5 research outputs found
ΠΠ½ΡΡΡΠΈΡΡΡΠΎΠ±Π½ΠΎΠ΅ ΠΊΠΎΠ»ΠΎΡΠΎ-ΡΠ΅Π·Π°Π½ΠΎΠ΅ ΡΠ°Π½Π΅Π½ΠΈΠ΅ ΡΠ΅Π±Π΅Π½ΠΊΠ° Ρ ΡΠ½ΠΎΠΉ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ
A distinct tendency to an increased number of pregnancies and deliveries among young women has been observed lately. Pregnant teenagers with various types of traumas can be admitted to a non-profile pediatric surgical in-patient facility where no gynecologist is available. Purpose. The article describes a clinical case of an injury to the uterus and 33β34-week fetus in 17-year-old pregnant woman after an accidental fall on a kitchen knife. Materials and methods. The patient in a severe condition was admitted to the hospital with a knife in the anterior abdominal wall. Post-hemorrhagic anemia was diagnosed (Hb 95 g/L, RBC3.0 Ρ
1012/L). Based on urgent indications of an operating team consisting of a pediatric surgeon and an obstetrician-gynecologist, a midline laparotomy was performed. 2L of blood was removed from the cavity, the cutting edge of a knife was removed from the uterus body. No other damages were found during abdominoscopy. Cesarean section was done in the inferior segment of the uterus, an alive fetus was removed, bilateral ligation of uterine arteries was done and a hemostatic supraplacental suture was applied. A double balloon obstetric catheter was used. The uterine wound was sutured. Total blood loss was about 3 L. It was compensated with red blood cells (1385 ml) and fresh frozen plasma (2740 ml) transfusion. The removed boy had a weight of 2,300 g and 2 Apgar scores. Resuscitation activities were successful. The child was taken to the ICU and put on life support. 2 cm long injury was found in the right axillary region not penetrating into the chest. Its primary surgical debridement was done. Postoperative period in a child and mother who was taken to the maternity home went on without complications. The child was examined in a year. He developed according to the age. Conclusions. It can be possible that pediatric surgical departments are not ready for Cesarean section and elimination of possible complications when dealing with pregnant teenagers with various types of traumatic injuries requiring urgent obstetric intervention. Thatβs why itβs better when the patients are admitted to maternity homes where a pediatric surgeon is available.Π¦Π΅Π»Ρ. Π ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π³ΠΎΠ΄Ρ Π½Π°Π±Π»ΡΠ΄Π°Π΅ΡΡΡ ΠΎΡΡΡΡΠ»ΠΈΠ²Π°Ρ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΡΠΈΡΠ»Π° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΈ ΡΠΎΠ΄ΠΎΠ² ΡΡΠ΅Π΄ΠΈ ΡΠ½ΡΡ
ΠΆΠ΅Π½ΡΠΈΠ½. ΠΠ΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ Π΄Π΅Π²ΠΎΡΠΊΠΈ-ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΈ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ Π²Π°ΡΠΈΠ°Π½ΡΠ°ΠΌΠΈ ΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ ΠΌΠΎΠ³ΡΡ ΠΎΠΊΠ°Π·Π°ΡΡΡΡ Π² Π½Π΅ΠΏΡΠΎΡΠΈΠ»ΡΠ½ΠΎΠΌ Π΄Π΅ΡΡΠΊΠΎΠΌ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅, Π³Π΄Π΅ ΠΎΡΡΡΡΡΡΠ²ΡΠ΅Ρ Π²ΡΠ°Ρ Π°ΠΊΡΡΠ΅Ρ-Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΠΎΠΏΠΈΡΠ°Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΠ°Ρ ΡΠ°Π½Π΅Π½ΠΈΡ ΠΌΠ°ΡΠΊΠΈ ΠΈ ΠΏΠ»ΠΎΠ΄Π° Π½Π° 33β34 Π½Π΅Π΄Π΅Π»Π΅ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ Ρ Π΄Π΅Π²ΡΡΠΊΠΈ 17 Π»Π΅Ρ ΠΏΠΎΡΠ»Π΅ ΡΠ»ΡΡΠ°ΠΉΠ½ΠΎΠ³ΠΎ ΠΏΠ°Π΄Π΅Π½ΠΈΡ Π½Π° ΠΊΡΡ
ΠΎΠ½Π½ΡΠΉ Π½ΠΎΠΆ. ΠΠ°ΡΠΈΠ΅Π½ΡΠΊΠ° Π΄ΠΎΡΡΠ°Π²Π»Π΅Π½Π° Π² ΡΡΠΆΠ΅Π»ΠΎΠΌ ΡΠΎΡΡΠΎΡΠ½ΠΈΠΈ Ρ Π½ΠΎΠΆΠΎΠΌ Π² ΠΏΠ΅ΡΠ΅Π΄Π½Π΅ΠΉ Π±ΡΡΡΠ½ΠΎΠΉ ΡΡΠ΅Π½ΠΊΠ΅, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½Π° ΠΏΠΎΡΡΠ³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠ°Ρ Π°Π½Π΅ΠΌΠΈΡ (He 95 Π³/Π», ΡΡΠΈΡΡΠΎΡΠΈΡΡ 3,0Γ1012/Π»). ΠΠΎ ΡΠΊΡΡΡΠ΅Π½Π½ΡΠΌ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡΠΌ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π±ΡΠΈΠ³Π°Π΄ΠΎΠΉ, ΡΠΎΡΡΠΎΡΡΠ΅ΠΉ ΠΈΠ· Π΄Π΅ΡΡΠΊΠΎΠ³ΠΎ Ρ
ΠΈΡΡΡΠ³Π° ΠΈ Π°ΠΊΡΡΠ΅ΡΠ°-Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³Π°, Π±ΡΠ»Π° Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° ΡΡΠ΅Π΄ΠΈΠ½Π½Π°Ρ Π»Π°ΠΏΠ°ΡΠ°ΡΠΎΠΌΠΈΡ, ΠΏΡΠΈ ΠΊΠΎΡΠΎΡΠΎΠΉ ΠΈΠ· Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ ΡΠ΄Π°Π»Π΅Π½ΠΎ ΠΎΠΊΠΎΠ»ΠΎ 2 Π»ΠΈΡΡΠΎΠ² ΠΊΡΠΎΠ²ΠΈ, Π° ΠΈΠ· ΡΠ΅Π»Π° ΠΌΠ°ΡΠΊΠΈ ΠΈΠ·Π²Π»Π΅ΡΠ΅Π½ΠΎ Π»Π΅Π·Π²ΠΈΠ΅ Π½ΠΎΠΆΠ°. ΠΡΠΈ ΡΠ΅Π²ΠΈΠ·ΠΈΠΈ Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ Π½Π΅ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ. ΠΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΠΊΠ΅ΡΠ°ΡΠ΅Π²ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π² Π½ΠΈΠΆΠ½Π΅ΠΌ ΡΠ΅Π³ΠΌΠ΅Π½ΡΠ΅ ΠΌΠ°ΡΠΊΠΈ, ΠΈΠ·Π²Π»Π΅ΡΡΠ½ ΠΆΠΈΠ²ΠΎΠΉ ΠΏΠ»ΠΎΠ΄, ΠΏΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½Π° ΠΏΠ΅ΡΠ΅Π²ΡΠ·ΠΊΠ° ΠΌΠ°ΡΠΎΡΠ½ΡΡ
Π°ΡΡΠ΅ΡΠΈΠΉ Ρ ΠΎΠ±Π΅ΠΈΡ
ΡΡΠΎΡΠΎΠ½ ΠΈ Π½Π°Π»ΠΎΠΆΠ΅Π½ΠΈΠ΅ Π³Π΅ΠΌΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ±ΠΎΡΠΎΡΠ½ΠΎΠ³ΠΎ Π½Π°Π΄ΠΏΠ»Π°ΡΠ΅Π½ΡΠ°ΡΠ½ΠΎΠ³ΠΎ ΡΠ²Π°. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ Π΄Π²ΡΡ
Π±Π°Π»Π»ΠΎΠ½Π½ΡΠΉ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΈΠΉ ΠΊΠ°ΡΠ΅ΡΠ΅Ρ. Π Π°Π½Π° ΠΌΠ°ΡΠΊΠΈ ΡΡΠΈΡΠ°. ΠΠ±ΡΠ°Ρ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° ΠΎΠΊΠΎΠ»ΠΎ 3 Π»ΠΈΡΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΡ Π²ΠΎΡΠΏΠΎΠ»Π½ΡΠ»ΠΈ ΡΡΠ°Π½ΡΡΡΠ·ΠΈΠ΅ΠΉ ΡΡΠΈΡΡΠΎΠΌΠ°ΡΡΡ (1385 ΠΌΠ») ΠΈ ΡΠ²Π΅ΠΆΠ΅Π·Π°ΠΌΠΎΡΠΎΠΆΠ΅Π½Π½ΠΎΠΉ ΠΏΠ»Π°Π·ΠΌΡ (2740 ΠΌΠ»). ΠΠ·Π²Π»Π΅ΡΠ΅Π½Π½ΡΠΉ ΠΌΠ°Π»ΡΡΠΈΠΊ Π²Π΅ΡΠΎΠΌ 2 300 Π³Ρ. ΠΈΠΌΠ΅Π» ΠΎΡΠ΅Π½ΠΊΡ ΠΏΠΎ ΠΠΏΠ³Π°Ρ 2 Π±Π°Π»Π»Π°. Π Π΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΡ Π±ΡΠ»ΠΈ ΡΡΠΏΠ΅ΡΠ½Ρ, ΡΠ΅Π±Π΅Π½ΠΎΠΊ ΠΏΠ΅ΡΠ΅Π²Π΅Π΄Π΅Π½ Π² ΠΠ ΠΠ’ ΠΈ ΠΏΠΎΠ΄ΠΊΠ»ΡΡΠ΅Π½ ΠΊ Π°ΠΏΠΏΠ°ΡΠ°ΡΡ ΠΠΠ. Π ΠΏΡΠ°Π²ΠΎΠΉ ΠΏΠΎΠ΄ΠΌΡΡΠ΅ΡΠ½ΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ ΡΠ΅Π±Π΅Π½ΠΊΠ° Π±ΡΠ»Π° ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Π° ΡΠ°Π½Π° Π΄Π»ΠΈΠ½ΠΎΠΉ ΠΎΠΊΠΎΠ»ΠΎ 2 ΡΠΌ, Π½Π΅ ΠΏΡΠΎΠ½ΠΈΠΊΠ°ΡΡΠ°Ρ Π² Π³ΡΡΠ΄Π½ΡΡ ΠΏΠΎΠ»ΠΎΡΡΡ, ΠΏΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½Π° Π΅Π΅ ΠΏΠ΅ΡΠ²ΠΈΡΠ½Π°Ρ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ°. ΠΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ ΡΠ΅Π±Π΅Π½ΠΊΠ° ΠΈ ΠΌΠ°ΡΠ΅ΡΠΈ, ΠΏΠ΅ΡΠ΅Π²Π΅Π΄Π΅Π½Π½ΠΎΠΉ Π² ΡΠΎΠ΄ΠΈΠ»ΡΠ½ΡΠΉ Π΄ΠΎΠΌ, ΠΏΡΠΎΡΠ΅ΠΊΠ°Π» Π±Π΅Π· ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. Π Π΅Π±Π΅Π½ΠΎΠΊ ΠΎΡΠΌΠΎΡΡΠ΅Π½ ΡΠ΅ΡΠ΅Π· Π³ΠΎΠ΄, ΡΠ°ΡΡΠ΅Ρ ΠΈ ΡΠ°Π·Π²ΠΈΠ²Π°Π΅ΡΡΡ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΡ. ΠΡΠ²ΠΎΠ΄Ρ. ΠΠ΅ΡΡΠΎΠ½Π°Π» Π΄Π΅ΡΡΠΊΠΈΡ
Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΉ ΠΏΡΠΈ ΠΏΠΎΡΡΡΠΏΠ»Π΅Π½ΠΈΠΈ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π΄Π΅Π²ΠΎΡΠ΅ΠΊ-ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎΠ² Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ Π²Π°ΡΠΈΠ°Π½ΡΠ°ΠΌΠΈ ΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ, ΡΡΠ΅Π±ΡΡΡΠΈΡ
ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π½Π΅ΠΎΡΠ»ΠΎΠΆΠ½ΡΡ
Π°ΠΊΡΡΠ΅ΡΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ², ΠΌΠΎΠΆΠ΅Ρ ΠΎΠΊΠ°Π·Π°ΡΡΡΡ Π½Π΅ Π³ΠΎΡΠΎΠ² ΠΊ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΊΠ΅ΡΠ°ΡΠ΅Π²ΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΡΡΡΠ°Π½Π΅Π½ΠΈΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. ΠΠΎΡΡΠΎΠΌΡ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎ, ΡΡΠΎΠ±Ρ ΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΠΏΠΎΡΡΡΠΏΠ°Π»ΠΈ Π² ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠ΅ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΡΠΎΠ΄ΠΎΠ²ΡΠΏΠΎΠΌΠΎΠΆΠ΅Π½ΠΈΡ, ΠΊΡΠ΄Π° ΠΌΠΎΠΆΠ½ΠΎ ΡΠΊΡΡΡΠ΅Π½Π½ΠΎ Π²ΡΠ·Π²Π°ΡΡ ΠΈ Π΄ΠΎΡΡΠ°Π²ΠΈΡΡ Π΄Π΅ΡΡΠΊΠΎΠ³ΠΎ Ρ
ΠΈΡΡΡΠ³Π°
Π’ΡΠ±ΡΠ»ΡΡΠ½Π°Ρ ΡΡΠ±ΡΠΎΡΠ°Π»ΡΠ½Π°Ρ ΡΠΎΡΠΌΠ° ΡΠ΄Π²ΠΎΠ΅Π½ΠΈΡ ΡΠΎΠ½ΠΊΠΎΠΉ ΠΊΠΈΡΠΊΠΈ
Duplication of the gastrointestinal tract is a relatively rare malformation. The incidence is approximately 1 in 10 000 live births with the small intestinal duplication in most cases. Malformations with a long duplication part are considered technically complex. A successfully treated clinical case of the subtotal small intestinal duplication in a child is presented in the article. The mid-median mini-laparotomy was performed and a subtotal 1 meter length small intestinal duplication was revealed (from the Treitzs ligament to the ileum in 50 cm from the ileocolic valve). The proximal part of the intestinal duplication and its mucous membrane of the distal part with the common wall were completely removed. Histological examination found ectopia of the gastric mucosa and pancreatic tissue. Surgical treatment of this malformation is aimed at the complete removal of the duplication part due to possible ectopia of the gastric mucosa or pancreatic tissue. If the resection of an entire part of the intestinal duplication is technically impossible, the mucous membrane can be removed.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π£Π΄Π²ΠΎΠ΅Π½ΠΈΠ΅ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ° ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ΅Π΄ΠΊΠΈΠΌ ΠΏΠΎΡΠΎΠΊΠΎΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ. ΠΠ°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ Π² ΡΡΠ΅Π΄Π½Π΅ΠΌ ΠΎΠΊΠΎΠ»ΠΎ 1 ΠΈΠ· 10 000 ΠΆΠΈΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½ΠΈΠΉ, ΠΏΡΠΈ ΡΡΠΎΠΌ Π±ΠΎΠ»ΡΡΠ°Ρ ΡΠ°ΡΡΡ ΡΠ΄Π²ΠΎΠ΅Π½ΠΈΠΉ Π·Π°ΡΡΠ°Π³ΠΈΠ²Π°Π΅Ρ ΡΠΎΠ½ΠΊΡΡ ΠΊΠΈΡΠΊΡ. ΠΠ°ΠΈΠ±ΠΎΠ»ΡΡΠΈΠ΅ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ Π² ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΏΠ»Π°Π½Π΅ ΡΠΎΠ·Π΄Π°ΡΡ Π²Π°ΡΠΈΠ°Π½ΡΡ ΠΏΠΎΡΠΎΠΊΠ° Ρ Π΄Π»ΠΈΠ½Π½ΡΠΌ ΡΡΠ°ΡΡΠΊΠΎΠΌ Π΄ΡΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ ΠΎΠΏΠΈΡΠ°Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΠ°Ρ ΡΡΠΏΠ΅ΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ΅Π±Π΅Π½ΠΊΠ° Ρ ΡΡΠ±ΡΠΎΡΠ°Π»ΡΠ½ΡΠΌ ΡΠ΄Π²ΠΎΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΎΠ½ΠΊΠΎΠΉ ΠΊΠΈΡΠΊΠΈ.
ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡ ΡΡΠ΅Π΄Π½Π΅-ΡΡΠ΅Π΄ΠΈΠ½Π½Π°Ρ ΠΌΠΈΠ½ΠΈ-Π»Π°ΠΏΠ°ΡΠΎΡΠΎΠΌΠΈΡ, Π½Π° ΠΊΠΎΡΠΎΡΠΎΠΉ Π±ΡΠ»ΠΎ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΡΡΠ±ΡΠΎΡΠ°Π»ΡΠ½ΠΎΠ΅ ΡΠ΄Π²ΠΎΠ΅Π½ΠΈΠ΅ ΡΠΎΠ½ΠΊΠΎΠΉ ΠΊΠΈΡΠΊΠΈ (ΠΎΡ ΡΠ²ΡΠ·ΠΊΠΈ Π’ΡΠ΅ΠΉΡΠ° Π΄ΠΎ ΠΏΠΎΠ΄Π²Π·Π΄ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Π² 50 ΡΠΌ ΠΎΡ Π±Π°ΡΠ³ΠΈΠ½ΠΈΠ΅Π²ΠΎΠΉ Π·Π°ΡΠ»ΠΎΠ½ΠΊΠΈ) ΠΎΠ±ΡΠ΅ΠΉ Π΄Π»ΠΈΠ½ΠΎΠΉ 1 ΠΌ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΏΠΎΠ»Π½ΠΎΠ΅ ΡΠ΄Π°Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠΎΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ°ΡΡΠΈ ΡΠ΄Π²ΠΎΠ΅Π½Π½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ ΠΈ Π΅Π΅ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ Π² Π΄ΠΈΡΡΠ°Π»ΡΠ½ΡΠΉ ΡΠ°ΡΡΠΈ, Π³Π΄Π΅ ΡΡΠ°ΡΡΠΊΠΈ ΠΈΠΌΠ΅Π»ΠΈ ΠΎΠ±ΡΡΡ ΡΡΠ΅Π½ΠΊΡ.
Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠΈ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Π° ΡΠΊΡΠΎΠΏΠΈΡ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΈ ΡΠΊΠ°Π½ΠΈ ΠΏΠΎΠ΄ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ.
ΠΡΠ²ΠΎΠ΄Ρ. ΠΡΠΈ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠΈ Ρ ΡΠ΅Π±Π΅Π½ΠΊΠ° Π»ΡΠ±ΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΈΡΠΊΠ»ΡΡΠΈΡΡ Π²Π°ΡΠΈΠ°Π½Ρ ΡΠ΄Π²ΠΎΠ΅Π½ΠΈΡ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ°. ΠΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΠΎΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄ΠΎΠ»ΠΆΠ½ΠΎ Π±ΡΡΡ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΎ, ΠΏΡΠ΅ΠΆΠ΄Π΅ Π²ΡΠ΅Π³ΠΎ, Π½Π° ΠΏΠΎΠ»Π½ΠΎΠ΅ ΡΠ΄Π°Π»Π΅Π½ΠΈΠ΅ ΡΠ΄Π²ΠΎΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΡΠΊΠ° Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΠΉ ΡΠΊΡΠΎΠΏΠΈΠΈ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΈΠ»ΠΈ ΡΠΊΠ°Π½ΠΈ ΠΏΠΎΠ΄ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ. ΠΡΠΈ ΠΎΡΡΡΡΡΡΠ²ΠΈΠΈ ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ Π²ΡΠ΅Π³ΠΎ ΡΡΠ°ΡΡΠΊΠ° ΡΠ΄Π²ΠΎΠ΅Π½Π½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ ΡΠ΄Π°Π»Π΅Π½ΠΈΠ΅ ΡΠΎΠ»ΡΠΊΠΎ Π΅Π΅ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ