Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC
Oe?a?ie

Aeoi/a? Oae?en Naiaiiae/

OAeE?616.231-089+616.24

Aianoac?ieia?/ia caaacia/aiiy oa ?ioaineaia oa?ai?y i?e ?aeiino?oeoeaieo
iia?aoe?yo ia ieaei?o aeeoaeueieo oeyoao

14.01.30 — Aianoac?ieia?y oa ?ioaineaia oa?ai?y

aaoi?aoa?ao

ia caeiaoooy iaoeiaiai nooiaiy

aeieoi?a iaaee/ieo iaoe

Ee?a- 1999

?iaioa aeeiiaia a Ee?anueeee iaaee/i?e aeaaeai?? i?neyaeeieiiii? ina?oe
?i.I.E.Ooieea IIC Oe?a?ie (Ee?a)

Iaoeiaee eiinoeueoaio: aeie oi?
iaaee/ieo iaoe, i?ioani?

Aaa??ia Iaiaae Iaino?iae/

i?ioanni? eaoaae?e ioeueiiiieia??

Ee?anueei? iaaee/ii? aeaaeai??
i?neyaeeieiiii?

ina?oe ?i.I.E.Ooieea IIC Oe?a?ie

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

Coaeia A?eoi? ?aaiiae/

caa?aeoaa/ a?aeae?eii
aianoac?ieia??

Ee?anueeiai ?inoeoooo ee?i?/ii?

oa aenia?aiaioaeueii? o??o?a??
AII Oe?a?ie

aeieoi? iaaee/ieo iaoe, i?ioani?,
/eai-

ei?aniiiaeaio AI oa AII Oe?a?ie
Iiaeoeueea-

Onaiei Ethaeieea Aanee?aia
caa?aeoaa/

eaoaae?e aianoac?ieia?? oa
?aai?iaoieia??

Aei?i?iiao?ianueei? aea?aeaaii?
iaaee/ii?

aeaaeai?? IIC Oe?a?ie

aeieoi? iaaee/ieo iaoe, i?ioani?
Aeoaeoeueeee

Aiaoie?e THoeiiae/ caa?aeoaa/
eaoaae?ith

aianoac?ieia??, ?aai?iaoieia??

oa iaaeeoeeie eaoano?io
Iaoe?iiaeueiiai

iaaee/iiai oi?aa?neoaoo ?i.
I.I.Aiaiiieueoey

IIC Oe?a?ie

I?ia?aeia onoaiiaa ?inoeooo caaaeueii? oa
iaa?aeeeaaeii?

o??o?a?? IIC Oe?a?ie, i.Oa?e?a,
a?aeae?e

o?aaiaoe/iiai oieo, ?aai?iaoe?? oa

?ioaineaii? oa?ai??

Caoeno a?aeaoaeaoueny “29”aa?aniy1999?. ia 11 aiaeei? ia
can?aeaii?

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

Aaoi?aoa?ao ?ic?neaiee “20”na?iiy 1999?.

A/aiee nae?aoa? niaoe?ae?ciaaiii? a/aii? ?aaee

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

1

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. Inoaii?i /anii cia/ii c?inea e?euee?noue oai?eo c
o?aaeaiiyie ai?oai? oa o?aoa?, ye? iio?aaothoue iia?aoe?eiiai
ao?o/aiiy. Oea coiiaeaii ca?eueoaiiyi /anoioe, c iaeiiai aieo,
ceiye?nieo ? aeia?iye?nieo iooeei ieaei?o aeeoaeueiuo oeyo?a, eaaaiue,
ueoiiiae?aii? caeice (Grillo H. et al.,1992; Kennedy L.,1992), a c
?ioiai aieo — e?eueeino? oai?eo c noaiicaie ai?oai? oa o?aoa?
aiane?aeie canoinoaaiiy aeiaaino?ieiai? ooo/ii? aaioeeyoe?? eaaaiue
(OAE) (Bisson A. et al., 1992). Oaeiae ca?eueoo?oueny e?euee?noue
o?aaiaoe/ieo ooeiaeaeaiue aeeoaeueiuo oeyo?a (Ai?aoiia A.A., 1994; Ayabe
H. Et al.,1993). LaMaglia M.V. et al. (1991) caa?oathoue oaaao ia oa, ui
iaoiaee e?eoaaiiy oai?eo ?c caoai?thaaiiyie o?aoa? iaaeinoaoiuei
aena?oeai? a e?oa?aoo??. I?iaeaie aianoac?ieia?/iiai caaacia/aiiy oa
?ioaineaii? oa?ai?? i?e ?aeiino?oeoeaieo iia?aoe?yo ia o?aoa? , iniaeeai
a ae?eyioe? a?oo?eaoe?? iathoue aeoaea aaaeeeaa cia/aiiy (Eaaaoia TH.I.
? ni?aaao.,1990; Ianeiaa E.A., Iioo?eaaa A.E., 1997), i?ioa aei oeueiai
/ano aiie ia ae??oai?. Oe? i?iaeaie iathoue ?yae iniaeeainoae, a ?o
ae??oaiiy ? iaaecae/aeii aeooaeueiith (Harastiak S. at al., 1996) ?
iaei??th c iaeneeaaei?oeo caaea/ a aianoac?ieia?? (Young-Beyer P.,
Wilson R., 1988). ?acoeueoaou aaaeei ii??aithaaoe aiane?aeie iaaaeeei?
e?eueeino? ioae?eaoe?e oa iaiaeii??aeiino? a?oi aeine?aeaeoaaieo oai?eo
(Bazelly B., 1992).

O cayceo c o?oaeiiuaie caaacia/aiiy aaioeeyoe?? eaaaiue i?ae /an
?aeiino?oeoeaieo iia?aoe?e ia o?aoa?, iniaeeai o aeiaaeeao cia/iiai
noaiico, c 60-o ?ie?a OO no. cai?iiiiaaii iaoiaee ooo/iiai e?iaiia?ao
(OE) oa aeno?aei?ii?aeueii? ieneaaiaoe?? (AI) (Woods F. et al.,1961;
Wolkers L.K. et al., 1992). Iacaaaeath/e ia iaaaciaeo canoinoaaiiy oeeo
iaoiae?a, oaea a 1990 ?. Franks R. ? Rothera N., a a 1992 ?. Ianagiri T.
et al. iia?aeiieythoue i?i aeei?enoaiiy OE oa AI aeey caaacia/aiiy
aaciiai?io i?ae /an ?aeiino?oeoeaieo iia?aoe?e ia o?aoa?. O?eueee a 1994
?. Grillo H., yeee ia? iaea?eueoee o na?o? aeina?ae iia?aoe?eiiai
ao?o/aiiy ia o?aoa?, aeneiaea aeoieo, ui canoinoaaiiy oeeo iaoiae?a
iaa?oue o ?ac? cia/iiai noaiicoaaiiy ieaei?o aeeoaeueieo oeyo?a ia ?
iaia’yceiaei. Aieiaiith i?iaeaiith aianoac?ieia?/iiai caaacia/aiiy i?ae
/an iia?aoe?eiiai ao?o/aiiy ia ieaei?o aeeoaeueiuo oeyoao ? caaacia/aiiy
aaeaeaaoii? aaioeeyoe?? eaaaiue (Bazelly B., 1992).

Ca inoaii? ?iee aoei aeinyaiooi iaaiiai i?ia?ano o ae??oaii? oe???
i?iaeaie. Ianaiia?aae, aoei cai?iaaaeaeaii a ee?i?/io i?aeoeeo iaoiae
aeniei/anoioii? ooo/ii? aaioeeyoe?? eaaaiue (A*OAE) (Jonzon A. et
al.,1971; Heijman G. et al.,1972), i?ioa e oey iaoiaeeea ia ae??oeea
on?o i?iaeai caaacia/aiiy aaioeeyoe?? i?ae /an ?aeiino?oeoeaieo
iia?aoe?e ia o?aoa? ? iniaeeai ?? a?oo?eaoe?? (Eieiiaineee A.A. ?
ni?aaao., 1996 ). Aei oeueiai /ano iathoue i?noea ?io?aiia?aoe?ei?
eaoaeuei? aeiaaeee (Bisson A.,1992 ), a oaeiae aaeeea e?euee?noue
oneeaaeiaiue (30-40%, ca aeaieie Eaaaaeaaie ?.I.,1988). Aenieith
caeeoa?oueny oaeiae i?neyiia?aoe?eia eaoaeuei?noue, iniaeeai i?ney
?acaeoe?e a?oo?eaoe?? o?aoa? (17% — Dunham M.E., 1994), 33%
(Ia?aeueiai I.E. ? ni?aaao., 1991).

Oaeei /eiii, iaoiaee aianoac?ieia?/iiai caaacia/iiy oa
?ioaineaii? oa?ai?? i?ae /an iia?aoe?e ia ieaei?o aeeoaeueiuo oeyoao ?
iaaeinoaoiuei aea/aiith i?iaeaiith, a ?? ae??oaiiy ? aeooaeueiei ye c
iaoeiai?, oae ? i?aeoe/ii? oi/ee ci?o aeey ioi?iie caei?ia’y.

Ca’ycie oaie c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Oaio
aeena?oaoe?? aianaii aei ieaio i??i?eoaoieo iai?yi?a
ia?iaeii-ainiiaea?nueeiai cia/aiiy a Oe?a?i? (Iinoaiiaa ? 859
Aea?aeeii?oaoo Oe?a?ie ii ieoaiiyi iaoee oa oaoiieia?? a?ae 13.10.1997
?. Caoaa?aeaeaii iaaee/iith ?aaeith IIC Oe?a?ie. Iiia?
Aea?ae?aa?no?aoe?? 0197 EI 14700).

Iaoa ? caaaeaiiy aeine?aeaeaiiy. Iaoith ?iaioe ? iie?auaiiy ?acoeueoao?a
aianoac?ieia?/iiai caaacia/aiiy oa ?ioaineaii? oa?ai?? i?e o??o?a?/iii
e?eoaaii? oai?eo c o?aaeaiiyie ai?oai? oa o?aoa?.

Aieiai? caaaeaiiy aeine?aeaeaiiy:

?ic?iaeoe iioeiaeuei? iaoiaee caaaeueiiai ciaaiethaaiiy i?ae /an
iia?aoe?eieo ao?o/aiue ia ieaei?o aeeoaeueieo oeyoao.

?ic?iaeoe iaeaoaeoeai?o? iaoiaee ooo/ii? aaioeeyoe?? eaaaiue i?ae /an
iia?aoe?eieo ao?o/aiue ia ai?oai? oa oeeiiio a?aeae?e? o?aoa?.

?ic?iaeoe iaeaoaeoeai?o? iaoiaee ooo/ii? aaioeeyoe?? eaaaiue i?ae /an
iia?aoe?eieo ao?o/aiue ia a?oaeiiio a?aeae?e? o?aoa?.

?ic?iaeoe iaeaoaeoeai?o? iaoiaee ooo/ii? aaioeeyoe?? eaaaiue i?ae /an
iia?aoe?eieo ao?o/aiue o ae?eyioe? a?oo?eaoe?? oa iaaea?oo?eaoe?eiiai
a?aeae?eo o?aoa?.

Aecia/eoe ia?aaaae oa iaaeie?ee aeniei/anoioii? OAE i?ae /an
?aeiino?oeoe?? o?aoa?.

?ic?iaeoe iioeiaeueioth iaoiaeeeo e?eoaaiiy oai?eo i?ney
?aeiino?oeoeaieo iia?aoe?e ia ieaei?o aeeoaeueieo oeyoao.

?ic?iaeoe ? cai?iaaaeeoe a i?aeoe/io ae?yeuei?noue iaoiaeeeo o?eaaei?
iacio?aoaaeueii? ?iooaaoe?? i?ney o?aoaiai?oaii? ?acaeoe??.

?ic?iaeoe caoiaee ciaioaiiy eaoaeueiino? e oyaeeeo oneeaaeiaiue
aiane?aeie ?aeiino?oeoeaieo iia?aoe?e ia ieaei?o aeeoaeueieo oeyoao.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. ?iaioa i?noeoue
iia? a?aeiiino? i?i iaoai?cie ii?ooaiiy aaciiai?io a eaaaiyo i?ae /an oa
i?ney ?aeiino?oeoeaieo iia?aoe?e ia ieaei?o aeeoaeueieo oeyoao. Aia?oa
c?iaeaii aiae?c ia?aiao??a aaciiai?io a eaaaiyo ? eeneioii-iniiaiiai
noaio e?ia? i?e ??cieo aa??aioao OAE oa cai?iiaiiaaii iioeiaeuei?
iaoiaee OAE i?ae /an iia?aoe?e ia ai?oai?, o?aoa?, a?oo?eaoe?? o?aoa?,
aieiaieo a?iioao. Aia?oa iaa?oioiaaii e ?ic?iaeaii iaoiaeeeo o?eaaei?
iacio?aoaaeueii? ?iooaaoe?? i?ney o?aoaiai?oaiii? ?acaeoe?? oa
cai?iiiiiaaii iaoiaeeeo ?? aeei?enoaiiy. Aia?oa cai?iiiiiaaii aeai?eoi
ae?e aianoac?ieiaa o aeiaaeeao oyaeei? o?aaie ieaei?o aeeoaeueieo
oeyo?a.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Aaeeeee aeina?ae
aianoac?ieia?/iiai caaacia/aiiy oa i?iaaaeaiiy ?ioaineaii? oa?ai?? o
oai?eo, yeeo iia?oaaee ia ieaei?o aeeoaeueieo oeyoao, aeaa ciiao
a?aoiaioiaaii ?aeiiaiaeoaaoe canoinoaaiiy oiai /e ?ioiai iaoiaeo
caaaeueiiai ciaaiethaaiiy, iaoiae?a OAE i?ae /an iia?aoe??, iaoiae?a
i?io?eaeoeee oa e?eoaaiiy a ?ac? oneeaaeiaiue i?ney iia?aoe??.
?ic?iaeaii i?aeoe/i? ?aeiiaiaeaoe?? uiaei caaacia/aiiy aaioeeyoe??
eaaaiue i?ae /an ??cieo yoai?a ?aeiino?oeoeaieo iia?aoe?e ia o?aoa?,
a?oo?eaoe?? o?aoa? oa aieiaieo a?iioao. Cai?iiaiiaaii aeai?eoi ae?e
aianoac?ieiaa o aeiaaeeao iaaeoiaeaeaiiy oai?iai c o?aaiith ieaei?o
aeeoaeueieo oeyo?a. Aeine?aeaeaii oeyoe i?aeaeuaiiy aaciaee iia?aoe?eieo
ao?o/aiue i?e caoai?thaaiiyo ? o?aaiao ieaei?o aeeoaeueieo oeyo?a.
Aiane?aeie cai?aaaaeaeaiiy cai?iiiiiaaieo iaoiae?a aoea cia/ii cieaeaia
eaoaeuei?noue ? e?euee?noue oyaeeeo oneeaaeiaiue i?e ?aeiino?oeoeaieo
ao?o/aiiyo ia ai?oai?, o?aoa? oa aieiaieo a?iioao. Io?eiai? ?acoeueoaoe
aeathoue ciiao ?aeiiaiaeoaaoe ?ic?iaeai? iaoiaee aianoac?ieia?/iiai
caaacia/aiiy oa ?ioaineaii? oa?ai?? aeey oe?ieiai ee?i?/iiai
ai?iaaaeaeaiiy.

Iniaenoee aianie caeiaoaa/a. Iaoa ? caaaeaiiy aeine?aeaeaiiy
aecia/ai? aaoi?ii. On? iaaaaeaii? a ?iaio? eiie?aoi? ?acoeueoaoe
aeine?aeaeaiue aoee io?eiai? iniaenoi caeiaoaa/ai. Aaoi? a?aa
aaciina?aaeith o/anoue a aea/aii? iaa?aeiieo ?ai?oa iniaeeainoae
aaciiai?io a eaaaiyo i?e ??ciiiai?oieo aeaeao ooo/ii? aaioeeyoe??
eaaaiue i?ae /an iia?aoe?e ia ai?oai?, o?aoa? oa aieiaieo a?iioao, o
?ic?iaeaii? iioeiaeueiuo iaoiae?a aianoac?ieia?/iiai caaacia/aiey,
i?io?eaeoeee oa e?eoaaiiy i?e aaaeeeo oneeaaeiaiiyo, ui aeaei ciiao
cia/ii iie?aueoe ?acoeueoaoe e?eoaaiiy oai?eo oe??? oyaeei? a?oie.
Aaoi?ii ?ic?iaeaii aeai?eoi ae?e aianoac?ieiaa o aeiaaeeao oyaeei?
o?aaie ieaei?o aeeoaeueieo oeyo?a. Naiino?eii caaacia/oaaa caaaeueia
ciaaiethaaiiy oa aacia/i?noue 80% ?aeiino?oeoeaieo iia?aoe?eieo
ao?o/aiue ia ieaei?o aeeoaeueieo oeyoao o ee?i?/i?e

e?ea?i? ?17 i. Ee?aa, a?aa o/anoue o i?iaaaeaii? ?ioaineaii? oa?ai?? a
i?neyiia?aoe?eiiio ia??iae? o 95% oai?eo oe??? a?oie. Aeena?oaioii
iniaenoi aeeiiaii noaoenoe/iee aiae?c oa ocaaaeueiaiiy io?eiaiieo
?acoeueoao?a aeine?aeaeaiiy.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iaoa??aee e iniiai?
iieiaeaiiy ?iaioe aoee iaaiai?ai? ia Ananithciiio neiiic?oi? c ieoaiue
o??o?a?? o?aoa? oa a?iio?a (Iineaa, 1986), ?anioae?eainuee?e
eiioa?aioe?? aianoac?ieia?a-?aai?iaoieia?a Oaaeaeeeenoaio
(Aeooaiaa,1987), ?anioaeeeainuee?e iaoeia?e eiioa?aioe?? c aeooaeueieo
ieoaiue ae?aaiinoeee ? e?eoaaiiy o?aaioieo noai?a (Oiaeueieoeueeee,
1988), 4-io C’?cae? aianoac?ieia?a ? ?aai?iaoieia?a N?N? (Iaeana,
1989)., 9-e Oe?a?inuee?e eioa?aioe?? c a?oaeii? o??o?a?? (Euea?a, 1990),
3-e ?anioae?eainuee?e eioa?aioe?? aianoac?ieia?a ? ?aai?iaoieia?a A?oc??
(Oa?e?n?, 1990), 2-io Anana?oiueiio eiia?an? aianoac?ieia?a
(I?aea?eaiaee, Aaaaa,1992), 9-io ?a?iiaeneiio eiia?an? aianoac?ieia?a
(?c?a?eue, ???onaeei, 1994), 2-io Iaoe?iiaeueiiio eiia?an?
aianoac?ieia?a Oe?a?ie (Oa?e?a,1996), 2-io Eiia?an? o??o?a?a Oe?a?ie
(Aeiiaoeuee,1998), 2-io C’?cae? ooec?ao??a ? ioeueiiiieia?a Oe?a?ie
(Ee?a,1998), Ieaioi? i?aae?iiy Anioe?aoe?? aianoac?ieia?a Oe?a?ie
(Euea?a,1998).

Ioae?eaoe??. Ca oaiith aeena?oaoe?? aoei iioae?eiaaii 37
iaoeiaeo ?aa?o, c ieo 16 noaoae a oeaio?aeueieo niaoe?aeueieo iaoeiaeo
aeo?iaeao ? 19 ?ia?o o aeaeyae? oac aeiiia?aeae o iaoa??aeao
i?aeia?iaeieo ? iaoe?iiaeueieo c’?cae?a, eiia?an?a, eiioa?aioe?e,
neiiic?oi?a. Io?eiaii iaoaio ia aeiao?ae “Niin?a ?aeiino?oeoe??
a?oo?eaoe?? o?aoa? i?ney ?? oe?iei? ?acaeoe??” (1997, ni?aaaoi?e Aaa??ia
I.I., ?iniianeee I.A., Aa?auaei ?.?.)

No?oeoo?a ? ianya aeena?oaoe??. Aeena?oaoe?y neeaaea?oueny c
anooio, iaeyaeo e?oa?aoo?e, aeanieo aeine?aeaeaiue (6 ?icae?e?a),
aiae?co e ocaaaeueiaiiy io?eiaieo ?acoeueoao?a, aeniiae?a, i?aeoe/ieo
?aeiiaiaeaoe?e, nieneo e?oa?aoo?e. Aeena?oaoe?eio ?iaioo aeeeaaeaii ia
307 noi??ieao iaoeiiieno, i?i?ethno?iaaii 28 oaaeeoeyie oa 20
iaethieaie. Nienie aeei?enoaii? e?oa?aoo?e i?noeoue 406 aeaea?ae.

Iniiaiee ci?no ?iaioe

Aeine?aeaeaiiy, aeeeaaeai? a aeena?oaoe??, a?oioothoueny ia
aeaieo ee?i?ei-eaai?aoi?iiai ? noaoenoe/iiai aiae?co e?eoaaiiy 362
oai?eo (223 /ieia?e?a ? 139 ae?iie) ?c caoai?thaaiiyie ieaei?o
aeeoaeueieo oeyo?a, yeei aoei aeeiiaii 370 iia?aoe?e ia ai?oai?, o?aoa?,
cie?aia ?? a?oo?eaoe?? ? aieiaieo a?iioao. A?e oai?eo eieeaaany a?ae 7
i?nyoe?a aei 90 ?ie?a (na?aaei?e 47±18).

Ia?aaaaeii i?e/eiith iia?aoe?eieo ao?o/aiue aoee ceiye?ni? oa
aeia?iye?ni? iooeeie (197 oai?eo /e 53,3%). Iae/ano?oeie aeaeaie
ceiye?nieo iooeei aoee ?ae o?aoa? ? i?eeaaeeo i?aai?a (ueoiiiae?aia
caeica, no?aaio?ae) /e oe?e?iae?iia o?aoa? (a?aeiia?aeii 55,1 ? 37,2%),
na?aae aeia?iye?nieo – aaeaiiia o?aoa?.
Ianiaoeeo?/iee noaiic ai?oai? oa o?aoa? aoa i?e/eiith iia?aoe?e o 119
oai?eo (32,2%). O 72 oai?eo (60,5%) oea oneeaaeiaiiy aoei iane?aeeii
o?eaaei? ?iooaaoe?? o?aoa?, a o 36 (30,2%) — o?aoainoii??. E??i oeueiai,
o 11 oai?eo (9,3%) ae?aaiinoiaaii iino?aae?aoe?eiee noaiic, ye iane?aeie
ooaa?eoeueico /e ii?eo aeeoaeueieo oeyo?a oa ?aeeiiaoe/iee noaiic.
I?e/eiith o?eaaei? ?iooaaoe?? o?aoa? ? o?aoainoii?? aoee oyaee?
o?aaie, ii?ooaiiy ooieoe?? oeaio?aeueii? oa ia?eoa?e/ii? ia?aiai?
nenoaie, io?o?iiy.

Ca nooiaiai iaoo?aoe?? ieaei?o aeeoaeueieo oeyo?a ca
eeaneo?eaoe??th Aaa??iaa I.I. (1987) oai?? c iooeeiaie ? ianiaoeeo?/iei
noaiicii ai?oai? oa o?aoa? ?iciiae?eyeeny oaeei /eiii: I nooi?iue —
85 oai?eo (31,6%); II — 56 (20,8%);III — 94 (34,9%);
IV — 34 oai?eo (12,7%).On? oai?? c III — IV nooiaiyie
noaiico aac o?aoainoii?? ia?aae iia?aoe??th aoee o oyaeeiio oa aeoaea
oyaeeiio noai? aiane?aeie oyaeeeo ii?ooaiue aeeoaiiy. O 30 oai?eo (8,1%)
i?e/eiith iia?aoe?? aoee o?aaie aeeoaeueieo oeyo?a (i?iieei? oa
cae?eo?). C ieo o 8 aeiaaeeao ooeiaeaeaiiy o?aoa? aeieeei i?ae /an
?iooaaoe??; 17 oai?eo oe??? a?oie (56,7%) aoei aeinoaaeaii a aeoaea
oyaeeiio noai? aiane?aeie ano?en?? /e e?iaioa/?. I?neyiia?aoe?ei? /e
i?neyo?aaiaoe/i? ii?eoe? o?aoa? /e aieiaieo a?iio?a aoee i?e/eiith
iia?aoe?? a 11 aeiaaeeao (3,0%), aeni??aoi?iee noaiic o?aoa? – o 5
(1,3%). O 8 oai?eo (2,1%) aeieeea iio?aaa o iiaoi?ieo iia?aoe?eieo
ao?o/aiiyo.

O 123 oai?eo (40%) ae?aaiinoiaaii oyaee? noiooi? caoai?thaaiiy,
na?aae yeeo iae/ano?oeie aoee caoai?thaaiiy na?oeaai-noaeeiii? nenoaie
(?oai?/ia oai?iaa na?oey – o 16 oai?eo (4,4%); aino?ee ?ioa?eo i?iea?aea
– o 2 (0,55%); a?ia?oii?/ia oai?iaa – o 20 (5,5%); ii?ooaiiy ?eoio
na?oey – o 5 (1,4%); noaie i?ney o??o?a?/ii? ei?aeoe?? i?e?iaeaeaieo
aaae na?oey – o 4 (1,1%); iaaeinoaoi?noue i?o?aeueiiai eeaiaia – o 2
(0,55%)); ia?aiai? nenoaie (noai i?ney o?eaaei? oyaeei? eiie,
iai?eeeaae o?aaie /a?aia, ?ioaeoe?ei? oai?iae, io?o?iiy) – o 14 (3,9%),
i?anoai?y gravis, i??eiiie??aaeeeoeiiaa?eo, ?inoeueo – o 9 (2,5%);
ii?ooaiiy ooieoe?? aiaeie?eiii? nenoaie (oeoe?iaee ae?aaao,a?ia?oe?aic,
a?iioe?aic,neiae?ii Eoo?iaa) – o 15 (4,1%) oa nenoaie aeeoaiiy (o?ii?/i?
ianiaoeeo?/i? caoai?thaaiiy eaaaiue, a?iio?aeueia anoia, noai i?ney
iiaaiiiaeoii??) – o 10 (2,8%). Aeai? oai?eo (0,55%) ia?aianee noai
ee?i?/ii? nia?o?.

Na?aae iia?aoe?eieo ao?o/aiue o?aoaiai?oaiia ?acaeoe?y noaiiaeoue
29,5% (109 iia?aoe?e), ?acaeoe?y o?aoa? – 30,6% (113 iia?aoe?e),
?acaeoe?y a?oo?eaoe?? o?aoa? – 11,6% (42 iia?aoe??), ?acaeoe??
a?oo?eaoe?? o?aoa? c ?acaeoe??th i?aai? eaaai? aaa ?? /anoee – 16,1% (60
iia?aoe?e), ?acaeoe?? a?oo?eaoe?? o?aoa? c ?acaeoe??th e?ai? eaaai?
(aeainoi?iiiy oi?aeioii?y) – 2,2% (8 iia?aoe?e), ?ic’?aeiaiiy ii?eoeue,
iaia?aii?ao?y o?aoa?, ooeaaiiy ?? i?ney o?aaie – 10% (37 iia?aoe?e) .
Na?aae iia?aoe?eieo ao?o/aiue ia?aaaaeaea oee?eoey?ia ?acaeoe?y (274
iia?aoe?? aai 74,1%). Aoei aeeiiaii aea? iia?aoe?? Grillo c ?acaeoe??th
a?oo?eaoe?? o?aoa? oa aoeaaiiyi e?aiai aieiaiiai a?iioa o i?ii?aeiee
a?iio i?aai? eaaai?.

Ca eeaneo?eaoe??th Aia?eeainueei? anioe?aoe?? aianoac?ieia?a (ASA)
oai?eo ca o?ce/iei ia?aaeiia?aoe?eiei noaiii iiaeia ?iciiae?eeoe ca
oaeeie nooiaiyie ?eceeo (Stoelting RK, Miller RD,1994): 1 — iaia; 2 —
iaia; 3 — 176 (48,6%); 3(A) — 32 (8,8%); 4 — 98 (27,1%), 4(A) — 21
(5,8%), 5 – 29 (8,0%), 5(A) — 6 (1,6%). Oaeei /eiii, a?eueoenoue oai?eo
iaee aenieee /e aeoaea aenieee nooi?iue ?eceeo uiaei iia?aoe?? oa
ia?eico.

O an?o oai?eo aei ? i?ney iia?aoe?? aoei i?iaaaeaii ?ooeii?
aeine?aeaeaiiy na/?, e?ia?, eiaaoeia?aio ,aeaeo?iea?ae?ia?o?th,
aei??thaaiiy oeaio?aeueiiai aaiiciiai oeneo (OeAO). O 210 oai?eo aoei
aecia/aii neeaae aac?a e?ia?, eeneioii-iniiaiee aaeain (EIA) aei ? i?ae
/an iia?aoe??,, a oaeiae a i?neyiia?aoe?eiiio ia??iae? aia?aoaie ABL
505, 520 oa «Iee?iano?oi» AAN-1 (RADIOMETER, Aeai?y): ni?aa?aeiioaiiy
iai?oae eenith a a?oa??aeuei?e e?ia? ? eiioeaio?aoe?? eiai o
aaeeooiiaaiiio aac? (PaO2 /FiO2), iai?oao aoaeaoeth ae?ieneaeo a
a?oa??aeuei?e e?ia? (PaCO2), ?I, aeao?oeeo /e iaaeeeoie iniia o e?ia?
(AA), iieaciee ?ici?uaiiy e?eai? aeenioe?aoe?? aaiiaeia?io (?50). O 113
oai?eo aei??thaaeiny ooiooaaiiy a iaeiio eie? e?iaiia?ao (Qs/Qt)
aia?aoii ABL520. I?ae /an iia?aoe?? o 122 oai?eo iino?eii i?iaiaeeee
ioeuenieneiao??th c aecia/aiiyi iane/aiiy e?ia? eeniai (SO2) aia?aoii
Ohmeda o 122 oai?eo. O 260 oai?eo aei ? o 90 i?ney iia?aoe?? aoei
aecia/aii iniiai? iieacieee ni??ia?aie: oaeeeiee ia’?i aeeoaiiy (OIAe),
/anoioo aeeoaiiy (*Ae), aeeoaeueiee ia’?i (Vt), aeeoo?ao ?ii?noue
eaaaiue (AE?E), AE?E aaeeoo, AE?E aeaeeoo, oi?niaaio AE?E, AE?E1, ia’?i
oi?niaaiiai aeaeioo (IOA), IOA1, iaeneiaeueio aaioeeyoe?th eaaaiue
aia?aoaie Ioeueia 01 (NI «?ani?ii», Aieaa??y) oa Iiaaiiea?ae?ieiiieaen
aaeia?aioanooth/ee E?E-15.30 (Oe?a?ia). O 260 oai?eo aecia/aii
i?iaiiciaaiee i?neyiia?aoe?eiee ia’?i oi?niaaiiai aeaeeoo. O 220 oai?eo
i?iaaaeaii aaeoa??ieia?/iee aiae?c nae?aoo o?aoa? ? a?iio?a, aecia/aii
/ooeea?noue i?e?ioei?e aei aioea?ioee?a aei ? i?ney iia?aoe??.
O?aoaia?iioineii?th aeeiioaaee i?ae ia?eicii a?iioineiiii O??aeaey
(I?ia//eia) o 86 oai?eo oa i?ae i?noeaaith aianoac??th
o?a?ia?iioineiiaie o??i OLYMPUS ? PENTAX (ssiii?y) – o 276 oai?eo.

Ia?iaeo ?acoeueoao?a i?iaaaeaii c canoinoaaiiyi iaoiae?a
aa??aoe?eii? noaoenoeee ?c aeei?enoaiiyi e?eoa???a O?oa?-No’thaeaioa ca
aeiiiiiaith noaiaea?oieo eiii’thoa?ieo i?ia?ai.

Iniiai? ?acoeueoaoe aeine?aeaeaiue

Aianoac?ieia?/ia caaacia/aiiy oa ?ioaineaia oa?ai?y aaaaoi
a /iio caeaaeaee a?ae oa?aeoa?o caoai?thaaiiy ? aeaeo iia?aoe?eiiai
ao?o/aiiy. Aieiaiith iaoith ia?aaeiia?aoe?eii? i?aeaioiaee o oai?eo ?c
noaiicii o?aoa? aoea naiaoe?y aeeoaeueieo oeyo?a, aieiaiei /eiii
o?aoaia?iioineii?y. O oai?eo c I – II nooiaiai noaiico aac oyaeei?
noiooiuei? iaoieia?? caaaeueiee noai aoa iaei ii?ooaiei, ui
i?aeoaa?aeaeothoue iieacieee aaciiai?io oa EIC (aeea. oaae.1). Aiie ia
iaee iio?aae a niaoe?aeueieo iaoiaeao e?eoaaiiy ia?aae iia?aoe??th,
aieiaiei /eiii i?iaiaeeeeny ae?aaiinoe/i? aeine?aeaeaiiy.

Oaaeeoey 1

Iieacieee aac?a a?oa??aeueii? e?ia? ia?aae iia?aoe??th caeaaeii a?ae
nooiaiy noaiico o?aoa? (n=90), (FiO2=0,21)

Cooi?iue noaiico

E?euee?noue

?I

?aNI2,

ii ?o.no.

AA, iiieue/e

?aI2,

ii ?o.no.

Qs/Qt,

% IIN

I – II

40

7,39±0,08

41±2,1

0,8±0,2

76±3,1

11±1,8

III

30

7,32±0,09*

46±1,8*

0,9±0,3

62±2,2*

17±2,0*

IV

20

7,25±0,10**

54±2,0**

2,1±0,5

54±3,5**

23±2,1**

* ?<0,05 ii??aiyii c I - II nooiaiai ** ?<0,05 ii??aiyii c III nooiaiai Oai?? ?c noaiicii o?aoa? III nooiaiy iio?aaoaaee na?eici?oi? i?aeaioiaee /a?ac ii?ooaiiy aaioeeyoe?? eaaaiue (oaae.1), /anoi oyaeeee o?aoaia?iio?o - o 82 oai?eo (87,2%) (ii??aiyii n 39,1% o oai?eo c I – II nooiaiai noaiico, ?<0,01). Aeey naiaoe?? aeeoaeueieo oeyo?a aiie iio?aaoaaee a?ae 2 aei 5 o?aoaia?iioineii?e. O 41% aeiaaee?a e?eoaaiiy aoei iaaoaeoeaiei, ui aieiaiei /eiii aoei iia’ycaii c aoaeaeoacii /anoeie eaaaiue ? iacia/iei aoaeoii aioea?ioeeioa?ai??. On? 34 oai?eo ?c noaiicii IV nooiaiy ia?aaoaaee a aeoaea oyaeeiio noai?, ui aoei iia’ycaii c? cia/iith iano?oeoe??th o?aoa? (/e ai?oai?) (aei 5ii o aei?ineeo), caiaeaiiyi eaaaiue ? cia/ieie ii?ooaiiyie aaciiai?io oa EIA (oaae.1). E??i oiai, o ieo aoee ii?ooaiiy a?ae?iaeeiai?ee a eaaaiyo c ?ioa?noeoe?aeueiei ?o iaa?yeii aiane?aeie cia/iiai cieaeaiiyy aioo??oiueiaeueaaiey?iiai oeneo i?ae /an aaeeoo.Aeey a?aeiiaeaiiy i?io?aeiino? aeeoaeueieo oeyo?a o 24 oai?eo aoei aeeiiaii ii 4 - 6 a?iioineii?e i?ae ia?eicii, o 10 – ii 5 – 6 o?a?ia?iioineii?e (OAN). O 11 oai?eo aeey a?aeiiaeaiiy i?io?aeiino? ai?oai? oa o?aoa? i?iaiaeeee aoaeoaaiiy o?aoa?. O ?ac? iaaoaeoeaiino? oeeo caoiae?a aoei iieacaii oa?i?iiaa iia?aoe?eia ao?o/aiiy. Aaaeeeaei iaoiaeii naiaoe?? aoei aioo??oiueio?aoaaeueia aaaaeaiiy aioea?ioee?a, aei yeeo aoea /ooeeaa iaoiaaiia i?e?ioei?a. Oeae iaoiae aoa iniiaiei o 31 oai?iai c o?aoainoii??th, yeo aoei i?iaaaeaii a ?ioeo e?eoaaeueieo caeeaaeao. Aaaeeeaith ? naiaoe?y aeeoaeueieo oeyo?a ? no?aaioiaeo o oai?eo c ii?eoeyie, o oiio /ene? aaaaeaiiy aioea?ioee?a c aioeaiaa?iaiith aeoeai?noth. Oai?? c o?aaiaie ia iio?aaoaaee ia?aaeiia?a?eii? i?aeaioiaee, a ?ac? iio?aae i?ioeoieiao oa?ai?th i?iaiaeeee iaeii/anii c ?iaeoeoe??th a ia?eic. I?aiaaeeeaoe?y o oai?eo c I – II nooiaiai noaiico ? o?aoainoii??th ia a?ae??ciyeany a?ae caaaeueiii?eeiyoi?. I?ioa o oai?eo c III – IV nooiaiai aeeaiea i?aiaaeeeaoe?y aoea iia’ycaia c aaeeeei ?eceeii ano?en??, oiio ia?eioe/ieo aiaeueaaoee?a oa iio?aeieo aaiciae?acai?io ia?aae iia?aoe??th ia aaiaeeee: ?ecee ia?aaeiia?aoe?eiiai no?ano aoa iaioei, i?ae ?ecee ano?en?? o oaeeo oai?eo. E??i oiai, ca aiaeeio aei iia?aoe?? oai?ei c ?eceeii OAEA aaiaeeee aaia?ei ( ii 2,5-5 oen. IAe i/o) /e o?aeneia?ei 7 500 Aoa ICU, a oai?ei c ?eceeii ?ioaeoe?eieo oneeaaeiaiue - aioea?ioee oe?ieiai niaeo?a ae??. Aaaaeaiiy a ia?eic o a?eueoino? aeiaaee?a aoei aioo??oiueiaaiiei. O?eueee o 12 ae?oae c o?aoainoiiith ?iaeoeoe?th a ia?eic aeeiioaaee ca aeiiiiiaith ooi?ioaio c ae?acio ieneaeii. sse iieacaa iao aeina?ae, o oai?eo ?c noaiicii 4-ai nooiaiy ?iaaeyoe?eia aaaaeaiiy a ia?eic aeeeeeaei oyaee? oneeaaeiaiiy aae aei ano?en??. Aacia/i?oei aoei aioo??oiueiaaiia aaaaeaiiy a ia?eic ?c canoinoaaiiyi i?i?aeaenaio?a ? ianooiiith ?iooaaoe??th o?aoa?. I?e oeueiio ia aoei aeiaaee?a oyaeeeo oneeaaeiaiue, iacaaaeath/e ia cia/iee noaiic. Aioo??oiueiaaiia aaaaeaiiy a ia?eic o 10 aeiaaeeao (2,7%) i?iaiaeeee ca aeiiiiiaith iaeiiai aianoaoeea (o?iiaioae-iao??th, 5,8(0,9 ia/ea /e ae?i?eaaio, 2 ia/ea). O an?o ?ioeo aeiaaeeao ia?eic aoa aaaaoieiiiiiaioiei: o?iiaioae-iao??th (3,1±0,4 ia/ea), iio?aei? aaiciae?acai?io (0,3 ±0,03 ia/ea), oaioai?e (0,15 ±0,3 ia/ea), iao??th ieneaooe?ao (2,0 ±0,3 a/ea), ae?i?eaai (1,7 ±0,3 ia/ea) o ??cieo ii?aeiaiiyo. Iaea?eueoee a?aenioie (62,5%) oneeaaeiaiue i?e aaaaeaii? a ia?eic iaa i?noea i?e i?iaaaeaii? iiiiia?eico (/ano?oa a?oa??aeueia a?iioaic?y), ui, iaaooue, aoei iia’aycaii ye c iaaaoeaiei aieeaii ia nei?ioeea?noue na?oeaaiai i’yca a aeicao o?iiaioaeo-iao??th, ye? aeei?enoiaoaathoueny aeey iiiiia?eico, oae ? c iaaeinoaoi?i caiia?aaiiyi no?ania?e ?aaeoe?? ia ?iooaaoe?th o?aoa?. Iaenoaa?euei?oei aaaaeaiiy a ia?eic aoei i?e ii?aeiaii? aaiciae?acai?io, oaioai?eo oa o?iiaioaeo-iao??th a iaaaeeeeo aeicao. O oai?eo c oyaeeeie noiooi?ie caoai?thaaiiyie na?oey ? noaeei aaaaeaiiy a ia?eic aeiiiaithaaee e?aeiea?iii (1-1,5 ia/ea a/a) – o 14 oai?eo oa i?o?iae?oea?eiii - o 13. O ?ac? iecueeiai a?oa??aeueiiai oeneo (AO) iaeaacia/i?oei aoei canoinoaaiiy iao??th ieneaooe?aoo ? eaoai?io. O a?eueoino? oai?eo (329) aeey ?iooaaoe?? o?aoa? canoiniaoaaee noeoeei?eoie?i (1-1,5 ia/ea), o e?aeiueiio ?ac? c iiia?aaei?i aaaaeaiiyi iaaeaiiey?ecoth/eo i?i?aeaenaio?a (o?ae??oi, a?aeoai), ine?eueee /aeaoe o?eaaeee /an ca oaeeo ianoaaei ?aeaenaoe?? i’yc?a aeoaea ?eceeiaaii. O o?ueio oai?eo c oyaeeeie noiooi?ie caoai?thaaiiyie ? c noaiicii I - II nooiaiy aeey ?iooaaoe?? o?aoa? aaiaeeee o?eueee iaaeaiiey?ecoth/? i?i?aeaenaioe (o?ae??oi, ii?eo?ii) O 47 oai?eo aoei i?iaaaeaii ?iaaeyoe?eiee ia?eic (?I): ooi?ioai + ae?acioo ieneae /e acaio?iiia noi?o + ae?acioo ieneae. I?e oeueiio a 65,9% aeiaaee?a ca?a?no?iaaii oneeaaeiaiiy: a?oa??aeueia a?ia?oaic?y (21,3%); a?oa??aeueia a?iioaic?y (34%); ii?ooaiiy ?eoio na?oey (10,6%). O ?aooe, 315 oai?eo, i?iaaaeaii oioaeueio aioo??oiueiaaiio aianoac?th (OAA) c ii?aeiaiiyie ??cieo aianoaoee?a: aaiciae?acai?ie (o 315 oai?eo): iao??th ieneaooe?aoo (188); ae?iia?eaeieo (136); eaoai?io (24); ae?i?eaaio (i?iiioie) (12). Aeey aiaeueaac?? on?i oeei oai?ei aaiaeeee oaioai?e. I?e canoinoaaii? oeueiai iaoiaeo e?euee?noue oneeaaeiaiue aoea iaioith (29,5%): a?oa??aeueia a?ia?oaic?y (21,8%); a?oa??aeueia a?iioaic?y (7,6%); ii?ooaiiy ?eoio na?oey (3,2%). Aeey ?aeaenaoe?? i’yc?a i?ae /an iia?aoe?? canoiniaoaaee iaaeaiiey?ecoth/? i?i?aeaenaioe. Aeey a?eueo ea?iaaiiiai ia?aa?ao OAA, i?io?eaeoeee ? e?eoaaiiy oneeaaeiaiue o 200 oai?eo ca iaaieo iieacaiue canoiniaoaaee aae’thaaioe (aeiiai?i – o 6 oai?eo; aeiaooai?i – o 1-ai; e?aeiea?i – o 26; i?o?iae?oea?ei – o 49; aa?iiai?e – o 24; iaai?th noeueoao – o 89). ?I ia iiaeia aoei canoiniaoaaoe i?ae /an aeayeeo iaoiae?a OAE (aeeaenue ieae/a). I?ioa i?e OAA oa?i?i i?iaoaeaeaiiy oai?eo i?ney iia?aoe??, a?aeiiaeaiiy aaeaeaaoiiai niiioaiiai aeeoaiiy oa aenooaaoe?? aoa o?eaae?oei ii??aiyii c ?I, iai?eeeaae, oa?i?i aenooaaoe?? a?aeiia?aeii 112(11 ? 42(8 oa (p<0,01) i?ney cae?i/aiiy iia?aoe??. Iaeneeaaei?oith i?iaeaiith aianoac?ieia?/iiai caaacia/aiiy ?aeiino?oeoeaieo iia?aoe?e ia ieaei?o aeeoaeueiuo oeyoao ? caaacia/aiiy ooo/ii? aaioeeyoe?? eaaaiue. Aieiaieie i?e/eiaie ? a?aenooi?noue i?ioyaii cia/iiai ia??iaeo iia?aoe?? aa?iaoecio aeeoaeueieo oeyo?a ? iai?ioeyoe?? o??o?aa ia aeeoaeueieo oeyoao c? ci?iith iieiaeaiiy ?iooaaoe?eii? o?oaee /e eaoaoa?a,/a?ac ye? cae?enith?oueny OAE. sseui iaoe ia oaac? ua oaeo caaea/o ye noai?aiiy iaeneiaeueii c?o/ieo oiia aeey o??o?aa i?ae /an iia?aoe??, noa? c?icoi?eei neeaaei?noue ae??oaiiy oe??? i?iaeaie aeey aianoac?ieiaa.Ia a?aei?io a?ae a?eueoino? ?ioeo aeae?a o??o?a?/ieo ao?o/aiue i?ae /an oaeeo iia?aoe?e iio??aii canoiniaoaaoe e?eueea iaoiae?a OAE, ianaiia?aae: o?aaeeoe?eio (oOAE) ? aeniei/anoioio (A*OAE). O?aaeeoe?eio OAE caaacia/oaaee ia?eicii-aeeoaeueiei aia?aoii “Iieeia?eii-2” ? ?ani??aoi?aie ?I-6, Oaca-5 c oaeeeiiei ia’?iii aeeoaiiy (OIAe) 8-14 e ia 1 oa oa Vt 5 - 8 ie /ea. A*OAE i?iaiaeeee ca aeiiiiiaith ?ani??aoi?a Oaca-5 o ?aaeei? Hight frequency positive pressure ventilation (HFPPV). Aeei?enoiaoaaee oa?iiieanoe/i? eaoaoa?e aioo??oi?i ae?aiao?ii 3 - 3,5 ii oa 45 ni caaaeiaaeee. Ia?aiao?e A*OAE aoee oae?: Vt = 80 - 160 ie, *Ae = 140 – 160 ia 1oa, ni?aa?aeiioaiiy aaeeo/aeaeeo (I:E) a?ae 0,3:1 aei 1,2:1, FiO2 = 0,8 – 1,0. Canoiniaoth/e A*OAE, iio??aii aoei i?aaeeueii anoaiiaeoe eaoaoa? o aeeoaeueieo oeyoao (4 - 5 ni aeeaoa a?ae ?icoeio no?iee o?aoa? /e a?iioa). O ?ac? a?eueo aenieiai ?icoaooaaiiy yoaeoeai?noue A*OAE cieaeoaaeanue, a iaaei??ii aeeaieiai - aeieeaea iaoo?aoe?y a?iioa c iaiiaeeea?noth aaeaeaaoiiai aeaeeoo. Iii?oi?eia i?ae /an i?iaaaeaiiy A*OAE iieyaaa o a?coaeueiiio (i?e iiaeeeaino?), aoneoeueoaoeaiiio eiio?ie? aaioeeyoe??, niinoa?aaeaii? ca ee?i?/ieie iciaeaie, iieacieeaie ioeuenieneiao?a ? aac?a e?ia?. Iaeiae iii?oi?eia A*OAE ? iaeiei c iaea?aceea?oeo eaiie oeueiai iaoiaeo: a?coaeueiee eiio?ieue ca aeneo?n?yie eaaai? ia caaaeaee iiaeeeaee, neeaaei?oei i?ae i?e oOAE ? aoneoeueoaoeaiee eiio?ieue, ia aea? iiceoeaii? ?ioi?iaoe?? iieaciee oeneo ia aenio? aaeeoo, ine?eueee a?i iaeaea ia ci?ith?oueny i?e ii?ooaii? aaioeeyoe??, iieacieee ioeuenieneiao?a /anoi cai?ciththoueny. Eaoaoa?e, ca aeiiiiiaith yeeo cae?enith?oueny A*OAE, /anoi caaeaathoueny caonoeaie e?ia? ? ci?uothoueny i?ae /an iai?ioeyoe?e o??o?aa. Oiio aianoac?ieia, aeei?enoaoth/e A*OAE a ?aaeei? a?aenooiino? naiino?eiiai aeeoaiiy oai?iai, iiaeiai iniaeeai oaaaeii aeaaoe i?i aoaeoeai?noue aaioeeyoe?? eaaaiue. Iacaaaeath/e ia oe? iaaeie?ee, iaoiae A*OAE ia? cia/i? ia?aaaae ii??aiyii c oOAE: aea? ciiao i?iaiaeeoe aaioeeyoe?th eaaaiue ca a?aenooiino? aa?iaoecio aeeoaeueieo oeyo?a ? caaacia/oaaoe c?o/i?o? oiiae aeey o??o?aa, iniaeeai i?ae /an iaeeaaeaiiy aianoiiico. Canoinoaaiiy oiai /e ?ioiai iaoiaeo OAE caeaaeaei, aieiaiei /eiii, a?ae aeaeo oa aoaio iia?aoe?eiiai ao?o/aiiy. O?aoaiai?oaia ?acaeoe?y. ?iooaaoe?y o?aoa? o oai?eo ?c noaiicii I – II nooiaiy aoea ianeeaaeiith: o?oaeo i?iaiaeeee ieae/a caoaeaii? ae?eyiee o?aoa?. I?ioa o oai?eo c aeia?iye?nieie iooeeiaie ai?oai? /e aa?oiueiai a?aeae?eo o?aoa? ia oiie?e i?aeoe? (9 aeiaaee?a) caaaeaee ? ?ecee a?ae?eao iooeeie c iiaeeeaith ano?en??th aiane?aeie iaoo?aoe?? i?th o?aoa?, oiio a oaeeo aeiaaeeao iio??aii c?aco aeeiiaoe OAN e aeeo/eoe iooeeio. O 24 oai?eo ?c noaiicii III ? iniaeeai IV nooiaiy ia?aae ?iooaaoe??th o?aoa? aeeiioaaee ?? aoaeoaaiiy ?iooaaoe?eieie o?oaeaie, niaoe?aeueieie aoaeaie aai ooaonii ?ea?aeiiai a?iioineiia. Oneeaaeiaiue ilae /ac aeeiiaiiy oeeo iai?ioeyoe?e ia aoei. I?ney ?iooaaoe?? iaa?oue ii??aiyii oiieith o?oaeith (?6 - 6,5 - o ae?iie oa 6,5 - 7 – o /ieia?e?a) aaeaaaeiny cae?enithaaoe yoaeoeaio OAE. Oea i?aeoaa?aeaeothoue ? na?aaei? iieacacieee aac?a e?ia? oa EIN o 22 oai?eo (Vt=5-6 ie/ea, OIAe=10 -11 e /oa): PaO2 /FiO2 = 435 ( 23 ii ?o.no.; PaCO2 = 33 ( 2,2 ii ?o.no.;Qs/Qt=6,7( 0,7%; pH = 7,44 ( 0,02; BE = -0,7 ( 0,1 iiieue/e; p50 = 26,0 ( 0,1 ii ?o. no. O oai?eo c o?aoainoii??th OAE ia ii/aoeiaiio yoai? iia?aoe?? i?iaiaeeee aeaiia oeyoaie: aeeiioaaee i?io?aoaaeueio ?iooaaoe?th, yeui caeeoaeany i?io?aei?noue ai?oai?, aai ?iooaaoe?th aaciina?aaeiuei /a?ac o?aoaio?nooeo /e o?aoaio?no?o a ?ac? iae?oa?aoe?? ai?oai? oa iaaea?oo?eaoe?eiiai a?aeae?eo o?aoa?. I?ney aeae?eaiiy ? ia?aoeiaiiy o?aoa? ieae/a iooeeie /e caoaeaii? ae?eyiee canoiniaoaaee ooio-aeeoaiiy. I?e oeueiio aeyaeaii oae? iieacieee aac?a e?ia? oa EIN (n=22) (Vt=6 - 8 ie/ea ? OIAe=11 -13 e /oa): PaO2 /FiO2 = 468 ( 33 ii ?o.no.;?aNO2 = 32 ( 3,4 ii ?o.no.; Qs/Qt = 5,9 ( 0,8%; pH = 7,45 ( 0,03;BE = -1,1 ( 0,2 iiieue/e; p50 = 25,8 ( 0,1 ii ?o. no. Aeey ooioa-aeeoaiiy canoiniaoaaee cae/aei? ?iooaaoe?ei? o?oaee, ca aeiiiiiaith yeeo e?aua cae?enithaaoe naiaoe?th aeeoaeueieo oeyo?a i?ae /an iia?aoe??. O?oaee a?eueoi? aeiaaeeie /e A-ia?aci? ia aeei?enoiaoaaee. O 14 oai?eo canoiniaoaaee A*OAE ca aeiiiiiaith cae/aeii? o?oaee, o?eueee aac aa?iaoecio aeeoaeueiiai eiioo?o /e eaoaoa?a. I?e oeueiio aoee oae? iieacieee aac?a e?ia? oa EIN ( n=14) ( Vt = 100 – 140 ie oa *Ae = 120 - 160 /oa): PaO2 /FiO2 = 310 ( 33 ii ?o.no.; PaCO2 = 45 ( 3,4 ii ?o.no.; Qs/Qt = 12,9 ( 0,7%; pH = 7,35 ( 0,02; BE = -0,3 ( 0,2 iiieue/e; p50 = 27,2 ( 0,2 ii ?o. no. O an?o aeiaaeeao aoei cae?eniaii aaioeeyoe?th iaio eaaaiue. Na?aaeiy o?eaae?noue A*OAE - 48±15,7 oa. I? a iaeiiio aeiaaeeo ia aoei cia/ieo ii?ooaiue aaioeeyoe??, ieneaaiaoe?? e?ia? oa EIA. SO2 ia ciaiooaaeiny ieae/a 88%, i?ioa o 4 oai?eo ?aNI2 ia?aaeuoaaei ii?iaeuei? iieacieee – 50 - 52 ii ?o.no. /a?ac 20 - 30 oa A*OAE. Ia?aae cae?i/aiiyi oi?ioaaiiy o?aoaiai?oaiiai aianoiiico ia?aoiaeeee ia aeeoaiiy /a?ac iacio?aoaaeueio o?oaeo. Caaacia/aiiy aaioeeyoe?? eaaaiue i?ae /an iia?aoe?e ia oeeii-a?oaeiiio a?aeae?e? o?aoa? iaei a?ae??ciyeinue a?ae iaaaaeaiiai aeua, iaeiae ia ii/aoeiaiio aoai? iia?aoe?? ?iooaaoe?eia o?oaea ?icoaoiaoaaeany aeua iooeeie /e noaiico. I?e oeueiio ia aoei cia/ieo ii?ooaiue aaciiai?io a eaaaiyo (n=12): PaO2 /FiO2=245 ( 24 ii ?o.no.; PaCO2 = 44 ( 2,6 ii ?o.no.;Qs/Qt = 14,8 ( 1,6%; pH = 7,32 ( 0,04;BE = -4,2 ( 0,3 iiieue/e; p50 = 28,8 ( 0,3 ii ?o. no.. Ca oeeo oiia canoiniaoaaeenue iaaaeee? cia/aiiy Vt i?e ii??aiyii iaaaeeeeo ye aeey iia?aoe?e ia o?aoa? cia/aiiyo OIAe c i?aeaeuaiiyi ni?aa?aeiioaiiy I : E aei 1 : 3, ?iaeoa ia caaacia/oaaany aeaeeo. I?ioyaii ei?ioeeo i?ii?aee?a /ano i?ae /an aeae?eaiiy o??o?aii o?aoa? aoee ii?ooaiiy aaioeeyoe?? c? cieaeaiiyi SO2 aei 68-70%, i?ioa a aeiaeiiio aeiaaeeo oea ia i?ecaaei aei oyaeeeo oneeaaeiaiue. Iaeneeaaei?oei aoei caaacia/aiiy aaioeeyoe?? eaaaiue i?e ?acaeoe?? a?oo?eaoe?? o?aoa?. I?ney ia?aoeiaiiy o?aoa? aeua iooeeie canoiniaoaaee ??ci? iaoiaee oa aa??aioe OAE. O?aaeeoe?eia OAE iaei??? e?ai? eaaai? i?e iayaiino? i?aai?. Iieacieee aac?a e?ia? oa EIA ( n=40) (Vt=4-6 ie/ea ? OIAe=10 -11 e /oa): PaO2/FiO2=165 ( 24 ii ?o.no.;PaCO2 = 44 ( 2,6 ii ?o.no.; Qs/Qt = 23,8 ( 3,1%;pH = 7,32 ( 0,04;AE = -4,2 ( 0,3 iiieue/e; p50 = 28,8 ( 0,3 ii ?o. no. Iaoiaeeeo oOAE e?ai? eaaai? aeei?enoiaoaaee o 122 oai?eo, o 113 c ieo (92,6%) aaeaaaeiny caaacia/oaaoe aaioeeyoe?th, o 9 oai?eo (7,3%) aeieeaea a?iienai?y i?ney 30 oa OAE, a a 6 (4,9%) – a?ia?eaii?y. Aieiaiei /eiii oea aoee oai?? iioeeiai a?eo /e o?,ye? a aiaiiac? iaee OICE. O a?eueoino? oai?eo oeae iaoiae caaacia/oaaa aeinoaoi?e aaciiai?i iaa?oue i?ioyaii o?eaaeiai /ano (aei 150 oa). Iaio iaae?eiith aoea A*OAE iaei??? e?ai? eaaai? (33 oai?eo). I?e canoinoaaii? oeueiai iaoiaeo iieacieee aac?a e?ia? oa EIN ( n=12) (Vt= 100 – 140 ie: *Ae = 120 - 160 /oa) aoee oaeeie: PaO2 /FiO2=165 ( 39 ii ?o.no.;PaCO2 = 48 ( 5,5 ii ?o.no.; Qs/Qt = 24,8 ( 2,9%; pH = 7,33 ( 0,02; BE= -1,3 ( 0,2 iiieue/e; p50 = 28,0 ( 0,3 ii ?o. no. Iacaaaeath/e ia oa, ui o 29 oai?eo i?ioyaii iaaiiai /ano, o 3 c ieo - o?eaaeiai (aei 90 oa), aaeaaaeiny caaacia/eoe aaciiai?i, o 4 oai?eo (7,5%) oaea ia ia?oeo oaeeeiao cieaeoaaeinue SI2, i?aeaeuoaaeinue ooiooaaiiy a iaeiio eie? e?iaiia?ao oa ?aNI2. O oeeo aeiaaeeao iio??aii aoei ia?aoiaeeoe ia oOAE. E??i oiai, iii?oi?eia ca aoaeoeai?noueth aaioeeyoe?? aeyaeany neeaaei?oei, ine?eueee aoa iaiiaeeeaee a?coaeueiee eiio?ieue ca aeeoaiiyi. Iaae?ei?oei iaoiaeii aoea A*OAE e?ai? eaaai? a ii?aeiaii? c A*OAE aa?oiuei? /e aeaio ieaei?o /anoie i?aai? eaaai? (47 aeiaaee?a). I?e oeueiio iieacieee aac?a e?ia? oa EIN ( n=14) (Vt= 100 – 140 ie oa *Ae = 120 - 160 /oa): PaO2 /FiO2=290 ( 28 ii ?o.no.;PaCO2 = 44 ( 2,4 ii ?o.no.; Qs/Qt = 13,6 ( 3,3%;pH = 7,35 ( 0,01;BE = 1,1 ( 0,4 iiieue/e; p50 = 27,3 ( 0,4 ii ?o. no. I?e oeueiio aa??aio? A*OAE o an?o aeiaaeeao aoei caaacia/aii aaeaeaaoiee aaciiai?i a eaaaiyo, oaeiae i?ino?oei aoa iii?oi?eia, ine?eueee caaacia/oaaany a?coaeueiee eiio?ieue ca aaioeeyoe??th i?aai? eaaai?. O 4 aeiaaeeao canoiniaoaaee A*OAE iaei??? i?aai? eaaai?. Aiane?aeie iaaaeeei? aeiaaeeie i?aaiai aieiaiiai a?iioa i?iaiaeeee aaioeeyoe?th ie?aii aa?oiuei? ? ie?aii ieaeiuei? e na?aaeiuei? /anoie. O?eaae?noue aaioeeyoe?? aoea iaaeeeeith (10 - 15oa).Canoiniaoaaoe oeae iaoiae oae naii ye ? oOAE iaei??? i?aai? eaaai? (2 aeiaaeee), aoei aeoaea neeaaeii, ? inoaii?i /anii eiai ia canoiniaoaaee. A 11 aeiaaeeao aeei?enoiaoaaee A*OAE ieaeiuei? oa na?aaeiuei? /anoie i?aai? eaaai? c oOAE e?ai? eaaai?. Iieacieee aac?a e?ia? oa EIN ( n=9) (Vt= 120 – 130 ie *Ae = 120 - 160 /oa): PaO2 /FiO2=380 ( 19 ii ?o.no.;PaCO2 = 32 ( 4,9 ii ?o.no.; Qs/Qt = 10,9 ( 2,8%; pH = 7,47 ( 0,02;AE = -3,8 ( 0,3 iiieue/e; p50 = 24,9 ( 0,6 ii ?o. no. Ii?ooaiue aaciaiai neeaaeo ? EIA a?oa??aeueiie e?ia? i?e oeueiio aa??aio? aaioeeyoe?? eaaaiue a aeiaeiiio aeiaaeeo ia aoei. Oae? nai? aeniiaee iiaeia c?iaeoe ? i?i A*OAE aa?oiuei? /anoee i?aai? eaaai? a ii?aeiaii? c oOAE e?ai? eaaai? (5 aeiaaee?a) O 18 aeiaaeeao aoei cae?eniaii A*OAE e?ai? eaaai? a ii?aeiaii? c oOAE ieaeiuei? oa n?aaeiuei? /anoie i?aai? eaaai?. Iieacieee aac?a e?ia? oa EIN ( n=13) (Vt= 120 – 130 ie, *Ae = 120 - 160 /oa): PaO2 /FiO2=395 ( 24 ii ?o.no.;PaCO2 = 33 ( 5,1 ii ?o.no.; Qs/Qt = 10,1 ( 2,8%;pH = 7,46 ( 0,01;AA= -3,5 ( 0,2 iiieue/e; p50 = 25,0 ( 0,7 ii ?o. no. O aeiaeiiio aeiaaeeo ia aoei ii?ooaiue aaciiai?io i?ae /an canoinoaaiiy oeueiai iaoiaeo OAE. Oa naia iiaeia neacaoe oaeiae i?i A*OAE e?ai? eaaai? a ii?aeiaii? c oOAE aa?oiuei? /anoee i?aai? eaaai? (19 aeiaaee?a). O aeiaaeeao ?acaeoe?? a?oo?eaoe?? o?aoa? oaeiae canoiniaoaaee oOAE e?ai? eaaai? oa aa?oiuei? /anoee i?aai? eaaai? (5 aeiaaee?a) ? oOAE e?ai? eaaai? oa ieaeiuei? ? na?aaeiuei? /anoie i?aai? eaaai? (3 aeiaaeee). Ii?ooaiue aaciiai?io ia aoei. Ia?ai?aeio aaioeeyoe?th eaaaiue, eiee ia??iaee a?ia?aaioeeyoe?? /enoei eeniai /a?aoaaeeny c ia??iaeaie aiiia i?ioyaii 1 - 1,5 oa, canoiniaoaaee ia aoai? oi?ioaaiiy o?aoaia?iio?aeueiiai aianoiiico o 39 oai?eo. Oneeaaeiaiue ia aoei. O 8 oai?eo, c ieo o 2 i?ae /an ?iieaioaoe?? e?aiai aieiaiiai a?iioa o i?ii?aeiee a?iio i?aai? eaaai? canoiniaoaaee aaioeeyoe?th eaaaiue oi?niaaiei iioieii eenith (aei 20-25 e/oa). Oeae iaoiae aeei?enoiaoaaee o?eueee ca aeiiiiiaith ?o/ii? aaioeeyoe?? i?oeii ia?eicii-aeeoaeueiiai aia?aoo, ine?eueee o?eueee ca oaei? oiiae aianoac?ieia i?a ?aaoethaaoe ? eiio?iethaaoe aaeaeaaoio iiaea/o eenith. . I?ney cae?i/aiiy oi?ioaaiiy aianoiiico o?oaeiiu?a ?c caaacia/aiiyi aaioeeyoe?? eaaaiue i?ae /an iia?aoe?? ia aeieeaei. Neeaaei? i?iaeaie ?c caaacia/aiiyi aaioeeyoe?? eaaaiue aeiaiaeeoueny ae??ooaaoe aianoac?ieiao o oai?eo c ?ic?eaaie o?aoa? oa ai?oai?. O oai?eo c ?aiith ia oe? ca iiaeeeaino? aeeiioaaee OAN (16 aeiaaee?a) ?, yeui ia aoei iiaiiai ?ic?eao o?aoa? /e o?aoaiai?oaiiai niieo/aiiy, ?iooaaoe?th aeeiioaaee ca aeiiiiiaith o?a?ia?iioineiia. O 2 oai?eo c iiaiei ?ic?eaii o?aoa? ?iooaaoe?th i?iaiaeea o??o?a /a?ac ?aio i?ae i?noeaaei ciaaiethaaiiyi. I? a yeiio ?ac? ia iiaeia aaiaeeoe i?i?aeaenaioe aei aeae?eaiiy o??o?aii aeenoaeueiiai a?ae??cea o?aoa? i?e ?? iiaiiio ?ic?ea? aiane?aeie aenieiai ?eceeo ano?en?? ? nia?o? oai?iai. Ia iaio neeaaeia neooaoe?y aeieeaea o aeiaaeeao ?ic?eao iaae?anoeiaeueiiai a?aeae?eo o?aoa? /e ?? a?oo?eaoe?? aiane?aeie o?aaie (3 oai?eo) /e iaaeinoaoiino? o?aoaia?iio?aeueiiai aianoiiico (6 oai?eo) ca iio?aae iia?aoe??. O oaeeo oai?eo i?ney i?aieneaaiaoe?? (15 – 20 oa), i?ney aaaaeaiiy i?i?aeaenaio?a (noeoeei?eoie?i) aac aaioeeyoe??, o oiio /ene? ianeith, c?aco i?iaiaeeee ?iooaaoe?th aieiaiiai a?iioa ( /ano?oa e?aiai) /a?ac o?a?ia?iioineii . Oea iaeaacia/i?oa oaeoeea a oaeeo aeiaaeeao. Oaeei /eiii, iiaeia eiinoaooaaoe : SYMBOL 183 f "Symbol" s 10 h SYMBOL 183 f "Symbol" s 10 h A on?o aeiaaeeao aoei caaacia/aii OAE i?ae /an iia?aoe?? aac canoinoaaiiy aeno?aei?ii?aeueieo iaoiae?a ieneaaiaoe??. SYMBOL 183 f "Symbol" s 10 h SYMBOL 183 f "Symbol" s 10 h E?euee?noue ?io?aiia?aoe?eiuo oneeaaeiaiue i?e o?aoaiai?oai?e ?acaeoe?? oa aenie?e ?acaeoe?? o?aoa? ia iaia’yceiai aeei?enoiaoaaoe A*OAE, ca aeiiiiiaith o?aaeeoe?eii? OAE iiaeia caaacia/eoe aaeaeaaoio aaioeeyoe?th eaaaiue, oi/a a aeayeeo aeiaaeeao, uia caaacia/eoe ni?eyoeea?o? oiiae aeey o??o?aa, iiaeia canoiniaoaaoe A*OAE. SYMBOL 183 f "Symbol" s 10 h SYMBOL 183 f "Symbol" s 10 h A?aenioie oyaeei? a?iienai?? oa a?ia?eaii?? i?ae /an iia?aoe?e ia a?oo?eaoe?? o?aoa? oa iaaea?oo?eaoe?ei?e ae?eyioe? aoa ieae/ei (23,5%) i?e canoinoaaii? oOAE oa A*OAE, i?ae i?e canoinoaaii? o?eueee oOAE (36,7%); on? aeiaaeee oneeaaeiaiue i?e A*OAE aoee iiaycai? c aaioeeyoe??th o?eueee iaei??? eaaai?, i?e A*OAE iaio eaaaiue /e iaei??? eaaai? oa iaei??? /e aeaio /anoie ae?oai? - oneeaaeiaiue ia aoei. Oae naii ye ? aianoac?ieiae/ia caaacia/aiiy, oaeoeea aaaeaiiy i?neyiia?aoe?eiiai ia??iaeo aaaaoi a /iio caeaaeeoue a?ae aeaeo iia?aoe?eiai ao?o/aiiy. I?ney o?aoaiai?oaii? ?acaeoe?? aeeoaiiy /a?ac i?e?iaei? aeeoaeuei? oeyoe ? iaiiaeeeaei /a?ac iaa?ye aianoiiico ? a?aenooi?noue aoaeoeaiiai eaoeth. I?ioa /a?ac iaaaoeai? aeanoeaino? o?aoainoii??, iniaeeai ?? ooeiaeaeoaaeueiee aieea ia aianoiiic, ie a?aeiiaeeenue a?ae oeueiai iaoiaeo. O oaeeo oai?eo ?aeeiith aeueoa?iaoeaith aoea o?eaaea iacio?aoaaeueia ?iooaaoe?y (IO?), yeo ie canoinoaaee i?ioyaii 3 – 36 ae?a o 109 oai?eo i?ney o?aoaiai?oaii? ?acaeoe?? oa o 27 oai?eo i?ney ?acaeoe?? oeeiiai a?aeae?eo o?aoa?. Ia?oith iaiao?aeiith oiiaith oni?oiiai canoinoaaiiy oeueiai iaoiaeo aoa aea?? iioeiaeueiiai ae?aiao?a ?iooaaoe?eii? o?oaee, ine?eueee caiaaeoi oe?iea o?oaea ca?eueoo? ?ecee ?oai?caoe?? neeciai? iaieiiee ai?oai? e o?aoa? ? iiaoi?iiai ?o noaiicoaaiiy, a caiaaeoi aocueea - cia/ii oneeaaeith? i?io?aei?noue ?iooaaoe?eii? o?oaee. O aei?ineeo ae?iie aeei?enoiaoaaee ?iooaaoe?eio o?oaeo ?7 – o 24 c 34 oai?eo, ?7,5 – o 5 ? ?6,5 – o 5; o aei?ineeo /ieia?e?a ?8 – o 13 c 24 oai?eo, ?7,5 – o 8, ?7 – o 3. Aeey ae?oae aeae?aee oaeee ?ici?? ?iooaaoe?eii? o?oaee, uia aiia aoea aoae/ith, i?ae iaeaoae/a ae?eyiea ieaei?o aeeoaeueieo oeyo?a, oiaoi a aeaiiiio aeiaaeeo - aianoiiico. I?aeoe/ii iioeiaeueiei aaaaeaee oaeee ?ici?? ?iooaaoe?eii? o?oaee, uia caa??aaany neeae aaco ia aaeeoo i?ae /an OAE, aea uia caeeoaeiny iaoo?oaeiaiei i?e?iaeia aeeoaiiy o aeeoeie. Aaaeeeaei iaoiaeii i?io?eaeoeee oneeaaeiaiue IO? aoei nenoaiaoe/ia ia?ai?uaiiy o?oaee a o?aoa?, a oaeiae oa, ui ia i?iaiaeeee /anoeo ?a?iooaaoe?e. I?aeoe/ii an? oai?? aeia?a aaeaiooaaeenue aei IO? aac canoinoaaiiy naaeaoeaieo cania?a. Aei canoinoaaiiy i?io?aoaaeueii? o?oaee oaei? aaeaioaoe?? aeinyaoe ia aaeaaaeinue. Aei ia?aaaa IO? ii??aiyii c i?io?aoaaeueiith ?iooaaoe?th iiaeii a?aeianoe iaae?ei?oo o?enaoe?th o?oaee ? iaioee ?ecee aeiaaeeiai? aenooaaoe??. Oe? ia?aaaae aeaaaee ciiao oai?iio aaea ia 2 – 3-oth aeiao ia?aoiaeeoe ia aeoeaiee ?ooiaee ?aaeei. Aieiai? caaaeaiiy i?ae /an IO? - i?aeo?eiaiiy i?io?aeiino? ?iooaaoe?eii? o?oaee ? i?io?eaeoeea o?aoaia?iio?oo. Aaeoa??eia?/iee aiae?c oa?eioeiiy i?iaiaeeee o 92 oai?eo, yeei i?iaiaeeee IO?. O?eueee a 19,5% aeiaaee?a ia aeyaeyeiny aa?iaii? iaoiaaii? i?e?ioei?e (aiae?ce ia aiaa?iai? i?e?ii?aai?cie ia i?iaiaeeeenue). O 68 oai?eo (73,9%) aen?aaee e?eueea aeae?a caoaeiee?a ?ioaeoe??: /ano?oa oea aoee a?aiiaaaoeai?, c ieo iniaeeai /anoi Ps. aeruginosa, a c a?ai-iiceoeaieo - Staph. aureus, ?o ii?aeiaiiy – o 29 oai?eo (31,5%). sse iiiieoeueoo?a oaeiae /ano?oa aen?aaeany Ps. aeruginosa – o 12 oai?eo (13,0%), a aeae? ca /anoioith aoee St. aureus – o 5 oai?eo (5,4%) ? Proteus vulgaris – o 4 oai?eo (4,3%). Aeey i?io?eaeoeee e e?eoaaiiy ?ioaeoe?eieo oneeaaeiaiue aaiaeeee aioo??oiueiaaii aioea?ioeee 68 oai?ei, aioo??oiueio?aoaaeueii – an?i, yeei i?iaiaeeee IO?. sseui ia aoei oneeaaeiaiue, /a?ac 8 – 10 ae?a aioo??oiueiaaiio aioea?ioeeioa?ai?th i?eieiyee. Inoaii?i /anii ca?eueoeeenue aeiaaeee ia/ooeeaino? caoaeiee?a aei an?o aeei?enoiaoaaieo aioea?ioee?a. O a?aeae?eaiiyo ?ioaineaii? oa?ai?? (A?O) oai?? i?ney o?aoaiai?oaii? ?acaeoe?? a na?aaeiueiio ia?aaoaaee 15,2±3,4 ae?a. I?neyiia?aoe?eia eaoaeuei?noue noaiiaeea 4,6% (5 oai?eo). I?e/eiaie ?? aoee: oneeaaeiaiiy c aieo aianoiiico c ?acaeoeii oyaeei? iiaaiii??, a?iceaia e?iaioa/a c iea/iaieiaiiai noiaao?a /e ai?oe, iaae?anoei?o. I?ney oee?eoey?ii? ?acaeoe?? o?aoa? a oeeiiio ? a?oaeiiio a?aeae?eao aieiaiei caaaeaiiyi oaeiae aoei caaacia/aiiy i?io?aeiino? aeeoaeueieo oeyo?a.Ca aeiyoeii 27 oai?eo aenooaaoe?th o?aoa? aeeiioaaee c?aco i?ney iia?aoe?? ca oiiae a?aeiiaeaiey aaeaeaaoiiai niiioaiiai aeeoaiiy (a na?aaeueiio /a?ac 110±25 oa). Aieiaiei iaoiaeii i?aeo?eiaiiy i?io?aeiino? aeeoaeueieo oeyo?a aoea o?a?ia?iioineii?y, yeo i?iaiaeeee a i?neyiia?aoe?eiiio ia??iae? i?ioycaii inoaiiueiai aeanyoe??//y an?i oai?ei oe??? a?oie (a na?aaeiueiio 6,7±1,6 i?ioeaaeo? i?ioyaii ia?oeo 11 ae?a i?ney iia?aoe??). Cia/ii oneeaaeithaaea aaaeaiiy i?neyiia?aoe?eiiai ia??iaeo a oeeo oai?eo iaiiaeeea?noue aeiiii?aeiiai aeeoaiiy /a?ac ?ecee ooeiaeaeaiiy aianoiiico. Cia/ieo ii?ooaiue aaciaiai neeaaeo e?ia? oa EIN o i?neyiia?aoe?eiiio ia??iae? o oai?eo oe??? a?oie ia aoei. Iacia/ii aoa cieaeaiiee iieaciee PaO2/FiO2 (aei 302 ( 57,6 ii ?o.no. ia 3-th aeiao i?ney iia?aoe?? ) oa i?aeaeuoaaeiny ooiooaaiiy a iaeiio eie? e?iaia?ao (aei 17 ( 4,4% oaeiae ia 3-th i?neyiia?aoe?eio aeiao). A na?aaeiueiio o A?O oai?? oe??? a?oie ia?aaoaaee 6,8±1,2 ae?a. I?neaiia?aoe?eia eaoaeuei?noue noaiiaeea 1,2%, iiia? 1 oai?ee aiane?aeie a?iceaii? e?iaioa/? c iea/i-aieiaiiai noiaao?a. Ia?aa?a i?neyiia?aoe?eiiai ia??iaeo o oai?eo i?ney a?eii/anoi? ?acaeoe?? o?aoa? oa eeeiiaeaeii? ?acaeoe?? a?oo?eaoe?? o?aoa? (39 oai?eo) aoa aac oneeaaeiaiue. Aenooaaoe?y o?aoa? oa ia?ao?ae ia niiioaiia aeeoaiiy a na?aaeiueiio cae?enithaaeenue /a?ac 55±21 oa i?ney iia?aoe??. Iieacieee aaciiai?io oa EIN o oai?eo oe??? a?oie aoee aac ii?ooaiue. Iio?aaa o i?iaaaeaii? OAN aeieeea o?eueee o 11 oai?eo (28,2%). Oaeoe/ii a?eueo?noue c ieo ia iio?aaoaaee ?ioaineaii? oa?ai??. Na?aaeiy o?eaae?noue o A?O noaiiaeea 1,7±0,3 ae?a. Eaoaeueieo aeiaaee?a ia aoei. O 20 c 24 oai?eo (83,3%) i?ney ooeaaiiy o?aoa? aiane?aeie o?aaie i?neyiia?aoe?eiee ia??iae ia noi?iaiaeaeoaaany oneeaaeiaiiyie. O 18 c ieo i?iaiaeeee OAN. Oyaeeeo ii?ooaiue aeeoaiiy ia aoei. Iiaeia cacia/eoe, ui ii?iaeuei? iieacieee aaciiai?io a oe?e a?oi? oai?eo e??i nai?/aniiai oa eaae?o?eiaaiiai o??o?a?/iiai ao?o/aiiy iiyniththoueny oaeiae aeia?ei ii/aoeiaei noaiii eaaaiue aei iia?aoe??. O 4 oai?eo c o?aaiith aeeoaeueiuo oeyo?a ? ianooiiei ooeaaiiyi o?aoa?, eio?eo aoei aini?oae?ciaaii o noai? oyaeeiai aaii?aa?/iiai oieo, i?iaeiaaeoaaeany i?ioeoieiaa oa?ai?y. O A?O oai?? oe??? a?oie ia?aaoaaee a na?aaeiueiio 3,5±0,9 ae?a. Iiia? 1 oai?ee (4,2%) a?eii 90 ?ie?a a?ae iaaeinoaoiino? ooieoe?? na?oey. Iacaaaeath/e ia oa, ui o aaaaoueio oai?eo i?ney oee?eoey?ii? ?acaeoe?? a?oo?eaoe?? o?aoa? c? cia/iith iano?oeoe??th aeeoaeueiuo oeyo?a i?ney iia?aoe?? ?oiy i?io?aei?noue iie?auoaaeanue (aoei aeiaaaeaii i?ae /an OAN), o 12 oai?eo (35,3%) ia 2 - 3-oth aeiao i?ney iia?aoe?? aeieeaee ii?ooaiiy aeeoaiiy, ye? ca ee?i?/iith neiioiiaoeeith iaaaaeoaaee iaa?ye eaaaiue. Aoaeo OAN i?iaeiaaeoaaany o?eueee i?ioyaii 10 - 15 oa. Iaeaea o an?o oai?eo oe??? a?oie (11) ia 4 - 5-oo aeiao iaei i?noea cia/ia iie?auaiiy noaio. O 1-ai oai?iai i?ney oee?eoey?ii? ?acaeoe?? a?oo?eaoe?? o?aoa? e /anoeiai i?aaiai aieiaiiai a?iioa o cayceo c o?aoaino?aaio?aeiith ii?eoeath aeieeea iaaeinoaoi?noue aianoiiico, iaae?anoei?o ? nainen, aiane?aeie /iai oai?ee iiia?. O 22 oai?eo o i?neaiia?aoe?eiiio ia??iae? oneeaaeiaiue ia aoei. Eaoaeuei?noue noaiiaeea 2,9%. I?neyiia?aoe?eiee ia??iae o oai?eo i?ney oee?eoey?ii? ?acaeoe?? a?oo?eaoe?? o?aoa? ? i?aainoi?iiiuei? iiaaiiiaeoii?? /e ?acaeoe?? iaei??? aai aeaio /anoie i?aai? eaaai? (60 oai?eo) aoa oyae/ei, i?ae o iiia?aaei?e a?oi?. I?e/eiaie iia?aoe?e o an?o aeiaaeeao aoee ceiye?nie iooeeie, a?e 18 oai?eo (30%) ia?aaeuoaaa 60 ?ie?a, a a 46 oai?eo (76,7%) aoee oyaee? noiooi? caoai?thaaiiy. I?aeoe/ii o an?o c ieo aoea iaaeinoaoi?noue aeeoaiiy. ? a oe?e a?oi? oai?eo iaeiaioee ??aaiue ieneaaiaoe?? e?ia? aecia/aany ia 3 – 4-oo aeiao i?ney iia?aoe??, i?ioa nooi?iue oeueiai cieaeaiiy aoa a?eueoei, i?ae o iiia?aaei?o a?oiao: oae iieaciee PaO2/FiO2 cieaeoaaany aei 302 ( 57,6 ii ?o.no. A?aeiia?aeii i?aeaeuoaaany e a?aenioie ooioa a iaeiio eie? e?iaiia?ao, aei??aithth/e ia 3-oth aeiao 26-27% OIN. O 3 oai?eo oe??? a?oie a i?neyiia?aoe?eiiio ia??iae? aeiee aino?ee ?ani??aoi?iee aeeno?an-neiae?ii, o 6 (10%) - a?ae?inoaoe/iee iaa?ye eaaaiue, o 15 (25%) - aoee iciaee ia?aiaaaioaaeaiiy iaeiai eiea e?iaiia?ao. Aieiaiei iai?yiii ?ioaineaii? oa?ai?? aoei cieaeaiiy oeneo a eaaaiaa?e a?oa???: cia/ia iaiaaeaiiy ia’?io aioo??oiueiaaieo ?iooc?e, i?o?aoe, a i?e cieaeaii? AO - ii?aeiaiiy i?o?iae?oea?eio (0,75 - 1 ia/ea) ? aeiiai?io (6 - 7 iea/ea/oa). Aeoaea aaaeeeai o oeeo oai?eo aeio?eioaaoeny iino?eueiiai ?aaeeio aei iie?ioaiiy noaio, /ano?oa aeoea?caoe?y aoea iiaeeeaith ia ?ai?oa 3 - 4-? aeiae. O oe?e a?oi? iiia?ee 4 oai?eo (6,7%). I?e/eiaie aoee: aioo??oiueiieaa?aeueia e?iaioa/a - 1 oai?ee, OAEA - 2, A?AeN - 1. Ainueie oai?ei aoei i?iaaaeaii oee?eoey?io ?acaeoe?th a?oo?eaoe?? o?aoa? c iiaaiiiaeoii??th ce?aa. O 5 oai?eo oe??? a?oie i?neyiia?aoe?eiee ia??iae aoa oyaeeei. E??i a?iienai?? aiane?aeie i?aeaeuaiiy ooiooaaiiy a iaeiio eie? e?iaiia?ao (PaO2/FiO2 noaiiaeei 240 - 300 ii ?o.no., Qs/Qt - 18 - 24%) aeieeaei ii?ooaiiy aeaaaeaiiy aoaeaoeth ae?ieneaeo (PaCO2 - 46 - 52 ii ?o.no.), ui, iiaeeeai, aoei iia’ycaii c ii?ooaiiyi aaioeeyoe?? eaaaiue aiane?aeie aeainoi?iiiuei? oi?aeioii??. Iaoiaee ?ioaineaii? oa?ai?? canoiniaoaaee oae? nai?, ye o iiia?aaei?e a?oi? oai?eo. Aeey ciaaiethaaiiy a i?neyiia?aoe?eiiio ia??iae? aaiaeeee ia?eioe/i? aiaeueaaoeee ? ianoa?i?aei? i?ioecaiaeuei? caniae (eaoi?ie, noaaeie, aiaeuea?i). Iiaei iaoiaeii i?neyiia?aoe?eiiai ciaaiethaaiiy ? i?ecia/aiiy nieiaaea?io a oaaeaoeao (Solpadein Soluble), yeee ie aeei?enoaee o 16 oai?eo. E??i oiai, i?noeaa? aianoaoeee aaiaeeee ia?aaa?oaa?aeueii ? 78 oai?ei i?ney oi?aeioii?e - aioo??oiueiieaa?aeueii. Aaaeeeaith oiiaith oieeiaiiy oneeaaeiaiue o i?neyiia?aoe?eiiio ia??iae? aoei ?aii? aioa?aeueia aeeaeaiiy, yea iaeaea o an?o oai?eo ii/eiaeiny i?aeoe/ii ianooiii? aeiae i?ney iia?aoe??. Oai?eo c IO? oa i?ney ooeaaiiy o?aoaino?aaio?aeii? ii?eoe? aiaeoaaee /a?ac iaciaano?aeueiue ciiae, a ?ioeo - i?e?iaeiei oeyoii. Oea ni?eyei caa?aaeaiith aa?’??ii? ooieoe?? eeoie oa caiia?aaiith oaeeo oneeaaeiaiue, ye neiae?ii nenoaiii? caiaeueii? a?aeiia?ae?, A?AeN oa iie?i?aaiii? iaaeinoaoiino?. Oaeei /eiii, ?aiiy i?neyiia?aoe?eia eaoaeuei?noue (i?ioyaii i?nyoey i?ney iia?aoe??) i?ney ?aeiino?oeoeaieo ao?o/aiue ia ai?oai?, o?aoa?, a?oo?eaoe?? o?aoa? oa aieiaieo a?iioao noaiiaeea 4,1% (c 362 i?iiia?iaaieo oai?eo iiia?ee 15). I?e ii??aiyii? oeueiai iieacieea ca ia??iae c 1978 ii 1987 ??e oa ca 1988 - 1998 ?iee aeyaeeinue, ui a?i ciaioeany c 7,3 aei 2,6% a?aeiia?aeii. E??i oiai, i?ioyaii inoaii?o o?ueio ?ie?a (c 1996 ii 1998 ?) na?aae 88 iia?iaaieo oai?eo oe??? a?oie eaoaeueiuo aeiaaee?a ia aoei. Ie i?iaiae?coaaee /eiieee, ye? ni?eyee iie?ioaiith ?acoeueoao?a e?eoaaiiy. Aeey oeueiai an? 362 oai?eo aoee iiae?eai? ia 2 a?oie: 1-oa – 149 iia?iaaieo c 1978 ii 1987 ?.; 2-aa – 213 oai?eo, iia?iaaieo i?ioyaii 1988 - 1998 ??. Nooo?aeo a?aei?iiinoae ca a?eii, neeaaei?noth iia?aoe?eieo ao?o/aiue, e?euee?noth oyaeeeo noiooi?o caoai?thaaiue, oyaee?noth aeiiia?aoe?eiiai noaio a iaio a?oiao ia aoei. Aaeaeiny ciaioeoe c 38,3 aei 21,3% e?euee?noue oyaeeeo oneeaaeiaiue i?ae /an iia?aoe?e. Ianaiia?aae ciaioeeany e?euee?noue aeiaaee?a ianeaii? e?iaioa/? (na?aaei?e ia’?i e?iaiao?aoe a 1-e a?oi? - 580±66ie, a a 2-e - 320±35ie, p < 0,01), ui ii?yae ?c canoinoaaiiyi a?ia?oii?/iiai ?ic/eio iao??th oei?eaeo aeaei ciiao cia/ii ??aeoa (iiiaae 3 ?ace) canoiniaoaaoe aaiio?ainooc??. Oeae /eiiee ni?eya oaeiae ciaioaiith aeiaaee?a A?AeN ? OAEA a 2-e a?oi? oai?eo ii??aiyii c 1-th (c 3,9 aei 1,8% ? 1,9 aei 0,9% a?aeiia?aeii). Cia/ii ciaioeeany na?aaeiy o?eaae?noue iia?aoe?e (3,6±0,18 a 1-e a?oi? i?ioe 2,9±0,11aiae a 2-e, p < 0,05). Ciaioaiith e?eueeino? A?AeN ni?eyee ciaioaiiy aeiaaee?a a?oa??aeueii? a?iioaic?? oa oyaeei? a?iienai?? i?ae /an iia?aoe?? a 2-e a?oi?, a a?aeiia?aeii e ?oai?? eaaaiaai? oeaieie. Ciaioaiith e?eueeino? iiaaiii?? ni?eyei oe?oa aeei?enoaiiy OAN (a 91% o oai?eo 2-? a?oie, a 1-e ia aeei?enoiaoaaeeny), ?aoe?iiaeuei?oa aioea?ioeeioa?ai?y, a oaeiae ciaioaiiy e?eueeino? oneeaaeiaiue c aieo aianoiiico. Ciaioaiith e?eueeino? OAEA ni?eyea aoaeoeai?oa i?io?eaeoeea, ianaiia?aae canoinoaaiiy i?yieo aioeeiaaoeyio?a (aaia?ei, o?aeneia?ei), a oie /an ye o 1-e a?oi? canoiniaoaaee iai?yi? aioeeiaaoeyioe. Aeey ciaioaiiyy oneeaaeiaiue c aieo aianoiiico e??i oaeineiiaeaiiy o??o?a?/ieo iaoiae?a aaaeeeaei /eiieeii aoei caiia?aaiiy ii?ooaiiyi e?iaia?ao ? aaciiai?io i?ae /an iia?aoe?? oa a i?neyiia?aoe?eiiio ia??iae?. AENIIAEE 1. Aieiaiith iaoith ia?aaeiia?aoe?ei?e i?aeaioiaee i?e ?aeiino?oeoeaieo iia?aoe?yo ia ai?oai?, o?aoa? oa aieiaieo a?iioao iio??aii aaaaeaoe naiaoe?th ieaei?o aeeoaeueieo oeyo?a, iaeaoaeoeai?oei iaoiaeii yei? ? o?a?ia?iioineii?y. I?aiaaeeeaoe?y o oai?eo c? cia/iei caoaeaiiyi ieaei?o aeeoaeueieo oeyo?a aac o?aoainoii?? ia iiaeiia aooe aeeaieith /a?ac aaeeee ?ecee ano?en??. Iaeaacia/ii?oei iaoiaeii ?iaeoeoe?? a ia?eic o oaeeo oai?eo iiaeia aaaaeaoe aioo??oiueiaaiio aianoac?th c aaaaeaiiyi i?i?aeaenaio?a ei?ioei? ae??. I?ae /an iniiaiiai aoaio iia?aoe?? aeioe?eueiei ne?ae aaaaeaoe canoinoaaiiy oioaeueii? aioo??oiueiaaiii? aianoac??, i?ioa a e?ioe? iia?aoe?? iaeni?eyoeea?oei ? ?iaaeyoe?eiee ia?eic. Oaea eiia?iaoe?y aea? ciiao caaacia/eoe aeinoaoith caaaeueio aianoac?th ca oiiae a?aenooiino? aa?iaoecio ieaei?o aeeoaeueieo oeyo?a ?c canoinoaaiiyi aeniei/anoioii? ooo/ii? aaioeeyoe?? eaaaiue ? oaeaeea i?iaoaeaeaiiy oai?iai c a?aeiiaeaiiyi aaeaeaaoiiai i?e?iaeiiai aeeoaiiy i?ney iia?aoe??, a oaeiae a?aeiia?aei oaeaeeo aenooaaoe?th eiai (yeui iaia? iieacaiue aei o?eaaei? ?iooaaoe?? a i?neyiia?aoe?eiiio ia??iae?). Caaacia/aiiy aaeaeaaoii? aaioeeyoe?? eaaaiue i?ae /an ?aeiino?oeoeaieo iia?aoe?e ia ai?oai?, o?aoa? ? iniaeeai ia a?oo?eaoe?? o?aoa? ? iaeneeaaei?oith i?iaeaiith aeey aianoac?ieiaa, yeo ne?ae ae??ooaaoe ?iaeea?aeoaeueii, caeaaeii a?ae aeaeo iia?aoe?eiiai ao?o/aiiy, eiai aoaio ? caaacia/oaaoe eiiieaenii iaoiae?a (o?aaeeoe?eia ooo/ia aaioeeyoe?y eaaaiue ?c canoinoaaiiyi ??cieo aa??aio?a ooioa-aeeoaiiy, aeniei/anoioii? OAE). I?e oaeeo iia?aoe?eieo ao?o/aiiyo iniaeeai aaaeeeaei ? iino?eiiee iii?oi?eia ca aoaeoeai?noth aaioeeyoe?? oa aaciiai?io a eaaaiyo. Canoinoaaiiy an?o no/anieo iaoiae?a OAE aea? ciiao oieeiooe aeno?aei?ii?aeueieo iaoiae?a aaciiai?io i?ae /an iaa?oue neeaaeieo ?aeiino?oeoeaieo ao?o/aiue ia o?aoa?. O?aaeeoe?eia OAE iaei??? eaaai? aea? ciiao oo?eioaaoe aaciiai?i i?ae /an iia?aoe?? ia aeinoaoiueiio ??ai?. Aeniei/anoioia OAE iaei??? e?ai? eaaai? a 7,5% aeiaaee?a ia caaacia/o? aeinoaoith ieneaaiaoe?th e?ia? oa aeaaaeaiiy aoaeaoeth ae?ieneaeo. Aeniei/anoioia OAE o?eueee i?aai? eaaai? ? neeaaeiith ca aeeiiaiiyi aiane?aeie iacia/ii? aeiaaeeie i?aaiai aieiaiiai a?iioa. Aeniei/anoioia OAE iaei??? eaaai? a ii?aeiaii? c aaioeeyoe??th iaei??? /e aeaio /anoie ae?oai? eaaai? caaacia/o? aaciiai?i ia aeinoaiueiio ??ai?. Aei ia?aaaa aeniei/anoioii? OAE iiaeia a?aeianoe caaacia/aiiy aaioeeyoe?? eaaaiue ca a?aenooiino? aa?iaoecio ieaei?o aeeoaeueieo oeyo?a ? noai?aiiy e?aueo oiia aeey i?aoe? o??o?aa. Aei iaaeie?e?a aeniei/anoioii? OAE ne?ae a?aeianoe neeaaei?oee iii?oi?eia ca aoaeoeai?noth aaioeeyoe?? eaaaiue ? oaoi?/i? o?oaeiiu? canoinoaaiiy oeueiai iaoiaeo. Aecia/aeueiei caaaeaiiyi i?neyiia?aoe?eiiai ia??iaeo ? caaacia/aiiy i?io?aeiino? ieaei?o aeeoaeueieo oeyo?a. O?aoainoii?th ?c canoinoaaiiyi O-iiae?aii? o?oaee Iiioaiia?? c oe??th iaoith ia iiaeia aaaaeaoe iioeiaeueiith iaoiaeeeith. I?ney o?aoaiai?oaii? ?acaeoe?? e?auith aeueoa?aioeaith oeueiio iaoiaeo iiaeia aaaaeaoe o?eaaeo iacio?aoaaeueio ?iooaaoe?th. Iae/ano?oith i?e/eiith noaiicoaaiiy ai?oai? ? aa?oiueiai a?aeae?eo o?aoa? ? aeei?enoaiiy ?iooaaoe?eii? o?oaee iaaaeaeaaoii oe?ieiai ae?aiao?a. Ca oiiae aecia/aiiy iioeiaeueiiai ?ici??o ?iooaaoe?eii? o?oaee ? eaae?o?eiaaiiai ?? aaaeaiiy o?eaaea iacio?aoaaeueia ?iooaaoe?y ia i?ecaiaeeoue aei noaiicoaaiiy ieaei?o aeeoaeueieo oeyo?a. Aaaeeeaei caaaeaiiyi o oeae ia??iae ? i?io?eaeoeea ? e?eoaaiiy o?aoaia?iio?oo, a oaeiae caaacia/aiiy i?io?aeiino? ?iooaaoe?eii? o?oaee. *ano? ?a?iooaaoe?? iaaeioe?euei?. Iaeieie c aieiaieo /eiiee?a iie?auaiiy ?acoeueoao?a e?eoaaiiy oai?eo, yeei iieacai? ?aeiino?oeoeai? iia?aoe?? ia ieaei?o aeeoaeueieo oeyoao, ii?yae c oaeineiiaeaiiyi iaoiaeeee ? oaoi?ee o??o?a?/ieo ao?o/aiue ?: oieeiaiiy i?ae /an iia?aoe?e o?eaaeeo ia??iae?a oyaeei? a?iienai??, a?ia?eaii??, a?oa??aeueii? a?iioaic??; nei?i/aiiy o?eaaeino? iia?aoe?eiiai ao?o/aiiy; - aoaeoeaia i?io?eaeoeea o?iiaiaiaie?? eaaaiaai? a?oa??? oa ?ioaeoe?eieo oneeaaeiaiue; - ??cea iaiaaeaiiy iieacaiue aei aaiio?ainooc?? ye i?ae /an oae ? i?ney iia?aoe??; - aea?? iioeiaeueiiai /ano aeey aeoea?caoe?? oai?iai i?ney iia?aoe??; ?aii? aioa?aeueia oa?/oaaiiy. 8. Canoinoaaiiy an?o no/anieo iaoiae?a caaaeueii? aianoac?? oa ?ioaineaii? oa?ai?? aeaei ciiao cia/ii iie?ioeoe ?acoeueoaoe e?eoaaiiy oai?eo i?ney ?aeiino?oeoeaieo iia?aoe?e ia ieaei?o aeeoaeueieo oeyoao, a naia oieeiooe eaoaeueiino? i?ae /an iia?aoe?eieo ao?o/aiue, ciaioeoe e?euee?noue oyaeeeo oneeaaeiaiue c 38,3 aei 21,3%; cieceoe i?neyiia?aoe?eio eaoaeuei?noue ca inoaii? 10 ?ie?a c 7,3 aei 2,6%. Nienie iioae?eiaaiieo i?aoeue ca oaiith aeena?oaoe?? 1. Eeeie/aneay eeanneoeeaoeey ino?ie aeuoaoaeueiie iaaeinoaoi/iinoe i?e cae?uoie o?aaia a?oaee // Aianoaceieiaey e ?aaieiaoieiaey.-1986.-?1.-N.36-39. (Iaea?ia A.A.) 2. Oie i?e o?aaia a?oaee // Aanoiee oe?o?aee ei. E.E.A?aeiaa, 1987, O 139, ?11, n. 140 - 144. (Aaeeiaa I.I., Iaea?ia A.A., Aii/a?aiei A.N.) 3. Eeeie/aneia eniieueciaaiea aeeeoaeueiie iacio?aoaaeueiie eiooaaoeee // Aianoaceieiaey e ?aaieiaoieiaey.-1989.-?1.-N.42-44. (O?aueineee A.E., E?aa/aiei A.I., Neoa?ee A.I.) 4. Aioo?eieaa?aeueiia iaacaieeaaiea iinea oi?aeaeueiuo iia?aoeee e o?aaiu a?oaee // Aianoaceieiaey e ?aaieiaoieiaey.-1991.-?2.-N.8-10. (O?aueineee A.E., Iaea?ia A.A., Inoaiiee E.I.) 5. Aianoaceieiae/aneia iaania/aiea i?e ?aeiino?oeoeaiuo iia?aoeeyo ia aeoo?eaoeee o?aoae // A?eue, ciaaiethaaiiy ? ?ioaineaia oa?ai?y.-1997.-?1.-N.15-18. 6. Eiooaaoeeiiiua iia?aaeaeaiey o?aoae // A?eue, ciaaiethaaiiy ? ?ioaineaia oa?ai?y.-1998.-?4.-N. 48-52. 7. I?ioeeaeoeea e ea/aiea ineiaeiaiee iinea auiieiaiey ?aeiino?oeoeaiuo iia?aoeee ia o?aoaa // Ee?i?/ia o??o?a?y.-1998.-?3.-N.3-4. (Aaae?ia I.I., ?iniianeee A.A., Aa?auaei ?.E.) 8. Eioaineaiay oa?aiey i?e ino?ii eoaie/aneii einoeueoa. –1998.-?1.-N.49-74. (O?aueineee A.E., Ei?ioei?o/ei A.A., Iieeuoe I.A.) 9. Iooe nieaeaiey eaoaeueiinoe i?e ?aeiino?oeoeaiuo iia?aoeaiuo aiaoaoaeuenoaao ia o?aoaa // Oe?a?inueeee iaaee/iee /aniien.-1999.-?1-2.-N.139-144. (Aaa??ia I.I.) 10. Caiii?aaiiy oieoaeueii? eaoaeueiino? oa oneeaaeiaiiyi i?ney iia?aoe?e ia o?aoa? // Oieoaeueia o??o?a?y.-1999.-?1.-N.82-85. (Aaa??ia I.I.) 11. ?aioiaa na?oeaaa nia?oue: aecia/aiiy, oaeoi?e ?eceeo, i?aaeeeoi?e ? iaoai?cie ?icaeoeo, aeai?eoie ?aaii?iaoe?? // A?eue, ciaaiethaaiiy ? ?ioaineaia oa?ai?y.-1999.-?2.-N. 64 – 79. (Aia?ia A.I., O??ueinueeee A.?., Oeaiae ?.I. oa ?i.) 12. Eniieueciaaiea auniei/anoioiie EAE a oe?o?aee o?aoae // Ee?i?/ia o??o?a?y.-1999.-?4.-N.38-40. 13. O?ainooceiiiay oa?aiey i?e oi?aeaeueiuo iia?aoeeyo e o?aaiao // Ee?i?/ia o??o?a?y.-1999.-?5.-N.20-22. (Eoiaoianeee I.A., Noneia A.A., Iynieeia Ae.A.) 14. O?aaiu ieaeieo aeuoaoaeueiuo iooae // Oe?a?inueeee iaaee/iee /aniien.-1999.-?3.-N.38-40. 15. Ino?ue ?anie?aoi?iue aeeno?ann-neiae?ii // A?eue, ciaaiethaaiiy ? ?ioaineaia oa?ai?y.-1999.-?2.-N. 16. Iaaee/ia aeiiiiiaa i?e ooeiaeaeaiiyo o?aoa? oa a?iio?a // Oieoaeueia o??o?a?y.-1999.-?3.-N. - . (Aaa??ia I.I.) 17. Niin?a ?aeiino?oeoe?? a?oo?eaoe?? o?aoa? i?ney ?? oe?iei? ?acaeoe??. Iaoaio ia aeiao?ae ?34335 ca 24.12.1997?. (Ni?aaaoi?e: Aaa??ia I.I., ?iniianueeee I.A., Aa?auaei ?.?.). 18. Aeei?enoaiiy aeniei/aoioii? aaioeeyoe?? eaaai?a o oi?aeaeuei?e o??o?a??. Ca??iee iaoeiaeo i?aoeue ni?a?ia?oiee?a EIAII ?i.I.E.Ooieea.-Ee?a.-1998.- Aeione 7. Eieaa 2.-N.34-38. (Eoiaoianueeee I.A., Noneia A.A.) 19. I?eiaiaiea iacio?aoaaeueiie eiooaaoeee iinea iia?aoeee ia o?aoaa. O ei.: Oe?o?aey o?aoae e a?iioia. Oac. Ananithciiai neiiiceoia.- Iineaa.-1986.-N.49-50. (Neoa?ee A.I., Aiaiaineay N.I., Aueeia A.I.) 20. EAE o aieueiuo n ionoonoaeai aa?iaoe/iinoe aeuoaoaeueiuo iooae. Oacenu 4 Nuacaea aianoaceieiaia-?aaieiaoieiaia NNN?.-Iaeanna.-1989.-N.39. (O?aueineee A.E., O?ioeaae/ A.A.) 21. Ieacaiea iiiiue iino?aaeaaoei n oi?aeaeueiie o?aaiie. O ei.: Congress of Emergency and Disaster medicine. Chechoslovakia.-1989.-P.41. (O?aueineee A.E., A?enoia A.A.) 22. Ia iiuoa i?eiaiaiey o?ae?eoia i?e oi?aeaeueiuo iia?aoeeyo. Oacenu 16 Nuacaea Aa?iiaeneeo aianoaceieiaia. –Aa?oaaa.-1990.-N.84. 23. Aioo?eaaiiay aianoacey i?e iiaoi?iuo oi?aeaeueiuo iia?aoeeyo. O ei.: Aeooaeueiua aii?inu oe?o?aee eaaeeo ia nia?aiaiiii yoaia. Oac. 9 Oe?aeineie eiioa?aioeee ii a?oaeiie oe?o?aee.-Eueaia.-1990.-N. 29-30. (O?aueineee A.E., A?enoia A.A., Aueeia A.I.) 24. Surgical treatment of wound and closed Thorax Trauma. O ei.: 1th international Congress of Cardiovascular and Thoracic Surgery.-Riga.-1990.-P.44. (Iaea?ia A.A., Aaoueiai A.A.) 25. Oioaeueiay aioo?eaaiiay aianoacey i?e oi?aeaeueiuo iia?aoeeyo. Iaoa?eaeu 3 ?anioaeeeaineie eiioa?aioeee aianoaceieiaia e ?aaieiaoieiaia A?ocee.-Oaeeene.-1990.-N.103-105. (O?aueineee A.E., O?ioeaae/ A.A., Aiiaea?ue I.A.) 26. The use of sodium chloride in 78 patients with chest and abdomen injuries. 10th World Congress of Anaesthesiologists, The Hague, 12-19 June.-1992.- ?. 788. (Treschinsky A.I., Makarov A.V., Aristov V.V.). 27. Blood reinfusion in patients with chest and abdomen trauma. 9th European Congress of Anaesthesiology.-Jerusalem.-1994.- ?. 518. ( Treschinsky A.I., Makarov A.V., Shlapak I.P.) 28. The use of Hypertonic solution of sodium chloride in intensive care. 9th European Congress of Anaesthesiology.- Jerusalem.-1994.- ?. 142. (Treschinsky A.I., Kligunenko E.N., Usenko V.A.). 29. I?eiaiaiea nieiaaeaeia iinea oi?aeaeueiuo iia?aoeee e o?aai. Iaaeeoeeia Oe?aeiu, 1996, ?2, N.51. (O?aueineee A.E., Iaea?ia A.A.). 30. I?aaiecaoeey niaoeeaeece?iaaiiie iiiiue i?e ea/aiee oyaeaeie ni/aoaiiie o?aaiu. O ei.: Iaoa??aee 2 Iaoe?iiaeueiiai eiia?ano aianoac?ieia?a Oe?a?ie.-Ee?a: Aeua oeiea.-1996.-N.23. (Iaea?ia A.A., Aaoueiai A.A., Neoa?ee A.I.) 31. Aeai?eoi aeaenoaee i?e iiaeic?aiee ia iia?aaeaeaiea o?aoae eee ieuaaiaea i?e eiooaaoeee o?aoae. O ei.: Iaoa??aee 2 Iaoe?iiaeueiiai eiia?ano aianoac?ieia?a Oe?a?ie.-Ee?a: Aeua oeiea.-1996.-N.29. (Iaea?ia A.A., Aaae?ia I.I., Noneia A.A.) 32. Iaania/aiea aaioeeyoeee eaaeeo i?e ?aeiino?oeoeaiuo iia?aoeeyo ia o?aoaa e a?iioao. O ei.: Iaoa??aee 2 Iaoe?iiaeueiiai eiia?ano aianoac?ieia?a Oe?a?ie.-Ee?a: Aeua oeiea.-1996.-N.193-194. . (Aaae?ia I.I., Aueeia A.I., Neoa?ee A.I.) 33. Iinoeiooaaoeeiiiua e iinoo?aoainoiie/aneea noaiicu ai?oaie e o?aoae. O ei.: Iaoa??aee 2 Iaoe?iiaeueiiai eiia?ano aianoac?ieia?a Oe?a?ie.-Ee?a: Aeua oeiea.-1996.-N.194-195. (Aaae?ia I.I., Aueeia A.I., Niee?ei A.E.) 34. Eioaineaiay oa?aiey o?aaiu e oiea. A ei.:O?aaia.- Eeaa:Aeua oeiea.-1996.-N.172-173. (O?aueineee A.E., Iaea?ia A.A.) 35. Aianoaceieiae/aneia iaania/aiea aiaoaoaeuenoa ii iiaiaeo o?aaiu o?aoae. II Eiia?an o??o?a?a Oe?a?ie. Ca??iee iaoeiaeo ?ia?o.- Ee?a-Aeiiaoeuee. “Ee?i?/ia o??o?a?y”-1998.-N.202-203. 36. Eiooceiiii-o?ainooceiiiay oa?aiey o iino?aaeaaoeo n o?aaiie a?oaee e aeeaioa, nii?iaiaeaeathuaeny aieueoie e?iaiiioa?ae. Eiia?an o??o?a?a Oe?a?ie. Ca??iee iaoeiaeo ?ia?o.- Ee?a-Aeiiaoeuee. “Ee?i?/ia o??o?a?y”-1998.-N.204-205. (Noneia A.A., Eoiaoianeee I.A.) 37. Nia?aiaiiua i?iaeaiu aeeaaiinoeee e ea/aiey iaeioi?uo iaioeiaeiuo ninoiyiee a ioeueiiiieiaee. Iaoa??aee iaoeiaeo i?aoeue II C‘?caeo ooec?ao??a ? ioeueiiiieia?a Oe?a?ie.-Ee?a.-N.85-88. (Iaea?ia A.A., Aaoueiai A.A.) ? wtoAelifc^[ wrmhc |wrmhc` vog_W Iau/iue Caaieiaie 1 Caaieiaie 3 Caaieiaie 5 Iniiaiie o?eoo aacaoea niiaiie?H?eoo?0acaoea? Iniiaiie oaeno n ionooiii 2 Iniiaiie oaeno n ionooiii niiaiie?Baeno?A?>onooiii?

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