IIIINOA?NOAI IOI?IIE CAeI?IA’ss OE?A?IE
EE?ANUeEA IAAeE*IA AEAAeAIIss IINEssAeEIEIIII? INAIOE
?i. I.E. Ooieea
AEOEAE Aieiaeeie? A?eoi?iae/
OAeE 616.381-002.1
II??AIssEUeIA IOe?IEA NIINIA?A ?ACAEOe?? IA*?IEE
14.01.03 – oi?o?aiy
Aaoi?aoa?ao aeena?oaoe??
ia caeiaoooy iaoeiaiai nooiaiy
eaiaeeaeaoa iaaee/ieo iaoe
EE?A – 1998
Aeena?oaoei?th ? ?oeiien.
?iaioa aeeiiaia a Iinoeoooi eeiii/ii? oa aenia?eiaioaeueii? oi?o?ai? AII
Oe?a?ie (i. Ee?a)
Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe
Eaeeoa Ieeiea sseiae/
caaiaeoaa/ aiaeaeieo ii?oaeueii? aiia?oaici? oa
oi?o?ai? ia/iiee Iinoeoooo eeiii/ii? oa
aenia?eiaioaeueii? oi?o?ai? AII Oe?a?ie
Ioioeieii iiiiaioe aeieoi? iaaee/ieo iaoe
Eeoaeiaiei Ieaenaiae? Ieaenaiae?iae/
i?ia?aeiee iaoeiaee ni?a?ia?oiee
a?aeae?eo ia?aaeiooeeiieo caoai?thaaiue
?inoeoooo iieieia?? oa ?aae?ieia?? 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?ie
I?iaiaeia onoaiiaa Euea?anueeee iaaee/iee oi?aa?neoao IIC Oe?a?ie,
eaoaae?a caaaeueii? oa oaeoeueoaonueei? o??o?a??.
Caoeno aiaeaoaeaoueny “ 30 “ a?oaeiy 1998 ?. i 14 aiaeeii ia caniaeaiii
niaoeiaeiciaaii? a/aii? ?aaee Ae 26.613.02 i?e Ee?anueeie iaaee/iie
aeaaeaii? iineyaeeieiiii? inaioe IIC Oe?a?ie (254112, i. Ee?a, aoe.
Aei?iaiaeeoeueea, 9).
C aeena?oaoei?th iiaeia iciaeiieoeny o aiaeiioaoei Ee?anueei? iaaee/ii?
aeaaeaii? iineyaeeieiiii? inaioe ?i. I.E. Ooi?ea (254112, i. Ee?a, aoe.
Aei?iaiaeeoeueea, 9).
Aaoi?aoa?ao ?icineaiee “ 18 “ eenoiiaaea 1998 ?.
A/aiee nae?aoa?
niaoeiaeiciaaii? a/aii? ?aaee
eaiaeeaeao iaaee/ieo iaoe, aeioeaio AAICAessE I.I.
CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE
Aeooaeuei?noue oaie. Iianthaeia c?inoaiiy caoai?thaaiiy ia/?iee a
inoaii? aeanyoe??//y i?ecaaei aei oiai, ui ieoiia aaaa ?aeo ia/?iee
na?aae ?ioeo iooeei, aeinyaea 10—11%, i?e oeueiio cieceany na?aaei?e a?e
oai?eo, yeee noaiiaeoue 40—45 ?ie?a (A.A. Oaeeiia e niaao, 1993; P.
McMaster et al., 1992). Aei nueiaiaei? iniiaiei iaoiaeii e?eoaaiiy ?aeo
ia/?iee caeeoa?oueny o??o?a?/iee, ine?eueee ?io? niiniae e?eoaaiiy
(aeeiaie?caoe?y, ?aa?iiaeueia o?i?ioa?ai?y, oioiaeeiai?/ia oa?ai?y,
a?oa??aeueia ?oai?y, e??iaeeno?oeoe?y) eeoa ei?ioei/anii iieaaoothoue
noai iaoe??io?a, aea ia ni?eythoue i?iaeiaaeaiith ?oiueiai aeeooy (K.
Yamakado et al., 1994). sse ?aaeeeaeuei?e iia?aoe?? iaea?eueoa ia?aaaaa
iaaea?oueny aiaoii?/i?e ?acaeoe?? (M. Makuuchi et. al., 1998).
Eaoaeuei?noue i?ney aeeiiaiiy ?aaeeeaeueieo iia?aoe?e neeaaea? 10—15% ca
ia?aeiii? iooeeie ? 20—25% i?e iaoanoaoe/iiio a?aaeaii? i?aaia, a ??ci?
oneeaaeiaiiy niinoa??aathoueny o 40—60% oai?eo (M. Shimada et al., 1994;
M. Suenaga et al., 1992). Iae/ano?oa iacaaeia?euei? ?acoeueoaoe
o??o?a?/iiai e?eoaaiiy niinoa??aathoueny o iaoe??io?a c iaoai?/iith
aeiaoyieoeath aiane?aeie oeaio?aeueii? eieae?caoe?? iooeeie ia/?iee,
?acaeoaaaeuei?noue i?e oeueiio ia ia?aaeuo? 10%. O a?eueoino? aeiaaee?a
iaoe??ioe ?c oaeei oneeaaeiaiiyi aaaaeathoueny iaiia?aaaeueieie ?
i?aeaeathoueny i?i?iaeueiiio iae?aoeaiiio ao?o/aiith. I?eioeei
aeio?eiaiiy ?aaeeeaeueiino? ao?o/aiiy aeiaaa? aeaeaeaiiy 40—60% ia’?io
ia?aio?ie ia/?iee, ui iaaaoeaii a?aeaeaa?oueny ia iane?aeeao e?eoaaiiy.
I?neyiia?aoe?eia eaoaeuei?noue i?ae /an ni?ia aeeiiaiiy ?aaeeeaeueiiai
ao?o/aiiy aeinyaa? 50—80% (H. Bismuth et al., 1994; R. Richlmayr et al.,
1995).
Eeth/iaeie iiiaioaie anyei? ?acaeoe?? ia/?iee ? aaeaeaaoi?noue ??
ia’?io, aea?? iaoiaeo, niiniao ?icn?/aiiy ia?aio?ie ? noa?aii?noue
aaiinoaco. A?ae i?aaeeueiino? aeeiiaiiy ? iaia’yceiaino? caa?aaeaiiy
oeeo iiiaio?a caeaaeeoue /anoioa e oa?aeoa? oneeaaeiaiue, a oaeiae
eaoaeuei?noue (T.E. Starzl et al., 1996). Iniiaiith i?e/eiith ?icaeoeo
i?neyiia?aoe?eieo oneeaaeiaiue ? iae?ic eoeueo? ia/?iee, yeee coiiaeth?
aeieeiaiiy aioo??/a?aaieo e?iaioa/, ia?eoii?oo, aeia/ieo ii?eoeue oa
aanoean?a (A.A. Oaeeiia e niaao., 1997).
I?aaeiaoii aea/aiiy ii nueiaiaei?oi?e aeaiue caeeoathoueny oaeoi?e
?eceeo aeeiiaiiy ?acaeoe?? ia/?iee (D. Mariette et al., 1997; S.
Miyagawa et al., 1995). Oea ieoaiiy iniaeeai aeooaeueia ca oiia
canoinoaaiiy iiaeo niinia?a ?icoeio ia?aio?ie e ii?aoethaaiiy
??caeiaaii? iiaa?oi? ia/?iee: oeueo?acaoeiaiai ani??aoi?a, a?aiiiaiai
ieaciaiiai neaeueiaey, eaca?iiai aeenaeoi?a, i?e?ioaeeueiaiai
eiaaoeyoi?a, aa?icieueieo iie?ia?ieo eiiiiceoe?e.
I?ioa aeiaeai ?c iienaieo iaoiae?a, ye? canoiniaothoueny naiino?eii, ia
aea? aaaeaieo ?acoeueoao?a ciaioaiiy oneeaaeiaiue oa cieaeaiiy
eaoaeueiino?, eio?a aeinyaa? 15—20% (A.A. Oaeeiia e niaao., 1994; C.
Huguet et al., 1992). Iacaaaeath/e ia i?ia?an, aeinyaiooee o
o??o?a?/iiio e?eoaaii? eieaeueii? iaoieia?? ia/?iee, iie?auaiiy oaoi?ee
?acaeoe?? ia an?o aoaiao aeeiiaiiy iia?aoe?? caeeoa?oueny iaei??th ?c
aeooaeueieo i?iaeai. *eneaii? oaoi?/i? aniaeoe ?acaeoe?? ia/?iee, na?aae
yeeo iaoiae aeeiiaiiy ?acaeoe??, niiniae ?icoeiaiiy ia?aio?ie oa
aaiinoaco aei oaia??oiueiai /ano aea/ai? iaaeinoaoiuei, a ieoaiiy
o??o?a?/ii? oaeoeee i?e iaoai?/ii? aeiaoyieoe? iathoue iieai?/iee
oa?aeoa? (H. Bismuth, 1994).
Ca’ycie i?aoe? ?c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?eia
i?aoey ? o?aaiaioii aaeocaai? iaoeiai? i?ia?aie ?inoeoooo ee?i?/ii? oa
aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie ii caieaiiaai?e oai?
«?io?ai?aaii? oa aeno?aei?ii?aeuei? ?acaeoe?? ia/?iee» (? 0194U007346
aea?ae?a?no?aoe??), aeeiiaii? o 1996—1998 ??.
Iaoa ? caaea/? aeine?aeaeaiiy. Iaoa oe??? i?aoe? — iie?auaiiy
?acoeueoao?a ?acaeoe?e ia/?iee i?e eieaeuei?e iaoieia?? ??ciiai
iioiaeaeaiiy. Aeey aeinyaiaiiy aeacaii? iaoe iaie aoee iinoaaeai? oae?
caaea/?:
A?aei?aoethaaoe a aenia?eiaio? oa oi?iaaaeeoe a ee?i?/io i?aeoeeo
oaoi?eo ?acaeoe?? ia/?iee ?c canoinoaaiiyi oeueo?acaoeiaiai ani??aoi?a.
Aea/eoe ii?oieia?th ?aia?aoeaieo i?ioean?a ia/?iee i?ney aeeiiaiiy
??cieo aeae?a ?acaeoe??.
Aeaoe eiiieaenio ioe?ieo ooieoe?iiaeueiiai ?aca?ao ia/?iee i?ney
aeeiiaiiy ??cieo aeae?a ?acaeoe??.
C?iaeoe ii??aiyeueio ioe?ieo ?acoeueoao?a o?aaeeoe?eieo ?
iaeio?aaiaoe/ieo ?acaeoe?e ia/?iee.
?ic?iaeoe ?aoe?iiaeueiee i?aeo?ae aei aeeiiaiiy ?acaeoe?? ia/?iee c
aeei?enoaiiyi i?eioeei?a iaeio?aaiiaaiino?.
Iaoiiaeoe iiaeeea?noue aeeiiaiiy ?aaeeeaeueieo ?acaeoe?e ia/?iee c
aeei?enoaiiyi i?eioeei?a iaeio?aaiiaaiino? i?e iaoai?/i?e aeiaoyieoe?
iooeeiiiai iioiaeaeaiiy.
Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. O oe?e ?iaio? aeeiiaiee
ii??aiyeueiee aiae?c ?acoeueoao?a o?aaeeoe?eiiai ? iaeio?aaiaoe/iiai
i?aeoiae?a aei aeeiiaiiy ?acaeoe?? ia/?iee. I?iaaaeaia ?aeaioeo?eaoe?y
aei- ? ?io?aiia?aoe?eieo oaeoi??a ?eceeo iani?eyoeeaiai ?acoeueoaoo
?acaeoe?? ia/?iee, aei yeeo iaeaaeaoue ii/aoeiaee ??aaiue ne?iaaoeiaiai
aeueaoi?io, caaaeueiiai a?e??oa?io, aeoeaiino? o?ainaieiac oa ia’?i
e?iaiao?aoe. Aeiaaaeaia a?aenooi?noue ei?aeyoe?? i?ae ii/aoeiaei noaiii
ooieoe?iiaeueiiai ?aca?ao ia/?iee oa ia’?iii ia?aaeaa/oaaii? ?acaeoe??
i?e aeei?enoaii? iaeio?aaiaoe/ieo niinia?a. ?ic?iaeaiee iaeio?aaiaoe/iee
eiia?iiaaiee iaoiae ?acaeoe?? ia/?iee, yeee caeeth/a?oueny a
canoinoaaii? oeueo?acaoeiaiai aeenaeoi?a aeey ?icoeiaiiy ia?aio?ie ?
?icoieoniaaiiai eaca?iiai i?iiaiy aeey inoaoi/iiai aaiinoaco. A
aenia?eiaio? aea/aia aeeiai?ea ?aia?aoeaieo i?ioean?a i?ae /an aeeiiaiiy
?acaeoe?e ia/?iee ??cieie niiniaaie. ?ic?iaeaiee iiaee niin?a oi?ioaaiiy
a?e?iaeeaanoeaiiai aianoiiica i?ae /an aeeiiaiiy ?acaeoe?? ia/?iee o
oai?eo c iaoai?/iith aeiaoyieoeath (Iaoaio Oe?a?ie 10489 A). Ia iniia?
iaea?aeaieo aeaieo ?ic?iaeaia ?aoe?iiaeueia o??o?a?/ia oaeoeea i?ae /an
e?eoaaiiy eieaeueii? iaoieia?? ia/?iee.
I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a. Cai?iiiiiaaiee o i?aoe?
eiiieaeniee iaeio?aaiaoe/iee i?aeo?ae aei aeeiiaiiy ?acaeoe?? aeicaieea
cia/ii iie?aueoe ?acoeueoaoe o??o?a?/iiai e?eoaaiiy eieaeueii? iaoieia??
ia/?iee. A eiai iniiaio iieeaaeaii: i?iaaaeaiiy noa?aiii? oii?/ii?
ae?aaiinoeee iaoieia?/iiai aiaieua, ioe?iea ooieoe?iiaeueiiai ?aca?ao
ia/?iee, eiia?iiaaia canoinoaaiiy no/anieo niinia?a ?icoeiaiiy ia?aio?ie
ia/?iee e inoaoi/iiai aaiinoaco. ?io?aiia?aoe?eia oeueo?acaoeiaa
aeine?aeaeaiiy aeicaiey? ia eeoa eieae?coaaoe iooeeio, aea e aecia/eoe
?? oiiia?aoi-aiaoii?/i? aca?iinoinoiee ?c noaeeiii-nae?aoi?ieie
no?oeoo?aie, ye? aieeaathoue ia aea?? iaoiaeo ? ianyao o??o?a?/iiai
e?eoaaiiy. ?ic?iaeaiee ? ai?iaaaeaeaiee o i?aeoeeo eiia?iiaaiee iaoiae
?acaeoe?? ia/?iee ?c canoinoaaiiyi oeueo?acaoeiaiai ani??aoi?a ?
?icoieoniaaiiai eaca?iiai i?iiaiy. ?ic?iaeaiee iiaee niin?a oi?ioaaiiy
a?e?iaeeaanoeaiiai aianoiiica i?ae /an aeeiiaiiy ?acaeoe?? ia/?iee o
oai?eo c iooeeiaie ia/?iee, oneeaaeiaieie iaoai?/iith aeiaoyieoeath.
?acoeueoaoe i?aoe? ai?iaaaeaeai? a i?aeoeeo e?eoaaeueieo caeeaae?a
Oe?a?ie oeyoii i?iaaaeaiiy ae?cieo nai?ia??a ? eiioa?aioe?e oa
iciaeiieaiiy c ieie i?aeoe/ieo e?ea??a o??o?a?a ia eo?nao ?ioi?iaoe?? ?
noaaeoaaiiy i?e ?inoeooo? ee?i?/ii? e aenia?eiaioaeueii? o??o?a?? AII
Oe?a?ie.
Iniaenoee aianie aeena?oaioa. Aaoi?o iaeaaeeoue iinoaiiaea iaoe oa
??oaiiy caaea/ aeena?oaoe?eii? i?aoe?, aea/aiiy ee?i?/iiai iaoa??aeo ii
?ic?iaeai?e i?ia?ai?. O i?ioean? aeeiiaiiy ?iaioe aaoi? i?iaiae?coaaa
no/anio iaoeiai-iaoiaee/io e?oa?aoo?o ii oai? aeine?aeaeaiiy. Eiieo?naio
a?aa aaciina?aaeith o/anoue a on?o iia?aoe?yo ? naiino?eii i?iiia?oaaa
38 oai?eo c eieaeueiith iaoieia??th ia/?iee. Aaoi? a?aa o/anoue o
?ic?iaoe? iioeiaeueii? e?eoaaeueii-ae?aaiinoe/ii? oaeoeee oa ia?aa??oe?
?? ee?i?/ii? aoaeoeaiino?. Aaoi?ii cai?iiiiiaaiee iaeio?aaiaoe/iee
eiia?iiaaiee iaoiae ?acaeoe?? ia/?iee, ?ic?iaeaiee iiaee niin?a
oi?ioaaiiy a?e?iaeeaaoeaiiai aianoiiica i?ae /an aeeiiaiiy ?acaeoe??
ia/?iee o oai?eo c iaoai?/iith aeiaoyieoeath. Aeena?oaio aea/ea
iniaeeaino? i?io?eaiiy i?neyiia?aoe?eiiai ia??iaeo ? ?ic?iaea niiniae
i?io?eaeoeee oneeaaeiaiue. Aaoi? iniaenoi aeeiiaa noaoenoe/iee aiae?c ?
ocaaaeueiaiiy iaea?aeaieo ?acoeueoao?a ?c aeei?enoaiiyi eiii’thoa?ieo
i?ia?ai.
Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy aeena?oaoe??
aeeeaaeai? ia ?O C’?cae? o??o?a?a A?ei?on? ( A?oaanuee, 1995), IIE
«O??o?a?/ia e?eoaaiiy ii?oaeueii? a?ia?oaic?? caoai?thaaiue ? o?aai
ia/?iee» (Oa?e?a, 1986), ?? I?aeia?iaei?e eiioa?aioe??
o??o?a?a-aaiaoieia?a (E??ia, 1994), IIE «Iiaa a ae?aaiinoeoe?
caoai?thaaiue i?aai?a o?aaeaiiy» (Oa?e?a, 1994), ? (XVII) c’?cae?
o??o?a?a Oe?a?ie (Euea?a, 1994), IIE «Aeooaeuei? ieoaiiy iaa?aeeeaaeii?
o??o?a?? (Ee?a, 1995), ??? I?aeia?iaei?e eiioa?aioe??
o??o?a?a-aaiaoieia?a (Naieo-Iaoa?ao?a, 1995), ieaioi? Iaoe?iiaeueiiai
oiaa?enoaa o??o?a?a Oe?a?ie (Iaeana, 1996), IIE «I?iaeaie ee?i?/ii?
o??o?a??» (Ee?a, 1997), IIE, i?enay/ai? 25-??//th ?inoeoooo ee?i?/ii?
o??o?a?? (Oa?e?n?, 1997), ?a?iiaenueeiio eiia?an? I?aeia?iaeii?
anioe?aoe?? aaiaoi-iaie?aaoi-a?e?a?ii? o??o?a?? (Aaiao?a, 1997), IIE
«Aeooaeuei? i?iaeaie aaiaoi-iaie?aaoi-a?e?a?ii? o??o?a??» (Ee?a, 1998).
Ioae?eaoe??. Ii oai? aeena?oaoe?? iioae?eiaaii 13 ae?oeiaaieo i?aoeue,
cie?aia, 6 noaoae a aeo?iaeao ? iaoeiaeo ca??ieeao, ?c ieo 1 naiino?eia,
6 oacen?a o ca??ieeao eiia?an?a, 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 iaoa??ae?a oa iaoiae?a aeine?aeaeaiue, aeaio ?icae?e?a
aeanieo aeine?aeaeaiue, aiae?co oa ocaaaeueiaiiy iaea?aeaieo
?acoeueoao?a, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e, nieneo aeei?enoaii?
e?oa?aoo?e. Aeena?oaoe?eia ?iaioa aeeeaaeaia ia 160 noi??ieao
iaoeiiieno, i?i?ethno?iaaia oaaeeoeyie, a?ao?eaie oa noaiaie ao?o/aiue.
Nienie aeei?enoaii? e?oa?aoo?e i?noeoue 336 aeaea?ae.
Iniiaiee ci?no ?IAIOE
Iaoa??aee ? iaoiaee aeine?aeaeaiue
O ?iaio? iiaeaii aiae?c ?acoeueoao?a ianoaaeaiiy oa o??o?a?/iiai
e?eoaaiiy 107 oai?eo ?c eieaeueiith iaoieia??th ia/?iee ??ciiai
iioiaeaeaiiy, iia?iaaieo a ?inoeooo? ee?i?/ii? ? aenia?eiaioaeueii?
o??o?a?? AII Oe?a?ie ca ia??iae 1986—1996 ??. Aeine?aeio a?oio neeaee 72
(67,3%) ae?iie ? 35 (32,7%) /ieia?e?a o a?oe? a?ae 17 aei 70 ?ie?a.
?iciiae?e oai?eo ca a?eii, noaooth ? oa?aeoa?ii iaoieia?? iiaeaii a
oaae.1.
Eiioeiaaio in?a i?aoeacaeaoiiai a?eo neeaa 80% oai?eo. Ceiye?nia oi?ia
eieaeueii? iaoieia?? ia/?iee (ia?aeiiee ? iaoanoe/iee ?ae, ?ae aeia/iiai
i?oo?a) aoea ae?aaiinoiaaia o 30% iaoe??io?a, o ?aooe 77 (72%) oai?eo
aeyaeaii aeia?iye?ni? caoai?thaaiiy (aaiaia?iia, aaeaiiia, ao?iieieic,
iie?e?noic, e?iiiaoic, iane?aeee o?aaie ia/?iee). Ee?i?/iee ae?aaiic aoa
aa?eo?eiaaiee aeaieie a?noieia?/iiai aeine?aeaeaiiy a on?o aeiaaeeao.
Aieaaee neiae?ii a?aecia/aii o 24 (80%) oai?eo ?c ceiye?niith oi?iith
eieaeueii? iaoieia?? oa o 35 (45%) — ?c aeia?iye?niith iaoieia??th.
Cieaeaiiy iane o?ea niinoa??aaeinue o 27 (90%) in?a ?c ceiye?niith
iaoieia??th e iineei no?eeee oa?aeoa?. O iaoe??io?a ?c aeia?iye?niith
iaoieia??th ciaioaiiy iane o?ea aeyaeaii eeoa o 38 (50%) aeiaaeeao.
Aeeniaioe/iee neiae?ii, ?c ioaeioith, aethaaiiyi, iaoai?eciii, iiiinii,
caii?ii, niinoa??aaany ?c iaeiaeiaith /anoioith (27%) i?e iaio oeiao
iaoieia??. Iayai?noue iaoai?/ii? aeiaoyieoe? a?aei?/aii o 8 (27%) in?a
?c eieaeueiith iaoieia??th ia/?iee ceiye?niiai iioiaeaeaiiy, ? eeoa o 2
(2,6%) iaoe??io?a — c aeia?iye?nieie caoai?thaaiiyie.
Aaiaoiiaaae?y eiinoaoiaaia o 16 (53%) oai?eo ?c ceiye?niei oeiii
iaoieia?? ? o 25 (32%) — c aeia?iye?niei. Ii?ooaiiy noeoiii?
?ioaa?aoeaii? ooieoe?? ia/?iee oa noaio aaiaoioeeo?a ca aeaieie
a?io?i?/ieo iieaciee?a niinoa??aaeinue o 8 (27%) oai?eo ?c ceiye?niith
oa o 20 (26%) — c aeia?iye?niith iaoieia??th.
On? iaoe??ioe, ye? iinooieee aei ee?i?ee, i?aeaeai? o??o?a?/iiio
e?eoaaiith o ieaiiaiio ii?yaeeo i?ney iiia?aaeiueiai ianoaaeaiiy ?
ia?aaeiia?aoe?eii? i?aeaioiaee. On? oai?? aoee iia?iaai? aia?oa, ie??i
aeaio, ye? ?ai?oa iia?oaaeenue c i?eaiaeo o?aaie ia/?iee a ?ioeo
e?eoaaeueieo onoaiiaao. Iieacieeaie aei aeeiiaiiy ?acaeoe?? ia/?iee
neoaeeee: ia?aeiiee ?ae — 18 (16,8%), ?ae aeia/iiai i?oo?a — 8 (7,5%),
iaoanoe/iee ?ae — 4 (3,7%), aaiaia?iia — 37 (34,6%), ao?iieieic — 21
(19,6%), nie?oa?i? e?noe — 10 (9,4%), aaeaiiia — 4 (3,7%), e?iiiaoic — 2
(1,8%), o?aaia 2 (1,8%), iie?en?oic — 1 (0,9%).
Aeey ioe?iee eaoaai??e ooeioe?iiaeueiiai ?aca?ao ia/?iee aeei?enoiaoaaee
e?eoa??? ca oeaeith Stone, ye? iiaeai? o oaae. 2.
Oaaeeoey 2
Eaoaai??? ooieoe?iiaeueiiai ?aca?ao ia/?iee ca Stone
E?eoa??? Oei A Oei B Oei C
Iaiaaeaiiy ooieoe?? ia/?iee
A?e??oa?i (ieiieue/e)
Aeueaoi?i (a/e)
Anoe?o
Aioeaoaeiiao?y
Noai oa?/oaaiiy
Iia?aoe?eia eaoaeuei?noue i?i?iaeueia
35,0
a?aenooi?e
a?aenooiy
+++
50,0
50%
C iaoith iiia?aaeiueiai aecia/aiiy iiaeeeaiai ianyao o??o?a?/iiai
ao?o/aiiy aeei?enoiaoaaee o?e a?oie ?eceeo ca Stone: oei A
(ooieoe?iiaeueiee ?aca?a ia/?iee caaeia?eueiee, ?aaaia?aoe?y ii?iaeueia,
iiaeeeaa ?acaeoe?y aei 85% ia?aio?ie); oei B (ooieoe?iiaeueiee ?aca?a
ia/?iee iiieaeaiee, ?aaaia?aoe?y iaiaaeaia, iiaeeeaa ?acaeoe?y aei 20%
ia?aio?ie); oei N (ooieoe?iiaeueiee ?aca?a ia/?iee iacia/iee,
?aaaia?aoe?y a?aenooiy, ?acaeoe?y iaiiaeeeaa).
Ie??i caaaeueiii?eeiyoeo aeine?aeaeaiue aeey ae?aaiinoeee eieaeueii?
iaoieia?? ia/?iee, ?? ao?ieia?? oa aaaeaiiai ia’?io ?acaeoe?? aoee
aeei?enoai? oa ?ino?oiaioaeuei? iaoiaee: oeueo?acaoeiaa aeine?aeaeaiiy
i?aai?a /a?aaii? ii?iaeieie (107), aeeiai?/ia noeeioea?ao?y ia/?iee
(28), eiii’thoa?ia oiiia?ao?y (48), aia?ia?ao?y, ui aeeth/a?
oeae?aeiiacaioa?eeia?ao?th ? ieaeith eaaaa?ao?th (18), ?io?aiia?aoe?eia
oeueo?aniiia?ao?y (36).
Aeey ioe?iee eaoaai??? ooieoe?iiaeueiiai ?aca?ao, ca?aeii c e?eoa??yie
Stone, aecia/aee oae? a?io?i?/i? iieacieee ne?iaaoee e?ia? (o aeoaeeao
iaaaaeai? ii?iaeuei? cia/aiiy), caaaeueiee a?e??oa?i (aei 20,5
ieiieue/e), ui oa?aeoa?eco? aene?aoi?io ooieoe?th ia/?iee, aeueaoi?i
(35,0—55,0 a/e) oa i?io?iia?iiaee ?iaeaen (90—100%), ui oa?aeoa?ecothoue
neioaoe/io ooieoe?th. I?i noai aaiaoioeeo?a noaeeee ca iieacieeaie
aeoeaiino? ne?iaaoeiaeo o?ainai?iac aeai?iai?iio?ainoa?ace (AEAO) (aei
0,68 ieiieue/a-e) oa ania?oai?iio?anoa?ace (ANAO) (aei 0,45
ieiieue/a-e). I?ae?aooiie ee?oei ia?eoa?e/ii? e?ia? oa a?io?i?/i?
aeine?aeaeaiiy aeeiioaaee ia?aeaeueii aei iia?aoe??, /a?ac 3—7—14 ae?a
i?ney iia?aoe?? oa o a?aeaeaeaiee ia??iae.
?acaeoe?? ia/?iee ?c aeei?enoaiiyi o?aaeeoe?eieo niinia?a ?icae?eaiiy
ia?aio?ie (aeea?oieeac?y, i?ioeaaiiy aia?aoaie OEE) ? inoaoi/iiai
aaiinoaco (?o/iee aaiinoaoe/iee oia) aoee aeeiiai? o 53 (49,5%) oai?eo.
?acaeoe?? ?c aeei?enoaiiyi iaeio?aaiaoe/ieo niinia?a ?icae?eaiiy
ia?aio?ie e inoaoi/iiai aaiinoaco c?iaeai? o 54 (50,5%) iaoe??io?a. O
oe?e a?oi? aeey ?icoeiaiiy ia?aio?ie ia/?iee canoiniaoaaee
oeueo?acaoeiaee ani??aoi? Aloka-SUS 201 D (ssiii?y), yeee ooieoe?iio? a
o?eeiioo?iiio ?aaeei? (???eaaoe?y, a?a?aoe?y ? ani??aoe?y), a oaeiae
ia?iaeyee ??ci? ia?aiao?e ?aaeei?a caeaaeii a?ae iaoiaeo oa ieaiiaaiiai
ia’?io ?acaeoe??. Eaca?io onoaiiaeo «?iiaoea-2» (N?N?) ia aac?
aoaea?iaeo oa aae?e-iaiiiaiai eaca?a, aeei?enoiaoaaee aeey ?icoeiaiiy
ia/?iee oeyoii aeia?oaaiiy ia?aio?ie a ?aaeei? ??caiiy c aeiiiiiaith
niaoe?aeueieo caaeei?a ? eiaaoeyoe?? ?acaeoe?eii? iiaa?oi?
?icoieoniaaiei i?iiaiai c iaoith cae?eniaiiy aaiinoaco.
Aeey aeinyaiaiiy inoaoi/iiai aaiinoaco i?iaiaeeee aenoooaaiiy e
eiaaoeyoe?th ?acaeoe?eii? iiaa?oi? no?oiaiai iia?o?y i?e oaiia?aoo??
200—500(N ca aeiiiiiaith iiaaiieiaaoeyoi?a «Leister» (Aano??y).
Iniaeeaino? ii?oieia?/ii? ?aaeoe?? ia?aio?ie i?e aeei?enoaii?
oeueo?acaoeiaiai ani??aoi?a Aloka-SUS 201 D oa o?aaeeoe?eii? iaoiaeeee
?acaeoe?? ia/?iee ?c canoinoaaiiyi aia?aoo, ui i?ioeaa?, aoee aea/ai? a
na??? ?c 20 aenia?eiaio?a ia a?eeo iaoetheao.
Noaoenoe/io ia?iaeo iaea?aeaieo ?acoeueoao?a ii O?oa?-Nouethaeaioo oa
I??niio i?iaiaeeee ?c aeei?enoaiiyi noaiaea?oieo eiii’thoa?ieo i?ia?ai.
?acoeueoaoe aaaaeaee aeinoia??ieie ca ??aiai cia/ouino? ?
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