saqarTvelos samedicino Jurnali Medical Journal of Georgia

1Tbilisis saxelmwifo samedicino universitetiТБИЛИССКИЙ ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ УНИВЕРСИТЕТTBILISI STATE MEDICAL UNIVERSITYsaqarTvelos samedicino Jurnalisamecniero-praqtikuli, meTodologiuri Jurnali.daarsda 1922 welsМедицинский журнал ГрузииНаучно-практический, методологический журнал. Основан в 1922 годуMedical Journal of GeorgiaScientific-practical methodological journal. Was established in 19222aprili-ivnisi2008

2Sinaarsiinfeqciuri daavadebebii. mWedliSvili, d. gelovani, T. mWedliSvili - zogierTi infeqciuri daavadebisgavrceleba saqarTveloSi.kurortologian. saakaSvili, i. WabaSvili - biliaruli sistemis paTologiisas saxarbediosmineraluri wyliT organizmSi mimdinare koreqciaendokrinologiaS. janjRava, q. asaTiani, l. uCava, a. xmeliZe, m. janjRava, e. xmeliZe, n. baramiZe,m. danelia - hiperprolaqtinemia mamakacebSi.profilaqtikuri medicinar. kverenCxilaZe, vad. saakaZe, m. cimakuriZe, l. baqraZe - saqarTvelos samrewveloobieqtebis sawarmoo garemos mdgomareobis profilaqtikis ZiriTadi principebijandacvis organizaciae. mirvelaSvili - Saqriani diabetiT daavadebulTa ganaTlebis zogierTi sakiTxisaqarTveloSi.eqsperimentuli medicina, paTomorfologiag. pataraia - eqsperimentsi tyviis (Pb) eqspoziciiT ganpirobebuli morfologiurfunqciuricvlilebebi da misi prevenciaTanamedrove teqnologiebi medicinaSiT. cecxlaZe - eleqtroqimiuri danadgariTa da teqnologiuri sistemiT warmoebulisadezinfeqcio da sasterilizacio xsnarebis efeqturoba da usafrTxoebamedicinis istoriar. iakobiZe, i. CinCalaZe - saqarTvelos wylis resursebis sistemuri Seswavlisaucilebloba - robert kupcisis gamocdileba da Rvawligaxsenebapirovneba, WeSmariti moqalaqe (oTar SalamberiZe)giorgi kereseliZeredaqtoris gverditradiciadaviT ciciSvilirCeuliirakli faRavagamosaTxovarikote barqaia

3infeqciuri daavadebebizogierTi infeqciuri daavadebis gavrcelebasaqarTveloSii. mWedliSvili, d. gelovani, T. mWedliSviliTssu epidemiologiisa da biostatistikis departamenti,daavadebaTa kontrolis da sazogadoebrivi janmrTelobiserovnuli centri(recenzenti - profesori g. kacitaZe)meoce saukunis meore naxevarSi miRweuliqna mniSvnelovani warmatebebi infeqciuridaavadebebis winaaRmdeg brZolissaqmeSi. miuxedavad amisa, maT kvlavwamyvani adgili ukavia adamianis paTologiaSi.janmos oficialuri monacemebiT,msoflioSi, yovelwliurad, infeqciuridaavadebiT avaddeba 1,5 miliardze metiadamiani (3). bunebrivia, rom infeqciuridaavadebebi mniSvnelovani problemaasaqarTvelosTvisac, romelic ganvi-Tarebad qveynebis ricxvs miekuTvneba. amjgufis qveynebSi ki es daavadebebi ufrofarTodaa gavrcelebuli, vidre ganvi-Tarebul saxelmwifoebSi.Cvens mizans Seadgenda saqarTveloSi,ocdameerTe saukuneSi, im infeqciuridaavadebebis gavrcelebis Seswavla, romlebicaqtualuria qveynisaTvis.upirveles yovlisa, unda SevexoTsaqarTveloSi aiv-infeqciis gavrcelebismdgomareobas. 2008 wlis 27 maisisaTvissaqarTveloSi gamovlenili iyo 1633SemTxveva. 1989-1996 wlebSi epidemiologiurisituacia aiv-infeqciis mimarTkeTilsaimedo iyo da wlis ganmavlobaSimxolod erTeuli SemTxveva vlindeboda.situacia mkveTrad Seicvala 1997 wlidan.am periodidan moyolebuli yovelwliuradgamovlenili SemTxvevebis ricxviaRemateboda wina wels registrirebulraodenobas da 2007 wels gamovlinda aivinfeqciisyvelaze meti – 344 axaliSemTxveva, ufro meti, vidre 1989-2001wlebSi erTad aRebuli. matebis aseTi tendenciamiT ufro mniSvnelovania im mdgomareobisfonze, rodesac rogorc msoflioSi,ise Cven mezoblad mdebare dsT-smTel rig qveynebSi aiv-infeqciis gavrcelebismasStabebi epidemiur xasiaTsiRebs (7). magaliTad ruseTSi 2006 welsukve 370 aTasze meti inficirebuli piriiyo gamovlenili (8). es faqti seriozulwinapirobas qmnis saqarTveloSi aiv-infeqciisepidsituaciis kidev ufrogarTulebisaTvis, rasac SeiZleba xeliSeuwyos qveyanaSi narkotikebis ineqciurmomxmarebelTa ricxvis ganuxrelma zrdamac.aRsaniSnavia, rom ise rogorc mTel rigqveynebSi (8), saqarTveloSic ganuxreladizrdeba sqesobrivi kontaqtis roli infeqciisgavrcelebaSi da ukve amJamad32,6%-Si infeqcia gavrcelda heteroseqsualurikontaqtis gziT. kontaqturimeqanizmis gaaqtiureba am infeqciiT avadobiszrdis mniSvnelovani safuZveliSeiZleba gaxdes. aiv-infeqciiT avadobiszrdis fonze sul ufro met mniSvnelobasiZens tuberkulozic, romlis epidemiologiurisituacia mniSvnelovnadgarTulda gasuli saukunis 90-ianiwlebidan moyolebuli (1,5,9), da rac ganpirobebuliarTuli socialurekonomikuripirobebiT da M. tuberculosisrezistentuli Stamebis farTo cirkulaciiT.tuberkulozTan asocirebuliaiv-infeqciis gamosavali ki friad arasasurvelia.yvela aRniSnuli mizezebisgamo, saqarTveloSi aiv-infeqciis problemisaqtualoba SeiZleba kidev ufrogaizardos.erT-erTi mniSvnelovani problemaavirusuli hepatitebi, romelTa registraciaqveyanaSi daiwyo 1953 wlidan damas Semdeg hepatitebs axasiaTebdaT avadobismatebis tendencia, rac gasulisaukunis 80-iani wlebis bolomde gagr-Zelda (2). damoukideblobis mopovebisSemdeg, daavadebulTa gamovlenisa daaRricxvis saqmeSi seriozuli naklovanebebisgamo, daiwyo virusuli hepatitebiTavadobis donis mniSvnelovani kleba,rac ukanasknel wlebSi kvlav Seicvala

4zrdis tendenciiT da 2007 wels avadobismaCvenebelma 100 aTas mcxovrebze Seadgina131,2, rac yvelaze maRali maCvenebelia1992 wlidan moyolebuli.cnobilia, rom virusuli hepatitebiZiriTadad 5 nozologiuri erTeulisaganSedgeba. esenia A, B, C, D, E hepatitebi.maTi xvedriTi wili virusuli hepatitebiTavadobaSi ocdameerTe saukuneSimniSvnelovnad Seicvala. Tu gasul saukuneSiSemTxvevaTa ZiriTadi nawili A hepatitzemodioda, amJamad sagrZnobladgaizarda sxva nozologiuri erTeulebisxvedriTi wilic (suraTi 1).gansakuTrebiT swrafad izrdeba qronikuliB da C hepatitis xvedriTi wilihepatitebiT saerTo avadobaSi. Tu gaviTvaliswinebT,rom A hepatitisagan gansxvavebiTB da C hepatitebi bevrad ufromZimed mimdinareobs da sakmaod xSiradmaTi gamosavalia RviZlis cirozi da hepatocelulurikarcinoma, gasagebi gaxdeba,Tu ra seriozul safrTxes uqmnis mosaxleobisjanmrTelobas parenterulihepatitebis farTo gavrceleba.SeuZlebelia ar aRiniSnos gauSifravietiologiis virusuli hepatitebis maRalixvedriTi wili. es ganpirobebuliasuraTi 1virusuli hepatitebis calkeuli nozologiuri erTeulebis xvedriTi wilisaqarTveloSi 2006-2007 wlebis monacemebiT36.20%Ahepatitimwvave B hepatiti B15.40%mwvaveC hepatiti C11.90%3.70%4.80%28%qronikuli B hepatiti Bqronikuli C hepatitiCD,EE da gauSifravi etiologiisvirusuli hepatitebivirusuli hepatitebis calkeuli nozologiuri erTeulebisxvedriTi wili TbilisSi 2006-2007 wlebis monacemebiTsuraTi 210.50%6.50% 6.20%36.70%A ????? hepatiti ?? ??? qronikuri ? ?? ?? ? C ? C hepatiti ????? ?? ?11.50%D, E ? da ? ??? gauSifravi ??? ? ??? etiologiis ?? ?? ? ? ??????????? virusuli hepatitebi ?????? ?? ????? qronikuli ? ?? ?? ? B ? B hepatiti ????? ?? ?28.60%?????? mwvave B C ????? hepatiti ?? ??????? mwvave C B ????? hepatiti ?? ?raionebSi virusuli hepatitebis specifikurimarkerebis gamosavlenad saWiroserologiuri kvlevebis Catarebis Seu-ZleblobiT. umjobesi iqneba Tu Sesabamisiklinikuri da epidemiologiuri monacemebissafuZvelzec daismeba hepatitebisdadasturebuli diagnozi. ukeTesimdgomareobaa TbilisSi, sadac arispirobebi Sesabamisi laboratoriuli kvlevebisCasatareblad da aq ufro zustisuraTi gvaqvs TiToeuli nozologiurierTeulis xvedriTi wilis Taobaze (sura-Ti 2). rogorc vxedavT SemTxvevebisTiTqmis 40% qronikul B da C hepatitebzemodis. bolo wlebSi A hepatitiT avadobisklebis fonze qronikuli B da C

5hepatitebiT avadobis donis mateba Cvensmezobel qveynebSic aRiniSneba (4,6).erT-erTi mniSvnelovani infeqciuridaavadeba, romlisTvisac damaxasiaTebeliasaqarTveloSi avadobis donis swrafimateba aris visceruli leiSmaniozi, romlispirveli SemTxveva qveyanaSi 1928wels gamovlinda. am daavadebis dinamikasaqarTveloSi naCvenebia suraT 3-ze.amasTan leiSmaniozis kerebi Ziri-Tadad Tbilissa da qvemo qarTlis regionebSiaganlagebuli. yvela sxva SemTxveva,romlebic sxva raionebSi aRiricxeba,anamnezurad Tbilissa da qvemoqarTls ukavSirdeba. gansakuTrebiT intensiuradaadaavadeba gavrcelebuliTbilisSi. 2000-2007 wlebSi saqarTvelo-Si visceruli leiSmaniozis SemTxvevaTasuraTi 3visceruli leiSmaniozis dinamika saqarTveloSi 2000-2007 wlebSiSemTxvevebis raodenoba2001801601401201008060402002000w2001w2002w2003w2004w2005w2006w2007wmalariis dinamika saqarTveloSi 2000-2007 wlebSisuraTi 4SemTxvevebisraodenoba5004504003503002502001501005002000w2001w2002w2003w2004w2005w2006w2007w63,2% swored dedaqalaqze modis. Tbilis-Si avadobis donis mateba ganpirobebuliunda iyos daavadebis ZiriTadi rezervuaris– ZaRlebis (gansakuTrebiT upatrono)da gadamtanis – flebotomusisraodenobis zrdiT.rogorc TbilisSi, ise mTlianadsaqarTveloSi ZiriTadad bavSvebi avaddebian.14 wlamde asakis bavSvebze mTeliSemTxvevebis 60% modis. aRsaniSnavia,rom avadobam imata mozrdilebSic.ar SeiZleba ar SevexoT kidev erT daavadebas,malarias, romelic gasuli saukunis60-iani wlebidan moyolebuli qveyana-Si praqtikulad likvidirebuli iyo.ocdameerTe saukuneSi malaria intensiuradgavrcelda ZiriTadad aRmosavleTsaqarTveloSi, kerZod, alaznisvelze mdebare lagodexis, siRnaRis, dedofliswyarosda yvarlis raionebSi, aseveqvemo qarTlis ramdenime raionSi. malariiTavadobis dinamika naCvenebiameoTxe suraTze. rogorc vxedavT, yvelazemeti SemTxveva 2001-2002 wlebSidafiqsirda. am wlebSi avadobis yvelazemaRali maCvenebeli aRiniSna siRnaRis

6raionSi – 390,7 100 aTas mcxovrebze dalagodexis raionSi _ 366,3.saxelmwifo programis farglebSiCatarebulma malariis kontrolisa daprofilaqtikis RonisZiebebma saTanadoSedegi gamoiRo da ukve 2007 wels daavadebismxolod 25 SemTxveva gamovlinda. malariakargi magaliTia imis sademonstraciod,rom Tu daavadebis mimarTprofilaqtikuri da epidsawinaaRmdegoRonisZiebebis gatareba Sesustdeba ansaerTod Sewydeba, aman SeiZleba gamoiwviosinfeqciis xelaxla aRmoceneba damisi intensiuri gavrceleba. amdenad, infeqciuridaavadebebis winaaRmdeg brZolaunda tardebodes ganuwyvetlad, raTaar miviRoT epidemiologiuri situaciisiseTi gauareseba, rogoric aRiniSnasaqarTveloSi malariis SemTxvevaSi.РАСПРОСТРАНЕНИЕ НЕКОТОРЫХ ИНФЕКЦИОННЫХЗАБОЛЕВАНИЙ В ГРУЗИИИ. Мчедлишвили, Д. Геловани, Т. МчедлишвилиДЕПАРТАМЕНТ ЭПИДЕМИОЛОГИИ И БИОСТИТИСТИКИ ТГМУНАЦИОНАЛЬНЫЙ ЦЕНТР КОНТРОЛЯ БОЛЕЗНЕЙ И ОБЩЕСТВЕННОГОЗДОРОВЬЯВ последние годы в Грузии достигнуты значительные успехи в снижении заболеваемостиинфекционными болезнями. Однако, при некоторых инфекциях не только не наблюдается тенденции кснижению, но имеет место рост заболеваемости. К числу последних, в первую очередь, относитсяВИЧ-инфекция. К 27 мая 2008 г. в Грузии было зарегистрировано более 1600 случаев заражения ВИЧ.С 1999 года ежегодно увеличивается число новых случаев, а в 2007 году было выявлено их рекордное344 ВИЧ-инфицированных. Заслуживает внимания, что в передаче этой инфекции все более активнуюроль играет гетеросексуальный поровой контакт.Наряду с этим, в последние годы в Грузии отмечаются значительные изменения и в структурезаболеваемости вирусными гепатитами. Постепенно снижается удельный вес гепатита А за счетувеличения гепатитов В и С, особенно их хронических форм, что свидетельствует о неблагополучнойэпидемиологической ситуации в отношении парентеральных гепатитов в стране.В ХХI веке актуальными стали в Грузии и такие болезни, как малария и висцеральный лейшманиоз,что является следствием снижения как объема, так и качества профилактических ипротивоэпидемических мероприятий при этих инфекциях.DISTRIBUTION OF SOME INFECTIOUS DISEASES IN GEORGIAI.Mchedlishli, D.Gelovani, T.MchedlishviliDespite the fact that for the last few years certain progress has been achieved by diminishing the morbidityrate of infectious diseases in Georgia, still it is reasonable to admit that several diseases maintain the tendencyof increasing their morbidity rate.HIV Infection definitely belongs to the above mentioned category. By the year 2008 (27 May) In Georgiamore than 1600 cases were registered. Since the year 1999 number of new cases have been increased and in2007 absolutely unbelievable number of cases (344) were identified. More frequent way of transmissionrecently has been Heterosexual contact.As for the morbidity of Viral Hepatitis For the last few years in Georgia certain changes have been observed.Number of cases of Hepatitis A have decreased but with Hepatitis B and C have occurred on thecontrary(especially it concerns the chronic forms). This means that in country epidemiological situation regardingparenteral Hepatitis is not good.In 21th century the diseases of high importance in Georgia are Malaria and Visceral Leishmaniosis as aresult of diminishing the quality, as well as the intensity of Prophylactic and Epidemiological measures towardsthese infections.

7l i t e r a t u r a1. gulua n. _ socialurad saSiSi infeqciebis profilaqtikisa da mkurnalobis organizaciuliproblemebi afxazeTidan da samaCablodan devnil mosaxleobaSi. avtoreferatidoqtoris akad. xarisxis mosapoveblad. Tbilisi, 2007w.2. mWedliSvili i. _ B da C hepatitebis gavrceleba saqarTveloSi. med. mecn. doqtorisdisertaciis avtoreferati. Tbilisi, 2002 w.3. mWedliSvili i. _ “infeqciur daavadebaTa epidemiologia”, I naw., Tbilisi, 2006w.4. Асратян А.А., Мелик-Андреасян Г.Г., Мхитарян И.Л. и др. - Динамика инфицированностивирусами гепатитов В и С в Ереване//Эпидемиология и инфекционные болeзни. -2004-№6- C.8-10.5. Низова А.В., Степанишина В.Н., Майская Н.В. и др. - Анализ устойчивости клиническихштаммов M. Tuberculosis к лекарственным препаратам первого и второго ряда.//Эпидемиология иинфекционные болeзни.-2007.-№4-С.7-11.6. Онищенко Г.Г., Шахгильдян И.В. - Актуальные вопросы эпидемиологии и профилактикивирусных гепатитов В и С в Российской Федерации.//ЖМЭИ, 2000.-№1.-С.50-54.7. Онищенко Г.Г. - ВИЧ-инфекция в России и странах СНГ: современная ситуация и перспективы.//ЖМЭИ.-2003.-№3.-С.21-27.8. Покровский В.В. - Когда наступит перелом в борьбе с ВИЧ/CПИДом? Эпидемиология иинфекционные болeзни.-2006.-№6.-С.4-9.9. Туберкулез, ассоцированный с ВИЧ-инфекцией, в странах мира.//Эпидемиология иинфекционные болeзни.-2007.- №4.-С.42-45.

8kurortologiabiliaruli sistemis paTologisas saxarbediosmineraluri wyliT organizmSi mimdinare koreqcian. saakaSvili, i. WabaSvilibalneologiuri kurorti, saqarTvelos kurortologiis,fizioTerapiis da samkurnalo turizmis samecnieropraqtikulicentri(recenzenti - asocirebuli profesori n. kvinikaZe daprofesori n. kakulia)kuW-nawlavis qronikuli daavadebebidReisaTvis iTvleba ‘saukunis~ daavadebebadda mTavar socialur problemas warmoadgens.a. skalnis (1999 w.) monacemebiT,am daavadebebis dros aRsaniSnavia mikroelementebisdisbalansis maRali maCvenebeli,kerZod, siliciumis (65%), magniumis(53%), qromis (40%), TuTiis (38%), spilen-Zis (35%), kaliumis (33%), rkinis (31%), selenis(27%) da aluminis 27 procentiTmomateba. Cven mier biliaruli sistemisdaavadebulebSi disbalansis koreqciisTvisgamoyenebuli iqna naklebad Seswavlilimineraluri wyali saxarbedio,romelic mdebareobs balneologiurikurortis, menjis, teritoriaze. mineraluriwyali saxarbedio warmoadgens dabalimineralizaciis (2,2 g/dm 3 ) sulfatur,qloridul, kalcium-magniumianTermul (42 o ) wyals. wlebis manZilzehidrogeologiur laboratoriaSi am wylisdinamikurma gamokvlevebma gviCvena,rom saxarbedios wyals aqvs stabiluriSemadgenloba. am wylis samkurnaloTvisebebi Seswavlil iqna qronikuli arakenWovaniqolecistitiT daavadebul 70avadmyofze.saerTo klinikuri gamokvlevebis garda,xdeboda sisxlis SratSi saerTo bilirubinisda qolesterinis Semcvelobisdadgena. cilebis koloiduri mdgradobisSeswavla xdeboda Timolis sinjis saSualebiT.naRvlis buStis evakuatorulifunqcia _ mravalmomentiani fraqciuliduodenuri zondirebiT, kuWis sekreciulifunqcia _ n. leporskis fraqciulimeTodiT, xolo reohepatogramebis registraciaxdeboda VPR-IA aparatiT. avadmyofebsutardebodaT gastroskopiulida veloergometriuli gamokvlevebi.biliaruli sistemiT daavadebulebs Tanaxlavs: kuWis mJavawarmomqmneli funqciisdarRveva 65,7% SemTxvevaSi, naRvlisbuStis diskinezuri cvlilebebi - 81%,RviZlis, sisxlis mimoqcevis moSla _ 20%,qolecisto-kardialuri sindromi _17,5% da a.S., rac cvlida qronikuli arakenWovaniqolecistitis klinikur gamovlinebas.avadmyofebi dayofilni iyvnen 2 jgufad:I jgufis avadmyofebi (40) dieturikvebis fonze Rebulobdnen mineralurwyals `saxarbedios~ kurort menjispirobebSi; II jgufis 30 avadmyofs utardebodamonoTerapia mineraluri wyliTkurortologiis samecniero-praqtikulicentris stacionaris pirobebSi. mkurnalobiskursi Seadgenda 24 dRes. mineraluriwyali eniSnebodaT 3,5 ml sxeulis1 kg masaze gaTvliT dReSi samjer kuWismJavawarmomqmneli sawyisi funqciurimdgomareobis mixedviT, xolo dispefsiurimovlenebis dros mineraluri wyalieZleodaT Wamis Semdegac.SeuRlebuli biliaruli paTologiiTdaavadebul avadmyofebSi mkurnalobisdasawyisSi Warbobda palpatorulitkivili marjvena ferdqveSa areSi _75,7%, dispefsiuri movlenebi _ 84,7%,kuWis sekreciuli funqciis darRvevebiaReniSneboda avadmyofebis 50%, qronikulikoliti _ 30%. mkurnalobis Semdeg,keris wertilSi tkivili Seumcirda avadmyofebis38%, dadebiTi cvlilebebiaRiniSneboda sxva niSnebzec. mkurnalobismeTormete dRes avadmyofebis 61%-smoexsna dispefsiuri movlenebi, xolo

9danarCenebs sagrZnoblad SeumcirdaT,avadmyofebis 28% gauumjobesda kuW-nawlavismoqmedeba.klinikuri suraTis gaumjobesebasTanerTad, mineraluri wyliT mkurnalobamgamoiwvia dadebiTi Zvrebi naRvlis buStisfunqciuri mdgomareobis mxriv. zondirebismonacemebis mixedviT, avadmyofebis_ 38%-Si dadasturda naRvlis buStishipertonuli-hiperkinetikuri diskinezia,naRvlis buStis evakuaciis periodisaSualod Semcirda 11 wuTamde. mkurnalobiskursis bolos naRvlis wvenisevakuaciis periodi gaxangrZlivda20,8±0,8 wT (P

10КОРРЕКЦИЯ ДИСБАЛАНСА В ОРГАНИЗМЕ МИНЕРАЛЬНОЙВОДОЙ САХАРБЕДИО ПРИ СОЧЕТАННЫХ ЗАБОЛЕВАНИЯХБИЛИАРНОЙ СИСТЕМЫН. Саакашвили, И. ЧабашвилиБАЛЬНЕОЛОГИЧЕСКИЙ КУРОРТ – НАУЧНО-ПРАКТИЧЕСКИЙ ЦЕНТРКУРОРТОЛОГИИ, ФИЗИОТЕРАПИИ, РЕАБИЛИТАЦИИ И ЛЕЧЕБНОГО ТУРИЗМА.ГРУЗИЯ, ТБИЛИСИЗаболевания желудочно-кишечного тракта представляют собой важную социальную проблемунынешнего столетия. Эти болезни сопровождаются дисбалансом микроэлементов в организме (А.Скальный, 1999). Нами впервые, для предотвращения развития подобного дисбаланса в организмебыли исследованы свойства малоизученной минеральной воды (МВ) Сахарбедио, источник которойнаходится на территории курорта Менджи. Минеральная вода Сахарбедио – слабоминерализованная(2,2 г/дм 3 ), термальная (42 о С) сульфатная, хлоридная кальциево-магниевая вода.Действие МВ изучалось на 70 больных с сочетанными заболеваниями билиарной системы, которымв течение 24 дней назначалось питьевое лечение. Установлено, что МВ Сахарбедио оказываетблагоприятное воздействие на больных с гепатобилиарной патологией: наряду с клиническим улучшениемвыявлена коррекция моторно-эвакуаторной функции жёлчного пузыря, биохимического состава пузырнойжёлчи, восстановление нарушенного печёночного кровообращения и желудочной секреции. Сахарбедио- экологически чистая, эффективная МВ, без побочного действия и с успехом может быть использованапри различных заболеваниях желудочно-кишечного тракта.CORRECTION OF ORGANISM DISBALANCE BY MEANSOF MINERAL WATER SAKHARBEDIO DURING THE NUPTIALSILLNESS OF BILIARY SYSTEMN. Saakashvili, I. ChabashviliAccording to A. Scaln (1999), people who have gastroduodenal disease experience the disbalance of microelement,such as Si (65%), MG (53%), CR (40%), Zn (38%), Cu (35%), K (33%), Fe (31%), Se (27%) and so on.Our purpose comprises frequent confluence of digestion organs, which is conditioned by the neuro-hormonalregulation.That’s why the correction of the disbalance of microelements is necessary: to enrich the feeding ration withmicroelements, which is possible using with less popular mineral water “Sakharbedio”.Sakharbedio – the law-mineralized water is located in Mendji. It was investigated on 70 patients, who werediseased with nuptials illness. They were taking this mineral water by the doze of 3,5 ml on 1 kg three times aday during 24 days on the phone of dietal feeding, according to stomach sore-forming functional condition.Mineral water Sakharbedio, is very effective on the hepato-biliar system. It’s very productive on the normalisationof the functions of the gall-bladder, in improving the chemical ingredients of the gall, in renew the functionof circulation of the blood of liver and the function of secretorial stomach, in reduction of the cholecysto-cardialsyndrom. The using of mineral water Sakharbedio during with nuptials illness guarantees the remission for ayear, that’s why it is recommended to repeat the treatment after 10-12 months.

11endokrinologiahiperprolaqtinemia mamakacebSiS.janjRava, q.asaTiani, l.uCava, a.xmeliZe,m.janjRava, e.xmeliZe, n.baramiZe m.daneliaiv.javaxiSvilis saxelobis Tbilisis saxelmwifouniversitetis medicinis fakultetis endokrinologiisdepartamenti(recenzia - med. mecn. kand. m. korinTeli)Sesavali: prolaqtini warmoadgens polipeptidurjaWvs, romelic Sedgeba 199aminomJavis naSTisagan. misi molekulurimasa 23kda, prolaqtinis sinTezze pasuxismgebeligeni moTavsebulia me-6 qromosomaze.prolaqtini gamomuSavdebahipofizis wina wilis laqtotrofebismier, romelic Seadgens adenohipofizisujredebis10-29%-s. maTi fiziologiurihiperplazia da hipertrofia aRiniSneba:orsulobisas, laqtaciisas da axalSobilebSi.hiperprolaqtinemiis sindromisaTvis,damaxasiaTebelia prolaqtinis hipersekrecia.daavadeba ufro xSirad gvxvdebaqalebSi, vidre mamakacebSi, boloperiodSi aRiniSneba misi matebis tendeciamamakacebSi (1,2,3).daavadebis etiologiuri faqtorebiSeiZleba iyos: 1) hipofizis sxvadasxvagvaridazianeba: a) hipofizis mTlianobisdarRveva, b) mikro an makro prolaqtinoma,g) ‘carieli” Turquli kexis sindromi,d) Sereuli forma (somatotropul-laqtotropuliadenoma),e) simsivneebi _ somatotropinoma,kortikotropinoma, Tireotropinoma,gonadotropinoma, v)kraniofaringioma, z) Serwymuli hipopituitarizmTanhipofizis adenoma, T) idiopaTiuriforma,2) hipiTalamur-hipofizuri funqciisdarRveva, kerZod: a) infeqciebi (meningiti,encefaliti), b) granulomatozuri dainfiltraciuli procesebi(sarkoidozi,histiocitozi, tuberkulozi da sxv.),g) simsivneebi(glioma, meningioma da sxva),d) metaboluri darRvevebi (RviZlis cirozi,Tirkmlis qronikuli ukmarisoba),e) travmebi (hipofizis fexis dazianeba,sisxlCaqceva da sxva), v) limfociturihipofiziti.3) simptomuri hiperprolaqtinemia:a) pirveladi hipoTireozi, b) sakvercxeebispolikistozi, g) estrogenmaproducirebelisimsivneebi, d) TandayoliliTirkmelzeda jirkvlis hiperplazia,e) hiperprolaqtinemia sportsmenebSi.4) farmakologiuri preparatebiTgamowveuli hiperprolaqtinemia: a) tricikluriantidepresantebi (imipramini, amitriptilini,haloperidoli), b) estrogenebi(Casaxvis sawinaaRmdegod ansamkurnalod), g) dofaminis blokatorebi(metiklopramidi, domperidoli, feno-Tiazidi), d) kalciumis arxebis blokatorebi(verapamili), e) H 2receptorebisblokatorebi (cimetidini, ranitidini), v)narkotikuli saSualebebi, z) adrenergulisistemis inhibitorebi (rezerpini, a-meTildofa, karbidofa) (4,5).klinikuri maxasiaTeblebi: hiperprolaqtinemiamamakacebSi gvxvdeba 40-59wlis asakSi, pacientebi eqims Semdegi ZiriTadiCiviliT mimarTaven: ereqciulifunqciis darRveva, uSviloba, libidosdaqveiTeba, iSviaTad ginekomastiiTa daufro iSviaTad galaqtoreiT. mamakcebSihiperprolaqtinemia ZiriTadad gamovlindebamakroadenomis saxiT, romeliciwvevs irgvlivmdebare qsovilebis rRvevasda gamovlindeba tropuli hormonebisdeficitiT. xSirad dasmuli diagnozi_“fsiqologiuriimpotencia” arasworia.avadmyofebi uCivian Tavis tkivils,mxedvelobis simaxvilis darRvevas, rac,ZiriTadad, mamakacebSi gamowveuli makroadenomisarsebobiT, testosteronisestrogenad gardaqmnis darRvevis gamo,

12gamoxatulia osteoporozis klinikac,magram qalebTan SedarebiT ufro naklebixarisxiT. dadgenilia, rom hiperprolaqtinemiismkurnaloba aumjobesebs Zvlovaniqsovilis struqturas, xSirSemTxvevaSi pacientebisaTvis damaxasiaTebeliacximovani qsovilis siWarbe.zogierTi avtoris monacemiT uSvilobamamakacebSi 4-49% gamowveulia aradiagnostirebulihiperprolaqtinemiis gamo.diagnostikis mizniT gamoiyeneba 3-etapi: 1) hiperprolaqtinemiis dadastureba2) simptomuri formebis gamoricxva.3) adenohipofizisa da hipoTalamusisvizualizacia (2,4).hiperprolaqtinemiis mkurnalobisaTvisarsebobs 2 meTodi: konservatulida qirurgiuli. konservatuli meTodebidangamoiyeneba xanmokle moqmedebisdofaminis agonistebi: (bromkriptini,parlodeli) da prolongirebuli moqmedebis(dostineqsi), xolo, rac Seexebaqirurgiul mkurnalobas igi gamoiyenebakonservatiuli mkurnalobis uefeqtobisasan didi zomis makroprolaqtinomisas.kvlevis masalebi iv.javaxiSvilis saxelobisTbilisis saxelmwifo universitetismedicinis fakultetis endokrinologiisdepartamentSi Seswavlil iqna 16pacienti, romelTac klinikur-laboratoriulikvlevebis safuZvelze daud-gindaThiperprolaqtinemia. Ppacientebis asakimeryeobda 19-62 wlamde, daavadebis xang-Zlivoba ki iyo 0,2-wlidan 1,5-wlamde.kvlevis mizans warmoadgenda daavadebisetiologiuri faqtorebis Seswavla,klinikuri suraTi da paTogenezze orientirebulimkurnalobis meTodis SerCeva.kvlevis meTodebi: pacientebs anamnezurimonacemebis gaTvaliswinebiT CautardaTSemdegi gamokvlevebi: anamnezisSegrovebis mizniT vaxdendiT pacientebissafuZvlian gamokiTxvas; prolaqtinisdonis gansazRvras sisxlSi; Tavisufalitestosteronos donis gansazRvras sisxlSi.adrenokortikotropuli hormonisada kortizolis cirkaduli ritmis gansazRvrassisxlSi; Tireotropuli hormonisada FT 4-s; RviZlis funqciur sinjebs;densitometria; magnitur-rezonansultomografias (MRI); Tirkmelzedajirkvlis ultrabgeriT gamokvlevas.kvlevis Sedegebi da maTi analizi:16-ve mamakacis sisxlSi momatebuli iyo prolaqtinisdone 40-220ng/ml (norma1,8-19,5ng/ml). 15 pacients daqveiTebuli hqondaTavisufali testosteronis done, 4 pacientsdaqveiTebuli hqonda akth-is done6,2-8,0pg/ml(norma7,9-66,1pg/ml) kortizoliscirkaduli riTmi iyo darRveuli 8.00231-294ng/ml(norma50-250ng/ml)16.00 146-200ng/ml (norma30-160ng/ml) 23.00 96-140ng/ml(norma47-98ng/ml) da ult. gamokvleviTaRiniSneboda Tirkmelzeda jirkvalis hiperplazia.4 pacients momatebuli hqondaTSH 3,98-7,8mlu/l (norma0,3-6,3mlu/l), xoloFT4 iyo daq-veiTebuli 0,4-0,9 ng/dl (norma0,8-2,0ng/dl), RviZlis funqciuri sinjebiyvela SemTxvevaSi iyo normis farglebSi,MRI-iT 10 pacients hqonda makroadenoma,xolo 4 pacients mikroadenoma. densitometriulimonacemebiT osteopenia aReniSneboda70%, osteoporozi _ 20%.gamokvlevebisa da anamnezuri monacemebisgaTvaliwinebiT, Cven mier Seswavlilipacientebis etiologiuri faqtorebiSemdegnairad ganawilda 4-SemTxvevaSihiperprolaqtinemiis mizezi iyopirveladi hipoTireozi, 3-SemTxvevaSifarmakologiuri preparatebi(2-narkotiulinivTierebebi. 1-Ca arxebis blokatorebi),erT SemTxvevaSi infeqciuri daavadeba,4-SemTxvevaSi Tirkmelzeda jirkvlishiperplazia,2-SemTxvevaSi travmulidazianeba, 2-SemTxvevaSi ver moxerxdaetiologiuri faqtoris dadgena.pacientebi ZiriTada uCiodnen: uSvilobas_ 100%, libidos daqveiTebas _ 80%,impotencias _ 80%, ginekomastias _ 10%,Tavis tkivils _ 60%, mxedvelobis dar-Rvevas _ 40%.mkurnalobis SerCeva xdeboda anamnezurida klinikur-laboratoriuli kvlevebisSedegebis Sejamebis safuZvelze.pirveladi hipoTireozis dros iniSnebodalevoTiroqsini, farmakologiuripreparatebiT gamowveuli hiperprolaqtinemiisasixsneboda aRniSnulipreparatebi, aseve osteopeniisa da osteoporozisdros iniSneboda Sesabamisisamkurnalwamlo saSualebebi. yvela pacientsSerCeviTad eniSneboda dofaminisxanmokle da prolongirebuli moqmedebisagonistebi. bromokriptini0,625mg(1/4abi)dozis matebiT 1,5-2,5mg-

13mde dReSi Wamis dros, xolo dostineqsi _0,25mg-dan dozis matebiT 1-2mg-mde kviraSierTxel. Catarebuli mkurnalobisSemdeg 14 pacientSi miRebul iqna dadebi-Ti Sedegi, xolo 2 SemTxvevaSi ver iqnamiRebuli sasurveli Sedegi da pacientebikonsultaciis mizniT gaigzavna neiroqirurgiulganyofilebaSi.daskvna: aradiagnostirebuli hiperprolaqtinemiaSeiZleba iyos erT-erTimizezi mamakacTa uSvilobisa; hiperprolaqtinemiisetiologiuri faqtorebisSeswavla mniSvnelovania mkurnalobisSerCevisaTvis; mamakacebSi hiperprolaqtinemiamomavali Seswavlis sagania.ГИПЕРПРОЛАКТИНЕМИЯУ МУЖЧИНШ.Джанджгава, К.Асатиани, Л. Учава, А.Хмелидзе,М.Джанджгава, Э.Хмелидзе, Н. Барамидзе, М. ДанелияДЕПАРТАМЕНТ ЭНДОКРИНОЛОГИИ МЕДИЦИНСКОГО ФАКУЛЬТЕТАТБИЛИССКОГО ГОСУДАРСТВЕННОГО УНИВЕРСИТЕТАИМ.И. ДЖАВАХИШВИЛИГиперпролактинемия у мужчин это синдром, характеризующийся гиперсекрецией пролактина. Пациентыобращаются к врачу, в основном, со следующими жалобами: нарушение эрекционной функции, бездетность,понижение либидо, редко гинекомастия. При этом часто диагноз «психологическая импотенция» являетсяошибочным.Цель исследований состояло в изучении этиологических факторов заболевания, клиническая картина ивыбор оптимального метода лечения. На базе эндокринологического департамента медицинского факультетаТбилисского государственного медицинского университета обследовано 16 мужчин в возрасте от 19 до 62лет, которым на основании клинико-лабораторных исследований была установлена гиперпролактинемия.Пациентам исследовали: 1) содержание уровня пролактина в крови; 2) уровень свободного тестостерона вкрови; 3) содержание в крови адренокортикотропного гормона и циркадного ритма кортизола; 4) TSH иFT4; 5) функции печени, а также проводили денситометрию; магнитно-резонансную томографию.На основании анамнестических и клинико-функциональных исследований установлено, что в 4 случаяхпричиной гиперолактинемии являлся первичный гипертиреоз, в 3 – фармакологические препа-раты, в одном- инфекционные заболевания, в 4- гиперплазия надпочечников, в 2 - травматические повреждения, а в 2случаях этиологический фактор установить не удалось.Подбор метода лечения осуществлялся на основании результатов изучения анамнеза и клинико-лабораторныхданных. После проведенного длительного лечения положительный результат отмечался у 14 пациентов.HYPERPROLACTINEMY IN MENSh. Janjghava, K. Asatiani, L. uChava, E. Khmelidze,M. Janjgava, A. Khmelidze, M. danelia. N. BaramidzeThe Hyperprolactinemy is a syndrome with prolactin hypersecretion. This disease is more often in women,than in men, but this has diseased increases in men lately. Hyperprolactinemy is often met in men during 40-59years period, patients refer to doctor with following complaints: disorder of erection function, childlessness,reduction of libido, but rarely gynecomasty.16 (sixteen) patients were examined in the Endocrinology department of the medical faculty of Iv. JavakhishviliTbilisi State University, whom on the bases of clinical-laboratorial research were diagnosed - Hyperprolactinemy.Their age was 19-62. The purpose of our research was to study etiological factors of the disease, clinical pictureand choice of the optimal methods of treatment. The patients were examined in order to: 1) determine prolaction

14level in blood; 3) to determine free testosterone in blood; 4) to determine an adrenocorticotrophical hormone andcircular rhythm of cortizol in blood; 5) TSH and FT4; 6) functional tests of liver; 7) densitometer; 8) magneticresonancetomography. With foreseen the examination and anamnesis dates, the patients’ etiological factors weredistributed as follows: In 4 cases by reason of hyperprolactinemy primary hypothyroidism was shown, in 3cases - a pharmacological preparations (2 narcotic materials and 1-Ca blood channel blockers), in one cases -infection diseases, in 4 cases - adrenal gland hyperplasia, in 2 cases - traumatic damage, but in 2 cases - it wasimpossible to detect the etiological factor.The Choice of the treatment was realized on the bases of total result of the anamnestic and clinical-laboratorialresearch. After the long treatment positive result is noted in 14 patients.literatura1. Возианова А.Ф., Горпиченко И.И. Сексология и андрология. Киев.: Абрис-1997-878С.2. Александров В.П., Михайличенко В.В. Урология и андрология. Справочник для врачей. Москва-Санкт-петербург.:. СОВА 2005-582С.3. Дедов И.И., Мельниченко Г.А., Фадеев В.В. Эндокринология. Москва-2000-С.108-116.4. Балаболкин М.И., Клебанова ЕМ., Креминская В.М. Дифференциальная диагностика илечение эндокринных заболеваний (руководство). Москва-2002-94-С.107.5. Балаболкин МИ. Эндокринология. Москва.-1998-С.134-142.

15qveynis samrewvelo sawarmoebSi arsebuliSromis pirobebis araxelsayrelimdgomareobis gamosworebisa da, Sesabamisad,garemos dabinZurebis SemcirebisZiriTad gzebad gvesaxeba: moqmedi samrewvelosawarmoebis modernizaciisa daTanamedrove teqnologiebis gamoyenebiTaxali mSeneblobis saxelmwifo programisSemuSaveba; sawarmoebSi iseTi teqnologiebisetapobrivi Semcireba, romlebicgaremos dabinZurebas ganapirobebs; garemosdabinZurebis mniSvnelovani wyaros -gacveTili, moralurad da teqnikuradmoZvelebuli sawarmoo aRWurvilobiseqspluataciidan gamoricxva; sawarmoebisxelmZRvanelTa (mewarmeTa) pasuxismgeblobisamaRleba teqnologiuri procesebisreJimis dacvisa da sawarmoo aRWurvilobissworiE eqspluataciisadmi; muSa-Ta samedicino uzrunvelyofis mwyobrisistemis funqcionirebis uzrunvelyofa;Sromis medicinis sferos uzrunvelyofasakanonmdeblo-normatiuli baziT.erovnuli meurneobis konkretul sferoSikompleqsuri gamajansaRebeliRonisZiebebis danergvis mniSvnelovanisamedicino da socialuri efeqtis TvalsaCinomagaliTs warmoadgens Cven miersaqarTvelos mrewvelobis erT-erTiwamyvani dargis - saSen masalaTamrewvelobis sawarmoebSi Catarebulioretapiani kompleqsuri gamokvlevebisSedegebi.saSen masalaTa mrewvelobis obieqtebisSromis pirobebisa da am sferoSi momuSaveTajanmrTelobis mdgomareobiskompleqsuri Seswavlis aucileblobaganpirobebulia 2 motiviT: Tanamedroveetapze Cvens qveyanaSi mimdinare mniSvnelovanisocialur-ekonomikuri cvlilebebprofilaqtikurimedicinasaqarTvelos samrewvelo obieqtebissawarmoo garemos mdgomareobis profilaqtikisZiriTadi principebir. kverenCxilaZe, vad. saakaZe, m. cimakuriZe, l. baqraZeTbilisis saxelmwifo samedicino universitetis garemosada profesiuli medicinis departamenti(recenzenti - profesor i. mWedliSvili)samedicino mecnierebis, kerZod,profilaqtikuri medicinis mniSvnelovaniamocanaa dasaqmebuli mosaxleobisSromisa da janmrTelobis dacvis uzrunvelyofaSesabamisi kompleqsuri RonisZiebebissafuZvelze [1,2].ukanasknel aTwleulSi, saqarTveloSiganviTarebuli epoqaluri cvlilebebisSedegad, mkveTrad daeca samrewvelowarmoebis moculoba. jandacvis sistema-Si dawyebuli reorganizaciis procesisdausruleblobam gamoiwvia dasaqmebulimosaxleobis janmrTelobis dacvisRonisZiebaTa mniSvnelovani rgolis –muSaTa avadobis analizisa da profilaqtikurisamedicino gasinjvebis Catarebismwyobri sistemis rRveva; mkveTrad Semcirdaprofesiul daavadebaTa gamovlenisdone, rac momavalSi maTi mZime, Sorswasuliformebis gamovlenis arasasurvelperspeqtivas qmnis.saqarTvelos socialur-ekonomikuriganviTarebis Tanamedrove etapi xasiaTdebaZveli, moZvelebuli teqnologiebismqone samrewvelo obieqtebis funqcionirebisaRdgeniT, rac araxelsayrel profesiulfaqtorTa generaciis winapirobaa.es garemoeba, mniSvnelovanwilad,ganapirobebs garemos dabinZurebisxarisxobrivi da raodenobrivimaCveneblebis zrdas. jer kidev mcireaaxali, progresuli teqnologiebis mqonesawarmoebis xvedriTi wili.qveyanaSi garemos damabinZurebelimrewvelobis ZiriTadi dargebia: samTomompovebeli,manqanaTmSeneblobis, qimiuri,saSeni masalebisa da metalurgiulimrewvelobis sawarmoebi, romlebic profesiulidaavadebebis ganviTarebis riskisfaqtorTa formirebis ZiriTadi mizezia.

16is fonze farTod ganviTarda samrewveloda samoqalaqo mSenebloba, ramac saSenimasalebisa da konstruqciebis mrewvelobisSemdgomi ganviTareba ganapiroba.mrewvelobis es dargi dRes erovnulimeurneobis erT-erT ZiriTadi da mniSvnelovanidargia. saqarTveloSi igi warmodgeniliamisi TiTqmis yvela ZiriTadiqvedargiT _ keramikis, silikaturi, cecxlgamZleda Tixis aguris, cementis,azbestcementis da rkinabetonis nakeTobaTa,betonis blokis, qviSis gamamdidrebelisawarmoebiT. meore mxriv, teqnologiuriprocesebis mravalferovnebisada mTeli rigi sawarmoebis teqnikuri damoraluri cveTis gamo, mrewvelobis aRniSnuldargSi mniSvnelovania arxelayreliSromis pirobebis mqone sawarmoebisa da samuSaoadgilebis xvedriTi wili [3].Cven mier Catarebuli 20-wliani dinamikurikompleqsuri gamokvlevebisSedegad gamovlinda Sromis pirobebisaraxelsayreli maCveneblebi da maTi ganviTarebisganmapirobebli faqtorebi,ris safuZvelzec daisaxa konkretuli mizanmimarTuliRonisZiebebi profilaqtikisada muSaTa kontingentis gajansaRebisaTvis.maTi praqtikaSi realizaciis Sedegebisaprobaciam TvalnaTliv daamtkica SemuSavebulirekomendaciebis efeqturoba.kerZod, mniSvnelovnad gaumjobesdasamrewvelo mtvris, mikroklimatisa daxmauris parametrebi, rac ganxorcieldasawarmoo nagebobebis racionaluridagegmarebiT da aRWurvilobis hermetizaciiT,teqnologiur ciklSi teqnikurteqnologiuriaspeqtiT ufro progresulisawarmoo aRWurvilobis gamoyenebisSedegad.garda amisa, Cven mier Catarebuli kompleqsurigamokvlevebis safuzvelzehigienuri Sefaseba mieca mowinave teqnologiursqemebs, ramac daamtkica maTiueWveli higienuri upiratesoba tradiciul,moZvelebul teqnologiebTan SedarebiT(haeris damtverianebis donis gansxvavebaidentur samuSao adgilebzestatistikurad sarwmunoa - t=3,1÷7,4).warmoebaSi teqnologiuri procesebisracionalizaciisa da mowinave teqnikuriaRWurvilobis danergvis Sedegad miRweuliamravali profesiis muSaTa SromissimZimis Semsubuqeba, zogierTi gansakuTrebiTSromatevadi profesia ki (magaliTad,kapselebSi amkrefi), saerTodlikvidirebulia.Sromis pirobebis gaumjobeseba, Tavismxriv, gavlenas axdens momuSaveTa janmrTelobismdgomareobaze. kerZod, muSa-Ta avadobis SedarebiTi SeswavliT dadginda,rom misi done, 20-wlian periodSi,statistikurad sarwmunod Semcirda.kerZod, yovel 100 muSaze SromisuunarobisdReTa raodenoba 12,1÷411,2 dRiT Semcirda,ramac mogvca droebiTi SromisuunarobisdReTa anazRaurebis Tanxis1,2÷38,2% wliuri ekonomikuri efeqti.analogiuri kanonzomieri SedegebiamiRebuli muSaTa janmrTelobis mdgomareobisklinikur-funqciuri gamokvlevebismonacemebis analiziT SedarebiT Wril-Si - Zveli da axali teqnologiebiT momuSavesawarmoebSi. kerZod, mowinave teqnologiiTmomuSave sawarmoebSi (sadacsamuSao haeris damtverianeba mniSvnelovnadnaklebia) praqtikulad janmrTelipirebi 9,8÷10,2%-iT meti gamovlinda(t=1,6), xolo sunTqvis organoebis daavadebebi,romelTa genezSi mniSvnelovaniamtvris faqtoris roli, 2,4-jer naklebia(t=1,8÷2,3); am or kontingentSi gamovlenildaavadebaTa struqtura mniSvnelovnadgansxvavdeba erTmaneTisagan(X 2 =22,8÷34,6).xazgasmiT unda aRiniSnos, rom Cvenmier miwodebuli kompleqsuri gamajansaRebeliRonisZiebebis SemuSavebasa darealizaciaSi aqtiurad iyo CarTuli Sesabamisisamrewvelo sawarmoebis usafrTxoebisteqnikis samsaxurebisa dasamedicino dawesebulebebis warmomadgenlebi,rac maTi efeqturi realizaciismniSvnelovani winapirobaa.amrigad, mecnierul-teqnikuri progresismiRwevebis praqtikaSi danergvawarmoebis kompleqsuri gajansaRebis sa-Sualebas iZleva Sromis pirobebis gaumjobesebisgziT, riTac miiRweva momuSave-Ta janmrTelobis mdgomareobis gaumjobesebamniSvnelovani samedicino, socialurida ekonomikuri efeqtiT.mxolod kompleqsuri RonisZiebebisgatarebisa da interseqtoruli Tanam-Sromlobis safuZvelzea SesaZlebelisawarmoo garemos mdgomareobisa da, Sesabamisad,dasaqmebuli mosaxleobis janmrTelobismdgomareobis gaumjobeseba.

17ОСНОВНЫЕ ПРИНЦИПЫ ПРОФИЛАКТИКИСОСТОЯНИЯ ПРОИЗВОДСТВЕННОЙ СРЕДЫПРОМЫШЛЕННЫХ ОБЪЕКТОВ ГРУЗИИР. Кверенчхиладзе, Вад. Саакадзе, М. Цимакуридзе, Л. БакрадзеДЕПАРТАМЕНТ МЕДИЦИНЫ ОКРУЖАЮЩЕЙ СРЕДЫ И ПРОФЕССИОНАЛЬНОЙПАТОЛОГИИ ТБИЛИССКОГО ГОСУДАРСТВЕННОГО МЕДИЦИНСКОГОУНИВЕРСИТЕТАСовременный этап социально-экономического развития Грузии характеризуется внедрением новых,прогрессивных технологий на фоне постепенного восстановления функционирования старыхпромышленных предприятий, что требует всесторонней гигиенической оценки. Основныминаправлениями улучшения условий трудa на промышленных предприятиях страны являются: разработкагосударственной программы строительства и рационального размещения новых предприятий сиспользованием ресурсов старых предприятий (модернизация и оснащение современной технологией);поэтапное устранение технологий на действующих предприятиях, вызывающих загрязнениюпроизводственной и окружающей среды; повышение ответственности руководителей предприятий(работодателей) за соблюдением режима технологических процессов и правильной эксплуатациейтехнологического оборудования; обеспечение функционирования налаженной системы медицинскогообеспечения работающих; обеспечение службы медицины труда соответствующей законодательнонормативнойбазой. На примере предприятий промышленности строительных материалов доказанаэффективность проведения комплексного, интерсекторального сотрудничества в этой области.MAIN PRINCIPLES OF PROPHYLACTICSOF INDUSTRIAL ENVIRONMENT CONDITIONS OF INDUSTRIALOBJECTS IN GEORGIAR. Kverenchkhiladze, V. Saakadze, M. Tsimakuridze, L. BakradzeThe present stage of social-economical development of Georgia is characterized by adopting new progressivetechnologies with the background of gradual restoration of old functioning industrial enterprises thatrequire overall hygienic assessment. The main directions of improvement of labour conditions in industrialenterprises are: elaboration of state program of construction and rational allocation of new enterprises using theresources of old enterprises (modernization and equipping with new technology; gradual removal of technologies,causing pollution of industrial and natural environment; increasing the responsibility of enterprise authority(workers) for maintenance of technology regime and correct exploitation of technological equipment; ensuringof functioning of worker medical insurance system; ensuring of labour medical service according to juridistical -normative basis. On the basis of industrial enterprises, producing the building materials, the effectiveness ofconduction of complex collaboration between sectors of this sphere is established.literatura:1. Измеров Н.Ф. Концептуальные подходы к сохранению и укреплению здоровья работающего населенияРоссии.//Бюллетень Научного Совета “Медико-экологические проблемы работающих”. 2003. №1.- С.4-10.2. Измеров Н.Ф., Сквирская Г.П. Социальная ответственность работодателя за здоровье работающихи роль медицины труда в современных условиях. //Медицина труда и промышленная экология. 2003. №12. –С.4-8.3. Ретнев В.М. Промышленность строительных материалов с точки зрения гигиены труда//МатериалыV Межгосударственной конференции по безопасности труда в промышленности строительных материалов истроительном производстве. Санкт-Петербург. - 1992. - С. 29-30.2. saqarTvelos samedicino Jurnali, 2, 2008 w.

18jandacvis organizaciaSaqriani diabetiT daavadebulTa ganaTlebiszogierTi sakiTxi saqarTveloSiTbilisis saxelmwifo samedicino universitetissazogadoebrivi jandacvis departamentie. mirvelaSvili(recenzenti - profesori j. mamalaZe)Saqrani diabeti erT-erTi farTodgavrcelebuli qronikuli daavadebaa.misi mzardi prevalentoba, diabeturigarTulebebi xSirad xdeba naadrevi letalurigamosavlisa da invalidizaciismizezi. daavadebis globaluri tvirTi,Saqrian diabets jandacvis sistemis erTerTumniSvnelovanes problemad aqcevs(1;3).saqarTvelos statistikis departamentismonacemebiT, endokrinuli daavadebebisstruqturaSi Saqriani diabetis wilisakmaod maRalia. diabetiani pacientebiendokrinuli sistemis daavadebebis, kvebis,nivTierebaTa cvlisa da imunitetisdarRvevebis mqone avadmyofTa 39%-sSeadgenen.mkurnalobis gegma diabetianebisaTvis,sxva punqtebTan erTad, moicavs, diabetianebisganaTlebas, kvebiT rekomendaciebsda kvebis dagegmvas. sxvadasxvagarTulebebis prevenciisaTvis (diabeturiterfi da sxva) ganaTleba gansakuTrebiTmniSvnelovani kontribuciaa (2).Tu gaviTvaliswinebT, rom diabetisdros swori kveba warmoadgens nivTierebaTcvlis darRvevis kargi kompensaciissafuZvels, savaraudoa, rom diabetianebisswori kvebis swavleba mniSvnelovnadgaaumjobesebs daavadebis movlasa da mimdinareobas(4).meTodebi. diabetianebis ganaTlebisSesafaseblad, sworad kvebis sakiTxebSi,gamoviyeneT Cven mier Sedgenili kiTxvari:‘Saqriani diabetiT daavadebulTakvebis mdgomareobis Sesaxeb~.kiTxvaris meSveobiT Segrovda informaciadaavadebis kontrolis iseTi mniSvnelovaniaspeqtis Sesaxeb, rogoricaa,avadmyofTa swavleba, kvebis dagegmva,dieturi mkurnalobisa da naxSirwylebisSezRudvis aucilebloba.miRebuli monacemebi damuSavdastatistikuarad, gamovTvaleT sinjis sa-Sualo da standartuli gadaxra (SD)dasakvirvebeli movlenis proporciasakvlev jgufSi- SE da 95%-iani CI.Sedegebi. Cven mier kiTxvarebiT gamoikiTxa1275 pacienti, 753 qali da 522 mamakaci,sinjis saSualo asaki Seadgenda47,46±11,08, qalebidan 283 avadmyofiitarebda insulinTerapias, 400 tablet da70-dietTerapias. mamakacebidan 224ikeTebda insulinis inieqciebs, 216 iRebdaSaqris damwev abebs, xolo 82 SemTxvevaSidaavadebis kompensacia miiRweodadietTerapiiT.gacemuli pasuxebis dajgufebis SedegadnaTeli gaxda, rom gamokiTxulTa40%-ma (510 pacienti) SE=1,37; 95%CI-37,32-42,68 araferi icis kvebis gegmis mniSvnelobasada dietTerapiis aucileblobaze.pacientTa 52% (663 avadmyofi)SE=1,39; 95%CI-49,28-54,72 kvebis reJims,arukavSirebs daavadebis kompensaciis Tudekompensaciis xarisxTan maT asevearaferi ician sakveb racionSi naxSirwylebisSezRudvis aucileblobaze. dietisdacvis dadebiTi Sedegebis Sesaxebinformirebulia 612 avadmyofi (48%).kiTxvaze: “iciT Tu ara, rom dietis dar-Rveva gavlenas axdens Tqvens janmrTelobaze”,maT uaryofiTi pasuxi gasces.kiTxvaSi specialurad ar iqna gamoyenebulisityva `uaryofiTi~, raTa Tavidanagvecilebina gamokiTxulTa mxridanSesaZlo mikerZoebis gaCenis Sansi.SemTxvevaTa TiTqmis 100%-Si (1260avadmyofi) ar xdeba glikemiisa da glukozuriisdonis mixedviT kvebis gegmaSi cvlilebebisSetana. pacientTa nawili (597avadmyofi-52%) amas ver axerxebs ekonomiuripirobebis gamo, nawili ki saerTod

19ver mixvda (663 avadmyofi-52%) SekiTxvisSinaarssa da mniSvnelobas.ucodinrobis gamo, gamokiTxulTaSoris arc erTi itarebda iseTi mniSvnelovanimaxasiaTeblis monitorings,rogoricaa glukozebuli hemoglobini,saerTi qolesterini da trigliceridebi.daskvna. amrigad, zemoT moyvanilimsjelobidan naTlad Cans, rom diabetianebisganaTlebis done, am davadebismovlisa da dietTerapiis sakiTxebSiaradamakmayofilebelia, isini ar flobenmniSvnelovan informacais dietTerapiisada sakveb racionSi daavadebis mimdinareobisSesabamisad cvlilebebis Setanisaucileblobisas.mniSvnelovani da aucilebelia diabetianTaganaTlebis programebis SemuSavebada implementacia jandacvis sistemissaxvadasxva rgolsa Tu doneze.НЕКОТОРЫЕ ВОПРОСЫ О ЗНАНИИ БОЛЬНЫХПО ПОВОДУ САХАРНОГО ДИАБЕТА В ГРУЗИИТБИЛИССКИЙ ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ ИНСТИТУТ ,ДЕПАРТАМЕНТ ОБШЕСТВЕННОГО ЗДРАВООХРАНЕНИЯЕ. МирвелашвилиСахарный диабет - широко распространенное заболевание, которое нередко характеризующеесятяжелым течением и большой частотой опасных для жизни больных осложнений с помощью опросчикаопрошены 1275 больных (753 женщин и 522 мужчин) с целью изучения вопросов их питания и специальныхзнаний о диабете. Оказалось, что 40% (510 больных) не имеют элементарных знаний по таким важнымвопросам, как планирование питания и необходимость диетического лечения, а 60 % (765 больных)имеют поверхностные знания по этим вопросам. Низкий уровень знаний больных о диабете - серьезнаяпроблема в системе здравоохранения страны.SOME ISSUES DIABETES EDUCATION IN GEORGIAE.MirvelashviliDiabetes mellitus is one of the most common noncommunicable diseases. The increasing prevalance ofdiabetes mellitus, the emergence of diabetes complications as a cause of early morbidity and mortality, and theenormous and mounting burden on health care systems make diabetes a priority health concern.The treatment plan for diabetes may include diabetes education, meal planning and nutritional recommendations.Education is the most important contribution in the prevention of diabetes complication (diabetes foot)during the study Questionnaire data was collected from 1275 participants. The questionnaires included educationquestions such as diabetes adequate care and meal planning.Results analyses show that, level of education among diabetes patients is low in Georgia.literatura1. F. Dinneen “Structured education for people with type 2 diabetes” 14 Feb 2008; BMJ;2. Charles Fox and Anne Kilve “ Intensive education for lifestyle change in diabetes” BMJ 2003;327;1120-11213. WHO, EMRO technical publications series 32// Guidelines for the prevention, management, and care ofdiabetes mellitus, 2007, 22-27.4. WHO, “Definition, Diagnosis and Classsfication of diabetes Mellitus and its complications” ,1999, 15-18.

20ufali ionebis Tanafardobis SemJavebisakengadaxra da, Sesabamisad, sisxlis pHismaCveneblis daqveiTeba. tyviis ionebsmravali fermentisa da cilebis sulfhidrul(SH-) jgufebTan gamoxatuli qimiuriTviseba akavSirebs, am ukanasknelTabolkiT safuZvlianad cvlis maT metabolizms[5] da iwvevs organizmSi Jangva-aRdgeniTireaqciebis mimdinareobis darRvevas.sayuradReboa tyviis ionebis garemo-Si gabnevis dinamikisa da gul-sisxlZarRv-Ta avadmyofobebis matebis Sesaxeb literaturisada jandacvis msoflio organizaciismonacemebis Sejereba. aRmoCnda,rom isini pirdapirproporciul kavSir-Sia, maSin rodesac, rogorc sayovelTaodcnobilia, xsenebuli sistemis avadmyofobebiZiriTadad yalibdeba da viTardebahipoqsiis fonze mimdinare nivTiereba-Ta cvlis moSlis Sedegad [16].miznad davisaxeT gamogvekvlia tyviisionebis qronikuli, aratoqsikuri doziTorganizmis datvirTvis Semdeg sisxlSi, guliskunTsa da filtvebSi Camoyalibebulimorfologiur-funqciuri cvlilebebisTaviseburebebi.kvlevis obieqtad SevarCieT `vistari~sxazis zrdasruli virTagvebi (sul 232),masiT 160-180 grami. sacdel cxovelebs,eqsperimentis pirvel etapze, ori TvisganmavlobaSi, eZleoda sasmel wyalSi gaxsniliZmarmJava tyvia - kilogram wonazegadaangariSebuli sufTa tyviis 0,3 (Ijgufi), 1,9 (II jgufi) da 17 (III jgufi) miligramisodenobiT dRe-Ramis ganmavloba-Si. dekapitaciamde sisxls viRebdiTvirTagvis kudis venidan, vamzadebdiTnacxs sisxlis formiani elementebisSesaswavlad da vsazRvravdiT hemoglobinismaCvenebels. eriTrocitebSi poreqsperimentulimedicina, paTomorfologiaeqsperimentSi tyviis (Pb) eqspoziciiT organizmSiganpirobebuli morfologiur-funqciuricvlilebebi da misi prevenciaklinikuri paTologiis samecniero-praqtikuli centri,Tbilisig. pataraia(recenzenti - asocirebuli profesori z. Tofuria)tyviiT intoqsikaciis paTogenezi,klinika da mkurnaloba SeswavliliasafuZvlianad [11]. samecniero literaturaSiZiriTadi yuradReba gamaxvilebuliaeqsperimentSi tyviis toqsikuridozebiT gamowveul organoTa cvlilebebisaRwerasa da mkurnalobis meTodebisSemuSavebaze. naklebi yuradReba aqvsdaTmobili an sruliad ugulebelyofilia,tyviis mcire, aratoqsikuri doziT xangrZlivieqspoziciiT gamokvlevas. aseTpirobebSi ki imyofeba kacobriobis, da,Sesabamisad saqarTvelos mosaxleobisumetesi nawili [12].organizmSi tyviis ionebi STainTqmebasunTqvisas, haerSi Sewonili aerozolebis,dabinZurebuli sasmeli wylisa dasakvebis gamoyenebis dros [15]. depo organoebSi(Zvlis qsovili, Zvlis tvini,parenqimuli organoebi da a.S.) dagrovilityvia didi xnis ganmavlobaSi rCeba organizmSi[9,13], zogjer mTeli sicocxlismanZilze da warmoadgens intoqsikaciismudmiv wyaros [6, 3]. zRvruli koncentraciismiRwevisa da xelsayreli pirobebisCamoyalibebamde igi klinikurad aravlens Tavis aqtiur Tvisebebs. sakmarisia,sxvadasxva mizezebis gamo, organizm-Si dairRves mJava-tutovani Tanafardoba,an, ufro mZime SemTxvevaSi, Camoyalibdesacidozisaken mimarTuli qronikulihipoqsia, rom tyviis ionebi Tavs warmoaCensmTeli Tavisi agresiulobiT,gamodis sisxlSi da amwvavebs arsebulqronikul intoqsikacias [1]. Sesabamisad,adamianis organizmSi, umravles SemTxvevaSi,mudmivad arsebobs riskis faqtori,romlis gamovlenac damokidebuliazogierTi Tanafaqtoris warmoqmnas-Tan, kerZod, rogoricaa wyalbadis Tavis-

21firinebis cvlis Taviseburebebis SeswavlismizniT, eqsperimentis dawyebidan,yoveli aTi dRis Semdeg, viRebdiT sisxlisI, II, III jgufis da intaqturi cxovelebiskudis venidan (TiToeuli jgufidan 17cxoveli) da porfirinebis fluoroscentulinaTebis xarisxs eriTrocitebSivafasebdiT maTi metabolizmis intensivobisSefasebis mizniT.lipiduri fraqciebis raodenobrivigansazRvrisaTvis masalas (sisxlis plazma,eriTrocitebi, gulis kunTi, filtvebi)viRebdiT kriostabilur pirobebSi davamuSavebdiT Bloor-is meTodiT, Одушко-sada Зеленина-s modifikaciiT. damuSavebulimasalis analizi Txel fenebSi xorcieldebaqromatografiis meTodiT mzafirfitebze Silufo UV-254. lipidurifraqciebis raodenobriv analizs vawarmoebdiTKarl Zeiss-is firmis eqsktinkciuliregistratoriT ERJ-10-iT. sisxlSi(plazma da eriTrocitebi), gulis kunTsada filtvebSi, lipidebis fraqciis raodenobivmaCveneblebs vsazRvravdiT mg%-Si.miRebuli masalis statistikuri damuSavebisaTvissarwmuno sxvaoba (P) ganisazRvrebodafiSer-stiudensis cxrilismeSveobiT realuri sxvaobis (t) koeficientisgaTvaliswinebiT.histologiuri kvlevisaTvis masalis(gulis kunTi, filtvebi) fiqsacia warmoebda12%-iani formaliniT, gauwylovanebaxdeboda aRmaval spirtebSi, xolovayalibebdiT celoidinSi (Celloidin inFlocken, VEB Laborachemi, DDR). marxilianmikrotomze daWrili anaTlebi iRebebodahemotoqsiliniTa da eoziniT.eriTrocitebi, gulis kunTsa dafiltvebSi ultrastruqturuli cvlilebebisgamosavlenad viyenebdiTeleqtronuli mikroskopiis meTods.masalas fiqsacias vawarmoebiT s-kolidinisbuferze momzadebuli glutaraldehidisWeibel-is fiqsatoriT da amavebuferze momzadebuli osmiumis fiqsatoriT- Bennett-Luft-is mixedviT. masalasvayalibebdiT epon-aralditis narevSiMollenhauer-is mixedviT. ultraTxelianaTlebis miReba xdeboda ultratom LKBIII-sa da Reichert Ultracut-E-ze. masalis ultrastruqturulianalizisaTvis viyenebdiTeleqtronul mikroskopebs Tesla BS-500-sa daЭМВ-100A-s.eqsperimentma gamoavlina mniSvnelovaniZvrebi sisxlis, gulis kunTisa dafiltvebis bioqimiur da struqturulorganizaciaSi. kerZod, tyviis ionebiseqspozicia periferiul sisxlSi iwvevsretikulocitebisa da eriTrocitebisbazofiluri marcvlovanebiT raodenobismomatebas. sakuTari kvlevis Sedegebi,naTlad miuTiTebs saeqsperimento cxovelebistyviis maRali doziTdatvirTvis pirobebSi eriTrocitebSiporfirinebis sinTezis Semcirebaze, ma-Sin, rodesac dabali doza aaqtivebs porfirinebisanabolizms. zemoTqmuli da hemoglobinisraodenobis Semcireba organizmSiganapirobebs anemiis fonis Camoyalibebasda eriTropoezis intensifikacias.amasTan, atipiuri hemoglobinis sin-Tezis, sisxlis plazmaSi uxeSdispersiulicilebis fraqciis momatebis, sisxlisdinebis siswrafis Semcirebisa da sisxlissiblantis momatebis pirobebSi aRiniSnebawvrili kalibris sisxlZarRvebSi tyviiTdatvirTuli gazrdili kuTri wonisada Secvlili muxtis mqone eriTrocitebisagregacia.tyvia iwvevs lipoproteinuli membranebislipiduri fraqciis fosfolipidebis,qolesterinisa da qolesteriniseTerebis metabolizmis Secvlas, ris SedegadacirRveva lipoproteinuli membranebis,rogorc funqciuri, aseve, bunebrivia,struqturuli organizaciac. membranebisfunqciis Secvlis Sedegad tyviisionebi advilad aRwevs yvela ujredSidakomponentTan, aqtiurad monawileobsda araspecifikurad warmarTavs mis metabolizms.eriTrocitebis ultrastruqturisgamokvleviT aRmoCnda, rom, hemoglobin-Semcveli marcvlebis raodenobis Semcirebisgamo, isini sxvadasxva simkvrivisaa.didi raodenobiT aRiniSneba, agreTve,eriTrocitTa Crdilebi, rac maT liziszemiuTiTebs. ujredebSi aRiniSneba heincerlihissxeulakebi, romlebic normuleriTrocitebSi ar vlindeba. igi rogorcwesi, warmoiqmneba im organizmTaeriTrocitebSi, romlebsac gaaCnia arastabilurihemoglobini. eriTrocitebisSemomsazRvreli membranebi gauxeSebulia,dawyvetilia da maTSi warmoiqmnebaporebi. membranebi alag ganicdis sruldezorganizacias. imis gaTvaliswinebiT,rom eriTrocitebis membranas gaaCniamniSvnelovani funqcia, savaraudoa, romeriTrocitebis membranebis struqturulimodifikacia gamoiwvevs maTi da, Sesabamisad,sisxlis funqciuri aqtivobisSecvlas.gulis kunTi ganicdis energiis deficitisada masTan dakavSirebuli meqanikurifunqciis darRvevisaTvis damaxasiaTebel

22ultrastruqturulad mniSvnelovan cvlilebebs.filtvis qsovilSi metabolizmisada ultrastruqturuli organizaciisSecvla ki, mizez-Sedegobrivadiwvevs hipoqsiisa da respiraciuli acidozisCamoyalibebas, izRudeba sisxlidanJangbadis aTviseba, kataboluriproduqtebis utilizacia, icvleba hemohaerovanibarieris struqtura da SesabamisadqveiTdeba misi funqcia.amrigad, tyviis ionebis eqspoziciamcire dozebiTac ki iwvevs eriTrocitebis,gulis kunTisa da filtvebis ultrastruqturuliorganizaciis da lipiduricvlis mniSvnelovan cvlilebebs, romlebickorelaciaSi imyofeba organizmistyviiT datvirTvis intensivobasTan. racmeti raodenobiTaa tyviis ionebi gamoyenebulieqsperimentSi, miT meti siRrmisadestruqciuli cvlilebebi.tyviis eqspoziciis saSiSroeba adamian-Ta janmrTelobisaTvis safuZvlianadaagacnobierebuli msoflio samedicino sazogadoebismier. aRniSnul sakiTxTandakavSirebiT Seqmnilia da xorcieldebamravali programa [CDC’s Lead Poisoning PreventionProgram (National Center for EnvironmentalHealth); Lead Poisoning Prevention Tips: Simple stepsto Protect Your Family From Lead Hazards (Dept. ofHousing and Urban Development, Office of LeadHazard Control): Lead Poisoning Prevention OutreactProgram (Environmental Health Center, environmentalProtection Agency) da sxva], romelic,ZiriTadad, sanitaruli ganaTlebis xasiaTsatarebs da miznad isaxavs garemoSityviis ionebis gabnevis raodenobis Semcirebas.amasTan, naTelia, rom tyviis ionebisgaremoSi gabnevis SeCereba administraciuliwesiT SeuZlebelia. didi materialurixarjebis gaRebis drosac ki Sesa-Zlebelia konkretul regionsa an saxelmwofoSimisi gabnevis mxolod moculobisSemcireba, rac arsebul problemas globaluradver gadawyvets. gamosavali, CveniazriT, tyviis eqspoziciis prevenciisalternatiuli mimarTulebis SemuSaveba-Sia. sadReisod metad aqtualurad migvaCniafarmakopeisaTvis cnobili im bunebrivisamkurnalwamlo saSualebebis gamovlenada SerCeva, romlebic gamodevnisorganizmidan tyviis ionebs da moawesrigebsmaTi eqspoziciiT ganpirobebuldarRvevebs nivTierebaTa cvlis procesebSi.eqsperimentis meore etapze sacdelcxovelebs, ori Tvis ganmavlobaSi, 0,3 da1,9 mg/kg raodenobiT, tyviiT datvirTvisSemdeg, eZleobdaT cal-calke, erTi TvisganmavlobaSi peqtini, askorbinis mJava daglutationi.gamokvleviT dadginda, rom tyviis ionebisorganizmidan gamodevnis mizniT, peqtinisgamoyenebis pirobebSi gamovlenilicvlilebebi sustadaa gamoxatuli da umravlesSemTxvevaSi Seswavlili obieqtebisstruqturuli organizacia umniSvnelodgansxvavdeba normisagan. aRniSnulidakavSirebuli unda iyos peqtinisTvisebasTan, xangrZlivi gamoyenebispirobebSi (erTi Tve), seleqciurad Sebo-Wos tyvia, Seqmnas wyalSi uxsnadi naerTebi(peqtinatebi, peqtatebi) da ukan SewovisgareSe gamodevnos isini kuW-nawlavistraqtis meSveobiT. masTan, SesaZloatyviis organizmidan gamodevnis dadebi-Ti efeqti ufro metad gaZlierdes, TupeqtinTan erTad kompleqsSi gamoyenebuliiqneba iseTi samkurnalwamlo saSualebebi,romlebic moawesrigebs tyviiseqspoziciiT darRveul natif bioqimiurprocesebs (Jangva-aRdgeniTi reaqciebi,SH-jgufebis bloki da a.S.). askorbinismJavasa da glutationis cal-calke gamoyeneba,miuxedavad imisa, rom isini tyviasver gamodevnis organizmidan, dadebiTzegavlenas axdens organizmSi mimdinareprocesebze. askorbinis mJavasa da glutationiskompleqsuri gamoyeneba, savaraudod,ufro metad gaaumjobesebs aRniSnulefeqts, radgan isini urTierTpotenciisgaZlierebiT iwvevs TavianTiTvisebebis intensifikacias.amrigad, rogorc organizmidan tyviisionebis gamodevnis mizniT da misi zemoqmedebiTgamowveuli cvlilebebis gasaneitraleblad,ise tyviis eqspoziciisprevenciul saSualebad SesaZlebeliagamoyenebul iqnes peqtinis, askorbinismJavasa da glutationis kompleqsi.

23МОРФО-ФУНКЦИОНАЛЬНЫЕ ИЗМЕНЕНИЯ ОРГАНИЗМА,ОБУСЛОВЛЕННЫЕ ЭКСПОЗИЦИЕЙ СВИНЦА (PB) ВЭКСПЕРИМЕНТЕ, И ВОЗМОЖНОСТИ ЕЕ ПРЕВЕНЦИИН/П ЦЕНТР КЛИНИЧЕСКОЙ ПАТОЛОГИИ. ТБИЛИСИГ.К. ПатараяПроведен двухэтапный эксперимент на 233 половозрелых линии «Вистар». Экспериментальные животныев течение двух месяцев получали растворенный в воде уксуснокислый свинец из расчета 0,3 (I группа), 1,9(II группа) и 1,7 (III группа) мг/кг чистого свинца в сутки. На втором этапе эксперимента животные втечение одного месяца получали пектин, аскорбиновую кислоту и глутатион.Изучали общий анализ крови и особенности порфиринового обмена в эритроцитах; количественнойхроматографией определяли липидные фракции плазмы кровы, эритроцитов, миокарда и легких;ультраструктурному анализу подвергались эритроциты, миокард и легкие.Установлено, что малые дозы свинца вызывают развитие в организме анемию и интенсификациюэритропоэза, нарушается липидный обмен и развиваются значительные изменения ультраструктурнойорганизации эритроцитов, миокарда и легких. Эти изменения находятся в прямой корреляции с интенсивностьюсвинцовой нагнузки организма: чем больше количество использованных в эксперименте ионов свинца, темглубже деструктивные изменения. С целью выведения ионов свинца из организма, нейтрализации вызванныхего воздействием изменений и превенции интоксикации целесообразно комплексное применение пектина,аскорбиновой кислоты и глутатиона.LEAD EXPOSITION IN THE EXPERIMENT CONDITIONED BYMORPHOLOGICAL AND FUNCTIONAL CHANGES IN THE ORGANISMAND THE PERSPECTIVE OF ITS PREVENTIONG. PataraiaThe experiment on the “Wistar” line full-grown rats (totally 233) was performed in two stages. During twomonths in the first stage the experimental animals were given acetic acid lead diluted in water-evaluated in kilogramweight pure lead 0,3 (I group), 1,9 (II group) and 17 (III group) milligrams during twenty four hours. On thesecond stage of the experiment these animals were given pectin, ascorbic acid and glutathione during the month.The following investigations have been carried out: general blood test; estimation of the porphirinies metabolismin the erythrocytes; chromatography of the lipid fraction in the blood plasma, erythrocytes, hearth muscle and lungsand the ultrastructural analyze of the erythrocytes, hearth muscle and lungs.Low-level lead exposition causes formation of the background of the anemia, intensification of the erythropoesys,disturbing the lipid changes and the important changes of the ultrastructural organization of the erythrocytes,heart muscle and lungs. The changes are in the correlation with the loading intensity of the body with the lead - asmore lead ions are used in the experiment, as deeper is the destruction changes. The complex of pectin, ascorbicacid and glutathione may be useful in order to eliminate lead ions, neutralization and prevention of the changescaused by its influance.

24literatura1. Архипова О.Г., Зорина Л.А., Соркина Н.С. Комплексоны в клинике профессиональных болезней.- М.: Медицина, 1975.-462 с.2. Воронцов А.И., Харитонова Н.З. Охрана природы. - М.: Высшая школа, 1977.3. Казначеев В.П. Очерки теории и практики экологии человека. - М.: Наука, 1983.4. Минаев В.Г., Алексеев А.А., Тришина Т.А. Тяжелые металлы в окружающей среде в условияхсовременной химизации. Сообщение 2. Свинец//Агрохимия, 1982.-№2.-С.126-140.5. Оксенгендлер Г.И. Яды и противоядия.- Л.: наука Ленингр. отд., 1982.6. Профессиональные болезни / Под ред. Е.М. Тареева, А.А. Безродных - М.: Медицина, 1976.7. Химия окружающей среды / Дж.О.М. Бокрис, Р.В. Рассел, Ч.Л. Куин и др. // М.: Химия, 1982.-671 с.8. Biological monitoring of chield lead exposure in the Czech Republic / Cikrt M., Smerhovsky Z., Blaha K.,Nerudova J., Sediva V. et all. // Environ. Health. Perspect., 1997 Apr.-105(4).-406-11.9. Cumulative concentrations of blood lead and postural stability. / S.E. Chia, H.P. Chia, C.N. Ong, J.Jeyartnam// Occup. Environ. Med., 1996 Apr.-53 (4).-264-8.10. Evolution of a state occupational lead exposure registry: 1986-1996. / L.M. Roche, R.Ramarpasad, B.Gerwel,M. Pearson, M. Stanbury, R. O’Leary // J. Occup. Environ. Med., 1998 Dec. -40 (12).-1127-33.11. Fisher A.M., Vesley J.A. Preventing lead poisoning and its consequences // Pediatr. Nurs., 1998 Jul-Aug.-24 (4).-348-50.12. Individual variation in response to lead exposure: a dilemma for the occupational health phisician/S.Mikrovic-Kraus, N.Rested-Samarzija, M. Samarzija, O.Kraus // Am. J. Int. Med., 1997 May. - 31 95).-631-5.13. Is there any association between the presence of bone disease and cumulative exposure to lead?/J.D.Adachi, D. Arlen, C.E. Webber, D.R. Chettle, L.F. Beaumont, C.L. Gordon // Calcif. Tissue. Int., 1998 Nov. - 63(5). - 429-32.14. Solberg W., Steinnes E. Heavy metal contamination of accresterial ecosystems from long distanceatmospheric transport // J. Heavy metals in the environment. Int. Conf. Heidelberg. Sept., 1983.-v. 1.-p.170-173.15. Srianujata S. Lead - the toxic metal to stay with human // J. Toxicol. Sci. 1998 Jul. - 23 Suppl. 2.-237-40.16. Sudden cardiac death / J. Sra, A. Dhala, Z. Blanck, S. Desphande, R. Cooly, M.Akhtar // Curr. Probl.Cardiol., 1999 Aug. - 24 (8).- P. 461-538.17. Tenenbein M. Leaded gasoline abuse: the role of tetraethyl lead // Hum. Exp. Toxicol., 1997 Apr.- 16 (4).- 217-22.

25Tanamedrove teqnologiebi medicinaSiredaqciisagan: saqarTvelos sainJinroakademiis samecniero-teqnikuri centrisgen. direqtoris, baton Tengiz cecxlaZismier warmodgenili axali samecniero-teqnikurimimarTulebisa da originaluri teqnologiismaRali efeqturoba da sxa me-TodebTan misi upiratesoba, rogorc sasmelida Camdinare wylebis gausnebovnebis,aseve epidemiologiurad usafrTxo pirobebisuzrunvelyofaSi, araerTgzis dadasturdaqveynis Sesabamis kompetentur kvleviTdawesebulebebSi. vfiqrobT, rom aRniSnuliteqnologiis farTo danergva, rasac upirvelesyovlisa mxars uWers saqarTvelosSromis, janmrTelobisa da socialuridacvis saministro, xels Seuwyobs aRniSnulisakiTxebis Tanamedrove moTxovnebis SesabamisadgadawyvetaSi.eleqtroqimiuri danadgariTa da teqnologiurisistemiT warmoebuli sadezinfeqcio dasasterilizacio xsnarebis efeqturoba dausafrTxoebaT. cecxlaZesaqarTvelos sainJinro akademiis samecniero-teqnikuri centri(recenzenti – profesori r. kverenCxilaZe)Tanamedrove msoflioSi, sicocxlisada adamianis janmrTelobisaTvis keTilsaimedosanitariul-higienuri da epidemiologiuripirobebis Seqmna, bunebrivikataklizmebis, xarisxiani sasmeli wylisdeficitis, eTnikuri da regionuli konfliqtebis,sagangebo situaciebis, bioteroristuliaqtebis, mosalodneli globaluridaTbobis mikroorganizmebze savaraudoddadebiTi zemoqmedebisa da sxvamizezebis gamo, dRiTidRe ufro aqtualurixdeba da misi gadawyveta nebismierisaxelmwifosTvis prioritetul mimarTulebaswarmoadgens.es sakiTxi saqarTvelosTvisac metadmniSvnelovania da qveyanaSi arsebuligardamavali periodis siZneleebiTacaaganpirobebuli.jandacvis msoflio organizaciis monacemebiT,avadobis gamomwvevi axali infeqcia„istoriulad uprecedento siswrafiT“warmoiSoba – weliwadSi erTi.amave organizaciis yovelwliur moxsenebaSixazgasmulia, rom 1970 wlidan,msoflioSi daregistrirebulia 39 axaliinfeqciuri daavadeba, bolo xuTi wlismanZilze ki aRiniSna epidemiis afeTqebis1 100 SemTxveva, maT Soris qoleris, poliomielitisada frinvelis gripis.saqarTvelos garemos higienis samoqmedoerovnul gegmaSi _ “garemo da janmrTeloba”,gaTvaliswinebulia garemosa da adamianisjanmrTelobaze mavne garemo faqtorebiszemoqmedebis prevencia da kontroli.dokumentSi erT-erTi mniSvnelovaniadgili adamianis janmrTelobisaTvisusafrTxo sanitariul-epidemiologiuripirobebisa da mosaxleobis xarisxiani sasmeliwyliT uzrunvelyofas ukavia.amave dokumentSi mkafiodaa gamoxatuliaRniSnuli problemis gadawyvetismniSvneloba (rogorc konstituciismoTxovna) - mkvidri mosaxleobisTvis usafrTxogaremos uzrunvelyofa, aseve,qveynis ekonomikuri aRmavlobisTvisuaRresad saWiro da prioritetuli mimarTulebis_ turizmis ganviTareba.saqarTveloSi turizmis, dasvenebisa dasanatoriul-sakurorto mkurnalobisSemdgomSi ganviTareba, gansakuTrebiTsaerTaSoriso doneze, dakavSirebuliaturizmisa da sakurorto raionebSi SeqmnilmTel rig araxelsayrel sanitariulhigienurpirobebTan. rac, garda mosaxleobisada damsveneblebis janmrTelobazeuaryofiTi moqmedebis, pirdapiri da arapirdapiriekonomikuri danakargebis, amTaviTvezians ayenebs saqarTveloSi saerTa-

26Soriso turizmis ganviTarebis perspeqtivas,negatiur gavlenas axdens saerTod sazogadoebasada qveynis prestiJze [1].saerTaSoriso turizmis ganviTarebisaTvisgasaTvaliswinebelia is garemoeba,rom igi dakavSirebulia mravali adamianisaxal garemoSi droebiT gadaadgilebasTan,sadac SesaZlebelia maTze zemoqmedebamoaxdinon mikroorganizmebma,romelTa mimarT gadaadgilebul pirebs,adgilobrivi mosaxleobisagan gansxvavebiT,ar gaaCniaT araviTari imuniteti [1].gasaTvaliswinebelia is garemoeba, romzRvis wylis xarisxTan erTad, kurortebzearsebuli sanitariul-higienuripirobebi da infeqciuri daavadebebisdone, damsveneblebisa da turistebis(gansakuTrebiT ucxoeTidan) mozidvisTvalsazrisiT, yvelaze mniSvnelovankriteriumebad iTvleba [1].erovnul gegmaSi, janmrTelobisdacvis msoflio organizaciis mier miRebulprogramebsa da saxelmZRvanelo dokumentebSi(mainis frankfurti, 1992w;helsinki, 1994w; londoni, 1992, 1999w.),mosaxleobis janmrTelobis dacvis sferoSi,Camoyalibebulia sakiTxis sruliadaxali midgoma da principi.aRniSnuli sakiTxebis praqtikuli gadawyvetisTvalsazrisiT, saqarTvelossainJinro akademiis samecniero-teqnikuricentri 2001 wlidan muSaobs axali,progresuli samecniero-teqnikuri mimarTulebisa(eleqtroqimiuri aqtivacia)da Sesabamisi teqnologiebis saqarTveloSifarTod danergvaze.mavne mikroorganizmebisa da infeqciuridaavadebebis gavrcelebis Tavidanacilebis mizniT, antimikrobuli qimiapreparatebisgamoyenebas didi xnis istoriaaqvs rogorc medicinaSi, aseve soflismeurneobaSi. dRes ukve eWvs ar iwvevsis faqti, rom imunologiuri da genetikuricvlilebebi, onkologiuri daavadebebi,paTologiuri mSobiaroba da axalSobilTadefeqtebi, ZiriTadad, qimiurnivTierebaTa gamoyenebis zrdisa daekologiuri mdgomareobis gauaresebisSedegia.adamianisaTvis kvebis produqtebis(maT Soris sasmeli wylis) mavneoba masSi“ucxo” nivTierebebis arsebobiT arisgamowveuli. gansakuTrebiT es exeba imSxamebsa da saSiS qimiur nivTierebebs,romlebic ar monawileobs nivTierebaTacvlaSi da organizmSi xdeba maTi akumulireba,ris gamoc, toqsikuri naerTebiskoncentracia adamianisa da cxovelisorganizmSi, mcenareebSi mravaljeraRemateba maT Semcvelobas niadagSi, wyalsada haerSi.momwamlav nivTierebaTa migraciaspraqtikulad sazRvari ar gaaCnia. TeTridaTvebis RviZlSi sxvadasxva toqsikurinaerTebis arseboba gamoavlina kanadisarqtikul zonaSi Catarebulma gamokvlevebma.mavne naerTebi aRmoCnda RrmaWaburRilebidan amoRebul samkurnalodaniSnulebis mineralur wylebsa da dedisrZeSic.ddt-s (diqlordifeniltriqlor-me-TilmeTani) pesticiduri aqtiurobis aRmoCenisaTvis,1948 wels, Sveicariis akademiiswardginebiT, nobelis premia mieniWapaul miulers. 20 wlis Semdeg ki amaveqveyanaSi kanoniT akrZales ddt-s gamoyeneba.mravali analogiuri magaliTi arsebobsimisa, rom meurneobis zogierTdargSi warmatebiT danergili sxvadasxvaproduqcia (maT Soris samedicino daniSnulebis)dRes ukve amoRebulia xmarebidan,vinaidan samecniero-teqnikuriprogresis mimdinare etapze SesaZlebeligaxda adamianis janmrTelobasa da garemozemisi uaryofiTi zemoqmedebisutyuari dasabuTeba.pirvelad antiseptiki (qlorwyali)gamoyenebul iqna sameano klinikaSi 1847wels i. zemelveisis mier. dReisTvis damuSavebulia450-ze meti dasaxelebispreparati. antimikrobuli saSualebebisaseTi nairsaxeobis faqti gamowveulia aramarto sabazro konkurenciiT, aramed esdakavSirebulia „idealuri“ monacemebismqone preparatis ZiebasTan. cnobilia,rom jamuri moTxovnebi „idealuri“preparatis gamoyenebis mimarT arisaranakleb 30-sa [2, 3]. tradiciuli teqnologiiTdamzadebuli arc erTi sadezinfeqciosaSualeba faqtiurad ar akmayofilebsantimikrobuli preparatis (idealuri)moTxovnebis erTobliobas [4].Cven mier warmodgenili teqnologiasamedicino daniSnulebisaa da gamoiyenebaTanamedrove moTxovnebis Sesabamisi,maRalefeqtiani, adamianis janmrTelobisada garemos mimarT usafrTxo, aqtivizebuli,ekologiurad sufTa da iafisarecxi, sadezinfeqcio da sasterilizacioxsnaris (neitraluri anoliti) adgilzesawarmoeblad (maT Soris savelepirobebSi).neitraluri anoliti, mravali dasaxelebisimportuli Tu samamulo warmoebissadezinfeqcio preparatebisagan gansxvavebiT,miiReba yovelgvari qimiuri

27reagentebis gamoyenebis gareSe, mxolodbunebrivi produqtis - sufris marilis,wylisa da eleqtroenergiis gamoyenebiT.natriumis hipoqloridisagan gansxvavebiT,romelic, agreTve, marilis wyalxsnarisaganmzaddeba, neitraluri anolitiaris universaluri daniSnulebissadezinfeqcio da sasterilizacio xsnari,aqvs antiseptikuri daniSnuleba. igigamoiyeneba sarecx da maTeTrebel saSualebad,sasmeli da Camdinare (maT Sorisinfeqciuri profilis dawesebulebebis)wylebis gausnebovnebis mizniT.neitraluri anoliti warmoadgens ufero,gamWvirvale siTxes. miuxedavad imisa,rom preparatis erT-erTi aqtiuri moqmedinivTiereba aris qlormJava, igi arganekuTvneba qloSemcvel sadezinfeqciosaSualebaTa jgufs. sxvadasxva saer-TaSoriso gamocemebSi gamoyenebuliterminologiis mixedviT, analogiurisaSualebebi Sedis Sereuli oqsidantebisjgufSi. aqtiurad moqmedi nivTierebebiskoncentraciis simciris gamo, anoliti –ГОСТ 12.1.007-76, organizmze zemoqmedebisxarisxiT ganekuTvneba naklebad saSiSnivTierebaTa meoTxe klass. anolitissasikvdilo doziT rom moiwamlos 70 kgwonis adamiani saWiroa miiRos maqsimalurikoncentraciis 350 l xsnari. veterinariaSi0.028% koncentraciis anolitigamoiyeneba dasalevad (3 mg aqtiuradmoqmedi nivTiereba wonis 1 kg-ze gadaangariSebiT).ZiriTadad, anoliti miiRebada gamoiyeneba aqtiuri qloris SemcvelobiT0.01%, 0.02%, 0.05% da pH-ismniSvnelobiT 7,2-dan 8.2-mde. anoliti,romelSic aqtiuri moqmedi nivTierebebiskoncentracia 0.01%-mdea, samkurnalopreparatia _ antiseptiki kanisa da Wrilobebiszedapirebis damuSavebisTvis.xsnaris gamoyeneba nebadarTulia,agreTve, ginekologiur stacionarebsada kvebis mrewvelobis obieqtebSi, sadacgansakuTrebiT mkacri moTxovnebia toqsikologiurusafrTxoebaze.sadezinfeqcio saSualeba efeqturadSeiZleba CaiTvalos mxolod im SemTxveva-Si, Tu xangrZlivi gamoyenebisas, mikroorganizmebimis mimarT ver SeiZens mdgradobasda ver gamoimuSavebs adaptaciurreaqciebs. mdgradi qimiuri naerTebissafuZvelze damzadebuli preparatebisgamoyenebisas, dezinfeqciis damTavrebisSemdeg, organuli naerTebi koncentrirdebaforovan moculobebsa da gluv zedapirebze,sadac gardaiqmneba uwvriles,TvaliT uxilav apkad. Semdgom ki, sublimaciuriprocesis safuZvelze, misi molekulebigamoiyofa apkidan haerSi. aRniSnulisSedegad warmoqmnil aerozols xSiradaraviTari suni ar gaaCnia da iqmneba misiusafrTxoebis iluzia. faqtiurad ki nagebobaSi,haeris yoveli litri ramdenimemiliard bunebrivad an sublimaciis SedegadaorTqlebul molekulas Seicavs. imSemTxvevaSic ki, Tu maTi koncentracia arfiqsirdeba Sesabamisi tabeluri xelsawyoebiTda Seadgens zRvrulad dasaSvebikoncentraciis Tundac meased da meaTasednawils, sunTqvis procesSi, aseve kanidanda lorwovani garsidan igi mainc xvdebaadamianis organizmSi (personali, pacienti),sadac agrZelebs Tavisi mTavari funqciisSesrulebas (damTrgunveli zemoqmedebaujredebis cxovelmoqmedebaze),am SemTxvevaSi ki, adamianis organizmisujredebze.aRniSnulis garda, sayuradReboa isfaqti, rom mikroorganizmebis sxvadasxvasaxeoba, romelic swrafad aRmoCndebaamave apkze (gamSral da mikrobiociduraqtivoba dakargul organul nivTierebaze),mas iyeneben sakvebad, amavdroulad ki,am saxeobis dezinfeqtantis mimarT gamoimuSavebenrezistentulobas. neitralurianolitis gamoyenebis SemTxvevaSiobieqtze ar rCeba moqmedi nivTierebebisaraviTari kvali (garda natriumis qloridisumniSvnelo mikroskopiuli moculobisa),rac gamoricxavs yovelgvar Sesa-Zleblobas mikroorganizmebis adaptaciisanarCen, moqmed nivTierebebTan da misidegradaciis produqtebTan.aqtivizebuli xsnari, relaqsaciisSemdgom periodSi, kargavs madezinficebelTvisebebs da degradirdeba odnavmarilian wylad, romelic araviTar safrTxesar uqmnis garemos da misi ganeitralebisan utilizaciisTvis araviTaridamatebiTi RonisZiebis gatareba saWiroar aris. aRniSnulidan gamomdinare,mravali sadezinfeqcio saSualebisagangansxvavebiT, misi gamoyeneba SesaZlebelianebismieri kategoriis gruntis,rogorc zedapiruli, aseve siRrmuli (cxovelTasamarxebi da zoonozuri infeqciebissxva kerebi) damuSavebisTvis,maT Soris Cveulebrivi da mineraluriwylebis formirebis zonaSi.anolits iyeneben ganzavebis gareSe,erTjeradad. anolitiT gausnebovnebaSeiZleba Catardes sveli wesiT gawmendis,dasvelebis, Sesxurebis, Cayursvis, aerozolurigafrqvevisa da siTxeSi ganzavebismeTodiT.

28miuxedavad imisa, rom preparatSi aqtiuradmoqmedi nivTierebebis minimalurikoncentraciaa, mas gaaCnia maRali madezinficebeli(viruliciduri, baqtericiduli,fungiciduri, tuberkuloziciduri,sporociduli) efeqti mikroorganizmebisyvela jgufisa da formis _ adamianisyvela cnobili paTogenuri virusebis(maT Soris enteruli da parenterulihepatitebi), aiv, poliomelitis, adenovirusis,adamianisa da frinvelis gripis(H5N1), atipuri pnevmoniis (SARS), herpesisada sxv. mimarT.saqarTvelos Sromis, janmrTelobisada socialuri dacvis saministrosl. sayvareliZis saxelobis daavadebaTakontrolisa da samedicino statistikiserovnuli centris, g. naTaZis saxelobissanitariisa da higienis samecniero-kvleviTiinstitutis, infeqciuri paTologiis,Sidsisa da klinikuri imunologiissamecniero-praqtikuli centris, Tbilisismeriis saxelmwifo sanitariuli zedamxedvelobisinspeqciis baqteriologiurilaboratoriisa da sxva kompetenturi organizaciebisSesabamis laboratoriebSiCatarebuli gamokvlevebisa da praqtikuladganxorcielebuli proeqtebis SedegebissafuZvelze, araerTxel dadasturdawarmodgenili teqnologiis upiratesiefeqti sxva cnobil meTodebTan SedarebiT,rogorc efeqturobis, adamianis janmrTelobisada garemos mimarT usafrTxoebis,aseve gamoyenebis praqtikulobisa daekonomikurobis TvalsazrisiT:1. l. sayvareliZis saxelobis daavadebaTakontrolisa da samedicino statistikiserovnuli centris gansakuTrebiTsaSiSi, zoonozuri da anaerobuli infeqciebislaboratoriaSi jilexis gamomwvevsporebze neitraluri anolitiszemoqmedebis pirveli kvlevis SedegebiT(cxrili 1);2. Tbilisis meriis saxelmwifo sanitariulizedamxedvelobis inspeqciis baqteriologiurlaboratoriaSi miRebulicxrili 1jilexis gamomwvev sporebze neitraluri anolitiszemoqmedebis Seswavlis Sedegebi# garemo eqspozicia1. xorcpept oniani bul ioni2. fiziol ogiuri xsnari3. onkanis wyal isporebis konc.1 ml . siTxeSi10 3 10 5 10 6 10 75 wT _ 1 8 3430 wT _ _ _ _60 wT _ _ _ _5 wT _ _ _ 630 wT _ _ _ _60 wT _ _ _ _5 wT _ 1 _ 3830 wT _ _ _ _60 wT _ _ _ _SeniSvna: aqtivizebuli xsnariT SesaZlebelia jilexisgamomwvevi sporebis wamebSi (1 wuTamde) ganadgureba.aqtivizebuli xsnarebiT gausnebovnebuli,Sidsisa da klinikuri imunologiissamecniero-praqtikuli centris Camdinarewylis (modeluri da saeqspluatacioreJimi) mikrobiologiuri gamokvlevisSedegebiT. standartul kvlevebSi,saeqspluatacio reJimSi damuSavebisasefeqturobam Seadgina 99,9999% (sacdeliwylis koli-indeqsi Seadgenda >238 000 000,damuSavebis Semdeg

29li centris teqnologiiT gausnebovnebuli,paTogenuri mikroorganizmebiT gabinZurebuli,erT-erTi korpusis Camdinarewylis mikrobiologiuri gamokvleva(cxrili 2);4. g. naTaZis saxelobis sanitariisa dahigienis samecniero-kvleviTi institutissanitariuli baqteriologiis, wylishigienisa da wyalsatevebis sanitariulidacvis laboratoriaSi 2006 wlis 18-21noembers Catarda aqtivizebuli xsnariTdamuSavebuli sasmeli wylis laboratoriuligamokvleva. mogvyavs daskvna aRniSnuligamokvlevis higienuri Sefasebidan:cxrili 2sakvlevi wylis mikrobiologiuri gamokvlevis Sedegi# maCvenebl ebi kont rol iproporcia(xsnari : wyal i)1 : 502 saaTisSemdeg1 saaTisSemdegproporcia(xsnari :wyal i)1 : 1002 saaTisSemdeg1 saaTisSemdeg1 mezofil uri aerobebis dafakul t at uri anaerobebis 32 000 0 0 0 0raodenoba 1 sm 32 kol i-indeqsi 240 000 0 0 0 03 Salmonella, 1dm 34 Staphylococcus aureus, 1 dm 35 St. faccalis, 1dm 312 000 0 0 0 012 000 0 0 0 014 000 0 0 0 06 Pseudomonas aeroginosa, 1dm 3 24 000 0 0 0 07 CL. Perfringens, 1 dm 320 000 0 0 0 0mikrobiologiuri gamokvlevis oqmi04 aprili 2006 w. Tbilisigamokvlevis mizanisaqarTvelos sainJinro akademiis samecniero-teqnikuri centris winadadebiTa daSesabamisi werilis (#01-19/61, 18.02.2006 w.) safuZvelze, infeqciuri paTologiis, Sidsisada klinikuri imunologiis samecniero-praqtikuli centris baqteriologiurlaboratoriaSi (28.03÷31.03.2006 w.) Catarda dawesebulebis sxvadasxva ganyofilebidan(reanimacia da mimRebi) aRebuli, paTogenuri mikrobebiT kontaminebuli (gabinZurebuli),sagnebisa (sasagne mina, sinjara, momWeri, makrateli, Tirkmela) da sinjis (avadmyofisgasasinji taxtis zedapiri) mikrobiologiuri gamokvleva.sadezinfeqcio, winasasterilizacio da sasterilizacio saSualebad gamoyenebuliiyo saqarTvelos sainJinro akademiis samecniero-teqnikuri centris mier adgilzewarmoebuli xsnari (neitraluri anoliti), instruqciis Sesabamisad.gamokvlevebi Catarda warmodgenili teqnologiisa da xsnaris gamoyenebis Tvalwarmodgenilimasalisa da laboratoriuligamokvlevis faqtobriv monacemebzedayrdnobiT dadasturda, rom sasmeliwylis damuSavebis aRniSnul meTods,rogorc teqnologiur siaxles, dezinfeqciissxva tradiciul da cnobil me-TodebTan SedarebiT, aqvs mravalmxriviupiratesoba rogorc efeqturobis, asevepraqtikulobis TvalsazrisiT. damuSavebuliwyali sruliad Seesabameba sasmeliwylis xarisxze arsebul normatiul moTxovnebsda mizanSewonilia mowodebulimeTodis gamoyeneba sasmeli wylis sadezinfeqciodrogorc centraluri wyalmomaragebissadgurebSi, aseve dasaxlebulipunqtebis wyalmomaragebis saTave da sxvateqnikur nagebobebSi.5. infeqciuri paTologiis, Sidsisa daklinikuri imunologiis samecnieropraqtikulicentris baqteriologiurlaboratoriaSi (28.03÷31.03.2006 w.) Catardaadgilze warmoebuli neitraluri anolitiTdamuSavebuli samedicino daniSnulebissxvadasxva sagnis mikrobiologiurigamokvleva. mogvyavs gamokvlevisCatarebis oqmi.

30sazrisiT praqtikulobis, adamianis janmrTelobisaTvis usafrTxoebisa da efeqturobissxva meTodebTan Sedarebis, personalisTvis meTodikis gacnobisa da organizaciaSimisi farTod danergvis mizniT.gamokvlevebis Sedegebi1. dawesebulebaSi Catarebuli laboratoriuli gamokvlevebis Sedegad dadginda,rom adgilze warmoebul xsnars (neitraluri anoliti) gaaCnia paTogenuri mikroorganizmebissruli biologiuri gausnebovnebis uaRresad maRali efeqturoba da far-To speqtri;2. gamoyenebis TvalsazrisiT, warmodgenili meTodi uaRresad praqtikulia, vinaidan,misi gamoyeneba da Senaxva ar saWiroebs gansakuTrebul pirobebs (individuri damcavisaSualebebi; qimiurad saSiSi da feTqebadi nivTierebis Senaxvasa da gamoyenebazemoTxovnebis uzrunvelyofa da sxv.), yvela procedurisaTvis (dezinfeqcia, winasasterilizaciogawmenda, sterilizacia da sxv.) saWiroa mxolod erTi dasaxelebisproduqcia.daskvna: zemoaRniSnulidan gamomdinare, migvaCnia, rom adamianis janmrTelobisada garemos mimarT usafrTxo, efeqturi da gamoyenebis TvalsazrisiT praqtikulisarecxi, sadezinfeqcio da sasterilizacio xsnarebis gamoyeneba (im garemoebisgaTvaliswinebiTac, rom misi saWiro raodenobiT warmoeba SesaZlebeli iqneba adgilze),xels Seuwyobs dawesebulebaSi normatiuli moTxovnebis Sesabamisi sanitariul-epidemiologiuripirobebis uzrunvelyofas da mniSvnelovan ekonomikur efeqts.dasaxeleba,mwarmoebeliqveyanaanoliti (saqarTvelo)natriumis hipoqloriti (ruseTi)anolitis SedarebiTi daxasiaTebasamuSao xsnariskoncentracia,%(grafikuladnaCvenebiakoncentraciebisTanafardoba)0,01-0,050,1-0,5antimikrobulimoqmedebisdaxasiaTebabaqteriebimikobaqteriebivirusebisokoebisporebialergiulobadatoqsikuroba:klasiГОСТ 12.1.007-76-ismixedviT(gdafikuladnaCvenebiatoqsikurobisdonis maCveneblebi)sadezinfeqcio da sarecxiTvisebebis Tavsebadobamikroorganizmebis xsnarebTanSeCveva(adaptacia)+ + + + + IV gaaCnia ar gaaCnia+ + + + _ IV ar gaaCnia gaaCniacxrili 3erTi litrisamuSao xsnarisRirebuleba(grafikuladnaCvenebiafasebisTanafardoba)presepti (aSS)qloramini (ruseTi)qlorgeqsidinabigl ukonati(ruseTi)0.51,0-3,00,5-0,4+ + + _ _ III ar gaaCnia gaaCnia+ + + + _ IV ar gaaCnia gaaCnia+ + + _ _ IV ar gaaCnia gaaCnia"lizoformin-speciali"(Sveicaria)0,5-0,4 + _ + _ _ III ar gaaCnia gaaCnia"virkon КРКА"(sl ovakeTi) 0,5-2.0 + _ + _ _ III gaaCnia gaaCnia"lizetol-АФ"(germania) 2,0-5,0 + + + + _ III gaaCnia gaaCnia"saideqsi"(aSS)2.0 + + + + + III ar gaaCnia gaaCnia"kold-spori"(aSS)2.0 + + + + + IV ar gaaCnia gaaCnia"dekoneqs 50ФФ"(Sveicaria) 0,5-4,0 + + + _ _ III gaaCnia gaaCniaSeniSvna: anolitis elementuri qimiuri Semadgenloba mtknari an marilis susti wyalxsnarisekvivalenturia. anolitis moqmedi nivTierebebia qlorJangbadovani da hidroperoqsidurioqsidantebi metastabilur mdgomareobaSi koncentraciiT ara umetes 0,05%.

31xsnarebis gamoyeneba gaTvaliswinebulia:1. sasmeli wylis gausnebovnebisTvisrogorc centraluri, aseve adgilobriviwyalmomaragebis sistemebSi, sainJinroteqnikurnagebobebsa da savele pirobeb-Si; 2. bioteroristuli aqtebisa da sxvaepidsituaciebis dros; 3. samedicinodawesebulebebSi sarecxi, sadezinfeqcioda sasterilizacio samuSaoebis Casatareblad(maT Soris samedicino daniSnulebisxelsawyo-iaraRebis, qirurgiuli instrumentebisada sxv.); 4. infeqciuriprofilis (maT Soris fTiziatriuli)dawesebulebebis, qalaqebis, dasaxlebulipunqtebisa da sxva konkretuliobieqtebis sayofacxovrebo-sameurneodaniSnulebis Camdinare wylebis gausnebovnebisaTvis,maT Soris sakurortozonebSi; 5. infeqciuri daavadebebiskerebsa da riskis zonebSi (maT Sorisjilexisa da tuberkulozis stacionarulkerebSi) sadezifenqcio saSualebebad;6. sayofacxovrebo daniSnulebis obieqtebSi(saparikmaxeroebi, salonebi, abanoebi,sauna, samrecxaoebi da sxv.) nagebobis,xelsawyo-iaraRebis sterilizaciisa dasadezinfeqcio samuSaoebis sawarmoeblad;7. bazrobebis, satransporto kvan-Zebis, miwisqveSa gadasasvlelebis, sacuraoauzebis, sanitariuli kvanZebis, nagavsayrelebisada sxva daniSnulebisobieqtebsa da teritoriaze sadezinfeqciosamuSaoebis sawarmoeblad; 8. sasazRvrogamSveb punqtebze sadezinfeqcio samuSaoebissawarmoeblad; 9. bavSvTa da moxucTasaxlebSi, skolebSi, sxvadasxva organizebuldawesebulebebSi; 10. penitencialurida Tavdacvis sistemis dawesebulebebSi;11. kvebis mrewvelobis sistema-Si (sarealizacio qseli, sazkvebis obieqtebi,rZis, xorcis, xilis, bostneulisa da sxv.daniSnulebis gadasamuSavebeli sawarmoebi)nagebobis, teqnologiuri danadgarebis,WurWlis, inventaris, taris, SesafuTimasalebis, satransporto saSualebebis,sasawyobo da samacivro saTavsebis dezinfeqciisada sterilizaciis mizniT; 12. memcenareobaSi;13. mecxoveleobisa da mefrinveleobiskompleqsebSi; 14. mefutkreoba-Si da sxv.ganvlil periodSi, warmodgenili teqnologiebisdanergvis sakiTxi jandacvissaministros garda, ganxiluli iyo,saqarTvelos garemos dacvisa da bunebriviresursebis, soflis meurneobis,ekonomikuri ganviTarebis, Tavdacvisa daSinagan saqmeTa saministroebSi, parlamentisgaremos dacvisa da bunebrivisuraTi 1 suraTi 2resursebis, soflis meurneobisa daagrarul sakiTxTa komitetebSi, saqarTvelosmecnierebaTa da sainJinro akademiisprezidiumebis, arasamTavroboseq-torisa da dargiT dainteresebulsxva (maT Soris aWaris avtonomiuri respublikis)kompetenturi uwyebebisa daorganizaciebis mier. miRebul daskvneb-Si gamoTqmulia sruli mxardaWera aRniSnuliteqnologiebis gamoyenebisa da far-To gavrcelebisadmi.teqnologiuri sistemebi danergilia:1. TbilisSi, infeqciuri paTologiis,Sidsisa da klinikuri imunologiis samecniero-praqtikulcentrSi, naxmari, Camdinarewylebis gausnebovnebis, organizaciaSisarecxi, sadezinfeqcio da sasterilizaciosamuSaoebis warmoebisTvis (suraTi 1);2. aWaris sakurorto zonis arakanalizebulteritoriaze, sofel kvariaTSimdebare 63_biniani sacxovrebeli saxlisgamwmend nagebobaSi, zRvaSi Camdinare

32wylebis normatiul moTxovnamde gausnebovnebisTvis;3. saqarTvelos Sinagan saqmeTa saministrossagangebo situaciebis marTvisdepartamentSi (suraTi 2) piradi SemadgenlobisqmediTunarianobis amaRlebismizniT, sagangebo situaciebisa da bioteroristuliaqtebis dros, agreTve, biologiuriusafrTxoebis sferoSi saer-TaSoriso TanamSromlobisas, rasac mxarsuWeren amerikeli eqspertebic;4. saqarTvelos iusticiis saministrossasjelaRsrulebisa da probaciis saswavlocentrSi aqtivizebuli xsnarebis adgilzesawarmoeblad sadezinfeqcio samuSaoebisCatarebisa da sasmeli wylis gausnebovnebismizniT (suraTi 3).5. aWaris avtonomiuri respublikissofel zeda axalSenis wyalsadenis reabilitaciisproeqti (wyalsadenis nagebobisdezinfeqcia da sasmeli wylis gausnebovnebaqlorirebis meTodis sanacvlod);6. tuberkulozis samkurnalo erov-nulcentrSi, Camdinare wylebis gausnebovnebisTvis;7. q. baTumis meriis #19 bavSvTa baRSi,rezervuarSi dagrovili sasmeli wylisgausnebovnebisa da sadezinfeqcio samuSaoebisCasatareblad (suraTi 4);8. aWaris avtonomiuri respublikiswminda samebis dedaTa monasterSi, Camdinarewylebis gausnebovnebis mizniT;zemoaRniSnulis safuZvelze, warmodgeniliaxali samecniero-teqnikuri mimasuraTi3 suraTi 4rTulebis ideologiidan da universalurobidangamomdinare, misi gamoyenebaqveyanaSi adamianis janmrTelobisa dagaremos usafrTxo sanitariul-epidemiologiuripirobebis uzrunvelyofisaTvis,maT Soris bioteroristuli aqtebis,frinvelis gripis mosalodneli pandemiisaTu sxva biologiuri xasiaTis sagangebosituaciebis aRmocenebis dros,SesaZleblobas mogvcems, qveynis masStabiT,maqsimalurad efeqturad da sayovelTaodxelmisawvdomi formiT, ganvaxorcieloTprevenciuli RonisZiebada Tavidan aviciloT sirTuleebTandakavSirebuli im samuSaoebis Catareba,romelic aucilebelia tradiciuli meTodis(mdgradi, arabunebrivi qimiurinaerTebis bazaze damzadebuli sadezinfeqciopreparatebi) gamoyenebis SemTxvevaSi,kerZod:1. sadezinfeqcio saSualebis importi (sa-SiSi qimiuri nivTierebis transportireba);2. sarezervo maragis Senaxva (saSiSi qimiurinivTierebisaTvis saWiro pirobebisuzrunvelyofa);3. saSiSi qimiuri nivTierebis moxmarebisadgilze transportireba;4. samuSao sadezinfeqcio xsnaris momzadebada gamoyeneba mxolod specialistebismier;5. sarezervo maragis periodulad Sevsebaan sawyisi kapitaldabandebis gazrda sadezinfeqciosaSualebis winaswargansazRvrulimoculobis erTjeradi SeZenisaTvis;6. sadezinfeqcio saSualebis Senaxvisvadis gasvlis Semdeg misi utilizeba.aRniSnuli teqnologiiT dasaxuli amocanisgadasawyvetad, uaRresad efeqturi, adamianisjanmrTelobisa da garemos mimarTusafrTxo, iafi, martivi da sayovelTaod xelmisawvdomi,saWiro moculobis sadezinfeqcioxsnarebis warmoeba SesaZlebeli iqnebamoxmarebis adgilze qveynis nebismier teritoriaze(maT Soris savele pirobebSi).

33danadgaris eqspluataciisTvis saWiroaeleqtroenergiis mcire xarji da nebismierisaxis denis wyaros gamoyeneba.xsnarebis sawarmoo teqnologiuri sistemismowyoba SesaZlebelia rogorc kapitalur,aseve nebismieri saxis droebiTnagebobaSi (maT Soris karavSi). modifikaciismixedviT, danadgaris ganTavsebaSesaZlebelia rogorc kedelsa da magidaze,aseve satransporto saSualebebze,risTvisac sakmarisia 1 m 2 farTobi.xsnarebis Senaxvis limitirebuli vadasporovani formebisaTvis 3-5 dRea, magramvegetaturis mimarT madezinficebelTvisebebs inarCunebs da gamoyeneba Sesa-Zlebelia 10 da meti dRis ganmavlobaSi.xsnarebis usafrTxoebidan da gamoyenebispraqtikulobidan gamomdinare, sadezinfeqciodaniSnulebiT misi gamoyenebaSesaZlebelia kerZo seqtorSi, individurad,maRali kvalifikaciis specialistebisgareSe. faqtiurad, es imas niSnavs, romiqmneba realuri SesaZlebloba, eqstremalursituaciasa Tu sxva SemTxvevebSi,problemis praqtikul gadawyvetaSi Caer-Tos ara marto Sesabamisi profilis organizaciebi,aramed mosaxleobac farTo mas-StabiT. rac Seexaba xsnarebiT organizebulibrigadebisa Tu kerZo seqtorisuzrunvelyofas, misi gadawyveta martivia,radganac, rogorc aRvniSneT, sakmarisiaqveynis nebismier regionSi, raionulcentrSi Tu sofelSi, ramdenime saaTSimovawyoT originaluri teqnologiurisistema, romliTac adgilze SesaZlebaliiqneba saWiro raodenobis preparatis warmoeba,romliTac SeiZleba individuradmomaragdes adgilobrivi mosaxleobac.Tu gaviTvaliswinebT zemoaRniSnul dasxva faqtorebs, epidemiisa Tu pandemiisSemTxvevaSi, warmodgenili teqnologiisgamoyenebiT miRebuli efeqti (maT Sorisekonomikuri) Zalze soliduri iqneba.saqarTvelos Sromis, janmrTelobisada socialuri dacvis saministros,agreTve, sxva kompetenturi organizaciebisSesabamis samecniero-kvleviTcentrebSi Catarebuli laboratoriuligamokvlevebis Sedegebisa da Cven mierwarmodgenili masalebis safuZvelze,2004 wlis dekemberSi, saqarTvelos Sromis,janmrTelobisa da socialuri dacvissaministros saxelmwifo sanitariulizedamxedvelobis inspeqciis mier moxdaeleqtroqimiuri aqtivaciis teqnologiisaRiareba da mis praqtikul gamoyenebasada danergvaze gaica dadebiTi higienuridaskvna.saqarTvelos Sromis, janmrTelobisada socialuri dacvis ministris 2006wlis 7 agvistos #217/n brZanebiT,saqarTvelos sainJinro akademiis samecniero-teqnikuricentris miersaqarTveloSi warmoebuli aqtivizebulixsnari “neitraluri anoliti” #59 punqtiTdaemata saqarTvelos Sromis, janmrTelobisada socialuri dacvis ministris#64/n brZanebiT damtkicebul sadezinfeqciosaSualebebis nusxas.damuSavebuli da reglamentebulia neitralurianolitis gamoyenebis meTodurimiTiTebebi.teqnologiuri danadgarebi da mis mierwarmoebuli aqtivizebuli xsnarebisgamoyenebis meToduri miTiTebebi SetaniliasaqarTvelos standartebisa da teqnikurireglamentebis saxelmwifo reestrSi.aqve xazgasmiT unda aRvniSnoT, rom aqtivizebulixsnaris usafrTxoeba da efeqturobamxolod im SemTxvevaSi iqneba garantirebuli,roca mas awarmoeben am dargismaRalkvalificiuri (uflebamosili)specialistebi an maT mier momzadebulikadrebi, mxolod originaluri teqnologiuridanadgarebisa da sistemebisgamoyenebiT.migvaCnia, rom warmodgenili axali,progresuli samecniero-teqnikuri mimarTulebisada teqnologiis farTod danergvaxels Seuwyobs da mniSvnelovanrols Seasrulebs adamianis janmrTelobisada garemos usafrTxo, TanamedrovemoTxovnebis Sesabamisi sanitariulhigienurida epidemiologiuri pirobebisuzrunvelyofaSi.3. saqarTvelos samedicino Jurnali, 2, 2008 w.

34ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ МОЮЩИХ,ДЕЗИНФЕКЦИОННЫХ И СТЕРИЛИЗАЦИОННЫХ РАСТВОРОВ,ПОЛУЧЕННЫХ ОРИГИНАЛЬНЫМИ ЭЛЕКТРОХИМИЧЕСКИМИУСТАНОВКАМИ И ТЕХНОЛОГИЧЕСКИМИ СИСТЕМАМИНАУЧНО-ТЕХНИЧЕСКИЙ ЦЕНТР ИНЖЕНЕРНОЙ АКАДЕМИИ ГРУЗИИТ. ЦецхладзеВ современном мире создание благоприятных санитарно-гигиенических и эпидемиологическихусловий для жизни и здоровья человека по многим причинам (природные катаклизмы, дефициткачественной питьевой воды, этнические и региональные конфликты, чрезвычайные ситуации,биотеррористические акты, положительное влияние на микроорганизмы ожидаемого глобальногопотепления и др.) становится всё более актуальным, и решение этой задачи является приоритетнымдля любого государства.Этот вопрос очень важен и для Грузии, что, в частности, обусловлено трудностями современногопереходного периода.Министерством труда, социальной защиты и здравоохранения Грузии рассмотрены наши предложенияпо вопросу внедрения новых научно-технических достижений, принципов и методов, обеспечениябезопасной для здоровья человека окружающей среды, в том числе обработки питьевой и сточных вод.Преимущество представленных новых технологий, в сравнении с другими методами, кромеэффективности, состоит также в практичности их применения. Химические растворы, производимыепо данной технологии, экологически безопасны и их получение возможно в любое время, в том числе вполевых условиях. Технология прошла соответствующую экспертизу, одобрена законодательнымиорганами Грузии и сертифицирована.На основании результатов наших исследовании считаем целесообразным внедрение этой технологиис целью обеспечения безопасности окружающей среды.Широкое внедрение технологии, имеет также и стратегическое значение, так как её применениепозволит создать реальную возможность замены метода хлорирования безопасным, эффективным идешевым альтернативным методом.Министерством труда, социальной защиты и здравоохранения Грузии издан ряд законодательныхактов и рекомендаций по внедрению технологического новшества, представленного «Научно-техническимцентром» Инженерной академии Грузии, полностью поддерживающих необходимость широкого внедренияпредставленных технологий, как для высококачественной обработки питьевых и бытовых сточных вод,так и с целью обеспечения безопасной для здоровья человека окружающей среды.Естественно, безопасность и эффективность активированных растворов будет гарантирована тольков случае их производства высококвалифицированными (уполномоченными) специалистами отрасли илиспециально подготовленными ими кадрами.Считаем, что широкое внедрение в стране представленных новых прогрессивных научно-техническихнаправлений и технологий в значительной степени будет способствовать обеспечению безопасных дляздоровья человека и окружающей среды санитарно-гигиенических и эпидемиологических условий,соответствующих современным требованиям.EFFECTIVENESS AND SAFETY OF DETERGENT DISINFECTION ANDSTERILIZATION SOLUTION PRODUCED WITH ORIGINALELECTROCHEMICAL EQUIPMENT AND TECHNOLOGICAL SYSTEMST.TsetskhladzeIn contemporary world the creation of beneficial sanitary-hygienic and epidemiologic conditions for publiclife and health due to numerous causes (including natural cataclysms, deficiency of high-quality potable water,ethnic and regional conflicts, emergency situations, bioterroristic acts, positive effect of prospective global warmingon micro organisms, etc.) becomes actual day by day and its solution is a priority problem for any country.

35This problem is also very urgent for Georgia and is stipulated with the difficulties of the transient period in thecountry.The Ministry of Labor, Social Protection and Public Health of Georgia has considered our proposals on theproblem of implementation of absolutely new scientific-technical achievements, principles and methods with thepurpose to ensure safety environment for people.The advantage of the presented new technologies compared to other methods is their effectiveness, as wellas, practicity in usage. Chemical solutions received by the given technology are ecologically safe and theirproduction is available at any time, including field conditions. The technology has all permissions necessary forusing. It is approbated and certified.With the account of the above said we think advisable to implement new technology with the aim to ensuresafe environment.Besides solution of the problem according to modern requirements, the wide implementation of the technologygets a strategic importance as in case of its using in the country there occurs a real possibility of substitutionof chlorination method with safe, effective and inexpensive alternative method.The Ministry of Labor, Social Protection and Public Health of Georgia has given several recommendationson introduction of technological novelty presented by “Scientific-technical Center” of Engineering Academy ofGeorgia and entirely supports the necessity of wide implementation of technologies presented by “ScientifictechnicalCenter” of Engineering Academy of Georgia for high quality treatment of potable and everyday wastewater,as well as with the purpose of ensuring of safety environment for health care of population.Here it should be underlined that safety and effectiveness of activated solution will be guaranteed only in thecase when it is produced by the specialists highly qualified in this sphere or the staff trained by them, using onlyoriginal technological equipment and systems.We presume that wide implementation of the presented new progressive scientific-technological directionand technology in the country will promote and play important role in provision of safe sanitary-hygienic andepidemiological conditions corresponding to modern demands respective human health and environment.literatura1. saqarTvelos garemos higienis samoqmedo erovnuli gegma _ ”garemo da janmrTeloba“.Tbilisi, 2003. _ 85-87gv.2. Шандала М.Г. / В кн. Актуальные проблемы дезинфектологии в профилактике инфекционных ипаразитарных заболеваний. – М.: ИТАР-ТАССБ 2002 - С. 9-16.3. Евплов В.И. Дезинфекция и стерилизация в лечебном учреждении. – Ростов-на-Дону: Феникс,2003. – С 124-125.4. Горячкин Б., Ярмак Н.//Мед. алфавит. – 2002. №11. – С. 24.

36medicinis istoriasaqarTvelos wylis resursebis sistemuriSeswavlis aucilebloba - robert kupcisisgamocdileba da Rvawlir. iakobiZe, i. CinCalaZesaqarTveloSi latvielTa sazogadoeba ‘Ave Sol~(recenzenti - prfesori r. Sengelia)diplomirebuli provizoris, misiudidebulesoba ruseTis imperator nikolozmeoris xeldasxmiT, 1908 wels TbilisSikavkasiis saeqsperto qimiuri laboratoriisdireqtoris Tanamdebobazemivlinebuli robert kupcisis cxovrebisada moRvaweobis Seswavlisas, kideverTxel davrwmundiT: Tanamedrove istoriografiisumTavresi principis, ‘istoriiskvlevis sagania ara is, Tu odesmerame momxdara, aramed is Tu rogori mniSvnelobaaqvs warsuls dRevandelobisaRmSeneblobaSi~, cxovelmyofelobaSi,Zveli berZnuli filosofiis mrwamsSi,rom gacnobierebuli warsuli dRevandelobisnawilia, misi qvakuTxedia, ‘rac iyo~imis codna gasaRebia ‘rac iqneba~ imisgasagebad.kvlevis dasawyis-Si Cveni mizani iyoSegveswavlasaqarTveloSi moRvaweeTnikurilatvieli mecnierisada pedagogissaqmianoba dagagverkvia misi mniSvnelobada rolilatvieli darobert kupcisis pirovnebis damaxasiaTebeliais, rom 1881 wels latviaSi,valkis uezdis mivardnil xutorSi, dabadebulmaglexis biWma miiRo umaRlesiakademiuri ganaTleba da daqorwindaprivilegiuri socialuri fenis warmomadgenelze.karieris TvalsazrisiT igi1908 wels saTaveSi Caudga saeqsperto-qimiursamsaxurs da sicocxlis bolomdexelmZRvanelobda mas, man kvleviTi saqmianobawarmarTa jer mTeli kavkasiis mas-StabiT, 1917 wlis revoluciis Semdeg ki _mTel saqaTveloSi.r. kupcisis xelmZRvanelobiT saqarTvelo-Si daarsda sasamarTlo eqspertizis laboratoria,sadac misi uSualo monawilerobertkupcisiqarTveli xalxisurTierTobebSi,raTa dRevandel informaciisnakadeb-Si ar gafantuliyoerTa Soris Tanam-Sromlobis mniSvnelovani furceli. arcqarTvel, da arc latviel xalxs ar hyavTdasakargi adamianebi, miT ufro, rom am patarasuverenuli saxelmwifoebis istoriuliTanamSromloba da urTierTpativiscemapirovnul gamoxatulebas efuZneba.gamokvleviT dadginda, rom ruseTiaponiisomis monawilem, robert kupcisma,tartus universitetis damTavrebisSemdeg, umaRlesi ganaTleba miiRo yazanisuniversitet-Si. colad Seir-To holandiuriwarmoSobis rusTavadTa STamomavalisofiagerkeni da mefissamsaxurSi CamdgariTbilisSirobert kupcisisdasaxlda. aqSeeZina mas samiSvili, SemdegSiSviliSvilebi dasaqarTvelos daqarTveli xalxissamsaxurSiRvawlmosiligardaicvala1954 wels, dasaflavebuliakukiissasaflaoze.

37obiT, warmoebda sasmeli, Termuli da mineraluriwylebis farmako-qimiuri analizi.man samecniero brunvaSi Seiyvana eqsploatirebulisasmeli da mineraluriwylebis umetesoba. amJamad r. kupcismapiradad gamoikvlia saqarTvelos 1000meti wyaro, aqedan 800 pirvelad. aseTidauRalavi Sromis Sedegad man moaxdinasaqarTvelos istoriaSi pirvelad mineraluriwylebis sistematizacia. maSindelifarmacevtikis ganviTarebis donidan gamomdinare,mineraluri wylebi sistematizdeboda8 jgufad. robert kupcismadaalaga saqarTvelos mineraluri wylebiaRniSnuli jgufebis mixedviT dadaaskvna, rom saqarTveloSi aris msoflioSicnobili yvela saxis wyali, gardadariSxaniani wylebisa da gamoTqva varaudiSovis maxloblad aseTi wylis aRmoCenisSesaZleblobaze.kupcisis samecniero interesebi arSemoifargleboda mxolod wylis samkurnaloTvisebebis kvleviT. is, rogorcsasamarTlo eqspertizis fuZemdebeli,saqarTveloSi sisxlsac ikvlevda. misigamokvleva ‘sisxlis saxeobebis SedarebasasamarTlo medicinis TvalsazrisiT~qrestomaTiuli xasiaTisaa da ‘kupcisisefeqtis~ saxeliT Sevida sasamarTloqimiis saxelmZRvaneloebSi.jerjerobiT mikvleulia misi 61 naSromi.r. kupcisis mecnieruli memkvidreobisZiebas ori ram abrkolebs. erTi is,rom naSromebi qveyndeboda specialursamedicino periodul gamocemebSi da meore- dRevandeli saarqivo masalebisaqarTveloSi metad rTul mdgomareoba-Sia. aseTi vaJkacuri da Tavdadebuli Sromagaxda, albaT, imis piroba, rom robertkupcisi gadaurCa komunistur represiebs,romlebic permanentulad xorcieldebodasaqarTveloSi 1924 wlidan 1954 wlisCaTvliT. misi saqmisadmi siyvarulma,tolerantobam da umaRlesma profesionalizmmaSeaZlebina erTnairi warmatebiTeSroma mefis ruseTis, damoukidebelisaqarTvelosa da komunisturi okupaciisperiodebSi. man aRzarda saqarTvelosprofesiuli qarTveli kadrebi. aswavlidaTbilisis saxelmwifo samedicino institutSi.yovelive amis gamo, disertaciisdaucvelad, mianiWes medicinis mecnierebaTakandidatis xarisxi (sxva ufleba adgilobrivsamecniero sabWos ar hqonda,doqtoris samecniero xarisxs aniWebdamxolod moskovi).informaciis Tanamedrove maTematikuriTeoria ganmartavs, rom informaciaaris faqtebs plius maTi mniSvneloba.axla, rodesac Cven movaxdineT robertkupcisis cxovrebisa da moRvaweobisumTavresi faqtebis konstantacia, aucilebeliavimsjeloT maT mniSvnelobaze.Cvens xelT arsebuli faqtebis zedapiruliganxilvac ki gviCvenebs, rom mas gaaCniamravali da gansxvavebuli mniSvneloba.kerZod, isini SesaZleblobas iZlevavimsjeloT robert kupcisze, rogorcmecnier-pedagogze, rogorc qarTveli dalatvieli xalxis megobrobisa da Tanam-Sromlobis kerZo istoriul magaliTze,rogorc kvalificiuri kadrebis migraciisspecifikur SemTxvevaze da a.S. robertkupcisma mravalmxrivi da Rrma kvali datovaCvens uaxloes istoriaSi. migvaCnia,rom dRevandeli Cveni sazogadoebriviganviTarebis problemebidan gamomdinare,uaRresad aqtualuria robert kupcisismemkvidreobis Seswavla saqarTveloSi wylisresursebis kvlevisa da msoflio sasmelida samkurnalo wylebis bazaze,saqarTvelos monawileobis TvalsazrisiT.msoflio globalur gamowvevaTaSoris erT-erTi umTavresi problema,romelic wamoiWra erovnuli saxelmwifoebiswinaSe, esaa mdgradi ganviTarebisaucilebloba. mastrixtis konferenciisganmartebiT, mdgradi iseTi ganviTarebaa,romelic ar uzRudavs ganviTarebissaSualebas momaval Taobas, magram mTelisimZafriT dgeba bunebrivi, ara ganaxlebadiresursebis pasuxismgebluri gamoyenebisaucilebloba. dReisaTvis msofrobertkupcisis SviliSvilebi:irana kupcisi da igor parastaevi saqarTveloslatvielTa sazogadoebaSi

38lios 6 miliardze meti mosaxleobidan 3miliardisTvis deficitia janmrTeli,xarisxiani sasmeli wyali, 2,5 miliardi kicxovrobs dabalnayofier da unayofo miwebze,3,5 miliardi sunTqavs normazemetad dabinZurebul haers, 3 miliardisdRiuri Semosavali aris 1 aSS dolarzenaklebi. am monacemebze dayrdnobiT,msoflios banki mouwodebs suverenulsaxelmwifoTa mesveurebs, rom maqsimaluradekonomiurad da efeqturad gamoiyenonmaT gankargulebaSi arsebuliresursebi. magram friad samwuxaroa, rommsoflios bankisa da sxva saerTaSorisoorganizaciaTa mowodebebi, romlebicemyarebian fundamentalur mecnierulgamokvlevebs, rCeba ‘xmad mRaRadeblisaudabnosa Sina~.cnobilia, rom saqarTvelo wylisresursebis raodenobiTa da mravalferovnebiTmsoflioSi erT-erTi umdidresiqveyanaa, magram Zalian samwuxaroa ismefis xelisufleba mniSvnelobas aniWebdasamkurnalo wylebs, radganac amresursis aTvisebaSi xedavda sazRvargareTsamkurnalod migrirebuli mosaxleobismier gaweuli xarjebis imperiis farglebSiSemobrunebis saSualebas, rac,udavod, gaaumjobesebda eqsport-importissaldos. ruseTis imperia saerTod arprofesori revaz sxilaZe,robert kupcisis mikroskopTanrobert kupcisi eqspediciaze 1913 welifaqti, rom igi dabalefeqturad da arakvalificiuradswavlobs Tavis am unikalurpotencials. ar eZebs bazrebs maTiseriozuli Sefasebisa da realizaciismizniT. qveyanaSi saerTod ar arsebobswylis resursebis gamoyenebis erTianisaxelmwifo politika. dabal donezea ammimarTulebiT moqmedi sakanonmdeblo danormatuli baza, misi marTvis institucionurida organizaciuli sistema. esuaRresad mniSvnelovani problema uyuradRebod,zogierTi enTuziastis anabaraadarCenili.saqarTveloSi wyali mudam iyo saxelmwifoebrivizrunvis sagani. mecxrametesaukunis meore naxevridan daiwyosaqarTvelos Termuli da samkurnalomineraluri wylebis intensiuri Seswavla.zrunavda mosaxleobis sasmeli wyliTuzruyvelyofaze, Sesabamisad, TbilisSi,1904 wels, specialuri gamokvlevebiT,dadginda, rom mosaxleobis sikvdilobismaRali donis mTavari mizezi qalaqisdamtverianebis, maRali donisa da rZisproduqtebis uxarisxobasTan erTad, iyosasmeli wylis dabali xarisxi.saqarTvelos wylis resursebis kompleqsuri,sistemuri kvleva ukavSirdebaara marto warmoSobiT latvieli robertkupcisis moRvaweobas, aramed amsaqmeSi seriozuli wvlili Seitana mismaufrosma Zmam - ianma. swored faramciismagistrma ian kupcisma Tavis moxsenebaSikavkasiis samedicino saimperatoro sazogadoebiswinaSe jer kidev 1912 welsaRniSna, rom saqarTvelos ‘wylebis umravlesobaSeuswavlelia da maTi mikuTvnebawylebis ama Tu im jgufisaTvis emyarebasunis, gemos da naleqis fers, rac ZalianxSirad mcdaria~. man daasabuTa, romwylebis Seswavla aucilebelia adgilzesruli farmako-qimiuri SemadgenlobisdadgeniT. Tavisi winadadeba man saqmiTdaamtkica da ukve 1913 wels, pirvelad,adgilze Seiswavla borjomis mineraluriwylebi. gamoavlina misi samkurnalo

39samedicino Tvisebebi da daadgina masSiSemavali mineralebis Sedgeniloba. borjomiswylebi ganmeorebiT Seiswavla 1923wels, aTi wlis Semdeg, misma umcrosmaZmam, diplomirebulma provizorma, robertkupcisma. man gamoavlina wylebis qimiuriSemadgenlobis mdgradoba da daadasturamisi samkurnalo Tvisebebis stabiluroba.latviis elCi saqarTveloSi andreisvilcansi da latviis sapatio konsuli reginaiakobiZe xsnian robert kupcisisadmimiZRvnil konferenciasdidi da xangrZlivi Sromis Semdeg, 1925wels, robert kupcisma daaskvna, romsaWiroa moiZebnos meqanizmebi, raTa‘saqarTvelos mineralur wylebzewisqvilebi ki ar brunavdnen, rogorc esTrusos xeobaSi, sofel kobiSSi xdeba,aramed igi gaxdes msoflios tanjuli mosaxleobisaTvisxelmisawvdomi~. es daskvnadResac aqtualuria, maSin rodesacmsoflios mTavari problema siRaribesTanbrZolaa, saqarTveloSi snosmineraluri wyali uqmad iRvreba,wisqvilsac ki aRar amoZravebs. unda daisvassakiTxi saerTaSoriso organizaciebiswinaSe, rom gamoinaxos SesaZleblobasaqarTvelos sasmeli wylebis eqsportisaTvismsoflios uRaribes qveynebSi, sadacdeficitia ekologiurad sufTa, jansaRisasmeli da samkurnalo wylebis.Cveni azriT, robert kupcisis pirovnebispopularizacia da misi Rvawlis saTanadodafaseba gaxdeba saqarTvelos sasmeliwylebis saerTaSoriso bazarze gatanisa damisi kompleqsuri kvlevis qmediTi argumenti.amitom saqarTveloSi latvielTasazogadoebam, ‘ave sol!~-is iniciativiT,2007 wlis 16-17 noembers Caatara saerTa-Soriso konferncia Temaze robert kupcisisRvawli qarTul mecnierebaSi~, romel-Sic aqtiuri monawileoba miiRo asze metmaadamianma. konferenciam miiRo rekomendacia- robert kupcisis saxelis ukvdavsayofadkurort wyaltubos meeqvse wyarosewodos misi saxeli da qalaq TbilisSi imsaxlze, sadac cxovrobda da moRvaweobdar. kupcisi, gakeTdes memorialuri dafa.migvaCnia, rom robert kupcisis namdviliaRiareba jer kidev winaa, misi saxeli metsxivosnobas SeiZens saqarTveloSi sasmeliwylis warmoeba-realizaciis moculobisada kulturis zrdasTan erTad. esgardauvalia, amas moiTxovs Tanamedroveglobaluri msoflio.НЕОБХОДИМОСТЬ СИСТЕМНОГО ИССЛЕДОВАНИЯ ВОДНЫХРЕСУРСОВ ГРУЗИИ – ОПЫТ И ЗАСЛУГИ РОБЕРТА КУПЦИСАОБЩЕСТВО ЛАТЫШЕЙ “AVE SOL”, ГРУЗИЯР. Иакобидзе, И. ЧинчаладзеИзучая научное наследие латышского ученого, почти всю жизнь, проработавшего в Грузии, мы ещераз убедились, что история изучается для того, чтобы понять сегодняшний день и прогнозировать будущее.Р. Купцис, по приказу Российского императора, прибыл в Грузию в 1908 году для изучения грузинскихвод, более 40 лет проработал руководителем экспертно-медицинской химической лаборатории; личноисследовал более 1000 водных источников, около 800 из них – впервые, и пришел к выводу о необходимостизамены визуальной оценки вод их химическим анализом. В результате этих исследований возникли иначали функционировать многие грузинские курорты.Массовые исследования грузинских источников позволила Р.Купцису создать классификациюпитьевых и лечебных вод, а также лечебных грязей. Исследователь установил, что из 8классификационных групп, существующих в мире, в Грузии наличествуют семь.

40Вода в современном мире стала стратегическим товаром; треть населения нашей планеты не имеетдоступа к питьевой воде, не говоря уже о лечебных водах. Следовательно, необходима стратегическаяполитика в отношении к грузинской воде. Мы призываем к заботе о ней. Вода – богатство!Латышское общество Грузии “Aве Сол!” провело 16-17.11 2007 года международную конференцию“Bклад Роберта Купциса в грузинскую науку”, в которой приняли участие более ста человек из Грузии,Латвии и России. Конференция приняла Резолюцию об увековечении памяти Роберта Купциса – присвоитьшестому источнику Цхалтубо имя Р.Купциса и установить мемориальную доску на доме, в которомрасполагалась химическая лаборатория и служебная квартира исследователя.НЕКОТОРЫЕ ОПУБЛИКОВАННЫЕ РАБОТЫ РОБЕРТА КУПЦИСА1. Краткий обзор минеральных вод и лечебных грязей Грузии. Из химической лаборатории НКЗССР Грузии//Вестник Наркомздрава, 1925, №1-3.2. Материалы к изучению химического состава питьевых вод дачных мест в окрестностях Тифлиса//Вестник НКЗ 1923, №1-3.3. Радиоактивность питьевой воды, как возможный этологический момент в возникновенииэндемического зоба//Народная медицина, Тбилиси, 1926, № 54. Радиоактивность минеральных вод Грузии//Советская медицина. Тифлис, 1930, № 6-7.5. Лечебные растения//Советская медицина. Тифлис, 1931, № 3, 4.6. Сравнительная оценка предварительных проб на крови в судебно-медицинской практике//Лечебныйвестник. Тифлис, 1926, часть 17. К вопросу об отделении алкалоидов от птомаинов. Труды 3-го Всеросийского сьезда судебныхэкспертов в 1927 году.8. Минеральные воды Имеретии ( часть 1 – Кутаисский уезд)//Советская медицина. 1930, № 3.9. Минеральные воды Имеретии ( часть 2 – Шоропанский уезд) //Советская медицина 1930, № 410. Кое-что о знахарском “врачевании” в Грузии.//Советская медицина. 1925, № 1.NECESSITY OF SYSTEM RESEARCH OF WATER RESOURCES OFGEORGIA - EXPERIENCE AND MERITS OF MR. ROBERT KUPTSISR. Iakobidze, I. ChinchaladzeStudying a scientific heritage of Latvia scientist, who almost all his life worked in Georgia, the author came toa conclusion that history is studied to understand and predict the future. R. Kuptsis under the order of theRussian emperor arrived in Georgia in 1908 in order to study the Georgian water. He worked as the heard ofexperimental-medical chemical laboratory more than 40 years. He personally investigated 1000 water sources,nearly 800 of them for the first time and came to conclusion about the necessity of visual evaluation replacementby chemical analysis.A multiple researches of the Georgian water sources has allowed R. Kuptsis to create classification asdrinking and medical waters, as medical dirts. he has found that from 8 classification groups which exist in theworld, 7 groups are in Georgia.Water in the modern world has become the strategic goods, third of population of our planet has no access topotable water, not speaking about medical waters. The strategic policy in regard to the Georgian water isnecessary, as well s its care. Water is wealth!In 16-17.11.2007 the Latvia society of Georgia “Ave Sol” held the international conference “The contributionof Mr. Robert Kuptsis to the Georgian science”. More than hundred participants from Georgia, Latvia andRussia took place in this conference. Conference accepted the resolution on perpetuating R. Kuptsis’ memory- to give the six sources of Tshaltubo R. Kuptsis’ name and to installate the memorial board on the house wherechemical laboratory and service apartment was located.

41gaxsenebanaTeli pirovneba, WeSmariti moqalaqegasuli saukunis 60-iani wlebidan,dedaqalaqis maSindel plexanovisgamzirze moxvedrisas, uneblied yuradRebasmiaqcevdiT auCqarebeli nabijiTmimaval axalgazrda mamakacs, romelicaSkarad gamoirCeoda sxva qveiTad mosiarulisgan:gansakuTrebuli keTilSobilida lamazi garegnobis, daxvewili gemovnebiTSemosili, dinjad, sakuTarsafiqralSi CaRmavebuli, igi dildilaobiTmiemarTeboda xolme gamziris bolosaken.pirvelive SexvedrisTanave, rodesacjer kidev piradad ar vicnobdi, mis danaxvazeanton Cexovis ‘Zia vanias~ personaJis,Cveni kolegis, eqim astrovis gamonaTqvamigamaxsenda: ‘adamianSi yvelaferi mSvenieriunda iyos - saxec, samosic, sulica da azrebic~.saxesa da samoss imTaviTve naTladvxedavdi da vixiblebodi. mis sulsa daazrebs ki mogvianebiT veziare, rodesacprof. n.maxvilaZis saxelobis Sromishigienisa da profesiul daavadebaTa samecniero-kvleviTiinstitutis klinikas CavudeqisaTaveSi. am periodSi batoni oTarSalamberiZe prof. g.naTaZis saxelobissanitariisa da higienis samecniero-kvleviTiinstitutis samecniero muSaobas warmarTavdadireqtoris moadgilis postze.orive instituti erTmaneTTan axlos iyoganlagebuli da maT samecniero kontaqtebicgaaCndaT. Cvenma urTierTobam ufromWidro xasiaTi miiRo, rodesac batonmaoTarma moRvaweobis gagrZeleba gadawyvitaCvens kvleviT institutSi Sromis hogienisganyofillebis xelmZRvanelad, daswored aq veziare mis gamorCeul adamianurTvisebebs - mSvenier sulsac da azrebsac.Cemze usazRvrod maRal STabeWdilebastovebda misi siRrmiseuli, logikurad Tanmimdevrulida Rrmad safuZvliani mosazrebebida mtkicebulebebi momuSave adamianTagaremos dacvisa da janmrTelobisSenarCuneba-gakaJebis Taobaze. mSvidad,auRelveblad, keTilganwyobili RimiliT,faqtobrivi masalis jerovani analizisSedegebis moSveliebiT, batoni oTariyovelTvis advilad axerxebda mopaeqrisdarwmunebas araswor, mcdar Sexedulebaze,arasworad interpretirebul mopovebulfaqtebze, da amgvari mecnieruli diskusiamSvidobianad mTavrdeboda xelmZRvanelisgamarjvebiT. rac mTavaria, yvelakmayofili da madlieri rCeboda: mopaeqre- momxsenebelic da damrigebeli - batonioTar SalamberiZec. TanamSromlebsa da xelmZRvanelsSoris sruli urTierTgagebada urTierTpativiscema sufevda, Tumca batonioTari gamoirCeoda uryevi principulobiT,erTi SexedviT - simkacriTac ki, magramam TvisebebiT igi amyarebda Tanam-Sromlebis mowesrigebulobas da saqmisadmierTgulebas, Rrmad dainteresebasa dadargis winsvlas - Tanamedroveobis moTxovnebissrul SesabamisobaSi.adamianisadmi uzomo siyvarulma da mismomavalze dauRalavma fiqrma, baton

42oTars gadaawyvetina 70-iani wlebidanmieZRvna mTeli Tavisi mecnieruli, organizatorulida piradadamianuri niWi axalgazrdaTaobebis swor Camoyalibebasada maTi fizikuri, sulieri da moralurijanmrTelobis dacvis mzrunvelobisaTvis:rodesac 1974 wlidan sicocxlisbolomde, 22 wlis manZilze igi saTaveSiCaudga Tbilisis saxelmwifo samedicinoinstitutis/universitetis bavSvTa damozardTa higienis kaTedras. es iyoaTwleulebi, rodesac batoni oTaris xibliamSvenebda saqarTvelos umaRlesisamedicino saswavleblis ara mxolodsaswavlo-samecniero mimarTulebasprofilaqtikuri medicinis dargSi,aramed mTlianad am umaRlesi samedicinosaswavleblis zogad avtoritetsac mniSvnelovnadSeuwyo xeli.universitetis xelmZRvanelobam uyoymanodgadasca mas sauniversiteto samecnierosabWos berketebi swavluli mdivnispostze daniSvniT. am droisaTvissaqarTvelom moipova damoukidebloba, dabatoni oTari dainiSna, agreTve, samecnieroxarisxis mimniWebel profesorTa sab-Wos swavlul mdivnadac. sicocxlis bolomdedauRalavad, iSviaTi wesrigisdacviT uTavsebda batoni oTari kaTedrazeenergiul samecniero-pedagogiurmoRvaweobas mniSvnelovan sazogadoebrivsaqmianobasswavluli mdivnis movaleobisCinebuli SesrulebiT.es periodi daemTxva qveyanaSi rTul socialur-polotikurgardaqmnebsa daekonomikur siduxWires. mZimed, magram garegnuliemociuri gamoxatvis gareSe itandabatoni oTari mraval gaWirvebas - qveyanaSic,samsaxurSic da, bunebrivia, piradi,yofiTi xasiaTisasac. ver gauZlo misma faqizma,mgrZnobiare, upatiosnesma gulmaamgvar rTul daZabulobas da, samwuxarod,man 75 wlis zRurblsac ki ver miaRwia...wels mas 85 weli Seusruldeboda...batoni oTari moaklda, upirvelesad,Tavis SesaniSnav ojaxs. ojaxs, romlisTiToeuli wevri yovelTvis da yvelafer-Si sanimuSo iyo, ganmsWvaluli patiosnebiT,SromismoyvareobiT, profesionalizmiTda sakuTari movaleobebis pirnaTladda dauRalavad SesrulebiT.batoni oTari moaklda qveyanas, romlissiZliere da perspeqtiuloba sworedim adamianTa cxovrebis wess eyrdnoboda,romliTac icxovra da iRvawa Tavad Cvenmasaamayo Tanamemamulem.batoni oTari moaklda dargsa da ers,profilaqtikuri medicinis ukeTilSobilesmimarTulebas - bavSvTa da mozard-Ta fizikuri, moraluri da sulieri janmrTelobisdacvas, rac esoden mniSvnelovaniaqarTveli erisaTvis, romlis demografiulimaxasiaTeblebi safuZvliangangaSs iwveven.batoni oTari moaklda qalaqs, romel-Sic dRes, samwuxarod, WeSmariti moqalaqeebiskohortam sagrZnoblad iklo.batoni oTari moaklda mis mSobliursamedicino universitets, romelSic prevenciulimedicinis bavSvTa da mozardTajanmrTelobis dacvis mimarTulebas gansakuTrebiTdidi Zalisxmeva, energia damiseuli gamocdileba aSkarad aklia.batoni oTari Cven mogvaklda, mis Tanamedroveebs,kolegebs da megobrebs,romlebsac ukve mxolod Tavisi gamoCeniTacda saubriTac ki gvamSvidebda da optimisturiRimiliT imeds gvinergavdaqveynisa da eris naTel momavalze.swored aseTma naTelma pirovnebebmada WeSmaritma moqalaqeebad dagvitovesoptimizmi, rac gvasuldgmulebs da imedsar gvakargvinebs, viciT ra, rom namdvilipatriotizmi da qveynisadmi siyvarulisam veSaps eyrdnoba - patiosnebas, ganaTlebulobasda Sromismoyvareobas.aseTi iyo batoni oTar SalamberiZe,romelmac Tavis cxovrebis wesiT pirnaTladmoixada vali yvelas winaSe da rwmenaCagvinerga - ‘kidevac daizrdebian!..~naTelSi amyofos misi suli maradiulsasufevelSi.saqarTvelos medicinis mecnierebaTa,medikur-biologiur mecnierebaTa,profilaqtikuri medicnis mecnierebaTa,afxazeTis mecnierebaTa akademiebis wevri,profesori vadim saakaZe

43xsovnagiorgi kereseliZeqarTulma samedicino sazogadoebriobam,saqarTvelos profesiuli kavSirebisgaerTianebam mZime danaklisi ganicada:gardaicvala janmrTelobis, socialuridacvisa da profkavSiruli moZraobisgamoCenili organizatori, sazogado moRvawe,medicinis akademiuri doqtori giorgikereseliZe.batonma giorgim, misi arcTu ise xangr-Zlivi sicocxlis manZilze, qveynis samedicinoda profesiul dargSi moRvaweobis asparezzeTavi gamoiCina rogorc RirseulmaxelmZRvanelma da niWierma muSakma.giorgi kereseliZe daibada 1949 welsTbilisSi. saSualo skolis damTavrebisTanavesaeqimo profesias daeufla leningradissaxelmwifo samedicino institut-Si, romlis damTavrebis Semdeg, praqtikulsaeqimo saqmianobas iwyebs m. winamZRvriSvilissaxelobis kardiologiis samecniero-kvleviTinstitutSi.perspeqtiuli, niWieri axalgazrdis momavalisaeqimo kariera SeumCneveli ar dar-CeniaT mis mecnierul xelmZRvanelebs. ma-Tive rekomendaciiT axalgazrda eqimi gaigzavnamoskovis meore saxelmwifo samedicinoinstitutis aspiranturaSi. muyaiTi dagamrje mkvlevari warCinebiT amTavrebs aspiranturasda amave umaRlesi samedicinosaswavleblis samedicino sabWos sxdomazewarmatebiT icavs sakandidato disertacias.batoni giorgis Semdgomi saeqimo saqmianobadakavSirebulia Tbilisisa da marneulissamedicino dawesebulebebTan, sadacasrulebda erT-erTi xelmZRvanelisa damkurnali eqimis movaleobas.ukanaskneli TiTqmis ori aTeuli weligiorgi kereseliZis saeqimo, organizatorulisaqmianoba mTlianad dakavSirebuliiyo saqarTvelos medicinis muSakTaprofesiul kavSirebTan. misi xelmZRvanelobiT,droTa ganmavlobaSi, es organizaciagadaiqca samedicino dargis muSak-Ta zrunvis, socialuri keTildReobis,SromiTi pirobebis gaumjobesebis mZlavrcentrad, ramac misi moRvaweobisadmi sayovelTaomxardaWera hpova.batoni giorgi, rogorc moqalaqe daqveynis WeSmariti patrioti, mudmivad iRvwodaTavisi xalxis sasikeTod, TansakuTrebiTSTambeWdavi iyo misi damokidebulebaqveyanaSi mimdinare procesebisadmi.is gansakuTrebuli mondomebiT zrunavdaaxalgazrda saeqimo kadrebis profesiulidaxelovnebisaTvis. man mraval axalgazrdaspecialists gauwia Tanadgoma damxardaWera.giorgi kereseliZis mravalmxrivi moRvaweobasaTanadod dafasda. mas miniWebulihqonda Cveni qveynis maRali jildo -Rirsebis ordeni.gulistkiviliT veTxovebiT Cvens megobarsada kolegas, Tanamoazres, romelmacicxovra da iRvawa qveynisaTvis mamuliSvilurierTgulebiT da amiT RirseulimagaliTi dautova momaval Taobas.saqarTvelos janmrTelobis, socialuridacvis, samedicino da qimiuri mrewvelobismuSakTa damoukidebeli profesiuli kavSiri

44redaqtoris gverditradiciaodiTganve profesiis arCeva ojaxistradiciidan gamomdinare, ar warmoadgensiSviaT movlenas. kacobriobis istoriaSimravlad moiZebneba saxelganTqmuliojaxuri dinastiebi, Taobidan Taoba-Si gadasuli profesiuli memkvidreobiTiprincipebiT. aseTi ojaxebi Zlieri fesvebidanarian aRmocenebuli da inteleqtismaRali doniT xasiaTdebian, vinaidantradiciuloba, rogorc movlena TavisiarsiT gulisxmobs axali Taobis wina TaobisRvawlisadmi Tayvaniscemas, mzadyofnasganagrZos da srulyos winaparTa profesiulisaqmianoba drois moTxovnaTaSesabamisad.saqarTveloSi bevri sxva qveynisagangansxvavebiT, profesiuli tradiciismemkvidreobiToba vrceldeba inteleqturlurisaqmianobis sxvadasxva sfroze,maT Soris medicinazec.saqarTveloSi eqimoba ramdenime Taobistradiciaa. STamomavlobiT eqimTaCamonaTvali Sors wagviyvanda. maTSorisaa ojaxebi, romlebic gansakuTrebiTdafasebulia sazogadoebis mier.Tqveni yuradReba gvinda SevaCeroTeqimTa brwyinvale gvaris or warmomadgenelze:mamaSvil irakli da daviTciciSvilebze. ciciSvilebis gvari, romucxo ar aris qarTuli medicinis istoriaSi,amas didi mkurnalisa da sazogadomoRvawis zaza fanaskerteli-ciciSvilisukvdavi saxelic metyvelebs. Tavad batoniirakli ciciSvili saerTo saxalxo siyvaruliTada pativiscemiT garemoculieqimia. man SeZlo moqalaqeobrivi da profesiulimoRvaweobis Sedegad moepovebinamTavari - xalxis upirobo mzadyofna -andon mas yvelaze Zvirfasi bavSvis sicocxleda janmrTeloba.batoni irakli qarTuli pediatriuliskolis Rirseuli warmomadgenelia. klinicisti,pedagogi, Tbilisis saxelmwifosamedicino universitetis bavSvTa sneulebaTakaTedris profesori. is qarTvel pediatrTaim pleadis warmomadgenelia,romelsac miekuTvnebodnen: irakli rcxilaZe,meri gelovani, irakli faRava,vladimer ToxaZe, ioseb kvaWaZe da bevrisxva. batoni irakli dResac nayofieradmoRvaweobs da mdidar gamocdilebasuziarebs axalgazrda kolegebs.gasul wels saqveynod cnobilma farmacevtulmafirmam ‘pfaizerma~ saqarTvelossamedicino sazogadoebam didi formatisilustrirebuli kalendriTdaasaCuqra. kalendris Tormet gverdzegamosaxuli iyo saqarTvelos sxvadasxvadargis Tormeti cnobili moRvawe. kalendrispirveli gverdi ixsneba batoni iraklisfoto-portretiT. suraTidan miRebuliSTabeWdilebiT mnaxveli eziareba imrealobas, Tu rogori unda iyos eqimi amsityvis WeSmariti gagebiT.yovelive amis Semdeg, gasakviri ar undayofiliyo, rom batoni iraklis vaJis, davi-Tis momavali profesia winaswarve iyo gansazRvruli.Tbilisis 53-e saSualos skolisdasrulebis Semdeg, daviTma swavla moskovispirvel saxelmwifo samedicino institutSiganagrZo. institutis damTavrebisSemdeg, daviT ciciSvili muSaobas iwyebs

45moskovis botkinis saxelobis klinikurisaavadmyofos zogadi profilis qirurgad.1989 wels Camodis TbilisSi da xelovndebaotolaringologiis profiliT.specializaciis kurss maSin akademikosisimon xeCinaSvili xelmZRvanelobda,romelic im periodSi eqimTa daxelovnebisTbilisis institutis yel-yur-cxvirisdaavadebaTa kaTedris gamge iyo. 1990 wlidandaviTi iwyebs muSaobas baton vaxtangxurciZesTan, romlis xelSewyobiT xvewsostatobas plastikur qirurgiaSi. aRsani-Snavia, rom daviT ciciSvili vaxtang xurciZesTavis maswavleblad miiCnevs. 1991wlidan daviTi ukve rogorc damoukidebelieqimi iwyebs muSaobas im xanad TbilisSierTaderT profilirebul samedicinodawesebulebaSi, plastikuri qirurgiisada kosmetologiis klinikaSi. 1992 welsdaviTi tovebs Tbiliss da gadadis moskovSi.aq iwyeba misi cxovrebisa da samedicinosaqmianobis axali etapi. ra sirTuleebsukavSirdeba misi profesiuli moRvaweobaiseT konkurentul qalaqSi,rogoric moskovia, advili warmosadgenia.miuxedavad amisa, sakmaod mokle xanSi daviTmamoskovis erT-erTi warmatebuliplastikuri qirurgis saxeli daimkvidra.kiTxvaze - Tu ra aris plastikuri qirurgiiswarmatebis saidumlo, daviTma xazi gausvaim faqts, rom operaciis teqnikuradsrulyofisaTvis, codnasaTan erTad, umniSvnelovanesiamxatvruli xedvis niWi,rac gulisxmobas imis aucileblobas, romeqimma individualurad aRiqvas pacientismonacemebi da mravalTagan SearCios esTetikurikoreqciis is erTaderTi varianti,romelic optimaluria.daviT ciciSvili srulyofilad flobsTanamedrove plastikuri qirurgiis yveladargs. is medicinis mecnierebaTa doqtoria.sadoqtoro sakvalifikacio naSromiexeba cxviris kompleqsuri operaciebisTemas. praqtikuli saqmianobisaTvis,metad mniSvnelovnad miiCnevs pacientisfsiqologiur mdgomareobas,gansakuTrebiT operaciis mosamzadebelperiodSi. daviT ciciSvili rogorcpirovneba - gulTbili da saurTierTodgaxsnili pirovnebaa. xasiaTis es Tvisebebiuadvilebs mas pacientebTan urTier-Tobas. hyavs sami Svili: ana, marina da irakli.meuRle profesiiT fsiqologia.daviTi moskovis or prestiJul klinikaSi‘lantansa~ da ‘laiv-taimSi~ moRvaweobs.Tumca ar iviwyebs Tbilissac dayoveli Camosvlisas uamravi pacientisguliTad madlobas imsaxurebs, amJamad issamedicino centr ‘qali da janmrTelobis~maRalkvalificiuri koleqtivisTanadgomiT, romelsac gamocdili menejeri,qalbatoni marina sayvareliZe xelmZRvanelobs,warmatebiT eweva konsultaciebsda operaciul mkurnalobas.

46adamianebTan, moqalaqeebTan piradiurTierTobis erT-erT saukeTeso qmedebadbaton iraklis miaCnda maTTanyoveldRiuri kontaqti Tbilisis quCeb-Si fexiT mosiarule baton iraklis miaCndamaTTan yoveldRiuri kontaqti TbilisisquCebSi fexiT mosiarule baton iraklisxvdebodnen misi Tayvanismcemlebi,uamravi nakadi qalaqelebisa. mas SekiTxviTmimarTavdnen usmendnen mis mosazrebebs,ixiblebodnen batoni iraklismWermetyvelobiT, siRrmiseuli logikiT,ubraloebiT.wilad mxvda pativi, ramdenime weli megobrulida SemoqmedebiTi urTierTobamqonoda baton iraklisTan. samedicinoJurnalis redaqciaSi misi stumroba yvelasgvaxarebda. TiToeuli CvenTagani akademiuriSekiTxvebis garda, vcdilobdiTaqtiur saubarSi CagveTria da siamovnebiTvismendiT mis mosazrebebs, vixiblebodiTmisi xedviT rogorc erovnul,ise yofiT, profesiul da sxva sakiTebze.batoni irakli Cinebulad iyo gaTviTcnobierebuliCveni qveynis istoriaSi,eamayeboda misi gmiruli warsuli, winaparTasaqmeni sagmironi. ‘istoriuli fesvebiamdidrebs da aZlierebs adamianisulierebas~ - ityoda saubarSi. misi sayovelTaodmomxibvleli leqciebi da sajarogamosvlebi gajerebuli iyo warsurCeulimaTes saxarebaSi vkiTxulobT: ‘esreTiyvnen winani da ukanani wina, rameTumravalni arian Cinebul da mciredirCeuln rCeulTa xvedri gamorCeulia sazogadoebrivasparezze. isini cxovrebiseuliavanscenidan amdidreben adamianTasulier Tu yofiT procesebs da amiT xelsuwyoben warmatebiT warmarTon maTiyoveldRiuri qmedeba sazogadoebis samsaxurSi.rCrulTa Soris gansakuTrebiT misaba-Zi iyo saxelovani mecnieris, pedagogis,sazogado moRvawis, WeSmaritad saxalxoeqimis baton irakli faRavas Rvawlierovnuli pediatriuli skolis ganvi-Tarebisa da aRmavlobis mamuliSvilursaqmeSi.batoni irakli misabaZi iyo aramartorogorc mecnieri da pedagogi, aramedrogorc moqalaqe, qveynis patrioti daqomagi. misabaZi iyo agreTve misi yoveld-Riuri cxovrebis kredo. moqalaqeebTanurTierToba da maT mimarT Tanadgoma, sajarogamosvlebis dros myari erovnulipoziciebi, momavali Taobisadmi erTgulisamsaxuri da Tavdadeba.adamianTa mimarT batoni iraklispirovnuli xibli, ganwyoba, komunikabeloba,sisadave izidavda yvelas - patarapacientebidan dawyebuli, Rrmad asakovanpirovnebebze.

47lis istoriuli faqtebiT, saxelovanwinapraTa mier Cvendami moRweuli fr-Tiani gamoTqmebiT da mecnieruli Tupraqtikuli koncefciebiT da rac yvelazemniSvnelovania, STambeWdavi iyomiseuli paralelebis gavlena da urTierTkavSiriwarsulTan da dRevandelobasTan.`aRvzardoT srulfasovani pirovneba~- aseTi iyo misi profesiuli da moqalaqeobrivipozicia, romelic saTaveswarsulidan iRebda, rac imaSi mdgomareobda,rom batonma iraklim safuZvlianadSeiswavla warsulSi gamoCenil erovnulmoRvaweTa xedva momavali Taobis janmrTelobisdacvis Taobaze da am mimarTulebiTsazogadoebas warudgina maTipozicia. aseTi iyo misi moxsenebasaqarTvelos pediatrTa yrilobaze 1987wels - ‘ilia WavWavaZe bavSvTa aRzrdisada janmrTelobis sakiTxebis Sesaxeb~.sabednierod, batoni iraklis mecnieruli,saeqimo, pedagogiuri tradiciebissasaxelod grZeldeba. mis memkvidreTasanaqebod unda iTqvas, rom erovnuli pediatriuliskolis dRevandeli Taba amdidrebsda amravlebs maTi TvalsaCinowinapris naanderZevs, mis mier Seqmnil dadanergil mecnierul da klinikur mimarTulebaTaformebsa da meTodebs, racWeSmariti garantiaa misi amqveyniuri ukvdavebisa.

48gamosaTxovaribatoni kote barqaias udroosikvdilma mTeli Cveni sazogadoebriobismwvave gancda da gulistkivili gamoiwvia.misi pirovnuli Tvisebebi, adamianTa mimarTmiseuli komunikabeloba gansakuTrebulxibls iwvevda yvela CvenTaganSi.cxovrebisadmi erTgulebiT aRsavsemTeli SemarTebiT grZnobda qveynisadmi,sazogadoebisadmi did pasuxismgeblobas,TiToeuli pirovnebisadmi movaleobasada Tanadgomas.siyvarulze siyvaruliTve pasuxobda.yvelgan keTili guli Seqonda, asevekeTili ganwyobiT xvdebodnen mas.uyvardaT misi mosmena da masTansaubari. sikeTesa da adamianur keTilSobilebasaravis ar daukargavda da Tavisigulis siTbosac zed daamatebda.qveynis, xalxis warsulisa da awmyos istoriaze,mis kulturaze, literaturaze,xelovnebaze uzomod Seyvarebulssaubris dros uamravi konkretuli faqtebiscitireba SeeZlo mdidari bibliografiuliwyaroebis moSveliebiT.sulieri silaRisa da simSvidis erT-erTdamamkvidrebel Zalad misTvis wigni dawignisadmi siyvaruli iyo.axalgazrdobas - qveynis saimedo dasasikeTo momavlad miiCnevda. maTi yoveliwinsvla da warmateba did siamayes gvridada mTeli arsebiT cdilobda gamoexatamaTdami siyvaruli da Tanadgoma.naTeli cxovrebiT icxovrad kote barqaiam.sadac ki umoRvawia: jandacvis, sagareosaqmeTa saministroebSi, saqarTvelosparlamentSi Tu sxvagan mamuliSviluriTavdadebiT emsaxureboda erovnulsaqmes da miuxedavad arc Tu xangrZlivicxovrebisa da valmoxdili wavida amqveyniuriyofidan.mas SeeZlo eTqva: ‘me vcxovrobdi ise,rogorc vgrZnobdi da vgrZnobdi ise,rogorc vcxovrobdi. me Cemi rwmeniserTguli davrCi~.samomavlod darCa kvali naTeli Sesani-Snavi pirovnebisa, megobrisa, moqalaqisa,romelmac Rirseulad iRvawa. samagaliTomogonebad darCeba yvelasTvis, vinc icnobdada axloblobda masTan.msubuqi iyos misTvis mSobliuri,qarTuli miwa.3. saqarTvelos samedicino Jurnali, 2, 2008 w.

49axali wignebi1. zurab xelaZe - kritikuli medicina. gamomcemloba ‘universali~. 2007 w.2. n. lebaniZe, s. qajaia - anesTeziologia da reanimatologia kiTxvebsa dapasuxebSi.3. lin s. bikli - beitsis klinikuri gamokvlevis safuZvlebi.4. jon p. klosherti - neonatologia5. T. Ciqovani - imunologia.6. tompsoni da tompsoni - genetika medicinaSi. 2008 w.7. o. gerzmava - sazogadoebrivi jandacva da menejmenti. 2008 w.8. avtorTa jgufi - fsiqologiis safuZvlebi.9. l. metreveli - funqciuri neiroanatomiis safuZvlebi. 2007 w.10. k. mardaleiSvili, T. baramiZe - yba-saxis avTvisebiani simsivneebi. Tssu 2008 w.wignebis SeZena SegiZliaTTbilisis saxelmwifo samedicino universitetisadministraciuli korpusis jixurSi, vaJa-fSavelas 33.konsultanti inglisur enaSi maka tatiSviliredaqciis misamarTi: Tbilisi, vaJa-fSavelas gamz. 33АДРЕС РЕДАКЦИИ: ТБИЛИСИ, ПРОСПЕКТ ВАЖА-ПШАВЕЛА 33xelmowerilia dasabeWdad: 22.07.08 w., formati 70 X 108 1/16fizikuri nabeWdi Tabaxi 3.0saaRricxvo-sagamomcemlo Tabaxi 3,5, tiraJi 300,fasi saxelSekrulebo

50indeqsi 76184saqarTveloSi latviuri farmaciis kompania “Grindeks” (grindeqsis) warmomadgenlobisxelmZRvaneli, eqimi Tea sxirtlaZe Cveni Jurnalis mkiTxvels sTavazobs rCeva-darigebas,romelic efuZneba misi saeqimo saqmianobis praqtikul gamocdilebas.uZiloba da misi mkurnalobara aris uZiloba?uZiloba - Zilis darRvevis erT-erTi yvelaze gavrcelebuli formaa.uZiloba moicavs CaZinebasTan dakavSirebul siZnleebs, xSir gamoRviZebas RamiT da naadrevgamoRviZebas diliT. uZiloba mniSvnelovnad auaresebs adamianis cxovrebis ritms da moqmedebsmis Sromisunarianobaze.uZilobis yvelaze xSiri mizezebia:stresebi _ ojaxuri problemebi, samsaxureobrivi usiamovnebebi, SfoTva mniSvnelovani movlenebiswin, avadmyofoba, tkivili, xmauri, amindis cvlileba. cxovrebis wesi _ mZime fizikuri SromasaRamos saaTebSi, Ramis cvlaSi muSaoba, Zilis win Warbi kveba, yavis an alkoholis miReba, Tambaqosmoweva. janmrTelobis darRvevebi _ sxvadasxva daavadebiT gamowveuli Civilebi-xvela, qoSini,xvrinva, qveda kidurebis uneblie moZraobebi da sxva.praqtikuli rCevebi· Zilis win nu miiRebT alkohols an kofeins, nu mowevT Tambaqos;· nu miiRebT msuye, noyier sakvebs;· nu daiZinebT dRisiT;· ar adge da ar daiwyoT siaruli an raimes keTeba, raTa dageZinoT;· nu CaunergavT Tavs, rom ver SeZlebT xelaxla daZinebas;· nu ifiqrebT sawolSi yoveldRiur problemebze.ra unda gaakeToT:· regularulad ivarjiSeT, mxolod daZinebamde 3-4 saaTiT adre;· dasaZineblad daweqiT erTsa da imave dros;· gaaniaveT sawoli oTaxi, magram nu gaacivebT;· Zilis win waikiTxeT msubuqi gasarTobi wigni, mousmineT mSvid musikas;· miirTviT msubuqad.Tu Tqven asrulebT Zilis higienis principebs, magram mainc ver iZinebT, mimarTeT eqims an farmacevts.Tqven unda mimarToT eqims Tu:· giWirT daZineba;· Tqveni Zili fxizeli da mousvenaria;· xSirad geRviZebaT;· geRiZebaT Zalian adre da ar geZinebaT;· gaRvizebisas Tavs grZnobT gamouZineblad, daRlilad;· dRisiT geZinebaT, giWirT koncentrireba, uCiviT Sromisunarianobis daqveiTebas.ra unda icodeT saZile saSualebebis Sesaxeb:· dasaZineblad daweqiT saZile saSualebis miRebisTanave;· nu miiRebT saZile saSualebis imaze met dozas, rac daginiSnaT eqimma;· saZile saSualebis miReba ar SeiZleba centraluri nerviul sistemaze moqmed medikamentebTanda alkoholTan erTad.saZile saSualebebi uzrunvelyofs srulfasovan Zils.eqimma gamogiweraT somnoli:· somnoli axali Taobis swrafad moqmedi saZile saSualebaa;· somnolis miRebis Semdeg dageZinebaT naxevar saaTSi;· somnoli uzrunvelyofs srulfasovan Zils 6 saaTisa da meti xnis ganmavlobaSi;· Tqven SeZlebT daZinebas maSinac ki, Tu raime mizeziT Zili iqna Sewyvetili. ar igrZnobTuZilobas diliT, SeinarCunebT mxneobasa da koncentrirebis unars;· asakovani pacientebisaTvis sakmarisia Zilis win 1/2 tableti somnolis miReba.· specialistebis azriT, somnoli saukeTeso preparatia uZilobis dros.· Tu gaqvT SekiTxvebi somnolis miRebasTan dakavSirebiT, mimarTeT eqims an farmacevts.

51saredaqcio kolegiisa dasabWos Tavmjdomare -giorgi menabdemTavari redaqtori -jangir mamalaZesaredaqcio kolegia:zaza beriSvili,nodar baqraZe,klara gelaSvili,oTar gerzmava,SoTa gogoxia,Tamar dekanosiZe (mTavariredaqtoris moadgile),fridon Todua,paliko kintraia,dimitri korZaia,gia lobJaniZe,vadim saakaZe (mTavariredaqtoris moadgile),irakli favleniSvili,merab qavTaraZe,eTer qemerteliZe,levan qurcikaSvili,zezva RuRuniSvili,nodar yifSiZe,roman SaqariSvili,ramaz Sengelia,gulnara CafiZe,daviT WavWaniZe,simon xeCinaSvili,ramaz xecurianiПРЕДСЕДАТЕЛЬ РЕДАКЦИОННОЙКОЛЛЕГИИ И СОВЕТА -Г.Т. МЕНАБДЕГЛАВНЫЙ РЕДАКТОР -ДЖ.А. МАМАЛАДЗЕРЕДАКЦИОННАЯ КОЛЛЕГИЯ:З.Л. Беришвили,Н.Д. Бакрадзе,К.Д. Гелашвили,О.Х.Герзмава,Ш.Д. Гогохия,З.Г. Гугунишвили,Т.И. Деканосидзе (зам.гл.редактора),М.Н. Кавтарадзе,Э.П. Кемертелидзе,П.Я. Кинтраиа,Н.Н. Кипшидзе,Д.Дж. Кордзаиа,Л.С. Курцикашвили,Г.В. Лобжанидзе,И.В. Павленишвили,В.П. Саакадзе (зам. главного.редактора),Ф.И. Тодуа,Р.Г. Хецуриани,С.Н. Хечинашвили,Д.Г. Чавчанидзе,Г.Э. Чапидзе,Р.Р. Шакаришвили,Р.М. ШенгелиаTHE CHAIRMAN OF EDITORIALBOARD AND COUNCIL -G. MENABDECHIEF EDITOR -J. MAMALADZEEDITORIAL BOARD:Z. Berishvili,N. BakradzeD. Chavchanidze,G. Chapidze,T. Dekanosidze,K. Gelashvili,O. Gerzmava,Sh. Gogokhia,Z.Gugunishvili,M. Kavtaradze,E. Kemertelidze,S. Khechinashvili,R. Khetsuriani,P. Kintraia,N. Kipshidze,D. Kordzaia,L. Kurtsikashvili,G. Lobjanidze,I. Pavlenishvili,V. Saakadze,R. Shakarishvili,R. Shengelia,P. Toduasaredaqcio sabWo:a. aladaSvili (Tbilisi)m. apostolovi (bulgareTi)i. beraZe (Tbilisi)m. boxua (Tbilisi)r. gagua (Tbilisi)g. gegeSiZe (samtredia)l. gujabiZe (Tbilisi)j. gujabiZe (Tbilisi)a. diamandopulosi (saberZneTi)i. eliaSvili (tyibuli)n. emuxvari (Tbilisi)g. vasaZe (Tbilisi)g. vekua (Tbilisi)n. vefxvaZe (Tbilisi)o. zurabiSvili (parizi)o. ToiZe (Tbilisi)z. Tofuria (Tbilisi)s. kapanaZe (Tbilisi)i. kvaWaZe (Tbilisi)a. kvezereli-kopaZe (Tbilisi)r. kverenCxilaZe (Tbilisi)v. kiknaZe (Tbilisi)n. kintraia (Tbilisi)z. kirtava (Tbilisi)a. koWlamazaSvili (Tbilisi)l. managaZe (Tbilisi)v. margvelaSvili (Tbilisi)i. megrelaZe (Tbilisi)m. mixaili (israeli)g. muxaSavria (Tbilisi)i. mWedliSvili (Tbilisi)q. nemsaZe (Tbilisi)T. sanebliZe (marneuli)r. sefiaSvili (moskovi)r. surmaniZe (baTumi)m. tatiSvili (Tbilisi)a. tuveidi (vaSingtoni)i. faRava (Tbilisi)e. qarTveliSvili (Tbilisi)b. qobulia (Tbilisi)v. yifiani (Tbilisi)r. yuraSvili (Tbilisi)a. CarTolani (mestia)T. CxikvaZe (Tbilisi)l. WeliZe (Tbilisi)n. xatiaSvili (Tbilisi)a. xomasuriZe (Tbilisi)n. javaxiSvili (Tbilisi)

52avtorTa sayuradRebod!`saqarTvelos samedicino Jurnali~ ganTavsebulia internetis veb-gverdze, referirebuliaВИНИТИ-is referatul Jurnalsa da monacmeTa bazebSi, vrceldeba sazRvargareTis sxvadasxva qveyanaSi.Jurnali, ZiriTadad, qarTulenovania, inglisuri da rusuli vrceli anotaciebiT. avtorTasurviliT Sromebi qveyndeba ucxo enebzec, Sesabamisi anotaciebiT.sadReisod, Jurnalis prioritetul mimarTulebis umaRles mizans kvlav warmoadgens: mecnieruliazrisa da praqtikis erTianobis principi, rogorc samamulo, aseve msoflio samedicinoda fundamentur gamokvlevaTa mkiTxvelamde mitana da mecnieruli codnis popularizacia.Tbilisis saxelmwifo samedicino universitetis xelmZRvanelobas ganzraxuli aqvs Jurnalissamedicino universitetis periodul samecniero-praqtikul da meTodologiur organod gadaqceva.Cveni azriT, es faqti Jurnalis mesveurebs udides pasuxismgeblobas akisrebs, rom Jurnaligaxados Tanamedrove akademiuri donis periodul gamocemad, gaaumjobesos misi dizaini da poligrafiulixarisxi.gvinda gauwyoT, rom JurnalSi gamoqveynebuli masalebis prioriteti gaTvaliswinebuli iqnebasakvalifikacio Tematikis damtkicebis, sakonkurso ganxilvis da sxvaTa dros.migvaCnia, rom Jurnalis mkiTxvelTa Tanadgoma sasikeTod waadgeba fundamenturi qarTulisamedicino periodikis gamocemas, mis popularobas da saerTaSoriso aRiarebas.saredaqcio kolegia

saqarTvelos samedicino Jurnali Medical Journal of Georgia

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