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Травма – лекция по общей хирургии

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Eaeoeey ii iauae oe?o?aee.

O?aaia.

Neiai o?aaia a ia?aaiaea n a?a/aneiai iaicia/aao iia?aaeaeaiea, ?aia.
O?aaia – yoi ii?oieiae/aneea ooieoeeiiaeueiua eciaiaiea a i?aaiecia,
ianooiathuea a ?acoeueoaoa aicaeaenoaey, ii naiae neea i?aainoiaeyuaai
nii?ioeaeyaiinoue oeaie. A ?acoeueoaoa iaoaie/aneeo iia?aaeaeaiee o?aaia
iiaoo auoue ioe?uoua e cae?uoua e eaoao?aaiu, oi anoue o?aaiu iieo/aiiua
i?e iaaeaiee n auniou. Eae i?aaeei, i?e eaoao?aaia iia?aaeaeaaony ia
iaeei i?aai, a iaaethaeaaony iiiaeanoaaiiua iia?aaeaeaiey – iieeo?aaia.
O?aaiu oaeaea iiaoo auoue oa?ie/aneeie, oeie/aneeie, yeaeo?io?aaiu,
ineoe/aneea o?aaiu, aa?io?aaiu, aicieeathuea a iniiaiii iinea ac?uaa (ca
n/ao ac?uaiie aieiu iia?aaeaeathony n?aaeiaa ooi, ?ac?ua aa?aaaiiie
ia?aiiiee, nii?iaiaeaeaaony yoi /a?aiii-iicaiauie i?iyaeaieyie –
nio?ynaieai, ooeaii aieiaiiai iicaa). Ii oneiaeyi aicieeiiaaiey o?aaiu
iiaoo auoue i?iecaiaenoaaiiua e iai?iecaiaenoaaiiua. I?iecaiaenoaaiiie
iacuaaaony o?aaia, iieo/aiiay ia i?aaei?eyoee, a oaeaea ii iooe ia
?aaioo eee n iaa. Aiaiiua o?aaiu iiae?acaeaeythony ia iaiano?aeueiua,
iaiaiano?aeueiua. sso?iaaiiua o?aaiu yoi o?aaiu iieo/aiiua ai a?aiy
auiieiaiey eaeeo eeai ea/aaiuo eee aeeaaiinoe/aneeo i?ioeaaeo?
(iai?eia?, i?e eaoaoa?ecaoeee). O?aaiaoeci iu iacuaaai niaieoiiinoue
o?aai, iieo/aiiuo ii?aaeaeaiiie eaoaai?eae ianaeaiey, eiioeiaaioia
ianaeaiey ca ii?aaeaeaiiue i?iiaaeooie a?aiaie. ?acee/atho o?aaiaoeci
iauee (ia 1000 /aeiaae a aiae), a oaeaea iieacaoaee i?iecaiaenoaaiiiai,
naeueneioicyenoaaiiiai, o?ainii?oiiai, auoiaiai e ae?. o?aaiaoecia. Yoe
aeaeu o?aaiaoecia ii?aaeaeythony a i?ioeaioao. Ii aeaiiui AIC ia 10 oun.
*aeiaae o?aaiu a ?aciuo no?aiao ninoaaeytho io 9 aei 15 aaeaaiaeii. NOA
ii eiee/anoao o?aai auei ia ia?aii ianoa, a nayce n ?acaeoeai
o?ainii?oa. Ioae/eiu iieo/atho o?aaiu a 2.1 ?aca /aua, /ai aeaiueiu.
Iniiao o?aaiaoecia ninoaaeytho ooeau e ?anoyaeaiey (aei 45% anao o?aai),
?aiu, nnaaeeiu ninoaaeytho ieiei 37%, 18% i?eoiaeeony ia oyaeaeua
o?aaiu. A NNN? n?aaeiee iieacaoaeue o?aaiaoecia ninoaaeye 13.5% ia 100
?aaioathueo, ia i?aaei?eyoeyo eiee/anoai aeiae iao?oaeiniiniaiinoe
ninoaaeyei 25 aeiae. A 1988 aiaeo o?aaio iieo/eei 19 iei. *aeiaae,
iiaeaei 278 oun. *aeiaae, 53576 o?aai iieo/eee aeaoe. A aieueoeinoaa
oeeaeeeciaaiiuo no?ai n?aaee i?e/ei nia?oe o?aaia iaoiaeeony ia aoi?ii
ianoa.

Iieeo?aaia ninoaaeyao 9-15%. Aieueoie iianiinoueth iieeo?aaia yaeyaony
?acaeoea o?aaiaoe/aneie aieacie.

O?aaiaoe/aneay aieaciue iaaethaeaaony a 50-60% ec anao ia?aianoeo
iieeo?aaio. A caaeneiinoe io noaiaie oyaeanoe eaoaeueiinoue ninoaaeyao
io 10 aei 90%. Oyaeanoue o?aaiaoe/aneie aieacie ii?aaeaeyaony noaiaiueth
oyaeanoe o?aaiu. I noaiaie oyaeanoe o?aaiu iu iiaeai noaeeoue, enoiaey
ec oiai nii?iaiaeaeaeanue ee iia oieii, e anee nii?iaiaeaeaeanue, oi
eaeie noaiaie. Anee oiea iao, ia ?acaeaaaony e o?aaiaoe/aneay aieaciue.
Anee a ?acoeueoaoa o?aaiu ?acaeaaaony oie ia?aie noaiaie, oaeay o?aaia
iacuaaaony eaaeie, e o?aaiaoe/aneay aieaciue oiaea ia ?acaeaaaony. I?e
o?aaia n?aaeiae noaiaie oyaeanoe aa?iyoiinoue ?acaeoey o?aaiaoe/aneie
aieacie ninoaaeyao ieiei 20%, a eaoaeueiinoue ninoaaeyao ieiei 10% o
eaaeaeiai caaieaaoaai o?aaiaoe/aneie aieaciueth. I?e oyaeaeie noaiaie
o?aaiu, eiaaea ?acaeaaaony oie 3 noaiaie o?aaiaoe/aneay aieaciue
iaaethaeaaony o anao iino?aaeaaoeo, aa?iyoiinoue aucaei?iaeaiey ieiei
60%. Anee o?aaia i?eciaia ianiaianoeiie n aeeciueth ?acaeaaaony naiia
oyaeaeia oa/aiea o?aaiaoe/aneie aieacie e eaoaeueiinoue ninoaaeyao 90% (
ana oaee 1 ec 10 /aeiaae auaeeaaao, iiyoiio iaiaoiaeeii ea/eoue, aeaaea
anee o?aaia i?eciaia ianiaianoeiie n aeeciueth). Aeey ii?aaeaeaiey
oyaeanoe oiea nouanoaoao ianeieueei e?eoa?eaa: 1. I?iaeieaeeoaeueiinoue
oiea. Oie ia?aie noaiaie i?iaeieaeaaony ia aieaa 6 /ania. Oie aoi?ie
noaiaie – ia aieaa nooie. Oie o?aoueae noaiaie ia aieueoa 48 /ania. 2.
Iieacaoaee AAe. I?e oiea ia?aie noaiaie AAe ia nieaeaaony. I?e oiea
aoi?ie noaiaie iii ia auaaao ieaea /ai 80, anee oie o?aoueae noaiaie, oi
AAe ieaea 80, anee ninoiyiea ianiaianoeii n aeeciueth, oi aeaaeaiea
iiaeao ia ii?aaeaeyoueny. 3. Oieiaue eiaeaen, eee eiaeaen Aeueaiaa?a
?aaiue /anoioa ioeuena, aeaeaiiie ia nenoiee/aneia aeaaeaiea. I?e oiea
ia?aie noaiaie ia i?aauoaao 1, i?e aoi?ie noaiaie – ia aieaa 2, a anee
eiaeaen aieaa 2 – ninoiyiea oa?aeoa?ecotho eae ianiaianoeiia n aeeciueth

A oa/aiea o?aaiaoe/aneie aieacie ninoiyiea oiea niaiyaony ninoiyieai
ino?ie oienaiee. Ia yoie noaaeee i?ienoiaeeo iaeiieaiea oieneiia a
e?iae. Oieneiu – yoi i?iaeoeou iaoaaieecia, ia?acothueany i?e iae?ica
oeaiae, e ieacuaathuea oiene/aneia aeaenoaea ia i?aaieci, aaeoa?eaeueiua
oieneiu – i?iaeoeou iee?iaia, eioi?ua ?aciiiaeathony ia ?aiaaie
iiaa?oiinoe. Eeeie/anee ino?ay oienaiey i?iyaeyaony a ?aceii iiauoaiee
oaiia?aoo?iie e?eaie auoa 38 a?aaeonia ( a i?e ninoiyiee oiea
oaiia?aoo?a ieaea ii?iaeueiie). Oyaeaeay eioieneeaoeey i?iyaeyaony
oaeaea a ieeaio?ee – auaeaeaiee ana oiaiueoathuaainy eiee/anoaa ii/e.
Aua a ninoiyiee oiea i?e ieacaiee iiiiue iaoeeaioo iaiaoiaeeii
niaethaeaoue i?aaeei o?ao eaoaoa?ia: iaeei eaoaoa? aeieaeai auoue a
iiaeeeth/e/iie aaia, aeey oiai /oiau iaania/eoue ieaciicaiauaiea, iioiio
/oi oie ethaiai i?ienoiaeaeaiey a iniiaa naiae eiaao ia?ooaiea
e?iaiia?auaiey, aoi?ie eaoaoa? aeieaeai auoue a aeuoaoaeueiuo iooyo – a
iiniaie oiae. Ii iaania/eaaao iiaea/o eenei?iaea. A o?aoee eaoaoa?
aeieaeai auoue a ii/aaii iocu?a, aeey oiai /oiau neaaeeoue ca
eiee/anoaii ii/e ii /anai. A ii?ia ii/ea auaeaeyao io 30 aei 50 ie a
/an. Anee iaiueoa 30 iu aiai?ei ia ieeaio?ee, anee iaiueoa 5 ie a /an –
aio?ey. A noaaeee ino?ie oienaiee ianooiaao ioiineoaeueiia oeo/oaiea
naii/oanoaey. Iaoeeaio ia?anoaao aeaeiaaoueny ia aieue, ii?iaeecoaony
eee au?aaieaaaony o?iaaiue a?oa?eaeueiiai aeaaeaiey. Oa?aeoa?iu
ineoe/aneea ?anno?ienoaa, eioi?ua iinyo oa?aeoa? aeaee?ey n iaee/eai
aaeethoeeiaoeee – neooiauo, c?eoaeueiuo, o ceioiio?aaeythueo aeeiaieai –
iinyo ono?aoathuee oa?aeoa?, oaeie /aeiaae iiaeao niaa?oeoue
noeoeeaeioth iiiuoeo, iiyoiio iaaei neaaeeoue ca iaoeeaioii, ia?aaeei
oeene?iaaoue, i?eiaiyoue naaeaoeaiua n?aaenoaa. I?iaeieaeeoaeueiinoue
noaaeee ino?ie oienaiee caaeneo io noaiaie oyaeanoe oiea e ninoaaeyao io
3-5 aei 7 nooie.

Naioeeiieaiey. A yoie noaaeee a iaoiaaiaca ia ia?aue ieai auoiaeyo
?anno?ienoaa eiioiiie nenoaiu. A nayce n oai, /oi eiioiiay nenoaia
aeieaeia o/anoaiaaoue a eeeaeaeaoeee iae?ioece?iaaiiuo oeaiae, yoe
eiioiiua iaoaieciu ia/eiatho aicaeaenoaiaaoue ia oieueei ia ia?oaua
oeaie, ii e ia aeeaua eeaoee, ?acaeaaaony aooieiioiiay aa?anney. Yoi
i?eaiaeeo e aaia?aeecaoeee eioaeoeee. Aaia?aeecaoeey eioaeoeee a ia?aoth
i/a?aaeue neacuaaaony ia eaaeeo. O 90% anao aieueiuo n o?aaiaoe/aneie
aieaciueth ?acaeaaaony oyaeaeay iiaaiiiey. Aoi?ia ii /anoioa ineiaeiaiea
– nainen ?acee/iie yoeieiaee, aeeth/ay e a?eaeiaue – eaiaeeaeiieeiciue
nainen. O aieueiuo ?acaeaathony aiieieee ?acee/iuo eieaeecaoeee,
oeaaiiiiciua aiiaiaeeoeeou, oieaoeenoeou, ia?ai?ieoeo, ia?aeieeo,
oeaaiiiu oiieie eeoee e aeaeoaeea. A oaee neo/ayo aicieeatho iieacaiey e
oe?o?ae/aneiio aiaoaoaeuenoao, eioi?ia i?aaenoaaeyao i/aiue aieueooth
neiaeiinoue ia oiia aooieiioiiuo ?anno?ienoa. Aneaaenoaea aooieiioiiie
aa?annee a i?aaiecia ?acaeaaaony iae?ioe/aneea yaeaiey – i?ieaaeie,
eioi?ua iiaoo i?eaiaeeoue e e?iaioa/aieyi. Aua iaeii oa?aeoa?iia
i?iyaeaiea naioeeioienaiee – ?aiaaay eaoaeney. Naioeeioienaiey aeeeony
aeieai ( io 1.5 aei 6-8 aeiae). Aaeaaeiaaiua iioa?e aaeea ninoaaeytho
io 40 aei 60 a?aii, yoi i?eaiaeeo e enoiuaieth. Iiyoiio i/aiue aaaeiu
oaeea ea/aaiua ia?ii?eyoey eae eiioiiiiaeoeyoeey ( iiaeaaeaiea
iaoieiae/aneeo, aeoeaecaoeey ii?iaeueiuo ?aaeoeee eiioiiuo),
iaycaoaeueii aioeaaeoa?eaeueiia ea/aiea. I/aiue aaaeiui yaeyaony
ieoaiea, iaiaoiaeeii iaania/eoue i?aaieci iaiaoiaeeiuie yia?aaoe/aneeie
e ieanoe/aneeie iaoa?eaeaie.

?aeiiaaeanoeaioeey ianooiaao n?aaieoaeueii iaaeeaiii. *aoeie a?aieoeu
ia nouanoaoao. Iaiaoiaeeia ei??aeoeey anao ia?ooaiee aicieeoeo a
i?aaeuaeoueo noaaeeyo. Yoa noaaeey iiaeao i?iaeieaeaoueny ianyoeu,
aiaeu, aei 60% ia?aianoeo o?aaiaoe/aneoth aieaciue yaeythony noieeeie
eiaaeeaeaie.

Cae?uoua iia?aaeaeaiey eiia/iinoae. Ecaanoii 7 aeaeia cae?uouo
iia?aaeaeaiee: 1. Nio?ynaiea – commotio. Anee iii inouanoaeyaony ia
nenoaiaoe/anee oi a?aaea iii ia i?aaenoaaeyao. I?e o?iie/aneeo
nio?ynaieyo ?acaeaaaony aea?aoeeiiiay aieaciue. Anoanoaaiiuie
aii?oecaoi?aie nio?ynaiee yaeythony nonoaau. 2. Ooea (contusio) . i?e
ooeaa eaeay-oi /anoue eeaoie iiaeaaao, iaycaoaeueii i?ienoiaeeo ?ac?ua
ninoaeia n e?iaieceeyieai ?acee/iiai oa?aeoa?a – iaoaoeaeueiua,
e?iaiiiaeoaee, e o.i. e?iaue iiaeao neaieeaaoueny a aeaea iieinoe,
ia?acothony aaiaoiio. Aoi?ie i?eciae ooeaa – ioae yaeyaony i?iyaeaieai
ainiaeeoaeueiie ?aaeoeee. Aieueoa i?e ooeaa iineo iaii?aaeaeaiiue,
?aceeoie oa?aeoa?. Ia?ooaiea ooieoeee i?ienoiaeeo aneaaenoaea aiee, e
aneaaenoaea e?iaieceeyiey aneaaenoaea ioaea. Ooieoeey iieiinoueth ia
oa?yaony, iia oieueei ia?ooaaony. A ea/anoaa ia?aie iiiiue o?aaoaony
oieiae, aeey oiai /oiau aucuaaoue niaci ninoaeia, eo caeoii?eo e
i?aaeioa?aoeoue e?iaieceeyiey. Aeey yoiai eniieuecotho oei?yoee, ii
enia?yaony e iaania/eaaao caii?aaeeaaiea oeaie. Cia/eoaeueii
oiaiueoaaony i?e eniieueciaaiee oieiaea e aieaaia iuouaiea ( aeaenoaea
ia niaoeeoe/aneea ?aoeaioi?u). Aoi?ia ea/aaiia ia?ii?eyoea –
eiiiaeeecaoeey, iaacaeaeaeeaaiea eiia/iinoe ia n?ie io ianeieueeeo /ania
aei 2 – 3 nooie. *oiau iinoaaeoue oi/iue aeeaaiic ooeaa iaiaoiaeeii
eneeth/eoue ana inoaeueiua aeaeu iia?aaeaeaiee.

?anoyaeaiea ( distorsio) e ?ac?ua (ruptura). Yoe iia?aaeaeaiey
eanathony oeaiae aieieienoiai no?iaiey – iuooe, nooiaeeeee, naycie,
oanoeee. Aeey ?anoyaeaiey oa?aeoa?ii iaee/ea ?ac?uaa ioaeaeueiuo aieieii
aac ia?ooaiey aiaoiie/aneie iai?a?uaiinoe oeaie. Aianoa n yoeie
aieieiaie ?ac?uaathony e ninoaeu, iiyoiio ?anoyaeaiea anaaaea
nii?iaiaeaeaaony e?iaioa/aieai. Ioae iiaeao auoue aeiaieueii
cia/eoaeueiui. Aieue i?e ?anoyaeaiee iineo /aoei eieaeeciaaiiue
oa?aeoa?. Oe?o?ae/aneia ea/aiea e i?e ooeaa e i?e ?anoyaeaiee ia
iieacaii. ?ac?ua oa?aeoa?ecoaony iieiui eee /anoe/iui ia?ooaieai
aiaoiie/aneie iai?a?uaiinoe oeaie. *anoe/iia ia?ooaiea iacuaaaony
iaae?uaii. I?e ?ac?uaa aieieii ?ac?uaathony e ninoaeu, iiyoiio
iaaethaeathony cia/eoaeueiua e?iaioa/aiey, ia?aciaaiea aaiaoii.
Iaia?oaeeaathony aaiaoiio i?e iaeueiaoeee, iaaethaeaaony neiioii
oetheooaoeee, cuaeaiea. I?e ?ac?uaa iiaeao auoue au?aaeai aeaoaeo oeaie,
eioi?ue nii?iaiaeaeaaony iuoa/iie a?uaeae oi anoue /a?ac yoio aeaoaeo
auiy/eaathony iuooeu. Ioae i/aiue cia/eoaeueiue, aieue i/aiue neeueiay,
iineo oaeaea eieaeueiue oa?aeoa?. Ooieoeey oeaie aoaeao ionoonoaiaaoue
oi anoue niioaaonoaothuea aeaeaeaiey aoaeoo iaaiciiaeiu. ?ac?ua anaaaea
o?aaoao oe?o?ae/aneiai aiaoaoaeuenoaa, n iiiiuueth eioi?iai iiaeii
aeiaeoueny iieiiai ainnoaiiaeaiey ooieoeee. Iacia/atho eiiiaeeecaoeeth a
oa/aiea 2-3 iaaeaeue, iaiaoiaeeia ?annanuaathuay oa?aiey.

Naeaaeaiea (compressio). Anee eiia/iinoue iiaeaa?aaaony aeeeoaeueiiio
naeaaeaieth ?acaeaaaony iniaay aieaciue, iieo/eaoay iacaaiea
“iei?aiaeueiue neiae?ii”. I?e aeeeoaeueiii naeaaeaiee /aeiaae a ia/aea
iuouaaony aieue, ?acaeaaaony oie, ii /a?ac 1 – 3 /ana aieue
oiaiueoaaony. Eae oieueei iu inaiaiaeaeaai eiia/iinoue oie iiyoue
?acaeaaaony e /a?ac ianeieueei nooie ia?aoiaeeo a ninoiyiea ino?ie
ii/a/iie iaaeinoaoi/iinoe, e a oa/aiea 4-5 nooie /aeiaae oie?aao iau/ii
io o?aiee.

Yoi aea yaeaiea auei iienaii iiae iacaaieai crush-syndrome eee ii
?onnee neiae?ii aeeeoaeueiiai naeaaeaiey. O ian neiae?ii aue eco/ai
I.E.Eoceiui. E?iia oiai eniieuecoaony oa?iei o?aaiaoe/aneee oieneeic.
Nouanoaoao oaeaea neiae?ii iiceoeeiiiiai naeaaeaiey – ii ?acaeaaaony o
ethaeae eioi?ua aeeeoaeueii iaoiaeyony a iaeiii e oii aea iieiaeaiee, ia
iaiyy aai oi anoue eaeea-oi /anoe oaea naeaaeeaathony naiei aea oaeii.
Yoi /aua anaai auaaao i?e io?aaeaiee aeeiaieai, ia?eioeeaie iiyoiio i?e
neiae?iia iiceoeeiiiiai naeaaeaiey iaiaoiaeeii i?iaiaeeoue e
aioeaeioioth oa?aieth i?ioea oiai oaeoi?a, eioi?ue aucaae
aanniciaoaeueiia ninoiyiea. 79.9% e?ao neiae?iia i?ienoiaeeo i?e
naeaaeaiee ieaeieo eiia/iinoae, iniaaiii iuooe aaae?a. A ?acoeueoaoa
aeeeoaeueiiai naeaaeaiey iuoa/iie oeaie ?acaeaaaony iae?ic eeaoie
iiia?a/ii-iieinaoie ioneoeaoo?u, inaiaiaeaeathony oaeea eiiiiiaiou eae
ieiaeiaei, eaeee, e?aaoei, oinoi?. Iaeaieeaathony i?iaeoeou ?aniaaea
aaeeia – ieeaiiaioeaeu, eeciniiaeueiua oa?iaiou, aeieiae/aneea aeoeaiua
aauanoaa. A ?acoeueoaoa ?ac?ooaiea y?eo?ioeeoia, i?ienoiaeeo
inaiaiaeaeaiea aaiiaeiaeia, i?e ?ac?ooaiee o?iiaioeeoia e eo neeaeaaiey
ia?acothony iee?iaeiaoeu, eioi?ua niiniaiu i?ioiaeeoue ii iaeeei aaiai.
I?e aeeeoaeueiii naeaaeaiee i?ienoiaeeo ?aceee ioae aeenoaeueiaa
naeaaeaiey, ca aai n/ao i?ienoiaeyo cia/eoaeueiua ieaciiiioa?e. A
caaeneiinoe io aeeeoaeueiinoe ?acee/atho 4 noaiaie naeaaeaiey. I?e 3-4
noaiaie ieaciiiioa?y iiaeao ninoaaeyoue aei 40% iauaia oee?eoee?othuae
e?iae. Iinea inaiaiaeaeaiey iuooea oa?yao 75% oinoi?a ( a AOO,
e?aaoeioinoao), aei 70% e?aaoeia, aei 66% eaeey, naiaiaeiua iei – e
aaiiaeiaei – ana yoe eiiiiiaiou e aucuaaaony neiae?ii naeaaeaiey. A
ia?aoth i/a?aaeue ?acaeaaaony iee?io?iiaic ii/ae. A ?acoeueoaoa
aeaenoaey aeieiae/anee aeoeaiuo aauanoa iaaethaeathony niaci eeoai/eiauo
ninoaeia e eaiaeueoeaauo ninoaeia, ia?ooaiea oeeueo?aoeeiiiie ooieoeee,
e ?aaani?aoeeiiiie ooieoeee ii/ae. Aaeie ia/eiaao auaeaeyoueny a ii/o
(ieiaeiaei, aaiiaeiaei a ii/a). Oi?ie?oaony III. E?iia oiai,
aeieiae/anee aeoeaiua aauanoaa e i?iaeoeou ?aniaaea iiiaaeatho ii iaeiio
e?oao a eaaeea, ?acaeaaaony ioae eaaeeo, ia?ooaaony neioac no?oaeoaioia
neeaathony aeueaaieu. Ca n/ao ieaciiiioa?e i?ienoiaeeo naouaiea e?iae,
aaiaoie?eoiia /enei aeinoeaaao 60-70%. Ayceay e?iaue ieioi i?ioiaeeo
/a?ac eaieeey?u, ia iaania/eaaao iieiioeaiiiai aaciiaiaia. Iiyoiio
ia?ainoaiaiiie ia?ie yaeyaony i?eiaiaiea n?aaenoa iiauoathueo ?aieiaeth
(?aiiieeaetheei). A neiae?iia naeaaeaiey auaeaeytho 3 iniiaiuo ia?eiaea:

?aiiee (oie) aeeeony ia aieaa 48 /ania. Oie iineo aeiiaieaie/aneee
oa?aeoa?. Oa?aeoa?iu neeueiua aiee ?anie?athuaai oa?aeoa?a, eoaie/aneea
i?iyaeaiey a naeaaeaiiuo eiia/iinoyo, ?aceia iiieaeaiea AAe. A e?iae
iiauoaaony eaeee, oinoi?, ieiaeiaei, a ii/a – aaiiaeiaei. Iiauoaaony
e?aaoeiei, ii/aaeia e?iae. Ieeaio?ey ia?aoiaeeo a aio?eth.

Ia?eiae III oa?aeoa?ecoaony ii?iaeecaoeeae aeaaeaiey. I?ia?anne?oao
acioaiey, aio?ey ia?ooaiea naa?ouaaaiinoe e?iae iiaeao i?eaanoe e
AeAN-neiae?iio. Iniiaiui iaoiaeii ea/aiey yaeyaony iiaeeeth/aiea
aaiiaeeaeeca, /oi iicaieyao ecaaaeoueny io acioenouo oeaeia, iiieceoue
aeia?eaeeaiee. I?eiaiaiea aaiiaeeaeeca nieaeaao 100% eaoaeueiinoue aei
25-30%.

Ia?eiae ainnoaiiaeaiey ( iicaeiee). Iiaeao eaeoe iiiaea aiaeu. Ia
i?ioyaeaiee yoiai ia?eiaea o?aaoaony ei??aeoeey ooieoeee anao i?aaiia.
O?oaeiniiniaiinoue ainnoaiaaeeaaaony aei 70% o auaeeaoeo.

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