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Ffiltvebis qronikuli obstuqciuli daavadeba da misi marTva

Ffiltvebis qronikuli obstuqciuli daavadeba da misi marTva. lali miqiaSvili tfdc. 2 marti, 2010. Ffiltvebis qronikuli obstuqciuli daavadeba (fqod) ( Chronic obstructive pulmonary disease- COPD). janmo-s 2005 wlis monacemebi: 80 mln adamiani daavadebulia fqod-s saSualo an mZime formiT.

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Ffiltvebis qronikuli obstuqciuli daavadeba da misi marTva

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  1. Ffiltvebis qronikuli obstuqciuli daavadeba da misi marTva lali miqiaSvilitfdc. 2 marti, 2010

  2. Ffiltvebis qronikuli obstuqciuli daavadeba (fqod) (Chronic obstructive pulmonary disease- COPD) janmo-s 2005 wlis monacemebi: • 80 mln adamiani daavadebulia fqod-s saSualo an mZime formiT. • 3 mln adamiani gardaicvala fqod-iT, rac globaluri sikvdilianobis 5%-s Seadgens. • sikvdilianobis 90% modis saSualo da dabalSemosavlianqveynebze.

  3. janmo-s monacemebi: • 2002 wels fqod-m daikava V adgili sikdilianobis mxriv; • 2030 wels savaraudod daiWers III adgils.

  4. Ffiltvebis qronikuli obstuqciuli daavadeba (fqod): (Chronic obstructive pulmonary disease- COPD) • aSS-Si uWiravs me-4 adgili sikvdilianobis mxriv; • aSS-Si sikvdilianobis 10 yvelaze xSirad gamomwvev daavadebas Soris, fqod aris erTaderTi, romlis sikvdilianobis maCvenebelic izrdeba.

  5. Ffqod-s gansazRvreba:(ERS/ATS) Ffqod-s aris daavadeba, romlis mkurnaloba da prevenciaSesaZlebelia da xasiaTdeba: • ventilaciis darRveviT, romelic arasrulad Seqcevadia; • Cveulebriv progresirebs; • asocirebulia gamRizianebel agentze filtvebSi araadeqvaturi anTebadi pasuxis ganviTarebasTan; • asocirebulia sistemur garTulebebTan.

  6. fqod aerTianebs : • qr. obstruqciuli bronqiti; • emfizema; • α-1 antitrifsinis deficiti.

  7. garTulebebi: • filtvismieri guli; • policitemia; • sunTqvis ukmarisoba; • Ramis hipoqsia; • bronqogenuli karcinoma; • motexilobebi; • barZayis Zvlis mineralizaciis darRveva; • kataraqta • depresia

  8. saWiroa fqod-s adreuli gamovlena: • klinicistebis ganswavla; • fqod-s specifiuri skriningi; • specialuri kiTxvaris roli pirveladi jandacvis qselSi

  9. spirometria

  10. spirometria:(Global Strategy for Diagnosis, Management, and Prevention of COPD).

  11. Ffqod-s mkurnaloba miznad isaxavs: • respiratoruli Civilebis Seamcirebas; • gamwvavebebis Semcirebas; • filtvis funqciis gaumjobesebas; • sicocxlis xangrZlivobis gazrdas.

  12. individualuri pacientisaTvis unda ganisazRvros ras vmkurnalobT : • sunTqvis ukmarisobas? • gamwvavebebs? – hospitalizaciis prevencia an misi vadis Semcireba? • aqtivobis gazrdas? eqimsac da avadmyofsac naTlad unda esmodeT mkurnalobis mizani

  13. Ffqod-s samkurnalo preparatebi: • antiqolinerguli bronqodilatatorebi; • xangrZlivi moqmedebis β-agonistebi; • sainhalacio kortikosteroidebi (kombinaciaSi);

  14. asTmisa da fqod-s samkurnalo medikamentebi gansxvavdeba erTmaneTisagan fqod-s dros ar gamoiyeneba: • qromolini; • leikotrinebis antagonistebi; • sainhalacioKkortikosteroidebis monoTerapia

  15. miRwevebi fqod-s mkurnalobaSi: or- da samkomponentiani reJimi: • bronqodilatatorebis sxvadasxva klasis kombinacia • β2-agonistebi: a. xanmokle moqmedebis (Albuterol) b. gaxangrZlivebuli moqmedebis (salmeteroli, formeteroli) • antiqolinerguli saS-bebi: a. xanmokle moqmedebis (Ipratropium bromide); b. gaxangrZlivebuli moqmedebis (Tiotropium) mag. Tiotropium+ formeterol; Tiotropium+salmeterol. • kortikosteroidebi bronqodilatatorebTan kombinaciaSi.

  16. iotropium

  17. Ppnevmoniis signali Psainhalacio kortikosteroidebi • pnevmoniis signali: maRali dozis kortikosteroidebis gamoyeneba asocirebulia pnevmoniasTan; • ar arsebobs sarwmuno cnobebi sikvdilianobis matebaze; • sikvdilianobis maCvenebeli klebulobs kombinirebuli Terapiisas. kvlevebi:TORCH, INSPIRE, SMART, UPLIFT, Registry Study in America, Erst and Suisa

  18. reabilitacia: • fizikuri varjiSi zeda da qveda kidurebis aqtiuri datvirTviT; • sasunTqi kunTebis varjiSi; • fizioTerapia; • fsiqosocialuri daxmareba (depresia); • ganaTleba.

  19. oqsigenoTerapia • PCvenebebi: • PPaO2 < 7,3 kPa ; SaO2 < 80% • Aan PaO2 = 7,3 - 7,8 kPa + filtvismieri guli, policitemia. • Ooqsigenaciis mizani: PPaO2 > 8kPa, SaO2 > 90%

  20. qirurgia: National Emphysema Treatment Trial (NETT)

  21. qirurgia: National Emphysema Treatment Trial (NETT)2

  22. sicocxlis xangrZlivoba:

  23. janmo-s prevenciuli RonisZiebebi Seiqmna: • GARD(Global Alliance against Chronic Respiratory Disease) Mmisi erTerTi nawilia • GOLD (Global Initiative for Chronic Obstructive Disease)

  24. Tambaqos mowevaze kontroli

  25. sabinao pirobebSi haeris dabinZureba

  26. daskvna • aucilebelia fqod-s adreuli gamovlena; • gasaumjobesebelia fqod-s gamovlenis strategia; • prevenciuli RonisZiebebis aqtiuri Catareba; • aucilebelia kombinirebuli Terapiis Catareba fqod-s gamosavlis gasaumjobeseblad; • pacientis mkurnalobaze damyolobis gaumjobeseba; • axali, efeqturi Terapiis aucilebloba.

  27. gmadlobT yuradRebisaTvis

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