Tavis tkivili

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Tavis tkivili

• saojaxo medicinis erovnuli saswavlo centri

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anamnezuri monacemebi

• Tavis tkivilis xandazmuloba
• tkivilis sixSire
• Setevis tipi
• Setevis xangrZlivoba
• tkivilis lokalizacia
• siZliere
• tkivilis daxasiaTeba

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• gamamwvavebeli faqtorebi
• sagangaSo simptomebi
• Tanmxlebi simptomebi
• Semamsubuqebeli faqtorebi da tkivilTan brZolis
  gzebi
• tramvis anamnezi
• medikamenturi anamnezi
• Tavis tkivilis ojaxuri anamnezi

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pirveladi Tavis tkivili

• a) Sakiki
• Sakiki auris gareSe
• Sakiki auriT (klasikuri Sakiki)
• garTulebuli Sakiki (romelsac Tan axlavs kargad
  gamoxatuli nevrologiuri simptomebi)
• bazilaruli Sakiki
• hemiplegiuri Sakiki
• ofTolmoplegiuri Sakiki

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• b) klasteruli Tavis tkivili
• epizoduri
• qronikuli
• g) epizoduri daZabvis Tavis tkivili
• d) qronikuli dRiuri Tavis tkivili
• qronikuli daZabvis Tavis tkivili
• Sakikis da daZabvis tipis Tavis tkivilis kopleqsi
  (Sereuli an kombinirebuli Tavis tkivilebi)
• analgeziuri saSualebebiT/ergotaminiT gamowveuli
  Tavis tkivili

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meoradi Tavis tkivilis mizezebi

• pacientebi subaraqnoiduli sisxlCaqceviT an
  intrakranialuri moculobiTi procesiT
• giganturujredovani anu kranialuri arteriti
• sunusiti
• posttramvuli Tavis tkivili
• trigeminuli nevralogia
• Tavis tkivili, gamowveuli xerxemlis kisris
  nawilis paTologiiT

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klasikuri Sakiki
tkivilis lokalizacia calmxrivad Subli da safeTqeli
iradiacia Tvalbude, kefa
xasiaTi Zlieri, mopulsire
Setevebis sixSire 1-2-jer TveSi
Setevis xangrZlivoba 4-72 sT (saSualod 6-8 sT)
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Setevis dawyeba uecari, upiratesad diliT
Setevis dasasruli gaivlis TavisTavad, xSirad daZinebis Semeg
maprovocirebeli faqtorebi emociuri daZabva
ra aZlierebs tkivils fizikuri da emociuri datvirTva
ra amsubuqebs mdgomareobas Zili, Rebineba
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Sakikis maprovocirebeli faqtorebi

• egzogenuri
• sakvebi (Sokoladi, citrusebi, pamidori, yveli),
  danamatebi (nitratebi)
• alkoholi (wiTeli Rvino)
• medikamentebi vazodilatatorebi, estrogenebi,
  indometacini
• kaSkaSa sinaTle
• Zlieri xmauri
• mkveTri suni
• qala-tvinis travma (umniSvneloc ki)

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• endogenuri
• xangrZlivi Zili
• daRliloba, fsiqo-emociuri gadaZabva
• alergia
• hormonuli Zvrebi pubertatuli periodi
  menstruacia klimaqsuri periodi orsuloba
• SimSili

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Sakiki auris gareSe

• ar axlavs nevrologiuri moSlilobebi. xSiri
  simpromebia
• gulisreva
• Rebineba
• fotofobia
• fonofobia
• zogadi mgrZnobelobiTi darRvevebi
• sxva simptomebia
• Tavbrusxveva
• muclis tkivili
• diarea
• cxviris gaWedva

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Tanmxlebi simptomebi gulisreva, Rebineba, mxedvelobiTi an mgrZnobelobiTi aura, bavSvebSi muclis tkivili, damaxasiaTebelia memkvidruli winaswar-ganwyoba, axlo naTesavebSi xSiria bronquli asTmis an neirodermatitis SemTxvevebi
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klasteruli (hortonis) Tavis tkivili
tkivilis lokalizacia Tvalbude
iradiacia Subli, safeTqeli
xasiaTi Zalian Zlieri, mburRavi an mwvave
Setevebis sixSire 1-2-jer dReSi, aRmocendeba seriulad 4-6 kviris manZilze, Semdeg dgeba naTeli periodi, romelic ramodenime Tve da weli grZeldeba
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Setevis xangrZlivoba 15 wT-dan 3 sT-mde (saSualod 30 wT)
Setevis dawyeba RamiT, erTsa da imave dros, daZinebidan 2-3 saaTSi
Setevis dasasruli TavisTavad
ra aZlierebs tkivils alkoholi (Setevebis seriis periodSi)
ra amsubuqebs mdgomareobas sumatriptani, Jangbadis inhalacia
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Tanmxlebi simptomebi rinorea, cremldena, tkivilis mxares Tvalis, Sublisa da loyis hiperemia, iSviaTad horneris sindromi
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daZabvis Tavis tkivili
tkivilis lokalizacia Subli, safeTqeli
iradiacia kefa
xasiaTi yru, moWeriTi, damaxasiaTebelia simZimis SegrZneba
Setevebis sixSire TiTqmis yoveldRe
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Setevis xangrZlivoba ramodenime saaTi
Setevis dawyeba diliT, gaRviZebis Semdeg
ra aZlierebs tkivils emociuri gadaZabva, muSaoba Seusveneblad
ra amsubuqebs mdgomareobas alkoholi
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Tanmxlebi simptomebi Tavbrusxveva, daRliloba, tkivili da SeboWiloba kisris areSi, SfoTvis gancda, daTrgunuli ganwyoba
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Tavis tkivili gamowveuli intrakranialuri
hipertenziiT
tkivilis lokalizacia Cveulebriv kefis areSi difuziuri tkivili
iradiacia Tvalbude
xasiaTi yru, intensivoba Setevis periodSi icvleba
Setevebis sixSire yoveldRiurad
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Tanmxlebi simptomebi Rebineba gulisrevis gareSe, Tavbrusxveva, Zilianoba, yurebis dagubeba (gvian stadiaze)
fizikaluri monacemebi kerovani nevrologiuri simptomatika, mxedvelobis nervis diskos SeSupeba (yovelTvis gamoxatuli ar aris)
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giganturujredovani arteritis epidemiologia

• avadobis piki aRiniSneba 60-75 wlis asakSi
• qalebSi daavadeba samjer ufro xSirad viTardeba,
  vidre mamakacebSi
• yovelwliurad avadobis maCvenebeli 50 wlis zemoT
  pirebSi Seadgens 18/100.000 mosaxleze
• daavadeba upiratesad TeTrkanian pacientebSi
  gvxvdeba
• aRwerilia ojaxuri SemTxvevebi, rac miuTiTebs
  daavadebis etiologiaSi genetikuri faqtorebis rolze

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revmatuli polimialgia

• kisris, mxris da menjis sartylis saxsrebSi
  tkivili da SeboWiloba
• sistemuri simptomebi, rogoricaa subfebriliteti,
  daRliloba da wonaSi dakleba
• eriTrocitebis daleqvis siCqaris mkveTri momateba
• kortikosteriodebis mcire dozebze aRiniSneba
  dramatuli pasuxi

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Setevis xangrZlivoba ramodenime saaTi, an grZeldeba mudmivad
Setevis dawyeba diliT, gaRviZebisas
ra aZlierebs tkivils xvela, dacemineba, gaWinTva
ra amsubuqebs mdgomareobas analgeziuri saSualebebi (aspirini), mjdomare da woliTi pozicia
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giganturujredovani arteritis mkurnaloba

• sawyisi doza _20-40 mg dReSi 8 kviris
  ganmavlobaSi.
• pacientebSi, mxedvelobiTi simptomebiT SesaZloa
  saWiro gaxdes 80 mg prednizolonis gamoyeneba.
• yovel 2-4 kviraSi SesaZloa Semcirdes doza 2-5
  mg-iT, vidre doza 10 mg ar gaxdeba, Semdeg doza
  SeiZleba Semcirdes 1 mg-iT 4-6 kviris
  ganmavlobaSi
• SemanarCunebeli doza
• dReSi daaxloebiT 3 mg

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revmatuli polimialgiis mkurnaloba

• sawyisi doza _ prednizoloni 10-20 mg dReSi, erTi
  Tve
• yovel 2-4 kviraSi SesaZloa Semcirdes doza 2-5
  mg-iT, vidre doza 10 mg ar gaxdeba, Semdeg doza
  SeiZleba Semcirdes 1 mg-iT 4-6 kviris ganmavlobaSi

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• SemanarCunebeli doza _ daaxloebiT 10 mg,
  mkurnalobis dawyebidan 6 Tve da 5-7,5 mg erTi
  wlis ganmavlobaSi.
• pacientis umravlesobas esaWiroeba 3-4 wliani
  mkurnaloba

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Tavis tkivili gamowveuli xerxemlis kisris nawilis
paTologiiT
tkivilis lokalizacia kefa
iradiacia calmxrivad, Txemisa da Tvalbudis areSi
xasiaTi yru, saSualo intensivobis
Setevebis sixSire yoveldRiurad
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Setevis xangrZlivoba 1-6 saaTi
Setevis dawyeba diliT, gaRviZebisas
Setevis dasasruli Cveulebriv, dRisiT
ganmapirobebeli faqtorebi saavtomobilo travma
ra aZlierebs tkivils Tavis motrialeba
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ra amsubuqebs mdgomareobas kisris areSi sicive an siTbo
Tanmxlebi simptomebi Tavis Tmiani nawilis paresTezia (iSviaTia), kisris SeboWiloba, Tavis areSi simZimis SegrZneba
fizikaluri monacemebi mtkivneuloba C1-C3-is palpaciisas, gansakuTrebiT, tkivilis mxares
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Tavis tkivilis marTvis ZiriTadi principebi

• ar aris aucilebeli, rom Tavis tkivilis gamomwvevi
  faqtori misi gaqronikulebis mizezi gaxdes
• mkurnalobis mTavari mizani ar aris Tavis tkivilis
  sruli kupireba
• mkurnalobis dros pacienti aqtiur Tanamonawiled
  unda iqces
• gadauWreli ojaxuri problemebi, SesaZloa, Tavis
  tkivilis gaqronikulebis mizezi gaxdes
• medikamentebis zedmetad gamoyeneba, xSirad, Tavis
  tkivilis mizezi xdeba
• mkurnaloba individualurad unda SeirCes