaeaiiy aea/eoe noai ?aa?iia?ii? aaiiaeeiai?ee oa
i?e?ioee?eoeyoe??.

· ?ic?iaeoe ia’?eoeai? e?eoa???, ye? a aeicaieeee i?iaiicoaaoe
?acoeueoaoe iiia?aeiai? neiiaoaeoii?? i?e e?eoe/i?e ?oai?? e?ioe?aee.

· Aecia/eoe iieacaiiy aei iiia?aeiai? neiiaoaeoii?? o oai?eo ia
iae?oa?oth/ee aoa?ineea?ic i?e o?ii?/i?e e?eoe/i?e ?oai?? ieaei?o
e?ioe?aie.

· Aea/eoe aaciina?aaei? oa a?aeaeaeaii? ?acoeueoaoe iia?aoe?? a
caeaaeiino? a?ae noaio ?aa?iia?ii? aaiiaeeiai?ee i?e o?ii?/i?e e?eoe/i?e
?oai?? ieaei?e e?ioe?aee.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. Aia?oa, ia iniia?
eiiieaeniiai ee?i?ei-?ino?oiaioaeueiiai aeine?aeaeaiiy oai?eo ia
iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? o?ii?/ii? e?eoe/ii? ?oai??
ieaei?o e?ioe?aie c o?aooaaiiyi noaio ?aa?iia?ii? aaiiaeeiai?ee,
?ic?iaeai? ia’?eoeai? e?eoa??? aeey i?iaiicoaaiiy ?acoeueoao?a
iiia?aeiai? neiiaoaeoii??, ?ic?iaeai? iieacaiiy aei ?? aeeiiaiiy.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Eiiieaenia aea/aiiy noaio
?aa?iia?ii? aaiiaeeiai?ee a ieaei?o e?ioe?aeao ca aeiiiiiaith
?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy aeicaieeei ?ic?iaeoe iieacaiiy
aei aeeiiaiiy iiia?aeiai? neiiaoaeoii?? oa i?iaiicoaaoe ?? ?acoeueoaoe o
oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? o?ii?/ii? e?eoe/ii?
?oai??.

Oea aeicaiey? o aaaaoueio aeiaaeeao i?e iaiiaeeeaino? aeeiiaiiy
?aeiino?oeoeaii? iia?aoe?? ia noaeeiao e?ioe?aee caiia?aoe ??
aiiooaoe??.

Ai?iaaaeaeaiiy a i?aeoeeo. ?acoeueoaoe aeine?aeaeaiue ai?iaaaeaeai? ia
eaoaae?? o??o?a?? oaeoeueoaoo oaeineiiaeaiiy e?ea??a Eoaainueeiai
iaaee/iiai oi?aa?neoaoo, Eoaainuee?e iaeani?e e?ea?i?, oa e?ea?iyo
iaeano?. Aieiai? iieiaeaiiy ?iaioe aeeth/ai? aei eaeoe?eiiai iaoa??aeo c
o??o?a?? aeey e?ea??a-eo?naio?a, ee?i?/ieo i?aeeiaoi??a oa ?ioa?i?a i?e
Eoaainueeiio iaaee/iiio oi?aa?n?oao?.

I?i?eoiiiaai? o??o?ae Oe?a?ie (?a?no? iaaeeei-a?ieia?/ieo
iaoeiai-oaoi?/ieo iiaiaaaaeaiue. Aei.7. – Ee?a, 1997.- ? 19/717).

Iniaenoee aianie caeiaoaa/a. Aaoi?ii i?iaiae?ciaaia iaoeiaa e?oa?aoo?a
uiaei ia?aii? oaie, i?iaaaeaiee aeeaieee ?ioi?iaoe?eiee iiooe. Ee?i?/ia
aeine?aeaeaiiy oai?eo ca aeiiiiiaith ?ino?oiaioaeuei?o iaoiae?a
aeine?aeaeaiiy (oeueo?acaoeiaa aeiiea?iiao??y oa aeiiea?ia?ao?y, eaca?ia
oeioiao??y, iaoe??ia ieneiao??y) a aei oa i?neyiia?aoe?eiiio ia??iae?,
noaoenoe/ia ia?iaea io?eiaieo aeaieo i?iaaaeaia iniaenoi aeena?oaioii.
Aia?ia?ao?/i? aeine?aeaeaiiy i?iaaaeai? ?acii c ni?ai?aoe?aieeaie
a?aeae?eaiiy ?aioaaiieia?? 9-? ? 1-? i?nueeeo e?ea?aiue i.Eoaainueea.
Iia?aoeai? ao?o/aiiy aeeiiai? naiino?eii o 70 (40%) aeine?aeaeaieo
oai?eo.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iaoa??aee aeena?oaoe?? aeeeaaeai?
oa iaaiai?ai? ia iaoeia?e eiioa?aioe?? ?in?enueei? ni?eee aia?ieia?a oa
noaeeiieo o??o?a?a (Ooea, 1994), ia iaoeiai-i?aeoe/i?e eiioa?aioe??
o??o?a?a Oe?a?ie (Oa?e?a, 1995), ia iaoeiai-i?aeoe/i?e eiioa?aioe??,
i?enay/ai?e 100-??//th c aeiy canioaaiiy 4-? i?nueei? e?ea?i?
i.Eoaainueea (Eoaainuee, 1995), ia iaoeiai-i?aeoe/i?e eiioa?aioe??
ni?ai?aoe?aiee?a iaaee/iiai oi?aa?neoaoo oa i?aeoe/ieo e?ea??a
Eoaainueei? iaeanii? o??o?a?/ii? ni?eee (Eoaainuee, 1997), ia iaoeia?e
eiioa?aioe?? ni?ai?aoe?aiee?a o??o?a?/ieo eaoaae? Eoaainueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (Eoaainuee, 1998).

Ioae?eaoe?? ca oaiith. Ca oaiith aeena?oaoe?? iaae?oeiaaii 11 iaoeiaeo
?ia?o, c ieo 3 — a oeaio?aeueieo iaaee/ieo aeo?iaeao, 3 — a ca??eao
iaoeiaeo i?aoeue, 4 — a iaoa??aeao iaoeiaeo eiioa?aioe?e. 5 c oeeo ?ia?o
iaienai? iaeiiiniaiai. Io?eiaii 4 iina?ae/aiiy ia ?aoe?iiae?caoi?nuee?
i?iiiceoe??.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 120
noi??ieao iaoeiiieno, i?noeoue 18 oaaeeoeue oa 14 ?ethno?aoe?e.
Aeena?oaoe?y neeaaea?oueny ?c anooio, 4-o ?icae?e?a (iaeyae e?oa?aoo?e,
iaoa??aee oa iaoiaee aeine?aeaeaiiy, 2-o ?icae?e?a aeanieo
aeine?aeaeaiue), aiae?co oa ocaaaeueiaiiy ?acoeueoao?a aeine?aeaeaiiy,
aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, iieaae/eea e?oa?aoo?e, yeee
i?noeoue 190 aeaea?ae, c ieo 76 — ?iicaiieo aaoi??a.

Ci?no ?iaioe.

?iaioa iniiaaia ia ?acoeueoaoao e?eoaaiiy 175 oai?eo iae?oa?oth/ei
aoa?ineea?icii c o?ii?/iith e?eoe/iith ?oai??th e?ioe?aee, ye?
e?eoaaeenue o a?aeae?eaii? noaeei eaoaae?e o??o?a?? oaeoeueoaoo
oaeineiiaeaiiy e?ea??a Eoaainueeiai iaaee/iiai oi?aa?neoaoo c 1989 aei
1997 ??. A?e oai?eo — a?ae 40 aei 75 ?ie?a, iaeneiaeueia a?eueo?noue
(91,4%) — 51-75 ?ie?a. *ieia?e?a aoei 171 (97%), ae?iie — 4 (3%).
O?eaae?noue caoai?thaaiiy 1-3 ?iee anoaiiaeaia o 60 oai?eo (34,2%), o
115 (65,8%) oai?eo aiia aoea a?eueoith, i?ae 3 ?iee.

Ieethc?? a ai?oi-eeoaiaiio naaiaio? iaee i?noea o 11 (6,2%) oai?eo,
noaaiiai-i?aeeie?iiiio — o 95(54,2%), ieethc?? a?oa??e aii?eee aoee o 69
(39,4%). Aaaee?noue ?oai?? ieaei?o e?ioe?aie o aeine?aeaeaieo oai?eo
ioe?ithaaeanue ii eeaneo?eaoe?? A.A.Iie?ianueeiai (1979): III no. ?oai??
aoea o 111 (63,5%) oai?eo, IV no. — o 64(36,5%) (Oaaeeoey ? 1). An?
oai?? nea?aeeeenue ia a?eue, yeee c’yaeyany i?ae /an oiaeueae ia i?ioyc?
iaioa 50 iao??a, ia a?eue o niiei? i?e iayaiino? aai a?aenooiino?
o?io?/ieo ii?ooaiue ia iaeueoeyo oa ia noii?. O an?o oai?eo
eiina?aaoeaia e?eoaaiiy ia i?ioyc? 2 oeaei?a ia aeaaaei iiceoeaiiai
?acoeueoaoo.

O a?eueoino? oai?eo aeyaeai? noiooi? caoai?thaaiiy, ye? iia??ooaaee
noai oai?iai. Oae, ?oai?/ia oai?iaa na?oey aoea o 80 (45,7%) oai?eo,
ia?aianaiee ?ioa?eo i?iea?aeo — o 20 (11,4%), a?ia?oii?/ia oai?iaa — o
39 (22,2%), caoai?thaaiiy eaaaiue iaee i?noea o 36 (20,5%).

Ianoaaeaiiy oai?eo aeeth/aei ee?i?/i?, eaai?aoi?i? oa ?ino?oiaioaeuei?
iaoiaee aeine?aeaeaiiy. C ?ino?oiaioaeueieo cania?a aeei?enoiaoaaeenue
oa?iiiao??y oe??e, ?aiaacia?ao?y, iaoe??ia ieneiao??y, oeueo?acaoeiaa
aeiiea?iiao??y, eaca?ia oeoiiao??y, ?aiaaieiio?anoia aia?ia?ao?y.

Oaaeeoey ? 1.

?iciiae?e oai?eo ii ??aith ieethc?? oa nooiaith ?oai??.

??aaiue

ieethc??Nooiai? ?oai?? (ii A.A.Iie?ianueeiio)AnueiaiIIIIVAi?oi-eeoaiaee

naaiaio7

4.0%4

2.2%11

6.2%Noaaii-i?aeeie?iiee

naaiaio59

33.7%36

20.5%95

54.2%A?oa??? aii?eee45

25.7%24

13.7%69

39.4%Anueiai111

63.4%64

36.6%175

100%

Oe? iaoiaee aeine?aeaeaiiy aeicaieeee neeanoe oyaeaiiy i?i i?noea
ieethc?? iaa?no?aeueieo noaeei oa ?? aeiaaeeio, i?i noai aeenoaeueiiai
noaeeiiiai ?onea ? eieaoa?aeueiiai e?iaiia?ao, cie?aia
i?e?ioee?eoeyoe??. Aeine?aeaeaiiy, ye? i?iaaaeai? iaie o 25 caei?iaeo
ethaeae (eiio?ieueia a?oia) oa o 175 oai?eo iae?oa?oth/ei aoa?ineea?icii
i?e iayaiino? III-IV nooiaiy ?oai??, aeicaieeee aeyaeoe noai
?aa?iia?iiai e?iaiia?ao oa i?e?ioee?eoeyoe?? ia aii?eoe? oa noii? i?e
o?ii?/i?e e?eoe/i?e ?oai?? e?ioe?aie (oaaeeoe? ? 2a ? ? 2a).

sse aeaeii c iaaaaeaieo aeaieo a oaaeeoeyo ? 2a ? 2a, o oai?eo i?e
iayaiino? III aai IV nooiai? ?oai?? ia aii?eoe? ? noii? a?aei?/a?oueny
noaoenoe/ii a??ia?aeia (a ii??aiyii? c caei?iaeie) cieaeaiiy iai?oae
eenith o oe??? oa oeaieiiiai e?iaiia?ao. E??i

oeueiai ia noii? aeyaey?oueny noaoenoe/ii a??ia?aeia cia/aiiy
oaiia?aoo?e oe??e, nenoie?/iiai a?oa??aeueiiai oeneo,
e?noi/eiai-iea/aaiai ?iaeaeno. I?e oeueiio ciaeaeaii, ui iaia?
noaoenoe/ii a??ia?aeii? ??cieoe? i?ae iieacieeaie ?ino?oiaioaeueieo
iaoiae?a aeine?aeaeaiiy o oai?eo c III oa IV nooiaiyie ?oai??. Oea
aeicaieeei iai ia i?aenoaa? oa?aeoa?o ?aa?iia?iiai e?iaiia?ao aeae?eeoe
?aeeio a?oio oai?eo c o?ii?/iith e?eoe/iith ?oai??th, aac iaeyaeo ia
ee?i?/i? aeai?. I?e oeueiio ie iii?oeee, ui /ei ieae/eie aoee iieacieee
noaio aaiiaeeiai?ee oa i?e?ioee?eoeyoe?? a?aaeaii? e?ioe?aee, iaea?aeai?
ca aeiiiiiaith ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy, oei aeoae/a
aoee ae?aaeai? ee?i?/i? iciaee ?oai??. O ca’yceo c oeei o oai?eo c
o?ii?/iith e?eoe/iith ?oai??th e?ioe?aee ie aeae?ey?ii 2 noaae??
ii?ooaiiy ?aa?iia?ii? aaiiaeeiai?ee:

?. A?aeiinia eiiiainaoe?y e?iaiia?ao.

??. Aeaeiiiainaoe?y ?aa?iia?iiai e?iaiia?ao.

Oaaeeoey ? 2a.

Iieacieee ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy

ia aii?eoe? o caei?iaeo oa o oai?eo

c o?ii?/iith e?eoe/iith ?oai??th ieaei?o e?ioe?aie.

A?oia

aeine?aeaeaiieoOaiia?aoo?a

oe??e

(a?aaeone Ni)Iai?oaa eenith o oe???

(ii ?o no)Oeaieiiee

e?iaiia?a (ie/oa ia

100a oeaieie)Caei?ia?

Oai?? c

??? no ?oai??

Oai?? c

IV no ?oai??29,0+1,5

24,5+1,8

p>0.05

22,4+2,0

p<0.0562,0+0,4 32,1+1,42 p<0.001 32,4+2,49 p<0.0011,4+0,15 1,1+0,17 p>0.05

1,2+0,18

p>0.05

I?e a?aeiini?e eiiiainaoe?? e?iaiia?ao nenoie?/iee a?oa??aeueiee oene o
a?oa??yo noiie aoa 40-60 ii ?o no, e?noi/eiai-iea/iaee ?iaeaen aoa ia
ieae/a 0.3-0.4, iai?oaa eenith o oe??? noiie — ia ieae/a 20 ii ?o.no.,
aaee/eia oe??iiai e?iaiia?ao ia 1 iaeueoe? oa noii? aoea a iaaeao
0.8-1.1 ie/oa/100a oeaieie.

I?e aeaeiiiainaoe?? e?iaiia?ao iieacieee ?aa?iia?ii? aaiiaeeiai?ee ?
i?e?ioee?eoeyoe?? aoee oaeeie: nenoie?/iee a?oa??aeueiee oene a noaeeiao
noiie aoa 0-30 ii ?o no, iai?oaa eenith o oe??? noiie — iaioa 20 ii ?o
no, aaee/eia oe??iiai e?iaiia?ao ia 1 iaeueoe? noiie — 0.2-0.5
ie/oa/100a oeaieie.

Oaaeeoey ? 2a.

Iieacieee ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy

ia noii? o caei?iaeo oa o oai?eo c o?ii?/iith

e?eoe/iith ?oai??th e?ioe?aie.

A?oia

aeine?ae-aeaieoOaiia?a-oo?a

oe??e

(a?aaeone) NiNenoie?/-iee a?oa??aeue-iee oene a CAA

(ii ?o no)E?noi/ei-

ai-iea/i-aee ?iaeaen

(E I ?)Iai?oaa eenith o oe???

(ii ?o no)Oeaieiiee

e?iaiia?a

(ie/oa ia

100a oeaieie)Caei?ia?

Oai?? c

??? no ?oai??

Oai?? c

IV no ?oai??27,01+1,0

23,5+0,6

p<0.05 22,4+2,0 p<0.05141,0+18 60,0+2,2 p<0.05 57,0+2,92 p<0.051,0+0,05 0,41+0,1 p<0.05 0,39+0,05 p<0.0560,0+2,2 24,1+1,22 p<0.05 22,4+1,85 p<0.051,4+0,15 1,1+0,17 p<0.05 1,2+0,18 p<0.05 Iao? ee?ie/i? niinoa?aaeaiiy iieacaee, ui i?e oaeeo iieacieeao e?iaiia?ao iiia?aeiaa neiiaoaeoii?y ia aeaaaea aoaeoo ? o?aaa aoei aeeiioaaoe aiiooaoe?th e?ioe?aee. Oei naiei ia iniia? i?iaaaeaieo aeine?aeaeaiue, a oaeiae ee?i?/ieo niinoa?aaeaiue ie anoaiiaeee, ui i?e aeaeiiiainaoe?? eieaoa?aeueiiai e?iaiia?ao, iiia?aeiaa neiiaoaeoii?y ? iaaoaeoeaiith ? iiaea aeeiioaaoenue o?eueee c iaoith cieaeaiiy ??aiy aiiooaoe?? e?ioe?aee. I?e iaya? a?aeiinii? eiiiainaoe?? ?aa?iia?iiai e?iaia?ao iiia?aeiaa neiiaoaeoii?y o a?eueoino? oai?eo aeicaieyea oieeiooe aiiooaoe?? e?ioe?aee a iane?aeie iie?auaiiy ?aa?iia?ii? aaiiaeeiaieee. I?i oea ia?aeiieeai aiai?youe aeai? a?oa??ia?ao??, ?aia?ao??, oeueo?acaoeiai? aeiiea?iiao???, iieacieee iai?oae eenith a oe??? ? oeaieiiiai e?iaiia?ao ia noii?. Oae, ia a?oa??ia?aiao, ye? c?iaeai? o iaeaeeae/? aei? i?ney iia?aoe??, a?aei?/aii ?icoe?aiiy iaa?no?aeueieo oa eieaoa?aeueieo noaeei ia noii? ? aii?eoe?. Oea noi?iaiaeaeo?oueny ca?eueoaiiyi nenoie?/iiai a?oa??aeueiiai oeneo a a?oa??yo noiie a iaaeao 11-13 ii ?o no, iai?oae eenith o oe??? ia 7-8 ii ?o no, a oaeiae aaee/eie oeaieiiiai e?iaiia?ao ia 0.4-0.8 ie/oa/100a oeaieie (oaaeeoey ? 3). Oaaeeoey ? 3. Iieacieee ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy ia noii? aei oa i?ney iiia?aeiai? neiiaoaeoii??. IieacieeeA?oieaeine?aeaeaieo?ino?oiaioaeue-ieoIIIno.IVno.aeine?aeaeaiuea ei INi?ney INaei INi?ney INOaiia?aoo?a oe??e (N0) 23,5+0,625,1+1,0 p>0.0523.0+0.724.6+1.1

p>0.05Nenoie?/iee a?oa??aeueiee oene a CAA

(ii ?o no) 60,0+2,273,0+2,3

p<0.0557,0+2,968,0+3,2 p<0.05Iai?oaa eenith a oe??? (ii ?o no)24,1+1,2233,1+1,38 p<0.0522,4+1,8530,4+2,16 p<0.05Oeaieiiee e?iaiia?a (ie/oa ia 100a)1,0+0,181,5+0,16 p<0.050,9+0,161,6+0,05 p<0.05 O oie aea /an, noaoenoe/ii a??ia?aeii? ??cieoe? iieaciee?a ?aa?iia?ii? aaiiaeeiai?ee o oai?eo ???-?V nooiaiyie ?oai?? ia io?eiaii. Ia iniia? io?eiaieo aeaieo, ie aaaaea?ii, ui o oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? o?ii?/ii? e?eoe/ii? ?oai?? ieaei?o e?ioe?aie (OE?IE) iieacaiiy aei aeeiiaiiy iiia?aeiai? neiiaoaeoii?? aeieeathoue o oeo aeiaaeeao, eiee ia iiaeeeai aeeiiaoe ?aeiino?oeoeaio iia?aoe?th ia noaeeiao, a aeai? ?ino?oiaioaeueieo aeine?aeaeaiue aeacothoue ia a?aeiinio eiiiainaoe?th e?iaiia?ao o a?aaeaii?e e?ioe?aoe?. O iaoeo niinoa?aaeaiiyo iaiao?aei?noue a IN o oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e OE?IE aeieeea o 69(39.5%) oai?eo c ieethc?yie a?oa??e aii?eee, o 95(54.3%) oai?eo - c ieethc?yie o noaaiiai-i?aeeie?iiiio naaiaio? i?e iiaaiiio noai? aeenoaeueiiai noaeeiiiai ?onea. O 6.2% aeiaaee?a aiia aeeiioaaeanue o oai?eo c ieethc?yie a ai?oi-eeoaiaiio naaiaio? i?e iayaiino? aaaeeeo noiooi?o caoai?thaaiue, ui ia aeicaieyee aeeiiaoe ?aeiino?oeoeaio iia?aoe?th. Ua iaeiei iieacaiiyi aei IN aoee aeiaaeee, eiee i?ney aeeiiaii? ?aeiino?oeoeaii? iia?aoe?? a ai?oi-eeoaiaiio naaiaio? aeieeaa o?iiaic aeenoaeueii ?ici?uaiieo iaa?no?aeueieo noaeei ? ia aoei oiia aeey aeeiiaiiy iine?aeiaiiai noaaii-i?aeeie?iiiai ooiooaaiiy. Oea niinoa??aaeinue o 11 oai?eo. Iia?aoeai? ao?o/aiiy - IN - aeeiioaaeeny i?ae ia?eaeo?aeueiei ciaaiethaaiiyi c iicai/a?aaeiiiai aeinooio ii ?iao oa neeaaeaeeny c aeaeaeaiiy ??-??? iiia?aeiai-neiiaoe/ieo aoce?a ia noi?ii? o?aaeaiiy. I?e iayaiino? iae?ioe/ieo ci?i ia iaeueoeyo aai noii? iaeii/anii c IN aeeiioaaeanue iae?aeoii?y aai aiiooaoe?y iaeueoe?a. Oae naii, ye ? ?io? aaoi?e, ie a?aei?oeee, ui iia?aoe?y ? iaeio?aaiaoe/iith, ? c oni?oii iiaea aeeiioaaoeny o oai?eo iioeeiai oa noa?a/iai a?eo, iaoyaeaieo ?oai?/iith oai?iaith na?oey, iino?ioa?eoiei ea?ae?ineea?icii, a?ia?oii?/iith oai?iaith, caoai?thaaiiyie i?aai?a aeeoaiiy. AEiaeai c iia?iaaieo oai?eo ia iiia?. I?ae /an aeeiiaiiy iia?aoe?? aoei eeoa 2 na?eicieo oneeaaeiaiiy, ui aoee coiiaeai? a iaeiiio aeiaaeeo iioeiaeaeaiiyi ieaeiuei? iiei?, a a ae?oaiio - iioeiaeaeaiiyi iiia?aeiai? aaie. I?ney iia?aoe?? oneeaaeiaiiy niinoa??aaee o 32 (18.2%) oai?eo o aeaeyae? cai/a?aaeiii? aaiaoiie (2), aeeiai?/ii? eeoeiai? iai?io?aeiino? (4), aaiaoiie i?aeoe??ii? iniiae (5), iiaa?oiaaiai iaaiithaaiiy ?aie (7), ieaei?-aeieueiai? iiaaiii?? (2), a?eoi?e (4), neiiaoaea?? (7). On? oe? oneeaaeiaiiy i?ae aieeaii i?iaaaeaiiai e?eoaaiiy cae?i/eeeny iaeoaeaiiyi. Aaciina?aaei? ?acoeueoaoe IN ie ioe?ithaaee ii ee?i?/iei aeaiei oa ca ?acoeueoaoaie ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiue, ui aeathoue ciiao ioe?ieoe noai ?aa?iia?iiai e?iaiia?ao. C ieo iaeaaaeeea?oeie aaaaeaee oeueo?acaoeiao aeiiea?iiao??th oa iaoe??io ieneiao??th. ?acoeueoaoe ioe?ithaaeeny ye aeia??, caaeia?euei? oa iacaaeia?euei?. Aei aeia?eo ?acoeueoao?a i?e ??? nooiai? ?oai?? a?aeiineee o? aeiaaeee, eiee i?ioiaeeee aie? o niiei?, cieeaee ia?anoac??, ca?eueooaaeany aeenoaioe?y oiaee. I?e iayaiino? ?oai?? IV nooiaith, e??i ia?ae?/aieo aeaieo, e?eoa???i aoaeoeaiino? iia?aoe?? yaeyeiny caaeeaeaiiy o?io?/ieo ae?acie aai ?ai, ui ooai?thaaeeny i?ney aeeiiaiiy iae?aeoii?? aai aiiooaoe?? iaeueoe?a. I?e aeia?iio ?acoeueoao? iia?aoe?? a?aei?/aeiny ca?eueoaiiy nenoie?/iiai oeneo a a?oa??yo noiie ia 10-12 ii ?o no, ca?eueoaiiy iai?oae eenith a oe??? noiie ia 8-10 ii ?o no, a oeaieiiiai e?iaiia?ao ia 0.4-0.8 ie/oa/100a oeaieie. Aei caaeia?eueieo ?acoeueoao?a a?aeiineee o? aeiaaeee, eiee i?ney iia?aoe?? cieeaee aai ciaiooaaeenue aie?, cieeaa iaa?ye oa oe?aiic oe??e ia noii?, aea caa??aaeeny iaa?ieia?/i? i?iyae ?oai?? o aeaeyae? ia?anoac?e aai ia?aco i’yc?a, a i?e iayaiino? IV nooiaiy ?oai?? ia /an aeienee oai?iai ia niinoa??aaeiny caaeeaeaiiy ae?acie oa ?ai. I?e oeueiio a?aei?/aeiny ca?eueoaiiy nenoie?/iiai a?oa??aeueiiai oeneo ia noii? a iaaeao 5-10 ii ?o no, iai?oae eenith a iaaeao 2-5 ii ?o no, a oeaieiiiai e?iaiia?ao ia 0.1-0.2 ie/oa/100a oeaieie. Iacaaeia?eueieie ?acoeueoaoaie aaaaeaeeny o? aeiaaeee, eiee i?ney iia?aoe?? iino?ei? aie? caa??aaeeny, aai eiee i?e ?o ciaioaii? a?aei?/aeiny ?iciianthaeaeaiiy ai?eii-iae?ioe/ieo ci?i ia nooii? ? i?e oeueiio iieacieee ?aa?iia?ii? aaiiaeeiai?ee oa i?e?ioee?eoeyoe?? ia iaee oaiaeaioe?? aei iie?auaiiy. Cacae/ae, on? aeiaaeee iacaaeia?eueieo ?acoeueoao?a cae?i/oaaeeny aiiooaoe??th e?ioe?aee. Aeai? i?i aaciina?aaei? ?acoeueoaoe IN i?e OE?IE iaaaaeai? o oaaeeoe? ? 4. Oaaeeoey ? 4. Aaciina?aaei? ?acoeueoaoe iiia?aeiai? neiiaoaeoii??. Anueiai oai?eoAeia??Caaeia?euei?Iacaaeia?euei?Nia?oue17589 50.8%72 41.2%14 8.0%0 sse aeaeii c oaaeeoe? ? 4, iie?auaiiy a caaaeueiiio noai? oai?eo i?ney iia?aoe?? IN, i?e o?aooaaii? noaio ?aa?iia?ii? aaiiaeeiai?ee, io?eiaii o 161 (91.9%) oai?eo. C iaoith anoaiiaeaiiy /eiiee?a, ui aieeaathoue ia ?acoeueoaoe iia?aoe??, ie aea/eee aaciina?aaei? ?acoeueoaoe IN (cie?aia /anoioo iacaaeia?eueieo ?acoeueoao?a) caeaaeii a?ae ??aiy ieethc?? iaa?no?aeueieo a?oa??e, nooiaiy ?oai?? oa aeo?aeiiai noaio ?aa?iia?iiai e?iaiia?ao. I?e oeueiio aeyaeeinue, ui /anoioa aiiooaoe?e ia caeaaeaea a?ae ??aiy ieethc?e iaa?no?aeueieo a?oa??e. Oae, o oai?eo c ieethc?yie o eeoaiai-noaaiaaiio naaiaio? aiiooaoe?? aeeiiaii o 9% aeiaaee?a, i?e ieethc?? o noaaiaai-i?aeeie?iiiio naaiaio? - o 7.3%, a i?e ieethc?? a?oa??e aii?eee - 8.8%. I?e noaoenoe/iiio ii??aiyii? oe? aeai? aeyaeeeny iaa??ia?aeieie (?>0.05).

Iaie anoaiiaeaii, ui /anoioa aiiooaoe?e i?ney IN o iacia/iiio nooiai?
caeaaeaea a?ae aaaeeino? ?oai??. Oae, c 111 oai?eo c ??? no. ?oai??
aiiooaoe?? aeeiiaii o 5 (4.6%), a c 64 oai?eo c IV no. ?oai?? — o 9
(14.2%) (p>0.05).

Iaea?eueoa aaciina?aaei? ?acoeueoaoe IN caeaaeaee a?ae aeo?aeiiai noaio
?aa?iia?ii? aaiiaeeiai?ee, ui aecia/aany ?ino?oiaioaeueieie iaoiaeaie.
Oae, c 152 oai?eo, o yeeo aei iia?aoe?? iaea i?noea a?aeiinia
eiiiainaoe?y ?aa?iia?iiai e?iaiia?ao (nenoie?/iee a?oa??aeueiee oene ia
CAA a iaaeao 40-60 ii ?o no, iai?oaa eenith a oe??? nooii? a?eueoa 20 ii
?o no), iacaaeia?euei? ?acoeueoaoe io?eiai? o 4 (2.7%), a o 23 c
aeaeiiiainaoe??th ?aa?iia?iiai e?iaiia?ao, iacaaeia?eueiee ?acoeueoao
io?eiaii o 10 (43.5%) (p<0/05). Oaeei /eiii noai ?aa?iia?iiai e?iaiia?ao e?ioe?aee ? iaeaaaeeea?oei oaeoi?ii, yeee aieeaa? ia ?acoeueoaoe IN o oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? OE?IE. A?aeaeaeai? ?acoeueoaoe (oa?i?iii a?ae 1 aei 7 ?ie?a) aea/ai? o 104 oai?eo. Oe? ?acoeueoaoe oaeiae ioe?ithaaeeny ye aeia??, caaeia?euei? oa iacaaeia?euei?. Aeia?eie aaaaeaee o? aeiaaeee, eiee iie?auaiiy, yeiai aeinyaee i?ney iia?aoe??, caa??aaeiny ia i?ioyc? anueiai ia??iaeo niinoa?aaeaiiy, ia?aiaaeath/a eoeueaaa?noue aeieeaea /a?ac 200-250 iao??a oiaee, ia aoei iaa?ieia?/ieo oa o?io?/ieo i?iya?a ?oai??, nenoie?/iee oene a a?oa??yo nooii? aoa o iaaeao 40-60 ii ?o. no. Aei caaeia?eueieo ?acoeueoao?a a?aeiineee o? aeiaaeee, eiee a?eue o e?ioe?aoe? aeieeaea /a?ac 100-150 iao??a oiaee, acaeiaae e?ioe?aee aeieeaee a?ae/oooy ia?anoac?? aai aoee o?io?/i? ae?acee ia noii? aac aieueiaiai neiae?iio. A?oa??aeueiee e?ia’yiee oene ia noii? noaiiaea 40-50 ii ?o no. Iacaaeia?eueieie aaaaeaee o? aeiaaeee, eiee aoei aeeiiaii aiiooaoe?th e?ioe?aee, aai ianooiaea nia?oue oai?iai. Iao? niinoa?aaeaiiy iieacaee, ui /a?ac 1 ??e c 104 oai?eo caaeia?euei? oa aeia?? ?acoeueoaoe caa??aaeeny o 89 (85.5%), aiiooaoe?? aeeiiaii o 9 (8.6%) ? nia?oue ianooieea o 6 (5.7%) iia?iaaieo. *a?ac 3 ?iee ianoaaeaii 79 oai?eo, aeia?? oa caaeia?euei? ?acoeueoaoe a?aei?/ai? o 60 (75.9%) c ieo, aiiooaoe?? aeeiiaii o 11 (14.0%), iiia?ei - 8 (10.1%) oai?eo. *a?ac 5 ?ie?a o 45 niinoa?aaeaiiyo aeia?? ?acoeueoaoe caa??aaeeny o 17 (37.7%), caaeia?euei? o 10 (22.2%) oai?eo. Iaiao?aei?noue aiiooaoe?? e?ioe?aee aeieeea o 10 (22.2%), iiia?ei - 8 (17.7%). *a?ac 7 ?ie?a aaeaeinue i?inoaaeeoe 22 oai?eo. Aeia?? ?acoeueoaoe a?aei?/ai? o 11 (50.0%), aiiooaoe?? aeeiiaii o 4 (18.1%), iiia?ei 7 (32.0%). Oaaeeoey ? 5. A?aeaeaeai? ?acoeueoaoe iiia?aeiai? neiiaoaeoii?? o oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e o?ii?/i?e e?eoe/i?e ?oai?? ieaei?o e?ioe?aie. Oa?i?iE?euee?noue?acoeueoaoeniinoa?a- aeaiiyoai?eoAeia?eeCaaeia?eueieeAiiooaoe??Iiia?-eiaei 1 ?ieo10453 (50.9%)36 (34.6%)9 (8.6%)6 (5.7%)1-3 ?iee7932 (40.5%)28 (35.4%)11 (14.0%)8 (10.1%)3-5 ?ie?a4517 (37.7%)10 (22.2%)10 (22.2%)8 (17.7%)5-7 ?ie?a227 (31.8%)4 (18.1%)4 (18.1%)7 (31.8%) Oaeei /eiii, aeai? iaoi? ?iaioe aeaiiino?othoue, ui o oai?eo ia iae?oa?oth/ee aoa?ineea?ic ieaei?o e?ioe?aie i?e iayaiino? OE?IE oa a?aeiini?e eiiiainaoe?? ?aa?iia?iiai e?iaiia?ao IN o a?eueoino? oai?eo noi?iaiaeaeo?oueny ee?i?/iei iie?auaiiyi, i?e oeueiio o 50% oai?eo oea iie?auaiiy caa??aa?oueny ia i?ioyc? cia/iiai /ano niinoa?aaeaiiy (aei 7 ?ie?a). Oiio oey iia?aoe?y o oai?eo ia iae?oa?oth/ee aoa?ineea?ic ieaei?o e?ioe?aie i?e OE?IE, ye aeueoa?iaoeaa aiiooaoe??, iieacaia a oeo aeiaaeeao, eiee a neeo ??cieo i?e/ei aeeiiaiiy ?aeiino?oeoeaii? iia?aoe?? ia iaa?no?aeueieo noaeeiao iaiiaeeeaa. Aeniiaee. 1. Iayai?noue o?ii?/ii? e?eoe/ii? ?oai?? ieaei?o e?ioe?aie o oai?eo ia iae?oa?oth/ee aoa?ineea?ic iiaeiia anoaiiaethaaoenue ia i?aenoaa? ee?i?/ieo aeaieo oa iieaciee?a ?ino?oiaioaeueieo cania?a aeine?aeaeaiiy, ye? oa?aeoa?ecothoue noai ?aa?iia?ii? aaiiaeeiai?ee. 2. A caeaaeiino? a?ae noaio ?aa?iia?ii? aaiiaeeiai?ee i?e o?ii?/i?e e?eoe/i?e ?oai?? e?ioe?aee iaiao?aeii aeae?eyoe noaae?th a?aeiinii? eiiiainaoe?? ? noaae?th aeaeiiiainaoe?? ?aa?iia?iiai e?iaiia?ao. 3. Noaae?y a?aeiinii? eiiiainaoe?? e?iaiia?ao oa?aeoa?eco?oueny nenoie?/iei a?oa??aeueiei oeneii o a?oa??yo noiie a iaaeao 40-60 ii ?o no, e?noi/eiai-iea/iaei ?iaeaenii - 0.3-0.4, iai?oaith eenith o oe??? noiie - ia ieae/a 20 ii ?o. no. oa aaee/eiith oeaieiiiai e?iaiia?ao ia noii? a iaaeao 0.8-1.1 ie/oa/100a oeaieie. 4. Ia i?aenoaa? aeaieo i?i noai ?aa?iia?ii? aaiiaeeiai?ee o a?aaeai?e e?ioe?aoe? iiaeeeai i?iaiicoaaoe ?acoeueoaoe iiia?aeia? neiiaoaeoii?? i?e o?ii?/i?e e?eoe/i?e ?oai?? e?ioe?aee. 5. Iiia?aeiaa neiiaoaeoii?y o oai?eo ia iae?oa?oth/ee aoa?ineea?ic ieaei?o e?ioe?aie i?e o?ii?/i?e e?eoe/i?e ?oai?? iieacaia o oeo aeiaaeeao, eiee iaiiaeeeai aeeiiaoe a?aeiiaio iia?aoe?th ia noaeeiao, a aeai? ?ino?oiaioaeueieo aeine?aeaeaiue aeacothoue ia iayai?noue a?aeiinii? eiiiainaoe?? ?aa?iia?iiai e?iaiia?ao. I?aeoe/i? ?aeiiaiaeaoe??. 1. O oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? o?ii?/ii? e?eoe/ii? ?oai?? e?ioe?aee i?e iaiiaeeeaino? aeeiiaiiy a?aeiiaii? iia?aoe?? ia noaeeiao c iaoith caa??aaiiy e?ioe?aee iiaea aooe aeeiiaia iiia?aeiaa neiiaoaeoii?y. 2. I?iaiicoaaiiy ?? ?acoeueoao?a iiaeiii aacoaaoeny ia noai? ?aa?iia?ii? aaiiaeeiai?ee o a?aaeai?e e?ioe?aoe?, aaaeeea?oeie iieacieeaie yei? ? nenoie?/iee oene o a?oa??yo noiie oa iai?oaa eenith o oe??? noiie. 3. C iaoith caa?aaeaiiy e?ioe?aee iiia?aeiaa neiiaoaeoii?y o oai?eo c o?ii?/iith e?eoe/iith ?oai??th iieacaia i?e a?aeiini?e eiiiainaoe?? e?iaia?ao (nenoie?/iee oene o a?oa??yo noiie ia ieae/a 40 ii ?o. no., iai?oaa eenith - ia ieae/a 20 ii ?o. no.). 4. I?e aeaeiiiainaoe?? ?aa?iia?iiai e?iaia?ao a ieaei?e e?ioe?aoe? iiia?aeiaa neiiaoaeoii?y iiaea aooe aeeiiaia c iaoith cieaeaiiy ??aiy aiiooaoe??. Nienie i?aoeue, ye? iioae?eiaai? ca oaiith aeena?oaoe??. 1. I.A.Oi?, A.E.AEaaeaiia. Iieacaiey e auiieiaieth e i?iaiice?iaaiea ?acoeueoaoa iiynie/iie neiiaoyeoiiee o aieueiuo n iaeeoa?e?othuei aoa?ineea?icii ninoaeia ieaeieo eiia/iinoae i?e o?iie/aneie e?eoe/aneie eoaiee ieaeieo eiia/iinoae. // Ee?i?/ia o??o?a?y. ?2, 1998. - N.5-6. 2. A.E.AEaaeaiia. Iaiin?aaenoaaiiua e ioaeaeaiiua ?acoeueoaou iiynie/iie neiiaoyeoiiee o aieueiuo iaeeoa?e?othuei aoa?ineea?icii ieaeieo eiia/iinoae i?e iaee/ee o?iie/ane?e e?eoe/aneie eoaiee. // I?iaeaie aeieia?/ii? oa iaaee/ii? aaiaoeee, ee?i?/ii? ?ioiieia??. - Ee?a-Eoaainuee. 1998. - ?2 - N.51-55. 3. A.E.AEaaeaiaia . Aeeyiea iiynie/iie neiiaoyeoiiee ia ?aaeiia?ioth aaiiaeeiaieeo e iee?ioee?eoeyoeeth o aieueiuo iaeeoa?e?othuei aoa?ineea?icii i?e iaee/ee o?iie/aneie e?eoe/aneee eoaiee eiia/iinoae. // I?iaeaie aeieia?/ii? oa iaaee/ii? aaiaoee, ee?i?/ii? ?ioiieia??. - Ee?a-Eoaainuee. 1997. - ? 3 - N. 51-55. 4. I.A.Oi?, A.E.AEaaeaiia. Iiynie/iay neiiaoyeoiiey o aieueiuo iaeeoa?e?othuei aoa?ineea?icii i?e oyaeaeie eoaiee ieaeieo eiia/iinoae. // Aiaeieiaey e ninoaeenoay oe?o?aey. ?2, 1998. - N.229-230. 5. I.A. Oi?., A. ?. AEaaeaiia. Niin?a i?iaiicoaaiiy ?acoeueoao?a iiia?aeiai? neiiaoaeoii?? o oai?eo iae?oa?oth/ei aoa?ineea?icii i?e e?eoe/i?e ?oai?? e?ioe?aie. // ?a?no? iaaeeei-a?ieia?/ieo iaoeiai-oaoi?/ieo iiaiaaaaeaiue. Aei.7. - Ee?a, 1997. - ?19/717. 6. I.A.Oi?, A.E.AEaaeaiia. ?acoeueoaou iiynie/iie neiiaoyeoiiee o aieueiuo iaeeoa?e?othuei aoa?ineea?icii ieaeieo eiia/iinoae ii aeaiiui Eoaaineiai iaeanoiiai ninoaeenoiai oeaio?a. // Nai?iee iao/iuo o?oaeia nio?oaeieeia Eoaaineiai iaaeeoeeineiai einoeoooa. - Eoaaine, 1991 - N.141-143. 7. I.A.Oi?, A.A.A?euaiei, A.E.AEaaeaiia. Eeioio?iiiia aaaaeaiea aioeaeioeeia aeey i?ioeeaeoeee iaaiiaiey ?ai i?e aiiooaoeeyo o aieueiuo iaeeoa?e?othueie caaieaaaieyie a?oa?ee ieaeieo eiia/iinoae. // Iaoa?eaeu iao/iie nannee “Aeooaeueiua i?iaeaiu yeieiae/aneie eiioiieiaee e aeea?aieiaee”. - Eeaa-Eoaaine, 1992 - N.131-132. 8. A.E.AEaaeaiia. Iieacaiey e i?eiaiaieth iiynie/iie neiiaoyeoiiee o aieueiuo iaeeoa?e?othuei aoa?ineea?icii i?e iaee/ee o?iie/aneie e?eoe/aneie eoaiee eiia/iinoae. // O?iie/aneay e?eoe/aneay eoaiey eiia/iinoae. Oacenu iao/iie eiioa?aioeee. - Iineaa-Ooea, 1994 - N.96-97. 9. I.A.Oi?, A.A.A?euaiei, A.E.AEaaeaiia. I?ioeeaeoeea iaaiiaiey ?ai iinea aiiooaoeee o aieueiuo n iaeeoa?e?othueie caaieaaaieyie a?oa?ee ieaeieo eiia/iinoae. // Aiieii-naioe/aneea ineiaeiaiey a iaioeiaeiie oe?o?aee. Oacenu aeieeaaeia iao/ii-i?aeoe/aneie eiioa?aioeee oe?o?aia Oe?aeiu. - Oa?ueeia, 1995 - N.327-328. 10. A.E.AEaaeaiia. Iieacaoaee ?aaeiia?iiai e?iaioiea o aieueiuo n iaeeoa?e?othuei aoa?ineea?icii ieaeieo eiia/iinoae i?e e?eoe/aneie eoaiee aei e iinea iiynie/iie neiiaoyeoiiee. // Iaoa?eaeu thaeeaeiie iao/ii-i?aeoe/aneie eiioa?aioeee, iinayuaiiie 100-eaoeth ni aeiy iniiaaiey 4-e ai?iaeneie aieueieoeu a.Eoaainea. - Eoaaine, 1995. - N.41-42. 11. A.E.AEaaeaiia. Iieacaiey e iiynie/iie neiiaoyeoiiee o aieueiuo n iaeeoa?e?othuei aoa?ineea?icii i?e e?eoe/aneie eoaiee ieaeieo eiia/iinoae. // Iao/iua o?oaeu nio?oaeieeia iaaeeoeeineiai oieaa?neoaoa e a?a/ae i?aeoe/aneiai cae?aaiio?aiaiey. - Eoaaine, 1997. - N.60-61. 12. I.A.Oi?, A.A.A?euaiei, A.E.AEaaeaiia. Ninoiyiea iee?ioee?eoeyoeee a ieaeieo eiia/iinoyo aei e iinea iiynie/iie neiioayeoiiee o aieueiuo iaeeoa?e?othuei aoa?ineea?icii i?e iaee/ee o?iie/aneie e?eoe/aneie eoaiee. //Iaoiaeieiaey oeioiao?ee.- Iineaa, 1998.- N.54 - 58. Aiioaoe?y. AEaaeaiia A.?. Iiia?aeiaa neiiaoaeoii?y o oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e o?ii?/i?e e?eoe/i?e ?oai?? ieaei?o e?ioe?aie. - ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.03 - o??o?a?y - Oa?e?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao, Oa?e?a, 1998. Ia iniia? eiiieaeniiai ee?i?ei-?ino?oiaioaeueiiai aeine?aeaeaiiy oai?eo ia iae?oa?oth/ee aoa?ineea?ic i?e iayaiino? o?ii?/ii? e?eoe/ii? ?oai?? ieaei?o e?ioe?aie c o?aooaaiiyi noaio ?aa?iia?ii? aaiiaeeiai?ee ?ic?iaeai? ia’?eoeai? e?eoa??? aeey i?iaiicoaaiiy ?acoeueoao?a iiia?aeiai? neiiaoaeoii??, ?ic?iaeai? iieacaiiy aei ?? aeeiiaiiy. Eeth/ia? neiaa: iiia?aeiaa neiiaoaeoii?y, o?ii?/ia e?eoe/ia ?oai?y ieaei?o e?ioe?aie, aeiiea?iiao??y, eaca?ia oeioiao??y, iai?oaa eenith o oe???. Aiiioaoeey. AEaaeaiia A.E. Iiynie/iay neiiaoyeoiiey o aieueiuo iaeeoa?e?othuei aoa?ineea?icii i?e o?iie/aneie e?eoe/aneie eoaiee ieaeieo eiia/iinoae. - ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.03 - oe?o?aey - Oa?ueeianeee ainoaea?noaaiiue iaaeeoeeineee oieaa?neoao, Oa?ueeia, 1998. Ia iniiaaiee eiiieaeniiai eeeieei-eino?oiaioaeueiiai enneaaeiaaiey aieueiuo iaeeoa?e?othuei aoa?ineea?icii i?e iaee/ee o?iie/aneie e?eoe/aneie eoaiee ieaeieo eiia/iinoae n o/aoii ninoiyiey ?aaeiia?iie aaiiaeeiaieee ?ac?aaioaiu iauaeoeaiua e?eoa?ee aeey i?iaiice?iaaiey ?acoeueoaoia iiynie/iie neiiaoyeoiiee, ?ac?aaioaiu iieacaiey e aa i?eiaiaieth. Eeth/aaua neiaa: iiynie/iay neiiaoyeoiiey, o?iie/aneay e?eoe/aneay eoaiey ieaeieo eiia/iinoae, aeiiiea?iiao?ey, eaca?iay oeioiao?ey, iai?yaeaiea eenei?iaea a eiaea. SUMMERY. Vladimir I. Zhadanov. Lumbal sympathectomy of the patients sick with arteriosclerosis obliterance of critical ischemiva of low axtremities. - Manuscript. The thesis is submitted for Candidate of Medical Science of speciality 14.01.03. - Surgery. Kharkov State Medical University, Kharkov, 1998. On the basis of the complex of clinical-instrumental investigation among the patients sick with arteriosclerosis obliterance having chronic critical ischemiva of low extremities considering the situation of the objective criterions for the prognosis of results of lumbal sympathectomy were worked out and the recomendations for using were worked out also. Key words: lumbal sympathectomy, cronic critical ischemiva of low extreemities, laser Doppler blood flow and transcutaneous oxygen plasurements in the skin.

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