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Клінічне значення етапної діагностики природжених вад розвитку у дітей в оцінці ефективності заходів щодо їх попередження: Автореф. дис… канд. мед.

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?INOEOOO IAAe?AO??? , AEOOA?NOAA OA A?IAEIEIA?? AEAAeAI??

IAAeE*IEO IAOE OE?A?IE

TH?*AIEI ??EIA A?EOI??AIA

OAeE : 616-007-053.1-053.31 :
618.33-084

Ee?i?/ia cia/aiiy aoaiii? ae?aaiinoeee i?e?iaeaeaieo aaae ?icaeoeo o
ae?oae a ioe?ioe? aoaeoeaiino? caoiae?a uiaei ?o iiia?aaeaeaiiy

14.01.10 – iaae?ao??y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoaoa iaaee/ieo iaoe

EE?A – 1999

Aeena?oaoe?y ? ?oeiiecii

?iaioa aeeiiaia a Iaeanueeiio aea?aeaaiiio iaaee/iiio
oi?aa?neoao? IIC Oe?a?ie

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, i?ioani?

I?ieia ?ai? Iao?iae/, iaoeiaee ea??aiee Aeeoy/iai
e?eoaaeueii-ae?aaiinoe/iiai Oeaio?a ?i. aeaae. A.ss. ?aci?ea, i. Iaeana

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

Aeaoeaae/ Aaeaioeia ?aaeieei?aia, caa?aeoth/a aeooa?nueeei a?aeae?eaiiyi
aeno?aaai?oaeueii? iaoieia?? ?inoeoooo iaae?ao???, aeooa?noaa oa
a?iaeieia?? AII Oe?a?ie

– aeieoi? iaaee/ieo iaoe, i?ioani?

Ooiueei ?eecaaaoa ?aaai?aia, caa?aeoth/a eaoaae?ith iaiiaoieia??
Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea
IIC Oe?a?ie

I?ia?aeia onoaiiaa: Iaoe?iiaeueiee aea?aeaaiee iaaee/iee oi?aa?neoao
?i.I.I.Aiaiiieueoey IIC Oe?a?ie, i.Ee?a, eaoaae?a iaae?ao??? ? 2

Caoeno a?aeaoaeaoueny ” 25 ” n?/iy 2000 ?ieo i 1300 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.553.01 ii caoenoo
aeena?oaoe?e ia caeiaoooy iaoeiaiai nooiaiy aeieoi?a iaoe ca
niaoe?aeueiinoyie “Iaae?ao??y”, “Aeooa?noai ? a?iaeieia?y” i?e ?inoeooo?
iaae?ao???, aeooa?noaa oa a?iaeieia?? AII Oe?a?ie (04050, i.Ee?a,
aoe.Iaio?euenueeiai, 8 ).

C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? ?inoeoooo
iaae?ao???, aeooa?noaa ? a?iaeieia?? AII Oe?a?ie (04050, i.Ee?a,
aoe.Iaio?euenueeiai, 8 ).

Aaoi?aoa?ao ?ic?neaiee “01”eenoiiaaea 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee
E.A.Eaaoi?ia

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. A inoaii? ?iee a?aei?/aii ca?eueoaiiy
ieoiii? aaae i?e?iaeaeaii? iaoieia?? a no?oeoo?? aeeoy/i?
caoai?thaaiino?, ?iaae?aeiino? oa aeeoy/i? nia?oiino?, ye? ? iaeiei c
iniiaieo iieaciee?a noaio caei?ia’y ianaeaiiy (I.I.Eoe’yiiaa, 1996;
A.ss.?aci?e,1996; I.C.Aiaoaeei oa ni?aaao., 1997).

I?e?iaeaeai? aiiiae?? ?icaeoeo iin?aeathoue 2-3 i?noea a
no?oeoo?? ia?eiaoaeueii? oa 2 i?noea a no?oeoo?? aeeoy/i? nia?oiino?
(?.A.Aiaaoe?ueiaa,1996; I.A.Aieaea, 1997). A?aei?/aii iioe?aiiy oe???
iaoieia?? na?aae aini?oaeueiciaaieo ae?oae, a oaeiae na?aae iiia?eeo
(?.I.I?ieia, 1995). Aaaeeeao ?ieue i?e?iaeaeai? aaaee a?athoue o
“o?ii?caoe??” iaoieia?/ieo i?ioean?a (I.I.Eoe’yiiaa oa ni?aaao.,1991)

A?ey 80% iaeaaeeoue i?e?iaeaeai?e iaoieia?? na?aae o??o?a?/ieo
caoai?thaaiue iiaiia?iaeaeaieo (O.E.Iai?eiaa oa ni?aaao. 1995 ).

Naia oiio, aaeeea cia/aiiy iathoue iaoeia? aeine?aeaeaiiy, ye?
ni?yiiaai? ia i?io?eaeoeeo ia?eiaoaeueii? caoai?thaaiino? oa nia?oiino?,
?ic?iaeo caoiae?a, uiaei ia?iaeaeaiiy caei?iai? aeeoeie
(A.I.Iiiiia?aiei,1994 ; TH.?.Aaeueo?u?a, 1995 ).

I?io?eaeoeea i?e?iaeaeaieo aaae ?icaeoeo iiaea aooe ia?aeiiith ?
aoi?eiiith ? i?iaiaeeoueny ia 3-o ??aiyo iioiaaiaco: i?iaia??iiaeueiiio,
aia??iiaeueiiio, i?aiaoaeueiiio ( A.A.Aieoaoeia oa ni?aaao.,1990 ;
I.A.?iiaae?ia, 1994 ).

Na?aae caoiae?a aoi?eiii? i?io?eaeoeee aaae ?icaeoeo aaeeea
cia/aiiy ia? i?aiaoaeueia ae?aaiinoeea. Iaeoi?aa?naeuei?oei oa aacia/iei
iaoiaeii c on?o iaoiae?a i?aiaoaeueii? ae?aaiinoeee, yeee ciaeoia
iaea?eueoa iioe?aiiy ? oeueo?acaoeiaa aeine?aeaeaiiy ieiaea. Aeai?
aaaaoueio oao?aoe?a
(I.ss.A?a/ai?ia,1992-1995;?.TH.Ai?ae??iei,1992-1994;I.I.Aa?iiioaaeyi,199
2-1994; R.Romero,1994) na?ae/aoue i?i iiaeeea?noue aeyaeaiiy
i?e?iaeaeaieo aaae ?icaeoeo a ae?oaiio o?eiano?? aaa?oiino? , a a
aeayeeo aeiaaeeao c 10-11 oeaei?a aaa?oiino?.

O ?yae? aeiaaee?a iio??aii aeeiai?/ia oeueo?acaoeiaa ne?aeeoaaiiy ,
niinoa?aaeaiiy ca noaiii i?aai?a ieiaea oa aeiiiaiaiiy aei?iaeiai?
ae?aaiinoeee aaae ?icaeoeo ?ioeie iaoiaeaie aeine?aeaeaiiy. Aei?iaeiaa
ae?aaiinoeea aea? iiaeeea?noue cae?enithaaoe i?aiaoaeueio
aeeniaina?ecaoe?th oai?eo (?.I.Aaaaaeaeaiyi, 1997) . Ia i?aenoaa?
iaea?aeaieo aoia?ao?/ieo aeaieo ae??oo?oueny oaeoeea aaaeaiiy aaa?oiino?
? iieia?a , aecia/athoueny ieoaiiy ei?aeoe?? oa e?eoaaiiy aeyaeaieo
aaae.

A e?oa?aoo?? ? aaeeea e?euee?noue ioae?eaoe?e uiaei i?aiaoaeueiiai
aeyaeaiiy i?e?iaeaeaieo aaae o ieiaea, a oaeiae ?iciianthaeaeaiino?
i?e?iaeaeaii? iaoieia?? o ae?oae, yea aea/aia i?e i?iaaaeaii?
iii?oi?eiaa aaae ?icaeoeo. Aea ?nioth/? iaoa??aee i?i ni?anoaaeaiiy
aoia?ao?/ieo ? ee?i?ei-ii?oieia?/ieo aeaieo aeine?aeaeaiue noinothoueny
ie?aieo i?aai?a oa nenoai ieiaea. Iaaaaaoi/enaeuei? ioae?eaoe?? i?i
iine?aeiai?noue oa aca?iica’ycie ae?e i?ae aeooa?aie, iaiiaoieiaaie,
iaae?ao?aie, o??o?aaie oa ?ioeie oao?aoeyie a ae?aaiinoeoe?
??ciiiai?oieo oi?i aaae ?icaeoeo, ?o iinoiaoaeueii? ei?aeoe?? ? oa?ai??.

Naia oiio aei?aaaeaii aea/aiiy ee?i?/iiai cia/aiiy aoaiii?
aeiiieiaiai? ? i?neyiieiaiai? ae?aaiinoeee aaae ?icaeoeo oa ioe?iee
aoaeoeaiino? i?io?eaeoe/ieo caoiae?a.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie.
Aeena?oaoe?eia ?iaioa aeeiiaia a iaaeao iaoeiai-aeine?aeii? i?aoe?
“A?iaeaeaiiua ii?iee ?acaeoey e ianeaaenoaaiiua aieacie o aeaoae:
iiieoi?eia, eiiiuethoa?iue e aaiaoe/aneee aiaeec, i?aiaoaeueiay
aeeaaiinoeea , eiiieaen i?ioeeaeoe/aneeo ia?ii?eyoee” (iiia?
aea?ae?a?no?aoe?? ? 0194 U 019984 ).

Iaoa ?iaioe. I?aeaeueoe aoaeoeai?noue ae?aaiinoeee i?e?iaeaeaieo
aaae ?icaeoeo o ae?oae, aeeniaina?ieo ? i?io?eaeoe/ieo caoiae?a oeyoii
iaa?oioiaoaaiiy i?eioeeio aoaiiino? oa aecia/aiiy ?ie? e?ea?y-iaae?ao?a
ia eiaeiiio ?c aeae?eaieo aoai?a.

Caaea/? aeine?aeaeaiiy.

1. Aecia/eoe iniiai? aoaie ae?aaiinoeee i?e?iaeaeaieo aaae ?icaeoeo
o ae?oae, aeeth/ath/e aioaiaoaeueiee ia??iae.

2. Aea/eoe ia eiaeiiio aoai? /anoioo oa no?oeoo?o i?e?iaeaeaieo aaae
o ae?oae ia i?aenoaa? ee?i?ei-ai?aeai?ieia?/ieo aeine?aeaeaiue.

3. Ii??aiyoe oa i?iaiae?coaaoe /anoioo ? no?oeoo?o i?e?iaeaeaieo
aaae ?icaeoeo ?c aaciaeie aeaieie ?aa?iiaeueiiai iii?oi?eiao.

4. Aea/eoe ao?ieia?/io no?oeoo?o i?e?iaeaeaieo aaae ?icaeoeo oa
nooi?iue cia/aiiy ie?aieo /eiiee?a uiaei ?o oi?ioaaiiy aeey iae?eo a
eiiieaen? i?io?eaeoe/ieo caoiae?a.

5. Ia i?aenoaa? iaea?aeaieo iaoa??ae?a ?ic?iaeoe i?aeoe/i?
?aeiiaiaeaoe?? uiaei aoaiii? ae?aaiinoeee, aeeniaina?ecaoe?? oa
i?io?eaeoeee i?e?iaeaeaieo aaae ?icaeoeo o ae?oae, a oaeiae ioe?iee
aoaeoeaiino? caoiae?a, ye? i?iaiaeyoueny.

Iaoeiaa iiaecia. Aia?oa iaa?oioiaaii ee?i?/io ?ieue ? caaaeaiiy
e?ea?y-iaae?ao?a a aoaii?e ae?aaiinoeoe? i?e?iaeaeaieo aaae ?icaeoeo (
IA? ) o ae?oae. Iieacaii iaiao?aei?noue nenoaiiiai iaaee/iiai
niinoa?aaeaiiy ca ae?oueie c IA?, ii/eiath/e c aioaiaoaeueiiai ia??iaeo.
I?iaaaeaii aacaea??eiaa aea/aiiy aeiaaee?a ia?iaeaeaiiy ae?oae, ye? iaee
aaaee ?icaeoeo. Ia i?aenoaa? aaeeeiai ee?i?ei-ai?aeai?ieia?/iiai
iaoa??aeo ni?anoaaeai? iieacieee /anoioe aaae ?icaeoeo oa ?o no?oeoo?e
ia aeiiieiaiaiio aoai? ? o iiaiia?iaeaeaieo ae?oae. I?iaaaeaii
ii??aiyiiy aaciaeo aeaieo iii?oi?eiaa IA? ?c iaoa??aeaie iioi/iiai
aea/aiiy. ?ic?iaeaii nenoaio aoaiiiai iaaee/iiai niinoa?aaeaiiy ca
oai?eie ae?oueie c IA? oa niin?a ioe?iee aoaeoeaiino? aioaiaoaeueiiai
aeyaeaiiy aaae ?icaeoeo, aeeth/ath/e aaaee ?icaeoeo oeaio?aeueii?
ia?aiai? nenoaie. Aea/ai? ? e?euee?nii ioe?iai? /eiieee ?eceeo noiniaii
oi?ioaaiiy aaae ?icaeoeo aeey i?iaaaeaiiy naeaeoeaiiai oeueo?acaoeiaiai
(OC) ne?ei?iao.

I?aeoe/ia cia/aiiy ?iaioe iieyaa? a i?aeaeuaii? aoaeoeaiino?
eiiieaenieo caoiae?a uiaei iiia?aaeaeaiiy ia?iaeaeaiiy ae?oae c aaaeaie
?icaeoeo oeyoii ai?iaaaeaeaiiy nenoaie aoaiii? aeiiieiaiai? oa
i?neyiieiaiai? ae?aaiinoeee aaae ?icaeoeo ?c canoinoaaiiyi OC
ae?aaiinoeee. Aoai anoaiiaeaiiy i?aiaoaeueiiai ae?aaiico aeicaiey?
nai?/anii i?iaanoe ee?i?/ia, eaai?aoi?ii-?ino?oiaioaeueia aeine?aeaeaiiy
iiaiia?iaeaeaieo ae?oae, ii/aoe ei?aeoe?th IA? ia aeiee?i?/iiio aoai?.

Aeei?enoiaoaaiiy e?eoa???a ioe?iee aoaeoeaiino? i?aiaoaeueii?
ae?aaiinoeee IA? a oe?eiio, ?, cie?aia aiiiae?e aieiaiiai iiceo,
aeicaiey? cia/ii ni?inoeoe nenoaio iae?eo oa aiae?co
caaaeueiiiiioeyoe?eieo /anoio aaae o ?aa?ii?, yeee aea/a?oueny.

?acoeueoaoe OC aeine?aeaeaiiy ae?iie, aeei?enoiaoth/e ?aeath
“cai?ioiueiai” ca’yceo, aeicaieythoue iae?/oaaoe a nenoai? iii?oi?eiao
IA? o? i?e?iaeaeai? aaaee, ye? aeyaeai? a i?ioean? i?aiaoaeueii?
ae?aaiinoeee oa ioe?ieoe ?? aoaeoeai?noue ia iniia? aa?eo?eaoe??
ae?aaiico ca aeaieie ee?i?ei-?ino?oiaioaeueieo ianoaaeaiue
iiaiia?iaeaeaieo /e aooiin?e (yeui aaa?oi?noue ae?i?iiaaii). Iniaeeaino?
no?oeoo?e i?e?iaeaeaieo aiiiae?e o ieiaea iaa?oioiaothoue i?aeaeuaiiy
oaaae aei aeyaeaiiy aaae iii?ii-?ooiaiai aia?aoo, ? oaeiae
na?oeaai-noaeeiii? nenoaie ?c canoinoaaiiyi iaoiaeo eieuei?iai?
aeiiea?aoiea?ae?ia?ao??. Aeeniaina?ia niinoa?aaeaiiy ca ieiaeaie c
aeyaeaiith o?iaai?oaeueiith iaoieia??th aeicaiey? ii/eiaoe ianoaaeaiiy
ua a ?aiiueiio iaiiaoaeueiiio ia??iae?, ui aea? iiaeeea?noue ooi/ieoe
ae?aaiic oa i?iaanoe ?aiith o?ieia?/io ei?aeoe?th ia aeiee?i?/iiio
aoai?. Aeei?enoiaoaaiiy ioe?iee cia/aiiy oaeoi??a ?eceeo aeicaiey?
oi?ioaaoe a ?aii? no?iee aaa?oiino? eiioeiaaio ae?iie, ye? iaeaaeaoue
oe?eani?yiiaaiiio ianoaaeaiith ? niinoa?aaeaiith aeey aeyaeaiiy aaae
?icaeoeo a ?aa?iiao, aea ia i?iaiaeeoueny OC ne?ei?ia (n?euenueea
i?noeaa?noue ).

Ai?iaaaeaeaiiy io?eiaieo ?acoeueoao?a.

Iniiai? i?aeoe/i? iieiaeaiiy aeena?oaoe?eii? ?iaioe, ye?
noinothoueny ae?aaiinoeee, aeeniaina?iiai niinoa?aaeaiiy,
?aaa?e?oaoe?eieo caoiae?a, aeaiaeiaoaaiiy oa i?io?eaeoeee aaae ?icaeoeo
a?aeia?aaeai? o 6-oe ?ioi?iaoe?eieo eenoao Iaeanueeiai oeaio?a
iaoeiai-oaoi?/ii? oa aeiiii?/ii? ?ioi?iaoe??: “Eiiieaen iaaeeoeeineeo
i?ioeeaeoe/aneeo ia?ii?eyoee ii i?aaeoi?aaeaeaieth a?iaeaeaiiuo ii?ieia
?acaeoey o aeaoae” (Iaeanna, 1997), “Iaoiaeeea iioi/ii? ?a?no?aoe??
o?iaeaeaieo aaae o ae?oae a nenoai? aaiaoe/iiai iii?oi?eiao” (Iaeana,
1997), “Niaaeei?ii?noue aoaiiiai iaaee/iiai niinoa?aaeaiiy ca ae?oueie c
i?e?iaeaeaieie aaaeaie ?icaeoeo oa niaaeeiaeie oai?iaaie” (Iaeana,
1997), “I?eioeeiu anoanoaaiiiai anea?ieeaaiey aeaoae ia?aiai aiaea
aeecie” (Iaeanna, 1998), “Nia?aiaiiua ?aeiiaiaeaoeee ii anoanoaaiiiio
anea?ieeaaieth aeaoae ia?aiai aiaea aeecie” (Iaeanna, 1998), “Ianniaue
oeueo?acaoeiaie ne?eieia – iaeia ec nia?aiaiiuo oi?i aeeniaina?ecaoeee
aeaoneiai ianaeaiey” (Iaeanna, 1998).

?acoeueoaoe aeena?oaoe?eiiai aeine?aeaeaiiy ai?iaaaeaeai? a ?iaioo
Iaeanueei? aeeoy/i? iaeanii? ee?i?/ii? e?ea?i?, i?aeiaeaniiai
iaaeeei-aaiaoe/iiai oeaio?o i. Iaeane, i?nueeiai Aeeoy/iai
e?eoaaeueii-ae?aaiinoe/iiai Oeaio?o ?i. aeaae ?aci?ea, aeeoy/i?
iie?ee?i?ee ? 6 i. Iaeane. Iniiai? iieiaeaiiy ?iaioe ai?iaaaeaeai? a
iaaeaaia?/iee i?ioean eaoaae?e oieoaeueii? iaae?ao??? Iaeanueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo.

Iniaenoee aianie caeiaoaa/a. Aeena?oaoe?eia ?iaioa aeeiiaia a
ia??iae iaa/aiiy aaoi?ee a i/i?e ani??aioo??. C?iaeea
iaoaioii-?ioi?iaoe?eiee iiooe, aiae?c iaoeiai? e?oa?aoo?e c
aeine?aeaeoaaii? i?iaeaie. Iniaenoi i?iaiae?coaaea iia?aeiieaiiy i?i
ia?iaeaeaiiy aeeoeie c i?e?iaeaeaiith aaaeith ?icaeoeo oa o?iiiniiiith
iaoieia??th. A a?o?a? aeeoy/i? iaeanii? ia’?aeiaii? i?icaeoo?e
cae?enithaaea ca?? oa aiae?c iaoa??ae?a aooiin?e. Iniaenoi aea/eea
cae?i/aiiy aaa?oiinoae ae?iie, o yeeo i?ae /an aoia?ao?/iiai
ianoaaeaiiy aoa aeyaeaiee ie?ae c aaaeith ?icaeoeo.

?ic?iaeea noaio aeeniaina?iiai niinoa?aaeaiiy ca ae?oueie c
i?e?iaeaeaieie aaaeaie. I?iaiaeeea i?aea?? oaiaoe/ieo oai?eo,
caaacia/oaaea ?o anaa?/ia ianoaaeaiiy. Aeeiiaea ee?i?/i?, aiaiianoe/i?,
aaiaaeia?/i?, niiaoiaaiaoe/i? aeine?aeaeaiiy c neiae?iiieia?/iei
aiae?cii i?iaaiae?a oa ?o n?iae. Naiino?eii i?iaiaeeea noaoenoe/io
ia?iaeo iaea?aeaieo aeaieo.

Ai?iaaoe?y ?acoeueoao?a aeine?aeaeaiue. Iniiai? iieiaeaiiy
aeena?oaoe?? aeeeaaeai? oa iaaiai?ai? ia I?aeia?iaei?e
iaoeiai-i?aeoe/i?e eiioa?aioe?? “Aiaea e caei?iauea” (Iaeana, 1998,
1999), ia 1 Eiia?an? oao?aoe?a ii oeueo?acaoeiaue ae?aaiinoeoe? “Ie?ae-
ye iaoe??io” (Oa?e?a, 1997),ia ia?oiio Oe?a?inueeiio Eiia?an? oao?aoe?a
c oeueo?acaoeiai? ae?aaiinoeee (Ee?a,1999), ia 6 Iaoeia?e eiioa?aioe??
Anioe?aoe?? na?oeaai-noaeeiieo o??o?a?a Oe?a?ie ca o/anoth Anioe?aoe??
iaae?ao??a Oe?a?ie “Aeooaeuei? ieoaiiy aeiiiiiae ae?oyi ?aiiueiai a?eo c
a?iaeaeaiith na?oeaai-noaeeiiith iaoieia??th” (Ee?a, 1998), ia
Iaoeiai-i?aeoe/i?e eiioa?aioe?? “Iaaeeei-nioe?aeuei? aniaeoe noaio
caei?ia’y ae?oae ? i?aee?oe?a” (Oa?e?a, 1998), ia caeeth/ieo
eiioa?aioe?yo Iaeanueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (naeoe?y
iieiaeeo a/aieo) (Iaeana, 1996-1997), ia can?aeaiiyo Iaeanueeiai
iaeaniiai iaoeiaiai oiaa?enoaa aeeoy/eo e?ea??a (Iaeana, 1997), ia
naeoe?? aeeoy/eo ea?ae?i?aaiaoieia?a (Iaeana, 1998), ia ee?i?/ieo
eiioa?aioe?yo eaoaae?e iaae?ao??? Iaeanueeiai aea?aeaaiiai iaaee/iiai
oi?aa?neoaoo (Iaeana, 1996-1998).

Ioae?eaoe??. Ca oaiith aeena?oaoe?? iioae?eiaaii 13 ?ia?o, c ieo : 5
– noaoae, 3 – o ca??ieeo iaoeiaeo i?aoeue, 4 – a oacao eiioa?aioe?e ?
nai?ia??a, 1 – o iin?aieeo aeey e?ea??a.

No?oeoo?a oa ianya aeena?oaoe??. ?iaioa neeaaea?oueny ?c anooio,
iaeyaeo e?oa?aoo?e, iieno iaoiae?a aeine?aeaeaiue, 4-o ?icae?e?a aeanieo
aeine?aeaeaiue, iaaiai?aiiy ?acoeueoao?a, aeniiae?a, i?aeoe/ieo
?aeiiaiaeaoe?e, nieneo aeei?enoaieo aeaea?ae, aeiaeaoe?a. ?iaioa
aeeiiaia ia 178 noi??ieao ae?oeiaaiiai oaenoo, ?ethno?iaaia 40
oaaeeoeyie, 7 ?enoieaie, 9 oioiea?oeaie, 3 aeiaeaoeaie. Oaenoiao /anoeio
aeeeaaeaii ia 132 noi??ieao. Nienie aeei?enoaieo aeaea?ae i?noeoue 237
aeaea?ae, ye? caeiathoue 30 noi??iie.

CI?NO ?IAIOE

Iaoa??aee ? iaoiaee aeine?aeaeaiiy. ?iaioa aoea i?iaaaeaia o o?ueio
iniiaieo iai?yieao:

1)Ee?i?/ii-ai?aeai?ieia?/i? aeine?aeaeaiiy uiaei aea/aiiy
?iciianthaeaeaiino? ? no?oeoo?e IA? o ae?oae, iaoeaioe?a
i?iieneiai?icaeiaiiai oeaio?o ? n?euenueei? i?noeaaino?, i?iaiaeeeenue
iaie iaoiaeii iaia’yceiai? iioi/ii? ?a?no?aoe?? aeyaeaieo aaae o
iiaiia?iaeaeaieo a iieiaiaeo aoaeeieao i. Iaeane, a?aooaaiiyi aaae a
aeeoy/?e ia’?aeiai?e i?icaeoo??, oa a 14-oe ?aeiiao Iaeanueei? iaeano?.
Cia/aiiy iieaciee?a ie?aieo aaae ?icaeoeo aoee iaea?aeai? i?e aiae?c?
iia?aeiieaiue o i?aeiaeaniiio iaaeeei-aaiaoe/iiio oeaio?? (ca 1993-1995
?.?.) ia iaoa??ae? 53568 ia?iaeaeaiue. Io?eiai? aeai? c?noaaeai? c
iaoa??aeaie aeine?aeaeaiue ieioeeo ?ie?a (1979-1991?.?.). Caaaeueia
/enaeuei?noue ae?oae, ye? aoee ioiieai? iii?oi?eiaii IA?, neeaea 150825
ae?oae. E??i caaaeueii? /anoioe, ?? aeeiai?ee ? aeeiai?ee an?o oi?i IA?,
aiae?coaaeeny “iiaeaeuei?” oi?ie, a naia: aiaioeaoae?y (AA),
nieiiiiceiaa eeea (NIE), ?icu?eeia aoae ? /aai i?aeiaa?iiy (?AI),
ao?ac?y no?aaioiaea ?/aai o?aoaino?aaioiaeiee naeu (AN ?/aai ON),
a?aenooi?noue e?ioe?aee aai ?? /anoeie (?A), iie?aeaeo?e?y (IAe),
a?iiniaae?y (A?I), ao?ac?y aiona ?/aai i?yii? eeoee (AA), oai?iaa
Aeaoia, iiiaeeii? IA? (IIA?).

Aiae?c naeoe?eieo iaoa??ae?a noinoaaany 1042 aooiin?e ca ia??iae
1993-1994 ?.?. a c?noaaeaii? ?c iaoa??aeaie ieioeeo ?ie?a (1974-1990
?.?.). Anueiai aoei i?iaiae?ciaaii 9060 aooiin?e.

2)Aeey aea/aiiy aoaeoeaiino? aoia?ao?/iiai aeine?aeaeaiiy oa
c’ynoaaiiy ee?i?/iiai cia/aiiy aoaiiino? aeiiieiaiai? ? i?neyiieiaiai?
ae?aaiinoeee oa i?aiaoaeueii? aeeniaina?ecaoe?? ae?oae c aaaeaie
?icaeoeo, aoei i?iaaaeaii ianoaaeaiiy 5720 aaa?oieo ae?iie a oa?i?i?
aaa?oiino? aei 22-24 oeaei?a ii i?ia?ai? ianiaiai OC ne?ei?iaa. A?e
ae?iie a?ae 17 aei 46 ?ie?a. OC aeine?aeaeaiiy i?iaiaeeeiny a
i?aeiaeaniiio iaaeeei-aaiaoe/iiio oeaio?? ca aeiiiiiaith aia?aoo ” ALOKA
– SSD 630″, ui i?aoethaaa o ?aaeueiiio ianooaa? /ano c aeei?enoaiiyi
o?ainaaaeii?iaeueiiai e?i?eiiai, naeoi?iiai, eiiaaeniiai aeao/ee?a
(/anoioa 3,5 ? 5 Iaoe). A iane?aeie i?iaaaeaieo ianoaaeaiue aoea
aeae?eaia a?oia aaa?oieo ae?iie (66 ae?iee) c iaoieia??th ieiaea, yea
iaaeae? aoea i?ae iaoei niinoa?aaeaiiyi c iaoith i?inoaaeaiiy
aaa?oiinoae, ca?aeii c ?ic?iaeaiith iaie noaiith aeeniaina?iiai
niinoa?aaeaiiy ca ieiaeii c IA?. Aeyaeaia iaoieia?y aa??o?eoaaeany c
o?aooaaiiyi aeaieo iaoa??ae?a iieiaiaeo aoaeeie?a ? aeeoy/eo iie?ee?i?e,
a oaeiae ?acoeueoao?a aooiin?e ia’?aeiaii? aeeoy/i? i?icaeoo?e.
Aoaeoeai?noue aeyaeaiiy i?e?iaeaeaii? iaoieia?? ia ??cieo aoaiao
ae?aaiinoeee aea/aeany i?e aiae?c? /anoioe ? no?oeoo?e IA? a 1662
aeiaaeeao aini?oae?caoe?? ae?oae a iaiiaoaeueiiio ia??iae? ? a 3363
aeiaaeeao aini?oae?caoe?? ae?oae a?eii a?ae 1 aei 12 i?nyoe?a.
I?aiaoaeueio aeeniaina?io a?oio neeaee 32 aeeoeie c IA?.

3)A oiiaao ??ciiiai?oieo a?aeae?eaiue iaeanii? ee?i?/ii? aeeoy/i?
e?ea?i? ? iaaeeei-aaiaoe/iiai oeaio?o aoei i?iaaaeaii iiaeeaeaia
ianoaaeaiiy ae?oae c ??ciiiai?oieie oi?iaie IA?. Anueiai aoei
i?iaiae?ciaaii iaoa??aee ianoaaeaiiy 928 ae?oae. Iicieia?/iee ae?aaiic
IA? noaaeany ia i?aenoaa? ?aoaeueiiai aiae?co noeoiiino?
ee?i?ei-aaiaaeia?/ieo, aiaiianoe/ieo, oeeoiaaiaoe/ieo,
?ino?oiaioaeueii-aeaeo?io?c?ieia?/ieo, oeueo?acaoeiaeo, aiaeineii?/ieo,
?aae?i-ioee?aeieo, ?aioaaiieia?/ieo iaoiae?a.

C iaoith aeeoa?aioe?aeueii? ae?aaiinoeee i?ae aiceiiiao?yie, ui
oaiioei?/ii iaaaaeothoue ?yae neiae?ii?a iiiaeeiieo aaae ?icaeoeo, a
oaeiae aeey ooi/iaiiy ae?aaiico aeayeeo niaaeeiaeo caoai?thaaiue, aoee
aeei?enoai? ?acoeueoaoe ?ioiieia?/iiai, ? a?io?i?/iiai oa
iieaeoey?ii-aaiaoe/iiai caniao aeine?aeaeaiiy iaoiaeii iie?ia?acii?
eaioethaiai? ?aaeoe??. Aiae?c an??? ee?i?/ii? neiioiiaoeee o ae?oae aoa
i?iaaaeai ca aeiiiiiaith ae?aaiinoe/iiai aeai?eoio ( A.ss.?aci?e ?
ni?aaao.,1994 ).

C iaoith aea/aiiy ?ie? /eiiee?a ?eceeo c oi?ioaaiiy IA? o ae?oae
aoei i?iaaaeaii ee?i?ei-aiaiianoe/ia aeine?aeaeaiiy 928 aacaea??eiaeo
aeiaaee?a ia?iaeaeaiiy ae?oae c IA? (1 iniiaia a?oia) ? 760 aeiaaee?a
ia?iaeaeaiiy ae?oae aac IA? (2 eiio?ieueia a?oia).

A??ia?aei?noue a?aei?i aecia/aee ca e?eoa???i No’thaeaioa, iaoiaeii o2.

?acoeueoaoe aeine?aeaeaiue oa ?o iaaiai?aiiy. Ee?i?ei-ai?aeai?ieia?/ia
aeine?aeaeaiiy IA? o ae?oae a iaiiaoaeueiiio ia??iae? iieacaei, ui
caaaeueii?aa?iiaeueiee iieaciee /anoioe aaae ?icaeoeo neeaa 21,38 ( aai
1 aeiaaeie ia 46,8 ia?iaeaeaiue. I?e oeueiio /anoioa iiiaeeiieo IA?
(IIA?) neeaea 2,91( aai 1 aeiaaeie ia 343,3.

?ic?aoiaaiee iieaciee caaaeueii? /anoioe IA? ia ia?aaeuo? aiaeia?/iiai
iieacieea a ?yae? ?a?iiaenueeeo e?a?i ( 25 : 1000 – 55 : 1000 )
(Arima M., 1988; Kurjak A. e.a., 1989; Czeizel A.,1989). Iaeiae,
a?aecia/aia eiai c?inoaiiy ii??aiyii c aeaieie aaciaiai iii?oi?eiao IA?
ieioeeo ?ie?a (15,70 : 1000 ia?iaeaeaiue ), ui iiaea aooe iiyniaii
a?eueo iiaiith ?a?no?aoe??th aiiiae?e ?icaeoeo o ae?oae.

A caaaeueii?aa?iiaeuei?e no?oeoo?? IA? i?ia?aeieie ca /anoioith
na?aae ?cieueiaaieo ? nenoaiieo (??N) aaae c’yaeeeny aiiiae?? neaeaoii?
nenoaie, na?oeaai-noaeeiii? ? na/iaeae?eueii? nenoaie (6,96 :1000 ;
3,56:1000 ; 2,93:1000 ).

I?e aea/aii? /anoioe ? no?oeoo?e IA? o ae?oae a oiiaao i?iieneiai
?icaeiaiiai i?noa a?aecia/ai? eieeaaiiy caaaeueii? /anoioe aaae a ie?ai?
?iee a?ae 8,3:1000 aei 23,2:1000. I?e oeueiio ca inoaii? 3 ?iee
niinoa??aa?oueny a?aeiinia noaa?e?caoe?y iieacieea caaaeueii? /anoioe ia
??ai? 20,54 ( aai 1 aeiaaeie ia 48,68 ia?iaeaeaiue.

Ii??aiyiiy no?oeoo?e IA? c iaoa??aeaie ieioeeo ?ie?a aeyaeei a??ia?aeia
ciaioaiiy aeiaaee?a aiiiae?e OeIN ( a?ae 12,6% aei 6,8%) ?
oeoieiai-eeoeiaiai o?aeoo ( OEO )( a?ae 14,6% aei 4,4%).

Na?aae ae?oae n?euenueei? i?noeaaino? caaaeueia /anoioa aaae neeaea
22,07 ( aai 1 aeiaaeie ia 45,3 ia?iaeaeaiue. I?e ?? ii??aiyii? c
iieacieeii /anoioe IA? na?aae ae?oae i?iieneiaiai oeaio?o a??ia?aeieo
a?aeciae ia a?aecia/aii ( ? (0,1). A c?noaaeaiiy iaoa??ae?a iioi/ii?
?a?no?aoe?? c aeaieie ieioeeo ?ie?a aeyaeei a??ia?aeia ca?eueoaiiy
caaaeueii? /anoioe aaae ?icaeoeo a inoaii? ?iee: a?aeiia?aeii 14,5% ?
22,07% ( ? (0,001). A oe?eiio ii ?aa?iio caaaeueia /anoioa ? /anoioa
“iiaeaeueieo” aaae (AA – 0,18(, NIE – 0,47(, IAe – 0,69(, A?I – 1,10( )
a?aeiia?aeathoue aeaiei, ye? iaaiaeyoueny a e?oa?aoo?? (Myrianthopoulus
N.C.,e.a.,1987; Stoll C.,e.a.,1988; Calzolari E.e.a.,1990;
Iaaecueaaaeue I.E.,1991 ). Ieae/a ieo aeyaeeeny /anoioe aiiiae?e: ?AI –
0,73(, ?A – 0,13(, AA – 0,07(, IIA? – 2,91(. Aeae?eueea aeua aeyaeany
iieaciee ?iciianthaeaeaiino? AN ? aai ON – 0,17(. Iaeaea /aoaa?oo
/anoeio a?ae caaaeueii? e?eueeino? IIA? caeia? oai?iaa Aeaoia (a?ey 24%)
aai 1 aeiaaeie ia 1488 ia?iaeaeaiue, ui iaaeeaea?oueny aei aeaieo ?ioeo
aaoi??a (Baird P.A. e.a.,1988; Bell L. e.a.,1989; Eacthe A.?. 1991).
Ii??aiyiiy iaoa??ae?a iioi/ii? ?a?no?aoe?? c aaciaeie aeaieie
iii?oi?eiao IA? aeyaeei i?aeaeuaiiy ieoiii? aaae AA ( 0,30( i?ioe 0,07(,
? (0,05 ). Oei ia iaioa, na?aae ae?oae i?iieneiaiai i?noa /anoioa AA
ieae/a e?oa?aoo?ieo aeaieo ( 0,33 – 0,38:1000 ) ? ?a?no?o?oueny aieiaiei
/eiii na?aae ae?i?iiaaieo ieiae?a. Aei iieacieea /anoioe IA? (
21,38:1000 ) a iaiiaoaeueiiio ia??iae? iaaeeaea?oueny iieaciee
caaaeueii? /anoioe aaae ?icaeoeo o ieiaea, yeee ca aeaieie
i?aiaoaeueiiai OC aeine?aeaeaiiy neeaa a na?aaeiueiio 18,0:1000 ?
?icoaoiaaiee a iaaeao eieeaaiue, icia/aieo ?ioeie aaoi?aie – 9,75:1000 –
25:1000 (A?a/ai?ia I.ss., 1992; Eoe’yiiaa I.I. oa ni?aaao., 1992;
Aiaaoe?ueiaa ?.A.,1995; Aeoae/aiei I.I.oa ni?aaao.,1995). Aeniea
ae?aaiinoe/ia oe?ii?noue iaoiaeo OC ae?aaiinoeee iieacaia i?e aeyaeaii?
iao?io??ia?ieo aiiiae?e (42,7%), aaae OeIN (24,3%), IIA? (11,7%). I?e
oeueiio iieacieee /anoio aaae OeIN ? ANN aeua a i?aiaoaeueiiio ia??iae?
(a?aeiia?aeii 4,37( ? 1,39 (; 7,69( ? 3,20(), a iieacieee /anoio
aiiiae?e NNN ? I?A a iinoiaoaeueiiio ia??iae? aeu?, i?ae a
i?aiaoaeueiiio (a?aeiia?aeii 4,50( ? 0,87( oa 5,08( ? 0,87() (?en.).

Ia aeyaeaii a?aei?iiinoae i?ae iieacieeaie /anoioe IA? OEO a
i?aiaoaeueiiio ? iinoiaoaeueiiio ia??iaeao ( a?aeiia?aeii 1,39(), ui
oaeiae iiaeeeai iiynith?oueny a/aniith ae?i?iaoe??th ieiae?a c oe??th
iaoieia??th. Aeiiieiaiaa aeyaeaiiy aaae OEO ia? iniaeeao aeooaeuei?noue,
ine?eueee a?eueo?noue aiiiae?e a?aeiineoueny aei oeo, ye? ei?aaothoueny,
ui aeicaiey? ?aii aecia/eoeny o a?aeiioaii? oaeoeee aaaeaiiy aaa?oiino?,
i?iaanoe aaeaeaaoi? caoiaee i?e iieiaao, iaaeaoe ?aiith o??o?a?/io
aeiiiiiao a iaiiaoaeueiiio ia??iae?.

A?aei?/aia ia?aaaaeaiiy iinoiaoaeueii? /anoioe aaae neaeaoii?
nenoaie ca’ycaii c ?a?no?aoe??th eieaeueieo ioeueoeoaeoi??aeueieo
aiiiae?e, ui ia ? oaiaoiaaieie, aea ui caeiathoue i?ia?aeia i?noea
na?aae ?ioeo nenoai, ye? aoiaeyoue a eiiieaen IIA?. C oeei iaaii
ca’ycaia a?eueo iecueea ieoiia aaaa iiiaeeiieo aiiiae?e a
aioaiaoaeueiiio ia??iae? ( 2,09( i?ioe 3,20(). Caaaeueiiiiioeyoe?eia
/anoioa IA? na/iaeae?eueii? nenoaie o ae?oae a?eueo, i?ae a 2 ?ace
ieae/a, i?ae i?e i?aiaoaeueiiio aeyaeaii? (3,20( ? 7,69( ).

I?iaiae?ciaaii eieeaaiiy iiioeyoe?eii? /anoioe AA i?ioyaii 20 ?ie?a.
Ine?eueee a 70-o? ? ia ii/aoeo 80-o ?ie?a i?aiaoaeueia ae?aaiinoeea ia
i?iaiaeeeany, oi an? aeiaaeee aaae aoee ae?aaiinoiaai? i?e ia?iaeaeaii?
( 0,22 : 1000 ). A inoaii? ?iee (1993-1994 ) an? AA a i. Iaean? aoee
aeyaeai? a aioaiaoaeueiiio ia??iae?, oi/a iieaciee /anoioe AA neeaa 0,7
:1000 ca aeaieie naeoe?eieo iaoa??ae?a, ui a 2 ?ace ia?aaeuo?
iiioeyoe?eiee ??aaiue (Iaaecueaaaeue I.E.,1991,Stoll.C.e.a., 1988) ?
iiaeeeai ? iane?aeeii aeieia?/iiai caa?oaeiaiiy na?aaeiaeua. Oaeei
/eiii, cieaeaiiy /anoioe AA iiaea aooe e?eoa???i ioe?iee aoaeoeaiino?
i?io?eaeoe/ieo caoiae?a uiaei iiia?aaeaeaiiy ia?iaeaeaiiy ae?oae c
aaaeaie ?icaeoeo.

C iaoith aea/aiiy ? ioe?iee /eiiee?a ?eceeo uiaei oi?ioaaiiy
i?e?iaeaeaieo aiiiae?e o ae?oae i?iaaaeaii ee?i?/ia ianoaaeaiiy 928
aeiaaee?a IA? o ae?oae (1 a?oia) ? 760 aeiaaee?a ia?iaeaeaiiy ae?oae aac
IA? (2 a?oia).A?eueo 3/4 a?ae anueiai eiioeiaaioo ae?oae 1 a?oie neeaee
ae?oe ia?oiai ?ieo aeeooy. ? ? N aaaee ?icaeoeo neeaee 55,8%, na?aae
yeeo iaea?eueo /enaeueiith ? a?oia aaae NNN ( 28,0%) ? na/iaeae?eueii?
nenoaie (22,0%). Aiiiae?? I?A caeiyee 16,8%, aaaee OEO -15%. Na?aae
iiiaeeiieo aaae (44,2%) aeiey neiae?ii?a o?iiiniiii? ao?ieia?? – 34,6%,
na?aae yeeo aeii?ioth/a iieiaeaiiy caeia? oai?iaa Aeaoia (54,2%), iio?i
neiae?iie Aaeaa?aena ? Iaoao (ii 10,6%), Oa?aoaanueeiai-Oa?ia?a
(9,9%).Iiiiaaii? neiae?iie neeaee 33% an?o aeiaaee?a IIA? iao?iiiniiii?
ao?ieia??, i?e oeueiio /anoea neiae?ii?a c aooiniiii-aeii?iaioiei ?
aooiniiii-?aoeaneaiei oeiii oniaaeeoaaiiy i?eaeecii iaeiaeiaa
(a?aeiia?aeii 37% ? 40%). Ianiaaeeia? neiae?iie neeaee 8,8%, a ieoiia
aaaa iaeeaneo?eiaaieo eiiieaen?a – 24% , ui iaaeeaea?oueny aei aeaieo
Eacthea A.?.? ni?aaao.(1983).

Aiae?c cia/ouino? /eiiee?a ?eceeo iieacaa ianooiia. Na?aaei?e a?e
iaoa??a, ui ia?iaeeee ae?oae c IA? aoa aeaui aeuee, i?ae a?e iaoa??a a
eiio?ieuei?e a?oi? ( a?aeiia?aeii 26,8 ( 0,31 i?ioe 25,5 ( 0,24, ?
(0,01). I?eaeecii ??aia e?euee?noue iaoa??a aoea a 1 ? 2 a?oiao o a?oe?
aei 20 ?ie?a, ? iaeaea a 2 ?ace aoei a?eueoa iaoa??a a 1 a?oi? o a?oe?
noa?oeo 35 ?ie?a ( a?aeiia?aeii 12,8% i?ioe 5,4%, ?(0,001). Iaea?eueoa
cia/aiiy iaa a?e iaoa?? i?e oai?ia? Aeaoia ? a na?aaeiueiio neeaa 26,8 (
0,73.

A iniiai?e a?oi? /ano?oa iaee i?noea i?ioan?eii-ae?iaie/?
oe?aeeeaino? ( a?aeiia?aeii 12,7% i?ioe 6,8%, ? (0,05). Oaeiae a
iniiai?e a?oi? aeua /anoioa ia?a?no?iaaieo ? e??aii?iaeeiieo oetha?a (
9,3% i?ioe 4,9% i?e ? (0,05 ? 0,76% i?ioe 0,09% i?e ? (0,001). Oaeiae
a?eueo /anoa aeno?aaai?oaeueia iaoieia?y na?aae ae?iie iniiaii? a?oie
(29,1% i?ioe 28,6% i?e ?(0,1), aea a??ia?aeii a?eueoa aiaeie?eiiiao?e,
o?ii?/ieo caiaeueieo caoai?thaaiue na/iai? nenoaie, a?iaeieia?/ieo
ii?ooaiue (28,0% i?ioe 26,8% i?e ?(0,05).

A?ey 40% ae?iie 1 a?oie iaee ooo/ia ia?a?eaaiiy aaa?oiino? a
aiaiiac? ? caaaeueia /anoioa ieiia?eueieo aai?o?a o ae?iie iniiaii?
a?oie o 1,5 ?ace a?eueoa. Cia/ii /ano?oa a aiaiiac? ae?iie iniiaii?
a?oie ? aeac?aee ia ia?iaeaeaiiy ae?oae c i?e?iaeaeaiith iaoieia??th
?ai?oa aai aeiaaeee aeeoy/i? nia?oiino?, ia?oaiia?iaeaeaiiy (1,7% ? 5,9%
i?ioe 0,26% ? 0,66%, ? ( 0,05 ? ? ( 0,001). I?e aaa?oiinoyo ieiaeaie c
IA? a 2 ?ace /ano?oa niinoa??aaany oieneeic 1 iieiaeie (33,4% i?ioe 16%,
?(0,05). Caa?ica ia?a?eaaiiy aaa?oiino? niinoa??aaeany o 21% ae?iie
iniiaii? a?oie i?ioe 17,1 % ae?iie eiio?ieueii? a?oie. *anoioa
?ioaeoe?eieo caoai?thaaiue a 1 iieiaei? aaa?oiino? a 3 ?ece /ano?oa a 1
a?oi? ae?iie (15,6 % ? 5,7 %, ?

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