Профілактика гнійно-септичних ускладнень у породіль з гестаційним пієлонефритом: Автореф. дис… канд. мед. наук / Н.І. Багній, Ін-т педіатрії, акушер

?INOEOOO IAAe?AO???, AEOOA?NOAA OA A?IAEIEIA??

AEAAeAI?? IAAeE*IEO IAOE OE?A?IE

Aaai?e Iaoae?y ?aai?aia

OAeE: 618.56-002.3; 616.61-0.023-84

I?io?eaeoeea ai?eii-naioe/ieo oneeaaeiaiue

o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii

14.01.01 — aeooa?noai ? 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 a Oa?iii?euenuee?e aea?aeaai?e iaaee/i?e aeaaeai??
?i.?.ss.Ai?aa/aanueeiai IIC Oe?a?ie.

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, i?ioani?

O?ai/oe Aiaoie?e THoeiiae/, Oa?iii?euenueea iaaee/ia aeaaeai?y
?i.?.ss.Ai?aa/aanueeiai IIC Oe?a?ie, eaoaae?a aeooa?noaa oa a?iaeieia??
iaaee/iiai oaeoeueoaoo.

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, i?ioani? Ooiaiiaa Ea?ena ?aaai?aia, ?inoeooo
iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie, ea??aiee a?aeae?eaiiy
i?io?eaeoeee ? e?eoaaiiy ai?eii-caiaeueieo caoai?thaaiue a aeooa?noa?;

aeieoi? iaaee/ieo iaoe, i?ioani? Aaeiae/aiei TH??e Iao?iae/, Ee?anueea
iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC Oe?a?ie,
caa?aeoaa/ eaoaae?e aeooa?noaa oa a?iaeieia?? ?1.

I?ia?aeia onoaiiaa: Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i.
I.I.Aiaiiieueoey IIC Oe?a?ie, i. Ee?a, eaoaae?a aeooa?noaa oa
a?iaeieia?? ?1.

Caoeno aeena?oaoe?? a?aeaoaeaoueny “ 19 ” aeiaoiy 1999?. 0 13 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee (Ae 26.553.01) ii caoenoo
aeena?oaoe?e ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe
ca niaoe?aeueiinoyie “Aeooa?noai ? a?iaeieia?y”, “Iaae?ao??y” i?e
?inoeooo? iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie (aae?ana:
252054, i.Ee?a, aoe.Iaio?euenueeiai,8).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? ?inoeoooo
iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie (aae?ana: 252054,
i.Ee?a, aoe.Iaio?euenueeiai,8).

Aaoi?aoa?ao ?ic?neaiee “ 26 ” /a?aiy 1999?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee
E.A.Eaaoi?ia

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. I?neyiieiaia? ai?eii-naioe/i? oneeaaeiaiiy a
no?oeoo?? iaoa?einueei? caoai?thaaiino? oa nia?oiino? caeiathoue iaeia c
ia?oeo i?noeue (I.A.Aieeia, 1990; A.I.Aaioeeianueeee oa ni?aaao., 1996;
A.I.Caii?iaeai oa ni?aaao., 1996; A.E.Noaiaie?anueea, 1996; D.E.Soper,
1993; S. Matsuda et al., 1994).

Aaaeo/a eaiea o ?o aeieeiaii? iaeaaeeoue ?ioaeoe?eiei caoai?thaaiiyi
na/iaea?aeieo oeyo?a, ia?aianaieo aei oa i?ae /an aaa?oiino? ?, cie?aia,
aanoaoe?eiiio i??eiiao?eoo (I.I.Aa?aeaineee oa ni?aaao., 1991;
A.I.Eociaoeia ? ni?aaao., 1994; E.A.Oeiioaiei ? ni?aaao., 1996;
E.?.Ooiaiiaa ? ni?aaao., 1996; J.C.Colan, 1993; I.Kuvaci et al., 1993).

Oa?aeoa?iith iniaeea?noth no/anieo ai?eii-caiaeueieo caoai?thaaiue o
i?neyiieiaiaiio ia??iae? ? ?o iie?ao?ieia?/i?noue. Aaeeea
??ciiiai?oi?noue caoaeiee?a, aieiaiei /eiii oiiaii-iaoiaaiieo
i?e?ii?aai?ci?a oa ?o anioe?aoe?e, iicaaaey? i?neyiieiaia?
ai?eii-naioe/i? caoai?thaaiiy iicieia?/ii? niaoeeo?/iino?. Aeaeiaa
no?oeoo?a ?o aeeiai?/ia ? ci?ith?oueny i?ae aieeaii oe?eiai ?yaeo
ciai?oi?o oa aioo??oi?o oaeoi??a, na?aae yeeo ?noioia cia/aiiy ia?
aioeaaeoa??aeueia oa?ai?y. Naia caaaeyee ?e c’yaeeenue ?acenoaioi? aei
e?ea?nueeeo na?aaeiee?a a?aiiiceoeai? oa a?aiiaaaoeai? i?e?ii?aai?cie
(I.I.I?eieae/oe, 1993; A.E.Ao?oiaie oa ni?aaao., 1996;
A.A.Caaie?eoeueeee oa ni?aaao., 1996; H.Yajima, 1992; A.Kampicano et
al., 1993).

O aeieeiaii? i?neyiieiaiaeo oneeaaeiaiue aaaeo/a ?ieue iaeaaeeoue ia
no?eueee oaeoi?o ?io?eoaaiiy, ne?eueee caeaoiino? iaoa?einueeiai
i?aai?cio i?ioenoiyoe eiio (A.A.Eooeaiei, 1994).

O i?neyiieiaiaiio ia??iae? a i?aai?ci? ae?iie a?aeaoaathoueny na?eici?
?ioiieia?/i? ii?ooaiiy, iiaiioe?ii?noue ?aaoeyoi?ieo iaoai?ci?a yeeo
iaiao?aeia aeey eiai ii?iaeueiiai ia?aa?ao (A.I.Aaioeeianueeee, 1997;
D.Vinatier et al., 1993)

Ia a?oio? i??eiiao?eoo ii?ooothoueny aaeaioaoe?ei? iiaeeeaino? ae?ii/iai
i?aai?cio, aeieeathoue ci?ie a ?ioii?e nenoai?, aeoeaothoueny i?ioeane
ia?aeeniiai ieeniaiiy e?i?ae?a oa i?eai?/o?oueny nenoaia
aioeieneaeaioiiai caoenoo, ui yaey?oueny iaei??th c iiaeeeaeo i?e/ei
i?aeaeuaiiai ni?eeiyooy ii?iae?eue aei ?ioaeoe?? (A.A.Eoiiaiaiei, 1995).
Iayai?noue neiae?iio aiaeiaaiii? ?ioieneeaoe?? i?e aeai?e iaoieia??
i?aeaeuo? ?ecee aeieeiaiiy i?neyiieiaiaeo ai?eii-naioe/ieo oneeaaeiaiue
(I.I.Eoeeeiaa, 1989).

Ia aeeaey/enue ia aaeeeo e?euee?noue iaoeiaeo i?aoeue, i?enay/aieo
i?neyiieiaiaei ai?eii-naioe/iei oneeaaeiaiiyi, aaaaoi noi??i oe???
i?iaeaie aena?oeaii iaiiai?noth. ?nioth/? ia nueiaiaei?oi?e aeaiue
no/ani? aioeaaeoa??aeuei? i?aia?aoe iineeththoue aiaeiaaiio
?ioieneeaoe?th oa cieaeothoue ?ioiieia?/io ?aaeoeai?noue i?aai?cio
(A.I.Na?ia, 1997), ui noai?th? iaaeaaii?e?ii? oiiae aeey ?icaeoeo
ioa?ia?aeueii? caoai?thaaiino?.

Oiio ieoaiiy eiiieaeniiai iaoiaeo i?io?eaeoeee caiaeueieo caoai?thaaiue
o aeaii? a?oie ?eceeo caeeoa?oueny iaae??oaiei. Iiaeaeueoa
oaeineiiaeaiiy a?aeiieo oa iiooee iiaeo, iaoiaaiaoe/ii iaa?oioiaaieo
iaoiae?a aeine?aeaeaiiy oa ?ic?iaee ia ?o iniia? eiiieaeniiai iaoiaeo
i?io?eaeoeee caiaeueieo caoai?thaaiue ? aeineoue aeooaeueiei. ?iaioa
aeeiiaia ca?aeii ieaio iaoeiai-aeine?aeieo ?ia?o eaoaae?e aeooa?noaa ?
a?iaeieia?? iaaee/iiai oaeoeueoaoo Oa?iii?euenueei? aea?aeaaii?
iaaee/ii? aeaaeai?? ?i.?.ss.Ai?aa/aanueeiai ( ? aea?ae?a?no?aoe?? 0195U
009227).

Iaoa ?iaioe — cieaeaiiy /anoioe ai?eii-naioe/ieo oneeaaeiaiue o
ii?iae?eue c aanoaoe?eiei i??eiiao?eoii oeyoii i?aeaeuaiiy aoaeoeaiino?
?o i?io?eaeoeee o i?neyiieiaiaiio ia??iae? ?c canoinoaaiiyi
aioa?ini?aaioo oa ?ioiiiiaeoeyoi?a.

Caaea/? aeine?aeaeaiiy:

A aeeiai?oe? i?neyiieiaiaiai ia??iaeo aecia/eoe noai O- ? A-nenoai
?ioi?oaoo o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii.

Aea/eoe ??aaiue aiaeiaaiii? ?ioieneeaoe?? i?aai?cio oi?iaeiaae ia?aa?ao
ioa?ia??th ia a?oio? ia?aianaiiai aanoaoe?eiiai i??eiiao?eoo.

Aeine?aeeoe oeueo?ano?oeoo?o iaeo?io?eueieo eaeeioeeo?a o ii?iae?eue c
aanoaoe?eiei i??eiiao?eoii a aeeiai?oe? ioa?ia??th.

I?iaanoe aaeoa??ieia?/ia aeine?aeaeaiiy ani??aoo c ii?iaeieie iaoee oa
na/? o aeaiiai eiioeiaaioo ae?iie ai?iaeiaae ia?aa?ao i?neyiieiaiaiai
ia??iaeo.

Ia i?aenoaa? io?eiaieo ?acoeueoao?a aeine?aeaeaiiy ?ic?iaeoe, ee?i?/ii
iaa?oiooaaoe oa ai?iaaaeeoe a i?aeoeeo eiiieaeniee iaoiae i?io?eaeoeee
ai?eii-naioe/ieo oneeaaeiaiue o ii?iae?eue c i??eiiao?eoii ?c
canoinoaaiiyi ?ioiiiiaeoeyoi?a ao?iaoea? io?io?iai? oa aioa?ini?aaioo
Neea?ae-I.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. Aia?oa o ii?iae?eue i?ney
ia?aianaiiai aanoaoe?eiiai i??eiiao?eoo aeiaaaeaii iayai?noue ae?aaeaii?
aiaeiaaiii? ?ioieneeaoe?? i?aai?cio, yea noi?iaiaeaeo?oueny
ii?oiooieoe?iiaeueieie ii?ooaiiyie iaeo?io?e?a e?ia?.

Aeyaeaii aeenooieoe?th ?ioiieia?/ii? ?aaeoeaiino? i?aai?cio oi?iaeiaae
ia?aa?ao i?neyiieiaiaiai ia??iaeo ia a?oio? ia?aianaiiai caiaeueiiai
i?ioeano a ie?eao.

O ii?iae?eue c aanoaoe?eiei i??eiiao?eoii anoaiiaeaii aenieee nooi?iue
?aeaioe/iino? i?e?ioei?e na/? oa ani??aoo c ii?iaeieie iaoee (54,87%),
na?aae yei? ia?aaaaeaee i?e?ii?aai?cie ?iaeeie aioa?iaaeoa??e.

Iaoeiai iaa?oioiaaii aeioe?euei?noue aeeth/aiiy aioa?ini?aaioo
Neea?aeo-I oa ?ioiiiiaeoeyoi?a ao?iaoea? io?io?iai? a eiiieaen
e?eoaaeueii-i?io?eaeoe/ieo caoiae?a uiaei ciaioaiiy /anoioe aeieeiaiiy
oneeaaeiaiue ia?aa?ao ioa?ia??th oa ai?eii-naioe/ii? caoai?thaaiino? o
ii?iae?eue c aanoaoe?eiei i??eiiao?eoii ca ?aooiie e?ea?aeaoe?? i?iya?a
aiaeioienai??, noaa?e?caoe?? oeueo?ano?oeoo?e iaeo?io?e?a e?ia?,
i?aeaeuaiiy iioaioe?aeo ?ioiieia?/ii? ?aaeoeaiino? i?aai?cio.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Cai?iiiiiaaii aoaeoeaiee
eiiieaeniee iaoiae i?io?eaeoeee ioa?ia?aeueii? caoai?thaaiino? o
ii?iae?eue c aanoaoe?eiei i??eiiao?eoii ?c aeeth/aiiyi aioa?ini?aaioo
Neea?ae-I oa ?ioiiiiaeoeyoi?a ao?iaoea? io?io?iai?.

Anoaiiaeaii iiaeeea?noue aeei?enoaiiy iieaciee?a aiaeiaaiii?
?ioieneeaoe?? oa ?ioiieia?/ii? ?aaeoeaiino? i?aai?cio, nooiaiy
ii?oiooieoe?iiaeueiiai ii?ooaiiy iaeo?io?e?a, eiiieaeniiai
aaeoa??ieia?/iiai ianoaaeaiiy ii?iae?eue i?ney ia?aianaiiai
aanoaoe?eiiai i??eiiao?eoo aeey ioe?iee aoaeoeaiino? cai?iiiiiaaii?
i?io?eaeoeee.

Aeiaaaeaii, ui aeaiee iaoiae i?io?eaeoeee cieaeo? aenieee ??aaiue
aiaeioienai?? i?e aeai?e iaoieia??, ii?iae?co? noai ?ioiii? nenoaie,
a?aeiiaeth? oeueo?ono?oeoo?o ee?oei e?ia? — iaeo?io?e?a, cieaeo? ??aaiue
i?e?iaiiai ian?iai?iiy iieiaiaeo oeyo?a oa i?aai?a na/iaiai o?aeoo
iaoiaaiiith oa oiiaii-iaoiaaiiith i?e?ioei?ith. Iie?auo?oueny
naiiii/oooy ii?iae?eue, nei?i/o?oueny oa?i?i ia?aaoaaiiy a noaoe?iia??,
ciaioo?oueny /anoioa ye oneeaaeiaiue ia?aa?ao ioa?ia??th, oae ?
i?neyiieiaiai? ai?eii-naioe/ii? caoai?thaaiino?.

Iiaee eiiieaeniee iaoiae i?io?eaeoeee i?neyiieiaiaeo ai?eii-naioe/ieo
caoai?thaaiue o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii ?c aeei?enoaiiyi
aioa?ini?aaioo Neea?ae-I oa ?ioiiiiaeoeyoi?a ao?iaoea? io?io?iai?
?ic?iaeaii a iana?aaoe?eiiio a?aeae?eaii? Oa?iii?euenueeiai ee?i?/iiai
iieiaiaiai aoaeeieo oa ai?iaaaeaeaii a ?iaioo aeooa?nueeeo a?aeae?eaiue
e?eoaaeueii-i?io?eaeoe/ieo caeeaae?a Oa?iii?euenueei?,
?aaii-O?aie?anueei?, Oiaeueieoeueei?, Aieeinueei? iaeanoae.

Iniaenoee aianie caeiaoaa/a.

Cae?eniaii ee?i?ei-noaoenoe/ia aeine?aeaeaiiy ia?aa?ao aaa?oiino?,
iieia?a oa i?neyiieiaiaiai ia??iaeo o 82 ae?iie oai?eo ia aanoaoe?eiee
i??eiiao?eo, ianoaaeaii 20 caei?iaeo ii?iae?eue oa 20 caei?iaeo
iaaaa?oieo ae?iie.

Oeueo?acaoeiaa aeine?aeaeaiiy iaoee ia 5-aeiao ioa?ia??th i?iaaaeaii o
82 ii?iae?eue c aanoaoe?eiei i??eiiao?eoii oa o 20 caei?iaeo ae?iie c
o?c?ieia?/iei ia?aa?aii ioa?ia??th.

A aeeiai?oe? i?neyiieiaiaiai ia??iaeo naiino?eii aeeiiaii caa??
aeine?aeaeoaaeueiiai iaoa??aeo c iaoith aecia/aiiy iieaciee?a
aiaeiaaiii? ?ioieneeaoe??, ?ioiieia?/ii? ?aaeoeaiino? i?aai?cio,
aaeoa??ieia?/iiai aeine?aeaeaiiy na/? oa ani??aoo c ii?iaeieie iaoee.

O 40 ii?iae?eue c aanoaoe?eiei i??eiiao?eoii cae?eniaii eiiieaenio
i?io?eaeoeeo ioa?ia?aeueii? caoai?thaaiino? ?c aeeth/aiiyi
aioa?ini?aaioo Neea?ae-I oa ?ioiiiiaeoeyoi?a ao?iaoea? io?io?iai?.

5. I?iaaaeaia noaoenoe/ia ia?iaea oa aiae?c io?eiaieo aeaieo.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iaoa??aee aeena?oaoe?? aeeeaaeai?
ia OOOIO i?aenoieia?e iaoeia?e eiioa?aioe?? Oa?iii?euenueiiai iaaee/iiai
?inoeoooo “Caeiaooee ee?i?/ii? oa aenia?eiaioaeueii?
iaaeeoeeie”(Oa?iii?eue, 1996), I oa II i?aeia?iaeieo eiia?anao
nooaeaio?a oa iieiaeeo a/aieo (Oa?iii?eue, 1997, 98??.), Ieaioio
Anioe?aoe?? aeooa??a-a?iaeieia?a Oe?a?ie c i?iaeaie “Iaaeiiooaaiiy
aaa?oiino?” (*a?i?aoe?, 1997), XLI i?aenoieia?e iaoeia?e eiioa?aioe??
Oa?iii?euenueei? iaaee/ii? aeaaeai?? “Caeiaooee ee?i?/ii? oa
aenia?eiaioaeueii? iaaeeoeeie” (Oa?iii?eue, 1998), can?aeaii? iaeaniiai
iaoeiaiai oiaa?enoaa aeooa??a-a?iaeieia?a, ni?eueiiio can?aeaii? eaoaae?
aeooa?noaa oa a?iaeieia?? e?eoaaeueiiai oaeoeueoaoo oa oaeoeueoaoo
i?neyaeeieiiii? ina?oe Oa?iii?euenueei? iaaee/ii? aeaaeai?? (Oa?iii?eue,
1998).

Ioae?eaoe??. Ii oai? aeena?oaoe?? iioae?eiaaii 9 ?ia?o, c ieo 4 ?iaioe o
oaoiaeo iaoeiaeo aeo?iaeao, 3 noaoo? a iaoeiaeo ca??ieeao.

Ia’?i oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 150
noi??ieao ae?oeiaaiiai oaenoo ? neeaaea?oueny ?c anooio, 6 ?icae?e?a ( a
oiio /ene? iaeyaeo e?oa?aoo?e, iaoa??aeo oa iaoiae?a oa 3 ?icae?e?a
aeanieo aeine?aeaeaiue, aiae?co oa ocaaaeueiaiiy ?acoeueoao?a
aeine?aeaeaiiy), aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo
aeei?enoaieo aeaea?ae, yeee i?noeoue 314 iaeiaioaaiue ? caeia?
32 noi??iee. ?iaioa ?ethno?iaaia 28 oaaeeoeyie oa 15 ?enoieaie,
ye? caeiathoue 20 noi??iie.

INIIAIEE CI?NO

Iaoa??ae oa iaoiaee aeine?aeaeaiiy. Anueiai ianoaaeaii 122 ae?iee, c ieo
82 ii?iae?ee? i?ae /an aaa?oiino? ia?aianee i??eiiao?eo, neeaee iniiaio
a?oio. A caeaaeiino? a?ae iaoiaeo i?io?eaeoeee o i?neyiieiaiaiio
ia??iae? ii?iae?ee? aoee iiae?eai? ia aea? i?aea?oie, ?aiaeii?ciaai? ca
a?eii, nioe?aeueiei noaiii, aeooa?nueeei oa a?iaeieia?/ieie aiaiiacaie.
Aei ?-i? i?aea?oie oa?eoei 42 ii?iae?ee? c aanoaoe?eiei i??eiiao?eoii, o
ioa?ia??? ye? io?eioaaee caaaeueiii?eeiyoo i?io?eaeoeeo ioa?ia?aeueii?
caoai?thaaiino? ca?aeii iaoiaee/ieo ?aeiiaiaeaoe?e IIC Oe?a?ie:
aioeaaeoa??aeuei? caniae ia?i?aeueii, o?inaioeee, aeanainea?e?coth/?
i?aia?aoe, a?oai?iioa?ai?th, ?ineeii? ae?o?aoeee oa aioenaioeee. ??-o
i?aea?oio neeaee 40 ii?iae?eue, o eiiieaeni?e i?io?eaeoeoe? ye? aaeeaaee
oaeiae aioa?ini?aaio Neea?ae-I oa ?ioiiiiaeoeyoi? ao?iaoeath io?io?iao.

Neea?ae-I aeei?enoiaoaaee o aeaeyae? iiia?aaeiuei i?eaioiaeaii? aiaeii?
noniaic?? c ?ic?aooieo 1 noieiaa eiaeea ia 50 ie aiaee iaoua 3 ?ace ia
aeaiue ca 2 aiaeeie aei i?eeiaiiy ?ae?. Na?aaeiy aeiaiaa
aeica i?aia?aoo neeaaeaea 7 a?ai?a. Ao?iaoeath io?io?iao i?eeiaee o
aeaeyae? ianoieee ii 20 e?aiaeue 3 ?ace ia aeaiue ca 15 oaeeei aei ?aee.
Eo?n i?io?eaeoeee o?eaaa 5-6 aei?a.

Eiio?ieueio a?oio neeaee 20 caei?iaeo iaaaa?oieo ae?iie oa?oeeueiiai
a?eo. 20 caei?iaeo ii?iae?eue c o?c?ieia?/iei ia?aa?aii i?neyiieiaiaiai
ia??iaeo oa?eoee aei a?oie ii??aiyiiy.

E??i caaaeueiiai ee?i?ei-eaai?aoi?iiai oa ?ino?oiaioaeueiiai ianoaaeaiiy
o a?oi? ii??aiyiiy, iniiai?e a?oi? oa ?? i?aea?oiao aea/aee nooi?iue
aiaeiaaiii? ?ioieneeaoe?? i?aai?cio, ee?oeiio oa aoii?aeueio eaiee
?ioi?oaoo, cae?enithaaee aeaeo?iiii-i?e?ineii?/ia aeine?aeaeaiiy
iaeo?io?e?a e?ia? oa aiae?c aaeoa??ieia?/iiai ai?noo ani??aoo c
ii?iaeieie iaoee.

O eiio?ieuei?e a?oi? aecia/aee iieacieee aiaeiaaiii? ?ioieneeaoe?? oa
?ioiieia?/ii? ?aaeoeaiino? i?aai?cio

Ii?iae?ee? ianoaaeoaaeenue ia 1-2 oa 6-7 aeiao i?ney iieia?a.

Iaie i?iaiaeeeenue aeine?aeaeaiiy iieaciee?a ee?oeiiiai (ai?no O-, A-,
0-e?ioioeeo?a) oa aoii?aeueiiai (ai?no ne?iaaoeiaeo ?ioiiaeiaoe?i?a G,
A, M) ?ioi?oaoo, aecia/aiiy e?eueeino? oee?eoethth/eo ?ioiieo eiiieaen?a
(Oe?E).

Aecia/aiiy O- (A-?OE), A- (AAN-?OE), 0-ee?oei i?iaiaeeeinue ii iaoiaeo
N.Mendes (1974) a iiaeeo?eaoe?? O.E.A?eoeiie, N.Itheea?a (1981).
E?ioioeeoe aeae?eyee c aaia?ei?ciaaii? e?ia? a iaeiineeaaeiaiio
a?aae??io? o?eie-aa?ia?ao?io aonoeiith 1,077 a/e.

Aeoeai? O- e?ioioeeoe (AA-?OE) aecia/aee ca iaoiaeii S.Smith et al.
(1977) a iiaeeo?eaoe?? A.I.*a?aaeaaaa oa ni?aaao. (1988).

Noaiiioeyoe?? O-e?ioioeeo?a aeine?aeaeoaaee ca aeiiiiiaith oanoo
/ooeeaino? aei oaio?e?io ca iaoiaeii A.Snore (1978). I?e oeueiio
aaaaeaee, ui a oaio?e?iiaiio oano? oaio?e?i ?acenoaioi? e?ioioeeoe
(O?-?OE) ? ia?aaaaeii O-ee?oeiaie c oaeia?iith aeoeai?noth, a oaio?e?i
/ooeea? (O*-?OE) — a iniiaiiio c noi?ani?iith ae??th.

Eiioeaio?aoe?th Oe?E o ne?iaaooe? e?ia? aecia/aee ca iaoiaeii
TH.A.A?eiaae/a oa A.I.Aeoa?iaie (1981), ui a?oioo?oueny ia naeaeoeai?e
i?aoeei?oaoe?? eiiiiiaio?a aioeaai-aioeo?ei a 3,75% iie?aoeeaiae?eie? c
ianooiiei oioiiao?e/iei aecia/aiiyi i?aoeei?oaoo.

?aaeoeai?noue aoii?aeueiiai ?ioi?oaoo aecia/aee ii ai?noo iniiaieo
eean?a ?ioiiaeiaoe?i?a (Igl G, Igl A, Igl M) ca iaoiaeii ?ioiiaeeooc??
ii G.Mancini et al. (1965). ?ic?aooiie eiioeaio?aoe?? ?ioiiaeiaoe?i?a
i?iaiaeeee ii ae?aiao?o e?eueoey i?aoeei?oaoe?? a ?aaeoe?? ?ioiiaeeooc??
(ae?aiao? e?eueoey i?aoeei?oaoe?? aaaaeaee i?iii?oe?eiei eiioeaio?aoe??
aioeo?e).

Aaaee?noue aiaeiaaiii? ?ioieneeaoe?? i?aai?cio ioe?ithaaee oeyoii
aea/aiiy ianiaoeeo?/ii? oiene/iino? ieacie e?ia?, yeo aecia/aee ii
ai?noo iieaeoe na?aaeiuei? iane (CI), ?o o?aeoe?e, ??aiy
a?eo?ioeeoa?iiai ?iaeaeno aiaeiaaiii? ?ioieneeaoe?? (A?A?) oa nooiaiy
oeueo?ano?oeoo?ieo ci?i iaeo?io?eueieo eaeeioeeo?a. ??aaiue NI aecia/aee
ca iaoiaeii I.E.Aaa?eyeyia, A.E.Eeiaoiaie (1984) a iiaeeo?eaoe??
N.N.Ee?aaaa (1990). I?e aeiaaeei? oaee? 254 ii aeine?aeaeoaaee
na?aaeiueiiieaeoey?i? iaioeaee, ui i?noyoue ioeeaioeaee (NI1), a i?e 280
ii — a?iiaoe/i? ai?iieeneioe (NI2). I?eioeei iaoiaeo iieyaa? a
inaaeaeaii? a?ee?a ne?iaaoee e?ia? 10% o?eoei?ioeoiaith eeneioith c
ianooiiei niaeo?ioioiiao?e/iei aeine?aeaeaiiyi noia?iaoaioo. ??aaiue
A?A? ioe?ithaaee oeyoii eiai aecia/aiiy ca iaoiaeeeith A.A.Oiaaiaaaaa oa
ni?aaao. (1988), nooue yei? iieyaa? a ca?eueoaii? ni?aoe?eii? caeaoiino?
a?eo?ioeeo?a i?ae aieeaii aiaeioienai??.

Nooi?iue aeano?oeoe?? iaeo?io?e?a e?ia? aea/aee o 7 ii?iae?eue iniiaii?
a?oie. Eiio?ieai neoaeeea e?ia 3 ii?iae?eue a?oie ii??aiyiiy.
Aeine?aeaeaiiy i?iaiaeeee ia aia?aoao AIA-100 AI oa AI-125E.
Eaeeioeeoa?io ie?aeo io?eioaaee oeyoii oeaio?eooaoaaiiy 3-5 ie e?ia?.
Oe? ee?oeie e?ia? o?enoaaee a 2,5% ?ic/ei? aethoa?aeueaeaa?aeo ia
oinoaoiiio aooa?? ?H 7,2-7,4, iinoo?enoaaee a 1% ?ic/ei? /ioe?ueioieeno
ini?th ii I?eiio, aeaa?ae?aooaaee a nie?oao ? aoeaoii?, eiio?anooaaee
o?ai?eaoeaoaoii oa caeeaaee a aiieneaei? niiee (1967).

Aeey i?iaaaeaiiy aaeoa??ieia?/iiai aeine?aeaeaiiy ani??aoo c ii?iaeieie
iaoee acyoe noa?eeueiei eaoaoa?ii ai?no iii?uaee a 5 ie noa?eeueiiai
o?c?ieia?/iiai ?ic/eio, ?aoaeueii ci?ooaaee eiai i?ioyaii 10 oaeeei.
Iio?i 0,1 ie io?eiaii? aioeueaiaaii? noi?o? iaiineee ia /aoeo Iao?? c
e?ia’yiei aaa?ii ? ?icoe?aee oiaoaeai. Iaeii/anii iaoeath i?iaiaeeee
iin?a aeine?aeaeoaaiiai iaoa??aeo ia naeoi? /aoee c na?aaeiaeuai Aiaei
oa aeiaoeiai-nieueiaei aaa?ii. Ianooiiiai aeiy i?iaiaeeee
?aeaioeo?eaoe?th i?e?ii?aai?ci?a.

Io?eiai? ?acoeueoaoe ii?aoeueiaai? iaoiaeii aa??aoe?eii? noaoenoeee.
??aaiue aeinoia??iino? aecia/aee ca e?eoa??yie Nouethaeaioa oa O?oa?a.
E?eoa???i aeinoia??iino? aaaaeaee eiia??i?noue ?, ??aia iai a?eueoa
95%, oiaoi ?ecee iioeaee iaioa 5%, a a aeieyo iaeeieoe? 0,05 ? iaioa.
Noaoenoe/ia ia?iaea aeaieo i?iaaaeaia ca aeiiiiiaith eiii’thoa?a “Compaq
— 151 FS”.

?acoeueoaoe aeanieo aeine?aeaeaiue oa ?o iaaiai?aiiy.

I?iaaaeai? ee?i?ei-eaai?aoi?i? aeine?aeaeaiiy aeicaieeee aeyaeoe
iaeineiioiii?noue i?iya?a aanoaoe?eiiai i??eiiao?eoo ia ia?oo aeiao
ioa?ia??th, ui i/aaeaeii iia’ycaii c o?ii?/iei ia?aa?aii aeaiiai
caoai?thaaiiy. 28 (34,14%) ae?iie iniiaii? a?oie ia ia?oo aeiao
i?neyiieiaiaiai ia??iaeo i?aae(yaeyee nea?ae ia i?aeaeuaiiy oaiia?aoo?e
o?ea, caaaeueio neaae?noue, eeoiiaieo oa a?eue o iiia?aeia?e
ae?eyioe?.

O 74 (90,24%) ii?iae?eue iniiaii? a?oie niinoa??aaee iayai?noue
o?ii?/ieo aiaieu ?ioaeoe?e, oiae? ye o a?oi? ii??aiyiiy — eeoa o 9
(40,0%), ?<0,001. O 54 (65,85%) ae?iie iniiaii? a?oie caiaeueiee i?ioean o ie?eao i?ae /an aaa?oiino? ?icaeioany ia oii? aaea ?nioth/i? ?o iaoieia??. O 79 (96,34%) ii?iae?eue iniiaii? a?oie i?neyiieiaiaee ia??iae ia?aa?aaa ia oii? aiai?? ??ciiai nooiaiy ae?aaeaiino?. O iaoe??ioie aeaiiai eiioeiaaioo a aaiia?aiao /anoi niinoa??aaany eaeeioeeoic, cnoa eaeeioeeoa?ii? oi?ioee ae?ai, i?eoaeaeoaia OIA. A aiae?cao na/? aeyaeaia i?ioa?io??y (aei 1 a/e), eaeeioeeoo??y, aaeoa??o??y. I?iaaaeai? i?e?ia?ieia?/i? aeine?aeaeaiiy iieacaee, ui o 79 (96,34%) ii?iae?eue iniiaii? a?oie ia ia?oo aeiao i?neyiieiaiaiai ia??iaeo iaei i?noea caaaeueia ian?iaii?iiy na/?. I?e oeueiio /anoioa aeae?eaiiy iiiieoeueoo?e i?e?ii?aai?ci?a oa ?o anioe?aoe?e ciaoiaeeeanue iaeaea o ??aieo ni?aa?aeiioaiiyo (a?aeiia?aeii 42,68% oa 53,66%). Na?aae caoaeiee?a caiaeueieo caoai?thaaiue ie?ie oa na/iaeo oeyo?a ia?aaaaeaea a?aia?ae’?iia aaoeeey?ia oei?a (63,90%), yea aoea i?aaenoaaeaia a iniiaiiio eeoeiaith iaee/eith, aioa?iaaeoa?ii, i?ioa?i, eeaan??eith. Aeai? i?i aeine?aeaeaiiy i?e?ioei?e ii?iaeieie iaoee noaa?aeaeothoue, ui ia 1-o aeiao i?neyiieiaiaiai ia??iaeo eeoa o 7(8,54%) ii?iae?eue iniiaii? a?oie o ii?iaeiei? iaoee aoa a?aenooi?e ??no aa?iaii? oei?e, oiae? ye o a?oi? ii??aiyiiy? — o 18 (90,0%), ?<0,001. O 20 (24,39%) ae?iie iniiaii? a?oie ii??aiyii c 2 (10,0%) ii?iae?eue a?oie ii??aiyiiy, ?<0,01, ia ia?oo aeiao ioa?ia??th c ani??aoo ii?iaeieie iaoee aeae?eaii iiiieoeueoo?o aaeoa??e, aea o a?eueoi? /anoeie ae?iie 55 (67,07%) — anioe?aoe?? i?e?ii?aai?ci?a, ye? aoee a?aenooi? o caei?iaeo ii?iae?eue. Na?aae aa?iaieo i?e?ii?aai?ci?a ia 1-o aeiao ioa?ia??th o ii?iaeiei? iaoee iniiaii? a?oie ia?aaaaeaee caoaeieee ?iaeeie Micrococcaceae (S. epidermidis, S. saprophyticus, Enteroccocus sp., S. aureus), ye? neeaee 57,0%. O 45 (54,87%) ii?iae?eue iniiaii? a?oie ia 1-o aeiao ioa?ia??th aeaeiaee neeaae i?e?ioei?e na/? oa ani??aoo c ii?iaeieie iaoee aoa ?aeaioe/iee. 66,6% na?aae aeae?eaieo i?e?ii?aai?ci?a neeaee i?e?ii?aai?cie ?iaeeie aioa?iaaeoa??e. Aeniea ieoiia aaaa ?aeaioe/iino? i?e?ioei?e na/? oa ii?iaeieie iaoee o ii?iae?eue iniiaii? a?oie iiaea aeacoaaoe ia ia?oi/a?aia?noue caiaeueiiai i?ioeano a ie?eao, yea a iine?aeoth/iio i?ecaiaeeoue aei aeieeiaiiy ai?eii-caiaeueieo oneeaaeiaiue a i?neyiieiaiaiio ia??iae?. Inoaii? i?aeoaa?aeaeo?oueny aenieith ieoiiith aaaith i?e?ii?aai?ci?a ?iaeeie aioa?iaaeoa??e, ye? ia nueiaiaei?oi?e aeaiue, ca aeaieie A.O.Ioneiie e niaao., 1996, ? aaaeo/eie o ?icaeoeo caiaeueiiai i?ioeano a ie?eao ? ni?e/eiythoue i?neyiieiaia? caiaeuei? oneeaaeiaiiy. Oea iaa?oioiao? iaiao?aei?noue canoinoaaiiy o aeaiiai eiioeiaaioo ae?iie o i?neyiieiaiaiio ia??iae? aioeaaeoa??aeueieo na?aaeiee?a ca?aeii iaoiaee/ieo ?aeiiaiaeaoe?e IIC Oe?a?ie. O 100% ii?iae?eue a?oie ii??aiyiiy ia 1-o aeiao ioa?ia??th ae?aaiinoiaaii i?aeaeuaiiy ??aiy A?, yea i?iyaeyeanue ca?eueoaiiyi e?eueeino? iieaeoe na?aaeiuei? iane (?<0,01– 0,05), A?A? i?e oeueiio caeeoaany iaci?iiei. Aei 5-6 aeiae i?neyiieiaiaiai ia??iaeo, i?e ia?aoiae? oace caiaeaiiy ?aiaai? iiaa?oi? iaoee o oaco ?aaaia?aoe??, ?o ??aaiue a?aeiiaethaaany aei iieaciee?a o ae?iie eiio?ieueii? a?oie. Oeae nooi?iue aiaeioienai?? o ae?iie a?oie ii??aiyiiy ia aieeaaa ia oeueo?ano?oeoo?o iaeo?io?eueieo eaeeioeeo?a, caa??aath/e ?o aoaeiao noaeith: i?aaeeueia ie?oaea oi?ia, /?oea ieaciieaia c iiiaeeiieeie i?e?iai?neieaie ia iiaa?oi?, iii??ia u?euei?noue oa ini?io?e?y oeeoiieacie, ??aiii??iee ?iciiae?e a?aioe ae?eiaaio, caaeia?eueia ni?aa?aeiioaiiy ia?aeiii? oa aoi?eiii? ca?ienoino?. E?euee?noue NI1 o ii?iae?eue iniiaii? a?oie ia 1-o aeiao noaiiaea 500,87(14,64oi.iae., ii??aiyii c 327,85(10,22 oi.iae., ?<0,001 o ii?iae?eue a?oie ii??aiyiiy ia 1-o aeiao ioa?ia??th, ui, ca aeaieie E.I.Ieoaeueiai, 1986, na?ae/eoue i?i iia??oaiiy ooieoe?iiaeueiiai noaio ie?ie. I?aeaeuaiee ai?no NI2, yeee aei??aithaaa a?aeiia?aeii 250,84(11,15oi.iae. i?ioe 183,65(3,53 oi.iae., ?<0,001, ie ?icaeyaeaee ye aoi?eiiee aoaeo. Iaeii/anii o ii?iae?eue iniiaii? a?oie ia ia?oo aeiao i?neyiieiaiaiai ia??iaeo niinoa??aaany aenieee ??aaiue A?A?, yeee noaiiaea 43,61(1,89% i?ioe 30,13(0,93%, ?<0,001 o a?oi? ii??aiyiiy. Aeaeo?iiiii?e?ineii?/ia aeine?aeaeaiiy naaiaioiyaea?iiai iaeo?io?ea o ii?iae?eue iniiaii? a?oie ia 1-o aeiao anoaiiaeei iayai?noue ci?i aeano?oeoeaieo oa?aeoa?o, ui ? ii?oieia?/iei i?iyaii aiaeioienai??: iii??ia ciaioaiiy ?o ia’?io, ou?eueiaiiy oa i?aeaeuaia ini?io?e?y oeeoiieacie, iaeiaeoeaia ieaciieaia, ?icoe?aiiy ia?eioeeaa?iiai i?inoi?o, iii??ia e?euee?noue aoi?eiieo a?aioe, iayai?noue aaeeeeo aaeoieaiiae?aieo no?oeoo?, ae?eyiie aooie?co oeeoiieacie. Aeai? ci?ie iiaeooue ni?e/eieoe ii?ooaiiy iniiaii? ooieoe?? iaeo?io?ea — aioeaaeoa??aeueii?, yea i?e aeai?e iaoieia?? caeia? ae??oaeueia cia/aiiy. I?iaaaeai? aeine?aeaeaiiy ?ioiieia?/ii? ?aaeoeaiino? i?aai?cio o ii?iae?eue a?oie ii??aiyiiy ia 1-o aeiao aeyaeee aeinoia??ia cieaeaiiy ooieoe?iiaeueii? aeoeaiino? O-e?ioioeeo?a, ciaioaiiy noaiiioeyoe?? O-oaeia??a, i?e iaeii/aniiio ca?eueoaii? ??aiy 0-ee?oei, e?eueeino? Oe?E oa ??aiy ?ioiiaeiaoe?i?a eean?a G, A, M. Ia 6-o aeiao i?neyiieiaiaiai ia??iaeo aeai? iieacieee a?aeiiaethaaany aei ??aiy iieaciee?a ae?iie eiio?ieueii? a?oie. E?euee?noue O-, A-e?ioioeeo?a oa O-noi?ani??a o ii?iae?eue a?oie ii??aiyiiy oaeiae nooo?ai ia ci?ithaaeanue. Ca ?acoeueoaoaie i?iaaaeaieo aeine?aeaeaiue o ii?iae?eue iniiaii? a?oie ia 1-o aeiao aeyaeaii nooo?aa i?eai?/aiiy O-ee?oeiii? eaiee ?ioi?oaoo o aeaeyae? cieaeaiiy a?aeiinii? ?o e?eueeino? aei 39,29±0,72% i?ioe 48,20±0,68%, ?<0,001 o a?oi? ii??aiyiiy, cieaeaiiy ?o ooieoe?iiaeueii? aeoeaiino? — 17,78±0,93% i?ioe 21,05±0,80%, ?<0,001, ii?ooaiiy i?ioean?a aeeoa?aioe?thaaiiy, ui i?iyaeyeinue ca?eueoaiiyi e?eueeino? iac??eeo 0-ee?oei a ia?eoa??ei?e e?ia? — 38,23±0,79% i?ioe 31,85±1,96 %, ?<0,001. I?e aiae?c? ai?noo ?ioii?aaoeyoi?ieo O-ee?oei o ii?iae?eue iniiaii? a?oie ia 1-o aeiao ca?a?no?iaaii aeinoia??ia iiieaeaiiy O?-?OE oa O*-?OE ii??aiyii ?c iieacieeaie a?oie ii??aiyiiy, ye? a?aeiia?aeii noaiiaeee 28,81±0,71% i?ioe 34,90±0,70%, ?<0,001 oa 10,48±0,94% i?ioe 13,30±1,0%, ?<0,05. Naia cieaeaiiy e?eueeino? O-noi?ani??a, ca aeaieie E.I.Ae’y/ai, 1994, iiaea a?ae?a?aaaoe aaaeeeao ?ieue a ni?eyii? ?icaeoeo i?aeaeuaii? /ooeeaino? ie?ie aei ?ioaeoe?? oa oi?ioaaii? o?ii?/ieo oi?i caoai?thaaiiy. E?euee?noue Oe?E o ii?iae?eue iniiaii? a?oie ia ia?oo aeiao noaiiaeea 153,42±10,97 oi.iae. i?ioe 98,50±7,92 oi.iae. o a?oi? ii??aiyiiy, ?<0,001, ui, a naith /a?ao iiaea iaaaoeaii aieeaaoe ia oe?e?ni?noue iaia?ai ee?oei e?ia?. O ii?iae?eue iniiaii? a?oie ia 1-o aeiao ??aaiue A-e?ioioeeo?a aeinoia??ii c?inoaa ? noaiiaea — 11,42(0,62% ii??aiyii c 8,10±0,70%, ?<0,001 o a?oi? ii??aiyiiy. Inoaii? iiaeia aeei?enoiaoaaoe ye aeiaeaoeiaee ia?ea? aeoeaiino? caiaeueiiai i?ioeano, ui a?aeia?aaea? nooi?iue aioeaaiii? noeioeyoe?? i?aai?cio. Ii?yae c oeei iaei i?noea ca?eueoaiiy ae?iaeaiiy aioeo?e ??cii? niaoeeo?/iino?. Cie?aia, IglA — 3,02±0,08a/e, IglG— 15,69±0,22a/e, IglM— 2,90±0,09 a/e ii??aiyii c iieacieeaie a?oie ii??aiyiiy ia 1-o aeiao a?aeiia?aeii: Igl A — 2,12±0,09 a/e, ?<0,001, IglG —9,69±0,14 a/e, ?<0,001, Igl M —1,56±0,05 a/e, ?<0,001. Ioe?iea aieeao ??cieo aeae?a i?io?eaeoeee ia iieacieee aiaeiaaiii? ?ioieneeaoe?? i?aai?cio o ?-?e oa ??-?e i?aea?oiao ae?iie i?aaenoaaeaia a oaae.1. Oae, aecia/aiiy aeeiai?ee ??aiy na?aaei?o iieaeoe a ?-?e i?aea?oi? ii?iae?eue ia 6-o aeiao iieacaei ?o cieaeaiiy o ii??aiyii? c iieacieeaie ia 1-o aeiao, ?<0,001, i?ioa ai?no ?o caeeoaany aenieei ? ia aeinyaaa aaee/eie a?oie ii??aiyiiy, ?<0,001. Aiaeia?/i? ci?ie aeyaeai? o eieeaaiiyo ??aiy NI2 o ?-?e i?aea?oi?. Oae, oeae iieaciee cieceany ii??aiyii c aeaieie ia 1-o aeiao, ?<0,001, aea caeeoaany aeinoia??ii aeuei a?ae eiai cia/aiiy o ae?iie a?oie ii??aiyiiy ia 6-o aeiao ioa?ia??th, ?<0,001. Aeai? c?ooaiiy iiaeooue aooe i?e/eiith ia eeoa ?aoeeaeeaoth/iai ia?aa?ao caoai?thaaiiy o ioa?ia???, aea e ca aeaieie I.I.Eoeeeiaa oa ni?aaao., 1989, ni?eyoe aeieeiaiith ai?eii-caiaeueieo oneeaaeiaiue o ioa?ia???. O ??-?e i?aea?oi? ii?iae?eue ia 6-o aeiao a?aeaoaaeanue iiaia ii?iae?caoe?y ai?noo NI1 oa NI2, iaeneiaeueii iaaeeaeath/e ?o ??aaiue aei iieaciee?a a?oie ii??aiyiiy ia 6-o aeiao, ?>0,05 .

??aaiue A?A? o ii?iae?eue ?-i? i?aea?oie ia 6-o aeiao aeinoia??ii
ciaiooaaany ii??aiyii c eiai cia/aiiyie ia ia?oo aeiao, ia nyaath/e,
iaeiae, iieaciee?a a?oie ii??aiyiiy, ?<0,001. O ??-?e i?aea?oi? ae?iie ia 6-o aeiao oeae iieaciee nyaaa ??aiy caei?iaeo ii?iae?eue, ?>0,05.

Oeueo?ano?oeoo?i? aeine?aeaeaiiy ia?eoa??eii? e?ia? o?ueio ii?iae?eue
?-i? i?aea?oie ia 6-o aeiao io?ia??th na?ae/aoue i?i iie?auaiiy noaio
naaiaioiyaea?ieo iaeo?io?e?a. Ia oii? ci?i aeano?oeoeaiiai oa?aeoa?o
c’yaeyeenue eiiiainaoi?ii-i?enoinoaaeuei? iciaee: aaaaoi aoi?eiieo
a?aioe, ca?eueoaiiy o ?ici??ao ia?aeiieo a?aioe, aaeoieaiiae?ai?
no?oeoo?e oeeoiieacie iinooiiai iaaoaaee i?eoaiaiio ?e ae??aio
ca?ieno?noue.

Aeaeo?iiiii?e?ineii?/i? aeine?aeaeaiiy iaeo?io?e?a /ioe?ueio ii?iae?eue
??-i? i?aea?oie ia 6-o aeiao iieacaei iinooiiaa a?aeiiaeaiiy ?o
no?oeoo?ii? i?aai?caoe?? — ee?oeii?, yaea?i? oa aioo??oiueiee?oeii?
iaia?aie ee?oei e?ia? aoee caa?aaeai? e?aua, a ieo ia?aaaaeaee ia
aeano?oeoeai?, a a?ia?ieanoe/i? ci?ie, ui ? ii?oieia?/iei i?iyaii
?icaeoeo aioo??oiueiee?oeiieo ?aaaia?aoi?ieo i?ioean?a a ee?oeiao oa
na?ae/eoue i?i noaa?euei?noue i?aaiae, aeia?o ?o caa?aaeai?noue. Inoaii?
aea? iiaeeea?noue iaeo?io?eai caaacia/eoe a e?ia? ?o
ii?oiooieoe?iiaeuei? aeanoeaino?.

Aiae?c ci?i ?ioiieia?/iiai noaoono aeine?aeaeoaaieo i?aea?oi ii?iae?eue
i?aaenoaaeaiee a oaae. 2, 3. Oae, o ?-?e i?aea?oi? ae?iie ia 6-o aeiao
ii??aiyii c iieacieeaie iniiaii? a?oie ia 1-o aeiao aeyaeaii c?inoaiiy
caaaeueii? e?eueeino? O-e?ioioeeo?a, noaiiioeyoe?? O-oaeia??a, ?<0,001. Ooieoe?iiaeueia aeoeai?noue O-e?ioioeeo?a ia a?aeiiaethaaeanue, ai?no O-noi?ani??a caeeoaany i?aeoe/ii ia iaeiiio ? oiio ae ??ai?, ?>0,05.
Aeaia i?io?eaeoeea o ?-?e i?aea?oi? ae?iie i?eaaea aei cieaeaiiy
e?eueeino? 0-ee?oei, ?<0,001, ii?yae c oeei a?aei?/aeanue eeoa oaiaeaioe?y aei cieaeaiiy A-e?ioioeeo?a, ?>0,05.

A aoii?aeuei?e eaioe? ?ioi?oaoo o ii?iae?eue ?-i? i?aea?oie ia 6-o aeiao
ii??aiyii c aeaieie ia 1-o aeiao a iniiai?e a?oi? niinoa??aaeinue
iiieaeaiiy Igl eeano A, G, M oa e?eueeino? Oe?E, ?<0,001. Oaeei /eiii, caaaeueiiaeciaia i?io?eaeoeea o ?-?e i?aea?oi? ae?iie ia aeinoaoiuei ii?iae?co? ?ioii? ii?ooaiiy o oai?eo ii?iae?eue. ??aaiue ?ioiieia?/ieo iieaciee?a aeinoia??ii a?ae??ciyany a?ae iieaciee?a a?oie ii??aiyiiy (?<0,01– 0,001). I?e aeei?enoaii? eiiieaeniiai iaoiaeo i?io?eaeoeee o iaoe??ioie ??-i? i?aea?oie ae?iie ia 6-o aeiao ii??aiyii c iieacieeaie iniiaii? a?oie ia 1-o aeiao a?aei?/aeanue cia/ia aeoeaaoe?y ?ioiii? nenoaie. Anoaiiaeaii nooo?aa c?inoaiiy caaaeueii? iiioeyoe?? O-e?ioioeeo?a, ?o ooieoe?iiaeueii? aeoeaiino?, noaiiioeyoe?? O-oaeia??a, ?<0,001 oa O-noi?ani??a, ?>0,05. Niinoa??aaeinue cia/ia iiieaeaiiy e?eueeino?
0-ee?oei, A-e?ioioeeo?a, Oe?E, ?ioiiaeiaoe?i?a eeano A, G, M, ?<0,001. An? iieacieee ee?oeiii? oa aoii?aeueii? eaiie ?ioi?oaoo ia 5-6 aeiao ioa?ia??th ia a?ae??ciyeenue a?ae iieaciee?a a?oie ii??aiyiiy ia 6-o aeiao (?>0,05).

Caaaeyee ae?aaeai?e aaeoa??inoaoe/i?e ae?? ao?iaoea? io?io?iai?
(V.Jurkotiene, 1998) o ??-?e i?aea?oi? ae?iie ia 6-o aeiao ioa?ia??th
aeinoia??ii ca?eueooaaeanue e?euee?noue aeiaaee?a, i?e yeeo iin?ae na/?
ia aeaaaee ?inoo iaoiaaiii? oa oiiaii-iaoiaaiii? i?e?ioei?e,
a?aeiia?aeii o 30,0% i?ioe 7,15% a ?-?e i?aea?oi?, ?<0,001. Iaa?iaii i?iii?oe?eia caeaaei?noue niinoa??aaeanue i?e aeyaeaii? anioe?aoe?e aeaieo i?e?ii?aai?ci?a: O ?-?e i?aea?oi? niinoa??aaeanue oaiaeaioe?y aei ?o cieaeaiiy — 40,47% i?ioe 53,66% a iniiai?e a?oi?. Oiae? ye o ??-?e i?aea?oi? aiie niinoa??aaeenue eeoa o 2,50% ae?iie, ?<0,001. Aeae?eaiiy iiiieoeueoo?e i?e?ii?aai?ci?a c na/? ia 6-o aeiao aoei aeinoia??iei aeuei o ??-?e i?aea?oi? ae?iie, yea neeaei 67,50% i?ioe 42,68% ia 1-o aeiao a iniiai?e a?oi?, ?<0,001. Oiae? ye o ?-?e i?aea?oi? aeaiee iieaciee aeinoia??ii ia ci?ithaaany ? noaiiaea 52,38%. Aiaeia?/i? ?acoeueoaoe io?eiai? i?e aiae?c? aaeoa??ieia?/ieo iieaciee?a ani??aoo c ii?iaeieie iaoee: o ??-?e i?aea?oi? ae?iie ia 6-o aeiao ioa?ia??th aeinoia??ii ca?eueooaaeanue e?euee?noue aeiaaee?a a?aenooiino? ?inoo aa?iaii? i?e?ioei?e a iaooe? — 40,0% i?ioe 9,52% o ?-?e i?aea?oi?, ?<0,001. Aeinoia??ii ciaiooaaeinue aeae?eaiiy anioe?aoe?e i?e?ii?aai?ci?a — 2,50% o ii??aiyii? c 26,20% a?aeiia?aeii, ?<0,001. ?noioii? ia?aaaae ia aeyaeaiiy iiiieoeueoo?e caoaeiee?a o ??-?e i?aea?oi? ii??aiyii c ?-ith ia aoei (a?aeiia?aeii 75,0% i?ioe 61,90%). E?euee?noue aeae?eaiiy i?e?ii?aai?ci?a ?iaeo aioa?iaaeoa??e o ??-?e i?aea?oi? ae?iie aeinoia??ii ciaioeeanue o ii??aiyii? c aeaieie ia 1-o aeiao ioa?ia??th o ii?iae?eue iniiaii? a?oie — 24,22% i?ioe 41,0%, ?<0,05. Cai?iiiiiaaia i?io?eaeoeea aeicaieeea aeinoia??ii ciaioeoe /anoioo oneeaaeiaiue ia?aa?ao ioa?ia??th o ae?iie ??-i? i?aea?oie ( c 28,57% o ?-?e i?aea?oi? aei 7,50%), ?<0,001. Oae, o ??-?e i?aea?oi? ae?iie ii??aiyii c ?-ith niinoa??aaeanue oaiaeaioe?y aei cieaeaiiy e?eueeino? aeiaaee?a caaino?aiiy i??eiiao?eoo o i?neyiieiaiaiio ia??iae?, a?aeiia?aeii o 5,0% i?ioe 14,29%, ?<0,07. Aeinoia??ii cieceeanue /anoioa ?icaeoeo noa?iaiethoe?? iaoee — o 2,5% ??-i? i?aea?oie i?ioe 11,90% ae?iie ?-i?, ?<0,05. O 2,38% ii?iae?ee? ?-i?aea?oie ia 9-o aeiao i?neyiieiaiaiai ia??iaeo aeieeea eio?iiao?a. O ii?iae?eue ??-i? i?aea?oie iiae?aiiai oneeaaeiaiiy ie ia a?aei?/aee. Cai?iiiiiaaiee iaoiae i?io?eaeoeee aeicaieea aeinyaiooe aeinoia??ieo ?acoeueoao?a uiaei ?icaeoeo i?neyiieiaiai? ai?eii-naioe/ii? caoai?thaaiino?, ine?eueee eeoa o 7,50% ae?iie ??-i? i?aea?oie i?ioe 26,18% ?-i? niinoa??aaeanue ?o iayai?noue, ?<0,001. Oae, o 2,38% ae?iee ?-i? i?aea?oie ia 8-o aeiao i?neyiieiaiaiai ia??iaeo ?icaeioany iao?iaiaeiiao?eo. O ??-?e i?aea?oi? ii?iae?eue aeaii? iaoieia?? ia a?aei?/aeinue. Eeoiiaiea i?ioyaii ia?oeo o?ueio ae?a ioa?ia??th niinoa??aaeanue o 23,80% ?-i? oa eeoa o 7,50% ae?iie ??-i? i?aea?oie, ?<0,01. I?ecia/aia ?ioiiei?aeoe?y oa aioa?ini?aoe?y o eiiieaeni?e i?io?eaeoeoe? ioa?ia?aeueii? caoai?thaaiino? o ii?iae?eue ??-i? i?aea?oie aeicaieeea aeinoia??ii nei?ioeoe /an ia?aaoaaiiy ii?iae?ee? o noaoe?iia?? c 9,10(0,30 aei 6,13(0,75 aeiy (?<0,001). AENIIAEE O caei?iaeo ii?iae?eue ia 1-o aeiao i?neyiieiaiaiai ia??iaeo i?aeaeuothoueny iniiai? ia?ea?e aiaeiaaiii? ?ioieneeaoe?? — na?aaei? iieaeoee, ye? ia 6-o aeiao ioa?ia??th nyaathoue iieaciee?a caei?iaeo iaaaa?oeeo ae?iie. A?eo?ioeeoa?iee ?iaeaen aiaeiaaiii? ?ioieneeaoe?? oa oeueo?ano?oeoo?a iaeo?io?eueieo eaeeioeeo?a ia ci?iththoueny. I?neyiieiaiaee ia??iae o caei?iaeo ii?iae?eue ia 1-o aeiao noi?iaiaeaeo?oueny o?aiceoi?iei ?ioiiaeao?oeeoii o aeaeyae? iiieaeaiiy ooieoe?iiaeueii? aeoeaiino? O-e?ioioeeo?a, ciaioaiiy ??aiy O-oaeia??a oa c?inoaiiy e?eueeino? 0-ee?oei, ?ioiiaeiaoe?i?a, oee?eoethth/eo ?ioiieo eiiieaen?a, ye? ia 6-o aeiao ioa?ia??th oaeaeei a?aeiiaeththoueny. Caaaeueia e?euee?noue O-ee?oei, ??aaiue O-noi?ani??a oa A-e?ioioeeo?a caeeoa?oueny iaci?iiith. O ii?iae?eue c aanoaoe?eiei i??eiiao?eoii a aiaiiac? ia 1-o aeiao ioa?ia??th ia? i?noea nooo?aa i?aeaeuaiiy e?eueeino? na?aaei?o iieaeoe, a?eo?ioeeoa?iiai ?iaeaeno aiaeiaaiii? ?ioieneeaoe??. Ia ia?oo aeiao ioa?ia??th o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii ia oeueo?ano?oeoo?iiio ??ai? niinoa??aathoueny aeano?oeoeai? ci?ie iaeo?io?eueieo eaeeioeeo?a: ciaioaiiy ?o ia’?io, ou?eueiaiiy oa i?aeaeuaia ini?io?e?y oeeoiieacie, iaeiaeoeaia ieaciieaia, ?icoe?aiiy ia?eioeeaa?iiai i?inoi?o, iayai?noue aaeoieaiiae?aieo no?oeoo?. I?ney ia?aianaiiai aanoaoe?eiiai i??eiiao?eoo ia 1-o aeiao i?neyiieiaiaiai ia??iaeo o ii?iae?eue ciaioo?oueny caaaeueia e?euee?noue O-e?ioioeeo?a, ?o noaiiioeyoe?e, iaaea? ?o ooieoe?iiaeueia aeoeai?noue, iaeiae c?inoa? e?euee?noue 0- ? A-e?ioioeeo?a, ui noi?iaiaeaeo?oueny ca?eueoaiiyi eiioeaio?aoe?? iniiaieo eean?a ?ioiiaeiaoe?i?a oa oee?eoethth/eo ?ioiieo eiiieaen?a. Caaaeueiii?eeiyoee eiiieaen e?eoaaeueii-i?io?eaeoe/ieo caoiae?a o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii ia 6-o aeiao ia i?ecaiaeeoue aei iiaii? ii?iae?caoe?? iieaciee?a aiaeiaaiii? ?ioieneeaoe??, ?ioiiiai noaoono, oeueo?ano?oeoo?e ee?oei e?ia? ? caeeoa? oiiae aeey ?aoeeaeeao iaoieia?/iiai i?ioeano a ie?eao ? aeieeiaiiy i?neyiieiaiaeo ai?eii-naioe/ieo caoai?thaaiue. Aeeth/aiiy o eiiieaen i?io?eaeoe/ieo i??ii?e?inoa ioa?ia?aeueii? caoai?thaaiino? o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii aioa?ini?aaioo Neea?ae-I oa ianoieee ao?iaoea? io?io?iai? i?aeaeuo? eiai aoaeoeai?noue, ni?ey? cieaeaiith aiaeiaaiii? ?ioieneeaoe??, iiceoeaii aieeaa? ia ?ioiiee noaoon, a?aeiiaeth? oeueo?ano?oeoo?o iaeo?io?eueieo eaeeioeeo?a. Cai?iiiiiaaiee eiiieaeniee iaoiae i?io?eaeoeee o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii iie?auo? ia?aa?a i?neyiieiaiaiai ia??iaeo, ciaioo? /anoioo oneeaaeiaiue ia?aa?ao ioa?ia??th oa i?neyiieiaiai? ai?eii-naioe/ii? caoai?thaaiino?, nei?i/o? oa?i?i ia?aaoaaiiy ii?iae?ee? a noaoe?iia?? ia 3 e?aeeiaei?. I?AEOE*I? ?AEIIAIAeAOe?? tc "I?AEOE*I? ?AEIIAIAeAOe??" \l 1 Ii?iae?eeyi i?ney ia?aianaiiai i?ae /an aaa?oiino? aanoaoe?eiiai i??eiiao?eoo o i?neyiieiaiaiio ia??iae? ?aeiiaiaeo?oueny i?eeii Neea?aeo-I o aeaeyae? iiia?aaeiuei i?eaioiaeaii? aiaeii? noniaic?? c ?ic?aooieo 1 noieiaa eiaeea ia 50 ie aiaee iaoua 3 ?ace ia aeaiue ca 2 aiaeeie aei i?eeiaiiy ?ae?. Na?aaeiy aeiaiaa aeica i?aia?aoo neeaaea? 7 a?ai. Ao?iaoeath io?io?iao i?eeiathoue o aeaeyae? ianoieee ei??iiy ii 20 e?aiaeue 3 ?ace ia aeaiue ca 15 oaeeei aei ?aee. Eo?n i?io?eaeoeee o?eaa? 5-6 aei?a. I?ioeiieacaiiyie aei eiai aeei?enoaiiy ? ae?aceiaa oai?iaa oeoieo a noaae?? caaino?aiiy, acioaa?o. Eiio?ieai ca aoaeoeai?noth i?iaaaeaii? i?io?eaeoeee ? aecia/aiiy iieaciee?a na?aaei?o iieaeoe i?e aeiaaeei? oaee? 254 oa 280ii, a?eo?ioeeoa?iiai ?iaeaeno aiaeiaaiii? ?ioieneeaoe??, O-e?ioioeeo?a oa ?o noaiiioeyoe?e, I-, A- ee?oei, oee?eoethth/eo ?ioiieo eiiieaen?a Aeaiee iaoiae i?io?eaeoeee ia aea? oneeaaeaiue, i?inoee, aeinooiiee, aeiiii?/ii aea?aeiee oa aenieiaoaeoeaiee, ine?eueee aieiae?? ae?aaeaiith aeaoieneeaoe?eiith, i?ioecaiaeueiith, ?ioiiiiaeoethth/ith ae?yie, ui i?ecaiaeeoue aei nei?i/aiiy oa?i?io ia?aaoaaiiy ii?iae?eue a noaoe?iia?? a na?aaeiueiio ia 3 e?aeeiaei?. IA?AE?E ?IA?O,IIOAE?EIAAIEO CA OAIITH AeENA?OAOe?? Eiiieaenia canoinoaaiiy aioa?ini?aaioo Neea?ae-I oa ?ioiiiiaeoeyoi?a ao?iaoea? io?io?iai? o e?eoaaii? ii?iae?eue c aanoaoe?eieie i??eiiao?eoaie: // E?ee. - 1997. - ?6. - N. 43-46. ?ioiiei?aeoe?y oa aioa?ini?aoe?y o eiiieaeniiio e?eoaaii? ii?iae?eue c aanoaoe?eieie i??eiiao?eoaie: // Aanoiee i?iaeai aeieiaee e iaaeeoeeiu. - 1997. - ?9. - N. 7-9. Iaa?oiooaaiiy ?ioiiei?aeoe?? oa aioa?ini?aoe?? o eiiieaeniiio e?eoaaii? ii?iae?eue c aanoaoe?eieie i??eiiao?eoaie: // E?ee. - 1998. - ?1. - N. 17-20. Eiiieaeniee iaoiae i?io?eaeoeee ai?eii-caiaeueieo oneeaaeiaiue o ii?iae?eue c aanoaoe?eieie i??eiiao?eoaie: // Iaae?ao??y, aeooa?noai oa a?iaeieia?y. - 1998. - ?1. - N. 89-92. Noai aiaeiaaiii? ?ioieneeaoe?? o ii?iae?eue c aanoaoe?eieie i??eiiao?eoaie // Oace aeii. I i?aeia?iaeiiai iaaee/iiai eiia?ano nooaeaio?a oa iieiaeeo a/aieo. -18-22 o?aaiy, Oa?iii?eue. - 1997. - N. 132. I?io?eaeoeea iaaeiiooaaiiy o ae?iie c aanoaoe?eieie i??eiiao?eoaie // Ca??iee iaoeiaeo i?aoeue “Iaaeiiooaaiiy aaa?oiino?”. - Ee?a. - 1997. - N. 407-409 ( o ni?aaao. O?ai/oe A. TH.). Eiiieaeniee iaoiae i?io?eaeoeee ai?eii-naioe/ieo oneeaaeiaiue o ae?iie “a?oie ?eceeo”, ?ic?iaeaeaieo iia?aoe??th eana?aaiai ?icoeio // Iaoa??aee XLI iaoeiai? i?aenoieiai? eiioa?aioe?? “Caeiaooee ee?i?/ii? oa aenia?eiaioaeueii? iaaeeoeeie”. - Oa?iii?eue. - Aei. 3. - 1998. - N. 339-342 ( o ni?aaao. Eiei/oi A. A., O?ai/oe A. TH., Ie?eiee I. I.). Eiiieaeniee iaoiae i?io?eaeoeee ai?eii-naioe/ieo oneeaaeiaiue o ae?iie a?oie ?eceeo // Oace aeii. II i?aeia?iaeiiai iaaee/iiai eiia?ano nooaeaio?a oa iieiaeeo a/aieo. - 6-8 o?aaiy, Oa?iii?eue. - 1998. - N. 285 ( o ni?aaao. Eiei/oi A., ss?inaae/ I., O?ai/oe I.). Eeeie/aneay yooaeoeaiinoue i?eiaiaiey yioa?ini?aaioa Neea?ae-I e eiioiiiiaeoeyoi?a yoeiaoeae io?io?iie a eiiieaeniii ea/aiee ?iaeeeueieoe n aanoaoeeiiiui ieaeiiao?eoii // Iaoa?eaeu iaaeae. iao/i. eiio. “Eco/aiea e eniieueciaaiea yoeiaoeae”. - Iieoaaa, 21-24naioya?y, 1998. - N. 100-103 ( o niaao. O?ai/oe A.A.). AIIOAOe?ss Aaai?e I.?. I?io?eaeoeea ai?eii-naioe/ieo oneeaaeiaiue o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii. – ?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. – ?inoeooo iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie. – Ee?a, 1999. ?iaioa i?enay/aia ?ic?iaoe? aoaeoeaiiai, iaoiaaiaoe/ii iaa?oioiaaiiai iaoiaeo i?io?eaeoeee i?neyiieiaiaeo ai?eii- caiaeueieo oneeaaeiaiue o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii. Anoaiiaeaii, ui o ii?iae?eue, ye? i?ae /an aaa?oiino? ia?aianee aanoaoe?eiee i??eiiao?eo, o ioa?ia??? a?aei?/a?oueny iayai?noue neiae?iio aiaeiaaiii? ?ioieneeaoe??, yeee noi?iaiaeaeo?oueny aeenooieoe??th ee?oeiii? oa aoii?aeueii? eaiie ?ioi?oaoo oa aeano?oeoe??th iaeo?io?eueieo eaeeioeeo?a ia oeueo?ano?oeoo?iiio ??ai?. Oe? ci?ie ? ia?aaeoiiaith aeey ?icaeoeo o aeaiiai eiioeiaaioo ae?iie i?neyiieiaiai? caoai?thaaiino?. Oaeineiiaeaii eiiieaen i??ii?e?inoa uiaei i?io?eaeoeee ioa?ia?aeueii? caoai?thaaiino? o ii?iae?eue c aanoaoe?eiei i??eiiao?eoii a aiaiiac? ?c aeei?enoaiiyi o i?neyiieiaiaiio ia??iae? aioa?ini?aaioo Neea?ae-I oa ?ioiiiiaeoeyoi?a ao?iaoea? io?io?iai?, aeniea aoaeoeai?noue yeiai iaa?oioiaaia oai?aoe/ii oa i?aeoaa?aeaeaia i?aeoe/ii. Iniiai? ?acoeueoaoe i?aoe? ciaeoee ai?iaaaeaeaiiy a ?iaioo e?eoaaeueii-i?io?eaeoe/ieo caeeaae?a Oe?a?ie. Eeth/ia? neiaa: aanoaoe?eiee i??eiiao?eo, i?neyiieiaia? ai?eii-naioe/i? oneeaaeiaiiy, i?io?eaeoeea, aioa?ini?aaio, ?ioiiiiaeoeyoi?, aiaeiaaiia ?ioieneeaoe?y, ?ioiieia?/ia ?aaeoeai?noue, iaeo?io?eueiee eaeeioeeo. AIIIOAOeEss Aaaiee I.E. I?ioeeaeoeea aiieii-naioe/aneeo ineiaeiaiee o ?iaeeeueieoe n aanoaoeeiiiui ieaeiiao?eoii. – ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.01 – aeooa?noai e aeiaeieiaey. – Einoeooo iaaeeao?ee, aeooa?noaa e aeiaeieiaee AII Oe?aeiu. – Eeaa,1999. ?aaioa iinayuaia ?ac?aaioea yooaeoeaiiai iaoiaaiaoe/anee iainiiaaiiai iaoiaea i?ioeeaeoeee iinea?iaeiauo aiieii-ainiaeeoaeueiuo ineiaeiaiee o ?iaeeeueieoe n aanoaoeeiiiui ieaeiiao?eoii. Onoaiiaeaii, /oi o aeaiuei, eioi?ua ai a?aiy aa?aiaiiinoe ia?aianee aanoaoeeiiiue ieaeiiao?eo, a ioy?ia?ee iaaethaeaaony neiae?ii yiaeiaaiiie eioieneeaoeee, eioi?ue nii?iaiaeaeaaony aeenooieoeeae eeaoi/iiai e aoii?aeueiiai caaia eiioieoaoa e aeano?oeoeeae iaeo?ioeeueiuo eaeeioeeoia ia oeueo?ano?oeoo?iii o?iaia. Yoe eciaiaiey niinianoaotho ?acaeoeth o aeaiiiai eiioeiaaioa ?iaeeeueieoe ioy?ia?aeueiie caaieaaaaiinoe. Oniaa?oainoaiaai eiiieaen i?ioeeaeoe/aneeo ia?ii?eyoee ioy?ia?aeueiie caaieaaaaiinoe o ?iaeeeueieoe n aanoaoeeiiiui ieaeiiao?eoii a aiaiiaca n eniieueciaaieai a iinea?iaeiaii ia?eiaea yioa?ini?aaioa Neea?ae- I e eiioiiiiaeoeyoi?a yoeiaoeae io?io?iie, aunieay yooaeoeaiinoue eioi?iai iainiiaaia oai?aoe/anee e iiaeoaa?aeaeaia i?aeoe/anee. Iniiaiua ?acoeueoaou enneaaeiaaiey iaoee naia i?eiaiaiea a ?aaioa ea/aaii-i?ioeeaeoe/aneeo o/?aaeaeaiee Oe?aeiu. Eeth/aaua neiaa: aanoaoeeiiiue ieaeiiao?eo, iinea?iaeiaua aiieii-naioe/aneea ineiaeiaiey, i?ioeeaeoeea, yioa?ini?aaio, eiioiiiiaeoeyoi?, yiaeiaaiiay eioieneeaoeey, eiioiieiae/aneay ?aaeoeaiinoue, iaeo?ioeeueiue eaeeioeeo. ANNOTATION Bagnij N. I. Prevention of pyo-inflammatory complications in puerperants with gestational pyelonephritis. The thesis for a candidate's degree of medicine by speciality 14.01.01 - Obstetrics and Gynecology. - Academy of Medical Sciences of the Ukraine. - Kiev, 1999. The work is devoted to development of an effective pathogenically validated method for the prevention of postpartum pyo-inflammatory complications in puerperants with gestational pyelonephritis. In postnatal state 82 womens with gestational pyelonephritis were examinated. Only in 34,14% of women the symptoms of the kidney’s infection were present, such as general weakness, low back pain, fever, that confirmed, that it was chronic process. In the majority of cases these patients had the pathological changes in the analisis of the blood and urine. It was established, that at the women, who had transferred gestational pyelonephritis during pregnancy, in postpartum the syndrome of endogenic intoxication was observed which lead to the dysfunction of the immunologic status of the organism and provoked the disturbance of the neutrophile’s ultrastructure. New data about dynamics indexes of the endogenic intoxication, cell’s and humoral brunches of immunity, morphologic structure of neutrophiles on the ground of enterosorbtion and immunocorrection in these women were determined. Patients with gestational pyelonephritis had the growth of the moleculas with middle mass, lowering quantity of T-cells due to T-lymphocytes subpopulations, decreasing of T-cell’s activity, increasing of a relative contain of B-cells, serum levels of the immunoglobulins G, M, A and the damage of the neutrophiles, which lead to their dysfuction. Traditional prophylactics doesn’t normalize foregoing indexes. The complex method of treatment gestational pyelonephritis in postpartum with the use of enterosorbent Silard-P and immunomodulator Echinacea purpurea is offered, high efficiency of which is testified theoretically and is practicaly confirmed. The ingradients of the prescribed therapy were one table-spoon-full of the enterosorbent Silard-P to 50 ml of water and 20 drops of the immunomodulator Echinacea purpurea infusion three times a day on an empty stomach. The duration of this treatment lasted 5-6 days. Any accesory phenomenous were not observed. It was proved, that the oral usage of silicon sorbent with echinacea purpurea in complex preventive treatment of puerperants with gestational pyelonephritis had lead to the disappearance of the degree of the endogenic intoxication – the amount of moleculas with middle mass and the erythrocyte indexes of the endogenic intoxication normalization. As a result of this – the restoration balance between T-B- lymphocytes, the immunoglobulins G, M, A, circulating immune complexes and the morphological structure of neutrophiles were observed. Prescribe immunocorrection and enterosorbtion in the complex prophylactics of puerperants with gestational pyelonephritis reduced therefore the incidence of postpartum complications, p<0,001. Just so, only in 3 (7,50%) cases out of 40 puerperants with gestational pyelonephritis due to application of Silard-P and Echinacea purpurea the postnatal diseases were observed: the decrease of uterine involution in 1(2,50%) and the attach of pyelonephritis in 2 (5,0%) patients. In the case of traditional preventive therapy - in 12 (28,57%) puerperants such complications were present: 1 (2,38%)- lochiometra, 6 (14,29%) - the attach of pyelonephritis, 5 (11,90%) - the decrease of uterine involution. Prescribe prevention reduce therefore the amount of postpartum pyoinflammatory complications from 26,18% to 7,50%, p<0,001. In the case of traditional prophylactics in 1(2,38%) woman endometritis was present and in 10 (23,80%) - fever, but during complex prevention only in 3 (7,50%) cases the high temperature was observed. Prescribe preventive treatment reduce the patient's staying in the hospital to three days. The main outcomes of a recearch work were introduced in the practice of medical-prophylactic establishments of Ukraine. Key words: gestational pyelonephritis, prevention, postpartum pyo-inflammatory diseases, enterosorbent, immunomodulator, endogenic intoxication, immunologic status, neutrophile.

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