1. AC MILAN (Off)
[ 11 Oct 2013, 8:41 ]
ra aris mowamvla, ra nishnebit sheidzleba misi amocnoba? - mowamvla anu intoqsikacia ewodeba patologiur mdgomareobas, romelic cocxali organizmisa da shxamis urtiertqmedebis shedegad vitardeba. shxamis rolshi shesadzloa mogvevlinos nebismieri qimiuri nivtiereba, romelsac sheudzlia gamoiwvios sasicocxlo funqciebis darghveva da amit safrtxe sheuqmnas adamianis sicocxles. organizmze toqsikuri nivtierebis zemoqmedeba da shedegi damokidebulia mraval faqtorze: shxamis koncentraciaze, organizmshi misi moxvedris gzaze, organizmshi shesvlisa da iqidan gamosvlis droze, mowamlulis sqesze, asakze, janmrtelobis mdgomareobaze, klimatze... mavne nivtiereba organizmshi sheidzleba moxvdes piris ghrudan, sasuntqi gzebidan, sisxlis mimoqcevis sistemidan, kanidan. yvelaze xshirad toqsikuri nivtierebebi organizmshi piridan xvdeba. zogierti matganis shewova da sisxlshi moxvedra piris ghrudanve iwyeba. umtavresad iwamlebian dzveli, vadagasuli sursatit, uxarisxo sasmlit, konservebit, sokoti. mowamvlis shedegi sxvadasxvagvaria, msubuqi diskomfortit dawyebuli, invalidobita da sikvdilit damtavrebuli (botulizmisa da alkoholit mowamvlis shemtxvevashi). uqeifobis pirvelma simptomebma shesadzloa tavi ichinos sakvebis an sasmlis mighebidan 5-6 an 12-14 saatis shemdeg. isini yvelastvis nacnobia: ghebineba, fagharati, dzlieri sisuste, muclis tkivili. sakvebit mowamvla gansakutrebit zafxulobit xshirdeba, rasac sicxe da maghal temperaturaze kvebis produqtebis gafuwheba ganapirobebs, amitom weliwadis am dros titoeul chvengans ormagi sifrtxile martebs. vicit, rom sakvebi gril adgilas unda shevinaxot da davinteresdet mati shenaxvis pirobebit shedzenis drosac. winaaghmdeg shemtxvevashi shesadzloa janmrtelobas ziani mivayenot. - rogor avicilot tavidan sokoti mowamvla? rogor moviqcet mowamvlis shemtxvevashi? - mowamvlas amoicnobt kuwhis tkivilit, piris gashrobit, ghebinebit, fagharatit, gonebis dakargvit, xel- fexis gacivebit, nevrologiuri darghvevebit, krunchxvit. mowamvlis pirveli nishnebistanave avadmyofs dauyovnebliv unda amovurecxot kuwhi da gavutavisuflot nawlavebi, mivcet gaaqtiurebuli naxshiri da saswrafod gadaviyvanot stacionarshi. - ra unda vicodet botulizmis shesaxeb, ramdenad sashishia igi? - botulizmi mdzime infeqciuri daavadebaa, romelsac iwvevs yvelaze dzlieri baqteriuli toqsini - botulotoqsini. mas, wesisamebr, konservebi da shashxi sheicavs. botulizmit daavadebis dasawyisshive ipyrobs yuradghebas mxedvelobis darghvevebi: avadmyofi bundovnad, gaorebulad xedavs, titqos burusshia, kitxvisas asoebi efanteba, tvalebis modzraoba shezghuduli aqvs an saertod ar sheudzlia. mxedvelobis moshlastan ertad irghveva ylapvisa da metyvelebis funqciac: avadmyofi sakvebs ver ylapavs, uwhirs enis modzraoba, laparaki, shecvlili aqvs xma da gaurkvevlad lughlughebs. daavadebis drouli da satanado mkurnalobis gareshe mdgomareoba dzalian mdzimdeba da avadmyofi suntqvisa da gulis gacherebit ighupeba. - rogor avicilot tavidan botulizmi? - botulizmis tavidan asacileblad aucilebelia, dakonservebis win produqtebi guldasmit gavrecxot, rata mtlianad movacilot miwa da fekaluri masebi, romelic botulizmis gamomwvevs sheicavs. saimedo metodad itvleba satanado sterilizacia maghali wnevisa da temperaturis (1200c) pirobebshi, magram mati mighweva shesadzlebelia mxolod qarxnuli wesit konservebis damzadebisas, shinaur pirobebshi ki gamomwvevis gamdzle formebis (sporebis) mospoba titqmis sheudzlebelia, amitomac aris sawhiro, produqti dakonservebamde zedmiwevnit kargad gairecxos. gamoyenebamde dakonservebuli produqti termulad unda damushavdes - 20-30 wutis ganmavlobashi idughos. - rogor moviqcet, tu botulizmi viewhvet? - botulizmze ewhvis shemtxvevashi avadmyofs, tu jer kidev ar daukargavs ylapvisa da xvelebis unari, unda amoerecxos kuwhi, dauyovnebliv motavsdes saavadmyofoshi da chautardes satanado mkurnaloba, xolo im pirebs, romeltac avadmyoftan ertad miighes saewhvo sakvebi, uketeben botulizmis sawinaaghmdego shrats. - ra xdeba alkoholit mowamvlisas? - alkoholis minimaluri sasikvdilo doza sxvadasxvaa, gaachnia minarevs da individualur mgrdznobelobas. alkoholis toqsikurma dozam shesadzloa sikvdilic ki gamoiwvios. etilis spirti (ghvinis spirti, arayi, whawha da sxva) moqmedebs gulze, sisxldzarghvebze, kuwh-nawlavis traqtze, ghvidzlze, tirkmelebze, yvelaze metad ki tavis tvinze. etanoli axdens fsiqotropul moqmedebas, aqvs narkotikuli efeqti, iwvevs fsiqomotorul agznebas. mdzime xarisxis trobis dros adamiani idzinebs, dzilidan ki gadadis ugono mdgomareobashi - komashi. xshiria pirghebineba da pirnaghebi masebis sasuntq gzebshi gadacdena, rac suntqvis sheferxebas da sikvdils iwvevs. mwvave alkoholuri intoqsikaciis nishnebia: wamowitlebuli, cianozuri (molurjo) saxe; civi, webovani kani; ugono, ukontaqto mdgomareoba; wyvetili, xmauriani suntqva; wnevisa da pulsis cvalebadoba. tu mowamluli ugonod aris an goneba aqvs dabinduli, dauyovnebliv daawvinet gverdze, rata uzrunvelyot sasuntqi gzebis gamavloba. saxe miqceuli unda iyos odnav qvemot, rata pirnaghebi masa ar moxvdes sasuntq gzebshi. rac sheidzleba swrafad gamoidzaxet saswrafo daxmarebis brigada. saswrafo daxmarebis mosvlamde mowamluli uyuradghebod ar datovot. alkoholi afartoebs kanis sisxldzarghvebs, amitom alkoholit gabruebuli adamiani swrafad kargavs sitbos. aman shesadzloa gadaciveba gamoiwvios, amitom tbilad daaxuret. garda amisa: tu mowamluls sheudzlia ylapva da xveleba, amourecxet kuwhi - miecit civi sodiani wyali da enis dzirze titis dawherit gamoiwviet pirghebineba; asuntqet nishaduris spirti; daalevinet aghmgznebi sashualeba (chai, yava); miecit gaaqtiurebuli naxshiri - 2 tableti 2 saatshi ertxel. tu mdgomareoba damdzimda, aucilebelia hospitalizacia. - ras gvetyvit medikamentebit mowamvlaze? - mowamvla shesadzlebelia nebismieri medikamentit, romelic ki chvens saojaxo aftiaqshi moidzebneba. yvelaze xshiria sicxis damwevi sashualebebit, antidepresantebit, barbituratebit, sadzileebit, wnevis damwevi sashualebebit mowamvla. medikamentebit, rogorc wesi, patara bavshvebi iwamlebian, romlebsac izidavt feradi tabletebi, magram sheidzleba moiwamlon ufrosebic, tu wamali eqimis danishnulebis gareshe miighes an tvitneburad gazardes misi doza. medikamentit mowamvlisas klinikuri surati damokidebulia medikamentis saxeobaze. sadzile da damamshvidebeli sashualebebit mowamvlisas tavs ichens modzraobis sheneleba, koordinaciis darghveva, motentiloba, dzilianoba, romelic shesadzloa gadaizardos ghrma dzilsa da ugono mdgomareobashic, rasac mohyeba suntqvisa da gul- sisxldzarghvta sistemis mushaobis moshla. gul-sisxldzarghvta sistemis samkurnalo sashualebebit (digoqsini, anaprilini, izoptini, klofelini) mowamvlisas aghinishneba arteriuli wnevis daqveiteba, kolafsi, gulis ritmis darghveva, zogjer gulis gacherebac ki. sicxis damwevebit da sxva antebis sawinaaghmdego arasteroiduli sashualebebit (aspirini, indometacini, diklofenaki, paracetamoli) mowamvlisas vitardeba agznebadoba, eiforia, tavbruxveva, shuili, smenisa da mxedvelobis daqveiteba, sutqvis moshla, bodva, koma, kanqvesha sisxlchaqcevebi da sxva saxis sisxldenebi. centraluri nervuli sistemis stimulatorebis (kofeini, aminofilini, eufilini) sashishi zedozirebis nishnebia: panika; sikvdilis shishi; fsiqomotoruli agzneba (adamiani adgils ver poulobs, aqet-iqit awydeba); arteriuli wnevis mateba; guliscemis gadzliereba da gaxshireba, aritmia; krunchxva; dzlieri mopulsire tavis tkivili; shuili yurebshi; temperaturis mateba. am nishnebis shemchnevisas dauyovnebliv gamoidzaxet saswrafo daxmareba. tu mowamluli gonzea da sakutar moqmedebas akontrolebs, daalevinet 3-4 whiqa tbili anadughari wyali da gamoiwviet ghebineba. kuwhis amorecxva aucilebelia 2-3-jer. modzraobis koordinaciis darghvevisas adamiani dauyovnebliv unda davawvinot. tu uceb dakarga goneba, tavi gverdze unda gadavubrunot, rata pirnaghebi masa sasuntq gzebshi ar gadascdes. eqimis mosvlisas shedzlebisdagvarad zustad miutitet preparatis doza da mighebis dro. suntqvisa da gulis mushaobis darghvevisas aucilebelia sareanimacio ghonisdziebebis chatareba. - dghes xshiria narkotikebit mowamvla da sikvdili... - narkotikis dozis gadawharbeba arghvevs sasicocxlo organoebis - tavis tvinis, ghvidzlis, gulis, filtvebis, tirkmelebis mushaobas. mosalodnelia gulis gachereba, suntqvis shewyveta, gonebis dakargva. narkotikebit mowamvlis riski, uwinares yovlisa, narkotikis raodenobasa da xarisxtan aris dakavshirebuli. sikvdilianobis yvelaze gavrcelebuli mizezia narkotikebis aghreva - rogorc ert shpricshi ramdenime narkotikis koqteili, aseve sxvadasxva sashualebis - opiatebis, dimedrolis, barbituratebis, alkoholis - ertdrouli gamoyeneba. ertmanettan kombinirebisas narkotikebis toqsikuri zemoqmedeba dzlierdeba. opiatebi da alkoholi momakvdinebeli kombinaciaa. rac ufro metia alkoholi organizmshi, mit ufro naklebi opiatia sawhiro dozis gadasawharbeblad. narkotikebis ert-erti taviseburebaa michveva. michvevisas adamiani idzulebulia, mosalodneli efeqtis - eiforiis, kaifis misaghwevad yovel jerze gamoiyenos ufro da ufro meti doza. dozis uwyveti gazrda adzlierebs narkodamokidebulebas da dzalian male iwvevs mowamvlas. shualedis (mkurnaloba, tavshekaveba, detoqsikacia da sxva) shemdeg chveuli dozis mighebac zrdis mowamvlis risks. narkotikebit (morfini, opiumi, kodeini da sxva) sashishi mowamvlis nishnebia: neli, gaishviatebuli suntqva; arteriuli wnevis dacema; guliscemis gaxshireba; gugebis sheviwroeba (wertilovani gugebi); tuchebisa da titis wverebis galurjeba (cianozi); kuntebis hipertonusi, tvit tonur-klonur krunchxvebamdec ki; cnobierebis darghveva (dzilad mivardnidan ugonobamde); metyvelebis darghveva (gaugebari saubari). tu mowamluli gonzea, axvelebs da sheudzlia ylapva, ganurchevlad narkotikis mighebis gzisa, miecit nebismieri sasaqmebeli sashualeba, shemdeg ki gaaqtiurebuli naxshiri. dzlieri ghebinebis shemdeg rekomendebulia daalevinot 2-4 whiqa wyali. gamoidzaxet saswrafo daxmarebis brigada, radgan aseti mdgomareoba kvalificiur samedicino daxmarebas sawhiroebs. gaarkviet, gonzea tu ara mowamluli: xmamaghla esaubret da ramdenjerme mimartet saxelit; tu ar reagirebs, uchqmitet yuris bibiloze - es adgili sakmaod mgrdznobiarea da tu adamiani gonzea, aucileblad moaxdens reagirebas. tu reaqcia arc amaze aqvs, dauzilet yurebi, dautrialet yuris bibiloebi, xelisgulebi urtyit loyebsa da kiserze, daasvelet bamba an qsovili nishaduris spirtit da miutanet nestoebtan. sheuxsenit mwhidrod shekruli tansacmeli, rata msubuqad isuntqos. tu suntqvis aghdgena ver moxerxda, ar chans gulmkerdis yafazis suntqviti modzraobebi, gugebi gafartoebulia, es imas nishnavs, rom mowamlulis sicocxle safrtxeshia, magram misi gadarchena shesadzlebelia. ai ramdenime martivi metodi, romlebic saswrafos mosvlamde dagexmarebat: daawvinet mowamluli magar zedapirze (iatakze, trotuarze), aramc da aramc - rbil sawolze. sheumowmet zeda sasuntqi gzebis (cxviris, piris, xaxis) gamavloba. suntqvas xels ushlis ukan gadavardnili ena (es yvela kuntis modunebis bralia) da pirnaghebi masa. titze qsovili an dolbandi shemoixviet da mowamluls piris ghru amouwmindet. enis ukan gadavardnisas: mowamluls xeli kisris qvesh amoudet da nazad aswiet, meore xelit ki daaweqit shublze. tavi ukan gadaiwevs. gaughet piri da wamouwiet qveda yba - mosinjet qveda ybis kutxeebi (isini mdebareobs simetriulad, yuris bibiloebis odnav qvemot) da ise gamoswiet win, rom zeda da qveda kbilebi ert sibrtyeze imyofebodes. tu suntqva ar aghdga, saswrafo daxmareba ki jer ar mosula, chautaret mowamluls xelovnuri suntqva da gulis masaJi. es ramdenime xnit shecvlis filtvebisa da gulis normalur mushaobas. gvaxsovdes: es organoebi chveulebriv mdgomareobashi ertdrulad mushaobs, amitom gul-filtvis reanimaciac ertdroulad unda chatardes. rogor chavatarot xelovnuri suntqva: ghrmad chaisuntqet. gaughet mowamluls piri da tuchebi mwhidrod shemoawhdet mis tuchebs (umjobesia, gamoiyenot cxvirsaxoci an raime qsovilis nawheri). titebit dauxshet cxviri (winaaghmdeg shemtxvevashi haeri cxviridan gamova). amoisuntqet da haeri dazaralebulis filtvebshi chaushvit. akontrolet suntqvis siswore - rodesac tqven amoisuntqavt, mowamlulis gulmkerdis yafazi zemot unda aiwios. gulmkerdis modzraobis ararseboba imaze miutitebs, rom haeri filtvebshi ar chadis. am shemtxvevashi kidev ertxel sheamowmet zeda sasuntqi gzebis gamavloba. aucileblobis shemtxvevashi xelaxla gawmindet. zogjer sawhiroa, gazardot chaberili haeris moculoba. gaxsovdet: tqven uzrunvelyoft mxolod chasuntqvas. amosuntqva unda moxdes tqveni monawileobis gareshe. ar ecadot haeris filtvebidan dzalit gamodevnas. xelovnuri suntqvis sixshirea 18-20 chasuntqva wutshi. naklebi sixshiris shemtxvevashi organizmi sakmarisi raodenobis Jangbads ver miighebs. rogor chavatarot gulis daxuruli masaJi: gulis masaJi ar daiwyot, tu majaze isinjeba pulsi. moxaret xelebi idayvshi. es dagexmarebat, zewolistvis gamoiyenot ara marto xelebis dzala, aramed sxeulis simdzimec. dadeqit muxlebze ugonod myofis gverdit. xelisguli moatavset mkerdis dzvalze ganivad, maxvilisebri morchidan daaxloebit 3 sm-it zemot (am nazi dzvlis motexva dzalian advilia). ecadet, xeli shua xazidan ar gadaanacvlot, tqveni titebi ar unda exebodes ugonod myofis neknebs - neknebze zewola xshirad iwvevs mat motexilobas. meore xelisguli daadet pirvels ise, rom neknebis mimart sheiqmnas 45-gradusiani kutxe. daiwyet masaJi: ganaxorcielet ritmuli zewola; shemdeg zewola shewyvitet, rata gulmkerdi daubrundes sawyis mdgomareobas, magram mtevnebi gulmkerdis yafazs ar moashorot. masaJis dros zewolis sixshire unda iyos wutshi daaxloebit 80-100. tu damoukideblad atarebt gulis daxurul masaJs da xelovnur suntqvas, tavdapirvelad gaaketet ori xelovnuri chasuntqva, amis shemdeg 15-jer daaweqit gulmkerdis yafazs. gaimeoret es modzraobebi imave tanamimdevrobit. xelovnuri suntqvisa da gulis masaJis chatarebisas yovel 2-5 wutshi ertxel ramdenime wutit shecherdit, rata sheamowmot, xom ar gachnda pulsi da ar aghdga damoukidebeli suntqva. dzalisxmevis efeqturobas daadgent shemdegi nishnebit: ugonod myofi cdilobs chaisuntqos; sadzile an bardzayis arteriebze chndeba pulsi; kans ubrundeba feri; guga viwrovdeba; xorxi spontanurad modzraobs. pulsisa da suntqvis aghdgenis shemdeg ugonod myofi gadaabrunet gverdze da tavqvesh rame amoudet, rom pirnaghebma masebma ar daaxrchos. - ukanasknel wlebshi sakmaod gaxshirda naxshirJangit mowamvlac... - mxutav gazs ar aqvs feri da suni, magram dzalian toqsikuria. igi sxvadasxva sawvavis arasruli wvis produqtia. sisxlshi advilad ukavshirdeba hemoglobins, rac organizmis mwvave Jangbadovan shimshilsa da sikvdils iwvevs. mowamvla damokidebulia mxutavi gazis koncentraciaze, misi moqmedebis xangrdzlivobasa da adamianis janmrtelobis mdgomareobaze. mxutavi airit mowamvla shesadzlebelia: sawarmoshi, sadac mxutav airs sxvadasxva organuli nivtierebis (acetoni, metilis spirti, fenoli) sintezisatvis iyeneben; cudi ventilaciis mqone shenobashi, gvirabshi, gzatkecilze an did avtostradaze. binashi, sadac gazqura, wyali da otaxis gamatbobeli gamartulad ar mushaobs. ganasxvaveben mxutavi gazit mowamvlis or xarisxs - msubuqs da mdzimes. msubuqi mowamvlisas adamiani uchivis: tavis dzlier tkivils (tavi titqos marwuxshi gaqvt moqceuli), tkivils shublis, safetqlebis midamoshi; yurebshi shuils; tavbruxvevas; sisustes; guliscemis gaxshirebas; gulisrevasa da pirghebinebas. adamiani gonzea, magram titqos gabruebulia. mdzime mowamvlisas shesadzloa: ganvitardes mxedvelobiti da smeniti halucinaciebi; saxeze gachndes vardisferi an lurji laqebi; dzilianoba, modzraobis koordinaciis darghveva, cnobierebis darghveva da komuri mdgomareoba, klonur-tonuri krunchxvebi. gugebi mkvetrad gafartoebulia; irghveva suntqva; momatebulia sxeulis temperatura, rac tvinis sheshupebis manishnebelia. pirveli daxmarebis gawevisas aucilebelia: dazaralebuli saswrafod gamoviyvanot saxifato zonidan, uzrunvelvyot sufta haeris miwodeba (gavaghot sarkmeli, fanjara, kari); vasuntqot Jangbadi; tu gonzea, davalevinot magari yava, chai, askilis nayeni. gamovidzaxot saswrafo daxmarebis brigada. tu adamiani komashia, saswrafo samedicino daxmarebis mosvlamde chautaret sareanimacio ghonisdziebebi. tu avadmyofi gonzea, savaraudod, mis sicocxles safrtxe ar emuqreba, magram eqimis konsultacia mainc aucilebelia. - rogor moviqcet, rom ar moviwamlot? - amistvis aucilebelia, davicvat usafrtxoebis wesebi: sawvavze momushave mowyobilobebis awyoba, eqspluatacia da shemowmeba unda moxdes profesionalis mier; sakvamuri mili garet unda gadiodes da kargad ukavshirdebodes shesabamis mowyobilobas; ar vamushaot dizelis dzrava daxurul sivrceshi. gaxsovdet: mowamlulis gadarchenistvis gadamwyveti mnishvneloba eniwheba momwamlavi nivtierebebis droul aghmochenas da misi moqmedebis shewyvetas. droulad gamoidzaxet saswrafo daxmareba.
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