aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
)gamomricxavi - aiv infeqcia/Sidsis gamomricxavi simptomebi da niSnebi ar arsebobs, aiv inficirebuls wlebis ganmavlobaSi SesaZloa simptomebi ar aReniSnebodes; tuberkulozis gamomricxavi niSnebi da simptobebia Civilebis ararseboba, kontaqtis ar arseboba aqtiuri tuberkuloziT daavadebulTan; mdgomareobebi dakavSirebuli aqtiur tuberkulozTan bavSvebSi tuberkulozi saeWvoa, rodesac adgili aqvs • anamnezSi kontaqts filtvis tuberkulozis dadasturebul SemTxvevasTan • wiTelas gadatanis Semdeg imunosupresiul mdgomareobas • wonaSi klebas, xvelas, paTologiur auskultaciur monacemebs filtvebSi, romelic ar daeqvemdebara farTo speqtris antibiortikoTerapias • zedapiruli limfuri kvanZebis umtkivneulo SeSupebas tuberkulozi savaraudoa, roca adgili aqvs saeWvo tuberkulozis SemTxevevas da erT-erT niSans qvemoT CamoTvlilTagan • tuberkulozis kanis testi 5 mm-ze meti induraciiT • Sesabamisi cvlilebebi gulmkerdis rentgenogramaze • Sesabamisi histologiuri cvlilebebi biofsiur masalaSi • dadebiTi Sedegi antituberkulozur mkurnalobaze tuberkulozi dadasturebulia, roca • tuberkulozis mikobaqteria identificirebulia biologiur sekretebSi an qsovilebSi • naxvelis nacxis samjeradi pirdapiri mikroskopiiT minimum or preparatSi aRmoCenilia mJavagamZle mikobaqteria 4.diagnostikur-laboratoriuli testebi da specialistTa konsultaciebi CD3, CD4, CD8 limfocitebis absoluturi ricxvis gansazRvra, aiv virusuli datvirTvis gansazRvra, sisxlis saerTo analizi, RviZlis funqciuri sinjebi, Tirkmlis funqciuri sinjebi, virusuli hepatitis markerebis gansazRvra, naxvelis nacxis gamokvleva mgb-ze, gul-mkerdis rentgenologiuri gamokvleva, muclis Rrus eqoskopia; eqininfeqcionistis konsultacia, eqim-fTiziatris konsultacia; 198
5.mkurnaloba tuberkulozis mkurnaloba aiv inficirebul pacientebSi unda daiwyos aqtiuri tuberkulozis diagnozis dadasturebidan rac SeiZleba male. aqtiuri tuberkulozis mkurnalobisTvis rekomendirebuli reJimebi aiv inficirebul pacientebSi tuberkulozis SemTxvevis tipi axali tbB pacienti adre tb-namkurnalebi pacienti, maT Soris • relafsi • mkurnaloba misi Sewyvetis Semdeg • sxva SemTxveva • uSedego mkurnaloba 4 qronikuli (zedamxedvelobis qveS Catarebuli ganmeorebiTi mkurnalobis Semdeg naxveli isev mgb pozitiuria) mrtb (aRiniSneba rezistentoba minimum H da R) tuberkulozis mkurnalobis reJimebi 1 intensiuri faza 2 gagrZelebis faza HRZE 2 Tvis HR 4 Tvis ganmavlobaSi 3 ganmavlobaSi HRZES 2 Tvis HRE 5 Tvis ganmavlobaSi ganmavlobaSi an HRZE 1 Tvis ganmavlobaSi specialuri reJimi H –izoniazidi, R – rifampicini, Z – pirazinamidi, E – etambutoli, S- streptomicini. 1 – aiv inficirebuli pacientebisaTvis aqtiuri tuberkuloziT mkurnalobis yoveldRiuri reJimia rekomendirebuli; 2 - rekomendebulia mkurnaloba uSualo zedamxedvelobis qveS Catarebuli qimioTerapiis mTeli kursis ganmavlobaSi. 3 – streptomicini SesaZloa gamoyenebul iqnes etambutolis nacvlad. tuberkulozuri meningitisas etambutoli unda Seicvalos streptomiciniT. 4- yvela SemTxvevaSi unda Catardes wamlebis mimarT mikroorganizmis mgrZnobelobis Seswavla mkurnalobis reJimis individualuri wesiT SesarCevad. tuberkulozis mkurnalobisTvis aiv inficirebul bavSvebSi rekomendirebulia igive reJimebi, rac mozrdilebSi. preparatebis dozireba xdeba sxeulis masis Sesabamisad. 199
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)gamomricxavi - <strong>aiv</strong> <strong>infeqcia</strong>/Sidsis gamomricxavi simptomebi <strong>da</strong> niSnebi<br />
ar arsebobs, <strong>aiv</strong> inficirebuls wlebis ganmavlobaSi SesaZloa simptomebi<br />
ar aReniSnebodes; tuberkulozis gamomricxavi niSnebi <strong>da</strong> simptobebia<br />
Civilebis ararseboba, kontaqtis ar arseboba aqtiuri tuberkuloziT<br />
<strong>da</strong>avadebulTan;<br />
mdgomareobebi <strong>da</strong>kavSirebuli aqtiur tuberkulozTan bavSvebSi<br />
tuberkulozi saeWvoa, rodesac adgili aqvs<br />
• anamnezSi kontaqts filtvis tuberkulozis <strong>da</strong><strong>da</strong>sturebul<br />
SemTxvevasTan<br />
• wiTelas ga<strong>da</strong>tanis Semdeg imunosupresiul mdgomareobas<br />
• wonaSi klebas, xvelas, paTologiur auskultaciur monacemebs<br />
filtvebSi, romelic ar <strong>da</strong>eqvemdebara farTo speqtris<br />
antibiortikoTerapias<br />
• ze<strong>da</strong>piruli limfuri kvanZebis umtkivneulo SeSupebas<br />
tuberkulozi savaraudoa, roca adgili aqvs saeWvo tuberkulozis<br />
SemTxevevas <strong>da</strong> erT-erT niSans qvemoT CamoTvlilTagan<br />
• tuberkulozis kanis testi 5 mm-ze meti induraciiT<br />
• Sesabamisi cvlilebebi gulmkerdis rentgenogramaze<br />
• Sesabamisi histologiuri cvlilebebi biofsiur masalaSi<br />
• <strong>da</strong>debiTi Sedegi antituberkulozur <strong>mkurnaloba</strong>ze<br />
tuberkulozi <strong>da</strong><strong>da</strong>sturebulia, roca<br />
• tuberkulozis mikobaqteria identificirebulia biologiur<br />
sekretebSi an qsovilebSi<br />
• naxvelis nacxis samjeradi pir<strong>da</strong>piri mikroskopiiT minimum or<br />
preparatSi aRmoCenilia mJavagamZle mikobaqteria<br />
4.diagnostikur-laboratoriuli testebi <strong>da</strong> specialistTa konsultaciebi<br />
CD3, CD4, CD8 limfocitebis absoluturi ricxvis gansazRvra, <strong>aiv</strong><br />
virusuli <strong>da</strong>tvirTvis gansazRvra, sisxlis saerTo analizi, RviZlis<br />
funqciuri sinjebi, Tirkmlis funqciuri sinjebi, virusuli hepatitis<br />
markerebis gansazRvra, naxvelis nacxis gamokvleva mgb-ze, gul-mkerdis<br />
rentgenologiuri gamokvleva, muclis Rrus eqoskopia; eqininfeqcionistis<br />
konsultacia, eqim-fTiziatris konsultacia;<br />
198
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