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Комплексне лікування хелікобактер-пілорі залежних кривавлячих виразок шлунка і дванадцятипалої кишки: Автореф. дис… канд. мед. наук / Я.М. Кучірка,

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I?i?noa?noai ioi?iie caei?ia’y Oe?a?ie Oa?iii?euenueea aea?aeaaia
iaaee/ia aeaaeai?y ?i.?.ss.Ai?aa/aanueeiai

EO*??EA ss?INEAA IEOAEEIAE*

OAeE[616.33-002.44+616.33-005.1+616.342]:616-078

EIIIEAENIA E?EOAAIIss

OAE?EIAAEOA?-I?EI?? CAEAAEIEO E?EAAAEss*EO AE?ACIE OEOIEA ?
AeAAIAAeOessOEIAEI? EEOEE

14.01.03.-o??o?a?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe

Oa?iii?eue – 1999

Aeena?oaoe?y ? ?oeiien.

?iaioa aeeiiaia a ?aaii-O?aie?anuee?e aea?aeaai?e iaaee/i?e aeaaeai??
IIC Oe?a?ie.

Iaoeiaee ea??aiee : aeieoi? iaaee/ieo iaoe , i?ioani? Aii/a? Ieoaeei
A?eai?iae/ ,

?aaii-O?aie?anueea aea?aeaaia iaaee/ia aeaaeai?y, caa?aeoaa/ eaoaae?e
o??o?a?? noiiaooaeoeueoaoo c eo?nii o?ieia??.

Io?oe?ei? iiiiaioe : aeieoi? iaaee/ieo iaoe , Ai?iaee ?aaai Iaeneiiae/,
Oa?iii?euenueea aea?aeaaia iaaee/ia aeaaeai?y ?i.?.ss.Ai?aa/aanueeiai,
i?ioani? eaoaae?e iaaeeoeeie iaa?aeeeaaeieo noai?a;

aeieoi? iaaee/ieo iaoe , i?ioani? I?eueeia Ai?en Ieaaiae/, Aoeiaeinueea
aea?aeaaia iaaee/ia

aeaaeai?y , i?ioani? eaoaae?e oaeoeueoaonueei? o??o?a??.

I?ia?aeia onoaiiaa: ?inoeooo ee?i?/ii? ? aenia?eiaioaeueii? o??o?a?? AII
Oe?a?ie , i. Ee?a.

Caoeno aeena?oaoe?? a?aeaoaeaoueny “18”eenoiiaaea 1999 ?ieo i1600aiaeei?
ia

can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee E.58.601.01. o Oa?iii?euenuee?e
aea?aeaai?e iaaee/i?e aeaaeai?? ?i.?.ss.Ai?aa/aanueeiai (46001
,i.Oa?iii?eue , Iaeaeai Aie?, 1).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Oa?iii?euenueei?
aea?aeaaii? iaaee/ii? aeaaeai?? ?i.?.ss.Ai?aa/aanueeiai (46001
I.Oa?iii?eue , aoe. ?onueea , 12).

Aaoi?aoa?ao ?ic?neaiee “18”aeiaoiy 1999 ?.

I.I. E?o

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee E58.601.01,

eaiaeeaeao iaaee/ieo iaoe , i?ioani?

Caaaeueia oa?aeoa?enoeea ?iaioe

Aeooaeuei?noue oaie. Ae?aceiaith oai?iaith oeoiea ?
aeaaiaaeoeyoeiaei? eeoee no?aaeaea? 5-10% aei?ineiai ianaeaiiy
(?.I.Iaeei, A.?.Iaeei oa ?i., 1996; E.ss.Eiaaeue/oe oa ?i.,1997;
I.Ae.Aaneethe oa ?i., 1998; G.Battaglia et al.,1992). Iacaaaeath/e ia
aaeeea iaaeeei-nioe?aeueia cia/aiiy oe??? iaaeoae, aaaaoi i?eioeeiiaeo
ieoaiue ao?ieia??, iaoiaaiaco, ee?i?ee oa e?eoaaiiy ?? caeeoathoueny
noia?a/eeaeie oa aei e?ioey ia c’yniaaieie (A.I.Iaeauoe oa ?i.,1995;
A.A.Oa?aaa?tho e ae?.,1997, I.A.O?eueoe oa ?i.,1998; M.Z.Panos et
al.,1993). Iaei a?aeii? i?e/eie ? oaeoi?e, ye? coiiaeththoue ?icaeoie ??
oneeaaeiaiue. Na?aae ieo iniiaia i?noea caeia? e?iaioa/a, yea
niinoa??aa?oueny o 13,7% – 42,3% oai?eo (I.ss.A?eai?ueaa e ae?.,1996;
A.A.Oaeeiia,1997; ?.I.Ai?iaee oa ?i.,1997; ?.ss.Aecthaaiianueeee oa ?i.,
1998; ?.A.Turner et al.,1991). Oea niiioea? ia iiooee iiaeo aniaeo?a
ao?iiaoiaaiaco, a?eueo aoaeoeaieo iaoiae?a ?o e?eoaaiiy oa i?io?eaeoeee
ye ae?aceiai? oai?iae a oe?eiio, oae ? ?? aaii?aa?/ieo oneeaaeiaiue.

Iaeiei c iaea?eueo aaaiieo aeinyaiaiue aano?iaioa?ieia?? a inoaii? ?iee
? oa, ui i?e/eiith ae?aceiai? oai?iae oeoiea ? aeaaiaaeoeyoeiaei? eeoee
iiaea aooe i?e?iaiee oaeoi?, oae caaiee Helicobacter pylori /H.pylori/
(A.O.Na?iei e ae?.,1996; I.?.Aieioei oa ?i.,1997; ?.I. Noa?iaeoa e
ae?.,1998; A.O.Aoii, 1993; M.I.G.Fartbing,1998). Aeine?aeaeaiiy aeayeeo
a/aieo (I.A.Aii/a? oa ?i., 1996,1997; ?.I.Eaoa?ei/oe,1996;
A.A.Ia?aaea?ee e ae?.,1997) aeicaieeee aeyaeyoe I. pylori o oai?eo
ae?aceiaith oai?iaith aeaaiaaeoeyoeiaei? eeoee iaeaea o 100% aeiaaee?a,
ui aeaei i?aenoaao na?aae i?e/ei aeieeiaiiy oa ?icaeoeo oeueiai
caoai?thaaiiy oa ie?aieo eiai oneeaaeiaiue, a?aoiaoaaoe ? H.pylori.

Ieoaiiy o??o?a?/ii? oaeoeee oa e?eoaaiiy aano?iaeoiaeaiaeueieo e?iaioa/
ae?aceiaiai aaiaco caeeoa?oueny iaeiei c iaea?eueo aeooaeueieo o
iaa?aeeeaaei?e o??o?a?? i?aai?a /a?aaii? ii?iaeieie. Ca inoaii? ?iee
aeinyaioo? cia/i? oni?oe o e?eoaaii? e?eaaaey/eo ae?acie oeoiea ?
aeaaiaaeoeyoeiaei? eeoee (A.Ae.A?aoonue e ae?., 1991,1997; A.O.Caeoeaa
oa ?i., 1994; A.E.Iai/e/ e ae?., 1997; I.A.Oaa/oe oa ?i., 1998;
I.I.Aaeeaioeeee e ae?., 1999; R.Bumm et al., 1989). Iaeiae ieoaiiy
oaeoeee, iieac?a aei iia?aoeaiiai /e eiina?aaoeaiiai e?eoaaiiy
caeeoathoueny aeeneooaaaeueieie oa aei e?ioey ia ae??oaieie. Ia aeoieo
ie?aieo aaoi??a (A.I.Oioiey e ae?., 1988; A.A.Oa?aaa?tho e ae?., 1994;
I.A.Aii/a? oa ?i., 1998; M.Trybo et al., 1992;! F.Bretagne,1995),
o??o?a?/io oaeoeeo i?e ae?aceiaeo aano?iaeoaaeaeueieo e?iaioa/ao ia
aeioe?eueii aoaeoaaoe ia i?eioeeiao iaaei??iiai caoiieaiiy o??o?a?/iith
aeoeai?noth. Oiio aeooaeueieie caeeoathoueny ieoaiiy eiina?aaoeaii?
oa?ai?? ae?aceiaeo e?iaioa/ (I.ss.Aaaae, A.Ae.Oaaea?iei, 1996) a
aino?iio ia??iae? c ianooiiei ieaiiaei iia?aoeaiei icaei?iaeaiiyi.

A?aoiaoth/e iiyao ua iaeiiai oaeoi?a /I.?o?ia?/, yeee aieeaa? ia
aeieeiaiiy oa ia?aa?a ae?aceiai? oai?iae oeoiea ? aeaaiaaeoeyoeiaei?
eeoee, a?aee?eaathoueny iia? ia?niaeoeai? iai?yiee iiooeo i?e/ei
?icaeoeo ?? aaii?aa?/ieo oneeaaeiaiue. Oea niiioea? aei a?eueo aeeaieiai
aea/aiiy oe??? “a?ei? ieyie” a aano?iaioa?ieia?? c iine?aeoth/ei
ae?iaeaiiyi aaeaeaaoiiai eiiieaeniiai e?eoaaiiy aeacaiiai a??ciiai
oneeaaeiaiiy ae?aceiai? oai?iae, anioe?eiaaii? I?-?ioaeoe??th.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?eia
?iaioa aeeiiaia a ?aieao iaoeiai? oaiaoeee aeaaeai?/ii? a?oie aeaaeai?ea
AII Oe?a?ie ?.I. Iaeea oa ca?aeii c ieaiaie iaoeiai-aeine?aeieoeueeeo
?ia?o ?aaii-O?aie?anueei? aea?aeaaii? iaaee/ii? aeaaeai?? “?ic?iaea
iiaeo iaaee/ieo oaoiieia?e oa noaiaea?o?a yeino? ae?aaiinoeee,
i?io?eaeoeee ? e?eoaaiiy ia?ioaeoe?eieo oa ?ioaeoe?eieo caoai?thaaiue”
(? aea?aeaaii? ?a?no?aoe?? 01.02.032.96n).

Iaoa aeine?aeaeaiiy. Aea/eoe iniaeeaino? ee?i?ei – a?io?i?/ieo oa
ooieoe?iiaeueii – ii?oieia?/ieo ci?i neeciai? iaieiiee oeoiea ?
aeaaiaaeoeyoeiaei? eeoee o aca?iica’yceo c ?io?eoaaiiyi I.?o?ia? oa
iaa?oiooaaoe aea?? iaoiaeo e?eoaaiiy I.?o?ia? -caeaaeieo e?eaaaey/eo
ae?acie oeoiea ? aeaaiaaeoeyoeiaei? eeoee.

Caaaeaiiy aeine?aeaeaiiy:

1. Aecia/eoe iniaeeaino? ?io?eoaaiiy I.?o?ia? neeciai? iaieiiee oeoiea ?
aeaaiaaeoeyoeiaei? eeoee o oai?eo c oeoieiai-eeoeiaeie e?iaioa/aie
ae?aceiaiai aaiaco.

2. Iieacaoe aca?iicaeaaei?noue nooiaith can?thaaiiy I.?o?ia? neeciai?
iaieiiee oeoiea a?ae nooiaith e?iaiao?aoe.

3. C’ynoaaoe noai ie?aieo oaeoi??a cai?oaeueii? nenoaie e?ia?, ??
?aieia?/i? aeanoeaino?, ai?no na/iaeie oa a?eeo e?ia? a caeaaeiino? a?ae
nooiaith e?iaiao?aoe oa iayaiino? I.?olir?.

4. Anoaiiaeoe iniaeeaino? nae?aoi?ii? ooieoe?? oeoiea a caeaaeiino? a?ae
nooiaith e?iaiao?aoe oa nooiaith ian?thaaiiy I.?o?ia? .

5. Aea/eoe oa?aeoa? a?noino?oeoo?e a?iin?eiiai oa iia?aoe?eiiai
iaoa??ae?a no?iee oeoiea o oai?eo c aano?iaeoiaeaiaeueieie e?iaioa/aie
ae?aceiaiai aaiaco, anioe?eiaaieo I.?o?ia? -?ioaeoe??th.

6. ?ic?iaeoe oa iaa?oiooaaoe e?eoaaeueio oaeoeeo e?eaaaey/eo ae?acie
oeoiea ? aeaaiaaeoeyoeiaei? eeoee a caeaaeiino? a?ae nooiaith
e?iaiao?aoe oa nooiaith ian?thaaiiy neeciai? iaieiiee oeoiea I.?olir?
-?ioaeoe??th.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a.

A ?iaio? aia?oa anoaiiaeaia iayai?noue I.?o?ia? i?e aaii?aa?/ieo
oneeaaeiaiiyo ae?aceiai? oai?iae a caeaaeiino? a?ae eieae?caoe??
ae?aceiaiai i?ioeano ? aaaeeino? e?iaiao?aoe. Aia?oa aea/aii iniaeeaino?
aieeao I.?o?ia? -?ioaeoe?? ia ?aieia?/i? aeanoeaino? e?ia? oa
i?e?ioee?eoeyoi?ia ?onei oeoiea, nae?aoi?io caeaoi?noue eiai caeic oa
ii?oino?oeoo?i? ci?ie neeciai? iaieiiee o oai?eo c ae?aceiaeie
e?iaioa/aie. Iaoeiai iaa?oioiaaii ? aeiaaaeaii aoaeoeai?noue ?
aeioe?euei?noue canoinoaaiiy aioeaaeoa??aeueieo na?aaeiee?a, iai?aaeaieo
ia cieuaiiy I.?o?ia? i?e e?eaaaey/eo ae?aceao oeoiea ?
aeaaiaaeoeyoeiaei? eeoee. Aeiiiaiaii iieace aei eiina?aaoeaiiai oa
iia?aoeaiiai e?eoaaiiy aano?iaeoiaeaiaeueieo e?iaioa/ ae?aceiaiai
aaiaco, a caeaaeiino? a?ae nooiaith e?iaiao?aoe oa nooiaith ian?thaaiiy
neeciai? iaieiiee oeoiea I.?o?ia?.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Aeiaaaeaia
aeioe?euei?noue aecia/aiiy iayaiino? I.?o?ia? ia neecia?e iaieiioe?
aio?aeueiiai a?aeae?eo oeoiea o oai?eo c aaii?aa?/ieie oneeaaeiaiiyie
ae?aceiai? oai?iae. Iiaeeo?eiaaia oa oaeineiiaeaia eeaneo?eaoe?y
nooiaith ian?thaaiiy I.?o?ia? neeciai? iaieiiee oeoiea c i?eaaaeaiiyi
aei 4 nooiai?a e?iaiao?aoe i?e e?eaaaey/eo ae?aceao oeoiea ?
aeaaiaaeoeyoeiaei? eeoee. Anoaiiaeaii i?e/eiiee ca’ycie iayaiino? oa
nooiaith ae?aaeaiino? oae?eiaaeoa??ico aio?aeueiiai a?aeae?eo oeoiea o
?icaeoeo ?aoeeaeea?a aaii?aa?/ieo oneeaaeiaiue ae?aceiai? oai?iae.
C’yniaaia iniaeea?noue oa ae?aaeai?noue ii?ooaiue ?aieia?/ieo
aeanoeainoae e?ia? oa nae?aoi?ii? ooieoe?? oeoiea a caeaaeiino? a?ae
nooiaith e?iaiao?aoe oa iayaiino? I.?o?ia? -?ioaeoe??. ?ic?iaeaii
eiiieaen eiina?aaoeaii? aioeoae?eiaaeoa?ii? oa?ai?? I.?o?ia?
-caeaaeieo aano?iaeoiaeaiaeueieo e?iaioa/ ae?aceiaiai aaiaco a
caeaaeiino? a?ae nooiaith can?iai?iiy I.?o?ia? . Aeiiiaiaii iieace aei
iia?aoeaiiai e?eoaaiiy oai?eo c I.?o?ia? -caeaaeieie e?eaaaey/eie
ae?aceaie oeoiea ? aeaaiaaeoeyoeiaei? eeoee – IV nooi?iue ian?thaaiiy
I.?o?ia? . C o?aooaaiiyi ae?iaeaii? oa canoiniaaii? oaeoeee e?eoaaiiy
oai?eo aeaii? iaoieia??, caaaeueia oa i?neyiia?aoe?eia eaoaeuei?noue
cieaeaia a?aeiia?aeii aei 2,17% oa 6,25%.

Io?eiai? ?acoeueoaoe ai?iaaaeaeai? a oa?aiaaoe/iiio oa o??o?a?/iiio
a?aeae?eaiiyo OeEE I.?aaii-O?aie?anueea, iaeanii? ee?i?/ii? e?ea?i?,
o??o?a?/ieo a?aeae?eaiiyo oeaio?aeueieo ?aeiiieo e?ea?aiue. Aiie
aeei?enoiaothoueny a iaaeaaia?/iiio i?ioean? ia eaoaae?ao
?aaii-O?aie?anueei? iaaee/ii? aeaaeai??.

Iniaenoee aianie caeiaoaa/a. Caeiaoaa/ai cae?eniaii ?ic?iaeo iniiaieo
oai?aoe/ieo oa i?aeoe/ieo iieiaeaiue ?iaioe. Aaoi? iaieiae?a no/anieie
iaoiaeaie aeyaeaiiy I?-?ioaeoe??, aecia/aiiy noaio o?aineai?ey?iiai
iai?io, aa?aaaoe?? o?iiaioeeo?a, nae?aoi?ii? ooieoe?? oeoea. Naiino?eii
i?ia?a e?oa?aoo?iee iaeyae c oe??? i?iaeaie. I?ecia/aa e?eoaaiiy,
i?iaiaeea ae?aaiinoe/i? ianoaaeaiiy 163 oaiaoe/iei oa 27 eiio?ieueiei
oai?ei . I?ia?a 17 iia?aoeaieo ao?o/aiue, a yeino? ia?oiai anenoaioa-12.
Aeaioiaeaiiy oa ?ioa?i?aoaoe?th ?acoeueoao?a a?noieia?/iiai oa
aeaeo?iiii-i?e?ineii?/iiai aeine?aeaeaiiy iaoa??aeo i?iaiaeea ia
eaoaae?? a?noieia?? oa aia??ieia?? (caa.eaoaae?e – ae.i.i.,
i?io.Ae?eueoeiaa 0.1.) oa ia eaoaae?? iaoieia?/ii? aiaoii??
(caa.eaoaae?e -ae.i.i.,i?io. Ieoaeethe 1.0.), a oaeiae noi?nii c
aeioeaioii eaoaae?e iaoieia?/ii? aiaoii?? e.i.i. N.A. Aa?auaiei
?aaii-O?aie?anueei? aea?aeaaii? iaaee/ii? aeaaeai??.

Aaoi? naiino?eii i?ia?a nenoaiaoecaoe?th oa aiae?c io?eiaieo
?acoeueoao?a, ii??aiya ?o c aeaieie a?o/eciyieo oa ca?oa?aeieo
aeine?aeiee?a, noi?ioethaaa aeniiaee oa i?aeoe/i? ?aeiiaiaeaoe??.
Ai?iaaaeea ?ic?iaeai? iaoiaeeee a i?aeoeeo.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Aeena?oaoe?y i?ieoea ai?iaaoe?th
ia ni?eueiiio can?aeaii? iaoeiai? eii?n?? oa o??o?a?/ieo eaoaae?
iaaee/ii? aeaaeai?? (?aaii-O?aie?anuee, 1998). Iniiai? oai?aoe/i? oa
i?aeoe/i? iieiaeaiiy aeena?oaoe?? aeiiia?aeaeeny ia I?aeia?iaeiiio
eiia?an? iieiaeeo a/aieo-oe?a?ioe?a (?aaii-O?aie?anuee, 1995),
can?aeaiiyo iaeaniiai iaoeiaiai oiaa?enoaa o 1995, 1996, 1997, 1998
?ieao, a iaoa??aeao iaoeiai-i?aeoe/ii? eiioa?aioe?? aiaeineii?no?a
Oe?a?ie “Aeooaeuei? i?iaeaie ae?aaiinoe/ii? oa e?eoaaeueii?
aiaeineii??”” ( Ee?a, 1996 ), iaoa??aeao 1-i? oa 2-i? tha?eaeii?
iaa/aeueii-iaoiaee/ii? oa iaoeiai? eiioa?aioe?e caa?aeoaa/?a eaoaae?
o??o?a?/ieo oai?ia noiiaooaeoeueoao?a iaaee/ieo aoc?a Oe?a?ie (Iieoaaa,
1997, 1998), ca??ieeo iaoeiaeo i?aoeue, i?enay/aiiai 75-??//th eaoaae?e
o??o?a?? EIA i?neyaeeieiiii? ina?oe IIC Oe?a?ie (Ee?a 1997), iaoa??aeao
oe?a?inueei? iaoeiai? eiioa?aioe?? c i?aeia?iaeiith o/anoth
“I?e?ioee?eoeyoe?y oa ?? a?eia? ci?ie” (Ee?a, 19-21 o?aaiy 1999 ?ieo),
iaoa??aeao Anaoe?a?inueei? iaoeiai? eiioa?aioe?? o??o?a?a “I?iaeaie
?ioiieia?? a o??o?a??” (?aaii-O?aie?anuee 22-24 aa?aniy 1999 ?ieo).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 12 iaoeiaeo
i?aoeue: 5 iaoeiaeo, noaooae o oaoiaeo iaoeiaeo aeaeaiiyo (1 – a
?iicaiiiio (?in?y)); 2 – o ca??ieeao iaoeiaeo i?aoeue; 4 – o iaoa??aeao
? 1 – o oacao iaoeiaeo eiioa?aioe?e, eiia?an?a. Iiaeaii cayaeo ia
aeiao?ae. Io?eiaii iina?ae/aiiy ia 1 ?aoe?iiae?caoi?nueeo i?iiiceoe?th.

Ianya ? no?oeoo?a aeena?oaoe??. Iaoa??aee aeena?oaoe?? aeeeaaeai? ia 175
noi??ieao iaoeiiieniiai oaenoo. Aeena?oaoe?y neeaaea?oueny c anooio,
iaeyaeo e?oa?aoo?e, iaoa??ae?a oa iaoiae?a aeine?aeaeaiiy, ?acoeueoao?a
aeanieo aeine?aeaeaiue, aiae?co oa ocaaaeueiaiiy ?acoeueoao?a
aeine?aeaeaiiy, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e. ?iaioa
?ethno?iaaia 26 oaaeeoeyie ? 28 ?enoieaie. O nieneo e?oa?aoo?e 345
aeaea?ae, c yeeo 190 ?iicaiieo.

Ci?no ?iaioe.

Iaoa??ae oa iaoiaee aeine?aeaeaiue. A iniiao
ee?i?ei-eaai?aoi?ii-?ino?oiaioaeueiiai aeine?aeaeaiiy iieeaaeaii aiae?c
?acoeueoao?a ianoaaeaiiy 189 oai?eo ia ae?aceiao oai?iao, oneeaaeiaio
e?iaioa/ath c ??ciei nooiaiai e?iaiao?aoe oa 39 iaoe??io?a c ae?aceiaith
oai?iaith aac oneeaaeiaiue (eiio?ieue). Aeey aeai?o aaeaeaaoii?
e?eoaaeueii? oaeoeee oa aeinoia??iino? ?acoeueoao?a aeine?aeaeaiiy
ei?enooaaeeny 4 nooiaiaaith nenoaiith aaaeeino? e?iaiao?aoe oa
iiaeeo?eiaaiith iaie (?aoe?iiae?caoi?nueea i?iiiceoe?y ?20 (2390 a?ae
21.04.1996 p.) 4-nooiaiaaith nenoaiith ioe?iee ian?thaaiiy neeciai?
iaieiiee oeoiea oae?iaaeoa??yie.

On? oai?? aoee iiae?eai? ia ee?i?/i? a?oie : ?- c e?iaiao?aoith ?
nooiaith; 2- II nooiaith; C- III nooiaith; 4-IV nooiaith; 5-oai?? c
??ciei nooiaiai e?iaiao?aoe, yeei i?iaiaeeeiny iia?aoeaia ao?o/aiiy.
Na?aae ianoaaeoaaieo iaoe??io?a aoee : c ae?aceith oeoiea – 54 /ie., c
ae?aceith aeaaiaaeoeyoeiaei? eeoee – 135 /ie. A?e iaoe??io?a eieeaaany
a?ae 17 aei 84 ?ie?a. C ieo : ae?iie – 68, /ieia?e?a – 160.

Iaoa??aeii aeine?aeaeaiiy neoaeeee a?iioaoe neeciai? iaieiiee oeoiea ?
aeaaiaaeoeyoeiaei? eeoee, ia?eoa??eia e?ia, oeoieiaiee n?e oa
iia?aoe?eiee iaoa??ae ianoaaeoaaieo i?aai?a. Aiae?c iniiaieo ee?i?/ieo
iieaciee?a i?iaiaeeany i?e iinooieaii?, a i?ioean? e?eoaaiiy ( 4-5 aeiaa
) oa a e?ioe? eo?no eiina?aaoeaiiai /e iia?aoeaiiai e?eoaaiiy (12-15
aeiaa). ?iaioa i?iaiaeeeanue ia aac? o??o?a?/iiai oa oa?aiaaoe/iiai
a?aeae?eaiue OeIEE i. ?aaii-O?aie?anueea.

A ?iaio? aoa canoiniaaiee eiiieaeniee i?aeo?ae c a?eueo aeaoaeueiei
aeine?aeaeaiiyi i?e?iaiiai oaeoi?o (I.?o?ia?). I?e oeueiio
aeei?enoiaoaaeeny no/ani? iaoiaee ? iaoiaeeee aeine?aeaeaiiy oai?eo c
aeaiith iaoieia??th:

1) ee?i?/i? niinoa?aaeaiiy oa aeine?aeaeaiiy e?ia? i?iaiaeeeenue ca
caaaeueiii?eeiyoeie iaoiaeeeaie;

2) aecia/aiiy a?io?ce/ieo aeanoeainoae e?ia?: o?aineai?ey?iee iai?i
aea/aee ca iaoiaeii A.I. Eacia/a?aa oa A.A. Aec?c?inueeiai (1975);

aa?aaaoe?th o?iiaioeeo?a aecia/aee ia OAE-56 ca iaoiaeii A.?. Ai?ia a
iiaeeo?eaoe?? A.A. Caoa??y oa I.A.E?iao (1986);

3) nae?aoi?io ooieoe?th oeoiea aeine?aeaeoaaee iaoiaeii o?aeoe?eiiai
ciiaeoaaiiy c ianooiiei oeo?oaaiiyi oeoieiaiai nieo;

4) acioaaiaano?iaeoiaeaiineii?th aeeiioaaee i?e iinooieaii? oai?eo oa a
??ci? oa?i?ie e?eoaaiiy o noaoe?iia?? (eiio?ieuei? aeine?aeaeaiiy). I?e
oeueiio i?iaiaeeee caa?? a?iin?eiiai iaoa??aeo neeciai? iaieiiee c
iaoith aeyaeaiiy I.?o?ia? iaoiaeii iinoaiiaee a?io?i?/ii? ?aaeoe?? ia
o?aaco ca aeiiiiiaith noaiaea?oieo CLO-oano?a oa i?e?ineii?? iace?a aeey
aecia/aiiy iayaiino? oa nooiaith ian?thaaiiy I.?o?ia?;

5) ii?oieia?/ia aeine?aeaeaiiy a?iin?eiiai oa iia?aoe?eiiai iaoa??ae?a
i?iaiaeeee i?ney caaa?aeaiiy aaiaoienee?i – oa aco?- aiceiii oa
aeaeo?iiii-i?e?ineii?/iiai aeine?aeaeaiiy, i?ney caio?aiiy oiaoi/ea
oeaieie (1o1 ii) o 2 % ?ic/ei /ioe?ueioieeno ini?th ? caeeth/aiiy a
noi?o aiiio c a?aeae?oii i?e ca?eueoaii? o 8-17 oeny/ ?ac;

6) noaoenoe/io ia?iaeo iaea?aeaieo aeaieo i?iaiaeeee caaaeueiii?eeiyoeie

iaoiaeaie, ioe?ithth/e a??ia?aei?noue ia ??ai? cia/eiino? ia iaioa 95 %

(?

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