Ранові ускладнення після хірургічних та акушерсько-гінекологічних операцій (профілактика, клініка, діагностика, лікування): Автореф. дис… канд. мед.

I?I?NOA?NOAI IOI?IIE CAeI?IA’ss OE?A?IE

E?EINUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO

?I. N.?. AAI?A??ANUeEIAI

OAeE 616-001.4+616-06+616-089.888:618.1-089

Ia i?aaao ?oeiieno

OAIAIAO IOAe-AeAEAIAE AAeAe?I

?aiia? oneeaaeiaiiy i?ney o??o?a?/ieo oa aeooa?nueei-a?iaeieia?/ieo
iia?aoe?e (i?io?eaeoeea, ee?i?ea, ae?aaiinoeea, e?eoaaiiy)

AAOI?AOA?AO

ae?na?oaoe?? ia caeiaoooy iaoeiaiai nooiaiiy

eaiaeeaeaoa iaaee/ieo iaoe

N?ioa?iiieue — 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a E?einueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ?i
N.?. Aai?a??anueeiai I?i?noa?noaa ioi?iie caei?ia’y Oeia?ie,

Iaoeiaee ea??aiee – Caneoaeaiee ae?y/ iaoee ? oaoi?ee Oe?a?ie,

Eao?aao Aea?aeaaii? i?ai?? Oe?a?ie,

Aeieoi? iaaee/ieo iaoe,

I?ioani? Oine?i Ee?eei Aeieo?iae/;

OII c eo?nii oaeoeueoaoneueai? o??o?a??

E?einueeiai aea?aeaaiiai iaaee/iiai oi?aaneoaoo ?i N.?. Aai?a??anueeiai,
i?ioani? eaoaae?e

Io?oe?ei? iiiiaioe: — aeieoi? ieaee/ieo iaoe,

I?ioani? Aieiao?a Ieeiea Ieeieaeiae/;

Eaoaae?a aini?oaeueii? o??o?a?? ? 1

E?einueeiai aea?aeaaiiai iaaee/iiai oi?aaneoaoo ?i. N.?. Aai?a??anueeiai

caa. eaoaae?ith

-Caneoaeaiee ae?y/ iaoee ? oaoi?ee Oe?a?ie,

Eao?aao Aea?aeaaii? i?ai?? Oe??ie,

Aeieoi? iaaee/ieo iaoe, i?ioani? Aaeeaioeueeee Ieeiea Ieeieaeiae/;

Eaoaae?a oi?aeaeueii-aaaeii?iaeueii? o??o?a??

Oa?e?anueeiai ?inoeoooo aaeineaiaeaiiy e?ea??a, caa. eaoaae?ith

I?ia?aeia onoaiiaa: Aeiai?iiao?ianueea iaaee/ia aeaaeai?y

Caoeno ae?na?oaoe?? a?aeaoaeaoueny “23” ethoiai 1999?. i 1400 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aiio ?aaee E 52.600.02 i?e E?einueeiio
a?aeaaiiioiaaee/iiio oi?aa?neoao? ?i. N.?. Aai?a??anueeiai (333006,
i.N?ioa?iiieue aoe. Eai?ia. 5/7).

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? E?einueeiai
aea?aeaaiiai iaaee/iiai oi?aaeoaoo ?i. N.?. Aai?a??anueeiai

Aaoi?aoa?ao ?ic?neaiee “ 22 ” n?/iy 1999?.

A/aiee nae?aoa?

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

Aeieoi? iaaee/ieo iaoe
I.I. Aa?eoiCAAAEUeIA   OA?AEOA?ENOEEA ?IAIOE. CAAAEUeIA 
 OA?AEOA?ENOEEA ?IAIOE.

 Aeooaeueiinoue oaie.  Aeooaeueiinoue oaie.

I?iaeaia iineyiia?aoeieieo oneeaaeiaiue ? iaeii?th ic oeaio?aeueieo
a oi?o?ai? oa aiiaeieiai? ye a Oe?a?ii, oae i ca ?? iaaeaie
(I.A.Ieeiiia n niaao. (1990), A.O.Naaiei n niaao. (1997). Iaeaieueo
/anoeie ? oneeaaeiaiiy c aieo ?aie, yei noia?ii neeaaeathoue 49-50 %
aiae caaaeueii? eieueeinoi iineyiia?aoeieieo oneeaaeiaiue
(E.E.Aa/aa,1989; TH.E.ssiia n niaao.,1997). Iaaeeaey/enue ia aaeeeo
eieueeinoue iaoeiaeo aeineiaeaeaiue, ?acoeueoaoe eieoaaiiy
iioieueo?aoia, iaaii?iue, na?ii oa aaaio?aoeie ua aeaeaei aiae
caaeiaieueieo. Nooo?ai, iniaeeai a inoaiii ?iee c?inee na?aaeii no?iee
iai?aoeacaeaoiinoi i eieueeinoue iani?eyoeeaeo ianeiaeeia, /anoioeie
noaee aeiaaeee aaia?aeicaoei? iioaeoei? oa ?iciiai ?iaeo
oieneei-aea?aieieo ?aaeoeie (A.?.Aaeueoaiae n niaao. (1997);
D,Pittetet; TH.E.ssiia n niaao.(1997).

I?ia?anoth/a aioeaiioeeinoieeinoue ?aiiai? iie?ioei?e i ca”ycia c
iath i?iaeaia ainiioaeicio, cieaeaiiy ?iaiy caoenieo ?aaeoeie
i?aaiicio oai?eo oi?o?ai/iiai i aiiaeieiai/iiai i?ioieth ?iaeyoue ana
aieueo o?oaeiith caaea/o ai?ioueae c iioaeoei?th (A.E.Aaiaeeaa,1985;
A.E.Ao?oiaia n niaao.,1981 ; A.Valcin et al.,1995).

Aiaeic eioa?aoo?ieo aeaieo aeicaiey? aeaeieeoe aeaeieueea aaaeeeaeo
iai?yieia, yei iai i?aaenoaaeythoueny iaeiaea/aieie. Oea ia?o ca ana,
?ic?iaea niiniaia ?aiiuei? aeiaaiinoeee, aoaeoeaieo caoiaeia
i?ioieaeoeee i aeeoa?aioeieii? eieoaaeueii? oaeoeee a caeaaeiinoi aiae
aeaeo oneeaaeiaiiy, no?ieia anoaiiaeaiiy aeiaaiico, aeaeo iie?ioei?e,
iayaiinoi aai aiaenooiinoi iioeo iineyiia?aoeieieo oneeaaeiaiue, noaio
oai?eo.

Aeeneonieieie ? ieoaiiy i?ioieaeoe/ii? aioeaaeoa?iaeueii? oa?aii?
(E.E.Iuoeei n niaao.,1991; J.Kiss, J.Schnitzler,1997). A eeiiioei ia
ciaoiaeyoue oe?ieiai canoinoaaiiy iaoiaee cae?eoiai eieoaaiiy ?ai, a
oaeiae oaei no/anii niiniae, ye aiaee?eoa eieoaaiiy aiieii?
iineyiia?aoeieii? ?aie o oaci aino?iai caiaeaiiy i iaeeaaeaiiy
aoi?eiieo oaia o oaci ?aaaia?aoei? (A.A.Ei?aeia n niaao.,1991). ia
ao?a/a? nai?? aeooaeueiinoi i?iaeaia aaaio?aoei?, yea cono?i/a?oueny o
0,1-1% oi?o?ai/ieo i aiiaeieiai/ieo oai?eo (N.N.Neana?aiei,1986).
Aaaio?aoeiy, aoaeo/e aeeiaii/ii ?icaeaath/einy a /ani i?ioeanii, /anoi
aeiaaiinoo?oueny a ia?iiae aaanoea?aoei? i?aaiia,ui iiaeaeathoue aeeooy
oai?eo iaaecae/aeiiio nooiaith ?eceeo.

A no/aniie oi?o?ai? iaaea/aiei ieoaiiyi caeeoa?oueny
aeiaaiinoeea i eieoaaiiy na?ii. Oei /anii, oea oneeaaeiaiiy ?ai
niinoa?iaa?oueny aeineoue /anoi, yaeyth/enue aeiaeaoeiaei aeaea?aeii
iaaii?iue i eiaaoo?ieo ii?eoeue.

I?aaiaiiy aea/eoe oei iaae?ioaii ieoaiiy, ae?iaeoe i?aeoe/ii
?aeiiaiaeaoei?, ?ic?iaeoe i?eioeeie i?ioieaeoeee i eieoaaiiy ?aiiaeo
oneeaaeiaiue, iineoaeeei iiaenoaaith oeueiai aeineiaeaeaiiy.

Ca”ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie.

?iaioa aeeiiaia a ?aieao iaoeiai? i?iaeaie 21.03 “Iaaiaeeeaaeia
oi?o?aiy”.

Oeo? oaie 1.11 N Aea?ae.?a?no?aoei? 0.01.96 OI. 14108.

Iaoa aeineiaeaeaiiy.

Iaoith ?iaioe ? ?ic?iaea niiniaia ?aiiuei? aeiaaiinoeee
iineyiia?aoeieieo ?aiiaeo oneeaaeiaiue, eeiii/ia ioeiiea eiiieaenieo
i?ioieaeoe/ieo i eieoaaeueieo caoiaeia, a oaeiae aiaeaeaeaieo
ianeiaeeia iaaii?iue, na?ii oa aaaio?aoeie.

 Caaea/i aeineiaeaeaiiy.

Aeeiiaiiy iinoaaeaii? iaoe aeiaaa? ae?ioaiiy neiaeoth/eo caaea/:

— aea/eoe /anoioo ?aiiio neiioiiia oa iciae ?aiiaeo
iineyiia?aoeieieo oneeaaeiaiue, iiaeaeaaoe ?o iaoaiaoe/iiio aiaeico i
iiaeaiooaaaoe aaco aeaieo aeey eiii”thoa?iiai iiiioi?eiao ca ia?aaiaii
?aiiueiai iineyiia?aoeieiiai ia?iiaeo o oi?o?ai/ieo i aiiaeieiai/ieo
oai?eo a?oie iniaeeaiai ?eceeo;

— ?ic?iaeoe ?aeeii e?eoa?i? ioeiiee noaio iineyiia?aoeieii? ?aie
ia iiaenoaai eeiii/ieo i aaeoa?iieiai/ieo iaoiaeia aeineiaeaeaiiy,
caa?ioaoe iniaeeao oaaao ia OCAe iineyiia?aoeieieo ?ai i aea/aiiy
aiaeiaaiii? iioieneeaoei?;

— i?iaanoe eeiii/io ioeiieo i?ioieaeoe/ieo caoiaeia, iai?aaeaieo ia
caiiaiaaiiy ?aiiaeo oneeaaeiaiue, yei i?iaiaeeeeny aei iia?aoei?, iiae
/an i iiney ia?;

— ?ic?iaeoe iaoiaeeeo i iieacaiiy aei oeueo?acaoeiaiai
aeineiaeaeaiiy aeey ?aiiuei? aeiaaiinoeee aeeaieeo iiaeaiiiaa?ioe/ieo
iaaii?iue i ii/aoeiaeo noaaeie aaaio?aoei?;

— ?ic?iaeoe i?eioeeie eieoaaeueii? oaeoeee c a?aooaaiiyi
iniaeeainoae eeiii/iiai ia?aaiao ?aiiaeo iineyiia?aoeieieo oneeaaeiaiue
ic a?aooaaiiyi oac ?aiiaiai i?ioeano, iayaiinoi aai aiaenooiinoi iioeo
iineyiia?aoeieieo oneeaaeiaiue i noaio oai?eo;

— oeyoii aea/aiiy aiaeaeaeaieo ?acoeueoaoia aea/eoe ianeiaeee
ia?aianaieo iaaii?iue,na?ii oa aaaio?aoeie.

Iaoeiaa iiaecia io?eiaieo ?acoeueoaoia.

— Aia?oa aea/aii eeiii/iee ia?aaia ?aiiaeo iineyiia?aoeieieo
oneeaaeiaiue ic aecia/aiiyi iaoaiaoe/iei oeyoii iioi?iaoeaiinoi

ie?aieo neiioiiia oa iciae.

— Aia?oa aeey ?aiiuei? aeiaaiinoeee ?aiiaeo oneeaaeiaiue canoiniaaii
iaoiae eiii”thoa?iiai aiaeico ia iniiai noai?aieo aeai?eoiia, ui
aeicaieeei iaeaieueo iiaii ?aaeicoaaoe i?eioeeie aeeoa?aioeiaeueii?
aeiaaiinoeee iaoieiai/ieo aiaeoeeaiue i?ioyaii iineyiia?aoeieiiai
ia?iiaeo.

— ?ic?iaeaii niinia ?aiiuei? oeueo?acaoeiai? aeiaaiinoeee aeeaieeo
iiaeaiiiaa?ioe/ieo iaaii?iue oa aaaio?aoeie.

 I?aeoe/ia cia/aiiy io?eiaieo ?acoeueoaoia.

?acoeueoaoe aeineiaeaeaiue aiaee?eaathoue iiai iiaeeeainoi
?aiiuei? aeiaaiinoeee ?aiiaeo iineyiia?aoeieieo oneeaaeiaiue, a iniiai
yeeo eaaeeoue eiiieaeniee iiaeoiae c aeei?enoaiiyi
oaoii/ieo,eeiii/ieo, eaai?aoi?ieo i aaeoa?iieiai/ieo iaoiaeia
aeineiaeaeaiiy.

C”yaeeany iiaeeeainoue ca aeiiiiiaith eiii”thoa?ieo oaoiieiaie
caeienieoe iaeaieueo aoaeoeaiee iiiioi?eia ca ia?aaiaii
iineyiia?aoeieiiai ia?iiaeo, iaio noeeueiee aei aieeao oaeeo oaeoi?ia,
ye eaaeioieaoeiy oi?o?aa i noa”?eoeaici a ioeiioei iaoieiai/ieo
neiioiiia.

Iaaeaii i?aeoe/ii ?aeiiaiaeaoei? ii i?ioieaeoeoei ?aiiaeo
oneeaaeiaiue i i?e aeai?o eieoaaeueii? oaeoeee.

?acoeueoaoe aeineiaeaeaiue ai?iaaaeaeaii a oi?o?ai/iiio
aiaeaeieaiii 6-i? iinueei? eiea?ii i.Niioa?iiiey, a oi?o?ai/iiio i
aiiaeieiai/iiio aiaeaeieaiiyo caeiciiaei?iaeiuei? eiea?ii
i.Niioa?iiiey (Aeoe ai?iaaaeaeaiiy aiae 15 /a?aiy 1998 ?.).

 Iniaenoee aeeaae aeena?oaioa.

Io?eiaii a ?iaioi aeaii ? ??coeueoaoii naiinoieiiai aeeiiaiiy
aeena?oaioii eeiii/ieo, aaeoa?iieiai/ieo i eaai?aoi?ieo
aeineiaeaeaiue. Iniaenoi aeena?oaioii noai?aii aeai?eoie eeiii/iiai
ia?aaiao ?aiiaeo oneeaaeiaiue aeey aaaaoiooieoeiiiaeueii? aenia?oii?
eiii”thoa?ii? nenoaie “Neaeueiaeue”, yea i?aaeiacia/aia aeey
aeiaaiinoeee oneeaaeiaiue a aaaeiiiiaeueiie oi?o?ai?. A aeena?oaoei?
aeei?enoaii aeineiaeaeaiiy ii OC-aeiaaiinoeoei ?aiiaeo oneeaaeiaiue
(aeeaieeo iiaeaiiiaa?ioe/ieo iaaii?iue, na?ii oa aaaio?aoeie),aeeiiaieo
iniaenoi aeena?oaioii.*anoeia iioaeieiaaieo noaoae iaienaia o
niiaaaoi?noai, aea o?aaiaioe noaoae, yei noinothoueny aeeiiaieo
aeena?oaioii aeineiaeaeaiue, iaienaii iei naiinoieii. Iniaenoi
aeena?oaioii aeeiiaii

42 iia?aoei? i?e iineyiia?aoeieieo oneeaaeiaiiyo. A 52 iia?aoeiyo ii
oaii aeena?oaoei? i?eeiaa o/anoue ye anenoaio.

Ai?iaaoeiy ?acoeueoaoia aeena?oaoei?.

Iaoa?iaee aeena?oaoei? iiaiaeiieaii ia caniaeaiii E?einueeiai
?anioaeieainueeiai iaoeiaiai oiaa?enoaa oi?o?aia ? 581
(15.02.1995); ia iaoeiaie nani? E?einueeiai iaaee/iiai iinoeoooo
(i.Niioa?iiieue,1995); ia iaoeiai-i?aeoe/iie eiioa?aioei? oi?o?aia
Oe?a?ie, i?enay/aiie aiieii-naioe/iei oneeaaeiaiiyi o iaaiaeeeaaeiie
oi?o?ai? (Oa?eia,1995); ia iiaeia?iaeieo oi?o?ai/ieo eiia?anao
(Oaeue-Aaia,1996,1998); ia iaoeiai-i?aeoe/iie eiioa?aioei? oi?o?aia
i.Niioa?iiiey (?aiaoi?iy,1996, Niioa?iiieue,1997).

 Ioaeieaoei?.

Ca oaiith aeena?oaoei? iioaeieiaaii 11 iaoeiaeo ?iaio. *ioe?e ic
ieo a iaoeiaeo aeo?iaeao, /ioe?e a cai?ieeao, 2 a iaoa?iaeao
iiaeia?iaeieo eiia?ania i ?anioaeieainueeie eiioa?aioei? oi?o?aia,
iaeia a oacao eiioa?aioei? oi?o?aia Oe?a?ie.

 Ianya i no?oeoo?a aeena?oaoei?.

Aeena?oaoeiy aeeeaaeaia ia 148 noi?iieao iaoeiiieniiai oaenoo,
iethno?iaaia 16 oaaeeoeyie, 20 ?enoieaie. ?iaioa aeeth/a? anooi, iaeyae
eioa?aoo?e,oa?aeoa?enoeeo iaoa?iaeia i iaoiaeia aeineiaeaeaiiy,
iniaenoi aeineiaeaeaiiy,caeeth/aiiy, aeniiaee, i?aeoe/ii
?aeiiaiaeaoei?, nienie aeei?enoaieo aeaea?ae, yeee aiiuo? 255 aeaea?ae
(185 aio/eciyieo i 70 ca?oaiaeieo).

INIIAIEE CIINO AeENA?OAOeI?. INIIAIEE CIINO AeENA?OAOeI?.

 Iaoa?iaee i iaoiaee aeine?aeaeaiiy.  Iaoa?iaee i iaoiaee
aeine?aeaeaiiy.

Aeineiaeaeaiiy i?iaaaeaii o 299 oai?eo,i?iiia?iaaieo a oi?o?ai/ieo
oa aeooa?nueei-aiiaeieiai/ieo eeiiieao E?einueeiai iaaee/iiai
oiiaa?neoaoo ca ia?iiae c 1992 ii 1997 ?iee. ?iciiaeie oai?eo ca
noaooth i aieii i?aaenoaaeaii a oaae.1.

Oaaeeoey 1 

?iciiae?e oai?eo ca noaooth ? a?eiaei a?oiai 

A?e oai?eo

(a
?ieao)NoaoueAnueiai/ieia?eeae?iee21-3024164031-4013213441-5033316451-602
6366261-4021224371-8011283980 ? noa?oa61117Anueiai134165299Eeiii/iee
ia?aaia ?aiiaeo iineyiia?aoeieieo oneeaaeiaiue aea/aii o 164 oai?eo .
 O ?aooe 135 oai?eo i?iaaaeaii iaoeiai aeineiaeaeaiiy ,  ni?yiiaaii ia
aea/aiiy aoaeoeaiinoi ?ic?iaeaiiai iaie i?ioieaeoe/iiai eiiieaeno
caoiaeia .

Oaaeeoey 2.

 Oa?aeoa? iia?aoeie ? ?o e?eueeinoue

Iia?aoeai? ao?o/aiiyE?euee?noue iia?aoe?eieaiiaeoaeno?aieoanueiai1.
Iia?aoe?? ia oeoieo (?acaeoe?y oeoieo, aano?aeoii?y, NIA)65112.
Iia?aoe?? ia aeia/iiio i?oo?? ? aeia/ieo oeyoao66123. Iia?aoe?? ia
oiano?e eeooe?1012224. Iia?aoe?? i?e ia?eoii?o?-29295. Iia?aoe?? i?e
aino??e eeoeia?e iai?io?aeiino?-666.Iia?aoe?? i?e o?aai? aeeaioa-997.
Iia?aoe?? i?e aino?iio aiaiaeeoeeo?-24248. Iia?aoe?? i?e a?eaeao304349.
A?iaeieia?/i? iia?aoe??11617?acii63101164

Ic ieo iaaii?iiy oa aaaio?aoeiy niinoa?iaaeany o 106- oai?eo
(64,63%), iioieueo?ao o 16-oe (9,75%), na?iie o 32-o (19,5%), aaiaoiia
— o 10-oe oai?eo (6,0%). O 56-oe oai?eo oei?? a?oie a no?iee aiae 1-ai
?ieo aei 3-o ?ieia iiney aeienee ic noaoeiiia?o aea/aii aiaeaeaeaii
ianeiaeee ?aiiaeo oneeaaeiaiue.

Eeiii/ii i?iyae oneeaaeiaiue c aieo iineyiia?aoeieii? ?aie aea/aii
ia iiaenoaai: ioeiiee noaio oai?eo, nea?a, aaiiaeeiaii/ieo iieacieeia,
aeaieo iaeyaeo oai?iai i ?aie, ioeiiee eaai?aoi?ieo aeaieo i
?acoeueoaoia OC-aeineiaeaeaiiy. Aeey aeiaaiinoeee nooiaith aiaeiaaiii?
iioieneeaoei? i?iaiaeeee aea/aiiy eeiii/ieo i eaai?aoi?ieo aeaieo
(eaeeioeeoa?iee iiaeaen -EII ca oi?ioeith Eaeueo-Eaeioa

(4IE +3TH + 2I + N) o (Ie + 1)

EII=

(E + I i ) o (3 + 1)

?iaaiue na?aaeiueiiieaeoey?ieo ieiaiiaioeaeia — NI a ne?iaaooei
e?iai ca iaoiaeeeith I.I.Aaa?i?eyi ic niiaaao. (1984).

Aeoiaey/e ic oiai , ui aaaaoi eeiii/ieo i eaai?aoi?ieo iciae
oneeaaeiaiue ?aiiaiai i?ioeano iathoue ?iciie nooiiiue aeiaaiinoe/ii?
iioi?iaoeaiinoi , iaie aeey iaa?oiooaaiiy eeiii/ii? aeiaaiinoeee
canoiniaaiee iaoaiaoe/iee iaoiae, yeee aecia/a? aeiaaiinoe/io
oeiiiinoue ie?aieo neiioiiia oa iciae. Nooue iaoiaeo caeeth/a?oueny a
oiio, ui cia/aiiy eiaeiiai neiioiio iaaoaa? aiaeiiaiaeio eieueeinoue
aaeia, ?iaio ca aaee/eiith e?eoa?ith No”thaeaioa.

Aea ?i —  oiiaia na?aaeiy eiiai?iinoue oneeaaeiaiiy aeey ani??
aeineiaeaeoaaii? a?oie. ?1  — oiiaia na?aaeiy eiiai?iinoue ?aiiaiai
oneeaaeiaiiy i?e iayaiinoi aeaii? aeiaaiinoe/ii? iciaee (o
i?ioeaioao), mi  i m1  — na?aaeii iiieeee aiaeiiaiaeii o aeaio a?oiao.

Iaeaieueo ?aiithth iciaeith oneeaaeiaiiy c aieo iineyiia?aoeieii?
?aie ? iiaeaeuaiiy oaiia?aoo?e oiea. O iaoeo eeiii/ieo niinoa?aaeaiiyo
oeae neiioii niinoa?iaaany o 94,8% oai?eo, ui ioeiiaii a 100 aaeia.
Iioi?iaoeieia aaaa ?aooe neiioiiia i i?eeiao ia/enethaaeany ca e?eoa?i?i
No”thaeaioa aiaeiinii ia?oiai iieacieea. O oaaeeoei 3 iieacaii i?eeeaaee
ia/eneaiiy iioi?iaoeieii? aaae oiai /e iioiai neiioiio oa iciaee.

Noia aaeia aecia/aea aeiaaiinoe/iee iiaeaen. *ei aii aeua, oei
aieueoa ai?iaiaeiinoue iineyiia?aoeieiiai oneeaaeiaiiy. Io?eiaii
?acoeueoaoe eyaee a iniiao i?e noai?aiii aeai?eoiia aenia?oii?
nenoaie “Neaeueiaeue”, caniiaaii? c iaoith eeiii/iiai iiiioi?eiao i
aeeoa?aioeieii? aeiaaiinoeee c iioeie iineyiia?aoeieieie oneeaaeiaiiyie.

Oaaeeoey 3.

I?eeeaaee ?ic?aooieo iioi?iaoeieii? aaae neiioiio /e ?aiiaiai

oneeaaeiaiiy.

Neiioii, iciaea*enei oai?eoP, %m0P1-P0t?ioi?iaoe?eia aaaa a
aaeaoOaiia?aoo?a o?ea7294,82,519229,2100A?eue o
?ai?6990,83,38823,279Oao?ea?ae?y4964,55,4961,710,636

I?eiioea: Aeineiaeaeoaaia a?oia — 76 oai?eo c iaaii?iiyi oa
iioieueo?aoii ?ai. ? i  — oiiaia na?aaeiy eiiai?iinoue ?aiiaiai
oneeaaeiaiiy a oi?o?ai/ieo oa aiiaeieiai/ieo oai?eo — 28%, m i  —
na?aaeiy iiieeea aeey ani?? a?oie a oeieiio.

Nenoaia “Neaeueiaeue”, yea noai?aia a E?einueeiio iaaee/iiio
oiiaa?neoaoi ca o/anoth oi?ie “Medissa”, ?aaeiciaaia aeey ?iaioe
eiii”thoa?a oeio IAI ?N/ AO. Nenoaia ?aaeiciaaia ia iiai NOAAe Fox PRO
aa?niy 2.

?ic?iaeaiee i canoiniaaiee iiaee niinia aeiaaiinoeee aeeaieeo
iiaeaiiiaa?ioe/ieo iaaii?iue i ii/aoeiaeo noaaeie aaaio?aoei? ca
aeiiiiiaith OCAe. Anueiai i?iaaaeaii 135 oeueo?acaoeiaeo aeineiaeaeaiue
?aiiaiai eaiaeo oa ioi/oth/eo oeaiei a ?icii no?iee iiney iia?aoei? ia
aia?aoi SSA-90 A oi?ie “Tochiba” (ssiiiiy), yeee i?aoeth? a ?aaeeii
?aaeueiiai /ano c aeei?enoaiiyi eiiaeiiai aeao/eea aeey iiaa?oiaaeo
aeineiaeaeaiue c /anoioith 7,5 Iaoe. Oeueo?acaoeiaee aeao/ee
anoaiiaethaaany acaeiaae ?aie c iaio aieia aiae ia?.

O 135 oai?eo c iniaeeaei ?eceeii aeieeiaiiy ?aiiaeo
iineyiia?aoeieieo oneeaaeiaiue ?ic?iaeaia eiiieaenia i?ia?aia
i?ioieaeoeee, yea aeeth/aea a naaa eieoaaeueii i oaoii/ii caoiaee, ui
i?iaiaeeeeny aei iia?aoei?, iiae /an i iiney ia?. Aoaeoeaiinoue
i?ioieaeoeee ioeiithaaeany ia iiaenoaai eeiii/ieo, eaai?aoi?ieo i
aaeoa?iieiai/ieo iaoiaeia aeineiaeaeaiiy.

Oaaeeoey 4.

Oa?aeoa? iia?aoeie i eieueeinoue oai?eo, i?ieieiaaieo ?c

canoinoaaiiyi eiiieaenii? i?ia?aie i?ioieaeoeee

Oa?aeoa? iia?aoe??E?euee?noue oai?eo,
noaouee?euee?noue/ieia?eeae?iee1.?aeaia?ioii?? i?ney o??o?a?/ieo ?
a?iaeieia?/ieo iia?aoe?e3211212.Iia?aoe?? i?e caaaeueiiio ? i?noeaaiio
ia?eoii?o?14953.?aeiino?oeoeai? iia?aoe?? ia oianoiio
eeoa/ieeo12664.Iia?aoe?? c i?eaiaeo ii?eoeue o?aaiiai o?aeoo (eeoeiaeo,
aeia/ieo,iaie?aaoe/ieo)8355.?aeiino?oeoeai? iia?aoe?? ia oeoieo ?
aeia/ieo oeyoao6516.?aaeeeaeuei? ? iae?aoeai? iia?aoe?? c i?eaiaeo ?aeo
o o??o?a?/ieo ? a?iaeieia?/ieo oai?eo12487. Iia?aoe?? i?e iaoe?ieo ?
a?a?ionueeeo i?neyiia?aoe?eieo a?eaeao4314298. Iia?aoe?? i?e ianeaieo
aano?iaeoiaeaiaeueieo e?iaioa/ao862Anueiai1355877 Oae, ia ii/aoeo i a
eiioei iia?aoei? i?iaiaeeee aaeoa?iieiai/ii iiniae c iiaeoei?iiaee?iai?
iniiae. O 32-o oai?eo c iaeaieueo aenieei ?eceeii iineyiia?aoeieieo
oneeaaeiaiue i?iaiaeeee eieueeinia aecia/aiiy aaeoa?ie a 1 a?. oeaiei,
acyoi? ic ?aie a eiioei iia?aoei? ca iaoiaeii E.Cloeble (1974) a
iiaeeoieaoei?, ?ic?iaeaiie iinoeoooii ii. A.A.Aeoiaanueeiai (I.E.Eocei n
niaao. ,1980).

A oeth a?oio oaieoee oai?i iiney iia?aoeie ia oianoie i i?yiie
eeooei, iiney ?icieo iia?aoeie c i?eaiaeo ?aeo.

Eiio?ieueio a?oio oai?eo neeaee 22 aeiaaeea iia?aoeie c i?eaiaeo
iaoe?ieo i aiaaionueeeo a?eae /a?aaii? noiiee, o yeeo ?ic?iaeaia iaie
eiiieaenia i?ioieaeoeea ?aiiaeo oneeaaeiaiue ia i?iaiaeeeany, a oi?o?ae
iaiaaeoaaeeny o?aaeeoeieieie iaoiaeaie caiiaiaaiiy aeciaaiiiai oa
aiaeiaaiiiai iioieoaaiiy ?ai.

A eeiii/iiio iaoa?iaei i?e ?ao?iniaeoeaiiio aiaeici no?ieia
aeiaaiinoeee oneeaaeiaiue c aieo iineyiia?aoeieii? ?aie o 164 oai?eo
aeyniaii, ui a ia?aaaaeiie aieueoinoi aeiaaeeia iaaii?iiy ?aie
aeiaaiinoo?oueny ia 4-5-7- aeiao iiney iia?aoei?, aaaio?aoeiy a
i?iiiaeie iiae 7 i 10 aeiaith, iioieueo?ao i na?iia ia 3-4-5- aeiao. I
eeoa aaiaoiia — a ia?oi 1-3 aeiae. A oie aea /an ia?oi ?aiii iciaee
oeeo iineyiia?aoeieieo oneeaaeiaiue ynii caii/aii ia 2-3 aeiao.
Iaoaiaoe/iee aiaeic ie?aieo neiioiiia oa iciae iieacaa, ui iaeaieueo
?aiiii ic ieo ? iii??iee a?eue a iaeano? i?neyiia?aoe?eii? ?aie, i
eaai?aoi?ii neiioiie aiaeiaaiii? iioieneeaoei?, oaei, ye noaoaa?eeueia
oaiia?aoo?a, iiaaia caaaeueia naiiii/oooy, oaoiea?aeiy i oiene/ii ciiie
a aiaeici e?iai (eaeeioeeoic, cnoa eaeeioeeoa?ii? oi?ioee aeiai, ?ino
eaeeioeeoa?iiai iiaeaeno iioieneeaoei? (EII) i na?aaeiuei-iieaeoey?ieo
ieiaiiaioeaeia (NI). Aeiaaiinoe/iee iiaeaen na?iie neeaa 174 aaea,
iineyiia?aoeieiiai iioieueo?aoo 248 aaeia,iaaii?iiy ?aie -409 aaeia,
/anoeiai? aaaio?aoei? -858 aaeia, iiaii? aaaio?aoei?- iiiaae 1000
aaeia.

Oae, ia aiaeiiio aiae ii?iaeueii i?ioieath/iai iineyiia?aoeieiiai
ia?iiaeo, i?e yeiio iieacieee ia?eoa?e/ii? e?iai i?ia?aneaii
iie?auothoueny, i?e iioaeoeieiiio i?ioeani a ?aii oeueiai ia
aiaeaoaa?oueny. O ieaiiai i?iiia?iaaieo oai?eo eieueeinoue eaeeioeeoia,
neeaaeath/e a 1-2 aeiao iiney iia?aoei? 9,54 ±  0,24 o 10 9 /e , aei
aeiy ?ic?ico aiieieea aeinyaa? 14,15  ±  0,45 o 10 9 /e. A
eieueeinoue iaee/eiyaea?ieo oi?i aiaeiiaiaeii 10,5  ±  0,31 % i 18,36
7± 1,8 %. EII caieueoo?oueny aiae 2,4  ±  0,6 aei 3,8 ±  1,1. NI-
0,0251  ± 0,012 o.i. aei 0,299 ± 0,012 o.i. O aeno?aii i?iiia?iaaieo
oai?eo oiene/iinoue e?iai ua

aeua. Eieueeinoue eaeeioeeoia a 1-2 aeiao iiney iia?aoei? neeaaea? 12,6
 ±  0,58 o 10 9 /e, a ia aeaiue ?ic?ico aiieieea- 18,60  ±  0,44
o 10 9 /e;EII — 3,6-3,9, NI -0,320 ±  0,11 o.i., aeinyaath/e a ie?aieo
aeiaaeeao 0,405  ±  0,018 o.i. Oaei neiioiie, ye iioaineaiee aieue a
iaeanoi ?aie, iioieueo?ao, iaa?ye, aiia?aiiy o nioci eiii? oaia,
i?iiieaiiy iia”ycee aii?i aai na?icii-aaii?aai/iith ?iaeeiith i oei
aieueoa, aainoea?aoeiy i?aaiia i?e aaaio?aoei? — ? iiciiie
neiioiiaie, yei c”yaeythoueny a i?iiiaeie iiae 5 i 10 aeiaith iiney
iia?aoei?.

Aoaeoeaiinoue ?aiiuei? aeiaaiinoeee oneeaaeiaiue ?icei
iiaeaeuo?oueny ca aeiiiiiaith iaie ?ic?iaeaiiai iaoiaeo
oeueo?acaoeiaiai aeineiaeaeaiiy (OCAe) iineyiia?aoeieieo ?ai, yeee
aeicaiey? aaea ia 2-3 aei ao aecia/eoe nooiiiue iaa?yeo oa
iioieueo?aoei? oeaiei, a oaeiae iaeiie/aiiy ?iaeeie a ?aiiaie
ii?iaeieii. Oeae iaiiaacieiee niinia aeiaaiinoeee ?icoiaeaeaiiy
e?a?a ?aie ia ?iaii /a?aaii-i”yciai-aiiiaa?ioe/iiai oa?o ? aeicaiey?
caiiaiaoe iiaii? aaaio?aoei?.

?iaeeia a ?aiiaie ii?iaeieii (e?ia, na?iciee o?ainnoaeao, aiie)
aicoaeico?oueny iiae /an OCAe ye /ioei aiaeiaaeiaaia aiiiaoiaaiia
ooai?aiiy iaaeueii? aai iai?aaeeueii? oi?ie, yea ?icoa?iao? i ?icaeaeaa?
oeaieie. I?e oeueiio iiaeeeaa aeiaaiinoeea aiieieea, na?iie aai
aaiaoiie ia oieueee a iiaeoei?iiaee?iaie eeio/aooei, aea i a aieueo
aeeaieeo oa?ao /a?aaii? noiiee, a oiaui i”ycia, iiae aiiiaa?icii i iiae
eiai eenoeaie, iiae i”yciai-aiiiaa?ioe/iei oa?ii i i/a?aaeiith.

Aeiaaiinoeea oi/ii? eieaeicaoei? aeicaiey? i?iaanoe i?eoeieueio
ioieoeith oa anii?aoeith aiinoo, a i?e iiaoi?iiio OCAe iiaeia noaeeoe
i?i ?? aoaeoeaiinoue.

Eeiii/ia ai?iaaoeiy eiiieaenii? i?ioieaeoeee i?iaiaeeeany o 135
oai?eo c aenieei ?eceeii iioaeoeieieo ?aiiaeo oneeaaeiaiue. Nthaee
aeeth/aii iiaoi?ii ?aeaia?ioiii? iiney oi?o?ai/ieo i aiiaeieiai/ieo
iia?aoeie, iia?aoei? i?e eeoeiaeo ii?eoeyo, ?aaeeeaeueii iia?aoei? c
i?eaiaeo ?aeo o?aaiiai o?aeoo i aaiioaeie, iia?aoei? i?e ia?eoiiioi oa
aino?ie eeoeiaie iai?ioiaeiinoi.

?ic?iaeaii iaie eiiieaenii i?ioieaeoe/ii caoiaee aeeth/athoue a
naaa: ?aoaeueio ia?iaeo iia?aoeieiiai iiey c iiia?aaeiueith naiaoei?th
iaoea?aoeie, ae?acie, eiaaoo?ieo ii?eoeue; i?ioieaeoe/ia canoinoaaiiy
aioeaiioeeia oe?ieiai niaeo?o aei? (oi?iai, iaoienei, oeei?iiie,
aaioaiioeei, aiiioeeeii); aoaiia aiaeiaaeoaaiiy anio oa?ia /a?aaii?
noiiee oe?ieeie ia?eaaeie na?aaoeaie, cii/aieie a aioenaioeeo;
aiaenieaiiy e?a?a aeaoaeoo /a?aaii? noiiee i?e ?aeaia?ioiii? i
iineyiia?aoeieieo a?eaeao — ye iioaioeiaeueiiio aeaea?aeo iioieoaaiiy
?ai; ciiio iino?oiaioia oa ?oeaae/ie iiney iaeaieueo “caa?oaeiaieo”
aoaiia iia?aoei?; canoinoaaiiy oieueee a?aaeoeaieo oiaieo iaoa?iaeia;
ae?aioaaiiy iineyiia?aoeieii? ?aie. A ?aiiueiio iineyiia?aoeieiiio
ia?iiaei oaeiae i?iaiaeeeany aioeaaeoa?iaeueia oa?aiiy; aeaeaeyany
?aiiaee o?ainnoaeao ca aeiiiiiaith aeoeaii? anii?aoei? aai ioieoei?,
canoiniaoaaeeny oiciioa?aiaaoe/ii i?ioeaaeo?e i eiea?nueei caniae, yei
noeioeththoue ?aaaia?aoeith.

I?iaaaeaii aaeoa?iieiai/ii aeineiaeaeaiiy(aaeoa?iieiai/ii iiniae c
iiaeoei?ii? eeio/aoee ia ii/aoeo i a eiioei iia?aoei?, aecia/aiiy
eieueeinoi iie?iaia a iaeiiio a?aii oeaiei) naiae/aoue i?i aenieo
aoaeoeaiinoue iaoiaeo. Oae, eeoa o 12 oai?eo a eiioei iia?aoei? iiniae
aoee iiceoeaieie (a eiio?iei — 13 ic 22 iiniaia). I?e oeueiio,
eieueeinoue iie?iaia a 1 a oeaieie ia ia?aaeuoaaea e?eoe/iee ?iaaiue
(10 5  iie?iaieo oie a 1 a oeaieie). Eeiii/ii ?acoeueoaoe aoee
neiaeoth/eie: iaaii?iiy ?aie aeieeei o 6 oai?eo (4,43%), iioieueo?ao o
2 oai?eo (1,58%),na?iia a oaao o 6 (4,43%). Aaiaoiie ia aiaeii/aii. O
iaeiiai oai?iai aeieeea iiaoi?ia aaaio?aoeiy. Caaaeueiee i?ioeaio
iineyiia?aoeieieo oneeaaeiaiue neeaa 8,82%.

Oaaeeoey 5.

Oa?aeoa? caaithaaiiy iineyiia?aoeieii? ?aie o oai?eo

 iiney canoinoaaiiy i?ioieaeoe/ieo caoiaeia.

E?euee?noue oai?eo

A?oie oai?eoAnueiaiOa?aeoa? caaithaaiiy
?aiia?aeiiaIaaii-?iiy?io?eueo?aoeyaaaio

?aoe?yna?iiaaaiaoiia1-a a?oia40381—1-2-a a?oia433621-4-3-y
a?oia52463111- I?eiioea: Aei ia?oi? a?oie aeeth/aii iaoei?ioe c
iaeiaioei ?eceeii ?aiiaeo oneeaaeiaiue. Aei ae?oai? a?oie — iia?aoei?
c i?eaiaeo aaeeeeo oa aiaaionueeeo iineyiia?aoeieieo oa aaio?aeueieo
a?eae. Aei o?aouei? a?oie — aeiaaeee iaeaieueoiai ?eceeo ?aiiaeo
oneeaaeiaiue.

O 52 iaeaieueo aaaeeeo oai?eo canoiniaoaaee eiii”thoa?iee iiii
oi?eia ca ia?aaiaii ?aiiueiai iineyiia?aoeieiiai ia?iiaeo ca aeiiiiiaith
aaaaoiooieoeiiiaeueii? aenia?oii? i?ia?aie “Neaeueiaeue”. Iioi?iaoeith
i?i oai?eo aaiaeeee a eiii”thoa? i?ioyaii ia?oeo 3-5 aeia. O 46 oai?eo
aeaii eiii”thoa?ii? aenia?oece naiae/eee i?i ii?iaeueiee ia?aaia
iineyiia?aoeieiiai ia?iiaeo. O 6 oai?eo aaeaeiny i?ioyaii 1-2 aeia
iiney iia?aoei? anoaiiaeoe iaaii?iiy ?aie. Io?eiaii ?acoeueoaoe
aeicaieeee c?iaeoe aeniiaie, ui canoinoaaiiy eiii”thoa?ieo oaoiieiaie
aeicaiey? ia i?eioeeiiaeueii iiaiio, iaeneiaeueii c?o/iiio, i aei oiai
ae iaaioue aeey inia c iiiiiaeueieie iaaeeaie ?iaioe ia ia?niiaeueiiio
AII ?iaii, caeienieoe aaaaeaiiy nenoaiaoeciaaieo aeaieo i?i oai?eo,
oi/ii iienoaaoe i?aeoe/ii ani noaie, yei cono?i/athoueny a
iineyiia?aoeieiiio ia?iiaei, oeiaethth/e iaaioue iacia/ii aiaeoeeaiiy
aiae ii?iaeueiiai eiai ia?aaiao.

Eiii”thoa?iee aiaeic aaaaeaii? iioi?iaoei? aeeeth/a? iiaeeeainoue
iaaeiioeiiee iayaieo o oai?iai neiioiiia i neiae?iiia, a oaeiae onoaa?
aeaiaio noa’?eoea?cio aeiaaeeiainoi a ?o o?aeoiaoei.

Iia?aoeaia i eiina?aaoeaia eieoaaiiy oai?eo c iineyiia?aoeieieie
oneeaaeiaiiyie ?aiiaiai i?ioeano i?iaiaeeeiny a caeaaeiinoi aiae aeaeo
oneeaaeiaiiy, nooiaiy ae?aaeaiinoi aiieii-iae?ioe/ieo ciii a ?aii,
aeaeo iie?ioei?e (aaiaeueia, aiaa?iaia), noaio oai?iai. Aiaee?eoa
aaaeiiiy aiieieo ?ai ic a?aooaaiiyi oaciinoi i?ioeania caiaeaiiy i
?aaaia?aoei? i?iaiaeeee o 24 oai?eo. Iiaia caaithaaiiy ?aie aeinyaaeiny
i?ioyaii 18-20 aeia iiney ?ice?eooy aiieieea. I?e aiaee?eoiio eieoaaiiy
o oaci aiae?aoaoei? i iaeeaaeaiiy aoi?eiieo oaia o oaci ?aaaia?aoei? o
16 oai?eo no?ie eieoaaiiy nei?ioeany aei 14-16

aeia. Ia?aeiiee oia ?aie iiae i?ee?eooyi aeoeaii? anii?aoei?
canoiniaaii o 26 oai?eo. Iiaoi?ia iaaii?iiy niinoa?iaaeiny a 5
aeiaaeeao. A iioeo oai?eo no?ie eieoaaiiy nei?ioeany aei 10 aeia.

*anoeiaa aaaio?aoeiy o 22 oai?eo eieoaaeany eiina?aaoeaii ii
aiaee?eoiio i?eioeeio eieoaaiiy aiieieo ?ai c iaeeaaeaiiyi aoi?eiieo
oaia (o 16 oai?eo) ii ii?i aoouaiiy aiieiiai i?ioeano. Iiaia
aaaio?aoeiy ye anaioe/ia, oae i a aiieio ?aio, iiaeeyaaea iaia”yceiaie
aeno?aiiie iia?aoei?. Ooo eieoaaiiy cae/ii ii?aeioaaeiny c eieoaaiiyi
ia?eoiiioo i ia?aeioe/ii? eeoeiai? iai?ioiaeiinoi. Canoinoaaiiy iaoiaeia
iia?aoeie ii A.N.Naaaeue?ao i A.Ae.Naa/oeo, ii E.Ae.Oineiio i
A.A.AEaa?ianueeiio a aieueoinoi aeiaaeeia caaacia/o? aa?iaoecaoeith
/a?aaii? noiiee. Iiaoi?ia aaaio?aoeiy ianoaea eeoa o 1 oai?iai.

I?iaaaeaii aeineiaeaeaiiy aeicaieeee noi?ioethaaoe aeniiaee i
c?iaeoe i?aeoe/ii ?aeiiaiaeaoei?.

AENIIAEEAENIIAEE

1. Iaeaieueo iioi?iaoeaieie ?aiiiie neiioiiaie oneeaaeiaiue c
aieo iia?aoeieii? ?aie ? eeiii/ii i eaai?aoi?ii iciaee aiaeiaaiii?
iioieneeaoei?, oaei ye oaoiea?aeiy, aa?y/ea, ?ino NI (iiiaae 0,240
oi.iae.) i EII (iiiaae 1,2). Iiii?iee nooiiiue oieneeico
niinoa?iaa?oueny i?e iioieueo?aoi i na?iii (AeI= 174- 248 aaeia),
na?aaeiie nooiiiue oeeo iieacieeia i?e aaiaeueieo iaaii?iiyo i
/anoeiaie aaaio?aoei? (AeI= 409 -858 aaeia), aenieee i?e iiaiie
aaaio?aoei? oa aia??iaiie iioaeoei? ?ai (AeI= 1000 i aieueoa aaeia).

2. Oeueo?acaoeiaa aeineiaeaeaiiy ?ai (OCAe) aeicaiey? aaea ia
2-3 aeiao iiney iia?aoei? ioeiieoe noai ?aiiaiai eaiaeo, aicoaeicoaaoe
nooiiiue iaa?yeo oa iioieueo?aoei? oeaiei a ciii i oi/ii aecia/eoe
eieaeicaoeith ?iaeeie (aiiy, e?iai, na?iciiai o?ainnoaeaoo) a oa?ao
ia?aaeiuei? /a?aaii? noiiee. OCAe, yea i?iaiaeeeiny a aeeiaiioei,
aeiiiiiaa? ioeiieoe aoaeoeaiinoue i?ioieaeoeee i eieoaaiiy.

3. Aeiaaiinoeea aaaio?aoei?,yea yaey?oueny aeeiaii/ii
?icaeaath/einy i?ioeanii, iaeaieueo iiaii i nai?/anii caeienithaoueny
ca aeiiiiiaith ?ic?iaeaii? iaie iaoiaeeee OCAe, yea aeicaiey? aecia/eoe
ii/aoeiai noaaei? ii?ooaiiy aa?iaoe/iinoi /a?aaiiai,
i”yciai-aiiiaa?ioe/iiai oa?ia.

4. O oai?eo iiney iia?aoei? c i?eaiaeo caaaeueiiai ia?eoiiioo,
?aeo, ii?eoeue o?aaiiai o?aeoo oa iioeo iia?aoeie c iniaeeai aaeeeei
?eceeii aeieeiaiiy ?aiiaeo iineyiia?aoeieieo oneeaaeiaiue canoinoaaiiy
cai?iiiiiaaiiai iaie eiiieaeno i?ioieaeoe/ieo caoiaeia aeicaiey? ?icei
cieceoe iie?iaio eiioaiiiaoeith ?ai (aei 1,75 o10 2 — 2,5 o 10 2  a 1a
oeaieie),ni?eyth/e cieaeaiith noia?ii? eieueeinoi iioieueo?aoia,
iaaii?iue, na?ii, aaiaoii oa aaaio?aoeie aei 8,82 %.

5. Eiii”thoa?iee iiiioi?eia iiney iia?aoei? o oai?eo c
ia?eoiiioii oa iioeie oai?iaaie c iniaeeai aenieei ?eceeii ?aiiaeo
oneeaaeiaiue aeicaiey? ca aeiiiiiaith AII caeienieoe aenia?oiee aiaeic
nenoaiaoeciaaieo i iiaeaeaieo iaoaiaoe/iie ia?iaoei aeaieo i?i oai?iai,
oi/ii aeiaaiinooaaoe i?aeoe/ii ani o?eaiaeii aiaeoeeaiiy aiae
ii?iaeueiiai ia?aaiao iineyiia?aoeieiiai ia?iiaeo. I?e oeueiio
caiaeeoueny aei iiiiioio noa”?eoeaici a ioeiioei iayaieo o oai?iai
neiioiiia oa iciae ?icaeaath/eony ?aiiaeo oneeaaeiaiue.

6. Aeai? iaoiaeo eieoaaiiy iia?aoeieieo ?ai caeaaeeoue aiae oace
?aiiaiai i?ioeano, aeaeo oneeaaeiaiue, iayaiinoi aai aiaenooiinoi iioeo
oneeaaeiaiue, oa?aeoa?o iie?ioei?e oa caaaeueiiai noaio oai?eo.

A ia?oie noaaei? ?aiiaiai i?ioeano oaeaeeee eeiii/iee aoaeo
aeinyaa?oueny canoinoaaiiyi aioei?e?iaieo i?aia?ao?a ,iae?ie?oe/ieo ?
aeaa?ae?aooth/eo caniaia o ii?aeiaiii c oiciioa?aii?th. Iia?aoeaia
cae?eooy ?aie i?e iaaii?iiyo oa aaaio?aoeiyo iiaeiii ii?aeioaaoeny c
aeoeaiith anii?aoei?th oa aeiaaiinoe/ieie ioieoeiyie ?aiiaiai eaiaeo, c
OCAe eiio?ieai i oiciioa?aiaaoe/iei eieoaaiiyi.

7. ?aiiai oneeaaeiaiiy ianooue a niai ia?aaeoiiae caoai?thaaiue
?oaoey o aiaeaeaeaieo no?ieao iiney ia?aianaieo iia?aoeie. Eiaaoo?ii
ii?eoei ooai?ththoueny a na?aaeiueiio o 60,9% oai?eo, iineyiia?aoeieii
a?eaei — o 75%.

I?AEOE*II ?AEIIAIAeAOeI?. I?AEOE*II ?AEIIAIAeAOeI?.

1.Aeey iiaeaeuaiiy aoaeoeaiinoi ?aiiuei? aeiaaiinoeee oneeaaeiaiue
?aiiaiai i?ioeano ie ?aeiiaiaeo?ii aeei?enoaiiy ia oieueee
o?aaeeoeieiiai iaeyaeo ?aie, aea i aea/aiiy eeiiiei-eaai?aoi?ieo iciae
aiaeiaaiii? iioieneeaoei? i aeiaaiinoe/ieo ioieoeie ?aiiai? ii?iaeieie.

2. Ic aeiaeaoeiaeo iaoiaeia aeiaaiinoeee neiae aiaeaeaoe ia?aaaao
oaeei iaiiaaceaiei iaoiaeai, ye OCAe, yea aeicaiey? aaea ia 2-3-th
aeiao aecia/eoe nooiiiue iaa?yeo oa iioieueo?aoei? oeaiei, iaeiie/aiiy
?iaeeie a ?aiiaie ii?iaeieii (aiiy, eiioe, e?iai), a oaeiae ioeiieoe
aa?iaoe/iinoue /a?aaii? ii?iaeieie ia ?iaii /a?aaiiai,
i”yciai-aiiiaa?ioe/iiai oa?ia.

3. Aeey i?aeoe/iiai aeei?enoaiiy i?iaaaeaiiai iaie iaoaiaoe/iiai
aiaeico neiioiiia oa iciae oneeaaeiaiue iiaea canoiniaoaaoeny
aaaaoiooieoeiiiaeueia eiii”thoa?ia aenia?oia i?ia?aia ,yea ?ic?iaeaia
a E?einueeiio iaaee/iiio oiiaa?neoaoi.

4.O oai?eo c aenieei nooiaiai ?eceeo ?icaeoeo ?aiiaeo oneeaaeiaiue ie
?aeiiaiaeo?ii iiaoaiio ?aaeicaoeith eiiieaeno i?ioieaeoe/ieo caoiaeia.
Aei iia?aoei?: i?ioieaeoe/ia aaaaeaiiy aioeaiioeeia; naiaoeiy
iaoea?aoeie, eiaaoo?ieo ii?eoeue i ae?acie. Iio?aiia?aoeieii: a) aoaiia
aiaeiaaeoaaiiy anio oa?ia /a?aaii? noiiee oe?ieeie ia?eaaeie
na?aaoeaie, cii/aieie a ?ic/eii oei?aiiio; a) aiaenieaiiy a?oaeo
?oaoeia a ciii ieanoeee i?e ?aoeeaeeaieo iineyiia?aoeieieo a?eaeao —
ye iioaioeiaeueieo aiaieu “ae?iiath/i? iioaeoei?”; a) ciiio
iino?oiaioia i ?oeaae/ie iiney aiaenieaiiy ?oaoeia (i?e
iineyiia?aoeieieo a?eaeao) i iiney caeii/aiiy /a?aaiiii?iaeieiiiai
aoaio iia?aoei?;a) o aeiaaeeao aeiieanoeee aeei?enoaiiy iia?aoeaieo
iaoiaeee, yei aeeeth/athoue noeeaiiy o?ainnoaeaoo c iiaeoei?iei
aee?iaei oa?ii; ae) canoinoaaiiy oieueee a?aaeoeaieo oiaieo
iaoa?iaeia, oaeeo ye eaanai, iaeeii, ooi?ano; a) i?iieaaiiy ?aie
ia?aae caoeaaiiyi ic aeaeaeaiiei i?iieaii? ?iaeeie, caonoeia, ia?eaeia
oeaiei aeaeo?iaiaeninii. Iiney iia?aoei?: ae?aioaaiiy ?aiiai? ii?iaeieie
i?ioyaii 1-3 aeia c aeei?enoaiiyi ?icieo oaoii/ieo caniaia i ia?aoiaeii
a iiaeaeueoiio ia uiaeaiii ioieoei? ?aiiai? ii?iaeieie iiae eiio?ieai
OCAe.

5. *anoeiaa aaaio?aoeiy c iaaii?iiyi ?aie ca aiaenooiinoth
ia?eoiiioo iiaeiia eieoaaoeny eiina?aaoeaii ca i?eioeeiii aiaee?eoiai
eieoaaiiy aiieieo ?ai, c iiaeaeueoei iaeeaaeaiiyi aoi?eiieo oaia
iiney noeoaiiy aiieiiai i?ioeano. Iiaia aaaio?aoeiy ,ye anaioe/ia, oae
i a aiieio ?aio, iiaeeyaa? iaia”yceiaie aeno?aiie iia?aoei?. Ooo
eieoaaiiy iiaeiii ii?aeioaaoeny c no/aniei, iieieiiiiiaioiei
eieoaaiiyi ia?eoiiioo i ia?aeioe/ii? eeoeiai? iai?ioiaeiinoi.

NIENIE IIOAEIEIAAIEO ?IA?O.NIENIE IIOAEIEIAAIEO ?IA?O.

1.AEaa?ianeee A.A., Oineei E.Ae., Ai?ianeee N.I., Oaiaiao Ae. Niinia
aeoaieie ieanoeee iaoiaiai eaiaea aac auaeaeaiey a?uaeaaiai iaoea e
naiaiiiai eaiaoeea. // Eeei. Oe?o?aey.- 1995.- ?2.- N. 43-44.

2.Oaiaiao Ae., AEaa?ianeay A.A., Eeue/aiei O.I. Ineiaeiaiey ni noi?iiu
?aiu a?thoiie noaiee iinea aeooa?nei-aeiaeieiae/aneeo iia?aoeee e eo
i?ioeeaeoeea. // Aanoi. i?iaeai aeieiaee e iaaeeoeeiu. — 1997.- ?32.- N.
24-28.

3.Oaaeaeue Oaoee, Ai?ianeee N.I., Eeneyeia A.A., AEaa?ianeay A.A.,
Oaiaiao Ae. ?ieue oece/aneeo oaeoi?ia a i?ioeeaeoeea e ea/aiee
iineaiia?aoeeiiiuo ineiaeiaiee a oe?o?aee e aeiaeieiaee. // Aanoi.
Oeceioa?aiee e eo?i?oieiaee. — 1997.- ?1.- N. 39-41.

4.Oaiaiao Ae. Eiiieaeniia ea/aiea iaaiiaiee iinea oe?o?ae/aneeo e
aeooa?nei-aeiaeieiae/aneeo iia?aoeee. // Aanoi. Oeceioa?aiee e
eo?i?oieiaee. — 1998.- ?2. — N. 29-31.

5.AEaa?ianeee A.A. , Eeue/aiei O.I., Naeeaaiia A.E., Aaeiaeaeia A.N.,
Ai?iaoeiaa O.N., Eacaeiaa A.A., Eaaiia A.A., Ai?ianeee N.I., Eeneyeia
A.A., Eaoeia A.I., Eaieineee E.A., Aaoae O., AEaa?ianeay A.A., Oaiaiao
Ae., Aeue-Aee Iaeia, Oaaeaeue O., O?ieia A.A., Eocie/aiie A.A.,
Ooiaiyioe I.I. I?iaeaiu nia?aiaiiie aa?ieiieanoeee. // I?iaeaiu,
aeinoeaeaiey e ia?niaeoeau ?acaeoey iaaeeeiaeieiae/aneeo iaoe e
i?aeoe/aneiai cae?aaiio?aiaiey: Na. o?. EIE. — Neioa?iiieue,
1995.-O.131,- N. 209 — 215.

6.AEaa?ianeay A.A., Eacaeiaa A.A., Oaiaiao Ae. Noaiaiue yiaeiaaiiie
eioieneeaoeee eae iieacaoaeue iaee/ey eee ionoonoaey ineiaeiaiee iinea
eana?aaa na/aiey. // I?iaeaiu, aeinoeaeaiey e ia?niaeoeau ?acaeoey
iaaeeeiaeieiae/aneeo iaoe e i?aeoe/aneiai cae?aaiio?aiaiey: Na. o?. EIE.
— Neioa?iiieue, 1996.-O.132, /. 1 — N. 3-9.

7.Oaiaiao Ae. Eeeieea e ea/aiea iineaiia?aoeeiiiuo yaaio?aoeee. //
I?iaeaiu, aeinoeaeaiey e ia?niaeoeau ?acaeoey iaaeeeiaeieiae/aneeo iaoe
e i?aeoe/aneiai cae?aaiio?aiaiey: Na. o?. EIE. — Neioa?iiieue, 1996.
-O.132, /.2 — N. 18-24.

8.Eeue/aiei O.I., Ai?iaoeiaa O.N., Eaieineee E.A., Eacaeiaa A.A.,
Ai?ianeee N.I., Eeneyeia A.A., Aaoae Oaeaea?, Oaoee Oaaeaeue, Oaiaiao
Ae. Ineiaeiaiey ?aiaaiai i?ioeanna iinea iia?aoeee i?e a?uaeao aeeaioa.
// Iaaeaeoia?iaeiue oe?o?ae/aneee eiia?ann. ?aiu, iaeiae e iiaycee: Na.
O?oaeia. — Oaeue — Aaea, 1996.- N. 201.

9.Oaiaiao Ae., AEaa?ianeay A.A. Eniieueciaaiea oeaiaia aeey i?ioeeaeoeee
eioaeoeee a aeooa?nei-aeiaeieiae/aneie eeeieea. // Iaaeaeoia?iaeiue
oe?o?ae/aneee eiia?ann. ?aiu, iaeiae e iiaycee: Na. O?oaeia. — Oaeue —
Aaea, 1998.- N. 92.

10.AEaa?ianeay A.A., Oaiaiao Ae. ?aiiyy aaoiiaoece?iaaiiay aeeaaiinoeea
ia?eoiieoa iinea eana?aaa na/aiey. // Aii?inu eeeie/aneie iaaeeoeeiu:
Iaoa?eaeu iao/ii-i?aeoe/aneie eiioa?aioeee oe?o?aia, iinayu?iiie
100-eaoiaio thaeeath i?io. A.E. Caoa?iaa. Neioa?iiieue, 1997. — N.
79-81.

11.Eeue/aiei O.I., Ai?ianeee N.I., Ai?iaoeiaa O.N., Eeneyeia A.A.,
Eaieineee E.A., AEaa?ianeay A.A., Eacaeiaa A.A., Aeue-Aee Iaeia, Oaiaiao
Ae., Aaoae O. Iineaiia?aoeeiiiua ineiaeiaiey ni noi?iiu ?aiu i?e
ouaie?iiuo a?uaeao aeeaioa. // Aiieii-naioe/aneea ineiaeiaiey a
iaioeiaeiie oe?o?aee: Oacenu aeieeaaeia iao/ii-i?aeoe/aneie eiioa?aioeee
oe?o?aia Oe?aeiu 12-14 ai?aey 1995. — Oa?ueeia, 1995.- N. 263 — 265.

AIIOAOeIssAIIOAOeIss

Oaiaiao Ioae-Aeaeaiaeue Aaeaeii ?aiiai oneeaaeiaiiy iiney oi?o?ai/ieo
oa aeooa?nueei-aiiaeieiai/ieo iia?aoeie (i?ioieaeoeea,
eeiiiea,aeiaaiinoeea, eieoaaiiy).-?oeiien.

Aeena?oaoeiy ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe
ca niaoeiaeueiinoth 14.01.03- oi?o?aiy.- E?einueeee iaaee/iee
oiiaa?neoao ii.N.I.Aai?ai?anueeiai, i.Niioa?iiieue, 1998 ?ie.

Aeena?oaoeith i?enay/aii ieoaiiyi i?ioieaeoeee i eieoaaiiy ?aiiaeo
oneeaaeiaiue iiney oi?o?ai/ieo oa aeooa?nueei-aiiaeieiai/ieo
iia?aoeie. Eeiii/ii aeineiaeaeaiiy i?iaaaeaii o 299 oai?eo. A ?iaioi
?icaeaa?oueny iiaee iai?yiie o i?ioieaeoeoei i ?aiiie aeiaaiinoeoei
iaaii?iue, iioieueo?aoia, na?ii oa aaaio?aoeie, a iniiai yeiai
eaaeeoue eiiieaeniee iiaeoiae c aeei?enoaiiyi oaoii/ieo caniaia,
aioeaaeoa?iaeueii? oa?aii?, OCAe i eiii”thoa?iiai iiiioi?eiao. Aia?oa
aea/aii eeiii/iee ia?aaia ?aiiaeo iineyiia?aoeieieo oneeaaeiaiue ic
aecia/aiiyi iaoaiaoe/iei oeyoii iioi?iaoeaiinoi ie?aieo neiioiiia oa
iciae. Cai?iiiiiaaii iiaee niinia ?aiiuei? aeiaaiinoeee aeeaieeo
iiaeaiiiaa?ioe/ieo iaaii?iue oa aaaio?aoeie. Aeniea aoaeoeaiinoue

aeineiaeaeaiue ii i?ioieaeoeoei ?aiiaeo oneeaaeiaiue oa ?o ?aiiuei?
aeiaaiinoeee iiaeoaa?aeaeaia i?aeoe/ii. Iniiaii ?acoeueoaoe ?iaioe
ai?iaaaeaeaii a oi?o?ai/ieo oa aeooa?nueei-aiiaeieiai/ieo noaoeiiia?ao.

Eeth/iai neiaa:  iineyiia?aoeieii oneeaaeiaiiy, iioieueo?ao,
aeiaaiinoeea, iia?aoeiy, eiii”thoa?ia i?ia?aia.

AiiioaoeeyAiiioaoeey

Oaiaiao Ioae — Aeaeaiaeue Aaeaeei “?aiaaua ineiaeiaiey iinea
oe?o?ae/aneeo e aeoa?nei — aeiaeieiae/aneeo iia?aoeee (i?ioeeaeoeea,
eeeieea aeeaaiinoeea, ea/aiea).”

Aeenna?oaoeey ia nieneaiea o/?iie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe
ii niaoeeaeueiinoe 14.01.03. — oe?o?aey. E?uineee iaaeeoeeineee
oieaa?neoao ei. N.E. Aai?aeaaneiai, a. Neioa?ieieue, 1998a.

Aeenna?oaoeey iinayuaia aii?inai i?ioeeaeoeee e ea/aiey ?aiaauo
ineiaeiaiee iinea oe?o?ae/aneeo e aeooa?nei-aeiaeieiae/aneeo iia?aoeee.
Eeeie/aneea enneaaeiaaiey i?iaaaeaiu o 299 aieueiuo. A ?aaioa
?acaeaaaony iiaia iai?aaeaiea a i?ioeeaeoeea e ?aiiae aeeaaiinoeea
iaaiiaiee, eioeeueo?aoia, na?ii e yaaio?aoeee, a iniiaa eioi?iai eaaeeo
eiiieaeniue iiaeoiae n eniieueciaaieai oaoie/aneeo n?aaenoa,
aioeaaeoa?eaeueiie oa?aiee, OCE e eiiiuethoa?iiai iiieoi?eiaa. Aia?aua
eco/aii eeeie/aneia oa/aiea ?aiaauo iineaiia?aoeeiiiuo ineiaeiaiee n
ii?aaeaeaieai iaoaiaoe/aneei ioo?i eioi?iaoeaiinoe ioaeaeueiuo neiioiiia
e i?eciaeia. I?aaeeiaeai iiaue niinia ?aiiae OCE aeeaaiinoeee aeoaieeo
iiaeaiiiaa?ioe/aneeo iaaiiaiee e yaaio?aoeee. Aunieay yooaeoeaiinoue
enneaaeiaaiee ii i?ioeeaeoeea ?aiaauo ineiaeiaiee e eo ?aiiae
aeeaaiinoeea iiaeoaa?aeaeaia i?aeoe/anee. Iniiaiua ?acoeueoaou ?aaiou
aiaae?aiu a oe?o?ae/aneeo e aeooa?nei-aeiaeieiae/aneeo noaoeeiia?ao.

Eeth/aaua neiaa: iineaiia?aoeeiiiua ineiaeiaiey, eioeeueo?ao,
aeeaaiinoeea, iia?aoeey, eiiiuethoa?iay i?ia?aiia.

Summary.Summary.

Mhd -Jamal Eddin Hamameh “ The complications of wound after surgical and
obstetric-ginecologic operations ( prophilaxis, clinic, diagnostic,
treatment ). The candidate of medical sciences degree dissertation on a
speciality of 14.01.03-Surgery. Crimean state medical University named
after S.I. Georgievsky, Simferopol, 1998.

Dissertation is held questions of prophilaxis and treatment wound
complications after surgical and obstetric-ginecologic operations.
Clinical investigations was held on 299 patients. In work was developed
new ways in prophilaxis and early diagnostics of supurations infiltrates
of wound and eventration. In base of this way lies complex analysis with
technical investigations, antibacterial therapy, ultrasound examination
and computer analysis programm. In first was studied clinical flow of
wound postoperative complications with estimation by mathematic way
information prise of some symptoms and signs.Was proposed new method of
early ultrasound diagnostics of deep subaponeurotic supurations and
eventrations.Hay effisiensy of investigations on prophilaxis of wound
complications and its early diagnostics was prouved in practics. The
main results of works was used in surgical and obstetric-gynecologic
clinics.

Key words: postoperative complications, infiltrates, diagnostics,
operation, computer programm.

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