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10 2009



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                                                                          ( -                             
                                                                         ):                                   
                                                                          1500 /                              
                                                                                                                 
                                                                          800 /                               
                                                                          :                            
                                                                            0,03                             
                                                                          - 3 /                              
                                                                         2- ,   30                               
                                                                          - 2 /                                    
                                                                                                           
                +-----------+-----------------+------------+-----------------+---------------------------+------------+--------------+
                ,          +                                                                          
                .            1                                                            
                                                                                          
                                                                                                    
                                                                                                  
                                                                                                             
                                                                                                               
                                                                                                       
                                                                                                          
                                                                                                         
                                                                                                              
+----------------+-----------+-----------------+------------+-----------------+---------------------------+------------+--------------+
          ,       .   1 - 2 .           20 - 25 .       
            .                         :  20 -                            
                                   30 /                                     
(J84)                                .                                                     
                                                                                          
                            -      -                    25 /                             
                                                           (                                   
                                                    )                                            
                           R-  1 - 2 /                   ,                              
                                                                                            
                                                                                                                   
                                                                                                            
                                                                                                              
                                                                                                                      
                +-----------+-----------------+------------+-----------------+---------------------------+------------+--------------+
                ,          +                                                                             
                .               1                                                     
                                        1                                                                            
                                                                                                                 
+----------------+-----------+-----------------+------------+-----------------+---------------------------+------------+--------------+
       , ,   .    1 - 2           ,          5      
   (  .                    
            ,                              
(D86.1)         -                                 :               3 - 5        
                (     1                 - -  600                     
                ))          /                     /                                               
                                                             -  30  - 2                                
                                                              /                                             
                           ( - )                                                                  
                           3-                                       (                                
                           R-                               )                                           
                                                            -                                         
                              2                             () 20 -                              
                                                                       30 / (1 ),                                 
                           -                                                                     
                            ( -                                                                    
                           )                                          5                                          
                                                                                                      
                                                                          5 - 10 /                                   
+----------------+-----------+-----------------+------------+-----------------+---------------------------+------------+--------------+
       , ,   .   1 - 2            ,        5 - 8    
;  (  .                              
         ,                  .                       
;     -                                         3 - 5      
          (                        (                        
     ))    1 /                      )                                           
            3-                                      -                                         
,               R-                               ()                                 
 ;                                                 20 - 30 / (1 ),                            
                  2                                                                  
(D86.0, D86.2,                                                            5                              
D86.8, D86.9)                                                                                             
                                                               5 -                              
                                                                 10 /                                            
                                                                (                                
                                                           )                                                
                                                                   -  ()                               
                                                                                             
                                                                          :                                         
                                                                         - -  600                             
                                                                         /                                               
                                                                         -  30  - 2                                
                                                                         /                                             
+----------------+-----------+-----------------+------------+-----------------+---------------------------+------------+--------------+
    , ,   .  +1   3                    :                           
()                                                                      
(84.0)                                                        () - .                           
                               1 .  2 - 3                  10000 ,                      - 
                           (                               - 70 - 100                            
                           )                                 /                                               
                                                         -  0,9% -                                
                                                              3 - 5                                 
                                 1   3                   /                                              
                               1   3                                                   
                           ( ,                                   ( mask)                               
                            )                                   -  (                              
                               1   6                   30  3 - 4 /)                                
                                                                            3 - 4               
                           : ,                                Ps.         .                  
                           ,                                    ruginosa:  4   3 - 4                
                            (K,                                - 2 /,                               
                           Na, Ca), ,                                                              
                                                                       15                                      
                                                                         // /                                    
                                                                          0,25  - 2                             
                                                                         /                                       
                                                                         :                                           
                                                                         -  80 - 160                              
                                                                         2 /                                           
                                                                         - 2-:                                    
                                                                          100 - 200                             
                                                                         (1 - 2 )                             
                                                                         - :                              
                                                                            1000 /                                 
                                                                          :                                       
                                                                         -                                 
                                                                            -                                
                                                                         6 - 8 /                                        
----------------+-----------+-----------------+------------+-----------------+---------------------------+------------+---------------




----------------+-----------+--------------------------------------------------------------------------------------+--------------
                                                                       
    +------------------------------------------------+-------------------------------------+   
 -                                                                                       
 (               +------------------+------------+----------------+-------------------------+-----------+              
-10)                                                              
                                                        ( .)                              -                 
                                                                                                                     
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
       1            2             3              4             5                    6                 7           8       
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
      ,                                1.      
(J12 - 18)                :             :                   -  
                          -  ( .               10 - 14 .2. 
                          );                   :                             
                          -                 .      I  -              (   
                          (          (                   - 
                           -  -         -                         
                                  - 1 - ( ):                    
                          ):        2               1 .                 
                           -        4 - 6 / /             )       
                             -          1 - 2  2 - 3                          
                           ,                30 - / /,                                  
                             -            60 )          1 - 2  1                             
                          ,   -                             / /                                       
                           ,                             II  (                            
                          - :                                 ):                                    
                                                                                            
                                                                                                
                                                             (  48                          
                                                             ) -  /                          
                                                          :                               
                                                             250 - 500                             
                          :                                  /                              
                           . :                              3-                                           
                                                                                                             
                          ,                                       -                
                                                           :                                   
                                                                   I :            -               
                                                            (1 - 2  1  14 - 18 .              
                                                            / /  / 5 -                           
                          :                                7 )                             
                          , ,                             (250 - 500   1                            
                          ,                                    /  500 /                            
                           (K, N                            / 1 / - 3 - 5                             
                          Ca), ,                                .)                                              
                           .                                 II :  10                          
                                                            // (                           
                          :                                       - 400 )                             
                          ,                                  2                                
                                                           1 - 2  2 -                          
                          ,                                        3 / /  /                            
                                                                                                        
                                                                                  
                                                                   -               
                          /                                         :      21 .                 
                                                        1 - 2  1                             
                                                            / /                             
                                                                  15                                   
                                                          //  1 - 2                                 
                                                           /, / - 7 -                           
                                                        10 ,                            
                          (                                0,5 / 1 / 3 - 5                           
                                                                                                         
                          ,                                                                      
                           ,                              -                             
                                                                                          
                          )                                                                     
                                                                         ()                            
                                                                          (                             
                                                                        )                                    
                                                                                                              
                                                                         .                           
                                                                                                       
                                                                        :                                          
                                                                        -  (                            
                                                                        )                                        
                                                                        -                                
                                                                        ( 7 - 10 )                               
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
                          +                                                 
                                     1         :                                          
                                             ( I :                                   
                                                        (1 - 2  1                           
                                              / /  / 5 -                           
                          .             1      )    7 )                             
                                                            (250 - 500   1                            
                                                            /  500 /                            
                          (                                   / 1 / - 3 - 5                             
                                                          .)                                              
                                                        II :  10                          
                                                           // (                           
                                                           - 400 )                             
                          30 - 60 .)                                 2                                
                                                                         1 - 2  2 -                          
                                                                        3 / /  /                            
                                                                                                                       
                                                                        /                         
                                                                         500/125                                 
                                                                         3 /  - 7                            
                                                                                                           
                                                                         0,5  1                             
                                                                        / /,                                   
                                                                         1 - 2  1                             
                                                                        /c. /  /,                            
                                                                        / 1                            
                                                                        2 - 3 / (                           
                                                                                                         
                                                                        )                                     
                                                                                                                          
                                                                                                      
                                                                                                      
                                                                          :                             
                                                                         1 - 2  1                             
                                                                        / / - 5 - 7                           
                                                                        +  15 //                           
                                                                         1 - 2  /                           
                                                                        / - 7 - 10 ,                             
                                                                         0,5  /                             
                                                                        1 / 3 - 5 ;                             
                                                                          -                             
                                                                         0,5  /                              
                                                                        2 - 4 / 5 - 7                              
                                                                                                                      
                                                                                                                          
                                                                                                           
                                                                        ,  P.                            
                                                                        aeruginosa,                            
                                                                                                     
                                                                        2 - 4  / 2 /                           
                                                                         /                              
                                                                        1,5 - 4  / 2                                   
                                                                        /.                             
                                                                                                           
                                                                                                           
                                                                                                               
                                                                                                          
                                                                        ( 15 - 20 /                           
                                                                        1 /)                                        
                                                                                                                          
                                                                                                       
                                                                        :                                          
                                                                        -  (                            
                                                                        )                                        
                                                                        -                                
                                                                        ( 7 - 10 )                               
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
               .       +                               -  1.      
                                 1          :                      
                                                      -            - 2. 
                           (        1            :              14 - 18 . 
                                                   :       1 - 2  1               (   
                                        ,      / /  /,               - 
                          )                     / 1               - 
                                                        ,   2 - 3 /                              
                                                        .      -                        
                                                                         :            )       
                                                                        I  -                                  
                                                                                                              
                                                                        1 - 2  1 / /                            
                                                                         0,5  1                             
                                                                        /  5                              
                                                                        II  -                             
                                                                        (  )                           
                                                                        0,5                                              
                                                                        1 / / +                                   
                                                                         0,5  /                            
                                                                          8                                 
                                                                         - 7 - 10                                
                                                                                                                          
                                                                                               
                                                                               -               
                                                                          :      21                 
                                                                         1 - 2  1                             
                                                                        / / - 5 - 7                           
                                                                        +  (                               
                                                                         ) 0,5                           
                                                                         1 / /                                
                                                                         15 //                            
                                                                        1 - 2  /,                               
                                                                        / - 7 - 10 ,                             
                                                                         0,5 / 1                             
                                                                        / 3 - 5 ;                            
                                                                         -                                 
                                                                         0,5  / 2 -                          
                                                                        4 / 5 - 7                              
                                                                                                                          
                                                                                                           
                                                                        ,  P.                            
                                                                        aeruginosa,                            
                                                                                                     
                                                                        2 - 4  / 2 /                           
                                                                        /                               
                                                                        1,5 - 4  / 2                                   
                                                                        /,                                      
                                                                         (                                 
                                                                         ) 0,5                           
                                                                         / 1 /                                   
                                                                                                         
                                                                                                     
                                                                                                           
                                                                                                          
                                                                        ( 15 - 20 /                           
                                                                        1 /)                                        
                                                                                                                          
                                                                                                       
                                                                        :                                          
                                                                        -  (                            
                                                                        )                                        
                                                                        -                                
                                                                        ( 7 - 10 )                               
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
       ,       .                    14 - 21 . 
                          : 2,     (                           
(J10 - 12)                       . 2, , SO2  24 - 48                             
                          :        ):                                  
                          , ,       :    ,                                  
                          ,                                          
                           (K, N ( -                                
                          Ca), ,    1 - 2  ):           ,                                 
                           .         ,                                
                                ,                                    
                                        40%.                           
                                             /          ,                           
                                                                                         
                          R-                   ,                           
                                           ( - ):   S.pneumoniae,                                
                                                        ,   S.aureus, H. Influenzae:                          
                                                        ,                                           
                                                                                         
                                                                         (.                            
                                                                        )                                          
                                                                                                           
                                                                        :                              
                                                                            1-                            
                                                                          -  100                           
                                                                        3 ,  2 - 3  -                            
                                                                         100  2 ,  4-                           
                                                                         100  1 ,                               
                                                                                                      
                                                                        .                                    
                                                                          30                           
                                                                         3 /,                                
                                                                                                             
                                                                          2 - 5                           
                                                                        20% - 3 - 4 /,                          
                                                                                                         
                                                                         0,25 - 0,5 - 2                            
                                                                        /                                          
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
               ,          +                                         +                                   
               .      :      1                                                       
                          2, 2, ,                               0,2  - 3 - 4                           
                          SO2                                           /   3 - 5                          
                                 1                       (                                  
                          :                                 )                                        
                                                                                                          
                           ( -                                                                                 
                          ): ,                                                                              
                          ,                                                                                         
                                                                                                         
                          /                                                                                
                                                                                                             
                          ( - ):                                                                                  
                          ,                                                                                   
                          ,                                                                                         
                                                                                                          
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
,     ,       .                   12 - 15 . 
                                                                   
Streptococcus                    .      :                             
pneumoniae                :              0,5 - 1  3 -                          
(J13)                     , ,       :      4 / - 7 - 10                           
                          ,             ,      /  / 7 - 10                            
                           (K, Na     0,5 3                            
                          Ca), ,    1 - 2  ,   /                                          
                           .         .                                        
                                                   -                                  
                                                            :                          
                                                                250 - 500                             
                                                            /                              
                          :                                      3-   500 /                           
                          ,                                  /                                               
                                                           30                           
                          , .                               3 /,                                
                                                                                            
                                                                          2 - 5                           
                                                                        20% - 3 - 4 /,                          
                                                                                                         
                                                                         0,25 - 0,5 - 2                            
                                                                        /                                          
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
                          +                                                                             
                                 1                                                                        
                                                                                                                    
                           -      1                                                                        
                                                                                                             
                                                                                                          
                                                                                                               
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                                
                          :                                                                                      
                          ,                                                                                 
                          ,                                                                                  
                                                                                                        
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
,     ,       .           :       12 - 15 . 
                               0,75 - 1,5                             
Haemophilus                      .     3 - 4 / /                             
influenzae                :              0,5  - 3                            


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