Дооперационная портальная венозная эмболизация как метод

реклама
Ô˜Â̸
ÑÓÓÔÂ‡ˆËÓÌ̇fl ÔÓڇθ̇fl ‚ÂÌÓÁ̇fl ˝Ï·ÓÎËÁ‡ˆËfl
Í‡Í ÏÂÚÓ‰ ÔÓ‚˚¯ÂÌËfl ·ÂÁÓÔ‡ÒÌÓÒÚË Ó·¯ËÌ˚ı
ÂÁÂ͈ËÈ Ô˜ÂÌË
ç. Ä. ç‡Á‡ÂÌÍÓ,
Ç. Ä. Ç˯Ì‚ÒÍËÈ,
ã. ë. äÓÍÓ‚, Ä. Ç. ɇ‚ËÎËÌ, ù. ä. ÉÛÒÂÈÌÓ‚,
à. å. ÅÛË‚,
Ç. Ç. ñ‚ËÍÛÌ
éÚ‰ÂÎ ‡·‰ÓÏË̇θÌÓÈ ıËÛ„ËË (ÛÍÓ‚Ó‰ËÚÂθ – ˜ÎÂÌÍÓ. êÄåç Ç.Ä. äÛ·˚¯ÍËÌ)
àÌÒÚËÚÛÚ‡ ıËÛ„ËË
ËÏ. Ä.Ç. Ç˯Ì‚ÒÍÓ„Ó êÄåç
(‰Ë. – ‡Í‡‰. êÄåç Ç.Ñ. î‰ÓÓ‚), åÓÒÍ‚‡
Ç ‡·ÓÚ Ô‰ÒÚ‡‚ÎÂÌ ÓÔ˚Ú ‚˚ÔÓÎÌÂÌËfl ˜ÂÒÍÓÊÌÓÈ ÔÓڇθÌÓÈ ‚ÂÌÓÁÌÓÈ ˝Ï·ÓÎËÁ‡ˆËË Û 8 Ô‡ˆËÂÌÚÓ‚ Ò ÔÂ‚˘Ì˚ÏË ÁÎÓ͇˜ÂÒÚ‚ÂÌÌ˚ÏË Ë ÏÂÚ‡ÒÚ‡Ú˘ÂÒÍËÏË ÓÔÛıÓÎflÏË Ô˜ÂÌË, ̇ıӉ˂¯ËıÒfl ̇ ΘÂÌËË ‚ àÌÒÚËÚÛÚ ıËÛ„ËË ËÏ. Ä.Ç. Ç˯Ì‚ÒÍÓ„Ó Ò
1996 ÔÓ 2000 „„. ñÂθ ÏÂÚÓ‰‡ ÒÓÒÚÓËÚ ‚ ÔÓ‚˚¯ÂÌËË ‰ÓÓÔÂ‡ˆËÓÌÌÓ„Ó ÙÛÌ͈ËÓ̇θÌÓ„Ó ÂÁÂ‚‡ Ô˜ÂÌË Û ·ÓθÌ˚ı Ò ‚˚ÒÓÍËÏ ËÒÍÓÏ ‡Á‚ËÚËfl ÔÓÒÎÂÓÔÂ‡ˆËÓÌÌÓÈ Ô˜ÂÌÓ˜ÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË. Ç˚ÔÓÎÌÂÌË ÔÓڇθÌÓÈ ‚ÂÌÓÁÌÓÈ ˝Ï·ÓÎËÁ‡ˆËË Ì ËÏÂÎÓ Á̇˜ËÚÂθÌ˚ı ÔÓ·Ó˜Ì˚ı ˝ÙÙÂÍÚÓ‚. ÉËÔÂÚÓÙËfl ΂ÓÈ ‰ÓÎË Ô˜ÂÌË ÒÓÒÚ‡‚Ë·
ÒÔÛÒÚfl 14–30 ‰ÌÂÈ ÔÓÒΠ˝Ï·ÓÎËÁ‡ˆËË ÓÚ 17.8 ‰Ó 150%. é·¯ËÌ˚ ‡Ì‡ÚÓÏ˘ÂÒÍËÂ
ÂÁÂ͈ËË Ô˜ÂÌË ‚˚ÔÓÎÌÂÌ˚ 7 Ô‡ˆËÂÌÚ‡Ï. èÓÒÎÂÓÔÂ‡ˆËÓÌÌ˚ı ÎÂڇθÌ˚ı ËÒıÓ‰Ó‚ Ì ·˚ÎÓ.
Preoperative Portal Venous Embolization – as a Safety
Increasing Tool in Extended Liver Resection
N. A. Nazarenko,
V. A. Vishnevsky,
L. S. Kokov, A. V. Gavrilin,
E.K. Huseinov,
I. M. Buriev, V. V. Tsvirkun
Department of abdominal Sergery
(Director – Academician corr.
RAMSci V.A. Kubishkin)
A. V. Vishnevsky Institute
of Surgery RAMSci (Director –
Academician RAMSci
V.D. Fedorov)
An experience of percutaneous portal venous embolization in 8 primary and metastatic liver
malignancy patients provided in A.V. Vishnevsky Institute of Surgery during 1996–2000 is
presented.
The purpose of tool consists in elevation of liver functional reserve in postoperative liver failure high risk patients. Percutaneous application of portal venous embolisation was not accompanied with any significant side effects. Liver left lobe hypertrophy in 14–30 days consisted
of 17.8 to 150%. Extended anatomic resections were carried out in 7 patients. No postoperative mortality was observed.
ǂ‰ÂÌËÂ
ë ˆÂθ˛ ‡Ò¯ËÂÌËfl ‚ÓÁÏÓÊÌÓÒÚÂÈ ‚˚ÔÓÎÌÂÌËfl éêè Û ·ÓθÌ˚ı Ò ˆËÓÁÓÏ, ÏÂı‡Ì˘ÂÒÍÓÈ
ÊÂÎÚÛıÓÈ flÔÓÌÒÍËÏË ‡‚ÚÓ‡ÏË [7–10] Ô‰ÎÓÊÂ̇ ÏÂÚÓ‰Ë͇ ˝Ï·ÓÎËÁ‡ˆËË ‚ÓÓÚÌÓÈ ‚ÂÌ˚ ‰ÓÎË
Ô˜ÂÌË, ÔÓ‡ÊÂÌÌÓÈ ÓÔÛıÓθ˛. ùÚÓÚ ÏÂÚÓ‰ ̇Ô‡‚ÎÂÌ Ì‡ ÒÚËÏÛÎflˆË˛ ÍÓÏÔÂÌÒ‡ÚÓÌÓÈ „ËÔÂÚÓÙËË Á‰ÓÓ‚ÓÈ ‰ÓÎË Ô˜ÂÌË Ë ÔÓ‚˚¯ÂÌË ڇÍËÏ Ó·‡ÁÓÏ ‰ÓÓÔÂ‡ˆËÓÌÌÓ„Ó ÙÛÌ͈ËÓ̇θÌÓ„Ó
ÂÁÂ‚‡ Ó„‡Ì‡.
é·¯ËÌ˚ ÂÁÂ͈ËË Ô˜ÂÌË (éêè) fl‚Îfl˛ÚÒfl
ÓÒÌÓ‚Ì˚Ï ÏÂÚÓ‰ÓÏ Î˜ÂÌËfl ·ÓθÌ˚ı Ò ÔÂ‚˘Ì˚ÏË ÁÎÓ͇˜ÂÒÚ‚ÂÌÌ˚ÏË ÓÔÛıÓÎflÏË Ô˜ÂÌË, ÏÂÚ‡ÒÚ‡Á‡ÏË ‚ Ô˜Â̸ ÍÓÎÓÂÍڇθÌÓ„Ó ‡Í‡, ÓÔÛıÓ΂˚Ï ÔÓ‡ÊÂÌËÂÏ ÔÓÍÒËχθÌ˚ı Ô˜ÂÌÓ˜Ì˚ı
ÔÓÚÓÍÓ‚. ᇠÔÓÒΉÌË „Ó‰˚ ‚ ıËÛ„ËË Ô˜ÂÌË
‰ÓÒÚË„ÌÛÚ Á̇˜ËÚÂθÌ˚È ÔÓ„ÂÒÒ, Ӊ̇ÍÓ ‚˚ÔÓÎÌÂÌË éêè ÔÓ-ÔÂÊÌÂÏÛ ÒÓÔflÊÂÌÓ Ò ‡θÌ˚Ï
ËÒÍÓÏ ‚ÓÁÌËÍÌÓ‚ÂÌËfl Ú‡ÍËı ÚflÊÂÎ˚ı ÓÒÎÓÊÌÂÌËÈ, Í‡Í Ï‡ÒÒË‚Ì˚ ËÌÚ‡ÓÔÂ‡ˆËÓÌÌ˚ ÍÓ‚ÓÚ˜ÂÌËfl Ë ÔÓÒÎÂÓÔÂ‡ˆËÓÌ̇fl Ô˜ÂÌӘ̇fl ̉ÓÒÚ‡ÚÓ˜ÌÓÒÚ¸. ÇÂÓflÚÌÓÒÚ¸ ‡Á‚ËÚËfl ÔÓÒΉÌÂÈ ÓÒÓ·ÂÌÌÓ ‚ÂÎË͇ ÔË ˆËÓÁÂ Ë ‰ËÒÚÓÙ˘ÂÒÍËı
ËÁÏÂÌÂÌËflı Ô˜ÂÌË [5, 6], ‡ Ú‡ÍÊ ÔË Ì‰ÓÒÚ‡ÚÓ˜ÌÓÏ Ó·˙ÂÏ (ÏÂÌ 20%) ÓÒÚ‡˛˘ÂÈÒfl ÔÓÒΠÂÁÂ͈ËË Ô‡ÂÌıËÏ˚. ÉÛÔÔÛ ËÒ͇ ÔË ‚˚ÔÓÎÌÂÌËË éêè ÒÓÒÚ‡‚Îfl˛Ú Ú‡ÍÊ ·ÓθÌ˚ ÒÚ‡˜ÂÒÍÓ„Ó
‚ÓÁ‡ÒÚ‡ ‚ Ò‚flÁË ÒÓ Á̇˜ËÚÂθÌ˚Ï ÒÌËÊÂÌËÂÏ (ÒÓÓÚ‚ÂÚÒÚ‚ÂÌÌÓ ‚ÓÁ‡ÒÚÛ) ‡ÍÚË‚ÌÓÒÚË „ÂÌÂ‡ÚÓÌ˚ı ÔÓˆÂÒÒÓ‚ ‚ Ô˜ÂÌË [11].
Ç àÌÒÚËÚÛÚ ıËÛ„ËË ËÏ. Ä.Ç. Ç˯Ì‚ÒÍÓ„Ó
ÏÂÚÓ‰ ‰ÓÓÔÂ‡ˆËÓÌÌÓÈ ÔÓڇθÌÓÈ ‚ÂÌÓÁÌÓÈ ˝Ï·ÓÎËÁ‡ˆËË (èÇù) ‚ÔÂ‚˚ ‚ Ô‡ÍÚËÍ ÓÚ˜ÂÒÚ‚ÂÌÌÓÈ ıËÛ„ËË ËÒÔÓθÁÓ‚‡Ì ‚ 1996 „. ‰Îfl ÔÓ‰„ÓÚÓ‚ÍË ·ÓθÌÓÈ Ò ÏÂÚ‡ÒÚ‡Ú˘ÂÒÍËÏ ÔÓ‡ÊÂÌËÂÏ
Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË Í ‡‰Ë͇θÌÓÏÛ ıËÛ„˘ÂÒÍÓÏÛ Î˜ÂÌ˲ [3, 4].
å‡ÚÂË‡Î Ë ÏÂÚÓ‰˚
ë 1996 „. ÔÓ Ù‚‡Î¸ 2000 „. ‰ÓÓÔÂ‡ˆËÓÌ̇fl
èÇù ‚˚ÔÓÎÌÂ̇ 8 ·ÓθÌ˚Ï (6 ÏÛʘËÌ Ë 2 ÊÂÌ˘Ë52
Ô˜Â̸
ç‡Á‡ÂÌÍÓ Ë ‰.
êËÒ. 1. é·ÁÓ̇fl ÔÓÚÓ„‡Ïχ. ä‡ÚÂÚÂ 6 F Ôӂ‰ÂÌ
˜ÂÒÍÓÊÌÓ ˜ÂÒÔ˜ÂÌÓ˜ÌÓ ‚ ÒÚ‚ÓÎ ‚ÓÓÚÌÓÈ ‚ÂÌ˚.
Ì˚) ‚ ‚ÓÁ‡ÒÚ ÓÚ 41 ‰Ó 71 „Ó‰‡ (Ò‰ÌËÈ ‚ÓÁ‡ÒÚ
58.8 „Ó‰‡). ì 2 ·ÓθÌ˚ı ·˚Î ‰Ë‡„ÌÓÒÚËÓ‚‡Ì „ÂÔ‡ÚÓˆÂÎβÎflÌ˚È ‡Í Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË, Û 1 – ‡Í
ÊÂΘÌÓ„Ó ÔÛÁ˚fl Ò ÔÓ‡ÒÚ‡ÌËÂÏ Ô‡ÂÌıËÏ˚
Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË Ë Û 5 – ÏÂÚ‡ÒÚ‡Ú˘ÂÒÍÓ ÔÓ‡ÊÂÌË (ÏÂÚ‡ÒÚ‡Á˚ ‡Í‡ Ó·Ó‰Ó˜ÌÓÈ Ë ÔflÏÓÈ Í˯ÓÍ Û 4, ÏÌÓÊÂÒÚ‚ÂÌÌ˚ ÏÂÚ‡ÒÚ‡Á˚ ÁÎÓ͇˜ÂÒÚ‚ÂÌÌÓ„Ó Í‡ˆËÌÓˉ‡ ‚ Ô‡‚Û˛ ‰Óβ Ô˜ÂÌË Û 1).
ÇÒ ·ÓθÌ˚Â Ò ÏÂÚ‡ÒÚ‡Ú˘ÂÒÍËÏË ÓÔÛıÓÎflÏË ·˚ÎË ‡Ì ÓÔÂËÓ‚‡Ì˚: 1 Ô‡ˆËÂÌÚÍ ‚˚ÔÓÎÌÂ̇
„‡ÒÚÓÔ‡ÌÍ‡ÚÓ‰ÛÓ‰Â̇θ̇fl ÂÁÂ͈Ëfl, 1 – ΂ÓÒÚÓÓÌÌflfl „ÂÏËÍÓνÍÚÓÏËfl, 1 – Ô‡‚ÓÒÚÓÓÌÌflfl
„ÂÏËÍÓνÍÚÓÏËfl, 2 – ·˛¯ÌÓ-‡Ì‡Î¸Ì‡fl ÂÁÂ͈Ëfl
ÔflÏÓÈ Í˯ÍË.
Ç 7 ̇·Î˛‰ÂÌËflı ÔÓ͇Á‡ÌËÂÏ Í ˝Ï·ÓÎËÁ‡ˆËË
‚ÓÓÚÌÓÈ ‚ÂÌ˚ fl‚ËÎÒfl ̉ÓÒÚ‡ÚÓ˜Ì˚È Ó·˙ÂÏ Ô‡ÂÌıËÏ˚ ΂ÓÈ ‰ÓÎË Ô˜ÂÌË Ë ˆÂθ  Á‡Íβ˜‡Î‡Ò¸ ‚ ÔÓ‰„ÓÚÓ‚Í ·ÓθÌ˚ı Í ‡‰Ë͇θÌÓÏÛ ıËÛ„˘ÂÒÍÓÏÛ ‚ϯ‡ÚÂθÒÚ‚Û ÔÛÚÂÏ ÔÓ‚˚¯ÂÌËfl
‰ÓÓÔÂ‡ˆËÓÌÌÓ„Ó ÙÛÌ͈ËÓ̇θÌÓ„Ó ÂÁÂ‚‡ Ó„‡Ì‡. ì 1 Ô‡ˆËÂÌÚ‡ Ò Ó·¯ËÌ˚Ï ÏÂÚ‡ÒÚ‡ÁÓÏ ‡Í‡
ÔflÏÓÈ Í˯ÍË ‚ Ô˜Â̸ Ë ‚ӂΘÂÌËÂÏ ‚ ÓÔÛıÓθ
‚ÒÂı ÚÂı Ô˜ÂÌÓ˜Ì˚ı ‚ÂÌ èÇù ‚˚ÔÓÎÌÂ̇ Ò Ô‡ÎΡÚË‚ÌÓÈ ˆÂθ˛. Ç ‰‡Î¸ÌÂȯÂÏ ·ÓθÌÓÏÛ ÔÓ‚Ó‰ËÎËÒ¸ ÍÛÒ˚ „ËÓ̇ÌÓÈ ıËÏËÓÚÂ‡ÔËË.
ÑÎfl ˝Ï·ÓÎËÁ‡ˆËË ÛÒ· ‚ÓÓÚÌÓÈ ‚ÂÌ˚ ̇ÏË
ËÒÔÓθÁÛÂÚÒfl ‡Á‡·ÓÚ‡ÌÌ˚È ‚ àÌÒÚËÚÛÚ ıËÛ„ËË ËÏ. Ä.Ç. Ç˯Ì‚ÒÍÓ„Ó ·ËÓÎӄ˘ÂÒÍËÈ ÓÍÍβÁËÛ˛˘ËÈ Ï‡ÚÂˇΠêÄÅêéå. èÓÒΉÌËÈ ÒÓÁ‰‡Ì ̇ ÓÒÌÓ‚Â ÙË·ÓÌÂÍÚË̇, ÔÓÎÛ˜‡ÂÏÓ„Ó ËÁ
ÍËÓÔˆËÔËÚ‡Ú‡ – ÔÂÔ‡‡Ú‡ Ô·ÁÏ˚ ‰ÓÌÓÒÍÓÈ
ÄççÄãõ ïàêìêÉàóÖëäéâ ÉÖèÄíéãéÉàà ÚÓÏ 6
êËÒ. 2. è‡‚‡fl ‚ÂÚ‚¸ ‚ÓÓÚÌÓÈ ‚ÂÌ˚, ÓÍÍβÁËÓ‚‡Ì̇fl ·‡ÎÎÓÌÓÏ. èÓڇθÌÓ ÛÒÎÓ Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË Á‡ÔÓÎÌÂÌÓ Í΂ÓÈ ÂÌÚ„ÂÌÓÍÓÌÚ‡ÒÚÌÓÈ ÍÓÏÔÓÁˈËÂÈ êÄÅêéå.
ÍÓ‚Ë. å‡ÚÂˇΠËÏÂÂÚ ‚Ë‰Ó‚Û˛ ·ËÓÒÓ‚ÏÂÒÚËÏÓÒÚ¸, ӷ·‰‡ÂÚ ÌËÁÍÓÈ Ì‡˜‡Î¸ÌÓÈ ‚flÁÍÓÒÚ¸˛
(0.005–0.01 è‡ · Ò), ·ÎËÁÍÓÈ Í ‚flÁÍÓÒÚË Ì‡ÚË‚ÌÓÈ
Ô·ÁÏ˚, Á‡‰‡ÌÌ˚Ï ‚ÂÏÂÌÂÏ ÓÚ‚Â‰ÂÌËfl (ÓÚ 3 ‰Ó
10 ÏËÌ), ÂÌÚ„ÂÌÓÍÓÌÚ‡ÒÚÌÓÒÚ¸˛ Ë ‡ÍÚË‚Ì˚ÏË
‡ÌÚË·‡ÍÚÂˇθÌ˚ÏË Ò‚ÓÈÒÚ‚‡ÏË [1, 2].
èË̈ËÔˇθÌ˚Ï ‚ÓÔÓÒÓÏ Ò˜ËÚ‡ÂÏ ËÒÔÓθÁÓ‚‡ÌË ‰Îfl ‰ÓÒÚÛÔ‡ Í ‚ÓÓÚÌÓÈ ‚ÂÌ ÚÓÈ ‰ÓÎË Ô˜ÂÌË, ÍÓÚÓ‡fl ÔÓ‡ÊÂ̇ ÓÔÛıÓθ˛ (7 ·ÓθÌ˚ı).
ã˯¸ ‚ 1 ̇·Î˛‰ÂÌËË ÔË ÚÓڇθÌÓÏ ÔÓ‡ÊÂÌËË
Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË ÓÔÛıÓθ˛ ËÒÔÓθÁÓ‚‡Ì ‰ÓÒÚÛÔ ˜ÂÂÁ ÎÂ‚Û˛ ‰Óβ.
åÂÚÓ‰Ë͇ ˝Ï·ÓÎËÁ‡ˆËË ÒÓÒÚÓfl· ‚ ÒÎÂ‰Û˛˘ÂÏ. Ç ÂÌÚ„ÂÌÓÚÂ΂ËÁËÓÌÌÓÈ ÓÔÂ‡ˆËÓÌÌÓÈ ÔÓ‰
ÛθÚ‡Á‚ÛÍÓ‚˚Ï ÍÓÌÚÓÎÂÏ Ë„ÎÓÈ Chiba 20 G
ÔÛÌÍÚËÓ‚‡ÎË Ò„ÏÂÌÚ‡ÌÛ˛ ‚ÂÚ‚¸ Ô‡‚ÓÈ ‚ÓÓÚÌÓÈ ‚ÂÌ˚. èÓ ÔÓ‚Ó‰ÌËÍÛ 20in ‚‚Ó‰ËÎË Í‡ÚÂÚÂ Pig
Tail 6 F. Ç˚ÔÓÎÌflÎË ÔflÏÛ˛ Ó·ÁÓÌÛ˛ ÔÓÚÓ„‡Ù˲ Ò ‚‚‰ÂÌËÂÏ 40 ÏÎ ÍÓÌÚ‡ÒÚÌÓ„Ó ‚¢ÂÒÚ‚‡
éÏÌËÔ‡Í-350 (ËÒ. 1). èÓÒΠÔÓÎÛ˜ÂÌËfl ÔÓÚÓ„‡ÏÏ˚ Ë ÛÚÓ˜ÌÂÌËfl ‰ÂÚ‡ÎÂÈ ÒÓÒÛ‰ËÒÚÓÈ ‡Ì‡ÚÓÏËË Ô˜ÂÌË ‚ Ô‡‚˚È ÒÚ‚ÓÎ ‚ÓÓÚÌÓÈ ‚ÂÌ˚ ‚‚Ó‰ËÎË ·‡ÎÎÓÌÌ˚È Í‡ÚÂÚÂ ÅÂχ̇ ËÎË ë‚‡Ì‡–ɇ̈‡. èÓÒΠ‡Á‰Û‚‡ÌËfl ·‡ÎÎÓ̇ Ë ÓÍÍβÁËË ËÏ
Ô‡‚ÓÈ ‚ÂÚ‚Ë ‚ÓÓÚÌÓÈ ‚ÂÌ˚ (‚Ó ËÁ·ÂʇÌË ÔÓÔ‡‰‡ÌËfl ˝Ï·ÓÎËÁËÛ˛˘Â„Ó Ï‡ÚÂˇ· ‚ ÒËÒÚÂÏÛ Î‚ÓÈ ‚ÂÚ‚Ë ËÎË ÓÒÌÓ‚ÌÓÈ ÒÚ‚ÓÎ) ‚ ÔÓÒ‚ÂÚ Ô‡‚ÓÈ
‚ÓÓÚÌÓÈ ‚ÂÌ˚ ‚‚Ó‰ËÎË ÍÎÂÂ‚Û˛ ÍÓÏÔÓÁËˆË˛
êÄÅêéå ‚ ÊˉÍÓÏ ‚ˉÂ, ËÒÔÓθÁÛfl ÔË ˝ÚÓÏ
2-ÏËÌÛÚÌÓ ‚ÂÏfl ÔÓÎËÏÂËÁ‡ˆËË (ËÒ. 2). êÂÌÚ„ÂÌÓÍÓÌÚ‡ÒÚÌÓÒÚ¸ êÄÅêéå ÔÓÁ‚ÓÎfl· ÍÓÌÚÓ‹1
2001
53
Ô˜Â̸
ÑééèÖêÄñàéççÄü èéêíÄãúçÄü ÇÖçéáçÄü ùåÅéãàáÄñàü
êÂÁÛθڇÚ˚
êËÒ. 3. äÓÌÚÓθ̇fl ÔÓÚÓ„‡Ïχ ËÁ ÒÚ‚Ó· ‚ÓÓÚÌÓÈ ‚ÂÌ˚. Ç ÔÂËÙÂ˘ÂÒÍË ÓÚ‰ÂÎ˚ Ô‡‚ÓÈ ‚ÂÚ‚Ë
‚ÓÓÚÌÓÈ ‚ÂÌ˚ ÍÓÌÚ‡ÒÚÌÓ ‚¢ÂÒÚ‚Ó Ì ÔÓÒÚÛÔ‡ÂÚ,
ÓÌË Á‡ÔÓÎÌÂÌ˚ ÍÓÏÔÓÁˈËÂÈ êÄÅêéå.
ÎËÓ‚‡Ú¸ ÔÓÎÌÓÚÛ Á‡ÔÓÎÌÂÌËfl ÓÍÍβÁËÛ˛˘ËÏ
χÚÂˇÎÓÏ ÛÒ· ‚ÓÓÚÌÓÈ ‚ÂÌ˚. ÑÎfl ÔÓ‰Ú‚ÂʉÂÌËfl ÌÓχθÌÓÈ ÔÓıÓ‰ËÏÓÒÚË ÒÚ‚Ó· v. portae
Ë Â Î‚ÓÈ ‚ÂÚ‚Ë ‚˚ÔÓÎÌflÎË ÍÓÌÚÓθÌÛ˛ ÔÓÚÓ„‡Ù˲ (ËÒ. 3). Çϯ‡ÚÂθÒÚ‚Ó Á‡‚Â¯‡ÎË ‚‚‰ÂÌËÂÏ ‚ ÔÛÌ͈ËÓÌÌ˚È Í‡Ì‡Î ÔË Û‰‡ÎÂÌËË Í‡ÚÂÚÂ‡ 5.0 ÏÎ êÄÅêéå ‰Îfl ÔÓÙË·ÍÚËÍË ‚ÌÛÚË·˛¯ÌÓ„Ó ÍÓ‚ÓÚ˜ÂÌËfl.
Ç ‡ÌÌÂÏ ÔÓÒÚ˝Ï·ÓÎËÁ‡ˆËÓÌÌÓÏ ÔÂËӉ „ÛÎflÌÓ (1 ‡Á ‚ 2–3 ‰Ìfl) ÍÓÌÚÓÎËÓ‚‡ÎË Í‡ÚËÌÛ
ÔÂËÙÂ˘ÂÒÍÓÈ ÍÓ‚Ë, ÔÓ͇Á‡ÚÂÎË ·ËÓıËÏ˘ÂÒÍÓ„Ó ‡Ì‡ÎËÁ‡ ÍÓ‚Ë, ÍÓ‡„ÛÎÓ„‡ÏÏ˚. ÑÎfl ËÁÛ˜ÂÌËfl ÒÓÒÚÓflÌËfl „ÂÏÓ‰Ë̇ÏËÍË ‚ ÒËÒÚÂÏ v. portae ‚
1, 5, 10- ÒÛÚÍË ÔÓÒΠ˝Ï·ÓÎËÁ‡ˆËË ‚˚ÔÓÎÌflÎË
‰ÛÔÎÂÍÒÌÓ Ò͇ÌËÓ‚‡ÌË ÒÓÒÛ‰Ó‚ ·˛¯ÌÓÈ ÔÓÎÓÒÚË. äÓÏÔ¸˛ÚÂÌÓ-ÚÓÏÓ„‡Ù˘ÂÒÍÓ (äí) ËÒÒΉӂ‡ÌË ‚˚ÔÓÎÌflÎË Ò ˆÂθ˛ ÓÔ‰ÂÎÂÌËfl Ó·˙ÂÏÓ‚ Ô‡ÂÌıËÏ˚ Ô˜ÂÌË, Ô‡ÚÓÎӄ˘ÂÒÍÓ„Ó Ó˜‡„‡,
΂ÓÈ ‰ÓÎË Ô˜ÂÌË ‰Ó ˝Ï·ÓÎËÁ‡ˆËË Ë ˜ÂÂÁ 2–4 ̉.
ÔÓÒÎÂ ÌÂÂ.
ÖÑ
500
í˜ÂÌË ·ÎËÊ‡È¯Â„Ó ÔÓÒÚ˝Ï·ÓÎËÁ‡ˆËÓÌÌÓ„Ó
ÔÂËÓ‰‡ ‚ 6 ̇·Î˛‰ÂÌËflı ·˚ÎÓ „·‰ÍËÏ. ÅÓθÌ˚Â
ÓÚϘ‡ÎË Î˯¸ ˜Û‚ÒÚ‚Ó ‰ËÒÍÓÏÙÓÚ‡, ÌÂÁ̇˜ËÚÂθÌ˚ ÚÛÔ˚ ·ÓÎË ‚ ӷ·ÒÚË Ô‡‚Ó„Ó ÔÓ‰·Â¸fl, Û ·Óθ¯ËÌÒÚ‚‡ ËÁ ÌËı ‚ Ú˜ÂÌË 2–3 ‰ÌÂÈ „ËÒÚËÓ‚‡ÎÓÒ¸ ÔÓ‚˚¯ÂÌË ÚÂÏÔÂ‡ÚÛ˚ Ú· ‰Ó
38°C Ò ÔÓÒÎÂ‰Û˛˘ËÏ ÒÌËÊÂÌËÂÏ Â ‰Ó ÒÛ·Ù·ËθÌ˚ı ˆËÙ Ë ÌÓχÎËÁ‡ˆËÂÈ Í 7–10-Ï ÒÛÚ͇Ï.
ÇÒ ԇˆËÂÌÚ˚ ÔÓÎÛ˜‡ÎË Ô‡ÂÌÚÂ‡Î¸ÌÓ ‡ÌÚË·ËÓÚËÍË ‰Ó ÌÓχÎËÁ‡ˆËË ÚÂÏÔÂ‡ÚÛÌÓÈ ÍË‚ÓÈ.
í‡ÌÁËÚÓÌÓ ÔÓ‚˚¯ÂÌË ÛÓ‚Ìfl ÎÂÈÍÓˆËÚÓ‚ ‚ ÔÂËÙÂ˘ÂÒÍÓÈ ÍÓ‚Ë (‚ Ú˜ÂÌË ÔÂ‚˚ı
2–3 ‰ÌÂÈ) ‰Ó 20 000 ÓÚϘÂÌÓ Û 2 ·ÓθÌ˚ı, Û ÓÒڇθÌ˚ı ÎÂÈÍÓˆËÚÓÁ ·˚Î ÌÂÁ̇˜ËÚÂθÌ˚Ï. ì ‚ÒÂı
Ô‡ˆËÂÌÚÓ‚ ̇·Î˛‰‡ÎÓÒ¸ ÔÓ‚˚¯ÂÌË ÛÓ‚Ìfl Ú‡ÌÒ‡ÏË̇Á Ò˚‚ÓÓÚÍË ÍÓ‚Ë ‚ ÌÂÒÍÓθÍÓ ‡Á ÔÓ Ò‡‚ÌÂÌ˲ Ò ËÒıÓ‰Ì˚Ï ÛÓ‚ÌÂÏ Ò ÌÓχÎËÁ‡ˆËÂÈ ÔÓ͇Á‡ÚÂÎÂÈ Í 7–8-Ï ÒÛÚÍ‡Ï (ËÒ. 4). ìÓ‚Â̸ ·ËÎËÛ·Ë̇ Ô‡ÍÚ˘ÂÒÍË Ì Ô‚˚¯‡Î ÌÓχθÌ˚ı
ÔÓ͇Á‡ÚÂÎÂÈ. Ç 2 ̇·Î˛‰ÂÌËflı ÓÚϘÂÌÓ ÛÏÂÂÌÌÓ Í‡ÚÍÓ‚ÂÏÂÌÌÓ ÔÓ‚˚¯ÂÌË cÓ‰ÂʇÌËfl
ÏӘ‚ËÌ˚.
ì ·ÓθÌÓÈ 68 ÎÂÚ Ò ÚflÊÂÎ˚ÏË ÒÓÔÛÚÒÚ‚Û˛˘ËÏË Á‡·Ó΂‡ÌËflÏË Ó„‡ÌÓ‚ ÒÂ‰Â˜ÌÓ-ÒÓÒÛ‰ËÒÚÓÈ
ÒËÒÚÂÏ˚ Ë ‰˚ı‡ÌËfl, ‚˚‡ÊÂÌÌ˚Ï ÓÊËÂÌËÂÏ
ÔÓÒΠ˝Ï·ÓÎËÁ‡ˆËË ‡Á‚ËÎËÒ¸ fl‚ÎÂÌËfl ΄ӘÌÓÒÂ‰Â˜ÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË, ˜ÚÓ ÔÓÚ·ӂ‡ÎÓ
Ôӂ‰ÂÌËfl ÍÓÏÔÎÂÍÒ‡ ËÌÚÂÌÒË‚Ì˚ı ÚÂ‡Ô‚Ú˘ÂÒÍËı ÏÂ.
ì Ô‡ˆËÂÌÚ‡ Ò Ï‡ÒÒË‚Ì˚Ï ÏÂÚ‡ÒÚ‡Ú˘ÂÒÍËÏ ÔÓ‡ÊÂÌËÂÏ Ô˜ÂÌË ‚ ·ÎËʇȯÂÏ ÔÂËӉ ÔÓÒÎÂ
˝Ï·ÓÎËÁ‡ˆËË ‚ÓÓÚÌÓÈ ‚ÂÌ˚ ÓÚϘÂÌÓ ‚ÌÛÚË·˛¯ÌÓ ÍÓ‚ÓÚ˜ÂÌËÂ, ÔÓ ÔÓ‚Ó‰Û ˜Â„Ó ÓÌ ·˚Î
˝ÍÒÚÂÌÌÓ ÓÔÂËÓ‚‡Ì. Ç Ó·ÓËı ̇·Î˛‰ÂÌËflı
·ÎËʇȯËÈ ËÒıÓ‰ ·˚Î ·Î‡„ÓÔËflÚÌ˚Ï.
èË ‰ÛÔÎÂÍÒÌÓÏ Ò͇ÌËÓ‚‡ÌËË ÒÓÒÛ‰Ó‚ ·˛¯ÌÓÈ ÔÓÎÓÒÚË Ì‡ ÔÓÚflÊÂÌËË ‚ÒÂ„Ó ÔÓÒÚ˝Ï·ÓÎËÁ‡ˆËÓÌÌÓ„Ó ÔÂËÓ‰‡ ˜ÂÚÍÓ ÙËÍÒËÓ‚‡ÎËÒ¸ ÓÚÒÛÚÒÚ‚Ë ÍÓ‚ÓÚÓ͇ ÔÓ Ô‡‚ÓÈ ‚ÂÚ‚Ë ‚ÓÓÚÌÓÈ ‚ÂÌ˚ Ë ‚
ÚÓ Ê ‚ÂÏfl ÛÒËÎÂÌÌ˚È ÍÓ‚ÓÚÓÍ ÔÓ ÒÚ‚ÓÎÛ Ë Î‚ÓÈ ‚ÂÚ‚Ë ‚ÓÓÚÌÓÈ ‚ÂÌ˚ (ËÒ. 5).
ÖÑ
600
(a)
(·)
500
400
400
300
300
200
200
100
0
100
5
10
15
20
0
ëÛÚÍË
5
10
15
20
êËÒ. 4. ÑË̇ÏË͇ ÛÓ‚Ìfl Äëí (‡) Ë Äãí (·) ÔÓÒΠèÇù.
54
ÄççÄãõ ïàêìêÉàóÖëäéâ ÉÖèÄíéãéÉàà ÚÓÏ 6
‹1
2001
Ô˜Â̸
ç‡Á‡ÂÌÍÓ Ë ‰.
èÓ ‰‡ÌÌ˚Ï äí-ËÒÒΉӂ‡ÌËfl, Û‚Â΢ÂÌË ӷ˙Âχ ΂ÓÈ ‰ÓÎË Ô˜ÂÌË ˜ÂÂÁ 2–4 ̉ ÔÓÒΠèÇù
ÒÓÒÚ‡‚ËÎÓ ÓÚ 17.8 ‰Ó 150% (Ò 254 ± 34.6 ‰Ó 450.2 ±
± 100.1 ÒÏ3; p = 0.052). ì Ô‡ˆËÂÌÚÓ‚ ÏÓÎÓ‰Ó„Ó ‚ÓÁ‡ÒÚ‡ ÔÓ͇Á‡ÚÂÎË Û‚Â΢ÂÌËfl Ó·˙Âχ ÌÂ˝Ï·ÓÎËÁËÓ‚‡ÌÌÓÈ ‰ÓÎË Ô˜ÂÌË ·˚ÎË ·ÓΠ‚˚ÒÓÍËÏË,
˜ÂÏ Û ·ÓθÌ˚ı ÒÚ‡˜ÂÒÍÓ„Ó ‚ÓÁ‡ÒÚ‡. í‡Í, Û 2 ·ÓθÌ˚ı 41 „Ó‰‡ ΂‡fl ‰ÓÎfl Ô˜ÂÌË Û‚Â΢Ë·Ҹ ÔÓÒÎÂ
˝Ï·ÓÎËÁ‡ˆËË Ì‡ 80.2 Ë 150% ÒÓÓÚ‚ÂÚÒÚ‚ÂÌÌÓ, Û Ô‡ˆËÂÌÚ‡ 59 ÎÂÚ – ̇ 60%, ‡ Û 2 ·ÓθÌ˚ı 71 „Ó‰‡ – ̇
41.9 Ë17.8% ÒÓÓÚ‚ÂÚÒÚ‚ÂÌÌÓ (ËÒ. 6).
åÂÚÓ‰Ë͇ ÒÔË‡Î¸ÌÓÈ ÍÓÏÔ¸˛ÚÂÌÓÈ ÚÓÏÓ„‡ÙËË Ò ·ÓβÒÌ˚Ï ÍÓÌÚ‡ÒÚÌ˚Ï ÛÒËÎÂÌËÂÏ ÔÓÁ‚ÓÎfl· ‚ËÁÛ‡ÎËÁËÓ‚‡Ú¸ ‚ ÔÓÒÚ˝Ï·ÓÎËÁ‡ˆËÓÌÌÓÏ
ÔÂËӉ ÒÚ‚ÓÎ v. portae Ë Â ÎÂ‚Û˛ ‚ÂÚ‚¸ Ë ÓÚÒÛÚÒÚ‚Ë ÍÓ‚ÓÚÓ͇ ‚ ÒËÒÚÂÏ Ô‡‚ÓÈ ‚ÓÓÚÌÓÈ ‚ÂÌ˚
(ËÒ. 7).
Ç Ô·ÌÓ‚ÓÏ ÔÓfl‰Í ‚ ÒÓÍË ÓÚ 2 ‰Ó 11 ̉ ÔÓÒΠ˝Ï·ÓÎËÁ‡ˆËË ÓÔÂËÓ‚‡ÌÓ 7 ·ÓθÌ˚ı (ÒÏ. Ú‡·ÎˈÛ). éÔÚËχθÌ˚Ï ÒÓÍÓÏ ‰Îfl ÓÔÂ‡ˆËË ÔÓÒÎÂ
‚˚ÔÓÎÌÂÌËfl èÇù Ò˜ËÚ‡ÂÏ 3–4 ̉, ˝ÚÓ ÌÂÓ·ıÓ‰ËÏÓ ‰Îfl ‡Á‚ËÚËfl ÔÓÎÌÓˆÂÌÌÓÈ „ËÔÂÚÓÙËË ÌÂ˝Ï·ÓÎËÁËÓ‚‡ÌÌÓÈ ‰ÓÎË Ô˜ÂÌË. Ç ÚÓ Ê ‚ÂÏfl
1 Ô‡ˆËÂÌÚ͇ ·˚· ÓÔÂËÓ‚‡Ì‡ ̇ 15- ÒÛÚÍË ÔÓÒΠèÇù ‚ Ò‚flÁË Ò ÔÓ‰ÓÁÂÌËÂÏ Ì‡ ̇΢ˠÙÎÓÚËÛ˛˘Â„Ó ÚÓÏ·‡ ‚ ÔÓÒ‚Âڠ΂ÓÈ ‚ÂÚ‚Ë ‚ÓÓÚÌÓÈ ‚ÂÌ˚. ÇÚÓ‡fl ·Óθ̇fl 68 ÎÂÚ ·˚· ÓÔÂËÓ‚‡Ì‡ Á̇˜ËÚÂθÌÓ ÔÓÁÊ ÂÍÓÏẨÛÂÏÓ„Ó ÒÓ͇
(̇ 76- ÒÛÚÍË), ˜ÚÓ Ò‚flÁ‡ÌÓ Ò ÌÂÓ·ıÓ‰ËÏÓÒÚ¸˛ ÍÓÂ͈ËË ‡Á‚Ë‚¯ËıÒfl ÔÓÒΠ˝Ï·ÓÎËÁ‡ˆËË ÒÂ‰Â˜ÌÓ΄ӘÌ˚ı ̇Û¯ÂÌËÈ. Ç 6 ̇·Î˛‰ÂÌËflı Ó·˙ÂÏ
ÓÔÂ‡ˆËË ÒÓÒÚÓflÎ ‚ ‚˚ÔÓÎÌÂÌËË Ô‡‚ÓÒÚÓÓÌÌÂÈ
„ÂÏË„ÂÔ‡Ú˝ÍÚÓÏËË (èÉÉù) Ë ‚ 1 – ‡Ò¯ËÂÌÌÓÈ
Ô‡‚ÓÒÚÓÓÌÌÂÈ „ÂÏË„ÂÔ‡Ú˝ÍÚÓÏËË (êèÉÉù).
èË ‚ËÁËË ÓÚϘ‡ÎÓÒ¸ Á̇˜ËÚÂθÌÓ ÛÏÂ̸¯ÂÌË ‡ÁÏÂÓ‚ Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË Ë Û‚Â΢ÂÌˠ΂ÓÈ (ËÒ. 8). Ç ·Óθ¯ËÌÒڂ ̇·Î˛‰ÂÌËÈ
‚ËÁۇθÌÓ ‡ÁÏÂ ΂ÓÈ ‰ÓÎË Ô˜ÂÌË ÒÓÒÚ‡‚ÎflÎ
40–50% Ó·˙Âχ ‚ÒÂÈ Ô‡ÂÌıËÏ˚. è‡‚‡fl ‰ÓÎfl ÔÂ-
ÒÏ3
800
‰Ó
ÔÓÒÎÂ
600
400
200
0
1
2
3
燷β‰ÂÌËfl
4
5
êËÒ. 6. ÑË̇ÏË͇ Ó·˙Âχ Ô‡ÂÌıËÏ˚ ΂ÓÈ ‰ÓÎË Ô˜ÂÌË ÔÓÒΠèÇù.
˜ÂÌË ·˚· Ïfl„ÍÓÈ, ÌÂÒÍÓθÍÓ ‰fl·ÎÓÈ Ì‡ Ó˘ÛÔ¸,
ˆË‡ÌÓÚ˘ÌÓÈ, ΂‡fl – Ó·˚˜ÌÓ„Ó ˆ‚ÂÚ‡. Ç ·Óθ¯ËÌÒÚ‚Â ÒÎÛ˜‡Â‚ ˜ÂÚÍÓ ÓÔ‰ÂÎfl·Ҹ ÎËÌËfl ‰Âχ͇ˆËË ÏÂÊ‰Û Î‚ÓÈ Ë Ô‡‚ÓÈ ‰ÓÎflÏË Ô˜ÂÌË.
Ç Ò‚flÁË Ò ÛÏÂ̸¯ÂÌËÂÏ ‚ ‡ÁÏÂ‡ı Ô‡‚ÓÈ ‰ÓÎË
Ô˜ÂÌË Ó·Î„˜‡ÎËÒ¸ χÌËÔÛÎflˆËË ÔÓ ÏÓ·ËÎËÁ‡ˆËË ÂÂ Ë ˝Ú‡Ô ‚ϯ‡ÚÂθÒÚ‚‡ ÔÓ ‚˚‰ÂÎÂÌ˲ ÍÓÓÚÍËı Ô˜ÂÌÓ˜Ì˚ı ‚ÂÌ. Ç ÚÓ Ê ‚ÂÏfl ÔÓ‚˚¯ÂÌ̇fl ıÛÔÍÓÒÚ¸ Ô‡ÂÌıËÏ˚ ˝Ï·ÓÎËÁËÓ‚‡ÌÌÓÈ ‰ÓÎË Ô˜ÂÌË ÒÓÁ‰‡‚‡Î‡ ÛÒÎÓ‚Ëfl ‰Îfl ΄ÍÓÈ ÂÂ
Ú‡‚χÚËÁ‡ˆËË Ë ÔÓ‚˚¯ÂÌÌÓÈ ÍÓ‚ÓÚӘ˂ÓÒÚË
Ô‡ÂÌıËÏ˚.
ÅÎËʇȯËÈ ÔÓÒÎÂÓÔÂ‡ˆËÓÌÌ˚È ÔÂËÓ‰ ÔÓÚÂ͇Π„·‰ÍÓ Û 5 Ô‡ˆËÂÌÚÓ‚. ì 2 ·ÓθÌ˚ı ÒÚ‡¯Â
70 ÎÂÚ ÔÓÒÎÂÓÔÂ‡ˆËÓÌÌÓ Ú˜ÂÌË ·˚ÎÓ ÚflÊÂÎ˚Ï, Ò ‡Á‚ËÚËÂÏ fl‚ÎÂÌËÈ Ô˜ÂÌÓ˜ÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË. Ç Ó‰ÌÓÏ Ì‡·Î˛‰ÂÌËË ÍÎËÌ˘ÂÒ͇fl ͇ÚË̇ Ô˜ÂÌÓ˜ÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË ÒÓ˜Âڇ·Ҹ Ò
ˆˉ˂‡ÏË ÊÂÎÛ‰Ó˜ÌÓ-Í˯˜ÌÓ„Ó ÍÓ‚ÓÚ˜ÂÌËfl
ËÁ ÒÚÂÒÒÓ‚˚ı flÁ‚ ‰‚Â̇‰ˆ‡ÚËÔÂÒÚÌÓÈ Í˯ÍË, ‚
‰Û„ÓÏ – Ò ‚˚‡ÊÂÌÌÓÈ ÔÓڇθÌÓÈ „ËÔÂÚÂÌÁË-
çÂÔÓÒ‰ÒÚ‚ÂÌÌ˚ ÂÁÛθڇÚ˚ èÇù Ë ÔÓÒÎÂ‰Û˛˘Â„Ó ‡‰Ë͇θÌÓ„Ó ıËÛ„˘ÂÒÍÓ„Ó ‚ϯ‡ÚÂθÒÚ‚‡ Û ·ÓθÌ˚ı Ò Ó˜‡„Ó‚˚ÏË ÔÓ‡ÊÂÌËflÏË Ô˜ÂÌË
‹ ̇·- ÇÓÁ‡ÒÚ,
β‰ÂÌËfl
„Ó‰˚
èÓÎ
ÉËÔÂÚÂÏËfl
ÔÓÒΠèÇù
àÌÚÂ‚‡Î ÏÂʉÛ
èÇù Ë ÓÔÂ‡ˆËÂÈ,
‰ÌË
ï‡‡ÍÚÂ
ÓÔÂ‡ˆËË
éÒÎÓÊÌÂÌËÂ
1
41
Ü.
38°C, 2 ‰Ìfl
42
èÉÉù
–
2
41
å.
38°C, 1 ‰Â̸
35
èÉÉù
–
3
64
Ü.
–
40
èÉÉù
–
4
68
Ü.
38–39°C, 3 ‰Ìfl
76
êèÉÉù
–
5
71
å.
38°C, 4 ‰Ìfl
37
èÉÉù,
äÎËÌӂˉ̇fl
ÂÁÂ͈Ëfl SIV
6
59
å.
–
35
èÉÉù
–
7
71
Ü.
–
15
èÉÉù
è˜ÂÌӘ̇fl ̉ÓÒÚ‡ÚÓ˜ÌÓÒÚ¸ (‚˚Á‰ÓÓ‚ÎÂÌËÂ)
8
55
å.
–
–
ÄççÄãõ ïàêìêÉàóÖëäéâ ÉÖèÄíéãéÉàà ÚÓÏ 6
–
‹1
2001
è˜ÂÌӘ̇fl ̉ÓÒÚ‡ÚÓ˜ÌÓÒÚ¸ (‚˚Á‰ÓÓ‚ÎÂÌËÂ)
–
55
Ô˜Â̸
ÑééèÖêÄñàéççÄü èéêíÄãúçÄü ÇÖçéáçÄü ùåÅéãàáÄñàü
(‡)
(·)
êËÒ. 7. äÓÏÔ¸˛ÚÂ̇fl ÚÓÏÓ„‡Ïχ Ô˜ÂÌË ‰Ó Ë ÔÓÒΠèÇù.
‡ – ‰Ó èÇù – ÍÓÌÚ‡ÒÚËÛ˛ÚÒfl ÒÚ‚ÓÎ, Ô‡‚‡fl Ë Î‚‡fl
‚ÂÚ‚Ë ‚ÓÓÚÌÓÈ ‚ÂÌ˚; · – ÔÓÒΠèÇù – ÍÓÌÚ‡ÒÚËÛ˛ÚÒfl ÒÚ‚ÓÎ Ë ÒËÒÚÂχ ΂ÓÈ ‚ÂÚ‚Ë ‚ÓÓÚÌÓÈ ‚ÂÌ˚.
ÂÈ, ÔÓfl‚Îfl‚¯ÂÈÒfl ‰ÎËÚÂθÌÓÈ ÔÓ‰Û͈ËÂÈ ‡ÒˆËÚ˘ÂÒÍÓÈ ÊˉÍÓÒÚË. é‰Ì‡ÍÓ ‚Ò ÓÒÎÓÊÌÂÌËfl Û‰‡ÎÓÒ¸ ÛÒÚ‡ÌËÚ¸ Ò ÔÓÏÓ˘¸˛ ÍÓÌÒÂ‚‡ÚË‚Ì˚ı ÏÂ,
·ÓθÌ˚ ·˚ÎË ‚˚ÔËÒ‡Ì˚ ‚ Û‰Ó‚ÎÂÚ‚ÓËÚÂθÌÓÏ
ÒÓÒÚÓflÌËË. 臈ËÂÌÚ͇ 68 ÎÂÚ, Û ÍÓÚÓÓÈ ÔÓÒÎÂ
èÇù ̇·Î˛‰‡ÎÒfl ˝ÔËÁÓ‰ ‡Á‚ËÚËfl ÒÂ‰Â˜ÌÓ-΄ӘÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË, ÔÂÂÌÂÒ· ÓÔÂ‡ˆË˛ ‚
Ó·˙ÂÏ êèÉÉù ·ÂÁ ÓÒÎÓÊÌÂÌËÈ Ë ÔËÁ̇ÍÓ‚ ‡Á‚ËÚËfl Ô˜ÂÌÓ˜ÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË.
èË‚Ó‰ËÏ ÍÎËÌ˘ÂÒÍÓ ̇·Î˛‰ÂÌËÂ.
ÅÓθÌÓÈ É., 71 „Ó‰‡, ÔÓÒÚÛÔËÎ ‚ àÌÒÚËÚÛÚ ıËÛ„ËË ËÏ. Ä.Ç. Ç˯Ì‚ÒÍÓ„Ó 28.09.98 Ò Ê‡ÎÓ·‡ÏË Ì‡ Ó·˘Û˛ Ò··ÓÒÚ¸. Ç Ë˛Î 1998 „. ÓÔÂËÓ‚‡Ì
‚ ËÌÒÚËÚÛÚ ÔÓ ÔÓ‚Ó‰Û ÔÂ‚˘ÌÓ-ÏÌÓÊÂÒÚ‚ÂÌÌÓ„Ó
‡Í‡ Ó·Ó‰Ó˜ÌÓÈ Í˯ÍË (Ò ÎÓ͇ÎËÁ‡ˆËÂÈ ÓÔÛıÓÎÂÈ
‚ ΂ÓÏ ËÁ„Ë·Â Ë ÌËÒıÓ‰fl˘ÂÈ Í˯ÍÂ) Ë ÏÂÚ‡ÒÚ‡Ú˘ÂÒÍÓ„Ó ÔÓ‡ÊÂÌËfl Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË – ‚˚ÔÓÎÌÂ̇ ΂ÓÒÚÓÓÌÌflfl „ÂÏËÍÓνÍÚÓÏËfl. éÔÂ‡ÚË‚ÌÓ ‚ϯ‡ÚÂθÒÚ‚Ó Ì‡ Ô˜ÂÌË ‚ Ó·˙ÂÏ Ô‡‚ÓÒÚÓÓÌÌÂÈ „ÂÏË„ÂÔ‡Ú˝ÍÚÓÏËË, Û˜ËÚ˚‚‡fl ÔÓÊËÎÓÈ
‚ÓÁ‡ÒÚ ·ÓθÌÓ„Ó, ¯ÂÌÓ ·˚ÎÓ ‚˚ÔÓÎÌflÚ¸ ‚ÚÓ˚Ï ˝Ú‡ÔÓÏ.
鷢 ÒÓÒÚÓflÌË ·ÓθÌÓ„Ó ÔË ÔÓÒÚÛÔÎÂÌËË
Ò‰ÌÂÈ ÚflÊÂÒÚË. éÌ ÛÏÂÂÌÌÓ ‡ÒÚÂÌËÁËÓ‚‡Ì,
ÔÓÌËÊÂÌÌÓ„Ó ÔËÚ‡ÌËfl, ÒÚ‡‰‡ÂÚ àÅë, „ËÔÂÚÓÌË56
˜ÂÒÍÓÈ ·ÓÎÂÁ̸˛ II ÒÚ‡‰ËË. ÜË‚ÓÚ Ô‡‚ËθÌÓÈ
ÙÓÏ˚, Ïfl„ÍËÈ, ·ÂÁ·ÓÎÂÁÌÂÌÌ˚È ÔË Ô‡Î¸Ô‡ˆËË
‚Ó ‚ÒÂı Óډ·ı. è˜Â̸ Ì ԇθÔËÛÂÚÒfl.
ìáà: Ô˜Â̸ Û‚Â΢Â̇ Á‡ Ò˜ÂÚ Ô‡‚ÓÈ ‰ÓÎË.
ょfl ‰ÓÎfl ÛÏÂÂÌÌÓ „ËÔÓÚÓÙ˘̇, Ó˜‡„Ó‚˚ı
Ó·‡ÁÓ‚‡ÌËÈ ‚ ÌÂÈ Ì ÓÔ‰ÂÎflÂÚÒfl. Ç Ô‡‚ÓÈ ‰ÓΠ3 „ËÔÂ˝ıÓ„ÂÌÌ˚ı Ó˜‡„‡ Ò ˝ıÓÌ„‡ÚË‚ÌÓÈ Í‡ÈÏÓÈ, ‡ÒÔÓ·„‡˛˘ËıÒfl ‚ V, VI, VII Ò„ÏÂÌÚ‡ı. ê‡ÁÏÂ˚ Ó˜‡„Ó‚ 35, 87 Ë 63 ÏÏ.
äí: Ô˜Â̸ Ó·˚˜Ì˚ı ‡ÁÏÂÓ‚, ÒÚÛÍÚÛ‡ Ì„ÓÏÓ„ÂÌ̇fl. Ç Ó·Î‡ÒÚË Ô‡‚ÓÈ ‰ÓÎË (V, VI, VII Ë
VIII c„ÏÂÌÚ˚) ÓÔ‰ÂÎflÂÚÒfl ÌÂÒÍÓθÍÓ Ô‡ÚÓÎӄ˘ÂÒÍËı Ó·‡ÁÓ‚‡ÌËÈ ÓÍÛ„ÎÓÈ ÙÓÏ˚ (Ò‡ÏÓÂ
·Óθ¯Ó ËÁ ÌËı ‡ÁÏÂÓÏ 9.6 × 7.4 ÒÏ), Ì„ÓÏÓ„ÂÌÌ˚ı, Ò Í‡Î¸ˆËÌËÓ‚‡ÌÌ˚ÏË ‚Íβ˜ÂÌËflÏË. é·˙ÂÏ
Ô‡ÂÌıËÏ˚ Ô˜ÂÌË 1765 ÒÏ3, Ó·˙ÂÏ II + III Ò„ÏÂÌÚÓ‚ 175 ÒÏ3 (ËÒ. 9).
êÂÌÚ„ÂÌÓ„‡ÙËfl Ó„‡ÌÓ‚ „Û‰ÌÓÈ ÍÎÂÚÍË: ˝ÏÙËÁÂχ ΄ÍËı, ÔÌ‚ÏÓÒÍÎÂÓÁ. 阇„Ó‚˚ı Ë ËÌÙËθÚ‡ÚË‚Ì˚ı ÚÂÌÂÈ Ì ‚˚fl‚ÎÂÌÓ.
ë Û˜ÂÚÓÏ ÔÓÊËÎÓ„Ó ‚ÓÁ‡ÒÚ‡ ·ÓθÌÓ„Ó, ̇΢Ëfl ÒÓÔÛÚÒÚ‚Û˛˘Ëı ‚ÓÁ‡ÒÚÌ˚ı ËÁÏÂÌÂÌËÈ ÒÂ‰Â˜ÌÓ-ÒÓÒÛ‰ËÒÚÓÈ ÒËÒÚÂÏ˚, Ó„‡ÌÓ‚ ‰˚ı‡ÌËfl, ̉ÓÒÚ‡ÚÓ˜ÌÓ„Ó Ó·˙Âχ Ô‡ÂÌıËÏ˚ ΂ÓÈ ‰ÓÎË Ô˜ÂÌË ¯ÂÌÓ ‚ ͇˜ÂÒÚ‚Â ÔÓ‰„ÓÚÓ‚ÍË ·ÓθÌÓ„Ó Í
Ô‡‚ÓÒÚÓÓÌÌÂÈ „ÂÏË„ÂÔ‡Ú˝ÍÚÓÏËË ‚˚ÔÓÎÌËÚ¸
‰ÓÓÔÂ‡ˆËÓÌÌÛ˛ ˝Ï·ÓÎËÁ‡ˆË˛ ‚ÓÓÚÌÓÈ ‚ÂÌ˚
Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË.
05.10 ·ÓθÌÓÏÛ ÔÓËÁ‚‰Â̇ ˜ÂÒÍÓÊ̇fl ˝Ï·ÓÎËÁ‡ˆËfl ‚ÓÓÚÌÓÈ ‚ÂÌ˚ Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË.
í˜ÂÌË ·ÎËÊ‡È¯Â„Ó ÔÓÒΠ˝Ï·ÓÎËÁ‡ˆËË ÔÂËÓ‰‡ „·‰ÍÓÂ. ÅÓ΂ÓÈ ÒËÏÔÚÓχÚËÍË Ì ·˚ÎÓ, ÓÚϘÂÌÓ ÔÓ‚˚¯ÂÌË ÚÂÏÔÂ‡ÚÛ˚ ‰Ó ÒÛ·Ù·ËθÌ˚ı ˆËÙ ‚ Ú˜ÂÌË 7 ‰ÌÂÈ. ç‡ ÔÓÚflÊÂÌËË 3 ‰ÌÂÈ
·ÓθÌÓÈ ÔÓÎÛ˜‡Î ÎËÌÍÓÏˈËÌ ÔÓ 60 Ï„ 3 ‡Á‡ ‚ ÒÛÚÍË. ãÂÈÍÓˆËÚ˚ ‰Ó ˝Ï·ÓÎËÁ‡ˆËË 4900, ÔÓÒΠ˝Ï·ÓÎËÁ‡ˆËË ‚ 1- ÒÛÚÍË 20 500, ̇ 2- ÒÛÚÍË 8400.
èË ÍÓÌÚÓθÌÓÏ ìáà Ë ‰ÛÔÎÂÍÒÌÓÏ Ò͇ÌËÓ‚‡ÌËË ÓÚϘÂÌ˚ Û‚Â΢ÂÌË ‚ ‡ÁÏÂ‡ı ΂ÓÈ ‰ÓÎË Ô˜ÂÌË, ÓÚÒÛÚÒÚ‚Ë ÔÓڇθÌÓ„Ó ÍÓ‚ÓÚÓ͇ ‚
Ô‡‚ÓÈ ‰ÓÎÂ, ÛÒËÎÂÌÌ˚È ÍÓ‚ÓÚÓÍ ‚ ΂ÓÈ ‰ÓÎÂ.
ÅÓθÌÓÈ ‚ Û‰Ó‚ÎÂÚ‚ÓËÚÂθÌÓÏ ÒÓÒÚÓflÌËË ‚˚ÔËÒ‡Ì Ò ÂÍÓÏẨ‡ˆËÂÈ ÔÓ‚ÚÓÌÓÈ „ÓÒÔËÚ‡ÎËÁ‡ˆËË ‰Îfl ÓÔÂ‡ÚË‚ÌÓ„Ó Î˜ÂÌËfl ˜ÂÂÁ 2 ̉ ÔÓÒÎÂ
‚˚ÔËÒÍË.
èÓ‚ÚÓÌÓ „ÓÒÔËÚ‡ÎËÁËÓ‚‡Ì 27.10.
äÓÌÚÓθÌÓ äí-ËÒÒΉӂ‡ÌË Ó„‡ÌÓ‚ ·˛¯ÌÓÈ ÔÓÎÓÒÚË Ì‡ 24- ÒÛÚÍË ÔÓÒΠèÇù: Ô˜Â̸ ÌÂÒÍÓθÍÓ Û‚Â΢Â̇, ÌÂÁ̇˜ËÚÂθÌÓ ‚˚ÒÚÛÔ‡ÂÚ ËÁÔÓ‰ Í‡fl ·ÂÌÓÈ ‰Û„Ë, ÒÚÛÍÚÛ‡ Ì„ÓÏÓ„ÂÌ̇fl.
Ç Ó·Î‡ÒÚË Ô‡‚ÓÈ ‰ÓÎË (V, VI, VII, VIII Ò„ÏÂÌÚ˚),
‡ Ú‡ÍÊ ̇ „‡Ìˈ Ô‡‚ÓÈ Ë Í‚‡‰‡ÚÌÓÈ ‰ÓÎÂÈ
ÓÔ‰ÂÎflÂÚÒfl ÏÌÓÊÂÒÚ‚Ó Ô‡ÚÓÎӄ˘ÂÒÍËı Ó·‡ÁÓ‚‡ÌËÈ ÌÂÔ‡‚ËθÌÓÈ Ë ÓÍÛ„ÎÓÈ ÙÓÏ˚ ‡ÁÏÂÓÏ
ÓÚ 1.1 ‰Ó 11.5 ÒÏ, Ì„ÓÏÓ„ÂÌÌ˚Â, Ò Í‡Î¸ˆËÌËÓ‚‡ÌÌ˚ÏË ‚Íβ˜ÂÌËflÏË, ̘ÂÚÍËÏ, ÌÂÓ‚Ì˚Ï ÍÓÌÚÛÓÏ. è‡‡‡ÓڇθÌ˚ ÎËÏÙÓÛÁÎ˚ Ì ۂÂ΢ÂÌ˚.
é·˙ÂÏ Ô˜ÂÌË 1890 ÒÏ3, Ó·˙ÂÏ II + III Ò„ÏÂÌÚÓ‚
213 ÒÏ3.
ÄççÄãõ ïàêìêÉàóÖëäéâ ÉÖèÄíéãéÉàà ÚÓÏ 6
‹1
2001
Ô˜Â̸
ç‡Á‡ÂÌÍÓ Ë ‰.
11.11 Ò ‰Ë‡„ÌÓÁÓÏ ÏÌÓÊÂÒÚ‚ÂÌÌÓ„Ó ÏÂÚ‡ÒÚ‡Ú˘ÂÒÍÓ„Ó ÔÓ‡ÊÂÌËfl Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË ·ÓθÌÓÈ
ÓÔÂËÓ‚‡Ì. Ñ‚ÛıÔÓ‰·ÂÌ˚Ï ‡ÁÂÁÓÏ ÚËÔ‡
“åÂÒ‰ÂÒ” ÔÓÒÎÓÈÌÓ ‚ÒÍ˚Ú‡ ·˛¯Ì‡fl ÔÓÎÓÒÚ¸.
èË ‚ËÁËË ‚ ÌËÊÌÂÏ ÓÚ‰ÂΠ·˛¯ÌÓÈ ÔÓÎÓÒÚË
ӷ̇ÛÊÂÌ ÛÏÂÂÌÌ˚È Òԇ˜Ì˚È ÔÓˆÂÒÒ ÔÓÒÎÂ
ÔÂÂÌÂÒÂÌÌÓÈ ‡Ì ÓÔÂ‡ˆËË, ӷ·ÒÚ¸ ‡Ì‡ÒÚÓÏÓÁ‡ Ò‚Ó·Ó‰ÌÓ ÔÓıÓ‰Ëχ. è˜Â̸ Ì ۂÂ΢Â̇.
è‡‚‡fl ‰ÓÎfl ÓÚ΢‡ÂÚÒfl ÔÓ ˆ‚ÂÚÛ ÓÚ Î‚ÓÈ Ë ËÏÂÂÚ ˆË‡ÌÓÚ˘Ì˚È ÓÚÚÂÌÓÍ, ÌÂÒÍÓθÍÓ ÛÏÂ̸¯Â̇ ‚
‡ÁÏÂ‡ı, ˚ı·fl, ‰fl·ÎÓ‚‡Ú‡fl. ょfl ‰ÓÎfl Ô˜ÂÌË ÍÓ˘Ì‚‡fl, ˝Î‡ÒÚ˘̇fl, Ó·˙ÂÏ Â ÒÓÒÚ‡‚ÎflÂÚ
ÔËÏÂÌÓ 30% Ó·˙Âχ ‚ÒÂÈ Ô˜ÂÌË. Ç VI Ò„ÏÂÌÚÂ
̇ ‰Ë‡Ù‡„χθÌÓÈ ÔÓ‚ÂıÌÓÒÚË ËÏÂÂÚÒfl ·ÂÎÂÒÓ‚‡Ú˚È ÛÁÂÎ ‡ÁÏÂÓÏ 7 × 7 ÒÏ, ‚ VIII, VII, V Ë Ò۷͇ÔÒÛÎflÌÓ – ‚ IV Ò„ÏÂÌÚ‡ı Ô˜ÂÌË ÓÔ‰ÂÎfl˛ÚÒfl Ú‡ÍÊ 4 ÛÁ· ‡ÁÏÂÓÏ 2 × 2, 1 × 1, 2 × 2 Ë 0.5 ÒÏ.
Ç ‰Û„Ëı Óډ·ı Ô˜ÂÌË ËÁÏÂÌÂÌËÈ Ì ‚˚fl‚ÎÂÌÓ.
ê„ËÓ̇Ì˚Â Ë ÓÚ‰‡ÎÂÌÌ˚ ÎËÏÙÓÛÁÎ˚ ‚ ·˛¯ÌÓÈ ÔÓÎÓÒÚË Ì ۂÂ΢ÂÌ˚. éÔÂ‡ˆËfl: Ô‡‚ÓÒÚÓÓÌÌflfl „ÂÏË„ÂÔ‡Ú˝ÍÚÓÏËfl. èÓËÁ‚‰Â̇ ıÓΈËÒÚ˝ÍÚÓÏËfl. Ç ‚ÓÓÚ‡ı Ô˜ÂÌË Â‰ËÌ˚Ï ·ÎÓÍÓÏ ÔÂ‚flÁ‡Ì˚ „ÎËÒÒÓÌÓ‚˚ ˝ÎÂÏÂÌÚ˚ Í Ô‡‚˚Ï
Á‡‰ÌËÏ Ë ÔÂ‰ÌËÏ ÒÂÍÚÓ‡Ï Ô˜ÂÌË. åÓ·ËÎËÁÓ‚‡Ì‡ Ô‡‚‡fl ‰ÓÎfl Ô˜ÂÌË, ÔË ˝ÚÓÏ ÔÂ‚flÁ‡Ì˚
3 ÍÓÓÚÍË Ô˜ÂÌÓ˜Ì˚ ‚ÂÌ˚, ‚Ô‡‰‡˛˘Ë ‚ ÂÚÓÔ˜ÂÌÓ˜Ì˚È ÓÚ‰ÂÎ ÌËÊÌÂÈ ÔÓÎÓÈ ‚ÂÌ˚. èÓ ÎËÌËË ‰Âχ͇ˆËË, ÓÚ‰ÂÎfl˛˘ÂÈ Ô‡‚Û˛ ‰Óβ Ô˜ÂÌË ÓÚ Î‚ÓÈ, ÔÓËÁ‚‰ÂÌÓ ‡Á‰ÂÎÂÌË ÔÂÂÌıËÏ˚
Ô˜ÂÌË. íÛ·˜‡Ú˚ ÒÚÛÍÚÛ˚ ÔÓ ÎËÌËË ÂÁÂ͈ËË
ÔÂ‚flÁ‡Ì˚ Ë ÔÂÂÒ˜ÂÌ˚. Ç˚‰ÂÎÂ̇ Ë ÔÂ‚flÁ‡Ì‡ Ô‡‚‡fl Ô˜ÂÌӘ̇fl ‚Â̇. ë ÔÓ‚ÂıÌÓÒÚË IV Ò„ÏÂÌÚ‡ ÍÎËÌӂˉÌÓ ËÒÒ˜ÂÌÓ 2 ÏÂÚ‡ÒÚ‡Á‡. ÉÂÏÓÒÚ‡Á ‡Ì‚ÓÈ ÔÓ‚ÂıÌÓÒÚË Ô˜ÂÌË. ç‡ ÒÂÁ Ô˜ÂÌË
̇ÎÓÊÂ̇ ÔÎÂÌ͇ “í‡ıÓÍÓÏ·”. ÇÂÏfl ÔÂÂʇÚËfl
„ÂÔ‡ÚÓ‰ÛÓ‰Â̇θÌÓÈ Ò‚flÁÍË ÒÓÒÚ‡‚ËÎÓ 7 ÏËÌ. éÔÂ‡ˆËÓÌ̇fl ÍÓ‚ÓÔÓÚÂfl 1000 ÏÎ.
å‡ÍÓÔÂÔ‡‡Ú: ÏÂÚ‡ÒÚ‡Á Ò Í‡ÁÂÓÁÌ˚Ï ‡ÒÔ‡‰ÓÏ ‚ ˆÂÌÚÂ. ëÓÒÛ‰ËÒÚÓÈ ËÌ‚‡ÁËË ÌÂÚ. ë„ÏÂÌÚ‡Ì˚Â Ë ÒÛ·Ò„ÏÂÌÚ‡Ì˚ ‚ÂÚ‚Ë Ô‡‚ÓÈ ‚ÓÓÚÌÓÈ ‚ÂÌ˚ Á‡ÔÓÎÌÂÌ˚ ÓÍÍβÁËÛ˛˘ËÏ Ï‡ÚÂˇÎÓÏ (ËÒ. 10).
åÓÙÓÎӄ˘ÂÒÍÓ ËÒÒΉӂ‡ÌË ۉ‡ÎÂÌÌÓÈ
ÓÔÛıÓÎË: ÏÂÚ‡ÒÚ‡Á˚ ÛÏÂÂÌÌÓ ‰ËÙÙÂÂ̈ËÓ‚‡ÌÌÓÈ ‡‰ÂÌÓ͇ˆËÌÓÏ˚ ‚ Ô˜Â̸.
ÅÎËʇȯËÈ ÔÓÒÎÂÓÔÂ‡ˆËÓÌÌ˚È ÔÂËÓ‰ ÔÓÚÂ͇ΠÚflÊÂÎÓ, Ò ‰ÎËÚÂθÌÓÈ „ËÔÂ·ËÎËÛ·ËÌÂÏËÂÈ ‰Ó 60–70 ÏÍÏÓθ/Î, ˆˉ˂ËÛ˛˘ËÏ ÍÓ‚ÓÚ˜ÂÌËÂÏ ËÁ ÓÒÚÓÈ flÁ‚˚ ÎÛÍӂˈ˚ ‰‚Â̇‰ˆ‡ÚËÔÂÒÚÌÓÈ Í˯ÍË, ÙÓÏËÓ‚‡ÌËÂÏ ÊˉÍÓÒÚÌÓ„Ó
ÒÍÓÔÎÂÌËfl ‚ ÁÓÌ ÂÁÂ͈ËË Ô˜ÂÌË Ë ‡ÍÚË‚Ì˚Ï
Ô‡‚ÓÒÚÓÓÌÌËÏ „ˉÓÚÓ‡ÍÒÓÏ. ÇÒ ÓÒÎÓÊÌÂÌËfl
ÍÛÔËÓ‚‡Ì˚ ÍÓÌÒÂ‚‡ÚË‚Ì˚ÏË ÏÂ‡ÏË. ÅÓθÌÓÈ
‚˚ÔËÒ‡Ì ‚ Û‰Ó‚ÎÂÚ‚ÓËÚÂθÌÓÏ ÒÓÒÚÓflÌËË.
é·ÒΉӂ‡Ì ‡Ï·Û·ÚÓÌÓ Ë ÒÚ‡ˆËÓ̇ÌÓ ˜ÂÂÁ
6 ÏÂÒ, 1 „Ó‰ Ë 1.5 „Ó‰‡ ÔÓÒΠÓÔÂ‡ˆËË. ëÓÒÚÓflÌËÂ
Ô‡ˆËÂÌÚ‡ Û‰Ó‚ÎÂÚ‚ÓËÚÂθÌÓÂ, ÓÌ ‡ÍÚË‚ÂÌ, ‚˚ÔÓÎÌflÂÚ ÙËÁ˘ÂÒÍÛ˛ ‡·ÓÚÛ ÔÓ ‰ÓÏÛ (ÔÓÊË‚‡ÂÚ
ÄççÄãõ ïàêìêÉàóÖëäéâ ÉÖèÄíéãéÉàà ÚÓÏ 6
êËÒ. 9. äÓÏÔ¸˛ÚÂ̇fl ÚÓÏÓ„‡Ïχ ·ÓθÌÓ„Ó É. ‰Ó èÇù.
‚ ÒÂθÒÍÓÈ ÏÂÒÚÌÓÒÚË). èËÁ̇ÍÓ‚ ˆˉ˂‡ Á‡·Ó΂‡ÌËfl Ì ‚˚fl‚ÎÂÌÓ.
é·ÒÛʉÂÌËÂ
Ç˚ÔÓÎÌÂÌË éêè Û ·ÓθÌ˚ı Ò ÌËÁÍËÏ ÙÛÌ͈ËÓ̇θÌ˚Ï ÂÁÂ‚ÓÏ Ô˜ÂÌË ÒÓÔflÊÂÌÓ Ò ‚˚ÒÓÍËÏ
ËÒÍÓÏ ‡Á‚ËÚËfl ÓÒÚÓÈ Ô˜ÂÌÓ˜ÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË ËÁ-Á‡ ÔÓÚÂË Á̇˜ËÚÂθÌÓÈ Ï‡ÒÒ˚ ÙÛÌ͈ËÓÌËÛ˛˘ÂÈ Ô˜ÂÌÓ˜ÌÓÈ Ô‡ÂÌıËÏ˚, ‡ Ú‡ÍÊ ÒÌËÊÂÌÌÓÈ ÒÔÓÒÓ·ÌÓÒÚË Ô˜ÂÌË Í „ÂÌÂ‡ˆËË.
ñÂθ ˜ÂÒÍÓÊÌÓÈ ˝Ï·ÓÎËÁ‡ˆËË ‚ÓÓÚÌÓÈ ‚ÂÌ˚ – ‰Ó·ËÚ¸Òfl „ËÔÂÚÓÙËË ‰ÓÎË Ô˜ÂÌË, ÒÓÒÛ‰˚
ÍÓÚÓÓÈ Ì ÔÓ‰‚Â„ÎËÒ¸ ˝Ï·ÓÎËÁ‡ˆËË, Ë ÔÓ‚˚¯ÂÌËfl  ‰ÓÓÔÂ‡ˆËÓÌÌ˚ı ÙÛÌ͈ËÓ̇θÌ˚ı ÂÁÂ‚Ó‚.
àϲ˘ËÂÒfl ‚ ̇¯ÂÏ ‡ÒÔÓflÊÂÌËË ÍÎËÌ˘ÂÒÍË ̇·Î˛‰ÂÌËfl (8 Ô‡ˆËÂÌÚÓ‚, ÔÂÂÌÂÒ¯Ëı ˝Ï·ÓÎËÁ‡ˆË˛ Ô‡‚ÓÈ ‚ÓÓÚÌÓÈ ‚ÂÌ˚, 7 ËÁ ÍÓÚÓ˚ı
Á‡ÚÂÏ ‚˚ÔÓÎÌÂÌ˚ Ó·¯ËÌ˚ ‡Ì‡ÚÓÏ˘ÂÒÍË ÂÁÂ͈ËË Ô‡‚ÓÈ ‰ÓÎË Ô˜ÂÌË) ۷‰ËÚÂθÌÓ Ò‚Ë‰ÂÚÂθÒÚ‚Û˛Ú Ó· ˝ÙÙÂÍÚË‚ÌÓÒÚË ÏÂÚÓ‰‡. éÚ˜ÂÚÎË‚Ó ۂÂ΢ÂÌË Ì ÔÓ‰‚Â„¯ÂÈÒfl ˝Ï·ÓÎËÁ‡ˆËË ‰ÓÎË Ô˜ÂÌË Á‡„ËÒÚËÓ‚‡ÌÓ Í‡Í ÔÓ ‰‡ÌÌ˚Ï
äí-ËÒÒΉӂ‡ÌËfl, Ú‡Í Ë ÔÓ ÂÁÛÎ¸Ú‡Ú‡Ï ËÌÚ‡ÓÔÂ‡ˆËÓÌÌÓÈ ‚ËÁËË.
ÑÓ‚ÓθÌÓ „·‰ÍÓ Ú˜ÂÌË ·ÎËÊ‡È¯Â„Ó ÔÓÒÚ˝Ï·ÓÎËÁ‡ˆËÓÌÌÓ„Ó ÔÂËÓ‰‡, Á̇˜ËÚÂθÌÓ Ì ̇Û¯‡‚¯Â ҇ÏÓ˜Û‚ÒÚ‚Ëfl, ÓÚϘÂÌÓ Û ·Óθ¯ËÌÒÚ‚‡
Ô‡ˆËÂÌÚÓ‚. ÇÏÂÒÚÂ Ò ÚÂÏ Ú‡ÍË ··Ó‡ÚÓÌ˚Â
‰‡ÌÌ˚Â, Í‡Í ÔÓ‚˚¯ÂÌË ÛÓ‚Ìfl Ú‡ÌÒ‡ÏË̇Á Ò˚‚ÓÓÚÍË ÍÓ‚Ë ‚ ÌÂÒÍÓθÍÓ ‡Á ÔÓ Ò‡‚ÌÂÌ˲ Ò ËÒıÓ‰Ì˚Ï ÛÓ‚ÌÂÏ, ÛÏÂÂÌÌÓ ÔÓ‚˚¯ÂÌËÂ Û ÌÂÍÓÚÓ˚ı ·ÓθÌ˚ı ÒÓ‰ÂʇÌËfl ·ËÎËÛ·Ë̇ Ë ÏӘ‚ËÌ˚, Ú‡ÌÁËÚÓÌ˚È ÎÂÈÍÓˆËÚÓÁ Ò ‚˚ÒÓÍËÏË
ˆËÙ‡ÏË, ‡ Ú‡ÍÊ Ú‡ÌÁËÚÓ̇fl „ËÔÂÚÂÏËfl „Ó‚ÓflÚ Ó ‡Á‚ËÚËË ÔÓÒΠèÇù ‡ÍÚË‚Ì˚ı ˯ÂÏ˘ÂÒÍËı Ë ‚ÓÒÔ‡ÎËÚÂθÌ˚ı ËÁÏÂÌÂÌËÈ ‚ Ô‡ÂÌıËÏÂ
˝Ï·ÓÎËÁËÓ‚‡ÌÌÓÈ ‰ÓÎË Ô˜ÂÌË, ˜ÚÓ Ú·ÛÂÚ ÔÓ‹1
2001
57
Ô˜Â̸
ÑééèÖêÄñàéççÄü èéêíÄãúçÄü ÇÖçéáçÄü ùåÅéãàáÄñàü
‚‰ÂÌËfl ÒÓÓÚ‚ÂÚÒÚ‚Û˛˘ÂÈ Ï‰Ë͇ÏÂÌÚÓÁÌÓÈ ÍÓÂ͈ËË.
Å·„ÓÔËflÚÌ˚ ËÒıÓ‰˚ ÔÓÒÎÂ‰Û˛˘Â„Ó ÓÔÂ‡ÚË‚ÌÓ„Ó ‚ϯ‡ÚÂθÒÚ‚‡, ÌÂÒÏÓÚfl ̇ ‡Á‚ËÚË ‚
2 ̇·Î˛‰ÂÌËflı Ô˜ÂÌÓ˜ÌÓÈ Ì‰ÓÒÚ‡ÚÓ˜ÌÓÒÚË,
۷‰ËÚÂθÌÓ Ò‚Ë‰ÂÚÂθÒÚ‚Û˛Ú Ó ˆÂÎÂÒÓÓ·‡ÁÌÓÒÚË ‚˚ÔÓÎÌÂÌËfl ‰ÓÓÔÂ‡ˆËÓÌÌÓÈ èÇù ÔË ‰ËÒÚÓÙ˘ÂÒÍËı ËÁÏÂÌÂÌËflı Ô‡ÂÌıËÏ˚ Ô˜ÂÌË, ‡ Ú‡ÍÊÂ
χÎÓÏ Ó·˙ÂϠ΂ÓÈ ‰ÓÎË, ÓÒÓ·ÂÌÌÓ Û Ô‡ˆËÂÌÚÓ‚
ÒÚ‡˜ÂÒÍÓ„Ó ‚ÓÁ‡ÒÚ‡. ÑÓÓÔÂ‡ˆËÓÌ̇fl ˝Ï·ÓÎËÁ‡ˆËfl Û 2 ·ÓθÌ˚ı 71 „Ó‰‡ ÔÓÁ‚ÓÎË· Á̇˜ËÚÂθÌÓ
ÒÏfl„˜ËÚ¸ ÚflÊÂÒÚ¸ ÓÒÎÓÊÌÂÌËÈ, ‡Á‚Ë‚¯ËıÒfl Û ÌËı
‚ ·ÎËʇȯÂÏ ÔÓÒÎÂÓÔÂ‡ˆËÓÌÌÓÏ ÔÂËÓ‰Â, Ë ‰Ó·ËÚ¸Òfl ‚˚Á‰ÓÓ‚ÎÂÌËfl. ì Ô‡ˆËÂÌÚÍË 68 ÎÂÚ Ò ÍÓÏÔÎÂÍÒÓÏ ÚflÊÂÎ˚ı ÒÓÔÛÚÒÚ‚Û˛˘Ëı Á‡·Ó΂‡ÌËÈ
ÔÓÒÎÂÓÔÂ‡ˆËÓÌÌ˚È ÔÂËÓ‰ ÔÓÚÂ͇Π·ÂÁ ÓÒÎÓÊÌÂÌËÈ.
чθÌÂȯ ̇ÍÓÔÎÂÌË ÍÎËÌ˘ÂÒÍÓ„Ó Ï‡ÚÂˇ· ÔÓÁ‚ÓÎËÚ ‰‡Ú¸ ·ÓΠÔÓÎÌÛ˛ ÓˆÂÌÍÛ ˝ÙÙÂÍÚË‚ÌÓÒÚË Ë ‚ÓÁÏÓÊÌÓÒÚflÏ ÏÂÚÓ‰‡ ‰ÓÓÔÂ‡ˆËÓÌÌÓÈ èÇù ‚ ıËÛ„ËË ÓÔÛıÓÎÂÈ Ô˜ÂÌË.
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2. á‡È‰ÂÌ·Â„ å.Ä., ä‡ÂÎËÌ Ä.Ä., ÅÛË‚ à.å., чÌËÎÓ‚ å.Ç., éÒÚˆӂ‡ ç.à., ĉ‡ÏflÌ Ä.Ä., 뇂‚Ë̇ í.Ç. êÂÌÚ„ÂÌÓÍÓÌÚ‡ÒÚÌ˚È ‡ÌÚË·‡ÍÚÂˇθÌ˚È
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‰ÓÓÔÂ‡ˆËÓÌÌÓÈ ÔÓڇθÌÓÈ ˝Ï·ÓÎËÁ‡ˆËË. å‡ÚÂ-
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ÄççÄãõ ïàêìêÉàóÖëäéâ ÉÖèÄíéãéÉàà ÚÓÏ 6
‹1
2001
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