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56<br />
rkinadeficituri anemiis simZimis Sefas<strong>eb</strong>a<br />
Hb _ 110-90 g/l - msubuqi forma; Hb _ 90-70 g/l<br />
_ saSualo simZime; Hb < 70 g/l _ mZime forma.<br />
diferencialuri diagnozi<br />
yvela hipoqromuli anemia ar aris rkinis<br />
deficitiT gamowveuli. saWiroa diferen cia -<br />
luri diagnozi gatardes:<br />
ü rkinis gadanawil<strong>eb</strong>iT anemi<strong>eb</strong>Tan (rkinis<br />
reutilizaciis darRveviT gamowveuli anemi<strong>eb</strong>i<br />
qronikuli anT<strong>eb</strong>iTi daavad<strong>eb</strong><strong>eb</strong>is, infeqci<strong>eb</strong>is,<br />
onkologiuri da sxva paTologiis dros);<br />
ü rkinis gajer<strong>eb</strong>is darRveviT gamowveul<br />
anemi<strong>eb</strong>Tan (sideroaqrestiuli Tandayolili<br />
da SeZenili);<br />
ü hemis sinTezis darRveviT gamowveul ane -<br />
mi<strong>eb</strong> Tan (Talasemia da sxva hemoglobino paTi<strong>eb</strong>i);<br />
ü sideroblastur anemi<strong>eb</strong>Tan;<br />
ü hemoragiuli sindromiT gamowveul<br />
anemie bTan;<br />
ü piridoqsin–deficitur anemias Tan;<br />
ü hipo–atransferinemiiT gamowveul<br />
anemiasTan;<br />
ü tyviiT mowamvliT gamowveul anemiasTan.<br />
rkinis deficiti da imunuri sistema<br />
sideropeniis Sedegad aRiniSn<strong>eb</strong>a organizmis<br />
dacviTi meqanizm<strong>eb</strong>is da, maT Soris, imunuri<br />
sistemis funqciis moSla, ris Sedegadac<br />
izrd<strong>eb</strong>a avadobis sixSire da xd<strong>eb</strong>a qronikuli<br />
proces<strong>eb</strong>is gaaqtiv<strong>eb</strong>a. rkinadeficituri anemia<br />
ar iTvl<strong>eb</strong>a vaqcinaciis winaaRmdeg Cven<strong>eb</strong>ad.<br />
acra SeiZl<strong>eb</strong>a Catardes hemoglobinis<br />
normalizaciis Semdeg, Tumca hemoglobinis<br />
zomieri daqveiT<strong>eb</strong>a (msubuqi forma) da<br />
antianemiuri mkurnaloba ar iTvl<strong>eb</strong>a<br />
vaqcinaciis gadad<strong>eb</strong>is safuZvlad.<br />
rkinadeficituri anemiis mkurnaloba<br />
rda mkurnalobis ZiriTadi mizania rkinis<br />
deficitis aRmofxvra da misi maragis Sevs<strong>eb</strong>a<br />
organizmSi. gasaTvaliswin<strong>eb</strong>elia, rom:<br />
1. rkinis deficitis Sevs<strong>eb</strong>a organizmSi<br />
rkinis preparat<strong>eb</strong>is gareSe nakl<strong>eb</strong>ad<br />
efeqturia;<br />
2. rkinadeficituri anemiis mkurnaloba<br />
kompleqsuria da Sedg<strong>eb</strong>a 3 etapisgan:<br />
ü anemiis kupir<strong>eb</strong>a;<br />
ü gajer<strong>eb</strong>is Terapia (organizmSi rkinis<br />
maragis aRdgena);<br />
ü recidivis sawinaaRmdego mkurnaloba.<br />
rkinadeficituri anemiis mkurnalobis<br />
ZiriTadi princip<strong>eb</strong>i<br />
1. rda paTogenezuri Terapia gulisxmobs<br />
rkinis preparat<strong>eb</strong>is gamoyen<strong>eb</strong>as, maT Soris<br />
upiratesoba eniW<strong>eb</strong>a orvalentiani rkinis<br />
Semcvel preparat<strong>eb</strong>s.<br />
2. rkinis preparat<strong>eb</strong>i or ZiriTad jgufad<br />
iyofa: oraluri (enteraluri) da parentera -<br />
luri. upiratesoba eniW<strong>eb</strong>a pirvels.<br />
socialuri, ekologiuri<br />
da klinikuri pediatria<br />
3. adreuli asakis bavSv<strong>eb</strong>isTvis gasaTvalis -<br />
win<strong>eb</strong>elia preparatis toqsiuroba da<br />
gamoSv<strong>eb</strong>is forma. upiratesoba eniW<strong>eb</strong>a Txier<br />
preparat<strong>eb</strong>s (sirofi, wveT<strong>eb</strong>i, roml<strong>eb</strong>ic<br />
nakl<strong>eb</strong>ad aRizian<strong>eb</strong>s kuW–nawlavis traqts).<br />
4. rkinadeficituri anemiis mkurnaloba,<br />
SemTxvevaTa umravlesobaSi, SeiZl<strong>eb</strong>a Catardes<br />
binis pirob<strong>eb</strong>Si, garda mZime hipoqsiis niSn<strong>eb</strong>iT<br />
mimdinare mdgomareobisa.<br />
5. feroTerapia unda Catardes Semdegi<br />
doz<strong>eb</strong>iT:<br />
ü 3 wlamde bavSv<strong>eb</strong>Si – 3–5 mg/kg dReSi;<br />
ü 3–dan 7 wlamde – 100–200 mg dReSi;<br />
ü 7 wlis zemoT 200 mg dReSi.<br />
doza nawild<strong>eb</strong>a dRis ganmavlobaSi 2_3<br />
miR<strong>eb</strong>aze.<br />
6. feroTerapia samkurnalo doziT tard<strong>eb</strong>a<br />
hemoglobinis normalizaciamde, xolo Semdeg<br />
4_8 kviris ganmavlobaSi rogorc profilaq -<br />
tikuri kursi (rkinis preparati iniSn<strong>eb</strong>a<br />
samkurnalo dozis naxevari).<br />
7. rkinis parenteraluri preparat<strong>eb</strong>iT mkur -<br />
naloba SesaZl<strong>eb</strong>elia mxolod mkacri Cven<strong>eb</strong>iT:<br />
ü kuW-nawlavis traqtis paTologia, naw -<br />
lavis Sewovis funqciis darRveva;<br />
ü oraluri preparat<strong>eb</strong>is absoluturi<br />
auta n loba (gulis reva, R<strong>eb</strong>in<strong>eb</strong>a);<br />
ü organizmis rkiniT swrafi gajer<strong>eb</strong>is<br />
aucil<strong>eb</strong>loba.<br />
garTul<strong>eb</strong>is acil<strong>eb</strong>is mizniT saWiro<strong>eb</strong>s<br />
mkacri dozir<strong>eb</strong>is dacvas.<br />
8. parenteraluri rkinis preparat<strong>eb</strong>is do ze bi<br />
bavSvis sxeulis masis gaTvaliswin<strong>eb</strong>iT Semdegia:<br />
ü 5 kg_mde _ 25 mg dReSi (0, 5 ml);<br />
ü 10 kg_mde 25_50 mg dReSi (0, 5 _ 1 ml);<br />
ü 20 kg_mde _ 100 mg dReSi (2 ml).<br />
rkinis preparat<strong>eb</strong>iT mkurnalobis<br />
efeqturobis kriterium<strong>eb</strong>i<br />
1. avadmyofis zogadi mdgomareobis<br />
gaumjobes<strong>eb</strong>a ramdenime dReSi;<br />
2. kunT<strong>eb</strong>is sisustis Semcir<strong>eb</strong>a;<br />
3. periferiul sisxlSi retikulocituri<br />
krizis ganviTar<strong>eb</strong>a (mkurnalobis me_5_7_10 dRe);<br />
4. eriTrocit<strong>eb</strong>is raodenobis yovel kvi -<br />
reuli mat<strong>eb</strong>a;<br />
5. hemoglobinis donis sarwmuno mat<strong>eb</strong>a<br />
(mkurnalobis me-3-4 kviras);<br />
6. rkinis maragis sruli Sevs<strong>eb</strong>a 2-3 TveSi;<br />
7. rkinis latenturi deficitis mkurnaloba<br />
aseve tard<strong>eb</strong>a xangrZlivi drois ganmavlobaSi;<br />
8. uSedego mkurnaloba rkinis preparat<strong>eb</strong>iT<br />
ganpirob<strong>eb</strong>ulia an dozis simciriT, an<br />
mkurnalobis arasakmarisi xangrZlivobiT,<br />
zogjer ki saerTod sideropeniis arars<strong>eb</strong>obiT<br />
(mcdari diagnozi).<br />
ZiriTadi mkurnalobis xangrZlivoba<br />
rkinadeficituri anemiis dros<br />
rda mkurnalobis kursi (saSualod)<br />
Seadgens 6-10 kviras. igi damokid<strong>eb</strong>ulia<br />
2012 weli
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