AeI?I?IIAO?IANUeEA AeA?AEAAIA IAAeE*IA AEAAeAI?ss

O E A * I A A I A ? ? ss TH ? ? ? A I A

OAeE 616.24 — 001 — 08 : 615,37

OEAEA NEIAe?IIO AINO?IAI OOEIAeAEAIIss EAAAI?A

O AECIA*AII? AeEOA?AIOe?EIAAII? ?ANI??AOI?II?

? ?IOIIEI?EAOTH*I? OA?AI??

O OAI?EO IA IIOE?AIEE IA?EOII?O

14.01.30 — aianoac?ieia?y oa ?ioaineaia oa?ai?y

AAOI?AOA?AO AeENA?OAOe??

ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Aei?i?iiao?ianuee — 1999

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Eoaainueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao?
I?i?noa?noaa ioi?iie caei?ia’y Oe?a?ie.

Iaoeiaee ea??aieeeaiaeeaeao iaaee/ieo iaoe, aeioeaio

IAEEO ?ai? ?inoeneaaiae/,

Eoaainueeee aea?aeaaiee iaaee/iee oi?aa?neoao, aeioeaio eaoaae?e
aianoac?ieia??, ?aai?iaoieia?? oa o??o?a?? oaeoeueoaoo i?neyaeeieiiii?
ina?oeIo?oe?ei? iiiiaioe:aeieoi? iaaee/ieo iaoe,  i?ioani?

OAII Aaeaioeia Iao??aia,

Aeiiaoeueeee aea?aeaaiee iaaee/iee oi?aa?neoao, i?ioani? eaoaae?e
aianoac?ieia??, ?ioaineaii? oa?ai?? oa iaaeeoeeie iaa?aeeeaaeieo noai?a
oaeoeueoaoo i?neyaeeieiiii? ina?oeaeieoi? iaaee/ieo iaoe, 
i?ioani?

OEAIAE ?ai? Ii?o???eiae/,

Ee?anueea aea?aeaaia iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i. I.E.
Ooi?ea, caa?aeoaa/ eaoaae?e aianoac?ieia?? oa ?ioaineaii?
oa?ai??I?ia?aeia onoaiiaa:Oa?e?anueeee aea?aeaaiee iaaee/iee
oi?aa?neoao, eaoaae?a iaaeeoeeie iaa?aeeeaaeieo noai?a oa
aianoac?ieia??, IIC Oe?a?ie, i. Oa?e?a.Caoeno a?aeaoaeaoueny » 26 »
aeiaoiy 1999 ?. i 11-00 ia can?aeaii? niaoeeae?ciaaii? a/aii? ?aaee Ae
08.601.01 o Aei?i?iiao?ianuee?e aea?aeaai?e iaaee/i?e aeaaeai?? (320044,
i. Aei?i?iiao?ianuee, aoe. Aeca?aeeinueeiai, 9).

C aeena?oaoe??th iiaeia iciaeiieoeny a a?ae?ioaoe? Aei?i?iiao?ianueei?
aea?aeaaii? iaaee/ii? aeaaeai?? (320044, i. Aei?i?iiao?ianuee, aoe.
Aeca?aeeinueeiai, 9).

Aaoi?aoa?ao ?ic?neaiee » 19 » aa?aniy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee, aeioeaio A.I.Oea/aiei

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue ?iaioe. Iacaaaeath/e ia cia/iee i?ia?an o ae?aaiinoeoe?
ia?eoii?oo, oi?iaaaeaeaiiy iiaeo iaoiae?a o??o?a?/iiai ?
iaaeeeaiaioiciiai e?eoaaiiy, canoinoaaiiy iia?oi?o aioeaaeoa??aeueieo
cania?a, /enei oai?eo c oneeaaeiaiiyie, ui aeieeathoue ia eiai oii?,
caeeoa?oueny iai?eionoeii aenieei [O??ueinueeee A.?., Aaneeue’?a A.A.,
Oeaiae ?.I. oa ni?aaao., 1992]. Iniaeeai iaaacia/iei ? neiae?ii aino?iai
eaaaiaaiai ooeiaeaeaiiy (NAOE). O na?o? ui??/ii ?a?no?o?oueny aei 150000
aeiaaee?a aeieeiaiiy NAOE, a oeeo?e eaoaeueiino? i?e oeueiio
aeinyaathoue 60% [Aaaaeaoue?a A.?. oa ni?aaao., 1996; Aooe???ac A. oa
ni?aaao., 1997]. Oeae oaeo iiaea na?ae/eoe i?i iaaeinoaoi? ciaiiy
iaoai?ci?a ?icaeoeo NAOE [C?eueaa? A.I., 1996].

O i?ioean? ?aoaeueiiai aea/aiiy ianoaaei aeieeiaiiy NAOE oaeaeiny
aeyaeoe aeae?eueea i?e/ei ni?eyoeeaiai eiai ?icaeoeo. O ia?oo /a?ao, oea
i?eioeeie oa?ai?? e?eoe/iiai noaio, yeeo aeio?eiothoueny ia caaaeaee, —
i?eioeei «cieioi? aiaeeie» [O??ueinueeee A.?., 1998]. Ia iaioa aaaeeeaei
oaeoii ? cieaeaiiy ?ioiii? ?aaeoeaiino? i?aai?cio e o ia?oo /a?ao
?ioi?oaoo eaaai?a. Iia??oaiiy aeieia?/iiai ioi/aiiy, noai o?ii?/iiai
no?ano ? noiooi? caoai?thaaiiy oaeiae i?eaiaeyoue aei ii?ooaiiy
iaoai?ci?a caaaeueii? ? i?noeaai? ?ioiii? ?acenoaioiino? i?aai?cio
[Iaeeo ?.?., Iiaea?a A.I., 1997; Iaeeo ?.?., 1998].

Aaaeaiiy i?iieeiooe a nooue NAOE, c iaei??? noi?iie, iiynith?oueny
a?aenooi?noth /?oeeo ae?aaiinoe/ieo e?eoa???a ioe?iee ?ioiieo ii?ooaiue
eaaai?a, ui aeicaieythoue aecia/aoe e?eoaaeueio oaeoeeo a?aeiia?aeii aei
noaae?? NAOE. C ?ioiai aieo, ai?iaaaeaeaiiy a ioi?iio caei?ia’y
aeaiaio?a no?aoiai? iaaeeoeeie aeiaaa? ?ic?iaee i?inoiai, aea a oie aea
/an ia’?eoeaiiai ?ino?oiaioo, ui aeicaieea ae ioe?ieoe oyaee?noue noaio
iaoe??io?a ? aea?aoe aeai?eoi iaaeaiiy aeeoa?aioe?eiaaiiai ia’?io
aeiiiiiae [?iu?i A.A., 1996; Iaeaiei TH.?., 1998].

Aieiaiei e?eoa???i aeai?o noaiaea?oo ?ioaineaii? oa?ai?? i?e NAOE aa?oi
aaaaeaoe oeaeo ioe?iee oyaeeino? noaio iaoe??io?a.

Ca’ycie ?iaioe c iaoeiaeie ieaiaie. ?iaioa iia’ycaia c ieaiii aeeiiaiiy
iaoeiai-aeine?aeieo ?ia?o Eoaainueeiai iaaee/iiai oi?aa?neoaoo oa
aeeiioaaeany ca ieaiii IAe? ca oaiith: «?ic?iaea noaiaea?o?a ?
aeai?eoi?a aianoac?? oa ?ioaineaii? oa?ai?? a aeno?aiaeuei?e iaaeeoeei?,
aeeth/ath/e iaaeeoeeio eaoano?io». Iiia? aea?ae?a?no?aoe?? 01980002213.

Iaoa ? caaea/? aeine?aeaeaiiy. Iaoith ?iaioe aoei cieaeaiiy eaoaeueiino?
oai?eo c neiae?iiii aino?iai ooeiaeaeaiiy eaaai?a i?e iioe?aiiio
ia?eoii?o?, nei?i/aiiy no?ie?a ?o aini?oae?caoe?? oa caeiaoooy
aeiiii?/iiai aoaeoo caaaeyee nai?/ani?e ae?aaiinoeoe? oa
aeeoa?aioe?eiaai?e ?ioaineai?e ?ani??aoi?i?e oa ?ioiiei?eaoth/?e oa?ai??
ia i?aenoaa? ?ic?iaee oeaee neiae?iio aino?iai ooeiaeaeaiiy eaaai?a.
Aeey aeinyaiaiiy cacia/aii? aeua iaoe aoei ae??oaii oae? caaea/?:

1. Aeyaeoe i?ia?aei? ii?ooaiiy, ui aeieeathoue i?e 2 oa 3 noaae?yo
neiae?iio aino?iai ooeiaeaeaiiy eaaai?a i?e iioe?aiiio ia?eoii?o? a
noai? i?noeaai? ?ioii?acenoaioiino? oa ?ani??aoi?ii? ooieoe?? eaaai?a,
oeyoii aea/aiiy aiethiao?e/ieo iieaciee?a, ieneaaioth/i? ni?iiiaeiino?
eaaai?a, ooieoe?iiaeueii-iaoaaie?/ii? aeoeaiino? ee?oeiii? eaiee
i?noeaaiai ?ioi?oaoo eaaai?a.

2. Anoaiiaeoe i?iaiinoe/ii cia/ou? ia?ea?e neiae?iio aino?iai
ooeiaeaeaiiy eaaai?a i?e iioe?aiiio ia?eoii?o?, ye? a?aeaeaathoue eiai
oyaee?noue ia ??cieo noaae?yo caoai?thaaiiy.

3. Oaeineiiaeeoe ee?i?/io ae?aaiinoeeo neiae?iio aino?iai ooeiaeaeaiiy
eaaai?a i?e iioe?aiiio ia?eoii?o? oeyoii ?ic?iaee oeaee oyaeeino?
eaaaiaaiai ooeiaeaeaiiy, yea aeicaiey? aecia/aoe noaae?th oa
i?iaiicoaaoe e?iaoeue caoai?thaaiiy.

4. ?ic?iaeoe iaoiaaiaoe/ii iaa?oioiaai? i?eioeeie ?ani??aoi?ii? ?
?ioiiei?eaoth/i? oa?ai?? neiae?iio aino?iai ooeiaeaeaiiy eaaai?a i?e
iioe-?aiiio ia?eoii?o? ia i?aenoaa? ?iaeaeno oyaeeino? eaaaiaaiai
ooeiaeaeaiiy.

5. Iie?ioeoe ?acoeueoaoe e?eoaaiiy oa iaea?aeaoe aeiiii?/iee aoaeo i?e
aeei?enoaii? a ee?i?/i?e i?aeoeoe? oeaee oyaeeino? eaaaiaaiai
ooeiaeaeaiiy o oai?eo c neiae?iiii aino?iai ooeiaeaeaiiy eaaai?a i?e
iioe?aiiio ia?eoii?o?.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a. Aia?oa aeyaeai? ci?ie
i?noeaaiai ?ioi?oaoo oa ?ani??aoi?ii? ooieoe?? eaaai?a o oai?eo ia
iioe?aiee ia?eoii?o, ye? oa?aeoa?i? aeey 2 ? 3 noaae?e neiae?iio
aino?iai ooeiaeaeaiiy eaaai?a.

Aeiaaaeaii, ui neiae?ii aino?iai ooeiaeaeaiiy eaaai?a aa?oi ?icaeyaeaoe
ye ?acoeueoao ci?i, ui aeieeathoue o nenoai? i?noeaai?
?ioii?acenoaioiino? c ?icaeoeii ?ioiiiai aeeno?an-neiae?iio (?AeN). I?e
2 noaae?? neiae?iio aino?iai ooeiaeaeaiiy eaaai?a a noai? i?noeaaiai
?ioi?oaoo ?icaeaa?oueny noaae?y ?ioiii? ?acenoaioiino? ?ioiiiai
aeeno?an-neiae?iio, ?ani??aoi?i? ooieoe?? eaaai?a iathoue ua
eiiiainiaaiee oa?aeoa?. I?e 3 noaae?? neiae?iio aino?iai ooeiaeaeaiiy
eaaai?a ?icii/eia?oueny ooieoe?iiaeueii-iaoaaie?/ia aeai?an?y ee?oeiii?
oa aoii?aeueii? eaiie i?noeaaiai ?ioi?oaoo ia oe? aeaeiiiainaoe??
?ani??aoi?ii? ooieoe?? aeeoaeueii? nenoaie.

Aeae?eaii ia?ea?e neiae?iio aino?iai ooeiaeaeaiiy eaaai?a, ui iiaii ?
anaa?/ii a?aeaeaathoue oyaee?noue eaaaiaaiai ooeiaeaeaiiy. Iaea?eueo
aaaeeeaeie ? iieacieee, ui oa?aeoa?ecothoue ee?oeiio oa aoii?aeueio
eaiee i?noeaaiai ?ioi?oaoo eaaai?a. Ia?ea?e neiae?iio neeaee iniiao
?ic?iaeaii? oeaee oyaeeino? eaaaiaaiai ooeiaeaeaiiy. Ia i?aenoaa?
?iaeaeno ooeiaeaeaiiy eaaai?a, ui aecia/a?oueny ca oeaeith, ?ic?iaeai?
i?eioeeie iaoiaaiaoe/ii iaoiiaeaii? ?ioaineaii? ?ani??aoi?ii? ?
?ioiiei?eaoth/i? oa?ai??. E??i ae?aaiinoe/ii? oe?iiino? ? iiaeeeaino?
aecia/aiiy ia’?io ?ioaineaii? ?ani??aoi?ii? oa?ai?? neiae?iio aino?iai
ooeiaeaeaiiy eaaai?a, ioe?iea oyaeeino? noaio iaoe??io?a ca
cai?iiiiiaaiith iaie oeaeith ia? aaeeea i?iaiinoe/ia cia/aiiy.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a:

–io?eiai? aeai? aeicaieythoue ?aeiiaiaeoaaoe aei aeei?enoaiiy a
ee?i?/i?e i?aeoeoe? aeyaeai? i?iaiinoe/ii cia/ei? ia?ea?e NAOE oa
neeaaeaio ia ?o iniia? oeaeo oyaeeino? eaaaiaaiai ooeiaeaeaiiy,
aieiaieie c ieo ? iieacieee ?ioi?oaoo eaaai?a;

–?aeiiaiaeiaaii aeei?enoaiiy ?ic?iaeaiiai aeai?eoio iaoiaaiaoe/ii
iaa?oioiaaii?, aeeoa?aioe?eiaaii? ?ioaineaii? ?ani??aoi?ii? oa
?ioiiei?eaoth/i? oa?ai?? ia iniia? oeaee oyaeeino? NAOE;

–aeei?enoaiiy oeaee oyaeeino? NAOE aeicaiey? i?iaiicoaaoe aeoiaee
e?eoaaiiy;

–a ?acoeueoao? aeei?enoaiiy ?ic?iaeaii? oeaee ioe?iee oyaeeino? NAOE o
iaoe??io?a c iioe?aiei ia?eoii?oii eaoaeuei?noue oai?eo aoea cieaeaia ia
12%.

Canoinoaaiiy ?iaeaen?a NAOE aeey aecia/aiiy ianya?a ?ioaineaii?
?ani??aoi?ii? oa?ai?? ai?iaaaeaeaii ? aeei?enoiao?oueny a e?eoaaeueiiio
i?ioean? o a?aeae?eaiiyo ?ioaineaii? oa?ai?? Eoaainueei? iaeanii?
ee?i?/ii? e?ea?i? (aeo ai?iaaaeaeaiiy a?ae 9.04.99), Eoaainueeeo
i?nueeeo e?ea?aiue ? 4 (aeo ai?iaaaeaeaiiy a?ae 15.04.99), ? 7 (aeo
ai?iaaaeaeaiiy a?ae 16.04.99), oeaio?aeueieo e?ea?aiue i?no Noaoaiiaa
(aeo ai?iaaaeaeaiiy a?ae 1.10.98) oa Ae/aanueea (aeo ai?iaaaeaeaiiy a?ae
11.04.99). ?acoeueoaoe aeine?aeaeaiiy aeei?enoiaothoueny o
aeeeaaeaoeueeiio i?ioean? ia eaoaae?? aianoac?ieia??, ?aai?iaoieia?? oa
o??o?a?? Eoaainueeiai aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (aeo
ai?iaaaeaeaiiy a?ae 15.01.98).

Iniaenoee aianie caeiaoaa/a o ?ic?iaeo iniiaieo iieiaeaiue aeena?oaoe??.
Aaoi? aeneiaeth? iniaeeao iiaeyeo Caneoaeaiiio ae?y/o iaoee ? oaoi?ee
Oe?a?ie, iei? iie?eiiio i?ioani?o Aaiiaae?th Ieaenaiae?iae/o Iiaea?ao ca
iaaeaiiy oaie aeena?oaoe?eii? ?iaioe, aeiiiiiao a i?aai?caoe??
aeine?aeaeaiue oa aiae?c? iaoa??aeo. Iaa?? ee?i?/iiai iaoa??aeo,
?iciiae?e iaoe??io?a ca ee?i?/ieie a?oiaie, aiae?c iaea?aeaieo
?acoeueoao?a i?iaaaeai? aaoi?ii iiae /an naiinoieieo iaoeiaeo
aeineiaeaeaiue. A ee?i?/iiio ianoaaeaii? ? e?eoaaii? an?o iaoe??io?a
aaoi? a?aa aaciina?aaeith o/anoue. Ani ?acoeueoaoe aoee noaoenoe/ii
ii?aoeueiaaii i i?iaiaeiciaaii iniaenoi aaoi?ii. Naiinoieii
noi?ioeueiaaii oa iaienaii oni iaoeiai iieiaeaiiy oa aeniiaee
aeena?oaoeieii? ?iaioe. Ca iaoa??aeaie aeena?oaoe?eii? ?iaioe
iioae?eiaai? iaoeia? noaoo? oa oace, c?iaeai? aeiiia?ae? ?acoeueoao?a
aeine?aeaeaiue ia iaoeiaeo eiioa?aioe?yo. O ni?eueieo ae?oeiaaieo
?iaioao aaoi?ia? iaeaaeeoue 85% ?aeae oa ?ic?iaie.

Ai?iaaoe?y ?iaioe. Iniiai? iieiaeaiiy ?iaioe aeeeaaeai? e iaaiai?ai? ia
I onoaiia/iio Ieaioi? oao?aoe?a Oe?a?ie c i?iaeaie «Aeno?aiaeueia
iaaeeoeeia» (i. Eoaainuee, 1997 ?.), ia iaoeiai-i?aeoe/i?e eiioa?aioe??,
i?enay/ai?e 10-??/iiio tha?eath ?iaioe ?inoianueei?-ia-Aeiio e?ea?i?
oaeaeei? iaaee/ii? aeiiiiiae ?2 (i. ?inoia-ia-Aeiio, 1997 ?.), ia
can?aeaii? Eoaainueei? iaeanii? Anioe?aoe?? aianoac?ieia?a (i.
Eoaainuee, 1998 ?.). Ai?iaaoe?y ?iaioe a?aeaoeany ia ni?eueiiio
can?aeaii? eaoaae? aianoac?ieia??, ?aai?iaoieia?? ? o??o?a??
oaeoeueoaoo i?neyaeeieiiii? ina?oe ? aini?oaeueii? o??o?a?? iaaee/iiai
oaeoeueoaoo Eoaainueeiai iaaee/iiai oi?aa?neoaoo 12 ea?oiy 1998 ?., ia
can?aeaii? oaoiaiai nai?ia?o c aianoac?ieia?? oa ?ioaineaii? oa?ai??
niaoe?aaee Ae 08.601.01 o Aei?i?iiao?ianuee?e aea?aeaai?e iaaee/i?e
aeaaeai?? 12 o?aaiy 1999 ?.

Ioae?eaoe?? ?acoeueoao?a aeine?aeaeaiiy. Ca iaoa??aeaie aeena?oaoe??
iioae?eiaaii 12 i?aoeue, 3 ?c ieo o oaoiaiio aeaeaii? (on? naiino?ei?),
?aooa – a oacao eiioa?aioe?e ? c’?cae?a.

Ianya ? no?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 153 noi??ieao
iaoeiiieno, neeaaea?oueny c anooio, i’yoe ?icae?e?a (iaeyae e?oa?aoo?e,
iaoa??-ae ? iaoiaee aeine?aeaeaiue, 3 ?icae?ee aeanieo aeine?aeaeaiue),
aiae?co oa ocaaaeue-iaiiy ?acoeueoao?a aeine?aeaeaiiy, aeniiae?a ?
i?aeoe/ieo ?aeiiaiaeaoe?e. Nienie aeei?enoaii? e?oa?aoo?e, aeeeaaeaiee
ia 33 noi??ieao, aeeth/a? 169 iaca ?ia?o a?o/eciyieo ? 147 –
caei?aeiiieo aaoi??a. ?iaioa ?ethno?iaaia 16 oaaeeoeyie ? 6 ?enoieaie,
ye? caeiathoue 22 noi??iee.

INIIAIA *ANOEIA

Iaoa??aee  ? ia’?i aeine?aeaeaiiy. Aeine?aeaeaiiy i?iaaaeaia o 63
iaoe??io?a ?c iioe?aiei ia?eoii?oii, ia oii? yeiai ?icaeany neiae?ii
aino?iai ooeiaeaeaiiy eaaai?a.

Oai?? ciaoiaeeeeny a ee?i?oe? ?ioaineaii? oa?ai?? ? ?aai?iaoe??
Eoaainueei? iaeanii? ee?i?/ii? e?ea?i? a ia??iae ?c 1993 aei 1997 ?.
Aeaea?aeii ?ioaeoe?? aoee aino?? caiaeuei? caoai?thaaiiy i?aai?a
/a?aaii? ii?iaeieie a 24 aeiaaeeao (38,10%), i?neyiia?aoe?ei?
oneeaaeiaiiy a 28 niinoa?aaeaiiyo (44,44%) ? o?aaia i?aai?a /a?aaii?
ii?iaeieie ? ca/a?aaiiai i?inoi?o o 11 iaoe??io?a (17,46%).

Na?aae iaoe??io?a ia?aaaaeaee iniae i?aoeacaeaoiiai a?eo a?ae 20 aei 55
?ie?a.

Aeine?aeaeaiiy aeeth/aei o?e aoaie: aaciina?aaeiuei i?ney iaaeoiaeaeaiiy
— 1-3 aeiaa, ia 5-7 aeiao ? ia 9-11 aeiao a?ae ii/aoeo caoai?thaaiiy. C
iaoith ioe?i-ee oyaeeino? noaio iaoe??io?a i?e iaaeoiaeaeaii? o ee?i?eo
? aecia/aiiy oyaeein-o? iie?i?aaiieo ii?ooaiue, ye? iaee i?noea i?e
iioe?aiiio ia?eoii?o?, aeei?enoiaoaaeeny ioe?ii? oeaee: APACHE-II [Knaus
W.A., 1985] ? oyaeeino? neiae?iio iie?i?aaiii? iaaeinoaoiino? (NIII)
[Marshal J.C. et al., 1995].

O 40 niinoa?aaeaiiyo — o iaea?eueoa oyaeeiai eiioeiaaioo oai?eo c
yaeuaie NIII aeeiiaia iiaeeaeaia aea/aiiy ?ani??aoi?ii? ooieoe?? e
?ioi?oaoo eaaai?a. Ooieoe?th ciai?oiueiai aeeoaiiy aea/aee ca iaoiaeii
aiethiao???, i?iaiaeeee ?aioaaiieia?/ia aeine?aeaeaiiy a?oaeii? ee?oee.
Aeai?, ui oa?aeoa?ecothoue iai?oao aac?a a?oa??aeueii? ? aaiicii? e?ia?,
aeine?aeaeoaaee ca aeiiiiiaith i?e?iiaoiaeo Ano?oia [Astrup, 1960]. Aeey
aea/aiiy ieneaaioth/i? ni?iiiaeiino? eaaai?a aeei?enoiaoaaany eeniaaee
iaoiae ? i?eioeei O?ea. Iieacieee ?ic?aoiaoaaee ca caaaeueiii?eeiyoeie
oi?ioeaie. Aea/aiiy noaio i?noeaaiai ?ioi?oaoo eaaai?a cae?enithaaee
oeyoii aeei?enoaiiy ?ioiieia?/ieo iaoiaeee ? oano?a. O i?ioean?
aeine?aeaeaiiy aoee aecia/ai? iniiai? ia?ea?e NAOE. Aiie noaee iniiaith
aeey ?ic?iaeaii? iaie oeaee oyaeeino? eaaaiaaiai ooeiaeaeaiiy.

?ic?iaeo oeaee i?iaiaeeee oeyoii aeei?enoaiiy iaoiaeieia?? nenoaiiiai
aiae?co. Aeaiee i?eioeei i?eioneaa ?icaeyae iaoieia?/iiai i?ioeano, aeey
oa?aeoa?enoeee yeiai ?ic?iaey?oueny oeaea ?c aaaaoii??ieo iiceoe?e
(aaaaoii??i?noue oeaee). I?ae oeei iaeiny ia oaac? oa, ui oeaea iiaeiia
a naaa aeeth/aoe aeai? ye i?i ii?oieia?/i? ci?ie, oae ? i?i
ooieoe?iiaeuei? ii?ooaiiy.

Ii?oieia?/i? ci?ie (iieacieee ee?oeiii? ? aoii?aeueii? eaiee ?ioi?oaoo
eaaai?a) ? nai???aeiei aacenii aeey i?iaiico ? aeai?o oaeoeee
?ioaineaii? oa?ai??, a ooieoe?iiaeuei? ii?ooaiiy (iieacieee aiethiao???
? ieneaaioth/i? ni?iiiaeiino? eaaai?a) oi?iothoue iaaeaoaeiao, ui
a?aeaeaa? ?acoeueoao ii?oieia?/ieo c?ooaiue.

Ianooiiei aoaiii ?ic?iaee oeaee aoa aeia?? iieaciee?a, ye?
ia?aaeaa/aeiny aeeth/eoe a oeaeo. Ioe?ithaaee ?ioi?iaoeaio cia/ei?noue
eiaeiiai aeine?aeaeoaaiiai iieacieea oeyoii i?iaaaeaiiy a?aeiia?aeiiai
aeenia?n?eiiai ? ei?aeyoe?eiiai aiae?co.

An? io?eiai? ?acoeueoaoe i?ioiaeeee eiiieaen noaoenoe/iiai ii?aoethaaiiy
ca i?ea?iaeueiith i?ia?aiith «BIOMETRY» ?c aeei?enoaiiyi ia?niiaeueiiai
eiii’thoa?a IBM ?N-AO [Iaeaiei TH.?., 1996].

Oi?ioaaiiy no?oeoo?e oeaee iieyaaei a inoaoi/iiio aeiai?? iieaciee?a
aeey aeeth/aiiy aei oeaee c ?icoi?iue ia o?eueee noaoenoe/ii?
?ioi?iaoeaiino?, aea ? ci?noiaii? oe?iiino?.

Caeeth/iee aoai ?ic?iaee aaaaoii??ii? oeaee — i?eaaaeaiiy
on?o

iieaciee?a, ye? aeei?enoiaoaaee, aei ?aeeii? oeaee a?aeiioaiue. Aeey
oe??? iaoe aeei?enoiaoaaee iaoiaeeeo ia?aaaaeaiiy a aeanyoeaaeueio oeaeo
noai?a [Aoaea? ?.A., 1990]. ?iaeaene NAOE aeeeaaeai? a oaae.1.

Oaaeeoey 1

?iaeaene NAOE

IciaeeAaee01234 f , (1/oa.)16-1819-2324-2728-35>35

OAEPaCO2, (ii.?o.no.)44-4039-3635-3231-29

aai 45-46<29 >46PaO2/FiO2, (ii ?o.no.)500-300299-240239-160159-100<100Qs/Qt, (%) 5-78-1415-1819-34>34D(A-a)O2, (ii ?o.no.)12-2021-2627-3637-42>42SIgA,
(a/e)0,23-0,220,21-0,090,08-0,050,04-0,030,02-0,01AEeoo?caeaoi? AI,
(%)80-7574-6362-5958-35<35O*, (y.i.)9-87,9-6,96,8-65,9-4,3<4,3IA, (%)1-23-4041-5758-71>71Ioe?iea: Aae Noaae?y Eaoaeuei?noue (%)

0 NAOE iaia? —

1-9 aae?a I noaae?y NAOE < 20% 10-18 aae?a II noaae?y NAOE 21% 19-27 aae?a III noaae?y NAOE 43% 28-36 aae?a IV noaae?y NAOE > 43%.

?acoeueoaoe aeanieo aeine?aeaeaiue. Aeae?eai? caaaeyee oeaeai APACHE-II
? NIII, a iio?i ia’?aeiai? ca oyaee?noth NAOE iaoe??ioe aa?eoee a aea?
aeine?aeaeoaai? a?oie. O ia?oo a?oio — 19 (47,50%) in?a c ioe?ieith ca
oeaeith APACHE-II, ia ia?aaeuoth/i? 16 aae?a ? ca oeaeith oyaeeino? NIII
ia a?eueoa 12 aae?a. I?e ioe?ioe? ca oeaeith oyaeeino? NAOE ?iaeaen NAOE
ciaoiaeeany a iaaeao 10-18 aae?a, ui a?aeiia?aeaei 2 noaae?? NAOE.

A ae?oao a?oio aa?eoia 21 (52,50%) iaoe??io. Oyaee?noue noaio ca oeaeith
APACHE-II ioe?ithaaeany a na?aaeiueiio 26 aaeaie, a ca oeaeith oyaeeino?
NIII o na?aaeiueiio 16 aaeaie. ?iaeaen NAOE i?e iaaeoiaeaeaii? a
noaoe?iia? neeaa 19-27 aae?a, ui a?aeiia?aeaei 3 noaae?? NAOE.

Naia 2 ? 3 noaae?? NAOE ? aeiyoeiai aaaeeeaeie ia??iaeaie. Ia
ia?aoeiaii? oeeo aoai?a ua iiaeeeai iiaa?iooe iacaae i?ia?anoth/ee NAOE.
O oeae /an ae??oothoueny ieoaiiy aeai?o aeeoa?aioe?eiaaieo iaoiae?a
?ioaineaii? ?ani??aoi?ii? oa?ai??.

Ia?oei i?iyaii aeeoaeueii? iaaeinoaoiino? i?e aeieeiaii? NAOE aoa
a?ia?aaioeeyoe?eiee neiae?ii. I?e 2 noaae?? NAOE ci?ie iieaciee?a
ciai?o-iueiai aeeoaiiy aoee ae?aaeai? iii??ii. Oae, oao?iiia (aei 26 ca
oa.), ui nii-noa??aaeiny ia ii/aoeiaeo aoaiao aeine?aeaeaiiy, o i?ioean?
e?eoaaiiy cieaeo-aaeiny aaea aei II aoaio (P>0,05), ?ici?? oaeeeiii?
aaioeeyoe?? eaaai?a (OAE) caeeoaany noaa?eueiei i?ioyaii onueiai
ia??iaeo niinoa?aaeaiiy (P>0,05). A oie aea /an i?e 3 noaae?? NAOE
i?inoaaeoaaeany ia?aeiieeaa oaiaeaioe?y aei ca?eueoaiiy ye /anoioe
aeeoaiiy (f) iiiaae 30 ca oa. (P<0,001), oae ? OAE. Iacaaaeath/e ia ?ioaineai? iaoiaee ?ani??aoi?ii? oa?ai??, iiaii? noaa?e?caoe?? oeeo iieaciee?a ia niinoa??aaeiny iaa?oue aei 9-11 aeiae caoai?thaaiiy. Aiaeia?/i? ci?ie aeyaeai? ? i?e aeine?aeaeaii? oaeeeiii? aeueaaiey?ii? aaioeeyoe?? (OAAE). Oae, i?e 3 noaae?? NAOE a?aecia/aee yaio oaiaeaioe?th aei ca?eueoaiiy OAAE, ? ia caeeth/iiio aoai? aiia aoea a?eueoa a 1,05 ?ace, i?ae i?e 2 noaae?? (P<0,05). I?aeoaa?aeaeaiiyi iayaiino? a?ia?aaioeeyoe?eiiai neiae?iio ? eiai noaa?e?caoe?? aei e?ioey aeine?aeaeaiiy o iaoe??io?a ia?oi? a?oie ? ae?aaeaia a?iieaii?y ia ii/aoeiaeo aoaiao aeine?aeaeaiiy, yea ciaioo?oueny a i?ioean? e?eoaaiiy. A ae?oa?e a?oi? ia ii/aoeo aeine?aeaeaiiy aecia/aeany iii??ia a?ia?eaii?y ? ii?iieaii?y a oiae? niinoa?aaeaiiy. Oaeei /eiii, yeui i?e 2 noaae?? NAOE ci?ie aiethiao?e/ieo iieaciee?a o i?ioean? ?ioaineaiiai e?eoaaiiy na?ae/eee i?i noaa?e?caoe?th i?ioeano, yeee ii/aany, oi i?e 3 noaae?? aoei aeyaeaii eiai yaia i?ia?anoaaiiy. ?icaeoie a?ia?aaioeeyoe?? ? eiiiainaoi?iei iaoai?ciii, ni?yiiaaiei ia i?aeo?eieo iaiao?aeiiai ??aiy ieneaaiaoe??. Iaeiae i?e 3 noaae?? NAOE a?ia?aaioeeyoe?y aaea ia i?eiineea aaaeaiiai aoaeoo. C ?icaeoeii NAOE ia?inoa? i?iieei?noue eaaaiaaeo i?e?inoaeei ?c ?ioa?noeoe?aeueiei iaa?yeii eaaai?a, aeeeeeath/e ii?ooaiiy ?ani??aoi?ieo ? ia?ani??aoi?ieo ooieoe?e eaaai?a [C?eueaa? A.I., 1996]. Iia??oaiiy aaioeeyoe?eii-ia?ooc?eieo ni?aa?aeiioaiue i?aeoaa?aeaeoaa-einy iecueeei cia/aiiyi ?aI2 aaea ia ?aii?o noaae?yo NAOE. ? yeui i?e 2 noaae?? a i?ioean? e?eoaaiiy aei II aoaio a?aeaoaaeany a?aeiinia noaa?e?caoe?y oeueiai iieacieea (P<0,001), oi i?e 3 noaae?? NAOE o oeae ia??iae aoee aeyaeai? ae?ae iecuee? cia/aiiy ?aI2 (P<0,001), ui ? aei III aoaio caeeoaeeny ieae/a a 1,37 ?ace, i?ae i?e 2 noaae?? (P<0,05). Ci?ia ?vI2 iaea?eueoa yne?aai aeyaeyeany ia II aoai? aeine?aeaeaiiy ? iaea ??ciiiai?aaeaiee oa?aeoa?. Oae, i?e 2 noaae?? NAOE, ?vI2 neeaaeaei 28,25 ii ?o. no., ui iiynithaaeiny aenieith iio?aaith oeaiei o eeni? ? ii/aoeiaeie i?iyaaie ia?aaaaeaiiy aiaa?iaiiai iaoaaie?cio [Aaeueoaiae A.?., 1988]. I?e 3 noaae?? NAOE iaee i?noea cai?ioi? ci?ie, ? ?vI2 ca?eueooaaeiny aei 44,70 ii ?o. no. (P<0,001). Oea iiaea na?ae/eoe i?i ae?ae oyaee? ii?ooaiiy i?ioean?a iaoaaie?cio, oeaieiiiai aeeoaiiy ? aiiainoaco, ui i?eaiaeeoue aei ao?aoe ni?iiiaeiino? ooee?coaaoe eenaiue oeaieiaie. Aei III aoaio oey ni?iiiaei?noue a?aeiiaethaaeany, iaeiae i?e 3 noaae?? NAOE oaea ii?iae?caoe?y a?aeaoaaeany ia oii? aeniei? iio?aae oeaiei o eeni?. ?iaeaenii aaeaeaaoiino? ieneaaiaoe?eii? ni?iiiaeiino? eaaai?a i?eeiyoi aaaaeaoe aeueaaiei-a?oa??aeueio ??cieoeth ca eeniai D(A-a)O2 [Caeeianueeee TH.ss., 1987]. I?e 3 noaae?? NAOE a?aeaoaaeiny ca?eueoaiiy oeueiai iieacieea a 1,16 ?ace a ii??aiyii? c eiio?ieueieie cia/aiiyie (P<0,001) ? eeoa aei III aoaio niinoa??aaeiny iacia/ia cieaeaiiy (P<0,05). Oea aiai?eoue i?i iayai?noue i?e 3 noaae?? NAOE ii?ooaiue aaea aiaoii?/iiai oa?aeoa?o. O oie aea /an i?e 2 noaae?? NAOE oae? ci?ie D(A-a)O2 iinyoue ooieoe?iiaeueiee oa?aeoa? ? caeaoi? aei noaa?e?caoe??. I?e 3 noaae?? NAOE a?aenioie aioo??oiueieaaaiaaiai ooiooaaiiy e?ia? (Qs/Qt) aei II aoaio aeinyaaa 35,10±1,26% oaeeeiiee ia'?i na?oey (P<0,001), a ?iaeaen a?iien?? 123 ii ?o. no., ui a 1,91 ?ace iaioa, i?ae o iaoe??io?a ia?oi? a?oie (P<0,01). Aiaoii?/iee oa?aeoa? ii?ooaiue i?e 3 noaae?? NAOE i?aeoaa?aeaeoaaany aeaieie ?aioaaiia?ao??. A?aecia/aeiny cieaeaiiy i?ici?ino? eaaaiaai? oeaie-ie, ui ioiiethaaei on? aaeee? ae?eyiee, iiyaa aaeeei? e?eueeino? o?iae o aeaeyae? "ieano?aoe?a". Aaea i?e 2 noaae?? NAOE ia oii? noaa?eueieo iieaciee?a ?ani??aoi?ii? ooieoe?? eaaai?a a?aecia/aeiny iii?oia cieaeaiiy iniiaieo ?ioiieiiiaoaio-ieo ee?oei eaaai?a - aeueaaiey?ieo iae?ioaa?a (AI). Ia o?aoueiio aoai? aeine?aeaeaiiy ai?no AI aoei a 2,95 ?ace (P<0,001) a?eueoa, i?ae i?e 3 noaae?? NAOE, ? aeeoo?caeaoieie aoee 61,35%. I?ia?anoth/a a?iienai?y ? oienai?y, iia??oaiiy "yeino? aeeooy" AI a ?acoeueoao? i?iaeiaaeaii? OAE, aaaaoie?aoieo ?iooaaoe?e ? naiaoe?e o?aoa? i?e-aaee aei eaoano?io?/iiai cieaeaiiy /enea AI i?e 3 noaae?? NAOE. Aei caaa?-oaeueiiai aoaio aeine?aeaeaiiy ?o caeeoaeiny onueiai 10,80% a?ae eiio?ieueieo cia/aiue, i?e/iio aeeoo?caeaoieo ?c ieo aoei eeoa 35,12% (P<0,01). A?aeaoaaeeny ci?ie ooieoe?iiaeueii-iaoaaie?/ii? aeoeaiino? AI. Oaaioeeoa?iee ?iaeaen (O?) ? oaaioeeoa?ia /enei (O*) o iaoe??io?a c 3 noaae??th NAOE i?ia?aneaii ciaiooaaeeny ia an?o aoaiao aeine?aeaeaiiy (P<0,001). Iiae?aiiai ia niinoa??aaeiny i?e 2 noaae??, aea O? ? O* oaeiae aoee iecueeeie ia ii/aoeo aeine?aeaeaiiy, aea aei III aoaio iii?oii ca?eueooaaeeny (P<0,05), ui, ia iaoo aeoieo, ca'ycaii c iie?ioaiiyi i?e?ioee?eoeyoe?? a ia?aio?i? eaaai?a, noaa?e?caoe??th o?io?ee, cieaeaiiyi ??aiy aiaeioienai??. Oeueiio ni?eyea nai?/ania ?ani??aoi?ia oa?ai?y c oaaaeaiiyi ?ioiiaeiaoe?i?a, ui aa?ooue o/anoue a aeoeaaoe?? ? iineeaii? oaaioeeoico, aeaoieneeaoe?eia oa?ai?y. Iiae?aiei niiniaii ci?ithaaeany ? aaeaaceaia ni?iiiaei?noue AI. Ca?eueooth/enue aei e?ioey aeine?aeaeaiiy a 2 ?ace o iaoe??io?a ?c 2 noaae??th (P<0,01), i?e 3 noaae?? NAOE cieaeaiiy aaeaaceaiino? c?inoaei c eiaeiei aoaiii (P<0,001). O iaoe??io?a ye ia?oi?, oae ? ae?oai? a?oi a?aenioie INO-iiceoeaieo ee?oei cia/ii ia?aaeuoaaa eiio?ieuei? iieacieee aae aei III aoaio aeine?aeaeaiiy, aea niinoa??aaee ??cea cieaeaiiy INO-oanoo (P<0,001). Aiaeia?/i? ci?ie a?aeaoaaeeny ? ?c na?aaei?i oeeoio?i?/iei eiao?oe??ioii INO. Aeai? cnoae iiaeooue neoaeeoe iai?yiith iciaeith ?acoeueoao?a aieeao ia oaaioeeoe oe?ieiai niaeo?o aiaeioiene/ieo noanoaioe?e, ui i?eaiaeeoue aei ia?aaoaeiae ieeniiai iaoaaie?cio ee?oeie c ooai?aiiyi aeoeaieo oi?i eenith [Iayinueeee A.I., 1994]. I?e 3 noaae?? NAOE cia/aiiy NOeO?-INO- ? NOeOE-INO-oano?a aoee iaaaaaoi aeueie, i?ae i?e 2 noaae??, ui iiaei i?eaiaeeoe aei ooeiaeaeaiiy aiaeioae?th ? aeieeiaiiy aeuaaeeeaaeaieo ii?ooaiue. Ia 9-11 aeiao a?aeaoaaeiny ??cea cieaeaiiy oeeo iieaciee?a. I?e NAOE ca?eueoo?oueny e?euee?noue iaeo?io?eioeeo?a (IA) o a?iioiaeueaaiey?iiio ciea? (AAC). Oea ciaeoei i?aeoaa?aeaeaiiy ? a iaoeo aeine?aeaeaiiyo. Ae?enii, e?euee?noue IA o AAC aoea cia/ii aeua a?ae eiio?ieth aaea i?e 2 noaae?? NAOE, aea aei III aoaio ?oiy e?euee?noue ciaiooaaeany ? neeaaeaea 45% (P<0,01). I?e 3 noaae?? NAOE niinoa??aaeiny i?ia?anoth/a ca?eueoaiiy IA (P<0,001). Aoii?aeueia eaiea ee?oeiiiai ?ioi?oaoo oaeiae i?aeaeaaaeany aeeaieei ci?iai. Iaeiae i?e 2 noaae?? NAOE aei III aoaio eiioeaio?aoe?y ?ioiiaeiaoe?io A (IgA) aeinyaaea eiio?ieueieo iieaciee?a, oi/a ??aaiue nae?aoi?iiai ?ioiiaeiaoe?io (SIgA) caeeoaany a 2,33 ?ace (P<0,001) ieae/ei ca eiio?ieue. O oie aea /an i?e 3 noaae?? NAOE aeyaeaia cia/ia ciaioaiiy eiioeaio?aoe?? ye SIgA, oae ? IgA. Aei III aoaio ?oi? eiioeaio?aoe?? aoee a 21,0 (P<0,001) ? 3,12 (P<0,001) ?ace ieae/a eiio?ieueieo ?ici???a. Ca?eueoaiiy eiioeaio?aoe?e IgA ? SIgA i?e 3 noaae?? NAOE iiaeia iiynieoe oaiaeaioe??th, ui iai?oeeany, aei a?aeiiaeaiiy aeanoeainoae neeciai? iaieiiee aeeoaeueii? nenoaie. Iayai?noue iecueeeo eiioeaio?aoe?e SIgA i?e 3 noaae?? ? ?acoeueoaoii ?icaeoeo caiaeueiiai i?ioeano a aeeoaeuei?e nenoai? ? iiaea na?ae/eoe i?i ??cea ciaioaiiy /enea ee?oei, a?aeiia?aeaeueieo ca neioac ye aeeia??a, oae ? naiiai nae?aoi?iiai eiiiiiaioo. Oeei iiynith?oueny ? a?aeiia?aeii iecueeee ??aaiue IgA, ui aac nae?aoi?iiai eiiiiiaioo eaaei ?oeio?oueny a aeeoaeuei?e nenoai? oa?iaioaie aaeoa??e [Aeai?aoeueeee E.?., 1983]. Oi?eath/enue aaeoa??ieia?/ieo aeine?aeaeaiue, ne?ae caoaaaeeoe, ui ia an?o noaae?yo NAOE ? a?aeiia?aei?noue i?ae aeaeaie caoaeiee?a, ye? aen?aathoueny ?c aeeoaeueii? nenoaie ? c /a?aaii? ii?iaeieie. sse i?aaeei, oea aoea a?ai-iaaaoeaia oei?a, iaeiae o 20% io?eiaii iaaaoeaiee ?acoeueoao iin?a?a o oai?eo ?c 2 noaae??th NAOE, o oie /an ye i?e 3 noaae?? aei III aoaio a 100% aecia/aany aiaeia?/iee caoaeiee. I?iaaaeaiee ei?aeyoe?eiee aiae?c aeicaieea aeyaeoe iayai?noue ?ai?oa ia ?nioth/eo ca'yce?a aaea i?e 2 noaae?? NAOE i?ae eaeeioeeoa?iei ?iaeaenii ?ioieneeaoe?? (E??) ? iieacieeaie i?noeaaiai ?ioi?oaoo eaaai?a: IA, AI, O*. I?ae E?? ? IA aoee anoaiiaeai? neeuei? iiceoeai? ei?aeyoe?ei? ca'ycee (r xy= 0,71). I?ae E??, AI ? O* aoee aeyaeai? iaaaoeai? ei?aeyoe?ei? ca'ycee na?aaeiuei? neee (r xy=-0,47, r xy=-0,45). I?ae ??aiyie AI ? IA onoaiiaeth-aaany neeueii ae?aaeaiee iaaaoeaiee ei?aeyoe?eiee ca'ycie (r xy=-0,52). Ii-ae?ai? ?acoeueoaoe iaoiiaeai? oei, ui aaea i?e 2 noaae?? NAOE iayaia aiaeioie-nai?y i?eaiaeeea aei ciaioaiiy e?eueeino? AI ? ?o oaaioeeoa?ii? aeoeaiino?. I?e 2 noaae?? NAOE ua iaia? aeineoue ae?aaeaieo ei?aeyoe?eieo ca'yce?a i?ae E?? ? ?iaeaenii a?iien?? (?aI2/FiO2) (r xy=-0,38). I?ae E?? ? Qs/Qt ei?aeyoe?? aoee a?aenooi?. Oea iiaeia ?icoe?ithaaoe ye oaeo oiai, ui ii?ooaiiy a ieneaaioth/?e ni?iiiaeiino? eaaai?a ia ? ia?aeiieie i?e NAOE, oi/a i?ae ??aiai IA ? ?aI2/FiO2 ia I ? II aoaiao aeine?aeaeaiiy aoee iaaaoeai? ei?aeyoe?ei? ca'ycee na?aaeiuei? neee (r xy =-0,46) ? aeineoue aenie? - i?ae IA ? Qs/Qt (r xy=-0,65). I?ae e?euee?noth AI ? ?aI2/FiO2 ia oeeo aoaiao onoaiiaeth-aaeeny iiceoeai? ei?aeyoe?ei? ca'ycee na?aaeiuei? neee (r xy=0,49). Oea iiaea neoaeeoe i?aeoaa?aeaeaiiyi oiai, ui ?ioii?aaeoeaia nenoaia ? ii/aoeiaith eaieith a eaioethc? iaoiaaiaco NAOE ? ia?oa ?aaao? ia aiaeiaaiio ?ioieneea-oe?th, a ii?ooaiiy ieneaaioth/i? ni?iiiaeiino? eaaai?a ? eeoa ?acoeueoaoii ci?i, ui a?aeaoaathoueny, ? i?ciei neiioiiii NAOE. Ei?aeyoe?eiee aiae?c, i?iaaaeaiee i?ae aiaeia?/ieie iieacieeaie a ae?oa?e a?oi?, aeyaea a?eueo o?ni? ca'ycee. Oae, i?ae E?? ? ??aiai IA, AI ? O* onoaiiaeai? aenie? iiceoeai? ei?aeyoe?ei? ca'ycee (r xy=0,60) o aeiaaeeo c IA, ? iaaaoeai? i?ae E?? e AI (r xy=-0,65), E?? ? O* (r xy=-0,52). Iineeaiiy ei?aeyoe?e i?ae oeeie iieacieeaie i?e 3 noaae?? NAOE iiaeia ?icoe?ithaaoe ye ?acoeueoao i?ia?anoaaiiy caiaeueii? ?aaeoe??, ia oii? yei? ca?eueooaaeany e?euee?noue IA, ?icaeaaeany iiiioeeoiiai?y, cieaeoaaeany oaaioeeoa?ia aeoeai?noue AI. Aenieei noa? eiao?oe??io ei?aeyoe?? i?ae E?? ? iieacieeaie ieneaaioth/i? ni?iiiaeiino? eaaai?a ?aI2 / FiO2 (r xy=-0,65), Qs/Qt (r xy=-0,58) a?aeiia?aeii, /iai ia niinoa??aaeiny a ia?o?e a?oi?. I?aeneethaaeeny iiceoeai? ei?aeyoe?ei? ca'ycee i?ae iieacieeaie ieneaaioth/i? ni?iiiaeiino? eaaai?a ? eaieaie i?noeaaiai ?ioi?oaoo aeeoaeueii? nenoaie: Qs/Qt ? IA (r xy=0,77), ui aoei i?aeoaa?aeaeaiiyi iayaieo i?e?ioee?eoeyoi?ieo ii?ooaiue, ni?iaieiaaieo o oiio /ene? ? eaeeiaa?aaa-oe??th, ui i?eaiaeeoue aei ?inoo a?aenioea aioo??oiueieaaaiaaiai ooiooaaiiy. I?ae iieacieeaie ?aI2/FiI2 ? AI, O* oaeiae a?aeaoaaeiny ca?eueoaiiy iayaieo aeineoue no?eeeo iaaaoeaieo ei?aeyoe?eieo ca'yce?a (r xy = -0,55, r xy = -0,50). I?e 3 noaae?? NAOE ia o?eueee aiaeioienai?y, aea ? eeniaaee aeao?oeeo, ui ?icaeaa?oueny aoi?eiii, noathoue i??i?eoaoieie /eiieeaie, ia oii? yeeo a?aeaoaa?oueny i?eai?/aiiy iioaioe?eieo iiaeeeainoae ?ioiii? a?aeiia?ae? AI. I?aeoaa?aeaeaiiyi oeueiai ? no?ee? iaaaoeai? ei?aeyoe?ei? ca'ycee i?ae E??, ?aI2 ? INO-oanoii, AI (r xy = -0,55, r xy = -0,49). ?acoeueoaoe ii??aiyeueiiai ? ei?aeyoe?eiiai aiae?co aeicaieythoue aeeeanoe, ui i?e NAOE, aeieeath/iio ia oii? iioe?aiiai ia?eoii?oo, a ?ioi?oao? aeeoaeueii? nenoaie aeieea? ?ioiiee aeeno?an-neiae?ii. I?e 2 noaae?? NAOE, ia oii? iii??ii? aiaeioienai?? ? eiiiainiaaii? a?iien??, ?AeN ia iaea?-aeo? iiaeaeueoiai ?icaeoeo ? caaa?oo?oueny a?aeiiaeaiiyi ?ioiieo ?aaeoe?e. Oe?eeii ?iaeoa neeaaea?oueny neooaoe?y i?e 3 noaae?? NAOE. I?ia?anoth/a aiaeioienai?y ? a?iien?y noathoue i?e/eiaie, ui i?iaieothoue iiaeaeueoee ?icaeoie ?AeN. Ianooia? oaca aeniaaeaiiy ?ioi?oaoo aeeoaeueii? nenoaie. Ioaea, eeoa noeoiia ioe?iea ii?ooaiue, ui aeieeathoue a ?ioii?aaeoeai?e nenoai? eaaai?a, ciai?oiueiio aeeoaii? ? ieneaaioth/?e ni?iiiaeiino? eaaai?a aea? iiaeeea?noue ia'?eoeaii a?aeaeaaoe oyaee?noue NAOE. C iaeyaeo ia ?acoeueoaoe i?iaaaeaiiai aeine?aeaeaiiy a iniiao oaeoeee oa?ai?? NAOE aoee iieeaaeai? i?eioeeie aeeoa?aioe?eiaaii? ?ioaineaii? ?ani??aoi?ii? oa?ai??, ?ic?iaeai? ia aac? cai?iiiiiaaii? iaie oeaee ?iaeaen?a oyaeeino? NAOE. Iaea?eueoa oe?iieie i?iaiinoe/ieie e?eoa??yie oeaee ? iieacieee, ui a?aeaeaathoue noai ?ioii?aaeoeaii? nenoaie, ine?eueee naia aiia a?a? aieiaio ?ieue o caioneo ? ?icaeoeo aeaiiai i?ioeano. ?iaeaen NAOE 0 aae?a. Ooeiaeaeaiiy eaaai?a iaia?. ?iaeaen  NAOE 1-9 aae?a. I noaae?y NAOE. 1. Eoi??oaaiiy iniiaiiai i?ioeano - iioe?aiiai ia?eoii?oo. 2. I?io?eaeoe/iee eiiieaen caoiae?a, ni?yiiaaiee ia iie?ioaiiy ?aieia?/ieo aeanoeainoae e?ia? (aeacaa?aaaioe, aia?ii?ioaeoi?e). 3. ?ani??aoi?ia o?c?ioa?ai?y. ?iaeaen  NAOE 10-18 aae?a. II noaae?y NAOE. 1. ?ani??aoi?ia o?c?ioa?ai?y. Ieneaaiioa?ai?y - FiO2 40%, aa?icieaoa?ai?y (aoeaoeeoeenoa?i 2,5 ie 10% ?ic/eio + 2,5 ie ?cioii?/iiai ?ic/eio iao??th oei?eaeo). Aaiaeeoe ca aeiiiiiaith iaaoeaeca?a. E?eoaaeueia ia?eon?y, a?a?aoe?eiee ? aaeooiiee ianaae. Iaai?oioa?ai?y ia i?aaie a?oaeii? ee?oee a aacia?a?aiiio ?aaeei? c iai?oaith aei 50 iOe, /anoioith 50 Aoe aea?/? ia aeaiue. 2. ?aaeeie ?ani??aoi?ii? i?aeo?eiee. ?aaeei naiino?eiiai aeeoaiiy c IOIA. ?ici?? IOIA aecia/aoe oeyoii aeine?aeo, iae?ath/e iaeieae/ee iiceoeaiee oene, ui caaacia/o? iaeaeuee ??aaiue PaO2 i?e aaeeoaii? 40% eiioeaio?aoe?? eenith. O na?aaeiueiio IOIA iiaeiai aei??aithaaoe 6-8 ni H2I. 3. E?ea?nueea oa?ai?y. - Cai?nia ?ioiiiiaeoeyoe?y. I?iaiaeeoueny oeyoii aiaeio?aoaaeueiiai aaaaeaiiy ?ioiiaeiaoe?io ethaeeie. Iiaeeeai aeei?enoaiiy oaeeo ?ioiiaeiaoe?i?a: aioenoao?eieieiaiai, i?ioea?eiiciiai, ii?iaeueiiai ethaenueeiai. Aiaeio?aoaaeueia aaaaeaiiy i?aia?ao?a i?iaiaeeoe ca aeiiiiiaith OC-?iaaeyoe?e aai /a?ac aiaeio?aoaaeueio o?oaeo a e?eueeinoyo, ?ic?aoiaaieo ca oi?ioeith: Aeao?oeeo Ig, a = (Ig ii?i., a/e - Ig oaeo., a/e) * 0,075 % iane o?ea, aea 0,075 - eiao?oe??io ia?a?aooieo, io?eiaiee, aeoiaey/e c oiai, ui i?iaeoeoe?y nae?aoo OAAe o ethaeeie neeaaea? 0,75 ie/ea/aeia, a eiioeaio?aoe?y IgA o nae?ao? 0,1-0,7 a/e [Oaeiaieueae I.I., 1994]. - Iie?ioaiiy eaaaiaaiai e?iaiia?ao (o?aioae, eo?aio?e - 10 ie ia aeiao). - Aioeieneaeaioe, aioea?iienaioe (a?oai?i N 5% ii 10 ie 2 ?ace ia aeiao, a?oai?i A 50-100 ia/aeia, oeeoiiae 30 ia aea?/? ia aeiao aioo??oiueiaaiii). - Naeaeoeaia a?iioaic?y iaeiai eiea (i?o?iae?oea?ei 20 ia o 400 ie 5% aetheice). - Ciaioaiiy iaa?yeo eaaai?a (oo?inai?ae 0,5-0,7 ia/ea). A oe?e noaae?? NAOE ?aeiiaiaeo?ii ia?aaiaeeoe oai?eo ia OAE, i?iaiaey/e ?? ia'?iaie, caiia?aath/eie aa?io?aai? eaaai?a. Iieacaiiy aei OAE aecia/athoueny a ia?oo /a?ao ia?ea?aie ?ioi?oaoo eaaai?a, a?aeiia?aeieo 2 noaae?? NAOE. ?iaeaen  NAOE  19-27 aae?a. III noaae?y NAOE. 1. ?aaeeie OAE. OAE c iioeiaeueiei IOIA (10-15 ni aiae. no.). C iaiaaeaiiyi ?aae < 30-35 ii ?o. no. Ieneaaiioa?ai?y c FiO2-60%. 2. Iinoo?aeueia oa?ai?y. 3. ?ani??aoi?ia o?c?ioa?ai?y. Ia?iuo?oueny ca ?aooiie: o?aoaaeueieo ?inoeeyoe?e (caieiaeaiiy, ioeie?oeee, i?ioeiaa?yeia?, i?ioecaiaeuei?, i-oie?iie?oeee, aioea?ioeee), a?iioiaeueaaiey?iiai eaaaaeo ? naiaoe?eieo o?a?ia?iioineii?e. 4. E?ea?nueea oa?ai?y ia?iuo?oueny ca ?aooiie: - Neiiaoii?iaoe/ia i?aeo?eiea - aeiaooai?i 5-8 iea/ea/oa., aeiiai?i 0,5-3 iea/ea/oa. - Aaia?eiioa?ai?y - 10-20 oen.iae. /aeia. a/a. ?iaeaen NAOE 28-36 aae?a. IV noaae?y NAOE. ?ioaineaia oa?ai?y iie?i?aaiii? iaaeinoaoiino?. I?e/eiith eaoaeueiino? a ia?o?e a?oi? a aeaio aeiaaeeao aoei i?ia?anoaaiiy NAOE c ia?aoiaeii 2 a 3 noaae?th, a iio?i a 4 noaae?th neiae?iio. O iaeiiai iaoe??ioa eaoaeueiee e?iaoeue aoa iia'ycaiee c aino?ith iaaeinoaoi?noth e?iaiia?ao ia oe? ?ioa?eoo i?iea?aea. I?iaaaeaiiy cai?iiiiiaaii? caaaeyee oeaee oyaeeino? NAOE ?ioaineaii? oa?ai?? aeicaieeei cieceoe eaoaeuei?noue o oai?eo c 2 noaae??th NAOE c 32% aei 21%. ?aii?e ia?ao?ae ia OAE aeicaieea nei?ioeoe ?? o?eaae?noue c 96 aei 48 aiaeei. Eaoaeuei?noue o ae?oa?e a?oi? aoea iia'ycaia c iaiai?ioiei ia?aoiaeii 3 noaae?? NAOE a 4 noaae?th. Ie??i NAOE, i?ia?anoaaee ?io? eiiiiiaioe iie?i?aaiii? iaaeinoaoiino?, ui oaeiae aoee aaciina?aaeiueith i?e/eiith nia?o? oai?eo. Caaaeyee aeei?enoaiith aeeoa?aioe?eiaaiiai i?aeoiaeo aei aeai?o iaoiae?a ?ani??aoi?ii? oa?ai?? o?eaae?noue OAE nei?i/oaaeanue c 192 aei 144 aiaeei, a eaoaeuei?noue - c 56% aei 43%. Iaiao?aeii ua ?ac i?aee?aneeoe, ui NAOE ? e?eoe/iei oneeaaeiaiiyi iioe?aiiai ia?eoii?oo. Eiai iaiiaeeeai eoi??oaaoe, ia onoioaoe iniiaio i?e/eio, ui caionea? ? i?aeo?eio? iaoieia?/iee i?ioean o eaaaiyo. Oni?o e?eoaaiiy o aaeee?e i??? caeaaeeoue a?ae i?eieiaiiy iaaeoiaeaeaiiy a e?iaiia?a i?iaeoeo?a ?iciaaeo, i?e?ii?aai?ci?a ? ?o oienei?a. Ioaea, onoiaiiy iniiaiiai ao?ieia?/iiai /eiieea - ia?eoii?oo - ? aieiaiei eeth/ai oa?ai??. *an aeeeoo? oaeineiiaeaiiy ye ?ani??aoi?ii? oa?ai?? o iaoe??io?a c NAOE, oae ? aaiethoe?th niinia?a ioe?iee eiai oyaeeino?. Aeei?enoaiiy cai?iiiiiaaii? oeaee aeicaiey? ioe?ieoe eiai oyaee?noue c iiceoe?e iaoio?c?ieia??, c iaeyaeo ia cia/aiiy ii/aoeiai? eaiee iaoiaaiaco NAOE - noaio ?ioii?aaeoeaii? nenoaie, ui ? ye ioneiaei, oae ? i?aeo?eioth/ei iaoai?ciii. Aeaiee i?aeo?ae ? iiaei ??oaiiyi i?iaeaie ae?aaiinoeee NAOE. Cai?iiiiiaaia iaie oeaea aeicaiey? ae?aaiinooaaoe NAOE aei ii/aoeo iaiai?ioieo ii?ooaiue, iie?ioeoe ?acoeueoaoe e?eoaaiiy NAOE ? ? oaeoe/iith iniiaith a ae?aaiinoeoe? aeaiiai eiioeiaaioo oai?eo. AENIIAEE 1. I?ia?aeieie ii?ooaiiyie i?e neiae?ii? aino?iai ooeiaeaeaiiy eaaai?a o oai?eo ia iioe?aiee ia?eoii?o ? ?icaeoie ?ioiiiai aeeno?an-neiae?iio a noai? i?noeaaiai ?ioi?oaoo eaaai?a c iiaeaeueoei aeniaaeaiiyi ?ani??aoi?ii? ooieoe?? aeeoaeueii? nenoaie. I?e 2 noaae?? neiae?iio aino?iai ooeiaeaeaiiy eaaai?a i?noeaaee ?ioi?oao ciaoiaeeoueny a oac? ?ioiii? ?acenoaioiino? ia oe? ua eiiiainiaaii? ?ani??aoi?ii? ooieoe??. I?e 3 noaae?? neiae?iio a?aeaoaa?oueny aeaeiiiainaoe?y ?ani??aoi?ii? ooieoe?? aeeoaeueii? nenoaie c ?icaeoeii ooieoe?iiaeueii-iaoaaie?/ii? aeai?an?? ee?oeiii? oa aoii?aeueii? eaiie i?noeaaiai ?ioi?oaoo. 2. I?iaiinoe/ii cia/oueie ?ioiieie oa ?ani??aoi?ieie ia?ea?aie eaaaiaaiai ooeiaeaeaiiy i?e iioe?aiiio ia?eoii?o? ? eiioeaio?aoe?y nae?aoi?iiai ?ioiiaeiaoe?io A, aeeoo?caeaoieo aeueaaiey?ieo iae?ioaa?a, oaaioeeoa?ia /enei, ai?no iaeo?io?eueieo a?aioeioeeo?a, /anoioa aeeoaiue, ia?oe?aeueiee oene aoaeaeeneiai aaco a a?oa??aeuei?e e?ia?, ?iaeaen a?iien??, aaee/eia eaaaiaaiai ooioa oa aeueaaiei-a?oa??aeueia ??cieoey ca eeniai. 3. Oeaea oyaeeino? neiae?iio aino?iai ooeiaeaeaiiy eaaai?a, ui ?ic?iaeaia, aeicaiey? aecia/eoe noaae?th i?ioeano oa i?iaiic caoai?thaaiiy. I?e ?iaeaen? neiae?iio aino?iai ooeiaeaeaiiy eaaai?a 0 aae?a o?aaeaiiy eaaai?a a?aenooi?, i?iaiic ni?eyoeeaee; i?e ?iaeaen? 1-9 aae?a ae?aaiinoo?oueny ? noaae?y neiae?iio, eaoaeuei?noue aei 20%; ?iaeaeno 10 - 18 aae?a a?aeiia?aea? 2 noaae?y neiae?iio, eaoaeuei?noue 21%; o iaoe??io?a c 19 - 27 aaeaie niinoa??aa?oueny 3 noaae?y neiae?iio, eaoaeuei?noue neeaaea? 43%; i?e 27 - 36 aaeao ia? i?noea 4 noaae?y neiae?iio aino?iai ooeiaeaeaiiy eaaai?a, eaoaeuei?noue ia?aaeuo? 43%. 4. ?ioaineaia e?eoaaiiy iaoe??io?a c 2 noaae??th neiae?iio aino?iai ooeiaeaeaiiy eaaai?a ca?aeii ?iaeaeno eaaaiaaiai ooeiaeaeaiiy neeaaea?oueny c ?ani??aoi?ii? o?c?ioa?ai??, iaai?oioa?ai??, ?ani??aoi?ii? i?aeo?eiee niiioaiiiai aeeoaiiy, iie?auaiiy eaaaiaaiai e?iaiia?ao, aioeieneaeaioii? oa aioea?iienaioii? oa?ai??, iaoiae?a, ui ni?yiiaai? ia onoiaiiy eaaaiaai? a?ia?oaic?? oa ciaioaiiy iaa?yeo eaaai?a; oaeiae i?iaiaeyoueny caoiaee uiaei a?aeiiaeaiiy oaeoi??a i?noeaai? ?ioii?aaeoeaiino?. ?ioiia?aeiiaethth/a oa?ai?y i?iaiaeeoueny oeyoii aiaeio?aoaaeueiiai aaaaeaiiy ?ioiiaeiaoe?i?a. A oe?e noaae?? iiaeaeueoa i?ia?anoaaiiy ?ioiieo ?iceaae?a ? iieacaiiyi aei ii/aoeo i?iaaaeaiiy ooo/ii? aaioeeyoe?? eaaai?a. ?ioaineaia oa?ai?y iaoe??io?a c 3 noaae??th neiae?iio aino?iai ooeiaeaeaiiy eaaai?a iioe?th?oueny: i?iaiaeeoueny ooo/ia aaioeeyoe?y eaaai?a a ?aaeei? iiceoeaiiai oeneo a e?ioe? aeaeeoo, a?iio?aeuei? naiaoe??, neiiaoii?iaoe/ia i?aeo?eiea, aaia?eiioa?ai?y. 5. Eiiieaen ?ioaineaii? ?ani??aoi?ii? oa ?ioiiei?eaoth/i? oa?ai??, yeee cai?iiiiiaaii ca aeiiiiiaith oeaee neiae?iio aino?iai ooeiaeaeaiiy eaaai?a, aeicaieea cieceoe eaoaeuei?noue i?e 2 noaae?? neiae?iio c 32% aei 21%, i?e 3 noaae?? - c 56% aei 43%. A oe?eiio ca a?oiaie eaoaeuei?noue aoea cieaeaia ia 12%. O?eaae?noue ooo/ii? aaioeeyoe?? eaaai?a i?e 2 ? 3 noaae?yo aoea cieaeaia ia 48 aiaeei, ui iaei cia/iee aeiiii?/iee aoaeo. I?AEOE*I? ?AEIIAIAeAOe?? 1. C iaoith ae?aaiinoeee neiae?iio aino?iai ooeiaeaeaiiy eaaai?a i?e iioe?aiiio ia?eoii?o? iaiao?aeii aeei?enoiaoaaoe ia?ea?e i?noeaaiai ?ioi?oaoo oa ?ani??aoi?ii? ooieoe?? eaaai?a oa ?ioa?i?aooaaoe ii?ooaiiy i?e 2 noaae?? neiae?iio ye ?ioiiee aeeno?an-neiae?ii a noaae?? ?ioii?acenoaioiino? c eiiiainiaaieie ?ani??aoi?ieie ooieoe?yie eaaai?a, a i?e 3 noaae?? - ye ?ioiiee aeeno?an-neiae?ii a noaae?? ooieoe?iiaeueii-iaoaaie?/ii? ?ioiiaeai?an?? c aeaeiiiainaoe??th ?ani??aoi?ii? ooieoe?? eaaai?a. 2. Ae?aaiinoe/ieie e?eoa??yie neiae?iio aino?iai eaaaiaaiai ooeiaeaeaiiy o oai?eo c iioe?aiei ia?eoii?oii ? oae? iieacieee,ui oa?aeoa?ecothoue ?ioi?oao aeeoaeueii? nenoaie: eiioeaio?aoe?y a a?iio?aeueiiio ciea? nae?aoi?iiai ?ioiiaeiaoe?io A, aeueaaiey?ieo iae?ioaa?a ? iaeo?io?eueieo a?aioeioeeo?a, oaaioeeoa?ia /enei, a oaeiae ia?aiao?e ?ani??aoi?ii? ooieoe?? eaaai?a: /anoioa aeeoaiiy, iai?oaa aoaeaeeneioe a a?oa??aeuei?e e?ia?, ?iaeaen a?iien??, nooi?iue aioo??oiueieaaaiaaiai ooiooaaiiy oa aeueaaiei-a?oa??aeueia ??cieoey ca eeniai. 3. Aeey iii?oi?eiao noaae?? neiae?iio eaaaiaaiai ooeiaeaeaiiy oa aeeoa?aioe?eiaaiiai i?aeoiaeo aei aeai?o ianyao ?ioaineaiiai e?eoaaiiy ne?ae aeei?enoiaoaaoe oeaeo ?iaeaen?a oyaeeino? aeaiiai neiae?iio. I?e ?iaeaen? neiae?iio aino?iai eaaaiaaiai ooeiaeaeaiiy, ui aei??aith? 0 aae?a, o?aaeaiiy eaaai?a a?aenooi?, i?iaiic iiceoeaiee; i?e ?iaeaen? 1 - 9 aae?a ae?aaiinoo?oueny 1 noaae?y neiae?iio, eaoaeuei?noue aei 20%; ?iaeaeno 10 - 18 aae?a a?aeiia?aea? 2 noaae?y neiae?iio, eaoaeuei?noue 21%; o iaoe??io?a c 19 - 27 aaeaie niinoa??aa?oueny 3 noaae?y neiae?iio, eaoaeuei?noue neeaaea? 43%; i?e 27 - 36 aaeao ia? i?noea 4 noaae?y neiae?iio aino?iai ooeiaeaeaiiy eaaai?a, eaoaeuei?noue ia?aaeuo? 43%. 4. ?ioaineaia oa?ai?y iaoe??io?a c 2 noaae??th neiae?iio eaaaiaaiai ooeiaeaeaiiy iiaeiia aeeth/aoe e?ea?aeaoe?th ia?eoii?oo, ieneaaiioa?ai?th 40% eeniai, aa?icieueia aaaaeaiiy aoeaoeeoeenoa?io ii 250 ia o?e/? ia aeiao, e?eoaaeueio ia?eon?th, aaeooiiee ? a?a?aoe?eiee ianaae, canoinoaaiiy iaai?oiiai iiey iai?oaith 50 iOe oa /anoioith 50 Aoe ia i?aaie a?oaeii? ii?iaeieie. I?iaiaeeoueny niiioaiia aeeoaiiy c iiceoeaiei oeneii a e?ioe? aeaeeoo a iaaeao 6 - 8 ii aiae.no. I?e iia??oaii? ?ioiieo ii?ooaiue ne?ae ii/eiaoe ooo/io aaioeeyoe?th eaaai?a. I?noeaaa oa?ai?y aeeth/a? ?ioiiaeiaoe?i ethaeeie ii?iaeueiee, i?ioea?eiiciee, aioenoao?eieieiaee, ye? aaiaeyoue a o?aoaia?iio?aeueia aea?aai. Iioei?caoe?y aioo??oiueieaaaiaai? aaiiaeeiai?ee aeinyaa?oueny aeei?enoaiiyi i?o?iae?oea?eio 20 ia a 400 ie 5% ?ic/eio aetheice, o?aioaeo, eo?aio?eo 10 ie/aeia, oo?inai?aeo 0,5-0,7 ia/ea. 5. O oai?eo c 3 noaae??th neiae?iio eaaaiaaiai ooeiaeaeaiiy e?eoaaiiy ne?ae i?aeneethaaoe ca ?aooiie i?iaaaeaiiy ooo/ii? aaioeeyoe?? eaaai?a c iice-oeaiei oeneii o e?ioe? aeaeeoo a iaaeao 10 - 15 ii aiae.no. oa ?inooeyoe??th 60% eenith. I?e noaa?eueieo ia?aiao?ao aaiiaeeiai?ee iaea?eueo aea?aeia iieiaeaiiy oai?iai ia aeeaio?, ii?yae c aeuacacia/aieie i?aia?aoaie ne?ae i?iaiaeeoe ?inoeeyoe?? a o?aoath ioeie?oee?a, i-oie?iie?oee?a, aioeaaeoa-??aeueieo cania?a. ?ani??aoi?i? naiaoe?? aeeth/athoue e?eoaaeuei? o?a?ia?iioi-neii??, a?iio?aeueiee eaaaae. A?ia?aeeiai?/iee oei e?iaiia?ao caaacia/o?oueny aeei?enoaiiyi aeiaooai?io 5-8 iea/ea/oa, aeiiai?io 0,5-3 iea/ea/oa. Aaia?eiioa?ai?y ii 10-20 oen.iae./aeia aioo??oiueiaaiii. NIENIE ?IA?O, IIOAE?EIAAIEO CA OAIITH AeENA?OAOe?? 1. Oea/aaa I.TH. Oeeoieiaey neiae?iia ino?iai eaai/iiai iia?aaeaeaiey (NIEI) n o/aoii eiioiiuo ia?ooaiee a nenoaia ianoiiai eiioieoaoa.// Oe?a?inueeee iaaee/iee aeueiaiao.- 1998.- ?3.- N.132-135. 2. Oea/iaa I.TH. Iaoiaee ?ioaineaii? ?ani??aoi?ii? oa?ai?? iaoe??io?a c neiae?iiii aino?iai iioeiaeaeaiiy eaaaiue (NAIE).// Oe?a?inueeee iaaee/iee aeueiaiao.- 1998.- ?4.- N.117-119. 3. Oea/iaa I.TH. Neiae?ii aino?iai iioeiaeaeaiiy eaaaiue: oa?i?iieia?/i? oa ?noi?e/i? aniaeoe, ee?i?ea, e?eoa??? ae?aaiinoeee.// Oe?a?inueeee iaaee/iee aeueiaiao.- 1999.- O.2, ?1.- N.143-145. 4. Iiaeaaa A.A., Iaeuo E.?, Oea/aaa I.TH., Iaeaiei TH.E. Eiaeaen eiiaeie?iaaiiie o?aaiu eae e?eoa?ee noaiaea?oa eioaineaiie oa?aiee.// Iaoa?eaeu aeieeaaeia 5-ai Ana?inneeneiai Nuacaea aianoaceieiaia e ?aaieiaoieiaia.- Aanoiee eioaineaiie oa?aiee.- 1996.- O.1.- N.23. 5. Oea/aaa I.TH., Iaeaiei TH.E. Iiiaiia?iua eiaeaenu oyaeanoe ninoiyiey a yeno?aiaeueiie iaaeeoeeia.// Yeno?aiaeueiay iaaeeoeeia. Iaoa?eaeu I o/?aaeeoaeueiiai ieaioia. - Eoaaine.- 1997.- N.108-110. 6. Oea/aaa I.TH., Oaeiaieueae I.A. ?anie?aoi?iay oeaea e aa cia/aiea a ioeaiea oyaeanoe neiae?iia ino?iai iia?aaeaeaiey eaaeeo i?e yeno?aiaeueiuo ninoiyieyo.// Yeno?aiaeueiay iaaeeoeeia. Iaoa?eaeu I o/?aaeeoaeueiiai ieaioia.- Eoaaine.-1997.- N.110-111. 7. Oea/aaa I.TH. Iauaeoeaecaoeey ninoiyiey iino?aaeaaoeo a yeno?aiaeueiie iaaeeoeeia.// Iaoa?eaeu iao/ii-i?aeoe/aneie eiioa?aioeee, iinayuaiiie 10-eaoiaio thaeeath ?inoianeie-ia-Aeiio aieueieoeu nei?ie iaaeeoeeineie iiiiue ?2.- ?inoia-ia-Aeiio.-1997.- N.182-183. 8. Oea/aaa I.TH. ?anie?aoi?iay oeaea e aa cia/aiea a ioeaiea ia?ooaiee ieneaaie?othuae niiniaiinoe eaaeeo e ianoiiai eiioieoaoa o?aoaia?iioeaeueiiai aea?aaa o aieueiuo n ?ani?ino?aiaiiui ia?eoiie-oii.// Iaoa?eaeu iao/ii-i?aeoe/aneie eiioa?aioeee, iinayuaiiie 10-eaoiaio thaeeath ?inoianeie-ia-Aeiio aieueieoeu nei?ie iaaeeoeeineie iiiiue ?2.- ?inoia-ia-Aeiio.-1997.- N.183-184. 9. Oea/aaa I.TH. ?anie?aoi?iay oeaea e aa cia/aiea a ioeaiea oyaeanoe neiae?iia ino?iai eaai/iiai iia?aaeaeaiey o iaoeeaioia n ?ani?ino?aiaiiui ia?eoiieoii.// Yeno?aiaeueiay iaaeeoeeia. Iaoa?eaeu Iaaeiaeanoiie iao/ii-i?aeoe/. eiioa?aioeee.- Eoaaine.- 1998.- N.208-209. 10. Oea/aaa I.TH. Oeaeu ioeaiee oyaeanoe neiae?iia ino?iai eaai/iiai iia?aaeaeaiey.// Yeno?aiaeueiay iaaeeoeeia. Iaoa?eaeu Iaaeiaeanoiie iao/ii-i?aeoe/. eiioa?aioeee.- Eoaaine.- 1998.- N.210-211. 11. Iaeuo E.?., Oea/aaa I.TH. Iiiaiia?iay oeaea ioeaiee oyaeanoe neiae?iia ino?iai eaai/iiai iia?aaeaeaiey n o/aoii eiioiiuo ia?ooaiee i?e iieei?aaiiie iaaeinoaoi/iinoe.// Yeno?aiaeueiay iaaeeoeeia. Iaoa?eaeu Iaaeiaeanoiie iao/ii-i?aeoe/. eiioa?aioeee.- Eoaaine.- 1998.- N.69-82. 12. Oaeiaieueae I.A., Oea/aaa I.TH., *a?iyaneee E.N. I?eiaiaiea ?iieieaeeeia i?e ?ani?ino?aiaiiii ia?eoiieoa.// Yeno?aiaeueiay iaaeeoeeia. Iaoa?eaeu Iaaeiaeanoiie iao/ii-i?aeoe/. eiioa?aioeee.- Eoaaine.- 1998.- N.218-219. AIIOAOe?ss Oea/iaa I.TH. Oeaea neiae?iio aino?iai ooeiaeaeaiiy eaaai?a o aecia/aii? aeeoa?aioe?eiaaii? ?ani??aoi?ii? ? ?ioiiei?eaoth/i? oa?ai?? o oai?eo ia iioe?aiee ia?eoii?o.– ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.30 - aianoac?ieia?y oa ?ioaineaia oa?ai?y.- Aei?i?iiao?ianueea aea?aeaaia iaaee/ia aeaaeai?y, Aei?i?iiao?ianuee, 1999. Aeena?oaoe?y i?enay/aia ?ic?iaoe? oeaee ioe?iee oyaeeino? neiae?iio aino?iai ooeiaeaeaiiy eaaai?a, yeee oneeaaeiea ia?aa?a iioe?aiiai ia?eoii?oo. Anoaiiaeaii, ui ii?ooaiiy ?ioi?oaoo aeeoaeueii? nenoaie ? iaea?eueo ?aii?i ? i?ia?aeiei iaoiaaiaoe/iei iaoai?ciii ?icaeoeo NAOE. Aeae?eai? i?iaiinoe/ii cia/ou? ia?ea?e NAOE, iaea?eueo oe?iieie c yeeo ? iieacieee i?noeaaiai ?ioi?oaoo eaaai?a. ?ic?iaeaia oeaea neiae?iio aino?iai ooeiaeaeaiiy eaaai?a, yea aeicaiey? aecia/eoe noaae?th neiae?iio, i?iaiicoaaoe e?iaoeue oai?iae ? aeeoa?aioe?eiaaii i?aeoiaeeoe aei aeai?o iaoiae?a ?ioaineaii? ?ani??aoi?ii? oa?ai??. Eeth/ia? neiaa: oeaea ioe?iee oyaeeino?, neiae?ii aino?iai ooeiaeaeaiiy eaaai?a, ?ioiiee aeeno?an-neiae?ii. AIIIOAOeEss Oea/aaa I.TH. Oeaea neiae?iia ino?iai iia?aaeaeaiey eaaeeo a ii?aaeaeaiee aeeooa?aioee?iaaiiie ?anie?aoi?iie e eiioiiei??eae-?othuae oa?aiee o iaoeeaioia n ?ani?ino?aiaiiui ia?eoiieoii.– ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.30 - aianoaceieiaey e eioaineaiay oa?aiey.- Aeiai?iiao?ianeay ainoaea?noaaiiay iaaeeoeeineay aeaaeaiey, Aeiai?iiao?iane, 1999. Enneaaeiaaiea i?iaaaeaii o 63 iaoeeaioia n ?ani?ino?aiaiiui ia?eoiieoii, ia oiia eioi?iai ?acaeeny neiae?ii ino?iai iia?aaeaeaiey eaaeeo (NIIE). N oeaeueth ioeaiee oyaeanoe ninoiyiey iaoeeaioia i?e iinooieaiee a eeeieeo e ii?aaeaeaiey oyaeanoe iieei?aaiiuo ia?ooaiee, eniieueciaaeenue ioeaii/iua oeaeu: APACHE-II e oyaeanoe neiae?iia iieei?aaiiie iaaeinoaoi/iinoe (NIII). A 40 iaaethaeaieyo - o eiioeiaaioa n yaeaieyie NIII, auiieiaii oaeoaeaiiia eco/aiea ?anie?aoi?iie ooieoeee e eiioieoaoa eaaeeo. A i?ioeanna enneaaeiaaiey auee ii?aaeaeaiu iniiaiua ia?ea?u NIIE. Iie noaee iniiaie aeey ?ac?aaioaiiie iaie oeaeu oyaeanoe eaai/iiai iia?aaeaeaiey. ?ac?aaioea oeaeu i?iaiaeeeanue iooai eniieueciaaiey iaoiaeieiaee nenoaiiiai aiaeeca. Aeaiiue i?eioeei iiae?acoiaaae ?anniio?aiea iaoieiae/aneiai i?ioeanna n iiiaiia?iuo iiceoeee. Iieacaoaee, eioi?ua i?aaeiieaaaeinue aeeth/eoue a oeaeo, aeieaeiu auee ianoe eioi?iaoeeth eae i ii?oieiae/aneeo eciaiaieyo, oae e i ooieoeeiiaeueiuo ia?ooaieyo i?e NIIE. I?e yoii ioeaieaaeanue eioi?iaoeaiay cia/eiinoue eaaeaeiai ec ieo iooai i?iaaaeaiey niioaaonoaaiiiai aeenia?neiiiiai e ei??aeyoeeiiiiai aiaeeca. Ana iieo/aiiua ?acoeueoaou i?ioiaeeee eiiieaen noaoenoe/aneie ia?aaioee ii i?eaeiaeueiie i?ia?aiia "BIOMETRY". Caeeth/eoaeueiue yoai ?ac?aaioee iiiaiia?iie oeaeu - i?eaaaeaiea anao eniieuecoaiuo a iae iieacaoaeae e aaeeiie oeaea ioiioaiee ii iaoiaeeea ia?aaiaea a aeanyoeaaeeueioth oeaeo noaiia. Auaeaeaiiua aeaaiaea?y oeaeai APACHE-II e NIII, a caoai iauaaeeiaiiua ii oyaeanoe NIIE, iaoeeaiou aioee a aeaa enneaaeoaiua a?oiiu. A ia?aoth a?oiio - 19 (47,50%) eeoe n ioeaieie ii oeaea APACHE-II, ia i?aauoathuae 16 aaeeia, e ii oeaea oyaeanoe NIII ia aieueoa 12 aaeeia. I?e ioeaiea ii oeaea oyaeanoe NIIE eiaeaen NIIE iaoiaeeeny a i?aaeaeao 10-18 aaeeia, /oi niioaaonoaiaaei 2 noaaeee NIIE. Ai aoi?oth a?oiio aioae 21 (52,50%) iaoeeaio. Oyaeanoue ninoiyiey ii oeaea APACHE-II ioeaieaaeanue a n?aaeiai 26 aaeeaie, a ii oeaea oyaeanoe NIII a n?aaeiai 16 aaeeia. Eiaeaen NIIE i?e iinooieaiee a noaoeeiia? ninoaaee 19-27 aaeeia, /oi niioaaonoaiaaei 3 noaaeee NIIE. Eaoaeueiinoue a ia?aie a?oiia iaoeeaioia ninoaaeea 21%, ai aoi?ie - 43%. Iia auea naycaia n iaia?aoeiui ia?aoiaeii 3 noaaeee NIIE a 4 noaaeeth e i?eniaaeeiaieai ae?oaeo eiiiiiaioia NIII, ooyaeaeythueo oa/aiea NIIE e ia?aaeei yaeythueony iaiin?aaenoaaiiie i?e/eiie nia?oe. Iieo/aiiua oeeo?u eaoaeueiinoe niaiaaeaee n i?iaiice?oaiuie ii oeaeai oyaeanoe NIII e APACHE-II. Eiaiii 2 e 3 noaaeee NIIE yaeythony eneeth/eoaeueii aaaeiuie ia?eiaeaie. Ia ia?ana/aiee yoeo yoaiia aua aiciiaeii iiaa?iooue aniyoue i?ia?anne?othuee NIIE. A yoi a?aiy ?aoathony aii?inu auai?a aeeooa?aioee?iaaiiuo iaoiaeia eioaineaiie ?anie?aoi?iie oa?aiee n ia?aoiaeii ia aieaa eiaaceaiua iaoiaeeee. ?acoeueoaou enneaaeiaaiey iicaieeee caeeth/eoue, /oi ia?ooaiey eiioieoaoa aeuoaoaeueiie nenoaiu yaeythony ?aiiei e aaaeouei iaoaieciii ?acaeoey NIIE. Ai 2 noaaeee NIIE, ia oiia eiiiaine?iaaiiie ?anie?aoi?iie ooieoeee, eiioieoao aeuoaoaeueiie nenoaiu iaoiaeeony a oaca eiioiiie ?acenoaioiinoe. I?e i?ia?anne?iaaiee NIIE a 3 noaaeee ooieoeeiiaeueii-iaoaaiee/aneay eiioiiaeai?anney ni/aoaaony n aeaeiiiainaoeeae ?anie?aoi?iie ooieoeee eaaeeo. Iaeaieaa oeaiiua e i?iaiinoe/anee cia/eiua e?eoa?ee oyaeanoe NIIE - ia?ea?u, noaee iniiaie aeey oeaeu oyaeanoe NIIE. Eniieueciaaiea eiaeaena NIIE iicaieyao aeeooa?aioee?iaaiii iiaeoiaeeoue e auai?o oaeoeee eioaineaiie ?anie?aoi?iie oa?aiee, a eiaiii ia/eiaoue i?iaaaeaiea EAE a eiioea 2 noaaeee NIIE, i?eaioe?oynue a ia?aoth i/a?aaeue ia naiue oiieee eiaeeeaoi? - eiioieoao eaaeeo. Oeaea iicaieyao ii?aaeaeeoue aeai?eoi ianoiie eiioiiei??eae?othuae oa?aiee, aaeaeaaoii eniieueciaaoue iaoiaaiaoe/anee iainiiaaiioth eaea?noaaiioth oa?aieth. E?iia aeeaaiinoe/aneie e oaeoe/aneie oeaiiinoe a ieaia auai?a iauaiia eioaineaiie oa?aiee oeaea oyaeanoe NIIE eiaao ii?aaeaeaiiia i?iaiinoe/aneia cia/aiea. Eeth/aaua neiaa: oeaea ioeaiee oyaeanoe, neiae?ii ino?iai iia?aaeaeaiey eaaeeo, eiioiiue aeeno?ann-neiae?ii. ANNOTATION Tkacheva M.Yu. The scale of the acute lung injury syndrome in determination of differential respiratory and immunocorrective care in patients with diffuse peritonitis.- Manuscript. Dissertation for degree of candidate of medical sciences in speciality 14.01.30 - anesthesiology and intensive care.- Dnepropetrovsk State Medical Academy, Dnepropetrovsk, 1999. Dissertation is devoted to the elaboration of the scoring system of syndrome of acute lung injury as complication of diffuse peritonitis. It was established that disturbances in immunity of respiratory system are most important and leading pathogenetic mechanisms in SALI development. Markers of SALI with prognostic properties were obtained; parameters of local immunity of lungs are most valuable among them. The scale of syndrome of acute lung injury was elaborated. This scale allows to determine the stage of syndrome and outcome prognosis and make possible the differential approach to identification of methods of intensive respiratory care. Key words: scoring system, syndrome of acute lung injury, immune distress-syndrome. Aaoi? aeneiaeth? ue?o aaey/i?noue aeieoi?o iaaee/ieo iaoe, i?ioani?o Ieaenaiae?o Aeieo?iae/o A?ey?anueeiio ca iaoiaee/io aeiiiiiao, oe?ii? ii?aaee oa caoaaaeaiiy uiaei ci?noo ?iaioe.

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