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Модифікація залобкової простатектомії: Автореф. дис… канд. мед. наук / С.М. Шамраєв, Ін-т урології та нефрології АМН України. — К., 1999. — 20 с. —

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?INOEOOO O?IEIA?? OA IAO?IEIA?? AII OE?A?IE

Oai?a?a Na?a?e Ieeieaeiae/

OAeE 616.65 – 089.87

IIAeEO?EAOe?ss CAEIAEIAI? I?INOAOAEOII??

14.01.06 – o?ieia?y

Aaoi?aoa?ao aeena?oaoe??

ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Ee?a — 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia ia eaoaae?? o?ieia?? ? iao?ieia?? Aeiiaoeueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i.I.Ai?ueeiai IIC Oe?a?ie.

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, i?ioani?Na?iye Iao?i
Noaiaiiae/, Aeiiaoeueeee aea?aeaaiee iaaee/iee oi?aa?neoao
?i.I.Ai?ueeiai, i?ioani? eaoaae?e o?ieia?? ? iao?ieia??.

Io?oe?ei? iiiiaioe:

1. Aeieoi? iaaee/ieo iaoe, i?ioani? Etheueei Ieaen?e Ieaen?eiae/,
Caii??cueeee aea?aeaaiee ?inoeooo oaeineiiaeaiiy e?ea??a, caa?aeoaa/
eaoaae?e o?ieia??.

2. Aeieoi? iaaee/ieo iaoe, i?ioani? Iaiai?i Aieiaeeie? ?icoiieeiae/,
Eoaainueeee aea?aeaaiee iaaee/iee oi?aa?neoao, caa?aeoaa/ eaoaae?e
o?ieia?? oa iieieia??.

I?ia?aeia onoaiiaa: Iaeanueeee aea?aeaaiee iaaee/iee oi?aa?neoao,
eaoaae?a o?ieia?? ? iao?ieia??, IIC Oe?a?ie, i.Iaeana.

Caoeno a?aeaoaeaoueny “21” a?oaeiy 1999 ?ieo i 13 aiaeei? ia can?aeaii?
niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.615.01 i?e ?inoeooo? o?ieia?? oa
iao?ieia?? AII Oe?a?ie ca aae?anith: 04053, i.Ee?a, aoe.
TH.Eioethaeinueeiai, 9-a.

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? ?inoeoooo o?ieia?? oa
iao?ieia?? AII Oe?a?ie ca aae?anith: 04053, i.Ee?a, aoe.
TH.Eioethaeinueeiai, 9-a.

Aaoi?aoa?ao ?ic?neaiee “ 20 ”eenoiiaaea 1999 ?ieo.

A/aiee nae?aoa?niaoe?ae?ciaaii? a/aii? ?aaee,

aeieoi? iaaee/ieo iaoe Aieei I.?.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. A?ia?ieac?y ia?aaei?oo?iai? caeice ? oyaeeei ?
iioe?aiei caoai?thaaiiyi /ieia?e?a iioeeiai ? noa?a/iai a?eo, ??aaiue
yeiai ia? oaiaeaioe?th aei c?inoaiiy. A?noieia?/i? iciaee iaoieia??
ciaoiaeyoue o 11% /ieia?e?a a?eii aei 40 ?ie?a, a?eueoa 40% aei 50
?ie?a, ? iiiaae 90% noa??oeo ca 80 ?ie?a (Cockett A.T.K. et al., 1996).
A Oe?a?i? ca inoaii? o?e ?iee (19961998 ??.) caoai?thaai?noue ia
a?ia?ieac?th i?inoaoe ca?eueoeeanue ia 40% ? noaiiaeea a 1998 ?. 206,9
ia 100 000 /ieia?/iai ianaeaiiy, iioe?ai?noue ia 30,8% ? aei??aithaaea,
a?aeiia?aeii, 509,7. O Aeiiaoeuee?e iaeano? cacia/ai? iieacieee
ia?aaeuothoue iiae?ai? a oe?eiio ii e?a?i?: ??aaiue caoai?thaaiino? c??n
ia 44% ? neeaaeaa a 1998 ?. 239,5, ?iciianthaeaeai?noue ia 32% ?
aeinyaaea, a?aeiia?aeii, 583,8 ia cacia/aia ianaeaiiy (E.I. Iaaeiaa i
ae?., 1997, 1998). Oea na?ae/eoue i?i ca?eueoaiiy e?eueeino? oai?eo ia
a?ia?ieac?th ia?aaei?oo?iai? caeice, ye? iio?aaothoue niaoe?ae?ciaaii?
iaaee/ii? aeiiiiiae. A?aeiii, ui ca inoaii? aeanyoe??//y nooo?ai
ci?ieeanue oaeoeea e?eoaaiiy oe??? iaoieia??. Aeei?enoaiiy no/anieo
iaaeeeaiaioicieo, ?ino?oiaioaeueieo, o??o?a?/ieo iaoiae?a iaiaaeaia
/?oeeie iieacaiiyie oa iio?aao? a?aeiia?aeiiai iaeaaeiaiiy.

I?ioa, i?ciy noaae?y iaoieia?/iiai i?ioeano, a ye?e aeineoue /anoi
ae?aaiinoo?oueny caoai?thaaiiy, aei oiai ae iaoyaeaia oneeaaeiaiiyie oa
noiooi?ie oai?iaaie, iaoieia?/i? iniaeeaino? aaceei-o?ao?aeueiiai
naaiaioa, i?ecaiaeyoue aei oiai, ui o??o?a?/ia e?eoaaiiy i?iaeiaaeo?
iin?aeaoe iiaiii?aaia i?noea ii?yae ?c no/anieie aeueoa?iaoeaieie
iaoiaeaie. Oei a?eueoa, ui aiii caeeoa?oueny iaoiaeii ?aaeeeaeueiiai
e?eoaaiiy iaoe??io?a, a oaeiae aeeeth/a? ?iia??i?noue iiaoi?iiai
?iaac?eiiai e?eoaaiiy o 4-14,1% oai?eo (Carraro J.C. et al., 1996,
Peeling W.B., 1994, Bartsch G., 1997). O??o?a?/ia ao?o/aiiy iaiao?aeia
o?ueii c 10 oai?eo, a i?ney 40 ?ie?a ?ecee i?aeianoe i?ae
i?inoaoaeoii?th noaiiaeoue 30-40%, yeui /ieia?e aeiaeeaa aei 80 ?ie?a
(Holtgrewe H.L. et al., 1996). Noaoenoe/i? aeai? na?ae/aoue, ui o
63,7-78,0% o??o?a?/ieo ao?o/aiue cae?enith?oueny o?aino?ao?aeueia
?acaeoe?y i?inoaoe, o 15-18% — a?aee?eoa i?inoaoaeoii?y, i?e oeueiio
caeiaeiaiio aeinooio iaeaaeeoue a?aeiia?aeia i?noea (Gibbons R.P. et
al., 1996, Ia?oia A.A., 1997). Aieiaia ia?aaaaa oe??? iia?aoe?? iieyaa?
o iiaeeeaino? oi?ioaaiiy o?ao?ioeenoiaianoiiico, oiaoi a?aeiiaeaiiy
ii?iaeueii? aiaoii?? aaceei-o?ao?aeueiiai naaiaioa. ?acii c oeei, ?nio?
i?iaeaia i?neyiia?aoe?eieo oneeaaeiaiue, a?aenioie yeeo caeeoa?oueny
aeineoue aenieei ? eieeaa?oueny, ca aeaieie ??cieo aaoi??a, a?ae 6,2 aei
47,2% niinoa?aaeaiue (Kirby R.S., McConnell S., 1995).

Cieaeaiiy e?eueeino? ?aii?o oa i?ci?o i?neyiia?aoe?eieo oneeaaeiaiue
caeaaeeoue, a iaai?e i???, a?ae oaoi?ee o??o?a?/iiai ao?o/aiiy, a oaeiae
oaeineiiaeaiiy iaoiae?a i?inoaoaeoii??, ui iaa?oioiao? iaiao?aei?noue
ii?aoethaaiiy iiaeo i?aeoiae?a aei iaaeaiiy o??o?a?/ii? aeiiiiiae oe?e
eaoaai??? oai?eo.

Ca’ycie caaaeaiue aeine?aeaeaiiy c i?iaeaiiei ieaiii ?icaeoeo iaaee/ieo
iaoe. Aeena?oaoe?eia ?iaioa ? o?aaiaioii iaoeiai-aeine?aeii? oaie
“Aea/aiiy iaoai?ci?a i?ioeiooeeiii? ?acenoaioiino? i?aai?cio o oai?eo ia
?ae ie?ee, na/iaiai i?oo?a ? ia?aaei?oo?iai? caeice” (?
aea?ae?a?no?aoe?? 0193V034676, oeo? AE 93.04.27), ui aeeiio?oueny ia
caiiaeaiiy Aea?aeaaiiai eii?oaoo c iaoee oa oaoi?ee.

Iaoa aeine?aeaeaiiy. Iaoith ?iaioe ? iie?auaiiy iaeaeeae/eo ?
a?aeaeaeaieo ?acoeueoao?a o??o?a?/iiai e?eoaaiiy oai?eo ia a?ia?ieac?th
ia?aaei?oo?iai? caeice oeyoii iiaeeo?eaoe?? oi?ioaaiiy
aaceei-o?ao?aeueiiai aianoiiico i?ney caeiaeiai? i?inoaoaeoii??.

Iniiai? caaaeaiiy aeine?aeaeaiiy:

1. Cae?enieoe aiae?c ee?i?ei-o?iaeeiai?/ieo ?acoeueoao?a o??o?a?/iiai
e?eoaaiiy oai?eo ia a?ia?ieac?th ia?aaei?oo?iai? caeice.

2. Oaeineiiaeeoe oaoi?eo caeiaeiai? i?inoaoaeoii?? oeyoii aia?aoiiai
oi?ioaaiiy o?ao?ioeenoiaianoiiico.

3. Ioe?ieoe ?acoeueoaoe caeiaeiai? i?inoaoaeoii?? c oi?ioaaiiyi
o?ao?ioeenoiaianoiiico aia?aoiei ? ?o/iei niiniaaie.

4. Aecia/eoe iieacaiiy aei caeiaeiai? i?inoaoaeoii?? c oi?ioaaiiyi
aaceei-o?ao?aeueiiai naaiaioa aia?aoiei niiniaii.

Iaoeiaa iiaecia ?acoeueoao?a aeine?aeaeaiiy. Aia?oa ii?aoeueiaaiee iiaee
niin?a a?aeiiaeaiiy aaceei-o?ao?aeueiiai naaiaioa i?e caeiaeia?e
i?inoaoaeoii?? c aeei?enoaiiyi aeiaeaeaiiai iaie aia?aoa aeey
iaeeaaeaiiy oa?a ia o?ao?o (iaoaio Oe?a?ie ?12640 ? na?aeioeoai i?i
ei?enio iiaeaeue ?in?? ?97109443/20 a?ae 22.07.97). Aia?oa aea/ai?
ee?i?ei-o?iaeeiai?/i? ?acoeueoaoe ??cieo niinia?a i?inoaoaeoii??. Aia?oa
aeiaaaeaia iaiao?aei?noue canoinoaaiiy ?iaeea?aeoaeueiiai
aeeoa?aioe?eiaaiiai i?aeoiaeo aei aeai?o iaoiaeeee o??o?a?/iiai
ao?o/aiiy ia i?aenoaa? ioe?iee nooiaiy oyaeeino? ?io?aaaceeaeueii?
iano?oeoe??, iaoieia?/ieo iniaeeainoae aaceei-o?ao?aeueiiai naaiaioa,
noiooi?o caoai?thaaiue i?inoaoe ? na/iaiai i?oo?a, a oaeiae
aiaoiii-ooieoe?iiaeueiiai noaio ie?ie ? aa?oi?o na/iaeo oeyo?a. Aia?oa
ii?aoeueiaaii ? anoaiiaeaii i?aeoe/ia cia/aiiy eeaneo?eaoe?? nooiaiy
?io?aaaceeaeueii? iano?oeoe??: S1-3 U1-3 P1-3. Aia?oa iaa?oioiaai? ?
aeiaaaeai? ia?aaaae aia?aoiiai iaeeaaeaiiy o?ao?ioeenoiaianoiiico i?e
caeiaeia?e i?inoaoaeoii??. Aia?oa ae?iaeai? /?oe? iieacaiiy aei
canoinoaaiiy oaeineiiaeaii? ?? iaoiaeeee.

I?aeoe/ia cia/aiiy aeine?aeaeaiiy. Ii?aoeueiaaiee ? ai?iaaaeaeaiee aei
ee?i?/ii? i?aeoeee iiaee niin?a o?ao?ioeenoiaianoiiico ?c canoinoaaiiyi
aia?aoa aeey iaeeaaeaiiy oa?a ia o?ao?o aeicaieea oaeineiiaeeoe
iaoiaeeeo caeiaeiai? i?inoaoaeoii?? oa ?icoe?eoe a?naiae o??o?a?/ieo
iaoiae?a e?eoaaiiy a?ia?ieac?? ia?aaei?oo?iai? caeice ? iie?ioeoe ?o
?acoeueoaoe. Iaa?oioiaai? ? ai?iaaaeaeai? iieacaiiy aei oe???
iiaeeo?eaoe?? caeiaeiai? i?inoaoaeoii??.

C?iaeai? eiie?aoi? i?iiiceoe?? uiaei oaeineiiaeaiiy o??o?a?/ii? oaoi?ee
i?ae /an aeeiiaiiy caeiaeiai? i?inoaoaeoii??, ii?aoeueiaaiee ?
ai?iaaaeaeaiee eiiieaen i?io?eaeoe/ieo caoiae?a i?ioe i?neyiia?aoe?eieo
oneeaaeiaiue aaceei-o?ao?aeueiiai naaiaioa, ui aeicaieeei ciaioeoe ?o
e?euee?noue, nei?ioeoe o?eaae?noue aini?oae?caoe?? ? aa?o?noue e?eoaaiiy
aeey iaoe??io?a ?, o e?ioeaaiio iane?aeeo, iie?ioeoe ?acoeueoaoe
i?inoaoaeoii??.

Aeey aecia/aiiy iaea?eueo ?aoe?iiaeueiiai i?aeoiaeo aei aeai?o niiniao
i?inoaoaeoii?? ? cae?eniaiiy iii?oi?eiao ca iaaee/iith ?aaa?e?oaoe??th
oai?eo aia?oa aeei?enoaia ? ai?iaaaeaeaia aei ee?i?/ii? i?aeoeee
eeaneo?eaoe?y nooiai?a ?io?aaaceeaeueii? iano?oeoe??: S1-3 U1-3 P1-3.
Iaa?oioiaaia canoinoaaiiy oe??? eeaneo?eaoe?? aeicaieeei
?iaeea?aeoae?coaaoe e?eoaaeueio oaeoeeo o eiaeiiai oai?iai.

Aeaeea?aoe?y iniaenoiai aianeo caeiaoaa/a o ?ic?iaeo iniiaieo iaoeiaeo
iieiaeaiue, ye? aeeeaaeai? o aeena?oaoe??. Iniaenoei aianeii aaoi?a ?
aeiao?ae ? aeaioiaeaiiy aia?aoa aeey iaeeaaeaiiy oa?a ia o?ao?o,
iiaeeo?eaoe?y caeiaeiai? i?inoaoaeoii?? ? aiae?c ee?i?ei-o?iaeeiai?/ieo
?acoeueoao?a o??o?a?/iiai e?eoaaiiy oai?eo ia a?ia?ieac?th
ia?aaei?oo?iai? caeice. Aaoi? naiino?eii aeeiiaa iiiaae 25% iia?aoe?e, a
oaeiae a?aa o/anoue ye anenoaio o a?eueoino? o??o?a?/ieo ao?o/aiue,
cae?enithaaa ia?aaeiia?aoe?eia ianoaaeaiiy ? i?neyiia?aoe?eia e?eoaaiiy
iaoe??io?a, ?ao?iniaeoeaiee aiae?c ?noi??e oai?ia. Iei ia?niiaeueii
cae?eniaiee aiae?c e?oa?aoo?e c i?iaeaie, ui aea/a?oueny, ca?? ? ia?iaea
oaeoe/iiai iaoa??aeo, i?aai?caoe?y ? i?iaaaeaiiy iaoeiaeo
aeine?aeaeaiue, noaoenoe/iee aiae?c iaea?aeaieo aeaieo. Oai?aoe/ia
ocaaaeueiaiiy aeaieo, inoaoi/ia ?ioa?i?aoaoe?y iaea?aeaieo ?acoeueoao?a
? oeeaaeaiiy a?aeiia?aeieo aeniiae?a aoei cae?eniaia ni?eueii ?c
iaoeiaei ea??aieeii.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
iaaiai?ai? ia iaoeiai-i?aeoe/ieo eiioa?aioe?yo o ee?i?oe? o?ieia?? ?
iao?ieia?? Aeiiaoeueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i.
I.Ai?ueeiai, ia can?aeaiiyo Aeiiaoeueeiai a?aeae?eaiiy Annioe?aoe??
o?ieia?a Oe?a?ie (1997,1998,1999), ia V-iio oa VI-iio I?aeia?iaeieo
c’?caeao o?ieia?a (Oa?e?a, 1997, 1998), ia IX-iio Ana?in?enueeiio
c’?cae? o?ieia?a (Eo?ne, 1997), ia VIII-iio Ieaioi? Anioe?aoe?? o?ieia?a
Oe?a?ie (O?oneaaaoeue, 1998), ia 10-th Videourology World Congress
(Montecatini, 1998).

Ai?iaaaeaeaiiy. ?ic?iaeai? o aeena?oaoe?? ?aeiiaiaeaoe?? uiaei
ianoaaeaiiy ? e?eoaaiiy oai?eo ia a?ia?ieac?th ia?aaei?oo?iai? caeice,
iiaeeo?eaoe?y caeiaeiai? i?inoaoaeoii?? ai?iaaaeaeai? a o?ieia?/iiio
a?aeae?eaii? Aeiiaoeueeiai iaeaniiai ee?i?/iiai oa?eoi??aeueiiai
iaaee/iiai ia’?aeiaiiy. Iaoa??aee aeena?oaoe?? aeei?enoai? o eaeoe?yo
aeey nooaeaio?a, e?ea??a-?ioa?i?a oa eo?naio?a eaoaae?e o?ieia?? ?
iao?ieia?? Aeiiaoeueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i.
I.Ai?ueeiai.

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 22 iaoeia? i?aoe?,
c ieo naiino?eii – 4, o oiio /ene? io?eiaii iaoaio Oe?a?ie ?12640 oa
aaoi?nueea na?aeioeoai ?in?? ?97109443/20.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?th aeeeaaeaii ia 140
noi??ieao iaoeiiieno. Aiia neeaaea?oueny c? anooio, iaeyaeo e?oa?aoo?e,
iaoa??aeo oa iaoiae?a aeine?aeaeaiiy, 3 ?icae?e?a, ye? aena?oeththoue
?acoeueoaoe aeanieo aeine?aeaeaiue, aeniiae?a. ?ethno?aoeaiee iaoa??ae
neeaaeathoue 30 oaaeeoeue, 18 ?enoie?a oa 2 aeiaeaoee. A?ae?ia?ao?/iee
iieaae/ee i?noeoue 272 aeaea?aea e?oa?aoo?e, c yeeo 163 a?o/eciyieo ?
109 – ?iicaiieo.

INIIAIEE CI?NO ?IAIOE

Iaoa??ae oa iaoiaee aeine?aeaeaiiy. Aeey ae??oaiiy iinoaaeaieo caaaeaiue
iaie cae?eniaiee ?ao?iniaeoeaiee aiae?c ?noi??e oai?iae 1932 iaoe??io?a,
ye? ia?aoa?i?ee ??ci? niiniae i?inoaoaeoii?? o ee?i?oe? o?ieia?? ?
iao?ieia?? Aeiiaoeueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i.
I.Ai?ueeiai i?ioyaii 1989-1997 ??. O?aino?ao?aeueio ?acaeoe?th i?inoaoe
i?iaiaeeee noaiaea?oieie ?acaeoineiiaie “AUTOCON 350” (“Karl Storz”,
I?ia//eia) c ooaonaie ?24 ? 27 ca Oa?ue??ii, aeey ??eaaoe??
aeei?enoiaoaaee noa?eeueiee 5% ?ic/ei aetheice. *a?aci?oo?iao
i?inoaoaeoii?th aeeiioaaee c iaeeaaeaiiyi eenaoiiai oao ?
ia?ao?ao?aeueiei aeaaaeaiiyi ieoie ia i?iiaaeeio ca E.O.Iiaeeiaei
(1974), a i?e oe?ieiio aoiae? a eiaea i?inoaoe – c eiai iiia?aaei?i
ooeaaiiyi 1-3 eaoaooiaeie e?aaoo?aie. Ca a?aenooi?noth i?ioeiieacaiue
ia?aaeith no?ieo na/iaiai i?oo?a ooeaaee iane?ii. Caeiaeiao
i?inoaoaeoii?th aeeiioaaee c ?o/iei oi?ioaaiiyi o?ao?ioeenoiaianoiiico
ca iiaeeo?eiaaiith iia?aoe??th I?e?ia. Aiae?c ee?i?ei-o?iaeeiai?/ieo
?acoeueoao?a ??cieo niinia?a i?inoaoaeoii?? ie i?iaiaeeee ca oaeeie
iieacieeaie: noia?iee aae ?iaeaeno IPSS, iaeneiaeueia ia’?iia
oaeaee?noue na/iaeioneaiiy oa ia’?i caeeoeiai? na/?, o?eaae?noue
i?neyiia?aoe?eiiai e?aeei-aeiy ? a?aeiiaeaiiy naiino?eiiai
na/iaeioneaiiy, i?neyiia?aoe?eia eaoaeuei?noue, /anoioa aeieeiaiiy o
oai?eo i?neyiia?aoe?eieo oneeaaeiaiue.

I?ae iaoei niinoa?aaeaiiyi ia?aaoaaei 132 oai?eo ia a?ia?ieac?th
i?inoaoe, ye? iia?iaai? a 1996—1997 ??. Aiie aoee ?iciiae?eai? ia aea?
a?oie. Ia?oa a?oia neeaaeaeanue c? 111 /ieia?e?a, yeei aeeiiaia
caeiaeiaa i?inoaoaeoii?y c iaioaeueiei iaeeaaeaiiyi oa?a ia na/?aiee ia
aoai? oi?ioaaiiy o?ao?ioeenoiaianoiiico; 21 iaoe??ioo ae?oai? a?oie oeae
aoai aeeiioaaee ?c canoinoaaiiyi aeiaeaeaiiai iaie aia?aoa aeey
iaeeaaeaiiy oa?a ia o?ao?o (iaoaio Oe?a?ie ?12640 oa aaoi?nueea
na?aeioeoai ?in?? ?97109443/20). A?e iaoe??io?a ia?oi? a?oie eieeaaany
a?ae 56 aei 83 ?ie?a ? o na?aaeiueiio neeaaeaa 68,0±4,5 ?ieo. A?e oai?eo
ae?oai? a?oie eieeaaany a?ae 53 aei 75 ?ie?a ? o na?aaeiueiio
aei??aithaaa 66,1±4,9 ?ieo. A?eueo?noue iaoe??io?a iaio a?oi (iiiaae
80%) aoee a?eii a?ae 60 aei 80 ?ie?a, aea? o?aoeie oai?eo no?aaeaeaee ia
?iceaaee na/iaeioneaiiy iiiaae aeaa ?iee. I?aee?aneeii, ui o an?o
iaoe??io?a niinoa??aaeinue iaeii/anii aeae?eueea ?ioa?eo?aioieo
caoai?thaaiue.

Aia?ao aeei?enoiaoaaee iiaeaeueoei /eiii. I?ney aioeeaaoe??
a?ia?ieanoe/ieo aoce?a ? aaiinoaco eiaea i?inoaoe, eiai aioaa?aaeii
oaiaeeee aei na/?aieea. Iinooiiaeie ?ooaie aia?aoa oi?ioaaee oeaieiiee
aaeee ? aeeiioaaee ??aiii??ia iaeiiiiiaioia i?ioeaaiiy i’youeia
e?aaoo?aie oeaiei o?ao?e ca ?? ia?eiao?ii. Iio?i aia?ao aeoyaoaaee ?c
o?ao?e ? cae?i/oaaee iaeeaaeaiiy aaceei-o?ao?aeueiiai aianoiiico oeyoii
i?ioeaaiiy oeeee na/iaiai i?oo?a ae?oaeie e?ioeyie e?aaoo?. Na/iaee
i?oo? ae?aioaaee eaoaoa?ii Foley.

On? oai?? i?aeeyaaee eiiieaeniiio o?ieia?/iiio ianoaaeaiith, yea
aae?aei: 1) c’ynoaaiiy nea?a ? aiaiianoe/ieo na?ae/aiue; 2) o?ceeaeueia
ianoaaeaiiy c iaeueoeaaei ?aeoaeueiei aeine?aeaeaiiyi ia?aaei?oo?iai?
caeice; 3) eaai?aoi?i? aeine?aeaeaiiy c iaia’yceiaei aecia/aiiyi ??aiy
caaaeueiiai ? a?eueiiai i?inoaoe/iiai niaoeeo?/iiai aioeaaio ieacie
e?ia?; 4) aeine?aeaeaiiy o?iaeeiai?ee ieaei?o na/iaeo oeyo?a; 5)
oeueo?aniiia?ao?th i?aai?a na/inoaoaai? nenoaie c aecia/aiiyi ia’?io
ia?aaei?oo?iai? caeice ? caeeoeiai? na/?; 6) c’ynoaaiiy oa?aeoa?o
noiooi?o caoai?thaaiue i?inoaoe ? oeeee na/iaiai i?oo?a.

Nooi?iue oyaeeino? noa’?eoeaii? neiioiiaoeee ?io?aaaceeaeueii?
iano?oeoe?? aecia/aany ca oeaeith neiioii?a IPSS. Oyaee?noue
neiioiiaoeee o oai?eo ?c iiaiith cao?eieith na/iaeioneaiiy
ioe?ithaaeanue ye oyaeea.

Oeueo?acaoeiaa neaioaaiiy ie?ie, na/iaiai i?oo?a ? ia?aaei?oo?iai?
caeice cae?enithaaee ia aia?aoao “Sonoline SI-450” (“Siemens”,
I?ia//eia), “Aloka SSD-630” (ssiii?y). Canoiniaoaaee ciai?oi?e naeoi?iee
aai eiiaaeniee aeao/eee c /anoioith 3,5 ? 5 IAoe ? oeueo?acaoeiaee ciiae
aeey o?ain?aeoaeueiiai neaioaaiiy c /anoioith 7 ? 7,5 IAoe.
Aeine?aeaeaiiy cae?enithaaee oeyoii o?ainaaaeii?iaeueiiai iaaeeiaeiaiai
? o?ain?aeoaeueiiai neaioaaiiy, ui aeicaieyei oi/ii ioe?ieoe iaoieia?/i?
iniaeeaino? aaceei-o?ao?aeueiiai naaiaioa, ae?aaiinooaaoe noiooi?
caoai?thaaiiy ie?ie ? na/iaiai i?oo?a, aecia/eoe ia’?i ? oi?io ?inoo
ia?aaei?oo?iai? caeice. Ia’?i i?inoaoe aecia/aee ca oi?ioeith (1)
(Terris M.K., Stamey T.A., 1991) i?e o?ain?aeoaeueiiio neaioaaii?, a i?e
o?ainaaaeii?iaeueiiio — ca oi?ioeith (2) (A?iiia A.E., 1997):

V = D1•D1•D2•/6 (1),

V = 1,3•D1•D2•D2•/6 (2),

aea V – ia’?i i?inoaoe, D1 – iaea?eueoee ae?aiao?, D2 – iaeiaioee
ae?aiao? i?inoaoe; – /enei “i?”, yea aei??aith? 3,14; 1,3 – eiao?oe??io
ia?a?aooieo.

Aeey aecia/aiiy ooieoe?iiaeueiiai noaio ieaei?o na/iaeo oeyo?a
aeei?enoiaoaaee uiaeaiiee na/iaeioneaiue, yeee aeiiiiaaa? neeanoe
caaaeueio oa?aeoa?enoeeo caeaoiino? na/iaiai i?oo?a aei iaeiie/aiiy ?
oo?eiaiiy na/?, a oaeiae o?ioeioiao??th, ye iaoiae noia?ii? ioe?iee
na/iaeioneaiiy, ia aia?ao? “Uroflow Nompact 27300” (“Karl Storz”,
I?ia//eia). O eiaeiiai iaoe??ioa o?ioeioiao??th cae?enithaaee
iaiaeii?aciai, i?e ??ciiio iaiiaiaii? na/iaiai i?oo?a. Nooi?iue
?io?aaaceeaeueii? iano?oeoe?? aecia/aee ca cia/aiiyie noie aae?a
?iaeaeno IPSS (S1-3: 1-7, 8-19, 20-35 aae?a), iaeneiaeueii? ia’?iii?
oaeaeeino? na/iaeioneaiiy Qiaen ca aeaieie o?ioeioiao??? (U1-3: 14-12
ie/n, 11-8 ie/n, 7 ie/n oa iaioa) ? nooiaiy ca?eueoaiiy ia’?io i?inoaoe
ca aeaieie oeueo?aniiia?ao?? (P1-3: 21-40 ie, 41-80 ie, 81 ie oa
a?eueoa) (Vallancien G., 1996).

Ooieoe?iiaeueiee noai ie?ie ? aa?oi?o na/iaeo oeyo?a ioe?ithaaee oeyoii
aecia/aiiy aeiaiaiai ae?o?aco i?e ?a?no?aoe?? uiaeaiieea na/iaeioneaiiy,
ieoiii? aaae na/?, a oaeiae ca e?aaoei?iii ieacie e?ia?, iayai?noth aai
a?aenooi?noth i??eiaeoac?? ca aeaieie oeueo?aniiia?ao??. Ai?no
caaaeueiiai oa a?eueiiai i?inoaoe/iiai niaoeeo?/iiai aioeaaio o
ne?iaaooe? e?ia? iaoe??io?a aecia/aee ca aeiiiiiaith noaiaea?oeciaaiiai
?ioiioa?iaioiiai oaa?aeioaciaiai (“Cobas PSA EIA Diaplus”, Oaaeoea??y)
aai ?ioii?aae?iiao?e/iiai (“IMMUNOTECH a.s.”) iaoiae?a.

Ii??aiyeueiee aiae?c ee?i?ei-o?iaeeiai?/ieo iniaeeainoae noaio ieaei?o
na/iaeo oeyo?a o iaoe??io?a aeine?aeaeaieo a?oi ie cae?enithaaee ia
iiiaio aeienoaaiiy c? noaoe?iia?o, /a?ac 3, 6 ? 12 i?nyoe?a i?ney
o??o?a?/iiai ao?o/aiiy. Oeeo?iaee iaoa??ae, iaea?aeaiee o i?ioean?
ianoaaeaiiy ? o??o?a?/iiai e?eoaaiiy oai?eo ia a?ia?ieac?th
ia?aaei?oo?iai? caeice, aoa i?aeaeaiee iaoaiaoe/i?e ia?iaoe? ca
aeiiiiiaith iaoiaeo aa??aoe?eii? noaoenoeee ?c canoinoaaiiyi t-e?eoa??th
Nouethaeaioa. A?aei?ii?noue i?ae ii??aithaaieie na?aaei?ie aaee/eiaie
(?) aaaaeaee nooo?aith ? noaoenoe/ii a??ia?aeiith, yeui p0,05) i?aee?aneth? aaeaeaaoi?noue oa iaeii??aei?noue
aea?aieo a?oi aeey aeine?aeaeaiiy.

Oaaeeoey 1

Nooi?iue ?io?aaaceeaeueii? iano?oeoe?? o oai?eo ia a?ia?ieac?th
ia?aaei?oo?iai? caeice

Nooi?iueE?euee?noue oai?eoS: aaee (IPSS)U: Qiaen, ie/nP: ia’?i i?inoaoe,
ie1-a a?oia 2-a a?oia 1-a a?oia 2-a a?oia 1-a a?oia 2-a a?oia
1008(7,2±2,5%)2(9,5±6,4%)2(1,8±1,2%)0240 (36,0±4,6%)5
(23,8±9,0%)44(39,6±4,6%)6(28,6±9,8%)44(39,6±4,6%)7(33,3±10,2%)371
(64,0±4,6%)16
(76,2±9,0%)59(53,2±4,7%)13(61,9±10,6%)65(58,6±4,7%)14(66,7±10,2%)?acii11
1 (100%)21 (100%)111 (100%)21 (100%)111 (100%)21 (100%)

Oaaeeoey 2

Ee?i?ei-ooieoe?iiaeuei? oa?aeoa?enoeee ianoaaeaiiy oai?eo ia
a?ia?ieac?th ia?aaei?oo?iai? caeice

Iieacieee1-a a?oia

(n=111) (I±m)2-a a?oia(n=21) (I±m)IPSS, aaee21,8±0,423,1±0,7QoL,
aaee5,0±0,15,1±0,1Qiaen, ie/n7,5±0,26,8±0,5?ii?noue na/iaiai i?oo?a,
ie300±9280±10Ia’?i na/iaeioneaiiy, ie150±6140±6Caeeoeiaa na/a,
ie150±8140±10Ia’?i i?inoaoe, ie92±293±5E?aaoei?i,
iiieue/e0,098±0,0050,092±0,007E?euee?noue oai?eoIiaia cao?eiea
na/iaeioneaiiy17 (15,3±3,4%)3 (14,3±7,6%)Noi?aaaceeaeueia iano?oeoe?y37
(33,3±4,5%)10 (47,6±10,9%)Noiooi?e i?inoaoeo66 (59,4±4,7%)11
(52,4±10,9%)Eaeeioeeoo??y (>10 a iie? ci?o)44 (39,6±4,6%)10 (47,6±10,9%)

A no?oeoo?? aeeiiaieo o??o?a?/ieo ao?o/aiue ia?aaaaea? caeiaeiaa
i?inoaoaeoii?y (57,6±1,1%), a oiae? yei? ?nio? iiaeeea?noue oi?ioaaiiy
o?ao?ioeenoiaianoiiico c a?aeiiaeaiiyi aiaoii?? aaceei-o?ao?aeueiiai
naaiaioa. *a?aci?oo?iao i?inoaoaeoii?th aoei aeeiiaii o 28,8±1,1%
oai?eo, ? eeoa o 9,7±0,7% niinoa?aaeaiue aeeiioaaeanue o?aino?ao?aeueia
?acaeoe?y i?inoaoe. Iaeaaeeoue a?aecia/eoe, ui ieoiia aaaa
o?aino?ao?aeueii? aeaeo?i?acaeoe?? ia?aaei?oo?iai? caeice a inoaii? 4
?iee ca?eueoeeanue a 3,6 ?ace – c 5% aei 18%. Ia i?aenoaa?
?ao?iniaeoeaiiai aiae?co ?acoeueoao?a o??o?a?/iiai e?eoaaiiy 1932
iaoe??io?a anoaiiaeaii, ui iniiaiith i?e/eiith ?io?a- oa
i?neyiia?aoe?eieo oneeaaeiaiue ??cieo niinia?a i?inoaoaeoii?? ?
a?aenooi?noue aeeoa?aioe?eiaaiiai i?aeoiaeo aei o??o?a?/ieo ao?o/aiue
aac o?aooaaiiy iaoieia?/ieo iniaeeainoae aaceei-o?ao?aeueiiai naaiaioa o
eiie?aoiiai oai?iai (ia’?io ? oi?ie ?inoo i?inoaoe, noaio o?iaeeiai?ee
aa?oi?o ? ieaei?o na/iaeo oeyo?a, iayaiino? ? ae?aciino? caiaeueiiai
i?ioeano a i?aaiao na/inoaoaai? nenoaie, noiooi?o caoai?thaaiue). E??i
oiai, iathoue cia/aiiy ia??oe o??o?a?/ii? oaoi?ee caeiaeiai?
i?inoaoaeoii??: iaaei??ia aeaeaeaiiy o?ao?e, o?aaiaoe/ia aioeeaaoe?y
a?ia?ieanoe/ieo aoce?a, iaaeinoaoi?e aaiinoac eiaea ia?aaei?oo?iai?
caeice oa oi?ioaaiiy o?ao?ioeenoiaianoiiico aac ooeaaiiy eiaea ?
i?ioeaaiiy na/?aieea ? oeeee na/iaiai i?oo?a ca ?o ia?eiao?ii, /anoeiaa
aeaeaeaiiy a?ia?ieanoe/ii? oeaieie, aeei?enoaiiy a?oaiai oiaiiai
iaoa??aeo ? o?ao?aeueiiai eaoaoa?a iaaaeaeaaoiiai ae?aiao?a, a oaeiae
iai?aaeeueiee aeiaeyae ca oai?ei i?ney iia?aoe??. Oiaoi, iaaaeaeaaoia
ae?aioaaiiy na/iaiai i?oo?a, ia aeineoue iiooaeia aioeaaeoa??aeueia
oa?ai?y, ianai?/ania aeaeaeaiiy o?ao?aeueiiai eaoaoa?a.

Aeai? ?ao?iniaeoeaiiai aiae?co ??cieo niinia?a i?inoaoaeoii??
na?ae/aoue, ui caeiaeiaa i?inoaoaeoii?y, ii??aiyii c /a?aci?oo?iaith
i?inoaoaeoii??th ? o?aino?ao?aeueiith ?acaeoe??th ia?aaei?oo?iai?
caeice, ia? e?au? ee?i?ei-o?iaeeiai?/i? ?acoeueoaoe, a naia ?iaeaen IPSS
/a?ac 6 i?nyoe?a i?ney iia?aoe?e neeaaeaa, a?aeiia?aeii, 7,6±0,01,
9,2±0,2 ? 8,8±0,4 aaea; iaeneiaeueiee iio?e na/? – 25,4±0,2, 15,8±0,3 ?
22,1±0,3 ie/n (?0,05)). Eiiieaen i?io?eaeoe/ieo caoiae?a i?neyiia?aoe?eieo
oneeaaeiaiue aaceei-o?ao?aeueiiai naaiaioa ia? aae?aoe: aeio?eiaiiy
i?aaee anaioeee ? aioenaioeee iaaee/iei ia?niiaeii; ?aoe?iiaeueio
aioeaaeoa??aeueio oa?ai?th ?ioaeoe?? i?aai?a na/inoaoaai? nenoaie;
a?aeiiao a?ae aaaaoi?aciaeo eaoaoa?ecaoe?e na/iaiai i?oo?a; iaa/eeao
aioeeaaoe?th a?ia?ieanoe/ii? oeaieie i?inoaoe; ?aoaeueio ?aa?c?th ?
aaiinoac eiaea i?inoaoe; oi?ioaaiiy o?ao?ioeenoiaianoiiico c i?ioeaaiiyi
na/?aieea ? oeeee na/iaiai i?oo?a ca ?o ia?eiao?ii; aeei?enoaiiy
iaiio?iiiaaiiai eaoaooa ia oiauiai, i?ae ?4 ia oeueiio aoai?;
aeei?enoaiiy eaoaoa?a ae?aiao?ii iaioei a?ae eae?a?o o?ao?e; aaeaeaaoia
ae?aioaaiiy na/iaiai i?oo?a. E??i oiai, ia i?aenoaa? ii??aiyeueiiai
aiae?co ??cieo niinia?a o??o?a?/iiai e?eoaaiiy a?ia?ieac?? i?inoaoe
a??ia?aeii anoaiiaeaii, ui ?aii?e i?neyiia?aoe?eiee ia?aa?a caeiaeiai?
i?inoaoaeoii?? e?auee o oai?eo c aaeeeei ia’?iii ia?aaei?oo?iai? caeice
(81 ie ? a?eueoa) ? iicai?oo?iaith ? ci?oaiith oi?iaie ?inoo. I?i oea
oaeiae na?ae/aoue aeai? Kirby R.S., McConnell S. (1995), Peeling W.B.
(1994) ? Bartsch G. (1997).

Aeeiiaiiy iaoi? iiaeeo?eaoe?? caeiaeiai? i?inoaoaeoii?? iieacaia i?e
ia’?i? ia?aaei?oo?iai? caeice iiiaae 100 ie o oai?eo ?c iicai?oo?iaith ?
ci?oaiith oi?iaie ?? ?inoo. O oaeeo niinoa?aaeaiiyo ?nio? iiaeeea?noue
iaae?eiiai ? ??aiii??iiai oi?ioaaiiy oeaieiiiai aaeeea ? eiai i?ioeaaiiy
aia?aoii aeey iaeeaaeaiiy oa?a ia o?ao?o aac o?aaioaaiiy eiaea i?inoaoe,
ui caaacia/o? aeia?o aaeaioaoe?th ?aiiaeo iiaa?oiiue na/?aieea ? oeeee
na/iaiai i?oo?a, a oaeiae ciaioo? ia’?i ?io?aiia?aoe?eii? e?iaiao?aoe
(100±16 ie), ii??aiyii c oai?eie, o yeeo ia’?i i?inoaoe iaioa 100 ie
(390±50 ie) (?? ????????????? ???????yyy???????????? y?/??? ????'yy??? ????'yy?????????? ????yyy???? ???????'yy??? ????yyy???? ???????y?/???????'yy??? ????yyy???? ???????y?/???????ue??yyy??????-?? ???u?????????"????-???? yyy???????????????????$???0? 0? ????????0????Y?+?????0??????0? ????? ??????????0??? ???u??????????"????-????-?????'yy??? ????-?????-??????????? yyy????y?/???? ???u?????????"????-?????????0??????yyy???????????? ???????uoy??????1/4???I??? Arial Cyr?I????-??????;???????????°?;????°???????en.1. Aeeiai?ea na?aaei?o cia/aiue ?iaeaeno neiioii?a IPSS o oai?eo ia a?ia?ieac?th i?inoaoe. wmetafile8? ??????$???????? ???????yyy???????????? C??? ????'yy??? ????'yy?????????? ????yyy???? ???????'yy??? ????yyy???? ???????C???????'yy??? ????yyy???? ???????C???????ue??yyy??????-?? ???u?????????"????-???? yyy???????????????????$?.?5?05?0??.???.?5????b?44?I ???5?.????5?0?????0?????.????5?.? ???u??????????"????-????-?????'yy??? ????-?????-??????????? yyy????C???? ???u?????????"????-?????????5?.????yyy???????????? ??.????uoy??????1/4???I??? Arial Cyr?I????-??????*??????.????N?*????N?.??????*?????? .????“?*????“?.????s?*????s?.????T?*????T?.????5?*? ???5?.??????.??????0???uoy??????1/4???I??? Arial Cyr?I????-????o?.??????.????o?•??????•????o?ue????? ?ue????o?b?????b???o?E?????E???o?0?????0???-? ???-?????u??????1/4???I"System?I???-????'yy??? ????-????-?????-????yyy???? yyy???? >?????-????-?????-????’yy???

????-????-?????-????yyy????
yyy????oe?42?+????-????-?????-????’yy???

????-????-?????-????yyy????
yyy????o?42?+????ue?????? ???-?
???u?????yyy?”????-?????????T?a????T?`????ue???????????
-????????????$?_?U?e?Y?f?W?`?S????X?f????Z?i?
???$?h?[?n?_?o?]?i?Y????^?o????`?r?
???$?q?a?w?e?x?c?r?_????d?x????g?????$?z?h???l?

?en.2. Aeeiai?ea na?aaei?o cia/aiue ?iaeaeno yeino? aeeooy QoL o oai?eo
ia a?ia?ieac?th i?inoaoe.

Oaeiae anoaiiaeaii, ui e?euee?noue oai?eo, o yeeo iaeneiaeueia ia’?iia
oaeaee?noue na/iaeioneaiiy Qiaen ca?eueoeeanue ia 100% oa a?eueoa o
ae?oa?e a?oi?, aoea o na?aaeiueiio ia 10,3±2,6% a?eueoa, i?ae o ia?o?e,
i?ioyaii onueiai ia??iaeo niinoa?aaeaiiy (?? ??L???9???????? ???????yyy???????????? 3??? ????'yy??? ????'yy?????????? ????yyy???? ???????'yy??? ????yyy???? ???????3???????'yy??? ????yyy???? ???????3???????ue??yyy??????-?? ???u?????????"????-???? yyy???????????????????$?=?6?i6?ia?=?a?=?6????E?. ?E ???6?=????6?i???a?i???a?=????6?=? ???u??????????"????-????-?????'yy??? ????-?????-??????????? yyy????3???? ???u?????????"????-?????????6?=????yyy???????????? a?=????uoy??????1/4???I??? Arial Cyr?I????-????a?9????a?=????¶?9????¶?=??????9?????? =????a?9????a?=????6?9????6?=????a?=????a?i???uoy?? ????1/4???I??? Arial Cyr?I????-????ae?=????a?=????ae?“????a?“????ae?e???? [email protected][email protected]???ae?–???a?–???ae?i???a?i??? -????-?????u??????1/4???I"System?I???-????'yy??? ????-????-?????-????yyy???? yyy???? .?????-????-?????-????'yy??? ????-????-?????-????yyy???? yyy????c??3?:????-????-?????-????'yy??? ????-????-?????-????yyy???? yyy????ae??3?:????ue?????? ???-? ???u?????yyy?"????-?????????A?h????A?g????ue??????????? -????????????$?f?A?l?1/4?m?3/4?g?A????1/2?m??????p? ???$?o???t?µ?u?·?p?»????¶?u??????y? ???$?x??????~?±?y?µ????°?~????? ?en.3. Aeeiai?ea na?aaei?o cia/aiue iaeneiaeueii? oaeaeeino? iioieo na/? Qiaen o oai?eo ia a?ia?ieac?th i?inoaoe. Oaeei /eiii, aeiaaaeaii, ui caeiaeiaa i?inoaoaeoii?y, ii??aiyii c o?aino?ao?aeueiith ?acaeoe??th ia?aaei?oo?iai? caeice ? /a?aci?oo?iaith i?inoaoaeoii??th, ia? a??ia?aeii e?au? ee?i?ei-o?iaeeiai?/i? ?acoeueoaoe. Cai?iiiiiaaia ?? iiaeeo?eaoe?y ?c canoinoaaiiyi aia?aoa aeey iaeeaaeaiiy oa?a ia o?ao?o aeicaiey? a??ia?aeii nei?ioeoe o?eaae?noue iia?aoe??, a?aeiiaeaiiy na/iaeioneaiiy ? i?neyiia?aoe?eii? aini?oae?caoe?? iaoe??io?a c a?ia?ieac??th i?inoaoe, cia/ii ciaioeoe e?euee?noue ?io?a- ? i?neyiia?aoe?eieo oneeaaeiaiue, a oaeiae aeiiiaoeny ca?eueoaiiy aoaeoeaiino? a?aeiiaeaiiy ia?aiao??a na/iaeioneaiiy o oe??? eaoaai??? oai?eo. Oea aeicaieeei caaacia/eoe a?eueo ?aiith ?o iaaee/io ? nioe?aeueio ?aaa?e?oaoe?th. AENIIAEE 1. C iaoith iie?auaiiy ?acoeueoao?a o??o?a?/iiai e?eoaaiiy oai?eo ia a?ia?ieac?th i?inoaoe aea?? niiniao i?inoaoaeoii?? ? iii?oi?eia ca iaaee/iith ?aaa?e?oaoe??th iaoe??io?a iathoue cae?enithaaoenue ?iaeea?aeoaeueii ia i?aenoaa? ioe?iee nooiaiy oyaeeino? ?io?aaaceeaeueii? iano?oeoe?? (S1-3), aeaieo o?ioeioiao??? (U1-3), ia’?io (P1-3) ? oi?ie ?inoo i?inoaoe, a oaeiae c o?aooaaiiyi oneeaaeiaiue ? noiooi?o caoai?thaaiue. 2. Ia i?aenoaa? ?ao?iniaeoeaiiai aiae?co ??cieo niinia?a i?inoaoaeoii?? aeyaeaii, ui caeiaeiaa i?inoaoaeoii?y, ii??aiyii c /a?aci?oo?iaith ? o?aino?ao?aeueiith ?acaeoe??th i?inoaoe, ia? a??ia?aeii e?au? ee?i?ei-o?iaeeiai?/i? ?acoeueoaoe, a naia: ?iaeaen IPSS i?ney iia?aoe?e neeaaeaa, a?aeiia?aeii, 7,6±0,01, 8,8±0,4 ? 9,2±0,2 aaea; iaeneiaeueiee iio?e na/? – 25,4±0,2, 22,1±0,3 ? 15,8±0,3 ie/n. O?aino?ao?aeueia ?acaeoe?y i?inoaoe, ii??aiyii c a?aee?eoith i?inoaoaeoii??th, ia? oae? ia?aaaae, ye iaio? /anoioa i?neyiia?aoe?eieo oneeaaeiaiue, e?euee?noue e?aeei-aei?a ? o?eaae?noue a?aeiiaeaiiy naiino?eiiai na/iaeioneaiiy. 3. Cai?iiiiiaaia aia?aoia oi?ioaaiiy o?ao?ioeenoiaianoiiico caaacia/o? a??ia?aeia ciaioaiiy na?aaeiueiai ia'?io ?io?aiia?aoe?eii? e?iaiao?aoe a 1,3 ?ace, ia 8% cieaeo? /anoioo ianeaieo i?neyiia?aoe?eieo e?iaioa/, ia 12% – e?euee?noue ?ioaeoe?eii-caiaeueieo, ia 9% — e?euee?noue iano?oeoeaieo i?neyiia?aoe?eieo oneeaaeiaiue, a oaeiae nei?i/o? o?eaae?noue a?aeiiaeaiiy na/iaeioneaiiy ? i?neyiia?aoe?eiiai e?eoaaiiy ia 15% ? 34%, a?aeiia?aeii. 4. Canoinoaaiiy aeiaeaeaiiai aia?aoa aeey iaeeaaeaiiy oa?a ia na/?aiee i?e caeiaeia?e i?inoaoaeoii??, ii??aiyii c ?o/iei niiniaii, caaacia/o? i?aeaeuaiiy aoaeoeaiino? a?aeiiaeaiiy naiino?eiiai na/iaeioneaiiy: ?aa?an?y ?iaeaeno IPSS c?inea ia 15%; ia 41% ca?eueoeeinue /enei oai?eo, ui ioe?ithaaee ye?noue naiai aeeooy ye "aeia?o"; e?euee?noue iaoe??io?a, o yeeo iaeneiaeueia ia'?iia oaeaee?noue na/iaeioneaiiy ca?eueoeeanue o 2-3 ?ace, aoea a?eueoa ia 10%. 5. Caeiaeiaa i?inoaoaeoii?y ?c canoinoaaiiyi aia?aoa aeey iaeeaaeaiiy oa?a ia o?ao?o ? iieacaiith oai?ei ?c iicai?oo?iaith ? ci?oaiith oi?iaie ?inoo ia?aaei?oo?iai? caeice i?e ?? ia'?i? iiiaae 100 ie aiane?aeie ??aiii??iiai ? iaae?eiiai i?ioeaaiiy na/?aieea, aeia?i? eiai aaeaioaoe?? ?c oeeeith na/iaiai i?oo?a, ui caaacia/o? aa?iaoe/i?noue o?ao?ioeenoiaianoiiico, a oaeiae ciaioo? ia’?i ?io?aiia?aoe?eii? e?iaiao?aoe. NIENIE IIOAE?EIAAIEO I?AOeUe CA OAIITH AeENA?OAOe?? 1. Iiaee niin?a oi?ioaaiiy aaceeio?ao?aeueiiai aianoiiico i?ney iicaeiiii? aaeaiiiaeoii?? ia?aaei?oo?iai? caeice // O?ieia?y. – 1999. – Oii 3, ? 1. – N. 52 - 54. 2. Aiaiocu?iay iicaaeeeiaeiaay i?inoaoyeoiiey // A?o. eeei. yeni. iaae. – 1999. – Oii 8, ? 1. – N. 42 - 44. 3. Iao aeina?ae o??o?a?/iiai e?eoaaiiy aeia?ieac?? ia?aaei?oo?iai? caeice // O?ieia?y. - 1999. – Oii 3, ? 2. – N. 48 - 51. A ni?aaaoi?noa?: TH.I.Na?iye, TH.I.A?iaioeia. 4. I?ioeeaeoeea e ea/aiea iineaiia?aoeeiiiuo ineiaeiaiee o aieueiuo aeia?ieaceae i?aaenoaoaeueiie aeaeacu // Aanoi. aea. yieae. – 1999. – Oii 3, ? 1. – N. 198 - 202. A ni?aaaoi?noa?: TH.I.Na?iye, TH.I.A?iaioeia. 5. Iao. 12640 A (UA), IEE A 61 A 17/11. Aia?ao aeey iaeeaaeaiiy oa?a ia o?ao?o / Na?iye I.N., Oai?a?a N.I., A?iaioeia TH.I., Eiaaoeue A.A. (Oe?a?ia). - ?96020602; Cayae. 19.02.96. Iioae. 28.02.98. Athe. ?1. – 2 c. 6. Naeaeaoaeuenoai ?inneeneie Oaaea?aoeee ia iieacioth iiaeaeue, IEE A61A17/11. Aiia?ao aeey iaeiaeaiey oaia ia o?ao?o / Na?iye I.N., Oai?aaa N.I, Aeiaioeia TH.A., Eiaaoe A.A. (Oe?aeia). - ? 97109443/20; Cayaeaii 23.06.97; Iioae. 22.07.97 oeyoii aeeeaaeee. 7. Aiaeec ?acoeueoaoia oe?o?ae/aneiai ea/aiey aieueiuo aaeaiiiie i?aaenoaoaeueiie aeaeacu // Aaeaiiia i?aaenoaoaeueiie aeaeacu. – O.: Oaeo, 1997. – N. 173–177. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia, A.A.Eiaaoeue. 8. Iiaeeoeeaoeey iicaaeeeiaeiaie aaeaiiiyeoiiee i?aaenoaoaeueiie aeaeacu // Aaeaiiia i?aaenoaoaeueiie aeaeacu. – O.: Oaeo, 1997. – N. 164–167. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia, A.A.Eiaaoeue. 9. I o?aino?ao?aeueiie ?acaeoeee i?e aeia?iea/anoaaiiie aeia?ieacee i?aaenoaoaeueiie aeaeacu // Aaeaiiia i?aaenoaoaeueiie aeaeacu. – O.: Oaeo, 1997. – N. 124–126. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia, TH.I.Na?iye, A.A.Eiaaoeue. 10. ?ieue o?ioeioiao?ee a ioeaiea ?acoeueoaoia oe?o?ae/aneiai ea/aiey aieueiuo aaeaiiiie i?aaenoaoaeueiie aeaeacu // Aaeaiiia i?aaenoaoaeueiie aeaeacu. – O.: Oaeo, 1997. – N. 93–95. A ni?aaaoi?noa?: TH.I.A?iaioeia. 11. Oe?o?ae/aneia ea/aiea aieueiuo aaeaiiiie i?aaenoaoaeueiie aeaeacu // Nia?aiaiiua iaoiaeu ea/aiey aaeaiiiu i?aaenoaoaeueiie aeaeacu. – Eeaa. – 1997. – N. 85–87. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia. 12. Ea/aiea i?aia?aoii “I?inea?” (Oeianoa?eae) aieueiuo n aeia?iea/anoaaiiie aeia?ieaceae i?aaenoaoaeueiie aeaeacu // Aaeaiiia i?aaenoaoaeueiie aeaeacu. – O.: Oaeo, 1997. – N. 237–239. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia. 13. E aii?ino i iaoiaaiaca aaeaiiiu i?aaenoaoaeueiie aeaeacu // Aaeaiiia i?aaenoaoaeueiie aeaeacu. – O.: Oaeo, 1997. – N. 76–81. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia. 14. O?iaeeiaie/aneea ?acoeueoaou aaeaiiiyeoiiee i?aaenoaoaeueiie aeaeacu// Nia?aiaiiua iaoiaeu ea/aiey aaeaiiiu i?aaenoaoaeueiie aeaeacu.–Eeaa.–1997.–N.102-104. A ni?aaaoi?noa?: TH.I.A?iaioeia. 15. O?aino?ao?aeueiay ?acaeoeey aeia?iea/anoaaiiie aeia?ieacee i?aaenoaoaeueiie aeaeacu // IX Ana?in. nuacae o?ieiaia: Iaoa?eaeu. – Iineaa, 1997. – N. 136 – 137. A ni?aaaoi?noa?: TH.I.A?iaioeia, TH.I.Na?iye. 16. O?iaeeiaie/aneea ?acoeueoaou oe?o?ae/aneiai ea/aiey aieueiuo aaeaiiiie i?aaenoaoaeueiie aeaeacu // IX Ana?in. nuacae o?ieiaia: Iaoa?eaeu. – Iineaa, 1997. – N. 353 – 354. A ni?aaaoi?noa?: TH.I.A?iaioeia, I.A.E?eooiia. 17. E i?iaeaia i?ioeeaeoeee eioaeoeeiiii-ainiaeeoaeueiuo ineiaeiaiee aaeaiiiyeoiiee i?aaenoaoaeueiie aeaeacu // Iaoa??aee iaoeiai-i?aeoe/. eiio. “Aeooaeuei? ieoaiiy iaaeeoeeie”. – Eeaa, 1997. – N. 32. A ni?aaaoi?noa?: TH.I.A?iaioeia, A.A.Eiaaoeue. 18. Iiuo oe?o?ae/aneiai ea/aiey aeia?iea/anoaaiiie aeia?ieaceae i?aaenoaoaeueiie aeaeacu // Aii?inu eeeie/aneie e yenia?eiaioaeueiie iaaeeoeeiu. – Aeiiaoee. – 1997. – N. 192 –195. 19. Iicaaeeeiaeiaay aaeaiiiyeoiiey i?aaenoaoaeueiie aeaeacu // Aii?inu eeeie/aneie e yenia?eiaioaeueiie iaaeeoeeiu. – Aeiiaoee. – 1997. – N. 195 –198. 20. E aii?ino i?ioeeaeoeee iano?oeoeaiuo ineiaeiaiee oe?o?ae/aneiai ea/aiey aieueiuo aeia?iea/anoaaiiie aeia?ieaceae i?aaenoaoaeueiie aeaeacu // Nia?aiaiiua i?iaeaiu o?ieiaee. – O.: Oaeo, 1998. – N. 243 – 246. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia, A.A.Eiaaoeue. 21. ?acoeueoaou ?acee/iuo niiniaia oi?ie?iaaiey o?ao?ioeenoiaianoiiica i?e iicaaeeeiaeiaie i?inoaoyeoiiee / Ii/aeaiaiiay aieaciue. – Oa?ueeia: Oa?ueeianeay iaaeeoeeineay aeaaeaiey iineaaeeieiiiiai ia?aciaaiey, 1999. – N. 354 – 358. A ni?aaaoi?noa?: I.N.Na?iye, TH.I.A?iaioeia. 22. Iiooiee ii/aaiai iocu?y, aeia?ieacey e ea?oeeiiia i?aaenoaoaeueiie aeaeacu, iiooiee ye/ae e iieiaiai /eaia / Iaoiaee/aneea oeacaiey. – Eeaa: ?IE IC Oe?aeiu, 1999. – 16 n. A ni?aaaoi?noa?: A??a TH.A., A?iaioeia TH.I. Oai?a?a N.I. Iiaeeo?eaoe?y caeiaeiai? i?inoaoaeoii??. – ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.06 – o?ieia?y. – ?inoeooo o?ieia?? oa iao?ieia?? AII Oe?a?ie, Ee?a, 1999. Aeena?oaoe?y c ieoaiue i?aeaeuaiiy aoaeoeaiino? o??o?a?/iiai e?eoaaiiy oai?eo ia a?ia?ieac?th ia?aaei?oo?iai? caeice. Aiane?aeie aea/aiiy ee?i?ei-o?iaeeiai?/ieo ?acoeueoao?a ??cieo niinia?a i?inoaoaeoii?? anoaiiaeaii, ui aea?? niiniao i?inoaoaeoii?? ? iii?oi?eia ca iaaee/iith ?aaa?e?oaoe??th iaoe??io?a iathoue cae?enithaaoenue ?iaeea?aeoaeueii ia i?aenoaa? ioe?iee nooiaiy oyaeeino? ?io?aaaceeaeueii? iano?oeoe?? (S1-3), aeaieo o?ioeioiao??? (U1-3), ia’?io (P1-3) ? oi?ie ?inoo i?inoaoe, a oaeiae c o?aooaaiiyi oneeaaeiaiue ? noiooi?o caoai?thaaiue. Canoiniaaia eeaneo?eaoe?y ca nooiaiai ?io?aaaceeaeueii? iano?oeoe??, iaa?oioiaaiee aeeoa?aioe?eiaaiee i?aeo?ae aei aeai?o e?eoaaeueii? oaeoeee o iaoe??io?a c a?ia?ieac??th ia?aaei?oo?iai? caeice. Oaeineiiaeaia oaoi?ea caeiaeiai? i?inoaoaeoii?? oeyoii canoinoaaiiy aeiaeaeaiiai aia?aoa aeey iaeeaaeaiiy oa?a ia na/?aiee ia aoai? oi?ioaaiiy aaceei-o?ao?aeueiiai aianoiiico. ?ic?iaeai? ? canoiniaai? ia i?aeoeoe? iieacaiiy aei aeeiiaiiy ??ciiiai?oieo niinia?a i?inoaoaeoii??. Eeth/ia? neiaa: a?ia?ieac?y ia?aaei?oo?iai? caeice, o??o?a?/ia e?eoaaiiy, ?io?aaaceeaeueia iano?oeoe?y, aaceei-o?ao?aeueiee aianoiiic, caeiaeiaa i?inoaoaeoii?y, iiaeeo?eaoe?y. Oai?aaa N.I. Iiaeeoeeaoeey iicaaeeeiaeiaie i?inoaoyeoiiee. – ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.06 – o?ieiaey. – Einoeooo o?ieiaee e iao?ieiaee AII Oe?aeiu, Eeaa, 1999. Aeenna?oaoeey iinayuaia aii?inai iiauoaiey yooaeoeaiinoe oe?o?ae/aneiai ea/aiey aieueiuo aeia?ieaceae i?inoaou. I?iaaaeai ?ao?iniaeoeaiue aiaeec ?acee/iuo niiniaia i?inoaoyeoiiee o 1932 iaoeeaioia. O?aino?ao?aeueiay ?acaeoeey i?inoaou auiieiaia a 187 (9,7±0,7%) iaaethaeaieyo, a 1113 (57,6±1,1%) — iicaaeeeiaeiaay e a 557 (28,8±1,1%) — /?aniocu?iay i?inoaoyeoiiey. Aeaiiua aiaeeca naeaeaoaeuenoaotho i oii, /oi iicaaeeeiaeiaay i?inoaoyeoiiey, ii n?aaiaieth n /?aniocu?iie e n o?aino?ao?aeueiie ?acaeoeeae i?inoaou, eiaao eo/oea eeeieei-o?iaeeiaie/aneea ?acoeueoaou: eiaeaen IPSS iinea iia?aoeee ninoaaeye, niioaaonoaaiii, 7,6±0,01, 9,2±0,2 e 8,8±0,4 aaeea; iaeneiaeueiue iioie ii/e – 25,4±0,2, 15,8±0,3 e 22,1±0,3 ie/n (?

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