Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 1367 - файл
.pdf
81
https://t.me/med1917
*
*
*
*
*
*
*
*
*
*
$HDUICK* O>P™* \* ‘{£^KGHLJS<* ZJGJKEFGH`UefJS* LFGCSEICDEN* GJ`LHEHS* (q:* L*
`JLHDHYCDEH*CE*UGCLIS*”z¯°*L*XFGLdF*ji*VJDCL*bH`IH*
*
*
*****.JKHY*CaGJ`CY<*XC[UVFIIdF*GF`U[NEJEd*RFYCIDEGHGUeE*LC`YCbICDEN*IF*EC[NKC*
RHJMICDEHGCLJEN*(q:*XCDGFRDELCY*CXGFRF[FIHS*THECKHICLCMC*XGC_H[S*KJ[J<*IC*H*
XGCMIC`HGCLJEN* GJ`LHEHF* GJIIFMC* (q:* D* XCYCfNe* CXGFRF[FIHS* KCITFIEGJTHH*
THECKHICL*L*KJ[F* L*XFGLdF*RLCF*DUECK*bH`IH* ICLCGCbRFIICMC>*,CRFGbJIHF*œ„^h*
aC[FF* ]<QP* XMmY[<* œ„^i* aC[FF* ]<Qh* XMmY[<* ”z¯a* aC[FF* ]<Qh* XMmY[* DCCELFEDELUFE*
XGCMIC`HGUFYCYU*GJIIFYU*(q:>*
82
https://t.me/med1917
ГЛАВА 4. ЗАКЛЮЧЕНИЕ
*
*****=C[ICTFIICF* gIEFGJ[NICF* XHEJIHF* \* `J[CM* UDXFcICMC* LdZJbHLJIHS* M[UaCKC*
IFRCICcFIIdZ* RFEFW<* CaFDXFVHLJefFF* CGMJIH`Y* IFCaZCRHYdYH* XHEJEF[NIdYH*
LFfFDELJYH*R[S*GJ`LHEHS*EKJIFW*H*DHDEFY*CGMJIH`YJ<*LK[eVJS*IFGLIUe*DHDEFYU>*
$JIIFF* RCDEHbFIHF* XC[ICMC* q=* XC`LC[SFE* H`aFbJEN* CD[CbIFIHW<* DLS`JIIdZ* D*
DCDURHDEdY*RCDEUXCY<*XCaCVIdYH*g__FKEJYH*XJGFIEFGJ[NICMC* XHEJIHS<*DIH`HEN*
VJDECEU* GJ`LHEHS* HI_FKTHW>* :GCYF* gECMC<* gIEFGJ[NICF* XHEJIHF* SL[SFEDS*
YCRH_HTHGUFYdY*_JKECGCY*(q:*H*XC`RIFMC*IFCIJEJ[NICMC*DFXDHDJ*\*RLUZ*DJYdZ*
LJbIdZ* XGHVHI* `JaC[FLJFYCDEH* H* DYFGEICDEH* IFRCICcFIIdZ*
ICLCGCbRFIIdZŸPk™ >*(CLCGCbRFIIdF*RFEH<*XFGFIFDcHF*(q:<*VJfF*XCRLFGbFId*
HI_FKTHCIIdY* `JaC[FLJIHSY<* VJfF* GJ`LHLJeE* XCDEIJEJ[NIUe* `JRFGbKU*
_H`HVFDKCMC* H* IFGLIC^XDHZHVFDKCMC* GJ`LHEHS* GJ`LHEHS<* CaUD[CL[FIIUe*
RF_HTHECY* XCEGFa[FIHS* XHEJEF[NIdZ* LFfFDEL* L* GJIIFY* IFCIJEJ[NICY* XFGHCRF<*
HYFeE* aC[NcUe* LFGCSEICDEN* [FEJ[NICMC* HDZCRJ* H* HILJ[HRICDEHŸQ]<* Ph] >*
/dRF[FIHF* ICLCGCbRFIIdZ*LdDCKCMC* GHDKJ* GJ`LHEHS* (q:* XC`LC[SFE* XGCLCRHEN*
GJIIee*RHJMICDEHKU*H*DIH`HEN*VJDECEU*GJ`LHEHS*gECMC*`JaC[FLJIHSŸko >**
*****,CM[JDIC*GF`U[NEJEJY*IJcFMC*HDD[FRCLJIHS<*_JKECGJYH*GHDKJ*GJ`LHEHS*(q:*U*
IFRCICcFIIdZ* ICLCGCbRFIIdZ<* DCM[JDIC* GF`U[NEJEJY* IJcFMC* HDD[FRCLJIHS<*
SL[SeEDS—*MFDEJTHCIIdW*LC`GJDE*YFIFF*Qomk*IFRF[N<*YJDDJ*EF[J*YFIFF*ojk*M<*IH`KJS*
CTFIKJ* XC* cKJ[F* %XMJG* IJ* k* YHIUEF* bH`IH<* CEDUEDELHF* XGCLFRFIHS*
YH[KHIMJmCEDGCVFIICMC*XFGFbJEHS*XUXCLHId<*YFEJaC[HVFDKHW*JTHRC`*L*XFGLdF*PQ*
VJDCL*bH`IH<*XGCLCRHYdF*EGJID_U`HH*gGHEGCTHEDCRFGbJfHZ*KCYXCIFIECL*KGCLH>*
*****=C[UVFIIdF*IJYH*GF`U[NEJEd*DCM[JDUeEDS*D*GSRCY*HDD[FRCLJIHW<*XCDLSfFIIdZ*
CXGFRF[FIHe* _JKECGCL* GHDKJ* (q:>* (H`KJS* YJDDJ* EF[J* XGH* GCbRFIHH* H*
MFDEJTHCIIdW* LC`GJDE* SL[SeEDS* IJHaC[FF* VJDEC* UXCYHIJFYdY* `IJVHYdY*
XGCMICDEHVFDKHY* _JKECGCY* R[S* GJ`LHEHS* (q:* DGFRH* ICLCGCbRFIIdZ* L*
DCLGFYFIICW* [HEFGJEUGFŸQ] >* .JK<* KGUXIdF* KCMCGEIdF* HDD[FRCLJIHS* CXHDdLJeE*
DJYUe*LdDCKUe*VJDECEU*(q:*DGFRH*RFEFW*D*IH`KCW*YJDDCW*EF[J*XGH*GCbRFIHHŸPhP<*
83
https://t.me/med1917
PhQ <* J* MFDEJTHCIIdW* LC`GJDE* KJK* _JKECG* GHDKJ* IFCaZCRHYCDEH* ZHGUGMHVFDKCMC*
LYFcJEF[NDELJŸQQ >*
*****/*IJTHCIJ[NICY*HDD[FRCLJIHH*/F[HKCaGHEJIHH*VJDECEJ*(q:*DCDEJLH[J*PPs*U*
RFEFW<* GCbRFIIdZ* IJ* Qj^W* IFRF[F* aFGFYFIICDEH<* H* DIH`H[JDN* RC* ]<ks* U* RFEFW<*
–CRHLcHZDS* IJ* OP^W* I~RF[~* aFGFYFIICDEHŸQ™ >* qEC* HDD[FRCLJIHF* EJKbF*
XGCRFYCIDEGHGCLJ[C* XCLdcFIIdW* GHDK* GJ`LHEHS* (q:* IJ* _CIF* DIHbFIHS* §^
XCKJ`JEF[S*YJDDd*EF[J*XGH*GCbRFIHH*pDKCGGFKEHGCLJIICF*);—*P<Q™š*™ks*#4—*P<Po\
P<jO*IJ*KJbRUe*FRHIHTU*DIHbFIHS*YJDDd*EF[J*XGH*GCbRFIHH*XC*§^•ž€†~r>*:GUXICF*
IJTHCIJ[NICF* HDD[FRCLJIHF* L* ,;%* HYF[C* JIJ[CMHVIdF* GF`U[NEJEd* H*
XGCRFYCIDEGHGCLJ[C*XCLdcFIIdW*GHDK*DYFGEH*CE*(q:*IJ*_CIF*UYFINcFIHS*+/**H*
YJDDd* EF[J* XGH* GCbRFIHHŸPhQ >* =CYHYC* gECMC<* D* ULF[HVFIHFY* YJDDd* EF[J* XGH*
GCbRFIHH*IJ*P]]*M*GHDK*GJ`LHEHS*ZHGUGMHVFDKCMC*(q:*DIHbJFEDS*IJ*ksŸPhO >*=GH*
gECY* EC[NKC* L* oªPks* D[UVJFL* (q:* IJa[eRJFEDS* U* RCICcFIIdZ* H[H*
IFRCICcFIIdZ*RFEFW*YJDDCW*EF[J*XGH*GCbRFIHH*aC[FF*Pk]]*MŸPhj >*
*****,CM[JDIC* GF`U[NEJEJY<*XGCLFRFIIFMC* IJYH* JIJ[H`J<* _JKECGCY* GHDKJ* GJ`LHEHS*
(q:* aC[NcF* SL[SFEDS*YJžDJ* EF[J* XGH* GCbRFIHH*YFIFF* ojk* M* XGH* MFDEJTHCIICY*
LC`GJDEF*aC[FF*Qomk*IFRF[N<*VEC*DCCELFEDELUFE*P]s*XFGTFIEH[e*XC*cKJ[F*!FIECI*H*
DLHRFEF[NDELUFE* C* `JRFGbKF* GJ`LHEHS* X[CRJ>* qEC* DCM[JDUFEDS* D* GF`U[NEJEJYH*
HDD[FRCLJIHS* ¨•ž}* …>* ž* DCJLE><* XCRVFGKHLJefFMC* JDDCTHJTHe* (q:* H*
IFDCCELFEDELHS*YJDDd*EF[J*MFDEJTHCIICYU*LC`GJDEU*D*H[H*aF`*IJGUcFIHS*KGCLCECKJ*
L* JGEFGHSZ* X[CRJ* XGH* RCXX[FGCLDKCY* HDD[FRCLJIHHŸOP >* $SR* JLECGCL* LdRF[SFE*
CDCaUe* _CGYU* (q:* \* GJIIHW* (q:* D* IJVJ[CY* L* XFGLUe* IFRF[e* bH`IH<*
CaUD[CL[FIIdW* @/-$* H* MHXCKDHVFDKH^HcFYHVFDKHY* XCLGFbRFIHFY* KHcFVICW*
DEFIKH*LC*LGFYS*aFGFYFIICDEHŸPhk<*Phh >*/*KCMCGEF*ICLCGCbRFIIdZ<*LCcFRcHZ*L*
IJc*GFEGCDXFKEHLIdW*JIJ[H`<*XGFCa[JRJ[*(q:<*RHJMICDEHGCLJIIdW*L*XFGLdF*o\P]*
RIFW>* =C* RJIIdY* [HEFGJEUGd* U* Ph* s* XJTHFIECL* (q:* LC`IHKJFE* DGJ`U* XCD[F*
GCbRFIHSŸPho >* * =CYHYC* gECMC<* XC* RJIIdY* w€†|€‚* v>* D* DCJLE>* (q:<*
RHJMICDEHGCLJIIdW* L* XFGLdF* RLF* IFRF[H* bH`IH<* ZJGJKEFGH`UFEDS* ESbF[dY*
EFVFIHFY*H*VJfF*JDDCTHHGCLJI*ž*XCEGFaICDENe*L*ZHGUGMHVFDKCY*[FVFIHHHŸPhi *H*
[FEJ[NIdY* HDZCRCYŸPh™ >* 4YFIIC* R[S* gECW*KJEFMCGHH* ICLCGCbRFIIdZ* IJHaC[FF*
84
https://t.me/med1917
JKEUJ[FI* JIJ[H`* XGC^* H* XGCEHLCLCDXJ[HEF[NICMC* XGC_H[S* THECKHICL* KJ[J*
ICLCGCbRFIICMC<* CEGJbJefHW* XCLGFbRFIHF* H* JKEHLJTHe* LIUEGHUEGCaICMC*
LCDXJ[HEF[NICMC*XGCTFDDJ*L*KHcFVICW*DEFIKFŸPo] >*
*****=C[UVFIIdF*IJYH*GF`U[NEJEd*DCM[JDUeEDS*D*„~~*ˆ>*D*DCJLE><*KCECGdF*CEYFVJeE*
ULF[HVFIHF*VJDECEd*(q:*U*ICLCGCbR•IIdZ<*XFGFIFDcHZ*JD_HKDHe*XGH*GCbRFIHH*
DC* DECWKHYH* YFEJaC[HVFDKHYH* IJGUcFIHSYH* L* XFGLdF* oQ* VJDJ* bH`IHŸOo >* =C*
IJcHY* RJIIdY<* IJHaC[NcFF* `IJVFIHF* L* XGCMIC`HGCLJIHH* (q:* HYFFE*
YFEJaC[HVFDKHW*JTHRC`*D* LdGJbFIIdY*RF_HTHECY* CDICLJIHW*L*XFGLdF* PQ*VJDCL*
bH`IH*IFRCICcFIICMC*GFaFIKJ>*=C*RJIIdY*HDD[FRCLJIHS*{‚ƒ•‚*x>*D*DCJLE>*IH`KJS*
€TFIKJ*XC*cKJ[F*%XMJG*L*KCITF*k*YHIUEd*H*YJDDJ*EF[J*XGH*GCbRFIHH*YFIFF*ok]*M>*
JDDCTHHGCLJId* D* GHDKCY* GJ`LHEHS* (q:* H* XFG_CGJTHFW* DEFIKH* KHcFVIHKJŸjP >*
;HGCKC* HDXC[N`UFYdF* `JGUaFbIdF* cKJ[d<* CXGFRF[SefHF* XGHIJR[FbICDEN*
IFRCICcFIIdZ* ICLCGCbRFIIdZ* K* MGUXXF* GHDKJ* GJ`LHEHS* (q:<* XCYHYC*
MFDEJTHCIICMC* LC`GJDEJ* H* YJDDd* EF[J<* LK[eVJeE* CTFIKU* XC* cKJ[F* %XMJG* IJ* k*
YHIUEF*YFIFF*h*aJ[[CL*\*w••£Ž~ž“Ÿko *H*YFINcF*o*aJ[[CL*\*~zt£Ÿki >*
*****/[HSIHF* XGCLFRFIHS* CEDGCVFIICMC* XFGFbJEHS* XUXCLHId* IJ* VJDECEU* GJ`LHEHS*
(q:* L* IJDECSfFF* LGFYS* SL[SFEDS* RHDKUEJaF[NIdY>* =CD[FRIHW* YFEJ^JIJ[H`<*
XGCLFRFIIdW*”‡†‚€¤^…€†|}*…>*H*DCJLE><*IF*LdSLH[*`IJVHYCW*L`JHYCDLS`HŸPoP <*L*
EC*LGFYS*KJK*aC[FF*GJIIHW*YFEJ^JIJ[H`*XCKJ`J[*DCKGJfFIHF*VJDECEd*(q:*IJ*j]s*
XGH* HDXC[N`CLJIHH* EFZIC[CMHH* CEDGCVFIICMC* XFGFbJEHS* XUXCLHIdŸPoQ <* VEC*
DCM[JDUFEDS*D*IJcHYH*RJIIdYH>*
*****%DDCTHJTHS*EGJID_U`HH*q,:*H*GJ`LHEHS*(q:*cHGCKC*H`LFDEIJ>*)RIJKC<*RC*DHZ*
XCG*IF*CXGFRF[FIC<*VEC*SL[SFEDS*KCIKGFEIdY*XCLGFbRJefHY*_JKECGCY*\*JIFYHS<*
XFGF[HLJIHF* KCYXCIFIEJ* KGCLH* H[H* HZ* DCVFEJIHFŸPoO<* Poj >* $SR* K[HIHVFDKHZ*
HDD[FRCLJIHW* XCRELFGbRJFE*XCLdcFIIdW* GHDK* GJ`LHEHS*(q:* XCD[F* XGCLFRFIHS*
MFYCEGJID_U`HHŸjk<* jh <* CDCaFIIC* L* D[FRUefHF* ji* VJDCLŸPok <* VEC* IJc[C*
CEGJbFIHF* L* LdcFUKJ`JIIdZ* K[HIHVFDKHZ* cKJ[JZ* ~zt£Ÿki * H* w••£Ž~ž“Ÿko >*
=CD[FRUefHF* CacHGIdF* YFEJ^JIJ[H`d* CXGCLFGMJeE* RJIIUe* EFCGHeŸQQ<* Poh >*
0C[FF*ECMC<*XC*RJIIdY*‘‡}*ž*žCJLE>*EGJID_U`HS*q,:*DIHbJFE*GHDK*GJ`LHEHS*(q:*U*
ICLCGCbRFIIdZ* RFEFW*IJ* jksŸPoo <* J*tŠ‡¡}‡|* …>* ž* DCJLE>*CEYFEH[H* JIJ[CMHVICF*
85
https://t.me/med1917
DIHbFIHF* GHDKJ* GJ`LHEHS* (q:<* IC* EC[NKC* DGFRH* RFEFW* q(9.ŸPoi >* =C* IJcHY*
RJIIdY<* [eaJS* XGCLFRFIIJS* MFYCEGJID_U`HS* q,:* IF`JLHDHYC* CE* LGFYFIH* FF*
XGCLFRFIHS<* SL[SFEDS* _JKECGCY* GHDKJ* GJ`LHEHS* (q:<* ZCES* H* CVFIN*
IH`KCDXFTH_HVIdY>**
*****(q:* JDDCTHHGCLJI* D* IFDKC[NKHYH* MFYJEC[CMHVFDKHYH* H`YFIFIHSYH<* H*
IFKCECGdF*H`*gEHZ*H`YFIFIHW*YCMUE*IFDEH*LJbIUe*XGCMICDEHVFDKUe*HI_CGYJTHe>*
)RIJKC* [HEFGJEUGIdZ* RJIIdZ<* CXHDdLJefHZ* LC`YCbIUe* XGFRHKTHe* GJ`LHEHS*
(q:*XC*RJIIdY*K[HIHKC^[JaCGJECGICMC*CaD[FRCLJIHS*L*XFGLUe*IFRF[e*bH`IH<*L*
IJDECSfFF* LGFYS* IFRCDEJECVIC>* =GFCa[JRJIHFY* GJIIFMC* (q:* L* KCMCGEF*
HDD[FRCLJIIdZ* IJYH* ICLCGCbRFIIdZ* RFEFW* RF[JFE* LC`YCbIdY* LdRF[FIHF*
ICLCGCbRFIIdZ* MGUXXd* LdDCKCMC* GHDKJ* GJ`LHEHS* (q:*XC* RJIIdY* K[HIHVFDKHZ*
JIJ[H`CL* KGCLH<* LdXC[IFIIdZ* L* XFGLdF* oQ* VJDJ>* 4`* [JaCGJECGIdZ* XCKJ`JEF[FW*
YJKDHYJ[NICF* XGCMICDEHVFDKCF* `IJVFIHF* R[S* GJ`LHEHS* (q:* XC* RJIIdY*
XGCLFRFIICMC* IJYH* JIJ[H`J* YFECRCY* RFGFLJ* GFcFIHW* SL[SeEDS* UGCLFIN*
EGCYaCTHECL<*[FWKCTHECL*L*P*DUEKH*H*[HY_CTHECL*IJ*O^H*H*bH`IH>*
*****.GCYaCTHECXFIHS* SL[SFEDS* IJHaC[FF* H`LFDEIdY* H* RCKJ`JIIdY* XCKJ`JEF[FY<*
JDDCTHHGCLJIIdY* D* GJ`LHEHFY* (q:>* .JK* XC* RJIIdY* ŸPo™ y>* D* DCJLE>* U*
ICLCGCbRFIIdZ* D*(q:* CEYFVJFEDS* EGCYaCTHECXFIHS* p¥Pk]* ¹*P]9m[r* L* k]*^* ™ks>*
.CVIdW*YFZJIH`Y<*CalSDISefHW*GJ`LHEHF*EGCYaCTHECXFIHH*XGH*(q:*RC*DHZ*XCG*
IFSDFI<* IC* LFGCSEIFF* LDFMC* EGCYaCTHECXFIHS* CaUD[CL[FIJ* CaGJ`CLJIHFY*
YHKGCEGCYaCL*L*YHKGCTHGKU[SECGICY*GUD[F*XCLGFbRFIIdZ*EKJIFW*KHcFVIHKJ*XCR*
LC`RFWDELHFY*aJKEFGHJ[NIdZ*ECKDHICLŸPi] >*=C*RJIIdY*z‡¦‡žŽ}-‡‹‡¦*¼>*D*DCJLE>*
EGCYaCTHECXFIHS* `J* Qj* VJDJ* XGFRcFDELUFE* GJ`LHEHe* K[HIHVFDKHZ* XGCSL[FIHW*
(q:ŸPiP <*J*XC*GF`U[NEJEJY*HDD[FRCLJIHS*…‡Ž~•Ž¤‡†}*y>*D*DCJLE>**IJHaC[FF*VJDEC*
CEYFVJFEDS* DXUDES* Qj\oQ* VJDJ* XCD[F* YJIH_FDEJTHH* (q:ŸPo™ >* .SbFDEN*
EGCYaCTHECXFIHH* KCGGF[HGUFE* D* K[HIHVFDKCW* DEJRHFW* (q:<* J* adDEGCF* XJRFIHF*
VHD[J* EGCYaCTHECL* RC* ¥P]]¹P]
IFDXFTH_HVFDKHYr* XGFRHKECGCY* XFG_CGJTHH* H* ZHGUGMHVFDKCMC*
LYFcJEF[NDELJŸPiQ >*/*DLCFW*GJaCEF*tŠ¦€‚~}¦*y>*D*DCJLE>*XCKJ`J[<*VEC*DIHbFIHF*
UGCLIS*EGCYaCTHECL*L*EFVFIHF*XFGLCW*IFRF[H*bH`IH*IJ*O]s*RJbF*XGH*ICGYJ[NICY*
9
m[* SL[SFEDS* VULDELHEF[NIdY* pZCES* H*
86
https://t.me/med1917
UGCLIF*EGCYaCTHECL*DLS`JIC*D*ULF[HVFIHFY*VJDECEd*GJ`LHEHS*(q:* H*[FEJ[NICMC*
HDZCRJŸPiO >**
*****&HY_CXFIHS* H* [FWKCXFIHS<* LdSL[FIIdF* L* XFGLdF* oQ* VJDJ* bH`IH<* YCMUE*
DLHRFEF[NDELCLJEN* C* EFVFIHH* LGCbRFIICMC*ESbF[CMC*HI_FKTHCIICMC*XGCTFDDJ* H*
adEN* YJGKFGJYH* GJIIFMC* IFCIJEJ[NICMC* DFXDHDJŸPij >* $SR* HDD[FRCLJEF[FW*
XCRVFGKHLJFE* JDDCTHJTHe* GJIIFMC* IFCIJEJ[NICMC* DFXDHDJ* H* (q:<* L* XFGLUe*
CVFGFRN*GJIIFMC*(q:ŸPik<*Pih<*Pio >*„‡¦¡~†•*¨>*D*DCJLE>*CEYFEH[H<*VEC*[HY_CXFIHS*
¥j]]]mYK[>* L* XFGLdF* ji* VJDCL* XCD[F* IJVJ[J* `JaC[FLJIHS* JDDCTHHGCLJIJ* D*
_U[NYHIJIEdY*EFVFIHFY*(q:*H*[FEJ[NIdY*HDZCRCY>*/*HDD[FRCLJIHF*LCc[H*aC[FF*
k]]* RFEFW* D* RHJMIC`CY* (q:<* H`* KCECGdZ* Ok* ph<osr* HYF[H* _U[NYHIJIEICF*
EFVFIHFŸPii >*v‡‚•‡Š€‚~*ˆ>*D*DCJLE>*LdSLH[H*DIHbFIHF*UGCLIS*[HY_CTHECL*L*D[UVJF*
GJ`LHEHS*(q:<*EGFaUefFMC*ZHGUGMHVFDKCMC*[FVFIHS*ŸPi™ >*
*****(FWEGCXFIHS*L*IJVJ[F*`JaC[FLJIHS*IJa[eRJFEDS*XGH*ESbF[CY*(q:*H*DLS`JIJ*D*
aC[NcFW*X[CfJRNe*XCGJbFIHS*KHcFVIHKJ*H*ZHGUGMHVFDKHY*LYFcJEF[NDELCYŸPiO >*
‘‡ƒ‡§§}*u>*D*DCJLE>*CEYFEH[H<*VEC*IFWEGCXFIHS*LC*LGFYS*RFaeEJ*(q:*ad[J*DLS`JIJ*
D* IFa[JMCXGHSEIdY* HDZCRCY<* J* DCVFEJIHF* IFWEGCXFIHH* H* EGCYaCTHECXFIHH* FfF*
aC[NcF*UZURcJ[C*XGCMIC`ŸP™] >*
*****9ICMC*GJaCE*XCDLSfFIC*DIHbFIHe*UGCLIS*YCICTHECL*H*JDDCTHJTHH*LF[HVHId*
XJRFIHS*gECMC*UGCLIS*L*DCCELFEDELHH*D*ESbFDENe*EFVFIHS*(q:*H*XGCMIC`HGUFYdYH*
HDZCRJYH>**.JK*¨~•}†‡«•*u>*D*DCJLE>*CEYFVJeE*DIHbFIHF*UGCLIS*YCICTHECL*IJ*jPs*
XGH* (q:* Q* DEJRHH* H* IJ* iPs* XGH* (q:* O* DEJRHHŸP™P >* #JIIdW* [JaCGJECGIdW*
XCKJ`JEF[N*YJIH_FDEHGUFE*CRICLGFYFIIC*ž*K[HIHVFDKHYH*XGH`IJKJYH*`JaC[FLJIHS*
H*YCbFE*CXGFRF[SEN*XGCMIC`*ESbFDEH*(q:>**
*****4`* _JKECGCL* GHDKJ* GJIIFMC* IFCIJEJ[NICMC* XFGHCRJ* YCbFE* HYFEN* `IJVFIHF*
gIEFGJ[NIJS* IJMGU`KJ>* )afFH`LFDEIdY* H* RCKJ`JIIdY* _JKECGCY* GHDKJ* GJ`LHEHS*
(q:*SL[SFEDS* HDKUDDELFIICF*LDKJGY[HLJIHF<*CIC* XCVEH*LRLCF* ULF[HVHLJFE*GHDK*
GJ`LHEHS* (q:ŸkQ >* .JK* bF* IF* GFKCYFIRCLJIC* R[HEF[NICF* MC[CRJIHF* L* DLS`H* D*
GHDKCY* GJ`LHEHS* JEGC_HH* gXHEF[HJ[NIdZ* K[FECK* bF[URCVIC^KHcFVICMC*
EGJKEJŸP™Q >* :GCYF*gECMC<* GSR* GFEGCDXFKEHLIdZ* HDD[FRCLJIHW* CEYFVJ[H*L[HSIHF*
adDEGCMC* ULF[HVFIHS* CalFYJ* q=* IJ* VJDECEU* GJ`LHEHS* (q:ŸP™O<* P™j >* 0C[FF*
87
https://t.me/med1917
DCLGFYFIIdF* $:4* IF* LdSLH[H* XCRCaICW* JDDCTHJTHH<* H* CXGFRF[H[H* GSR*
XGFHYUfFDEL* _CGDHGCLJIICW* EJKEHKH*q=<* EJKHZ* KJK* DCKGJfFIHF* HDXC[N`CLJIHS*
XJGFIEFGJ[NICMC*XHEJIHS<*XCEGFaICDEH*L*TFIEGJ[NICY*LFIC`ICY*RCDEUXF*H*GHDKJ*
XC`RIHZ* HI_FKTHWŸo™<* ik >* =C* IJcHY* RJIIdY* DEJGECLdW* CalFY* gIEFGJ[NICMC*
XHEJIHS* H* CalFYd* DUECVICMC* ULF[HVFIHS* gIEFGJ[NICW* IJMGU`KH* IF* XCL[HS[H* IJ*
VJDECEU*(q:*XGH*XGCLFRFIHH*GFDEGCDXFKEHLICMC*JIJ[H`J>**
*****(FDYCEGS* IJ* `IJVHEF[NIdF* RCDEHbFIHS* IFCIJEC[CMHH<* YICMCCaGJ`HF*
XGCLFRFIIdZ* HDD[FRCLJIHW<* CEDUEDELUFE* KCIDFIDUD* L* CEICcFIHH* CXEHYJ[NICW*
DEGJEFMHH*gIEFGJ[NICMC*XHEJIHS<*CDCaFIIC*R[S*RFEFW*gKDEGFYJ[NICW*H*CVFIN*IH`KCW*
YJDDd* EF[J<* KJK* IJHaC[FF* US`LHYdZ* K* GJ`LHEHe* IFXFGFICDHYCDEH* gIEFGJ[NICW*
IJMGU`KH*H*(q:ŸiQ >**
*****,CM[JDIC* GF`U[NEJEJY* IJcFMC* XGCDXFKEHLICMC* YU[NEHTFIEGCLCMC*
GJIRCYH`HGCLJIICMC* HDD[FRCLJIHS* XGCMGJRHFIEICF* ULF[HVFIHF* CalFYJ*
gIEFGJ[NICMC* XHEJIHS* IJ* O]* Y[mKMmDUE* U* ICLCGCbRFIIdZ* RFEFW* MFDEJTHCIICMC*
LC`GJDEJ* YFIFF* OQm]* IFRF[N* DXCDCaDELUFE* aC[FF* adDEGCYU* RCDEHbFIHS* =q=<*
DCKGJfFIHe*XCEGFaICDEH*L*XCDEJICLKF*+/&<*IF*L[HSFE*IJ*VJDECEU*(q:>*
*****(JcH* RJIIdF* DCM[JDUeEDS* D* YFEJJIJ[H`CY* {||}~* u>* D* DCJLE><* CaCafJefFYU*
RJIIdF* Pj* K[HIHVFDKHZ* HDXdEJIHW<* LK[eVJLcHY* aC[FF* j]]]* RFEFW<*
RFYCIDEGHGUefHY*aF`CXJDICDEN*H*g__FKEHLICDEN*adDEGCMC*ULF[HVFIHF*q=*pO]\j]*
Y[mKMmDUErŸi] >* (JcF* HDD[FRCLJIHF* HYFFE* GSR* IFDCYIFIIdZ* XGFHYUfFDEL<*
CE[HVJefHZ*FMC*CE* aC[NcHIDELJ*JIJ[CMHVIdZ*HDD[FRCLJIHW>*/*XFGLUe*CVFGFRN<*
gEC*LK[eVFIHF*L*MGUXXd*HDD[FRCLJIHS*IFRCICcFIIdZ*ICLCGCbRFIIdZ*RFEFW*LIF*
`JLHDHYCDEH* CE* HZ* GFDXHGJECGICMC* H* MFYCRHIJYHVFDKCMC* DEJEUDJ>* #JIIdW* _JKE*
XC`LC[SFE* aC[FF* cHGCKC* gKDEGJXC[HGCLJEN* XC[UVFIIdF* RJIIdF* IJ* CafUe*
XCXU[STHe*ICLCGCbRFIIdZ>*
*****,[FRUefHY* LJbIdY* CE[HVHFY* SL[SFEDS* YHIHYJ[NIdW* DGCK* XFGHCRJ*
EGC_HVFDKCMC*XHEJIHS*H*GJDcHGFIHF*CalFYJ*gIEFGJ[NICW*IJMGU`KH*UbF*DC*LECGCMC*
RIS<*VEC*XC`LC[SFE*RF[JEN*LdLCR*C*aF`CXJDICDEH*EJKCW*EJKEHKH*ULF[HVFIHS*CalFYJ*
q=* L* XFGLdF* IFDKC[NKC* RIFW* XCD[F* GCbRFIHS>* /* EC* LGFYS* KJK<* * L* IJHaC[FF*
YJDcEJaICY* HDD[FRCLJIHH<* XCDLSfFIICY* H`UVFIHe* EFYXCL* ULF[HVFIHS*
88
https://t.me/med1917
gIEFGJ[NICW* IJMGU`KH* uœ¯”<* DGFRIHW* LC`GJDE* IJVJ[J* ULF[HVFIHS* CalFYJ* q=* H*
DCCELFEDELFIIC*LDEUX[FIHS*GFaFIKJ*L*HDD[FRCLJIHF*ad[*j*RISŸP™k >***
*****"fF* CRICW* UIHKJ[NICW* VFGECW* IJcFMC* HDD[FRCLJIHS* SL[SFEDS* DJYJ* YFECRHKJ*
XGCMGJRHFIEICMC* IJGJfHLJIHS* q=>* (FCRICKGJEICF* ULF[HVFIHF* L* EFVFIHF* DUECK*
CalFYJ* gIEFGJ[NICMC* XHEJIHS* UELFGbRFIC* L* DCDEJLF* IFKCECGdZ* XGCECKC[CL* H*
J[MCGHEYCL* GJDcHGFIHS* q=<* CRIJKC<* RJIIdZ* Ca* H`C[HGCLJIICY* L[HSIHH* gECW*
YFECRHKH*IJ*HDZCRd*U*M[UaCKC*IFRCICcFIIdZ*ICLCGCbRFIIdZ*IFE>*)E[HVHEF[NICW*
CDCaFIICDENe* XGFR[JMJFYCW* IJYH* XGCMGJRHFIEICW* DZFYd* IJGJfHLJIHS* q=*
SL[SFEDS*IF*EC[NKC*ULF[HVFIHF*CalFYJ*gIEFGJ[NICMC*XHEJIHS*L*KJbRCF*KCGY[FIHF*
pJ*IF*KJbRdF*Q^O*KCGY[FIHS*KJK*L* XGCECKC[F*Œ‘xyŸ™j <*£~Š~‚*‘>Ÿ™k <* KJbRdF*j*
KCGY[FIHS^**„~‡±*y>Ÿ™O <*h^PQ*VJDCL*\*uœ¯”*Q]PhŸP™k r<*IC*H*LC`YCbICDEN*GJDcHGSEN*
DUECVIdW*CalFY*gIEFGJ[NICMC*XHEJIHS*CE*P]*RC*O]*Y[mKMmDUE<*JRJXEHGUS*XGCMGJYYU*
K* HYFefFWDS* K[HIHVFDKCW* DHEUJTHH* H* HIRHLHRUJ[NICW* XFGFICDHYCDEH*
gIEFGJ[NICW*IJMGU`KH٪P >*
*****)RIHY*H`*IJHaC[FF*CbHRJFYdZ*g__FKECL*adDEGCMC*IJGJfHLJIHS*gIEFGJ[NICMC*
XHEJIHS*SL[SFEDS* DCKGJfFIHF* DGCKCL*RCDEHbFIHS* XC[ICMC* CalFYJ*q=>* /* IJcFY*
HDD[FRCLJIHH*XGCMGJRHFIEICF*ULF[HVFIHF*q=*IJ*O]*Y[mKMmDUE*XC`LC[H[C*RFESY*H`*
gECW*MGUXXd*RCDEHMIUEN*=q=*RCDECLFGIC*adDEGFF*IJ*O*H*PQ*RIFW<*VFY*L*RLUZ*RGUMHZ*
MGUXXJZ*DCCELFEDELFIIC>*Bae S.*:GCYF*ECMC<*RC[S*RFEFW<*RCDEHMcHZ*=q=*L*XFGLUe*
IFRF[e* bH`IH<* DCDEJLH[J* j]s* XC* DGJLIFIHe* D* ]s* L* RGUMHZ>* %IJ[CMHVIdF*
GF`U[NEJEd*ad[H*XC[UVFId*L*PP*HDD[FRCLJIHSZ<*L*KCECGdZ*GJ`IHTJ*YFbRU*DGCKJYH*
RCDEHbFIHS*=q=*DCDEJL[S[J*CE*]<k*RC*k<O*RIFWŸi] >**
*****=C* XC[UVFIIdY* IJYH* RJIIdY<* CEYFVJFEDS* DCKGJfFIHF* XCEGFaICDEH*
HDXC[N`CLJIHS* +/&* D* TF[Ne* XGCLFRFIHS* XJGFIEFGJ[NICMC* XHEJIHS* L* MGUXXF*
ICLCGCbRFIIdZ* +/* Qi\OQ* IFRF[H* YJDDCW* EF[J* YFIFF* Pk]]M><* VEC* YCbFE* HYFEN*
RCXC[IHEF[NICF* H* gKCICYHVFDKCF* `IJVFIHF>* /* MGUXXF* IFRCICcFIIdZ* RFEFW* +/*
YFIFF* Qi* IFRF[N* XC[UVFId* RCKJ`JEF[NDELJ* D[JaCW* DH[d* C* DCKGJfFIHH* DGCKCL*
HDXC[N`CLJIHS*6/:*L*MGUXXJZ*XGCMGJRHFIEICMC*IJGJfHLJIHS*q=*IJ*h*RIFW*H*=/:*
IJ*Ph*RIFW>*
89
https://t.me/med1917
*****%IJ[CMHVIdF* GF`U[NEJEd* XC[UVFId* L* HDD[FRCLJIHH* y¡|~Š^y§}§* u>* D* DCJLE>—*
XGCRC[bHEF[NICDEN* XJGFIEFGJ[NICMC* XHEJIHS* ad[J* KCGCVF* L* P<k* GJ`J* L* MGUXXF*
adDEGCMC* IJGJfHLJIHS* q=* ph<k* RI>* XC* DGJLIFIHe* ™<O* RI><* G¥]<]]PrŸP™h >* qEC*
DCM[JDUFEDS* D* RJIIdYH* u‡Ž‡* „>* D* DCJLE><* KCECGdF* CEYFEH[H* UYFINcFIHF*
R[HEF[NICDEH*HI_U`HCIICW*EFGJXHH*L*P<k*GJ`J*U*RFEFW*YJDDCW*EF[J*YFIFF*Pk]]*M>*H*
L*Q*GJ`J*R[S*RFEFW*YJDDCW*EF[J*Pk]]\Qk]]*M>*L*MGUXXF*_CGDHGCLJIICMC*IJGJfHLJIHS*
q=ŸP™o >*=C*RJIIdY*4CICLJ*)>/>*H*DCJLE>*adDEGCF*ULF[HVFIHF*CalFY*q=*XC`LC[H[C*
IJ*k*RIFW*DCKGJEHEN*LGFYS*HDXC[N`CLJIHS*6/:*H*L*Q*GJ`J*DCKGJEHEN*R[HEF[NICDEN*
_UIKTHCIHGCLJIHS*=/:Ÿ™] >**
*****,CKGJfFIHF* XCEGFaICDEH* H* R[HEF[NICDEH* HDXC[N`CLJIHS* LIUEGHLFIIdZ*
KJEFEFGCL*L*IJcFY*HDD[FRCLJIHH*IF*XGHLF[C*K*DIHbFIHe*IJ`IJVFIHS*JIEHaHCEHKCL*
GF`FGLJ*L*HDD[FRUFYdZ*MGUXXJZ>*
*****=C* RJIIdY*YHGCLCW* [HEFGJEUGd<*R[HEF[NICF* HDXC[N`CLJIHF*XJGFIEFGJ[NICMC*
XHEJIHS* JDDCTHHGCLJIC* D* GHDKCY* GJ`LHEHS* XC`RIFMC* IFCIJEJ[NICMC* DFXDHDJŸoP >*
9FEJJIJ[H`* {||}~* u>* D* DCJLE>* XCKJ`J[<* VEC* YFR[FIICF* ULF[HVFIHF* gIEFGJ[NICW*
IJMGU`KH* XGHLCRHE* K* RCXC[IHEF[NICYU* gXH`CRU* GJ`LHEHS* XC`RIFW* HI_FKTHH* U*
KJbRCMC*k]^MC*ICLCGCbRFIICMCŸi] >*qECE*LdLCR*IJcF[*CEGJbFIHF*L*GJaCEF*4CICLJ*
)>/>* D* DCJLE><* XCKJ`JLcFW<* VEC*aC[FF* adDEGCF* ULF[HVFIHF* CalFYJ*q=* XGHLF[C* K*
DIHbFIHe*L*P<k*GJ`J*VJDECEd*IJ`IJVFIHS*JIEHaHCEHKCL*GF`FGLJ*Ÿ™] >*
*****/* IJcFY* HDD[FRCLJIHH* XGCMGJRHFIEICF* IJGJfHLJIHF* q=* O]* Y[mKMmDUE* IF*
DCXGCLCbRJ[CDN*ULF[HVFIHFY*VJDECEd*GJ`LHEHS*(q:*H*RHDKHIF`HH*2:.>*=CYHYC*
gECMC<*IJYH*CTFIHLJ[JDN*DXCDCaICDEN*RFEFW*R[HEF[NIC*UDLJHLJEN*q=*aC[FF*P]]*H*
Ph]* Y[mKMmDUE<* D* TF[Ne* GFMHDEGJTHH* RJbF* YHIHYJ[NIdZ* XGCSL[FIHW*
HIEC[FGJIEICDEH* K* gIEFGJ[NICW* IJMGU`KF>* .JK<* XGCMGJRHFIEIdW* ZJGJKEFG*
IJGJfHLJIHS* CalFYJ* q=* XC`LC[H[* ULF[HVHEN* gEH* XCKJ`JEF[H* IJ* Q<k* H* j* RIS*
DCCELFEDELFIIC*DGFRH*ICLCGCbRFIIdZ*+/Qi^OQ*IFRF[H*YJDDCW*YFIFF*Pk]]M>*<*H*IJ*O*
H*PQ*RIFW*L*MGUXXF*+/*YFIFF*Qi*IFRF[N>*
/* [HEFGJEUGF* HYFeEDS* XGCEHLCGFVHLdF* RJIIdF* C* VJDECEF* LC`IHKICLFIHS*
HIEC[FGJIEICDEH* K* gIEFGJ[NICW* IJMGU`KF* H* (q:* L* `JLHDHYCDEH* CE* EFYXCL*
ULF[HVFIHS*q=>*.GJRHTHCIIC*DVHEJFEDS<*VEC*aC[NcHW*CalFY*ZUbF*UDLJHLJFEDS*H*
90
https://t.me/med1917
YCbFE*XGHLFDEH*K*DGdMHLJIHe<*L`RUEHe*bHLCEJ<*GJ`LHEHe*MJDEGCg`C_JMFJ[NICMC*
GF_[eKDJ*H*JDXHGJTHH<*HIEC[FGJIEICDEH*K*gIEFGJ[NICW*IJMGU`KH*H*(q:Ÿhj<*PQQ >*
=CD[FRIHW*YFEJJIJ[H`*{||}~*u>*D*DCJLE>*XCKJ`J[<*VEC*YFR[FIICF*ULF[HVFIHF*CalFYJ*
gIEFGJ[NICMC* XHEJIHS* IF* DIHbJFE* GHDK* (q:<* IC* YCbFE* ULF[HVHEN* GHDK*
IFXFGFICDHYCDEH* q=Ÿi] >* /* JIJ[H`F* •J‚ƒ* Œ>* D* DCJLE>* CEYFVFIC* UYFGFIICF*
DIHbFIHF*VJDECEd*(q:*H*IFXFGFICDHYCDEH*q=*L*MGUXXF*D*adDEGdY*IJGJfHLJIHFY*
q=ŸP™i <*VEC*EJK*bF*DCCEICDHEDS*D*GF`U[NEJEJYH*4CICLJ*)>/>ŸQ]] >**
*****/* EC* bF* LGFYS* …‡•€Š}* ¨>* ž* DCJLE>* L* DLCFW* GJaCEF<* CDICLJIICW* IJ* LECGHVICY*
JIJ[H`F* XGCDXFKEHLIdZ* HDD[FRCLJIHW* H`* h^H* ebICJYFGHKJIDKHZ* DEGJI<*
LK[eVJefHZ* aC[FF* PQ]]]* XJTHFIECL* YJDDCW* EF[J* XGH* GCbRFIHH* YFIFF* Pk]]* M><*
XCKJ`J[H<*VEC*YFR[FIICF*IJGJfHLJIHF*q=*DIHbJFE*GHDK*(q:Ÿih >*/*YFEJJIJ[H`F*
‘‡¦‡•¤‡¦‹* •>* D* DCJLE><* LK[eVJefFY* Oo* HDD[FRCLJIHW* H* aC[FF* hk]]*
ICLCGCbRFIIdZ* +/* YFIFF* OQ* IFRF[N<* JLECGd* XGHc[H* K* LdLCRU<* VEC* IJHaC[FF*
CXEHYJ[NICW*EJKEHKCW*D*IJHYFINcHY*GHDKCY*GJ`LHEHS*(q:*SL[SFEDS*FbFRIFLICF*
ULF[HVFIHF* q=* DC* DGFRIHY* CalFYCY* Q]\Qk* Y[mKMmDUE>* %IJ[H`* LECGHVIdZ*
GF`U[NEJECL* XCKJ`J[<* VEC* GFbHYd* KCGY[FIHS* D* CEICDHEF[NIC* aC[FF* GJIIHY*
IJVJ[CY<* YFINcHY* XFGHCRCY* EGC_HVFDKCMC* XHEJIHS* H* aC[NcHYH* EFYXJYH*
ULF[HVFIHS* q=* pO]\j]* Y[mKMmDUEr* ZJGJKEFGH`UeEDS* YFINcHY* GHDKCY*
HIEC[FGJIEICDEH* K* gIEFGJ[NICW* IJMGU`KFŸPk™ >* )RIJKC<* IH* CRHI* H`* GFbHYCL*
KCGY[FIHS<*H`UVFIIdZ*JLECGJYH<*IF*XGHLF[*K*[UVcHY*HDZCRJY*U*ICLCGCbRFIIdZ*
+/* YFIF*Q™* IFRF[N<* U* ICLCGCbRFIIdZ*D* CEDUEDELHFY* H[H* H`YFIFIHFY*KCIFVIdZ*
RHJDEC[HVFDKHZ* DKCGCDEFW* KGCLCECKJ* L* RCXX[FGCLDKHZ* HDD[FRCLJIHSZ* XUXCVICW*
JGEFGHH*X[CRJ*H*U*ICLCGCbRFIIdZ*H`*DEGJI*D*LdDCKHY*UGCLIFY*RCZCRJ>*
*****/* IJcFY* HDD[FRCLJIHH* L* MGUXXF* XGCMGJRHFIEICMC* ULF[HVFIHS* q=* IJ* O]*
Y[mKMmDUE*DGFRH*ICLCGCbRFIIdZ*+/*YFIFF*Qi*IFRF[N*VJDECEJ*(q:*ad[J*IHbF<*VFY*
L*RLUZ*RGUMHZ<*IC*GJ`IHTJ*ad[J*DEJEHDEHVFDKH*IFRCDECLFGIJ>*=GH*gECY<*L*MGUXXF*
XGCMGJRHFIEICMC*IJGJfHLJIHS*O]*Y[mKMmDUE*RCDECLFGIC*VJfF*CEYFVJ[HDN*`IJVHYdF*
YJEFGHIDKHF* _JKECGd* GHDKJ* \* ZCGHCJYIHCIHE* H* R[HEF[NIdW* aF`LCRIdW*
XGCYFbUECK>* =C* RJIIdY* [HEFGJEUGd* ZCGHCJYIHCIHE* L* O* GJ`J* ULF[HVHLJFE* GHDK*
GJ`LHEHS* (q:<* KJK*H* R[HEF[NIdW* aF`LCRIdW* XGCYFbUECKŸQQ >* .JKbF* IJ* VJDECEU*
Соседние файлы в папке @xirurgi_2025