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4. qronikuli xvelis mqone pacientebs, romelTac imavdroulad aReniSnebaT g.e.f.r., mxolod maSin SeiZleba refluqsiT gamowveuli xvelis diagnozi davusvaT, Tu antirefluqsuri mkurnaloba iwvevs xvelis Sewyvetas an mniSvnelovan Semcirebas. B. 5. qronikuli xvelis mqone pacientebSi g.e.f.r.-is diagnozis dasadastureblad yvelaze sensitiuri da specifiuri meTodia 24 saaTiani ezofaguri PH-monitoringi. testis Sedegi negatiurad iTvleba Tu monitoringis periodis ganmavlobaSi refluqsinducirebuli xvela ar vlindeba. B. 6. qronikuli xvelis mqone pacientebs, romelTac CautardaT 24 saaTiani ezofaguri PH-monitoringi da aRmoaCndaT dabali asociacia xvelasa da refluqss Soris, ar daesmebaT g.e.f.r.-iT gamowveuli xvelis diagnozi. B. 7. g.e.f.r.-iT gamowveuli xvelis diagnozis mqone pacientebs, gastro-ezofaguri motorikis darRvevis done ganesazRvreba PH-monitoringis iseT maCvenebelTa vareabelurobiT, rogoricaa refluqsis sixSire da xangrZlivoba. aRsaniSnavia, rom es monacemebi SeiZleba ar korelirdebodes xvelis simZimesa da sixSiresTan. B. 8. ara aciduri g.e.f.r.-is diagnozi SeiZleba daisvas mxolod bariumis gamoyenebiT Catarebuli ezofagografiis saSualebiT. B. 9. qronikuli xvelis mqone pacientebSi, romelTac klinikuri monacemebis safuZvelze daesvaT g.e.f.r.-is mi zeziT gamowveuli xvelis diagnozi, magram ezofagosko pi iT ver iqna nanaxi Sesabamisi cvlilebebi, gadaWriT ar unda vuaryoT g.e.f.r.-is diagnozi, rogorc xvelis mizezi. B. 10. Tu pacientebSi klinikuri monacemebi gvafiqrebineben, rom qronikuli xvelis mizezi SeiZleba iyos usimptomod (munji) mimdinare g.e.f.r., an im pacientebSi, romelTac qronikul xvelasTan erTad aReniSnebaT gastro-intestinaluri traqtis zemo nawilis iseTi simptomatika, romelic g.e.f.r.-is arsebobaze SeiZleba gvaeWvebdes, rekomendirebulia sacdeli antirefluq- 26
suri mkurnaloba. B. 11. rodesac davadgenT an eWvi migvaqvs, rom xvela gamowveulia g.e.f.r.-iT, rekomendirebulia Semdegi mkurnaloba: a) dieta da cxovrebis stilis Secvla. b) antaciduri Terapia. g) prokinetikur Terapia; maSinve an imis Semdeg, rac pirveli ori meTodi uSedego aRmoCndeba. Terapiul efeqts unda velodoT 1 dan 3 Tvis ganmavlobaSi. E/A. 12. qronikuli xvelisa da g.e.f.r.-is saeWvo diagnozis mqone pacientebSi, empiriuli antirefluqsuri mkurnalobis uSedegobis SemTxvevaSi, maSinve ar unda uarvyoT refluqsis diagnozi da unda CavataroT Sesabamisi kvleva refluqsis gamosavlenad da misi intensivobis dasadgenad. radgan empiriuli antirefluqsuri mkurnaloba SeiZleba ar iyos adeqvaturad intensiuri, rac mis uefeqtobas SeiZleba iwvevdes. E/A. 13. zogierT pacients xvela SeiZle Seuwydes mxolod antaciduri saSualebebis an H2 antagonistebis gamoyenebiT. Tu H2 antagonistebi uSedegoa, mkurnaobis kursSi rTaven protonuli arxebis inhibitorebs. Tu es saSualebac uefeqtoa _ iyeneben prokinetikur Terapias da dietas. B. 14. g.e.f.r.-is sawinaaRmdego intensiuri Terapia gulisxmobs: a) antirefluqsuri dieta _ ara umetes 24 g. cximisa 24 saaTSi. sakvebi racionidan unda amoviRoT iseTi produqtebi, rogoricaa: yava, Cai, Sokoladi, citrusi, pamidori, alkoholi, nikotini. unda SeizRudos fizikuri datvirTvis iseTi forma, romelic gazrdis intraabdominalur wnevas. b) simJavis supresia da protonuli arxebis inhibitorebTan erTad iseTi komorbiduli mdgomareobebis mkurnaloba, rogoricaa Zilis dros ganviTarebuli obstruqciuli apnoe. E/A. 15. Tu intensiuri Terapia uSedegoa, sWiroa qirurgiuli Careva.E/A. SeniSvna: bavSvebSi naklebadaa dadasturebuli g.e.f.r.- 27
- Page 1 and 2: m. d. ramaz RulaZe m. d. daviT frui
- Page 3 and 4: winasityvaoba xvela aris pacientis
- Page 5 and 6: xvelis marTva klinikuri gaidlaini g
- Page 7 and 8: monacemTa sarwmunoobis xarisxi aRin
- Page 9 and 10: 4. yefis msgavsi xvela. 5. xvela re
- Page 11 and 12: neiro-regulatorulipaTologiebi rekur
- Page 13 and 14: adiografiuli monacemebi da gansakuT
- Page 15 and 16: gia da zogadi sisuste. xvela vlinde
- Page 17 and 18: uli virusuli infeqciis mizeziTac, r
- Page 19 and 20: sainhalacio glukokortikosteroidebi.
- Page 21 and 22: meore jgufs miekuTvneba zeleutoni (
- Page 23 and 24: iski da sxva gziT miRebul medikamen
- Page 25: oloSi _ saxis niRabi an munStuki. s
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- Page 31 and 32: uli anTebadi kerebi. bronqitis dros
- Page 33 and 34: zianeblebisagan Tavis arideba. aRni
- Page 35 and 36: ara asTmuri eozinofiluri bronqitiT
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- Page 41 and 42: sunTqvis ukmarisobis seriozuli gamo
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- Page 45 and 46: Cutardes gulmkerdis R-grafia. E/A.
- Page 47 and 48: angiotenzin-SemboWveli enzimis inhi
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- Page 51 and 52: profesiuli da garemoSi arsebuli miz
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4. qronikuli xvelis mqone pacientebs, romelTac imavdroulad<br />
aReniSnebaT g.e.f.r., mxolod maSin SeiZleba<br />
refluqsiT gamowveuli xvelis diagnozi davusvaT, Tu<br />
antirefluqsuri mkurnaloba iwvevs xvelis Sewyvetas an<br />
mniSvnelovan Semcirebas. B.<br />
5. qronikuli xvelis mqone pacientebSi g.e.f.r.-is diagnozis<br />
dasadastureblad yvelaze sensitiuri da specifiuri<br />
meTodia 24 saaTiani ezofaguri PH-monitoringi.<br />
testis Sedegi negatiurad iTvleba Tu monitoringis<br />
periodis ganmavlobaSi refluqsinducirebuli xvela ar<br />
vlindeba. B.<br />
6. qronikuli xvelis mqone pacientebs, romelTac CautardaT<br />
24 saaTiani ezofaguri PH-monitoringi da aRmoaCndaT<br />
dabali asociacia xvelasa da refluqss Soris,<br />
ar daesmebaT g.e.f.r.-iT gamowveuli xvelis diagnozi. B.<br />
7. g.e.f.r.-iT gamowveuli xvelis diagnozis mqone pacientebs,<br />
gastro-ezofaguri motorikis darRvevis done<br />
ganesazRvreba PH-monitoringis iseT maCvenebelTa vareabelurobiT,<br />
rogoricaa refluqsis sixSire da xangrZlivoba.<br />
aRsaniSnavia, rom es monacemebi SeiZleba ar<br />
korelirdebodes xvelis simZimesa da sixSiresTan. B.<br />
8. ara aciduri g.e.f.r.-is diagnozi SeiZleba daisvas mxolod<br />
bariumis gamoyenebiT Catarebuli ezofagografiis<br />
saSualebiT. B.<br />
9. qronikuli xvelis mqone pacientebSi, romelTac klinikuri<br />
monacemebis safuZvelze daesvaT g.e.f.r.-is mi zeziT<br />
gamowveuli xvelis diagnozi, magram ezofagosko pi iT<br />
ver iqna nanaxi Sesabamisi cvlilebebi, gadaWriT ar unda<br />
vuaryoT g.e.f.r.-is diagnozi, rogorc xvelis mizezi. B.<br />
10. Tu pacientebSi klinikuri monacemebi gvafiqrebineben,<br />
rom qronikuli xvelis mizezi SeiZleba iyos<br />
usimptomod (munji) mimdinare g.e.f.r., an im pacientebSi,<br />
romelTac qronikul xvelasTan erTad aReniSnebaT<br />
gastro-intestinaluri traqtis zemo nawilis iseTi<br />
simptomatika, romelic g.e.f.r.-is arsebobaze SeiZleba<br />
gvaeWvebdes, rekomendirebulia sacdeli antirefluq-<br />
26
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