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is mizeziT gamowveuli xvelis arseboba. Tumca es sakiTxi naklebadacaa Seswavlili. avtorebs miaCniaT, rom aseTi asociacia arsebobs. magram igi ar aris maRali da yovel SemTxvevaSi bavSvebSi gamovlenili izolirebuli xvela nalkebad iZleva g.e.f.r.-ze eWvis mitanis safuZvels, vidre mozrdilebSi (10). Tumca sxva avtorebs miaCniaT, rom g.e.f.r. Cvili asakis bavSvebSic ki SeiZleba iyos araspecifiuri xvelis mizezi (14). mwvave bronqitiT gamowveuli xvela. ( 6 ). 1. pacientebSi, sadac mwvave respiratoruli infeqcia manifestirebs upiratesad xveliT, naxvelis gamoyofiT an mis gareSe, rac grZeldeba ara umetes 3 kvirisa, Tu ara gvaqvs pnevmoniis R-grafiuli dadastureba, Tu diagnostirebuli ar aris asTma an filtvis qronikuli obstruqciuli daavadebis gamwvaveba, an Tu daavadebis simptomatika scildeba «gaciebis» klinikur suraTs, Sei- Zleba daisvas mwvave bronqitis diagnozi. E/A. 2. mwvave bronqitis diagnozis dasadgenad (dasadastureblad) ar aris saWiro rutinuli virusologiuri, baqteriologiuri an serologiuri kvleva. radgan gamomwvevis identifikacia klinikur praqtikaSi uSedegoa. C. 3. mwvave bronqitis diagnozis dasadastureblad ar aris saWiro rutinuli R-grafiuli kvleva. intensiuri xvelisa da naxvelis gamoyofis SemTxvevaSi, pnevmoniis gamosaricxad, gulmkerdis R-grafiuli kvleva saWiroa, Tu: mozrdil pacientebSi 1. P > 100 wuTSi., 2. R > 24. 3. piris Rrus temperatura > 38 C. 4. filtvebis auskulptaciiT gamoxatulia fokaluri cvlilebebi da bronqofonia an xixini. B. 4a. mwvave bronqiti 70% _ 85% SemTxvevaSi virusuli etiologiisaa. amitom am daavadebaze eWvis mitanis an diagnozis dadasturebis SemTxvevaSi ar gamoiyeneba rutinuli antibiotikoTerapia. D. 28
4b. mwvave bronqitis diagnozis mqone pacientebSi antibiotikis daniSvnis an masze uaris Tqmis sakiTxi wydeba individualurad. Tumca aseT pacientTa umetesoba Tavad iRebs gadawyvetilebas antibiotikis miRebis Sesaxeb, piradi gamocdilebis an ara profesionalis rCevis Sesabamisad. E/B. 5. bavSvebsa da mozrdili asakis pacientebSi, vinc sae- Wvoa (an diagnozi dadasturebulia) yivanaxvela infeqciis arsebobaze, rekomendirebulia makrolidiT mkurnaloba da mkurnalobis dawyebidan 5 dRiani izolacia. aseTi RonisZieba ufro efeqturia daavadebis (xvelis) dawyebidan pirveli kvireebis ganmvlobaSi. am periodis Semdeg mkurnaloba nakleb efeqturi an uefeqtoa. A. 6a. mwvave bronqitis diagnozis SemTxvevaSi, xvelis Sesamcireblad, B2-agonistebis rutinuli gamoyenena araa rekomendirebuli. D. 6b. im SemTxvevaSi, Tu xvelas Tan erTvis xmauriani da amosunTqvis procesSi mstvinavi xmianobis sunTqva, Sei- Zleba B2-agonistebis gamoyeneba. C. 7. mwvave bronqitis dros, xvelis supresantebi (mag. deqstrometorfani an naproqsani) SeiZleba gamoviyenoT Ser- CeviT, xanmokle droiT da simptomaturad. C. 8. mwvave bronqitis dros, mukolitikur saSualebebs ara aqvT efeqti da isini ar arian rekomendirebuli. I . SeniSvna: mwvave bronqiti aris mwvave respiratoruli infeqcia, rac iwvevs bronqebis lorwovanis dazianebas da manifestirdeba xveliT, naxvelis perioduli gamoyofiT an mis gareSe da grZeldeba ara umetes 3 kvirisa(1). Tu xvela grZedeba 3 kviraze met xans _ unda ganvixiloT sxva mizezebi. Tu adgili aqvs bronqebis obstruqcias da hiperreaqtiulobas, xvela SeiZleba gagrZeldes 6 kvirac. mwvave bronqitis diagnostikisas unda ganvasxvavoT Semdegi daavadebebis arsebobis SesaZlebloba: 1. surdos 2. qronikuli bronqitis gamwvavebis, 3. pnevmoniis, 29
- 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 and 26: oloSi _ saxis niRabi an munStuki. s
- Page 27: suri mkurnaloba. B. 11. rodesac dav
- 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
- Page 37 and 38: gamoxatulia lorwos hipersekrecia (W
- Page 39 and 40: 11. d.p.b.-iT daavadebis dros saWir
- Page 41 and 42: sunTqvis ukmarisobis seriozuli gamo
- Page 43 and 44: yivanaxvela, unda gaviTvaliswinoT S
- Page 45 and 46: Cutardes gulmkerdis R-grafia. E/A.
- Page 47 and 48: angiotenzin-SemboWveli enzimis inhi
- Page 49 and 50: viloT iseTi faqtorebis arsebobaze,
- Page 51 and 52: profesiuli da garemoSi arsebuli miz
- Page 53 and 54: is arsebobis SesaZleblobac, romlebi
- Page 55 and 56: 8a. qronikuli xvelis mqone paciente
- Page 57 and 58: eriuli supresantebi, rogoricaa maga
- Page 59 and 60: duram SeiZleba mdgomareobis gauares
- Page 61 and 62: li faqtorebi, rogoricaa magaliTad T
- Page 63 and 64: algoriTmi 3. qronikuli xvelis marTv
- Page 65 and 66: algoriTmi 5. qronikuli, specifiuri
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is mizeziT gamowveuli xvelis arseboba. Tumca es sakiTxi<br />
naklebadacaa Seswavlili. avtorebs miaCniaT, rom aseTi<br />
asociacia arsebobs. magram igi ar aris maRali da yovel<br />
SemTxvevaSi bavSvebSi gamovlenili izolirebuli xvela<br />
nalkebad iZleva g.e.f.r.-ze eWvis mitanis safuZvels,<br />
vidre mozrdilebSi (10). Tumca sxva avtorebs miaCniaT,<br />
rom g.e.f.r. Cvili asakis bavSvebSic ki SeiZleba iyos araspecifiuri<br />
xvelis mizezi (14).<br />
mwvave bronqitiT gamowveuli xvela. ( 6 ).<br />
1. pacientebSi, sadac mwvave respiratoruli infeqcia<br />
manifestirebs upiratesad xveliT, naxvelis gamoyofiT<br />
an mis gareSe, rac grZeldeba ara umetes 3 kvirisa, Tu<br />
ara gvaqvs pnevmoniis R-grafiuli dadastureba, Tu diagnostirebuli<br />
ar aris asTma an filtvis qronikuli<br />
obstruqciuli daavadebis gamwvaveba, an Tu daavadebis<br />
simptomatika scildeba «gaciebis» klinikur suraTs, Sei-<br />
Zleba daisvas mwvave bronqitis diagnozi. E/A.<br />
2. mwvave bronqitis diagnozis dasadgenad (dasadastureblad)<br />
ar aris saWiro rutinuli virusologiuri,<br />
baqteriologiuri an serologiuri kvleva. radgan gamomwvevis<br />
identifikacia klinikur praqtikaSi uSedegoa. C.<br />
3. mwvave bronqitis diagnozis dasadastureblad ar<br />
aris saWiro rutinuli R-grafiuli kvleva. intensiuri<br />
xvelisa da naxvelis gamoyofis SemTxvevaSi, pnevmoniis<br />
gamosaricxad, gulmkerdis R-grafiuli kvleva saWiroa,<br />
Tu: mozrdil pacientebSi 1. P > 100 wuTSi., 2. R > 24. 3.<br />
piris Rrus temperatura > 38 C. 4. filtvebis auskulptaciiT<br />
gamoxatulia fokaluri cvlilebebi da bronqofonia<br />
an xixini. B.<br />
4a. mwvave bronqiti 70% _ 85% SemTxvevaSi virusuli<br />
etiologiisaa. amitom am daavadebaze eWvis mitanis an<br />
diagnozis dadasturebis SemTxvevaSi ar gamoiyeneba rutinuli<br />
antibiotikoTerapia. D.<br />
28
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