Tp Gopi noGosoi kinbkocti cei — nepute ypanimine ceyosunyckaHHs npososutTsca B yniras, notim nporarom s06H (Hanpukaan, 3 9.00 parky 20 9,00 patky nactynHoro HA) nposoaurses 3Gip scici 20G0B0! KinbKocti cexi 8 onMH sncTuii nocya. B mpoueci sGopy sca ceva mosHHHa 3Gepiratica 6B XOJORIAbHMKY pH Temnepatypi +4°C, n0 48°C, Tlicas HMeHHA 00H BCA 3iGpaHa cea perembHo nepeiulyerscs, B uucTHi nocya i aciel aoGosoi Kimkocti sianisca GnusbKo 50 ma, ykasyerbca saranbiuii oG'em cesi 3a a06y i Marepian ocTapnacrsca ® s1a6opaTopito Tlepen nowatkom 36opy qoGonoi ceui gna gocaigenusa wa 3Mict agpenasiny i Hopaapenasiny 6 nocys aonaersea 10 Ma 25% posunHy cosaHo! KiesIOTH 36ip ceai aan aocainat i ini Joa mponenenna aocaisxens neoGxinuo orpumatn 8 meamaHomy ofpici aaGoparopii nopowiok-Koucepsanr (TuMon) i KoHTeliNep ana cevi. Tlepea mianosum sGopom cevi ana BH3HAWeHHA KaTexonaMinis npotarom 3-x jHiB He MOsxkHa 3acTOcoByBaTH npenapaTu, payBosmpit0, wo wictars, Teodinin, uitporninepun, Koeln, eranon. SKMO MoxkNBO, He npuiimarn inuti saikapcbki 3ac0Ou, a TakOx XapyoBi NpoAYKTH, mo MicTATe cepoTOHiH (woxonaa, cupi i imum = Mosouni npoayKrH, Ganann), He BoKHBATH ankoromb, YanKari Gismwnoro Havanraxenns, crpecis, xypinua, Goasosux aii, aKi BUKnUKaIOTD ¢bisionorisunit nigiioM KaTexomaMinis, Basqanerias Ha qHO uucTO! eMKocTi, B aky S6upaTHMeTsca ces, BICHMaOTS KOHCepBAHT Nopoulok 3 OTpHMAHO! B xaGopaTopii MpoGipKH. CropoxHaoTs cevoBHii mixyp (Iu Moputi1o BHANBAIOTE), 3acikaloTs Yac i 36upawOTb ce4y B EMHICTh 3 KOHCepBAHTOM piBHO NpoTaroM AOGH, OcTaHHE CedoBUNyckaHHA B cyAMHYy Mae GyTH 4epes 24 roAHHH Bia 3aci¥eHoro 4acy (Hanpuknast, 3 8.00 paniky 10 8.00 paky HactynHoro aKa). Moxsnentii 3Gip cevi sa 12, 6, 3 Toki aGo pazoxa nloputis, Kpaule B AeHHUTI ac B xinni nepioay sGopy amipari saransinii oG'em cesi, simaisenoi 3a noGy, nepemimarn ii, siaMHTH YacrHHy B cneuianbHo BHAaHHt KONTeliNep i Biapasy MpHHeCTH Ha aocaisKeHHA Tipu saa4i marepiaay cig oGon's3KoB0 BinMith 4ac 36uparia i 3arambuuii oG'em ceui, 36ip cesi aus AocainxeHHa HaaBHOCTI NCHXOAKTHBHHX pe1oBHHt 1. ¥ Meamutomy odici orpumaete Koxtelinep CKK (crepumbuuit KoHTeliHep 3 KPHUIKOIO, 30 ma), 2. Ceva mac Gyrm siGpana 8 uuctuii, ne suKopucrannit paniue Kowreiinep. Jomiurxn rinOxsOpHTy, MMFONHX 3acOOiB i iHIIHX PeYOBHH MOxKYTb crloTBOpIOBATH pesy.TaT 3.Heraiino nicna sGopy, ceva ac Gyr noimena B KoHTeliHep 3 mnisibHO10 Kpuurkoro (CKK), mo sano6irac sunaposysanmo i oKucnenmo. Konreiinep aaa 36opy ceui cain sanoBHiTH nOBHicTIO Ana SanoGiraHHA BHMApOBYBAHHIO ni KPHIIKOW. Jloctasntn KoxteiiHep 8 aaGoparopi mpotarom gus. AKWO Hemae MoxsHBOCTi Biapasy AOcTaBHTH ce4y, TO KoHTeliMep 3 ce4ero cin sGepirarH B XosOAMAMBHNKY MpH +2°C no +8°C (He Ginbure 36 roan) Tipu 3G0pi zoGosoi cexi Ha ousnavens xinsKocri Koprusomy B cyzmHy ana sGopy aonaerbea 10 rpam Gopioi KucstorH. Jlocaiaxenns yporenrasbuoro Marepiany (cocbkoOu, Mazanns, BiAGHTKU) Tlicas nonepenupoi nigrorosku xBoporo (aupica po3nia 1.), muTHnit pexum sensaiinnit. 1. ¥ nepeGiry 3 216 BukmounTH BxKHBAHKA anKOromo i craTeBe XKUTTA, YHHKATH MicueBOrO gactocynania anTucertukia i axTiGioruKin — 2 TwKHi 2. ¥ nepeGiry 3 roaun yrpumaries sia cesosunycKanus. 3. B ne 3naui anasisy He nposoguTH TyaneT 30BHiMHix ceyocTaTeBHX opratis. 9.2, 3araabni BaacrHBocTi ce Anamis cesi nonsrac y pupyenni saranbnx ii Baactupocteli, a Takoxk mponegenni ximisnoro i wixpockonisoro ocaimKent TIpaxriiHo 3x0posi gopocai moan mporarom 206H BugisuoTe 3 cevew Bin 0,6 go 2,0 1 pinwnn. TIpH usomy seHHHit oG'em cesi, Wo BHBOANTECA, cknaae sasBHualt 1s, HiuiNit—0,5 J. pH KOTHBAHHI BILHOCHO! WiMbHOCTI Bia 1,003 gO 1,028. 95CraH, mpi skomy s0SoBuii oem (aiypes) ceui nepesmumye 2 9, imeHyerbes nauypicro. Haronouyersca mpi pacHomy mrrti, uykpopomy i HeuyxpoBomy ziaGeti, y xBopiX Heppocksepos0M, pi inumix saxnopronanniax HMpox (xponiumnii romepynouedpur, —xpouismuii nienonedpirr, Xponiutia Hupkopa HeocranHicrs, XHH), nyxsMHax HUPOK, TPABMAX, MOLIKOIDKCHHSX HeHTpATbHOi Hepaopo! cucTeMH, nyxiuni Mosky, aneHoni rinogi Tipu suainenni 3a n06y Mere S00 mam cesi KoncraTyioTb onizypino. Onirypia ninposainscreca Ha —ipepetianbry, —peHabHyI0, nocrpeHanbHyt, ane Moke GyTH OOyMOBeHa ONHOYACHO jeKisIbKOMA npHMTHaMH. Tipepenarony oxizypiio suxsikae wexocraTwicts KposoHanosHenlia HipoK. Cnocrepiracrbea Mp rinososemii, BHKAHKAHiM: 3MeHUIeHHAM Od'eMy UMPKysOIOUO! Kposi, HaLiHKI TOHYCy cysHH (kposoreva, rinosonemia), nigsimenni mponmuocti Kaninapin, cepuenifi nenocraruoeri Gmenwenns issrpauii cevi yHacaitok ynoBisbHeHKA KPOBOTOKY), CTeHOs! HHPKOBHX — cya Heippockaeposi Gyab-AKoi etionori Hupxoea oxizypia oSymonaena nopyueuna dinvrpauii cei yracaigox sananbinx amino kulyGoukax HUpoK. CynpoBomwkye ToMepyoHeDpiTH, BHKIUKAHI aHTHTiaMH sO roMepyuspHOi MeMOpaH, UNpKyOIOUIMN iMyHHMMH KOMMeKcaMH — inionarianiit raomepysoHedpiT, uo iBi1Ko mporpecye mp sipycunx, Gaxrepitinuns indbexuiax Jlo onirypii npusonsrs ty6yaoiHrepcriunaabHuit HeKpos, rocrpuii ixrepcrHuianbunit Hedpur Tlocrpetassia oxirypia mos'saHa 3 oGtypauicio MoueBiuesitembHol cHcTeMH KaMeHeM, KPOB'AHHIM 3ryCTKOM, MYXAHHONO. Tlosie npuninenta praiscenta cesi Hasnpactbca anypici (disionoriuna y HOBoHApONDKEHHX Mpotarom mepuioro roauHHHKka x«uTTA). Croctepiracreca Mp BaxKKOMY ypakeHHi HUpOK, roctpiii HuIpKosili HeocrarHocti, mporpecyrovomy nepuToniti, orpyeHHax. To x Moxe BinGysarHea pH GAKYNOPUi CeHOBHBIAHHX LIAXiB KAMeHEM aSo NyXsIIHOK, BUSBAETbCA Y XBOPUX 3. B@KKHMIL — AereHeparuBiiiM ypakeHHAMM HNpOK, pH MOpasKax sanuBo! vacrKi rinopisa 3a paxyHoK nociutenol cexpeuii sasonpecuny. Pedbexropa auypia ciocrepiracrsea mpi aeaKiKX rocrpHx xipypriaimx crawax 8 nopoxnuni MatoroTasy i akiBora, OOUMPHIX TpaBMax ckemeTHIX M's3iB, Buin oGemy (i ckmaay) cesi Mowyrb sinGysaruca Takox nin anaNBoM mepeoxonosZxeHHA, diswannx i neuxivHHX nepeHanpy:KeH — yHacninox yHKUIOHANHUX 3MiH, mOB'S3AHUX 13 abismbUIeHHAM MpoHHKHOCTI HUPKOBOrO dimsrpy aGo ynoBismHeHHAM MoTOKY KpoBi B KxYGOUKAX HMIpoK, TloSosnii aiypes npuiinsro ninposninsrn Ha neHniii i Hivnili, BinHOMeHHA Mix HUM 3 — 4: 1 3Ginsuentis isuoroaiypesy — mixmypis. Cnocrepiracrsca pi rineprpopii _mpocraru, Heuyxponomy i uyxposomy aiaGeri, BaKKx ypaxennn HNpOK (MOK GyTHE PaHIHDOIO OsHAKOKO possutky XHH), np mopyuienni dyskuii cepueso-cyrnHHoi cricreMm, BHpaskoBifi xBopoti yay i I2-nanoi Kuk, Tloxaakiypia — vacte cesosunyckaniis. Morse cnocrepirarniea np npuiioni: senior Kisbkocri piAHHH, criasMi aGo 3anaJeHHi CevOBHBIAHHX ULIAXiB, CeVOBOrO Mixypa, TyGepKysIbO3i_HIIPOK. Ontaxuypia — pinxicne cevonunyexanna, cnocrepiracrsea np OOMexenni moro pexuMy i HepsHopedslekTopHiix rlopyurenna. uzypia — posnaa cesoaiirtyckasiia, cuMmroM Gararsox 3axBopioBalib cevocraresol cuCTeMI, aycrpisaersca = mp ceoxiicsomy —inbaperi —-Monowapomxeumn, yperpirax, uMCTHTaX, uuctoniesirax, cxsieposi uiiki ce¥oBoro Mixypa, SfaBsIeHHI CeMOBIINYCKANIBHOTO KaHa.Ty Hempunanna —cexi (enuresis) nos'saue 3 nopymentiam cipistkrepin cevozoro mixypa, BIABAACTACH CeYOBHTYcKANHAM Ges NOSHBY. Tua oink snaTHocti HMpoK posBoguTH i KOHUeHTpyBATH ceuy B YMOBaX CraHsaprHOro. MurrHoro pexuMy Mpit seaiiniii pyxouifi axTusHocti sacrocosyersca npoba 3inuinKozo. Boua AOSBONAE —BUSHAYATH KONHBAHHZ siaHOCHO! ujinbHOCTI i KimbKocTi cevi MporaroM 06H Koanpantia —kimbkocti cei B OKpeMHX 3 8-Mu ii mopuiii (ysaTHX 4epes neBHi inTeppaNH Hacy mporarom 06H) Moxe GyrH Biz 50 20.400 ma aianazoH BiAHOCHO! uimbHOCTi Mae GytH Big 1,003 20 1,028. Yum Ginbwwe pisHi Mirk MAKCHMATBHIM i MIKIMAIBHHM SHAMeHHAM BiJIHOCHO: ujabHocti, THM Bie dyHKuioHaNbHa szaTHicrs HUPOK. Y HopMi BoHa Mac Gyr He MeHLNe 960,007. Ta npo6a syranpinia 0 BuBrenHa naTonorii Kavanbuie, wim naronorii KayGouKie. TIpH nopywenni bynxuionamHoro crany HMpoK Moxe Gyrit osirypis, noanypis, anypis, sGinbueHH niunoro aiypesy, sHirkeHHs amuity;H KomMBaHb BiXHOCHO utinbHOCTI B NlopuisX ceui, Ake Moxe BHABISTHCA = 3HIDKEHHSM = MAKHCMAJIbHOIi BiJHOCHOI IbHOCTi, a TakKOXK BHIeHHAM ce4i 3 signocuoi uinpnicrio pistioi 1,010, To6ro Komn Hepon nepecraiorb KoHUeHTpysaTH ceyy. TIpoGa 3imiikoro NOsBOAAE —BIIABARTH 3axBOpIOBAHHA HHPOK Ha paHHix cramisx ix opmyzauiia, akUIO BOHN cynpoRoAATEcA MopasKoIO KaHabuia, i Me noTiM — Ti ix dopo, aki XapaKrepiayioTbes NOpAsKOKO KanyGouKiD, Konip cesi CONOM'IHO-KOBTHIL —Y MpakTHYHO 3H0poBHX sOAeM, BarexKUTe Bin 3MicTy nirmertin: ypoxpomy A i B, ypotisiny, ypoepirpina, remaronopcbipmuy. Ha xonip cesi snmae signocua “uimbiicrs: pit BucoKiMt uiinbHocri ceva Mae Ginbur HacHHeHuit xKoBTuMt Koxip, pH nupeKili — Moxe GyTH Maite Ges6apsHor0, BaGapanenia cei Moxke awinionaTuica B epponynaty (aia nomen p uili remoraodiny), 9 KopHuHeBy — i338 nepexomy B Ce4y 2KOBYHMX NiTMeHTIB (UIA KpaMLOrO IX BHABHA jOCHTS a6oerarH nopuito cei: :KosTa nia AkwKe Ha HasBHicTh B NocaiKyRAHOMy 3pazky 2%OBUHIX nirmenia). Cea moxe Gyr ceitmo1o, cna6o sa6apanenow — Haiivactinme np noamypil yracninok posGanneHHa nponyktis OOMiny, uO MictaTbea B Hill, y BenMKOMy oG'eMi pin iszionoriuna —rinoxpomia cnocrepiraersca np nomnypii, nocuieHomy murHomy pexuni, npuiiomi nponyxtin xapsynanis, mo wanaiors cevorinmuii eext. Cex Grignx siatinin aGo GesGappria —sycrpivacrsca =—y_-—=«XBOpIX ~—iaGeTOM, —nienoHedpprrTom, —_xportisitim rslomepys10HeppHToM, mp XHH. Y HosonapowKenmx ceva GesSapena, moti BoHa crac sHTapHO- KOpHUHeBOW 3a paxyHoK GisipyGinypil; ceva rpymHux aireli sapacIM cpitaime, HK y Opocax sIxmo ceva mac Kosip ixi aGo sixis, To ue nepeaGaac naspnicrs nopyuien uipok, ToGTO TaKy sosiHy noTpIGHO peremHo oGererKiTi Tunepxponia ¢isioaoriwa moxe Gyr np oOMexeuni mutta, nociexomy noroauaizenti Tunepxpomia cntoctepiracreca put onirypii 2a paxysox copmysania HaGpaxin, tpancysatie i excyyavis, npn 3acriiiniii nupui. Piska runepxpomia HaroslOUlyerbea TPH reMOMIITHIHEX craHax. Teamuii, maibxe uopruit Konip piHayereca nps rocrpifi remoniriuniii nupui 3a paxyHox remorsodinypil, pu amkarrronypil — ynacsigox ewicry Bill romorenrisiniopoi xucaoru (y nauierris wiei rpymu BincyrHili cepmert romoreHTisinoKcrutasa), MPH MesaHOCApKOMe 3a paxyHOK Menaniny, Uepoonnii Komp cesi moxe GyrH oSyMosrenni aominuKor eswintenoi Kposi, xpon'st nirmenrip, aenkux aixin (remarypia, remoraobittypia, nlopeipia). 3enenoro Kombopy cea HaGysae np npuiiomi meruaeHoRoi cuni, mpi Mexaniunux KOBTAHIILAK —~ 3a paxyHOK Gisinepanny. Monouno-Sinni—piatinoK ceui_—oSymosseHnit —HasBHicrio Kpaneab -xUpy, rHoiTb abo neopranisnioro doctopy. Moxosno-Sianii xonip cesi moxe Gyr mpm 2xNposomy nepepoxxer HupKH, simocrasi, Hedpotisiom cunapomi, a rakox ruilinifi cevi, npu docdarypii Geskosboposa ceva nepenGaviae Haseuicre aiaGery a6o npifiom nesiKoi Kimsxocti pizist Bninwoskonra ceva nepenGavac naspnicts nedpockseposy TemHoxosra ceva nepenGauac HasBHicre HenocrarHocTi KpoBoosiry. Koaip cesi — ’a3oni nomi — nepenGavac Hasaicts raomepysouedpity, Hacaiakn nepposiriasy, yuroxxenna nipgu, orpyenmti ouerom, Ciposaromonouniii Komip cei nepenGayae HasBHicTs dbocdatypii Kipnisuo-tepnouiii Konip nepenGaiac naxeuicre ypatypii, oxcasarypil Koaip cevi - ax craporo, Temoro mia nepenGaae Haspuicrs indexuiiinoro renarstry. Poxkeso-iepaoniii Konip cevi neperGaac HasBiicTh oTpycHiia eonamm aGo 3u0RxKiBaHHA aixami (aHanbrix, amigonipin). Uopua, Gapwana ceva nepenGavae HasBHicTh nyxsinHoro mpouecy y HipKax, aGo paxKKe onpyeHis ¢benosasu. 8 pesoninti 97Hposopicms. Hopwansia ceva nposopa i smuie npit crosHikiyrBopioerbea Myth 3a paxyHOK raikosaMinorsixaros, TIposopicrs ceui Moxe GytH noBHOIO i HenloBHOIO, PospiskimoT ceyy mposopy, c1aGo Kanamyriy, pisko Kasamyrny. Tomyrinnia cesi nos'asane 3 suainennam coneii, cams, smictom —BesuKoi —kibKOCTI —opMeHIX —enemenTiB, Gakrepiti, “Ay. Karamytiicrs Moke Gynt ca1aGko10, nomipHoio i auparkexow. Peaxuia cewi. Cea nosogie ueiitpansuoio, Knicno10 aGo cao ay2xHo10 peau. Axrupia peakuis (pH) cisi ckaatae 8 HopMi 5,0-7,0en, Peaxuia cexi sanexurs nin xapaxrepy KUBNEHHS, TuNTHOTO pexUMy i B HopMi y Aopocmoi suomi i aireli crapmioro BiKy cslaG0 kite, CaaGonyxta ceva Moke GyTH NpH BKUBAHKI MOnONHO-PocmHAG! ii, Kiem — y snoGuTeniB MsicHHX npoxyktip. Y HovoHapowKeHIX ceva Kucsa (pH noHKeHNi 20 5,9). y negonourenm pisko xucma (pH 4,8~5.4), mpm rpyavomy suromosysanni pH cist cxnanae 78, npu urrysniomy — sia 5.4 20 6.9. Tipu oxpemux chopmax marosorii ceva HaGyeae ay:xHol peaxuil (xponissx yperprrrax, uucrirax) — 3a paxyHOK Gaxrepifiioro aMiasnoro Gpositma, To a cnocrepiractsca mpi POScMOKTyBAHHi HAGpsKiB, TpaHcysaris, ekcysaris, GuOBOTI, ¥aCTHX NPOMMBAHHAX ULIYHKY, y XBOPIX BHASKOROK xBopOoI ulmyHKy i 12-nanoi KMKH — isa mpuiomy nauicrrraxs anrToutit0s, Coan, Minepanbinr son. JIyaxnili Xapakrep cei susHavacroca mpi niesonedpirrax, BHKINKAHHX BYZBTApHHM —MpoTeeM, Tip sikysaHKi —cevOriHHUMM sacoSaMn, GnoKyIOuNNMHL xapSoanriapasy (eyrimuay aurutpasy), nepailaHomy asibocrepowizMe, y XBOpHX cHHIpOMOM Iuenko-Kyummra, pecniparopromy ankanosi, np Hexommencosattit srpari Kasi. Janax. Ceirkosnmyutena ceva aGo He Mae sanaxy, aG0 sosonie Hepiskum creumpisHnM ganaxom sig npucyrHocti & Hili Hepenukoi xKimbKOCTI 2KUPHIEX KHCAOT, seTIOMIX peyoBIIH inoi, cnixka cikuM Mae AX — seneHoro Bosocekoro ropixy. Ha xapaktep sanaxy snmusae a, HANDHKIAL, BANBAHHA HACHUKy, XpiHy, KaBiL. [Ip TpHBaIOMy crosHHi S'aBNIeTBCA Galax aviaky, akuii BHABNACTACA TaKOK MpH unCTHTax, nieniti, nienonedprrax. TIpu siaGermHomy auNOsi S'ABAETECA samax rHILIHX sGayk (38 paXyHOK KeTOHOBIX Tia), TaKOxk, HasBHicr Bi cei ayxy auetony nepenGaac KoMy 4H mpeKomarosHili cran BHacaizoK uyxpoBoro aiaGeTy. Jixwo 8 cei BuaBaReTEcA i KUMIKOBA NaAH4Ka, TO BHHMKAE 3anax KUCAOTO GyzBiiony; 3anax TYXOFO Misica S'aBuLXETbCA pH postal KPOBI, rHusTTi GizKa. Sxujo ceva Mae 3anax ixi aGo sikis, TO ye Mependayac HasBHicTs nopyuleHHA pesonini nipox, ToGro Taky moginy norpiGHo peremuo oGcrexiti Hfitenicms ceui npaxrisiio sn0poBux jopocnnx soneli 3a361vaii papitoerses (nporsrom 10611) » wexax 1,012 — 1,020 rpawa, Hirsuka utiniicrs criocrepiracrica y crpaxmaiownnx xpouisinn ZANIQSIBHMIMIL SAXBOPIOBAHHAMH HUPOK, BHICOKA — y XBOPHX UIyKPoBHIM giaGeTOM (ue Gararo B HOMy o6yMonzeHo BMicToM 8 Hii rmoKo3H), Tinenmenta uimHocti cesi MaibKe samxnH nos'sane i3 aMeHUIeHHAM soG0BOrO aiypesy, i BiaHOcHa uinbiicTs cesi sanexurrs sin KimbKOcTI poses uiimbeHs pesopunt 6 1 stirpi ces Tinocmenypia — swicxents BiHOCHO: ulinbHocTi cevi — BHHUKAe yHAcHiOK YacrkoBOL BrparH anarnocti HMpok —KoHuerTpysaTH ceuy. Bustiavacrsea mpi nocimenomy murHomy peskumi, npuiioni cevorinuux npenaparin; piske suinseria Biauocoi utimuocri cei cnocrepiracrses pit Heuyxposomy aiaGeri (1,001 ~ 1,004), noctifiio missKa aigHocHa utinbiicrs (1,004 — 1,013) BUSIBAACTECA IPH XPOHINHIX —3aXBOpIORAHHAX —HMPOK, —_XpoHlisiii_-HMpKOBiTt HenocraTHOCTi, amisoinosi, aiaGeruuHoMy roMepysiocpkstepose, nosikHeTo3e, roctpili HUPKOBIii —HenocrarHocri (THE) Tinepemenypiat — viasinnenna sianocuoi uinuocri cesi — moxe Gyr mpi cyxoeaenti siuxoMaHui, PscHOMy mloTiHKi, np excrpaperianbioli prpati pinunu, uykposomy iaGeri, nedpotisiom cumapomi, (popmysanni HaGpaxin, rpaucyaarin i excyaatip. Tpnsane suaisenia cevi 3 sigvocnow utiabnico pisnoi sianocHoi ujinsHocri nepsummoi cesi (1,010) Hasnpactica isxoemenypin. Iaoctenypia cocrepiractsea y BIMANKAX BaXKKOTO. YpAaxKeHA HupOK np xposiuuix raomepyzonedpirax i Heppockteposi, € NoraHoI mporHocTH4HOIO OsHaKOIO, UO CBIUHTS pO BIPATy KOHLeHTpanifinNX sniGHocTe!t Tuno- i isocmenypin — MoHOTOHHO HUBbKA NpOTATOM AOGH BiNHOCHA u limbHICTS ceui, 98BISHANAETHCA MPH XPOHIHUX 3aXBOpIOBAHHAX HUIPOK. Binox @ ceui Busonacrsca y XBopux 3 yp@xenHaMn HHpox i/a60 cevosusinHHX uvAxiB Tp piskomy niigsimenni nponuxnocri supxosoro gimstpy (neporisanit cumiapom) KiseKicrs Ginka, mo BuineTHCA 3 CeHeIO, Moxe AOCATATH KoHLIeHTpantt 100 rpawist 3a no6y y aopocaoi monuin ewainsersca 10 150 ~200 sisirpam Ginka, y aiteli — ao 135 Misirpam. TIponmxnenna Ginka sepes uupxosiit ¢imsrp 6 mpocsit Kanansuis HMpoK sanexurrs Bia crany GasanbHioi memGpann, sia opm i posMipis Ginkosoi Monekyan, KinbKocTi Ginka B nuxaaMi, Y Hopmi 4epes HupKosuii dimsrp npoxoasrs Ginkit 3 MomeKysApHoI Macow Ao 70 K/ (ansGymin, serki nanworn imyHoro6ysitis, Gararo dpepmerrris) 3dinuleHHA smicry Ginka B cei Ha3sHBaerbca nporeiHypier. Pospisiators nporeirypito nupxosy i sHermpxony. Y cnoio sepry, Hupxosa nporeinypia aimmaca na gynxnionamsny i opraniuny, @ynkuionansi nporeinypii wenqKo npoxogsrs, 3ycrpivaiorsca nica npuiiomy BemiKoi xiasxocti Ginkonoi tai, Toswa Ginka 8 cesi Mowe cnocrepiraruca np amini nonoxenia tina is TOpHOHTaNbHOrO YY BepTHkaibHe. PospisisioTb oproctariuy mporeiHypiio, mos's3aHy 3 opyuieniam remosusaMixn 8 HupKax, HIporeiypii np rinepnopaosi syctpiaiorien B Gymb- aKOMy noTOxeHHI Tina, BHABAOTKCH actin y sini 14-15 poxis. [poreinypia nanpyru S'ABAAETKCA NPM HaTypy3kaX Ha HIDKHI KiHULIBKH Oprauisii nporeitypii noe'szasi 3 nopaskow Heppoxy. Boui moxkyre Gyru cenexrupsi i necenextusni. Tipu cenextusniii suGopuili nporeinypii sepes Gasantuy mempany Kay6ouKa MpoxogaTs GinkH 3 MoseKyApHO!O Maco1o He Ginbue 100 K/la, B OCHOBHOMy ambOyMin. HecenexTusHa mporeinypia cynposogutécs stpaToro Ginka pisHoi MoseKyspHoi Macu i B ce4 BHABIAIOTHCA BCI GisIKH MuasMit. TIpHUnHH nporeiHypit pisHomaninHi PospisHaloTb mpepeHalbHi, peHalbHHe i ocTpeHambAHe nporeiHypii TIpepenanuunit Mexani3m nospu Ginka B cei nos'a3annii 3 HaKommennaM B KpoBoHOcHOMy pycai Ginkib 3 HUBDKOIO MosIeKynApHOIO Maco ~ Ginka Benc-Jbwouca, nerkux nanuoris imyxorao6yainin — npn wicnomilt xeopoi, npoaykrie posnaay reMorsoGiny — mpi nepemmeanti necyMicnol xposi, wiorsoGiny — mpi BarkKinX TpaBMaX TkaHNEHE Hupkosa nporeitypia Moke BHHMKATH yHacsigoK mopaskH KiyGouKa i / aGo KaHambus nedpony. Uactiuie aycrpivacrsca swiuiaHa KayGo¥Ko-KaHanbueras nporeiuypis. KayGouxona nporeinypia nios'sana is SiipkenHaM semen HeraTHBHOrO sapany GasanbHol MeMOpant, a TAKOK NOWKODKCHHIM GasaMbHO! MeMOpaHHt iMyHHMMH KOMIUIeKCAMH, Kiy6ouxoea npomeiaypia eunukacrs np rnomepynouepirax, amiinoinosi, aiaSeriomy Tomepynoceknepose, TPOMGOsi HPKOBHX Bex, MicoMif’ xBOpO‘i. i: xpoposi, arepocreporisiiom He*ppocksteposi Tlopyurentia npouecia peaScopOuii Ginka B npoKCHMaMbHOM BiZAiTi KaHanbUT aGO MocHTEHa cexpeuii Horo KsiTHHHHMH eneMeHTaMH Giskis raiKonporeiHoso! npupon B nepsHHHY ceyy OGyMOBMOIOTS Kanatuesyio npomeluypiro, BoHa BUHIKAC pI criankOB OSyMOBseHITi AGO npuiaGanift nopasui Kananbuis (ryGynonatiax): —roctpomy —=sKawlamsulesom—_exposi, inreperuuianbomy rioMepysionedpirri, mpupowxenux i mpuaGanux TyGystonatisx. Baiicr Ginka 8 cesi s6imuryeT&ca pH oHKonOriMH saxBopioBaHHAx HUPOK, rocTpifi HupKoBit negocraTHocti, 2kuponomy —nlepepomxenni nievinky, Tp Henocrarnbomy — KposooGiry, nica npuiiomy aaTHGiorHkis, cymbdarivamianyx npenapatis, Muu'aky, woKosiii Hupui, MeraGoaiuHnx nopyuentsx (Rikorevosax, xponiusiii srpati Kaia), mp Koaarenosax, renaropeHambHoMy, TeMOLIIITHKO-ypeMIIsHOM cHLIpONAN. Tipu supaxeniti wedponarit Moke BHHHKHYTH aMiuana npomeinypia. Tlopaska crimkn ceopupiquux uuaxis (sacrime 3a inexuiiiny mpupony) cynposoauTeca nepexonom posi ix mpocsir; moninos, Hosoyrsopenia npuBoasT» 10 nocmpenat'noit npomelnypit TIpowuKHenHs Kposi B ceuy mpi wucronienivax, yperprrax, Bymbeoraruuitax, cevoKam'auiii XBOpOGI, NYXJNHAX CeMOBHBIAHHN UNIAXiB BHKINKAE NosMLtKoay npomelnypiro. Touoxosa, Y cexi npaktuHo s10poBnx sHosleli rmoKosa, ak i GiNOK, sBitvaiiHuMM MerosaMt 99RocaivKeHisi He BUABWETECH, BoHa BIBIXETECA JMUIe Np cHoxNBAHHI BeMUKOL KiNbKOCTI ByraeBoniB, NcHXoeMOUitiHifl HaNpy3i, CTPeCOBHX CHTYAniAX, a TAKOX nin AieIO ACAKUX sIKAPCEKHX nperaparis (npeanisonox, Kodein ra in). Y scix ux sunaakax KouyeHTpauia raoKosH 6B kposi mepesimtye HupKosnii xHpHOL i GinKOBOI ii (Ges syraesonis). Tp ronoaysanni, uykposomy aiaGeri xeronypia nos'asana is smenuennan. smicty rikoreay 8 nevinui, Keronypia sunikae np cyOapaxHoinanbHoMy KpOBOBILTHBi, ‘TupeoToKcuKosi, exaaMncil, pu OSWHPHIX onepauisx, YepenHOMOSKOBHX TpaBMaX, Kaxexcii, rinepincyninemii, axpomerasii 3a HasBHocti 3anaxy aueToHy B cesi, npH rmoKosypii aaGoparT 30G08'ssanuii BHSHasITTH kerouosi tina i Ges npusHavessia sikaps Binipyoin y cesi npaxruno sx0posix opocsmx smonelt He BHABIAETHCA Jlo BusHaentia GinipyGiny (i ypoGininy) Baaiorsca B OGoB'aKOBOMY Mlopsiky, aKUIO nina cexi saGapanena 6 >xosTHli xomip, a cana ceva mac senenysaroKosre KOBTIHHLI BHHMKAIOTb: CipyxrypHo-pynkunonanbine awit rerarousros (cynposomcysani sMoputysanniam Kirin i POSWNPeHHAM Mik HM MpoMickkiB) Ta HaGpaK chomyHHo! TkaMMN, Yuacnitox nigsumeHoro THCKy >2KOBMi B 2KOBYHHX XONaX BOHA nepeMiujaersca B pycno Kposi, B pesyabrati 3aranbHuii amict GinipyGiny nimpmuycrsca — mepenarxo 3a paXyHOK oB's3aHOrO 3 TmOKypoHOBOKO soTOHo (tIpsMoro) Y panomy nepioni 3axpopionaHHa B Kposi HakommMyerica Me3obininored (ypodinivioreH y nacHomy cenci uboro ca0sa), aknli mepemiuiacrsca 3 pycna Kposi B ce4y Hepes MMpKOBHii diasrp. Toy mpo6a Ha ypodininosn Tinta BusBAserecs pisko nosHTHBHOL. BinipyOiKypix nocarac MaKcuMambHol BHpaxkeHocri mp xonecrasi i, ocoGmHBO, Kom posBHBAcTECH KapriMa MeXaHiMHo ~xostanmni, TIp acrkosomy a60. nosHomy siawosnenni mpoxiauocti 2oB4HIX unxiB xonueipauia GisipyGiny 8 Kposi siipxyerscs, i pin sHMKAe 3 cevt B npoueci onyxkant renarouirrn jaieko He Biqpasy HaGyeaioTk 3naTHocti 3aTpuMyearH i pylitysarn ypodisinoren (mesoGininores). Tomy Bair ypoGisiHoBHx Tin B cevi sammmacrsea BHCOKIIM, 1013GinbweHtia swicry HekowiorosaHoro GinipySiny 8 cuposarni Kposi_ criocrepiraerbca npn dyuxuionarouec cinepdiripydineninx, snxanKanns cranKoBHNn AGO npHAGaHHMN nopymteHHAN MeraGosismy GinipyGiny, nos'xsanmmn 3 iforo mepeMimentiam epes MeMGpann nesintkosoi karin i mpouecom raroKyporiponanns (cumpom WKinsGepra, noctrenariria rinepGisipySinemis Kanoxa, cusiapom Kpirnepa-Haiiapa, cininpomn JlyGina-Jbxoucowa, Poropa, stikapceka >KOBTAHIA, Gisiororisna sKosraRMR HoBOHApoMKeHTE). Cnepxotininozen. Ha sinwiny sia SinipySiny ¢ cHOpManbHHM™ KoMMOHeHTOM ceHi, 0G0Be BuBeaeHHA aKOrO ckiasiae 0-6 Mistirpan. Octosia Kinbkicts ctepKobistinoreia BHBONTECH 3 KaTOM, 10% crepKobiziHoreHa “Epes TeMOpOiUIbHi BeHH BCMOKTYETECH B KPOB i MOTpaMUUe B ceUy. Tlocnnenma exckpeuii crepxoninorena 3 cesero xapaxteprnit ana remonitienoi xKxosrannti Ypobixinypia, Buswnenna i Kinvxicne susiiavenna uboro nponykry 8 cesi xapakrepni jaa indexuifinoro renariry i imum sananbHnx ypaxKeHb mevinKu. Ypobitinoeu mia (ypobisivoren, crepKoGininoren, x-ypoGnsmHoren, Tperiii ypoGininoren) B HopMi & HesesiKifi KimbKocri MpHcyTHI B ce4i AOpocHIOT MOM i npencTaBeHi ronOBHUM HOM CTepkOGiniHOreHOM, aKHIi BCMOKTYcTHCH epes CAIBOBY OGONOHKY ToRCTOTO KHUeUHIKA B remopoinaaiim ser. Y nopmi ypoGininosn tina siacyrni y HoBonapomKenmx, ocKimpKM 8 KumedHUKy BixeyTHA daiopa, epMeHTH sKoI CrIpUOTS nlepexony GisipySiny B CrepkOOiniHOTeH, Ypotisinypia — nigsmumeria smicty 8 cesi ypoGinivosix tia. Ypodininypia xapaxrepra ana Temonirnsiin —— cranis, napoKcusMansHoi ——HisMoi ~——remoroGinypii, epsrrpemm, BHYTPILINBOCYAHHOTO —reMomisy, — POsCMOKTYBAHHA —OGUINPHHX —reMaToM, BipycHOrO i XpOHiHoro TenlaTiMTy, TOKCHMHIX ypaxeHb nevinKi, MeracTasin B neviHKy, exinoKoKosy. PisKo sOibUuyerser pier ypoGininoreny npH uMposi nevinkH, nlopranbuifi rineprensii, tpomGosi HopranbHHX Bex, YpOGisiHOBH Tita MO:KYTb 3'BIATHCA MPH SAXBOPIOBAHHAX KILICHHHKA, KOMI Topyulyersca neMoxrysanns ypoGisinonix tia, Haiisactime Taxa Kaprina croctepiractsca aireli npu xostiti, Henpoxiauocri KumesinKa, saxpenax. (id maTH Ha yBasi, mO ypoSiniHoBH Tina MoxkYTS He BHGHAYATHICR Mp aNCSaKTepiosi, Xpouiinnx saXpopionaHiiax KULIeSHIKa, pH sikypauni armuGioTiKanan Bupwkea —ypodisinorenypia € OMIM 3 4YTIBHX i OCTOBIPHX O3HAK, 110 sinopaxarors ykuionanbunii cTaH renavowirros, sKujo y mauieHtin Hemac remonisy i narosiorii_kummesniKa. Tenamypia — niospa epwrpounris B cesi, Kpos 8 cesi Moxe sitipasrHea pH reMatypii (snanamotsca epttpoumri) i remornoGinypii (posunnennit xpos'sunit nirerr), Epytpourti Hopi 3ycrpisaioreca y mpaxtuano s2oposix mozeii (y airtel i aopocmmx). Y omnomy sitpi cei Buapaserben y siti 0,75 * 10°/n. Y Hosonapomxenmx B HeueHTpHyrosaniii — cexi BIBHatacTbca 0 0,05 + 10° /a eprrpounrti, Tewatypia Moxke BuabsaTica y pirnani Mikporemarypii, KonH epitpounri BHaBsIAIOTCA ‘Tinbkn niin MikpocoKonoM i Komip ce4i He 3MitoeTboa, Tp Mikporemarypii BisyanbHO Mae Mictte swinta Kombopy cei 8 poxesiit aGo Gypnii siarinox ~ sanexno Bin KimbKocti epirrpounrrin. Temarypia moxe Gyr mpepenasbror, penanbuoii i nocrpenanuoii, Tepuia nos'asana is abinbueHHAM npoHHKHOCTI KanisapHol cTinKH NpH reMoparisHomy aiaresi, PeHambHas remarypis OSyMonaeHa SaxnopionanaMM HHNpOK i cyMponomtTica nopyurenHAM mponMKHocri GasambHoi MemOpaHH KulyOouka, BHHHKAeTb TakOK pH Mopasui KaHaNbUiB aGO MK omHOMACKIT nopasui kaySouka i kanambus, Toctpevamssaa resarypia wae Mice mpi 3anambHix mpouecax, HOBOYTsOpeHHEX cevOBUBIANNX uniaxis, Tlocrpenanbune rearypii se'xsani 3 THX, mo CYMPOBOAATECK —_KPOBOTeeHO SANIBHIIM —MpOLIeCOM A500 TPABMOH CeHOBHBIAHIN ULAAXiB, Bycrpisaiorsca npu nicaiti, uncrurax, yperpurax, mpocraritax, Kamensx i nysanHax cevoBoro Mixypa. TIpu ceoxam'sniii xpopodi nosna xponi 8 cexi nlon's3aHla 3 TOWIKOZUKeHHAM CAH30BOi OGonoHKH ceHoRORy aG0 ceyonOTO | Mixypa _KaMeHeM, pH nyXanHax cevoBoro Mixypa epHTpouNTH npoHHKaoTe B ceHy B pesyasrari pyfinyBanna M'spo801 TKaHIHH criMKH Mixypa i noukomkenti Ti cyst B uissx ampeperuiauii supxosot i nocrperansio remarypii, s'icysaisi ocoGanpocrel 102PopMyBantia OCTAHHBOIO 3ACTOCOBYHOTB TPbOXCKIAHKOBY MIpody, B XOAi BHKOHAHHA sAKOi nauicHt 36upac ypaniunio ceyy B TPH cyauHN, JocaiKeHHO nignaraoTs nepula, mpyra i pera nopuii cevi, Axo Kpos siaBaACTEcR B nepuloMy crakani (novaTKoBa a0 iniuiaTHBHa remarypis), TO We cBiMMITTS Mpo OMiMky KpoBI 3 ypeTpH. SIKILO KPOB BHABNIETCA TIABKH B ‘TperboMy crakasi (TepMinanbHa reMarypis), TO Ue FOBOpHTh mpo Mlopasky ce4oBoro Mixypa. Jikto aoMimKa Kposi pisomipo posnosinserses y cix phox cTakanax —(Torambia Tematypis) — ule niTBepsckye MpHMyMLeHHA MPO TeMaTypi10 HUpKOBOrO NOXOAKEHHEH. Lit Hupkosoi Temarypii xapakrepHi omimika xposi y scix Tpsox nopuimx cevi, posTamysannt epimpounrin y piraani MoneTHHX cTosTYNKiB, HaaBnicrs sMinenux epmrpowris i nporcin- epitpoumrapHoii acouiauii, Kpim Toro, mpi HUpKOBi epimpomrrapri Go reornoGinosi uniziniaps, Caria amhepenuirosarn ynkuiowanuy i opraniny resarypito. Tlepuia siksmkacroca nocitteHoi0 npouuknicrio aGo imo HecpOMoxHicrio HUpKOBOTO ¢pistéTpY, Hepe? MLO reMaTypist ganascrsca niicna vemuxoro ¢isisoro Hasarrrarkesma, nepenazin Temmepatypu, npuliomy aiikapcbkux — 3acodis (aruGioTuKis, cysbbanisiaminHix mpenapatis), Bisoma oprocraruuna rematypia (npH rinepnopnosi Ta inum BuKpHEneHHAX xpeGra), Opranisiia rewarypia oGycaapninacres ypaxentiam inreperimianpoi Twanma pox (i nepur 3a Bce — GasanbHoi MemGpanu KnitoK xKayGouKosoro disbrpy). Tak, npu rocrpomy riomepysoxesppurri rematypit cnocrepiracrbca mporsrom choo nepioay 3axpopiozanis. Y neputi zexinsxa iG iioro ¢opmysa MOXKE BHABARTHICH Makporematypis, MMixporematypia BIBHAAcTECR TIP ocepenKosifi nopasti GasambHo! MeMGpann KayGouKa, Cova Mowe Gyr POKEBOIO, ale YacTiMIe — KOABOPH «M'ACHIX MOMHiB> — 3a _paXYHOK 3MiHeHUX epmTpouTis, Xponivnuit riomepysioned)pur cynposomursca riomipHoro rematypieio (ae fioro sarocrpenna MpHBOAITS 10 Makporemarypii). [ieioHepuTH piakO cynpoBomsrbc! Mikporemarypieo, Tpit cesoxamanifi xnopoti (Hecppositiasi) nimmxacrs —ixporemarypia, mo nocumocrsca nin 4ac Harty HupKoBO-KaM'axo! XBOpOGH. TIpH nyxaHHax Bona Moxke GyTH BHpakeHoI i HocHTH nocrifimuii xapaxrep. Temarypia cnocrepiraereca y © XBOpHX, cTpaxkmalounx TyGepKysIb030M HHPOK, TPOMGOIOM HUPKOBHX weH, indapKTOM HUpKEL Bunissiors sacrifisi remarypii mpi cepuesiii HenocrarHocti, TpaBMi Temarypis sycrpivacrsca mpi KomareHozax, reMoparivaux packystirax, mpupomxenux i npuaGaninx Koarynorarisx Tematypia 3mintaioro xapakrepy coctepiracrbca np nienoHedpurax (sananbHomy mpoueci, mo savinac kayGouKu i Gani Hupox), remoparisuomy aiatesi Temormosinypis. Tossa remornodiny 8 cesi Mowe arm icue mp remostisi epirpounin, uo siaGysacrsca GesmiocepenHbo B cevi, aTAKOK Bpesy:NbTaTi MPOHMKHEHH Temorsio6iny 3 mutaaMu Kposi B cesy \epes HupKopuli dimsrp (allicHa remorobinypis), Buyrpimnbocyammnnii remosis epimpountin Moxe —BHIAHKATH —mIpH OTpyeHHi — xinisHu pevosnnamm — (akininoBuMH bapGrukasn, cysibanizaniniusi —mpeniaparani), Toxenkoinpexuisx. Bigoma mapwesa a60 napoxcrsMambia remornoGinypis. MiorsoGinypis. Tossa iorsoGiny 8 cesi Moke Gyr TpasmarHuHo? npupomH i BHANKaTH npH OOUMpAUX TpaBMax s's30R0i TkAHNHN ( CHHAPOM 3naBneHHs, Kpaul-cuHpom), Mp ynapax enexrpisiuum crpyMom. MiornoGinypia Moxke Gyr Hetpapsariuno1o — npit arpopii m'ssis, indapkti Miokapay, TpoMGosi cyAHH M's3iB, OTPYEHHAX BYTIEKHCIHM raz0M, Inaixanypis. Y cesi snoponoi mopuin innikan Mictureca 8 HesHaWHIX KimbKOCTAX i sousaiinunmt axicuum —mpoGamn He —suiastacrecs. Inaikanypia —crtocrepiracrses_mpit HenpoxiaHocti TOHKorO —KMUeYHHKa, KomiTi, TYGepKysbOsi KIMeYHHKA, mp — mocHeHHi Tun mpouecin B KHUIeNHKY, MpH TpuBATHX saKperiax, nepirToniti, posmasi_nyxmunno! reanunn, mp Tui, 3a HasBHocTi ruin orm & opranismi, Kom BinGynacrsca nocusenHii posnan TkaHHHHHX GinkiB (eMniema, aGcuec, rHHMbHHiT Gponxir), 9,3, Oca cesi (mopdoaorisnnii anasis) Y ocinanni cesi Moxkyrb Gyr puaBneni KniTHHKi i MeKniTHHHi —esreMeHTH KpOBi (epuTpountrn, selikouHTH), CevOBHBITHHX uLLAXiB, eeMeHTH eniTemiO cesocTateBorO TpakTy, a 103 remarypii 8 cei BisiBamoTc Gis0K,TakOK ChlepMarosoisIH Ta IHL KIiTHHH — pakosi, Gakrepiiitsi, rpHOKosi, napasirapHi, ocan coneti (pocibari, yparu, oxcanaru), Tp Mixpockonistiomy —ocnismxermi ocany cei MOxkYTb BISBIATHCA SHINKH HHPKOBHX KaHaTbUiB — TaK SBaKi cuULTNApHD. Mase sGinbuleHHA JO3BONse BHABITH LMT, KOMMTeKCH KaiTOK, sifitt napasiTiB i KpyTIH xpucram Tipu aocsisxeni «opmanioiy cesi y nomi sopy ixpockona suannmorsca onntutnt epurpountH, 0-2 sefikoutis, 0-3 enirenianbunx KaitoK, 20 50000 Gakrepiti Ha 1 mut ceui Lwiinapa sigcytsi. Y 1 ma oogoi cesi 3m0posux mogeii icrutsca: 0 4000 jixounTiB, 201000 epmrpourris, 0-1 unainapis (Meron Heunmoperko) Touniumm, ase Gisbul TpyzomicrkHM B sON@GopaTopHOlt i OOuNCMOBaNbHiI YacTHHi, 4AM meron Heunnopenko — meron AmGropae Opranisonani ocizanns. Tepe com nauicnr ssinbiite cevoonti wixyp, sepes 10-12 rom 36upaiore ceay B SHCTHii Mocya, B AKWii 3a3ganerinb omaoTs AeKinbKAa KpuctasiB THMOTY (aGo xpanaio hopwaniny). Has gocaimxenia siaGupaioTe cesy, suaineny sa 1/5 roam (3a 12 xpiuik). Kispkicrs dopMenux esiementin B 20G0BOMy OG'eMi cesi BISHAYaIOTh 3a JonoMoroi paxyHKoRo! KaMep Topacea 93.1. Cneyiatoui memodu docaidsenna cowsudirenns Memod Kaxoscoxozo-Addica Jbw suasnensi seiikounrypii cery 36upaiors 3a 10-12 rom (3 21 roauan ao 9 romun). BiGpany cevy peremswo posmimryiors i siwiprorors ii wimbxicrs, Ha aocnimxenna HanpapanioTs 20 Ma, cevy ueHTpidyryiorb i aocaixxyioT® nia Mixpockoriom ocag B KaMepi Topacea. Y nopmi npotarom go6u no Amaucy-Kakoscpxomy siisaersca | + 10° epmrpouuria, 2+ 10° netixourtin, 0,02 + 10° unninapie. Tadinaya 2 Pecbepentni BeawuuHn npH BUKOHAHH KainiMHHX aaGopaTopHHX AocTiMKeHE Cem Tliapaxywox cpopmenux enemextin no Agaucy-Kakoncskomy’ aeiiKouMTH ao 2*10°/n06y epurpowmr 20 0,5* 10°/n06y uuainapy 0 0,02*10"/n06y Tiapaxywox dbopmenmx enementis no Hesnnopenko: E 0 2,5*10/xB. epurpounrn no 2*10°/xp TiinpaxyHox (bopmenux entementin no AmGiopixe aefikounTH 0 2,5*10/xB epurpounrn no 2x10 xB Tpo6a 3a Sivniusxum Tip sewvaiinomy muiomy pexuni cesy s6upaiorh npotarom aoGu 3a KoxHHX 3 roauHH, mepuia nopuit cesi y 6 roaHHi paHky susuBacrbca, Ha KOxHY muIsUIKy HakseWeTECA eTHKETKA 3 BKAsIBKOIO npiseuly, MatatH, HoMepH nopuii i MpoMixxKy wacy, 3a axuii siGpana nopuia (6 —9 ~12 roaun ir. a). Bee 8 nopuiii nanpasnsore na RocHvKeHHA nHTOMO! Barn (utinbHicTS) ce4i, B HOPMi MOxIHBI KOTHBAHHA Bin 1,005 0 1,028 (Hopma KomHBaH 30 0,007) i BuMipropanna KimbKOCTi AeHHOTO, HiMHOro i 20G0B0r aiypesy. Takum snom susnasacrocs dynkuia aNcTanbHI KanambuiB Hebpoxos. Tipo6a na KonueHrpauito cexi 5a Doabrapsom, Cyxoenenia Ha 13 — 36 rogue. 3a ueii 4ac 36upaemo ceuy KoxKHI 4 roquHH 3 pusnavennam utinbHocti i Kimbkocri cei. Jlocsarum utinbHocti 1,028 nocaisrKenna TpHMUHeMO— Ue NOKasHHK HOPMaNbHOI MaKCHMambHOI KOHWeHTpAUil TIpotnnokasanns: roctpa HMpKoBa HegocTaTHict, roctpuii romepysionedput, roctpi Gaxrepitini inhexuitini saxsopiosanna nupoK 104Bogue nasantaxenns 3a Moabrapazom (mpo6a na posseaennst cesi) TIpononyemo nauicHrosi BHNHTH BoaH 3 pospaxyHky Ha I Kisorpam Mac Tina — 20 Mn soa. Ticaa usoro sGupacmo cesy ® nepeGiry 4 roaun i aocsigxyemo Ha Kimpxicrs cexi i KONMBAHKA timbHOcTi ce4i, Y HopMi: 3a 4 roauHH BHainseTbca BCA npulinara pinnna i usiasicts Komupaereca # Mexax 1,001 Tlpo6a 3a Ambiopxe Tipusvavena Aaa BHSHAYeHHA KimbKOcTi opMeHHX eneMeHTIB BHVeMeHHX 3 KPoBI 3 ceyeIO 3a 1 xBuauny. Tlepme cevosunyckanua B yuita3, “epe3 3 rogHHM 36upacmo ceay B nepeGiry 3 roan, mepemimyemo, Gepemo 10 mui cesi — ueHtpidyryem, notim Gepemo 0,5 Mi ocaly i gocaisvkyemo nin MikpockorloM 3 BHKOpHcTaHHaM KamepH Topsesa, paxyemo xinbkicrs eprTpountis, sefKountin, unainapin. Y nopmi: epirounros — no 2 * 10°/xp, sefikountis — a0 2,$ « 10'/xp, uninapis — 2 * 10 Bugeaenux 3a 1 xBiamiy TpoGa 3a Hesnnopenxo Tipusvavena 21a BHSHAYeHHA KimbKOCTI opMeHHX esleMeHTiB BIeAeHHX 3 ceuerO 3a 1 nosy. 36upaemo roGosy cevy B GanKy (qonaeMo B GaHKy S Kpanen KoHcepsaHTa — dopmaniny a6o inworo Koncepsanra). Ceay perenbo nepemimyemo i Gepemo 3 cepenuboi Tomi ceui 1 ma, Lexrpidbyryem, orpumannii ocan Mikpocbkorlyem 3a joroMororo KaMmepHt Topsesa. Merog Heuunopesko nonsrac y BisHaueHHi KiNbKOCTI KIITHHHEX esleMeHTiB (eprpourti, nefikousris) i uusinapin 8 cei 2a 1 xpiumny. Y Hopsii mo Hesnnopenko y opocax stefikountiB no (2—4)+ 10° /xp, epurpountis no | — 10° /xp, nuutinapie Bia O 20 0,02 + 10 Jxe,y aiteii — neiikowtin go 2+ 10° /xp, eprrpounrtia 70 0,75 + 10° /xe, unminapia Bin 0 no 0,02 +10° xe Busnaenus kaipency wmpox Kaipenc -C — kinbkicts Kposi B Ma ake o¥MMacTBcA HUpKaMH Bia aaHOi pesoBHAN 3a 1 xpunny. OGuncmocreca 3a opmynow: C = UxV:P P — koHueHTpauia petosunn B ma3Mi KpoBi U — xonuentpauia perosnnn B cesi V — xpnninii aiypes OGos'ssKosnit nepepaxyHox Ha cranmaprHy BeaMuMHy = C crangaprHuit (1,73): nosepxns ina nauiewra (oOuncmocTsea no TaGauui 3 ypaxysanHm jOBAUNH Ta MacH Tita), Busnayenus 8 cesonomy ocaai Knitox Ulrepureiimepa - Manboina Le simoamineni Kairku—rpanysounrn npeacrannenu y eurasai wenukux, Kpyrioi aGo osanbHoi a60 rpymosnaxoi opmm sefixoutin 3 BHGANCKyIOOIO sCKpABOIO MpoTONTasMoKO (2a paxyHok rpanya — aki 3HaxonaTeca 8 GpoynincbKomy pyci). I sacrocyBarinam nposoxanii: YBU a60 seesenua npeauisonony pu starexTailt pops nieaity, nicaonepputy sGinbuyerses axtuBHicr sefikoumrin 6 2 pasH, wo i nigtsepmxye aiarHos. AKUIO nica nposoxauii 8 gocsizkysaHomy ocati akriBauii He inGysacrbca — y mauicHTa HeMac ieairy, nienonedpury 9.4. Teopin i npaxrmsa gocaiqxent Kairnunux enementin cevoporo ocaay Enireniii, uo susianscrica 8 ceui, Moxe Gyrit ninockuM, nepexiguim a0 HUpKoBUM. TLnocKuii eniresiii y xinox notpanaac m cesy 2 nixen i cmmonoi oGonouKi aopninmix craven opranin i cBiAuHTS TIPO HenpasHIHO 3iGpaHy ceuy. BiH BsBAAeTECA y BeNMKilt KisbKOCTI MpH sefiKOMAKii cexosoro mixypa, nociineniii ecrporeniii crumyssuii, sarivirax. Y ninuarox noaBy mosepxHeBoro naocKoro enireniro sigoGparKac crarese sospisanna aurmi, Tepexianmit enivesiii norpanaae B ceuy 3 Ganili, cevononis, ce4oporo Mixypa, 3 BepxHBoi TpeTHHH yperpu. Hupkosuii enireniit puspaacricn B cei mp mopasui naperximm smpox. Enireniii nepeaixyponoi sano orpanaae B ce¥y 3 COKOM sazosn, vacTimme B citHboMy iui. Eprmpousrrn B ociaamni MoxKyT® Gyrt Heaminenuimn i awineni (Geodapeni, Taki, mo MaioTb KOBTAHMLEHO. Teuocudepin — sanizoemicta vactuna revativa. Buarnaersca npn xpoxisHux remonitiannx anemiax, nocienomy remostisi eprpouttis, TpomGosi cyaun, Tevamoidin suspasersca np posnani Kpos’aoro sryerka Ges noctyny KucHto, paky, tpaswax i inuux cravax. lac 3 as0THOW KuCHOTOIO cHHE cpapOysaHHa, Ke UIEHLIKO aumae, 3. eroro excrpenol aiarnoctixn pikopicroyioTs 3 aGo 5 cpksaHoNHy cnpoby sKicHix xapakrepucTuk cei, 3 — cbKAHO'HA cnpoOa: y Mepuly ckAAHKY, Ala OuiHOBaHHA craHy yperpi, tpe6a sinycriri 0 10 Minisirpis cevi, 8 apyry CKNAHKY, 2118 OUiMIOBAHHA craHy ciosoro mixypy, TpeGa sinycriti ycio ciMy, 10 KparuuboBoro BiaisTeHH CeMi, B TPETHO CKIAHKY, ana ouimonanna crany Hipxosix Ganifi i cesenogis, ninychxaiors yci ocrankn cexi. 5 ChkuaHOWHa crpoda: y Nepuly cksHKy sBinycbKaioTh oS MinisirpiB cewi, muta ouimionanns crany mepemuboi uactini yperpi, y apyry cknaiky rpeGa sinycriti takox 20 5 Minisirpin ana ouimtonaria nosanuoi activi yperpi, y TpeTIo cknsuKy BimycpKacTeca ceva 3 ceuoBoro Mixypa 20 CIIMHY HaTHCKy ceMi, y YeTBepTY CKIHKY, 3 MeTOIO OUiHTOBAHHA craHy ceuenoain, ainychkaior» 20 10 Minisitpin ceui, y maty cknaHiky a6ipaemo ocraHiio ci4y aaa ouimosanns crany Hipxosix Ganiti 10. 3micr KkumesinKa, ioro zocaivKenHst Tonka xiuka — niapisox xmmesimka, axiii ekmovae tpH sigaian: ananaqusrinany (duodenum) (25 — 30 cw), xyay (jejunum), taxy, aka cknanae 2/5 nOBKHH BCiei TOHKOL KHMIKH, i kaySony Kiurky (jleum), Ha aKy fOBoNATECR ocTaHHi 3/5 nomANH JloBKHIHA TOHKOTO 107