” ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ ɇȼ. ɋɕɑɂɄɈȼ Ê ÂÎÏÐÎÑÓ ÓËÓ×ØÅÍÈß ÐÅÇÓËÜÒÀÒΠÐÅÇÅÊÖÈÈ ÆÅËÓÄÊÀ

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ɇȼ. ɋɕɑɂɄɈȼ
Ê ÂÎÏÐÎÑÓ ÓËÓ×ØÅÍÈß ÐÅÇÓËÜÒÀÒΠÐÅÇÅÊÖÈÈ ÆÅËÓÄÊÀ
ɍɁ «Ɇɨɝɢɥɺɜɫɤɚɹɝɨɪɨɞɫɤɚɹɛɨɥɶɧɢɰɚʋ1»,
Ɋɟɫɩɭɛɥɢɤɚ Ȼɟɥɚɪɭɫɶ
Ɋɟɡɟɤɰɢɹɠɟɥɭɞɤɚɜɪɚɡɥɢɱɧɵɯɜɚɪɢɚɧɬɚɯɢɜɧɚɫɬɨɹɳɟɟɜɪɟɦɹɲɢɪɨɤɨɩɪɢɦɟɧɹɟɬɫɹɩɪɢ
ɪɚɡɥɢɱɧɨɣɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣɩɚɬɨɥɨɝɢɢ. ɍɦɧɨɝɢɯɩɚɰɢɟɧɬɨɜɜɩɨɫɥɟɞɭɸɳɟɦɪɚɡɜɢɜɚɸɬɫɹɩɚɬɨɥɨɝɢɱɟɫɤɢɟɩɨɫɥɟɨɩɟɪɚɰɢɨɧɧɵɟɫɢɧɞɪɨɦɵ.
ȼɫɬɚɬɶɟɨɩɢɫɵɜɚɟɬɫɹɧɚɲɨɩɵɬɢɧɞɢɜɢɞɭɚɥɶɧɨɞɢɮɮɟɪɟɧɰɢɪɨɜɚɧɧɨɝɨɩɨɞɯɨɞɚɤɜɵɛɨɪɭ
ɦɟɬɨɞɚɨɩɟɪɚɰɢɢ, ɩɨɤɚɡɚɧɢɹɤ ɬɨɦɭɢɥɢ ɢɧɨɦɭɜɚɪɢɚɧɬɭ ɪɟɡɟɤɰɢɢɜ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɤɥɢɧɢɤɢ,
ɪɟɡɭɥɶɬɚɬɨɜɨɛɫɥɟɞɨɜɚɧɢɹ. ɉɪɢɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣɹɡɜɟɜɵɞɟɥɹɟɬɫɹɝɪɭɩɩɚɛɨɥɶɧɵɯɫɩɪɨɝɧɨɡɨɦ
ɧɟɛɥɚɝɨɩɪɢɹɬɧɨɝɨ «ɡɥɨɤɚɱɟɫɬɜɟɧɧɨɝɨ» ɬɟɱɟɧɢɹ. ɉɪɟɞɫɬɚɜɥɟɧɚɦɟɬɨɞɢɤɚɪɚɧɧɟɝɨɜɵɹɜɥɟɧɢɹɷɬɢɯ
ɛɨɥɶɧɵɯɞɥɹɬɨɝɨ, ɱɬɨɛɵɨɩɟɪɢɪɨɜɚɬɶɢɯɞɨɪɚɡɜɢɬɢɹɨɫɥɨɠɧɟɧɢɣ, ɩɟɪɢɹɡɜɟɧɧɵɯɪɭɛɰɨɜɨɢɧɮɢɥɶɬɪɚɬɢɜɧɵɯɩɪɨɰɟɫɫɨɜ, ɩɨɪɚɠɟɧɢɹɫɨɫɟɞɧɢɯɨɪɝɚɧɨɜ. Ɉɛɪɚɳɚɟɬɫɹɜɧɢɦɚɧɢɟɧɚɜɚɠɧɨɫɬɶɫɨɨɬɜɟɬɫɬɜɭɸɳɟɣɩɪɟɞɨɩɟɪɚɰɢɨɧɧɨɣɩɨɞɝɨɬɨɜɤɢɩɪɢɛɨɥɶɲɨɣɨɛɫɟɦɟɧɺɧɧɨɫɬɢ Helicobacter pylori,
ɜɵɪɚɠɟɧɧɨɦɝɚɫɬɪɢɬɟ. ɉɪɢɜɵɹɜɥɟɧɢɢɫɨɩɭɬɫɬɜɭɸɳɢɯɯɢɚɬɚɥɶɧɵɯɝɪɵɠ, ɠɟɥɱɧɨɤɚɦɟɧɧɨɣɛɨɥɟɡɧɢ ɜɵɩɨɥɧɹɟɬɫɹ ɨɛɹɡɚɬɟɥɶɧɚɹ ɯɢɪɭɪɝɢɱɟɫɤɚɹ ɤɨɪɪɟɤɰɢɹ ɢ ɷɬɨɣ ɩɚɬɨɥɨɝɢɢ. Ⱦɥɹ ɭɥɭɱɲɟɧɢɹ
ɪɟɡɭɥɶɬɚɬɨɜɪɟɡɟɤɰɢɢɩɨ Bilroth-II (ȼ-II) ɩɪɟɞɥɚɝɚɟɬɫɹɪɚɡɪɚɛɨɬɚɧɧɵɣɢɩɪɢɦɟɧɹɟɦɵɣɫ 1986 ɝɨɞɚ
ɫɩɨɫɨɛɪɟɡɟɤɰɢɢɫɝɚɫɬɪɨɷɧɬɟɪɨɚɧɚɫɬɨɦɨɡɨɦ (ȽɗȺ) ɧɚɤɥɚɩɚɧɲɩɨɪɟ (Ʉɒ). ɗɬɨɬɦɟɬɨɞɩɪɢɦɟɧɟɧɩɪɢɯɪɨɧɢɱɟɫɤɢɯɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɵɯɹɡɜɚɯ, ɞɢɫɬɚɥɶɧɵɯɠɟɥɭɞɨɱɧɵɯɨɩɭɯɨɥɹɯ. ȼɵɩɨɥɧɟɧɨ
ɨɤɨɥɨ 300 ɨɩɟɪɚɰɢɣ (ɝɟɦɢɪɟɡɟɤɰɢɹ, ɪɟɡɟɤɰɢɹ 2/3 ɢɫɭɛɬɨɬɚɥɶɧɚɹɪɟɡɟɤɰɢɹɠɟɥɭɞɤɚ, ɚɧɬɪɭɦɷɤɬɨɦɢɹɫɫɟɥɟɤɬɢɜɧɨɣɜɚɝɨɬɨɦɢɟɣ) ɫȽɗȺɧɚɄɒ.
Ɉɛɫɥɟɞɨɜɚɧɢɹɨɩɟɪɢɪɨɜɚɧɧɵɯɩɚɰɢɟɧɬɨɜɜɨɬɞɚɥɟɧɧɨɦɩɟɪɢɨɞɟɫɜɢɞɟɬɟɥɶɫɬɜɭɸɬ, ɱɬɨɞɚɧɧɚɹɬɚɤɬɢɤɚɜɟɞɟɧɢɹɛɨɥɶɧɵɯ, ɮɨɪɦɢɪɨɜɚɧɢɟȽɗȺ ɧɚɄɒɢɩɪɢɨɛɲɢɪɧɵɯ, ɢɩɪɢɷɤɨɧɨɦɧɵɯ
ɪɟɡɟɤɰɢɹɯɠɟɥɭɞɤɚɫɜɚɝɨɬɨɦɢɹɦɢɫɧɢɠɚɟɬɱɚɫɬɨɬɭɢɬɹɠɟɫɬɶɩɨɫɬɪɟɡɟɤɰɢɨɧɧɵɯɩɚɬɨɥɨɝɢɱɟɫɤɢɯ
ɫɢɧɞɪɨɦɨɜ, ɩɨɜɵɲɚɟɬɭɫɬɨɣɱɢɜɨɫɬɶɡɨɧɵɚɧɚɫɬɨɦɨɡɚ ɤɪɚɡɜɢɬɢɸɹɡɜɟɧɧɨɞɟɫɬɪɭɤɬɢɜɧɵɯ ɩɪɨɰɟɫɫɨɜɢɧɚɮɨɧɟɫɨɯɪɚɧɟɧɢɹɤɢɫɥɨɬɨɩɪɨɬɟɚɡɧɨɣɮɭɧɤɰɢɢɠɟɥɭɞɤɚ.
Ʉɥɸɱɟɜɵɟɫɥɨɜɚ: ɠɟɥɭɞɨɤ, ɪɟɡɟɤɰɢɹ, ɩɪɨɝɧɨɡɢɪɨɜɚɧɢɟ, ɚɧɬɪɭɦɷɤɬɨɦɢɹ, ɤɥɚɩɚɧɲɩɨɪɚ, ɫɟɥɟɤɬɢɜɧɚɹɜɚɝɨɬɨɦɢɹ.
At present the stomach resection in its various forms is widely applied in various gastroduodenal
pathologies. Many patients later develop pathological post-operative syndromes.
Our own experience of the individual-differential approach to the choice of a surgical technique is
described in the article as well as indications for this or that resection variant depending on the clinical
picture and results of the examination. In case of gastroduodenal ulcer, the group of patients is singled out
in whom unfavorable malignant course of disease is prognosticated. The method of early detection of
such patients permits to operate on them before the complications, periulcerous cicatricial-infiltrative
processes, lesions of neighboring organs occur. The attention is paid to the importance of appropriate
preoperative preparation at huge dissemination of Helicobacter pylori, marked gastritis. Obligatory surgical
correction is carried out in case of revelation of accompanying hernias, cholelithiasis. To improve the
resection results according to Bilroth-II (ȼ-II), the resection method, worked out and used since 1986,
with gastroenteroanastomosis, on the spur valve is suggested. This method can be used in case of chronic
gastro-duodenal ulcers, distal stomach tumors. About 300 surgeries were performed (hemiresection, 2/3
resection, subtotal resection of the stomach, antrumectomy with selective vagotomy) with
gastroenteroanastomosis on the spur valve.
Examinations of the operated patients in the distant period testify that the given tactics of the
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patients’ treatment, gastroenteroanastomosis on the spur valve formation in case of vast and thrifty stomach
resections with vagotomies decreases the frequency and acuteness of the post-operative pathological
syndromes, increases the stability of anastomosis zone to the development of ulcerous-destructive processes
and as the background of acidic-protease function of the stomach preserving.
Keywords: stomach, resection, prognosis, antrumectomy, spur valve, selective vagotomy.
Ɋɟɡɟɤɰɢɹɠɟɥɭɞɤɚɜɩɨɤɚɡɚɧɧɵɯɫɥɭɱɚɹɯɢɜɧɚɫɬɨɹɳɟɟɜɪɟɦɹɲɢɪɨɤɨɩɪɢɦɟɧɹɟɬɫɹ ɩɪɢ ɹɡɜɟɧɧɨɣ ɛɨɥɟɡɧɢ ɠɟɥɭɞɤɚ, ɞɜɟɧɚɞɰɚɬɢɩɟɪɫɬɧɨɣɤɢɲɤɢ (ȾɉɄ), ɪɚɤɟ, ɩɨɥɢɩɨɡɟ, ɚɬɚɤɠɟɩɪɢɞɪɭɝɨɣ, ɪɟɠɟɜɫɬɪɟɱɚɸɳɟɣɫɹɩɚɬɨɥɨɝɢɢ. Ɋɟɡɭɥɶɬɚɬɵɨɩɟɪɚɰɢɢ,
ɤɚɱɟɫɬɜɨɠɢɡɧɢɩɚɰɢɟɧɬɨɜɩɨɫɥɟɨɩɟɪɚɰɢɢ
ɜɨ ɦɧɨɝɨɦɡɚɜɢɫɹɬɨɬɩɪɚɜɢɥɶɧɨɫɬɢɜɵɛɪɚɧɧɨɝɨɜɚɪɢɚɧɬɚɪɟɡɟɤɰɢɢ, ɤɚɱɟɫɬɜɚɟɺɜɵɩɨɥɧɟɧɢɹɢɨɬɫɜɨɟɜɪɟɦɟɧɧɨɫɬɢɨɩɟɪɚɰɢɢ.
ɒɢɪɨɤɨɪɚɫɩɪɨɫɬɪɚɧɟɧɧɨɟɜɧɚɲɟɦɨɛɳɟɫɬɜɟɦɧɟɧɢɟ, ɱɬɨɩɪɢɯɪɨɧɢɱɟɫɤɨɣɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣɹɡɜɟɜɨɬɥɢɱɢɟɨɬɨɧɤɨɩɚɬɨɥɨɝɢɢ «ɧɚ ɨɩɟɪɚɰɢɸ ɧɢɤɨɝɞɚ ɧɟ ɩɨɡɞɧɨ»
ɝɥɭɛɨɤɨɨɲɢɛɨɱɧɨ. ȼɪɟɡɭɥɶɬɚɬɟɩɨɡɞɧɟɝɨ
ɨɛɪɚɳɟɧɢɹɩɪɢɨɩɟɪɚɰɢɢɦɵɱɚɫɬɨɜɢɞɢɦ
ɭɠɟɞɚɥɟɤɨɡɚɲɟɞɲɢɣɹɡɜɟɧɧɨɞɟɫɬɪɭɤɬɢɜɧɵɣ ɩɪɨɰɟɫɫ, ɟɝɨ ɩɟɪɟɯɨɞ ɢ ɧɚ ɫɨɫɟɞɧɢɟ
ɨɪɝɚɧɵ, ɪɭɛɰɨɜɨɢɧɮɢɥɶɬɪɚɬɢɜɧɵɟɩɪɨɰɟɫɫɵɜɩɚɪɚɹɡɜɟɧɧɨɣɡɨɧɟ (ɩɪɢɫɨɟɞɢɧɢɜɲɢɣɫɹ ɩɚɪɚɹɡɜɟɧɧɵɣ ɫɢɧɞɪɨɦ), ɱɬɨ ɭɯɭɞɲɚɟɬ
ɪɟɡɭɥɶɬɚɬɵɨɩɟɪɚɰɢɣ.
Ȼɥɚɝɨɞɚɪɹɭɫɩɟɯɚɦɯɢɪɭɪɝɢɱɟɫɤɨɣɝɚɫɬɪɨɷɧɬɟɪɨɥɨɝɢɢ, ɚɧɟɫɬɟɡɢɨɥɨɝɢɢ, ɫɧɢɠɟɧɢɸɩɨɫɥɟɨɩɟɪɚɰɢɨɧɧɨɣɥɟɬɚɥɶɧɨɫɬɢ, ɨɫɨɛɟɧɧɨɜɩɥɚɧɨɜɨɣɯɢɪɭɪɝɢɢ, ɫɭɳɟɫɬɜɨɜɚɜɲɟɟɪɚɧɟɟɦɧɟɧɢɟ, ɱɬɨɯɢɪɭɪɝɢɱɟɫɤɨɦɭɥɟɱɟɧɢɸɞɨɥɠɧɚɩɨɞɜɟɪɝɚɬɶɫɹɬɨɥɶɤɨɨɫɥɨɠɧɟɧɧɚɹɹɡɜɟɧɧɚɹɛɨɥɟɡɧɶ (ɬɟ. «ɞɨɲɟɞɲɚɹ»
ɞɨɝɪɚɧɢ ɫɦɟɪɬɟɥɶɧɨɝɨ ɢɫɯɨɞɚ), ɜɧɚɫɬɨɹɳɟɟɜɪɟɦɹɭɫɬɚɪɟɥɨ. ɋɨɜɪɟɦɟɧɧɚɹɤɨɧɰɟɩɰɢɹɫɨɫɬɨɢɬɜɬɨɦ, ɱɬɨɯɢɪɭɪɝɢɱɟɫɤɚɹɤɨɪɪɟɤɰɢɹɞɨɥɠɧɚɩɪɟɞɭɩɪɟɠɞɚɬɶɨɫɥɨɠɧɟɧɢɹ
ɹɡɜɟɧɧɨɣɛɨɥɟɡɧɢ, ɚɧɟɫɥɟɞɨɜɚɬɶɡɚɧɢɦɢ.
ɂɜɷɬɨɦɩɥɚɧɟɨɱɟɧɶɜɚɠɧɨɟɦɟɫɬɨɡɚɧɢɦɚɸɬ ɜɨɩɪɨɫɵ ɩɪɨɝɧɨɡɢɪɨɜɚɧɢɹ ɬɟɱɟɧɢɹ
ɛɨɥɟɡɧɢ, ɬɟ. ɜɵɹɜɥɟɧɢɟ ɫɪɟɞɢ «ɧɟɨɫɥɨɠɧɺɧɧɵɯɹɡɜ» ɬɟɯ, ɭɤɨɬɨɪɵɯɛɭɞɟɬɩɪɨɝɧɨɫɬɢɱɟɫɤɢɧɟɛɥɚɝɨɩɪɢɹɬɧɨɟ, «ɡɥɨɤɚɱɟɫɬɜɟɧɧɨɟ» ɬɟɱɟɧɢɟ. Ʉɚɤɢɡɜɟɫɬɧɨ, ɱɚɫɬɶɛɨɥɶɧɵɯ
ɫɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɵɦɢɹɡɜɚɦɢɫɥɚɛɨɪɟɚ-
ɝɢɪɭɸɬ ɧɚ ɫɨɜɪɟɦɟɧɧɨɟ ɚɧɬɢɫɟɤɪɟɬɨɪɧɨɟ
ɦɟɞɢɤɚɦɟɧɬɨɡɧɨɟɥɟɱɟɧɢɟ. Ɉɧɢɫɨɫɬɚɜɥɹɸɬɨɫɧɨɜɧɭɸɝɪɭɩɩɭ, ɜɤɨɬɨɪɨɣɜɨɡɧɢɤɚɸɬ
ɨɫɥɨɠɧɺɧɧɵɟ ɮɨɪɦɵ, ɧɟɪɟɞɤɨ ɜɟɞɭɳɢɟ ɤ
ɫɦɟɪɬɢ. ɉɨɷɬɨɦɭ ɷɬɚ ɝɪɭɩɩɚ ɧɭɠɞɚɟɬɫɹ ɜ
ɪɚɧɧɢɯɩɥɚɧɨɜɵɯɨɩɟɪɚɰɢɹɯ – ɞɨɪɚɡɜɢɬɢɹ
ɨɫɥɨɠɧɟɧɢɣ. Ʉɬɨɦɭɠɟɨɩɟɪɢɪɨɜɚɧɢɟɟɳɺ
ɧɟɨɫɥɨɠɧɟɧɧɵɯɯɪɨɧɢɱɟɫɤɢɯɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɵɯɹɡɜɞɚɟɬɡɧɚɱɢɬɟɥɶɧɨɥɭɱɲɢɟɩɨɫɥɟɨɩɟɪɚɰɢɨɧɧɵɟ ɪɟɡɭɥɶɬɚɬɵ, ɭɦɟɧɶɲɚɟɬ
ɤɨɥɢɱɟɫɬɜɨ ɨɫɥɨɠɧɟɧɢɣ, ɥɟɬɚɥɶɧɨɫɬɶ ɩɨ
ɫɪɚɜɧɟɧɢɸɫɝɪɭɩɩɨɣ ɨɫɥɨɠɧɟɧɧɨɣ ɹɡɜɵ,
ɤɨɝɞɚɹɡɜɟɧɧɨɞɟɫɬɪɭɤɬɢɜɧɵɣɩɪɨɰɟɫɫɩɨɪɚɠɚɟɬɭɠɟɢɫɨɫɟɞɧɢɟɨɪɝɚɧɵ. Ʉɫɨɠɚɥɟɧɢɸ, ɨɬɞɚɥɟɧɧɵɟɮɭɧɤɰɢɨɧɚɥɶɧɵɟɪɟɡɭɥɶɬɚɬɵ ɪɟɡɟɤɰɢɣ ɠɟɥɭɞɤɚ ɢ ɩɪɢ ɩɥɚɧɨɜɵɯ
ɨɩɟɪɚɰɢɹɯ ɞɚɥɟɤɨ ɧɟ ɜɫɟɝɞɚ ɭɞɨɜɥɟɬɜɨɪɢɬɟɥɶɧɵ [1, 3]. Ɉɫɨɛɟɧɧɨɩɪɨɛɥɟɦɧɨɣɜɩɥɚɧɟ ɜɨɡɦɨɠɧɨɫɬɢ ɩɨɥɭɱɢɬɶ ɭɞɨɜɥɟɬɜɨɪɢɬɟɥɶɧɨɟɤɚɱɟɫɬɜɨɠɢɡɧɢɩɨɫɥɟɩɟɪɟɧɟɫɟɧɧɨɣɨɩɟɪɚɰɢɢɹɜɥɹɟɬɫɹɝɪɭɩɩɚɛɨɥɶɧɵɯ, ɭ
ɤɨɬɨɪɵɯɯɪɨɧɢɱɟɫɤɚɹ ɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɚɹ
ɹɡɜɚɫɨɱɟɬɚɟɬɫɹɫɨɪɝɚɧɢɱɟɫɤɨɣɢɥɢɜɵɪɚɠɟɧɧɨɣɮɭɧɤɰɢɨɧɚɥɶɧɨɣɧɟɫɨɫɬɨɹɬɟɥɶɧɨɫɬɶɸȾɉɄ, ɜɨɜɥɟɱɟɧɢɟɦɨɪɝɚɧɨɜɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣ ɡɨɧɵ ɢ ɞɭɨɞɟɧɨɟɸɧɚɥɶɧɨɝɨ
ɩɟɪɟɯɨɞɚɫɨɫɜɹɡɤɨɣ Treitz. ɗɬɨ, ɤɚɤɩɪɚɜɢɥɨ, ɢɦɟɟɬɦɟɫɬɨ ɩɪɢɯɪɨɧɢɱɟɫɤɢɯ ɨɫɥɨɠɧɺɧɧɵɯɹɡɜɚɯɫɞɥɢɬɟɥɶɧɵɦɚɧɚɦɧɟɡɨɦ, ɭ
©ɡɚɫɥɭɠɟɧɧɵɯ ɹɡɜɟɧɧɢɤɨɜ». ɍ ɧɢɯ ɩɨɫɥɟ
ɨɪɝɚɧɨɫɨɯɪɚɧɹɸɳɢɯɨɩɟɪɚɰɢɣ ɢ ɦɟɬɨɞɢɤ
B-I ɨɬɞɚɥɺɧɧɵɟɪɟɡɭɥɶɬɚɬɵɟɳɺɯɭɠɟ, ɱɟɦ
ɩɨɫɥɟ ɤɥɚɫɫɢɱɟɫɤɨɣ ɨɛɲɢɪɧɨɣ ɪɟɡɟɤɰɢɢ
ɠɟɥɭɞɤɚ ɩɨ Hofmeister-Finsterer (H-F) ɫ ɟɺ
ɞɨɜɨɥɶɧɨ ɱɚɫɬɵɦɢ ɩɨɫɥɟɨɩɟɪɚɰɢɨɧɧɵɦɢ
ɩɚɬɨɥɨɝɢɱɟɫɤɢɦɢ ɫɢɧɞɪɨɦɚɦɢ [1]. ɗɬɢ
ɫɢɧɞɪɨɦɵ ɨɛɭɫɥɨɜɥɢɜɚɸɬɫɹ, ɜɨɩɟɪɜɵɯ,
ɩɨɬɟɪɟɣɜɚɠɧɵɯɦɧɨɝɨɝɪɚɧɧɵɯɠɟɥɭɞɨɱɧɵɯ
ɮɭɧɤɰɢɣ (ɢɱɟɦɛɨɥɶɲɚɹɱɚɫɬɶɠɟɥɭɞɤɚɭɞɚɥɹɟɬɫɹ, ɬɟɦ ɜ ɛɨɥɶɲɟɣ ɫɬɟɩɟɧɢ ɫɬɪɚɞɚɸɬ,
©ɬɟɪɹɸɬɫɹ», ɷɬɢ ɮɭɧɤɰɢɢ, ɢ ɬɟɦ ɦɟɧɶɲɟ
29
”ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ
ɲɚɧɫɨɜ, ɱɬɨɨɧɢɫɨɜɪɟɦɟɧɟɦɜɨɫɫɬɚɧɨɜɹɬɫɹ). ȼɨɜɬɨɪɵɯ, ɷɬɢɩɚɬɨɥɨɝɢɱɟɫɤɢɟɫɢɧɞɪɨɦɵɪɚɡɜɢɜɚɸɬɫɹɩɨɫɥɟɪɟɡɟɤɰɢɣɩɨɦɟɬɨɞɢɤɚɦ ȼ-II ɜɫɥɟɞɫɬɜɢɟ ɜɨɡɧɢɤɚɸɳɢɯ ɭ
ɨɩɟɪɢɪɨɜɚɧɧɵɯɡɚɛɪɨɫɨɜɢɡɠɟɥɭɞɤɚɜɩɪɢɜɨɞɹɳɭɸɤɢɲɤɭ, ɢɡɛɵɬɨɱɧɨɝɨɜɧɭɬɪɢɠɟɥɭɞɨɱɧɨɝɨɪɟɮɥɸɤɫɚ, ɧɚɪɭɲɟɧɢɹɮɢɡɢɨɥɨɝɢɱɟɫɤɨɣ ɪɟɝɭɥɹɰɢɢɮɭɧɤɰɢɣ, ɬɪɨɮɢɤɢ ɷɡɨɮɚɝɨɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣɢɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣɫɢɫɬɟɦ. ɋ 1986 ɝ. ɞɥɹɭɥɭɱɲɟɧɢɹɨɬɞɚɥɟɧɧɵɯɪɟɡɭɥɶɬɚɬɨɜɪɟɡɟɤɰɢɢɠɟɥɭɞɤɚɩɨ
ȼ-II ɩɪɢɪɟɡɟɤɰɢɹɯ 2/3 ɢɫɭɛɬɨɬɚɥɶɧɨɣɦɵ
ɫɬɚɥɢ ɩɪɢɦɟɧɹɬɶ ȽɗȺ ɧɚ Ʉɒ [6], ɚ ɫ
1996 ɝ., ɭɛɟɞɢɜɲɢɫɶɜɯɨɪɨɲɢɯɪɟɡɭɥɶɬɚɬɚɯ
ɨɩɟɪɚɰɢɢ, ɩɪɢɦɟɧɢɥɢɩɪɢɯɪɨɧɢɱɟɫɤɨɣɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣɹɡɜɟɛɨɥɟɟ «ɨɪɝɚɧɨɫɛɟɪɟɝɚɸɳɢɟ» ɪɟɡɟɤɰɢɢ – ɚɧɬɪɭɦɷɤɬɨɦɢɢ ɫ
ɫɟɥɟɤɬɢɜɧɨɣɜɚɝɨɬɨɦɢɟɣ (ɋȼ). ɉɪɢɷɬɨɦɋȼ
ɞɟɥɚɟɦ ɧɟ ɜ ɪɚɞɢɤɚɥɶɧɨɦ, ɚ ɜ «ɳɚɞɹɳɟɦ»
ɜɚɪɢɚɧɬɟ, ɜɡɹɜɡɚɨɫɧɨɜɭɭɩɪɨɳɟɧɧɭɸɦɟɬɨɞɢɤɭ H. Burge [8].
Ɇɚɬɟɪɢɚɥɢɦɟɬɨɞɵ
Ʉ ɧɚɫɬɨɹɳɟɦɭ ɜɪɟɦɟɧɢ ɜ ɨɛɥɚɫɬɧɨɣ,
ɨɬɞɟɥɟɧɱɟɫɤɨɣ ɛɨɥɶɧɢɰɚɯ ɝ. Ɇɨɝɢɥɟɜɚ ɢ
ɩɪɢɜɵɟɡɞɚɯɩɨɫɚɧɚɜɢɚɰɢɢɜɪɚɣɨɧɵɩɪɢ
ɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɵɯɹɡɜɚɯ, ɞɢɫɬɚɥɶɧɵɯɠɟɥɭɞɨɱɧɵɯɨɩɭɯɨɥɹɯɜɵɩɨɥɧɟɧɨ ɨɤɨɥɨ 300
ɪɟɡɟɤɰɢɣɠɟɥɭɞɤɚɫȽɗȺɧɚɄɒ. ɉɪɢɩɥɚɧɨɜɵɯ ɨɩɟɪɚɰɢɹɯɩɨ ɩɨɜɨɞɭ ɹɡɜɫ ɭɱɺɬɨɦ
ɧɚɤɨɩɥɟɧɧɨɝɨ ɨɩɵɬɚ, ɞɚɧɧɵɯ ɥɢɬɟɪɚɬɭɪɵ
[4, 5] ɩɨɤɚɡɚɧɢɹɤɨɩɟɪɚɰɢɢɫɬɚɜɢɦɫɭɱɺɬɨɦ ɩɪɨɝɧɨɡɢɪɨɜɚɧɢɹ ɬɟɱɟɧɢɹ ɛɨɥɟɡɧɢ.
ɉɪɢ ɷɬɨɦ ɭɱɢɬɵɜɚɟɦ ɤɥɢɧɢɤɭɢ ɪɟɡɭɥɶɬɚɬɵɨɛɫɥɟɞɨɜɚɧɢɹɛɨɥɶɧɨɝɨ: ɪɟɡɭɥɶɬɚɬɵɷɧɞɨɫɤɨɩɢɢ, ɨɰɟɧɤɭ ɦɨɬɨɪɧɨɷɜɚɤɭɚɬɨɪɧɨɣ
ɮɭɧɤɰɢɢɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣɡɨɧɵ, ɯɚɪɚɤɬɟɪ ɫɟɤɪɟɬɨɪɧɨɣ ɮɭɧɤɰɢɢ ɠɟɥɭɞɤɚ, ɭɬɨɱɧɟɧɢɟɨɬɤɥɨɧɟɧɢɣ ɢɢɯ ɯɚɪɚɤɬɟɪɚ ɫɨ ɫɬɨɪɨɧɵɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣɡɨɧɵ. Ʉɩɪɢɡɧɚɤɚɦɧɟɛɥɚɝɨɩɪɢɹɬɧɨɝɨɩɪɨɝɧɨɡɚɦɵɨɬɧɨɫɢɦɫɥɟɞɭɸɳɟɟ:
ɩɨɪɟɡɭɥɶɬɚɬɚɦ, ɩɨɥɭɱɟɧɧɵɦɩɪɢɷɧɞɨɫɤɨɩɢɱɟɫɤɨɦ ɨɛɫɥɟɞɨɜɚɧɢɢ:
- ɜɨɩɟɪɜɵɯ, ɹɡɜɚɛɨɥɶɲɟ 1 ɫɦɜɨɛɥɚɫɬɢ
ɫɮɢɧɤɬɟɪɨɜ – ɛɭɥɶɛɨɞɭɨɞɟɧɚɥɶɧɨɝɨ, ɩɪɢ30
ɜɪɚɬɧɢɤɚ (ɩɪɢɨɛɨɫɬɪɟɧɢɹɯɭɷɬɢɯɛɨɥɶɧɵɯ
ɨɛɵɱɧɨ ɩɨɹɜɥɹɸɬɫɹ ɢ ɩɪɢɡɧɚɤɢ ɫɬɟɧɨɡɢɪɨɜɚɧɢɹ);
- ɜɨɜɬɨɪɵɯ, ɝɥɭɛɢɧɚɹɡɜɟɧɧɨɝɨɤɪɚɬɟɪɚ 4–
5 ɦɦɢɛɨɥɶɲɟ (ɞɚɠɟ, ɟɫɥɢɹɡɜɚɦɚɥɟɧɶɤɚɹ);
- ɜɬɪɟɬɶɢɯ, ɢɦɟɸɬɫɹɩɪɢɡɧɚɤɢɪɭɛɰɨɜɨɝɨɫɬɟɧɨɡɢɪɨɜɚɧɢɹ (ɬɟ. ɢɩɨɫɥɟɤɭɪɫɚɩɪɨɬɢɜɨɜɨɫɩɚɥɢɬɟɥɶɧɨɣɬɟɪɚɩɢɢɨɧɨɢɤɥɢɧɢɱɟɫɤɢɢɷɧɞɨɫɤɨɩɢɱɟɫɤɢɨɫɬɚɺɬɫɹ);
- ɜɱɟɬɜɺɪɬɵɯ, ɦɧɨɠɟɫɬɜɟɧɧɵɟɯɪɨɧɢɱɟɫɤɢɟɹɡɜɵ (2 ɢɛɨɥɶɲɟ) ɜɠɟɥɭɞɤɟɢȾɉɄ;
- ɜɩɹɬɵɯ, ɦɢɝɪɢɪɭɸɳɢɟ ɯɪɨɧɢɱɟɫɤɢɟ
ɹɡɜɵ;
- ɜɲɟɫɬɵɯ, ɞɢɫɩɥɚɡɢɹ II–III ɫɬ. ɢɡ ɤɪɚɹ
ɹɡɜɵ;
ɩɨɯɚɪɚɤɬɟɪɭɫɟɤɪɟɬɨɪɧɨɣɮɭɧɤɰɢɢ:
- ɜɨɩɟɪɜɵɯ, ɫɬɨɣɤɨɟ (ɢɧɨɱɶɸ) ɢɧɬɟɧɫɢɜɧɨɟɧɟɩɪɟɪɵɜɧɨɟɤɢɫɥɨɬɨɨɛɪɚɡɨɜɚɧɢɟ, ɱɬɨ
ɜ ɤɥɢɧɢɤɟ ɩɪɨɹɜɥɹɟɬɫɹ ɛɨɥɶɸ, ɢɡɠɨɝɨɣ
ɞɚɠɟɩɨɫɥɟɫɧɚ, ɩɨɭɬɪɚɦ;
- ɜɨɜɬɨɪɵɯ, ɚɬɪɨɩɢɧɪɟɡɢɫɬɟɧɬɧɵɣ ɬɢɩ
ɹɡɜɟɧɧɨɣɛɨɥɟɡɧɢɫɞɟɤɨɦɩɟɧɫɚɰɢɟɣɨɳɟɥɚɱɢɜɚɸɳɟɣɮɭɧɤɰɢɢɚɧɬɪɭɦɚ (ɳɟɥɨɱɧɨɟ
ɜɪɟɦɹ – ɦɟɧɶɲɟ 6 ɦɢɧ);
ɩɨ ɯɚɪɚɤɬɟɪɭ ɦɨɬɨɪɧɨɷɜɚɤɭɚɬɨɪɧɨɣ
ɮɭɧɤɰɢɢ:
- ɜɨɩɟɪɜɵɯ, ɚɧɬɪɚɥɶɧɵɣ ɫɬɚɡ, ɝɚɫɬɪɚɥɶɧɚɹɚɬɨɧɢɹ (ɜɡɜɟɫɶɫɭɥɶɮɚɬɚɛɚɪɢɹɨɫɬɚɟɬɫɹɜɠɟɥɭɞɤɟɛɨɥɶɲɟ 6 ɱɚɫɨɜ) ɫɨɬɪɢɰɚɬɟɥɶɧɵɦɰɟɪɭɤɚɥɨɜɵɦɬɟɫɬɨɦ;
- ɜɨɜɬɨɪɵɯ, ɜɵɪɚɠɟɧɧɵɣ ɞɭɨɞɟɧɨɝɚɫɬɪɚɥɶɧɵɣɪɟɮɥɸɤɫ (ȾȽɊ), ɤɨɝɞɚɤɨɧɰɟɧɬɪɚɰɢɹ ɠɟɥɱɧɵɯ ɤɢɫɥɨɬ ɜ ɠɟɥɭɞɨɱɧɨɦ ɫɨɤɟ
ɛɨɥɶɲɟ 0,6 ɦɝɦɥ.
Ɍɚɤɠɟɤɷɬɨɣɝɪɭɩɩɟɧɟɛɥɚɝɨɩɪɢɹɬɧɨɝɨɩɪɨɝɧɨɡɚɦɵɨɬɧɨɫɢɦɛɨɥɶɧɵɯɫɧɟɤɭɩɢɪɭɟɦɵɦɛɨɥɟɜɵɦɢɞɢɫɩɟɩɫɢɱɟɫɤɢɦɫɢɧɞɪɨɦɨɦ ɧɚ ɮɨɧɟ ɫɨɜɪɟɦɟɧɧɨɣ ɚɧɬɢɫɟɤɪɟɬɨɪɧɨɣ ɢ ɚɧɬɢɯɟɥɢɤɨɛɚɤɬɟɪɧɨɣ ɬɟɪɚɩɢɢ,
ɜɨɜɥɟɱɟɧɢɟɦɨɪɝɚɧɨɜɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣ
ɡɨɧɵ ɢ ɯɪɨɧɢɱɟɫɤɢɦ ɧɚɪɭɲɟɧɢɟɦ ɞɭɨɞɟɧɚɥɶɧɨɣɩɪɨɯɨɞɢɦɨɫɬɢ (ɏɇȾɉ), ɤɨɝɞɚɩɪɢ
ɨɛɫɥɟɞɨɜɚɧɢɢɜɵɹɜɥɹɟɬɫɹɝɢɩɨɤɢɧɟɬɢɱɟɫɤɚɹ ɞɢɫɤɢɧɟɡɢɹ ȾɉɄ (ɩɪɢ ɷɧɞɨɫɤɨɩɢɢ –
ɡɢɹɧɢɟ ɩɪɢɜɪɚɬɧɢɤɚ, ɟɝɨ ɞɢɚɦɟɬɪ ɛɨɥɶɲɟ
1 ɫɦ, ɪɟɮɥɸɤɫ ɠɟɥɱɢ, ɜ ȾɉɄ – ɫɬɚɪɚɹ
ɠɟɥɱɶ, ɨɫɬɚɬɤɢɩɢɳɢ, ɫɝɥɚɠɟɧɧɨɫɬɶɛɭɥɶ-
ʋ4x2008 iɬɨɦ 16
ɛɨɞɭɨɞɟɧɚɥɶɧɨɝɨɩɟɪɟɯɨɞɚ – ɩɟɪɟɯɨɞɚɩɪɨɞɨɥɶɧɵɯɫɤɥɚɞɨɤɜɩɨɩɟɪɟɱɧɵɟ).
ȼɩɥɚɧɟɜɵɛɨɪɚɜɚɪɢɚɧɬɚɨɩɟɪɚɰɢɢɩɪɢ
ɹɡɜɟɧɧɨɣ ɛɨɥɟɡɧɢ ɩɪɢɞɟɪɠɢɜɚɟɦɫɹ ɢɧɞɢɜɢɞɭɚɥɶɧɨɞɢɮɮɟɪɟɧɰɢɪɨɜɚɧɧɨɝɨɩɨɞɯɨɞɚ.
ɉɪɟɞɩɨɱɬɟɧɢɟ ɦɟɬɨɞɢɤɚɦ ȼ-II ɦɵ ɨɬɞɚɟɦ
ɭɩɚɰɢɟɧɬɨɜ, ɭɤɨɬɨɪɵɯɩɨɫɥɟɞɧɹɹɫɨɱɟɬɚɟɬɫɹɫɨɪɝɚɧɢɱɟɫɤɨɣɢɥɢɡɧɚɱɢɬɟɥɶɧɨɣɮɭɧɤɰɢɨɧɚɥɶɧɨɣ ɧɟɫɨɫɬɨɹɬɟɥɶɧɨɫɬɶɸ ȾɉɄ,
ɜɨɜɥɟɱɟɧɢɟɦɨɪɝɚɧɨɜɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣ
ɡɨɧɵ ɢ ɞɭɨɞɟɧɨɟɸɧɚɥɶɧɨɝɨ ɩɟɪɟɯɨɞɚ ɫɨ
ɫɜɹɡɤɨɣ Treitz. ɉɪɢɡɧɚɤɢɜɨɜɥɟɱɟɧɢɹɜɩɚɬɨɥɨɝɢɱɟɫɤɢɣɩɪɨɰɟɫɫ ɞɭɨɞɟɧɨɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣɡɨɧɵ ɦɨɠɧɨɭɫɥɨɜɧɨɪɚɡɞɟɥɢɬɶ
ɧɚ ɦɟɧɟɟ ɢ ɛɨɥɟɟ ɡɧɚɱɢɦɵɟ, ɢ, ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ, ɩɪɢɡɧɚɤɢ ɞɥɹ ɜɵɛɨɪɚ ɜɚɪɢɚɧɬɚ
ɨɩɟɪɚɰɢɢ: ɦɟɧɟɟɢɛɨɥɟɟɡɧɚɱɢɦɵɟ.
Ʉ ɦɟɧɟɟ ɡɧɚɱɢɦɵɦ ɨɬɧɨɫɢɦ ɫɥɟɞɭɸɳɟɟ:
1. ɂɦɟɸɳɢɟɫɹɭɤɚɡɚɧɢɹɜɚɧɚɦɧɟɡɟɧɚ
ɧɟɨɞɧɨɤɪɚɬɧɨɩɟɪɟɧɟɫɟɧɧɵɟ ɯɨɥɟɰɢɫɬɢɬɵ,
ɩɚɧɤɪɟɚɬɢɬɵ, ɠɟɥɬɭɯɢ (ɜɨɡɦɨɠɧɨ, ɨɧɢɛɵɥɢ
ɢɡɡɚɢɦɟɸɳɟɣɫɹɩɚɬɨɥɨɝɢɢɛɨɥɶɲɨɝɨɞɭɨɞɟɧɚɥɶɧɨɝɨɫɨɫɨɱɤɚ (ȻȾɋ), ɩɚɪɚɮɚɬɟɪɢɚɥɶɧɵɯɞɢɜɟɪɬɢɤɭɥɨɜ, ɜɟɞɶɧɚɧɚɫɬɨɹɳɟɦɭɪɨɜɧɟɞɢɚɝɧɨɫɬɢɤɢɭɫɬɚɧɨɜɢɬɶɢɥɢɢɫɤɥɸɱɢɬɶ
ɷɬɨɞɨɫɬɨɜɟɪɧɨɛɵɜɚɟɬɞɨɜɨɥɶɧɨɬɪɭɞɧɨ);
2. ɍɫɬɚɧɚɜɥɢɜɚɟɦɵɟɩɪɢɷɧɞɨɫɤɨɩɢɱɟɫɤɨɦɨɛɫɥɟɞɨɜɚɧɢɢ (ɎȽȾɋ) ɩɪɢɡɧɚɤɢɚɬɪɨɮɢɱɟɫɤɨɝɨ ɝɚɫɬɪɢɬɚ, ɩɚɬɨɥɨɝɢɱɟɫɤɨɝɨ
ȾȽɊ – ɡɢɹɧɢɟɩɢɥɨɪɢɱɟɫɤɨɝɨɠɨɦɚ, ɧɚɥɢɱɢɟɠɟɥɱɢɜɠɟɥɭɞɤɟ; ɩɪɢɡɧɚɤɢɩɚɬɨɥɨɝɢɢ
ȻȾɋ, ɩɨɥɢɩɵ ɢ ɫɤɨɩɥɟɧɢɹ ɠɟɥɱɢ ɜ ȾɉɄ,
ɱɬɨɝɨɜɨɪɢɬɨɛɨɥɶɲɨɣɜɟɪɨɹɬɧɨɫɬɢɧɚɥɢɱɢɹɞɭɨɞɟɧɨɫɬɚɡɚ;
3. ɈɩɪɟɞɟɥɹɟɦɵɟɩɪɢɍɁɂɢɡɦɟɧɟɧɢɹ
ɫɨɫɬɨɪɨɧɵɩɨɞɠɟɥɭɞɨɱɧɨɣɠɟɥɟɡɵ (ɢɡɦɟɧɟɧɢɹ ɷɯɨɝɟɧɧɨɫɬɢ, ɭɜɟɥɢɱɟɧɢɟ ɠɟɥɟɡɵ),
ɩɪɢɡɧɚɤɢɯɪɨɧɢɱɟɫɤɨɝɨɯɨɥɟɰɢɫɬɢɬɚ, ɝɟɩɚɬɢɬɚ, ɞɢɫɤɢɧɟɡɢɢ ɠɟɥɱɟɜɵɞɟɥɢɬɟɥɶɧɵɯ
ɩɭɬɟɣ, ɭɫɬɚɧɚɜɥɢɜɚɟɦɵɟɚɷɪɨɛɢɥɢɹ, ɪɚɫɲɢɪɟɧɢɟɠɟɥɱɧɵɯɩɭɬɟɣ;
4. ɉɨɥɭɱɟɧɧɵɟ ɞɚɧɧɵɟ ɨ ɧɚɪɭɲɟɧɢɢ
ɦɨɬɨɪɢɤɢɠɟɥɱɟɜɵɞɟɥɢɬɟɥɶɧɵɯɩɭɬɟɣɩɪɢ
ɞɢɧɚɦɢɱɟɫɤɨɣ ɛɢɥɢɨɫɰɢɧɬɨɝɪɚɮɢɢ, ɞɚɧɧɵɟɡɚɞɢɫɤɢɧɟɡɢɸȾɉɄɩɪɢɪɟɧɬɝɟɧɨɫɤɨɩɢɢ ɠɟɥɭɞɤɚ.
Ʉɛɨɥɟɟɡɧɚɱɢɦɵɦɩɪɢɡɧɚɤɚɦɨɬɧɨɫɢɦ:
1. ɇɚɥɢɱɢɟ ɜ ɛɢɨɩɫɢɣɧɨɦ ɦɚɬɟɪɢɚɥɟ
ɜɡɹɬɨɦ ɩɪɢ ɎȽȾɋ) ɤɚɪɬɢɧɵ ɯɪɨɧɢɱɟɫɤɨɝɨ ɚɬɪɨɮɢɱɟɫɤɨɝɨ ɝɚɫɬɪɢɬɚ ɫ ɩɪɢɡɧɚɤɚɦɢ
ɷɧɬɟɪɨɥɢɡɚɰɢɢ (ɤɢɲɟɱɧɚɹ ɦɟɬɚɩɥɚɡɢɹ,
ɩɪɨɥɢɮɟɪɚɰɢɹ);
2. ɍɫɬɚɧɨɜɥɟɧɧɵɟɩɪɢɎȽȾɋɞɢɜɟɪɬɢɤɭɥɵȾɉɄ – ɜɩɚɩɢɥɥɹɪɧɨɣɡɨɧɟɢɥɢɞɢɫɬɚɥɶɧɟɟ;
3. ɉɪɢ ɩɟɪɨɪɚɥɶɧɨɣ ɪɟɧɬɝɟɧɨɫɤɨɩɢɢ
ɠɟɥɭɞɤɚ ɫɛɚɪɢɟɜɨɣ ɜɡɜɟɫɶɸ: ɚ) ɩɪɢɡɧɚɤɢ
ɧɚɥɢɱɢɹ ɞɢɜɟɪɬɢɤɭɥɚ ȾɉɄ ɜ ɩɚɪɚɮɚɬɟɪɢɚɥɶɧɨɣɡɨɧɟɢɥɢɞɢɫɬɚɥɶɧɟɟ, ɛ) ɞɚɧɧɵɟɡɚ
ɫɭɛ- ɢɥɢ ɞɟɤɨɦɩɟɧɫɢɪɨɜɚɧɧɵɣɝɚɫɬɪɨɫɬɚɡ
ɧɚɮɨɧɟɨɬɫɭɬɫɬɜɢɹ (ɩɪɢɎȽȾɋ) ɨɪɝɚɧɢɱɟɫɤɨɝɨɩɪɟɩɹɬɫɬɜɢɹɩɚɫɫɚɠɭɜɠɟɥɭɞɤɟɢȾɉɄ,
ɜ) ɩɪɢɡɧɚɤɢɏɇȾɉ;
4. ɉɪɢ ɍɁɂ – ɞɚɧɧɵɟɡɚɞɭɨɞɟɧɨɫɬɚɡ:
ɷɤɬɚɡɢɪɨɜɚɧɧɚɹ ȾɉɄ ɫ ɡɚɫɬɨɣɧɵɦ ɫɨɞɟɪɠɢɦɵɦ; ɭɜɟɥɢɱɟɧɧɵɣ, ɩɟɪɟɩɨɥɧɟɧɧɵɣ
ɠɟɥɱɶɸ, «ɡɚɫɬɨɣɧɵɣ» ɠɟɥɱɧɵɣɩɭɡɵɪɶ;
5. Ɉɩɪɟɞɟɥɹɟɦɵɣɩɪɢɝɟɩɚɬɨɛɢɥɢɚɪɧɨɣ
ɫɰɢɧɬɢɝɪɚɮɢɢȾȽɊ;
6. ɇɟɨɞɧɨɤɪɚɬɧɵɟɜɯɨɞɟɨɛɫɥɟɞɨɜɚɧɢɹ
ɩɨɜɵɲɟɧɢɹɚɦɢɥɚɡɵɜɤɪɨɜɢɢɦɨɱɟ;
7. ɉɪɢɢɧɬɪɚɨɩɟɪɚɰɢɨɧɧɨɣɪɟɜɢɡɢɢ: ɚ)
ɞɚɧɧɵɟɡɚɞɭɨɞɟɧɨɫɬɚɡ (ɭɜɟɥɢɱɟɧɧɵɣ, ɩɟɪɟɩɨɥɧɟɧɧɵɣ ɠɟɥɱɶɸ ɠɟɥɱɧɵɣ ɩɭɡɵɪɶ,
ɪɚɫɲɢɪɟɧɧɨɟ ɩɢɥɨɪɢɱɟɫɤɨɟɤɨɥɶɰɨ ɜ ɫɨɱɟɬɚɧɢɢɫɷɤɬɚɡɢɟɣɠɟɥɭɞɤɚ, ɪɚɫɲɢɪɟɧɧɚɹ
ȾɉɄ – ɧɢɠɧɟɝɨɪɢɡɨɧɬɚɥɶɧɚɹɜɟɬɜɶɟɺɞɨ
4 ɫɦɢɛɨɥɶɲɟ); ɛ) ɩɪɢɡɧɚɤɢɜɵɪɚɠɟɧɧɨɝɨ ɩɟɪɢɞɭɨɞɟɧɢɬɚ (ɫɩɚɟɱɧɵɣ ɢ ɪɭɛɰɨɜɨɢɧɮɢɥɶɬɪɚɬɢɜɧɵɣɩɪɨɰɟɫɫɩɟɪɢɞɭɨɞɟɧɚɥɶɧɨ, ɡɧɚɱɢɬɟɥɶɧɵɟ ɞɟɮɨɪɦɚɰɢɢ ɫɬɟɧɤɢ
ȾɉɄ); ɜ) ɩɪɢɡɧɚɤɢɩɚɧɤɪɟɚɬɢɬɚ (ɢɡɦɟɧɟɧɢɟɪɚɡɦɟɪɨɜɠɟɥɟɡɵ, ɟɺɭɩɥɨɬɧɟɧɢɟ), ɯɪɨɧɢɱɟɫɤɨɝɨ ɯɨɥɟɰɢɫɬɢɬɚ ɢɥɢ ɞɢɫɤɢɧɟɡɢɢ
ɠɟɥɱɧɨɝɨ ɩɭɡɵɪɹ (ɫɩɚɟɱɧɵɣ ɩɪɨɰɟɫɫ ɜ
ɡɨɧɟɩɭɡɵɪɹ, ɟɝɨɞɟɮɨɪɦɚɰɢɹ, ɭɜɟɥɢɱɟɧɢɟ
ɛɨɥɶɲɟ 10ɯ5 ɫɦ); ɞ) ɩɪɢɡɧɚɤɢɧɚɥɢɱɢɹɞɢɜɟɪɬɢɤɭɥɚ ȾɉɄ, ɤɨɬɨɪɵɣ ɧɟɜɨɡɦɨɠɧɨ
ɜɤɥɸɱɢɬɶɜɡɨɧɭɪɟɡɟɤɰɢɢ; ɟ) ɜɵɪɚɠɟɧɧɵɣ
ɫɩɚɟɱɧɵɣɢɥɢɪɭɛɰɨɜɨɢɧɮɢɥɶɬɪɚɬɢɜɧɵɣ
ɩɪɨɰɟɫɫɜɡɨɧɟɞɭɨɞɟɧɨɟɸɧɚɥɶɧɨɝɨɩɟɪɟɯɨɞɚ, ɤɨɪɧɹɛɪɵɠɟɣɤɢɦɟɡɨɤɨɥɨɧɢɥɢɞɪɭɝɢɟ ɩɪɢɡɧɚɤɢ ɯɪɨɧɢɱɟɫɤɨɝɨ ɬɪɟɣɬɰɢɬɚ
31
”ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ
ɨɛɵɱɧɨ ɤɚɤ ɪɟɡɭɥɶɬɚɬɨɫɬɪɨɣ ɢɥɢ ɪɟɰɢɞɢɜɢɪɭɸɳɟɣɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣɩɚɬɨɥɨɝɢɢ).
ɉɪɢɧɚɥɢɱɢɢɯɨɬɹɛɵɨɞɧɨɝɨɡɧɚɱɢɦɨɝɨɢɥɢ ɩɪɢ ɫɨɱɟɬɚɧɢɢ ɧɟɫɤɨɥɶɤɢɯ ɧɟɡɧɚɱɢɦɵɯ ɩɪɢɡɧɚɤɨɜ ɜɨɜɥɟɱɟɧɢɹ ɜ ɩɪɨɰɟɫɫ
ɞɭɨɞɟɧɨɩɚɧɤɪɟɚɬɨɛɢɥɢɚɪɧɨɣɡɨɧɵɨɬɨɪɝɚɧɨɫɨɯɪɚɧɹɸɳɢɯɢɪɟɡɟɰɢɪɭɸɳɢɯɦɟɬɨɞɢɤ ɩɨ ȼ-I ɨɬɤɚɡɵɜɚɟɦɫɹ ɜ ɩɨɥɶɡɭ ɦɟɬɨɞɢɤ B-II. ɉɪɢɤɥɢɧɢɱɟɫɤɢɥɚɬɟɧɬɧɨ, ɛɟɫɫɢɦɩɬɨɦɧɨ ɩɪɨɬɟɤɚɸɳɢɯ ɮɨɪɦɚɯ ɹɡɜɟɧɧɨɣɛɨɥɟɡɧɢ, ɤɨɬɨɪɵɟɜɩɟɪɜɵɟɩɪɨɹɜɢɥɢɫɶ
ɬɚɤɢɦɢ ɨɫɥɨɠɧɟɧɢɹɦɢ, ɤɚɤ ɤɪɨɜɨɬɟɱɟɧɢɟ, ɩɟɪɮɨɪɚɰɢɹ, ɩɪɢɡɧɚɤɢ ɫɬɟɧɨɡɚ,
ɩɪɟɞɩɨɱɬɟɧɢɟ ɨɬɞɚɟɦ ɨɪɝɚɧɨɫɨɯɪɚɧɹɸɳɢɦɢɪɟɡɟɰɢɪɭɸɳɢɦɦɟɬɨɞɢɤɚɦɩɨȼ-I.
ɗɬɢ ɦɟɬɨɞɢɤɢ ɬɚɤɠɟ ɩɪɟɞɩɨɱɢɬɚɟɦ ɩɪɢ
ɧɟɞɥɢɬɟɥɶɧɨɦɹɡɜɟɧɧɨɦɚɧɚɦɧɟɡɟ. Ɇɟɬɨɞɢɤɟɪɟɡɟɤɰɢɢɩɨ Roux ɨɬɞɚɜɚɥɢɩɪɟɞɩɨɱɬɟɧɢɟɬɨɥɶɤɨɩɪɢɨɛɲɢɪɧɵɯ – ɫɭɛɬɨɬɚɥɶɧɵɯ ɢ ɩɪɟɞɟɥɶɧɨ ɫɭɛɬɨɬɚɥɶɧɵɯ ɪɟɡɟɤɰɢɹɯ, ɜɫɥɭɱɚɹɯɭɜɟɪɟɧɧɨɝɨɢɫɤɥɸɱɟɧɢɹɭɝɪɨɡɵ ɪɚɡɜɢɬɢɹ ɩɨɫɬɪɟɡɟɤɰɢɨɧɧɨɝɨ Ɋɭɫɬɚɡ ɫɢɧɞɪɨɦɚ, ɩɟɩɬɢɱɟɫɤɨɣ ɹɡɜɵ ȽɗȺ.
ɉɨɫɥɟɞɧɹɹ, ɤɚɤɢɡɜɟɫɬɧɨ, ɧɟɪɟɞɤɨɪɚɡɜɢɜɚɟɬɫɹɩɨɫɥɟ ɷɬɨɣ ɦɟɬɨɞɢɤɢ ɢ ɞɚɠɟɩɪɢ
ɧɟɜɵɫɨɤɨɣɤɢɫɥɨɬɨɩɪɨɬɟɚɡɧɨɣɚɝɪɟɫɫɢɢ
ɤɭɥɶɬɢɠɟɥɭɞɤɚ. ȿɫɥɢɩɪɢɪɟɡɟɤɰɢɢɩɨɇF ɩɟɩɬɢɱɟɫɤɢɟɹɡɜɵɪɚɡɜɢɜɚɸɬɫɹɩɪɢɤɨɧɰɟɧɬɪɚɰɢɢ ɫɨɥɹɧɨɣ ɤɢɫɥɨɬɵ ɤɭɥɶɬɢ ɠɟɥɭɞɤɚ ɨɤɨɥɨ 26 ɦɦɨɥɶɥ ɢ ɜɵɲɟ, ɬɨ ɩɪɢ
ɪɟɡɟɤɰɢɢɩɨ Roux ɭɠɟɩɪɢ 10,7 ɦɦɨɥɶɥ
[3].
ɂɡ 300 ɪɟɡɟɤɰɢɣɠɟɥɭɞɤɚɫȽɗȺɧɚɄɒ ɩɪɢ ɯɪɨɧɢɱɟɫɤɨɣ ɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣ
ɹɡɜɟɜɵɩɨɥɧɟɧɨ 244 ɨɩɟɪɚɰɢɢ. ɂɡɧɢɯɭ 107
ɩɚɰɢɟɧɬɨɜɪɟɡɟɤɰɢɹ 2/3 ɠɟɥɭɞɤɚ, ɭ 1 – ɫɭɛɬɨɬɚɥɶɧɚɹ ɪɟɡɟɤɰɢɹ, ɭ 53 – ɝɟɦɢɪɟɡɟɤɰɢɹ
ɠɟɥɭɞɤɚɫɜɵɫɨɤɢɦɢɫɫɟɱɟɧɢɟɦɦɚɥɨɣɤɪɢɜɢɡɧɵ, ɭ 73 – ɚɧɬɪɭɦɷɤɬɨɦɢɹ ɫ ɫɟɥɟɤɬɢɜɧɨɣɜɚɝɨɬɨɦɢɟɣ. ɋɩɨɫɨɛ ɪɟɡɟɤɰɢɢɠɟɥɭɞɤɚɫɄɒɢɚɧɬɪɭɦɷɤɬɨɦɢɢɫɋȼɢȽɗȺɧɚ
Ʉɒɨɩɢɫɚɧɵɪɚɧɟɟ [6, 7]. ɉɟɪɟɞɨɩɟɪɚɰɢɟɣɩɪɢɜɵɪɚɠɟɧɧɨɦɝɚɫɬɪɢɬɟɢɥɢɛɨɥɶɲɨɣ
ɩɟɪɢɹɡɜɟɧɧɨɣɨɛɫɟɦɟɧɺɧɧɨɫɬɢ Helicobacter
pylori ɛɨɥɶɧɵɦɜɬɟɱɟɧɢɟɧɟɞɟɥɢɩɪɨɜɨɞɢɥɢ ɫɨɨɬɜɟɬɫɬɜɭɸɳɭɸ ɩɪɟɞɨɩɟɪɚɰɢɨɧɧɭɸ
32
ɩɨɞɝɨɬɨɜɤɭ. ɉɪɢɜɵɹɜɥɟɧɢɢɫɨɩɭɬɫɬɜɭɸɳɟɣ
ɠɟɥɱɧɨɤɚɦɟɧɧɨɣɛɨɥɟɡɧɢɤɨɪɪɟɤɬɢɪɨɜɚɥɢ
ɢɟɺ, ɯɢɚɬɚɥɶɧɵɟɝɪɵɠɢɭɫɬɪɚɧɹɥɢɨɛɵɱɧɨ
ɨɩɟɪɚɰɢɟɣɉɟɬɪɨɜɫɤɨɝɨɄɚɧɲɢɧɚ. Ⱦɥɹɩɪɨɮɢɥɚɤɬɢɤɢɜɧɭɬɪɟɧɧɢɯɥɢɝɚɬɭɪɧɵɯɫɜɢɳɟɣ
ɜ ɨɛɥɚɫɬɢ ȽɗȺ ɩɨɫɥɟɞɧɢɣ ɮɨɪɦɢɪɨɜɚɥɢ
ɪɚɫɫɚɫɵɜɚɸɳɢɦɢɫɹ ɧɢɬɹɦɢ (ɨɛɵɱɧɨ ɞɟɤɫɨɧɨɦɢɥɢɜɢɤɪɢɥɨɦ 3/0). Ɉɛɪɚɳɚɟɦɜɧɢɦɚɧɢɟɧɚɜɚɠɧɨɫɬɶɚɞɟɤɜɚɬɧɨɝɨɨɛɟɡɛɨɥɢɜɚɧɢɹɩɨɫɥɟɨɩɟɪɚɰɢɢ. ɉɪɨɦɟɞɨɥɧɚɡɧɚɱɚɥɢɜɬɟɱɟɧɢɟ 4–5 ɫɭɬɨɤ (ɧɟɦɟɧɶɲɟ), ɭɱɢɬɵɜɚɹ, ɱɬɨɨɧɢɝɪɚɟɬɧɚɢɛɨɥɟɟɩɨɥɨɠɢɬɟɥɶɧɭɸɪɨɥɶɧɚ 3–4-ɟɫɭɬɤɢɩɨɫɥɟɨɩɟɪɚɰɢɢ,
ɤɨɝɞɚ ɪɟɡɤɨ ɚɤɬɢɜɢɡɢɪɭɟɬɫɹ ɤɢɫɥɨɬɨɩɪɨɬɟɨɥɢɬɢɱɟɫɤɚɹɚɤɬɢɜɧɨɫɬɶɜ ɠɟɥɭɞɤɟɩɨɫɥɟɩɟɪɟɧɟɫɟɧɧɨɣɨɩɟɪɚɰɢɨɧɧɨɣɚɝɪɟɫɫɢɢ,
ɫɬɪɟɫɫɚ.
Ɋɟɡɭɥɶɬɚɬɵ ɢ ɨɛɫɭɠɞɟɧɢɟ
ɉɪɢɚɧɚɥɢɡɟɞɚɧɧɵɯɨɛɫɥɟɞɨɜɚɧɢɹɨɩɟɪɢɪɨɜɚɧɧɵɯ ɫ ɩɪɨɜɟɞɟɧɢɟɦ ɫɩɟɰɢɚɥɶɧɵɯ
ɢɫɫɥɟɞɨɜɚɧɢɣɭɫɬɚɧɨɜɥɟɧɨ, ɱɬɨɜɵɲɟɢɡɥɨɠɟɧɧɚɹɬɚɤɬɢɤɚɜɟɞɟɧɢɹɛɨɥɶɧɵɯ, ɮɨɪɦɢɪɨɜɚɧɢɟ ȽɗȺ ɧɚɄɒ ɩɪɢ ɪɟɡɟɤɰɢɹɯ ɫɤɚɡɵɜɚɟɬɫɹɩɨɥɨɠɢɬɟɥɶɧɨɧɚɪɟɡɭɥɶɬɚɬɚɯɜɵɩɨɥɧɟɧɧɵɯɨɩɟɪɚɰɢɣ. ȼɨɬɞɚɥɟɧɧɨɦɩɟɪɢɨɞɟɩɨɫɥɟɪɟɡɟɤɰɢɢ 2/3 ɠɟɥɭɞɤɚɩɪɨɜɟɞɟɧɨ
ɨɛɫɥɟɞɨɜɚɧɢɟ ɞɜɭɯ ɪɚɧɞɨɦɢɡɢɪɨɜɚɧɧɵɯ
ɝɪɭɩɩ ɛɨɥɶɧɵɯ ɩɨ 50 ɱɟɥɨɜɟɤ. Ɉɫɧɨɜɧɚɹ
ɝɪɭɩɩɚ (30 ɩɚɰɢɟɧɬɨɜɫɹɡɜɟɧɧɨɣɛɨɥɟɡɧɶɸ
ȾɉɄɢ 20 – ɹɡɜɟɧɧɨɣɛɨɥɟɡɧɶɸɠɟɥɭɞɤɚ),
ɜɤɨɬɨɪɨɣɮɨɪɦɢɪɨɜɚɥɢȽɗȺɧɚɄɒ; ɤɨɧɬɪɨɥɶɧɚɹɝɪɭɩɩɚ (30 ɩɚɰɢɟɧɬɨɜɫɹɡɜɟɧɧɨɣ
ɛɨɥɟɡɧɶɸȾɉɄɢ 20 – ɹɡɜɟɧɧɨɣɛɨɥɟɡɧɶɸ
ɠɟɥɭɞɤɚ), ɭɧɢɯɮɨɪɦɢɪɨɜɚɥɢȽɗȺɩɨɇ-F.
ɉɪɢɷɬɨɦɭɫɬɚɧɨɜɥɟɧɨ, ɱɬɨɩɨɫɥɟɮɨɪɦɢɪɨɜɚɧɢɹȽɗȺɧɚɄɒɛɨɥɟɟɧɚɞɟɠɧɨɩɪɟɞɭɩɪɟɠɞɚɟɬɫɹɡɚɛɪɨɫɠɟɥɭɞɨɱɧɨɝɨɢɬɨɳɟɤɢɲɟɱɧɨɝɨ ɫɨɞɟɪɠɢɦɨɝɨ ɜ ɩɪɢɜɨɞɹɳɭɸ
ɤɢɲɤɭ. Ɉɧɛɵɥɨɬɦɟɱɟɧɩɪɢɪɟɧɬɝɟɧɨɥɨɝɢɱɟɫɤɨɦɨɛɫɥɟɞɨɜɚɧɢɢɫɩɪɨɜɨɤɚɰɢɨɧɧɵɦɢ
ɧɚɝɪɭɡɤɚɦɢɜɨɫɧɨɜɧɨɣɝɪɭɩɩɟɭ 30% ɨɩɟɪɢɪɨɜɚɧɧɵɯ: ɜ 2% – ɦɚɫɫɢɜɧɵɣ, ɜ 8% – ɡɧɚɱɢɬɟɥɶɧɵɣ, ɜ 20% – ɧɟɡɧɚɱɢɬɟɥɶɧɵɣ. ȼɤɨɧɬɪɨɥɶɧɨɣɝɪɭɩɩɟɡɚɛɪɨɫɢɦɟɥɦɟɫɬɨɭ 60%
ɨɩɟɪɢɪɨɜɚɧɧɵɯ, ɩɪɢɱɟɦɜ 12% ɧɚɛɥɸɞɟɧɢɣ
ʋ4x2008 iɬɨɦ 16
ɨɧɛɵɥɦɚɫɫɢɜɧɵɦ, ɜ 34% – ɡɧɚɱɢɬɟɥɶɧɵɦ.
Ʉɥɢɪɟɧɫɫɚɦɨɨɱɢɳɟɧɢɹɩɪɢɜɨɞɹɳɟɣɤɢɲɤɢ
ɩɪɢɡɚɛɪɨɫɟɜɧɟɺɤɨɧɬɪɚɫɬɧɨɣɜɡɜɟɫɢɤɨɪɪɟɥɢɪɨɜɚɥɫɦɚɫɫɢɜɧɨɫɬɶɸɡɚɛɪɨɫɚɢɜɨɫɧɨɜɧɨɣ, ɢɜɤɨɧɬɪɨɥɶɧɨɣɝɪɭɩɩɚɯ; ɢɩɪɢɡɧɚɱɢɬɟɥɶɧɨɦ ɡɚɛɪɨɫɟ ɤɨɧɬɪɚɫɬɧɨɟ ɜɟɳɟɫɬɜɨ
ɡɚɞɟɪɠɢɜɚɥɨɫɶɜɩɪɢɜɨɞɹɳɟɣɤɢɲɤɟ (ɬɟ. ɜ
ȾɉɄ) ɛɨɥɟɟ 30–40 ɦɢɧ. ɜɩɨɥɨɜɢɧɟɧɚɛɥɸɞɟɧɢɣ, ɩɪɢɦɚɫɫɢɜɧɨɦ – ɭɜɫɟɯɨɩɟɪɢɪɨɜɚɧɧɵɯ. Ʉɚɤɢɡɜɟɫɬɧɨ, ɭɡɞɨɪɨɜɵɯɥɸɞɟɣ (ɛɟɡ
ɞɭɨɞɟɧɨɫɬɚɡɚ) ɤɨɧɬɪɚɫɬɧɨɟɜɟɳɟɫɬɜɨɜȾɉɄ
ɧɟɡɚɞɟɪɠɢɜɚɟɬɫɹɛɨɥɟɟ 20–30 ɫɟɤɭɧɞ.
ɋɨɯɪɚɧɟɧɢɟɪɟɡɟɪɜɭɚɪɧɨɣɮɭɧɤɰɢɢɠɟɥɭɞɤɚɫɩɨɪɰɢɨɧɧɨɣɷɜɚɤɭɚɰɢɟɣɱɟɪɟɡȽɗȺ
ɜɨɫɧɨɜɧɨɣɝɪɭɩɩɟɨɬɦɟɱɟɧɨɜ 84%, ɜɤɨɧɬɪɨɥɶɧɨɣ – ɜ 68% ɧɚɛɥɸɞɟɧɢɣ. ɉɪɢɢɡɭɱɟɧɢɢ ɫɥɢɡɢɫɬɨɣ ɤɭɥɶɬɢ ɠɟɥɭɞɤɚ ɜɢɡɭɚɥɶɧɨ
ɩɪɢɷɧɞɨɫɤɨɩɢɢɧɨɪɦɚɥɶɧɨɟɟɺɫɨɫɬɨɹɧɢɟ
ɨɬɦɟɱɟɧɨɜɨɫɧɨɜɧɨɣɝɪɭɩɩɟɜ 10%, ɜɤɨɧɬɪɨɥɶɧɨɣ – ɜ 6% ɧɚɛɥɸɞɟɧɢɣ, ɷɪɨɡɢɜɧɵɣ
ɝɚɫɬɪɢɬ – ɫɨɨɬɜɟɬɫɬɜɟɧɧɨɜ 4 ɢ 12%, ɷɪɨɡɢɜɧɵɣɚɧɚɫɬɨɦɨɡɢɬ, ɜɧɭɬɪɟɧɧɢɟɥɢɝɚɬɭɪɧɵɟɫɜɢɳɢ – ɜ 4 ɢ 14% ɧɚɛɥɸɞɟɧɢɣ. ɉɪɢ
ɝɢɫɬɨɥɨɝɢɱɟɫɤɨɦ ɢɫɫɥɟɞɨɜɚɧɢɢ ɛɢɨɩɫɢɣɧɨɝɨɦɚɬɟɪɢɚɥɚɜɨɫɧɨɜɧɨɣɝɪɭɩɩɟɩɪɟɜɚɥɢɪɨɜɚɥ ɩɨɜɟɪɯɧɨɫɬɧɵɣ ɢ ɩɪɟɚɬɪɨɮɢɱɟɫɤɢɣɝɚɫɬɪɢɬ (25 ɢ 35% ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ), ɜ
ɤɨɧɬɪɨɥɶɧɨɣ – ɚɬɪɨɮɢɱɟɫɤɢɣ (45%), ɩɪɢɱɟɦɜ 10% ɫɥɭɱɚɟɜɛɵɥɚɨɬɦɟɱɟɧɚɤɢɲɟɱɧɚɹɦɟɬɚɩɥɚɡɢɹ.
Ɍɚɤɠɟ ɜ ɫɪɨɤɢ 3–4 ɝɨɞɚɩɨɫɥɟ ɨɩɟɪɚɰɢɣɛɵɥɨɩɪɨɜɟɞɟɧɨɪɚɧɞɨɦɢɡɢɪɨɜɚɧɧɨɟ
ɨɛɫɥɟɞɨɜɚɧɢɟ ɞɜɭɯ ɪɚɧɞɨɦɢɡɢɪɨɜɚɧɧɵɯ
ɝɪɭɩɩ ɛɨɥɶɧɵɯɩɨɫɥɟɜɵɩɨɥɧɟɧɢɹɚɧɬɪɭɦɷɤɬɨɦɢɢ ɫ ɋȼ ɩɨ ɩɪɟɞɥɨɠɟɧɧɨɣ ɧɚɦɢ
ɦɟɬɨɞɢɤɟ. ɍɛɨɥɶɲɢɧɫɬɜɚɷɬɢɯɩɚɰɢɟɧɬɨɜ
ɜɚɧɚɦɧɟɡɟɢɦɟɥɢɫɶɩɢɥɨɪɨɞɭɨɞɟɧɚɥɶɧɵɟ
ɢ ɞɭɨɞɟɧɚɥɶɧɵɟ ɹɡɜɵ ɫ ɜɵɫɨɤɨɣ ɩɪɨɞɭɤɰɢɟɣɫɨɥɹɧɨɣɤɢɫɥɨɬɵ. ɍɛɨɥɶɲɢɧɫɬɜɚɢɡ
ɧɢɯ, ɤɚɤ ɢɡɜɟɫɬɧɨ, ɢ ɩɨɫɥɟ ɪɟɡɟɤɰɢɢ ɫɨɯɪɚɧɹɟɬɫɹɤɢɫɥɨɬɨɩɪɨɬɟɚɡɧɚɹɚɤɬɢɜɧɨɫɬɶ
ɤɭɥɶɬɢ ɠɟɥɭɞɤɚ ɫ ɜɵɫɨɤɢɦ ɭɪɨɜɧɟɦ ɫɟɤɪɟɰɢɢ [2]. ȼ 1-ɣɝɪɭɩɩɟ (50 ɛɨɥɶɧɵɯ) ɮɨɪɦɢɪɨɜɚɥɢ ɚɧɚɫɬɨɦɨɡ ɧɚ Ʉɒ, ɜɨ 2-ɣ (50
ɛɨɥɶɧɵɯ) – ɩɨɩɟɪɟɱɧɵɣ ȽɗȺ (ɛɟɡ Ʉɒ),
ɩɨɫɥɟ ɧɚɥɨɠɟɧɢɹ ɤɨɬɨɪɨɝɨ ɮɢɤɫɢɪɨɜɚɥɢ
ɩɪɢɜɨɞɹɳɭɸɤɢɲɤɭɞɜɭɦɹɲɜɚɦɢɤɡɚɞɧɟɣ
ɫɬɟɧɤɟɠɟɥɭɞɤɚ. ɉɪɢɚɧɤɟɬɢɪɨɜɚɧɢɢɨɩɟɪɢɪɨɜɚɧɧɵɯɤɥɢɧɢɱɟɫɤɢɟɩɪɨɹɜɥɟɧɢɹɝɢɩɨɝɥɢɤɟɦɢɱɟɫɤɨɝɨɢɞɟɦɩɢɧɝɫɢɧɞɪɨɦɚɜ
1-ɣɝɪɭɩɩɟɨɬɦɟɱɟɧɵɜ 6%, ɜɨ 2-ɣ – ɜ 14%
ɧɚɛɥɸɞɟɧɢɣ (ɫɥɚɛɨɫɬɶ, ɩɨɬɥɢɜɨɫɬɶ, ɫɟɪɞɰɟɛɢɟɧɢɟ, ɞɪɨɠɶ, ɧɟɭɫɬɨɣɱɢɜɵɣɫɬɭɥ, ɞɢɚɪɟɹɩɨɫɥɟɩɪɢɟɦɚɩɢɳɢ). ɑɚɫɬɨɩɨɜɬɨɪɹɸɳɢɟɫɹ ɛɨɥɢ ɜ ɠɢɜɨɬɟ, ɞɢɫɩɟɩɫɢɹ, ɬɹɠɟɫɬɶ ɜ ɷɩɢɝɚɫɬɪɚɥɶɧɨɣ ɨɛɥɚɫɬɢ ɜ 1-ɣ
ɝɪɭɩɩɟɨɬɦɟɱɟɧɵɭ 7 (14%) ɩɚɰɢɟɧɬɨɜ, ɜɨ
2-ɣ – ɭ 15 (30%). ɍ 1 (2,0%) ɛɨɥɶɧɨɝɨ 1-ɣ
ɝɪɭɩɩɵ ɨɛɪɚɡɨɜɚɥɚɫɶ ɩɟɩɬɢɱɟɫɤɚɹ ɹɡɜɚ
ȽɗȺ. ɗɬɚɹɡɜɚɡɚɠɢɥɚɧɚɮɨɧɟɤɨɪɨɬɤɨɝɨ
ɤɭɪɫɚ ɤɨɧɫɟɪɜɚɬɢɜɧɨɝɨ ɥɟɱɟɧɢɹ ɢ ɧɟ ɪɟɰɢɞɢɜɢɪɨɜɚɥɚ. ȼɨ 2-ɣ ɝɪɭɩɩɟ ɛɵɥɨ 4
(7,8%) ɛɨɥɶɧɵɯɫɩɟɩɬɢɱɟɫɤɨɣɹɡɜɨɣȽɗȺ.
ɍ 1 ɢɡɧɢɯɹɡɜɚɡɚɠɢɥɚɧɚɮɨɧɟɤɨɧɫɟɪɜɚɬɢɜɧɨɝɨɥɟɱɟɧɢɹ, ɭ 1 ɛɨɥɶɧɨɝɨɹɡɜɚɞɜɚɠɞɵɪɟɰɢɞɢɜɢɪɨɜɚɥɚɩɨɫɥɟɩɨɜɬɨɪɧɵɯɤɭɪɫɨɜɬɟɪɚɩɢɢ, ɜ 2 ɧɚɛɥɸɞɟɧɢɹɯɜɵɩɨɥɧɟɧɵ
ɩɨɜɬɨɪɧɵɟɨɩɟɪɚɰɢɢɜɫɜɹɡɢɫɤɪɨɜɨɬɟɱɟɧɢɟɦ. ɍɱɢɬɵɜɚɹ ɷɬɨɢɪɟɡɭɥɶɬɚɬɵ ɷɧɞɨɫɤɨɩɢɱɟɫɤɨɝɨɢɝɢɫɬɨɥɨɝɢɱɟɫɤɨɝɨɢɫɫɥɟɞɨɜɚɧɢɣ ɫɥɢɡɢɫɬɨɣ ɤɭɥɶɬɢ ɠɟɥɭɞɤɚ ɩɨɫɥɟ
ɨɛɲɢɪɧɨɣɪɟɡɟɤɰɢɢ (2/3), ɥɨɝɢɱɧɨɩɪɟɞɩɨɥɨɠɢɬɶ, ɱɬɨɮɨɪɦɢɪɨɜɚɧɢɟȽɗȺɧɚɄɒɩɨɜɵɲɚɟɬ ɭɫɬɨɣɱɢɜɨɫɬɶɡɨɧɵ ɚɧɚɫɬɨɦɨɡɚɤɪɚɡɜɢɬɢɸ ɹɡɜɟɧɧɨɞɟɫɬɪɭɤɬɢɜɧɵɯ
ɩɪɨɰɟɫɫɨɜ.
ȼɵɜɨɞɵ
1. ȼɵɹɜɥɟɧɢɟɫɪɟɞɢɛɨɥɶɧɵɯɫɯɪɨɧɢɱɟɫɤɨɣ ɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣ ɹɡɜɨɣ ɝɪɭɩɩɵ ɫ
ɧɟɛɥɚɝɨɩɪɢɹɬɧɵɦ, «ɡɥɨɤɚɱɟɫɬɜɟɧɧɵɦ»
ɩɪɨɝɧɨɡɨɦɬɟɱɟɧɢɹɛɨɥɟɡɧɢɟɳɺɞɨɪɚɡɜɢɬɢɹɨɫɥɨɠɧɟɧɢɣ (ɚɡɧɚɱɢɬ, ɢɨɩɟɪɢɪɨɜɚɧɢɟ
ɢɯɞɨɫɬɚɞɢɢɨɫɥɨɠɧɟɧɢɣ) – ɨɞɢɧɢɡɩɭɬɟɣ
ɭɥɭɱɲɟɧɢɹɪɟɡɭɥɶɬɚɬɨɜɪɟɡɟɤɰɢɢɠɟɥɭɞɤɚ.
2. ɂɧɞɢɜɢɞɭɚɥɶɧɨɞɢɮɮɟɪɟɧɰɢɪɨɜɚɧɧɵɣ
ɩɨɞɯɨɞɜɵɛɨɪɚɜɚɪɢɚɧɬɚɨɩɟɪɚɰɢɢɜɟɞɺɬɤ
ɭɦɟɧɶɲɟɧɢɸ ɩɨɫɬɪɟɡɟɤɰɢɨɧɧɵɯ ɧɚɪɭɲɟɧɢɣɢɜɨɬɞɚɥɺɧɧɨɦɩɟɪɢɨɞɟ, ɩɨɷɬɨɦɭɜɚɠɧɨ, ɱɬɨɛɵ ɨɩɟɪɢɪɭɸɳɢɣɜɥɚɞɟɥɪɚɡɧɨɨɛɪɚɡɧɵɦɢɦɟɬɨɞɢɤɚɦɢɨɩɟɪɚɰɢɣ ɧɚɷɡɨɮɚɝɨɝɚɫɬɪɨɞɭɨɞɟɧɚɥɶɧɨɣɡɨɧɟ.
3. ɎɨɪɦɢɪɨɜɚɧɢɟȽɗȺɧɚɄɒɩɪɢɪɟɡɟɤ33
”ɇɨɜɨɫɬɢɯɢɪɭɪɝɢɢ
ɰɢɹɯɠɟɥɭɞɤɚ (ɢɩɪɢɨɛɲɢɪɧɵɯ, ɢɩɪɢɷɤɨɧɨɦɧɵɯɫɜɚɝɨɬɨɦɢɟɣ) ɭɥɭɱɲɚɟɬɪɟɡɭɥɶɬɚɬɵ
ɨɩɟɪɚɰɢɢ, ɫɧɢɠɚɹɱɚɫɬɨɬɭɢɬɹɠɟɫɬɶɩɚɬɨɥɨɝɢɱɟɫɤɢɯɩɨɫɬɪɟɡɟɤɰɢɨɧɧɵɯɫɢɧɞɪɨɦɨɜ.
ɅɂɌȿɊȺɌɍɊȺ
1. ɋɨɱɟɬɚɧɧɵɟɩɨɫɬɝɚɫɬɪɨɪɟɡɟɤɰɢɨɧɧɵɟɫɢɧɞɪɨɦɵ
/ Ⱥ. ɉ. Ɇɢɯɚɣɥɨɜ [ɢɞɪ.] // ȼɟɫɬɧ. ɯɢɪ. – 2002. – ʋ
1. – ɋ. 23-28.
2. ɇɚɭɦɨɜ, ȼ. Ɏ. Ⱦɭɨɞɟɧɨɩɢɥɨɪɨɩɥɚɫɬɢɤɚɪɟɡɟɰɢɪɨɜɚɧɧɵɦ ɠɟɥɭɞɤɨɦ ɩɪɢ ɹɡɜɟɧɧɨɣ ɛɨɥɟɡɧɢ. / ȼ. Ɏ.
ɇɚɭɦɨɜ, Ƚ. ȼ. ɒɩɚɥɢɧɫɤɢɣ, ɋ. Ɋ. Ƚɚɛɞɪɚɭɥɨɜɚ // ɏɢɪɭɪɝɢɹ. – 2000. – ʋ 10. – C. 49-55.
3. ɉɨɞɨɥɭɠɧɵɣ, ȼ. ɂ. ɉɟɪɟɜɚɪɢɜɚɸɳɚɹɚɤɬɢɜɧɨɫɬɶ
ɯɢɦɭɫɚɤɭɥɶɬɢɠɟɥɭɞɤɚɩɪɢɩɨɫɬɪɟɡɟɤɰɢɨɧɧɵɯɹɡɜɚɯ / ȼ. ɂ. ɉɨɞɨɥɭɠɧɵɣ, Ⱥ. ɉ. Ɏɢɥɶɤɨɜ // ȼɟɫɬɧ. ɯɢɪ.
– 1992. – ʋ 4-5-6. – C. 284-288.
4. Ȼɚɪɚɧɨɜɫɤɢɣ, Ⱥ. Ⱥ. ɉɪɨɝɧɨɡ ɬɟɱɟɧɢɹɢɜɨɡɦɨɠ-
ɧɨɫɬɢɩɪɟɜɟɧɬɢɜɧɨɣɬɟɪɚɩɢɢɹɡɜɟɧɧɨɣɛɨɥɟɡɧɢ: ɧɚɭɱɨɛɡɨɪ / Ⱥ. Ⱥ. Ȼɚɪɚɧɨɜɫɤɢɣ // Ɇɟɞɢɰɢɧɚɢɡɞɪɚɜɨɨɯɪ.: ɨɛɡɨɪ. ɢɧɮɨɪɦ. / ɇɉɈɋɨɸɡɦɟɞɢɧɮɨɪɦ. – Ɇ.,
1991. – 73 ɫ.
5. Ɋɵɱɚɝɨɜ, Ƚ. ɉ. ɉɪɨɝɧɨɡɢɪɨɜɚɧɢɟɢɩɪɨɮɢɥɚɤɬɢɤɚ
ɧɟɤɨɬɨɪɵɯɩɨɫɥɟɨɩɟɪɚɰɢɨɧɧɵɯɨɫɥɨɠɧɟɧɢɣɜɯɢɪɭɪɝɢɢɹɡɜɟɧɧɨɣ ɛɨɥɟɡɧɢ: ɚɜɬɨɪɟɮ. ɞɢɫ. … ɞɪɚɦɟɞ.
ɧɚɭɤ / Ƚ. ɉ. Ɋɵɱɚɝɨɜ. – Ɇ., 1988. – 36 c.
6. ɋɵɱɢɤɨɜ, ɇ. ȼ. Ɋɟɡɭɥɶɬɚɬɵɪɟɡɟɤɰɢɢɠɟɥɭɞɤɚɩɨ
ɦɟɬɨɞɭȻɢɥɶɪɨɬ-II ɜɧɚɲɟɣɦɨɞɢɮɢɤɚɰɢɢ: ɚɜɬɨɪɟɮ.
ɞɢɫ. … ɤɚɧɞ. ɦɟɞ. ɧɚɭɤ: 14.00.27 / ɇ. ȼ. ɋɵɱɢɤɨɜ. –
Ɇɢɧɫɤ, 1994. – 20 ɫ.
7. ɋɵɱɢɤɨɜ, ɇ. ȼ. Ɉɩɵɬɩɪɢɦɟɧɟɧɢɹɝɚɫɬɪɨɷɧɬɟɪɨɚɧɚɫɬɚɦɨɡɚɧɚɤɥɚɩɚɧɲɩɨɪɟɜɯɢɪɭɪɝɢɢɹɡɜɟɧɧɨɣ
ɛɨɥɟɡɧɢ / ɇ. ȼ. ɋɵɱɢɤɨɜ // ɏɢɪɭɪɝɢɹ. – 2005. – ʋ
5. – C. 39-42.
8. ɑɟɪɧɨɭɫɨɜ, Ⱥ. Ɏ. ɏɢɪɭɪɝɢɹɹɡɜɟɧɧɨɣɛɨɥɟɡɧɢɠɟɥɭɞɤɚɢɞɜɟɧɚɞɰɚɬɢɩɟɪɫɬɧɨɣɤɢɲɤɢ: ɪɭɤɨɜɨɞɫɬɜɨ
ɞɥɹ ɜɪɚɱɟɣ / Ⱥ. Ɏ. ɑɟɪɧɨɭɫɨɜ, ɉ. Ɇ. Ȼɨɝɨɩɨɥɶɫɤɢɣ, Ɉ. ɋ. Ʉɭɪɛɚɧɨɜ. – Ɇ.: Ɇɟɞɢɰɢɧɚ, 1996. – 256
ɫ.
ɉɨɫɬɭɩɢɥɚ 29.10.2007 ɝ.
ɑɂɌȺɃɌȿȼɋɅȿȾɍɘɓȿɆɇɈɆȿɊȿ:
Ⱦɨɩɨɫɥɟɞɧɟɣɦɢɧɭɬɵ...
Ʉ 175-ɬɢɥɟɬɢɸɫɨɞɧɹɪɨɠɞɟɧɢɹȿɜɫɬɚɮɢɹɂɜɚɧɨɜɢɱɚȻɨɝɞɚɧɨɜɢɱɚ.
ɇɟɩɨɫɪɟɞɫɬɜɟɧɧɵɟɢɨɬɞɚɥɺɧɧɵɟɪɟɡɭɥɶɬɚɬɵ
ɷɧɞɨɜɚɫɤɭɥɹɪɧɨɣɩɪɨɮɢɥɚɤɬɢɤɢɌɗɅȺ.
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