Tavis tkivili saojaxo medicinis erovnuli saswavlo centri anamnezuri monacemebi Tavis tkivilis xandazmuloba tkivilis sixSire Setevis tipi Setevis xangrZlivoba tkivilis lokalizacia siZliere tkivilis daxasiaTeba.
Download ReportTranscript Tavis tkivili saojaxo medicinis erovnuli saswavlo centri anamnezuri monacemebi Tavis tkivilis xandazmuloba tkivilis sixSire Setevis tipi Setevis xangrZlivoba tkivilis lokalizacia siZliere tkivilis daxasiaTeba.
Tavis tkivili saojaxo medicinis erovnuli saswavlo centri anamnezuri monacemebi Tavis tkivilis xandazmuloba tkivilis sixSire Setevis tipi Setevis xangrZlivoba tkivilis lokalizacia siZliere tkivilis daxasiaTeba gamamwvavebeli faqtorebi sagangaSo simptomebi Tanmxlebi simptomebi Semamsubuqebeli faqtorebi da tkivilTan brZolis gzebi tramvis anamnezi medikamenturi anamnezi Tavis tkivilis ojaxuri anamnezi pirveladi Tavis tkivili a) Sakiki: Sakiki auris gareSe Sakiki auriT (klasikuri Sakiki) garTulebuli Sakiki (romelsac Tan axlavs kargad gamoxatuli nevrologiuri simptomebi) bazilaruli Sakiki hemiplegiuri Sakiki ofTolmoplegiuri Sakiki b) klasteruli Tavis tkivili epizoduri qronikuli g) epizoduri daZabvis Tavis tkivili d) qronikuli dRiuri Tavis tkivili qronikuli daZabvis Tavis tkivili Sakikis da daZabvis tipis Tavis tkivilis kopleqsi (Sereuli an kombinirebuli Tavis tkivilebi) analgeziuri saSualebebiT/ergotaminiT gamowveuli Tavis tkivili meoradi Tavis tkivilis mizezebi pacientebi subaraqnoiduli sisxlCaqceviT an intrakranialuri moculobiTi procesiT giganturujredovani anu kranialuri arteriti sunusiti posttramvuli Tavis tkivili trigeminuli nevralogia Tavis tkivili, gamowveuli xerxemlis kisris nawilis paTologiiT klasikuri Sakiki tkivilis lokalizacia calmxrivad – Subli da safeTqeli iradiacia Tvalbude, kefa xasiaTi Zlieri, mopulsire Setevebis sixSire Setevis xangrZlivoba 1-2-jer TveSi 4-72 sT (saSualod 6-8 sT) Setevis dawyeba uecari, upiratesad diliT Setevis dasasruli gaivlis TavisTavad, xSirad daZinebis Semeg maprovocirebeli faqtorebi ra aZlierebs tkivils ra amsubuqebs mdgomareobas emociuri daZabva fizikuri da emociuri datvirTva Zili, Rebineba Sakikis maprovocirebeli faqtorebi egzogenuri sakvebi (Sokoladi, citrusebi, pamidori, yveli), danamatebi (nitratebi) alkoholi (wiTeli Rvino) medikamentebi – vazodilatatorebi, estrogenebi, indometacini kaSkaSa sinaTle Zlieri xmauri mkveTri suni qala-tvinis travma (umniSvneloc ki) endogenuri xangrZlivi Zili daRliloba, fsiqo-emociuri gadaZabva alergia hormonuli Zvrebi: pubertatuli periodi; menstruacia; klimaqsuri periodi; orsuloba SimSili Sakiki auris gareSe ar axlavs nevrologiuri moSlilobebi. xSiri simpromebia: • • • • • gulisreva Rebineba fotofobia fonofobia zogadi mgrZnobelobiTi darRvevebi sxva simptomebia: • • • • Tavbrusxveva muclis tkivili diarea cxviris gaWedva Tanmxlebi simptomebi gulisreva, Rebineba, mxedvelobiTi an mgrZnobelobiTi aura, bavSvebSi – muclis tkivili, damaxasiaTebelia memkvidruli winaswar-ganwyoba, axlo naTesavebSi xSiria bronquli asTmis an neirodermatitis SemTxvevebi klasteruli (hortonis) Tavis tkivili tkivilis lokalizacia Tvalbude iradiacia Subli, safeTqeli xasiaTi Zalian Zlieri, mburRavi an mwvave Setevebis sixSire 1-2-jer dReSi, aRmocendeba seriulad 4-6 kviris manZilze, Semdeg dgeba naTeli periodi, romelic ramodenime Tve da weli grZeldeba Setevis xangrZlivoba 15 wT-dan 3 sT-mde (saSualod 30 wT) Setevis dawyeba RamiT, erTsa da imave dros, daZinebidan 2-3 saaTSi Setevis dasasruli TavisTavad ra aZlierebs tkivils alkoholi (Setevebis seriis periodSi) ra amsubuqebs mdgomareobas sumatriptani, Jangbadis inhalacia Tanmxlebi simptomebi rinorea, cremldena, tkivilis mxares Tvalis, Sublisa da loyis hiperemia, iSviaTad – horneris sindromi daZabvis Tavis tkivili tkivilis lokalizacia Subli, safeTqeli iradiacia kefa xasiaTi yru, moWeriTi, damaxasiaTebelia simZimis SegrZneba Setevebis sixSire TiTqmis yoveldRe Setevis xangrZlivoba Setevis dawyeba ra aZlierebs tkivils ra amsubuqebs mdgomareobas ramodenime saaTi diliT, gaRviZebis Semdeg emociuri gadaZabva, muSaoba Seusveneblad alkoholi Tanmxlebi simptomebi Tavbrusxveva, daRliloba, tkivili da SeboWiloba kisris areSi, SfoTvis gancda, daTrgunuli ganwyoba Tavis tkivili gamowveuli intrakranialuri hipertenziiT tkivilis lokalizacia Cveulebriv kefis areSi difuziuri tkivili iradiacia Tvalbude xasiaTi yru, intensivoba Setevis periodSi icvleba Setevebis sixSire yoveldRiurad Tanmxlebi simptomebi Rebineba gulisrevis gareSe, Tavbrusxveva, Zilianoba, yurebis dagubeba (gvian stadiaze) fizikaluri monacemebi kerovani nevrologiuri simptomatika, mxedvelobis nervis diskos SeSupeba (yovelTvis gamoxatuli ar aris) giganturujredovani arteritis epidemiologia avadobis piki aRiniSneba 60-75 wlis asakSi qalebSi daavadeba samjer ufro xSirad viTardeba, vidre mamakacebSi yovelwliurad avadobis maCvenebeli 50 wlis zemoT pirebSi Seadgens 18/100.000 mosaxleze daavadeba upiratesad TeTrkanian pacientebSi gvxvdeba aRwerilia ojaxuri SemTxvevebi, rac miuTiTebs daavadebis etiologiaSi genetikuri faqtorebis rolze revmatuli polimialgia kisris, mxris da menjis sartylis saxsrebSi tkivili da SeboWiloba sistemuri simptomebi, rogoricaa subfebriliteti, daRliloba da wonaSi dakleba eriTrocitebis daleqvis siCqaris mkveTri momateba kortikosteriodebis mcire dozebze aRiniSneba dramatuli pasuxi Setevis xangrZlivoba Setevis dawyeba ra aZlierebs tkivils ramodenime saaTi, an grZeldeba mudmivad diliT, gaRviZebisas xvela, dacemineba, gaWinTva ra amsubuqebs mdgomareobas analgeziuri saSualebebi (aspirini), mjdomare da woliTi pozicia giganturujredovani arteritis mkurnaloba sawyisi doza _20-40 mg dReSi 8 kviris ganmavlobaSi. pacientebSi, mxedvelobiTi simptomebiT SesaZloa saWiro gaxdes 80 mg prednizolonis gamoyeneba. yovel 2-4 kviraSi SesaZloa Semcirdes doza 2-5 mg-iT, vidre doza 10 mg ar gaxdeba, Semdeg doza SeiZleba Semcirdes 1 mg-iT 4-6 kviris ganmavlobaSi SemanarCunebeli doza dReSi daaxloebiT 3 mg revmatuli polimialgiis mkurnaloba sawyisi doza _ prednizoloni 10-20 mg dReSi, erTi Tve yovel 2-4 kviraSi SesaZloa Semcirdes doza 2-5 mg-iT, vidre doza 10 mg ar gaxdeba, Semdeg doza SeiZleba Semcirdes 1 mg-iT 4-6 kviris ganmavlobaSi SemanarCunebeli doza _ daaxloebiT 10 mg, mkurnalobis dawyebidan 6 Tve da 5-7,5 mg erTi wlis ganmavlobaSi. pacientis umravlesobas esaWiroeba 3-4 wliani mkurnaloba Tavis tkivili gamowveuli xerxemlis kisris nawilis paTologiiT tkivilis lokalizacia kefa iradiacia calmxrivad, Txemisa da Tvalbudis areSi xasiaTi yru, saSualo intensivobis Setevebis sixSire yoveldRiurad Setevis xangrZlivoba 1-6 saaTi Setevis dawyeba diliT, gaRviZebisas Setevis dasasruli Cveulebriv, dRisiT ganmapirobebeli faqtorebi saavtomobilo travma ra aZlierebs tkivils Tavis motrialeba ra amsubuqebs mdgomareobas kisris areSi sicive an siTbo Tanmxlebi simptomebi Tavis Tmiani nawilis paresTezia (iSviaTia), kisris SeboWiloba, Tavis areSi simZimis SegrZneba fizikaluri monacemebi mtkivneuloba C1-C3-is palpaciisas, gansakuTrebiT, tkivilis mxares Tavis tkivilis marTvis ZiriTadi principebi ar aris aucilebeli, rom Tavis tkivilis gamomwvevi faqtori misi gaqronikulebis mizezi gaxdes mkurnalobis mTavari mizani ar aris Tavis tkivilis sruli kupireba mkurnalobis dros pacienti aqtiur Tanamonawiled unda iqces gadauWreli ojaxuri problemebi, SesaZloa, Tavis tkivilis gaqronikulebis mizezi gaxdes medikamentebis zedmetad gamoyeneba, xSirad, Tavis tkivilis mizezi xdeba mkurnaloba individualurad unda SeirCes