1. AC MILAN (Off)
[ 11 Oct 2013, 8:57 ]
gul-sisxldzarghvta sistemis daavadebata statistikas imedismomcems namdvilad ver vuwodebt. gaxshirda gulis ishemiuri daavadeba, arteriuli hipertenzia. amastanave, sagrdznoblad shemcirda avadmyofebis asaki. reanimaciul ganyofilebebshi ufro da ufro xshirad xvdebian axalgazrda pacientebi miokardiumis infarqtis diagnozit. gaxshirda kardiologiuri daavadebebis usimptomo an mciresimptomuri mimdinareobac - avadmyofebi eqims mashingha mimartaven, rodesac ukve gartulebata mteli taigulia chamoyalibebuli, zogierti ki saavadmyofoshi pirdapir saswrafo daxmarebis manqanit mihyavt. - rogor moviqcet, tu chvens tvalwin vinmes guli wauvida? - tavdapirvelad avxsnat, ra aris gulis wasvla. gulis wasvla anu sinkope aris gonebis xanmokle dakargva, romelic umtavresad tavis tvinshi sisxlis arasakmarisi midenit aris ganpirobebuli. rodesac tavis tvins Jangbadi da sakvebi nivtierebebi akldeba, adamians ewyeba tavbruxveva, mtqnareba, yurebshi shuili chaesmis, fitrdeba, kidurebi ucivdeba, goneba ebindeba, zogjer guli misdis. arteriuli wneva am dros dabalia, suntqva - zerele. sinkope ramdenime ateuli wamidan 4-5 wutamde grdzeldeba. gons mosul adamians cnobiereba swrafad da savsebit aghudgeba. arsebobs ortostatikuri gulis wasvlac, romelic mwoliare adamianis mkvetri wamodgomisas vitardeba. am dros gul-sisxldzarghvta sistema ver aswrebs tavis tvinis srulfasovan momaragebaze gadartvas. gulis wasvla aseve mosalodnelia sxvadasxva jgufis samkurnalo preparatebis, magalitad, beta- blokerebis, diuretikebis, nitratebis ertdrouli mighebis dros. axla - rac sheexeba tqvens shekitxvas. gulwasuli adamianis wamoyeneba ar scadot. umjobesia, daawvinot moxerxebulad, gaaridot saxifato sagnebs. tu waqcevamde miashvelet xeli da axlomaxlo arc divania da arc sawoli, sheidzleba dasvat da zurgit miayrdnot skamis sazurges. tavi sxeulis doneze unda iyos. aucileblad unda uzrunvelvyot Jangbadis kargi miwodeba (zogjer marto amanac ki sheidzleba gamoiyvanos adamiani mdgomareobidan) - shevuxsnat sayelo, qamari. aseve sheidzleba, saxeze vapkurot civi wyali an cxviris nestoebtan mivutanot nishaduris spirtshi dasvelebuli bamba. - ra aris kolafsi da rogor davexmarot am dros adamians? - kolafsi mdzime, sicocxlistvis sashishi mdgomareobaa. is shesadzloa gamoiwvios: mdgomareobis shecvlam; dzlierma tkivilma da stresma; xangrdzlivma diaream (sitxis didi odenobit dakargvam); dzlierma sisxldenam; sisxldzarghvovan centrze toqsinebis zemoqmedebam (mwvave infeqciuri daavadebisa da mowamvlis dros). kolafsis nishnebia: sifitre; wnevis mkvetri dacema; dzafiseburi pulsi; civi ofli; tavbruxveva; cnobierebis dabindva an dakargva. kolafsis dros dauyovnebliv unda gamovidzaxot eqimi. avadmyofi unda davawvinot da avuwiot qveda kidurebi. sheidzleba, cxvirtan mivutanot nishaduris spirtiani bamba. - ratom iyeneben gulwasulis gonze mosayvanad nishaduris spirts? - nishaduris spirti anu amiakis xsnari cxvir-xaxashi arsebul nervul daboloebebs aghizianebs, rasac suntqvis centris aghgzneba, chasuntqvis gadzliereba da organizmistvis meti Jangbadis miwodeba mohyveba. - ert-erti mdzime daavadebaa stenokardia, romelmac shesadzloa miokardiumis infarqtamde migviyvanos. rogor moviqcet, rodesac infarqts vewhvobt? - gulis areshi tkivils bevri uchivis. is shesadzloa iyos rogorc gulis organuli daavadebis gamoxatuleba, aseve funqciuri darghvevis simptomi. gulis tkivili ori tipisaa: stenokardia da kardialgia. kardialgias xshirad uchivian qalebi klimaqsur periodshi. mas xsnis validolis sublingvuri migheba (enis qvesh dadeba), rac stenokardiisa da kardialgiis sadiferenciacio ert-erti kriteriumia: stenokardias xsnis nitroglicerini, kardialgias - validoli. stenokardia ishemiuri daavadebis anu gulis mkvebavi sisxldzarghvebis dazianebis gamoxatulebaa, amitom pacientma droulad unda mimartos eqims, rata moxdes tkivilis diferencireba da adekvaturi mkurnalobis danishvna. ar sheidzleba tvitmkurnaloba, medikamentebis migheba axloblebis rchevit. gulmkerdis areshi mwvave tkivilis dros aucilebelia saswrafo daxmarebis gamodzaxeba. fizikuri datvirtvisas aghmocenebuli stenokardiuli tkivilis dros datvirtva dauyovnebliv unda shewydes. tu tkivili horizontalur mdgomareobashi aghmocenda, sawhiroa wamojdoma da sawolidan fexebis chamoshveba. tu gulis ishemiuri daavadeba ukve diagnostirebulia, adamianma mudam tan unda iqonios nitroglicerinis abebi an sainhalacio forma da sawhiroebisas gamoiyenos. miokardiumis infaqti anu gulis kuntis nekrozi sicocxlistvis sashishi daavadebaa. mis mwvave periodshi avadmyofi specializebul klinikashi unda motavsdes. stenokardiisa da miokardiumis infarqtis dros pirveli daxmareba tkivilis rac sheidzleba swrafad moxsnas gulisxmobs. gaxangrdzlivebuli stenokardiuli shetevis dros aucilebelia saswrafo daxmarebis gamodzaxeba. - ar sheidzleba, gverdi avuarot hipertoniul daavadebas. ra gvaewhvebinebs hipertoniuli krizis moaxloebas? - hipertoniuli krizis simptomebia: maghali arteriuli wneva; tavis tkivili; tavbruxveva; sifitre; zogadi mdgomareobis mkvetri gauareseba; gulisreva, ghebineba; aghgzneba an dzilad mivardna; mxedvelobis darghveva. zogierti avadmyofi gulmkerdshi simdzimis shegrdznebas uchivis. am dros, uwinares yovlisa, unda gamovidzaxot saswrafo daxmareba. shemdeg avadmyofs mivcet raime damamshvidebeli sashualeba (valeriani, valokordini, korvaloli) da eqimis mier danishnuli hipotenziuri preparati. - aranakleb usiamovnoa wnevis dacema - hipotoniuri krizi. iqneb amazec gvitxrat oriode sityva? - praqtikulad janmrtel adamianebshi wnevis mkvetri dacemis mizezad sheidzleba iqces dzlieri emocia. hipotoniuri krizis dros aghmocendeba yru tavis tkivili, zogjer amas daertvis gulisreva, ghebineba. arteriuli wnevis cifrebi ar aghemateba 90/60 mm.vwy.sv-s. am dros adamiani unda davamshvidot da davalevinot magari chai an shavi yava - kofeini wnevas aswevs. - rogor moviqcet guliscemis gaxshirebis dros? - paroqsizmuli taqikardia - es aris gulis shekumshvebis mkvetri gaxshireba, romlis drosac pulsis sixshirem wutshi sheidzleba 130-150-s miaghwios. am dros gulis ritmi shesadzloa tanabaric iyos. guliscemis gaxshirebas ertvis sisuste, qoshini, shishi. bevri uchivis tavbruxvevas, ghebinebas, mxedvelobis darghvevas. am dros gamoidzaxet saswrafo daxmareba. - rogor moviqcet aritmiis shemtxvevashi? - aritmia sxvadasxva xasiatisa da tipisaa. sxvadasxvaa misi mizezic. gulis ritmis darghvevis shemtxvevashi, uwinares yovlisa, swored gamomwvevi mizezi unda dadgindes da satanado mkurnaloba chatardes. rac sheexeba pirvel daxmarebas, avadmyofs unda mivcet damamshvidebeli sashualeba - 30-50 wveti korvaloli an valokordini - da rac sheidzleba swrafad mivmartot eqims
[Pasuxi][Cit]|