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.., .., ..

(, , )

. , 2011

1.
2. -
3.
4.
5. -
6.
7. -
8.
9.
10.
10.1.
10.2.
10.3.
10.4.
11.
12.
12.1.
12.1.1.
12.1.2. -
12.1.3.
12.1.4. -
12.1.5.
12.1.6.
12.2. 12-
12.2.1.
12.2.2.
12.2.3.
12.2.4.
12.2.5.
12.3.
12.3.1.
12.3.2.
12.4.
12.4.1.
12.4.2.
12.4.3.
12.4.4.
12.4.5.
12.4.6.
12.4.7.
12.5.
12.6. -

..
(1955) ,
- ()
, ,
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.
,

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.
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4

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.
: ,
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.

5
1. -

-
,
(r W., Peterson W.L., 1997; Aabakken S., 2001; Karanicolas P.J. et oth., 2008;
Neu B. et al. 2005).
, ,
(. 1 2).
,
.
. 1.

. 2.

3 :

1) ;
2) (per diapedesum)
;
3) .
( 98%)
. (.3).

6

,
.
.
,
,
.




<100 / 120 (
> >100
/

- )


7
.3

,
, ,
.

.
, .
,

, .
-
(, , 12- ) (,
),

.
.
(.. NaLly, 1998; B.S.Lewis, 1995; May A. et al. 2005; Karanicolas P.J.
et al. 2008),

.
.
. ..
(2001) 9%
.
, , 300
[Lichtenstein D.R., Berman M.D., Waife M.M., 1997].

8
48 144 100 000
(Matthews J.B., Silen W. 1997).
2.
200 .
,
. (.. ,
1955; .. , 1991; .. , 2001; Lichtenstein D.R., Berman M.D.,
Walfe M.M., 1997) 55 87%
.
3 (. 4).
( ) 9-11%
. ,
,
1-3%.

(100%)



(55-87%) (15-44%) (1-3%)

. 4.

,
, ,
.

9
, ,
4 (. 1).
. 1.

/ 100%
. 84%
1. 55%
2. 15%
3. 10%
4. 5%
5. - 3%
6. 2%

. 15%
1.
2.
3.
4.
5. ( -)
6. ( )
7.
8.
9. -
10.
11.
12.
13.
14.
. 1%

1.
2.
3.
4. : , , ,
5.
6.
7.
8.
9.
10.
11. -
12. --
13. - ()
14. -
15. -
16.
10
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27. ( , ..)
28.
29. ,
30.
V.
1.
2.
3.

12- ,
,
, ,
. .
4,2-16%
[.. ., 1987; .. , 1991; .. ., 2005].
,
, ,
[.. ,
1960; .. ., 1983; L. Cipolletta et al. 2001]. ..
. (1983),
13,6%, 30,9% 55,5%.
,
( 50%
),
[..

11
, 1955; .. , 1960; .. , 1991].
- [.. , 1982;
.. , .. , 1984; Y. Leontiadis et al. 2005].
,
[.. ., 1987].
6
, . 41,2%
, 58,8% - 12- (.. , .. ,
1985).
,

Helicobacter pylori. ,
, ,
.
(,
..) .
, .
, .
, ,
, , ( )
(. 2.).
. 2. ,
( .. ., 1987)

/

12
1. , 23
2. 5
3. 10
4. 8
5. 2
6. 11
7. 15
8. 5
9. 4
10. 17
11. , 1

103

(. 1.).

(.3.),
, (.. , 1969; S.
Palmer, 1980; .. , 1991).
. 3.
(.. , 2001)
1.
2. :





3.
4.
5.
6.
7.
8.
9.

13
10.


,
,
(.. , 1991).
,
. ,
,
.
. 2/3
(H. Eder, H.I. Yastrup, 1971)
, 25% - .
, ,
.
, ,
, , .
, 10%
(.. , 1991),
21% .
, ,
, ,

(, , ,
). , 0,5-9%
(.. , .. , .. , 1987), 1/3 -
.

14
.
,
,
.

(.. .,
1977).

() ,
. , , ,
,
.

/



15
. 5.

, , -
(. 5.).
[Y. Lord, 1970; .. , 1991; Bracy
W, Peterson W.L., 1997 .] , ,
- ,
.
5-6 , ,
. , ,
,
.
,
, 3 :
1.
;
2. - ;
3. ,


-
-. , ,

. (. 6.).
,
,
.
16
,
.

. 6. -




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

17

2 15% [..
., 2001; .. , 2001; McDermott W., 1984]
(, , )
. ,
, , ,
.
6,2 12% ,
.
,
.
. ,
15,3-34% [
.. ., 1979; .., .., 1980]. ,

,
.
[.. 1991] ,
,
,
.
,
,

.
270 100000 7,5%
[.. ., 1987; ..
., 2001].
18

, ,
, ,
.
, .
, ,
, .

.

,
( , ,
).
.
,
.
3
[.. , 1991] .7) 1).; 2);
3) .

;
;

19
.

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.
,
.
, .
,
,

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-,
,
.
, .
(),

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.
,
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20
,
, ,
: , ,
- .
,
.

[.. , 1974,
.. , 1991, I. Rivers, L. Wilbur, 1963, J.B. Mattehew, W. Silen, 1997].
, 6-8

, ,
-. [ .., 2001; Bracy W., Peterson W.L., 1997].
()
- ( )
,
(, , , ..) [.. , ..
, 1996; .. , 1999]. ,
,
,
purpura abdominalis.

( purpura)
, 5% , .
,
. ,

,
21
.
() ,
.
: ,
, , ,
(. Cornero , 1984). -
,
, , .
,
,
(.. , 2001), ,
, .
, ( --)
.
,
,
[S Roby et al., 1981]. ,
,
.
.
per diapedesum.

, .
,
,
. ,
, ,
.
22
. ,
,
. Veyraide et al (1999),
, (-)
,
,
,
.
,
, .
( --)
() ,
.
.
, .
- .
1 , 40%
, , 9
g33-g34. 1,
12 g13 2 [58, 62,
63]. 5 , 3.
D 4 ( SD 4),
4.
,
, .

.

23
.
,

.
() ,
. [ .., .. 2001],
, ,
. (, , ,
, , )
,
- , ,
.
,
, .
, ,
-, - .
2 50 .
- -
,
,
.
-,
.
16-62% [.. , .. ,
.. , .. , 2001].
, ,
.

24

.
GAVE
,
.
, - .
.
.
- ,
, (), (), ,
.
,

.
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.
, , ,
.


.
,
(.. , 2001).
.
.
. , ,
, ,
3500 .
25
30 , .

, ,
,
.
30%
.
,
,
10% . .. , .. , ..
(1987) , 62,7% .
,
.
,
, .
, ,
, - ,
, , -
. 80% .
, 15% ,
, 1%, - ,
.

26
3.

,
, .
, , ,
,
. ,
, 2 :
, ,
,
.
,
,
(.1).
4 :
1. (-, ,
, ) ( ,
,
, ) ;
2. (
, , );
27
3.
(, ..);
4. .
, 55-75%
, -
,
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.

, .
l
, . ,
l
, .
l
, , [ .., 1981; .. .,
1982]. + ,

. , ,
[ .., 1983] -
.
, l,
,
[ .., ..,
1970; .., .., .., . 1981].
,
24 .

28
,
.

.pylory,
,
l
.

,
.
,
.
.
,


,
.
[ .., 2001]:
,
.

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.
,
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.
29
.
, ,
, . ,
,
.
.
,
. ,
,
,
.
[.. ,
2001].
,

[ .., .., .., 2007].
. ,
500,0 , 15%
, ,
, .

()
.
15%
,
.
(. 4). ( 25-45
70 ) 42,0 . 7 .,
30
3,2 ( ).
,
1 36 40 (hn J.N., Yulha N.H.,
Broden M.I. t al., 1977).
. 4. ( 70 )
(P.L. Marino, 1996).
%
23,0 55
8,4 20
6,3 15
3,2 7,5
1,1 2,5
42 100%

,
. - 35% ,
4% (P.L. Marino, 1996).
.
750,0-1500,0
(. 8). -
15-25%.

,
10-100 3-4 .

.
, , ,
.
31

, ,
, .

.
.
,

.

2
> 750 ml


,

,



Na ,



10-100
3-4

,


(, ,
.)


,

32
. 8.

, .
.
,
.
,
, . ,

( ). ,
. ,
, ,

( .., ..,
1995). , , 25% ,

.

1500,0 (
25% ), (. 9).

,
,
.

, ,

33

.
:
- .
,
, .

, 1,5 .

Exitus

. 9. (>1,5 )

34

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- (
).

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,
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35

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4. -

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,

,
. ,
. 10
Fe 5 .
1,5-2,5
. ( - 1 /, 2
/) , , ,
, mensis. Fe
(. 10)
.
( 8,95-28,64 /, 7,16-26,85 /)
, 4
. , Fe
10 .
( 0,5 2,0
), ,

36

, , , .
(70%)
, 15-25% ,
Fe. (8%) ,
(, )
.


1,5-3,0 (70%)

,

,

0,3-0,4 (8%)

,
,
12-25
/ 12-15
/



80-180 /

:

1 /

2 /
2-3 /

Fe

0,5-1,2 (20-30%)

. 10

37
,
, , ,
, ,
.
, ,
,
.
Fe, .
,
,
400-500 / ( 20-350, 10-150 /)
10 000 /.
, (. 11),
.
, ,

, (, , ,
),
.
, , ,
[.. , .. , 2001].
,
,
.
,
,
.

38
,
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.
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,
,

,
.



Fe

Fe , , ,



39 (,
,
.)
. 11

5. -
:
,
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4 :
- ;
- ;
- ;
- ,
.

,
, , .

,
,
. ,
, .
2 :
() .
,
(haematemesia),

40
(malena haemateshesia) ,
.

:
. .
, , 500,0 , ,
,
.
750,0 ,
.
, , ,
, , .

. .

, ,
. (12-16%)
.
.
,
, 20 ./.
(10-15%) ,
(.5)
. 5.


1- 10-20% , 90 ./;
>110 . .

41
0,54-0,78
150-120/
5 3,5 1012/
t 44 38,5
15%
50 60 /
2- 21-30% , 90-100 ./.
, 110-80 .
, , .
0,78-1,37
120-100 /
3,5-3,0 1012/
( t 38-32%
15-25%
, 40-50 /
)
3- 31-40% , 110-120 ./.
, 80-70 . .
, 1,38-1,5
100-80 /
2,5-2,0 1012/
t 32-22%
25-35%
30-40 /
4- 41-70% , >120 ./.
, 70 . .
>1,5
80 /
2 1012/
t 22%
35%

42
30 /


. 1,5 2,5
, .
. 120 ./.,
70 .. (),

, 1,38-1,5 ( 0,4-0,6).
80 /, ,

( ).
.

(),
31-40%.
, , ,
. 30
/, ,
(. 9)
-.
, ,
- .

[.. , .. , 2005].
,
. 3-5 ,
, 6-7 .
43
2 . , 40%
, ,
.
. ,
120 ./, <70 ..
35%. ,
,
- .
.
, ,
, ,
. ,
,
[.. , 1978],
:
-
-
-
-
, [MeNally P.R., 1999] ,
,
.
, ..
,
. ,
. , ,
62%
, .
44
, ,
.
52% [.. ,
1992]. ,
.
, ,
,
.
.
,

, .
100 , -
, . ,
- , ,
.

, (
1-2 ), .
5 , ,
( ) [..
, 1992].

,

. ,
. , , - ,
.
45
(, , )
, 100 / .
6-24 . ,
, ,

. ,
.
1000 1-2 ,
3-4 .
, (),
, 1-2 .


- () ,
,
.
,
,
.

46
6. -

-
,
.
.
40
/ .
, ,
7%,

80 /.
3
(.6): , ,
, ,
.6.

1. 1.
( ) 2., , ,

3.
4. ,

47
5.
6. ,
2. 1. ,
() 2.
3. ,
. .
.
4.

3. 1.
2.

3.

[.. , .. , .. , .. ,
2004]. -
, - .
, ,
, , .
-
( ), ,
, , .
.
,
, .
, .
, , ,
, . ,
. ,

48
, , .
1-2 - .
, ,
, ,
50 /,- .
, , ,
(
)

.

49
7. -
, ,
.
: -, , -
, , -,
(.. , 2001; .. , 2001).

, .

,
.
,
,
, .

,
,
,
(, ) .

,
50
( ,
, , , ,
).
,
.
,
.
, ,
, ,
,
,
, , , .
(1-3 )
, (
, ) -
.

. ,
, 150 .
,
.

. ,

. ,
55%
( )
.
51
1-2, , ,
4-5 , ..
. (.. , 1991; .R. Me Nally, 1999).

, .
,
, ,
(-, , ).
(
) (
, ).
, ,
100 ,
.
( ), ,
15 /. -
3
,
. ,
.
( ),
30 /.

.. .. (1982).
7-14
(P.R.
McNally, 1999).

52

( )
0,5%
200,0 500,0 . 10%
.
,
.

.
,
.
,
, .
, ,
.
92-
98% [.. , 2001, J.E. de Vries,2006].
,
,
, .
.

. ,

[M. Appleyard, A. Ylukonovsky et al. 2000]. -
.

:
53
(),

.
, 80-95%
[.. , 2001; .. , .. , ..
, 1987, J.E. de Vries,2006, J.Y. Lan, J.Y. Sung, Y. Lam a.otn., 1999]
.

.

.
. ( <100
..)
(
) [.. , .. , .. ., 2002].

, ,
. , ,
, ,

.

,

.
( ),
,

54
,
[.. , .. , .. ., 2001].
- :
- , ,
;
- ;
- ;
-
;
-
[.. , .. ,
.. , 2005].

[.. , ..
, .. , 2002].
2%
. ,
.

, .

.
,
.

.

NaCl,
55

.
.

,

4 ,
.
, .. .

. ,
,

[.. , .. , .. , , 2002].


.
, ,

-.
()

Forrest (. 7)

.7
Forrest.
%

56


Forrest 1 Forrest 1a 100%

Forrest 1B
80-85%

Forrest 2 Forrest 2a
50%
,

Forrest 2B -
40%

Forrest 2C
- 5%
-

Forrest 3
- 1-2%


,
( 1).

57
. ,
, .

,
.
,

.
,
-
.
- ,
. ,
[.. , .. , .. ,
2002]. .
, .
,
,
.

-
. ,
.
.
-
. ,
,
5-8 , 1 5 . .
58
, - .
.
,
, .
,

.
(, , ). 200,0
1500 .
1-1,5 6-7 .

.
,
.
, ..
10-12%
[.. , .. , .. ., 1985].

(, , ,
).
-

.
,
.


[.. , .. ., 2001].
59

7,2-12 -
12-20 .
.
200-400 ,
.
.
, ,
.
, , ,
.

.

, .
,

.


, .

, , [.. , ..
, .. , 1987, .. , 2001], 2-8%
.
( ,
, ).
,
60
( , ,
..), ,
. ,
,
.

,
,
,
[.. , .. , .. ,
1987, King D.K.,1982].
:
, (131J)
(99mTc). 1-2

,
.
, .
,
,
.

.

,
. . Rioll et al.,
(2004), J.E. de Vries (2006)
.
61

,
.

,
, ( 2).
Nally P.R. (1997)
(. 8).
. 8
( Nlly P.R. 1977)

I.
- ,
-
-
-
-
-
-
II.
- ,
-
50 50
- -
-
-


,
[Leitman I.M. (1989)], [2007
by the AGA Institute].
()
3 .

62

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

.
, ,
250
. [Lewis, Swain, 2002;
Mylonaki et al., 2003; Alder et al., 2004; Nou et al., 2005]
25-
38%.
()


41 80% [May et
al., 2005; Di Caro et al., 2005; Nakamura et al., 2006].
Yamamoto et al., 2001 .
, 200
1,5 ( 140 , 12 ).
,
.
, (45
..),
.
. ,
63
: 240 100 360 177 [Mahdiraden S.,
Ross A., Gerson L. 2006] pus-and-pull , ..
.

.

[Yamamoto et al., 2004; May et al. 2005; Matsumoto et al. 2005; Nakamura et al.
2000] 14 86% .
, (0,3%).
72,323
. 75 28 ., [May et al. 2005] 9541 . 102 38 .
,.
45% 86%
(Yamamoto et al., 2004) - .
.
2 .
,

. ,
5 30%
- ,
,

( )
.
50%
.

64
,
,
, .
,
.
()

, -
,
,
.
(3) 1126
, , , 2
, [Meron G.D., 2008].

, .

, ,
. ,

, , .

.
;
, .

. .
,
65
[Paveras G., Pigueras J., Moreno V.J. et
al. 2005; Leighton J.A., Sharma V.K., Srivathsan K. et al. 2004]
[106]. ,
, ,
,
.

8 - 2 .
57600 .
.
15
. 57600 64
.
.

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

,
, ,
, ,
,
.
66
1400 723 ,
65%
[2007, by the AGA Institute]. 10

,
(.9), 2
63%.
. 9. ()
() [2007 by the AGA Institute]
, -


, % , %
, %
Lewis, Swain, 2002 21 6 (30) 11 (55) 6 (30) 25
Ell et al, 2002 32 9 (28) 21 (66) 6 (19) 38
Mylonaki et al, 2003 50 16 (32) 38 (76) 44
Saurin et al, 2003 28 , 3 (3) 21 (35) 19 (32) 32
32
Hartman et al, 2003 33 7 (21) 25 (76) 31 (94) 55
Adler et al, 2004 20 5 (25) 14 (70) 45
Mata et al, 2004 26 , 8 (19) 31 (74) 8 (19) 55
16
Ge et al, 2004 32 9 (25) 21 (66) 9 (25) 41
Pennasio et al, 2004 34 , 15 (29) 30 (59) 12 (24) 30
17
Neu et al, 2005 37 , 15 (38) 38 (68) 30
19
397 93 (23) 250 (63) 39,5



[. linical Gastronterology and Hepatology.
2008. - 1, V.1. . 70-81]:


.
67
, .

. , ,
, .
, ,
.

(.10).
. 10 ,


/
1. b / 130-160
120-140
2. RBC / 4,0-5,01012
( 3,9-4,71012
)
3. 0,85-1,05
4. t 0,40-0,48
0,36-0,42
5. V () 80-94
6. b 26-34
()
7. RDW % 11,5-14,5
8. % 0
9. % 0,2-1
10. / 180-320109/
11. Fe / 12,5-30,4

12. / 0,8-1,3
(
)
13. / 60-150
14. / 80-180
15. / 18-89


,
68
. ,

.
,
.
.
,
( ). ,
5 .
. ,

,
.
.
,
, 1 , ,
-
, ,

. ,
, -
, ,
.


, , ,
, Fe. -,
, 12,5-
69
30,4 /. Fe
, ,
.
, , , .. ,
,
. 15-20 % Fe .
, .. ,
, , Fe
,
.
. 10 /
, 400-500 /
.
10 000 /. ,
,
[ .. ., 2003].

. ,
, ,
,
, Fe .
,
Fe [ .. ., 2004].
, ,
( 30-85
/) (
20-55%).
Fe,
70
.
,
, 0,8-1,3 / 0
.
, ,
4 (. 11).
. 11. (.
, . , 2004)

119-91 90-71 70-51 < 51


/
% 6-15 16-30 31-45 45

% 6-15 16-30 31-45 45


% 1-5 6-15 16-24 24

78-80 66-75 56-65 < 56-42


(V)

30-31,5 29-30 28,5-29 < 28,5

()

10,5-12,5 8,5-10,4 6,5-8,4 < 6,5


/
10-12 7-9 4-6 <4
/

71
8.

,
,
: .

, (, ,
) .

.

, ..
.
,
. ,
. ,
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,
:
72
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,
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73
(10-15 .)
,
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, .
30-40 .
, .
:
,

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.
.
, .
, ,
.


, .
, ,
. ,
.
.

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

74


.
.

,
,
NaCl 0,5%
.
, ,
( ,
, ,
),
. , ,

,
, , .
,
. 12.
. 12
(.., 1999)

1
2 , -,
,

3
4


75

5 .
,
.


6

7 , ,
,

,

,
.
,
,
. 4,

.
,
.
,

[
(G), 2007].

,
,
(

76
).
[Leighton J.A., Goldstein J., Hirota W.,
et al. 2003].
, .
( , )

.

,
(. 13).
. 13 -
( .2007)


40





40









, ,
77
,
.

: ,
.

.

.

, 5% .

.
( ) ,
,
, , .

, , , ,
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.
,
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.
,

2-5 ,
78
,
.
.
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,
.

: ;
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-
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,

(. ). ,
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, .

,
.

,
79
().
( ,
, ) -
.
.
,
, - , ,
,
, ,
, .


( ).

. ,
12% [AGA, 2007:46,48,49].

,
[Siegel L.M., Stevens P.D., Lightdale C.J. et
al. 1997].

, 5%
[Thompson J.N., Hemingway A.P., Mc Pherson G.A. et al.
1984]. ,
.
,
, ,
,
80
[Ott D.J., Chen Y.M., Gelfand D.W. et al. 1985; Saurin J.C., Delvaux M.,
Gaudin J.L. et al. 2003].
,
,
.
-
,
.

.
, -
70-100% ,
[Voderhdzer W.A., Ortner M., Rogalla P. et al. 2003].
99m
, ..
[Howarth D.M., Tang K., Lees W. 2002].
-
[Bloomfeld R.S., Smith T.P., Schneider A.M., Rockey D.C., 2000; Shetrline
M.A., Suhocki P., Dash R., Rockey D.C., 2000].

.
1349
70% [Jacob P. ., 2005; De Looze ., 2005; Neu B.
., 2005; Leighton J.A., Sharma V.K., Hentz J.Y. et al. 2006]. 90%
,
.
,

81
.

60 .
<10%.

,
,
.
,
, .
,
, .
.
,
[Albert J., Gobel C.M., Lesske J. et al. 2004],
,
, ,
[Ben-
Soussan E., Savoge G., Antonietti M. et al. 2005; Scwarzberg M.N. 2005].
,
, .

[May A., Nachbar L., Ell C. 2005].

,
, 360177

182165
82
. 2 , .. 45%
[May A., Nachbar L., Ell C. 2005] 86% [Yamamoto et al, 2001]
, .
5 30% [Di Caro S., May A., Heine D.G. et
al. 2005]. ,
,
80%. -.
, ..
.
, 6 ,
.
2 ,
20%
, 28%. ,
, ,
[May A ., 2005; ].

.
,
,
, 1653 .
4264
[Goldfarl et al, 159].
G (2007)

.
,

83
, -.
, .20

. 20

,
,
.


84


9. -
,
. -10
. , ,
, .92,2 (578,9) -

. .625 (569,3)
.

(.., 2001),
14.
. 14 -
1. :
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) ( )
2. :
) ()
)
3. :
) ()
) ()
85
4. :
)
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5. :
)
)
6. :
)
)
)
7. :
)
) ().


. ,
,
.
...
. 15 ( .. 1998)
(, )
(, )
(, )
(>7% )
(5-7% )
(<5% )
(0,5-10% 0,5)
(11-20% 0,5-1)
(21-40% 1-2)
(41-70% 2-3,5)
(>70% 3,5)
86
( 10-20%, 30%,
)
- ( 21-30%, 30-45%,
)
( 31-40%, 46-60%,
)
( 40%,
60%, , )



(.16).
.16
(. .L.Marino, 1998)

(%)
I 15
II 20-25
III 30-40
,
IV , 40
, 4
( ) .
,

20 ./. 15%.
20-25%. .
15
... .
.

87
30 40%.
, ( 400 ./.)

, .
40%.


.

,
,
, (.17)
.17
-
60



:
,






:


88
:
, ,
, .
,
60 ,
,
(.18).
.18
( F.Silverstein et al., 1996)
, %
10,8
:
32,7
7,1
:
10,1
29,9
:
0 2,6
1 6,5
2 9,9
3 14,6
4 27,0
5 44,1
6 66,7
:
60 8,7
60 13,4
:
0 2,5
1-3 6,7
4-6 11,7
10 34,2

:
, , 6
89
, 8,2
19,1
12,3
19,4
28,7


.
.19
, % ( F. Silverstein et al., 1996)

60 30
50 12
26 6
22 4
11 7
- 6 3

-
6%, 3%,
60 30%.
.. Rockall, R.F.A. Logan, H.B. Delvin (1996)
(.20 )
. 20 (.. Rockall et al., 1996)

0 1 2 3
< 60 60 79 80 -


. 100 . < 100
. 100 . .
. 100 < 100
< 100 /. /.
/.
- -

90
,



-
, -





,
- -


:
1). = 6
2). = 11

, 11
, 2007

- (
. 2008. - 5 (18) . 135-141).

.

(.21)
.21




65 1,3
91
70 2,3
(. < 100 . ..) 1,2-3,65
(S) 1,94-7,63
1,6-7,63
3,21 (1,53-6,74)
3,14 (2,4-4,12)


< 100 / <0,3 0,8-2,99
( ) 1,96 (1,46-2,64)

1,6 (1,1-2,4)
3,76 (2,26-6,26)
1,1-11,5
1,2-5,7

2,5-6,48
1,91-4,81
1,72-1,9
> 2 2,29-3,54
2,7 (1,2-4,9)

2,79
13,9
9,2
1969 2000
,
.

(.22)
. 22



60-69 3,5 (1,5-4,7)
75 4,5-12,7
80 5,7 (2,9-10,2)
(. < 100 . ..) 1,18-6,4
(S) 2,6-9,52
1,19-12,1
5,29-76,23

92
0,43-18,9
2,0 (1,1-3,5)
2,95 (1,29-6,76)
2,77 (1,64-4,66)

5,5-18
> 150 / 14,8 (2,6-83,5)
4,2-20,2
5,4 (1,5-19,6)


10.

,
,
.. .


,
,
[.. , 2001; ..
, .. , 2007].
2 :
.
1. ,
:
- ,
- (- , ,
, ),
- ( ),
- ( ).
2. , :
93
- (- ,
, , , ),
- (, ,
),
- .
3. - :
- , ,
- ().
. (
)
1. ,
2. , .

.


, , ,
. ,
,
8 20%, ,
( ).
, .
(
, )
( )
2-4% (..
, 2001).

94
,
,
30% 2-4%,
0,2% [ national clinical guideline 2008; Scotland, Khan S., Gudur
S.C., Sutton R., 2006, Kahi C.J., Jengen D.M., Sung J.Y. et al. 2005 ].
10.1.
, (65-80%)
() [..
, 2001; Lichtenstein D.R., Berman M.D., Walfe M.M., 1997]
.
,
.

, , ,

.

. ,
10%,
(.23) .
, /
1-5% 100 / .
4 , 15,0 .
. 23

/
.
1. 100,0 / 100
(1 = 50 /,
4
95
) ,
15 /




2. 50 (1 50-100 / /,
(, ) -/- = 10 100 /, 1-2
), . . 3-4
0,25
3. 50 (1 = 10-15 /,
(, , -/- 10 ), 8
) . 0,25 , 4-6 . 2-
3
.
1. . 1,0 / 1,0 1
(, ) (15 ) . 2
. 0,015

2. . 10 % - / 10,0-15,0
10


3. () . 2.0 /, / 2,0
(1 = 125
)
. 0,25
4. () 60, / 4,5 /
120, 240 ,

,
2, 4, 8 ..

2-3



.
1. . 200,0 /
200,0-1200,0




2. 15,0 / 3-4
(1 ) .
NaCl

96


IV.
1. 40 / 80
: , ,
. 8
(, , /
, .) 72
. 2 - . 20 20
-/- 2
(, )
2. . 0,1 / / 100
(, ) L (0,05-0,1) ,
, 25-30 /
0,9 %
NaCl
, 3 .


(,
, ) 15 / Nacl.
8 .
(, )
50-100 / / 100 /. 12,5%
() 125-250 /
.

(, , ),
/ 150-300 .
8 . ,
.
(, ) ,
(/ 1,0 ). /
(1%-200,0 10%-10,0 )
97
.
(),
VII.
I
I ,
.
, V VIII ,
.
.
/ 90 (4,5 ) .
2-3 ,
4, 6, 8 12 2-3 .
,
.

1,5 ,
,
.
(),
13 [.. , 2005].
370 /
200,0 1200 . ,
,
2000,0 . 600,0-800,0 ,
6-8 300-400 .
, / 3-4
0,9% NaCl.

98
. ,
.
.

.
- ,
.
3 500,0 .

- -,
-.
[J.A. Collins, 1980; .. , 2001].

. -
I. , -

, ,
. 4,0
[.. ,
.. , 2007; .. , 2004; .. , .. , ..
, .. , 2005; .N. Bardon, J.M. Marshall, 1999; J.S. Hiramoto,
2003].
I
2 :
1. 2- ()
2. (, , ,
, )

99

2-
/ 40 20
12 72 .
J.A. Collins Langman (1985) (.24),
2- ,
.24 -
(
, 2007)
-

J.A. Collins 2-
Langman, 27 0,89 () 0,78 0,7
1985
Selby ., 17 2-
2000 3
1 0,727 0,707 1,14 ()
Levin ., - 2- -7% (-0,7% 6,7% (-0,7% 3,2%
2002 13,7%) 12,8%)
Gisbert 11 2- 0,4 0,7 () 0,69 ()
., 2001
Zed ., 2-
2001 9 0,5 0,47 0,92 ()

Imperial
Birgisson,
1997 14 2- 0,53 0,71


Bardou -15,6% -6,1% -2,8
., 2003
2- -20,2% -0,3% () -1,9% ()
25
2- -11,1% -11,8% 5,3% ()

10%, 20% 30% .


, Selby . (2000) 3566
100
(7,2, 6,7 3,2% ),
, Bardon . (2003), ,
2-
.
(2007)
2-
- .
-3,0,
8 12 .
2-

( + / + - ), 6,0-7,0
24 ,
() 46 .
( 1, 1, 2, 2) /
80 30 ., 8 / 72
. ,
40 1-2
20 . (F 2, 3)
.
(2007)

.
4 ,


2- , ,
[ . 2005; J.J. Sung, ,
101
2009]. Sung . (2005), 156
(
), ,
/
. .., .. (2007) ,

2,5-3,1 . Leontiadis Y.F., Sharma
V.K., Howden C.W. (2005) -
,

.
,

,
.
,

,

. ..
[Aubert R.E., Epstein
R.S., Geagarden J.B. et al. 2008; .., .., ..
, 2010].

, , ,
(, ,
) ,
.
102
,
. ,
,
.
,
. Lin . (1995) / 100 ,
25 / 1,40,6 .
83,3% , ,
/ 100 12 (54,8%).
Imperiale G., Birigisson S. (1997)
(n =1829), ,
47%, 52%.
S. Jenkins . (1998)
,
, .

(),

.
3,5 / 500,0 0,9
- NaCl, , 100
8 48 .
,
,
.

,
[Abgerinos A., 1998].
103

[Jenkins S et al 1997],

, 6
. ,
,

- [DAmico G., Politi F.,
Morabito A., et al., 1998; Sadowski D., 1997].
,
, .

20
200,0 5% .
5-10 /.
, .


, co [Blich
M., Fruchter O., Edelstein S. et al., 2003; Gonzalez D., Elizondo B.J., Haslag S. et al.
2001].
Helicobacter pylori

- . .. (2001),
Lichtenstein D.R., Berman .D., Walfe M.M. (1997) ,

Helicobacter pylori
, ..
104

46 30%
.
[Schilling D., Demel A., Nusse J. ., 2003;
Udd M., Miettinen P., Palma A. c c., 2003] ,
Helicobacter pylori
.

-
(2007) .
Hlicobacter ylori


. Hlicobacter ylori,


.
Hlicobacter ylori. , ,
.
,
85-90% . 10-15%

.
.
10.2.

:
1. :
105
1) (- )
2) ()
3) (, )
4) ( )
2. ( )
3.

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

, .

, .
, ..
[ .. ,2002].
, ,

( 4), ,
, ,
, .
, .
.

106
,

.
.

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

, 0,001% - , 0,5% , 70% 90%
1% .
(.12)
3 50 .
: 3% - 5% , , , ,
, 1% (.25).

.25 ,
[ .. ,2002].


()
()
()
1:10000 2 8-10
(0,001:%)
0,9% NaCl 5-10 50-300

107

0,25- 5-10 50-300
0,5%
98% , 0,1 0,6-1,0 1

1% , 1 3-5 5

, 3 10-15 ? ?

, ,
, .
. 2 1
8-10 NaCl, 0,5% -
(5-10
50 300 )
.
.
0,1-0,2
98%, .
,
, . 60
, 2 ,
70 / .

3% , 5% -
(), , 96% . 0,5-1,0

.
108
, .
10-15 .
2 4 . 3
,
. ,

[ .., 2001].
,
.

.

.
[ .., .., .., 2001]

.
.

.
, .

.

. .
.
,
,
.
109


.
, ..
.
.
, .
,
.
( 5 5),
, , .

.
Hayashi .
1975 .
( 6),

. EZ-clip ( )
,
, .

( 7), . ,

, [ .., 2007].

. EZ-clip
8 16 .

110
,
,
.
-

, ,
[ .., ..,
.. ., 2001; .., .., .., 2007].
, (-6, -7, -8).
13,3-17%
. ,
. ..,
(2007)

.
[Jacke S. et al., 2001; Chalosani N. et al.,
2003; DAmico G. et al., 2003]
,
.
11 36%.
(),
,
[Krige et al., 2006].
.. . (2004), .. . (2008)
,
5 . .. . (2008),
,

111
.. . (2008),
.
10.3.

, .
,
0,5 /. ,
.
.

( ),

.
[DOthel B.J.,
Surapaneni P., Rabkin et al., 2006; Ljungdahl M., Eriksson L.G., Nyman R.,
Gustavsson S., 2002]. ( 6.) ,

.
.


( minicoins - )

[.. , 2008; Silver A.,
Bendick P., Wasvary H. 2005; Keeling W.B., Armstrong P.A., Stone P.A. et al.,
2006; Ljungdahl M Eriksson L.G., Nyman R., et al., 2002].
80%-98% [Carreira J.M.,
Reyes R., Pulido-Duque J.M., et al. 1999; Defreyne L., Vanlangenhove P., De Vos
112
M., et al. 2001; DOthel B.J., Surapaneni P., Rabkin et al., 2006],

.
Karanicolas H.J. . (2008)

50% , 5%
. Tan
K.K., Wong D.,Sim R. (2008)
,
63% , 34%
3%
.

, (30%
70% - )
.



6 12 1 3.

, 60-110
. . .

,
,

.
113
140-160 ..
.

.
64-81%,
71,6% 23-31% [ .., .., .. .,
2007; .., .., .. ., 2007].

.. (2001) . ,
2- ,
,
( )

.

, ,
. 1-2
.
1-2 .


.
, ..
.

. ,

114
.
.

(, , , ),
, ,
.


.
, ,
.

,
1-2 ,
.



,
.

, (, ,
, , .)
(.25 .107).
. ,
,
,

115
, [.., .., 2007,
.. .2008].
.. (2001) ,
,
0,5 ,
2
2 .

(2008)
,
.
,
,
,

. ,
,

,
.

10.4.

. ,
.
.
(17%) .

116
,
[ .., .., ..
.2007].

; ;
,
, , ;
.

,
.
,
.
,
,

(.13). ..

.

.

.
, .

,
, . 2-
.
117

(.14).
,

(. 15).

, . .. .
(2001) .

.

,
(. 16), 20-30%
2-3 .
.. (2008)

.
,
2-4 .
3 5,
.

.
20-30
.
, , .
, ,
, .
118

. ,
, ..
.
,
3-6 ( ,
) .
-
.
,
( ), ,
,
, ,
[ .., ..,
.. ., 2007; .., .., .. .
2005].
,
.


, , .

.
, ,
.
, ,
,

119
.
.
-
( 56,8% ), 13,5%.
68,8%,
2,8% ,
. ,
, ,
- .
, -
,
.
, - .

105.

,

120
,
.
,
, .
.
(. 8
. 27, . 9 . 29),

.

4 :
1. ;
2. ;
3. ;
4. .

,
, .

W.B. Saunders (1982), . 26.
. 26 W.B.Saunders (. P.L.
Marino, 1989)

(%)
I 15
,
II (

121
15 . 20-25
.
)
III
, (33 < /) 30-40

IV , ( 40
)

-
(.27), .

.27
-
-
0,4-0,6 0%
0,7-0,8 10 %
0,9-1,2 20 %
1,3-1,4 30 %
1,5 40 %

.
= . g = ,
100
g .
70 , 60 .
.
122
(
)
= . g Hbg- Hbf ,
Hbg

Hbg , = 150 /
Hbf ,

g ()
70 /
60 /
75 /

r (.. , .. , 1995): = g tg Htf =


Htg
;
g N ;
Htg ( - 45%, 42%);
tf , .
, ,
, [. , .
, . , 2007].

.
, ,
, ,
, .
, , .

123
, ..
.

, .. .
,
( 80 . .).
100 . .
[.. , .. , 2005; .. , .. , ..
, 2009; Thomopouler, K.P. Minidis,Y.I.Theo charis t al, 2005].
-
,
,

.


[.. , .. , 1995;
.. ., 2003; .. ., 2009; ..
., 2008]. ,

,
,
, ,
,
.

. 200,0-300,0
, .
124
, .
[.. , .. 2005; .. , ..
, .. ., 2008; V.Y. Nielsen, S. Tan, A.E. Brix et al. 1997],
,
- .
,
, .
400-600 1000-1500 .
-
,

.
, .., .., .. . (2001)
-
(. 28),
.
. 28 - (
.., ., 2001)


1,5 1,5
45 . 150 .
400 400
100 - 800
- 600 100
1:1

3-4 2,5-3
- 1,5 3-4
: 600 400
: 800 - 800
200-300 400
- 800 200
:800 400
2:2:1 500-750 400-500
125

5 4-5
- 180 . 12
: 800-1000 800
: 1000 - 1000
300-400 300
- 1000 1000-1500
1000-1500
1:1:2


,
, , -

(.29).

(), , ,
, .
.29



1. ,
1.1.
, 6% - . 400,0-1200,0
, (10 / )
54-66 .
, 400,0-1200,0
, 10% - . , (10 / )
, 30-40 .

1.2.
1). 8% - . 400,0-1000
15-20 .+Na,
, , l,

2). 4% - .
30 .+ Na,
, , l,

126
4% - . , 500,0-1000,0
30 .+ Na, , , l ( 2000,0 )
,

1.3. ()
6% -, . 500,0-1500,0
200 . ( 20 / )
,
,

-N 10% -, . __ / __ __ / __
200 .

6% -, . __ / __ __ / __
200 .

6% -, . __ / __ __ / __
200 .

6% -, . __ / __ 250,0-1000,0
450 . ( 20,0 /
)

- 6% -, . __ / __ __ / __
200 .
1.4.
1 - , 200,0-600,0
200,0 , 19 , (3-10 / )
, 6
NaCl; 0,3 KCl; ,
0,2 MgCl; 0,1 CaCl. ,

1 - __ / __ 1500,0-1800,0
60 , 19 (10-15 / )
, 6 +
NaCl; 0,3 KCl;
0,2 MgCl; 0,1 CaCl.
1.5. ( )
- 100,0-1200,0
()

10% - __ / __

__ / __

127
2. ,
2.1.
NaCl 0,9 - 3000,0 /

NaCl 10% - 10,0-20,0

aCl 10% - , 10,0



2.2.
Na, K, Cl, ,

NaCl, Na .
,
Na, K, Cl,

Na, K, Cl,

Na, ,

- Na, K, Ca, Cl,


2.3.
+ , 200,0-1500
, ( 20,0 /
- ( + )
) ,
+
+

3.
10% 0,5 7,0 /
,
,

,
,
,
[.., .., 2007, .. ., 2009,
.., .., .., 2007]
128
, -
:
, , (2/6),
.
.
0,7 2
, 0,6 - 10 , 0,45 4 . ,
,
. (300-309
/) .
(.30) ,
.

. 30




( )
, , 130000 0,4 3
(Tetrastarch) ,
, , - 200000 0,5 4-8
(Pentastarch) , ,
-
-

, , 450000 0,7 10-48
(Hetastarch)

,
>400 000 >0,6, [Gndi
S.D., Weiskopf R.B. et al. 2007; Tryes C., Madjdpour C., Francarolo P. et al. 2006].

129
, ,

[Madjdpour C., Dettory N., Francarolo P. et al. 2005; Schramm S., Thyes C.,
Francarolo P. et al. 2007].
,
[ .., .., 2007],
(650/0,42 450,07) 15-20 /,
130/0,4 200/0,5 (, , )
,
.
.. .. (2007), .. , ..
, .. , N. Vogt, U. Brothner, A. Brinkmann et al. (1999), ,
.
,
.
1500
, (38,4 /)
.
35%
(<0,05), .
(-) (Berlin-
Chemil) ,
(.. , .. , .. .,
2007).

(, ),
(, ),
, ,
130
- (, Na, Ca, K, Mg, Cl).
[. 31].
. 31 -
(.., .., .., ..,
.., 2002)

()
50 2
100 3-4
- 6% 100 6-8
- 10% 140 6
, 100 3-4
145 4-6
130 6
170 4

,
1,2 /.
,
, , (0,9%
, , -, , ,
, .), (7,5%
NaCl),
[ ..,
.., 2007; .., .., 2004].

0,9% NaCl -.

, , ..
20% . ,

.
131
[Shires T., Carrino J.,
1994].
(, ),
.
0,9%
NaCl , NaCl
K, , Mg . (, , , , ,
.).
,

.
. ,
2 .
Mg ,
,
,
.
,
, , ,
.),
, - -
[Coimbra R., Porcides R., 2006].
,
, 7,5% . 4/
1-2 ,
,
.

132
(1-2 ) ,
- .
5% -
,
.
[Voll Cl, Auer R.N.,1988;
Lundy E.F.,Kuhn J.E., Kwon J.M., 1987].

,
. , 10%
30-40 .
10 25 /
. ,
60,0 1 , 200,0
1 . 3 10 / ,
, , ,
. ,
,
.
, ,
,
.
. 3
,
.
200 , 400
- ,

133
[..,..,
.. ., 2006].

32.
.32

-40 (10% -)



(5% )

-70 (6% -)
Nl(0,9% )


- + - - +++ + + - - - - - -

- +++ - + +++ ++ - + + - + - -

( + ++ + + +++ + + + + ++ +++ +++ -


)
- ++ - +++ + - - - - + +++ ++ +

- +++ - - +++ ++ - - - - - - ++

- ++ - - +++ + +++ + + + + - -

- +++ - - +++ + +++ - - - - - -

+ +++ - ++ +++ ++ ++ ++ ++ - - - -

/ +++ - ++ +++ - - - - - - - - -

- + + + +++ + - - - - - - -

- - - - - - - - - +++ ++ +++ -

- + - - +++ - - - - - - - -

134

( ),

.
, +, Na+, 2+, g2+
, ,
Na .
,
.
[..
., .. , .. . 2006]
1000-1400 ( 20 /), / 2,1-
3,0 // :
, , / , /
, /
1000 5-10 10-30 6-9 -
1000-1500 10-15 15-25 7-10 -
1500 20 30 15-20 8-10

, ,
( ) ,
620.

,
.
,
. , 30-40 /
,
80 /
. ,
135

.
,
.
1500 ,
.

- . 1500 2500

600,0 .
1200
, ,
.
.

5 [..,
.., 2006].

() [.., .., 1999; .., 2008;
.., .., 2006], -
, ,
.

.
,
, .
,
,
136
.

(0,5-2,5 /),
(7 /).

(.33).
.33
(.., .., 1999.)

20% 2-4 /
21-40% 4-7 /
41-70% 7-10 /
71-100% 10-15 /


10 /. 5-7
.
24 [
.., .., 2005; .., .., 1995].
, ,
,
,
.

,
(, ), ,
,
(, ),

137
. (,
),
,
,
(. 17).
( ),
( )
, ,

[ .., .., 2005].
(
) ,
(.34).
. 34 -
.. .. ..
(2005)


% ( %

)
10 200-300 ()

0,7:0,3

20 200 ,
, 0,4:0,4:0,2

21-40 180 ,
, ,
0,2:0,3:0,2:0,3 +
,

V 41-70 170 ,
, ,
138
0,2:0,2:0,2:0,4 +
,

V 71-100 150 ,
, ,
0,2:0,1:0,2:0,5 +
, ,

, 500
, / 15 , 4-6%.
500 , 15 ,
100%- . 15
80% , 20%
, .. 20% [
.., .., 2005].


. ,
, -. ,
0,9% - NaCl -
,
.
, ,
(2,5-7,5%) NaCl [
.., .., .., .., 2002]. ,
10-15% 4,5 /
,
2 .

139
.
( 2 ) .
, 800 ,
: -
1:1 1500 . 1500
2000 ( II .)
2 (3000-4000 ),
- ,
() 2:1:1. (3) (
4)



[.. , .. , ..
., 2006; .. , .. , .. , .. ,
2006].

, , ..


. ,
,
.
,

().
/ 400 250
NaCl. :
140
5-10 / . ,
2
;
10-20 / .
;
20 / . ,
2,
.
- -
,
, ,
,
, .
/ 250 500,0 . NaCl,
2,5 5 /. ,
10 / ., , ,
, , - .
.
(0,4-1,0 /)
(0,2-0,5 /), ,
.
,
1500 ,
, ( -).
, .
-
(ISTH) [Demple C.E. 2006]

141
. -
,
.

,

, ( -),


(, , ) [.. , 2005; .. , 2006; U.
Seligson; 2001].
-,
- ,
. -
,
() ,
.
(FM).
-
,
[..
, 2006; M. Levi, 2004].

- (FPA).
- ()
. ,

.
142
-
, , -.
,
-,
. -
.
(IS)
- (.35).
.35 -
.
> 100 / =0
< 100 / = 1
< 50 / = 2
.
:
= 0
= 1
= 2
.
< 3 = 0
> 3 < 6 = 1
> 6 = 2
.
> 1,0 / = 0
1,0 / = 1
5 -
.

143
-
, ,

.
() 10-15 /,
8-12 . ,
13
-.
3
.
,
[.. , .. , .. , 2006; .. ,
2005].

, ,
. :
- ( VIII ) 90
- 250
-
-
- IgA IgG
-
15 (1 ). 3-4 0,9%
. , ,

[.. , 2005],

-
144

[. Sevi, 2004].
- 300-500
/ .
[.. , 2005; . Sevi,
2004].

(, , ).
50000-100000 /
5-6 , 500000.

(15-40/ /),
.
, ,
V (Novoseven)
, .
60-90 / / 2 .
[.. , 2006;
. Sevi, 2004].
-
.
Zink K.A., Sambasian C.N., Halcomb I.B.
(2009) , , 6 ,

. Perkins J.G., Andrew
C.D., Syinello P.C. et al. (2009) ,
1:8
24
145
.
, Halcomb J.B., Wade C.E.,
Michalek J.E. . (2008) 1:1. Miller
R.D. (2009) ,
,

<50/109/.
,

, .

.
, ,
,
, .

. 1
45 85109/ 50,0-60,0 .
6-10
200 800109/ .
5010 9/.
() 5-
10109/ (70).
-
1 10 [ .., ..,
.., 2006].

- 30-40 /.
146
,
.


1 (>50,0-60,0109/).
-
( , , , -).
(,
, 1 /),
, .
,
,
(4 /), ,
.

(.36),

.36. ( ..
., 2002)
. 50-60 / . 200-300 /
. 100 / V . 500 /


. 320
150 /., .

147
-
:
-
1000,0 .
,

.

:
1) 1,5
(18 );
2)
(50-60 ) 1,5 ;
(1,0/) ,
;
3) 25%

1 10 .

20109/.
(, , )
1000 //
.
,
.

, , 100 250-300 0.9% NaCl
(20-30).
148
, -
: ,
,
. ,
, .
11.



,
.
, ,
.

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

. 40% e , , ,
. 5-30
.
(>5%)
, , , , , (1-5 %) ,
, , (, , ).
(<1%) , , , , .
149
(25-30%)
3-5%.
, , , ,
, , , , ,
. , :
1. , , , ,
2. , , , , , , .
3. :
- Ca,Mg,Bi,Al ( )
- Mo,Co,Cn,Ca,Se,Mn ( , ..
Fe)
4. , , , ;
5. ( )
6. ()
7. ()
8. ()
,
, 1 1 .
, ,
,
, e,
2,5 .
20 .
,
6 (.37)

(, )
, ,
150
,
, 15-
+20%.
.37
( .. .,2004)
/
1 , , , , ,
, .
2 , , , .
, ,
3 .

4 ,

( )
5 , -12 (),
(, )
6 , , ,
-

, ,
, , , .
.

, .. . ,
, 0,5-1%
. ,
.



,
, ,

151
: , -12, ..
4
,
. .

(.13).

152

Fe :
:
60 /
100 /
120 /
160-200 /

(
) 7-9

1. (8-12%) 1.
2. b 1 // 2%
2. b
1 //

1,5-2 ,

1-2 .

Fe 60 /

2-3 .
Fe 14 /

1. Fe
(
60 / ) 0,8-1,3 /

. 13
:
60/ 200 /
. 2

153

.
7-9 .
10-12% ( )
1 / ,
,
. 2%
1/
2 ,
,
.
130 /, 125 /.
,
, 60
/. 2-3
.
140 /.
40-50 / 2-4 .

,
(60-150 /) ,
0,8-1,3 /.
,

(.38).

.38 ,
(..., ... .., 2002)
154
,

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

(,)
,
(,
, ,
,
)
, ,

(,
, , )
(,
, ,

5-7 )

(,)
(,
, ,
)
(, )
(,
, ,
,
)

, , ,
10-15





,



12 0,05-0,2


(,

155
,
, )
()
()
(,
)
(,
)

Fe ,
,
.
[Davis C., Yreger J.S., 1992; . ,
2004],
, ,
, , ,
. ,
,

.
,
. ,

, .
, , .
,
,
.
,
, ,
,
156

, /.
,
25% .
/ :
()= () (150 -
+500 ( Fe). ,
, 1700 ,
(100)= (17
), . 1
17 . /
100 , ..
.
( , , , ).
,
.
,
, ..,
.
, , ( ,
, , ), , ,
, , ,
, .
,

50 / .


157
,
[Atabek U., Gaudiani Y.A., Mason H.D., 1991].
.
(90%) - ,
.
-,
, ..
(,
), .
-
.
.
: --
(, ) -- (, ).
3-4 .

100/ 30% 125
1 4 .

20 3
60 / 1 ,
(.14), 720 /
[ , 1999].

158
20 /
3


0,5 % < 0,5 %
4

40
/ 3


0,5 % 0,5 %
8

,

(240 / )

30-35 %, 100-120 /

:
.

.14
(1999)

2 / ,
, ,
159
12.
.

. 100 /,
20% 200-300
/ 100 /.
:
,
130 /, 120 /, 140
/, 60 /, 0,8-1,3 /.
,
, ,
, .

160
12. , -

,
,
,
,
. , ,
,

,
.
12.1.

, (), ,
().
,

( ).
12.1.1.


. ,

.

.
.
(70-80%).
161
: ,
, ,
.

( ), -,
,
( ).

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

. 3 :
3-4 ,
4-6 ,
6 .

,
. .

. 3 :
( ), (
),

162
. ,
, , .

, , .
(, , ,
)
.

.
(). -

.

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

, , ,
.
.
.

.
163
( 8), , 1/3

( 9,10), .

,
. ,

, ,
, .
.

.
, ,
,
, , - -
, , ,
.
:
1). ;
2). ;
3). .
.


- (.15).

, .

164
. , 2-3
.
. 12

1-2 .

(, )
. 42
85%, 72 93%.


( 4 .60).
,
,
.
( . 10).
,
15-20 200 5% 5-10 20
30 .
,
( ).
- ( 0,04 0,2 ),
() .
,
, ,
- .

.
165
,

,
.
,



.
V (, 2005) (De Frenchis R, 2005):
1.1.
6
, (t
27%) (b 90 /).
1.2.
5 2
:
1.2.1.
100 ;
1.2.2. b t 3 9
;
1.2.3. ;
1.2.4.
R (Adjusted blood transfusion requirement index) 0,75
.
R = (t tn ) U + 0,1,
t ,
tn ,
166
U .
:
t = 24% b = 80 /.
1.3.
:
1.3.1.
100 ;
1.3.2. R 0,5;
1.3.3. b 3 / .

:
;
;
c ;
V .
,
, :
1) ;
2) VPG (Hepatic vein
pressure gradient)
.

,
VPG,
,
.

167
V

:
1.
VPG 12 . .
.
-
VPG. ,
.
2. , -
, -,
.
3. ,

-.
,
,
-.
4.

-, -
.
5.

,
-. ,
,
.
168
6.
:
)
, b
80 /, ,
, :
)
;
) VIIa
( );
d)

;
)
/,
.
7.
, -,
, VPG, ,
,
. ,

.
,
, .
,
, 12 .

169
8.
24
, .
9. , , ,
.
,
, 2-5
.
10.
, .

.
N-
.
11. ,
-,
TPS (Transjugular
Intrahepatic Portosystemic Sunting) ,



. S
,
,

- .
12. :

170
)
;
b) S;
c)
;
d)
.

,
.

[ ..
. 2005; , 2009.].

, ,
[ .. . 2005].
,
Child-Pugh.
.
38.
. 38


1 2 3
(/) < 34 34-51 > 51
(/) 35 28-35 < 28
(%) > 70 50-70 < 50

1-2 3-4

171
(), 6,
,
,
.
(), 7-9,

, ,
.

[ .. ., 2006; .., 2006].
,
, 1,5-
3,0%. 10 ,
. ,
3
Child-Pugh 68 /, 28
/ 50%.

. , -


.

, ,
( ), .
:
() - .

172

.

.

80% ,
.
,
.

,
. ,
.
.

(, ,
.) .
,
.

,
20-25%.

()

. Warren W. (1998)

, ,
173
.
[
.. ., 2005].
(,
, )
,

. ,

[ .. ., 2005; ..
., 2007; .., 2007].
12.1.2. -
-
, ,
.
-
(), 60%
[L.Aabakken,2001]. -

[ .., .., 1978],
.
,
.
, ,
[ .. ., 1987].
.
2 :

174
,
,
,
- , [
.., 2002; J.KSachdev,Juta,2003].

,
, .
.
, .
.

.

( 11 12).
.
, ,
.
-
,
() ,

. ,

, .
-,
[W.Breoy,W.L.Peterson,1997].

175

.
, , .
(2-3% ,
1,0 150,0
NaCl .).
() -
(, ),
, ,

[ .., 2004].
: , , , .,
, 1
. ,
-
: (, )
().

. -
.

,
, ,
.

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

- .
176
,

,
.
12.1.3.
,
. .
, ,

, ,
. ,
, , -,
.
,
.

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

177


.
( , ,
, ),
.

.
0,5-1%
.

( , , , .).
.
.
.

, 71-83 % ( .. ., 2007).


.

, ,

.

, ,
.

178
(85% ),
, , [
.., 1999].
12.1.4. -



( )

. Y.K. Mallory S. Weiss
1929 . 3 . 13.
-
, .
,
, ,
().
,
,
.
-
, . Bellman
(1973) :
;
, ;
.
( 13, 14, 15, 16)

, 2-3 4-5
179
, 1-5 . , 2-3 .
,
, .
87%
- I , II
28% , III
,
(.. , 1991).
-

.

(, , .).
. NaCl,
,
.
(..
, 1991). .. , .. (2007)
.

,
. 6

.

.
.

180
5-10%
. ,
.
-
(, ), ,
.
6-12
.
12.1.5.

1,1-1,3% [.. ., 2005].
( 3 .)
75-90%, 5-15%
4-10%. 15-20%
.


.

.
, -
(, , , )
. ,

(, ).
( , ),
.

181
, .
,
.

.

.
, ,
( ),

, .
.

.

.

,
.

.

( 15,16)
.

-.
.
(
182
)
.

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

. , ,
,
,
[.. , .. ,
2009].
3-4
2,5 .
.
12.1.6.
,
,
.
. ,
183
, ,
.
3 :
1. ()
;
2. ;
3. .
1-2%,
.
70-80%, 20-28% .
50-70 .
2
.

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

: ,
, , .
, ,
. ,
( 19).
. .
,
.
184

, , ,
, .

.
,
. 5%
,
( , ,
)
.

.
12.2

70%
,
, [.. ., 1987; ..
., 2007; .. , 2001; Velays F.S. et al., 2004; Lecleire S. et al. 2005].

[Breski G.,Paris G.,Bertoni M. et al., 2005].
,
,
,
elicobacter pylori
,
,
.
185
12.2.1.
, 2,
. ,
,
, .
, ,
,
.

.
,
,
()
[.. , .. , .. , 2001].
,
(.16),

186

1. . ylori 1.

2.

3. , 2.

4.

5. - 3.

6. 4.

7.
5.
.
8.

.16 (.. ,
.. , 2009)
,
, .,
- elicobacter pylori.

(l, ). - ,

187
12-

90-120 .

50 % 12-
, ,
, ,
.


,



,





90-120
,


.

10 %
,

188
. 17 (.. , ..
, 2009)
.
(
, ,
),
elicobacter pylori, 70 %
. (,
- , ,
.)
,
,
.

(.17) ,

.
( 7).

, (, , ),
,
.
( 20 21)
, F1,

(,
, , , ),
.
189
,
.
,
.

- , ( 22 23),
F2.


.

( 24), ( 25) ( 26),
( 27).
( 28 29). 50%
, ,

.
( 30) ( 31)
.
(
)

( ,
),
.
(-),
elicobacter pylori (,
).
190
12-

- +


1-1,5


+ -


+ -


+ -

17 ( ..,
.., 2009)
191

elicobacter pylori (. 17).
2-2000 [ .., , 2005; The Maastricht 2-
2000 Consensus Report, 2009] 7-14
: + + .
elicobacter pylori 87,8%.
, (
) ,
, ,
( .), .
( 2-3%),
3-2005 elicobacter pylori
,
(, , ,
) 14 .

. 3-4
.
(.18): () 400 2
, . ,

: () 1,0 - 120 4
. 1 .
-
,
,
, .
[.. , 2002].
192
, ,
, , .

, - ,

. 2 (80
) / /, 1 . 200
,
2,5-3 [..
, 2000; .. , .. , .. , 2008].
,
.
,

30 %
. , ,
, 50% [..
.,2006; N.Chalasani et al, 2005]

.
.

,
3-5 .

(4-5 ),
( , ).

193
12.2.2.

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

, , ,
, ,
.
- 20-
25%, 30%, 11-19%,
8-24%. ,
,
53% [.. , 1991; .. , .. , 1998; ..
. 2005,L.Saine,C.Brombardier.,C.J.Hawkey,2002].
, 2/3 .

, , ,
, , ,


, .

194

3 :
, .
( 3 ), ,
9-30 % .
, .
[.. . 2005].
,
.

.
, ,
,

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

.
: ,

.

()
195
,
.
,
,
.
- , - -
(, , )
, . (75-
325 /) -
2-4 [.. , 2009].


.
( ).
75/15,2 150/30 .

- ,
.



.
,



(),
, .
196
12.2.3.
.. (1991) ( 6
) , 12% 31 %
.
, ,
.
(
), ,
,
.
() ,
.
,
.
,
,
.
,
.
,
.
- .
,

, .
.
,
, , .,
197
. , (,
-, .)
[..
., 2001].

,
.
, .
, . ,
. ,
,
.
.
,
,
.
,
( 32)
( 33).
( 34 35).
( 36)
( 37).


,
, ,
.
.
198
.

.
.

.


[.. , .. , 1996].
.
:
, (), , .
-, ,
.
.
,

, .

4-6
2- ( .)
(). Helicobacter
ylori .
12.2.4.
,
4,3% . 1,4
13,5 %, 86,5 %. 4,6-
15,9 % [.. ., 1987;
199
.. ., 2007; Y. Jawasa, 2004; V.P. Khatri, D.O. Harold, 2004].
,
.
,

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

:
1. ;
2. - ;
3.
;
4. ;
5. ;
6. .
200

.

. ,
. , 11000
, , 52 %
, 27,8 % - , 8 % -
, 1,3 % - 10,9 % [..
., 1987].

.
( ,

, .), .

( 38, 39, 40) ,
,
.
, ,
.
,
,
.

5-,
600, .
, ,

201
,
[.. , 2001].

.

.
( ).


(,
, , .) [.. ., 2001; ..
, 2007; .. , 2007].


. ,
,
.
,
,
3-6
. .. . (2007) ,
48%

.

(), ,
, ,
,
202
[.. ., 2005;
.. ., 2005; .. ., 2005; I. Iwasa, 2004; V.P.
Khatri, D.O. Harold, 2004].
(, , )
. ( 1,4%
) .
,
,
.
(9 %) .
,
. .

. 5
.
,

.

5 . , ..

, .
12.2.5.

. , 0,5-1 %
(. 3.
).
, , .
203

( , )
( 41 42)

2-5 ,
, .
.
,
,
[.. , 2001].

( 43). ,
.
, ,
, , ,
. ( 95 %)
, 5-6 -
. , .
, (30 %),
(50 %) (20 %).
40-60 [Lichtenstein D.R., Berman M.D., Walfe M.M.,
1997; .. , .. , 2001].
--
.
40-50 . , -
, , , .
, , , 25 %
. 80%
204
, .
5 % .

(GAVE) ( 44). 70 ,
,
.
.
.
,
.
( 45)
,
,
[.. , 2001].
, ,
( ,
, ).

(, ).
.
(-
, , ,
) 50-85 % [D.R. Lichtenstein et al. 1997;
.. , 2001; R.C. Ghomopoulos et al. 2005].

.

(, ,
205
) (,
, ).
[T. Sato et al., 2005.].
12.3.
,
,
.

, .. (, ) ,
, ..
( 7 ).
12.3.1.
1 6 %
. :
, , , .
.
(, , , )
19-28 % ,
.

, , ,
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.
,
.
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206

.
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.
, 55 % ,
[.. .,
2001].
( --) 25%
.
- .

, . 46-60 %
, 28-30 % -
, , , .
6-40 % .
( ) ,
.
,
, , , ,
, ,
, () .
, .

, 5-
.


207
.
(400,0 500 ).
,

.
( 46).

.
,
.

.
.
12.3.2.
.
,
2%, 0,25 %
.
( ).
. (),
, , ,
. ,
,
.


.
.
208

,
.
.
.

.
,
.
( 47)
-
.
. ,
( )
,
, ,
.
12.3.3.
()
,
. (80 %)
.
.
.
, ,
.
, (50 %) [.. , 2001].

209
:

- .
12.3.4.

.
.
45-50% , 25% -
, 20% - , 5% -
. ( 60%) .
10-15%
10-15% .
50% .
,
.
() , ,
[.. , 2001; J.B. Matthew et al
1997].

.
, 95%.
,
.
(25-30%
).
12.3.5.
(, ,
..) .
210
. ,
: , ,
.

,
.
, , .

.

: ,
, ,
, , ,
,
. ,
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.

( 48, 49, 50) .

,

.
(

),
.
211

.


.
12.4.

.
.
.
,
. (
) .
.
, .
12.4.1.

9,2 93%, 2,8-5,4% [..
. 1987; .. . 2001; F.S. Velayos et al. 2004].
,
,

.

, 1,5-2 .
, . 60-85%
, ,
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212

, ,
,
.
( , ,
). ,
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.

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

.
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( 51, 52, 53, 54), ,
,
.
213
()
,
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.
- ,
.
12.4.2.

, , , ,
.
,

. .
( 55, 56, 57, 58),
.
, .


.
. ()
.

214
12.4.3.

.

.
,
. 25 %
.

,
.
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.
,
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, .
- .

.

, ..
. , ,

. ( 59,
60, 61) .
, -
215
, .

12-15 .

.
, , (
),
(,
), .

, .


,
. -,
, .

muscularis mucosa.
300-500
(1-2,2 %) [.. , .. ,
1982; .. . 1987; .. , 2001].
70 /
, ,
.

,
.

216
5-
(, , , ),
,
.
,
() ().

. 1 / ,
1,5-2 /,
.
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.
, , ,
.

, 12,
. (100
) ( 60 600 1 ).
.
:
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.
12.3.4.
,
.
,
. ,

217
, .. ,
.
( , ,
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.).
,
, ,
.

, ,
.
.

.
.
38-390.
. .
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.
, .
.
, .
, , .

218

, ( 62, 63, 64, 65).
-,
.

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.

.

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, , ,
.
,
,
[.. , 2001].
(,
)
, , .

, , 5-
, .

, . ,
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219
: ,
. , ,
.


.
.
, ().
12.3.5.
,
15 % 60 , 70 50-60 %, [..
, .. , 1996; .. . 2001].
90 % ,
.
3 20 % , 2-6 %
.

. -,
. -,

, . , ,
,
, ,
.

. ,
, ,
, -
220
, ,
. ,
.

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66 67). ,
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221

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.
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.
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( , , , 96% ).
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.
(60-80 %)
.
.
:
1.
(, , ,
, . );
2.
, (,
, , ), ;
222
3. ,
, , .;
4.
(, , , .);
5. /, /, .
:
,
, , .
,
.
.

.

.
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[.. . 1987; .. . 2001].

, ,
, ,
, .
12.3.6.
, , ,
.

( , ,
223
- ), (,
).

,
. ,

.

:
1). (
30-50
, , )
60 ,
( , ,
);
2). ;
3).
, .. mesenterica
inferior;
4). .
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( 68)
, , - ,
,
.
,
: ,
(
224
)
.
mesenterica inferior,
.

.
:
- (
,
,
, -3 -6
);
- (, ,
);
- (, ,
);
- (, , ,
);
- (,
, .).

, (,
.).

. 20%
,
.

225

.
12.3.7.
,
5-15% .

.
, ,
.
,
, .
, ,
.
,
. ,
( , 10-14
). , , .
.
, . .

, .
. .

. (
69) , ,
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226

, ,
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, .


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- ,
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.
12.3.8.

227

, .
10 58% (.. .
1987; Longstreth Y.T., 1997) 80-90 % .


.
, ,
, .
.V. Cava inf.
(,
) .

, .
.
, ,
, ,
.

, ,
,
, .
, ,
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.
.
228
300-500 . ,
I , II
. III ,
,
.

,
.

.

.
: (), , .

, .
,
.
, ,
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, .).
, ,
.

.
.

, , ,
(1-2 .) (5-7 ),
229
.
, . 3
3
.
.
:

6-7 , ,
-
.. (1979).
,
.
(-1).
10-12%
.

.
,

6 , 3 [.. , 2008]. Logo
(1998)
,
( ),
, ,
,

(Moringa 1995; .. , .. , .. ,
.. , 2008).
230

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

, , ,
, . 85 %
6 , 8-9 % ()
. 1-2 , - 0,2-0,5 ,
0,1-0,2 .

,
.
, .

. ,
.
, .

231

,

, .
.
, ,
(, .).
(600,0-800,0 ) , ,
, , .
.
, (, , ,
.).

:

.
12.4. - ,

200 ,
.
1,5 % .
12.4.1 -

.
.
20 .
.
.
232
- .

( 70) ( 71),
( 72) ( 73)
. -
.


.
.
12.4.2.
30 % .
, 10-20%
.
, .
90%
.
,
.
12.4.3.

3-4 , ..
.
, .
,
( 70) ( 71) ,
( 72).
(reponema pallidum).
233
(
).

.
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1% .
3
:
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3.
.
12.4.4.1.

.
,
. , -
. -
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(
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.
234

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.

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.
12.4.4.2. -


, .
(>95%)
VIII ( , ) IX ( ).
( VII, X, V, XI, XII, II) .
-
,
235
(II,VII,X, V), ,
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.
,
: .
,
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)
.
( ),
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( , , .).

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.

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.

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).
, .
.
236
.,
.
.
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( -, ),
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. ,
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30 .
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.

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.
.

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237
(,
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238

-
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, 200
,

.
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,
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, ,

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, .
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,
.
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,
.
, .

239
, 87%
, ..
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, , .)


.
,
.

, 20%.
2-4%
.
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0,2%. ,
,
.


, , ,
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.



, , .

240
,

,
.

(
130 /, 125/),
,
:
., 0,8 /
( ). ,
80 /
,
2 /.

, . .

,
,
.


, . 3 6

, .
(, ,
.)
.
241
,
,

.
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.
, -, , .

.
(
), ,
.
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,
.
.


,

.


.


( .)

242
( ).
.
, -
, ,
,
.

.


.

243
:
1. . -
// . - 2009. - . 85-87
2. .., .. -
- . - . 1996. - 67 .
3. .. .
// .
- 2002. - 4 (10). - . 26-31
4. .., .., .., ..,
.. // . -
2008. - 8. - . 68-72
5. ..
// . .. -
2005. .: . - 3. - . 90-107
6. .., .., .., .., ..,
.., .., .., ..
// . .
. - 2001. - 5(1). - . 16
7. .., .., .., ..
. - . - 2006.
140 .
8. .., .., .., ..,
..
,
// . .
. - 2007. - 2(11). - . 22

244
9. .., .., .. ,
( ) // . .
. - 2007. - 2. - . 19
10. .., .., .. -
// . .
. - 2007. - 5(11). - . 39
11. ..
- // .: . - 1991. - 270 .
12. .. -
// . . .
- 2001. - 1. - V5. - . 5
13. .., .., .., - ..,
.., .., .., ..
- // . .
. - 2007. - 2(11). - . 23
14. .., .., .. -
//
. - 2009. - 2. - . 18-21
15. .. // .
. - 1999 - 5. - . 45-47
16. .., .., .., ..,
.., ..
// . . . -
2007. - 2(11). - . 24
17. ..
( ) // . -
2006. - 33. - . 12-18

245
18. ..
,
// . . . . . - . 1995. - . 19
19. .., .., .., ..,
.., ..
//
. - 2007. - 1. - . 38-43
20. ., . // 2004.
- 9. - . 25-29
21. ..
// . . , . - 2002. -
5. - . 23-28
22. .., ..
//
. - . - 2006. - 33. . 251-253
23. .. -
// . .
. - 2001. - V5.1. - . 18
24. .., .., .., ..,
..
// . .
. - 2009. - 13(1). - . 27
25. .., .. :
, // . - 2007. - 18(225). - . 6-
7
26. .., .., ..
// . . 1999. - 6. - . 52

246
27. .., .., ..
// .: . - 1996. - 149 .
28. .., .., .., .., ..,
..
// . - 2005.
- . 19
29. .., ..
,
// . - 2006. - 33. . 86-90
30. .., .., .., ..

// . .
. - 2007. - 2. - V.11. - . 38
31. .., ..

// . .
. - 2009. - 13(1). - . 19-22
32. .., .., ., ..
//
. .. , .. , .. . -
.: - - 2001 - . 39-60
33. .., ..
// . .
. - 2009. - 13(1). - . 19-29
34. .., ..
// .: . WORD. 2005. 227 .

247
35. .., .., .. ..
: , , . - . -
2004. 78 .
36. ..

// . .. . - 2006. - .165. -
1. - . 76-78
37. .., .., .., ..

// . - 2005. - .10. - 2.
- . 77-78
38. .., .., .., .., ..,
..
//
. . 1999. - 3. - . 5-7
39. .., .., .., ..
,
: // . .
. - 2007. - 2. V.11. - . 32
40. .., .., .., ..
- // . .
- 2002. - 18 .
41. ..
//
. - 2007. - .12. - 2. - . 8-15
42. ..

: . . . . - 2005
248
43. .., .., ..
// .: - - 2001. - 457 .
44. .., .., .., ..,
..
- //
- - : . - 2008. -
1. - . 72-76
45. .., .., ., ..,
.. ,
- // . - 2008. - 4.
- . 42-45
46. ., .. //
.: - 2005. - 146 .
47. .., .., ..
- // . .
. - 2007. - V.11. - . 18-119
48. .., .., .. -
: //
- 2006. - 33. - . 119-123
49. .., .. -
- // . .
. - 2007. - V.11. - . 20
50. .., .., ..
// . .
. - 2001. - 5(1). - . 29
51. .., .., ..

249
// . 2008. - .13. - 4. - . 76-
84
52. ..
: , , , //
, , . - 2008 - 2. - . 76-87
53. .., .., .., ..
,
, // . . - 1999. - 4. -
. 5-7
54. .. -

// . . . - 2001.
- 5(1). - . 27
55.
-
// . - 2008. - 5(18). - . 135-141
56. .., .., ..
-
//
- 2005. - .10. - 12. - . 8-83
57. ..
// . ..
. - 2000. - .9. - .2. - . 257-260
58, .., ..
- // . .
. - 2007. - 4(11). - . 32
59. .., ..

250
// . .
. - 2007. - 2. - V.11. - . 38
60. .. Z-CLSP

- // . .
. - 2007. - 4. - 11. - . 24-26
61. .., ..
// . .
. - 2008. 1. 12. - . 21-28
62. -
,
(AGA) //
. . - 2008. - 1,2. . 70-81
63. .., .., .., ..
-
// . - 2005. - 1. - . 38-42
64. .., .., ..
-
//
. 2005. - .10. - 2. - . 85
65. ..
// . . . -
2008. - 1,12. - . 27-31
66. .., .., .., ..
// . .
. - 2008. - 12(3). - . 23-28
67. .., .., .., ..
// . - 2000. - 3. - . 21-27
251
68. .., .., .., ..,
.., .., .., ..

(
) // .:
. - 2001. - 48 .
69. .., .., ..
// .: . 1987. - 256 .
70. .., .., .., ..

//
. - 2000. - 1. - . 73-76
71. .., .., .., .. .
//
. - 2003. - 2. - . 36-41
72. .., ..

(+ )
// - 11:
. - 2008. - 81. - . 140-147
73. ..
-

// . . . . . - .
1996. - 15 .
74. .., .., .., .., ..,
..

252
// . .
. - 2007. 2,11. - . 31
75. .., .., ..
- 1997-384 .
76. ..,

// . 2002. - 1. - 2. - . 39-41
77. ..
, // . . . . .
. - 1994-22 .
78. .., .., .., ..,
.. , -
//
. 2010. - 2. . 1-4
79. .., .., .., ..,
.., ..
- // .
, . - 2006. - 4. . 33-38
80. .., ..
,
// . - 2006. -
33. - . 311-314
81. .., .., .., ..
-
// . - 200. - 4. - . 4-10
82. .., ..
// . - 2007. - 7/1 (). - .33-35

253
83. .., .., ..
// Consillium Medicum
Ukraina. 2008. .2. - . 5. . 21-24
84. .., ..
( ). 2009 - 14 .
85. ..
// .
- 2008. - 3. - . 74-75
86 .., .., .., ..
- // . -
2009. - 4. - . 33-35
87. .., .. .
.: . 2004. - 583 .
88. .. . // . . ., ,
. 1999. 1. - . 67-71
89. .., .., .., ..
( ) // : -. - 2005. -
250 .
90. .., .., .., ..

// . - 2009. - 9. - . 46-49
91. .., ..
-
V // . - 2006. - 8. - . 49-51
92. .. :
- //
. 2009. - 10(215). . 42-43

254
93. .. ,
// 2009. - 20(225). - . 63
94. ..

// . - 2008. - 3. - . 4-9
95. .., .., .., .., .. //
,
( ). - . - 2005. - 12 .
96. .., .., ..
-
// . 2005. - 7(023) . 36-38
97. .., .., ..
-
// . . .
- 2007. - 11. - . 21
98. ..
//
. 2005. - .10. - 2. - . 91-92
99. .., .., .., ..,
.. -
// . . . - 2007. -
2. - V.11. - . 35
100. .., .., .., ..
-
// . - 2005. - 1. - . 8-15
101. .., .., .., ..,
.. //
. - 2008. - 6. - . 31-33
255
102. .., .., .. .
(, , )
( , , , ).
. . . 2006-40 .
103. .., .., ..
//
. - 1999. - 6. - . 10-14
104. ..
(GAVE-) //
, . - 2005. - . 26. - . 82-85
105. .., .., .., ..,
.., .., .., .. :
// . -
2006. - 3. . 155-160
106. .., .., .., ..

// . - 2000. - 2. - . 24-26
107. .., .., .., ..,
. - -:
. 2003-598 .
108. .., .. -
: () //
. - 2007. - 112. . 80-84
109. .., ..
. //
. 2002. - 9. - . 16
110. - - (,
). . .
256
: .. , .. , .., .. .
. 2006. 36 .
111. .., .., .., ..

//
. . . 2005. - 9. . 599-601.
112. bakken L. Non-varicel upper gastrointestinal bleeding // Endoscopy. -
2001. - Vol.33. - 1. - . 16-23
113. dler D.G., Knipschield M., Gostour C.A. Aprospective comparison of
capsule ndoscopy and push enteroscopy in patents with GI bleeding of obscure
origin // Gastrointest Endosc. - 2004. - 59. - . 492-498
114. Appleyard M., Ylukhovsky A., Yan S., Swain P. Wireless capsule
endoscopy in patients with dufficult gastrointestinal bleeding // Endoscopy. - 2000. -
Vol.32. - Suppl.1. - . 59
115. Atabek U., Alwarez R., Pello M.J. et al. Erythropoietin accelerates
hematocrit recovery in postsurgical anemia // Am. Surg. 1995. 61. - . 74-77
116. Avgerinos A. Appraach to the management of bleeding esophageal
varices: role of somatostatin // Digestion. 1998. - 59(sup.1). - . 1-22
117. Ben-Soussan E., Savoye G., Antonietti M. et al. Factors that affect gastri
passage of video capsule // Gastrointest Endosc. - 2005. - 62. - . 785-790
118. Bhasin D.K., Malhi N.J. Variceal bleeding and portal hypertension: much
to learm, much to explore // Endoscopy. - 2002. - Vol.34. - . 119-128
119. Blackwall S., Hendrix P.C. Common Anemias: What Lies Beneath
Clinician Rviews. 2001. - V.11. - 3. - . 53-62
120. Blish M., Gruchter O., Edelstein S., Edoute Y. Somatostatin therapy
ameliorates chronic and refractory gastrointestinal bleeding caused by diffuse
angiodysplasia in a patient on anticoagulation therapy // Scand. J. Gastrornterol.
2003. 38. - . 801-803
257
121. Bloomfeld R.S., Smits T.P., Schneider A.M., Rockey D.C. Provocative
angiography in patients with gastrointestinal in patients with gastrointestinal
hemorrhage of obscure origin // Am.J. Gastroenterol. - 2000. - 95. - . 287-290
122. Bour B., Pearson B., Cahus P. et al. Introbserver agreement on endosopic
diagnosis of bleeding petic ulcers // Gastrointest Endosc. 1997. - 46. - . 27-32
123. Bracy W., Peterson W.L. Medical therapy of nonvariceal upper
gastrointestinal hemorrhage // Gastrointestinal Emergencies / Ed. M.B. aylor.
(Williams and Wilkins). 1997. - . 151-162
124. Bresci G.,Parisi G., Bertoni M. et al. The role of video capsule endoscopy
for evaluating obscure gastrointestinal bluding: usefulness of carly use //
J.Gastroenterol. - 2005. 40. - . 256-259
125. Carreira J.M., Reyes R., Pulido-Duque J.M., Traviso M.M., Gorriz E.,
Pardo M.D., Mayhar M. Diagnosis and percutaneous tratment of gastrointestinal
hemorrhage // Rev. Es. Enferm. Dig. - 1999. - 91(10). . 684-692
126. Chalasani N., Kahi C., Francois F. et al. Improved patient survival after
acute variceal bleeding: a multicenter, cohort study // Am. J. Gastrornterol. - 2003. -
98(3). . 653-659
127. Cipolletta L., Bianco M.O., Marmo R. et al. Endoclips versus heater probe
in preventing early recurrent bleeding from petic ulcer. A prospective and
randomized trial // Gastrointest. Endosc. - 2001. 53. - . 147-151
128. Corwin H.L., Hall J.B., Manthous C. and Manthous C. Current Trends in
the management of critically ill patients. Anemia and Blood Transfusion in the ill
Patient: The Role of Erythropoietin // American Collrge of Chest Physicians http:
www. medscape. com/viewprogram. - 2001. - 206 p.
129. DAmico G., Politi F., Morabito A. et al. Octreotide compared with
placebo in a treatment strategy for early rebleeding in cirrhosis. A double blind
randomized pragmatic trial // Hepatology. - 1998. - 28. - . 1206-1214

258
130. DAmico G., D Franchis S. Ulcer digestive bleeding in cirrhosis Post-
therapeutic outcome and prognostic indicators // Hematology. - 2003. - 38(3). .
599-612
131. Dancygier H., Lightdale C.J., Stevens P.D. Stomach; Benighn Discases:
Vascular lesions // Endosonography in Gastroenterology. Thieme. - 1999. - . 80-83
132. Davis C., Greger J.L. Longitudinal changes of manganese-dependant
superoxide dismutase and other indexes of manganese and iron status in women //
Am. J. Clin. Nutr. - 1992. 55. - . 747-752
133. De Franchis R. Evolving Consensus in Portal Hypertention Report of the
Baveno IV Consensus Workshop on methodology of diagnosis and therapy in portal
hypertention. Special report // Hepatology. - 2005. -V. 43 - . 167-176
134. De Looze D.A.M., Botelberge T., Beke C., De Vos M. The impact of
capsule endoscopy of the outcome of presumed bleeding of small intestinal origin //
Gut (supplement) 2005. - 1.37. . A288
135. Demple C. E. Predicting disseminated intravascular coagulation the
intewnsive care unit // Hematol. - 2006. - 2(1). - . 235-238
136. De Songe E., Levi M. Effects of different plasma substitutes on blood
coagulation: a comparative review // Crit Care Med. 2001. Vol.29. - 6. - .
1261-1267
137. Dente C.J., Shar B.H., Nicholas J.M., Harris R.S., Wyrzkowski A.D., Patel
S., Shah A., Vercruyss G.A. Improvements in early mortality and coagulopathy are
sustained better in patients with blunt trauma after institution of a massive transfusion
protocol in a civilian level 1 trauma center // J. Trauma. 2009. - 66(6). - . 1616-
1624
138. Defreyne L., Vanlangenhove P., De Vos M., Pattyn P., Van Maele G.,
Decryenaere J., Troisi R., Kunnen M. Embolization as a first approach pith
endoscopically unmanageable acute nonvariceal gastrointestinal hemorrhage //
Radiology. - 2001. - 218(3). . 739-748
259
139. Di Caro S., May A., Heine D.G. et al. The European experienct wits
double-balloon nteroscopy: indication, methodology, safety, and clinical impact //
Gastrointest. Endosc. - 2005. - 62. - . 545-550
140. Perraboli R., Malheiro P.S., Abdulkader R.C. et al. Anuric acute renal
failure caused by dextran-40 administration // Ren. Fail. - 1997. - 19. - . 303-306
141. Fullarton G.M., Murray W.R. Prediction of reblleeding in peptic ulcers by
visual stigmata and endoscopic Doppler ultrasound criteria // Endoscopy. 1990. -
Voll.22. - . 68-71
142. Gandhi S.D.Weiskopf P.B.,Jungheinrich C. et al. Volume replacement
therapy during major orthopedis surgery using voluven (Hydroxyethyl Starch
130/0,4) or Hetastarch // Anestesiology. - 2007. 106(6). . 1120-1127
143. Gaudiani V.A., Mason H.D. Pre-operative erythropoietin in Jehovahs
Witnesses who required cardiac procedures // Ann. Thorac. Surg. 1991. 51. - .
823-824
144. Goldfarb N., Phillips A., Conn M. et al. Economic and health obtcomes of
capsule endoscopy // Dis. Manage. - 2002. - 5.- . 123-135
145 Gisbert J.P., Khorrami S., Carballo F., Calvet X., Gene E., Dominguer-
Munoz J.E. H.pylori eradication therapy us. antisecretory non-eradication therapy
(with or without longterm maintenance antisecretory therapy) for the prevention of
recurrent bleeding from pepti ulcer // The Cochrane Library issue. 4. - 2005. -
London: John Wiley and Sors Ltd
146 Gotzshe P.C., Hrobjartsson A. Somatostatin analogues for acute bleeding
oesophageal varices (Cochrare Review) // The Cochrare Library, Issue 3. - 2008. -
London: John Wiley 8 Sors.
147. Gustavsson A., Johansson U., Bergman J., Bohr J., Salen E., Sandberg-
Gertsen H., Tysk C. Capsule endoscopy in the diagnosis of recurrent obsure GI
Bleeding // Gut. 2005. - 1,37. - P. 286

260
148. Hadithi M. Heine G.D.,Jacobs M.A. et al. A prospective study comparing
video capsule endoscohy with obscuve gastrosntestinal blceding // Am. J.
Gastroenterol. - 2006. 101. - . 52-57
149. Hanson G.C. // . : Ogilvie. C Birchs mergeincies in
medical practice.-Edinburgh, London, Melbourne, New York. - 1981
150. iramoto J.S. Evidence-based analysis: postoperative gastric bleeding:
etiology and prevention // Surgical Oncology - 2003. 12. - P. 9-19
151. Holcomb J.B., Wade C.E., Michalek J.E. et al. Increased plasma and
platelet to red blood all ratios improves autcome in 466 massively transfused civilian
trauma patiets // Ann Surg. - 2008. - 248(3). - . 447-458
152. Howarth D.M., Tang K., Lees W. The clinical utility of nuclear medicine
imaging for the detection of occult gastrointestinal haemorrhage // Nucl. Med.
Commun. - 2002. - 23. - . 591
153. Jamil LH., Krause K.R., Chengelis D.S., Jury R.R. Jackson C.M. Cannon
M.E.,Duffy M.C. Endoscopic management of early gastrosnestsnal hemorrhage
following laparoscopic Roux-en-y gastric bypass // Am. J. Gastroenterol. - 2008. -
103. . 86-91
154. Imperiale T.F., Birgisson S. Somatostatin or octreotide compared with H2-
antogonists and placebo in the management of acute norvariceal upper gastrointestinal
hemorrhage: a meta-analisis // Ann. Intern. Med. - 1997. - 127(12). - . 1062-1071
155. Jacob P., Fovre O., Dauder J., Lapalus M., Ben Sous E., Sarin J. Clinical
impact of capsule endoscopy for unexplained bleedind in cirrhosis: resuts for 21
patients // Gut supplement. 2005. - 1,37. - . 287
156. Jacke S. et al. Endoscopische Therapie bei varikoser gastrointestnaler //
Blutung. Dtsch. Artzteblatt. - 2001. - 98. . 608-612
157. Jenkins S., Shields R., Davies M. et al. A multicentre randomized trial
comparing octeotide and injection sclerotherapy in the management and outcome of
acute variceal haemorrhage // Gut. - 1997. - 41. - . 526-533
261
158. Johnston J.H. The sentinel clot and invisible vessel: pathologic anatomy of
bleeding peptic ulcer // Gastrointestinal Endoscopy. - 1984. - Vol.30. - . 313-315
159. European best practice guidelines for the management of anaemia in
patients with chronic renal failure // Nephrology Dialysis Transplantation. - 1999. -
sup. 5
160. Kane B. Determining the optimal treatment for anemia // 44th Annual
Meeting of the American Society of Hematolozy. The treatment of secondary
Anemia// Medscape. - 2002
161. Karanicolas P.J., Colduhoun P.H., Dahlke E., Guyatt G.H. Mesenteric
angiography for the localization and treatment of acute lower gastrointestinal bleeding
// Can J. Surg. - 2008. - 51(6). - . 437-441
162. Khan M.G. Manual of cardiac drug therapy 2-hd ed. Philadelphia: W.B.
Cannders. 1988. 121 .
163. Keeling W.B., Armstrong P.A., Stone P.A. et al. Risk factors for recurrent
hemorrhage after successful mesenteric arterial emboliztion // Am. Surg. - 2006. -
72(9). . 802-6
164. Kohler B., Riemann J.F. Does Doppler ultrasound improve the prognosis
of acute ulcer bleeding? // Gepato-Gastroenterology. 1994. Vol.41. - . 51-53
165. Kovacs T.O.G., Jensen D.M. Therapeutic endoscopy for nonvariceal upper
gastrointestinal bleeding // Gastrointestinal Emergencies/ Ed.M.B. Taylor-Williams
and Wilkins - 1997. - . 181-198
166. Krige J.E., Kotre U.K., Borman P.C., Shaw J.M., Klipin M. Variceal
recurrence, rebleeding, and survival after endoscopic in injection sclerotherapy in 287
alcoholic cirrohotic patients with bleeding esophageal varices // Ann. Surg. 2006. -
244(5). . 764-770
167. Lai K.C., Swain C.P. The size of vessel in patients dying from bleeding
gastric ulcer // Gastroenterology. - 1993. - 104. . A202

262
168. Laine L., Brombardier C., Hawkey C.J., Stratifying the risk of NSAID-
related upper gastrointestinal clinical events: results of a double-blind outcomes studi
in patients with rheumatoid arthritis // Gastroenterology. - 2002. - 123. - . 1006-1012
169. Lau J.Y.W., Sung J.J.Y., Lee K..C. et al. Effect of intravenous
omeprazole on recurrent bleeding after ndoscopic treatment of bleeding peptic ulcers
// The New England Jornal of Medicine. 2000. - 343(5). - . 310-316
170. Lau J.Y.W., Sung J.Y., Lam Y. and oth. Endoscopic reatment compared
with surgery in patients with recurrent bleeding after initial endoscopic control of
bleeding ulcers // Engl. J. Med. 1999. 340. . 751-756
171. Lecleire S., Di Fione F., Merle V., Herve S., Duhamel C., Rudelli A. et al.
Acute upper gastrointestinal bleeding in patients with liver cirrhosis and in
noncirrhotic patients: epidemiology and predictive factors of mortality in prospective
multicenter population-based study // J. Clin. Gastroenterol. 2005. - 39(4). - . 321-
7
172. Leighton J.A., Goldstein J., Hirota W. et al. Obscure gastrointestinal
bleeding // Gastrointest. Endosc. - 2003. - 58. - . 650-655
173. Leighton J.A., Sharma V.K., Srivathsan K., et al. Safety of capsule
endoscopy in patients with pacemakers // Gastrointest. Endosc. - 2004. - 59. - . 567-
569
174. Leighton J.A., Sharma V.K., Hentr S.G. et al. Capsule endoscopy verus
push enteroroscopy for evaluation of obsure gastrointestinal bleeding with 1-year
outcomes // Dig. Dis Sci. - 2006. - 51-h. . 891-899
175. Leontiadis G., Sharma V.K., Howden C.W. Systematic review and meta-
analysis: Proton-pump inhibitor treatment for ulcer bleeding reduces transfusion
requirements and hospital stay-Results from the Cochrane Collaboration // Aliment.
Pharmacol. Ther. - 2005. 22. - . 169-175
176. Levi M., ten Cate H. Disseminated intravascular coagulation. // New Engl.
J. Med. - 1999. - 341. - . 586-592
263
177. Levi M. Current undestanding of disseminated intravascular coagubation //
Brit. Journal of haemat. - 2004. - 124,5. - . 567-576
178. Lewis B.S., Swain P. Capsule endoscopy in the evaluation of patient with
suspected small intestinal bleeding: results of a pilot studi // Gastrointest. Endosc. -
2002. - 56. - . 349-353
179. Lichtenstein D.R., Berman M.D., Walfe M.M. Approach to the patient
with acute upper gastrointestinal hemorrhage // Gastrointestinal Emergencies / Ed.
M.B. Taylor.-Williams and Wilkins. - 1997 - . 99-130
180. Lin H.J., Wang K., Perng C.L. et al. Natural history of bleeding peptic
ulcers with a tightly adherent blood clot a prospective observation // Gastrointest
Endosc. - 1996. - 43. V.5. - . 470-473
181. Llungdahl M., Eriksson L.G., Nyman R., Gustavsson S. Arterial
embolisation in management of massive bleeding from gastric and duodenal ulcers //
Eur. J. Surg. - 2002. - 168(7). . 384-90
182. Longstreth G.F. Epidemiology and outcome of patents hospitalized with
acute lower gastrointestinal hacmorrhage: a population-based study // Am. J.
Gastroenterol. - 1997. - 92(3). - . 419-24
183. Madjdpour C., Dettori N., Frascarolo P. et al. Molecular weight of hydro
yethyl starch: is there an effection blood coagulation and pharmacokinetics // British
Journal of Anesthesia. 2005. - 94(5). - . 569-574
184. Management of acute upper and lower gastrointestinal bleeding. - 2008. -
Scottish Intercollegiate Guidelines Network. - 58 p.
185. Matthews J.B., Silen W. Surgical therapy of upper gastrointestinal
hemorrhage // Gastrointestinal Emergencies / Ed. M.B. Taylor. - Williams and
Wilkins - 1997 - . 199-208
186. Matsumoto F.,Esaki M..Moriyama T. et al. Comparison of capsule
ndoscopy and enteroscopy with the double-ballon method in patients with obscure
bleeding and polyposis // Endoscopy. - 2005 - 37. - . 827-832
264
187. May A., Nachbar L., Ell C. Double-ballon enteroscopy (push-and-pull
enteroscopy) of the small bowel: Feasibility and diagnostic and therapeutic yield in
patients with suspected small bowel disease // Gastroenterol. lin. oil. 2005 - 60
. 62-70
188. Mendizaden S., Ross A., Gersch L. tt al.What is the learning curve
associated with double balon in G.U.S. tertiari care ctaters //Gastrointest Endosc. -
2006. - 64. - . 740-750
189. Veron G.D. The development of the swallowable video capsule (M2A) //
Gastrointest Endosc. - 2000. - 52. - . 817-819
190. Miller L.S., Friedman L.S. The endoscopic Doppler and ulcer rebleeding
risk: probing the sourse // Gastrornterology. - 1992. - Vol.102. - . 734-736
191. Miller R.D. Massive blood transfusions: the impact of Vietnam military
data on modern cilivian transfusion medicine // Anesthesiology. 2009. - 110(6). - .
1412-6
192. Morran C.G., Carter D.C. Complications of peptic ulcer // Petic ulcer/
Ed. D.C. Carter. - Churchill Livingstone. 1983. - . 115-131
193. Miloki M., Fritscher-Ravens A., Swain P. Wireless capsule endoscopy: a
comparison with push enteroscopy in patients wits gastroscopy and colonoscopy
negative gastrointestinal bleeding // Gut. - 2003. - 52. - . 1122-1126
194. Nakamura M., Niwa Y., Ohmiga N. Preliminary comparison of capsule
endoscopy and double-balloon enteroscopy in patients with suspected small-bowel
bleeding // Endoscopy. - 2006. 38. - . 59-66
195. Nielsen V.G., Tan S., Brix A.E. et al. Hextend (hetastarch solution)
decrease multiple organ injury and xanthine oxidase release after hepatoenteric
ischemia-reperfusion in rabbits // Crit. Care. Med. 1997. - 25. P. 1565-1574
196. Neu B., Ell C., May A., Schmid E., Riemann J.F., Hagenmuller F.,
Keuchel M., Soehendra N., Seitz U., Meining A., Rosch T. Capsule endoscopy versus

265
standard tests in influencing management of obscure digestive bleeding: Results from
a German multicentr trial // Am J. Gastroenterol. 2005. - 100. - . 1736-1742
197. Paveras G., Pigueras J., Moreno V.J. et al. Effects of casule endoscopy
on cardiac pacemakers // Endoscopy. - 2005. 37. - . 1181-1185
198. J.de ia Pena, Brullet E., Sancher-Hernander E., Rivera M.,Vergara M.,
Martine-Lorente J.l., Carcia Suarer C., Study Group EVL. Variceal ligtion plus
nadalol compared with ligation for prophylaces of variceal rebleeding: A multicenter
trial // Hepatology. - 2005. 41. - P. 572-573
199. Perkins J.G., Andrew C.P., Spinella P.C., Blackbourne L.H., Grathwohl.,
Repine T.B., Ketchum L., Waterman P., Lee R.E. An evaluation of the impact of
apheresis platelets used in the setting of massively transfused trauma patients // J.
Trauma. - 2009. - 66(4). - P. S77-84
200. Porter D.H., Kim D. Angiographic intervention in upper gastrointestinal
bleeding // Gastrointestinal Emergencies / Ed. M. B. Taylor - Williams and Wilkins/ -
1997. - P. 163-180
201. Revised European best practice guidelines for the management of anemia
in patients with chronic renal failure // Nephr. Dial. Transplant. - 2004. - V.19. -
Suppl 2
202. Rockall T.A., Logan R.F.A., Devlin H.B. et al. Risk assessment after acute
upper gastrointestinal haemorrhage // Gut. 1996. - Vol.38. - P. 316-321
203. Rollhauser C., Fliischer D.E. Ulcers and Nonvariceal leeding. //
Endoscopy. 1999. - Vol.31. - 1. - P. 17-25
204. Sachder G.K., Gupta S.K. Effect of addition of IV ranitidine to IV
pantoprasole on 24 hour intragastric pH and its role in control of non-variceal upper
G bleed // Am. J. Gastroenterol. - 2003. 98. . 850
205. Sadowski D. Use of octreotide in the acute management of bleeding
esophageal varices // Can. J. Gastroenterol. 1997. 11. - . 339-343

266
206. Sato T., Yamazaki K., Toyota J., Karino Y., Ohmura T., Ataike J., Kuwata
Y., Suga T. Effect of argon plasma coagulation for gastric antral vascular ectasia
associated with chronic liver disease // Hepatol. Res. - 2005. - 32. - . 121-126
207. Sarin S.K., Wadhawan M., Amgarwal S.R., Tyadi P., Sharma B.C.
Endoscopis variceal ligation plus propranolol versus endoscopic variceal ligation
alone in primary prophylaxs to variceal bleeding // Am.J. Gastroenterol. 2005.
100. - . 797-804
208. Saurin J.C., Delvaux M., Gaudin J.L. et al. Diagnostic value of endoscopic
cansule in patients with obscure digestive bleeding: blinded comparison with video
push-enteroscopy // Endoscopy. 2003. 35. - . 574-584
209. Schilling D., Demel A., Nusse T., Weidmann E., Ricman J.F. Helicobacter
pylori infection does not affect the early rebleeding rate in patients with peptic ulcer
bleeding after successful endoscopic hemostasis: a prospective single-center trial //
Endoscopy. - 2003. - 35(5). - . 393-6
210. Shramm S., Thyes C., Frascarolo P. et al. Impact of C2/C6 ratio of
highmolecular-weight hydroxyethyl starch on pharmacokinetics and blood
coagulation in pigs // Anastelogy. - 2007. - 107(3). . 442-451
211. Shaheen N.J., Stuart E., Schmitr S.H., Mitchell K,L., Fried M.W., Zacks
S., Russo M.W., Galanko J., Shrestha R. Pantoprazole reduces the size of postbanding
ulsers affor variceal bond ligation: A randomized controlled trial // Hepatolgy. -
2005. - 41. - . 588-594
212. Sterline M.A., Suhoski P., Dash R., Rockey D.C. Provocative angiography
in obsure gastrointestinal bleeding // South Med. J. - 2000. - 93. . 1205-1208
213. Silver A., Bendick P., Wasvary H. Safety and efficacy of superselective
angoembolization in control of lower gastrointestinal hemorrhage // Am. J. Surg. -
2005. 189(3). . 361-3
214. Silverberg D.S., Wexler D., Shepes D., Blum M. et al. The effect of
correction of mild anemia in severe resistant congestive heart failure using
267
subcutaneous eryrhropoietin and intravenous iron: a randomized controlled study // J.
Am. Coll. Cardiol. - 2001. - 37,1. . 1775-80
215. Sotoudehmanesh R., Kolahdoozan S., Khatibian M., Asgri Ali A., Mikaeli
J., Ansari R., Ainechi S. Role of endoscopic ultrasound in prevention of unnecessary
ERCP // Gut. 2005. - 1. - V.37 - . A.284
216. Sperry J.L., Ochoa J.B., Gunn S.R. An FFP: PRBC transfusion
ratio>/=1:1,5 is associated with a lower risk of mortality after massive transfusion. //
J. Trauma. - 2008. - 65(5). - . 986-993
217. Su M., Chin C., Hsu C., Chen P. Double ballon enteroscopy - the last
blind-point of the Gastrointestinal tract // Gut. - 2005. 1.37 - . 284
218. Sung J.J.V., Barkun A., Kuipers E.I.
:
// . - 2009. - 279. - .11-14
219. Swain C.P., Storey D.W., Bown S.Y. et al. Nature of the bleeding vessel in
recurrently bleeding gastric ulcers // Gastrointerology. - 1986. 90. - . 595-408
220. Scwareberg M.N. Pro-kinttic medications as aids in imaging the small
bowel by video-capsule // Med. Hypotheses. - 2005. - 64. - . 602-607
221. Seligsohn U. Disseminated intravascular coagulation // Williams
Hematology, 6 Edim. Red. E. Benter, B.S.Coller. - New York. - 2001. - . 1677-1695
222. Tann K.K., Wong D., Sim R. Superselective embolization for lower
gastrointestinal hemorrhage: an institutional review over 7 years // World J. Surg. -
2008. - 32(12). - . 2707-2715
223. Thomopoulos K.C., Minidis K.P., Theocharis G.J. Gatopoulon A,G.,
Kartalis G.N., Nikolopoulou V.N. Acute upper gastrointestinal bleeding in patients on
long-term oral anticoagulation therapy: endoscopic findings, clinical management and
outcome // World J.Gastroenterol. - 2005. - 11(9). - . 1365-8.
224. Thyes C., Madjdpour C., Francarolo P. et al. Effect of high-and
lowmolecular-weight low-substituted hydroxyethyl starch on blood coagulation
268
during acute normovolemic hemodilution in pins // Anastelogy. - 2007. - 107(3). .
442-451
225.Tsibouris P.,Zintzaras E.,Lappas C., Moussio, Tsianos G.,Galeas T.,
Patamianos S. High-dose Pantoprazole continuons infusion is superior to somatostatin
after endoscopic hemostasis in patients with peptic ulcer bleeding // Am. J.
Gastrointerology. - 2007. 102. - P. 1192-1199
226. Udd M., Miettinen P., Palmu A., Julkunen R. Effect of short-term
treatment with regular or high doses of omeprazole on the detection of Helicobacter
pylori in bleeding peptic ulcer patients // Scand J. Gastroenterol.-2003. - 38(6). - .
588-93
227. Zink K.A., Sambasivan C.N., Holcomb J.B., Chisholm G., Sckreiber M.A.
A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of
massive transfusion improves outcomes in a large multicener study // Am. J. Surg. -
2009. - 197(5). - . 565-570
228. Varga R., Tk L., Srabo A., Kovacs F., Keresztes M., Varga G., Kaszki
J., Boros M. Effects of colloid solutions on ischemia-reperfusion-induced periosteal
microcirculatory and inflammatory reactions: comparison of dextran gelatin and
hydroxyethyl starch // Crit. Care. Med. - 2008. - 36(10). - . 828-837
229. Velayos F.S., Williamson A., Sousa K.H., Lung E., Bostrom A., Weber
E.J. Early predictors of severe lower gastrointestinal bleeding and adverse outcome: a
prospective study // Clin. Gastroenterol. Hepatol. - 2004. - 2(6). - . 485-90
230. Voderholzer W.A. Or tner M.,Rogalla P. et al. Diagnostic yield of wireless
capsule enteroscopy in comparison with computed tomografy enterolysis //
Endoscopy. - 2003. - 35. - . 1009-1014
231. Vogt N., Bothner U., Brinkmann A., De Petriconi R., M, Georgieff M.
Perioperative tolerance to large-dose 6% HES 200/0,5 in major urological procedures
compared with 5% human albumin // Anaesthesia. 1999. V.54(2). . 121-127

269
232. De Vries J.E. Surgery in proximal (nonvariceal) bleeding: indications
timing and type of surgery. Amsterdam. - 2006
233. Weinberg J.A., Mc Gwin G. Jr., Marques M.B., Cherry S.A., Reiff D.A.,
Kerby J.D., Rul L.W. Transfusions in the less severely injured: does age of transfused
blood affect outcomes? // J. Trauma. - 2008. - 65(4). - . 794-8
234. Welade L.S., Berardi R.R. Evalution of omeprazole, lansoprazole,
pantoprazole and rabeprazole in the treatment of acid-relates diseases. // J. Am.
Pharm. Assos. - 2000. - 40,1. - . 52
235. Yamamoto H., Kita H., Sunda K. t al. Clinical outcome and treatment of
small-intestinal diseases // Clin. Gastroenterol Hepatol. - 2003. - 35. - . 981-991

270

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