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    Postanovlenie 8

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    ApyrEx
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    cnequalJll,tcToB rIO QeurronH, rap6alla:enun, BaurbrrpoeB r Kl,rcJrora.
    NOKA3AHI,I'M.
    flpr.l 6oregoM cr,rHApoMe: aHqnbreruKr.r-aHTwrr{perr{K}r: MeraMr.r-

    t6

    3or rtarprrr, naparleraMor; HIIBC: 4r.rxlo@euar, reronpoSeH, reToponaK, MeJroKcr{KaM, u6ynpo$eH, rleneKoKcu6.
    flpll qeHrpa.lll'Hom neitponarraqecKoM 6oiresol.t ct4H4poMe: nport4BognunenruqecKHe cpeAcrBa: rap6alralenar, ra6aneuruu, npera6a,rnu;
    anTlr.uenpeccaHTrr: aMr{Tpurrrr4-rrun, $lyorceuH, napoKcerr.tH.
    llpr.r runeprepMrrr{: aHirJrbrerr{Kr,r-aHTrrnriperfirra: ACK, MeraMr{3or Harpr{r, uaparleraMoJr; HIIBC: 4ururo(penar, xeronpoQeu, xeTopoJrar, MelroKct'tKaM, u6ynpo$eu, ueneroxca6.
    flpu cnacruvecKoM crrHApoMe: MrropeJraKcaHTbr rreHTpaJrbHoro
    Aeficrsns : 6ar.no$eH, ToJrnepr.r3oH.
    flplr rurepreu3r.roHHoM cr{HApoMe:
    MoqeroHHble cpe.[crBa: rlrApox;roprna3Na, Qypocerrang.
    flplr necru6ynrpHoM cr.rH.rlpoMe: cpeAcrBa Anr ycrpaHeHr,ur ronoBoKpyxeHr.rr : 6srarucrns.
    flpu r,tncounuu: cHorBopHbre u ceAarr,rBr{bre cpeAcrBa: 3orrtrr;roH.
    flpra .4enpeccuu: aHTr{,uenpeccarrrbr: aMr.rrpr.rrrrr.rJrr{H, $ayorcemn,
    napoKc€TuH.
    flpu erc, panr.rpaMr,r.qHoM cr,rHApoMe: AorraMraueprnqecKr.re cpeAcrBa: aMalfra.ultH, rrpaMr{neKcor,,resoaona./rap6r.r.uon4 JreBoAona./6encepasr.r,q.

    OT, JIOK, MexaHorepan[r, ncrrxorepafl[r, JroroneA.

    Iloclegcrnrr

    O6uufi

    BOCNIIJII{TEJIb-

    Hbrx

    6oaeguefi

    qenrpamHofi
    Hepnuofi cucreun (G09)

    3xo3C.

    flo

    KpoBr4.

    33f.

    flprl rorlrururHbrx HapyrneHraxx:

    KoHcy.nrraqru

    Koucymraqul

    sTfiJrMeTHJrfrZApoKcr{nfipr.rAr4Ha CyKTIUHaT, MeTr,rJr3Tr4JrnUpr,rAr.rHOIa

    Bpaqa-

    Bpaqa-IIcuxuaTpaHapKoJrora (npavancI4xoTepaneBTar,

    rlrApoxnopu.{, Hl,rqeproJruH, nupaueTaM, BHHnorleTrrH, nrr{qr,rH;
    flapacr{MnaroMnMerr4qecKr,re cpe.ucrBa: xoJrr{Ha a.nrQocqepar,

    ananr.rs

    ooTa,'rbMorora

    (ocrpora
    HI4t,

    3pe-

    COCTO'HTTe

    Ipyrfix

    7-to

    noxa:auusM:

    rrnr{aaKpr,rH

    nefiponporeKropHa, Tepa[fir:

    .

    upauei- flpr,r cy.4opoxuoM cr,rHApoMe: nporrrBo3[rderrrr,Frecrue cpeAcrBa:
    IIO QeHurorH, rap6aua:enuu, B€rJrbrrpoeBiur Kr.tclrora.
    flpn 6o,reaou cr,rH,upoMe: aHaJrbferr4Kr.r-anTr4nrrperr,rKn: MeraMr,r-

    fJriBHoro AHa, cleuu{IJII{cToB
    no,:rg :pen[t).
    IIOKA3AHI{'IM.

    3o"q

    narprr, napaueraMoJr; HIIBC: ,1ar,roQeHax, xeronpo(peH, re-

    TopoJraK, MenoKcuraM,

    z6ynpo$eu, qeneroxcn6.
    cnacrauecKoM cnH,4poMe: Mr4openaKcagTbr Uer{rprulbHoro
    Iefi crBv{ : 6ax.noQen, Tonnepr,r3ou.

    llplr

    flplr runepreH3lroHHoM

    cr4HApoMe:

    Moqer oHHbre cpeacrBa:

    rr.rApox;roprr{a3ul Qypocerur,ra.
    flpra eecrn6yarpHoM cr,rHApoM€: cpeAcrBa llu yc,rpaHeHri, roJro_

    BoKpyxeHrur: 6erarncrrn.
    llpu zucol.rHnu: cHorBopHbre tr ceAarI,rBHbte cpe.qcrBa: 3orlr,rrJroH.
    flpu genpeccuu: aHTr.rAerrpeccaHTbr: aMrrrpr.trrrrr:ruH, (pnyoxcerr.rn,
    napoKceTl{H.

    llpu

    srcrpanupaMlrlHoM cr.rHlpoMe: .(onaMuHeprrqecKrre cpe.q_
    crBa: aMarrraAuH, npaMr,rneKcon, ;renogona/rap6ugona, neBoAo_
    na./6encepasu.q.
    OT, JIOK, KrdHe3orepamrrr, rrcnxoreparrul, noroneA.

    BoregHr feH- O6rqufi analus
    ruurroHa (G10) rlpoBr.r.

    Y3I,I

    6prouruofi

    Br.roxr,rnar,r.recroe

    flpu nepnuvuofi nocrasome AxarHo3a naq[errra HanpaBJurror Ha
    KoHcyJrBTarlurc n o6lacrrrlro, pecrry6;rr,rxancrg/ro opt-aHx3arlruo

    CTI,I.

    3ApaBOOXpal{eHr.rr.

    lrccJreAoBaHve
    KpoBx: oflpeAe-

    Koucylrraqu-a

    opraHoB
    rrolro-

    lloc.rre ycranoBJreHnr K;rr4ur,rqecKoro,qr4arHo3a flpoAoJrx(ullor
    o6rqefi HaIlHaqeHI,te JreKapcTBeHHbrx cpeIcTB no cxeMe, peKoMeHIOBaH_
    Tpa\r4u DIroKo- nparruxu), .upyrfix Hofr B crarl[ouapHhrx ycJroBnrx o6nacrHoii, pecny6:rzrancroft
    3br, o6ulero apauefiopraHusaquft 3IpaBooxpaHeHr.r;r.
    6erra, o6rqero clequaJrncToB no flpr.r yrr,repenHoM xopenrecKoM rr.r[epKr{He3e:
    6uaupy6uHa,
    noKa3aHr'|M.
    aonaMr{Hepr[qecKr4e cpe,qsfBa: aMarrTaAnH;
    JIeHUe

    KOHUeH-

    Bpaqa-TepaIIeBTa

    (npava

    MOqeBI,rHhr, Kpe-

    npoTr.tBoSnrrnenTr.r.recKHe CpeAsrBa: KJIOHa3enaM:

    a;ruHLIHA.

    aHT|4rICtIXOTHqecKI.re

    lJaTpul{, Karrltt,

    flpu rrxelofi xopee:

    xrropa, AIAT,
    AcAT

    3Kf.

    cpeIcTBa: KIO3aIIIIH.

    aHTuncplxoTr,rqecKl4e CpeAcTBa: rzuolepl,tAoJ], KJIO3anr4H. cvJrbIIIr_
    PHA;

    l8

    Koucyllrarlur

    KI.{CJIOTA.

    Bpaqa-

    flo

    o$ramuolora

    llpu rornurunHbrx HapyrxeHnlx:

    (ua:Hoe

    rora.aaHuqN,r:

    nefiponporercropHar repalr,rJ{:

    r,'ruql{H, .qoHenff IIJI; MeMaHTI{H.

    rHo,

    ocTpoTa 3peHr4r,
    rroJrr 3peHr4r),
    Bpaqa-

    flpu,4enpeccun:
    aHTr4AerrpeccaHTbr : aMlrrpr4nruJl14H. 0nyoKcerr.rH, napoKceruH.

    flprz axuneruro-purprlHoM cr{HApoMe:

    crrxuatpa-

    AOnaMUHepnuqecKrre cpeAcTBa: aMaHTaar4H, npaMr.rneKcoJr.

    HapKoJrora.

    Y3ll

    KpoBr{.

    opraHoB
    6pouruofi noJro-

    flpu nepnuvuoft nocrauosre Ar,rarHo3a naqr{eHTa HanpaBJrrror Ha
    KOHCynr,TaUl O B O6racfirylo, pecny6Jrr4KaHcKylo opraHr.Barlr{K)

    Koucymraqu-a

    cTt4.

    3ApaBOOXpaHeHr4Jr.

    Bparra-

    Koucymraquu

    oQramuo.nora

    rpa.refrcfleqflanI,IcToB

    HacregcrneH-

    O6qnfi

    HAA

    (Gll)

    ATAKCV'

    ana;rua

    (raa.suoe

    AHo,

    oqpoTa 3peHur,
    rroJrr 3peHnr).

    IIOKA3AHI,T'M.

    flocle

    ycranoBneHnJr KJrr{Hr{qecroro Ar4aruo3a npoAoJDl(itror
    Ha3HaqeHHe JreKapcTBeHrrbrx cpeacTB rro cxeMe, peKoMeHAoBaJ{HoX B sraqsoHapHbrx ycJroBr{rx oonacrHox, pecrry6nr.rKaHcKofi
    opraHr8arl fi 3.upaBooxpaHeHrxr.

    Hefiponporerropnar repanrur:

    arr4JrMerr,rJr {.upoKcr{nupr,tAr,rHa

    cyKrlrrHaT, fJrr4rlr.rH; [apacr{MnaToMl4MeTr,rqecKr,re cpe.qcTBa: xoJrr{na a,rr@ocqepar, vtnv Aar.pvn.
    .{onauunepruuecKr,re cpeAcrBa: aMa}rraAr,tH.
    flo noxasaurrrru:
    IIpz corryrctn).ro[IeM TpeMope: 6era-a4peno6.noKaropbr: [ponpaHOJIOJI.

    flplr secru6ylrpHoM

    crrHApoMe: cpeAcrBa
    BoKpyxeHr,rr : 6erarucrlrn.
    flo noxagaHIa.f,l{:

    flpu

    enusogr.rqecxofi araxcuu;

    Arr

    ur'ruitrropu

    ycrpaHeur.rlr roJro-

    rap6oanrur.qpa:u:

    arleTa3oJraMrr,ql

    rrporuBo3nnJlerrrlrqecKr4e cpeacrBa: rap6aua:enuu.
    flpu runepruHerr,rqecKoM cr,tHlpoMe:

    t4-20

    l9
    ItpoTr4Bo3trHIeIIrI,IqecKHe cpeac.t.Ba: Kjrolta3enaM, BanbflpoeBiut
    KUCJIOTA.

    flpra 4enpecclu4: aHTlrAenpeccaH.rbr : aMr.rrpt{rrruJrr,rH, $nyoxcerlrH,
    napoKceTuH.

    OT, JIOK.
    flpu nepnuvuofi nocraHosre A afHo3a [aurreHTa nanpan,rrror tna
    KoHcyJrbraulxo n o6lacrnyro, pecny6luxaucKyro opraHr,r3ar1r4ro

    CnuHa.,rrna.fl

    O6rqufi

    MbIIIICqH'UI

    KpoBr.i.

    arpoQu-r u po4-

    O6rqufi ananur

    (rpaua

    CTBEHHbIC CI4H-

    MOqI{.

    nparcrurul).

    apouu (Gl2)

    Braoxuur,rqecroe

    KoHcy,rrraqnu
    flocre ycrauoBJreHl,Ir KlruHr,rqecKoro .{[arHo3a npoAoJrxaror
    .qpyrux npauefi- Ha3HarreHle JreKapcTBeHHbrx cpeAcTB rro cxeMe, peKoMeH,uoBaH_
    cneql{iultcToB IIO uofi n crauuoHapHbrx ycnoBlrrx o6nacruofi, pecrry6lnrancxofi
    TIOKA3AH14'M.
    opraHrleauufi 3ApaBooxp:HeHnr.

    ananus

    Bpaqa-TepaneBTa

    I,ICCJIeAOBaHlte

    4poBr.r: onpeAeJIEHI,IC KOHIICHTpaquu DrroKo-

    3H,

    6elra,

    o6qero
    o6qero

    dunupy6nrua,
    MOqCBI,IHbI,

    Hfltpu,, Karvfl,
    xjropa, onpe.[eJIEHUC AKTI,IBHO-

    crr.r

    Koucy.nrraqur

    AIAT,

    AcAT, KOK.

    3KI.
    3nerrponefipo-

    urorpaQvr (garee - 3HMf).
    KoHcylrraqu-e
    Bpaqa-

    oQralruolora

    (ruasnoe

    AHo,
    ocTpoTa 3peHr{r,

    o6qeii

    3.[paBooxpaHeHr.rJr.

    Hefiponporerropuar repalr4r:

    3TtrJrMerr,r.nrzApoKcr{flfipr,rAr4Ha
    cyKrIr4HaT, MeTnJr3TuJIIr[pVry\]4HOrA n4ApOXrOpU,q, fnuqr,IH.

    flapacuunarouuMerurrecKr{e cpe.qcrBa: xoJrrdHa aarQocqepar,
    nruaKpr.rH.

    Mgra6oluxr.r: ruelr4onrfi , HaHApoJroH.
    flpovze cpeAcrBa BJrr.trrcr{ue Ha nr,rqeBapr,rrenbHyro cr{creMy It
    nrgra6onu.recrc,re flpoueccbr: Tr,roKToBuur Kr{cJrora.

    OT, JIOK, MacciDr(.
    B pavxax oKuBaHlrl na,r:rHarusHofi noMotqr{:
    rrpr,r Bbrp:DKeHHoM HapyIneHnI,I fJroTaHlu, cHr,Dr(eHr,t[ Maccbr TeJIa
    ga l0%o r.tJ ,t r.rHAeKce Maccbr TeJra rraenee l8 rr/u2: noxa:ana ycraHoBKa Ha3oracrpilnbHoro 3oHJ\a u [poBeAeHr,re qpecnoxnofi 3H_
    AocKonr{qecKofi racrpocror.ruv Ana ocyqecrBJreHr,rlr 3oHloBoro
    3HTepzurbHoro nr4TaHnA qepe3 Ha3oracrpalruufi 3oHA rrJrr,r 3oHA
    BBeAeHHr,rfr B croMy craHAaprHbrMrr r,r3oK:uropr.recKuMr,r nrra_
    TEJIbHIiIMI,I CMEC'MI4.

    I4-20

    20

    nonr 3peHur).

    Eorosofr

    ar4uo-

    rpotpuvecrufr
    crorepo3

    aHa.nus

    KpoBH.

    (6o;r*- tr4H.qerc

    HU ABr4ra'reJILHoro HeBpoHa)
    (G12.2)

    O6rqzfr

    Maccbr

    TCJIA.

    Buoxuur,rqecroe
    uccJIeIoBaHI{e
    KpoBn: onpeAeJIeHrre KoHueH-

    Tpaqu[

    FJrroKo-

    36r, o6rqero
    6ema, anb6y-

    Cnupolrerpur
    (npu 4srxarersusrx
    HapyrxeHr4rx KoH-

    lIpH nepauvuofi rocranosxe AuarHo3a fiar]Herrra HanpaBJrrror

    rr.recrqa).

    floc;re

    rpo,rr I pa:n3
    Koncylrraqlrr:
    Bpaqa-TepaneBTa

    (rpaua

    Koncynbraur4ro

    n

    3.qpaBooxpaHeHr,rr.

    ycrauoBJreHr,rrr K;llHuqecKoro,{nafHo3a npoAoJrxaror
    HiBHaqeHr,re JreKapcTBeHHblx cpe,{cTB rro cxeMe, peKoMeHAoBaHnofi n craqraoHapHbrx yc:roBr.rJrx o6racrHofi, pecrry6ruraucrofi
    opraHn:aqufi 3ApaBooxpaHeHnr.

    o6uefi
    nparrraru), npaua- Hefiponporerropnar repan
    nyn6MoHotora,
    Bpaqa ficl,Ixrralpa-

    Ha

    o6,racrHyro, pecny6.laxaHcKyro opraHr{3arlxro

    t:

    3Tu.nMerr.r.JrruApoKcxrrr4pr4Ar.rHa

    cyKuHHaT, MeTnn3Tr4Jrnr{pr4AHHOJra ruIpOXnOpHA, rJrr,rur4H, XOJrrrHa

    a:rQocqepar,

    ru,qafpun.
    MlrHa, o6qero HapKorom, Bpaqa- Mera6orraKr,r: uenrgonufi , HaHApoJroH, r,tHo3ltH.
    6unupyGuua,
    IIclrxoTepaneBTa,
    flpo.rue cpe.qcrBa, Bnr,lrroullte Ha flrlrueBapr.rrenbHyro ctrcreMy I4
    MorreBuHbr,4pe- Apyfnx rpauefi- ugra6oluqecrc,re fipoqeccbr : Tr.roKroB:ur Kr4crora.
    xtLtHvHa,'
    creul{aulHcToB IIo JI@K, uaccax.
    }IarpuJ|,
    NOKUBAHI,I'M.
    flo noxa:anr,Lru:
    '(arvt,
    xropa, o6qero
    flpu yrvrepeHnoM r{ BBrpiDr(eHHou ncen4o6ylr6apuoru cnHrpoMe:
    KZUrbrIr4{, Onpearrrrr.qeflpeccaHrrr: $lyoxce'rr.rH, aMrlrpr4nrltJlltH, rrapoKcerr4H;
    nporr4Bogrrr{Jre[r[rrecKrre cpeAcrBa: rap6aruasenuu.
    AeJreHue aKtItBHocru AIAT,
    flpn runepcaruBarlru: arrl{.qenpeccarrrbr: aMl{tpurrrnJrr.tH.
    AcAT, K flpu ersxofi Morgore: ofiapKl{Bilrotqae cpeAcrBa: arrerr.tJrrlnsre3HMI.
    r.rH; nHfaJrruuu c MyKoJrr{TnKaMfi .
    IIpu 6oresnenHbrx MbrrrerrHbtx crr{BM:rx (rparranr.r) u Qacqr.rrylrUI{rx: nporr,rBo3[r.r.renrr,rrrecKr,te cpeAcrBa: rap6auasenun.
    flpr cnacruvecKoM cuH.qpoMe: Mr.ropeJraKcaHTbr qeHTpaJrbHoro
    fi

    AeficrBr,n: 6ax.no$eu.
    flpu lenpecculr: aHTr,rAenpeccaurrr: $lyorcerxH, aM[Tpr,{rrr{Jrr,rH,
    napoKceTuH.
    flplr 6eccounuqe u noBbrrueHuofi yroulreuocra: arrrnaenpeccaHrrt : QlyorcernH, aMr.rrpunrr,rJrr4H, rrapoKcerraH.

    JIOK. OT.

    20-30

    B parvxax na,truartasHofi noMotrlu :
    npr't BbIpaxeHHoM Hapy eHur{ rurol.aHvt, cHuxeHutt Maccbr TeJra
    na 10o/o r-rJr 14 lrHAeKce Maccbl reJra lre Hee l g Kr /u2: norca:ana ycra_
    HoBKa Ha3oracrpaJrbHoro 3oHAa uJru npoBe1eHr{e upecxoxnofi auAocKoluqccrofi facrpocroMur4 2.Jtfl ocyqecrBJreHt, 3oHAoBofo
    3HTep:ul6Horo nuraunrt qepe3 Ha3oracrpa,rruui 3oHI nJrr4 3oH,u
    BBeAeHHbrf B croMy craHlaprHbrMr,t r.r3oKaJloplqecxr.r Mu nvffa_
    TeJIbHhIM14 CMeCtMI4l
    B

    TepMr{HiurrHoh crap.uu:-

    npu 6olenou cr4HApoMe: aHaJlbrerr,tKtj-arrrr4rrrlperr,rrr,r: MeraMH3oJr
    H?{tprl , naparlEraMoJr; HIIBC: guxlo$euax, xeronpoQeu, xero_
    poJraK, MeJroKclrrarrl, u6ynpo$eH, rleJreKoxcr.r6. flpn nupaNeHuorrl
    6oresoM cr-rHApoMe n uesQtferrurHocrlr aHiulbrernron r.r IIIBC _
    onrrora.qbr: TpaMaAoJr, ruop$r.rn.

    flpra Hapyurenuu cHa cHorBopnbre

    Lt ceAarr,rBHhre cpeAcrBa: Mr{Aa_

    3onaM:

    flpu perore: aHKcr,Io;rrirl,rqecKrre cpeAcrBa: ro@usonaru,
    T

    4ua_

    3enaM; nporr.tBognrr,rerrfl4qecKr{e cpe.qcrBa:
    Qeno6ap6r,rran, rno_
    Ha3enaM.

    llpu

    6ynr6apHoM cr.tHApoMe anrr.r.4errpeccauru: Qlyoxcerru,

    aMHTpr{nTr.tJrHH, napoKceTnH; npoTrnBo3nzjrerlTr.rqecKl,re cpe.qcTBa:

    rap6aua.:enuu.

    flpu 4ucntoe u xpoHuvecrofi oAhrrlKe:
    crBa: Arra3erraM; orruor.rAbr: uopelrn
    flpu .4rxarelrnofi uelocraroqHocrr,r

    FonesHr flap- O6rqufi
    runcoua (G20).

    O6rqrlfi
    Bropuvnufi
    IIapKr.rHcoHr.I3M

    ana,rns

    KpoBx.

    KoHcylrraqlu:
    Bpaqa-ncrxrraTpa-

    aua.lua

    HapKoJrora,

    MOqA.
    EuoxttN.rr.rqecrcoe

    Apyrr4x

    IICCJIeAOBaH14e

    IIOKA3AH14'M.

    npaveficneqIIaJIHCTOB nO

    I,I

    aHKclroJrrrrnqecKr{e cpeA_

    BbrporeuHbrx

    6ylr6apnrx

    Ha panuefi (ueoc:roNnenuoft) cralnu ga6onesaHu, y Jrr,ru MoJro_ IIocrorHAofo Bo3pacra (<55 ler), He non;AraBlrrr,rx paHee JreqeHrre, Haql,r_ nrrfi npueu
    HaroT c MOHOTepa[HLI:

    JreKap-

    AofiaMuHeprfiqecKr{e cpe.qcTBa: aMaHTa.qr4H, rrpaMrrleKcojr, nupu_

    CTBCHHbIX

    6el,un.
    Ha panuefi (Heocloxsemto it) craauu:a6o,resaHu, y Jrr{rr craDrxe

    cpeAcTB

    65 ner, IIe noryqaB[rrx parrec JreqeHlje, rraquHax)T a

    {pyrue

    trl4tl:
    "o"o*o*
    aonaMHrrepFuqecKl4e CpeAcrBa: aMaHTaArrH, npaMrr[eKcoJr. nHDu_

    aereHeparuBHbre 6o-

    JIe3HLl 6a:a,rr-

    H6IX

    6egul;

    IAHIJIUEB

    (nauroreuarrlrHa3HaA HefrpoAereHepaqlUr,

    rporpeccHpy-

    rcIIIar

    HaAb-

    s.J.epllag os-

    6urupy6una,
    MOqCBI,IHhI,

    Harpv,., Karvf,
    xjropa, onpeAeJICHUC AKTI{BHO-

    cru

    ArtAT,

    TilJIbMOIIJIefut,
    cTprraToHr,r-

    AcAT.

    r-panbHiur lereHepautrc) (G23)

    Koncylrraqu-a

    3Kf.
    Bparra-

    oSralruo,rora

    (rna:Hoe

    AHo,
    ocTpoTa 3peHr,rJr,

    norr :peunr).

    npenapaTbr lIeBo.{oII6r B MaJrbrx .uo3ax:
    ;reno4ona./ xap6ra4ona,

    leno.qona/ 6encepa:ul (no noxa:anurM _ KarrcyJ,rH c uo4usuqlr_
    poBaHHhIM nrrcno6oxgeHneM, Ar{c[eprupyeurre ra6lerrra).
    flpr.r rperrlope: 6era-agpeuo6noxaropbr: nponpaHonorr; [porr.rBo_
    3rrr{JrenTr,IqecKr,re cpeAcTBa: BilJrbtrpoeBrur Kr,rcJroTa.

    no:4Hefi (ocloxHenHoii) craaur.r ra6oresaHar:
    npenaparbr JreBoAo[br c xoppexqueft gosrr (4_6 rcparHsrfi npuerra):
    reno4ona./ rap6r.rgona,
    reno.qona./ oeucepasag (no norca-:auurM _ KancyJrbr c uo4raQuqu_
    poBaHHbrM srrcso6oxAeHraeM, Alrc[eprfipyelrne ra6lerxr,r);
    .qo6asreHfie K npefiaparaM JreBo,qorrbr aorraMr,rHeprurecKr.D(
    pr.r

    cpe.qcrB: aMarrraAr,ru, npaMrrneKcolr, nupu6e4r.ur;
    cMeHa craHAapruoft @opruu Ao3r.rpoBaHr.r, JreBoAonrr ua
    {oplry c
    KoHTpoJrr.rpyeMrrlr nrrcno6oxgeHrreM rrpr4
    (KoHrIa
    SeHoueue
    Ao_
    3br) H npu Ho.rHofi awrme3vu (KoHrIa Ao3br)).

    llpu

    .qucruHe3l{rx: AonaMl.rHepruqecKr,re cpe,qcrBa: aMaHTaAr,rH,
    npaMr.rrleKcon (rro noKa3aHI4rM
    - npoJroHrr.tpoBaHHoro geftmnru),
    nupu6egun; nporr{Bor3BeHHhre cpeAcrBa r_r cpe.qcrBa, npr,rMeHre_
    Mbre npfi racrpos:oSarealrHofi pe$nrorcnofi 6olegnu: naHTorrpa_
    3OrI; IlpoTr.tBoSnr.r.Jrerrfl{lrecKr4e cpeAcTBa: BzurbllpoeBuu Kr,tcJIOTa.

    [o

    noxa":aHlun:
    IIpu ncuxoruvecrrax HapyueHr.rrx: aHTr,{rc[xorltqecKrre cpe.4crBa:
    KJIO3AII,IH. KBETI'ANI,IH.

    flpu genpeccrrr:
    [apoKceTHH.

    llpu
    MI,IH.

    aHTraAenpeccaHTbr: aMnrpr{nruJrr.rH;

    SnyorceruH;

    rorulrruuHr,rx Hapy[reHurx: Drr{qrra, AoHerrer{Jr, ralaHTa_

    23

    llpz naHroreuarxuna:sofr Heipo4ereHepaufin, nporpeccr4pyrouet Ha,UbrAepnoil oQralr,uonlrerr4pr, crprzaroHr4rparsuofi lereHepa[[u: aononHul

    eJ]6Ho Ha3HariaroT rrptr KonHttTI4BHbrx Hapy[e[apacuMnaroMnMerrrqecKl4e
    HLItx:
    cpeAcrBa: xoJILIHa alsr[ocqe-

    paT, nnr4AaKpt{H, cpeAcTBa MA netteHyrli.ueMeHu}ru: MeMaHTrrH.

    OT,IIOK.
    llpra uanuvnu nora:annft:

    ua npaue6uyro
    KoHcynbTauruo n Pecrry6.nuraucKHil Hayq Ho- nparruvecxufi qeurp
    (ganee - PHIID HeBpoJroru[ r.r neipoxupyp rlrla IJrfl pertr€Hrtn Bonpoca o xfipypnrrrecKoM JrerreHr4r4.
    HanpaBJreHr{e nauueHTa

    fenaroneHrlrO6qr.rfi ana;rur
    KynrpHrur Aere- KpoBI,I, nOACrreT

    MPT
    MO3ra.

    npaue6nyo KoHcyJrbrarlruo

    Heparyn (E83.0)

    Koucylrraqxu

    raHr.r3arlruo 3iqpaBooxp aHeHr,rr.

    KOnl4qeCTBa

    Apyrrx

    rpo116oqrror
    KpoBr,r.

    O6u1ufi ana:rlr:
    MOqI'.

    I4ccregonanue
    noxa.sareJefi

    reMocTa3a:

    aK-

    TUBT4pOBaHHO€

    qacTl{ltHoe

    TpoM6orrasruHOBOE

    BpeMc

    (garee

    ArITB),

    npo-

    poubnnoroe
    nperrlr (ganee IIB), nporpouT

    6unosrrfi

    r,rH-

    AeKC (AZrJree

    roJroBHofo

    -

    Bpacefrcleq[:rnucToB IIo
    noKa3aHI4tM.

    flpu nepnnuuoft nocranosxe

    r

    AnarHo3a rrauuerrra HanpaBJrrror Ha
    o6lacrrryro, pecrry6nnrancKyro op-

    flocro*rurrE npueu
    JreKapCTBEHHbIX

    flocle ycranoBJreHr.ur K;rr.rulrrecKoro I arHo3a npo.qonxaror cpeAcrB.
    Ha3HaqeHr,Ie JreKapcTBeHHbrx cpeAcTB rro cxeMe, peKoMeHAoBaHnofi r craqraoHapHbrx ycnoBr{rx o6lacrHofi, pecny6nuxancxoft
    opraHH3arluu 3apaBooxpaHeHr,rr.
    flpo.qolxaror Ha:lHarreHue 6agucnrrx flpeflaparoB: neHfirru.nnaMrrHa r,rJrr{ qr,ruKa cynrQa'ra.
    llpu no46ope A036r n€Hrlrr4JrJraMriHa r{.Jrr{ uuHKa cynrQara ocyxIecTBJttIoT:
    KorrrpoJrb o6qero aHaJrr{3a KpoBH u o6uero auaJru3a uovn I pa": n
    2 seg.e:lu B TeqeHr,re 2 uec,rqer, garerr,r I p:B B Mecrq B TeqeHr.re 3
    MectueB:
    KOHTpOJTb KOHrIeHrpaqUI,I qepyJronJra3Mr.rHa u MeAH B KpoBr,r.

    Blrrauransr l.r 3cceHu[ulJrbHrre Qoc(po.rrranulbr : TuaMuH, rrr,rpu.{oKcrrH, 3cceHur,rilJnnue Soctpo.rrunngu.

    flo nora:arusrl:

    flpu

    excrpanupaMr,rAHoM ctrHApoMe: aonaM[Hep 4qecxrle cpe.q-

    crBa:

    aMaHTaAr{H, npaMr4neKcoJr, nnpu6eputt,

    JreBoAo-

    nTW,

    MexayHapo.qHoe HopM:IJI}I3OBAHHOE
    OTHOlxCHHC

    (aa,'ree

    -

    MHO),

    Qn6pr.ruoren,
    feMaToKpIlT
    Euoxr,lnaa.recroe
    I{CCJIeAOBaHI{e

    KpoBrr: onpeleJreHI{e KOHqeH-

    Tpaquu DIroKo3hr, o6uero
    6enxa, 6r.rnrpy-

    6uua,

    MoqeBr.r-

    HbI, Ha'rpnr, Karvt,
    xJlopa,
    onpeAeJreHr,re
    AKTI{BHOCTI,I

    A.rrAT,AcAT.

    9Kf.

    Y3I,I

    opraHoB
    Iro-

    6prorunofi
    ,TIOCTI,I.

    Koncynmaqur
    Bpaqa-

    ot[ralrruolora

    (masHoe
    ocTpoTa

    IroJIt

    AHo,

    3pe'ln'j
    3peHlrt,

    KoJrbrlo Kaii:e-

    na/ rap6u gona, leno4oua.i6eucepa3ul.

    lueta c flcrn]oqeHr.reM
    roQe, 6o6onue, opext4,

    6orarrrx preAr,ro (urorona4,
    rpu6rr, neueur il gpyrue).
    npoAyKToB,

    KoHcy,rrraqran
    Bpaqa-

    repanenra (npava o6rqefi npaxrurrz).
    K:rouuqecrufi
    relru(paqualr-

    O6ullrfi

    ana,rrc

    3HMf u Hro;rrrra- flpu nepruvHofi nocraHosxe
    raq

    KpoBr.r.

    3HMf.

    O6rqufi aua,rn: 33f.

    Y31,1

    MOqI{.

    Buoxl.tuuqecxoe
    r,rccJreAoBaHr,re

    KpoBr,r: onpeAe-

    JIeHI{e

    KOHUeH-

    Tpaqu[

    3br,

    HrroKo-

    rpeqepe6pa.nrHux cocy-

    nuarHo3a rralrreHTa Ha.rpaerr*or Ha flocrosHapave6uyro KoHcyJrbrar1urc r o6,'racrryro, pecny6luraHcKyro op_ nufi
    nprelr
    raH 3aquro 3ApaBooxpaHeHur.
    neKap-

    llocle

    ycrauoBJreHr,rr K;rnHr4qecKoro Ar,rarHo3a upoAoJrxaror
    AOB.
    Ha3HaqeHlle JreKapcTBeHHbrx cpeIcTB rro cxeMe, peKoMeHAOBaH_
    Tpaucrpauualrnar nofi n crar-luoHapHbtx ycJroBrrrx o6,racrnoft, pecny6lurancxofi

    golnleporpa$aa
    (ga,ree -

    TKI|).

    o6uero

    6ema,

    o6rqero
    6utrupy6uua,

    CTBEHHbIX

    cpeacTB.

    opraHr43aul4rr 3.qpaBooxpaHeHr,rr.

    Muopenaxcarrnr rleHlpzurbHoro gefi crnux: 6arno6en.
    flpornnoenulerrrr,rqecKr4e cpeAcrBa: rap6arrlarenuH, MoHa3enaM.
    llplr orcyrcrnnu sS(perra naqt,terrra HarrpaBlutor Ha rpaue6uyo
    KoHcyJlbraqrxo r o6lacrHyro opraHll3arlulo 3.qpaBooxpaHeHr,H.

    MOqEBI{HbI,

    Ha:fpvt, Kurufl,
    xjropa, oflpe.qeJIEHUC AKTI.IBHO-

    sru

    ArrAT,
    AcAT.
    KoHcylrraqur
    BpaqaTeparreBTa.

    fiucrouut
    (G24)

    O6rul,tft

    aHarras

    KpoBr,r.

    O6rqufi anarfi:
    MOqI4.

    KoHcylrraqru
    Bpaqa-Tepa[eBTa

    (npa.ra

    o6rqeI

    llpr lepruuuoii

    nocrasonre Ar{arHo3a naurreHTa narpaurrror;
    npaue6nyro KoHcynbrarruro n o6,lacrnyro, pecny6luraucKylo op_

    flocrosH-

    Hrrfi tpueu
    JreKapCTBEHHBIX

    26

    Fuoxulragecxoc

    flocne ycrauoBJlellut Knl4Hr4qecKofo Ar.rafHo3a rrpoAoJrxalor

    IrccJteAoBaHrre

    IIo cxeMe, peKOMeHAOBaHcrauuoHapHbrx ycnoBr,rrx o6aacrHoil, pecny6,ruraucroii
    opfaHv 3arlr4 H 3apaBooxpaHeHur.
    flpn roHfiqecroM fr4rrepKrrHe3e: rrporrrBonapri4HcoHr4qecKr4e
    cpeAcrBa: aHTnxonr{Heprr4qecrr4e cpeAcrBa rleHTpanbHoro aeitcrBuJr: Tpr.reKcaSeuu4un; MHopeJraKcar{TH rreHTpiurbHoro Aeficrru.r: 6axnoSeH.
    flpn x;lounvecKoM rr{nepKr.rHe3e: rrporr.rBogrrr4Jre[TnqecKr,re cpeAcrBa: BaJrbnpoeBar Klrc;rora, xap6aua:enuu, KJroHa3erraM.
    IIpu L-DOPA qyBcrBr{reJrbHofi Qoprue: .uofiaMr{HepFuqecKr,re
    Ha3Har{eHr4e J.leKapcTBeHHbIx cpeAcTB

    nofi e

    KpoBH: OrrpeAeJIEHHE KOHIICHTpar\uvl nrroKo-

    3br,

    o6uero

    6erxa,

    o6ulero
    6ustupy6uua,

    MOqEBI,IHbI,

    HATpLls, Karnl',
    xJIOpa, oflpele-

    cpeAcrBa: renogona/rap6r.rAorra, JreBo4ona./6encepa.:n4; rrporr.rBognni'rerrruqecKrre cpeAcrBa: BIIJIbnpoeBar Kr,{clrora, rap6aua.:enun.
    flpu renepa.nugoeaHHoft ArrcroHr4r.l: aHTr4nc[xorr,rqecKne cpeAcrBa: KJro3arrltH, riurofleprlon, cyJrbnr,rpu.q, pficneprnoH; 6eraaApeHo6roKaroprr: flponpanonoJr.

    JICHITC AKTI,IBHO-

    cru

    cpeAcrB.

    ArrAT,

    AcAT.
    Koucynrraqu.a
    Bpaqa-

    repaneara (rpava o6u1efi npar-

    OT, JIOK, ncrxorepanur.

    flpu pearrax r{ cJro)r(Hbrx na.qax SoralrHofi uurueqsofr Ar,rcroHur,r,
    orcyrcrBr.rr sQQerra or MeAr{KaMe}rro3Horo JleqeHlls Ha o6lacr-

    TLrKr{).

    HoM ypoBHe Ha3Haqalor: Mr{opeJraKcaHTrr nepuQepuuecxoro Aefi-

    crrzr: 6orylmorcraH A.

    flpr.r narnuun noraeauufi: HanpaBJreHrie [auueHTa Ha KoHcyJrbrarlriro Bpaqa-HeBpoirora u uefipoxl.rpypra g PHftrI HeBpoJroruu fi
    uefpoxlrpyprur{ AJrr pe reHr,rrr Bonpoca o xupyprrqecKoM JreqeHI,tt.

    O6ufifi

    oKcrpanHpaMr.lAHbre r.r

    KpoBr{.

    ABr,rraTeJlbHbIe

    O6qrfi

    .{pyrue

    ananus
    ananraa

    napyureuux (sc- MOqI4.
    celrulta,rrHrti
    Euoxr,rMr,r.recroe
    (G25)
    uccJIeAoBaHHe
    meuop)

    Eraoxravuqecroe
    lrccneAoBaHue
    KpoBr.r
    onpeAeJreHUe ropMoHoB UIHToBr,rAHoi xeJre3br.
    Y3I4
    opraHoB

    :

    Be'ra-a4peHo6noKaropbr: [ponpaHoJroJr.
    flporueoenurerrrr4qecKr{e cpeAcrBa: Tou,rpaMar.
    Hefiponporerropuar repafifir: 3Tr,tJrMeranruApoxcr{nr{pr.ra],rHa
    CYKIII{HAT, IIIqI,IH.

    OT. Ilcuxorepanur.
    flpu unaarrnrl:lrpyrculeM TpeMope: nporlrBo3nr{JrenrnrrecKre

    flocrocH-

    Hnfi rpueu
    JreKapCTBEHHhIX

    cpeAcTB.

    27

    KpoBx: olpeAe- bpnuruofi noJroJIeHr.Ie KOHrleH- cru. Y3I4 qrnoTparlnr4 fJtloKo- euAHoi xeJle36l
    o6uefo KoHcy;rraqn.n

    3r,r,

    6e,rra, o6uero

    Bpaqa-TepaneBTa

    6unupy6uua,

    (rpava
    o6uei
    nparrurxlr), Apyrrx
    npaveficnequiu[4cToB rro
    noKa3aHttM.

    MOqEBI,IH6I,

    Hdrpu'., KaJInfi.,
    xjropa, onpeleJIEHI4C AI(TI,IBHO-

    srrt

    cpelcTBa: TOnUpaMaT.
    Ilpu uar'uuuu nora:asnfi : HanpaBreHue nauu eHTa Ha KOHCynbTauuro Bpaqa-HeBponora z uefipoxupypra n PHIIIJ HeBporrorrn r.r
    Heiipoxnpypruu Anr pelreHr.rr Boflpoca o x[pypnr4rrecKoM reqeHI4TI.

    AIAT,

    AcAT.

    3Kf.
    3xo3C.
    Koncyrtrraqrar
    Bpaqa-

    oQranrruolora

    (ua.:Hoe

    AHo,

    ocTpoTa 3peHHr,
    nonr apenr.u).

    Cr.trr.qpolr (
    O6qufi anallr: Koncylrraqu.r

    II,t UHOTO qeJIO-

    xpoBr{.

    rero

    (G25.8)

    O6uufi

    Bpaqa-oHKoJrofa.
    aHanlrs

    MOrII,I.

    Koucylrraquu

    Apyrux

    Fuoxnvuqecxoe

    Bpa.reficfleqlralJll,tcToB IIO

    HCCJreAOBaHr,re

    IIOKA3AHI,I'M

    KpoBr.r: onpeAeJIEHI,IE KOHIIEHTpauxu rurroKoo6rqero
    6ema, o6ruero

    3Er,

    .

    IIpu uepnuvnofi

    gr,rarnocrr,rre rauueHTa HarrpaBnrror s
    nyro, pecrry6nr.rKaHcKyro opraHH3arluro 3ApaBooxpaHenr,rr.

    o6ricr- flocro-{H-

    nufi

    uplrev

    JreKap-

    flocle

    yc, anoBJIeHI,tr K,'rr,rHrrrrecKoro Al,rarHo3a npoAoJrxiuor CTBEHHhIX
    Ha3HaqeHr,te cpeAcrB rro cxeMe, peKoMeHAoBaHuofi n craquonap_ cpeIcTB.
    Hbrx ycJroB[rx o6lacruoft, pecrry6.nuraucxofi opraur:aqw 31pa_
    BOOXpaHeHr.r'r :

    aHKcr4oJrr.trl,rqecKr,re cpe.ucrBa: Alra3enaM, roensonau;
    npoTr4Bo3nHn€rTn{qecK}re cpeAcTBa: KJrOHa3enaM;

    MnopeJraKcaHTrr rleHTpanbHoro 1efi
    fJpra orcyrcrnr.l u r60erra:

    crnur: 6arno$eH, ToJrnepu3oH.

    28

    6utupy6uua,

    1 nloKoKopTlrKorl 4br l\nu cr{cTeMHot-o lpuMeHeHur BHyTpUBeHI{O
    (lrerulnpe4ur.r:lo:roH) r4lru nepop:rJrbHo (lreru:rnpe4nu:o,ron,
    npe4Hueo.roH) c KoppeKropaMrz - npe[aparauu xa,rur (xalru
    xjropna, KoN tneKcHbrMr{ npenapaTaMu, coAepxauzMr{ r,roHbl Ka_
    nr4t u Marrus), xa;rrafic6eperarcxlr,rMr4 At4yperr4r(aMn (cnuponorarroH) r{ cpeAcrBaMu gru npo$unarruKu racrponarr{ u (uuru6uTopbr nporoHHoii nolrnu: oMenpa3on, narronpa:oa) (aanee -

    MOqCBHHI;I,

    HA'rpt4A,

    KaJrMq)

    xropa, o6uero
    KaJlbrlur, MafHr.rr, onpeAeneHUC AKTI,IBHOCTI,I

    A.nAT, AcAT

    |CII).

    3Kf.
    3xo3C.
    Koncynrraqua
    Bpaqa-

    o(lrarrruo.nora

    (ruasuoe

    AHo,

    ocTpoTa 3pellu'.,

    rroJrr

    speHr.re).

    Koncymraqlu
    Bpaqa-

    repanenra (npava o6qei npaxrr.lxu).

    Eoreeur Alrq- O6rquft
    refiuepa (G30)

    flpn

    nepuavHoft gr.rarnocrure narIHeHTa HarrpaBnrlor s o6racrnyro, pecny6luKaHcKyro opraHu3aur{rc 3ApaBooxpaHeHur.
    O6rqufi ana;rur KpoBr.r: oflpeAene- flpogorxaror Ha3HarreHr{e JreKapcrBeHHbrx cpeAcrB no cxeMe, peMOqI{.
    HI{e ropMoHoB rqu- KoMeHAoBaHHofi r craqrouapHbrx ycJroBnrx o6lacrnofi opraHr,rBzoxrrr,l.rqecxoe ronugHofi ,(eJre3br, 3arlr{x 3ApaBooxpaHeHr,rJr:
    HCCJIeAOBaHUe
    C-pearrunHoro
    flpn xoruarueHhrx HapyrneHurx: HefiponporexTopHar repa ut:
    KpoBr4: onpeAe- 6erxa.
    HUrIepfoJ[rH, Br,IHIrOrIeTr,rH, rJrHrIr,rH; [apacxMnaToM MeTr,rqecKr{e
    JIEHI{C KOHIIEH- Cepororravecrue
    cpe.qcrBa: xoJlr4ua alrQocrlepar, AoHene3r,rJr, MeMaHTrrH, r4rrr{IaTpar\Lru rJlroKo- uccJreAoBaHuir Ha Kpr,rH, raJraHTaMr,rH.
    36r, o6rqero Br.rpyc r,rMMyHoIe- flo noxagaHprqM:
    KpoBr,r.

    ananr.rs

    Euoxl,ltrraqecxoe
    nccJreAoBaHr{e

    flocrorH-

    nrrfr

    npueru

    JreKapCTBCHHbIX

    cpeAcTB.

    6crra"

    o6ureno

    6uuupy6uua,

    Qr.rqura qeJloBeKa llpu rrcrzxoruvecKr,rx HapytlreIl]lrx: aHr.nncuxort{qecKr4c cpeAcrBa:
    (aanee - BI4q), KBCTLIallHH, KJr03anI,|H, XJIOpnpoTr4KceH.
    cu$r.r,ruc, 6oppe- llpra 4enpeccun: aHT AenpeccaHrn: S.nyorcernH, aMr.rrp[nrr4Jrr.tH,

    MOqeBuHbl, KpeaTAHnHa,
    nHo3.
    fiaTpnr, Kurvtfi, Koncy,uraquu
    xJropa, onpeaenpauefrJICHHE AKTI,IBHO- cIeur4:IJrr,rcToB lto

    Apyrfix

    c:rvt AIAT,
    AcAT
    PeurreHorpa-

    Qnr

    opFaHoB

    rpyaHofi

    KrreT-

    KI,I.

    3Kt.

    KT /MPT roJIOBHOTO MO3-

    ra.***

    Y3l'I

    qr.r'rorug-

    uofr xelegrr.

    33f.
    KoHcylmaqu-r
    Bpar{a-

    oQralruolora

    (oc'rpora 3peHVI', rJIa3HOe
    .qHo).

    KoHcyarraqu.r
    Bpaqa-

    repanenra (npava o6rqefi npaxKoHcvmrauHq

    noKa3aHl,ttM.

    napoKceTr.tH.

    flpu cyaopoxuoM
    rap6arva.:enuH.

    J]OK.

    cr,tHApoMe: nporr4Bosnr{ren.ruqecKr4e cpeAcrBa:

    Pacce-slrHufi
    cx.nepoa (G35)
    (ae6ror,
    o6ocrpenue,
    I]porpeIHeHTnoe reveHne).

    O6qni

    ana.nu:

    KpoB14.

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    ca.

    Koncy.rrraqlu
    BpaqaoToprrHonapr4HroJrora.

    Koncyrlraqu-e
    BpaqacToMaToJrora.

    Koncylrtaqnr
    Bpaqa-

    oQramruorora
    IHo,

    (uasnoe

    oc'rpoTa 3peHnr,
    non-r spenu-n).

    flopaxenue

    O6rquft

    JrurleBoro HepBa

    MOqI{.

    (G5l)

    Euoxlrlruqecxoe

    ana.,rug

    I,Icc,'reAosaHue

    rponu xa Jlafiu6oppenuor, cu-

    fCfI:

    rr.rernnnpeAHn3oJroH, npeAHr{3oJroH naperrrepiurbHo r.rJrr.r
    Br{y'rpb c KoppercropaMr.r.
    llporunonupycHbre cpeAcrBa flprMoro Aeficrsfir: aULrKJIoBr.rp, Ba-

    cTeMHyo KpacHyro naqr,rKJroBr4p.
    KpoBn: oflpeae- BorqaHKy (,qa:ree - MoqeroHHue cpeAcrBa: Qypoceuua.
    IeHr4e KOHTIeH- CKB), cu(punuc, fleprzSepuvecrrre Ba3o.qr4rararop6r: nelr-roKcr.r(prurnr.rn, HrrqeproTpaqrrr.r FJrrcKo- ry6epxyres, BlI9. JIIIH.
    36r, o6rqero KT r.r.rru MPT ro- HefiponporerropHiur repanr,rJr: rurrqr{H.
    I,ICCJIe,qoBaIrI4e

    8-20

    43

    6e,rra, o6ueno noBHoro rto3fa** * flapacuunarovuMerr{qecKl4e cpeacrBa (npn orcy'rctnull
    KaJW'q>

    xrropa, AIAT,

    HeBpIIHOMbI JrI4Ue-

    AcAT.
    KoHcy.nrraqul:

    BOrO HepBa, rtoMycHofi onyxo;rli,

    flo noraraHuqr{:
    flpu yrpore pa3Bvrvts KoH'IpaKrypbt

    BpaqaoTopI.rHonapI.rH-

    MeHLIHIIIOMLI, CapKOMbI, IIIBAHHOMI,I,

    roJIora,

    3JIOKAqECTBEHHOTO

    Bpaqa-

    noaoo6pasonauru

    otfra.nruorora

    CJIIOHHbIX XCJIE3 I,t

    nporr,rBognHnenrl,rllecKue cpeAcrBa: rap6alla:enlH; MI'ropeJraKcaHTbr qeHTpaJuroro Aeiic'reut: 6auoQen, ToJrnepI'I3oH.
    OT, JIOK.
    flpn orcyrcrrura eQ(lerra: nautieHT HarpaBrterct s o6nacrHyro
    opraHll3allurc 3.qpaBooxpaHeHur, PHIIII HeBpoJrorHI'I r'r nefipoxltpypruu Ant yroqHeHlrt AI{arHo3a r{ KoppeKrII'Iu JIeqeH[t.

    MOqeBrrHbl,

    HATpLrg,

    (rra:Hoe
    ocTpora

    nort
    nJleqeBoro
    oIIJ|eTeHus

    (Gs4.o)

    KoHTpar(rypbr Mr{Mr{qecKl4x lrrturq) veper 4 HeAerI{ or HaqaJra 3a6oresaHfiq: fJlI{qI,IH, Heocrl4rMtrH, xoJIHHa anr$ocqepar, unu4a-

    ucKrlol{eHnt
    '.nfl
    Honoo6pa:onaHufi
    (xorecrearousr,

    6utrupy6uua,

    flopaxenue

    yrpo3bl

    AHo,

    gpyroro).

    KprrH.

    MI4MI'IqecKax MI'Ilxq:

    3peHr,IJl,

    spenr.rx).

    fCfI:

    ruerurnpeAHlt3oJloH, npeAHI't3oJroH napeHTepiurbHo Itnn
    rpouu na Jlafiu- Bnyrpb c KoppeKTopaMr.r flpu l,IAllonarl{rlecroft, gua6errfiecrofi
    KpoBI4.
    O6rquft aHarlas 6oppenr,ror, penua- rrJreKcorrarr,ru, rrJreKcorlarr,lu npu cficTeMHblx BacKyJII{Tax.
    TOJIOTHqECKI,IE 3A- Arru6uoruror eparrur rrpv JIafi na-6oppenuose: qeQrpuaxcon;
    MO!{U.
    Blroxuuprqecroe 6oresaHnt. KT rrporr.rBoBr.rpyc HM Tepa vs rIpH Br{pycax Herpes simplex I u 2
    u,rr.r MPT urefinoro Tr.rnoB, Br{pyce Varicella zoster, Bnpyce 3nurreftna-Eapp n ul'rroI,ICCJIEAOBAHI,IC
    KpoBr.r: onpeA€- oTAeJra rro3BoHoq- MeftInoBnpyce : auu KJToBI{p.
    neHHe KoHIIeH- HI,IKa***, nrerleBo- flepr.r(pepuvecxr.re Ba3oAl{Jrararopbt: nelrroKcl'tQu;tnlltt, KcarrrnHoJra HuKoTr,rHar, Hr.tueproJrr{H.
    Tpaqmr rJ oKo- rO CIUIETCHIUI.
    3H, o6uero KT opraHor rpya- flocne xypca fCfI:
    HefrponporercropHat repanruI: 3TI{rMerI{Jrn'I,qpoKcI'InupxAI'IHa
    6erra, o6uero sofi x;rgrKI,I* * *.
    cyKrIuHaT, MeTITJI3TI'IJrII4pI,I.qIIHOJIa fI,IApOXnOpfi.q;
    3HMf.
    6ustupy6una,
    napacuMrraToMl4MeTuqecKI,Ie cpeAcTBa HeocTI,IfMlrH, I'InI'IAaKpr{H.
    Koucymraquu
    MOqEBI'HbI,
    rpaueft- flo norasaHn Nr:
    Harpl4t, KarJrrrt,
    xnopa, KOK, cleullaJll,tcroB rlo flplr neftponau4qecKoM 6oresoru cltH,4poMe: HIIBC npolonrupoBaHHoFo Aefrcrsut LIJII4 nporHBopeBMarllqecKl{e cpeAcrnQ Q vq&
    noKa3aHl,rcM.
    A;rAT, AcAT.

    O6rqr.rfi

    aHa.nra:

    I,IccreAosanLIe

    Ipyrux

    l2-25

    44

    PenrreHorpaQur ruefinoro

    IeHHbrM BbICBOOOXAeHTTeM: AI.IKJIO(peHaK, I,IH,qOMeTaqHH, KeTOnpo(peu; KeroponaK, rlenexoxcu6; nporlrBofnrl;renrnqecKre cpeAcma: xap6auaselnH, ra6aneHruH, npera6alr.rH; aHTr,rAenpeccaHTbr : aMlrrpunrunun, QlyorceruH, rrapoKcerr{H.
    OT. JIOK. MexaHorepannr.
    flpu orcyrcrarau s$Serra or npoBoluMoit repanuu npr4 HerpaBMarr,rsecKoM reH$e ga6oreBaHur [au errra HanpaBnrlor Ha Bpar{e6Hyro KoHcyJrbrarlurc n o6,racrHyrc opraur{3arlno 3.rlpaBooxpanenu.r, PHfII] HeBpoJrorur4 u Hefipoxrapyp ruvt Me yroqHenr.rr Ar4arHo3a u KoppeKrlr{x JreqeHnr.
    IIpu rpannraruqecKoM renege ga6oaeBaur{Jr npfi Bbrp,DKeHHoM
    ABI4rareJrbHoM Aeihurlr4Te naquerrra HarrpaBJrrror na npave6rryro
    KoHcyJrbrarlr4ro r PHIII-I HeBpoJrorr{r{ n Hefipoxr.rpyp rurr Mt perneHr.rJr Bonpoca o x[pypruqecKoM JreqeHnr{.

    oTAeJra IIO3BOHOTIHIIKa, KO-

    crefi n,reqesoro
    Irotca.

    flopaxenue
    'CHI{IIHO-

    O6u1ufi ana,rus 3HMf.
    fCfI: rr.rerrurnpeAuu3onoH, npelHrr3onoH laperrrepanbHo nnrl
    KpoBn.
    V3LI opranon ua- Blqrrpb c KoppeKropaMu npu li.qrrotraruuecroft, 4.ra6eru.recrofi

    KpecrrloBoro

    O6ulllft

    cnlereHr{t
    (Gs4.1)

    MOqLt.

    aHanug

    Bu oxurr,ruqecxoe
    r,rccJIeAoBaHr4e

    KpoBr.r: oflpeAe-

    JIeHUe

    KOHTIeH-

    TpaIIU[

    FJIOKO-

    3br,

    o6qero

    6erra, o6qero
    5unupy6uua,
    MOIICBI,IHhI,

    HairpAA,

    xrropa,

    l(alrt'j
    K@K,

    A,rAT, AoAT.
    Penrreuorpa-

    rrJreKcoflaTnrr, ruleKcorraTHl{ rlpu cugf€MHbrx BacKyJIr,ITax.
    opraHoB Asryr6uorurorepanur rrpx JIafi rr,r-6oppenraose: qe@rpuarcon;
    6prourHofi noJro- nporr,rBoBr{pycHat repanvfl npr.r Bupycax Herpes simplex u 2
    CTI{.
    Tr.rnoB, Br4pyce Varicella zoster, Bupyce 3nnnefina-Bapp fi qr{To6prcunroro MerirnoBl4pyce: auHKJroBHp.
    oTlena aopTbr co- flepuQeprauecrr.re Bir3oAr.r,Jrararopn: nerrorcraQrurJrr.rH, KcaHTHHocyAoB Hr{xHr.rx Ko- Jra HrrKoTr,rHaT, Hl,tueproJrr{H.
    ueqnoctefi.
    flo noraganu-ffrlr:
    I4ccreAosanne
    flpu nefiponarnqecKoM 6oresoM cHHApoMe: HIIBC npononrupoKpoBr.r Ha [ICA.
    BaHHoro geEcreru r,rJrra nporr,rBopeBMar[qecKue cpeAcrBa c MeAKT uru MPT no- JreHHbrM B[,IcBo6oxq{eHr.reu: gurc,roQeuaK, rnHAoMera(r.lH, KerotcHr{qHonpoQeu, KeropoJlar, qelexorcu6; nporr,rBo?nrfienrlqecKue cpeAKpecTqoBoro oTAe- crna: rap6aua-rennu, ra6anenrnu, npera6aluH; ar{Tvaerrpeccaura no3BoHoqHln- Tbr: aMr{rpuml,urun, QnyorceruH, napoKcerr{H.
    Ka* * *flapaclrunarourlMerrltre cKfie cpeAcrBa: Heocrr,{t-Mr,tH, I{nr.raaKpr.rH.
    JIOrO Ta3a.

    Y3I4

    I

    Y3I4

    t2-25

    45

    opraHoB (DT, JIOK, MexaHorepanrr.
    Qur rcocrei ra- KT
    ra, ra:o6egpeu- 6prourHoi noJro- llpu orcyrcrnull 3OQeKra or [poBoAI4Mo i,r repartuu ltpn HerpaBHr,rx cycTaBoB, cru* * *.
    Marr.{qecKoM rene3e :a6oleBaHI4JI flaul4eHT HanpaBJltercg s o6IIO'CHIIqHOKT opraHon uzuro- Jracrnyro opraHu3auurc 34paBooxpaHeHur, PHIII HeBpoJrorr4r4 r.r
    KpecTrloBoro
    oTAeJra lro3Bo-

    fo ta3a*+*.
    Koucynrraquu

    HOqH'IKA.

    apyrr4x

    Bpaqexcnerlr4:rnlcToB rlo

    ueftpoxupypruri AJrr yroqHeHIlt AxarHo3a r{ KoppeKqr4r4 JreqeHr,rr.
    flpu rpanrr.rarnqecKoM reHege sa6oresaHr,rr naquelrr HanpaBrrercs

    Ha npaue6Hyro KoHcyJrbrauruo r PHIIII HeBpoJrorufi u Hefiporurpyprr{r4 AJrr pemeHtrr Bonpoca o nefipoxupypr[rrecKoM JreqeHr{rz.

    NOKA3AHI4'IM.

    Er.roxrlrr,rraqecroe

    MOTIeBI{Hbr,

    poKceTrrH.

    HaTpI,rJt, KilnI,It,

    Sarrop.

    OT. JIOK, MexaHorepannr.
    flpu orcyrcrwrn 300eKra or npoBoluMofr tepanuu npn HerpaBMarr.rqecKoM renege ga6oneBaHr,rr [aqrreHT nanpamrercr r o6nacrHyro opraHr43aurto 3.qpaBooxpaHeHuc, PHIIU HeBpoJror[rr u
    uefipoxr,rpyprur.r Anr )"ToqHeHlrr Ar.rarHo3a 14 Koppexul,rlr JleqeHwi.

    O6ur-rfi anarfis gHMf,

    fCfI:

    O6ur.rfi

    cKrur

    KpoB[.

    aMr{oTpo-

    Qur (Gsa.s)

    fCII:

    rue'rrurnpeaHu3onoH IrIt clrcreMHoro [pr.rMeHeHur*, c nocJreAyrorqnM nepexoAoM Ha MeTlrnnpealrr{3oiroH, npeAHrr3oJroH
    Blry'rpb.
    MoqeroHHue cpeAcrBa: t[ypocerr,rr,rg.
    flapacuunarorr,rrrMsrr.rqecKr,re cpeAcrBa: Heocr[rMr,rn, r{nI,IAaIpLrH.

    Henparruve-

    anaJrlrs

    O6qufi anarln
    MOqI,I.

    3HMf.
    KoHcy.nrraqu-e
    Bpaqa-TepaneBTa

    (npava

    o6ueft

    15-30

    flpaKruKnr.
    flo noragaHu.trr.r:
    HCCJIEAOBTIHI,I€
    KoHcylr,raqr.ru
    KpoBr.r: onpeAe- ApyrEx Bparrer- flpu neftponarrvecron 6oresoM cr.rHApoM€: HIIBC npononnapoJICHI,IE KOHIIEH- cneul,I:ulucToB IIo BariHoro Aefisrsnr nnu flporr,rBopeBMarnqecKr{e cpeAcrBa c Me.uTPiuIUr,r DrroKo- NOKA3AHI'I'M .
    JreEHbrM srrcno6orq(eHueu: gr,rx;ro(penaK, rlHAoMerarlnu, Keroponar, reronpoQeH, rleJreKoKcr{6;
    3Br, o6uero
    6ema, o6qero
    nporr,rBo3rrr,rJrerrrr,rrecKr{e cpeAcrBa: Kap6aMa3e[r.rH, ra6aneHrun,
    npera6aruu; aHTr.r.[enpeccaHTbr: aMl,trpunrrrnfiH, Qlyorceruu, na6mupy6uu4

    xrropa, AIAT,

    AoAT, KOK,
    CPE, peBMoMoHoHenponaTvrr.r nepxHefi

    Peurrenorpa(pur

    KpoBr,r.

    KOHCqHOCTI,I

    O6uufi

    (G56).

    MOqI{.

    anarug

    urefinoro

    or.qeJra
    no3BoHoqHLtKa, cy-

    nrernrnpeAHlr3oJroH, [peAuu3onoH napeHTep:urbHo r{Jrr.r
    BHyrpb c KoppeKTopaMrr.
    MoqeroHHne cpeAcrBa: $ypocerrrng.
    fleputbepnqecrlre Ba3oAr,rJrararopr,r: rreHToKcr{du.nnrn, KcaHTr4Ho-

    l0-20

    46

    MoHoHenpona'turt Hr.l)(Hefi
    KOHCTIHOCTI'

    (G57)

    6uoxnlruqecroe

    craBoB

    r4ccneAoBaHrre

    KOHEqHOCTI,I.

    KpoBr,r: onpeAeJreHr,re KoHqeHTpaqnu fJrloKo-

    xeJre3bI.
    PenrreHorpaQrax

    BepxHet

    V3l4 uuroelraHofi

    3hI,

    JIa HI,IKOTI4HaT, HUUepfolrrlH.

    Ilapacrarr narouuMernqecKrre cpeAcrBa HeocrurMIrH, I{nnaaKpr{H.
    Mera6o,uxr,r : lrerugonuil.

    flo

    nora":aHr,rsN,r:

    flpv

    Hefiponarfi qecKoM 6o.nesor4 cr.tHlpoMe: rrporlrBo3rrr4rerrurrecxr,re cpeAcrna: xap6auasenun, ra6anerrrlru, npera6alu u; aHrraAelrpeccaHTrr: aMHTp14fiTrrnlrH, QnyorceruH, napoKcer].tH.

    o6uero NO,'ICHI,ItIHO6ema, o6uero KpecTuoBoro oTA€6*rrupy6uua,
    JIA TIO3BOHOqHI'KA, OT, JIOK, MexaHoreparrr.
    MOrreBuHhI,
    Kocrefi Ta3a, cy- fmororopruxoLr4br AJts, neqe6urrx 6lorag:

    Hatprrl, KurIl'{, craBoB HzxHefi

    xrropa,

    Merr4Jr[peAHr.r3oJroH,

    AeKCaMeTa3OH.

    KOK, KOHEqHOCTI4.
    OT. JIOK. MexaHorepanlu.
    A;IAT, AcAT.
    V3I4 opranon ua- flpu rynnelrubrx cHHApoMax (cuHlportl KapnurbHoro KaHirna, KyJroro TiBa, opraHoB 6rra.nrsoro xaua;ra) [pr.r Bbrp KeHHoru peSparrepnoru Heipona6pnuruofi fiolro- TI,rsecKoM 6onesoM cr.rHApoMe r.r BbIpalKeHHoM ABrrra r.eJrbHoM AeCTI,T.
    Ququle naqueHT HanpaBnrercr na npave6nyro KoHcyJrrTarrlrro B
    KoHcyrur:aquu
    PHIIIf Henpol orlrfll rr Heftpoxrpypnax AJrr peureHr.rrr Bonpoca o

    apyrxx

    apauefi- K{pypraqecKoM JreqeHl,tu.
    cnequiuucToB rlo
    NOKt|3AHI,I'M.

    HacnegcrnenHlur r,r HII{oIIa-

    O6uquft ana:rus 3HMI.
    KpoBx.

    flepr.r(feprvecxxe Ba3oAr.rJrararopn: nerroxcuQrurJrlrH,

    Y3LI quronraguofi

    JIA HI,IKOTHHAT, IIUqEPTOJI I,IH.

    )I(eJIe3hI.

    HefiponporerropHar repaurur:

    KcaHTr.rHo-

    TI{qCCK{UI

    O6qrfi

    HeBponaTr,rt

    MOqI,I.

    (c60)

    Eroxr.rnruqecxoe

    6pronuofi

    uccJre,[oBaH14e

    CTI{.

    KpoBr.r: onpeAeJIEHI,IC KOHIIEH-

    Koncy,rrraqr,rr
    Bpaqa-

    3Tr{JrMerr4Jrrr.tApoKcr{r pnAr.rHa
    cyKrlr,rHaT, MeTr.r.Jr9TI4JInHpnAr,rHOJIa rfi lpoxJropu.{.
    flpu xpouuvecxou neipona:rrrecKoM 6oresorr,r cuH,{poMe: npoTtlBo3nr4Jrenrr,rqecKr,re cpe.ucrBa: rap6aua:enr,rH, ra6auenmn, npera6atuu; aHTxgerrpeccaHThr: aMr{Tpr{nrr,rJrun, @lyorcerun, napoKceTr4H.

    Tparlr4n rurroKo36r> o6rqero

    o$ramuolora

    OT. nOK, MexaHorepanr.ut.

    ananr.la

    Y3I4

    (masuoe

    6enra, o6uero osrpoTa
    6unupy6una,

    opraHoB
    noJro-

    rroJrr

    AHo,
    3peHr{r,

    gpenus).

    .II.lrr.nenrHOCTb JleqeHI,I' 3ABIICI{T

    OT KJII,THI,IqecKofr ctrTya\vu.

    47

    Bocnall.rrenr-

    MOqCBIZHbI,

    KOHCyJrr,Taqut

    Hafpt4'{,

    Bpaqa-

    Kanvg.,

    xnopa,

    KOK,
    A.nAT, AcAT.

    3HAOKpr4HOJrOra.

    06nlrafi

    Y3I4

    ana.,rus

    Htu nonl,fHeBpo- KpoB14.
    narur (G6l ).
    O6qufi anarus
    MOqIl.

    Ocrpar

    BocnaJII,MCJIbHtUI IIOJrr,rHeBpoflaTr,rrr

    (G61.0).

    EHoxr,rMr,r.recxoe

    llpu

    CTII.

    nogospeul4r't Ha ocrpylo BocnaJrr,rreJrbHyro nonxueBporrarr4K)
    ercr:peunnft [epeBoA n o6lacrnyro opfaHu3aqrrrc 3ApaBooxpaHerrvt IJt npoBeAeHr.rr naroreHerr{qecrofi repanuu.

    PerrrreHorpa(pr.ra
    opraHoB rpy,4Hofi

    Ha pafioHHorrl ypoBHe oKa3aHr{r nreAurluscrofi rroMorqr

    opraHoB
    6prorunofi noJro-

    20-60

    -

    rrocJre

    Bbr[ncKu npoAonxarcT Hil3HaqeHl{e JreKapcTBeHHbrx cpeAcTB rro
    KpoBn: onpeAe- Koucylrraqu-r
    cxeMe, peKoMeH,uoBaHHofi B crarluouapHblx ycJroBtlrx o6nacrnofi,
    JICHI4E KOHIIEH- Bpaqa-TepaneBTa
    pecrry6ruxancroft opraulrsaquft r.qpanooxpanenur.
    Tpa\utr HrroKo- (npava o6utefi HefiponporerropHaur repaflrur: nuparleraM, rnlqr,rn, 3Tr.r.JrMerr{Jr3br, obqero nparmru).
    rurlpoKcuflnpu,qr,rHa cyKrlr,rHaT, MeTr.tjr3THJrnnpr4lr,rHona rfi,qpo6elxa, o6qero Koucylrraquu
    xropu{, napacuMnaToM[MeTr,rqecKr,re cpelcTBa: HeocTIrrMuH, Xo6urupy6r.lHa,
    Apyrr.D( Bpaqer- nr.rra anrQocuepar, r,rnuAa\pr.rH.
    MOqeBr{HbI,
    cneqIIaJIucToB IIo Mgra6onuru: nre:raoHufi .
    14CCJre.UOBaHIre

    KJICTKI{.

    Harpvt, Karuf,

    NOKA3AHI,I'M.

    xnopa,

    flo

    KOK,

    noxaganlr,flNr:

    npu nefiponaruqecKoM boresoM cr,rHApoMe: [porl,rBoglurerrnFrecKr.re cpeAcrBa: ra6anerrmn, xap6altaselun, npera6a:run; arrrnAe-

    A.nAT, AcAT.

    npeccaHTbr: aMr4Tpr,rmt,rnHH, QrryorccenrH. napoKceruH.

    OT. JIOK, MexaHoreparur.

    Xpouuvecrar

    O6lllrft

    BOCN:IJII,ITCJIbHIUI

    rcpoBr.r.

    AeMUeIXHr.r3rr-

    O6uuii

    pylotrIar

    rroJrnHeBpoIIarr{t
    (G61.8)

    llpu

    3HMI.

    u o6ocrpenlru sa6olenanzr ocyPenrrenorpa(pru
    uIecTBJrrIoT rocflr,rT,urr,r3arlr4ro naqr{errTa B HeBpoJroruqecKoe oTAeaua.,rnr opraHoB rpy,uuofr neur,re o6ragrnofi oprauusaqur,r 3,qpaBooxpaHeHr- r.
    ana.nug

    MOqLt.

    KJICTKI,I.

    Ettoxunrlrqecroe

    Y3I4

    opraHoB

    14CCJIeAOBaH}{e

    6proutrofi

    r(poBr4: orrpeAe-

    crr,r,

    rroJro-

    rqr,trosl4aHofi

    nepnuunoft graarnocrure

    Ha paftouuoll ypoBHe

    oKa3aHr.rJr ueAurgncrcofi noMorr1l.r locJre
    Bblrr4cKr{ npoAoJr)KaroT Ha3HaqeHr{e uMMyHoMoAyJrr{pyroqr{x JreKapcTBeHHbrx cpeAcTB r{ nMMyHocylpeccopoB no cxeMe, peKo-

    20-60

    48

    JteHr{c KoHueH- XeJIe3LI.
    Tparlu[ fJrroKo- Koncylrraqu.a

    3br,
    6elra,

    MeH4osarrHofi B craufi oHapHhrx ycJloBllqx o6racruofi, pecny6;rurancxofi opr-aHr43arlrli 3ApaBooxpaHeHv.f, .

    o6uefo Bpaqa-TepaneBTa
    .I[onomrnremno:
    o6uero (npaua o6urefi Mera6o:ruru: rraearAonufi

    .

    6utrupy6una,

    rparrrxu).

    flepu$epHuecrue Ba3oAr.rJrararopbr : IreHToKcIrQul.nun, KcaHTIiHo-

    MOqEBI,IH6I,

    Koucy,rrraquu

    na Hr{Korr,rHar, Hr.rueproJIr{H.

    H?rrpr4s, KaJ]v[,

    Apyfnx

    Hefiponporerropuar repanr.ur: gTunMerl rn{.upoxcr{nnpltAlrHa

    xrropa,

    upavefi-

    KOK, cleqaarncToB rro cyKrInHaT, MeTr,lJrgTr{Jrnr{pr,rAr{Hona ru,qpoxroptrA.
    flapacunrnaroltl,IMeruqecKr,Ie cpe.qcrBa HeocrzrM[H, I,InI,IAa\pI4H.
    ACAT,
    [OKA3AHI,IJIM.
    AJIAT,
    flpu xpounvecxou HefiponanaqecKoM 6oresoN{ cI{HApoMe: npoCPE, peBMoTI-IBO9III, IENTI,ITIECKI,IE CPCACTBA: KAP6AMiBENITH, TA6AIIEHTI'H, NPE-

    $arropa.

    ra6anr,rH; aHTr-r,uelpeccaHTbr: aMI{TpLInrI.rJIun, (pnyorcerun, na-

    3Kf.

    poKceTr,rH.

    @T. JIOK, MexaHorepannr.
    rIorIHHeBponaTr{n

    O6Iqrft

    (G62)

    O6rqrfi

    .{pyrue

    aHaaus

    Mgra6olurra: naenrAoHrafi, Br,naMlH Bl
    3HMf.
    86 u B12.
    TiMEHaMr.r
    V3I,I ruuroenqHofi

    aHa,rus

    )KeJIe3br, opraHoB flepuQeprvecrrae Ba3oAl,IJrararoprr: nerrorcrQltJrJrllH, KcaHTrrHo-

    KpoBr.r.

    6prorunofi

    MOqI4.

    Euoxraruraqecroe
    I4CCJICAOBAHI,IC

    KpoBr,r: onpeaeireHr4e KoHIIeHTpauuu rloKo-

    3br,

    o6uero

    noJrocTr,r, opraHoB MaJroro Ta3a.

    ofAc.
    Bpaqa-TepaneBTa

    (npava

    HaTItXt, Knruq,

    npaKTr,rKrr,l.

    T,I

    o6uefi

    xropa,

    KOK, KoHcyrurar1nra
    AIAT, AcAT.
    Apyrux npavefiCflCUUAJII,ICTOB IIO

    ero roM6unaqrla c sH-

    KOTUHAT, HHIICPTOJII,IH.

    gTHnMerI4JIfl{.upoKcxnHpLt,uI4Ha

    cyKrlnHar, MeTI{ngTunnlrpH,unHoJra nrApoxrropuA.
    flapacuunarouuMerlrqecKr,Ie cpeAcrBa HeogrlrrMl4H, It[uAaKpI,rH.
    noragaHra.flM:

    flpu

    IO'IETKI-I.

    MOqeBUHbI,

    H

    Hefiponporerropuar repartalL:

    Penrrenorpa$ur
    opraHoB fpyAHor flo

    6ema, o6uero Koncymraqua
    6utrupy6uua,

    JIA

    r-r

    nefiponart*IecKoM 6oresoNr crrH,4poMe: nporLIBogrIHJreIr {rrecKr,re cpeAcrBa: rap6auarenran, ra6anenrr,ru, npera6a.nun; anraAelpeccaHTbr: aMrrrpr{fiTrrnr,rH, Srryorcenan, [apoKcerl4H.
    flpu,qua6eruvecrofi n alrororuofi norunefipouaruu: TLIoICroBat
    KI'ICJIOTA.

    OT. JIOK, MexzrHorepanr.rr-

    r0-30

    49

    NOKA3AHI,I'M.

    MuacreHra.s
    rpaBnc n lpyrue
    HapyrrreHut

    flpra nepwruHofi

    loplroHu

    AlrafHoCTLIKe:

    nugHofi x(ene3br.

    HepBHO-

    KpoBr-r;

    urlrro-

    o6rqr.rii aHa ug V3l{ rqurosfianofr

    flpu

    nepnuuHofi guaruocruxe ga6oLresaHaq rrarlr4eHTa HanpaBJrlr- ,{lurenrror na npave6uyro KoHcyJrbrarrprro B PHIIU HeBpoJrora[ u nefipo- HOCTb Jleqexupypruu.
    HV' 3ABIdCUT

    XCJIE3bI.

    OT

    Y3Vl

    opraHoB
    6prouruoft noJro-

    llpu

    6r,roxuur-rqecroe

    CTI{.

    HU3AryId 3.qpaBooxpaHeHujr.

    flopaNeur.rr

    r4ccJreAoBaHLIe

    MPT r.rnu KT ro-

    HepBHO-

    4poBr.r: orpeAe-

    MbllreqHofo
    Hanca (G70).

    cI4-

    o6ufiii

    anarns

    MOIIU;

    JIoBHofo Mo3fa.** *

    Mbl[reqHofo cu- neHxe KoHueH- Koucynrraqnr
    I,I MEIIIIU Tpar\uv DIroKo- Bpaqa-TepaneBTa
    flpx 6o;re:nrx, 36r, o6qero (npaua o6ruefi
    xlaccuQuqlrpo6erra, o6qero nparruru).
    BaHHbrx B Apy- 6utrupy6un4
    ofIC.
    ruIx py6pr.rxax MOIIEBI{HBI,
    Koncym:raqu.r
    (G73)
    Harptt', I(uru'! Bpaqaxrropa, ArAT, erl4orcpunorora (o
    AcAT, KOK;
    cryqae pa3BvTr4t
    HANCA

    Ha

    pafioHHorra ypoBHe oKiBaHr,ur ueAurluHcrofi noMorrpr nocre
    BbrrrncKr,r npoAo.rxaroT Ha3HaqeHrre JreKapcTBeHHbrX CpeAcTB no
    cxeMe, peKoMeu.qosaHHoft B crarlr4oHapHbrx ycnoBr,Itx o6nacruoft,

    pecrry6rrxaHcrofi opraHntaqufi tgparooxpaueuu.r.
    flapacr,rrunarouuMerltqecKre cpeAcrBa: nnplrgocrt rMHH, HeoCTIITMI,IH.

    flpu mcyrmerau

    eQQercra

    or

    rrpueMa flapacnMnaroMr.rMerlrrrecKr.rx

    cpelcrB Hasua.{aror: f CfI.
    OT, JIOK.
    llpu .qerounencaquu cocrorHr4r: yBerr-tquBuuor Ao3y rrupnAo-

    IlccJreAoBaHr{e

    cTepoHAHoro ca-

    rloKa3arerefi

    xapuoro gna6era).

    flpu na,rrvuu Dra3onBr{rareJnnux, 6ylt6apnlrx,

    reMocTa3a:

    Koncylrraqur

    uapylreuufr, nrrpaxenuofi cla6osrn B KoHerrHosrrx:

    npava-o(pra:nuo-

    Tr,r.rlpeAHr.t3oroH, rrpeAHrr3oJroH.

    AqTB, TIB,
    NTVI MHO,
    Qr.r6pr.rnoren,
    rcMaTO4pnT;

    3Kf;
    HEOCTI'TMI,IHO-

    nrri recr.

    flpu

    ycraHoB-

    JTeHHOM

    A'dA-

    CTHTMI,IHA.

    AhlxareJrbHbrx

    lCfI: rrae-

    rrora (qpu no.qo3peHI,Il.t Ha KaTa-

    flpr,r otcy"rcrnzll peMrrccm Ha MoHorepalluu rurloKoxopruKor4AaMu, a raxxe flaquerrraM c caxapubrM .qua6erou, ctrcreMHhrM ocreparcry, o6ycroB- onopo3oM, r.lueunqecrofi 6ole:nrro cep4qa (.qanee - I4EC) il eHJreHIIyrc TJIIOKO- paKeuHbrMr.r 6ynr6apurrrr.l.l n (utn) Ahrxar€JrbHhrMr4 HapylreHxrroprurougalru).
    Mr{, He oTBeqaroxlrlM}r Ha Tepalurc fJrroKoKopT[Kor4AaMr,r, Ha3Ha_
    MPT u,rn KT op- qaror r{MMyHoAenpeccaHTbr: a3arr,ronpl{Hr c rrocrerreHHhrM
    raHoB cpeAocTeHr.r.s yMeHbrxeHlleM Ao3bI IpC,{HLI3OJTOHa LLJII4 MeTI'JIIIpeIHU3OnOHa

    (nzlo.morofi xene:n)

    **

    *.

    KJ]IIHI{-

    gexouneucaquu sa6oleuaHnr ocyrqecrBJrtror tocrrr4Tiurr{3a- .recKofi cuunrc flaqnerrra B HeBpoJronr,rrrecKoe orAereHne o6lacruofi opra_ Tya\str.

    BHyTpb.

    flpr.r orcyrcrnuu s0derra or npueMa a3arr.ronpuHa c

    fCfI

    s re.ie-

    50

    IH03E:

    o6r,eM

    o6cne-

    AOBaHUT aHUUIO-

    ,IqCH

    O6T,CMY

    o6c,'reAoBaHr4t

    p

    nepBl4trHor

    uue 8-I2 MectqeB: aurulrle ra6o;rlrrr,t: MerorpeKcar* * l.um ul,rruyHoaenpeccaHTbl : IluxlocnoptH * x.
    OT, JIOK.
    flpu pa:nnrun Kpu3a: 3KcrpeHHar nocrrr{TaJrl43allrlt B orAeneHue
    aHecre3lrororufi u peaHltMauulr pafionHofi, o6lacrHofi opraHn3aurrr,r 3ApaBooxpaHeHr,rr.

    AI{arHOCTLrKe
    AOIIOJIH}ITCJIbHO:

    KT

    opraHoB
    cpeAocTeHr,r'
    (npu noAo3peHI,IIT HA PEqNTI,IB

    TI,IMOMbI,).

    IIpu

    .unr{re;Ib-

    HOM rrpr{eMe

    fCII:

    npo$uru

    fJrloKo3br, KoH-

    rpom A,{.

    Ilpr.r Anr eJrb-

    HOM

    rrpueMe
    r,rMMyHoAenpec-

    calnoB:

    o6uttft

    alg.antuz

    fpoBr.r (refixo-

    qrru,

    rpona6o-

    qrrbl);
    Er,roxnnr,r.recxoe
    r.rccIe,[oBaHr,re

    KpoBr.r: AJIAT,
    AcAT.
    flepafiqHrre no- O6utufi anarus KoHcv;rrauuq:

    flpu nepslrquofi auarHocrure

    ga6oresaHr.rs naqr,rerrra HzlnpaBJrr-

    t2-t4

    51

    paxeHHq Mbrrxq
    (G7 |, G72)

    ror Ha

    I{CCIeAOBaHUe

    BDaqa-TepaleBTa
    (rpa.ra
    o6uterZ
    npar(tr.{Kr,r), BpaqaxapAr4onora, Bpaqa-

    npave6Hylo Koucy!'rsTaquro B o6nacrHyro opfaHn3al(nrc
    3ApaBooxpaHeHur, PHIII_I HeBpoJroruu n nefipoxupypruu.
    Ha pafiouuou ypoBHe oKa3aHr4r ueAr.rquncxofi noMortr4 rrpoAolrxaroT Ha3HaqeHue JleKapcTBeHHbIX CpeICTB rIO CX€Me, peKoMeH_
    gonannofi B ycJroBr.rrx o6.nacrHoil, pecny6luraucrofi opranu:a-

    KpoBr.r: oflpeAe-

    3H.qOKpnHOJrOfa.

    uI,Ir{ 3ApaBOOXpaHeH[rr.

    KpoB14.

    O6ulufr

    aHa,ru:

    Mortu.

    6uoxguuqecroe

    JreHI{e KOHUeHTpaquH fJrroKo-

    3br,

    flpn

    noAo3peHrrx

    Msra6orurca: uelr.qonufi , HaH.qpoJron,

    I{Ho3r.rH.

    HA BOCNZTJII'TCJIb- flapacuunarorulrMerr,rrecKue cpelcrBa: HeocrnrMrlH, LInr,rAaKpHH.
    o6qero HbIE MI,IOIIATI,II4: flpn ruuonarnu [roneHa: fCfI: rr,rerunnpeAHr{3oJroH, npeAHrr3o-

    6enxa, o6qerc
    6utupy6ux4

    MoqeBlrrrbr, 4peut\tHt'tHa.

    Brrj4pb.

    KOHCyJTbTaIIUt

    JroH

    Bpaqa-

    oT,noK.

    peBMaToJrora.

    Koncymraqun

    HaTpLrr, KanuJI, Apyrrx npa.refixJropa, Mr.rorJro- CII€qI{aJIIICTOB nO

    6uua, AIAT,

    AcAT,

    nrf
    Cy6apaxnonAaJrbHoe KpoBour.rrurnue (160)

    9Kf.
    O6qufi

    IIOKZBAHI{'M.

    KOK, 3HMf.

    MPT

    roJroBHoro

    M03ra.
    aHa:rrag

    KpoBr,r.

    O6Iur.rft aHarrc

    Koncymraqur
    Bpaqa
    ra.

    -

    KapAr.roJro-

    flpu

    pa":ru'rrr.r CAK naquenra 3KcrpeHHo rocflr{Tiurrr3r.rpyror B
    naJrary peaHnMalg;au rr r.trreHc suofi Tepalrrrl clleuuaJrll3r.rpoBaHHofo HeBpo:loruqecKoro (r,rHcynr,rnoro) or.ueJreHr,rJr [Jrr.r B orAeJreHr,re aHecle3r4oJronu[ u peanr.tMaquu pafiounofi, o6lacruofi opra-

    KoHcy,rrraquu
    Apyrfix npavefi- Hr,r3arluI 3.qpaBooxpaHeHHr.
    r,rccJreAoBaHr{e
    cneuuflJrr.rcToB no
    KpoBr,r: onpe.qe- noKaIlaHI4tM.
    Ha paftonnolr ypoBHe oKa3aHr.rr ve4lrquncxofi noMotqu locJre
    JIEHI,IC KOHIIEHBbrnr,rcKr't npoAonxilroT Ha3HaqeHne JreKapcTBeHHsrX CpeACTB IrO
    TpauHrj nrroKocxeMe, peKoMeHAoBaHHofr B crarl[oHapHbrx ycJroBr,rJ{x opraHu3aMOIIII.

    Br.roxuurqecxoe

    3br,

    o6qero

    6enra, o6ulero

    qr{r{ 3ApaBooxpaHeHl{r.
    flo nora3aHuN.r:

    6unupy6uua,

    flplr ncr.rxouoropuou ros6yN4euuu:

    MOqEBI,IHbI,

    aHKCUOJrr4Tr.rqeCKr.re

    cp€AcTBa: aHTr.rrctrxoTr{qecKr{e cpeacTBa:

    20-60

    52

    Hafpus, Kanvfl,
    xrropa, AIAT,

    Tpl{Qnyonepa3}rH, xnopnpoTnKceH.
    flpu 6olenou cr{H.qpoMe q rfineprepM]u.r HIIBC: MeraMrr3oJ'r
    Harpur^, napaqeraMon, 4r,rxloQeuax, reronpo$eu, KeropoJraK, MeJroKcuKaM. u6ynpoQeu. qererorcu6.
    flplr cygopoxuoM crrHApoMe: nporr.tBo3nr4lrerrrr{qecxr{e cpeAcrBa:
    Qenrrrouu, xap6alrasenrzu, BiIJrbnpoeBzu Kr,tcirora;
    llpn rnnepreu3r.roHHoM crrHlpoMe: MorreroHHbre cpegcrna: $ypoceMI,IA, rr,rApoxjropTHa3u/4.
    flpu ronrururHbrx HapyrueHurx: nefiponporercropHrur repanrur:
    fl uparreraM, FJrr{rlr4H, xoJII{Ha anrQocqepar.

    AcAT.
    I4ccJrerosaHne

    rIoKa3arerei
    reMocTa3a:

    AT{TB, rIB,
    ilTU, MHO,
    Su6pr.rnoren,
    reMaToKpHT.

    KoHcymraqur
    Bpaqa-

    otpra;rruolora

    (ocrpora 3peHtlt, nla3Hoe
    .qHo, floJrr 3peHr{r).

    Koncymraqur
    BpaqaTeparreBTa (Bpa-

    va o6rqefi npaxTI,IKI,I,).

    Bnyrplruosro-

    O6qr.rfi anan[s Koncynmaqur

    BOe rlpoBor,r3Jrr.tauue (161).

    KpoBr,r.

    O6uufi

    HerpaB-

    KoHcylrraquu
    Apyrlrx cnerlr4anu-

    cueHofi Teparruu cnequaJrn3r{poBaHHoro HeBpororuqecKoro (uHcyn6THoro) oTAeneHr{r tr,Jru B oTAeJreHr.te aHeqre3l,roJrorurr4 Lt peaHr{Marlfi u pafi oHHofi , o6nacruofi opran u3aqr.fl.t 3.upaBooxpaHeHr.rr.

    Bpaqa
    aHarrag

    MOqI,I.

    Apyroe

    KapAlroJro-

    flpu pasnmau BFyrprrMo3roBoro KpoBorl3Ju.trrrrlr (BMK) naqr4eHTa 9KCTpeHHO focnrralr.r3r,rpyroT B naJraTy peaHr.rMarlul{ u trrrTeH-

    Fuoxr,ruuqecroe

    -

    ra

    MATI4IIECKOC

    I,ICCJIeAOBaHI4e

    CTOB TIO TIOKA3AHI,I-

    BnyTpr4r{epenHOe KpOBOr,r3nUsuue (162)

    KpoBr.r: onpeAe-

    tM.

    JIeHUe KOHIIeH-

    Tpaquu n oKo-

    Ha pafioHHou ypoBHe

    oKa3aHr,rJr rr.re4uquncroii noMorqfi rocJre
    BblrrlrcKr,r npoAoJrxaroT HaBHaqeHr,{e JreKapcTBeHHr,rx cpeAcTB [o
    cxeMq, peKoMeHAoBaHHofr B crarltoHapHbrx ycJroBr,rrx opraHu3a-

    20-60

    53

    3hr,

    o6ulero
    6enra, o6rqero
    6utrupy6uua,
    MOTieBITHI'I,

    Harpu'i, KaJl|,'g,
    xJropa, ArrAT,
    AcAT.
    Llccre.qosaHne
    noKa3areJret
    reMocTa3a:

    AqTB, IIB,
    TITI4, MHO,
    Qu6puHoreu,
    reMaToKpI,IT.

    3Kf.
    3xo3C.
    KoHcylrraqNr

    rlr414

    3ApaBOOXpaHeHut.

    flpr.r npooeaeHuu Koppe(uuu A,{ c 4ocruxeHlieM qeJIeBbIX ypoBH€i fipeAno.rrureJlr,H6r aHTun{nepreH3r4BHbre cpeAcrBa ocHoBHbIx
    aHTltrr.tnepTeH3r,rBHblx KltaccoB rt vtx rorr.l6ruauun, B ToM ql,rcJre
    JreKapcrBeHHbrx cpeacrB c QraxcuponaHHbrMr4 Ao3aMu, cofJlacHo
    KJrr't Hr4qecKoMy rrporoKoJry .ql4afuocrr{Kn rr Jreqenut sa6o.nerauuft ,
    xapaKrepr43yrouluxcr rroBbrrrreHHhrM KpoBrHnlr aasreHuev (nocraHoBJreHr{e MuHncrepcrra 3ApaBooxpaHeHur Pecny6nuru Eenapyo J\b 59 or 06.06.2017).

    flo

    noxasaHurr{:

    flpu

    ncnxorrroropHorr.r noe6yNgenuu:
    aHKcuoJrrrurqecKne cpeAcrBa: ro$naonau;
    aHTr,rflc[xor[qecKr{e cpeAcrBa: rpnQrryonepa3uH, xJropnporllKceH.
    flpu 6onenoru crrH.qpoMe: au:IJrbrerr,rKr{-anTurluperl.rKr,r: MeraMu3ofi rrurpnA, rraparleraMorr; HIIBC: 4r.rrurorpenarc, rvroupotpeH, reToponaq MeJroKcnKaM, r.r6ynpo(peu, ueneroxcu6.

    Bpaqa-

    llpu

    o(pramuo.nora

    lxfipvr,

    (oc:rpma 3peHv'j rJra3Hoe

    rfineprepMr,r[: aHzurbferr,rKr,r-aFrrr.rluperlrKx: MeraMI,I3oJI
    napaueraMorr; H|IBC: .quxlotpenar, reronpot$eu, reroponaK, MeJroKcr.rrarr.r, r.r6ynpo$en, qererorclt6.
    flpu cyAopoxnoM cLIH.qpoMe: rIporI.tBo3[[JIem[rIecKLIe cpeAcrBa:

    AHO, rrOJUr 3peHut).

    Qeurrouu, xap6auarenuH,

    Koncymraqna
    Bpaqa TepaneB-

    ceMr4.{, ruApoxJropTl,Ia3rrA.

    ra (rpava

    o6-

    rqeft nparruxu),
    (npaua obrqefi
    npaKTHKr4).

    BaJrbnpoeBaJr Kr,rcJrora.

    flpu mnepren3r{oHHoM cl.tn.(poMe:

    flpu xornuurHbrx

    MoqeroHHhre cpegclna: Sypo-

    HapyrxeHnrx: HefiponporeKropHzlt reparrt,rt:
    nuparreraM, FJrr{quH, xoJrHHa amQocqepar.
    flpu cnacruuecKoM cl{H.qpoMe: MltopeJraKcarrrH IIeHTpaJrbHoro
    Aeficrnur: 6arnoQen, ToJrnepn3oH.
    flpr recu.r6ynrpHoM cnH,upoMe: cpeAcrBa AJrt ycrpaHeHl{t roJloBoKpyxeHrrr: 6etaructrn.
    flpu .qenpeccnu: aHTr4aerrpeccalrrbr: aMITrpHrITLtnlH, Qnyorcurnn,
    napoKcerl.tH.

    54

    IIpu

    :xcrpanupaMl4AHoM cr,tH.qpoMc: AonaMr.rHepruqecKr4e cpeA-

    crBa: aMaHTa.qr{H, npaM}.rneKcoJr, JreBo,qona/Kap6r.tAona, neBoAona./6encepa-:ug.

    I,IuQaprr
    (163)

    OT, JIOK, KnHe3orepar[r, flcrxorepanr4r, noroneA.
    O6llrafi aHa,rlrs Y3Af npeqepe- flpu pa:nuruu uuQapma Mo3ra rraurreHTa 3KcrpeHHo rocnr{Tirlrr4KpoBr{.
    6pa,rrHnx cocy- 3r{pyror B cnequ rr{3r,rpoBanHoe HeBponorr4qecKoe (raHcylrrHoe)
    O6r{rfi ana.nu: AOB.
    or.(eneHr4e pafiouHofi, o6nacrnoft opraHr,r3auu[ 3apaBooxpaHeMOqI{.
    Xorrepoecxoe rrao- HITI.
    Br.roxr.rMr,rqecKoe

    Hr{TOpXpOBaHrre

    I,tccJreAoBaHI4e

    3Kf,

    MOqeBr{HBr, Kpe-

    cleqniuscToB

    ATWH,NHA,

    IIOKA3AHI4JIM.

    A'4.
    KpoBr.r: onpeAe- Arperarorpanrua
    JIEHI{E KOHIIEH- 'rpou6oqrror.
    Tpaqnr4 urroKo- Koncym'raqu-a
    36r, o6ulero Bpatra-Kapar,ronofa.
    6elxa, o6rqero Koncymraqur
    6unupy6uu4
    Apyrr.rx npauefirro

    Hdfpr4g, Kanvt, KoHcymraqnx

    x;ropa, AIAT,
    AcAT, noxasaTenefi nunu,uHo-

    fo

    o6MeHa:

    oxc,

    xc

    JIIIHII,

    XC

    JIIIBN, Tf.
    14ccneAosaHr.re

    noragarenefr
    reMocTa3a:

    AIITB,

    TITI,I,

    ITB,

    MHO,

    0r.r6pusoreH,

    BparlaaHruoxr4pypra,
    Bpaqa-peHTreHOSHAOBaCKyJTTp-

    Horo

    x

    pypra.

    Ha

    pafioHuorr.r ypoBHe oKa3aHl-rr MeAnur.rHcKofi noMorrlu nocJre
    Bbrrr[cKr4 rrpoAoJrxaroT Ha3HarreHr,re JreKapcTBeHHr,rx cpeAcTB no
    cxeMe, peKoMenAosaHHofi B crarluoHapHbrx ycJroBr{rx opraHu3aqr4 r,r 3ApaBooxpaHeHut .
    flocrosHlrlIfi npl{eM iu{Tr,rarperaHTHbrx JreKapcrBeHHbrx cpe.qcrB
    rrpr,r HeKapArrrognr6onr.rqecronr unoaprre Mo3ra Ir rapAzosna6oluqecxoM r,rnQaprre Mo3ra c [porr{BonoKa3antr,AMur K HerrprMbrM aHTr.rKoaryJrrHTaM:

    ACK.

    V

    naquenron c paHee lrepeHeceHHbrMu noBTopHLrMr.r HeKap,uxogM6or[.recKr,IMr unQaprrauu Mo3ra Ha QoHe npuerua ACK, nprl
    HeflepeHocr.rMocrr ACK, a raroxe npn na6oparopnofi peancrerrrACK: ruronr.rAorpeJr.
    Ocrprtfi roponapnufi cnHApoM,
    HOCTr.r K

    BhrnoJrHeHHoe qpecKo)KHoe Kopo-

    HapHoe BMeulaTeJrbgrBo, a TaroKe olepaqlu SHAoBacKyJrrpHoro
    crer xpoBaHr,rr gKcrpafpaHr{rrJrrnrx aprepufi - a6corrorHbre rtoKa3aHr,ir K ABofiHoft alrrr{arperaHTHofi Tepanux: ACK s co.{sraHflr.r
    c Klroflr.rAolpeJrov 90 AHefi, a AaJree npoaolrxeHr.re cporon 4noftHoft aHTuarperanrrHofi Tepanfiu no coFJracoBaHI,IIo c Kap.q[oJroroM,
    c rrocJre.qyrcqr4M nepexoloM Ha MoHoTepanuro aHTr4arperaHTHbrM
    JreKapcTBeHHhlM cpeacTBoM.
    flpu nrrcorou pncKe Kapar4aJnnofi eM6orzr, (@fI, rporrr6 neaoro
    npeAcepAur, TpaHcMypaJrbHuft rnQaprr MHoKapAa repe.qneft
    creHKx AaBHocrsro MeHee 4 seAem, T pou6 ,nenoro x(enyAoqKa,

    20-60

    55

    |eMaToKpHT.

    3Kf.
    Koncylrraqu.r:
    Bpaqa-

    o$ra,rmrorora

    (ocrpora 3peHltg, FJra3HOe
    AHO, noJrr 3peHnr).

    Koncylrraqur
    Bpaqa-

    repanerra (npava o6rqefi npax-

    Tr.rrui),

    (npaua

    o6rqeft nparruru).

    r.rcKyccTBeI{Hbte KJrarraHbl cepAua, peBMaTHqecKo€ nopa){(eHl{e
    KJranaHoB, uu$aprr Mo3ra B coqe'raHur4 c ocrpbrM TpaHcMypaJTbusrv uu$aprroM Mr,roKapAa nepe4uefi creHxr,t c rroAbeMoM ceruenra ST, 6e: npu:naroa Soprur.rporaHnr rpou6a JreBoro xenyAoq(a, npu rrarv.ur4r4 lepeAHe-Bepxyueqnofi aKr{He3}ir{ ulrll Agrcxunesulr), Auccexrlrru aprepr4r{, conpoBoxgarcrqeft cr r.trQaprrorrl
    MO3fa:

    aHTlrrpoM6orltqecKl{e cpeAcrBa: aHTr{KoaryJrf,rrrbr HelprMofo
    Aeficrnrr: napQapuu noA KoHTporreu MHO, qelenofi ypoBeHb
    MHO 2-3, Korrrponb MHO: s reqeHr4e rrepBbrx 5-7 gneE nocne
    Ha:lHaqeHltr exeAHeBHo r.rJru qepe3 AeH6, 3areM 1-2 paza B He,qeJrIo, nocJre cta6unnzaguu MHO na neo6xoAulrola ypoBHe - I pas
    s 2-3 r;.e4eru. flpu nr,rcorou pncKe KapAnuurnofi eru6onur.r (neKJra[aHHiur OII, rpou6 neBoro npeAcep.qur, rpaHcMypa.nrnrrfi
    uuQaprr Mr,roKap,qa nepe.qHeft creHKr.r AaBHocrrro ruesee 4 HeAeJrb,
    ocloxnennrrft TpoM6oM JreBoro xeJryAoux4 un(paprr Mo3ra B coqeraHrar{ c ocrphrM 'rpanct!ryp:InbHnu rHQaprrou Mr{oKap.qa nepe.quefi creHKr, ocrroxHeHHbrM QopuuporanueM MyparnbHoro
    rporrl6a neBoro x€nyAoqKa r,rJrr{ HapyureHneM rroABIDKHogM rrepe,qHefi u (utu) aepxyme.rnofi o6racrr.r c orpaHlrrreHr.rerr,r Qpaxqur
    nu6poca reBoro xeryAorrra <40o/o) n BbrcoKoM pr.rcKe KpoBoreqeHrft, n torrr qltcre npu cHr.DxeHr,ru x;rr,rpeHca Kpearr,rHr,rHa .uo 30-50
    MI/MI{H:
    aHTr,rrpoM6orr.rqecKue cpeAcrna: npruofi r.ruru6u:rop rpona6una 4a6ura'rpaua gTeKcr.urar urr nprruofi uuru6rrop $arropa Xa punaporca6an.
    flaquerrraru c rapAuoeru6ol[lrecKuM uu$aprrolr Mo3ra B coqeraHI,Irr c KopoHapnofi 6oaegurro luru crernxpoBaHrreM KopoHapHrrx
    aprepnfi Bo3MoxHa roru6unaqr.Lr eapQaplrua u ACK a go:e 75100 rrar/cy.rru flpu ycJroBrrr,r orcyrcrBr,rr B aHaMHe3e yrcasaHlrfi na
    srrcoKufi pr{cK KpoBoreqesui.t u B coorBercrBr{u c pe3yJrbraraMr,r
    oueHKr.r pncKa KpoBore.reHr.rfi no utrane HAS-BLED 90 gnefi, a

    56

    ,4anee [po,4on)KeHne cpoKoB rxBofi Hoii ar{Tl4TpoMdoTrzqecKoft Tepanun no cofnacoBaHr,fo c KapauonoroM, c [ocJr€Ayrcrq]rM nepexoAoM Ha MoHoTepaIHIo aIITIt'tpoM6oTt4qecKI.IM JIeKapcTBeHHbIM
    cpe.ucTBoM.

    Kopperqu.r A.{, naporcu:rr.roB HapyueH[r cepAeqHoro pr,rrMa.
    flarluerrralu c JraKyHapHbrM rlnQaprrorrr Mo3ra noKa3aH qeresofi
    ypoBeHr AA < 130/80 MM pr. cr.; nprr BbrpaxeHuoM creHo3r.rpyrorleM arepocxrrepo3e SIIA (>70%) rroKa3aH qelenofi ypoBeub
    A,{ a npegenax 140-150/90 MM pr. cr.; naquerrraM c c.xaprrbrM
    Axa6eroM rroKzraH rlerreBoft ypoBeHb A'{ <140/85 MM pr. cr., raquerraM c xpoufiqecKnMlr 3a6oneBaHr,rrMu noqer rIoKa3aH ue:Ienofi yponeHr AI < 140/90 MM pr. cr.; n nospacre >75 Jrer noKa3aH
    uerreBoft ypoBeHb A,{ n npegenax 140/90-150/90 MM. pr. cr.
    flpu nponegenfir-r KoppeKur{u A,[ c .qocrlrxeuneM ueneBbrx ypoBHef rlpeAlotrrr,rrenbHbr auTr,rrfinepreH3llBuhre cpeAcrBa ocuoBHbrx
    arrrr,rrurflepreH3r.rBHbrx K;raccoB r.r rx rou6r.traqr.ru, B ToM qr,rcJre
    JreKapcrBeHHbrx cpeAcrB c QurcuporanHblMl,r Ao3aMr4, conracHo
    K;rrrHr{qecKoMy rrporoKoJry AuarHocruKrr r,{ Jreqeur4Jr 3a6oneBaHufi,
    xapaKTepu3yro[u.rxcs noBBIIueHHbrM KpoBrHurrl 4ameHneu (nocraHoBlreHr,re Mr,rnlrcrepcrna 3.upaBooxpaHeHur Pecny6.nnxra Benapycr Ns 59 m 06.06.2017).
    flo uoragaHu.rv:
    flpu rrneprnnr{AeMr.lr : rurroJrunnAeMr{qecKue cpeAsma:
    aropBacrarr.rH, po3yBacrarr{H B BbrcoKo3$abermsnofi Aose.
    flpr.r cyaopoxHoM cr.rHApoMe: nporr.rBo3nrr;rerru{qecKue JrexapcrBeHHbre cpeAcrBa: Ar.ra3enaM, QeuuronH, BaJrbnpoeBzur Kr,tcJrora,
    Kap6aMa3enr.rH.

    IIpu

    ncuxorr,roropHoM noa6yxgenulr: aHKcr,roJurrflqecKue cpe,{crBa: Toibr43orraM; aHTr,rlcuxoruqecKr{e cpeacrBa: x;ropnpornrceH,

    rpraSra"rran.

    flpu 6orenou

    cr{HApoMe

    r,

    rur[eprepMr{u: aHalrbrerr,tKn-

    aHT},rlIdpervK*l: MeTaMH3OJI HATpI"lfl , [apaIIeTaMOn.

    57

    flpu necru6ynrpHoM cuHrpoMe:

    cpe.qcrBa

    Arr ycrpaHeu[s foro-

    BoKpyxeHur: 6erarucrprn.
    llpu cnacruuecKoM cuHApoMe: Mr,ropeJraKcaHTbr rreHTpanrHoro
    leiicrnnr: 6ax,ro$eH, ToJrnepu3oH.
    flpu srcrpanupaMr4AHoM cnHrpoMe: aonaMuHeprxqecKr{e cpeAcTBa: aMaHTaArrH.

    flpu 4enpeccuri:

    aHTuAenpeccaHTrr: aMr,rrpr{rrrwtvrH,

    $lyoncernu,

    napoKceTr.rH.

    flpu xorHmurHrtx HapyrxeHurx:

    uefiponporeKropHzut reparrrlJr:
    nl4paqeraM, rnuur-tH; xoJtr.rHa arrQocuepar, Hnr.uaKpr.rH.
    flporegeHue paHHefi pea6vlrral4iuu [aqueHToB, H,xoArrrl[xcr B
    cra6l,rrbHoM cocrorHr.rfi .
    JIOK, OT, rroroneA.
    V naquenron c nuQapmorr Mo3ra c 6ucrpo o6panarr,rrru HeBponor[qecKr,tM geQuqrmorra (>) B Teqeur{e
    uepBrlx 2 r'eyels flocJre r,rucyJrbra flpu mcunarepaurbnoM BhrpaxeHHoM cTeHo3e SKCTpaKpaHnaJrbHOrO OTAeJra COHHITX apTepr,rfr
    (70-99o/o) peKoMeH,qyercr KapornAHiur 3HlaprepsrcroMrax (4anee K3A), ecln pucK flepuonepaur{oHHofi sa6orenaerr4ocm u cMeprHocrlr cocraBJl sgt v.elg.ee 6Yo.
    flpn uucu.narep:urbHoM yMepeHHoM creuo3e gKcrpaKpaHr.raJrbnoro
    orAeJra coHHbrx aprepufi (50-69%) Br.rA orreparr4BHoro BMerlaTeJrbcrBa (K3A ruu aHmoruracrr,rKa H creHTr.rpoBaHue) sanracrr or
    Bo3pacra r{ cofl]"rcrByrcrqr{x 3a6oJreBanufi. flpu orcyrcrBr.M [poTltBorroKa3aHnfi penacry.rupl,BaUlflo seo6xo.quuo BrrrlotrHr,rrb B
    TeqeHr.re 2 :aegent nocne TI4A.
    Kapmu.qna"r aHrr,ronJracrr{Ka r,r creHTnpoBaHr4e rroKa3aHbr KaK ilJrbTepHarnBa K9A npr,r uncr4JrarepalnbHoM creHo3e gKc,rparpanr,raJr6HO|O OTIeJra COHnOfi apTepr,ru > 70o/o npu neunsa3r,rgHofi Br,r3yaIJIr{3ar\vv rrJtu > 50%o npu B.u3yaru3a\fivt MeToAoM KaTeTepr,r3arlr4oHHofi auruorpaQuu npu cpe.qHefi r,uru nragrofi crerreHrr prrcKa
    ocroxHeHrrfi, cBr3aHHbrx c SHAoBacKyJrrpHhrM BMerrrareJrbcrBoM.

    58

    .ftr

    noxu,:rux [aqr.reHToB (craprue 70 ,rer) [pe,qnoqrrrrenbHee
    K3A, grtr 6olee lroloAr,rx naqr{eHToB K3A sxsusareHTHa Kapora4uoi aHruonJlacruKe u creHTr{poBaHHIo.
    flaqraeHrau c u[cnJrareprrJrrHrrM BhrpzDr(eHHrrM creHo3oM (> 7 0o/o)
    rrpr.r BbrpiDKeHHoM pr4cKe xupyprurrecKofo BMerrraTeJrbcTBa uru
    rlpu Hanvqvu pa,ur4arlr4oHHoro cTeHo3a uJrH pecTeHo3a nocJre
    K3A, npu oKK;rro3r4rr nporr,rBofloJroxnofi connofi apreprrri rroKa3aHa KapoTI,rAHiur aHrr{onJracT}rKa

    14

    cTeHTrrpoBaHr.re.

    O6ulr.rft ana,rus I4ccneAosaHue no- lloc'rorgttrrft nplreM aHflrarperanTr{brx JreKapcrBenHblx cpeagrB:
    aTepocKjrepo3
    KpoBr,r.
    Ka3aTener reMo- ACK.
    (arepocrurepoO6ulrfi ana.irus cra:a: AHTB, fIB, llplr oucorov plrcKe Kap.{niurrHoft slr6oruu (OfI, rpou6 nenoro
    TlrqecKat 3HIIe- MOqIt.
    IITI4, MHO, Qu6- npeAcepAr.rr,'rpou6 renono xeryAorrKa, r.rcKyccrBeHHbre K;rarraHbr
    (palonarur)
    Er,roxuruuqecroe pI{HOreH, reMaTo- cepAua, peBMaTlrqecKoe nopzDreHr{e xlanaHon):
    (167.2)
    I,tccJreAoBaHLIe
    Kpr,rT.
    anrrrpou6otuqecKne cpeAcrBa: anTuKoaryJrrrrrbr Henp{Moro
    KpoBr.r: orrpeAe- KT lrnu MPT ro- AeficrBur: nap(fapun [o.[ Ko]rlporreu MHO, rlerreBofi )r'poBeub
    JICHI{E KOHIIEH- JIoBHoro Mo3fa.*** MHO 2-3, Korrrponb MHO: n reqeHr,re repBhrx 5-7 Auefi nocne
    TpaqI,IIr fJrroKoHa:'HarreHr,rr exeAHeBHo nrl qepe3 AeHb, 3areM l-2 paza B HeAe3br, oorqero Y3Af npeqepe- Jrro, rocJre cra6utuza\uu MHO sa neo6xogranaou ypoBHe - I pag
    6enra, o6uero 6pamnux cocy- s 2-3 HeAerr.r.
    6utrupy6uu4
    BapQapuH He H:BHaqaror npr.r BhrpaDreHHofi qepe6parbHofi arepoAOB.
    MOqCBI{H6I,
    TKA|.
    cKreporxrrecKofi ur.rrpoanruorrarult Lr avnror,unofi MlrrcpoaHruoHaTplrr, K:rJrr4r, ArpemroMsrpr4-g
    aauv.
    xropa, cPB,
    rpou6oqr.r:ron.
    V naqr,rerros c pauee nepeHeceuHbrMl noBTopHbrMH HeKap.quoAJIAT, AcAT, Xorrepoocxoe ruo- grr6o.nr.rqecxr.rnau TVA, r.rnQaprrarr,ta Mo3ra Ha Qone npraenra ACK,
    noragarenefi
    Hr,rTopr.rpoBaHrre
    rrpu HelepeHocr.rMocrr.r ACK, a raKxe pl,t ra6oparopHofi pe:lrmlnr,rAnoro o6- AA,3Kf.
    crenrHocru r ACK: Krronr.rAorpen.
    rr,reHa: OXC, XC flpu creuore npe- Koppexulrr A.{, napoxcr.rsrrloB HapyrneHr4r cepAetrHoro pmMa.
    JII]HIi, XC uepe6panrHofi ap- flpu nnpaxenHoM creHo3r.rpybrqeM arepocKrrepore EI{A (>70%)
    JII]BII, Tf, KA. repuu 6oree 50olo rroK:BaH qeresoft ypoBeHb A.{ n npe,4enax 140/90 -150/90 vrr.r pr.
    3KT..
    - KOHCyrbTarIUt cr. flauraenraru c caxapHr,rM 4ua6erou rroKa3aH qelenofi ypoBeHb
    KoHrponr A,I[
    BpaqaAn < 140/85 MM pr. cr.; naqueHTaM c xpoHr.rqecKr.rMr :a6o. esallepe6panrnrrft

    l0-20

    59

    Koucylsraqru

    aHfltoxrrpypfa

    HJrr,r

    Bpalla-

    Bpaqa-

    oQralrrraolora

    peHTreHo3HAOBaC-

    (ua:uoe

    AHo,

    KyJrrpHoro xupyp-

    oc'rpoTa 3peHi4_r,

    ra.

    noJrr

    Koucy,rrraqtu

    3peHr.rr).

    Koucymraqrr
    BpaqaTeparreBTa (Bpaqa o6uefi npaKTI,IKX)

    npyrurx

    HlrrMu noqeK noKa3aH ueJreBofi ypoBenb AA< 140190 MM pr. cr.;
    B Bo3pacre >75 ler noKiBaH rlenenofi ypoBeHr, A[ n npege.rrax
    140/90-150/90 MM pr. cr.
    flpu npoae4enur.r KoppeKrluu A{ c gocruNeHr{eM rlelcBbrx ypoBHei npeAnoqrfiTeJrbHbr aHTlfunepreH3nBHbre cpeAcrBa ocHoBHbrx
    aHflafu epreH3nBur,rx MaccoB r,r rax rou6nnaqur, B ToM qr.rcJre
    neKapcTBeHHhrx cpeAcTB c QurcuponauHbrMr,r Ao3aMr,r, co lacHo

    Bpa.refcfleullajrr,rcToB no Klr,rHr4qecKoMy npoToKoJry Ar,rarHocTl.tKr.r r{ JreqeHr4r 3a6oneBaHr,rfi,
    [oKa3aHI4tM.
    xapaKrepr,t3yrouluxcr noBbrrrreHHbrM KpoBrHrrru gan,renueu (uocraHoBJreHr4e Munucrepcrna 3ApaBooxpaHeHnr Pecny6lr,rxlr Eenapycr J\!r 59 or 06.06.2017).

    flo noragaHurrr{:
    flpu runeplunv4eMuvri r[[oJIItnr{AeMI,IqecKne cpeAcrBa:

    aropBa-

    cTaTuH, pO3yBaCTaTLIH.

    flpr.r cygopoxHoM cr.lu.upoMe: rlporr.rBogflrnenrr{qecKrre

    JreKapcTBeHHbre cpeAcTBa: AHa3enaM, (penrrronH. B:rJr6[poeBiur Kr,rcnoT4
    Kap6aMa3enHH.

    flpra ncuxouoropnorra noe6yx4eHr.tu:

    aHKcr,roJrnryrqecKr,re cpeA-

    crna: roQusonaM; aHTrlncnxorr,rqecKr.re cpeAcrBa: x;ropnporr,rKceH,
    Tptl$ra3r4H.
    flpu necrz6ynrpHoM cr.ruApoMe: cpeAcrBa,unr ycrpaHeHnr roJroBoKpyxeHur : 6grarxcrun.
    flpu cnacruvecKoM cLrHApoMe: MlropeJraKcaHTrr IreHTpaJrbHoro
    4eftcrnur: 6aruroQen, Tonnepr.r3oH.
    IIpu ercrpanupaMuAHoM cr.rHApoMe: AorraMuHeprrrqecKue cpeAcTBa: aMaHTaAr.rH.

    flpu genpeccnu:
    napoKceTr.rH

    aHTr4aenpeccarrrbr: aMr.trpltmnJl4H, Snyoxcerrlrr,

    .

    IIpu roruurunHrrx HapylreHr.ux:
    n[parleraM, rurtrqr,rH,
    OT, JIOK, rrofoneA.

    flplr

    xoJrl,rHa

    neftponporercropHarr repanrarr:

    alrtpocqepar,

    l,tnr,rAaKpr{H.

    rancurarepa!'rbHoM BbrpiDKeHHoM creHo3e 3xcrpaKpaHrra.nbHo-

    60

    ro orgera conHbrx apreprlfi (70-99%) peKoMeHAyercq K3A, ecru
    pr,rcK rrepr4onepaqzonnofi gaboregaenocrr4

    lt

    cMeprHocru cocraB-

    nger veltee 60/o.
    flpn ulcularep:urbHoM yMepeHHoM creHo3e 3KcrpaKpaHzaJrrHoro
    orAera corrHsrx aprepufi (50-69%) Br,ra orreparr4BHoro BMe[IaTeJrbcrBa (K3A r.rrru aHfr,roruracrlrKa r.r creHTrnpoBauue) sarucur or
    Bo3pacra u conyrcrByrorqr.rx sa6orenauufi. flpu orcyrcrBllu npoTr4BonoKa3aHr,rfi peracry,rrpn3arrfiro Heo6xoa[Mo BHnorHrrrb B
    T€qeHHe 2 :He,ietrc nocre TI,1A.
    KaporlrgHar aHrr{oruracrr.rKa r.r creHTr,rpoBaHrre rroKa3aHbr KaK aJrbTepHarr{Ba K3A npu r4ncr{JlarepulJlrHoM creHo3e gKc'rpargaHr,riurbHoro orAeJra coHHofi apTepI{E > 70%o npu HezHaa3l.{eHoft Bu3yaJIu3Ar\I{Vt Vrlrlr > 50o/o npu BrByanr.BaIII4Ii MeTOAOM Karereprr3arl[oHnofi anruorpa@lru upr.r cpeAHefi rrJru Hr.tsKofi creneHu pucKa
    ocJroxHeHl{f, cBr3aHHbrx c 3H,qoBacKy;rrpHhrM BMerxareJrbcrBoM.
    ,ftr noxu.nux flaquerrroB (crapure 70 ler) npeAnoqrr{TeJrbHee
    K3A, ans 6oree naonoAux naquerrroB K3A gKBr.rsarelrrHa Kaporrlqnofi aHrr,rorrJracrr,rKe n crerrrr.rpoBaHr,rrc.
    flauuenrana c [nclrJlarepa,rbHbrM BbrprDKeHHbrM creHo3oM (> 7O%)
    npu Bbrptr)KeHHoM pr.rcKe xupypruqecKoro BMerrrareJrbcrBa
    '{rwr
    flpv Hallv'I{r4vr paAuaunoHHoro cTeHo3a rrJrr,r pecTeHo3a IIocJIe
    K3A, npu oKKJTK)3r.m flporuBonoJroxuofi connofi aprepr.rr4 noKa3aHa KapoTlt.qHar aHnrorrJracTHKa r,r cTerrTr,rpoBaHr.re.

    O6uri

    llccneAoranue no- flogrorssrrfi npneM aHTr.rarperanTHhrx JreKapcrBeHHbf,x cpeAcrB:
    xagarelefi reMo- ACK.
    c;rant lefirogn- O6uuft asa:rug crasa: AIITB, fIB, flpu nrrcorou prrcKe KapAriaJrsnoft en6orun (OfI, rporu6 nenoro
    qeSa,ronaru.r
    MOqI{.
    IITI4, MHO, Qu6- npe.qcepAfic, T pou6 renoro xeny.uoilKa, I4cKyccrBeHHbIe Kra[aHbr
    (167.3).
    Br.roxrlMr.r.recroe puHoreH, reMaTo- ceparla, peBMarl,rqecKoe nopaDKeHI,Ie KJrarIaHoBJ:
    KpriT.
    arrrrrpou6orraqecKr,re cpeAcrBa: aHTuKoaryJrrrrrbr HenptMoro
    UCCJICAOBAHI'C
    KpoBr,r: orrpeAe- KT rlru MPT ro- Aeficreul: aap$apun rroA KoHTponeu MHO, qe,resofi ypoBeHb
    fiuepreusr,reHas. euqedaro- NEHIIE KOHUCH- JIOBHOTO MO3- MHO 2-3, KoHTpoJrb MHO: s rerreHr{e lepBbrx 5-7 anefi nocre

    flporpeccupy-

    rcuar

    cocy.uu-

    KpoBn.

    aHanus

    to-20

    nar|/.fl (167.4)

    ra.***.

    TPAUI]'{ IJIIOKO3br, o6ulero
    6enxa, o6rqero
    6unupy6una,

    Y3If

    Ha3HaqeHr4r exeAHeBHo urH rrepg AeHb> 3areM l-2 paza B HeAe_
    Jrro, nocJre cra6unlr:aquu MHO na ueo6xorlulron ypoBHe
    I pas

    AOB.

    MOqeBr{HhI,

    TK4-.

    Harpvtt,

    n 2-3 uegetu.
    Bap$apun He Ha3Haqanr npr.r BbtpaxeuHofi qepe6pa-nrHofi arepocxreporr.rqecKofr mrzrpoaHrlro rrur rr auulouAnoii MrrKpoaHrzo-

    ArpemroMgfpt4t

    Kanldfl,
    xlopa, CPE,

    npeqepe6panrHux cocy-

    'rpon6oqr.rroe.

    turAT,

    -

    ATHI{.

    V naluenros c paHee

    [epeHeceHHhrMr4 noBTopHrrMt4 Hercapar.to-

    AcAT, Xorrepoocroe nro- gv6oruqecrrlun TVA, ltr(paprcravu Mo3ra Ha rpone npuerr.ra ACK,
    noxa-sare,lefi
    HnTOpr,tpoBaHr,re
    nprl HerrepeHocnMocru ACK, a raKxe flpn na6oparopHofi peurunlrgnoro o6- AI,3Kf.
    crelrrHocrr,r r ACK: KJronr.rAorper.
    ueua: OXC, XC flpn creHore npe- Koppexqra.a A.{, naporcuarrloB Hapy[reHr.lr cepAerrHoro pr,rrMa.
    xc qepe6palrnofi ap- flaquerrrau c cuxapHrrM Aua6srou [oKa3aH qeleaoft yponenr A.{
    JITIBTI, Tf, KA. repnu 6olee 50olo <140/85 MM pr. cr.; flaU[e]rraM c xpoHr.rqecKr.rMr.r ga6onesanucMr.r
    3Kf.
    - KOHCyJrbTarIr4t rroqeK rroKuBaH rleneBofi ypoBeHb AA <140/90 MM pr. cr.; B Bo3_
    Korrponr A{.
    Bpaqapac.rte >75 rer noKa3aH qelenoft ypoBeHb A.{ n npe4enax 140/90Koncylrraqu,r
    aHflroxfipypra r{Jrr.r 150/90 urra pr. cr.

    [IHn,

    Bpaqa-

    flpn

    nponegeHr4tr Kopperqr.rlr A.{ c .qocruxeHr.reM rleJreBbrx ypoBnefi npe4novrureJrbHhr aHTr,rfl4nepreu3r,rBHhle cpeAcrBa ocHoBHbIx
    (uarHoe AHo, xxpypra.
    aHTr.rrulepreH3rlBnhrx K;raccoB r,r ux xou6r.rnaur.rq. B ToM rll,rcJre
    oc'rpoTa 3peHr,tjr, Koncynr,raquu
    reKapcrBeHHhrx cpeAcrB c QurcuponannblMlr lo3aMr,r, couracHo
    rroJrr :penur) . Apyr
    npaueft- KJrr.rulrqecxoMy rrporoKony Ar,rarHocrr.rKr,r v re'tenva sa6olenauufi,
    Koncylsraqlu
    crequiulrlcToB no xapaKrepr,t3)[ou[xcs noBhrureHHbrM KpoBsHrrv 4aurenr,reu (no_
    BpaqaNOKtl3AHI,I'M.
    craHoBJreHr.re Muuucrepcrra 3ApaBooxpaHeHua Pecny6nuxr,r EeTeparreBTa (Bparapycr J\! 59 m 06.06.2017).
    va o6rqefi nparflo norasanra-rt\,r:
    rrru).
    flpu rzneplun v,nev,uvti lu noJrltnuAeMnrrecKue cpeAcrBa: aropBacT aTu'l, po3yBacTaTrrH.
    flpu cygopoxuoM cuHApoMe: rrpornBo3nrrJrenrr,rqecKze JreKapcrBeHHBre cpeAcrBa: Ar.ra3e[aM, SeHnronn, Buurb[poeBiur Kr4cJrora,
    xap6aua:enun.
    flpu ncr,lxonaoropHoM nos6yx,{euuu: aHKcr{oJrr4Tr,tq€cKrre cpelcTBa: TOOfi 30naM i aHTUnCWXOTI,l qecKI,Ie
    : XJI

    o(pra.nruolora

    Bpaqa-peHTreHo3HAOBaCKyJrrpHoro

    x

    62

    TprrQTa314H.

    flpra necru6yrrpHoM clrHApoMe: cpeAcrBa Ant ycrpaHeHr4r roJroBoKpy)r(eHxr : 6erarrcrun.
    llpu ercrpanupaMr4.uHoM cr,rHApoMe: AonaMlrHeprr4qecKxe cpe,ucTBa: aMaHTaAUH.
    flpu .qenpeccrzlr: aHTrrrenpeccaHTlr: aMrrrpurrrr,rlrr,rH, Qnyorcenru,
    rrapoKceTHH.
    flplr rorHurunHbrx HapyureHl4tx: HefiponporelcropHzLs repa[[t:
    nuparleraM, rnrulrH; xoJrlrHa a:r$ocqepar, [[I{AaKpr{H.

    OT. JIOK, rroror€A.

    fIopaxeuue

    O6u1uft analu: (Dyuxquona.nrHar

    MEXIIO3BOHKO-

    MOqI'.

    BOrO

    3KT.

    AHCKa

    rueinoro orAena PerrrrenorpaIpyroro rlrna Sut ureiHoro
    (AxcroreHnar
    oTAeJra rro3BoqepBr{KrInrfir,

    qepnuro6paxlraaru-r) (M50.2)

    HOqHI,IKA.

    penrreHorpaQral
    rnefrHoro orAena
    II03BOHOqHI,IKA.
    Er,roxr4 rr{nqecxoe

    uccJre.qoBaHI,Ie

    6onerorr.r cr.rH.upoMe: HIIBC: u6ynpoQeH, 4NuoSeHar, reronpoQen, KeropoJraK, MeJroKcr{KaM, qereroxcu6.
    B ocrpona flepnoAe sa6orenaHfir rrpLr ycvrenv:a 6otresoro crHApoMa B Hoqnoe BpeMrr: aHrr.roqporeKtophr: L-Jlusuna scquHar.
    flpr,r xpoHrauecKoM Horrfiqerrrr,rnnotvr 6oneeoM cuHApoMe: aHrtreflpecc:ruThr: aMr.rrpr,rrrrr,rJrr,rH, QnyorceruH, napoKcerllH.

    flpn

    OT, JIOK,
    flpra nefipoaracrpoQnvecrou cr.rHApoMe (uevenonarovnoi nepuapr:ponarr.rn) Bbr[oJrueHr,re reqe6nrrx 6noxaA: KoprnKocrepon{[,r
    AJrr cr4cTeMHofo npr4MeHeHr{r: TpI.raMIII.rHonoHa cycrreH3l.rt AJI'
    nlpy6r4Ha, Morre- urrexqr.rft r,rJrr{ MernJtrlpe,qHr.r3oJroHa cycneH3ltt Arr usrexqni c
    KpoBr.r: onpeAeneHr,re KoHqenTpaqru
    rurroKo3br, o6qero
    6erxa, o6qero 6n-

    pacrBopoM rrpoKar4Ha r4Jrr,r Jrr{Aoxar.rua r cy6arporr,uarlrHoe rrpocrpaHcrBo, B clxoxr,rJrr.rr, JroKaJrbHo B KypKoBhre 3oHbr r,rJrH Tpr4r'(uru[,
    xrop4 CPB.
    repHbre Toqxx.
    KT
    MPT flpu nes(p$erurBHocr KoHcepBarlrBHoro JreqeHLIr s re.reHre 2
    mefrnoro orAeJra MecrqeB: KoHcyJrbrarl[r npava-uefipoxupypra AJIt peureHl.rt Bono3noHoqgura+**
    npoca o6 o[eparuBHoM JleqeHr{r,r.
    Br.rHhr, 4peaTr.rHr.rHa,

    Hatptrs,>

    flO

    IIOKA3AHI4'M.

    Y3Af

    rpeqepecocy-

    bpa,rruux

    AOB.

    TKA|.

    6-18

    63

    Koucymraqux
    Bpaqa-TepaneBTa

    (npaua

    o6uefi

    nparrlrru).
    flopaxenue

    O6rquii

    Mex[o3BoHKO-

    KpoBr,r.

    O6ulufi

    aHanlrg

    flpu

    6onenorr,r cr{HApoMe

    HIIBC: u6ynpo$eu, guuo$enax, rero-

    npo(peu, KeroponaK, MeiroKclKaM, rrenerorccr.r6.
    KpoBl4: onpeAeJre- B ocrpou nepuoAe ga6onenanur npl4 ycuneHln 6onesoro cLrHHI,Ie KOHrIenTpaUnU ApoMa B HoqHoe BpeMt: aHrrtonporeKropbr: L-Jluzmua 3cul{Har.
    rJIIoKo3br, o6uero flpu orcyrcrrur s$Qerra: fCfI: rr,rerunnpeAHx3orroH, rpe.qHn3o6ema, o6uero 6n- noH rrapeHTepanbHo LrJrH BHyTpb c KoppeKropaMr.r.
    tupy6uua, Moqe- flapacrlunarorulrMeruqecKl,Ie cpeAcrBa rlpu orcyrcrBlln 6oresoro

    I-ICCJIEAOBAHI{C

    ana,rur

    urefinoro orAera MOIII.
    c pa,quKyJrorra- Penrreuorparueftnoro
    ruefi (M50.1)
    oT,qeJra no3Bo-

    Sut

    Enoxravruecroe

    cr,rHApoMa: Heocrr,lrMr,rH, I{nLrAaKpt4H.

    HOqHI,IKA.

    BI,IHbI, KPEATI,IHI.IHA,

    3Kf.

    Bsrnonnenue,'reqe6nr,rx 6aoraA: DrroKoKoprl{Kou,qx (cycneu:lrr
    MerunnpeAHr,r3oJroua rrpoJroHrl,IpoBanuoro Aeficrn,vt c pacrBopoM
    xrropa,
    uporanna).
    @ynrqnona.nrnar
    peHrrenorpaQrx
    flpra neipoaucrpo@nuecxoru cLtHApoMe (nneuenonarounofi nepuureftuoro orAeJra aprpona'ruu) BbrrroJrHeHr.re neqe6nr,rx 6norar: KopruKocrepou,{bl
    II03BOHOIIHI,IKA.
    Ars cusreMHofo [pI4MeHeHHt: TpI.iaMIIr{HOJTOHa CyCrIeH3I4t AJUI
    npeqepe- usre xrlufi I{Jru Merr,rJrrrpeAHl.r3oJroHa cycneH3rt .qrs flHrexqnft c
    6pamnux cocy- pacrBopoM rrpoKauHa I{JIL JTI{.(oKaHHa n cy6arponuilJlbHoe rrpoc'fpaHcrBo, B cyxoxr,rJrr.rt, JloKurJIbHo B KypKoBbre 3oHbr I4JrH TpI'IfAOB.

    HaTpI{r,

    KiIJIttt,
    CPB.

    Y3Af
    TKItr.

    KT \l:l:n
    uefiHoro

    repHhre ToqKr.r.

    MPT

    orAeJIa
    no3goHoqgura+ * +

    flo noragaruru:
    flpu xponuvecroru 6oresoM

    ct4H,{poMe: rlporrtBognlrJlenrllqecxr{e
    cpeAcrBa: rap6anaarenuH, ra6anerrnu, npera6arnn; aHTI,IAenpeccaHTbI: aMr,rrpr{rrrr4Jrr,rH, Qlyorcerun, napoKcerl.rH.

    OT,JIOK.
    Ilpr,r nesrlrlerrlrBHocrr,r KoHcepBarl{BHoro JIeqeHLrt s reqeHr,re 2
    Mec.f,ueB: KoHcyJrbrarrr4t npa.ra-nefrpoxnpypm AJII pelneulul Bonpoca o x[pYprnqecKoM JIeqeHLI[.

    I4-20

    flopaxenrze

    O6uuft

    (DyHrqzoHalrnar
    KoHcylrraqu-a npaua-Hefipoxupypr-a rurx perreHr.r, nonpoca o xr,r_
    Aucxa KpoBr.t.
    peurreuorpaQzr
    pypruqecKoM rerreHu[ B curyarryl^'^x, rpe6lroruux 3Kc,rpeHHoro
    HeyToqHeHHat
    O6ur.rfi aHanfi:l nefrnoro orlena ITJIU HeOTJIOX(HOfO Mellrqr,IHcKoro BMelltaTeJrbcTBa.
    (Alrcronennar
    MOqr4.
    II03BOHOqHI4KA.
    llepaSepnuecxt,le Ba3oAr,r!'rararopbr: nemoKcrrQnl;u.rH, KcaHTrrHo_

    lrefinoro

    palrrKyJror,rme-

    aHa.,ru:

    PenrreHorpa-

    Er-roxr,rvu.recroe

    Mrr'I, panuKylto- Qur urefinoro
    uuelouureuur) oTAeJra no3Bo(M50.e)
    HOqHIlKa.

    3Kr.

    KpoBr4

    :

    Jra HI,TKOTLHaT, Hr4rleproJrxH.

    flpu orcyrcrnun eQserra: fCfI : ruerunnpeAHrr3o;roH,

    rr ccJIe.qoBaHI{e

    OrrpeAene-

    npeAHr43o_

    JroH napeHTepaJrbHo rrrrl4 BHyrpb c KoppeKropaMr.r.

    Hr.re KoHrleHTpaqnx

    rurK)Ko3br, o6tqero

    6e,rra, o6rqero

    trupy6uu4

    6r.r-

    Motre-

    BrrHhr, 4peaTr,tHHHa,

    Ha.TpEA,

    KaJItt',

    x.nopa, CPF.

    KT ,rlyt

    MPT

    mefiHoro

    orAeJra
    ttogsoHoqHu(a* * *.

    flapacuunaroufiMerr{qecKr,re cpeAcrBa rrpr4 orcyrcrBr.in 6olenoro
    cnH.qpoMa: HeocTnrM[H, XnH,rlaKpHH.
    flpr.l 6oneeona crrHApoMe HIIBC: auxno@eHax, reronpoQeH, rero_
    ponaK, MeJroKcrararr,r, r.r6ynpo$en, qelerorcrn6.
    flprl nefipouarr.lqecKoM 6oresolr cr,rHApoMe: flporr,rBogru4Jre[r{_
    qecKue cpeAcrBa: rap6aua.:enzu, ra6anerrruru,
    npera6alun; auru_
    Aerlpeccarrrrr: aMlrrpumxJrl,IH, Snyoxceun, napoKcerr.rH.
    OT, JIOK.

    KoHcylrrargtu
    Bpaqa-

    uefipoxr.rpypra,
    Bpaqa-opToneAaTpaBMaTOJIOra.

    Apyrar yroqHeHH:UI .qereHepau[r Me)r(ro3BOIIKOBOTO

    grcxa

    (nepre6poreHHaJr TOpararrzr) (M51.3)

    O6Irlt,rfi ana,rug Euoxuuuqecxoe

    u6y@

    flpu- 6o;renonr cr4HApoMe HIIBC:
    npoQen, Keroponar, MeJroKcr{KaM, qelexorcu6.
    O6rqufi aHanlrs KpoBr.r: ofipeiqene- flpu xpoHr.rvecKoM HorllrIlemfisHor{ 6o,.resoM
    cnHApoMe:
    MOtI'I.
    Hr{e KoHrleHlpauuu npeccaHTbr: (plyorceruH, aMr4Tpr,rnrrrJrr{H, napoKcerr.rH.
    PenrrenorpauroKo3bt, o6qero OT, JIOK.
    rpy,qHoro
    6erra. o6urero 6r.r$ut
    KpoBn.

    oTAena

    I,ICCJIC.IIOBAHI'E

    rro3Bo-

    HoqHr4Ka

    s

    2-

    tupy6una,

    Moqe-

    aHT}r.qe_

    65

    npoeKrllrrx.
    Ha'rput, K:lJrHr,
    PeHrreHorpax,ropa, CPE.
    $tu opraHoB Y3I4 opraHoB

    rpyguofr

    KJrer-

    6prournofi

    noJro-

    cTu.

    KI,I.

    ofIC.
    KT ulr4

    3Kf.

    rpyAHoro

    MPT

    oTAeJra

    NO3BOHOqHI,IKA IIO

    nora3aHltttt*

    *

    *

    .

    KoHcyarraqul
    Bpatra-TepaneBTa

    (npava

    o6qefi

    nparnmt).
    Koncylrraqur
    Bpaqa-opTone.qalpaBMaTOnOra.

    ,{pynue

    yro.r- O6l1rafi ana:rus Er,roxurura.lecxoe

    HeHHbIe CMerqe-

    Ht'lt

    KpoBr.r.

    Mexno- O6rqufi aHalut

    3BOHKOBbTX AlrC-

    MOqr{.

    KOB

    PenrrenorpaSun norcHr{q-

    nal

    (.4r4CKOreH-

    nronr6anrr,u,

    mou6aro)
    (M51.2)

    HOrO

    OTIeJra

    N03BOHOqHI,IKA.

    IlccJre.uoBaHre
    KpoBr,r: onpeAeJreHr.re KoHrleHTpaquu

    DrloKo3br. o6ruero

    6erra, o6uero 6rtrupy6uua, MoqeBItHbr, HaTpr,rr, Ka-

    rua, xropa, A;IAT,
    AcAT. CPE.
    OynrquonalrHar
    perrrrenorpaQur

    notcHltrlHofo

    oTrlo3BoHoqHr.qera

    flpu 6oreeorlr

    cr.rnApoMe HIIBC: ra6ynpoQeu, ,quuo(penar, xeronpoQeH, KeropoJraK, MeJroKcr{KaM, rleneKoKc[6.
    flptt xponuuecKoM Horllrqenrr,rsHolr 6oresoM cHHApoMe:
    arrrl,IAeflpeccaHrrr: Q.nyorcvruH, aMuTpr.rrrrunr,rH, rrapoKcerr{H.

    OT, JIOK.

    s-10

    66

    Ka.

    v3I{

    opfaHoB
    noJro-

    6prouuofi

    cru,

    6pnrrnofi

    aopTbt.

    V3lI Ma,roro rasa.
    KT unu MPT no{cHI,IqHOrO OTAeJIa
    noaBouo.IHvra* * +.

    Koncylrraquu
    rpavefi-

    cneuu IlIcToB

    rro

    TIOKiBAHI,UIM.

    ,(pyroe

    yroq- O6rqrafi aHaJr[s EloxuMr4.recroe
    llpu OoneBoM cr.tHApoMe HIIBC: u6ynpo$en, .qurcloQenar, rero_
    HeHHOe nopa- KpoBr4.
    r,rccJre,qoBaHI,re
    npoSeH, KeroponaK, MeJroKcr,rKaM, qeleroxcu6; BhrrroJruenne JrexeHI,Ie Me)Kno- O6rqr.rfi aua.nus KpoBr{ : onpe.qeJre- qe6Hrx o6ea6oluuaroqrx napauep:re6paJrbHbrx 6.noxa4.
    3BOHKOBOTO
    MOqI{.
    HI,IE KOHIICTITPAUEI{
    B ocrporr,r flepuoAe ga6oresanr,Is flpv ycwre:rrlzra 6onesoro cr.rrr_
    .qr{cKa (4ucro- Peu:rrenorparJrroKo3hr, o6qero ApoMa B HoqHoe BpeMir: aHrr{oflporeKTopbr: L-Jluglrua ec{zuar.
    reHnas rroM6o- Sw rorcHr.rq- 6erna, o6uqero 6u- flpu xpoHrvecKoM Hour{qemusnon 6oreeoM cr{HApoMe:
    ntluuwlr:ut)

    HOrO

    (Msl.8)

    II03BOHOqHI,IKA.

    OTAeJra

    :lupy6uua,

    MoqeBXHbr, HaTpr,rjr, Karur, x.nopa, AIAT,
    AcAT, CPB.

    aHTr4Aerrpeccanrrr: (prryoxcerun, aM Tpr{[rr,rJruH, flapoKcerrrH.
    flpu neeS(peru.rBHosrl KoHcepBarr,rBHono JreqeH[r s reqeHNr.r 2
    MecrUeB: KoHcyJrbrarlurt rpava-nefipoxnpypra Inr perrreHrrr Bo[poca o xupyprFrecKoM JreqeHrrr,r.

    OyHxquoualrnax

    OT, JIOK.

    peurrenorpalpr.rx
    IIO-,ICHI,TIIHOTO OT-

    Aena no3BoHorrHuKa.

    KT uru MPT notcHr.IqHoro oTAeJIa
    rtogsoHoqHuxa* * * .

    8-20

    67

    Y3I4 opraHoB
    6pnulrofi rroJrocrl,r, 6prourHofi
    aopTEr.

    Y3I4 ua,roro ra.:a.

    KoHcylrraquu
    rpa.reftcfleqfiaJrr,icToB rro
    IIOK:l3AHI4-'IM.

    flopaNeune

    O6rquft aHarfla Euoxr.ruuqecroe

    Mexn03BoHKoB6IX ATTCKOB nO-

    KpoBx.

    I,IccneAoBaHr,re

    O6qlrfi

    aHa.nu:

    rcHI,IqHOrO V, MOqU.
    Apyrrx oT,[eJroB PeurreHorpa-

    c

    pa.{LrKyirona-

    rtlefi (M5l.l)

    Qu.r

    florcur.rq-

    HOrO

    OTAeJra

    TIO3BOHOqHI{KA.

    flpu 6onenou

    cr.rHApoMe HIIBC: u6ynpo$eH, Ir4rorolpeHaK, KeronpoQen, KeropoJraK, MeJroKcHKaM, qelerorcu6.

    r9oBn: onpelene- llpu orcyrcrnuu

    sQ(f erra:
    Hr,re KoHuerrlparlHu
    rraernnnpe,{Hl.r3oJron, npeAHr.r3o:roH napeHTepaJrrHo r.rJrr,r
    MoqeBr,rHbr, 4pea- Brryrpb c KoppercropaMrr.
    TrrllyrHa, 6usrupy- B ocrporu neplroAe sa6oresanltr npu ycr.rJreHr.ru 6onesoro cuHArAT, apoMa B Hor{Hoe BpeMr: aunroflporeKropbr: L-Jlurnna ecqunar.
    AcAT, CPE.
    flapacuunarour.rMerr{qecKr{e cpeAsrBa rrp}r orcyrcrBr,flr 6oresoro
    opmHoB cr.rHlpoMa: HeocTarMr,tH, unl,I.qaKpr{H.
    6prournofi rroJro- Brrnonuenze Jre.re6Hrrx 6lorag: nrrcKoKoprlaKorqsr (cycnenaur
    6prourrofi MerrrJrnpe.uHr{3oJroHa npoJlonr[poBaHHoro leficrrur c pacrBopoM
    aopTbr.
    rrporiMHa naparepre6pa;rrHo).
    V3lI Ma:roro ra3a. flo noragannau:

    fCfI:

    6uua,

    Y3I4
    cru,

    Oynrquoualrnar
    flpu uefipouar[rrecKoM 6oresoM crrHApoMe: nporr.rBo3rruJremfiqecKlae cpeAcrBa: rap6arua-renr,IH, ra6anerrrl{u, npera6a:u,tr; anrr.rperrrrenorpaQur
    IIO'CHI,IIIHOTO OT- AenpeccaHTrr: aMnrpr,rnrl{JrrrH, @lyorcerran, napoKcerr.tH.
    AeJra no3BoHoqHr,r- OT, JIOK.
    Ka.
    flpn ueeQQerrrlBHocrl,t KoHcepBarr,rBHoro Jrerrenl,tr s re\enue 2
    KT snlr MPT no- MecrrleB: KoHcyJrbrarl[r npava-Hefipoxupypm .uJrr perxeHr.rr BotcHr.rltHono oTAeJIa npoca o xr4pypfruecKoM JreqeHun.
    no3noHo.ttutra* * +.
    Koucyrtr'raqur,r
    npauefi-

    l4-20

    68

    cnerluajlr4cToB no
    noKa3aHIrqM.

    llopa:renne no- O6qufi analn: Buoxfi]r]r.recroe

    Koncy,:rraqua npava-nefipoxlrpypra AJrr perneHr.rr Bonpoca o xt,t-

    tcHI,rrrHofo

    KpoBH.

    Me)Kno3BOHKO-

    O6u1nfi analu: KpoBn: onpeAeJre-

    BOIO .IUCKa HeyroqHeHHoe

    MOqIl.

    Hr.re KoHr,leHTpau[u

    Peurreuorpa-

    (Arcxoreuuar

    Qur

    MoqeBr,rHbr, KpeaTlrlavna, 6utrupy-

    pyprl'qecKoM JreqeHnr,r.
    Ilpr.r 6onerou cuHApoMe: HIIBC: guxloQeHar, u6ynpo$en, rvronpo$eu, KeropoJraK, MeJroKcr{KaM, qenerorcu6.
    fleplrQepr.r.recxue BiBoAuJrararopbr: neHToKcuQr.rruuu, Kcarrrr.rHo-

    pa.[uKynoumeMr,rr, pa.qr4Kyno-

    uuelolrureuru)
    (M51.9)

    I4CCJTeAOBaHUe

    norcHr.rq-

    HOrO

    OTAeJra

    tIO3BOHOqHI{KA.

    6uua,
    HI'E

    onpeAeJre-

    AK|I,IBHOCTI,I

    AJIAT,

    Jra Hr,rKoTr.rHaT, Hr{ueproJrr{H.

    llapacurlrna'rolrlrMeruqecKr4e cpeAcrBa npll orcyrcrBt4ra 6onesoro
    cuH,qpoMa: HeocTLIrMXH, r.rnxAaKpuH.

    AcAT, flpu uefrponaulrecKoM 6onesola cr.rH,qpoMe: nporr.rBognr-rJrerrrfiqecKr4e cpeAcrBa: rap6alra:enun, ra6anerrrun, npera6aauu; armlCPB.
    OyHrquoua,rrHa-n
    AellpeccaHTbr: aMr.rrpfi mI{JILrH, $nyorcerun, napoKceruH.
    peHTreHorpaabut
    OT. JIOK.
    notcHl,rrlHoro oTAeJra rIo3BoHotIHI,IKa.

    Y3lI

    oprauoB

    6prorunofi

    efi,

    rroJro-

    6proruuofi

    aopTbl.
    V3LI rraanoro raga.

    KT

    r.uru

    MPT noOTA€JIA

    'CHI,ftIHOTO
    IIO3BOHOIIHI,IKA* +*.

    Koncymraqr.rx:
    Bpaqa-aKyIIreparltHeKonora, Bpa-

    qa-yponora.
    flopaxeHu-n

    O6u1ui analz: 3HMf.

    Koucymraqu-r npava-uefipoxr.rpypra Anr perneuur Borrpoca o xu-

    20-40

    69

    MEXTIO3BOH(O-

    KpoBn.

    B6IX AI,ICKOB

    O6uufi

    TIOU

    MOq

    aua:rue

    .

    'CHI,IqHOIO
    Ipynrx oTAeJroB Euoxulruqecroe
    C MI,ICNOIIATI4Efi I{CCJIeAOBaHHe
    (M51.0)

    4poBn: oflpele-

    JICH E KOHIIEHTpaqrar4 FJrroKo-

    36r,

    o6qero
    6erra, o6uero
    6unupy6un4
    MOIICBI,IHbI,

    prur, KzurraJl,
    xrropa, AIAT,
    HaT

    AcAT, CPE.

    KT unu MPT notcHI4qHOrO OTIeJla
    no3got'to.rHuKa* * *.

    HefiponporerropHuu reparlrrr: nupaueraM, BrrHnousr.uH, rJrxr1lrH,
    STLLIMeTr4JIfI,lIpOKCI.InuplrAr]Ha cyKIlI{HaT, MeTLrn3TI'IJrnUpI4ALrHOIa

    Koncynrraquu

    rr,rapoxnopr{A;
    napacl'IMnaToMliMeTuqecKl4e cpe.qcTBa: HeocTLlfMI4H, XOJII,THa aIIb_
    cneqnaJll4cToB IIO Socqepar, r4rrulaKpr.tH,
    noKa3aHl,ttM.
    flepu@epravecrrre Ba3oArrnararoprr: nenrorcrz(pr,tJrJrHH, KcaHTr4HoJra HT4KOTUHaT, rruqeprojrl4H.
    flo norasaHraru:
    flpu cnacruuecKoM crrHApoMe: Mr,ropeJraKcalrrbr ueH.rpaJrrHoro
    Aefi crsrar: 6ax;roQeH, ToJrnepu3oH.
    flplr ueiiporenHux paccrpoficrnax MoqeficrrycKaHr.ur:
    cpeAcrBa Arr rerreHr-rr )ponoruqecKr.rx sa6oresaHfift : oxcu6yrun,
    Tpocrrur xJropru; cpeAcrBa, npxMerureMhre npu,qo6pora.recrBeHapauefr-

    uofi runepua"ur npe,ucrarenrgoii xelegn: TaMcyJro3uH.
    flpr.r 6o;renou cnurpoMe: HIIBC: ,qr.rKroQexarq rvroupoQeH, rceTopoJraK, MeJroKcr.rKaM, u6ynpo(!en, qelerorcu6.
    flpr neftponarIllrecKoM 6onenoru cHHApoMe: rrporr.{Bo9fluJrem[qecKl4e reKapcrBeHHbre cpeAcrBa: rap6auatenuu, ra6anermaH,
    npera6aruH; aHTnleflpeccanrn: Qlyoxcernn, aM[Tpr,rr]Tr4Jrr4H, rra-

    PerrrreuorpaQtrrt [orcHr.[q-

    HOrO

    pyprHqecKoM JrerreHun.

    OTAeJra

    fIO3BOHOIIHIiKA.

    poKcerr,rH.

    OT. JIOK. MexaHsrepannr.
    Corp-rcenue ro- I4sruepenrne A,{.
    JIOBHOTO MO3ra

    O6ult{ft

    (s06.0)

    4poBn.

    ananus

    33r.

    KT

    roJroBHoro

    MO3ra***

    .

    3Kf.

    PerrrrenorpaQr.r.r

    PenrreHorpaQur .repena.

    ulefrHoro

    3xo9C.

    Koucy,rrraqru

    Koncyrr,raqra-e
    Bpaqa-

    Apyrux

    orleJra

    II03BOHOqHI,IKA.

    BpaqeicneqlzaJlucToB IIO

    flpr.r pa:arnura 3a6o,'reBaHl,Ir naq[errra gKcrpeHHo rocflmaJrlr3upyror B Hefipoxupypnauecxoe (xr.rpypru.recroe) or.qe,renue pafionuofi (ropo4croft) opranueaqnr,r 3gprrBooxpaHeHr.rr.

    flocre

    Bblrrr.rcKr4 npoAoJrr€Ior Ha3HaqeHr,re JleKapcrBeHHbrx
    cpe.qcrB rro cxeMe, peKoMeHgoBaunofi s crarlfionapHbrx yc;roBlrrx
    opraHr{3aqr{[ 3IpaBooxpaHeHrxr.
    Moqeronnue cpeAcrBa: Qypoceur.r.4.
    Heiiponporercropsu Tepanvr.:- rJrr.tur4H, truparleraM, 3TrdrMerrrJr-

    5-14

    70

    ooTarr,Morora
    (r,la.:noe IHo,

    ocTpoTa

    TIOKA3AHI''M.

    fl.rApoKcr4nupr4lnHa cyKrlr4HaT, MeTr,tJl3Tnnnr4p},r.4rrHojra nuapoxJroprrA.

    flo nora.:aHrlqu:

    3pe-

    flpu

    ncr.rxouoropHoM Bo36ylqqenur4: aHKcfiorr,rrr,rqecKr{e cpeacrna: 'roSusonau.
    flpr,r cygopoxnoM cHHApoMe: nporxBognr{JrerruqecKr{e cpe.qcrBa:
    QeHur:otu, Kap6aMa3ennH, BilJlbrrpoeB:rr KncJrora.
    llprl 6oleeou cnHApoMe: aHaJlbreruKr4-arrrr4rll,rperr,rKrr: MeraMr,r-

    lF'r1'fl).

    HaTpr{r, napaueTaMon.
    flplr pnore: rpoKr.rHerr,rKr{: .qoMnepu,qoH, MeroK;rorrpaMxA.
    flpra recrr.r6yrrpHoM cr{H.qpoMe: cpeAcrBa Anr ycrpaHeHrr.r rono3OJr

    BorpyxeHuJr: 6erarucruu.
    OT, JIOK.

    Ouaroaar Tpar- O6u1r.rfi auanrls Euoxurrauqecroe
    MA TOJIOBHOTO KpoBr,r.
    rrccJIe,qoBaHIre

    flpu parnrruu

    Mo3ra (yru6 9Kf.

    pylor B HefipoxupyprrqecKoe (xrpypmtrecKoe) orlelenue pafi-

    CTCNCHI,I

    onaofi (ropogcKofi) opraHlr3arlur.r 3ApaBooxpaHeHr.rJr.

    l0-18.

    KpoBr.r: o[pe.qene-

    A,{.

    toJIoBHOTO MO3-

    I,Isrraepenue

    ra) (506.3)

    PerrrenorpaQr.rr vepena.

    3a6oreBanrrr naqleHTa 3KcrpeuHo rocrr,rraJrlt3lt-

    HI,I€ KOHII€IITpaIIITIII

    MorreBr,rHbr, Kpea- flocle Bbrrnrcxrl npoAoJrxaror Ha3HaqeHr{e JreKapcrBeHHbrx
    T*rur4taa, 6utrupy- cpe,qcrB tto cxeMe, peKoMeHAoBaHHofi n craqrouapHbrx ycJroBr.trx

    6uua,

    3xo3C.
    Koncylrraqur

    AcAT.

    Bpaqa-

    33f.

    AIAT,

    opraHr.r3arlrrr4 3ApaBooxpaHeHr4c.

    flpu ueSanruvecKoM

    cuH.qpoMe: aHaJrbrerr,rKr,r-auTr,mlrperriKr,r: Me-

    Harput.. flapaueTaMon.
    o([rarrrruorora
    PeHrrenorpaQr.rr
    Moqeronnrre cpe.qcrBa: Qypoceur4.
    (rlasnoe AHo, firefiHoro orAeJra HeftponporerropHaur repaflll: nu,rqr,rH, nr{parleraM, gTr,rJrMerr.r;rocTpoTa 3pe- II03BOHOqHI'KA
    fnApoKcr.rrrupn,4nHa cyKuI{HaT, MeTr.UrSTlrJrnr,rpr,rAl,rHona ru,qpoHLIA).
    KT nnu MPT ro- xrropru.
    JIoBHoro Mo3ra+** flapacuunarour{Merr{qecKr4e cpeAcrBa: xoJrr.rHa am$ocqepar,
    TaMra3oJr

    nnr{aaKpr,rH.

    KoHcylmaqlu:

    llo nora:anuql{:

    Bpaqa-

    flpu genpeccuu: aHTr,rAerrpeccar

    Hefrpoxnpypra.

    napoKceTnH.

    br: aMuTpr{mr.rJrr,rH, QnyoxcerlrH,

    flpu nerrofi

    flpu

    cpeAgrefleHr,r
    Hefi

    - t4-25.
    llpu rr)r(elofi

    crenenu

    -30v6oJIEC.

    7l

    Koucyrr,raquu

    flpr.r ncuxol.roropHoM noa6yx4eHnn : anTuncr4xorr,rqecKue cpeAApyrl4x Bpa.refi- crna: rpuQlyonepa3r{H, ra!'roneprzAoJr, x;ropnporrrKceH, KJro3arr}rH,
    cnequanl{cToB rro cynbnl,Ipr4a, KBeTLIa UH; aHKCr4OJII,tTHqeCKr.re cpeAcTBa: rosuro_
    NOK'BAHII'M.

    naM, AI,Ia3eIaM.

    flpu cyaopoxuoM

    cr{HApoMe: nporr4Bo3[uJrerrnrrecKue cpeacrBa:
    rf enurouu, xap6arua-:enun, BaJrbrrpoeBzur Kr.rcJrora.
    flpu poore : npoKrrHerrixr,r: AoMnepr,rAoH, MeroK;ronpaMHI.
    flpu necru6ynrpHoM cr{H,ApoMe: cpeAcrBa Arr ycrpaHeHr.r, roroBoKpyxeHnr : 6erarncrun.

    OT. JIOK.
    Snugypa;rrnoe

    O6qr.rfi

    rq)oBo143JIrrrHr.re

    4poBr.r.

    (s06.4).

    ana.,rns

    lpu pa3Bl{rurl saboresaHr.rq flaqtrerra 3KcrpeHHo rocn?rraJrLt 3r,t_
    pyror B neftpoxupyprnvecroe (xr.rpyprrvecroe) orlelerue pai_

    Er,roxurr,rr.tqecroe

    I

    I,ICCJIC,IIOBAHI,IE

    3Kr.

    KpoBr4

    A,{.

    I,Isuepenrae

    :

    orrpeAeJre-

    oHuoii (ropo4crofi ) opraHr.rsaqur, 3ApitBooxpaHeHr.rlr.

    HI,IE KOHIICFTPAIII4 I,I

    Tparuarnvecroe cy6gypanr-

    Pernreuorpa-

    MoqeBr,rHbr, Kpea-

    Qua .repena.

    HOe KpOBOU3JIH-

    3xo9C.
    Koucylrraqur

    TlrHr,rHa, 6uttupy- cpeAcrB tro cxeMe, peKoMeH.qoBaHHofr n c:raquonapHbtx ycJroBlt x
    6uua,
    AIAT, opraHr.r3arlur{ 3ApaBooxpaHeHr,rr.
    AcAT.
    Heftponporerropuau repaflHrr: rrr.rrluH, rruparleraM, 9T[nMerLtJr39f.
    rHApoKcr{[[pr{Ar,rHa cyKrIr.IHaT, MeTrUrgTlrJrlrfiplrlr.tHoJra rx,qpo_

    ruue (S06.5).

    Bpaqa-

    Tpanuaruvecroe cy6apaxuo-

    (uasnoe

    AHo,

    r,rAaJrbHoe Kpo-

    ocTpoTa

    3pe-

    BOI,I3JII.I'HI,IC

    latrrr).

    (s06.6).

    oQ:ra.,rruolora

    flocae BblnrrcKu npoAonxaror

    Ha3HaqeHr,re JreKapcrBeHHhrx

    xJrop I.
    rrefrHoro orAeJra flapacurranarour,rMerr.rqecKr4e cpeacrBa: xoJtr.rHa
    II()3BOHOIIHI'KA
    urrxla4pr.rH.
    Penrrenorpa(pr.rr

    anrQocqepar,

    KT ulra MPT ro- flo noxa-sagr,rrlr:

    JroBHoro Mo3ra* * *

    Koncylrraqnr:
    Bpaqa-

    uefipoxlEpypra.

    Koncylrraquu

    Apyrrx

    npauefr-

    c[equaJllrcToB

    nO

    flpu

    4enpeccur4: aHTr.rAenpeccarrrbr: aMr.frpurrrr4Jll,rH, (pnyorcemn,
    napoKceTr{H.
    flpr.r ncuxotroropHonr nos6yN4eHrrut, attt4rrcvtxoruqecKrie cpeAcrna: rpr.rQ.nyoflepiur4H, ftraoleprlloJr, xnopnpornKceH, ruro3arrnH,
    cynbflr,rpr.IA, KBeTXanr4H; aHKcuoJrr.tTr,rqecKrre cpeAcTBa: roQuso_
    IIaM, AI,Ia3e[aM.
    flpu cyaopoxnoM clrHApoMe: rrporrlBo3nrarrerr .rqecKt,re cpeAcrBa:
    OeHr.rrouH, xap6aMasenm, BaJrbrrpoeBalr Klrc;rora.

    10-30

    '72

    llpu pnore : [poKr4uerr4Kr.r : .{oMnepr4,uoH, MerornotrpaMrrA.
    flpu recru6ylrpHoM cHHApoMe: cpeAcrBa IJrr ycrpaHeHr4r roJro-

    IIOKA3AHI,I'M.

    BOKpyXeHr{r: 6erarncl.rg.
    @T, JIOK.

    Tpanlra Hepnor O6uluft ana,rvs 3HMf.

    j

    llpu

    ra:onupoeaHriofi TpaBMe

    B

    cJryqae pe:Koro

    Ha

    ypoBHe
    npe.qnneqbt

    Qua

    orpaHuqeur{t
    l,PerrrenorpaQlr.a
    KoHerrHocTH
    H
    HeBO3MOXHOCTT4
    npoBeAeHr.rr
    ireqeHrr B
    QYUttUlru
    opraHoB lpyAHofi I aMoynaTopHbrx yciroBtrrx ocyqecTBJueTcr SKCTpeHHiUr focnr,rTa_
    I
    KJIETKII.
    I nu3aw4t naUlreHTa r ueipoxr.rpypruqecKoe unu HeBpoJrorFrrecKoe
    Koncy:rraqlrx:
    orAeJreHrre pafiouuofi, o6racrHofi opraur,r3arllrr4 3.qpaBooxpaHeBpaqaHvg.
    Hefipoxupypra,
    llplr couerannoft Tpaerue ocyrqecrBJrrercr

    (s54).

    ca.

    TpaBMaTOnOra.

    Ha ypoBHe rrJre- KpoBn.
    qeBofo notca n B eas[cr4r{ocflr
    rueua (S44).
    oT noKiurr{3arlulr
    noBpexAeHur:
    Tpanua HepBoB PernreHorpa-

    rocrefi
    IIJICAIEBOTO IIO'- Bpaqa-opToneAa-

    Pernrenorpa$ut xocrefi
    Ha ypoBHe 3aru- lpeAnneqbr.
    CTI' LI KSICTI{ Perrrrenorpa(s64).
    lyqeQur
    3arurcTHoro cyTparlra HepBoB crasa u xocreft

    Tpanua

    HepBoB

    Ha ypoBHe Ta3o-

    KI,ICTI{.

    6e4pennoro cy- Pernreuorpacrana u 6egpa Qru roc, efi ra(s74).
    sa z :raso6egpeHHbrx cycTaTpanrr,ra HepBoB

    BOB.

    Ha ypoBHe ro- Perrrreuorpaureuu (S84).
    Ma Kocrefr roJIEHI{.

    Tpanua nepnon Penrrenorpau-

    Ha ypoBHe ro-

    MA TOICHOCTOII-

    sKcrpeHu:ur rocrtrlTaJr 3a\ut nau[eHTa B TpaBMaroJroruqecKoe orAeJreHrre pafioHHofi,
    o6racrnofi opraHrrarlHr,t 3ApaBooxpaHeHr{r.

    floc.ne BhI[[cKr,r npoAonxaror

    Ha3Har{eHr.re JreKapcrBeuuhrx
    cpeAcrB rro cxeMe, peKoMeH.qoBaHHofr B craquoHapHbrx ycnoBllrx
    opraHr8arlrrr4 3lpaBooxpaHeHrur.
    flo noxasanzsM ocyrqecrBJrrercr xrpypfruecKoe JreqeHne.
    flpu 6olenona cr,rH.qpoMe: HIIBC: u6ynpo$eH, grxlo$eHar, reronpoSen, Keropo:IaK, MeJIoKcuKrM, rlelerorcu6.
    Moqeronnne cpeAcrBa: Qypocelru4.
    fCfI: naerunnpeAHu3oJroH, rrpeAHr.BonoH BH)npb.
    HefiponporerropHalr reparrwr: nnparleraM, r.lrrrlnH, 3Tl rMerr.nflupoKcnllHprlql.IHa cyKrIuHaT, MeTI,LJISTrrJr[r.IptrAtrHoJra rr{Apo_

    xjropuI.
    flapacuvnarour,rMerr4qecKue cpeAcrBa: Heocrr,trMr,rH, r.rn[IaKpI.IH.
    llepr.r$epr.ruecrze Ba3oArr.Jrararoprr: nerrroxcuQr,rJrJrr,tH, Kcarrrr.tHoJIA HI4KOTI,IHAT, HHIICPTOJII,IH.

    flpn

    uefipona:nrqecKoM 6oresoM cr,rnApoMe: nporr.rBo3nr{Jrerr,rrrecKlre cpe.qcrBa: rap6ana:enraH, ra6anerrrrn, npera6alnu; anruAenpeccaHThr: aMr{Tprzrrrnnt rH, $nyorceruH, napoKcerHH.

    8-30

    73

    JIEHOCTOIIHOfO

    fioro cycraBa

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    paft onnoi opraHrr3arlnn 3ApaBooxpaHerrrr.

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    (cnuHuoro)
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    Eoxosoft
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    (Grz.2)

    O6uuil

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    ruesee

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    flpu

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    cpe.ucrBa: Mr.rAa3oJraM;

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    9l
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    (G20).

    Ha pauueii (ucocroxueunofi) cra4nu :a6onesannt t0-t2
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    pes 3 vaca n

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    (G21).

    KpoBr.r: onpeAeJICHHE KOHUEHTpaqufi fnroKo-

    Er.roxr.rurqecroe uc- Ha panuefi (Heocroxnennoi) cra.qlru ga6onesaHllt
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    dusrupy6uu4
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    nnpu6eglrr.

    AorraMr{HepmqecKr4e cpeAcTBa: aMaHTa,u[H, npaMr,rneKcoJr, nupu6e.qur;
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    -

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    Hr{rpiurbHau

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    4erenepaqlu)
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    oQraaruorora

    flpr.r no:.qnefi (ocroxnennofi) cra.qlru ga6oresaHut:
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    -

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    -

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    33f;

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    flpu

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    (E83.0)

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    Koncymraqur
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    PHruI
    o6oregonaulu n pafioHnofi opraur.r3a- .UOTIOJIHI,ITCJII'HO :
    paftornrofi opra- rlrrH 3ApaBooxpaHe- ocyqecrBJrrror rrepBuqHyro,qr,rarHocrr,rKy 3a6oneHeBpoJroftltl
    *l HII3a\fiV SlPa- Htta,
    BAHWfl;
    nefipoxuBOOXpaHeHr,rr,
    npoBoArr: no,q6op Ao3br neHr.rrlrdJliliuuna KJrr,r
    AOnOJIH[TeJrbHO:
    pyprnr.
    33f;
    cynrQara qr{HKa rro,q KorrrpoJreM o6uero arLurnsa
    AOIIOJIHI{TEJIbHO:
    MOireKyJUrpHoKpoBu r{ o6ulero alaaJtur3a ruoura I pas g 2 ueAerr,r n
    6lloxr,runqecroe reHeTl{tlecKat .qua- TerreHue 2 ruec-rqes, saren I pa3 B Mecrrl B Teqefire
    O6lacr-

    r,rccJreAoBftHr.re

    THOC[I,IKA;

    KpoBr.r: oflpeAe- KOHCyJrbTarIuU ApyJICHI{C KOHIICH- rllx
    npauefiTparlxn {epyJto- cleq[rlJrxcToB Iro IIoIIJIA3MIHA

    Il

    MC-

    3 rr,recgues:
    KOnTpOnB KOHrIeHTpaqr4Lr qepyno[Jra3MrrHa vr Me4vr
    B KpOBr{.

    KA3AHI.IJIM .

    TN;
    onpeAeJreHr-Ie

    sKc4peqrl,I Mecyrounofi

    gr r

    MOqe;

    MPT rolonnoro
    MO3fa.

    .{ucroHra-r

    Pafion-

    O6uuft

    ananzs

    PeHrrenorpaSu-r

    flpu

    nepnuuuofi Anaruocrure flau eHT HanpaBnfi-

    r0-t2

    KpoBr{.

    O6uluir auatuz
    MOqU.

    BlroxrEuuqecroe
    uccJIeAOBaHr,re

    KpoBr{: onpeaeneHI,Ie KOHTIeHTpaqI,Iu rJrroKo-

    3H,
    6erra,

    3BOHOIIH14KA.

    s o6racrnyo,

    pecny6nxKaHcryro opraur{3a-

    qrrr4 3ApaBOOXpaHeHut.

    flpu rouuuecroM

    rr4nepKr4He3e: rrporrzBonapKr,rHcoHr{qecKue cpeAcTBa: aHTr.txoJrHHeprr4qecKr,re cpeA_

    crBa ueHTprurbHoro .qefrcrBr4r:

    Tpr.IreKcrl(beHr4.ql{Jr;

    MlropenaKcaHTBr rIeHTp:IJrbHoro geficrr'ur.:

    x.nonuuecKoM rr.rnepKriHse: rporr.tBo3nr{Jle[rrc,rora, rap6a_

    TUqecKI,Ie CpeAcTBa: BanbrrpoeBrur

    o6tr1ero

    MA3CIII{H, KIIOHA3ENAM.

    MOqEBI,IHBI,

    HaTpI{r, Kiulnt,
    xJrop4 orrpeleJICHI,IC AKTIIBHO-

    AIAT,

    AcAT.
    Koucylrraqnr
    BpaqaTepiureBTa.

    6arlo_

    QCH.

    flpu

    o6uero

    6unzpy6una,

    crr.r

    urefHoro orAera no- elc-s

    IIpu L-DOPA qyBcrBr{rerrBnofi Qopue:
    na./rap6r.r.qoua, nesoAona/6euceparug (xancylsr c
    ruogr,rSuquporanurrM srrcso6oxgennerr,r) ;
    npoTr,rBo3ruLJrerExqecKr,re cpeAcTBa: BulJrb[poeBiur
    Kr,IcJroT4 xap6alrasenzu.
    flpn reuepanusoBauHofi .qrcrour.rr.t:
    alrtr,rllcuxoTuqecKHe cpeAcTBa: KJrO3alr,rH, raJrone_
    pr,rlojr, cynbnxpuA, pr.rcnepr4AoH;
    6era-a.qpeno6aoKarophr: npolpaHonon.

    OT, JIOK, ncrxoreparrr.
    O6,racrHbIC.

    PHruI
    HeBpoJro-

    muu

    uefipoxzpyprr.rH.

    O6reu

    u

    Fnoxuuuqecxoe uc- Jleqeuae axaroruqno JreqeHr,Ilo, [poBoAr.rMoMy ttanocrr o6clego- cJIeAOBaHI,re KpoBlr: rlr.reHTy n pafiounofi opraHrl3arlur,r 3ApaBooxpaue_
    BAHIUI AHtINO- o[peAeJreHr,re KoH- HUg.
    rr,rqnhr o6teuy qelrlpaql{r4 rlepyJro- .qorroJIHr,rTe.rrbHo :
    o6clegonaHux I ruIA3MI,IHA, MCAI,I.
    nplr flepBr,rrrHbrx KpaHr.riurbHbtx 4acronurx _ 6le_
    paftonnofi opra- KT ruru MPT rononEapocna3Me, qepanraluro[ Avlcrolanv npn orcyr_
    Hr{3aIIfiU gAPa- Horo (cnr.rnnoro) crnun sQQerra or MeAr.rKaM€HTo3Horo
    JrerleHr.rr Ha
    BOOXpaHeHr,tr.
    MO3ra.
    o6lacruou ypoBHe Ha3Haqaror: Mr,ropeJrarcauTbr
    V3Z opranon 6prolr- nepr.rSepnvecxoro 4eft cteu_r: 6or:v,roroxcus A:
    Hofi nolocra.
    rcpar-

    99

    Qerra or MeAr,rKaMeHTo3Horo rerreHr4r n PHIIII
    reHeTr4qecKar I'IIa- HeBponoflu4 u uefrpoxupyprr4tr: Mr,ropeJraKcarrrbr
    THOCTI4KA.
    nepu(pepuuecr KoHcylrraqur rcn- flpu nallruur.r noK:BaHr,rfi: Bpaqe6Hhrfi Koncr{Jrr{yM B
    xoJrofa.
    PHfII{ neupol or}rv u Heiipoxupyprr4r,r ,4rrr pe eMolexy.nrpHo-

    HLrt Bonpoca o xupyprHqecKoM JreqeHr,rr4.
    KroHr,r,{ecKr,rfi

    Pafion-

    O6qr.ri

    reuuQaqlraar-

    H6IC.

    KpoBr{.

    flpu nepeuvnofi Auarnoc'rure na[uerrr HarrpaBJrr- 7-r0
    grcs e o6racrrryro, pecrry6nuKaHcKyrc opraHu3a-

    aHalua

    nufi

    O6qrzft analus

    (G51.3)

    MOIIU.

    qr,rr{ 3ApaBooxpaHeHr4r.

    Mnopelaxcarrbr qeuTpanbHoro .qefic"rntr: 6auo-

    Euoxltur,rqecroe

    Oes.

    nccJre,[oBaHue
    KpoBn: onpeAe-

    flpol.rnosnulerrn{qecKne cpeAcrBa: rap6aruareIIXH, KJIOHA3CNAM.

    JICHI{C KOHIICE-

    Tpaqfix

    HrroKo-

    3br,

    o6uero

    6erxa,

    o6urero

    6utntpy6uu4
    MOIICBI,THbI,

    Harptr'., Kanvl,
    xJropa, onpeAeJICHI{C AKTI,IBHO-

    crr.r

    ArAT,

    AcAT.
    Koucynrraqn-n
    BpaqaTepaneBTa.

    O6racr-

    O6teu

    HBIC.

    AOBaHI'I aH{UIOfl{qeH o6beMy
    o6clegonauzr n

    PHruI
    HeBpoJro-

    o6cre-

    3HMf u r4roJrbqariur ,[ononnrrelr,uo:
    3HMf.

    33f.
    Y3Z

    o6lacrnou ypoBHe Ha3Haqaror Mr,ropeJraKcaHTbr
    neplrSepuvecxoro gefi crnr.rr: 6orylmoxcuu A.
    upeuepe6panr- llpu uatuuuu noxa:anzfi (npu orclrcrsuu eibderHa

    7-t0

    fLlU
    Hefipoxu-

    pafioHHofi opraHH3arIHr,l 3Apa-

    pypfHr.r.

    BOOXpaHeHr.rr.

    Ll

    H61X

    COCyAOB,

    TpaHcKpaHr4aJrbHaJl

    Ta

    or

    6orylororcuna A): epaue6u;tfi
    n PHIII \ HeBponorun u nefipoxupyp-

    BBeAeHrur

    KoHcr.rJrr.{yM

    rulr Nr', pelxeHr]r Bonpoca o ppyprfiqecKoM JreqeAornJrepolpaout
    (aa.ree - TKlf), uar- Hnr.r - Mr4KpococyAucrofi .ueKoMrlpeccl4l{.
    HUTHO-pe3OHaHCHIUI

    MP)anrlrorpa$nr, npn
    HaJrr4qr{u nefiponacKyJrrpHoro nonQnurTa AJrr o[peAeneHLrJI
    (aanee

    norasaHui K MI{Kponacryrupnofi .4erotr,tIlpeccuu
    Qus.

    .{pyrue

    eKcTpaflupaMr.r,q-

    HbIe H ABI{faTCJIbHbIE

    HapyureHnJr
    (gCCeHrIr{aJrb-

    nufi

    (G2s)

    rpeuop)

    PaftonHbIC.

    -

    aHnrorpa-

    O6qufi

    aua:rug Koncyarraryrr Bpa- Bera-a,qpeno6roKaropbr: nponpaHonon.
    flponmoenulerrrr{qecKr{e cpeAcrBa: TorlupaMar.
    KpoBu, noAcqeT qa-ncuxHa'TpaKOJIUqECTBA
    HapKoJrora, flc[xoJro- HeiponporemopHar repaflnJr: grl. rMerI,LJrrI,LupoKT
    pona6oqnron
    cvfi rrlpvJJdHa cyKrIHHaT, rJIItqr{H.
    ra.
    KpoBr{.
    Koucymraqux Bpa- OT. flcrxorepanur.
    O6qufi ana,rvg qaMOqLt.

    I,IccneAosaHr.re

    noragateneft
    feMocTa3a:

    AqTB, IIB,
    IITLI, MHO,
    Qlr6punoren,
    reMaToKpr{T.
    Eraoxranru.recroe
    ucclleAoBaHIre
    KpoBr.r: onpeAe-

    racTp03HTeporora.

    5-10

    l0l
    JIEHITE KOHIIEHTparlrrt4 HrroKoo6urero

    3br,

    6erra, 6ulnpy6uua, MoqeBrrHbr, HaTpI{t, Ka-

    n5,

    xJIOpa,

    onpeAeJreHlle
    AKTI,IBHOCT}T

    AIAT, AcAT.
    9Kr.

    Y3I4

    opraHoB
    6proutrofi rro-

    JIOCTH.

    Koncylrraqur
    Bpaqa-

    o(framuoaora

    (ua:noe

    AHo,
    ocTpoTa 3peHr,lc,
    rroJrr 3peHHt,
    KoJrruo Kaftgepa-Onefturepa).

    Koncymraqru
    BpaqaTeparreBTa.

    O6rell

    O6lac:r-

    O6rertr

    o6creAosa-

    Jleqenue aHaJIorIrqHo JreqeHl,to, poBoAnMoMy na-

    AOBaHI4' aHaJrO- Hrar analoruqen o6r- rlr.reHTy n pafiounoft opraHll3allulr 3ApaBooxpaHefl{lreu o6tervry euy o6cne4oraur,rr B Httt,
    o6creAosaHur s paftounofi opraHr.Ba- AOIOJIHIITEJIBHO :
    paftounofi opra- quu 3ApaBooxpaHe- IIpI4 ITIHBIIJIIIAI{3I,IpyIOIIeM Tp€Mope: {pOTI'IBO9 I{-

    Hbte.

    PHTIII
    HeBpoJIO-

    I.uv

    o6cre-

    pl

    HU3aUI,II{ 3Apa-

    HII',,

    remrFrecKue cpeAcTBa: To[upaMaT.

    5-10

    rreupoxu-

    pyprnr.

    BOOXpaHeHUr,

    AOrroJIH14Ten6HO:

    AOIIOJIHI,fTEJIbHO:

    33f;

    flpu uasruuun noxa:anufi: rpave6Hufi KoHcr4JrHyM B
    PHIIIJ nenpon orrir vt neipoxnpyprlru AJrfl peue-

    MOreKynrpHo-

    HHC BOnpOCa O

    6uox14rarlqecroe

    reHeTr4qecKar [va-

    I,TCCJIEAOBAHI,IE

    fHOCTI,IKA;

    XllpypfuqecKoM

    JreqeH14I4.

    KpoBr{: onpeAe- KOHCyJrbTarIr.r[ ApyJIeHUe KOHIIeHnpa.refrTpauur qepyno- cfleqlr:urrcToB rro noIIJITI3MUHA I,I MC- (a3aHutM.

    rux

    ALI;

    onpeAeneHr.re

    3Kc4peurfi

    gu n

    Me-

    c1,rounofi

    MOTIE;

    MPT roroenoro
    M03ra.

    Cnn4pona
    Pafion-

    O6rqrafi

    rulHoro treloneru (G25.8)

    HbIC.

    KpoBr4.

    O6u1ufi

    anaJrus

    PenrrenorpaSr.r.r
    urefinoro ornena

    flpu nepeuunofi Auarnocrure [au[er{T
    srcr s o6racrrryro, pecrry6nuxaHcKyro

    auam.rs

    3BOHOTIHI,IKA

    uI{LI 3ApaBooxpaHeHr.rr.

    HanpaBJrropraHr.r3a-

    r.rccJre.[oBaHlte

    flpo.qorxaror Ha3HaqeHHe cpe,qcrB no cxeMe, peKoMeH.qoBaHHoii n craqaonapHrrx ycnonrux n o6;racmoft, pecny6luxaacxoft opraHnraqun 3.qpaBo-

    KpoBr-r: onpeAe-

    oxpaHeHItI:

    neHHe KoHrIeHTpaqnn nrroKo3br, o6uerc
    6erra, o6qero
    6unupy6uu4

    aHKcr,roJrr4Tr,rqecKr.re

    MOqH.

    Bnoxr,rM[qecxoe

    MOqEBI'HBI,

    H{rpr4',

    KaJrrrJr,

    xJropa, onpele-

    cpe,qcrBa: Ar{a3€rraM, roQuso-

    IIAM:
    npoTr,rBoSnr4JrenTr,rqecKxe cpeAcTBa: HroHa3eIIaM;

    Mr{opeJraKcarrrBr uempaJrbHoro
    Qen, rornepusou.
    flpu orcyrcrnnra etp
    |CII.

    geftcrnux: 6ax.no-

    l0-14

    r03

    JICH}IE AKTUBHO-

    crr

    A.,IAT,

    AcAT.
    Koncymraqur
    BpaqaTepaneBTa.

    O6;racr-

    O6rerr.r r.r rpar-

    HbIC.

    HOCTb O6CneAO-

    PHnU
    HeBpono-

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    t
    fvt4
    nefrpoxupypruil.

    o6cneAonannx s rrJra3MI{Ha, Me,qr4.
    pafionnoft opra- KT unn MPT roros(cnunnoro)
    Hrr3arlru 3Apa-

    Er.roxuuuqecroe uc- Jleqeuue aHilJrorr4qHo JreqeHr,fio, npoBoArrMoMy rIacJreAoBaHI4e KpoBr,r: ur.reuTy n pafioHuoi opraHu3arlltfi 3ApaBooxpane-

    r0-t2

    HTI',,
    .[OIIOJIHI,NEJIbHO

    :

    npu orc).rcrBnr,r srpQerra: rura:ruaQepes.

    Horo

    BOOXpaHeHr,rr.

    MO3ra.

    Y3I{ opraxor 6ptoutHOft nOnOCTIr.

    MonerynrpnoreHeTltqecK:ul AvaTHOCTI{KA.

    Koncylrraqur

    ncu-

    xoJrora.

    Boregnr Alrq- PafioHrefiuepa (G30) HbIC.

    O6rqufi anarus 6uoxr.rrvrr,rqecroe

    r.rc-

    flpu neparvuofi

    nocranosre AnarHo3a nauuerrr 14-16
    HanpaBnrercr a o6racruyro opraHr.Ballmo 3ApaBo-

    cJreAoBurHr{e KpoBr.r:
    O6qufi anarus onpe,ueneH[e ropMo- oxpaHeHrrr.
    HOB [IrrOSr,rAHOfi flplr ycranon:reHHoM Ar,rarHo3e ocyqecrBrrerct
    MOIII4.
    C- rocrr,rraJrl8aqur naquerrra npr,r HeBo3MoxHocrI,I
    Er-roxr,rrranqecroe xeJre3hr,
    pearruuuufi
    o6creAosaHm n au6yraropubrx ycJroBr{f,x u npn
    6eror.
    uccJre,uoBaHr,re
    KpoBr{: oflpeAe- Cepo.norrauecrr.re lrc- ueo6xornrr,rocrlr upoBe.qeHur nrola6anrnofi rryurJreHue KoHIIeH- cJreAoBaHr,rr sa BI,Ir{, qfiu.
    Tpaqufi rJrroKo- cr.rQunrac, 6opperraoe. Ilpo4orNaror Ha3HaqeHne JreKapcrBeHnbrx cpeAcrB
    no cxeMe, peKoMeH.qoBaHnofi s o6racrlrofi oprauu3br, o6uero
    r9oBr,r.

    6erxa, o6uero

    HATpIdA, KATIdA,

    3arluu 3.qpaBooxpaHeHr4jr :
    flo noragauuqru:
    flpu rorHr.nunHrrx HapyrneHr4lx u AeMeHrrr4r,r: ruIII,IH, AoHene3r4n, MeMaHTI4H, nnX.qaKpI,IH, raJIaHTaMrrH> xoJrr4Ha anrQocqepar, Br4rrnousrI,IH, Hltqepro-

    xjropa, onpeAe-

    ]II,IH.

    JIEHI,IE AKTI'BHO-

    fIpN ncnxorn.recKr,rx HapyueHr{rx:

    6unupy6uua,
    MOqeBr4Hbt, KpeATI,IHI,IHA,

    cTI,I

    AIAT,

    aHTr,rncr4xorr{qecKr,Ie cpeAcTBa: KBeTuam,rH, KJIo3anr,rH.

    AcAT.

    flpu genpeccnu: aHTu.uenpeccaurbr:

    PenrrenorpaQur opranoB

    flpu cy4opoxnoM

    rpyAHor

    KJrer-

    9Kf.

    KT

    aMr,tTpItmfin14H, napoKceTI4H.
    cKr{e cpeAcrBa:

    JIOK.

    KI,I.

    r.urn MPT

    foJroBHoro Mo3-

    ra***.

    V3lI

    Irlrfloslra-

    HOi Xene3br.

    39f.
    Koucylrraqna
    Bpaqa-

    oSra,rrruorora

    (ocrpora
    HVtt,

    3pefira3Hoe

    AHOJ.

    Koucymraqru
    BparlaTepaneBrra.

    Koncy.nrraqnr
    BpaqaIIcnxrraTpa-

    QJryoKcerr.rH,

    cHHApoMe: nporr.IBosnl rerrmqe-

    rap6auasenun.

    105

    HapKonofa.

    O6;racr-

    O6seu o6cle- O6r,eu

    HbIC.

    AOBaHI/u aHIUIO-

    fHrreH

    PHIII]
    HeBpoJrovl
    fLlll
    ueftpoxu-

    pyprru.

    o6beMy
    o6cre.{oBaHr.rr B

    o6cre,qona-

    HIax aHa.[o[r.{eH o6r,eMy o6cneAoB aH B

    t

    flpn nepau.ruoii 4raarHocrNre

    naqueHT HanpaBJrrgrcq e o6racriryro opraHn3aur.rro 3ApaBooxpaHeHr.rr,

    14-16

    .UOIIOJIHI4TCJIbHO :

    pafioHHofi opraHrr3a- IelreHue aHaJIofvrIHo JIeqeHI4Io, [poBoII,IMoMy IIapafioHHofi opra- wu 3ApaBooxpaHe- rIneHTy B paftoHHoil opraHr{3auur4 3,upaBooxpaHeHr{3arlr4n 3Apa- HLI',
    HEg,.
    BOOXpaHeHT{r,

    AOTIOJIHI4TCJIbHO:

    AOnOnHrreJrb-

    6uoxr,rMlrqecroe r,rccJreAoBaHI{e KpoBn:
    onpe.qeJreHr{e KoHrlerrrparlr.rH rlepyno-

    HO:

    KOHCyJrbTarlI{t

    nclD(oJrora.

    [Jr{l3Mr{Ha,

    c-

    pearrunnoro 6elra;
    arrmQocQorrnnrgH6IE AHTI,NCJIA.

    PacceqHHrri
    cuepos (G35)
    (ae6rcr,
    o6ocrpeHr.re,
    npolpeAneHTHOe

    reqeHfie).

    Oc'rpufi pacce-

    rr*rsrfr

    3HrIe-

    Qalorrllrenrat
    (G3s).

    OrmaronenpoMr4eJrlrr [6o.rrerHr lerura]

    Pafton-

    O6qufi aualus V3I4 oprauor 6plour- flpu

    HhIE.

    KpoBr.r.

    O6qr.rfi

    nepnnunofi 4uanrocrrare: flaquenT HanpaBJr.f,s o6rac:rr,'ro, pecrry6nurancrgro opraHr.BaKoucy;traqu.a Bpa- rlrrrc 3Ap:rBooxpaEeHut rrprl oTcyTcTBrrr{ Bo3Moxrra-TepaleBTa.
    Hocrr.r BblfloJrHenfi.r MPT c KoHTpacrr,rpoBaHleM
    Koucyltraqr.rra Apy- roJroBHoro (cnraHnoro) Mo3ra B pafioHHofi opraHnrrlx
    npauei- 3arlur, 3ApaBooxpaHeHr,rr.
    clequaJrxcToB rro no- fcII.
    KA3AHII'M.
    flpu o6ompeuur PC, mcyrcrBrrr 900eKra or KopTr4Kocrepor.rAon na paionnoM ypoBHe naqreHTa
    HafipaBirrrcT B o6racru]ro opraHu3arlurc 3,qpilBooxpaH€Hur AJUr npoBe.4eHvt repafivu BTopofi Jr[HOfr IIOJIOCTI,I.

    aHa:rns

    MOqU.

    Br,roxurranqecxoe
    llccJIe,qoBaHr4e

    KpoBr,r: onpeAeJICHI{C KOHIICHTpaql nrroKo-

    3br,

    o6uero
    6elxa, o6uero
    6utrupy6uu4

    ercs

    nr,u.r

    -

    ruasrr,ra(pepe3a, a raror(e AJrr peueHuJr Bonpo-

    MOqEBUHbI,

    ca o npoBe,qeHr.rr xMMyHoMo.uuQnupyouefi repa-

    Hdrpua, Karus'
    xjropa, onpele-

    fivn.
    flpu pequgranno-peMlrrrrlpyrcureM

    TerreHr.rr4

    PC npr.r

    10-14

    (G36.0).

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    nesQQernaBHocru Monorepanr{rr JreKapcrBenHbrMr{ cpeAcrBaruu neproft nunuu (*) rloKa3aHo
    HiBHarreHr{e cpeAcrB nropofi nunr.rn (**). fIpI',I Hea(p{ernrnnocru ruarcrauanrnofi repauenntuecxofi
    AO3br JreKapcTBeHHoro cpeAcTBa B pexlrMe MoHoTepallrr{ BMecro uero geo6xoAuMo Ha3Haql'rrb Apyroe
    cpeAcrBo - npeuapar nepnofi (*) la.ru rropofi .nuHIau
    (**), unreroqufi unoft uexanugn Aeftsrst,tt.
    Ha:Haqeuue HoBoro nporr'IBo9[[nelTrl{qecKoro
    cpeAcTBa cJreAyeT HaTILIHaTb rIocTerIeHHo, AocTI'Irat
    ypoBeHb KJn{HLrlIecKLI eS(perrunnofi gosrr ('repes 24 neAenu). 3areu nponogrr rlocreneHHyrc orMeHy
    npeAbrAyrrlero fiporuBo3rllurelTrrlqecKoro cpeAcrBa.

    flpu

    Hes
    npoTuBo3nHJrenTHqecKr4M cpeacTBoM npu coxpaHeHHn npHcrynoB Ha3HaqaroT KoMbHHaurrro AByx
    npoTr,rB03nuJrerTrnqecKux cpeAcTB.
    flpe4nourzrerr,Hbr cJre,ryrorqne xou6unaqrau ;reKapcTBeHHbrx cpeAcTB:

    [pr4 cJroxHbrx napuuanr,Hblx npficrynix: rap6aua3enr.rH r,r BaJrbrrpoeBiu Kr,(cJroTa;

    npu napuuanbHbrx npucryfiax (npocrux, cJtoxHbrx,
    BTopurruo-reHepaJrr.BoBaunblx): xap6auasenur u
    ra6anerrrr.tr;
    IIpu feHep:rJrr,r3oBaHHbrx flpxcTynulx: JraMoT pI,IIxflrH
    r,r BiulbnpoeB r KncnoTa;
    npu a6caucax:
    BiulbnpoeBlur Kr.rcJIoTa r{ KjroH:u}erraM; BanbrrpoeBaur
    Kr.rcJroTa n TorrrrpaMaT; TorlupaMaT r.r naMoTpI,IIxr,rH;
    npu pe$parrepnofi r[opnae enrrrrerrcIltt:
    Tonr,rpaMaT H JraMoTpr,rArctH.

    flpu nnoxoft nepeHocr,rMocrn flepBofo HiBHaqeHHoro neKapcTBeHHoro cpeAcTBa B pexnMe MoHoTepao6rsaTeruHa. flpn xo[epeHocr4 Mocrr.r u uee(pQerrunHocrl nepaAeKBaTHO Ha3HarIeHHOrO B pexr{Me MOHOTe-

    ru.rr.r BTopiur MoHoTepamrr

    pouefi
    BOFO

    paIII,II,I IlpoTr,rBo3rrr, rerrTr,rqecKoro cpeAcTBa Bo3MoxeH rrepexoA ua xou6unnpoBarrlryo reparrnro IByMJr cpeAcrBaM[. Ar rerbuoe Jreqenr.re AByMr [poTrrBo3rrr,rJrenTr.FrecKr,rMH cpeAcTBaMr4 ocyqegTBnrroT
    r,rcKJrroqrrTeJrbHo npr4 HeBo3MoxHocTrl a.qeKBaTnofr
    MOHOTepannu.
    JleqeHr,re rpeMr rrporr,rBo3nlrJrerrrraqecrr.rMr,r cpeAcrBaMLr rleJrecoo6pa3Ho roJrbKo npx uesSrpernarHOCTr,r Tepanuu AByMr aAeKBaTHbrMr{ cpeAcTBaMrr.

    flpra pa:nn'ruz xapaKTeponor[qecKr4x n nc[xorr,t-

    I

    l5
    rrecKr.rx

    Hapyueunii: na6lrcIeHl,te flaquel{Ta B rrc[-

    x'|aTprqecKoM .[fi cnaHcepe.
    flpu orcl"rcrnur4 3fir,rJrenrnqecKux flpl4cryfloB B Teqeuue 2-5 Jrer npoBoArr nocreneHHylo orMelry
    rrporr4Bo3nr{renrr.tqecKoro cpeAcrBa: na I I 8-l / 4 or
    cy'rouuofi ,qo36l B TeqeHI,Ie 1-2 Irlecsqes, noA KoHrpolerr.r 33f.

    Heiponporerropnat repaltrt: srrtJrMerlaJrrlr.qpoKcurlrrpr,'Iulla cyKrIr{HaT, MeTHJT3TI{JIrII4pl4Ar4HOra
    f r,lApoxjroplrA, rJrr{ulrH.

    Jle'{e}rue aHaJIorFrHo JreqeHI, o, npoBoAtrMoMy naHbIC.
    AOBaHlrJr aHajro- nu.t aHarorn.ren o6r- I1ueH'ry n paftonnoft opraHn3aII]II{ 3ApaBooxpaHerurreH o6rerrry eruy o6cnegonarwr B HV{.
    PHruI
    o6creAosauut s pafiounofi opraHl,l3a- flplr perlparreplroft (loprr,re 3rllrrrercr .I c qastbrMlt
    HeBpoJron pafionuofi opra- \r4r4 3ApasOOXpaHe- qpr.rcrynaMlr, BeAyIqr{Mt K BbIpDKeHHofi srofixoft
    I.t{Ll
    yrpar€ Tpy.qocnoco6nosru: rpaue6nrrfi KoHcI,urI{yM
    HrEarI[u 3Apa- Hv'.
    refipoxr.rs PHIII HeBporrorux u neftpoxlpypntn AJII peuepyprrrr.
    .IIONOJIHUTEJIbHO:
    BOOXpaHeHT{JI,
    c)"ToqHoe 33f ruosu- HUr BOnpOca o Klpypr[qecKoM JIeqeHnLI.
    AOnOJrHI4TeJrb-

    O6nacr-

    O6rerrl o6cle- O6rena

    HO:

    MPT ruu

    o6cne.[oBa-

    Topr.rpoBaHrre;

    KT srueo

    33f

    MoHI{To-

    ronoBHoro Mo3- pupoBaHne;
    ra c aHnloflpo- MOHtffopHHr KoHrIeHTpaulrrr aHTr,rKoHrpauruofi.
    Bynbcar{roB B KpoBrr;

    KOHCytbrarI[r: ncu-

    xoJlora,

    Bpaqauefipoxnpypra, Bpa-

    qa-ncrxr{aTpaHapKoJrora.

    8-10

    116

    3nulemrlqePafioncxr.rii craryc HbIE.

    O6uufi

    cyaopoxHbrx

    O6,racr-

    O6rqufi

    nprrnaAKoB

    H6IC.

    MOqI{.

    (G41.0)

    PHINI

    Euoxznazqecxoe

    HeBpono-

    I,tccJreAoBaHLIe

    aHarr.r:

    KpoBr4.

    I4ccleronanlre CM)K Meponpurrru

    Ha 6eror,

    qr,rro3,

    TpaBMbr foJroBr,r

    no
    I,I

    npeAynpexAeHulo acnupauur4,

    ryJroBrdrrla.

    nefpoxu-

    JICHI'E

    pyprr{u.

    Tpar\uv rJIIoKo3br, obuero
    6e.nxa, o6uero
    6utupy6una,

    KrETo.IHr,rfi cocraB, O6ecne.renr4e npoxoar,rMocrrr BepxHnx AHxareJrbIJIIOKO3a, XJTOpXAEI.
    nrrx nyrefi, rolaqa Kr,rcJlopoAa trepe3 nasamHrrft
    Ocuo,rrpuocrr Kpo- 3oHA co cKopocrbro 2-4 n/uus.
    B]iI.
    Vcranosra Ha3oracrpalbHoro 3oHAa, MoqeBoro KaTorcnrororzqecrue
    Terepa.
    uccleAoBaHr4n Moqn.
    Kopperqur rurroBoJreMl4r,r: Harpr4Jt x;roprl.u, gneKqePenrneuorpa(pur
    Tporr.rrbr (uarpw auerarl Harpflr x;ropr.t llxar,us,
    pena.
    x,ropfi.q) (aqeconr); 3JrercrpoJrxrhr (narpur t PeurrenorpaQvt op- xmut xnopuS/ K:rrrbur.rr xrropur) (Pnnrep); pacrBop
    ranon rpygnofi xrer- rffoKo3El 40Yo: taunewnM c rKoroJrbHofi 3aBLIcH-

    MOqeBUHbI,

    KII.

    ruI,l

    t4

    aHa.rus

    KpoBr.r: onpeAeKOHIICH-

    Ha'rpll,I, Karvl,
    xjropa, MarHI{t,
    onpeAeneHr.re
    AICTIiBHOSTI,I

    A.nAT, AoAT.
    3rcrpeHuoe
    onpeAeJreHr{e

    KOHrlerrTparluu
    aHTr,rKoHBynbcarrToB B KpoBI,I.
    Korr,ruerc ce-

    pororuqecKr,rx
    peaxq.rfi na o.rQu.nuc.

    Onpegererure
    ra3oBoro cocTa-

    Mosrbro, ucrorrleHHbrM flaqueHTaM, 6epenaennrtu pacrBop fJrroKo3br 4O%o c rualuunou.
    Jleqenue paHuero nepuo.qa cyAopoxHoro 3rnrJreflTr.rqecKoro craryca (n neper,re 5-20 rraranyr):
    npoTr.rBo3rllulefimqecKr{e cpeAcTBa:,qraa-:enau* r/n;
    cHorBopHrre cpeAcrBa: ulr4a:onau * n/u.
    Bropa"a Qasa nevexrl.a cyAopoxuoro grrr{,Jrenrr.rqecKoro craryca (20-40 uuwyr cy,qopolruofi arcrr.rBHOCTI,I):

    npoTl{Bo3nllnellrl{qecKl{e cpeAcTBa: BilJrbnpoeBUr
    rucrma* * s/s.
    PeQparrepnufi sn Jrerrrr.rqecKrlfi craryc (40 u 6onee Mlryr cyAopoxuot arnarnocru) - rperrr (pasa
    Tepanufi: noBTopHo BaulbrrpoeBtu xr,rcnora*
    s/s.
    flpu orcyrcrnur,r sQQeKra or [poBoAr{Moro Jreqe-

    *

    Hr4r nepeBoA Ha r{cKyccTBeHHyro BeHTr,rJrrquro JIer-

    xrx

    33f.

    - ZBJI):
    npelaparbr ffrr o6qeft
    npono(fon ** *n/n;

    3Kt.

    cHorBopHbre cpeAcrBa:

    Ba KpoBr,r.

    (ga.nee

    aHecre3r,rr4: TrlorerrraJr*

    +

    *,

    uuna3olau*** s/s He r{eHee

    <

    11

    I

    l7

    o(brarbMorora
    (rua:Hoe IHo,

    24 't. Bo BpeMr BBeIeHI,r-{ Trro[eHTaJra r,rJrlt rrporrolpora npo4o;rxaror repanzrc [pornBogfir{JrerrrrrqecKnMr4 cpeAcrBaMn: (feur.rrorlu, (feuo6ap6lrran,
    BarrbnpoeBzur Kr,rcJroTa 3HTepan6Ho (qep€ 3oHA).
    CyneppeSparrepuufi cyaopoxuufi annremrqecKr.rfi craryc:
    npelaparbr Int o6uefi aHecre3ur,r: ruoneurar***,
    lpofloQor***, retauun** * n/n;
    cnorBopHbre cpe.ucrBa: MrrAa3oJraM* * * B/8.
    B r cpe4craa 2-ft 14 3-Ir r Hwr4 B BbrcoKr,fx Ao3ax.

    ocTpcna 3peHIxI,

    |CII.

    uorr

    Heftponporerropuu reparrr4r: MarHwr cynr(par n/n.

    3xo3C.

    KT uru

    MPT

    roJloBHofo Mo3-

    ra

    (npr,r ce.qaqru).
    Mouuropnnr
    AA.
    Koncynrraqux
    Bpaqa-

    spenr.r-a).

    A6cancHnfi 3nruemtrqecKr{ft craryc (G4 1. 1 ):
    rrpoTr,rBo3nr{nemuqecKne cpeAcTBa: Aua:enalr s/s
    o.uHoKparHo, BarrnpoeBiu KncJlora n/n npr mcyrcrauu s$(perra c nocne,qyrourrM BBeAeHneM rrpelapara qepe 3 vaca, aarerr,r K:uKAbre 6-qacos.

    C.noxnufi nap{ualrnr,rfi 3rrr.r:Ierrfl{qecKr,rfi craryc
    (G4r.2):
    npoTr{Bo3nrfi errTr,rqecKr,Ie cpeAcTBa:,uuagenalr s/s+,
    BilJlrnpoeBar Kr{c;rora n/a*, enrepalrno rIporLIBo3[r{JrerTMllecKl,re cpeAcTBa.
    Pe(pparrepnufi cloxnrrfi napquuurbHBrfi grrr.rJrerrrr.r-

    vecxufi craryc, o6yc,ronleuHbrft

    a).Tor.tMMyHHbrM

    suqe(parurou:

    fCII.
    fha.:nra(peper.
    I{vnryuorno6yJrnHbr : rrMMyHoruro6ynr,rH rreJroBeKa
    noprraalrnrrft r/r.

    Brzlalrugrr: TrraMIrH.
    HefiponporerropHa;r repanur: 3TnnMerrlJrrr.rapoKcr4rrr{prlqr{Ha cyKrIr4HaT, MeTr4Jr3TrrJrnupr4ar,rHoJra
    fr{Alroxjropr{A.

    flporunoorevn as repa vt', nJrzr3Mo3aMerrlarcupre u
    repQyauomrrre pacrBopbr: pacrBopbr c ocMolrrypeTuqecKnM Aefiqrsnel,r: MaHHrrroJr, copMaHTon;
    MoqefoHubre cpeacrBa: Qypoceuul;

    flo noraganr,r-s r:
    flpu aprepuanurofi runeprenruu (noeuureHne A,{

    3Haqr,rreJlbHo Bbtrlle rleireBux noxalate.nefi): cpegcrBa qelrrpanbuoro ,qefcrBlrr: KJroHr{.[uH; neputpepr{rrecKr.re aHTr{aApeHeprfiqecKue JreKapcTBeHHLIe
    cpeAcTBa: ypa nAl r.
    flpu nogorpenua na untpexqr o ArrxareJrbHhrx r,rlrr
    MoqeBhrBoArrqlD( rryrei - arma6arrepraa:rBuble JIeKapgrBeHHbre cpe.4srBa.

    Mrarpenr
    (G43)

    O6ur.rfi

    ana:rug

    Y3.ry

    qepe6puur6H6rx

    I,ICCJIC,[OBAHHC

    cocyaoB, TK,ry.
    KT r.ur.r MPT rolongoro Mo3ra* **.
    MPT r.urfi KT c anrronporpalrnlofi* * + .

    KpoBrr: onpeAe-

    33f.

    KpoBH.

    O6qufi

    ananrg

    Morru.

    Elloxnuuqecxoe

    JreHre KoHrIeHTpaqur4 rroKo3br, obqero
    6ema, o6uero
    6utrupy6nna,
    MOIIEBI{HbI,

    HaTpvJd, Kallufl9

    .{nx rynuponanr.rJr rrpncryna

    Mr{fpeHr.r:

    anilJlbrerl,IKx-ar{Tr,rflfiperr{Krl:
    MeTaM r.r3oJr

    ACK,

    napaqerauon,

    llarput'.

    HIIBC: gururoQenar, KeroponaK, MeJroKcr{KaM,
    u6ynpoQeH (r rou vr.rcae xola6unaqulr yKa:lauubrx
    cpegcra);
    aroHr,rcrhr ceporoHuHoBbrx 5-HTr peqerrropoB: cy-

    JreKapcrBeHHbrx

    MaTpr.rnTaH, 3onMl,tTpumafl

    .

    flpr,r prme: npoKr.rHeruKr.r: AoMrrepu,qoH, Meror;ronpaMr4.q.

    fIpN runrpenosHoM craryce:
    fCfI: npe4laroJroH, .[eKcaMera3oH;
    ,ftr rynuponaHur nprrcryna Mr.rrpeHr{:

    7-t0

    I

    xjropa, onpeAe-

    aHurJrr,rerr,rKr4-aHTr{[uperI{KI{:
    MeTaMfi3Or HArpUr;

    JIEHITE AKTUBHO-

    crri

    l9

    ACK,

    napaqetarvron,

    HIIBC: gurnoQenar,

    ArAT,

    AcAT.
    3xo3C.
    Koucyarraqlr-r

    KeropolraK, MeJroKcr.rKaM,
    u6ynpo(peH (n rou vr.rcre rolr6r.traquu yKa3aHHbrx
    ireKapcrBeHHbrx cpe4cre);
    oluorrAbr: TpaMaAon;

    Bpaqa-

    npoTr4BoMrrrpeHo3Hbre cpeAcTBa: cyMaTpI.rnTaH.

    o(fra:rrruolora

    flczxocrurrayrrropbr r{ Hoorponbl: xoQeuna 6euso-

    (r.nasuoe

    aT.

    AHo,

    noJrr 3peHr{r,
    ocrpc[a 3peE rt).
    O6.nacrIlbIE.

    PHINI
    HeBpoJroTTII,I

    O6rerr.r o6cre- O6renr o6cne.roBa- Jleqenue aHaJrof[rrHo JleqeHr,fio, npoBoAr{MoMy na- 7-10
    AOBaHr,rr aHturo- Hfi.g auaJro[r.reH o6r- uxerrry n paftonnofi opraHr.r3a[nu 3,[paBooxpaHenlqeH o6terr'ry eruy o6c.negon auvt B Ht4t.
    o6creAoganu.s s pafionnofi opftrurcat. pafiorHoft opra-

    ql{u

    3,r[paBooxpaHe-

    nefipoxu-

    Hr,r3full'u 3Apa- Ht4t,

    pyprEr.r.

    BOOXpaHeHr,rr,

    AOnOrHnreJrbHo:

    AOnOJtHI{TeJIb-

    uccreaonanue CM)K

    Ha 6enor;

    qrrro3,
    r:Igro.rHbrfi cograB,
    33f;
    MPT r.uru KT urroKo3y, xjropnAbr.
    TOJIOBHOFO MO3- V3,{f uepe6panrHux
    ra;
    cocyAoB;
    MPT ruu KT c KoHCyJIbTaUI{u Apynpavefirrlx
    aHn{oIIporpaMcnerlHaJrr,rcToB no nolrofi.
    HO:

    KA3AHI',IM.

    flpexo.qrque
    TpaH3rropHhIe

    PafionHbIC.

    O6rquft analug
    rlpoBu

    c

    onpe-

    Y3Af

    npeqepe-

    6pamnux cocyloB.

    flpu pa:nurun TIIA naqr.rerrra gKcrpeHHo rocnuraJrn3upyror

    B

    cnerluaJIH3LIpoBaHHoe (uHcynbruoe)

    10-18

    B

    3ABI,ICI,IMO-

    qepe6paJr6HbIe

    aeJreHI{eM qucna

    TKAI-.

    I4lIICMI'qECKI4C

    rpou6oquron o

    Xo.irrepo ncxoe lronu-

    npr{cryn6r

    EI,.HAMVKC,

    ropupoeanue

    3Kf.

    (araru) u

    po.qCTBEHHbIE CI'H.

    O6rqzfi

    Cy'rouuoe

    MoHrrro-

    MOqI{.

    pupoaanue A,{.

    apouu (G45)

    Buoxuuuqecxoe

    3xoKf.

    uccJre.qoBaHI,te

    ArperaroMsrpr4t

    aHa,'ru:

    v u

    Ha nHcyJrLTlIyIo
    roftxy uenpoloD{qecxoro or.qereHr,rs pafiouuofi
    (ropogcrofi ) opraHx3allun 3ApaBooxpaHeHr{r.
    HeBpoJlofl4qecKoe oTAeJIeHIIe

    KorrpomA.{.

    A,{ npoao4rt npu CA.{ >220 uu pr.
    cr., [A[ >120 nrr',r pr. cr. A,{ cHLIXaIor ne 6oree
    qeM Ha l1oh or ucxoAHoro ypoBIUI s reqeHue 24
    Kopperqr.rro

    qacoB.
    KpoBr.r: onpeAe- TpoM6oqr.rroB.
    JIEHI,IE KOHIICH- KoHcymraqux Bpa- B nocnegyrorqeM noAAepxaHrie Ha .uocrr.rrHyroM
    ypoBHe A,{, npe,qornpa leHr,re ero noAteMoB:
    Tpaqfiu urroKo- qa-KapAuoJrora.
    3br, o6Ir1ero Koncyruraqru Apy- nnm6rroprr AfI@: xamonpur, snaranpur (n roru
    npavefi- rrr.rcre Anr Bgyrpr4BeHHono uneleuu,r), n n3HHonptln,
    6ema, o6Ir1ero
    6utrupy6uu4
    cneq[aJrl,IcToB rlo IIo- paMr.rIIpr.rJr;
    MOqCBI'HbI,
    KA3AHI'qM.
    ar{TaroHr.rcrhr peqemopoB aHrr.roreH3l.rHa II: ;rosap-

    r.I{x

    HaTpnr, Ka[na,

    TaH, BZlJrCapraH;

    AcAT,

    rrpn HercylupyeMoM no.u6eMe A'{ - nerKo flnpyeMbre JreKapcrBeHHBIe cpeAcrBa: nepurpepravecrue

    Hopa, AIAT,

    OXC,
    XC JIIIHII, XC
    JIIIBTI, Tf.
    llccneAosal .re
    uoragaT elefi
    reMocTa3a:

    ATITB,

    trTvt,

    IIB,
    MHo,

    i[u6punoreH,
    reMaroKpI{T.

    3KI.

    Y3Af

    qepe6pamnrrx cocyAoB.

    3xoOC.

    IIpoQum A.{.

    arrTr,ra,(peHeprnecKr{e cpeAcTBa: wanv4vrr.
    flaquerrraru c T}IA na tpone nrrpaxenHoro creHo3r{pypqero arepocKrrepo3a EtLA (>70%) noKa3aH
    ueneBofi ypoBeHb A,{ npe,4enax 140-150/90 uu
    pr. sr.; naq[eHTaM c caxapHbrM Alra6eroM rIoKa3aH
    rleJreBof ypoBeHb AA <140/85 MM pr. cr., rrarlrreHTaM C XpOHI,rqeCKnMr,r 3a6OJreB AHIdAMU IIOqeK nOKa3aH rlerreBofi ypoBeHb AA <140/90 MM pr. cr., rraulerrraM B Bo3pacTe >75 rer rroKa3aH qerenoft
    ypoBenb A.{ n npegenax 140/90-150/90 MM. pr. cr.

    r

    flpu aprepuanrnoil runorenguu (CA.{ <110 urra pr.
    cr.): o6tentsarrlecruTeJrbHajr repanur rrJra3Mo3aMerIiuorrIHMH npenapaTaMn: aeKcTpaH, nrApoKcl,tgrr,rJrKpixMan (sa ucurovenr{eM conyrcrByrouero
    nnQaprra M r4oKapra. aprrnrrau).

    CTII

    creneH14

    Trx(ecTI,t

    TI4A

    Koncynrraqu-r

    llpu Ttr{A uerapAnoou6oJrr.lqecKoro reHe3a r Kapguoau6olr.rvecKoro feHe3a c nporuBonoKa3anvrtvivl
    K aHTr4KoaryncrrraM noKa3aH nocroruuuE npueu
    arrrr4arperaHTH6rx JreKapcrBeHHbrx cpe,qcrB: ACK.
    V narlueuron c pauee nepeHeceHHbrMu TIdA u unQaprraruu Mo3ra Ha Qone upuenra ACK, npra HenepeHocr{Mocrr.r ACK, a raKxe flpE na6oparopHofi

    Bpaqa-

    pe3r{creHTHocrr.r

    Koucy.nrraqua
    Bpaqa-

    ot[ramvorora

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    14

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    4

    HU ,
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    KT opranon rpygnofi
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    l0-14

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    Herpes
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    vI

    .UONOJIHI,MCJIT'HO

    :

    JleqeHne iuraflorl{quo JreqeHr4ro, npoBoAIlMoMy Iraufierrry s pafiounofi opranr43arlur 3ApaBooxpaHeHUt.
    AONOJIHI,ITCJIbHO:

    npn TyHHeJrbHbrx cr,rHApoMax (cunapov KapnaJrbHoro KaHaJra, Ky6urarbHoro KaHaJra) npn Bhrpa-

    AOnOJIHI4TeJTbHO:

    qr.rro3,

    r,reroqnsrfi

    3HMf;

    Y3U

    Ha 6elor,

    HepBHbrx

    cocraB,
    rnroKo3y, xjroprrAbr;

    I,I M'T.

    r{ccJreAoBaHr,re KpoBr{

    CTBOJIOB

    I{

    BbIpaxeHHoM ABL{rareJIbHoM ,qetpuqure npaue6usri KoHcI4JIr{yM n PHIII-I HeBpoJrorI4I4 Lr
    nefipoxupyprltl4 AJrf, perrreHl4;t Bonpoca o xnpypruqecKoM JreqeHllll.

    ucc.neAonauue CM)K .qpoMe

    rux rranefr ro- ua Jlaiiu-6opperuo:,
    HeqHogrei.

    CKB,
    BI,I9;

    cu(praruc,

    V3lI

    cocyaoa nepxI,I HI,DKHI,IX KO-

    HI,TX

    neqnocreft;

    V3I,I neprnrrx crnoros fi M.rrKux rxaHefi
    xone.rHocreft:

    KT

    MPT meftno(noxcHnvHoro)

    r.r.nu

    ro

    cnaeJroB rro3BoHoqHI'KA;

    KoHcyJrbTarlul,I Apy-

    rurx

    npauefrcleqrraJrHgtoB IIo noKA3AHI,I'M.

    PafiosHacre,[crBeH}lag, Lt tt4uorra- HbIC.

    O6ur.rft aua:rug 9HMf.

    TI4qCCKUI

    O6uufi

    HeBponarut
    (G60)

    Y3LI opranon 6prour- cffrupr{,qHHa cyKII}IHaT, MeTI{JI9TI,iJIUItplI,4lrrIOJIa
    r-r.rapoxrlopI{4.
    Euoxrruu.recxoe nofi nonogrn.
    Koncymraqr.u Bpa- flpu uefiponauqecKoM 6onesoM cLIHApoMe: npoI4CCJIe,(OBaHne
    Tr,rBognr,rJrenrl,rqecKr{e cpe,qcrBa: rap6aua:enln, raKpoBrr: o4pe.qe- va-o(pra,rruonora
    JIEHI'C KOHIICH- (rrasuoe AHo, ocrpo- 6aneHrun, npera6arun; aHTraAenpeccaHTBr: aMI4T-

    Y3I4

    KpoBri.
    anarr.rg

    ruurosu.qHofi

    xeJIe3bI.

    MOqI{.

    Ta 3DeHI,r. IlOJrt

    flepnQepnvecxrae Ba3oAraJrararoprr: neHrorcntpu.nJrr,rH, Kcalrr?rHoJra Hl{KorrrHar, Hl{uepronI.rH.
    Heftponporerropuat repanfit: grl4rMerltnru.qpoK-

    136

    3br,

    o6tllero

    Hus),

    6ema, o6qero

    Bpaqa-

    6ullnpy6uua,

    SHAOKpUHOJTOTa.

    KoHcynbrarlr4t

    OT, JI@K, MexaHoreparur.

    MOqEBI'HbI,

    HaTpI{r, KaJrr{Jl,
    xJropa, olpe,{eJTCHI,IC AKTI,IBHO-

    crr.r

    KOK,
    AIAT, AcAT.
    llccregonanr.re
    CN,DK na 6enor,

    rlrro3,

    KJICTOq-

    nr,rft
    cocTaB,
    nrroKo3y, xJro-

    pnlbr.

    O6renr o6cre- O6reru

    O6lacrHbIC.

    HeBpoJroLI

    JIe.reH[e aHiulomrrHo reqeguro, npoBoAr,rMoMy rra-

    Hul aualoruqett o6r- qllerry
    rr4qeu o6beMy euy o6cne.qon alaur B HUt.
    o6cnegorauua n pafioHuofi opraHu3apafionnofi opra- r\uri 3,qpaBooxpaHeHu3aruu 3Apa- Hllg.
    AOBaHUTT aHano-

    PHITII
    I.tlu

    o6creAoBa-

    Hefrpoxlr-

    BOOXpaHeHr.rJr,

    pyprur.

    .uonoJIHr{TeJrb-

    AorroJrHnTenbHo:
    ICCneAOBaHICe KpOBU

    HO:

    Ha JlafiM-6opperro3,

    3HMf.

    CKB,
    BIITI;

    cuQr.urr.rc,

    V3lI uepenrrx crnoIOe L MqTKXX ftaHefi
    ronevnocrefi;
    rI{CTOJIOIIFICCKOC I{C-

    cJleaoBaHr,re HepBal

    r

    pafronnofi opraHr€aquu

    3ApzrBooxpaHe-

    r0-t2

    MOneKyJrrpHo-

    reHeTl4qecKo€

    KoH-

    cynbTfipoBaHue;

    KoHCyjrbTaur{u Apy-

    fl{x

    Bpaqeficneuu:ull,IcToB IIo noKA3AHI,I'M.

    Bocna.nrrenr-

    PafioH-

    HAA

    HbIC.

    TIOJII,I-

    HeBponaTl,rt

    (G61).

    Ocrpar rocnaJIIITE,TIbHTUI IIO-

    O6qufi

    Y3I,I opranor 6proru- flplr nogosperur.r Ha ocrpyro Bocnaurr{TeJrbHyro ro- t2-14
    KpoBx.
    nofr nolocru.
    Jrr{HeBpo[aTuro - 3Kc'rpeHHtur rocnrrTiullBarl]trl B
    O6rquft ana,rus 9HMf.
    o6nacnryro opraHr.r3arluro 3ApaBooxpaHeHnt IJtt
    MOqI,I.
    PerrrrenorpaQr4r op- rrpoBeAeHr,rr rlaroreHeruqecrofi repanuu.
    Eraoxururaqecr ana:rus

    r,rccJreAoBiIHr,re

    KI,I.

    4poBx: orpe,qe- KoHcylrra[r.ru

    Bpa-

    JIItHeBpOrraTr,ur

    JreHr{e KoHueH- qefi-cnequa;rr,rsron

    (G61.0)

    Tpauln

    HrroKo-

    3hr,

    o6uero
    6ema, o6uero
    6unnpy6uua,
    MOqeBItHBI,

    Hdrpv',
    xropa,

    KiuIIrr,

    oflpe,qe-

    JICHI{C AKT}IBIIO-

    crr.r

    AIAT,

    KOK,
    AcAT,

    CPE.

    o6uufi

    Tenq.
    flo.qnrrue roJroBHoro ronqa rporaru na 30o.
    Vcranosra Ha3oracrpaJrbHoro 3oHIa, MoqeBofo KaTeTepa IIo noKa3aHr[rlM.

    KorrrpomA{.

    Alr

    csuNesnr A,{ npe.4no.ma:relbHbr JlerKo rr{T-

    pyeMbre JreKapcTBeHHbre cpeAcTBa:

    llccregonanue
    CI\IDK na r.lre-

    ro.lrrrfi

    NO IIOKANAHI''M.

    rro CXeMe, peKOMeHAOBaHnoft na craquoHapHoM grarre Jreqeul,rr s o6racrHoft,
    pecny6lmancroi opraurraq?ra 3,4paBooxpaHeunr.
    Morrrropuponauue A!r,3Kf, qCC Ar.q cBoeBperr.rennofi KoppeKrlrru cnHApoMa nepr.r(pepuuecxofi
    sersrarunHofi HeAocraroqHocru. flepenog sa I,IBJI
    rro rroK,tsaHluM (uptr XEJI rrlesee 15 un/rr vaccrr
    JTeKapcTBeHHEIX CpeACTB

    cocraB,

    6e;ro4
    fJrroKo3y, 3JreK-

    nepu(peprvecrr,re aHTrralpeHepmqecKrre npenapa-

    rtr: ypanugnn e/n;
    unrur6u:ropu A[IO: rarrronprul, :ua.nanpul (n rorrl
    qlrcre,unr

    BlryTpr,rBeHHoI.o nne.qeur,u).

    flpr.r raxnxapguu: iera-agpeno6loraropu: rpo-

    138

    TponnTr'r.

    rrpaHoJroJr, Me'ronponon, 6raconpo:ro.n, KapBeAnJroJr,
    areHonoJr, He6usoror.

    3Kf.
    Koucyrr,raqrl-r:

    flpra aprepuanrsoi rrlnorerr:r.ru (cucronrvecxoe
    A! Hlrxe ll0 vrrl pr. cr.): o6reMsar.{ecrrremHat
    Tepanut: njra3Mo3aMetu:uou_trre npenapaThr: fr.rApoKcr{3Tr,rJrr{paxMa!'r,,qeKc'rpaH (3a r,rcKjrroqeHr{eM

    Bpaqa-

    oQralruolora
    (rna:noe lno).
    KoHcymraqzx

    corrlrcrByrouero nnQaprra Mr,roKapAa. apraruran).
    Ilpra orcyrcrBr.ut eiflperra: Kap,(rroroHr.rqecKr4e

    BpaqaTeparreBTa.

    cpe.qcTBa: IonaMr.lH.

    Hlrsrlte Ao3hr renapr.rua, HMf Ha3Haqaror c rreJrbro
    npoQr.urarrnxn T porra6osa uy6oxux nen y o6es,uBItKeHHbrx naquerrroB, rtpr{ Bapr,IKo3Hofi 6oregHl
    Hr.rxHr{x roHevnocreft, npu TOJIA B aHaMHe3e, TeM
    IaquerrTiM, KoMy rrpoTltBorroKillaHbr alrTrrKoary-

    rlffrrrrr - ACK.
    flapacuruna, our,rMerr,rlrecrr4e cpe.qcrBa: xoJruHa
    amQocqepar, finnAaxpr{H.

    flo nora:aglrru:

    IIpI{ rfinepTepMr.M: itHaJrbreTuKI.I-aHT flrrpeTuKu:
    ACK, nreraMus o Hxrptrt, [aparleraMon;
    npu uefiponaruqecKoM 6onenou cr{HApoMe:
    nporr.rBo3nr,IJrenrr.rqecKrie cpeAgrBa: xap6alra-:entn,
    ra6anermlH, npera6:urr{H; ar u,qeflpeccanTbr:
    aMr.rrpltnruJrr{H, Qlyorcerun, flapoKcerr,rH.
    flpz nogospeHuu na un$exquro ,uhrxareJrbHbrx nJrr.r
    MOqeBbIBOATTqUX lryrefi
    arrru6arrepr{ajlbHhle
    cpeAcTBa.

    -

    OT. JIOK.
    O6nasr-

    O6terra o6cre- O6reru

    H6IE.

    AOBaHr,rr aHaJro-

    o6cneaonanu-fl aHarorurqeH o6r,-

    fr{qeH o6teuy

    JIeqeHEe aHulJrorurrHo rerreHr,fio, npoBoAr,rMoMy IIarIr{eHTy n pafionnofi opraHr{3arluu 3.qpaBooxpaHe-

    eMy

    Hllt,

    o6cJre.qoB

    anvs.

    B

    l2-14

    PHnrl
    HeBpoJro-

    ft4t4

    vr

    o6c.fleAosau].rs s pafiouuoil opraHr{3apaftoHnoft opra- \vu 3ApaBooxpaHe-

    IONOJIHI'TCJIbHO:

    HIi'iA\UU

    H'I',

    urrruynouo6yrxH6r: r,rMMyHouo6ynuu qeroBeKa

    .UOTIOJIHHTEJIbHO:

    noprua:rrHrrfi.

    gAPa-

    uefrpoxu-

    BOOXpaHeHr.rr,

    pyprulr.

    .qorIoJrHI4TeJrb-

    6raoxruuqecroe

    HO:

    CJIEAOBAHIIC

    KOHTpOJT6 Cy-

    onpe.ueJrear.re CPE,

    TOIIHOTO AI,IYPE3a;

    penrraoQarropa;
    BI{pyconoruqecKoe
    r.rccJre,{oBaHl{e KpoBr,r
    u CM)K;
    I{CCJIE,IIOBAHI{C BhI3BAIIHbIX COMATOCCHcopHblx rroTeHIIHaJroB, Bn6paqnoHHofi
    rryBcTBltTenbHosrx;
    Koncymraqur Bpaqa-oToHeBporora.

    r.rccJreAoBaHue

    4ponu na JIa[u6opperuos,
    CKB, cutpnnrlc,

    BIF|
    I{MMyHOrOrXqecKoe r,rccJreaoBaHUe KpOBr.r;

    3HMf;

    rac-

    KPOBI,I

    n^naanraQepes;

    Kopperqur rnrroBoJreMr.r[: Harpnr x;ropu,q.

    :

    MPT rorosHoro

    n (ulz)

    cnr.tr-

    HOrO MO3ra.

    Xponuuecrar

    Pafion-

    BOCIIAJII,NEJIb-

    HbIE.

    Hat

    AeMIreJII,t-

    rrx3ripyrcqair
    rroJrr.rHeBpofla-

    rur

    (G61.8)

    O6rqlrfi ana;rur PenrreuorpaQu{ op- flpr nepnrunofi .quamocruKe ocy[IecrBnrerct l4-16
    ranor rpyguofi xler- rocflI{Tiulu3aqr,rr naqueHTa r o6lacrxyrc, pecny64poBr.r.
    O6uuE ana.nrls KI{.
    JruKaHcKyIo opraHr,r3arlruo 3ApaBooxpaHeHr{r.
    MOqI,I.
    V3I4 opranon 6prour- flpogorxaror Ha3HatreHr.re noA.qepxr.rBaroqefi TeEuoxr,rruuqecxoe nofi nolocrra, rqr.rro- pafi',,vr 14 ApyrrD( JreKapcTBeHHbIx cpe.qcTB no cxeMe,
    I{CCJIeAOBaHI,Ie
    peKoMeHloBansoft na crarlr{oHapHoM grarre JrerresuAHofi )r(eJre3br.
    KpoBr.r: o[peAe- Koncyruraqnr Bpa- nra-r a o6rag rofi, pecny6nurancrofi opraHr.rsaqur,l
    JIeHXe

    KOHTIeH-

    Tpaql.lfi

    3br,

    rroKo-

    o6ulero

    rra-TepaneBTa.

    3ApaBOOxpaHeHr{r.

    Koncymaquu

    rrrx

    Apy- flpu nefiponarfiqecKoM 6olenou clrH.qpoMe:
    npauefi- nporuBof nuJrenruqecKr{e cpeacrBa: rap6aua:enrH.

    140

    6elxa,

    o6rqero
    6utrupy6uua,

    cneqlrzlJlncToB

    ra6aneurun, npera6a.rlrn;

    KA3AHI4'M.

    aH'r'r4,qeflpeccaHTr,r:

    aMvrpvrlnvnur4 QnyorceruH,

    MOqeBIlHhr,

    rrapoKceTHH

    Ija;fpLtfl' Kar fl,

    OT. JIOK. MexaHorepanr.u.

    .

    xjropa,

    onpeAeJIEHIIE AKTITBHO-

    crlr
    AIAT,

    KOK,
    AcAT.,

    CPE.

    llccreAonauue

    CMX na rreroqnr,rfi cocraB,

    o6rqufi

    6e,ror,
    DrroKo3y, SneKTpoJrr,rT6r.

    9Kf.
    Koucyruraqux
    BpaqaTepaneBTa.

    Konrpom

    cy-

    TOqHOTO ,qrrype34.

    Hccre.uosaHfie
    r CKB, cu$u.nuc,

    BIITI.
    O6nacrHbIC.

    PHIIU

    O6rev

    Onpe,qereHue altrtr- Jleqenue aHa.[omrrHo JreqeHr{ro, npoBoar,rMoMy naAOBaHIT' aHaJIO- Hy$reapHbrx aHTH- rrr.reHTy n pafionnofi opraHr.r3aqnu 3ApaBooxpaHe.rqeH o6reruy TCJI.
    HUt,
    o6creaonanru n I4ccre.uosaHr,re Kposu AOIIONH TEJII,HO:
    o6cre-

    t2-14

    pafioHHofi opra-

    HeBpoJro-

    ftiu
    Herpoxrpypruu.

    14

    Ha Br{pycHbre felraTltHlr3ar,lr4r,r 3Apa- ru (A, B, C).
    BOOXpaHeHr4r,

    AOnOJIHI{TeJIbHO:

    SHM|;
    MPT cnussoro
    M03fa.

    ceHcoMoTopHtur lpopMa:
    fCII: rr.rerznnpeAHlr3oJroH

    Anr ctrcreMHoro npr4MeBupyco,roruuecxoe
    HeHI4r*, c [ocJreAyroqrrM [epexoAoM Ha Mer.rccJreAoBaHr.re KpoBrt THJTnpeAHLBOnOH, npe.UHr,r3OJrOH BHyTpb; trMMyu CIr,DK.
    nor,'ro6ynlrHrr: uurrlyuouo6y;rrrH qeroBeKa HopSrerrpoQopes 6e,r- uamHrrfi*i
    KOB CbrBOpOTKlr KpOBU IJlg, I4CKrIOqeHnt
    napalpoTerrHeMrru,

    PeHrreHorpaQnr
    nJrocKr,rx

    rua:rrlaQepes**
    I4solnponaunar MoropHuur Qoprua:
    rrMMyHorllooyJrr.rHhr:
    r.rMMyHoDro6yJrr,rH qeJIoBeKa noprualrurrft

    .

    rocrefi Arc flo44epxunaroru:ur repam4lr npr.r AaHHbrx Br,rA.tx

    I,ICKIIIOqEHI'JI MI{E-

    Heftpo arr.ru:
    JroMHOfi 60.neguu.
    ecJrr{ Tepanru nepnofi Jrr.rHr.trr oK:l3brBaorcr slDOeKofAC.
    TlrBHoft, To ee [poAoJDr(ilror .uo MoMerrra AocrroKefn crororr,rqecroe
    Hlu MaKcHMaJrHoro sQQercra. 3areru Ao3y cpeAI,ICCJre,qOBaHI,Ie He- crBa cHrDKaror Ao MaKcuMaJrbno gugroft e$$erpBoB.

    Y3I4

    rr,rsHofi.
    uepr.r(pepuue-

    cKlrx HepBoB.

    flpu mcyrcrnuu s
    rrpla flpueMe B KaqecrBe
    noAAeprflnBdorqefi repanvu Brryrpr,rBeHHoro uMMyuorno6ylr,tra qeJroBeKa HopMirnbHoro ruru fCfI

    rurfi

    rura3MaQepe3a AonoJrHr,rreJrbHo Ha3Haqaror

    uMrvfyHocynpeccopbr:
    nMMyHolenpeccar{Tbr: a3aTr{onpnH, rlr.rKjloclopr,rH;
    aJrKr. rupyrouxe arerrTbl:
    qax.noQoc@anrug,
    arrrrarrr gra6onr.rrlr : MerorpeKcar.

    My,'rrru(porarbHiu MoropHar nefiponaru.r:
    urr,rllynomo6ylr,rHhr: r,IMMyHouo6ylnn qeJroBeKa
    Hoprraa;rrnrrfi. BnyrpuneuHoe BBeAeHr{e B TerleHue
    5 cynor, ecJrr.r uMeercr rroJror(r,rreJrr,Hiur Ar,rHaMrrra,
    HA IIOAA

    nayHoruro6ylr.rHou. He noxaranrr fCfI u ua:uaQepe3, T.K. OHX yXyAUarOT KJrr4HuqeCKOe TeqeHr4e 3a6oneeaHr,rs.

    flo44epxunarcuar reparufi npn uylrru(pora.nrHo[ uoropnofi neftpolarura:
    I,Ituuynorno6yJrr.rH qeJroBeKa nopualrnrrfi BHyrpHBeHHo BBoArr oAr{H pir: n 2-4 uegenu ulu I pas n l2 ruecs{a. Ecau e$@errr,rBHocrb BH)/'rpr{BeHHofo
    ulruynouo6ylr.rHa rreJroBeKa HopMilJlbHoro HeAocraroqHa B yMeHb reHr,rll HeBpororuvecKoro .qeQ[rlnTa u AocTr,rxeHr{r peMr,rccHn, To K reqeHxro ,qo-

    6asrrrot:
    LlMMyHoAerrpeccaHTbr: a3aTr,Io[pr,rH, rlr,rKnocnopl,IH;
    rlr{ToroKcxqecKr,re anra6roruxu u poAcrBeHHbre I{M
    coeAr.rHeHrfi : MrrToKcarrTpoH.
    He perouen,qyercr Ha3HaqeHxe qurc,roQoc$avr.rga

    BBUAy BbrcoKofi ToKcr4qHocrI,I

    npn gaHnofi

    cxenae

    JIEqCHI,I'.

    .{pyrne norn-

    Pafion-

    O6rqnfi

    HeBponaTr{r,l

    HbIC.

    r9oBn.

    (G62)

    O6nluft

    ana.nr.rg

    alra.nng

    MOIIII.
    Er,roxr,rruraqecroe

    I.tccreAoBaHue
    KpoBx: onpeAe,rleHue KoHIIeH'rparyr[ n oKo-

    3br,

    3HMf.

    Y3I4

    Mgra6orurur: naenr,qonuft, BuraMnH
    rqurosxAHoi 6uuat\t'tu c Br,rraMr.ruaMl,t 86

    Bl

    u ero rou-

    uBl2.

    xeJre3br,

    flepr.r(lepr.rvecrue Ba3oAr4Jrararopn: nern:oxcnlpul-

    6proulrofi

    JII'IH, KqIIITI,IHOJIA HIIKOTHHAT, HIIqCPTONHH.

    opraHoB
    rroJrocrn,
    opraHoB Mturoro Ta3a.
    PerrreHorpaQnr opranon rpyAnofi x.ner-

    flapacuunaroul,rMerurlecKl{e cpeAcrBa: Heocrl,rrMXrr, I,III4qa4pHH.

    HefiponporemopHarr

    repa[[r:

    KI,I.

    cvrrupv4nHa cyKunHaT,

    ofAc.

    rrrApoxjropxA.

    srr.rnMerrinrr{ApoK-

    MeTrrJrSTI.IJInr{pr.ri4lrHoJra

    o6qero Koucymraqlu Bpa- flo norasaHr,rrM:
    6erra, o6qero qa-TepaneBTa.
    flpu xpoHnvecrov nefiponarurrecKoM 6onesoM
    KoHcy,rr:raqun Apy- cr.rHApoMe: npoTr,rBo3nr{JrenTr,rqecKtre cpe.[cTBa:
    6usrupy6nua,
    npauefi- rap6avasenru. ra6anerrrnn. npera6aluHl aHTHreMOIICBI-IHbI,
    rt,tx

    10-16

    HaTput, Karvf, cneuuzulncToB IIo flo- lpeccaHTbr: aMLrtpvrnrvrlvtH, S,ryorceran, naporce_
    xjropa, onpeAe- KA3AHI,I'M.
    TI{H.
    JIEHI,{E AKIUBHOflpu gua6etnuecxofi z anrorol*rofi nonuueiipona-

    crr.r

    KOK,
    AIAT, AcAT.

    TIIIT : T}IOKTOBA' KI,ICJIOTA.

    OT, JIOK, MexaHorepanur.

    14ccregonaHue
    CIIIDK na 6e;rox,

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    O6tev

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    na Jlaftu-6oppelr,Ior,
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    I'

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    AI4ATHOCTI,IKE:

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    147

    PHNII

    O6lelr

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    14
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    rr

    r4c-

    cJleAoBaHue

    CNDK ua 6enorg
    rIHTO3, KJIeTOqnuft cocraB,

    rnloKo3y,

    (rlarpur aqerar

    MeTr,ul3Tr,r.nnupxaxHoJla

    fr4ApoxJropr.rA.

    flo nora:anlr-s Nr:
    IIpu ncnxouoropnolr aor6yx,{enuu:
    aHKcrroJruTr,rqecKr,re cpe,qcrBa: ro$uronau.

    4r.ra-

    3ETIAM;

    Koncylrraqnr

    aHTr,rlcrlD(oTrrqecKre cpelcTBa: Tpr{onyo[epa3r,rH,
    xropnpoTnKceH.
    flpu 6oneaonr currlpoMe lr rraneprepMurr: aniurreTr,rKr,r-aHTr.rlltpeTr,rKH: MeTaMu3on HaTpr{r, napaqe:raruor, HIIBC:,qux,roQenar, xeronpo$en, KeropoJraK, MeJroKcr{Karu, r-r6ynpoQes, qenexoxcu6; onno-

    Bpaqa-

    Ll,qbr: TpaMaAon.

    uefipoxupypra.

    flpr.r prore: flporr.rHerr.tKr.r: AoMrrepxAoH, MeroKrro-

    Koucynrraqnr

    [paMH.u.

    Bpaqa-

    flpu cygopoxHoM cxH,[poMe: nporr.tBosnmerrrtrqe-

    oQralruorora
    (rnasnoe AHo),

    cKI,Ie cpe.qcrBa: QeHlrrouu, rap6anaa:enuu, BirJrb[poeBat KIrcIoTa.
    flpu roarynonnvu (flTl4 <60%, AqTB >35 ceryHa): C3fl s/s xaneJrr,Ho (Ao nopr'.ra:rasaunu noKa-

    truit,

    Ka-

    uurpui,r,

    xropr.raf,r,

    3pr.rT-

    poqr,rTbr cBexl{e,
    BbIlqeJroqeHHhre.

    BpaqaTepaneBTa.

    garerefi roarynorpalrruu).
    flpu uunuuecruor r.r KT-npra3HaKax Hapacraroqero
    oreKa Mo3ra, noBbrrrreHr4r4 BiI.{ 6olee 15 rr,rrr,r p'r. cr.

    (no IaHHbrM MoHnTOpnHfa), He cHrD(arorlerocr Ha
    QoHe ce4arlur.r u (unu) atlrarre3vrl, ypoBHe Harpr4t
    rura3Mbr llenee 150 urrao.nrh (ronrpolr gnercry)oJrr-tToB He pex(e 2 par e cyrrz):
    pacrBophr c ocMoAuyperr4qecKltM gefi crrueu n/n:
    copMaHToJr, MaHHATOJI, C [OCJreA].rOrq]rM BBeAeHI,Iev s/s MoqeroHHbrx cpe,qcrB: Sypocetrug. BregeHr,Ie yKruaunbrx cpeAcrB uoBToprrcT raxgue 4-5
    qacoB c yr{eroM K;rr,tHnqecKr,tx npornleHufi u ypoB-

    Hs

    ocMoJrrpHocru rrJrailMbr

    (ue 6olee

    295

    MMOJTb/Kr).

    Bnegenre ocMorr,FrecKr.tx Ar{yperxKoB rrpcrnrBonoKa3aHo npr noqeqnofi HeAocraroqHocrr,r, oreKe
    JrerKr,rx

    u

    AeKoMrreHcr{poBaHHoft cep,qeqHofi HeAo-

    CTATOqHOCTI,I.

    flpu namvau

    r.nunuro-nefipoBr{3yr}Jru3arluouublx
    nprlsHaKoB ocrpofi orx.rroglronno[ ru,qpoqeQartufi
    (npu flpophrBe KpoBn B xery,qoqKfl morra): xlpypr[lrecKfur oflepaurut: ycTaHoBKa HapyxHoro BeHTpr{I(yJrrpHoro ApeH&Ka c,qafir.rKoM BHyTp[qepenHoro .qaB:reHr{rr (aa;ree - 89.{).
    flpu nucorou pucxe rpom6osM6oruu us uy6orr.rx
    BeH HrrxHr.rx roueqnocrefi u TSJIA: npephrBxsralr
    nHeBMaTr.rqecKiul KoMrrpeccHr, IIpn oTcyTcTBr{r,r KoMnpeccroHHhre qyrKr-r; rerrapr.rH tlu HMf vepes

    3-4 cyror flocne

    rgoBol,r3 Jrvrr^nrrr^; TeM rraqueHTaM,
    KoMy npornBo[oKa3aHrr arrr,rroaryLrrrrrr: ACK.
    B cryvae 'rpona6osa rrry6orutx BeH: relapnu rlJrn

    HMf uep* 1-4 cyror

    nocne KpoBor{3rrr.rrHr.rr; rrocJre oKKjlro3r{r,r aHeBpr{3Mbr - He paHee, ueu .repes 12
    q rrocJre onepaqr{lr u 6egouararenruo - noc.le rofiJII,IHTA.

    AHln6axrepua,'rrHbre cpeAcrBa rrpu noAo3peHxrr Ha
    ITHQeKIITIIO AbIXaTeJI6Hbrx I4JlIl MOqeBbIBO.UtrulIx
    nyrefr.

    u xpar- AnanoruqeH o6seuy Ana. orr-rqHo JreqeHnro, npoBo.qr4MoMy narlr4eHTy
    o6c,rego- o6cle4onaHnr a pafi- pafi onuofi opraHn3ar1uta 3ApaBooxpaHeH]rr,

    O6:racr-

    O6reu

    Hbte.

    uocrr

    Prilq

    BAHU'
    rl,rqHbr

    HeBpoJro-

    f u
    rtefipoxta-

    pyprulr.

    L1

    AHAJIO-

    B

    ounofr opraH

    14-30

    B

    3ABTCIIMO-

    3aryll.u AOIIOJIHNTCJIbHO:
    cTx oT Tt3ApaBooxpaHeHr4r,
    flpu nuruenulr Meuror.rarofi aHeBpu3Mbr urv ap- xecTl,t coIl
    rCpaTHoCTIl AOrroJtHr{teJrbHo:
    TepI,IoBeHo3Hofi ruanrQoprr,raquu r,r rrxecrl{ cocror_ cTorHtIr.
    o6cnegonanur
    npfi
    ucKjrroqeHllH Hr.rr, coorBercrryrouqefi IV-V crenen r,r no IIrKaJre
    o6nacruofi op- ueurorqarofi aHe- Xasra n Xecca:
    TAHI,i3AIITU
    Bpr43MEr I,.Irn apTe- MeAr4KaMeHTo3Har repanr r
    4o cra6lr.nusaquu co_
    3ApaBooxpaHepnorenosuofi MaJIb- crotHr.ul
    conracoBaur.
    BparroM_

    o6rerray

    I

    (no

    Hnt,

    .(orroJrHr{reJrEHO:

    npH

    Qopuaqzn: yroqHe- neipoxupyprorra).
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    o

    c

    aHeBpn3MbI ruru apreprlosenosuofi nra:rrQopnraqurr, Tnrecrr.r cocror_
    KpoBr.r, o[yxonb ro- Hr.rr, coorBercrnyor4efi I-III creneHrr.r no rrrKane
    JIOBHOrO MO3ra, Xaura u Xecca, noc.ne KoHcyrBTarluu Bpaqa-

    Qarropa:

    oTCyTCTBr,ru

    npr.BHaKoB Ar,rcJroKarur,r Mo3ra:

    rporrr6os

    BeHo3Hbrx

    uefipoxNpypra:

    cI{HycoB MO3ra, aH- rrepeBoA n uefipoxupypf[qecKoe m4eneune pHfII_l
    CI\IDK na 6enor, rlr(pocQonunlrgHufi
    HeBponorur u uefipoxr.lpyprvnr Mt xupyprxqecKo_
    quTo3, KIeTOq- cr.rHApoM, (OJUrare- ro JIeqeHLtt.
    I,ICCJIEAOBAHI,IE

    H6Ifi

    cocraB,
    rnloKo3y, xJIo-

    prrAEr, sprfrpoTIHTbI CBeXI,Ie,
    BbrrqenoqeHHSIE;

    KT

    r.uru MPT

    TOJIOBIIOTO MO3-

    ra;
    KT unv MPT - c

    HO3, peBMaTr.r3M.

    IIepeA onepaqueft uporo4rrcr npaue6nrrfi rcoxcllJrr{yM B COCTaBe Bpaqa-HeBporora, Bpaqa_
    Hefipoxlpypra, Bpaqa-peHrreHosHloBacKyJt pnoro
    xupypra r.r Bpaqa-aHecTe3r.toJrora,qff oflpeAereHv,
    omlarr,ra.nrnoft raKfr{KI{ Jreqegr.rrl.
    B cryuarx, KofAa K;rr,rnupoBaHue H rofinr-rnr oaraHaKoBo eQQernrenrr, npeAfloqrrrerbHee K;rr.rflupoBaHUe.

    TaKXe OOJIee npe,{norlTuTenbHo

    aHruoIrporpaM-

    naqrlelrToB MOJTOAOFO BO3paCTa, flpll H:UIUqI,IH
    rnyrpuuepenHofr reMaroMhr, npfi aHeBpr43Max
    cpe4nefi voarosoft aprepvwr, ueplmannesHofi aprepzu, ulrporofi urefixe auenpu3Mrr, a raxxe B cJry-

    ruofr;

    peHTfeHKoH-

    TpacTHas 4vrvTaJrbH:ur cy6-

    qae, Koraa He[ocpeacTBeHHO rr3 MerrrKa aHeBpr{3Mhr
    BhrxoAtT apTepr,taurbHble BsTBlr.

    TpaKrIlroHHat

    aurrorpaQr.u;

    3ngonacrylrpHoe BMe[rareJrbgrBo npeAnorrrnTeJrbuee y naqrrenToB crapne 70 net, npu orcy"r_

    TKIf.

    crBr4u BHyrpr.lvepenuofi reMaroMhr, [p]I aHeBpr,r3_
    uax neprebpo-6aaulrpnoro 6acceftHa, y:rofi ureftKe aHeBpu3Mbr, rrpr4 o.qHoKaMepuofi atrenpu:nae.

    Bnyrpuuoero-

    PafioH-

    BOe

    HbIE.

    ICpOBOr43-

    rarune (16l )

    Oqenxa ypoBlur
    CO3HAHI,TJI IIO

    KT unu MPT roros- focnu'ralugaqur u rgqeqne

    naurreHTa B uaJrare pe- l4-30
    Horo Mo3ra, KT Nru.r anuMa\uu z r{HreHcusHofi Tepalxn cleql{aJrr,I3r{po_ B 3aBrrc[lllKf, rrrK re MPT c rorrpacrnuna BaHHoro HeBpororuqecKoro (nrcylrrnoro) or.qe- MOCTI,I C'T
    Xanr r.r Xecca.
    ycr,r.JreHr4eM npu IIo- ner{ t t4ltlr B OTAeJTeHI{r{ aHecTe3r,ronorfifi
    peaHv_ TtxecTI4
    Crprmunr Ha AO3peHr.[r Ha cocyAr,r- MarIr4Lr opraHl8arlrix 3,4paBooxpaHeHrrjr.
    cocTotHlt I.
    H:lJrrfrue Hapy- cryro ua.irrQopnra- O6ecneqenue npoxo.qr,rMocrn Bepxxr{x
    lrrxarenbruenufi Hrora- qmo n on)rxoJrB ro- nrrx nyrefi, rroAaqa Kr{cnopoAa .repes ua:aarnrrfi
    HUt.
    JIOBHOTO MO3ra.
    3oHA co cxopocrrro 2-4 t/v.uu.
    I,IlrreHcnsHoe
    [ururutsnat cy6- Ilepeno.q Ha I4BJI ro noKa3aHr.rrM.
    MOHr4TOpnpoBaTpaKIInoHHar aHflro- flo4nrrr,re roJroBnoro xoHqa r Hue )4)oBHr CO- rpaQur.
    YgranosKa Ha3orac,rpzurbHoro 3oHra, MorreBoFo Ka-

    3HAHI,I', Afl, 33f npu laaJfirqvtvl TeTepa IIo noKa3aHWIM.
    9KI., reunepa- grrnllprrcTyrroB r{ Ko- MonrropturA,,{.
    Typbr Tena.

    MourrropuHr

    THI,ITI,IBHOM CHI,IXCHnu.

    flaqueurau c CA!, 150-220
    TI{BorIoKa3aHr{fi

    rr,rrrl

    r r,rrrencrsuoMy

    pr. cr. u 6es nponeqeHr,rro

    A,{ no-

    PenrrenorpaQur op- ra":ano 6srcrpoe cHr.rxeHr.re CA,4 Ao 140 ruu pr. cr.
    raron rpygnofi x.ner- flaquenrav c CA,{ > 180 nrr.r [pr.r Hanuqru rtprlrefrroqlrros.
    KI4.
    snaron qepe6pa:rbHoro Ba3ocrrzrMa uJrr.t rroBhlrrreO6n1zfi aHa;rras KoHcylrraquu Apy- suq BrI,4 A! cHr.rxaror
    ao 160/90 MM pr. cr. B TeKpoBr{ c noA- rrx
    npauefr- qesue l-1,5 qacoB c nocJreAyroqr.rM noA.qepxaHrreM
    HrroKo3br KpoBr.r,
    gnelopoJlr.rToB It

    CqCTOM KOJII4qC-

    cnelIaJII4CTOB nO nO-

    cTBa rpoM6orlr4-

    KA3AHI,I'M.

    TOB, peTr.rKynorIr.rToB KpoBt4.

    O6u1r.rfi analus
    MOqU.

    Buoxvrrluqecxoe
    r,rccJre,uoBaHr.re

    4poBr.r: onpeAeJICHI{E KOHIIEHrpa\w nrroKo3H, O6qero
    6err4 arb6y-

    MI{Ha, o6qero
    6utrupy6wna,
    MOqeBltHbr,

    Hflfpu',,

    uop4

    KaJru[,,

    AnAT,

    Ha AOCTHTTTyTOM ypOBHe.

    Ec;ru cucro:ruqecroe A{ > 220 uu pr. cr., u (nru)
    Auacrorr.rq€cKoe A! >140 MM pr. cr. (no pery.nrraTaM ABy(parHoro r{3Mepeulr{ c unrepna.noru 5 uu-

    nyr):
    6ucrpoe r,rHTeHcr,rBHoe cHuxeHr,re A.{ c npr,rrueHeHr{eM Heflpepbrnnoi rrry'rpznennofi uuQyanu uepz$epuvecroro aHTxaApeHeprurqecKoro flpenapara
    ypa u2.wr ro cxeMe u uourropunra A[.
    Mr npo(lu.narrrrr.r aHnrocna3Ma: 6loraropu
    Kalbur{eBBrx KaHanoB:
    HlrMoAr.rn[H nuyrpr (npu Hapyureur.r[ Hroranr.rr
    qepe3 Ha3oracrpirnbHbrfi song). IIpu HeBo3Mo)r(Hocrn nprreMa HHMoAnnrlHa Buyrpb - a/e nne4enue
    HIrMoAr,InrrHa B TeqeHHe 5-7 cy'ror c nocneAyror{r,rM
    npHeMoM BHyrpb.
    flpu aprepraanrnofi rranorener.rr.r (cr.rcrolrauecroe
    A,{ Hr.rxe
    rr.rrr.r pr. cr.): o6rerrrsaMecurrcmHat

    -

    ll0

    AcAT.

    TepaJrr,n:

    I,IccneAosaHr.re

    fipenapaTbr rrJrat3MSI 4poBn r{ rrJra3Mo3aMerqaroryre
    npeflapaTbr : rxApoKculTr.{nKpaxMaJr,,qeKcTpaHa (3a
    IrcKlrroqeHr{eM colyrcrByrcrqero uuQaprra ruuoKapAa, apr.rTMr.ru).
    orcyrcrBr.ru etbQeKra: KapArroroHr{qecxr.re

    noxagatenefi
    reMocTa3a:

    AIITB,

    TITI4,

    I]B,
    MHO,

    IIpu

    (plr6pauoren,

    cpe,ucTBa:

    reruaro4pur, .{-

    AorraMr.rn.

    Ar.rMepsr.

    Moruropunr

    AI.

    3Kf.
    PerrreHorpa(pu-r uepena npra

    B gas[cutuocrl,r or reMo,ru,rHaMnqecKoro
    e$Qerra (yponnr A!, rICC) Kopprrupyrcr cKopocrr a/r BB€AeHr.rr AonaMuHa.
    Kopperqnr KoHrleHTpaqnr rnroKo3br KpoBr,r: npu
    KoHr-Ierrrpaquu rJrroKo3br rpoau 10 uuolr/,r r.r grrrue 4po6noe BBeAeHr{e r{HcynuHa c yqeroM ypoBH-s
    fJ]I4KCMI4I{ HE3ABUCIIMO OT HAJII,IqI,U IIJII,I OTCVTCTBI,I'

    loAo3peHxx
    qMT.

    3xo3C

    Ha

    (npu

    orcyrcrnnu KT
    (r\PT).

    KT urr.r MPT
    fojroBHoro
    fa.

    KT

    r.urr.r

    Mo3-

    MPT c

    aHn{onporpaM-

    c:xapHono I.ua6era B aHaMHe3e.

    flo4gepNauue HopMoBoneMr.ru noa
    UB.{ u grype:a.

    KoHTpoJreM

    Koppenqru rurroBofleMl,Iu:
    HaTpxr xr.ropr4.q; 3rercrporHTbr (Ha'rpHJr arIeTaT
    /uxrpw. x;roprr,q /KaJrur x.ttopn4) (aueconr);
    3neKTpoJrrrrbr (narpur xropnq lxatut xttopug
    /ramqlrx x.nopr.rg) (Puurep).
    HeftponporerropH:ur repanur: MarHur cynrQar.
    Pelrenue Borrpoca o xupyprrrecKoM JreqeHr,ur rro-

    uofi***.

    cJre rpave6nofi

    Koncylrra4ax:

    uefipoxlrpypra.
    flpu nrrcorou pr,rcre T ponr6oela6onuu r,rs rny6oKrD(
    BeH HrDKHr.rx KoHeqHocrefi u TSJIA: [pepbrBr{crarr
    rrHeBMaTlrrrecKtur KoMllpeccnt, npr{ oTcyrcTBr,[r KoMnpeccuoHHbre rryJrKr.r, renaprrH rarfi HMI s reqeHr.re 3-4 cyror(; TeM naqfierrraM, KoMy nporr{BorroKa3aHbr aHTHKoaryntHTbr: ACK. B cJr).qae rpoM6osa rny6orr.rx BeH: reflaplrH lrnu HMf vepes 1-4
    cyroK rrocJre KpoBox3nr{rHur; TeM narlxeHTaM, KoMy nporuBonoKa3aabr arru.moaryn-aHrrr: ACK.
    flpu uuHuuecxro< u KT-npu:Ha(:x Hapacr: orqero
    orexa Mo3ra, noBrrrrreHnr{ BrII 6oree 15 runr p:r. cr.
    (no ,qaHnnu uouvrropr.*rra), He cHruKarculerocr Ha
    $one cegaqrlu u (u:tu) aHaJrre3r{r{, ypoBHe r.xrp}rt
    rura3M6r Meuee 150 rrruoruh (rorrpolr sneKrponrroB rre pexe 2 par o cymu):
    pacrBopbr c ocMoAqper[qecxr.rM .left crBr.reM B/B :
    copMaHToJr, MaHHr,rToJr, c flocJreAjr'rou[M BBeAeHr,reu e/n MoqeroHHbrx cpeAcrB: r[ypoceur.r.q. Bne.4eHr{e yKa3aHHbrx cpeAcrB fioBToprror raxgrre 4-5 .r
    c y'{eroM KJrrrHr,rvecK}rx nporBneHIdX Lr ypoBHt

    Bpaqa-

    nefipoxupypra,
    BpaqaTepaneBTa, Bpaqa-

    oQramuonora
    (rua:noe gno).
    flplr otcyrcralrra
    npH3HaKOB Ar,rCJroKarlul, Mo3ra:
    IICCJIeAOBaHLIe

    CM)K na 6elor,
    rlr{To3, KJIeTOq-

    nr,rfi

    cocraB,

    r[oKo3y,

    xjro-

    puAhr, 3pr{rporlI,IT6r cBexl{e,
    BbII{EJIOIICHHI,IC.

    KoHcyJrbrarlnr,r

    Bpaqa-

    ocMorrrpHocrr.r rrJra3Mbr (ne 6onee 295 rvrrlolr/rr).
    Bse.qeHue ocMoruqecKux Anyperr.rKoB nporr,rBorroKa3aHo rlpn noqeqHoft HeAocraroqHocrl4, oreKe
    JrerKux u AeKoMrreHcrrponannofi cepAeqHoft HeAo-

    craroqHocru.

    flpn
    BL

    I

    runoambyMr{HeMr4rr: npenaparbr nJra3Mbr KporrJra3Mo3aMeuaour{e flpenaparbr: ars6yvrHa

    B/8.

    flpu

    runeprouuqecKnx KpoBoIr3iII,IrHnf,x rro rr4rry
    reMopparuqecKoro npoflr,rrhrBaHll.f,: nllraMuH K r,r
    Apyrue reMocTaTI,IKIl: STttM3nlaT.
    flpra xoaryronarr.rn (IITI4 <60%, A9TB >35 ceryn,{): C3fI B/B KaIIenbHo (4o nopnranuraquu noKagarenefi xoaryrorpauurr).

    flaqrenrau c BMf, MHO rmoprrx

    floBbrcnJrocb

    BCneAgfBue npxeMa arrTaroulrcToB nlrraruuna K,
    rroKa3au KoMrr;reKcHbrfi KoHrIeHTpar suraMrur-K3aBr{cr.rM6rx

    BlrraMr{H

    $arropor

    K

    cBeprErBaHr{r

    nrryrpunenno,

    MHO.
    flaquerraru c

    C3fI

    (IL VII, IX, X),
    .qJrr KoppeKqnlr

    BMf,

    Koropbre [pnHr.rMitrcT opiurbHbre aHTr,rKoarymtrrbr - aa6rrraTpaHa sTeKcr,rJrar HJ|H

    punaporca6aH: KoaryJrrur.roHHhre Qarropu
    X,il,VII u X s roM6lrHarluu c uporexuoM C x
    rrporelrHoM S; arrunrporanurrfi yrom, ecJrr{ nocleanufi rpueM HOAK 6rrrr se 6oree 2 .racos
    Hir3AJI.

    flaquerrrau c

    BMf,

    Koropoe pa3Burocb Ha QoHe
    pr.reMa HMf, renapuua: flporaMrrHa cynr(par n/n
    uo4 xorrrpoleru MHO.

    flo noxaganu-rNr:
    flpu ncraxouoropHoM Bo36yr(AeHr.rn

    :

    157

    AHKCI4OIII,ITITI{CC KHE

    cpe.qcrBa: ro$usonau, gua-

    3enaM;
    AHTIIIICI4XOTI' qCCKI,IC

    cpeAcrBa: rprqplyonepa.:lrH,

    xjropnpoTr4KceH.
    flplr 6orenorra cr-iHApoMe r4 rr.rneprepMr{r4: aHaJrreTr.rKr.r-aHTlrIfipeTuKr,r: MeTaMr,t3oI HaTpur, apaqerarlrol; HfIBC: gruoQeHar, KeronpoabeH, KeropoJraK, MeJroKcr.rKaM, fi6ylpoQeu, qenerorcu6, rpaMAIOJI.

    flpn prore:
    npoKr,rHeTr{Kr4: i[oMnepr,rAoH, MeToruonpaMr.rA.

    flpu

    cy,qopoxHoM cr{HApoMe: nporuBo3nr.rJrenrr.rqecKrre cpe.qcrBa: Qeurroun, rap6auasenun, BaJrbrrpoeB:ur Kr{cJroTa.

    flpu

    cnacruvecKoM cr,rlApoMe:

    Mr.topeJraKcarrrhr
    rlerrrp:urbHoro A€itgrcus:. 6axno$eu, ToJrrreprr3oH.

    flplr

    recru6yn-apHoM cr.rHApoMe: cpeAcrBa Arrt
    ycrpaneur{r roJroBofpy}(eur{r: 6sranrcrr,rH.
    flpr.r erc'rpauupaM4qHoM cr4nApoMe: AonaMr.rHeprurrecKue cpeAcTBa: aMarrTaAr,rH.
    P aHuss pea6unnra\vt flaquer{ToB,

    Haxolrt{rxcr

    B

    cra6rubHoM cocrotgur{.
    OT, JIOK.

    Ananorrqno

    O6nacr-

    Ana. orn.reH o6reuy Anarorrqno JreqeHr4ro, npoBoiqliMoMy rraqueHTy
    o6renry o6cne- o6cnegoranur n pafi- paftoHHofi opraHr,r3arluu 3ApaBooxpaHeHxr,
    AoBaHur B pafi- ounoi oprauusa4vrr ,uoIIotrHltTen6Ho:
    oHnofi opraHu- 3ApaBOOXpaHeHr,rr.
    no roKa3aHu_sM - xnpyprFrecKoe JretleHr{e.

    H6IE.

    Prilu
    HeBpoiro-

    fLlu
    nefipoxrapypfr{r.r.

    t4

    3a\vu

    3Ap:tBO-

    oxpaHeHItt,
    AONOJIHIiTCJII,HO:

    l4-30

    B

    3ABI,ICII-

    MOCTT'I OT
    T'XECTI,I

    cocTotHltt.

    KT ruu

    MPT
    ronoBHoro Mo3ra.
    I,Ia(paprr
    ra (163)

    PafionHr,te

    3rc:rpeHnoe o6cJIeAOBaHIle narIueHTa c ycTa-

    Hosxofi Ar.rarHosa n re.IeHue 45
    MIIH C MOMCHTA

    Orpegereute noKa- f ocnraranu:aqr,ur H JreqeHr{e flaqr{eHTa B nalrare pe- t4-30
    sarerefr JllrrrlnHofo aHvMa\uru u unreucr.nnofi Tepanu cfleqfiaJrr,r3l,rpo- B 3ABI'CIIo6ruena: OXC, XC BaHHono HeBpoJrorrqecKoro (uucylsrHoro) orle- Mogtr oT
    JIIIHII. XC JIIIBII. reHv'..
    T'XECTI,I

    Tf, KA npu creHo- O6ecneqenrae npoxo.qr-rMocrr,t BepxHr{x lbrxareJrb3npyrcrleM rlepe- urx rryrefr, rto,{aqa Kl,rcJropoAa vepea natalruuft

    .UOCTABKI,I.

    6pa;rrnou

    Oqenra nerpo-

    crurepo3e.

    arepo-

    2-4 n/unn.
    flepeaog waIlBIl no noKa3anr.rrM.
    JIOrl{qeCKOrO
    IIpu orc;r'TcrBr,ru flo4rrnre ro;roBHoro ronqa rpoaaru na 30o.
    AeQuqrlra ro IIpU3HaKOB Ar,rCJrOKa- Ysranoexa Ha3oracrpaJrbHoro 3oHI4 MoqeBoro xartrKare I{HcyJrbTa qr,rn Mo3ra I{ npu no- TeTepa no rroKa3aHl,rrM.
    Haquona.nruux .qo3peHr.rr na BMf, Kopperqrx Korrlerrrpaqnu rurroro3hr KpoBr{: npu
    uHcfl-rryroB
    NHQexquonurre, Ae- Konqerrrpau[r DrbKo3bI tcporu l0 rrluo;rrl.n rl grr3.qpaBooxpaHeMI{ennHr.r3r.rp}'rcIIIue,
    ure gpo6noe BBeAeHr,re r.lHcyJrnHa c )AeroM ypoBHt
    Hru, (MHSS).
    a)'TorrMMyHHbre Boc- ruIuKeMr,ru He3aBHcr4Mo OT H:IJrr,Frr.rJr r,ull4 OTCyTc-rBI,ur
    Ouenxa Qynr- flaurr,rreJrbubre 3a6o- caxaproro gua6eta B aHaMHe3e.
    qfir,r HroTaHrrr.
    JIEBAHI,I' TOJIOBHOTO Monrropr.urr A!.
    O6qufi aHa:rn: MO3ra: UCCJre.{oBaHue Kopperrg{r A.{ nporogrrrcr B rrepBbre cyrKr.r r{HKpoBr,r.
    CI\4)K: 6enox, qlrros, cyJrETa npl,l cucroJrr,rqecKoM M >220 MM pr. cr.,
    O6qufi ana.nus xJreroqrbrfi cocraB, Anacrorrqec(orr,r A'4 >120 MM pr. cT.
    MOIIT.
    DITOKO34 XJTOpU,IIEL
    flpu ua;rrvun conyrcrByrouefi cep.qevuofi ne.qoBr,roxuuzqecrcoe Ormlqecrar arpera- crarorrnocrr,t, paccnar.rBilloqei auerpu:nau aopr:rr,
    uccJreloBaHr,re
    ToMEIpr4r rpoM6oqu- ocrporo unQaprra Mr.roKapAa, ocrpofi noueuHofi
    4poBr.r: onpeAe- TOB IIJII,I I{M[E.UAHC- HeAocraroqHocru, npu Heo6xoAr,rMocrrr [poBeAeJIeHI,Ie KOHUeH- H:Ur arperaToMerpvr Hur rpou6ona3r,rca HJrrr Brryrpr{BenHoro BBeAeHr.tt
    Tpaqur{ nrroKo- 'rpou6oqlrroe.
    renapuHa KoppeKrlrrr A.{ neo6xo.qzMa rrpr.r MeH63br, o6qero KT unu MPT c an- ruux ur.rr$pax A[.
    6enra, o6uero ruonporpauuofr
    A{ cHuxaror He 6olee geMl ua l5%o oT }rcxo.uHoro
    3oH,q co cKopocrbro

    cocTorHl,rr.

    6utrupy6una,

    npv

    noAo3peHr.tr4 Ha
    MOTICBI,THbI,
    AncceKr.u4ro, 3acKyHafpufl, KaJlI4t, JILTT, CTeHO3, OKK!'IIOxjropa, onpe.qe- 3I.Irc r,rHTpaKpaHr.tarJrbJIEHI,IC AKTI4BHO-

    cru

    Hbrx

    furAT, 3xoKf.

    AcAT.,

    flpegnoururelrHbr: JrerKo rnrpyeMbre neKapcrBeHHr,re cpeAcTBa:

    nepu$epavecrfie aHTlraApeHepruqecKr{e npefiapaaqepuir. r,r: yparrugutr t/z;
    urrn6u-ropu AfI@: ramonpr.n, sualanpul (n rou

    CPB,
    noragare,refi
    auuugHoro o6-

    V3H

    OXC, Tf.
    I{cclegonaHue
    noragatenefi

    33f npra Harusrrlr

    gnHrrpltcTylloB

    reMocTa3a:

    ctoxnufi.

    $u6pr.ruoren,

    prrrMa cep.qqa u

    reuarorpu'r, ,{-

    'rpo[oHr,rHoBbre TecTbI

    rrleHa:

    ypoBnr e reqeHue 24 qac.

    rrr4cJre AJrr BIryrpr4BeHHofo BBeAeHr4r), Jrr,r3uHonpr,rjr,

    npeqepe6panrHHx cocy.qor, TKlf.

    paMr4I]pr,rJr;

    3xo3C.

    aHTaroul,rcrbl peqerropoB aHnroreH3r,rHa

    CI-IHKOII:IIIbHbIX

    Lr

    CO-

    II: losap-

    TaH, BaIJrCapTaH.

    flpu lracrolrvecrona A,{ >140

    una pr. cr. (no pe3ynbTaTaM .qByKpaTHOrO r,t3MepeEr.rr c [HTepBuuroM

    5 uun.):

    Ha3naqeHrne nepuQeprvecrurx aHTr{aApeHeprarrecKr.rx npelapaToB: yparmJ.vlr.

    AIITB, IIB, Cyrovnoe MoHr,noNTV, MHO, pr.rpoBanr.re A[ u B nocne,45noqeM no,q..qepxaHr.re Ha Aocrr.rrr'.ToM
    ar{Mep6r.

    3Kf.
    Monrropuur

    AI.
    KT

    3Kf,

    IIpu noAo3peHu

    Ha

    r'rlrQapm Mr.roKapAa.
    Bpa-

    KoHcylrr:aqru
    IIA-KAPAHOIOTA.

    ypoBHe A,{, npeaor.-spauleHr.re ero noAbeMoB.
    flaqr.rermaru npr{ areporpoM6mlrqecrou unQaprre
    neptQepruecrr.re aHTraa,qpeHepruqecKr.re npeflapa-

    ru: ypanugnn r/a;
    llnrrl6uropu AIIO: rarrronpm, snalanpul (r ronr
    .rncre Na BHy'rpt,lBeHHoro anegeHu_r), nn3rrHonp[n,

    u.nu MPT flpu creuose npeqe- paMuflpfin;

    roJroBHoro Mo3-

    *.
    Perrrrenorpar.a* *

    Sur

    opranoB

    rpy4lroil

    Krrer-

    KI,I.

    IlpoQr.r,rn

    A!.

    Koncynrraqrx
    Bparla-

    oSra,rruorora

    pe6pa,rrnofi aprepr{[ Arrrarouucrrr peqerrropoB aHruoreu3r{Ha II: ;rosap-

    Mo3ra 6olee

    50Vo;

    bTarlur Bparla-

    TaH, BancapTaH.

    flpz guacroluqecKoM AA >

    140 MM pr. cr. (no peljlrr4 3yJrETaTaM ABy4paTHOrO r.r3MepeHrrr c urrrepB roM
    Bpaqa peHTreHo3HAO- 5 nrr.rn): Ha3HaqeHr{e nepuQepuuecxax aHTr.raApeBacKyJrrpHoro xlr- HeprFrecKr.rx fipeflapaToB: ypafluAr{Jr.
    pypra.
    B uocle4yloqeM [oAAepxaHr,te Ha Aocrr,rruyroM
    ypoBHe A'(, npeaorspaqeHue ero noAbeMoB.
    flaqlreurau flpu areporpoM6orr.rqecxo].r r.trr(paprre
    Mo3ra, pa3BuBllHMcr Ha QoHe eupaxeuHoro creKOHCyn

    aHrrroKrpypra

    (ua3Hoe
    BpaqaTepaneBTa.

    AHo),

    Ho3r.rpyrcqero arepocKrrepo3a BL{A (>70%) norasaH ueresoi ypoBeHb
    n npe.qelax 140/90-150
    MM pT. CT., npr,r JraKyHapHorrl nnQaprre Mo3fa <130/80 MM pr. cr.; naqtreHTaM c caxapnsru gua6eroM noKa3aH ueneBofi ypoBeHb A.{ <140/85 MM. pr.
    cr., narIHeHTaM c xpoHr,rqecKnMl{ 3a6oneBaHlrtMvr
    noqeK noKa3aH rleneBofi ypoBeHb A.{ <140/90 uu
    pr. cr., B Bo3pacre >75 lgr - noKa3aH qenenoft yporeHr A,{ B npeAerrax 140190-150190 MM pr. cr.

    A!

    flpn

    apreplranrnofi rrlnoreHauu (cucrolruecxoe
    A,{ Hlrxe 110 r'.t'l pr. cr.): o6rerr,rgauecrrreltsar
    Tepanlu:
    flna:rrrosaueularc

    ue

    flpenaparhr: H.tApoKclrSTr,uKprxM:ur, Aer(crpaHbr (ra ucx.nro.reHueM conyrcrByrcrqero nnQaprra MnoKap.qq apurrrlur.r).
    orc;r'TcrBuu sQQeKra: KapAxoroHr{qecKne
    cpeAcTBa: ,(onaMr.rH.
    flpu xoarynonarru (fITlI <60%, ATITB >35 ceryHg): C3II s/g raneruHo (Ao uopua.nnsauu noKagarenefi roarylorparuruu).

    flpu

    Kopperryrr napoKcu3MoB HapyueHnr cep.ueqsoro
    prfrMa.
    flpn xrnnuuecKrD( n KT-npH3HaKix Hapacrarc[Iero
    orexa Mo3ra, rroBhrrneHur.r B9.{ 6oree 15 rrlrrl pr. cr.
    (no gaHxuu uoHraropr.lura), He cHu)K:uouerocr Ha
    Sone cegaqr.ru u (unu) aHaJrre3r{r{, ypoBHe Harpr{t
    rIJIa3Mbr ruenee 150 uuolr/l (rorrponr sJreKrponnToB He pexe 2 pa: n cyrxr.r):
    pacrBoprr c ocMoAr{yperr{rrecKnM Aefigrsuev s/n:
    copMallTon, MaHHr,rToJr, c IlocJreAyrcrqflM BBe.qeHr.relr n/s L{oqeroHHbrx cpeAcrB: rpypocenau4. Bne4eHr{e yKa3aHH6rx cpeAcrB noBToptlor KaxAbre 4-5

    qaca c yqeToM KJrr4Hr,HeCKr,rX nporBJr€Hr.rfi H ypoBH,
    ocMoJrrpHocrr,r njla3Mbt (ne 6onee 295 uuolr/rcr).
    Bne4enze ocMorr.FrecKr,rx Ar{yperr.rKoB rrporxBonoKa3aHo npr4 noqeqHofi HeAocrarorrHocrra, oreKe
    JrerKux H AeroMleHcr4posaHHofi cepAeqHofi He,qo_
    CTATOqHOCTI,I.

    flpu

    o6urzpuorra r.rnqpaprcre Mo3xeqKa KoHcyJrbrauu-e npava-Hefipoxupypra .qJrr pelreHr.u Bonpoca o

    -

    xupypruqecKoM rerreHr.rI,I.
    Auru6arrepua;rr,Hbre cpeAcrBa npu noAo3peur.rr,r Ha
    r.rHQerquro AbrxareJlbHhrx uJur MoqeBhrBoarrqffx
    rr',refi.
    llpu uuruuuu HeftpoBrrcyanrcaquu B craur.roHapHbrx yc:roBuf,x: arrrrpou6orrrvecKr{e cpeAcrBa:
    fulbTellna3a.
    Cugrerunufi :rpona6orulsrc c [c[onb3oBaHueM aJrbTerura3br naquerrraM B nepBbre 3 .raca unQaplcra
    uosra neo6xoguMo Haqarb B TerreHrre 60 uranyr or
    MOMeHTa [OCTyrrJreHr{r flaquellTa B opragx3arlurc
    3ApUtBOOxpaHeHuJr.

    Vcnosfir npoBeAeHn;lrpou6o;rusuca: orcyrcrBr{e y
    rraqueuTa reMopparurlecKr.tx r,rgveneuuft npn KT
    roJroBHoro uolra, cra6zlrbHoe AA Ire BEIIITe
    180/105 MM pr. cr. Tpou6o.nzauc Moxer rpoBo.qKTBCt TOJTbKO B OTAeJTeHIfiX aHecTe3r4 oJroruu n
    peaHr,rMarluu r.rjrl{ rraJraT:x peaHr{Marll.Ifi I,I lrrrTeH_
    cr.lsnofi Tepaflru B opraHr.r3arlnrx 3ApaBooxpaneurr, cnoco6urrx o6ecneqr,rrb co6,rroAenne Bcex rroKa3aHr,rft u npor Bonoraganufi x AaHHoMy Mero.{y
    JIEIICHI4'.

    Tpou6olu:r,rcy no.qJrexar rraqlrerrrbr, yAoBJrerBoptrory[e cJrel]rcur.rM rgrrepvrM: nospacr 18_80

    reT,

    rorr4Hr4r{ecK}rfr .qrrarHo3 r4HoapKra Mo3ra c
    onpeAenreMbrM HeBpoJrorrrrecKr,rM Aeduul,froM
    AonxeH 6srrs ycraHoueH BpaqoM-HeBpoJroroM no_

    c.ire KT roJroBHoro Mo3ra; BpeMr Harralra cI,IMnro_
    MoB MeHee 4,5 vacon ,uo Haqana reqegr.ur. B/s ege_

    AeHrre zlJrbTerua3br He peKoMeHAyeTc, B Cnyqarx,
    KOrAa HeBo3MOXHO TOrrHOe o peAefleHr,re Haqara
    ga6olenaHz.r.
    Tporra6o.nurrc He rroKa3aH :
    rrpu Hurr'Itun BllyTpmepenHoro KpoBoI,I3Jrr,IJIHr,rrr Ha
    6ecxoHrpacrnofi KT rorogHoro Mo3ra vrr4 BbrrBJreHnI,I 3oHhr nonuxeunofi rrJlorlrocrr,r. 3aHr{M:uo_
    rqefi 6onee l/3 .reppu:ropulr rronymapr-rrr roJroBHoro
    Mo3ra ([pr.r3Harur o6urlrpuoro uuQaprra naosra);

    olpeAeJrrroTcr ToJIbKO Mr,tHuMiurbHbre
    cr,tMrrroMrr r.ruQaprra
    MO3ra; KJrr,rHxqecKrr vMeeTct BEICOKIUT CTerreHB IIo_
    Ao3peur,rr na cybapaxuor,rgaflbuoe KpoBolt glrvrsuue,
    B ToM qrrcJre n rrpn HopMaJrrnoft rapruHe KT ro_
    KJrr,IHr,rqecKr,r

    tlrtr 6ncrpo npexo.qrrrlne

    JToBHOTO

    TeqeHr,

    t

    MO3ra; [pl{ aKTr,rBHoM BnyrpeHHeM KpOBO_
    (r(enyAorrHo-KumeqHoM, r,r3 MoqeBbIBO,[r_

    umx nyrefi fi Ip.) s reqeHr{e [ocJreAHrD( 3 ueaelr
    (21 geur); npv Halflrsanl reMopprruqecr[x 3a6one_
    Balrvir u cr.Ig,qpoMoB, BKrroqtuI 6eccv rurrrorr,rrr!.to

    rpo;rt6oqrroneuuro; npu Hurwl4u
    ,""ar""
    "
    rrpeArrrecrByrcq[x 3 MecrUen nnyrpr.rvepenuofi
    onepaqll4 qepenHo-Mo3ronofi r:paurr.rn wnr uH_
    Qaprra Mo3ra; npu HrrJrr.rrr! { B Teqeur,re 14 npealre_
    crByrounx cyror 6olrurux xfipypruqecKr,rx BMe_
    rrrareJrbcrB, TpaBM; npn negaurefi rryHKrlr_Ifi apre_
    plru Ha HecAaBnriBaeMoM Mecre (nanptrrlep, na
    uree); cnunnouoerosofi [yHKrInr4 B TeqeHr,re rrpeA_

    rrrecrB)'rcullrx '7 auei1, npr{ Hanr,Hult B aHaMHe3e
    BHyTpnqepenHoro KpoBor,r3Jrr4JrHuJr, apTepr.roBeHo3nofi ua,ru$opru at\vfir vfiv aprepualrHofi aHeBpr.r3Mb[ H:rJrr{qr.rn cyAopor pv pasr.vrrrrr uuQaprra
    M03ra; He.4aBHuft r.rHQaprr MHoKapAa (npeaurecrByrcrqfie 3 rr,recrqa); flpu noBrrrrreHuu A!, npu

    A[

    > 180
    noBTopHbrx u3MepeHurx cncroJrr{trecKoro
    MM pr. cr. r,rrr.r Ar4acrornqecroro AA >105 rurrl pr.
    cT.
    flpu erou, ecrn uaulreHT B Teqeur.re flpe.4rxecrBy-

    rcusx 48 q norryrrar [prMBre

    arrrr.rxoaryJrrrrrbr u
    3HaqeHr{e TB / MHO He npeBr,utraer Bepxnro}o rpaHr,rqy HopMbr, npoBeAeHr.re MeAxKaMeHTo3Horo
    rpou6oluauca Bo3MoxHo.
    Ec,rr,r naquerrr .qo I,Iucynbra rrpnHr,rMarJr HerrprMbre
    (nepoparuuue) arrrrrroarynrrrrsr u MHO He npeBbrrtraer 1,7, na:nauenue perou6unanrHofo rKaneBoro alcruBaropa rrJra3MllHorena sogr4oxHo. Ecrll
    MHO nperuuraer 1,7 rryu npoKcrrMzrnbHofi orx;uo3r{n Kpynublx aprepNfi Kaporr.r.qHbrx 6accefinos [oKa3aHa gHAOBaCKyJrrpHtUI p€KaHanr8arlHr.
    Brqrrpunennufi cucreusufi TpoM6onr.Buc c rlcnoJrb3oBaHr{eM aurbTerula3Bl He rrpoBoAr,rTcr IIaqI,IeHTaM, nOCTyIII,IBIIILIM Ha CTaUI,IOHapHOe JIeqeHI,I€ B

    nepuo.q or 3 Ao 4,5 vacon or Haqiua r,rn(baprcra
    Mo3ra, np HaJrr{qrlu cneAyrorqrD( rparropon: eoapacr > 80 Jrer; rrpueM arrruKoaryrxurEr He3aBrrcuMo
    or ypoBHJr MHO; nnpaxeHHocrb HeBpoJroruqecKoro geQuqura > 25 6annos no rnKarre NIHSS; o6IIrnpHbIfi oqar ulreMr{qecKoro noBpexqeul{t, 3zurnuaroIr1uft 6o.nee l/3 Tepprropun cpegnefi rraosronofi
    aprepr.rv; caxapHsrft gua6et.

    t64

    3u4onacrynpHrur peKaHaJru:aqlu: rpou6sKtoMrrt
    c noMorrlbro ycrpoficrn Ar.t MexaH[rrecxofi rponr6sKcrpaKrlnu (c novoulrro creHToB-perplrBepoB I,IJrn
    acrrupal;au) rroKa3aHa nplr npoKcuMaJrnofi orr.nro3r.rr.r fpynHbrx aprepuit Kaporll,qHbrx 6accefiHos I.r
    orcyrcrBr.rrl eQr[erra or cr.rcreMHoro'rpou6oluenca
    B TeqeHue 4,5 vacon HJrr,r Ao 6 .{acos or MoMeHTa
    norBJreHur nepBhlx cnMrnoMoB sa6olenaunr; ecun
    r{MenTcr rrporuBonoKa3aHl{r K cr,IcreMHoMy rpoM6orurucy.
    Peuenue o npoBeAeHLI[ rr,rexanuqecrofi rporr,t6srTOMr{r{ npr{HI{MaETCt KOHCI4JTITyMOM C yrlacTl,IeM
    Bparra-HeBponora cocyAncToro oTAeJreHut, BpaqapeHTreHo3H,qoBacl(yntpHoro xupypra n BpatlaaHecTe3r,roJrora-peaHrrMaTonora.
    flaquerrrrr, noABepnnfiect BrrJEpuBeHHoMy BBeAeHr{K) aJrbrerura3br, He AonxHEr rlolq larb:
    arrrr,rarperarrrLr: ACK, rnonr.rgorpel;
    nptMbre arrrr{KoaryJIJIIrTEr,
    HerrprMnre aHTLIKoaryJrtHThr - rapQapun, unu Apyrue arrnarpou6orr.IqecKl,Ie u aHTxarperauTHble JIeKapcrBeHHbre cpe,qcrBa B TerreHI,Ie flepBbrx 24 'a rocrre rPoqe.r[ypbr.
    HerapMoeu6orrqecxr.rfi unQaprr Mo3ra I{Jrr'I Kapurosu6orr.rveclcafi rni[aprr Mo3ra c nporl{BouG'
    Ka3aHItIMr,r K HenprMhrM aHTuKoaryJrtHTaM:
    arrnarperanrrr,r : ACK.
    I,InQaprr Mo3ra, pa3BlrBurfific.t ua (pone nocronrHoro nprreMa ACK, uynrrNt[oramnoro arepocKirepo3a, caxapHoro rua6era, nonropnufi nerap.quoetvr6onr{ecrr.rfi nn(paprr Mo3ra, HerIepeHocLIrraocrr ACK lr ra6opa'ropnal pe3l,IcreHTHogrb K

    ACK: rcrronugorpen.

    Ocrprrfi ropoHapnrrfi crrHApoM, BbrrroJrHeHHoe
    qpecKo)IGoe KopoHaprroe BMeUIaTeJIBCTBO, a TaIOKe
    olepaqxr 3HAoBacKyrspHoro cTeHTr.rpoBar rr 3KcTpaKpaHr,ranrHr,rx aprepufi - a6comotnrre rroKa3auur x 4nofinoft anrfiarpefaHTHofi repannu: ACK u
    coqeraHr,lt c Knolr,rAorpelou 90 grreft, a gwrce
    npoAoJrxeHne cpoxon .qnoiHofi arnuarperarruoft
    TepaflI,Iu IIo co racoBallxro c Kap,quoiloroM, c nocneAyroqr,rM rrepexoAoM Ha MoHoTepanno aHTI,IarperarrTHblM JreKapgrBeHHhrM cpeIcTBoM.
    flprurre arrrr.rKoaryJrrrrru (renapru u.nra HMf :
    Qparcr.rnapun, Ha.qpoflapr.rH, anorcanapuu) rr,roryr
    6rrrr uagnaqenlr nocJre KT rurr MPT npu:
    noreHruaJrbHo Bf,rcoKoM pncre pannefi Kap.qrriurl-

    Hofi su6om{u

    (OfI a couvranuu c

    BryrpucepAeqrrcKyccrBenHrrfi rnauag cepArla,
    unQaprr MuoKap,qa AaBHocrbro rrlenee 4 ne.qenr),
    Ar{cceKrlr. r apTepr.r[, coflpoBox.qruoqeficr Kr[Hr.rqecrofi cr.runroMarr,rKofi (sa ncrlro.rerzena CAK na
    KT), u npu nporpeccrpyrcrqeM KruHuqecKoM Te'reHuu un$aprTa Mo3ra, r,BBecrHbrx cosrorHlrJ{x
    rurnepKoaryJrrqnu, rporrl6ose BeH u cr.ruycoB, a
    Tarfie tIpr,r oKKJIro3r,r[ ocuoBHofi aprepur Ao r{Jrr,r
    rrocJre r{rrrpaaprepr.riurbHoro rpoM6onx3[ca.
    Arrruroarylrrrrr He BBoArr rrpr,r KoMe 3 creneur,r,
    o6ulrpHoM raH$aprre ruosra (npenrruraroruerrr 50%
    6accei*ta cpegneft rr,rogronofi aprepuu), BrryrpeHHeM KpoBor€qeHr.lr, BbrcoKoM ypoBHe AA (200/100
    MM pT. CT. r.r BbtIIIe), 3nr{JrerT[{lrecKrrx qpxflaAKax,
    TrxeJroM noporeHr{n nouer, nevenra, YMT.
    fenapun Ha3Haqaror n/r n oronorry[oqHyro rurer-

    nrru rpoubotrl,

    qarKy noA KoHTpoJreM A9TB s reqeHlle 5-7 cyr c
    nocreneHHLrM cHr.rxeHr4eM Ao3bI I,I nocJreAyloql,rM
    rrepeBoAoM Ha HelrprMr,re aHTuKoaryJItHTI>l LIIITI aHTUaIperaHThr.
    B ocrporra nep[o.[e ltr(f aprra Mo3ra LrrrrencnBH.lt
    naperrrep:urbH:ur aHTr{KoaryJIrHTHtur reparu{r relapr.rHoM r4Jrr.r HMf (HagponapltH, .[:urbrenapr{H,
    enorcanapuu) He noKa3aHa tlaquenTaM c I,I|M na
    Qone arepocx;repo3a rlepe6panrurx aprepufi .
    Hugxue Ao3br reflapr.rHa, HMf Ha3HaqarcT c rleJrBro

    npoQunarrurr.r rpou6osa rrry6oxux ren y o6erABuxeHHlrx flaquerrroB, npx BapllKo3Hofi 6olegnu
    HTDKHT,D( KoHerrHocrefi, npr TSIA s aHaMHe3e.
    B cryuae nporpeccupyorlero Krrr{Hr{qecKoro reqe-

    Hvrr. unQaprra Mo3fa nerapAuoeru6olr.rqecrofi
    3Tr,roJron,r, H:urrFrr{fi cTeHo3r{pyouero aTepocKJrepo3a KopoHapHbrx aprepHi, arepocKjrepo3a nepx-

    Qepu.recrrx aprepufi, caxapHoro rua6era reparut
    ACK rrroxer 6rrn .uononneHa Hr,r3KHMr{ ao3aMr,r renapvn4 HMf ,un-r npoQunarruru rporu6osa rrry6oxrnx seH r.r T3JIA.
    Arrrurcoaryl-rrrrrr HenprMoro Aeficrsur Ha3Haqaror
    za 3-4 lns Ao orMeHbr renapr{HoB rrpn KapAr,ro3M6oru'recroM uu(paprre Mo3ra c BhrcororM plrcKoM
    rap.uua:rrHofi eu6ouun (OfI, rpou6 neBoro npeAcepAt,tr, TpaHcMyprrJrbHr,rfi lru$aprr Mr.roKapAa rrepe.qHefi creHKrr AaBHocrbro Menee 4 uegeru, :rpou6
    JreBofo xeJryAoqKa, rrcKyccTBeHHBIe KJra[aHbI
    cepaua, peBMaTrtlecKoe IIopiDKeHHe KjrarraHoB, LIH$aprr ruosra B correraHr4r,r c ocrpbrM TpaHcMypzlJrburru znQaprroM Mr.roKapAa nepe4reE creHKr.I c
    noAbeMoM cerMerrra ST, 6eg [pr.BHaKoB (poptlrupo-

    BaHHr rpoM6a JreBoro )r(ejryAoqKa, npll
    'Jary|s.r[r4
    nepeAHe-BepxyueqHofi aKIrHe3LIn [JrI{ .qrIcKI4He3UIa), trpv ArrcceKr{4r4 aprepuu, conpoBox.qarcuefi cr r.rHoapmoM Mo3fa, aHeBpI,I3Me ocHoBHofi apTeprrH, r,r3BecTHbrx cocTotHl4tx runepKoaryItqnu:
    Arrrrrponr6o'rutrecrfie cpe.ucrBa: aHTI{KoaryJrtHThI
    HenprMoro Aefrc'rgr4c - arrraroHucrbl sural\.tuua K:
    eaplpaprur noA KolrrporeM MHO, ueaesofi ypoBenb
    MHO 2-3, KouTponb MHO: n reqeHlle nepaux 5-7
    Anefr noc.rre HaBHaqeHr.tt exe.[HeBHo Irnu qepe3
    AeH6, 3areM I-2 paza B HeAeJrn, nocae sra6mr.rgaqur.r MHO sa neo6xoAurvroM ypoBHe - I pas n 2-3
    HE.IIEJII,I.

    flpra nrrcoxou pncKe KapAr{arrrnofi snr6onr.rn (lreKJrarraHH r AaBHocrblo uenee 4 HeAeJIB, ocnoxnennrrfi rporu6oM nesoro xeryAoqKa, uuQaprr Mo3ra B coqeraHru c ocrphrM 'rpaHcM)?aJrbHnrr,I turQaprrou ulroKapAa [epeAHefi crenrz, ocnoxHeHHbIM lpoptrupoBaHr.reM MypaJrbHoro rporr,r6a JreBoro xenyAoqKa
    r,rJrn HapyueH eM no,qBlDKHocrr.t nepe.qHeft u/ nru.r
    nepxyurevuofi o6;racrs c orpaHurreHlteru Qpar4{t
    an6poca neBoro ,r(eJry.qovra <40%) LI BEIcoKoM
    pucKe KpoBore.reHr,Ifi, B ToM rrncre qpl{ cuuxeHr{r4
    uupeHca KpearrHuHa ao 30-50 ur/runn: arrru:r-

    pou6ornuecxrle cpeAcrBa: BOIAE nprruofi unru6rrop rporr.r6nna - ,qa6lrrarpana gTeKcr{Jrar, npruofi
    uxru6u:rop (parropa Xa - purapoxca6an.
    flaquenraru c rapguosu6ornqecKr.rM IaHQaprrorr,r
    Mo3ra B coqeraHrrr{ c roponapnofi 6onenrro rum
    creHTr.rpoBaHneM KopoHapHbtx aprepfifi Bo3MoxHa

    KoM6r.ruarlur Bap(bapr,rHa r4 ACK B .qo3e 75-100
    ur/cyrrrz npu ycJroBuu orcyrcrBr,rr B aHaMHe3e
    yrasauuir Ha srrcoruft pr4cK KpoBoreqenrail ra s cooTBeTCTBT,[i C pe3yJrbTaTZrMr.r OqeHK]r pncKa KpoBoreqeHr.rfi ro rrrK.ure HAS-BLED 90 asefi, a Aaree
    [poAonxeH e cpoxon,qnofinoft anrurpolr6orravecKofr Tepalr{n IIo cornacoBaHr,rro c KapAxoJroroM, c
    nocireAyrour{M uepexoAoM Ha MoHoTeparruro aH:rrrponr6mu'recKr,rM JreKapcrBeHHbrM cpeAcrBoM.
    flpn noauneur{r4 ypoBrur rerrlorno6r.rna, spnrporyTO3e: rrJra3Mo3aMerqarcnlle npe[apaTBl: AeKcTpaH;
    HaTpxr xJropr,rA - Ao cHI,rxeH r rerr,rarorpn:ra na l0l5Yo utru AocflDKeHI{JI ypoBIIt rerr,ramrprra 3335%.
    Hefiponporerropuiur repaflrrr: rrrurllrH, MarHrrr
    cynboar;
    flapaclrunarour.rMerr.rqecKr.re cpeAcrBa: r,rflnAafpr.ru,
    xonuna amQocqepar.
    flo norasaHurM:

    flpn

    runeplrxnltAeMl{x:

    rrlrroJrr,rrru.qeMl{qecKl,re
    cpeAcTBa: aTopBacTaTnH, po3yBacTaTI,IH.

    flpu cygopoxlroM

    cr.ruApoMe: flporrBogflnfiefiTntre-

    cKr,re JreKapcrBerrHbre cpeAcrBa: .uua3erraM,

    QeHrno-

    rrH, BzlJrbnpoeBar Kuctora, rap6auasenr,u.
    flpu ncrxorrrmopHoM Bo36yx.qeHr.ru: aH Kcrr oJurrl.rqecKr.re cpe.qcrBa: .ufi a3enaM, ro(prconau; aHTnflcuxorrrqecKr.re cpeAcrBa: xJropnporr,rKcen, r:putpra:uH.
    flpu pnote: nporr{BopBorHhre cpeAqrBa: MeroKrroIlpaMr.ra> aoMnep4qoH.

    flpu

    necru6ynrpHoM cr{H,qpoMe: cpeAcrBa IJrt
    ycrpaHeur,rr ronoBoKpyxennc: 6erarncrr-rH.
    fIpH cnacruvecKoM cxuApoMe: MropeJraKcaHTbr

    t69
    ueHTpaurL,Hofo Aefi

    crgrx: 6ar.noQen, Torrrepr,r3oH.

    flpz srcrpanupaMnAHoM

    cHHApoMe: .qonaMr.rHepru-

    qecKrre cpeAcTBa: aMaHTaAI,rH.
    flpu 4enpeccuu: aHTr.LqenpeccaHTbr: aMrrrplrrrrr{nr.tr, Qnyorcerr{H, napoKcerr.rH.

    flponegenue pannefi pea6unuraryuu naquerrroB,
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    JIOK, OT, nororreA.

    O6.nacrHbIC.

    O6rerra o6cre- O6rena o6cregona- Jleqenue auiurorr4qHo JreqeHr,fio, [poBo,qr,rMoMy na- 14-30
    3a,qoBaHls alraJro- nlr ana.noruqeH o6r- urlelrry n pafionnofl oprauu3aqn[ 3ApaBooxpaHe- B
    ,rtleH o6reuy enry o6oe4oeanut B Hv'.,
    BI{CI,IMOCTI.I
    pafionnofi
    oT
    Ttxeopraurta- JIOTIOJIHI'TTEJIbIIO :
    o6cre,uosal {r s
    pafionnoft opra- wr 3ApaBooxpaHe- Y naqraenros c unQaprrou Mo3ra c 6rrcrpo o6pa- CTI,I
    TxMbrM HeBpoJronFrecKuM ge(plrqrnona ( HrBaur.[r 3Apa- HIII.
    BOOXpaHerrur,
    .I[oo6creAosar e B nnSaprronr ruosru) B TetreHne nepBrrx 2 nelerlr
    cJrrr Ix HercHoro nocJre r.rHcyJrbTa rrpu uucr raTepaJrbHoM BbrpD(eHAOIIOJIHI,ITEJIb9TI,IOJIOrrlttecKOrO

    HO:

    KT r.urr MPT Qarropa:
    ronoBHoro
    m;

    Mo3-

    V3,{f

    npeuepe6pa;rrnr,rx apr:epr'tir;

    TK,4-;

    npu

    sreHo3e
    npeqepe6pa;rr-

    nofr

    aprepun

    6oree

    50o/o

    KOHCyJrbTarlfit

    Bpaqa-

    aHn{oxupypra

    HOM CTeHO3e 3KCTpaKpaHr.rZrJrbHOrO OTAena COHHbTX

    anruQoc- aprepufi (70-99o/o) peKoMeHAyercr K3A, eura pucx
    Soirrnngnufi cnu- lep[oflepaqxonnofi ga6onesaeMocrr{ fi cMeprnocrr.r
    ApoM, KOJrJrareHo3, cocraBJuer lr,euee 6%o.
    BacKyJrxThr, Kap- flpu uncmarepanbuoM yMepeHHoM creHo3e gxcIIITaJILHAU IIATOJIONI' rpaKpaHr{iurbHoro orAeJra coHHbrx aprepufi (50KlranaHHoro annapa- 69%) tull oneparnBHoro BMerare:rbcrBa (KOA
    T4 OT4pBrTOe OBanb- r,rJr aHnnorulag ,IKa I,t creHTr{poBiu{ e) rarucrm m
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    neo6xo.uuuo BhInoJrHItrb B TeqeHI,Ie 2 neaens nocne
    va-nefipoxnpypra.
    TI4A.
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    vrlr

    connofi aprep:,r:r, > 70oh npu ner.trnarunnofi nr.r:yanI,I3aIl[[ unn > 50%o rrplr Bv3yar' 3arlur,r MeroAoM
    Karereprcaur{onnoft amuorpa(pur.r npu cpeAHefi
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    noxr4Jrbrx narlr4errroB (cT apure 70 ler) flpe.qnoqrv-

    Bpaqa-

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    xrpypra.

    TeJrbHee K3A, arq 6olee uonoarrx naqHeHToB
    KOA sxBrnarer{THa KaporltAHoi aHn{onracruKe lr
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    flaUnerrrau c nncnnarepaJlbullM BbrptDKeHHhrM
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    BMerrraTeJrbcTBa v]M rrpkr Ilurvrqvu paAvaqr,roHHoro creuo3a I.IJII,T pecreuo3a uocne KgA,
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    I{epe6panrHnfi
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    qe(paronanu)

    Enoxururqecxoe

    reMaToKprrr.

    (167.2)

    r{ccJreAoBauue
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    r.urr.r

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    noro uo3ra* *+.

    v3[

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    JreKap-

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    HX'X MnepKoaryJrrrlur:
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    MHO, qe.nenoft yponenr MHO 2-3, KoH'rponb
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    He.qeJrro, nocne cra6r,rJlr,rgaqr,rr,r MHO na ueo6xo,uuMoM ypoBHe - I pa: n 2-3 ueaetu.
    BapQapuu He Ha3Haqaror npr.r Bbrp:DKeHHofi qepe-

    8-12

    AIAT,

    AcAT,
    noxa:atelefr
    nranzgnoro o6veua: OXC, XC
    il]HN, XC
    JIIIBN, Tf, KA.

    3Kf.
    Kou:rponr A,{.
    KoHcylrr:aqar
    BpaqaoQra,rrnao.nora

    (ua:uoe

    AHo,

    ocrpoTa 3peHr.t'r,

    rroJrr

    speHrra),

    BparraTeparIeBTa.

    flpu creHoae npeqe- 6panrnoft arepocrcreporuvecxofi uurpoaHrr{onape6pa,'rbHofi aprepuu Tuu H aMurrouIH ofi Mr,rKpoaHntorrarlrl,t.
    6otee 50o/o - KoH- V naqrleHron c paHee nepeHeceHHhrMr,t rroBTopHbrcynbTarllH Bpaqa- Mu HexapAr.ro3ru6onrqecKr.rr\.{[ TI4A, unQaprrarun
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    pypra.
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    Koncylrraquu

    Apy- flpr nupaxeunoM creHo3r.rpyo IeM arepocKJrepo3e
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    rrx

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    r,rH,

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    .

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    flpu

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    HUt,

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    fufi

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    oIIpeAeneHue
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    [oKa3arerefi
    reMocTa3a:

    AqTB,
    IITT4,

    NB,
    MHO,

    qa-oToHeBpoJrora.

    HnrnrbHoro orAeJra coHHErx aprepuft (70_99%) pe_
    Koncylrraquu Apy- KoMeH.qyercr K3A, ec;rr.r pxcK [epuonepaquounofi
    rurx
    Bpaqefr- la6oresaeMocu u cMeprHocrr.r cocraBrrer Meuee
    cneq[zurncToB IIO nO- 6%.
    KA3AHI,IJIM.
    flpu uncnnarep:rJrbHoM yMepeHHoM creHo3e gKcrpa4paHr.raJrbHoro orAeJra coHHBrx aprcpraft (50_
    690/o) nug oleparr.rBuoro BMerrrareJrbcrBa (K3A
    rv aHrvrorrracruKa r,r crerrrrrponanue) aanr.rcr.r:r or
    Bo3pacra fi co[yrcrByrouux sa6oreeaHrafi. flpu or_

    relrarorpur,

    !-

    neo6xogLllrao BbIrroJrHI,ITb B TeqeHI,Ie 2

    KOHCynbTarIn I

    nenelr nocne
    TI4A.
    Kaporugnar aHrlronJlacrl4Ka Lt crerrrltpoBaHr{e noK:BaHH KaK albrepHarr.rBa K3A npra ulc[JrarepzurbHoM cTeHo3e 3KCTpaXpaHrr:rJrBHoro oTAeJIa
    conHofi apTepr4r.r > 7 0o/o npu neuneasr.rnnofi erasya,rcar\tlr4 utru > 50Yo npv Rrlsyur 3arll,Ix MeToAoM
    Karerepx3arluoHnoft anruorpaQuu npll cpe4nefi
    Hr[ Hr.r3Kofr crerreHr,t plrcKa ocJroxHeuufi, cusanHbIx c gHAoBacKyJrrpHrrM BMelllareJrbcrBol,r. .{u
    fioxfl.rJrhrx naruerrroB (crapure 70 ner) flpe.qloqrr.rTeJrbHee K3A, airc 6olee trolo,qux [aq[errroB
    K3A sKBusaremHa Kaporr.r.qHofi anrraouacrr.rxe z

    Bpaqa-

    cTerrTl,lpoBaIMrc.

    aHrr{oxr{pypra

    flaqnenrau

    Ar.rMepbr;

    V3!f npeqepe6pa.nrHrrx aprepufi, TK,[;
    KT lmu

    MPT

    ToJIoBHOTO MO3-

    ra;

    flpu

    creuo3e
    rpeqepe6panb-

    Hofi

    aprepw

    6oree

    50o/o

    c

    [ncr{JrarepaJrbHhrM BhIp:DKeHEbrM
    creHo3oM (> 70o/o) npr.r BbrpaKeHHoM pr.rcKe xr.q)yprrrqecKoro BMertraTeJrbcTBa un plt Hrulltqufi pa,qu_
    aurroHHoro creHo3a r{nr.r pecreuo3a nocne K3A,
    rrpn oKKJrro3xr.r [poTnBonoJloxHofr coHHOfi apTepull
    rroKa3aHa KapoTnqHu arfr,rorrJracTr{Ka r.r cTeHTr,Ipo-

    wtu

    BpaqaperrTreHoSH,{oBacKyrrrpHoro

    xupypra.

    BAHI,IE.

    flporpeccr.rpyrcq:rr cocyAtr-

    gra.s refirogHqeSa;ronalu
    (167.3).

    Pafion-

    O6nlr.rfi auallrg Xorrepoecxoe uoull- locnu:ralagaqrtl It JreqeHxe naqfierrra B nanare pe- t0-12

    HbIC.

    r(poBr.r.

    O6qufi

    Topr.rpoBaHr.te

    ana.nus

    MOqU.

    Euoxlrur,rqecroe
    r,rccJleAoBar ,re

    finnepreurunHar snqeQalonanw(167.4)

    KpoBr{: onpeAeJIEHI,IC KOHIIEHrJrrcKoo6rqero

    u
    3Br,

    Tpaq

    3Kf,

    arrl{Marlfiu t,r zrrrencr,rsHoft Tepanrltl cnequant34poBaHHoro HeBpoJrornrecKoro (uHcylrrHoro) mleArperarouerpu-e
    JIeHr.rr opraHr,r3arllr,r 3npaBooxp aIJe'Jv',
    rpou6oqr.rroo.
    O6ecneqeuve [poxoAr,rMocrr4 BepxHr.rx IHXareJIbKoncylrraqllu Apy- nrrx rryreft, noAaqa Kr,rcJropoAa repes na:alrnrrfi
    npauefi- 3oH.u co cKoposrbro 2-4 nllluu.
    clequaJII,IcToB IIO flO- flognmue roJroBHoro rouqa rcponaru na 30o.
    KAI}AHI,I'M.
    Ycranosxa Ha3orac'rpaJrrHoro 3oHAa, MoqeBoro KaTeTepa no IIoKa3aHI,ItM.

    AA.

    rurx

    6erxa, o6uero
    6utupy6una,
    MOqeBUHBI,

    Hdrpvtfl,

    Koppexqua KoHrleHTparlrur HrroKo36r KpoBr.r: npn
    (oHueHTparluu rJrroKo3br xporu l0 rMo.ttr/rr u srrnre .qpo6uoe BBeAeHHe fiHcyrrrna c yqeroM ypoBH-fl

    Koncyarraqu-e

    IJII{KeMII{ He3aBI,tCItMO OT HaJII,HI,I' IrnH OTCyTCTBT.{'
    caxapHoro Nraiera B aHtMHe3e.
    flaqlrerrrau c nepeHeceHuhrM naKyHapHhrM HH(paprrorr.r Mo3ra rroKa3aH rleneBofi yponenr A,{ <
    130/80 rr.ru pr. cr.; rrpu BbrpoKeHHoM creHo3r4pyrorrleM arepocK:repore BI{A (>70%) - roxa3iur rleJreBofi ypoBeHb A! n npegenax 140-150/90 MM pr. cr;
    [a{Ee}rraM c caxapHBIM Aua6groM rroKa3au rleJrenoft ypouenr A,{ <140/85 MM pr. cr.; nal([errraM c
    xpoHrrrecrr,rMl,r 3a6oneBarrnrMr norreK loKat:lau rlenenoi ypoeenb A,,{ <140/90, B Bo3pacre >75 ner
    loxa3aH qererofi ypoBeHb A{ r upegenax 140/90150/90 utr,t pt. cr.
    Iloxa:anrr unrr6rroprr AII@: Karnonpr{n,
    gHananpu.Jr (a rorrr vucre Ars BHyrpr,rBeHHoro BBeAeHnr), Jru3r.rHorrpnJr, paMlrnpr.rr;
    aHTaronl,rcrbl peqemopoB aHn{oreH3r{Ha II: no:ap-

    Bpaqa-

    TaH, BfIJrCapraH.

    or$ralrruolora

    flocre AocrllxeHlrlr

    xrrop4

    KaJr'IJI,

    onpeAe-

    JIEHUE AKTI,IBHO-

    crr

    AIAT,

    AcAT., noKa3arerefi nr,rnr,r,qno-

    ro

    o6MeHa:

    oxc,

    JtrIHII,

    xc
    XC

    JIIIBTI, TT.

    9Kf.
    KTltltUMPT.

    Ilpor[rur A'{.

    Y3.[

    npeqepe-

    6pamurrx aprepr.rfi,

    TK,[.

    (rna3Hoe

    AHo,
    ocTpora 3p€Hr{r,

    rroJrr

    3peurrr),

    KOHCyJrbTarlnt

    BpaqaTepaneBTa,

    A,{ - flosrotHHas aHT[rulepTeH3r.rBHar Teparlv'j npeArrorrTureltua xou6urupoBaHHnr repaflurl.
    flocrosHuufi np[eM arTr.rarperanrnhrx neKapcrBeHHhrx cpegcrn: ACK.
    flplr nncoxoru pxcKe KapAr{iurnofi srr,r6onuu (OfI,
    rporu6 renoro rrpeAcep,qur, rpou6 lenoro xerryueJreBrrx ypoBHefi

    AOrIKa, UCKyCCrBeHHhre KjrarraHhr cep,qqa, peBMaTr,rqecKoe nopaxeHue KrranaHoB):

    aru,rrporu6oruqecx[e cpelcrBa: auTqKoaryJUrrrrbr
    He[prMofo geficrcux Bap(bapnH troA KoHTponeM

    MHO, qenenofi yponenr, MHO-4

    MHO: n reqeHr.re nepBbrx 5-7 guefi no"o" "orlpo*
    "us"u""_
    Hr.rJr er(eAHeBHo r4rrr rrepe3 AeH6, 3areM l_2
    paza s
    HeAeJrro, nocle cta6nru:aqrr.r MHo Ha neo6xo.nu_
    MoM ypoBHe - I pas r 2-3 negenu.

    BapQapnH He Ha3Haqz

    or

    npr.t BrrpaxeHrrofi qepe_

    6panurofi arepocrJreporrrecxofi unrpoura"oaru_
    Trlu u aMvutou4Hofi MrrKpoaunlonarr,In.
    V naquerrron c paHee flepeueceHnbrMr{ loBTopubr_
    Mn HeKap,qlro3rrl6o;ruqecxrur.r TI4A, nu(paprcrarur.r
    Mo3ra Ha $oHe npueua ACK, npr.r uerrepeuocuro_
    cru ACK, a raro(e upu la6oparopHofi pe3r.rcreHT_
    nocru x ACK: K;ro[r.rAorpeJr.
    flpn runepJrnnuAeMurr: mnoJrr{fl4ueMl{qecKr{e
    cpe.qcTBa: aTOpBacTaTr.rH, po3yBacTaTuH.

    flapacunanarorrlr.rMerrrrecKne cpeAcrBa: rrlurAaKpaH,

    alrQocqepar.
    Heftponpo:rerropriur repanrlr: gTrarMerunrrtApoK_
    cururpr{AlrHa cyKIInHaT, MeTr,r.n3Tr4Jrn[pI.qr,rHoJra
    MlpoxJropr{A, Martr.rr cyJrbQar, rJrurlr4H, fiupaqe_
    xoJrr{Ha

    TAM.

    flepuSepr.rvecrure Ba3oArurararopr,r: nerrorcaQnr_
    nI4H, HrrqeproJrr{H.

    ffo norasaHr.rrM:
    flpa cyaopoxuoM

    cr.rHApoMe: rrporr.rBognr{Jrenrrre_

    cKr.re neKapcrBeuHbre cpeAcrBa:,u[a3enaM,
    Qeunro_
    uH, BillrbrlpoeB:ur Kr{cJIor4 rap6auasenuu.

    flpr

    ncrxouoropHoM noa6yxgennn:

    aHKcHoJIr.rrt4_

    qecKr,re cpe.qcrBa:
    Ana3erraM, r:oSzsonanr; arrrr,rflcu_

    xorr,rrecKue cpe.qcrBa: x;ropflporrrKcen, rpuQraszn,
    KBETIiANIiH.

    flpr.r pnme: nporuBopBorHrre cpeAcrBa: MeroKJro_

    116

    npaMrrA, AoMnepr{AoH.

    llpz

    necru6yJrrpHoM cr.rHIpoMe: cpeAcrBa,qJrt
    ycrpaHeHlrr r-onoBoKp)?KeHur: 6erarucrnH.
    flprn sxcrpanupaMnAHoM crrulpoMe: AorraMuHeprfiqecKr{e cpe.qcTBa: aMarrTaAnH.
    IIpz 4enpecclru: ar{TuAenpeccaHTbr: aMr{TprznrltrNH, Qryorcvrr.rH, flapoKceruH.
    JIOK, OT, nororreA.

    O6nacr-

    O6rerr,r o6cre- 33f.

    HhIE

    AOBaHT,U aH:IJIO-

    KorumasHrre

    rnrreH o6reny

    3BaHHhre ncneHrlr,ra- Hvt.

    PHIII

    o6creAosaHnr s
    fltvr
    tl paftonnofi opraneftpoxuHH3arII,IX 3lpapypnru
    BOOXpaneHI{J|,
    HeBpoJro-

    ,UOIIOJIHIITCJIbHO:

    uccJreAoBaHue

    noraga:relefi
    reMocTa3a:

    AqTB, IIB,
    NT|l, MHO,
    Qr.r6pr.ruoren,

    reruarorprr, ,{.qr.rMephr;

    arperaToMeTpr{t
    rpou6oqr.r:ron;
    orrpeAeJreHr,re
    AKTI,IBHOCTI,I

    CPE;

    V3.IIf

    npeqepe-

    JILI.

    Bhr-

    JleqenNe aHulorfirrHo JreqeHuro, npoBoAnMoMy naur,reHTy n pafionnofi opraHr43arlruo 3.qpaBooxpane-

    t0-t2

    6pa.lrHnx aprepuii, TK!l;
    KT unra MPT
    roroBHoro Mo3na;

    flpu

    creuo3e
    npeqepe6pa.rraprepvur

    nofr
    Mo3ra
    50% -

    6oree

    cyrbTarlfir

    KoH-

    Bpa-

    qa-

    aHruoxupypra

    vurv

    BpaqapeHTreHogH,qoBacKyJrrpHoro

    xupypra.
    flopaNenue

    Pafion-

    MCXII03BOHKO-

    HbIE.

    BOrO

    Ar{CKa

    ruefttroro o'rAena Apyroro Tr-r-

    na

    (Ar.rcKoreH-

    HA'

    IIEPBI,IKAII-

    rvt,

    qepBn-

    ro6paxra.nrraa)
    (M50.2)

    O6rIlr.rfi anarr.rg Oynrquonalrnar
    flpu 6onerorrl cr.rH.upoMe: HIIBC: ,qux.noQenar, re- 6-12
    pernrenorpaQvr
    KpoBr{.
    ronpoQen, KeropoJraK, MeJroKcuKaM, u6ynpor[er,
    O6[INfi aHaJrus rueftnoro orneJra lto- qererorcu6.
    MOqIt.
    38OHOTIHHKA.
    flpu xponuuecKoM Horll{qerrusnov 6oresoNr cuH3KT.
    Buoxr,ruuqecroe nc- ApoMe: arnraerrpeccaHThr: aMltlpurrrunuH, QrryoPerrrrenorpacJreloBaHue KpoBI,r: KCETI,IH, TIAPOKCCTITH.
    Qur rueftlroro onpeAeJreHHe KoH- flpr.r HefipoaracrpoQuvecron cnHApoMe (rne.rorooTAeJra [o3Bo- rler{Tpaunu ruIloKo3bl, naroqgofi nepuaprporraruu) nrrnolnenue re.re6HOqHI,IKA.
    o6qero 6elra, am- nrrx 6roraA: Koprr,rKocreponAbr AJrr c sreMuoro
    6ytrllrna, o6qero 6r.r- rrpr,rMeHeHr{r: Tpr{aMrlnHoJroHa cyc[IeH3uJr AJrr ItHbnupy6uu4 MoqeBl,r- erqufi ruu MerlrnlpeAHr,r3oJroHa cycrreH3vt I t

    Hbr,

    rautexrluft c pacrBopoM rrpoKar,rrra r,rJrr,r Jrn.qoKar,rHa B
    HaTpI{t, KilJrr.I', xjto- cy6arpouua.nsHoe npocrpaHsrBo, B cyxo)r oa. CPE.
    JroKaJrbHo B KypKoBbre 3oHbr r4Jrr,r TplrffepHbre ToqKpeaTuHr,rHa,

    178

    KT uru MPT rueftno-

    KI,I.

    ro

    OT, JIOK.

    oTAeJra no3BoHoqHItKa* * * no noKa3a-

    flpu

    HeeQQerrr{Bnocrr,r KoHcepBaruBHoro rerreHfic
    TeqeHr{e 2 uecrqeg: KoHcyrbrarlr,ur Bpaqanefipoxlrpypra AJrr pe[reHrrq Bonpoca o6 onepa-

    HII'M.

    B

    rpeqepe6parrunx aprepuit,

    TI4BHOM JICIIEHI{I{.

    Y3Af
    TKro-.

    Koucyruraqur

    Bpa-

    qa-TepaleBTa, BpaqaopToneAaTpaBMaTOnOra,

    npava-neipoxr.rpypra.

    O6nacrHbIE.

    O6reru

    n

    KpaTHocTb

    o6cneAosaHlrt
    AHAJIOTI{qHhI

    o6reuy r{ Kparnocru o6cle4oaanur n pafton-

    O6se[.r

    o6creAosa- Jle.reHr,re aHalorrrHo JreqeHr,[o, npoBoArnMoMy naHrfi aHarorurqeg o6r- qnenry n pafionuoft opraHr{3arrufi 3,r1paBooxpaHeeuy o6cre.4on alaua B HIXI.
    pafioHHofi opranr{3a-

    t0-12

    t\urr

    3Ap:rBooxpaHeHUt,
    ,qoIIoJIHrrellbHo:
    opraHr.r3a- nccreAonam.re CMX
    3ApaBo6elor<, qr{To3,
    oxpaHeHI,JI,
    rlrgroqnrrfr cocraB,
    nrloKo3y, xJropr4,qbr;
    AOIIOJIHI,NCJIbHO:
    rpeqepeKOHCynbTaqrrt
    6pamHrrx aprepnfi;
    BpaqaMPT nnu KT lrefinouefipoxupypra.
    ro oTAeJIa no3BoHorl-

    sofi
    t\uu

    Ha

    Y3.4f

    HI{KA.

    PHIIrI
    HeBpoJro-

    O6rela r.r rcpar- O6rerr,r o6cneAosa- Jleqenue aHilJrorriqHo JreqeHlrro, npoBo,qr,rMoMy rra- t0-12
    gocrr o6c,re,qo- nnr aHarorrreH o6r- rIHeHTy n pafioHrofi, o6racrHofi opraHx3arlfiu

    ruu
    Hefrpoxupypfr{14.

    v BAHUS AHZIJIO- euy o6cregoe aHut B
    rr{qHbr o6reuy o6nacrHofi opraHn-

    r,I

    KpaTHOCTI,I

    o6c;relouanul e

    3arlfiu

    3ApaBOOXpaHeHr4r.

    3,qparBooxpa-

    HCHI,T'.

    paEoHnofi opraHrr3arII,Iu sIPaBOOXPaHeHr.rrr.

    Ilopaxeuxe

    Pafton-

    MCXIIO3BOHKO-

    HbIC.

    BOrO

    AlIcKa

    lrefiuoro mge-

    na c

    pa,qnKy-

    rouaruefi
    (M50.1)

    O6qufi

    buoxr,IMrrqecKoe uc- flpra 6onenou crrH.qpoMe: HIIBC: .qr.rxlor[enax, recJre.uoBaHr4e KpoBrr: 'ronpoQeH, KeroponaK, MeJroKcHKaM, r.r6ynpo(feu,
    4poBn.
    O6qr.rfi aHa.nlr: o[peAeJreHr,Ie KoH- qeaerorcu6.
    MOqI,I.
    rlelfrpaqfir.r fJrloKo3br, flpu orcl"rcrnralr eQQerra: fCfI: ruvnrrupeAHr.r3oPernreuorpaobrqero 6elra, a.tr- noH, npeAHu3oJroH rrapeHTepaJrbHo r,r.Jlrr BlryTpb c
    neftnoro 6ynruHa, o6rqero 6u- KoppeKropaMr.r.
    oTneJra [o3Bo- ll.upyduua, MoqeBr4- flapacuunarouuMerltrrecKr,re cpeAcrBa nprr orcyrHOIIHI,TKA.
    HH,
    KpeaTr{Hr{Ha, crsfiu 6oaenoro cr.rHApoMa: HeocrnrMr,ru, Ltflura3Kf.
    Ilarpur, K:urr{r, xJIo- I(pnH.
    pa" CPE
    Brrnolnenne neqe6grrx 6nora"q: rJrroKoxoprl,rKor{(Dynrqlronalrrrar
    gu (cycnensru Mefl{JrrrpeAHr.r3onoHa nponoHn{poperrtrenorpaQNr
    BaHHoro 4eftcrnu.r c pacrBopoM npoxauna) napamefinoro orAeJra no- nep're6pa;rrno.
    ananus

    $ut

    3BOHOTIHUKA;

    v3Af

    npeuepe-

    6pa;rrnux apreplrfi.

    TKA|
    KT r.nu MPT ruefino-

    ro

    oTAelIa [o3BOHOrr-

    HLrKa* * + .

    flo

    noxaganrasu:
    flpu neftponarr,rqecKoM 6onenou cxHlpoMe: 4poTr,rBo3nr,rJremwrecKne cpeAcrBa: rap6aua:enun, ra6anernun, upera6zurr.rH; aHT nenpeccauTbr: aMrrrpnmrdrnn, Snyorcenrn, napoKcerr.rH.
    flpu nefipoar.rcrpoQruecxou cr.rHApoMe (rueuenonaroqHofi [ep]raprporraruu) rrrnonnenlre neqe6nrx 6nora4: Koprr,rKocrepouAbr IJrr crcreMrroro
    rrpr{MeHeHur: TprraMrII,rHoJroHa cycfieH.3lt'i AJII ],tJr_
    ext\uit unu Merr.rJrnpeAHr,l3oJroua cycneH3rrr 1ll^

    t0-12

    180

    unrerqlrft c pacrBopoM npoxar4Ha vrr JrtrpoKavna B
    cy6axporrlna,rrHoe npocrpaHcrBo, B cyxolKulrut,
    noKarbHo B KypKoBr,re 3oHbr

    r,rJ ,r

    TprrrrepHbre Toq-

    KI,I.

    OT, JIOK.
    IIpz HeeQQernrBnocrr4 KoHcepBarr.rBuoro rerreHr4t
    B Teqeur4e 2 ruecrqen: KoHcynBTarlnr Bpaqauefrpoxupypra Anr perueHr{J{ Bonpoca o xupyprnqCCKOM JIEqCHI,IU.

    O6iracrHbIC.

    PHTTII
    HeBpono-

    O6relr

    u

    KpaTHocTb

    o6creAonanras
    AHAJION4qHhI

    O6renr

    o6cneAoBa-

    tl obreuy r.r Kpar- rryvr 3ApaBooxpaHeHefrpoxr.rsocru o6cle,uo- llUA,
    pyprHrr.
    aanlu n paftou- IOIIONHI'TCJIbHO:

    futl

    nofr

    opraHn3a3Apa3ooxpaHeHr.rr,

    ql{u

    ncsreaosaHue CM)K

    Ha 6eror"

    qrrro3,
    cocraB,

    .qo[oJrHITreJIb-

    r.ngroqnrrfi
    rnloKo3y, xjropr.rAhr

    HO:

    NO IIOKA3AHH'M;

    KOHCyrbTarIUt
    Bpaqa-

    9HMf;

    uefipoxr.rpypra.

    Jleqenue aHaIJIorrl.IHo JleqeHr,fio, npoBoAxMoMy na-

    nug anaroruqeu o6r,- rIrreHlry n pafiounoft opraHr.Barluu 3,q)aBooxpaHeeruy o6c,regon aravrt B HTI'.
    pafionuoft opfaurna-

    V3I4 ru-srKr.rx rxanefi
    o6lacnr rueu;
    MPT r.uru KT lrefiHo-

    ro

    or.ueJra no3BoHoq-

    HI.IKA;

    KOHCyJrbTarIUr,r Bpaqa-

    opTo[eaaTpaBMaTOJrOra.

    t0-12

    flopaxeHr.re
    IllefiHoro IHcKa
    HeyToqHeHHarl
    (AUCKOreHHrur

    pa,qr{Kynournel,rdvt. pa4r4KyJroMr4eJro-

    xrrreMnr)

    (Ms0.e)

    PafioHHbIE.

    O6rquii

    aHaans

    (DyurquoHaarua.a

    3xcrpeHual KoHcyrrrTarllrJr upaua-Heiipoxzpypna
    perrrreHorpa$ur
    Aff pellleHr,r.r Bonpoca o xupypMqecKoM Jreq€Hrar{.
    O6u1uft aHa,'lllg rrefrHoro orAeJra no- llpu 6olenoru cr.rHApoMe: HIIBC: guxloQenar, rceMOq .
    3BOHOqHnKa.
    ronpoQen, KeroponaK, MeJroKcr.rKaM, u6yupo(pen,
    Penr:reuorpaKoncy:rraqulr Bpa- qerexoxcu6.
    ruefiHoro qa-opTonelaHefiponporerropuzur reparrur: gTr.rJrMerr rrurIpoKoTAeJIa no3Bo- TpaBMaTOJrOra.
    cvnupuI.vtlla cyKrII,rHaT, MeTrtlgTr{Jr[r}tprr4\rFo[a
    KpoBH.

    $ut

    HOqHI,IKA.

    3Kf.
    Eraoxr,ruaqecxoe
    r,tccjreAoBaHr,re

    KpoBn: onpeAeJIEHI{E KOHIIEH-

    Tpaqxfi rnroKo3Br, o6qero
    6enxa, o6rqero

    fr.upoxrropr.rA.
    IlepIaSeplrvecrrae Ba3oAr,r./'rararopu: neHtorcuQunJrIIr, KCiUtTr.rHoJra HrrxoTr,rHaT, Hl,rqepronr.rH.
    flpz orcyrcrnulr sr$Qerra: fCfI: nrenurnpeAxr.t3oJIOH, npeaHH3olroH rraperrTepilJrbHo r,rJrlt BnyTpb c
    KoppercropaMx.
    flapacurr.ruarouuMerr,rqecKl,Ie cpeAcrBa flpx orcyrcrsur 6oregoro cr{H.qpoMa: Heocrr,rrMl4H, I,InltAarspr{H.

    6utmpy6uua,

    flpra uefiponanrqecKoM 6olenona crrHApoMe: qpo-

    MOqeBHHBT, Kpe-

    Tr,rBo9[r,r.JrelnrrecKr.re cpeAcrBa: rap6aruasenun, ra6anerrruH, npera6aazn; aHTl{Ae[peccauTbr: aMr{TpurrnlJrr.ru, SnyoxcerlH, napoKcerflH.

    ATUHIdHA,

    Ha[pu'.,

    K:ulujr,

    xJropa, o6rqero
    Kiurbrl[r, CPB
    KT
    (N,IPT)

    ueftnoro or.qeJIA NO3BOHOIIHI{Ka*** B gKcTpeHHOM

    rro-

    prAKe.

    Koncylrraqru
    Bpaqa-

    OT. JIOK.

    t2-t4

    Heipoxupypra a
    3KCTpeHHOM nOprAKe.

    O6nacr-

    O6reu

    HbIE.

    AOBaHr,u aHruro-

    PHTtrI

    rlrqeH o6reuy euy o6clegon aHuA B

    HeBpono-

    fvru
    neftpoxapypn{I{.

    o6cle-

    o6clegorauur

    n

    u pafioHHoft opra-

    Hr{3aunE

    O6rervr
    Hu_fl

    o6c.nenosa-

    aHarorrreH o6r-

    pafionnofi

    quu

    opraHr,Ba3ApaBooxpaHe-

    HU',

    sAPaBOOXpaHeHx{,

    AOnOJrHI.rTeJrbHo:

    AOIIOnHTATeJIb-

    r.rccle4onanue ClvOK

    Ha 6oror,

    EO:

    MPT

    JleqeHue aHiuroruqHo JreqeHr.fto, npoBoAnMoMy rra_
    qxeHry n paiouuoft opraHra3arluu 3ApaBooxpaHe_
    HUt.

    qu:ro3,

    (KT) Krgro'rHhlfi cocraB.

    xrefiHoro or.qe- nrrcKo3a,

    xJIOprl,4bI;

    JIA IIO3BOHOqHI,I-

    3HMf;

    KA;

    KOHCyrbTaIIrrr Bparra-

    KOHCynbTarlr,ur

    TeparreBTa;

    Bpaqa-

    KoHcynbTarlxr Bpaqa_

    tefrpoxupypra n opTorreAano- TpaBMaTOJrOfa.
    prlKe.
    3KCTpeHHoM

    Ipyras

    yroq- Pafton-

    HeHH,Ur AereHepaqur Me)r(no3BOHKOBOTO

    4rcxa (repre6poreHHau TOparamul)
    (M51.3)

    H6IC.

    O6qufi

    ana:rrc

    Br.roxrauuqecxoe r.rc- Ilpr.r 6olerou cr.rH,qpoMe: IlfBeau6ynpo0eH,
    AuK_
    KpoBr.r.
    cJreAoBaHr,Ie KpoBr,r: noQenar<, KeronpoQeH, KeropoJraK,
    MeJrorcr.rKarM.
    O6n1zft ananr.rs o[peAeJreHr,re KoH- qenerorcu6;
    MOqU.
    rleHTpaqfln nrloKo3hr, BBrrroJrHeHr.re neqe6nrrx o6es6orusarcutlx
    napa_
    PerrrreHorpao6qero 6enra. o6rue- nepre6pa.nrnrrx 6loral.
    $ut npy,qnorc ro 6rzlupy6uua, uo- flpu xpouuvecKoM Horlr,Iqenr[sHoM 6oregor4 cr,rH_
    oTIeJra Iro3BO- rreBIHhr, 4peaTnHr,rHa, ApoMe: aHTr4Aerlpeccarrrbr:
    QnyorceruH, aMr.rr_
    HoqHr{Ka s 2- HaTpnr, K:IJrlrrr, xjro- punrI{,JILIH, [apOKceTLIH.

    t83

    KT

    KI,I.

    rnrur MPT rpyaHOIO OTAEJIA TIO3BOHOqHIIKA IIO NOKA3AHutM* * *.

    3Kf.

    Koncymraqua

    PeHrreuorpa-

    $fiq

    opraHoB
    ryyaHofi K;rer-

    Y3Vl

    Bpa-

    opraHoB qa-TepaneBTa.
    6prourHofi rro- Koncymraqu-a Bpaqa-opToneAaJIOCTII.

    ofAC.

    TpaBMaTOJrOra.

    Koncymraquu

    Bpa-

    uefi-cuequa,urcron
    no [oKa3aHItIM.

    ,{pyrue yro.rHCHHbIC CMEIqeHItt Mexno3BOHKOBbIX

    AHcKoB (AuCKOFEHHZUI

    moru6a:rnu,
    mou6aro)

    (Msl.2)

    Paftonnue

    O6uufi

    BaoxgMfi.recxoe ucKpoBH.
    cJre.qoBitHue KpoBr,r:
    O6ulufi anaang onpeAeJreHxe KoHMOIIU.
    ueHrlpaqn DrroKo3hr,
    Perrrenorpao6uero 6ema" o6rueQur norcHr.[q- ro 6r.uupy6ltra, uoHOrO OTAeJra nO- qeBr.rHbl, Harpur, Ka3BOHOqH14KA.
    Jrr{r, xJropa, o[peAeaHa.rrc

    NEHI,IE AKTI,IBHOCTI,I
    AIAT, AcAT, CPE.
    (Dynrqronamnar
    perrrrenorpaQ[r rroSCHI'IIHOTO

    OT,IICJIA

    NO3BOHOqHIIKA.

    V3lI

    oprauoa 6prour-

    noft noroc'ru, 6prournofi aoprrr.

    V3lI na;roro raga.
    KT mlr MPT norc-

    flpu 6oaerou cHHApoMe: HIIBC: rl6ynpo$en, .qrr- 5-10
    noQenar<, reronpo(pen, KeropoJraK, MenoKcr.rraM,

    uerexorcu6.
    OT, JI@K.

    Hr4qHOrO OT.[ena no3BoHortHrrKa* * * KogcyJlbraur.rr4 npa.reficllequaJlltcToB IIo noKA3AHI,UIM.

    ,{pyroe yro.{-

    PafioH-

    HeHHOe nopa-

    HhIE.

    XCHI.IE MEXNO3BOHKOBOTO

    gucra (gucroTEHHIUI NIOM6or.rurualrnx)
    (M51.8)

    O6qt,tft

    EuoxraMu.recxoe r.rc- flpu 6orenou cuH,qpoMe: HIIBC: n6ynpo0en, .qmKpoBr.r.
    cIeAoBaHI,re KpoBn: ro$euax, reronporpeu, KeroponaK, MeJroKcuKaM,
    O6u1ufi ana.nras orrpeAeJreHr,Ie KoH- uerexoxcn6.
    MOqI4.
    IICHTPAIIUII NIIOKO3bI, flplr xponuuecKoM HoruqemnsHov boresotr{ cr,rHPerrreuorpao6qero 6elxa alr- IpoMe: aHTrrAenpeccaHTbr: Q;ryoxcerun, aMtrrQur norcultrr- 6yur,rna, o6rqero 6r.r- prrIITl,I.nlrH, napoKceTl,rH.
    HOrO OTAena UO- llupydmua, MoqeBr{- OT, JIOK.
    3BOHOqHUKa.
    HhI, HaTpr.tr, K:IJrr.ur, llpu HeeQQenraBHocru KoHcepBaruBuoro neqeHr.rt
    xnopa, onpeAeneHue B TeqeHrle 2 nrecrqen: KoHcynbrarlnr BpaqaaKTr.rBHocrtr AIAT, nefipoxupypra Anr peureHr.rr Bonpoca o xrpypruaHa:rus

    AcAT, CPE.

    qCCKOM JICIIEHHI,I.

    tDynrquona.nsuar

    perrrreuorpaSrur rro-

    rcHl{qHoro

    oTneJra

    N03BOHOIIHI,IKA.

    KT

    u.nra MPT uorcHI{rIHOrO OTneJIa no3BouoqHuxa* * * .
    V3Z oprauon 6pronrHofi uo.locru, 6promHoI aoprbr.
    V3Z i.ra.noro rasa.
    Koncylrraqu-r Bpava-nefipoxl.rpypra.
    KoHcylrraquu Bpaqefr-cneuua.nlrcron

    10-12

    185
    TIO IIOKA3AHI,U{M.

    O6lacr-

    O6r,eu

    HbIE.

    nocrr

    PHrirl
    HeBpoJro-

    fu||{

    neipoxupyprulr.

    u

    rpar-

    O6rer'r

    o6creaoea-

    Hul agalornqen o6tBAHU'
    euy o6c:regon aHut B
    rrrqHbr o6relry paftonnofi opraHltao6oreAo-

    AHtIJIO-

    JleqeHr,re aHarorurrHo JrelreHuro, npoBoaI.IMoMy nautaen]ry n paionuoft opraHr43auuu 3ApaBooxpaHe-

    t0-12

    HUg..

    r{

    4parHocrrr rIIrH 3ApaBOOXpaHeo6cneAoeauufl e HU'..
    paftonnofi opra- .UONOJIHI{TEJIbHO:
    H,l3Auli|IT eAPa- uccreaoeaHne CMX
    BOOXpaHeHItI.
    Ha 6euor, q ro3,
    Krgto.rghrfi cocraB,
    rnroKo3y, xrroprubl;
    KoHCynbrarluc Bpaqanefipoxupypra;

    KoHCynbraqnx Bpaqefi-cnerura:rrlctos
    no noKa3aHL[tM.
    flopaxenrae
    ME)IfiIO3BOHKO-

    BbIX

    I1TCKOB

    IIO-XCHI{TIHOTO H

    Apyrrx
    JroB

    c

    orAepaAlrKy-

    IONATI,ICft

    (Msl.1)

    PaftonHbIC.

    O6qrzfi ananrc Buoxttuuqecroe ucKpoBr.r.

    cJreAoBaHxe

    KpoBI,r :

    flpu

    6onenou cr.rurpoMe: HIIBC: gurutoSenar,

    u6ynpoQeH, reronpoQen, Keroponax, MeJroKcr{KaM,

    O6rqnft asa:rug onpeAeneHrre KoH- qereroxcu6.
    qelIrpaqrur MorIeBI.l- flpu orcyrcrer.ru sQ(perra:
    MOqU.

    fCfI:

    laerrutupe,qHn3oHbr, Kpearr,rHn na, 6u- noH, rrpeAHr{3onoH rraperrTepulbHo r.Ijrrr BnyTpb c
    PerrrrenorpaQtu flo.flcrr.rq- trupy6uua, onpeAe- KoppemopaMlr.
    HOrO OTAeJIa nO- JIEHI4E AKTUBHOCTIT flapacrarunarorur,rMerlrrrecKr{e cpe.qcrBa npr{ orcyrAIAT, AcAT., CPE. crsuu 6oresoro cxHApoMa: Heocrr.rMlrH, Ilrlrua3BOHOqHUKa.
    KoHcymraqru
    Y3I,I opranon 6prour- 4pnH.
    uofi nolocrlr, 6prcru- Brruonnenue leqe6nrrx 6rora,{: HrloKoKoprr{KouBpaqanofi aoprrr.
    uefipoxlrpypra
    Abr (cycfleH3r.rc MernnnpelHr,r3oJroHa rrponoHnlpoY3I4 M{uroro ra3a. BaHHoro 4eitcreus c pacrBopoM npoKal4Ha napa(DvHruuona:rrnar
    nepre6pa,rrno).

    t0-12

    186

    peHrreHorpaQul no- fIo norasaH

    tcHuqHono

    oTAena

    II()3BOHOqH14KA.

    KT

    u.nH

    MPT nocc-

    HI,TTIHOTO

    OTAena IIo-

    r.t.sr\.t:

    flpu uefiponaruqecKoM 6onenou cr4HApoMe: npoTHBognltJrenrnqecKr{e cpeAcrna: rap6aua.senuH, ra6anerman, npera6a.nun; auTuAenpeccaHTbr: aMHTpr.rrrrr{JuH, Qlyorceu.ru, napoKcernH.

    OT, JIOK.
    KoHcy.nrraqun Bpa- IIpu uesrpQerrlrBHocrlt KoHcepBarrrBHoro Jreqennt
    vefi-cnequalracton
    B TeqeHI{e 2 uecxqea: KoHcyrbTarl[t Bpaqano noKa3aHH.sM.
    Hefipoxr.rpypra ,Urr perueHur Borrpoca o xnpyprn3BOHOqHI,IKA.

    qCCKOM JIEqEHI,I!I.

    O6renr o6cle- O6rela

    O6aacrHbIE.

    PHrnI
    HeBpoJro-

    ruu

    o6cre.uosa- Jle,reHne aHanomqHo JleqeHuro, [poBoArrMoMy ltaHns anarorrreH o6r- uHeFry n pafroHuofi opraHrrarlr.tu 3.upitBooxpaHemqeH o6reuy enay o6cle,qonaHrrJr B HUg.
    o6clegooanu-e n paftouHofi opraHn3apafionnoft opra- rIHu 3ApaBooxpaHe-

    r0-12

    AOBaHT{' aHIIJIO-

    L7

    uefrpoxr,t-

    HH3arll|lt

    pypruu.

    BOOXpaHeHr,rt,

    ,UONOJIHIITENbHO:

    AOnOJIHHTeJTbHO:

    KOHCynbTarIr4Ir Bpaveft-cneqza;rucron

    gAPa-

    KT unn MPT

    HUJ|.

    NO TIOKA3AHI'IM.

    IIO'CHI,ITIHOTO

    oTAena

    rIo3BO-

    HOqITI'KA.

    flopaxeHrle

    Pafion-

    NO'CHITIHO|O

    HbIE.

    Mexno3BoHKoBOrO Ar,rCKa He-

    yToqHeHHoe

    (.uucroreHHar
    paAuKyrolrme-

    O6rqufi aHarns Elroxlrrrrlrqectcoe uc- Koncyruraqu-r npaua-ueftpoxupypra .qru perxeHr.rt

    cJre.(oBaHue KpoBr,t :
    4poBn.
    O6uufi aHa:rrc onpeAeJreHr.re KoHMOqI'.
    rlerrTpaquu MoqeBr.rPerrrreHorpaHhr, KpeaTr.lHr.t wa, 6u$nr norcHuq- nupy6ull.a, onpeAeHOrO OTIeJra nO- JICHI,IE AKTI,IBHOCTI4

    Bonpoca o xflpypfHqecKoM JleqeHl,tu B HeoTIoxHoM
    nopr.uKe.

    llpn 6oleronr cr.rHApoMe: HIIBC: ltr.noQeHax, xeronpoQeu, KeroponaK, MerroKcrlKaM, u6ynpo(peH,
    qereroxcr.r6.

    HeftponporerropHiu repanur: 3TTurMerr.urruapoK-

    r0-12

    t87
    MLIA

    ,

    pa.qrrKy-

    3BOHOqH14KA.

    KT nnlr

    AIAT, AcAT,

    CPE.

    MPT (Dyuxquoualurar
    flo,lcHI,rqHoro
    peurrenorpa$u-r nooTAeJra no3Bo- tcHl,rrlHoro oT.qeJIa
    goqguxa*+*.
    IIO3BOHOqHUKA.
    Koncymraqur
    V3I4 opranon 6prouBpaqanofi norocru, 6prournefipoxrpypra n Hofi aoprrr.
    3KCTpemIOM rro- Y3I4 MzrJroro ra3a

    JIOMI,|CJIOI4[IE-

    Mrrr) (M51.9)

    KoHcymraqux: apa-

    prAKe.

    qa-aKyrrrepa-

    rr,rHeKoJrora, Bpaqa-

    cunvpul\u]la cyKqriHaT,

    MeTunSTr,u[[pLlILrHOrra

    rl,rApoxjroplr,4.

    lleprl$epuvecxtre Ba3o,qrrJrararopu: nenrorculpralJIrrH, KCaHT?rHOJIa HI,TKOTT{HaT, Hr.rUepronr,rH.

    flapacraunarorrar,rMerr.rqecrrle cpeAcrBa rlpr4 orcyrcrsufi 6orenoro cr4HApoMa: Heocrr,rrMr,rH, r,rflr,tAaKpr{H.

    flpu uefiponaruqecKoM 6onesorr{ cr.tHApoMe: npoTr,rBo3rrnJle[r[rlecKr{e cpeAcrBa: Kap6aMa3e[I,rH, ra6anen'u,rn, npera6aJrr.rH; aHTr41enpeccaHTbr: zlMr,rrpvff rslruH, Q.lryorcerlrtr, uapoKcerr.rH.
    OT. JI@K,

    ypoJrora.

    Koucynrraqru
    rpa.ra-(prr.rsr.rarpa,

    Bpaqa-oHKoIora,
    Bparra-TpaBMaToloraopTorreAa.

    O6teu

    o6cre- O6rerr.r o6creAoBa- Jleqesue aHaJrorr4qHo reqeHr.uo, [poBo/4r.tMoMy rraHbIC
    AOBaHr,rr aHaIJIO- Hris aHaJorurqeH o6r- querry n paftouuoi opraHr{3arlulr 3ApaBooxpaHePHmI
    nlueu o6reny eny o6cre4oaaHr{r B HI{'.
    HeBponoo6creloranrr r pafioHHofi opr:urrnarEl{
    u pafiomrofi opra- Ilnfi 3ApaBooxpaHenefipoxuHr{3arlurr gAPa- Hv[,
    pyprHn
    BOOXpaHeHT{r,
    AOIIOJIHIflCJTbHO :
    nccre4onanue CM)K
    AO[OJrHr{teJIbO6nacr-

    Ha 6elor,

    HO:

    MPT

    qr{To3,

    t,trtr.r KT rc,reroqnrrfi cocraB,

    NO'CHI,TTIHOfO

    rnroKo3y, xjropr,rAbr;

    oTAeJra [o3Bo-

    3HMf;

    HOqHI4KA;

    KOHCyJrb',raqlrfl

    r0-12

    KOHCyJTbTaTIH'

    epava-$rusuarpa,

    Bpaqa-

    Bpaqa-oHKoJrOra,

    Hefipoxnpypra n Bpaqa-TpaBMaTOJIOra3KCTpeHHOM rro-

    opToneaa.

    prlKe.

    flopaxeunr

    PafionHne

    MEXII03BOHKO-

    BbIX

    Ar,tcKoB

    lotcHlrrrHoro

    Apyrfix
    JIOB C

    narrefi

    (Msl.0)

    I,l

    oTAe-

    MI.IEJIO-

    O6rqr.rft aHarlrs 3HMf.
    Koncylrraqul rpaua-nefipox_r.rpypra
    peurenrra
    KpoBr,t.
    KT u.iru MPT no.rc- BOUpOCa O xupypFnqecKoM JreqeHr.ru. An
    O6utrafi alra.nr.rg Hr,rqHoro oTAeJIa no- flapacuunarorvr{MerrilecKrre
    cpe.qcrBa: Heocrr{r_

    xa***

    MOqI,t.

    3BoHoqH

    EuoxlaNru.recxoe

    KoHcylrraqu-r

    I,ICCJIEAOBAHI,IE

    rra-opTone.qa-

    Bpa-

    JIITH, KcaHTI,lHoJIa HHKOTLIHaT, Hltqepronr,rH.

    xpoBr.t: o[pe.qe- TpaBMaTonora.
    JIeH

    e

    KOHUeH-

    Tpauu[

    3br,

    Bpa-

    DIK)KO-

    qefi-cfleql,rarficroB

    o6uero

    NO TIOKA3AHfi'M.

    6e;rra, o6ulero
    6wmpy6nu4
    MOqEBI,IHhI,

    Harpu''. KaJrut,
    xjrop4 orpeAeJIEHI,IC AKTIIBHO-

    crr.r

    Koucylrraquu

    AIAT,

    AcAT, CPE.
    Perrrreuorpa-

    $w

    [orcHr.[rrHOrO oT.qeJra no3BOHOqHIIKA.

    Koncylrraqu.r
    Bpaqa-

    uefipoxupypra.

    H, r{nnAaKpxH, xoJrnHa anB(bocqepar.
    flepr.rQeptvecxr.re Ba3oAr.r;rararopu: neurorcu@tl_
    Mt4

    -

    HefiponpmerropHzu Tepanbr: gTr.rnMerr.r;rrr.rApoK_
    ctr uprt''vHa cyKIII,rHaT, MeTrrJISTZlrrupzAr.tHoJIa
    ruApoxJropnA, fJrr.rrlHrr, nuparleTaM.
    flo uoxagaHr.rru:

    flpt

    cnacruuecKoM cr{H,qpoMe: MuopeJraKca}rrhr

    uenrp:rJrbHoro AefrcrBur: 6arcnoQeu, Tonneplt3oH.

    flpu uefiporenurrx pacc.rpofi"."*

    "o""r"rry"*u_
    HUt:
    cpeAgrBa .qnr nerlexxrl ypoJlorullecKrrx sa6oresa_
    uufi: oxcu6yrnH, Tpocfl[r x;ropfi.q; cpeAcrBa, [pH_
    MenreMhre npu go6poravecrseHHofi rxfleprura3lru
    npe.qgrarenbHofr xene3Er: TaMcvJIo3r,IH.
    flpu 6onenou cxH,qpoMe: UfniC: .quxlo0enar, xe_
    ronpoQen, KeroponaK, MeJroKcr{xaM, n6ynporpen,
    uenexorcu6.
    flpra uefiponaruqecKoM 6oresol, cr.rHApoMe: [po_
    T[Bo9nlJre[Tr.rtrecKr,re neKapcTB€HHbte cpe.qcTBa:
    xap6auarenuH, ra6aneHruu, npera6aluu; aHTuae_
    flpeccaHTbr: Qnyorcernu, aMurpr,Inrl.urr.rH, napoKce_
    TI,IH.

    12-t6

    189

    OT, JIOK, MexaHorepa[ulr.

    06racr-

    O6renr

    o6cre-

    O6reu

    o6clegoaa- Jle.renue aHaJrorurlHo reqeHr{ro, npoBoAr,rMoMy naHbIC.
    AOBaHr,rt aHaJIO- nrzr aHalorraqen o6r- rIueHTy r pailounofi opraHr43arlr.rrc 3ApaBooxpaHePHITII
    rl,rqeH o6reuy eruy o6cnegon aHvr^ B HI4,{.
    HeBpoJroo6creAoBaH[r B paftoHuoft opraHr.r3a- .IIONOJIHI{IEJIbHO:
    ruu
    u pafionnofi opra- qru 3apaBooxpaHe- KoHcyJrbraqr{r npaua-uefrpoxnpypra
    peIIIeHLITI
    nefipoxraHr{3arlllu sAPa- Httt.
    Bonpoca o xfipyprurqec KoM JreqeHuu.
    pypfr{r{.
    BOOXpaHeHr,rr,
    .trOTIOJTHI TCJIbHO :
    AOTIOJIHI4TCJIb-

    ypoAr.rHurMr.rtrecKoe

    HO:

    r{ccneaoBaHI{e;

    MPT nnr.r

    KT

    t0-t2

    Koucymrargu

    IIOtCHUqHOfO

    Bpaqefi-cneuua:rr,rgron

    oT.qeJra no3Bo-

    TIO flOKA3AHIUM.

    HOIIHI,IKA.

    Corprcenue

    Pafion-

    IOJIOBHOTO

    HbIC.

    Korrponr A,{, Zccaegonanue CMX Mo.reroHHhre cpeAcrBa: (fypocerr.rng.
    qcc.
    Ha TIBST, [po3paq- HeftponporerropH:ur repan[r: srnJrMernJrrr,LqpoK-

    (pu-r uepena.

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    flrroKo3y, xjrop[,q6r.
    flo noraganvqM:
    33f.
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    3xo3C.
    Korcymraqur

    Peurreuorpa$ur
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    Bpaqa-

    38OHOIIHI{KA.

    M03TA

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    (s06.0)

    KpoBn.

    ana,rng

    Perrrrenorpa-

    IIpoTI,lKceH.

    KT unu MPT roros- flpu cy4opoxnoM crrHApoMe: npor!{Bo3rrrrJrefiMqe(rrasHoe AHo, goro Mo3ra***.
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    qefi-cnequanr,rcron
    HUt).
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    IIO IIOKA3AHI,I'M.

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    flplr prore:

    [poKr{Herr4xr{:,qoMneprlgoH, MeroKJro-

    5-10

    190

    npaMr4,u.

    flpra

    necrr.r6yarpHoM cr,ruApoMe: cpeacrBa
    ycrpaHeHnr nonoBoKpyxeHun: 6etarnctuu.
    OT, JIOK.

    O6ulrzfi

    Oqarosat
    TpaBMa ronoB-

    Pafion-

    HOrO

    O6.iracr-

    O6uIu[

    HbIE.

    MOIIU.

    Koncyarraqru

    Er,roxlrulrqecxoe
    uccjreAoBaHr{e
    4poBr,r: onpe.qe-

    qa-ficrxl{aTpa-

    MO3ra

    (ynru6

    roJroB-

    HOrO

    UO:ra)

    (s06.3)

    HI,IE.

    aHarr.rs

    ureiuoro orgela

    4poBr.r.

    JIeHI{e

    PenrreuorpaQrar

    anarlrs

    KOHqeH-

    Tpaqxu fnloKo-

    3br, o6rqero
    6ema, arb6yMr,rHa, o6qero

    6utupy6uu4
    MOqeB[Hbr,
    HaTpr,m, Kulug,,
    xrrop4 onpeAeJIEEUC AKTI{BHO-

    crtr

    ArAT,

    3BOHOTIHI,IKA.

    HapKojrora.

    33f.

    .qJUr

    flpu

    6onerorr.r crrHApoMe 14 rxrreprepMr.ra: HIIBC:
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    Mo.reroHHrre cpeAcrBa: $ypocerr.rrag.
    Bpa- flpra xlnHrvecrrx r.r KT-nprsHaKurx Hapacrilro lero
    oreKa Mo3ra, noBbrrrreHrlfi BIII 6olee 15 urr,r pr. cr.
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    SoHe cegaqr.ru u (ruu) anaJrresvLr, ypoBHe Harpr{t
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    ) {eroM rurr,rHl,IqecKlfx rrpotBJIeHI,Ifi Ir ypoBHt
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    JrerKr,rx lr .ueKoMrleHcl,tposauHofi cepAeuHofi neAo-

    c

    AcAT.

    STATOIIHOCTII.

    LlccreAoeaHne

    flo norasaHurr,r:
    flpu rorurrueHbrx Hap)'rnerr.rr{x: uefiponporemop-

    nora:arenefi
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    AqTB,
    TITI4,

    IIB,

    MHO,
    Qu6prnoren,
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    I4ccneaonanr.re

    HaJr Tepflllnjl: 9TI4JrMeTr4Jrrr.LqpOKCnnItpr,rAr.rHa cyKIIIIHaT, MeTr4Jr3Tr,r,Jrn[pU,qUHOJra nr,qpoxJroprrA, rnurlrrH, flupaueTaM;
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    t0-20

    t9l

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    nr,ru, t[,nyorceurH, rrapoKcerr-lH.

    npo3paqHocTb,
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    rurgroqnrrfr cocTaB, fJrroKo3y,

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    xJropl,rAbr.

    aHKctto,q[TuqecKrle cpeAcrBa: :rolpusonaru, nva-

    PerrrenorpaQur uepena.
    KT urr.r MPT

    3EIIAM.

    ToJIoBHOTO MO3-

    J.a***.

    npoeBiul KI,IcJrora.
    flpu pnore: [poKr4HerrKr.r: AoMrrepr.rAoH, Meror;ro-

    Korrpo.nr A'{,

    IIpaMu,q.

    qcc.
    3Kf.

    3xo3C.
    Koncylsraqnr
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    flpu

    necrn6ynxpHoM cr.rulpoMe: cpeacrBa Anf
    yc'rpaHeHnr ronoBoKpyxeHn-r: 6erarucrun.
    flpr cnacr:ruecKoM cr.rH,qpoMe: Mr.ropeJraKciurrBr
    rlerrrp:IJrbHoro Aeficrsrr: 6auo(!en, Tonneprr3oH.
    OT, JIOK.

    o(pramrrronora

    (rJrtl3Hoe

    ocrpoTa

    AnO,

    3pe-

    HrrA),

    Bpaqa-

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    Snnqlpanrnoe

    Pafton-

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    HhIE.

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    Perrrrenorpa(pur
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    rnefinoro orAeJra no- oTleJreHue opraHu3arlrrr4 3ApaBooxpaHeHr,rr.
    O6rqnft ana:rus 3BOIIOIIHI.IKA.
    Koncymraqru npava-nefipoxupypra ruu perneHr{t
    MOIIH.
    33f.
    Bonpoca o xupypruqecKoM JrerreHr{rr.
    Er,roxuura.tecroe Koncymraqlrr Bpa- J}oru6amnas rryHKrlr{r 1 pas n 5 .qsefi no 5 nal Ao
    qa-flcrxpraTpaI,ICCJICAOBAHI'C
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    KpoBH: OrrpeAe- HapKoJrora.
    flpu 6orenou cr4H,qpoMe r.r rrlneprepMr.r : aHaJrreJreHr.re KoHueHTHKIT-alITtrII{peTI,lKI{: MeTaM}I3OJI HaTp}rt, napaUe-

    O6qlrfi

    aHa:nrs

    t0-20

    192

    Hr{e

    (s06.5)

    Tpaqrrr4

    TAMOJI.

    3r,I,

    MoqeroHHbre cpeAcrBa: Qypocernrr.rg.
    flpr,r rc,uuuuecxrx r.r KT-npu3HaKax Hapacrarorqero
    oreKa Mo3ra, rroBhrrrreHrrrl B9.{ 6oree l5 MM pr. cr.
    (no .qaHHsrnr uoHuropuura). He cHr4)K:Iloruerocr Ha
    rpoHe ce,qa4ru u (utru) aHrlJrre3r.r[, ypoBne Harpr{t
    rrJrasMbr rrlenee 150 uuonr/n (rourpom 3nercrpoJrr{roB He pexe 2 par n cyrxlr):
    pasrBopbr c ocMoA[yperr.rqecxrana 4eficrrueu r/r:
    copMaHToJr, MaHHHTOJT, C IIOCJreAyrcUUM BBeAeHr{eM s/s rlroqerouHbrx cpeAcrB: Qypoceuua. Bne,qeHHe yKa3aHHbrx cpe.qcrB rroBToprror raxArre 4-5
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    rroKoO6IIIerO

    6enra, o6uero
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    MOqeBI4HhI,

    HaTpr,rr, KaJftt'.,

    xropa,

    oflpeAe-

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    ctm

    AIAT,

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    feMocra3a:

    AqTB, IIB,
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    reMaToKpl{t,
    llccneAosaHne
    CIvDK na rper,
    npo3parrHocTb,
    6e.norc, qr{To3,

    CTATOIIHOCTII.

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    flapacurunarorur4Merr.IqecKxe cpeAcrBa: xoJruHa
    a.nrQocqepaT, [rrHAaKpr{H.

    x:rqro.rtrbrfr co-

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    poqrrbr rrpfi orcyrcrBHr-r Ilpo-

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    xJrop[p0,rKceH, cyJrbrrr,rpl{I, KBeTr,ranIrH;

    TI,IBONOKA3AHI,Ifi.

    aHKcuorr,rr[qecKne cpe.ucrBa: roQutonav. rua3eniM.
    flpu cy.qopoxnoM clrHApoMe: rrporr4Bognu;ren FrecKr.re cpeAcrBa: tpeHrarolrn, rap6aruasenun, BirJrbnpoeBar Kr.rcJroTa.

    fls,

    3xo3C.
    KT r.sru MPT
    TOJIOBHOTO MO3-

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    {.

    ,t

    3Kf.

    .

    flpu

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    flptt psore: flpoKr,rHerr,rrr,r:,qoMrrepr,rAoH,

    MeroK;ro-

    193

    Kourpo:n A{,
    qcc.

    npaMna.
    eecrr.r6ynqpHoM cr,rHlpoMe: cpeAcrBa
    ycrpaHeHr,rr roJroBoKpyxeHus: 6erarucrus.
    @T, JIOK.

    flpu

    PeurreuorpaQlr-a uepena.

    Koucymraqu-r
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    (uasnoe ruo,
    ocrpoTa 3per.rre),
    Bpaqa-

    ueftpoxupypra.

    O6uufi

    Tparuana.recKoe cy6apax-

    Pafion-

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    O6nacr-

    O6qlrft

    4poBou3Jrr{r-

    HbIE.

    MOqU.

    nve (506.6)

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    6o114

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    33f.

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    I

    pa: n 3 Anq no 5 nrl

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    ) reroM K:rrlHuqecKr,rx nporeleHufi [r ypoBut
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    IIpa

    c

    n

    t6-20

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    xjropr,rAbr.

    flpu

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    flplr prore: nporlrHerlrKlr: AoMnepnqoH, MeroKnorlpaMI,I4.

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    noro uoara**+

    .

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    (s24).

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    flpu

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    HIIBC: u6ynporpen, Arr-

    noQenar, reronpoQeu, KeroponaK,
    qerexorcu6.

    MeJIoKcr{KaM'

    nefiponaruqecKoM 6onesoM cI'IH.{poMe: [poTr4Bo3rrr,rJlerrrl{qecKne cpeAcrBa: xap6auarenun, ra6anerrmn, npera6aauH; arrrzulefipeccanTbl: aMrfipumuJrr.tH, (pnyorcerun, fiapoKcerllH.
    flpu cnacrrvecKoM cnHApoMe: MuopeJlaKcaHThr
    rlerrrpanbHoro reitcrsur". 6aruro(pen, ToJIrIepu3oH.
    OT, JIOK.

    flpu

    AIAT,

    KJIeTOq-

    cocraB,

    nrroKo3y, xjropuAbl.

    PenrrenorpaQu.r nosaonouHI,IKA B COOTBET-

    cTBnI{

    c

    ypoB-

    HeM TpaBMbr.

    O6rerr,r o6cne- O6rerr.r o6cre.qosa- Jleqenne agaJrorutlHo rerregl'fio, npoBo.quMoMy nan pafiounofr opraul{3auull 3ApaBooxpaHeAOBaHT{f, aH:IJIO- ur,r-r aHaroMqeH o6t- rlr,reHTy
    n{qeH o6teuy euy o6cle4on {!It B HVIA.
    o6creAosaH[r s pafiouttofi oPraHI,I3a- IONOJIHITTEJIbHO:

    O6racrHbIC.

    PHTtrI
    HeBpoJro-

    |I,IH
    nefrpoxu-

    U

    pafionnoft oPra-

    qr{u

    Iln3Auxvt

    H119,

    3Apa-

    3ApaBooxpaHe-

    npu nefiporenublx paccrpoficrBtx MorleucnycKaHrut
    rrocJre npoBeAeHI,lJI ypoAr{HaMl'ftlecKoro ccleAoBaHttJr: cpe,ucrBa Nra reveunr ypororurqecKl4x 34o-

    .UOIOJIHI,ITCJIbHO:

    MPr

    ypoAr4HaMr.rqecKoe
    NCCJIEIOBAHI4C.

    (KT)

    CTII,THHOTO MO3-

    ra,

    reeaHfiii: orcu6yruH, rpocnnr xropuA; cpeAcrBa,
    npr{MerllteMbre npu go6poravec'rseHnofi rlflepnJra3rzu npeAcrarelrnofi xelegrr: TaMcyno3r{H.
    Bpave6Hufi KoHcnJrriyM .urur peureHl{r Bonpoca o
    x[p]?mrrecKoM JreqeHrrr{.

    MneJrorpa-

    Qru;

    Y3Vl

    HepBHbrx

    H M'Txux txauefi roCTBOJIOB

    Tpauua nepnon Pafton-

    Ha

    ypoBHe
    IUICqCBOTO TO-

    aca u

    firetla

    (s44).

    Tparua nepnon

    Ha

    ypoBHe

    npe,uureqBt
    (s54).

    HbIE.

    neqnocrefi.
    O6qr.rfi anarus

    Koncymra4.u

    KpoBu.

    .ra-uefipoxlrpypra.

    Buoxuvvqecroe
    Itccjre.[oBaHue
    4poBr.r: oupeAeJIEHI{C KOHIIEHTpaw{n rJrroKoo6rqero

    3H,

    Bpa-

    flo

    noraeanu-rM ocyrqecrBJr-{ercr xrlpyprnrrecKoe

    JICqEHI,IC.

    flpu 6oneeonr cr.rHApoMe: HIIBC: r.r6ynpo(pen, gurloQenax, reronpoQen, Keroporarq Meno(cHKaM,
    qelerorcu6.
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    MOqEBI'HbI,

    s/e MoqeroHHrrx cpeAcrB: (p1poceruu,q.
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    nrApoxjropaA, rnnlxH.

    6erxa,

    o6ulero
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    Tpanrua nepnoa
    Ha ypoBHe 3a-

    Ha'rptu, KaJIvt,

    |CII.

    xJropa, onpeAe-

    flapacnrunarour,IMerurrecKxe cpe.qcrBa: Heocrur-

    fl\cTbt v KI{gfu

    JICHNC AKTIIBHO-

    (s64).

    crr{

    AIAT,

    MrrH, r[r,rAaKpr.rH.

    fleprQepnuecxue Ba3o.unararoprr: nen'rorcn$ul-

    AcAT.

    JrlrH, KcalrTr,rHoJra Hr,rKoTnHaT, Hr,rqepronr.rH.

    Tpaanaa nepsor

    Perrrrenorpa-

    flpu

    Ha ypoBHe ra-

    Qur rocreft co-

    :o6e,qpenHoro

    OTBETCTBEHHO

    cycrana ra
    pa (S74).

    ypoBHro nopa-

    6e.E-

    xeHl,('.

    nefiponarfiqecKoM 6oresolr cuHlpoMe: [poTrrBo3rrraJremrFrecKr,re cpeAcrBa: rap6aua.renr,lH, ra6anerrruu, npera6aruu; aHTnlenpeccaHTbr: aMr{TplrrrrxJrl,rH, @rryorcerun, flapoKcerr,rH.
    OT, JI@K.
    Ilpr.r pe$parrepHoM BbrpaxeHuov Hefiponar[qe-

    t0-20

    191

    cron 6olenou

    Tparua HepBoB
    Ha ypoBHe roreuu (S84).

    cr,rHApoMe: HanpaBJreHr.re Ha KoHcyJrbrarrr.{rc n PHIII{ HeBpono {u u nefrpoxlrpyprun
    AJrr perxeHr,rr Bonpoca o xfipyprr4rrecKoM JreqeHrrr.r.

    Tparrua HepBoB
    Ha ypoBHe roJICHOCTONHOTO

    cycTaBa u cronu (S94)

    O6racr-

    O6reu

    HbIC.

    AOBaHXT aH:UrO-

    Prilq

    o6cre-

    rl{qeH

    o6renry
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    rTilll
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    pyprnu.

    Koncylrraqur

    Bpa-

    va-nefipoxnpypra.

    Jleqenue aHaJrorr{rrHo JleqeHr,no, npoBoALI MoMy narllreHTy s pafiounofi opraHr8aqr.fir 3ApaBooxpaHe-

    l0-20

    HVA,

    BOOXpaHeHT{r,
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    SHM|;

    Y3lI

    HepBHbrx

    CTBOJIOB

    rrx
    *

    I-I

    MJIT-

    rranefi ro-

    geqnogrefi.
    JlerapcrreuHbre cpelcrBa nepnofi :nuuuu, uau6otree omr.rMaJrbHrre c yqeroM xluuu recxofi stplpernannocnr u croltMocrr.r.

    **

    JlerapcrneHHbre cpeAcrBa BTopofi runulr.
    Bo3MoxHogtl,t BblrroJIHeHI4JI KT lr.nu MPT rcclegoBaHt{t B paftonurrx opraHH3all[rx 3rpitnooxpareHr.rr no gKcTpeHHIIM noKa3:rHr.rJrM rlaquerrrhr HanpaBJrrrorcr r ruexpafionnrre opraHr,r3aul,Iu 3.IlpaBooxpalleHltr r,rr pacqera AocrylHocrr,r c pagrycoru n 70
    KM, eCJrIr pafionnar opraHu3arlut 3ApaBooxpalreHl{Jl HixoA}fTcr BHe 3oHbr Bo3MoxHoro [poBe.4eHr{r AaHHoro nccJreloBaHr4t - a o6lacrnyro opraHu3auno 3ApaBooxpaHeHltt, B rrJr:ruoBoM noptAKe (upr nepnuuuofi noqranosre .q!Iaruo34 B AuHaMuKe npu )D(yArxeHnr{ cocTorHr4r rraqueHra, o6ocrpenuu r,r uporpeccuposaHuu :a6orenanur) - n uexpafioHnue u o6nacttre opraHrcarlru 3ApaBooxpaHeur{r.

    +** fJpu orcyrcrBnu