029ED Ozerskaya I A Ehografiya V Ginekologii

. .
. .
2005

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0,71 (0,50-0,80)
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0,53 0,2
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0,77 0,2
0,66 0,2
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0,51 0,02
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0,68 0,03
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0,681 0,03
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15-17
0,43 0,02
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0,511 0,03
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0,59 0,04
(0,53-0,71)
0,8210,04
(0,71-1,02)
18-22
0,41 0,02
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0,52 0,03
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0,57 0,03
(0,44-0,72)
0,64 0,03
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23-26
0,46 0,01
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0,50 0,01
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0,62 0,03
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[27, 28].
, ,
,
3- 20-
[11].

0,001 10%
[29-31].

,

.

:
1.
,
.
2.
(
).
3.
.
4. .
5. .
6. .

. 2.1.
. 2-
; :
1 ; 2
; 3 ; 4 S - ; 5
; 6 ;
7 fc - ; 8 '- ; 9 ; 10
; 11 ; 12
; 13 ; 14 ; 15 ;
16 ; 17 ;
18 [13, . 23 ]

,
(. 2.2)
:
.
.
(

).
2. __________________________________________________
43
. 2.2. : ; ;
; -
; ;
; - ; ;
[32, . 554, ]
.
.
(
).
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,
,
[32, 33].

,

. ,

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,
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44~"V
. 2.4. , 3D: 1 ; 2 ~

. 2.6. : 1
; 2 . ( )
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. ( )

, (. 2.4).
,
,

. 2.5. : 1mg'
; 2 . ( )

,
[34].

.
(
) (
),
I ,

.

, -,
2- (. 2.5,
2.6) [3, 5, 6, 8, 33].
(. 2.7,
2.8, 2.9).

,
,

.
[35].

,
.

,
(. 2.10).

.

,

,
,
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. 2.8. : 1 *
. ( )

, ,
,
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,

,
[35].

,

[36, 37].
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20
[38].
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,
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[17].
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[39].
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.

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,

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, . 1(- ; 2

. 2.11.

: 1 ; 2
. ( )
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), . - :

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)
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II ,
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)
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,
[3, 5, 6, 8, 33].

,
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,
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(,
)
() [32, 44].
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-
(. 2.13) [3, 5, 6, 8, 33].

,

II
(. 2.14, 2.15) [6, 40]. ,

,
, ,

(. 2.16) [34].
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[41-46].

(. 2.17). , ..
.,

2.
. 2.15. , II , : 1 ; 2 . ( )
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. 2.17. , : ( ); 6
: { ). ( )
3 ,
[47]. N. Saadi .

. 2.1 8. : 1 ; 2
. ( )
-- ,
[48].

,

(. 2.18) [8, 44, 47, 49].
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-,
,

[50, 51].

,
.

,
,

10 100% [45, 52, 53].

, , ,
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;
;
;
.

,

[11, 12, 53].

[54].
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[3, 6, 8].
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,
, ..

(. 2.21).
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,

. 2.19. ,
: ;
; ; [32, . 554,
]
. 20. , ,
: 1 . 6 : 1 ; 2 , ,
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2.
.
, (,
retroflexio)
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.

.

,

,
(7-9 ), (10-13 )
(14-17 ) [11, 55].

,
.
[27,28, 32].

.
, ,

[3, 5, 6, 8].
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,
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:
( ).
.
.
()
.

,

2:1
[3, 5, 6]. -
[6, 32, 47]. ,
,

, [28,
32].
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,
,

[27, 28]. ,
,
,

[27]. 15,7%
. 2.21. : ; 6
. ( )
. 2.22. : ;
6 . ( )

,

[55]. ,
,

[27, 28, 55].

,
,
[56].
,

(. 2.23).
,
,
(. 2.24).

.

,
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( )
. 2.25. , . (
)
. 2.24. . ( )

, .. 1:1 [5,6, 56].
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, ,
[56]. ,
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,
.

(, -)
[56].

( ).
10 30 ,
[5, 6].
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(. 2.26) [47].

.

[52, 57].
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18 , 9 ,
; 6 ,
14 . ( )
:
.
.
.
, ,
,

[5, 6].
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,
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[58].

,
.

:
- ( 45 ),
( 47 XXX 47 XXY) [12,
41].
,
[27, 47].

(),
() . [27, 55, 56].

,
. 30%

[27].

-
( 45X0).
,

-

, ..
[6, 8, 12, 55, 59].
,
[8].
,

46XY,

[28].
,
, .
,

[28, 31].
[6].

,
[27, 28].
.

,
,
. 2.27. .
(58 19 ).
( )
[6, 32].

( ),
, ,
[6, 60].

.

,
[61, 62]. ,
.

()
()
(),
,
( ) [1].
,
,

,
[5, 6, 8].

20 40 ,
[6, 8, 13]. ,
, ,
60 , ,
[6, 8, 63].

,
[8]. ,
, .
,
. 2.28. ,
: 1 ; 2 ;
: 1 -; 2 - . ( )
. 2.29. : 1 ; 2
; 3 . ( ). (
.. )
. 2.30. , , 6
: 1 ; 2 - ; 3
; 4 . .
( )
2.

[8, 631, .. , 3
,
,
(MAC 8,3 3,2)
( 0,63 0.2) [8].
,
,

(. 2.28) [5, 6, 8].

,
,
[6,13],
( )

()
[8, 64].

,
(. 2.29) [8].
,
,

[65].

[66].
,

[64, 67, 68].

(),

[1, 13].

( 15 ) , ,

.
(. 2.30).
,
,

.

, ,
[13, 28, 56, 58, 69, 70]. :
(
, );
;
;
- ;
;
;
;

(, , ).

,
,
[12, 18, 71, 72].

,

.
,

,
.. [69]:
: ,
.
:
.
: ( 90%),
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, .

- , .. ,
,

[4, 12, 69].

,

()
.

,
.

, .

,
5 , .

.
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,
6-40%,
[28].
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10% [69].

50% [28, 69].

[4, 28, 73].
,
.

:

;
, ;
;
3-
-;
0,43-0,60 [18].

I [4, 8, 73]. 82,6%
52,3-60,7%
[4, 73, 74].
(2-5 ) - ,
(. 3.1-3.3)
[4, 8, 73, 74].
. 3.1. , , ;
, . . ( )
. 3.2. , , ,
, . ( )
. 3.3. , { );
, ( ). ( )
56~
. 3.4. .
17 . ( )
. 3.5. , .

, . ( ).
. 3.6. , .
, - , (

, , ,

[4, 8, 73, 75].
10-15 ,
20 (. 3.4) [3, 4, 6, 8, 18, 73-75].

, , .. .. ,

[6, 74].
(. 3.5) [8, 74, 75].

(. 3.6, 3.7).

.
5
5 (. 3.8) [3, 4, 8, 73, 76-79].
3 ,
,
. 3.7. . -
( ). ( )
. 3.8. (
). ( )
3.
. 3.9.
, 15 .
5,3 ,
, -. (
)
/5 7
. 3.10. :
, . ( )
. 3.11. : -; ;
, 0,75. ( )
(. 3.9)
[6, 74, 80].

.

12
64,7% [8, 18, 72, 79] (. 3.10).
. , , ..
28,6% 7,1%
[18]. ,
0,5,
: 0,4
(. 3.11, 3.12) [8, 18, 72, 77, 79, 81].

,
,
, .
. 3.12. : ; 6 , 0,67.
( )
. 3.13. .
. (
)
,
. ,

.

( in situ) [69, 71].
,

(. 3.13). .. .. ,

[74].

(. 3.14).
,
, 2 -4 (. 3.15) [74].

, ,
8-9 (. 3.16)
[73].
() ,

(. 3.17) [4, 8, 18, 72-74].

(-), - ,

[4, 6, 28, 73].

9,3 2,9 , 13,4 3,0 [73].
.. ,
(10 )
43,3%,
- 12,5% [18].

,

(. 3.18, 3.19).
\59
. 3.14. , [ ),
; - [ ), . ( )
. 3.15. [
). ( )
. 3.16. , [
). ( )
. 3.17. [ ).
( )
. 3.18. [ ).
( )

;
;
;
:
,
;
6(TV
. 3.20. .
{ ). ( )
. 3.19. {
), (
)
. 3.21.
- {
). ( )
;
0,5-0,6 [8, 18].

,
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:
, ;
, .
. Caspi . ,

96% (. 3.20) [82].
,
- (. 3.21). ,

,

(. 3.22).
,
(. 3.23).
. 3.22. { ),
. ( ): ,
;

J, _______________________________________________________________
^\
. 3.23. . ( ): , ,
{ ); , ,
( )
. 3.24. : ; 3D
( ). ( )

(. 3.24) [83-85].

: ,
(. 3.25) [20].

.
(,
, )
,
(. 3.26) [26, 61, 86-88].

,

, ,
.
. 3.25. { ) . ( )
62~V
. 3.26. { )
. ( )
. 3.28. { ), .
( )
. 3.27. , :
, { ); 6
, . (
)
. 3.29. , :
{ ); 6 , ( ).
( )

.

.

31,3-36,7% ,
6,6-15,4% [18]. ,

, (. 3.27, 3.28)
3.
. 3.30. , 0,60. ( )
[8, 88].
(. 3.29).
,
0,45 (. 3.30) [7, 8, 18, 79].

.

(, ).
,
,

6-12 [18].
..
75,5% ,
[18].

2 ,

.

,

95,9% [89].

.
,
[89, 90].

,
(. 3.31) [89, 91].

,

3 [91,92].
,

( 3.32).
[91].

, ,

,
,
[89]. 6

[89, 93].
. 3.31. :
( ); ( )
. ( ). ( .. )
. 3.32. : , , , ; 6
1 , . ( )

, 11,3%
,
[89].

( )
-

-
.
,
, 42%
[13].
,

.
,
1985 ., .
[69]:
0 (
).
1 ,
.
1 .
16 1 .
1 1 ,
.
II
, .
III
, .

/
/ .
III6;
/ .
IV
/
.
IVa /
.
/

.

0 ,

.
:
-;
-;
;
() ;

;
-, -
;
,
;
;
( ) ;
,
.

.
,

.
5
- 8
, , [4, 79].
3.
. 3.38. . { )
^ 67
. 3.39. .
. ( )
. 3.41. .
, 0,40. ( ). (
.. )
. 3.40. : 1
; 2
. (
)
. 3.42. .
( 40 /). (
)
,
[112].
,
0,35-0,45 (. 3.41)
[7, 8, 25, 103, 113, 114].
. 3.43. .
. ( )

,
(. 3.42)
[8, 25, 79, 103, 114]. ..
MAC 20 / [114].
. 3.35. : - ; ,
-. ( )
. 3.36. :
( ), ; 6 ,
. ( )

. , , D . Senoh,
75% [109].
,
. 3.37.
, : 1
; 2 ,
. ( )
(20 ),
.
,

(. 3.37).

,

(. 3.38).

90% (. 3.39) [25, 79,
103].

(. 3.40) [8, 79, 110].
,
, .

[111].
A. Vimercati . ,
3.
. 3.33. ,
. ,

, ..
. 36
,
5
4-5 [25]. :
-,
. ,
.. .. ,
3
[74].

. ,

[94-97].

, 20%
[98].
50%
[25,99,1001.
, .. ..

(. 3.33) [101].

.
,
,
[25, 74, 79, 101, 102]. ,
( 15 )
, - .
,
, (. 3.34) [25].
,

. .. .
[25]. ,

,
.

(. 3.35).
.. ,
...

[103]. ,
,
(. 3.36)
[25]. ,

77%,
[104-108].
,
3 34. : [ ), ,
; - [ ),
. { )
. 3.44. , -, ,
; - , ; ( . 3.44, ) ,
(. 3.44, ). ( )

,
(. 3.43,3.44).

[115].
, ,
,
,
[103, 116].
28% ,

,
1 2 [117],
, , ,
. ,

.. ., 1997 [5]
Gardner FJ.etal., 1998 [123]
Mourits MJ. et al., 1999 [124]
Franchi M. et al., 1999 [125]
Love C D .etal., 1999 [126]
Elhelw B. et al., 1999 [127]
Ceci 0. et al., 2000 [128]
Kavak Z.N. et al., 2000 [129]
Strauss H.G. et al., 2000 [130]
Bertelli G. et al., 2000 [131]
Valenzano M. et al., 2001 [132]
Taieb S.etal., 2003 [133]

,
>10
>5
>5
>4
>5
>5
>7
>10
>8
>8
>5
>5
,
%
50
84,5
58
60
39
47,4
54,5
32,8
31,4
44
34,5
58

,
,
[103, 116, 119, 120].

[118, 121, 122].
, ,
.
.

,
. , , . Nahari
. 181 ,
7-8 ,

[134].
I. Cohen . [135].
C.D. Love ., 357
5,5 , -
[126].
,
6 [136].

, ,
(. 3.45)
[102, 117, 124]. , .
,
(. 3.46) [119].

(. 3.47).
.

,
, 2-
3.
_ ^ 69
. 3.45. :
, , ,
[ )-, [
). ( )
. 3.46.
.
( ). ( )
. 3.47.
.
, .
( ).

,
[128, 136].

,
0,5,

,
( 0,4)
[5, 6, 8, 25, 26], ,
(MAC 20 /)
[114]. ..
.. ,

92,2%, 97,3%, ,

86,4%, 87,9%,
25% [74]. ,

, .
,
,

.

:
;
;
;
;
;
;
.

.

,

.
,
,
.
, ,
.
, ,
.
.
,

[61, 117].

,
.
,
, ,
, ,
( 0,4)
(MAC 30,8 0,67 /) [103].
,
.

--
.
, .

,

.

.

.

,
: 20-24
40-49
[71].

,
-
4-6 [6].
,
,
.

.

.

,
20% 30-35 [103, 137141].
(60,1%),
(9,4%) [103]. ,
,
5-10%

[103, 137, 138]. - ,
77% [137].

,
.
(),
, ,
;
,
[137, 141, 142].

:

. ,

- [141].

,
,
[137, 141, 142].
,
,
, . [137, 142].

, -
,
, ,
- Na/K
, .
,

, , ,

[142].
45%
1, 6, 7, 1 2 1 4
,

[138].

[137, 139, 142]:
I
.
,
,
, ,

.
II
(
).
III - ( ).

, 70%
, 30%
[137, 138].

(90-96%) , ,
; () 4-10%
[25,103, 137, 140].
(. 4.1):
(,
) ,
.
, ,
43-61% [6, 25, 103].
() ,

.

.
,

.
12,3-38% [6, 25, 103].

82,9% [103].
. 4.1. : 1
; 2 ; 3 " ; 4 --; 5 - ( ); 6
( ); 7 ; 8 -
() ,

.

(
, 1995 .) [138]:
0
.
I
50%.
II
50%.
, (0 )

.
6-28% [6, 25, 103].

,
.
,
, .
, -
.
[137]:
,
;
,
,
,
;
,

.
.
-
.

,
.
,
. - [137]
5%
37%
, ,

, , ( , - , (
)
, , -
, )
(
)
()
()

(46,6%)
(32,6%),
- (26,1%),
(13%)
(64,9%),

(58,8%),
(39,8%)

(37,5%)
4.

,
4 -10 [4, 8, 25].

[3, 4, 8, 25, 137, 143]:
;
;

;
;
;
,

--
;

.
,
,
,
[142].

. , -
, ,
,
,
(. 4.2) [142].
,
.

,
.

.
, ,
,

[137,142].

,
, , ,
,
(. 4.3).
,
[4, 8, 25,137,143].

.

,

(. 4.4) [4, 137].
. 4.2. . ( ). (
)
. 4.3. : 1

; 2
. (
)
. 4.4.

( ). ( ).
74~ V
. 4.5. : ( ),
;
( ).
. ( )
. 4.6. : ( ); 6
( ), retroflexio. ( )
. 4.7. - , : 1 ; 2 ; 3 ,
; 6 : 1 ; 2 ,
. ( )

().
().
, -
(. 4.5).

(. 4.6).
_________________________________________________________ /
75
. 4.8. - , : 1 ,
( ); 6 : 1 ^ . , ( )
. 4.9. - : ; 6 .
[ ). ( )
. 4.10. - : ; 6 -
, , .
( ). ( )
(),
, .. - (. 4.7). ,

, ,
(. 4.8).

,
(. 4.9, 4.10).
,
, (. 4.11).
76~
. 4.11. , .
( )

-

, ,
,
, ,
.
,

,
,
. , ,
,
(. 4.12).

,
,
.
,
. 4.12. , : ,
( ) ; 6 :
, ( )
. 4.13. :
. ( )
; 2 ; -; -, ,
.4.14. , : 1 ; 2 ; 6:1 ; 2
, . . ( )
. 4.15. , : 1 ; 2 , 114 96 ;
: 1 ; 2 , 20 .
. ( )
,
.

.

,
,
(. 4.13).
, ,

(. 4.14,
4.15). ,
( ,
) (. 4.16) [142].
,
,

(. 4.17).

,

(. 4.18).

,
[144, 145]. ( ,
) ,
, .

, ,

(. 4.19) [61].

.

,
(. 4.20).
78~
. 4.16. , , anteflexio: 1 ; 2 - ; 3 -
; retroflexio:
; 2 - . . (
)
. 4.17. , . ( ): 1
; 2 ; . ( ): l B - ; 2 1 - .

. 4.18. . ( ), ( ); ,
, ( )
. 4.19. II .
( )
,
( )
. 4.20. : 1
; 2
. ( )
. 4.21. , ( ); 6
- ( ); ,
( ), (1) ; - , . ( )
,

,
,
[28, 89, 137, 138, 141].
,
,
[137].
,
(. 4.21). ,
8 (T V
. 4.22.
: 1 , 2
. 4.23.
, .
. 4.24. , - (1) , ,
. ; 6 (1) , (
), (2). { )
. 4.25. : 1
; 2
. ( )
. 4.26. ,
( ),
^ 81

. , ,

, I II
.

10-20%,
- 50% (. 4.22) [17].

95% ,

96%
[146].

,
(. 4.23, 4.24).
85-90%
:
,
,
, (. 4.25-4.27) [137, 142, 148].
, ,

,
(. 4.28).
, ,
.

,

.
,
,
.
, ,
, ,
,
.
( )

.

, ,

(. 4.29).
44 91%,
7,5 69% [6, 8, 19, 25, 89, 147-150].

,
. 4.27. , .

,
( )
. 4.28. ( ),
,
,
. ,

[19, 137, 142].
, , ,
, ( 1015 ) (. 4.30) [89].

.
,
(. 4.31) [19, 151].
.
, , Aleem . Predanic ,
,
. Tsuda .
84,6%
. 4.29. , : ; 6
; -^ ; 5 ?.: , ;
. ( )
, 57,7% [149, 152].

(. 4.32-4.34) [25, 148].

98%
[146].

.
. 4.30. , .

, [ ).
( )
^83
,
. ,

(. 4.35) [8, 25, 137, 148].

,
() [25, 19, 89, 153].

.

,

. ,
,

[137, 142].
. 4.31. : - > [ )
; 6 , . ( )
. 4.32. : , 6 . ( )
. 4.33. , ; ; .
( )
. 4.35. ,
,
. 4.34. , : -
; .
( )
,
, 0,43 0,68,
0,34 0,59 [25,19, 89,154].
.. .. ,
,
6 [25]. ..
,

10 15 ,
15
, ,
[89].

,
, (. 4.36, 4.37).

85
. 4.36. : , , 0,72; , 0,67. ( )
. 4.37. : , , 0,47; , 0,83. ( )
. 4.38.
. , ,
0,76. ( )
, ,
.

,
- (. 4.38) [19, 150].

.

,
, [148].
0,45
0,60 (. 4.39, 4.40)
86^V
V

66
Rl-5/
.Arterial
Uterial
Rt.Ov.
i-t.Ov".
.67
8 8911/S
8 03B/S
R I= S
PS= .
*=
.
-!5/0= 3.8
. 4.39. : 0,67; 6
0,59. ( )
. 4.40. : a -
, 0,43; 6 , 0,33. ( )
. 4.41. : , , 6 /; 6
, , 13,4 /. ( )
[25, 137, 148].

( 14 /) (. 4.41) [1481
, 60.

,
,

, ,
-~87
. 4.42. -
, ,
. 4.43. ,
, ,
( .. ); 6
. 4.44. ,
: -
; 1 ; 2- ; - (
)
,
, [103, 137, 142].

.

,
(. 4.42) [3].
,

.

(. 4.43, 4.44) [142]. .. .

8iPV
[155]. ,
[137].
,
,
,
, ,
[137, 142].

: ,
. 4.45. , .
: 1 -; 2 .
( )
. 4.46. ,
, : 1
; 2 - ; 6
, -, - , { ).
( )
. 4.47.
,
.
(
). ( )
. 4.48. ,
, ,
4.
[5, 6].
,
. ,
,
.
,

89
(. 4.45-4.48) [103].

,

,
(. 4.49, 4.50) [89, 141].

. 4.49.
:
, ,
; 6
, , ,
;
, ,
, . (
)
. 4.50.
0,56; 0,58; 0,70. ( )
: 0,45;
. 4.50.
. 4.51. : -
,
{ ).
( ); 6
, {
). ( );

,
(
). ( )
, .
,
,
(. 4.51).

2-12,5%
[32, 156].
,
4.
91
. 4.52. : , 26 0,25,
MAC 36 /. ( ); - , 22 ,
0,63, MAC 59 /. ( )
[19, 156,
157].

,
,

(. 4.52). .. . ,
0,39,
[147].

.. .
,
[157].

,
I
. ,
, 5 .

, 16-17
.
5 , .
,

.
, ,
.
, ,

(. 4.53) [32, 137].
. 4.53. ,
: 1
; 2
; 6 -
: 1 ; 2
; *;
: 1 ; 2 . ( )
. 4.54. 7 :
1 ,
. ( )
. 4.55.
II : 1 ;
2
. 4.56. ,
(1);
: 1 ;
2 ; -^
: 1 ;
2 . ( )

,

.

.
,
,

(. 4.54) [26, 142].

, ,
, ,
93
. 4.57. : 0,20, MAC 30 /; 6 -S

0,26, MAC 47 /. ( )

(. 4.55).

,
(. 4.56).

(. 4.57).

.

,
, -.

, , ,
,
,
.

50 70% ,
81-92%, -
8-19% [89, 138].

: , ,
- [2, 13, 28,
32, 141].

,
[103, 137, 158-162].

,
[153]. ,
, [161].
,

, ,

. ,
,

,
[162].

.

.

[89].

, .
.. ,

,

[89]. ,
,
: 2-
,

,

,
(. 4.58).
, ,
[89].
. 4.58.
:
; 6
;
. (
.. )
. 4.59. : ;
. ( ..
)

.

,

(. 4.59).
, -
43-68% [138, 163-166].
. 4.60.
1 .
,
0,50, MAC 14 /

(. 4.60) [167].

, .
50 ,

|
1
_
- mk fJ*m11-
1
vS*
jg j jI
1 111 |||
. 4.61. ( ). (
)
,
,
[3, 168-170].
8 12
,
[171].
,

[8, 172].

.
(),
(, ), (, .).
,
.
[8, 175].
.
[8, 169].

, , ,
- ,
(. 4.61) [3, 8, 173]. ..
.
,
[172].

(. 4.62)
[8, 25].
,
(MAC 12 /) - 0,5 [8].
. 4.62. .
. ( )
9 ~ \ _______________________________________

,
, (. 4.63,
4.64).
,
[25],
. 4.63. , -
. ( )

0,25-0,75%,
3,7% [71,
141]. ,

,
[137].
,

[137].
,
2
, [103].
.. ,
61%,
18%,
21%
[69]. -^

[69, 174].
-
,

,
.
,
[4, 6, 8, 25, 102, 137,
140, 141]:

.
.
.

.

.
,
.

,

.

. 4.64. : ,
,
( ). ( )
-^~7
. 4.65. , , - ;
.

4-5% [69].

.
57,7%
[69].
(40-62%), (40-8%),
(15%)
(5-15%) [6, 8, 25, 69].

,
,

.. [69].
-
:
I - :
1<
( );
16
^ .
II
, .
III
, :

/ ;
III6 /
/
.
IV
/ :
IVa -^ ;
IV6 .
,
- , [3, 6, 8, 25, 175, 176].
,

(. 4.65) [3].
, 8 ,

[176, 177]. .. .
,

,

[177].

.
,

100% [6, 8, 25,
175-178]. ,
.

, ,
[8, 175, 178].

,
< 0,4 (. 4.66) [6, 8, 25, 151, 175, 176, 178, 179].

.
,
(MAC)
,
[8, 25, 178, 179]. . Hata .
MAC 41 /
(. 4.67) [179]. ..
,
MAC 45 / 0,4,

100%,
4 ) 89,6% [25].
9* .
. 4.66. 15 : 1 -, ; ,
; , 0,40.
( )
RI-5/D
'Arterial
-uterial
-Rt.Ou,
Lt.Ou.
. 4.67. : MAC 68 /, 0,51. ( ); MAC 74 /, 0,61.

( )

.
, ,
,
.

.

:
;
(, .);
- ;
.

50% ,
[137,
139, 141]. , ,

,
.

,
.

. .. Chiang .
-

. ,

,
88%, ,
, ,
87%.
, <1,17
84%, 1,17 , 82% [180].

()
(, ),

.
,
.
, ,
.

.

,
.

.

,
- [25].
, , , ( < 0,4)

40 /,
[8, 25].
, ,

-

[181].

:
;
( ,
);
;
;

;
(,
) ;

.

.
,
.

,
, ,
.

.

,
.
,

.
-

.

[6].
, ,
, .

.
,

. ,

,
. ,
.. .. ,
,
[3].
.
lo o V
. 4.68.
: 1 ; 2
. ( )

,
,
.
.

.
.

,
10 [182].

(
) (. 4.68). (
92%)

[182].

. ,

,
.

.

,
,
.

,
.

-
.
, :
;
.

35-40%
[138]. , ,
,
,
, ,
.
, ,
,
.
,
[61].

,
,
.
_ 1
. 42,070,4% [183, 184].

100% ,
, ,
, - 35,8% [183].

,
[185, 186].

, (2-8 )
(. 5.1). , (. 5.2, 5.3)
[183]. ,
, (ovulae Nabothi),
30 (. 5.4, 5.5) [4].
, ,
,
.
[183].

,

(. 5.6).
,
, 10
- ,
.
. 5.1. .
{): 1
. ( )
. 5.2. .
{ ): 1 - . ( )

.

, .

,
.

.
,
(, )
,
(+ )
,
.
.
.

102V
. 5.3. .
.
. (
)
. 5.4. . ,
{ ): 1
. ( )
. 5.5. : - ; 6 . (
)
. 5.6. : **! -; 6 , , . (
)
5 -

, , ,
,
.
. 5.7.
. ( )

(0,5-1,5 )
,
(. 5.7).
,
,
, [183],

.

,
19% [184].
, 40-50
[185]. , ,

[185,
186].
43,3% - [184].

, -, [ 141 ].

[184].

:

;

;

-
, .

,

(. 5.8). ..
.. , ,
,
5-10 [184].

3-5 ,
. ,

,
, 62,3% [184].

,
,
(. 5.9).

(. 5.10).

(. 5.11).

,

,
.
. 5.8. : ( ); 6 -19
[ ), . ( )
104V
. 5.9. : ( )', 6 ^
( ) . ( )
. 5.10.
(), ,
. 5.11. : 20-,
, ; 6 3D , . ( )
5-
"5
. 5.12. , : a J ; .
( )
,
.

,
(. 5.12). 0,5.
.

,

[185].

.

(. 5.13).

,

(2-3 /).

.
.

.
45-55 ,, ,
20

( 29 ),
2,1% [110].

[69, 188]:
;
;
;
;
;
;
.

, , 17-

. , , .. .
[141], .. [69], .. .. [188]
, .. .
[110]
.
,

() (),
[69, 70].
(32-55,6%),
(33,3-52%) (16%) [189, 190].
.. ,
. 5.13. .

, ,
( ). ( )
. 5.14. : ( ); 6 ( ); 1 . ( )
17,6% ,
80%,
2,4% [71].

, .
,

,
[190].
( , 1985) [6]:
:
0
(- ;
) , in situ.
,
Ia ,
;
3 ,
,
1 ( ).

16 '-^, ,
;
3 .
( )

;
, / /
.
;
,
,
(
.
).
111 .^

/ ;

.
16,
III6 -
16,5 3,2 [191].
, / ,
, .
/ ,
, .
,
IV
(. 5.14) [190,
/ .
191].
IV6 , ,
.
,

(. 5.15) [190].

.
(. 5.16) [192].
,
,
0 ,
-
in situ , . .. , 24,7%

5.
107
. 5.15. , {
) . ( )
. 5.16.
( ), .
. ( )
. 5.17. , . (
)
. 5.18. ,
. ( )
,

.

[110].
,
,
, (
).
,
.
,

: ,
(. 5.17) [6, 174]. ,

,

,
(. 5.18) [6].
(
)

(. 5.19).

,
(. 5.20)
[6].
( )
,
. ,
,

- , .
io s
. 5.19. , : ,
( ), (
.. ); 6 ,
. ( )
. 5.20. , (
). ( ). ( ..
)
. 5.21. : ( ) ( ); ( )

,

.
,

111.
5-
. 5.22.
.
( )

,
, - ,
III6
.
IVa
,
,
, ,

(. 5.21).

.
10

,

, - (50-150 ).
,
,
,

.
()
,
1 (. 5.22).
,
(. 5.23)
[190,191].
100% [191].

(. 5.24).

,

[191, 193].

,'*, , 1
0,64 0,1, 16 0,60 0,06, ,

0,57-0,68 [183,
191, 194].
(. 5.25) [195].

I ..
[191, 194 MAC
1^ 12,1 6,0 /, 16
20,4 6,8 /.
9,4 5,3 / 10,9 / .
..
MAC > 1 0 / > 7 /
,
90% 80%,
87% 82%
. 5.23. : -, ; ( .. ); ,
. ( )
. 5.25. , 0,50, MAC 14 /.

( )
. 5.26. ,
8 /. ( )
. 5.24. :
; -
;

; . (
). ( .. )
. 5.27. 23 .
.
( )
(. 5.26).
MAC
7,8 3,2 /, - 4,2 3,0 / [191].
,
1 16, ..

, .
,
, ,
1
, 16
(. 5.27) [69, 110].
5.

.

,
.
,

, .
,
,
,

,
.

.

.
, ,
.
,

,
,

. ,
,
.

, ,
[8, 196, 197]. ,

.
,
[196].
,
,
,
.
,

,
, .

.

,

.

, ,
.
112V

,

.
,
, 10 80%,
[28,
198-204]. ,

, ,
[137,
142,198-20lj,
30-40 , , 38,3-65%

20
[202, 205]. ,

, ,

(77,9%),
(68-83,7%) [17, 201, 202]. ,
[17,
28, 137, 198-201, 206]:
;
(
, , ;
, ,
,
; ,
);
(
, ,
);
,
, ,
;
;
,
;
- ,
;
(,
, ).
,
R.W. Shaw
(. 6.1) [207].

- ,
,
.

,

,
[198-201, 208, 209].

,
,
, ,
, ,
[198, 200, 201, 208, 209].

, II
,
6,8%,
- 1% [209]. ..
..
, ..

. 6.1.
( )
6.

11,4%
[69, 203].
,

,
[198, 199, 210]. , ,
,

[69, 200, 201, 210].
,

,
, , ,
.

,

-.

,

.
:
( ,
);
(,
, , ,
, ).

, ,

, ..
., 63,9%
(. 6.2) [137].

,
,

,
. ,

[200].

.. .. ,
[211].

:
I
2-3 .
II
.
III
.

II-III ,

,
, ,
I-II
, ,
.. ,
[4, 199]. ,

,
[4-6, 8, 19, 212].
-,
[198,
200, 201, 213, 214].
40%
(, ), 50-67%
71,4%
,
[142, 198-201].

.

6,5 (. 6.1).
. 6.2. : ; ;
1 1 4 \ ________________________________________________________
6.1.
.. ., 1997 [212]
.. , 2002 [201]
.. , 2000 [89]
.. ., 2001 [4]
. Atzori et al., 1996 [215]
P. Vercellini et al., 1998 [216]
A. Kurjak, S. Kupesic, 2000 [217]
S. Chatterjee, S. Chakravarti, 2000 [218]
B. Bromley etal., 2000 [219]
M. Dueholm et al., 2001 [220]
M. Bazot et al., 2001 [221]
J. Korczydski, S. Sobkiewicz, 2001 [222]
*, %
**, %
, %
94,3
86,4
88,7
80,0
-
75,2
86,0
-
33,3
-
61,5
84,3
>l.y I
, %
-
;
-
86,6
82,7
86
-
96,2
67,1
50
-
68
65,0
88,8
65
97,5
94,6
* .
** .

[4-6, 8, 89,
198-201, 212, 213, 219, 221, 223]:

;
;
;
;
-
(1-5 )
,
;

,
;

;
,
.
. 6.3. , .
. ( )

II-III
,
,
, .

,
40 ,

(. 6.3, 6.4) [5, 201, 212]. ..
.
,
128 3.

1,00-1,18 [4].
,
[142].

, ,
1:1,5.
,
1:2, III [89, 201].
..

15-20 -

(. 6.5) [89].

-
,

(. 6.6-6.9) [200, 201]. ,
,
[201, 209].
6.
. 6.4. , . ( ). :
10 , 59 ; 22 , .
. 6.5.
. 20

. ( )
. 6.6. , .
( ). (
)
. 6.7. , , :
( )-, - ^ ( )
.
1 1 6 \_
. 6.8. , .

,
( ). ( )
. 6.9. , ,
.
,

..

(. 6.10) [201]:
1) ,
,
;
2)
;
3)
.

II

,
, ,

. ,
-

,
(. 6.11)
[201].
,
,
,

[198-200]. ,
,
,

[4, 199].

. ,
.. ,
,
,
6,8% [209].

, ..
. 5,8% [4].
, .. ., . Bromley .

[212, 219].
,
,

[4, 212, 219]. ,
, ,
, ().
,
(. 6.12).

. 6.10.
( )
6.
. 6.11. , , -^ ;
,

,
,
.
,
.

,
,
[201].

, , .
,
,

,
(. 6.13)
[201,209,212].

I , .. .
[212],

. , ,
I
3 ,
,

.
(1-2 ) - ,

,
,
,
. I

(. 15).

, ,
. ,

, ,
,
(. 6.14) [199, 201, 212].
,
, ,
[199, 201, 212].
,
(. 6.15).

, (. 6.16).
()
. 6.12. .
,
. ( )
. 6.13. , : *-*
,
; 6
{ ); -
; , ;
,
, . (
)
, ,
.

, ,
.

,
,

, .
.

[26, 223]. --
, , ,

.
6.
. 6.14. , .
:
; . ( )
. 6.15. , ,
[ );
: 1 ; 2 ^ - . ( )
. 6.16. , : - ;
,
. ,
, . ( )
1 2 0 \.
. 6.17. : ,
- , 1,0; 6
0,73, MAC 11 /, e l
, 0,71, MAC 7 /. ( )
. 6.18. . : S ; 6
Hatle, 240 ; : 0,87, Hatle 230
( )
II-III
.

0,43 1,0, 1,53-1,56
(. 6.17) [8, 19, 89, 223-226].

,
1,0 [8, 19, 89, 152, 199, 224-226].
,

,

.

( Hatle)
,
,
S
6.
[152, 199]. Hatle

. .. .
,

110
54,22 2,01 (. 6.18) [152, 199].
,

Hatle,

,
[152, 199].

:
;
;
(
, );
;

(, .);
- ;
.

,
,
- .
,
,

.

,
,
,

, -
.

,
,
,

.

,
,
,
,
(, )
.

.
,
.
.
,
,
(. 6.19).

,
,
-
[6].

-
BAOftfe
. 6.19. ,
: ,
( );
,
( ). (
)
122V
. 6.20. :
(
); JS ( ); e?U-
,
,
( ). ( )
. 6.21. ,
.

. , ,
, ,
, .
( )
, ,

[26].

- .
, ,

,

- .

50% ,

(. 6.20, 6.21) [4, 201, 212].
,
,

,

6.
. R. Huang .
,
5 80%
94,3% [227].
,
, ()
(, ), . ,
,
,
()
() [8].

,
.

.

,
( 1,9 /)
( 0,4)
[6].

,
-. , ,

( < 0,4)
40 /,
[8, 25, 181, 227].

. Hirai
.
(. 6.2) [229]. 5 ,

96%, 100% ^ - 83% [226].
,
,
. , ,
.. ,
22,8% [201]. ..
..
,
25%
, ,
[200].
.. . ,

,
[198].
,
V l2 3
6.2.

> 28

+1
+1
> 22
> 1,4
+1
+1
+1
+1
+1
-1
< 0,43
-1
> 23,4 /
-1

[4, 6, 198-200]. ,

,

[198, 199].

:
1. ,
,

.
2.
;
3.
,
, ;
4.

.

, , , - ,
.

2- ( )
1-

[198, 199, 203].
1 2 4 \ __________________________________________________
6.3.
.. ., 1997 [212]
.. ., 1997 [232]
.. ., 2001 [4]
, %
.., .., 2002 [203]

J.LAIcazaretal., 1997 [233]
94
72,9
92,2
j| - 1
-
F.Ubaldietal., 1998 [234]
I r jf l
A.Kurjak, S.Kupesic, 2000 [217]
,
, .
,
,
[17, 205-207].

,
.

,

[202, 229].

,

,
.

, .

,
,

[198].

,
, %
, %
75
88,9
90,0
99,0
'
75
91,0
96,7
99,6
[28, 198, 200, 202]. ..

,
2,3-2,9% [69].
, -

98%,

[231].

. 6.3.

10 ,
,
70 [6, 8, 200].

.
,

. 1/3
,
19% [5, 212].

(. 6.22).
[4-6, 8, 25, 200, 212, 217,

233-237]:

;
. 6.22. , - :
1 ; 2 ; 3 . { ); 6
, . ( )
6.
2-6 ,
, ;

5-10 ;
-- ;
,
;

0,5-0,6;

;
.
, - .

, , ,

,
(. 6.23) [198-200, 230]. ..
.,
72% ,
[212].
80%
,
5-10

,
(. 6.24) [8, 235, 236].
,

, , ,
63-95% [4-6, 8, 25, 217,
235-237].

.

[8, 237]. .. .,
48% ,
34%, 16% 2%
[212]. ,
,

(. 6.25).
.. ,
16 ,

,

(. 6.26) [8].

.
125
. 6.23. ,
{ ). ( )
. 6.24. ,
{
). ( )
,

(. 6.27) [8, 238].
70-78,6%, ,

(MAC 11,4 5,2 /),
- ,
22 / [8, 19]. .. ..
,

,

2- [19].

.
,
0,5-0,6 [5, 8, 234, 235].

(0,45-0,65) (. 6.28) [19, 217].
12
. 6.25. :
;
;
.

. ( )
. 6.26. .
; : 1 ; 2 . (
)

.

,
, , .. .,

[152].

,
.
.
^127
6.
. 6.27. , , ;
, { )
.Arterial
Uterial
Rt.Ov.
tt.av.
. 6.28. : , ,
0,64, MAC 14 /; , , 0,70.
( ). ( .. )

:
, , ;
;

(, , -, );
();
;
.
,
, ,
,
, ,
.

95%
,
19% [236].

,
,
,
[5, 8,
19, 217].

, 2%
[212].
.

:
-
,
.

,

,
.
128V
-

.
, -
,
, ,

,
.
,
,
.

,

,
.
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,
[212].

()
.
6.4.
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(/
)
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< 0,40
0,41-0,60 /

-125 35-65 /
2
1
2
2
2
2
1
2
2
4
2
2
2

. ,
,

[6, 8, 69]. , ,

30%,
- 19% ,
[5,212].

.
,
,

. ,
,
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. 5
,
[212].
98% [212].
,
,
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,
.

, , ,
, .

.
,
,
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, ,
,
.

,
,
.
A. Kurjak S. Kupesic

,

99,0% 99,6%
(. 6.4) [217].

.
6.
\2

, , I
[28,198,199,201].

[198].
-
,
[198, 201].
.. .,

[198].

,

.
,
,
.

,

.

,
.
,
,

.

.
, ,
5-10 [8,28,198,199,201,203],
30-35 [8].
,
,
.

(. 6.29). ,
,
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.
, ,
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,
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,
,

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). ( )
. 6.30. ,
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:
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.

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,

,
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.
0,1-0,4%
[239,240].
, ,
, .

.

,
- ,
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.
,
80,6-95,8%
71,2-92,6% [8, 212].

[203, 212]:

,
, 40 ;
, ;
();
, ;

;

.

, -
.

,
, .
.. . ,
63%, 20%,
17% , ..
.. ,
(. 6.32) [203, 212].

,
(.6. 33).

,
. ..
.,
, 15%
. 6.32. .
,
( ): ,
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, , ;
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; - ^ ,
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;
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6.
. .. [
) : a S
; ; ; , . ( )
132V
. 6.34.
: 1 ; 2 -
; 3 ,
. ( )
,
[198, 202, 203, 210, 241].

,
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, ,
.

,
(. 6.34).
,

(. 6.35) [242].
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)
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. 6.36. , (
) . ( .. )
[212].
,
,
.
:
, -

,

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- [243].
,
, ,

. ..
.,

- [212].

, .. .
0,5%
[4]. ,
,

. .. ,
1-2% [8].

, (. 6.36).

.
33

,
.
.
2-3
[5]. ,
,
,
.

.
,
,
,
,
, [56].
,

810 [28].
.

, , II
-
,
[12].

II
(. 7.1).

(. 7.2).
, ,
II I
(. 7.3) [25].

.

?!
. 7.1. : - ;
. ( )
134V
. 7.3.
, . 0,67, MAC 6 /.
( )
. 7.2. .
( ).
. 7.4. , :
; : 0,55, MAC 11 /;

, : 0,54, MAC 15 /.
( )
,

, ,

[28].
.

,
25% [32].

- .
( 2 )

[5, 244].

0,5,

7.
-^135
12,7 / ( 29,8 2,1

) (. 7.4) [5, 25]. ,

.

:
;
;
.

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,
15% [245].

.
, , :
,
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,
,
;
10 ;

.
,

(. 7.5) [245-247].

.
,

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,

[28, 32, 248].

.
,
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,
[28].
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;

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{ )

(. 7.6) [248].

()
,

1 3 \ ___________________________________________________________
7 .1. -

( )
,

.
, ,
-,
,
,
.
[28].
-
,

[245-247].

20-30
.

, , , ,
[28,248].

11% [249],
[250],
75% [251],
,
85% [28].

:
8 3
[28, 245, 252];
10
, ,
[28, 248, 251, 252];
3-10 ,
[28, 251, 252];

[27, 28, 245, 251, 252];
[6, 26, 27];

[28, 248, 252];
[25, 251,
253];

(0,54-0,70) [25, 252, 253].

. 7.1.

,
. :
,
,

(. 7.7, 7.8).

,
, ^
. ..
.. - (),

( ) [3].
, > 3,5, 91%
,
( < 3 ,5 )| | 85% .
.. . 10

[245].
,
15,9% , 1,2 0,1.

8 3

(8 3
). 3,5

, 69,4%
74,8% [245].

,
,
, ,
(. 7.9).
7.
31
. 7.7. , . ,
. 1 , 2 , -
. 7.8. : ; 6
, ;
. { )
. 7.9. .
, , : 1 ; 2 .
, ; . ( )
138V
. 7.10. ( ). (
), : 1 ; 2 ; ,
[ ). ( )

( =
/ )
, [254]. ..
.. > 3,3
, ( 3,2),
, ,
97,3%, 94,1%
100% [254], ,

.

10 ,
, (
) [26, 28, 56, 252].

, (. 7.10).

. ,
0,6 ,

(. 7.11) [56Jf:

[249].

, 25-29,4%,

100% [245, 254].

-
(. 7.12). ,

. ,
. 7.11. .
1 . ( )
. 7.12.
.
,
, , . ( )
7,
^ 1 3 9
. 7.13. : - ; 6 - . ( )
. 7.14. : a j g , 0,75; 6 ,
0,67. ( )
.
,
[6].

,
(. 7.13) [8, 25, 26,
253].

,

, 0,54-0,70
(. 7.14) [25, 26, 247, 249, 252, 253].

. ..

,
[255].

16-18G 30 ,
, .

8-15
5-9 3-5
2,09 .

,
1-2- (. 7.15).

,

,
. .. . - .
40%
, 60%
(
) 30%
.

,

( ),
,
140\.
. 7.15.
:
{ ); { ); {
). ( ). (
.. )
. 7.16. , , ,
, 20 30 ; 58 31 ,
( )

.
,
.

[28, 256].
,

, ,
,
[256].

[257-259].
7.
y^ vn
. 7.17. , : 66 32 . ( );
12 , { ). ( )
. 7.18. , :
( )
; 6 , 0,50.

1-7%
[26] 22,1% [28], ,

[28, 256].

60 ,
20 ,
-
[25, 256]. -
,
.

,
,

(. 7.16).

60
120 . ,
(. 7.17) [28, 256].

120 ,
- 50-60 .
()
[25, 28, 256].

,

(. 7.18) [26].
-
, ,
2-3 [5].

:
;
;
142V

[28, 256].

, 50%
, ,
(. 7.19) [5, 25, 26].
. 7.19. .
. ( )

;
;
.

, .
,
,

[12].
2 10%
[28fj; ,
,
,

[28].

40 .
,
,

,

[28].
,
, ,
, [28, 12].
,
.

[12].

, ,

(. 7.20).
. 7.20. , , ; 6

143

0,7-0,8%

3-6
[11].
, ,
[28, 27].

,

-
. 30%
[28].

. , .

(. 7.21).
. 7.21.
. 38 21 ,

. ( )

,
(Sheehan),
( ,
)

,
,
[11, 28, 260].
, ,
,
2/3 4 [11].

,
, .

5 (. 7.22) [6].

,
.

.

,
[28, 12].
. 7.22.
: ;
.
( )
. 7.23. , .

, ,
.
,
(. 7.23). .
14 4 V
7.2. - ,
>10
>10
>5
<20
<10
>25
7.3. - ,
3-5
3-5
3-5
3-5

,
[56].
,

[12, 28, 56].

,
. 7.2., 7.3.

,

, , ,
,
.

(
), ,

. ,
,
.

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[25, 26].

.
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.
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[3, 13, 261].
:
- .
.
.
.
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,

(. . 7,
),
(. . 6).

[261].
,
7,8%
52,3%
,
. [6, 262, 263].

.
,
25 35 [261, 262],

-
[262, 264].

,
.
25 ,
,
25 [12, 261].
-,
1-3
,
.
[265].
1-3 ,
, ,
,
[28].
,
,
.

:
, ;
30 100 [3, 6], - ^ 6 0 70 [5, 8, 25];
,
;
,
;

;

0,5 [5, 8, 25];

4-12 [6, 261, 265].
,
,
. ,

(. 8.1).
8.
V l4 7
. 8.1. . >~ ,
: 1 ; 2 , . ( ); 6 ,
, ; 4 :
; 3 , ( )
, ,
,
,

,
[261].
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,
,
,
(. 8.2).

,
,
92% [8, 28, 178].

(MAC 4-18 /), 0,500,58,

(. 8.3, 8.4) [8, 28, 178].
. 8.2.
.
, ( ),
. (
)
148V
. 8.3. , :
; 6 ,
0,64, MAC 14 /; ,
7 /, . (
).

[102, 117, 266].

,
, , ,

.
5

. 8.4.
, . : 0,67, MAC
6 /. ( )
,
,

,
[12]. ,

, 3 ,

(. 8.5) [266].
,

60 8% [266].

, ,
0,5%
[267]. 3-10% [6],
12 ,
16 , [8, 268].
. ( )

[8, 261].
,
30 , ,
100 ,
50 [3, 6, 261].
8.
. 8.5. , , 5 , 25 ; 17 ,
5 . {
, - .
,
,
(. 8.6).

:
, ;
;
, ;

;

0,5 [5, 6, 8, 178];
8-12 ,
16 [265]';*';.:

.
2-6 ,
[4].
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: 57,1%
-
; 11,2% ; 31,6%
(
)
[261, 269].

- ,
,
, .

[102, 117].

(. S.7-8.9)
[4, 261].
(. 8.10).
100%
,
,
[28, 178].
(11,3-42,4 /)
(0,32-0,46) (. 8.11) [28, 178].
. 8.6.
: 1 , 2 , 3
. ( )
15oV
. 8.7. : a-
-
.
. ( )
. 8.8. : ,
; 11 . ( )
152 V
. 8.10. , ;
; (1) (2) . ( )
. 8.11. , :
0,43; 0,55. ( )
:

,

.
.

, ,
[102, 117, 178]. ,
, R. Albayram . ,

73%, 20%,
7% [270].
, , 87%
,

(. 8.12).

(40%),
(13%) (17%)
,
;
(. 8.13) [270].

:

. 8.12. .
, ,
( ). ( )
. 8.13. : -,
[
); ,
, 0,63, MAC 8 /. ( )
,
,
[270].

,
.
.. Fleischer ,

[178]. ,
,
,
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,

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,

, :
.
.
,
. 8.14. .
. (
)
. .. .

,
[261].
,
,

.
,

,

[102, 117].

,

(. 8.14) [117, 271].

.

,

1-2
,

12-16
,
[8, 268].

,
.
, 50-60 ,
,

, ,
[2, 13, 55].
1 54V
. 8.15. ,
{ ). ( ). ( .. )

70-80 3-4
,

[2, 17, 102, 103, 117].
.. .
,

82%,
100% [261]. ,
97% .
.

.
[272]:
;
;
12
;

;
40 .

[2, 272]:
;
;

.
,
,

(. 8.15).
,

,
[6].
[273].

(40%),
, 1,5%
[6, 274].
, , - ,
, 34,8%
[6, 274].

44%
[275]. , ,
,
, , 50 .
,

[274, 275].

. -
( d)
50-70
50
120 ,
70
60
--
>0,5
<0,5
0,5-0,6
4-12
8-12
8-12

96 [273].

,

, [276].

, .

, . ,

. ,

.
,

,
[261].
11% ( )

,
.
,
1 ,
2 .

- .
0,5
. ,

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:

;
( )
;

;
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;
.
-

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, -
.
, , ,
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,
.

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.

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30 .

, ,
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,

.
.

,

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.
,

,
.

. 9.

70% [6, 69, 103].
()
, , ,
,

[110].
,
.
,
,
.
2-3-

, , o r
1- 49% [71, 110].

,
,
40 [69].

[6, 69]:
;
;

;

;
( ) .
, 40%
- ,
;
30-50 [6].
.
() ,

, , 1973 . ( 1996 .) .
[69]:
,
.
,

,
.

() [103].
.
10-12% [8],
.
,
.
.
(
100%
) 80%,
20% [6].

(). ,
<20
20-29
30-39
40-49
50-59
60-69
>69
, 20
(30%),

70 85%
.

.
[2]
9.
5 30 [20, 52], 15
[6, 20].
(
) :
,
;
, ;
, ;
1 8 [20, 52];
(
) [71, 103, 262];
, ;
;
, ,
> 0,5 [5, 6].

(. 9.1).

2-3 .
.. ., 1/3

, [261].
80%
,
0,5 [178, 277].

( ),

. :
2
(. 9.2) [261].
, ,
.. .,
,
[4].

,
50% [58, 103].
,
,
, 89,2-98,6%
(. 9.3) [277, 278].
0,4,
0,4
[6, 277, 278].
.
5060 10 20%
[6, 8].

(),

. ,

-/157
. 9.1. :

103 53 . ( );
( ); ,

. ..
., 85%
15 [6]. 10%
[20].

:
, -;
;
158\.
. 9.2. , ,
; -
;
,
; -
;
,

. 9.3. : , ;
, . ( )
9.
. 9.4. , ,
; 6
;

; ; ,
. (
.. )
,
;
,
;
, (
) > 0,4
. [5, 6] .

.

,

,
,
[6, 8,
103].
,
.

(. 9.4).

.

, 0,4
(. 9.5) [277].
1
46^4783
7*
. 9.5. .
; ,
; ,
. ( ). ( .. )

() ,

(. 9.6} [6, 8].

[278]<,.<v
17% [103, 263].
. 9.6. . ( ). (
.. )

.

.
,
,

, , ,
:
, ,
,
[69].
[6].

25%
[5, 6].

() (. 9.7).
.
( ) ,
0,6 2,6%
,
161
9.
. 9.7. , 20 : ^ - ; 6
. ( )
. 9.8. , , -; 1 - ,
2 ; , . ( )
( 63 ),
,
[6, 69].

.
,
5-10 [6].
, -, ,
, -
.
.

,
,
(. 9.8) [5, 261].

-
[6, 8, 20].

,
4-5% [71].
, , ,

.
3-
,
1-
49%, 5-
20-28% [110, 279].
,
60 70
, 50 60 ,
[110]. 80%
II-III [6].

.
, , -
. 9.9. , -
,
( .. );
( ): 1 , 2 ,
; ( ),
,
9.
. 9.10. : - , .
( ). ( 8 .. )

.
FIGO (
) [69]:
I
(
).
II
(, ..).
III
/ /.
IV .
, , I ,
,
[69]. ,
,
: Grade I
; Grade II
Grade 1 .

:
() ;
(), ();
, -,
;

, ;
;

, ;
,
.

,
,
,
,
(. 9.9, 9.10).

,
. ,

[4].
164V
. 9.11. , :
: 1 ; 2 , ; 6
( );
; . ( )
,
,

.
,
[5, 6, 8, 26, 103, 280):
;

;
,

;

;

.

,
1-2 (. 9.11).
,
.

, ,
,
.

.
(, ), (
.) ,
.
165
.. , [69].

().

.
(
), 40 60 ,

50 , 39 [8, 69].
.. .
4-25% [58],
.. 66% [69].
-
. 50-85%
(
, -
) 25% [188, 281].
,
[71, 281].

,
,

.
-
[58, 69, 71].

,
.
, ,
, , [69, 281].

, ,
,
10 .

, ,
(. 9.12)
[5, 6]. ..
[281]:
1.
.
2. - .
3. -
.
4. .
,
,
0,36-0,59,
0,46 [281, 282].

,
, -
.
- . -
() -
.
3,8% [58]
50
[71]. , 4-5% [71].
,
( ),
. ,
[69].
,
,
. 9.12. , : 1 : , 2 ; 6 . ( )
. 9.13. : , ( );
, ( )
. 9.14. : , ; - , . ( )

, , .

,
, 0,39 0,52,
0,48 (. 9.13) [282].
. ,
,
7%
[58, 71]. ,
,
,
.
,
.

.

, - ,
, ,
,
(. 9.14) [6, 8ft
,
14,3% [282]. ,
,
, , ,
[69, 71].
,
-
.

:
, .

, ,
'167
[6].
.. .. ,

, , 42,9%
,
0,46-0,63
0,54 [282].
( 73%)
, 30% [263].

[283].

10-15%
[5, 71].
( ).
. (,
, )
,
, 0,4
2%
20-35 ,
[5, 47, 58, 69].
, , 30%
[47].

.

,
(. 9.15).
100% ,

0,40-0,52 0,45 [282].
.

[263, 283].
,
(
).
, ,
(,
),
[69].

,
;
,
,
[69, 71]. ,
, .

, ,
,
(. 9.16) [6, 284, 285].
.
,
. 9.15. ( ). , - ,
. 9.16. . ( ):
1 ; 2 ; 3 .
( )
1 8 \.
. 9.17. , : ,
2 ( ). ( );
. ( );
, . ( );
, . ( );
[ ) . ( ); :

9.
,

100% [284, 285].
.
[69,
71].

,

. ,
,
,
().
( , ,
) 97%
[20]. , , ,
, ,
5 15 , ,
40 [3, 5, 20, 263].

, 7
,
[286].

,
(
) ,
[4, 20, 52, 261].

, , , , , , ,
.
( )
[8, 20, 52].
,
[4, 2871.
. 9.18.
_/ 9
,

.
:
1. (
). 47-60% [3-5].
-,
.

,
.

, (. 9.17).
2. .
20-43% [3-5].
,
,

,
, .

, , , .
, ,
4
[261, 288].

,
(. 9.18).
3. . 9-20%
[3-5]. ,
,

(. 9.19'). ,
, ,
, ,
- ; ,
170\.
. 9.19. , ,
; ,
; -

[287].
,

.
[3, 261].

(),
,

9.
86-97,1% [261, 289, 290].

, ,
[110].

[277], , 0,4-0,6,
, 20% [5, 287].
(,
, ) 1-2,5%
,
20-30 ,
,
, [69,71].

,
, - .

0,4 (. 9.20^|5, 287].
()

5 20%
,

, [5, 69, 140].
( 40 ) [69, 140].

( 50%),
- ,
, , ,
[5, 140, 291].
70% ,
IV
[69, 103].

.

.
,
,
, ,
- [291, 292].
.. .

-
[291]. , ,
73% ,

,
- 47%
. 9.20. .
, - , ( )
,
( 10 ).
,

.

,
-

.
,

,

, ,
:
;
;
;
.

.
,

(. 9.1).

,
,
172V
. 9.1. -
40
70
,
40
70
,
40
50
,
()

()

()

, ,
.
,
,
.
, ,
1-2
.

.

,
.
, ,

.
, ,
.
,
.

.
, , ,

,
,
, .

- .

. , -
.
,
,
,
40
50
(),
()

.

, .

,
.

, ,
,
.

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,

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60
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60

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,
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,
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[293-304].

,

,
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,
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,
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, , ,
,
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.

[8, 26, 293].

23-47%
95-98% [8, 294,
296].
69% 100%
, - 54% 73%
[26].

.
M.R. Orden et al. , ()
,
, -
[304]. ,
,

, .

,
,
[303].
,
,

[305].

,

(. 9.3).
1 7 4 \ ______________________________________________ __________________
9.3. -

MAC

..

[300]:
. 9.21. ,
: -,
, ,
; -4 ,
. ( )
>0,4
15 /
5 /
<0,4
30 /
10 /

MAC ,

MAC ,
Grade I Grade III
MAC

.

.

.

.

MAC
19,0 /; 5,0 /; 0,44 (. 9.21, 9.22).

,

,
91-94%,
,
2002 [300, 306].
. 9.22. . : 0,44, MAC 52 /. (

)
f v ib

.

65-70%
,
,
,
16-25
[58, 141, 188, 307].
,

,
()

[141, 188, 307, 308]. ..
. , 3-9
, 2
70%
,
86%

[141].

, -,
, , , .
, 20

1% [2].
, Neisseria gonorrhoeae
25 65% , a Chlamydia tracho
matis 30 56%,
25-40% [188, 309-311].

, 70-80%
, , ,

[141, 312, 313]. Actinomyces Israeli 15%
/\
JL V/
,
, ,

[188]. ,
.

3 [13, 314, 315]:
1- (),

.
2- -
(),
, -
,
.
3- (
) .

. ,
7-10 ( ) ,

,

[13, 28, 313]. , ,
[313]. ,

,

, ,
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[13,28, 313, 316].
,
,
.

.

(),
(), (),
(), ().

, , .

96-98% [17, 317]. ,
,
,
, III-IV
[17, 313].

[11, 318].
-
100%
,
[313].
,
,

. .. .,
.. .

92%, 92,5% [4,
313]. .. .. ,

72% [3].
()
()
, ,
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,
[319].
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(), ,
,

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,
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[183]. ,

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(. 10.2).
, (. 10.3) [320,
321].

, ,
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[321].
20
[322]. ,

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. 10.3. , .

17\.
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);
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[2, 13, 28, 32, 58].
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[32, 58].

[28].
,

[26, 324]. .. .. , 60%

[28].

,
.
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,

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;
() ;
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10.
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. 10.11. ,
,
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,
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(. 10.10) [32].

, ,
(. 10.11).

,
. .. .
, 3
, ,

[74]. , ,
2-3

(. 10.12, 10.13).
17-20%
. 10.12. ,
,
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, II
. - 29 [ ),
, ,
, ,
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,

182V
. 10.14. ,
, (
), ;
, ( );

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; . ( ). ( .. )
10.
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. 10.17. ,
,
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, { ), ;
5 { )

[328].

7 [74, 102]. ,

,
,
,
,
, (. 14)
[8, 102].

(. 10.15).

,

() (. 10.16). ,
,
[102].

.
(. 10.17).

, ,
[329].
,

,
(. 10.18) [330]. ,
, ..
.
[74].

,
184V
. 10.19. , , ,
-, ,
, 10 ;
-,
, 12 ;
-, , 2
,
-
.
.

,

(. 10.19) [8].

(. 10.20).
I ,

,
[18, 19].
,
,

(. 10.21) [8].

, 0,50 0,08
[297]. ,
,

(. 10.22) [297].

86 92%
,
, ,
-
.

.
.
,
,
, 1948 .
,
(Asherman).

[331]:
;
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;
, ,
.
10.
_ / l8 5
. 10.20. : ; ,
, ;
. (
)
.. .

[74].

,
.

.
,
,
,
(. 10.23).
-
.

-
,
.

,

(. 10.24).
-
,

.
. 10.21. ,

-
1 8 \.
. 10.22. : - , 0,67; 6 , 2 / ( )
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. 10.23. {),
. ( )
. 10.24. , .

{ ),
: 1 - . (
)
. 10.25. , ,
( ); 6 (
)
10.
,
,

, -
.
(. 10.25).

,
(. 10.26).
,
,
,
9497%, I - 83-89% [61,117, 332].
[26].

,

.
.
.

. ..
. ,
[313].
.. .

, ,
,

[58].

.

,

-
, .

, ,

.
,
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, .. , ,
.

,
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. 10.26. , .
, ,

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[58, 141, 188, 307].

29 %
[333]. ...
, ,
,
[3-6].

,
.
,
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[8,
333]. .. .. ,

[20].

,
.

[3-6, 8, 333]:
,
- ;
, ;
;

;
,
;
;
;
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188V
. 10.27. :
1
,
, 2 - , . ( ); (1),
(2). ( )
. 10.28. , , - ; ; ; ,

[3, 4,
319, 333]. , ,

,
, , P.J. Sulak ., 50%
[334].
,
,
,
[17, 333, 335].
10.
. 10.29. ( ),
. ; 6 ;

,
(. 10.27).

.

;
,

. ,
[335].

,
,

, (. 10.28).

, ,
.

,
,
.

,
(. 10.29). ,
,

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, (. 10.30).

. 10.30. , ( ),

19\.
. 10.31. , ( ), ,
;
,

.
L.A. Boardman .
97%,

32% [*

,

, ,
20,3-41,6% [319, 333].

, , ,
,
(. 10.31).

1 7 ,

(. 10.32) [333].

. 10.32. , (
),

:
,
, ,

.
, , ,
.
(. 10.33),
, ,
[8, 333, 337, 338].
,

,
(. 10.34).

[333].

54,5-78,0%

, , ,

100% (. 10.35) [178, 297, 333].

.
0,53 0,77 (. 10.36) [8, 25, 178, 333, 339].
:

0,6, -
0,6.

.

,

,
.
. ..
., ,
10.
191
. 10.33. ,
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; - ( .. );

,
[340].

.
,

, ,
[11, 58, 318].

6-10%

[8, 333].

[5, 6, 8, 333]:
;
;
;
;
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;
;
;
;
.

, ,
,
()
. 10.34. ,
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.
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65
velocity
Arterial
llterial
tt.Qv.
. .
. 10.36. , :
, , 0,71;
, , 0,50;
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)
10.
. 10.37. , : ,
, ; 6 ^
, ;
.
( )
[5, 6, 8, 20].
,
8 3,
[3, 6, 341].
,
,
,

, .
,

,
, .

, 32%
,

16% [333].

.
,

,
(. 10.37) [333].

, . ,
, , ,
. ,
,
, (. 10.38, 10.39) [4,
342]. , .. ,
[342]. ,
,

[4, 342].
,
[4].

, [4].

, , ,
(. 10.40).

,
84 76% [333].
36% ,
,
,
1 9 4V
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( )-, 6 ( ), . ( )
. 10.39. . -^ : ,
( ); 6 : , .
( )
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10.
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. 10.41. , { ):
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343].
.

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MAC,

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,
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10. 1
SvH
, , ,

[178, 297].

-

,

[313, 333, 344, 345].
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[6].
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-
.

[313].
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.
,
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[4,17, 313].

,

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[3-6, 102, 313, 333]:

;

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;
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. 10.44.
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: 1 , 2
;
.
,
,

[3-6;
8, 141, 178, 313, 319, 333, 337]. ,

.
I.E. Timor-Tritsch .

(. 10.44) [337].
198V
. 10.45. , , , - ;
,
. 10.46. ,
. ( )
. 10.47. , (
). ( )

-
- .

76,7% , 81,7% [333].
, ,

, 2-7 ,

[333, 346].
10.
35
150 , 50-70 [333, 347].
100%
: .
-
3% .

, .
, -
,
.

(. 10.45).

,
,
(. 10.46) [52].

,
(. 10.47) [52, 178, 333, 347].

( )
,
[152].
3-
0,74 0,04, 4-5
0,68 0,02, 7-8
0,71 0,03, 15
0,68 0,04, .. .
,
[152].

.

, ,
, ()
(. 10.48,10.49).
,
,
,

[178,297, 339, 348].
. 10.48. : - - , . ( )
200V
. 10.49. : , 6 . (
).
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0,40 0,72 (. 10.50) [8,19,25,178,297, 333,339,
348, 349]. ,
,

. R.
., ,

, 0,60,
. 10.51.
, 0,82. .
( )
0,52 [350].

,
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-

,
90% [333]. ,

.

(
, ).
/ 2 0 1
10.

97
91
95
1 1
.
( %) [333]
. 10.52. , .
( ).

,

, (
). ,

, .
,
.

67,1%,
78,0% [333].

().

[313]:
;

;
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, ; 6
;

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,
.
,

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.

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.

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.

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[58, 202,
313, 351, 352]. , - ,
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318, 352].

[17, 256].

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[17, 352].
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, ,
- , [352].

,
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[353]
, %
33,3
31,7
26,7
15,0
15,0
8,3

[353].

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.
,
:
.

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10-15 .
1
,
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,

(. 10.54).

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[354].
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[353],
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.
(, , ,
) ,
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10.
/203
. 10.54. , .
[ ); ~
[ );
[ ); + - [
);

[5, 102,
352].

[352].

[102, 208].
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[102].
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. 10.55. . ( )

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5 , , ,

,
.
(. 10.55).

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[102].

.
, ,

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[355]. . 8.
,

,
, [356361].

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96 .
,

.

.

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[356].

.

,

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MAC > 1 0 / > 7 /
,

[191]. ,

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40-49 [71].

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. ,

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[362].

,

[5, 6, 8, 102].
,

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[6, 181].
,
50% [19, 26].

.
_^205

:
;
;
;
;
;
.

[363].

, ,
. ,
,
74% , ,
34% ,
* - 87% [364].

, - ( 5
)
[365].
[365]:
1) ;
2) ;
3)
;
4)
;
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6) ,

;
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;
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.

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,

.
. 180,
.

,
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,

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,
,

[316]. . , , - , ,
,

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[316].

. ,
.
1-3
- ,
.

.

:

;
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;
,
;

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;
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[238].
.

. . ,

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, ,

[178].
, ,
, .
,
,
[102].
,
,

.
. ,
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-

, . 9.

,
:
10.
;
;
;
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, ,
,

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,
.

[102].
[1].

, ,

, , .

( ,
)

.
(
)
,
.

.
, ,
.
-
,
,
, ,
.

,

,
71%
26% [333].

() ?,
.

,
1,3 6%
,

7,4% [188, 367].
30-39
[239].

,
, .

:
1. ,

, (47-55%)
[188, 239, 367-369]. ,
,
,
.
.
64-83%
[20, 309].
2. .

.
, 18-20%

[188,
367, 370].

. , 5%
,
,
, 3% [239, 370].
-|
A X
3. -
.

. ,
,
( 25%)
,

[188, 239, 352].
4. ().
,
1976 ., .

, 5,8-10,6%,
1,9% [256, 371].
5.
.

, , ,
. ,

,
[12, 28].
6. .

! + - /
,

.

,
[188, 208, 372].
7. .

,

.

11.
/ 2,

[239, 367].
8. .
, ,
, ,
,

[188, 367, 368].
9.
+ - [239, 367, 372].

,
,
,
()
. ,
[12, 32,
56, 239].
,
. .. .
, 66%
[239].

[3-6, 28, 188,
239, 371]:
98,5%, ,
43-92%, 13-40% 2 2,8%;

0,1-1,3%.
0,1-0,4%.
0,1-0,9%.
0,1%.
0,2-0,9%.
.

4
[188, 239, 367, 373, 374]:
1) ;
2) ,
;
3) ,
;
4) .

, ,
,
,

.
^ 2 0 9

[3 - 8 , 26, 27, 102, 239]:
:

().
:

,
;
;

;
-
(
);

;

;
;

.

5 -2 9 ,1 %
[3 - 6 , 20, 3 75]. .. .,
, ,

,
,
[3 7 5 ].
, 76%

.

,
: ,
(. 11.1). ,
90% ,

, ,
,

(. 11.2). ,

, ,
,

[3 7 6 -3 7 8 ].

[3, 6, 102, 178, 239,
3 79].
. ,

21oV
. 11.1. : ( )
: 1 . ( ); 6 { ) : 1 . (
); . ( );
. ( )
. 11.2. ( ):
( ); 6
,
- ,

.

,

(. 11.3) [102, 375].
11.
211
. 11.3. : ( ): 1
; ^ -
{ ); ; ( ).
( )

.

, ,
,
[375].
-

,
.
,
,
. ,
,
,
.

,
0,02%,

(. 11.4) [8, 368, 374, 380, 381].

20-30% [6].

,
. 11.4. : 1 ; 2
. ( ). ( ..
)
212V
12-24
(. 11.5) [3-6, 8, 178, 239,
375]. ,
,
[102]. -
14-27,8%
, ,
,
[4-6, 374].
33% 3

, [374].

,
,
(. 11.6).

[4, 102].

,
, .
,
,

- . 4-5

, 5-6

(. 11.1) [5, 6, 102, 178, 375].

(. 11.7).
.. .,

[20, 239].

. 11.2.

, ,
.

.
, ,
,
,
,
, .
,

, ,
,
.
.

, ,
- ,
(. 11.8, 11.9) [4, 239].
. 11.6. { ). (
)
. 11.7.
. ( )
. 11.5. ,
. ( )
11.
11.1. -

-
+

+
+
11.2. [102]
, ,
60%
, 300F
400 ,
[239].

,

(. 11.10).

(
, %
, %
8-34
100
40-68
89-100
46-75
29-63
56
21
100
92-99
69-83
21-96
96
92
, ).

[3, 5, 6, 8, 20, 239, 373].

.
10-61%

(. 11.11) [374].
,
,
. 11.8. , , [ )
, ; ,

214\.
. 11.9. , ,
; ( .. ); -

. 11.10. ,
(
). ( )
. 11.11. ,
, .
( )
. 11.12. , , : (
), ( ) (1). ( )
( .. ); , 0,53, MAC 47 /
, . 8092% [19, 217].

10 [19, 382].

11. ___________________________________________________________________________
215
. 11.13. : .
( ); - , 0,38. ( )

,
6
[8, 102, 382].

-
,

,
0,35-0,53 (. 11.12) [5, 6, 8, 25, 102, 178, 382-385].

,
, ,
0,36 0,53,

(. 11.13) [8, 382,
386, 387].

,

[388, 389].

,
97-99% [384].

.

(-)
()
,

.

,
.

(. 11.14).
, ,
,

. 11.14. ,
.
( ),
, ( .. )

,
[389].
,
-
[239].
,
[239, 390, 391]:
(
,
21
. 11.15. , , ,
; ,

, ,
).

.
.
.
.

.

.

[239, 390, 391]:

;
;
;
.
,
,
,
. 11.16. (). (
) ( .. )

(. 11.15) [392].
, ,
, .

1-2
[393].

[390, 391].
(!)
,
.

.

, 5-6 ,
[393].

.
,

[395-398].
,

5 [391].

(
),
(
) [239].
,

[239, 399].
11.

.

,
, , , ,
, - ,
(. 11.16) [239, 400, 401].

I , ,

.
11
,
[401]. ,
, .
,
II .

[239, 399-401]:
;
() ;
;
;
;
;
;
.
.. . , ,
, 35-75%

, , , , [239].

,

,

,
.

20%, * 80-91%
[239].

,
[239].

()
() [239].

,
,
[239].

,
,
. 11.17. .
,
{ ). ( )
.
,
5
, - , .
,

[239, 402].
,

,

(. 11.17) [403].

[239].

[239].

11 12 ,
- [378].

.
,

. :
, ;
-
;
;

;

;

;
;
;

.

4 - 5
,
2 - 4 [24, 4 0 4 ]. 5 - 6
, - 4 - 5 ,
6 ,

[21, 24, 4 0 4 ].

.

, ,
,
.

,
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;
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;

;

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.

.

,

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,

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.

,

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, .

,

0,42 0,04,

0,64 0,04 [405].

,
.
,
!
,

[239, 406,
407].
, [408]. ,
,

,
.
12.

,
,
- .

( ),
,

[69].

, ,
[69, 71, 409].

, [239,
410].
,
[69, 411].

,
.

[6, 69]:
0 .
1 .
II
.
III .
IV (,
..).

.
70% ,

,
, ,
, [69, 412].

[69,412].

, ,
219
, ,

,
[69, 71].
.
,
[69].

: 20-24
40-49 [71].

[3, 5, 6, 102, 174 412, 413]:
;
;
, ;

-
4-6 ;
. 14-50%
- .

56-82% ,
-
(. 12.1) [412, 413].
.. ,
-
4

[6].

. ..
.

[5]. ..
,

[283]. . . , ,

[26].

[102, 414].

220V
. 12,1. , ,
;
, . ( )
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( )

,

,
,

(. 12.2) [415].

,

[102].

12.
. 69,
XXX 69, XXY,
, 70-90%
,

[102,416-419].

(. 12.3).
[412,418].

.

15% [102,420].

.

,

(
) ,

[69, 174, 283].

,

[411].

(38,5%), (32,7%),
(13,5%), (12%),
(3,3%) [69]. 5-
.

. 5
52,9% ,

68,9%,
78,6%,
89,8%,
100% [69]. . M onclair .
, [421].
5 .
,
, , ,
.
26
. ,
,
^221
. 12.3. : 7 . (
)
,
[422].

[6, 102, 423, 424]:
;
(
20 );

( 5 12 );
-

.
, ,
,
, .
, ,
,
(. 12.4).
, -
,
[6].

[26, 102, 425].

,
0,4 (. 12.5) [26].

[426]. ,
( - ) 70%,

[424].
,
,
,
.
222 .
. 12.4. : ;
,
( ) ( .. );
( )', - ( ). ( )
. 12.5.
: -; 6
( .. );
8 , 0,42, MAC 47 /. (
)
12.

.

,
[69].

[427]. ,

,

[428]. ,

[429].

:
;
;
;
;
;
;
-/2 2 3
;
;
- .

,

,
-
.
, , ,
,
.
,
,
, - .

.

, -
.

, .

.

,
,

[432].
-
.
- (plexus utero-vagynalis),
(plexus vesicalis) (plexus rectalis)
. ,
,
,
, ,
() (plexus
pampiniformis ovarii).

. ,
, ,
,
, .
,
,
-
[1, 430].
,
,
,
[17, 430, 431].

-
, ,
, ,
[432-436].

,

, ,
, , ,
[437, 438].
AJ
,
[432, 438,
439].

[432],

, ,
80% [432, 433, 437, 440-442].

,

[433, 437, 443].

[4, 8, 17, 74, 437, 443].

,
, , 11,5
38% [432, 433, 437, 443, 444].
90%

[445, 446].

, ,
,
. ,

[437, 445-447].

,

.
[432, 433,
437, 448, 449]:

;
;
;

;
13.
. 13.1. ,
, . ( )
;
- ;
.

.

, , ,
[432, 437, 448-455].
-

,
- (. 13.1).

.
,
,
.
225
, 5 [432,
437, 448].
[437],
,
. -

,
.
.

(. 13.2).

(. 13.3).
.. .

(. 13.4) [456]:
I 5 (
);
II % 6-10
,
,
;
III > 10

.
,

,
.

(. 13.5,13.6).

.
, ,

(. 13.7).
. 13.2. , : ;
{ ) , (1)
22
. 13.3. :
, . (
): 1 ; 2 ; ,
, . ( )
. 13.4. , , , 4,3 .
: -^ , I , 5 ; II , 7,5 ;
III , 11
13.
. 13.5. ( ) ,

, .
,
- ,
/2 2 7
..

[437].
,

:
10,4 4 2,9 /,
14,8 2,7,
- 9,1 2,6.

.

, ,

(. 13.8, 13.9) [437].

,
.
,
,
,
.
. 13.6. ( ) : -; 6 . ( )
4+ 35
Single
34Uld
Level K P g l>
.BPQ
84,7
0F0
199.8
ARAB
188.7
'TAD
311.S
HC
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296.7
FL
67.4
AFI
2274
i = 25. i n
. 13.7. : -^ , I ,
; , 25,1 . III ,
. ( )
228V
. 13.8. , ,
, [ )
9 ; 6 4,5 /
. 13.10. : ( ),
; - [ ). (
)
13-
. 13.11. : ;
, . ( ..
.. )

(. 13.10).

.
( 3 )
,
[457].

.
,

50%
[437, 458].
,

, 5 11 ,
,
.
,

(. 13.11). ..
3 ,
,
,

, [437].

, ,
,
,
, ..
. .. .
3,5% ,
69,7%

[432].

, , ,
.
.

2 [25].

- ,
2 .
,

, (. 13.12).

.
,
10 /, ,
. 13.12. .
{ )
, ;
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IP {
), 1 ,
2 3 0 \.
. 13.12.
. 13.13. : , 4,5 /,
1,3 /; - , . ( )
,

[25].

,
(. 13.13).
- (
, , - )

, [25].
,
30 ,

, ,
[6].

,
.
-
,
.
:
,
(. 13.14).
- - , .

, (. 13.15).

,
0,41-0,48 [459, 460].
, -
MAC 0,25-1,9 /,
(. 13.16) [6, 459].

-

"{138, 461-463].
,

[138,461].
13. ________________________________________________________________________ " 2 3 1
. 13.14. - : , ; ,
;
. ( )
. 13.15. -
. ( )

:
;
;
;
;
.
. 13.16. - , 0,31, MAC 33 /. (

.. )

,

(. 13.17).
,

,
.

0

232
. 13.17.
.
; 6 ;
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, ,
.

,

.

.

, -
, ,
, .

,

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- .

, , .

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0,4) [ | ;
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.

,
, .

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. ,
, -
. ,
,
[102].

.
()

,
100 .
[464, 465].

,
[2, 464, 465]:
,
;
;
;
;

;

;

.

(, 1995),

[464]:
;
. ;

( 3-
);
. /;
;

;
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, .. 13-
5 . ,
[69].
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,
,
, ,
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,
[28].
:
1. .
2. :
;
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.
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S, .
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.

3-5 ,
.
,
5-7
(. 14.1) [3].

,
.

,

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.
,

, :
1)
(Cu-7 Gravigard, -200, Multiload-250, Nova-T
.); 2) ( -380,
Multiload-375 .).
234V
. 14.1. , : ( );
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, 2.
,
- ,
,
36 ,
,
,

[464, 465].

,
.
,
,

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. 1 4 .2 .30-
,
5-7 (. 14.3)
[3, 6].

, ,
, ,
32
. [464].

,

( Cu-380 A, Ag, S) (. 14.4).
-
(. 14.5).
,
,
.
Multiload

.

, ,

(. 14.6).
,
. Multiload
,
-
24-29 [464].
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7, 28 22
(. 14.7) [464].
,

,
.
14
. 14.4. Cu-, : { ),
; ( ). ( )
. 14.5. Cu-, .
( )
. 14.6. Multiload,
( )
-

,
Progestasert
- ,
1-1,5 , [4 6 6 ].
3-5
Mirena,
(
), [4 6 7 ].
,

,
[4 6 8 ]. Mirena
,

,
[469, 4 7 0 ].
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.
,
. 14.7. Cu-7 Gravigard, -
236V
. 14.8. Mirena, 2- (
). ( )
,

, (. 14.8) [74].
,
,
(Mirena),

(Mirena, Rico Aurum),

(Rico Aurum) [2, 74,
464, 465, 471, 472].

5
2 [2, 74, 464,471].

.

.
[313,
464, 465]:
;
;
;

.
,

,

,
(
).
13 100 ;
3,5-4 1 M irena
[464, 472, 473].

,
[464, 465,
471]. ,
.

,
.
(. 14.9).

,
[74].
1,3 1 .
,

[464].
,
anteflexio
retroflexio. ,

. ,
[465].
,
( )
,

, ,
.
,

(. 14.10).
, ,
.

(. 14.11).
,
,
,
[474].

,
[74, 475, 476]. ,
,
.

, .
0,5-2%
, 1/3
[464]. ,
50-60% ,
,
II [464, 477]. ,
14.
________________________________________________________________
237
. 14.9. :
, (
). ( ); 6
. ( ); -
(
), . ( )
. 14.10. :
( )-, 6 , ,
. ( )
,

, ,
I
[3, 477, 478].
,
(. 14.12) [3, 74,
478]. ,
,
238\.
. 14.11. , Cu-
. ( ). (
.. )
. 14.12. : -^ . ( ); & I , . ( )
. 14.13. ,
. ( )

(. 14.13) [3, 74].

,

.
,
25
9 , ,
[464].
14
. 14.14. :
, ;
,
; , . (
)

, - ,

,
[479].

2-3 - ,
(. 14.14) [188, 464, 466].
,
,

[32, 188, 313, 466].
,
5 [480, 481].
,

. ,

,
.
, ,
. , ,
, ,

0,5 1 . - 0,2 1 ., ,
,
1,2-1,4%
[482-484].

.

,
() .

,
.
, 5
,
.

,
(. 14.15).

Mirena [464, 468, 473].
- ,
,

,
, [74].
240\.
. 14.15. , 3D
. 14.16. ,
.
, (
)

.
,
1995 .,
:
,
,
[464].
,
,
, ,
.

,
,
,
.
, () ,

:
().
(
).
( ).
.

. ,

. ,

,
[74].

,

.
-
.. ..

[74].

(. 14.16).
-
,
.

:

;

;
;
.

,
.
,

,
.

,
[74].
14-
^241
. 14.17.
:
, . (
); - .
( );
. ( )
,
, ,

, .
, ,
,
, .

,
,
(. 14.17).

.
,
,
, ,
, ,
.
,
.
, ,

. ,

, 42,5-80,5%
48,2-73,1%
[323].
,
14,2% ,
,
,
9,2% [485].
, 20%

.

.
16% , 1'
100% [486]. 1/3 ,
,
[487].

,
,
,
.

.
-

.

,
.
.

,
.
,
, , -

.
20

.

.. 1985 . [488, 489,
490].
(). , ,
.

,
.

,
,
,
.
()
. 15.1 .
, ( Prefuma .)^
.
.. .,

35,1% , - 12,1% [509].
243
15.
15.1.
B.C. ., 1999 [491]

.., 1999 [61]
.., 1999 [503]
Darwish .. Youssef .., 1999 [504]
Lev-Toaff A.S. et al., 2001 [505]
. ., 2001 [26]
Prefuma F. et al., 2002 [506]
Afborzi S. et al., 2003 [508]
, %
95
89
86
92
91
96
-
, %
, %
97
94
84
74
78
93
15.2.
B.C. ., 1999 [491]

.., 1999 [61]
Malinova ., 1999 [492]
Kamel H.S. et al., 2000 [493]
Soares S.R. et al., 2000 [494]
Chittacharoen A. et al., 2000 [495]
, %
, %
87
97
100
84
97
95
100
96
93
94
100
98
83
, %
-
83
94
Bernard J.P. et al., 2001 [496]
86
95
Becker EJ.etal., 2002 [497]
100
90
Mihm L.M. et al., 2002 [498]
97
70
Nanda S. et al., 2002 [499]
95
97
76
100
99
Kazandi M. et al 2003 [500]

Timmerman D. etal, 2003 [501]
T.B., 2003 [502]

[/ I
94
-
, ,
,

10% [26, 61, 507].

, ,

.

, .
()
, ,
. 15.2.
, ,
,
.

. ,
,
.
62
95
/&
:
.
.
.
.
.
.

:
1. .
2. .
3.
( ).
1.
2.
3.
4.
5.
6.

.
, ,

.
. 15.1. (: ): 1
, ; 2
; 3
; 4
. 15.2. registor (: ): 1
, ; 2 ,
; 3
; 4

,

,
.
1. ,
,
3,5
5,0-7,5 .

, .
2. ,
.
3. ,
, .
4.
.
5.
.
6.
37.
7. 20-50 .
.
,
25 .

,
2 ,
2-3
1,5-3
.

,
(. 15.1).

,
.
registor (: )
,
,
:
1. .
2.
.
3. :
, ,

, , .
4. :
, ,
, .
5. .
:
1.
.
2.
.
3. .
4. IIIIV ,

.
5. (
,
, ).
6. .
7. .
8. (
-200 ).
- .

:
15.

.
,
(. 15.2).

,
.
.
.

(1:5000),
, 0,25% ,
.
,

.

-200

.
-200 D -
20 / 20% D -. (
D -) 20% D -

[510].
-200

.
-200
[510].
,
(,
), D -
. D-ra .
, ,
.
D - [510].

, D- L-ra
.
-200.
,
.
.
,

,

.

,
^ 2 4 5

, ,
,

. ,

.
, , ,

30 .

,
,

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,
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.

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,
()
.

.

.

, ,
,

.
.

,

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,

. ,
,
,

;

.
( )
,

.
246V
. 15.3. [510]
,
,
,
anteversio,
, retrover
sio.
.
,
, ,
,

( ,
4). ,
, ,
,
.

, ,
.
,
(. 15.3).

37 ,

.
(. 15.4).

.
. 15.4. :
( ) ; 6
( )
;
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15
/2 4 7
. 15.5. , : ; 6 -
( 4,5 , 4 ); ^
,
; . ( )
. 15.6. : , . ( );
( ). ( ); , . (
); , . ( ):
. 15.7. : [ ), -;
(
)
,
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,
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. 15.8.
-200 [
). ( )
90,

,
.
,
(. 15.6).
,
. ,

1 ,
- .

,
,
(. 15.7).

,

.

(. 15.8)
15.
-/249
. 15.9. : - { ).
( ); ,-
[ ). ( ); - [ ),
. ( ); , ( )
. 15.10. :
. ( ); 6 ^ .
( )
. 15.11. :
( ), . ( ); [ )
. ( )
. 15.12. : a

, 15
; - ,

. ( )

,
.
,

.
,

,

(. 15.9, 15.10). -200
,

(. 15.11).

,
,

.

100%
,
,

.

,

,
(1-3 )
,
.
,

. 15.13. : (
)-, ( ). ( )

.

,
(. 15.12).

.
-
(. 15.13).
.
,

. ,
,
.
.

,
, ,

(1-3 ) .
: 2-3
,
[4]. ,

.
,
,

(. 15.14).
.

, -
.

.
,
,
.

,

,
,
. ,

, - ,
(. 15.15).

,
,
.
,
,
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,

,
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,

.

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-200 .

,
-200
(. 15.17).
I
252V
. 15.14. :
( );
( );
;
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; - ( )
( )
15- ___________________________________________________________________________
253
. 15.15. : , - ,
;

, , . { )
. 15.16.
: a l o , , ;
I , 50%
; II , 50% .
( )
,
.
.
(, ) ,
,
,
.
,
.
.

,
(. 15.18).

.
.
,
254V
. 15.17. I
, -200 { ). ( )

,
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,
( )

,

.

(. 15.20).

.

.
,
, .

,
.
.

.

II ,
,
.
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: ,
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)
15-
. 15.19. ,
. { )
,

.

, ,
, ,
(. 15.21-15.23).

(
). ,
, ,
,
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,

. ,
,
. 15.20. : ( ), . ( ); --^
( ), . ( );
[ ). ( ); - , (
). ( )
25\.
. 15.21. :
( ),
,
;
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.
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. 15.22. : - Y- , . ( );
, . ( )
(
) ,
,
,
(. 15.24).

.
.. .

[511, 512].
,
, ,
,
15-
(. 15.25). 186 ,
,

.

5-10
[61].

,

. ,

,

.
^257
. 15.23. ,
,
. ( )

,

3-5 [26, 61].

,
.
15-30
[61].

.
,
,

, ,
.
,
,
.

,
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,
,
(. 15.27). -200
,
, ,
(. 15.28).
,
,
(. 15.29).
. 15.24. -200
.

. ( )
. 15.25.
,
,
. retroflexio. ( ^
2 5 8 \.
. 15.26. : - ( );
( ); - , ;
. ( )
. 15.27. ( ): , ;
. ( )

-
.
. 15.28.
( ).
. ( )
. 15.29.
( ), -200. ( )
,
.

, 5-7 ,
15-20 , , ,
,

[61].
.

,
-200 ,

.
, (. 15.3).

,
.

15.3.

. 15
-200 ,

,

:
,
+
*
.
+

+

, .
+
.
,
( -
+

, ,
+

.
+

+
+

.
+

+

(
+ .

)
+

.
+

+

,
.+ ;-

.
1 1
19
26oV

,
.
, ,
.

,
.

,
.
, , .
, ,

.
, ,
.

,

.

. 15.30. (1) (2),
: ( ); 6 ( ). ( )
. 15.31. : - ( ), ; (
) ,
. ( )
15
261

.
.
.
.
,
, , ,
,
, .

,
,
, .

,
(. 15.30).

50-150 - . ,

.
79,0%,
75,8%, 100%, .
,
100%,
.
gjf 11,8% [353].
,

,
.
,
(. 15.31).
.

2.

.
,
,
, ,
.
, , 20-37%
,
,
, , , ,
2-4% [61, 513,' 514].
,
, ,
.
, ,
,
,
.
.

,

.
.
:
8
4 . , 40-50
10-15
( ).
[6, 61, 62,
,
515-518].
1.
-
20-30 .

,

. 2-
.
,
,
T04HQM .
retroflexio, , ,

,
.

,
.
. ,
-200, 10-15
.

.

.
,
, ; > 4-5 ,
.
30-40
,
,
,
,

,
. ,

.

.
,
.

,
.
,
.
20 .,
,
.

, ,
, ,
.
4.

,
,
37
.

5-7
. ,
3.
15 ,
, 1-2 .

,

.
,
,
. ,

. , U. Deichert

D egenhardt
10-15 [519, 520].
.
.

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. .

. 1.3. anteversio, anteflexio, :

. 1.4. retoversio, retroflexio, :

. 1.5. anteversio, anteflexio:

7,8 2,6 [15]

Ovarian vessels/suspensory tig.

( > 0,6; > 1,2) ,

, 57,7% [149, 152].

. 4.36. : , , 0,72; , 0,67. ( )

. 4.37. : , , 0,47; , 0,83. ( )

[25, 137, 148].

. 4.57. : 0,20, MAC 30 /; 6 -S

. 4.67. : MAC 68 /, 0,51. ( ); MAC 74 /, 0,61.

. 42,070,4% [183, 184].

. 5.25. , 0,50, MAC 14 /.

[152, 199]. Hatle

.., .., 2002 [203]

F.Ubaldietal., 1998 [234]

A.Kurjak, S.Kupesic, 2000 [217]

[28, 198, 200, 202]. ..

[4-6, 8, 25, 200, 212, 217,

12,7 / ( 29,8 2,1

86-97,1% [261, 289, 290].

. 9.22. . : 0,44, MAC 52 /. (

() [3-6, 8, 74, 102, 325-327]:

. 10.50. : 0,67; 0,60. ( )

, . 8092% [19, 217].

. 12.2. I : , ; , 0,32, MAC 37 /.

13. ________________________________________________________________________ " 2 3 1

. 13.16. - , 0,31, MAC 33 /. (

. 14.7. Cu-7 Gravigard, -

B.C. ., 1999 [491]

B.C. ., 1999 [491]

Bernard J.P. et al., 2001 [496]

Becker EJ.etal., 2002 [497]

Mihm L.M. et al., 2002 [498]

Nanda S. et al., 2002 [499]

Kazandi M. et al 2003 [500]

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19 2 .P au er H.U., V iereck V., B urfeind P. et al. U terin e cervical

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242. Fedele L D o rta ., B o rru to F. et al. T ransrectal u ltra so

246 .A d am sb au m ., M etsdagh P., A n d re . et al. C ystic ovarian

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