Профілактика акушерських та перинатальних ускладнень у жінок після медикаментозної корекції гормональної дисфункції яєчників: Автореф. дис… канд. ме

16

I?I?NOA?NOAI IOI?IIE CAeI?IAss OE?A?IE

EE?ANUeEA IAAeE*IA AEAAeAI?ss I?NEssAeEIEIIII? INA?OE ?i. I.E.OOIEEA

EANE?IA THE?ss NA?A??AIA

OAeE 618.5-089:888.61:616-071.1

I?IO?EAEOEEA AEOOA?NUeEEO OA

IA?EIAOAEUeIEO ONEEAAeIAIUe O

AE?IIE I?NEss IAAeEEAIAIOICII?

EI?AEOe?? AI?IIIAEUeII?

AeENOOIEOe?? ss?*IEE?A

14.01.01 — aeooa?noai oa a?iaeieia?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai

nooiaiy eaiaeeaeaoa iaaee/ieo iaoe

Ee?a– 1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia ia eaoaae?? aeooa?noaa, a?iaeieia?? oa ia?eiaoieia??
Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC
Oe?a?ie

IAOEIAEE EA??AIEE:

aeieoi? iaaee/ieo iaoe, i?ioani? Aaeiae/aiei TH??e Iao?iae/,

caa?aeoaa/ eaoaae?e aeooa?noaa, a?iaeieia?? oa ia?eiaoieia?? Ee?anueei?
iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC Oe?a?ie

IO?Oe?EI? IIIIAIOE:

aeieoi? iaaee/ieo iaoe, i?ioani? Eieii?eoeaaa Aioii?ia Aai?a??aia, caa.
a?aeae?eaiiyi iaoieia?? aaa?oiino? oa iieia?a ?inoeoooo iaae?ao???,
aeooa?noaa oa a?iaeieia?? AII Oe?a?ie;

aeieoi? iaaee/ieo iaoe, i?ioani? Aieioa Aeaaeeneaa sseiae/, caa?aeoaa/
eaoaae?e aeooa?noaa oa a?iaeieia?? ?3 Iaoe?iiaeueiiai iaaee/iiai
oi?aa?neoaoo ?i. aeaae. I.I.Aiaiiieueoey

I?IA?AeIA ONOAIIAA:

Iaeanueeee aea?aeaaiee iaaee/iee oi?aa?neoao IIC Oe?a?ie, eaoaae?a
aeooa?noaa oa a?iaeieia??.

Caoeno aeena?oaoe?? a?aeaoaeaoueny “ 04 ” _ethoiai_ 2000 ?ieo

i _11_ aiaeei? ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.613.02
i?e Ee?anuee?e iaaee/i?e aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea
IIC Oe?a?ie (254112, i. Ee?a, aoe.Aei?iaiaeeoeueea, 9).

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC Oe?a?ie (i. Ee?a,
aoe. Aei?iaiaeeoeueea, 9)

Aaoi?aoa?ao ?ic?neaiee “_31_”_a?oaeiy_ 1999 ?.

A/aiee nae?aoa?

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

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

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. A?aeiiaeaiiy ?ai?iaeoeoeaii? ooieoe?? ae?iie, ye?
no?aaeaeathoue ia iaie?aei?noue, ? aeooaeueiith iaaee/iith ?
nioe?aeueiith i?iaeaiith. A ?? ae??oaii? ianoaiiy ca/aooy ? o?eueee
ia?oei aoaiii, ca yeei aeieeaathoue caaea/? caaacia/aiiy aeiiooaaiiy
aaa?oiino? oa ia?iaeaeaiiy caei?iai? aeeoeie. Ooieoe?iiaeueia
iaie?aei?noue, coiiaeaia ii?ooaii? iaoeyoe??th aai iaaeinoaoi?noth
ethoa?iiai? oace oeeeeo, neeaaea? a?ae 30 aei 50% an?o aeiaaee?a
ae?ii/i? iaie?aeiino? (?.A.Aiae,1998; A.A.Ei?iaoeueea, 1998;
E.?.?aaithoa,1998). Aeey e?eoaaiiy aeenooieoe? y?/iee?a o ae?iie c
iaie?aei?noth oe?iei aeei?enoiaothoueny aioeano?iaaii? i?aia?aoe,
aioiaii?noe aeioai?io, aiiaaeio?ii?i-?ee?c?ia ai?iii (ethe?aa?ei) oa
eiai aiaeia?, a oaeiae i?iaanoa?ii.

O no/an?ie e?oa?aoo?? ? ia/eneaii? oa noia?a/eea? iia?aeiieaiiy i?i
iniaeeaino? ia?aa?ao oa e?ioey aaa?oiino?, yea ianoaea i?ney
iaaeeeaiaioicii? ei?aeoe?? ai?iiiaeueii? iaaeinoaoiino? y?/iee?a o
ae?iie c iaie?aei?noth (A.I.I?eeaineay, 1994; O.ss.Iineaeaiei, 1995;
A.E.Othothiiee oa ni?aaao., 1999). A?aenooi?noue ?aeeii? oi/ee ci?o
iiaeia iiynieoe ??ciiiai?oi?noth ii?ooaiue ?ai?iaeoeoeaii? ooieoe??, ye?
ia?aeiothoueny oa?i?iii “ai?iiiaeueia iaaeinoaoi?noue y?/iee?a”,
iaiaeii??aei?noth a?oi eiio?ieth, a oaeiae ??ciith e?euee?noth (?iiae?
aeoaea iaaaeeeith) ianoaaeaieo ae?iie. E??i oiai, ia aaea?oueny
i?inoaaeeoe /?oeo caeaaei?noue iniaeeainoae ia?aa?ao oa e?ioey
aaa?oiino? a?ae oeio oa nooiaiy ae?aaeaiino? ii?ooaiue ooieoe?? y?/iee?a
aei aaa?oiino?, a?ae aeaeo oa o?eaaeino? oa?ai??, ye? ia?aaeoaaea
aaa?oiino?. Aeeneon?eiei caeeoa?oueny ieoaiiy i?i iieacaiiy aei
i?iaaaeaiiy oa?ai??, ni?yiiaaii? ia caa?aaeaiiy aaa?oiino?, ?? ia?io o
ae?iie c aeenooieoe??th y?/iee?a (A.I.Aeoeyaaa oa ni?aaao., 1990;
A.I.Na?ia oa ni?aaao., 1995; A.?.A?euaiei oa ni?aaao., 1998). Oaeiae,
iaiaeiicia/ia aeoiea ??cieo aaoi??a (O.ss.Ioaie/ieeiaa, 1991;
TH.E.Aa?aoiaa,1996) i?i aieea oa?ai??, yea ia?aaeoaaea aaa?oiino?, o
ae?iie c aiaeie?eiiith iaie?aei?noth, ia noai iiaiia?iaeaeaieo oa
iiaeaeueoee ?o ?icaeoie.

Ana aeeeaaeaia aeua aeeeoo? iaiao?aei?noue iiaeaeueoiai aea/aiiy
iniaeeainoae ia?aa?ao aaa?oiino? oa iieia?a o ae?iie c aeenooieoe??th
y?/iee?a a aiaiiac? aeey iioeiaeueii? oaeoeee aaaeaiiy aaa?oieo oa
iie?ioaiiy ?acoeueoao?a ?ic?iaeaeaiiy.

Caycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie

Aeeiiaia iaoeiai-aeine?aeia ?iaioa ? o?aaiaioii iaoeiai? ?iaioe eaoaae?e
aeooa?noaa, a?iaeieia?? oa ia?eiaoieia?? Ee?anueei? iaaee/ii? aeaaeai??
i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea, ? ae.?. 0196 40 10590.

Iaoa ?iaioe ? caaea/? aeine?aeaeaiiy

Iaoa ?iaioe: cieaeaiiy /anoioe aeooa?nueeeo oa ia?eiaoaeueieo
oneeaaeiaiue o ae?iie i?ney iaaeeeaiaioicii? ei?aeoe?? ai?iiiaeueii?
aeenooieoe?? y?/iee?a ia i?aenoaa? aea/aiiy ee?i?ei-aiaeie?eiieia?/ieo
iniaeeainoae oa ?ic?iaee eiiieaeno i?io?eaeoe/ii-e?eoaaeueieo caoiae?a.

Caaea/? aeine?aeaeaiiy:

1. Aea/eoe iniaeeaino? ai?iiiaeueiiai noaoono (a oiio /ene? aeaee
aeenooieoe?? y?/iee?a) oa ee?i?/iiai ia?aa?ao ia??iaeo aei aaa?oiino? o
ae?iie c aiaeie?eiiith iaie?aei?noth.

2. I?iaanoe ee?i?ei-noaoenoe/iee aiae?c iniaeeainoae ia?aa?ao aaa?oiino?
oa ?ic?iaeaeaiiy ae?iie c aiaeie?eiiith iaie?aei?noth a aiaiiac?.

3. Aea/eoe iniaeeaino? ooieoe?iiaeueiiai noaio oaoiieaoeaioa?iiai
eiiieaeno o ae?iie c aiaeie?eiiith iaie?aei?noth a aiaiiac?.

4. Aea/eoe iieacieee ooieoe?iiaeueiiai noaio ueoiaeaeii? caeice o ae?iie
c aiaeie?eiiith iaie?aei?noth aei aaa?oiino? oa i?ae /an aanoaoe?eiiai
ia??iaeo oa ?ic?iaeaeaiiy.

5. Anoaiiaeoe aca?iicaycie i?ae ee?i?/ieie, aoia?ao?/ieie oa
aiaeie?eiieia?/ieie ci?iaie o ae?iie c aiaeie?eiiith iaie?aei?noth a
aiaiiac?.

6. ?ic?iaeoe oa ai?iaaaeeoe eiiieaen i?io?eaeoe/ii-e?eoaaeueieo caoiae?a
aei ? i?ae /an aaa?oiino? aeey ae?iie c aiaeie?eiiith iaie?aei?noth a
aiaiiac? oa anoaiiaeoe eiai aoaeoeai?noue.

Iaoeiaa iiaecia io?eiaieo ?acoeueoao?a. Aia?oa i?iaaaeaii aea/aiiy
iniaeeainoae ee?i?/iiai ia?aa?ao aaa?oiino? oa iieia?a, a oaeiae noaio
iiaiia?iaeaeaieo o ae?iie i?ney iaaeeeaiaioicii? ei?aeoe?? ??cieo oei?a
iaa??aeueii? iaaeinoaoiino?. Anoaiiaeaii, ui iniaeeaino? ia?aa?ao
aaa?oiino?, iieia?a oa i?neyiieiaiaiai ia??iaeo coiiaeai? ia o?eueee
oeiii ai?iiiaeueii? iaaeinoaoiino? y?/iee?a, aea oaeiae oeiii oa
o?eaae?noth ?? iaaeeeaiaioicii? ei?aeoe?? aei aaa?oiino?.

Aea/ai? iniaeeaino? oi?ioaaiiy oa ooieoe?iiaeueiiai noaio
oaoiieaoeaioa?iiai eiiieaeno i?e iayaiino? a aiaiiac? aeenooieoe??
y?/iee?a.

Aia?oa anoaiiaeaiee aca?iicaycie i?ae ee?i?/ieie, aoia?ao?/ieie oa
aiaeie?eiieia?/ieie iniaeeainoyie noaio oaoiieaoeaioa?iiai eiiieaeno o
ae?iie i?ney iaaeeeaiaioicii? ei?aeoe?? ??cieo aa?eaio?a iaa??aeueii?
iaaeinoaoiino?. Oea aeicaieeei ?icoe?eoe aeai? i?i iaoiaaiac
oaoiieaoeaioa?ii? iaaeinoaoiino?, a oaeiae iaoeiai iaa?oiooaaoe eiiieaen
i?io?eaeoe/i-e?eoaaeueieo caoiae?a, ni?yiiaaieo ia iie?ioaiiy
?acoeueoao?a ?ic?iaeaeaiiy.

I?aeoe/ia cia/aiiy io?eiaieo ?acoeueoao?a. Aea/aii aieea ??cieo
iaoiae?a iaaeeeaiaioicii? ei?aeoe?? oa aa?eaio?a iaa??aeueii?
iaaeinoaoiino? ia /anoioo oa nooi?iue ae?aaeaiino? ??cieo aeooa?nueeeo
oa ia?eiaoaeueieo oneeaaeiaiue. Anoaiiaeai? nooo?a? a?aei?iiino? a
/anoio? aeooa?nueei? oa ia?eiaoaeueii? iaoieia?? o ae?iie c ??cieie
aeenooieoe?yie y?/iee?a aei aaa?oiino?. Ooi/iai? ?yae oaeoi??a ?eceeo
?icaeoeo oaoiieaoeaioa?ii? iaaeinoaoiino? o ae?iie c iaie?aei?noth a
aiaiiac?.

?ic?iaeaii eiiieaen e?eoaaeueii-i?io?eaeoe/ieo caoiae?a uiaei cieaeaiiy
/anoioe aeooa?nueeeo oa ia?eiaoaeueieo oneeaaeiaiue aeey aaa?oieo c
aiaeie?eiiith iaie?aei?noth a aiaiiac? ia i?aenoaa? aeeoa?aioe?eiaaiiai
i?aeoiaeo aei i?io?eaeoe/ii? ai?iiiioa?ai??.

Iniaenoee aianie caeiaoaa/a. Ieaioaaiiy oa aeeiiaiiy iaoeiaeo
aeine?aeaeaiue i?iaaaeaii aaciina?aaeiuei aaoi?ii ca ia??iae 1997-1999
?.?. Aaoi?ii i?iaaaeai? ee?i?ei-noaoenoe/i? aeine?aeaeaiiy 175 aeiaaee?a
?ic?iaeaeaiiy ae?iie i?ney iaaeeeaiaioicii? ei?aeoe?? ??cieo aa?eaio?a
iaa??aeueii? iaaeinoaoiino?. I?iaaaeaii ee?i?ei-eaai?aoi?ia ianoaaeaiiy
100 ae?iie c aeenooieoe??th y?/iee?a a aiaiiac?, io?eioaaaoeo ??ci?
iaoiaeeee ei?aeoe?? oaoiieaoeaioa?ii? iaaeinoaoiino?. Naiino?eii
i?iaaaeaii caa?? oa i?aeaioiaeo a?ieia?/iiai iaoa??aeo. Iaoa??aee
aeine?aeaeaiiy aeeiiai? aaciina?aaeiuei aaoi?ii oa ca eiai o/anoth.

Aaoi?ii ?ic?iaeai? i?aeoe/i? ?aeiiaiaeaoe?? uiaei cieaeaiiy /anoioe
aeooa?nueei? oa ia?eiaoaeueii? iaoieia?? o ae?iie i?ney iaaeeeaiaioicii?
ei?aeoe?? ??cieo aa?eaio?a iaa??aeueii? iaaeinoaoiino?. Noaoenoe/ia
ia?iaea io?eiaieo aeaieo i?iaaaeaia aeeeth/ii aaoi?ii.

Ai?iaaoe?y ?acoeueoao?a aeine?aeaeaiiy. Iniiai? iieiaeaiiy oa aeniiaee
aeena?oaoe?eii? ?iaioe aoee aeiiia?aeai? oa iaaiai?ai? ia ?? ieaioi?
anioe?aoe?? aeooa??a-a?iaeieia?a Oe?a?ie (?aiaoi??y, aa?anaiue 1998); ia
can?aeaii? aeooa??a-a?iaeieia?a Ee?anueei? iaeano? (/a?aaiue, 1999); ia
can?aeaii? i?iaeaiii? eii?n?? “Aeooa?noai oa a?iaeieia?y” Ee?anueei?
iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?i.I.E.Ooieea (aa?anaiue
1999).

Ioae?eaoe??. Ca oaiith eaiaeeaeaonueei? aeena?oaoe?? iioae?eiaaii 7
iaoeiaeo ?ia?o, 5 c yeeo o aeo?iaeao, caoaa?aeaeaieo AAE Oe?a?ie,
i?e/iio 1 – naiino?eia.

No?oeoo?a oa ianya aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 106
noi??ieao iaoeiiieno, neeaaea?oueny c anooio, iaeyaeo e?oa?aoo?e,
?icae?eo iaoiae?a aeine?aeaeaiiy, o?ueio ?icae?e?a aeanieo
aeine?aeaeaiue, ?o iaaiai?aiiy, aeniiae?a oa iieaae/eea e?oa?aoo?e, yeee
aeeth/a? 100 a?o/eciyieo oa 84 ca?oa?aeieo aeaea?aea. ?iaioa
?ethno?iaaia 15 oaaeeoeyie ? 18 iaethieaie.

INIIAIEE CI?NO ?IAIOE

Ia?eo, iaoiaee oa iaoiaeieia?y aeine?aeaeaiue. O a?aeiia?aeiino? c
iaoith oa caaea/aie iaoi? iaoeiai? ?iaioe aeine?aeaeaiiy aoee i?iaaaeai?
a aeaa aoaie. Ia ia?oiio – aea/ai? ee?i?ei-noaoenoe/i? iniaeeaino?
?ic?iaeaeaiiy 175 ae?iie c ??cieie aa??aioaie aiaeie?eiii?
iaie?aeiino?, ye? niina??aaeenue ? aoee ianoaaeai? ye aei aaa?oiino?,
oae ? i?ae /an ia?. I?e oeueiio o 93 ae?iie (53,1%) iaea i?noea
aiiaoeyoe?y (? a?oia), a o 82 ae?iie (46,9%)- iaaeinoaoi?noue
ethoa?iiai? oace (?? a?oia).

Ia ae?oaiio aoai? aoei nii/aoeo i?iaaaeaii ee?i?/ia niinoa?aaeaiiy oa
aiaeie?eiieia?/ia ianoaaeaiiy 100 ae?iie c aiaeie?eiiith iaie?aei?noth
a aiaiiac? (??ci? aa??aioe iaa??aeueii? iaaeinoaoiino?) aei iiiaioo
ianoaiiy aaa?oiino?. Iaaeae? o ieo aoee aea/ai? iniaeeaino? ee?i?/iiai
ia?aa?ao aaa?oiino?, noai oaoiieaoeaioa?iiai eiiieaeno (aoia?ao?/i? oa
aiaeie?eiieia?/i? iniaeeaino?), oneeaaeiaiiy iieia?a oa iaoieia?y
iiaiia?iaeaeaieo. An? ae?iee aoee ?iciiae?eai? ia aea? a?oie c
o?aooaaiiyi eiiieaeno e?eoaaeueii-i?io?eaeoe/ieo caoiae?a: ??? a?oia –
50 ae?iie, i?iaaaeaieo ca caaaeueiii?eeiyoith iaoiaeeeith; ?V a?oia – 50
ae?iie, i?iaaaeaieo ca ?ic?iaeaiith iaie iaoiaeeeith.

Eiio?ieueio a?oio neeaaeaee 50 ia?ai?iaeyueo o a?oe? 20-25 ?ie?a aac
aeooa?nueei? oa niiaoe/ii? iaoieia??.

Caaaeueiii?eeiyoa aaaeaiiy aaa?oiino? o ae?iie c aeaiith iaoieia??th
aeeth/aei aei naaa o a?aeiia?aeiino? c ?aeiiaiaeaoe?yie E.A.Ia?e?ia oa
ni?aaao. (1996) a?oai?iioa?ai?th (a?oai?ie N, ?, ?); aioeieneaeaioe;
niaciie?oeee; iaia?aiinoaa?e?caoi?e oa aioeaa?aaaioe oa ai?iiiaeueio
oa?ai?th (oo??iae o aacia?a?aiiio ?aaeei?).

A?aei?oieie iniaeeainoyie i?io?eaeoe/ii-e?eoaaeueii? iaoiaeeee, ui
aeei?enoiaoaaeany iaie, yaeeiny canoinoaaiiy iaaiac?aeueii? oa?ai??:
10-20 ie 25% ?ic/eio i?ioyaii 10-14 aei?a 3 eo?na ia aaa?oi?noue (6-8;
16-20; 26-30 oeae. aaa?oiino?) oa ni?yiiaaii? ai?iioa?ai??, yea
i?iaiaeeeany c o?aooaaiiyi eiie?aoiiai aeaeo ai?iiiaeueii?
iaaeinoaoiino? y?/iee?a. Oae, o ae?iie c aiiaoeyoe??th a aiaiiac? o
aei?, ye? a?aeiia?aeathoue ? oac? iaino?oaeueiiai oeeeeo, i?iaiaeyoue
oa?ai?th o?eueee oie?eoe?iii, a oie /an ye o aei?, ye? ni?aiaaeathoue c
?? oacith – a?aeiia?aeii i?iaanoa?iiii. O ae?iie c iaaeinoaoi?noth
ethoa?iiai? oace a aiaiiac? aeei?enoiaoaaany o?eueee i?iaanoa?ii a
aei?, ye? a?aeiia?aeathoue ?? oac? iaino?oaeueiiai oeeeeo. I?io?eaeoe/ia
aeei?enoaiiy ai?iioa?ai?? i?iaiaeeeinue o an?o ae?iie ?V a?oie,
ii/eiath/e c 4-5 ? aei 35-36 oeaei?a aaa?oiino?. I?e oeueiio aeiaia?
aeicoaaiiy ai?iiiaeueieo i?aia?ao?a aoee i?i?iaeueieie: 0,7 – 1,0 ie 1%
?ic/eio i?iaanoa?iio oa 0,3-0,5 ie oie?eoe?io (1 ie – 5000 iae.)
o?eaae?noue oa ci?ia aeicoaaiiy ai?iiiaeueieo i?aia?ao?a i?ae eiio?ieai
eieueiioeeoieia?/ieo oa ?aae?i?ioiieia?/ieo iieaciee?a c o?aooaaiiyi
?iaeea?aeoaeueii? /ooeeaino?.

Oeueo?acaoeia? aeine?aeaeaiiy i?iaiaeeeenue ia aia?ao? “Toshiba”,
“Aloka” oa “Philips”. Nei?ioeeao ae?yeuei?noue iaoee aea/aee ca
aeiiiiiaith ea?ae?ioieia?aoa “A?iiaaeeea”(?oae?y) iaoiaeii ciai?oiuei?
a?noa?ia?ao??. Aeey ?icoeo?iaee ea?ae?ioieia?ai ieiaea aeei?enoiaoaaee
aaeueio ioe?ieo ca oeaeith A.N.Aioue? (1988).

Aeey ioe?iee aiaeie?eiii? ooieoe?? oaoiieaoeaioa?iiai eiiieaeno
aeei?enoiaoaaee ?aae?i?ioiieia?/i? iaoiaee (A.A.?aci?eiaa, 1990) oa
aecia/aee oae? iieacieee: ano??ie, ano?aae?ie, i?iaanoa?ii, oi??ii?/iee
aiiaaeio?ii?i, ieaoeaioa?iee eaeoiaai, oe?aio?iiiee ai?iii,
o?eeiaeoe?iiei oa oe?ienei.

Iaoaiaoe/ia ia?iaea io?eiaieo aeaieo i?iaiaeeeanue a 3 aoaie: noai?aiiy
i?ia?aiiiai eiiieaeno ia?iaee aeaieo; aaaaeaiiy aeaieo a eiiithoa?
“Pentium – 150” o??ie “Samsung” (Ei?ay); Aeanii ia/enethaaeueia ?iaioa
ca noaiaea?oieie i?ia?aiaie.

Iaoaiaoe/i? iaoiaee aeine?aeaeaiiy aoee aeeiiai? ca?aeii ?aeiiaiaeaoe?e
I.I.I?ioea?a oa ni?aaao. (1998).

?acoeueoaoe aeine?aeaeaiue oa ?o iaaiai?aiiy. Na?aaei?e a?e ianoaaeaieo
ae?iie ia ? aoai? neeaaeaa 34,23,1 ?ieo ? ca a?oiaie aeinoia??ii ia
a?ae??ciyany (?>0,05). Iaei??th c aaaeeea?oeo iniaeeainoae
i?aii?a?aeiiai oiio ? ia?aianaia aei aaa?oiino? aai?oaeueia iaoieia?y
(?.A.Aiae,1990; E.?.?aaithoa,1990; R.Homburg, 1996). Ca?aeii io?eiaieo
iaie aeaieo iae/ano?oa o ae?iie c ai?iiiaeueiith aeenooieoe??th y?/iee?a
cono??/aeeny ??ci? ii?ooaiiy iaino?oaeueiiai oeeeeo, ye? ia?aaaaeaee i?e
aiiaoeyoe??, ii??aiyii c iaaeinoaoi?noth ethoa?iiai? oace (59,1%
ii??aiyii c 46,3%; ?<0,05). I?e no?oeoo?iiio aiae?c? oeueiai iieacieea anoaiiaeaii, ui iniiai? a?aei?iiino? coiiaeai? ??ciith /anoioith ie?aiiaii?a? (55,9% i?ioe 35,4%; ?<0,05). I?e aiae?c? ?aooe iicieia?/ieo oi?i a?iaeieia?/ii? caoai?thaaiino? iaie ia anoaiiaeaii aeinoia??ieo a?aei?iiinoae i?ae a?oiaie (?>0,05). Ii?yae c oeei, caa?oa? ia naaa
oaaao cia/ia ieoiia aaaa iaoieia?/ieo ci?i oeeee iaoee (29,1%);
a?iiieac?? iaoee (21,1%) oa o?ii?/iiai naeuei?iaiioi?eoo (17,7%). Ia iao
iiaeyae, oaeee aenieee ??aaiue ii?aeiaieo oi?i aai?oaeueii? iaoieia??
na?ae/eoue i?i aca?iicaycie ai?iiiaeueieo oa caiaeueieo ci?i i?e ??ci?e
aeenooieoe?? y?/iee?a, ia ui oaeiae oeacothoue aeaye? aeine?aeieee
(O.ss.Ioaie/ieeiaa, 1991; A.I.Niaoiee oa ni?aaao., 1997; P.O. Karlstrom
et.al.,1992).

*anoioa ia?aeiii? iaie?aeiino? neeaaeaea 64,6% a caaaeuei?e a?oi? oa
caeaaeaea a?ae aa??aioo ii?ooaiue ai?iiiaeueii? ooieoe?? y?/iee?a. Oea
i?aeoaa?aeaeo?oueny oei oaeoii, ui aeaiee iieaciee aoa aeinoia??ii aeuei
(aei 75,3%; ?<0,05) o ae?iie c aiiaoeyoe??th i?e iaeii/aniiio eiai cieaeaii? ia oii? iaaeinoaoiino? ethoa?iiai? oace (aei 52,4%; ?<0,05). I?e oeueiio, na?aae ??cieo aa??aio?a cae?i/aiiy iiia?aaei?o aaa?oiinoae o ae?iie c iaie?aei?noth ?? iiaeia a?aei?oeoe yaia ia?aaaaeaiiy a?oeo?oe?eieo aai?o?a (25,4%). O?eaae?noue iaie?aeiino? oeoaeany a?ae 2 aei 18 ?ie?a oa neeaaeaea, a na?aaeiueiio, 6,20,5 ?ieo, i?e/iio aac aeinoia??ieo a?aei?iiinoae ca a?oiaie (?>0,05).

Ieoaiiy ae?aaiinoeee ??cieo ai?iiiaeueieo ii?ooaiue o ae?iie c
iaie?aei?noth iiaycai? c ?acoeueoaoaie i?iaaaeaieo eieueiioeeoieia?/ieo
oa aiaeie?eiieia?/ieo aeine?aeaeaiue (O.Ae.O?aayiei, 1989; A.I.Aeoeyaaa,
1997; A.E.Othothiiee oa ni?aaao., 1999). Ia i?aenoaa? aeiaeaoeiaeo
iaoiae?a aeine?aeaeaiue o iaoeo oai?eo cono??/aeeny o?e iniiai?
aa??aioe, ye?, i?e?iaeii, a?ae??ciyeeny ca a?oiaie. Oae, o ae?iie c
iaaeinoaoi?noth ethoa?iiai? oace aeinoia??ii /ano?oa (aei 58,5%; ?<0,05) iaea i?noea ii?iiaiiaaeio?iiia ii?iii?ieaeoeiai?/ia ia?aeiii-y?/ieeiaa iaaeinoaoi?noue. A naith /a?ao, o ae?iie c aiiaoeyoe??th /ano?oa aoee ae?aaiinoiaai? neiae?ii iie?eenoicieo y?/iee?a (aei 30,1%; ?<0,05) oa a?ia?i?ieaeoeiai?/ia iaaeinoaoi?noue (aei 26,9%; ?<0,05). Oaea ??cieoey ? oe?eeii caeiiii??iith, iniaeeai c o?aooaaiiyi iienaieo aeua a?iaeieia?/ieo caoai?thaaiue, a ia?oo /a?ao ?? ii?aeiaieo oi?i. Aeoiaey/e c iienaiiai aeua iaee i?noea nooo?a? a?aei?iiino? ca aa??aioaie i?iaiaeeii? aei aaa?oiino? ai?iiiaeueii? ei?aeoe??, ui aeineoue oaee oe?iei iaaiai?th?oueny o a?o/eciyi?e oa ca?oa?aei?e e?oa?aoo?? (O.ss.Ioaie/ieeiaa, 1991; A.I.I?eeaineay, 1994; A.A.Ei?iaoeueea, 1998; J.O.Parinaud et.al.,1992). O ae?iie c aiiaoeyoe??th o an?o aeiaaeeao (100,0%) aeei?enoiaoaaee eeii?oai aai eeino?eueaaa?o oa aeiaeaoeiai a 44,1% aeiaaee?a ia?eiaeae, a a 17,2% ? i?iaanoa?ii. Ii??aiyii c oeei, o oai?eo c iaaeinoaoi?noth ethoa?iiai? oace e??i i?iaanoa?iio (100,0%) a 21,9% niinoa?aaeaiue canoiniaoaaee ia?eiaeae ? a 14,6% eeii?oai (eeino?eueaaa?o). Oea ua ?ac i?aeoaa?aeaeo? aeoieo A.A.Ei?iaoeueei? (1998) i?i nooo?ao ?ieue ii?aeiaieo oi?i ai?iiiaeueii? aeenooieoe?? y?/iee?a o oai?eo c iaie?aei?noth. E??i ai?iiiaeueii? oa?ai??, aeineoue /anoi aeei?enoiaoaaee ??cio o?c?ioa?ai?th (86,9%); ?icniieooth/o (81,7%) oa aioeaaeoa??aeuei? i?aia?aoe (60,0%), i?e/iio aeinoia??ieo a?aei?iiinoae ca a?oiaie ie ia niinoa??aaee (?>0,05). *anoioa ??cieo o??o?a?/ieo ao?o/aiue ii??aiyii c
eiina?aaoeaiith oa?ai??th aoea ia ii?yaeie ieae/ith (20,6%) c yaiei
ia?aaaaeaiiyi ?acaeoe?? y?/iee?a (17,7%) oa a?aenooi?noth aeinoia??ieo
a?aei?iiinoae ca a?oiaie (?>0,05).

A iao /an aaaaea?oueny aeiaaaeaiei oaeo iayaiino? aca?iicayceo i?ae
ai?iiiaeueiith aeenooieoe??th y?/iee?a oa niiaoe/iith caoai?thaai?noth,
yeee /anoi aeiiiaith? iaeei iaeiiai (A.I.I?eeaineay oa ni?aaao., 1991;
A.E.Nioieeiaa oa ni?aaao., 1994; A.I.Niaoiee oa ni?aaao., 1997).
Io?eiai? iaie ?acoeueoaoe na?ae/aoue i?i aeinoaoiuei aenieee ??aaiue
(54,3%) noiooiuei? aeno?aaai?oaeueii? iaoieia??, /anoioa yei? ca a?oiaie
aeinoia??ii ia a?ae??ciyeany (?>0,05).

Aeai? i?i iniaeeaino? ia?aa?ao aaa?oiino? oa iieia?a o ae?iie c
iaie?aei?noth a aiaiiac? ia/eneaii? ? ?ic??ciai? oa /anoi iinyoue
noia?a/eeaee oa?aeoa? (O.A.Iaca?aiei, 1989; TH.E.Iaioiie?ia oa ni?aaao.,
1991; A.E.Nioieeiaa, 1993; A.I.I?eeaineay, 1994; E.A.Ia?e?i, 1996).
Ca?aeii io?eiaieo iaie ?acoeueoao?a, /anoioa iniiaieo oneeaaeiaiue
aaa?oiino? caeaaeaea a?ae aeaeo ai?iiiaeueii? aeenooieoe?? y?/iee?a.
Oae, aei 20 oeaei?a aaa?oiino? o ae?iie c aiiaoeyoe??th a aiaiiac?
?icaeaaeeny caa?ica iaaeiiooaaiiy (aei 77,4%; ?<0,05), a o oai?eo c iaaeinoaoi?noth ethoa?iiai? oace oeae iieaciee aoa aeinoia??ii ieae/ei (aei 45,1%; ?<0,05). A ?? iieiaei? a?aei?iiino? iineee a?eueo ae?aaeaiee oa?aeoa?. Iniaeeai iai/ii oea i?iaeyaea?oueny c aieo /anoioe oaoiieaoeaioa?ii? iaaeinoaoiino? (65,6% i?ioe 37,8%; ?<0,05); i?ci?o oieneeic?a (56,9% ii??aiyii c 40,2%; ?<0,05) oa caa?ice ia?aae/anieo iieia?a (54,8% i?ioe 41,5%; ?<0,05). ??aaiue ?aooe oneeaaeiaiue aoa aeinoaoiuei aenieei: aiai?y aaa?oieo (58,9%) oa caaino?aiiy aeno?aaai?oaeueii? iaoieia?? (12,0%), iaeiae aac aeinoia??eo a?aei?iiinoae ca a?oiaie (?>0,05). Iacaaaeath/e ia i?iaiaeeio
caa??aath/o oa?ai?th, ieiia?eueiee aeeeaeaiue a?aeaoany o 19,1% ae?iie c
aiiaoeyoe??th a aiaiiac? ? o 10,9% — c iaaeinoaoi?noth ethoa?iiai? oace.
I/aaeaeii, i?aeneeaiiy noeioeyoe?? iaoeyoe?? ia caaaeaee
noi?iaiaeaeo?oueny neio?iiieie ci?iaie a aiaeiiao???, ye? iiaee a
caaacia/eoe iiaiioe?iiee ?icaeoie aaa?oiino?, ui ianoaea.

I?e aiae?c? /anoioe iaaeiiooaaiiy a?ae aeaeo oa o?eaaeino?
iaaeeeaiaioicii? ei?aeoe?? ai?iiiaeueii? iaaeinoaoiino? y?/iee?a aei
aaa?oiino? anoaiiaeaii, ui i?e e?eoaaii? i?iaanoa?iiii oa ia?eiaeaeii
/anoioa ieiia?eueieo aeeeaei?a aoea aeinoaoiuei iecueeith (2,2%),
iniaeeai yeui aaa?oi?noue ianoaea i?ney 3 oa a?eueoa i?nyoe?a. Na?aae
an?o ae?iie, ye? io?eioaaee aei aaa?oiino? e?eoaaiiy ia?eiaeaeii a
eiiieaen? c ?ioeie i?aia?aoaie, a 4,9% aeiaaee?a aeyaeaia aaa?oi?noue,
ui ia ?icaeaa?oueny, i?e oeueiio, i?aeoe/ii, an? aiie io?eioaaee eo?n
oeueiai i?aia?aoo iaio 3 i?nyoe?a. sse aeaeii, o oai?eo c a?iiooieoe??th
y?/iee?a ia?eiaeae caeaoiee aeineoue oaeaeei aeeeeeaoe iaoeyoe?th,
iaeiae iiaiioe?iia ooieoe?iioaaiiy aeiaoiai o?ea ianoa? i?ci?oa (i?ney 3
? a?eueoa i?nyoe?a e?eoaaiiy ia?eiaeaeii). Oea ni?aiaaea? c aeoieith
A.I.I?eeainueei? (1998) i?i iaiao?aei?noue a?eueo o?eaaeiai aeei?enoaiiy
ia?eiaeaeo o eiiieaeniiio e?eoaaii? oai?eo c aiaeie?eiiith
iaie?aei?noth. I?e e?eoaaii? aiiaoeyoe?? o?eueee eeii?oaiii aai
eeino?eueaaa?oii /anoioa iaaeiiooaaiiy oa caia?oi? aaa?oiino? (2,2%)
iaaiaee a?eueo iecueea, yeui eo?n e?eoaaiiy neeaaeaa aei 3 i?nyoe?a.
Iacaaaeath/e ia eiiieaenio i?io?eaeoeeo iaaeiiiooaaiiy a iaio a?oiao,
/anoioa ia?aae/anieo iieia?a neeaaeaea 8,6% a caaaeuei?e a?oi? c
ia?aaaaeaiiyi oeueiai iieacieea o ae?iie c aiiaoeyoe??th a aiaiiac?
(10,8%) ii??aiyii c iaaeinoaoi?noth ethoa?iiai? oace. Aacoiiaii, a iaoo
oa caaea/? i?iaiaeeiiai iaoeiaiai aeine?aeaeaiiy ia aoiaeeei i?aeaeuaiiy
aoaeoeaiino? e?eoaaiiy aeaii? oi?ie iaie?aeiino?, iaeiae a?aei?/ai?
caeiiii??iino?, ia iao iiaeyae, iathoue i?aeoe/ia cia/aiiy ? iiaeooue
aieeiooe ia oaeoeeo i?iaaaeaiiy i?io?eaeoe/ii-e?eoaaeueieo caoiae?a.

Aaaeii?iaeueia ?ic?iaeaeaiiy ? iaei??th c iniiaieo i?iaeai no/aniiai
aeooa?noaa, ui coiiaeaii cia/iei c?inoaiiyi oeueiai iieacieea ia oii?
noaa?eueii aenieiai ??aiy ia?eiaoaeueieo oo?ao (A.E.E?aniiiieueneee oa
ni?aaao., 1993; A.I.Na?ia oa ni?aaao., 1997; A.I.Aaioee?anueeee, 1998).
Iniaeeao a?oio ooo neeaaeathoue ae?iee c iaie?aei?noth a aiaiiac?,
/anoioa eana?nueeeo ?icoei?a o yeeo oeoa?oueny a?ae 30% aei 90%
(A.I.Naaaeueaaa, 1990; A.E.Nioieeiaa oa ni?aaao., 1994; Y.Agata et.al.,
1995). Ia iaoo aeoieo, oaea nooo?aa ieoiia aaaa ??cieo oneeaaeiaiue i?ae
/an aaa?oiino? aieeioea ? ia /anoioo eana?nueeeo ?icoei?a, yea neeaaea?
a caaaeuei?e a?oi? 64,6% ? aoea aeinoia??ii aeuith o ae?iie c
aiiaoeyoe??th a aiaiiac? (75,3%; ?<0,05). I?e aiae?c? no?oeoo?e iniiaieo iieacaiue aei aaaeii?iaeueiiai ?ic?iaeaeaiiy aeinoia??i? a?aei?iiino? niinoa??aaeeny o?eueee c aieo aioo??oiueioo?iaii? a?iien?? ieiaea, yea ia i?aeaea?oueny iaaeeeaiaioici?e ei?aeoe?? (50,0% i?ioe 41,9%; ?<0,05), yea aoea a?aeiia?aeii aeuith o ae?iie c aiiaoeyoi?iei oeeeeii a aiaiiac?. I?e ioe?ioe? ?aooe iieaciee?a aeinoia??ieo a?aei?iiinoae ia aoei, iaeiae iiaeia a?aei?oeoe a?aeiinii aenieo ieoiio aaao oaeeo ye: a?e i?e ia?oeo iieiaao iiiaae 30 ?ie?a (37,2%); ia?aae/aniee ?ic?ea ieiaeiaeo iaieiiie (37,2%); aiiiae?? iieiaiai? ae?yeueiino? (29,2%); oaciaa ia?aaeeaaeaiiy (18,6%) oa e?oiiee ie?ae (17,7%). Ii??aiyeueiee aiae?c noaio iiaiia?iaeaeaieo iieacaa aeinoia??i? a?aei?iiino? c aieo /anoioe ano?en?? ??ciiai nooiaiy oyaeeino? (75,3% i?ioe 47,6%; ?<0,05) oa a?iio?io?? (26,9% ii??aiyii c 15,9%; ?<0,05). I?e/iio, a?eueo ae?aaeaii no?aaeaeathoue ae?oe a?ae iaoa??a c aiiaoeyoe??th a aiaiiac?. A oe?e aea a?oi? aoee aeinoia??ii aeueie ? ieoiia aaaa iinoa?iiene/ii? aioeaoaeiiao?? (34,4% i?ioe 24,4%; ?<0,05). Caeeth/i? aeine?aeaeaiiy, i?enay/ai? aiae?co i?neyiieiaiai? caoai?thaaiino? ae?iie c ??cieie ii?ooaiiyie ooieoe?? y?/iee?a a aiaiiac?, iieacaee a?aenooi?noue aeinoia??ieo a?aei?iiinoae ca a?oiaie (?>0,05). Iae/ano?oa ooo iaee i?noea noa?iaiethoe?y iaoee (16,0%);
?aiiaa ?ioaeoe?y (8,6%) oa aiaeiiao?eo (6,9%). Oaeiae, iaiao?aeii
caa?iooe oaaao ? ia aenieo /anoioo a?iiaaeaeo?? (50,9%), yea aeinoia??ii
/ano?oa cono??/aeany o ae?iie c aiiaoeyoe??th a aiaiiac? (61,6%
ii??aiyii c 40,0%; ?<0,05). Ioaea, ye iieacaee ?acoeueoaoe i?iaaaeaieo ee?i?ei-noaoenoe/ieo aeine?aeaeaiue, ae?iee c ai?iiiaeueiith ei?aeoe??th ii?ooaiue ooieoe?? y?/iee?a neeaaeathoue a?oio aenieiai ?eceeo uiaei ?icaeoeo, a ia?oo /a?ao, oaoiieaoeaioa?ii? iaaeinoaoiino?, a oaeiae i?ci?o oieneeic?a oa aiiiae?e iieiaiai? ae?yeueiino?. Oea coiiaeth? o ieo aenieo /anoioo eana?nueeeo ?icoei?a oa ia?eiaoaeueii? iaoieia??. Ii??aiyeueiee aiae?c io?eiaieo aeaieo c o?aooaaiiyi eiie?aoiiai aeaeo ai?iiiaeueieo ii?ooaiue (aiiaoeyoe?y aai iaaeinoaoi?noue ethoa?iiai? oace) iieacaa, ui o ia?oiio aeiaaeeo aeinoia??ii /ano?oa ?icaeaathoueny oaoiieaoeaioa?ia iaaeinoaoi?noue oa i?ci? oieneeice, ui iaaaoeaii aieeaa? ia ia?eiaoaeuei? aeoiaee ?ic?iaeaeaiiy. Ana aeeeaaeaia aeua na?ae/eoue i?i iaiao?aei?noue ?ic?iaee niaoeeo?/ieo e?eoaaeueii-i?io?eaeoe/ieo caoiae?a aeey oe??? a?oie oai?eo c iaoith iie?ioaiiy ?acoeueoao?a ?ic?iaeaeaiiy. ?acthioth/e iniaeeaino? ee?i?/ii? oa?aeoa?enoeee ianoaaeaieo ae?iie ia ?? aoai? iaoi? ?iaioe (??? oa ?V a?oia) iaiao?aeii a?aei?oeoe, ui ?o ?iciiae?eaiiy i?iaiaeeeiny a?aeiia?aeii i?eioeeio ?aiaeii?i?caoe??, iaiao?aeiiai aeey aaeaeaaoii? ioe?iee io?eiaieo ?acoeueoao?a. Iniiai? iiiaioe i?aii?a?aeiiai oiio, ae?aaiinoeee oa e?eoaaiiy aeaii? oi?ie iaie?aeiino? ni?aiaaeathoue c onoaiiaeaieie ?ai?oa ia aoai? ee?i?ei-noaoenoe/ieo aeine?aeaeaiue. ?ic?iaeaiee iaie eiiieaen i?io?eaeoe/ii-e?eoaaeueieo caoiae?a i?iaiaeeany a ?V a?oi? oai?eo /ioe?ueia eo?naie a oae? oa?i?ie aaa?oiino?: 6-8; 16-20; 26-30 oa 34-38 oeaei?a. 1 eo?n aeeth/aa a naaa iaaiac?aeueio oa?ai?th; niaciie?oe/io; naaeaoeaio oa ai?iiiiei?aeoe?th, yea yaeeany i?iaeiaaeaiiyi iaaeeeaiaioicii? oa?ai?? iaaeinoaoiuei? ooieoe?? y?/iee?a. I?io?eaeoe/ia aeei?enoaiiy ai?iiiiei?aeoe?? ca iienaiith aeua noaiith ii/eiaeiny c iiiaioo inoaoi/ii? ae?aaiinoeee iaoeiai? aaa?oiino? ? aei 35-36 oeaei?a aaa?oiino?. Oaeee i?aeo?ae coiiaeaiee ?acoeueoaoaie iaoeo iiia?aaei?o aeine?aeaeaiue, a oaeiae inoaii?ie aeaieie ?yaeo aeine?aeiee?a (A.E.Nioieeiaa oa ni?aaao., 1994; A.E.Othothiiee oa ni?aaao., 1994; 1999) i?i iaiao?aei?noue aeei?enoaiiy i?e aenieiio ?eceeo iaaeiiooaaiiy oe?eani?yiiaaii? ai?iiiaeueii? ei?aeoe??, yea a?aeiia?aea? e?eoaaiith aeo?aeiiai noaio oai?eo. Aeei?enoaiiy oi??ii?/iiai aiiaaeio?ii?io i?iaiaeeeiny noai?i ?iaeea?aeoaeueii i?ae eiio?ieai oeueiai iieacieea iacaeaaeii a?ae aeaeo ii?ooaiue ai?iiiaeueii? ooieoe?? y?/iee?a a aiaiiac?. A ??? a?oi? ai?iiiioa?ai?y i?iaiaeeeany oo??iaeii ca caaaeueiii?eeiyoei aeicoaaiiyi (E.?.?aaithoa, 1990). 2 eo?n (16-20 oeaei?a) aoa ni?yiiaaiee ia i?io?eaeoeeo i?ci?o oieneeic?a, ieaoeaioa?ii? iaaeinoaoiino? oa caa?ice ia?a?eaaiiy aaa?oiino? oa aeeth/aa: iiaoi?ia canoinoaaiiy iaaiac?aeueii? oa?ai??, niaciie?oe/i? i?aia?aoe, aioeaa?aaaioe, aioeieneaeaioe oa ai?iiiiei?aeoe?th c o?aooaaiiyi iienaieo aeua iniaeeainoae. 3 eo?n (26-30 oeaei?a) aeeth/aa a naaa an? iienai? aeua iniaeeaino? ca aeiyoeii ai?iiiioa?ai??. 4 eo?n aoa ni?yiiaaiee ia ei?aeoe?th oneeaaeiaiue, ui ?icaeioeeny, ? ia i?aeaioiaeo aaa?oii? aei ?ic?iaeaeaiiy. Iaaiac?aeueia oa?ai?y i?ney 36 oeaei?a ia i?iaiaeeeany. I?e oeueiio, aeey aeiiieiaiai? i?aeaioiaee aeei?enoiaoaaany i?inoei A2 (aaa?iaeueiee aaeue aai aaa?iaeuei? oaaeaoee) ii 0,5 ia oi?iaeiaae 3-5 aei?a. I?e aeia??e aioiaiino? iieiaiaeo oeyo?a oa eiiiainiaaiiio noai? ieiaea i?iaiaeeeeny i?ia?aiiaai? iieiae c ?aiiueith aii?ioii??th, nei?i/aiiyi ? ia??iaeo iieia?a oa iaeneiaeueiei aeei?enoaiiyi niaciie?oee?a. sse na?ae/aoue io?eiai? iaie aeai?, aeinoia??ia a?aei?ii?noue c aieo /anoioe ??cieo oneeaaeiaiue iaea i?noea aaea a ? iieiaei? aaa?oiino?. Iniaeeai iai/ii oea i?iaeyaea?oueny i?e ioe?ioe? ??aiy caa?ice ia?a?eaaiiy (60,0% ii??aiyii c 24,0%; ?<0,01) oa ?aii?o oieneeic?a (46,0% ii??aiyii c 22,0%; ?<0,01). Iacaaaeath/e ia i?iaiaeeio caa??aath/o oa?ai?th aaa?oi?noue ia?a?eaaeany a ?aii? oa?i?ie (aei 14 oeaei?a) o?eueee a ??? a?oi? a 4,0% aeiaaee?a. ?icaeyaeath/e ieoaiiy o?eaaeino? noaoe?iia?iiai e?eoaaiiy, a iniiaiiio, c i?eaiaeo caa?ice iaaeiiooaaiiy, iaiao?aeii a?aei?oeoe, ui a ??? a?oi? oeae iieaciee neeaaeaa 53,44,2 aeiy, a a ?V – aoa cia/ii ieae/ei (21,21,8 aeiae; ?<0,01). Oi?eath/eny aoaeoeaiino? i?iaiaeeieo i?io?eaeoe/ii-e?eoaaeueieo caoiae?a iiaeia oeacaoe, ui i?e aoia?ao?/ieo aeine?aeaeaiiyo a ? iieiaei? aaa?oiino? /anoioa iino?eiiai a?ia?oiiono iaoee aoea cia/ii ieae/ith i?e aeei?enoaii? ?ic?iaeaii? iaie iaoiaeeee – 32,0% i?ioe 68,0% (?<0,01). I?e aiae?c? iaeiani?eyoeea?oeo oa?i?i?a o ae?iie c ai?iiiaeueiith iaaeinoaoi?noth ooieoe?? y?/iee?a a aiaiiac? ne?ae a?aei?oeoe, ui iae/ano?oa noaoe?iia?ia e?eoaaiiy i?iaiaeeeiny a 10-14 oeaei?a, a oaeiae c 18 oeaei?a aaa?oiino?. A ?? iieiaei? aaa?oiino? iae/ano?oei oneeaaeiiiyi, i?e/iio aac aeinoia??ieo a?aei?iiinoae ca a?oiaie, aoea aiai?y aaa?oieo (52,0% ? 50,0%; ?>0,05), a c aieo ?aooe iieaciee?a, ye? aea/athoueny, iaee i?noea
aeinoia??i? a?aei?iiino?. Oae, ia oii? caaaeueiii?eeiyoeo
i?io?eaeoe/ii-e?eoaaeueieo caoiae?a cia/ii /ano?oa cono??/aeeny
oaoiieaoeaioa?ia iaaeinoaoi?noue (54% i?ioe 22,0%; ?<0,01); i?ci? oieneeice (50,0% ii??aiyii c 28,0%; ?<0,05) oa caa?ica ia?aae/anieo iieia?a (48,0% i?ioe 26,0%; ?<0,01). I?e a?eueo aeaoaeueiiio aiae?c? iniiaieo i?iya?a oaoiieaoeaioa?ii? iaaeinoaoiino? iaiao?aeii a?aei?oeoe iii?oia ia?aaaaeaiiy a ??? a?oi? iaeiaiaeaey (18,0% ii??aiyii c 6,0%; ?<0,01) oa cao?eiee aioo??oiueioo?iaiiai ?icaeoeo ieiaea ca aneiao?e/iei aa??aioii (16,0% i?ioe 6,0%; ?<0,01) oa neiao?e/iei aa??aioii cao?eiee aioo??oiueioo?iaiiai ?icaeoeo ieiaea (8,0% i?ioe 4,0%; ?<0,01). Na?aae ??cieo oi?i i?ci?o oieneeic?a a iaio a?oiao ia?aaaaeathoue eaae? oi?ie (iaa?ye oa iao?iiao?y ? no.) – 42% ? 22,0% (?<0,01). Na?aaei? ia?aaoaaiiy oai?eo a noaoe?iia?? aaea ca ii?aeiaieie iieacaiiyie (caa?ica ia?aae/anieo iieia?a; oaoiieaoeaioa?ia iaaeinoaoi?noue oa i?ci? oieneeice) neeaaeaei a ??? a?oi? 67,35,2 aeiy, a a ?V – 33,22,8 aeiae (?<0,01), ui iaioa a 2 ?ace. Ioaea, ?acoeueoaoe i?iaaaeaieo ee?i?/ieo aeine?aeaeaiue aeicaieythoue a?aei?oeoe nooo?ao ee?i?/io aoaeoeai?noue ?ic?iaeaii? i?io?eaeoe/ii-e?eoaaeueii? iaoiaeeee o ae?iie c ??cieie aa??aioaie ai?iiiaeueii? aeenooieoe?? y?/iee?a a aiaiiac?. Aacoiiaii, aeey aaeaeaaoiiai o?aeooaaiiy io?eiaieo ?acoeueoao?a aoei i?iaaaeaii aeiaeaoeiaa aea/aiiy aiaeie?eiii? ooieoe?? oaoiieaoeaioa?iiai eiiieaeno. A iao /an ia aeeeeea? noii?a?a oie oaeo, ui eiiieaenia ioe?iea noaio oaoiieaoeaioa?iiai eiiieaeno c aeeth/aiiyi aiaeie?eiieia?/iiai noaoono ? iaea?eueo aaeaeaaoiith oa aeicaiey? aeei?enoiaoaaoe io?eiai? ?acoeueoaoe c iaoith i?iaiicoaaiiy oa ioe?iee aoaeoeaiino? i?iaiaeeieo i?io?eaeoe/ii-e?eoaaeueieo caoiae?a (A.I.Naaaeueaaa, 1991; E.A.Ia?e?i, 1996; R.D.Moss et.al.,1991). Ca?aeii io?eiaieo iaie ?acoeueoao?a ia oii? caaaeueiii?eeiyoiai aaaeaiiy aaa?oiino? a 10-12 oeaei?a ie ia niinoa??aaee aeinoia??ieo a?aei?iiinoae c aieo an?o iieaciee?a, ui aea/athoueny (?>0,05). Iaaeae?,
a 20-22 oeaei?a iaei i?noea aeinoia??ia ca?eueoaiiy ai?noo oi??ii?/iiai
aiiaaeio?ii?io (aei 395,119,1 iiieue/e; ?<0,05); o?eeiaeoe?iieio (aei 3,20,3 iiieue/e; ?<0,05) oa oe?ieneio (aei 198,110,3 iiieue/e; ?<0,05) ia oii? cieaeaiiy ??aiy ieaoeaioa?iiai eaeoiaaio (aei 72,36,2 iiieue/e; ?<0,05); i?iaanoa?iio (aei 373,528,3 iiieue/e; ?<0,05) oa oe?aio?iiiiai ai?iiio (aei 1,30,1 iIA/e; ?<0,05). A 27-28 oeaei?a ia aeiaeaoie aei oeueiai a?aeaoaa?oueny aeinoia??ia cieaeaiiy ai?noo ano??ieo (aei 52,34,7 iiieue/e; ?<0,05) oa ano?aae?ieo (aei 36,22,8 iiieue/e; ?<0,05). An? oe? ci?ie caa??aathoueny aei iiiaioo ?ic?iaeaeaiiy (37-38 oeaei?a). Iniiaiith a?aei?ii?noth aiaeie?eiiiai noaoono o ae?iie, i?iaaaeaieo ca iaoith iaoiaeeeith, yaeany aeinoia??ii a?eueo aenieee ??aaiue a 10-12 oeaei?a ano??ieo (aei 11,31,2 iiieue/e; ?<0,05); ano?aae?ieo (aei 13,11,1 iiieue/e; ?<0,05) oa i?iaanoa?iio (aei 190,817,3 iiieue/e; ?<0,05), a a 20-22 oeaei?a – o?eueee ano??ieo (aei 61,25,4 iiieue/e; ?<0,05) oa ano?aae?ieo (aei 49,13,2 iiieue/e; ?<0,05). Iacaaaeath/e ia oea, iaaeae?, a oaeiae c aieo ?aooe iieaciee?a, ui aea/athoueny, ie ia niinoa??aaee aeinoia??ieo a?aei?iiinoae (?>0,05).

Ni?anoaaeyth/e ?acoeueoaoe i?iaaaeaieo ?aae?i?ioiieia?/ieo
aeine?aeaeaiue c ee?i?/iei ia?aa?aii aaa?oiino? iaiao?aeii a?aei?oeoe
aenieee ??aaiue aeenooieoe?e ieaoeaioe o ae?iie c ai?iiiaeueiith
iaaeinoaoi?noth y?/iee?a a aiaiiac?. Aacoiiaii, oea yaeeiny i?aenoaaith
aeey ci?iaiiy iniiaii? oaeoeee aaaeaiiy aaa?oiino?, ui ? aoei i?iaaaeaii
a ?V a?oi?. Iaoyaeaiee i?aii?a?aeiee oii o ianoaaeaieo ae?iie ia
aeicaieya iiai?noth iiia?aaeeoe iniiai? aeooa?nuee? oneeaaeiaiiy, iaeiae
?o cieaeaiiy a 2-2,5 ?ace ? aeoaea iiceoeaiei iiiaioii oa na?ae/eoue i?i
aenieo aoaeoeai?noue ?ic?iaeaii? iaie iaoiaeeee.

I?e aiae?c? iniaeeainoae ?ic?iaeaeaiiy iaiao?aeii aeacaoe, ui /anoioa
ia?aae/anieo iieia?a neeaaeaea a ??? a?oi? 12,0%, a a ?V – aoea a 3 ?ace
ieae/ith (4,0%). E??i oiai, aeoaea aaaeeeaei oaeoii ? oa, ui ??aaiue
eana?nueeeo ?icoei?a ia oii? caaaeueiii?eeiyoeo
i?io?eaeoe/ii-e?eoaaeueieo caoiae?a aoa 66,0%, a na?aae iieacaiue
ia?aaaaeaee aioo??oiueioo?iaia a?iien?y ieiaea (52,0%); a?e iiiaae 30
?ie?a i?e ia?oeo iieiaao (38,0%); ia?aae/aniee ?ic?ea ieiaeiaeo iaieiiie
(36,0%) oa aiiiae?? iieiaiai? ae?yeueiino? (30,0%). Aeei?enoaiiy
?ic?iaeaii? iaie iaoiaeeee aaaeaiiy aaa?oiino? c i?ia?aiiaaiei
?ic?iaeaeaiiyi aeicaieeei cieceoe /anoioo eana?nueeeo ?icoei?a o ae?iie
c iaaeinoaoi?noth ooieoe?? y?/iee?a a aiaiiac? aei 36,0%. Oea a?aeaoeiny
ca ?aooiie ciaioaiiy ??aiy aioo??oiueioo?iaii? a?iien?? ieiaea (c 52,0%
aei 16,0%; ?<0,01) oa aiiiae?e iieiaiai? ae?yeueiino? (c 30,0% aei 10,0%; ?<0,01). Ioe?ithth/e ia?eiaoaeuei? aeoiaee ?ic?iaeaeaiiy iiaeia a?aei?oeoe nooo?a? a?aei?iiino? c aieo /anoioe ano?en?? ??ciiai nooiaiy oyaeeino? (66,0% ii??aiyii c 36,0%; ?<0,05) c a?iio?io??th ieiaea (22,0% i?ioe 12,0%; ?<0,01). Oaeee aenieee ??aaiue ia?eiaoaeueii? iaoieia?? iai/ii a?aeia?aaeo? nooi?iue eiiiainaoe?? oaoiieaoeaioa?iiai eiiieaeno ia oii? ??cieo iaoiaeee aaaeaiiy aaa?oiino? o ae?iie c iaaeinoaoi?noth ooieoe?? y?/iee?a a aiaiiac?. Oaeei /eiii, ye iieacaee ?acoeueoaoe iaoeo aeine?aeaeaiue, ae?iee, ye? io?eioaaee ??ci? aa??aioe ai?iiiaeueii? ei?aeoe?? o cayceo c iaaeinoaoi?noth ooieoe?? y?/iee?a, neeaaeathoue a?oio aenieiai ?eceeo uiaei ?icaeoeo, a ia?oo /a?ao, oaoiieaoeaioa?ii? iaaeinoaoiino?. Oea i?ecaiaeeoue aei aeniei? /anoioe iaaeiiooaaiiy oa iaaeiiiooaaiiy, a i?e ?ic?iaeaeaii? – aei aiiiae?e iieiaiai? ae?yeueiino? oa a?iien?? ieiaea, yea ia i?aeaea?oueny iaaeeeaiaioici?e ei?aeoe??. Ana oea a noeoiiino? aecia/a? cia/iee ??aaiue aaaeii?iaeueiiai ?ic?iaeaeaiiy oa ia?eiaoaeueii? iaoieia??. Iaaeinoaoiy aoaeoeai?noue caaaeueiii?eeiyoeo i?io?eaeoe/ii-e?eoaaeueieo caoiae?a coiiaeaia iaiao?aei?noth ?o ci?ie, ui a inoaoi/iiio i?aenoieo, aeicaieeei iie?ioeoe ?acoeueoaoe ?ic?iaeaeaiiy o ae?iie a?oie aenieiai ?eceeo. Oea aea? iai i?aenoaao ?aeiiaiaeoaaoe ?ic?iaeaio iaoiaeeeo aeey oe?ieiai aeei?enoaiiy a i?aeoe/i?e ioi?ii? caei?iay. AENIIAEE: 1. AE?iee i?ney iaaeeeaiaioicii? ei?aeoe?? ai?iiiaeueii? iaaeinoaoiino? ooieoe?? y?/iee?a i?ae /an aaa?oiino? ? a?oiith aenieith ?ceeo ?icaeoeo aeayeeo oneeaaeiaiue: oaoiieaoeaioa?ia iaaeinoaoi?noue (52,6%); caa?ica iaaeiiooaaiiy (62,3%) oa iaaeiiiooaaiiy (48,6%), a oaeiae ?aii? (39,4%) oa i?ci? oieneeice (49,1%). 2. Oaoiieaoeaioa?ia iaaeinoaoi?noue o ae?iie c ai?iiiaeueiith aeenooieoe??th y?/iee?a a aiaiiac? caeaaeeoue a?ae aa??aioo aeenooieoe?? y?/iee?a oa ?icaeaa?oueny ia oii? ae?aaeaiiai ai?iiiaeueiiai aeenaaeaino, yeee i?iyaey?oueny a 20-22 oeaei?a aeinoia??iei ca?eueoaiiyi ai?noo oi??ii?/iiai aiiaaeio?ii?io (aei 395,119,1 iiieue/e; ?<0,05) ia oii? iaeii/aniiai cieaeaiiy ??aiy ieaoeaioa?iiai eaeoiaaio (aei 72,36,2 iiieue/e; ?<0,05); i?iaanoa?iio (aei 373,528,3 iiieue/e; ?<0,05. A 27-28 oeae. ia aeiaeaoie aei oeueiai a?aeaoaaeiny aeinoia??ia cieaeaiiy ai?noo ano??ieo (aei 52,34,7 iiieue/e; ?<0,05) oa ano?aae?ieo (aei 36,22,8 iiieue/e; ?<0,05), ui a noeoiiino? caa??aa?oueny aei iiiaioo ?ic?iaeaeaiiy (37-38 oeae.). 3. Ooieoe?y ueoiaeaeii? caeice o ae?iie c iaa??aeueiith aeenooieoe??th a aiaiiac? i?ae /an aaa?oiino? oa?aeoa?eco?oueny a 20-22 oeaeiy aeinoia??iei ca?eueoaiiyi o?eieaeoe?iieio (aei 3,20,3 iiieue/e; ?<0,05) oa oe?ieneio (aei 198,110,3 iiieue/e; ?<0,05) ia oii? iaeii/aniiai cieaeaiiy oe?aio?iiiiai ai?iiio ( aei 1,30,1 iIA/e; ?<0,05). Iaaeae? aei iiiaioo ?ic?iaeaeaiiy oe? ci?ie caa??aathoueny c aiaeia?/iith caeiiii??i?noth. 4. *anoioa eana?nueeeo ?icoei?a o ae?iie c ai?iiiaeueiith aeenooieoe??th y?/iee?a a aiaiiac? neeaaea? 64,6%, i?e oeueiio iniiaieie iieacaiiyie ? aioo??oiueioo?iaia a?iien?y ieiaea (46,9%); a?e iiiaae 30 ?ie?a i?e ia?oeo iieiaao (37,2%) oa aiiiae?? iieiaiai? ae?yeueiino? (29,2%). 5. Iniiaieie aa??aioaie ia?eiaoaeueii? iaoieia?? o ae?iie i?ney iaaeeeaiaioicii? ei?aeoe?? ai?iiiaeueii? iaaeinoaoiino? ? ano?en?y (62,3%) oa a?iio?io?y (21,7%) iiaiia?iaeaeaieo, a oaeiae iinoa?iiene/ia aioeaoaeiiao?y (29,7%) oa iinoiaoaeueia ?ioaeoe?y (19,3%). 6. C aeooa?nueeeo oa ia?eiaoaeueieo iiceoe?e aiiaoeyoe?y ? iaio ni?eyoeeaei oiiii ai?iiiaeueii? aeenooieoe?? y?/iee?a ii??aiyii c iaaeinoaoi?noth ethoa?iiai? oace, ui i?aeoaa?aeaeo?oueny a?eueo aenieei ??aiai oaoiieaoeaioa?ii? iaaeinoaoiino? (65,6% ii??aiyii c 37,8%; ?<0,05); caa?ice iaaeiiooaaiiy (77,4% i?ioe 45,1%; ?<0,05) oa iaaeiiiooaaiiy (54,8% ii??aiyii c 41,5%; ?<0,05); i?ci?o oieneeic?a (56,9% i?ioe 40,2%; ?<0,05); ano?en?? (75,3% ii??aiyii c 47,6%; ?<0,05) oa a?iio?io?? (26,9% i?ioe 15,9%; ?<0,05) iiaiia?iaeaeaieo, a oaeiae iinoa?iiene/ii? aioeaoaeiiao?? o ae?oae (34,4% ii??aiyii c 24,4%; ?<0,05). 7. AE?iie c ai?iiiaeueiith iaaeinoaoi?noth y?/iee?a iaiao?aeii oe?eani?yiiaaii aiooaaoe aei ianooiii? aaa?oiino? a oiiaao ae?ii/i? eiinoeueoaoe?? c aeei?enoaiiyi anueiai eiiieaeno e?eoaaeueii-i?io?eaeoe/ieo caoiae?a. 8. Iniiaieie a?aei?iiinoyie aaaeaiiy aaa?oiino? o ae?iie c ai?iiiaeueiith aeenooieoe??th y?/iee?a a aiaiiac? ? ai?iiiioa?ai?y i?e aiiaoeyoe?? a aiaiiac? a aei?, ye? ni?aiaaeathoue c ? oacith iaino?oaeueiiai oeeeeo - o?eueee oie?eoe?i (0,3-0,5 ie i?e 5000 iae. a 1 ie), a a aei?, ye? ni?aiaaeathoue c ?? oacith – o?eueee i?iaanoa?ii (0,5 – 0,7 ie 1% ?ic/eio), i?e iaaeinoaoiino? ethoa?iiai? oace – o?eueee i?iaanoa?ii a aei?, ye? ni?aiaaeathoue c ?? oacith oeeeeo; o?eaae?noue ai?iiiioa?ai?? ii/eia?oueny c 4-5 aei 36 oeaei?a aaa?oiino?; i?io?eaeoe/ia iaaiac?aeueia oa?ai?y a 6-8; 16-20 oa 26-30 oeaei?a, a oaeiae i?ia?aiiaai? iieiae c aeei?enoaiiyi i?inoeio A2 o aeaeyae? aaa?iaeueiiai aaeth aai oaaeaoie. 9. Aiaeie?eiieia?/iee noaoon o ae?iie c ai?iiiaeueiith aeenooieoe??th y?/iee?a a aiaiiac?, i?iaaaeaieo i?ae /an aaa?oiino? ca iaoith iaoiaeeeith, oa?aeoa?eco? aeinoia??ia i?aeaeuaiiy a 10-12 oeaei?a ano??ieo (aei 11,31,2 iiieue/e; ?<0,05); ano?aae?ieo (aei 13,11,1 iiieue/e; ?<0,05) oa i?iaanoa?iio (aei 190,85,4 iiieue/e; ?<0,05), a a 20-22 oeae. – o?eueee ano??ieo (aei 61,25,4 iiieue/e; ?<0,05) oa ano?aae?ieo (aei 49,13,2 iiieue/e; ?<0,05) i?e a?aenooiino? aeinoia??ieo a?aei?iiinoae c aieo ?aooe iieaciee?a u?eueii aei ?ic?iaeaeaiiy (37-38 oeaei?a). 10. Aeei?enoaiiy ?ic?iaeaiiai iaie eiiieaeno i?io?eaeoe/ii-e?eoaaeueieo caoiae?a o ae?iie i?ney iaaeeeaiaioicii? ei?aeoe?? ai?iiiaeueii? aeenooieoe?? y?/iee?a aeicaieeoue cieceoe /anoioo oaoiieaoeaioa?ii? iaaeinoaoiino? (c 54,0% aei 22,0%; ?<0,01); caa?ice iaaeiiooaaiiy (c 60,0% aei 24,0%; ?<0,01) oa iaaeiiiooaaiiy (c 48,0% aei 26,0%; ?<0,05); i?ci?o oieneeic?a (c 50,0% aei 28,0%; ?<0,05) oa aiiiae?e iieiaiai? ae?yeueiino? (c 30,0% aei 10,0%; ?<0,01), ui ni?ey? ciaioaiith /anoioe eana?aaeo ?icoei?a (c 66,0% aei 36,0%; ?<0,05); ano?en?e (c 66,0% aei 36,0%; ?<0,05) oa a?iio?io?e (c 22,0%; 12,0%; ?<0,05) iiaiia?iaeaeaieo, a oaeiae iinoa?iiene/ii? aioeaoaeiiao?? (c 30,0% aei 12,0%; ?<0,01). NIENIE IIOAE?EIAAIEO I?AOeUe CA OAIITH AeENA?OAOe??: 1. Eane?ia TH.N., Aa?aneiiaa O.A., Aiaiaa I.A., Oeoaiei O.I. Iniaeeaino? oaoiieaoeaioa?iiai eiiieaeno o oai?eo c a?iiaiiaaeio?iiiith oi?iith aiaii?a? //Oe?a?inueeee iaoeiai-iaaee/iee iieiae?aeiee aeo?iae. – 1998. - ?1-2. – N.108-110. 2. Eane?ia TH.N., Aa?aneiiaa O.A., Aiaiaa I.A., Oeoaiei O.I. Iniaeeaino? aeooa?nueei? oa ia?eiaoaeueii? iaoieia?? o ae?iie c aiaeie?eiiith iaie?aei?noth a aiaiiac? //Iaae?ao??y, aeooa?noai oa a?iaeieia?y. – 1998. - ?3. – N.74-76. 3. Aaeiae/aiei TH.I., Oaaeeoi Ae.?., Aiaiaa I.A., Eane?ia TH.N., Oeoaiei O.I., Ei?/einueea I.I. ?ic?iaeaeaiiy ae?iie c iaie?aei?noth a aiaiiac? //Iaae?ao??y, aeooa?noai oa a?iaeieia?y. – 1999. - ?1. – N.109-113. 4. Aaeiae/aiei TH.I., Ia?o?ia ss.A., Ei?/einueea I.I., Eane?ia TH.N., Oaeueei I.A., Aiaiaa I.A. I?ia?aiiaaiee eana??a ?icoei o ae?iie c iaie?aei?noth a aiaiiac? //Aoeiaeinueeee iaaee/iee a?niee. – 1999. - ?2. – N. 35-39. 5. Eane?ia TH.N. Ee?i?ei-noaoenoe/i? iniaeeaino? ?ic?iaeaeaiiy ae?iie c aiaeie?eiiith iaie?aei?noth a aiaiiac? //Iaoeiaee a?niee Oaeai?iaenueeiai oi?aa?neoaoo. Na??y “Iaaeeoeeia”. – aei.8. – 1999. – N.174-176. 6. Aa?aneiiaa O.A., Eane?ia TH.N., Aiaiaa I.A., Oeoaiei O.I. Aa?aiaiiinoue e ?iaeu o aeaiuei n aiaii?aae //A na. iao/. o?. E?uineiai iaaeoieaa?neoaoa ei. N.E.Aai?aeaaneiai “I?iaeaiu, aeinoeaeaiey e ia?niaeoeau ?acaeoey iaaeeei-aeieiae/aneeo iaoe e i?aeoe/aneiai cae?aaiio?aiaiey”. – 1997. – o.133.- /.1. – N.193-198. 7. Aa?aneiiaa O.A., Oeiaiei I.A., Eane?ia TH.N., Aiaiaa I.A., Oeoaiei O.I. Eana?nueeee ?icoei o ae?iie c iaie?aei?noth a aiaiiac? //Oace aeii. ?? ieaioio Anioe?aoe?? aeooa??a-a?iaeieia?a Oe?a?ie “Eana?nueeee ?icoei a no/aniiio aeooa?noa?”. – N?ioa?iiieue. – 1998.- N.62-63. AIIOAOe?ss Eane?ia TH.N. I?io?eaeoeea aeooa?nueeeo oa ia?eiaoaeueieo oneeaaeiaiue o ae?iie i?ney iaaeeeaiaioicii? ei?aeoe?? ai?iiiaeueii? aeenooieoe?? y?/iee?a. - ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.01 – aeooa?noai oa a?iaeieia?y. - Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC Oe?a?ie. Ee?a, 1999. Ia iniia? ee?i?ei-noaoenoe/ieo iaoiae?a aeine?aeaeaiiy anoaiiaeai? iniaeeaino? aeooa?nueei? oa ia?eiaoaeueii? iaoieia?? o ae?iie i?ney iaaeeeaiaoiicii? ei?aeoe?? ??cieo oei?a iaa??aeueii? iaaeinoaoiino?. Iaoeiai iaa?oioiaai?, ?ic?iaeai? oa ai?iaaaeaeai? i?aeoe/i? ?aeiiaiaeaoe?? uiaei cieaeaiiy /anoioe aeooa?nueeeo oa ia?eiaoaeueieo oneeaaeiaiue o ae?iie c ai?iiiaeueiith aeenooieoe??th y?/iee?a a aiaiiac? ia i?aenoaa? aeeoa?aioe?eiaaiiai i?aeoiaeo aei i?io?eaeoe/ii? ai?iiiioa?ai??. Ana oea a noeoiiino? aeicaieeei iie?ioeoe ?acoeueoaoe ?ic?iaeaeaiiy o ae?iie c iaie?aei?noth a aiaiiac?. Eeth/ia? neiaa: aaa?oi?noue, iieiae, i?io?eaeoeea, ia?eiaoieia?y, iaaeeeaiaioicia ei?aeoe?y, ai?iiiaeueia iaaeinoaoi?noue, y?/ieee. ANNOTATION Laskina Yu.S. Prophylaxic of obstetric and perinatal complications in women after medicamental correction of hormonal ovarian dysfunction.- Manuscript. Thesis for a degree of candidate of medical sciences on specialty 14.01.01 – obstetric and gynecology. P.L.Shupik Kyiv Medical Academy of Post-Graduate Education of Health of Ukraine. Kyiv, 1999. In the basis of clinicostatistical methods of the study the distinctive features of obstetric and perinatal pathology in women after medicamental correction of various types of ovarian insufficiency have been established. The practical recommendations concerning the reduction of the frequency of obstetric and perinatal complications in women with hormonal ovarian dysfunction in anamnesis have been scientifically substantiated, developed and introduced on the basis of differentited approach to the prophylaxis and hormonotherapy. All this on the whole permitted to improve the results of delivery in women with infertility in anamnesis. Key words: pregnancy, labor, prophylaxis, perinatology, medicamental correction, hormonal insufficiency, ovaries. AIIIOAOeEss Eaneeia TH.N. I?ioeeaeoeea aeooa?neeo e ia?eiaoaeueiuo ineiaeiaiee o aeaiuei iinea iaaeeeaiaioiciie ei??aeoeee ai?iiiaeueiie aeenooieoeee ye/ieeia. – ?oeiienue. Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.01 – aeooa?noai e aeiaeieiaey. - Eeaaneay iaaeeoeeineay aeaaeaiey iineaaeeieiiiiai ia?aciaaiey ei.I.E.Ooieea IC Oe?aeiu. - Eeaa, 1999. Iao/iay ?aaioa iinayuaia ?aoaieth aeooaeueiiai aii?ina nia?aiaiiiai aeooa?noaa - oeo/oaieth ?acoeueoaoia ?iaei?ac?aoaiey aeaiuei n aanieiaeeai a aiaiiaca. Iao/iay iiaecia i?iaaaeaiiuo enneaaeiaaiee caeeth/aaony a oii, /oi aia?aua i?iaaaeaii eco/aiea iniaaiiinoae eeeie/aneiai oa/aiey aa?aiaiiinoe e ?iaeia, a oaeaea ninoiyiey iiai?iaeaeaiiuo o aeaiuei iinea iaaeeeaiaioiciie ei??aeoeee ?acee/iuo oeiia iaa?eaeueiie iaaeinoaoi/iinoe. Onoaiiaeaii, /oi iniaaiiinoe oa/aiey aa?aiaiiinoe ?iaeia e iinea?iaeiaiai ia?eiaea iaoneiaeaiu ia oieueei oeiii ai?iiiaeueiie iaaeinoaoi/iinoe ye/ieeia, ii oaeaea oeiii e aeeeoaeueiinoueth aa iaaeeeaiaioiciie ei??aeoeee aei aa?aiaiiinoe. Eco/aiu iniaaiiinoe oi?ie?iaaiey e ooieoeeiiaeueiiai ninoiyiey oaoiieaoeaioa?iiai eiiieaena i?e iaee/ee a aiaiiaca aeenooieoeee ye/ieeia. ?acoeueoaou i?iaaaeaiiuo enneaaeiaaiee naeaeaoaeuenoaotho, /oi oaoiieaoeaioa?iay iaaeinoaoi/iinoue o aeaiuei n ai?iiiaeueiie aeenooieoeeae ye/ieeia a aiaiiaca ?acaeaaaony ia oiia au?aaeaiiiai ai?iiiaeueiiai aeenaaeaina, eioi?ue i?iyaeyaony a 20-22 iaaeaeue aeinoiaa?iui oaaee/aieai niaea?aeaiey oi?eiie/aneiai aiiaaeio?iieia (aei 395,119,1 iiieue/e; ?<0,05); o?eeiaeoe?iieia (aei 3,20,3 iiieue/e; ?<0,05) e oe?ieneia (aei 198,110,3 iiieue/e; ?<0,05) ia oiia iaeii/aniiai nieaeaiey o?iaiy ieaoeaioa?iiai eaeoiaaia (aei 72,36,2 iiieue/e; ?<0,05); i?iaanoa?iia (aei 373,528,3 iiieue/e; ?<0,05) e oe?aio?iiiiai ai?iiia (aei 1,30,1 iIA/e; ?<0,05). A 27-28 iaae. a aeiiieiaiea e yoiio ioia/aaony aeinoiaa?iia nieaeaiea niaea?aeaiey yno?eiea (aei 52,34,7 iiieue/e; ?<0,05) e yno?aaeeiea (aei 36,22,8 iiieue/e; ?<0,05), /oi a niaieoiiinoe nio?aiyaony aei iiiaioa ?iaei?ac?aoaiey (37-38 iaae.). Iniiaiuie aa?eaioaie ia?eiaoaeueiie iaoieiaee o aeaiuei iinea iaaeeeaiaioiciie ei??aeoeee ai?iiiaeueiie iaaeinoaoi/iinoe yaeyaony anoeeney (62,3%) e aeiio?ioey (21,7%) iiai?iaeaeaiiuo, a oaeaea iinoaeiiene/aneay yioeaoaeiiaoey (29,7%) e iinoiaoaeueiay eioaeoeey (19,3%). N aeooa?neeo e ia?eiaoaeueiuo iiceoeee aiiaoeyoeey yaeyaony iaiaa aeaaii?eyoiui oiiii ai?iiiaeueiie aeenooieoeee ye/ieeia ii n?aaiaieth n iaaeinoaoi/iinoueth ethoaeiiaie oacu, /oi iiaeoaa?aeaeaaony aieaa aunieei o?iaiai oaoiieaoeaioa?iie iaaeinoaoi/iinoe (65,6% ii n?aaiaieth n 37,8%; ?<0,05); oa?icu iaauiaoeaaiey (77,4% i?ioea 45,1%; ?<0,05) e iaaeiiaoeaaiey (54,8% ii n?aaiaieth n 41,5%; ?<0,05); iicaeieo oieneeicia (56,9% i?ioea 40,2%; ?<0,05); anoeenee (75,3% ii n?aaiaieth n 47,6%; ?<0,05) e aeiio?ioee (26,9% i?ioea 15,9%; ?<0,05) iiai?iaeaeaiiuo, a oaeaea iinoaeiiene/aneie yioeaoaeiiaoee o aeaoae (34,4% ii n?aaiaieth n 24,4%; ?<0,05). Iniiaiuie ioee/eyie aaaeaiey aa?aiaiiinoe o aeaiuei n ai?iiiaeueiie aeenooieoeeae ye/ieeia a aiaiiaca yaeyaony ai?iiiioa?aiey i?e aiiaoeyoeee a aiaiiaca a aeie, niioaaonaothuea ? oaca iaino?oaeueiiai oeeeea - oieueei oieeeeoeei (0,3-0,5 ie i?e 5000 aae. a 1 ie), a a aeie, niioaaonoaothuea ?? oaca – oieueei i?iaanoa?ii (0,5 – 0,7 ie 0,5% ?anoai?a), i?e iaaeinoaoi/iinoe ethoaeiiaie oacu – oieueei i?iaanoa?ii a aeie, niioaaonoaothuea ?? oaca oeeeea; aeeeoaeueiinoue ai?iiiioa?aiee ia/eiaaony n 4-5 aei 26 iaaeaeue aa?aiaiiinoe; i?ioeeaeoe/aneay iaaiaceaeueiay oa?aiey a 6-8; 16-20;26-30 e 34-36 iaaeaeue, a oaeaea i?ia?aiie?iaaiiua ?iaeu n eniieueciaaieai i?inoeia A2 a aeaea aaaeiaeueiiai aaey eee oaaeaoie. Aiaeie?eiieiae/aneee noaoon o aeaioei n ai?iiiaeueiie aeenooieoeeae ye/ieeia a aiaiiaca, i?iaaaeaiiuo ai a?aiy aa?aiaiiinoe ii iaoae iaoiaeeea, oa?aeoa?ecoao aeinoiaa?iia iiauoaiea a 10-12 iaaeaeue yno?eiea (aei 11,31,2 iiieue/e; ?<0,05); yno?aaeeiea (aei 13,11,1 iiieue/e; ?<0,05) e i?iaanoa?iia (aei 190,85,4 iiieue/e; ?<0,05), a a 20-22 iaae. – oieueei yno?eiea (aei 61,25,4 iiieue/e; ?<0,05) e yno?aaeeiea (aei 49,13,2 iiieue/e; ?<0,05) i?e ionoonoaea aeinoiaa?iuo ioee/ee ni noi?iiu inoaeueiuo iieacaoaeae aieioue aei ?iaei?ac?aoaiey (37-38 iaaeaeue). Eniieueciaaiea ?ac?aaioaiiiai iaie eiiieaena i?ioeeaeoe/anee-ea/aaiuo ia?ii?eyoee o aeaiuei iinea iaaeeeaiaioiciie ei??aeoeee ai?iiiaeueiie aeenooieoeee ye/ieeia iicaieeo nieceoue /anoioo oaoiieaoeaioa?iie iaaeinoaoi/iinoe (n 54,0% aei 22,0%; ?<0,01); oa?icu iaauiaoeaaiey (n 60,0% aei 24,0%; ?<0,01) e iaaeiiaoeaaiey (n 48,0% aei 26,0%; ?<0,05); iicaeieo oieneeicia (n 50,0% aei 28,0%; ?<0,05) e aiiiaeee ?iaeiaie aeayeueiinoe (n 30,0% aei 10,0%; ?<0,01), /oi niinianoaoao oiaiueoaieth /anoiou eana?aauo na/aiee (n 66,0% aei 36,0%; ?<0,05); anoeenee (n 66,0% aei 36,0%; ?<0,05) e aeiio?ioee (n 22,0% aei 12,0%; ?<0,05) iiai?iaeaeaiiuo, a oaeaea iinoaeiiene/aneie yioeaoaeiiaoee (n 30,0% aei 12,0%; ?<0,01). Eeth/aaua neiaa: aa?aiaiiinoue, ?iaeu, i?ioeeaeoeea, ia?eiaoieiaey, iaaeeeaiaioiciay ei??aeoeey, ai?iiiaeueiay iaaeinoaoi/iinoue, ye/ieee.

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