ჯანდაცვის პრობლემები საქართველოში

Medicinis istoria itvleboda da itvleba eris kulturis ert ert sazomad  , vinaidan adamianis janmrteloba qveynad siketis dasawyisia , jer kidev chveni weltagricxvamde(XIII-XII saukuneebshi ) kolxeti da iberia cnobili iyo rogorc unikaluri samkurnalo sashualebebis mcodne mxare . kolxetis mepis aietis cols hekatesa da qalishvilis medeas saxletanaa dakavshirebuli8 . yvelaze adreuli  miti “sisxlis gadasxmis shesaxeb” da “gaaxalgazrdavebis” shesaxeb  . arc isaa shemtxveviti rom sayoveltao sityva “medicina”  kollxi qalis medeas saxels ukavshirdeba. medicinis ostoriis mkvlevartatisvis cnobilia rom kolxetis dablobze  gashenebuli yopila  “hekates bagi ”  (dzv.w.650w )  romelshic 40ze meti samkurnalo mcenare moxvedrila . msoplio medicinis istoriss pirvelsave tomshi pirvelive qvesatauri  “udzvelesi kolxuri medicinit” iwyeba .  saqartveloshi xalxuri medicini ganvitarebis udidesi warsulis machvenebelia dzveli qartuli samedicino werilobiti wyaroebi  : qananelis  “usworo karbidani” (X_s)  , xoja yopilis “wigni saaqimoi” zaza panaskertel-cicishvilis  “samkurnalo wigni karbidini” davit bagrationios “iadgar daudi ” . kacobriobis arsebobis xangrdzliv istorias mravali inpeqciur daavadebata epidemia axsovs mat shorisaa AIV inpeqcia shidsi  .  klinikurad igi pirvelad agweres  ASHSH-shi 1981 wels  . is gavrcelebas xeli sheuwyo aprikidan iapasiani sisxlis eqsportma amerikisa da evropis sisxlis  bankebshi . msoplios umravles  qveynebshi shids edzaxian AIDS – es saxelwodeba modis inglisuridan  acquired immuno deficiency syndrome  , rac qartulad nishnavs  shedzenili imuno depicitis sindromi  anu shidsi . igi gadamdebi daavadebaa . adamianis imuno depicitis virusi miekutvneba  retro virusebs . arsebobs midi  2 tipi AIV 1 da AIV 2  , romlebic ertmanetisagan gansxvavdebian rogorc genetikuri shedgenilobit aseve mat mier gamowveuli daavadebebs mimdinareobit . AIV 2 inpeqcia klinikurad upro msubuqad mimdinareobs da nela progresirdeba . mtel mshoplioshi AIV 1 gavrcela mnishvnelovnad agemeteba AIV 2is gavrcelebas . AIV 2 umetesad gvxvdeba  afrikis kontinentze . shidsis virusi sheicavs RNM-is ormag jajvs  . virussis shignit motavsebulia cpecipikuri permenti  shebrunebiti transkriptaza . romelic axorcielebs  erenemidan deenemis cintezs ris shedegadac warmoqmnili orjajviani deenemi chainergeba samizne ujredebis  genetikur  masalashi . AIV-is samizne ujredebs umetesad warmoadgenen adamianis imunuri sistemis centraluri ujredebi , kerdzod T limpocitebis ert-ert qvejgupi , romlebsac saertashoriso klasipikaciit CD4 limpoebi ewodeba . sadgeisot ar arsebobs iseti medikamentebi  romeltac shesadzloa shidsisgan sruli gankurneba  , tumva arsebobs mteli rigi medikamentebi , romelta megeba mudmivad mteli sicocxlis mandzilze trgunavs virusis gamravlebas .arsebobs shidsis samkurnalo  medikamentebis sami dziritadi jgupi   da es dayopa jgupebad gamomdinareobs preparatis qimiuri agebulebisa da imisgan tu virusis romel komponentze  moqmedebs esa tu is  preparati  . garda antiretrovirusuli mkurnalobisa  . shidsis mqone   pacientebs utardeb mkurnaloba , shesabamisi oportunistuli inpeqciebis winaagmdeg , tu es inpeqciebi ganvitardeba .  uaxlesi mimdinareioba shidsis mqone avadmyopebshi  imunuri  sistemis makoregirebuli  mkurnaloba interlekin 2it antiretrovirusuli medikamentebis gamoyenebis paralelurad  . AIV inpeqciis  diagnostika xorcieldeba virusis saeinaagmdego antisxeulebis agmochenit serologiuri metodebis gamoyenebit .sakringisatvis gamoiyeneba imunofermentuli analizi-iafa (ELISA) xolo damadasturebeli metodia imunoblotingi. saqartveloshi aiv-inficirebis gadacemis gzebi ase gamoiyureba                                                                                                   sqesobrivi gzit-35,6%                                                                                                                           intravenuri narkomania-60%                                                                                                              inficirebuli sisxlis gadasxma-0,7%                                                                                                   dedidan   axalshobilze-2,4%                                                                amrigad, saqartveloshi iav infeqciis gadacemis dziritad gzaa intravenuri narkomania. martalia msoflio statistikit saqartvelo miekutvneba shidsis dabali prevalenbis qveynebis, magram shidsis registrirebuli shemtxvevebis ukan dgas daaxloebit 4000-mde araregistrirebuli shemtxveva, es ki iseti mcirericxovani qveynisatvis, rogorc saqartveloa ukve soliduri ricxvia. saqartveloshi aiv-infeqcia( shidsis pirveli shemtxveva gamovlinda 1989 w). saqartveloshi 2010 wlis monacemebit infeqciuri patologiis, shidsisa da klinikuri imunologiis samecniero- praqtikul centrshi registrirebulia 1863 mamakaci da 656 qali pacientta uamravlesoba 29-da 40 wlamdea. jer kidev 2010 wlis 25 tebervalis monacemebit, saqartvelos masshtabit 61 axali aiv inficirebis shemtxveva dafiqsirda, dxes ki es ricxvi 67- adamianit gaizarda. uaxloesiori tvis mandzilze 26 axali shemtxveva gamovlinda tbilisshi, 10- adzarashi, amdenive samegreloshi, 8-imeretshi. hepatiti sakmaod gavrcelebuli da sashishi infeqciuri daaavadebaa. hepatiti pirdapiri mnishvnelobit gvidzlis antebas nishnavs, misi gamomwvevia virusi. saqartveloshi virusuli hepatitebis B da C dainficirebulta machvenebelta mesame adgilzea. gamomwvevi virusis mixedvit ganasxvaveben ramdenime tipis hepatits: A,B,C,D,E,F da G. hepatitebit daavadebebis riskis jgufs warmoadgenen narkomanebi, medzavebi, homoseqsualebi. maxali inficirebis jgufs miekutvneba agrtve sisxltan myofi samedicino personali, hemodialiszze momushave pirebi, qirurgebi, ginekologebi, hematologebi, laborantebi, saoperacio meddebi. virusuli hepatitebis  formebi sheidzleba dabyot or jgufad; inficirebis fekaluri-oraluri meqanizmit mimdinare A da E fepatitebi da parenteruli meqanizmebit -B,C,D,F da G hepatitebi. B da C hepatitebi dxeistvis problemas warmoadgens. yvelaze mdzime formaa C  hepatit. mas sxvanairad posttransfuziuli(gadasxmis shemdgomi) hepatits uwodebe. hepatitis nishnebisa da gamomwvevs dasadgenad mnishvnelovania sisxlis specipikuri analizebis shedegebi. mati sashualebit xdeba specifikuri vrusuli cilebis (antigeni) an viirusis sawinaagmdego antisxeulebis agmochena, uaxlesi gamokvlevebit shesadzlebelia virusis genetikuri masalis indentificireba. hepatitze saejvo pacintebs xshirad uketeben ori an sami cilis analizs: alanin aminotrnsferaza(ALT) da aspartat aminotranferze(AST) , arsebobs kidev sxva cila bilirubini,  romlis sintezi gvidzshi ar mimdinareobs, magram xdeba misi9 ganeitraleba. hepatitis shemtxvevashi misi raodenoba momatebulia. sisxlis analizis sashualebit sheidzleba agmovachiot specifikuri virusbi an mati wsawinaagmdego antisxeulebi. mato arseboba miutitebs mwvave daavadebaze. sisixlis analizis garda qronikuli hepatitis shemtxvevashi gamoiyeneba agretve sxva testebi,ormelta sashualebit shesadzlebelia gvidzlis mtliani suratis an misi mcire nawilias gamokvleva. herpesi virusuli infeqciaa, romelsac iwvevs martivi herpesis virusi. arsebobs virusis ori tipi, kerjod piris da saxis dazianebis gamomwvevi da genitaluri anu sasqeso organoebi sinfeqciis gamomwvevi daavadeba. shemtxvevata 80% infeqcia klinikuri gamovlinebebebis gareshe mimdinareobs. misi gaaqtiureba sheidzleba gamoiwvios stresma, travmam da sxva. dedis daavadebis shemtxvevashi nayofs muclad yofnis dros gadaecema bolo dros herpesis daavadeba sakmaod xshiria. 2009 wlis marti-aprilis tveebshi H1N1 virusi gavrcelda meqsikashi, shemdeg amerikashi. bolos fartod gavrcelda. goris gripi istoriuli monacemebit pirvelad agmoachines gorebshi 1918-1919 wlebshi. xolo adamianisan pirvelad gamoeyo 1974 wels daavadeba shesdzlebelia shegxvdes nebismier asakshi, tumca mcire asakis bavshvebsa da moxucebshi ufro mdzimed mimdinareobs.

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