ტუბდისპანსერის 100 წლის შენობა კაპიტალურ რემონტს საჭიროებს
მარიამ ხითარიშვილი 27 48 93 –
tuberkulozi infeqciuri daavadebaa, romlis damarcxeba SesaZlebelia swori mkurnalobiT. miuxedavad amisa, igi dRemde rCeba infeqciuri daavadebebiT sikvdilianobis wamyvan mizezad. jandacvis msoflio organizaciis (janmo) monacemebiT, tuberkuloziT yoveldRiurad avaddeba 30 000 da iRupeba 4 500 adamiani
ra xdeba am mimarTulebiT saqarTveloSi da, kerZod, aWaraSi, ra meTodebiT ebrZvian am daavadebas, ra miRwevebi da problemebi aqvT, gvesaubreba tuberkulozis erovnuli programis koordinatori aWaraSi da ftiziopulmonologiuri departamentis ufrosi dimitri cecxlaZe.
– batono dimitri, Tu SeiZleba, Tavad daavadebaze TqviT oriod sityva da ganmarteT, ratom aRiniSneba mis winaaRmdeg brZola 24 marts?
– tuberkulozi aris infeqciuri daavadeba, romelsac iwvevs tuberkulozis mikobaqteriebi. daavadeba uZvelesi droidanaa cnobili, magram misi Seswavla me-19 saukunis meore naxevridan daiwyo, rodesac uamravi aRmoCena dafiqsirda. 1882 wlis 24 marts germanelma mecnierma robert koxma samecniero sabWos sxdomaze waradgina tuberkulozis gamomwvevi mikobaqteria. am dRidan daiwyo misi mecnieruli Seswavla. aRmoCenisTvis robert koxs 1905 wels nobelis premia mianiWes, xolo Tavad baqterias koxi daerqva, Tumca axla saxeli Seucvales da mJavagamZle baqteria uwodes.
– ratom?
– imitom, rom aris mJavagamZle, Zalian didxans Zlebs yinvaSi, Tumca mzis sxivis pirdapiri moqmedebiT male kvdeba da masStaburad veRar vrceldeba. gavrcelebis wyaroa filtvis tuberkuloziT daavadebuli, romelic daxvelebiT an saubrisas haerSi gamoyofs mikobaqteriebis uamrav raodenobas, romelTac janmrTeli adamiani Tu CaisunTqavs, dainficirdeba. erT gadamdeb pacients 10 adamianis daavadeba SeuZlia, romelTagan sami an xuTi gaxdeba avad, anu daainficirebs mets, magram tuberkulozi daemarTeba naklebs. tuberkuloziT dasnebovnebis albaToba gansakuTrebiT maRalia daxurul da cudad ganiavebul garemoSi xangrZlivad yofnis dros. dasnebovneba SesaZlebelia sakvebis gziTac, magaliTad, infeqcia organizmSi SeiZleba SeiWras tuberkulozuri mikobaqteriebis Semcveli auduRari rZis an rZis produqtebis miRebisas. aseT SemTxvevaSi infeqciis wyaros warmoadgens tuberkuloziT daavadebuli saqoneli. aqve aRvniSnav, rom WurWliT an sxva sayofacxovrebo nivTebiT (pirsaxociT, TeTreuliT) tuberkulozi ar gadadis. mis ganviTarebaSi gamoyofen 2 stadias: inficirebisa da daavadebis. tuberkulozis gamomwvevi baqteriebi zeda sasunTqi gzebiT (cxviris Rru, xorxi, traqea, bronqebi) CasunTqul haeris nakadTan erTad filtvis alveolebs aRwevs. Tu organizmis damcvelobiTi Zalebi Zlieria, tuberkulozis mikobaqteriis winaaRmdeg gamomuSavdeba antisxeulebi, romlebic infeqciis gamomwvevis irgvliv sqel kedels qmnian da Trgunaven mis gamravlebas: warmoiqmneba tuberkulozis pirveladi kera. es aris mdgomareoba, rodesac tuberkulozis Cxiris organizmSi moxvedris miuxedavad, inficirebul adamians ar aReniSneba daavadebis gamovlineba da ar warmoadgens infeqciis janmrTel pirebze gadacemis wyaros.
– bevri Tvlis, rom tuberkulozi me-19 saukuneSi darCa da axla aRar iwvevs problemebs.
– es mcdari warmodgenaa. marTalia, axla tuberkulozi inkurneba, magram rTulia am diagnozis matarebeli adamianebis aRmoCena da mkurnaloba. tuberkulozi isev arsebobs da msoflios masStabiT isev iwvevs sikvdils. amas vambob 5-6 wlis win mowodebuli saerTaSoriso kvlevebis monacemebze dayrdnobiT, anu weliwadSi daaxloebiT milion rvaasi aTasi avadmyofi kvdeboda, xolo registrirebuli iyo aTi milioni. am daavadebiT sikvdilianoba mexuTe adgilze iyo, Semdeg gadmoinacvla ukan. . .
– axla ra mdgomareobaa?
– saqarTveloSi Camoyalibda tuberkulozis erovnuli programa, romelmac moawesriga am daavadebis aRricxva da mkurnaloba. manamde filtvis an sxva formis tuberkuloziT daavadebuli ramdenime weli imyofeboda dispanserul aRricxvaze. TandaTan mowesrigda samedicino servisebi da sruliad sxva tipis mkurnalobaze gadavediT. amJamad cnobilia tuberkulozis filtvis da filtvgareSe formebi.
– Tu SeiZleba, gangvimarteT.
– nebismieri organos tuberkuloziT daavadebaa SesaZlebeli. gansakuTrebiT yuradsaRebi da saSiSia centraluri nervuli sistemis dazianeba, eqsudaciuri plevriti, muclis Rrus, ZvalsaxsarTa sistemis, sasqeso organoebis tuberkulozi da sxva, anu tuberkulozuri procesi uxSiresad viTardeba filtvebSi, miuxedavad amisa, igi SeiZleba ganviTardes nebismier sxva organoSi. rac Seexeba simptomebs: pacients aReniSneba zogadi sisuste, umadoba, xvela, zogjer sisxliani naxveli, sicxe – 37 an 37,5 gradusi, tkivilebi gulmkerdis areSi da sxva.
– Tqven mogvawodeT saerTaSoriso mdgomareobis amsaxveli cifrebi. ra situaciaa saqarTveloSi?
– saqarTveloSi tuberkulozis SemTxvevebis raodenoba Zalian maRali iyo. am erovnuli programis da axali medikamentebis saSualebiT, SevZeliT daavadebis mkurnalobis garkveul CarCoSi moqceva. problema aRmoCnda 2000 wlis Semdeg dawyebuli rezistentuli tuberkulozi. avadmyofebSi, romlebsac bolomde ar mihyavdaT mkurnaloba, ar icavdnen higienas da axlo kontaqtSi iyvnen filtvis tuberkuloziT daavadebul pacientebTan (ufro socialurad daucvel fenas da riskis jgufebs vgulisxmobT – narkomanebs, alkoholis momxmareblebs), warmoiSva es rTuli formebi. Tu Cveulebriv tuberkulozs vmkurnalobdiT 6-8 Tves, rezistentuls sWirdeboda – 2 wlamde. mTeli am xnis ganmavlobaSi pacients yoveldRe unda mieRo wamali. es sakmaod mZime iyo. mdgomareoba gaumjobesda, rodesac mivuerTdiT saerTaSoriso programas. axla CvenTan ukve ise mkurnaloben, rogorc evropis ganviTarebul qveynebSi. amasTan, bolo 5 welia, qveyanaSi Semovida 4 axali ZiriTadi preparati. aqve gavixseneb, rom 1941 wels tuberkulozis samkurnalod gamoiyeneboda streptocidi, romelmac milionobiT adamiani ixsna sikvdilisgan. sxva wamlebi ar iyo iseTi efeqturi, bolos rom mouRebda tuberkulozs.
– ramdeni ganikurna aWaraSi?
– Cven gvyavda 50 tuberkuloziT daavadebuli pacienti. axali medikamentebiT SevZeliT am cifris 10-mde dayvana. Tqven warmoidgineT, gamojanmrTeldnen is pacientebi, wlebis ganmavlobaSi uSedegod rom mkurnalobdnen da qronikulad iTvlebodnen.
– ramdenxniania mkurnaloba?
– daavadebis SemTxvevaSi, mkurnaloba or fazas moicavs: intensiursa da gagrZelebiTs. mkurnalobis intensiuri faza daaxloebiT 2-3 Tves, xolo mTliani kursi saSualod 6-9 Tves moicavs. mniSvnelovania, rom pacientma mkurnaloba daniSnulebis Sesabamisad, Tanmimdevrulad, uwyvetad da zustad Caitaros. pacientisa da eqimis optimaluri TanamSromlobis gareSe saukeTeso medikamentebis gamoyenebac ki sasurvel Sedegs ver moitans. rodesac xdeba tubsawinaaRmdego medikamentebis araregularuli miReba an mkurnalobis vadaze adre Sewyveta, SeiZleba ganviTardes egreT wodebuli rezistentuli tuberkulozi, daavadebis medikamentebisadmi gamZle forma. problema isaa, rom aseTi tipis daavadebis gankurneba gacilebiT rTulia, magram – SesaZlebeli. aqve aRvniSnav, rom tuberkulozis programa iTvaliswinebs aWaris yvela municipalitetSi tuberkulozis dispanseris funqcionirebas, sadac muSaoben kvalificiuri, sertificirebuli eqimebi. iq yvela pirobaa Seqmnili, rom adgilze, ufasod Caitaron kvlevebi am daavadebaze eWvmitanilebma. kvlevaSi Sedis: gul-mkerdis rentgenografia, sisxlis saerTo da naxvelis analizi. baTumSi moqmedebs fiziopulmonologiuri dispanseri, radgan tuberkulozis saavadmyofo gaerTianda infeqciurTan da saerTo qudqveS moveqeciT. am bolo 5 wlis ganmavlobaSi tuberkulozi daudginda: 2017 wels – 385 adamians, 2018-Si – 264-s, 2019-Si – 270-s, 2020-Si – 233-s, 2021 wels ki 227-s, anu klebis dinamika gvaqvs. stacionarSi, bolo 5 wlis monacemebiT, 2017 wels 200 pacientma imkurnala, 2018-Si – 167-ma, 2019-Si – 128-m, 2020-Si – 102-ma da 2021-Si – 101-ma. erovnuli programis mizania, 2030 wlisTvis davamarcxoT tuberkulozi.
– ramdenad xarT momaragebuli saWiro medikamentebiT?
– Zalian kargad gvamarageben. 1995 wlis Semdeg, rodesac erovnuli programa Camoyalibda, ar maxsovs tuberkulozis samkurnalo preparatebis mowodebaSi wyveta. centridan droulad gvawvdian wamlebs rogorc rezistentuli formis tuberkulozis, ise sensitiuri formis samkurnalod. aseve SemoviReT mkurnalobis wamaxalisebeli RonisZiebebi. kerZod, Tuki yoveldRiurad Rebulobs pacienti wamals, 60 lars vaZlevT, xolo mkurnalobis dasrulebisas – 100 lars. rezistentuli tuberkulozis mkurnalobisas – yovelTviurad vuricxavT 100 lars. cxadia, wamali yoveldRe unda dalios.
– Tu ar dalia?
– amas akontrolebs videoTvali, gamyolobis konsultanti awvdis wamals da aRricxvasac awarmoebs. maT telefonebic davurigeT, kontroli xelmisawvdomi rom yofiliyo. manZilis miuxedavad, Tuki pacienti ver modis, konsultanti midis masTan da aZlevs wamals.
– ratom uWirT ase am wamlis miReba?
– zogjer gverdiTi movlenebi aReniSnebaT – gulis reva, Tavis tkivilebi, diarea. eqimi adgens, drois romel monakveTSia ukeTesi konkretuli pacientisTvis wamlis miReba, meTvalyureobis qveS hyavs. TbilisSi moqmedebs komiteti, romelic Seiswavlis da ganixilavs am gverdiT movlenebs. pacients an uCereben mkurnalobas, an ucvlian wamals. strategiis qvakuTxedia misi warmoSobis safuZveli – DOT anu moklevadiani qimioTerapia uSualo meTvalyureobis qveS. saerTaSoriso rekomendaciebis mixedviT, DOTs da rezistentuli tuberkulozis SemTxvevaSi, DOTs plus strategia gamarTlebulia da efeqturi samedicino da ekonomikuri TvalsazrisiT, ris gamoc igi msoflios asobiT qveyanaSi safuZvlad daedo tuberkulozTan brZolis saxelmwifo programebs. inficirebulTa umravlesobas ar uviTardeba aqtiuri tuberkulozi, mxolod SemTxvevaTa aTi procentia dafiqsirebuli, roca tuberkulozis mikobaqteriiT inficirebul adamians daavadeba ganuviTarda. aqve xazgasmiT aRvniSnav, rom Zalian gvexmareba `pacientTa kavSiri~, arasamTavrobo organizacia, romelSic gaerTiandnen yofili pacientebi. maT zustad ician, rogor daakvalianon adamianebi, riTi daexmaron da sxva.
– batono dimitri, SeuZlebelia, ar aRvniSnoT, rom Tqvens dispanserSi aqamde ar Catarebula remonti. . .
– es marTlac mtkivneuli sakiTxia. 50 welia, rac aq vmuSaob. umaRlesi kategoriis eqimebi da samedicino personali gvyavs, saavadmyofos xelmZRvaneloba yovelmxriv gvexmareba, ramdenjerme Catarda kosmetikuri remonti, magram Senoba Zalian didi da Zvelia, saWiroebs ZviradRirebul restavracias, rac did saxsrebs moiTxovs. urTules viTarebaSi varT, kedlebi dazianebulia, stacionarSi wyali Camodis, ver vuTavdebiT wvril remonts. gaTboba, saxuravi, kedlebi. . . kapitaluri remonti gvWirdeba, yvelaferi Tavidanaa gasakeTebeli. . . albaT, ajobebs, sxva SenobaSi gadagviyvanon an arsebuli nagebobis naxevari mainc mowesrigdes, Torem ase gagrZeleba aRar SeiZleba. 1930 wels aSenda es Senoba, lamis 100 wlisaa da. . . aRar daadga saSveli. minda, Tqveni gazeTis saSualebiT mivmarTo aWaris mTavrobas: umorCilesad gTxovT, mogvxedeT. Zalian bevri gakeTda samedicino sferoSi, sasikeTo Zvrebi aSkaraa. albaT, mxolod Cven varT aseT pirobebSi, msgavsi materialur-teqnikuri baza aRarc darCa. eqimebs rcxveniaT pacientebis, arada, udides saqmes vakeTebT yvela erTad da imedi gvaqvs, momavalSic gavakeTebT.

