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Ma JICKapCTBeHHblX rrperrapaTOB (cepJJ;eqHble rJII1K03J1Abl.
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aTCJIbHOM yxo-


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aTb
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l.l\eHHJiI.
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cnY'l.3eB. I( BTOpJ.1'1HbIM Jil3MeHiEHHRM KO>KHhIX nOKpoBoB,
KOTopble np"t 3TOM J13MCHJlIOT CBOIO oKpacKY. I1CTOH'IaIOT-
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npH06peTaeT YXO,IJ; 3a KO>Keit J1 npe,IJ;ynpe>K,IJ;eHJile 06pa30-
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11 MaCCa>K. KOTopbIe HY)KHO npoBoAHTb O'leHb OCTOpO)KHO,
yqJilTbIBa.H TOHKOCTb JiI paHHMOCTh KO>KJiI Y nO>KHJIbIX 60JIb-
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nHTb M030nl1.
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B 6plOlllHO:M I1flH 1I1IeBpanbHO:M nOnOCTJiI, HapymafOIJ..teH

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COCy,n;OB BhInyl.l\eHHoi't JKMJJ;KOCTblO JiI C B03MO>KHOCTblO
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nanca). nepelJ; nYHKIJ;HeH, oc06eHHO JIJ1QaM C HopManb-
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paKa, JiI ,n;p.).
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J1HranHI.{JilJ.1 KI1Cnopo,n;HO:M CMeCJ1, nporrymeHHO:H 'Iepe3
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165


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HeHuM nOKa3aTeneM KpOBI1.
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MO>KHO 06H3PYJl(HTb KpOBOH31I11HHJilR B ceT'IaTKY. KapTHHY
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CABJilrO.M neHKOIJ;JilTapnOH c:popMynhI BnCBO. YBenl11feHJile
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n pco6naJ1a tOT JilllICM 11 '1eCKJile nOpaJKeH H R M03ra.
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mCCTBYIOT npeXOJJ;R
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paI.l\CHJiI.R. KOTOpbIC HBJIHIOTCR. enelJ;CT BHCM KpaTKOBpCMeH-
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n RIOTCR ronOBOKpY>KeHJilR. KpaTKOBpCMCHHhIC paccTpoii-
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tlHe B rJIa3aX- L1rneMI1'lecKI1i't HHeynbT MO>KeT pa3BJilTbCH
B mo6oe BpeMR CYTOK. HO '1al.l\C OH B03J1HKaeT nOLl YTPO
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apKTOM M110-
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llaCOB. 3 HHorAa H ,n;HcH) HapaCTaHJilC 01..JarOBbIX HeBpOJIO-
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pa>KCHHOCTb CHMnTOMOB - TO YCHnJilBaeTCJI, TO CHOBa
t JCIIa6n ReTCR. n pJil 3M6oII H '-leCKOM JillIICMJiI qeCKOM 11 Hey 11 b-
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06naJJ;aHJilC oqarOBbIX CJilMnTOMOB Ha,n; 06ll1.CM03rOBhIMJiI.


167


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OCHOBbl repOIfT0J10nUt 101 repVlIDp1011o1


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ne'leHlfe H yxo,IJ;. ne'leHHe 60nhHhIx C M03rOBbIM HH-
cynbTOM AOJI>KHO npOBO,IJ;JlITbCH B CT3l\MOH3pe. DOJIbHJil1J-
HbCe ycnOBJ.1H 3HaQHTenbHO paCllIJilpHIOT TepaneBTJiI'IeCKJile
B03MO>K HOCTH H o6eCne'lHB31OT nOCTO.HHIIhI:M KOHTpOJIb
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nOJJ;JIe>KaT 60nbHble C HanJ11iJileM rJIy6oKoro KOMaT03Horo
COCTOHHJiI.st C rpy6bIM HapymeHJ1eM )K113HeHHblX 4>YHK-
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nOBTopHblX H3pYllleUJll:M M03rOBoro KpOBoo6par.qeHJilH C
HaJIH'IMeM .D;eMeHI.\HM 11 ,n;pyrHx nCI1XH'IeCKJilX Hapyme-
HH:M. 601IbHbIX C HeM31Ie'lHMbIMJiI COM3TJil1feCKJilMJ13a6one-
BaH JilJlMJiI.
06Il.I;J1MI1 nplifHl\J1n3MJiI ne'ieHJiI.H HHcynbTa RBnJIfOTC.R:
. B03,IJ;eikTBH.R Ha Ae.RTeJIbHOCTb cep,n;e'lHO-COCYAMCTOii
CHCTeMbI - npHMeHeHl1e Cep,IJ;e'lHhIX rnJilK03J1AOB npJil
Bblpa>KeHHOM CHI1>KeHI1Ji1 COKpaTI1TenbHoi''I cnoco6HO-
CTI1 MJilOK3p,n;a. rl1nOTeH3HBHbIe cpe.n;CTB3 (3HT3rOHJiI-
CTbl KanbU;l1.R (HI1q,e,IJ;l1nJilH). p-6nOKaTopbI (063MJ],3H).
JJ;l1ypeTI1KI1 (na3I1Kc). AhIXaTeJIbHbIe aHanenTMKH (KOp-
JJ;l1aMJ1H. cynb<pOK3McPOKaMH).
. KoppeKI.\I1H rOMeOCTa33 BBe)J;eHJileM paCTBopOB 3neK-
TpOnJilTOB (paCTBOp rJIIOK03bl 5%. 0,9% pacTBop H3-
TpJil.R xnopJil,IJ;a. paCTBOp PI1Hrepa. 4% pacTBop 6MK3p-
6oH3Ta HaTpJ1J1. nonSlpI13YIOIl.I;3J1 CMeCb B 06LlteM o6'b-
eMe ,IJ;O 2JI). HJ13KOMOJIeKYJI.RpHhIX ,n;eKCTpaHOB (peono-
nJilrlIlOKJilHa ,IJ;O 400 Mn). KoppeKI.J;I1J1 rJilnOKanJileMHM.
rl1nOxnopeMJilJiI.
. EOpb63 C OTeKOM M03ra: BHYTpHBenHo BBO
J1TC.R 10 Mn
2.4% 3yqmJIJIJilHa. 1 Mn na3MKC3, np" He06xolIMMO-
CTJiI- MaHHJilTon. M01feBJilHa; 3HTJilrJilCTaMHHHble npe-
nap3Tbl (A"'IMeJJ;pon. n"'InOnb
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npl1MeHHTbCH rJil,IJ;pOKOpTM30H, ,n;eKc3MeT330H. npeA-
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TepMHJiI H33Ha'laIOT (JIJ1TJiI'IeCKHe» CMeCH. BKnlO1JalO-
r.qHe ,IJ;JilMe,IJ;pon. HOBOKaJilH, aHanbrJ1H; npoBO,IJ;J1TCH
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p3HHe TeJIa 601IbHoro CnJilpTOM AOKpacHa. GTO YBeJIM-
u
'1J'1BaeT TennooT,n;3'1Y, npoBe)J;eHHe perJ10n3pHOH fJilnO-
TepMm1 KpynHbIX COCYJJ;OB (oXJIa>KAeHJile o6nacTH COH-
HbIX apTepJ1:M. nOJJ;MbIllIe1fHbL'X H naXOBhIX o6naCTe:M).
YKYTbIBaHJile Bj(3)KHbIMJiI npOCTbIHJlMI1.
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["ynJilpYIO
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l\aeMocTb cOCY,IJ;JilCTO:M CTeHKJiI. JilCnOJIb3Y.R npenap3TbI
KaJIbl.\MH (10 Mn 10% pacTBopa xJIopJil,IJ;a K3nbl.{l1J1
BHYTpHBeHHo HnH rnlOKOHaTa K3nbl.\J1.R BHYTpJilMbl-
lIIe'4Ho). BJilKaCOn (2 MJI 1%).5-10 Mn 3% pacTBopa ac-
Kop6Ji1HOBOH KI1CJIOThl. )f(enaTJ1H 10% - 20-50 Mn
BHYTpHBeHHo.PYTJilH.PYT

JilH.£-3MHHoKanpoHoBYro
KJilCJ10TY (5% -,IJ;O 100 Mn). ,n;11U;JilHOH ( 2 MJI - 250 Mr)
BHYTPM BeH HO JilnJil BHYTpJil MhIme'l HO; B03MO>K H 0 XI1-
pyprHqCCKOe JIe'leHHe - nYHKI.{HOHHOe cTepeOT3KCJ1-
1feCKOe y,IJ;aneHJile naTepaJIbH01'1: feM3TOMhI nocne KT.
P331IMqHbIe MeTO,IJ;hI xJilpypfJ1'1eCKOro ne1feHJilH 3HeB-
pl13M cocy,n;o
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. TIpJil HllIeMJilqeCKOM MHcynbTe: YBenH'IJlIBaIOT npHToK
KpOBH K M03fY nYTeM paCmJilpeHJiI.H pefJilOH3JIbHbIX
M03rOBbIX COCY,IJ;OB H YMeHbmeHHH cna3Ma COCy,n;OB.
ynY'lllIeHJiI H Konn aTepan bHoro Kp oBoo6par.qeHJiI H.
npJ1MeHHR Ba30,lJ;JilJI3TaTOpbI (10 MJI 2.4% p3cTBopa 9Y-

J1JInHHa BHYTpJilBeHHo). HJ1KOTJilHOBYro KJilcnoTY (l %
p3CTBOp 1-2 Mn BHYTpJilBeHHo). cTyrepoH, TpeHT3n


168


169




OCHOBbi repOHTOnOr


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u
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Toiil.Jl1BOrO cTyna.
B nO>Kl1nOM H CTapqeCKOM B03paCTe 60rreBhIe npl1cryrrhI
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BOit: 6enKoBblH OMneT. KapTocpenbHoe nrope. eyn OBCJlHblH




cnH3I1CTbIH. eyn nepnoBblH CJIH3HCThIH. nlOpe MJlCHoe na-
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pOB (2400 KarropHii)-
MeJJ;JlCKaMeHTo3HaH Tepanl1J1 npH o60cTpeHHH TaKaH
>Ke. KaK npl1 OCTpOM n3HKpeaTMTe.


I
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nOM 11 CTapqeCKOM B03paCTe HBnHIOTCH: JJ;1,f(KOM
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KOBb 11 .D.p.), COK11, CBeKJIa. rB03AHKa, naBpOBbIH nHCT,
KalliH (OBC.RHaH, nepll0Ba.R. rpeq
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JJ;HHOBble OCHOBaHH.fI).
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«p arH .



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MeHTHhIX nperrapaTOB.
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mcne3bl. no COCTaBY rrop,pa3.IIcnHIOTCH Ha 4 rpynn:w:
1) naHKpeaTl1l.JCCKHe 4>epMeHThl (naHKpeonaH. nau-
Kpe3TI1H);
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I1MeeTC.1I )J;u6aBKa 9neMeHTOB >Kenq11 (rr3Iu<peoH);
3) npenapaThl, KOTopble. cBepx Toro. cop;epmaT nen-
CI1H, conHHYIO KHcnoTY (naH3HIIopM);
4) npenap3TbI. KOTopble, KpoMe naHKpeaTa.fqeCKI1X
cpepMeHToB 11 aneMeHTOB :>KCnqH. co.n;epmaT H K11-
IlJeqHblC cpepMcIITbl (<pecTan. JJ;Hrccran).
Bile 060CTpeHI1H 3a60neBaHHJI JJ;nH nOBbIIlJeHHH aK-
THBHOCTH nOJJ;>KCny.noI.JHoi1 mene3bl npl1Mell.RIOT rmOKOHaT
KanhIJ;I1H H 3Y«P"JIn11H.
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01: co6nro)J;eHl1e pe>KI1Ma nJ1TaHHJI (AP06Hoe, ManblMI1
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pOJIOrH qeCKOrO n poqmJIJI.


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199


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rroKa lie nOnTBep>K.£(eH bL
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y,n;nHHeHHeM MO'lCHcnYCKaIlH.R ,n;o HecKonbKI1X MHHYT.
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nYCKaHI1H. B 3TOT nepHOJJ; sa60neBaHH.R BbIJlBnJleTC.R OCTa-
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npe1J;CT3TenbHoH :>KeneSbl - BCTpe'laeTCR y 30-40% MY:>K-
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pael' HapyrneHHe ropMOHanhHoro 6aJIaHCa npl1 CTapeHJlCH:
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CBeT 3aAHei1 qaCTI1. qTO c03.£(aeT conpOTHBJIeHI1e TOKY
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.LIJ;ero onpegeJIHTh pa3Mepbl 11 KOHCHcTeHu.111O npeA-
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C aCKop611HOBOM KI1CnoToi1:.
.Qn1l ynY'IlIJetll1.H peaKTI1BHOCTM OpraHIi13Ma nO>KI1JIoro
'lenOBeKa npl1MfH.RfOT TaKli1e cpep;CTBa KaK nOnI1BIi1TaMJ.1-
tlbI, neHTOKCMn J MeTMnypalJ,Mn 11 T. n.
I1pl1 yxoAe 3a repl1aTpli1"leCKI1M naI..tMCHTOM c nMeno
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Hep;enJO) "3MepCH"e Bop;Horo 6anaHca. 60nee "laCTblU I<OH-
Tponh COCTO.HHM.H napaMeTpoB rCMoAI1HaMI1KM 11 TeMne-
paTypbJ Tena. Ba>KHO nOMOqb rral1,HeHTY npM npOBCl!;eHI111
rl1rl1eHMqeCKI1X npou;ep;yp, nOAfOTOBKf K Ii1HeTpYMeH-
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HIi1.R Tpe6YlOT nlO.n;(II nmKl1nOro 11 cTap'JecKoro B03paCTa.
H aX On.RlQl1ec.R tla nOCTenbHOM pe>KI1Me. I1MefOII.J;"e Hapy-
llIeHI1
 nCI1XMKIi1, BbICOKJ1i1: pl1CK pa3BI1T".H oeTpoM eocy-
AI1CTOI1 HeAocTaTOqnOcTI1.


3. OCHOBbi replofaTplof



3.9. np06AeMC OCTeonop03C
OCTeonopo3 - 3a6oneBaHI1e CKeneTa. npOJlBn.HfOlI{er-
C1I CHI1}KeHJ1eM KOCTHOi1: MaCCbI 11 MI1KpOCTPYKTypHbIM
nOBpe:»CAetll1eM KOCTHo:f1 TKaHIi1, npMBo.n..R.
JlJM K nOBblIlIe-
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pli1CKa rrepenOMa (KoneHrareH, 1990 r.).
TIpli1 oCTeonopo3e Bbl.n;en1llOT ABa fnaBHMX npOI..teCLJ
KOCTHoro 06MeHa. Ka:iKAbIH 113 KOTOpblX npJlJBOp;I1T K CHH
:»ceHl1fO MaCCbI KOCTI1: 1) BbICOKaH CTeneHh pe30p6I..tIi1.l1 I{OC
TI1 He KOMneHC"pyeTCR. HopManhHbIM I1n" nOBbIllleHHLIM
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Ha HOpMaJIhHOM YPOBHC. HO CHJ1JKaeTCH ypoBeHh KocTe06-
pa30BaHJIJ JI.


OCTconop03 MO>KeT 6bl1.'b nepBl1qUhlM: IOBeHMnbHbIl1.
I1AeOilaTUGeCK"M y MonO)J,blX B3pucnbLX. nocTMeHonaysan:t:..
RbIM (1 Tun) 11 CeH"nhHblM (II Tl1n)
 11.J11i1 nTOpli1qHblM -
np11. Tl1peOTOKCIi1K03C. 6one3HIi1 " CJ.1H.n;poMe J.1u.eHKo-Ky-
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Manba6cop6u. 1i111 , peBMaTOI1AHOM apTpl1Te J capKoM.n;03C,
3n ORa qeCTBCHII bl x onyxon1lx. Ii1 MM0611 nI13al1,"11. neqefl HIi1
HCKOTOpbIMIi1 nCKapcTBeHRblM (II npcnapaTaMI1 (KOPTI1I<O-
cTepol1.n;aM(II.6ap6Ii1TypaTaMI1, rcnapMHoM. npoTI1BOCYJJ;O-
pO>KHbIM 11 cpeJJ;CTI:
aMI1 r Ii1MMYH op;enpecca H TaMI1, anfOM
-
HIi1 Hco.n;ep>KalQ" MJ.1 3HTaUl1naMIi1).
Y niOAeM nO}l{li1noro Ii1 CTapQeCKOrO B03pacTa Ii1MelOT
MeCTO l<aK rrepBl1qHblC, TaK J1 BTOpH'LJHble npl1'lHHbl OCTCO-
1l0p03a. 06lQa1l rrOTCp.H KOMn3KTtlOrO BCIlI.eCTBa K 70 rOAaM
.n;oCnllaeT 19% y MY>Kqli1t1 H 32% Y >KeHLqIi1H. Y6bInb ry6qa-
TOTO BelQCeTBa nOCJIe 25 neT He3aBl1CI1.MO OT nona COCTaB-
n.HCT, B CpeAHeM, 1% B ro.n; 11 I< 70 ro.n;aM .n;OXOJJ:I1T AU 40%.
I1pcApacnonarafOLqIi1MH
aKTopaMI1 oCTe on opo3a RB-
n.HIOTC1I:
. non U KOMnneK1;u..fl: y My>K'll1H 1i13-3a 6onbllloro KOnl1-
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np0'luee; Y>KCH1.l.J;I1H npol1,CCCbI pe30p6u. 1i111 KOCTHOM
MaCCbI Ii1AYT aKTIi1BHee, oco6eHHo B nepli1o.n; MeHonay-
31'01 (y 50% -.n;o 1-2% B rOJJ;) "nl1 nocnc YAaneHI1.H .Hl1q-


HI1KOB (3aMcAnRfOTC.H OHI1 npl1 pO>K.n;eHJllIi1 neTCIi1 -
Ka>KAbIC pOAbl CHI1>KafOT pli1CK nepeno MoB Ha 9%);
BblCOKIi1C 11 XYAblC nIdAI1 60nee nonBCp>KeHbI OCTconO-
po3Y. qeM nJO.n;H nnOTHoro TenocnO>KeHIi1.H 11 HCBbKO-
Koro pOCTa.
. Mal101100BUJKflbfU o6pa3 :HCU3HU: .n;nl1TCnhHaJl HMM0611.-
nM3aUI1.H npMBOAIi1T K oCTeonopo3Y, TaK :»ce KaK IIpe-
6blBa H He B HCBeCQMOCTI1.


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Ii1 MexaHM3Me 06pa30BaHI1.H KOCTHOIA Tl<aHI1 (BI1TaMIi1H
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Teonop03a y )KCHll\I1H.
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rCHCTl1qCCKIi1X 11 CCMCHHbJX cpaJ<.TopOB Ha nnOTHOCTb
KOCTI1 (Hanpl1Mep. OCTt::onop03 penKO BCTpeqaeTC.H V
w .
npe.ncraBJ1TCnCI1 HerpOIi1AHoi1: paCbJ), a BKJIa)]; Hacne


CTBCHHbIX $aKTopOB B 113MCtlql1BOCTh 3Toro rrOKa3a-
Ten.H COCTaBnHCT AO 80%.
· CPaKmopbl nUmaH.UR: KoeTh COCTOHT. B oeHOBHOM. 113
KanhlJ;Ii1Ji J.1 .poc$opa. KOTopbIe OTKJIBAhIBaJOTCH B 6en-
KOBOM Ma'rpl1Kce. Ha3bIBaeMOM OCTCOA. a 6anaHC Kanb-
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C MOEfOIA. nOTOM Ii1 .peKanJ1HMl1.
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r..u;cnKJ1 rOnCHI1.
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TaK KaK \laeTO OH npoTcKacT ManOCIi1MnTOMHO 11 BbUIBn.H-
CTCJI Y>KC npl1 Hanl1qJf" nepenoMoB KocTeH. OAHBKO Y
60nhllIJ1HCTBa nalJ,l1CHTOB I1MeIOTC.H >KaJI06bI HB 60nJ1 D
cnJ1l1e (MC)f{)J;Y nonaTKaMM Hnl1 B IIOJICHMqHO-KPCCTl.\OBO.i't
06nacTI1). YC.I1nJ.tBBIOlI{J1eC.H nocnc $113:M'lCCKOit HarpY3KI1.
:n;nli1TClIbtlOra npc6blBBHI1H B OAHOM nOnO>KCHIi1M (cTOJll1nl1
CI1.n;.H). 3TIi1 60nl1 o6nerilBfOTcH I1JII11i1CqC3afOT nocnc OTJJ;bl-


xa ne>KB. KOTOpbli1 Tpc6yeTC.H 60nbllblM MHoroKpaTHo B
TeqeHJ1C AH.H. B aHaMHC3C MorYT 6bITb YKB3aH(IIH lIa 3nJ1-
30AbI OCTpblX 60nei1 B cnli1He. KOTOpblC pBClJ;CHIi1Banli1 KaK
nO.HClIl1l1HO-KpeCTIJ;OBbIM paA"Kynl1T BcnenCTBl1e OCTCO-
XOH:n;po3a Ii1 .n;ecpopMl1pyfOll\CrO cnOIlAli1ne3B. K KOCBetl-
HblM npl13HaKaM 60ne3HI1 OTHOC.HTe.H CTap"lCCKaJl CYTY-
nOCTb (rop6), HOqHblC cYJJ;opUCJ1 tlor, nOBbIllIeHHaH YTOM-
n.HeMOCTh. napa.n;OHT03. xpynKocTb HorTeH H npCJKneBpe-
MeHHoe noce.n;eHI1C. 11 XOT.H Hanl1qli1e 3TIi1X CIi1MnTOMOB He
.HBnJleTC.H 100% nQATBep>KneHIi1CM AJ1arHo3a. OHO Bce-TaKl1
n03BOn.HeT onpe.n;enli1Tb Kpyr I1ccne.n;oBaHHi1:. He06xonl1-


MblX .n;nJl ero YTOqHCHI1H.
T paAHl.\l1 OH Hoe peH TrCHOnOr}1. qec Koe. Ii1C cneJI,OB aH 11 C
n03Bon.HCT onpe.n;enli1Tb CHH)f(CHl1e KOCTHOH nnOTHOCTJ1 C
ypOBH.H 25-30%. TeM He MeHec. Ba)KHoi1: HBnHeTC.H peHT-
renorpacpli1.H rpy.n;HbIX n03BOHI<OB. CHIi1>KCHli1e nnOTlIOCTJ1
KOTOpbIX 'LJBCTO HaQIi1HaeTCH paHbllIC. l1eM B .n;pyrli1x OT.n;e-
nax n03BOHOQHOrO eTon6a.
KOCTHaJl .n;eHCIi1TOMCTpl1.R. 113Mep.HfO
a.H YPOBCHb no-
rnOl..QCHH.H peHTrCHOBCKI1X nY'lei1 KOCTHbIM BeI.QeCTBOM.
n03BOn.HeT ou,eHIi1Tb rrROTHOCTb KOCTI1 KaK OCHOBY ee
npO'LJHOCTI1. OJJ;HaKO OCTeonop03 JlBJIHeTCH 3a60neBaHHt::M
6enKOBOl'0 MaTpJ1KCa KoeTH. a co.n;ep>KaHli1e M"HepanOB
113MeHJleTCJI BTOpl1'-lHO 11. KpOMe Toro, :n;aHHaJl MeTOAIi1Ka


HC COBceM ToqHa J13-3a 1i13MepeHIi1H nli111Ih npOCKLl.Ii1OHHOJ1
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TOJII.QI1Hbl KOCTIi1) 11 Reo.n;tlopOAHOCTIi1 KOCTHoi1: TKaHH (e
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MCTQAI1Ka ABYX3HepreTli1qeCKoi1 penTreHoBcKo:i1 a6-
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BblroAHhIX Ka\leCTB: B03MO>KHOCTb Hccne.n;OBBTb OCCBOI1
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(oc06eH HO 3eneHble), KYH>KYT. MI1H.n;anb. apaxl1c. ce-
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2) 06e36onI1BafOlll.'i'le cpe,u,cTBa B ncpl1o.n; 060CTpCHJ.1H
(necTCpO(ll.n;HhlC npOTIotBOBOCnan11TenhHble npenapa-
Tbl, aHanbreTI1KIi1);
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3Ii1QeCKi1£ HarpY3K(II J.1 neqe6t1YIO 4>H3KynhTYPY;
4) nomeHl1e I<OpCeTOB;
5) Macca>K Qepe3 3-6 MeCHu.eB OT HaEfana cpapMaKoTe-
parrl1M.
Bee cpe.n;cTBa naTorelleTMQeeKOrO nel1eHJ.1:f1 OCTeorro-
p03a MOmEO ycnoBHo pa3Aen11Th Ha Tpl1 rpynnbl:
1. npenapambf C npeuMyt«eCml3£HflbIM nooaaneHueM pe-
30p6u,uu KOcmu: HaTypanbHble 3CTporeHbl (3CTpareH-
rccTareHHble npenapaTbI). Kanbll,JITOHI1HbJ (Mli1aKanb-
U.I1K.CIi16aKanh
HH.Kanb
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(9TH:n;poHaT. a.lleH.n;pon aT . pe30APoHaT)

2. npenapambl. cmuMynupYJOUiue Kocmeo6pa306aHue

conl1.pTopa (4)TOpMCTbIJi HaTpIi1H. MOHocpmopo4>occpa-
Tbl), 4>parMeHTbl napaTfOpMoHa. eOMaTOTporrHblJi fOP-
MOH. aHa60nli1qeCKI1e c re pol1JJ;bl;
3. npenapamb
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ecca KocmHOlO peMo(}enUpOBaHUJI: BHTaMMH Dz J.1 BM-
TaMMH D3. aKTI1BHbTC MeTa6on'i'lTbl BHTaMJ.1Ha D3. anb-
cp aKa rrbUIi1.n;on. Kanb4 li1T pl10n,OCTeoreHO H .
Opocpli1naKT'i'lKa OCTeonop03a .n;on>KHa 6bITb HarrpaB-
netla Ha CBoeBpeMeHHoe Bbl.HBneHl1e 11 ycTpalleHl1e cpaKro-
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KBaTHoro neqelIMH Ha paHHI1X CTaAli1.f1X pa3BIi1TM.H 60ne3HI1
(JJ;O B03HIi1KHOBeHI1J1 nepenOMOB).
llpo.pHnaKTH'IleCKIIMII HBRHIOTCJI cJlep;ylOlD,He Me-
ponpHHTH.H:
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KH Ha n03BOHOQHIi1K lot CYCTaBbl;


II
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BbICOKYIO TO'IHOCTb 11 HI13Kym OllIM6KY BOCnp0Ii13BO)3;I1MO-
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J.1R. (06'beMHaH Cnl1panh-
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TYPY KaK n03BOHO'lHMKa. TaK 11 6e.n;pelluoi1: KOCT1IJ, XOT.R
OCTaeTCH AoporocToH
I1M MeTOAOM C BbTCOI<OM nyqeBUM
l:iarpY3Ko:i1. C TaKI1M >KC ycnexoM MO>KeT 6blTb I1CnOJIb30-
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C nOMOIll.bfO AaHHoro MeTo,lJ;a MO>KHO I1ccne.n;OBaTb n SlTOq-
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rl1e nOBcpXHOCTIIO pacnOnO>KeHHble KOCTI1.
JIe'leHl1e OCTeonop03a npe.nCTaBJI.HCT c060ii CnO>KHYfO
npc:6neMY. T 3K KaK 3360nCB3HI1e Ii1MeeT MHQTOKOMnOneHT-
HbIIi1 rraTorCHC3 11 reTcporcHiIyJO npl1po.n;y. 3aAaqaMI1 ne-
qeHMH OCTeonopo3a .HBn HIOTCH:
. 33Me,nJIeHl1e I1nJ.1 npeKpaLU,CHIi1C nOTepM MaCCbl KOCTI1.
>KenaTeJIeH ee npl1pOCT H3 cpOHe nel1CHM.H;
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ynYQmeHl1e 06lQero COCTO.HHIi1.H nal1,MCHTa;
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HO B03MO>KHOe BOCCTaHOB}lCHli1e TpYAocnoc06HOCTI1 J.1
ynYQmeIll1e KaqeCTBa >K113HI1 60nhHoro.
ClleTeMaTH'ICC.KOe ne'llCHlle OCTeonop03a BKnlOqaeT
B ce6.f1:
1) npl1MCHeHl1e .n;l1eTbl, c6analfCIi1pOBaHHoH no COn.HM
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MenKaJl pb[6a C KOCT.HMI1. capnl1HbI. mnpOTbJ. OBO
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215


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OcHOBbi repoHlDJ10n.t" III rep
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· OTKa3 OT IIo:n;'beMa TH)f{eCTeM (Beca 60nee 2-3 Kr);
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6ynboHoB, KOHcepBoB. KOn'leHOcTci1. Kocpe.lIIoKona.n;a)
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ll\EBbIX A06aBoK. BJ1TaMI1HHbIX II penapaToB.
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 npou,eCC B replo1aTP"'"


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pe
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n p e.n;BIi1AeHHbIe ocnU>KHeHI1.H COCTOJlHI1H rrau. li1eHTa . Hepe-

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a) YBenl1qeHl1e 06"heMa M03ra
6) Crna)101BaHI1e J13BJ.WI1H
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r) OTCfTCTBHe 113MeHeHI1i1:.
npJ1 CTapeHI1J1 pel1,eIITOpM cocy:n;HCTOM CTeHKI1:
a) He J13MeHHIOTcH
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a) TaXI1Kap)];J1.H
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6) HaYKa 0 rrpeAynpe>K.n;eHI1J1 CTapeHIi1H
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:iKMlIOrO B03paC"ra
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6) cne.n;CTBHe BpeAHblx rrpJ1BbIqeK
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r) nepl1o.n; )K113Hl1_
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a) 14-18 B Ml1HYTY
6) 16-20 B MI1HYTY
B) 22-24 B MIi1HYTY
r) 18-20 B MI1t1YTY.
4. I1pl1 CTapeH1i11i1 YBenHql1BaeTCJI cneAYlOIlI.I1H IJOKa3a-
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11. fipOH XHan bH bIe >KeJIe3bI n pH CTa pCHH11:
a) YBenJ1qli1BaiOT Konli1QeCTBo ceKpeTa
6) BbIpa6aTbmafOT ceKpeT nOBbIllIetlHoi1: B.H3I<OCTJ1
B} tie H3MeHHIOT KOnl1QeCrBO ceKpern
...
r} BbIpa6aTbIBalOT ceKpeT nOHIi1>KeHHOJ1 BH3KOCTJ1.
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)KaeTC.H BcnenCTBJ1e:


a} OKOCTeHCHJ1J1 rJ1anJ1HOBbIX xpHlQeli1
6) yomeHJ1H rpy;nHorO Kl1cp03a
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r) yMCHblllCUIi1.H nOJlCHJ11IHOrO nopAo3a.
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HbIM 06'heM:
a) MJ1HYTHbIH 06'heM JJ;bIXaHJ1H
6) 06'beM McpTBoro npoC'rpaHCTB3
B) o6'"beM rpYAHOM KnCTKl1
r) oCTaTOQH bIi1: 06'heM.
14. J13MeHcHHC KallineBOfO pecpncKca npJ1 cTapeHJ11i1 npl1-
BO.n;J1T K:
a) qacroMY KallinfO
6) peAKoMY KallinfO
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r) 'lYBCTBY «neplIIeHI1.H)) B ropne.
15. I13MeHcHHe ra3006MeH3 npJ1 cTapellli11i1 conpOBO>K.n;a-
eTCH:
a) rli1nOKanHJ1ei't
6) rl1nOl<cCMJ1ei1:
B) ype>KeHJ1eM .n;bIxaHJ1.H
r) yrny6neHIi1cM ,llbIxaHIi1.H.
16 B CB.H31i1 C B03pacTHbIMIi1 M3MCHeHJ1HMIi1 B rronOCTIi1 pTa
y repli1aTpIi1 'Iec KOTO naUJ1eHTa IT pCH M ylI{eCTBeH HO na-
pYlllaCTC.H:


a) nepCBapli1BaHJ1e >KJ.1pOB
6) nepeBapJ1BanJ1e yrm::BOJJ;OB
B) YCBOeHJ1C B11TaMIi1HOB
r) IIcpeBapli1BaHli1e 6eJIKoB.
17. B03paCTIt bIe J.13MeHeHJ1.H >KelIYAOqHO-KHlIIe'tJHoro TpaK-
Ta rrpJ1Bo.n;HT:
a) K YCl1neHJ1fO nepJ1CranbTMKJ1
6) K 3aMc:n;nCH"fO nepJ1CTanbTIi1KJ1
B) K rrOBblllIeHHOM npo.n;YK1I.J1" CnJ13J1
r) K yCKopeHli11O BcaCbIBaHJ1H.
18. CornacHo -rpc60BaHJ.1.HM repO
J1eTernKJ1 Kanopuf1HocTb
nJ1Il\eBorO pau.iowHa IIO)l(lf.noro 'lCnOBeKa AomKHa:
a) COOTBCTCTBOB3Tb ::loHepro3aTpaTaM
6) 6bITb B TpH pa33 MeHbllIe. qeM B MonOll;OCTI1
B) COOTBe7CTBOBaTb 6bIBIlICi1 npo$eCCJ1J1
r} 6bITb Ha 20% MeHbme. QCM B Mono.n;OCTJ1.
19. B CBoeM paL\HOHe lIo>KJ1noi1: 'lenoBeK .n;on>KeH orpaHH-
qli1BaTh:
a) 6enKIi1 )KIi1BOTHOro npOJ1CXO>K,lJ.CHJ1.H
6) 6en KM paCnUCJIbHOrO npOJ1CXQ)K.n;eHJ1H
B) JKli1pbI >KJ1BOTHOro npOJ1CXO>K:n;eHJ1H
r} )f(MpbI paCTJ1TenbHOro npoJ1CXO>Kn eHJ1 .H.
20. nepeBapJ1BalOlQa.H cnoco6HoCTh COKa nO,[t)KenYJJ;O'l-


HOJ1 >KCne3bI C B03paCTOM:
a) YMcHhlIIaeTCJI
6) YBenJ1'lJ1BaCTC.H
B) He 113MeHR.eTCH
r) 1i13BpalQaeTcH.
21. 4pe3MepHoe ynoTpe6neHIi1e 6eJIKOBoi1 nli1Il1.J1 nO>KJ1-
nblM QenOBeKOM cOnpOBO)K.n;aeTcH:
a) YBeJIJ1qeHli1eM 6pO>KeHIi1H B KJ1IlIeqHIi1Ke
6) YCJ1nCHIi1CM ncpHCTanbTI1KI1
B) YBenJ1qCHHCM rHli1eHH.H B KJ111Ie'lHJ1Ke
r) MeTeOpJ13MOM.


I
"I


I
11
II
I M


I
I
I
I
I
I


8-


227


I
I
1
I




226





 II
I


\I


OCHOBbi repoHT0J10r


 rep
aTp




KoHTpo.nbHble BOnpocbl


22 B CepAelIHOM MbIIlILI,e nO)f(}l1noro lIenOBeKa:
a) YBenli1ql1BaeTCJI B036y.n;HMOCTb
6) 33Me.n;n.HeTCH npOBO.n;I1MOCTh
B) YMeUblllaeTC.H Macca
r) YCli1lII1BaeTC.H COKpaT1IJMOcTb.
23. An.H 113MeHeHIi1:i1: B tlepBHO:H CI1CTeMe npli1 CTapeH1i111
xapaKTepHo:
a) nOBbIllieH li1e 3KTMBHOCTIi1 KOpbI ronOBHoro M03f3
6) nOBbIWeHl1e CKOpOCTI1 nepe,p;aq1lJ HepBHOI'O I1M-
nynbc3 B CI1HanCaX
B) YBenl1'leHl1e BpeMeHI1 pe
neKca
r) YMCHbIlIeHJ1e BpeMeHIi1 pecpneKca.
24. nmKl1flbIM nfOJJ;.HM peKoMeHnyeTcH npocpeCCli10Hanh-
HaR .n;eHTenbHocTh, CBH33HHa.R c:
a) JJ;nl1TenbHbIM nCI1XM'leCKJ1M HanpH>KeHl1eM
6) 06Y"leHl1eM rrepCOHana
B) pa60TOJi Ha KOHBe:i1:epe
r) Heo6xOAI1MOCTblO 6bICTpO npl1J1MMaTb pellieHIi1H.
25. MaKCI1ManhHO AonycTIi1MOJ1: tpl13li1oflOrl1QeCKo:i1: 'lacTO-
TOH HOQHblX MOqeli1cnycK3HI1:i1: AnH nO>Kl1noro qenOBe-
Ka Cql1TaeTCJI:
a) 1
6) 2
B) 4
r) 6.
26_ CYTO'l.{HbIH AIi1ype3 y QenOBeKa rrpli1 CrapeHI1J1:
a) yMeHbIllaeTC.H 3a ClIeT HOlIHOrO Al1ype3a
6) YBenli1ql1BaeTCJI 33 ('-leT HOQHOrO n l1 ype3a
B) YBenl1'1I1BaeTC.H 33 C'leT .n;HeBHoro .n;l1ype3a
r) He J13MeIUIeTcH.
27. CTap'leCKaJI 3Mcpl13eM3 corrpoBO>KAaeTCJI:
a) YBenl1'leHl1eM OCTaTOlIHOrO 06-"beM3
6) YBenl11.1eHIi1eM pe3epBHoro 06'heMa BbI.n;oxa


B) YMeHbllIeHl1eM AbIX3TenbHoro 06"heMa
r) YMeJlbllleHJ1eM pe3epBHoro o6-"beMa BAoxa
28. CHIi1>Kenl1e CaMOO"lI1
eHI1.H .n;blx3TenbHblx nYTeii Y
CTapl1KOB 06ycnOBJIeHo:
a) ocna6neHI1eM AbIxaTenbHo:i1: MYCKynaTypbI
6) 3aMe:n;neHli1eM .n;BI1>KeHI1JI BOpCI1HOK 3nli1Tenl1.H
B) OKOCTeHeHl1eM rJ1anl1t1oBbIX XP Ju u. e i1: pe6ep
r) paCllIli1peHli1eM npOCBCTa rOpT3HI1.
29. B03BpaT KpOBI1 K cep:n;u;y B crapocrn: CHI1>KaeTC.H J13-3a:
a) paCllIli1peHI1H BeH03Horo pycna
6) paCllIl1peHIi1.H Kanl1nn.HpHOH CeTl1
B) nOHI1>KeHI1.H BHYTPl1rpy.n;Horo .n;aBneHI1J1
r) ynnoTHeHI1.H creHOK apTepl1i1.
30. Y nO>Kl1nbIX flfOD,c:i1: B HopMe $opMa rpy.n;Hoit KneTKI1:
a) KOHI1'leCKaH
6) Ul1nl1t1npJ1QeCKaH
B) 60'lKOo6pa3H3H
r) BOpOHKoo6p33H3.H.
31. M1IJKpoc):mopa KIi111Ie'lHJ1Ka IIPH CTapCHIf.I1:
a) 3t1aQIi1TenbUO YBenl11II1BaeTCJI
6) cyIl..\eCTBeHHo J13MeHHeT cBoi1: COCTaB
B) nporpeCCIi1BHO YMeHblllaeTCH
r) He 113MeHHeTC.H.
32. nO>KJ1nbIM nlOJJ;.HM C 1IJ36bITO'lHOU MaccoM Tena HY>KHO
npl1HIi1MaTh nl1w.y:
a) 2-3 pa3a B .n;eHb
6) 5-6 pa3 B AeHh
B) "lepe3 AeHh
r) B rrpl1BbLQHOM pe>KIi1Me.
33. CooTHolIIeHHe OCHOBtibIX KOMnOHeHTOB III1T3HI1J1
(6enKl1, >KJ1pbr
 yrncBoAbl) B paU;J10He repUaTpl1"leCKO-
co lIal
l1eHTa .n;on>KHO 6bITb:
a) 1: 1 : 4






I I
I


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I


j I


229


228


'"




OcHOBbi repoHT0I10r11
 M rep
aTp
Ut


KOlfTpoJ1bHble BOnpocbl


6) 1: 1 : 2.
B) 1: 0,8 : 3,5
r) 0,8: 1 : 3,7
34. repOH roq,061uI - 3TO:
a) cTpax nepep; cTapocTbIO
6) Bpa>Kp;e6HOe OTHoweHHe nO>KHnbIX nlOAeJ1 K CTa-
pOCTIr1
B) Bpa)Kne6HOe OTllorneHlr1e K nO>KHnbIM mOp;.fIM
r) CTpax CMCpTIr1.
35. npJ.1 cTapeIIHH CTeHKH MO'leBoro nY3blp.fl CTaHOBJlTCfI:
a) SnaCT:H':IHbIMJ1.
6) pl1rlr1p;HbIMI1
B) TOHKHMJ.1
r) ynpyr:HMH.
36. rny61r1Ha ncpepa60TKH nlr111
H y nO)KIr1110ro ':IeJIOBCKa:
a) YMcHblllaeTC.H
6) He H3MeHJleTCfI
B) YBenJ1.'1HBaeTC.H
r) 3aMep;nHeTC.H.
37. npH CTapeHIr1H BbIpa60TKa Tlr1pOKcHHa:
a) YBenl.f'lHBaeTCfI
6) YMeHblllaeTcfI
B) OCTaeTc.JI 6e3 H3MeHeHHH
r) YCKop.fleTcfI.
38. IIp:H cTapeHH:H npOnYKqlr1H Tlr1peOTpOnHoro ropMoH3
r:Hnoq, 113 a:
a) YBenlr1':1HBaCTC.H
6) YMeHbIlIaeTC.H
B) npeKparu;aeTCfI
r) He H3Men.fleTCJI.
39. npH cpanHeHH" B03pacTHbIx 113MeHeHIr1iii B fHnoq,H3c
I1I..I!HTOBJ.1AHOH >Kene3e H3XOAJ.1T CBoe nOATBep>KJJ;eHlr1e
CJIep;YTOLLJ;a.fl 33KOHOMepnOCTb t..T3peHlIJfI:
a) reTepoxpOHHOCTb


6) reTepOKaTeq,TeHHOCTb
B) reTepOKHHe'IH'::IHOCTb
r) reTepoTponHocTb.
40_ Paanl1QHafi BbIpa>KeHHOCTb B03pacTHbIx H3MeHeHIr1J1
p;nfl pa3J-1bIX opraHoB Ir1 pa3Hblx TKaHeH OnHoro :H Toro
)Ke opraHa - ::ITO:
a) reTepoxpOH HoeTh
6) reTepoTpollHOCTb
B) reTepOKaTeq,TeHHOCTb
r) reTepoKHHeTH'lHOCTb..
41. ECl1l1J KaneHp;apHbIH B03pacT ':IenOBeKa onepe)KaeT ero
6HOnOrHqeCKIr1M B03paCT. TO TaKOM Tlr1n CTapeH"fI Ha-
3bIBaeTCfI:
a) YCKopeHHbIM
6) saMep;neHHbIM
B} eCTeCTBeH HbIM
r) npoTHBoecTecTBellHbIM.
42. BbI6eplr1Te H31r160nee TO':lHoe onpep;eneHlr1e eTapOCTH:
3) npoqecc YB.Hp;aHIIJ.H opraHH3 Ma
6) B03pacTHoH nepHOP;
B) KOHelt. >KH3HH
r) 6HonorW..IeCKIr1H npouecc.
43. TIO>KHnbIM C':I:HTaeTC.H qenOBeK. '1eH B03paCT HaXOp;Ir1T-
C.fI B npenenax:
a) 90 -100 neT
6) 45-59 neT
B) 75-89 neT
r) 60-74 ron a
44. BHTaYKT -
no:
a) Ha60p BHTaMHHOB
6) npoqecc. nOBbIIllalOrn;:HM. HaJJ;e>KHOCTb opraHH3Ma
B) npoqecc CTapeHHJI
r) 06pa3 )t(H3HIr1
OnrO>KHTeneJ1.
45. B03pacTHa.fl rHnep-rpoq,:H.H MHoKapp;a - ::11'0:


I


I


231


230




OcHoBbi repotfTo.nor


 rep
aTp




KOHTpollbHble BOnp:x:bI


a) npOJlBlIetlHe cTapcHHfI
6) OTpa>KeHJtle BHTaYKTa
B) pe3ynbT3T CHH>KeHIr1f1 OCHOBHoro 06MeH3
r) JIpOfiBlIeHHe 3a6oneBaHIr1f1.
46_ npH CTapeHIr1M BHYTpeHHfIfi cpeJJ;3 opraHH3Ma:
a) He 1113MCHJleTCJI
6) CKnOHHa K al
HJJ;03Y
B) CKnOHHa K anKan03Y
r) fHp;po.pHnbHa-
47. ,IJ,m::r B03pacTHbIx J13MeHeHHH KOHe'lHOrO M03ra xap3K-
TepHo:
a) YTOnLLJ;eHHe H3BMlIHH
6) paclIIHpeHHe 60p03.D;
B) YCHneHJtle TOpM03Horo BnMJlHHfI KOpbI ronOBHoro
M03ra
r) aKTHBHoe pa3BJtlTHe aCCO
HaTHBHbIX CBJl3eH.
48. ,IJ,nJl HopManl13al
HH COCT3Ba KHlIIeq HOM MIr1Kpo.pnopbl
B repop,HeTeTHKe peKoMeHp;yeTcfI:
a) yrroTpe6nflTb 60nbllie MJlCa
6) ynoTpe6n.R:Tb 60nbUIc paCTHTeJIbHOrO Macna
B) '1atne Hcnonb30BaTb KHcnOMOnO'::IHbIe JIpOP;YKTbl
r) 'latne ynoTpe6nJlTb MOPCKYIO PbI6y.
49. K npHpoAHbIM aHTHoKcHp;aHTaM O'THOCMTCJI:
a) JIeKTHH
6) nel
HTHH
B) nHnasa
r) TOKo.pepon.
50. npOJlBneHMJlMH cTapeHH» B 3Mo
HoHanbHoit: c
epe
HBnJleTCJI:


51. BbI6epJtlTe )KJtl3HeHHYID n03Hl
111O nO)KHllOrO 'lCnOBCKa.
KOTopafl xapaKTepH3yeTcR nOHCKO.\1 nOMOtnH Ii npH-
3HaHI1H. nOBblllieH HOH 06Jt1P;'lJtlBOCTblO:
a) KOHCTPYKTHBHa»
6) 3all11r1THaJl
B) 3aBMCIr1Ma»
r) «Bpa>KJJ;e6HOCTb K MJtlPY
.


3TanOHbI OTBeTOB: L B); 2. a); 3. B); 4. a); 5. B); 6. B);
7. B): 8. 6): 9. r)j 10. r); 11. 6); 12. a)j 13. a); 14. 6); 15. 6);
16. 6); 17. 6); 18. a)j 19. B); 20. a); 21. B); 22. 6); 23. B); 24. 6);
25. 6); 26. 6}; 27- a}; 28. 6); 29. a); 30. 6); 31. 6); 32. 6); 33. B);
34. a); 35. 6); 36. a); 37. 6); 38. a); 39. 6); 40. 6); 41. 6); 42. 6);
43. r); 44. 6); 45. 6); 46. 6); 47. 6); 48. B); 49. r); 50. 6); 51. B).


K pC3AeAY N 2 3


a) 3KcTpaBepCIr1f1 3.
6) H HTpaBepCJtlJI
B) OIJTHMJ1.3M
r)

YCTOHqHBOCTb.


1. OJJ;HOH H3 nplr1'1HH oCTeonopo3a flBn»eTCJI:
a) JJ;e.pIr1QJ1T >KHpOB
6) 1r136b1TOl< 6enKOB
B) 1r136blTOK MarHIr1J1
r) p;e.p1r11
Ir1T Kanbl
HJI.
2. AnneprH'leCKHe peaKI.J;Ir1H Ha neKapcTBeHHble cpep;cTBa
y nO>KHnbIX nal
HeHTOB 6bIBaIOT:
a) 'lame, qeM Y MOnO'p;bIX
6) pe>Ke, '1eM Y MOnOp;b1X
B) C TOH >Ke '1aCTOTOH. '1TO' H B P;PyrHx B03pacTHbIX
rpynnax
r) npaKTIr1'leCKIr1 Ha Bee MeJJ;HKaMeHTbL
3
.peKT OT neKapCTBeHHOH TepaIJHH Ha6nlOJJ;aeTCJl Y
nmKHnbIX JJIOp;eH:
a) 6blcTpee
6) Mep;neHHee


232


233








OcHOBbi repoHTOJ10n1M
 rep
aTp




KOHTpollbHble Bonpocbl


B) npH 60nbrneit p;03e
r) IIplr1 TaKOiI )Ke p;03e.
4 nOcTenbHbIH pe)KHM repHaTpJ1.'IeCKHM naUIr1CHTaM Ha-
3Ha'lalOT:
a) Bcerp;a IIplr1 rocnHTaJIH3auHH
6) IIpH ManeJUneM YXYAIIIeHHH COCTOJlHJ1.fI
B) no CTpOfHM IIOK33aHHHM
r) He Ha3Ha'laIOT.
5. HapyrncHJtle nocTyrmeHHJI mCJIqH B KHlllCqHJtlK Y re-
pHaTpJ1.'IeCKOrO IIaIJ;HCHTa CB.H3aHO:
a) C 31r1J1HHeM rrpJtlBpaTHIr1KOBorO C
HHKTepa
6) co CIIa3MOM Kapp;HanbHoro C.pHHKTcpa
B) C oIIy-..neHHeM BHYTPCHHJ1X opraHOB
r) C rI1IIOnHHaMlr1c:i'1:.
6. OCHOBHOi1: MeJJ;HKo-CO
J.1anbHoi't: 3ap;a'lCH nnfl nHU no-
>Klr1noro B03pacTa flBnJleTCfI:
a) 06eCne'leHl1e MaTepHanhHoTo 6narononY'lHfI
6) coxpaHcHMe .pI13H'ICCKOi1: aKTJ.1BHOCTH
B) 06eCneQeHHC pa3BJICKaTenhHbiX IIporpaMM
r) .n;ocTynHocTb nYTeIlIecTBHi1:.
7. CHH>KCHMe P;03bI neKapcTBeHHblx IIpenapaToB p;nfl re-
pHaTpl1E:1.eCKHX naI.J;HCHToB 06ycnoBncHo:
a) ocna6neHJtlCM COKpaTHTenbHOJ1 cnoc06HOCTJ.1 M1r10-
Kapp,a
6) 3aMep;neHM.CM BcaCbIBaHJUI B KJtlIlICqHIr1KC
B) YCKopeHHeM IIO'le'lHorO KpOBOTo
a
r) CHM>KCHHCM
YHK
JtlH renaroqlr1TOB.
8. PCKOMCHP;ycMoe CYTOQHOe KOn11'JeCTBO >KHP;KOCTIr1 B
cTapocTH p;On>KHO 6bITb:
a) 2-2.5 n
6) 1-1.5 n
B) 1.5-2 n
r) 0.8-1 n.


9_ K nCHXOnOrlr1'IeCKIr1M oc06eHHOCTJlM repH3TpH'IeCKOrO
naQl1eHTa OTHOCHTCJI:
a) a,n;eKBaTHafi oueHKa c06cTBeHHoro COCTOHHIr1J1
6) rrOBbIIlIeHHaJl arpeccHBHoCTb
B) fJ,€:..pH l
H T 0611
eHIr1J1
r) JJ;e
HUHT cal\1006cnY>KHBaH H.fL
10. K .pH31r10nOrWiecKHM OC06CHHOCTJlM replr1a-rpI1'IeCKOrO
naI.J;McHT30THOCHTCfI:
a) ap,eKBaTHafi oI.J;eHKa C06CTBcHHoro COCTOSlHlr1lI
6) IIOBbIIlIeHHaJl arpeCCJtlBHOeTb
B) p;e.pIr1QIr1T 06LLJ;CHIr1J1
r) P;Ccplr1
Ir1T caMo06enY>KHBaHHJL
11. CHIr1>KCHIr1C ypOBHJI anb6YMHHOB B KpOBM IIPH eTape-
HJ.1H npIt1BOfJ,HT:
a) K 3aMe,Il,neHHIO BcaCblB3HI1.H neKapCTB
6) K IIOBbIIlIeHHIO plr1CKa annCprH'IeCKHX peaKl\Ir1M
B) K 33MefJ,neH..HOMY neilCTBHIO npenapaTOB
r) K KYMynJlQIiIH neKapCTBCHHbIX cpep,cTB.
12. 3aMep;neHHoe BcaCbIBaHHC nCKapcTBcHHbIX npenapa-
TOB y repJtlaTpMqeCKIr1X rraQlr1eJlTOB 06ycnoBneHo:
a) cTapeHHeM ne'lCHH
6) yMcHbllleHHeM 'IMCna He.ppOHOB
B) cocroHHHeM TOHKoro KHIIIe'lHIr1Ka
r) H3MeHeHHeM COCT3B3 KpOBH_
13. BbI6epHTe repMaTpH'IeCKOe cpep;cTBo, KOTopoe OTHO-
CliTeJl K 3HTHOKCHp;aHTaM:
a) aCKopYTJtlH
6) meHb-lllf.'Hb
B) pCTa60nJ'In
r) 3neYTepoKoKK.
14. BbI6eplr1TC repHaTpH'leCKOe Cpe)\CTBo. KOTopoe OTHO-
CIr1TeH K ::JHTepocop6eHTaM:
a) peTa60nl1n


1\
II


235


234




OCHOBbi repoHTOJ10n1

 rep
aTP
M


KOHl"pOflbHble Bonpocbl


6) TOKo$epon
B) Qenmon03a
r) aCKopYTHIi.
15. y YMlr1palO
ero cTapHKa p;On>KHO 6bITb Bee, KPOME:
a) OnJtlHO'ICCTBa
6) EJ:HCTOTbI
B) TJtlIlIHHbI
r) nopflJJ;Ka.
16. TIpJtl p;e$ML\Ir1Te Kanbl..p1H peKoMeHP;YIOT:
a) nplr1eM MHHepanbHblx p;o6aBoK
6) ynoTpe6neH.11e BHTaMJtlHa C
B) ynoTpe6neHHe BJ1TaMJ.1Ha A
r) BHyrpHBeHHoe BBep;eHHe HOBOKaHHa_
17. Oco6eHHOCTJ.1 nH'IHoi1: rHTJ1eHbl B nO>KHnOM B03pacTe:
a) He -rpe6yeTcfI H3-3a aTpo
J.11.f >Kene3 KO)KH
6) 'Ia
e rrplr1HHM3Tb rop»'1Jt1e BaHHbI
B) npJ1MeHeHlote nHTaTenbHbIX Kpe.MOB
f) IIPH MeHeH lr1e JJ;e3Jt1H<pHUIr1PY IOIllIr1X cpeJJ;cTB.
18. BbI6eplllTe BepHoe BbICKa3blBaHIr1e OTHo
HTenbHo ap-
....
TepHanbHoH TJtlnepTOHHIr1 y nO>KJtlJI
IX:
a) HIlIeMHfI M03....a MO)KeT cnoco6cTBoBaTb apTepJtlanh-
HlJ
t rHrrepToHHH;
6) Y '1aCTH 60nbHhix apTeplr1anbHaJl rHnepToHMfI B03-
HIr1KaeT Bcne.n; 3a JtlIlIeMJ1.1::lCCKOH 6one3HbJO cepp;
a;
B) na6HnhHO-KpH30Boe Te'leHJtle Hepep;KO npH CTapqe-
CKOM rHnepTOHJtlIr1;
r) CHCTeMaTH'leCKMH nplr1EM aHTHarperaHTa MO>KeT
6bITb none3eH nplr1 CTap'leCKOM rl1nepTOHHIr1.
19. TIp" neqeHHH renaplr1HOM KOHTponbHbIM TeCTOM JlBnfl-
eTCfI :
a) ypOBeHb qm6pHHoreHa
6) ypOBCHb rrpOTpOM6HHa
B) BpeMH CBepTbIBaHIr1H KpOBl1


r) BpeMJI KpOBOTeQeHJ1»
p;) KOnH4eCTBO TpoM6m.J;JtlTOB.
20. Bbl6epHTe
aKTop pHcKa HIIIeMHQeCKOM 60JIe3HJ1
cepJJ;I.J.a. 3HaqeHI1e KOToporo C B03pacToM YBeJIJ1\.lJ1Ba-
eTC»:
a) HepaU;l1oHanbHoe nHTaH"e
6) KypeHlr1e
B) flfnOp;Ir1HaMHH
r) CTpeCc.
21. Y cTapHKoB "laI.IJ;e Ha6moJJ;aeTcH:
a) 6oneBoii CMHP;pOM npM cTeHUKapp;HI1
6) 6e36oneB3R cpopMa cTeHOKap.i:tH H
B) npHcTynbI O.n;bIUlKH. aCTMaTHEJ:eCKOe COCTORHHe
r) OTCYTCTBlr1e O,a;blIlIKM_
22. ATepocKnepo3 - 3TO:
a) npoSiBneHlile 6J10nOrJtlH B03pacTa
6) pe3YJIbTaT B03paCTHbJX M3MeHeHJ1H CTapelOlltero
OpraH.M3M3
B) naTOnOI'M'IeCKJtlM npou;ecc.
23. BbI6epHTe BepHoe BbICKa3bIBaHJtle OTHOCIr1TenbHO
aK-
Topa pJtlCKa pa3BJ1THH JJ;06pOKa'leCTBeHHoi1: fMnepnna-
3MH npe,a;cTaTenbHOH }f(ene3bl:
a) HeT H3LJ;emHbIX AaHHbIX 0 BnMHHJtlH nonoBoii 3K-
TJtlBHOCTJtI Ha pa3BJ1Tl1e aToH 6one3HH;
6) y MYJK'IJ1H cTapIIIe 60 neT BepOHTHOCTb HapymeHHM
MOqeMcnYCKaHHH. CBfl33HHb[X C p;06pOKaQeCTBeH-
HOll rJtlneprrna311eM npC,D;CTaTCJ1bHOH >KeJ1e3bI, OKO-
no 40%;
B) KypeHHe 3aMe.n;JIJlCT pa3BJ1THe JJ;o6pOKaEJ.eCTBCHHOI"1
rJ1rrepnna3HIr1 npep;CTaTenbllOM >Kene3bl;
rJ ypOBfHb p;eCJtlP;pOTeCTOCTepOHa CbIBOpOTKJ1 KpOBIr1
npHMepHO npolIopL\ HOHaneH pa3MepaM npen CTa -
u
TenbHOH >Kene3bI.


236


237




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J\L-1TEPATYPA


1. AKCaMeH11'lOB T.B. KnHHIr1'IeCKHe Ir1
YHK1
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pOB 1/3.n;paBooxpaHeHHe. - 2002. - Nil 2. - C. 51-54.
2. AJJbl1epOBu
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HailbHaR repoHTonorHfI. CepHR:
«Y'Ie6HJ1.KH JtI y1..[e6HbIe nOC06H.R». - POCTOB HfA: cDe-
HI1KC,1997.
3. AnpaC'KUHa K. Yxop; 3a nO>KJtlnbIMH naql1eHTaMIr1 nplr1
HapYIlIeHHRx MO'leBbIp;eJIJtlTenbHOJ1
YHKqJ1H II CecT-
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4. £e3Bcpxail M.C. 4>apMaKOKJ1HeTHKa npH CTapeHJtlH I
non pep,. B.M. 3anap,HIOKa. - K14eB: 3JJ;OPOBbJl. 1991-
5_ BUCbHeBC'Ka-POtuKOeC1W K. HOBafi :>KH3Hb nOCJ1e lIIec-
THneCHTIr1. - M_: TIporpecc. 1989.
6. TaJIKUH P.A. U ap. TIo)l(Jtlnoi1: na
HeHT. - CaMapa: M-BO
3.n;paBooXpaHeHJ.1.H P<D; CaMap. MeA. YH-T.1999.
7. KOPKYWKO O.B.. Qe6011'lllpe8 11..t:P' J KanUHOBCKQJl E.r.
feplr1aTplilJl B TepaneBTH'::IeCKOJ1 npaKTJtlKe. - KJ.1eB:
3p,0poBbe. 1993.
8. TOBopKa R. Aopora K 1J;ollronenno- - M_: npOcpJ13.naT.
1990.
9. fy6al.leB IO.M.. MaKueHKo B.B. fepl1aTpH'IeC:KHe npo-
6neMbI CeMeHJIOH Mep,1r11
i1HbI. - CTI6: DI10HT. 2000.


246


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OcHOBbi repOHT0110nWI
 rep
aTp




nMTepaTYPa


LO. J!.60peijKUU fl. TIo>l(J.woi1: 60nbHOJ1: KnHHJtlqeCKHe. nCJtI-
XOnOrH'feCKHe It coqHanbHbIe npo6neMbI II Bpa'l. -
2000_ - Nil 7. - C. 4-8.
11. J!.btCKUJ-l A.A., PeUlemlOK A.II. 3P;OpOBbC H TPYP; B no-
)Klr1nOM B03pacTe. - M.: Me.n;JtlqHHa. 1988
12. Tpeitep E. TIpHHqHnbI 3p;opoBoro IrnTaHl1srll CecTpHH-
CKOe JJ;elIo. - 2003. - N:t 2. - C. 34.
13. 3JJ;OpOBbe nO>KHRbIX. ,I],oKnap; :::mcrrepToB B03. - ?vI.:
MeJJ;HqIr1Ha, 1992.
14. U611Ho6a 1I.<P. U op. CeCTpl1HCKHH rrpoqecc B repoHTo-
nOfHH JtI repJtlaTpHJtI. - Qe6oKcapbI. 1999.
15. KJIHHJtI'IeCKaJl repoHTOnOrHJI. NQ 1, 3 1999.
16. KOKye8a O.B. fleqeHl1e XpOHl1'lJeCKOrO naHKpeaT11Ta /I
Knl1Hlr1qeCKasr Me)J,Ir1QHHa. - 1999. - NQ 8. - C. 41-45.
17. KOPKYUlKO O_B., lJe6omape6 J!.-M. fepHaTpHR B Tepa-
rreBTIf'leCKOH rrpaKTHKe. - KHeB: 3p,opoBbe. 1993.
]8_ KomenbHuKo6 r.n. U op. fepoHTonorlr1J1 If replr1aTpJtl».-
M.: Mep;lr1qJtlHa. 1997.
19. lIopaHc,cail T.M.. lliaX08CKaJl A.K. ne'le6HOe nHTaHHe
npJ.1 XOneqIr1CTHTaX " Me.n;Ir1UHHCKafi cecTpa. - 2003. -
NQ 1.
20. MapaxOBC'KUU 1O.X. }l(eJI'IHOKaMeHHaJl 6one3Hb: cOBpe-
MeHHoe COCTOJlHlr1e npo6neMbI /I Poc. >KypH. racTpo::)H-
Tepon.. renaTon.. KononpoKTon. - 2003. - NQ I. -
C.81-92.
21. MeneHmbeB A.C. u op. fepJtlaTpJtlqeCKJtle acrreKTbI BHYT-
peHHHX 60ne3HeH. - M.: MeJJ;HUJ1.Ha. 1995.
22. MW-tYWKUH. O_H. 3anopbl H npJtlHIJ;HnblIilX ne'leHHfI II
TepaneBTH'IeCKHH apxHB. - 2003. - NQ 1. - C. 15-19.
23. MYXUl-lll CA.. TapHo6cKaH I1.M. TeOpeTlr1qeCKJtle OCHO-
BbI cecTpHHcKoro p;ena. - M.: Mep;HqHHa, 1996.


24. HayqHo-norrYJUlpHbIJ1 »<ypHan «CTaprnee nOKOJIeH11.e)).
25. 06rnenpaKTHQeCKafll-t ceMeHHafi Mep;HQl1Ha I nop, pep,.
MIr1Xa3n» M- KoxeHa. - MIr1HCK: Eenapycb. 1997.
26_ napif1eHo8 A.U- TIoHoe iii 3anop /I KnHHJ.f'feCKa» Mep;lr1-
QHHa. - 1997. - M 3. - C. 53-60.
27. TIO»<HnoM 601IbHOM. Ka'leCTBO >KH3HIo1. VII Me)KP;YHa-
pOp,HaJl HaY'lHO-rrpaKTH'IecKa» KOH.pepeHqlr1f1. MocK-
Ba. 1-3 OKTH6pfl 2002 1'. KnHH}PJeCKafi repoHTOnOrJtlJl
NQNQ 8-9.
28. TallKuH P.A., KomenbHuKo8 r. n., R'K06ne6 O.r.. <Punnu-
»08a A_ TIO>KHnOH naUJ1eHT. - POCTOB HIll.: <1>eHIr1KC.
2000.
2.9. noco6Jt1e no repHaTplilJ1. nn» cpeJJ;Hero Men H Q11HcKoro
pa60THJtlKa I ilop, pep;. lle60TapeBa IL.<I>. - KHeB: 3,n;o-
pOBbC. 1986.
30. TIpaKTHqeCKaJl repHaTpJtlH I nop; pep;_ npocp. f.TI. Ko-
TenbHHKOBa. - CaMapa: CaMMfY. 1995.
31. Po6ep Kpucrnonb. CeKpeTbI Monop;OCTH. - M11HCK.
1995.
32. Pn61.lUK08a T.R, Ha3apo6a H.A. CeCTpJlHCKIr1H npo
ecc
(YQC6HO-MeTOnlr1qeCKOe noco6Ir1e). - M.: BYHMQ,
2000.
33. RK08J1e6 O. r.. 3axapoea H.O. CeCTpJtlHCKOe p;eno B Te-
panlr1H. - CaMapa: CaMMry, 1999.
34. KopfJ.ZUHa r. A.. <PoMYUl'KUJ-la U. A' J TonoBeHKo O.A. Ce-
CTpHHCKJtle ycnyrH nHIJ;aM nO>KHnorO Ir1 CTap':leCKOrO
B03pacTa. - M.. 1997.
35. CU80xuHa U. K. CnpaBO'lHIr1K no ne'le6HoMY nHTa-
HIHO. - M.: HOBafi BonHa. 2000.
36. CnpaBO'lHHK MeJIJ1QHHCKOH cecrpbI I nO,LJ, pe.n;. O.fl. 3a-
P;BOpHOM. :>K.X. TYPb.JIHoBa. T.I, II. - M.: ROBaJl BOlI-
Ha. 1998.


248


249




I


OCHOBbi repoHTOnOnU1 M rep
aTp




orJ\ABJ\EH1I1E


37. CnpaB01..lHHK no AHarHocTHKe H neqeHHIO 3a6oneBa-
HI1H y nO>KHnbIX I nop, pep,. ,l],BopCI.\KOrO J1M. 11 JIa3e6-
HHKa n.B. -- M.: HOBaR BonHa. 2000.
38. Xapou 11. Bpaq. cecTpa. 6onbHow. -- Byp,anfllIT. 1987.
39. XMcne6cKaR C.C. IlpoTwBonoKa3aHHR W B03MO>KHbIe
OCJIO>KHeHI1R neKapcTBCHHOJ1 TepanHJ1 y nHU; CTaplIIJlX
B03pacToB.--KHeB:3AopoBbe
 1987
40. Qe6omape6/1..flJ. fepl1aTpwH (YQe6HOe noco6He). -- M..
1990.
41. lJe6omape6 p..cJJ. nOCo6He no rapJ1aTpHJ.1 p,nR cpep,HHx
Me.n;I1UHHcKHX pa60THJ1 KOB. -- Kl1eB: 3AopoBbe. 1986.
42. VI EBponeHcKHH KOHrpecc no KflJ1HHQeCKoi1 repoHTo-
norHH. J.1IOHb 18-21 2002 r.
 MocKBa, POCCHH: Te311cbI 1/
KnHHJ1QeCKa.fl repoHTOJIOrwH. -- 2002 -- N
 5.
43. lllenmoH r. fonop,aHl1e H 3p,opoBbe. -- M.: Mon. TBap-
AHH
 1996.


1. n PE)J;J1 cn OBJ1E............. ..... '" ..... .... ..... .......... .....-- .00......... 3


2. OCHOBbI OE:mEiiI fEPOHTOnOr11J1....m.... n ......... 8
2.1. CTa peHHe H CTa pOCTb.... .............- _00 _00.... ....... ..- -. .,. ..... '" - 8
2.1.1. 0611111e nOHHTl1ll repoHTonorHH ........m.............. 8
2_1.2. 3ar<oHoMepHocTJI npouecca cTapeHI1H .__...........9
2.1.3. 061l1.He MexaHH3MbI crapeHH.H ...............00......... 10
2.1.4. nOHSITHe B03pacTa B repoHTonocHI1 .........__.....12
2.2. B03pacTHblc 1f3MeHeHlfB opraHoB H ClfCTeM ........ 14
2.2.1. J.13MeHeHHH opraHoB ,LJ;bIXaHHfI .m............--....... 14
2.2.2. J.13MeHeHHH Cepge'lHO-cocyp,J1CToif. cHcTeMbI...16
2.2.3. J.13MeHeRJ1 II opraHoB nH
eBapeHI1H ...-............ 18
2.2.4. 113MeHeH
H opraHoB MOqeBbIp,eneHHH ..........0020
2.2.5- V13MeneHI1H 3Hp,OKpI1HIIOif. CHCTeMb( ...............21
2.2.6. 113MeHeHHH KO>KH .....m.................-...................... 23
2.2.7. B03pacTHbTe H3MeHeHWH CI1CTeMhl
24
KpoBeTBopeHH H .... .......... ..... ......... ........ ...... .......... ....... ..... ..... ....... ..... ....... .... ..... II


2.2.8. 113MeHeHHH onopHo-ABlfraTenbHoro
26
annapaTa .11 ......... ..... .... ........... ..... ......... ...... ..... ..... ............ .......... II II ...... ............. ..... ......... ....
2.2.9. B03pacTHbIe H3MeHeHHH opraHa 3peHHH........- 27
2.2.10. B03pacTHbIe H3MeHeH11H opraHa cnyxa .........27
2.2.11- B03pacTHbIe H3MeHeHHR HepBHoH CJ1creMbI ....28
2.3. TIcHXOJlOrH-IeCKlfe oc06eHHocTH nO)KHnorO


qeJl.OB eRa.... ....... ..... .... ._..... .... ..... ..... ..... _ __. ......... ........... .......... ............. .......... --. ........ ... ....... 29


2.4. TIYTH yBeIIH'leHHH npo.n;OJDKHTelIbHOCTH »<.11:3HH... 33
2.4.1. PaU;l1oHanbHoe nWTaHHe nwu; nO>KJ1noro
B03paCl'a (repO,LJ;l1eTHKa) ...... '" ....... ................ .-. ...... .m_. 34
2.4.2. ILBH raTenbHaH aKTI1BHoCTb..... ..00_ -.... .... ...... .....00 37
2.4.3. COQHonoro-ncHxonm HqeCKaH a,AanTal\Hll
K B03pacTHbI M I1.iMeHeH H HM ... ....._ .............. ..... ......... ...40
2.4.4. TIO>KHflOH 'lenOBeK H ceMbH .........._.................00.47


250


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3.6. Oc06eHHocTIf COCY.D;HCTbIX 3a60rreBaHlfH
1'01l08HOrO M03ra Y repHa'l'pJPleCKllx naD;HeHToB..... 165
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y IIIOp,eii nO>KJllIoro B03pacTa ..000000......................-.......... 171
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.........-........

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198

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. . 00
Y JlIOp,eH nO>KJlJloro B03pacTa ..' "" ..... ... .--........... .m.... .... 2
3_8.1. ILo6pOKaqeCTBeHHaH rnnepnna3HR

 200
npep;CTaTen hHOH >Kene3bI .. .00__ ...... '" .-. ........ ._m... .........
3 _ 8.2. XPOHW-I eCKHH n Heno He q.p11'I'... ........... ...... ...... .206
3.9. np06neMa oCTeonop03a .................................00........ 210


2A.5. Tpyp,oBaJlp,eRTenhHocTh B nO>KnnOM
Jf CT a pqeCKOM B03pacTe ............................ n. .., ........ ....... 51
2 A. 6. feporHf WEHa .... __ n_h......... ..... ........... .., ........... ....... 54
2 A. 7. n pl1MeHeH we reponpoTeKTopoB...... .... ....... .......57
2.5. COIJ;HanbHaH nOMoID;b IIIOp,HM nmKHnoro
If cra p'leCKOfO B03p aCT a . ...... ..................... ..... ...... '" .mnn.. 60


3. 0 CROBbI fEPI1A TPMM ....... ........ ............. ......... .m...m 65
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3.2. Oc06eHHocTH repHaTpH'IeCKOrO naItJleHTa ......... 70
3.2.1. Oc06eHHoC'I'H yxoAa 3a repHaTpHqeCKI1M


3.2.2. OCHOBbI pea6wn WTaQHW repHaTpl1qeCKOrO


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3.2.3. fleKapcTBeHHaH TepanHJI B repHaTpl1w............ 75
3.3. 06mn:e np06J1eMbl rePJ{aTpH'IeC:KOro naIJ;HeHTa.. 83
3.3.1. .ll.eoHTOnOfH'leCKHe npo6neM bl.... ....h.. '" .mm.... 84
3.3.2. H apymeHH H fOMeOCTa3a __." ." ..... ......... .,. ...........88
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(uapyweH 11 H c03HaHHH) .... ........ ..... '" ........... ........ no ._._..98
3.3.5. Hep,ep>KaHHe MO'IH .............................._...m......_ 10]
3.3.6. HeAep>KaHHe Kana...... ...... .00" ..... ." '" '" ._...... ._, ..._ 104
3.3.7. HapymeHHH CHa.. ........ ...... ..... ..... ... ....--..... ." --..... 105
3.3.8. 06MOpOK ." ...... ..... ........ ...:. ...... ..... '" .00.. ......... .00.... ] 12
3.4. 3a601leBaHHg opraHoB .D;bIXaHIiB


nO:>l'H nhlX n IOAeH.... ..... ........ .... ...... ........ ...... ..... II II ..... II..... ..... ....... .... .... .... ..... _. .... _. 115


4. CECT PMHCKMiiI npOIJ;ECC B rEPJ1A TPJ1I1--... 217
KOHTPOTIhHbIE BOnpOCbl_..........-........................... 224
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pa3p,eny - . '" '.--' ...... ....--.. ..... .,. _.........- - .


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3.5. 3a60neBaHHH opraHoB KpoBo06pameHHH
y JIIO,r:r;eii nOJKJfnoro BospacTa... '" "00' ..... .., ........... ......... ..136
3.5.1. 111IIeMH qeCKaJl 6one3Hh cepp,IJ;a....... .... ..... 00"". 137
3_5.2. ApTepl1anbHaR fHnepTeH3HH.........m...mmm...153


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247
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252


253