2

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

AIAOTHE Ieeiea A?eai?iae/

OAeE: 616.33/34-002.44-089

II?AeIAI? IIA?AOe?? IA I?AAIAO ACIOAAIAANO?IAeOIAeAIAEUeII? CIIE A
I?IO?EAEOEOe? IINOOIEAOeENOAEOII?*IIAI NEIAe?IIO

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 ia aac? ?inoeoooo ee?i?/ii? oa aenia?eiaioaeueii?
o??o?a?? AII Oe?a?ie (i.Ee?a)

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

Eii/ae Aieiaeeie? Ieoaeeiae/,

caa?aeoaa/ a?aeae?eii o??o?a?? i?aeoeoieiai? caeice ? ?aeiino?oeoeaii?
o??o?a?? aeia/ieo oeyo?a ?E?AO AII Oe?a?ieIo?oe?ei? iiiiaioe:aeieoi?
iaaee/ieo iaoe, i?ioani?

?aaec?oianueeee Aiaoie?e Iaaeiae/,

caa?aeoaa/ eaoaae?ith o??o?a?? oa ii?eiai? oai?iae Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I.E Ooieea IIC Oe?a?ie;aeieoi?
iaaee/ieo iaoe, i?ioani?

Caoa?ao Ieoaeei Iao?iae/,

ia/aeueiee iaaee/iiai oi?aae?iiy Neoaeae aaciaee Oe?a?ieI?ia?aeia
onoaiiaa:Iaoe?iiaeueiee iaaee/iee Oi?aa?neoao

?i. I.I.Aiaiiieueoey IIC Oe?a?ie,

(eaoaae?a oaeoeueoaonueei? o??o?a?? ?1)Caoeno a?aeaoaeaoueny 28 ea?oiy
1999 ?. i 1100 aiae. 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 (254112, i.Ee?a, aoe. Aei?iaiaeeoeueea, 9).

C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? aeaaeai?? (i.Ee?a,
aoe. Aei?iaiaeeoeueea, 9).

Aooi?aoa?ao ?ic?neaii “_25_”__03_______ 1999 ?.

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

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

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. A inoaii?e /an ?ioa?an oe?ieiai eiea o??o?a?a
aei i?iaeaie ii?aeiaieo caoai?thaaiue iaaieiii c?inoa?. Aea ia?ciai?noue
i?aeoe/ieo e?ea??a noiniaii ae??oaiiy oeueiai ieoaiiy /anoi iaaeinoaoiy.
A ooiaeaiaioaeueieo i?aoeyo N.A.Oae?iiaa (1982), A.N.Caineiaa (1982),
E.A.Iioaoiaa (1994) oa ?ioeo aaoi??a a?aei?/aii iio??ai?noue
aeia/iieai’yii? oai?iae (AEEO) c ?ioeie oai?iaaie i?aai?a
acioaaiaano?iaeoiaeaiaeueii? ciie (AAAeC). I?e oaeiio ii?aeiaii?
ae?aaiinoeea AEEO cia/ii oneeaaeiaia, ine?eueee ?? ee?i?/i? i?iyae
oa?aeoa?ecothoueny neeaaei?noth oa aaaaoia?ai?noth. Iiiaeeiie? i?aoe?,
i?enay/ai? oe?e i?iaeai?, ia aeathoue iiaii? oyae i?i iniaeeaino?
ee?i?/ii? ea?oeie oa ae?aaiinoeee AEEO a ii?aeiaii? c ?ioeie
caoai?thaaiiyie i?aai?a AAAeC. A oie aea /an, oeiia? i?iyae oeeo
caoai?thaaiue /anoi iiieeeiai ?icoe?iththoue ye aoeiiao ea?oeio AEEO.
Aiane?aeie ae?aaiinoe/ieo oa oaeoe/ieo iiieeie iacaaeia?euei?
?acoeueoaoe oieaoeenoaeoii?? /a?ac ia e?ea?aeiaaio aeno?aa?e?a?io
iaoieia?th a?aei?/athoue o 5–30% (A.A.Ao?iinueea, 1984; A.?. Aaeueia??i,
1987;I.I. Oae?iia, 1988). A inoaii? ?iee a?aei?/aii a?aeiinia c?inoaiiy
/anoioe ii?aeiaieo caoai?thaaiue i?aai?a /a?aaii? ii?iaeieie, iia’ycaia
ye c ca?eueoaiiyi o?eaaeino? aeeooy, oae ? c oaeineiiaeaiiyi ee?i?ei-
ae?aaiinoe/ieo iaoiae?a aeine?aeaeaiiy.

No/aniee ??aaiue ?icaeoeo o??o?a?? aeicaiey? oe?oa canoiniaoaaoe
ii?aeiai? iia?aoeai? ao?o/aiiy, ni?yiiaai? ia aeinyaiaiiy iiaeeeai
iiaiiai icaei?iaeaiiy oai?eo. Ia aeaeue, aei oeueiai /ano ia aecia/ai?
ia o?eueee iieacaiiy, aea e iioeiaeuei? iaoiaeeee iaeiiiiiaioiiai
o??o?a?/iiai e?eoaaiiy AEEO oa caoai?thaaiue i?aai?a AAAeC. Ia aecia/aia
oaeiae o??o?a?/ia oaeoeea i?e aino?iio oieaoeenoeo?, ii?aeiaiiio c
iaoieia??th i?aai?a AAAeC. Iioae?eiaai? i?aoe? (N.A.Aeaoeaiei, 1988;
C.N.Iaooeoaiia, 1991; N.?.Oiaeueieoeueeee, 1996), i?enay/ai? aea/aiith
ci?i i?aai?a AAAeC o iaoe??io?a c AEEO, ia a?aeia?aaeathoue an?o
aniaeo?a ii?oiooieoe?iiaeueiiai noaio oeeo i?aai?a, ia ?ic?iaeaii
oaeoeee ?aaa?e?oaoe?? oai?eo i?ney aeeiiaiiy oieaoeenoaeoii??.

?acii c oei, ca?ac oe?iei canoiniaothoue oeueo?acaoeiaa aeine?aeaeaiiy
(OCAe) aeey ae?aaiinoeee aaaaoueio caoai?thaaiue i?aai?a /a?aaii?
ii?iaeieie. O??o?a, ye i?aaeei, i?e aeyaeaii? eiie?aiaio?a a
aeia/iiaea?aeieo oeyoao iiaeaeueoa ianoaaeaiiy iaoe??ioa i?eieiy? ?
aeeiio? oieaoeenoaeoii?th, a noiooiy iaoieia?y i?aai?a AAAeC
caeeoa?oueny ia ?ici?ciaiith, ui i?ecaiaeeoue aei ca?eueoaiiy /anoioe
aeieeiaiiy IOAN.

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, oaiaie. Oaia aeena?oaoe??
“Ii?aeiai? iia?aoe?? ia i?aaiao acioaaiaano?iaeoiaeaiaeueii? ciie o
i?io?eaeoeoe? iinooieaoeenoaeoii?/iiai neiae?iio” ? /anoeiith
iaoeiai-aeine?aeii? ?iaioe “Aea/eoe i?e/eie iacaaeia?eueieo ?acoeueoao?a
i?ney oieaoeenoaeoii??, ia iniia? /iai ?ic?iaeoe iaoiaee ?o ei?aeoe??”,
yea aeeiiaia a ?inoeooo? ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII
Oe?a?ie i?ioyaii 1993-1995 ??. Aea?ae?aa?no?aoe?y ?0193E042733

Iaoa oa caaea/? aeine?aeaeaiiy ?iaioe. Iie?auaiiy a?aeaeaeaieo
?acoeueoao?a e?eoaaiiy oai?eo ia AEEO oa c noiooiueith iaoieia??th
i?aai?a AAAeC.

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

1. Aea/eoe /anoioo oa aa??aioe ii?aeiaiiy AEEO c caoai?thaaiiyie i?aai?a
AAAeC.

2. Aeyaeoe iniaeeaino? ee?i?/ii? ea?oeie o oai?eo ia AEEO a ii?aeiaii? c
caoai?thaaiiyie i?aai?a AAAeC.

3. Ooi/ieoe ae?aaiinoe/io oe?ii?noue iaoiae?a aeine?aeaeaiiy ii?aeiaii?
iaoieia?? i?aai?a AAAe ciie i?e AEEO.

4. Ca aeiiiiiaith ?ino?oiaioaeueieo iaoiae?a aeine?aeaeaiiy oa
ooieoe?iiaeueieo i?ia ioe?ieoe ii?oiooieoe?iiaeueiee noai i?aai?a AAAeC
i?e AEEO.

5. Aea/eoe aaciina?aaei? oa a?aeaeaeai? ?acoeueoaoe iaeiiiiiaioiiai
o??o?a?/iiai e?eoaaiiy AEEO, ii?aeiaii? c caoai?thaaiiyie i?aai?a AAAeC.

6. ?ic?iaeoe caoiaee, ni?yiiaai? ia aeinyaiaiiy ?aaa?e?oaoe?? oai?eo
i?ney oieaoeenoaeoii??.

Iaoeiaa iiaecia ?iaioe. Ia iniia? aiae?co cia/iiai ca ianyaii ee?i?/iiai
iaoa??aeo aea/aia /anoioa ii?aeiaii? iaoieia?? i?aai?a AAAeC i?e AEEO.
Aeaoaeueii ?icaeyioo? iniaeea?no? ee?i?/ii? ea?oeie o oai?eo c
ii?aeiaiith iaoieia??th i?aai?a AAAeC ? ia iniia? oeueiai ?ic?iaeaiee
aeai?eoi ianoaaeaiiy oai?eo ia AEEO c i?eiouaiiyi i?i iayai?noue o ieo
noiooiuei? iaoieia??.

Ca aeiiiiiaith no/anieo ?ino?oiaioaeueieo iaoiae?a ? ooieoe?iiaeueieo
i?ia iiaeaia aeaoaeueia oa?aeoa?enoeea noaio i?aai?a AAAeC i?e AEEO, ia
iniia? /iai ae?iaeaia iaoiaeeea ?aaa?e?oaoe?? oai?eo i?ney aeeiiaiiy o
ieo oieaoeenoaeoii?? ? aeieeiaiiy ci?i i?aai?a AAAeC. ?ic?iaeaia oaeoeea
o??o?a?/iiai e?eoaaiiy c i?eaiaeo aino?iai oa o?ii?/iiai oieaoeenoeoo a
ii?aeiaii? c iaoieia??th i?aai?a AAAeC. ?ic?iaeaia iaoiaeeea ae?aioaaiiy
aeia/iiai i?oo?a i?e aino?iio oieaoeenoeo? ye can?a onoiaiiy aino?iai
oieaoeenoeoo.

I?aeoe/ia oe?ii?noue ?iaioe. Cai?iiiiiaaii eiiieaen caoiae?a c
ae?aaiinoeee oa aeeoa?aioe?aeueii? ae?aaiinoeee AEEO a ii?aeiaii? c
caoai?thaaiiyie i?aai?a AAAeC. ?ic?iaeaia oaeoeea o??o?a?/iiai e?eoaaiiy
oai?eo c ii?aeiaiith iaoieia??th i?aai?a AAAeC i?e aino?iio oa
o?ii?/iiio oieaoeenoeo?. Cai?iiiiiaai? iia? aoaeoeai? iaoiaee
iia?aoeaieo ao?o/aiue, ye? ni?eythoue ciaioaiith /enea iacaaeia?eueieo
?acoeueoao?a. ?ic?iaeaia eiiieaenia i?ia?aia ?aaa?e?oaoe?eieo caoiae?a,
ui aeeth/a? e?eoaaeueio o?ceoeueoo?o, aeaeo?inoeioeyoe?th,
aieei?aoeaenioa?ai?th oa nenoaio ae??oioa?ai?? a i?neyiia?aoe?eiee
ia??iae.

Iniaenoee aianie caeiaoaa/a. Caeiaoaa/ai ?ic?iaeai? iniiai? oai?aoe/i?
oa i?aeoe/i? iieiaeaiiy ?iaioe, aecia/aii iaoo oa caaaeaiiy
aeine?aeaeaiiy. Iniaenoi caeiaoaa/ai aai ca eiai aaciina?aaeiueith
o/anoth aeeiiaii iiiaae 60% iia?aoeaieo ao?o/aiue o oai?eo, ui aoee
aeeth/ai? aei aiae?co. Aaoi? a?aa o/anoue o ?ic?iaoe? iioeiaeueii?
ae?aaiinoe/ii? oa e?eoaaeueii? oaeoeee, ia?aa??oe? ?? ee?i?/ii?
aoaeoeaiino?. Aaoi?ii cai?iiiiiaaii iiaee niin?a e?eoaaiiy aino?iai
oieaoeenoeoo. Aeena?oaio aea/ea iniaeeaino? noaio i?aai?a AAAeC o oai?eo
ia AEEO, aeia?a iaao?aei?noue ?aiiueiai i?iaaaeaiiy caoiae?a,
ni?yiiaaieo ia ii?iae?caoe?th noaio oeeo i?aai?a oa ?o ?aaa?e?oaoe?th.
Aaoi? a?aa o/anoue o ?ic?iaoe? eiiieaenii? i?ia?aie ?aaa?e?oaoe?? oaeeo
oai?eo, iniaenoi aeeiiaa noaoenoe/iee aiae?c io?eiaieo ?acoeueoao?a c
aeei?enoaiiyi eiii’thoa?ieo i?ia?ai.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aeeeaaeai? ia XV?? (?) c’?cae? o??o?a?a Oe?a?ie (Euea?a, 1994 ?.),
neiiic?oi?, i?enay/aiiio 150-??//th eaoaae?e oaeoeueoaonueei? oa?ai??
Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo (Ee?a, 1994?.), Ieaioi?
i?aae?iiy Iaoeiaiai oiaa?enoaa o??o?a?a Oiaeueieoeueei? iaeano?
(Oiaeueieoeueeee, 1995 ?.), iaoeiai-i?aeoe/i?e eiioa?aioe?? ca
i?aeia?iaeiith o/anoth “Aeooaeuei? ieoaiiy o??o?a?? i?aai?a /a?aaii?
ii?iaeieie” (Ee?a – Oiaeueieoeueeee – A?iieoey 1995 ?.), ?? ?in?enueeiio
aano?iaioa?ieia?/iiio oeaei? (Iineaa, 1996 ?.).

Ioae?eaoe??. Ca oaiith aeena?oaoe?? iioae?eiaaii 9 iaoeiaeo i?aoeue,
iaoiaee/i? ?aeiiaiaeaoe??, iaea?aeaii iaoaio Oe?a?ie 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, 3
?icae?e?a aeanieo aeine?aeaeaiue, i?aenoie?a, aeniiae?a, i?aeoe/ieo
?aeiiaiaeaoe?e, nieneo aeei?enoaii? e?oa?aoo?e, ui i?noeoue 244
aeaea?aea. Aeena?oaoe?eia ?iaioa aeeeaaeaia ia 164 noi??ieao iaoeiiieno,
?ethno?iaaia 11 oaaeeoeyie, 9 iaethieaie.

INIIAIEE CI?NO ?IAIOE.

Caaaeueia oa?aeoa?enoeea oai?eo oa iaoiaee aeine?aeaeaiue.

A ?inoeooo? ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie c 1990
ii 1994 ?. e?eoaaee 2418 oai?eo ia AEEO. O 121 (5,2%) c ieo AEEO
ae?aaiinoiaaia a ii?aeiaii? c iaoieia??th i?aai?a AAAeC, ui iio?aaoaaei
o??o?a?/ii? ei?aeoe??. Oa?aeoa? oa /anoioa aeyaeaieo caoai?thaaiue
i?aaenoaaeai? a oaaeeoe? 1.

Oaaeeoey 1.

Caoai?thaaiiy AAAeC i?e AEEO.

Ii?aeiaia iaoieia?y i?aai?a AAAeC i?e AEEO*enei oai?eo% oai?eoAe?acea
AeIE4234,7Ae?acea oeoiea3125,6A?eaea NIAe1512,4Aeeaa?oeeoe
AeIE21,7Aoaeac?y ea?ae??21,7O??aaea Casten1411,6Iie?ie oeoiea43,3Oai?iae
iia?iaaiiai oeoiea119,1Anueiai:121100

O a?aeiia?aeiino? c iinoaaeaieie caaaeaiiyie ?c caaaeueiiai /enea oai?eo
c IOAN, yeeo e?eoaaee a ee?i?oe? ?inoeoooo c 1990 ii 1994 ?., aeae?eaia
ae?oaa a?oia (20 iaoe??io?a), ye? ?ai?oa o no?iee a?ae 9 i?n. aei 5
?ie?a ( a na?aaeiueiio 3,8 ?ieo) aoee iia?iaai? c i?eaiaeo AEEO a ?ioeo
e?eoaaeueieo caeeaaeao. I?ae /an ia?oiai iia?aoeaiiai ao?o/aiiy
ii?aeiaia iaoieia?y ia aoea aeyaeaia, ui noaei i?e/eiith iiaoi?iiai
iia?aoeaiiai ao?o/aiiy. I?ae/an aea/aiiy aeienieo aeieoiaio?a oeeo
oai?eo aeyaeaii, ui 16 (80,1%) c ieo iia?iaai? a o?aaioiiio ii?yaeeo c
i?eaiaeo aino?iai oieaoeenoeoo.

Oe? oai?? neeaee iniiaio a?oio. ?iciiae?e oai?eo iniiaii? a?oie ca a?eii
? noaoothiiaeaii a oaaeeoe? 2.

Oaaeeoey 2

?iciiae?e oai?eo ca a?eii ? noaooth

A?e, ?ie?a*ieia?eeAE?ieeaei 30 ?ie?a—31 — 4081741 — 5092551 — 60113061
— 70151670 oa noa?oa73Anueiai:5091

A?e oai?eo c ii?aeiaiith iaoieia??th nooo?ai ia a?ae??ciyany a?ae oaeiai
i?e iayaiino? eeoa AEEO (aeea. Oaae.2). Iieiaeee, i?aoeacaeaoiee, a?e
oai?eo na?ae/eoue i?i cia/io nioe?aeueii-aeiiii?/io aeooaeuei?noue
aeaii? i?iaeaie.

Ee?i?/ia ea?oeia o oai?eo ia AEEO a ii?aeiaii? c iaoieia??th i?aai?a
AAAeC a?ae??ciyeanue cia/iei iie?ii?o?ciii ? caeaaeaea a?ae aeaeo
noiooiuei? iaoieia??. O 59 (48,9%) oai?eo ia?aaaaeaee iciaee AEEO, o 26
(22%) aoee coiiaeai? iayai?noth aeno?aa?e?a?ii? iaoieia?? i?aai?a AAAeC,
o ?aooe — ci?oaiiai oeio.

Iniiai? ?acoeueoaoe aeine?aeaeaiue

Caaaeath/e ia iie?ii?o?ci ee?i?/ieo i?iya?a i?e ii?aeiai?e iaoieia??, ie
?ic?iaeee eiiieaen iaoiae?a aeiiia?aoe?eiiai ianoaaeaiiy oai?eo ia AEEO
? i?eiouaiiyi i?i iayai?noue o ieo noiooiuei? iaoieia?? i?aai?a AAAeC,
yeee aeeth/a? canoinoaaiiy OCAe, OAAAeN, i?e iayaiino? acioaa?oo
?aioaaiineii?? no?aaio?aeii-oeoieiaiai ia?aoiaeo. OCAe aei iia?aoe??
i?iaaaeaii an?i oai?ei iniiaii? a?oie. E??i AEEO o 3 oai?eo aeyaeaii
oieaaeioie?o?ac.

Aiaeineii?/ia ianoaaeaiiy aeeiiaii o 1-? a?oie 52 (42,8%) oai?eo. O 41 c
ieo aeyaeaia ae?aceiaa oai?iaa oeoiea oa AeIE.

?aioaaiieia?/ia aeine?aeaeaiiy i?aai?a AAAeC a 1-e a?oi? i?iaaaeaii 25
(20,5%) oai?ei, ye i?aaeei, o ?ac? i?eiouaiiy i?i iaaeinoaoi?noue
acioaaiea?ae?aeueiiai ia?aoiaeo. O 18 oai?eo ae?aaiinoiaaia a?eaea NIAe,
o 2 – aoaeac?y ea?ae??, o 5 – o??aaea Casten .

C iaoith aea/aiiy ii?oieia?/ieo oa ooieoe?iiaeueieo ci?i i?aai?a AAAeC
i?e AEEO iaie ianoaaeaiee 21 oai?ee. Ii?yae c iniiaieie iaoiaeaie
ianoaaeaiiyie aeei?enoiaoaaee aeine?aeaeaiiy oeoieiai? nae?aoe??,
aecia/aiiy ae?aaeaiino? aeoiaeaiiaano?aeueiiai ?aoetheno ca aeaieie
aaiaoiaano?inoeeio?a?ao??, iiaa?oiai? iaiiiao??? a i?ieneiaeueieo
a?aeae?eao o?aaiee eaiae (OE), a?noieia?/ia aeine?aeaeaiiy neeciai?
iaieiiee oeoiea, aaeoa??ieia?/ia aeine?aeaeaiiy uiaei iayaiino?
Helicobacter pilori (HP) a neecia?e iaieiioe? aio?aeueiiai a?aeae?eo
oeoiea. I?ae /an a?noieia?/iiai aeine?aeaeaiiy NIO o 13 (63%) oai?eo ia
AEEO ae?aaiinoiaaii o?ii?/iee ao?io?/iee aano?eo, o 6 (28%) iiaa?oiaaee
aano?eo, o 2 (9%) –a?ia?ieanoe/iee aano?eo c aiaieuaie iaoaieac??. O 13
(61%) oai?eo aeyaeaii a?ia?aoeeaeiee oei eeneioii?iaeoeoe??. O 2 (11%)
aano?eo aoa a?iiaoeeaeiiai oeio ? o?eueee o 6 (28%) – naea?aoe?y oeoiea
aoea a iaaeao ii?ie. A 18 (85%) niinoa?aaeaiiyo a ii?oe?yo oeoieiaiai
nieo aeyaeaii ai?no aeia/?. Nooi?iue aeoiaeaiiaano?aeueiiai ?aoetheno
aecia/aee ?aae?iioee?aeiei iaoiaeii.O 15 (71,4%) i?aeaeine?aeii? a?oie
oai?eo aeyaeaii iayai?noue aeia/? a oeoieiaiio nieo: o 8 (54%) –
iacia/ia e?euee?noue, o 7 (46%) – iii??ia e?euee?noue. ?aae?iioee?aeiee
iaoiae ie aeei?enoaee aeey aea/aiiy iioi?ii-aaaeoaoi?ii? ooieoe??
oeoiea. A 6 (28,5%) niinoa?aaeaiiyo ia??iae iai?anii?iaeiaiiy oeoiea
noaiiaea 112,5 oa, a a 15 (71,5%) – 78,4 oa. I?ae /an iiiiaa?oiai?
iaiiiao??? OE o 15 (71,4%) iaoe??io?a i?aeaeine?aeii? a?oie
ae?aaiinoiaaia iii??ia a?ia?oaic?y oeoiea ? AeIE, o 4 (19%) – ae?aaeaia
a?ia?oaic?y, o 2 (9%) – iieacieee iaiiiao??? aoee o iaaeao ii?ie. O 15
(70,1%) oai?eo o neecia?e iaieiioe? aio?aeueiiai a?aeae?eo oeoiea
aeyaeai I?.

Ca ?acoeueoaoaie ianoaaeaiiy oai?eo aeaii? a?oie i?e AEEO a?aeaoaa?oueny
ii?oiooieoe?iiaeueia ia?aaoaeiaa i?aai?a AAAeC, ui iiaea ni?e/eieoe aei
aeieeiaiiy noiooi?o caoai?thaaiue i?aai?a oe??? ciie. A ca’yceo ?c oeei
ie aaaaea?ii, ui aeey iiia?aaeaeaiiy o?aaeaiiy i?aai?a AAAeC iaiao?aeia
o??o?a?/ia e?eoaaiiy AEEO, a i?e aeyaeaii? ii?oiooieoe?iiaeueieo ci?i
i?aai?a AAAeC a ?aiiueiio i?neyiia?aoe?eiiio ia??iae? – canoinoaaiiy
?aaa?e?oaoe?eieo caoiae?a. Iaie ?ic?iaeaia noaia eiiieaenii?
?aaa?e?oaoe?? oai?eo, yeei cae?eniaii oieaoeenoaeoii?th ? o yeeo
aeyaeai? ii?oiooieoe?iiaeuei? ci?ie i?aai?a AAAeC. Noaia aeeth/a?:
i?ecia/aiiy ae??oioa?ai??; eiiieaeno EOE ia ??cieo noaae?yo
i?neyiia?aoe?eiiai ia??iaeo, caeaaeii a?ae ?ooiaiai ?aaeeio oai?iai;
canoinoaaiiy aeaeo?inoeioeyoe?? i?aai?a AAAeC a ?aii?e i?neyiia?aoe?eiee
ia??iae; i?iaaaeaiiy aieei?aoeaenioa?ai?? c iaoith onoiaiiy aieueiaeo
neiioii?a, a?aeiiaeaiiy ooieoe?e OE; aeei?enoaiiy cania?a caoenoo
neeciai? iaieiiee oeoiea a?ae aieeao aa?aneaiiai aeoiaeaiaeueiiai ai?noo
oa cieaeaiiy aeoeaiino? eeneioii-iaioe/iiai oaeoi?o (aioaoeeaei?
i?aia?aoe, aeieaoi?e I2-?aoeaioi??a, oa ?i.).

Iaeiiiiiaioia o??o?a?/ia ei?aeoe?y iaoieia?? a?e?a?ii? nenoaie oa
i?aai?a AAAeC aeeiiaia o 121 oai?iai ia?oi? a?oie. Oa?aeoa? iia?aoeaieo
ao?o/aiue iaaaaeaii a oaaeeoe? 3.

Oaaeeoey 3

Ii?aeiai? iia?aoe?? c i?eaiaeo AEEO ? iaoieia?? i?aai?a AAAeC

Iia?aoeaia ao?o/aiiy*enei oai?eoAe?aceiaa oai?iaa AeIENIA (
?cieueiaaia)29NIA ( c ae?aioth/eie oeoiie iia?aoe?yie)23NA ( c
ae?aioth/eie oeoiie iia?aoe?yie)7Ae?aceiaa oai?iaa oeoiea?acaeoe?y
oeoiea ? c caa?aaeaiiyi ai?ioa?y12?acaeoe?y oeoiea ca A?eue?io-? aac
caa?aaeaiiy ai?ioa?y11?acaeoe?y oeoiea ca
Aioiaenoa?ii–O?inoa?a?ii6Aen?/aiiy ae?acee1A?eaea no?aaio?aeiiai ioai?o
ae?ao?aaieOoiaeiie?eaoe?y ca I?naiii27E?o?i?ao?y2Aoaeac?y
ea?ae??Iicaneeciaa acioaaiea?ae?ii?ioii?y c aai?ooiaeiie?eaoe??th2Iie?ie
oeoieaAen?/aiiy iie?i?a4?aeiino?oeoeai? iia?aoe?? ia oeoieo?a?acaeoe?y
oeoiea ca ?o5Aano?iaeoiaeaiiieanoeea ca Caoa?iaei–Aeiea?i6Anueiai:135

Iniiaieie caaaeaiiyie i?ae /an aeeiiaiiy iia?aoe?e ia i?aaiao AAAeC,
aoee: iaeio?aaiaoe/i?noue, caa?aaeaiiy cae/aeiiai ianaaeo ii OE,
ii?iae?caoe?y oa iie?auaiiy ooieoe?? i?aai?a AAAeC. O iaoe??io?a c
ae?aceiaith oai?iaith AeIE, ye i?aaeei, aeeiioaaee NIA, ae?aceiaith
oai?iaith oeoiea – ?acaeoe?th oeoiea ca A?eue?io-? ? c caa?aaeaiiyi
ai?ioa?y. I?ae /an aeeiiaiiy iia?aoeaieo ao?o/aiue a on?o oai?eo ie
aeei?enoiaoaaee aa?oithna?aaeeiio eaia?ioii?th. Oea aeaei iai
iiaeeea?noue cae?enieoe aaeaeaaoio ?aa?c?th aeia/iaea?aeieo oeyo?a oa
ioe?ieoe noai i?aai?a AAAeC, a oaeiae aac cia/ieo oaoi?/ieo o?oaeiiu?a
i?iaanoe iia?aoe?? ia aeia/iaea?aeieo oeyoao oa i?aaiao AAAeC. C iaoith
aeio?eiaiiy aeiia anaioeee ia?oei aoaiii i?iaiaeeee iia?aoeaia ao?o/aiiy
ia i?aaiao a?e?a?ii? nenoaie, iio?i ei?aeoe?th i?aai?a AAAeC.

Aeey e?eoaaiiy oai?eo c aino?ei iaaeano?oeoeaiei (eaoa?aeueiei)
oieaoeenoeoii c ii?aeiaiith iaoieia??th i?aai?a AAAeC, ye i?aaeei
canoiniao?ii eiina?aaoeaii-ae/?eoaaeueio oaeoeeo, ui aeeth/a?
i?ecia/aiiy aioea?ioee?a oe?ieiai niaeo?o ae??, niaciie?oe/ieo oa
aiaeaaoe/ieo i?aia?ao?a, ni?yiiaaieo ia onoiaiiy aino?iai caiaeaiiy
aeia/iiai i?oo?a, c ieaiiaith ei?aeoe??th aeyaeaieo caoai?thaaiue a
“oieiaeiiio” ia??iae?.

Iaie cai?iiiiiaaii ? io?eiaii Iaoaio Oe?a?ie ia aeiao?ae niin?a
e?eoaaiiy aino?iai oieaoeenoeoo oeyoii aiaeineii?/iiai ae?aioaaiiy
aeia/iiai i?oo?a /a?ac aaeeeee nini/ie AeIE. Niin?a oni?oii canoiniaaii
o 4 oai?eo.

I?e aino?iio aeano?oeoeaiiio oieaoeenoeo? a ii?aeiaii? c o?ii?/ieie
o??o?a?/ieie caoai?thaaiiyie i?aai?a AAAeC, iaiaaeo?iinue aeeiiaiiyi
oieaoeenoaeoii?? c iaeii/aniei i?iaaaeaiiyi eiina?aaoeaiiai e?eoaaiiy
aeyaeaii? noiooiuei? iaoieia?? a i?neyiia?aoe?eiiio ia??iae?,
ni?yiiaaiiai ia iiia?aaeaeaiiy caaino?aiiy iaei?eaiaaii? iaoieia??.
Ei?aeoe?th oe??? iaoieia?? i?iaiaeeii o ieaiiaiio ii?yaeeo ia iaio, ye
/a?ac 2 i?n i?ney oieaoeenoaeoii??. Iiae?aio oaeoeeo ie canoinoaaee o 6
oai?eo, oi?io? aaciina?aaei? ? a?aeaeaeai? ?acoeueoaoe.

A ?aiiueiio i?neyiia?aoe?eiiio ia??iae? iiia?ee 2 (1,6%) oai?eo.
I?e/eiith nia?o? iaeiiai oai?iai aoea aino?a na?oeaaa iaaeinoaoi?noue,
ua iaeiiai oai?iai – aino?a ia/?ieiai-ie?eiaa iaaeinoaoi?noue.

A?aeaeaeai? ?acoeueoaoe aea/ai? o 118 iia?iaaieo iaie oai?eo o no?iee
a?ae 1 aei 3 ?ie?a. Iiceoeaiee aoaeo e?eoaaiiy (cieeiaiiy aieueiaiai
neiae?iio, aeeniaioe/ieo yaeu, ii?iae?caoe?y ooieoe?? i?aai?a AAAeC)
a?aei?/aiee o 116 (97,7%) c ieo.

Ioaea, o oai?eo, yeei aeeiiai? ii?aeiai? iia?aoe??, /anoioa aeieeiaiiy
IOAN cieceeanue o 2,5 ?aco ? neeaea 2,3 %.

Aiae?coth/e ?acoeueoaoe e?eoaaiiy oai?eo, yeei cae?eniai? ii?aeiai?
iia?aoeai? ao?o/aiiy, ie ae?eoee aei aeniiaeo, ui ca oyaee?noth ia?aa?ao
i?neyiia?aoe?eiiai ia??iaeo aiie ia a?ae??ciyeeny a?ae oeo oai?eo, o
yeeo aoea aeeiiaia o?eueee oieaoeenoaeoii?y, ? iathoue cia/i? ia?aaaae a
ii??aiyii? c iaoe??ioaie iia?iaaieo aeaiia aoaiaie. Ce?ae cacia/eoe, ui
o oai?eo ae?oai? a?oie i?ae /an aeeiiaiiy iia?aoe?? cia/ii a?eueo?
oaoi?/i? o?oaeiiu?, iia’ycai? c ae?aaeaiei niaeeiaei i?ioeanii o
/a?aai?e ii?iaeiei?, i?ae a ia?o?e a?oi?. Oiio o?eaae?noue ao?o/aiiy o
oeeo oai?eo aoea a na?aaeiueiio ia 30 oa a?eueoa, i?ae o oai?eo ia?oi?
a?oie. E?euee?noue e?aeei-aei?a o oai?eo ia?oi? a?oie neeaei 12.8, ui ia
1,3 aeiy iaioa, i?ae o oai?eo ae?oai? a?oie. Oneeaaeiaiiy a ?aiiueiio
i?neyiia?aoe?eiiio ia??iae? /ano?oa a?aei?/aee o oai?eo ae?oai? a?oie.

Ioaea, ?acoeueoaoe e?eoaaiiy oa ia?aa?a i?neyiia?aoe?eiiai ia??iaeo o
oai?eo ia?oi? a?oie aoee cia/ii e?au?, i?ae o oai?eo ae?oai? a?oie.

AENIIAEE.

1. Ii?aeiaiiy AEEO c o??o?a?/ieie caoai?thaaiiyie i?aai?a AAAeC
iaoiaaiaoe/ii coiiaeaia ? a?aecia/a?oueny ca iaoeie aeaieie a 5,2%
niinoa?aaeaiue.

2. Iaoieia?/i? ci?ie i?aai?a AAAeC, ye? ia iio?aaothoue o??o?a?/ii?
ei?aeoe??, a?aei?/athoue o 78,3% oai?eo ia AEEO, aiie iiaeooue noaoe
i?e/eiith aeieeiaiiy i?aai?/ieo o?aaeaiue i?aai?a oe??? ciie.

3. Ae?aaiinoeea AEEO, ii?aeiaii? c caoai?thaaiiyie i?aai?a AAAeC,
iiaeiia a?oiooaaoenue ia eiiieaeniiio aeiiia?aoe?eiiio ianoaaeaii?, ui
aeeth/a? aiae?c iniaeeainoae ee?i?/ieo iciae, canoinoaaiiy OCAe, OAAAeN,
?aioaaiieia?/ia aeine?aeaeaiiy no?aaioiaeo, oeoiea oa AeIE.

4. Iayai?noue AEEO, ii?aeiaii? c o??o?a?/iith iaoieia??th i?aai?a AAAeC,
ia?aaeaa/a? iaeii/anio ei?aeoe?th aeyaeaieo caoai?thaaiue ca
a?aenooiino? aino?i? o??o?a?/ii? iaoieia?? i?aai?a /a?aaii? ii?iaeieie.

5. I?e aino?iio iaaeano?oeoeaiiio oieaoeenoeo? (eaoa?aeueiiio) o oai?eo
c ii?aeiaiith iaoieia??th ne?ae aeio?eioaaoenue
eiina?aaoeaii-i/?eoaaeueii? oaeoeee, ni?yiiaaii? ia onoiaiiy aino?iai
caiaeaiiy aeia/iiai i?oo?a c iaeii/aniith ei?aeoe??th ii?aeiaieo
caoai?thaaiue a “oieiaeiiio” ia??iae?. Aiaeineii?/ia ae?aioaaiiy
aeia/iiai i?oo?a /a?ac aaeeeee nini/ie AeIE – aoaeoeaiee iaoiae
?icaaioaaeaiiy aeia/iiai i?oo?a oa onoiaiiy i?enooio aino?iai
oieaoeenoeoo.

6. I?e aino?iio aeano?oeoeaiiio oieaoeenoeo?, ii?aeiaiiio c o??o?a?/ieie
caoai?thaaiiyie i?aai?a AAAeC, ne?ae cae?enithaaoe oieaoeenoaeoii?th c
iaeii/aniei i?iaaaeaiiyi eiina?aaoeaii? oa?ai??, ni?yiiaaii? ia
iiia?aaeaeaiiy oneeaaeiaiue oa caaino?aiue iaei?eaiaaieo caoai?thaaiue.

7. Iayai?noue iaoieia?/ieo ci?i i?aai?a AAAeC o ia?aaaaeii? a?eueoino?
oai?eo ia AEEO coiiaeth? iaiao?aei?noue ?aiiueiai i?iaaaeaiiy
o??o?a?/iiai e?eoaaiiy, a oaeiae ?aaa?e?oaoe?eieo caoiae?a ca?aeii c
cai?iiiiiaaiith iaie noaiith aeey i?io?eaeoeee aeieeiaiiy IOAN.

8. Ai?iaaaeaeaiiy a i?aeoeeo cai?iiiiiaaii? o??o?a?/ii? oaeoeee ?
?ic?iaeaieo iaie iaoiae?a e?eoaaiiy aeicaieeei aeinyaoe iiceoeaieo
a?aeaeaeaiieo ?acoeueoao?a o 97,7% iia?iaaieo oai?eo ? cieceoe c 7 aei
2,3% /anoioo aeieeiaiiy IOAN.

Nienie ioae?eaoe?e ca oaiith aeena?oaoe??.

1. Eii/ae A.I., Ae?iiia A.E., Aiaothe I.A. Auiieiaiea neioeueoaiiuo
iia?aoeee ii iiaiaeo aeae/iieaiaiiie aieacie e niioonoaothueo
caaieaaaiee i?aaiia ycioaaiaano?iaeoiaeaiaeueiie ciiu — niinia
i?ioeeaeoeee iinooieaoeenoyeoiie/aneiai neiae?iia.// Ee?i?/ia
o??o?a?y.-1996.-?9.-N.12-13.

2. Aiaothe I.A., Oo?iaiaiei A.Ae., A?eai?iaa E.A., Aoe?aaa A.I.,
Eiia?aiaoe A.E. ?aoethen-aano?eo, iaoneiaeaiiue Helicobacter pilori, eae
i?e/eia iaoaeiaeaoai?eoaeueiiai ?acoeueoaoa oieaoeenoyeoiiee. // Ee?i.
o??o?a?y.-1997.-?1.-N.16-17

3. Iaoaio 10413 A Oe?a?ia A61I25/00; A61A17/00. Niin?a e?eoaaiiy
aino?iai eieueeoeueiciiai oieaoeenoeoo / Ianoaoaiei ?.E., Eaeeoa I.ss.,
Eioaiei I.A., Ieai?i A.A., Aiaothe I.A. (Oe?a?ia). — ? 95010420; Cayae.
30.01.95; Iioae. 25.12.96 Athe. ? 4.-3N.

4. Eii/ae N.E., Aiaothe I.A. ?aaa?e?oaoe?y oai?eo i?ney aeaeaeaiiy
aeia/iiai i?oo?a: Iaoiae. ?aeiiaiaeaoe??.-E.,1997.-14 n.

5. Aiaothe I.A. Oe?o?ae/aneay oaeoeea i?e ni/aoaiiie iaoieiaee aeae/iiai
iocu?y e i?aaiia ycioaaiaano?iaeoiaeaiaeueiie ciiu// ?in. AEo?i.
aano?iyioa?ieiaee, aaiaoieiaee, eieii?ieoieiaee. I?ee. ?3. Iaoa?eaeu 2-e
?in. Aano?iyioa?ieia. Iaaeaee (Iineaa, 7-13 aeae. 1996
a.)-1996.-?4.-N.216.

6. Eaa?ee A.N., Aiaothe I.A. Aeoiaeaiiaano?aeueiee ?aoethen o aieueieo ?
oeiii ycau aeaeoaeea// Iaoa??aee neiiic?oio, i?enay/ai? 150-??//th
ea?aae?e oaeoeueoaonueei? oa?ai?? Iaoe?iiaeueiiai iaaee/iiai
oi?aa?neoaoo ?i. I.I.Aiaiiieueoey.- E., 1994.- N.173

7. ?ae/oe E.A., Aa?e/ O.I., *anaeia N.A., Ea?iaeeoa N.N., Aiaothe I.A.
Eniieueciaaiea iaae?aaa?iiai–iaciaano?aeueiiai aeinooia i?e
iaeiiiiiaioiuo iia?aoeeyo ia ii/ea e aeae/iii iocu?a //Aeooaeuei?
ieoaiiy o??o?a?? i?aai?a /a?aaii? ii?iaeieie. Iaoa??aee Ieaioio
i?aae?iiy iaoeiaiai oiaa?enoaa o??o?a?a Oiaeueieoeueei?
iaeano?.-Oiaeueieoeueeee, 1995.-N.95.

8. ?ae/oe E.A., Ieeeo/aiei TH.A., Neiueeea N.A., Aiaothe I.A., *anaeia
N.A. Neioeueoaiiua iia?aoeee a i?ioeeaeoeea iinooieaoeenoyeoiie/aneiai
neiae?iia // Iaoa??aee iaoe.-i?aeo. eiio. ca i?aeia?. o/anoth
“Aeooaeuei? ieoaiiy o??o?a?? i?aai?a /a?aaii?
ii?iaeieie”.-Ee?a-Oiaeueieoeueeee-A?iieoey, 1995.-N.93.

9. Neoin A.A., *i?iee A.A., Aiaothe I.A. Ci?ie a o??o?a?/i?e oaeoeoe?
e?eoaaiiy oai?eo c o?ii?/iei eaeueeoeueiciei oieaoeenoeoii,
oneeeaaeiaiei oieaaeioie?o?acii//Ia?oee (OV??) c’?cae o??o?a?a Oe?a?ie:
Oace aeii.-Euea?a, 1994-N.126.

AIIOAOe?ss.

Aiaothe I.A. Ii?aeiai? iia?aoe?? ia i?aaiao acioaaiaano?iaeoiaeaiaeueii?
ciie a i?io?eaeoeoe? iinooieaoeenoaeoii?/iiai neiae?iio.-?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 IIC Oe?a?ie ?i. I.E.Ooieea, Ee?a, 1999.

Aeena?oaoe?y i?enay/aia i?iaeai? iie?ioaiiy ?acoeueoao?a o??o?a?/iiai
e?eoaaiiy AEEO. Ia iniia? cia/iiai ca ianyaii ee?i?/iiai iaoa??aeo
aea/aia /anoioa ii?aeiaiiy iaoieia?? i?aai?a AAAeC c AEEO. Aeaoaeueii
?icaeyioo? iniaeeaino? ee?i?/iiai ia?aa?ao caoai?thaaiiy o oaeeo oai?eo,
ia iniia? /iai cai?iiiiiaaii eiiieaen ae?aaiinoe/ieo caoiae?a. Ca
aeiiiiiaith no/anieo iaoiae?a aeine?aeaeaiiy aeyaeai? iaoieia?/i? ci?ie
i?aai?a AAAeC i?e AEEO. ?ic?iaeai? iaoiaee ?aaa?e?oaoe?? oai?eo i?ney
oieaoeenoaeoii??. ?ic?iaeaia o??o?a?/ia oaeoeea o oai?eo c ii?aeiaiith
iaoieia??th i?aai?a AAAeC i?e aino?iio oa o?ii?/iiio oieaoeenoeo?.

I?iaaaeaiee aiae?c ?acoeueoao?a o??o?a?/iiai e?eoaaiiy oai?eo aeicaieea
aeyaeoe ia?aaaae canoinoaaiiiy ii?aeiaieo iia?aoe?e. Ai?iaaaeaeaiiy
?ic?iaeaii? oaeoeee aeicaieeei cieceoe /anoioo aeieeiaiiy IOAN a 2,5
?aco – c 7 aei 2,3%.

Eeth/ia? neiaa: iinooieaoeenoaeoii?/iee neiae?ii, aeia/iieai’yia
oai?iaa, ii?aeiaia iaoieia?y, o??o?a?/ia e?eoaaiiy, ?aaa?e?oaoe?y.

SUMMERY.

Gnatiuk N.G. conikined surgical procedures on esophagogastroduodenal
zone in prophylaxis of the postcholecystectomy syndrome.- Manuscript.
The thesis for a Degree of a Candidate of Medical Sciences on specialty
14.01.03- surgery. Kiev Medical Academy of Post-Graduate Education of
Ministry of Health of Ukraine, Kiev, 1998.

The thesis is devoted to surgical treatment of cholelithiasis . The
frequency of combined pathology of the esophagogastroduodenal zone is
studied. Natural course of cholelithiasis in patients with combined
pathology of the esophagogastroduodenal zone is studied in details,
diagnostic complexes proposed. Contemporary diagnostic methods
revealed pathology of the esophagogastroduodeunal zone in patients with
cholelithiasis.

Methods of surgical treatment of patient with acute and chronic
cholecystitis and postsurgical reabilitation are elaborated. Analysis
of results of surgical treatment revealed cousideralle improvement
folloixiug combined surgical procedures. The newsurgical strategy
provided two-fold decrease of postcholecystectomy syndrome.

Key words: postcholecystectomy syndrome, cholelithiasis , combined
pathology, surgical treatment, reabilitation.

AIIIOAOeEss.

Aiaothe I.A. Ni/aoaiiua iia?aoeee ia i?aaiao
ycioaaiaano?iaeoiaea-iaeueiie ciiu a i?ioeeaeoeea
iinooieaoeenoyeoiie/aneiai neiae?iia. — ?oeiienue.

Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe
ii niaoeeaeueiinoe 14.01.03 — oe?o?aey. Eeaaneay iaaeeoeeineay aeaaeaiey
iineaaeeieiiiiai iao/aiey IIC Oe?aeiu ei. I.E.Ooieea, Eeaa, 1999.

Aeenna?oaoeey iinayuaia i?iaeaia oeo/oaiey ?acoeueoaoia oe?o?ae/aneiai
ea/aiey aeae/iieaiaiiie aieacie. A Einoeoooa eeeie/aneie e
yenia?eiaioaeueiie oe?o?aee AII Oe?aeiu n 1990 ii 1994 a. ea/eee 2418
iaoeeaioia n AEEA. O 121 (5,2%) ec ieo aeeaaiinoe?iaaia ni/aoaiiay
iaoieiaey i?aaiia YAAeC, o?aaothuay oe?o?ae/aneie ei??aeoeee. A
niioaaonoaee n iinoaaeaiiuie caaea/aie ec iauaai /enea aieueiuo
auaeaeaia aoi?ay a?oiia aieueiuo, eioi?ua ?aiaa, a n?iee io 9 ian aei 5
eao (a n?aaeiai 3,8 aiaea), iia?e?iaaiu ii iiaiaeo AEEA a ae?oaeo
ea/aaiuo o/?aaeaeaiey e iinooieee a eeeieeo n aeeaaiicii IOYN. A
iineaaenoaee i?e ianeaaeiaaiee auyaeaia iaoieiaey i?aaiia YAAeC, eioi?ay
ia auea ono?aiaia ai a?aiy oieaoeenoyeoiiee. I?e eco/aiee iniaaiiinoae
eeeie/aneie ea?oeiu AEEA o aieueiuo ni/aoaiiie iaoieiaeae i?aaiia
YAAeC, aieaa /ai o 50% aieueiuo i?aiaeaaeaee eeeie/aneea i?eciaee AEEA,
o 22% – yeno?aaeeea?iie iaoieiaee e o 28% – niaoaiiua. A nayce n
iieeii?oeciii eeeie/aneeo i?iyaeaiee, iaie ?ac?aaioai eiiieaen iaoiaeia
aeiiia?aoeeiiiiai ianeaaeiaaiey aieueiuo, aeeth/athuee iniiaiua (OCE,
OYAAeN, ?aioaaiineiieth ieuaaiaea, aeaeoaeea e AeIE – i?e yaeaieyo
ycioaaeoa) e aeiiieieoaeueiua (enneaaeiaaiea aeaeoaei/iie nae?aoeee,
ii?oieiae/aneia enneaaeiaaiea NIAe, ?aaeeiioeeeaeiue iaoiae, aaaeiia
cia/aiea a auyaeaiee niioonoaothuae iaoieiaee ioaiaeei
eio?aiia?aoeeiiiie ?aaecee i?aaiia a?thoiie iieinoe) iaoiaeu. A oeaeyo
eco/aiey ii?oieiae/aneeo e ooieoeeiiaeueiuo eciaiaiee i?aaiia YAAeC i?e
AEEA iaie ianeaaeiaai 21 aieueiie n i?eiaiaieai iniiaiuo e
aeiiieieoaeueiuo iaoiaeia. Iieo/aiiua ?acoeueoaou naeaeaoaeuenoaotho i
oii, /oi i?e AEEA i?ienoiaeeo ii?oieiae/aneay e ooieoeeiiaeueiay
ia?ano?ieea i?aaiia YAAeC, aneaaenoaea /aai aiciiaeii aicieeiiaaiea
i?aaie/aneie iaoieiaee i?aaiia YAAeC. A nayce n yoei iu n/eoaai, /oi i?e
auyaeaiee AEEA iieacaii naiaa?aiaiiia oe?o?ae/aneia ea/aiea,
iaoieiae/aneeo eciaiaiee i?aaiia YAAeC, a ?aiiai iineaiia?aoeeiiiii
ia?eiaea – i?iaaaeaiea ?aaaeeeoaoeeiiiuo ia?ii?eyoee ii ?ac?aaioaiiie
iaie noaia, aeeth/athuae iacia/aiea aeeaoioa?aiee, eiiieaena EOE,
yeaeo?inoeioeyoeee i?aaiia YAAeC, i?iaaaeaiea eaei?aoeaenioa?aiee,
i?eiaiaiea n?aaenoa, iai?aaeaiiuo ia caueoo neecenoie iaiei/ee io
aicaeaenoaey aa?anneaiiai aeoiaeaiaeueiiai niaea?aeeiiai e nieaeaiea
aeoeaiinoe eeneioii-iaioe/aneiai oaeoi?a.

Iaie ?ac?aaioaia oaeoeea oe?o?ae/aneiai ea/aiey aieueiuo n ni/aoaiiie
iaoieiaeae i?aaiia YAAeC i?e ino?ii e o?iie/aneii oieaoeenoeoa. Iaie
i?aaeeiaeai niinia yiaeineiie/aneiai ae?aie?iaaiey aeae/iiai iocu?y
/a?ac aieueoie nini/ae AeIE, caueuai iaoaioii Oe?aeiu ia ecia?aoaiea.
Iinea eoie?iaaiey ino?iai ainiaeaiey a aeae/iii iocu?a a ieaiiaii
ii?yaeea auiieiyai ni/aoaiiia iia?aoeaiia aiaoaoaeuenoai. I?e ino?ii
aeano?oeoeaiii oieaoeenoeoa, ni/aoathuainy n oe?o?ae/aneeie
caaieaaaieyie i?aaiia YAAeC, neaaeoao auiieieoue oieaoeenoyeoiieth n
iineaaeothuai i?iaaaeaieai a eiina?aaoeaiie oa?aiee, iai?aaeaiiie ia
i?aaeioa?auaiea ineiaeiaiee ni noi?iiu iaono?aiaiiie iaoieiaee. Aiaeec
?acoeueoaoia oe?o?ae/aneiai ea/aiey aieueiuo ia?aie e aoi?ie a?oii
iicaieee auyaeoue i?aeiouanoaa eniieueciaaiey ni/aoaiiuo iia?aoeee a
n?aaiaiee n iia?aoeaiuie aiaoaoaeuenoaaie, auiieiaiiuie a aeaa e o?e
yoaia. Aiaae?aiea ?ac?aaioaiiie oaeoeee iicaieeei nieceoue /anoioo
aicieeiiaaiey IOYN n 7 aei 2,3%.

Eeth/aaua neiaa: iinooieaoeenoyeoiie/aneee neiae?ii, aeae/iieaiaiiay
aieaciue, ni/aoaiiay iaoieiaey, oe?o?ae/aneia ea/aiea, ?aaaeeeoaoeey.

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