aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/Sidsis fonze ganviTarebuli munis marTvis saxelmwifo standarti (protokoli) 1.daavadebis /nozologiis / sindromis mokle ganmarteba _ aiv infeqcia/Sidsi ewodeba adamianis imunodeficitis virusiT gamowveul infeqciur daavadebas. daavadeba munis gamomwvevia tkipa Sarkoptes scabiei. mdedr tkipas kanSi gahyavs gasasvleli, romelsac aqvs ramodenime sm sigrZis zedapiridan wamoweuli wiTeli nawiburis Sesaxedaoba. mdedri tkipa gayvanil gasasvlelSi debs kvercxebs da Semdeg gadaadgildeba sxeulis sxva nawilSi. kvercxebidan gamodis tkipebis axali Taoba, romlebic izrdebian, jvardebian, gahyavT axali gasasvlelebi da deben axal kvercxebs. 2.kriteriumebi _ a)damadasturebeli _ aiv infeqcia/Sidsis damadasturebeli kriteriumebia: aiv antisxeulebis arseboba sisxlis SratSi imunoblotingis meTodiT, aiv rnm-is raodenobrivad da/an aiv provirus dnm-is Tvisobrivad aRmoCena sisxlSi polimerizaciis jaWvuri reaqciis meTodiT. munis diagnozi diagnozi ismeba klinikuri gamovlinebebisa da dazianebuli keris anafxekis mikroskopuli gamokvlevis safuZvelze. mikroskopiisas aRmoCndeba tkipebi an/da maTi kvercxebi. b)gamomricxavi _ aiv infeqcia /Sidsis gamomricxavi kriteriumebia: aiv antisxeulebis ar arseboba sisxlis SratSi imunofermentuli meTodiT, raodenobrivad aiv rnm-is da/an Tvisobrivad aiv provirus dnm-is ar arseboba sisxlSi polimerizaciis jaWvuri reaqciis meTodiT. munis gamomricxavi kriteriumebia anafxekis mikroskopisas tkipebis an/da maTi kvercxebis ar arseboba. 3.simptomebi da niSnebi a)damadasturebeli _ aiv infeqcia/Sidss paTognomuri klinikuri niSnebi ar gaaCnia. igi miekuTvneba laboratoriulad sadiagnozo daavadebebs. simptomebidan SeiZleba gamovyoT: gaxangrZlivebuli cxeleba, gaxangrZlivebuli faRaraTi, limfadenopaTia, aramotivirebuli profuzuli oflianoba, Zlieri saerTo sisuste, aramotivirebuli wonaSi kleba (erTi Tvis ganmavlobaSi sxeulis wonis 10% da meti), sxvadasxva gamonayari kansa da lorwovanze, kandidozuri ezofagiti, cns-is atipiuri dazianebebi da sxva. munis dros kanqveSa gasasvlelis adgilze viTardeba gamonayari, romelic xSirad gvxvdeba: o xelebze - mtevnebze (gansakuTrebiT TiTebs Soris), o majis, idayvis, muxlismomxrel zedapirebze, o winamxris idayviskena zedapirze, o sasqeso asoze, o sarZeve jirkvlebsa da o beWebze. o avadmyofs ZiriTadad awuxebs tanis Zlieri qavili, gansakuTrebiT RamiT. 180
o imunodeficitis mqone pacientebs xSirad uviTardebaT munis mZime forma, romelsac uwodeben norvegiuls. misTvis damaxasiaTebelia vezikuluri gamonayari da sqeli fufxebis warmoqmna mTel sxeulze. munis am formis dros qavili ar aris gamoxatuli. o qavilis gamo muni xSirad rTuldeba meoradi infeqciebiT. b)gamomricxavi _ aiv infeqcia/Sidsis gamomricxavi simptomebi ar arsebobs, aiv inficirebuli wlebis ganmavlobaSi SeiZleba Civilebs ar warmoadgendes. munis gamomricxavi faqtoria Sesabamisi Civilebisa da simptomebis ar arseboba. 4.diagnostikur _ laboratoriuli testebi da specialistTa konsultaciebi CD3, CD4, CD8 limfocitebis absoluturi ricxvis gansazRvra, aiv virusuli datvirTvis gansazRvra polimerizaciis jaWvuri reaqciis meTodiT, sisxlis saerTo analizi, RviZlis funqciuri sinjebi, Tirkmlis funqciuri sinjebi, virusuli hepatitis markerebi, dazianebuli keris anafxekis mikroskopuli Seswavla, dermatologis konsultacia. A5.munis mkurnalobaA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA SerCevis preparats warmoadgens adgilobrivad gamosayenebeli 1%-ani gamabenzen heqsaqloridi, romelic ismeba mTels tanze, Tavis garda, mozrdilebSi Camoibaneba 24 sT-Si , xolo bavSvebSi_8sT-Si. sakmarisia erTjeradi damuSaveba. aseve SesaZlebelia kanis damuSaveba 1%-ani permetriniT an 1%-ani lindaniT; es preparatebic ismeba mTels tanze da Camoibaneba 8 sT-Si. permetrinisa da lindanis gamoyeneba ar SeiZleba orsulebisaTvis, meZuZuri dedebisa da bavSvebisaTvis. norvegiuli munis samkurnalod, imunodeficitis mqone pacientebSi, efeqturia ivermeqtini, 200 mg/kg PO erTjeradad. tansacmeli, TeTreuli da pirsaxocebi unda gamoixarSos da dauTovdes gaSrobis Semdeg. munis mkurnaloba unda Cautardes sqesobriv partniors da yvelas vinc sayofacxovrebo kontaqtSi iyo avadmyofTan. 7.gaidlaini, romelsac eyrdnoba aRniSnuli protokoli aRniSnuli protokoli eyrdnoba jandacvis msoflio organizaciis 2006 wlis gaidlains: “aiv/SidsiT daavadebul mozrdil da mozard pirebSi oportunistuli infeqciebis profilaqtika da mkurnaloba”, aseve protokoli Sejerebulia DHHS, USA-AIS da EACS 2005 wlis oportunistuli infeqciebis mkurnalobis gaidlainebTan. 181
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- Page 136 and 137: 5. mkurnaloba a) rekomendebuli pirv
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- Page 140 and 141: joxiseburi TiTebi. Tumca wlebis man
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<strong>aiv</strong> <strong>infeqcia</strong>/Sidsis fonze ganviTarebuli munis marTvis<br />
saxelmwifo stan<strong>da</strong>rti (protokoli)<br />
1.<strong>da</strong>avadebis /nozologiis / sindromis mokle ganmarteba _ <strong>aiv</strong><br />
<strong>infeqcia</strong>/Sidsi ewodeba a<strong>da</strong>mianis imunodeficitis virusiT gamowveul<br />
infeqciur <strong>da</strong>avadebas. <strong>da</strong>avadeba munis gamomwvevia tkipa Sarkoptes scabiei.<br />
mdedr tkipas kanSi gahyavs gasasvleli, romelsac aqvs ramodenime sm<br />
sigrZis ze<strong>da</strong>piri<strong>da</strong>n wamoweuli wiTeli nawiburis Sesaxe<strong>da</strong>oba. mdedri<br />
tkipa gayvanil gasasvlelSi debs kvercxebs <strong>da</strong> Semdeg ga<strong>da</strong>adgildeba<br />
sxeulis sxva nawilSi. kvercxebi<strong>da</strong>n gamodis tkipebis axali Taoba,<br />
romlebic izrdebian, jvardebian, gahyavT axali gasasvlelebi <strong>da</strong> deben<br />
axal kvercxebs.<br />
2.kriteriumebi _<br />
a)<strong>da</strong>ma<strong>da</strong>sturebeli _ <strong>aiv</strong> <strong>infeqcia</strong>/Sidsis <strong>da</strong>ma<strong>da</strong>sturebeli<br />
kriteriumebia: <strong>aiv</strong> antisxeulebis arseboba sisxlis SratSi<br />
imunoblotingis meTodiT, <strong>aiv</strong> rnm-is raodenobrivad <strong>da</strong>/an <strong>aiv</strong><br />
provirus dnm-is Tvisobrivad aRmoCena sisxlSi polimerizaciis<br />
jaWvuri reaqciis meTodiT. munis diagnozi diagnozi ismeba<br />
<strong>klinikuri</strong> gamovlinebebisa <strong>da</strong> <strong>da</strong>zianebuli keris anafxekis<br />
mikroskopuli gamokvlevis safuZvelze. mikroskopiisas aRmoCndeba<br />
tkipebi an/<strong>da</strong> maTi kvercxebi.<br />
b)gamomricxavi _ <strong>aiv</strong> <strong>infeqcia</strong> /Sidsis gamomricxavi kriteriumebia: <strong>aiv</strong><br />
antisxeulebis ar arseboba sisxlis SratSi imunofermentuli<br />
meTodiT, raodenobrivad <strong>aiv</strong> rnm-is <strong>da</strong>/an Tvisobrivad <strong>aiv</strong> provirus<br />
dnm-is ar arseboba sisxlSi polimerizaciis jaWvuri reaqciis<br />
meTodiT. munis gamomricxavi kriteriumebia anafxekis mikroskopisas<br />
tkipebis an/<strong>da</strong> maTi kvercxebis ar arseboba.<br />
3.simptomebi <strong>da</strong> niSnebi<br />
a)<strong>da</strong>ma<strong>da</strong>sturebeli _ <strong>aiv</strong> <strong>infeqcia</strong>/Sidss paTognomuri <strong>klinikuri</strong><br />
niSnebi ar gaaCnia. igi miekuTvneba laboratoriulad sadiagnozo<br />
<strong>da</strong>avadebebs. simptomebi<strong>da</strong>n SeiZleba gamovyoT: gaxangrZlivebuli<br />
cxeleba, gaxangrZlivebuli faRaraTi, limfadenopaTia,<br />
aramotivirebuli profuzuli oflianoba, Zlieri saerTo sisuste,<br />
aramotivirebuli wonaSi kleba (erTi Tvis ganmavlobaSi sxeulis<br />
wonis 10% <strong>da</strong> meti), sxva<strong>da</strong>sxva gamonayari kansa <strong>da</strong> lorwovanze,<br />
kandidozuri ezofagiti, cns-is atipiuri <strong>da</strong>zianebebi <strong>da</strong> sxva. munis<br />
dros kanqveSa gasasvlelis adgilze viTardeba gamonayari, romelic<br />
xSirad gvxvdeba:<br />
o xelebze - mtevnebze (gansakuTrebiT TiTebs Soris),<br />
o majis, i<strong>da</strong>yvis, muxlismomxrel ze<strong>da</strong>pirebze,<br />
o winamxris i<strong>da</strong>yviskena ze<strong>da</strong>pirze,<br />
o sasqeso asoze,<br />
o sarZeve jirkvlebsa <strong>da</strong><br />
o beWebze.<br />
o avadmyofs ZiriTa<strong>da</strong>d awuxebs tanis Zlieri qavili, gansakuTrebiT<br />
RamiT.<br />
180
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