Атлас макроскопической патологии человекa

ɧɵɦɢ ɬɪɚɜɦɚɬɢɱɟɫɤɢɦɢ ɩɨɜɪɟɠɞɟɧɢɹɦɢ, ɜɨɡɧɢɤɚɟɬ ɤɚɪɬɢɧɚ ^ɥɨɤɚɥɢɡɨɜɚɧɧɨɝɨ ɰɟɪɟɛɪɚɥɶɧɨɝɨ ɩɨɜɪɟɠɞɟɧɢɹ ɫ ɩɫɢɯɨɩɚɬɨɥɨɝɢɱɟɫɤɨɣ ɫɢɦɩɬɨɦɚɬɢɤɨɣ. Ʉɥɢɧɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ ɩɚɬɨɥɨɝɢɢ ɧɚɱɢɧɚɸɬ ɨɛɧɚɪɭɠɢɜɚɬɶɫɹ ɤɚɤ ɦɢɧɢɦɭɦ ɱɟɪɟɡ 4—6 ɦɟɫ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɟɬɫɹ ɫɤɨɩɥɟɧɢɟ ɤɪɨɜɢ ɦɟɠɞɭ ɬɜɟɪɞɨɣ ɢ ɦɹɝɤɢɦɢ ɦɨɡɝɨɜɵɦɢ ɨɛɨɥɨɱɤɚɦɢ. ɂɧɤɚɩɫɭɥɢɪɨɜɚɧɢɟ ɝɟɦɚɬɨɦɵ ɧɚɱɢɧɚɟɬɫɹ ɱɟɪɟɡ 72—96 ɱ

ɫɦɨɦɟɧɬɚ ɟɟ ɨɛɪɚɡɨɜɚɧɢɹ ɫɨ ɫɬɨɪɨɧɵ ɨɛɨɢɯɩɨɜɟɪɯɧɨɫɬɟɣ.

5.1.3.ɋɭɛɚɪɚɯɧɨɢɞɚɥɶɧɨɟ ɤɪɨɜɨɢɡɥɢɹɧɢɟ ɨɛɵɱɧɨ ɧɟ ɹɜɥɹɟɬɫɹ ɫɚɦɨɫɬɨɹɬɟɥɶɧɵɦ ɩɪɨɹɜɥɟɧɢɟɦ ɩɨɜɪɟɠɞɟɧɢɣ ɩɨɫɥɟ ɬɪɚɜɦɵ, ɚ, ɫɤɨɪɟɟ, ɫɨɩɭɬɫɬɜɭɟɬ ɞɪɭɝɢɦ ɤɥɢɧɢɱɟɫɤɢ ɢ ɦɨɪɮɨɥɨɝɢɱɟɫɤɢ ɛɨɥɟɟ ɬɹɠɟɥɵɦ ɫɨɫɬɨɹɧɢɹɦ.

5.1.4.Ʉɨɦɦɨɰɢɹɯɚɪɚɤɬɟɪɢɡɭɟɬɫɹ ɪɚɫɩɪɨɫɬɪɚɧɟɧɧɵɦ ɧɚɪɭɲɟɧɢɟɦ ɮɭɧɤɰɢɢ ɦɨɡɝɚ ɛɟɡ ɜɢɞɢɦɵɯ ɨɪɝɚɧɢɱɟɫɤɢɯ ɦɚɤɪɨɫɤɨɩɢɱɟɫɤɢɯ ɩɨɜɪɟɠɞɟɧɢɣ. Ɉɛɵɱɧɨ ɫɨɩɪɨɜɨɠɞɚɟɬɫɹ ɫɩɨɧɬɚɧɧɵɦ ɜɵɡɞɨɪɨɜɥɟɧɢɟɦ. ɉɚɬɨɝɟɧɟɡ ɤɨɦɦɨɰɢɢ ɞɨ ɤɨɧɰɚ ɧɟ ɢɡɭɱɟɧ, ɧɨ ɫɨɫɬɨɹɧɢɟ, ɜɟɪɨɹɬɧɟɟ ɜɫɟɝɨ, ɫɜɹɡɚɧɨ ɫ ɭɞɚɪɧɨɣ ɜɨɥɧɨɣ, ɜɨɡɧɢɤɚɸɳɟɣ ɜ ɪɟɡɭɥɶɬɚɬɟ ɬɪɚɜɦɵ, ɢ ɪɨɬɚɰɢɨɧɧɵɦ ɞɜɢɠɟɧɢɟɦ ɦɨɡɝɚ.

5.1.5.Ʉɨɧɬɭɡɢɹɹɜɥɹɟɬɫɹ ɭɲɢɛɨɦ ɦɨɡɝɨɜɨɣ ɬɤɚɧɢ ɜɫɥɟɞɫɬɜɢɟ ɭɞɚɪɚ ɨ ɤɚɥɶɜɚɪɢɭɦ. ɉɪɢ ɷɬɨɦ ɪɚɡɜɢɜɚɟɬɫɹ ɡɧɚɱɢɬɟɥɶɧɚɹ ɷɧɟɪɝɢɹ, ɫɩɨɫɨɛɧɚɹ ɩɨɜɪɟɠɞɚɬɶ ɫɨɫɭɞɵ ɦɢɤɪɨɰɢɪɤɭɥɹɰɢɢ ɫ ɢɯɪɚɡɪɵɜɨɦ. ɉɨɜɪɟɠɞɟɧɢɟ ɦɨɠɟɬ ɛɵɬɶ ɥɨɤɚɥɢɡɨɜɚɧɨ ɤɚɤ ɜ ɦɟɫɬɟ ɩɪɢɥɨɠɟɧɢɹ ɩɨɜɪɟɠɞɚɸɳɟɝɨ ɨɛɴɟɤɬɚ, ɬɚɤ ɢ ɧɚ ɩɪɨɬɢɜɨɩɨɥɨɠɧɨɣ ɫɬɨɪɨɧɟ ɜɟɳɟɫɬɜɚ ɦɨɡɝɚ (ɤɨɧɬɪɭɲɢɛ). ɇɚɢɛɨɥɟɟ ɱɭɜɫɬɜɢɬɟɥɶɧɵɦɢ ɦɟɫɬɚɦɢ ɹɜɥɹɸɬɫɹ ɥɨɛɧɵɟ (ɩɟɪɟɞɧɟ ɡɚɞɧɟɟ ɧɚɩɪɚɜɥɟɧɢɟ) ɢ ɜɢɫɨɱɧɵɟ (ɛɨɤɨɜɨɟ ɧɚɩɪɚɜɥɟɧɢɟ) ɞɨɥɢ. Ʉɥɢɧɢɱɟɫɤɢ ɯɚɪɚɤɬɟɪɢɡɭɟɬɫɹ ɩɨɬɟɪɟɣ ɫɨɡɧɚɧɢɹ ɫ ɜɨɡɦɨɠɧɵɦ ɫɩɨɧɬɚɧɧɵɦ ɜɵɡɞɨɪɨɜɥɟɧɢɟɦ, ɨɞɧɚɤɨ ɜ ɪɹɞɟ ɫɥɭɱɚɟɜ ɪɟɝɢɫɬɪɢɪɭɸɬɫɹ ɤɨɦɚ ɢ ɫɦɟɪɬɶ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɫɜɟɠɢɣ ɭɲɢɛ ɩɪɟɞɫɬɚɜɥɟɧ ɨɝɪɚɧɢɱɟɧɧɵɦ ɭɱɚɫɬɤɨɦ ɦɨɡɝɚ ɫ ɜɵɪɚɠɟɧɧɵɦ ɨɬɟɤɨɦ ɢ ɦɟɥɤɢɦɢ ɤɪɨɜɨɢɡɥɢɹɧɢɹɦɢ, ɚ ɫɬɚɪɚɹ ɤɨɧɬɭɡɢɹ —ɡɚɩɚɞɚɸɳɢɦ ɭɱɚɫɬɤɨɦ ɩɚɪɟɧɯɢɦɵ ɬɟɦɧɨ ɫɟɪɨɝɨ ɰɜɟɬɚ ɫ ɜɨɡɦɨɠɧɵɦ ɨɛɪɚɡɨɜɚɧɢɟɦ ɤɨɪ ɤɨɜɨ ɦɟɧɢɧɝɟɚɥɶɧɨɣ ɤɢɫɬɵ.

5.1.6.ɉɪɹɦɵɟ ɩɨɜɪɟɠɞɟɧɢɹ (ɪɚɡɦɨɡɠɟɧɢɹ) ɬɤɚɧɢ ɦɨɡɝɚ ɧɚɛɥɸɞɚɸɬɫɹ ɩɪɢ ɩɪɨɧɢɤɚɸɳɢɯ ɪɚɧɟɧɢɹɯ ɱɟɪɟɩɚ. Ʉɥɢɧɢɱɟɫɤɚɹ ɤɚɪɬɢɧɚ ɰɟɥɢɤɨɦ ɡɚɜɢɫɢɬ ɨɬ ɨɛɴɟɦɚ ɩɨɜɪɟɠɞɟɧɢɹ ɢ ɟɝɨ ɥɨɤɚɥɢɡɚɰɢɢ ɢ ɫɜɹɡɚɧɚ ɫ ɭɬɪɚɬɨɣ ɮɭɧɤɰɢɢ ɫɨɨɬɜɟɬɫɬɜɭɸɳɟɝɨ ɨɬɞɟɥɚ ɦɨɡɝɚ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɫɬɪɭɤɬɭɪɵ ɦɨɡɝɚ ɧɟ ɨɩɪɟɞɟɥɹɸɬɫɹ, ɬɤɚɧɶ ɜ ɨɛɥɚɫɬɢ ɩɨɜɪɟɠɞɟɧɢɹ ɪɵɯɥɚɹ, ɱɚɫɬɨ ɩɪɟɞɫɬɚɜɥɟɧɚ ɧɚ ɜɫɟɦ ɩɪɨɬɹɠɟɧɢɢ ɞɟɬɪɢɬɨɦ.

5.2.Ɍɪɚɜɦɚɫɩɢɧɧɨɝɨɦɨɡɝɚ. Ʉɪɨɜɨɢɡɥɢɹɧɢɹ ɜ ɦɹɝɤɢɟ ɨɛɨɥɨɱɤɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɤɚɤ ɫɚɦɨɫɬɨɹɬɟɥɶɧɚɹ ɩɚɬɨɥɨɝɢɹ ɜɫɬɪɟɱɚɸɬɫɹ ɞɨɜɨɥɶɧɨ ɪɟɞɤɨ, ɧɨ ɦɨɝɭɬ ɫɨɩɪɨɜɨɠɞɚɬɶ ɜɧɭɬɪɢɱɟɪɟɩɧɵɟ ɫɭɛɞɭ ɪɚɥɶɧɵɟ ɤɪɨɜɨɢɡɥɢɹɧɢɹ. ɗɩɢɞɭɪɚɥɶɧɵɟ ɤɪɨɜɨɢɡɥɢɹɧɢɹ ɨɛɵɱɧɨ ɜɨɡɧɢɤɚɸɬ ɩɨɫɥɟ ɩɟɪɟɥɨɦɨɜ ɩɨɡɜɨɧɤɨɜ. Ʉɨɧɬɭɡɢɹ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɜɫɬɪɟɱɚɟɬɫɹ ɡɧɚɱɢɬɟɥɶɧɨ ɪɟɠɟ, ɱɟɦ ɝɨɥɨɜɧɨɝɨ. Ʉɥɢɧɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɟɬɫɹ ɩɚɪɚɥɢɱ ɤɚɭɞɚɥɶɧɟɟ ɦɟɫɬɚ ɬɪɚɜɦɵ. ɋɩɨɧɬɚɧɧɚɹ ɪɟɦɢɫɫɢɹ ɧɚɛɥɸɞɚɟɬɫɹ ɜ ɩɨɞɚɜɥɹɸɳɟɦ ɛɨɥɶɲɢɧɫɬɜɟ ɫɥɭɱɚɟɜ. Ƚɟɦɚ ɬɨɦɢɟɥɢɹ ɹɜɥɹɟɬɫɹ ɪɟɡɭɥɶɬɚɬɨɦ ɪɟɡɤɨɝɨ ɫɝɢɛɚɧɢɹ/ ɪɚɡɝɢɛɚɧɢɹ ɩɨɡɜɨɧɨɱɧɨɝɨ ɫɬɨɥɛɚ ɢɥɢ ɬɹɠɟɥɨɣ ɧɟɩɪɨɧɢɤɚɸɳɟɣ ɬɪɚɜɦɵ. Ɉɬɦɟɱɚɟɬɫɹ ɨɬɫɭɬɫɬɜɢɟ ɬɟɦɩɟɪɚɬɭɪɧɨɣ ɢ ɛɨɥɟɜɨɣ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɢ ɤɚɭɞɚɥɶɧɟɟ ɭɪɨɜɧɹ ɤɪɨɜɨɢɡɥɢɹɧɢɹ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɛɧɚɪɭɠɢɜɚɟɬɫɹ ɤɪɨɜɨɢɡɥɢɹɧɢɟ ɜ ɫɩɢɧɧɨɣ ɦɨɡɝ, ɱɚɳɟ ɜ ɡɚɞɧɢɯ ɢ ɥɚɬɟɪɚɥɶɧɵɯ ɪɨɝɚɯ, ɫ ɬɟɧɞɟɧɰɢɟɣ ɪɚɫɩɪɨɫɬɪɚɧɟɧɢɹ ɤɚɤ ɜ ɤɪɚɧɢɚɥɶɧɨɦ, ɬɚɤ ɢ ɜ ɞɢɫɬɚɥɶɧɨɦ ɧɚɩɪɚɜɥɟɧɢɹɯ.

Ʉɨɦɩɪɟɫɫɢɹ ɢ ɤɨɧɬɭɡɢɹ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɹɜɥɹɟɬɫɹ ɪɟɡɭɥɶɬɚɬɨɦ ɞɢɫɩɨɡɢɰɢɢ ɩɨɡɜɨɧɤɨɜ ɢ ɱɚɳɟ ɨɩɪɟɞɟɥɹɟɬɫɹ ɜ ɧɢɠɧɟɣ ɲɟɣɧɨɣ ɱɚɫɬɢ ɩɨɡɜɨɧɨɱɧɢɤɚ ɜ ɫɜɹɡɢ ɫ ɨɫɬɪɵɦ ɮɨɪɫɢɪɨɜɚɧɧɵɦ ɫɝɢɛɚɧɢɟɦ ɝɨɥɨɜɵ ɢ ɲɟɢ, ɱɬɨ ɱɚɳɟ ɜɫɟɝɨ ɧɚɛɥɸɞɚɟɬɫɹ ɩɪɢ ɞɨɪɨɠɧɨ ɬɪɚɧɫɩɨɪɬɧɵɯ ɩɪɨɢɫɲɟɫɬɜɢɹɯ, ɥɢɛɨ ɜ ɧɢɠɧɟɦ ɝɪɭɞɧɨɦ/ ɩɨɹɫɧɢɱɧɨɦ ɨɬɞɟɥɚɯ, ɱɬɨ ɛɨɥɟɟ ɯɚɪɚɤɬɟɪɧɨ ɞɥɹ ɩɚɞɟɧɢɹ.

ɉɪɹɦɵɟ ɩɨɜɪɟɠɞɟɧɢɹ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɜɨɡɧɢɤɚɸɬ ɩɪɢ ɩɪɨɧɢɤɚɸɳɟɣ ɬɪɚɜɦɟ ɢ ɜɫɬɪɟɱɚɸɬɫɹ ɡɧɚɱɢɬɟɥɶɧɨ ɪɟɠɟ, ɱɟɦ ɚɧɚɥɨɝɢɱɧɵɟ ɩɨɜɪɟɠɞɟɧɢɹ ɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ.

Ɋɢɫ. 12.47. Ɇɧɨɠɟɫɬɜɟɧɧɵɣ(ɪɚɫɫɟɹɧɧɵɣ) ɫɤɥɟɪɨɡ

6. ȾȿɆɂȿɅɂɇɂɁɂɊɍɘɓɂȿ ɂ ȾȿȽȿɇȿɊȺɌɂȼɇɕȿ ȻɈ-

ɅȿɁɇɂ. ɉɪɢ ɞɟɦɢɟɥɢɧɢɡɢɪɭɸɳɢɯ ɛɨɥɟɡɧɹɯ ɢ ɫɨɫɬɨɹɧɢɹɯ ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɩɨɪɚɠɚɟɬɫɹ ɛɟɥɨɟ ɜɟɳɟɫɬɜɨ ɦɨɡɝɚ. Ⱦɟɫɬɪɭɤɰɢɹ ɦɢɟɥɢɧɚ, ɤɨɬɨɪɚɹ ɹɜɥɹɟɬɫɹ ɧɚɢɛɨɥɟɟ ɯɚɪɚɤɬɟɪɧɨɣ ɱɟɪɬɨɣ ɷɬɢɯ ɩɪɨɰɟɫɫɨɜ, ɜ ɛɨɥɶɲɟɣ ɢɥɢ ɦɟɧɶɲɟɣ ɫɬɟɩɟɧɢ ɫɨɩɪɨɜɨɠɞɚɟɬɫɹ ɩɨɬɟɪɟɣ ɚɤɫɨɧɨɜ ɢ ɨɬɫɪɨɱɟɧɧɵɦ (ɩɨɡɞɧɢɦ) ɧɟɤɪɨɡɨɦ ɞɪɭɝɢɯ ɧɟɣɪɨɧɚɥɶ ɧɵɯ ɢ ɝɥɢɚɥɶɧɵɯ ɫɬɪɭɤɬɭɪ.

ɉɪɢ ɞɟɝɟɧɟɪɚɬɢɜɧɵɯ ɛɨɥɟɡɧɹɯ ɧɟɣɪɨɧɚɥɶɧɵɟ ɫɬɪɭɤɬɭɪɵ ɩɨɜɪɟɠɞɚɸɬɫɹ ɩɟɪɜɢɱɧɨ, ɜɨɜɥɟɤɚɹ ɨɞɧɭ ɢɥɢ ɧɟɫɤɨɥɶɤɨ ɪɚɡɥɢɱɧɵɯ ɦɨɪɮɨɮɭɧɤɰɢɨɧɚɥɶɧɵɯ ɝɪɭɩɩ.

ɇɚ ɫɟɝɨɞɧɹɲɧɢɣ ɞɟɧɶ ɦɧɨɝɢɟ ɜɨɩɪɨɫɵ ɷɬɢɨɩɚɬɨɝɟɧɟɡɚ ɹɜɥɹɸɬɫɹ ɧɟɢɡɭɱɟɧɧɵɦɢ, ɨɞɧɚɤɨ ɱɚɫɬɶ ɛɨɥɟɡɧɟɣ ɷɬɢɯ ɝɪɭɩɩ ɢɦɟɟɬ ɜɵɪɚɠɟɧɧɵɣ ɚɭɬɨɢɦɦɭɧɧɵɣ ɯɚɪɚɤɬɟɪ. ɉɪɨɝɪɟɫɫɢɪɭɸɳɚɹ ɦɭɥɶɬɢ ɮɨɤɚɥɶɧɚɹ ɥɟɣɤɨɷɧɰɟɮɚɥɨɞɢɫɬɪɨɮɢɹ (ɫɦ. ɪɚɡɞ. 3.2.5 ɧɚɫɬɨɹɳɟɣ ɝɥɚɜɵ) ɹɜɥɹɟɬɫɹ ɞɟɦɢɟɥɢɧɢɡɢɪɭɸɳɢɦ ɡɚɛɨɥɟɜɚɧɢɟɦ ɜɢɪɭɫɧɨɣ ɷɬɢɨɥɨɝɢɢ.

6Ʌ. Ɇɧɨɠɟɫɬɜɟɧɧɵɣ (ɪɚɫɫɟɹɧɧɵɣ) ɫɤɥɟɪɨɡ (G 35). Ȼɨɥɟɡɧɶ ɜ ɨɫɧɨɜɧɨɦ ɩɨɪɚɠɚɟɬ ɥɢɰ ɦɨɥɨɞɨɝɨ ɜɨɡɪɚɫɬɚ (20—40 ɥɟɬ). Ʉɥɢɧɢɱɟɫɤɢ ɫɢɦɩɬɨɦɵ ɞɨɫɬɚɬɨɱɧɨ ɪɚɡɧɨɨɛɪɚɡɧɵ ɜ ɫɜɹɡɢ ɫ ɦɧɨɝɨ ɨɱɚɝɨɜɨɫɬɶɸ ɩɨɜɪɟɠɞɟɧɢɣ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ, ɢɯ ɢɧɬɟɧɫɢɜɧɨɫɬɶ ɜɟɫɶɦɚ ɜɚɪɢɚɛɟɥɶɧɚ ɢ ɡɚɜɢɫɢɬ ɨɬ ɪɚɡɦɟɪɨɜ ɢ ɤɨɥɢɱɟɫɬɜɚ ɨɱɚɝɨɜ. ɇɚɱɚɥɨ ɛɨɥɟɡɧɢ ɱɚɳɟ ɦɟɞɥɟɧɧɨɟ, ɜ ɜɢɞɟ ɩɨɫɬɟɩɟɧɧɨɝɨ ɧɚɪɚɫɬɚɧɢɹ ɧɟɜɪɨɥɨɝɢɱɟɫɤɢɯ ɧɚɪɭɲɟɧɢɣ, ɧɨ ɦɨɠɟɬ ɛɵɬɶ ɢ ɨɫɬɪɵɦ (ɜ ɬɟɱɟɧɢɟ ɧɟɫɤɨɥɶɤɢɯ ɱɚɫɨɜ ɢɥɢ ɫɭɬɨɤ). Ⱦɥɹ ɤɥɢɧɢɱɟɫɤɨɝɨ ɤɭɪɫɚ ɯɚɪɚɤɬɟɪɧɵ ɫɦɟɧɹɸɳɢɟ ɞɪɭɝ ɞɪɭɝɚ ɩɟɪɢɨɞɵ ɪɟɦɢɫɫɢɣ ɢ ɨɛɨɫɬɪɟɧɢɣ. ȼ ɯɨɞɟ ɩɪɨɝɪɟɫɫɢɪɨɜɚɧɢɹ ɛɨɥɟɡɧɢ ɨɛɵɱɧɨ ɨɬɦɟɱɚɟɬɫɹ ɤɭɦɭɥɹɬɢɜɧɵɣ ɷɮɮɟɤɬ ɩɨɜɪɟɠɞɟɧɢɣ, ɜɟɞɭɳɢɯ ɤ ɪɚɡɜɢɬɢɸ ɫɬɨɣɤɢɯ ɮɭɧɤɰɢɨɧɚɥɶɧɵɯ ɧɚɪɭɲɟɧɢɣ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɜ ɛɟɥɨɦ ɜɟɳɟɫɬɜɟ ɤɚɤ ɝɨɥɨɜɧɨɝɨ, ɬɚɤ ɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɨɩɪɟɞɟɥɹɸɬɫɹ ɦɧɨɠɟɫɬɜɟɧɧɵɟ ɮɨɤɭɫɵ ɞɟɦɢɟɥɢɧɢɡɚɰɢɢ, ɢɥɢ «ɛɥɹɲɤɢ», ɬɟɦɧɨ ɫɟɪɨɝɨ ɰɜɟɬɚ, ɨɤɪɭɝɥɨɣ ɢɥɢ ɨɜɚɥɶɧɨɣ ɮɨɪɦɵ, ɜ ɫɪɟɞɧɟɦ ɨɤɨɥɨ 6 ɦɦ ɜ ɞɢɚɦɟɬɪɟ, ɱɟɬɤɨ ɨɬɝɪɚɧɢɱɟɧɧɵɟ ɨɬ ɨɤɪɭɠɚɸɳɟɣ ɬɤɚɧɢ (ɪɢɫ. 12.47).

6.2.Ʌɟɣɤɨɞɢɫɬɪɨɮɢɢ — ɷɬɨ ɩɚɬɨɥɨɝɢɱɟɫɤɢɟ ɩɪɨɰɟɫɫɵ, ɫɜɹɡɚɧɧɵɟ ɫ ɞɟɮɟɤɬɚɦɢ ɦɟɬɚɛɨɥɢɡɦɚ ɦɢɟɥɢɧɚ, ɩɪɨɹɜɥɹɸɳɢɟɫɹ ɥɢɛɨ ɜ ɧɟɩɪɚɜɢɥɶɧɨɦ ɟɝɨ ɮɨɪɦɢɪɨɜɚɧɢɢ, ɥɢɛɨ ɜ ɢɧɬɟɧɫɢɜɧɨɦ ɪɚɫɩɚɞɟ. Ⱦɚɧɧɵɟ ɫɢɧɞɪɨɦɵ ɹɜɥɹɸɬɫɹ ɧɚɫɥɟɞɫɬɜɟɧɧɵɦɢ ɢ ɯɚɪɚɤɬɟɪɢɡɭɸɬɫɹ ɨɱɟɧɶ ɜɵɫɨɤɨɣ ɞɟɬɫɤɨɣ ɫɦɟɪɬɧɨɫɬɶɸ. ɉɪɢɦɟɪɨɦ ɦɨɠɟɬ ɫɥɭɠɢɬɶ ɛɨɥɟɡɧɶ Ʉɪɚɛɛɟ (ȿ75.2), ɩɪɢ ɤɨɬɨɪɨɣ ɰɟɪɟɛɪɨɡɢɞ ɦɢɟɥɢɧɚ ɢɦɟɟɬ ɞɟɮɟɤɬɧɭɸ ɫɬɪɭɤɬɭɪɭ ɢ ɚɤɤɭɦɭɥɢɪɭɟɬɫɹ ɜ ɪɚɡɥɢɱɧɵɯ ɨɬɞɟɥɚɯ ɧɟɣɪɨɧɨɜ ɢ ɝɥɢɢ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɚɹ ɤɚɪɬɢɧɚ ɧɟɫɩɟɰɢɮɢɱɧɚ.

6.3.Ⱥɦɢɨɬɪɨɮɢɱɟɫɤɢɣ ɥɚɬɟɪɚɥɶɧɵɣ ɫɤɥɟɪɨɡ (G12.2). ɏɪɨɧɢɱɟ-

ɫɤɨɟ ɡɚɛɨɥɟɜɚɧɢɟ, ɜɨɜɥɟɤɚɸɳɟɟ ɜɟɪɯɧɢɟ ɢ ɧɢɠɧɢɟ ɦɨɬɨɪɧɵɟ

ɧɟɣɪɨɧɵ ɝɨɥɨɜɧɨɝɨ ɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ɑɚɳɟ ɜɫɬɪɟɱɚɟɬɫɹ ɭ ɦɭɠɱɢɧ ɜ ɜɨɡɪɚɫɬɟ 40—50 ɥɟɬ. Ʉɥɢɧɢɱɟɫɤɢ ɛɨɥɟɡɧɶ ɩɪɟɞɫɬɚɜɥɟɧɚ ɫɥɚɛɨɫɬɶɸ ɫ ɩɨɫɥɟɞɭɸɳɟɣ ɜɢɞɢɦɨɣ ɚɬɪɨɮɢɟɣ ɦɵɲɰ ɤɨɧɟɱɧɨɫɬɟɣ. Ȼɨɥɟɡɧɶ ɹɜɥɹɟɬɫɹ ɫɦɟɪɬɟɥɶɧɨɣ ɜ ɬɟɱɟɧɢɟ 2—3 ɥɟɬ ɜ ɫɜɹɡɢ ɫ ɞɵɯɚɬɟɥɶɧɵɦ ɩɚɪɚɥɢɱɨɦ ɢ ɜɬɨɪɢɱɧɨɣ ɢɧɮɟɤɰɢɟɣ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɚɹ ɤɚɪɬɢɧɚɧɟɫɩɟɰɢɮɢɱɧɚ.

6.4.Ⱦɟɬɫɤɚɹ ɫɩɢɧɚɥɶɧɚɹ ɦɵɲɟɱɧɚɹ ɚɬɪɨɮɢɹ ȼɟɪɞɧɢɝɚ—Ƚɨɮɮ ɦɚɧɚ (ɢɧɮɚɧɬɢɥɶɧɚɹ ɫɩɢɧɚɥɶɧɚɹ ɦɵɲɟɱɧɚɹ ɚɬɪɨɮɢɹ) (G12.0) ɫɜɹɡɚɧɚ ɫ ɞɟɝɟɧɟɪɚɰɢɟɣ ɧɢɠɧɢɯ ɦɨɬɨɪɧɵɯ ɧɟɣɪɨɧɨɜ ɫɩɢɧɧɨɝɨ ɢ ɩɪɨɞɨɥɝɨɜɚɬɨɝɨ ɦɨɡɝɚ. ɗɬɨɬ ɫɢɧɞɪɨɦ ɹɜɥɹɟɬɫɹ ɧɚɢɛɨɥɟɟ ɱɚɫɬɨɣ ɮɨɪɦɨɣ ɧɟɣɪɨɦɵɲɟɱɧɨɣ ɩɚɬɨɥɨɝɢɢ, ɫɨɩɪɨɜɨɠɞɚɸɳɟɣɫɹ ɩɪɨɝɪɟɫɫɢɪɭɸɳɟɣ ɦɵɲɟɱɧɨɣ ɫɥɚɛɨɫɬɶɸ ɜ ɞɟɬɫɤɨɦ ɜɨɡɪɚɫɬɟ. ɗɬɢɨɥɨɝɢɹ ɧɟɢɡɜɟɫɬɧɚ, ɨɞɧɚɤɨ ɜɨ ɦɧɨɝɢɯ ɫɥɭɱɚɹɯ ɨɩɪɟɞɟɥɹɟɬɫɹ ɚɭɬɨɫɨɦ ɧɨ ɞɨɦɢɧɚɧɬɧɵɣ ɬɢɩ ɧɚɫɥɟɞɨɜɚɧɢɹ. ɇɚɢɛɨɥɟɟɟ ɱɚɫɬɵɦɢ ɩɪɢɱɢɧɚɦɢ ɫɦɟɪɬɢ ɹɜɥɹɸɬɫɹ ɞɵɯɚɬɟɥɶɧɚɹ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɶ ɢ ɜɬɨɪɢɱɧɚɹ ɢɧɮɟɤɰɢɹ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɩɟɪɟɞɧɢɟ ɪɨɝɚ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɡɧɚɱɢɬɟɥɶɧɨ ɭɦɟɧɶɲɟɧɵ ɜ ɪɚɡɦɟɪɚɯ, ɢɧɬɟɧɫɢɜɧɨ ɫɟɪɨɝɨ ɰɜɟɬɚ.

6.5.ɋɢɪɢɧɝɨɦɢɟɥɢɹ (G 95.0). Ɂɚɛɨɥɟɜɚɧɢɟ, ɪɚɡɜɢɜɚɸɳɟɟɫɹ ɜ ɪɟɡɭɥɶɬɚɬɟ ɨɛɪɚɡɨɜɚɧɢɹ ɩɚɬɨɥɨɝɢɱɟɫɤɢɯ ɳɟɥɟɣ ɢ ɩɨɥɨɫɬɟɣ ɜ ɬɤɚɧɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ɗɬɢɨɥɨɝɢɹ ɩɪɨɰɟɫɫɚ ɧɟɢɡɜɟɫɬɧɚ, ɩɪɟɞɩɨɥɚɝɚɟɦɨɟ ɭɱɚɫɬɢɟ ɚɫɬɪɨɰɢɬɨɜ ɜɬɨɪɢɱɧɨ. ɋɢɦɩɬɨɦɚɬɢɤɚ ɧɚɱɢɧɚɟɬ ɩɪɨɹɜɥɹɬɶɫɹ ɜ ɜɨɡɪɚɫɬɟ 20—30 ɥɟɬ. Ɇɭɠɱɢɧɵ ɛɨɥɟɸɬ ɱɚɳɟ ɠɟɧɳɢɧ. ɉɪɢɦɟɱɚɬɟɥɶɧɵɦ ɢ ɫɩɟɰɢɮɢɱɧɵɦ ɞɥɹ ɷɬɨɝɨ ɯɪɨɧɢɱɟɫɤɨɝɨ ɡɚɛɨɥɟɜɚɧɢɹ ɹɜɥɹɟɬɫɹ ɧɚɪɭɲɟɧɢɟ ɛɨɥɟɜɨɣ ɢ ɬɟɦɩɟɪɚɬɭɪɧɨɣ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɢ ɧɚ ɤɨɠɟ ɪɭɤ ɢ ɝɪɭɞɧɨɣ ɤɥɟɬɤɢ ɫ ɨɞɧɨɣ ɢɥɢ ɫ ɞɜɭɯ ɫɬɨɪɨɧ (ɩɨ ɬɢɩɭ «ɤɭɪɬɤɢ» ɢɥɢ «ɩɨɥɭɤɭɪɬɤɢ») ɩɪɢ ɧɨɪɦɚɥɶɧɨɦ ɮɭɧɤɰɢɨɧɢɪɨɜɚɧɢɢ ɞɪɭɝɢɯ ɜɢɞɨɜ ɤɨɠɧɨɣ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɢ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɸɬɫɹ ɟɞɢɧɢɱɧɵɟ ɩɨɥɨɫɬɢ ɜ ɜɟɳɟɫɬɜɟ ɦɨɡɝɚ, ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɜ ɲɟɣɧɨɦ ɨɬɞɟɥɟ, ɯɨɬɹ ɪɚɫɩɪɨɫɬɪɚɧɟɧɢɟ ɩɚɬɨɥɨɝɢɱɟɫɤɨɝɨ ɩɪɨɰɟɫɫɚ ɦɨɠɟɬ ɧɚɛɥɸɞɚɬɶɫɹ ɧɚ ɜɫɟɦ ɩɪɨɬɹɠɟɧɢɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ɇɚ ɭɪɨɜɧɟ ɩɨɥɨɫɬɢ ɫɩɢɧɧɨɣ ɦɨɡɝ ɦɨɠɟɬ ɛɵɬɶ ɤɨɥɥɚɛɢɪɨɜɚɧ ɢɥɢ ɭɩɥɨɳɟɧ. ɉɨɥɨɫɬɶ ɨɛɵɱɧɨ ɡɚɩɨɥɧɟɧɚ ɛɟɫɰɜɟɬɧɨɣ ɢɥɢ ɫɜɟɬɥɨ ɹɧɬɚɪɧɨɣ ɠɢɞɤɨɫɬɶɸ.

6.6.Ȼɨɥɟɡɧɶɉɚɪɤɢɧɫɨɧɚ(G20) ɩɨɪɚɠɚɟɬɞɨɩɚɦɢɧɷɪɝɢɱɟɫɤɢɟ ɫɬɪɭɤɬɭɪɵ ɱɟɪɧɨɣ ɫɭɛɫɬɚɧɰɢɢ ɫɬɜɨɥɚ ɦɨɡɝɚ ɢ/ ɢɥɢ ɛɚɡɚɥɶɧɵɯ ɹɞɟɪ. ɗɬɨ ɦɟɞɥɟɧɧɨ ɩɪɨɝɪɟɫɫɢɪɭɸɳɟɟ ɡɚɛɨɥɟɜɚɧɢɟ ɧɟɢɡɜɟɫɬɧɨɣ ɷɬɢɨɥɨɝɢɢ ɨɛɵɱɧɨ ɧɚɛɥɸɞɚɟɬɫɹ ɭ ɩɨɠɢɥɵɯ ɥɢɰ ɢ ɫɨɩɪɨɜɨɠɞɚɟɬɫɹ ɷɤɫɬɪɚɩɢɪɚɦɢɞɧɨɣ ɪɢɝɢɞɧɨɫɬɶɸ, ɛɪɚɞɢɤɢɧɟɡɢɟɣ ɢ ɫɬɟɪɟɨɬɢɩɧɵɦ ɞɪɨɠɚɧɢɟɦ. ɑɚɫɬɶ ɛɨɥɶɧɵɯ ɨɬɦɟɱɚɸɬ ɡɚɦɟɞɥɟɧɧɨɫɬɶ ɦɵɲɥɟɧɢɹ, ɫɧɢɠɟɧɢɟ ɩɚɦɹɬɢ; ɞɟɦɟɧɰɢɹ ɜɵɹɜɥɹɟɬɫɹ ɩɨɱɬɢ ɭ 30% ɛɨɥɶɧɵɯ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɚɹ ɤɚɪɬɢɧɚ ɧɟɫɩɟɰɢɮɢɱɧɚ, ɧɚ ɩɨɡɞɧɢɯ ɫɬɚɞɢɹɯ ɜɨɡɦɨɠɧɵ ɧɟɫɩɟɰɢɮɢɱɟɫɤɢɟ ɚɬɪɨɮɢɱɟɫɤɢɟ ɢɡɦɟɧɟɧɢɹ ɦɨɡɝɨɜɵɯ ɫɬɪɭɤɬɭɪ.

6.7.Ȼɨɥɟɡɧɶ Ʉɪɟɣɬɰɮɟɥɶɞɬɚ—əɤɨɛɚ (F02.1/ A81.0). ɗɬɚ ɮɨɪɦɚ ɛɵɫɬɪɨɩɪɨɝɪɟɫɫɢɪɭɸɳɟɣ ɞɟɦɟɧɰɢɢ ɫɜɹɡɚɧɚ ɫ ɢɧɮɟɤɰɢɟɣ ɩɪɢ ɨɧɨɦ (ɜɢɪɭɫɨɩɨɞɨɛɧɵɦ ɚɝɟɧɬɨɦ). ɑɚɫɬɨ ɨɩɪɟɞɟɥɹɟɬɫɹ ɜ ɜɨɡɪɚɫɬɟ 50—60 ɥɟɬ. Ʉɥɢɧɢɤɚ ɜɤɥɸɱɚɟɬ ɩɢɪɚɦɢɞɧɵɟ ɢ ɷɤɫɬɪɚɩɢɪɚɦɢɞɧɵɟ ɫɢɦɩɬɨɦɵ, ɩɚɬɨɥɨɝɢɱɟɫɤɢɟ ɪɟɮɥɟɤɫɵ ɢ ɫɮɢɧɤɬɟɪɧɵɟ ɪɚɫɫɬɪɨɣɫɬɜɚ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɟɬɫɹ ɧɟɫɩɟɰɢɮɢɱɟɫɤɚɹ ɰɟɪɟɛɪɚɥɶɧɚɹ ɚɬɪɨɮɢɹ.

6.8.ȻɨɥɟɡɧɶȺɥɶɰɝɟɣɦɟɪɚ (F00) ɩɪɨɬɟɤɚɟɬɤɚɤ ɩɪɨɝɪɟɫɫɢɪɭɸɳɚɹ ɞɟɦɟɧɰɢɹ. ɇɚɱɚɥɨ ɛɨɥɟɡɧɢ ɨɬɦɟɱɚɟɬɫɹ ɭ ɩɚɰɢɟɧɬɨɜ ɜ ɜɨɡɪɚɫɬɟ ɦɟɠɞɭ 45 ɢ 60 ɝɨɞɚɦɢ. ȼ ɧɚɫɬɨɹɳɟɟ ɜɪɟɦɹ ɜ ɋɒȺ ɡɚɪɟɝɢɫɬɪɢɪɨɜɚɧɨ 2 ɦɥɧ 200 ɬɵɫ. ɛɨɥɶɧɵɯ. ȼ ɞɚɥɶɧɟɣɲɟɦ ɢɯ ɫɬɚɧɟɬ ɟɳɟ ɛɨɥɶɲɟ ɜ ɫɜɹɡɢ ɫ ɪɨɫɬɨɦ ɱɢɫɥɚ ɥɢɰ ɩɨɠɢɥɨɝɨ ɢ ɫɬɚɪɱɟɫɤɨɝɨ ɜɨɡɪɚɫɬɚ ɢ ɭɜɟɥɢɱɟɧɢɟɦ ɩɪɨɞɨɥɠɢɬɟɥɶɧɨɫɬɢ ɠɢɡɧɢ.

ɗɬɢɨɥɨɝɢɹ ɡɚɛɨɥɟɜɚɧɢɹ ɧɟɢɡɜɟɫɬɧɚ, ɨɞɧɚɤɨ ɜɵɫɨɤɚɹ ɱɚɫɬɨɬɚ ɨɛɧɚɪɭɠɟɧɢɹ ɛɨɥɟɡɧɢ Ⱥɥɶɰɝɟɣɦɟɪɚ ɜ ɨɞɧɨɣ ɫɟɦɶɟ, ɚ ɬɚɤɠɟ ɯɪɨɦɨɫɨɦɧɵɣ ɚɧɚɥɢɡ ɫɩɨɪɚɞɢɱɟɫɤɢɯ ɫɥɭɱɚɟɜ ɭɤɚɡɵɜɚɸɬ ɧɚ ɝɟɧɟɬɢɱɟɫɤɭɸ ɩɪɢɪɨɞɭ ɡɚɛɨɥɟɜɚɧɢɹ. Ʉɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɚɹ ɫɯɨɠɟɫɬɶ ɛɨɥɟɡɧɢ Ⱥɥɶɰɝɟɣɦɟɪɚ ɢ ɫɢɧɞɪɨɦɚ Ⱦɚɭɧɚ ɩɨɞɬɜɟɪɠɞɚɟɬ ɷɬɨ ɩɪɟɞɩɨɥɨɠɟɧɢɟ, ɩɨɫɤɨɥɶɤɭ ɭɫɬɚɧɨɜɥɟɧɚ ɧɟɫɨɦɧɟɧɧɚɹ ɫɜɹɡɶ ɦɟɠɞɭ ɩɚ

Ɋɢɫ. 12.48. ȺɬɪɨɮɢɹɤɨɪɵɦɨɡɝɚɩɪɢɛɨɥɟɡɧɢȺɥɶɰɝɟɣɦɟɪɚ

ɬɨɥɨɝɢɟɣ ɯɪɨɦɨɫɨɦɵ 21 ɢ ɛɨɥɟɡɧɶɸ Ⱥɥɶɰɝɟɣɦɟɪɚ. Ʉɪɨɦɟ ɬɨɝɨ, ɜɵɞɜɢɝɚɸɬɫɹ ɬɟɨɪɢɢ ɨ ɜɨɡɦɨɠɧɨɦ ɢɧɮɢɰɢɪɨɜɚɧɢɢ ɦɟɞɥɟɧɧɵɦ ɜɢɪɭɫɨɦ, ɧɟɢɡɜɟɫɬɧɨɣ ɢɧɬɨɤɫɢɤɚɰɢɢ ɢ ɬɪɚɜɦɟ.

Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɟɬɫɹ ɧɟɫɩɟɰɢɮɢɱɟɫɤɚɹ ɭɦɟɪɟɧɧɨ ɜɵɪɚɠɟɧɧɚɹ ɚɬɪɨɮɢɹ ɤɨɪɤɨɜɨɝɨ ɜɟɳɟɫɬɜɚ, ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɜ ɥɨɛɧɵɯɞɨɥɹɯ (ɪɢɫ. 12.48).

6.9. Ȼɨɥɟɡɧɶ ɉɢɤɚ (F02.0), ɷɬɢɨɥɨɝɢɹ ɤɨɬɨɪɨɣ ɬɚɤɠɟ ɧɟɢɡɜɟɫɬɧɚ, ɤɥɢɧɢɱɟɫɤɢ ɫɢɦɭɥɢɪɭɟɬ ɛɨɥɟɡɧɶ Ⱥɥɶɰɝɟɣɦɟɪɚ. ɇɟɫɤɨɥɶɤɨ ɱɚɳɟ ɡɚɛɨɥɟɜɚɧɢɟ ɨɛɧɚɪɭɠɢɜɚɟɬɫɹ ɭɠɟɧɳɢɧ. ɉɪɢ ɛɨɥɟɡɧɢ ɉɢɤɚ ɭɦɟɪɟɧɧɚɹ ɢ ɡɧɚɱɢɬɟɥɶɧɚɹ ɚɬɪɨɮɢɹ ɤɨɪɵ ɦɨɡɝɚ ɨɩɪɟɞɟɥɹɟɬɫɹ ɜ ɥɨɛɧɵɯ ɢ ɬɟɦɟɧɧɵɯɞɨɥɹɯ.

7. ɈɉɍɏɈɅɂ ɐȿɇɌɊȺɅɖɇɈɃ ɇȿɊȼɇɈɃ ɋɂɋɌȿɆɕ.

ɉɟɪɜɢɱɧɵɟ ɨɩɭɯɨɥɢ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɹɜɥɹɸɬɫɹ ɩɪɢɱɢɧɨɣ 9—11% ɜɫɟɯɫɦɟɪɬɟɣ, ɫɜɹɡɚɧɧɵɯɫ ɧɨɜɨɨɛɪɚɡɨɜɚɧɢɹɦɢ. ɉɪɢɛɥɢɡɢɬɟɥɶɧɨ 11% ɜɫɟɯ ɛɨɥɟɡɧɟɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɩɪɟɞɫɬɚɜɥɟɧɵ ɧɟɨɩɥɚɫɬɢɱɟɫɤɢɦɢ ɩɪɨɰɟɫɫɚɦɢ.

Ɉɩɭɯɨɥɢ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɜɫɬɪɟɱɚɸɬɫɹ ɜ ɥɸɛɨɦ ɜɨɡɪɚɫɬɟ, ɨɞɧɚɤɨ ɢɯɤɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ ɜ ɛɨɥɶɲɨɣ ɫɬɟɩɟɧɢ ɫɜɹɡɚɧɵ ɢɦɟɧɧɨ ɫ ɜɨɡɪɚɫɬɧɵɦ ɩɚɪɚɦɟɬɪɨɦ. Ɍɚɤ, ɭɞɟɬɟɣ 70% ɨɩɭɯɨɥɟɣ ɹɜɥɹɸɬɫɹ ɩɨɞɬɟɧɬɨɪɢɚɥɶɧɵɦɢ (ɬɨɩɨɝɪɚɮɢɱɟɫɤɢ ɧɢɠɟ ɦɨɡɠɟɱɤɨɜɨɝɨ ɧɚɦɟɬɚ), ɭ ɜɡɪɨɫɥɵɯ ɨɛɧɚɪɭɠɢɜɚɟɬɫɹ ɨɛɪɚɬɧɚɹ ɬɟɧɞɟɧɰɢɹ — 70% ɨɩɭɯɨɥɟɣ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɹɜɥɹɸɬɫɹ ɫɭɩɪɚɬɟɧɬɨɪɢɚɥɶɧɵɦɢ. ȼ ɞɟɬɫɤɨɦ ɜɨɡɪɚɫɬɟ ɨɩɭɯɨɥɢ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɫɨɫɬɚɜɥɹɸɬ ɨɤɨɥɨ 23% ɜɫɟɯ ɧɟɨɩɥɚɫɬɢɱɟɫɤɢɯ ɩɪɨɰɟɫɫɨɜ, ɭɜɡɪɨɫɥɵɯ— ɜɫɟɝɨ ɨɤɨɥɨ 8%.

Ƚɢɫɬɨɥɨɝɢɱɟɫɤɨɟ ɬɢɩɢɪɨɜɚɧɢɟ ɨɩɭɯɨɥɟɣ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɬɚɤɠɟ ɜ ɡɧɚɱɢɬɟɥɶɧɨɣ ɫɬɟɩɟɧɢ ɡɚɜɢɫɢɬ ɨɬ ɜɨɡɪɚɫɬɚ: ɭ ɞɟɬɟɣ ɩɪɟɢɦɭɳɟɫɬɜɟɧɧɨ ɨɛɧɚɪɭɠɢɜɚɸɬɫɹ ɚɫɬɪɨɰɢɬɨɦɵ, ɦɟɞɭɥ ɥɨɛɥɚɫɬɨɦɵ, ɷɩɟɧɞɢɦɨɦɵ ɢ ɤɪɚɧɢɨɮɚɪɢɧɝɢɨɦɵ, ɭɜɡɪɨɫɥɵɯ — ɚɫɬɪɨɰɢɬɨɦɵ, ɦɟɬɚɫɬɚɬɢɱɟɫɤɢɟ ɪɚɤɢ ɢ ɦɟɧɢɧɝɢɨɦɵ.

Ɋɚɫɫɦɨɬɪɢɦ ɧɟɤɨɬɨɪɵɟ ɚɫɩɟɤɬɵ ɞɨɛɪɨɤɚɱɟɫɬɜɟɧɧɨɫɬɢ ɢ ɡɥɨɤɚɱɟɫɬɜɟɧɧɨɫɬɢ ɨɩɭɯɨɥɟɣ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ.

Ɉɩɭɯɨɥɟɜɵɟ ɩɪɨɰɟɫɫɵ ɦɨɝɭɬ ɝɢɫɬɨɝɟɧɟɬɢɱɟɫɤɢ ɩɪɨɢɫɯɨɞɢɬɶ ɢɡ ɥɸɛɨɝɨ ɬɢɩɚ ɤɥɟɬɨɤ ɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ — ɝɢɫɬɨɥɨɝɢɱɟɫɤɢ ɦɧɨɝɢɟ ɢɡ ɧɢɯ ɢɦɟɸɬ ɛɨɥɟɟ ɡɥɨɤɚɱɟɫɬɜɟɧɧɭɸ ɚɬɪɢɛɭɬɢɤɭ, Ⱦɪɭɝɢɟ ɨɛɥɚɞɚɸɬ ɱɢɫɬɨ ɞɨɛɪɨɤɚɱɟɫɬɜɟɧɧɵɦɢ ɯɚɪɚɤɬɟɪɢɫɬɢɤɚɦɢ. ȿɫɥɢ ɜ ɨɫɬɚɥɶɧɵɯ ɨɪɝɚɧɚɯ ɢ ɬɤɚɧɹɯ ɫɭɳɟɫɬɜɭɟɬ ɞɨɫɬɚɬɨɱɧɨ ɱɟɬɤɚɹ ɫɜɹɡɶ ɦɟɠɞɭ ɝɢɫɬɨɥɨɝɢɱɟɫɤɨɣ ɫɬɪɭɤɬɭɪɨɣ ɨɩɭɯɨɥɢ ɢ ɟɟ ɛɢɨɥɨɝɢɱɟɫɤɢɦ ɩɨɜɟɞɟɧɢɟɦ, ɬɨ ɜ ɨɩɭɯɨɥɹɯ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɷɬɨɬ ɩɚɪɚɥɥɟɥɢɡɦ ɨɬɫɭɬɫɬɜɭɟɬ. Ɉɩɪɟɞɟɥɟɧɢɟ ɡɥɨɤɚɱɟɫɬɜɟɧɧɨɫɬɢ ɨɩɭɯɨɥɢ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɬɪɟɛɭɟɬ ɫɩɟɰɢɚɥɶɧɨɝɨ ɦɟɬɨɞɨɥɨɝɢɱɟɫɤɨɝɨ ɩɨɞɯɨɞɚ. ȼ ɫɜɹɡɢ ɫ ɷɬɢɦ ɨɩɭɯɨɥɢ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɭɫɥɨɜɧɨ ɪɚɡɞɟɥɹɸɬ ɧɚ ɞɜɟ ɝɪɭɩɩɵ — ɨɩɭɯɨɥɢ ɝɥɢɚɥɶɧɨɝɨ ɢ ɧɟɝɥɢ ɚɥɶɧɨɝɨ ɩɪɨɢɫɯɨɠɞɟɧɢɹ.

Ɋɢɫ. 12.49. Ⱥɫɬɪɨɰɢɬɨɦɚ

Ƚɥɢɚɥɶɧɵɟɨɩɭɯɨɥɢɨɛɧɚɪɭɠɢɜɚɸɬɢɧɮɢɥɶɬɪɚɬɢɜɧɵɣ ɬɢɩ ɪɨɫɬɚ, ɱɬɨ ɩɨɡɜɨɥɹɟɬ ɪɚɫɫɦɚɬɪɢɜɚɬɶ ɢɯ ɫ ɛɢɨɥɨɝɢɱɟɫɤɨɣ ɬɨɱɤɢ ɡɪɟɧɢɹ ɤɚɤ ɡɥɨɤɚɱɟɫɬɜɟɧɧɵɟ. ȼ ɛɨɥɶɲɢɧɫɬɜɟ ɫɥɭɱɚɟɜ ɬɚɤɢɟ ɨɩɭɯɨɥɢ ɭɞɚɥɹɸɬ ɥɢɲɶ ɱɚɫɬɢɱɧɨ ɜ ɫɜɹɡɢ ɫ ɧɟɜɨɡɦɨɠɧɨɫɬɶɸ ɪɚɞɢɤɚɥɶɧɨɝɨ ɢɫɫɟɱɟɧɢɹ ɜɨɜɥɟɱɟɧɧɵɯɜ ɩɪɨɰɟɫɫ ɬɤɚɧɟɣ.

ɇɟɝɥɢɚɥɶɧɵɟ ɨɩɭɯɨɥɢɜ ɨɫɧɨɜɧɨɦ ɪɚɫɬɭɬ ɷɤɫɬɟɧɫɢɜɧɨ ɢ ɩɨɷɬɨɦɭɯɢɪɭɪɝɢɱɟɫɤɨɟ ɥɟɱɟɧɢɟ ɜ ɞɚɧɧɨɦ ɫɥɭɱɚɟ ɹɜɥɹɟɬɫɹ ɜ ɡɧɚɱɢɬɟɥɶɧɨɣ ɫɬɟɩɟɧɢ ɪɚɞɢɤɚɥɶɧɵɦ.

Ɉɞɧɨɣ ɢɡ ɧɚɢɛɨɥɟɟ ɢɧɬɟɪɟɫɧɵɯɨɫɨɛɟɧɧɨɫɬɟɣ ɧɨɜɨɨɛɪɚɡɨɜɚɧɢɣ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɹɜɥɹɟɬɫɹ ɛɨɥɶɲɚɹ ɪɟɞɤɨɫɬɶ ɜɧɟɱɟɪɟɩɧɵɯɦɟɬɚɫɬɚɡɨɜ, ɞɚɠɟɩɪɢ ɜɵɪɚɠɟɧɧɨɣ ɚɧɚɩɥɚɫɬɢɱɟɫɤɨɣ ɫɬɪɭɤɬɭɪɟ ɨɩɭɯɨɥɢ ɫ ɜɵɫɨɤɨɣ ɫɬɟɩɟɧɶɸ ɜɨɜɥɟɱɟɧɢɹ ɫɨɫɭɞɨɜ.

ɂɡɜɟɫɬɧɵ ɫɥɟɞɭɸɳɢɟ ɩɚɬɨɮɢɡɢɥɨɝɢɱɟɫɤɢɟ ɷɮɮɟɤɬɵ ɨɩɭɯɨɥɟɣ ɰɟɧɬɪɚɥɶɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ:

—ɩɪɹɦɵɟɷɮɮɟɤɬɵ. Ɉɩɭɯɨɥɢ ɦɨɡɝɚɩɪɨɞɭɰɢɪɭɸɬɤɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɢɟ ɫɢɦɩɬɨɦɵ ɜ ɫɜɹɡɢ ɫ ɩɪɹɦɵɦ ɜɨɡɞɟɣɫɬɜɢɟɦ ɧɚ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɟ ɫɬɪɭɤɬɭɪɵ ɦɨɡɝɚ, ɩɪɢ ɷɬɨɦ ɥɨɤɚɥɶɧɵɣ ɧɟɜɪɨɥɨɝɢɱɟɫɤɢɣ ɞɟɮɢɰɢɬ ɫɜɹɡɚɧ ɫ ɭɝɧɟɬɟɧɢɟɦ ɚɮɮɟɪɟɧɬɧɨɣ ɢɧɧɟɪɜɚɰɢɢ ɢ ɧɟɣɪɨɧɵ ɫɬɚɧɨɜɹɬɫɹ ɷɥɟɤɬɪɢɱɟɫɤɢ ɧɟɫɬɚɛɢɥɶɧɵɦɢ ɢ ɥɟɝɤɨ ɢɧɢɰɢɢɪɭɸɬ ɷɩɢɥɟɩɬɢɮɨɪɦɧɭɸ ɚɤɬɢɜɧɨɫɬɶ. ȿɫɬɟɫɬɜɟɧɧɨ, ɱɬɨ ɨɫɧɨɜɧɚɹ ɤɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɚɹ ɫɢɦɩɬɨɦɚɬɢɤɚɨɩɭɯɨɥɢ ɫɜɹɡɚɧɚɫɟɟɥɨɤɚɥɢɡɚɰɢɟɣ;

—ɜɬɨɪɢɱɧɵɟɷɮɮɟɤɬɵ. Ɉɬɟɤ, ɜɨɡɦɨɠɧɨ, ɹɜɥɹɟɬɫɹ ɧɚɢɛɨɥɟɟ ɜɚɠɧɵɦ ɮɚɤɬɨɪɨɦ, ɨɩɪɟɞɟɥɹɸɳɢɦ ɫɢɦɩɬɨɦɚɬɢɤɭɨɩɭɯɨɥɟɣ ɦɨɡɝɚ ɜ ɤɨɧɬɟɤɫɬɟ ɧɟɜɪɨɥɨɝɢɱɟɫɤɨɝɨ ɢ ɩɫɢɯɨɩɚɬɨɥɨɝɢɱɟɫɤɨɝɨ ɮɭɧɤɰɢɨɧɢɪɨɜɚɧɢɹ ɦɨɡɝɚ. Ⱦɪɭɝɢɟ ɧɟɩɪɹɦɵɟ ɷɮɮɟɤɬɵ ɰɟɪɟɛɪɚɥɶɧɵɯ ɨɩɭɯɨɥɟɣ ɜɤɥɸɱɚɸɬ ɰɢɪɤɭɥɹɬɨɪɧɵɟ ɷɮɮɟɤɬɵ (ɤɨɦɩɪɟɫɫɢɹ — ɫɨɫɭɞɢɫɬɵɣ ɤɨɥɥɚɩɫ —ɢɲɟɦɢɹ), ɤɨɦɩɪɟɫɫɢɸ ɢ ɩɟɪɟɦɟɳɟɧɢɟ ɫ ɩɨɫɥɟɞɭɸɳɟɣ ɞɢɫɥɨɤɚɰɢɟɣ ɰɟɪɟɛɪɚɥɶɧɵɯ ɫɬɪɭɤɬɭɪ (ɬɚɤ ɧɚɡɵɜɚɟɦɵɣ ɦɚɫɫ ɷɮɮɟɤɬ), ɧɚɪɭɲɟɧɢɟ ɰɢɪɤɭɥɹɰɢɢ ɰɟɪɟɛɪɨɫɩɢɧɚɥɶɧɨɣ ɠɢɞɤɨɫɬɢ ɢ ɝɢɞɪɨɰɟɮɚɥɢɸ, ɞɢɫɥɨɤɚɰɢɨɧɧɵɟ ɤɪɨɜɨɢɡɥɢɹɧɢɹ ɜ ɫɪɟɞɧɢɣ ɦɨɡɝ ɢ ɦɨɫɬ (ɨɞɧɨɫɬɨɪɨɧɧɹɹ ɞɢɫɥɨɤɚɰɢɹ ɢ ɜɤɥɢɧɟɧɢɟ ɫɬɜɨɥɚ ɦɨɡɝɚ).

ɉɨɱɬɢ ɩɨɫɬɨɹɧɧɵɦɢ ɤɥɢɧɢɱɟɫɤɢɦɢ ɫɢɦɩɬɨɦɚɦɢ ɹɜɥɹɸɬɫɹ ɝɨɥɨɜɧɚɹ ɛɨɥɶ, ɬɨɲɧɨɬɚ ɢ ɪɜɨɬɚ. ɇɟɫɤɨɥɶɤɨ ɪɟɠɟ ɤɥɢɧɢɱɟɫɤɚɹ ɤɚɪɬɢɧɚ ɨɩɭɯɨɥɟɣ ɯɚɪɚɤɬɟɪɢɡɭɟɬɫɹ ɥɟɬɚɪɝɢɟɣ, ɷɩɢɥɟɩɬɢɮɨɪɦɧɵ ɦɢ ɫɭɞɨɪɨɝɚɦɢ, ɩɚɪɚɥɢɱɚɦɢ, ɚɮɚɡɢɟɣ, ɫɥɟɩɨɬɨɣ ɢ ɧɚɪɭɲɟɧɢɟɦ ɫɥɭɯɚ. ɉɪɢ ɩɨɪɚɠɟɧɢɢ ɥɨɛɧɵɯɞɨɥɟɣ ɞɨɜɨɥɶɧɨ ɲɢɪɨɤɨ ɩɪɟɞɫɬɚɜɥɟɧɵ ɪɚɡɥɢɱɧɵɟɮɨɪɦɵ ɧɚɪɭɲɟɧɢɹ ɩɨɜɟɞɟɧɢɹ.

7.1. Ɉɩɭɯɨɥɢ ɚɫɬɪɨɰɢɬɚɪɧɨɝɨ ɩɪɨɢɫɯɨɠɞɟɧɢɹ. ɇɨɪɦɚɥɶɧɵɟ ɚɫ ɬɪɨɰɢɬɵ ɜ ɩɪɢɫɭɬɫɬɜɢɢ ɩɨɜɪɟɠɞɟɧɢɹ ɨɛɵɱɧɨ ɮɨɪɦɢɪɭɸɬ ɝɥɢɚɥɶɧɵɟ ɮɢɛɪɢɥɥɵ ɢ ɩɪɨɹɜɥɹɸɬɜɵɪɚɠɟɧɧɵɣ ɨɬɟɤ. ɉɪɢ ɷɬɨɦ ɹɞɟɪɧɨ ɰɢɬɨɩɥɚɡɦɚɬɢɱɟɫɤɢɣ ɢɧɞɟɤɫ ɭɦɟɧɶɲɚɟɬɫɹ. ɇɟɨɩɥɚɫɬɢɱɟɫɤɚɹ ɬɪɚɧɫɮɨɪɦɚɰɢɹ ɚɫɬɪɨɰɢɬɨɜ ɦɨɠɟɬ ɩɪɢɧɢɦɚɬɶ ɫɚɦɵɟ ɪɚɡɧɨɨɛɪɚɡ-

ɧɵɟ ɮɨɪɦɵ, ɜɟɫɶɦɚ ɧɚɩɨɦɢɧɚɸɳɢɟ ɧɨɪɦɚɥɶɧɵɟ ɤɥɟɬɤɢ ɢɥɢ ɪɟɚɤɬɢɜɧɵɟ ɩɪɨɰɟɫɫɵ, ɢ ɨɛɵɱɧɨ ɯɚɪɚɤɬɟɪɢɡɭɟɬɫɹ ɧɨɪɦɚɥɶɧɵɦ ɩɟɪɢ ɜɚɫɤɭɥɹɪɧɵɦ ɪɚɫɩɨɥɨɠɟɧɢɟɦ. Ɉɞɧɚɤɨ ɩɪɢ ɢɫɬɢɧɧɵɯ ɨɩɭɯɨɥɹɯ ɨɩɪɟɞɟɥɹɸɬɫɹ ɢɡɦɟɧɟɧɢɹ, ɫɩɟɰɢɮɢɱɧɵɟ ɢɦɟɧɧɨɞɥɹ ɞɚɧɧɨɝɨ ɩɚɬɨɥɨɝɢɱɟɫɤɨɝɨ ɩɪɨɰɟɫɫɚ.

7.1.1. Ⱥɫɬɪɨɰɢɬɨɦɵ(Ɇ9400/3) ɫɨɫɬɚɜɥɹɸɬɨɤɨɥɨ 35% ɜɫɟɯɝɥɢ ɚɥɶɧɵɯɨɩɭɯɨɥɟɣ. ɍɜɡɪɨɫɥɵɯɜ ɛɨɥɶɲɢɧɫɬɜɟ ɫɥɭɱɚɟɜ ɨɧɢ ɥɨɤɚɥɢɡɭɸɬɫɹ ɜɰɟɧɬɪɚɥɶɧɨɦɫɟɪɨɦɜɟɳɟɫɬɜɟɦɨɡɝɚ, ɚɭɞɟɬɟɣ —ɜɦɨɡɠɟɱ- ɤɨɜɵɯ ɝɟɦɢɫɮɟɪɚɯ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɚɫɬɪɨɰɢɬɨɦɵ ɢɦɟɸɬ ɜɢɞ ɩɥɨɬɧɵɯ ɧɟɱɟɬɤɨ ɨɬɝɪɚɧɢɱɟɧɧɵɯɨɩɭɯɨɥɟɣ ɛɟɥɨɝɨ ɢɥɢ ɫɟɪɨ ɛɟɥɨɝɨ ɰɜɟɬɚ, ɝɪɚɧɢɰɵ ɤɨɬɨɪɵɯ ɨɱɟɧɶ ɬɪɭɞɧɨ ɨɩɪɟɞɟɥɢɬɶ (ɪɢɫ. 12.49). Ⱦɚɧɧɵɟɧɨɜɨɨɛɪɚɡɨɜɚɧɢɹ ɦɨɝɭɬɫɨɞɟɪɠɚɬɶɦɧɨɠɟɫɬɜɟɧɧɵɟɦɟɥɤɢɟ ɤɢɫɬɵ ɢɥɢ ɧɟɫɤɨɥɶɤɨ ɛɨɥɟɟ ɤɪɭɩɧɵɯ, ɡɚɩɨɥɧɟɧɧɵɯɠɟɥɬɨɣ ɩɪɨɡɪɚɱɧɨɣ ɠɢɞɤɨɫɬɶɸ. Ʉɢɫɬɨɡɧɚɹ ɞɟɝɟɧɟɪɚɰɢɹ ɨɩɭɯɨɥɢ ɧɟ ɹɜɥɹɟɬɫɹ ɞɢɚɝɧɨɫɬɢɱɟɫɤɢɦ ɩɪɢɡɧɚɤɨɦ ɧɢ ɟɟ ɡɥɨɤɚɱɟɫɬɜɟɧɧɨɫɬɢ, ɧɢ ɞɨɛɪɨɤɚɱɟɫɬɜɟɧɧɨɫɬɢ.

Ⱥɫɬɪɨɰɢɬɨɦɵ ɦɨɡɠɟɱɤɚ ɩɪɢɧɰɢɩɢɚɥɶɧɨ ɨɬɥɢɱɚɸɬɫɹ ɨɬ ɰɟɪɟɛɪɚɥɶɧɵɯɚɧɚɥɨɝɨɜ ɤɚɤ ɤɥɢɧɢɱɟɫɤɢ, ɬɚɤ ɢ ɦɨɪɮɨɥɨɝɢɱɟɫɤɢ. ȼɫɟ ɷɬɢ ɨɩɭɯɨɥɢ, ɫɨɫɬɚɜɥɹɸɳɢɟ 30% ɜɫɟɯ ɬɚɤ ɧɚɡɵɜɚɟɦɵɯ ɦɚɫɫ ɡɚɞɧɟɣ ɱɟɪɟɩɧɨɣ ɹɦɤɢ, ɭɞɟɬɟɣ ɢ ɦɨɥɨɞɵɯɜɡɪɨɫɥɵɯɪɚɡɜɢɜɚɸɬɫɹ ɞɨ 20 ɥɟɬɧɟɝɨɜɨɡɪɚɫɬɚ.

ɉɪɨɝɧɨɡ ɰɟɪɟɛɪɚɥɶɧɵɯɨɩɭɯɨɥɟɣ ɡɚɜɢɫɢɬ ɨɬ ɜɨɡɦɨɠɧɨɫɬɢ ɢɯ ɬɪɚɧɫɮɨɪɦɚɰɢɢ ɜ ɛɨɥɟɟ ɡɥɨɤɚɱɟɫɬɜɟɧɧɵɟ ɝɥɢɨɛɥɚɫɬɨɦɵ. Ɉɛɵɱɧɨ ɜɵɠɢɜɚɟɦɨɫɬɶ ɩɨɫɥɟ ɩɟɪɜɢɱɧɨɝɨ ɩɨɞɬɜɟɪɠɞɟɧɧɨɝɨ ɞɢɚɝɧɨɡɚ ɤɨɥɟɛɥɟɬɫɹ ɨɬ 1 ɞɨ 10 ɥɟɬ. ɉɪɢ ɚɞɟɤɜɚɬɧɨɦ ɯɢɪɭɪɝɢɱɟɫɤɨɦ ɥɟɱɟɧɢɢ ɰɟɪɟɛɟɥɥɹɪɧɵɯɚɫɬɪɨɰɢɬɨɦ ɯɨɪɨɲɢɣ ɩɪɨɝɧɨɡ ɫ 5 ɥɟɬɧɟɣ ɜɵɠɢɜɚɟɦɨɫɬɶɸ ɫɨɫɬɚɜɥɹɟɬ ɨɤɨɥɨ 90%. Ɉɞɧɚɤɨ 10% ɛɨɥɶɧɵɯ ɩɨɫɥɟ ɨɩɟɪɚɰɢɢ ɫɬɪɚɞɚɸɬ ɫɬɨɣɤɢɦ ɧɟɜɪɨɥɨɝɢɱɟɫɤɢɦ ɞɟɮɢɰɢɬɨɦ.

7.1.2. Ƚɥɢɨɛɥɚɫɬɨɦɵ(Ɇ9440/3) — ɛɵɫɬɪɨ ɪɚɫɬɭɳɢɟ ɨɩɭɯɨɥɢ, ɯɚɪɚɤɬɟɪɢɡɭɸɳɢɟɫɹ ɫɚɦɵɦɢ ɪɚɡɧɨɨɛɪɚɡɧɵɦɢ ɤɥɢɧɢɱɟɫɤɢɦɢ ɫɢɦɩɬɨɦɚɦɢ, ɱɚɳɟ ɜɫɟɝɨ ɨɬɪɚɠɚɸɳɢɦɢ ɛɵɫɬɪɨ ɩɨɜɵɲɚɸɳɟɟɫɹ ɜɧɭɬɪɢɱɟɪɟɩɧɨɟ ɞɚɜɥɟɧɢɟ. Ɉɧɢ ɫɨɫɬɚɜɥɹɸɬ ɨɤɨɥɨ 40% ɜɫɟɯ ɝɥɢ ɚɥɶɧɵɯ ɨɩɭɯɨɥɟɣ ɢ ɱɚɳɟ ɜɫɬɪɟɱɚɸɬɫɹ ɭ ɦɭɠɱɢɧ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɭɯɨɥɢ ɩɪɟɞɫɬɚɜɥɟɧɵ ɯɨɪɨɲɨ ɨɬɝɪɚɧɢɱɟɧɧɵɦɢ ɦɚɫɫɚɦɢ ɦɹɝɤɨɣ ɤɨɧɫɢɫɬɟɧɰɢɢ, ɫ ɛɨɥɶɲɢɦ ɤɨɥɢɱɟɫɬɜɨɦ ɫɨɫɭɞɨɜ ɢ ɪɚɡɧɨɰɜɟɬɧɨɣ ɩɚɪɟɧɯɢɦɨɣ (ɪɢɫ. 12.50). Ʉɥɚɫɫɢɱɟɫɤɢ ɝɥɢɨɛɥɚɫɬɨɦɵ ɥɨɤɚɥɢɡɭɸɬɫɹ ɜ ɛɟɥɨɦ ɜɟɳɟɫɬɜɟ ɦɨɡɝɚ.

Ȼɵɫɬɪɨɟ ɪɚɫɩɪɨɫɬɪɚɧɟɧɢɟ ɨɩɭɯɨɥɢ ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɩɟɪɢɮɨ ɤɚɥɶɧɵɦ ɨɬɟɤɨɦ ɫɨɡɞɚɟɬɭɫɥɨɜɢɹ ɞɥɹ ɤɨɦɩɪɟɫɫɢɢ ɢ ɫɦɟɲɟɧɢɹ ɰɟɪɟɛɪɚɥɶɧɵɯ ɫɬɪɭɤɬɭɪ ɫ ɩɨɫɥɟɞɭɸɳɟɣ ɞɢɫɥɨɤɚɰɢɟɣ ɢ ɭɳɟɦɥɟɧɢɟɦ ɫɬɜɨɥɚ ɦɨɡɝɚ. Ⱦɨɜɨɥɶɧɨ ɱɚɫɬɨ ɷɬɢ ɨɩɭɯɨɥɢ ɢɧɮɢɥɶɬɪɢɪɭɸɬ ɦɨɡɨɥɢɫɬɨɟ ɬɟɥɨ ɢ ɩɪɨɪɚɫɬɚɸɬ ɜ ɤɨɧɬɪɚɥɚɬɟɪɚɥɶɧɨɟ ɩɨɥɭɲɚɪɢɟ. Ƚɥɢɨɛɥɚɫɬɨɦɵ ɫɨɱɟɬɚɸɬɫɹ ɫ ɝɟɧɟɬɢɱɟɫɤɢɦɢ ɧɚɪɭɲɟɧɢɹɦɢ ɜ ɯɪɨɦɨɫɨɦɚɯ 7,9 ɢ 10. ȼ 50% ɫɥɭɱɚɟɜ ɷɬɨɣ ɝɪɭɩɩɵ ɨɩɭɯɨɥɟɣ ɜɵɹɜɥɹɸɬɫɹ ɩɪɨɬɨɨɧɤɨɝɟɧɵ c sis ɢ c erb ȼ. ɉɪɨɝɧɨɡɧɟɛɥɚɝɨɩɪɢɹɬɧɵɣ, ɯɨɬɹ

Ɋɢɫ. 12.50. Ƚɥɢɨɛɥɚɫɬɨɦɚ

Ɋɢɫ. 12.51. Ɉɥɢɝɨɞɟɧɞɪɨɝɥɢɨɦɚ

Ɋɢɫ. 12.52. ɗɩɟɧɞɢɦɨɦɚ

ɧɟɤɨɬɨɪɵɟ ɮɨɪɦɵ ɝɥɢɨɛɥɚɫɬɨɦ ɞɨɜɨɥɶɧɨ ɭɫɩɟɲɧɨ ɥɟɱɚɬɫɹ ɪɚɞɢɨɬɟɪɚɩɟɜɬɢɱɟɫɤɢɦɦɟɬɨɞɨɦ.

7.1.3. Ɉɥɢɝɨɞɟɧɞɪɨɝɥɢɨɦɵ (Ɇ9450/3). Ɉɩɭɯɨɥɢ ɷɬɨɣ ɝɪɭɩɩɵ ɫɨɫɬɚɜɥɹɸɬ ɨɬ 5 ɞɨ 9% ɜɫɟɯɢɧɬɪɚɤɪɚɧɢɚɥɶɧɵɯɧɨɜɨɨɛɪɚɡɨɜɚɧɢɣ. ɇɚɢɛɨɥɟɟ ɱɚɫɬɨ ɨɧɢ ɜɫɬɪɟɱɚɸɬɫɹ ɜ ɰɟɪɟɛɪɚɥɶɧɵɯ ɝɟɦɢɫɮɟɪɚɯ ɭ ɜɡɪɨɫɥɵɯ. ɉɨɞɚɜɥɹɸɳɟɟ ɛɨɥɶɲɢɧɫɬɜɨ ɨɥɢɝɨɞɟɧɞɪɨɝɥɢɨɦ ɢɦɟɸɬ ɩɨɫɬɟɩɟɧɧɵɣ ɤɭɪɫ ɤɥɢɧɢɱɟɫɤɨɝɨ ɬɟɱɟɧɢɹ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɟɬɫɹ ɯɨɪɨɲɨ ɨɬɝɪɚɧɢɱɟɧɧɚɹ ɨɩɭɯɨɥɶ ɫɟɪɨ ɛɟɥɨɝɨ, ɢɧɨɝɞɚ ɫɟɪɨ ɠɟɥɬɨɝɨ ɰɜɟɬɚ. ȼ ɧɟɤɨɬɨɪɵɯ ɫɥɭɱɚɹɯ ɩɚɪɟɧɯɢɦɚ ɨɩɭɯɨɥɢ ɩɪɨɪɚɫɬɚɟɬɜ ɤɨɪɭɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ (ɪɢɫ. 12.51).

7.2.ɗɩɟɧɞɢɦɨɦɵ(Ɇ9391/3). ɗɬɚɝɪɭɩɩɚ ɨɩɭɯɨɥɟɣ ɩɪɨɢɫɯɨɞɢɬ ɢɡ ɤɥɟɬɨɤ, ɨɛɪɚɡɭɸɳɢɯ ɷɩɟɧɞɢɦɚɥɶɧɵɣ ɫɥɨɣ ɠɟɥɭɞɨɱɤɨɜ ɢ ɰɟɧɬɪɚɥɶɧɨɝɨ ɤɚɧɚɥɚ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. 45% ɷɩɟɧɞɢɦɨɦ ɥɨɤɚɥɢɡɭɸɬɫɹ ɫɭɛɬɟɧɬɨɪɢɚɥɶɧɨ ɢ ɨɤɨɥɨ 40% — ɫɭɩɪɚɬɟɧɬɨɪɢɚɥɶɧɨ. ɇɟɤɨɬɨɪɵɟ ɢɡ ɧɢɯ ɪɚɫɩɨɥɚɝɚɸɬɫɹ ɜ ɰɟɧɬɪɚɥɶɧɨɦ ɤɚɧɚɥɟ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ɗɩɟɧɞɢɦɨɦɵ ɜɫɬɪɟɱɚɸɬɫɹ ɜɥɸɛɨɣ ɜɨɡɪɚɫɬɧɨɣ ɝɪɭɩɩɟ, ɨɞɧɚɤɨ ɱɚɳɟ ɜɫɟɝɨ —ɭɞɟɬɟɣ 3—4 ɥɟɬ. ɇɚɢɛɨɥɟɟ ɱɚɫɬɵɦ ɤɥɢɧɢɱɟɫɤɢɦ ɫɢɦɩɬɨɦɨɦ ɹɜɥɹɟɬɫɹ ɩɨɜɵɲɟɧɢɟ ɜɧɭɬɪɢɱɟɪɟɩɧɨɝɨ ɞɚɜɥɟɧɢɹ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɟɬɫɹ ɯɨɪɨɲɨ ɨɬɝɪɚɧɢɱɟɧɧɚɹ ɩɥɨɬɧɚɹ ɨɩɭɯɨɥɶ ɫɟɪɨɝɨ ɢɥɢ ɫɟɪɨ ɛɟɥɨɝɨ ɰɜɟɬɚ, ɥɟɠɚɳɚɹ ɩɨ ɩɟɪɢɮɟɪɢɢ ɠɟɥɭɞɨɱɤɨɜɨɣ ɫɢɫɬɟɦɵ ɦɨɡɝɚ ɢ ɢɧɨɝɞɚ ɭɡɭɪɢɪɭɸɳɚɹ ɫɬɟɧɤɭɠɟɥɭɞɨɱɤɚ ɫ ɪɚɡɜɢɬɢɟɦ ɤɪɨɜɨɬɟɱɟɧɢɹ (ɪɢɫ. 12.52). ɉɪɨɝɧɨɡ ɧɟɛɥɚɝɨɩɪɢɹɬɧɵɣ, ɨɱɟɧɶ ɧɟɦɧɨɝɢɟ ɥɢɰɚ ɩɟɪɟɠɢɜɚɸɬ 4 ɥɟɬɧɵɣ ɫɪɨɤ ɩɨɫɥɟ ɭɫɬɚɧɨɜɥɟɧɢɹ ɞɢɚɝɧɨɡɚ.

7.3.Ɇɟɞɭɥɥɨɛɥɚɫɬɨɦɵ(Ɇ9470/3) ɹɜɥɹɸɬɫɹ ɡɥɨɤɚɱɟɫɬɜɟɧɧɵɦɢ ɫ ɤɥɢɧɢɱɟɫɤɨɣ ɢ ɦɨɪɮɨɥɨɝɢɱɟɫɤɨɣ ɬɨɱɟɤ ɡɪɟɧɢɹ ɢ ɤɥɚɫɫɢɱɟ-

ɫɤɢ ɨɬɧɨɫɹɬɫɹ ɤ ɩɚɬɨɥɨɝɢɢ ɞɟɬɫɤɨɝɨ ɜɨɡɪɚɫɬɚ. ɉɨɞɚɜɥɹɸɳɟɟ ɢɯ ɛɨɥɶɲɢɧɫɬɜɨ ɨɩɪɟɞɟɥɹɟɬɫɹ ɜ ɜɨɡɪɚɫɬɟ ɞɨ 14 ɥɟɬ. ɑɚɳɟ ɜɫɟɝɨ ɦɟɞɭɥɥɨɛɥɚɫɬɨɦɵ ɥɨɤɚɥɢɡɭɸɬɫɹ ɜ ɦɨɡɠɟɱɤɟ. Ȼɨɥɶɲɢɧɫɬɜɨ ɨɩɭɯɨɥɟɣ ɪɚɫɬɟɬɩɨɫɪɟɞɢɧɧɨɣ ɥɢɧɢɢ ɦɨɡɠɟɱɤɚɤɡɚɞɢ ɢ ɢɧɬɟɧɫɢɜɧɨɜɨɜɥɟɤɚɟɬ ɨɬɬɨɤ ɫɩɢɧɧɨɦɨɡɝɨɜɨɣ ɠɢɞɤɨɫɬɢ. ɋ ɬɨɱɤɢ ɡɪɟɧɢɹ ɝɢɫɬɨɝɟɧɟɡɚ ɷɩɟɧɞɢɦɨɦɵ ɧɟɞɚɜɧɨ ɛɵɥɢ ɤɥɚɫɫɢɮɢɰɢɪɨɜɚɧɵ ɤɚɤ ɦɟɥɤɨɤɥɟɬɨɱɧɵɟ ɨɩɭɯɨɥɢ ɢɡ ɩɪɢɦɢɬɢɜɧɨɣ ɧɟɣɪɨɷɤɬɨɞɟɪɦɵ.

Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɜ ɤɥɚɫɫɢɱɟɫɤɨɦ ɜɚɪɢɚɧɬɟ ɷɬɢ ɨɩɭɯɨɥɢ ɤɪɚɫɧɨ ɫɟɪɨɝɨ ɰɜɟɬɚ, ɦɟɥɤɨɡɟɪɧɢɫɬɵɟ, ɝɨɦɨɝɟɧɧɵɟ, ɯɨɪɨɲɨ ɨɬɝɪɚɧɢɱɟɧɧɵɟ, ɪɚɫɬɭɳɢɟ ɢɡ ɤɪɵɲɢ IV ɠɟɥɭɞɨɱɤɚ ɦɨɡɝɚ ɢ ɱɚɫɬɨ ɡɚɩɨɥɧɹɸɳɢɟ ɟɝɨ ɩɨɥɨɫɬɶ (ɪɢɫ. 12.53). ɉɪɨɝɧɨɡ ɧɟɛɥɚɝɨɩɪɢɹɬɧɵɣ — ɫɦɟɪɬɶ ɨɛɵɱɧɨ ɧɚɫɬɭɩɚɟɬ ɜ ɬɟɱɟɧɢɟ 1—2 ɥɟɬ ɫ ɦɨɦɟɧɬɚ ɭɫɬɚɧɨɜɥɟɧɢɹ ɞɢɚɝɧɨɡɚ.

7.4.Ɇɟɧɢɧɝɢɨɦɵ (Ɇ9530/1 — Ɇ9530/3). Ⱦɨɫɬɚɬɨɱɧɨ ɱɚɫɬɨ ɜɫɬɪɟɱɚɸɳɚɹɫɹ ɝɪɭɩɩɚ ɧɨɜɨɨɛɪɚɡɨɜɚɧɢɣ, ɫɨɫɬɚɜɥɹɸɳɚɹ ɨɤɨɥɨ 20% ɜɫɟɯ ɢɧɬɪɚɤɪɚɧɢɚɥɶɧɵɯ ɨɩɭɯɨɥɟɣ ɭ ɜɡɪɨɫɥɵɯ. Ɇɟɧɢɧɝɢɨɦɵ ɱɚɳɟ ɜɫɬɪɟɱɚɸɬɫɹ ɭ ɠɟɧɳɢɧ, ɨɞɧɚɤɨ ɜ ɨɩɪɟɞɟɥɟɧɧɨɦ ɩɪɨɰɟɧɬɟ ɫɥɭɱɚɟɜ ɧɚɛɥɸɞɚɸɬɫɹ ɢ ɭ ɞɟɬɟɣ. 60% ɦɟɧɢɧɝɢɨɦ ɥɨɤɚɥɢɡɭɸɬɫɹ ɛɥɢɠɟ ɤ ɫɪɟɞɢɧɧɨɣ ɥɢɧɢɢ ɝɨɥɨɜɵ ɢ ɜ ɬɟɦɟɧɧɨɣ ɨɛɥɚɫɬɢ. ɋɩɢ ɧɚɥɶɧɵɟ ɦɟɧɢɧɝɢɨɦɵ —ɧɚɢɛɨɥɟɟ ɱɚɫɬɵɟ ɨɩɭɯɨɥɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚɢ ɟɝɨ ɨɛɨɥɨɱɟɤ, ɨɞɧɚɤɨ ɜɫɬɪɟɱɚɸɬɫɹ ɡɧɚɱɢɬɟɥɶɧɨ ɪɟɠɟ ɜ ɫɪɚɜɧɟɧɢɢ ɫ ɜɧɭɬɪɢɱɟɪɟɩɧɵɦɢ.

Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɩɪɟɞɫɬɚɜɥɹɸɬ ɫɨɛɨɣ ɩɥɨɬɧɵɟ ɧɨɜɨɨɛɪɚɡɨɜɚɧɢɹ ɛɟɥɨɝɨ ɢɥɢ ɤɪɚɫɧɨ ɩɟɫɨɱɧɨɝɨ ɰɜɟɬɚ (ɪɢɫ. 12.54), ɯɨɪɨɲɨ ɨɬɝɪɚɧɢɱɟɧɧɵɟ ɨɬ ɩɪɢɥɟɠɚɳɟɣ ɰɟɪɟɛɪɚɥɶɧɨɣ ɩɚɪɟɧɯɢɦɵ, ɤɨɬɨɪɭɸ ɨɧɢ ɫɞɚɜɥɢɜɚɸɬ, ɧɨ ɧɟ ɢɧɮɢɥɶɬɪɢɪɭɸɬ (ɪɢɫ. 12.55). ɉɪɢ ɫɜɨɟɜɪɟɦɟɧɧɨ ɢ ɪɚɞɢɤɚɥɶɧɨ ɩɪɨɜɟɞɟɧɧɨɣ ɨɩɟɪɚɰɢɢ ɩɪɨɝɧɨɡ ɛɥɚɝɨɩɪɢɹɬɧɵɣ, ɫ ɩɨɥɧɵɦ ɜɵɡɞɨɪɨɜɥɟɧɢɟɦ. ɇɟ ɩɨɥɧɨɫɬɶɸɭɞɚɥɟɧɧɵɟ ɨɩɭɯɨɥɢ ɦɨɝɭɬɪɟɰɢɞɢɜɢɪɨɜɚɬɶ.

7.5.Ⱦɪɭɝɢɟɨɩɭɯɨɥɢɰɟɧɬɪɚɥɶɧɨɣɢɩɟɪɢɮɟɪɢɱɟɫɤɨɣɧɟɪɜɧɨɣɫɢ-

ɫɬɟɦɵ.

Ƚɟɦɚɧɝɢɨɛɥɚɫɬɨɦɵ (Ɇ9161/1) ɫɨɫɬɚɜɥɹɸɬ 7% ɜɫɟɯ ɨɩɭɯɨɥɟɣ ɡɚɞɧɟɣ ɱɟɪɟɩɧɨɣ ɹɦɤɢ. ȼɫɬɪɟɱɚɸɬɫɹ ɜ ɨɫɧɨɜɧɨɦ ɭɞɟɬɟɣ ɫɬɚɪɲɟɝɨ ɜɨɡɪɚɫɬɚ ɢ ɦɨɥɨɞɵɯ ɜɡɪɨɫɥɵɯ. Ɉɩɭɯɨɥɶ ɜ 50% ɫɥɭɱɚɟɜ ɥɨɤɚɥɢɡɭɟɬɫɹ ɜ ɫɩɢɧɧɨɦ ɦɨɡɝɟ. Ʉɥɢɧɢɱɟɫɤɢ ɩɪɨɹɜɥɹɟɬɫɹ ɧɚɪɭɲɟɧɢɟɦ ɩɨɯɨɞɤɢ ɢ ɪɚɜɧɨɜɟɫɢɹ. ȼ ɧɟɤɨɬɨɪɵɯ ɫɥɭɱɚɹɯ ɫɨɩɭɬɫɬɜɭɸɳɢɦ ɡɚɛɨɥɟɜɚɧɢɟɦ ɹɜɥɹɟɬɫɹ ɩɨɥɢɰɢɬɟɦɢɹ (ɨɩɭɯɨɥɶ ɩɪɨɞɭɰɢɪɭɟɬ ɷɪɢɬɪɨ ɩɨɷɬɢɧ). Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɪɟɞɟɥɹɟɬɫɹ ɯɨɪɨɲɨ ɨɬɝɪɚɧɢɱɟɧɧɚɹ ɤɪɚɫɧɨ ɛɭɪɚɹ ɝɭɛɱɚɬɚɹ ɨɩɭɯɨɥɶ, ɤɨɬɨɪɚɹ ɦɨɠɟɬ ɛɵɬɶ ɤɚɤ ɫɨɥɢɞɧɨɣ, ɬɚɤ ɢ ɤɢɫɬɨɡɧɨɣ (ɪɢɫ. 12.56). ɂɧɨɝɞɚ ɤɪɭɩɧɵɟ ɤɢɫɬɵ ɜɤɥɸɱɚɸɬ ɫɨɛɫɬɜɟɧɧɨ ɨɩɭɯɨɥɟɜɭɸ ɬɤɚɧɶ ɜ ɜɢɞɟ ɧɟɛɨɥɶɲɨɝɨ ɢɧɬɪɚɦɭ ɪɚɥɶɧɨɝɨ ɭɡɥɚ. ɋɨɥɢɬɚɪɧɵɟ ɪɚɞɢɤɚɥɶɧɨ ɢɫɫɟɱɟɧɧɵɟ ɝɟɦɚɧɝɢɨɛɥɚɫɬɨɦɵ ɢɦɟɸɬɯɨɪɨɲɢɣ ɩɪɨɝɧɨɡ.

ɇɟɜɪɢɥɟɦɦɨɦɵ(ɲɜɚɧɧɨɦɵ) (Ɇ9560/1 —Ɇ9560/3) —ɨɩɭɯɨɥɢ ɨɛɨɥɨɱɟɤ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯɧɟɪɜɨɜ. ɗɬɢ ɧɨɜɨɨɛɪɚɡɨɜɚɧɢɹ ɫɨɫɬɚɜɥɹɸɬ ɨɤɨɥɨ 8% ɜɫɟɯɢɧɬɪɚɤɪɚɧɢɚɥɶɧɵɯɨɩɭɯɨɥɟɣ. ɑɚɳɟ ɧɚɛɥɸɞɚɸɬɫɹ ɭɥɢɰ ɫɪɟɞɧɟɝɨ ɜɨɡɪɚɫɬɚ. Ʌɨɤɚɥɢɡɚɰɢɹ ɫɚɦɚɹ ɪɚɡɧɨɨɛɪɚɡɧɚɹ, ɧɨ ɱɚɳɟ ɬɚɤɢɟ ɨɩɭɯɨɥɢ ɨɛɧɚɪɭɠɢɜɚɸɬɫɹ ɜ 8 ɣ ɩɚɪɟ ɱɟɪɟɩɧɨ ɦɨɡɝɨɜɵɥ ɧɟɪɜɨɜ (ɚɤɭɫɬɢɱɟɫɤɢɟ ɧɟɜɪɨɦɵ), ɤɨɬɨɪɵɟ ɦɨɝɭɬ ɛɵɬɶ ɤɚɤ ɫɩɨɪɚɞɢɱɟɫɤɢɦɢ, ɬɚɤ ɢ ɹɜɥɹɬɶɫɹ ɱɚɫɬɶɸ ɛɨɥɟɡɧɢ Ɋɟɤɥɢɧɝɯɚɭɡɟɧɚ 2 ɝɨ ɬɢɩɚ. Ʉɥɢɧɢɱɟɫɤɢɟɩɪɨɹɜɥɟɧɢɹ ɩɪɟɞɫɬɚɜɥɟɧɵɩɨɬɟɪɟɣ ɫɥɭɯɚ, ɧɚɪɭɲɟɧɢɟɦ ɪɚɜɧɨɜɟɫɢɹ ɢ ɝɨɥɨɜɧɨɣ ɛɨɥɶɸ. ɑɚɫɬɨ ɨɩɭɯɨɥɢ ɧɟɞɢɚɝɧɨɫɬɢɪɭɸɬɫɹ, ɩɨɫɤɨɥɶɤɭɫɢɦɭɥɢɪɭɸɬ ɧɟɣɪɨɫɟɧɫɨɪɧɭɸ ɝɥɭɯɨɬɭ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɞɚɧɧɵɟ ɧɨɜɨɨɛɪɚɡɨɜɚɧɢɹ ɫɜɹɡɚɧɵ ɫ ɩɟɪɢɮɟɪɢɱɟɫɤɢɦ ɧɟɪɜɨɦ, ɧɨ ɪɚɫɬɭɬ ɷɤɡɨɮɢɬɧɨ. ɉɚɪɟɧɯɢɦɚ ɨɩɭɯɨɥɢ ɝɨɦɨɝɟɧɧɚɹ, ɦɟɥɤɨɡɟɪɧɢɫɬɚɹ, ɜɧɟɲɧɢɣ ɜɢɞ ɫɮɟɪɢɱɟɫɤɢɣ ɢɥɢ ɩɪɨɞɨɥɝɨɜɚɬɵɣ, ɢɧɨɝɞɚ ɨɩɪɟɞɟɥɹɸɬɫɹ ɦɟɥɤɢɟ ɤɢɫɬɵ (ɪɢɫ. 12.57). ɉɪɨɝɧɨɡ ɛɥɚɝɨɩɪɢɹɬɧɵɣ ɞɚɠɟɩɪɢ ɱɚɫɬɢɱɧɨɣ ɪɟɡɟɤɰɢɢ ɢ ɪɟɰɢɞɢɜɚɯ.

Ʉɪɚɧɢɨɮɚɪɢɧɝɢɨɦɵ(Ɇ9350/1) ɨɛɵɱɧɨ ɜɫɬɪɟɱɚɸɬɫɹ ɭɞɟɬɟɣ ɜ ɜɨɡɪɚɫɬɟ 4—16 ɥɟɬ. Ʉɥɚɫɫɢɱɟɫɤɢ ɷɬɢ ɨɩɭɯɨɥɢ ɩɪɟɞɫɬɚɜɥɟɧɵ ɪɚɫɩɨɥɨɠɟɧɧɵɦɢ ɧɚɞ ɬɭɪɟɰɤɢɦ ɫɟɞɥɨɦ ɤɚɥɶɰɢɮɢɰɢɪɨɜɚɧɧɵɦɢ ɦɚɫɫɚɦɢ, ɫɞɚɜɥɢɜɚɸɳɢɦɢ ɝɢɩɨɬɚɥɚɦɭɫ, ɱɬɨ ɩɪɢɜɨɞɢɬ ɤ ɜɢɡɭɚɥɶ

Ɋɢɫ. 12.59. ɏɨɪɞɨɦɚ

ɨɫɧɨɜɚɧɢɹ ɡɚɬɵɥɨɱɧɨɣ ɤɨɫɬɢ. ɂɧɨɝɞɚ ɯɨɪɞɨɦɵ ɨɛɧɚɪɭɠɢɜɚɸɬ ɱɪɟɡɜɵɱɚɣɧɭɸ ɚɝɪɟɫɫɢɜɧɨɫɬɶ, ɞɟɫɬɪɭɢɪɭɸɬ ɤɨɫɬɶ ɢ ɩɚɪɟɧɯɢɦɭɨɫɧɨɜɚɧɢɹ ɦɨɡɝɚ ɢ ɢɧɮɢɥɶɬɪɢɪɭɸɬ ɤɨɫɬɧɵɟ ɫɬɪɭɤɬɭɪɵ ɨɫɧɨɜɚɧɢɹ ɱɟɪɟɩɚ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɨɩɭɯɨɥɶ ɫɟɪɨ ɛɟɥɨɝɨ ɰɜɟɬɚ, ɨɱɟɧɶ ɦɹɝɤɚɹ, ɥɨɦɤɚɹ, ɞɨɥɶɱɚɬɚɹ (ɪɢɫ. 12.59). Ȼɨɥɶɲɢɧɫɬɜɨ ɛɨɥɶɧɵɯɩɪɢ ɚɝɪɟɫɫɢɜɧɨɦ ɬɟɱɟɧɢɢ ɩɪɨɰɟɫɫɚɭɦɢɪɚɸɬɞɨɜɨɥɶɧɨ ɛɵɫɬɪɨ.

Ɉɩɭɯɨɥɢɷɩɢɮɢɡɚ[Ɇ9360 (Ɇ9362/1 Ɇ9362/3)] ɨɛɵɱɧɨ ɪɚɫ-

ɫɦɚɬɪɢɜɚɸɬ ɤɚɤ ɬɟɪɚɬɨɦɵ. ɉɨ ɤɥɟɬɨɱɧɨɦɭɫɨɫɬɚɜɭɨɧɢ ɛɨɥɟɟ ɜɫɟɝɨ ɫɨɨɬɜɟɬɫɬɜɭɸɬ ɝɟɪɦɢɧɨɝɟɧɧɵɦ ɨɩɭɯɨɥɹɦ ɹɢɱɤɚ ɢɥɢ ɹɢɱɧɢɤɚ. ȼ ɤɥɚɫɫɢɱɟɫɤɨɦ ɜɚɪɢɚɧɬɟ ɜɫɬɪɟɱɚɸɬɫɹ ɭ ɦɨɥɨɞɵɯ ɦɭɠɱɢɧ ɜ ɜɨɡɪɚɫɬɟ ɞɨ 20 ɥɟɬ. Ʉɥɢɧɢɱɟɫɤɚɹ ɫɢɦɩɬɨɦɚɬɢɤɚ ɜɤɥɸɱɚɟɬ ɩɨɜɵɲɟɧɢɟ ɜɧɭɬɪɢɱɟɪɟɩɧɨɝɨ ɞɚɜɥɟɧɢɹ ɜ ɫɜɹɡɢ ɫ ɨɛɫɬɪɭɤɰɢɟɣ ɫɢɥɶɜɢɟɜɚ ɜɨɞɨɩɪɨɜɨɞɚ ɢ ɬɪɟɬɶɟɝɨ ɠɟɥɭɞɨɱɤɚ ɦɨɡɝɚ. ɉɪɨɝɧɨɡ ɡɚɜɢɫɢɬ ɨɬɝɢɫɬɨɥɨɝɢɱɟɫɤɨɣ ɫɬɪɭɤɬɭɪɵ ɧɨɜɨɨɛɪɚɡɨɜɚɧɢɹ. Ɍɚɤ, ɱɢɫɬɵɟ ɫɟɦɢɧɨ ɦɨɩɨɞɨɛɧɵɟ ɨɩɭɯɨɥɢ ɨɛɥɚɞɚɸɬ ɜɵɫɨɤɨɣ ɪɚɞɢɨɱɭɜɫɬɚɜɢɬɟɥɶɧɨ ɫɬɶɸ ɢ ɢɦɟɸɬ ɨɬɧɨɫɢɬɟɥɶɧɨ ɛɥɚɝɨɩɪɢɹɬɧɵɣ ɩɪɨɝɧɨɡ, ɜ ɬɨ ɜɪɟɦɹ ɤɚɤ ɞɪɭɝɢɟɬɢɩɵ ɨɩɭɯɨɥɟɣ —ɦɟɧɟɟɩɨɡɢɬɢɜɧɵɣ.

Ɇɟɬɚɫɬɚɬɢɱɟɫɤɢɟɨɩɭɯɨɥɢɫɨɫɬɚɜɥɹɸɬɨɤɨɥɨ23% ɜɫɟɯɨɩɭɯɨɥɟɣ ɦɨɡɝɚ. Ɇɟɬɚɫɬɚɡɵ ɜ ɦɨɡɝɫɜɹɡɚɧɵ ɫ ɝɟɦɚɬɨɝɟɧɧɨɣ ɞɢɫɫɟɦɢɧɚɰɢɟɣ, ɨɞɧɚɤɨ ɩɪɢ ɪɚɡɜɢɬɢɢ ɩɚɪɚɤɪɚɧɢɚɥɶɧɵɯɨɩɭɯɨɥɟɣ ɜɨɡɦɨɠɧɨ ɩɪɹ

Ɋɢɫ. 12.60. Ɇɟɬɚɫɬɚɬɢɱɟɫɤɚɹɨɩɭɯɨɥɶɦɨɡɝɚ(ɩɟɪɜɢɱɧɵɣɪɚɤ ɥɟɝɤɢɯ)

Ɋɢɫ. 12.61. Ɇɟɬɚɫɬɚɬɢɱɟɫɤɚɹɨɩɭɯɨɥɶɦɨɡɝɚ(ɩɟɪɜɢɱɧɚɹɤɨɠɧɚɹ ɦɟɥɚɧɨɦɚ)

ɦɨɟ ɪɚɫɩɪɨɫɬɪɚɧɟɧɢɟ. ɇɚɢɛɨɥɟɟ ɱɚɫɬɨ ɜ ɝɨɥɨɜɧɨɣ ɦɨɡɝɦɟɬɚɫɬɚɡɢ ɪɭɸɬɨɩɭɯɨɥɢ ɥɟɝɤɢɯ—45—50% ɭɦɟɪɲɢɯɢɦɟɸɬɜɦɚɤɪɨɫɤɨɩɢɱɟɫɤɨɣ ɢ ɦɢɤɪɨɫɤɨɩɢɱɟɫɤɨɣ ɫɢɦɩɬɨɦɚɬɢɤɟ ɜɨɜɥɟɱɟɧɢɟ ɩɚɪɟɧɯɢɦɵ ɦɨɡɝɚ ɢɥɢ ɟɝɨ ɨɛɨɥɨɱɟɤ (ɪɢɫ. 12.60). Ɂɚɬɟɦ ɩɨ ɱɚɫɬɨɬɟ ɦɟɬɚɫɬɚɡɢɪɨ

ɜɚɧɢɹ ɜ ɩɨɪɹɞɤɟ ɭɛɵɜɚɧɢɹ ɫɥɟɞɭɸɬ: ɥɟɣɤɨɡɵ ɢ ɥɢɦɮɨɦɵ, ɨɩɭɯɨɥɢ ɤɢɲɟɱɧɢɤɚ, ɩɨɱɟɤ ɢ ɦɨɥɨɱɧɨɣ ɠɟɥɟɡɵ. ɂɡ ɦɟɧɟɟɪɚɫɩɪɨɫɬɪɚɧɟɧɧɵɯ ɨɩɭɯɨɥɟɣ ɧɚɢɛɨɥɟɟ ɱɚɫɬɨ ɦɟɬɚɫɬɚɡɢɪɭɟɬ ɡɥɨɤɚɱɟɫɬɜɟɧɧɚɹ ɦɟ ɥɚɧɨɦɚ, ɩɪɢ ɤɨɬɨɪɨɣ ɩɨɪɚɠɟɧɢɟ ɦɨɡɝɚɨɩɪɟɞɟɥɹɟɬɫɹ ɜ 50% ɧɚɛɥɸɞɟɧɢɣ (ɪɢɫ. 12.61), ɮɨɥɥɢɤɭɥɹɪɧɵɣ ɪɚɤ ɳɢɬɨɜɢɞɧɨɣ ɠɟɥɟɡɵ ɢ ɧɟɤɨɬɨɪɵɟ ɫɚɪɤɨɦɵ. Ʉɥɢɧɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ ɦɟɬɚɫɬɚɬɢɱɟɫɤɢɯ ɨɩɭɯɨɥɟɣ ɝɨɥɨɜɧɨɝɨ ɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɧɟ ɨɬɥɢɱɚɸɬɫɹ ɨɬ ɬɚɤɨɜɵɯ ɩɪɢ ɩɟɪɜɢɱɧɵɯɨɩɭɯɨɥɹɯ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢ ɦɟɬɚɫɬɚɬɢɱɟɫɤɢɟɨɩɭɯɨɥɢ ɩɪɟɞɫɬɚɜɥɟɧɵ ɪɚɡɥɢɱɧɵɦ ɱɢɫɥɨɦ ɭɡɥɨɜ, ɰɜɟɬɢ ɤɨɧɫɢɫɬɟɧɰɢɹ ɤɨɬɨɪɵɯ ɡɧɚɱɢɬɟɥɶɧɨ ɜɚɪɶɢɪɭɸɬ, ɨɬɪɚɠɚɹ, ɫɤɨɪɟɟ, ɨɫɨɛɟɧɧɨɫɬɢ ɩɟɪɜɢɱɧɨɣ ɨɩɭɯɨɥɢ, ɱɟɦ ɰɟɪɟɛɪɚɥɶɧɨɝɨ ɩɪɨɰɟɫɫɚ. Ɍɪɚɞɢɰɢɨɧɧɨ ɦɟɬɚɫɬɚɡɵ ɪɚɫɩɨɥɚɝɚɸɬɫɹ ɧɚ ɝɪɚɧɢɰɟ ɛɟɥɨɝɨ ɢ ɫɟɪɨɝɨ ɜɟɳɟɫɬɜɚ, ɬ.ɟ.

ɜɡɨɧɚɯɫ ɡɚɦɟɞɥɟɧɧɵɦ ɤɪɨɜɨɬɨɤɨɦ ɢ ɦɟɧɶɲɢɦ ɱɢɫɥɨɦ ɫɨɫɭɞɨɜ.

8.ɉȺɌɈɅɈȽɂə ɉȿɊɂɎȿɊɂɑȿɋɄɈɃ ɇȿɊȼɇɈɃ ɋɂɋɌȿɆɕ.

8.1.ɉɟɪɢɮɟɪɢɱɟɫɤɚɹɧɟɜɪɨɩɚɬɢɹ (ɜɨɡɦɨɠɧɨ ɢɫɩɨɥɶɡɨɜɚɧɢɟ ɦɧɨɠɟɫɬɜɟɧɧɵɯɤɨɞɨɜ ɜ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬɷɬɢɨɥɨɝɢɢ). Ɇɨɧɨɧɟɜɪɨɩɚɬɢɹ ɨɩɪɟɞɟɥɹɟɬɫɹ ɤɚɤ ɮɨɤɚɥɶɧɵɣ ɩɚɬɨɥɨɝɢɱɟɫɤɢɣ ɩɪɨɰɟɫɫ ɜ ɨɞɧɨɦ ɩɟɪɢɮɟɪɢɱɟɫɤɨɦ ɧɟɪɜɟ, ɬɨɝɞɚ ɤɚɤ ɩɨɥɢɧɟɜɪɨɩɚɬɢɹ ɨɛɵɱɧɨ ɩɪɟɞɫɬɚɜɥɹɟɬ ɫɢɫɬɟɦɧɵɣ ɩɪɨɰɟɫɫ ɩɚɬɨɥɨɝɢɱɟɫɤɢɯ ɢɡɦɟɧɟɧɢɣ ɜ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯɧɟɪɜɚɯ. ɗɬɢɨɥɨɝɢɹ ɱɪɟɡɜɵɱɚɣɧɨ ɪɚɡɧɨɨɛɪɚɡɧɚ ɢ ɚɫɫɨɰɢɢɪɭɟɬɫɹ ɫ ɯɪɨɧɢɱɟɫɤɢɦɢ ɥɨɤɚɥɶɧɵɦɢ ɢɧɮɟɤɰɢɹɦɢ, ɢɦɦɭɧɨɥɨɝɢɱɟɫɤɢɦɢ ɪɟɚɤɰɢɹɦɢ (ɫɢɧɞɪɨɦ Ƚɢɣɟɧɚ—Ȼɚɪɪɟ), ɨɬɪɚɜɥɟɧɢɟɦ ɬɹɠɟɥɵɦɢ ɦɟɬɚɥɥɚɦɢ, ɚɥɤɨɝɨɥɟɦ ɢ ɧɟɤɨɬɨɪɵɦɢ ɞɪɭɝɢɦɢ ɯɢɦɢɤɚɬɚɦɢ (ɱɟɬɵɪɟɯɯɥɨɪɢɫɬɵɣ ɭɝɥɟɪɨɞ), ɦɟɬɚɛɨɥɢɱɟɫɤɢɦɢ ɪɚɫɫɬɪɨɣɫɬɜɚɦɢ ɢ ɝɢɩɨɜɢɬɚɦɢɧɨɡɚɦɢ. ɉɟɪɢɮɟɪɢɱɟɫɤɢɟ ɧɟɜɪɨɩɚɬɢɢ ɦɨɝɭɬ ɫɨɩɪɨɜɨɠɞɚɬɶ ɬɚɤɢɟ ɫɨɫɬɨɹɧɢɹ, ɤɚɤ ɛɟɪɟɦɟɧɧɨɫɬɶ, ɞɟɝɢɞ-

ɪɚɬɚɰɢɸ, ɪɚɡɥɢɱɧɵɟ ɧɚɪɭɲɟɧɢɹ ɨɛɦɟɧɚ ɷɥɟɤɬɪɨɥɢɬɨɜ. ɇɟ ɢɫɤɥɸɱɟɧɵ ɝɟɧɟɬɢɱɟɫɤɢɟ ɮɨɪɦɵ ɧɟɜɪɨɩɚɬɢɱɟɫɤɢɯɫɢɧɞɪɨɦɨɜ, ɩɪɢɦɟɪɨɦ ɱɟɝɨ ɹɜɥɹɟɬɫɹ ɛɨɥɟɡɧɶ ɒɚɪɤɨ—Ɇɚɪɢ—Ɍɭɬɚ. Ɇɚɤɪɨɫɤɨɩɢɱɟɫɤɢɯɢɡɦɟɧɟɧɢɣ ɜ ɩɟɪɢɮɟɪɢɱɟɫɤɢɯɧɟɪɜɚɯɧɟ ɨɩɪɟɞɟɥɹɟɬɫɹ.

8.2.Ɍɪɚɜɦɚɬɢɱɟɫɤɚɹɧɟɜɪɨɩɚɬɢɹ. ɉɨɜɪɟɠɞɟɧɢɟ ɩɟɪɢɮɟɪɢɱɟ-

ɫɤɨɝɨ ɧɟɪɜɚ ɦɨɠɟɬ ɜɨɡɧɢɤɧɭɬɶ ɜ ɥɸɛɨɣ ɢɡ ɫɥɟɞɭɸɳɢɯ ɫɢɬɭɚɰɢɣ: ɤɨɦɩɪɟɫɫɢɹ (ɨɩɭɯɨɥɢ, ɪɭɛɰɵ, ɚɧɟɜɪɢɡɦɵ, ɜɨɫɩɚɥɟɧɢɹ, ɢɧɮɢɥɶɬ ɪɚɬɢɜɧɵɟ ɩɪɨɰɟɫɫɵ), ɪɚɫɬɹɠɟɧɢɹ ɢ ɩɟɪɟɝɢɛɵ (ɩɟɪɟɥɨɦɵ ɤɨɫɬɟɣ ɫɨ ɫɦɟɳɟɧɢɟɦ ɮɪɚɝɦɟɧɬɨɜ, ɢɧɬɟɧɫɢɜɧɵɟ ɞɜɢɠɟɧɢɹ ɢɡɛɵɬɨɱɧɨɣ ɚɦɩɥɢɬɭɞɵ ɢ/ɢɥɢ ɩɪɨɬɹɠɟɧɧɨɫɬɢ), ɩɪɹɦɵɟ ɩɪɨɧɢɤɚɸɳɢɟ ɩɨɜɪɟɠɞɟɧɢɹ.

8.3.ɇɟɜɪɨɩɚɬɢɹɜɢɫɯɨɞɟɫɨɫɭɞɢɫɬɨɣɩɚɬɨɥɨɝɢɢ. ɉɨɥɢɚɪɬɟɪɢɢɬ ɦɨɠɟɬ ɜɵɡɵɜɚɬɶ ɫɢɦɩɬɨɦɚɬɢɤɭ ɧɟɜɪɨɩɚɬɢɢ ɜ ɫɜɹɡɢ ɫ ɪɚɡɜɢɬɢɟɦ ɢɲɟɦɢɱɟɫɤɢɯ ɩɨɜɪɟɠɞɟɧɢɣ ɧɟɪɜɚ ɢɥɢ ɝɪɭɩɩɵ ɧɟɪɜɨɜ. Ⱦɢɚɛɟɬɢɱɟɫɤɚɹ ɧɟɜɪɨɩɚɬɢɹ ɪɚɡɜɢɜɚɟɬɫɹ ɜ ɪɟɡɭɥɶɬɚɬɟ ɞɢɚɛɟɬɢɱɟɫɤɨɣ ɦɢɤ ɪɨɚɧɝɢɨɩɚɬɢɢ ɫ ɩɨɫɥɟɞɭɸɳɢɦɢ ɢɲɟɦɢɱɟɫɤɢɦɢ ɩɨɜɪɟɠɞɟɧɢɹɦɢ ɧɟɪɜɧɵɯɫɬɜɨɥɨɜ. Ʉɥɚɫɫɢɱɟɫɤɚɹ ɞɢɚɛɟɬɢɱɟɫɤɚɹ ɧɟɜɪɨɩɚɬɢɹ ɩɪɟɞɫɬɚɜɥɹɟɬ ɫɨɛɨɣ ɫɢɦɦɟɬɪɢɱɧɭɸ ɞɢɫɬɚɥɶɧɭɸ ɩɨɬɟɪɸ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɢ ɜɟɪɯɧɢɯ ɢ ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ (ɧɚɪɭɲɟɧɢɹ ɬɢɩɚ «ɧɨɫɤɢ»

ɢ«ɩɟɪɱɚɬɤɢ»).

8.4.Ⱦɪɭɝɢɟ ɩɪɢɱɢɧɵ ɧɟɜɪɨɩɚɬɢɣ. Ⱥɦɢɥɨɢɞɨɡ, ɹɜɥɹɹɫɶ ɢɧ ɮɢɥɶɬɪɚɬɢɜɧɵɦ ɩɪɨɰɟɫɫɨɦ, ɩɨɪɚɠɚɟɬ ɤɚɤ ɩɟɪɢɮɟɪɢɱɟɫɤɭɸ ɨɛɨɥɨɱɤɭ ɧɟɪɜɨɜ, ɬɚɤ ɢ ɫɨɛɫɬɜɟɧɧɨ ɫɬɜɨɥ. Ɉɩɭɯɨɥɢ ɧɟɪɜɨɜ ɦɨɝɭɬ ɹɜɢɬɶɫɹ ɩɪɢɱɢɧɨɣ ɦɨɧɨɧɟɜɪɨɩɚɬɢɢ, ɨɞɧɚɤɨ ɩɪɢ ɬɚɤɢɯɫɨɫɬɨɹɧɢɹɯ, ɤɚɤ ɛɨɥɟɡɧɶ Ɋɟɤɥɢɧɝɯɚɭɡɟɧɚ, ɜ ɤɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɨɣ ɤɚɪɬɢɧɟ ɡɚɛɨɥɟɜɚɧɢɹ ɦɨɠɟɬ ɩɪɢɫɭɬɫɬɜɨɜɚɬɶ ɫɢɦɩɬɨɦɚɬɢɤɚ ɩɨɥɢɧɟɜɪɨɩɚɬɢɢ.

ɇɚɫɬɨɹɳɢɣ ɫɩɢɫɨɤ ɥɢɬɟɪɚɬɭɪɵ ɢ ɫɚɣɬɵ ɫɝɪɭɩɩɢɪɨɜɚɧɵ ɩɨ ɪɚɡɞɟɥɚɦ ɜ ɫɨɨɬɜɟɬɫɬɜɢɢ ɫ ɨɩɢɫɚɬɟɥɜɧɨɣ ɱɚɫɬɜɸ ɤɧɢɝɢ. ȼ ɧɟɤɨɬɨɪɵɯ ɪɚɡɞɟɥɚɯ ɱɢɬɚɬɟɥɶ ɦɨɠɟɬ ɜɫɬɪɟɬɢɬɶ ɡɧɚɤ (*). Ⱦɥɹ ɜɵɯɨɞɚ ɧɚ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɣ ɫɚɣɬ ɧɟɨɛɯɨɞɢɦɨ ɧɚɛɪɚɬɶ ɷɥɟɤɬɪɨɧɧɵɣ ɚɞɪɟɫ ɢ ɜɧɟɫɬɢ ɚɧɝɥɨɹɡɵɱɧɵɣ ɬɟɪɦɢɧ, ɭɤɚɡɚɧɧɵɣ ɜ ɫɤɨɛɤɚɯ ɜɦɟɫɬɨ ɦɧɨɝɨɬɨɱɢɹ.

ɇɚɩɪɢɦɟɪ, ɞɥɹ ɞɟɦɨɧɫɬɪɚɰɢɢ ɫɥɭɱɚɹ ɚɫɛɟɫɬɨɡɚ ɫɥɟɞɭɟɬ ɜɵɣɬɢ ɧɚ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɣ ɷɥɟɤɬɪɨɧɧɵɣ ɚɞɪɟɫ //www.vh.org/ Providers/ Textbooks/ DiffuseLung/ Text/....html ɢ ɜɧɟɫɬɢ ɬɟɪɦɢɧ «Asbestosis» ɜɦɟɫɬɨ ɦɧɨɝɨɬɨɱɢɹ.

Ɍɚɤɢɦ ɨɛɪɚɡɨɦ, ɡɚɤɥɸɱɢɬɟɥɶɧɵɣ ɷɥɟɤɬɪɨɧɧɵɣ ɚɞɪɟɫ ɛɭɞɟɬ ɜɵ-

ɝɥɹɞɟɬɶ ɫɥɟɞɭɸɳɢɦ ɨɛɪɚɡɨɦ: //www.vh.org/ Providers/ Textbooks/ DiffuseLung/ Text/Asbestosis.html

ȿɫɥɢ ɱɢɬɚɬɟɥɶ ɜɫɬɪɟɱɚɟɬ ɡɧɚɤ (**), ɬɨ ɩɪɨɢɡɜɨɞɢɬ ɚɧɚɥɨɝɢɱɧɭɸ ɨɩɟɪɚɰɢɸ, ɜɜɨɞɹ ɱɢɫɥɨ, ɭɤɚɡɚɧɧɨɟ ɜ ɫɤɨɛɤɚɯ, ɜɦɟɫɬɨ ɦɧɨɝɨɬɨɱɢɹ.

ɇɚɩɪɢɦɟɪ, ɢɧɜɚɡɢɜɧɵɣ ɚɫɩɟɪɝɢɥɥɟɡ ɢɞɟɬ ɩɨɞ ɧɨɦɟɪɨɦ 180, ɢ ɡɚɤɥɸɱɢɬɟɥɶɧɵɣ ɷɥɟɤɬɪɨɧɧɵɣ ɚɞɪɟɫ ɞɥɹ ɞɟɦɨɧɫɬɪɚɰɢɢ ɞɚɧɧɨɝɨ ɫɥɭɱɚɹ ɜɵɝɥɹɞɢɬ ɫɥɟɞɭɸɳɢɦ ɨɛɪɚɡɨɦ: //www.brighamrad.harvard.edu/ Cases/ bwh/ hcache/ 180/full.html

ȿɫɥɢ ɱɢɬɚɬɟɥɶ ɢɦɟɟɬ ɜɵɯɨɞ ɧɚ ɫɚɣɬ ɇɚɰɢɨɧɚɥɶɧɨɣ ɦɟɞɢɰɢɧɫɤɨɣ ɛɢɛɥɢɨɬɟɤɢ, ɬɨ ɞɥɹ ɩɨɥɭɱɟɧɢɹ ɩɨɥɧɨɝɨ ɬɟɤɫɬɚ ɫɬɚɬɶɢ ɨɧ ɦɨɠɟɬ ɢɫɩɨɥɶɡɨɜɚɬɶ ɭɤɚɡɚɧɧɵɣ 8 ɡɧɚɱɧɵɣ ɧɨɦɟɪ (NLM Cit. ID :) ɢɥɢ

[PMID:...]

ɉɨɫɤɨɥɶɤɭ ɷɥɟɤɬɪɨɧɧɵɟ ɚɞɪɟɫɚ ɦɨɝɭɬ ɫɨ ɜɪɟɦɟɧɟɦ ɦɟɧɹɬɶɫɹ, ɬɨ ɞɥɹ ɩɨɥɭɱɟɧɢɹ ɛɨɥɟɟ ɫɜɟɠɟɣ ɢɧɮɨɪɦɚɰɢɢ ɩɨ ɪɚɡɥɢɱɧɵɦ ɪɚɡɞɟɥɚɦ ɩɪɟɞɫɬɚɜɥɟɧɧɨɝɨ ɜ ɧɚɫɬɨɹɳɟɣ ɤɧɢɝɟ ɦɚɬɟɪɢɚɥɚ ɦɨɠɧɨ ɜɵɣɬɢ ɧɚ ɨɛɳɢɣ ɜɟɛ ɫɚɣɬ ɢ ɨɬɪɚɛɨɬɚɬɶ ɢɧɬɟɪɟɫɭɸɳɢɟ ɪɚɡɞɟɥɵ.

Ɉɛɳɢɣ ɷɥɟɤɬɪɨɧɧɵɣ ɚɞɪɟɫ ɜɵɝɥɹɞɢɬ ɫɥɟɞɭɸɳɢɦ ɨɛɪɚɡɨɦ:

//www.books.mcgraw hill.com/medical/lange/cmdt/ch....html

Ⱦɪɭɝɨɣ ɷɥɟɤɬɪɨɧɧɵɣ ɚɞɪɟɫ ɞɥɹ ɜɵɯɨɞɚ ɧɚ ɨɛɳɢɣ ɫɚɣɬ ɢɫɬɨɱɧɢɤɨɜ ɥɢɬɟɪɚɬɭɪɵ ɢ ɷɥɟɤɬɪɨɧɧɵɯ ɚɞɪɟɫɨɜ: www.cmdtlinks.com

ɇɢɠɟ ɩɪɢɜɟɞɟɧ ɫɩɢɫɨɤ ɪɚɡɞɟɥɨɜ ɩɚɬɨɥɨɝɢɢ ɫ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɦɢ ɧɨɦɟɪɚɦɢ, ɤɨɬɨɪɵɟ ɧɚɞɨ ɜɧɟɫɬɢ ɜ ɷɥɟɤɬɪɨɧɧɵɣ ɚɞɪɟɫ ɜɦɟɫɬɨ ɦɧɨɝɨɬɨɱɢɹ.

—Ɉɛɳɢɟ ɜɨɩɪɨɫɵ ɞɢɚɝɧɨɫɬɢɤɢ ɛɨɥɟɡɧɟɣ (1).

—ɉɪɟɞɨɩɟɪɚɰɢɨɧɧɨɟ ɨɛɫɥɟɞɨɜɚɧɢɟ ɛɨɥɶɧɵɯ(2).

—Ɉɛɳɢɟ ɩɪɨɛɥɟɦɵ ɝɟɪɢɚɬɪɢɢ ɢ ɝɟɪɨɧɬɨɥɨɝɢɢ (3).

—Ɉɛɳɢɟ ɩɪɨɛɥɟɦɵ ɨɧɤɨɥɨɝɢɢ (4).

—Ⱦɟɨɧɬɨɥɨɝɢɱɟɫɤɢɟ ɚɫɩɟɤɬɵ ɭɦɢɪɚɧɢɹ ɢ ɫɦɟɪɬɢ (5).

—Ȼɨɥɟɡɧɢ ɤɨɠɢ ɢ ɟɟ ɩɪɢɞɚɬɤɨɜ (6).

—Ɉɮɬɚɥɶɦɨɥɨɝɢɹ (7).

—Ɉɬɨɪɢɧɨɥɚɪɢɧɝɨɥɨɝɢɹ (8).

—ɉɭɥɶɦɨɧɨɥɨɝɢɹ (9).

—Ȼɨɥɟɡɧɢ ɫɟɪɞɰɚ (10).

—ɋɢɫɬɟɦɧɚɹ ɚɪɬɟɪɢɚɥɶɧɚɹ ɝɢɩɟɪɬɨɧɢɹ (11).

—Ȼɨɥɟɡɧɢ ɤɪɨɜɟɧɨɫɧɵɯ ɢ ɥɢɦɮɚɬɢɱɟɫɤɢɯ ɫɨɫɭɞɨɜ (12).

—Ȼɨɥɟɡɧɢ ɫɢɫɬɟɦɵ ɤɪɨɜɟɬɜɨɪɟɧɢɹ (13).

—Ȼɨɥɟɡɧɢ ɠɟɥɭɞɨɱɧɨ ɤɢɲɟɱɧɨɝɨ ɬɪɚɤɬɚ (14).

—Ȼɨɥɟɡɧɢ ɝɟɩɚɬɨɛɢɥɢɚɪɧɨɣ ɫɢɫɬɟɦɵ (15).

—Ȼɨɥɟɡɧɢ ɦɨɥɨɱɧɨɣ ɠɟɥɟɡɵ (16).

—Ȼɨɥɟɡɧɢ ɠɟɧɫɤɨɣ ɫɢɫɬɟɦɵ ɪɟɩɪɨɞɭɤɰɢɢ (17).

—ɇɟɤɨɬɨɪɵɟ ɚɫɩɟɤɬɵ ɚɤɭɲɟɪɫɤɨɣ ɩɚɬɨɥɨɝɢɢ (18).

—Ⱥɥɥɟɪɝɢɱɟɫɤɢɟ ɢ ɢɦɦɭɧɨɥɨɝɢɱɟɫɢɟ ɛɨɥɟɡɧɢ (19).

—Ȼɨɥɟɡɧɢ ɨɩɨɪɧɨ ɞɜɢɝɚɬɟɥɶɧɨɝɨ ɚɩɩɚɪɚɬɚ (20).

—ɇɚɪɭɲɟɧɢɹ ɜɨɞɧɨ ɷɥɟɤɬɪɨɥɢɬɧɨɝɨ ɝɨɦɟɨɫɬɚɡɚ (21).

—ɇɟɮɪɨɥɨɝɢɹ (22).

—ɍɪɨɥɨɝɢɹ (23).

—Ȼɨɥɟɡɧɢ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ (24).

—ɉɫɢɯɢɚɬɪɢɹ (25).

—ɗɧɞɨɤɪɢɧɨɥɨɝɢɹ (26).

—ɋɚɯɚɪɧɵɣ ɞɢɚɛɟɬ (27).

—ɉɚɬɨɥɨɝɢɹ ɠɢɪɨɜɨɝɨ ɨɛɦɟɧɚ (28).

—Ȼɨɥɟɡɧɢ, ɫɜɹɡɚɧɧɵɟ ɫ ɩɢɬɚɧɢɟɦ (29).

—Ɉɛɳɢɟ ɩɪɨɛɥɟɦɵ ɢɧɮɟɤɰɢɨɧɧɨɣ ɩɚɬɨɥɨɝɢɢ (30).

—Ɋɟɬɪɨɜɢɪɭɫɧɚɹ ɢɧɮɟɤɰɢɹ ɢ ɫɢɧɞɪɨɦ ɩɪɢɨɛɪɟɬɟɧɧɨɝɨ ɢɦɦɭɧɨɞɟɮɢɰɢɬɚ (31).

—ȼɢɪɭɫɧɚɹ ɢ ɪɢɤɤɟɬɫɢɨɡɧɚɹ ɢɧɮɟɤɰɢɹ (32).

—Ȼɚɤɬɟɪɢɚɥɶɧɚɹ ɢ ɯɥɚɦɢɞɢɣɧɚɹ ɢɧɮɟɤɰɢɹ (33).

—ɋɩɢɪɨɯɟɬɨɡɧɚɹ ɢɧɮɟɤɰɢɹ (34).

—Ȼɨɥɟɡɧɢ, ɫɜɹɡɚɧɧɵɟ ɫ ɩɪɨɫɬɟɣɲɢɦɢ ɢ ɩɚɪɚɡɢɬɚɦɢ (35).

—Ɇɢɤɨɬɢɱɟɫɤɚɹ ɢɧɮɟɤɰɢɹ (36).

—ɉɪɨɬɢɜɨɢɧɮɟɤɰɢɨɧɧɚɹ ɯɢɦɢɨɬɟɪɚɩɢɹ ɢ ɚɧɬɢɛɢɨɬɢɤɢ (37).

—Ȼɨɥɟɡɧɢ, ɫɜɹɡɚɧɧɵɟ ɫ ɜɨɡɞɟɣɫɬɜɢɟɦ ɮɢɡɢɱɟɫɤɢɯɮɚɤɬɨɪɨɜ (38).

—Ɉɬɪɚɜɥɟɧɢɹ (39).

—Ɇɟɞɢɰɢɧɫɤɚɹ ɝɟɧɟɬɢɤɚ (40).

—Ⱦɢɚɝɧɨɫɬɢɱɟɫɤɢɟ ɬɟɫɬɵ ɢ ɢɯ ɨɰɟɧɤɚ (41).

—Ɇɟɞɢɰɢɧɫɤɚɹ ɢɧɮɨɪɦɚɬɢɤɚ ɢ ɬɟɥɟɦɟɞɢɰɢɧɚ (42).

1. ɈȻɓɂȿȼɈɉɊɈɋɕ ɄɅɂɇɂɑȿɋɄɈɃ ɉȺɌɈɅɈȽɂɂ 1.1. Ɍɟɨɪɟɬɢɱɟɫɤɢɟ ɚɫɩɟɤɬɵɤɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɢɯ ɫɢɧɞɪɨɦɨɜ

Ƚɢɩɟɪɯɨɥɟɫɬɟɪɨɥɟɦɢɹ

JAMA patient page: Cholesterol//JAMA, 1999; 281: 206 (NLM Cit. ID: 99114164).

Pignone M.P. et al. Screening and treating adults for lipid disorders: the summary of the evidence for US Preventive Services Task Force//Am. J. Prev. Med., 2001; 20 (3 Suppl.): 77 [PMID: 11306236].

Sloop G.D. A critical analysis of the role of cholesterol in atherogene sis//Atherosclerosis, 1999; 142: 265 (NLM Cit. ID: 99153447). Ɇɟɯɚɧɢɡ-

ɦɵ ɚɬɟɪɨɝɟɧɟɡɚ ɩɪɢ ɝɢɩɟɪɯɨɥɟɫɬɟɪɨɥɟɦɢɢ, ɦɨɪɮɨɥɨɝɢɱɟɫɤɢɟ ɨɫɨɛɟɧɧɨɫɬɢ ɫɨɫɭɞɢɫɬɵɯ ɚɬɟɪɨɦ.

Vogel R.A. et al. Cholesterol, cholesterol lowering and endothelial dys function//Prog. Cardiovas. Dis., 1998; 41: 117 (NLM Cit. ID: 99005073).

Ɋɚɫɫɦɨɬɪɟɧɵ ɜɨɩɪɨɫɵ ɦɨɪɮɨɝɟɧɟɡɚ ɢ ɩɚɬɨɮɢɡɢɨɥɨɝɢɢ ɚɬɟɪɨɦ ɚɪɬɟɪɢɚɥɶɧɵɯ ɫɨɫɭɞɨɜ.

Ƚɢɩɟɪɬɨɧɢɱɟɫɤɢɣ ɫɢɧɞɪɨɦ

Andersson O.K. et al. Survival in treated hypertension: follow up study after two decades//BMJ, 1998; 317: 167 (NLM Cit. ID: 98332662). Ƚɢɩɟɪ-

ɬɨɧɢɤɢ ɜ ɫɢɦɩɬɨɦɧɵɯ ɫɬɚɞɢɹɯ ɨɛɧɚɪɭɠɢɜɚɥɢ ɛɨɥɟɟ ɜɵɫɨɤɢɣ ɭɪɨɜɟɧɶ ɡɚɛɨɥɟɜɚɟɦɨɫɬɢ ɢ ɫɦɟɪɬɧɨɫɬɢ, ɱɟɦ ɩɪɢ ɨɬɫɭɬɫɬɜɢɢ ɬɹɠɟɥɨɣ ɝɢɩɟɪɬɨɧɢɢ, ɧɟɫɦɨɬɪɹ ɧɚ ɩɪɨɜɨɞɢɦɭɸ ɷɮɮɟɤɬɢɜɧɭɸ ɬɟɪɚɩɢɸ.

ɋɤɪɢɧɢɧɝɨɜɵɟ ɦɟɬɨɞɵ ɢɫɫɥɟɞɨɜɚɧɢɹ

Walsh J.M. et al. Prevention in year 2002: some news, some issues. Prim. Care Clin. North Am., 2002; 29:727 [PMID: 12529906]. ȼɫɬɚɬɶɟɪɚɫɫɦɨɬɪɟɧɵɩɪɨɛɥɟ-

ɦɵɩɪɢɦɟɧɟɧɢɹ ɫɤɪɢɧɢɧɝɨɜɵɯɦɟɬɨɞɨɜɩɪɢ ɧɚɢɛɨɥɟɟɲɢɪɨɤɨɪɚɫɩɪɨɫɬɪɚɧɟɧɧɵɯɡɚɛɨɥɟɜɚɧɢɹɯɢ ɨɛɫɭɠɞɚɸɬɫɹ ɩɪɨɛɥɟɦɵɧɨɜɵɯɫɤɪɢɧɢɧɝɨɜɵɯɫɢɫɬɟɦ.

1.2. ɇɟɤɨɬɨɪɵɟɚɫɩɟɤɬɵɢɧɮɟɤɰɢɨɧɧɨɣɩɚɬɨɥɨɝɢɢ, ɚɥɥɟɪɝɢɢɢɢɦɦɭɧɨɥɨɝɢɢ

//www.cdc.gov/nip/schedule/adult/default.html

Ⱥɥɥɟɪɝɢɹ ɢ ɚɫɬɦɚ

//www.aanma.org

Ⱥɥɥɟɪɝɢɹ, ɚɫɬɦɚ ɢ ɢɦɦɭɧɨɥɨɝɢɹ ɜ ɢɧɬɟɪɧɟɬɟ

//allergy.mcg.edu

Ⱥɦɟɪɢɤɚɧɫɤɚɹ Ⱥɤɚɞɟɦɢɹ ɚɫɬɦɵ, ɚɥɥɟɪɝɢɢ ɢ ɢɦɦɭɧɨɥɨɝɢɢ

//www.aaaai.org

ȼɢɪɭɫɧɵɟ ɝɟɩɚɬɢɬɵ — ɂɧɮɨɪɦɚɰɢɨɧɧɵɣ ɰɟɧɬɪ

//www.hepnet.com

Ƚɟɪɩɟɬɢɱɟɫɤɚɹ ɢɧɮɟɤɰɢɹ ɂɧɮɨɪɦɚɰɢɨɧɧɵɣ ɰɟɧɬɪ

//www.herpeszone.com/MainManu.html

ɇɚɰɢɨɧɚɥɶɧɵɣ ɂɧɫɬɢɬɭɬ ɚɥɥɟɪɝɢɢ ɢ ɢɧɮɟɤɰɢɨɧɧɵɯɛɨɥɟɡɧɟɣ

//www.niaid.nih.gov

ɋɢɧɞɪɨɦ ɩɪɢɨɛɪɟɬɟɧɧɨɝɨ ɢɦɦɭɧɨɞɟɮɢɰɢɬɚ — ɂɧɮɨɪɦɚɰɢɨɧɧɵɣ ɰɟɧɬɪ

//www.aidsnyc.org

//www.hiv.infoweb.org //www.hiv.medscape.com/Home/Topics/AIDS/AIDS. Html

Ɍɭɛɟɪɤɭɥɟɡ — ɂɧɮɨɪɦɚɰɢɨɧɧɵɣ ɰɟɧɬɪ ɢ ɞɟɦɨɧɫɬɪɚɰɢɹ ɫɥɭɱɚɟɜ

//path.upmc.edu:80/cases/case30.html

//path.upmc.edu:80/cases/case53.html

//www.umdnj.edu/ntbc //www medlib.med.utah.edu/WebPath.html

Ⱥɇ ɇ. et al. Mechanisms of inflammation and leukocyte activation//Med. Clin. North Am., 1997; 81:1 (NLM Cit. ID: 97164991).

CasaliP. et al. Structure and function ofnatural antibodies//Curr. Top Microbiol. Immunol., 1996; 210:167 (NLM Cit. ID: 96148122). Ɉɛɡɨɪ ɥɢɬɟɪɚɬɭɪɵ ɢ ɫɨɛɫɬɜɟɧɧɵɟɧɚɛɥɸɞɟɧɢɹ, ɤɚɫɚɸɳɢɟɫɹ ɜɨɡɪɚɫɬɧɵɯɨɫɨɛɟɧɧɨɫɬɟɣ ɢɦɦɭɧɨɥɨɝɢɱɟɫɤɨɝɨɨɬɜɟɬɚɫɬɨɱɤɢ ɡɪɟɧɢɹ ɤɥɟɬɨɱɧɨɣ ɢ ɦɨɥɟɤɭɥɹɪɧɨɣ ɛɢɨɥɨɝɢɢ.

Cunha ȼ. A. Fever of unknown origin//Infect. Dis. Clin. North Am., 1997; 10: 111 (NLM Cit. ID: 96244915).

Dutton R.W. et al. T cell memory//Annu Rev. Immunol., 1998; 16:201 (NLM Cit. ID: 98259413).

Greene J.N. et al. Infectious complications of cancer therapy//Infect. Dis. Clin. North Am., 1996; 10(2) (NLM Cit. ID: 96396501).

Huston D.P. The biology of the immune system//JAMA, 1997; 278:1804 (NLM Cit. ID: 98057348). ɉɪɨɝɪɚɦɦɧɚɹ ɫɬɚɬɶɹ, ɤɚɫɚɸɳɚɹɫɹ ɨɫɧɨɜɧɵɯ ɩɪɨɛɥɟɦ ɮɢɡɢɨɥɨɝɢɱɟɫɤɨɝɨ ɢɦɦɭɧɧɨɝɨ ɨɬɜɟɬɚ ɢ ɩɪɢɧɰɢɩɨɜ ɮɨɪɦɢɪɨɜɚɧɢɹ ɢɦɦɭɧɨɥɨɝɢɱɟɫɤɢɯ ɛɨɥɟɡɧɟɣ.

McArthurJ.C. NeuroAIDS: Diagnosis and management//Hosp. Pract. (Off. Ed.), 1997, Aug; 32:73 (NLM Cit. ID: 99421845).

Ranula W.A. (editor). Nosocomial infections//Infect. Dis. Clin. North Am., 1997; 11(2). ȼ ɫɨɨɛɳɟɧɢɢ ɞɢɫɤɭɬɢɪɭɸɬɫɹ ɜɨɩɪɨɫɵ ɦɢɤɪɨɛɢɨɥɨɝɢɢ ɜɧɭɬɪɢɛɨɥɶɧɢɱɧɵɯɢɧɮɟɤɰɢɣ, ɦɨɥɟɤɭɥɹɪɧɨɣ ɷɩɢɞɟɦɢɨɥɨɝɢɢ, ɥɟɤɚɪɫɬɜɟɧɧɨɣ ɪɟɡɢɫɬɟɧɬɧɨɫɬɢ.

Royce R.A. et al. Sexual transmission on HIV//N. Engl. J. Med., 1997; 336:1072 (NLM Cit. ID: 97224095).

Rubin R.N. (editor). Infections in transplantation/ / Infect. Dis. Clin. North Am., 1995; 9(4): 1.

VanBuskirk A.M. et al. Transplantation immunology//JAMA, 1997; 278:1993 (NLM Cit. ID: 98057369). Ɉɛɡɨɪ ɥɢɬɟɪɚɬɭɪɵ ɢ ɨɪɢɝɢɧɚɥɶɧɚɹ ɢɧɬɟɪɩɪɟɬɚɰɢɹ ɬɪɟɯ ɨɫɧɨɜɧɵɯɮɨɪɦ ɨɬɬɨɪɠɟɧɢɹ ɬɪɚɧɫɩɥɚɧɬɚɬɚ, ɤɚɠɞɚɹ ɢɡ ɤɨɬɨɪɵɯ ɢɦɟɟɬ ɫɨɨɬɜɟɬɫɬɜɭɸɳɢɟ ɝɢɫɬɨɩɚɬɨɥɨɝɢɱɟɫɤɢɟ ɢ ɩɚɬɨɛɢɨɥɨ ɝɢɱɟɫɤɢɟ ɯɚɪɚɤɬɟɪɢɫɬɢɤɢ, ɱɬɨ ɩɪɟɞɩɨɥɚɝɚɟɬ ɪɚɡɥɢɱɧɵɣ ɤɥɢɧɢɤɨ ɞɢɚɝɧɨɫɬɢɱɟɫɤɢɣ ɢ ɥɟɱɟɛɧɵɣ ɩɨɞɯɨɞ.

1.3. Ʉɭɪɟɧɢɟɤɚɤɮɚɤɬɨɪɪɢɫɤɚɪɚɡɥɢɱɧɨɣɩɚɬɨɥɨɝɢɢ

Ʉɭɪɟɧɢɟ ɤɚɤ ɮɚɤɬɨɪ ɪɢɫɤɚ ɩɪɢ ɪɚɡɥɢɱɧɵɯ ɛɨɥɟɡɧɹɯ

//158.72.20.10/pubs/guidecps/

//text.nlm.nih.gov/ftrs/pick?dbName=smkc&ftsK=43861&cp=l&t=9 2842561 l&collect=ahcpr

//www.cdc.gov/nccdphp/osh/tobacco.htm

Parmer S. et al. JAMA Patient Page. Smoking and the heart// JAMA, 2003; 290:146 [PMID: 12837726]. ȼ ɫɬɚɬɶɟ ɨɛɫɭɠɞɚɟɬɫɹ ɦɟɯɚɧɢɡɦ ɜɨɡɞɟɣɫɬɜɢɹ ɤɭɪɟɧɢɹ ɬɚɛɚɤɚ ɧɚ ɫɨɫɬɨɹɧɢɟ ɫɟɪɞɟɱɧɨ ɫɨɫɭɞɢɫɬɨɣ ɫɢɫɬɟɦɵ ɢ ɩɪɢɜɟɞɟɧɚ ɫɪɚɜɧɢɬɟɥɶɧɚɹ ɯɚɪɚɤɬɟɪɢɫɬɢɤɚ ɢɫɯɨɞɨɜ ɛɨɥɟɡɧɟɣ, ɫɜɹɡɚɧɧɵɯ ɫ ɤɭɪɟɧɢɟɦ, ɢɡɪɚɡɥɢɱɧɵɯɷɩɢɞɟɦɢɨɥɨɝɢɱɟɫɤɢɯɩɪɨɟɤɬɨɜ.

Stefandalis ɋ. et al. Unfavorable effects of passive smoking on aortic function in men//Ann. Intern. Med., 1998; 128; 426 (NLM Cit. ID: 98156406).

ɉɪɢ ɢɫɫɥɟɞɨɜɚɧɢɢ ɮɭɧɤɰɢɨɧɚɥɶɧɨɝɨ ɫɨɫɬɨɹɧɢɹ ɚɨɪɬɵ ɜ ɥɚɛɨɪɚɬɨɪɧɵɯ ɭɫɥɨɜɢɹɯɭɫɬɚɧɨɜɥɟɧɨ ɧɟɝɚɬɢɜɧɨɟ ɜɥɢɹɧɢɟ ɤɚɤ ɚɤɬɢɜɧɨɝɨ, ɬɚɤ ɢ ɩɚɫɫɢɜɧɨɝɨ ɤɭɪɟɧɢɹ.

1.4. Ʉɚɧɰɟɪɨɝɟɧɟɡɢɜɨɩɪɨɫɵɨɛɳɟɣɨɧɤɨɥɨɝɢɢ

//cancernet.nci.nih.gov/chnpdq/screening_h.html //www.cancer.org/noframes.html //www.medsch.wisc.edu/bca //www.cnetdb.nci.nih.gov/overviewhtml //www.oncolink.upenn.edu/

AJCC Cancer Staging Manual//American Joint Committee on Cancer, 5t n ed. Lippincott Raven, 1997 (The bible of TNM staging).

Agarwala S.S. Paraneoplastic syndromes//Med. Clin. North Am., 1996; 80; 173 (NLM Cit. ID: 96110856). ȼ ɪɚɛɨɬɟ ɩɪɟɞɫɬɚɜɥɟɧɵ ɫɨɜɪɟ-

ɦɟɧɧɵɟ ɩɪɨɛɥɟɦɵ ɷɬɢɨɩɚɬɨɝɟɧɟɡɚ ɢ ɤɥɢɧɢɤɢ ɩɚɪɚɧɟɨɩɥɚɫɬɢɱɟɫɤɢɯ ɫɢɧɞɪɨɦɨɜ.

Chang F. et al. Implications of the^5J tumor supressor gene in clinical oncology//J. Clin. Oncol., 1995; 13; 1009 (NLM Cit. ID:95222299). Ɉɛɡɨɪ ɥɢɬɟɪɚɬɭɪɵ ɢ ɫɨɛɫɬɜɟɧɧɵɟ ɢɫɫɥɟɞɨɜɚɧɢɹ ɢɡɦɟɧɟɧɢɣ ɪ53 ɢ ɟɝɨ ɭɱɚɫɬɢɟ ɜ ɩɚɬɨɝɟɧɟɡɟ, ɞɢɚɝɧɨɡɟ, ɩɪɨɝɧɨɡɟ ɢ ɬɟɪɚɩɢɢ ɪɚɡɥɢɱɧɵɯɪɚɤɨɜ.

Friedman M. et al. Endoscopic sinus surgery in patients infected with HIV//Laryngoscope, 2000; 110 (lOpart 1): 1613 [PMID: 11037812].

Harris R. et al. Screening for prostate cancer: an update from the evidence for US Preventive Services Task Force//Arm. Intern. Med., 2002; 137: 347 [PMID: 12204020].

Ignoffo R. et al. (editors). Cancer Chemotherapy Pocket Guide. Lippincott Raven, 1997.

Moore PS. et al. Detection of herpesvirus lire DNA sequences in Kaposi's sarcoma in patient with and those without HIVinfection//N. Engl. J. Med., 1998; 338: 948 (NLM Cit. ID: 95214703). ȾɇɄ ɝɟɪɩɟɫ ɜɢɪɭɫɚɜɫɟɝɞɚ ɩɪɢɫɭɬɫɬɜɭɟɬ ɜ ɤɥɟɬɤɚɯ ɫɚɪɤɨɦɵ Ʉɚɩɨɲɢ ɜɧɟ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɢɧɮɢɰɢɪɨɜɚɧɢɹ ɪɟɬɪɨɜɢɪɭɫɨɦ.

1.5. Ⱥɥɤɨɝɨɥɢɡɦɢɧɚɪɤɨɦɚɧɢɹ

//www.niaaa.nih.gov/

//wwwnida.nih.gov/DrugAbuse.htmI

JAMA patient page: Alcohol//JAMA, 1999; 281: 1352 (NLM Cit. ID: 99222834).

US Preventive Services Task Force: Guide to Clinical Preventive Services: A Report of the US Preventive Services Task Force/ / 2nc* ed. International Medical Publishing, 1997.

1.6.ɇɟɤɨɬɨɪɵɟ ɤɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɢɟ ɚɫɩɟɤɬɵɝɟɪɢɚɬɪɢɱɟɫɤɨɣ ɦɟɞɢɰɢɧɵ

//www.cdc.gov/nccdphp/sgr.htm

//www.acc.org/clinical/guidelines/index.html

ɉɚɥɥɢɚɬɢɜɧɨɟ ɜɟɞɟɧɢɟ ɛɨɥɶɧɵɯɢ ɟɝɨ ɨɫɧɨɜɧɵɟ ɩɪɢɧɰɢɩɵ

//www.palliative.org

ȼɭɨɫɤ I.R. The nature of suffering and nature of opportunity in the end of life//Clin. Geriatr. Med., 1996; 12: 237 (NLM Cit. ID: 96392557).

Cassel E.J. The nature of suffering and the goals of medicine//N. Engl. J. Med., 1982; 306: 639 (NLM Cit. ID: 82125263).

Lynn J. et al. Accurate prognostication of death: Opportunities and challenges for clinicians//West J. Med., 1995; 163: 250 (NLM Cit. ID : 97106265).

1.8. Ɇɟɞɢɰɢɧɫɤɚɹɝɟɧɟɬɢɤɚ

Ⱥɦɟɪɢɤɚɧɫɤɚɹ Ⱥɫɫɨɰɢɚɰɢɹ ɩɨ ɢɫɫɥɟɞɨɜɚɧɢɸ ɫɢɧɞɪɨɦɚ Ɇɚɪɮɚɧɚ

//www.marfan.org/publications.html

Ȼɢɨɯɢɦɢɱɟɫɤɨɟ ɬɟɫɬɢɪɨɜɚɧɢɟ ɩɪɢ ɝɟɧɟɬɢɱɟɫɤɢɯ ɛɨɥɟɡɧɹɯ

//www.biochemgen.ucsd.edu/wbgtests/dz tst.htm

Ƚɟɧɟɬɢɱɟɫɤɢɟ ɛɨɥɟɡɧɢ —ɂɧɮɨɪɦɚɰɢɨɧɧɵɣ ɰɟɧɬɪ

//www.kumc.edu/gec/support/group.html

Ƚɟɧɟɬɢɱɟɫɤɢɟ ɤɥɢɧɢɤɢ — ɂɧɮɨɪɦɚɰɢɨɧɧɵɣ ɰɟɧɬɪ

//www.geneclinics.org/

Ɉɛɳɢɟ ɜɨɩɪɨɫɵ ɝɟɧɟɬɢɤɢ ɜ ɢɧɬɟɪɧɟɬɟ

//medhlp.netusa.net/www/agsg.htm

ɋɢɧɞɪɨɦ Ⱦɚɭɧɚ ɂɧɮɨɪɦɚɰɢɨɧɧɵɣ ɰɟɧɬɪ

//www.nas.com/downsyn/index.html //www.ndss.org/information/clinical_info.html //www.brighamrsd.harvard.edu/Cases/bwh/hcache/185/full.html

Beaudet A.L. Genetics and disease//In: Harrison's Principles of Intern. Medicine. 14th ed. Fauci A.S. et al. (editors), McGraw Hill, 1998.

McPhee S.J. et al. (editors). Pathophysiology of disease: An Introduction to Clinical Medicine. 3 r d ed., McGraw Hill, 2000.

Rimoin D.L. et al. (editors). Principles and Practice of Medical Genetics. Churchill Livingstone, 1997.

Scriver C.R. et al. (editors). The Metabolic and Molecular Basis of Inherited Disease. 7r d Ed., McGraw Hill, 1995.

Statement of the American Society of Clinical Oncology: Genetic Testing for Cancer Susceptibility//J. Clin. Oncol, 1996; 14: 1730 (NLM Cit. ID: 9608855).

1.9. ɇɟɤɨɬɨɪɵɟɚɫɩɟɤɬɵɤɥɢɧɢɤɨ ɥɚɛɨɪɚɬɨɪɧɨɣɩɚɬɨɥɨɝɢɢ

//www.bconnex.net. jascah/preop.html //www.aoa.dhhs.gov

Fleisher Ɍ.A. et al. Introduction to diagnostic laboratory immunology// JAMA, 1997; 278:1823 (NLM Cit. ID: 98057350). ɉɪɟɞɫɬɚɜɥɟɧ ɨɛɡɨɪ ɧɟ-

ɤɨɬɨɪɵɯ ɫɨɜɪɟɦɟɧɧɵɯ ɦɟɬɨɞɨɜ ɢɦɦɭɧɨɥɨɝɢɱɟɫɤɨɣ ɞɢɚɝɧɨɫɬɢɤɢ.

LawlorGJ. et al. (editors). Manual of Allergy and Immunology. 3r d ed. Little, Brown, 1995.

Rose N.R. at al. (editor). Manual of Clinical Laboratory Immunology. 5 r d ed. American Society of Microbiology, 1997.

Schiffer M. Molecular anatomy and pathologic expression of antibody light chains//Am. J. Pathol., 1996; 148:1339 (NLM Cit. ID: 96208111).

Sox H.C. The evaluation of diagnostic tests: Principles, problems, and new development//Annu Rev. Med., 1996; 47:463 (NLM Cit. ID: 96226658).

1.10. ɂɧɬɟɪɧɟɬ, ɢɧɮɨɪɦɚɬɢɤɚɢɬɟɥɟɦɟɞɢɰɢɧɚɜɩɪɚɤɬɢɤɟ ɫɨɜɪɟɦɟɧɧɨɝɨɜɪɚɱɚ

ȼȼɋ (ɇɨɜɨɫɬɢ) — Ɂɞɨɪɨɜɶɟ

//www.news.bbc.co.uk/hi/English^ealth/default.htm

CNN (ɇɨɜɨɫɬɢ) — Ɂɞɨɪɨɜɶɟ

//www.cnn.com/HEALTH

Ɇɟɞɢɰɢɧɫɤɚɹ ɢɧɮɨɪɦɚɰɢɹ ɜ ɢɧɬɟɪɧɟɬɟ. ɇɚɫɬɨɹɳɢɣ ɫɚɣɬ ɜɤɥɸɱɚɟɬ: ɞɨɫɬɭɩ ɤ ɥɢɬɟɪɚɬɭɪɟ ɜ ɢɧɬɟɪɧɟɬɟ, ɩɨɥɧɵɟ ɬɟɤɫɬɵ ɦɟɞɢɰɢɧɫɤɢɯ ɫɬɚɬɟɣ ɢ ɤɧɢɝ, ɩɨɩɭɥɹɪɧɵɟ ɥɟɤɰɢɢ ɞɥɹ ɛɨɥɶɧɵɯ, ɩɪɚɤɬɢɱɟɫɤɢɟ ɪɟɤɨɦɟɧɞɚɰɢɢ, ɢɧɮɨɪɦɚɰɢɸ ɨ ɧɨɜɵɯɥɟɤɚɪɫɬɜɟɧɧɵɯ ɩɪɟɩɚɪɚɬɚɯɢ ɦɧɨɝɨɟ ɞɪɭɝɨɟ.

//www.mdcosult.com

ɋɨɜɪɟɦɟɧɧɚɹ ɞɢɚɝɧɨɫɬɢɤɚɢ ɥɟɱɟɧɢɟ. ɇɚɫɬɨɹɳɢɣ ɫɚɣɬɞɚɟɬɩɪɹɦɨɣ ɞɨɫɬɭɩ ɤ ɪɚɡɧɨɨɛɪɚɡɧɨɣ ɢɧɮɨɪɦɚɰɢɢ ɢ ɜɵɯɨɞɭ ɧɚ ɞɪɭɝɢɟ ɦɟɞɢɰɢɧɫɤɢɟ ɫɚɣɬɵ ɤɚɤ ɞɥɹ ɜɪɚɱɟɣ, ɬɚɤ ɢ ɞɥɹ ɩɚɰɢɟɧɬɨɜ. Ɏɨɪɦɚɬ ɫɚɣɬɚ ɩɪɟɞɫɬɚɜɥɟɧ ɤɚɤ ɪɭɤɨɜɨɞɫɬɜɨ, ɫɨɫɬɨɹɳɟɟ ɢɡ 42 ɝɥɚɜ.

//www.books.mcgraw hill.com/medical/lange

Classen D.C. Clinical decision support system to improve clinical practice and quality of care//JAMA, 1998; 280:1360 (NLM Cit. ID: 99008449).

Gridsby J. et al. Telemedicine: Where it is and where it's going//Ann. Intern. Med., 1998; 129: 123 (NLM Cit. ID: 98318192).

Kane B. et al. Guidelines for the clinical use of electronic mail with patients/ / J. Am. Med. Inform. Assoc, 1998; 5:104 (NLM Cit. ID : 98115079).

Mandl K.D. et al. Electronic patient physician communication: Problems and promise//Ann. Intern. Med., 1998; 129: 495 (NLM Cit. ID : 98396874).

2. ɉȺɌɈɅɈȽɂəɋȿɊȾȿɑɇɈ ɋɈɋɍȾɂɋɌɈɃ ɋɂɋɌȿɆɕ

AHCPR: ɇɟɫɬɚɛɢɥɶɧɚɹ ɫɬɟɧɨɤɚɪɞɢɹ

//text.nlm.nih.gov/ftrs/pick?dbName=cahc&ftrsK=45767&cp=l&t=9

28428519&collect=ahcpr

Ⱥɦɟɪɢɤɚɧɫɤɢɣ ɤɨɥɥɟɞɠ ɤɚɪɞɢɨɥɨɝɨɜ — Ⱥɦɟɪɢɤɚɧɫɤɚɹ ɚɫɫɨɰɢɚɰɢɹ ɤɚɪɞɢɨɥɨɝɨɜ

//www.acc.org/clinical/guideUnes/index.html

Ɋɭɤɨɜɨɞɫɬɜɨ ɩɨ ɫɟɪɞɟɱɧɵɦ ɚɪɢɬɦɢɹɦ

//www.med.edu.com/ htdocs/ einthoven.html

Ⱥɬɥɚɫ ɩɪɚɤɬɢɱɟɫɤɨɣ ɷɯɨɤɚɪɞɢɨɫɤɨɩɢɢ

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Ƚɢɩɟɪɬɨɧɢɱɟɫɤɢɣ ɫɢɧɞɪɨɦ, ɞɢɚɥɢɡ, ɤɥɢɧɢɱɟɫɤɚɹ ɧɟɮɪɨɥɨɝɢɹ, ɩɨɱɟɱɧɵɟ ɝɢɩɟɪɬɨɧɢɢ (ɉɟɪɢɨɞɢɱɟɫɤɢɣ ɠɭɪɧɚɥ ɜ ɢɧɬɟɪɧɟɬɟ)

//www.hdcn.co

Ⱥɋɋ/ ȺɇȺ Guidelines for Clinical Applications of Echocardiography/ / !. Am. Coll. Cardiol., 1997; 29: 862 (NLM Cit. ID : 97226403).

ȼ ɪɚɛɨɬɟ ɩɪɟɞɫɬɚɜɥɟɧɵ ɲɢɪɨɤɚɹ ɞɢɫɤɭɫɫɢɹ ɢ ɪɟɤɨɦɟɧɞɚɰɢɢ ɩɨ ɩɪɢɦɟɧɟɧɢɸɷɯɨɤɚɪɞɢɨɫɤɨɩɢɢ.

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ɦɟɧɧɵɟ ɚɫɩɟɤɬɵ ɩɚɬɨɮɢɡɢɨɥɨɝɢɢ ɯɪɨɧɢɱɟɫɤɨɣ ɫɟɪɞɟɱɧɨɣ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ.

Becker R.C. et al. A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction/ / J. Am. Coll. Cardiol, 1996; 27: 1321 (NLM Cit. ID: 96228176). ɇɟɫɦɨɬɪɹ ɧɚ ɬɨ, ɱɬɨ ɪɚɡɪɵɜɵ ɫɟɪɞɰɚ ɨɫɥɨɠɧɹɸɬ ɬɟɱɟɧɢɟ ɨɫɬɪɨɝɨ ɢɧɮɚɪɤɬɚ ɦɟɧɟɟ ɱɟɦ ɜ 1%, ɨɧɢ ɫɨɫɬɚɜɥɹɸɬ ɛɨɥɟɟ 3% ɜɫɟɣ ɜɧɭɬɪɢɛɨɥɶɧɢɱɧɨɣ ɫɦɟɪɬɧɨɫɬɢ. Ɋɚɡɪɵɜɵ ɜɫɬɪɟɱɚɸɬɫɹ ɪɟɠɟ ɭ ɛɨɥɶɧɵɯ, ɩɨɥɭɱɚɸɳɢɯ ɚɞɟɤɜɚɬɧɭɸ ɬɪɨɦɛɨɥɢɬɢɱɟ ɫɤɭɸ ɬɟɪɚɩɢɸ.

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Burke A.P. et al. Coronary risk factors and plague morphology in men with coronary artery disease why die suddenly//N. Engl. J. Med., 1997; 336: 1276 (NLM Cit. ID: 97258686). ɉɪɨɜɨɞɹɬɫɹ ɤɥɢɧɢɤɨ ɚɧɚɬɨɦɢɱɟɫɤɢɟɩɚɪɚɥɥɟɥɢ ɩɪɢ ɜɧɟɡɚɩɧɨɣ ɤɨɪɨɧɚɪɧɨɣ ɫɦɟɪɬɢ.

Carabello B.A. et al Valvular heart diseases//N. Engl. J. Med., 1997; 337: 32 (NLM Cit. ID: 97330770). Ɉɛɫɭɠɞɚɸɬɫɹ ɜɨɩɪɨɫɵ ɩɚɬɨɮɢɡɢɨɥɨɝɢɢ ɩɪɢɨɛɪɟɬɟɧɧɵɯɩɨɪɨɤɨɜ ɫɟɪɞɰɚ, ɫɨɜɪɟɦɟɧɧɵɟ ɦɟɬɨɞɵ ɞɢɚɝɧɨɫɬɢɤɢ ɢ ɯɢɪɭɪɝɢɱɟɫɤɨɝɨ ɥɟɱɟɧɢɹ.

Castelli W.P. The new pathophysiology of coronary artery disease//Am. J. Cardiol, 1998; 82 (10B): 60T (NLM Cit. ID: 99075721). ɇɟɫɬɚɛɢɥɶɧɵɟ