aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
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aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...

aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...

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)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

5.<strong>mkurnaloba</strong><br />

tuberkulozis <strong>mkurnaloba</strong> <strong>aiv</strong> inficirebul pacientebSi un<strong>da</strong> <strong>da</strong>iwyos<br />

aqtiuri tuberkulozis diagnozis <strong>da</strong><strong>da</strong>sturebi<strong>da</strong>n rac SeiZleba male.<br />

aqtiuri tuberkulozis mkurnalobisTvis rekomendirebuli reJimebi <strong>aiv</strong><br />

inficirebul pacientebSi<br />

tuberkulozis SemTxvevis tipi<br />

axali tbB pacienti<br />

adre tb-namkurnalebi pacienti, maT<br />

Soris<br />

• relafsi<br />

• <strong>mkurnaloba</strong> misi Sewyvetis<br />

Semdeg<br />

• sxva SemTxveva<br />

• uSedego <strong>mkurnaloba</strong> 4<br />

qronikuli (ze<strong>da</strong>mxedvelobis qveS<br />

Catarebuli ganmeorebiTi mkurnalobis<br />

Semdeg naxveli isev mgb pozitiuria)<br />

mrtb (aRiniSneba rezistentoba minimum H <strong>da</strong> R)<br />

tuberkulozis mkurnalobis<br />

reJimebi 1<br />

intensiuri faza 2 gagrZelebis<br />

faza<br />

HRZE 2 Tvis HR 4 Tvis<br />

ganmavlobaSi 3 ganmavlobaSi<br />

HRZES 2 Tvis HRE 5 Tvis<br />

ganmavlobaSi ganmavlobaSi<br />

an<br />

HRZE 1 Tvis<br />

ganmavlobaSi<br />

specialuri reJimi<br />

H –izoniazidi, R – rifampicini, Z – pirazinamidi, E – etambutoli, S- streptomicini.<br />

1 – <strong>aiv</strong> inficirebuli pacientebisaTvis aqtiuri tuberkuloziT mkurnalobis<br />

yoveldRiuri reJimia rekomendirebuli;<br />

2 - rekomendebulia <strong>mkurnaloba</strong> uSualo ze<strong>da</strong>mxedvelobis qveS Catarebuli<br />

qimioTerapiis mTeli kursis ganmavlobaSi.<br />

3 – streptomicini SesaZloa gamoyenebul iqnes etambutolis nacvlad. tuberkulozuri<br />

meningitisas etambutoli un<strong>da</strong> Seicvalos streptomiciniT.<br />

4- yvela SemTxvevaSi un<strong>da</strong> Catardes wamlebis mimarT mikroorganizmis mgrZnobelobis<br />

Seswavla mkurnalobis reJimis individualuri wesiT SesarCevad.<br />

tuberkulozis mkurnalobisTvis <strong>aiv</strong> inficirebul bavSvebSi<br />

rekomendirebulia igive reJimebi, rac mozrdilebSi. preparatebis<br />

dozireba xdeba sxeulis masis Sesabamisad.<br />

199

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