4

I?I?NOA?NOAI IOI?IIE CAeI?IA`ss OE?A?IE

EE?ANUeEA IAAeE*IA AEAAeAI?ss I?NEssAeEIEIIII? INA?OE

?i. I.E.Ooieea

Oa?eaoeueeee Aieiaeeie? Ieeieaeiae/

OAeE 616.37-002.2-089.168

E?EOAAIIss IAE?IOE*IIAI IAIE?AAOEOO

C CANOINOAAIIssI A?AeE?EOIAI NIINIAO IIA?AOe?? – AeEIAI?*II?
IIAIOIIAIE?AAOINOII??

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 Oe?a?inueeiio iaoeiai-i?aeoe/iiio oeaio?? aeno?aii?
iaaee/ii? aeiiiiiae oa iaaeeoeeie eaoano?io IIC Oe?a?ie oa Ee?anuee?e
i?nuee?e ee?i?/i?e e?ea?i? oaeaeei? iaaee/ii? aeiiiiiae

IAOEIAEE EA??AIEE: aeieoi? iaaee/ieo iaoe

Aeiiainueeee Ai?en Anaaieiaeiae/,

aieiaiee iaoeiaee ni?a?ia?oiee Oe?a?inueeiai iaoeiai-i?aeoe/iiai oeaio?o
aeno?aii? iaaee/ii? aeiiiiiae oa iaaeeoeeie eaoano?io IIC Oe?a?ie

IO?Oe?EI? IIIIAIOE: aeieoi? iaaee/ieo iaoe, i?ioani?

Oiiaooe ?aai I?ieiiiae/,

aieiaiee o??o?a E?eoaaeueii-icaei?ia/iai ia‘?aeiaiiy i?e Eaa?iao?
I?i?no??a Oe?a?ie;

aeieoi? iaaee/ieo iaoe, i?ioani?

Ooo/aiei Ieeiea ?aaiiae/,

caa?aeoaa/ eaoaae?e o??o?a?? noiiaoieia?/iiai oaeoeueoaoo
Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo ?i. I.I.Aiaiiieueoey IIC Oe?a?ie

I?IA?AeIA ONOAIIAA:

?inoeooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie (a?aeae?e
o??o?a?? i?aeoeoieiai? caeice ? ?aeiino?oeoeaii? o??o?a?? aeia/ieo
oeyo?a)

Caoeno a?aeaoaeaoueny “11”aeiaoiy 1999 ?ieo i 11 aiaeei? ia can?aeaii?
niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.613.02 i?e Ee?anuee?e iaaee/i?e
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea IIC Oe?a?ie (254112, i.
Ee?a, aoe. Aei?iaiaeeoeueea, 9).

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E. Ooieea (254112, i. Ee?a,
aoe. Aei?iaiaeeoeueea, 9).

Aaoi?aoa?ao ?ic?neaii “10”aa?aniy 1999 ?ieo.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee

eaiaeeaeao iaaee/ieo iaoe, aeioeaio
Aaicaeye I.I.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. I?iaeaia ae?aaiinoeee oa e?eoaaiiy iae?ioe/iiai
iaie?aaoeoo (II), caeeoa?oueny iaei??th c iaea?eueo neeaaeieo ?
aeeneon?eieo a aaaeii?iaeuei?e o??o?a?? (Oaeeiia A.A. e niaao., 1998;
Oaeeiia N.A. e niaao, 1990; Caineia A.N. e niaao., 1998; Naaaeueaa A.N.,
Eoauoeei A.A., 1993; Oeeei A.E., Einoth/aiei A.E., 1994; Beger H.G. et
al., 1995; Cruickhank A.H., 1995; Gebhardt Ch., 1994; Niederau C. et
al., 1995).

Ca aeaieie noaoenoeee /anoioa iae?ioe/iiai iaie?aaoeoo, iniaeeai na?aae
in?a i?aoeacaeaoiiai a?eo, iino?eii ca?eueoo?oueny. I?e i?ia?anoth/eo
oi?iao caoai?thaaiiy eaoaeuei?noue, ye ? ?ai?oa, aeniea ? nyaa? 70-80%,
a i?e aeeneaae/ieo – iaa?oue 100% (Aii/a? I.A. ? ni?aaao., 1998;
Eieiaeia N.A., 1992; Eiaiaea N.A., 1990; Oaeeiia A.A. e niaao., 1994;
Fugger R. et al., 1995; Mithofer et al., 1996). Iaoe??ioe, ui aeaeeee,
ia??aeei iathoue oneeaaeiaiiy, ye? iaoiiaeththoue ?iaae?aei?noue (A?aoia
A.E. e niaao., 1991; Naaaeueaa A.N. e niaao., 1993; Oaeeiia N.A. e
niaao., 1990), ui a oe?eiio iaaaoeaii a?aeaeaa?oueny ia
iaaeeei-aeaiia?ao?/i?e neooaoe??.

Ia nueiaiaei?oi?e aeaiue ye a iao?e e?a?i?, oae ? ca ei?aeiiii, ua ia
?nio? ?aeeii? aeieo?eie o??o?a?/iiai e?eoaaiiy oyaeeeo oi?i aino?iai
aeano?oeoeaiiai iaie?aaoeoo. Iaaeinoaoiy aoaeoeai?noue ?nioth/eo
iaoiae?a e?eoaaiiy a?ae?iaeeea ?ioa?an aei aeaaii a?aeiii? iia?aoe??
ia?noi?ae?caoe??, yea aeicaiey? i?iaiaeeoe e?eoaaiiy ai?eiiai aiaieua
a?aee?eoei niiniaii – iaoiaeii “a?aee?eoiai aeeaioa”. Aei oaia??oiueiai
/ano niaoe?ae?noaie iaaooi aeinoaoiuei iiceoeaiiai aeina?aeo
o??o?a?/iiai e?eoaaiiy a?aee?eoei iaoiaeii oyaeeeo oi?i iaie?aiiae?ico.
Iaeiae i?aaeiaoii aeey aeeneon?? caeeoa?oueny aea?? iieacaiue oa
oa?i?i?a aeeiiaiiy o??o?a?/ieo ao?o/aiue, ianya ? oaoi?/i? i?eeiie
iia?aoe?e, a oaeiae iecea ieoaiue eiina?aaoeaiiai i?neyiia?aoe?eiiai
e?eoaaiiy (Caineia A.N. e niaao., 1998; Eaaiia A.I., 1998; Eoiaeueoeaa
E.A., 1998; ?aaeceoianeee A.I. e niaao., 1998; Oaeeiia A.A. e niaao.,
1997, 1998; Oaa/oe ?.I., 1998), aeeth/ath/e, cie?aia, niiniae
?ioiiei?aeoe??.

Ca?eueoaiiy /anoioe, iacaaeia?euei? ?acoeueoaoe e?eoaaiiy oyaeeeo oi?i
II, aeniea eaoaeuei?noue oa ?iaae?aeecaoe?y oai?eo oe??th iaoieia??th
aecia/athoue aeooaeuei?noue oa iaiao?aei?noue i?iaaaeaiiy
aeine?aeaeaiue, ni?yiiaaieo ia iioei?caoe?th o??o?a?/iiai ?
eiina?aaoeaiiai e?eoaaiiy oeueiai caoai?thaaiiy.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?eia
?iaioa aeeiiaia ia aac? ee?i?ee iaa?aeeeaaeii? o??o?a?? Ee?anueei?
i?nueei? ee?i?/ii? e?ea?i? oaeaeei? iaaee/ii? aeiiiiiae ca ieaiii IAe?
Oe?a?inueeiai iaoeiai-i?aeoe/iiai oeaio?o aeno?aii? iaaee/ii? aeiiiiiae
oa iaaeeoeeie eaoano?io IIC Oe?a?ie ? ? /anoeiith IAe? 0195 V027858
“Iniaeeaino? ae?aaiinoeee oa o??o?a?/iiai e?eoaaiiy niieo/aieo
iioeiaeaeaiue i?aai?a a?oaeii? ee?oee ? /a?aaii? ii?iaeieie ie?iiai
/ano”.

Iaoa ? caaea/? aeine?aeaeaiiy. Iaoith ?iaioe aoei iie?ioaiiy
?acoeueoao?a o??o?a?/iiai e?eoaaiiy oai?eo oyaeeeie oi?iaie II oeyoii
aeei?enoaiiy iiaeeo?eiaaiiai “a?aee?eoiai” niiniao o??o?a?/iiai
ao?o/aiiy – aeeiai?/ii? iiaioiiaie?aaoinoii?? (AeIIN) a ii?aeiaii? c
iiaeie oaeoe/ieie caoiaeaie eiina?aaoeaii? iaaeeeaiaioicii? oa
iaiaaeeeaiaioicii? oa?ai??.

Aeey aeinyaiaiiy aeacaii? iaoe aoee iinoaaeai? oae? caaea/?:

1. Aecia/eoe nooi?iue oyaeeino? ia?aa?ao II ia i?aenoaa? i?iaaaeaiiy
eiiieaeno ee?i?ei-ii?oieia?/ieo oa eaai?aoi?ii-?ino?oiaioaeueieo
ianoaaeaiue oai?eo.

2. Oaeineiiaeeoe iaoiae “a?aee?eoiai” o??o?a?/iiai e?eoaaiiy oai?eo ia
iae?ioe/iee iaie?aaoeo – aeeiai?/ii? iiaioiiaie?aaoinoii?? (AeIIN).

3. Ii??aiyoe aoaeoeai?noue AeIIN a iao?e iiaeeo?eaoe?? ? “cae?eoiai”
niiniao o??o?a?/iiai e?eoaaiiy oai?eo ia oyaee? oi?ie II.

4. Aea/eoe aieea aioo??oiueinoaeeiiiai eaca?iiai ii?ii?iaiiy e?ia?
(AEIE) ia aeeiai?eo iaeaaaeeea?oeo iieaciee?a ia?eoa?e/ii? ?ioiii?
nenoaie, /anoioo ? no?oeoo?o i?neyiae?ioe/ieo oneeaaeiaiue oa /anoioo
eaoaeueieo aeiaaee?a i?e II.

5. ?ic?iaeoe aeai?eoi eiiieaeniiai e?eoaaiiy oai?eo oyaeeeie oi?iaie II.

Iaoeiaa iiaecia ?iaioe. ?ic?iaeaii aeai?eoi eiiieaeniiai e?eoaaiiy
oai?eo ia oyaee? oi?ie II, yeee ia?aaeaa/a? /?oeo /a?aia?noue
o??o?a?/iiai ? eiina?aaoeaiiai aoai?a e?eoaaiiy, a oaeiae oa?i?ie oa
ianya i?iaaaeaiiy e?eoaaeueieo caoiae?a a caeaaeiino? a?ae noaae??
oai?iae.

?ic?iaeaii niin?a o??o?a?/iiai e?eoaaiiy II (iiceoeaia ??oaiiy i?i
aeaea/o iaoaioo ia aeiao?ae a?ae Aea?aeiaoaioo Oe?a?ie ca ? 99041841
a?ae 30.08.99?.), yeee a?oioo?oueny ia aeei?enoaii? aeeiai?/ii?
iiaioiiaie?aaoinoii?? a ii?aeiaii? c eiina?aaoeaiith oa?ai??th, ui
aeeth/a? AEIE, ? aea? iiaeeea?noue cieceoe /anoioo i?neyiae?ioe/ieo
oaoaeueieo oneeaaeiaiue oa eaoaeueieo aeiaaee?a caoai?thaaiiy.

?ic?iaeai? e?eoaaeueii-ae?aaiinoe/i? caoiaee iiaeooue aooe i?aea?oioyi
aeey iiaeaeueoiai iiaeeaeaiiy ? ?icaeoeo iaoeiai? i?ia?aie iioei?caoe??
eiiieaeniiai e?eoaaiiy oyaeeeo oi?i II.

I?aeoe/ia oe?ii?noue ?iaioe. Noi?ioeueiaaii ? ?aeiiaiaeiaaii aeey
i?aeoe/iiai aeei?enoaiiy iniiai? i?eioeeie eiiieaeniiai o??o?a?/iiai
e?eoaaiiy oyaeeeo oi?i II, ye? iieyaathoue a aeeoa?aioe?eiaaiiio
i?aeoiae? aei aeai?o ianyao, iaoiae?a ? oa?i?i?a i?iaaaeaiiy
eiina?aaoeaieo ? o??o?a?/ieo caoiae?a a caeaaeiino? a?ae noaae?? ?
iiia?aaeiuei aecia/aiiai nooiaith oyaeeino? ia?aa?ao caoai?thaaiiy.
Canoinoaaiiy iaoiaaiaoe/ii iaa?oioiaaiiai eiina?aaoeaiiai e?eoaaiiy c
aeeth/aiiyi no/anieo iaoiae?a ei?aeoe?? ?ioiieo ?iceaae?a, cie?aia AEIE,
a ii?aeiaii? c iioeiaeueii a?aeno?i/aieie iia?aoeaieie ao?o/aiiyie
“a?aee?eoei” iaoiaeii (AeIIN) a iao?e iiaeeo?eaoe?? caaacia/o?
i?aeaeuaiiy aoaeoeaiino? e?eoaaiiy II, ui aeyaey?oueny a iioei?caoe??
ia?aa?ao iaoieia?/iiai i?ioeano caaaeyee ciaioaiith /anoioe oaoaeueieo
i?neyiae?ioe/ieo oneeaaeiaiue, cieaeaii? eaoaeueiino? oa iie?ioaii?
yeino? aeeooy oai?eo a ia??iae ?aeiiaaeanoeaioe??.

Cai?iiiiiaaii oaeineiiaeaiee iaoiae a?io?i?/ii? ae?aaiinoeee II, yeee
a?oioo?oueny ia aecia/aii? noia?ii? i?ioaacii? aeoeaiino? iaie?aaoe/iiai
nieo, ui aeicaiey? i?aeaeueoe oi/i?noue oa i?enei?eoe i?iaaaeaiiy
aiae?co (Aao. na?ae. ? 1741080 a?ae 15.02.1992?.).

Iniaenoee aianie caeiaoaa/a. Aeena?oaoe?y ? iniaenoith i?aoeath, a ye?e
aaoi?ii aeeeaaeaii e?eoe/iee aiae?c aeaieo e?oa?aoo?e a?aeiinii no/anieo
aeinyaiaiue a ieoaiiyo ao?iiaoiaaiaco, ae?aaiinoeee oa e?eoaaiiy
aino?iai iaie?aaoeoo, cie?aia eiai iae?ioe/ieo oi?i, a oaeiae aeani?
?acoeueoaoe i?iaaaeaiiai iei aiae?co ee?i?/iiai iaoa??aeo oa
aeine?aeaeaiiy iiaeeeainoae no/anieo iaoiae?a ae?aaiinoeee ?
eiiieaeniiai e?eoaaiiy oai?eo II. Ia i?aenoaa? naiai aeina?aeo aaoi?
iaa?oiooaaa eiiieaen aaeaeaaoieo ca ianyaii, /a?aia?noth ? oa?i?iaie
canoinoaaiiy eiina?aaoeaieo oa o??o?a?/ieo caoiae?a i?e e?eoaaii?
oyaeeeo oi?i II ia eiaeiiio aoai?; ?ic?iaea iiaeeo?eaoe?th “a?aee?eoiai”
o??o?a?/iiai iaoiaeo e?eoaaiiy II – aeeiai?/ii? iiaioiiaie?aaoinoii??
(AeIIN). A?eueo?noue iia?aoe?e aeeiiaii aaoi?ii iniaenoi. Naiino?eii
i?iaaaeaii noaoenoe/iee aiae?c ?acoeueoao?a ianoaaeaiiy oa e?eoaaiiy
oai?eo.

Ni?aaaoi?noai ?ioeo aeine?aeiee?a o iaoeiaeo i?aoeyo, iioae?eiaaieo ca
iaoa??aeaie aeena?oaoe??, iieyaa? o ?o eiinoeueoaoeai?e aeiiiiic? oa
ni?ao/ano? a ae?aaiinoe/ii-e?eoaaeueiiio i?ioean?.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aeeeaaeai? ia: Ananithci?e eiioa?aioe?? o??o?a?a-iaie?aaoieia?a (Ee?a,
1988), iaoeiai-i?aeoe/i?e eiioa?aioe?? e?ea??a (Ee?a, 1990), V Eiia?an?
na?oiai? oaaea?aoe?? Oe?a?inueeeo e?ea?nueeeo oiaa?enoa
(Aei?i?iiao?ianuee, 1994), iaoeiai-i?aeoe/i?e eiioa?aioe?? o??o?a?a
(Caii??aeaey, 1993), ?? Oe?a?inuee?e iaoeiai-i?aeoe/i?e eiioa?aioe?? c
i?iaeai iaa?aeeeaaeii? aeiiiiiae (Iaeana, 1994), iaoeiai-i?aeoe/i?e
eiioa?aioe??, i?enay/ai?e 25-??//th Euea?anueei? e?ea?i? oaeaeei?
aeiiiiiae (Euea?a, 1997), can?aeaii? A/aii? ?aaee Oe?a?inueeiai
iaoeiai-i?aeoe/iiai oeaio?o aeno?aii? iaaee/ii? aeiiiiiae oa iaaeeoeeie
eaoano?io IIC Oe?a?ie (Ee?a, 1998).

Ioae?eaoe??. Ca oaiith aeena?oaoe?? iioae?eiaaii 25 iaoeiaeo i?aoeue,
iaea?aeaii 1 Aaoi?nueea na?aeioeoai oa iaeia iiceoeaia ??oaiiy ia
aeiao?ae.

No?oeoo?a aeena?oaoe??. Aeena?oaoe?y neeaaea?oueny ?c anooio, iaeyaeo
e?oa?aoo?e, iieno ee?i?/iiai iaoa??aeo oa iaoiae?a aeine?aeaeaiiy,
cae?i/aiiy, aeniiae?a ? nieneo aeei?enoaieo aeaea?ae, ui aeeth/athoue
224 iaeiaioaaiiy, a oiio /ene? 125 aeaea?ae e?oa?aoo?e e?a?i NIAe oa 99
– ?iicaiii?. Ianya aeena?oaoe?? neeaaea? 162 noi??iee oaenoo, iaa?aiiai
eiii’thoa?iei niiniaii. ?iaioo ?ethno?iaaii oaaeeoeyie (23), iaethieaie
(12) oa aeienaie c ?noi??? oai?ia (4).

INIIAIEE CI?NO ?IAIOE

Caaaeueia oa?aeoa?enoeea oai?eo oa iaoiaee aeine?aeaeaiiy. ?iaioa
a?oioo?oueny ia ?acoeueoaoao eiiieaeniiai ianoaaeaiiy oa e?eoaaii? 174
oai?eo ia oyaee? oi?ie II, ui neeaaeathoue 19,7% a?ae caaaeueii?
e?eueeino? iaoe??io?a (8823) c aino?ei iaie?aaoeoii, ye? e?eoaaeenue a
Ee?anuee?e i?nuee?e ee?i?/i?e e?ea?i? oaeaeei? iaaee/ii? aeiiiiiae
i?ioyaii 1985-1998??.

Eiioeiaaio oai?eo a caeaaeiino? a?ae iia?aoeaiiai e?eoaaiiy iiae?eaii ia
aea? a?oie: ? – iniiaio (97 in?a) oa ?? – eiio?ieueio, oae caaio a?oio
ii??aiyiiy (77 in?a). Iaoe??ioe iniiaii? a?oie aoee iia?iaai? c
canoinoaaiiyi “a?aee?eoiai” iaoiaeo – aeeiai?/ii? iiaioiiaie?aaoinoii??
(AeIIN) a iao?e iiaeeo?eaoe??, a?oie ii??aiyiiy – o?aaeeoe?eiei
“cae?eoei” o??o?a?/iei niiniaii.

C o?aooaaiiyi no/anieo oyaeaiue uiaei iaoiaaiaco II ? nooo?ai? ?ie? a
iueiio ?iceaae?a ?ioiii? nenoaie, c iaeiiai aieo (Aaeue E.N. e niaao.,
1986; Naaaeueaa A.N. e niaao., 1983; Oaeeiia N.A. e niaao., 1990;
Oaeeiia A.A. e niaao., 1997; Cruikhank A.H., 1995; Krumberger G.M.,
1993), ? aeaieo i?i iiceoeaiee aaaaoinoi?iii?e, a oiio /ene?
?ioiiei?aaoth/ee, aieea ia i?aai?ci iecueeiaia?aaoe/ieo eaca?ieo
i?iiai?a, c ?ioiai aieo (Aaiaeay I.A., 1972, 1981; Caineia A.N. e
niaao., 1985; Eiiiaaeia A.I., 1988; Eoiaeueoeaa A.E. e niaao., 1986), a
eiiieaeniiio e?eoaaii? oai?eo aoei aeei?enoaii aioo??oiueinoaeeiia
eaca?ia ii?ii?iaiiy e?ia? (AEIE). A ca’yceo c oeei oai?? iniiaii? a?oie
aoee aeiaeaoeiai ?icae?eai? ia 2 i?aea?oie, oiiaii iicia/ai? ye: ?
i?aea?oia “AeIIN+AEIE” – 48 in?a, a e?eoaaiiy yeeo aoei aeeth/aii AEIE;
?? i?aea?oia “AeIIN” – 49 in?a, ye? AEIE ia io?eioaaee.

A?e oai?eo a iniiai?e oa a?oi? ii??aiyiiy eieeaaany a?ae 20 aei 89
?ie?a, c ia?aaaaith a?ae 30 aei 70 ?ie?a (76,3%). A?eueo?noue oai?eo
a?aeiineeanue aei i?aoeacaeaoiiai a?eo ? neeaaeaea na?aae /ieia?e?a ?
ae?iie a iniiai?e a?oi? a?aeiia?aeii 72,4% ? 62%, a a?oi? ii??aiyiiy –
59,5 ? 87,5%.

Aeii?ioth/eie ao?ieia?/ieie /eiieeaie caoai?thaaiiy aoee aeia/ii-eai’yia
oai?iaa oa aeeiaie?ci, ye? neeaaeaee 67% a iniiai?e oa 74% a a?oi?
ii??aiyiiy. Ae?oaa i?noea ii /anoio? caeiaa ?ae?iiaoe/iee iaie?aaoeo –
19,6% a iniiai?e, 16,9% a a?oi? ii??aiyiiy. ?aooa aeiaaee?a
caoai?thaaiiy aoea i?neyiia?aoe?eiiai oa i?neyo?aaiaoe/iiai
iioiaeaeaiiy.

An? oai?? aoee ianoaaeai? ca aeiiiiiaith eiiieaeno iaea?eueo
?ioi?iaoeaieo ee?i?ei-eaai?aoi?ieo (aaiaoieia?/ieo, ?ioiieia?/ieo,
a?io?i?/ieo, i?e?ia?ieia?/ieo, iaoiii?oieia?/ieo) oa ?ino?oiaioaeueieo
iaoiae?a (eaia?ineii?/iiai, niiia?ao?/iiai, ?aioaaiieia?/iiai,
aiaeineii?/iiai, eiii’thoa?ii-oiiia?ao?/iiai).

C iaoith a?eueo oi/ii? ae?aaiinoeee, i?iaiicoaaiiy ia?aa?ao II oa aeai?o
aaeaeaaoiiai e?eoaaiiy aecia/aee nooi?iue oyaeeino? oai?iae o eiaeiiai
iaoe??ioa ca iaoiaeii Ranson ? ni?aaao. (1974, 1978) o iiaeeo?eaoe??
?IOeO ?AII ? A?iieoeueeiai oeaio?o o??o?a?? i?aeoeoieiai? caeice ?
aeia/ieo oeyo?a (TH.O.Eaaeiuoe, 1991), yeee, ia iao iiaeyae, aaeaei
ii?aeio? ?yae ea?aeeiaeueieo a?io?i?/ieo oa ooieoe?iiaeueieo e?eoa???a.

Ai?iaeiaae ia?oi? aeiae i?eeiaee aei oaaae 3 i???ioe?e – ??aaiue
aetheice ? aaiiaeia?io, e?euee?noue eaeeioeeo?a e?ia? oa ua 4 iieacieee,
ye? eaaei aecia/athoueny: a?e iaoe??ioa, iayai?noue oao?ea?ae??,
a?iioii??, no?eeiai aieueiaiai neiae?iio, iacaaaeath/e ia aaeaeaaoio
oa?ai?th. A ianooiio aeiao, e??i oiai, a?aee aei oaaae ua 5 iieaciee?a:
ai?no ANO, AEO, ?o ni?aa?aeiioaiiy (?iaeaen ??o?na), ??ai? e?aaoei?io a
ne?iaaooe? e?ia?, eenaiue a?oa??aeueii? e?ia?, aeao?oeeo eoa?a. I?e
oeueiio iaia’yceiai a?aoiaoaaee no?ee?noue oao?ea?ae?? ? a?iioii??.
A?aeiia?aeii aei ?aeiiaiaeaoe?? aaoi??a (Eaaeiuoe TH.O., 1991) i?e
iayaiino? o oai?eo aei 3 ?c cacia/aieo e?eoa???a ia?aa?a II aaaaeaee
eaaeei, a?ae 4 aei 6 – na?aaeiuei? oyaeeino?, 7 ? a?eueoa – oyaeeei.
Aoaeoeai?noue “a?aee?eoiai” ? “cae?eoiai” o??o?a?/iiai ao?o/aiiy i?e
e?eoaaii? II ioe?ithaaee oeyoii ni?anoaaeaiiy no?oeoo?e ? /anoioe
oneeaaeiaiue oa eaoaeueieo aeiaaee?a.

E?eoa??yie aeey ioe?iee aieeao AEIE ia aoaeoeai?noue e?eoaaiiy II
neoaoaaee ci?ie iaea?eueo ?ioi?iaoeaieo ?ioiieia?/ieo iieaciee?a,
/anoioa i?neyiae?ioe/ieo oneeaaeiaiue oa eaoaeueieo aeiaaee?a
caoai?thaaiiy.

Ooi/iaiiy ae?aaiico II ? eiai aeeoa?aioe?thaaiiy a?ae ?ioeo oai?ia c
iiae?aieie neiioiiaie a?oiooaaeenue ia ianoaaeaii? on?o oai?eo ca
aeiiiiiaith ?aioaaiieia?/iiai, niiia?ao?/iiai iaoiae?a, cae?eniaii?
eaia?ineii??, eiii’thoa?ii? oiiia?ao??, iaie?aaoioieaia?ia?ao??.
Ia’?eoeai?noue ae?aaiico II, e??i oiai, i?aeoaa?aeaeoaaee i?iaaaeaiiyi
eiiieaeno a?io?i?/ieo, aaiaoieia?/ieo aeine?aeaeaiue.

Anueiai aoei cae?eniaii aeecueei 850 ??cieo ?ino?oiaioaeueieo ao?o/aiue,
aeeiiaii aeecueei 17 oen. ??cieo aiae?c?a, 174 ia?aeiieo iia?aoe??.

Aiae?c iayaiiai ee?i?/iiai iaoa??aeo iieacaa, ui ee?i?/ia ea?oeia II o
oai?eo iaio a?oi nooo?ai ia a?ae??ciyeanue, neiioiiaoeea caoai?thaaiiy
oa?aeoa?ecoaaeanue iie?ii?o?ciii oa ??ciith iai?oanoaoeai?noth i?iya?a.

I?e oeueiio aoei aeyaeaii ia?aaaaeii oyaeeee ia?aa?a II: o 67% oai?eo
iniiaii? ? 67,5% – eiio?ieueii? a?oie. O ?aooe oai?eo a?aei?/aii
na?aaei?e nooi?iue oyaeeino? – a?aeiia?aeii o 33% ? 32,5% aeiaaee?a.
Eaae? oi?ie II aoee a?aenooi?.

Iiaeaeueo? niinoa?aaeaiiy ca ia?aa?aii iaoieia?/iiai i?ioeano o oai?eo,
a oaeiae aeai? iaoieiaiaiaoii?/ieo aeine?aeaeaiue i?aeoaa?aeeee
oi/i?noue ? iaae?ei?noue aeei?enoaieo e?eoa???a oa aeioe?euei?noue ?o
canoinoaaiiy ia i?aeoeoe?.

Eiiieaenia e?eoaaiiy oai?eo ia iae?ioe/iee iaie?aaoeo. E?eoaaeueia
oaeoeea II a iao?e ?iaio? a?oiooaaeanue ia no/anieo iiaeyaeao ia
ao?ieia?th ? iaoiaaiac oai?iae c o?aooaaiiyi aaaaoia?aiiino? oa
noaae?eiino? ?icaeoeo.

Aeoiaey/e c ii/aoeiaiai ia?aaaaeii ia?ioaeoe?eiiai ia?aa?ao II (o 60-70%
aeiaaee?a), ie aeio?eioaaeenue aeoeaii-i/?eoaaeueii? oaeoeee e?eoaaiiy,
?icaeyaeath/e eiina?aaoeaio oa?ai?th ia ye aeueoa?iaoeao o??o?a?/iiio, a
ye iaia’yceiaee neeaaeiaee aeaiaio aeoeaiiai eiiieaeniiai e?eoaaiiy, a
iniia? yeiai aoee o?e aieiaieo caaaeueiii?eeiyo? i?eioeeie: 1) e?eoaaiiy
caiaeaiiy IC ? iaie?aaoiaaiiiai ia?eoii?oo; 2) i?io?eaeoeea ? e?eoaaiiy
iaie?aaoiaaiii? oienai??, oiene/ieo oneeaaeiaiue ? iaoaaie?/ieo
?iceaae?a; 3) i?io?eaeoeea ? e?eoaaiiy i?neyiae?ioe/ieo oneeaaeiaiue.
Ca?aene i/aaeaeii, ui ianya oa oa?aeoa? e?eoaaeueieo caoiae?a caeaaeaa
a?ae oyaeeino? ia?aa?ao oa noaae?? caoai?thaaiiy.

Eiina?aaoeaia oa?ai?y iaea nai?th iaoith caaacia/aiiy iaeneiaeueiiai
ooieoe?iiaeueiiai niieith IC, i?eai?/aiiy i?ioaie?oe/ii? anoa?acii?
aeoeaiino?, a?aeiiaeaiiy aiaeii-aeaeo?ie?oii? ? a?eeiai? ??aiiaaae a
i?aai?ci?, aeei?enoaiiy aioea?ioee?a oe?ieiai niaeo?o ae?? c iaoith
i?io?eaeoeee oa e?eoaaiiy ai?eii-naioe/ieo oneeaaeiaiue ? cae?eniaiiy
?ioiiei?aeoe??.

?ic?iaeaiee iaie ? cae?enithaaiee ia i?aeoeoe? aeai?eoi e?eoaaiiy II
iaaaaeaii ia ?en.

Oai?? c AeIIN

aei noaa?e?caoe?? caaaeueiiai noaio (?c iia?aoe?eiiai a?aeae?eaiiy)

Oai?? c AeIIN

ia ieaiiao iaie?aaonaeaano?aeoii?th (a iia?aoe?eia a?aeae?eaiiy)

? aai e?eoaaiiy II, yeee o?eaaa 8-14 aei?a c /ano aini?oae?caoe?? ?
i?iaiaeeany, ye i?aaeei, a ?aai?iaoe?eiiio aeioe?, iieyaaa a cae?eniaii?
?ioaineaii? oa?ai?? aaaeeeo a?noea?aeueieo ii?ooaiue (aeeoaeueii?,
na?oeaai-noaeeiii?, ia/?ieiai-ie?eiai?), iaeaaiaeaeaii? ia?eoiiaaeueiiai
ae?ae?co.

?? aoai e?eoaaiiy ioiiethaaa ianooii? 3-8 oeaei?a ? i?iaiaeeany a
o??o?a?/iiio a?aeae?eaii?. Iia?aoeai? ao?o/aiiy a oeae /an cae?enithaaee
eeoa i?e iayaiino? aeeoo?aeo iieacaiue (aanoeaaeoaaiiy iae?ic?a, ui
noi?iaiaeaeoaaeinue caa?icith i?i?eao aai i?i?eaii ai?eieea a /a?aaio
ii?iaeieio, a?iceai? e?iaioa/?, ia?inoaiiy iaoai?/ii? aeiaoyieoe?).
Oeiiaei ianyaii o??o?a?/iiai ao?o/aiiy, i?e oeueiio aoee
ae?a?oieeanoe/ia iaie?aaoiiae?aeoii?y oa iaeeaaeaiiy eaia?inoiie.

??? aoai e?eoaaiiy – 8-12 i?nyoe?a a?ae ii/aoeo caoai?thaaiiy, iieyaa? a
aeeiiaii? ieaiiaeo iia?aoe?e (oeenoiaioa?i-, oeenoiaano?inoii??) i?e
oi?ioaaii? inaaaeieeno IC.

Aeeeaaeaia noaia e?eoaaiiy ia caaaeaee aoea iiaeeeaa aeey cae?eniaiiy.
Oea noino?oueny aeiaaee?a ?aiiueiai ?io?eoaaiiy iaie?aiiae?ico, yea
niinoa??aa?oueny o 30-40% oai?eo ? ? iaea?eueo caa?iceeaei ? iaaacia/iei
oneeaaeiaiiyi.

Aeey i?aeoaa?aeaeaiiy ?io?eoaaiiy i?iaiaeeee i?e?ia?ieia?/ia
aeine?aeaeaiiy iae?ioe/ieo oeaiei, io?eiaieo oeyoii /a?acoe??ii?
ani??aoe?? ca aeiiiiiaith oiiei? aieee i?ae eiio?ieai oeueo?acaoeiaiai
aeine?aeaeaiiy aai eiii‘thoa?ii? oiiia?ao??. Iiceoeai? ?acoeueoaoe aoee
iieacaiiyi aei o??o?a?/iiai ao?o/aiiy aaea i?ioyaii ia?oeo 10-14 aei?a
i?ney aini?oae?caoe??. Aeiaaeee ia?nenooth/eo /e caiiai aeieeeeo /a?ac
2-5 oeaei?a i?ney oei/aniaiai caoeoaiiy oa?aeoa?ieo neiioii?a oaeiae
aoee iieacaiiyie aei o??o?a?/ii? iia?aoe??. A iiae?aieo neooaoe?yo ianya
o??o?a?/iiai ao?o/aiiy aeeth/aa ?aoaeueia aeaeaeaiiy aeaa?oae?ciaaieo
oeaiei, ?ice?eooy aiiye?a ? iaeeaaeaiiy eaia?inoiie c iaoith
iine?aeoth/i? i?ia?aiiaaii? naiaoe?? /a?aaii? ii?iaeieie.

Cai?iiiiiaaia iaie iiaeeo?eaoe?y aeeiai?/ii? iiaioiiaie?aaoinoii??
iieyaa? a ianooiiiio: aeeiiaii? iaae?nii-iiia?a/ii? eaia?ioii?? a?ae
na?aaeeie i?aai? ?aaa?ii? aeoae aei na?aaeeie e?ai? iaoaiai? e?i??, ui
caaacia/o? a?eueiee aeinooi ? oi?io? oiiae aeey iaeyaeo
iaie?aaoi-aeoiaeaiaeueii? ciie, iine?aeoth/iai cae?eniaiiy oe?iei?
iia?e?caoe?? IC ? ?ao?iiaie?aaoiaeoiaeaiaeueiiai i?inoi?o c iaoith
a?eueiiai a?aeoieo ai?eii-iae?ioe/ieo ian oa aaeaeaaoiiai ae?aioaaiiy;
aeei?enoaii? aiaeineii?/iiai ?ino?oiaioa??th aeey nai?/aniiai
iaeneiaeueii ?aoaeueiiai aeaeaeaiiy iia?oa?eeo oeaiei. Eaia?inoiia
o?eno?oueny ea?eanii ?c ?ia?oiiai oaeaeeioaa?ae?th/iai noiiaoieia?/iiai
iaoa??aeo “Stomatoflex solid”, oiaoi oi?io?oueny “a?eueca aeeiai?/iiai
niinoa?aaeaiiy”, yea aeicaiey? i?iaiaeeoe a?coaeueiee iii?oi?eia
iaoieia?/iiai i?ioeano aac iiaoi?ieo ?aiia?aoe?e.

Ne?ae i?aee?aneeoe, ui ianya oa oa?aeoa? ia?aeiieo o??o?a?/ieo ao?o/aiue
aa??thaaee a?ae ae?a?oieeanoe/ii? iae?aeoii?? aei noaoioaeueii?
e?aia?/ii? ?acaeoe?? ? aecia/aeenue ?iaeea?aeoaeueii a caeaaeiino? a?ae
aeyaeaieo i?ae /an iia?aoe?? iaoieia?/ieo ci?i oa caaaeueiiai noaio
oai?iai. Oioaeueio ?acaeoe?th aaaaeaee a oeeo aeiaaeeao iaaeioe?eueiith
a ca‘yceo c o?eaae?noth i?iaaaeaiiy ? aaeeeith o?aaiaoe/i?noth. A
?ic?iaoe? no?aoaa?/iiai ieaio o??o?a?/iiai ao?o/aiiy aaaeeeaa cia/aiiy
iaaeaaaee oeueo?acaoeia?e niiia?ao?? oa eiii’thoa?i?e oiiia?ao??, ye?
aeicaieythoue nai?/anii aecia/eoe ?ici??e oa eieae?caoe?th
aeano?oeoeaieo iioeiaeaeaiue.

Ii??aiyeueia ioe?iea aoaeoeaiino? iiaeeo?eiaaiiai “a?aee?eoiai” iaoiaeo
aeeiai?/ii? iiaioiiaie?aaoinoii?? ? cae?eoiai niiniao iia?aoe??.
Eiiieaenia e?eoaaiiy oyaeeeo oi?i II aeaei ciiao iaea?aeaoe iiceoeai?
?acoeueoaoe o 67,0% iaoe??io?a iniiaii? a?oie ? 42,8% – eiio?ieueii?
(a?oie ii??aiyiiy). C iaoith ia‘?eoeaii? ioe?iee aoaeoeaiino?
aeei?enoaieo iaie o??o?a?/ieo iaoiae?a aeey e?eoaaiiy II i?iaiae?ciaaii
iaea?eueo aaaii? a oeueiio a?aeiioaii? iieacieee: /anoioo ? oa?aeoa?
i?neyiae?ioe/ieo oneeaaeiaiue oa /anoioo ? i?e/eie eaoaeueieo aeiaaee?a
caoai?thaaiiy.

?acoeueoaoe oeueiai aiae?co aeicaieythoue eiinoaooaaoe, ui no?oeoo?a
oneeaaeiaiue (ai?eii-naioe/ieo, a?noea?aeueieo) a iniiaiiio aoea
noiaeith o oai?eo iaio a?oi, ca aeiyoeii aeaaaia?aoeaieo (iani?aaaei?
e?noe IC), ye? aoee ca?a?no?iaai? eeoa o iaoe??io?a, iia?iaaieo
“cae?eoei” iaoiaeii (oaae. 1).

Oaaeeoey 1

I?neyiae?ioe/i? oneeaaeiaiiy o oai?eo II, iia?iaaieo “a?aee?eoei” ?
“cae?eoei” iaoiaeaie

OneeaaeiaiiyA?oie, e?euee?noue oai?eo

?iniiaia (n=97)ii??aiyiiy (n=77)aan.%aan.%123456 ?. Ai?ei?Ai?eia
o?aaeaiiy i?aeoeoieiai? caeice (ai?eiee iaie?aaoeo)6364,95470,2>
0,05Ai?eiee ia?aiaie?aaoeo5253,64355,9> 0,05Ai?eiee
iiaioiao?neo1515,53646,8< 0,001Ai?eiee ia?eoii?o1010,32228,6< 0,01Aanoeane i?aai?a /a?aaii? ii?iaeieie ? cai/a?aaeiiiai i?inoi?o1414,42127,3< 0,05Oi?aeaeuei? ai?ei? oneeaaeiaiiy66,21316,9< 0,05Nainen1212,41924,7< 0,05 I?iaeiaaeaiiy oaaeeoe? 1 123456 ??. A?noea?aeuei?Iaie?aaoe/i? ii?eoe?77,21114,3< 0,05Ii?eoe? o?aaiiai eaiaeo1111,32026,0< 0,05A?iceai? e?iaioa/?66,2125,6>
0,05Ii?eoe? iicaia/?ieiaeo aeia/ieo i?ioie?a—11,3> 0,05 ???.
Aeaaaia?aoeai?Iani?aaaei? e?noe i?aeoeoieiai? caeice—56,5< 0,05*enei oneeaaeiaiue ia iaeiiai oai?iai2,023,34 sse aeaeii c aeaieo oaaeeoe? 1, iaea?eueo /anoi o oai?eo ye iniiaii?, oae ? eiio?ieueii? a?oie, niinoa??aaee ??ci? ai?ei? oneeaaeiaiiy. Ai?eii-naioe/i? i?ioeane iaoiiaeee ?icaeoie a?noea?aeueieo oneeaaeiaiue, cie?aia ii?eoeue ??cii? eieae?caoe?? (aaciina?aaeiuei a IC a i?noeyo iaea?eueo aeeaieiai ?icoaooaaiiy aiaieu ?icieaaeaiiy ?? oeaiei, aeaaiaaeoeyoeiae?e, oiano?e, oiie?e eeoeao, oeoieo, ni?euei?e aeia/i?e i?ioioe?). O?nooe?caoe?y i?aai?a o?aaiiai eaiaeo i?ecaaea aei a?iceaieo e?iaioa/ ?c noaeei IC, ae?ao?aaie, ai??oii? aaie ? ?? a?eie, a?eie /a?aaii? a?oa??? oa aa?oiuei? a?eaeiai? a?oa???. Iae/ano?oa iaee i?noea e?iaioa/? c aaiicieo noaeei, ye? noi?iaiaeaeoaaee ai?eii-aieeuei? oneeaaeiaiiy. I?e?ia?ieia?/i? aiae?ce ai?noo aiaieu aeano?oeoe?? IC oa ia?aiaie?aaoe/ieo oeaiei iieacaee, ui o oai?eo II c iayai?noth ai?eieo oneeaaeiaiue aeii?io? aieeueia i?e?ioei?a /eeoeiaa iaee/ea (68,4%), aioa?ieiee (39,1%) aoeueaa?iee i?ioae (39,7%)/, ??aeoa aeyaeythoueny aii?oai?i? i?e?iae /noao?eieie cieioenoee (38%) oa a?eee (17,3%)/ aaiie?oe/iee, no?aioieie aaiie?oe/iee (4,6%), nei?ai?eia iaee/ea (33,4%). *anoioa ?icaeoeo ??cieo oneeaaeiaiue o oai?eo iniiaii? a?oie (oaae. 1) aoea ieae/ith, i?ae a eiio?ieuei?e a?oi?. E?euee?noue oneeaaeiaiue a na?aaeiueiio ia iaeiiai oai?iai neeaaeaea 2,02 ii??aiyii c 3,34 a eiio?ieuei?e a?oi?, oiaoi aoea a 1,7 ?aca iaioith. Aiae?c e?eueeino? oa i?e/ei eaoaeueieo aeiaaee?a na?ae/eoue i?i iiceoeaiee aieea iiaeeo?eaoe?? iiaioiiaie?aaoinoii?? oaeiae ia oe? iieacieee (oaae. 2). *anoioa eaoaeueieo aeiaaee?a na?aae oai?eo iniiaii? a?oie neeaaeaea 33,0% ? aoea ieae/ith ii??aiyii c oai?eie eiio?ieueii? a?oie (57,2%), yeeo e?eoaaee o?aaeeoe?eiei iaoiaeii. Oaaeeoey 2 I?e/eie nia?o? o oai?eo II, iia?iaaieo “a?aee?eoei” ? “cae?eoei” iaoiaeii I?e/eie nia?o?A?oie, e?euee?noue oai?eo ?iniiaia (n=97)ii??aiyiiy (n=77)aan.%aan.%Na?oeaai-noaeeiia iaaeinoaoi?noue11,022,6> 0,05Na?oeaai-eaaaiaaa iaaeinoaoi?noue55,245,2>
0,05Ia/?ieiai-ie?eiaa iaaeinoaoi?noue22,133,9> 0,05Ai?eia ?icieaaeaiiy
i?aeoeoieiai? caeice88,2810,4< 0,05Ai?eii-iae?ioe/iee iaie?aaoeo33,179,1< 0,001Ai?eiee ia?eoii?o--45,2< 0,001Nainen44,179,1< 0,01A?iceai? e?iaioa/?22,145,2< 0,01O?iiaic noaeei /a?aaii? ii?iaeieie ? cai/a?aaeiiiai i?inoi?o33,122,6> 0,05Iiaaiii??44,133,9>
0,05Anueiai3233,04457,2< 0,001 I?e oeueiio ??aaiue nia?oiino? aiane?aeie iie?i?aaiieo ?iceaae?a a iaio a?oiao nooo?ai ia a?ae??ciy?oueny (p>0,05). A oie aea /an e?euee?noue
iiia?eeo a?ae eieaeueieo ai?eii-naioe/ieo oneeaaeiaiue, naineno,
a?iceaieo e?iaioa/ a a?oi? ii??aiyiiy (eiio?ieuei?e) aoea a??ia?aeii
a?eueoith (p<0,05 – p<0,001) – a 1,3-3 ?ace. A?aei?iiino? iieaciee?a oneeaaeiaiue oa nia?oiino? o oai?eo iniiaii? a?oie a oe?eiio a?ae aiaeia?/ieo iieaciee?a o oai?eo eiio?ieueii? a?oie caa??aathoueny oaeiae o oai?eo ?? i?aea?oie iniiaii? a?oie, yeeo e?eoaaee “a?aee?eoei” iaoiaeii aac AEIE. Aeyaeai? caeiiii??iino? i?aeoaa?aeaeothoue iiceoeaiee aieea ?ic?iaeaii? iaie iiaeeo?eaoe?? AeIIN oa aeioe?euei?noue ?? aeei?enoaiiy aeey e?eoaaiiy oyaeeeo oi?i iae?ioe/iiai iaie?aaoeoo. I?e oeueiio ne?ae a?aei?oeoe aeaui aeu? ??ai? ai?eieo ? a?noea?aeueieo oneeaaeiaiue (ai?eia o?aaeaiiy IC, ai?eiee iiaioiao?neo, ai?eiee ia?eoii?o, aanoeane i?aai?a /a?aaii? ii?iaeieie ? cai/a?aaeiiiai i?inoi?o, nainen, ii?eoe? o?aaiiai eaiaeo, a?iceai? e?iaioa/?) oa /anoioe nia?oiino? na?aae oai?eo ?? i?aea?oie, i?ae caaaeii na?aae oai?eo iniiaii? a?oie, ui i/aaeaeii, a?aeia?aaea? iiceoeaiee aieea AEIE ia oe? iieacieee. Aioo??oiueinoaeeiia eaca?ia ii?ii?iaiiy e?ia? a eiiieaeniiio e?eoaaii? oai?eo ia iae?ioe/iee iaie?aaoeo. AEIE, ye cacia/aii aeua, aoei i?ecia/aii eeoa oai?ei ? i?aea?oie (“AeIIN+AEIE”) iniiaii? a?oie. Aoaeoeai?noue e?eoaaiiy ioe?ithaaee ia i?aenoaa? aecia/aiiy ci?ie iieaciee?a ooieoe?iioaaiiy ia?eoa?e/ii? eaiee ?ioiii? nenoaie a aeeiai?oe?, a oaeiae /anoioe ? oa?aeoa?o i?neyiae?ioe/ieo oneeaaeiaiue ? eaoaeueieo aeiaaee?a caoai?thaaiiy o oai?eo ? i?aea?oie a c?noaaeaii? c aiaeia?/ieie iieacieeaie o oai?eo ?? i?aea?oie (“AeIIN”) iniiaii? a?oie. ?acoeueoaoe aea/aiiy oeeo iieaciee?a a i?ioean? e?eoaaiiy na?ae/aoue i?i ?ioiinoeioethth/o ae?th eaca?ieo i?iiai?a ia O-eaieo ?ioi?oaoo, yea aoea iaea?eueo a?ae/ooiith /a?ac 8-10 oeaei?a i?ney o??o?a?/iiai ao?o/aiiy. Oea aeyaeeinue o oai?eo ? i?aea?oie i?aeaeuaiiyi ooieoe?iiaeueii? aeoeaiino? ee?oeiii? eaiee ?ioi?oaoo, ui i?aeoaa?aeaeothoue aeinoia??i? (p<0,05-0,01-0,001) ca?eueoaiiy ii??aiyii c aeo?aeieie aaee/eiaie e?eueeino? O-e?ioioeeo?a i?e ci?i? ni?aa?aeiioaiiy ?o noaiiioeyoe?e (O-oaeia?e, O-noi?ani?e) ? ca?eueoaiiyi ?ioii?aaoeyoi?iiai ?iaeaeno, i?aeaeuaiiy i?ie?oa?aoeaii? aeoeaiino? O-e?ioioeeo?a ? oaaioeeoa?ii? aeoeaiino? iaeo?io?eueieo a?aioeioeeo?a ia?eoa?e/ii? e?ia?, a oaeiae aeoeaaoe?y eiai aoii?aeueiiai eiiiiiaioo (aeinoia??i? (p<0,05-0,01-0,001) ca?eueoaiiy e?eueeino? A-e?ioioeeo?a, cieaeaiiy eiioeaio?aoe?? ?ioiiaeiaoe?io G oa oee?eoethth/eo ?ioiieo eiiieaen?a e?ia?). O oai?eo ?? i?aea?oie cacia/ai? ci?ie, ui aiai?youe i?i ii?iae?caoe?th ooieoe?? ia?eoa?e/ii? eaiee ?ioi?oaoo, ia aoee a??ia?aeieie (p>0,05).

Eaca?ia ii?ii?iaiiy e?ia? iaoiiaeei oaeiae nooo?aa ciaioaiiy
(p<0,05-0,001) e?eueeino? ai?eii-naioe/ieo oa a?noea?aeueieo oneeaaeiaiue (ai?eiiai iiaioiao?neoo, ia?eoii?oo, naineno, ai?eieo oi?aeaeueieo oneeaaeiaiue, o?nooe o?aaiiai eaiaeo oa a?iceaieo e?iaioa/). Ciaioaiiy e?eueeino? oneeaaeiaiue a naith /a?ao i?eaaei aei cieaeaiiy /anoioe oaoaeueieo aeiaaee?a caoai?thaaiiy. A oe?e i?aea?oi? iiia?ei 14 iaoe??io?a ?c 48, oiaoi 29,2%, a ?? i?aea?oi? – 18 ?c 49, oiaoi 36,7%. I?e aiae?c? no?oeoo?e i?e/ei nia?o? oai?eo ? oa ?? i?aea?oi a??ia?aeia ??cieoey (p<0,01-0,05) aeyaey?oueny eeoa a /anoio? ai?eii-naioe/ieo oa a?noea?aeueieo oneeaaeiaiue. *anoioa iie?i?aaiii? iaaeinoaoiino? (na?oeaai-noaeeiia, na?oeaai-eaaaiaaa, ie?eiai-ia/?ieiaa oiui) ye i?e/eie eaoaeueieo aeiaaee?a nooo?ai ia a?ae??ciyeanue (p>0,05).

Ioaea, aeei?enoaiiy AEIE a e?eoaaii? II ie??i ei?aaoth/i? ae?? ia ?ioii?
?iceaaee a i?aai?ci? oai?eo ni?e/eiy? ciaioaiiy /anoioe
nia?oaeueiiiaaacia/ieo i?neyiae?ioe/ieo ai?eii-naioe/ieo ?
a?noea?aeueieo oneeaaeiaiue, a oaeiae oaoaeueieo aeiaaee?a
caoai?thaaiiy.

Oaeei /eiii, i?aenoiiaoth/e ?acoeueoaoe i?iaaaeaieo aeine?aeaeaiue
aoaeoeaiino? e?eoaaiiy oai?eo ia oyaee? oi?ie II, iia?iaaieo c
canoinoaaiiyi “a?aee?eoiai” iaoiaeo a iao?e iiaeeo?eaoe?? (AeIIN) ?
o?aaeeoe?eiiai “cae?eoiai” niiniao ca ii??aiyeueieo oiia eiina?aaoeaiiai
e?eoaaiiy, ne?ae eiinoaooaaoe i/aaeaeio ia?aaaao ia?oiai c ieo. Oeae
aeniiaie a?oioo?oueny ia ni?eyoeeaiio ia?aa?ao oai?iae, yeee
niinoa??aaee o oai?eo – ciaioaiiy /anoioe oaoaeueieo ai?eii-naioe/ieo,
a?noea?aeueieo oa aeaaaia?aoeaieo oneeaaeiaiue ? ye iane?aeie –
ca?eueoaiiy e?eueeino? oai?eo, ye? iaeoaeaee. Eaca?ia ii?ii?iaiiy e?ia?,
yea ni?e/eiy? ?ioiiei?eaoth/o ae?th, oaae aea? iaaiee aeeaae a
?aae?caoe?th ni?eyoeeaiai ia?aa?ao oa cae?i/aiiy oe??? oyaeei? oai?iae.

AENIIAEE

1. Oyaee? oi?ie iae?ioe/iiai iaie?aaoeoo neeaaeathoue, ii iaoei aeaiei,
19,7% a no?oeoo?? aino?eo iaie?aaoeo?a, oa?aeoa?ecothoueny aenieith
eaoaeuei?noth, ?iaae?aeecaoe??th iaoe??io?a, ye? aeaeoaeaee, ui
iaaaoeaii a?aeaeaa?oueny ia iaaeeei-aeaiia?ao?/i?e neooaoe?? oa caaaea?
cia/ieo nioe?aeueii-aeiiii?/ieo caeoe?a.

2. Ee?i?ei-ii?oieia?/i?, eaai?aoi?ii-?ino?oiaioaeuei? ianoaaeaiiy oai?eo
ia oyaee? oi?ie iae?ioe/iiai iaie?aaoeoo aeicaieeee ioe?ieoe oyaee?noue
ia?aa?ao ? ?ic?iaeoe aeai?eoi eiiieaeniiai e?eoaaiiy, yeee aeaoa?i?io?
ianya oa /a?aia?noue i?iaaaeaiiy eiina?aaoeaieo ? o??o?a?/ieo caoiae?a
ia eiaei?e noaae?? caoai?thaaiiy.

3. ?ic?iaeaii iiaeeo?eaoe?th oaoiieia?? “a?aee?eoiai” o??o?a?/iiai
e?eoaaiiy iae?ioe/iiai iaie?aaoeoo – aeeiai?/ii? iiaioiiaie?aaoinoii??,
yea iieyaa? a aeeiiaii? iaane?nii-iiia?a/ii? eaia?ioii??, oi?ioaaii?
a?euece aeeiai?/iiai niinoa?aaeaiiy c ?ia?oiiai oaeaeei oaa?ae?th/iai
iaoa??aeo “Stomaflex solid”, cae?eniaii? oe?iei? iia?e?caoe??
i?aeoeoieiai? caeice ? cai/a?aaeiiiai i?inoi?o, niaoeeo?/iiio
?icoaooaaii? ae?aiaae?a, a oaeiae aeei?enoaii? aiaeineii?/ii? oaoi?ee a
i?ioean? eiio?iethaaiiy iiaioiiaie?aaoinoiie.

4. Canoinoaaiiy aeeiai?/ii? iiaioiiaie?aaoinoii?? a iao?e iiaeeo?eaoe??
ni?iuo? aeinooi aei i?aai?a ? oeaiei iaie?aaoi-aeoiaeaiaeueii? ciie,
caaacia/o? nai?/ania i?iaaaeaiiy ?aaeeeaeueii?
iaie?aaoiiae?naeaano?aeoii??, noai?aiiy aaeaeaaoieo oeyo?a aaaeoaoe??
ai?eiiiae?ioe/ieo ian oa iaeneiaeueio a?coae?caoe?th iaoieia?/iiai
i?ioeano a aeeiai?oe? aac ?aiia?aoe??.

5. Aeei?enoaiiy iiaeeo?eaoe?? “a?aee?eoiai” o??o?a?/iiai iaoiaeo a
eiiieaeniiio e?eoaaii? oai?eo ia oyaee? oi?ie iae?ioe/iiai iaie?aaoeoo
caaacia/eei ciaioaiiy e?eueeino? ai?eieo, a?noea?aeueieo oa
aeaaaia?aoeaieo i?neyiae?ioe/ieo oneeaaeiaiue aei 2,02 ia iaeiiai
oai?iai ? cieaeaiiy eaoaeueiino? aei 33,0% ii??aiyii c a?aeiia?aeieie
iieacieeaie 3,34 oa 57,2% i?e e?eoaaii? cae?eoei o??o?a?/iei niiniaii.

6. Anoaiiaeai? e?euee?ni? a?aei?iiino? iniiaieo i?e/ei nia?o?,
iia’ycaii? c i?neyiae?ioe/ieie oneeaaeiaiiyie: na?aae in?a, yeeo
iia?oaaee iiaeeo?eiaaiei iaoiaeii aeeiai?/ii? iiaioiiaie?aaoinoii??,
/anoioa eaoaeueieo aeiaaee?a aiane?aeie ai?eiiai ?icieaaeaiiy
i?aeoeoieiai? caeice, ai?eii-iae?ioe/iiai iaie?aaoeoo, naineno, ai?eiiai
ia?eoii?oo a 1,3-3 ?ace iaioa, i?ae na?aae iaoe??io?a, yeeo e?eoaaee
cae?eoei o??o?a?/iei iaoiaeii.

7. A eiiieaeniiio e?eoaaii? oai?eo ia oyaee? oi?ie iae?ioe/iiai
iaie?aaoeoo aeioe?eueii aeei?enoiaoaaoe aioo??oiueinoaeeiia eaca?ia
ii?ii?iaiiy e?ia?, yea ni?e/eiy? ei?eaoth/ee aieea ia ?ioiiee noaoon,
ni?ey? a??ia?aeiiio cieaeaiith caaaeueii? /anoioe oneeaaeiaiue a 2,7
?ace ? ciaioaiiyi eaoaeueiino? aei 29,2% ii??aiyii c 36,7% a a?oi?
iaoe??io?a, yeeo e?eoaaee aac aeei?enoaiiy eaca?ieo i?iiai?a.

NIENIE IIOAE?EIAAIEO I?AOeUe CA OAIITH AeENA?OAOe??

1. Ei?ioeee A.I., Eaeeoa I.ss., ?iuei A.A., Aaaaneay A.A., Niaa A.I.,
Oa?eaoeeee A.I. Niinia aeeaaiinoeee aeaeooo //A?a/aaiia aeaei. – 1986. –
? 10. – N.75-77.

2. Eaaeaei Ae.I., Eiiiaaeia A.I., Neeaa A.A., Caineiaa I.A., Oa?eaoeeee
A.I. Eniieueciaaiea eio?aei?ii?aeueiiai eaca?iiai iaeo/aiey e?iae i?e
ea/aiee aieueiuo n aiieii-ainiaeeoaeueiuie caaieaaaieyie // Eeeie/aneay
oe?o?aey. – 1988. – ? 3. – N.59-60.

3. Aeiiaineee A.A., Oiaiaoe A.N., Eeoaeiaiei A.E., Oa?eaoeeee A.I.,
Iaiueei N.I., Aaneeue/oe A.A. Aiaeec iineaiia?aoeeiiiie eaoaeueiinoe i?e
ino?ii oieaoeenoeoa // Eeeie/aneay oe?o?aey. – 1990. – ? 11. – N.35-37.

4. Oaa/oe E.I., Oa?eaoeeee A.I. Eeeie/aneea aa?eaiou oa/aiey
iineaiia?aoeeiiiie e?iaioi/auae no?anniaie ycau // Eeeie/aneay oe?o?aey.
– 1993. – ? 4. – N.6-8.

5. Aeiiaineee A.A., Oiaiaoe A.N., Eiiiaaeia A.I., Oa?eaoeeee A.I.
Iaiao?aoeey ycau aeaaiaaeoeaoeia?noiie eeoee a i?ioie iiaeaeaeoaei/iie
aeaeacu // Eeeie/aneay oe?o?aey. – 1994. – ? 11. – N.71-72.

6. A.n. ? 1741080: Niinia ii?aaeaeaiey noiia?iie i?ioaaciie aeoeaiinoe
iaie?aaoe/aneiai niea / Oaaai/oe A.I., Eeieai A.I., Eoeaooe A.Ae.,
E?aoiaeaa A.I., Eeoaeiaiei A.E., Oa?eaoeeee A.I., Eoa?aaaiei N.ss.
(NNN?). – Cayaea ? 4717235. I?ei?eoao ecia?aoaiey 11 ethey 1989a.
Ca?aaeno?e?iaaii a Ain?aano?a ecia?aoaiee NNN? 15.11.1992a.

7. Niin?a e?eoaaiiy iae?ioe/iiai iaie?aaoeoo / Oa?eaoeueeee A.I.,
Eiiiaaeia ?.I., ?iuei A.A., Iaianaiei N.?., E?ano’yiia I.TH., Oaaeieaiei
A.A., Uaiaoia A.A. (Oe?a?ia). – ??oaiiy i?i aeaea/o iaoaioo ia aeiao?ae
? 99041841. Ca?a?no?iaaii Aea?aeiaoaioii Oe?a?ie 30.08.99?.

8. Oa?eaoeueeee A.I., Eiiiaaeia ?.I. E?eoaaiiy oyaeeeo oi?i aino?iai
iaie?aaoeoo c aeei?enoaiiyi aiaeiaaneoey?ii? eaca?ii? ?ioiioa?ai?? oa
ni?aoe?eii? aeaoieneeaoe?? // Aeni?an-iiaeie: Iaoea, oaoi?ea,
ae?iaieoeoai. – Ee?a, 1996. – ? 7-8. – N.42.

9. Oa?eaoeeee A.I., Eiiiaaeia A.I., ?iuei A.A., Iaianaiei N.E. I auai?a
oe?o?ae/aneie oaeoeee i?e iae?ioe/aneii iaie?aaoeoa // Aiiaeu
oe?o?ae/aneie aaiaoieiaee: I?aai iaaeaeoia?iaeiie iauanoaaiiie
i?aaiecaoeee “Annioeeaoeey oe?o?aia-aaiaoieiaia”, iao/ii-i?aeoe/aneia
ecaeaiea. – Eeaa: IAEE-“Iaoea”, 1998. – O. 3, ? 3. – N.294-295.

10. Oa?eaoeeee A.I., Eiiiaaeia A.I. Aeeyiea AEIE ia ia?eoa?e/aneia
O-caaii eiioiiie nenoaiu aieueiuo iae?ioe/aneei iaie?aaoeoii // Iiaua
oaoiieiaee a oe?o?aee: Na. iao/. ?aaio, iinayu. 75-eaoeth eaoaae?u
oe?o?aee Eeaaneie iaaeeoeeineie aeaaeaiee iineaaeeieiiiiai ia?aciaaiey
IC Oe?aeiu. – E.: A?o-A?aoee. – 1997. – N.80.

11. Aeiiaineee A.A., Eeoaeiaiei A.E., Oiaiaoe A.N., Oa?eaoeeee A.I.,
*a?iue A.A. Ino?ue oieaoeenoeo, ineiaeiaiiue aeaeoooie // VII nuacae
oe?o?aia Iieaeaaee: Oac. aeiee. – Eeoeiaa, 1986. – N.21-22.

12. Aeiiaineee A.A., Eeoaeiaiei A.E., Oa?eaoeeee A.I., Noaeueia/aiei
TH.I. Ino?ue iaie?aaoeo // Aeooaeueiua aii?inu oe?o?aee iiaeaeaeoaei/iie
aeaeacu: Oac. aeiee. – E., 1988. – N.22-23.

13. Aeiiaineee A.A., Eeoaeiaiei A.E., Oiaiaoe A.N., Oa?eaoeeee A.I.,
Iaiueei N.I., Eacaiaoe E.A. Iaoaie/aneay aeaeoooa a iaioeiaeiie oe?o?aee
// Yeno?aiiay oe?o?ae/aneay aano?iyioa?ieiaey: Iaoa?eaeu
niaaonei-iieueneiai iao/i.-i?aeo. neiiiceoia ai?iaeia iia?aoeiia
Caii?iaeuea-A?ioeeaa. – Caii?iaeuea, 1989. – N.39-40.

14. Aeiiaineee A.A., Oa?eaoeeee A.I., Eeoaeiaiei A.E. e ae?. E aii?ino
ea/aiey iaie?aiiae?ica // Iiaia a aeeaaiinoeea e ea/aiee iaoieiaee
i?aaiia a?thoiie iieinoe. Aeooaeueiua aii?inu oe?o?aee: Oac. aeiee.: E.,
1990. – N.23-24.

15. Aeiiaineee A.A., Eeoaeiaiei A.E., Oa?eaoeeee A.I., Oiaiaoe A.N.
Ieacaiea oe?o?ae/aneie iiiiue i?e ineiaeiaiiuo oi?iao ino?iai
oieaoeenoeoa aioo?aiiuie aeae/iuie naeuaie // Iaoa?eaeu ?anioaeeeaineie
iao/i.-i?aeo.eiio., iinayu. 70-eaoeth neoaeau nei?ie iaaeeoeeineie
iiiiue a.Ieinea: Oac. aeiee. – Ieine, 1992. – N.117-118.

16. Aeiiainueeee A.A., Eeoaeiaiei A.?., Oa?eaoeueeee A.I., Eiiiaaeia
?.I. Oaeoeea e?eoaaiiy aino?iai iaoo?aoe?eiiai oieaoeenoeoo o oai?eo
a?oie aenieiai ?eceeo a ee?i?oe? iaa?aeeeaaeii? o??o?a?? // Aeooaeuei?
i?iaeaie aeno?aiaeueii? iaaeeoeeie: Iaoa??aee iaoe.-i?aeo.eiio. – E.,
1993. – N.33-34.

17. Aeiiainueeee A.A., Oa?eaoeueeee A.I., Eiiiaaeia ?.I., Oiaiaoeue A.N.
Eaia?inoii?y a eiiieaeniiio o??o?a?/iiio e?eoaaii? aeano?oeoeaieo oi?i
aino?iai iaie?aaoeoo // ?ioaa?aeueia oa niaoe?aeueia aeno?aiaeueia
iaaeeoeeia: Oace aeii.iae.iaoe.-i?aeo.eiio. – Caii??aeaey, 1993. –
N.41-42.

18. Aeiiainueeee A.A., Oiaiaoeue A.N., Oa?eaoeueeee A.I., Eiiiaaeia ?.I.
Ia?eoii?o ye oneeaaeiaiiy aeia/ii-eai‘yii? oai?iae // ?ioaa?aeueia oa
niaoe?aeueia aeno?aiaeueia iaaeeoeeia: Oace aeii.iae.iaoe.-i?aeo.eiio. –
Caii??aeaey, 1993. – N.41.

19. Domansky B.V., Terletsky V.N., Konovalov E.P., Umanets V.S.
Enterostomal nutrition technique in the management of acute pancreatitis
// Absts. Of 15 th ESPEN Congr. On cl. Nutrition and Metabolizm. 12-15
Sept, 1993. – Budapest, Hungary, 1993. – P.118-119.

20. Aeiiainueeee A.A., Oa?eaoeueeee A.I., Eiiiaaeia ?.I., Oiaiaoeue
A.N., Eeoaeiaiei A.?. A?aee?eoee niin?a o??o?a?/iiai e?eoaaiiy aino?iai
iaie?aiiae?ico // Iaoa??aee V Eiia?ano na?oiai? oaaea?aoe?? oe?a?inueeeo
e?ea?nueeeo oiaa?enoa: Aei?i?iiao?ianuee, 1994. – N.106.

21. Aeiiainueeee A.A., Oa?eaoeueeee A.I., Eiiiaaeia ?.I. I?i o??o?a?/io
oaeoeeo oneeaaeiaieo oi?i aino?iai iaie?aaoeoo // ?? Oe?a?inueea
iaoe.-i?aeo. eiioa?aioe?y c iaa?aeeeaaeii? aeiiiiiae “Aeooaeuei? ieoaiiy
iaa?aeeeaaeii? aeiiiiiae”: Oace aeii. – Iaeana, 1994. – N.218-219.

22. Aeiiainueeee A.A., Eiiiaaeia ?.I., Oa?eaoeueeee A.I., Eeoaeiaiei
A.?., Oiaiaoeue A.N., Aaneeue/oe I.A. Aeaye? aniaeoe iaoai?/ii?
aeiaoyieoe? a iaa?aeeeaaei?e o??o?a?? // ? (XVII) c‘?cae o??o?a?a
Oe?a?ie: Oace aeii. – Euea?a, 1994. – N.71.

23. Oa?eaoeueeee A.I. I?i aoaeoeai?noue aioa?inoiiaeueiiai oa?/oaaiiy a
eiiieaeniiio e?eoaaii? aino?iai iaie?aaoeoo // ?? Oe?a?inueea
iaoe.-i?aeo. eiio. c iaa?aeeeaaeii? aeiiiiiae “Aeooaeuei? ieoaiiy
iaa?aeeeaaeii? aeiiiiiae”: Oace aeii. – Iaeana, 1994. – N.240.

24. Aeiiainueeee A.A., Eiiiaaeia ?.I., Oa?eaoeueeee A.I. Aeeyiea AEIE ia
aeoeaiinoue aaaeoueo ooieoeeiiaeueiuo nenoai aieueiuo n
aiieii-naioe/aneeie ii?aaeaieyie // Aeooaeuei? i?iaeaie iiaeaiiy
aeno?aiii? iaaee/ii? aeiiiiiae i?e iaa?aeeeaaeieo noaiao:
Iaoa?.iae.-i?aeo.eiio. – E., 1995. – N.43.

25. Aeiiainueeee A.A., Eiiiaaeia ?.I., Oa?eaoeueeee A.I. I?eioeeie
o??o?a?/iiai e?eoaaiiy aino?iai iaie?aiiae?ico // No/ani? aniaeoe
iaa?aeeeaaeii? iaaee/ii? aeiiiiiae: Iaoa??aee tha?eaeii?
iaoe.-i?aeo.eiio., i?ena. 25-??//th noai?aiiy Euea?anueei?
i?nuee. ee?i?/ii? e?ea?i? oaeaeei? iaae. aeiiiiiae. – Euea?a, 1997. –
N.90-91.

26. Aeiiainueeee A.A., Eiiiaaeia ?.I., Oa?eaoeueeee A.I., Eeoaeiaiei
A.?., Oiaiaoeue A.N., Noiey?/oe N.I., Oiiaiei ?.I. I?i aeeiai?eo
?iaeeeaoi?ieo ne?iaaoeiaeo aicei?a o oai?eo c aino?ei iaie?aaoeoii i?e
aioo??noaeeiiiio eaca?iiio ii?ii?iaii? e?ia? // No/ani? aniaeoe
iaa?aeeeaaeii? iaaee/ii? aeiiiiiae: Iaoa??aee tha?eaeii?
iaoe.-i?aeo.eiio., i?ena. 25-??//th noai?aiiy Euea?anueei?
i?nuee. ee?i?/ii? e?ea?i? oaeaeei? iaae. aeiiiiiae. – Euea?a, 1997. –
N.91.

27. Aeiiainueeee A.A., Eiiiaaeia ?.I., Oa?eaoeueeee A.I. Iaianaiei N.I.
Aeeyiea AEIE ia eiioieoao aieueiuo n iae?ioe/aneei iaie?aaoeoii // ??
Eiia?an o??o?a?a Oe?a?ie: Ca. iaoe. ?ia?o. – Ee?a; Aeiiaoeuee, 1998. –
N.107-108.

AIIOAOe?ss

Oa?eaoeueeee A.I. E?eoaaiiy iae?ioe/iiai iaie?aaoeoo c canoinoaaiiyi
a?aee?eoiai niiniao iia?aoe?? – aeeiai?/ii? iiaioiiaie?aaoinoii??. –
?oeiien.

Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe
ca niaoe?aeuei?noth 14.01.03 – o??o?a?y. – Ee?anueea iaaee/ia aeaaeai?y
i?neyaeeieiiii? ina?oe ?i. I.E.Ooieea IIC Oe?a?ie, Ee?a, 1999.

Aeena?oaoe?th i?enay/aii ae??oaiith ieoaiue, iia’ycaieo c iie?ioaiiyi
?acoeueoao?a e?eoaaiiy oyaeeeo oi?i iae?ioe/iiai iaie?aaoeoo (II).
?iaioa a?oioo?oueny ia aeaieo eiiieaeniiai ee?i?ei-ii?oieia?/iiai,
eaai?aoi?iiai ? ?ino?oiaioaeueiiai iane?aeoaaiiy 174 oai?eo ia II oa ?o
e?eoaaiiy c canoinoaaiiyi “a?aee?eoiai” o??o?a?/iiai iaoiaeo o aeani?e
iiaeeo?eaoe?? (97 iaoe??io?a) oa o?aaeeoe?eiiai “cae?eoiai” niiniao (77
iaoe??io?a). Io?eiai? aeai? aeei?enoaii aeey ?ic?iaee ? iaa?oiooaaiiy
aeai?eoio eiiieaeniiai e?eoaaiiy iae?ioe/iiai iaie?aaoeoo.

Iiaeeo?eiaaii oaoiieia?th a?aee?eoiai niiniao o??o?a?/iiai e?eoaaiiy –
aeeiai?/ii? iiaioiiaie?aaoinoii?? (AeIIN) oa aeieacaia aeioe?euei?noue
aeei?enoaiiy eiai aeey e?eoaaiiy oyaeeeo oi?i II. Anoaiiaeaii, ui
canoinoaaiiy iiaeeo?eaoe?? oeueiai iaoiaeo a e?eoaaii? oai?eo ia II a
ii?aeiaii? c aaeaeaaoiith eiina?aaoeaiith oa?ai??th oa
aioo??oiueinoaeeiiei eaca?iei ii?ii?iaiiyi e?ia? ni?ey? iie?ioaiith
aaciina?aaei?o ?acoeueoao?a o??o?a?/iiai e?eoaaiiy, yea aeyaey?oueny a
ciaioaii? /anoioe ai?eii-naioe/ieo ? a?noea?aeueieo oneeaaeiaiue oa
e?eueeino? nia?oaeueieo aeiaaee?a (33,0%) na?aae iaoe??io?a ii??aiyii c
oai?eie, iia?iaaieie o?aaeeoe?eiei cae?eoei o??o?a?/iei iaoiaeii
(57,2%).

Eeth/ia? neiaa: iae?ioe/iee iaie?aaoeo, oyaee? oi?ie, oneeaaeiaiiy,
eaoaeuei?noue, aeai?eoi eiiieaeniiai e?eoaaiiy, iiaeeo?eaoe?y
“a?aee?eoiai” iaoiaeo o??o?a?/iiai e?eoaaiiy – aeeiai?/ii?
iiaioiiaie?aaoinoii??, aioo??oiueiaaiia eaca?ia ii?ii?iaiiy e?ia?.

SUMMARY

Terletsky V.N. Treatment of necrotizing pancreatitis by using the “open”
surgical method – dynamic omentopancreatostomy. – Manuscript.

Thesis for a degree of candidate of medical sciences in speciality
14.01.03 – surgery. – Kiev Medical Academy for Post-Graduate Education
named after P.L.Shupik of Ministry of Health of Ukraine, Kiev, 1999.

The thesis was aimed at the improvement of the results of acute
necrotizing pancreatitis surgical treatment.

The complex clinico-morphological, laboratory, instrumental examinations
and treatment of 174 patients with severe necrotizing pancreatitis were
performed.

Data obtained were used to develop and substantiate the complex
treatment algorithm determing the taking turns, optimum terms and volume
of conservative and surgical medical measures depending on the stage and
clinical course peculiarities of severe necrotizing pancreatitis. It was
also developed the modified technique of “open” abdominal treatment –
dynamic omentopancreatostomy (DOPS).

The advantage of this method as compared with traditional “closed” ones
was proved. Using of DOPS in treatment of patients with severe
necrotizing pancreatitis permitted to improve the clinical course of
disease, decrease the numbers of fatal postnecrotizing complications and
lethality from 57,2% to 33,0%.

Besides, the positive influence of intravenous laser blood irradiation
on these results and its immunocorrecting effect were shown.

Key words: severe necrotizing pancreatitis, compications, mortality,
complex treatment algorithm, “open” abdominal treatment, modification of
dynamic omentopancreatostomy method, intravenous laser blood
irradiation.

AIIIOAOeEss

Oa?eaoeeee A.I. Ea/aiea iae?ioe/aneiai iaie?aaoeoa n eniieueciaaieai
ioe?uoiai niiniaa iia?aoeee – aeeiaie/aneie iiaioiiaie?aaoinoiiee. –
?oeiienue.

Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo
iaoe ii niaoeeaeueiinoe 14.01.03 – oe?o?aey. – Eeaaneay iaaeeoeeineay
aeaaeaiey iineaaeeieiiiiai ia?aciaaiey ei. I.E.Ooieea IC Oe?aeiu, Eeaa,
1999.

Aeenna?oaoeey iinayuaia aii?inai oeo/oaiey ?acoeueoaoia ea/aiey oyaeaeuo
oi?i iae?ioe/aneiai iaie?aaoeoa (II), eioi?ua ninoaaeee 19,7% neo/aaa io
anao aieueiuo ino?ui iaie?aaoeoii, i?ioiaeeaoeo ea/aiea a oa/aiea
1985-1998aa. a Eeaaneie ai?iaeneie eeeie/aneie aieueieoea nei?ie
iaaeeoeeineie iiiiue. ?aaioa aace?oaony ia aeaiiuo eiiieaeniiai
eeeieei-ii?oieiae/aneiai, eaai?aoi?iiai, eino?oiaioaeueiiai
ianeaaeiaaiey e ea/aiey 174 aieueiuo.

Aeey ea/aiey II eniieueciaaee “ioe?uoue” oe?o?ae/aneee iaoiae –
aeeiaie/aneoth iiaioiiaie?aaoinoiieth (AeIIN) a nianoaaiiie
iiaeeoeeaoeee (iniiaiay a?oiia 97 aieueiuo) e o?aaeeoeeiiiue “cae?uoue”
(eiio?ieueiay a?oiia 77 aieueiuo).

*anoue aieueiuo iniiaiie a?oiiu, eioi?uo ea/eee “ioe?uoui” oe?o?ae/aneei
iaoiaeii, a iineaiia?aoeeiiiii ia?eiaea, e?iia oiai, iieo/eee eo?n
eaca?iie oa?aiee iooai aioo?eaaiiiai iaeo/aiey e?iae (AEIE).

Aic?ano aieueiuo iaaeo a?oii eieaaaeny io 30 aei 70 eao. O?oaeiniiniaiue
aic?ano n?aaee ioae/ei iniiaiie a?oiiu ninoaaee 72,4%, a eiio?ieueiie –
59,0%, n?aaee aeaiuei – niioaaonoaaiii 62,0% e 87,5% neo/aaa.
Aeiieie?othuei yoeieiae/aneei oaeoi?ii auee aeae/aeaiaiiay aieaciue e
aeeiaieeci: 67,0% neo/aaa a iniiaiie e 74,0% – a eiio?ieueiie a?oiia.

Eeeie/aneay ea?oeia II o aieueiuo iaaeo a?oii auea noiaeiie e
oa?aeoa?eciaaeanue iieeii?oeciii e ?aciie iaieoanoaoeaiinoueth
i?iyaeaiee.

I?e ioeaiea oyaeanoe caaieaaaiey n iiiiuueth e?eoa?eaeueiie oeaeu o
67,0% aieueiuo iniiaiie e 67,5% – eiio?ieueiie a?oiiu onoaiiaeaia
i?aeiouanoaaiii oyaeaeay noaiaiue oa/aiey II. O inoaeueiuo iaoeeaioia –
o 33,3% a iniiaiie e 32,5% a eiio?ieueiie a?oiia ioia/aia n?aaeiyy
noaiaiue oyaeanoe II. Eaaeea oi?iu ionoonoaiaaee.

Ea/aaioth oaeoeeo II oi?ie?iaaee eiaeeaeaeoaeueii aeey eaaeaeiai
aieueiiai, enoiaey ec nia?aiaiiuo acaeyaeia ia yoeieiaeth e iaoiaaiac e
ioeaiee noaiaie oyaeanoe caaieaaaiey ii e?eoa?eaeueiie oeaea.
?acoeueoaou enneaaeiaaiee eniieueciaaiu aeey ?ac?aaioee e iainiiaaiey
aeai?eoia eiiieaeniiai ea/aiey II, ii?aaeaeythuaai i/a?aaeiinoue,
iioeiaeueiua n?iee e iauai i?iaaaeaiey eiina?aaoeaiuo e oe?o?ae/aneeo
ea/aaiuo ia?ii?eyoee a caaeneiinoe io noaaeee caaieaaaiey e iniaaiiinoae
aai oa/aiey.

?ac?aaioaia iiaeeoeeaoeey “ioe?uoiai” oe?o?ae/aneiai ea/aiey II –
aeeiaie/aneie iiaioiiaie?aaoinoiiee, eioi?ay caeeth/aaony a
eini-iiia?a/iie eaia?ioiiee e oi?ie?iaaiee aeeuecu aeeiaie/aneiai
iaaethaeaiey ec eia?oiiai, auno?i caoaa?aeaaathuaai iaoa?eaea
“Stomatoflex-solid”, inouanoaeaiee oe?ieie iiaeeecaoeee iiaeaeaeoaei/iie
aeaeacu e caa?thoeiiiai i?ino?ainoaa, niaoeeoe/aneii ?aniieiaeaiee
ae?aiaaeae e eniieueciaaiee yiaeineiie/aneie oaoieee a i?ioeanna
eiio?iey iiaioiiaie?aaoinoiiu.

Eniieueciaaiea AeIIN oi?iuaao aeinooi e iiaeaeaeoaei/iie aeaeaca e
ie?oaeathuei i?aaiai e oeaiyi e iaania/eaaao yooaeoeaiia oaeaeaiea
aiieii-iae?ioe/aneeo iann, iaaethaeaiea ca oa/aieai iaoieiae/aneiai
i?ioeanna e ?acoeueoaoaie ea/aiey aac ?aiia?aoeee.

Onoaiiaeaiu e eeeie/anee iainiiaaiu i?aeiouanoai e oeaeaniia?aciinoue
eniieueciaaiey AeIIN aeey ea/aiey II. I?eiaiaiea yoiai iaoiaea a
eiiieaeniii ea/aiee aieueiuo oyaeaeuie oi?iaie caaieaaaiey iicaieeei
oeo/oeoue eeeie/aneia oa/aiea, oiaiueoeoue eiee/anoai oaoaeueiuo
aiieii-naioe/aneeo, aenoea?aeueiuo e aeaaaia?aoeaiuo iineaiae?ioe/aneeo
ineiaeiaiee aei 2,02 ia iaeiiai aieueiiai, nieceoue eaoaeueiinoue aei
33,0% ii n?aaiaieth niioaaonoaothuei iieacaoaeyi 3,34 e 57,2% o
aieueiuo, ea/aiiuo “cae?uoui” niiniaii.

Aeieacaii aeaaii?eyoiia aeeyiea ia iieacaoaee ineiaeiaiee e
eaoaeueiinoe, a oaeaea eiioiiei??eae?othuaa aeaenoaea aioo?eaaiiiai
eaca?iiai iaeo/aiey e?iae. O aieueiuo II, a eiiieaeniii ea/aiee eioi?uo
i?eiaiyee eaca?iua eo/e (AEIE), ioia/aii oiaiueoaiea noiia?iie /anoiou
aiieii-naioe/aneeo e aenoea?aeueiuo ineiaeiaiee a 2,7 ?aca e nieaeaiea
nia?oiinoe aei 29,2% ii n?aaiaieth 36,7% n?aaee iaoeeaioia, ea/aiiuo aac
AEIE.

Eeth/aaua neiaa: iae?ioe/aneee iaie?aaoeo, oyaeaeua oi?iu, ineiaeiaiey,
eaoaeueiinoue, aeai?eoi eiiieaeniiai ea/aiey, iiaeeoeeaoeey “ioe?uoiai”
iaoiaea oe?o?ae/aneiai ea/aiey – aeeiaie/aneie iiaioiiaie?aaoinoiiee,
aioo?eaaiiia eaca?iia iaeo/aiea e?iae.

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