Шляхи оптимізації лікування хворих з гострою хірургічною патологією органів черевної порожнини, ускладненої розлитим перитонітом: Автореф. дис… канд

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

EiCaiei ETHAeIEEA AAEAIOEI?aia

OAeE 616.381-002-031.81-07-089-085.37

OEssOE IIOEI?CAOe?? E?EOAAIIss OAI?EO C AINO?ITH O??O?A?*IITH
IAOIEIA??TH I?AAI?A *A?AAII? II?IAEIEIE, ONEEAAeIAII? ?ICEEOEI
IA?EOII?OII

14.01.03 — o??o?a?y

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy

iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe

Aei?i?iiao?ianuee, 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Aei?i?iiao?ianuee?e aea?aeaai?e iaaee/i?e aeaaeai??
IIC Oe?a?ie.

Iaoeiaee ea??aiee:aeieoi? iaaee/ieo iaoe, i?ioani?, Caneoaeaiee ae?y/
iaoee ? oaoi?ee Oe?a?ie Aiiaea?aiei Ieeiea Iaoa?eiae/,
Aei?i?iiao?ianueea aea?aeaaia iaaee/ia aeaaeai?y, caa?aeoth/ee
eaoaae?ith o??o?a?/ieo oai?ia.

Io?oe?ei? iiiiaioe: aeieoi? iaaee/ieo iaoe, i?ioani? ss?aoei Aieiaeeie?
A?eai?iae/, Caii??cueeee aea?aeaaiee ?inoeooo oaeineiiaeaiiy e?ea??a,
caa?aeoth/ee eaoaae?ith o??o?a?? ? 2.

aeieoi? iaaee/ieo iaoe, Eao?aao aea?aeaaii? i?ai?? Oe?a?ie, i?ioani?
Aeanyoa?ee Aieiaeeie? ?aaiiae/, Aei?i?iiao?ianueea aea?aeaaia iaaee/ia
aeaaeai?y, caa?aeoth/ee eaoaae?ith o??o?a??, o?aaiaoieia?? ? i?oiiaae??
OII.

I?ia?aeia onoaiiaa: ?inoeooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a??
AII Oe?a?ie, a?aeae?e o??o?a?? ia/?ie? oa ii?oaeueii? a?ia?oaic??, i.
Ee?a.

Caoeno a?aeaoaeaoueny «12» aeiaoiy 1999?. i 13 aiaeei?, aoaeeo. ?9 ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae08.601.01 o
Aei?i?iiao?ianuee?e aea?aeaai?e iaaee/i?e aeaaeai?? ca aae?anith:
320044, i.Aei?i?iiao?ianuee, aoe.Aeca?aeeinueeiai, 9.

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? AeAeIA ca aae?anith:
i.Aei?i?iiao?ianuee, aoe.Aeca?aeeinueeiai, 9. .

Aaoi?aoa?ao ?ic?neaiee «10» aa?aniy 1999?.

A/aiee nae?aoa?

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

aeioeaioOea/aiei A.I.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. A iei?oi?e /an aeinyaioo? cia/i? oni?oe a
ae?aaiinoeoe? oa eiiieaeniiio e?eoaaii? aino?i? o??o?a?/ii? iaoieia??
i?aai?a /a?aaii? ii?iaeieie. Iaeiae, oyaee?noue ia?aa?ao aino?i?
o??o?a?/ii? iaoieia??, aeniea eaoaeuei?noue iiyniththoue oa, ui aeaia
i?iaeaia iino?eii ciaoiaeeoueny a oeaio?? oaaae o??o?a?a, ye? iaaeathoue
iaa?aeeeaaeio aeiiiiiao (I.?. Eoc?i, 1996; I.A. A?eueoeaithe, 1996; I.?.
Ai?ae?e/oe, 1996; A.I. Aeai?aeia oa ni?aaao.,1996).

A?aeiii, ui ia?aa?a oa iane?aeie aino?eo caiaeueieo caoai?thaaiue
i?aai?a /a?aaii? ii?iaeieie aaaaoi a /iio caeaaeeoue a?ae ?ioiieia?/ii?
?aaeoeaiino? i?aai?cio. I?e aaeaeaaoiiio noai? ?ioiieo oaeoi??a caoenoo
caoai?thaaiiy iaaoaa? ni?eyoeeaiai ia?aa?ao, a i?e cieaeaii? aai
niioai?aii? ?ioiieo ?aaeoe?e ia?inoa? iaaaciaea aaia?ae?caoe??
caiaeueiiai i?ioeano, aeieeiaiiy naioe/ieo oneeaaeiaiue oa nia?o? oai?eo
(I.I. Ni?oeei oa ni?aaao., 1996; A.A. Oi?, A.A. A?euaiei, 1993; A.?.
Eiaaeue/oe ? ni?aaao., 1991).

O?aaeeoe?eiee eiiieaen e?eoaaeueieo caoiae?a, yeee aeeth/a?
aioeaaeoa??aeueio oa?ai?th, ia iniia? aeei?enoaiiy aioea?ioee?a oe?ieiai
? iaaeoe?ieiai niaeo?o ae??, aeaeaei ia caaaeaee i?eaiaeeoue aei
aaaeaieo ?acoeueoao?a. Oiio oaeineiiaeaiiy e?eoaaeueii? aeiiiiiae oai?ei
c aino?ith o??o?a?/iith iaoieia??th ? iaea?eueo aeooaeueiith i?iaeaiith.
I?eioeeiiai aaaeeeaei ? aeine?aeaeaiiy oa ?aoe?iiaeueia aeei?enoaiiy
iiaeo, a?eueo aoaeoeaieo cania?a i?noeaai? oa caaaeueii? ae??,
iai?aaeaieo ia i?aeaeuaiiy ?ioiiiai caoenoo i?aai?cio oa aeoeaaoe?th
?aia?aoeaieo i?ioean?a.

A inoaii? ?iee iniaeeaa oaaaa i?eae?ey?oueny i?aia?aoai, ye? caeaoi?
aieeaaoe ia ?ioii?aaoeyoe?ei? i?ioeane, cie?aia, oeeoie?iai.

Iaeiae, oe?ieiio ai?iaaaeaeaiith a i?aeoeeo ia?aoeiaeaeo?, ia?o ca ana,
aei?iaiaecia eiia?oe?eieo ?aeiia?iaioieo oeeoie?i?a. E??i oiai,
neioaoe/i? oeeoie?ie iathoue ae?aaeai? iia?/i? ae??.

Aiae?c no/anieo ioae?eaoe?e iieacaa, ui a inoaii?e /an ?ic?iaeythoueny
iia? i?aeoiaee aei oeeoie?iioa?ai?? – aooioeeoie?iioa?ai?y, nooue yei?
iieyaa? a aeoeaaoe?? aioo??oieo ?aaoeyoe?eieo ?aca?a?a i?e?iaeieo
?ioiieiiiaoaioieo ee?oei (E.A. Eiaaeue/oe ? ni?aaao., 1996; A.A. Iia?eia
? ni?aaao., 1995; A. ?aoooaon ? ni?aaao., 1996). ?ioi?iaoe?? i?i aeaiee
i?aeo?ae aei ?ioiioa?ai?? oai?eo c aino?ith o??o?a?/iith iaoieia??th ie
ia ciaeoee.

Iaoeiai-i?aeoe/ia ae??oaiiy oe??? i?iaeaie aena?oeaii a cai?iiiiiaai?e
?iaio?.

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

Aeena?oaoe?y aeeiiaia o a?aeiia?aeiino? c ieaiii iaoeiai-aeine?aeieo
?ia?o Oe?a?inueeiai IAe? aano?iaioa?ieia?? ? ? o?aaiaioii
aeine?aeaeaiue, ye? aeeiioaaeenue ai?iaeiaae inoaii?o 5 ?ie?a o
a?aeae?eaii? o??o?a?? i?aai?a o?aaeaiiy ca oaiaoeeith: «?ic?iaea iiai?
iaaee/ii? oaoiieia??, i?io?eaeoeee, ?aiiuei? ae?aaiinoeee ? ??cieo
aa??aio?a ?aaa?e?oaoe?eiiai e?eoaaiiy ii?ooaiue o?aaeaiiy i?ney
iia?aoe?e ia oeoieo ? iicaia/?ieiaeo aeia/ieo i?ioieao», oeo? oaie
IE.91.81. ? aea?ae?a?no?aoe?? OA 01001749.

Iaoa ? caaea/? aeine?aeaeaiiy. I?aeaeueoe aoaeoeai?noue o??o?a?/iiai
e?eoaaiiy oai?eo c aino?ith o??o?a?/iith iaoieia??th i?aai?a /a?aaii?
ii?iaeieie, oneeaaeiaiith ?iceeoei ia?eoii?oii, oeyoii aeyaeaiiy oa
ei?aeoe?? ee?i?/ii cia/eieo ii?ooaiue ?ioiiiai noaoono.

Aeey aeinyaiaiiy oe??? iaoe iinoaaeai? oae? caaea/?:

1. Ioe?ieoe ?ioiiee noaoon o oai?eo c aino?ith o??o?a?/iith iaoieia??th
i?aai?a /a?aaii? ii?iaeieie aei iia?aoe?? ? a ?aiiueiio
i?neyiia?aoe?eiiio ia??iae? (1-10 ae?a).

2. Aea/eoe aca?iica’ycie i?ae oa?aeoa?ii ee?i?/iiai i?iyaeaiiy
caoai?thaaiiy oa aa??aioaie ii?ooaiue ?ioiiiai noaoono, iniaeeainoyie
oi?ioaaiiy ianiaoeeo?/ii? ?acenoaioiino? i?aai?cio, ? ia ?o iniia?
?ic?iaeoe e?eoa??? i?iaiico ia?aa?ao ?aiiueiai i?neyiia?aoe?eiiai
ia??iaeo.

3. ?ic?iaeoe niin?a ?ioiii?io?eaeoeee oa ?ioiiei?aeoe?? ai?eii-naioe/ieo
oneeaaeiaiue c aieo i?aai?a /a?aaii? ii?iaeieie.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a

Aia?oa o oai?eo c aino?ith o??o?a?/iith iaoieia??th i?aai?a /a?aaii?
ii?iaeieie aeyaeai? ii?ooaiiy ?aaoeyoe?eieo iaoai?ci?a ?ioi?oaoo,
cie?aia, ii?ooaiiy iaae?aoi?ii? ooieoe?? ?ioiieiiiaoaioieo ee?oei.
Anoaiiaeaii, ui ae?aaeai?noue ii?ooaiue ?ioii?aaoeyoe?? ei?aao? c
oyaee?noth iaoieia?/iiai i?ioeano, ui na?ae/eoue i?i iaoiaaiaoe/io
cia/ei?noue aeyaeaieo a?aeoeeaiue.

Iieacaii, ui cia/ia cieaeaiiy o e?ia? aieiaieo iieaciee?a O-nenoaie
?ioi?oaoo, aeecaaeain ?aaoeyoe?eieo noaiiioeyoe?e O-e?ioioeeo?a, ?o
iaae?aoi?ii? ooieoe??, ? iani?eyoeeaeie ee?i?ei-ae?aaiinoe/ieie ?
i?iaiinoe/ieie iieacieeaie, ye? noai?ththoue iiaeeeaino? aeey ?icaeoeo
ai?eii-naioe/ieo oneeaaeiaiue o ?aiiueiio i?neyiia?aoe?eiiio ia??iae?.

Aia?oa aeyaeai? aa??aioe ci?ie ooieoe?iiaeueiiai noaio ?ioiii? nenoaie,
oa?aeoa?i? aeey aino?i? o??o?a?/ii? iaoieia?? i?aai?a /a?aaii?
ii?iaeieie, iieacaia ?o caeaaei?noue a?ae noaio eiiiainaoe?eieo
iiaeeeainoae i?aai?cio, ye? iaoiiaeththoue oyaee?noue iaoieia?/iiai
i?ioeano, ui aeicaiey? i?iaiaeeoe ?iaeea?aeoaeueio ioe?ieo ?ioiiiai
noaoono eiaeiiai oai?iai.

Aeiaaaeaii iiaeeea?noue aeei?enoaiiy ie?aieo iieaciee?a ?ioi?oaoo ye
ia’?eoeaiiai e?eoa??th oyaeeino? ia?aa?ao aino?i? o??o?a?/ii? iaoieia??
i?aai?a /a?aaii? ii?iaeieie, oneeaaeiaii? ia?eoii?oii, a oaeiae iieacaii
aaaeeeao ?ieue ?o a i?iaiicoaaii? ia?aa?ao ?aiiueiai i?neyiia?aoe?eiiai
ia??iaeo.

Canoinoaaiiy aaaaoioaeoi?iiai aiae?co io?eiaieo aeaieo aeaei
iiaeeea?noue iaea?aeaoe iiao ?ioi?iaoe?th i?i iaoiaaiaoe/i? iaoai?cie
aeyaeaieo ii?ooaiue: ia?o ca ana, ?icaaeainiaai?noue i?ae aoaeoi?iei ?
?aaoeyoe?eiei oaeoi?aie ?ioi?oaoo eaaeeoue a iniia? iaoai?cio ia?aoiaeo
eiiiainiaaieo aa??aio?a ii?ooaiue ?ioiiiai noaoono a aeaeiiiainiaai? ?
na?ae/eoue i?i iaiao?aeio oaeei oai?ei ?ioiiei?aeoe?th.

?ic?iaeaii iiaee iaoiae ?ioiiei?aeoe?? o oai?eo c aino?ith o??o?a?/iith
iaoieia??th i?aai?a /a?aaii? ii?iaeieie, oneeaaeiaiith ia?eoii?oii, —
aooioeeoie?iioa?ai?y. Oaeineiiaeaii niiniae aaaaeaiiy aooioeeoie?i?a
aaciina?aaeiuei a ina?aaeie o?aaeaiiy. Iieacaia aeniea aoaeoeai?noue ?
aacia/i?noue iaoiaeo.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a

1. Iieacaii iaiao?aei?noue eiiieaeniiai ?ioiieia?/iiai ianoaaeaiiy
oai?eo c aino?ith o??o?a?/iith iaoieia??th aeey aeyaeaiiy ii?ooaiue
?ioi?oaoo.

2. ?ic?iaeaii ? cai?iiiiiaaii aeey aeei?enoaiiy a i?aeoeoe? ioi?iie
caei?ia’y niin?a aecia/aiiy oyaeeino? aino?iai ?iceeoiai ia?eoii?oo oa
i?iaiicoaaiiy eiai ia?aa?ao o i?neyiia?aoe?eiiio ia??iae? (iiceoeaia
??oaiiy ia aeaea/o iaoaioo ? 97115655 a?ae 12.10.1998).

3. Cai?iiiiiaaii e?eoa??? i?iaiico a??ia?aeiino? aeieeiaiiy oneeaaeiaiue
ai?eii-naioe/iiai oa?aeoa?o a ?aiiueiio i?neyiia?aoe?eiiio ia??iae?. Aei
iaea?eueo ni?eyoeeaeo iciae a?aeianaii: caa?aaeaiiy ia i?ioyc? 3-o ae?a
i?ney iia?aoe?? aeeaiei? O-e?ioiiai??, cieaeaiiy e?eueeino? O-oaeia?ii?
? O-noi?ani?ii? noaiiioeyoe?e, A-e?ioiiai?th, i?eai?/aiiy iaae?aoi?ii?
aeoeaiino? e?ioioeeo?a.

4. Cai?iiiiiaaii iaoiae ?iaeea?aeoaeueii? ioe?iee ?ioiiiai noaoono c
aeae?eaiiyi 5 aa??aio?a aeecaaeaino aoaeoi?iiai oa ?aaoeyoi?iiai
iaoai?ci?a ?ioi?oaoo.

5. ?ic?iaeaii ? ai?iaaaeaeaii a ee?i?eo iaoiae aooioeeoie?iioa?ai?? o
oai?eo c aino?ith o??o?a?/iith iaoieia??th (iaoaio ? 17733).

6. Oaeineiiaeaii iaoiae aaaaeaiiy aooioeeoie?i?a (iaoaio ? 21140,
?aoe?iiae?caoi?nueea i?iiiceoe?y ?36).

Aeai? aeena?oaoe?eii? ?iaioe ai?iaaaeaeai? a i?aeoeeo o??o?a?/ieo
a?aeae?eaiue i. Aei?i?iiao?ianueea ? Aei?i?iiao?ianueei? iaeano?
(Ee?i?/ia ia’?aeiaiiy oaeaeei? iaaee/ii? aeiiiiiae, aeoe ai?iaaaeaeaiiy
?? 17, 20, 21, 24 a?ae 1998 ?.), a?aeae?eaiue oa eaai?aoi??e Oe?IAe?
aano?iaioa?ieia?? (aeoe ai?iaaaeaeaiiy ?? 5, 6, 7 a?ae 1999 ?.).
Iaea?aeai? ?acoeueoaoe aeei?enoiaothoueny a i?ia?aiao eaeoe?eieo eo?n?a
? i?aeoe/ieo caiyoue Aei?i?iiao?ianueei? aea?aeaaii? iaaee/ii?
aeaaeai??.

Iniaenoee aianie caeiaoaa/a

I?aaenoaaeai? a ?iaio? iaoa??aee ? iniaenoei aeeaaeii aaoi?a a i?iaeaio.
I?ae ea??aieoeoaii iaoeiaiai ea??aieea — caa?aeoth/iai eaoaae?ith
o??o?a?/ieo oai?ia Aei?i?iiao?ianueei? aea?aeaaii? iaaee/ii? aeaaeai??,
aeieoi?a iaaee/ieo iaoe, i?ioani?a I.I. Aiiaea?aiea aecia/ai? iai?yiee
aeine?aeaeaiue, noi?ioeueiaai? iaoa ? caaaeaiiy ?iaioe.
Iaoaioii-?ioi?iaoe?eiee iiooe, iaeyae e?oa?aoo?e, iaa?? oa ia?iaea
oaeoe/iiai iaoa??aeo, ee?i?/i? ianoaaeaiiy, ?iciiae?e oai?eo ia a?oie,
aeeiiaiiy iia?aoeaieo ao?o/aiue, oai?aoe/ia ocaaaeueiaiiy iaea?aeaieo
?acoeueoao?a ? i?aeoe/ia canoinoaaiiy io?eiaieo iieiaeaiue,
oi?ioethaaiiy aeniiae?a ? i?aeoe/ieo ?aeiiaiaeaoe?e, noaoenoe/ia ia?iaea
iaoa??aeo aeeiiai? aaoi?ii naiino?eii. ?ioiieia?/i? aeine?aeaeaiiy
aeeiiai? ia aac? eaai?aoi??? i?e?ia?ieia?? oa ?ioiieia?? Oe?a?inueeiai
IAe? aano?iaioa?ieia?? (caa?aeoth/a eaai?aoi???th — aieiaiee iaoeiaee
ni?a?ia?oiee, aeieoi? iaaee/ieo iaoe Oaioiieiaa O.I.). ?acoeueoaoe
ee?i?/ieo aeine?aeaeaiue aeeeaaeaii a 9 ae?oeiaaieo ioae?eaoe?yo,
i?aaenoaaeaii a aeiiia?aeyo ia eiia?anao oa eiioa?aioe?yo. A ni?eueieo
ae?oeiaaieo i?aoeyo aaoi?o iaeaaeeoue iiiaae 85% ?aeae oa ?ic?iaie.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??

Iaoa??aee aeena?oaoe?? aoee iia?aeiieai?, iaaiai?ai? oa noaaeai? ia
Ia?oiio Oe?a?inueeiio eiia?an? aano?iaioa?ieia?a (Aei?i?iiao?ianuee,
1995); Ae?oaiio eiia?an? o??o?a?a Oe?a?ie (Aeiiaoeuee, 1998),
iaoeiai-i?aeoe/ieo eiioa?aioe?yo (Aei?i?iiao?ianuee 1991, 1995, 1996;
E??aee ??a 1990, 1998; Oa?e?a 1995, 1998; Iaeana 1996; A?iieoey 1998);
can?aeaii? Aei?i?iiao?ianueeiai iaeaniiai oiaa?enoaa o??o?a?a
(1998-1999), can?aeaiiyo a/aii? ?aaee Aei?i?iiao?ianueei? aea?aeaaii?
iaaee/ii? aeaaeai?? (1998).

Ioae?eaoe??

Ca iaoa??aeaie aeena?oaoe?? aaoi?ii iioae?eiaaii 14 iaoeiaeo noaoae. C
ieo 1 naiino?eia o oaoiaiio aeaeaii?, 3 o ni?aaaoi?noa? o oaoiaeo
aeaeaiiyo, 10 a ca??ieeao iaoeiaeo i?aoeue, a iaoa??aeao ? oacao
eiioa?aioe?e. Io?eiaii Iaoaio ? 17733A (Oe?a?ia) ia aeiao?ae «Niin?a
i?io?eaeoeee oa e?eoaaiiy i?neyiia?aoe?eieo ai?eii-caiaethaaeueieo
oneeaaeiaiue»; Iaoaio ? 21140A (Oe?a?ia) ia aeiao?ae «Niin?a e?eoaaiiy
aino?iai ?iceeoiai ia?eoii?oo»; ??oaiiy ia aeaea/o iaoaioo ia aeiao?ae ?
97115655 (Oe?a?ia) «Niin?a aecia/aiiy oyaeeino? aino?iai ?iceeoiai
ia?eoii?oo oa i?iaiicoaaiiy eiai ia?aa?ao o i?neyiia?aoe?eiiio
ia??iae?».

Ianya oa no?oeoo?a ?iaioe

?iaioa aeeeaaeaia ia 136 noi??ieao iaoeiiieniiai oaenoo ? neeaaea?oueny
c? anooio, iaeyaeo e?oa?aoo?e, 4 ?icae?e?a ?acoeueoao?a aeanieo
aeine?aeaeaiue, aiae?co ? ocaaaeueiaiiy, aeniiae?a, i?aeoe/ieo
?aeiiaiaeaoe?e oa nieneo aeei?enoaii? e?oa?aoo?e, yeee i?noeoue 257
e?oa?aoo?ieo aeaea?ae (208 a?o/eciyieo oa 49 caei?aeiiieo). Aeena?oaoeey
?ethno?iaaia 3 ?enoieaie, 27 oaaeeoeyie, ye? caeiathoue noi??iie.

INIIAIA *ANOEIA ?IAIOE

Iaoa??aee oa iaoiaee. Niinoa?aaeaiiy i?iaiaeeeenue ca 105 oai?eie,
aini?oae?ciaaieie a ee?i?/ia ia?aeiaiiy oaeaeei? iaaee/ii? aeiiiiiae
i.Aei?i?iiao?ianueea ca ia??iae c 1992 ii 1998 ?iee. Na?aae ianoaaeaieo
oai?eo ia?oi?aoeaia ae?acea oeoiea niinoa??aaeanue o 31 oai?iai,
ia?oi?aoeaia ae?acea aeaaiaaeoeyoeiaei? eeoee — o 13, ia?oi?aoe?y
aeia/iiai i?oo?a — o 5, aeano?oeoeaiee aiaiaeeoeeo — o 13, i?i?aaiee
aanoean /a?aaii? ii?iaeieie — o 5, aino?a eeoeiaa iai?io?aei?noue — o
11, o?aaia i?aai?a /a?aaii? ii?iaeieie — o 13. E??i oiai, 14 iaoe??io?a
aoee i?ney iiaoi?iiai iia?aoe?eiiai ao?o/aiiy c i?eaiaeo ?aiiuei?
niaeeiai? eeoeiai? iai?io?aeiino? oa i?ia?anoth/iai ia?eoii?oo.
Aeeoociee ia?eoii?o noi?iaiaeaeoaaa aino?o o??o?a?/io iaoieia?th o 33
iaoe??io?a (31%). Ia?aaaaeii oea aoee oai?? c aeano?oeoeaiei
aiaiaeeoeeoii, ia?oi?aoeaiith ae?aceith oeoiea oa aeaaiaaeoeyoeiaei?
eeoee. O ?aooe oai?eo aeyaeaii ?iceeoee ia?eoii?o. C ieo 35 iaoe??io?a
(33%) iaae?eoee aei ee?i?ee a ?aaeoeai?e noaae?? ?iceeoiai ia?eoii?oo, a
37 (35%) — a oiene/i?e. Aiae?c eiioeiaaioo oai?eo ca a?eii na?ae/eoue,
ui 95% — iniae i?aoeacaeaoiiai a?eo. *ieia?ee neeaaeaee 84% oai?eo,
ae?iee — 16%.

Oai?? i?aeeyaaee eiiieaeniiio ianoaaeaiith, yea aeeth/aei ii?yae c
caaaeueiii?eeiyoeie iaoiaeaie ? niaoe?aeuei?, ni?yiiaai? ia aea/aiiy
ooieoe?iiaeueiiai noaio oeoieiai-eeoeiaiai o?aeoo: ?aioaaiia?ao?th,
o?a?iaano?iaeoiaeaiineii?th, eaia?ineii?th. ?ioiieia?/i? aeine?aeaeaiiy
aeeth/aee e?euee?nio ioe?ieo O-e?ioioeeo?a (aeA-?OE, A-?OE),
A-e?ioioeeo?a (AAN-?OE), oaeia?io (NAe4+) ? noi?ani?io (A45-?OE)
noaiiioeyoe?e O-e?ioioeeo?a, ??aaiue IgA, IgM oa IgG, Oe?E, INO-oano
(?.A. Iao?ia ? ni?aaao., 1992). Iaae?aoi?io ooieoe?th e?ioioeeo?a
aea/aii ca ?o cae?ai?noth ?aoeaiooaaoe ?ioa?eaee?i-1 (?E-1) oa
?ioa?eaee?i-2 (?E-2) a eoeueoo?? ee?oei ia?eoa??eii? e?ia? (E.A.
Eiaaeue/oe ? ni?aaao., 1986).

Aeey aecia/aiiy ?ie? ?ioiii? nenoaie a ia??iae ?aaa?e?oaoe?? a ?aiiueiio
i?neyiia?aoe?eiiio ia??iae? ?ioiiee noaoon aea/aii a aeeiai?oe?: ia
ia?oo aeiao i?ney iia?aoe?? — o 33 oai?eo, /a?ac 2-3 aeiae — o 42, /a?ac
5-7 ae?a — o 36 oai?eo. Anueiai i?iaaaeaii 113 aeine?aeaeaiue.

C iaoith iioei?caoe?? aeine?aeaeaiue ? aaoiiaoecaoe?? i?ioean?a ia?iaee
? aeieoiaiooaaiiy ?ioi?iaoe?? an? aeo?aei? aeai? ca eiaeiei oai?ei
aaiaeeeenue a nenoaio oi?aae?iiy aacaie aeaieo, caoaeiaaio ca
aeiiiiiaith ?ioaa?iaaiiai iaeaoa i?ia?ai Microsoft Works 4.0 ia
iniaenoiio eiiiuethoa?? IBM Pentium-133 i?ae ea?oaaiiyi iia?aoe?eii?
nenoaie MS-DOS 7.0 a na?aaeiaeu? Windows 95 OSR-2. Noaoenoe/ia ia?iaea
?acoeueoao?a aeine?aeaeaiue ? iiaoaeiaa iaoaiaoe/ii? iiaeae? i?ioean?a
aeeiiaia iaoiaeaie aa??aoe?eii? noaoenoeee, ?aae?ciaaieie noaiaea?oieie
iaeaoaie i?ia?ai noaoenoe/iiai aiae?co STADIA 4.0 e STATISTICA FOR
WINDOWS 5.0.

?acoeueoaoe aeanieo aeine?aeaeaiue.

I?iaaaeai? aei iia?aoe?? aeine?aeaeaiiy iieacaee, ui o ianoaaeaieo iaie
oai?eo aino?a o??o?a?/ia iaoieia?y i?aai?a /a?aaii? ii?iaeieie i?io?eaea
ia oii? aeeaieeo a?aeoeeaiue ?ioiiiai noaoono. Iaea?eueo oa?aeoa?ieie ?c
aeyaeaieo a?aeoeeaiue aoea e?ioiiai?y, iniaeeai O-e?ioiiai?y.
Ia?aeaeueii iaea i?noea aeoeaaoe?y aioeaaeoa??aeueiiai caoenoo, ui
i?iyaeyeinue eaeeioeeoicii ca ?aooiie ca?eueoaiiy ai?noo a e?ia?
iie?ii?oiiyaea?ieo iaeo?io?e?a, iaei/eiyaea?ieo oi?i ?o, aeoeaaoe??th
?aoeaioi?ii? ooieoe?? e?ioioeeo?a o a?aeiioaii? ?E-1 oa ?E-2, ui iiaea
na?ae/eoe i?i iai?oao ?aaoeyoe?eieo iaoai?ci?a ?ioi?oaoo. Ci?ia ?ioiiiai
aiiainoaco a iaio?e i??? caeaaeaea a?ae i?e/eiiiai oaeoi?o aino?i?
o??o?a?/ii? iaoieia??, a a a?eueo?e — a?ae nooiaiy ae?aaeaiino? oieiaiai
noaio, ?ioieneeaoe??, oyaeeino? oa iioe?aiiy noiooiueiai ia?eoii?oo o
ianoaaeaieo oai?eo. Iaea?eueo aeeaie? a?aeoeeaiiy aeyaeyeenue o oai?eo,
ye? iaae?eoee a oiene/i?e noaae?? ia?eoii?oo. O ieo niinoa??aaeenue
iciaee oyaeeiai aoi?eiiiai ?ioiiaeao?oeeoo: cia/ia cieaeaiiy O- ?
A-iiioeyoe?e e?ioioeeo?a, O-oaeia?ii? oa O-noi?ani?ii? noaiiioeyoe?e.
E?euee?niee aeao?oeeo ?aaoeyoe?eieo noaiiioeyoe?e O-e?ioioeeo?a
ii?aeioaaany c ineaaeaiiyi iaae?aoi?ii? ooieoe?? ?ioiieiiiaoaioieo
ee?oei, i?i ui na?ae/eoue ineaaeaiiy ?aoeaioi?ii? aeoeaiino? e?ioioeeo?a
o a?aeiioaii? ?E-1 ? ?E-2. Oiene/ia noaae?y ?iceeoiai ia?eoii?oo
oa?aeoa?ecoaaeanue iai?oaeai?noth ianiaoeeo?/ieo iaoai?ci?a
?acenoaioiino? i?aai?cio (oaaioeeoa?ii? nenoaie), ia?inoaiiyi ??aiy Oe?E
a ne?iaaooe? e?ia?, ui iiaeeeai ?icoe?ieoe ye c?ea eiiiainaoe?eieo
iiaeeeainoae i?aai?cio.

Aiae?c ?ioiieia?/ieo iieaciee?a o ?aiiueiio (1-10 ae?a)
i?neyiia?aoe?eiiio ia??iae? iieacaa, ui ia i?ioyc? ia?oeo o?ueio ae?a
i?ney iia?aoe?? caa??aaany ae?aaeaiee e?euee?niee aeao?oeeo e?ioioeeo?a,
a iniiaiiio O-oaeia?ii? noaiiioeyoe?? i?e aeoeaaoe?? ?o iaae?aoi?ii?
ooieoe?? oa ianiaoeeo?/ieo oaeoi??a caoenoo. Aei iyoi? aeiae i?ney
iia?aoe?? a?aei?/aii oaiaeaioe?th aei ii?iae?caoe?? aea/aieo iieaciee?a:
cieaeaiiy a e?ia? ??aiy oee?eoethth/eo iie?ii?oiiyaea?ieo eaeeioeeo?a,
?o iaei/eiyaea?ieo oi?i; c?inoaiiy ia?io oee?eoethth/eo e?ioioeeo?a O-
oa A-iiioeyoe?e; ii?iae?caoe?y ?aoeaioi?ii? ooieoe?? e?ioioeeo?a ii
a?aeiioaiith aei ?E-1. ?aoeaioi?ia aeoeai?noue e?ioioeeo?a ii
a?aeiioaiith aei ?E-2 caeeoaeanue i?aeaeuaiith, ui aeaco? ia aenieo
aeoeai?noue ?aaoeyoi?ieo noaiiioeyoe?e (O-oaeia??a).

C iaoith aeyaeaiiy iaea?eueo oa?aeoa?ieo a?aeoeeaiue, ye? ia?aaeothoue
?icaeoeo ai?eii-naioe/ieo oneeaaeiaiue, iaie i?iaaaeaii aiae?c aeeiai?ee
iaea?eueo cia/eieo ?ioiieia?/ieo iieaciee?a ia i?ioyc? ia?oeo 3-o ae?a
i?ney iia?aoe??. ? a?oio neeaee 24 oai?eo, ye? iaae?eoee aei noaoe?iia?o
a ?aaeoeaio noaae?th ia?eoii?oo, ?c ieo o 16 oai?eo ia?aa?a
i?neyiia?aoe?eiiai ia??iaeo aoa aeaaiiieo/iei, o 8 — oneeaaeiaiei. ??
a?oio neeaee 23 oai?eo , ye? iaae?eoee a oiene/i?e noaae?? ia?eoii?oo (o
7 ia?aa?a i?neyiia?aoe?eiiai ia??iaeo aoa aeaaiiieo/iei, o 16 —
oneeaaeiaiei). Anoaiiaeaii, ui ye i?iaiinoe/ii iani?eyoeea? ne?ae
o?aoiaoaaoe a?aeiinio oa aaniethoio O- ? A-e?ioiiai?th. Oae, /a?ac 3
aeiae i?ney iia?aoe?? o oai?eo ?? a?oie c oneeaaeiaiei ia?aa?aii
caoai?thaaiiy aaniethoia /enei (o109 ee/e) e?ioioeeo?a neeaaeaei 0,980,2
i?ioe 1,560,21 o oaeeo aea oai?eo c iaoneeaaeiaiei ia?aa?aii
caoai?thaaiiy, i?e ii?i? 1,80,09, ?<0,05. A?aei?/aeinue oaeiae cieaeaiiy ??aiy A-?OE - a?aeiia?aeii 0,120,02 i?ioe 0,290,11, i?e ii?i? 0,880,05, ?<0,001. Iaea?eueo oa?aeoa?iei e?eoa???i oneeaaeiaiiai ia?aa?ao i?neyiia?aoe?eiiai ia??iaeo aoei nooo?aa cieaeaiiy ia o?eueee O-oaeia?ii? noaiiioeyoe?? e?ioioeeo?a, a ? O-noi?ani?ii? - a?aeiia?aeii 0,080,04 i?ioe 0,150,05, i?e ii?i? 0,310,03, ?<0,05. Aeao?oeeo A-ee?oeiiiai ?ioi?oaoo oaeiae yaey?oueny i?iaiinoe/ii iani?eyoeeaei oaeoi?ii, ia?aaeoth/ei ?icaeoeo ai?eii-naioe/ieo oneeaaeiaiue. Oae, o oai?eo c oneeaaeiaiei ia?aa?aii caoai?thaaiiy ia o?aoth aeiao i?neyiia?aoe?eiiai ia??iaeo ??aaiue A-ee?oei (o109 ee/e) cieceany aei 0,070,02 i?ioe 0,410,10, ?<0,01, o oaeeo aea oai?eo c aeaaiiieo/iei ia?aa?aii i?neyiia?aoe?eiiai ia??iaeo. O oai?eo, ye? iaae?eoeeee a ?aaeoeai?e noaae?? ?iceeoiai ia?eoii?oo, aeaaiiieo/iiio ia?aa?ao ?aiiueiai i?neyiia?aoe?eiiai ia??iaeo ia?aaeoaaea aeoeaaoe?y A-ee?oeiiiai ?ioi?oaoo, ui i?iyaeyeinue ca?eueoaiiyi a?aeiiniiai /enea (%) A-ee?oei (25,23,2 i?ioe 17,31,0 a ii?i?, ?<0,05), ??aiy ?ioiiaeiaoe?i?a eeano A (a?aeiia?aeii 3,470,69 i?ioe 1,420,3, ?<0,05) ? I (a?aeiia?aeii 1,80,35 i?ioe 1,420,3, ?<0,05). ?icaeoeo oneeaaeiaiue, ye i?aaeei, ia?aaeoaaee iecuee? oeeo?e icia/aieo iieaciee?a. ?icaeoeo oneeaaeiaiue a ?aiiueiio i?neyiia?aoe?eiiio ia??iae? ia?aaeo? oaeiae ii?ooaiiy iaae?aoi?ii? ooieoe?? e?ioioeeo?a. Oae, eiee iaoneeaaeiaiee ia?aa?a ii?aeioaaany c aenieith ?aoeaioi?iith aeoeai?noth e?ioioeeo?a o a?aeiioaii? ?E-1 ? ?E-2, oi oneeaaeiaiee - c ineaaeaiiyi ?aoeaioi?ii? aeoeaiino?, iniaeeai o oai?eo a oiene/i?e noaae?? ?iceeoiai ia?eoii?oo: na?aaei? iieacieee (oi.iae.) ?aoeaioe?? aei 3-? aeiae cieaeoaaeenue o ieo a?eueoa i?ae a 2 ?ace o a?aeiioaii? aei ?E-1 (c 0,940,17 a ia?oo aeiao aei 0,440,12, ?<0,05) ? ?E-2 9a?aeiia?aeii c 1,680,21 aei 0,80,27, ?<0,05). I?iaaaeaiee iiaeeaeaiee noaoenoe/iee aiae?c iaea?aeaieo ?acoeueoao?a, iaoiaeii noaoenoe/ii caaaeaieo neiae?ii?a (A.A. ?aoeia ? ni?aaao., 1995) aeicaieea ?ic?iaeoe ? cai?iiiioaaoe niin?a aecia/aiiy oyaeeino? aino?iai ?iceeoiai ia?eoii?oo oa i?iaiicoaaiiy eiai ia?aa?ao o i?neyiia?aoe?eiiio ia??iae? (iiceoeaia ??oaiiy ia aeaea/o iaoaioa ? 97115655 a?ae 12.10.1997). Nooue niiniao iieyaa? a oiio, ui a i?ioean? iine?aeiaiiai aeene?ei?iaioiiai aiae?co iaea?aeaieo iieaciee?a aoei aeyaeaii iyoue ia?aiao??a, iaea?eueo cia/eieo aeey aeeoa?aioe?thaaiiy nooiaiy oyaeeino? noaio oai?iai. Aei ieo aoei a?aeianaii: caaaeueio e?euee?noue eaeeioeeo?a, iaei/eiyaea?ieo iaeo?io?e?a, e?ioioeeo?a, aaee/eie ?aoeaioe?? ?E-1 ? ?E-2. Cia/aiiy oeeo iieaciee?a aoei iaoaiaoe/ii ia?iaeaii ? ?ic?aoiaaii eeaneo?eaoe?ei? eiao?oe??ioe eiaeii? iciaee i?e ??ciiio nooiai? oyaeeino? caoai?thaaiiy. Aeey eiaeiiai iieacieea ?ic?aoiaoaaee aeene?ei?iaioi? ooieoe??, ii iaeneiaeueiiio ci?uaiith yeeo aecia/aee nooi?iue oyaeeino? caoai?thaaiiy, a ii aeeiai?oe? ci?uaiiy iaeneiaeueiiai cia/aiiy - i?iaiic ia?aa?ao caoai?thaaiiy. Aeaiee niin?a aoa aei?iaoaaiee ia 85 oai?eo c aino?ith o??o?a?/iith iaoieia??th ? aeicaieea i?iaiicoaaoe oyaee?noue ia?aa?ao ? aeo?ae caoai?thaaiiy c aenieei nooiaiai a??ia?aeiino? - 68,9%. A?aeiii, ui i?e cia/i?e aa??aaaeueiino? ?ioiieia?/ieo iieaciee?a o ii?i? oa i?e iaoieia??, ioe?ieoe ?ioiiee noaoon a eiaeiiio eiie?aoiiio aeiaaeeo aaaeei. A?aoiaoth/e oie oaeo, ui o ianoaaeaieo oai?eo ii?ooaiiy, aieiaiei /eiii, noinoaaeeny ?aaoeyoe?eiiai (O-oaeia?e ? O-noi?ani?e) e aoaeoi?iiai (A-e?ioioeeoe, oaaioeeoa?ia nenoaia) eaioetha?a ?ioi?oaoo, iaie aoei cai?iiiiiaaii iaoiae ?iaeea?aeoaeueii? ioe?iee ?ioiiiai noaoono ia iniia? o?aooaaiiy nooiaiy caaeainiaaiino? oeeo eaioetha?a. Aeae?eaii iyoue aa??aio?a ii?ooaiue ?ioiiiai noaoono. Ia?oee aa??aio oa?aeoa?ecoaaany aeoeaaoe??th aoaeoi?ieo eaioetha?a ?ioi?oaoo: ni?aa?aeiioaiiy ?aaoeyoe?eieo noaiiioeyoe?e O-e?ioioeeo?a aoei a ii?i?. ?iaeaen ni?aa?aeiioaiiy Oo/On aoa a iaaeao 1,8-4,0. Ae?oaee aa??aio oa?aeoa?ecoaaany aeoeaaoe??th aoaeoi?ieo eaioetha?a ?ioi?oaoo (A-ee?oei, oaaioeeoa?ii? nenoaie) ia oii? ?iaa?n?? ?aaoeyoe?eieo noaiiioeyoe?e O-ee?oei. ?iaeaen Oo/On aoa ieae/a 1,8. O?ao?e aa??aio oa?aeoa?ecoaaany aeoeaaoe??th aoaeoi?ieo eaioetha?a ia oii? nooo?aiai cieaeaiiy O-noi?ani??a. ?iaeaen oo/on aoa aeua 4,0. *aoaa?oee aa??aio oa?aeoa?ecoaaany i?eai?/aiiyi A-ee?oeiiiai ?ioi?oaoo ia oii? aeecaaeaino ?aaoeyoe?eieo noaiiioeyoe?e O-e?ioioeeo?a. Iyoee aa??aio oa?aeoa?ecoaaany cia/iei cieaeaiiyi e?eueeino? ? ooieoe?iiaeueii? aeoeaiino? A-e?ioioeeo?a, O-oaeia??a, O-noi?ani??a, ui ?icoe?ithaaeinue ye iciaee iiaoi?iiai ?ioiiaeao?oeeoo. I?iaaaeaiee ?iaeea?aeoaeueiee aiae?c ?ioiiiai noaoono iieacaa, ui i?aeoe/ii o an?o oai?eo (95,2%) aino?a o??o?a?/ia iaoieia?y i?io?ea? ia oii? aeecaaeaino ?aaoeyoe?eieo i?ioean?a ?ioi?oaoo, a o iieiaeie (51,4%) ianoaaeaieo nooo?a? ii?ooaiiy ?aaoeyoe?eieo iaoai?ci?a ii?aeioaaeenue c aeeaieei A-ee?oeiiei aeao?oeeoii. Anoaiiaeaii, ui /anoioa oa oa?aeoa? aeyaeaieo ii?ooaiue ciaoiaeeeenue a caeaaeiino? a?ae oyaeeino? aino?i? o??o?a?/ii? iaoieia??, iioe?aiiy ia?eoii?oo ? aecia/aee iniaeeaino? ia?aa?ao ?aiiueiai i?neyiia?aoe?eiiai ia??iaeo. Oae, 1 ? 2 aa??aioe ii?ooaiue ?ioiiiai noaoono c iii??ii ae?aaeaieie ii?ooaiiyie ?aaoeyoe?eieo i?ioean?a ia oii? aeoeaaoe?? aoaeoi?iiai eaioethaa ?ioi?oaoo aeyaeyeenue o iieiaeie (50,08,6%) ianoaaeaieo oai?eo c aeeoociei ia?eoii?oii, o 36,18,0% oai?eo, iinooieaoeo a ?aaeoeaio noaae?th ?iceeoiai ia?eoii?oo ? o?eueee o 5,73,9% - a oiene/i?e noaae?? ia?eoii?oo (?<0,001). A oie aea /an, iaea?eueo aeeaie? a?aeoeeaiiy ?ioiiiai noaoono ca oeiii iiaoi?iiai ?ioiiaeao?oeeoo (5 aa??aio ii?ooaiue) aeyaeyeenue iaeaea o iieiaeie ianoaaeaieo (48,68,5%), anooieaoeo a ?aaeoeaio noaae?th (22,26,9%, ?<0,05) ? a 4 ?ace /ano?oa, i?ae o oai?eo c aeeoociei ia?eoii?oii (11,85,5%, ?<0,05). Ne?ae a?aei?oeoe, ui aeao?oeeo A-ee?oeiiiai ?ioi?oaoo a aeaa ?ace /ano?oa aeyaeyany o oai?eo c ?iceeoei ia?eoii?oii (62,05,8%) a ii??aiyii? c oai?eie, o yeeo ia?eoii?o aoa aeeoociei (29,47,8%), ?<0,01. Oea iiaea aooe iaei??th c i?e/ei ?icaeoeo oyaeeeo ai?eii-naioe/ieo oneeaaeiaiue o ?aiiueiio i?neyiia?aoe?e-iiio ia??iae? o oai?eo c ?iceeoei ia?eoii?oii. Iaoneeaaeiaiee ia?aa?a ?aiiueiai i?neyiia?aoe?eiiai ia??iaeo o a?eueoino? aeiaaee?a (48,9%) ii?aeio?oueny c 1 ? 2 aa??aioaie ii?ooaiue ?ioiiiai noaoono. Aeieeiaiiy oneeaaeiaiue o aeaeyae? iaiaaeaiiai caiaeueiiai i?ioeano /ano?oa (61,4%) a?aeaoaaeinue ia oii? aeoeaaoe?? A-ee?oeiiiai ?ioi?oaoo ? iieaciee?a ianiaoeeo?/ii? ?acenoaioiino? i?aai?cio (1-2-3 aa??aioe). ?icaeoeo oyaeeeo ai?eii-naioe/i?o oneeaaeiaiue, ye i?aaeei (61,7%), ia?aaeoaaa 5 aa??aio ii?ooaiue. Oaeei /eiii, cai?iiiiiaaiee iaie iae?e nooiaiy ?icaaeainiaaiino? i?ae aoaeoi?iei oa ?aaoeyoi?iei eaioethaaie ?ioi?oaoo aeicaiey? i?iaiaeeoe ?iaeea?aeoaeueio ioe?ieo ?ioiiiai noaoono a eiaeiiio eiie?aoiiio aeiaaeeo ? i???iooaaoeny o aeai?? ?ioiiei?aaoth/i? oa?ai??. Oai??, ye? ciaoiaeeeeny i?ae iaaeyaeii, i?aeeyaaee eiiieaeniiio e?eoaaiith, yea aeeth/aei iia?aoeaia ao?o/aiiy, ni?yiiaaia ia onoiaiiy naioe/iiai ina?aaeea, naioaaiiy ? ae?aioaaiiy /a?aaii? ii?iaeieie, ei?aeoe?th ia?aiao??a aiiainoaco, i?iaaaeaiiy aeac?ioieneeaoe?eieo caoiae?a, ?aoe?iiaeueio aioeaaeoa??aeueio oa?ai?th. A?aoiaoth/e, ui ci?ie ?ioiiiai noaoono o a?eueoino? ianoaaeaieo oai?eo oa?aeoa?ecoaaeenue ii?ooaiiyi ?aaoeyoe?eieo iaoai?ci?a, iniaeeaa oaaaa i?eae?eyeanue ?ioiio?iiiei i?aia?aoai, ui ni?eyei nenoaiiiio aieeao ia ?aaoeyoe?ei? i?ioeane. Iiae?aieie aeanoeainoyie aieiae?thoue oeeoie?ie - iaae?aoi?e ?ioiii? nenoaie, ye? aa?ooue o/anoue o aaaaoueio o?c?ieia?/ieo ? iaoio?c?ieia?/ieo i?ioeanao, cie?aia, o ?icaeoeo oa caaa?oaii? caiaeueii? ?aaeoe??. Aea ?o aeei?enoaiiy c iaoith e?eoaaiiy iiaea i?eaanoe aei oneeaaeiaiue oiene/iiai aai aea?a?/iiai oa?aeoa?o, oiio iaie canoiniaoaaany iaoiae aooioeeoie?iioa?ai??, nooi?noue yeiai iieyaaea o noeioeyoe?? aiaeiaaiieo oeeoie?i?a, ?iaeoeoth/eo ?ioii?aaoeyoe?ei? iaoai?cie, ui i?ecaiaeeoue aei ?ioiiei?aeoe??. Ni?anoaaeaiiy aeeiai?ee ?ioiieia?/ieo iieaciee?a o ?aiiueiio i?neyiia?aoe?eiiio ia??iae? i?iaiaeeee o o?ueio a?oiao oai?eo: 1 a?oia (30 /ieia?e) iaea?aeoaaea noaiaea?oio oa?ai?th; 2 a?oia (19 /ieia?e) ia oii? o?aaeeoe?eieo e?eoaaeueieo caoiae?a io?eioaaea o?iae?i o aeic? 1,0 ia i?ioyc? 7-10 aei?a; 3 a?oia (24 /ieia?e), a ye?e, ie??i noaiaea?oiiai e?eoaaiiy, i?iaiaeeeanue aooioeeoie?iioa?ai?y. Aeine?aeaeaiiy iieacaee, ui ?aii?e i?neyiia?aoe?eiee ia??iae o oai?eo 1 a?oie i?ioiaeea ia oii? aeeaiei? ?ioiinoi?an??. Ia 5-10 aeiao i?ney iia?aoe?? nooo?ai (?<0,05) ca?eueooaaeanue eeoa aaniethoia e?euee?noue (o109 ee/e) A-?OE: c 0,200,01 a ia?oo aeiao i?ney iia?aoe?? aei 0,440,08 a ianooii? aei?. Aoea a?aenooiy aeeiai?ea ?ioiieia?/ieo iieaciee?a. O oai?eo, ye? iaea?aeoaaee o?iae?i, niinoa??aaeanue iiceoeaia aeeiai?ea ?yaeo ?ioiieia?/ieo iieaciee?a. Ia 5-7 aeiao nooo?ai c??n ia?i (o109 ee/e) aeA-?OE - a?aeiia?aeii c 0,280,06 aei 0,500,10, ?<0,05; NAe4-?OE - a?aeiia?aeii c 0,260,04 aei 0,460,07, ?<0,05. Ii?iae?coaaany ??aaiue ?gA e ?gI a ne?iaaooe? e?ia?. Aea ??aaiue O-e?ioioeeo?a, cie?aia, O-oaeia??a caeeoeany iecueeei. Caa??aaany aenieee ??aaiue Oe?E oa aeniea ?aoeaioi?ia aeoeai?noue e?ioioeeo?a ii a?aeiioaiith aei ?E-2. C 24 /ieia?e, ye? iaea?aeoaaee aooioeeoie?iioa?ai?th, o?noueii oai?ei aooioeeoie?ie aaiaeeeenue i?aeoe??ii a ae?eyieo i?neyiia?aoe?eii? ?aie a aeic? 100 iea/ie; aeanyoueii oai?ei canoiniaaii oaeineiiaeaiee iaie niin?a aaaaeaiiy aooioeeoie?i?a (Iaoaio ?211140), nooue yeiai i?noeoueny o ia?aaea?thoeiiiio aaaaeaii? aooioeeoie?i?a a aeic? 100 iea/ie a ia?oo aeiao i?ney iia?aoe?? ? aeae? /a?ac aeaiue aei ianoaiiy ee?i?/iiai aoaeoo; ainueie oai?ei aooioeeoie?ie aaiaeeeenue o?ainoia?e?eaeueii. Canoinoaaiiy aooioeeoie?i?a i?ecaiaeeei aei ii?iae?caoe?? iaeaea on?o aea/aieo iieaciee?a (?en.1, 2). A?aecia/aany iiceoeaiee ia?aa?a caiaeueiiai i?ioeano, o cayceo c /ei nei?i/oaaeanue o?eaae?noue i?neyiia?aoe?eiiai noaoe?iia?iiai e?eoaaiiy. Oaeei /eiii, cai?iiiiiaaiee iaie iaoiae aooioeeoie?iioa?ai?? ? aoaeoeaiei caniaii onoiaiiy i?neyiia?aoe?eii? ?ioiinoi?an??: a?i e?ea?aeo? aeenaaeain ?aaoeyoe?eieo noaiiioeyoe?e O-e?ioioeeo?a, aeoeao? aioeaaeoa??aeueiee caoeno ? a?aeaa?oa? ?icaeoie oneeaaeiaiue caaaeueiiai oa?aeoa?o o i?neyiia?aoe?eiiio ia??iae?. AENIIAEE 1. Aino?a o??o?a?/ia iaoieia?y i?aai?a /a?aaii? ii?iaeieie o ia?aaaaeii? a?eueoino? ianoaaeaieo (95,2%) i?io?ea? ia oii? aeeneii?ae?iaoe?? ?aaoeyoe?eieo iaoai?ci?a ?ioi?oaoo. Ae?aaeai?noue oa iai?aaeai?noue aeyaeaieo a?aeoeeaiue ei?aeth? c oyaee?noth noaio oai?iai, ui na?ae/eoue i?i aenieo ?ioi?iaoeai?noue aeey ee?i?ee aea/aieo iieaciee?a ? iaiao?aei?noue aeyaeaiiy aei iia?aoe?? oai?eo c ii?ooaiiyie ?ioii?aaoeyoe??. 2. Ci?ia ?ioiiiai noaoono o oai?eo c aino?ith o??o?a?/iith iaoieia??th ia? o?ce/iee oa?aeoa? ? caeaaeeoue a?ae nooiaiy ae?aaeaiino? caiaeaiiy oa ?ioieneeaoe??: i?ioyaii ia?oi? aeiae (?aaeoeaia noaae?y ia?eoii?oo) aeyaeai? a?aeoeeaiiy oa?aeoa?ecothoueny i?aeaeuaiiyi iai?oae ?aaoeyoe?eieo ?aaeoe?e, ae-oeaaoe??th aoaeoi?ieo ooieoe?e ?ioi?oaoo; ianooiia (oiene/ia noaae?y) - i?eai?/aiiyi ie?aieo eaioetha?a ?ioi?oaoo, a a oyaeeeo aeiaaeeao - ?icaeoeii iciae aoi?eiiiai ?ioiiaeao?oeeoo. 3. Ee?i?/iee ia?aa?a ?aiiueiai i?neyiia?aoe?eiiai ia??iaeo (1-10 ae?a) aecia/a?oueny oyaee?noth e iioe?aiiyi ia?eoii?oo, a oaeiae aeeaeiith i?neyiia?aoe?eii? ?ioiinoi?an??. Aeaaiiieo/iee ia?aa?a ?aiiueiai i?neyiia?aoe?eiiai ia??iaeo ii?aeio?oueny c iii??iith O-e?ioiiai??th, ciaioaiiyi e?eueeino? O-oaeia?ieo (NAe4+) ee?oei c i?aeoe/ii iaci?iiei /eneii O-noi?ani??a, aeoeaaoe??th iaae?aoi?ii? ooieoe?? e?ioioeeo?a, ianiaoeeo?/ieo oaeoi??a caoenoo c ii?iae?caoe??th aeyaeaieo a?aeoeeaiue ia 5-7 aeiao. ?icaeoie oneeaaeiaiiai ia?aa?ao i?ioiaeeoue ia oii? aeeaiei? O-e?ioiiai??; ciaioaiiy e?eueeino? ia o?eueee oaeia?ii?, a e noi?ani?ii? noaiiioeyoe?? O-ee?oei, ii?ooaiiy ?ioiieia?/ieo ooieoe?e O-e?ioioeeo?a; ineaaeaiiy iaae?aoi?ii? aeoeaiino? e?ioioeeo?a, cieaeaiiy ?aca?aieo iiaeeeainoae ianiaoeeo?/ieo oaeoi??a caoenoo. 4. *anoioa oa oa?aeoa? aeyaeaieo oneeaaeiaiue a ?aiiueiio i?neyiia?aoe?eiiio ia??iae? a a?eueoino? aeiaaee?a iaoiiaeai? noaiii ?ioiiiai noaoono a ia?o? 3 aeiae i?ney iia?aoe??. Iiya? oneeaaeiaiue a oi?i? iaiaaeaiiai caiaeueiiai i?ioeano iae/ano?oa ia?aaeo? aeoeaaoe?y A-ee?oeiiiai ?ioi?oaoo ? iieaciee?a ianiaoeeo?/ii? ?acenoaioiino? i?aai?cio, ?icaeoeo oyaeeeo ai?eii-naioe/ieo oneeaaeiaiue ia?aaeo? aeeaiea O-e?ioiiai?y, A-e?ioiiai?y, i?eai?/aiiy ooieoe?iiaeueii? aeoeaiino? O-e?ioioeeo?a. 5. ?ioiiee noaoon o a?eueoino? aeiaaee?a iaoiiaeaiee noaiii aioo??oi?o aca?ii-cayce?a i?ae ie?aieie ia?aiao?aie ?ioi?oaoo. Cie?aia, nooi?iue ae?aaeaiiy ?icaaeainiaaiino? aioo??oiueinenoaiieo cayce?a aecia/a? noai eiiiainaoe?eieo iiaeeeainoae ?ioi?oaoo, oyaee?noue ia?aa?ao caoai?thaaiiy, /anoioo oa oa?aeoa? oneeaaeiaiue a ?aiiueiio i?neyiia?aoe?eiiio ia??iae?. 6. Ia iniia? iae?eo caaeainiaaiino? i?ae aoaeoi?iei ? ?aaoeyoe?eiei eaioethaaie ?ioi?oaoo aeae?eaii 5 aa??aio?a ii?ooaiue ?ioiiiai noaoono, ui aeicaiey? i?iaiaeeoe ?iaeea?aeoaeueio ioe?ieo a eiaeiiio eiie?aoiiio aeiaaeeo ? iacia/eoe aaeaeaaoio ?ioiiei?eaoaaeueio oa?ai?th. 7. Iaoiae ?ioiiei?aeoe?? - aooioeeoie?iioa?ai?y, ni?yiiaaiee ia iia?e?caoe?th aiaeiaaiieo ?aaoeyoe?eieo oaeoi??a oai?iai, ? aacia/iei ? aenieiaoaeoeaiei caniaii i?io?eaeoeee i?neyiia?aoe?eii? ?ioiinoi?an?? ? aeicaiey? onoiooe ?icaeoie oyaeeeo oneeaaeiaiue a ?aiiueiio i?neyiia?aoe?eiiio ia??iae?. I?AEOE*I? ?AEIIAIAeAOe?? 1. Ae?aaiinoeea aino?i? o??o?a?/ii? iaoieia?? i?aai?a /a?aaii? ii?iaeieie, oneeaaeiaii? ?iceeoei ia?eoii?oii, ie??i o?aaeeoe?eieo ee?i?/ieo, eaai?aoi?ieo oa ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy, iiaeiia caniiaoaaoeny ia ?acoeueoaoao ?ioiieia?/ieo oano?a, eio?? aeicaieythoue iaea?eueo iiaii i?iaiaeeoe e?eoaaeuei? caoiaee. 2. Aeoeaaoe?y A-ee?oeiiiai eaioethaa ?ioi?oaoo oa iieaciee?a ianiaoeeo?/ii? ?acenoaioiino? i?aai?cio ? aeinoia??iei oaeoi?ii, ia?aaeoth/ei ?icaeoeo o ?aiiueiio i?neyiia?aoe?eiiio ia??iae? oneeaaeiaiue o aeaeyae? iaiaaeaiiai caiaeueiiai i?ioeano, ui aeaco? ia iaiao?aei?noue i?iaaaeaiiy a?aeiia?aeii? ?ioiiei?eaoaaeue-ii? oa?ai??. 3. Aeeaiea O- ? A-ee?oeiia e?ioiiai?y, i?eai?/aiiy ooieoe?iiaeueii? aeoeaiino? O-e?ioioeeo?a, aecia/ai? a ?aiiueiio i?neyiia?aoe?eiiio ia??iae?, ? oaeoi?aie, ia?aaeoth/eie ?icaeoeo oyaeeeo ai?eii-naioe/ieo oneeaaeiaiue ? iio?aaothoue iaaaeiiai ?aaaoaaiiy. 4. ?icaaeainiaai?noue i?ae aoaeoi?iei ? ?aaoeyoe?eiei eaioethaaie ?ioi?oaoo, yea ae?aaea?oueny ?iaeaenii ni?aa?aeiioaiiy O-oaeia??a ? O-noi?ani??a, aeicaiey? aecia/eoe 5 aa??aio?a ii?ooaiue ?ioiiiai noaoono, ui aea? iiaeeea?noue i?iaaaeaiiy ?iaeea?aeoaeueii? ioe?iee ?ioiiiai noaoono eiaeiiai eiie?aoiiai oai?iai, a oaeiae iioeiaeueiiai aeai?o ?ioiiei?eaoaaeueii? oa?ai??. 5. Iaoiae aooioeeoie?iioa?ai?? caeeth/a?oueny a i?aeoe??iiio aaaaeaii? a ae?eyieo i?neyiia?aoe?eii? ?aie aooioeeoie?i?a a aeic? 100 iea/ie ? aeicaiey? oieeiooe ?icaeoeo ai?eii-naioe/ieo oneeaaeiaiue o o??o?a?/iiai oai?iai. 6. Canoinoaaiiy aooioeeoie?i?a, ye? aaiaeeee ia?aae/a?aaii oa o?ainoia?e?eaeueii a aeic? 100 iea/ie a ia?oo aeiao i?ney iia?aoe?? ? a ianooii? aei?, aeicaiey? ii?iae?coaaoe i?aeoe/ii an? iniiai? ?ioiieia?/i? iieacieee, a, ioaea, ciaioeoe /anoioo ai?eii-naioe/ieo oneeaaeiaiue o oai?eo c iioe?aieie oi?iaie ia?eoii?oo. 7. Iae?e iieaciee?a 5 ia?aiao??a: e?eueeino? eaeeioeeo?a, iaeo?io?e?a ? e?ioioeeo?a, a oaeiae iieaciee?a ?aoeaioe?? ?E-1 ? ?E-2, oa ?ic?aooaaiiy ca ?o aeiiiiiaith (ca cai?iiiiiaaieie oi?ioeaie) aeene?ei?iaioieo ooieoe?e aeicaieythoue i?iaiicoaaoe ia?aa?a i?neyiia?aoe?eiiai ia??iaeo ii aeeiai?oe? ci?uaiiy aaee/eie aeene?ei?iaioii? ooieoe??, cie?aia, i?e ci?uaii? iieacieea o a?e eaaeiai nooiaiy caoai?thaaiiy - ni?eyoeeaee ia?aa?a, a i?e ci?uaii? o a?e oyaeeiai nooiaiy - iani?eyoeeaee ia?aa?a caoai?thaaiiy, iiaeeea?noue ?icaeoeo ai?eii-naioe/ieo oneeaaeiaiue. NIENIE I?AOeUe, IIOAE?EIAAIEO CA OAIITH AeENA?OAOe?? 1. ?ieue naineaeeecaoeee i?aaiecia a ?acaeoee ia?eoiieoa a yenia?eiaioa / Eooiaie A.A., E?aiai/ooeeee A.I., Aaa?eeaiei A.E., Eicaiei E.A., Iie/aiia ?.I.// Eeei. oe?o?aey.- 1992.- ? 2.- N. 19-22. 2. Eooiaie A.A., Eicaiei E.A. Yenia?eiaioaeueiay iiaeaeue ?aceeoiai ia?eoiieoa // Ee?i. o??o?a?y.- 1995.- ? 3.- N. 38-39. 3. Ioeaiea eiioiieiae/aneeo iieacaoaeae o aieueiuo n ino?uie oe?o?ae/aneeie caaieaaaieyie i?aaiia a?thoiie iieinoe, ineiaeiaiiuie ia?eoiieoii / Aiiaea?aiei I.I., Eicaiei E.A., Oaioiieiaa O.I., A/a?aoiyy I.I., Eoae?yaoeaaa A.A., Nu/aiei E.A. // Ee?i. o??o?a?y.- 1996.- ? 2-3.- N. 12. 4. Eicaiei E.A. Ee?i?ei-?ioiieia?/i? c?noaaeaiiy o oai?eo a ?aiiueiio i?neyiia?aoe?eiiio ia??iae? c i?eaiaeo aino?i? o??o?a?/ii? iaoieia??, oneeaaeiaii? aino?ei ia?eoii?oii // Iaaee/i? ia?niaeoeae.- 1998.- O. ???.- N. 50-54. 5. Eooiaie A.A., Iie/aiia ?.I., Eicaiei E.A. Aeeyiea aeoeaiie niaoeeoe/aneie eiioiecaoeee ia eioeoee?iaaiea ii/ae i?e aioo?ea?thoeiiii ca?aaeaiee aeeaioiuo // Aeooaeueiua aii?inu eeeie/aneie e yenia?eiaioaeueiie iaaeeoeeiu.- E?eaie ?ia, 1990.- N. 28-29. 6. Eooiaie A.A., Eicaiei E.A., A/a?aoiyy I.I. E aii?ino i ianoiii e nenoaiiii eiioieoaoa i?e ?aceeoii ia?eoiieoa // Aeooaeueiua aii?inu eeeie/aneie e yenia?eiaioaeueiie iaaeeoeeiu.- E?eaie ?ia, 1990.- N. 31-32. 7. Eooiaie A.A., Ieeaeeianeee I.TH., Eicaiei E.A. Ineoiaaaaoaoeaiua ei??aeyoeee o aieueiuo ?aceeoui ia?eoiieoii // Aeooaeueiua aii?inu iaaeeoeeiu e aeieiaee.- Aeiai?iiao?iane, 1995.- N. 82. 8. Aiiaea?aiei I.I., Eicaiei E.A., Aiiaea?aiei TH.I. Ioe?iea ?ioiieia?/iiai noaoono o oai?eo c ia?oi?aoeaiith ae?aceith oeoiea oa aeaaiaaeoeyoeiaei? eeoee // Aeooaeuei? i?iaeaie i?neyaeeieiiii? ina?oe.- E?eaee ??a, 1998.- N. 73. 9. Niinia ii?aaeaeaiey oyaeanoe ino?iai ?aceeoiai ia?eoiieoa e i?iaiice?iaaiey aai oa/aiey a ?aiiai iineaiia?aoeeiiiii ia?eiaea / Aiiaea?aiei I.I., Eicaiei E.A., Oaioiieiaa O.I., Eaanthe A.E., E?aeiei A.O. // Aeooaeueiua aii?inu iaioeiaeiie oe?o?aee i?aaiia a?thoiie iieinoe.- Oa?ueeia, 1998.- N. 76-77. 10. Eooiaie A.A., Eicaiei E.A. Aeeyiea i?aaeaa?eoaeueiie naineaeeecaoeee e?un ia ianaiaiaiea a?thoeiu e ia?aioeiaoiciuo i?aaiia cieioenoui noaoeeieieeii i?e aioo?ea?thoeiiii eioeoee?iaaiee aeeaioiuo // Aeooaeueiua i?iaeaiu yenia?eiaioaeueiie oe?o?aee: Iao. iao/.-i?aeo. eiio., iinayuaiiie 75-eaoeth AeIE.- Aeiai?iiao?iane, 1991.- N. 33-34. 11. Aiiaea?aiei I.I., Eicaiei E.A., Eooiaie A.A. Eciaiaiea o?iaiy ?aoeaioeee eioa?eaeeeia-1 o oe?o?ae/aneeo aieueiuo, iia?e?iaaiiuo ii iiaiaeo ino?iai aiiaiaeeoeeoa e ia?oi?aoeaiie ycau aano?iaeoiaeaiaeueiie ciiu, ineiaeiaiiuo ?aceeoui ia?eoiieoii // Aiieii-naioe/aneea ineiaeiaiey a iaioeiaeiie oe?o?aee: Oac. aeiee. iao/.-i?aeo. eiioa?aioeee oe?o?aia Oe?aeiu.- Oa?ueeia, 1995.- N. 88-90. 12. Iniaeeaino? ci?i ?ioiiiai noaoono oa ??aiy ?aoeaioe?? ?ioa?eaee?i?a-1 ? -2 (?E-1, ?E-2) o oai?eo c ia?oi?aoeaiith ae?aceith aano?iaeoiaeaiaeueii? ciie ? aino?ei aiaiaeeoeeoii, oneeaaeiaieie ?iceeoei ia?eoii?oii / Aiiaea?aiei I.I., Eicaiei E.A., A/i?aoiy I.I., Eoae?yaoeaaa A.?. // Ia?oee Oe?a?inueeee eiia?an aano?iaioa?ieia?a: Oac. aeii.- Aei?i?iiao?ianuee, 1995.- N.103. 13. Aooioeeoieeiioa?aiey – iiaue iiaeoiae e ea/aieth aiieii-ainiaeeoaeueiuo ineiaeiaiee o oe?o?ae/aneeo aieueiuo / Aiiaea?aiei I.I., Oaioiieiaa O.I., Eicaiei E.A., Aa?acieoeeee A.ss. // Iaoa??aee ?? eiia?ano o??o?a?a Oe?a?ie.- Ee?a-Aeiiaoeuee, 1998.- N. 13-15. 14. I?eiaiaiea aooioeeoieeiioa?aiee i?e ea/aiee aieueiuo n ia?oi?aoeaiie ycaie aeaeoaeea e aeaaiaaeoeaoeia?noiie eeoee, ineiaeiaiiuo ?aceeoui ia?eoiieoii /Aiiaea?aiei I.I., Eicaiei E.A., Aiiaea?aiei TH.I., Ei?ieue A.A., Eio I.A. // Iaoa??aee VI Anaoe?a?inueei? iaoe.-i?aeoe/ii? iaa/aeueii-iaoiaee/ii? eiioa?aioe?? caa. eao. caaaeueii? o??o?a?? iaae. aoc?a Oe?a?ie.- A?iieoey, 1998.- N. 56-57. NIENIE AEIAOIAe?A 1. Iaoaio ? 17733A Oe?a?ia. Niin?a i?io?eaeoeee oa e?eoaaiiy i?neyiia?aoe?eieo ai?eii-caiaethaaeueieo oneeaaeiaiue / Oaioiieiaa O.I., Aiiaea?aiei ?.I., A/i?aoiy I.I., O?iiei E.A., *a?iyeiaa A.?., Eicaiei E.A., E?aei?i I.O., A?eai??aeo ?.I. (Oe?a?ia). Cayae. 20..97. 2. Iaoaio ? 21140A Oe?a?ia. Niin?a e?eoaaiiy aino?iai ?iceeoiai ia?eoii?oo / Eicaiei E.A., Oaioiieiaa O.I., E?aei?i I.O., Aiiaea?aiei I.I. (Oe?a?ia). Cayae. 04..97. 3. ??oaiiy i?i aeaea/o iaoaioo ia aeiao?ae ? 97115655 Oe?a?ia. Niin?a aecia/aiiy oyaeeino? aino?iai ?iceeoiai ia?eoii?oo oa i?iaiicoaaiiy eiai ia?aa?ao o i?neyiia?aoe?eiiio ia??iae? / Eicaiei E.A., Oaioiieiaa O.I., ?aanthe I.?., E?aei?i I.O. (Oe?a?ia). Cayae. 12..98. AIIOAOe?ss Eicaiei E.A. Oeyoe iioei?caoe?? e?eoaaiiy oai?eo c aino?ith o??o?a?/iith iaoieia??th i?aai?a /a?aaii? ii?iaeieie, oneeaaeiaiith ?iceeoei ia?eoii?oii. - ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaith eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.03. - O??o?a?y. - Aei?i?iiao?ianueea aea?aeaaia iaaee/ia aeaaeai?y, Aei?i?iiao?ianuee, 1999. Aeena?oaoe?y i?enay/aia i?iaeaiai aea/aiiy e?eoa???a ioe?iee oyaeeino? oa i?iaiicoaaiiy ia?aa?ao aino?i? o??o?a?/ii? iaoieia?? i?aai?a /a?aaii? ii?iaeieie, oneeaaeiaii? ?iceeoei ia?eoii?oii c o?aooaaiiyi iieaciee?a ?ioiiiai noaoono, a oaeiae aeai?o iaoiaeo aoaeoeaii? ?ioiiei?aeoe?? ia iniia? io?eiaieo ?acoeueoao?a. Ca aeiiiiiaith noaoenoe/iiai aiae?co ?ice?eoi iaoiaaiaoe/i? iaoai?cie, ye? eaaeaoue a iniia? ia?aoiaeo eiiiainiaaieo aa??aio?a ii?ooaiue ?ioiiiai noaoono a aeaeiiiainiaai? o oai?eo c ?iceeoei ia?eoii?oii. ?ic?iaeaii aoaeoeaiee oa aacia/iee iaoiae ?ioiiei?aeoe?? - aooioeeoie?iioa?ai?y, oaeineiiaeaii niiniae aaaaeaiiy aooioeeoie?i?a. Eeth/ia? neiaa: ia?eoii?o, ?ioiieia?y, ?aoeaioe?y ?ioa?eaee?i?a-1 oa -2, aooioeeoie?iioa?ai?y. AIIIOAOeEss Eicaiei E.A. Iooe iioeiecaoeee ea/aiey aieueiuo n ino?ie oe?o?ae/aneie iaoieiaeae i?aaiia a?thoiie iieinoe, ineiaeiaiiie ?aceeoui ia?eoiieoii. - ?oeiienue. Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.03 - Oe?o?aey. - Aeiai?iiao?ianeay ainoaea?noaaiiay iaaeeoeeineay aeaaeaiey, Aeiai?iiao?iane, 1999. Aeenna?oaoeey iinayuaia i?iaeaiai eco/aiey e?eoa?eaa ioeaiee oyaeanoe e i?iaiice?iaaiey oa/aiey ino?ie oe?o?ae/aneie iaoieiaee i?aaiia a?thoiie iieinoe, ineiaeiaiiie ?aceeoui ia?eoiieoii e auai?o iaoiaea yooaeoeaiie eiioiiei??aeoeee ia iniiaaiee iieo/aiiuo ?acoeueoaoia. A aeeiaieea eco/aiu eciaiaiey eiioiiiai noaoona a ?aiiai iineaiia?aoeeiiiii ia?eiaea o 91 aieueiiai, iia?e?iaaiiiai ii iiaiaeo ?ani?ino?aiaiiuo oi?i ia?eoiieoa, i?e/eiaie eioi?iai yaeyeenue: ia?oi?aoeaiay ycaa aeaeoaeea, ia?oi?aoeaiay ycaa aeaaiaaeoeaoeia?noiie eeoee, ino?ue aeano?oeoeaiue aiiaiaeeoeeo, ino?ue aeano?oeoeaiue oieaoeenoeo, ino?ay eeoa/iay iai?ioiaeeiinoue, ane?uaoeeny aanoeann a?thoiie iieinoe, o?aaia i?aaiia a?thoiie iieinoe, a oaeaea o 14 aieueiuo, ia?aianoeo ?aeaia?aoiieth ii iiaiaeo i?ia?anne?othuaai ia?eoiieoa e ?aiiae niaa/iie eeoa/iie iai?ioiaeeiinoe. Eiioiieiae/aneea enneaaeiaaiey i?iaaaeaiu niaeanii iaoiaeieiae/aneei ?aeiiaiaeaoeeyi (Iao?ia ?.A. e niaao., 1992). ?aoeaioeey eioa?eaeeeiia-1 e -2 eco/aia a eoeueoo?a eeaoie ia?eoa?e/aneie e?iae, ?acaeaeaiea iiiiioeeaa?iuo eeaoie ia eeaoee-i?iaeooeaiou EE-1 e EE-2 i?iaaaeaii ii iaoiaeo Eiaaeue/oea E.A. e niaao., 1986. N iiiiuueth noaoenoe/aneie ia?aaioee iieo/aiiuo aeaiiuo ?ane?uou iaoiaaiaoe/aneea iaoaieciu, eaaeauea a iniiaa ia?aoiaea eiiiaine?iaaiiuo aa?eaioia ia?ooaiee eiioiiiai noaoona a aeaeiiiaine?iaaiiua. Onoaiiaeaii, /oi ino?ay oe?o?ae/aneay iaoieiaey i?aaiia a?thoiie iieinoe o i?aiaeaaeathuaai /enea ianeaaeiaaiiuo (92,5%) i?ioaeaea ia oiia aeeneii?aeeiaoeee ?aaoeyoi?iuo iaoaieciia eiioieoaoa, au?aaeaiiinoue e iai?aaeaiiinoue eioi?uo ei??aee?iaaea n oyaeanoueth ninoiyiey aieueiiai. Eeeie/aneia oa/aiea ?aiiaai iineaiia?aoeeiiiiai ia?eiaea ii?aaeaeyeinue oyaeanoueth e ?ani?ino?aiaiiinoueth ia?eoiieoa, a oaeaea aeoaeiie iineaiia?aoeeiiiie eiioiinoi?annee. Onoaiiaeaii, /oi aeoeaaoeey A-eeaoi/iiai caaia eiioieoaoa e iieacaoaeae ianiaoeeoe/aneie ?acenoaioiinoe i?aaiecia yaeyeenue aeinoiaa?iuie oaeoaie, i?aaeoanoaiaaaoeie ?acaeoeth a ?aiiai iineaiia?aoeeiiiii ia?eiaea ineiaeiaiee a aeaea ia?aie/aiiiai ainiaeeoaeueiiai i?ioeanna. Aeoaieay O- e A-eeaoi/iay eeioiiaiey, oaiaoaiea ooieoeeiiaeueiie aeoeaiinoe O-eeioioeeoia yaeyeenue oaeoi?aie, i?aaeoanoaiaaaoeie ?acaeoeth oyaeaeuo aiieii-naioe/aneeo ineiaeiaiee. O/ao naaeaine?iaaiiinoe iaaeaeo yooaeoi?iui e ?aaoeyoi?iui caaiueyie eiioieoaoa, au?aaeathueeny niioiioaieai O-oaeia?ia e O-noi?anni?ia, iicaieee auyaeoue 5 aa?eaioia ia?ooaiee eiioiiiai noaoona, /oi aeaei aiciiaeiinoue i?iaanoe eiaeeaeaeoaeueioth ioeaieo eiioiiiai noaoona o eiie?aoiiai aieueiiai e aua?aoue aaeaeaaoioth eiioiioa?aieth. ?ac?aaioai iiaue yooaeoeaiue e aaciianiue iaoiae eiioiiei??aeoeee - aooioeeoieeiioa?aiey, iai?aaeaiiue ia iiaeeecaoeeth yiaeiaaiiuo ?aaoeyoi?iuo iaoaieciia caueou. Iiaeeiaeiia aaaaeaiea a iaeanoue iineaiia?aoeeiiiie ?aiu eiiieaena aooioeeoieeiia a aeica 100 ieaie iicaieeei i?aaeioa?aoeoue ?acaeoea aiieii-naioe/aneeo ineiaeiaiee o aieueiuo, iia?e?iaaiiuo ia i?aaiao aeaeoaei/ii-eeoa/iiai o?aeoa. I?eiaiaiea aooioeeoieeiia i?aaea?thoeiii e o?ainoiaeeeeaeueii a aeica 100 ieaie a ia?aua nooee iinea iia?aoeee e a iineaaeothuea aeie iicaieeei ii?iaeeciaaoue i?aeoe/anee ana iniiaiua eiioiieiae/aneea iieacaoaee e nieceoue /anoioo aiieii-naioe/aneeo ineiaeiaiee o aieueiuo n ?ani?ino?aiaiiuie oi?iaie ia?eoiieoa. Eeth/aaua neiaa: ia?eoiieo, eiioiieiaey, ?aoeaioeey eioa?eaeeeia-1, ?aoeaioeey eioa?eaeeeia-2, aooioeeoieeiioa?aiey. SUMMARY Lozenko L.V. The ways of treatment optimisation of patients with acute surgical pathology of abdominal cavity organs, complicated with diffuse peritonitis. - Manuscript. Thesis for a higher medical degree on a speciality 14.01.03. - Surgery. - Dniepropetrovsk state medical academy, Dniepropetrovsk, 1999. The dissertation is devoted to the problems of criterion estimation study of severity and prognosing of course of acute surgical pathology of abdominal cavity organs, complicated with diffuse peritonitis regarding immune status and also selection of effective immunocorrection on the base of received results. Pathogenetic mechanisms lying on the base of transition of compensated varients of immune status disturbance into decompensated in patients with diffuse peritonitis were revealed with the help of statistical analysis. The new effective and safe method of immunocorrection has been worked out - autocytocinotherapy; the ways of autocytocine introducing were improved. Key-words: peritonitis, immunology, reception of interleukin-1, reception of interleukin-2, autocytocinotherapy.

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