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Анестезіологічне забезпечення та інтенсивна терапія при реконструктивних операціях на нижніх дихальних шляхах: Автореф. дис… д-ра мед. наук / Ф.С. Г

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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**

* ?onooiii?

Aa?oiee eieiioeooe

a?oiee?:ieiioeooe?

Iniiaiie oaeno

niiaiie?Baeno?

Table Text

Table Text

Body Single

Body Single

Bullet 1

Bullet 1

Iniiaiie oaeno n ionooiii 3

‘Aeiaieueiue iieueciaaoaeue Microsoft Office

C:DISDOC3130THdoc’

C:DISDOC313a.doc’Aeiaieueiue iieueciaaoaeue Microsoft
Office!C:windowstempAaoieiiey 13a.asd’Aeiaieueiue iieueciaaoaeue
Microsoft Office

C:DISDOC30aoi?aoTH ASCII.doc’

C:DISDOC3aaoi?ao. ASCII.doc’Aeiaieueiue iieueciaaoaeue Microsoft Office

C:DISDOC30aoi?aoTH ASCII.doc’

C:DISDOC3aaoi?ao. ASCII.doc’Aeiaieueiue iieueciaaoaeue Microsoft
Office(C:windowstempAaoieiiey aaoi?ao. ASCII’Aeiaieueiue iieueciaaoaeue
Microsoft Office

C:DISDOC30aoi?aoTH ASCII.doc’

C:DISDOC3aaoi?ao. ASCII.doc’Aeiaieueiue iieueciaaoaeue Microsoft Office

C:DISDOC30aoi?aoTH ASCII.doc’

C:DISDOC3aaoi?ao. ASCII.doc’Aeiaieueiue iieueciaaoaeue Microsoft
Office(C:windowstempAaoieiiey aaoi?ao. ASCII’Aeiaieueiue iieueciaaoaeue
Microsoft Office

C:DISDOC30aoi?aoTH ASCII.doc’

C:DISDOC3aaoi?ao. ASCII.doc’Aeiaieueiue iieueciaaoaeue Microsoft Office

A:0aoi?aoTH ASCII.doc

A:aaoi?ao. ASCII.doc

?

Times New Roman

Times New Roman

Symbol

Symbol

Courier New

Courier New

Baltica

Baltica

‘Aeiaieueiue iieueciaaoaeue Microsoft Office’Aeiaieueiue iieueciaaoaeue
Microsoft Office

iieueciaaoaeue Microsoft Office

Normal.dot

iieueciaaoaeue Microsoft Office

Microsoft Word 8.0

_PID_GUID

9E02F161-59FC-11D3-8B96-B259AB470A6F

9E02F161-59FC-11D3-8B96-B259AB470A6F

Root Entry

1Table

1Table

WordDocument

WordDocument

SummaryInformation

SummaryInformation

DocumentSummaryInformation

DocumentSummaryInformation

CompObj

CompObj

Microsoft Word

MSWordDoc

Word.Document.8

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