ɂɋ. ɋɆɈɌɊɂɇ, əɊ. ɆȺɐɘɄ, Ɋȿ. Ʌɂɋ ÑÒÐÓÊÒÓÐÍÛÅ È ÖÈÒÎÕÈÌÈ×ÅÑÊÈÅ ÈÇÌÅÍÅÍÈß Â ÑÒÅÍÊÅ ÒÎÍÊÎÉ ÊÈØÊÈ ÏÐÈ ÊÎÍÒÀÊÒÍÎÌ ÂÎÇÄÅÉÑÒÂÈÈ ÎÁÒÓÐÀÒÎÐÀ ÈÇ ÏÅÍÎÏÎËÈÓÐÅÒÀÍÀ È ÔÒÎÐÎÏËÀÑÒÀ ɍɈ «Ƚɪɨɞɧɟɧɫɤɢɣ ɝɨɫɭɞɚɪɫɬɜɟɧɧɵɣ ɦɟɞɢɰɢɧɫɤɢɣ ɭɧɢɜɟɪɫɢɬɟɬ», Ɋɟɫɩɭɛɥɢɤɚ Ȼɟɥɚɪɭɫɶ ɉɪɨɜɟɞɟɧɵ ɷɤɫɩɟɪɢɦɟɧɬɚɥɶɧɵɟ ɢɫɫɥɟɞɨɜɚɧɢɹ ɩɨ ɢɡɭɱɟɧɢɸ ɜɥɢɹɧɢɹ ɷɥɚɫɬɢɱɟɫɤɢɯ ɨɛɬɭɪɚɬɨɪɨɜ ɢɡ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɢ ɮɬɨɪɨɩɥɚɫɬɚ ɧɚ ɫɬɪɭɤɬɭɪɧɵɟ ɢ ɰɢɬɨɯɢɦɢɱɟɫɤɢɟ ɢɡɦɟɧɟɧɢɹ ɜ ɫɬɟɧɤɟ ɬɨɧɤɨɣ ɤɢɲɤɢ. ɍɫɬɚɧɨɜɥɟɧɨ, ɱɬɨ ɩɪɢ ɤɨɧɬɚɤɬɧɨɦ ɜɨɡɞɟɣɫɬɜɢɢ ɧɚ ɤɢɲɤɭ ɜ ɬɟɱɟɧɢɟ 14 ɫɭɬɨɤ ɞɚɧɧɵɟ ɷɥɚɫɬɢɱɟɫɤɢɟ ɨɛɬɭɪɚɬɨɪɵ ɧɟ ɜɵɡɵɜɚɸɬ ɜɵɪɚɠɟɧɧɵɯ ɢɡɦɟɧɟɧɢɣ ɜ ɫɬɟɧɤɟ ɤɢɲɤɢ, ɚ ɜɵɹɜɥɟɧɧɵɟ ɨɬɤɥɨɧɟɧɢɹ ɜ ɚɤɬɢɜɧɨɫɬɢ ɮɟɪɦɟɧɬɨɜ ɜ ɷɩɢɬɟɥɢɨɰɢɬɚɯ ɜɨɪɫɢɧɨɤ ɦɚɥɨ ɜɵɪɚɠɟɧɵ ɢ ɧɟ ɦɨɝɭɬ ɩɨɜɥɢɹɬɶ ɧɚ ɢɯ ɮɭɧɤɰɢɨɧɚɥɶɧɨɟ ɫɨɫɬɨɹɧɢɟ. Ʉɥɸɱɟɜɵɟ ɫɥɨɜɚ: ɬɨɧɤɚɹ ɤɢɲɤɚ, ɨɛɬɭɪɚɬɨɪ ɢɡ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɢ ɮɬɨɪɨɩɥɚɫɬɚ The experimental studies have been done to determine the influence of the elastic obturators made of foamed polyurethane and teflon on the structural and cytochemical changes in the small intestine wall. It was determined that the present elastic obturators do not cause marked changes in the intestinal wall during the contact impact on the intestine for 24 hours within 14 days and the revealed deflections in enzyme activity of the epithelial cell villi are feebly marked and can not influence villi functional condition. Keywords: small intestine, elastic obturators of foamed polyurethane and teflon Ʌɟɱɟɧɢɟ ɧɚɪɭɠɧɵɯ ɤɢɲɟɱɧɵɯ ɫɜɢɳɟɣ ɨɫɬɚɺɬɫɹ ɫɥɨɠɧɨɣ ɩɪɨɛɥɟɦɨɣ ɩɪɚɤɬɢɱɟɫɤɨɣ ɯɢɪɭɪɝɢɢ. ɇɟɫɦɨɬɪɹ ɧɚ ɛɨɥɶɲɢɟ ɞɨɫɬɢɠɟɧɢɹ ɜ ɯɢɪɭɪɝɢɢ ɠɟɥɭɞɨɱɧɨɤɢɲɟɱɧɨɝɨ ɬɪɚɤɬɚ, ɥɟɬɚɥɶɧɨɫɬɶ ɩɪɢ ɤɨɧɫɟɪɜɚɬɢɜɧɨɦ ɢ ɨɩɟɪɚɬɢɜɧɨɦ ɥɟɱɟɧɢɢ ɛɨɥɶɧɵɯ ɫ ɤɢɲɟɱɧɵɦɢ ɫɜɢɳɚɦɢ ɨɫɬɚɺɬɫɹ ɜɵɫɨɤɨɣ ɢ ɤɨɥɟɛɥɟɬɫɹ ɨɬ 10 ɞɨ 50% [1, 2, 3]. Ʉɨɦɩɥɟɤɫɧɨɟ ɥɟɱɟɧɢɟ ɧɚɪɭɠɧɵɯ ɤɢɲɟɱɧɵɯ ɫɜɢɳɟɣ ɜ ɪɹɞɟ ɫɥɭɱɚɟɜ ɬɪɟɛɭɟɬ ɢɫɩɨɥɶɡɨɜɚɧɢɹ ɪɚɡɥɢɱɧɨɝɨ ɪɨɞɚ ɨɛɬɭɪɚɬɨɪɨɜ. Ɉɧɢ ɩɪɢɦɟɧɹɸɬɫɹ ɤɚɤ ɧɚ ɷɬɚɩɟ ɩɨɞɝɨɬɨɜɤɢ ɛɨɥɶɧɨɝɨ ɤ ɨɩɟɪɚɰɢɢ, ɬɚɤ ɢ ɜ ɤɚɱɟɫɬɜɟ ɨɫɧɨɜɧɨɝɨ ɦɟɬɨɞɚ ɥɟɱɟɧɢɹ ɩɪɢ ɬɪɭɛɱɚɬɵɯ ɤɢɲɟɱɧɵɯ ɫɜɢɳɚɯ. ɋɨɜɪɟɦɟɧɧɵɟ ɞɨɫɬɢɠɟɧɢɹ ɨɪɝɚɧɢɱɟɫɤɨɣ ɯɢɦɢɢ ɩɨɡɜɨɥɢɥɢ ɲɢɪɨɤɨ ɢɫɩɨɥɶɡɨɜɚɬɶ ɜ ɤɥɢɧɢɱɟɫɤɨɣ ɦɟɞɢɰɢɧɟ ɢɡɞɟɥɢɹ ɢɡ ɬɚɤɢɯ ɦɚɬɟɪɢɚɥɨɜ, ɤɚɤ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧ ɢ ɮɬɨɪɨɩɥɚɫɬ. ɇɚɦɢ ɪɚɡɪɚɛɨɬɚɧɵ ɢ ɢɡɝɨɬɨɜɥɟɧɵ ɢɡ ɜɵɲɟ ɭɤɚɡɚɧɧɵɯ ɦɚɬɟɪɢɚɥɨɜ ɷɥɚɫɬɢɱɟɫɤɢɟ ɨɛɬɭɪɚɬɨɪɵ. ɉɪɨɜɟɞɺɧɧɵɦɢ ɢɫɫɥɟɞɨɜɚɧɢɹɦɢ ɛɵɥɨ ɭɫɬɚɧɨɜɥɟɧɨ, ɱɬɨ ɢɦɩɥɚɧɬɢɪɨɜɚɧɧɵɣ ɷɥɚɫɬɢɱɟɫɤɢɣ ɨɛɬɭɪɚɬɨɪ ɢɡ ɤɨɦɩɨɡɢɬɧɨɝɨ ɦɚɬɟɪɢɚɥɚ ɧɚ ɨɫɧɨɜɟ ɮɬɨɪɨɩɥɚɫɬɚ ɧɟ ɨɤɚɡɵɜɚɟɬ ɨɬɪɢɰɚɬɟɥɶɧɨɝɨ ɜɨɡɞɟɣɫɬɜɢɹ ɧɚ ɨɛɳɭɸ ɫɨɜɨɤɭɩɧɨɫɬɶ ɦɟɬɚɛɨɥɢɱɟɫɤɢɯ ɩɪɨɰɟɫɫɨɜ ɜ ɨɪɝɚɧɢɡɦɟ ɷɤɫɩɟɪɢɦɟɧɬɚɥɶɧɵɯ ɠɢɜɨɬɧɵɯ, ɚɧɚɥɢɡɢɪɭɟɦɵɯ ɫ ɩɨɦɨɳɶɸ ɬɚɤɢɯ ɢɧɬɟɝɪɚɥɶɧɵɯ ɩɨɤɚɡɚɬɟɥɟɣ, ɤɚɤ ɫɜɨɛɨɞɧɵɟ ɚɦɢɧɨɤɢɫɥɨɬɵ (ɢɯ ɢɧɞɢɜɢɞɭɚɥɶɧɵɟ ɤɨɧɰɟɧɬɪɚɰɢɢ ɢ ɫɬɪɭɤɬɭɪɚ ɩɭɥɚ) [4]. ɇɚɪɹɞɭ ɫ ɷɬɢɦ, ɤɥɢɧɢɱɟɫɤɨɟ ɩɪɢɦɟɧɟɧɢɟ ɷɥɚɫɬɢɱɟɫɤɢɯ ɨɛɬɭɪɚɬɨɪɨɜ ɢɡ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɢ ɮɬɨɪɨɩɥɚɫɬɚ ɬɪɟɛɭɟɬ ɩɪɨɜɟɞɟɧɢɹ ɢɫɫɥɟɞɨɜɚɧɢɣ ɩɨ ɢɡɭɱɟɧɢɸ ɜɥɢɹɧɢɹ ɞɚɧɧɵɯ ɢɡɞɟɥɢɣ ɧɚ ɦɨɪɮɨɮɭɧɤɰɢɨɧɚɥɶɧɨɟ ɫɨɫɬɨɹɧɢɟ ɫɬɪɭɤɬɭɪɧɵɯ ɤɨɦɩɨɧɟɧɬɨɜ ɤɢɲɟɱɧɨɣ ɫɬɟɧɤɢ. ɉɪɨɜɟɞɺɧɧɵɣ ɚɧɚɥɢɡ ɥɢɬɟɪɚɬɭɪɵ ɩɨɤɚɡɚɥ, ɱɬɨ ɩɨɞɨɛɧɵɯ ɢɫɫɥɟɞɨɜɚɧɢɣ ɧɟ ɩɪɨɜɨɞɢɥɨɫɶ. ɐɟɥɶ ɪɚɛɨɬɵ: ɢɡɭɱɢɬɶ ɜɥɢɹɧɢɟ ɷɥɚɫɬɢɱɟɫɤɢɯ ɨɛɬɭɪɚɬɨɪɨɜ ɢɡ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɢ ɮɬɨɪɨɩɥɚɫɬɚ ɧɚ ɫɬɪɭɤɬɭɪɧɵɟ ɢ ɰɢɬɨɯɢɦɢɱɟɫɤɢɟ ɢɡɦɟɧɟɧɢɹ ɜ ɫɬɟɧɤɟ ɬɨɧɤɨɣ ɤɢɲɤɢ. 3 ɇɨɜɨɫɬɢ ɯɢɪɭɪɝɢɢ Ɇɚɬɟɪɢɚɥ ɢ ɦɟɬɨɞɵ ɗɤɫɩɟɪɢɦɟɧɬɚɥɶɧɵɟ ɢɫɫɥɟɞɨɜɚɧɢɹ ɩɪɨɜɟɞɟɧɵ ɧɚ ɤɪɨɥɢɤɚɯ ɨɛɨɟɝɨ ɩɨɥɚ ɦɚɫɫɨɣ 1,5–1,7 ɤɝ. ɀɢɜɨɬɧɵɟ ɛɵɥɢ ɪɚɡɞɟɥɟɧɵ ɧɚ 4 ɝɪɭɩɩɵ: 1 ɝɪɭɩɩɚ – ɤɨɧɬɪɨɥɶɧɚɹ (6 ɠɢɜɨɬɧɵɯ) – ɠɢɜɨɬɧɵɦ ɷɥɚɫɬɢɱɟɫɤɢɟ ɨɛɬɭɪɚɬɨɪɵ ɧɟ ɢɦɩɥɚɧɬɢɪɨɜɚɥɢɫɶ; 2 ɝɪɭɩɩɚ – ɩɥɚɰɟɛɨ (18 ɠɢɜɨɬɧɵɯ) – ɩɨɞ ɤɚɥɢɩɫɨɥɨɜɵɦ ɧɚɪɤɨɡɨɦ ɤɨɫɵɦ ɪɚɡɪɟɡɨɦ ɜ ɩɪɚɜɨɣ ɩɨɞɜɡɞɨɲɧɨɣ ɨɛɥɚɫɬɢ ɩɨɫɥɨɣɧɨ ɜɫɤɪɵɜɚɥɚɫɶ ɛɪɸɲɧɚɹ ɩɨɥɨɫɬɶ, ɧɚ ɪɚɫɫɬɨɹɧɢɢ 5–7 ɫɦ ɨɬ ɢɥɟɨɰɟɤɚɥɶɧɨɝɨ ɭɝɥɚ ɬɨɧɤɚɹ ɤɢɲɤɚ ɩɨɞɲɢɜɚɥɚɫɶ ɤ ɛɪɸɲɢɧɟ, ɚ ɪɚɧɚ ɛɪɸɲɧɨɣ ɫɬɟɧɤɢ ɭɲɢɜɚɥɚɫɶ; 3 ɝɪɭɩɩɚ – ɩɟɧɨɩɨɥɢɭɪɟɬɚɧ (ɉɉɍ, 18 ɠɢɜɨɬɧɵɯ) – ɩɨɞ ɤɚɥɢɩɫɨɥɨɜɵɦ ɧɚɪɤɨɡɨɦ ɤɨɫɵɦ ɪɚɡɪɟɡɨɦ ɜ ɩɪɚɜɨɣ ɩɨɞɜɡɞɨɲɧɨɣ ɨɛɥɚɫɬɢ ɩɨɫɥɨɣɧɨ ɜɫɤɪɵɜɚɥɚɫɶ ɛɪɸɲɧɚɹ ɩɨɥɨɫɬɶ, ɧɚ ɪɚɫɫɬɨɹɧɢɢ 5–7 ɫɦ ɨɬ ɢɥɟɨɰɟɤɚɥɶɧɨɝɨ ɭɝɥɚ ɬɨɧɤɚɹ ɤɢɲɤɚ ɩɨɞɲɢɜɚɥɚɫɶ ɤ ɛɪɸɲɢɧɟ, ɧɚ ɤɢɲɤɭ ɭɤɥɚɞɵɜɚɥɫɹ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɵɣ ɨɛɬɭɪɚɬɨɪ, ɡɚɬɟɦ ɪɚɧɚ ɭɲɢɜɚɥɚɫɶ; 4 ɝɪɭɩɩɚ – ɮɬɨɪɨɩɥɚɫɬ (ɉɌɎɗ, 18 ɠɢɜɨɬɧɵɯ) – ɩɨɞ ɤɚɥɢɩɫɨɥɨɜɵɦ ɧɚɪɤɨɡɨɦ ɤɨɫɵɦ ɪɚɡɪɟɡɨɦ ɜ ɩɪɚɜɨɣ ɩɨɞɜɡɞɨɲɧɨɣ ɨɛɥɚɫɬɢ ɩɨɫɥɨɣɧɨ ɜɫɤɪɵɜɚɥɚɫɶ ɛɪɸɲɧɚɹ ɩɨɥɨɫɬɶ, ɧɚ ɪɚɫɫɬɨɹɧɢɢ 5–7 ɫɦ ɨɬ ɢɥɟɨɰɟɤɚɥɶɧɨɝɨ ɭɝɥɚ ɬɨɧɤɚɹ ɤɢɲɤɚ ɩɨɞɲɢɜɚɥɚɫɶ ɤ ɛɪɸɲɢɧɟ, ɧɚ ɤɢɲɤɭ ɭɤɥɚɞɵɜɚɥɫɹ ɮɬɨɪɨɩɥɚɫɬɨɜɵɣ ɨɛɬɭɪɚɬɨɪ, ɚ ɪɚɧɚ ɧɚɞ ɧɢɦ ɭɲɢɜɚɥɚɫɶ. Ⱦɥɹ ɢɡɝɨɬɨɜɥɟɧɢɹ ɨɫɧɨɜɵ ɷɥɚɫɬɢɱɟɫɤɢɯ ɨɛɬɭɪɚɬɨɪɨɜ ɢɡ ɮɬɨɪɨɩɥɚɫɬɚ ɧɚɦɢ ɛɵɥ ɢɫɩɨɥɶɡɨɜɚɧ ɦɟɞɢɰɢɧɫɤɢɣ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧ ɉɉɍ) ɩɥɨɬɧɨɫɬɶɸ 38–40 ɤɝɦ3, ɩɨɪɢɫɬɨɫɬɶɸ 98,5%. ɉɨɜɟɪɯɧɨɫɬɶ ɡɚɝɨɬɨɜɤɢ ɢɡ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɜ ɢɧɫɬɢɬɭɬɟ ɦɟɯɚɧɢɤɢ ɦɟɬɚɥɥɨɩɨɥɢɦɟɪɧɵɯ ɫɢɫɬɟɦ ɢɦ. ȼȺ. Ȼɟɥɨɝɨ ɇȺɇ ɊȻ ɦɨɞɢɮɢɰɢɪɨɜɚɥɚɫɶ ɦɟɬɨɞɨɦ ɥɚɡɟɪɧɨɣ ɚɛɥɹɰɢɢ ɩɨɥɢɬɟɬɪɚɮɬɨɪɷɬɢɥɟɧɨɜɵɦ ɉɌɎɗ, ɮɬɨɪɨɩɥɚɫɬ) ɫɥɨɟɦ ɬɨɥɳɢɧɨɣ 2 ɦɦ ɢ ɩɨɪɢɫɬɨɫɬɶɸ ɨɤɨɥɨ 85%. ɂɡ ɷɤɫɩɟɪɢɦɟɧɬɚ ɠɢɜɨɬɧɵɟ ɜɵɜɨɞɢɥɢɫɶ ɩɨɞ ɧɚɪɤɨɡɨɦ ɧɚ 3, 7 ɢ 14 ɫɭɬɤɢ ɩɨɫɥɟ ɜɵɲɟɭɤɚɡɚɧɧɵɯ ɨɩɟɪɚɬɢɜɧɵɯ ɜɦɟɲɚ4 ɬɟɥɶɫɬɜ. ɍɱɚɫɬɤɢ ɬɨɳɟɣ ɤɢɲɤɢ ɪɚɡɦɟɪɨɦ ɞɨ 1 ɫɦ ɡɚɛɢɪɚɥɢɫɶ ɞɥɹ ɝɢɫɬɨɥɨɝɢɱɟɫɤɨɝɨ ɢ ɰɢɬɨɯɢɦɢɱɟɫɤɨɝɨ ɢɫɫɥɟɞɨɜɚɧɢɹ. ɉɪɟɩɚɪɚɬɵ ɞɥɹ ɝɢɫɬɨɥɨɝɢɱɟɫɤɨɝɨ ɢɫɫɥɟɞɨɜɚɧɢɹ ɨɤɪɚɲɢɜɚɥɢɫɶ ɝɟɦɚɬɨɤɫɢɥɢɧɨɦ ɢ ɷɨɡɢɧɨɦ [5]. ɑɚɫɬɶ ɤɭɫɨɱɤɨɜ ɩɨɞɜɟɪɝɚɥɢ ɝɥɭɛɨɤɨɦɭ ɡɚɦɨɪɚɠɢɜɚɧɢɸ ɜ ɠɢɞɤɨɦ ɚɡɨɬɟ ɫ ɩɨɫɥɟɞɭɸɳɟɣ ɦɨɧɬɢɪɨɜɤɨɣ ɧɚ ɨɛɴɟɤɬɨɞɟɪɠɚɬɟɥɟ ɜ ɤɪɢɨɫɬɚɬɟ ɮɢɪɦɵ Leica CM-1850 ɩɪɢ -15°ɋ. ɂɡɝɨɬɨɜɥɟɧɧɵɟ ɨɞɧɨɦɨɦɟɧɬɧɨ ɢɡ ɡɚɦɨɪɨɠɟɧɧɵɯ ɤɭɫɨɱɤɨɜ ɤɨɧɬɪɨɥɶɧɨɣ ɢ ɨɩɵɬɧɵɯ ɝɪɭɩɩ ɠɢɜɨɬɧɵɯ ɤɪɢɨɫɬɚɬɧɵɟ ɫɪɟɡɵ ɬɨɥɳɢɧɨɣ 10 ɦɤɦ ɢɫɩɨɥɶɡɨɜɚɥɢ ɞɥɹ ɝɢɫɬɨɯɢɦɢɱɟɫɤɢɯ ɢɫɫɥɟɞɨɜɚɧɢɣ ɧɚ ɩɪɟɞɦɟɬ ɜɵɹɜɥɟɧɢɹ ɜ ɬɤɚɧɹɯ ɬɨɳɟɣ ɤɢɲɤɢ (ɷɩɢɬɟɥɢɨɰɢɬɚɯ ɜɨɪɫɢɧɨɤ) ɚɤɬɢɜɧɨɫɬɢ ɫɭɤɰɢɧɚɬɞɟɝɢɞɪɨɝɟɧɚɡɵ (ɋȾȽ) – ɦɚɪɤɟɪɚ ɰɢɤɥɚ ɬɪɢɤɚɪɛɨɧɨɜɵɯ ɤɢɫɥɨɬ, ɥɚɤɬɚɬɞɟɝɢɞɪɨɝɟɧɚɡɵ ɅȾȽ) – ɦɚɪɤɟɪɚ ɚɧɚɷɪɨɛɧɨɝɨ ɝɥɢɤɨɥɢɡɚ, ɇȺȾɇ – ɞɟɝɢɞɪɨɝɟɧɚɡɵ (ɇȺȾɇÂȾȽ) – ɩɨɤɚɡɚɬɟɥɶ ɚɤɬɢɜɧɨɫɬɢ ɦɢɬɨɯɨɧɞɪɢɚɥɶɧɵɯ ɩɪɨɰɟɫɫɨɜ [6, 7, 8]. ȼɫɟ ɝɢɫɬɨɯɢɦɢɱɟɫɤɢɟ ɪɟɚɤɰɢɢ ɫɨɩɪɨɜɨɠɞɚɥɢɫɶ ɛɟɫɫɭɛɫɬɪɚɤɬɧɵɦɢ ɤɨɧɬɪɨɥɹɦɢ [9]. Ʉɨɥɢɱɟɫɬɜɟɧɧɭɸ ɨɰɟɧɤɭ ɚɤɬɢɜɧɨɫɬɢ ɮɟɪɦɟɧɬɨɜ ɜ ɰɢɬɨɩɥɚɡɦɟ ɷɩɢɬɟɥɢɨɰɢɬɨɜ, ɧɚɯɨɞɹɳɢɯɫɹ ɜ ɫɪɟɞɧɟɣ ɱɚɫɬɢ ɤɢɲɟɱɧɵɯ ɜɨɪɫɢɧɨɤ, ɩɪɨɜɨɞɢɥɢ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɩɪɢɛɨɪɚ ɦɢɤɪɨɚɛɫɨɪɰɢɨɦɟɬɪɚ – ɮɥɸɨɪɢɦɟɬɪɚ ɜ ɤɨɦɩɥɟɤɬɟ ɫɨ ɫɤɚɧɢɪɭɸɳɢɦ ɦɢɤɪɨɫɤɨɩɨɦ ɆɎɌɏ-2Ɇ ɩɪɢ ɞɥɢɧɟ ɜɨɥɧɵ 580 ɧɦ ɢ ɜɵɪɚɠɚɥɢ ɜ ɟɞɢɧɢɰɚɯ ɨɩɬɢɱɟɫɤɨɣ ɩɥɨɬɧɨɫɬɢ (ɟɞ. ɨɩɬ. ɩɥ.). ɉɨɥɭɱɟɧɧɵɣ ɰɢɮɪɨɜɨɣ ɦɚɬɟɪɢɚɥ ɨɛɪɚɛɚɬɵɜɚɥɫɹ ɫɬɚɬɢɫɬɢɱɟɫɤɢ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɥɢɰɟɧɡɢɪɨɜɚɧɧɨɣ ɩɪɨɝɪɚɦɦɵ Statistica 6.0 ɞɥɹ Windows. ɂɥɥɸɫɬɪɚɬɢɜɧɵɣ ɦɚɬɟɪɢɚɥ ɝɢɫɬɨɫɬɪɭɤɬɭɪ ɬɨɳɟɣ ɤɢɲɤɢ ɩɨɥɭɱɚɥɢ ɫ ɢɫɩɨɥɶɡɨɜɚɧɢɟɦ ɦɢɤɪɨɫɤɨɩɚ Axioscop 2 plus (Carl Zeis, Ƚɟɪɦɚɧɢɹ) ɫ ɰɢɮɪɨɜɨɣ ɜɢɞɟɨɤɚɦɟɪɨɣ Leica DFC 320. Ɋɟɡɭɥɶɬɚɬɵ ɢɫɫɥɟɞɨɜɚɧɢɣ ȼ ɧɨɪɦɟ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɚɹ ɫɬɪɨ- ʋ4x 2009 i ɬɨɦ 17 ɦɚ ɫɥɢɡɢɫɬɨɣ ɬɨɧɤɨɣ ɤɢɲɤɢ ɤɚɤ ɤɨɧɬɪɨɥɶɧɵɯ, ɬɚɤ ɢ ɠɢɜɨɬɧɵɯ ɝɪɭɩɩɵ ɩɥɚɰɟɛɨ ɛɵɥɚ ɢɧɮɢɥɶɬɪɢɪɨɜɚɧɚ ɧɟɛɨɥɶɲɢɦ ɤɨɥɢɱɟɫɬɜɨɦ ɥɢɦɮɨɰɢɬɨɜ. ɉɨɫɥɟɞɧɢɟ ɱɚɫɬɨ ɜɫɬɪɟɱɚɥɢɫɶ ɦɟɠɞɭ ɷɩɢɬɟɥɢɨɰɢɬɚɦɢ ɜɨɪɫɢɧɨɤ ɢ ɜ ɦɟɧɶɲɟɣ ɫɬɟɩɟɧɢ ɤɪɢɩɬ. ȼ ɫɬɪɨɦɟ ɜɨɪɫɢɧɨɤ ɥɟɝɤɨ ɩɪɨɫɦɚɬɪɢɜɚɥɢɫɶ ɮɢɛɪɨɛɥɚɫɬɵ, ɩɥɚɡɦɨɰɢɬɵ, ɟɞɢɧɢɱɧɵɟ ɷɨɡɢɧɨɮɢɥɵ ɢ ɧɟɣɬɪɨɮɢɥɵ. Ʉɪɨɜɟɧɨɫɧɵɟ ɤɚɩɢɥɥɹɪɵ, ɪɚɫɩɨɥɨɠɟɧɧɵɟ ɩɨɞ ɷɩɢɬɟɥɢɟɦ ɜ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɫɬɪɨɦɟ ɜɨɪɫɢɧɨɤ, ɢɦɟɥɢ, ɤɚɤ ɩɪɚɜɢɥɨ, ɩɪɨɫɜɟɬ 5–7 ɦɤɦ ɜ ɞɢɚɦɟɬɪɟ. ȼ ɰɟɧɬɪɚɥɶɧɨɣ ɱɚɫɬɢ ɫɬɪɨɦɵ ɜɨɪɫɢɧɨɤ ɧɚɯɨɞɢɥɢɫɶ ɜ ɧɟɛɨɥɶɲɢɯ ɤɨɥɢɱɟɫɬɜɚɯ ɦɢɨɰɢɬɵ. ȼɵɫɬɢɥɚɸɳɢɟ ɫɧɚɪɭɠɢ ɜ ɫɪɟɞɧɟɣ ɱɚɫɬɢ ɜɨɪɫɢɧɨɤ ɤɚɟɦɱɚɬɵɟ ɷɧɬɟɪɨɰɢɬɵ ɢɦɟɥɢ ɜɵɫɨɤɨɩɪɢɡɦɚɬɢɱɟɫɤɭɸ ɮɨɪɦɭ ɞɥɢɧɨɣ 25–30 ɦɤɦ. ɂɯ ɰɢɬɨɩɥɚɡɦɚ ɨɬɥɢɱɚɥɚɫɶ ɜɵɪɚɠɟɧɧɵɦɢ ɨɤɫɢɮɢɥɶɧɵɦɢ ɫɜɨɣɫɬɜɚɦɢ. ɇɚ ɚɩɢɤɚɥɶɧɨɦ ɨɬɞɟɥɟ ɰɢɬɨɩɥɚɡɦɵ ɷɧɬɟɪɨɰɢɬɨɜ ɱɺɬɤɨ ɩɪɨɫɦɚɬɪɢɜɚɥɚɫɶ ɳɺɬɨɱɧɚɹ ɤɚɺɦɤɚ, ɜɵɞɟɥɹɸɳɚɹɫɹ ɩɨɜɵɲɟɧɧɨɣ ɨɤɫɢɮɢɥɢɟɣ. ȼɫɬɪɟɱɚɟɦɵɟ ɦɟɠɞɭ ɷɩɢɬɟɥɢɨɰɢɬɚɦɢ ɛɨɤɚɥɨɜɢɞɧɵɟ ɤɥɟɬɤɢ ɛɵɥɢ ɭɦɟɪɟɧɧɨ ɧɚɩɨɥɧɟɧɵ ɫɥɚɛɨ ɛɚɡɨɮɢɥɶɧɵɦ ɦɭɤɨɢɞɧɵɦ ɫɟɤɪɟɬɨɦ. ɗɩɢɬɟɥɢɨɰɢɬɵ ɤɪɢɩɬ ɨɬɥɢɱɚɥɢɫɶ ɦɟɧɶɲɟɣ ɜɵɫɨɬɨɣ (ɨɤɨɥɨ 18–22 ɦɤɦ), ɫɧɢɠɟɧɧɨɣ ɨɤɫɢɮɢɥɢɟɣ ɰɢɬɨɩɥɚɡɦɵ ɢ ɛɨɥɟɟ ɬɨɧɤɨɣ ɤɚɺɦɤɨɣ. ɋɟɪɨɡɧɚɹ ɨɛɨɥɨɱɤɚ, ɩɨɤɪɵɜɚɸɳɚɹ ɫɧɚɪɭɠɢ ɦɵɲɟɱɧɭɸ, ɬɨɧɤɚɹ (10–25 ɦɤɦ). ȼ ɟɺ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɨɫɧɨɜɟ ɜɫɬɪɟɱɚɥɢɫɶ ɜ ɧɟɛɨɥɶɲɨɦ ɤɨɥɢɱɟɫɬɜɟ ɥɢɦɮɨɰɢɬɵ ɢ ɟɞɢɧɢɱɧɵɟ ɩɥɚɡɦɨɰɢɬɵ. ȼɫɬɪɟɱɚɟɦɵɟ ɜ ɧɟɣ ɤɪɨɜɟɧɨɫɧɵɟ ɫɨɫɭɞɵ ɢ ɤɚɩɢɥɥɹɪɵ ɢɦɟɥɢ ɧɨɪɦɚɥɶɧɵɣ ɞɢɚɦɟɬɪ. ɇɚ 3-ɢ ɫɭɬɤɢ ɜɨɤɪɭɝ ɢɦɩɥɚɧɬɢɪɨɜɚɧɧɨɝɨ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɨɝɨ ɨɛɬɭɪɚɬɨɪɚ ɜ ɪɵɯɥɨɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɨɛɨɥɨɱɤɟ ɫɬɟɧɤɢ ɤɢɲɤɢ ɪɚɡɜɢɜɚɥɚɫɶ ɥɟɣɤɨɰɢɬɚɪɧɚɹ ɢɧɮɢɥɶɬɪɚɰɢɹ ɫ ɨɛɢɥɢɟɦ ɜ ɧɟɣ ɥɢɦɮɨɰɢɬɨɜ. ɉɨɫɥɟɞɧɢɟ ɜ ɟɞɢɧɢɱɧɵɯ ɤɨɥɢɱɟɫɬɜɚɯ ɨɛɧɚɪɭɠɢɜɚɥɢɫɶ ɢ ɜ ɩɪɨɫɥɨɣɤɚɯ ɦɟɠɞɭ ɜɨɥɨɤɧɢɫɬɵɦɢ ɷɥɟɦɟɧɬɚɦɢ ɩɟɪɢɮɟɪɢɱɟɫɤɨɣ ɱɚɫɬɢ ɜɵɲɟɧɚɡɜɚɧɧɨɝɨ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɨ- ɝɨ ɨɛɬɭɪɚɬɨɪɚ (ɪɢɫ. 1, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). ȼ ɩɨɞɷɩɢɬɟɥɢɚɥɶɧɨɣ ɱɚɫɬɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɫɬɪɨɦɵ ɜɨɪɫɢɧɨɤ ɨɱɚɝɨɜɨ ɪɚɫɲɢɪɹɥɢɫɶ ɢ ɧɚɩɨɥɧɹɥɢɫɶ ɤɪɨɜɶɸ ɤɪɨɜɟɧɨɫɧɵɟ ɤɚɩɢɥɥɹɪɵ. ɂɯ ɞɢɚɦɟɬɪ ɞɨɫɬɢɝɚɥ 15–20 ɦɤɦ. ɗɬɨ ɫɨɩɪɨɜɨɠɞɚɥɨɫɶ ɪɚɡɜɢɬɢɟɦ ɭɦɟɪɟɧɧɨ ɜɵɪɚɠɟɧɧɨɣ ɩɟɪɢɤɚɩɢɥɥɹɪɧɨɣ ɨɬɺɱɧɨɫɬɢ ɢ ɥɢɦɮɨɰɢɬɚɪɧɨɣ ɢɧɮɢɥɶɬɪɚɰɢɢ. ɍɫɢɥɢɜɚɥɚɫɶ ɢɧɮɢɥɶɬɪɚɰɢɹ ɥɢɦɮɨɰɢɬɚɦɢ ɢ ɷɩɢɬɟɥɢɹ ɤɪɢɩɬ ɢ ɜɨɪɫɢɧɨɤ, ɜɵɫɨɬɚ ɤɨɬɨɪɨɝɨ ɧɟɡɧɚɱɢɬɟɥɶɧɨ ɜɨɡɪɚɫɬɚɥɚ (27–35 ɦɤɦ). ɑɚɳɟ ɜ ɫɬɪɨɦɟ ɜɨɪɫɢɧɨɤ ɢ ɫɥɢɡɢɫɬɨɣ ɨɛɨɥɨɱɤɟ ɜ ɰɟɥɨɦ ɫɬɚɥɢ ɨɛɧɚɪɭɠɢɜɚɬɶɫɹ ɩɥɚɡɦɚɬɢɱɟɫɤɢɟ ɤɥɟɬɤɢ. Ȼɨɤɚɥɨɜɢɞɧɵɟ ɤɥɟɬɤɢ ɜɨɪɫɢɧɨɤ ɢ ɤɪɢɩɬ ɭɜɟɥɢɱɢɜɚɥɢɫɶ ɜ ɪɚɡɦɟɪɟ (ɪɢɫ. 2, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). ɍɦɟɪɟɧɧɨɟ ɪɚɫɲɢɪɟɧɢɟ ɤɪɨɜɟɧɨɫɧɵɯ ɫɨɫɭɞɨɜ ɢ ɩɟɪɟɩɨɥɧɟɧɢɟ ɢɯ ɤɪɨɜɶɸ, ɫɨɩɪɨɜɨɠɞɚɟɦɨɟ ɫɥɚɛɨɣ ɥɢɦɮɨɰɢɬɚɪɧɨɣ ɢɧɮɢɥɶɬɪɚɰɢɟɣ, ɢɦɟɥɨ ɦɟɫɬɨ ɢ ɜ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɨɫɧɨɜɟ ɩɨɞɫɥɢɡɢɫɬɨɣ ɨɛɨɥɨɱɤɟ ɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɨɫɧɨɜɟ ɫɟɪɨɡɧɨɣ ɨɛɨɥɨɱɤɢ. Ⱥɧɚɥɨɝɢɱɧɚɹ ɤɚɪɬɢɧɚ ɧɚɛɥɸɞɚɥɚɫɶ ɢ ɫɨ ɫɬɨɪɨɧɵ ɫɟɪɨɡɧɨɣ ɨɛɨɥɨɱɤɢ ɬɨɧɤɨɣ ɤɢɲɤɢ, ɤɨɬɨɪɚɹ ɤɨɧɬɚɤɬɢɪɨɜɚɥɚ ɫ ɨɛɬɭɪɚɬɨɪɨɦ ɢɡ ɮɬɨɪɨɩɥɚɫɬɚ. ȼɫɺ ɷɬɨ ɫɨɩɪɨɜɨɠɞɚɥɨɫɶ ɧɟɡɧɚɱɢɬɟɥɶɧɨɣ ɨɬɺɱɧɨɫɬɶɸ ɢ ɭɦɟɪɟɧɧɨɣ ɥɢɦɮɨɰɢɬɚɪɧɨɣ ɢɧɮɢɥɶɬɪɚɰɢɟɣ (ɪɢɫ. 3, 4, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). Ʉ ɫɟɦɢ ɫɭɬɤɚɦ ɜ ɫɟɪɨɡɧɨɣ ɨɛɨɥɨɱɤɟ, ɤɨɧɬɚɤɬɢɪɭɸɳɟɣ ɫ ɨɛɬɭɪɚɬɨɪɨɦ ɢɡ ɮɬɨɪɨɩɥɚɫɬɚ, ɤɪɨɜɟɧɨɫɧɵɟ ɫɨɫɭɞɵ ɟɺ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɨɫɧɨɜɵ ɨɫɬɚɜɚɥɢɫɶ ɪɚɫɲɢɪɟɧɧɵɦɢ. ɗɬɨ ɬɚɤɠɟ ɫɨɩɪɨɜɨɠɞɚɥɨɫɶ ɨɬɺɱɧɨɫɬɶɸ ɢ ɧɟɡɧɚɱɢɬɟɥɶɧɨ ɜɵɪɚɠɟɧɧɨɣ ɥɢɦɮɨɰɢɬɚɪɧɨɣ ɢɧɮɢɥɶɬɪɚɰɢɟɣ (ɪɢɫ. 5, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). ȼɨɡɪɚɫɬɚɥɚ ɩɪɢ ɷɬɨɦ ɢ ɮɢɛɪɨɛɥɚɫɬɢɱɟɫɤɚɹ ɪɟɚɤɰɢɹ ɫ ɭɜɟɥɢɱɟɧɢɟɦ ɤɨɥɢɱɟɫɬɜɚ ɮɢɛɪɨɛɥɚɫɬɨɜ ɧɟ ɬɨɥɶɤɨ ɜ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɨɫɧɨɜɟ ɫɟɪɨɡɧɨɣ ɨɛɨɥɨɱɤɢ, ɧɚɯɨɞɹɳɟɣɫɹ ɜ ɤɨɧɬɚɤɬɟ ɫ ɮɬɨɪɨɩɥɚɫɬɨɦ, ɧɨ ɢ ɜ ɭɱɚɫɬɤɚɯ ɤɢɲɤɢ, ɩɪɢɥɟɠɚɳɢɯ ɤ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɨɦɭ ɨɛɬɭɪɚɬɨɪɭ (ɪɢɫ. 6, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). Ɍɳɚɬɟɥɶɧɨɟ ɢɡɭɱɟɧɢɟ ɝɢɫɬɨɥɨɝɢɱɟɫɤɢɯ 5 ɇɨɜɨɫɬɢ ɯɢɪɭɪɝɢɢ ɩɪɟɩɚɪɚɬɨɜ ɩɨɤɚɡɚɥɨ, ɱɬɨ ɩɪɢ ɷɬɨɦ ɢɦɟɥɚ ɦɟɫɬɨ ɚɤɬɢɜɚɰɢɹ ɚɞɜɟɧɬɢɰɢɚɥɶɧɵɯ ɤɥɟɬɨɤ ɤɪɨɜɟɧɨɫɧɵɯ ɫɨɫɭɞɨɜ ɦɢɤɪɨɰɢɪɤɭɥɹɬɨɪɧɨɝɨ ɪɭɫɥɚ, ɤɨɬɨɪɵɟ ɩɨ ɫɬɪɭɤɬɭɪɧɵɦ ɢ ɬɢɧɤɬɨɪɢɚɥɶɧɵɦ ɫɜɨɣɫɬɜɚɦ ɜɟɫɶɦɚ ɫɯɨɠɢ ɫ ɬɚɤɨɜɵɦɢ ɮɢɛɪɨɛɥɚɫɬɨɜ ɪɵɯɥɨɣ ɧɟɨɮɨɪɦɥɟɧɧɨɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ, ɪɚɫɩɨɥɨɠɟɧɧɨɣ ɜɛɥɢɡɢ ɫɨɫɭɞɨɜ (ɪɢɫ. 7, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). ɋɬɚɧɨɜɢɬɫɹ ɨɱɟɜɢɞɧɵɦ, ɱɬɨ ɭɫɢɥɟɧɢɟ ɮɢɛɪɨɛɥɚɫɬɢɱɟɫɤɨɣ ɪɟɚɤɰɢɢ, ɩɪɢɜɨɞɹɳɟɣ ɤ ɭɜɟɥɢɱɟɧɢɸ ɱɢɫɥɟɧɧɨɣ ɩɥɨɬɧɨɫɬɢ ɮɢɛɪɨɛɥɚɫɬɨɜ ɜ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɨɫɧɨɜɟ ɫɟɪɨɡɧɨɣ ɨɛɨɥɨɱɤɢ, ɧɚɯɨɞɹɳɟɣɫɹ ɜ ɤɨɧɬɚɤɬɟ ɫ ɮɬɨɪɨɩɥɚɫɬɨɦ, ɩɪɨɢɫɯɨɞɢɬ ɧɟ ɬɨɥɶɤɨ ɡɚ ɫɱɺɬ ɦɚɥɨɞɢɮɮɟɪɟɧɰɢɪɨɜɚɧɧɵɯ ɤɥɟɬɨɤ ɮɢɛɪɨɛɥɚɫɬɢɱɟɫɤɨɝɨ ɪɹɞɚ ɪɵɯɥɨɣ ɧɟɨɮɨɪɦɥɟɧɧɨɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ, ɧɨ ɢ ɡɚ ɫɱɺɬ ɚɤɬɢɜɚɰɢɢ ɚɞɜɟɧɬɢɰɢɚɥɶɧɵɯ ɤɥɟɬɨɤ ɧɚɪɭɠɧɨɣ ɨɛɨɥɨɱɤɢ ɤɪɨɜɟɧɨɫɧɵɯ ɫɨɫɭɞɨɜ. Ʉ ɷɬɨɦɭ ɫɪɨɤɭ (7 ɫɭɬɨɤ) ɜɨɤɪɭɝ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɨɝɨ ɨɛɬɭɪɚɬɨɪɚ ɡɚ ɫɱɺɬ ɮɢɛɪɨɛɥɚɫɬɢɱɟɫɤɨɣ ɪɟɚɤɰɢɢ ɭɠɟ ɧɚɛɥɸɞɚɥɨɫɶ ɮɨɪɦɢɪɨɜɚɧɢɟ ɮɢɛɪɨɡɧɨɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɤɚɩɫɭɥɵ. ɉɪɨɧɢɤɲɚɹ ɜ ɧɟɤɨɬɨɪɵɯ ɭɱɚɫɬɤɚɯ ɜ ɹɱɟɣɤɢ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɤɪɨɜɶ ɩɪɟɜɪɚɳɚɥɚɫɶ ɜ ɤɥɟɬɨɱɧɵɣ ɞɟɬɪɢɬ (ɪɢɫ. 8, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ), ɱɬɨ ɫɩɨɫɨɛɫɬɜɨɜɚɥɨ ɨɪɝɚɧɢɡɚɰɢɢ ɜ ɷɬɢɯ ɭɱɚɫɬɤɚɯ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɵɯ ɩɪɨɫɥɨɟɤ (ɪɢɫ. 9, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). ɂɡɦɟɧɟɧɢɹ ɜ ɫɚɦɨɣ ɫɬɟɧɤɟ ɬɨɳɟɣ ɤɢɲɤɢ ɜ ɨɬɜɟɬ ɧɚ ɤɨɧɬɚɤɬɧɨɟ ɜɨɡɞɟɣɫɬɜɢɟ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɢ ɮɬɨɪɨɩɥɚɫɬɚ ɛɵɥɢ ɧɟɡɧɚɱɢɬɟɥɶɧɵ. ȼ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɨɣ ɫɬɪɨɦɟ ɫɥɢɡɢɫɬɨɣ ɢɦɟɥɨ ɦɟɫɬɨ ɭɦɟɪɟɧɧɨɟ ɪɚɫɲɢɪɟɧɢɟ ɝɟɦɨɤɚɩɢɥɥɹɪɨɜ, ɫɨɩɪɨɜɨɠɞɚɸɳɟɟɫɹ ɧɟɡɧɚɱɢɬɟɥɶɧɨɣ ɥɢɦɮɨɰɢɬɚɪɧɨɣ ɢɧɮɢɥɶɬɪɚɰɢɟɣ. ɑɚɳɟ ɜɫɬɪɟɱɚɥɢɫɶ ɥɢɦɮɨɰɢɬɵ ɢ ɫɪɟɞɢ ɷɩɢɬɟɥɢɨɰɢɬɨɜ ɤɪɢɩɬ ɢ ɜɨɪɫɢɧɨɤ. ȼɵɫɨɬɚ ɷɩɢɬɟɥɢɨɰɢɬɨɜ ɜɨɪɫɢɧɨɤ ɩɪɨɹɜɥɹɥɚ ɬɟɧɞɟɧɰɢɸ ɤ ɭɜɟɥɢɱɟɧɢɸ (27– 32 ɦɤɦ), ɨɞɧɚɤɨ ɢɯ ɫɬɪɭɤɬɭɪɧɵɟ ɢ ɨɤɫɢɮɢɥɶɧɵɟ ɫɜɨɣɫɬɜɚ ɫɭɳɟɫɬɜɟɧɧɨ ɧɟ ɦɟɧɹɥɢɫɶ. ȼɫɟɝɞɚ ɜ ɢɯ ɚɩɢɤɚɥɶɧɨɦ ɨɬɞɟɥɟ ɨɬ6 ɱɺɬɥɢɜɨ ɜɵɹɜɥɹɥɚɫɶ ɤɚɺɦɤɚ. ɇɚɯɨɞɹɳɢɟɫɹ ɜ ɨɛɢɥɢɢ ɦɟɠɞɭ ɤɚɺɦɱɚɬɵɦɢ ɷɩɢɬɟɥɢɨɰɢɬɚɦɢ ɜɨɪɫɢɧɨɤ ɢ ɤɪɢɩɬ ɛɨɤɚɥɨɜɢɞɧɵɟ ɤɥɟɬɤɢ ɩɟɪɟɩɨɥɧɹɥɢɫɶ ɦɭɤɨɢɞɧɵɦ ɫɟɤɪɟɬɨɦ (ɪɢɫ. 10, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). ɇɚ 14-ɟ ɫɭɬɤɢ ɜɨɤɪɭɝ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɨɝɨ ɨɛɬɭɪɚɬɨɪɚ ɢɦɟɥɨ ɦɟɫɬɨ ɪɚɡɜɢɬɢɟ ɦɨɳɧɨɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ, ɩɪɢɜɨɞɹɳɟɟ ɤ ɮɨɪɦɢɪɨɜɚɧɢɸ ɧɟ ɬɨɥɶɤɨ ɮɢɛɪɨɡɧɨɣ ɨɛɨɥɨɱɤɢ, ɧɨ ɢ ɜɵɪɚɠɟɧɧɵɯ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɵɯ ɩɪɨɫɥɨɟɤ, ɜɧɟɞɪɹɸɳɢɯɫɹ ɜɧɭɬɪɶ ɢɦɩɥɚɧɬɚɬɚ ɦɟɠɞɭ ɟɝɨ ɹɱɟɢɫɬɨɜɨɥɨɤɧɢɫɬɵɦɢ ɷɥɟɦɟɧɬɚɦɢ (ɪɢɫ. 11, 12, ɫɦ. ɰɜ. ɜɤɥɚɞɵɲ). ȼ ɷɬɢɯ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɵɯ ɨɛɪɚɡɨɜɚɧɢɹɯ ɨɬɦɟɱɚɥɨɫɶ ɨɛɢɥɢɟ ɭɦɟɪɟɧɧɨ ɪɚɫɲɢɪɟɧɧɵɯ ɝɟɦɨɤɚɩɢɥɥɹɪɨɜ. ȼ ɫɚɦɨɣ ɫɬɟɧɤɟ ɬɨɳɟɣ ɤɢɲɤɢ ɩɪɨɞɨɥɠɚɥɚ ɧɚɛɥɸɞɚɬɶɫɹ ɭɦɟɪɟɧɧɚɹ ɥɢɦɮɨɰɢɬɚɪɧɚɹ ɢɧɮɢɥɶɬɪɚɰɢɹ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɫɥɢɡɢɫɬɨɣ ɨɛɨɥɨɱɤɢ, ɨɫɨɛɟɧɧɨ ɜ ɨɛɥɚɫɬɢ ɜɨɪɫɢɧɨɤ. Ȼɨɥɶɲɨɟ ɤɨɥɢɱɟɫɬɜɨ ɥɢɦɮɨɰɢɬɨɜ ɜɫɬɪɟɱɚɥɨɫɶ ɢ ɫɪɟɞɢ ɷɩɢɬɟɥɢɨɰɢɬɨɜ ɜɨɪɫɢɧɨɤ. ɋɪɟɞɢ ɤɥɟɬɨɱɧɵɯ ɷɥɟɦɟɧɬɨɜ ɪɵɯɥɨɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɫɥɢɡɢɫɬɨɣ, ɢɦɟɥɨɫɶ ɦɧɨɝɨ ɩɥɚɡɦɨɰɢɬɨɜ, ɨɫɨɛɟɧɧɨ ɜ ɨɛɥɚɫɬɢ ɜɨɪɫɢɧɨɤ. ɋɨɞɟɪɠɚɧɢɟ ɦɭɤɨɢɞɧɨɝɨ ɫɟɤɪɟɬɚ ɜ ɛɨɤɚɥɨɜɢɞɧɵɯ ɤɥɟɬɤɚɯ ɤɪɢɩɬ ɢ ɜɨɪɫɢɧɨɤ ɭɦɟɧɶɲɚɥɨɫɶ. ɇɟɡɧɚɱɢɬɟɥɶɧɵɦɢ ɛɵɥɢ ɢ ɰɢɬɨɯɢɦɢɱɟɫɤɢɟ ɢɡɦɟɧɟɧɢɹ (ɬɚɛɥɢɰɚ). Ɍɚɤ, ɭ ɠɢɜɨɬɧɵɯ ɩɪɢ ɢɦɩɥɚɧɬɚɰɢɢ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɨɝɨ ɨɛɬɭɪɚɬɨɪɚ ɧɚ 3 ɢ 7 ɞɧɢ ɨɩɵɬɚ ɜ ɫɪɚɜɧɟɧɢɢ ɫ ɠɢɜɨɬɧɵɦɢ ɝɪɭɩɩɵ ɩɥɚɰɟɛɨ ɧɚɛɥɸɞɚɥɨɫɶ ɫɧɢɠɟɧɢɟ ɜ ɷɧɬɟɪɨɰɢɬɚɯ ɜɨɪɫɢɧɨɤ ɚɤɬɢɜɧɨɫɬɢ ɋȾȽ. ɋɨɨɬɜɟɬɫɬɜɟɧɧɨ ɫɪɨɤɚɦ ɩɨɫɥɟɞɧɹɹ ɫɨɫɬɚɜɥɹɥɚ 13% ɢ 17%, ɢ ɬɨɥɶɤɨ ɧɚ 14 ɫɭɬɤɢ ɧɚɛɥɸɞɚɥɨɫɶ ɜɨɡɜɪɚɳɟɧɢɟ ɟɺ ɤ ɧɨɪɦɟ. ɇɟɫɤɨɥɶɤɨ ɫɧɢɠɟɧɧɨɣ ɧɚ 3 ɫɭɬɤɢ ɨɩɵɬɚ ɛɵɥɚ ɢ ɚɤɬɢɜɧɨɫɬɶ ɅȾȽ. ɇɚ 7 ɢ 14 ɫɭɬɤɢ ɟɺ ɚɤɬɢɜɧɨɫɬɶ ɧɟ ɨɬɥɢɱɚɥɚɫɶ ɨɬ ɬɚɤɨɜɨɣ ɜ ɝɪɭɩɩɟ ɩɥɚɰɟɛɨ. Ⱥɤɬɢɜɧɨɫɬɶ ɜ ɷɩɢɬɟɥɢɨɰɢɬɚɯ ɇȺȾɇÂȾȽ ɛɵɥɚ ɫɧɢɠɟɧɧɨɣ, ɜ ɫɪɚɜɧɟɧɢɢ ɫ ɤɨɧɬɪɨɥɶɧɵɦɢ ɠɢɜɨɬɧɵɦɢ, ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ ɫɪɨɤɚɦ ɢɫɫɥɟɞɨɜɚɧɢɹ ɧɚ 12,3%, 5,3% ɢ 12,7%. Ⱥɧɚɥɨ- ʋ4x 2009 i ɬɨɦ 17 ɉɥɚɰɟɛɨ ɉɌɎɗ ɉɉɍ 3 ɫɭɬ. 7 ɫɭɬ. 14 ɫɭɬ. 3 ɫɭɬ. 7 ɫɭɬ. 14 ɫɭɬ. 3 ɫɭɬ. 7 ɫɭɬ. 14 ɫɭɬ. Ʉɨɧɬɪɨɥɶ 174,00r19,39 165,00r17,56* 194,29r15,25 218,33r7,03 158,00r23,54* 231,43r37,57 230,00r68,68 270,00r20,82 185,00r26,30 200,00r20,82 87,00 82,50 97,1 109,2 79,0 115,7 115,0 135,0 92,5 100,0 75,7 61,1 105,2 94,9 58,5 125,1 100,0 100,0 100,0 – 976,00r29,09 1095,00r36,63 1041,43r24,83 1096,67r24,04 1026,00r20,88 1060,00r18,13 1080,00r68,43 1103,00r35,28 1060,00r21,21 1070,00r40,41 91,2 102,3 97,3 102,5 95,9 99,6 100,9 103,8 99,1 100,0 90,4 99,3 98,3 101,5 93,0 100,0 100,0 100,0 100,0 – 820,00 r 52,91 900,00 r 50,17 855,71 r 62,82 893,33 r 29,40 972,00 r 45,87 895,71 r 27,50 935,00 r 68,86 950,00 r 65,06 980,00 r 39,37 960,00 r 78,10 % ɤ ɤɨɧɬɪɨɥɶɧɵɦ % ɤ ɩɥɚɰɟɛɨ ɍɪɨɜɟɧɶ ɚɤɬɢɜɧɨɫɬɢ ɇȺȾɇÂȾȽ % ɤ ɤɨɧɬɪɨɥɶɧɵɦ % ɤ ɩɥɚɰɟɛɨ ɍɪɨɜɟɧɶ ɚɤɬɢɜɧɨɫɬɢ ɅȾȽ % ɤ ɤɨɧɬɪɨɥɶɧɵɦ % ɤ ɩɥɚɰɟɛɨ ɍɪɨɜɟɧɶ ɚɤɬɢɜɧɨɫɬɢ ɋȾȽ ɋɪɨɤɢ ɢɫɫɥɟɞɨɜɚɧɢɹ Ƚɪɭɩɩɵ ɠɢɜɨɬɧɵɯ Ɍɚɛɥɢɰɚ Ⱥɤɬɢɜɧɨɫɬɶ ɮɟɪɦɟɧɬɨɜ ɰɢɬɨɩɥɚɡɦɵ ɷɧɬɟɪɨɰɢɬɨɜ ɜɨɪɫɢɧɨɤ ɬɨɧɤɨɣ ɤɢɲɤɢ ɩɪɢ ɢɦɩɥɚɧɬɚɰɢɢ ɷɥɚɫɬɢɱɟɫɤɢɯ ɨɛɬɭɪɚɬɨɪɨɜ ɩɨ ɞɚɧɧɵɦ ɰɢɬɨɮɨɬɨɦɟɬɪɢɢ ( ɟɞ. ɨɩɬ. ɩɥ. ° 1000) 85,4 93,8 89,1 93,1 101,3 93,3 97,4 99,0 102,1 100,0 87,7 94,7 87,3 95,5 102,3 91,4 100,0 100,0 100,0 – * – ɫɬɚɬɢɫɬɢɱɟɫɤɢ ɞɨɫɬɨɜɟɪɧɵɟ ɪɚɡɥɢɱɢɹ ɫ ɠɢɜɨɬɧɵɦɢ ɝɪɭɩɩɵ ɩɥɚɰɟɛɨ ɩɪɢ ɪ 0,05 ɝɢɱɧɚɹ ɡɚɤɨɧɨɦɟɪɧɨɫɬɶ ɩɪɨɫɥɟɠɢɜɚɥɚɫɶ ɭ ɠɢɜɨɬɧɵɯ ɝɪɭɩɩɵ ɩɥɚɰɟɛɨ ɩɨ ɫɪɚɜɧɟɧɢɸ ɫ ɤɨɧɬɪɨɥɟɦ. ɉɪɢ ɢɦɩɥɚɧɬɚɰɢɢ ɨɛɬɭɪɚɬɨɪɚ ɢɡ ɮɬɨɪɨɩɥɚɫɬɚ ɢɡɦɟɧɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɮɟɪɦɟɧɬɨɜ ɜ ɷɧɬɟɪɨɰɢɬɚɯ ɜ ɫɪɚɜɧɟɧɢɢ ɫ ɠɢɜɨɬɧɵɦɢ ɝɪɭɩɩɵ ɩɥɚɰɟɛɨ ɬɚɤɠɟ ɛɵɥɢ ɧɟ ɫɭɳɟɫɬɜɟɧɧɵɦɢ. ɍɦɟɧɶɲɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɋȾȽ ɧɚ 3 ɢ 7 ɫɭɬɤɢ ɫɨɫɬɚɜɢɥɨ 24,3% ɢ 38,9%. Ⱥɤɬɢɜɧɨɫɬɶ ɠɟ ɅȾȽ ɛɵɥɚ ɦɟɧɶɲɟɣ ɥɢɲɶ ɧɚ 7 ɞɟɧɶ, ɚ ɧɚ 3 ɢ 14 ɫɭɬɤɢ ɩɪɚɤɬɢɱɟɫɤɢ ɧɟ ɨɬɥɢɱɚɥɚɫɶ ɨɬ ɤɨɧɬɪɨɥɶɧɵɯ ɩɨɤɚɡɚɬɟɥɟɣ. Ⱦɥɹ ɇȺȾɇÂȾȽ ɫɧɢɠɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɧɚ 3 ɢ 14 ɞɧɢ ɩɨɫɥɟ ɩɪɢɦɟɧɟɧɢɹ ɨɛɬɭɪɚɬɨɪɚ ɫɨɫɬɚɜɢɥɨ 4,5% ɢ 8,6%. ɗɬɚ ɡɚɤɨɧɨɦɟɪɧɨɫɬɶ ɫɨɯɪɚɧɹɥɚɫɶ ɢ ɜ ɫɪɚɜɧɟɧɢɢ ɫ ɠɢɜɨɬɧɵɦɢ ɝɪɭɩɩɵ ɩɥɚɰɟɛɨ. ȼɵɜɨɞɵ 1. ɗɥɚɫɬɢɱɟɫɤɢɟ ɨɛɬɭɪɚɬɨɪɵ ɢɡ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ ɢ ɮɬɨɪɨɩɥɚɫɬɚ ɩɪɢ ɤɨɧɬɚɤɬɟ ɫ ɬɤɚɧɹɦɢ ɬɨɧɤɨɣ ɤɢɲɤɨɣ ɜ ɬɟɱɟɧɢɟ 14 ɫɭɬɨɤ, ɩɨ ɞɚɧɧɵɦ ɝɢɫɬɨɯɢɦɢɱɟɫɤɢɯ ɢɫɫɥɟɞɨɜɚɧɢɣ, ɧɟ ɜɵɡɵɜɚɸɬ ɜ ɧɢɯ ɜɵɪɚɠɟɧɧɵɯ ɢɡɦɟɧɟɧɢɣ. 2. ɇɚ 7 ɫɭɬɤɢ ɢɫɫɥɟɞɨɜɚɧɢɹ ɨɬɦɟɱɚɟɬɫɹ ɩɪɨɪɚɫɬɚɧɢɟ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɜ ɹɱɟɣɤɢ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɚ. ɇɚ 14-ɟ ɫɭɬɤɢ ɜɨɤɪɭɝ ɩɟɧɨɩɨɥɢɭɪɟɬɚɧɨɜɨɝɨ ɨɛɬɭɪɚɬɨɪɚ ɢɦɟɟɬ ɦɟɫɬɨ ɪɚɡɜɢɬɢɟ ɦɨɳɧɨɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ, ɩɪɢɜɨɞɹɳɟɟ ɤ ɮɨɪɦɢɪɨɜɚɧɢɸ ɧɟ ɬɨɥɶɤɨ ɮɢɛɪɨɡɧɨɣ ɨɛɨɥɨɱɤɢ, ɧɨ ɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɵɯ ɩɪɨɫɥɨɟɤ, ɜɧɟɞɪɹɸɳɢɯɫɹ ɜɧɭɬɪɶ ɢɦɩɥɚɧɬɚɬɚ ɦɟɠɞɭ ɟɝɨ ɹɱɟɢɫɬɨɜɨɥɨɤɧɢɫɬɵɦɢ ɷɥɟɦɟɧɬɚɦɢ. ɉɪɨɪɚɫɬɚɧɢɟ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɜ ɨɛɬɭɪɚɬɨɪ ɢɡ ɮɬɨɪɨɩɥɚɫɬɚ ɧɟ ɧɚɛɥɸɞɚɟɬɫɹ. 3. ɍɫɬɚɧɨɜɥɟɧɧɵɟ ɨɬɤɥɨɧɟɧɢɹ ɚɤɬɢɜɧɨɫɬɢ ɮɟɪɦɟɧɬɨɜ ɜ ɷɩɢɬɟɥɢɨɰɢɬɚɯ ɜɨɪɫɢɧɨɤ ɩɪɢ ɤɨɧɬɚɤɬɟ ɨɛɬɭɪɚɬɨɪɚ ɫɨ ɫɬɟɧɤɨɣ ɤɢɲɤɢ ɧɟ ɫɭɳɟɫɬɜɟɧɧɵ ɢ ɧɟ ɦɨɝɭɬ ɩɨɜɥɢɹɬɶ ɧɚ ɢɯ ɮɭɧɤɰɢɨɧɢɪɨɜɚɧɢɟ. 7 ɇɨɜɨɫɬɢ ɯɢɪɭɪɝɢɢ ɅɂɌȿɊȺɌɍɊȺ 1. ɗɬɚɩɧɨɟ ɥɟɱɟɧɢɟ ɛɨɥɶɧɵɯ ɫ ɧɚɪɭɠɧɵɦɢ ɬɨɧɤɨɤɢɲɟɱɧɵɦɢ ɫɜɢɳɚɦɢ / ɋ. Ⱥ. ȼɨɪɨɛɶɟɜ [ɢ ɞɪ.] // ȼɟɫɬɧɢɤ ɯɢɪɭɪɝɢɢ ɢɦ. ɂ. ɂ. Ƚɪɟɤɨɜɚ. – 2008. – ʋ 6. – ɋ. 114-118. 2. A novel approach to the problem of intestinal fistulization arising in patients managed with open peritoneal cavities / S. Girard [et al.] // Am. J. Surg. – 2002. – Vol. 184, N 2. – P. 166-167. 3. Improving outcome in patient of high output small bowel fistula / N. Kaur [et al.] // Trop. Gastroenterol. – 2004. – Vol. 25, N 2. – P. 92-95. 4. ȼɥɢɹɧɢɟ ɷɥɚɫɬɢɱɟɫɤɢɯ ɨɛɬɭɪɚɬɨɪɨɜ ɢɡ ɤɨɦɩɨɡɢɬɧɨɝɨ ɦɚɬɟɪɢɚɥɚ ɧɚ ɫɨɞɟɪɠɚɧɢɟ ɫɜɨɛɨɞɧɵɯ ɚɦɢɧɨɤɢɫɥɨɬ ɩɥɚɡɦɵ ɤɪɨɜɢ ɢ ɩɟɱɟɧɢ ɩɪɢ ɢɦɩɥɚɧɬɚɰɢɢ ɢɯ ɜ ɨɪɝɚɧɢɡɦ ɠɢɜɨɬɧɨɝɨ / ȼ. Ɇ. ɒɟɣɛɚɤ [ɢ ɞɪ.] // ɀɭɪɧɚɥ Ƚɪɨɞɧ. ɝɨɫ. ɦɟɞ. ɭɧɬɚ. – 2009. – ʋ 2. – ɋ. 151155. 5. ȼɨɥɤɨɜɚ, Ɉ. ȼ. Ɉɫɧɨɜɵ ɝɢɫɬɨɥɨɝɢɢ ɫ ɝɢɫɬɨɥɨɝɢɱɟɫɤɨɣ ɬɟɯɧɢɤɨɣ / Ɉ. ȼ. ȼɨɥɤɨɜɚ, ɘ. Ʉ. ȿɥɟɰɤɢɣ. – Ɇ.: ɇɚɭɤɚ, 1982. – 304 ɫ. 6. Ʉɨɜɚɥɶɫɤɢɣ, Ƚ. Ȼ. Ʉɨɥɢɱɟɫɬɜɟɧɧɚɹ ɝɢɫɬɨɯɢɦɢɹ ɞɟɝɢɞɪɨɝɟɧɚɡ // ȼɜɟɞɟɧɢɟ ɜ ɤɨɥɢɱɟɫɬɜɟɧɧɭɸ ɝɢɫɬɨɯɢɦɢɸ ɮɟɪɦɟɧɬɨɜ / Ƚ. Ȼ. Ʉɨɜɚɥɶɫɤɢɣ, Ɍ. ȼ. ɀɭɪɚɜɥɟɜɚ, Ɋ. Ⱥ. ɉɪɨɱɭɯɚɧɨɜɚ; ɩɨɞ ɪɟɞ. Ɍ. ȼ. ɀɭɪɚɜɥɟɜɨɣ, Ɋ. Ⱥ. ɉɪɨɱɭɯɚɧɨɜɨɣ. – Ɇ.: Ɇɟɞɢɰɢɧɚ, 1978. – 58 ɫ. 7. Ɏɨɝɟɥɶ, Ɏ. Ƚɟɧɟɬɢɤɚ ɱɟɥɨɜɟɤɚ / Ɏ. Ɏɨɝɟɥɶ, Ⱥ. Ɇɨɬɭɥɶɫɤɢɣ. – Ɇ.: Ɇɢɪ, 1990. – Ɍ. 2. – 378 ɫ. 8. Ʌɨɣɞɚ, Ɂ. Ƚɢɫɬɨɯɢɦɢɹ ɮɟɪɦɟɧɬɨɜ. Ʌɚɛɨɪɚɬɨɪɧɵɟ ɦɟɬɨɞɵ / Ɂ. Ʌɨɣɞɚ, Ɋ. Ƚɨɫɫɪɚɭ, Ɍ. ɒɢɛɥɟɪ. – Ɇ.: Ɇɢɪ, 1982. – 272 ɫ. 9. ɉɢɪɫ, ɗ. Ƚɢɫɬɨɯɢɦɢɹ ɬɟɨɪɟɬɢɱɟɫɤɚɹ ɢ ɩɪɢɤɥɚɞɧɚɹ / ɗ. ɉɢɪɫ. – Ɇ.: ɂɅ, 1962. – 961 ɫ. `д!е“ дл *%!!е“C%…де…ц,, 231371, pе“C3Kл,*= aел=!3“ь, г. c!%д…%, м,*!%!=L%… a=!=…%",ч,-1, Cе!. oе“%ч…/L, д. 9; 2ел. м%K.: +375 29 781-00-78, e-mail: [email protected], qм%2!,… h.q. ɉɨɫɬɭɩɢɥɚ 15.07.2009 ɝ. ɑɂɌȺɃɌȿ ȼ ɋɅȿȾɍɘɓȿɆ ɇɈɆȿɊȿ: ɆȻ. Ɇɢɪɫɤɢɣ ɋɵɧ ɛɟɥɨɪɭɫɫɤɨɣ ɡɟɦɥɢ. ɏɢɪɭɪɝ ɢ ɷɤɫɩɟɪɢɦɟɧɬɚɬɨɪ – ȿɜɫɬɚɮɢɣ Ȼɨɝɞɚɧɨɜɫɤɢɣ ȼɇ. ɒɢɥɟɧɨɤ ɫ ɫɨɚɜɬ. ɉɪɨɛɥɟɦɵ ɯɢɪɭɪɝɢɱɟɫɤɨɝɨ ɥɟɱɟɧɢɹ ɭɡɥɨɜɵɯ ɨɛɪɚɡɨɜɚɧɢɣ ɳɢɬɨɜɢɞɧɨɣ ɠɟɥɟɡɵ 8