I?I?NOA?NOAI IOI?IIE CAeI?IA`ss OE?A?IE
EE?ANUeEA IAAeE*IA AEAAeAI?ss I?NEssAeEIEIIII? INA?OE
?i. I. E. Ooieea
AI?I AOIAAe AAAeAEUe
OAeE: 616.367-007.271-089
IOe?IEA ??CIEO AEAe?A AEIA*IA?AeA?AeIEO IIA?AOe?E I?E AENIEEO ?OAOeAAEO
NO?EEOO?AO AEIA*IEO I?IOIE
14.01.03 – o??o?a?y
AAOI?AOA?AO
aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy
eaiaeeaeaoa iaaee/ieo iaoe
Ee?a – 1999
Aeena?oaoe??th ? ?oeiien.
?iaioa aeeiiaia ia eaoaae?? oi?aeiaaaeii?iaeueii? oa noaeeiii? o??o?a??
Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I. E. Ooieea
IIC Oe?a?ie oa o a?aeae?e? eaia?ineii?/ii? o??o?a?? oa oieae?o?aco
?inoeoooo ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie.
Iaoeiaee ea??aiee:
aeieoi? iaaee/ieo iaoe Ie/eoaeei Ieoaeei THoeiiae/ – ea??aiee a?aeae?eo
eaia?ineii?/ii? o??o?a?? oa oieae?o?aco ?inoeoooo ee?i?/ii? oa
aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie.
Io?oe?ei? iiiiaioe:
aeieoi? iaaee/ieo iaoe Eeoaeiaiei Ieaenaiae? Ieaenaiae?iae/, i?ia?aeiee
iaoeiaee ni?a?ia?oiee Oe?a?inueeiai iaoeiai-aeine?aeiiai ?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?ia?aeia onoaiiaa:
Iaoe?iiaeueiee iaaee/iee oi?aa?neoao ?i. I. I. Aiaiiieueoey IIC Oe?a?ie.
Caoeno aeena?oaoe?? a?aeaoaeaoueny 24.01. 2000 ?. ia 12 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.613.02 i?e Ee?anuee?e
iaaee/i?e aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I. E. Ooieea IIC Oe?a?ie
(254112, i. Ee?a, aoe. Aei?iaiaeeoeueea, 9).
C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I. E. Ooieea IIC Oe?a?ie (i. Ee?a,
aoe. Aei?iaiaeeoeueea, 9).
Aaoi?aoa?ao ?ic?neaii 23.12. 1999 ?.
A/aiee nae?aoa?
niaoe?ae?ciaaii? a/aii? ?aaee
eaiaeeaeao iaaee/ieo iaoe, aeioeaio Aaicaeye I. I.
CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE
Aeooaeuei?noue oaie. O oaia??oi?e /an o ca`yceo c i?aeaeuaiiyi /anoioe
aeyaeaiiy aeia/iieai`yii? oai?iae cia/ii c?inea /anoioa aeeiiaiiy
oieaoeenoaeoii??. O oie aea /an iacaaeia?eueiee ?acoeueoao
oieaoeenoaeoii??, ca aeaieie ??cieo aaoi??a, aeyaeythoue o 5-40% oai?eo
(Y. E. Aaeueia?ei oa ni?aaao., 1988, 1989, 1990; A. A. Oaeeiia, 1988,
1990; I. A. Ie/eoaeei, 1996, 1999; D. J. Diziel oa ni?aaao., 1993; M. C.
Richardson oa ni?aaao., 1996). Iaeiei c iaea?eueo oyaeeeo oneeaaeiaiue,
yea aeieea? i?ney aeeiiaiiy oieaoeenoaeoii??, ? ?oaoeaaa no?eeoo?a
aeia/ieo i?ioie. ?? i?e/eiith, ye i?aaeei, ? ianai?/anii ae?aaiinoiaaia
oa ei?eaiaaia yo?iaaiia ooeiaeaeaiiy aeia/iaea?aeieo oeyo?a.
I?ney aeeiiaiiy a?aee?eoiai ao?o/aiiy oaea oneeaaeiaiiy aeyaeythoue o
0,05-0,2% niinoa?aaeaiue, oeae iieaciee eeoa?oueny iaci?iiei i?ioyaii
20-30 ?ie?a; i?ney eaia?ineii?/ii? iia?aoe??, yeo ana /ano?oa
canoiniaothoue o ee?i?/i?e i?aeoeoe? – o 0,4-1% (A. N. Aaeaeueei, 1996;
Oaaei?ia oa ni?aaao., 1998; M. C. Richardson oa ni?aaao., 1996).
A ia??iae iiaioaaiiy iaoiaeeee eaia?ineii?/ii? oieaoeenoaeoii??
niinoa??aaee cia/ia ca?eueoaiiy /anoioe iioeiaeaeaiiy aeia/ieo i?ioie.
Oae, ca aeaieie Iaoe?iiaeueiiai eii?oaoo ii aini?oaeyo NOA (D. J. Diziel
oa ni?aaao., 1993), /anoioa iioeiaeaeaiiy aeia/ieo i?ioie o ee?i?eao,
aea aeeiioaaee iaioa 100 iia?aoe?e eaia?ineii?/ii? oieaoeenoaeoii??,
noaiiaeea 0,65%, iiiaae 100 oaeeo ao?o/aiue – 0,42%. Ca aeaieie R.
Orlando oa ni?aaaoi??a (1994), 8 c 15 iioeiaeaeaiue aeia/ieo i?ioie
niinoa??aaee i?ae /an aeeiiaiiy ia?oeo 10 iia?aoe?e, 5 – i?e cae?eniaii?
11-50-ai ao?o/aiiy ? o?eueee 2 – i?ney aeeiiaiiy iiiaae 50 iia?aoe?e.
Aiaeia?/i? aeai? iaaaaeai? I. N. Richardson oa ni?aaaoi?aie (1996), ye?
a?aecia/eee ciaioaiiy /anoioe iioeiaeaeaiiy aeia/ieo i?ioie a?ae 0,8 aei
0,4% o 1995-1998 ??. A?eueo?noue c ieo aeieeee aiane?aeie iaa??iiai
canoinoaaiiy ae?aoa?i??, ?iiae? – /anoeiai? iano?oeoe?? i?ioiee i?e
oeaiiio ee?ioaaii?.
Iaaeinoaoiuei aea/ai? iniiai? i?e/eie aeieeiaiiy aeniei? ?oaoeaai?
no?eeoo?e aeia/ieo i?ioie, i?e/eie oa iiaeeeaino? iiyae ?? ?aoeeaeea?a
i?ney aeeiiaiiy ?aeiino?oeoeaieo oa, iniaeeai, a?aeiiaieo iia?aoe?e,
ieoaiiy ae?aaiinoeee, cie?aia oii?/ii?. Ia iaa?oioiaai? iieacaiiy e
i?ioeiieacaiiy aei i?iaaaeaiiy /a?acoe??ii? /a?acia/?ieiai?
oieaia?ia?ao??, ?ao?ia?aaeii? aiaeineii?/ii? oieaia?ia?ao??;
iaaeinoaoiuei aea/aia aoaeoeai?noue ii?aeiaiiai canoinoaaiiy oeeo
iaoiae?a o ae?aaiinoeoe? ??aiy no?eeoo?e, ?? aeiaaeeie, noaio i?ioieiai?
nenoaie aeenoaeuei?oa e i?ieneiaeuei?oa noaiiciaaii? ae?eyiee; ia
aecia/aia ?ieue /a?acoe??ii? /a?acia/?ieiai? oieaia?inoii?? oa
aioo??oiueii?ioieiaeo e?eoaaeueieo iai?ioeyoe?e c aeei?enoaiiyi
/a?acoe??iiai /a?acia/?ieiaiai aeinooio i?ae /an e?eoaaiiy ?oaoeaaiai
noaiico i?ney oi?ioaaiiy a?e?iaeeaanoeaiiai aianoiiica.
Iaaeinoaoiuei aea/aia aoaeoeai?noue aeayeeo aeae?a aeia/ia?aea?aeieo
aianoiiic?a, ye? canoiniaothoue aeey a?aeiiaeaiiy iaa?no?aeueiiai
aeia/ia?aeoieo i?ney aen?/aiiy ?oaoeaai? no?eeoo?e, ?icoaoiaaii? o
ai?ioao ia/?iee.
Iaia? ?aeeii? aeoiee uiaei iieacaiue aei aeei?enoaiiy ea?eaniiai
ae?aioaaiiy, aeai?o eiai niiniao, o?eaaeino? ae?aioaaiiy, /anoioe cai?ie
/a?acia/?ieiaeo ae?aiaae?a.
Iio?aao? ?ica`ycaiiy i?iaeaia ai?ioueae c aeno?aeiei oieaia?oii ye
iaei??th c i?e/ei aeieeiaiiy ?aoeeaeeao no?eeoo?e o oai?eo, yeei aoa
iaeeaaeaiee aeia/ia?aea?aeiee aianoiiic. Ia aea/aia aoaeoeai?noue ??cieo
aeae?a aianoiiic?a o ??ci? no?iee i?neyiia?aoe?eiiai ia??iaeo a aniaeo?
i?io?eaeoeee ?aoeeaeea?a caoai?thaaiiy.
Ca`ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeena?oaoe?y ?
o?aaiaioii eiiieaenii? IAe? ?inoeoooo ee?i?/ii? oa aenia?eiaioaeueii?
o??o?a?? AII Oe?a?ie (ee?i?/ia aaca eaoaae?e oi?aeiaaaeii?iaeueii? oa
noaeeiii? o??o?a?? Ee?anueei? iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe
?i. I. E. Ooieea IIC Oe?a?ie) o 1996-1998 ??. (? aea?aeaaii? ?a?no?aoe??
0196I0110228).
Iaoa oa caaea/? aeine?aeaeaiiy. Iioei?caoe?y ?acoeueoao?a o??o?a?/iiai
e?eoaaiiy ?oaoeaai? no?eeoo?e aeia/ieo i?ioie oeyoii ?ic?iaee
o??o?a?/ii? oaeoeee, aoaeoeaieo niinia?a a?aeiiaeaiiy iaa?no?aeueiiai
aeia/ia?aeoieo oa i?io?eaeoeee ?aoeeaeea?a no?eeoo?e, cieaeaiiy
i?neyiia?aoe?eii? eaoaeueiino?.
Aeey aeinyaiaiiy oe??? iaoe aecia/ai? ianooii? caaea/?.
1. Aea/aiiy i?e/ei aeieeiaiiy aeniei? ?oaoeaai? no?eeoo?e oa ?aoeeaeea?a
noaiico i?ney aeeiiaiiy ??cieo aeae?a aeia/ia?aea?aeieo ao?o/aiue.
2. Anoaiiaeaiiy caeaaeiino? /anoioe aeieeiaiiy ?aoeeaeea?a caoai?thaaiiy
a?ae niiniao a?aeiiaeaiiy iaa?no?aeueiiai aeia/ia?aeoieo o oai?eo c
?oaoeaaith no?eeoo?ith aeia/ieo i?ioie.
3. ?ic?iaea iaoiaeeee e?eoaaiiy oa i?io?eaeoeee ai?eii? ?ioaeoe??
a?e?a?iiai o?aeoo o oai?eo c ?oaoeaaith no?eeoo?ith aeia/ieo i?ioie.
4. Ioe?iea aoaeoeaiino? ??cieo aeae?a aeia/ia?aea?aeieo aianoiiic?a o
oai?eo c aenieith ?oaoeaaith no?eeoo?ith aeia/ieo i?ioie, ?ic?iaea
?aoe?iiaeueii? oaeoeee ?o e?eoaaiiy.
Iaoeiaa iiaecia ?iaioe. ?acoeueoaoe i?iaaaeaieo aeine?aeaeaiue
aeicaieeee anoaiiaeoe i?e/eie aeieeiaiiy ?oaoeaai? no?eeoo?e aeia/ieo
i?ioie oa noaiico aeia/ia?aea?aeieo aianoiiic?a, ia iniia? /iai
?ic?iaeai? caoiaee uiaei ?o i?io?eaeoeee. Anoaiiaeaiee iaea?eueo
?aoe?iiaeueiee ianya ae?aaiinoe/ieo aeine?aeaeaiue, aeeiiaiiy yeeo
aeicaieeei a iioeiaeuei? no?iee iaea?aeaoe ?ioi?iaoe?th i?i
eieae?caoe?th no?eeoo?e, ?? aeiaaeeio, noai ia/?ieiaeo i?ioie
i?ieneiaeuei?oa oa aeenoaeuei?oa ae?eyiee noaiico, nooi?iue oyaeeino?
oieaia?oo, a oaeiae oa?aeoa? ? ae?aaeai?noue ci?i o ia/?ioe? oa
noi?aeieo i?aaiao. Oaeineiiaeaiee ? ai?iaaaeaeaiee o ee?i?/io i?aeoeeo
niin?a aeeeaoaoe?? oa noaiooaaiiy ae?eyiee ?oaoeaaiai noaiico
a?e?iaeeaanoeaiiai aianoiiico c aeei?enoaiiyi /a?acia/?ieiaiai aeinooio.
Cai?iiiiiaaia aoaeoeaia noaia eiiieaenii? i?io?eaeoeee i?neyiia?aoe?eieo
ai?eii-naioe/ieo oneeaaeiaiue.
Ia iniia? ioe?iee a?aeaeaeaieo ?acoeueoao?a a?aeiiaieo ?
?aeiino?oeoeaieo iia?aoe?e, ni?yiiaaieo ia a?aeiiaeaiiy iaa?no?aeueiiai
aeia/ia?aeoieo, ia?aeiieeai aeiaaaeai? ?o ia?aaaae, a oaeiae
iaaeioe?euei?noue oe?ieiai canoinoaaiiy a?e?ia?e?a?ieo aianoiiic?a ca
iayaiino? oee?eoey?iiai aeaoaeoo i?ioie i?ney aen?/aiiy no?eeoo?e.
I?aeoe/ia oe?ii?noue ?iaioe. I?ae /an aiae?co iaeaeeae/eo oa
a?aeaeaeaieo ?acoeueoao?a e?eoaaiiy anoaiiaeaii, ui canoinoaaiiy
no/anieo iaoiae?a ianoaaeaiiy oai?eo, i?iaaaeaiiy aaeaeaaoii?
ia?aaeiia?aoe?eii? i?aeaioiaee, nai?/aniee ? ?aoe?iiaeueiee aea??
iia?aoeaiiai ao?o/aiiy c i?eaiaeo ?oaoeaai? no?eeoo?e aeia/ieo i?ioie,
i?ecia/aiiy ?aoe?iiaeueii? aioea?ioeeii?io?eaeoeee oa aioeaaeoa??aeueii?
oa?ai?? ni?eythoue cieaeaiith eaoaeueiino? e /anoioe i?neyiia?aoe?eieo
oneeaaeiaiue, onoiaiith caa?ice aeieeiaiiy ?aoeeaeea?a ?oaoeaai?
no?eeoo?e oa ?anoaiico aeia/ia?aea?aeieo aianoiiic?a.
Ia iniia? i?iaaaeaiiai aiae?co i?e/ei yo?iaaiiiai iioeiaeaeaiiy oa
?oaoeaai? no?eeoo?e aeia/ieo i?ioie ? aeieeiaiiy ?aoeeaeea?a noaiico
aeia/ia?aea?aeieo aianoiiic?a ?ic?iaeai? eiie?aoi? i?aeoe/i?
?aeiiaiaeaoe?? uiaei ?o i?io?eaeoeee ia ??cieo aoaiao iaaeaiiy
o??o?a?/ii? aeiiiiiae oai?ei.
?ic?iaea aeai?eoio canoinoaaiiy ia?iaaceaieo oa ?iaaceaieo iaoiae?a
ae?aaiinoeee aea? iiaeeea?noue nai?/anii aeeoa?aioe?thaaoe ?oaoeaao
no?eeoo?o aeia/ieo i?ioie a?ae ?ioeo caoai?thaaiue, cae?enieoe ??
oii?/io ae?aaiinoeeo aei aeeiiaiiy iia?aoe??.
Aeei?enoaiiy cai?iiiiiaaii? oaeoeee e?eoaaiiy aeniei? ?oaoeaai?
no?eeoo?e aeia/ieo i?ioie, yea ia?aaeaa/a? ioe?ieo noaio oai?eo ?
iiaeeea?noue aeeeaoaoe?? ae?eyiee ?oaoeaaiai noaiico, nai?/ania
aeeiiaiiy iia?aoeaiiai ao?o/aiiy, ?aoe?iiaeueiee aea?? niiniao
?aeiino?oeoe?? oa a?aeiiaeaiiy iaa?no?aeueiiai aeia/ia?aeoieo c
iaa?oiooaaiiyi iieacaiue ? aeaeo ea?eaniiai ae?aioaaiiy, a oaeiae
i?io?eaeoeeo i?neyiia?aoe?eieo ai?eii-naioe/ieo oneeaaeiaiue, aeicaieeee
cieceoe i?neyiia?aoe?eio eaoaeuei?noue, iie?ioeoe iaeaeeae/? oa
a?aeaeaeai? ?acoeueoaoe e?eoaaiiy, ciaioeoe o?eaae?noue oa iie?aueoe
ye?noue iaaee/ii?, nioe?aeueii? oa o?oaeiai? ?aaa?e?oaoe?? oai?eo. Oea
i?aeoaa?aeeei aoaeoeai?noue ia?aiiai iai?yieo aeine?aeaeaiue.
Iniaenoee aianie caeiaoaa/a. Aeena?oaoe?y ? iniaenoith i?aoeath, a ye?e
aaoi?ii aeeeaaeaii e?eoe/iee aiae?c aeaieo e?oa?aoo?e noiniaii no/anieo
oyaeaiue i?i ao?ieia?th, iaoiaaiac, ae?aaiinoeeo oa e?eoaaiiy ?oaoeaai?
no?eeoo?e aeia/ieo i?ioie, a oaeiae aeani? ?acoeueoaoe aiae?co
ee?i?/iiai iaoa??aeo oa iiaeeeainoae no/anieo iaoiae?a ae?aaiinoeee ?
eiiieaeniiai e?eoaaiiy ?oaoeaai? no?eeoo?e aeia/ieo i?ioie.
Caeiaoaa/ai iniaenoi ?ic?iaeai? iniiai? oai?aoe/i? oa i?aeoe/i?
iieiaeaiiy ?iaioe, aecia/aii iaoo ? caaea/? aeine?aeaeaiiy, i?iaaaeaii
aiae?c ? noaoenoe/io ia?iaeo iaea?aeaieo ?acoeueoao?a. A?eueo?noue (65%)
iia?aoeaieo ao?o/aiue o oaiaoe/ieo oai?eo aeeiiai? aaoi?ii iniaenoi aai
ca eiai aaciina?aaeiueith o/anoth. ?acoeueoaoe aeine?aeaeaiue aeeeaaeai?
aeena?oaioii o noaooyo, iaoa??aeao iaoeiaeo eiioa?aioe?e oa aeiiia?aeyo.
Ni?aaaoi?noai ?ioeo aeine?aeiee?a o iaoeiaeo i?aoeyo, iioae?eiaaieo ca
iaoa??aeaie aeena?oaoe??, iieyaa? a eiinoeueoaoeai?e aeiiiiic? oa
ni?euei?e o/ano? a ae?aaiinoe/ii-e?eoaaeueiiio i?ioean?.
Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iaoa??aee ? iieiaeaiiy
aeena?oaoe?? aeeeaaeai? ? iaaiai?ai? ia VI Ieaioi? o??o?a?a Oe?a?ie
(Iaeana, 1996), ?anioae?eainuee?e iaoeiai-i?aeoe/i?e eiioa?aioe??
“Aeooaeuei? i?iaeaie iaa?aeeeaaeii? o??o?a?? i?aai?a /a?aaii? ii?iaeieie
oa o?iaai?oaeueiiai o?aeoo” (Ee?a, 1997), can?aeaii? eaoaae?e
oi?aeiaaaeii?iaeueii? oa noaeeiii? o??o?a?? Ee?anueei? iaaee/ii?
aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I. E. Ooieea IIC Oe?a?ie
(aeiaoaiue, 1999).
Ioae?eaoe??. Ca oaiith aeena?oaoe?? iioae?eiaai? 6 iaoeiaeo i?aoeue, c
ieo 5 – o oaoiaeo iaaee/ieo aeo?iaeao.
No?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 131 noi??ieao
ae?oeiaaiiai oaenoo, aeeth/a? oaaeeoeue, ?ethno?iaaia iaethieaie.
?iaioa neeaaea?oueny c anooio, iaeyaeo e?oa?aoo?e, o?ueio ?icae?e?a
aeanieo aeine?aeaeaiue, caeeth/aiiy, aeniiae?a ? nieneo aeei?enoaii?
e?oa?aoo?e. Iieaae/ee e?oa?aoo?e i?noeoue 245 aeaea?ae, o oiio /ene?
?ia?o ?iicaiieo aaoi??a.
INIIAIEE CI?NO ?IAIOE
Caaaeueia oa?aeoa?enoeea oai?eo oa iaoiaee aeine?aeaeaiiy
Aeine?aeaeaiiy a?oioo?oueny ia aiae?c? ?acoeueoao?a e?eoaaiiy 90 oai?eo
c aenieith ?oaoeaaith no?eeoo?ith aeia/ieo i?ioie, iia?iaaieo a
?inoeooo? ee?i?/ii? oa aenia?eiaioaeueii? o??o?a?? AII Oe?a?ie (ee?i?/ia
aaca eaoaae?e oi?aeiaaaeii?iaeueii? oa noaeeiii? o??o?a?? Ee?anueei?
iaaee/ii? aeaaeai?? i?neyaeeieiiii? ina?oe ?i. I. E. Ooieea IIC Oe?a?ie)
c 1993 ii 1998 ?. A?e oai?eo a?ae 20 aei 69 ?ie?a, a?eueo?noue (78%) c
ieo – i?aoeacaeaoiiai a?eo (20-55 ?ie?a). Caaaeath/e ia oea, i?iaeaia
i?neyiia?aoe?eii? iaaee/ii? ? o?oaeiai? ?aaa?e?oaoe?? oai?eo iaaoaa?
aaaeeeaiai nioe?aeueii-aeiiii?/iiai cia/aiiy.
Ae?aaiinoeea aeniei? ?oaoeaai? no?eeoo?e aeia/ieo i?ioie ia?aaeaa/a?
iine?aeiaia ae??oaiiy ianooiieo caaaeaiue.
1. Caeeth/ia aa?eo?eaoe?y aaiaco aeiaoyieoe? ca ?? iayaiino?.
2. Aecia/aiiy ??aiy ?oaoeaai? o?ainoi?iaoe?? aeia/ieo i?ioie, ??
aeiaaeeie, nooiaiy iaoo?aoe?? aeia/iaea?aeieo oeyo?a.
3. Ioe?iea noaio aeenoaeueieo a?aeae?e?a caaaeueii? aeia/ii? i?ioiee oa
aaeeeiai nini/ea aeaaiaaeoeyoeiaei? eeoee.
4. Ioe?iea noaio i?ieneiaeueieo ae?eyiie aeia/ieo i?ioie (aeua
iaoo?aoe??).
5. Aecia/aiiy nooiaiy ii?ooaiiy ooieoe?? ia/?iee oa ?ioeo aeeoo?ai
aaaeeeaeo i?aai?a.
Cacia/ai? caaaeaiiy ae??oai? oeyoii anaa?/iiai aiae?co
ee?i?ei-eaai?aoi?ieo iieaciee?a ? aeaieo niaoe?aeueieo iaoiae?a
aeine?aeaeaiiy.
Iaeiei c oa?aeoa?ieo ee?i?/ieo neiioii?a aeniei? ?oaoeaai? no?eeoo?e,
yeee ia? ia o?eueee ae?aaiinoe/ia, a e i?iaiinoe/ia cia/aiiy, ?
aeiaoyieoey. O 21,5% oai?eo aiia aoea no?eeith, o 38% – i?ia?anoth/ith,
o 29,1% – oaeeaiiae?aiith, a 11,4% – noaee?i?/iith.
Ee?i?/i? i?iyae iai?io?aeiino? aeia/iaea?aeieo oeyo?a, coiiaeaii?
aenieith no?eeoo?ith (a?eue, i?aeaeuaiiy oaiia?aoo?e o?ea, aeiaoyieoey),
niinoa??aaee o 56,4% oai?eo. Ia iniia? aiae?co a?io?i?/ieo iieaciee?a c
iiaeaeueoith aa?eo?eaoe??th ca aeiiiiiaith niaoe?aeueieo aei- oa
?io?aiia?aoe?eieo iaoiae?a o oai?eo c aenieith ?oaoeaaith no?eeoo?ith
aeae?eai? aea? oi?ie aeiaoyieoe?: iicaia/?ieiaa (iaoo?aoe?eia) oa
ci?oaia. O 32 oai?eo aeyaeaia iaoo?aoe?eia aeiaoyieoey, o 47 – ci?oaia.
I?ae /an ianoaaeaiiy iaoe??io?a c iaoith anoaiiaeaiiy ae?aaiico ?
iieacaiue ca i?eioeeiii a?ae i?inoiai aei neeaaeiiai, aa?o/e aei oaaae
?ioi?iaoeai?noue iiia?aaei?o aeaieo, canoiniaoaaee ee?i?/i?,
eaai?aoi?i?, a?io?i?/i? oa niaoe?aeuei? ?ino?oiaioaeuei? iaoiaee
aeine?aeaeaiiy. I?iaiaeeee caaaeueiee aiae?c e?ia? ? na/?, aecia/aee
aeoeai?noue ai?eace o ne?iaaooe? e?ia? ? na/? ca iaoiaeii Ni?oa – ?iy a
iiaeeo?eaoe?? Oaie?aa. Aeine?aeaeoaaee ai?no a?eea a ne?iaaooe?
(?ao?aeoiiao?e/iei iaoiaeii), caaaeueiiai a?e??oa?io (ca Aeaeaeniiii),
eiai o?aeoe?e (ca Aaa?eaeiii), caeeoeiaiai acioo ? na/iaeie – c
aeei?enoaiiyi iaai?o “Lachema” (*aoineiaa//eia). O oai?eo c i?aeaeuaiith
oiea?aioi?noth aei aetheice aoaeaaiaeiee iai?i aea/aee ca aeiiiiiaith
aia?aoo ooo/ii? i?aeoeoieiai? caeice o??ie “Aeinoaoi?” (Miles, NOA-O?A),
ui aeaaaei iiaeeea?noue aecia/aoe ai?no aetheice a e?ia? oai?iai
uioaeeeie.
?aioaai?anueeo eiii`thoa?io oiiia?ao?th cae?enieee o 31 oai?iai.
Aeei?enoiaoaaee aiia?ao “Somaton CR” o??ie “Siemens” (O?A). Ia
oiiia?aiao aeia/iee i?oo? iaa aeaeyae ae?eyiee iaaeniei? u?eueiino?
ae?iniiiae?aii? ie?oaei? oi?ie. AEia/i? i?ioiee a ii?i? ia
a?coae?coaaeeny, i?e cia/iiio ?icoe?aii? iaee aeaeyae ?icaaeoaeaii?
n?oee c ie?oaeeie ae?eyieaie cieaeaii? u?eueiino?. Eaiai? aeia/ieo
i?ioie i?ae /an aeeiiaiiy eiii`thoa?ii? oiiia?ao??, ye i?aaeei, ia
aeyaeyee.
?iooc?eio oieaia?ia?ao?th ia ia?oiio aoai? aeine?aeaeaiiy canoiniaoaaee
i?ney iia?eueiiai (i?ioyaii 5 oa) aaaaeaiiy 50% ?ic/eio a?e?aiinoo c
?ic?aooieo 1 ie ia 1 ea iane o?ea oai?iai. Ci?iee ?iaeee /a?ac 15, 30,
45 oa oa 1 aiae. Aecia/aee oe?eio caaaeueii? aeia/ii? i?ioiee,
iayai?noue aeaoaeo?a ?? iaiiaiaiiy, aeaoi?iaoe??, ??aeoa – ci?ie o
oa?i?iaeueiiio a?aeae?e?, a oaeiae oaeaee?noue aaaeoaoe?? eiio?anoii?
?a/iaeie aei aeaaiaaeoeyoeiaei? eeoee.
Iniiai? ?acoeueoaoe aeine?aeaeaiue
Ioe?iea ?acoeueoao?a oeueo?acaoeiaiai aoioiiineaioaaiiy, iaea?aeaieo
i?ae /an ianoaaeaiiy oai?eo c ?oaoeaaith no?eeoo?ith /anoeiaeo
ia/?ieiaeo i?ioie, ni?anoaaeaiiy ?o c aeaieie ?ioeo ?ino?oiaioaeueieo
iaoiae?a aeine?aeaeaiiy (/a?acoe??ia /a?acia/?ieiaa oieaia?ia?ao?y,
?ao?ia?aaeia aiaeineii?/ia oieaia?ia?ao?y) oa ?io?aiia?aoe?eii? ?aa?c??
na?ae/aoue, ui aeei?enoaiiy aoia?ao?/ieo e?eoa???a aecia/aiiy
iaoo?aoe?eii? oa ia?aio?iaoicii? aeiaoyieoe? aeicaieeei o 97% oai?eo
a??ii anoaiiaeoe aeae oeueiai oneeaaeiaiiy. A oie aea /an ??aaiue
iano?oeoe??, ?? aaiac ca aeiiiiiaith aoia?ao?? aecia/ai? o 50,8% oai?eo.
Ioaea, iacaaaeath/e ia oa, ui aoia?ao?y ? ?ioi?iaoeaiei ? aacia/iei
?ino?oiaioaeueiei iaoiaeii ae?aaiinoeee aeniei? ?oaoeaai? no?eeoo?e
aeia/ieo i?ioie, aiia ia iiaea cai?ieoe iaoiaee ?o i?yiiai
eiio?anooaaiiy, cia/aiiy yeeo iniaeeai aaaeeeaa o oii?/i?e ae?aaiinoeoe?
oeueiai caoai?thaaiiy.
C iaoiae?a i?yiiai eiio?anooaaiiy aeia/ieo i?ioie iaea?eueo?
ae?aaiinoe/i? iiaeeeaino? iathoue ?ao?ia?aaeia aiaeineii?/ia
oieaia?ia?ao?y oa /a?acoe??ia /a?acia/?ieiaa oieaia?ia?ao?y. Cacia/ai?
iaoiaee canoiniaai? o 27 oai?eo c ?oaoeaaith no?eeoo?ith /anoeiaeo
ia/?ieiaeo i?ioie.
sseui ?oaoeaaa no?eeoo?a oneeaaeith?oueny ooai?aiiyi ciai?oiuei?
aeia/ii? ii?eoe?, a aeiaoyieoey noa? ia?ai?aeiith, aeey ioe?iee noaio
aeia/iaea?aeieo oeyo?a, ooi/iaiiy i?e/eie aeieeiaiiy aeia/ii? ii?eoe?,
?? oa?aeoa?o aeioe?eueii canoiniaoaaoe o?nooeioieaia?ia?ao?th.
I?iaaaeai? aeine?aeaeaiiy iieacaee, ui o?eueee aeei?enoaiiy i?yieo
?aioaaiieiio?anoieo iaoiae?a aeicaiey? inoaoi/ii aecia/eoe aeae
aeiaoyieoe?, ??aaiue iano?oeoe?? aeia/ieo i?ioie, iaea?aeaoe
?ioi?iaoe?th i?i noai aeia/iaea?aeieo oeyo?a i?ieneiaeuei?oa (ca
aeiiiiiaith /a?acoe??ii? /a?acia/?ieiai? oieaia?ia?ao??,
o?nooeioieaia?ia?ao??) oa aeenoaeuei?oa (c aeei?enoaiiyi ?ao?ia?aaeii?
aiaeineii?/ii? oieaia?ia?ao??) ??aiy iaoo?aoe??.
I?ioa, aeey aecia/aiiy ?aoe?iiaeueii? oaeoeee e?eoaaiiy ?oaoeaai?
no?eeoo?e o eiaeiiai oai?iai ne?ae aieiae?oe iiaiith ?aioaaiieia?/iith
?ioi?iaoe??th i?i noai a?e?a?iiai o?aeoo. Oea iiaeeeai caaacia/eoe ca
oiiae ii?aeiaiiai canoinoaaiiy ?ao?ia?aaeii? aiaeineii?/ii?
oieaia?ia?ao?? oa ?ao?ia?aaeiiai eiio?anooaaiiy aeenoaeueieo a?aeae?e?a
aeia/iaea?aeieo oeyo?a a?ae aaeeeiai nini/ea aeaaiaaeoeyoeiaei? eeoee
aei ??aiy iaoo?aoe??, a oaeiae /a?acoe??ii? /a?acia/?ieiai?
oieaia?ia?ao?? (a ca iayaiino? ciai?oiuei? aeia/ii? ii?eoe? –
o?nooeioieaia?ia?ao??) c eiio?anooaaiiyi aeia/ieo i?ioie i?ieneiaeuei?oa
i?noey iaoo?aoe??. O?eueee i?e ni?anoaaeaii? oeeo aeaieo iiaeeeai
inoaoi/ii aecia/eoe ??aaiue iaoo?aoe??, ?? nooi?iue, aeiaaeeio ciie
o?aaeaiiy, noai aaeeeiai nini/ea aeaaiaaeoeyoeiaei? eeoee oa
aeia/iaea?aeieo oeyo?a i?ieneiaeuei?oa ? aeenoaeuei?oa ae?eyiee
no?eeoo?e.
Eiia?iiaaia i?yia eiio?anooaaiiy aeia/ieo i?ioie oni?oii cae?eniaii
iaie o 45 oai?eo.
Oaeei /eiii, ye na?ae/eoue aiae?c ?acoeueoao?a iaoeo ee?i?/ieo
niinoa?aaeaiue, aeeoa?aioe?eia ae?aaiinoeea ?oaoeaai? no?eeoo?e aeia/ieo
i?ioie c aeei?enoaiiyi ee?i?ei-eaai?aoi?ieo iaoiae?a aeine?aeaeaiiy ?
i???ioiaiith. Inoaoi/ia aecia/aiiy ??aiy o?aaeaiiy, eiai aeiaaeeie, a
oaeiae noaio i?ioieiai? nenoaie i?ieneiaeuei?oa oa aeenoaeuei?oa
ae?eyiee no?eeoo?e iiaeeeaa ca oiiae canoinoaaiiy niaoe?aeueieo
?ino?oiaioaeueieo iaoiae?a: oeueo?acaoeiaiai oiiineaioaaiiy,
?ao?ia?aaeii? aiaeineii?/ii? oieaia?ia?ao??, o?nooeioieaia?ia?ao??,
/a?acoe??ii? /a?acia/?ieiai? oieaia?ia?ao??. Aeei?enoaiiy eiia?iiaaiiai
aioa- ? ?ao?ia?aaeiiai eiio?anooaaiiy ca aeiiiiiaith ?ino?oiaioaeueieo
iaoiae?a aeicaiey? i?aaeeueii aecia/eoe oaeoeeo e?eoaaiiy oai?eo c
?oaoeaaith no?eeoo?ith aeia/ieo i?ioie.
I?iaaaeai? iaie aeine?aeaeaiiy iieacaee, ui iniiaieie i?e/eiaie
aeieeiaiiy aeniei? ?oaoeaai? no?eeoo?e aeia/ieo i?ioie ? yo?iaaiia
iioeiaeaeaiiy ?o no?iee i?ae /an aeeiiaiiy iia?aoeaiiai ao?o/aiiy ia
i?aaiao /a?aaii? ii?iaeieie, ye i?aaeei, oieaoeenoaeoii??, a?aee?eoi?
aai eaia?ineii?/ii?, cia/ii ??aeoa – ?acaeoe?? oeoiea, a oaeiae
?aoeeaeea noaiico ?ai?oa noi?iiaaiiai aeia/ia?aea?aeiiai aianoiiica
(/ano?oa – oieaaeioiaeoiaeaiiaianoiiica). O ca`yceo c oeei iaa?oioiaaia
?nioaaiiy aeaio iniiaieo iai?yie?a i?io?eaeoeee ?oaoeaai? no?eeoo?e
aeia/ieo i?ioie. Oea iiia?aaeaeaiiy ?o yo?iaaiiiai iioeiaeaeaiiy i?ae
/an aeeiiaiiy oieaoeenoaeoii??, a?aee?eoi? e eaia?ineii?/ii?, oa
?acaeoe?? oeoiea, a oaeiae oaoi?/ii i?aaeeueia aeeiiaiiy
caaaeueiii?eeiyoeo ?aeiino?oeoeaieo ? a?aeiiaieo iia?aoe?e, ni?yiiaaieo
ia a?aeiiaeaiiy iaa?no?aeueiiai aeia/ia?aeoieo i?ney aen?/aiiy ?oaoeaai?
no?eeoo?e aeenoaeueii? eieae?caoe?? (ae?eyiea ia/?ieiai? oa
aeenoaeueiiai a?aeae?eo caaaeueii? aeia/ii? i?ioie). Naia ?aoeeaeea
noaiico ni?e/eith? aeieeiaiiy no?eeoo?e i?ieneiaeueii? eieae?caoe??
aiane?aeie aeno?aeiiai oeio e?iaiiinoa/aiiy no?iie iica- oa
aioo??oiueiia/?ieiaeo aeia/ieo i?ioie. E??i oiai, ne?ae noai?i ca
iieacaiiyie oa oaoi?/ii i?aaeeueii oi?ioaaoe
oieaaeioiaeoiaeaiiaianoiiic.
Aeey ?ic?iaee ?aoe?iiaeueii? eiioeaioe?? e?eoaaiiy aeniei? ?oaoeaai?
no?eeoo?e /anoeiaeo ia/?ieiaeo i?ioie iio??aia /?oea ae?aaiinoe/ia
i?ia?aia, yea iiaeiia aooe aeaioaoaiiith ? aeeth/aoe canoinoaaiiy
ia?iaaceaieo iaoiaeee (oeueo?acaoeiaa aeine?aeaeaiiy, eiii`thoa?ia
oiiia?ao?y) ia I aoai?, a oaeiae iaoiae?a i?yiiai eiio?anooaaiiy
aeia/iaea?aeieo oeyo?a ca aeiiiiiaith aioa- ? ?ao?ia?aaeii?
oieaia?ia?ao??.
Iaea?eueo iiaio ?ioi?iaoe?th iaea?aeothoue i?e aeei?enoaii?
eiia?iiaaiiai eiio?anooaaiiy (?ao?ia?aaeii? aiaeineii?/ii? oa
/a?acoe??ii? /a?acia/?ieiai? oieaia?ia?ao??).
Ioe?ithth/e ?acoeueoaoe o??o?a?/ii? ei?aeoe?? ?oaoeaai? no?eeoo?e
ia/?ieiaeo i?ioie ? ?aoeeaeeao noaiico ?ai?oa noi?iiaaiiai
a?e?iaeeaanoeaiiai aianoiiica, ie anoaiiaeee, ui o oaeeo oai?eo iiaeia
aeeiioaaoe ??ci? iia?aoeai? ao?o/aiiy. ?o iniiao neeaaeathoue ianooii?
iia?aoeaii-oaeoe/i? i?eioeeie.
1. Iaeneiaeueii iiaia aen?/aiiy ?oaoeaai-ci?iaieo oeaiei aeia/ieo
i?ioie.
2. Oi?ioaaiiy oe?ieiai aeia/ia?aea?aeiiai ni?aonoy aac iaoyao oeaiei, ui
c`?aeiothoueny. C i?eaiaeo ?aoeeaeeao noaiico aaiaoeei?thiaeueiiai
aianoiiico aeeiiothoue ianooii? ao?o/aiiy:
a) aeeeaoaoe?th oa aeaeo?i?icn?/aiiy ae?eyiee noaiico ?ai?oa
noi?iiaaiiai ni?aonoy c aeei?enoaiiyi /a?acoe??iiai /a?acia/?ieiaiai
aeinooio;
a) ciyooy ?ai?oa iaeeaaeaiiai aianoiiica ? oi?ioaaiiy iiaiai;
a) ?aeiino?oeoe?y ?ai?oa noi?iiaaiiai aaiaoeei?thiiaianoiiica.
Oni?oia aeeeaoaoe?y ?oaoeaai? no?eeoo?e ia/?ieiaeo i?ioie o 4 oai?eo c
aeei?enoaiiyi /a?acoe??iiai /a?acia/?ieiaiai aeinooio aeicaieeea
iiceoeaii ioe?ieoe oeae iaoiae ? ?aeiiaiaeoaaoe eiai canoinoaaiiy o
oai?eo c noaiicii aeia/ia?aea?aeiiai aianoiiica ca iayaiino?
a?aeiia?aeieo ?ino?oiaio?a oa i?aeaioiaeaiiai o??o?aa. I?e iaaaeaeeo
ni?iaao aeeeaoaoe?? oa noaiooaaiiy ae?eyiee noaiico aianoiiica
iia?aoe?th iiaeeeai cae?i/eoe ciai?oiueith aaiaoeeinoii??th, ui
caaacia/o? onoiaiiy oieaia?oo oa aeiaoyieoe? ? iiaea aooe ? aoaiii
?aeiino?oeoeaiiai ao?o/aiiy.
O?c?ieia?/i?noue a?aeiiaieo iia?aoe?e o ii??aiyii? c ?aeiino?oeoeaieie c
ooiooaaiiyi i?e?iaeiiai aeia/ia?aeoieo na?ae/eoue i?i iaiao?aei?noue
a?eueo oe?ieiai iiooeo niinia?a, ui aeicaieythoue ?icoe?eoe iiaeeeaino?
?o aeeiiaiiy. Oi/ia oii?/ia ae?aaiinoeea, ?aoaeueiee iiooe aeenoaeueieo
a?ae??ce?a aeia/ieo i?ioie, ei?aeoe?y noaiico aaeeeiai nini/ea
aeaaiaaeoeyoeiaei? eeoee, canoinoaaiiy ea?eanieo ae?aiaae?a aeicaieeee
iai ?icoe?eoe iieacaiiy aei aeeiiaiiy a?aeiiaieo iia?aoe?e ia ? aoai?
aeine?aeaeaiiy. I?ioa iaa?oue i?e aeinoaoi?e ia`?eoea?caoe?? iieacaiue
aei cae?eniaiiy oaeeo ao?o/aiue ieoiia aaaa ?o iaaeniea, ca iaoeie
aeaieie neeaaea? 12-13%.
O oeae ia??iae iaoiai aeine?aeaeaiiy a?aeiiai? iia?aoe?? aeeiiai? o 9
oai?eo (o 6 – noi?iiaaiee a?e?ia?e?a?iee aianoiiic, o 3 – cae?eniaia
ieanoeea i?ioiee ca Aaeiaea – I?eoe?/ai). I?ae /an aiae?co a?aeaeaeaieo
?acoeueoao?a i?ney iaeeaaeaiiy a?e?ia?e?a?ieo aianoiiic?a anoaiiaeaii,
ui o no?iee a?ae 9 aei 15 i?n i?ney ao?o/aiiy ?aoeeaeea no?eeoo?e aeiee
o 6 oai?eo c 7. Aeoiaey/e c oeueiai, ie c?iaeee aeniiaie i?i
iaaeioe?euei?noue canoinoaaiiy oaeeo ao?o/aiue i?e iiaiiio oee?eoey?iiio
iioeiaeaeaii? aeia/ii? i?ioiee. I?ney iia?aoe?? ca Aaeiaea – I?eoe?/ai,
aeeiiaii? a oie aea ia??iae, o no?iee aei 3 ?ie?a ?aoeeaeeao ia aoei.
*a?ac iayai?noue ?oaoeaaiai o?aaeaiiy i?ieneiaeueieo a?aeae?e?a aeia/ieo
i?ioie, o?oaeiiu? ?aeaioeo?eaoe?? oeaieiieo no?oeoo? ? iaeeaaeaiiy
aianoiiica aeinoaoiuei? oe?eie, iai?eaeaoi?noue aeey aianoiiicoaaiiy
aeenoaeueieo a?aeae?e?a aeia/ieo i?ioie o aaaaoueio oai?eo c aenieith
?oaoeaaith no?eeoo?ith ?aeeii iiaeeeaei ao?o/aiiyi ?
aaiaoeei?thiinoii?y.
I?e iaiiaiiio aen?/aii? no?eeoo?e, aocueeeo aeia/ieo i?ioieao ?
ae?aaeaiiio oieaia?o? o i?ina?o aianoiiica ne?ae anoaiiaethaaoe
ea?eaniee ae?aiaae. Aeio?eiaiiy caaeaii? o?eaaeino? ae?aioaaiiy
iaea?eueo iiaii iiaeeeai caaacia/eoe i?e canoinoaaii? /a?acia/?ieiaiai
ae?aiaaeo ca Smith aai iane??ciiai /a?acia/?ieiaiai ae?aiaaeo ca Saypol.
Uia caiia?aoe aeieeiaiith neiae?iio iaae?aiiaaii? /anoee ia/?iee,
aeioe?eueii oi?ioaaoe aaiaoeei?thiiaianoiiic ?icae?eueii c /anoeiaeie
ia/?ieiaeie i?ioieaie. I?ae /an iaeeaaeaiiy i?yieo aianoiiic?a c
/anoeiaeie ia/?ieiaeie i?ioieaie ia?niaeoeaii aeei?enoaiiy
iiiio?eaiaioieo ieoie “iaoaeeao?aai” oa i?aoeec?eii? oaoi?ee.
Canoinoaaiiy i?aoeec?eii? oaoi?ee oeueo?acaoeiaiai neaeueiaey aeicaieeei
iai o ?? ia??iae? ?iaioe i?aeoe/ii a?aeiiaeoeny a?ae aeei?enoaiiy
ea?eanieo ae?aiaae?a.
Caaaeuei? ?acoeueoaoe e?eoaaiiy oai?eo c aenieith ?oaoeaaith no?eeoo?ith
iaaaaeai? a oaaeeoe?. Aaiaoeei?thiiaianoiiic oi?ioaaee o 66,6% oai?eo c
aenieith ?oaoeaaith no?eeoo?ith. ?aoeeaeea noaiico aianoiiica aeiee o 4
(6,8%) oai?eo, iia?iaaieo o ? ia??iae ?iaioe. O ?? ia??iae? ?aoeeaeeao
noaiico aianoiiica ia aoei.
Aeae iia?aoeaiiai ao?o/aiiy, yea aeeiioaaee c i?eaiaeo aeniei? ?oaoeaai?
no?eeoo?e aeia/ieo i?ioie, oa eiai ?acoeueoao
Iia?aoe?y
E?euee?noue oai?eo
Iiia?ee
Cae?eoa aeeeaoaoe?y aaiaoeei?thiiaianoiiica c aeei?enoaiiyi
/a?acoe??iiai /a?acia/?ieiaiai aeinooio
4
–
A?aeiiai? iia?aoe??
oi?ioaaiiy a?e?ia?e?a?iiai aianoiiica
ieanoeea i?ioiee ca Aaeiaea – I?eoe?/ai
aoaeoaaiiy no?eeoo?e c /a?acia/?ieiaei ae?aioaaiiyi
6
5
1
–
–
–
Aaiaoeeiaeoiaeaiinoii?y
4
–
?aeiino?oeoeai? iia?aoe?? (aaiaoeei?thiinoii?y)
c ea?eaniei ae?aioaaiiyi iaei??? c /anoeiaeo aeia/ieo i?ioie
?icae?eueia iaeeaaeaiiy aianoiiica c iaiia /anoeiaeie i?ioieaie
oi?ioaaiiy aenieiai aaiaoeei?thiiaianoiiica c i?iaeieueiei
?icn?/aiiyi i?aai? oa e?ai? ia/?ieiaeo i?ioie
9
10
51
2
–
1
?acii …
90
3
I?ney iia?aoe?? c i?eaiaeo ?oaoeaai? no?eeoo?e /anoeiaeo ia/?ieiaeo
i?ioie iiia?ee 3 oai?eo (eaoaeuei?noue noaiiaeea 3,3%). I?ae /an aiae?co
oneeaaeiaiue, iaeaeeae/eo oa a?aeaeaeaieo ?acoeueoao?a e?eoaaiiy oai?eo
c aenieith ?oaoeaaith no?eeoo?ith ia/?ieiaeo i?ioie anoaiiaeaii, ui
iniiaiith i?e/eiith ?o nia?o? o iaeaeeae/iio i?neyiia?aoe?eiiio ia??iae?
? i?ia?anoth/ee ai?eiee oieaia?o ? coiiaeaia iei ai?eia ?ioieneeaoe?y c
ooai?aiiyi aioo??oiueiia/?ieiaeo oa iaaeieiia/?ieiaeo aanoean?a.
Canoinoaaiiy ?aoe?iiaeueii? aioea?ioeeii?io?eaeoeee oa
aioeaaeoa??aeueii? oa?ai?? c ia?aaaaeiei i?ecia/aiiyi aioea?ioee?a, ui
eoioeththoueny ? aeae?eythoueny c aeia/th (oeaoia?ae), ii?aeiaiiy ??cieo
oeyo?a aaaaeaiiy i?aia?ao?a, a oaeiae aeei?enoaiiy iaoiae?a oieani?aoe??
oa ?aa?iia?ii? ?ioiiei?aeoe?? ni?eyee cieaeaiith /anoioe aeieeiaiiy
oyaeeeo ai?eii-naioe/ieo oneeaaeiaiue.
Iacaaeia?eueiee a?aeaeaeaiee ?acoeueoao e?eoaaiiy ni?e/eiaiee
aeieeiaiiyi ?aoeeaeeao no?eeoo?e, noaiico ?ai?oa noi?iiaaiiai ni?aonoy,
aeaoaeoaie oaoi?ee aeeiiaiiy iia?aoe??, iaaaeaeaaoiei ea?eaniei
ae?aioaaiiyi c iiyaith neiae?iio iaae?aiiaaii? /anoee ia/?iee,
ii?oaeueiith a?ia?oaic??th aiane?aeie aeieeiaiiy aai i?ia?anoaaiiy
oee?ico ia/?iee, oa?i?iaeueiiai ai?eiiai oieaia?oo.
Oaeei /eiii, aeeoa?aioe?eiaaiee i?aeo?ae aei aeai?o niiniao
a?aeiiaeaiiy aeia/ia?aeoieo, oaoi?/ii i?aaeeueia oi?ioaaiiy aianoiiic?a,
?aoe?iiaeueia canoinoaaiiy ea?eanieo ae?aiaae?a, aaeaeaaoia aaaeaiiy
i?neyiia?aoe?eiiai ia??iaeo caaacia/othoue iie?auaiiy iaeaeeae/eo oa
a?aeaeaeaieo ?acoeueoao?a e?eoaaiiy oai?eo. Canoinoaaiiy nenoaie
i?io?eaeoe/ieo caoiae?a ni?eyei cia/iiio cieaeaiith /anoioe
ai?eii-naioe/ieo oneeaaeiaiue.
AENIIAEE
1. ?oaoeaaa no?eeoo?a aeia/ieo i?ioie o 97% aeieea? aiane?aeie
iaei?eaiaaiiai iioeiaeaeaiiy ?o no?iee i?ae /an aeeiiaiiy a?aee?eoi? aai
eaia?ineii?/ii? oieaoeenoaeoii??, ?acaeoe?? oeoiea, a oaeiae noaiico
?ai?oa noi?iiaaiiai aeia/ia?aea?aeiiai aianoiiica.
2. Eiia?iiaaia oieaia?ia?ao?y c aeei?enoaiiyi aioa- oa ?ao?ia?aaeiiai
eiio?anooaaiiy – o 50% oai?eo aeicaiey? aeeoa?aioe?thaaoe ?oaoeaao
no?eeoo?o, ?? ??aaiue oa aeiaaeeio.
3. A?aeiiaeaiiy iaa?no?aeueiiai aeia/ia?aeoieo oeyoii cae?eniaiiy
ieanoeee aeia/ieo i?ioie ca Aaeiaea – I?eoe?/ai iiaeeeaa eeoa ca
iayaiino? iaiiaii? no?eeoo?e, aeiaeaoeiai ne?ae i?iaiaeeoe ea?eania
ae?aioaaiiy ciie ieanoeee i?ioyaii 8-12 i?n.
4. Iniiaiei iaoiaeii a?aeiiaeaiiy iaa?no?aeueiiai aeia/ia?aeoieo i?ney
aen?/aiiy aeniei? ?oaoeaai? no?eeoo?e aeia/ieo i?ioie ?
aaiaoeei?thiinoii?y c iaoeath ii?iaeiuei? eeoee, aeeeth/aii? c o?aaeaiiy
ca ?o. Canoinoaaiiy i?aoeec?eii? oaoi?ee aeicaiey? o 95% oai?eo
oi?ioaaoe aianoiiic aac ae?aiaaeo-ea?eano.
5. Aeey caiia?aaiiy ?aoeeaeeao ?oaoeaai? no?eeoo?e /anoeiaeo ia/?ieiaeo
i?ioie oa neiae?iio iaae?aiiaaii? /anoee ia/?iee i?e iaiiaiiio
aeaeaeaii? ?oaoeaai-ci?iaieo oeaiei aaiaoeei?thiiaianoiiic ne?ae
oi?ioaaoe ca aeiiiiiaith iane??cieo /a?acia/?ieiaeo ae?aiaae?a ca
Saypol, ye? i?iaiaeyoue e??cue i?ina?o iaio /anoeiaeo i?ioie.
6. Caoiaee iiia?aaeaeaiiy ai?eieo oneeaaeiaiue i?ney iia?aoe?e c
i?eaiaeo ?oaoeaai? no?eeoo?e /anoeiaeo aeia/ieo i?ioie aeeth/athoue
i?io?eaeoe/ia i?ecia/aiiy aioea?ioee?a (ca 12 aiae aei ii/aoeo
iia?aoe??), oe?iea aeei?enoaiiy iaoiae?a oieani?aoe??, ?aa?iia?io
oa?ai?th ai?eiiai oieaia?oo.
7. Aeei?enoaiiy ?ic?iaeaieo oa aaeineiiaeaieo iaoiae?a o??o?a?/iiai
e?eoaaiiy oai?eo c aenieith ?oaoeaaith no?eeoo?ith aeia/ieo i?ioie
ni?eyei cieaeaiith i?neyiia?aoe?eii? eaoaeueiino? aei 3,3%, /anoioe
iacaaeia?eueieo ?acoeueoao?a iia?aoe?? – aei 15,7%.
NIENIE IIOAE?EIAAIEO I?AOeUe CA OAIITH AeENA?OAOe??
1. Iioeianeee A. TH., Ie/eoaeei I. A., Ua?aeia N. E., Ai?i Aoiaae
Aaaeaeue. Eiaaceaiua aiaoaoaeuenoaa iiae eiio?ieai oeueo?acaoeiaiai
enneaaeiaaiey o aieueiuo n aanoeannaie ia/aie e ieieiia/aii/iiai
i?ino?ainoaa // Ee?i. o??o?a?y. – 1996. – ? 2-3. – N. 39-40.
2. Ie/eoaeei I. A., Aeaienaiei A. E., Iiiaie Oaooee Ceyae, Ai?i Aoiaae
Aaaeaeue. Auiieiaiea ?aiiae ?aeaia?ioiiee iinea iia?aoeee ia ia/aie e
aeae/iuo i?ioieao // Ee?i. o??o?a?y. – 1996. – ? 2-3. – N. 41-42.
3. Ie/eoaeei I. A., Iai?iaeiee I. A., Eeoaeiaiei A. I., Neoin A. A.,
Eiiae?aothe A. I., Ai?i Aoiaae Aaaeaeue. AEae/iue ia?eoiieo iinea
eaia?ineiie/aneie oieaoeenoyeoiiee // Ee?i. o??o?a?y. – 1996. – ? 2-3. –
N. 42.
4. Ie/eoaeei I. A., Iai?iaeiee I. A., Naiei I. Ae., Iiiaie Oaooee
Ceyae, Ai?i Aoiaae Aaaeaeue. Aeeaaiinoe/aneay yooaeoeaiinoue
yiaeineiie/aneie ?ao?ia?aaeiie iaie?aaoeeioieaiaeia?aoee i?e
iaoaie/aneie aeaeoooa // Oe?. aeo?i. iaei?iaacea. oa aiaeineii?/.
o??o?a??. – 1998. – O. 2, ? 3. – N. 51-55.
5. Ie/eoaeei I. TH., Neoin A. A., Eo/a?oe A. A., Ai?i Aoiaae Aaaeaeue.
Aaiethoe?y o??o?a?/ii? oaeoeee a e?eoaaii? iioeiaeaeaiue aeia/ieo i?ioie
i?e oieaoeenoaeoii?? // Oieoae. o??o?a?y. – 1999. – ? 1. – N. 18-23.
6. Ie/eoaeei I. A., Oiaeo?ia E. I., Oiiye E. A., Ai?i Aoiaae Aaaeaeue.
Eiioiiei??aeoeey eaoa?iiii o aieueiuo aiieiui oieaoeenoeoii //
Aeooaeuei? i?iaeaie iaa?aeeeaaeii? o??o?a?? i?aai?a /a?aaii? ii?iaeieie
oa o?iaai?oaeueiiai o?aeoo: Iaoa??aee ?ani. iaoe.-i?aeo. eiio. – E.,
1996. – N. 59-60.
AIIOAOe?ss
Ai?i Aoiaae Aaaeaeue. Ioe?iea ??cieo aeae?a aeia/ia?aea?aeieo iia?aoe?e
i?e aenieeo ?oaoeaaeo no?eeoo?ao aeia/ieo i?ioie. – ?oeiien.
Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe
ca niaoe?aeuei?noth 14.01.03. – o??o?a?y. – Ee?anueea iaaee/ia aeaaeai?y
i?neyaeeieiiii? ina?oe ?i. I. E. Ooieea IIC Oe?a?ie, Ee?a, 1999.
Aeena?oaoe?y i?enay/aia ?ica`ycaiith i?iaeai iie?ioaiiy ?acoeueoao?a
e?eoaaiiy aeniei? ?oaoeaai? no?eeoo?e aeia/ieo i?ioie. ?iaioa iniiaaia
ia aeaieo ioe?iee eiiieaeniiai ianoaaeaiiy 90 oai?eo c aenieith
?oaoeaaith no?eeoo?ith aeia/ieo i?ioie c aeei?enoaiiyi
ee?i?ei-eaai?aoi?ieo oa ?ino?oiaioaeueieo iaoiae?a. Oaeineiiaeaia
eeaneo?eaoe?y aeniei? ?oaoeaai? no?eeoo?e, ?ic?iaeaia aeaioaoaiia
?aoe?iiaeueia noaia-aeai?eoi ia?aaeiia?aoe?eii? ae?aaiinoeee c
canoinoaaiiyi ia?aaaaeii ia?iaaceaieo iaoiae?a ia ? aoai? oa iaoiae?a
i?yiiai eiio?anooaaiiy aeia/iaea?aeieo oeyo?a – ia ?? aoai?. Ioe?iaia
aoaeoeai?noue ??cieo iaoiae?a a?aeiiaeaiiy iaa?no?aeueiiai
aeia/ia?aeoieo i?ney aen?/aiiy ?oaoeaai? no?eeoo?e. Anoaiiaeaii, ui
iniiai? iia?aoe?? (oi?ioaaiiy a?e?ia?e?a?ieo aianoiiic?a, ieanoeea
i?ioie?a ca Aaeiaea-I?eoe?/ai) aeioe?eueii aeei?enoiaoaaoe eeoa i?e
/anoeiaiio o?aaeaii? ?oaoeaaei i?ioeanii no?iie i?ioie. I?e
oee?eoey?iiio aeaoaeo? aiane?aeie o?aaie i?ioieo /e aen?/aiiy
?oaoeiai-ci?iaieo oeaiei iia?aoe??th aeai?o ? aeniea
aaiaoeei?thiinoii?y, yea aeeth/a? iicaeiaaei?e ?ic??c ia?aaeiuei? no?iee
e?ai? ia/?ieiai? i?ioiee oa oi?ioaaiiy aianoiiica c e?aei oa i?aaei
i?ioieaie ie?aii (i?e iioeiaeaeaii? a?oo?eaoe??) aai ?acii (i?e
caa?aaeaii? a?oo?eaoe??) c iaoeath oiiei? eeoee, aeeeth/aii? c o?aaeaiiy
ca ?o. Aeey i?io?eaeoeee ?aao?a?oaoe?eiiai oieaia?oo aeiaaeeia
aeeeth/aiiai naaiaioo iiaeiia aooe ia iaioa 80 ni.
Eeth/ia? neiaa: aeia/i? i?ioiee, iioeiaeaeaiiy, ?oaoeaaa no?eeoo?a,
aeai?eoi ianoaaeaiiy, aaiaoeei?thiinoii?y, a?e?ia?e?a?iee aianoiiic.
SUMMARY
Amro Akhmad Abdel. Estimation of various kinds of the biliary drainage
operations in high biliary ducts cicatricial strictures. – Manuscript.
Thesis for candidate of medical sciences degree on speciality 14.01.03
– Surgery. – Kiev Medical Academy of Post-Graduate Education of Ministry
of Health of Ukraine, Kiev, 1999.
Dissertation is devoted to the problems solving concerning improvement
of the treatment results of high biliary ducts cicatricial stricture.
The work is based on the data of the complex examination estimation in
90 patients with high biliary ducts cicatricial stricture using
clinico-laboratory and instrumental methods. The classification of high
cicatricial stricture is improved, the two-staged rational
algorithm-scheme of preoperative diagnosis using predominantly
noninvasive methods, at the first stage, and of the direct biliary ways
contrasting, at the second stage, is elaborated.
The efficacy of various methods restoration of the main biliary ducts
outflow after the cicatricial stricture excision was estimated. It is
established that the principal operations (the biliobiliary anastomoses
formation, the ducts plasty according to Heineke – Miculicz method) one
expedient to apply in partial cicatricial affection of the ducts walls.
While the circular defect present due to the duct trauma and the
cicatricially-changed tissues excision, high hepaticojejunostomy is the
operation of choice. This intervention includes the longitudinal
incision of anterior wall of left hepatic duct and the anastomosis
formation with left and right ducts separately (while the bifurcation
injury) or together (while intact bifurcation) with jejunal loop in
Roux-en-Y fashion and the excluded segment no less than 60 cm long for
the regurgitational cholangitis prophylaxis.
Key words: biliary ducts, injury, cicatricial stricture, algorithm of
examination, hepaticojejunostomy, biliobiliary anastomosis.
AIIIOAOeEss
Ai?i Aoiaae Aaaeaeue. Ioeaiea ?acee/iuo aeaeia aeae/aioaiaeyueo
iia?aoeee i?e aunieeo ?oaoeiauo no?eeoo?ao aeae/iuo i?ioieia –
?oeiienue.
Aeenna?oaoeey ia nieneaiea iao/iie noaiaie eaiaeeaeaoa iaaeeoeeineeo
iaoe ii niaoeeaeueiinoe 14.01.03 – oe?o?aey. Eeaaneay iaaeeoeeineay
aeaaeaiey iineaaeeieiiiiai ia?aciaaiey ei. I. E. Ooieea IC Oe?aeiu,
Eeaa, 1999.
Aeenna?oaoeey iinayuaia i?iaeaiai aeeaaiinoeee, ea/aiey e i?ioeeaeoeee
yo?iaaiiiai iia?aaeaeaiey aiaia/aii/iuo aeae/iuo i?ioieia e aai
iineaaenoaee – aicieeiiaaiey aunieie ?oaoeiaie no?eeoo?u e ia?aciaaiey
aeae/iiai naeua. Oe?o?ae/aneia ea/aiea yo?iaaiiiai iia?aaeaeaiey
aeae/aauaiaeyueo iooae e aai iineaaenoaee yaeyaony iaeiie ec aeooaeueiuo
i?iaeai aeeea?iie oe?o?aee. Iiene yooaeoeaiuo iaoiaeia aai
oe?o?ae/aneiai ea/aiey – iaeia ec aaaeiaeoeo caaea/ i?aeoe/aneiai
cae?aaiio?aiaiey.
N ?inoii /anoiou auyaeaiey aeae/iieaiaiiie aieacie, oaaee/aieai
eiee/anoaa iia?aoeaiuo aiaoaoaeuenoa, auiieiyaiuo ia aeae/iuo i?ioieao,
aiaae?aieai a i?aeoeeo eaia?ineiie/aneie oieaoeenoyeoiiee cia/eoaeueii
iiauneeny ?ene iia?aaeaeaiey iauaai aeae/iiai i?ioiea n iineaaeothuei
aicieeiiaaieai ?oaoeiaie no?eeoo?u. *anoioa iia?aaeaeaiey i?ioieia i?e
auiieiaiee ioe?uoie oieaoeenoyeoiiee ninoaaeyao 0,05-0,6%,
eaia?ineiie/aneie – 1%, ?acaeoeee aeaeoaeea – 0,4-0,2%. I?e/eiie
yo?iaaiiiai iia?aaeaeaiey aeae/iuo i?ioieia yaeyeenue: au?aaeaiiue
ainiaeeoaeueiue eee ?oaoeiai-niaa/iue i?ioeann a iiaeia/aii/iii
oaeoaeaiee; ionoonoaea aeinoaoi/iiai iiuoa a aeeea?iie oe?o?aee;
iaaaeaeaaoiua oneiaey auiieiaiey iia?aoeee; aiiiaeee i?ioieiaie nenoaiu;
inaiaiea iaoiaeeee eaia?ineiie/aneie oe?o?aee – “e?eaay o/aaa”.
?ac?aaioaiiay noaia-aeai?eoi ianeaaeiaaiey aieueiuo ia I yoaia
aeeth/aao oeueo?acaoeiaia enneaaeiaaiea i?aaiia a?thoiie iieinoe,
eiiiuethoa?ioth oiiia?aoeth. Ia II yoaia a oeaeyo onoaiiaeaiey oa?aeoa?a
e eieaeecaoeee iia?aaeaeaiey auiieiytho /?aneiaeioth /?ania/aii/ioth
oieaiaeia?aoeth, ?ao?ia?aaeioth yiaeineiie/aneoth
iaie?aaoioieaiaeia?aoeth, aioo?eaaiioth oieaiaeia?aoeth, a oaeaea
oenooeioieaiaeia?aoeth i?e iaee/ee ia?oaeiiai aeae/iiai naeua. Aiaeec
?acoeueoaoia oe?o?ae/aneiai ea/aiey 90 aieueiuo naeaeaoaeuenoaoao i
oeaeaniia?aciinoe e aiciiaeiinoe auiieiaiey ?acee/iuo oeiia iia?aoeee:
?aeiino?oeoeaiuo e ainnoaiiaeoaeueiuo.
Ioeaiea ioaeaeaiiuo ?acoeueoaoia enneaaeiaaiey iieacaea, /oi
ainnoaiiaeoaeueiua iia?aoeee (oi?ie?iaaiea aeeeiaeeea?iiai aianoiiica,
ieanoeea i?ioieia ii Aaeiaea – Ieeoee/o) neaaeoao i?eiaiyoue oieueei i?e
iaee/ee iaiieiiai aeaoaeoa noaiee i?ioiea iinea enna/aiey
?oaoeiai-eciaiaiiuo oeaiae. I?e oee?eoey?iii aeaoaeoa iinea enna/aiey
?oaoeiaie no?eeoo?u iaeiaeaiea aeeeiaeeea?iiai aianoiiica noaei i?e/eiie
aicieeiiaaiey ?aoeeaeeaa noaiica a n?iee io 8 aei 15 ian o 6 ec 7
iia?e?iaaiiuo aieueiuo. Enoiaey ec yoiai, iieaaaai, /oi iaoiaeii auai?a
ainnoaiiaeaiey iaaeno?aeueiiai aeae/aiooiea i?e iieiii oee?eoey?iii
aeaoaeoa noaiee i?ioiea aeieaeia auoue aunieay aaiaoeeiathiinoiiey,
eioi?ay i?aaeiieaaaao iieiia enna/aiea ?oaoeiai-eciaiaiiuo oeaiae,
i?iaeieueiia ?anna/aiea ia?aaeiae noaiee eaaiai aeieaaiai i?ioiea aeey
oaeeeiaiey aianoiiica, iaeiaeaiea nionouey iaaeaeo eoeueoyie i?ioieia e
iaoeae oiieie eeoee, aueeth/aiiie ec ieuaaa?aiey ii ?o. Ai ecaaaeaiea
aicieeiiaaiey ?aao?aeoaoeeiiiiai oieaiaeoa aeeeia aueeth/aiiiai naaiaioa
oiuae eeoee aeieaeia auoue ia iaiaa 75-80 ni. Iaeneiaeueii iieiia
enna/aiea ?oaoeiai-eciaiaiiuo oeaiae e eniieueciaaiea i?aoeeceiiiie
oaoieee ai a?aiy oi?ie?iaaiey aianoiiicia iicaieeei iai ai II ia?eiaea
enneaaeiaaiey o 98% aieueiuo ioeacaoueny io i?eiaiaiey ea?eaniuo
ae?aiaaeae. Oieueei i?e iaaiciiaeiinoe iieiinoueth enna/ue
?oaoeiai-eciaiaiiua oeaie e iaeiaeeoue oe?ieia aeae/aioaiaeyuaa nionouea
neaaeoao onoaiaaeeaaoue ea?eaniue /?ania/aii/iue ae?aiaae.
I?e noaiica aeae/aioaiaeyueo aianoiiicia iaie ?ac?aaioaia e oniaoii
i?eiaiaia o 4 aieueiuo iaoiaeeea aeeeaoaoeee o/anoea noaiica /?aneiaeiui
/?ania/aii/iui aeinooiii.
?ac?aaioaiiay oe?o?ae/aneay oaeoeea ea/aiey aunieie ?oaoeiaie no?eeoo?u
aeae/iuo i?ioieia n i?aeiouanoaaiiui eniieueciaaieai aunieie
aaiaoeeiathiinoiiee iicaieeee nieceoue eaoaeueiinoue ai II ia?eiaea aei
3,5%, a oaeaea iieiinoueth ecaaaeaoue ?aoeeaeeaa ?oaoeiaie no?eeoo?u.
Iieo/eea ?acaeoea ?ac?aaioaiiay nenoaia i?ioeeaeoeee iia?aaeaeaiey
aeae/iuo i?ioieia i?e inouanoaeaiee ioe?uoie e eaia?ineiie/aneie
oieaoeenoyeoiiee.
Iniiaiua ?acoeueoaou ?aaiou iaoee i?aeoe/aneia i?eiaiaiea.
Eeth/aaua neiaa: aeae/iua i?ioiee, iia?aaeaeaiea, ?oaoeiaay no?eeoo?a,
aeai?eoi ianeaaeiaaiey, aaiaoeeiathiinoiiey, aeeeiaeeea?iue aianoiiic.
Нашли опечатку? Выделите и нажмите CTRL+Enter
