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Ƚɍ «Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚɹ ɦɟɞɢɰɢɧɫɤɚɹ ɚɤɚɞɟɦɢɹ ɆɁ ɍɤɪɚɢɧɵ» *
ɤɚɮɟɞɪɚɧɟɜɪɨɥɨɝɢɢɢɨɮɬɚɥɶɦɨɥɨɝɢɢ (ɡɚɜ. – ɞ. ɦɟɞ. ɧ. Ⱥ.ȼ. ɉɨɝɨɪɟɥɨɜ)
ɭɥ. Ⱦɡɟɪɠɢɧɫɤɨɝɨ, 9, Ⱦɧɟɩɪ, 49044, ɍɤɪɚɢɧɚ
Ʉɍ «Ⱦɧɟɩɪɨɩɟɬɪɨɜɫɤɚɹ ɨɛɥɚɫɬɧɚɹ ɤɥɢɧɢɱɟɫɤɚɹ ɨɮɬɚɥɶɦɨɥɨɝɢɱɟɫɤɚɹ ɛɨɥɶɧɢɰɚ ȾɈɋ» **
Ⱦɧɟɩɪ, 49000, ɍɤɪɚɢɧɚ
SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» * Department of Neurology and Ophthalmology
Dzerzhinsky str., 9, Dnipro, 49044, Ukraine
CE «Dnipropetrovsk Regional Clinical Ophthalmologic Hospital» ** Dnipro, 49000, Ukraine
e-mail: kzdokol@ukr.net
Ʉɥɸɱɟɜɵɟɫɥɨɜɚ ɧɨɜɨɪɨɠɞɟɧɧɵɟ, ɞɚɤɪɢɨɰɢɫɬɨɰɟɥɟ, ɮɥɟɝɦɨɧɚ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ
.H\ZRUGV newborns, dacryocystocele, lachrymal sac phlegmon
Ɋɟɮɟɪɚɬ ȿɮɟɤɬɢɜɧɿɫɬɶ ɞɪɟɧɭɜɚɧɧɹ ɫɥɿɡɧɨɝɨ ɦɿɯɭɪɚ ɩɪɢ ɞɚɤɪɿɨɰɢɫɬɨɰɟɥɽ ɭ ɧɨɜɨɧɚɪɨɞɠɟɧɢɯ ɋɚɤɨɜɢɱ
ȼɆɋɟɪɞɸɤȼɆɄɥɨɩɨɰɶɤɚɇȽɌɚɪɧɨɩɨɥɶɫɤɚȱɆɍ ɫɬɚɬɬɿ ɧɚɜɨɞɹɬɶɫɹ ɪɟɡɭɥɶɬɚɬɢ ɥɿɤɭɜɚɧɧɹ 14
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.ORSRWVND\D1* 7DUQRSROVND\D,1 The article represents results of treatment of 14 newborns with unilateral
dacryocystocele. Patients age was 7.2±0.5 days. In 9 newborns (64.3%) dacryocystocele was complicated with lachrymal sac phlegmon; in 5 children (35.7%) any complications were absent. Drainage of lachrymal sac through the lower lachrymal canaliculus, instillation of antibiotics, systemic antibiotic therapy in case of phlegmon were performed in all the children. Lachrymal sac washing was performed with a solution of the antibiotic ofloxacin till clear fluid evacuation. If necessary the drainage was repeated in 10 days. The drainage of lachrymal sac was successful in all the patients. 2-3 weeks after the drainage probing of nasolachrymal duct was perfomed in 4 children (28.6%) including those 3 with lacrymal sac phlegmon. In 71.4% regression of dacryocystocele occurred itself. Any complications and side effects were not observed. Positive effect of the drainage, according to the authors, can be explained so that dilatation of lachrymal canaliculus before the procedure allows to eliminate Rosenmüller valve stenosis and evacuation of fluid, mucus and pus, being breeding ground for microorganisms from lachrymal sac, promotes inflammation subsiding. Authors also recommend to pay attention on prenatal diagnosis of dacryocystocele, using ultrasound investigation in the 3rd trimester of pregnancy.
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ɐɟɥɶɸ ɪɚɛɨɬɵ ɛɵɥɨ ɢɡɭɱɢɬɶ ɷɮɮɟɤɬɢɜɧɨɫɬɶ ɞɪɟɧɢɪɨɜɚɧɢɹ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɱɟɪɟɡ ɧɢɠɧɢɣ ɫɥɟɡɧɵɣɤɚɧɚɥɟɰɭɧɨɜɨɪɨɠɞɟɧɧɵɯɫȾɐɐ
ɆȺɌȿɊɂȺɅɕɂɆȿɌɈȾɕɂɋɋɅȿȾɈȼȺɇɂɃ
ɉɨɞ ɧɚɲɢɦ ɧɚɛɥɸɞɟɧɢɟɦ ɧɚɯɨɞɢɥɨɫɶ ɞɟɬɟɣɝɥɚɡɫɞɢɚɝɧɨɡɨɦȾɐɐɞɟɬɟɣɛɵɥɢ ɩɟɪɟɜɟɞɟɧɵɢɡɪɨɞɢɥɶɧɵɯɞɨɦɨɜɢɧɚɩɪɚɜɥɟɧɵ ɜɪɚɱɨɦ ɩɨ ɦɟɫɬɭ ɠɢɬɟɥɶɫɬɜɚ ɋɪɟɞɧɢɣ ɜɨɡɪɚɫɬ ɞɟɬɟɣ±ɞɧɹȾɟɜɨɱɟɤɛɵɥɨɦɚɥɶɱɢɤɨɜ± ɍɪɚɡɜɢɥɚɫɶɮɥɟɝɦɨɧɚɫɥɟɡɧɨɝɨɦɟɲ ɤɚɚɭȾɐɐɩɪɨɬɟɤɚɥɨɛɟɡɨɫɥɨɠɧɟɧɢɣ
ɍ ɩɚɰɢɟɧɬɨɜ ɩɨɪɨɤ ɪɚɡɜɢɬɢɹ ɫɥɟɡ ɧɨɝɨɦɟɲɤɚɜɵɹɜɥɟɧɜɪɟɡɭɥɶɬɚɬɟɩɪɟɧɚɬɚɥɶɧɨɝɨ ɭɥɶɬɪɚɡɜɭɤɨɜɨɝɨɢɫɫɥɟɞɨɜɚɧɢɹɜɦɬɪɢɦɟɫɬɪɟ
ɉɪɨɜɨɞɢɥɫɹ ɧɚɪɭɠɧɵɣ ɨɫɦɨɬɪ ɛɢɨɦɢɤɪɨ ɫɤɨɩɢɹɩɟɪɟɞɧɟɝɨɨɬɪɟɡɤɚɝɥɚɡɚɨɮɬɚɥɶɦɨɫɤɨɩɢɹ ɭɥɶɬɪɚɡɜɭɤɨɜɨɟ ɢɫɫɥɟɞɨɜɚɧɢɟ ɨɛɥɚɫɬɢ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚɨɛɳɟɤɥɢɧɢɱɟɫɤɢɟɚɧɚɥɢɡɵɤɪɨɜɢɢɦɨɱɢ ɤɨɧɫɭɥɶɬɚɰɢɹ ɧɟɨɧɚɬɨɥɨɝɚ ɢɥɢ ɩɟɞɢɚɬɪɚ ɉɪɢ ɭɥɶɬɪɚɡɜɭɤɨɜɨɦɫɤɚɧɢɪɨɜɚɧɢɢɭɜɫɟɯɞɟɬɟɣɜɵɹɜ ɥɟɧɨ ɚɧɷɯɨɝɟɧɧɨɟ ɢɥɢ ɝɢɩɨɷɯɨɝɟɧɧɨɟ ɨɛɪɚɡɨ ɜɚɧɢɟ ɭ ɜɧɭɬɪɟɧɧɟɣ ɫɩɚɣɤɢ ɜɟɤ ɧɟ ɫɜɹɡɚɧɧɨɟ ɫ ɝɥɚɡɧɵɦɹɛɥɨɤɨɦɢɫɝɨɥɨɜɧɵɦɦɨɡɝɨɦɋɪɟɞɧɢɣ ɪɚɡɦɟɪɨɛɪɚɡɨɜɚɧɢɹɦɦ
Ɇɟɬɨɞɢɤɚ ɞɪɟɧɢɪɨɜɚɧɢɹ ɜ ɬɟɱɟɧɢɟ ɞɧɟɣ ɩɪɨɜɨɞɢɥɢɪɚɫɲɢɪɟɧɢɟɫɥɟɡɧɵɯɤɚɧɚɥɶɰɟɜɤɨɧɢ ɱɟɫɤɢɦɢɡɨɧɞɚɦɢɫɰɟɥɶɸɫɨɡɞɚɧɢɹɭɫɥɨɜɢɣɞɥɹ ɨɬɬɨɤɚ ɫɨɞɟɪɠɢɦɨɝɨ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɉɚɪɚɥ ɥɟɥɶɧɨ ɜɵɩɨɥɧɹɥɢ ɜɨɫɯɨɞɹɳɢɣ ɦɚɫɫɚɠ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚɞɥɹɭɦɟɧɶɲɟɧɢɹɟɝɨɨɛɴɟɦɚɢɨɛɥɟɝɱɟɧɢɹ ɩɨɩɚɞɚɧɢɹ ɜ ɧɟɝɨ ɚɧɬɢɛɢɨɬɢɤɚ ȼ ɞɚɥɶɧɟɣɲɟɦ ɭɞɚɥɹɥɢ ɫɨɞɟɪɠɢɦɨɟ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɩɭɬɟɦ ɟɝɨ ɩɪɨɦɵɜɚɧɢɹ ɧɚ ɞɟɧɶ ɪɚɫɬɜɨɪɨɦ ɚɧɬɢɛɢɨ ɬɢɤɚɨɮɥɨɤɫɚɰɢɧɛɟɡɡɨɧɞɢɪɨɜɚɧɢɹɧɨɫɨɫɥɟɡɧɨɝɨ ɤɚɧɚɥɚ
əɜɥɹɹɫɶ ɚɧɬɢɛɢɨɬɢɤɨɦ ɢɡ ɝɪɭɩɩɵ ɮɬɨɪɯɢɧɨ ɥɨɧɨɜ ɨɮɥɨɤɫɚɰɢɧ ɹɜɥɹɟɬɫɹ ɩɪɟɩɚɪɚɬɨɦ ɜɵɛɨɪɚ ɩɪɢ ɥɟɱɟɧɢɢ ɜɨɫɩɚɥɢɬɟɥɶɧɵɯ ɡɚɛɨɥɟɜɚɧɢɣ ɫɥɟɡɧɵɯ ɩɭɬɟɣ Ʉɪɨɦɟ ɬɨɝɨ ɩɨ ɞɚɧɧɵɦ ɥɢɬɟ ɪɚɬɭɪɵ ɩɪɢ ɟɝɨ ɩɪɢɦɟɧɟɧɢɢ ɧɟ ɨɬɦɟɱɟɧɨ ɫɢɫɬɟɦɧɵɯ ɩɨɛɨɱɧɵɯ ɷɮɮɟɤɬɨɜ ɱɬɨ ɞɚɟɬ ɜɨɡ ɦɨɠɧɨɫɬɶɢɫɩɨɥɶɡɨɜɚɬɶɟɝɨɜɩɟɞɢɚɬɪɢɢɜɬɱɭ ɧɨɜɨɪɨɠɞɟɧɧɵɯ>@
ɉɪɨɦɵɜɚɧɢɟ ɩɪɨɜɨɞɢɥɨɫɶ ɞɨ ɷɜɚɤɭɚɰɢɢ ɩɪɨɡɪɚɱɧɨɣ ɠɢɞɤɨɫɬɢ ɉɪɢ ɧɟɨɛɯɨɞɢɦɨɫɬɢ ɧɚ ɥɢɱɢɟɨɬɞɟɥɹɟɦɨɝɨɢɡɫɥɟɡɧɵɯɬɨɱɟɤɩɨɜɬɨɪɧɨɟ ɩɪɨɦɵɜɚɧɢɟɩɪɨɜɨɞɢɥɢɱɟɪɟɡɞɧɟɣ
ɊȿɁɍɅɖɌȺɌɕɂɂɏɈȻɋɍɀȾȿɇɂȿ
ɍ ɜɫɟɯ ɩɚɰɢɟɧɬɨɜ ɞɪɟɧɢɪɨɜɚɧɢɟ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚɨɤɚɡɚɥɨɫɶɭɫɩɟɲɧɵɦ±ɨɬɦɟɱɚɥɨɫɶɢɫɱɟɡ ɧɨɜɟɧɢɟ ɨɬɞɟɥɹɟɦɨɝɨ ɢɡ ɫɥɟɡɧɵɯ ɬɨɱɟɤ ɩɪɢ ɧɚ ɞɚɜɥɢɜɚɧɢɢ ɧɚ ɫɥɟɡɧɵɣ ɦɟɲɨɤ ɫɬɢɯɚɧɢɟ ɩɪɢɡ ɧɚɤɨɜ ɜɨɫɩɚɥɟɧɢɹ ɋɪɟɞɧɹɹ ɞɥɢɬɟɥɶɧɨɫɬɶ ɚɧɬɢ ɛɚɤɬɟɪɢɚɥɶɧɨɣɬɟɪɚɩɢɢɫɨɫɬɚɜɢɥɚɞɧɹ
ɍ ɪɟɛɟɧɤɚ ɫ ɧɟɨɫɥɨɠɧɟɧɧɵɦ Ⱦɐɐ ɱɟɪɟɡ ɧɟɞɟɥɢ ɩɨɫɥɟ ɜɬɨɪɨɝɨ ɞɪɟɧɢɪɨɜɚɧɢɹ ɜɨɡɧɢɤ ɪɟɰɢɞɢɜ ɡɚɛɨɥɟɜɚɧɢɹ ɱɬɨ ɩɨɬɪɟɛɨɜɚɥɨ ɜɵ ɩɨɥɧɟɧɢɹ ɡɨɧɞɢɪɨɜɚɧɢɹ Ɍɚɤɠɟ ɩɨɫɥɟ ɩɨɥɧɨɝɨ ɫɬɢɯɚɧɢɹ ɜɨɫɩɚɥɢɬɟɥɶɧɵɯ ɹɜɥɟɧɢɣ ɱɟɪɟɡ ɧɟɞɟɥɢɩɨɬɪɟɛɨɜɚɥɨɫɶɩɪɨɜɟɞɟɧɢɟɡɨɧɞɢɪɨɜɚɧɢɹ ɞɟɬɹɦɥɟɱɢɜɲɢɦɫɹɩɨɩɨɜɨɞɭɮɥɟɝɦɨɧɵɫɥɟɡ ɧɨɝɨ ɦɟɲɤɚ Ɍɚɤɢɦ ɨɛɪɚɡɨɦ ɧɟɨɛɯɨɞɢɦɨɫɬɶ ɜ ɡɨɧɞɢɪɨɜɚɧɢɢɧɨɫɨɫɥɟɡɧɨɝɨɤɚɧɚɥɚɜɨɡɧɢɤɥɚɭ ɞɟɬɟɣ ȼ ɪɟɝɪɟɫɫ Ⱦɐɐ ɧɚɫɬɭɩɢɥ ɫɚɦɨɫɬɨɹɬɟɥɶɧɨ ɱɬɨ ɫɨɝɥɚɫɭɟɬɫɹ ɫ ɞɚɧɧɵɦɢ ɥɢ ɬɟɪɚɬɭɪɵ>@
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Ɉɞɧɚɤɨɜɫɥɭɱɚɟɪɚɡɜɢɬɢɹɮɥɟɝɦɨɧɵɡɨɧɞɢɪɨ ɜɚɧɢɟ ɧɟɜɨɡɦɨɠɧɨ ɜ ɫɜɹɡɢ ɫ ɱɟɦ ɩɪɨɜɨɞɢɬɫɹ ɯɢɪɭɪɝɢɱɟɫɤɨɟɜɫɤɪɵɬɢɟɦɟɲɤɚɩɪɢɪɚɡɦɹɝɱɟɧɢɢ ɮɥɟɝɦɨɧɵɉɨɫɥɟɯɢɪɭɪɝɢɱɟɫɤɨɝɨɜɦɟɲɚɬɟɥɶɫɬɜɚ ɢɫɚɦɨɫɬɨɹɬɟɥɶɧɨɝɨɜɫɤɪɵɬɢɹɮɥɟɝɦɨɧɵɨɫɬɚɟɬɫɹ ɜɢɞɢɦɵɣ ɤɨɠɧɵɣ ɪɭɛɟɰ ɇɟ ɢɫɤɥɸɱɟɧɨ ɮɨɪɦɢɪɨɜɚɧɢɟɫɜɢɳɚɫɥɟɡɧɨɝɨɦɟɲɤɚȼɫɜɹɡɢɫ ɷɬɢɦ Ȼɨɛɪɨɜɨɣ ɇɎ Ⱦɟɦɛɨɜɟɰɤɨɣ Ⱥɇ ɞɥɹ ɥɟ ɱɟɧɢɹ ɮɥɟɝɦɨɧɨɡɧɨɝɨ ɞɚɤɪɢɨɰɢɫɬɢɬɚ ɧɨɜɨ ɪɨɠɞɟɧɧɵɯɛɵɥɪɚɡɪɚɛɨɬɚɧɦɟɬɨɞɞɪɟɧɢɪɨɜɚɧɢɹ ɫɥɟɡɧɨɝɨɦɟɲɤɚ>@
Ʉɚɤ ɩɨɤɚɡɵɜɚɟɬ ɧɚɲ ɨɩɵɬ ɞɪɟɧɢɪɨɜɚɧɢɟ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɷɮɮɟɤɬɢɜɧɨ ɧɟ ɬɨɥɶɤɨ ɩɪɢ ɮɥɟɝɦɨɧɟ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɧɨ ɢ ɩɪɢ ɥɟɱɟɧɢɢ Ⱦɐɐ ɱɬɨ ɨɛɴɹɫɧɹɟɬɫɹ ɦɟɯɚɧɢɡɦɨɦ ɪɚɡɜɢɬɢɹ ɞɚɧɧɨɣɩɚɬɨɥɨɝɢɢ
Ⱦɐɐ ɫɜɹɡɚɧɨ ɫ ɚɧɚɬɨɦɢɱɟɫɤɨɣ ɨɛɫɬɪɭɤɰɢɟɣ ɤɥɚɩɚɧɚ ɏɚɫɧɟɪɚ ɢ ɮɭɧɤɰɢɨɧɚɥɶɧɵɦ ɡɚɤɪɵɬɢɟɦ ɤɥɚɩɚɧɚ Ɋɨɡɟɧɦɸɥɥɟɪɚ ɋɯɟɦɚɬɢɱɟɫɤɨɟ ɢɡɨ ɛɪɚɠɟɧɢɟ ɫɥɟɡɨɨɬɜɨɞɹɳɢɯ ɩɭɬɟɣ >@ ɩɪɟɞ ɫɬɚɜɥɟɧɨɧɚɪɢɫɭɧɤɟ
ɄɅȱɇȱɑɇȺ
ɆȿȾɂɐɂɇȺ
Ⱥɧɚɬɨɦɢɹɫɥɟɡɨɨɬɜɨɞɹɳɢɯɩɭɬɟɣ
ɍɫɥɨɜɧɵɟɨɛɨɡɧɚɱɟɧɢɹ±ɫɤɥɚɞɤɢɤɥɚɩɚɧɵ±ɏɚɫɧɟɪɚ±ɏɭɲɤɟ±Ʌɢɝɬɚ±Ɋɨɡɟɧɦɸɥɥɟɪɚ±Ɏɨɥɶɬɰɚ±Ȼɨɯɞɚɥɟɤɚ± ɏɨɥɶɬɚ±Ʉɪɚɭɡɟ±Ɍɟɣɥɟɮɟɪɚ±ɧɢɠɧɹɹɧɨɫɨɜɚɹɪɚɤɨɜɢɧɚ
ɇɨɫɨɫɥɟɡɧɵɣ ɤɚɧɚɥ ɪɚɡɜɢɜɚɟɬɫɹ ɢɡ ɷɩɢɬɟ ɥɢɚɥɶɧɨɣɯɨɪɞɵɄɚɧɚɥɢɡɚɰɢɹɯɨɪɞɵɧɚɱɢɧɚɟɬɫɹ ɨɬ ɝɥɚɡɚ ɤ ɧɨɫɨɜɨɦɭ ɤɨɧɰɭ ɧɚ ɧɟɞɟɥɟ ɜɧɭɬɪɢɭɬɪɨɛɧɨɝɨ ɪɚɡɜɢɬɢɹ ȼ ɷɬɨ ɜɪɟɦɹ ɤɚɧɚɥ ɡɚɩɨɥɧɟɧ ɫɥɢɡɢɫɬɨɠɟɥɚɬɢɧɨɡɧɵɦɢ ɦɚɫɫɚɦɢ ɉɨɥɧɚɹ ɤɚɧɚɥɢɡɚɰɢɹ ɡɚɤɚɧɱɢɜɚɟɬɫɹ ɤ ɦɟɫ ɝɟɫɬɚɰɢɢ ɨɞɧɚɤɨ ɧɨɫɨɜɨɣ ɤɨɧɟɰ ɩɪɨɬɨɤɚ ɦɨɠɟɬ ɨɬɤɪɵɜɚɬɶɫɹ ɬɨɥɶɤɨ ɤ ɦɨɦɟɧɬɭ ɪɨɠɞɟɧɢɹ ɢɥɢ ɩɨɡɠɟ ɉɟɪɫɢɫɬɟɧɰɢɹ ɬɨɧɤɨɣ ɫɥɢɡɢɫɬɨɣ ɩɥɟɧɤɢ ɦɟɠɞɭ ɩɪɨɬɨɤɨɦ ɢ ɧɨɫɨɜɨɣ ɩɨɥɨɫɬɶɸ ± ɤɥɚɩɚɧ ɏɚɫɧɟɪɚ ± ɩɪɢɜɨɞɢɬ ɤ ɧɚɤɨɩɥɟɧɢɸ ɜ ɫɥɟɡɧɨɦ ɦɟɲɤɟɫɥɢɡɢɢɠɢɞɤɨɫɬɢɋɥɢɡɶɦɨɠɟɬɜɵɯɨɞɢɬɶ ɜ ɩɨɥɨɫɬɶ ɧɨɫɚ ɜɵɡɵɜɚɹ ɡɚɬɪɭɞɧɟɧɢɹ ɧɨɫɨɜɨɝɨ ɞɵɯɚɧɢɹ ɢ ɡɚɬɪɭɞɧɟɧɢɹ ɩɪɢ ɤɨɪɦɥɟɧɢɢ ɪɟɛɟɧɤɚ ɪɟɫɩɢɪɚɬɨɪɧɵɣɞɢɫɬɪɟɫɫɫɢɧɞɪɨɦ
Ⱦɪɭɝɨɣ ɤɥɚɩɚɧɧɵɣ ɦɟɯɚɧɢɡɦ ɜ ɩɪɨɤɫɢ ɦɚɥɶɧɨɦ ɨɬɞɟɥɟ ɤɥɚɩɚɧ Ɋɨɡɟɧɦɸɥɥɟɪɚ ɩɪɟɞ ɨɬɜɪɚɳɚɟɬ ɪɟɮɥɸɤɫ ɫɨɞɟɪɠɢɦɨɝɨ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɜ ɫɥɟɡɧɵɟ ɤɚɧɚɥɶɰɵ ɉɪɢ ɧɚɤɨɩɥɟɧɢɢ ɦɚɫɫ ɜ ɫɥɟɡɧɨɦ ɦɟɲɤɟ ɪɚɡɜɢɜɚɟɬɫɹ ɟɝɨ ɮɭɧɤ ɰɢɨɧɚɥɶɧɚɹɨɛɫɬɪɭɤɰɢɹ>@
Ɋɚɫɲɢɪɟɧɢɟ ɫɥɟɡɧɵɯ ɤɚɧɚɥɶɰɟɜ ɩɟɪɟɞ ɩɪɨɜɟ ɞɟɧɢɟɦ ɞɪɟɧɢɪɨɜɚɧɢɹ ɩɨɡɜɨɥɹɟɬ ɭɫɬɪɚɧɢɬɶ
ɫɬɟɧɨɡ ɤɥɚɩɚɧɚ Ɋɨɡɟɧɦɸɥɥɟɪɚ ɚ ɷɜɚɤɭɚɰɢɹ ɠɢɞɤɨɫɬɢ ɫɥɢɡɢ ɢ ɝɧɨɹ ɢɡ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɹɜɥɹɸɳɢɯɫɹ ɩɢɬɚɬɟɥɶɧɨɣ ɫɪɟɞɨɣ ɞɥɹ ɦɢɤɪɨ ɨɪɝɚɧɢɡɦɨɜ ɫɩɨɫɨɛɫɬɜɭɟɬ ɫɬɢɯɚɧɢɸ ɜɨɫɩɚɥɢ ɬɟɥɶɧɨɝɨ ɩɪɨɰɟɫɫɚ ɉɨɹɜɥɹɟɬɫɹ ɜɨɡɦɨɠɧɨɫɬɶ ɞɨɠɞɚɬɶɫɹ ɟɫɬɟɫɬɜɟɧɧɨɝɨ ɩɪɨɰɟɫɫɚ ɜɨɫɫɬɚ ɧɨɜɥɟɧɢɹ ɩɪɨɯɨɞɢɦɨɫɬɢ ɧɨɫɨɫɥɟɡɧɨɝɨ ɤɚɧɚɥɚ Ɍɨɥɶɤɨ ɜ ɫɥɭɱɚɟɜ ɬɪɟɛɭɟɬɫɹ ɛɨɥɟɟ ɚɝɪɟɫ ɫɢɜɧɨɟ ɜɦɟɲɚɬɟɥɶɫɬɜɨ Ɍɚɤɢɦ ɨɛɪɚɡɨɦ ɩɨ ɧɚ ɲɟɦɭ ɦɧɟɧɢɸ ɞɪɟɧɢɪɨɜɚɧɢɟ ɫɥɟɡɧɨɝɨ ɦɟɲɤɚ ɭ ɧɨɜɨɪɨɠɞɟɧɧɵɯ ɫ Ⱦɐɐ ɹɜɥɹɟɬɫɹ ɩɚɬɨɝɟɧɟɬɢ ɱɟɫɤɢ ɨɛɨɫɧɨɜɚɧɧɵɦ ɢ ɩɪɢɜɨɞɢɬ ɤ ɯɨɪɨɲɢɦ ɮɭɧɤɰɢɨɧɚɥɶɧɵɦɪɟɡɭɥɶɬɚɬɚɦɞɚɠɟɩɪɢɧɚɥɢɱɢɢ ɜɨɫɩɚɥɢɬɟɥɶɧɵɯɨɫɥɨɠɧɟɧɢɣ
ȼɕȼɈȾɕ
Ⱦɪɟɧɢɪɨɜɚɧɢɟɫɥɟɡɧɨɝɨɦɟɲɤɚɭɦɥɚɞɟɧɰɟɜ
ɫ ɞɚɤɪɢɨɰɢɫɬɨɰɟɥɟ ɹɜɥɹɟɬɫɹ ɩɚɬɨɝɟɧɟɬɢɱɟɫɤɢ ɨɛɨɫɧɨɜɚɧɧɵɦ ɢ ɜ ɩɨɡɜɨɥɹɟɬ ɞɨɫɬɢɝɧɭɬɶ ɯɨɪɨɲɢɯ ɮɭɧɤɰɢɨɧɚɥɶɧɵɯ ɪɟɡɭɥɶɬɚɬɨɜ ɛɟɡ ɩɪɨɜɟɞɟɧɢɹ ɡɨɧɞɢɪɨɜɚɧɢɹ ɜ ɬɨɦ ɱɢɫɥɟ ɩɪɢ ɩɪɢɫɨɟɞɢɧɟɧɢɢɮɥɟɝɦɨɧɵɫɥɟɡɧɨɝɨɦɟɲɤɚ
ȼ ɫɜɹɡɢ ɫ ɱɚɫɬɵɦ ɪɚɡɜɢɬɢɟɦ ɭ ɞɟɬɟɣ ɫ
ɥɟɱɟɧɢɟ ɠɟɥɚɬɟɥɶɧɨɩɪɨɜɨɞɢɬɶɤɚɤ ɦɨɠɧɨɪɚɧɶ ɲɟɩɨɫɥɟɟɝɨɜɵɹɜɥɟɧɢɹ
ȼɪɚɱɚɦ ɚɤɭɲɟɪɚɦɝɢɧɟɤɨɥɨɝɚɦ ɩɪɨɜɨɞɹ
ɳɢɦ ɭɥɶɬɪɚɡɜɭɤɨɜɨɟ ɨɛɫɥɟɞɨɜɚɧɢɟ ɛɟɪɟɦɟɧɧɵɯ ɚ ɬɚɤɠɟ ɧɟɨɧɚɬɨɥɨɝɚɦ ɢ ɩɟɞɢɚɬɪɚɦ ɫɥɟɞɭɟɬ
ɨɛɪɚɳɚɬɶɜɧɢɦɚɧɢɟɧɚɫɜɨɟɜɪɟɦɟɧɧɨɟɜɵɹɜɥɟɧɢɟ ɞɚɤɪɢɨɰɢɫɬɨɰɟɥɟ ɭ ɩɥɨɞɨɜ ɢ ɧɨɜɨɪɨɠɞɟɧɧɵɯ ɫ ɰɟɥɶɸ ɫɜɨɟɜɪɟɦɟɧɧɨɝɨ ɢɯ ɧɚɩɪɚɜɥɟɧɢɹ ɧɚ ɨɛɫɥɟɞɨɜɚɧɢɟɢɥɟɱɟɧɢɟ
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Ⱥɦɨɫɨɜȼɂ ɉɪɟɧɚɬɚɥɶɧɚɹ ɭɥɶɬɪɚɡɜɭɤɨɜɚɹ
ɞɢɚɝɧɨɫɬɢɤɚɞɚɤɪɢɨɰɢɫɬɨɰɟɥɟȼɂȺɦɨɫɨɜȾȼȼɨ ɪɨɧɢɧɆɇɄɨɪɥɹɤɨɜɚɅɭɱɟɜɚɹɞɢɚɝɧɨɫɬɢɤɚɢɬɟɪɚ ɩɢɹ±±Ɍʋ±ɋ
ȻɨɛɪɨɜɚɇɎȼɪɨɠɞɟɧɧɵɣɞɚɤɪɢɨɰɢɫɬɢɬɢɟɝɨ ɨɫɥɨɠɧɟɧɢɹ ɇɎȻɨɛɪɨɜɚ ȺɇȾɟɦɛɨɜɟɰɤɚɹ Ɉɮɬɚɥɶɦɨɥɠɭɪɧɚɥ±±ʋ±ɋ
Ȼɪɠɟɫɤɢɣȼȼ Ɉɫɨɛɟɧɧɨɫɬɢ ɚɧɬɢɛɚɤɬɟɪɢɚɥɶ ɧɨɣ ɬɟɪɚɩɢɢ ɜ ɤɨɦɩɥɟɤɫɧɨɦ ɥɟɱɟɧɢɢ ɞɟɬɟɣ ɫ ɞɚɤɪɢɨ ɰɢɫɬɢɬɨɦȼȼȻɪɠɟɫɤɢɣɌɇȼɨɪɨɧɰɨɜɚɆȼɆɢɯɚɣ ɥɨɜɚɄɥɢɧɢɱɨɮɬɚɥɶɦɨɥɨɝɢɹ±ʋ±ɋ
ȼɚɥɹɜɫɤɚɹɆȿɊɟɡɭɥɶɬɚɬɵɥɟɱɟɧɢɹɮɥɟɝɦɨɧɵ ɫɥɟɡɧɨɝɨɦɟɲɤɚɢɞɚɤɪɢɨɰɢɫɬɨɰɟɥɟɭɧɨɜɨɪɨɠɞɟɧɧɵɯ ɆȿȼɚɥɹɜɫɤɚɹȺȼɈɜɱɢɧɧɢɤɨɜɚȿɘɆɚɪɤɨɜɚ Ɉɮɬɚɥɶɦɨɥɨɝɢɹ±±Ɍʋ±ɋ±
ȼɢɬȼȼ ɋɬɪɨɟɧɢɟ ɡɪɢɬɟɥɶɧɨɣ ɫɢɫɬɟɦɵ ɱɟɥɨ ɜɟɤɚȼȼȼɢɬ±ɈɞɟɫɫɚȺɫɬɪɨɩɪɢɧɬ±ɫ
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.LP <+ /HH <- 6RQJ 0- +DQ %+ /HH <+ /HH .6 'DFU\RF\VWRFHOH RQ SUHQDWDO XOWUDVRQRJUDSK\ GLDJQRVLV DQG SRVWQDWDO RXWFRPHV 8OWUDVRQRJUDSK\
:LWWHUV-*-.HVWHO\Q36O\FNHQ69HUVWUDHWH$ $NHQ (+ 3UHQDWDO GLDJQRVLV RI GDFU\RF\VWRFHOH (\H
7DYDUHV /6+ *RQoDOYHV (' )HUUDUL 6-$ &RQ JHQLWDO GDFU\RF\VWRFHOH FDVH UHSRUW DQG WUHDWPHQW 5HYLVWD%UDVLOHLUDGH2IWDOPRORJLD
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