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Венозна церебральна патологія у гострому періоді легкої закритої черепно-мозкової травми та шляхи її корекції: Автореф. дис… канд. мед. наук / М.М.

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Oa?e?anueeee ?inoeooo oaeineiiaeaiiy e?ea??a

AA?OeAA Ieeiea Ieeieaeiae/

OAeE 616.831 – 001.34 – 005.3 – 08

AAIICIA OeA?AA?AEUeIA IAOIEIA?ss O AINO?IIO IA??IAe? EAAEI? CAE?EOI?
*A?AIII-IICEIAI? O?AAIE OA OEssOE ?? EI?AEOe??

14.01.15. – ia?aia? oai?iae

Aaoi?aoa?ao

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Oa?e?a – 1999

2

Aeena?oaoei?th ? ?oeiien

?iaioa aeeiiaia a Iaeanueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoaoi

Iaoeiaee ea??aiee:Caneoaeaiee i?aoe?aiee Aeui? oeiee Oe?a?ie, aeieoi?
iaaee/ieo iaoe, i?ioani?

EO?AEI TH??e Eueaiae/ – caaiaeoaa/ eaoaae?e ia?aiaeo oai?ia Iaeanueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo

Io?oe?ei? iiiiaioe:

*eai-ei?aniiiaeaio AII Oe?a?ie, aeieoi?

iaaee/ieo iaoe, i?ioani?

IAAeA*AIEI ?aaai Aai?a?eiae/ – ea??aiee a?aeae?eo iae?io?aaiaoieia??
?inoeoooo iae?io??o?a?? AII Oe?a?ie, Aieiaiee iae?io??o?a IIC Oe?a?ie

Aeieoi? iaaee/ieo iaoe, i?ioani? AeAIAIEI Aaneeue Aeieo?iae/ –
caaiaeoaa/ eaoaae?e caaaeueii? oa aeeoy/i? iaa?ieia??

Oa?e?anueeiai ?inoeoooo oaeineiiaeaiiy e?ea??a

I?ia?aeia onoaiiaa:

Ee?anueea iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe IIC Oe?a?ie ?i.
I.E.Ooieea

Caoeno a?aeaoaeaoueny “ 30 ” aa?aciy 1999 ?. i 10 aiaeei? ia can?aeaii?
Niaoe?ae?ciaaii? a/aii? ?aaee Ae. 64.609.01 i?e Oa?e?anueeiio ?inoeooo?
oaeineiiaeaiiy e?ea??a IIC Oe?a?ie ca aae?anith:

310176, i. Oa?e?a, aoe. Ei?/aa?ioe?a, 58.

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Oa?e?anueeiai
?inoeoooo oaeineiiaeaiiy e?ea??a ca aae?anith:

310176, i. Oa?e?a, aoe. Ei?/aa?ioe?a, 58.

Aaoi?aoa?ao ?icineaiee “25 ” ethoiai 1999 ?

A/aiee nae?aoa? Niaoe?ae?ciaaii?

a/aiii ?aaee, aeieoi? iaaee/ieo iaoe A?eai?iaa ?.A.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie

C?inoaiiy /a?aiii-iiceiaiai o?aaiaoecio aiaeii/a?oueny a onio e?a?iao
naioo. Uiaei aeaieo Ananaioiuei? i?aaiicaoei? ioi?iie caei?ia`y, ca
inoaiii 10 -15 ?ieia /a?aiii-iiceiaa o?aaia caieueoo?oueny o
na?aaeiueiio ia 2% o ?ie. O no?oeoo?i o?aaiaoecio iioeiaeaeaiiy
aieiaiiai iiceo noaiiaeyoue 25-30%. A Oe?a?ii /anoioa /a?aiii-iiceiai?
o?aaie aei??aith? 4 – 4,2 aeiaaee?a ia 1000 in?a ianaeaiiy ui?i/ii
(Iaaea/aiei A.A., Ii?icia A.I., 1993).

Eaaea cae?eoa /a?aiii-iiceiaa o?aaia ? iaeiei c iaea?eueo iioe?aieo
iioeiaeaeaiue aieiaiiai iiceo, noaiiaey/eo 74%-83% an?o iae?io?aai
(TH.A.Iaoi/ei, A.I.Aonaa, 1970; I.A.Caiieia, E.A.Eeooa?iai,
A.I.Oienoiiyoia, 1975), i?ae yea i?aeiaaeathoue ia?aaaaeii ethaee
iieiaeiai oa iaea?eueo i?aoeacaeaoiiai a?eo.

Niinoa??aa?oueny oaiaeaioe?y aei iiaeaeueoiai c?inoaiiy iae?io?aaie ye
ca /anoioith, oae ? ca ?? aaaee?noth (A.I.?iiiaeaiia, I.I.Iinee/oe,
1990; A.A.ss?oeaa e niaao. 1991; A.A.Iaaea/aiei, 1993; Butterworth
J.F., Dewit D.S., 1989). Aaeeeee a?aenioie iai?aoeacaeaoiino? ye o
aino?iio, oae ? o a?aeaeaeaiiio ia??iaeao, no?ee? iane?aeee, ui
niinoa??aathoueny o 50% oai?eo (TH.E.Eo?aei, 1984; A.A.Iaaea/aiei,1984;
A.I.?iiiaeaiia, 1986), noaiiaeyoue i?iaeaio e?eoaaiiy /a?aiii-iiceiai?
o?aaie o ?yae iniaeeai aeooaeueieo.

O ?acoeueoaoi eiiieaeno ooiaeaiaioaeueiuo oa i?eeeaaeieo aeineiaeaeaiue
iiaeoaa?aeaeaii i?ia?anoth/ee oa?aeoa? ciii, aeieeath/eo o aino?iio
ia?iiaei o?aaie oa aecia/ath/eo ?icaeoie aiaeaeaeaieo ianeiaeeia.
Aeiaaaeaii, ui oai?i c “eaaeith” /a?aiii-iiceiaith o?aaiith iiaeiii
?icaeyaeaoeny, ye iino?aaeaeaei c ia?inoath/eie iaoaaiei/ieie
ii?ooaiiyie, ii?iaeicaoeiy yeeo niinoa-?iaa?oueny oieueee a iaeii??
o?aoeie iino?aaeaeaeeo (Iaaea/aiei A.A. e niaao., 1996).

Oa?ai?y o aino?iio ia??iae? o?aaiaoe/iii oai?iae aieiaiiai iiceo –
aeoaea a?aeiia?aeaeueia caaaeaiiy, ine?eueee iaeaaaeeea?oith ?? iaoith ?
i?io?eaeoeea ?icaeoeo o iiaeaeueoiio ??cieo iaa?ieiai/ieo neiae?ii?a
iinoo?aaiaoe/ii? aioeaoaeiiao??.

Oyaey?oueny iaea?eueo ?aoe?iiaeueiei e?eoaaiiy, ni?yiiaaia ia
eiiiainaoe?th iniiaiiai ee?i?/iiai neiae?iio – ei?aeoe?th iiceiaiai oa
nenoaiiiai e?iaiia?ao, iaoieia?/ieo ?aaeoe?e noiaao?iaeo oa
aeiaioeaoaeueieo a?aeae?e?a aieiaiiai iiceo, onoiaiiy no?aniaeo
?aaeoe?e.

?yae aeine?aeaeaiue na?ae/eoue i?i ia?aaaaeia cia/aiiy oea?aa?aeueieo
noaeeiieo ii?ooaiue o iaoiaaiac? o?aaiaoe/ii? oai?iae aieiaiiai iiceo
(A.?.Oa?aiia, 1962; TH.E.Eo?aei, 1969, 1971; ?.A.Aeoaaiei, 1973;
A.E.Oaeoee?i, 1981; I.A.Aieioei, 1984, 1993; TH.E.Eo?aei, A.A.Aoe?ia,
1989; A.Ae.Aeaiaiei, 1990; oa ?i.). I?e oeueiio i?aee?aneth?oueny ?ieue
aeenoiii? aai iiceo o ?icaeoeo eieai?iaiia?oaicieiiai neiae?iio o
oi?ioaaii? iiaoi?ieo noaeeiii-aeenoee?eoeyoi?ieo ?iceaae?a.

Aecia/aii i?aeaeuaiiy iio?ae?aiiaeueiiai aaiiciiai oeneo,
iie?ioee?eoeyoi?ii ii?ooaiiy, ca?eueoaiiy ii?iciinoe iiceiaeo noaeei,
ei?aethth/? c aaaeeinoth /a?aiii-iiceiai? o?aaie.

A?aeiiaeaiiy ii?iaeueii? no?oeoo?e oa ooieoe?? aaiicieo noaeei aieiaiiai
iiceo, ia a?aei?io a?ae a?oa??aeueieo, niinoa??aaeinue o?eueee i?ci?oa
ca aeae?eueea i?nyoe?a i?ney o?aaie.

Cai?iiiiiaai? oai??? iaoiaaiaco, ui iia’ycothoue aeyaeai? ci?iaiiy c
iae?i?aoeaeoi?ieie oa iae?iaoii?aeueieie iaoai?ciaie (TH.E.Eo?aei, 1969,
1971; A.I.Iai/aiei, 1973; O.E.Oaaeaaeiaa, 1975; A.E.Oa?aoiaa, 1982;
E.I.Aeaeeia, 1986; TH.E.Eo?aei, A.A.Aoeeia, 1989; A.I.?iiiaeaiia, 1991;
Oppenheimer, 1968; oa ?i.).

Iaeiei c iniiaieo iai?yieia o iaoiaaiaoe/iiio e?eoaaii? o?aaiaoe/iiai
iioeiaeaeaiiy aieiaiiai iiceo a?eueo?noue aaoi??a aaaaeathoue ei?aeoe?th
iiceiaiai e?iaioaiao, cie?aia – aaiicii? oea?aa?aeueiii aeecaaii?.
Iienaii canoinoaaiiy iaaeeeaiaioicieo i?aia?ao?a aaiioiii/ii? ae??,
o?ce/ieo oaeoi??a (iaai?oioa?ai?y, AeIO-oa?ai?y, aeaeo?inii,
?aoeaeoi?ii-iaaeeeaiaioicia oa ?aoeaenioa?ai?y – I.A.Aeaenaiae?ia, 1978;
A.E.Yieiy, 1979; A.O.Oniaiiaa, 1985; C.C.Iniiiaaeiaa, 1986; E.I.Aeaeeia,
1986; A.Ae.Aeaiaiei, 1990; J.Waisbort, 1980; R.Mrowka, 1984;
J.M.Minderhoud, M.E.M. Boelens, 1989; oa ?i.).

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie

?iaioa ? o?aaiaioii iaoeiai? i?ia?aie eaoaae?e ia?aiaeo oai?ia
Iaeanueeiai aea?aeaaiiai iaaee/iiai oiiaa?neoaoo “No/anii aniaeoe
iaoiaaiaco eaaei? cae?eoi? /a?aiii-iiceiai? o?aaie”.

Iaoa aeine?aeaeaiiy

Aea/aiiy noaio oea?aa?aeueiiai aaiiciiai e?iaiia?ao o aino?iio ia??iae?
eaaei? cae?eoi? /a?aiii-iiceiai? o?aaie, ia iiaenoaai /iai – ?ic?iaea
iiaiai e?eoaaeueii-i?io?eaeoe/iiai eiiieaeno aeey ei?aeoe??
iinoo?aaiaoe/ii? oea?aa?aeueii? aaiicii? aeecaaii?.

Iniiai? caaaeaiiy aeine?aeaeaiiy

1. Aea/eoe noai aaiiciiai e?iaiia?ao o aino?iio ia??iae? eaaei? cae?eoi?
/a?aiii-iiceiai? o?aaie oa aeyaeoe cia/aiiy eiai ii?ooaiue o iaoiaaiac?
?icaeoeo oneeaaeiaiue o?aaiaoe/iii oai?iae aieiaiiai iiceo.

2. ?ic?iaeoe niin?a e?eoaaiiy eaaei? cae?eoi? /a?aiii-iiceiai? o?aaie,
ui aeeth/a? aea?iaoiia?aiiaiee (aioo?ioiueioeaieiiee) aeaeo?ioi?ac
i?aia?ao?a aaiioiii/ii? ae??.

3. Ii??aiyoe aoaeoeai?noue e?eoaaiiy cai?iiiiiaaiei niiniaii c oaeei o
a?oi? oai?eo, ui iaea?aeaee “o?aaeeoe?eio” oa?ai?th.

4. Oi?iaaaeeoe cai?iiiiiaaiee niin?a o i?aeoeeo
e?eoaaeueii-i?io?eaeoe/ieo oa iaa/aeueieo onoaiia.

Iaoeiaa iiaecia ?iaioe

1. Aeeiiaii eiiieaenia ee?i?/ia aeine?aeaeaiiy noa’?eoeaiiai oa
ia’?eoeaiiai noaoono oai?eo o aino?iio ia??iae? eaaei? cae?eoi?
/a?aiii-iiceiai? o?aaie c canoinoaaiiyi ee?i?/ieo, iae?io?c?ieia?/ieo,
eaai?aoi?ieo, no/anieo ?aioaaii?aaeiieiai/ieo, iooaeueiieiai/ieo oano?a.

2. Iaea?aeai? iiai aeai? i?i ooieoe?iiaeueiee noai aaiicii? nenoaie
aieiaiiai iiceo o aino?iio ia??iae? eaaei? cae?eoi? /a?aiii-iiceiai?
o?aaie, aea/aia aeeiai?ea iaoieia?/iiai i?ioeano.

3. Ia iiaenoaai eiiieaeniiai ianoaaeaiiy aeiaaaeaia ?noioia ?ieue
oea?aa?aeueii? aaiicii? aeecaaii? o iaoiaaiac? eaaei? cae?eoi?
/a?aiii-iiceiai? o?aaie.

4. Aia?oa canoiniaaii oe?eani?yiiaaiee aieea ia aaiicio nenoaio
aieiaiiai iiceo o aino?iio ia??iae? eaaei? cae?eoi? /a?aiii-iiceiai?
o?aaie ?ic?iaeaiei e?eoaaeueiei eiiieaenii.

5. Aea/ai? aaciina?aaei? oa a?aeaeaeai? ianeiaeee e?eoaaiiy
cai?iiiiiaaiei niiniaii, i?aeoaa?aeaeoth/i eiai oa?aiaaoe/iee aoaeo.

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

Ia iniia? i?iaaaeaieo aeine?aeaeaiue, aeia?aoeo inoioia cia/aiiy
iinoo?aaiaoe/ii? oea?aa?aeueii? aaiicii? aeecaaii? o iaoiaaiac? eaaei?
cae?eoi? /a?aiii-iiceiai? o?aaie, ?ic?iaeaiee ? canoiniaaiee niin?a
ei?aeoe?? aeecaaii/ieo ii?ooaiue, ui aeicaiey? aeinyaoe a?eueo no?eei?
oa cia/ii? eiiiainaoe?? o iino?aaeaeaeeo, nei?ioeoe no?iee oei/aniai?
iai?aoeacaeaoiino?, aeinyaoe iaioi? eieueeino? oneeaaeiaiue o
a?aeaeaeaiiio ia??iae?.

Canoinoaaiiy o aino?iio ia??iae? eaaei? cae?eoi? /a?aiii-iiceiai? o?aaie
e?eoaaeueiiai eiiieaeno i?aia?ao?a aaiioaiceaii? ae??, ui aeeth/a?
aioo?ioiueiaaiia aaaaeaiiy eaaiioiio, o?ienaaaceio, neaaciio,
anei?aiiiai? eineioe, a?oai?i?a a?oie “A” c iiaeaeueoith
aiaeiiacaeueii-iioeee/iith aaeueaaiicaoei?th aoaeoeaii aieeaa? ia
iniiai? eaioethae iaoiaaiaco o?aaiaoe/ii? oai?iae aieiaiiai iiceo,
i?eaiaeeoue aei a?eueo oaeaeeiai aeinyaiaiiy noaio ee?i?/ii?
eiiiainaoe??.

A?aoiaoth/e aaaeeeaa cia/aiiy oea?aa?aeueii? aaiicii? aeecaaii?,
iaiao?aeiino? ?iaeea?aeoaeueii? ioe?iee ?? nooiiiy, aeey iioei?caoe??
oa?ai?? ?aeiiaiaeo?oueny caaaeueiii?eeiyoee ianya ee?i?/iiai ianoaaeaiiy
aeiiiaieoe oaeeie caaaeueiiaeinooiieie iaoiaeeeaie, ye
?aiaioeaoaeia?aoiy oa aiiiie?ineiiiy aoeueaa?ii? eii’thieoeae.

?ic?iaeaiee iaoiae e?eoaaiiy ?aeiiaiaeo?oueny canoiniaoaaoe o
iaa?ieiai/ieo, iae?io??o?a?/ieo noaoe?iia?ao.

Iniaenoee aianie caeiaoaa/a

Aaoi? naiino?eii aeeiiaa iiaiee ianya ?iaioe c e?oa?aoo?ith oa i?ia?a
iaoaioii-?ioi?iaoe?eiee iiooe o iaoeiaeo oa iaoeiai-iaaee/ieo
a?ae?ioaeao Ee?aa, Iaeane, Iineae.

A?ae?a?aa oa ianoaaeea 125 oai?eo o aino?iio ia??iae? eaaei? cae?eoi?
/a?aiii-iiceiai? o?aaie ?c canoinoaaiiyi na??? aaeaeaaoieo
ae?aaiinoe/ieo caoiae?a, ia?iaea oa i?iaiae?coaaa ?o ?acoeueoaoe.

?ic?iaea iiaee e?eoaaeueii-i?io?eaeoe/iee eiiieaen aeey ei?aeoe??
iinoo?aaiaoe/ii? oea?aa?aeueii? aaiicii? aeecaaii?.

Ia iniia? ii??aiyeueii? oa?aeoa?enoeee ?acoeueoao?a e?eoaaiiy o iniiaiie
oa eiio?ieueiie a?oiao iaa?oiooaaa iaiao?aei?noue i?iaaaeaiiy oa?ai??
eiiieaenii aaiioaiceaieo cania?a, o oiio /ene? iaoiaeii ?o
aioo??oiueioeaieiiiai aeaeo?ioi?aco. Oeeaa oa a?ae?aaeaaoaaa oaenoiao e
?ethno?aoeaio /anoeie aeena?oaoe?? oa aaoi?aoa?aoo.

Ai?iaaaeaeaiiy a i?aeoeeo

Iaoa??aee aeena?oaoe?? oi?iaaaeaeai? a i?aeoeeo ?iaioe ee?i?ee eaoaae?e
ia?aiaeo oai?ia IAeIO, ia aac? IIIAe i. Iaeane, iaa?ieiai/iiai
a?aeae?eaiiy Iaeanii? ee?i?/ii? e?ea?i?, a?aeae?eaiiy iae?io??o?a?? IEE
?11 i. Iaeane; a iaa/aeueiee i?ioean ia oaeoeueoao? i?neyaeeieiiii?
i?aeaioiaee IAeIO, ia?aaeaoanoaoe?eieo eo?nao e?ea??a-iaa?iiaoieiaia
Iaeanueei? oa Ieeiea?anueei? iaeanoae Oe?a?ie.

Iioaeieiaaii iioi?iaoeieiee eeno, iieaaooth/ee ai?iaaaeaeaiiy iane?aee?a
?iaioe a iaaee/ieo caeeaaeao.

Ai?iaaoe?y ?iaioe

?acoeueoaoe i?iaaaeaieo aeine?aeaeaiue aeieeaaeaii ia I oa II C’?caeao
iae?io??o?a?a Oe?a?ie (1993, 1998), can?aeaiiyo eaoaae? ia?aiaeo oai?ia
(1995, 1998), aianoaciieiai?, ?aaiiiaoieiai? oa iae?io??o?a?? IAeIO
(1996), Iaeanueeiio iaeaniiio oiaa?enoa? iaa?iiaoieiaia oa ineo?ao??a
(1997, 1998), Iaeanueeiio iaoeiaiio oiaa?enoa? iae?io??o?a?a (1995,
1997), Aei? ineoiiaa?ieiaa (1997, 1998), I?aenoieia?e iaoeia?e
eiioa?aioe?? iieiaeeo a/aieo (1991), iaoeiai-i?aeoe/ieo eiioa?aioe?yo
i?enay/aieo 100-?i//th c aeiy ia?iaeaeaiiy Caneoaeaiiai ae?y/a iaoee
i?ioani?a A.I.Oa?aiiaa (Eeoeiaa, 1997), 200-?i//th Iaeanueeiai
ie?oaeiiai a?enueeiaiai aini?oaey (1997), caaaeueiie?ea?iyi?e
iaoeiai-i?aeoe/i?e eiioa?aioe?? (1995), noi?nieo can?aeaiiyo
iae?io??o?a?/ieo a?aeae?eaiue IEE ?11 i.Iaeane, i?ae?aa?iiaeueieo
iaoeiai-i?aeoe/ieo eiioa?aioe?yo iaa?iiaoieia?a oa ineo?ao??a (Oa?nii,
1997; ?cia?e, 1998).

Ioaeieaoei? iaoa?iaeia ioeiaeo aeineiaeaeaiue

Ca oaiith aeena?oaoei? iioaeieiaaii 15 iaoeiaeo ?iaio, c ieo – 3 noaoo?
o oaoiaeo aeo?iaeao (1 – naiino?eia).

Iaea?aeai Iaoaio ia aeiao?ae ?97115515 a?ae a?ae 8.07.98.

Aeaeaii oa ?icineaii a on? ?aa?iie Oe?a?ie ?ioi?iaoe?eiee eeno (? 83 –
1997).

No?oeoo?a oa ianya aeenna?oaoeieii? ?iaioe

Aeena?oaoe?y neeaaea?oueny c anooio, 4 ?icae?e?a, aeniiaeia, nieneo
aeei?enoaieo aeaea?ae, ui i?noeoue 405 ?ia?o (321 – aaoi??a e?a?i NIAe,
84 – iiicaiieo) Caaaeueiee ianya ?iaioe noaiiaeoue 169 noi??iie
iaoeiiieno. Oaeno ?ethno?iaaiee 20 oaaeeoeyie, ye? caeiathoue 19
noi??iie oa 6 iaethieaie ia 6 noi??ieao.

INIIAIEE CI?NO ?IAIOE

Ia’?eo oa iaoiaee aeine?aeaeaiiy

Aea/aii iniaeeaino? aaiiciiai oea?aa?aeueiiai e?iaiia?ao o 125 oai?eo o
aino?iio ia??iae? eaaei? cae?eoi? /a?aiii-iiceiai? o?aaie. A?aoiaoth/e
iaiao?aei?noue i?iaaaeaiiy ii??aiyeueii? oa?aeoa?enoeee ?acoeueoao?a
e?eoaaiiy oai?eo “o?aaeeoe?eiei” iaoiaeii oa cai?iiiiiaaiei niiniaii,
na?aae ianoaaeaiiai eiioeiaaioo aeae?eai? iniiaia (75 oai?eo) oa
eiio?ieueia (50 oai?eo) a?oie, iaeii??aei? ca noaooth, a?eii oa
aaaeeinoth o?aaie.

A?e ianoaaeaieo – a?ae 15 aei 59 ?ie?a, i?ioa ia?aaaaeath/a a?eueo?noue
– iniae thiaoeueeiai, iieiaeiai oa na?aaeiueiai a?eo – 91,2% (c ieo
/ieia?eia – 64,8%, ae?iie – 35,2%).

A a?oio eaaei? /a?aiii-iiceiai? o?aaie ia’?aeiai? oai?? c no?onii
aieiaiiai iiceo (63,2%) oa caai?i eaaeiai nooiaiy (36,8%). Ianoaaeaiiy
i?iaiaeeeinue i?ioyaii 3-o oeaei?a a?ae iiiaioo o?aaie.

Canoiniaoaaeinue caaaeueia ee?i?/ia iaa?ieiai/ia ianoaaeaiiy c
o?aooaaiiyi ia’?eoeaieo oa noa’?eoeaieo neiioii?a o niieo/aii? c?
niaoe?aeueieie iaoiaeaie.

Oea?aa?aeueia noaeeiia nenoaia, cie?aia – ?? aeanoioiii/i? aeanoeaino?,
??aaiue e?iaiiaiiaiaiiy, aaiiciee a?aeo?e aeine?aeaeai? iaoiaeii
?aiaioeaoaeia?aoi?.

Aea/aiiy aeeiai?ee ia?aiao??a oeoii/eiai? nenoaie iiceo cae?eniaii ca
aeiiiiiaith aaaaoia?nueiai? aoiaioeaoaeia?aoi?.

Ioe?iea ooieoe?iiaeueiiai noaio aieiaiiai iiceo, eiai eaaieueiinoi,
?aaeoeaiino?, caeaoiino? canaithaaoe iaa’ycaiee ?aaeei i?ioyaii aino?iai
ia??iaeo /a?aiii-iiceiai? o?aaie i?iaiaeeeanue ia i?aenoaa? aeaieo
aeaeo?iaioeaoaeia?aoi?.

Iaoiaeii oea?aa?aeueii? ?aaeiioee?eoeia?aoi? aecia/aeenue ia?aiao?e
e?i?eiiai e?iaiooeo o aieiaiiio iiceo (noia?iiai oa c aeae?eaiiyi eiai
a?oa??aeueii? ? aaiicii? oace), ui aeicaieyei ie??i yeinieo
oa?aeoa?enoee e?eaeo (aiie?ooaea, oi?ia, e?ooecia i?aeeiio oa
niaaeaiiy), iaea?aeaoe oeeo?ia? aeai? aeinooii? noaoenoe/i?e ia?iaoei,
iaoaiaoe/iiio aiae?co. Aeine?aeaeaiiy i?iaiaeeeinue ia
?aaeiioee?eoeia?aoi oai?nueeiai ae?iaieoeoaa “EN-110”. sse ?iaeeeaoi?
canoiniaoaaany aeueaoiii, iicia/aiee I131.

A?aoiaoth/e /eneaii? ioaeieaoe?? i?i aenieo ei?aeyoeieio
aiaeiiaiaeiinoue ?aoeii-eii’thieoeaaeueiiai e?iaiooeo oa aaii?aieiai/ieo
iieaciee?a oea?aa?aeueiiai iie?ioee?eoeyoi?iiai ?onea (A.C.Iueyieia,
1981; A.E.Ia/a?ao, E.C.Naiinthe, E.A.Aa?eooa, 1985; N.A.*aiacia, 1985;
E.A.Eauaiei, E.Ae.A?a/aa, 1988; E.ss.?iiaiiaa, 1988; I.A.Eaaaaeaaa oa
?i. 1990; oa ?i.) – i?iaaaeaii iooaeueiieiai/ia ianoaaeaiiy an?o oai?eo
o aeeiai?oe? aino?iai ia??iaeo o?aaie, ui aeeth/a? iooaeueiineii?th
i/iiai aeia, aiiiie?ineiiith aoeueaa?ii? eii’thieoeae. sseinia oa
eieueeinia ioe?ithaaiiy noaio iie?ioee?eoeyoi?iiai ?onea cae?eniaii ca
iaoiaeeeith E.O.Iaei? ? ni?aaao. (1974).

Ii?oieia?/ia no?oeoo?a aieiaiiai iiceo, ?ici??e oa eiio?ao?aoe?y eiai
oeoii/eiai? nenoaie, noai iaieiieiaeo i?inoi??a, u?euei?noue n??i? oa
aiei? ?a/iaei aea/aeenue iaoiaeii aeniaeueii? eiii’thoa?ii? oiiia?aoi?.
Aeine?aeaeaiiy i?iaiaeeeinue ia aia?aoao N?O – 1010 oa “Somatom” o??ie
“Siemens”. U?euei?noue ?a/iaei iiceo aei??yeany a iae. I (Hounsfield,
1973). Aeey ia’?eoea?caoe?? iaoieia?/ieo ci?iaiue oeoii/eiai? nenoaie
aeei?enoiaoaaee cia/aiiy oea?aa?iaaio?eeoey?ieo ?iaeaen?a – OeAI
(A.I.Ei?ieaiei, I.ss.Aanei, A.A.Eocueiaiei, 1987; Hahn J. et al, 1976;
Mees W. et al. 1980).

I?iaaaeaii iiaeeaeaia aea/aiiy noaio aaaaoaoeaii? ia?aiai? nenoaie c
aeine?aeaeaiiyi ?? oiiono, ?aaeoeaiino? oa aaaaoaoeaiiai caaacia/aiiy
ae?yeueiino?. Oa?aeoa?enoeeith aaaaoaoeaiiai oiiono aaaaeaee
aaaaoaoeaiee ?iaeaen Ea?aei oa oaeeeiiee ianya e?ia?, ae?aoiaoaaiee ca
oi?ioeith Eieue?oo?aiaea oa Oeaiaea?a. I?i aaaaoaoeaio ?aaeoeai?noue
ia?aneiiaoe/iiai a?aeae?eo aeniiaoaaee ii i?iaao Aeaiiii-Aoia?a,
neiiaoe/iiai – ii i?oinoaoe/i?e i?iai I?aaaey. Aaaaoaoeaia caaacia/aiiy
ae?yeueiino? – ca iaoiaeii Ia?oiia.

On?i ianoaaeaiei ?iaeeenue iaeyaeia? ?aioaaiia?aie /a?aia o 2-o
i?iae-oe?yo, ca iieacaiiyie – ?aioaaiia?aie oeeiiai a?aeae?eo o?aaoa
oaeiae o 2-o i?iaeoe?yo.

Aeey ioe?ithaaiiy noaio nenoaiii? aaiiaeeiai?ee aea/aany a?oa??aeueiee
oene, eiai aneiao??y (o oiio /ene? – i?ney i?oieeiiinoaoe/ii?
ooieoe?iiaeueii? i?iae), eoaioaeueiee aaiiciee oene.

Eaai?aoi?ii-a?io?i?/iee eiiieaen aeeth/aa caaaeueiee aiae?c e?ia?, na/?,
aeine?aeaeaiiy nieiiiiiceiai? ??aeeie, eiaaoeia?aio, i?ioa?iia?aio,
ai?no aetheice o e?ia?, aeaeo?ieioe, aaciaee neeaae e?ia?.

Iaoiaeeea e?eoaaiiy

C e?eoaaeueii? iaoith o iniiai?e a?oi? oai?eo canoiniaaiee eiiieaen
i?aia?ao?a aaiioiii/ii? ae??, ui aeeth/a? uiaeaii? (i?ioyaii 7-10 ae?a)
aioo??oiueiaaiii e?aiaeueii iiooci? eaaiioiio – 2 ie (10ia) ia 200 ie
icioiii/iiai ?ic/eio NaCl o niieo/aii? c ?icae?eueiei ii/a?aiaei
aioo??oiueiaaiiei oaaaeaiiyi o?ienaaaceio – 5 ie 10% ?ic/eio,
anei?aiiiai? eeneioe – 3 ie 5% ?-io, ii?eaeieneio aiae?ioei?eaeo 5% – 1
ie, oiaiiio a?ii?aeo 6% – 1ie, neaaciio 5% – 1ie.

A aeaiiee /an i?iaiaeeeenue a/i ?i’?eoe?? aoo?e?io 24% – 1 ie, aiaeaiio
50% – 2 ie, eiea?aieneeace – 100 ia.

Aa/??iueiai /ano – aoo?e?i 24% – 1 ie, aiaeaii 50% – 2 ie, aeeiaae?ie 1%
– 1 ie a/i.

C 3-4 aeiae i?ecia/aany aiaaaiie ca noaiith (1-e oeaeaeaiue – ii 2
oaae. 3 ?ace ia aeaiue, iio?i – ii 1 oaae. 3 ?ace ia aeaiue) aai aneocai
ii 20 e?aiaeue 3 ?ace ia aeaiue.

C iaoith i?aeaeuaiiy eiioeaio?aoe?? e?ea?nueeeo ?a/iaei o aeueo
?aaoeyoi?ieo oeaio?ao aaaaoaoeaii? ia?aiai? nenoaie aeei?enoaii ciin?a
aea?iaoiia?aiiaiiai (aioo??oiueioeaieiiiai) aeaeo?ioi?aco.

Aeey oeueiai i?ney aioo??oiueiaaiiiai aaaaeaiiy iaaeeeaiaioiciiai
e?ea?nueeiai eiiieaeno i?iaiaeyoue aiaeiiacaeueii-iioeee/io
aaeueaai?caoeith, caaaeyee /iio ciia iapaaeaa/oaaiiai iaeneiaeueiiai
oa?iaeieia?/iiai aieeao ?icoaoiao?oueny o iiaeaeaeo?iaeiiio i?inoi??. O
?acoeueoao? aeiiiioth/i? caeaoiino? iino?eiiai no?oio oee?eoethth/? o
e?ia? e?ea?nuee? ?a/iaeie eiioeaio?othoueny o cii? aieeao aeaeo?e/iiai
iiey. Oaeei /eiii noai?th?oueny aenieee ai?no i?aia?ao?a o oeaio?aeueieo
aaiaeiyo, aeiaioeaoaeueii-aiiioaeaii/ieo, noiaao?iaeo a?aeae?eao, oiaoi
no?oeoo?ao, ui iathoue iaea?eueoa a?aeiioaiiy aei ?aaoeyoi?ieo ooieoeie
i?aai?cio. O?ce/iee oaeoi? – aeaeo?e/iee no?oi, ui aoiaeeoue aei
e?eoaaeueiiai eiiieaeno, aeeeeea? aeoeaaoe?th iae?iaeeiai?/ieo
i?ioean?a, aioeia?aaiioe/io ia?aaoaeiao ooieoe?iiaeueieo no?oeoo? iiceo,
ii?iae?co? iaoaaieici, i?iieei?noue aaiaoiaioeaoaei/iiai aa?’??o,
iie?ioo? ae?yeuei?noue aiiioaeaii-aiiioica?ii-iaaeie?eiai? nenoaie.
Aeacaiee niin?a canoiniao?oueny ii/a?aiai c aiaeiiacaeueiei
aeaeo?ioi?acii o?ienaaaceio neioni?aeaeueii iiaeoeueiaaiei no?oiii o
ni?yieaiiio ?aaeei?, /ei aeinyaa?oueny aeeaiea i?iieeiaiiy i?aia?aoo aei
oeaio??a aeui? aaaaoaoeaii? ?aaoeyoe??, nieiiiiiceiai? ??aeeie,
aaciina?aaeiuei aei noaeei aieiaiiai iiceo. Aeyaey?oueny iiceoeaiee
?aoeaeoi?iee aieea ?c ?aoeaioi??a neeciai? iaieiiee iina e??cue neeaaei?
aiaoiii-ooieoe?iiaeuei? ca’ycee o??e/anoiai oa ithoiaiai ia?a?a.

Oai?? eiio?ieueii? a?oie iaea?aeoaaee o?aaeeoe?eio oa?ai?th, ui aeeth/a?
aiaeaaoeee, aeanaineaieicoth/i, aeaaiae?aooth/i caniae, a?oai?ie a?oie
“A”.

?acoeueoaoe aeine?aeaeaiiy oa ?o iaaiai?aiiy

On? iino?aaeaeae? aecia/aee ei?ioei/anio (a?ae aeae?eueeio naeoiae aei
aeae?eueeio oaeeei) ao?aoo na?aeiiino? i?ney o?aaie. Iniiaieie nea?aaie
aoee oae?: aieiaiee a?eue, ioaeioa, aethaioa, caiaii?i/aiiy, ??ci?
i?iyae anoaiiiaa?ioe/iiai neiae?iio – i?aeaeuaia noiiethaai?noue,
ae?ao?aeea?noue, caaaeueia ieya?noue – ??cii? ae?aciinoi oa o?eaaeinoi.

Ia’?eoeaia iaa?ieiai/ia neiioiiaoeea a?ae??ciyeanue aeeiai?/i?noth, o
??aeeeo aeiaaeeao iaea /?oei ie?aneaiee aiaieuaaee oa?aeoa?.

Iaie i?iaaaeaii ?aiaioeaoaeia?aoi/ia aeine?aeaeaiiy noaeeiii? nenoaie
aieiaiiai iiceo i?ae /an iaaeoiaeaeaiiy oai?iai aei noaoe?iia?o (1 – 3
aeiaa i?ney /a?aiii-iiceiai? o?aaie), i?ci?oa ca 1 oeaeaeaiue oa
i?ioyaii 2 – 3-ai oeaeiae i?ney o?aaie.

I?e aiae?c? eiiieaeno ia?aiao??a ?AA aeyaeai? ci?iaiiy, ui
oeeaaeathoueny o oaeiio:

· O 72,3% oai?eo eiio?ieueii? oa 75,4% iniiaii? a?oi i?ioyaii ia?oiai
oeaeiy i?ney o?aaie oi?iothoueny iciaee oneeaaeiaiiy aaiiciiai a?aeoieo,
ui caa??aathoueny aei e?ioey 3-ai oeaeiy o 64.3% oai?eo eiio?ieueii? oa
40,9% iniiaii? a?oi.

· ??aaiue ioeueniaiai e?iaiiaiiaiaiiy ca?eueooaaany aei 3-5 aeiae i?ney
o?aaie o 69,6% oai?eo.

· Ii?iaeicaoeiy ioeueniaiai e?iaiiaiiaiaiiy ianoa? i?ci?oa o a?oi?
oai?eo c eaaeei caai?i aieiaiiai iiceo, i?ae ca eiai no?ono.

· I?aeaeuaiiy noaeeiiiai oiiono caa??aa?oueny aei e?ioey 3-ai oeaeiy
i?ney o?aaie o 22,2% oai?eo eiio?ieueii? ? 10,3% iniiaii? a?oi.

· ssai?, aai aeyaeaii i?ae /an ooieoe?iiaeueieo i?ia iciaee
oea?aa?aeueii? aaiicii? iaaeinoaoiino? caa??aaeenue aei e?ioey 3-ai
oeaeiy o 64,3% oai?eo eiio?ieueii? ? 40,9% iniiaii? a?oie, ui iaea?aeaee
eo?n oa?aii? ?ic?iaeaiei niiniaii (?

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