. 1
( 2 .)



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eOCaAieaeEau

eO?U O?EIAIAIE? aIE? ‚ IOIOIAIOIOE
UA?OEE E?AIE?AOIE? ?A‚ IOIA?IOOUAE U ·OI?I??
OEOUAII?IE ?A‚IUE?AOIEIE A·OIA‚IE?IE
(OOEOIEA IIEIE?AOIE? OIU?A‚)
a.e. AII?A‚, I.I.I. a.c. eU?O‚OEUO‚, e.C. NAOEIO‚
N.I.I.
Ei aIOUEUUU ?A‚IUOIO„EE eAac, aOOI‚

enoaiiay neea?iaa?iey e nenoaiiay e?aniay aie- ooiey?ueo n?aanoa e aniiiiaaoaeuiuo i?aia?aoia iiy-
N ?aiea ioiinyony e aooieiioiiui aieaciyi nenoai- oaiii, i?eaioe?oynu ia iio?aaiinoe iaoeaioa, noae en-
iiai oa?aeoa?a, a iniiaa eioi?uo ea?eo i?ia?anne?o?- iieuciaaouny a ea?aiee e iaiieieiae?aneie aiee. Ia-
uaa e iaia?aoeiia no?oeoo?iia iia?a?aaiea ninoaia. iaei i?e ?acaeoee ecuycaeaiee ia oiia o?iie?aneie
Aey nenoaiiie neea?iaa?iee (NNA) aieaa oa?aeoa?ii aeiienee iacia?aiea i?inouo aiaeuaaoeeia e ianoa?i-
aiaea?aiea iaeeeo a?oa?ee e a?oa?eie, i?e nenoaiiie eaiuo i?ioeaiainiaeeoaeuiuo i?aia?aoia (IIAI) aa?a
e?aniie aie?aiea (NEA) aiaeaea?ony ninoau e?aiai ea- a iaeneiaeuiuo oa?aiaaoe?aneeo aicao ia anaaaa aaao
eea?a. Ia?ooaiey a ninoaenoie noa?a i?e NNA iaonei- aaaeaaoio? aiaeaace?. Ia?eioe?aneea aiaeuaaoeee ai-
aeaiu aacinianoe?aneeie ?aaeoeyie, ieee?ceaiui ii- nooiiu oa?aiaaoai oieuei a noaoeiia?a e ia iiaoo i?e-
?a?aieai a?oa?ee (aneaanoaea i?ieeoa?aoee yiaioa- iaiyouny aeeoaeuii. Oaeei ia?acii, a ianoiyuaa a?aiy
eey) e caionoaieai iee?ioe?eoeyoi?iiai ?onea n oi?- auai? n?aanoa ea?aiey neeuiie o?iie?aneie iaiieiei-
ie?iaaieai aaaneoey?iuo o?anoeia. I?e NEA aaaouei ae?aneie aiee inoaaony ia?aie?aiiui. A yoii ieaia au-
cuaaao eioa?an iiaue eiiaeie?iaaiiue i?aia?ao Cae-
iaoaieciii yaeyaony aaneoeeo. A ?acoeuoaoa o?iie?a-
aea?. Eiiiiiaiou Caeaea?a – o?aiaaie e ia?aoaoaiie
neie aiienee oeaiae ?acaeaa?ony cia?eoaeuiua oe?eo-
eyoi?iua ?anno?ienoaa, iniaaiii au?a?aiiua a ae- – aaa aiaeuaaoeea, aaaii iiaoaa?aeaoea nai? yooae-
?aeuiuo ioaaeao eiia?iinoae. Ia eii?eeao iaeuoaa, a oeaiinou a iiiioa?aiee ino?ie e o?iie?aneie aiee ?ac-
iaeanoe einoiuo aunooiia (iaa nonoaaaie), a iaeanoe ee?iiai aaiaca. O?aiaaie ioiineony e aiaeuaaoeeai
ooiuo ?aeiaei e aa?a aae iiyaey?ony ecuycaeaiey, ia- n?aaiae neeu ca n?ao neaauo iieieaiuo e au?a?aiiuo
?aaei n iaaiiaieai. O?ioe?aneea ia?ooaiey iiaoo i?i- ia–iieieaiuo yooaeoia. Iaiau?iinou aaieiiai iaoa-
yaeyouny a aeaa aeoaieeo eee aieaa iiaa?oiinoiuo yca iecia aaenoaey o?aiaaiea iauyniyaony oai, ?oi ?anou
aai iieaeoe aeoeae?oao i?ioeaiaieaaua µ–iieieaiua
aieaiae, ia neeiiiuo e ca?eaeaie?. A i?ioanna i?i-
a?anne?iaaiey oy?aeiai ninoaenoiai ii?a?aiey eiia?- ?aoaioi?u. Aoi?ay ?anou iieaeoe o?aiaaiea iaiia?a-
iinoae, a oae?a a ia?eia aeoeaaoee iaoieiae?aneiai iaiii aeoeae?oao iaiieieaiua i?ioeaiaieaaua nenoa-
i?ioanna, ?acaeaaaony nooay aaia?aia iiaoaauo oaeaia iu – eiaeae?oao ia?aoiue caoaao na?ioiieia eee ii-
iaeuoaa ?oe eee iia. ?acaeoea yca, iniaaiii ae?aeu- ?aa?aiaeeia a ia?aiuo neiainao. Eiaiii neia?aeci
iuo, anaaaa nii?iai?aaaony aieaaui neia?iiii, aaoo iaoaieciia aaenoaey o?aiaaiea iaoneaaeeaaao
au?a?aiiinou eioi?iai caaeneo io noaiaie iia?a?aaiey aai aunieo? yooaeoeaiinou. Aoi?ie eiiiiiaio Caeae-
ninoaia, iyaeeo oeaiae, ia?aiuo no?oeoo? e einoae. Eae a?a – ia?aoaoaiie (N–aoaoee–?–aieiioaiie) ioiineo-
i?aaeei, yoi iinoiyiiua neeuiua aiee, eioi?ua oneee- ny e oi?ioi ecaanoiui oaio?aeuii aaenoao?uei aiae-
aa?ony ii?u? ai iaauiineiuo. Ia?yao n oooaoaieai aaoeeai e aioeie?aoeeai. Iaoaieci aai aaenoaey oi?ii
iauaai ninoiyiey, oaeea aiee iiaoo iieiinou? ia?o- ia onoaiiaeai. Iieaaa?o, ?oi aiaeaacey aucaaia iiau-
oeou nii e ooieoee eiia?iinoe. Iaoiaaiac aieaaiai oaieai ii?iaa aiee, eiaeae?iaaieai aunaiai?aaiey
neia?iia i?e ?acaeoee ycaaiii–iae?ioe?aneeo ii?a?a- nieiaeuiiai i?inoaaeaiaeia A2 e oi?ii?aieai neioaca
iee eiia?iinoe nei?ai e, ii–aeaeiiio, aee??aao ia- ieneaa acioa, iiin?aaiaaiiia ?aoaioi?aie iae?i-
neieuei oeiia aiee. Ia?yao n iioeoaioeaiui oeiii, o?ainieooa?ia (NMDA e noanoaioee ?). Oaeei ia?acii,
Caeaea? i?iyaeyao au?a?aiiue aiaeuaaoe?aneee
iaoneiaeaiiui ?aca?a?aieai iioeoaioi?ia oeaiae a
yooaeo a nayce n eiiaeiaoeae o?ao ?acee?iuo iaoa-
ciia eo aano?oeoee, iaiia?aiaiii iia?a?aaaony e ia-
?eoa?e?aneay eiia?aaoey, eieoee?oy iae?iiaoe?aneo? ieciia aaenoaey, ea?aue ec eioi?uo aiineo aeeaa a
aieu. nie?aiea aieaaiai iuouaiey.
Ea?aiea neeuiie aiee o oaeeo aieuiuo i?aanoaaey- Eiiieaen o?aiaaie/ia?aoaoaiie ?aeiiaiaiaai aey
ao ii?aaaeaiiua o?oaiinoe. Aey ea?aiey iieieiae?a- ea?aiey oia?aiiie eee neeuiie aiee n aice?iaeie, iia-
neie aiee Anaie?iie i?aaiecaoeae ca?aaiio?aiaiey ae?aaiie ii iio?aaiinoe a oao neo?ayo, eiaaa ?aea-
auea i?aaei?aia o?aonooiai?aoay nenoaia i?eiaiaiey oaeuii ni?aoaiea auno?iai ia?aea e aieuoie i?iaie-
aieaooiey?ueo n?aanoa. A ia?aea ea?aiey auae?a?o ?eoaeuiinoe aiaeuaaoe?aneiai aaenoaey. O?iie?aneea
iaiieaoiua aiaeaaoeee (naeeoeeaou, a?oaea IIAI, ia- ?aaiaoe?aneea caaieaaaiey oa?aeoa?eco?ony cia?e-
?aoaoaiie). Anee ie iaii ec ieo ia ii?ao a ainoaoi?iie oaeuiie eciai?eainou? eioaineaiinoe aieaaiai nei-
noaiaie oiaiuoeou aieu, oi neaaoao eniieuciaaou iaei a?iia. Iniaaiii ?anoi ia?eiau ?aceiai oneeaiey aieae
ec iieaoia, i?aaiacia?aiiuo aey ea?aiey oia?aiiie e aicieea?o ai a?aiy iaino?aiey eee ?acaeoey inei?ia-
neeuiie aiee (aea?ieiaii, ii?oei). A iineaao?uai iee. A «eanoieoa aiaeuaaoeeia» AIC Caeaea? ii?aaa-
i?eioei «eanoieou aiaeuaaoeeia», eee aaaaaiea aiea- eyaony eae n?aanoai aoi?ie nooiaie aey iaoeaioia, ei-

573

13, 8, 2005
eOCaAieaeEau
?a ianneaiay ninoaenoay oa?aiey, aee??aaoay aaci-
oi?ui o?aaoaony aieuoay yooaeoeaiinou, ?ai oa, eioi-
i?inoai a 5 neo?ayo. A noaoeiia?a auea iacia?aia aea-
?o? iiaoo iaania?eou n?aanoaa ia?aie nooiaie (iaei
eay nooi?iay aice?iaea Caeaea?a a aica 6–8 oaaeaoie a
ia?aoaoaiie, IIAI), ii aua ia o?aao?ony aieaa neeu-
nooee (ii 2 oaaeaoee 3–4 ?aca). Iaoeaioai auea i?aaei-
iua iieaou.
?aia naiinoiyoaeuiay ei??aeoey nooi?iuo aic Caeaea-
Iu i?eiaieee Caeaea? aey eoie?iaaiey neeuiie
?a e oao IIAI, eioi?ua iaoeaiou i?eieiaee ?aiaa. Oe-
aiee a iaeanoe ycaaiii–iae?ioe?aneeo ninoaenouo ?an-
o?iaaiey aicu i?aia?aoa ia i?iaiaeeinu. Eo?n ea?aiey
no?ienoa e aaia?aiu o aieuiuo nenoaiiuie ?aaiaoe?a-
i?iaie?aeny 12–14 aiae.
neeie caaieaaaieyie. A ia?aii o?eiano?a 2005 aiaa
Caeaea? aue yooaeoeaai o anao aieuiuo (oaae. 1).
Caeaea? aue iacia?ai a oneiaeyo noaoeiia?a oanoe
O?a ?a?ac nooee iinea ia?aea oa?aiee auea ioia?aia
aieuiui (ana ?aiueiu a aic?anoa 22–70 eao), ec ieo aaa
iiei?eoaeuiay aeiaieea aiee a ianoao ycaaiii–iae?i-
no?aaaee nenoaiiie e?aniie aie?aieie e 4 – nenoaiiie
oe?aneeo aaoaeoia, oeo?oeeenu iauaa naii?oanoaea e
neea?iaa?ieae. O anao iaoeaioie eiaeenu au?a?aiiua
yiioeiiaeuiia ninoiyiea iaoeaioia, nii, aiiaoeo. Iae-
aeeoaeuii nio?aiy?ueany e i?ia?anne?o?uea o?ioe-
aieaa au?a?aiiay aeiaieea auea auyaeaia e eiioo
?aneea ia?ooaiey aieiou ai ?acaeoey ycaaiii–iae?ioe-
aoi?ie iaaaee ea?aiey Caeaea?ii. Ioia?aii nouano-
?aneeo eciaiaiee e aaia?aiu (o 1 aieuiie). O iaiie ia-
aaiiia oiaiuoaiea aieae. Iyou aieuiuo, i?eieiaaoeo
oeaioee ioia?aeenu aeoaieea ycaaiiua aaoaeou a ia-
IIAI ai iinooieaiey a noaoeiia?, ioiaieee eo iieii-
eanoe eieoaauo naeaia, o iaiie – ycaaiii–iae?ioe?a-
nou?, ana naiinoiyoaeuii oiaiuoeee aico Caeaea?a ai
neia ii?a?aiea ei?e noii e aieaiae, o 4 – iii?anoaai-
3–6 oaaeaoie a aaiu. Ia?aiineiinou i?aia?aoa auea oi-
iua aeaeoaeuiua ycau e iae?icu ?acee?iie noaiaie au-
?ioae, ia?aeaoaeuiuo ?aaeoee ia auei auyaeaii. Ia
?a?aiiinoe. O?ioe?aneea ia?ooaiey nii?iai?aaeenu
oiia eiiieaeniiai ea?aiey ?a?ac aaa iaaaee ioia?a-
ia?anoa?uei ii neea aieaaui neia?iiii. Eioainea-
eanu iiei?eoaeuiay aeiaieea ni noi?iiu iniiaiiai ca-
iinou aiee ioaieaaeanu ii 100 ii aecoaeuiie aiaeiai-
aieaaaiey. Ia?yao n yaiui oiaiuoaieai aieaaiai nei-
aie oeaea (AAO). I?e ioaiea iaoeaioii iauaai naii-
a?iia iaiaoeeanu oaiaaioey e oeo?oaie? ianoiiai
?oanoaey oae?a eniieuciaaeanu AAO. I?e iinooieaiee
i?ioanna, i?iyaeaoayny a oiaiuoaiee ioaea e aeia?a-
ana aieuiua ioaieaaee naia naii?oanoaea e yiioei-
iee a iaeanoe yca, iiyaeaiee aaia?eaoeiiiie eeiee o
iaeuiia ninoiyiea eae e?aeia ieioia (70–100 ii ii
aieuiie n aaia?aiie, iaiaei ieiuaau ecuycaeaiee in-
AAO) e ioiaoeee aunieee o?iaaiu aiee (80–100 ii).
oaaaeanu i?a?iae.
Ana iaoeaiou ia aiaoeaoi?iii yoaia a oa?aiea aee-
E iiiaioo auienee (?a?ac aaa iaaaee) 3 iaoeaioee
oaeuiiai a?aiaie i?eieiaee n oaeu? iaacaieeaaiey
i?iaie?aee i?eieiaou 3–5 oaaeaoie Caeaea?a. O iaiie
?acee?iua IIAI e aiaeuaaoeee (aeeeioaiae, ieiano-
iaoeaioee, ea?aiea ae?eiei?oeeieaaie eioi?ie auei ia-
eea, eaoii?ioai, iaioaeaei, iaoaiecie e a?.) aac yo-
cia?aii aia?aua, iiei?eoaeuiie aeiaieee caaieaaaiey
oaeoa. I?e iinooieaiee iaoeaioai iacia?aeanu aaae-
ca ei?ioeee ia?eia ainieoaeecaoee ia auei ioia?aii, e
aaoiay oa?aiey iniiaiiai caaieaaaiey, o anao aee??ea-
iia auea auio?aaia i?eieiaou ai 6 oaaeaoie Caeaea?a a
oay ae?eiei?oeeieau a iiaaaey?ueo aicao. O?ia aieu-
nooee, oae eae iaiuoay aica ia eoie?iaaea aiee. A ea?a-
iuo i?eieiaee oeoioiene?aneea aaaiou (oeeeioinoa-
noaa eee?no?aoee i?eaiaei eeeie?aneea i?eia?u.
iea e acaoeii?ei), iaia – ieaeaaiee. I?iaiaeeanu oae-
Oaaeeoa 1. Aeiaieea aiee e naii?oanoaey
AOI?I? O., 34 IAU, I?OEIO? I OU?EOI?IOI IA?AIEE ‚ Ei
ia oiia oa?aiee Caeaea?ii (n=5)
aIOUEUUUA ?A‚IUOIO„EE ‚ ?I‚?A 2005 „. O E„IOAOI: eEOUAII?
1 2 3
OIIA?OA?IE? OOU?O„O UA?AIE?. e?E OOOUUOIAIEE O?A??‚I?I EIO-
Aieu, ii 80–100 67,2 53,6 34,5
·? I OO‚??AIEA UAIOA?UU?? UAI O 38°e, I EAIAIAIEA ?‚AU IE-
(AAO) (56–80) (45–70) (30–40)
OUAE, IEUAI?IO IAAEE‚??EA ?A‚O?IE I OI??? E ?A‚? ‚ O·IOUE
Naii?oanoaea, ii 70–100 70,8 55,8 42
IOIUAE, OO?UIEA, OIO?OE OOAUEU (UOUO 1,1).
(AAO) (60–85) (50–70) (30–50)
COA?‚?A E„IOA OEOUAIIOE OIIA?OA?IEE ‚?OU‚IAI ‚ 2001 „.,
IAI?AI O?AIEAOIOI 25 I„/OUU., IUO?AIEI 250 I„/OUU. e ‚AOI? 2003 „.
eUIAUEI OO?‚IAIEA OA?‚?? U?OUE?AOIE? I?U?AIEE – E„EUI?I??




Oioi 1a. Eenoe iaoeaioee A., no?aaa?uae nenoaiiie
Oioi 1. ?caa a iaeanoe eieoaaiai nonoaaa o aieuiie A. neea?iaa?ieae 4 aiaa


574 13, 8, 2005
?U·?EIO‚, ?A‚O?AI. e ‚AOI? 2004 „. – O·?AO‚IEA ·OIAAIAII?? IEUAI?IO IAAEE‚??E? ?A‚ I IOEA ‚ O·IOUE IOIUA‚?? O„E·O‚. NI? UIAI??A-
IE? ·OIAE ‚ IAOU? ?A‚AII?? AUAIUO‚ O?EIEII IEIAOUIE 200 I„/OUU., EIIOUAII, IAUOO?OUAI ·AA OU?AOU‚AIIO„O ?UUAIU.
e?E OOOUUOIAIEE OOOUO?IEA O?AIAE U?EAOUE, OOIEEAIIO„O OEUIE?, IOIOO·?AIOOU? IE?, «IEOAU” ‚OI?U„ ?U, UIAI??AIEA ?OUO‚OE
OA?UU??, EUUUAI? „EOA?OE„IAIU?E?, EIU??E? IOEE IEOUAE, O?AOIA?EE, OIA?, IE?, OIIA?OIUEIE?, O„E·UAI?I?A IOIU?IUU?? OI?-
?A‚ IEOUAE; E„EUI?I?A ?U·?EIE E ?A‚O?IE, „IU·OIEA ?A‚? I IOEA IOIUA‚?? O„E·O‚ EIAU?OI 1,5?2,5 OI O ‚??EAII?I ·OIA‚?I OEI?O-
IOI. AOI? OO CAo 80 II. aA–A ·OIAE – O„?IE?AIEA ‚EEAIEE ‚A??IE? IOIA?IOOUAE, O?EAIUI IA IOEAU OIOOUO?UAI?IO OAU?O?, OO‚A?-
?U? „E„EAIE?AOIEA O?O?AU??.
c UOIA IOIOIAIOIOE UA?OEE, ‚II??E‚?AE aIE? (OO 6 U·IAUOI ‚ AI?) I IOI?U OA?‚OE IAAIE OUIA?AI ‚??EAII? OOIOEEUAI?I? E-
IIEI ·OIE ‚ IAOU? ?A‚AII?? AUAIUO‚, UIU??EIOO? OIO?U‚OU‚EA ·OI?IOE, IO?IIEAO‚IEO? OOI E OOAUEU, IOU?OAIEA. C UA?AIEA OA?‚OE IA-
AIE ·?IE OUIAIAI? ceCe, I ‚UO?OE IAAIA OA AIE? OIEEAI O 3 U. ‚ OUUIE. a IOIAIUU ‚?OEOIE O?AIE‚I ·OI? ‚ 45 II.

AOI?I? a. 22 IAU, I?OEIO? I OU?EOI?IOI IA?AIEE ‚ Ei aIOUEUUUA ?A‚IUOIO„EE eAac O E„IOAOI: eEOUAII? I?OI? ‚OI?I-
I, OOU?O„O UA?AIE?, IU. 3–2. UIO·? O?E OOOUUOIAIEE: I OUA?IOOU?, OOI?OIAIEA OUOO E „OIAIAE, I ?AAIO ·OIAAIAII?A ?A‚? I IOEA O‚O-
OUOO E „OIAIAE, OOO?O‚OE??EAO? EEAIEAI E ?OOE?IEAI, IA‚OAIOEIOOU? OIOOUO?UAI?IO OA?A‚E„U?O?, OO‚??AIEA UAIOA?UU?? UA-
I O 38°e, OIO?OE OOI EA–A ·OIAE ‚ IO„?.
aA IIIAA: AOI?I O OOAIE 2004 „., ·?I E„IOOUE?O‚I eaC, „AIO??„E?AOIEE ‚OIUIEU. i?U?AIEA OOOUO?IE? AEIOE 2005 „.: IE?O-
?I O 38°e, ‚?OAIEA ‚OIOO, ?U?I„EE, OUAIE E OOI?OIAIEA OUOO, „OIAIAE, OO?‚IAIEA IOEII??EUO‚ IOIAE, ?A‚AIIO–IAI?OUE?AOIE? EA-
IAIAIEE I IOEA O‚O OUOO E IO?EAI, UOEIAIEA ·OIAE ‚ IAOU? OO?EAIE?.
e?E OOOUUOIAIEE: eOOUO?IEA O?AIAE U?EAOUE, EA–A ·OIAE ‚ IAOU? ?A‚AIIO–IAI?OUE?AOIE? AUAIUO‚ OA?A‚E„AUO? O OOIO??? IOOU?-
IAE. aOE ·IAI?, OU??; IEOUE O?O?II?A I O?UO?, OUA?U?E OEI?OI eAEIO, IOII?A E OOO?‚AII?A IOEII??EU?; I IOEA O‚O OUOO
‚ O·IOUE IO?EAI E IEEIAE U?AUE „OIAIAE IIOEAOU‚AII?A „AIO??„E?AOIEA IO?O?IE, ?A‚AIIO–IAI?OUE?AOIEA EAIAIAIE? (UOUO 2). AOI? OO
CAo 93 II.
NOOOIIEUAI?IO I OOIO‚IOE UA?OEE „I?IOIO?UEIOEIE, ?EIIOUOOUIEOI E ‚AOO?OOUIOI ·?I IAI?AI aIE? ‚ OAA 6 U. ‚ AI?.
c UOIA O?EAI O?AO?U OOOUO?IEA ·OI?IOE UIU??EIOO?, AI?EUAI?IO UIAI??EIEO? ·OIE ‚ IAOU? IAI?OAO‚, I IOI?U 1–E IAAIE O?EAI ·?-
IE OUIAIAI? ceCe, ·OI?I? OIO„I OA?A‚E„U?O? OIOOUO?UAI?IO, UIU??EIEO? OOI E OOAUEU.

AOI?I? a., 33 IAU, I?OEIO? I OU?EOI?IOI IA?AIEE O E„IOAOI: eEOUAII? I?OI? ‚OI?II, ??OIE?AOIO„O UA?AIE?, IU. 3–2.
UIO·? O?E OOOUUOIAIEE: I OOOEIAIEA E OO?‚IAIEA U?OUIO‚ IAI?OA I 1,2 OI??? OUOO, OOO?O‚OE??EAO? ‚??EAIIOE ·OI??; ·AO-
OOIOEOU‚O, I?U?AIEA OI, ?IO?EOII?IU? IAUOUOE?E‚OOU?.
aA IIIAA: e?EAIUI OU?AU eaC OIOIO 15 IAU. a·OIA‚IEA O?OUAIAU O OA?EOIE ‚?OOIOE IIEIEIO–I·O?UO?IOE E EIIUIOIO„E-
?AOIOE IUE‚IOOUE. e?EAIUI IAIOIOIAIUI, IA?AIEA O?AIEAOIOIOI E ?EIIOUOOUIEOI O?O‚OEU IA?A„UI??IO E IA ‚ AI‚UI?? OA?
(OIOOUO?UAI?IO OUIAI?AU O?AO?U?, OIEEAU OA?). i?U?AIEA OOOUO?IE? ‚ ?I‚?A 2005 „., IO„ OOOIA OU?AOO OO?‚EIEO? ·OIE E OEI??-
I?A O?UI I OI??? OUOO, IOUO??A OOOUAOAIIO ?‚OI??EOIE?O‚IE ‚ AOI? IAI?OAO‚ (I?U 2005 „.), OOO?O‚OE??EAO? OEI?I?I ·OIA‚?I OEI-
?OIOI. eIOOUO?UAI?IO O?EIEII ·?I„EI, IAUOO?OUAI, EIIOUAII ·AA OU?AOU‚AIIOE EIIEIE ·OIE. e?E OOOUUOIAIEE: U?EAOU? OOOUO-
?IE? O·UOIO‚IAI IAI?OUE?AOIEI ‚OIUIEUOI O OO?EAIEAI OI??A‚ OUOO. aEOUE O?O?II?A I O?UO?; IOE OU??, ?AIU?EUO? I OI???;
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AOI? OO CAo 100 II. aA–A ·OIAE O?EAIUI OOOUO?IIO OI?AU, ·AOOOIOEI, IA IOEAU OI„O I?OEUO? ‚ OIOI OOIOEAIEE, IO??? IA
OOEU, OOAUEU OIEEAI. C OA?‚?E AI? „OOOEUIEA?EE I OOIO‚IOE UA?OEE ·?I O·‚IAI aIE? ‚ OAA 8 U. ‚ AI?. iEA ?A?AA 3 I? O?EAI
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UAI?IO UIAI??EIO? (O 40 II OO CAo), UIU??EIOO? OIO?U‚OU‚EA E ?IO?EOII?IOA OOOUO?IEA O?EAIUIE, IO?IIEAO‚IO? OOI.

AOI?I? O., 41 „O, OOOUUOEI O EIO·IE I ·OIAAIAII?A ?A‚O?IE, IAI?OA? I OI??? IEOUAE, OA??A·EAIEA, OIO?OE OOI. eU?AU OEOUAI-
IOE OIIA?OA?IEAE ‚ UA?AIEA 13 IAU. aA?EIO? IAUEIO?AIEAOIOIOI (12 I„/OUU.), OA?EOE?AOIE O?EIEII OAIUOIOEUEIIEI, IEUAEOEI. C UA?A-
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5 ·AA ?UUAIU. e?E OOOUUOIAIEE OOOUO?IEA O?AIAE U?EAOUE. aOIOO·?AIOOU? IE?, «IEOAU» ‚OI?U„ ?U, OIIA?OIUEIE?, O„E·UAI?I?A IOIU-
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OUO?IE? O·UOIO‚IAI ‚??EAII?IE U?OUE?AOIEIE I?U?AIE?IE E AI?EUAI?I?I ·OIA‚?I OEI?OIOI. AOI? OO CAo – 100 II. aA–A ·OIE ?AAIO
O„?IE?AI UUII?E? IEOUAE, ·OI?I? O?EIEIAU ‚?IUEAIIOA OOIOEAIEA, IO??? IA OOEU, OI?AU. eOIEIO OOIO‚IOE UA?OEE IAUEIO?AIEAOIOIOI
12 I„, OOOUEOU?IE O?AO?UIE ·?I IAI?AI aIE? ‚ OAA 6 U. ‚ OUUIE O ?AI?? IUOE?O‚IE? ·OIA‚O„O OEI?OI. iEA I IOI?U OA?‚?? OUUOI O?E-
AI O?AO?U OUIA?AIO UIAI??AIEA ·OIAE (O 70 II OO CAo). cE·OIAA OU?AUIE‚? OOIOEEUAI?I? EIIEI OUIA?IO? I 5 OUUIE (50 II OO
CAo), UIU??EIOO? O·?AA OIO?U‚OU‚EA E IOU?OAIEA ·OI?IOE, IO?IIEAO‚IO? OOI.

Ia i?aanoaaeaiiuo eeeie?aneeo i?eia?ao aieuiua n oy?aeie ninoaenoie iaoieiaeae, inei?ieaoaeny ?acae-
oeai ycaaiii–iae?ioe?aneeo iia?a?aaiee, a oa?aiea aaoo iaaaeu a noaoeiia?a iieo?aee aeoeaio? i?ioeai?aaia-
oe?aneo? oa?aie?, a ?acoeuoaoa eioi?ie iaiaoeeanu ii?aaaeaiiay iiei?eoaeuiay aeiaieea eeeieei–eaai?aoi?-
iuo i?iyaeaiee iniiaiiai caaieaaaiey. Aee??aiea a eiiieaen aiaeaaoeea Caeaea?a i?eaaei e io?aoeeaiio nie-
?aie? eioaineaiinoe aiee o anao 6 aieuiuo, ioiaia IIAI e oiaiuoaie? aicu Caeaea?a e eiioo aaooiaaaeuiiai
eo?na ea?aiey. I?e nenoaiiie neea?iaa?iee e nenoaiiie e?aniie aie?aiea au?a?aiiue aieaaie neia?ii i?aeio-
uanoaaiii ninoaenoiai aaiaca, ia eoie?iaaaoaainy IIAI, oiaiuoaeny a aieuoeinoaa neo?aaa, e o 5 ec 6 aieuiuo
eOCaAieaeEau
Cancer Pain. Glenview, IL: American Pain Society, 1999
nii?iai?aaeny iiei?eoaeuiie aeiaieeie ninoaenouo 2. Mullican WS, Lacy JR. Tramadol/acetaminophen combination tablets and
?anno?ienoa. codeine/acetaminophen combination capsules for the management of chronic pain: a
Iaoioeceieiae?aneea iaoaieciu aiee, naycaiiua n comparative trial. Clin Ther 2001; 23: 1429–1445.
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iae ?aaeoee i?aaiecia e iooe aicaaenoaey ia ieo iiiai-
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ia?aciu e ai iiiaii inoa?ony iayniuie. Nei?iinou e
4. Rosenthal N, Kamin M, Jordan D, Wu S–C. Efficacy and safety of tramadol/aceta-
iiiaioaeoi?iinou ia?aaa?e e iiaoeyoee aieaaiai ei- minophen tablets (UltracetTM) as add–on therapy for osteoarthritis in patients taking
ioeuna iauyniyao oio oaeo, ?oi ia anaaaa aieu oaaaony COX–2 NSAIDs: a multicenter, outpatient, randomized, double–blind, placebo–controlled
iiaaaeou eaeei–eeai iaiei oa?iaeieiae?aneei aaai- study. J Pain 2002; 3(2 suppl 1): 10.
oii. Ia i?aeoeea aaaouei yaeyaony ioeuoeiiaaeuiue
iiaoia e ea?aie? aiee. Iaei ec niiniaia oeo?oeou ea-
?aiea ino?ie e o?iie?aneie aiee yaeyaony i?eiaiaiea
eiiaeiaoee aieaooiey?ueo n?aanoa, eia?ueo acaeii-
aiiieiy?uea iaoaieciu e a?aiaiiua oa?aeoa?enoeee
aaenoaey. Aeaaiie oaeu? oaeiai iiaoiaa e ea?aie? ya-
eyaony iaania?aiea aieaa neeuiie aieaooiey?uae ae-
oeaiinoe, ii n?aaiaie? n ea?aui ec eaea?noa, aoiayueo
a eiiaeiaoe?. Yoi i?aeiouanoai a oa?aiaaoe?aneii
aaenoaee ?anoi ainoeaaaony i?e iaiuoeo aicao ea?aiai
ec aeoeaiuo eiiiiiaioia, iioaioeaeuii oeo?oay ia?a-
iineiinou e oa?aeoa?enoeee aaciianiinoe eniieucoaiuo
aiaeuaaoeeia. Iiyaeaiea iiauo aiaeuaaoe?aneeo n?aanoa
?anoe?yao aicii?iinoe aaaeaaoiiai ea?aiey ino?ie e
o?iie?aneie aiee i?e ?aaiaoe?aneeo caaieaaaieyo.

aEUA?UU?
1. American Pain Society. Principles of Analgesic Use in the Treatment of Acute Pain and




Oioi 2. ?caaiii–iae?ioe?aneia ii?a?aiea ei?e
o iaoeaioee I., no?aaa?uae nenoaiiie e?aniie aie?aieie




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