EUeA?ANUeEEE AeA?AEAAIEE IAAeE*IEE OI?AA?NEOAO

?i. AeAIEEA AAEEOeUeEIAI

COA AIEIAeEIE? ?AAIIAE*

OAeE: 617.53-002.3-02:615.032)-06: 616.89-008.441.13]-07-089

INIAEEAINO? EE?I?EE, Ae?AAIINOEEE OA O??O?A?*IIAI E?EOAAIIss
I?NEss?I’?EOe?EIEO AI?EII-CAIAEUeIEO

CAOAI?THAAIUe OE? O OAI?EO-IA?EIIAI?A

14.01.03 — O??O?A?ss

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

EUeA?A — 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia o Euea?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao?

?i. Ae. Aaeeoeueeiai IIC Oe?a?ie

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, aeioeaio

Aa?e/ ?ai?
Aeeii?c?eiae/,

aeioeaio eaoaae?e
oaeoeueoaonueei? oa caaaeueii?
o??o?a?? Euea?aueeiai aea?aeaaiiai
iaaee/iiai

oi?aa?neoaoo ?i. Aeaieea Aaeeoeueeiai

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

Aaaeye
Aeieo?i ?aaaiiae/,

caa?aeoaa/ eaoaae?e oieoaeueii? o??o?a??

Euea?anueeiai aea?aeaaiiai iaaee/iiai

oi?aa?neoaoo ?i. Aeaieea Aaeeoeueeiai IIC Oe?a?ie

— aeieoi? iaaee/ieo iaoe, i?ioani?

Eyi?n
Ieoaeei Ieaenaiae?iae/,

caa?aeoaa/ eaoaae?e caaaeueii? o??o?a??

Oa?iii?euenueei? iaaee/ii? aeaaeai??

?i.
?.ss.Ai?aa/aanueeiai IIC Oe?a?ie

I?ia?aeia onoaiiaa: Aeiiaoeueeee aea?aeaaiee iaaee/iee oi?aa?neoao
IIC

Oe?a?ie, eaoaae?a caaaeueii? o??o?a??

Caoeno aeena?oaoe?? a?aeaoaeaoueny «09» ea?oiy 1999 ?ieo i 13 aiaeei?
ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 35. 600. 01. o
Euea?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ?i. Aeaieea
Aaeeoeueeiai (290010, i. Euea?a, aoe. Iaea?nueea, 69).

C aeena?oaoe??th iiaeia iciaeiieoeny a iaoeia?e a?ae?ioaoe?
Euea?anueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo ?i. Ae. Aaeeoeueeiai
(290000, i. Euea?a, aoe. N?/iaeo No??eueoe?a, 6).

Aaoi?aoa?ao ?ic?neaiee “06” aa?aciy 1999 ?ieo.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee *oee?i N. I.
CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE tc «CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE»

Aeooaeuei?noue oaie. Iaaieiia c?inoaiiy a Oe?a?i? e?eueeino? in?a, ui
ceiaaeeaathoue ia?eioeeaie, coiiaeei ieceo iiaeo nioe?aeueii-aeiiii?/ieo
? iaaee/ieo i?iaeai [Iaea? Ae.A. ? Aa?e/ ?.Ae., 1993; Eaauaiei A.A.,
1995; Ooeueaa I.A. e niaao., 1996, Ae?ey A.E. e niaao., 1998]. Na?aae
ieo aaeeeiai cia/aiiy ca inoaii? aeanyoe??//y iaaoee ai?eii-caiaeuei?
oneeaaeiaiiy ?i’?eoe?eii? ii?eii? ia?eiiai?? (ACO?I), ye? aeieeathoue
aiane?aeie ia?aioa?aeueiiai ceiaaeeaaiiy naii?iaieie ia?eioe/ieie
caniaaie [Vlahov D. et al., 1992; Walker P.J. et al., 1992; Dammacco F.,
1993; Aa?e/ ?.Ae., 1998]. Oea coiiaeth?oueny no??ieei ca?eueoaiiyi
/anoee ia?eiiai?a o no?oeoo?? iaoe??io?a caaaeueiio??o?a?/ieo
noaoe?iia??a, o o./. oai?eo c ??aee?nieie oi?iaie oa “aaaeeei”
aiaoii?/iei ?ici?uaiiyi ACO?I, ? c?inoaiiyi e?eueeino? iia?aoe?e, ui
aeeiiothoueny c ?o i?eaiaeo [Neville R.G. et al., 1988; Iaea? Ae.A. ?
Aa?e/ ?.Ae., 1994; Pereles T.R. et al., 1995; O?aaoaaiei A.E. e niaao.,
1996].

Iaeiei c iaeia?aeiieo ? ia aea/aieo aniaeo?a i?iaeaie ACO?I o
oai?eo-ia?eiiai?a ? i?ney?i’?eoe?ei? ai?eii-caiaeuei? caoai?thaaiiy oe?
(IACCO) [Williams M.F. et al., 1993; Beasley D.J. et al.,
1995].

I?ioa, o a?o/eciyi?e iaaee/i?e e?oa?aoo?? iaia? ?ia?o, i?enay/aieo
IACCO. O ca?oa?aeieo iaoeiaeo aeaea?aeao ?niothoue iiiaeeiie?
ioae?eaoe?? uiaei IACCO, ye?, caeaa?eueoiai, iathoue iieniaee oa?aeoa?,
??oioothoueny ia iae?e e?eueeino? ee?i?/ieo niinoa?aaeaiue ?
aena?oeththoue eeoa ie?ai? o?aaiaioe oe??? iiai? i?iaeaie ai?eii?
o??o?a??. Ia/enaeuei? aeine?aeaeaiiy c oea?eie IACCO a?aeaeca?eaeththoue
aoeiia?noue ?o ee?i?/ieo i?iya?a, aaaee?noue ia?aa?ao, oaeaeeee ?icaeoie
iaaacia/ieo aeey aeeooy oneeaaeiaiue, iaiiaiioe?ii?noue o?aaeeoe?eieo
ae?aaiinoe/ieo i?aeoiae?a ? iacaaeia?euei? ?acoeueoaoe e?eoaaiiy oe???
iaoieia?? c iiceoe?e eeane/ieo eaiii?a ai?eii? o??o?a?? [Espiritu M.B.
et al., 1980; Myers E.M. et al., 1988; Endress C. et al., 1990]. Oea
aeyaey?oueny aenieeie iieacieeaie ae?aaiinoe/ieo iiieeie i?e IACCO (25 —
40 %), cia/ieie ??aiyie eaoaeueiino? (1,1 -10 %) oa i?neyiia?aoe?eieo (1
— 43 %) oneeaaeiaiue [Williams M.F. et al., 1993; Beasley D.J. et al.,
1995; Bergstein J.M. et al., 1995].

Aiaeii/an, caeeoathoueny ia c’yniaaieie ieoaiiy ao?ieia?? oa iaoiaaiaco
IACCO, ia aea/aia ?ioi?iaoeai?noue ee?i?/ieo e aeiiii?aeieo iaoiae?a ?o
ae?aaiinoee, ia ?ici?aoeueiaai? i?ino? ae?aaiinoe/i? e?eoa??? ??cieo
oi?i iaoieia??, ia ?ic?iaeai? caoiaee c aeyaeaiiy oa e?ea?aeaoe??
eieaeueieo oneeaaeiaiue IACCO, ia ?ica’ycai? i?iaeaie e?eoaaeueii?
oaeoeee i?e ii?aeiaii? ai?eii? oa noaeeiii? iaoieia?e, ia ae??oai?
ieoaiiy i?io?eaeoeee ?io?aiia?aoe?eieo yo?iaaiieo iioeiaeaeaiue oa ?o
o??o?a?/ii? ae?i?iaoe??.

A?aenooi?noue aoaeue-yeeo iaoeiaeo ii?aoethaaiue e i?aeoe/ieo
?aeiiaiaeaoe?e uiaei e?eoaaiiy IACCO ? iaaeinoaoi?noue o?aaeeoe?eieo
ae?aaiinoe/ii-e?eoaaeueieo i?aeoiae?a ? aieiaieie i?e/eiaie
iacaaeia?eueieo ?acoeueoao?a e?eoaaiiy oe??? iaoieia?? [Aa?e/ ?.Ae.,
1998].

Iaaaaeai? oaeoe aecia/athoue aeooaeuei?noue i?iaeaie IACCO, a ioaea —
aeioe?euei?noue ?? anaa?/iiai oa ?aoaeueiiai ?ici?aoethaaiiy.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?y
aeeiiaia ca?aeii c ieaiii IAe? Euea?anueeiai aea?aeaaiiai iaaee/iiai
oi?aa?neoaoo?i. Aeaieea Aaeeoeueeiai (EAeIO), ? Ae? 0196V013958
“?ic?iaeoe ae?aaiinoe/io oa e?eoaaeueio oaeoeeo i?e ai?eii-caiaeueieo
i?ioeanao, iniiaaio ia aea/aii? iniaeeainoae ao?ieia??, iaoiaaiaco oa
ee?i?ee no/anii? o??o?a?/ii? ?ioaeoe??”.

Iaoa ? caaaeaiiy aeine?aeaeaiiy. Iaoa aeine?aeaeaiiy — iie?ioaiiy
?acoeueoao?a e?eoaaiiy oai?eo-ia?eiiai?a ?c IACCO oeyoii ?ici?aoethaaiiy
eiiieaeno ae?aaiinoe/ii-e?eoaaeueieo caoiae?a i?e oe?e iaoieia??.

Caaaeaiiy aeine?aeaeaiiy:

1. Aecia/eoe ao?ieia?/i? /eiieee oa iniaeeaino? iaoiaaiaco IACCO.

2. C’ynoaaoe iniaeeaino? ee?i?/ii? ea?oeie ? neiioiiaoeee IACCO.

3. Ia’?eoeaii ioe?ieoe ?ioi?iaoeai?noue ee?i?/ieo ? aeiiii?aeieo
iaoiae?a ianoaaeaiiy oai?eo ?c cacia/aiith iaoieia??th.

4. Iioei?coaaoe i?ia?aio ae?aaiinoe/iiai iiooeo IACCO.

5. Aaeineiiaeeoe ?nioth/? oa ?ici?aoethaaoe iia? iaoiaee o??o?a?/iiai
e?eoaaiiy IACCO oa ?o oneeaaeiaiue.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. C’yniaaii niaeo? eaocaeueieo
caoaeiee?a IACCO ? i?e?iaiee iaecaae iniiaieo aeaea?ae ?ioaeoe?? o
ia?eiiai?a (naii?iaieo ia?eioee?a, oi?eoe?a, aieie). Aia?oa aecia/ai?
oa?aeoa? i?ney?i’?eoe?eieo iaoiii?oieia?/ieo ci?i oe? oa ?o ?ieue o
iaoiaaiac? IACCO. Noi?ioeueiaaii a?iioaco i?i aioo??oiueioeaieiio
a?ia?oaic?th ye aieiaio iaoiaaiaoe/io eaieo IACCO. Ioe?iaii
?ioi?iaoeai?noue ee?i?/ieo ? aeiiii?aeieo iaoiae?a ae?aaiinoeee oe???
iaoieia??, ?ici?aoeueiaaii iioeiaeueio noaio ?? ae?aaiinoe/iiai iiooeo.
Iienaii iia? neiioiie aeey ee?i?/ii? ae?aaiinoeee IACCO oa ?o
oneeaaeiaiue — iciaee eiii?an?? i?aai?a ? no?oeoo? oe?, o??aaea o?iiaico
aioo??oiuei? y?aiii? aaie (AssA). ?ici?aoeueiaaii oeueo?aniiia?ao?/io
iaoiaeeeo ae?aaiinoeee ia?aaacaeueieo IACCO ? caoai?thaaiue
iaa?no?aeueieo noaeei oe?, niin?a ?aioaaiae?aaiinoeee naioe/iiai a?o?eoo
a?oaeeiii-eeth/e/iiai c’?aeiaiiy. Cai?iiiiiaaii aeai?eoi
aeeoa?aioe?eiaaieo i?aeoiae?a aei e?eoaaiiy IACCO, iiaee niin?a
o??o?a?/iiai ao?o/aiiy c i?eaiaeo oeaaiii noaeeiii-ia?aiaiai io/ea (NII)
oe? (Iaoaio Oe?a?ie ? 18981 A).

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. I?ia?aei? iieiaeaiiy oa
aeniiaee aeena?oaoe?? aaeaioiaaii aeey ai?iaaaeaeaiiy oa canoinoaaiiy a
oiiaao i?aeoe/ii? eaiee ioi?iie caei?ia’y.

Ia’?eoeaii ioe?iaii ?ioi?iaoeai?noue ee?i?ei-eaai?aoi?ieo ? aeiiii?aeieo
iaoiae?a ianoaaeaiiy i?e IACCO. Iienaii iia? neiioiie IACCO, aeyaeaiiy
yeeo ni?ey? iie?ioaiith ?acoeueoao?a ee?i?/iiai ?ici?ciaaaiiy oe???
iaoieia??. Oeyoii ie?aneaiiy iecee ae?aaiinoe/ieo e?eoa???a ? aecia/aiiy
ae?aiaciio aeioe?eueieo a?coae?caoe?eieo iaoiae?a aeine?aeaeaiiy
iioei?ciaaii ae?aaiinoe/io i?ia?aio, canoinoaaiiy yei? cia/ii i?aeaeuo?
aoaeoeai?noue ae?aaiinoeee IACCO.

Cai?iiiiiaaii iaoiaeeeo oeueo?aniiia?ao?/ii? ae?aaiinoeee ia?aaacaeueieo
IACCO (iina?ae/aiiy ia ?aoe?iiae?caoi?nueeo i?iiiceoe?th ? 12, aeaeaia
27.12.1995 ?. A??Aii OIC *a?i?a?anueei? IAeA) ? caoai?thaaiue
iaa?no?aeueieo noaeei oe? (iina?ae/aiiy ia?aoe?iiae?caoi?nueeo
i?iiiceoe?th ? 716, aeaeaia 12.05.1998 ?. A??Aii OIC Euea?anueei? IAeA),
niin?a ?aioaaiae?aaiinoeee naioe/iiai a?o?eoo a?oaeeiii-eeth/e/iiai
c’?aeiaiiy (iina?ae/aiiy ia ?aoe?iiae?caoi?nueeo i?iiiceoe?th ? 704,
aeaeaia 30.05.1997 ?. A??Aii OIC Euea?anueei? IAeA), ae?aaiinoe/io
o??aaeo o?iiaico AssA (iina?ae/aiiy ia ?aoe?iiae?caoi?nueeo i?iiiceoe?th
? 679, aeaeaia 21.09.1995 ?. A??Aii OIC Euea?anueei? IAeA). Ia??oioiaaii
aeeoa?aioe?eiaai? iieace, oa?aeoa? oa ianya iia?aoeaieo ao?o/aiue i?e
??cieo IACCO oa ?o oneeaaeiaiiyo. Ii?aoeueiaaii ? ai?iaaaeaeaii a
i?aeoeeo iiaee niin?a o??o?a?/iiai e?eoaaiiy oeaaiii NII oe? (Iaoaio
Oe?a?ie ? 18981 A).

?acoeueoaoe aeine?aeaeaiue c iiceoeaiei aoaeoii ai?iaaaeaeaii o
i?aeoe/io ae?yeuei?noue o??o?a?/ieo a?aeae?eaiue Euea?anueei? i?nueei?
ee?i?/ii? e?ea?i? oaeaeei? iaaee/ii? aeiiiiiae (EIEEOIAe), A?iieoeueei?,
Aeiiaoeueei?, Iieoaanueei?, *a?i?aaoeueei?, i?nueeeo ee?i?/ieo
e?ea?aiue, 7-i? i?nueei? e?ea?i? i. N?ioa?iiiey, 2-i? i?nueei?
e?ea?i? i.*a?i?aiaa, a?aeae?eaiiy uaeaiiai-eeoeaai? o??o?a?? EIEEOIAe oa
o iecoe? o??o?a?/ieo a?aeae?e?a oeaio?aeueieo ?aeiiieo e?ea?aiue
Euea?anueei? iaeano?.

Iniiai? iaoeia? iieiaeaiiy aeena?oaoe?? aeeth/ai? aei eaeoe?eiiai
iaoa??aeo oa aeei?enooaothoueny i?ae /an i?aeoe/ieo caiyoue c?
nooaeaioaie e e?ea?yie-eo?naioaie ia eaoaae?ao caaaeueii? o??o?a??
Euea?anueeiai, A?iieoeueeiai, Aeiiaoeueeiai aea?aeaaieo iaaee/ieo
oi?aa?neoao?a, o??o?a?? oaeoeueoaoo i?neyaeeieiiii? ina?oe EAeIO.

Ca iaoa??aeaie aeine?aeaeaiue aeaeaii ?ioi?iaoe?ei? eenoe IIC Oe?a?ie
“Niin?a o??o?a?/iiai e?eoaaiiy oeaaiii noaeeiii-ia?aiaiai io/ea oe?”
(E., 1996) ? “Iaoiaeeea oeueo?aniiia?ao?/ii? ae?aaiinoeee ia?aaacaeueieo
ai?eieo caoai?thaaiue” (E.,1996), io?eiaii 8 iina?ae/aiue ia
?aoe?iiae?caoi?nuee? i?iiiceoe??, iaeei Iaoaio Oe?a?ie (? 18981A).

Iniaenoee aianie caeiaoaa/a. Aeena?oaoe?eia ?iaioa ? caaa?oaiei
naiino?eiei iaoeiaei aeine?aeaeaiiyi A.?. Coaa. Aaoi?ii cae?eniaii
ieaioaaiiy ?iaioe, iiaiiaai? iaiao?aei? iaoiaee ianoaaeaiiy. E?eoaaiiy
oai?eo, aeeth/ii c iia?aoeaieie ao?o/aiiyie, i?iaaaeaii aeena?oaioii
naiino?eii. Aiae?c oa ?ioa?i?aoaoe?y aeaieo o?ceeaeueiiai e aeiiii?aeieo
iaoiae?a ianoaaeaiiy cae?eniai? caeiaoaa/ai, a ie?aieo aeiaaeeao — ca
o/anoth i?aeoe/ieo e?ea??a, i?aoe?aiee?a ? oaoi?/ieo neoaea aeiiii?aeieo
i?ae?icae?e?a EIEEOIAe, EAeIO oa Euea?anueeiai ae?aaiinoe/iiai oeaio?o.

Iniiai? iaoeia? iieiaeaiiy, a?iioace, ia??oiooaaiiy ? aeniiaee
iaeaaeaoue A.?. Coao. Aaoi? aecia/ea oaiaoeeo, i?iaeaiaoeeo ?
eiioeaioe?th aeeeaaeo iaoa??aeo, iaaaaeaiiai a ioae?eaoe?yo ca oaiith
aeena?oaoe?eii? ?iaioe. Ni?aaaoi?noai ?ioeo aeine?aeiee?a o iaoeiaeo
i?aoeyo, iioae?eiaaieo ca iaoa??aeaie aeena?oaoe??, iieyaa?,
caeaa?eueoiai, o ?o eiinoeueoaoeaii-oaoi?/i?e aeiiiiic? oa ni?ao/ano? a
ae?aaiinoe/ii-e?eoaaeueiiio i?ioean? oai?eo ?c IACCO, /anoeiai — o
oaenoiaiio aeeeaae? io?eiaieo ?acoeueoao?a aeine?aeaeaiue. Aeiyoie
neeaaea? ?iaioa iaae ?ioi?iaoe?eieie eenoaie IIC Oe?a?ie oa Iaoaioii
Oe?a?ie, ye? ? ?acoeueoaoii ni?ai?aoe? eieaeoeao aaoi??a.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. ?acoeueoaoe aeine?aeaeaiue oa
iniiai? iaoeia? iieiaeaiiy ?iaioe aena?oeaii a aeiiia?aeyo ia
can?aeaiiyo eaoaae?e oaeoeueoaonueei? oacaaaeueii? o??o?a?? EAeIO
(1996-1998), iaoeiai-i?aeoe/i?e eiioa?aioe??, i?enay/ai?e10-??//th
eaoaae?e oa?ai?? ?2 OOE?I EAeIO (Euea?a, 1996), iaoeiai-i?aeoe/i?e
eiioa?aioe?? “No/ani? aniaeoe iaa?aeeeaaeii? iaaee/ii? aeiiiiiae”,
i?enay/ai?e 25-??//th EIEEOIAe (Euea?a, 1997), ? I?aeia?iaeiiio
iaaee/iiio eiia?an? nooaeaio?a oa iieiaeeo iaoeiaoe?a (Oa?iii?eue,
1997), V? Anaoe?a?inuee?e o/aiai-iaoiaee/i?e oa iaoeia?e eiioa?aioe??
caa?aeoaa/?a eaoaae? caaaeueii? o??o?a?? iaaeaoc?a Oe?a?ie (A?iieoey,
1998), ?? tha?eaei?e iaa/aeueii-iaoiaee/i?e oa iaoeiai-i?aeoe/i?e
eiioa?aioe?? caa?aeoaa/?a eaoaae? o??o?a?/ieo oai?ia noiiaoieia?/ieo
oaeoeueoao?a iaaee/ieo AOC?a Oe?a?ie (Iieoaaa, 1998), ?
iaoeiai-i?aeoe/i?e eiioa?aioe?? EIEEOIAe “Aeooaeuei? i?iaeaie ai?eii?
o??o?a??” (Euea?a, 1998).

Ioae?eaoe??. Ca iaoa??aeaie aeena?oaoe?? iioae?eiaaii 12 ae?oeiaaieo
i?aoeue, (a o./. 4 — noaoo? o iaoeiaeo aeo?iaeao, 2 — noaoo? o
ca??ieeao iaoeiaeo i?aoeue, 6 — noaoo? o iaoa??aeao ? oacao
eiioa?aioe?e), aeaa ?ioi?iaoe?ei? eenoe IIC Oe?a?ie, io?eiaii Iaoaio
Oe?a?ie (? 18981A).

No?oeoo?a ? ianya aeena?oaoe??. Aeena?oaoe?y neeaaea?oueny c? anooio,
i’yoe ?icae?e?a, aeniiae?a, nieneo aeei?enoaieo e?oa?aoo?ieo aeaea?ae ?
aeiaeaoeo c eii?yie aeo?a ai?iaaaeaeaiiy. Iiaiee ianya aeena?oaoe??
neeaaea? 224 noi??iee. ?enoiee (35), oaaeeoe? (24), aeienee c ?noi??e
oai?ia (9), aeiaeaoie c eii?yie aeo?a ai?iaaaeaeaiiy (24) oa nienie
aeei?enoaieo e?oa?aoo?ieo aeaea?ae (229 a?ae?ia?ao?/ieo aeaea?ae)
caeiathoue 85 noi??iie.

INIIAIEE CI?NO ?IAIOE tc » INIIAIEE CI?NO ?IAIOE»

Iaoa??aee ? iaoiaee aeine?aeaeaiiy tc » Iaoa??aee ? iaoiaee
aeine?aeaeaiiy»

Ee?i?/iee iaoa??ae aeine?aeaeaiiy neeaee 120 in?a, na?aae yeeo 45 —
oai??-ia?eiiaie (OI) ?c IACCO (iniiaia a?oia), 45 — iaoe??ioe ?c
ai?eii-caiaeueieie caoai?thaaiiyie oe? ia?i’?eoe?eiiai aaiaco (I
eiio?ieueia a?oia), 30 — caei?ia? aeiii?e (II eiio?ieueia a?oia).

A?e oai?eo iniiaii? a?oie eieeaaany a?ae 15 aei 45 ?ie?a (a na?aaeiueiio
— 29,5 ± 0,9 ?ieo), ia?aaaaeaee iniae /ieia?/i? noao? (73,3 %), i?e
ni?aa?aeiioaii? /ieia?ee/ae?iee — 2,8 : 1. Ia /an aini?oae?caoe?? a
noaoe?iia? on? oe? iaoe??ioe ceiaaeeaaee naii?iaieie ?ic/eiaie aeno?aeoo
iaeiai? nieiiee, ?i’?eoth/e ?o o aaie oe?: 38 (84,4 %) — o AssA, 4 (8,9
%) — o i?aeeeth/e/i? oa 3 (6,7 %) — o i?aeoe??i? aaie. Oa?i?ie
ia?eiiai?? eieeaaeeny a?ae 8 i?n. aei 30 ?ie?a (8,1 ± 1,2 ?ieo),
o?eaae?noue ioieooaaiiy noaeei oe? — a?ae 2 i?n. aei 36 i?n. (15,2 ± 3,1
i?n).

O 45 oai?eo eiinoaooaaee 47 IACCO, ine?eueee o aeaio iaoe??io?a aoei
aeaa ai?eii-caiaeueieo aiaieua oe?. O ae?aiacii? iniiaii? iaoieia??
ia?aaaaeaee ai?ei? caoai?thaaiiy (33 aeiaaeee; 70,2 %), na?aae yeeo
aeii?ioaaee aanoeane oa oeaaiiie ia?aaacaeueieo oooey??a (26; 63,8
%). Iaai?ei? i?ioeane ?ioeo ee?oeiaeiieo i?inoi??a (A?oaa?a,
ia?aaeo?aoaaeueiiai oa ?i.) ? i?aeoe??i? ai?eieee oe? aeyaeee o 4 (8,5
%) oa 3 (6,4 %) oai?eo a?aeiia?aeii. Caiaeuei? o?aaeaiiy oeaiei oe?, ye?
iaiaaeoaaeeny noaae??th na?iciiai ?io?eueo?aoo, aoee o 10 (21,3 %)
niinoa?aaeaiiyo, naioe/ia iaoieia?y noaeei — o 4 (8,5 %). Ia?aa?a
iniiaiiai caoai?thaaiiy o 33 (73,3 %) in?a noi?iaiaeaeoaaany
nenoaiieie(AeAC-neiae?ii, aaeoa??eiee aiaeiea?aeeo, i?aaiia
iaaeinoaoi?noue oa ?i.) ? eieaeueieie (e?ioaaeai?o, naioe/i? o?iiaice
aai, inoaii??e?o eeth/eoe? oiui) oneeaaeiaiiyie. O 28 (62,2 %)
iaoe??io?a aoee noiooi? niiaoe/i? caoai?thaaiiy, na?aae yeeo ia?aaaaeaee
iaoieia?/i? i?ioeane, coiiaeai? ceiaaeeaaiiyi ia?eioee?a oa ?o
oiene/iith ae??th ia i?aai?ci OI — oiene/i? aaiaoeo (14; 31,1 %), iao?eo
(7; 15;6 %), i?iea?ae?iaeeno?io?y (3; 6,7 %) oa ?i.

I?iiia?oaaee 33 (73,3 %) OI, i’youeio (15,2 %) c ieo — aea?/?: o?ueio o
ca’yceo c i?ia?anoaaiiyi ai?eiiai caiaeaiiy, aeaio — c i?e/eie
oi?ioaaiiy iiaeo ai?eiee?a oe?. A on?o niinoa?aaeaiiyo canoiniaoaaee
o?aaeeoe?ei? eiina?aaoeaio oa?ai?th oa e?eoaaiiy i?neyiia?aoe?eieo ?ai.

Ia?oo eiio?ieueio a?oio neeaee iaoe??ioe ?c ai?eii-caiaeueieie
caoai?thaaiiyie oe? (ca aeeeth/aiiyi iaoieia?? oe??e oa ?? aea?eaao?a)
ia?i’?eoe?eiiai aaiaco, c iaaaoeaiei uiaei ceiaaeeaaiiy ia?eioeeaie
aiaiiacii oa aac noiooiueiai oeoe?iaiai ae?aaaoo, a?eii a?ae 16 aei 50
?ie?a (36,8 ± 1,6 ?ieo). Oey a?oia a??ia?aeii ia a?ae??ciyeany a?ae
iniiaii? ca noaoaaith i?eiaeaaei?noth oai?eo ((2 = 0,058; p > 0,05),
ni?aa?aeiioaiiyi /ieia?e?a ? ae?iie (p > 0,05), na?aaei?ie iieacieeaie
o?eaaeino? caoai?thaaiiy ia /an aini?oae?caoe?? (p > 0,01); /anoioith
ai?eieo caoai?thaaiue (70,2 % a iniiai?e i?ioe 86,7 % — o eiio?ieuei?e
a?oi?; (2 = 1,736; p > 0,05) oa ?o aeeaieeo eieae?caoe?e (a?aeiia?aeii
90,9 % ? 92,3 % niinoa?aaeaiue; (2 = 0,458; p > 0,05). O??o?a?/ia
e?eoaaiiy oa eiina?aaoeaia oa?ai?y oai?eo eiio?ieueii? a?oie
a?aeiia?aeaee caaaeueiiaeciaiei i?eioeeiai — ?ice?eooy aiaieua,
ae?i?iaoe?y aiith, onoiaiiy eieaeueieo oneeaaeiaiue, ae?aioaaiiy — c
ianooiiei canoinoaaiiyi aioeaaeoa??eieo, i?ioecaiaeueieo,
aeacaa?aaaioieo oa ?ioeo na?aaeiee?a. Iiae?ai?noue iaeaeaio a?oi ca
ieceith cacia/aieo e?eoa???a oiiaeeeaethaaea ?o ei?aeoia ii??aiyiiy.

O?ceeaeueia ianoaaeaiiy iaoe??io?a i?iaiaeeee ca o?aaeeoe?eieie
?aeiiaiaeaoe?yie. Ie??i oeueiai, o oai?eo iniiaii? a?oie ca
?ici?aoeueiaaiith a ee?i?oe? iaoiaeeeith c’yniaoaaee oa?aeoa? ?
o?eaae?noue ia?eiiai??, aeooaeuei? ?acia? oa aeiaia? aeice, ciie
?i’?eoaaiiy ia?eioe/ieo na?aaeiee?a, o?eaae?noue ? /anoioo ioieoe?e
noaeei oe?. Aeaoaeueii ?icieooaaee OI i?i oaoi?eo, oiiae oa iniaeeaino?
aeeiiaiiy ?i’?eoe?e. Aeynithaaee /anoioo e ee?i?/i? i?iyae iane?aee?a
“oaoi?/ieo ia??o?a” ?i’?eoaaiiy — iiieeeiaeo ioieoe?e a?oa??e, aaaaeaiiy
ia?eioe/iiai noano?aoo aioo??oiueia?oa??aeueii aai aeno?aaacaeueii.
Cae?aee a?aeiiino? i?i ?iaeea?aeoaeuei? iniaeeaino? ia?aa?ao
aanoeiaioiiai neiae?iio, ia?aianai? o?aini?n?ei? oa ai?eii-caiaeuei?
caoai?thaaiiy, e?eoaaiiy a ia?eieia?/ieo noaoe?iia?ao. O?aaeeoe?eia
ianoaaeaiiy ae?eyiee loci morbi aeiiiaithaaee iaeyaeii ?ioiaeioee oa
aeine?aeaeaiiyi ooieoe?e IX-XII ia? /a?aiii-iiceiaeo ia?a?a.

Ianya eaai?aoi?ieo e a?io?i?/ieo aeine?aeaeaiue a?aeiia?aeaa
caaaeueiiaeciaiei aeiiaai. A ie?aieo aeiaaeeao eiai aeiiiaithaaee
oanoaie ioe?iee nooiaiy aiaeiaaiii? ?ioieneeaoe??: aecia/aiiyi ??ai?a
iie?iaioeae?a na?aaeiuei? iieaeoey?ii? iane (ca Aaa?eyeyi I.E. e niaao.,
1981) ? eaeeioeeoa?iiai ?iaeaena ?ioieneeaoe?? (ca Ino?ianeee A.E. e
niaao., 1983). ?ioiieia?/i? ianoaaeaiiy iieyaaee o aecia/aii? e?eueeino?
O- ? A-e?ioioeeo?a (iaoiaeii niiioaiiiai oa eiiieaiaioa?iiai
?icaoeiooai?aiiy e?ioioeeo?a c a?eo?ioeeoaie aa?aia), “i?e?iaeieo
ee?oei-e?ea??a” (ca Iiaeeeue/ae I.Ae e niaao., 1991), ??ai?a
?ioiiaeiaoe?i?a eeano A, I, G (ca Mancini M.,1965)
oa oee?eoethth/eo ?ioiieo eiiieaen?a (ca Oaoeiaa E. a iiaeeo?eaoe??
Ianiiia A.E.,1978). Niaeo? na?ieia?/ieo iaoiae?a aeine?aeaeaiiy
i?noea ?ioiioa?iaioiee aiae?c ia A?E, ?aaeoe?th Aanna?iaia, aeyaeaiiy
iiaa?oiaaiai aioeaaio a??ona aaiaoeoo A.

Aaeoa??ieia?/ia ianoaaeaiiy ?io?a- oa i?neyiia?aoe?eii caa?aiiai
iaoa??aeo, aaiicii? e?ia?, ?ic/ei?a naii?iaieo ia?eioee?a ? aaeeaaiiai
?i’?eoe?eiiai cia?yaeaey (aieie, oi?eoe?a) ia?aaeaa/aei o?aaeeoe?eia
aa?iaii-aiaa?iaii-a?eaeiaa eoeueoeaoaaiiy, ?aeaioeo?eaoe?th
eieii?ciaaieo i?e?ii?aai?ci?a, aecia/aiiy ?o /ooeeaino? aei
aioea?ioee?a, ioe?ieo nooiaiy aaeoa??eii? eiioai?iaoe?? ia?eioe/ieo
na?aaeiee?a oa ?i’?eoe?eiiai i?eeaaeaey. Iaoiii?oieia?/ia aeine?aeaeaiiy
aenoeec?eieo ?io?aiia?aoe?eieo a?iioao?a oeaiei e aaoiin?eiiai iaoa??aeo
i?iaiaeeee iaoiaeii na?oeiai? i?e?ineii??.

Ae?aiacii ?io?o aeiiii?aeieo iaoiae?a ianoaaeaiiy i?noea
oeueo?aniiia?ao?th (ONA), eiii’thoa?io oiiia?ao?th (EO), oa?iineii?th
(ON), aeiiiea?ia?ao?th, ?aiaioeaoaeia?ao?th, ?aioaaiaeine?aeaeaiiy,
iai?yio ea?eiaineii?th oa iooaeueiineii?th.

Aa??aoe?eii-noaoenoe/ia ii?aoethaaiiy ?acoeueoao?a aeine?aeaeaiue
cae?enieee ca aeiiiiiaith e?eoa???a No’thaeaioa-O?oa?a oa (2 ia
ia?niiaeueiiio eiii’thoa?? ca aeiiiiiaith i?ia?aie aeey noaoenoe/iiai
aiae?co aeaieo iaaeeei-a?ieia?/ieo ianoaaeaiue “Instat” (GraphPad
Software Inc., 1993). Ae?aaiinoe/io ?ioi?iaoeai?noue ie?aieo iaoiae?a
aeine?aeaeaiiy ioe?ithaaee ca ?acoeueoaoaie aecia/aiiy ?o /ooeeaino? (s)
oa niaoeeo?/iino? (f).

?acoeueoaoe aeine?aeaeaiue tc » ?acoeueoaoe aeine?aeaeaiue»

Ao?ieia?/i? /eiieee oa iaoiaaiac IACCO. Aaciina?aaeiueith i?e/eiith
aeieeiaiiy IACCO aoee ?i’?eoe?? naii?iaieo ii?eieo ia?eioee?a o oeaieie
oa noaeeie oe?. Niaeo? eaocaeueieo i?e?ii?aai?ci?a IACCO neeaaeaee
aa?iai? aaeoa???, na?aae yeeo ia?aaaaeaea eieiaa oei?a (78,8 %).
Aeii?ioth/eie i?aaenoaaieeaie oeueiai eeano caoaeiee?a aoee S.aureus (47
%) ? S.epidermidis (26,5 %). Eeoeiaa oei?a (Str.fecium, Enterobacter
aerogenes, E.coli) aeyaeyeany o 15,9 % aeiaaee?a, ia a?oie i?ioaeii?
oa inaaaeiiiiaaeii? ?ioaeoe?? i?eiaaeaei ii 5,3 % a?aeiia?aeii.

Aiae?c ?acoeueoao?a aaeoa??ieia?/iiai aeine?aeaeaiiy aeyaea ca?aaiiy o
3/4 aeiaaee?a aeaeiaiai niaeo?o, a?aenioeiaiai neeaaeo oa nooiaiy
aioea?ioeei?acenoaioiino? i?e?ii?aai?ci?a, aen?yieo c aenoaeaoo
caiaeueieo aiaieu, ?ic/ei?a ia?eioee?a ? ciea?a c ?i’?eoe?eiiai
cia?yaeaey, ui aeaei i?aenoaae aeey aecia/aiiy ia?eioe/ieo na?aaeiee?a e
cania?a ?o aaaaeaiiy ye iniiaieo ao?ieia?/ieo aeaea?ae IACCO.

Ioe?iea noaio caoenieo ?aaeoe?e i?aai?cio OI cana?ae/eea cieaeaiiy
ii?iao nenoaiii? eaiee aioe?ioaeoe?eii? ?acenoaioiino?,
?ioiinoi?aniaai?noue e iani?eyoeeaee caaaeueiiniiaoe/iee oii o 34 (75,6
%) ia?eiiai?a. “Eiii?iiaoaoe?y” ?ioiiiai noaoono iaoe??io?a aeyaeyeany
ieceith ee?i?/ieo iciae (i?ia?aneaia ao?aoa aaae — 68,9 %,
aaia?ae?ciaaia e?ioaaeaiiiao?y — 40 %, nieaiiiaaae?y — 26,7 % oa ?i.) ?
i?aeoaa?aeaeoaaeanyaeaieie ?ioiieia?/ieo oano?a: ciaioaiiyi e?eueeino?
O- ? A-e?ioioeeo?a, a?ia??ioiiaeiaoe?iai??th A (66,7 %) oa G (41,7 %),
i?aeaeuaiiyi ??ai?a Oe?E (83,3 %), c?inoaiiyi e?eueeino? “i?e?iaeieo
ee?oei-e?ea??a” (83,3 %) oa ?i. ?ioiinoi?aniaai?noue OI
i?aeoaa?aeaeoaaeany ?acoeueoaoaie iaoiii?oieia?/ieo aeine?aeaeaiue
?ioiieiiiaoaioieo i?aai?a: ciaioaiiyi ?ici???a, neea?icoaaiiyi ?
ca?aeiaiiyi e?ioaoe/ieie ee?oeiaie caa?oaeeiii? caeice; oie?eoey?iith ?
ia?aei?oeeaeueiith a?ia?ieac??th e?ioaoe/ieo aoce?a ?c i?iaeoeoeaieie
aiaieuaie a?no?ioeeo?a, ieaciaoe/ieo oa ai?oae?aeueieo ee?oei o
ei?oeeaeueiiio oa??, ciaioaiiyi ae?aiao?o oie?eoe?a e?ioiaoce?a ?
noe?aiiyi ?aaeoeaieo oeaio??a — cii i?iaeoeoe?? O-e?ioioeeo?a;
nieaiiiaaae??th, ?io?aoie?eoey?iith a?ia?ieac??th naeac?iee,
iaa?iiaaeaeaiiyi o ?? oie?eoeao iae?ioaa?a e ieaciaoe/ieo ee?oei.
Caaaeueiiniiaoe/iee oii o a?eueoino? oai?eo (62,2 %) iaoyaeoaaany
noiooiueith niiaoe/iith iaoieia??th (oine/i? aaiaoeo, iao?eo,
ooaa?eoeueic eaaaiue oiui).

Eieaeueia eaiea aioe?ioaeoe?eii? ?acenoaioiino? OI oa?aeoa?ecoaaeany
iino?eiith iayai?noth “ao?aeieo ai??o” ?ioaeoe??, cieaeaiiyi
?ioaineaiino? e?iaiiinoa/aiiy oa ?ic?inoaiiyi iecueeiii??ii? niieo/ii?
oeaieie c oi?ioaaiiyi nai???aeii? iaoieia?/ii? no?oeoo?e —
“?i’?eoe?eiiai eaiaeo” (?E). A?i ?ici?uoaaany a i?iaeoe?? iaa?no?aeueieo
noaeei ? aeyaeyany ae?eyieith oeee?iae?e/iiai aeaoaeoo an?o oeaieiieo
oa??a o i?noe? ia?iaiaioieo ioieoe?e. ?E i?inoyaaany a?ae iiaa?oi? oe??e
aei iaaiiai naaiaioo noaeeie, a yeo, cacae/ae, aeeiioaaeeny ?i’?eoe??.
Ao?aeiei ioai?ii eiai aoa ie?oaeee aai iaaeueiee aeaoaeo oe??e (o. ca.
“oaooa”), aeiii — i?ee?eoa aeao?eoii ? cai?oeaie e?ia? iaoieia?/ii
ci?iaia noaeeiia no?iea. Niieo/ia oeaieia, eio?a ooai?thaaeany
aiane?aeie iinoioieoe?eieo ?oaoeaai-neea?ioe/ieo ci?i, oi?ioaaea no?iee
eaiaeo, iaaeiei yeiai ?icoaoiaoaaeeny a?ia?ieaciaai?, ooieoe?iiaeueii
“aeieiaai?” e?ioiaocee. ?E o?eaaeee ia??iae /ano aoa iino?eiei i?noeai
aaaaeaiiy naii?iaieo ia?eioe/ieo ?ic/ei?a, a ioaea — ciiith c aenieei
??aiai aaeoa??eii? eiioai?iaoe??.

Iacaaaeath/e ia noaea ni?a?nioaaiiy iniiaieo aeaoa?i?iaio [J.H.Meakins,
1991] ?ioaeoe?eii-caiaeueiiai i?ioeano (iino?eia ?iieoeyoe?y oa
aaaaoaoe?y caoaeiee?a o oeaieiao oe?, ii?ooaiiy nenoaiii? oa eieaeueii?
eaiie aioe?ioaeoe?eii? ?acenoaioiino? i?aai?cio OI), i?ioyaii o?eaaeiai
/ano IACCO ia aeieeaee. Aeaoaeueia aea/aiiy iniaeeainoae ?i’?eoaaiiy
i?ecaaei ian aei i?eiouaiiy, ui ?i?oe?aeueiei iaoai?ciii IACCO aoei
i?aeaeuaiiy aioo??oiueioeaieiiiai oa//e aioo??oiueioanoe?aeueiiai oeneo,
yea aeieeaei aiane?aeie oaoi?/ieo ia??o?a eiie?aoii? ioieoe??: aaaaeaiiy
ia?eioeea o a?eynoaeeii? ae?eyiee, aeno?aaacaoe?? e?ia? /a?ac ioieoe?ei?
aeaoaeoe no?iee a?oa??e /e aai, ooai?aiiy iinoo?aaiaoe/ieo aaiaoii oiui.
Oeae aeniiaie i?aeoaa?aeaeoaaany ?acoeueoaoaie aiae?co
i?e/eiii-iane?aeeiaeo ca’yce?a, yeee cana?ae/ea, ui o 42 (93,3 %) OI
ii/aoie caoai?thaaiiy aoa aaciina?aaeiuei iia’ycaiee c “iaaaeaeith”
o?aaiaoe/iith ?i’?eoe??th.

A?aoiaoth/e oeae oaeo e iniaeeaino? aiaoii?/ieo ci?i oe? a cii?
ioieoe?e, ie iiynieee iaoai?ci aeieeiaiiy IACCO oaiiiaiii eieaeueiiai
i?aeaeuaiiy oeaieiiiai oeneo, ia ??oio? yeiai noi?ioethaaee a?iioaco i?i
aioo??oiueioeaieiio a?ia?oaic?th ye aieiaio eaieo iaoiaaiaco oe???
iaoieia??. ?? nooue iieyaa? o ianooiiiio. Ia iaaiiio
aoai?a?eue (91,1 %), ii?ooaiiy ooieoe?? (66,7 %), eieaeueio a?ia?ai?th
(53,3 %), eieaeueio a?ia?oa?i?th (40 %). Oaeee a??ia?aeiee neiioii
ai?eiiai aiaieua ye oetheooaoe?y aecia/aany iiceoeaiei eeoa a 15,3 %
niinoa?aaeaiue.

Ioe?iea ?ioi?iaoeaiino? cacia/aieo eieaeueieo i?iya?a ca e?eoa??yie s ?
f cana?ae/eea ?o iecueeo ?ioi?iaoeai?noue aeey a??ia?aeii? ae?aaiinoeee
IACCO. Oea i?aeoaa?aeaeoaaeiny aenieith /anoioith (40 %) ae?aaiinoe/ieo
iiieeie, i?eiouaieo ia aoai? iaa?iiaaeaeaiiy ia?aeiiiai aeina?aeo
e?eoaaiiy oai?eo ?c cacia/aiith iaoieia??th (1990-1992 ?.?.). C iaoith
aaeineiiaeaiiy ?nioth/eo ae?aaiinoe/ieo i?aeoiae?a, a oaeiae aacoth/enue
ia iaoiaaiaoe/ieo iniaeeainoyo oe??? iaoieia?? oa anaa?/i?e ioe?ioe?
aeaieo o?ceeaeueiiai ianoaaeaiiy, ie a?ae?a?aee i?eaeaoi? aeey
ae?aaiinoeee a?aeii? (aieth/ee iioo c? ne?aeaie ?i’?eoe?e oa
iinoioieoe?eieie aeaoaeoaie oe??e a eiai i?iaeoe?? — s > 90 %) ? iienaee
iia? neiioiie IACCO, na?aae yeeo iaea?eueoith ?ioi?iaoeai?noth
oa?aeoa?ecoaaeeny iciaee eiii?eioth/i? ae?? iiooo ia i?aaie ? no?oeoo?e
oe? oa i?iyae o?iiaioe/iiai o?aaeaiiy AssA.

Neiioiie eiii?an?? oiiaii aeie?aieee a ianooii? a?oie:

— caaaeuei? (aeeneieaoe?y i?aai?a oe?, ii?ooaiiy i?io?aeiino? aa?oi?o
aeeoaeueieo oeyo?a, cao?oaeiai? ?ooe ieaeiueith uaeaiith) — ci?uaiiy
na?aaeeiii? e?i?? oe? ia 1,2 ± 0,2 ni o “caei?iao” noi?iio, aeaa?aoe?y
oa aeaoi?iaoe?y aeioee ? o?aoa?, caoaeaiiy ?o i?ina?oo oa ci?uaiiy a
i?ioeeaaeio a?ae iiooo noi?iio, iaa?ye aieiniaeo ca’ycie oa ?i., ye?
aeyaeyeeny ca aeaieie o?ceeaeueiiai ianoaaeaiiy, EO,
?aioaaiaeine?aeaeaiiy, iai?yii? ea?eiaineii??;

— iaa?ieia?/i? (iciaee ia?eoa??eiiai ia?aco aeoeath/iai ia?aa, ii?ooaiiy
ooieoe?? iea/iaiai nieao?iiy oa aeiaeaoeiaiai ia?aa) — iiouaiiy i’yeiai
i?aeiaa?iiy oa cieaeaiiy aeioeiaiai ?aoeaeno ia “o?aaeai?e” noi?ii?,
ci?uaiiy yce/ea o “caei?iaee” a?e, ci?ia aieino, ii?ooaiiy eiaoaiiy;
a?i- ? ia?anoac?? aeenoaeueieo a?aeae?e?a ?oee, iaiaaeaiiy ?? ?ooeeaino?
a iea/iaiio oa e?eoueiaiio noaeiaao, cieaeaiiy nooiaeeeeiaeo ?aoeaen?a;
i?aeiyooy aa?oiuei? ii?oe?? o?aiaoeaaeaeiiai i’yca ia noi?ii? iiooo. Oe?
iciaee aecia/aeeny i?e aeine?aeaeaii? ooieoe?? IX-XI ia?
/a?aiii-iiceiaeo ia?a?a;

— EI?-neiioiie — a?ia?ai?y c?ao, ieaaeaeeea oa aeoaeie c? noi?iie iiooo,
oeaio?aeueia ci?uaiiy ieaaeaeeea ? iioiauaiiy aeoaeie ia “o?aaeaiiio”
aioe?, ye? aeyaeyeeny i?e iaeyae? ?ioiai? ii?iaeieie.

Ioe?iea cacia/aieo i?iya?a ca e?eoa??yie s i f aeyaeea ?o aenieo
ae?aaiinoe/io ?ioi?iaoeai?noue (s > 90 %, f > 80 %) aeey
aeeoa?aioe?aoe?? aeeaieiai /e iiaa?oiaaiai ?ici?uaiiy iaoieia?/iiai
aiaieua oa aecia/aiiy eiai eieae?caoe?? a?aeiinii iaa?no?aeueieo noaeei
(aanaeie AssA aai i?aeeeth/e/ii? aaie). Aiaeii/an, i?iaiae?coaaaoe
iaoai?ci eiii?eioth/i? ae??, ?? aieea ia ia?aa?a caoai?thaaiiy oa
iiaeeea? iane?aeee, ie iio?aeooaaee ca aeioe?eueia eaae?o?eoaaoe
eiii?an?th i?aai?a ? no?oeoo? oe? ye iaoiaaiaoe/ii aeaoa?i?iiaaia
eieaeueia oneeaaeiaiiy IACCO, yea ne?ae a?aoiaoaaoe i?e aeai??
e?eoaaeueii? oaeoeee.

?ici?aoeueiaaia ae?aaiinoe/ia o??aaea o?iiaico AssA i?noeea ianooii?
neiioiie: 1) iiyaa aai iineeaiiy aieth a eeaaeuei?e ae?eyioe? i?e
iaooaeoaaii? oai?iai (aieth/a i?iaa Aaeuenaeueae); 2) iooeee iaa?ye
i?aeoe??ii? ee?oeiaeie e eiioo?oaaiiy i?aeoe??ii? aaiicii? n?oee
iaaeie?//y, i?aeeeth/e/ii? oa eiiaoeiai? ae?eyiie; 3) aie? a aieia? ia
noi?ii? caiaeueiiai iiooo.

I?aeoe/ia canoinoaaiiy iiaeui? o??aaee cana?ae/eei ?? aenieo
aoaeoeai?noue (100 %) ? aeicaieeei a on?o aeiaaeeao (/ioe?e
niinoa?aaeaiiy) ee?i?/ii anoaiiaeoe i?aaeeueiee ae?aaiic o?iiaico AssA,
yeee i?aeoaa?aeaeoaaany ?acoeueoaoaie aeiiii?aeieo iaoiae?a ianoaaeaiiy.

Na?aae inoaii?o iaea?eueoith ae?aaiinoe/iith ?ioi?iaoeai?noth noiniaii
IACCO oa ?o oneeaaeiaiue a?aecia/aeeny ONA ? EO. ?o aeei?enoaiiy
oiiaeeeaeei anoaiiaeaiiy ii?oieia?/iiai oa?aeoa?o iaoieia?/iiai aiaieua
(?io?eueo?ao /e ai?eiee), oe?ieiai eiea eiai oa?aeoa?enoee
(eieae?caoe?y, ?ici??e, oi?ia, aeeaeia caeyaaiiy, oeyoe iioe?aiiy oiui),
aeyaeaiiy eieaeueieo oneeaaeiaiue (noaeeiieo, e?noeiaeo, e?ioaoe/ieo),
aeiiia?aoe?eio ioe?ieo neioii?? ae?eyiee loci morbi oa
?iaeea?aeoae?caoe?th e?eoaaeueii? i?ia?aie IACCO c o?aooaaiiyi
eiinoaoiaaieo aeaieo (aea?? o??o?a?/iiai aeinooio, oa?aeoa?o oa ianyao
ao?o/aiiy). Noaa?aeaeaia aeniea aoaeoeai?noue ONA (96,2 %) ? EO
(91,7 %) aoea i?aenoaaith aeey aecia/aiiy oeeo aeine?aeaeaiue ye
iaoiae?a aeai?o ae?aaiinoeee IACCO oa ?o oneeaaeiaiue.

Cia/ii aoae/ee niaeo? ?ioi?iaoe?? iaaeaaaee ON ? ?aioaaiieia?/ia
ianoaaeaiiy ae?eyiee ?icoaooaaiiy iaoieia?/iiai aiaieua. Oae, aeai? ON
aeaaaee ciiao ioe?ieoe eeoa iaae? iioe?aiiy ciie a?ia?ai?? oa
a?ia?oa?i?? ? aoee ia aeinoaoi?ie aeey aeaoaeueii? oa?aeoa?enoeee loci
morbi. ?aioaaiaeine?aeaeaiiy aeyaeei aoaeoeai?noue noiniaii ae?aaiinoeee
caiaeueiiai o?aaeaiiy e?noie oa ?o c’?aeiaiue. C iaeyaeo ia oea,
canoinoaaiiy cacia/aieo iaoiae?a ? aeioe?eueiei ca aeeoa?aioe?eiaaieie
iieacaie: ON aeey ia’?eoea?caoe?? ie?aieo aeaieo o?ceeaeueiiai
ianoaaeaiiy, ?aioaaiaeine?aeaeaiiy — aeey aeyaeaiiy e?noeiai-noaeiaiai?
iaoieia?? oa i?e i?aeic?? ia ?aioaaieiio?anoi? noi?iii? o?ea i’yeeo
oeaiei oe?.

Aeiiiea?ia?ao?y aeicaieyea noaa?aeeoe /e caia?a/eoe ii?ooaiiy e?iaiieeio
ii iaa?no?aeueieo noaeeiao oe? ? oa?aeoa?ecoaaeany aenieith
ae?aaiinoe/iith aoaeoeai?noth noiniaii o?iiaioe/iiai o?aaeaiiy aaiicieo
noiaao??a, ui iaaeaei iiaeeea?noue eaae?o?eoaaoe ?? ye iaoiae aeai?o
aeey ianoaaeaiiy noaeeiiiai ?onea.

?acoeueoaoe ioe?iee ?ioi?iaoeaiino? aeaieo o?ceeaeueiiai oa aeiiii?aeieo
iaoiae?a aeine?aeaeaiiy neeaee i?ae??oioy aeey aaeineiiaeaiiy
ae?aaiinoe/iiai iiooeo IACCO oa eiai aaeaioaoe?? aei iaoiaaiaoe/ieo ?
oiiia?aoiaiaoii?/ieo iniaeeainoae oe??? iaoieia??.

Iniiao ae?aaiinoe/ii? i?ia?aie, yeo aacoaaee ia aiae?c? iecee
aeniei/ooeeaeo (s > 80 %) aiaiianoe/ieo, ia’?eoeaieo aeaieo ?
?acoeueoao?a aeiiii?aeieo iaoiae?a aeine?aeaeaiiy, neeaa i?eioeei
a?coae?caoe?? iaoieia?/iiai aiaieua. Eiai nooue iieyaaea o caaacia/aii?
oi?ioaaiiy o e?ea?y i?inoi?iaiai oyaeaiiy i?i caiaeueiee oieon IACCO.
Caaeey eiai ?aae?caoe?? aeie?aiethaaee ? eiiieaenii ioe?ithaaee oo
?ioi?iaoe?th, yea a iaaeaaaea iae?aoe?iiaeuei?oo ?ioi?iaoe?th i?i
oa?aeoa? IACCO, eiai eieae?caoe?th a?aeiinii iae?ineiiiaeo aiaoii?/ieo
i???ioe??a, a oaeiae ni?eyea nai?/aniiio aeyaeaiith eieaeueieo
oneeaaeiaiue.

I?iiiiiaaia ae?aaiinoe/ia noaia IACCO (?en.1), ie??i aeyaeaiiy
o?aaeeoe?eii?ee?i?/ii? ?ioi?iaoe??, ia?aaeaa/a? ?icoe?aiiy iiooeiaiai
ae?aiaciio eiaeiiai aoaio aeine?aeaeaiiy ca ?aooiie aeyaeaiiy iecee
i?eioeeiiaeo aeaieo c aenieeie s i f.

Ai?iaaaeaeaiiy a i?aeoeeo i?iiiiiaaii? noaie ae?aaiinoeee IACCO
aeicaieeei a on?o aeiaaeeao ?? canoinoaaiiy aeyaeoe aeinoaoi?e ianya
aaaeaii? ?ioi?iaoe??, ui caaacia/eei aenieo aoaeoeai?noue
ae?aaiinoe/iiai iiooeo, cieaeaiiy /anoioe oeaieo ae?aaiinoe/ieo
aeniiae?a ?c 40 % aei 0 % (c2 = 13, 217; p < 0,001), a ioaea - ni?eyei nai?/aniiio ? iiaiioe?iiiio aeai?o e?eoaaeueii? i?ia?aie a eiaeiiio eiie?aoiiio aeiaaeeo IACCO. Aenieo ae?aaiinoe/io aeinoaoi?noue ?ici?aoeueiaaieo i?eioeei?a aeei?enoaiiy a?coae?caoe?eieo iaoiae?a aeine?aeaeaiiy oaeiae cana?ae/eee ?acoeueoaoe ?o ai?iaaoe?? o oai?eo eiio?ieueii? a?oie c ai?eii-caiaeueiith iaoieia??th oe? ia?i’?eoe?eiiai aaiaco. O??o?a?/ia e?eoaaiiy IACCO. Iniiao o??o?a?/ii? oaeoeee i?e IACCO neeaaeaa i?eioeei ?aaeeeaeueiiai onoiaiiy iaoieia?/iiai aiaieua oa nai?/anii? ae?i?iaoe?? eieaeueieo oneeaaeiaiue. Caaeey eiai ?aae?caoe?? oa a?aoiaoth/e /enaeuei? ao?ieia?/i?, iaoiaaiaoe/i? e ee?i?/i? iniaeeaino? IACCO ie aaeineiiaeeee oa aaeaiooaaee ?nioth/? o?aaeeoe?ei? i?aeoiaee aei iia?aoeaiiai e?eoaaiiy ai?eieo aiaieu oe? oeyoii ?ici?aoethaaiiy iecee oaeoe/ieo caoiae?a, a naia: - ia?aaeiia?aoe?eia aecia/aiiy e?i?? o??o?a?/iiai aeinooio oa i???ioiaiiai ianyao ao?o/aiiy ca ?acoeueoaoaie aeiiia?aoe?eii? ONA; - i?iaaaeaiiy iia?aoe?? ia “nooiio iia?aoe?eiiio iie?” oeyoii canoinoaaiiy i?aaaioeaiiai eiaaoeyoe?eiiai aaiinoaco - ia?aae ?icn?/aiiyi i?aeoe??ii? ee?oeiaeie oa eiaeiiai ianooiiiai aiaoii?/iiai oa?o cae?enithaaee ae?aoa?iieiaaoeyoe?th oeaiei a ae?eyieao ?iia??ii? eieae?caoe?? noaeei iaeiai oa na?aaeiueiai eae?a?o a i?noe? ?ic??co oa ca ia?eiao?ii ?aie; - caaacia/aiiy aioeaiaie?/iiai oa?aeoa?o ao?o/aiiy ca ?aooiie ?ici?uaiiy oai?iai ia iia?aoe?eiiio noie? a iieiaeaii? O?aiaeaeaiao?aa, i?aeaeuaiiy aia?aoiiai oeneo ia aaein? i?e OAE, ?io?aiia?aoe?eii? eiii?an?? iaa?no?aeueieo noaeei; - aeinyaiaiiy iioeiaeueii? o??o?a?/ii? aeniiceoe?? oa iiaiioe?iii? a?coaeueii? ?aa?c?? ai?eii? ii?iaeieie ca aeiiiiiaith aaeaeaaoieo, ONA-aecia/aieo, iia?aoe?eieo aeinooi?a; - iaia’yceiaa aeaeaeaiiy e?ioaoe/ieo aoce?a ca ia?eiao?ii ?aie - ii?oieia?/iiai noano?aoa caiaeaiiy c e?eoe/ii aenieei ??aiai eiioai?iaoe??; aeeiiaiiy iae?aeoii?e, naiaoe?? oa ae?aioaaiiy ai?eiee?a; - canoinoaaiiy cania?a caoenoo iaaee/iiai ia?niiaeo a?ae ?io?aiia?aoe?eiiai ?io?eoaaiiy caoaeieeaie o?aini?n?eieo caoai?thaaiue - caoenieo ieoey??a, oa?ooo?a, eieue/oaeieo ?oeaae/ie ? o.i. Cacia/ai? oaeoe/i? iniaeeaino? neeaee i?ae??oioy aeey ?ici?aoethaaiiy iiaiai niiniao o??o?a?/iiai e?eoaaiiy oeaaiii NII (Iaoaio Oe?a?ie ? 18981 A) oa aaeineiiaeaiiy ?nioth/eo iia?aoe?e c i?eaiaeo ai?eiee?a ?ioeo eieae?caoe?e oe?. E?eoaaeueio oaeoeeo iae?aee ca?aeii c ?ici?aoeueiaaiei aeai?eoiii aeeoa?aioe?eiaaieo i?aeoiae?a, yeee ia?aaeaa/aa aeie?aieaiiy ca aeaieie ee?i?/iiai, ONA- ? EO-ianoaaeaiiy IACCO iiaa?oiaai? oa aeeaiei? eieae?caoe?? (I ??aaiue aeai?eoio), iiaeaeueoo aeeoa?aioe?aoe?th iaoieia?/iiai aiaieua ia ai?eiee /e ?io?eueo?ao (II ??aaiue), ?o ?iciiae?e ia oneeaaeiai? /e iaoneeaaeiai? oi?ie caoai?thaaiiy (III ??aaiue). Ia iniia? anoaiiaeaii? ?ioi?iaoe?? cae?enithaaee aea?? a?aeiia?aeii? e?eoaaeueii? i?ia?aie (IY ??aaiue). I?e iaoneeaaeiaiiio ?io?eueo?ao? ?? ianya i?noea eiina?aaoeaio oa?ai?th ca o?aaeeoe?eieie noaiaie (aioeaaeoa??eia, i?ioecaiaeueia, i?noeaaa e?eoaaiiy oiui). O aeiaaeeo o?ainoi?iaoe?? na?iciiai ?io?eueo?aoo a ai?eia aiaieua aeeiioaaee iia?aoeaiaao?o/aiiy. Iiaa?oiaa? iaoneeaaeiai? ai?ei? IACCO ?ice?eaaee aeinooiii /a?ac ?o oeaio?aeueiee oieon, aaaeothaaee ai?e, naioaaee oa ae?aioaaee ii?iaeieie. I?e aeeaieeo iaoneeaaeiaieo ai?eieeao (?en.2) canoiniaoaaee ?ice?eooy ai?eiiai aiaieua c ONA-i???ioiaaieo aeinooi?a, e?ioaaeai- ? iae?aeoii??, naiaoe?th oa ae?aioaaiiy ?ai i’yeeie aoiiaeie ae?aiaaeaie. Ianya o??o?a?/iiai ao?o/aiiy i?e oneeaaeiaieo IACCO ia?aaeaa/aa ?ice?eooy ai?eii? ii?iaeieie ? e?ea?aeaoe?th eieaeueieo oneeaaeiaiue. Iia?aoe?yie aeai?o aoee: i?e o?iiaioeaa?o? i?aeoe??ieo aai - aen?/aiiy o?aaeaieo naaiaio?a noaeei ?c ia?aa’yceith eoen o iaaeao caei?iaeo oeaiei; i?e eiii?an?? i?aai?a oe? oa//e oeaaio?iiaic? iaa?no?aeueieo aai - aeaeiii?an?eia aea?iioanoe?ioii?y; i?e iaaii?ieo inaaaeiaiaa?eciao i?aeeeth/e/ii? a?oa??? - aen?/aiiy aiaa?ecie ia oii? i?ieneiaeueii-aeenoaeueiiai eiio?ieth aaiinoaco c ianooiiei e?aoaaiiyi a?oa??? a iaaeao caei?iaeo oeaiei; i?e aeaoaeoao no?iee iaa?no?aeueieo noaeei - caoeaaiiy aeaoaeoo c a?ioaiiiiaaeith e?i?? oa?a aai ia?aa’ycea noaeeie; i?e inoaii??e?o? eeth/eoe? oa a?oaeeie - ?acaeoe?y e?noee aai iae?naeaano?aeoii?y, i?e a?o?eo? a?oaeeiii-eeth/e/iiai c’?aeiaiiy – iia?aoe?y a?o?ieeac??. I?iiiiiaaiee aeai?eoi aeeoa?aioe?eiaaieo e?eoaaeueii-oaeoe/ieo i?aeoiae?a aei IACCO aeicaieea o eiaeiiio eiie?aoiiio aeiaaeeo nai?/anii ia?aoe e?eoaaeueio oaeoeeo (eiina?aaoeaio /e iia?aoeaio), /?oei aecia/eoe ianya ? oa?aeoa? o??o?a?/iiai ao?o/aiiy, oieeiooe iaia?aaeaa/aieo neooaoe?e ? ianiiae?aaieo ?io?aiia?aoe?eieo ciao?aeie, i?io?eaeooaaoe yo?iaaii? oneeaaeiaiiy oa cacaeaeaa?aeue ia?aaeaa/eoe iiaiioe?iia iaoa??aeueia caaacia/aiiy iia?aoe?e (a?aeiia?aeiee ?ino?oiaioa??e, oiaiee iaoa??ae oiui). Aeieacii aeniei? aoaeoeaiino? ?ici?aoeueiaaiiai aeai?eoio aoei cieaeaiiy ia ae?oaiio aoai? (1993- 1998 ?.?.) aeeiiaiiy iaoiai aeine?aeaeaiiy e?eoaaeueii-oaeoe/ieo iiieeie ?c 40 % aei 0 % ((2 = 13, 217; p < 0,001), i?neyiia?aoe?eieo oneeaaeiaiue oa iiaoi?ieo ao?o/aiue ?c 26,1 % aei 3,3 % ((2 = 3,4; p >
0,05), eaoaeueiino? c 13,3 % aei 3,3 % ((2 = 0,3; p > 0,05).

Ai?iaaoe?y cacia/aieo iniaeeainoae o??o?a?/ii? oaeoeee o 10 (32,2 %)
iaoe??io?a eiio?ieueii? a?oie c ai?eieie caoai?thaaiiyie oe?
ia?i’?eoe?eiiai aaiaco aeicaieeea aaaiii iie?aueoe ?acoeueoaoe ?o
e?eoaaiiy, ui aeyaeeiny nei?i/aiiyi oa?i?i?a auooaiiy caiaeueiiai
i?ioeano a i?neyiia?aoe?eiiio ia??iae?. Oae, oa?i?ie ae?i?iaoe??
ia?eoieaeueieo i?iya?a caiaeaiiy nei?ioeeeny c 6,6 ± 0,6 aei 4,7 ± 0,3
ae?a (p < 0,05), i?eieiaiiy ai?eii? aenoaeaoe?? - c 8,2 ± 0,9 aei 6,0 ± 0,4 ae?a (p < 0,05), aeiiaiaiiy ?aie a?aioeyoe?yie - c 10,2 ± 0,9 aei 7,3 ± 0,7 ae?a (p < 0,05), ui cana?ae/eei aeioe?euei?noue canoinoaaiiy ?ici?aoeueiaaieo i?eioeei?a o??o?a?/iiai e?eoaaiiy a on?o aeiaaeeao ai?eii-caiaeueii? iaoieia?? oe?. AENIIAEE tc " AENIIAEE" 1. IACCO - oea iiaa, ni?e/eiaia ?i’?eoe?yie naii?iaieo ia?eioe/ieo ?ic/ei?a o noaeeie oa oeaieie oe?, iaoieia?y, yea iae?/o? oe?ieee ae?aiacii caiaeueieo caoai?thaaiue ? oa?aeoa?eco?oueny aeeaieei ?ici?uaiiyi ai?eii-caiaeueieo aiaieu, a?oaeie iaoiii?oieia?/ieie ci?iaie oa ii?ooaiiyie neioii?? a ae?eyioe? ?o eieae?caoe??. 2. Aeii?ioth/ei ao?ieia?/iei caoaeieeii IACCO ? noao?eieieiaa oei?a (73,5 %), o o?aoei? (31,8 %) aeiaaee?a - iaiiaoiaaie. Ia?aaeoiiaaie aeieeiaiiy oe??? iaoieia?? ? ia?iaiaioia ?iieoeyoe?y “aoee/ieo” i?e?ii?aai?ci?a o oeaieie oe?, eieaeuei? i?ney?i’?eoe?ei? iaoiii?oieia?/i? ci?ie oa ?iceaaee aioe?ioaeoe?eii? ?acenoaioiino? i?aai?cio OI. Iaea??ia?aei?oith i?e/eiith ?i?oe?aoe?? oa aieiaiith iaoiaaiaoe/iith aeaoa?i?iaioith IACCO ? aioo??oiueioeaieiia a?ia?oaic?y, coiiaeaia aeno?aaacaoe??th e?ia? aai iicanoaeeiiei aaaaeaiiyi ia?eioee?a. Eiii?an?th i?aai?a ? no?oeoo? oe? ne?ae o?aeooaaoe ye eieaeueia oneeaaeiaiiy IACCO, yea iiaeiia a?aoiaoaaoeny i?e aeai?? e?eoaaeueii? oaeoeee. 3. Ee?i?/ia ea?oeia IACCO aeyaey?oueny oe?ieei niaeo?ii neiioii?a, na?aae yeeoaeii?iothoue i?iyae ai?eii? oa o?ii?/ii? ia?eioe/ii? ?ioieneeaoe??, ?ioiinoi?aniaaiino?, noiooiuei? niiaoe/ii? iaoieia??. Eeane/i? caiaeuei? iciaee IACCO ? iecueei ?ioi?iaoeaieie, a ioaea - iai?eaeaoieie aeey ?o ei?aeoii? ae?aaiinoeee. Aeyaeaiiy iienaieo neiioii?a eiii?an?? i?aai?a ? no?oeoo? oe?, ae?aaiinoe/ii? o??aaee AssA, a oaeiae eiinoaoaoe?y aieth/iai iiooo oe? c? ne?aeaie ?i’?eoe?e /e iinoioieoe?eieie aeaoaeoaie oe??e neeaaea? aaaiia i?ae??oioy aoaeoeaii? ae?aaiinoeee IACCO. 4. Ae?aaiinoe/iee iiooe IACCO iiaeiai aacoaaoeny ia i?eioeei? a?coae?caoe?? iaoieia?/iiai aiaieua oeyoii eiiieaenii? ioe?iee aeaieo o?ceeaeueiiai ianoaaeaiiy ? ?acoeueoao?a aeiiii?aeieo a?coae?caoe?eieo iaoiae?a aeine?aeaeaiiy. Iaoiaeaie aeai?o aeey ae?aaiinoeee IACCO ? ONA ? EO. Aeiiiea?ia?ao?y aeicaiey? aoaeoeaii ae?aaiinooaaoe o?iiaioe/ia o?aaeaiiy aaiicieo noiaao??a, ui aea? i?aenoaae eaae?o?eoaaoe ?? ye iaoiae aeai?o aeey ianoaaeaiiy noaeeiiiai ?onea oe?. ON aeioe?eueii aeei?enoiaoaaoe aeey ia’?eoea?caoe?? ie?aieo aeaieo o?ceeaeueiiai ianoaaeaiiy (aecia/aiiy ?aaeueieo iaae iioe?aiiy eieaeueii? a?ia?ai?? oa a?ia?oa?i??), ?aioaaiaeine?aeaeaiiy - aeey aeyaeaiiy e?noeiai-noaeiaiai? iaoieia?? oa i?e i?aeic?? ia ?aioaaieiio?anoi? noi?iii? o?ea oeaiei oe?. 5. Noaa?aeaeai? ao?ieia?/i?, iaoiaaiaoe/i? e ee?i?/i? iniaeeaino? IACCO aeiaaathoue aaeaioaoe?? oa ?iaeea?aeoae?caoe?? o?aaeeoe?eiiai niaeo?o e?eoaaeueieo caoiae?a. Aea?? i?ia?aie e?eoaaiiy IACCO ne?ae ??oiooaaoe ia aoaiiiio aeai?eoi?/iiio i?eioeei? aeie?aieaiiy a?oi oai?eo ?c ??cieie aeaeaie IACCO ? canoinoaaii? o ieo ?ici?aoeueiaaieo ianya?a iia?aoeaieo ao?o/aiue. ?aaeeeaeueia o??o?a?/ia e?eoaaiiy IACCO iiaeiii ia?aaeaa/aoe canoinoaaiiy aaeaeaaoieo ONA-i???ioiaaieo iia?aoe?eieo aeinooi?a, i?aaaioeaiiai eiaaoeyoe?eiiai aaiinoaco, eiiieaeno aioeaiaie?/ieo caoiae?a, caaacia/oaaoe aeaeiii?an?eiee oa?aeoa? ao?o/aiiy, iioeiaeueio ?io?aiia?aoe?eio aeniiceoe?th ai?eieo ii?iaeiei, iaia’yceiaa aeaeaeaiiy e?ioaoe/ieo aoce?a ca ia?eiao?ii ?aie, i?iaaaeaiiy iae?aeoii?e, naiaoe?? oa ae?aioaaiiy aiaieu. 6. Aeniea aoaeoeai?noue canoinoaaiiy ?ici?aoeueiaaieo oaeoe/ieo iniaeeainoae o OI ?c IACCO ? iiceoeai? aene?aee ?o ai?iaaoe?? o iaoe??io?a c ai?eieie caoai?thaaiiyie oe? ia?i’?eoe?eiiai aaiaco na?ae/aoue i?i aeioe?euei?noue aeno?aiieyoe?? ?ici?aoeueiaaieo i?eioeei?a ae?aaiinoeee oa o??o?a?/iiai e?eoaaiiy IACCO, ianya?a iia?aoeaieo ao?o/aiue ? aaeineiiaeaii? oaoi?ee aeeiiaiiy iia?aoe?e ia an? aeiaaeee e?eoaaiiy ai?eii-caiaeueii? iaoieia?? oe?. NIENIE I?AOeUe, tc " NIENIE I?AOeUe," IIOAE?EIAAIEO CA OAIITH AeENA?OAOe?? tc " IIOAE?EIAAIEO CA OAIITH AeENA?OAOe??" 1. Aa?e/ ?.Ae., Coa A.?. *e iiaeeeaee ?icaeoie ai?eiiai iaae?anoei?oo ye oneeaaeiaiiy i?ney?i’?eoe?eieo ai?eiee?a noaeeiii-ia?aiaiai io/ea oe? o caaaainiaaieo aioo??oiueiaaiieo ia?eiiai?a? // Iiaeie noiiaoieia??. - 1995. - ?1-2. - N. 93-94. 2. Aa?e/ ?.Ae., Coa A.?. Ii??aiyeueia ioe?iea iaoiae?a ae?aaiinoeee i?ney?i’?eoe?eieo ai?eii-caiaeueieo caoai?thaaiue oe? o oai?eo-ia?eiiai?a // I?aeoe/ia iaaeeoeeia. - 1997. - ?3-4. - N. 22-24. 3. Aa?e/ ?.Ae., Coa A.?. Inoaii??e?o eeth/eoe? ye oneeaaeiaiiy i?ney?i’?eoe?eii? ia?aaacaeueii? oeaaiiie oe? o aioo??oiueiaaiiiai ia?eiiaia // I?oiiaaeey, o?aaiaoieiaey e i?ioace?iaaiea. - 1998. - ?2. - N. 103-105. 4. Aa?e/ ?.Ae., Coa A.?. ??aee?niee ee?i?/iee aeiaaeie eieae?caoe?? ai?eiiai aiaieua a ne?iiio i?oeo A?oaa?a // Iiaeie noiiaoieia??. - 1998. - ?3. - N. 53-54. 5. Iaoaio 18981 A Oe?a?ia, IIE A61A 17/ 00. Niin?a e?eoaaiiy oeaaiii noaeeiii-ia?aiaiai io/ea oe? / ?. Ae. Aa?e/, A.?. Coa (Oe?a?ia). - ? 95020829; Cayae. 23.02.95; Iioae. 25.12.97. Athe.? 12. - 2 c. 6. Aa?e/ ?.Ae., Aa?a?inueea A.N., Coa A.?. Ao?iiaoiaaiaoe/i? aniaeoe ii?ooaiue nenoaie aaiinoaco ? ?aieia?? e?ia? o aioo??oiueiaaiieo ia?eiiai?a // Aeooaeuei? ieoaiiy iaaeeoeeie: Ca. iaoe. i?aoeue, i?enay/aieo 10-??/iiio tha?eath eaoaae?e oa?ai?? ? 2 OOE?I EAeI?. - Euea?a, 1995. - N. 102-103. 7. Aa?e/ ?.Ae., Coa A.?. Aeaye? iniaeeaino? oa i?iaeaie e?eoaaiiy i?ney?i’?eoe?eieo oeaaiii noaeeiii-ia?aiaiai io/ea oe? o oai?eo-ia?eiiai?a // Aeooaeuei? ieoaiiy iaaeeoeeie: Ca. iaoe. i?aoeue, i?enay/aieo 10-??/iiio tha?eath eaoaae?e oa?ai?? ? 2 OOE?I EAeI?. - Euea?a, 1995. - N. 103-104. 8. Coa A.?., Caeoeaa ?.A., O?ooye I.A. Eiii’thoa?ia oiiia?ao?y a ae?aaiinoeoe? i?ney?i’?eoe?eieo ai?eiee?a oe? o ia?eiiai?a // No/ani? aniaeoe iaa?aeeeaaeii? iaaee/ii? aeiiiiiae: Iaoa?. iaoe.-i?aeo. eiio., i?enay/aii? 25-??//th EIEEOIAe. - Euea?a,1997. - C. 106 - 107. 9. Coa A.?. I?ney?i’?eoe?ei? ai?eii-caiaeuei? caoai?thaaiiy oe? o ia?eiiai?a: ee?i?ei-ae?aaiinoe/i? iniaeeaino? // Oacenu aeieeaaeia I Iaaeaeoia?iaeiiai iaaeeoeeineiai eiia?anna nooaeaioia e iieiaeuo o/aiuo. - Oa?iiiieue, 1997. - N. 291-292. 10. Coa A.?. I?ney?i’?eoe?ei? ai?eii-caiaeuei? caoai?thaaiiy oe? o ia?eiiai?a // Iaoa?. VI ?ani. o/aiai-iaoiae. oa iaoe. eiio. caa?aeoth/eo eaoaae?aie caaaeueii? o??o?a?? iaaeaoc?a Oe?a?ie. - A?iieoey, 1998. - N. 117-120. 11. Iaea? Ae.A., Coa A.?. O??o?a?/ia oaeoeea i?e oneeaaeiaieo i?ney?i’?eoe?eieo ai?eii-caiaeueieo caoai?thaaiiyo oe? o ia?eiiai?a // Iaoa?. II tha?eaeii? iaa/aeueii-iaoiae. oa iaoeiai-i?aeo. eiio. caa?aeoaa/?a eaoaae? o??o?a?/ieo oai?ia noiiao. oaeoeueoao?a AOC?a Oe?a?ie.- Iieoaaa, 1998. - N. 45-46. 12. Coa A.?. Iniaeeaino? iia?aoeaiiai e?eoaaiiy i?ney?i’?eoe?eieo ai?eiee?a oe? o ia?eiiai?a // Iaoa?. II tha?eaeii? iaa/aeueii-iaoiae. oa iaoeiai-i?aeo. eiio. caa?aeoaa/?a eaoaae? o??o?a?/ieo oai?ia noiiao. oaeoeueoao?a AOC?a Oe?a?ie.- Iieoaaa, 1998. - N. 46-47. 13. Aa?e/ ?.Ae., Coa A.?. Ae?aaiinoeea i?ney?i’?eoe?eieo naioe/ieo o?iiaic?a aai oe? o ia?eiiai?a // Iaoa?. I iaoeiai-i?aeo. eiio. Euea?anueei? i?nueei? ee?i?/ii? e?ea?i? oaeaeei? iaaee/ii? aeiiiiiae. - Euea?a, 1998. - N. 33. 14. Aa?e/ ?.Ae., Coa A.?., Niaaei C.O. Iaoiaeeea oeueo?aniiia?ao?/ii? ae?aaiinoeee ia?aaacaeueieo ai?eieo caoai?thaaiue: ?ioi?i. eeno / Euea?a. iaae. ?i-o. - E.: OOeII?, 1996. - 2 n. (i?iae. “O??o?a?y”. - Aei. 4, ? 58). 15. Aa?e/ ?.Ae., Coa A.?. Niin?a o??o?a?/iiai e?eoaaiiy oeaaiii noaeeiii-ia?aiaiai io/ea oe?: ?ioi?i. eeno / Euea?a. iaae. ?i-o. - E.: OOeII?, 1996. - 2 n. (i?iae. “O??o?a?y”. - Aei. 4, ? 59). AIIOAOe?ss tc " AIIOAOe?ss" Coa A.?. Iniaeeaino? ee?i?ee, ae?aaiinoeee oa o??o?a?/iiai e?eoaaiiy i?ney?i’?eoe?eieo ai?eii-caiaeueieo caoai?thaaiue oe? o oai?eo-ia?eiiai?a. - ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.03 - o??o?a?y. - Euea?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao ?i. Aeaieea Aaeeoeueeiai, Euea?a, 1999. I?iaiae?ciaaii ?acoeueoaoe caaaeueiiee?i?/iiai, eaai?aoi?ii-a?io?i?/iiai, aaeoa??ieia?/iiai, ?ioiieia?/iiai oa ?ino?oiaioaeueiiai iaoiae?a ianoaaeaiiy oai?eo-ia?eiiai?a ?c i?ney?i’?eoe?eieie ai?eii-caiaeueieie caoai?thaaiiyie oe? (IACCO). Aecia/aii ao?ieia?/i?, iaoiaaiaoe/i?, ee?i?/i? iniaeeaino? IACCO. Ia??oioiaaii a?iioaco i?i aioo??oiueioooey?io a?ia?oaic?th ye aieiaio iaoiaaiaoe/io eaieo IACCO. ?ici?aoeueiaai? aoaeoeai? i?eioeeie eiiieaenii? ae?aaiinoeee, iiaee niin?a o??o?a?/iiai e?eoaaiiy ai?eiee?a noaeeiii-ia?aiaiai io/ea oe?, aeai?eoi aeeoa?aioe?eiaaieo i?aeoiae?a aei e?eoaaiiy IACCO. Aeieacaia aeniea aoaeoeai?noue ?o ee?i?/iiai canoinoaaiiy. Eeth/ia? neiaa: ai?eia o??o?a?/ia ?ioaeoe?y; ai?eii-caiaeuei? caoai?thaaiiy oe?; ?i’?eoe?eia ia?eiiai?y; aanoean; oeaaiiia; oeaaio?iiaic; o?iiaioeaa?o; a?oa??aeueia aiaa?ecia; ee?i?ea, ae?aaiinoeea, e?eoaaiiy o??o?a?/ii? ?ioaeoe??. AIIIOAOeEss tc " AIIIOAOeEss" Coa A.E. Iniaaiiinoe eeeieee, aeeaaiinoeee e oe?o?ae/aneiai ea/aiey iineaeiuaeoeeiiiuo aiieii-ainiaeeoaeueiuo caaieaaaiee oae o aieueiuo-ia?eiiaiia. - ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.03 - oe?o?aey. - Eueaianueeee ainoaea?noaaiiue iaaeeoeeineee oieaa?neoao ei. Aeaieea Aaeeoeeiai, Eueaia, 1999. I?iaiaeece?iaaiu ?acoeueoaou iauaeeeie/aneiai, eaai?aoi?ii-aeioeie/aneiai, aaeoa?eieiae/aneiai, eiioiieiae/aneiai e eino?oiaioaeueiiai iaoiaeia ianeaaeiaaiey aieueiuo-ia?eiiaiia n iineaeiuaeoeeiiiuie aiieii-ainiaeeoaeueiuie caaieaaaieyie oae (IAACO). Ii?aaeaeaiu yoeieiae/aneea, iaoiaaiaoe/aneea, eeeie/aneea iniaaiiinoe IAACO. Iainiiaaia aeiioaca aioo?eoooey?iie aeia?oaicee eae iniiaiiai iaoiaaiaoe/aneiai caaia IAACO. ?ac?aaioaiu yooaeoeaiua i?eioeeiu eiiieaeniie aeeaaiinoeee, iiaue niinia oe?o?ae/aneiai ea/aiey aiieieeia ninoaeenoi-ia?aiiai io/ea oae, aeai?eoi aeeooa?aioee?iaaiiuo iiaeoiaeia e ea/aieth IAACO. Aeieacaia aunieay yooaeoeaiinoue eo eeeie/aneiai i?eiaiaiey. Eeth/aaua neiaa: aiieiay oe?o?ae/aneay eioaeoeey; aiieii-ainiaeeoaeueiua caaieaaaiey oae; eiuaeoeeiiiay ia?eiiaiey; aanoeann; oeaaiiia; oeaaio?iiaic; o?iiaioeaaeo; a?oa?eaeueiay aiaa?ecia; eeeieea, aeeaaiinoeea, ea/aiea oe?o?ae/aneie eioaeoeee. SUMMARY tc " SUMMARY " Zub V.I. The peculiarities of clinics, diagnosis and surgical treatment of postinjection purulent and inflammatory diseases of the neck in drug abusers.-Manuscript. Thesis for getting Candidate of Medical Sciences’ Degree by speciality 14.01.03. - Surgery. - L’viv State Medical University by name Danylo Halycky, L’viv, 1999. The randomized prospective research included 120 among which 45 patients (the basic group) were drug abusers with postinjection purulent and inflammatory diseases of the neck (PPIDN); another 45 persons (the 1-st control group) were the patients with neck purulent diseases of non-injection origin but without prior drug-addicting data; and the last 30 people (the 2-nd control group) were represented by healthy donors. Forty-seven cases of PPIDN were revealed in 45 drug abusers. The cases ranged paravasal abscesses (26 patients; 55,2 %) and cellulitis (10; 21,3 %) to other abscesses with location in fascial compartment of the neck (7; 14,9 %), suppurative subclavian artery aneurysm (2; 4,3 %) and cervical venous thromboses (2; 4,3 %). Etiologic, pathogenic and clinical distinctions of PPIDN were determined on the basis of the results obtained from general, laboratory, biochemical, bacteriological, immunological and clinical studies. Opioid narcotics when injected in cervical tissue and local vessels were found to be the direct cause of PPIDN. The germs from aerobic cocci species were dominating in casual agents spectrum. Most of the patterns were represented by S.aureus (47 %) and S. epidermidis (26,5 %). Intestinal species (Str.fecium, Enterobacter aerogenes, E.coli) were found in 15,9 % of the cases examined, while Proteus and Pseudomonas groups were identified in 5,3 % of patterns each. It was established that tissue and compartmental hypertension prevailed in PPIDN development wich, in turn, arised due to various technical errors when injecting drugs. Increasing pressure in the cervical fascial compartment caused by blood outflow from punctured vessels, as well as injecting narcotics into scarred tissue around vessels, resulted in microcirculation disorders, tissue hypoperfusion and ischemia within injured sites, and therefore, the local anti-microbal resistance collapsed. At the same time, on the background of compartmental hypertension the virulence of the innoculated germs increased proportionally to depression of the local defensive factors. And thus, PPIDN was finally initiated. The efficiancy of PPIDN clinical signs was studied with respect to the criteria of “sensitivity” (s) and “specificity” (f). It was established that the classical symptoms of a suppurative process (pain, swelling, local hypertermia and hyperemia) have not been proven to be of great importance to diagnostics of PPIDN. The fact of neck structures compressed by an inflammatory oedema has been considered to be the local complication of PPIDN, and such the consideration of the above has been shown as expediently substantiated. New symptoms of neck structure compression have been described, and their diagnostic value proved as well. Diagnostic triad of symptoms which are the most evident for the diagnosis of the internal jugular vein thromboses have been developed. The special diagnosing techniques have been studied, and they are as follows: ultrasound (US), CT scan, dopplerography, thermoscopy, X-ray examination. US and CT scan have been shown as the most effective in case of PPIDN. A method of US examination for paravasal abscesses and cervical blood vessels pathology has also been worked out. A schedule is proposed for diagnosing both PPIDN and their complications, and the principle of a mattery site visual availability is seen as the primarily fundamental. This principle can be achieved by means of identifying both the well-known and newly described PPIDN signs with their high sensitivity (s > 80 %) and specificity (f > 80 %), and
also with the use visualization techniques like US and CT scanning are.

Treatment schedule has been worked out for PPIDN and it includes the
following: 1-st level — pathologic site differentiated as a superficial
or a deep forms PPIDN; 2-nd level — pathologic site differentiated as an
abscess or a cellulitis; 3-rd level — PPIDN divided into complicated or
non-complicated forms; 4-th level — management policy was choosen after
all information obtained had been analyzed.

The principles of surgical treatment depending on location have been
developed for PPIDN, and these include: surgical approach more
perfected; scope of intervention; precise surgical technique; embolism
prophylaxis; measures preventing neck blood vessels from professional
damages; intraoperative prophylaxis of medical staff contamination with
HIV and virus hepatitis infections. A new operation of abscess of
vessels-nervous bunch of the neck has been invented.

The practical application of the above-mentioned principles for PPIDN
diagnosing and treatment has allowed to reduce the rate of diagnostic
errors from 40 % to 0 % ((2 = 13,217; p < 0,001), postoperative complications and reoperations rates were decreased from 26,1 % to 3,3 % ((2 = 3,4; p > 0,05), mortality rate was lowered from
13,3 % to 3,3 % ((2 = 0,3; p > 0,05).

Key words: suppurative surgical infection; deep neck infection;
injection drug abuse; abscess; cellulitis; thrombophlebitis; arterial
aneurysm; clinics, diagnosis, treatment of surgical infection.

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