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A.E.BEAOYCOB PYBLIbI U Ux KOPPEKUWUA OUEPKU TIAACTUWYECKON1 XUPYPHMA _ oer Canxr-Terep6ypr Visaareascrso «KOMAHAOP-SPB» 2005 oN Fi a) NPEAUCHOBNE BEAEHVE rABA1. THABA2. HABA 3. 3ADKMB/IEHME PAH! A DOPMUPOBAHNE PYBLA 1.1. Kantanxa # Mopbonornst saxnatenist par 1.2. Yro onpeneaser xapaxtepucTHkH py6u0n? 1.3. Baansioe aansiane OGULHX H MeCTHEIX YenOBHH saKHBTIEHHS part BuGawoepaduneckuit enucox KAIMHMYECKME XAPAKTEPUCTUKM PYBLOB 2.1, Outenka xapaxrepucrik py6uon 2.2. Yactuise xapaxtepucruku py6uon 2.3. Hirterpabuste xapakrepucriks py6u0n 2.4, Ochopnbie KmHHHMecKHe CHHApOMEI 2.5, AdaToMo-*pusHouorHueckHe xapakTepHCTHKM OKPYKAIOIINX py6cu TkaHteit 1 Hx KIMHHYECKOe HaMeHHe BuGauoepadureckuit enucox CNOCOBbI 3AKPBITMA PAH M1 KAYECTBO PYBUA 3.1, OGuiHe npustunmt xupypristeckoro saxpHrTHa part 3.2. Mectuie yes1onust saxpbrTHa pan: eM 3aKoHuTes pateBoll nponece? 3.3. Cnoco6w1 saxparrns pan 3.4. Yponnn HanoxeHia u1H0B 3.5. Wonnutit marepuas u ero nanstite na 3aKunrenHe pat 3.6. Textinka KoxHOrO IBA 3.7. Apenmponarne part 3.8. Bexenne panei 8 noctconepaunonHom nepHone BuGauoepagueckuit cnucox 12 18 a a1 21 29 31 35 7 9 38 ees 59 60 63 NPEAUCHOBMI Kax xopouio isvectii, oGpasonarine py6uion — 910 vopwatatan QyHKLNA HonpexaeHHBsX TkaHel, Ge3 KOTO- oil ne Moxer cyieerwoRaT® HH OI AHO OprAMISM. Y xaxstoro eHoReKA ~ HOH PYG, H HX NHCHO B TeYeHIE -xvant neyxaono nospactaer, Camo poxctenite peGenka © onzeaenteM ntynoniiit npipositr x o8padonatNO nepHO- ro py6tia, KorOpH n niLte nynka crannies OGssxTe:h- un anenentoM nepeanelt Gprouno cTenK B ormmwe or exyvalix nompexeni, ocranasi0- tuunx pyGusd Ha Tee enoveKa, XHPypris saMMMacTeH M10 cyt ena “nponsnoact#os py6uos”. C oanotl cTopons, ‘bopwposannte py6uovoit TKAHH, HANExHO CoeIMAHO- ute noppexaeHie EYpyETypH, sMIAETEN BaAHeMUIM yexosites autatoponaeni naumeta, C apyrott cropoxs, pyGunt — 910 noGouna pesyabrar paGori xupypra, OCy- utectumeusero AocTyi K NoppeActenHtoMy (GoxsHOMY) OP- ran. H sro o6,barenbitoe nocaencraneonepanlnn OcraeT= TOM Hanceraa, MHOFAA cyWIeCTBEHHO CHUDKAS asecTno ero x34 Kak yrnepaaaer nocrownas wyapocrs ".1en0ReK MO- XXeT NpOxitTE MOTO eT, HO TAK I He YHA B MEM Ke exten xutn", elicrarenbio, 018 Gosbunnsicra soe “zat camuiKon Tpyana, TOG 3aAyMuNATCH HA DUNO corbexuINHt nonpocasin. Take 18 XEPYPE: MOHO PO “xvETbLINNHYO XspyPIIEICEKY¥O KWH, He OMI YM vauich 0 py6uax. Ont — Kak Horo, KOTOpAK| MOxeT OBIT aysue, Hm xyke, Ho KoTOpas — neeraa ecrD. M 1a KOTO Pyto ti acto He o6pautaent ania xara — 970, pexse ncero, ame pass- sen XIPYPTA, © MPOBENAX Ht PeABHN, HOIMO:KHOCTIX oppexutn py6io8, fl Havewoc, 0 mpaenenmete w KH re warepnians Gyayr miepeck OMBITHBIN eneMaZICTOR st rosBonsr HasmnaOMUIN xNpyPFAM 19GEKATH HEKOTOPH oumnox. Xouy nupasis expen ovo puanarenbocrb 3a Kpl- Tuncky 0 oueHnKy cover pK NaRMEAHONN TOM KIT CcHon soronerHiN ApyaHAM H KORAETAM ~ npoxbeccopy CX.Kurvewacony (aanbinnxy Kaibeapit TepunrieeKinx nnopaentit BMA) 1 nposbeccopy H.B.Llneaoncnxo (re= epanstowy anpextopy Cankr-Tlerep6yprexoro HaysiHo- paxriseckoro Lentpa mesuKo-couvarnoll oxeneprit= Sui, nporesnponanin H peaGHaITaIa mRATHAOR HM. A An6pexta). oi] 2B) } 91h : Kak anecrio, opasonannte py6ua noce nowpexxe- iA KOHL pH TpaBMax H OnlepaNHAX stmaAeTCs GOOCH Neckoii 3axoNOMepHOCTHIO H BOCKPIEANMAeTEs 1 XHPYPIA- OH TAHHEHTaNIE KaK eHeHGEKHOE 10. na npaxraxn saxno To o6crosrenvcrso, «70 oKoH- aTenbHoe dbopmmposanne py6ua 8 ocHoRHom sanep- ‘waerea nuip cnycta 6-12 mecayes nocne Toro, KaK Bbi~ onniena onepauna. M 8 >TH Ke cpoKH xapaxtepucrHKit celle oad PYBLIOB Hlepayio cuyamino set serpevaem npit orKparraix ‘paRMAX H WX XHPYDrVECKOM /IeveHN, Kora H NaLbHeNT, ‘WXUpyPr eraKunaioTes ¢ ye HacTyHNUIN 110 Bo: eAy- an Mlompexaennem. 310 wocnpmnnNaetes nausenToM aK pesyabtar caywaiintsx OGcrosTemcr® w daxrisieckHt ‘cHHMaeT © xupypra oTvercTBEHHOCTE 32 KauecrHo 6yAy~ ux py6i08. Bropax curyaua sosnuxaer mpi Heorxoxnuy 1 MaaHoBBIX XHpyprHvecKHX onepamAX, Korna eX, Kak MpaBiNA0, wer o.cnaceNHM sAOpOBKS, a 4acTO HAHA NHC naueHra, 1 2218 9TOFO TKANH nauHeHTa paccexaIor ‘oa Xupypritteckua cxaabnestem. HoatoMy xupypra Bo:.- Hyer, mpexate neero, He Kavecrso Gyayutero py6ua, aro, ax Gosee yerieuiNo penis ocHoBHyIO sala¥y seveHNS (anpuvep, yaauens nocnasenubsit anneHanxe, ocraso- Birr» Butyrpenee KpovoTeYeHHe, peseLLKpoBATE ONYXONE ura), We nepsow at no wropow c:yyaax xupypr, sanepuias ‘onepauino HaKIamEivas BHI, B NepRY!O oNepeR’ Ay- Maer He 0 KavecTBe Gyayutero pyGua, a 0 HeocTOKNEH- Hom (nepansioM) saxuaenin pants. Bea » Goab- unmeTHe caywaes pewleHNe HMEHHO ITO! 3a1a4H O6eC~ Hewnpaer OG yerex BMeMIaTeNscrBa, nosBoAIeT B KOPOTKHe CPOKH BUIHCATS HaMMeNTa Hs crauMOMApA MmosTOMy sseTes OMIM HES BAAxHDIX KPHTEpHER Ix>- hextisnocru xupyprisieckoit paGoral. H ToBKO 4epes Heckonbxo Mecttes nocse Toro, KaK paNa saxWIa, Gomunoit nuist0ponen ¢ GxaroxapuocTsio paccrates, Pact. Fpmsnnes BO3HUKHOBeHIA py6uos (o6vacnenne 8 rexcre). XMpyprom, HactynaeT mpeMst OUeHKH naMsteHTTOM Ka ‘ecrua noc:teonepaunonneix pyGuos. M Tyr Ho MHOrHX Ccayasx cTAHOBHTeH O¥eBILLHEIN, STO XapAKTEpHCTIKH, PyGua urpaIOT BAxHYIO por w xIIHM MaUMeHTa H He- PesKo SACTARAMOT ero BHOBE OGpamlarbcs K XHPypraM. Tipu oro npetensmit x onepuponanimemy cnennanne- ‘Ty, Kak mpawiito, He npemsmasores. M 970 — B ues10M cnpaseautuno. Conepuiennio apyrofi noaxox K oueHKe KavectHa pyO- luo xapakrepen 11s 9cTerH¥eckoH XMpyprii, Kora F1aB- as Wee XMpypra — yaysNETs BHeMNUAH wiLa nauHeHTa, H, cortamaice Ha onepaiuno, naumerr oxNoppemerHo Cortauiaeres W Ha nosHuKHopeNHe Gyayuun py6uOB. Hx BBEDEHMI xapaxrepcTHkit craMonsTea BAxHeHUNIM noKadeTeTeM awectsa aeiicrsnil mpava, KoTopHlit ene to xupypruyec- Koro BMewlarenersa OG83aH HoxpOOHO MpouopxpO- 'BaTS nauettTa 0 BosMOAHOM xapakrepe GyayuLNx pyGuoR, Sra mniop aun MoswOAKeT GoxBHOMy cOrnacHTbes WK ‘orkasarbeH OT onlepatuint, a locze sweuaTesker#A — npHt HeyaomtersopenNocT xapaktepicruKamit py6uon — Hpesrassitrs xMpypry mpereH i B revenme mocmeaHNx cta ster Guit0 ceaaKo Hena- 0 HONBTOK HaftrH crocoG adxbeKTHEBHOM HexuyprH- eckoit Koppexumu pyOuon: or o6mel repanun (innsexiuit azto9 Han cTeKOBIUIHOTO Tena, OKcHTeHO- ‘Tepans mp.) 10 MeetHOrO (He xpyprutecKoro) Boa aelierns Ha py6um (enomba0RaHHe Kpeasorouoro Macxa, nenicHHa ¢ coARHOM KHexIOTO!, THOsHHAMHa, penaparon caamunaonoll KMexOTH, npHMeHenite rHA- POKOpTHsOMA MH ero aNatoron H stH. Ip). Yeu, HH OA M9 9THX MoAXOAOB He MpoxeMoHeTpHpowA XopoUel pesyatbtaripHocri. AKTHBHESaL miUEaHIH XHpyProB K TpobneMe KANE” ‘Taa py6u108 npowsounta po Bropolt nowronnie XX-ro neKa, Bromy cnocoServoK70 paste HIacTHIeCKOlt XHPYP- it, a-TaGKe Bee Gombuce NoHUMarHe OOulecTHOM MBH AMGOBAMMBX CTPA BAxHeMIMIeM POM BMeUIHerO BAIA 15 AWWW YesIOReKA. Co BpeMeHEM sHavHETemMBHYIO YaCTE ‘acTuvieekix onepaustit CAH BHITOAHSTTs © UecBIO KOP- PexumH pyOuOB, H 97a rpynina AMemaTemKeTR cocraRNa BUBIMOrPA@UYECKM CNUCOK croxnyo raany neaerHeCKOH W peKoNCTPYKTIAHO x= Pyrat K coxarenno, aussi oni xaxaoro xupypra com AeTeAKCTRYET 0 TOM, TO SHANHTEABHOTO dyexra B KOP= PeKiMNH pYOUON AOOUTKCH GiinaeT TPYAHO, @ HHOrRA — MewosMoxno. Xupyprist pyGl08 — 910, GeccnopHo, caoxnax oGstacT, KOTOpol pesyabraToR nulTOnHeHtIaX omepauii naunenry npuxosurres Axarb MNorHe seca, aux roxus. Hn Kone annTeasHo0r0, acto MHOrO9TaN- Noro events xmpypra it naweHTa MOxeT ALE ado ‘wapouanne. Boswoxnio mento no stoi mpwinne Kir, nocEa ltentax npoGewan (bopwnponartis H xupyprin pyGuor ‘ets stato. 3a nocaesmine 30 er » Hause expat wonpo- ut xnpypriecxoil Koppexiuin pyGuio8 paceMarpiiic stun, w araacax Al Zonrana [3,4] yx rapax KM, BI Iuenuet 0x penaxuuiei ropa » 1998 roay (2,5) Ete ve oworpadn Guan nlocsiueMls Mopsponorun naronor- "Yeckitx py6u08 H HeKoTOPHIM wO3MOAHOCTIN IK KoNICEp- varrunioro evens [1, 6) Hannan paGora cicrewernsnpyet BosMoxHOcTit xi Pyprivveckolt KoppeKili PYGOD € yeTOM, Kak ANHOTO oma anropa, Tax H omsra conpementiolt nxacrHeeKoMt xupyprint. Kitra Tare wksnosaer CD-autex ¢ npesenra- ve pura Kcuamcveckin HaGmOReHI, KoTOPHE MoryT Sure venomssosame wiraresaMi w mpaxritteckoit paGore ‘mautenran 1. Boaxoeumunoea JLT, Hassoea M.H. ~ Kexowsse pyOuss. // M.: Meamunna, 1977, -136 2. Besoycoe A.E., Kynpun ILE. ~ 3axunnemne pans v ontnstatsaeit pyOeu, — B xi. «ILtactuyeckan pexonerpykTHmiaat i acretveckas xupypris. // CIIG, Menmuna, 1998, ~ ¢. 106-122. 3. 3auman 51. — Onrruansait pyGeu. // Tlep. ¢ vexrepexoro. Bynaneurr: Man, Axatewun tay Benrpinn, 1974. — 175.. 4. 3oaman 31. — Mlepecaaxa koxn. / Tlep. c nenrepexoro. Byaaneurr: Han. Axaaewmn wayk Bemrpin, 1984. — 304 5. Kynpun T1.E, ~ Koppexuna xoxwuix pyGuon, // B xx.’ «I Lacraveckast peKoNctpyKTHBHAN H 9CTeTHMeCKAN XMPYpEH — CT16, Meanuua, 1998. ~ c. 724-731 6. Mloceunos C.B., Apuit EL, Baimuncep B®. — Taroxormieckue Koxwe pyGuss. // Tonck: waa. «Texarnas anytbaxtypar, 2004, ~ 140 c. 3A.KUBJIEHME PAHbI VU ®OPMUPOBAHME PYBLIA 1.1. KAMHUKA WU MOP®ONOMMA 3A.KUBJIEHUA PAH Baxunene parts — 970 aerepsunpoRAHHAH 6HO- -Romveexutt npouece, KOTOpEAR ATER OKOO TOMA H 38 epuiaetes bopuuponanen spexoro pyGua. OxHaKo Wn nocaeayouieN TKaLKH, o6peayoune PyBeHL, cHOCOBHL XK Hepenenam, xO7s H » xNaNsHOM CreneNtt ‘C npaxnitieckoft roux apes aos npowtecce MOK Ho YeOBHO muni HecKO.TEKO Cran, Ha NPOTHCHIN KOTOpHKX eyieeTHCHHO WSWeHAMOTEH ABA TOKASATEAR, Hk NGorIee BEANIE H SLIM XiPypra, H -LE# GonbHOrO: NpOM- ocr» KOXHOTO yO Ht eFO BHCUINE xapaKTepHETHKH (a6, 1.1). Cragma_1_= nocneonepaunonnoro_socnanenna ‘4 2omrTenmausn paris! (1-10 crm nocne onepausn). B xone Toro nepwosa » pane npoxcxoasr npouecest Hoe ieontepaunonnioro (ocrrpasManiteckoro) BocriateHis, HHoeae paspeuleHms KOTOpOrO YMeHuIAeres OTEK, Ht pH “ompeaeteniHbix yesoniax (HeocaoxHentst paxesoit mpo- Lece M Xopouiee Conocranienne Kpaes Koa) HacrynaeT murresmsaun KOXHOH paris, OraMTesHOM ocoBeHHO- ‘cTw}o aToit cTaUINM sRAKeTes CoeAIHEHME KDC paw (pa HyAALMONHO! TKAMDIO, a He pyOuOM. FosTowy, ec:n# uin6t ‘CHHIMAIOT Ha 7-10,1eHb, Kaa Pall MOTYT ArKO paDoirHieh oa aciicTAMEM HaTHXCHHA OKPyAMOUUX TKAHeit AL noaysenns 8 Gyayiiem siHMaNbHOrO No mHEpHHE KOAHOFO pyOila 9TO HATEACHME O.DAHO ObtTE GO He scuodeno, aNGo HeltrpamaonaNo HaLOxeHLIM. wIRAMIt (ic npexae sero — nuyrpennsa) sta nporsexeHN repi ‘1 oGpasosaiis npouoro pyOus. Cranmn 2 - axruanoro duGpannorenesa 1 06pa20- ‘Bani nenpownoro py6ua (10-30 cyran nocne onepa- lu), B xone 2r0r0 nepuona woosat rpanyamuIOMHaD Tal, PaCOTOKCHHAS MEAILY KPANIK Pal, OMICTPO CO- spesaer, 470 conpowoasiaeTes yMenbureHieM KomYecTBA CocyAOB M KACTONHEIX aneMeHToB, © ostHOH cropon, iM yueanmvensen siteaa KOAMATEHOBBIX Hf 9AACTHYEEKHX BO- 20KOH, ¢ apyroll. B Kone STO CTasIMM KPa PAH Ye CO- ceamiettit NoiomsIM HeoKpemHM pyOuoM, KOTOPHI OKA locraeres OTHOCHTEsIBHO.AEFKO PACTHDKHMM H XOPOMLIO 52- Meru ¥3-20 GoxbUIOrO KoNeCTHa comepAxAMLEXCH -BMeM cocyaon. ranma 2 ~ o6paxonarie nposnoro pyGua (20-90 grr), Mpoaoxxaeres » Tevexe BropOroM TpeTKETO me- ete roene tpansts (onepau). B Xone 3Toro nepuona omit¥ecTH0 posoxHHcru’x crpyxryp 8 pyOue satTeiM0 YemUURAETEN, a 1X HRN MpHOGPETAIOT OMPEAEEHHYIO Copietraniio n coorBeTETHI ¢ JONHAPyOUHN HarIpaB~ ‘entem narpyaKn na pyBeu. CoorveTerveHNo, Komvecr- bo KAeTOSHX 92eMeHTOR H COEYHOB B PYOUORO! TKK cyILECTHEHHO YMeNDIIAETEX, TO MpoRKAKETEH BAAHOM scmuneyeekoi Texszenutet — npespausenten Gaxee spK0- ro 4 Goaee aawertioro py6utam pyGett meee pK 0- oroMy Mente aaNeruatt, B uesoM na npotsxenint TpeTbe- Fo Nepwowa soxumNeNHH parts npouccest penaparisHoi perenepauni TKaHeM 3Ha¥HTeABNO MeHsOT cBO¥ HETEH- cunniocrs: OF oTHOCiFTEAAHO BLICOKOIH 10 MISKOML OPMAPOBAHE PYBLIA. ME PAMbI = 3axi16) Ta6nmua 1.1 Craain @opmmnposannn Koxnoro py6ua NpH HeOCnoKHeHHOM 3axKHBNENHM YUINTOR Xnpyprnseckor pant! LL. Mlocae crams uno Koxnit py6en Ccranionsrres npownun Menee sameruuin, B meGnaronpusriix yerosnsx py6en awitaer runeprpoduposarsca WIM Hloapeprarcs. Kenowt0sy Koxmuit py6eit nocreneHno aocruraer MaxenMansoit mnpouocrn 1 ‘crawosirres emte menee sameTHBM, B neGnaronpusrix Yyeronsx oxoHareLHO ‘bopampyerca Fumeprpodrvccxstit wa -enowuet pybeu BAXKVIBNEHNE PAHbI M DOPMMPOBAHNE PYBLIA Mpaxrwyeckn saxHo, 470 8 TeveHHe >To! aan! aMauurrenbHoe Bnuanne Ha XapakrepncrnKn oGpasy- loweroca py6ua oKasmisaeT Bosmelicrene sHeUHiX ‘cua. Tak, np npogonsiom pactaxennn py6ua s ero ‘TKAHM MPoMcKoRRT AononHUTeNbHoe OGpasoBanne 1 Gonee verkan opmenTauin Konnarenoseix snac~ ‘TuWeCKMx BONOKOH, H TeM B Gonbwlei creneHM, Wem Cee ACU ett 3 Tease nua a sty = Pac. 11. Ocnosnwie baxrope, annaioue na npouecce! bopmuposanna pybua. ‘Craann 4 - oxonvarenbian rpanccbopmaunn py6ua (4-12 mecaues_nocne onepausn). Xapaxtepuayeres ‘aLTbHefMHINN Boe Ganlee MesZIEMHIM CospenaHHeM pyGUO- oft TKAMH € MONTE HOM MeMeSHOREHIEM HS Hee Me Xv KPoneHOCHBEX COeYsOB MPH THEME CHETEMATH- Sautt so70KOHHX CTPYKTYP BCOOTRETeTINC AeleTHYIO- usa a Aan aony evan PesyauraroM yMeHbienii# KonHeeTBA CoCysO8 HI res MenIenHoe HaMeHeHe tera pyBua: OF Goxee spKO- Fo poson0r0 10 Greanoro. B neGnarompusrix yexouisn anepuaetes oGpaaonaiine rurieprpodbieckiX W KeAONA- ‘nx pyGuoo. Baaxwo orversry, 10 » Goxbusncr¥e enya 0 HMeHNO B cepestHNe Yerveproro nepwosa (OBHHO — n SAXVIBNIEHME PAH! | OPMIAPOBAHNE PYBLIA NHoeae wieerit secsiues) KOXMME PYOU MOKHO OlLeHITE Kak cibopsumposanuniecs H OMpeNIENIITD BOIMOXHOCTH HX. oppexiut 1.2. YTO ONPEAENAET XAPAKTEPUCTUKU PYBLIOB? Bee dakrope, RANOUINE Ha xapaKTepHETUKK pyOUA, woryr Gus pasenentt Ha OGuune M MecTHIMe (puE. 1.1). OBLUME @AKTOPHI Boxpact naunenra, Xopouio uspecrHo, “0 aKTHB- HocTs Mpoueccom pertaparisHolt perentepaunn TKaHIeH NawGonee nbicoka B seTeTBE H 8 MasIOROCTH. B apestse FO- AM npoueccet saxnatenus pants H cbopuponanHst pyO- uos suasrTeabHo Gosee HHeprHM, a y NOKHAMX sHoseit cute Gomue saesLasores. Hacneacteennos axrop, Buoxorwsecks.serepat- nposarnbte peak opraniaMa, sanyexawuNHees pst Gpasosanit pan, uNeNOT y KAXIOTO HesOREKA CRON, Fe~ eriteekit oGyetowaeHme ocoGeHHOeTH. TakNe, KaK cO- Tontne uGpoGracTuecKoro pocTKa, aKrHBHOCTD paGo~ ‘Tu HARNOMESHHNKOB, YPONeH KOHHHTpALLE B KPODM HX Topmowos u wHOrHe apyrue. B nocaeane roms NON AAHHE 0 HANIEIHHE FeHeTHIeCKOM NpeapAcnOAOxEHHIOCTH x oGpasonanito xe:xowxssnx py6uo (8). Moampreni cratyc naunenta, Or cocroanis HMtyH Hof cHCTEMBI BO MHOTOM saBMCHT poUece SuAMBTEHIA pant. TIpi nospextenin KoxH & pane paswnnaeTes BoC Inaxevie, NanpanenHoe Ha OTIpaHtieHMe HexpoTuyec- oll TKAHH 1 axTHNHNxpoGHy sauneTy opranuaMa. CKon- aeHMe B Oware HOpAxCHH HeitTPOdHLIBNX sIeHKOUTOR hnpeaynpeasiaer pacnpocrpanene KipeKUMOHHOTO 1IpO- LUecea, a MPOMNKHOBEHINE H KPOBb NPOAYKTOB TkaHtenorO paca nese K 3aNYCky HMMYHHOrO oTBeTa — o6paz0na- io antes H ceneHGWiNsHpORaHEX aNMousTOD, Ha cneayioutes srane HaGmonaetes maxporpara.tsnio-dbi6- poGacruyeckas Koonepaluis. [pi 970M BaanMonelicraHe Mealy Maxposbaranit H iaHOOrHIEC- oii 1 penaparusioit perenepaui), Ho HB KpaTKOCpOH- HOM MacurTaGe (naMeHeHMe cocTosIHHI RHYTpeHtHel epe- a opranitava nauieHToB toa maNsMNeM erpecca, Goxes- MM, ropMonatbABAx caBHOB H Np.) Bor novemy, cca nopmorpoduseckiit pyGent esbop- Munponauten m pamnest eTeTBe, KOPPeKUM ero MAMPI Hora MOET HeOHLAAMHO ANH XHPyPra MIpHBECTH K O6- Pasonanio pyGua rutteprpoueckoro, MECTHDIE DAKTOPbI Xupypr axTusHo Baster Ha npouccees saxHBEHHs Panis, Wo Yacro ocoGeHHOCTH panenoro Mpoliecca on peneamores cayyaiiaeann oGcrostembcrnamn, Hesani- ‘mule OF XMpypra MecTHe hakTOPEL HOSKHKAKOT MPH PaHax tpanwariveckoro mponexoxaenus, a dbakropLl, OnpeaeasieMie XHPyproM, KapAkTepH LAM pat, HaHO- ccuntix ckamanteent (pic. 1.1) ‘OuerKa anianun mecrHbix ycnoBni Ha xapakrepHc~ “TMKx Gyalyuiero pyGua wenseTCA KmMOYOM B cocrasneHHK CAYYAMHbIE DAKTOPDI (OMPEMENAIOLLE 3AKVBIEHME TPABMATMMECKIX PAH) Aoxannsauna par, Sloxanisauis past urpaer knoe Bylo ports B oueHKe xapakTepucTHK Gyayutero pyBUA, TAK ax pactiooxcuse pyOlla Ha OTKPHTOM YMACTKE KOKH It, Meniteckml sedbexr, BTO BpeMs Kak TaKoM Ke pyGeut B OT- HOCHTeNbHO expuITO! aHaTOMICYecKOII soHe Yacro owe ‘RAETOR KaK SereTHYeCKH Gonee npiienressit. 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Sto saute acero Go.tee HoARIXeH, OMAKO MPH PASHTUN OH B cHo}o ONepeD MOXET TIPHBECTH K OGPASOBANHIO HOMO eH (i, COOTHETCTHEHHO, HOENE YReRHYEHIA TOMLIN Mrrenbtux KONTYpHAX HapyuieHMi pH ABMEACHUIX Texa —_OKPY-KMOU pyGeu TKAHeil) MOKET CTATH YEIyGNCHHMM U1 KowewHocreHt naxmteHTa, 1, Taki OGpas0w, Gonee aaMteTHAM, BUBIMOFPAMUYECKM CNUCOK 1. Besoycoe A.E., Kynpun 11.£. ~ Thiactuxa aedextos wepuon. // B xi: «Maactieckan pexonerpykTnian H 9ereTHec ast xupyprusi, ~ CI1G.: Funoxpar, 1998, ra. 16. —c. 150-167. 2, Boxxoeumunoea JLT, Haasoea M.H. ~ Kenonavsse py6un // M.: Mennunna, 1977. — 136 © 3. Hemoue AA. — Vccnenopanie MeraGomaMa Koszarena raneprpospiYeckiX MH Ke.toHLANux pyGuoR // Beers. PAMH. 1995. Ne 12.—€. 41-48. 4. Kynpun T1.E. — Koppexuua xeaowaniix u rineptpoxpnieckux py6uon M yTHL HX NporpILIaKriNkH B LAACTHYECKOM xMpY- in // Astopedp. antec. .. Kanu Mea Hayk. Beankuit Honropoa, 2003, 5. Osepexan O.C. ~ Tlarorenetumeckoe oGocHonanue HOBMIX MeTOOR Teparlih pyGu08 // ABToped) ANC. . 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Tipnmunnes saxpeiraa KOKHOM patel Yenosns | Yaepmanne Tounoe Aocrarounoe Mnnmuansnoe saxperran | crenox panwi 8 | conocrasnenne | xposocnabmenne | sosaericrene paves nonoxennn co- | xpaes panei | crenox paviel purest na npuxocHosenna nocne nanoenna | nosepxnocre B revenne cero we08 rox nepuona popmnpowannn npownoro py6ua Enaronpn- | slerko nocrynio | Bossoxo » octane, Moxer 6th sriie ayrem atoxcina | nomon wepe mH | T1610 yanoxenws 20K nocaoiinoro uma | stiorocaoitHow a ston eee = — = rere m = Baers _ He6naro- | Broswoitwepe | Boamoxnio Snawiremio | Bpaaccayanen npusribie | \Wen02Moxn0. ‘B HenosHoH cimxeno, wa | repser cwinies, acto de ope. exoropuix yaaerkax | Hep0:u0x10 1-38 onerca a “eyGxoumencuponao | nanexenna reanet umpoxitit py6eu TIpMMeHerist isa Gonee cnoxinnx popessimanns — | napnanton Saxperri pases (CTOCOBbI 3AKPbITHIS| PAH M KAYECTBO PYBLIA. OcoGennocrs xupypriseckod TexHuKst: |. Yaepxanne creHOK pant w noxOxeHHH TIpiiuins saxparrist pant erko peamayiores mpi . OcHosnan saa xMpypra ~ n06uTIeH ToMHOTO como CcrantenHa Kpak Tpedyer npunene- ita epesETH OMFTHYECKOTO YBEANEHNA M COOTRETCTY- KoAHOM pant, Tipu nonepxmoctiux aMeMHAx KOxHMX panax or sunita KOcMeTHYeCKMIL aqybeKT MOET GIT J1OCTH- THY? pH HeMtomB3ORAHM ToMbKO seliKONAAcTEIpHOI nHonsaaki, TIpx ray6oKnx paniax Moxer norpeGonath- es HaTOxCHME WHR Ha 2-3 ypORHAX. TPHKOCHOBEHH OOKHO HEOBXOIMO JIHUIK Ha oTHO- cifTextsH0 KoPpOTKH repro OGpasonAHH HeNpOXHOTO yGua (20 30 ane). . OTCYTETHME HaTHDKEHIS TRAN Ha AHL UIHOR NO- © MaKcHMAIbHBIM COXpaneHieM KPosooGpauteHH ‘Teaviell, 910 R KOHeNHOM c¥eTe MPHBOAMT K HlepRHt- HoMy s4xmBAeNIHO pan M opMUPORAHINO omrTH- wasnoro py6ut. Kaacciveckiw mpunepoM 9TOMy sinnseTen aaxpuirHe an knlepeaH OF yUIHOM paKOBNHA! B xoxe onepauin ma. B Tex ea.y4asx, Kora XMpypr npa- [UILHO Onpeae.ier FpArbs HCCeeHIA HIGHTKA KOH, ALU NOayYeHN «iLteatbHoro» pyOua AOCTATONHO HaLI0- -XIIT OTHOCHTeABHO peaKHe HILTpaLtepMarbubIe paccactt- BAIOUINECH MIBM 8 CONETANHH c paHlo YARALEMBIM Henpe PAIBHIM STHMIePNALTBIIM MitKPOMIBOM (PHC. 3.22). Zaxpeimite pan 8 Gnaronpuarneix ycnosnax: + sunmwambHoe HH yMepeHHoe HaTseKeHE TkaHHelt + ommlocireabnoe coornercraue Harpansens pant nmanats Sasarepa; + aocraToUnloe kposocHaGxentHe creHox pal OcoGennocra xupypruveckoit rexiinn: |. nocrosntice saacriueckoe narsoxeHie TRaNelt HeBest- Ko M.1erko HeltrpasntayeTes MyTeM HATOKEHA UIHOR Ha ecKOMBKHX ITIKAX; 2. nasxene rane npoosixaer 2eficrwoRATE MB NoCe= omtepaustonHon nepwoe, 170 e1aeT HeOBXOmHMEIM YHep:xane Kpaew pant TlovOXerHH r0THOFO ConA KOcHOBEHHI 8 TeYeHIe HepHosa ¢bopMMpoBAILHA pO Pc.3.2, Hopmorpocbmveckie pyBut, cqPopmuposasuineca 8 WNeaNbHbsx ycnoBHeX Mocne nonTaKKi TKaHer Nua: 42, 6 ~ npasnneHoe onperenenne rpannu ncceYeniia 136bITKa KOXN; 18 — Tanmnesi 3pensil (7 Mecayes) TOHKIN; HOpMOTpOduNEcKHN; pyBel: 1 ~ OTHOCHTENSHO LMpOKHIA HopMoTpobiNMecKHHT pyBeu (oBwacnente 8 Texcre) COCO! 3AKPLIT AHH V KAMECTBO PYBLIA Puc. 3.3, Horo pyGua (no 3-x wecaues). JL sToro Henonssyior opti Narepua, paccac: INT B EPOKH AO 6 MecstIeS H nox: f€ KoTOporo MpoHtexo~ iaxcon, UIC); 3. ympoutemmit noaxon k saxperrino parc HaTOKeHHeM HeaoeTaTONHOTO siesarayGOKMX if KOXHIX UIBOB MO- -xeT MpmBecru K cbopmispoRaY ua (pue. 3.21), Orwerum, s10 Ha npaxrike rpatie HUME H GnaroNpHBITHEAMN yexoBHeNy ecb yerowia. OxtHako wax, eayaaX NM cooTHETeTAYWIEN TexHiNKe aKp Hit MoxRMO tasTyuitTE BbIcoKOe KaYeCT apyrom Saxperrne pari # HeGnaronpnaTHeix ycnopitex [CTENKH paris MOxHO cOnMSHIT» To. wm Poxoit MoGuANsauHH, N60 nyteMt nepereu BUIpaxCHHOe HarHxCHME TkaNell Ha aMHHO ws TPYANsIer TouNoe COMOCTARCHHe KpAcB KO. * KponoctiaGxenite cTeHOK partht pesKo yxvauia. oTpodburveckinx (a) u raneprpopnveckix (6) py64o8 nocne onepaunit KKH KOH Mua (OOBACHEHHE B TeKcTe) OcoBennocrH xupyprnveckoid TexHunnt: 1. yaepxanne xpaew parti nuyrpentiet unas ve Boero nepnoaa oOpasonanna rpoxnoro py6 Gperaer ocoBoe anayenne; ey DyieHunit KPonooGpauuevis rKaret PAEXOATICNTIT KpAeB PAH Ha HeKOTOpIX yacTKAX. ITO Moxxer nipiBecT#t x o6paz0naHH0 1tHPOKHX HOpMOTpOXbI eckiX pyu08 (Puc. 3.3, 6) ETHEHHO MOBMAETEs PHCK PARBITHA OKADA Ha 1 Takxe neposTHOC! Syecxanx st rinepepoxpa 3. 80 MHorit exysamx xupypr MOxET AOGHTLEA TORHOO H npowwioro cocamHenHs creHOK parte H NOyWIETS ce Nepsnunioe sexsMTEHE 3a cer sHaUHTETRHOTO Orpa- Hen ABinxerUni (a, enenoRATeDNO, M HaTsKeHIL TKaNefl) B, cooTueTerEyIOMLeH aHaTOMHYeCKOH soNe Onwako nauner Huvutnare sBHOKeHHH H-TeveHHE HeeTO CPOKA chopultpo- BaHHA npoworo pyGua (6-8 Mecsuten). Flocre 80306: -xAIOIIINX pyGeu TKaNell neaeT K HlosTopHOMY pacumnpe 100 bopspyioUterocs pyGuia, KoTOpLiT K TOMY xe MO~ Ker crane runeprpod>ieekns
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