ÏÀËËÈÀÒÈÂÍÀß ÒÅÐÀÏÈß ÎÍÊÎËÎÃÈ×ÅÑÊÈÕ
ÁÎËÜÍÛÕ Â ÓÑËÎÂÈßÕ ÌÅÆÎÁËÀÑÒÍÎÉ
ÁÎËÜÍÈÖÛ¹19
A.A. Ca??e, A.I. Ciaaa
Oi?aaeaiea eniieiaiey iaeacaiee Ieienoa?noaa ?noeoee
?inneeneie Oaaa?aoee ii ?inoianeie iaeanoe O?. -398/19
?ino eiee?anoaa iieieiae?aneeo aieuiuo IV noaaee a oneiae-
yo eni?aaeoaeuiuo o??a?aaiee e ?acee?iua nioeaeuiua aniae-
ou, ia iicaiey?uea ain?i?ii inaiai?aaou aieuiuo n aaiiie
iaoieiaeae, i?eaaee e oiio, ?oi yoa eaoaai?ey aieuiuo eiioaio-
?e?oaony a oe?o?ae?aneii ioaaeaiee ia?iaeanoiie aieuieou
¹ 19, a nayce n ?ai ino?i noieo i?iaeaia ieacaiey iaeeeaoea-
iie iiiiue.
Kiee?anoai caiouaiiuo neo?aaa ec aiaa a aia ?anoao e ninoa-
aeyao 60% io iauaai eiee?anoaa iieieiae?aneeo aieuiuo. Aia-
eec neo?aaa caiouaiiinoe iicaieyao naaeaou auaia, ?oi yoi nay-
caii n iicaiae ia?auaaiinou? aieuiuo (60%), ionoonoaeai
iaaea?auae iaoa?eaeuii-oaoie?aneie aacu (40%).
Ia?aia ianoi a nenoaia caaieaaaaiinoe caieiaao ?ae eaaei-
ai (35%), aoi?ia — ?ae ?aeoaea (18%), o?aoua — ?ae ai?oaie
(18%).
Iaeeeaoeaiay iiiiuu aieuiui a IV noaaee ia?yao n neiioi-
iaoe?aneie oa?aieae a oneiaeyo oe?o?ae?aneiai ioaaeaiey
IIA-19 caee??aaony a i?iaaaaiee yiaieeioaoe?aneie iieeoe-
ieioa?aiee. I?iaiaeiay ?aiaa nenoaiiay oeieioa?aiey, e?ae-
ia ia?aie?aiiay aaeao iauaai oy?aeiai ninoiyiey aieuiuo, au-
?a?aiiie aiaiee, ii?a?ii-ia?aii?iie iaainoaoi?iinoe, i?ae-
oe?anee ia ieacuaaea iiei?eoaeuiiai yooaeoa i?e cia?eoaeu-
iie au?a?aiiinoe iiai?iuo yaeaiee.
Iaie iaa?aia a?oiia ec 20 aieuiuo ?aeii eaaeiai IV noaaee
e 2 aieuiuo n iii?anoaaiiuie iaoanoacaie i?e iaeii ia?ae-
?iii i?aaa, eioi?ui i?iaiaeeanu yiaieeioaoe?aneay iieeoe-
ieioa?aiey a n?aaieo aicao (oeeeioinoai — 1 a, iaoio?aenao —
100 ia, 5-ooi?o?aoee — 500 ia). 8 aieuiuo oia?ee a oa?aiea 1
ian, 7 — a oa?aiea 6 ian. O 5 aieuiuo ca aanu ia?eia iaae?aa-
iey ioia?aeinu oeo?oaiea iauaai ninoiyiey, «noaaeeecaoey
iiooiee».
E?iia oiai i?eiaiyeanu noaia yiaieeioaoe?aneiai aaaaa-
iey eiioiiiiaoeyoi?ia (AO?) i?e ?aea eaaeiai IV noaaee e o
oy?aeuo aieuiuo, eioi?ui i?ioeaiiieacaiu ?acee?iua aeau
oeieioa?aiee. Aaiiay iaoiaeea i?eiaiyeanu o 4 aieuiuo n au-
?a?aiiui eeeie?aneei yooaeoii.
Oaeei ia?acii, iieo?aiiua ?acoeuoaou iicaiey?o naaeaou
auaia i aicii?iinoe i?eiaiaiey yiaieeioaoe?aneie iieeoe-
ieioa?aiee e eiioiiiiaoeyoi?ia i?e ?aea eaaeiai IV noaaee
aey oeo?oaiey ea?anoaa ?ecie e oaaee?aiey iieacaoaeae au?e-
aaaiinoe a oneiaeyo EOO.
IV Eiioa?aioey «Iaeeeaoeaiay iiiiuu a iieieiaee», ai?aeu, 1999,
Aioaeey, Iaeeeaoeaiay iaaeoeia e ?aaaeeeoaoey, 1999, ¹ 2, n. 37.
K ËÅ×ÅÍÈÞ ÐÀÑÏÐÎÑÒÐÀÍÅÍÍÛÕ
ÔÎÐÌ ÕÎÐÈÎÊÀÐÖÈÍÎÌÛÌÀÒÊÈ
A.A. Eaaiiaa, O.A. Oaaioiaa
Iao?ii-enneaaiaaoaeuneee iieieiae?aneee einoeooo,
?inoia-ia-Aiio, ?inney
Ai ianoiyuaai a?aiaie oi?eiea?oeiiia caieiaao iniaia
ianoi n?aae iieiaeiaeieiae?aneie iaoieiaee. K?aeiyy noaiaiu
ceiea?anoaaiiinoe, iaee?ea nianoaaiiiai ia?ea?a, enee??e-
oaeuii aaiaoiaaiiue ioou iaoanoace?iaaiey, ii?a?aiea ?ai-
uei a iniiaiii ?ai?iaoeoeaiiai aic?anoa canoaaeyao ian
eiinoaoe?iaaou, ?oi e a eiioa XX aaea oi?eiea?oeiiia — «ia
i?inoi ?aniiciaaaaiay aieaciu ni noaiaa?oiui oa?aieai, ii
ninoiyiea, eioi?ia ?anoi iai?eaaiii e iai?aaneacoaii» (A.
Mogenson).
Oniaoe oeieioa?aiee, eioi?ay yaeyaony iniiaiui iaoiaii
ea?aiey oi?eiea?oeiiiu, ii?aceoaeuiu: io 100% nia?oiinoe a
60-o aiaao, ai i?aeoe?anee 100% au?eaaaiinoe (i?e iaiaoanoa-
oe?aneeo oi?iao) a 90-o aiaao.
A oi ?a a?aiy ieiei 70% aieuiuo, iinooia?ueo a niaoeaee-
ce?iaaiiua noaoeiia?u, — yoi aieuiua n iaoanoaoe?aneie oi-
?eiea?oeiiiie, o?aao?uea eioaineaiie, iaoiaaiaoe?aneie e
neiioiiaoe?aneie oa?aiee; o 20% ec ieo n ?ani?ino?aiaiiui
iiooieaaui i?ioannii (iaoanoacu a ia?aie, ii?aaii iocu?a,
eeoa?ieea, aieiaiii iicaa) oy?anou iauaai ninoiyiey aaeaao
i?iaaaaiea aa?anneaiie iieeoeieioa?aiee e?aeia cao?oaie-
oaeuiui, a ii?ie e iaaicii?iui.
Iiene iooae iioeiecaoee ea?aiey aieuiuo n caiouaiiuie
oi?iaie oi?eiea?oeiiiu, iicaieeee iai i?eiaiyou yiaieei-
oaoe?aneia aaaaaiea oeoinoaoeeia, ni?aoa?uaa nei?inou ?aa-
eecaoee i?ioeaiiiooieaaiai yooaeoa n ieieiaeuiie oiene?ii-
nou? e aunieie yooaeoeaiinou?.
Ec 12 aieuiuo n oi?eiea?oeiiiie III-IV noaaee 4 eiaee auni-
eee ?ene aieacie. Yiaieeioaoe?aneia aaaaaiea iaoio?aenaoa
(eo?niaay aica 800-1200 ia aaiaeeanu aaoiy eiooceyie a oa?a-
iea 7-10 aiae), eae ia?aue yoai ea?aiey, iicaieeei anai aieu-
iui ia?aou niaoeaeece?iaaiio? oa?aie? n ia?auo nooie i?aau-
aaiey a noaoeiia?a, a oa?aiea ia?aie iaaaee nieceou enoiaiue
o?iaaiu oi?eiie?aneiai aiiaaio?iieia aaaia, ecaa?aou oiene-
?aneeo ?aaeoee e inei?iaiee aac i?eiaiaiey aioeaioiuo i?a-
ia?aoia. ?a?ac 2-3 iaa noaio ea?aiey aiiieiyee iieeoeieioa-
?aieae eee oe?o?ae?aneei aiaoaoaeunoaii n iineaao?ueie
eo?naie iieeoeieioa?aiee.
2 aieuiuo ec yoie a?oiiu iiaeaee a ?acoeuoaoa i?ia?anne?i-
aaiey i?ioanna a oa?aiea ia?aiai aiaa ?ecie. Inoaeuiua ?eau
5 eao e aieaa.
Iiiaieaoiee iiei?eoaeuiue iiuo i?eiaiaiey yiaieeioaoe-
?aneiai aaaaaiey oeoinoaoeeia i?e ea?aiee ?ani?ino?aiaiiuo
oi?i oi?eiea?oeiiiu iicaieyao iai n?eoaou aai aunieiyooae-
oeaiui e ia?niaeoeaiui.
IV Eiioa?aioey «Iaeeeaoeaiay iiiiuu a iieieiaee», ai?aeu, 1999, Ai-
oaeey, Iaeeeaoeaiay iaaeoeia e ?aaaeeeoaoey, 1999, ¹ 2, n. 36-37.
K ÂÎÏÐÎÑÓ Î ÏÐÈÌÅÍÅÍÈÈ
ÌÈÀKÀËÜÖÈKÀ Ó ÁÎËÜÍÛÕ
Ñ ÌÍÎÆÅÑÒÂÅÍÍÛÌÈ ÊÎÑÒÍÛÌÈ
ÌÅÒÀÑÒÀÇÀÌÈ ÏÐÈ ÏÐÎÃÐÅÑÑÈÐÓÞÙÅÌ
PAKE ÌÎËÎ×ÍÎÉ ÆÅËÅÇÛ
A.A Kaooaineee, E.N. Aaaeaaiei, N.I. Iioaiei
Ai?ianeie iieieiae?aneee aeniaina?, K?aniiaa?, ?inney
Iaiei ec ?anouo inei?iaiee i?ia?anne?o?uaai ?aea iiei-
?iie ?aeacu yaeyaony iaoanoace?iaaiea a einoe neaeaoa. I?e
yoii aicieeaao eioaineaiue aieaaie neia?ii, ai?uaa n eioi-
?ui inoaaony ia naaiaiyoiee aaiu aeooaeuiie i?iaeaiie.
Aey ea?aiey aieaaiai neia?iia iaie eniieuciaaeny i?aia-
?ao ieaeaeuoee — neioaoe?aneee eaeuoeoiiei eininy. Iia ia-
ae?aaieai iaoiaeeenu 19 aieuiuo a aic?anoa io 24 ai 68 eao.
Iaoanoaoe?aneia ii?a?aiea einoae auei iiaoaa??aaii i?e ii-
iiue ?aioaaiieiae?aneiai enneaaiaaiey e noeioea?aoee einoae
neaeaoa. Ai ia?aea ea?aiey 15 aieuiuo yoie a?oiiu, iaoiayueo-
ny iia iaae?aaieai a aeniaina?a, ec-ca au?a?aiiiai aieaaiai
neia?iia iieo?aee ia?eioe?aneea aiaeuaaoeee. I?aia?ao aai-
aeeny a aica 100 ME a?aaiaaii a 1-? iaaae? n iineaao?uei
aaaaaieai 100 ME 3 ?aca a iaaae? a oa?aiea 1 ian. Kaeeo eeai
inei?iaiee i?e i?eiaiaiee i?aia?aoa iaie ia iaae?aaeinu.
Ana aieuiua ia?aeeaeuii iieo?aee oeieioa?aie? ii noaia
CAF. O 6 (31,5%) aieuiuo nie?aiea aiee i?iecioei ia 3-e aaiu
iinea ia?aea ea?aiey n iieiui ioeacii io ia?eioe?aneeo aiaeu-
aaoeeia. O 8 (42,1%) aieuiuo ia 2-e iaaaea ea?aiey iieiinou?
ii?iaeeciaaeenu aae?aiey ai anao nonoaaao e en?ac aieaaie
neia?ii. O 3 (15,7%) aieuiuo ioia?aii iacia?eoaeuiia oiaiu-
524
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