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Клініко-морфологічна діагностика внутрішнього ендометріозу матки: Автореф. дис… канд. мед. наук / О.М. Носенко, Ін-т педіатрії, акушерства та гінеко

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?INOEOOO IAAe?AO???‚ AEOOA?NOAA OA A?IAEIEIA??

AEAAeAI?? IAAeE*IEO IAOE OE?A?IE

IINAIEI IEAIA IEEIEA?AIA

OAeE 618.14-002-071 + 572.7

EE?I?EI-II?OIEIA?*IA Ae?AAIINOEEA

AIOO??OIUeIAI AIAeIIAO??ICO IAOEE

14.01.01 – aeooa?noai ? a?iaeieia?y

A a o i ? a o a ? a o

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a -1999

Aeena?oaoe??th ? ?oeiien.

?iaioo aeeiiaii a Aeiiaoeueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao?
?i. I.Ai?ueeiai IIC Oe?a?ie.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe‚ i?ioani? *AEEA AIEIAeEIE? EE?EEIAE*

caa?aeoth/ee eaoaae?ith aeooa?noaa‚ a?iaeieia?? oa ia?eiaoieia?? OII
Aeiiaoeueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i.I.Ai?ueeiai IIC
Oe?a?ie

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe‚ i?ioani? ?AAITHOA E?Ae?ss ?AAI?AIA‚

caa?aeoth/a a?aeae?eaiiyi ?aaa?e?oaoe?? ?ai?iaeoeoeaii? ooieoe?? ae?iie
?inoeoo iaae?ao???‚ aeooa?noaa oa a?iaeieia?? AII Oe?a?ie

aeieoi? iaaee/ieo iaoe‚ i?ioani? EIOAIAAE* ?AAAI?ss A?EOI??AIA‚

caa?aeoth/a eaoaae?ith aeooa?noaa oa a?iaeieia?? ?2 Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E.Ooi?ea IIC Oe?a?ie

I?ia?aeia onoaiiaa:

Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i.I.I.Aiaiiieueoey IIC Oe?a?ie‚
eaoaae?a aeooa?noaa oa a?iaeieia?? ? 1(i.Ee?a)

Caoeno aeena?oaoe?? a?aeaoaeaoueny “26” aeiaoiy 1999?. i 13 aiae. ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.553.01 ii caoenoo
aeena?oaoe?e ia caeiaoooy iaoeiaiai nooiaiy aeieoi?a iaaee/ieo 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-50‚
aoe.Iaio?eueneiai‚ 8).

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? ?inoeoooo
iaae?ao???‚ aeooa?noaa oa a?iaeieia?? AII Oe?a?ie (04050‚ i.Ee?a-50‚
aoe.Iaio?eueneiai‚ 8).

Aaoi?aoa?ao ?ic?neaiee “26” eeiiy 1999 ?ieo.

A/aiee nae?aoa?

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

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Ieoiia aaaa aioo??oiueiai aiaeiiao??ico iaoee
(AAI) na?aae on?o o?aaeaiue aai?oae?e aiaeiiao??icii aeinyaa? 70-90%
[A.I.No?eaeaeia‚ A.?.Aeaaeaeia‚ 1995]. Oea caoai?thaaiiy ia? o?eaaeee
oa ?aoeeaeeaoth/ee ia?aa?a, ia??aeei i?eaiaeeoue aei ii?ooaiue
?ai?iaeoeoeaii? ooieoe??, ao?aoe ae?oi?iaeieo i?aai?a, cieaeaiiy aai
ao?aoe i?aoeacaeaoiino? ae?iie [A.I.No?eaeaeia‚ A.?.Aeaaeaeia‚ 1995;
E.A.Aaeaiyi‚ 1996; E.?.?aaithoa‚ N.A.?aaithoa, 1997; ?.A.Eioaiaae/ oa
?io?‚ 1998; A.Bergquist, 1998].

Ee?i?/ia ae?aaiinoeea AAI iia’ycaia c iaaieie o?oaeiiuaie [A.I.Aaneaeia,
1990; A.I.No?eaeaeia‚ A.?.Aeaaeaeia‚ 1995; E.A.Aaeaiyi‚ 1998;
A.M.McCausland, 1991;C.Wood, M.Wingfield, 1994]. A?eueo?noue oai?eo
(88,6%) iio?aiey? a noaoe?iia? aac ae?aaiico “aiaeiiao??ic” c
aeac?aeith ia ?ioo noiooith eiio iaoieia?th, ? AAI ae?aaiinoo?oueny
o?eueee i?ney a?noieia?/iiai aeine?aeaeaiiy iia?aoe?eieo iaoa??ae?a o
93,2% aeiaaee?a [?.? Eooeaiei‚1988]. Aeiiia?aoe?eiee ae?aaiic
anoaiiaeth?oueny i?e ii/aoeiaeo oi?iao AAI o 6,2% oai?eo‚ i?e ae?aaeaieo
– o 17,3% [A.I.Iaoeia‚ 1993]. Iecueeei oeeo?ai aeiiia?aoe?eii?
ae?aaiinoeee noia?a/aoue aeai? ca aenieo ?ioi?iaoeai?noue
?ino?oiaioaeueieo iaoiae?a ae?aaiinoeee‚ oaeeo ye
a?noa?inaeuei?iaia?ao?y (ANA) , oeueo?acaoeiaa aeine?aeaeaiiy (OCAe) ‚
a?noa?ineii?y (AN); ne?ae a?aei?oeoe ? noia?a/eea?noue aeaieo ca
?ioi?iaoeai?noue oeeo iaoiae?a aeine?aeaeaiiy : ANA – a?ae 25‚0%
[A.I.Naaaeueeiaa‚ 1983] aei 94‚0% [A.A.??iae‚ 1994]‚ OCAe – a?ae 10‚8
% [H. Freidman et alt., 1985 ] aei 88‚7% [A.I. Aeaieaeia oa ?io?‚
1996]‚ AN – a?ae iiaiiai caia?a/aiiy ae?aaiinoe/ii? oe?iiino? [A.?.
Aeaaeaeia‚ 1994] aei 83‚9% [I.I.Aeaie?ia‚ 1991].

Ii?oieia?/ia aeine?aeaeaiiy aeaeaeaii? iaoee oaae ia caaaeaee
aeyaey? AAI, ine?eueee aieiaia oaaaa i?eae?ey?oueny ia aiaeiiao??ico,
a noiooi?e eiio iaoieia?? [I. I. Aeaie?ia oa ?io?‚ 1993]. *anoioa
aeyaeaiiy AAI ii?oieia?/iei iaoiaeii neeaaea? 70-85% [A. I. Aaneaeia,
1990].

Eiioeaioe?? iaoi- ? ii?oiaaiaco AAI oe?iei iai??eiaoaaeenue o e?oa?aoo??
[A.I.O?ioei‚ 1987; ?.?.Eooeaiei‚ 1988; E.O.Oeiea?aaa oa ?io?‚ 1989;
A.I.Aaneaeia‚ 1990; I.O.Eaueinueeee‚ 1990; A.I.Iaoeia‚ 1993; ?.A.
Oaa?iaa‚ 1993; A.I.No?eaeaeia‚ A.?.Aeaaeaeia‚ 1995; E.?.?aaithoa‚
N.A.?aaithoa‚ 1997‚ E.A.Aaeaiyi‚ 1998; I.I.?iaiaa‚ 1998; ?.A.Eioaiaae/
oa ?io?‚ 1998; A.A.N?i?ie‚ 1998; H.Ota et alt., 1995; T.Toki et alt.,
1996]‚ aea aeaye? ieoaiiy iaoi- ? ii?oiaaiaco AAI caeeoathoueny
iaeiaea/aieie aai aeeneon?eieie. Aeai? ca ii?oiooieoe?iiaeueiee noai
y?/iee?a ? aooii?/iiai aiaeiiao??y (AA) iiiaeeiie?. Ui aei
ni?aa?aeiioaiiy no?iiaeueiiai ? caeicenoiai eiiiiiaioo
aiaeiiao??i?aeieo aaoa?ioii?e (AA) aeai? noia?a/eea?. A?aenooiy
ii??aiyeueia ii?oiooieoe?iiaeueia oa?aeoa?enoeea AA‚ AA ? y?/iee?a, a
oaeiae ii??aiyeueia ee?i?/ia oa?aeoa?enoeea oai?eo ia AAI c ??cieie
eiai ee?i?ei-ii?oieia?/ieie oi?iaie oa a ??ci? ia??iaee aeeooy ae?iee.
Iiiaeeiie? ?iaioe i?enay/ai? aeine?aeaeaiith AAI o ae?iie a
iinoiaiiiaoc?. Iaei aena?oeaia ?ieue AAI o ?icaeoeo ii?aeiaii?
aeia?iye?nii? iaoieia?? iaoee.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie.
Aeena?oaoe?y aeeiiaia ca?aeii c ieaiii IAe? Aeiiaoeueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i. Ai?ueeiai IIC Oe?a?ie, ?
o?aaiaioii eiiieaenii? oaie “?ic?iaea iiaeo i?aeoiae?a aei i?io?eaeoeee
oa e?eoaaiiy aacie?aeiiai oethao” IIC‚ N aea?aeaaii? ?a?no?aoe??
0197V002125, oeo? oaie IE 950605. Aaoi? ? aeeiiaaoeai oaie.

Iaoa aeine?aeaeaiiy. I?aeaeueoe aoaeoeai?noue ae?aaiinoeee
aioo??oiueiai aiaeiiao??ico iaoee oeyoii aeyaeaiiy eiai a??ia?aeieo
ae?aaiinoe/ieo e?eoa???a ia iniia? aea/aiiy oa c?noaaeaiiy ee?i?/ieo‚
?ino?oiaioaeueieo aeaieo ianoaaeaiiy oai?eo oa ?acoeueoao?a
a?noieia?/iiai aeine?aeaeaiiy a?aeiia?aeieo iia?aoe?eieo iaoa??ae?a, a
oaeiae ?ic?iaee ? ai?iaaaeaeaiiy iiaiai niiniao ae?aaiinoeee
caoai?thaaiiy.

Caaea/? aeine?aeaeaiiy.

1. Aea/eoe ee?i?/i? iniaeeaino? aioo??oiueiai aiaeiiao??ico iaoee
a caeaaeiino? a?ae ee?i?ei-ii?oieia?/ii? oi?ie caoai?thaaiiy oa ia??iaeo
aeeooy ae?iee.

2. Aea/eoe iiaeeeaino? a?noa?inaeuei?iaia?ao??, oeueo?acaoeiaiai
aeine?aeaeaiiy‚ a?noa?ineii?? a ae?aaiinoeoe? aioo??oiueiai
aiaeiiao??ico iaoee ? anoaiiaeoe a??ia?aei? ae?aaiinoe/i? e?eoa???
caoai?thaaiiy ia iniia? c?noaaeaiiy ?ino?oiaioaeueieo aeaieo
aeiiia?aoe?eiiai ianoaaeaiiy oai?eo oa ?acoeueoao?a a?noieia?/iiai
aeine?aeaeaiiy a?aeiia?aeieo iia?aoe?eieo iaoa??ae?a.

3. Aea/eoe ii?oiooieoe?iiaeuei? iniaeeaino? aooii?/iiai aiaeiiao??y,
aiaeiiao??i?aeieo aaoa?ioii?e ? y?/iee?a i?e aioo??oiueiai aiaeiiao??ico
iaoee a caeaaeiino? a?ae ee?i?ei-ii?oieia?/ii? oi?ie caoai?thaaiiy oa
ia??iaeo aeeooy ae?iee.

4. ?ic?iaeoe i?eno??e aeey a?noa?ineii?/ii? aieeiai? ioieoe?eii?
a?iin?? aiaei- oa i?iiao??y.

5. Iaoeiai iaa?oiooaaoe, ?ic?iaeoe oa ai?iaaaeeoe niin?a
ae?aaiinoeee aioo??oiueiai aiaeiiao??ico iaoee oeyoii eiiieaeniiai
aeei?enoaiiy a?noa?ineii??‚ o?ainaaa?iaeueiiai oa o?ainaaaeii?iaeueiiai
oeueo?acaoeiaiai aeine?aeaeaiiy‚ a?noa?ineii?/ii? aieeiai? ioieoe?eii?
a?iin?? i?iiao??y ? a?noieia?/iiai aeine?aeaeaiiy a?iioao?a.

Iaoeiaa iiaecia ?iaioe. Aea/aii oaeoi?e ?eceeo ?icaeoeo AAI o
oai?eo c a?noieia?/ii i?aeoaa?aeaeaiith iayai?noth oe??? iaoieia??. Ia
iniia? aea/aiiy ? c?noaaeaiiy ee?i?/ieo‚ ?ino?oiaioaeueieo aeaieo
ianoaaeaiiy iaoe??ioie c AAI oa ?acoeueoao?a a?noieia?/iiai
aeine?aeaeaiiy a?aeiia?aeieo iia?aoe?eieo iaoa??ae?a aeyaeai?
iiaeeeaino? ANA, OCAe oa AN o ae?aaiinoeoe? AAI oa a?aeiia?aei?
niaoeeo?/i? ?ino?oiaioaeuei? ia?ea?e. ?ic?iaeaii i?eno??e aeey
aieeiai? ioieoe?eii? a?iin?? i?iiao??y. ?ic?iaeaii niin?a ae?aaiinoeee
AAI c canoinoaaiiyi aieeiai? ioieoe?eii? a?iin?? i?iiao??y ?
iiia?aaeiueiai o?ainaaa?iaeueiiai oa iaeii/aniiai o?ainaaaeii?iaeueiiai
OCAe. Aea/aii ii?oiooieoe?iiaeuei? iniaeeaino? AA, AA ? y?/iee?a o
caeaaeiino? a?ae ee?i?ei-ii?oieia?/ii? oi?ie caoai?thaaiiy oa ia??iaeo
aeeooy ae?iee. Aia?oa cai?iiiiiaaii ? iaoeiai iaa?oioiaaii aeae?eaiiy
oaei? ee?i?ei-ii?oieia?/ii? oi?ie AAI ye e?noicia. Aena?oeaia ?ieue AAI
o ?icaeoeo ii?aeiaii? aeia?iye?nii? iaoieia?? iaoee. I?inoaaeaii
ee?i?ei-ii?oieia?/i? ia?aeae? o oai?eo ia AAI c ??cieie
ee?i?ei-ii?oieia?/ieie eiai oi?iaie oa a ??ci? ia??iaee aeeooy
ae?iee.

I?aeoe/ia cia/aiiy ?iaioe. Aeey i?aeoe/ii? ?iaioe e?ea??a
a?iaeieia?a cai?iiiiiaai? ee?i?/i? oa ?ino?oiaioaeuei? ae?aaiinoe/i?
e?eoa??? ??cieo ee?i?ei-ii?oieia?/ieo oi?i AAI oa oa?aeoa?enoeea
iniaeeainoae caoai?thaaiiy a caeaaeiino? a?ae ia??iaeo aeeooy ae?iee.
Aeey ae?aaiinoeee AAI ?ic?iaeaii i?eno??e aeey aieeiai? ioieoe?eii?
a?iin?? i?iiao??y; ?ic?iaeaii oa ai?iaaaeaeaii niin?a ae?aaiinoeee
AAI oeyoii eiiieaeniiai aeei?enoaiiy a?noa?ineii??‚ o?ainaaa?iaeueiiai
oa o?ainaaaeii?iaeueiiai oeueo?acaoeiaiai aeine?aeaeaiiy‚
a?noa?ineii?/ii? aieeiai? ioieoe?eii? a?iin?? i?iiao??y ?
a?noieia?/iiai aeine?aeaeaiiy a?iioao?a‚ ui i?aeaeueei
?ioi?iaoeai?noue AN c 11,1% oa OCAe c 19,6% aei 50,0%. ?acoeueoaoe
aeine?aeaeaiiy oa ?ic?iaeaia iaoiaeeea ae?aaiinoeee AAI
ai?iaaaeaeai? o ?iaioo a?iaeieia?/ieo ? iaoieiaiaiaoii?/ieo a?aeae?eaiue
i. Aeiiaoeueea‚ i. Ia??oiiey‚ i.E?an-iia?i?enueea. ?ic?iaeai? “Iia?
iaoiaeeee ae?aaiinoeee oa e?eoaaiiy aai?oaeueiiai aiaeiiao??ico”
caianai? a ?a?no? iaaeeei-a?ieia?/ieo ? iaoeiai-oaoi?/ieo iiaiaaaaeaiue
(?a?no? 56 8/8). Oai?aoe/i? iieiaeaiiy oa i?aeoe/i? ?aeiiaiaeaoe??
aeena?oaoe?eii? ?iaioe aeei?enoiaothoueny a iaa/aeueiiio i?ioean? ia
eaoaae?? aeooa?noaa, a?iaeieia?? oa ia??iaoieia?? OII oa eaoaae?e
iaoieia?/ii? aiaoii?? Aeiiaoeueeiai iaaee/iiai oi?aa?neoaoo ?i.
I.Ai?ueeiai.

Iniaenoee aianie caeiaoaa/a. Aeena?oaioea i?iaaea naiino?eia
aea/aiiy a?o?aieo iaoa??ae?a Aeiiaoeueeiai aea?aeaaiiai ?aa?iiaeueiiai
oeaio?o ii ioi?ii? iaoa?einoaa oa aeeoeinoaa c 1990 aei 1995 ?ieo, ia
iniia? yeiai iaa?oioiaaii iaoa ? caaea/? aeine?aeaeaiiy; aea?aea
aaeaeaaoi? iaoiaee/i? caoiaee; naiino?eii i?iaaea ee?i?/ia,
?ino?oiaioaeueia ianoaaeaiiy iaoe??ioie oa ?acii c i?io. ?.A.Aaneeaiei
a?noieia?/ia aeine?aeaeaiiy iia?aoe?eieo iaoa??ae?a; a?aea o/anoue a
iia?aoeaiiio e?eoaaii? oai?eo; aea/eea oaeoi?e ?eceeo ?icaeoeo AAI o
oai?eo c a?noieia?/ii i?aeoaa?aeaeaiith iayai?noth oe??? iaoieia??;
aea/eea ee?i?/i? ? ii?oiooieoe?iiaeuei? iniaeeaino? AAI o caeaaeiino?
a?ae ee?i?ei-ii?oieia?/ii? oi?ie caoai?thaaiiy oa ia??iae?a aeeooy
ae?iee; ooi/ieea iiaeeeaino? iaeiioe?ai?oeo iaoiae?a ae?aaiinoeee AAI,
oaeeo ye ANA, OCAe oa AN, ia iniia? c?noaaeaiiy aeaieo
?ino?oiaioaeueiiai ianoaaeaiiy oai?eo ia AAI oa a?aeiia?aeieo aeaieo
a?noieia?/iiai aeine?aeaeaiiy iia?aoe?eieo iaoa??ae?a aeyaeea
a?aeiia?aei? a??ia?aei? ?ino?oiaioaeuei? ae?aaiinoe/i? ia?ea?e AAI;
?ic?iaeea i?eno??e aeey aieeiai? ioieoe?eii? a?iin?? i?iiao??y;
?ic?iaeea oa ai?iaaaeeea iiaee niin?a ae?aaiinoeee AAI; i?iaaea aiae?c
an?o io?eiaieo ?acoeueoao?a oa ?o noaoenoe/io ia?iaeo.

Ai?iaaoe?y ?iaioe. Iaoa??aee aeena?oaoe?? aeiiia?aeaeeny ia
can?aeaii? eaoaae?e aeooa?noaa, a?iaeieia?? oa ia??iaoieia?? OII
AeiiAeIO (i.Aeiiaoeuee, 1996); ia can?aeaii? A/aii? ?aaee IAe?
iaaee/ieo i?iaeai n?i’? (i.Aeiiaoeuee, 1996, 1999); ia can?aeaii?
A/aii? ?aaee AeiiAeIO (i.Aeiiaoeuee, 1996): ia iaeanieo
iaoeiai-i?aeoe/ieo eiioa?aioe?yo aeooa??a-a?iaeieia?a
(i.Aeiiaoeuee, 1997,1998); ia can?aeaii? iaeaniiai iaoeiaiai oiaa?enoaa
iaoieiaiaiaoii?a (i.Aeiiaoeuee, 1997); aoee i?aaenoaaeai? ia O c’?cae?
aeooa??a-a?iaeieia?a Oe?a?ie (i.Iaeana, 1996); ia I?aeia?iaeiiio
Eiia?an? c aiaeiiao??ico c eo?nii aiaeineii?? (i.Iineaa, 1996); ia V
Anana?oiueiio Eiia?an? c aiaeiiao??ico (i.Eieiaaia, ssiii?y, 1996);
ia XV Anana?oiueiio Eiia?an? c aeooa?noaa oa a?iaeieia??
(i.Eiiaiaaaai, Aeai?y, 1997).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 17 ?ia?o, c
yeeo 6 – noaoo? o oeaio?aeueieo iaaee/ieo aeo?iaeao, 1 – noaooy a
ca??ieeo iaoeiaeo i?aoeue, 10 – oace aeiiia?aeae ia c’?caeao oa
eiioa?aioe?yo, c ieo 5 – ia i?aeia?iaeieo eiia?anao. Io?eiaii iaoaioe
ia 2 aeiaoiaee.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia oe?a?inueeith
iiaith ia 185 noi??ieao iaoeiiieniiai oaenoo ? neeaaea?oueny c
anooio‚ iaeyaeo e?oa?aoo?e‚ /ioe?ueio ?icae?e?a c aeeeaaeaiiyi
?acoeueoao?a aeanieo aeine?aeaeaiue‚ caeeth/ii? /anoeie‚ aeniiae?a‚
i?aeoe/ieo ?aeiiaiaeaoe?e‚ nieneo aeei?enoaieo aeaea?ae. Oaenoiaa
/anoeia aeeeaaeaia ia 121 noi??ioe?. E?oa?aoo?iee iieaae/ee aeeth/a? 211
aeaea?ae‚ c ieo 104 – a?o/eciyieo ? 107 – ?iicaiieo aaoi??a‚ ye?
caeiathoue 20 noi??iie. ?iaioa ?ethno?iaaia 33 oaaeeoeyie‚ 45
?enoieaie‚ ye? caeiathoue 44 noi??iee.

Aeneiaethth aeeaieo iiaeyeo aeieoi?o iaaee/ieo iaoe‚ i?ioani?o
?.A.Aaneeaiei ca eiinoeueoaoeaio aeiiiiiao c ieoaiue iaoieia?/ii?
aiaoii??.

INIIAIEE CI?NO ?IAIOE

Iaoa??aee oa iaoiaee aeine?aeaeaiiy. C iaoith aeine?aeaeaiiy
?iciianthaeaeaiino? AAI oa yeino? eiai aeiiia?aoe?eii? ae?aaiinoeee
iaie aoee aea/ai? a?o?ai? iaoa??aee Aeiiaoeueeiai aea?aeaaiiai
?aa?iiaeueiiai oeaio?o ii ioi?ii? iaoa?einoaa oa aeeoeinoaa c 1990
aei 1995 ?ieo. I?iaaaeaii ianoaaeaiiy 195 ae?iie o a?oe? a?ae 29 aei
75 ?ie?a, c yeeo iniiaio a?oio neeaee 107 i?iiia?iaaieo a ianyc?
a?noa?aeoii?? oai?eo ia AAI ( 40 iaoe??ioie c “/enoei” AAI, 67 – c AAI
o ii?aeiaii? c i?iiith iaoee)‚ ? eiio?ieueio a?oio – 63 a?iaeieia?/ii
caei?ia? ae?iee‚ ?? eiio?ieueio a?oio – 25 i?iiia?iaaieo a ianyc?
a?noa?aeoii?? oai?eo ia “/enoo” i?iio iaoee. Ae?aaiic AAI oa i?iie iaoee
aoei aa??o?eiaaii a?noieia?/ii.

Aeey aea/aiiy ii?oiooieoe?iiaeueieo ? ee?i?/ieo iniaeeainoae AAI o
??ci? ia??iaee aeeooy ae?iee a?aeiia?aeii eeaneo?eaoe?? AIIC (1980) an?o
oai?eo iniiaii? a?oie ie ?icae?eeee ia 3 i?aea?oie: I – 31
iaoe??ioea (29,0%) ?ai?iaeoeoeaiiai ia??iaeo aeeooy ( na?aaei?e a?e
39‚0±0‚7 ?ie?a); II – 51 iaoe??ioea (47,7%) i?aiaiiiaocaeueiiai
(na?aaei?e a?e – 48‚2±0‚4 ?ie?a); III- 25 iaoe??ioie (23,4%)
iinoiaiiiaocaeueiiai, c o?eaae?noth iaiiiaoce a?ae 1 aei 20 ?ie?a
(na?aaei?e a?e 56‚3±1‚1 ?ie?a).

Aeey aea/aiiy ii?oiooieoe?iiaeueieo ? ee?i?/ieo iniaeeainoae AAI o
caeaaeiino? a?ae ee?i?ei-ii?oieia?/ii? oi?ie AAI an?o oai?eo iniiaii?
a?oie ie ?icae?eeee ia 4 i?aea?oie: i?aea?oia A – 69 (64,5%)
niinoa?aaeaiue aeeoocii? oi?ie, i?e ye?e ??no AA o oiauo i?iiao??y
a?ae aacaeueiiai oa?o AA a?aei?/aany i?aeoe/ii ia anueiio i?ioyc?
neeciai? iaieiiee iaoee; i?aea?oia A – 37 (34,6%) niinoa?aaeaiue
aiaieuaai? oi?ie, i?e ye?e ??no AA o oiauo i?iiao??y a?ae aacaeueiiai
oa?o AA niinoa??aaany a ie?aieo ae?eyieao neeciai? iaieiiee iaoee;
i?aea?oia N – 14 (13,1%) niinoa?aaeaiue aoceiai? oi?ie, i?e ye?e AA
oi?ioaaee aocie o oiau? i?iiao??y; i?aea?oia Ae – 21 (19,6%)
niinoa?aaeaiiy e?noicii? oi?ie, i?e ye?e ?ici??e i?ina?o?a
e?noicii-?icoe?aieo caeic AA ia?aaeuoaaee 1 iiea ci?o i?e?ineiia i?e
iaeiio ca?eueoaii? oa iiaee aooe a?coae?ciaai? i?e OCAe iaoe??ioee.

A i?aea?oi? A o a?aeiia?aeiino? c eeaneo?eaoe??th AIIC (1975) aoei 7
(10,1%) niinoa?aaeaiue c I nooiaiai ?iciianthaeaeaiino? AAI, 20 (29,0%)
– c II , 42 (60,9%) – c III .

Na?aae on?o ae?iie iaie aea/aii aeooa?nueeee,
a?iaeieia?/iee, niiaoe/iee oa n?iaeiee aiaiiac‚ nioe?aeueii-aeiiii?/iee
noai, oiiae i?aoe? oa iiaooo. On? 195 ae?iie aoee iiai?noth
eaai?aoi?ii ianoaaeai? oa aeey aeyaeaiiy aeno?aaai?oaeueii? iaoieia??
i?ieiinoeueoiaai? oa?aiaaoii, aiaeie?eiieiaii, iaa?iiaoieiaii,
o??o?aii.

Noai ciai?oi?o ? aioo??oi?o noaoaaeo i?aai?a ioe?ithaaee oeyoii
a?iaeieia?/iiai a?iaioaeueiiai aeine?aeaeaiiy‚ iaeyaeo oeeee iaoee a
aeca?eaeao‚ canoiniaoaaiiy ?aioaaiieia?/ieo, oeueo?acaoeiaeo oa
aiaeineii?/ieo (eieueiineii?y, eaia?ineii?y, AN) iaoiae?a ianoaaeaiiy.
ANA i?iaiaeeee aiaei?ic/eiieie eiio?anoieie ?a/iaeiaie ca aeiiiiiaith
?aioaaiieia?/iiai aia?aoo “?aioaai-30” ia 2-3-e aeaiue i?ney cae?i/aiiy
iaino?oaoe?? aai ia 2-3-e aeaiue i?ney aeoe??aaiiy neeciai? iaieiiee
iaoee. OCAe aeeiioaaee oeueo?acaoeiaei aia?aoii “Kranzbuhler” c
aeei?enoaiiyi o?ainaaaeii?iaeueiiai ? o?ainaaa?iaeueiiai eiiaaenieo
aeao/ee?a /anoioith 3,5 oa 5 IAoe. Eaia?ineii?th i?iaiaeeee
aia?aoo?ith o??ie “Wiest” ( I?ia//eia). AN aeeiioaaee ia 7-10-e aeaiue
iaino?oaeueiiai oeeeeo a?noa?ineiiii o??ie “Wiest”(I?ia//eia). Aeey
?icoe?aiiy ii?iaeieie iaoee canoiniaoaaee aoaeaeeneee aac, yeee
?inooethaaee aia?aoii “Hysteroflator 1500 ” o??ie “Wiest”, aai 5%
?ic/ei aetheice, eio?ee iiaeaaaee aia?aoii “Hysteromator 1500” o??ie
“Wiest”. Eieueiineii?th aeeiioaaee aia?aoii “Albert Awetzlar 8862”
o??ie “Zeiss Kolposkope” ( I?ia//eia) .

Iia?aoe?ei? iaoa??aee o?enoaaee a 10% ?ic/ei? iaeo?aeueiiai
oi?iae?io, i?iaiaeeee /a?ac ia?ao?i, c??ce oiaueiith 5 iei oa?aoaaee
aaiaoienee?iii ? aiceiii oa ii aai A?ciio, aea/aee ca aeiiiiiaith
na?oeiai? i?e?ineii??. Aeai? a?noieia?/iiai aeine?aeaeaiiy caiineee a
niaoe?aeueii ?ic?iaeai? ea?oe .

An? iaea?aeai? ?acoeueoaoe ia?iaeyee ca aeiiiiiaith AII oeio IAM
PC. A??ia?aei?noue io?eiaieo aeaieo ioe?ithaaee ca iaoiaeaie
aa??aoe?eii? noaoenoeee c aeei?enoaiiyi e?eoa??th Nouethaeaioa oa
eooiaiai ia?aoai?aiiy O?oa?a. Ia/eneaiiy eiao?oe??ioo a?aeiinii?
caoai?thaaiino? in?a c ??cieie a?oiaie e?ia? ?iaeee ca aeiiiiiaith
eiao?oe??ioo Aoeueoa c a?aeiia?aeieie iii?aaeaie, ye? iienaee
TH.?.Aoaiia oa E.A.Iaaieoeueeee (1977).

C iaoith i?aeaeuaiiy aoaeoeaiino? ae?aaiinoeee AAI iaie aoei
?ic?iaeaii i?eno??e aeey a?noa?ineii?/ii? ioieoe?eii? aieeiai? a?iin??
i?iiao??y‚ a iniiao yeiai aoea iinoaaeaia caaea/a io?eiaiiy a?iioaoo
i?iiao??y oeyoii eiai oe?eani?yiiaaiiai caai?o ca ?aooiie ciiae
a?coae?coaaoe no?iee ii?iaeieie iaoee. Nooue aeiaoiaeo iieyaa? a oiio,
ui i?eno??e, yeee aeeth/a? ei?ion a?noa?ineiia, eaitheth ? aeenaeoi? c
ae?ieith‚ aeiaeaoeiai ia? o?eia/-iaoo?aoi? c eaiaeii, a?n? eaiaeo oa
o?eia/a-iaoo?aoi?a neeaaeathoue eoo 5i c aa?oeiith, eio?a iiaa?iaia a
iai?yi? aei i?iiao??y, o?eia/-iaoo?aoi? ?ooiii ianaaeaeaii ia ei?ion
a?noa?ineiia oae, ui ?o a?n? ca?aathoueny.

A?noa?ineii aea? ciiao a?coae?coaaoe noai no?iie ii?iaeieie iaoee i?e
iioe/iiio ca?eueoaii? a 7-8 ?ac?a; o?eia/-iaoo?aoi? caaania/o?
o?enaoe?th i?eno?ith ia aeine?aeaeoaaiiio i?aai?, iaoo?o?
oea?a?eaeueiee eaiae, caiia?aa? aeo?eaiith ?a/iaeie, yea ?icoe?th?
ii?iaeieio iaoee i?e i?iaaaeaii? AN; iayai?noue o o?eia/?-iaoo?aoi??
eaiaeo, a?nue yeiai neeaaea? eoo 5 i c a?nnth o?eia/a-iaoo?aoi?a‚
aea? ciiao niieo/eoe iaeyaeiaee e?iaoeue a?noa?ineiia c ?iai/ei e?ioeai
eaithe?, o yeo aaiaeyoue ci?iiee aeenaeoi? /e eiaaoeyoi?‚ ui i?aeaeuo?
aaciaeo i?e aaaaeaii? i?eno?ith /a?ac oea?a?eaeueiee eaiae; aeenaeoi?
neoao? aeey caai?o a?iioaoo, i?eaeaoiiai aeey a?noieia?/iiai
aeine?aeaeaiiy; eiaaoeyoi? caaania/o? iaae?eiee aaiinoac.

I?aoeth? i?eno??e oaeei /eiii. O ?ac? iaiao?aeiino? ae?aaiinoeee
AAI oai??e ?icoe?ththoue oea?a?eaeueiee eaiae ?icoe?thaa/aie Aaaa?a,
aaiaeyoue a?noa?ineii o ii?iaeieio iaoee, iiaeathoue ?icoe?thth/o
?a/iaeio a ii?iaeieio iaoee. *a?ac iioe/io nenoaio ei?iono
a?noa?ineiia iaeyaeathoue ii?iaeieio iaoee aeey aeai?o i?noey a?iin?? c
iayai?noth niaoeeo?/ieo a?noa?ineii?/ieo iciae AAI. Iaoe?eththoue
eaitheth c eiaaoeyoi?ii ia aea?aia i?noea a?iin?? oa o?enothoue
iieiaeaiiy . Cai?iththoue eiaaoeyoi? ia aeenaeoi? oa caio?ththoue
inoaii?e o no?ieo iaoee ia iaiao?aeio aeeaeio. Eaitheth ianaaeaeothoue
ia aeenaeoi? ? a?aen?eathoue /anoeio i?iiao??y. Aeenaeoi? c a?iioaoii,
yeee caiiaith? ae?ieo, aeaeaeythoue c eaithe? , a aei ia? aaiaeyoue
eiaaoeyoi? ? eiaaoeththoue ?aio i?ney a?iin?? a no?ioe? iaoee.
Eaitheth aeaeaeythoue. Eiio?ieththoue aaiinoac iaeyaeii i?noey
a?iin??. Aeaiaeyoue i?eno??e iaciai?.

Iaie ?ic?iaeaii niin?a ae?aaiinoeee AAI, o iniiao yeiai iinoaaeaia
caaea/a i?aeaeuaiiy a??ia?aeiino? ae?aaiinoeee AAI oeyoii eiiieaeniiai
canoinoaaiiy OCAe, AN, a?noa?ineii?/ii? aieeiai? a?iin?? i?iiao??y oa
a?noieia?/iiai aeine?aeaeaiiy a?iioao?a. Nooue niiniao iieyaa? a
ianooiiiio. Oai??e i?iaiaeyoue iiia?aaei? o?ainaaa?iaeueia OCAe,
iio?i – AN c iaeii/aniei o?ainaaaeii?iaeueiei OCAe aeey aeai?o
iioeiaeueiiai i?noey a?iin??, cae?eniththoue caa?? oeaieie i?iiao??y
i?eno?i?i aeey a?noa?ineii?/ii? ioieoe?eii? aieeiai? a?iin?? i?iiao??y
i?ae eiio?ieai aeeaeie caio?aiiy ioieoe?eii? aieee a i?iiao??e ca
aeiiiiiaith OCAe, a?noieia?/ii aeine?aeaeothoue a?iioao, aenoaaeythoue
ae?aaiic AAI i?e iayaiino? aiaeiiao??i?aeieo aiaieu o a?iioao?.

A?noa?ineii?/iee iaeyae‚ iiia?aaei? o?ainaaa?iaeueia‚
iaeii/ania o?ainaaaeii?iaeueia OCAe aeathoue ciiao a?coae?coaaoe
ae?eyiee no?iie iaoee c iciaeaie o?aaeaiiy aiaeiiao??icii oa i?iaanoe
oe?eani?yiiaaiee aea?? iioeiaeueiiai i?noey a?iin??. I?iaaaeaiiy
iaeii/aniiai c a?iin??th o?ainaaaeii?iaeueiiai OCAe aea? ciiao aeyaeoe
iaiao?aeio aeeaeio caio?aiiy ioieoe?eii? aieee a i?iiao??e.
I?iaaaeaiiy aieeiai? a?iin?? caiaeeoue aei i?i?ioio ?oeioaaiiy aiaei-
oa i?iiao??y. Eiaaoeyoe?y i?noey a?iin?? ia i?ae /an caai?o
a?iioaoo, a i?ney eiai aeeo/aiiy aeeeth/a? eiaaoeyoe?eia iioeiaeaeaiiy
a?iioaoo, ui iie?ioo? ye?noue a?noieia?/ii? ae?aaiinoeee.

?acoeueoaoe aeanieo aeine?aeaeaiue. Ca iaoeie aeaieie, na?aaei?e a?e
i?iiia?iaaieo o ianyc? a?noa?aeoii?? oai?eo ia AAI neeaa 47,1±0,5 ?ie?a.

Neeaae ae?iie ianoaaeaieo a?oi o caeaaeiino? a?ae
nioe?aeueii-aeiiii?/iiai noaio a??ia?aeii ia a?ae??ciyany, aea o
oai?eo ia AAI i?aoey a 2,5 ?ace /ano?oa aoea iia’ycaia c i?ioan?eieie
oe?aeeeainoyie

Na?aaei?e a?e iaia?oa o ae?iie oai?eo ia AAI (13,7±0,1 ?ie?a), na?aaeiy
o?eaae?noue iaino?oaoe?e ( 5,5±0,2 aei?a), na?aaeiy o?eaae?noue
iaino?oaeueiiai oeeeeo (28,9 ± 0,2 aei?a) ia a?ae??ciyeenue a?ae oaeeo
na?aae caei?iaeo ae?iie ( a?aeiia?aeii – 13,2±0,2 ?ie?a, 5,0±0,2
aei?a, 28,4±0,3 aei?a‚ ? > 0‚05), ui a?aeiia?aea? aeaiei e?oa?aoo?e
[I.?.Eiiae?eeia‚ E.A.Aaeaiyi oa ?io?‚1997].

Na?aaeiy e?euee?noue iieia?a o oai?eo ia AAI neeaea 1,7±0,1, aai?o?a –
4,0 ± 0,4 ? a??ia?aeii ia a?ae??ciyeanue a?ae oaeeo na?aae caei?iaeo (
a?aeiia?aeii 2‚1±0‚1 ? 4,0 ± 0,5; ? > 0‚05). Aea o ae?iie c AAI a
aiaiiac? aoee ca?a?no?iaai? /ano?oa iaoieia?/i? iieiae iaeaea a 1,6
?ace, oneeaaeiaiiy ooo/ieo aai?o?a – a 2,4 ?ace, i?ae o a?oi?
caei?iaeo.

O?ii?/i? caiaeuei? caoai?thaaiiy iaoee aoei a?noieia?/ii
i?aeoaa?aeaeaii o 56,0% i?iiia?iaaieo iaoe??ioie c AAI.

Iaoieia?/i? iieiae, oneeaaeiai? aai?oe, o?ii?/i? caiaeaiiy aiaei- oa
i?iiao??y ooai?ththoue ni?eyoeea? oiiae aeey caio?aiiy AA a i?iiao??e
ca ?aooiie iae?i-aeeno?io?/ieo ci?i a cii? a?noia?ieia?/iiai aa?ue??a
[E.O.Oeiea?aaa oa ?io?‚ 1989] oa ii?ooaiue aeaniie?oe/ieo ?
aeaniiieanoe/ieo i?ioean?a o niieo/i?e oeaiei? aiaei- oa i?iiao??y
[A.I.O?ioei‚ 1987].

AAI /ano?oa cono??/aee o ae?iie c iayai?noth aeno?aaai?oaeueii?
iaoieia??, oaei? ye caoai?thaaiiy na?oeaai-noaeeiii? ?
iae?i-aaaaoaoeaii? nenoaie (64,5%). Noaoaa? ai?iiie aieeaathoue ia
iaoaaie?ci e?iii?ioa?i?a, i?yii ae?thoue ia aaciaeoeai? iaioeaee,
i?inoaaeaiaeeie, iai?ii? i?ioeane a niieo/i?e oeaiei?
[A.?.Eoeaeia‚1996]. O no?ieao a?oa??e ? i?iea?ae? aeyaeaii ?aoeaioi?e
aei noaoaaeo ai?iii?a [A.A.Ee?e/aiei oa ?io?‚1998]. O 79,8% oai?eo ia
AAI ie aeyaeee no?iiaeueiee oaeiiaoic o y?/ieeao. Ca aeaieie
a?noio?i?/ieo aeine?aeaeaiue ai?oae?i?aeiei ee?oeiai i?eoaiaiia aeniea
ooieoe?iiaeueia aeoeai?noue, o ia?oo /a?ao – aiae?iaaii?iaeoeooth/a
[I.O.Iaeueoeaaa oa ?io?‚ 1995]. A?ia?aiae?iaai?y aeeeeea?
?acenoaioi?noue aei ?inoe?io, noeioeth? nae?aoe?th aiaeioae?io ?
o?iiaienaio, iiaeaaey? ae?iaeaiiy i?inoaoeeee?io, i?eaiaeeoue aei
ii?ooaiiy aoa?iaaiiiai i?io?eth e?i?ae?a, o ca’ceo c /ei
i?aeaeuo?oueny ?ecee a?oa??aeueii? a?ia?oaic?? ? ?oai?/ii? oai?iae
na?oey [A.Vermeulen, J.Kaufman, 1998]. Oaeei /eiii‚ ai?iiiaeuei?
ii?ooaiiy i?e AAI ni?eythoue ?icaeoeo na?oeaai-noaeeiii? iaoieia??. O
naith /a?ao‚ na?aae /anoeie iaoe??ioie c na?oeaai-noaeeiiith
iaoieia??th ne?ae i/?eoaaoe iayai?noue ai?iiiaeueii caeaaeieo
caoai?thaaiue, o oiio /ene? AAI.

Ai?iiiaeuei? ii?ooaiiy a?athoue ?ieue aaaeeeaeo oaeoi??a,
ye? ni?eythoue aeieeiaiith oa ?icaeoeo AAI [I.N.Aeaeeaei‚ 1993;
A.I.No?eaeaeia‚ A.?.Aeaaeaeia ‚ 1995; E.?.?aaithoa‚ N.A.?aaithoa, 1997;
E.A.Aaeaiyi‚ 1998; I.I ?iaiaa.‚ 1998; ?.A.Eioaiaae/ oa ?io?‚ 1998; I.Ota
et alt., 1995]. Ia oea aeaco? iayai?noue ii?ooaiue iaino?oaeueiiai
oeeeeo o a?eueoi? iieiaeie ianoaaeaieo oai?eo o aeaeyae? aie?nieo,
?ynieo iaino?oaoe?e ? iacaieie aei oa i?ney iaino?oaeueii? e?iaioa/?,
o?eaaea noaiiaeaiiy iaino?oaeueiiai oeeeeo o 42,9% ae?iie, a oaeiae
aeyaeai? iniaeeaino? ii?oiooieoe?iiaeueii? aoaeiae AA, AA ?
y?/iee?a i?e AAI: aaoa?iaaii?noue ? iie?ii?o?ci aoaeiae ? iaoieia?/ieo
ci?i, a?noio?c?ieia?/ia iaa?aeiia?aei?noue ee?i?/iei oacai
iaino?oaeueiiai oeeeeo, iaa?aeiia?aei?noue ai?oae?aeueiiai ?
no?iiaeueiiai eiiiiiaio?a, ia/?oeee ?iciiae?e aai a?aenooi?noue
?iciiae?eo AA ia aacaeueiee ? ooieoe?iiaeueiee oa?e o a?eueoino?
oai?eo, iayai?noue o iieiaeie oai?eo, ui iaino?oththoue‚ aiiaoeyoe??
oa iaaeinoaoiino? ethoa?iiai? oace.

Oneeaaeiaiiy aea?aieia?/iiai aiaiiaco o 25,2% ae?iie c AAI oa
iayai?noue aea?a?/ieo i?iya o 3-4 ?ace /ano?oa, i?ae o caei?iaeo
ae?iie, iai?yiei /eiii i?aeoaa?aeaeothoue ?ieue ii?ooaiue ?ioiiiai
aiiainoaco o aeieeiaii? oa ?icaeoeo AAI. I?e iaoiii?oieia?/iiio
aeine?aeaeaii? AA iaie anoaiiaeaii, ui ee?oeiia ?io?eueo?aoe?y
no?iie ??ciiai nooiaiy ae?aaeaiino? ? neeaaeo aoea o 32,7% iaoe??ioie.
Na?aae ee?oei ee?oeiiiai ?io?eueo?aoo ia?aaaaeaee e?ioioeeoe. ?o
e?euee?noue cia/ii ciaiooaaeanue c i?ia?anoaaiiyi AAI. I?e
?iciianthaeaeaieo oi?iao AAI o no?ii? AA cono??/aeenue iiiaeeiie?
e?ioioeeoe. Io?eiai? aeai? na?ae/aoue ca i?ia?anoaaiiy caoai?thaaiiy a
oiiaao yaiiai cieaeaiiy ?ioiiiai eiio?ieth ca oe?e?ni?noth i?aaio. Oea
iieiaeaiiy ciaoiaeeoue aiaeia?th a ?yae? ?ia?o [E.ss.Noi?oi, 1983;
A.I.O?ioei‚ 1987].

Aiae?c n?iaeiiai aiaiiaco o ianoaaeaieo iaie ae?iie aeaco? ia
?ieue niaaeeiaino? a ?icaeoeo AAI, yeee /ano?oa ?icaeaa?oueny o
ae?iie, iaoa?? yeeo iaee ii?ooaiiy iaino?oaeueiiai oeeeeo ca oeiii
aie?nieo, ?ynieo iaino?oaoe?e (37,4%), a oaeiae i?iio iaoee (44,9%),
e?noe y?/iee?a.(32,7%).I?e aea/aii? ca’yceo i?ae a?oiith e?ia? oa
noeeuei?noth aei AAI aoei aeyaeaii, ui /anoioa cono??/a?iino? a?oie
e?ia? A (??) na?aae oai?eo ia AAI neeaaea? 58,9%, na?aae oai?eo ia
“/enoee” AAI – 61,7% oa na?aae oai?eo ia AAI o ii?aeiaii? c i?iiith
iaoee – 56,7%, a na?aae caei?iaeo ae?iie – 38,1% (?

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