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Kamvrmrpo CKOIUiQeCKaH KapTHH8 xapaKTCp H3yeTcH YBempleHHeM l(RaMeTPa

K8ID1JU1S1POB Ha centoHe pe3KOrO )MeHbilIeHIDI I1X KOJIlf1leCTBa llO3TOMy npH

KpHTHl ecKoi-i HliIeMID1 IIamu eB KHCTH YMeHhllleHl1e JllIaMeTp8 H KOnl-fleCTBa

KanMJIJlsrpoB CBliJleTeJIbCTByeT B nOJlb3Y 06mnepHPYlOmero TpOM6aRrnBTa a

YCKllCHIfe nO~COCOlKOBOro CiineTeHlliI H Hap ymeE l1e xo~a KallIDlJlSlpOB

HOITeBOr O JIO)l(8 HaomonaeTcSI )Kc Ha HaqaJThHbl X CT8DIDIX 06rrnTepHpyromero

TpoM6 aRfr-IHTa -qero HeT np n CKlIep OJlepMHH

HaH60nee fCTKID CBH3b Me)l(ll) cren eHblO HIlleMmf H rl1nOKcHeil TK8HeH

JleMoHcTPRPYeTCSI UpH Tp8HCKT8HHOl B3MCPCHHlf HanpH~cBHR KHCJlOpOla

Koarn KHCTn (TcP0 2) ECJlli y 8CHMl1TOMHhlX 6 0Jlb HhlX npn nepBOH H BTopol1

CTeneHli I1mCMHH TcP0 2 6 hIJIO H8 HH)KHeH rpaHHle HOPMbI- 4 8 2plusmnI 2

MMpTCT TO npH KpHTWreCKOM l1l11eMHI1 OTMeI8JlOCb pe3Koe CHWKeRHe nora

IIOKa3aTeIDi nO 30 MMpTCT [I03TOMy HanpIDICeHBe KJlCnOpOl(8 Mhl OTHOCHM K

0lRJ1M H3 OCHOBHbIX 0 6 beKTHBRhlX IlOKa3aTeneil CTen eHH lilIJeMBH Y 6 0JIbHhIX

0 6m iTepHp yroIURM 1]loM6aHnrnToM

PCHTrCHKoIlTpaCTHYJO aUfuorpacj)81O MbI B oeROBROM BhlIIOJIIDlJlli

IIp Kpl1UNeCKOH mrreMJrn Tlepen onepanlBRhIM BMemaTentCTBOM llaHHbrH

BHI BCClIellOBaHIDI 6M] BbmOJIFleR 11 6 0JIbHbTM 06lTHTep Hp)lOIUlfM

TPoM6anBTIrnToM llB)M 60JThHbtM co BTOPOH CTeneHhlO HmeMBH BepXHHx

KOHeiHOCTefi If 9 60JlhHbIM C KpHTlfteCKOH I1IlleMHeM KOHelHOCTH AHaJlH3

j

aHTlIOrpaMM lIbUlBHn CJleLl) lOlllHH npoKCHMal1gtmrK Ii illCTalTJil fbIH ypoaeHb

OKKJJJ03H1I (Ta6n 6 H 7 COOTBCTCTBeHlIO)

Tn61u~a 6 np~ VlH ypuorn 0 VnnJ~JU o ~ IUU02PCUPUU~ _IJao V _

)QQBem OKK1103lilI Komrqecl1O 6oThllblX

IblKJIKllHiH1lJj 1 (91) ap-repWl lloJlMhlJllefflllll 1I1G1 I 3(273) lIDeleBaJI apleplUI

AprepllJl~mmelbjj 7(636) Bcero I]

C omaCHO IlBUHhlM rrpcuCTaBJICHHhlM Ta6mllle 636 60lTbHblX HMeJUI

npOKCIiMaJTbHhlll ypoaem 0KKJl103HJf AHCTdJThHec JlOlMeBOro CYCTaB8

AHaJIH3 8HflfOrpaMM AHCTaJThHOrO apTepHaJ11Horo pycna y 60JIhIImHCTBa

Tl8U)ieHTOB BIgtUrBHJI lie T01rblW CTeH03 HO H 0KIOIJ03BIO apTepflii rrpelrTnetfbJI

KHCTII fI TlaJThueBhIX apTepHH (Ta6n 7)

oseHb OKKllJ03UU no OflJllLblAl QIIZUOZDQl1Juu OKK1l031UI Crea03HpOllaHlle

)J8HHhIe aRTHorpaciJID1 CBfJ(eTellbcTBYlOT 0 TOM iTO 1aCTOTa 0KK11031oJf

YBenW-Il1BaeTCSI B )UCTaHOM H8npaBJJemUf H B nanhueBbIX apTepl1HX cornactlo

HallIRM llaHHhlM COCTaBJUleT Y 8 18 60mmIx

rHCTOJlOrHqectme BCCJlellOBaHJUl apTcpJoti1 aMTIY111pOBaHHb1X namueB

6blJIB BhI110JIHeHbI y 3 60JThltllX o6lJ1ITeprrpYIOmHM 1poM6aHrHHTOM TIpraquo no

BblSlBJIeHO HanHlfle BOCIIaJTlITeJIIIlO-Aer eUep8TI1BBhIX Fl3MeHeHIDi He lOJIhKO B

nruIhueBbIX apTcp rurx EO H B Ml1l1POUHPKymTOpROM pycne rramuesshy

apTepHOlIax Ii BeHYJIax ITO xapaKTep HO AJUI MopqOJIOrlfieCKOH KapTHlJ

ap TepHH lilHKH11X KOHefHOCTei-i rTpH 06nHrcpnp)IOtmfM rpoM6aHT1irrre

T aKHM 06pa30M TOJIhKO KOMnneKCHru lUIarnOCTBKa BKJllOIlUOmW

HCClelOBaHHe He TOJlJKO MrumiddotI1CTPamHbCX 8plepIDi HO H

MiiKpOUHpKYnSITopHOro pycna c nOMOlI(llO IlynneKcHoro CKaHHpOSaHlliI l1

15

nHaMeTPa (2 l3plusmnO7SM1CM) H KOJTHleCTBa KaIIHJIIDpoundPOB (346plusmn 12 8liM)

(T a6nS)

Ta6Jlu~a 5 KOJluecm6eH1faJI xapalCJnepucmUJltQ KanUJlJlJlpOCKOnUIeCKOU

KQpmUllbl 8 HopMe U IPU KpUtnuIecKoii UlUeMUU tlepXHUX K01lelOCmeU

npuOT KOJIWleCTBeHHbe

napaMeTPhI

HOPM8 OT

lJHaMeTp KarutnmlPOB 4 l plusmn l 4 2 13plusmn075

KOllWlecTBo

Karm JTJIjlpOB

92plusmn1 3 346plusmn1 2 8

(plt OOS)

B OTlIHIRe OT o6rurrepHPYlOmera TPoM6aHnnfTa IIpI1 c KJIeponep MHH

Kamvrmrpo CKOIUiQeCKaH KapTHH8 xapaKTCp H3yeTcH YBempleHHeM l(RaMeTPa

K8ID1JU1S1POB Ha centoHe pe3KOrO )MeHbilIeHIDI I1X KOJIlf1leCTBa llO3TOMy npH

KpHTHl ecKoi-i HliIeMID1 IIamu eB KHCTH YMeHhllleHl1e JllIaMeTp8 H KOnl-fleCTBa

KanMJIJlsrpoB CBliJleTeJIbCTByeT B nOJlb3Y 06mnepHPYlOmero TpOM6aRrnBTa a

YCKllCHIfe nO~COCOlKOBOro CiineTeHlliI H Hap ymeE l1e xo~a KallIDlJlSlpOB

HOITeBOr O JIO)l(8 HaomonaeTcSI )Kc Ha HaqaJThHbl X CT8DIDIX 06rrnTepHpyromero

TpoM6 aRfr-IHTa -qero HeT np n CKlIep OJlepMHH

HaH60nee fCTKID CBH3b Me)l(ll) cren eHblO HIlleMmf H rl1nOKcHeil TK8HeH

JleMoHcTPRPYeTCSI UpH Tp8HCKT8HHOl B3MCPCHHlf HanpH~cBHR KHCJlOpOla

Koarn KHCTn (TcP0 2) ECJlli y 8CHMl1TOMHhlX 6 0Jlb HhlX npn nepBOH H BTopol1

CTeneHli I1mCMHH TcP0 2 6 hIJIO H8 HH)KHeH rpaHHle HOPMbI- 4 8 2plusmnI 2

MMpTCT TO npH KpHTWreCKOM l1l11eMHI1 OTMeI8JlOCb pe3Koe CHWKeRHe nora

IIOKa3aTeIDi nO 30 MMpTCT [I03TOMy HanpIDICeHBe KJlCnOpOl(8 Mhl OTHOCHM K

0lRJ1M H3 OCHOBHbIX 0 6 beKTHBRhlX IlOKa3aTeneil CTen eHH lilIJeMBH Y 6 0JIbHhIX

0 6m iTepHp yroIURM 1]loM6aHnrnToM

PCHTrCHKoIlTpaCTHYJO aUfuorpacj)81O MbI B oeROBROM BhlIIOJIIDlJlli

IIp Kpl1UNeCKOH mrreMJrn Tlepen onepanlBRhIM BMemaTentCTBOM llaHHbrH

BHI BCClIellOBaHIDI 6M] BbmOJIFleR 11 6 0JIbHbTM 06lTHTep Hp)lOIUlfM

TPoM6anBTIrnToM llB)M 60JThHbtM co BTOPOH CTeneHhlO HmeMBH BepXHHx

KOHeiHOCTefi If 9 60JlhHbIM C KpHTlfteCKOH I1IlleMHeM KOHelHOCTH AHaJlH3

j

aHTlIOrpaMM lIbUlBHn CJleLl) lOlllHH npoKCHMal1gtmrK Ii illCTalTJil fbIH ypoaeHb

OKKJJJ03H1I (Ta6n 6 H 7 COOTBCTCTBeHlIO)

Tn61u~a 6 np~ VlH ypuorn 0 VnnJ~JU o ~ IUU02PCUPUU~ _IJao V _

)QQBem OKK1103lilI Komrqecl1O 6oThllblX

IblKJIKllHiH1lJj 1 (91) ap-repWl lloJlMhlJllefflllll 1I1G1 I 3(273) lIDeleBaJI apleplUI

AprepllJl~mmelbjj 7(636) Bcero I]

C omaCHO IlBUHhlM rrpcuCTaBJICHHhlM Ta6mllle 636 60lTbHblX HMeJUI

npOKCIiMaJTbHhlll ypoaem 0KKJl103HJf AHCTdJThHec JlOlMeBOro CYCTaB8

AHaJIH3 8HflfOrpaMM AHCTaJThHOrO apTepHaJ11Horo pycna y 60JIhIImHCTBa

Tl8U)ieHTOB BIgtUrBHJI lie T01rblW CTeH03 HO H 0KIOIJ03BIO apTepflii rrpelrTnetfbJI

KHCTII fI TlaJThueBhIX apTepHH (Ta6n 7)

oseHb OKKllJ03UU no OflJllLblAl QIIZUOZDQl1Juu OKK1l031UI Crea03HpOllaHlle

)J8HHhIe aRTHorpaciJID1 CBfJ(eTellbcTBYlOT 0 TOM iTO 1aCTOTa 0KK11031oJf

YBenW-Il1BaeTCSI B )UCTaHOM H8npaBJJemUf H B nanhueBbIX apTepl1HX cornactlo

HallIRM llaHHhlM COCTaBJUleT Y 8 18 60mmIx

rHCTOJlOrHqectme BCCJlellOBaHJUl apTcpJoti1 aMTIY111pOBaHHb1X namueB

6blJIB BhI110JIHeHbI y 3 60JThltllX o6lJ1ITeprrpYIOmHM 1poM6aHrHHTOM TIpraquo no

BblSlBJIeHO HanHlfle BOCIIaJTlITeJIIIlO-Aer eUep8TI1BBhIX Fl3MeHeHIDi He lOJIhKO B

nruIhueBbIX apTcp rurx EO H B Ml1l1POUHPKymTOpROM pycne rramuesshy

apTepHOlIax Ii BeHYJIax ITO xapaKTep HO AJUI MopqOJIOrlfieCKOH KapTHlJ

ap TepHH lilHKH11X KOHefHOCTei-i rTpH 06nHrcpnp)IOtmfM rpoM6aHT1irrre

T aKHM 06pa30M TOJIhKO KOMnneKCHru lUIarnOCTBKa BKJllOIlUOmW

HCClelOBaHHe He TOJlJKO MrumiddotI1CTPamHbCX 8plepIDi HO H

MiiKpOUHpKYnSITopHOro pycna c nOMOlI(llO IlynneKcHoro CKaHHpOSaHlliI l1

15

KaIDIJlllRpOCKOmrn D03BOJUleT BMSfBHTh nOpaJKCHlie apTeplrn BCPXHliX

KOHeIHOCTeA npM ofirnlTepl1pyrOIT11M rpoMfiaRTHrrre lIa HaqaJTbHhlx nanax

3afioJleBaHHlI A BbUIBJletrne yromueHIUl c-reHOK apTepHH np eADnelhH H KMCTM

CBbIllJe 05 MM C HCLfe3ROReIDIeM leTKOH AI1qqep eHIJMpOBKH na CJJOH I1

yaenl1-leHl1eM nepHqepwrecKoro COrrpOTl-mneHl1J1 B 3THX apTepllllX npM

KpI1THieCKOH lillIeMUI1 KOHelHOCTH RBJUleTCR OCBOBHbIM npH3HaKOM

nOpa)J(eHIDI rrpM o6mrrepwpylOIlJlfM TpoMoaurllliTe

Onpe)le1emle aKTHSHOCTIt BOCnaneHWl I1 CTeneHH DOpa)J(ellIDI

KOHeIHOCTH n 03BOJlffiOT IlpaBHnbHO BbI6paTb TaKTJU(Y JIeIeHID

MeTOJl CTBTI1CTnlec~oii o6pa6OTKH MaTepOaJla

CTaTHCTIl-leCKaR o6pa6oTKa n OnYlCHHhIX QaHHldX npol13Be)leHa na

nepCOH8JThHOH 3BM mna IBM PC c neMOLUblO naKCTa lJPorpaMM Statistica

45 B cpeJle Windows 95 lJoCTosep HOCTh p a3lli1fIDl OIJeHRBMI1 C

I1C(JOnb30BaHHeM KpHTepliR CnlOlIeHTa p a3HIDJa CfHTanaCb )lOCTOBepHoH npl1

plt OOS

1iR~aHWHe B oTn8J1eHHble pel)JlblaTbl KOMDJleKCHOro ne-leUIUI 60JlbHhlX

BceM 60JJbl-fb1M 06JIHTCpMP)IO[IJJiM TpoM6annn-lTOM C rrOp3)l(eHHeM

apTepIDi aepXHIfX KOHelHOcTei-l ne-leIDIe HaqHHaJTH C KOHcepBaTHaHO~

Tepamm KOTOPaR B P8Jle cJI)flles K)IllipoBaJla HBJleHHR HIIIeMIm nrm IDImUlaCb

nOlrOTOBH1enbHbIM nanOM K onepaTKBHoM) JIeleIDllO

KOHcepBaTHBHOe neqeHHe BKJIlOIanO cTall)lapTH)IO KOHcepBanmHyrO

TepanlUO (CK1)- alB HHIPY3HH paCTl30pa PeonoJlJUJDQKHHa C paCTBopoM

TpeHTana C OOR3aTeJIbHhlM onperen eHHeM aKTliBfiOc-rn BocnaneHHll

Y 29 (674) H3 43 60nlgtHTTX DIilliBJleHO DOBhllUelUie 1l0Ka3aTeJleil

ryMOpaJl1gtHOrO HMMHRTera (lgG IgM WIK H CP5) qTO HBJUiJIOCb

rrOKa3aHl1CM K npoBeileHIDO nYJIhC-TepanMlI IgM lf8JLllJ1Cll cKpmrnHr -TecTOM

3qQleKTffBHOC1li IlpoTl1BOBOCnaJlHTeJChHOH repamrn TI03TOMY ITpH coxpaHelUlH

nOBhIIDCHH1gtIX nOKa3aTeneif IgM rrynhc-Tepanmo nOBTOpllJ1li

16

flpoaeueIIl1e CTaH)lapTHOH KOHCepBaTHBHol1 TepaIJJ1H B COleTaH1Ul C

nYJlbC-lepaI lHefi OKa3aIJOCL 3qcpeKIHIIllOH Y Bcex 60nbHbIX C 1 CTeneHLlO

HrueMHI1 BepXH11X KOHClliOCTCR l Y 667 60JIbSblX co 2 cTerreHblO HIDeM1ill

ocralThHhIM 33 3 60llhHhlM co BTOpoH CTCnClThlO lifIlle~nrn BbmOJlHeHO

XI1pypr114ecKoe ne4etlliC

KOHCepaaTlffiHaii TepaIIIHI Y 60JlbHhIX C KplITHfeCKott mneMHeH OKalanaCb

3ltlgtIPeKTIfBHoif 6onee -IeM y nOJIORHlIb 6 0nbHhIX- 583 C 6a3aJTbHb1M

ypOBReM TcP02 tfa KI1CTH 6 0Jlee 30 MMpTCT (Ta6 8)

Ta61uu 8 ]CollcepwmU6HaR mepanWi 6 zpynne 60IlIIX CKpUmUeCKOU uUte4fueU

COleT8RHe KOJJWICKTBO OOJ1hHbL( KyrlJipOBaIDlC K11llocqe J1eKapCTBeElIlol Tep8mm KOliCepBIlTKBBOli repamm

(5e1 ouepBqiHI CKT 5 1 (20) CKT+PgEl 5 2 (40l CKT~m - 6 4 (667) CKTrrT+PgEl 8 7 (87510) BceJO 24 I 14 (583)

3qqeKTIiBHOCTb KOHcepBaTHBHofi Tepamm B OTl(aneHHbIe CpOKH pe3Ko

rroarxmaercJI 11p11 COIeTaHHH CTaHZaprnoH KOHcepBanmnOll Tepamrn C nymcshy

repanHeH 11 DpOCTarnaHlI1UIOM E1 H nOCTHraer 875 TorJH KaK

1130JIUPOS8H1l8l CTaHJJapnfBsr KOHCCpBaTHBHaJi Tepamul OKa3blBaeTCll

3ltpqeTI1BHOH JIHmb y 20 60JlblThlX

XHpypralecKoe Jle-leHlJe

n p a He3qqeIltTl11lHOCTH KOHcepBa-nmHoH repanlfH 60JTbHbJM MhI CTaBHillI

nOKa3amur K orrepaTIlBlioMY n eieHIDO X apyprn1eCKoMY Jle-IeHHlO

iloJ1leprnHCL 2 60nbHhlx CO STopoH CTeneHLro H 10 60JtbBhlX C KpHTHqeCKoii

lfllleMraquoCH BepxHMX KOHeTIJOCTeR

TIPl-i Bbl60pe oneparum Mbl OTAllBaJlH npelJrlOlTeIDIe ruyHTHpylOillMM

pelltOHcTpYKTI1BI1bIM OnepaIJIDlM xou xapaKTepHoe JDIII o6muepHpYlOmer o

YpoM6aHnnrra npeHM)IUcCTBeHHoe nOpaJKeHHe JlHCTanbBOTO pycna ( apTepmi

npennJle-lr)l KHCT1 Ii 1l8JlbIJeBblX aprepHi1) pe3Ko y-MeHbDIaer )cpqeKTl1BllOCTh

17

1I0u06HhlX BMerrraTerhCTB LITO IDlHJlOCh n pHlHHOH He6oJlhworo ~JHCJla

Ha6JUollCllliM

lJBYM 60JlbHblM CO BTOpoJj CTenellblO HWelUlH 6hIJUI tpOl13BeneHhl

llOllKJI10tfHltUlO-nO)MbTrneQHOe COffiTO-nO)JMhImeLJHoe 11 nOTMlgtUlelHO-nyqeBOe

WYlITHpOBaHlIe I-b HJlX Y 1 60llbHOro BhmOJ1HeHbJ (Be peKocTpyrrrJmmTe

onepauIDI H a olJHoki KOHeIHOCTH- IJOllKJllOlRlHO-IJO)JMbHDernoe H COBROshy

I IO~IUlJelfROe mYBTHpOBaHHe B TOPru onepaIllU 6hlJla BhlIJOrHeH8 Iepe3 10

iJe1 nocne nepBOR B CBs[3H C HllIeMJWH Bh13BaR HOM TpOM6030M 1IIYHTa Y

BToporo 60IlhHOro H3 noii rpynnw OKK1l103ID nneleBOH aprepHH COfeTarraCh C

BbJpfUKeHHhlMH J13MeHeHMJlMH lUiCraJIbHoro apTepruulIlIoro pycna H

BhHlOJlHeHl-le lllyrrrllpYTOmefi oneprunm ilpHBeJTO K p a l-JleMY TpoM603Y rnylITa

IIeoLlHoKpaTHhle IJOlThlTKH rpoM6nTOMHH aprfBeJ1H K n OBTopHWM rpoM603aM H

pel(~I1By lillleMFH iTO nOTpe6oBaJlO ~myrawm KOHelHOCTH Ha yposHe

nneLJa

LBYM 6011IlThlM C KpHTlIleCKOH mnerUicH KOHeqHOCH I BblDOilHeHbJ

nOnMLlmelllO-lllJeqeBOe II Ilnele-MegtKKOCTHOe ill)HllipOBBHRe ITp1l rrepBoH

onepauYlH )JJiCTaJTbHh1R aHaCTOM03 HaJltJlaznll3aIJC5I ITO nmy KoHen B 60K

TOTltaC nan 611ltjJ)pJltaIUlefi IJJlefeBOH ap TeplUl Bo sropoM cJlytlae Jly-qeB85I Ii

JlOKieBruI apTepl1M 6hL1fH OKKJlJ03HpOB3HhI rr03TOMy DHCTalThHhlH aBaCTOM03

HaKJl81UgtJBanCJI no THrry KOHen B KOHe n C MeiKKOCTHoi aPTepHeit YI11Tbm ltUI

Manhlii BOCIIpHHliM8JOIJUlli 06beM AJilCTalThH o r o PYCJIa nonO1RHTeJIMlO

HaIJO)KeB aaaCTOM03 C BeTBbJO Jl)leBOH apTepIDI H myHTOM n o TIill) KOHen B

KOHell B 060HX CJI)aJIX HCnOJlb30BanaCb p eBepCHpOBaHFJru ayrOBelia

no HaimtM naHHbJM 3rpcpeKTIilmOCTh myHTHpYJOIIHX onepa~ B

6mtjkaHmeM IJepFloue COCTaBHJJa 80 OueHJ(a OTnaneHHhlX pe3YlThTaToB B

CpOKI1 CBhlOle 2 Jle1 CBHneTemCTBOSaJTa 0 pemutHBe HmeMHR y 2 H3 4

6oJlbHhlX TIpH-leM pelUi)JHB KPMTH1fecKOff JiIl1eMJfH Ha6mo)JaJICJpound TOJIbKO y 1

60JlbHoro T eM He MeHee MbJ Cll1TaeM ITO 110JHOCThIO OTK83blBaTICH OT

ITpIiMeHerlFlJpound rnyHTHpylOI]]ID oncpauali Heuenecoo6pa3HO TaK KaJlt IfX ycnex

HpegtKJlC Bcero 311BHCIIT O Dp3BHJlbHhIX nOKa3amrlt

18

ilpI1 fwmmiddotnlpOB8HIfl1 rpY~llOi1 CHlI1naT3KTOMIDf MII IIpHllep)Klrn811HCh

pe3YJIhTaTOB npOlHOCTI1ecKHX Tee-rOB nOJlOgtKlfTeJTIJlasJ npo6a peaKTRBHoll

ftillepeMJ1K (nplpocl mmeHHOH CKOPOCTII KposoTOKa 1]0 une1JeSOH apTepliH

60nee 50 01 HC(O)HOro nOKa39TeJlJI) H llanpJlgtKelme TcP02 KOgtKH lOIcTeii

50lIee 30 MMpTCI ITO q~e BCIpelaeTCf npli ltPYHKu HOHaJThTlOn CT8tllf1

3a6oJICBaHl1f

PYiUlaJJ CliMl1aT3KTOMHH 6bJ1la BbIDOJIHCHa 4 60JTbHblM C KPHTHICCKOfi

HweMueH KOHefHOCTH Bo Bcex CJlY8JlX HerrocpeuCTBeHHhle pe3YJlhraTbl

onepauHH 6bJJIH XOPOIDHMI1 Or)taJTeHllhle p e3YJ1bTaTbl CBHuerenbCTBOBam 0

pelHtnHBe MUJeMTrn Y llOJIOBHHbl 60JIbHbX cnyCTJI I rou j(aHHhlii pe3YJlbT8T

MOIIltCfO CHTaTh He~oCTOBeprngtTM B CB5i3H C HeOOJ1JlIlRM 1I-iCIOM o6cneoyeMblx

60JlbHblX

Cpellli 60JlbHhlX C KplITlftfeCKOH lillJeMHeH Bep XHHX KOHeHOCTeH Y 4

6bJna TOTaJIhHaJI 06JlWlepaUHeti apTepl1H rrpeDTIJTe-lhJI KliCTll fI llaJIbUeBblX

apTepMu a T8JOlltC H113KHH ypOl~eHh Oa3a1bHOrO HaDpJlgtKeHl1Jl KI1CllopoJJa KOiKl1

KEeTeii (HIDKC 20 MMpTCT) ITO SlBHnOCb rrpOTIrnOIlOKa3aHJ1eM K

nrYllTHpylOIIJHM oncpaul1gt1M lot rpY)(Holl CFfMnaT3hTOMIUI B lfamei1 pa60Te

npl-fBOJJllTCSJ Pe3YJlbTaThI 5 apTepllaJlIi3aUHn nOBepxHoCTHoH BeHo3HoH

CI1 CTeMbl y 4 60mUhlX o6rurrepHPYJOilll1M rpoM68HrIlliToM OCHOBHhlMH

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