I?i?noa?noai ioi?iie caei?ia’y Oe?a?ie

Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I.I.Aiaiiieueoey

Iia/ Ieaa Aiae??eiae/

OAeE 616.33-002.44-06-001.5-005.1-0.89

O??o?a?/ia oaeoeea i?e ae?aceia?e oai?ia?,

oneeaaeiai?e iaeii/anii ia?oi?aoe??th oa e?iaioa/ath

14.01.03 — o??o?a?y

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a-1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Iaoe?iiaeueiiio iaaee/iiio oi?aa?neoao? ?i. I.I.
Aiaiiieueoey.

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, i?ioani?, Oii?i Iao?i
Aeieo?iae/ ,

eaoaae?a oaeoeueoaonueei?
o??o?a?? ?2 Iaoe?iiaeueiiai iaaee/iiai

oi?aa?neoaoo ?iai?
I.I.Aiaiiieueoey, caa?aeoth/ee eaoaae?ith

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, i?ioani? Iioithe TH??e Ieeieaeiae/,
eaoaae?a oaeoeueoaonueei? o??o?a?? ?1 Iaoe?iiaeueiiai iaaee/iiai
oi?aa?neoaoo ?iai? I.I.Aiaiiieueoey, i?ioani?;

aeieoi? iaaee/ieo iaoe, i?ioani? Iai/e/ Aieiaeeie? ?aaiiae/,
eaoaae?a o??o?a?? c eo?nii oiiia?ao?/ii? aiaoii?? oa iia?aoeaii?
o??o?a?? Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?iai?
I.E.Ooieea, caa?aeoth/ee eaoaae?ith

I?ia?aeia onoaiiaa: ?inoeooo ee?i?/ii? ? aenia?eiaioaeueii?
o??o?a?? AII Oe?a?ie (a?aeae?e o??o?a?? o?aaiiai o?aeoo), i. Ee?a.

Caoeno a?aeaoaeaoueny 21 o?aaiy 1999 ?. i 14 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee

Ae 26.003.03 i?e Iaoe?iiaeueiiio iaaee/iiio oi?aa?neoao? ?i.
I.I.Aiaiiieueoey (252 004, i. Ee?a, aoeueaa? Oaa/aiea, 13).

?c aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe?
Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo ?i. I.I.Aiaiiieueoey (252 057,
i.Ee?a, aoe. Ciieia?/ia, 1).

Aaoi?aoa?ao ?ic?neaii 12 ea?oiy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? A/aii? ?aaee

eaiaeeaeao iaaee/eo iaoe, aeioeaio
A?oianueeee ss.I.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. Ieoaiiyi o??o?a?/ii? oaeoeee, aeai?o iioeiaeueieo
iaoiae?a o??o?a?/iiai e?eoaaiiy i?e ia?oi?aoeaieo oa aino?ie?iaioi/eaeo
aano?iaeoiaeaiaeueieo ae?aceao i?enay/aia aaeeea e?euee?noue
aeine?aeaeaiue ye o iao?e e?a?i?, oae ? ca ei?aeiiii (A.A.Oaeeiia e
ae?., 1987; A.Ae.A?aoonue, 1991; I.E.Ooo/aiei e ae?., 1995; A.E.Iai/e/ e
ae?., 1996; A.I.Ei?ioeee oa ni?aaao., 1996; A.O.Naaiei e ae?., 1996;
I.Ae.Oiiei e ae?., 1996; O.B.Bulut et al., 1996; M.K.Yii, P.S.Hunt,
1996; I.I.Ao?ei, E.A.Eiaoiia, 1997; E.E.Caoaaaoei e ae?., 1997;
?.ss.Aecthaaiianueeee oa ni?aaao., 1998; A.I.Eeeiaiei e ae?., 1998;
I.I.Eocei, I.I.E?ueia, 1999; A.N.Iiiaeia, A.A.Niaaei, 1999).

?acii ?c oei, ii?aeiaiiyi ae?aceiaeo e?iaioa/ ?c ia?oi?aoe??th
iaeii/anii, a no/ani?e a?o/eciyi?e oa ca?oa?aei?e e?oa?aoo?? iaeaea ia
i?eae?ey?oueny iaeaaeii? oaaae, oi/a /anoioa aeieeiaiiy ia?oi?aoeaeo
aino?ie?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie (IAAAeA) neeaaea? 0,9 —
20% ii a?aeiioaiith aei caaaeueii? e?eueeino? oai?eo ?c ia?oi?aoeaieie
(A.E.Eaieinean, 1985; K.S.Dasmahapatra et al., 1988; A.Ae.A?aoonue,
1991; I.Ae.Oiiei e ae?., 1996; A.A.Eo?uaei e ae?., 1997) oa 0,05-9,9% —
?c aino?ie?iaioi/eaeie aano?iaeoiaeaiaeueieie ae?aceaie (AAAeA)
(K.S.Dasmahapatra et al., 1988; A.I.Ia?iyeia, Ae.A.Ieeiaaieei, 1989).
?nioth/? iaaaaaoi/eneaii? ioae?eaoe?? ii i?iaeai? IAAAeA aacothoueny, ye
i?aaeei, ia iaaaeee?e e?eueeino? ee?i?/ieo niinoa?aaeaiue ? na?ae/aoue
i?i cia/i? o?oaeiiu? a nai?/ani?e ae?aaiinoeoe? aeaii? iaoieia??, ui ?
i?e/eiith aaeeei?, aei o 100% iia?iaaieo, e?eueeino? i?neyiia?aoe?eieo
(i/i) oneeaaeiaiue (A.E.Aeoaeaiei e ae?., 1983;
A.I.Iiaeiiaiei-Aiaaeaiiaa, I.I.Eeoiaeae, 1985) oa aeniei?, a?ae 34,4 aei
80%, i/i eaoaeueiino? (A.E.Eaieinean, 1985; E.E.Iaeia?e, 1988;
K.S.Dasmahapatra et al., 1988; A.I.Ia?iyeia, Ae.A.Ieeiaaieei, 1989).
Ca?aene, i?iaeaia IAAAeA aeiaaa? iiaeaeueoiai aea/aiiy aeey iie?auaiiy
ye nai?/anii? ae?aaiinoeee, oae ? aeai?o iioeiaeueieo iaoiae?a
iia?aoeaieo ao?o/aiue. Naia oeei ieoaiiyi ? i?enay/aia iaoa ?iaioa.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie. Aeena?oaoe?y ? o?aaiaioii
iaoeiai-aeine?aeii? ?iaioe, ui aeeiio?oueny ia eaoaae?? oaeoeueoaonueei?
o??o?a?? ?2 Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo ?i.
I.I.Aiaiiieueoey: «?ic?iaea e?eoa???a aeai?o iaoiaeo iia?aoe??, nooiaith
?eceeo ? aoaeoeaiino? o??o?a?/iiai e?eoaaiiy aino?ie?iaioi/eaeo
aano?iaeoiaeaiaeueieo ae?acie oa iooeei oeoieo ia ?aiiueiio
aini?oaeueiiio aoai? aeey iie?auaiiy aaciina?aaei?o oa a?aeaeaeaieo
?acoeueoao?a» (? Aea?ae?aa?no?aoe?? — 0186. 0117978).

Iaoa aeine?aeaeaiiy. Aea/eoe iniaeeaino? ee?i?/iiai ia?aa?ao oa
ae?aaiinoeee IAAAeA ? ?ic?iaeoe aeai?eoi aeai?o iaea?eueo ?aoe?iiaeueii?
o??o?a?/ii? oaeoeee aeey iie?auaiiy aaciina?aaei?o oa a?aeaeaeaieo
?acoeueoao?a e?eoaaiiy oai?eo.

Caaaeaiiy aeine?aeaeaiiy:

1. Aea/eoe /anoioo oa aa??aioe ii?aeiaiue IAAAeA;

2. I?iaiae?coaaoe iniaeeaino? ee?i?/iiai i?io?eaiiy IAAAeA i?e ??cieo
aa??aioao ii?aeiaiue ia?oi?aoe?? oa e?iaioa/?. Ci?anoaaeoe ee?i?/i?
iciaee IAAAeA c ia?oi?aoeaieie aano?iaeoiaeaiaeueieie ae?aceaie (IAAeA)
aac e?iaioa/?;

3. ?ic?iaeoe aeai?eoi aeiaeaoeiaeo iaoiae?a aeine?aeaeaiue aeey
nai?/anii? ae?aaiinoeee oa aeai?o ?aoe?iiaeueii? o??o?a?/ii? oaeoeee,
aeae?a iia?aoeaieo ao?o/aiue ?c a?aooaaiiyi iniaeeainoae aa??aio?a
ii?aeiaiue IAAAeA;

4. Aeine?aeeoe iniaeeaino? i?io?eaiiy ia?eoii?oo oa iaa?oiooaaoe iaoiaee
?ioaineaii? oa?ai?? a ia?aae- oa i?neyiia?aoe?eieo ia??iaeao i?e IAAAeA.

5. Aea/eoe aaciina?aaei? oa a?aeaeaeai? ?acoeueoaoe e?eoaaiiy oai?eo
?c IAAAeA.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. Aia?oa anoaiiaeaii, ui iaeaea
iaeii/ania aeieeiaiiy ia?oi?aoe?? oa e?iaioa/? niinoa??aa?oueny a 27,9%
oai?eo, a o 72,1% iaoe?aio?a — ia?oi?aoe?y ianooia? o ?aiiueiio
ia??iae? i?ney coieiee aaii??aa??. I?iaiae?ciaai? iniaeeaino? ee?i?/iiai
ia?aa?ao IAAAeA i?e ??cieo aa??aioao ii?aeiaiue ia?oi?aoe?? oa
e?iaioa/?. Cai?iiiiiaaia eeaneo?eaoe?y IAAAeA ii eieae?caoe?? oa
aa??aioai ?icaeoeo iaeaeaio oneeaaeiaiue ae?aceiai? oai?iae (AO).

I?aaenoaaeaia ii??aiyeueia ioe?iea iniaeeainoae ia?aa?ao ia?eoii?oo oa
ee?i?/ieo neiioii?a IAAAeA oa IAAeA (aac e?iaioa/?). Aeae?eaiee neiae?ii
«iaeeo» iciae IAAAeA ? cai?iiiiiaaiee aeai?eoi aeiaeaoeiaeo iaoiae?a
aeine?aeaeaiue aeey nai?/anii? ae?aaiinoeee aeaii? iaoieia??.

Aecia/ai? iieacaiiy aeey aeai?o ??cieo, ia?aaaaeii ?aaeeeaeueieo,
aeae?a iia?aoeaieo ao?o/aiue i?e IAAAeA. ?ic?iaeaiee iiaee niin?a
naeaeoeaii? i?ieneiaeueii? aaaioii??, ia yeee io?eiaii Iaoaio 22790A
Oe?a?ie «UA» IIE A 61 A 17/00 a?ae 21.04.98 ?ieo. Aea/ai? i?e/eie i/i
eaoaeueiino? oa /anoioa ? oa?aeoa? i/i oneeaaeiaiue i?e IAAAeA.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Cai?iiiiiaai? aiaeineii?/i?
e?eoa??? ?eceeo aeieeiaiiy IAAAeA o caeaaeiino? a?ae eieae?caoe?? oa
iaoe?iino? ae?aceiai? aeano?oeoe??, ui aeicaiey? ?aeiiaiaeoaaoe a?eueo
aeoeaio o??o?a?/io oaeoeeo c iaoith i?io?eaeoeee aeieeiaiiy ia?oi?aoe??.

Aeae?eaiee neiae?ii «iaeeo» iciae IAAAeA aeiaaa? canoinoaaiiy
aeiaeaoeiaeo iaoiae?a aeine?aeaeaiiy (OAAeN, iaeyaeiaa ?aioaaiia?ao?y
/a?aaii? ii?iaeieie, iiaaiiaano?ia?ao?y, eaia?ioeaioac) aeey
nai?/aniiai anoaiiaeaiiy a??iiai ae?aaiico.

?aiiy ae?aaiinoeea IAAAeA ?icoe?th? iieacaiiy aei ?aaeeeaeueieo
iia?aoeaieo ao?o/aiue. Cai?iiiiiaaiee aeai?eoi aaaeaiiy oai?eo o
ia?aae-, i?ae /an oa i/i ia??iae? aeicaiey? o 3,5 ?ace cieceoe i/i
eaoaeuei?noue, iie?aueoe aaciina?aaei? oa a?aeaeaeai? ?acoeueoaoe
e?eoaaiiy.

Ai?iaaaeaeaiiy ?acoeueoao?a aeine?aeaeaiiy. ?acoeueoaoe i?iaaaeaieo
aeine?aeaeaiue ai?iaaaeaeai? a i?aeoeeo ? aeei?enoiaothoueny a ?iaio?
Ee?anueeiai i?nueeiai Oeaio?o ii iaaeaiith iaa?aeeeaaeii? aeiiiiiae
oai?ei ?c oeoieiai-eeoeiaeie e?iaioa/aie ia aac? o??o?a?/iiai
a?aeae?eaiiy IEE ?12 oa o??o?a?/ieo ee?i?eao IAI oaeaeei? aeiiiiiae oa
iaaeeoeeie eaoano?io i?noa Ee?aa, o??o?a?/ieo a?aeae?eaiiyo e?eoaaeueieo
caeeaae?a i?no Oaeai?iaea, Ioea/aaa.

Iniiai? iieiaeaiiy ?iaioe canoiniaothoueny a o/aiaiio i?ioean? ia
eaoaae?ao o??o?a?? Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo
?i.I.I.Aiaiiieueoey, Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii?
ina?oe ?i. I.E.Ooieea IIC Oe?a?ie, iaaee/iiai oaeoeueoaoo
Oaeai?iaenueeiai aea?aeaaiiai oi?aa?neoaoo.

Iniiai? iieiaeaiiy, ye? aeiinyoueny ia caoeno.

1. Ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/? i?e ae?aceia?e oai?ia? oeoieo oa
12-iaei? eeoee oa?aeoa?eco?oueny 2-ia aa??aioaie ia?aa?ao:

a) iaeii/ania aeieeiaiiy iaeaeaio oneeaaeiaiue — o 27,9% iaoe?aio?a;

a) ia?oi?aoe?y ianooia? o ?aiiueiio ia??iae? i?ney coieiee ae?aceiai?
e?iaioa/? — o 72,1% oai?eo, noi?iaiaeaeoth/enue i?e oeueiio ?aoeeaeeaii
e?iaioa/? (?E) — a 54,5% /e aac iueiai — a 45,5% oai?eo. I?e iaeaeaio
aa??aioao IAAAeA iiaeeeaa ia?oi?aoe?y ? e?iaioa/a ?c iaei??? ? o??? ae
ae?acee /e ia?oi?aoe?y iaei???, a e?iaioa/a — ?c ?ioi? ae?acee oeoieo /e
i?ei?iaeoiaeaiaeueii? ciie (IAeC).

2. Aeae?eaiee neiae?ii «iaeeo» iciae o oai?eo ?c AAAeA aeicaiey?
canoinoaaoe aeiaeaoeia? iaoiaee aeine?aeaeaiue ? nai?/anii
ae?aaiinooaaoe IAAAeA.

3. Aoeiia?noue i?io?eaiiy ia?eoii?oo i?e IAAAeA caeaaeeoue a?ae
aa??aio?a ii?aeiaiue ia?oi?aoe?? ? e?iaioa/?, nooiai? aaaeeino?
e?iaiao?aoe oa a?eo oai?eo.

4. ?aiiy ae?aaiinoeea oa nai?/ania iia?aoeaia ao?o/aiiy aeicaieythoue
?icoe?eoe /anoioo aeeiiaiiy ?aaeeeaeueieo iaoiae?a iia?aoe?e.

Iniaenoee aianie caeiaoaa/a. Aeena?oaoe?y ? iniaenoith i?aoeath aaoi?a,
yeee naiino?eii cae?eniea aiae?c ee?i?/iiai iaoa??aeo aeey iniiaii?
a?oie iaoe?aio?a ?c IAAAeA, i?ia?a eiai noaoenoe/io ia?iaeo oa
ii??aiyiiy io?eiaieo aeaieo ?c oai?eie iaeaeaio eiio?ieueieo a?oi.
Caeiaoaa/ ?ic?iaea oa ai?iaaaeea o ee?i?/io i?aeoeeo eeaneo?eaoe?th
IAAAeA ii eieae?caoe?? oa aa??aioai ee?i?/iiai ia?aa?ao, aeae?eea
neiae?ii «iaeeo» iciae aeey nai?/anii? ae?aaiinoeee aeaii? iaoieia??;
i?eeiaa aaciina?aaeith o/anoue o aeeiiaii? iia?aoeaieo ao?o/aiue, a
aiae?c? oa ocaaaeueiaii? ?acoeueoao?a aeine?aeaeaiiy, oi?ioethaaii?
aeniiae?a ? iieiaeaiue ?iaioe, aeianaieo ia caoeno, i?aeaioiaoe?
iaoeiaeo aeaieo aei ioae?eaoe?? ? aeiiia?aeae ?o ia eiioa?aioe?yo oa
c»?caeao.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aeiiia?aeaeenue ? iaaiai?thaaeenue ia:1-io (OV??) c’?cae? o??o?a?a
Oe?a?ie (Euea?a, 1995); I?aeia?iaeiiio eiia?an? «Actualitati in
chirurgia toracoabdominalia. Rezumatele lucrarilor congresuli al VIII —
LEA de chirurgie» (Chisinau, 1997); iaoeiai-i?aeoe/ieo eiioa?aioe?yo:
«Aeooaeuei? i?iaeaie aeno?aiii? iaaeeoeeie» (Ee?a, 1993); «Aeooaeuei?
i?iaeaie iiaeaiiy aeno?aiii? iaaee/ii? aeiiiiiae i?e iaa?aeeeaaeieo
noaiao» (Ee?a, 1995); «O??o?a?/ia e?eoaaiiy ?aoeeaeeaoth/eo
aano?iaeoiaeaiaeueieo ae?acie oa ?o oneeaaeiaiue» (Ee?a, 1995);
«Aeooaeuei? i?iaeaie iaa?aeeeaaeii? o??o?a?? i?aai?a /a?aaii? ii?iaeieie
oa o?iaai?oaeueiiai o?aeoo» (Ee?a, 1996); «?ioaineaia oa?ai?y i?e
ia?oi?aoeaieo aano?iaeoiaeaiaeueieo ae?aceao» (Aa?aee/?a, 1996);
«No/ani? aniaeoe iaa?aeeeaaeii? iaaee/ii? aeiiiiiae» (Euea?a, 1997);
«Iiaua oaoiieiaee a oe?o?aee» (Ee?a, 1997); ia can?aeaiiyo Iaoeiaiai
Oiaa?enoaa O??o?a?a i.Ee?aa oa iaeano? (1996-1998 ??.); ia can?aeaii?
Ai?iaaoe?eii? ?aaee «Caaaeuei? ieoaiiy o??o?a??» Iaoe?iiaeueiiai
iaaee/iiai oi?aa?neoaoo ?i.I.I.Aiaiiieueoey (1997). Ii caaaeaiith
I?i?noa?noaa iaoee oa iaoeiaeo oaoiieia?e iaoa??aee ?iaioe
aeniiioaaeenue ia aenoaaoe? i?e Eaa?iao? I?i?no??a Oe?a?ie (Ee?a, 1997).

Ioae?eaoe??. Ii ?acoeueoaoai aeena?oaoe?eieo aeine?aeaeaiue iioae?eiaaii
20 iaoeiaeo i?aoeue, ?c ieo 2 noaoo? — o oaoiaeo iaoeiaeo iaaee/ieo
aeo?iaeao, 3 ?iaioe — a ca??eao iaoeiaeo i?aoeue, 13 noaooae — a
iaoa??aeao oa oacao eiioa?aioe?e; io?eiaiee 1 Iaoaio Oe?a?ie ia
aeiao?ae, aeaeaiee 1 ?ioi?iaoe?eiee eeno.

Ia»?i oa no?oeoo?a ?iaioe. Aeena?oaoe?y neeaaea?oueny ?c anooio, iaeyaeo
e?oa?aoo?e, oanoe oaiaoe/ieo ?icae?e?a, caeeth/aiiy, aeniiae?a,
i?aeoe/ieo ?aeiiaiaeaoe?e, iieaae/eea e?oa?aoo?e. ?iaioa aeeeaaeaia ia
157 noi??ieao iaoeiiieniiai oaenoo, ?ethno?iaaia 19 oaaeeoeyie, 4
?enoieaie. Iieaae/ee e?oa?aoo?e aeeth/a? 320 aeaea?ae, a oiio /ene? 135
— ?iicaiieo.

INIIAIA *ANOEIA

Iaoa??ae oa iaoiaee aeine?aeaeaiue. A iniiao ?iaioe iieeaaeai? aeai?
ananoi?iiiueiai aeine?aeaeaiiy oa aiae?co ?acoeueoao?a ae?aaiinoeee oa
o??o?a?/iiai e?eoaaiiy 122 oai?eo ?c IAAAeA, ui ia?aaoaaee c 1982 ii
1996 ?iee ia e?eoaaii? a Ee?anueeiio i?nueeiio Oeaio?? ii iaaeaiith
iaa?aeeeaaeii? aeiiiiiae iaoe?aioai ?c aino?eie oeoieiai-eeoeiaeie
e?iaioa/aie. Aeaia a?oia oai?eo aoea iniiaiith aeey aea/aiiy ? neeaea
1,4% a?ae caaaeueii? e?eueeino? c 8822 iaoe?aio?a ?c AAAeA, ui
e?eoaaeenue o Oeaio?? ca oeae aea i?ii?aeie /ano.

Aeey ci?anoaaeaiiy ? ii??aiyiiy iniaeeainoae ee?i?/iiai ia?aa?ao,
ae?aaiinoeee oa e?eoaaiiy o oai?eo iniiaii? a?oie aoei aeae?eaii
eiio?ieueio a?oio ?1, yeo neeaee 474 iaoe?aioe c IAAeA aac e?iaioa/? oa
eiio?ieueio a?oio ?2, o yeo oa?eoee aeai? aeine?aeaeaiue 8700 oai?eo ?c
AAAeA.

O i?ioean? ianoaaeaiiy iaoe?aio?a iniiaii? oa eiio?ieueii? a?oi
aea/aeenue aiaiianoe/i? oa ee?i?/i? aeai?, caaaeuei? iieacieee
aaiia?aie, a?io?i?/i? aeine?aeaeaiiy, ooieoe?iiaeueiee noai ie?ie.
Nooi?iue aaaeeino? ?ioieneeaoe?? aecia/aee ii eaeeioeeoa?iiio ?iaeaeno
?ioieneeaoe?? (E??) (ss.ss.Eaeueo-Eaeeo, 1941). Anueiai i?iaaaeaii 67990
eaai?aoi?ieo aeine?aeaeaiue 24-o iieaciee?a aiiainoaco. Nooi?iue
aaaeeino? e?iaiao?aoe ioe?ithaaee ii ee?i?ei-eaai?aoi?iei oa
aaiiaeeiai?/iei iieacieeai ?, ca?aeii eeaneo?eaoe?? A.Ae.A?aoony (1991),
aeae?eyee eaaeo, na?aaeith oa aaaeeo nooiai? e?iaiao?aoe.

Aeey aeyaeaiiy eieae?caoe??, iniaeeainoae ae?aceiai? aeano?oeoe?? oa
noaio aaiinoaco a cii? ae?aceiaiai e?aoa?o ? ae?aaiinoeee oa e?eoaaiiy
??ciiiai?oieo i/i oneeaaeiaiue aoei aeeiiaii 1987
o?a?iacioaaiaano?iaeoiaeaiineii?/ieo (OAAAeN) aeine?aeaeaiue aia?aoaie
«Olimpus» (GIF-K, GIF-1T). I?e aeyaeaii? iciae i?iaeiaaeaiiy e?iaioa/?
/e ianoaa?eueiiai aaiinoaco a cii? ae?acee canoiniaoaaee caniae
aiaeineii?/iiai aaiinoaco, ui aeeth/aee iiii- /e a?iiey?io
ae?aoa?iieiaaoeyoe?th aai iaianaiiy ie?aeiooai?thth/eo iie?ia??a.

O i?ioean? aeine?aeaeaiiy oai?eo ?c IAAAeA oa IAAeA cae?eniaii 479
iaeyaeiaeo ?aioaaiia?ao?e /a?aaii? ii?iaeieie oa 82 aiaeineii?/i?
iiaaiiaano?ia?ao??.

I?ae /an iia?aoeaiiai ao?o/aiiy aiae?coaaee e?euee?noue oa oa?aeoa?
aenoaeaoo a /a?aai?e ii?iaeiei?, iioe?ai?noue oa nooi?iue ae?aaeaiino?
caiaeueieo ci?i c aieo i?aai?a oeoieiai-eeoeiaiai o?aeoo. I?e oeueiio
aeae?eyee yaeua i?noeaaiai (eieaeueiiai), aeeoociiai oa ?iceeoiai
ia?eoii?oo (A.Ae.Naa/oe, 1988). Aeey aea/aiiy oa?aeoa?o i?e?ioei?e oa
/ooeeaino? ?? aei 8 iaea?eueo aaeeaa?ieo aioea?ioee?a, o 21 iaoe?aioa
iniiaii? oa 48 — eiio?ieueii? a?oie ?1 aoei i?iaaaeaii 207
aaeoa??ieia?/ieo aeine?aeaeaiue.

An? io?eiai? oeeo?ia? cia/aiiy, ye a iniiai?e, oae ? a eiio?ieuei?e
a?oiao, aoee i?aeaeai? noaoenoe/i?e ia?iaoe? ? ii??aiyiith ia PC Pentium
166 MMX ?c aecia/aiiyi aeinoia??iino? ??cieoeue ii e?eoa??th
Nouethaeaioa (? < 0,05). Aeey aeyaeaiiy o?niioe - ca"yceo ye?nieo iciae aeei?enoiaoaaee eiao?oe?aio na?aaeiueiai eaaae?aoe/iiai ni?yae?iiy I??niia oa eiao?oe?aio aca?iiiai ni?yae?iiy *oi?iaa (Ae.A.Naiaoeeaa, 1968; A.A.Aaeeeia e ae?., 1973; E.A.Iieyeia, I.N.Nieieiaa, 1975; A.A.Aoaea?, 1978). ?acoeueoaoe aeine?aeaeaiue. I?ioyaii 15-??/iiai ia??iaeo niinoa?aaeaiue o ee?i?oe? a?aei?/aii oaiaeaioe?th aei ca?eueoaiiy e?eueeino? oai?eo ?c IAAAeA. sseui ca ia?o? 10 ?ie?a (1982-1991 ??.) ie iaee 67 iaoe?aio?a ?c aeaiith iaoieia??th (a na?aaeiueiio - 6,7 ia ??e), oi ca inoaii? 5 ?ie?a (1992-1996 ??.) - a ee?i?oe? e?eoaaeinue 55 oai?eo ?c iaeii/aniei aeieeiaiiyi ia?oi?aoe?? oa e?iaioa/? i?e ae?aceia?e oai?ia? (a na?aaeiueiio - 11 ia ??e). I?e aiae?c? a?eiaeo iniaeeainoae o oai?eo ?c ??cieie aa??aioaie ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/? i?e ae?aceia?e oai?ia? anoaiiaeaii, ui 49 (40,2%) iaoe?aio?a ?c 122 aoee iioeeiai oa noa?a/iai a?eo, ui noaoenoe/ii aeinoia??ii (?<0,05) aeua, ii??aiyii c aeine?aeaeoaaieie iaeaeaio eiio?ieueieo a?oi. I?e aeine?aeaeaii? iniaeeainoae eieae?caoe?? IAAAeA aeyaeaii, ui 20 (16,4%) ?c 122 oai?eo iniiaii? a?oie iaee oeoieiaa ?ici?uaiiy ia?oi?aoeaii? aino?ie?iaioi/eai? ae?acee, i?e/iio o 18 ?c ieo niinoa??aaeanue ia?oi?aoe?y ? e?iaioa/a c iaei??? ? o??? ae ae?acee oeoieo; a 1 iaoe?aioa - ia?oi?oaaea iaeia, a e?iaioi/eea ?ioa ae?acea oeoieo, a ua a 1 oai?iai ae?aaiinoiaaii ia?oi?aoe?th ae?acee oeoieo, a e?iaioa/o c ae?acee i?ei?iaeoiaeaiaeueii? ciie (IAeC) (Jonson ? ?). Na?aaei?e ?ici?? ia?oi?aoeaii? aino?ie?iaioi/eai? ae?acee oeoieo (IAAO) neeaa 2,9 +/- 0,2 ni, ui noaoenoe/ii aeinoia??ii (?<0,05) a?eueoa, i?ae o iaoe?aio?a ?c oeoieiaith eieae?caoe??th ae?acee a eiio?ieuei?e a?oi? ?1 (na?aaei?e ?ici?? - 1,5 +/- 0,2 ni) oa eiio?ieuei?e a?oi? ?2 (na?aaei?e ?ici?? - 1,9 +/- 0,3 ni). O oe?eiio, 12 ?c 20 oai?eo c IAAO iaee ?ici??e ae?aceiaiai noano?aoo a?eueoa 3,0 ni (a?aaionuee? ae?acee oeoieo). O ?aooe 102 (83,6%) iaoe?aio?a iniiaii? a?oie, aeyaeaia ?ici?uaiiy ia?oi?aoeaii? aino?ie?iaioi/eai? ae?acee a IAeC, i?e/iio a 74 ?c ieo iaea i?noea ia?oi?aoe?y oa e?iaioa/a c iaei??? ? o??? ae ae?acee, o 23 oai?eo anoaiiaeaii iayai?noue ia?oi?aoe?? iaei???, a e?iaioa/? - c ae?oai? ae?acee IAeC ("aeca?eaeuei? ae?acee"), a ua a 5 - ae?aaiinoiaaii ia?oi?aoe?th ae?acee IAeC, a e?iaioa/o c ae?acee oeoieo (Jonson ? ?). Na?aaei?e ?ici?? ia?oi?aoeaii? aino?ie?iaioi/eai? ae?acee IAeC (IAAIAeC) aoa 1,9 +/- 0,08 ni, ui noaoenoe/ii aeinoia??ii (?<0,05) a?eueoa, ii??aiyii c ?ici?uaiiyi ae?acee a IAeC na?aae iaoe?aio?a eiio?ieueii? a?oie ?1 (na?aaei?e ?ici?? - 1,1 +/- 0,07 ni) oa eiio?ieueii? a?oie ?2 (na?aaei?e ?ici?? - 1,3 +/- 0,07 ni). A?eueoa ye o iieiaeie (o 53 ?c 102) oai?eo ?c IAAIAeC anoaiiaeaii iayai?noue a?aaionueeeo ae?acie (caeiathoue a?eueoa 1/2 ia?eiao?o IAeC). O oe?eiio, a 92 (75,4%) ?c 122 iaoe?aio?a iniiaii? a?oie niinoa??aaeanue ia?oi?aoe?y ? e?iaioa/a c iaei??? ? o??? ae ae?acee oeoieo /e IAeC, a a ?aooe 30 (24,6%) - iaea i?noea ia?oi?aoe?y iaei???, a e?iaioa/a - c ae?oai? ae?acee oeoieo /e IAeC. I?e aiae?c? nooiai? aaaeeino? e?iaiao?aoe a oai?eo iniiaii? a?oie, iii??io nooi?iue iaee 43(35,2%), na?aaeith - 35(28,7%) ? aaaeeo - 44(36,1%) iaoe?aio?a, oiae? ye o eiio?ieuei?e a?oi? ?2 (AAAeA), oe? iieacieee neeaee 57%, 32% oa 11% a?aeiia?aeii. A oe?eiio, na?aaeiy oa aaaeea nooiai? e?iaiao?aoe o iaoe?aio?a iniiaii? a?oie niinoa??aaeenue o 1,5 ?ac?a /ano?oa, i?ae o oai?eo eiio?ieueii? a?oie ?2. Iii??ia nooi?iue aaaeeino? e?iaiao?aoe aeyaeyeanue o 2,6 ?ace ??aeoa, a na?aaeiy oa aaaeea nooiai? e?iaiao?aoe - a 1,5 oa 1,3 ?ace /ano?oa, a?aeiia?aeii, i?e IAAO, i?ae i?e IAAIAeC. I?e ?aoaeueiiio aiae?c? iniaeeainoae aeieeiaiiy oa ee?i?/iiai ia?aa?ao IAAAeA iaie anoaiiaeaii oa aeae?eaii aeaa aa??aioe ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/?: 1. Iaeii/aniee ?icaeoie e?iaioa/? oa ia?oi?aoe?? aano?iaeoiaeaiaeueieo ae?acie - o 34(27,9%) iaoe?aio?a; 2. Ia?oi?aoe?y ae?acee ianooia? a ?aiiueiio a?aeno?i/aiiio ia??iae? i?ney coieiee e?iaioa/? - o 88(72,1%) oai?eo. I?e oeueiio a 48(54,5%) iaoe?aio?a ia?oi?aoe?y ae?acee noi?iaiaeaeo?oueny ?aoeeaeeaii e?iaioa/? (?E), a a 40(45,5%) - aac ?E. Ia i?aenoaa? aea/aiiy iniaeeainoae eieae?caoe??, ?icaeoeo oa ia?aa?ao IAAAeA, iaie cai?iiiiiaaia eeaneo?eaoe?y aeaii? iaoieia??. Eeaneo?eaoe?y IAAAeA. A. Ii eieae?caoe??: 1. Ia?oi?aoe?y ? e?iaioa/a c iaei??? ? o??? ae ae?acee: a) oeoieo; a) IAeC. 2. Ia?oi?aoe?y iaei???, a e?iaioa/a - c ?ioi? ae?acee: a) ia?oi?aoe?y ae?acee ia ia?aaei?e no?ioe?, a e?iaioa/a - c ae?acee caaeiuei? no?iee IAeC; a) ia?oi?aoe?y ae?acee IAeC, e?iaioa/a c ae?acee oeoieo (Jonson II); a) ia?oi?aoe?y ae?acee oeoieo, e?iaioa/a c ae?acee IAeC (Jonson II); a) ia?oi?aoe?y iaei???, a e?iaioa/a - c ?ioi? ae?acee oeoieo. A. Ii ?icaeoeo oa ee?i?/iiio ia?aa?ao: 1. Iaeaea iaeii/aniee ?icaeoie e?iaioa/? oa ia?oi?aoe??; 2. Ia?oi?aoe?y ae?acee a ?aiiueiio, i?ney coieiee e?iaioa/?, ia??iae?: a) ia?oi?aoe?y ae?acee noi?iaiaeaeo?oueny ?E; a) ia?oi?aoe?y ae?acee aac ?E. Ca?aeii iaoeo aeaieo, aeey IAAO aoei oa?aeoa?iei o 1,5 ?ace /ano?oa aeieeiaiiy ia?oi?aoe?? o a?aeno?i/aiiio ia??iae? i?ney coieiee e?iaioa/?, ii??aiyii c IAAIAeC, aeey yeeo niinoa??aaeanue i?eaeecii iaeiaeiaa /anoioa ?icaeoeo iaeaeaio aa??aio?a oneeaaeiaiue. A?aeiinii oa?i?io aeieeiaiiy ia?oi?aoe?? aino?ie?iaioi/eaeo ae?acie (AA) o a?aeno?i/aiiio ia??iae? anoaiiaeaii, ui ia?oi?aoe?y AA oeoieo a 93,8% aeiaaee?a ianooiaea ia 2-5 aeiao, a ia?oi?aoe?y AA IAeC o 75% in?a ?icaeaaeanue o ia?o? o?e aeiae c iiiaioo coieiee e?iaioa/?. ?E i?e ?icaeoeo ia?oi?aoe?? ae?acee o a?aeno?i/aiiio ia??iae? i?ney coieiee e?iaioa/? ia??iae? niinoa??aaany a 56,3% oai?eo ?c IAAO oa 54,2% - c IAAIAeC. ??ciiiai?oi?noue aa??aio?a ?icaeoeo oa ii?aeiaiue ia?oi?aoe?? oa e?iaioa/? i?e AO iaoiiaeththoue aoeiia?noue ee?i?/iiai ia?aa?ao IAAAeA, ii??aiyii c IAAeA. Ii??aiyeueiee aiae?c aeyaeaieo neiioii?a IAAAeA oa IAAeA i?aaenoaaeaiee o oaaeeoe?1. Oaaeeoey 1 *anoioa iciae i?e IAAAeA oa IAAeA I c i a e e Aa??aioe I A A Ae A IAAeA A 1 (n=34) A 2a (n=48) A 2a (n=40) (n=474)1. ?aioiaee ??ceee a?eue 23,5% 18,8% 52,5% 89%2. "O?ai?eon"-neiioii 11,8% 6,3% 32,5% 41,4%3. "Aeioeiiiae?aiee" aeea?o 17,6% 16,7% 57,5% 92,6%4. A?aenooi?noue ia/?ieiai? ooiino? 41,2% 31,3% 55% 61,4%5. Neiioiie iiae?aciaiiy i/a-?aaeie 20,6% 18,8% 62,5% 92,4%6. Ioeuen ca 1 oaeeeio 106+/-13,1110+/-15,696+/-11,6 80+/-10,17. E?euee?noue eaeeioeeo?a o e?ia? o109 13,3+/-4,7 15,1+/-4,2 11,1+/-3,6 10,6+/-3,1 *anoioa iniiaieo iciae IAAAeA iaaeeaeaeanue aei oeiiai? IAAeA o?eueee i?e ?icaeoeo ia?oi?aoe?? ae?acee o ?aiiueiio a?aeno?i/aiiio ia??iae? aac ?E. I?e ?ioeo aa??aioao ?icaeoeo ia?oi?aoe?? oa e?iaioa/? oeiia? iciaee ia?oi?aoeaii? ae?acee cono??/aeenue cia/ii ??aeoa (p<0,05). Oea iaoiiaeaii iiiaaeaiiyi o /a?aaio ii?iaeieio oeoieiaiai ai?noo, iaeo?ae?ciaaiiai e?ia"th, yeee ia ni?e/eith? ae?aaeaii? iiae?acithth/i? ae?? ia i/a?aaeio. E??i oiai, ia?aaaaa in?a iioeeiai oa noa?a/iai a?eo ?c cieaeaiith ?aaeoeai?noth i?aai?cio, oaeiae iaoiiaeththoue noa?o?noue ee?i?/ii? ea?oeie o aeuaaeacaieo a?oiao. Naia oea ni?e/eith? i?ci? oa?i?ie ae?aaiinoeee ii?aeiaiue ia?oi?aoe?? oa e?iaioa/?. C iaoith aea/aiiy iiaeeeainoae ?aiiuei? ae?aaiinoeee IAAAeA iaie aoa i?iaaaeaiee ?aoaeueiee aiae?c an?o ee?i?/ieo neiioii?a ? ia i?aenoaa? oeueiai - aeae?eaiee neiae?ii "iaeeo" iciae i?e ii?aeiaii? ia?oi?aoe?? oa e?iaioa/?. Aei iueiai a?aeiineii: caa?aaeaiiy /e aeieeiaiiy ??cii? ?ioaineaiino? aieae o aeeaio?, iayai?noue i?e iaeueiaoe?? iaa?oue iacia/ii? aieth/ino? ? iai?oaeaiiy i"yc?a ia?aaeiuei? /a?aaii? no?iee, noii?aieo iciae iiae?aciaiiy i/a?aaeie, ii/auaiiy ioeueno oa i?aeaeuaiiy e?eueeino? eaeeioeeo?a o oai?eo ?c ae?aceiaeie e?iaioa/aie. Aeyaeaiiy aeacaiiai neiioiiieiiieaeno iio?aao? i?iaaaeaiiy aeiaeaoeiaeo iaoiae?a aeine?aeaeaiiy: iaeyaeiai? ?aioaaiia?ao?? /a?aaii? ii?iaeieie, OAAAeN, aiaeineii?/ii? iiaaiiaano?ia?ao??, eaia?ioeaioaco. Ai?iaaaeaeaiiy a ee?i?/io i?aeoeeo ae?aaiinoe/iiai aeai?eoio i?e iayaiino? neiae?iio "iaeeo" iciae IAAAeA aeicaieeei ca?eueoeoe ?aiith, a ia?o? 6 aiaeei, ae?aaiinoeeo aeaii? iaoieia?? a 2,9 ?ace: c 34,5% (?-ee ia??iae - 1982-1993 ??.) aei 100% (??-ee ia??iae - 1994-1996 ??.) ? ?icoe?eei iiaeeeaino? aeey aeeiiaiiy ?aaeeeaeueieo iia?aoeaieo ao?o/aiue. Iia?aoeai? ao?o/aiiy ? iniiaiei iaoiaeii e?eoaaiiy IAAAeA. ?c 122 oai?eo - iaie iia?iaaii 112 (91,8%). ?aooa 10 (8,2%) - ia iia?iaai? ? iiia?ee: 4 iaoe?aio?a - aeinoaaeai? a aaiiaeueiiio noai? ? iiia?ee a ia?o? 2-4 aiaeeie; o 3 oai?eo, noa?oa 70 ?ie?a, aoea ae?aaiinoiaaia IAAAeA, iaeiae aaaeea e?iaiao?aoa, ae?aaeaia noiooiy iaoieia?y, ?ioieneeaoe?y ia aeicaieyee aeeiiaoe iia?aoeaia ao?o/aiiy, a canoinoaaiiy iaoiaea Oaeei?a ia i?eianei oni?oo; ua a 3 iaoe?aio?a noa?a/iai a?eo, ?c-ca aaaeeeo noiooi?o caoai?thaaiue, ia iiaeeeai aoei canoinoaaoe aeiaeaoeia? iaoiaee aeine?aeaeaiiy ? ae?aaiic IAAAeA aoa onoaiiaeaiee o?eueee ia aooiin??. ?c 112 iia?iaaieo, ?aaeeeaeuei? iia?aoeai? ao?o/aiiy aeeiiai? 74 (66,1%) oai?ei: ?acaeoe?? oeoieo - 24 (32,4%), aaaioii?? - 50 (67,6%), a 38 (33,9%) iaoe?aioai - aoee cae?eniai? ia ?aaeeeaeuei? (ooeaaiiy, aen?/aiiy ae?acee) iia?aoe??. Na?aae 16 iia?iaaieo ?c IAAO, ?acaeoe?ei? iaoiaee canoiniaai? o 8 (i?ei?icaa??aath/? ?acaeoe?? - o 2) ? iaee?aoeai? - oaeiae o 8 in?a. Na?aae 96 iia?iaaieo ?c IAAIAeC, ?acaeoe?? oeoieo aeeiiai? a 16 (16,7%), ??ci? aeaee aaaioii?e ?c ?aaeeeaeueiei ao?o/aiiyi ia ae?acoe? - o 50 (52,1%) (naeaeoeaia i?ieneiaeueia aaaioii?y - o 14, naeaeoeaia aaaioii?y - o 8, eiia?iiaaia aaaioii?y - o 3, o?oieoey?ia aaaioii?y - o 25) ? iaee?aoeai? iia?aoe?? - o 30 (31,2%) oai?eo. ?aaeeeaeueieie ao?o/aiiyie ia ae?aceiaiio noano?ao? aoee aen?/aiiy aai aeaaaeaiiy ae?acee ca iaae? i?ina?oo oeoieiai-eeoeiaiai o?aeoo c iaia"yceiaith ?aa?c??th caaeiuei? no?iee oeeaoeeie 12-iaei? eeoee ?, i?e aeyaeaii? ae?aceiaiai noano?aoo, ao?o/aiiy ia iueiio. I?e aeeiiaii? iia?aoe?e, yaeua i?noeaaiai ia?eoii?oo aoee a 55 (45,1%), aeeoociiai - a 34 (27,9%) ? ?iceeoiai - a 33 (27%) iaoe?aio?a. Aeeoociee oa ?iceeoee oi?ie ia?eoii?oo cono??/aeenue o 1,3 ?ace /ano?oa (p<0,05) i?e IAAAeA, i?ae i?e IAAeA i?e a?aenooiino? nooo?aeo a?aei?iiinoae o aeaeiaiio neeaae? i?e?ioei?e. Anoaiiaeaii, ui iieacieee E?? i?e na?aaei?e oa aaaee?e nooiaiyo e?iaiao?aoe noaoenoe/ii aeinoia??ii (p<0,05) aeu? i?e a?aeiia?aeieo i?iyaao ia?eoii?oo a iaoe?aio?a ?c IAAAeA, i?ae i?e IAAeA. I?e aeeiiaii? iia?aoeaiiai ao?o/aiiy o 18 oai?eo, ia?aaaaeii c yaeuaie ?iceeoiai ia?eoii?oo oa ?E, cae?enithaaee iaciaano?aeueio ?iooaaoe?th eeoe?aieea c iaoith ciaioaiiy aiaeiaaiii? ?ioieneeaoe??, coiiaeaii? ia?eoii?oii oa iayai?noth ci?iaii? e?ia? a i?ina?o? oeoieiai-eeoeiaiai o?aeoo. Iia?aoe?th cae?i/oaaee ?aoaeueiith naiaoe??th /a?aaii? ii?iaeieie oa ae?aioaaiiyi ??, a a 4-o iaoe?aio?a - oe?eani?yiiaaii aeei?enoiaoaaee iaoiaeeeo i?ia?aiiaaii? eaia?inoii?? ?c aeeiiaiiyi iiaoi?ieo naiaoe?e /a?aaii? ii?iaeieie ia 3-4-o aeiao i?ney iia?aoe??. Aacoiiaii, iane?aeie eiaeiiai c aeaeo iia?aoeaieo ao?o/aiue iaoiiaeth?oueny ?aoe?iiaeueii iiaoaeiaaiith i?ia?aiith ?ioaineaii? oa?ai??. Iniaeeai oea ia? cia/aiiy o iaoe?aio?a ?c ii?aeiaiiyi aeaio aaaeeeo oneeaaeiaiue AO - ia?oi?aoe?? oa e?iaioa/?. ?ic?iaeaiee aeai?eoi aaaeaiiy oai?eo ?c IAAAeA aeeth/a?: a) iiiiaiaiiy e?iaiao?aoe; a) ai?ioueaa c ?ioaeoe??th oa yaeuaie ia?eoii?oo ?aoe?iiaeueiei i?ecia/aiiyi aioea?ioee?a oe?ieiai niaeo?o ae??, ii/eiath/e c iiiaioo iinoaiiaee ae?aaiico IAAAeA; a) ai?aeo?aeueia aianoac?y a ?aiiueiio i/i ia??iae?; a) ni?aoe?ei? iaoiaee aeaoieneeaoe?? i?aai?cio (aaiini?aoe?y, ieaciini?aoe?y, ieaciaoi?ac); ae) canoinoaaiiy aioo??oiueiaaiiiai eaca?iiai ii?ii?iaiiy e?ia?. ?c ai?iaaaeaeaiiyi o ee?i?/io i?aeoeeo aeiaeaoeiaeo iaoiae?a aeine?aeaeaiue i?e iayaiino? neiae?iio "iaeeo" iciae aeicaieeei iie?aueoe ae?aaiinoeeo, ciaioeoe a 1,8 ?ace e?euee?noue iaee?aoeaieo iia?aoe?e ca ?aooiie ca?eueoaiiy c 61,9% (?-ee ia??iae) aei 78,6% (??-ee ia??iae) /enea ?aaeeeaeueieo iia?aoeaieo ao?o/aiue. Iaie ?ic?iaeaiee iiaee iaoiae naeaeoeaii? i?ieneiaeueii? aaaioii?? (Iaoaio 22790A Oe?a?ie "UA" IIE A 61 A 17/00 a?ae 21.04.98 ?ieo), nooue yeiai iieyaa? a noana?ici?e neaeaoecaoe?? iaei? e?eaeie oeoieo oa ia?an?/aii? i?ieneiaeueieo a?oie ia?aa Eaoa?aea ?c caa?aaeaiiyi o?eueee aeenoaeueii? a?oee, yea ?iia?ao? i?ai?ei?e/iee a?aeae?e o iaaeao 3 ni aei i?ei?e/iiai aeiio. Aeaiee iaoiae aea? a?eueo no?eea cieaeaiiy oeoieiai? eeneioii?iaeoeoe??, a cia/ii a?eueo?e i??? i?eai?/o? aaaonio noeioeyoe?th ae?iaeaiiy aio?aeueiiai aano?eio ?, oei naiei, ciaioo? /anoioo i/i ?aoeeaeea?a ae?acie. Aeaee iia?aoe?e oa iieacieee i/i eaoaeueiino? ii ia??iaeai niinoa?aaeaiue i?aaenoaaeai? a oaaeeoe? 2. Oaaeeoey 2 Aeaee iia?aoe?e oa eaoaeuei?noue i?e IAAAeA I i a ? a oe ? ? Ia??iaee niinoa?aaeaiue A n ue i a i ?-ee (1982-1993) ??-ee (1994-1996)E?euee?noue oai?eoIiia?- ee (%)E?euee?noue oai?eoIiia?- ee (%)E?euee?noue oai?eoIiia?- ee (%)1. ?acaeoe?? oeoieo 16 4 25% 8 1 12,5% 24 5 20,8%2. Aaaioii?? 36 - 14 - 50 -3. Iaee?aoeai? 32 17 53,1% 6 1 16,7% 38 18 47,4% Anueiai: 84 21 25% 28 2 7,1% 112 23 20,5% Iie?auaiiy ae?aaiinoeee, ciaioaiiy e?eueeino? iaee?aoeaieo ao?o/aiue, ?ic?iaea oa ai?iaaaeaeaiiy cania?a ?ioaineaii? oa?ai??? a i/i ia??iae? aeicaieeee i?ioyaii ??-ai oa?i?io ee?i?/ieo niinoa?aaeaiue cieceoe i/i eaoaeuei?noue: caaaeueio - c 25% aei 7,1% (a 3,5 ?ace), i?e iaee?aoeaieo ao?o/aiiyo - c 53,1% aei 16,7% (a 3,2 ?ace), i?e ?aaeeeaeueieo iia?aoe?yo - c 7,6% aei 4,5% (a 1,7 ?ac?a), a oiio /ene? i?e ?acaeoe?yo oeoieo - c 25% aei 12,5% (a 2 ?ace). ?c 89 iaoe?aio?a, ui iaeoaeaee i?ney iia?aoe?e, o 38 (42,7%) niinoa??aaeenue 63 ??cieo aeaea i/i oneeaaeiaiue (eaaaiaai? nenoaie - 20, i?iyae na?oeaai-noaeeiii? iaaeinoaoiino? - 12, ii?ooaiiy iioi??-aaaeoaoi?ii? ooieoe?? oeoieo - 17, i/i iaie?aaoeo - 6, iaaii?iiy i/i ?aie - 8), c yeeie aaeaeinue ni?aaeoenue i?iaaaeaiiyi aaeaeaaoii? oa?ai??. O oe?eiio, i/i oneeaaeiaiiy niinoa??aaeenue o 2,2 ?ace /ano?oa i?e IAAAeA, ii??aiyii c iaoe?aioaie c IAAeA (p<0,05) oa o 1,8 ?ac?a /ano?oa i?e IAAAeA, i?ae o oai?eo ?c AAAeA (p<0,05), ui iaoiiaeaii neiae?iiii aca?iiiai iioyae/aiiy iaeaeaio oneeaaeiaiue AO o iaoe?aio?a iniiaii? a?oie. I?e/eiaie i/i eaoaeueiino? aoee: iie?i?aaiia iaaeinoaoi?noue i?e aaaee?e e?iaiao?ao? oa ?iceeoiio ia?eoii?o? (17), o?iiaiaiaie?/i? oneeaaeiaiiy (3), iani?iiiaei?noue eoeueo? 12-iaei? eeoee (1), aeano?oeoeaiee iaie?aaoeo (1), ia?oi?aoe?y aino?i? ae?acee oeoieo (1). ?c 89 aeienaieo i?ney iia?aoe?e iaoe?aio?a o 77 (86,5%) aoee i?inoaaeai? a?aeaeaeai? ?acoeueoaoe: a?ae 1 aei 5 ?ie?a - 42, a?ae 6 aei 10 ?ie?a - 24, a?eueoa 10 ?ie?a - 11. Ia iniia? aeaieo aieaoiiai iieooaaiiy (32), aiaoeaoi?iiai (20) ? noaoe?iia?iiai (25) ianoaaeaiue a?aei?ii? oa oi?io? ?acoeueoaoe ii oeae? Visick io?eiai? a 57 (74%) oai?eo, caaeia?euei? - o 15 (19,5%) ? iacaaeia?euei? - o 5 (6,5%) iaoe?aio?a ?c IAAAeA. A?aeaeaeai? ?acoeueoaoe caeaaeaee a?ae aeaeo aeeiiaiiai iia?aoeaiiai ao?o/aiiy. Oaeei /eiii, iie?auaiiy ?acoeueoao?a o??o?a?/iiai e?eoaaiiy caeaaeeoue a?ae ?aiiuei? ae?aaiinoeee, nai?/aniiai aeeiiaiiy, ia?aaaaeii, ?aaeeeaeueieo iia?aoeaieo ao?o/aiue oa ?aoe?iiaeueiiai i?iaaaeaiiy ?ioaineaii? oa?ai?? a i/i ia??iae?. A E N I I A E E 1. Ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/? ? iaeiei ?c iaea?eueo aaaeeeo oneeaaeiaiue AO, ui i?io?ea? ii oeio neiae?iio aca?iiiai iioyae/aiiy, aeieea? a 1,4% oai?eo ?c aino?eie ae?aceiaeie e?iaioa/aie ? niinoa??aa?oueny a 40,2% iaoe?aio?a iioeeiai oa noa?a/iai a?eo. 2. Ia?oi?aoe?? aino?ie?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie oa?aeoa?ecothoueny aeaiia aa??aioaie ?icaeoeo: iaeii/aniei aeieeiaiiyi iaeaeaio oneeaaeiaiue (27,3%) oa ianooieaiiyi ia?oi?aoe?? a ?aiiueiio, i?ney coieiee e?iaioa/?, ia??iae? (72,1%). Iaeaea o eiaeiiai /aoaa?oiai iaoe?aioa (24,6%) niinoa??aa?oueny ia?oi?aoe?y iaei???, a e?iaioa/a - c ae?oai? ae?acee oeoieo /e 12-iaei? eeoee. 3. Ia?oi?aoe?y a ?aiiueiio, i?ney coieiee e?iaioa/?, ia??iae? o 54,5% oai?eo noi?iaiaeaeo?oueny ?E ? a 45,5% iaoe?aio?a - aac ?E ia oii? ??ciiai nooiaith aiai??. 4. Ee?i?/ia ea?oeia ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/? i?e AO oa?aeoa?eco?oueny aoeiia?noth ? noa?o?noth i?iya?a ia?eoiiaaeueieo iciae, nooi?iue ae?aaeaiino? yeeo caeaaeeoue a?ae aa??aio?a ?icaeoeo iaeaeaio oneeaaeiaiue oa nooiaith aaaeeino? e?iaiao?aoe. 5. Aeae?eaiee neiae?ii "iaeeo" iciae o oai?eo ?c AAAeA aeicaiey? cai?aeic?eoe oa, canoinoaaaoe aiaeineii?/i? ? ?aioaaiieia?/i? iaoiaee aeine?aeaeaiiy, nai?/anii ae?aaiinooaaoe aeieeiaiiy ia?oi?aoe?? aino?ie?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie. 6. ?aiiy ae?aaiinoeea ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/? aea? iiaeeea?noue ?icoe?eoe ae?aiacii ?aaeeeaeueieo iia?aoeaieo ao?o/aiue ?c 61,9 aei 78,6%, a ai?iaaaeaeaiiy a ee?i?/io i?aeoeeo aeai?eoio i?iaaaeaiiy ?ioaineaieo i??ii?e?inoa o ia?aae-, i?ae /an oa a ?aiiueiio i/i ia??iae?, aeicaiey? cieceoe i/i eaoaeuei?noue o 3,5 ?ace - c 25 aei 7,1%. I?AEOE*I? ?AEIIAIAeAOe?? 1. Oai?? c aino?ie?iaioi/eaeie ae?aceaie oeoieo /e IAeC, o yeeo i?e aiaeineii?/iiio ianoaaeaii? aeyaeaii iayai?noue aaeeeeo oa a?aaionueeeo ?ici???a ae?aceiaiai noano?aoo, iniaeeai i?e yaeuao i?iaeiaaeaiiy e?iaioa/? /e iano?eeiai aaiinoaco a e?aoa?? aai ia? i?noea ae?aaeaia ?oaoeaai-ae?aceiaa aeaoi?iaoe?y oeeaoeeie 12-iaei? eeoee, ?c-ca /iai inoaiiy - ia i?io?aeia aeey aiaeineiio, iiaeii? aooe iia?iaai? a aeno?aiiiio ii?yaeeo /e a ?aiiueiio a?aeno?i/aiiio (aei3- 5 ae?a) ia??iae? aeey iiia?aaeaeaiiy iiaeeeai? ia?oi?aoe?? ae?acee. 2. Iayai?noue o oai?eo ?c iciaeaie ae?aceiai? e?iaioa/? neiae?iio "iaeeo" iciae, ui oa?aeoa?ia aeey ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/? i?e AO, ? iieacaiiyi aei canoinoaaiiy aeiaeaoeiaeo ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiy c ianooiiith ioe?ieith ?o oa ci?anoaaeaiiyi ?c ee?i?/ieie aeaieie. 3. I?e iia?aoeaiiio e?eoaaii? IAAIAeC, ia?aaaao iaiao?aeii a?aeaeaaaoe i?aaiicaa??aath/ei iaoiaeeeai ?c ??cieie aeaeaie i?ei?i- /e aeoiaeaiiieanoee ?c ao?o/aiiyi ia ae?aceiaiio noano?ao? oa iaia’yceiaith ?aa?c??th caaeiuei? no?iee oeeaoeeie 12-iaei? eeoee. I?e ?acaeoe?eieo iaoiaeao iia?aoeaieo ao?o/aiue o iaoe?aio?a ?c IAAO, iaiao?aeii i?aaiooe aei aeeiiaiiy i?ei?icaa??aath/eo aeae?a ?acaeoe?? oeoieo. 4. Iaia’yceiaith oiiaith e?eoaaiiy oai?eo ?c ii?aeiaiiyi ia?oi?aoe?? oa e?iaioa/? i?e AO iiaeiii aooe aeei?enoaiiy ?ic?iaeaiiai aeai?eoio eiina?aaoeaieo i??ii?e?inoa o ia?aae-, i?ae /an oa ?aiiueiio i/i ia??iae?, ui, ii?yae ?c ?aiiueith ae?aaiinoeeith oa aeai?ii iioeiaeueiiai aeaeo iia?aoeaiiai ao?o/aiiy, aeicaiey? cieceoe i/i eaoaeuei?noue oa ciaioeoe /anoioo i/i oneeaaeiaiue i?e IAAAeA. NIENIE IIOAE?EIAAIEO ?IA?O II OAI? AeENA?OAOe??. 1. O??o?a?/ia e?eoaaiiy ia?oi?aoeaieo aino?ie?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie // Ee?i?/ia o??o?a?y. - 1997. - ?9-10. - N.11-12 (ni?aaao. Oii?i I.Ae., Eiceia N.I.). 2. Iniaeeaino? ee?i?ee oa ae?aaiinoeee ia?oi?aoe?? aino?ie?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie // E?ea?nueea ni?aaa. - 1997. - ?6. - N.66-69 (ni?aaao. Oii?i I.Ae.). 3. Iaoaio 22790 A Oe?a?ie "UA" IIE A 61 A 17/00 Niin?a naeaeoeaii? i?ieneiaeueii? aaaioii?? // ni?aaao. Oii?i I.Ae., Oaiaoueei ?.I., Oaiaoueei A.I. (Oe?a?ia) IIO ?97010012. Iiaeaii 03.01.97 ?. Iioae. 21.04.98 ?. Athe.?2. 4. ?aoeeaeeau yca iinea aaaioiiee // Aeooaeueiua i?iaeaiu yeno?aiaeueiie iaaeeoeeiu: Oacenu aeieeaaeia iao/i.-i?aeo. eiio. - Eeaa, 1993. - N.48-49. (niaao. Ieeeoaaa A.E., Iaoeeaiue A.I., Noaoe I.I.). 5. Oe?o?ae/aneia ea/aiea ia?oi?aoeaiuo aano?iaeoiaeaiaeueiuo yca // Aeooaeueiua i?iaeaiu yeno?aiaeueiie iaaeeoeeiu: Oacenu aeieeaaeia iao/i.-i?aeo. eiio. - Eeaa, 1993. - N.70-71. (niaao. Oaiaoueei A.I., Neaei?aiei A.I.). 6. Ee?i?/iee ia?aa?a ae?aceiai? oai?iae, oneeaaeiaiee iaeii/anii ia?oi?aoe??th oa e?iaioa/ath // Aeooaeueiua aii?inu oe?o?ae/aneie aano?iyioa?ieiaee. Na. iao/i. o?. iieiaeuo o/aiuo. - Oa?ueeia, 1994. -o.??. - N.77. (ni?aaao. Caieaanueeee I.A.). 7. O??o?a?/ia oaeoeea i?e ae?aceia?e oai?ia?, oneeaaeiai?e iaeii/anii ia?oi?aoe??th oa e?iaioa/ath // Aeooaeueiua aii?inu oe?o?ae/aneie aano?iyioa?ieiaee. Na. iao/i. o?. iieiaeuo o/aiuo. - Oa?ueeia, 1994. -o.??. - N.78. (ni?aaao. Oaiaoueei ?.I.). 8. Iiaee i?aeo?ae aei o??o?a?? ae?aceiai? oai?iae, oneeaaeiaii? iaeii/anii ia?oi?aoe??th oa e?iaioa/ath // Iiaia a aeeaaiinoeea e ea/aiee caaieaaaiee i?aaiia ieuaaa?aiey. Iao/ii-i?aeoe/aneay eiioa?aioeey: Oacenu aeieeaaeia. - Oa?ueeia, 1994. - N.204-205. (ni?aaao. Oii?i I.Ae., Oaiaoueei ?.I.). 9. I?aai?caoe?y o??o?a?/ii? aeiiiiiae oai?ei ?c aino?eie oeoieiai-eeoeiaeie e?iaioa/aie // Ia?oee (OV??) c"?cae o??o?a?a Oe?a?ie: Oace aeiiia?aeae. - Euea?a: Na?o, 1994. - N.33. (ni?aao. Oii?i I.Ae., A?aoonue A.Ae., Oaiaoueei ?.I. oa ?io?). 10. Iniaeeaino? ee?i?ee oa e?eoaaiiy oai?eo ?c ae?aceiaith oai?iaith, oneeaaeiaiith iaeii/anii ia?oi?aoe??th oa e?iaioa/ath // Aeooaeuei? i?iaeaie iaaeaiiy aeno?aiii? iaaee/ii? aeiiiiiae i?e iaa?aeeeaaeieo noaiao: Iao. iaoe.-i?aeo. eiio. - Ee?a, 1995. - N.60-61. 11. N?aaieoaeueiay oa?aeoa?enoeea ia?oi?aoeaiuo e ia?oi?aoeaiuo ino?ie?iaioi/aueo aano?iaeoiaeaiaeueiuo yca // Oe?o?ae/aneia ea/aiea ?aoeeaeeae?othueo aano?iaeoiaeaiaeueiuo yca e eo ineiaeiaiee: Iao. ?ani. iao/i.-i?aeo. eiio. - Eeaa, 1995. - N.53-55. (niaao. Oiiei I.Ae., Oaiaoueei A.I., Caieaaneee A.A. e ae?.). 12. Ni/aoaiea ia?oi?aoeee e e?iaioa/aiey i?e aano?iaeoiaeaiaeueiuo ycaao // Oe?o?ae/aneia ea/aiea ?aoeeaeeae?othueo aano?iaeoiaeaiaeueiuo yca e eo ineiaeiaiee: Iao. ?ani. iao/i.-i?aeo. eiio. - Eeaa, 1995. - N.55-56. 13. Ae?aaiinoe/i? e?eoa??? ia?oi?aoe?? e?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie. Aeione 6ii i?iaeai? "O??o?a?y" // ?ioi?iaoe?eiee eeno. - Ee?a, 1995 (ni?aaao. Oii?i I.Ae., Oaiaoueei ?.I., Iaoeeaiue A.I.). 14. Ieei?inio?aiythuea iia?aoeee n aaaioiieae i?e ?aoeeaeeae?othueo aeoiaeaiaeueiuo ycaao // Oe?o?ae/aneia ea/aiea ?aoeeaeeae?othueo aano?iaeoiaeaiaeueiuo yca e eo ineiaeiaiee: Iao. ?ani. iao/i.-i?aeo. eiio. - Eeaa, 1995. - N.85-86. (niaao. Oiiei I.Ae., Oaiaoueei A.I., Oaiaoueei A.I. e ae?.). 15. E?eoaaiiy ia?eoii?oo i?e ia?oi?aoe?yo aino?ie?eaaaey/eo aano?iaeoiaeaiaeueieo ae?acie // Aeooaeuei? i?iaeaie iaa?aeeeaaeii? o??o?a?? i?aai?a /a?aaii? ii?iaeieie oa o?iaai?oaeueiiai o?aeoo: Iao. ?ani. iao/i.-i?aeo. eiio. - Eeaa, 1996. - N.104-105. (ni?aaao. A?aoonue A.Ae., Eiceia N.I., E?nnia I.?. oa ?io?). 16. Ee?i?ea ia?eoii?oo i?e ia?oi?aoe?yo aino?ie?eaaaey/eo aano?iaeoiaeaiaeueieo ae?acie // Aeooaeuei? i?iaeaie iaa?aeeeaaeii? o??o?a?? i?aai?a /a?aaii? ii?iaeieie oa o?iaai?oaeueiiai o?aeoo: Iao. ?ani. iao/i.-i?aeo. eiio. - Eeaa, 1996. - N.119-120. (ni?aaao. Oii?i I.Ae., Oaiaoueei ?.I.). 17. E?eoa?ee e aeai?eoiu nieaeaiey eaoaeueiinoe i?e ia?oi?aoeaiuo ycaao // Aeeaaiinoeea e oe?o?ae/aneia ea/aiea caaieaaaiee e iia?aaeaeaiee aiaia/aii/iuo aeae/iuo i?ioieia: Iao. ?ani. iao/i.-i?aeo. eiio. - Eeaa, 1996. - N.143. (niaao. Oaiaoueei A.I.). 18.Iniaeeaino? ee?i?ee oa ae?aaiinoeee iaeii/aniiai oneeaaeiaiiiy aano?iaeoiaeaiaeueieo ae?acie ia?oi?aoe??th oa e?iaioa/ath // No/ani? aniaeoe iaa?aeeeaaeii? iaaee/ii? aeiiiiiae: Iao. iaoe.-i?aeo. eiio. - Euea?a, 1997. - N.153-154. (ni?aaao. Oaaei??a N.A., Caiinoue?a E.I., ?e?ca?ia A.A. oa ?io?). 19. Iniaaiiinoe eeeieee e aeeaaiinoeee ia?oi?aoeee ino?ie?iaioi/aueo aano?iaeoiaeaiaeueiuo yca // Actualitati in chirurgia toracoabdominalia. Rezumatele lucrarilor congresuli al VIII - LEA de chirurgi. - Chisinau, 1997. - N.67. (niaao. Oiiei I.Ae.). 20. No/aniee i?aeo?ae aei i?iaeaie ia?oi?aoeaieo aino?ie?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie // Iiaua oaoiieiaee a oe?o?aee: Na. iao/i. o?. - Eeaa, 1997. - N.31. AIIOAOe?ss Iia/ I.A. O??o?a?/ia oaeoeea i?e ae?aceia?e oai?ia?, oneeaaeiai?e iaeiinanii ia?oi?aoe??th oa e?iaioa/ath.- ?oeiien Aeena?oaoe?th i?enay/aii ieoaiith ee?i?/iiai ia?aa?ao, ae?aaiinoeee oa aeai?o o??o?a?/ii? oaeoeee i?e ae?aceia?e oai?ia? (AO), oneeaaeiai?e iaeii/anii ia?oi?aoe??th oa e?iaioa/ath. Aeae?eai? aeaa aa??aioe ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/? i?e AO: iaeii/ania aeieeiaiiy oneeaaeiaiue (27,9%) oa ia?oi?aoe?y o ?aiiueiio, i?ney coieiee e?iaioa/?, ia??iae? (72,1%). Cai?iiiiiaaia eeaneo?eaoe?y ia?oi?aoeaieo aino?ie?iaioi/eaeo aano?iaeoiaeaiaeueieo ae?acie (IAAAeA). Anoaiiaeaii, ui ??ciiiai?oi?noue aa??aio?a ii?aeiaiue ia?oi?aoe?? oa e?iaioa/? iaoiiaeththoue aoeiia?noue ee?i?/iiai ia?aa?ao IAAAeA, ii??aiyii c ia?oi?aoeaieie aano?iaeoiaeaiaeueieie ae?aceaie (IAAeA). Aeae?eaiee neiae?ii "iaeeo" iciae ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/?, aeyaeaiiy yeiai coiiaeth? iaiao?aei?noue canoinoaaiiy aeiaeaoeiaeo iaoiae?a aeine?aeaeaiiy (iaeyaeiai? ?aioaaiia?ao?? /a?aaii? ii?iaeieie, o?a?iacioaaiaano?iaeoiaeaiineii???, iiaaiiaano?ia?ao??, eaia?ioeaioaco) aeey nai?/anii? ae?aaiinoeee aeaii? iaoieia??. Aea/ai? iniaeeaino? ia?aa?ao ia?eoii?oo ia oii? e?iaiao?aoe ??ciiai nooiaith aaaeeino? ? ai?iaaaeaeaia a ee?i?/io i?aeoeeo eiiieaenia i?ia?aia aaaeaiiy oai?eo ?c IAAAeA o ia?aae- oa i?neyiia?aoe?eiiio ia??iae?. ?ic?iaeaia ?aoe?iiaeueia o??o?a?/ia oaeoeea i?e IAAAeA o caeaaeiino? a?ae eieae?caoe?? ae?acee, aa??aioo ee?i?/iiai ia?aa?ao ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/?, nooiai? aaaeeino? e?iaiao?aoe, i?iya?a ia?eoii?oo. Iie?auaiiy ae?aaiinoeee ?acii ?c ai?iaaaeaeaiiyi cania?a ?ioaineaii? oa?ai?? i?e IAAAeA aeicaieeei ciaioeoe e?euee?noue iaee?aoeaieo iia?aoeaieo ao?o/aiue a 1,8 ?ace, cieceoe i?neyiia?aoe?eio eaoaeuei?noue a 3,5 ?ace. Eeth/ia? neiaa: ae?aceiaa oai?iaa, ii?aeiaiiy ia?oi?aoe?? oa e?iaioa/?, ae?aaiinoeea, ee?i?/iee ia?aa?a, o??o?a?/ia oaeoeea. AIIIOAOeEss Iia/ I.A. Oe?o?ae/aneay oaeoeea i?e ycaaiiie aieacie, ineiaeiaiiie iaeiia?aiaiii ia?oi?aoeeae e e?iaioa/aieai. - ?oeiienue. Aeenna?oaoeey iinayuaia aii?inai eeeie/aneiai oa/aiey, aeeaaiinoeee e auai?o ?aoeeiiaeueiie oe?o?ae/aneie oaeoeee i?e ycaaiiie aieacie (ssA), ineiaeiaiiie iaeiia?aiaiii ia?oi?aoeeae e e?iaioa/aieai. Iiaeaa?aioou ananoi?iiiaio enneaaeiaaieth e aiaeeco ?acoeueoaou aeeaaiinoeee e oe?o?ae/aneiai ea/aiey 122 aieueiuo n ia?oi?aoeaiie ino?ie?iaioi/auae aano?iaeoiaeaiaeueiie ycaie (IIAAess), eioi?ua ninoaaeee 1,4 % io iauaai eiee/anoaa n 8822 iaoeeaioia n ino?ie?iaioi/aueie aano?iaeoiaeaiaeueiuie ycaaie (IAAess), ea/eaoeony a Eeaaneii ai?iaeneii Oeaio?a aeaeoaei/ii-eeoa/iuo e?iaioa/aiee ia i?ioyaeaiee 15 eao. Iieo/aiiua ?acoeueoaou n?aaiaiu n aeaiiuie i 474 aieueiuo n ia?oi?aoeaiie aano?iaeoiaeaiaeueiie ycaie (IAAess) (eiio?ieueiay a?oiia ?1) e aeaiiuie enneaaeiaaiee 8700 aieueiuo n IAAess (eiio?ieueiay a?oiia ?2). Ioia/aia oaiaeaioeey e oaaee/aieth eiee/anoaa iaoeeaioia n IIAAess: ia i?ioyaeaiee ia?auo 10 eao a eeeieea ea/eeinue aaeaaiaeii, a n?aaeiai, 6,7 aieueiuo, a a iineaaeiea 5 eao - 11 iaoeeaioia n ni/aoaieai ia?oi?aoeee e e?iaioa/aiey i?e ssA. Onoaiiaeaii, /oi 40,2% aieueiuo iniiaiie a?oiiu auee iiaeeeiai e noa?/aneiai aic?anoa, a 64,8% enneaaeiaaiuo eiaee n?aaeithth e oyaeaeoth noaiaie e?iaioa/aiey. I?e ouaoaeueiii aiaeeca iniaaiiinoae aicieeiiaaiey e eeeie/aneiai oa/aiey IIAAess onoaiiaeaii e auaeaeaii aeaa aa?eaioa ni/aoaiey ia?oi?aoeee e e?iaioa/aiey: 1. Iaeiia?aiaiiia ?acaeoea e?iaioa/aiey e ia?oi?aoeee aano?iaeoiaeaiaeueiuo yca - 34(27,9%) iaoeeaioia; 2. Ia?oi?aoeey ycau a ?aiiai iono?i/aiiii, iinea inoaiiaee e?iaioa/aiey, ia?eiaea - 88(72,1%) aieueiuo. I?e yoii a 48(54,5%) iaoeeaioia ia?oi?aoeey ycau nii?iaiaeaeaaony ?aoeeaeeaii e?iaioa/aiey (?E), a a 40(45,5%) - aac ?E. Ia iniiaaiee eco/aiey iniaaiiinoae eieaeecaoeee, ?acaeoey e eeeie/aneiai oa/aiey IIAAess, iaie i?aaeeiaeaia aeey eeeie/aneiai i?eiaiaiey eeanneoeeaoeey aeaiiie iaoieiaee. ?aciiia?acea aa?eaioia ?acaeoey e ni/aoaiee ia?oi?aoeee e e?iaioa/aiey i?e ssA iaoneaaeeaatho aoeie/iinoue eeeie/aneiai oa/aiey IIAAess, a n?aaiaiee n IAAess. I?iaaaeai niiinoaaeoaeueiue aiaeec iaia?oaeeaaaiuo neiioiiia IIAAess e IAAess. Onoaiiaeaii, /oi /anoioa iniiaiuo i?eciaeia IIAAess i?eaeeaeaeanue e oeie/iie IAAess oieueei i?e ?acaeoee ia?oi?aoeee ycau a ?aiiai iono?i/aiiii ia?eiaea aac ?E. I?e ae?oaeo aa?eaioao ?acaeoey ia?oi?aoeee e e?iaioa/aiey oeie/iua neiioiiu ia?oi?aoeaiie ycau ano?a/aeenue cia/eoaeueii ?aaea (p<0,05). Yoi iaoneiaeaii iiiaaeaieai a a?thoioth iieinoue aeaeoaei/iiai niaea?aeeiiai, iaeo?aeeciaaiiai e?iaueth, eioi?ue ia eiaao au?aaeaiiai ?acae?aaeathuaai yooaeoa ia a?thoeio. E?iia yoiai, i?aiaeaaeaiea eeoe iiaeeeiai e noa?/aneiai aic?anoa ni nieaeaiie ?aaeoeaiinoueth i?aaiecia, oaeaea iaoneaaeeaatho noa?oinoue eeeie/aneie ea?oeiu a auoaoeacaiiuo a?oiiao. Iaie auaeaeai neiae?ii "iaeuo i?eciaeia" i?e ni/aoaieee ia?oi?aoeee e e?iaioa/aiey, e eioi?ui ioiinei: nio?aiaiea eee aicieeiiaaiea ?aciie eioaineaiinoe aiee a aeeaioa, iaee/ea i?e iaeueiaoeee aeaaea iacia/eoaeueiie aieaciaiiinoe e iai?yaeaiey iuooe ia?aeiae a?thoiie noaiee, niiieoaeueiuo i?eciaeia ?acae?aaeaiey a?thoeou, o/auaiea ioeuena e iiauoaiey eiee/anoaa eaeeioeeoia o aieueiuo n ycaaiiuie e?iaioa/aieyie. Auyaeaiea oeacaiiiai neiioiiieiiieaena o?aaoao i?iaaaeaiey aeiiieieoaeueiuo iaoiaeia enneaaeiaaiey (iaci?iie ?aioaaiia?aoee a?thoiie iieinoe, oea?iycioaaiaano?iaeoiaeaiineiiee, iiaaiiaano?ia?aoee, eaia?ioeaioaca) e iiauoaiiie ianoi?iaeaiinoe oe?o?aa e aiciiaeiiio aicieeiiaaieth iaeiia?aiaiii iaaeo ineiaeiaiee ssA. Aiaae?aiea a eeeie/aneoth i?aeoeeo aeeaaiinoe/aneiai aeai?eoia i?e iaee/ee neiae?iia "iaeuo i?eciaeia" IIAAess iicaieeei oaaee/eoue ?aiithth, a ia?aua 6 /ania, aeeaaiinoeeo aeaiiie iaoieiaee a 2,9 ?ac: n 34,5% (1-ue ia?eiae - 1982-1993 aa.) aei 100% (2-ie ia?eiae - 1994-1996 aa.) e ?anoe?eei aiciiaeiinoe aeey auiieiaiey ?aaeeeaeueiuo iia?aoeaiuo aiaoaoaeuenoa. ?ac?aaioaia iaeaieaa ?aoeeiiaeueiay oe?o?ae/aneay oaeoeea i?e IIAAess a caaeneiinoe io eieaeecaoeee ycau, noaiaie oyaeanoe e?iaioa/aiey, aa?eaioa ?acaeoey ia?oi?aoeee e e?iaioa/aiey, noaiaie ?ani?ino?aiaiiinoe ia?eoiieoa, iaee/ey niioonoaothuae iaoieiaee. Eco/aiu iniaaiiinoe i?ioaeaiey ia?eoiieoa ia oiia e?iaiiioa?e ?acee/iie noaiaie oyaeanoe. Aiaae?ai a eeeie/aneoth i?aeoeeo aeai?eoi i?iaaaeaiey ia? eioaineaiie oa?aiee a iineaiia?aoeeiiiii (i/i) ia?eiaea, aeeth/athuee aaeaeaaoiia ainiieiaiea e?iaiiioa?e e nia?aiaiiua iaoiaeu ai?ueau n ia?eoiieoii. Oeo/oaiea ?aiiae aeeaaiinoeee IIAAess iicaieeei a 1,8 ?aca oiaiueoeoue eiee/anoai iaeeeaoeaiuo iia?aoeee ca n/ao oaaee/aiey n 61,9% (1-ue ia?eiae) aei 78,6% (2-ie ia?eiae) /enea ?aaeeeaeueiuo iia?aoeaiuo aiaoaoaeuenoa. A oeaeii, oeo/oaiea aeeaaiinoeee, oiaiueoaiea eiee/anoaa iaeeeaoeaiuo aiaoaoaeuenoa, ?ac?aaioea e aiaae?aiea ia? eioaineaiie oa?aiee a i/i ia?eiaea iicaieeee ia i?ioyaeaiee 2-ai ia?eiaea eeeie/aneeo iaaethaeaiee nieceoue i/i eaoaeueiinoue: iauoth - n 25 aei 7,1% (a 3,5 ?ac), i?e iaeeeaoeaiuo aiaoaoaeuenoaao - n 53,1 aei 16,7% (a 3,2 ?aca), i?e ?aaeeeaeueiuo iia?aoeeyo - n 7,6 aei 4,5% (a 1,7 ?aca), a oii /enea i?e ?acaeoeeyo aeaeoaeea - n 25 aei 12,5% (a 2 ?aca). Eeth/aaua neiaa: ycaaiiay aieaciue, ni/aoaiea ia?oi?aoeee e e?iaioa/aiey, aeeaaiinoeea, eeeie/aneia oa/aiea, oe?o?ae/aneay oaeoeea. SUMMARY Povch O.A. Surgical tactics in case of peptic ulcer simultaneously complicated by perforation and bleeding.- Manuscript. The thesis is dedicated to the problem of clinical course, diagnosis and choice of surgical tactics in case of peptic ulcer (PU) complicated simultaneously by perforation and bleeding. Two variants of combination of perforation and bleeding in PU are considered: simultaneous arising of complications (27,9%) and perforation in the early, after arrest of bleeding, period (72,1%). There is proposed a classification of perforated acute-hemorrhagic gastroduodenal ulcers (PAHGDU). It has been determined that the diversity of variants of the combination of perforation and bleeding causes an atypical nature of clinical course of PAHGDU as compared with perforated gastroduodenal ulcers (PGDU). There is considered the syndrome of ‘’minor’’ symptoms of the combination of perforation and bleeding revealing of which calls forth application of additional methods of examination (abdominal cavity roentgenography, fibroesophagogastroduodenoscopy, pneumogastrography, laparocentesis) for a timely diagnosis of this pathology. There have been studied the peculiarities of the course of peritonitis with hemorrhage of different degree of gravity. A complex program of follow-up of patients with PAHGDU before and after operation is introduced in clinical practice. There is elaborated a rational surgical tactics in PAHGDU cases depending on ulcer localization, the variant of clinical course of the combination of perforation and bleeding, hemorrhage gravity degree, peritonitis symptoms. Improvement of diagnosis together with introduction of the means of intensive therapy in PAHGDU cases allowed to decrease the number of palliative surgical interventions by 1,8 and to lower a post-operative lethality by 3,5. Key-words: peptic ulcer, combination of perforation and bleeding, diagnosis, clinical course, surgical tactics.

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