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 Tbilisis saxelmwifo samedicino universiteti
 ТБИЛИССКИЙ ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ УНИВЕРСИТЕТ
             TBILISI STATE MEDICAL UNIVERSITY




saqarTvelos samedicino Jurnali
      samecniero-praqtikuli, meTodologiuri Jurnali.
                     daarsda 1922 wels


       Медицинский журнал Грузии
   Научно-практический, методологический журнал. Основан в 1922 году



          Medical Journal of Georgia
       Scientific-practical methodological journal. Was established in 1922




                                      2
                      aprili-ivnisi
                           2008
                                            2



                                    Sinaarsi


infeqciuri daavadebebi
i. mWedliSvili, d. gelovani, T. mWedliSvili - zogierTi infeqciuri daavadebis
    gavrceleba saqarTveloSi.


kurortologia
n. saakaSvili, i. WabaSvili - biliaruli sistemis paTologiisas saxarbedios
    mineraluri wyliT organizmSi mimdinare koreqcia


endokrinologia
S. janjRava, q. asaTiani, l. uCava, a. xmeliZe, m. janjRava, e. xmeliZe, n. baramiZe,
m. danelia - hiperprolaqtinemia mamakacebSi.


profilaqtikuri medicina
r. kverenCxilaZe, vad. saakaZe, m. cimakuriZe, l. baqraZe - saqarTvelos samrewvelo
    obieqtebis sawarmoo garemos mdgomareobis profilaqtikis ZiriTadi principebi


jandacvis organizacia
e. mirvelaSvili - Saqriani diabetiT daavadebulTa ganaTlebis zogierTi sakiTxi
    saqarTveloSi.


eqsperimentuli medicina, paTomorfologia
g. pataraia - eqsperimentsi tyviis (Pb) eqspoziciiT ganpirobebuli morfologiur-
    funqciuri cvlilebebi da misi prevencia


Tanamedrove teqnologiebi medicinaSi
T. cecxlaZe - eleqtroqimiuri danadgariTa da teqnologiuri sistemiT warmoebuli
   sadezinfeqcio da sasterilizacio xsnarebis efeqturoba da usafrTxoeba


medicinis istoria
r. iakobiZe, i. CinCalaZe - saqarTvelos wylis resursebis sistemuri Seswavlis
    aucilebloba - robert kupcisis gamocdileba da Rvawli
gaxseneba
pirovneba, WeSmariti moqalaqe (oTar SalamberiZe)
giorgi kereseliZe
redaqtoris gverdi
tradicia
daviT ciciSvili
rCeuli
irakli faRava
gamosaTxovari
kote barqaia
                                            3



                           infeqciuri daavadebebi


    zogierTi infeqciuri daavadebis gavrceleba
                  saqarTveloSi

                               i. mWedliSvili, d. gelovani, T. mWedliSvili
                      Tssu epidemiologiisa da biostatistikis departamenti,
                      daavadebaTa kontrolis da sazogadoebrivi janmrTelobis
                      erovnuli centri

                                                (recenzenti - profesori g. kacitaZe)


    meoce saukunis meore naxevarSi miR-         iyo gamovlenili (8). es faqti seriozul
weul iqna mniSvnelovani warmatebebi in-         winapirobas qmnis saqarTveloSi aiv-in-
feqciuri daavadebebis winaaRmdeg brZo-          feqciis epidsituaciis kidev ufro
lis saqmeSi. miuxedavad amisa, maT kvlav        garTulebisaTvis, rasac SeiZleba xeli
wamyvani adgili ukavia adamianis paTolo-        Seuwyos qveyanaSi narkotikebis ineqciur
giaSi. janmos oficialuri monacemebiT,           momxmarebelTa ricxvis ganuxrelma zr-
msoflioSi, yovelwliurad, infeqciuri             damac.
daavadebiT avaddeba 1,5 miliardze meti             aRsaniSnavia, rom ise rogorc mTel rig
adamiani (3). bunebrivia, rom infeqciuri        qveynebSi (8), saqarTveloSic ganuxrelad
daavadebebi mniSvnelovani problemaa             izrdeba sqesobrivi kontaqtis roli in-
saqarTvelosTvisac, romelic ganvi-               feqciis gavrcelebaSi da ukve amJamad
Tarebad qveynebis ricxvs miekuTvneba. am        32,6%-Si infeqcia gavrcelda heterose-
jgufis qveynebSi ki es daavadebebi ufro         qsualuri kontaqtis gziT. kontaqturi
farTodaa gavrcelebuli, vidre ganvi-             meqanizmis gaaqtiureba am infeqciiT ava-
Tarebul saxelmwifoebSi.                         dobis zrdis mniSvnelovani safuZveli
   Cvens mizans Seadgenda saqarTveloSi,         SeiZleba gaxdes. aiv-infeqciiT avadobis
ocdameerTe saukuneSi, im infeqciuri             zrdis fonze sul ufro met mniSvnelobas
daavadebebis gavrcelebis Seswavla, rom-         iZens tuberkulozic, romlis epidemi-
lebic aqtualuria qveynisaTvis.                  ologiuri situacia mniSvnelovnad
   upirveles yovlisa, unda SevexoT              garTulda gasuli saukunis 90-iani
saqarTveloSi aiv-infeqciis gavrceleb-           wlebidan moyolebuli (1,5,9), da rac gan-
is mdgomareobas. 2008 wlis 27 maisisaTvis       pirobebulia         rTuli    socialur-
saqarTveloSi gamovlenili iyo 1633               ekonomikuri pirobebiT da M. tuberculosis
SemTxveva. 1989-1996 wlebSi epidemi-            rezistentuli Stamebis farTo cirku-
ologiuri situacia aiv-infeqciis mimarT          laciiT. tuberkulozTan asocirebuli
keTilsaimedo iyo da wlis ganmavlobaSi           aiv-infeqciis gamosavali ki friad arasa-
mxolod erTeuli SemTxveva vlindeboda.            survelia. yvela aRniSnuli mizezebis
situacia mkveTrad Seicvala 1997 wlidan.         gamo, saqarTveloSi aiv-infeqciis prob-
am periodidan moyolebuli yovelwli-              lemis aqtualoba SeiZleba kidev ufro
urad gamovlenili SemTxvevebis ricxvi            gaizardos.
aRemateboda wina wels registrirebul                erT-erTi mniSvnelovani problemaa
raodenobas da 2007 wels gamovlinda aiv-         virusuli hepatitebi, romelTa regis-
infeqciis yvelaze meti – 344 axali              tracia qveyanaSi daiwyo 1953 wlidan da
SemTxveva, ufro meti, vidre 1989-2001           mas Semdeg hepatitebs axasiaTebdaT ava-
wlebSi erTad aRebuli. matebis aseTi ten-        dobis matebis tendencia, rac gasuli
dencia miT ufro mniSvnelovania im mdgo-         saukunis 80-iani wlebis bolomde gagr-
mareobis fonze, rodesac rogorc msof-            Zelda (2). damoukideblobis mopovebis
lioSi, ise Cven mezoblad mdebare dsT-s          Semdeg, daavadebulTa gamovlenisa da
mTel rig qveynebSi aiv-infeqciis gavr-          aRricxvis saqmeSi seriozuli naklov-
celebis masStabebi epidemiur xasiaTs            anebebis gamo, daiwyo virusuli hepatite-
iRebs (7). magaliTad ruseTSi 2006 wels          biT avadobis donis mniSvnelovani kleba,
ukve 370 aTasze meti inficirebuli piri          rac ukanasknel wlebSi kvlav Seicvala
                                            4



zrdis tendenciiT da 2007 wels avadobis             gansakuTrebiT swrafad izrdeba qron-
maCvenebelma 100 aTas mcxovrebze Seadg-         ikuli B da C hepatitis xvedriTi wili
ina 131,2, rac yvelaze maRali maCvenebe-        hepatitebiT saerTo avadobaSi. Tu gav-
lia 1992 wlidan moyolebuli.                     iTvaliswinebT, rom A hepatitisagan gan-
   cnobilia, rom virusuli hepatitebi            sxvavebiT B da C hepatitebi bevrad ufro
ZiriTadad 5 nozologiuri erTeulisagan            mZimed mimdinareobs da sakmaod xSirad
Sedgeba. esenia A, B, C, D, E hepatitebi.       maTi gamosavalia RviZlis cirozi da hepa-
maTi xvedriTi wili virusuli hepatite-           toceluluri karcinoma, gasagebi gaxde-
biT avadobaSi ocdameerTe saukuneSi              ba, Tu ra seriozul safrTxes uqmnis mo-
mniSvnelovnad Seicvala. Tu gasul sauku-         saxleobis janmrTelobas parenteruli
neSi SemTxvevaTa ZiriTadi nawili A hepa-        hepatitebis farTo gavrceleba.
titze modioda, amJamad sagrZnoblad                 SeuZlebelia ar aRiniSnos gauSifravi
gaizarda sxva nozologiuri erTeulebis            etiologiis virusuli hepatitebis maRa-
xvedriTi wilic (suraTi 1).                      li xvedriTi wili. es ganpirobebulia

                                                                  suraTi 1
     virusuli hepatitebis calkeuli nozologiuri erTeulebis xvedriTi wili
                  saqarTveloSi 2006-2007 wlebis monacemebiT


                                                  A hepatiti
                                                   A
                                      36.20%
                                                                B
                                                   mwvave B hepatiti

          15.40%                                   mwvave          C
                                                            C hepatiti

                                                   qronikuli B           B
                                                                   hepatiti
            11.90%
                     3.70% 4.80%         28%       qronikuli C hepatiti               C

                                                  D,E E da gauSifravi etiologiis
                                                   D,
                                                   virusuli hepatitebi



                                                                                                   suraTi 2
                 virusuli hepatitebis calkeuli nozologiuri erTeulebis
                    xvedriTi wili TbilisSi 2006-2007 wlebis monacemebiT

                                                             A ? hepatiti ?
                                                             A ? ? ?? ? ?
                   6.50%      6.20%
                                                36.70%
         10.50%                                              ?qronikuri C C ? ? ? ? ? ? ? ?
                                                               ? ? ? ? ? ? ? ? hepatiti

                                                             D, E ? da ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?
                                                              D, E ? gauSifravi etiologiis
        11.50%                                                 ? ? ? ? ? ? ? ? ? ??
                                                             ?virusuli?hepatitebi? ? ? ? ?
                                                             ?qronikuli? B? B ? ? ? ? ? ? ? ?
                                                               ? ? ? ? ??         hepatiti

                                                             ?mwvave ? B ? ? ? ? ? ? ? ?
                                                               ? ? ? ? C hepatiti
                  28.60%
                                                             ?mwvave ? C ? ? ? ? ? ? ? ?
                                                               ? ? ? ? B hepatiti




raionebSi virusuli hepatitebis speci-           pirobebi Sesabamisi laboratoriuli kv-
fikuri markerebis gamosavlenad saWiro           levebis Casatareblad da aq ufro zusti
serologiuri kvlevebis Catarebis Seu-            suraTi gvaqvs TiToeuli nozologiuri
ZleblobiT. umjobesi iqneba Tu Sesabami-         erTeulis xvedriTi wilis Taobaze (sura-
si klinikuri da epidemiologiuri mo-             Ti 2). rogorc vxedavT SemTxvevebis
nacemebis safuZvelzec daismeba hepa-            TiTqmis 40% qronikul B da C hepatite-
titebis dadasturebuli diagnozi. ukeTe-          bze modis. bolo wlebSi A hepatitiT ava-
si mdgomareobaa TbilisSi, sadac aris            dobis klebis fonze qronikuli B da C
                                                                                         5



hepatitebiT avadobis donis mateba Cvens                                                         amasTan leiSmaniozis kerebi Ziri-
mezobel qveynebSic aRiniSneba (4,6).                                                         Tadad Tbilissa da qvemo qarTlis re-
   erT-erTi mniSvnelovani infeqciuri                                                         gionebSia ganlagebuli. yvela sxva SemTx-
daavadeba, romlisTvisac damaxasiaTebe-                                                       veva, romlebic sxva raionebSi aRiricxe-
lia saqarTveloSi avadobis donis swrafi                                                       ba, anamnezurad Tbilissa da qvemo
mateba aris visceruli leiSmaniozi, rom-                                                      qarTls ukavSirdeba. gansakuTrebiT in-
lis pirveli SemTxveva qveyanaSi 1928                                                         tensiuradaa daavadeba gavrcelebuli
wels gamovlinda. am daavadebis dinamika                                                      TbilisSi. 2000-2007 wlebSi saqarTvelo-
saqarTveloSi naCvenebia suraT 3-ze.                                                          Si visceruli leiSmaniozis SemTxvevaTa
                                                                       suraTi 3
          visceruli leiSmaniozis dinamika saqarTveloSi 2000-2007 wlebSi


                                               200
                      SemTxvevebis raodenoba




                                               180
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                                                                                                                                                  suraTi 4
                                               malariis dinamika saqarTveloSi 2000-2007 wlebSi

                                                 500
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                                                 350
            SemTxvevebis
             raodenoba




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63,2% swored dedaqalaqze modis. Tbilis-                                                      nis 60-iani wlebidan moyolebuli qveyana-
Si avadobis donis mateba ganpirobebuli                                                       Si praqtikulad likvidirebuli iyo.
unda iyos daavadebis ZiriTadi rezer-                                                            ocdameerTe saukuneSi malaria inten-
vuaris – ZaRlebis (gansakuTrebiT upa-                                                        siurad gavrcelda ZiriTadad aRmosav-
trono) da gadamtanis – flebotomusis                                                          leT saqarTveloSi, kerZod, alaznis
raodenobis zrdiT.                                                                            velze mdebare lagodexis, siRnaRis, ded-
   rogorc TbilisSi, ise mTlianad                                                             ofliswyaros da yvarlis raionebSi, aseve
saqarTveloSi ZiriTadad bavSvebi avad-                                                        qvemo qarTlis ramdenime raionSi. ma-
debian. 14 wlamde asakis bavSvebze mTeli                                                     lariiT avadobis dinamika naCvenebia
SemTxvevebis 60% modis. aRsaniSnavia,                                                        meoTxe suraTze. rogorc vxedavT, yve-
rom avadobam imata mozrdilebSic.                                                             laze meti SemTxveva 2001-2002 wlebSi
   ar SeiZleba ar SevexoT kidev erT daa-                                                     dafiqsirda. am wlebSi avadobis yvelaze
vadebas, malarias, romelic gasuli sauku-                                                     maRali maCvenebeli aRiniSna siRnaRis
                                                        6



raionSi – 390,7 100 aTas mcxovrebze da                      RonisZiebebis gatareba Sesustdeba an
lagodexis raionSi _ 366,3.                                  saerTod Sewydeba, aman SeiZleba gamoi-
  saxelmwifo programis farglebSi                            wvios infeqciis xelaxla aRmoceneba da
Catarebulma malariis kontrolisa da                          misi intensiuri gavrceleba. amdenad, in-
profilaqtikis RonisZiebebma saTanado                        feqciuri daavadebebis winaaRmdeg brZo-
Sedegi gamoiRo da ukve 2007 wels daavade-                   la unda tardebodes ganuwyvetlad, raTa
bis mxolod 25 SemTxveva gamovlinda. ma-                     ar miviRoT epidemiologiuri situaciis
laria kargi magaliTia imis sademonstra-                     iseTi gauareseba, rogoric aRiniSna
ciod, rom Tu daavadebis mimarT                              saqarTveloSi malariis SemTxvevaSi.
profilaqtikuri da epidsawinaaRmdego



           РАСПРОСТРАНЕНИЕ НЕКОТОРЫХ ИНФЕКЦИОННЫХ
                     ЗАБОЛЕВАНИЙ В ГРУЗИИ
                                                   И. Мчедлишвили, Д. Геловани, Т. Мчедлишвили
                               ДЕПАРТАМЕНТ ЭПИДЕМИОЛОГИИ И БИОСТИТИСТИКИ ТГМУ
                              НАЦИОНАЛЬНЫЙ ЦЕНТР КОНТРОЛЯ БОЛЕЗНЕЙ И ОБЩЕСТВЕННОГО
                              ЗДОРОВЬЯ

   В последние годы в Грузии достигнуты значительные успехи в снижении заболеваемости
инфекционными болезнями. Однако, при некоторых инфекциях не только не наблюдается тенденции к
снижению, но имеет место рост заболеваемости. К числу последних, в первую очередь, относится
ВИЧ-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 рекордное
344 ВИЧ-инфицированных. Заслуживает внимания, что в передаче этой инфекции все более активную
роль играет гетеросексуальный поровой контакт.
   Наряду с этим, в последние годы в Грузии отмечаются значительные изменения и в структуре
заболеваемости вирусными гепатитами. Постепенно снижается удельный вес гепатита А за счет
увеличения гепатитов В и С, особенно их хронических форм, что свидетельствует о неблагополучной
эпидемиологической 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 и
противоэпидемических мероприятий при этих инфекциях.




     DISTRIBUTION OF SOME INFECTIOUS DISEASES IN GEORGIA
                                                             I.Mchedlishli, D.Gelovani, T.Mchedlishvili
    Despite the fact that for the last few years certain progress has been achieved by diminishing the morbidity
rate of infectious diseases in Georgia, still it is reasonable to admit that several diseases maintain the tendency
of increasing their morbidity rate.
    HIV Infection definitely belongs to the above mentioned category. By the year 2008 (27 May) In Georgia
more than 1600 cases were registered. Since the year 1999 number of new cases have been increased and in
2007 absolutely unbelievable number of cases (344) were identified. More frequent way of transmission
recently has been Heterosexual contact.
    As for the morbidity of Viral Hepatitis For the last few years in Georgia certain changes have been ob-
served. Number of cases of Hepatitis A have decreased but with Hepatitis B and C have occurred on the
contrary(especially it concerns the chronic forms). This means that in country epidemiological situation regard-
ing parenteral Hepatitis is not good.
    In 21th century the diseases of high importance in Georgia are Malaria and Visceral Leishmaniosis as a
result of diminishing the quality, as well as the intensity of Prophylactic and Epidemiological measures towards
these infections.
                                              7




                                    literatura

   1. gulua n. _ socialurad saSiSi infeqciebis profilaqtikisa da mkurnalobis or-
ganizaciuli problemebi afxazeTidan da samaCablodan devnil mosaxleobaSi. av-
toreferati doqtoris akad. xarisxis mosapoveblad. Tbilisi, 2007w.
   2. mWedliSvili i. _ B da C hepatitebis gavrceleba saqarTveloSi. med. mecn. doq-
toris disertaciis 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 инфицированности
вирусами 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 клинических
штаммов M. Tuberculosis к лекарственным препаратам первого и второго ряда.//Эпидемиология и
инфекционные болeзни.-2007.-№4-С.7-11.
   6. Онищенко Г.Г., Шахгильдян И.В. - Актуальные вопросы эпидемиологии и профилактики
вирусных 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 и
инфекционные болeзни.-2006.-№6.-С.4-9.
   9. Туберкулез, ассоцированный с ВИЧ-инфекцией, в странах мира.//Эпидемиология и
инфекционные болeзни.-2007.- №4.-С.42-45.
                                               8



                                   kurortologia


  biliaruli sistemis paTologisas saxarbedios
mineraluri wyliT organizmSi mimdinare koreqcia

                                                             n. saakaSvili, i. WabaSvili

                        balneologiuri kurorti, saqarTvelos kurortologiis,
                        fizioTerapiis da samkurnalo turizmis samecniero-
                        praqtikuli centri

                          (recenzenti - asocirebuli profesori n. kvinikaZe da
                                                       profesori n. kakulia)


   kuW-nawlavis qronikuli daavadebebi              da veloergometriuli gamokvlevebi.
dReisaTvis iTvleba ‘saukunis~ daavadebe-           biliaruli sistemiT daavadebulebs Tan
bad da mTavar socialur problemas war-              axlavs: kuWis mJavawarmomqmneli funqci-
moadgens. a. skalnis (1999 w.) monacemebiT,        is darRveva 65,7% SemTxvevaSi, naRvlis
am daavadebebis dros aRsaniSnavia mikro-           buStis diskinezuri cvlilebebi - 81%,
elementebis disbalansis maRali maCvene-            RviZlis, sisxlis mimoqcevis moSla _ 20%,
beli, kerZod, siliciumis (65%), magniumis          qolecisto-kardialuri sindromi _
(53%), qromis (40%), TuTiis (38%), spilen-         17,5% da a.S., rac cvlida qronikuli arak-
Zis (35%), kaliumis (33%), rkinis (31%), se-       enWovani qolecistitis klinikur gamov-
lenis (27%) da aluminis 27 procentiT               linebas.
momateba. Cven mier biliaruli sistemis                avadmyofebi dayofilni iyvnen 2 jgu-
daavadebulebSi disbalansis koreqci-                fad: I jgufis avadmyofebi (40) dieturi
isTvis gamoyenebuli iqna naklebad Ses-             kvebis fonze Rebulobdnen mineralur
wavlili mineraluri wyali saxarbedio,               wyals `saxarbedios~ kurort menjis
romelic mdebareobs balneologiuri                   pirobebSi; I jgufis 30 avadmyofs utarde-
kurortis, menjis, teritoriaze. miner-              boda monoTerapia mineraluri wyliT
aluri wyali saxarbedio warmoadgens da-             kurortologiis samecniero-praqtikuli
bali mineralizaciis (2,2 g/dm3) sulfa-             centris stacionaris pirobebSi. mkur-
tur, qloridul, kalcium-magniumian                  nalobis kursi Seadgenda 24 dRes. miner-
Termul (42 o ) wyals. wlebis manZilze              aluri wyali eniSnebodaT 3,5 ml sxeulis
hidrogeologiur laboratoriaSi am wy-                1 kg masaze gaTvliT dReSi samjer kuWis
lis dinamikurma gamokvlevebma gviCvena,            mJavawarmomqmneli sawyisi funqciuri
rom saxarbedios wyals aqvs stabiluri               mdgomareobis mixedviT, xolo dispefsi-
Semadgenloba. am wylis samkurnalo                  uri movlenebis dros mineraluri wyali
Tvisebebi Seswavlil iqna qronikuli ar-             eZleodaT Wamis Semdegac.
akenWovani qolecistitiT daavadebul 70                 SeuRlebuli biliaruli paTologiiT
avadmyofze.                                        daavadebul avadmyofebSi mkurnalobis
   saerTo klinikuri gamokvlevebis gar-             dasawyisSi Warbobda palpatoruli
da, xdeboda sisxlis SratSi saerTo bi-              tkivili marjvena ferdqveSa areSi _
lirubinis da qolesterinis Semcvelobis              75,7%, dispefsiuri movlenebi _ 84,7%,
dadgena. cilebis koloiduri mdgradobis              kuWis sekreciuli funqciis darRvevebi
Seswavla xdeboda Timolis sinjis saSu-              aReniSneboda avadmyofebis 50%, qroniku-
alebiT. naRvlis buStis evakuatoruli                li koliti _ 30%. mkurnalobis Semdeg,
funqcia _ mravalmomentiani fraqciuli               keris wertilSi tkivili Seumcirda avad-
duodenuri zondirebiT, kuWis sekreci-               myofebis 38%, dadebiTi cvlilebebi
uli funqcia _ n. leporskis fraqciuli               aRiniSneboda sxva niSnebzec. mkurnalo-
meTodiT, xolo reohepatogramebis reg-               bis meTormete dRes avadmyofebis 61%-s
istracia xdeboda VPR-IA aparatiT. avad-            moexsna dispefsiuri movlenebi, xolo
myofebs utardebodaT gastroskopiuli
                                             9



danarCenebs sagrZnoblad SeumcirdaT,                 mineraluri      wylis     saxarbedios
avadmyofebis 28% gauumjobesda kuW-naw-           erTjeradma miRebam dadebiTi cvlilebe-
lavis moqmedeba.                                 bi gamoiwvia RviZlis Sida sisxlis mimo-
   klinikuri suraTis gaumjobesebasTan            qcevaSi, rac me-15 wuTidan gamoixatebo-
erTad, mineraluri wyliT mkurnalobam              da sistoluri (P < 0,05) da diastoluri
gamoiwvia dadebiTi Zvrebi naRvlis buS-           (P < 0,002) indeqsebis momatebiT (dias-
tis funqciuri mdgomareobis mxriv. zon-           toluri talRis gavrcelebis dro Sem-
direbis monacemebis mixedviT, avadmyo-           cirda 75,9 wamidan 54,4 wamamde). sakon-
febis _ 38%-Si dadasturda naRvlis buS-           trolo jgufSi (20) wyalsadenis wylis
tis hipertonuli-hiperkinetikuri disk-            erTjeradi miRebis dros RviZlis hemod-
inezia, naRvlis buStis evakuaciis perio-         inamikaSi cvlilebebi ar aRiniSneboda.
di saSualod Semcirda 11 wuTamde. mkur-           savaraudoa, rom mineraluri wylis sax-
nalobis kursis bolos naRvlis wvenis              arbedios maRali efeqturoba ganpirobe-
evakuaciis periodi gaxangrZlivda                 bulia misi mkafiod gamoxatuli mas-
20,8±0,8 wT (P<0,001), xolo naRvlis wvenis       timulebeli moqmedebiT RviZlis sisxlis
raodenoba gaizarda 23,2 ± 2 ml-dan               mimoqcevasa da misi ujredebis funqciur
31,5 ±1,5 ml-mde (P<0,001). hipertoniuli         aqtivaciaze. RviZlis sisxlZarRvebis
diskineziebiT daavadebuli avadmyofeb-            kapilarebis rezervebis CarTviT RviZl-
is ricxvi Semcirda 38%-dan 12%-mde,              Si Zlierdeba Jangva-aRdgeniTi procese-
xolo hipotoniuri diskineziebiT Sepy-             bi, naRvlis buStSi xdeba SegubebiTi pro-
robil avadmyofTa raodenoba _ Sedare-             cesebis likvidacia da anTebiTi proces-
biT naklebad (43%-dan30%-mde). hipermo-          ebis Semcireba. naRvlis Semadgenlobis
toruli diskineziebiT daavadebul avad-            gaumjobesebas Tan axlavs naRvlis buS-
myofebSi mkurnalobamde dadgenili iyo             tidan paTologiuri impulsebis gavlenis
naRvlis buStSi qolesterinis donis                Semcireba gulsa da sxva paTologiur
daqveiTeba. mineraluri wyliT mkur-               procesebSi CarTul organoebze.
nalobis Semdeg, aRiniSneboda misi mo-               igive monacemebi miviReT eqsperimen-
mateba 4,72 ± 0,5 mmol/l-dan 5,05 ± 0,09         tSi _ ZaRlebSi (oTxi). eqsperimentul mo-
mmol/l-mde (P < 0,001) II jgufs hipermo-         nacemebze dayrdnobiT mineraluri wyl-
toruli diskineziebiT daavadebulebSi              is saxarbedio aZlierebs RviZlis funqci-
naRvelSi qolesterinis daqveiTeba da              ur mdgomareobas, diurezs. dadebiT gav-
qolis mJavas donis momateba SesaZlebe-           lenas axdens naRvlis buStis motorul da
lia aixsnas qolesterinidan naRvlis               koncentraciul funqciaze. avadmyofeb-
mJavebis sinTezis gaZlierebiT.                   is 47%-Si remisia Seadgenda erT wels,
   Tu mkurnalobamde qronikuli qole-              xolo daavadebis recidivi Semcirda 1,8-
cistitiT daavadebulebSi kuWis sekreci-           jer.
uli funqciis momateba aReniSneboda                  mineraluri wylis saxarbedios gamokv-
avadmyofebis 40%-s, mkurnalobis Semdeg           levebis Sedegad miRebul iqna damajere-
maTi raodenoba sagrZnoblad Semcirda (-           beli monacemebi, romelsac gaaCnia dez-
3,4%-mde), xolo kuWis wvenis raodenoba           intoqsikaciuri, spazmolizuri, diure-
stimulirebul fazaSi _ 141,2±6,5 ml-dan           zuli moqmedeba. aris ekologiurad suf-
111,2±6,5 ml-(P<0,01)-mde. aRsaniSnavi iyo       Ta, efeqturi, ekonomiuri bunebrivi faq-
aseve saerTo mJaveobis, mjaveobis                tori, ar gaaCnia gverdiTi movlenebi, rac
produqciis, Tavisufali mJaveobisa da             xSirad axasiaTebs medikamentur mkur-
misi debitis mxriv sarwmuno Semcireba.           nalobas. mkurnalobis Semdeg avadmyo-
rac Seexeba avadmyofebs, romelTac                febSi mniSvnelovnad gaizarda Sromisu-
aReniSneboda qronikuli gastriti                  narianoba. amitomac, Cven, kurortologe-
daqveiTebuli sekretoruli funqciiT,               bi, upiratesobas vaniWebT bunebrivi faq-
maT umniSvnelod aReniSnebodaT kuWis              torebiT mkurnalobas.
sekretoruli funqciis gaZliereba.
                                                         10




       КОРРЕКЦИЯ ДИСБАЛАНСА В ОРГАНИЗМЕ МИНЕРАЛЬНОЙ
       ВОДОЙ САХАРБЕДИО ПРИ СОЧЕТАННЫХ ЗАБОЛЕВАНИЯХ
                    БИЛИАРНОЙ СИСТЕМЫ
                                                                           Н. Саакашвили, И. Чабашвили
                               БАЛЬНЕОЛОГИЧЕСКИЙ КУРОРТ – НАУЧНО-ПРАКТИЧЕСКИЙ ЦЕНТР
                               КУРОРТОЛОГИИ, ФИЗИОТЕРАПИИ, РЕАБИЛИТАЦИИ И ЛЕЧЕБНОГО ТУРИЗМА.
                               ГРУЗИЯ, ТБИЛИСИ

    Заболевания желудочно-кишечного тракта представляют собой важную социальную проблему
нынешнего столетия. Эти болезни сопровождаются дисбалансом микроэлементов в организме (А.
Скальный, 1999). Нами впервые, для предотвращения развития подобного дисбаланса в организме
были исследованы свойства малоизученной минеральной воды (МВ) Сахарбедио, источник которой
находится на территории курорта Менджи. Минеральная вода Сахарбедио – слабоминерализованная
(2,2 г/дм3), термальная (42оС) сульфатная, хлоридная кальциево-магниевая вода.
    Действие МВ изучалось на 70 больных с сочетанными заболеваниями билиарной системы, которым
в течение 24 дней назначалось питьевое лечение. Установлено, что МВ Сахарбедио оказывает
благоприятное воздействие на больных с гепатобилиарной патологией: наряду с клиническим улучшением
выявлена коррекция моторно-эвакуаторной функции жёлчного пузыря, биохимического состава пузырной
жёлчи, восстановление нарушенного печёночного кровообращения и желудочной секреции. Сахарбедио
- экологически чистая, эффективная МВ, без побочного действия и с успехом может быть использована
при различных заболеваниях желудочно-кишечного тракта.




         CORRECTION OF ORGANISM DISBALANCE BY MEANS
      OF MINERAL WATER SAKHARBEDIO DURING THE NUPTIALS
                  ILLNESS OF BILIARY SYSTEM

                                                                               N. Saakashvili, I. Chabashvili

    According to A. Scaln (1999), people who have gastroduodenal disease experience the disbalance of microele-
ment, 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-hormonal
regulation.
    That’s why the correction of the disbalance of microelements is necessary: to enrich the feeding ration with
microelements, 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 were
diseased with nuptials illness. They were taking this mineral water by the doze of 3,5 ml on 1 kg three times a
day 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 normal-
isation of the functions of the gall-bladder, in improving the chemical ingredients of the gall, in renew the function
of circulation of the blood of liver and the function of secretorial stomach, in reduction of the cholecysto-cardial
syndrom. The using of mineral water Sakharbedio during with nuptials illness guarantees the remission for a
year, that’s why it is recommended to repeat the treatment after 10-12 months.
                                              11



                                 endokrinologia



               hiperprolaqtinemia mamakacebSi

                                    S.janjRava, q.asaTiani, l.uCava, a.xmeliZe,
                                   m.janjRava, e.xmeliZe, n.baramiZe m.danelia
                       iv.javaxiSvilis saxelobis Tbilisis saxelmwifo
                       universitetis medicinis fakultetis endokrinologiis
                       departamenti

                                       (recenzia - med. mecn. kand. m. korinTeli)

   Sesavali: prolaqtini warmoadgens po-            sisxlCaqceva da sxva), v) limfocituri
lipeptidur jaWvs, romelic Sedgeba 199              hipofiziti.
aminomJavis naSTisagan. misi molekuluri               3) simptomuri hiperprolaqtinemia:
masa 23kda, prolaqtinis sinTezze pasux-            a) pirveladi hipoTireozi, b) sakvercxee-
ismgebeli geni moTavsebulia me-6 qromo-            bis polikistozi, g) estrogenmapro-
somaze. prolaqtini gamomuSavdeba                   ducirebeli simsivneebi, d) Tandayolili
hipofizis wina wilis laqtotrofebis                 Tirkmelzeda jirkvlis hiperplazia,
mier, romelic Seadgens adenohipofizis              e) hiperprolaqtinemia sportsmenebSi.
ujredebis10-29%-s. maTi fiziologiuri                  4) farmakologiuri preparatebiT
hiperplazia da hipertrofia aRiniSneba:             gamowveuli hiperprolaqtinemia: a) tricik-
orsulobisas, laqtaciisas da axalSo-                luri antidepresantebi (imipramini, ami-
bilebSi.                                           triptilini, haloperidoli), b) estro-
   hiperprolaqtinemiis sindromisaTvis,             genebi (Casaxvis sawinaaRmdegod an
damaxasiaTebelia prolaqtinis hip-                  samkurnalod), g) dofaminis blokatore-
ersekrecia. daavadeba ufro xSirad gvx-             bi (metiklopramidi, domperidoli, feno-
vdeba qalebSi, vidre mamakacebSi, bolo             Tiazidi), d) kalciumis arxebis bloka-
periodSi aRiniSneba misi matebis tende-            torebi (verapamili), e) H2 receptorebis
cia mamakacebSi (1,2,3).                           blokatorebi (cimetidini, ranitidini), v)
   daavadebis etiologiuri faqtorebi                narkotikuli saSualebebi, z) adrener-
SeiZleba iyos: 1) hipofizis sxvadasxvag-           guli sistemis inhibitorebi (rezerpini, a-
vari dazianeba: a) hipofizis mTlianobis            meTildofa, karbidofa) (4,5).
darRveva, b) mikro an makro prolaqtino-               klinikuri maxasiaTeblebi: hiperpro-
ma, g) ‘carieli” Turquli kexis sindromi,           laqtinemia mamakacebSi gvxvdeba 40-59
d) Sereuli forma (somatotropul-laq-                wlis asakSi, pacientebi eqims Semdegi Zir-
totropuliadenoma), e) simsivneebi _ so-            iTadi CiviliT mimarTaven: ereqciuli
matotropinoma, kortikotropinoma, Ti-               funqciis darRveva, uSviloba, libidos
reotropinoma, gonadotropinoma, v)                  daqveiTeba, iSviaTad ginekomastiiTa da
kraniofaringioma, z) Serwymuli hipopi-             ufro iSviaTad galaqtoreiT. mamakcebSi
tuitarizmTan hipofizis adenoma, T) id-             hiperprolaqtinemia ZiriTadad gamov-
iopaTiuri forma,                                   lindeba makroadenomis saxiT, romelic
   2) hipiTalamur-hipofizuri funqciis              iwvevs irgvlivmdebare qsovilebis rRve-
darRveva, kerZod: a) infeqciebi (meningi-          vas da gamovlindeba tropuli hormoneb-
ti, encefaliti), b) granulomatozuri da             is deficitiT. xSirad dasmuli diag-
infiltraciuli procesebi(sarkoidozi,                nozi_“fsiqologiuri impotencia” aras-
histiocitozi, tuberkulozi da sxv.),                woria. avadmyofebi uCivian Tavis tkivils,
g) simsivneebi(glioma, meningioma da sxva),        mxedvelobis simaxvilis darRvevas, rac,
d) metaboluri darRvevebi (RviZlis cir-             ZiriTadad, mamakacebSi gamowveuli mak-
ozi, Tirkmlis qronikuli ukmarisoba),               roadenomis arsebobiT, testosteronis
e) travmebi (hipofizis fexis dazianeba,            estrogenad gardaqmnis darRvevis gamo,
                                           12



gamoxatulia osteoporozis klinikac,                 kvlevis Sedegebi da maTi analizi:16-
magram qalebTan SedarebiT ufro nakle-           ve mamakacis sisxlSi momatebuli iyo pro-
bi xarisxiT. dadgenilia, rom hiperpro-          laqtinis done 40-220ng/ml (norma1,8-19,5ng/
laqtinemiis mkurnaloba aumjobesebs Zv-          ml ). 15 pacients daqveiTebuli hqonda
lovani qsovilis struqturas, xSir                Tavisufali testosteronis done, 4 pa-
SemTxvevaSi pacientebisaTvis damaxasi-          cients daqveiTebuli hqonda akth-is done
aTebelia cximovani qsovilis siWarbe.            6,2-8,0pg/ml(norma7,9-66,1pg/ml) kortizo-
zogierTi avtoris monacemiT uSviloba             lis cirkaduli riTmi iyo darRveuli 8.00
mamakacebSi 4-49% gamowveulia aradiag-          231-294ng/ml(norma50-250ng/ml)16.00 146-
nostirebuli hiperprolaqtinemiis gamo.           200ng/ml (norma30-160ng/ml) 23.00 96-140ng/
   diagnostikis mizniT gamoiyeneba 3-           ml(norma47-98ng/ml) da ult. gamokvleviT
etapi: 1) hiperprolaqtinemiis dadas-            aRiniSneboda Tirkmelzeda jirkvalis hip-
tureba 2) simptomuri formebis gamor-            erplazia. 4 pacients momatebuli hqonda
icxva. 3) adenohipofizisa da hipoTalamu-        TSH 3,98-7,8mlu/l (norma0,3-6,3mlu/l), xolo
sis vizualizacia (2,4).                         FT4 iyo daq-veiTebuli 0,4-0,9 ng/dl (nor-
   hiperprolaqtinemiis mkurnalobi-              ma0,8-2,0 ng/dl), RviZlis funqciuri sinjebi
saTvis arsebobs 2 meTodi: konservatuli          yvela SemTxvevaSi iyo normis farglebSi,
da qirurgiuli. konservatuli meTode-             MRI-iT 10 pacients hqonda makroadenoma,
bidan gamoiyeneba xanmokle moqmedebis           xolo 4 pacients mikroadenoma. densito-
dofaminis agonistebi: (bromkriptini,            metriuli monacemebiT osteopenia aReniS-
parlodeli) da prolongirebuli mo-                neboda 70%, osteoporozi _ 20%.
qmedebis (dostineqsi), xolo, rac Seexeba           gamokvlevebisa da anamnezuri monace-
qirurgiul mkurnalobas igi gamoiyeneba           mebis gaTvaliwinebiT, Cven mier Seswav-
konservatiuli mkurnalobis uefeqtobi-            lili pacientebis etiologiuri faq-
sas an didi zomis makroprolaqtinomisas.         torebi Semdegnairad ganawilda 4-SemTx-
   kvlevis masalebi iv.javaxiSvilis sax-        vevaSi hiperprolaqtinemiis mizezi iyo
elobis Tbilisis saxelmwifo universite-          pirveladi hipoTireozi, 3-SemTxvevaSi
tis medicinis fakultetis endokri-               farmakologiuri preparatebi(2-narko-
nologiis departamentSi Seswavlil iqna 16        tiuli nivTierebebi. 1-Ca arxebis bloka-
pacienti, romelTac klinikur-laborato-           torebi), erT SemTxvevaSi infeqciuri daa-
riuli kvlevebis safuZvelze daud-gindaT          vadeba, 4-SemTxvevaSi Tirkmelzeda jir-
hiperprolaqtinemia. Ppacientebis asaki          kvlis hiperplazia,2-SemTxvevaSi travmu-
meryeobda 19-62 wlamde, daavadebis xang-        li dazianeba, 2-SemTxvevaSi ver moxerx-
Zlivoba ki iyo 0,2-wlidan 1,5-wlamde.           da etiologiuri faqtoris dadgena.
   kvlevis mizans warmoadgenda daavade-               pacientebi ZiriTada uCiodnen: uSvi-
bis etiologiuri faqtorebis Seswavla,            lobas _ 100%, libidos daqveiTebas _ 80%,
klinikuri suraTi da paTogenezze orien-          impotencias _ 80%, ginekomastias _ 10%,
tirebuli mkurnalobis meTodis SerCeva.           Tavis tkivils _ 60%, mxedvelobis dar-
   kvlevis meTodebi: pacientebs anamne-         Rvevas _ 40%.
zuri monacemebis gaTvaliswinebiT Cau-              mkurnalobis SerCeva xdeboda anamne-
tardaT Semdegi gamokvlevebi: anamnezis          zuri da klinikur-laboratoriuli kv-
Segrovebis mizniT vaxdendiT pacienteb-          levebis Sedegebis Sejamebis safuZvelze.
is safuZvlian gamokiTxvas; prolaqtinis          pirveladi hipoTireozis dros iniSnebo-
donis gansazRvras sisxlSi; Tavisufali           da levoTiroqsini, farmakologiuri
testosteronos donis gansazRvras sisx-           preparatebiT gamowveuli hiperpro-
lSi. adrenokortikotropuli hormonisa             laqtinemiisas ixsneboda aRniSnuli
da kortizolis cirkaduli ritmis gan-             preparatebi, aseve osteopeniisa da os-
sazRvras sisxlSi; Tireotropuli hor-             teoporozis dros iniSneboda Sesabamisi
monisa da FT4-s; RviZlis funqciur sin-          samkurnalwamlo saSualebebi. yvela pa-
jebs; densitometria; magnitur-rezonan-          cients SerCeviTad eniSneboda dofamin-
sul tomografias (MRI); Tirkmelzeda              is xanmokle da prolongirebuli mo-
jirkvlis ultrabgeriT gamokvlevas.               qmedebis agonistebi. bromokriptini
                                                0,625mg(1/4abi)dozis matebiT 1,5-2,5mg-
                                                       13



mde dReSi Wamis dros, xolo dostineqsi _                       daskvna: aradiagnostirebuli hiper-
0,25mg-dan dozis matebiT 1-2mg-mde kvi-                     prolaqtinemia SeiZleba iyos erT-erTi
raSi erTxel. Catarebuli mkurnalobis                         mizezi mamakacTa uSvilobisa; hiperpro-
Semdeg 14 pacientSi miRebul iqna dadebi-                    laqtinemiis etiologiuri faqtorebis
Ti Sedegi, xolo 2 SemTxvevaSi ver iqna                      Seswavla mniSvnelovania mkurnalobis
miRebuli sasurveli Sedegi da paciente-                      SerCevisaTvis; mamakacebSi hiperpro-
bi konsultaciis mizniT gaigzavna neiro-                     laqtinemia momavali Seswavlis sagania.
qirurgiul ganyofilebaSi.




                       ГИПЕРПРОЛАКТИНЕМИЯ                             У МУЖЧИН
                                        Ш.Джанджгава, К.Асатиани, Л. Учава, А.Хмелидзе,
                                      М.Джанджгава, Э.Хмелидзе, Н. Барамидзе, М. Данелия
                              ДЕПАРТАМЕНТ ЭНДОКРИНОЛОГИИ МЕДИЦИНСКОГО ФАКУЛЬТЕТА
                              ТБИЛИССКОГО ГОСУДАРСТВЕННОГО УНИВЕРСИТЕТА
                              ИМ.И. ДЖАВАХИШВИЛИ


   Гиперпролактинемия у мужчин это синдром, характеризующийся гиперсекрецией пролактина. Пациенты
обращаются к врачу, в основном, со следующими жалобами: нарушение эрекционной функции, бездетность,
понижение либидо, редко гинекомастия. При этом часто диагноз «психологическая импотенция» является
ошибочным.
   Цель исследований состояло в изучении этиологических факторов заболевания, клиническая картина и
выбор оптимального метода лечения. На базе эндокринологического департамента медицинского факультета
Тбилисского государственного медицинского университета обследовано 16 мужчин в возрасте от 19 до 62
лет, которым на основании клинико-лабораторных исследований была установлена гиперпролактинемия.
Пациентам исследовали: 1) содержание уровня пролактина в крови; 2) уровень свободного тестостерона в
крови; 3) содержание в крови адренокортикотропного гормона и циркадного ритма кортизола; 4) TSH и
FT4; 5) функции печени, а также проводили денситометрию; магнитно-резонансную томографию.
   На основании анамнестических и клинико-функциональных исследований установлено, что в 4 случаях
причиной гиперолактинемии являлся первичный гипертиреоз, в 3 – фармакологические препа-раты, в одном
- инфекционные заболевания, в 4- гиперплазия надпочечников, в 2 - травматические повреждения, а в 2
случаях этиологический фактор установить не удалось.
   Подбор метода лечения осуществлялся на основании результатов изучения анамнеза и клинико-лабораторных
данных. После проведенного длительного лечения положительный результат отмечался у 14 пациентов.



                              HYPERPROLACTINEMY IN MEN
                                                Sh. Janjghava, K. Asatiani, L. uChava, E. Khmelidze,
                                              M. Janjgava, A. Khmelidze, M. danelia. N. Baramidze

   The 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 40-59
years 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. Javakhishvili
Tbilisi 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 picture
and choice of the optimal methods of treatment. The patients were examined in order to: 1) determine prolaction
                                                         14



level in blood; 3) to determine free testosterone in blood; 4) to determine an adrenocorticotrophical hormone and
circular rhythm of cortizol in blood; 5) TSH and FT4; 6) functional tests of liver; 7) densitometer; 8) magnetic-
resonance tomography. With foreseen the examination and anamnesis dates, the patients’ etiological factors were
distributed as follows: In 4 cases by reason of hyperprolactinemy primary hypothyroidism was shown, in 3
cases - 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 was
impossible to detect the etiological factor.
    The Choice of the treatment was realized on the bases of total result of the anamnestic and clinical-laboratorial
research. After the long treatment positive result is noted in 14 patients.




                                               literatura

   1. 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 и
лечение эндокринных заболеваний (руководство). Москва-2002-94-С.107.
   5. Балаболкин МИ. Эндокринология. Москва.-1998-С.134-142.
                                            15



                          profilaqtikuri medicina



       saqarTvelos samrewvelo obieqtebis
  sawarmoo garemos mdgomareobis profilaqtikis
              ZiriTadi principebi

                   r. kverenCxilaZe, vad. saakaZe, m. cimakuriZe, l. baqraZe
                      Tbilisis saxelmwifo samedicino universitetis garemosa
                      da profesiuli medicinis departamenti

                                     (recenzenti - profesor i. mWedliSvili)


   samedicino mecnierebis, kerZod,                  qveynis samrewvelo sawarmoebSi arse-
profilaqtikuri medicinis mniSvnelo-              buli Sromis pirobebis araxelsayreli
vani amocanaa dasaqmebuli mosaxleobis            mdgomareobis gamosworebisa da, Sesabam-
Sromisa da janmrTelobis dacvis uzrun-            isad, garemos dabinZurebis Semcirebis
velyofa Sesabamisi kompleqsuri RonisZ-           ZiriTad gzebad gvesaxeba: moqmedi sam-
iebebis safuZvelze [1,2].                        rewvelo sawarmoebis modernizaciisa da
   ukanasknel aTwleulSi, saqarTveloSi            Tanamedrove teqnologiebis gamoyenebiT
ganviTarebuli epoqaluri cvlilebebis              axali mSeneblobis saxelmwifo programis
Sedegad, mkveTrad daeca samrewvelo               SemuSaveba; sawarmoebSi iseTi teqnolo-
warmoebis moculoba. jandacvis sistema-           giebis etapobrivi Semcireba, romlebic
Si dawyebuli reorganizaciis procesis             garemos dabinZurebas ganapirobebs; gare-
dausruleblobam gamoiwvia dasaqmebuli             mos dabinZurebis mniSvnelovani wyaros -
mosaxleobis janmrTelobis dacvis                  gacveTili, moralurad da teqnikurad
RonisZiebaTa mniSvnelovani rgolis –              moZvelebuli sawarmoo aRWurvilobis
muSaTa avadobis analizisa da profilaq-           eqspluataciidan gamoricxva; sawarmoeb-
tikuri samedicino gasinjvebis Catareb-           is xelmZRvanelTa (mewarmeTa) pasuxismge-
is mwyobri sistemis rRveva; mkveTrad Sem-        blobis amaRleba teqnologiuri proces-
cirda profesiul daavadebaTa gamovle-             ebis reJimis dacvisa da sawarmoo aRWur-
nis done, rac momavalSi maTi mZime, Sors-        vilobis sworiE eqspluataciisadmi; muSa-
wasuli formebis gamovlenis arasasurv-            Ta samedicino uzrunvelyofis mwyobri
el perspeqtivas qmnis.                           sistemis funqcionirebis uzrunvelyofa;
   saqarTvelos socialur-ekonomikuri              Sromis medicinis sferos uzrunvelyofa
ganviTarebis Tanamedrove etapi xasiaT-           sakanonmdeblo-normatiuli baziT.
deba Zveli, moZvelebuli teqnologiebis               erovnuli meurneobis konkretul sf-
mqone samrewvelo obieqtebis funqcion-            eroSi kompleqsuri gamajansaRebeli
irebis aRdgeniT, rac araxelsayrel pro-           RonisZiebebis danergvis mniSvnelovani
fesiul faqtorTa generaciis wina-                 samedicino da socialuri efeqtis Tval-
pirobaa. es garemoeba, mniSvnelovan-             saCino magaliTs warmoadgens Cven mier
wilad, ganapirobebs garemos dabinZure-           saqarTvelos mrewvelobis erT-erTi
bis xarisxobrivi da raodenobrivi                 wamyvani dargis - saSen masalaTa
maCveneblebis zrdas. jer kidev mcirea            mrewvelobis sawarmoebSi Catarebuli
axali, progresuli teqnologiebis mqone            oretapiani kompleqsuri gamokvlevebis
sawarmoebis xvedriTi wili.                       Sedegebi.
   qveyanaSi garemos damabinZurebeli                saSen masalaTa mrewvelobis obieqteb-
mrewvelobis ZiriTadi dargebia: samTomom-         is Sromis pirobebisa da am sferoSi mo-
povebeli, manqanaTmSeneblobis, qimiuri,          muSaveTa janmrTelobis mdgomareobis
saSeni masalebisa da metalurgiuli                kompleqsuri Seswavlis aucilebloba
mrewvelobis sawarmoebi, romlebic profe-          ganpirobebulia 2 motiviT: Tanamedrove
siuli daavadebebis ganviTarebis riskis           etapze Cvens qveyanaSi mimdinare mniSvnelo-
faqtorTa formirebis ZiriTadi mizezia.            vani socialur-ekonomikuri cvlilebeb-
                                             16



is fonze farTod ganviTarda samrewvelo             sakuTrebiT Sromatevadi profesia ki (ma-
da samoqalaqo mSenebloba, ramac saSeni            galiTad, kapselebSi amkrefi), saerTod
masalebisa da konstruqciebis mrewvelo-            likvidirebulia.
bis Semdgomi ganviTareba ganapiroba.                 Sromis pirobebis gaumjobeseba, Tavis
mrewvelobis es dargi dRes erovnuli                mxriv, gavlenas axdens momuSaveTa janm-
meurneobis erT-erT ZiriTadi da mniS-              rTelobis mdgomareobaze. kerZod, muSa-
vnelovani dargia. saqarTveloSi igi war-           Ta avadobis SedarebiTi SeswavliT dadg-
modgenilia misi TiTqmis yvela ZiriTadi            inda, rom misi done, 20-wlian periodSi,
qvedargiT _ keramikis, silikaturi, cecx-          statistikurad sarwmunod Semcirda.
lgamZle da Tixis aguris, cementis,                kerZod, yovel 100 muSaze Sromisuunar-
azbestcementis da rkinabetonis nakeTo-            obis dReTa raodenoba 12,1÷411,2 dRiT Sem-
baTa, betonis blokis, qviSis gamamdi-             cirda, ramac mogvca droebiTi Sromis-
drebeli sawarmoebiT. meore mxriv, te-             uunarobis dReTa anazRaurebis Tanxis
qnologiuri procesebis mravalferovneb-             1,2÷38,2% wliuri ekonomikuri efeqti.
isa da mTeli rigi sawarmoebis teqnikuri da           analogiuri kanonzomieri Sedegebia
moraluri cveTis gamo, mrewvelobis aRniS-          miRebuli muSaTa janmrTelobis mdgomar-
nul dargSi mniSvnelovania arxelayreli             eobis klinikur-funqciuri gamokvleveb-
Sromis pirobebis mqone sawarmoebisa da sa-        is monacemebis analiziT SedarebiT Wril-
muSao adgilebis xvedriTi wili [3].                Si - Zveli da axali teqnologiebiT mo-
   Cven mier Catarebuli 20-wliani di-             muSave sawarmoebSi. kerZod, mowinave te-
namikuri kompleqsuri gamokvlevebis                qnologiiT momuSave sawarmoebSi (sadac
Sedegad gamovlinda Sromis pirobebis               samuSao haeris damtverianeba mniS-
araxelsayreli maCveneblebi da maTi gan-           vnelovnad naklebia) praqtikulad janm-
viTarebis ganmapirobebli faqtorebi,               rTeli pirebi 9,8÷10,2%-iT meti gamovlin-
ris safuZvelzec daisaxa konkretuli mi-            da (t=1,6), xolo sunTqvis organoebis daa-
zanmimarTuli RonisZiebebi profilaq-               vadebebi, romelTa genezSi mniSvnelova-
tikisa da muSaTa kontingentis gajan-              nia mtvris faqtoris roli, 2,4-jer nak-
saRebisaTvis.                                     lebia (t=1,8÷2,3); am or kontingentSi gamov-
   maTi praqtikaSi realizaciis Sedegeb-           lenil daavadebaTa struqtura mniS-
is aprobaciam TvalnaTliv daamtkica Se-            vnelovnad gansxvavdeba erTmaneTisagan
muSavebuli rekomendaciebis efeqtur-               (X2=22,8÷34,6).
oba. kerZod, mniSvnelovnad gaumjobesda               xazgasmiT unda aRiniSnos, rom Cven
samrewvelo mtvris, mikroklimatisa da              mier miwodebuli kompleqsuri gamajan-
xmauris parametrebi, rac ganxorcielda             saRebeli RonisZiebebis SemuSavebasa da
sawarmoo nagebobebis racionaluri                  realizaciaSi aqtiurad iyo CarTuli Se-
dagegmarebiT da aRWurvilobis hermeti-             sabamisi samrewvelo sawarmoebis usa-
zaciiT, teqnologiur ciklSi teqnikur-              frTxoebis teqnikis samsaxurebisa da
teqnologiuri aspeqtiT ufro progre-                samedicino dawesebulebebis warmomad-
suli sawarmoo aRWurvilobis gamoyeneb-             genlebi, rac maTi efeqturi realizaciis
is Sedegad.                                       mniSvnelovani winapirobaa.
   garda amisa, Cven mier Catarebuli ko-             amrigad, mecnierul-teqnikuri pro-
mpleqsuri gamokvlevebis safuzvelze                gresis miRwevebis praqtikaSi danergva
higienuri Sefaseba mieca mowinave te-             warmoebis kompleqsuri gajansaRebis sa-
qnologiur sqemebs, ramac daamtkica maTi           Sualebas iZleva Sromis pirobebis gaum-
ueWveli higienuri upiratesoba tradici-            jobesebis gziT, riTac miiRweva momuSave-
ul, moZvelebul teqnologiebTan Sedar-              Ta janmrTelobis mdgomareobis gaum-
ebiT (haeris damtverianebis donis gansx-          jobeseba mniSvnelovani samedicino, so-
vaveba identur samuSao adgilebze                  cialuri da ekonomikuri efeqtiT.
statistikurad sarwmunoa - t=3,1÷7,4).                mxolod kompleqsuri RonisZiebebis
   warmoebaSi teqnologiuri procesebis             gatarebisa da interseqtoruli Tanam-
racionalizaciisa da mowinave teqnikuri            Sromlobis safuZvelzea SesaZlebeli
aRWurvilobis danergvis Sedegad miR-               sawarmoo garemos mdgomareobisa da, Se-
weulia mravali profesiis muSaTa Sromis            sabamisad, dasaqmebuli mosaxleobis jan-
simZimis Semsubuqeba, zogierTi gan-               mrTelobis mdgomareobis gaumjobeseba.
                                                        17



                   ОСНОВНЫЕ ПРИНЦИПЫ ПРОФИЛАКТИКИ
                   СОСТОЯНИЯ ПРОИЗВОДСТВЕННОЙ СРЕДЫ
                    ПРОМЫШЛЕННЫХ ОБЪЕКТОВ ГРУЗИИ
                             Р. Кверенчхиладзе, Вад. Саакадзе, М. Цимакуридзе, Л. Бакрадзе
                              ДЕПАРТАМЕНТ МЕДИЦИНЫ ОКРУЖАЮЩЕЙ СРЕДЫ И ПРОФЕССИОНАЛЬНОЙ
                              ПАТОЛОГИИ ТБИЛИССКОГО ГОСУДАРСТВЕННОГО МЕДИЦИНСКОГО
                              УНИВЕРСИТЕТА

   Современный этап социально-экономического развития Грузии характеризуется внедрением новых,
прогрессивных технологий на фоне постепенного восстановления функционирования старых
промышленных предприятий, что требует всесторонней гигиенической оценки. Основными
направлениями улучшения условий трудa на промышленных предприятиях страны являются: разработка
государственной программы строительства и рационального размещения новых предприятий с
использованием ресурсов старых предприятий (модернизация и оснащение современной технологией);
поэтапное устранение технологий на действующих предприятиях, вызывающих загрязнению
производственной и окружающей среды; повышение ответственности руководителей предприятий
(работодателей) за соблюдением режима технологических процессов и правильной эксплуатацией
технологического оборудования; обеспечение функционирования налаженной системы медицинского
обеспечения работающих; обеспечение службы медицины труда соответствующей законодательно-
нормативной базой. На примере предприятий промышленности строительных материалов доказана
эффективность проведения комплексного, интерсекторального сотрудничества в этой области.



              MAIN PRINCIPLES OF PROPHYLACTICS
     OF INDUSTRIAL ENVIRONMENT CONDITIONS OF INDUSTRIAL
                     OBJECTS IN GEORGIA
                                R. Kverenchkhiladze, V. Saakadze, M. Tsimakuridze, L. Bakradze
       The present stage of social-economical development of Georgia is characterized by adopting new pro-
gressive technologies with the background of gradual restoration of old functioning industrial enterprises that
require overall hygienic assessment. The main directions of improvement of labour conditions in industrial
enterprises are: elaboration of state program of construction and rational allocation of new enterprises using the
resources of old enterprises (modernization and equipping with new technology; gradual removal of technolo-
gies, 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; ensuring
of 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 of
conduction of complex collaboration between sectors of this sphere is established.



                                              literatura:
   1. Измеров Н.Ф. Концептуальные подходы к сохранению и укреплению здоровья работающего населения
России.//Бюллетень Научного Совета “Медико-экологические проблемы работающих”. 2003. №1.- С.4-10.
   2. Измеров Н.Ф., Сквирская Г.П. Социальная ответственность работодателя за здоровье работающих
и 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//Материалы
V Межгосударственной конференции по безопасности труда в промышленности строительных материалов и
строительном производстве. Санкт-Петербург. - 1992. - С. 29-30.


   2. saqarTvelos samedicino Jurnali, 2, 2008 w.
                                           18



                           jandacvis organizacia


    Saqriani diabetiT daavadebulTa ganaTlebis
          zogierTi sakiTxi saqarTveloSi

                                                                       e. mirvelaSvili
                     Tbilisis saxelmwifo samedicino universitetis
                     sazogadoebrivi jandacvis departamenti

                                           (recenzenti - profesori j. mamalaZe)


   Saqrani diabeti erT-erTi farTod                 miRebuli monacemebi damuSavda
gavrcelebuli qronikuli daavadebaa.              statistikuarad, gamovTvaleT sinjis sa-
misi mzardi prevalentoba, diabeturi             Sualo da standartuli gadaxra ( SD )
garTulebebi xSirad xdeba naadrevi le-           dasakvirvebeli movlenis proporcia
taluri gamosavlisa da invalidizaciis            sakvlev jgufSi- SE da 95%-iani CI.
mizezi. daavadebis globaluri tvirTi,               Sedegebi. Cven mier kiTxvarebiT gamoi-
Saqrian diabets jandacvis sistemis erT-         kiTxa 1275 pacienti, 753 qali da 522 mamaka-
erT umniSvnelovanes problemad aqcevs            ci, sinjis saSualo asaki Seadgenda
(1;3).                                          47,46±11,08, qalebidan 283 avadmyofi
   saqarTvelos statistikis departamen-          itarebda insulinTerapias, 400 tablet da
tis monacemebiT, endokrinuli daavade-           70-dietTerapias. mamakacebidan 224
bebis struqturaSi Saqriani diabetis wili        ikeTebda insulinis inieqciebs, 216 iReb-
sakmaod maRalia. diabetiani pacientebi          da Saqris damwev abebs, xolo 82 SemTx-
endokrinuli sistemis daavadebebis, kve-         vevaSi daavadebis kompensacia miiRweoda
bis, nivTierebaTa cvlisa da imunitetis          dietTerapiiT.
darRvevebis mqone avadmyofTa 39%-s                 gacemuli pasuxebis dajgufebis Sede-
Seadgenen.                                      gad naTeli gaxda, rom gamokiTxulTa
   mkurnalobis gegma diabetianebisaTvis,        40%-ma (510 pacienti) SE=1,37; 95%CI -
sxva punqtebTan erTad, moicavs, diabe-          37,32-42,68 araferi icis kvebis gegmis mniS-
tianebis ganaTlebas, kvebiT rekomenda-          vnelobasa da dietTerapiis aucileblo-
ciebs da kvebis dagegmvas. sxvadasxva           baze. pacientTa 52% (663 avadmyofi )
garTulebebis prevenciisaTvis (diabeturi         SE=1,39; 95%CI-49,28-54,72 kvebis reJims,ar
terfi da sxva) ganaTleba gansakuTrebiT          ukavSirebs daavadebis kompensaciis Tu
mniSvnelovani kontribuciaa (2).                 dekompensaciis xarisxTan maT aseve
   Tu gaviTvaliswinebT, rom diabetis            araferi ician sakveb racionSi naxSirw-
dros swori kveba warmoadgens nivTiere-          ylebis SezRudvis aucileblobaze. di-
baT cvlis darRvevis kargi kompensaciis          etis dacvis dadebiTi Sedegebis Sesaxeb
safuZvels, savaraudoa, rom diabetianeb-         informirebulia 612 avadmyofi (48%).
is swori kvebis swavleba mniSvnelovnad          kiTxvaze: “iciT Tu ara, rom dietis dar-
gaaumjobesebs daavadebis movlasa da mim-        Rveva gavlenas axdens Tqvens janmrTe-
dinareobas (4).                                 lobaze”, maT uaryofiTi pasuxi gasces.
   meTodebi. diabetianebis ganaTlebis           kiTxvaSi specialurad ar iqna gamoyeneb-
Sesafaseblad, sworad kvebis sakiTxebSi,         uli sityva `uaryofiTi~, raTa Tavidan
gamoviyeneT Cven mier Sedgenili kiTx-           agvecilebina gamokiTxulTa mxridan
vari: ‘Saqriani diabetiT daavadebulTa           SesaZlo mikerZoebis gaCenis Sansi.
kvebis mdgomareobis Sesaxeb~.                       SemTxvevaTa TiTqmis 100%-Si (1260
   kiTxvaris meSveobiT Segrovda infor-          avadmyofi) ar xdeba glikemiisa da gluko-
macia daavadebis kontrolis iseTi mniS-          zuriis donis mixedviT kvebis gegmaSi cv-
vnelovani aspeqtis Sesaxeb, rogoricaa,          lilebebis Setana. pacientTa nawili (597
avadmyofTa swavleba, kvebis dagegmva,           avadmyofi-52%) amas ver axerxebs ekono-
dieturi mkurnalobisa da naxSirwylebis           miuri pirobebis gamo, nawili ki saerTod
SezRudvis aucilebloba.
                                                      19



ver mixvda (663 avadmyofi-52%) SekiTxvis                   movlisa da dietTerapiis sakiTxebSi
Sinaarssa da mniSvnelobas.                                 aradamakmayofilebelia, isini ar floben
   ucodinrobis gamo, gamokiTxulTa                          mniSvnelovan informacais dietTerapiisa
Soris arc erTi itarebda iseTi mniS-                        da sakveb racionSi daavadebis mimdinare-
vnelovani maxasiaTeblis monitorings,                       obis Sesabamisad cvlilebebis Setanis
rogoricaa glukozebuli hemoglobini,                         aucileblobisas.
saerTi qolesterini da trigliceridebi.                         mniSvnelovani da aucilebelia diabe-
   daskvna. amrigad, zemoT moyvanili                       tianTa ganaTlebis programebis SemuSave-
msjelobidan naTlad Cans, rom diabe-                        ba da implementacia jandacvis sistemis
tianebis ganaTlebis done, am davadebis                     saxvadasxva rgolsa Tu doneze.



                 НЕКОТОРЫЕ ВОПРОСЫ О ЗНАНИИ БОЛЬНЫХ
                 ПО ПОВОДУ САХАРНОГО ДИАБЕТА В ГРУЗИИ
                                                                                       Е. Мирвелашвили
                             ТБИЛИССКИЙ ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ ИНСТИТУТ ,
                             ДЕПАРТАМЕНТ ОБШЕСТВЕННОГО ЗДРАВООХРАНЕНИЯ

   Сахарный диабет - широко распространенное заболевание, которое нередко характеризующееся
тяжелым течением и большой частотой опасных для жизни больных осложнений с помощью опросчика
опрошены 1275 больных (753 женщин и 522 мужчин) с целью изучения вопросов их питания и специальных
знаний о диабете. Оказалось, что 40% (510 больных) не имеют элементарных знаний по таким важным
вопросам, как планирование питания и необходимость диетического лечения, а 60 % (765 больных)
имеют поверхностные знания по этим вопросам. Низкий уровень знаний больных о диабете - серьезная
проблема в системе здравоохранения страны.



              SOME ISSUES DIABETES EDUCATION IN GEORGIA
                                                                                            E.Mirvelashvili
   Diabetes mellitus is one of the most common noncommunicable diseases. The increasing prevalance of
diabetes mellitus, the emergence of diabetes complications as a cause of early morbidity and mortality, and the
enormous 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 recommenda-
tions. 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 edu-
cation questions such as diabetes adequate care and meal planning.
   Results analyses show that, level of education among diabetes patients is low in Georgia.



                                             literatura
   1. 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-
1121
   3. WHO, EMRO technical publications series 32// Guidelines for the prevention, management, and care of
diabetes mellitus, 2007, 22-27.
   4. WHO, “Definition, Diagnosis and Classsfication of diabetes Mellitus and its complications” ,1999, 15-18.
                                             20



              eqsperimentuli medicina, paTomorfologia



eqsperimentSi tyviis (Pb) eqspoziciiT organizmSi
    ganpirobebuli morfologiur-funqciuri
         cvlilebebi da misi prevencia

                                                                              g. pataraia
                       klinikuri paTologiis samecniero-praqtikuli centri,
                       Tbilisi

                          (recenzenti - asocirebuli profesori z. Tofuria)

   tyviiT intoqsikaciis paTogenezi,               ufali ionebis Tanafardobis SemJavebi-
klinika da mkurnaloba Seswavlilia                 saken gadaxra da, Sesabamisad, sisxlis pH-
safuZvlianad [11]. samecniero liter-              is maCveneblis daqveiTeba. tyviis ionebs
aturaSi ZiriTadi yuradReba gamaxvile-             mravali fermentisa da cilebis sulfhi-
bulia eqsperimentSi tyviis toqsikuri              drul (SH-) jgufebTan gamoxatuli qimi-
dozebiT gamowveul organoTa cvlilebe-              uri Tviseba akavSirebs, am ukanasknelTa
bis aRwerasa da mkurnalobis meTodebis             bolkiT safuZvlianad cvlis maT metabo-
SemuSavebaze. naklebi yuradReba aqvs              lizms [5] da iwvevs organizmSi Jangva-aRd-
daTmobili an sruliad ugulebelyofil-               geniTi reaqciebis mimdinareobis darRve-
ia, tyviis mcire, aratoqsikuri doziT xan-         vas. sayuradReboa tyviis ionebis garemo-
grZlivi eqspoziciiT gamokvlevas. aseT             Si gabnevis dinamikisa da gul-sisxlZarRv-
pirobebSi ki imyofeba kacobriobis, da,            Ta avadmyofobebis matebis Sesaxeb lit-
Sesabamisad saqarTvelos mosaxleobis               eraturisa da jandacvis msoflio orga-
umetesi nawili [12].                              nizaciis monacemebis Sejereba. aRmoCnda,
   organizmSi tyviis ionebi STainTqmeba           rom isini pirdapirproporciul kavSir-
sunTqvisas, haerSi Sewonili aerozoleb-            Sia, maSin rodesac, rogorc sayovelTaod
is, dabinZurebuli sasmeli wylisa da               cnobilia, xsenebuli sistemis avadmyo-
sakvebis gamoyenebis dros [15]. depo or-          fobebi ZiriTadad yalibdeba da viTarde-
ganoebSi (Zvlis qsovili, Zvlis tvini,             ba hipoqsiis fonze mimdinare nivTiereba-
parenqimuli organoebi da a.S.) dagrovili          Ta cvlis moSlis Sedegad [16].
tyvia didi xnis ganmavlobaSi rCeba orga-             miznad davisaxeT gamogvekvlia tyviis
nizmSi [9,13], zogjer mTeli sicocxlis             ionebis qronikuli, aratoqsikuri doziT
manZilze da warmoadgens intoqsikaciis             organizmis datvirTvis Semdeg sisxlSi, gu-
mudmiv wyaros [6, 3]. zRvruli koncen-             lis kunTsa da filtvebSi Camoyalibebuli
traciis miRwevisa da xelsayreli pirobe-           morfologiur-funqciuri cvlilebebis
bis Camoyalibebamde igi klinikurad ar             Taviseburebebi.
avlens Tavis aqtiur Tvisebebs. sakmari-              kvlevis obieqtad SevarCieT `vistari~-
sia, sxvadasxva mizezebis gamo, organizm-         s xazis zrdasruli virTagvebi (sul 232),
Si dairRves mJava-tutovani Tanafardo-             masiT 160-180 grami. sacdel cxovelebs,
ba, an, ufro mZime SemTxvevaSi, Camoyalib-        eqsperimentis pirvel etapze, ori Tvis
des acidozisaken mimarTuli qronikuli              ganmavlobaSi, eZleoda sasmel wyalSi gax-
hipoqsia, rom tyviis ionebi Tavs war-             snili ZmarmJava tyvia - kilogram wonaze
moaCens mTeli Tavisi agresiulobiT,                gadaangariSebuli sufTa tyviis 0,3 (I
gamodis sisxlSi da amwvavebs arsebul              jgufi), 1,9 (II jgufi) da 17 (II jgufi) mili-
qronikul intoqsikacias [1]. Sesabamisad,          gramis odenobiT dRe-Ramis ganmavloba-
adamianis organizmSi, umravles SemTx-             Si. dekapitaciamde sisxls viRebdiT
vevaSi, mudmivad arsebobs riskis faq-             virTagvis kudis venidan, vamzadebdiT
tori, romlis gamovlenac damokidebu-               nacxs sisxlis formiani elementebis
lia zogierTi Tanafaqtoris warmoqmnas-             Sesaswavlad da vsazRvravdiT hemoglo-
Tan, kerZod, rogoricaa wyalbadis Tavis-           binis maCvenebels. eriTrocitebSi por-
                                                 21



firinebis cvlis Taviseburebebis Seswav-               retikulocitebisa da eriTrocitebis
lis mizniT, eqsperimentis dawyebidan,                 bazofiluri marcvlovanebiT raodeno-
yoveli aTi dRis Semdeg, viRebdiT sisx-                bis momatebas. sakuTari kvlevis Sedege-
lis I, I , I I jgufis da intaqturi cxovelebis         bi, naTlad miuTiTebs saeqsperimento cx-
kudis venidan (TiToeuli jgufidan 17                   ovelebis      tyviis    maRali    doziT
cxoveli) da porfirinebis fluoroscen-                  datvirTvis pirobebSi eriTrocitebSi
tuli naTebis xarisxs eriTrocitebSi                    porfirinebis sinTezis Semcirebaze, ma-
vafasebdiT maTi metabolizmis inten-                   Sin, rodesac dabali doza aaqtivebs por-
sivobis Sefasebis mizniT.                             firinebis anabolizms. zemoTqmuli da he-
    lipiduri fraqciebis raodenobrivi                  moglobinis raodenobis Semcireba orga-
gansazRvrisaTvis masalas (sisxlis plaz-               nizmSi ganapirobebs anemiis fonis Camoy-
ma, eriTrocitebi, gulis kunTi, filtve-                alibebas da eriTropoezis intensifika-
bi) viRebdiT kriostabilur pirobebSi da                cias. amasTan, atipiuri hemoglobinis sin-
vamuSavebdiT Bloor-is meTodiT, Одушко-sa              Tezis, sisxlis plazmaSi uxeSdispersiu-
da Зеленина-s modifikaciiT. damuSavebu-               li cilebis fraqciis momatebis, sisxlis
li masalis analizi Txel fenebSi xor-                  dinebis siswrafis Semcirebisa da sisxlis
cieldeba qromatografiis meTodiT mza                   siblantis momatebis pirobebSi aRiniSne-
firfitebze Silufo UV-254. lipiduri                    ba wvrili kalibris sisxlZarRvebSi tyvi-
fraqciebis raodenobriv analizs vawar-                 iT datvirTuli gazrdili kuTri wonisa
moebdiT Karl Zeiss-is firmis eqsktinkciu-             da Secvlili muxtis mqone eriTrociteb-
li registratoriT ERJ-10-iT. sisxlSi                   is agregacia.
(plazma da eriTrocitebi), gulis kunTsa                   tyvia iwvevs lipoproteinuli mem-
da filtvebSi, lipidebis fraqciis raode-               branebis lipiduri fraqciis fosfolip-
nobiv maCveneblebs vsazRvravdiT mg%-Si.               idebis, qolesterinisa da qolesterinis
miRebuli masalis statistikuri da-                     eTerebis metabolizmis Secvlas, ris Sed-
muSavebisaTvis sarwmuno sxvaoba (P) gan-              egadac irRveva lipoproteinuli mem-
isazRvreboda fiSer-stiudensis cxrilis                 branebis, rogorc funqciuri, aseve, bune-
meSveobiT realuri sxvaobis (t) koefici-               brivia, struqturuli organizaciac. mem-
entis gaTvaliswinebiT.                                branebis funqciis Secvlis Sedegad tyvi-
    histologiuri kvlevisaTvis masalis                 is ionebi advilad aRwevs yvela ujredSi-
(gulis kunTi, filtvebi) fiqsacia war-                 da komponentTan, aqtiurad monawileobs
moebda 12%-iani formaliniT, gauwylov-                 da araspecifikurad warmarTavs mis me-
aneba xdeboda aRmaval spirtebSi, xolo                 tabolizms.
vayalibebdiT celoidinSi (Celloidin in                    eriTrocitebis ultrastruqturis
Flocken, VEB Laborachemi, DDR). marxilian             gamokvleviT aRmoCnda, rom, hemoglobin-
mikrotomze daWrili anaTlebi iRebebo-                  Semcveli marcvlebis raodenobis Semcir-
da hemotoqsiliniTa da eoziniT.                        ebis gamo, isini sxvadasxva simkvrivisaa.
    eriTrocitebi, gulis kunTsa da                     didi raodenobiT aRiniSneba, agreTve,
filtvebSi ultrastruqturuli cv-                        eriTrocitTa Crdilebi, rac maT lizisze
lilebebis gamosavlenad viyenebdiT                     miuTiTebs. ujredebSi aRiniSneba heinc-
eleqtronuli mikroskopiis meTods.                      erlihis sxeulakebi, romlebic normul
masalas fiqsacias vawarmoebiT s-kolidi-               eriTrocitebSi ar vlindeba. igi rogorc
nis buferze momzadebuli glutaralde-                   wesi, warmoiqmneba im organizmTa
hidis Weibel-is fiqsatoriT da amave                   eriTrocitebSi, romlebsac gaaCnia ara-
buferze momzadebuli osmiumis fiqsa-                   stabiluri hemoglobini. eriTrocitebis
toriT - Bennett-Luft-is mixedviT. masalas             SemomsazRvreli membranebi gauxeSebu-
vayalibebdiT epon-aralditis narevSi                   lia, dawyvetilia da maTSi warmoiqmneba
Mollenhauer-is mixedviT. ultraTxeli                   porebi. membranebi alag ganicdis srul
anaTlebis miReba xdeboda ultratom LKB                 dezorganizacias. imis gaTvaliswinebiT,
III-sa da Reichert Ultracut-E-ze. masalis ul-         rom eriTrocitebis membranas gaaCnia
trastruqturuli analizisaTvis viyeneb-                 mniSvnelovani funqcia, savaraudoa, rom
diT eleqtronul mikroskopebs Tesla BS-500-sa da        eriTrocitebis membranebis struqturu-
ЭМВ-100A-s.                                           li modifikacia gamoiwvevs maTi da, Sesa-
    eqsperimentma gamoavlina mniSvnelo-               bamisad, sisxlis funqciuri aqtivobis
vani Zvrebi sisxlis, gulis kunTisa da                 Secvlas.
filtvebis bioqimiur da struqturul                        gulis kunTi ganicdis energiis defic-
organizaciaSi. kerZod, tyviis ionebis                 itisa da masTan dakavSirebuli meqanikuri
eqspozicia periferiul sisxlSi iwvevs                  funqciis darRvevisaTvis damaxasiaTebel
                                                        22



ultrastruqturulad mniSvnelovan cv-                           organizmidan tyviis ionebs da moawes-
lilebebs. filtvis qsovilSi metabo-                           rigebs maTi eqspoziciiT ganpirobebul
lizmisa da ultrastruqturuli orga-                            darRvevebs nivTierebaTa cvlis proces-
nizaciis Secvla ki, mizez-Sedegobrivad                       ebSi.
iwvevs hipoqsiisa da respiraciuli aci-                          eqsperimentis meore etapze sacdel
dozis Camoyalibebas, izRudeba sisxl-                         cxovelebs, ori Tvis ganmavlobaSi, 0,3 da
idan Jangbadis aTviseba, kataboluri                          1,9 mg/kg raodenobiT, tyviiT datvirTvis
produqtebis utilizacia, icvleba hemo-                        Semdeg, eZleobdaT cal-calke, erTi Tvis
haerovani barieris struqtura da Sesa-                        ganmavlobaSi peqtini, askorbinis mJava da
bamisad qveiTdeba misi funqcia.                              glutationi.
   amrigad, tyviis ionebis eqspozicia                           gamokvleviT dadginda, rom tyviis ion-
mcire dozebiTac ki iwvevs eriTrocite-                        ebis organizmidan gamodevnis mizniT, peq-
bis, gulis kunTisa da filtvebis ultras-                      tinis gamoyenebis pirobebSi gamovlenili
truqturuli organizaciis da lipiduri                          cvlilebebi sustadaa gamoxatuli da um-
cvlis mniSvnelovan cvlilebebs, rom-                          ravles SemTxvevaSi Seswavlili obieqte-
lebic korelaciaSi imyofeba organizmis                        bis struqturuli organizacia umniS-
tyviiT datvirTvis intensivobasTan. rac                       vnelod gansxvavdeba normisagan. aRniS-
meti raodenobiTaa tyviis ionebi gamoy-                       nuli dakavSirebuli unda iyos peqtinis
enebuli eqsperimentSi, miT meti siRrmisa                     TvisebasTan, xangrZlivi gamoyenebis
destruqciuli cvlilebebi.                                     pirobebSi (erTi Tve), seleqciurad Sebo-
   tyviis eqspoziciis saSiSroeba adamian-                    Wos tyvia, Seqmnas wyalSi uxsnadi naerTe-
Ta janmrTelobisaTvis safuZvlianadaa                          bi (peqtinatebi, peqtatebi) da ukan Sewo-
gacnobierebuli msoflio samedicino sa-                        vis gareSe gamodevnos isini kuW-nawlavis
zogadoebis mier. aRniSnul sakiTxTan                          traqtis meSveobiT. masTan, SesaZloa
dakavSirebiT Seqmnilia da xorcieldeba                        tyviis organizmidan gamodevnis dadebi-
mravali programa [CDC’s Lead Poisoning Pre-                  Ti efeqti ufro metad gaZlierdes, Tu
vention Program (National Center for Environmental           peqtinTan erTad kompleqsSi gamoyeneb-
Health); Lead Poisoning Prevention Tips: Simple steps        uli iqneba iseTi samkurnalwamlo saSu-
to Protect Your Family From Lead Hazards (Dept. of           alebebi, romlebic moawesrigebs tyviis
Housing and Urban Development, Office of Lead                eqspoziciiT darRveul natif bioqimiur
Hazard Control): Lead Poisoning Prevention Outre-            procesebs (Jangva-aRdgeniTi reaqciebi,
act Program (Environmental Health Center, environ-           SH-jgufebis bloki da a.S.). askorbinis
mental Protection Agency) da sxva], romelic,                 mJavasa da glutationis cal-calke gamoy-
ZiriTadad, sanitaruli ganaTlebis xasi-                       eneba, miuxedavad imisa, rom isini tyvias
aTs atarebs da miznad isaxavs garemoSi                       ver gamodevnis organizmidan, dadebiT
tyviis ionebis gabnevis raodenobis Sem-                      zegavlenas axdens organizmSi mimdinare
cirebas. amasTan, naTelia, rom tyviis ion-                   procesebze. askorbinis mJavasa da glu-
ebis garemoSi gabnevis SeCereba adminis-                     tationis kompleqsuri gamoyeneba, savar-
traciuli wesiT SeuZlebelia. didi mate-                       audod, ufro metad gaaumjobesebs aRniS-
rialuri xarjebis gaRebis drosac ki Sesa-                     nul efeqts, radgan isini urTierTpo-
Zlebelia konkretul regionsa an saxelm-                       tenciis gaZlierebiT iwvevs TavianTi
wofoSi misi gabnevis mxolod moculobis                        Tvisebebis intensifikacias.
Semcireba, rac arsebul problemas glo-                           amrigad, rogorc organizmidan tyviis
balurad ver gadawyvets. gamosavali, Cve-                     ionebis gamodevnis mizniT da misi zemo-
ni azriT, tyviis eqspoziciis prevenciis                      qmedebiT gamowveuli cvlilebebis gasa-
alternatiuli mimarTulebis SemuSaveba-                        neitraleblad, ise tyviis eqspoziciis
Sia. sadReisod metad aqtualurad migvaC-                      prevenciul saSualebad SesaZlebelia
nia farmakopeisaTvis cnobili im bune-                        gamoyenebul iqnes peqtinis, askorbinis
brivi samkurnalwamlo saSualebebis gam-                       mJavasa da glutationis kompleqsi.
ovlena da SerCeva, romlebic gamodevnis
                                                         23



         МОРФО-ФУНКЦИОНАЛЬНЫЕ ИЗМЕНЕНИЯ ОРГАНИЗМА,
           ОБУСЛОВЛЕННЫЕ ЭКСПОЗИЦИЕЙ СВИНЦА (PB) В
          ЭКСПЕРИМЕНТЕ, И ВОЗМОЖНОСТИ ЕЕ ПРЕВЕНЦИИ
                                                                                                  Г.К. Патарая
                              Н/П ЦЕНТР КЛИНИЧЕСКОЙ ПАТОЛОГИИ. ТБИЛИСИ

   Проведен двухэтапный эксперимент на 233 половозрелых линии «Вистар». Экспериментальные животные
в 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 в
течение одного месяца получали пектин, аскорбиновую кислоту и глутатион.
   Изучали общий анализ крови и особенности порфиринового обмена в эритроцитах; количественной
хроматографией 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 интенсификацию
эритропоэза, нарушается липидный обмен и развиваются значительные изменения ультраструктурной
организации эритроцитов, миокарда и легких. Эти изменения находятся в прямой корреляции с интенсивностью
свинцовой нагнузки организма: чем больше количество использованных в эксперименте ионов свинца, тем
глубже деструктивные изменения. С целью выведения ионов свинца из организма, нейтрализации вызванных
его воздействием изменений и превенции интоксикации целесообразно комплексное применение пектина,
аскорбиновой кислоты и глутатиона.




  LEAD EXPOSITION IN THE EXPERIMENT CONDITIONED BY
MORPHOLOGICAL AND FUNCTIONAL CHANGES IN THE ORGANISM
        AND THE PERSPECTIVE OF ITS PREVENTION
                                                                                                      G. Pataraia
    The experiment on the “Wistar” line full-grown rats (totally 233) was performed in two stages. During two
months in the first stage the experimental animals were given acetic acid lead diluted in water-evaluated in kilogram
weight pure lead 0,3 (I group), 1,9 (II group) and 17 (III group) milligrams during twenty four hours. On the
second 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 metabolism
in the erythrocytes; chromatography of the lipid fraction in the blood plasma, erythrocytes, hearth muscle and lungs
and 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 erythropoe-
sys, 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 - as
more lead ions are used in the experiment, as deeper is the destruction changes. The complex of pectin, ascorbic
acid and glutathione may be useful in order to eliminate lead ions, neutralization and prevention of the changes
caused by its influance.
                                                         24




                                                literatura
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    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 distance
atmospheric 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.
                                            25



                  Tanamedrove teqnologiebi medicinaSi


   redaqciisagan: saqarTvelos sainJinro          bis uzrunvelyofaSi, araerTgzis dadastur-
akademiis samecniero-teqnikuri centris           da qveynis Sesabamis kompetentur kvleviT
gen. direqtoris, baton Tengiz cecxlaZis          dawesebulebebSi. vfiqrobT, rom aRniSnu-
mier warmodgenili axali samecniero-teqni-        li teqnologiis farTo danergva, rasac up-
kuri mimarTulebisa da originaluri te-            irveles yovlisa mxars uWers saqarTvelos
qnologiis maRali efeqturoba da sxa me-           Sromis, janmrTelobisa da socialuri
TodebTan misi upiratesoba, rogorc sasme-         dacvis saministro, xels Seuwyobs aRniSnu-
li da Camdinare wylebis gausnebovnebis,          li sakiTxebis Tanamedrove moTxovnebis Se-
aseve epidemiologiurad usafrTxo pirobe-          sabamisad gadawyvetaSi.


  eleqtroqimiuri danadgariTa da teqnologiuri
     sistemiT warmoebuli sadezinfeqcio da
    sasterilizacio xsnarebis efeqturoba da
                 usafrTxoeba

                                                                            T. cecxlaZe
                      saqarTvelos sainJinro akademiis samecniero-teqnikuri centri

                                   (recenzenti – profesori r. kverenCxilaZe)


   Tanamedrove msoflioSi, sicocxlisa                saqarTvelos garemos higienis samoqme-
da adamianis janmrTelobisaTvis keTil-            do erovnul gegmaSi _ “garemo da janmrTe-
saimedo sanitariul-higienuri da epide-           loba”, gaTvaliswinebulia garemosa da ad-
miologiuri pirobebis Seqmna, bunebrivi           amianis janmrTelobaze mavne garemo faq-
kataklizmebis, xarisxiani sasmeli wylis          torebis zemoqmedebis prevencia da kon-
deficitis, eTnikuri da regionuli kon-            troli. dokumentSi erT-erTi mniSvnelo-
fliqtebis, sagangebo situaciebis, biot-          vani adgili adamianis janmrTelobisaTvis
eroristuli aqtebis, mosalodneli glo-             usafrTxo sanitariul-epidemiologiuri
baluri daTbobis mikroorganizmebze sa-            pirobebisa da mosaxleobis xarisxiani sas-
varaudod dadebiTi zemoqmedebisa da sxva          meli wyliT uzrunvelyofas ukavia.
mizezebis gamo, dRiTidRe ufro aqtu-                 amave dokumentSi mkafiodaa gamoxatu-
aluri xdeba da misi gadawyveta nebismieri        li aRniSnuli problemis gadawyvetis
saxelmwifosTvis prioritetul mima-                mniSvneloba (rogorc konstituciis
rTulebas warmoadgens.                            moTxovna) - mkvidri mosaxleobisTvis us-
   es sakiTxi saqarTvelosTvisac metad            afrTxo garemos uzrunvelyofa, aseve,
mniSvnelovania da qveyanaSi arsebuli             qveynis ekonomikuri aRmavlobisTvis
gardamavali periodis siZneleebiTacaa             uaRresad saWiro da prioritetuli mima-
ganpirobebuli.                                   rTulebis _ turizmis ganviTareba.
   jandacvis msoflio organizaciis mo-               saqarTveloSi turizmis, dasvenebisa da
nacemebiT, avadobis gamomwvevi axali in-         sanatoriul-sakurorto mkurnalobis
feqcia „istoriulad uprecedento sisw-             SemdgomSi ganviTareba, gansakuTrebiT
rafiT“ warmoiSoba – weliwadSi erTi.              saerTaSoriso doneze, dakavSirebulia
amave organizaciis yovelwliur mox-               turizmisa da sakurorto raionebSi Seqmnil
senebaSi xazgasmulia, rom 1970 wlidan,           mTel rig araxelsayrel sanitariul-
msoflioSi daregistrirebulia 39 axali             higienur pirobebTan. rac, garda mosaxle-
infeqciuri daavadeba, bolo xuTi wlis             obisa da damsveneblebis janmrTelobaze
manZilze ki aRiniSna epidemiis afeTqebis         uaryofiTi moqmedebis, pirdapiri da ara-
1 100 SemTxveva, maT Soris qoleris, po-          pirdapiri ekonomikuri danakargebis, amTav-
liomielitisa da frinvelis gripis.                iTve zians ayenebs saqarTveloSi saerTa-
                                            26



Soriso turizmis ganviTarebis perspeqti-          organizmSi, mcenareebSi mravaljer
vas, negatiur gavlenas axdens saerTod sa-        aRemateba maT Semcvelobas niadagSi, wy-
zogadoebasa da qveynis prestiJze [1].            alsa da haerSi.
   saerTaSoriso turizmis ganviTarebi-               momwamlav nivTierebaTa migracias
saTvis gasaTvaliswinebelia is garemoe-           praqtikulad sazRvari ar gaaCnia. TeTri
ba, rom igi dakavSirebulia mravali adami-        daTvebis RviZlSi sxvadasxva toqsikuri
anis axal garemoSi droebiT gadaadgile-           naerTebis arseboba gamoavlina kanadis
basTan, sadac SesaZlebelia maTze zemo-           arqtikul zonaSi Catarebulma gamokv-
qmedeba moaxdinon mikroorganizmebma,             levebma. mavne naerTebi aRmoCnda Rrma
romelTa mimarT gadaadgilebul pirebs,             WaburRilebidan amoRebul samkurnalo
adgilobrivi mosaxleobisagan gansxvave-           daniSnulebis mineralur wylebsa da de-
biT, ar gaaCniaT araviTari imuniteti [1].        dis rZeSic.
   gasaTvaliswinebelia is garemoeba, rom            ddt-s (diqlordifeniltriqlor-me-
zRvis wylis xarisxTan erTad, kurorte-            TilmeTani) pesticiduri aqtiurobis aR-
bze arsebuli sanitariul-higienuri                moCenisaTvis, 1948 wels, Sveicariis aka-
pirobebi da infeqciuri daavadebebis              demiis wardginebiT, nobelis premia mien-
done, damsveneblebisa da turistebis              iWa paul miulers. 20 wlis Semdeg ki amave
(gansakuTrebiT ucxoeTidan) mozidvis              qveyanaSi kanoniT akrZales ddt-s gamoy-
TvalsazrisiT, yvelaze mniSvnelovan               eneba. mravali analogiuri magaliTi ar-
kriteriumebad iTvleba [1].                       sebobs imisa, rom meurneobis zogierT
   erovnul gegmaSi, janmrTelobis                 dargSi warmatebiT danergili sxvadasxva
dacvis msoflio organizaciis mier miRe-           produqcia (maT Soris samedicino daniS-
bul programebsa da saxelmZRvanelo do-            nulebis) dRes ukve amoRebulia xmare-
kumentebSi (mainis frankfurti, 1992w;            bidan, vinaidan samecniero-teqnikuri
helsinki, 1994w; londoni, 1992, 1999w.),         progresis mimdinare etapze SesaZlebeli
mosaxleobis janmrTelobis dacvis sfer-            gaxda adamianis janmrTelobasa da gare-
oSi, Camoyalibebulia sakiTxis sruliad            moze misi uaryofiTi zemoqmedebis
axali midgoma da principi.                       utyuari dasabuTeba.
   aRniSnuli sakiTxebis praqtikuli gada-            pirvelad antiseptiki (qlorwyali)
wyvetis TvalsazrisiT, saqarTvelos                gamoyenebul iqna sameano klinikaSi 1847
sainJinro akademiis samecniero-teqni-            wels i. zemelveisis mier. dReisTvis da-
kuri centri 2001 wlidan muSaobs axali,           muSavebulia 450-ze meti dasaxelebis
progresuli samecniero-teqnikuri mima-            preparati. antimikrobuli saSualebebis
rTulebisa (eleqtroqimiuri aqtivacia)             aseTi nairsaxeobis faqti gamowveulia ara
da Sesabamisi teqnologiebis saqarTve-            marto sabazro konkurenciiT, aramed es
loSi farTod danergvaze.                          dakavSirebulia „idealuri“ monacemebis
   mavne mikroorganizmebisa da infeqci-          mqone preparatis ZiebasTan. cnobilia,
uri daavadebebis gavrcelebis Tavidan             rom jamuri moTxovnebi „idealuri“
acilebis mizniT, antimikrobuli qimi-             preparatis gamoyenebis mimarT aris
apreparatebis gamoyenebas didi xnis is-          aranakleb 30-sa [2, 3]. tradiciuli te-
toria aqvs rogorc medicinaSi, aseve sof-         qnologiiT damzadebuli arc erTi sadez-
lis meurneobaSi. dRes ukve eWvs ar iwvevs        infeqcio saSualeba faqtiurad ar akmay-
is faqti, rom imunologiuri da gene-              ofilebs antimikrobuli preparatis (ide-
tikuri cvlilebebi, onkologiuri daa-              aluri) moTxovnebis erTobliobas [4].
vadebebi, paTologiuri mSobiaroba da ax-             Cven mier warmodgenili teqnologia
alSobilTa defeqtebi, ZiriTadad, qimiur           samedicino daniSnulebisaa da gamoiyene-
nivTierebaTa gamoyenebis zrdisa da               ba Tanamedrove moTxovnebis Sesabamisi,
ekologiuri mdgomareobis gauaresebis              maRalefeqtiani, adamianis janmrTelo-
Sedegia.                                         bisa da garemos mimarT usafrTxo, aqtiv-
   adamianisaTvis kvebis produqtebis             izebuli, ekologiurad sufTa da iafi
(maT Soris sasmeli wylis) mavneoba masSi         sarecxi, sadezinfeqcio da sasteriliza-
“ucxo” nivTierebebis arsebobiT aris              cio xsnaris (neitraluri anoliti) adg-
gamowveuli. gansakuTrebiT es exeba im            ilze sawarmoeblad (maT Soris savele
Sxamebsa da saSiS qimiur nivTierebebs,           pirobebSi).
romlebic ar monawileobs nivTierebaTa                neitraluri anoliti, mravali dasax-
cvlaSi da organizmSi xdeba maTi akumu-           elebis importuli Tu samamulo warmoeb-
lireba, ris gamoc, toqsikuri naerTebis           is sadezinfeqcio preparatebisagan gan-
koncentracia adamianisa da cxovelis              sxvavebiT, miiReba yovelgvari qimiuri
                                            27



reagentebis gamoyenebis gareSe, mxolod           maciuri procesis safuZvelze, misi mole-
bunebrivi produqtis - sufris marilis,            kulebi gamoiyofa apkidan haerSi. aRniSnu-
wylisa da eleqtroenergiis gamoyenebiT.           lis Sedegad warmoqmnil aerozols xSir-
   natriumis hipoqloridisagan gansx-             ad araviTari suni ar gaaCnia da iqmneba misi
vavebiT, romelic, agreTve, marilis wy-           usafrTxoebis iluzia. faqtiurad ki nage-
alxsnarisagan mzaddeba, neitraluri an-           bobaSi, haeris yoveli litri ramdenime
oliti aris universaluri daniSnulebis             miliard bunebrivad an sublimaciis Sede-
sadezinfeqcio da sasterilizacio xs-              gad aorTqlebul molekulas Seicavs. im
nari, aqvs antiseptikuri daniSnuleba. igi        SemTxvevaSic ki, Tu maTi koncentracia ar
gamoiyeneba sarecx da maTeTrebel saSu-           fiqsirdeba Sesabamisi tabeluri xelsawy-
alebad, sasmeli da Camdinare (maT Soris          oebiT da Seadgens zRvrulad dasaSvebi
infeqciuri profilis dawesebulebebis)             koncentraciis Tundac meased da meaTased
wylebis gausnebovnebis mizniT.                   nawils, sunTqvis procesSi, aseve kanidan
   neitraluri anoliti warmoadgens uf-            da lorwovani garsidan igi mainc xvdeba
ero, gamWvirvale siTxes. miuxedavad imi-         adamianis organizmSi (personali, pacien-
sa, rom preparatis erT-erTi aqtiuri mo-          ti), sadac agrZelebs Tavisi mTavari fun-
qmedi nivTiereba aris qlormJava, igi ar          qciis Sesrulebas (damTrgunveli zemo-
ganekuTvneba qloSemcvel sadezinfeq-              qmedeba ujredebis cxovelmoqmedebaze),
cio saSualebaTa jgufs. sxvadasxva saer-          am SemTxvevaSi ki, adamianis organizmis
TaSoriso gamocemebSi gamoyenebuli                ujredebze.
terminologiis mixedviT, analogiuri                  aRniSnulis garda, sayuradReboa is
saSualebebi Sedis Sereuli oqsidantebis           faqti, rom mikroorganizmebis sxvadasx-
jgufSi. aqtiurad moqmedi nivTierebebis           va saxeoba, romelic swrafad aRmoCndeba
koncentraciis simciris gamo, anoliti –           amave apkze (gamSral da mikrobiocidur
ГОСТ 12.1.007-76, organizmze zemoqmede-          aqtivoba dakargul organul nivTiereba-
bis xarisxiT ganekuTvneba naklebad saSiS         ze), mas iyeneben sakvebad, amavdroulad ki,
nivTierebaTa meoTxe klass. anolitis              am saxeobis dezinfeqtantis mimarT gamoi-
sasikvdilo doziT rom moiwamlos 70 kg             muSaveben rezistentulobas. neitraluri
wonis adamiani saWiroa miiRos maqsi-             anolitis gamoyenebis SemTxvevaSi
maluri koncentraciis 350 l xsnari. vet-          obieqtze ar rCeba moqmedi nivTierebeb-
erinariaSi 0.028% koncentraciis anoli-           is araviTari kvali (garda natriumis qlo-
ti gamoiyeneba dasalevad (3 mg aqtiurad          ridis umniSvnelo mikroskopiuli mocu-
moqmedi nivTiereba wonis 1 kg-ze gadaan-         lobisa), rac gamoricxavs yovelgvar Sesa-
gariSebiT). ZiriTadad, anoliti miiReba           Zleblobas mikroorganizmebis adaptaci-
da gamoiyeneba aqtiuri qloris Sem-               isa narCen, moqmed nivTierebebTan da misi
cvelobiT 0.01%, 0.02%, 0.05% da pH - is          degradaciis produqtebTan.
mniSvnelobiT 7,2-dan 8.2-mde. anoliti,              aqtivizebuli xsnari, relaqsaciis
romelSic aqtiuri moqmedi nivTierebeb-            Semdgom periodSi, kargavs madezinfi-
is koncentracia 0.01%-mdea, samkurnalo           cebel Tvisebebs da degradirdeba odnav
preparatia _ antiseptiki kanisa da Wri-          marilian wylad, romelic araviTar sa-
lobebis zedapirebis damuSavebisTvis.             frTxes ar uqmnis garemos da misi ganei-
xsnaris gamoyeneba nebadarTulia,                 tralebis an utilizaciisTvis araviTari
agreTve, ginekologiur stacionarebsa              damatebiTi RonisZiebis gatareba saWiro
da kvebis mrewvelobis obieqtebSi, sadac          ar aris. aRniSnulidan gamomdinare,
gansakuTrebiT mkacri moTxovnebia to-             mravali sadezinfeqcio saSualebisagan
qsikologiur usafrTxoebaze.                       gansxvavebiT, misi gamoyeneba SesaZlebe-
    sadezinfeqcio saSualeba efeqturad            lia nebismieri kategoriis gruntis,
SeiZleba CaiTvalos mxolod im SemTxveva-          rogorc zedapiruli, aseve siRrmuli (cx-
Si, Tu xangrZlivi gamoyenebisas, mikroor-        ovelTa samarxebi da zoonozuri in-
ganizmebi mis mimarT ver SeiZens mdgra-          feqciebis sxva kerebi) damuSavebisTvis,
dobas da ver gamoimuSavebs adaptaciur            maT Soris Cveulebrivi da mineraluri
reaqciebs. mdgradi qimiuri naerTebis             wylebis formirebis zonaSi.
safuZvelze damzadebuli preparatebis                 anolits iyeneben ganzavebis gareSe,
gamoyenebisas, dezinfeqciis damTavrebis          erTjeradad. anolitiT gausnebovneba
Semdeg, organuli naerTebi koncentrird-           SeiZleba Catardes sveli wesiT gawmendis,
eba forovan moculobebsa da gluv zeda-            dasvelebis, Sesxurebis, Cayursvis, aero-
pirebze, sadac gardaiqmneba uwvriles,            zoluri gafrqvevisa da siTxeSi ganzave-
TvaliT uxilav apkad. Semdgom ki, subli-          bis meTodiT.
                                                28



   miuxedavad imisa, rom preparatSi aqti-            xedvelobis inspeqciis baqteriologiuri
urad moqmedi nivTierebebis minimaluri                laboratoriisa da sxva kompetenturi or-
koncentraciaa, mas gaaCnia maRali madez-             ganizaciebis Sesabamis laboratoriebSi
inficebeli (viruliciduri, baqtericid-                Catarebuli gamokvlevebisa da praqtiku-
uli, fungiciduri, tuberkulozici-                     lad ganxorcielebuli proeqtebis Sedege-
duri, sporociduli) efeqti mikroorga-                 bis safuZvelze, araerTxel dadasturda
nizmebis yvela jgufisa da formis _ ad-               warmodgenili teqnologiis upiratesi
amianis yvela cnobili paTogenuri vi-                 efeqti sxva cnobil meTodebTan Sedare-
rusebis (maT Soris enteruli da parenter-             biT, rogorc efeqturobis, adamianis janm-
uli hepatitebi), aiv, poliomelitis, ade-             rTelobisa da garemos mimarT usafrTxoe-
novirusis, adamianisa da frinvelis gri-              bis, aseve gamoyenebis praqtikulobisa da
pis (H5N1), atipuri pnevmoniis (SARS), her-          ekonomikurobis TvalsazrisiT:
pesisa da sxv. mimarT.                                  1. l. sayvareliZis saxelobis daavade-
   saqarTvelos Sromis, janmrTelobisa                 baTa kontrolisa da samedicino statis-
da socialuri dacvis saministros                      tikis erovnuli centris gansakuTrebiT
l. sayvareliZis saxelobis daavadebaTa                saSiSi, zoonozuri da anaerobuli in-
kontrolisa da samedicino statistikis                 feqciebis laboratoriaSi jilexis ga-
erovnuli centris, g. naTaZis saxelobis               momwvev sporebze neitraluri anolitis
sanitariisa da higienis samecniero-kv-               zemoqmedebis pirveli kvlevis SedegebiT
leviTi institutis, infeqciuri paTologi-              (cxrili 1);
is, Sidsisa da klinikuri imunologiis                    2. Tbilisis meriis saxelmwifo sani-
samecniero-praqtikuli centris, Tbili-                tariuli zedamxedvelobis inspeqciis baq-
sis meriis saxelmwifo sanitariuli zedam-             teriologiur laboratoriaSi miRebuli

                                                           cxrili 1
                   jilexis gamomwvev sporebze neitraluri anolitis
                           zemoqmedebis Seswavlis Sedegebi

                                                                          l
                                                        sporebis konc. 1 m . siTxeSi
              #               re o
                            ga m           eqspozicia
                                                        13
                                                        0      15
                                                               0        16
                                                                        0       17
                                                                                0
                                              5 wT       _      1        8      34
              1.   xorcpe    ia i
                         pton n bul ioni      30 wT      _      _       _        _
                                              60 wT      _      _       _        _
                                              5 wT       _      _       _        6
                                  a
              2. fiziol ogiuri xsn ri         30 wT      _      _       _        _
                                              60 wT      _      _       _        _
                                              5 wT       _      1       _       38
              3.   onka      a
                       nis wy l i             30 wT      _      _       _        _
                                              60 wT      _      _       _        _

             SeniSvna: aqtivizebuli xsnariT SesaZlebelia jilexis
                  gamomwvevi sporebis wamebSi (1 wuTamde) ganadgureba.


aqtivizebuli xsnarebiT gausnebovnebu-                xsnaris maqsimaluri efeqturobis dadge-
li, Sidsisa da klinikuri imunologiis                 nis mizniT, amave wylis nimuSebze Catare-
samecniero-praqtikuli centris Cam-                   bul kvlevebSi, aRniSnuli parametri mi-
dinare wylis (modeluri da saeqspluata-               uaxlovda sasmeli wylis maCvenebels da
cio reJimi) mikrobiologiuri gamokvle-                Seadgina <9;
vis SedegebiT. standartul kvlevebSi,                    3. g. naTaZis saxelobis sanitariisa da
saeqspluatacio reJimSi damuSavebisas                 higienis samecniero-kvleviTi institut-
efeqturobam Seadgina 99,9999% (sacdeli               is mikrobiologiis laboratoriaSi, in-
wylis koli-indeqsi Seadgenda >238 000 000,           feqciuri paTologiis, Sidsisa da klini-
damuSavebis Semdeg <950), xolo modelur,              kuri imunologiis samecniero-praqtiku-
                                                     29



li centris teqnologiiT gausnebovneb-                      is sanitariuli baqteriologiis, wylis
uli, paTogenuri mikroorganizmebiT ga-                     higienisa da wyalsatevebis sanitariuli
binZurebuli, erT-erTi korpusis Cam-                       dacvis laboratoriaSi 2006 wlis 18-21
dinare wylis mikrobiologiuri gamokv-                      noembers Catarda aqtivizebuli xsnariT
leva (cxrili 2);                                          damuSavebuli sasmeli wylis laboratori-
    4. g. naTaZis saxelobis sanitariisa da                uli gamokvleva. mogvyavs daskvna aRniSnu-
higienis samecniero-kvleviTi institut-                    li gamokvlevis higienuri Sefasebidan:

                                                                     cxrili 2
                     sakvlevi wylis mikrobiologiuri gamokvlevis Sedegi

                                                               proporcia             proporcia
                                                             xsn ri     a
                                                            ( a : wy l i)          xsn ri wy l
                                                                                  ( a : a i)
       #                a v n bl bi
                       mCee e              kontrol i             1 : 50                1 :100
                                                              a
                                                          2 sa Tis       a
                                                                     1 sa Tis       a
                                                                                2 sa Tis       a
                                                                                           1 sa Tis
                                                             m g
                                                           Se de        m g
                                                                      Se de        m g
                                                                                 Se de        m g
                                                                                            Se de
        1    e
            m zofil uri aerobebis da
            fa kul ta      na
                     turi a erobebis        32 000           0          0          0          0
            ra n a 1 sm
               ode ob     3

        2         in qsi
            kol i- de                      240 000           0          0          0          0
        3   Salmonella,   1 3
                           dm               1 000
                                             2               0          0          0          0
        4   Staphylococcus aureus, 1 dm3    1 000
                                             2               0          0          0          0
        5   St. faccalis, 1 3
                           dm               1 000
                                             4               0          0          0          0
        6   Pseudomonas aeroginosa, 1 3
                                     dm     24 000           0          0          0          0
        7   CL. Perfringens, 1   dm3        20 000           0          0          0          0



  warmodgenili masalisa da laborato-                      infeqciod rogorc centraluri wyalmo-
riuli gamokvlevis faqtobriv monaceme-                     maragebis sadgurebSi, aseve dasaxlebuli
bze dayrdnobiT dadasturda, rom sasme-                     punqtebis wyalmomaragebis saTave da sxva
li wylis damuSavebis aRniSnul meTods,                     teqnikur nagebobebSi.
rogorc teqnologiur siaxles, dezin-                          5. infeqciuri paTologiis, Sidsisa da
feqciis sxva tradiciul da cnobil me-                      klinikuri imunologiis samecniero-
TodebTan SedarebiT, aqvs mravalmxrivi                     praqtikuli centris baqteriologiur
upiratesoba rogorc efeqturobis, aseve                     laboratoriaSi (28.03÷31.03.2006 w.) Catar-
praqtikulobis TvalsazrisiT. damuSave-                     da adgilze warmoebuli neitraluri ano-
buli wyali sruliad Seesabameba sasmeli                    litiT damuSavebuli samedicino daniS-
wylis xarisxze arsebul normatiul moTx-                    nulebis sxvadasxva sagnis mikrobi-
ovnebs da mizanSewonilia mowodebuli                       ologiuri gamokvleva. mogvyavs gamokv-
meTodis gamoyeneba sasmeli wylis sadez-                   levis Catarebis oqmi.

                                  mikrobiologiuri gamokvlevis oqmi
  04 aprili 2006 w.                                                     Tbilisi
                                    gamokvlevis mizani
  saqarTvelos sainJinro akademiis samecniero-teqnikuri centris winadadebiTa da
Sesabamisi werilis (#01-19/61, 18.02.2006 w.) safuZvelze, infeqciuri paTologiis, Sid-
sisa da klinikuri imunologiis samecniero-praqtikuli centris baqteriologiur
laboratoriaSi (28.03÷31.03.2006 w.) Catarda dawesebulebis sxvadasxva ganyofilebidan
(reanimacia da mimRebi) aRebuli, paTogenuri mikrobebiT kontaminebuli (gabinZure-
buli), sagnebisa (sasagne mina, sinjara, momWeri, makrateli, Tirkmela) da sinjis (avad-
myofis gasasinji taxtis zedapiri) mikrobiologiuri gamokvleva.
  sadezinfeqcio, winasasterilizacio da sasterilizacio saSualebad gamoyenebu-
li iyo saqarTvelos sainJinro akademiis samecniero-teqnikuri centris mier adgilze
warmoebuli xsnari (neitraluri anoliti), instruqciis Sesabamisad.
  gamokvlevebi Catarda warmodgenili teqnologiisa da xsnaris gamoyenebis Tval-
                                                          30



sazrisiT praqtikulobis, adamianis janmrTelobisaTvis usafrTxoebisa da efeqtur-
obis sxva meTodebTan Sedarebis, personalisTvis meTodikis gacnobisa da organiza-
ciaSi misi farTod danergvis mizniT.

                                 gamokvlevebis Sedegebi
   1. dawesebulebaSi Catarebuli laboratoriuli gamokvlevebis Sedegad dadginda,
rom adgilze warmoebul xsnars (neitraluri anoliti) gaaCnia paTogenuri mikroor-
ganizmebis sruli biologiuri gausnebovnebis uaRresad maRali efeqturoba da far-
To speqtri;
   2. gamoyenebis TvalsazrisiT, warmodgenili meTodi uaRresad praqtikulia, vinaid-
an, misi gamoyeneba da Senaxva ar saWiroebs gansakuTrebul pirobebs (individuri dam-
cavi saSualebebi; qimiurad saSiSi da feTqebadi nivTierebis Senaxvasa da gamoyenebaze
moTxovnebis uzrunvelyofa da sxv.), yvela procedurisaTvis (dezinfeqcia, winasas-
terilizacio gawmenda, sterilizacia da sxv.) saWiroa mxolod erTi dasaxelebis
produqcia.
   daskvna: zemoaRniSnulidan gamomdinare, migvaCnia, rom adamianis janmrTelobisa
da garemos mimarT usafrTxo, efeqturi da gamoyenebis TvalsazrisiT praqtikuli
sarecxi, sadezinfeqcio da sasterilizacio xsnarebis gamoyeneba (im garemoebis
gaTvaliswinebiTac, rom misi saWiro raodenobiT warmoeba SesaZlebeli iqneba adg-
ilze), xels Seuwyobs dawesebulebaSi normatiuli moTxovnebis Sesabamisi sanitari-
ul-epidemiologiuri pirobebis uzrunvelyofas da mniSvnelovan ekonomikur efeqts.

                                                                                                                                   cxrili 3
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  SeniSvna: anolitis elementuri qimiuri Semadgenloba mtknari an marilis susti wyalxs-
naris ekvivalenturia. anolitis moqmedi nivTierebebia qlorJangbadovani da hidroperoq-
siduri oqsidantebi metastabilur mdgomareobaSi koncentraciiT ara umetes 0,05%.
                                              31



   xsnarebis gamoyeneba gaTvaliswinebu-            curao auzebis, sanitariuli kvanZebis, na-
lia: 1. sasmeli wylis gausnebovnebisTvis           gavsayrelebisa da sxva daniSnulebis
rogorc centraluri, aseve adgilobrivi               obieqtebsa da teritoriaze sadezinfeq-
wyalmomaragebis sistemebSi, sainJinro-             cio samuSaoebis sawarmoeblad; 8. sasazR-
teqnikur nagebobebsa da savele pirobeb-            vro gamSveb punqtebze sadezinfeqcio sam-
Si; 2. bioteroristuli aqtebisa da sxva             uSaoebis sawarmoeblad; 9. bavSvTa da mox-
epidsituaciebis dros; 3. samedicino                ucTa saxlebSi, skolebSi, sxvadasxva orga-
dawesebulebebSi sarecxi, sadezinfeqcio             nizebul dawesebulebebSi; 10. peniten-
da sasterilizacio samuSaoebis Casatare-            cialuri da Tavdacvis sistemis dawese-
blad (maT Soris samedicino daniSnuleb-             bulebebSi; 11. kvebis mrewvelobis sistema-
is xelsawyo-iaraRebis, qirurgiuli in-              Si (sarealizacio qseli, sazkvebis obieqte-
strumentebisa da sxv.); 4. infeqciuri              bi, rZis, xorcis, xilis, bostneulisa da sxv.
profilis (maT Soris fTiziatriuli)                  daniSnulebis gadasamuSavebeli sawarmoe-
dawesebulebebis, qalaqebis, dasaxlebu-             bi) nagebobis, teqnologiuri danadgareb-
li punqtebisa da sxva konkretuli                   is, WurWlis, inventaris, taris, SesafuTi
obieqtebis sayofacxovrebo-sameurneo                masalebis, satransporto saSualebebis,
daniSnulebis Camdinare wylebis gaus-               sasawyobo da samacivro saTavsebis dezin-
nebovnebisaTvis, maT Soris sakurorto               feqciisa da sterilizaciis mizniT; 12. mem-
zonebSi; 5. infeqciuri daavadebebis                cenareobaSi; 13. mecxoveleobisa da mefr-
kerebsa da riskis zonebSi (maT Soris               inveleobis kompleqsebSi; 14. mefutkreoba-
jilexisa da tuberkulozis stacionarul               Si da sxv.
kerebSi) sadezifenqcio saSualebebad;                  ganvlil periodSi, warmodgenili teq-
6. sayofacxovrebo daniSnulebis obieq-              nologiebis danergvis sakiTxi jandacvis
tebSi (saparikmaxeroebi, salonebi, abanoe-         saministros garda, ganxiluli iyo,
bi, sauna, samrecxaoebi da sxv.) nagebobis,        saqarTvelos garemos dacvisa da bune-
xelsawyo-iaraRebis sterilizaciisa da               brivi resursebis, soflis meurneobis,
sadezinfeqcio samuSaoebis sawarmoe-                ekonomikuri ganviTarebis, Tavdacvisa da
blad; 7. bazrobebis, satransporto kvan-            Sinagan saqmeTa saministroebSi, parla-
Zebis, miwisqveSa gadasasvlelebis, sa-             mentis garemos dacvisa da bunebrivi




              suraTi 1                                                       suraTi 2


resursebis, soflis meurneobisa da                     teqnologiuri sistemebi danergilia:
agrarul sakiTxTa komitetebSi, saqarT-                 1. TbilisSi, infeqciuri paTologiis,
velos mecnierebaTa da sainJinro aka-               Sidsisa da klinikuri imunologiis samecni-
demiis prezidiumebis, arasamTavrobo                ero-praqtikul centrSi, naxmari, Camdinare
seq-torisa da dargiT dainteresebul                 wylebis gausnebovnebis, organizaciaSi
sxva (maT Soris aWaris avtonomiuri res-            sarecxi, sadezinfeqcio da sasterilizacio
publikis) kompetenturi uwyebebisa da               samuSaoebis warmoebisTvis (suraTi 1);
organizaciebis mier. miRebul daskvneb-                2. aWaris sakurorto zonis arakanali-
Si gamoTqmulia sruli mxardaWera aRniS-             zebul teritoriaze, sofel kvariaTSi
nuli teqnologiebis gamoyenebisa da far-            mdebare 63_biniani sacxovrebeli saxlis
To gavrcelebisadmi.                                gamwmend nagebobaSi, zRvaSi Camdinare
                                              32



wylebis normatiul moTxovnamde gaus-                   5. aWaris avtonomiuri respublikis
nebovnebisTvis;                                    sofel zeda axalSenis wyalsadenis reabil-
   3. saqarTvelos Sinagan saqmeTa samin-           itaciis proeqti (wyalsadenis nagebobis
istros sagangebo situaciebis marTvis               dezinfeqcia da sasmeli wylis gausnebovne-
departamentSi (suraTi 2) piradi Semad-             ba qlorirebis meTodis sanacvlod);
genlobis qmediTunarianobis amaRlebis                  6. tuberkulozis samkurnalo erov-nul
mizniT, sagangebo situaciebisa da biot-            centrSi, Camdinare wylebis gausnebovnebi-
eroristuli aqtebis dros, agreTve, bi-              sTvis;
ologiuri usafrTxoebis sferoSi saer-                   7. q. baTumis meriis #19 bavSvTa baRSi,
TaSoriso TanamSromlobisas, rasac mxars             rezervuarSi dagrovili sasmeli wylis
uWeren amerikeli eqspertebic;                      gausnebovnebisa da sadezinfeqcio sam-
   4. saqarTvelos iusticiis saministros            uSaoebis Casatareblad (suraTi 4);
sasjelaRsrulebisa da probaciis saswavlo               8. aWaris avtonomiuri respublikis
centrSi aqtivizebuli xsnarebis adgilze             wminda samebis dedaTa monasterSi, Cam-
sawarmoeblad sadezinfeqcio samuSaoebis             dinare wylebis gausnebovnebis mizniT;
Catarebisa da sasmeli wylis gausnebovneb-             zemoaRniSnulis safuZvelze, warmod-
is mizniT (suraTi 3).                              genili axali samecniero-teqnikuri mima-




                     suraTi 3                                    suraTi 4



rTulebis ideologiidan da universa-                    2. sarezervo maragis Senaxva (saSiSi qi-
lurobidan gamomdinare, misi gamoyeneba             miuri nivTierebisaTvis saWiro pirobeb-
qveyanaSi adamianis janmrTelobisa da               is uzrunvelyofa);
garemos usafrTxo sanitariul-epidemi-                  3. saSiSi qimiuri nivTierebis moxmare-
ologiuri pirobebis uzrunvelyofi-                   bis adgilze transportireba;
saTvis, maT Soris bioteroristuli aqte-                4. samuSao sadezinfeqcio xsnaris mo-
bis, frinvelis gripis mosalodneli pan-             mzadeba da gamoyeneba mxolod special-
demiisa Tu sxva biologiuri xasiaTis sa-            istebis mier;
gangebo situaciebis aRmocenebis dros,                 5. sarezervo maragis periodulad Sevseba
SesaZleblobas mogvcems, qveynis masSta-            an sawyisi kapitaldabandebis gazrda sadez-
biT, maqsimalurad efeqturad da say-                infeqcio saSualebis winaswargansazRvruli
ovelTaod xelmisawvdomi formiT, gan-                moculobis erTjeradi SeZenisaTvis;
vaxorcieloT prevenciuli RonisZieba                    6. sadezinfeqcio saSualebis Senaxvis
da Tavidan aviciloT sirTuleebTan                   vadis gasvlis Semdeg misi utilizeba.
dakavSirebuli im samuSaoebis Catareba,                aRniSnuli teqnologiiT dasaxuli amoca-
romelic aucilebelia tradiciuli meTo-               nis gadasawyvetad, uaRresad efeqturi, ad-
dis (mdgradi, arabunebrivi qimiuri                 amianis janmrTelobisa da garemos mimarT
naerTebis bazaze damzadebuli sadezin-              usafrTxo, iafi, martivi da sayovelTaod xe-
feqcio preparatebi) gamoyenebis SemTx-             lmisawvdomi, saWiro moculobis sadezinfeq-
vevaSi, kerZod:                                    cio xsnarebis warmoeba SesaZlebeli iqneba
   1. sadezinfeqcio saSualebis importi (sa-        moxmarebis adgilze qveynis nebismier teri-
SiSi qimiuri nivTierebis transportireba);          toriaze (maT Soris savele pirobebSi).
                                             33



   danadgaris eqspluataciisTvis saWiroa           gamokvlevebis Sedegebisa da Cven mier
eleqtroenergiis mcire xarji da nebis-             warmodgenili masalebis safuZvelze,
mieri saxis denis wyaros gamoyeneba.              2004 wlis dekemberSi, saqarTvelos Sro-
xsnarebis sawarmoo teqnologiuri siste-            mis, janmrTelobisa da socialuri dacvis
mis mowyoba SesaZlebelia rogorc kapi-             saministros saxelmwifo sanitariuli
talur, aseve nebismieri saxis droebiT             zedamxedvelobis inspeqciis mier moxda
nagebobaSi (maT Soris karavSi). modi-             eleqtroqimiuri aqtivaciis teqnologi-
fikaciis mixedviT, danadgaris ganTavse-           is aRiareba da mis praqtikul gamoyenebasa
ba SesaZlebelia rogorc kedelsa da mag-            da danergvaze gaica dadebiTi higienuri
idaze, aseve satransporto saSualebebze,           daskvna.
risTvisac sakmarisia 1 m2 farTobi.                        saqarTvelos Sromis, janmrTelo-
   xsnarebis Senaxvis limitirebuli vada           bisa da socialuri dacvis ministris 2006
sporovani formebisaTvis 3-5 dRea, magram          wlis 7 agvistos #217/n brZanebiT,
vegetaturis mimarT madezinficebel                 saqarTvelos sainJinro akademiis samec-
Tvisebebs inarCunebs da gamoyeneba Sesa-          niero-teqnikuri         centris     mier
Zlebelia 10 da meti dRis ganmavlobaSi.            saqarTveloSi warmoebuli aqtivizebuli
xsnarebis usafrTxoebidan da gamoyeneb-            xsnari “neitraluri anoliti” #59 pun-
is praqtikulobidan gamomdinare, sadez-            qtiT daemata saqarTvelos Sromis, janm-
infeqcio daniSnulebiT misi gamoyeneba             rTelobisa da socialuri dacvis minis-
SesaZlebelia kerZo seqtorSi, individu-            tris #64/n brZanebiT damtkicebul sa-
rad, maRali kvalifikaciis specialisteb-           dezinfeqcio saSualebebis nusxas.
is gareSe. faqtiurad, es imas niSnavs, rom           damuSavebuli da reglamentebulia nei-
iqmneba realuri SesaZlebloba, eqstrem-            traluri anolitis gamoyenebis meTo-
alur situaciasa Tu sxva SemTxvevebSi,             duri miTiTebebi.
problemis praqtikul gadawyvetaSi Caer-               teqnologiuri danadgarebi da mis mier
Tos ara marto Sesabamisi profilis orga-           warmoebuli aqtivizebuli xsnarebis
nizaciebi, aramed mosaxleobac farTo mas-          gamoyenebis meToduri miTiTebebi Seta-
StabiT. rac Seexaba xsnarebiT organize-           nilia saqarTvelos standartebisa da te-
buli brigadebisa Tu kerZo seqtoris                qnikuri reglamentebis saxelmwifo re-
uzrunvelyofas, misi gadawyveta martiv-            estrSi.
ia, radganac, rogorc aRvniSneT, sakmari-             aqve xazgasmiT unda aRvniSnoT, rom aq-
sia qveynis nebismier regionSi, raionul           tivizebuli xsnaris usafrTxoeba da efeq-
centrSi Tu sofelSi, ramdenime saaTSi              turoba mxolod im SemTxvevaSi iqneba ga-
movawyoT originaluri teqnologiuri                 rantirebuli, roca mas awarmoeben am dar-
sistema, romliTac adgilze SesaZlebali             gis maRalkvalificiuri (uflebamosili)
iqneba saWiro raodenobis preparatis war-          specialistebi an maT mier momzadebuli
moeba, romliTac SeiZleba individurad              kadrebi, mxolod originaluri te-
momaragdes adgilobrivi mosaxleobac.               qnologiuri danadgarebisa da sistemeb-
   Tu gaviTvaliswinebT zemoaRniSnul da            is gamoyenebiT.
sxva faqtorebs, epidemiisa Tu pandemiis              migvaCnia, rom warmodgenili axali,
SemTxvevaSi, warmodgenili teqnologiis             progresuli samecniero-teqnikuri mima-
gamoyenebiT miRebuli efeqti (maT Soris            rTulebisa da teqnologiis farTod dan-
ekonomikuri) Zalze soliduri iqneba.               ergva xels Seuwyobs da mniSvnelovan
   saqarTvelos Sromis, janmrTelobisa              rols Seasrulebs adamianis janmrTelo-
da socialuri dacvis saministros,                  bisa da garemos usafrTxo, Tanamedrove
agreTve, sxva kompetenturi organiza-              moTxovnebis Sesabamisi sanitariul-
ciebis Sesabamis samecniero-kvleviT               higienuri da epidemiologiuri pirobeb-
centrebSi Catarebuli laboratoriuli                is uzrunvelyofaSi.




  3. saqarTvelos samedicino Jurnali, 2, 2008 w.
                                                          34



        ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ МОЮЩИХ,
    ДЕЗИНФЕКЦИОННЫХ И СТЕРИЛИЗАЦИОННЫХ РАСТВОРОВ,
    ПОЛУЧЕННЫХ ОРИГИНАЛЬНЫМИ ЭЛЕКТРОХИМИЧЕСКИМИ
      УСТАНОВКАМИ И ТЕХНОЛОГИЧЕСКИМИ СИСТЕМАМИ
                                                                                                    Т. Цецхладзе
                                НАУЧНО-ТЕХНИЧЕСКИЙ ЦЕНТР ИНЖЕНЕРНОЙ АКАДЕМИИ ГРУЗИИ

    В современном мире создание благоприятных санитарно-гигиенических и эпидемиологических
условий для жизни и здоровья человека по многим причинам (природные катаклизмы, дефицит
качественной питьевой воды, этнические и региональные конфликты, чрезвычайные ситуации,
биотеррористические акты, положительное влияние на микроорганизмы ожидаемого глобального
потепления и др.) становится всё более актуальным, и решение этой задачи является приоритетным
для любого государства.
   Этот вопрос очень важен и для Грузии, что, в частности, обусловлено трудностями современного
переходного периода.
   Министерством труда, социальной защиты и здравоохранения Грузии рассмотрены наши предложения
по вопросу внедрения новых научно-технических достижений, принципов и методов, обеспечения
безопасной для здоровья человека окружающей среды, в том числе обработки питьевой и сточных вод.
   Преимущество представленных новых технологий, в сравнении с другими методами, кроме
эффективности, состоит также в практичности их применения. Химические растворы, производимые
по данной технологии, экологически безопасны и их получение возможно в любое время, в том числе в
полевых условиях. Технология прошла соответствующую экспертизу, одобрена законодательными
органами Грузии и сертифицирована.
   На основании результатов наших исследовании считаем целесообразным внедрение этой технологии
с целью обеспечения безопасности окружающей среды.
   Широкое внедрение технологии, имеет также и стратегическое значение, так как её применение
позволит создать реальную возможность замены метода хлорирования безопасным, эффективным и
дешевым альтернативным методом.
   Министерством труда, социальной защиты и здравоохранения Грузии издан ряд законодательных
актов и рекомендаций по внедрению технологического новшества, представленного «Научно-техническим
центром» Инженерной академии Грузии, полностью поддерживающих необходимость широкого внедрения
представленных 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 только
в случае их производства высококвалифицированными (уполномоченными) специалистами отрасли или
специально подготовленными ими кадрами.
   Считаем, что широкое внедрение в стране представленных новых прогрессивных научно-технических
направлений и технологий в значительной степени будет способствовать обеспечению безопасных для
здоровья человека и окружающей среды санитарно-гигиенических и эпидемиологических условий,
соответствующих современным требованиям.



EFFECTIVENESS AND SAFETY OF DETERGENT DISINFECTION AND
    STERILIZATION SOLUTION PRODUCED WITH ORIGINAL
ELECTROCHEMICAL EQUIPMENT AND TECHNOLOGICAL SYSTEMS
                                                                                                   T.Tsetskhladze
    In contemporary world the creation of beneficial sanitary-hygienic and epidemiologic conditions for public
life 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 warming
on micro organisms, etc.) becomes actual day by day and its solution is a priority problem for any country.
                                                          35



    This problem is also very urgent for Georgia and is stipulated with the difficulties of the transient period in the
country.
    The Ministry of Labor, Social Protection and Public Health of Georgia has considered our proposals on the
problem of implementation of absolutely new scientific-technical achievements, principles and methods with the
purpose to ensure safety environment for people.
    The advantage of the presented new technologies compared to other methods is their effectiveness, as well
as, practicity in usage. Chemical solutions received by the given technology are ecologically safe and their
production is available at any time, including field conditions. The technology has all permissions necessary for
using. It is approbated and certified.
    With the account of the above said we think advisable to implement new technology with the aim to ensure
safe environment.
    Besides solution of the problem according to modern requirements, the wide implementation of the technol-
ogy gets a strategic importance as in case of its using in the country there occurs a real possibility of substitution
of chlorination method with safe, effective and inexpensive alternative method.
    The Ministry of Labor, Social Protection and Public Health of Georgia has given several recommendations
on introduction of technological novelty presented by “Scientific-technical Center” of Engineering Academy of
Georgia and entirely supports the necessity of wide implementation of technologies presented by “Scientific-
technical Center” of Engineering Academy of Georgia for high quality treatment of potable and everyday waste-
water, 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 the
case when it is produced by the specialists highly qualified in this sphere or the staff trained by them, using only
original technological equipment and systems.
    We presume that wide implementation of the presented new progressive scientific-technological direction
and technology in the country will promote and play important role in provision of safe sanitary-hygienic and
epidemiological conditions corresponding to modern demands respective human health and environment.




                                                literatura

   1. saqarTvelos garemos higienis samoqmedo erovnuli gegma _ ”garemo da janmrTe-
loba“. Tbilisi, 2003. _ 85-87gv.
   2. Шандала М.Г. / В кн. Актуальные проблемы дезинфектологии в профилактике инфекционных и
паразитарных 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.
                                              36



                                medicinis istoria


       saqarTvelos wylis resursebis sistemuri
       Seswavlis aucilebloba - robert kupcisis
               gamocdileba da Rvawli

                                                               r. iakobiZe, i. CinCalaZe
                       saqarTveloSi latvielTa sazogadoeba ‘Ave Sol~

                                               (recenzenti - prfesori r. Sengelia)


  diplomirebuli provizoris, misi                      gamokvleviT dadginda, rom ruseT-
udidebulesoba ruseTis imperator ni-                iaponiis omis monawilem, robert kupcis-
koloz meoris xeldasxmiT, 1908 wels Tbi-            ma, tartus universitetis damTavrebis
lisSi kavkasiis saeqsperto qimiuri lab-            Semdeg, umaRlesi ganaTleba miiRo yaza-
oratoriis direqtoris Tanamdebobaze                                           nis universitet-
mivlinebuli robert kupcisis cxovreb-                                         Si. colad Seir-
isa da moRvaweobis Seswavlisas, kidev                                        To holandiuri
erTxel davrwmundiT: Tanamedrove isto-                                        warmoSobis rus
riografiis umTavresi principis, ‘is-                                         TavadTa STamo-
toriis kvlevis sagania ara is, Tu odesme                                     mavali    sofia
rame momxdara, aramed is Tu rogori mniS-                                     gerkeni da mefis
vneloba aqvs warsuls dRevandelobis                                           samsaxurSi Camd-
aRmSeneblobaSi~, cxovelmyofelobaSi,                                          gari TbilisSi
Zveli berZnuli filosofiis mrwamsSi,                                          dasaxlda.     aq
rom gacnobierebuli warsuli dRevande-                                         SeeZina mas sami
lobis nawilia, misi qvakuTxedia, ‘rac iyo~                                   Svili, SemdegSi
imis codna gasaRebia ‘rac iqneba~ imis                                       SviliSvilebi da
                      gasagebad.                                             saqarTvelos da
                         kvlevis dasawyis-                                   qarTveli xalxis
                      Si Cveni mizani iyo                                    samsaxurSi
                      S e g v e s w a v l a                                  Rvawlmosili
                      saqarTveloSi moR-                                      gardaicvala
                      vawe       eTnikuri              robert kupcisis       1954 wels, dasa-
                      latvieli         mec-                                 flavebulia kuki-
                      nierisa da pedago-                                    is sasaflaoze.
                      gis saqmianoba da               robert kupcisis pirovnebis damaxasi-
                      gagverkvia misi mniS-        aTebelia is, rom 1881 wels latviaSi,
                      vneloba da roli              valkis uezdis mivardnil xutorSi, da-
                      latvieli           da        badebulma glexis biWma miiRo umaRlesi
                      qarTveli xalxis              akademiuri ganaTleba da daqorwinda
                      urTierTobebSi,               privilegiuri socialuri fenis warmo-
                      raTa dRevandel in-           madgenelze. karieris TvalsazrisiT igi
                      formaciis nakadeb-           1908 wels saTaveSi Caudga saeqsperto-qi-
  robert kupcisi Si ar gafantuliyo                 miur samsaxurs da sicocxlis bolomde
                      erTa Soris Tanam-            xelmZRvanelobda mas, man kvleviTi saqmi-
Sromlobis mniSvnelovani furceli. arc               anoba warmarTa jer mTeli kavkasiis mas-
qarTvel, da arc latviel xalxs ar hyavT             StabiT, 1917 wlis revoluciis Semdeg ki _
dasakargi adamianebi, miT ufro, rom am pa-         mTel saqaTveloSi.
tara suverenuli saxelmwifoebis istori-                r. kupcisis xelmZRvanelobiT saqarTvelo-
uli TanamSromloba da urTierTpativis-               Si daarsda sasamarTlo eqspertizis lab-
cema pirovnul gamoxatulebas efuZneba.              oratoria, sadac misi uSualo monawile-
                                             37



obiT, warmoebda sasmeli, Termuli da min-          cia aris faqtebs plius maTi mniSvneloba.
eraluri wylebis farmako-qimiuri anal-             axla, rodesac Cven movaxdineT robert
izi. man samecniero brunvaSi Seiyvana eqs-        kupcisis cxovrebisa da moRvaweobis
ploatirebuli sasmeli da mineraluri                umTavresi faqtebis konstantacia, auci-
wylebis umetesoba. amJamad r. kupcisma            lebelia vimsjeloT maT mniSvnelobaze.
piradad gamoikvlia saqarTvelos 1000               Cvens xelT arsebuli faqtebis zedapiru-
meti wyaro, aqedan 800 pirvelad. aseTi            li ganxilvac ki gviCvenebs, rom mas gaaC-
dauRalavi Sromis Sedegad man moaxdina             nia mravali da gansxvavebuli mniSvnelo-
saqarTvelos istoriaSi pirvelad miner-             ba. kerZod, isini SesaZleblobas iZleva
aluri wylebis sistematizacia. maSindeli           vimsjeloT robert kupcisze, rogorc
farmacevtikis ganviTarebis donidan ga-            mecnier-pedagogze, rogorc qarTveli da
momdinare, mineraluri wylebi sistem-              latvieli xalxis megobrobisa da Tanam-
atizdeboda 8 jgufad. robert kupcisma              Sromlobis kerZo istoriul magaliTze,
daalaga saqarTvelos mineraluri wyle-              rogorc kvalificiuri kadrebis migraci-
bi aRniSnuli jgufebis mixedviT da                 is specifikur SemTxvevaze da a.S. robert
daaskvna, rom saqarTveloSi aris msofli-           kupcisma mravalmxrivi da Rrma kvali da-
oSi cnobili yvela saxis wyali, garda              tova Cvens uaxloes istoriaSi. migvaCnia,
dariSxaniani wylebisa da gamoTqva varau-          rom dRevandeli Cveni sazogadoebrivi
di Sovis maxloblad aseTi wylis aRmoCe-            ganviTarebis problemebidan gamomdinare,
nis SesaZleblobaze.                               uaRresad aqtualuria robert kupcisis
   kupcisis samecniero interesebi ar
Semoifargleboda mxolod wylis samkur-
nalo Tvisebebis kvleviT. is, rogorc
sasamarTlo eqspertizis fuZemdebeli,
saqarTveloSi sisxlsac ikvlevda. misi
gamokvleva ‘sisxlis saxeobebis Sedareba
sasamarTlo medicinis TvalsazrisiT~
qrestomaTiuli xasiaTisaa da ‘kupcisis
efeqtis~ saxeliT Sevida sasamarTlo
qimiis saxelmZRvaneloebSi.
   jerjerobiT mikvleulia misi 61 naS-
romi. r. kupcisis mecnieruli memkvidre-
obis Ziebas ori ram abrkolebs. erTi is,
rom naSromebi qveyndeboda specialur
samedicino periodul gamocemebSi da me-
ore - dRevandeli saarqivo masalebi
saqarTveloSi metad rTul mdgomareoba-
Sia. aseTi vaJkacuri da Tavdadebuli Sro-
ma gaxda, albaT, imis piroba, rom robert
kupcisi gadaurCa komunistur represiebs,                    robert kupcisis SviliSvilebi:
romlebic permanentulad xorcieldebo-                  irana kupcisi da igor parastaevi saqarTve-
da saqarTveloSi 1924 wlidan 1954 wlis                    los latvielTa sazogadoebaSi
CaTvliT. misi saqmisadmi siyvarulma,
tolerantobam da umaRlesma profesion-              memkvidreobis Seswavla saqarTveloSi wy-
alizmma SeaZlebina erTnairi warmatebiT            lis resursebis kvlevisa da msoflio sas-
eSroma mefis ruseTis, damoukidebeli               meli da samkurnalo wylebis bazaze,
saqarTvelosa da komunisturi okupaciis             saqarTvelos monawileobis TvalsazrisiT.
periodebSi. man aRzarda saqarTvelos                  msoflio globalur gamowvevaTa
profesiuli qarTveli kadrebi. aswavlida            Soris erT-erTi umTavresi problema,
Tbilisis saxelmwifo samedicino insti-             romelic wamoiWra erovnuli saxelmwi-
tutSi. yovelive amis gamo, disertaciis            foebis winaSe, esaa mdgradi ganviTarebis
daucvelad, mianiWes medicinis mecniere-           aucilebloba. mastrixtis konferenciis
baTa kandidatis xarisxi (sxva ufleba adg-         ganmartebiT, mdgradi iseTi ganviTare-
ilobriv samecniero sabWos ar hqonda,              baa, romelic ar uzRudavs ganviTarebis
doqtoris samecniero xarisxs aniWebda              saSualebas momaval Taobas, magram mTeli
mxolod moskovi).                                  simZafriT dgeba bunebrivi, ara ganaxle-
   informaciis Tanamedrove maTema-                badi resursebis pasuxismgebluri gamoy-
tikuri Teoria ganmartavs, rom informa-            enebis aucilebloba. dReisaTvis msof-
                                            38



lios 6 miliardze meti mosaxleobidan 3            mefis xelisufleba mniSvnelobas aniWeb-
miliardisTvis deficitia janmrTeli,               da samkurnalo wylebs, radganac am
xarisxiani sasmeli wyali, 2,5 miliardi ki        resursis aTvisebaSi xedavda sazRvarga-
cxovrobs dabalnayofier da unayofo mi-            reT samkurnalod migrirebuli mosaxle-
webze, 3,5 miliardi sunTqavs normaze             obis mier gaweuli xarjebis imperiis far-
metad dabinZurebul haers, 3 miliardis            glebSi Semobrunebis saSualebas, rac,
dRiuri Semosavali aris 1 aSS dolarze             udavod, gaaumjobesebda eqsport-impor-
naklebi. am monacemebze dayrdnobiT,              tis saldos. ruseTis imperia saerTod ar
msoflios banki mouwodebs suverenul
saxelmwifoTa mesveurebs, rom maqsi-
malurad ekonomiurad da efeqturad gam-
oiyenon maT gankargulebaSi arsebuli
resursebi. magram friad samwuxaroa, rom
msoflios bankisa da sxva saerTaSoriso
organizaciaTa mowodebebi, romlebic
emyarebian fundamentalur mecnierul
gamokvlevebs, rCeba ‘xmad mRaRadeblisa
udabnosa Sina~.
   cnobilia, rom saqarTvelo wylis
resursebis raodenobiTa da mravalfer-
ovnebiT msoflioSi erT-erTi umdidre-
si qveyanaa, magram Zalian samwuxaroa is




                                                          profesori revaz sxilaZe,
                                                       robert kupcisis mikroskopTan

                                                 zrunavda mosaxleobis sasmeli wyliT
                                                 uzruyvelyofaze, Sesabamisad, TbilisSi,
                                                 1904 wels, specialuri gamokvlevebiT,
                                                 dadginda, rom mosaxleobis sikvdilobis
                                                 maRali donis mTavari mizezi qalaqis
                                                 damtverianebis, maRali donisa da rZis
                                                 produqtebis uxarisxobasTan erTad, iyo
                                                 sasmeli wylis dabali xarisxi.
   robert kupcisi eqspediciaze 1913 weli            saqarTvelos wylis resursebis ko-
                                                 mpleqsuri, sistemuri kvleva ukavSirde-
faqti, rom igi dabalefeqturad da ar-             ba ara marto warmoSobiT latvieli rob-
akvalificiurad swavlobs Tavis am uni-            ert kupcisis moRvaweobas, aramed am
kalur potencials. ar eZebs bazrebs maTi          saqmeSi seriozuli wvlili Seitana misma
seriozuli Sefasebisa da realizaciis              ufrosma Zmam - ianma. swored faramciis
mizniT. qveyanaSi saerTod ar arsebobs            magistrma ian kupcisma Tavis moxsenebaSi
wylis resursebis gamoyenebis erTiani             kavkasiis samedicino saimperatoro sa-
saxelmwifo politika. dabal donezea am            zogadoebis winaSe jer kidev 1912 wels
mimarTulebiT moqmedi sakanonmdeblo da            aRniSna, rom saqarTvelos ‘wylebis umrav-
normatuli baza, misi marTvis institu-            lesoba Seuswavlelia da maTi mikuTvneba
cionuri da organizaciuli sistema. es             wylebis ama Tu im jgufisaTvis emyareba
uaRresad mniSvnelovani problema uyura-           sunis, gemos da naleqis fers, rac Zalian
dRebod, zogierTi enTuziastis anabaraa            xSirad mcdaria~. man daasabuTa, rom
darCenili.                                       wylebis Seswavla aucilebelia adgilze
   saqarTveloSi wyali mudam iyo saxelm-          sruli farmako-qimiuri Semadgenlobis
wifoebrivi zrunvis sagani. mecxramete            dadgeniT. Tavisi winadadeba man saqmiT
saukunis meore naxevridan daiwyo                 daamtkica da ukve 1913 wels, pirvelad,
saqarTvelos Termuli da samkurnalo                adgilze Seiswavla borjomis mineraluri
mineraluri wylebis intensiuri Seswavla.          wylebi. gamoavlina misi samkurnalo
                                                 39



samedicino Tvisebebi da daadgina masSi                Trusos xeobaSi, sofel kobiSSi xdeba,
Semavali mineralebis Sedgeniloba. bor-                aramed igi gaxdes msoflios tanjuli mo-
jomis wylebi ganmeorebiT Seiswavla 1923               saxleobisaTvis xelmisawvdomi~. es daskv-
wels, aTi wlis Semdeg, misma umcrosma                 na dResac aqtualuria, maSin rodesac
Zmam, diplomirebulma provizorma, rob-                 msoflios mTavari problema siR-
ert kupcisma. man gamoavlina wylebis qi-              aribesTan brZolaa, saqarTveloSi snos
miuri Semadgenlobis mdgradoba da daa-                 mineraluri       wyali uqmad iRvreba,
dastura misi samkurnalo Tvisebebis sta-               wisqvilsac ki aRar amoZravebs. unda dais-
biluroba.                                             vas sakiTxi saerTaSoriso organizacieb-
                                                      is winaSe, rom gamoinaxos SesaZlebloba
                                                      saqarTvelos sasmeli wylebis eqsporti-
                                                      saTvis msoflios uRaribes qveynebSi, sa-
                                                      dac deficitia ekologiurad sufTa, jan-
                                                      saRi sasmeli da samkurnalo wylebis.
                                                         Cveni azriT, robert kupcisis pirovneb-
                                                      is popularizacia da misi Rvawlis saTana-
                                                      do dafaseba gaxdeba saqarTvelos sasmeli
                                                      wylebis saerTaSoriso bazarze gatanisa da
                                                      misi kompleqsuri kvlevis qmediTi argu-
                                                      menti. amitom saqarTveloSi latvielTa
                                                      sazogadoebam, ‘ave sol!~-is iniciativiT,
                                                      2007 wlis 16-17 noembers Caatara saerTa-
                                                      Soriso konferncia Temaze robert kupci-
                                                      sis Rvawli qarTul mecnierebaSi~, romel-
                                                      Sic aqtiuri monawileoba miiRo asze metma
                                                      adamianma. konferenciam miiRo rekomenda-
                                                      cia - robert kupcisis saxelis ukvdavsay-
      latviis elCi saqarTveloSi andreis               ofad kurort wyaltubos meeqvse wyaros
 vilcansi da latviis sapatio konsuli regina           ewodos misi saxeli da qalaq TbilisSi im
    iakobiZe xsnian robert kupcisisadmi               saxlze, sadac cxovrobda da moRvaweobda
            miZRvnil konferencias                     r. kupcisi, gakeTdes memorialuri dafa.
                                                      migvaCnia, rom robert kupcisis namdvili
                                                      aRiareba jer kidev winaa, misi saxeli met
   didi da xangrZlivi Sromis Semdeg, 1925             sxivosnobas SeiZens saqarTveloSi sasme-
wels, robert kupcisma daaskvna, rom                   li wylis warmoeba-realizaciis moculo-
saWiroa moiZebnos meqanizmebi, raTa                   bisa da kulturis zrdasTan erTad. es
‘saqarTvelos     mineralur      wylebze               gardauvalia, amas moiTxovs Tanamedrove
wisqvilebi ki ar brunavdnen, rogorc es                globaluri msoflio.




    НЕОБХОДИМОСТЬ СИСТЕМНОГО ИССЛЕДОВАНИЯ ВОДНЫХ
    РЕСУРСОВ ГРУЗИИ – ОПЫТ И ЗАСЛУГИ РОБЕРТА КУПЦИСА
                                                                    Р. Иакобидзе, И. Чинчаладзе
                          ОБЩЕСТВО ЛАТЫШЕЙ “AVE SOL”, ГРУЗИЯ

    Изучая научное наследие латышского ученого, почти всю жизнь, проработавшего в Грузии, мы еще
раз 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 грузинских
вод, более 40 лет проработал руководителем экспертно-медицинской химической лаборатории; лично
исследовал более 1000 водных источников, около 800 из них – впервые, и пришел к выводу о необходимости
замены визуальной оценки вод их химическим анализом. В результате этих исследований возникли и
начали функционировать многие грузинские курорты.
    Массовые исследования грузинских источников позволила Р.Купцису создать классификацию
питьевых и лечебных вод, а также лечебных грязей. Исследователь установил, что из 8
классификационных групп, существующих в мире, в Грузии наличествуют семь.
                                                         40



   Вода в современном мире стала стратегическим товаром; треть населения нашей планеты не имеет
доступа к питьевой воде, не говоря уже о лечебных водах. Следовательно, необходима стратегическая
политика 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 – присвоить
шестому источнику Цхалтубо имя Р.Купциса и установить мемориальную доску на доме, в котором
располагалась химическая лаборатория и служебная квартира исследователя.

                            НЕКОТОРЫЕ ОПУБЛИКОВАННЫЕ РАБОТЫ РОБЕРТА КУПЦИСА

   1. Краткий обзор минеральных вод и лечебных грязей Грузии. Из химической лаборатории НКЗ
ССР 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 возникновении
эндемического зоба//Народная медицина, Тбилиси, 1926, № 5
   4. 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//Лечебный
вестник. Тифлис, 1926, часть 1
   7. К вопросу об отделении алкалоидов от птомаинов. Труды 3-го Всеросийского сьезда судебных
экспертов 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, № 4
   10. Кое-что о знахарском “врачевании” в Грузии.//Советская медицина. 1925, № 1.


   NECESSITY OF SYSTEM RESEARCH OF WATER RESOURCES OF
   GEORGIA - EXPERIENCE AND MERITS OF MR. ROBERT KUPTSIS
                                                                               R. Iakobidze, I. Chinchaladze
    Studying a scientific heritage of Latvia scientist, who almost all his life worked in Georgia, the author came to
a conclusion that history is studied to understand and predict the future. R. Kuptsis under the order of the
Russian emperor arrived in Georgia in 1908 in order to study the Georgian water. He worked as the heard of
experimental-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 replacement
by chemical analysis.
    A multiple researches of the Georgian water sources has allowed R. Kuptsis to create classification as
drinking and medical waters, as medical dirts. he has found that from 8 classification groups which exist in the
world, 7 groups are in Georgia.
    Water in the modern world has become the strategic goods, third of population of our planet has no access to
potable water, not speaking about medical waters. The strategic policy in regard to the Georgian water is
necessary, 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 contribution
of Mr. Robert Kuptsis to the Georgian science”. More than hundred participants from Georgia, Latvia and
Russia 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 where
chemical laboratory and service apartment was located.
                                              41



                                      gaxseneba




           naTeli pirovneba, WeSmariti moqalaqe

   gasuli saukunis 60-iani wlebidan,               ta Cvens kvleviT institutSi Sromis hogie-
dedaqalaqis       maSindel     plexanovis          nis ganyofillebis xelmZRvanelad, da
gamzirze moxvedrisas, uneblied yura-               swored aq veziare mis gamorCeul adamianur
dRebas miaqcevdiT auCqarebeli nabijiT              Tvisebebs - mSvenier sulsac da azrebsac.
mimaval axalgazrda mamakacs, romelic               Cemze usazRvrod maRal STabeWdilebas
aSkarad gamoirCeoda sxva qveiTad mo-               tovebda misi siRrmiseuli, logikurad Tan-
siarulisgan: gansakuTrebuli keTilSo-               mimdevruli da Rrmad safuZvliani mo-
bili da lamazi garegnobis, daxvewili ge-           sazrebebi da mtkicebulebebi momuSave ad-
movnebiT Semosili, dinjad, sakuTar                 amianTa garemos dacvisa da janmrTelobis
safiqralSi CaRmavebuli, igi dildilaobiT            SenarCuneba-gakaJebis Taobaze. mSvidad,
miemarTeboda xolme gamziris bolosaken.             auRelveblad, keTilganwyobili RimiliT,
   pirvelive SexvedrisTanave, rodesac              faqtobrivi masalis jerovani analizis
jer kidev piradad ar vicnobdi, mis danax-          Sedegebis moSveliebiT, batoni oTari
vaze anton Cexovis ‘Zia vanias~ personaJis,        yovelTvis advilad axerxebda mopaeqris
Cveni kolegis, eqim astrovis gamonaTqvami          darwmunebas araswor, mcdar Sexeduleba-
gamaxsenda: ‘adamianSi yvelaferi mSvenieri         ze, arasworad interpretirebul mopove-
unda iyos - saxec, samosic, sulica da azre-        bul faqtebze, da amgvari mecnieruli dis-
bic~. saxesa da samoss imTaviTve naTlad            kusia mSvidobianad mTavrdeboda xelmZRv-
vxedavdi da vixiblebodi. mis sulsa da              anelis gamarjvebiT. rac mTavaria, yvela
azrebs ki mogvianebiT veziare, rodesac             kmayofili da madlieri rCeboda: mopaeqre
prof. n.maxvilaZis saxelobis Sromis                - momxsenebelic da damrigebeli - batoni
higienisa da profesiul daavadebaTa samec-          oTar SalamberiZec. TanamSromlebsa da xe-
niero-kvleviTi institutis klinikas Ca-             lmZRvanels Soris sruli urTierTgageba
vudeqi saTaveSi. am periodSi batoni oTar           da urTierTpativiscema sufevda, Tumca ba-
SalamberiZe prof. g.naTaZis saxelobis              toni oTari gamoirCeoda uryevi principu-
sanitariisa da higienis samecniero-kvlev-          lobiT, erTi SexedviT - simkacriTac ki, ma-
iTi institutis samecniero muSaobas war-            gram am TvisebebiT igi amyarebda Tanam-
marTavda direqtoris moadgilis postze.              Sromlebis mowesrigebulobas da saqmisad-
orive instituti erTmaneTTan axlos iyo              mi erTgulebas, Rrmad dainteresebasa da
ganlagebuli da maT samecniero kontaqte-            dargis winsvlas - Tanamedroveobis moTx-
bic gaaCndaT. Cvenma urTierTobam ufro              ovnebis srul SesabamisobaSi.
mWidro xasiaTi miiRo, rodesac batonma                 adamianisadmi uzomo siyvarulma da mis
oTarma moRvaweobis gagrZeleba gadawyvi-            momavalze dauRalavma fiqrma, baton
                                             42



oTars gadaawyvetina 70-iani wlebidan              TiToeuli wevri yovelTvis da yvelafer-
mieZRvna mTeli Tavisi mecnieruli, orga-           Si sanimuSo iyo, ganmsWvaluli patios-
nizatoruli da piradadamianuri niWi ax-            nebiT, SromismoyvareobiT, profesion-
algazrda Taobebis swor Camoyalibebasa             alizmiT da sakuTari movaleobebis pir-
da maTi fizikuri, sulieri da moraluri             naTlad da dauRalavad SesrulebiT.
janmrTelobis dacvis mzrunvelobi-                      batoni oTari moaklda qveyanas, rom-
saTvis: rodesac 1974 wlidan sicocxlis             lis siZliere da perspeqtiuloba swored
bolomde, 22 wlis manZilze igi saTaveSi            im adamianTa cxovrebis wess eyrdnoboda,
Caudga Tbilisis saxelmwifo samedicino             romliTac icxovra da iRvawa Tavad Cven-
institutis/universitetis bavSvTa da               ma saamayo Tanamemamulem.
mozardTa higienis kaTedras. es iyo                   batoni oTari moaklda dargsa da ers,
aTwleulebi, rodesac batoni oTaris xi-             profilaqtikuri medicinis ukeTilSo-
bli amSvenebda saqarTvelos umaRlesi               biles mimarTulebas - bavSvTa da mozard-
samedicino saswavleblis ara mxolod                Ta fizikuri, moraluri da sulieri janm-
saswavlo-samecniero        mimarTulebas           rTelobis dacvas, rac esoden mniSvnelo-
profilaqtikuri medicinis dargSi,                  vania qarTveli erisaTvis, romlis de-
aramed mTlianad am umaRlesi samedicino            mografiuli maxasiaTeblebi safuZvlian
saswavleblis zogad avtoritetsac mniS-             gangaSs iwveven.
vnelovnad Seuwyo xeli.                               batoni oTari moaklda qalaqs, romel-
   universitetis xelmZRvanelobam uyoy-            Sic dRes, samwuxarod, WeSmariti mo-
manod gadasca mas sauniversiteto samec-           qalaqeebis kohortam sagrZnoblad iklo.
niero sabWos berketebi swavluli mdivnis              batoni oTari moaklda mis mSobliur
postze daniSvniT. am droisaTvis                   samedicino universitets, romelSic pre-
saqarTvelom moipova damoukidebloba, da            venciuli medicinis bavSvTa da mozardTa
batoni oTari dainiSna, agreTve, samecnie-         janmrTelobis dacvis mimarTulebas gan-
ro xarisxis mimniWebel profesorTa sab-            sakuTrebiT didi Zalisxmeva, energia da
Wos swavlul mdivnadac. sicocxlis bo-              miseuli gamocdileba aSkarad aklia.
lomde dauRalavad, iSviaTi wesrigis                   batoni oTari Cven mogvaklda, mis Tan-
dacviT uTavsebda batoni oTari kaTe-               amedroveebs, kolegebs da megobrebs,
draze energiul samecniero-pedagogiur              romlebsac ukve mxolod Tavisi gamoCen-
moRvaweobas mniSvnelovan sazogadoebriv-           iTac da saubriTac ki gvamSvidebda da op-
saqmianobas swavluli mdivnis movaleobis           timisturi RimiliT imeds gvinergavda
Cinebuli SesrulebiT.                              qveynisa da eris naTel momavalze.
   es periodi daemTxva qveyanaSi rTul so-            swored aseTma naTelma pirovnebebma
cialur-polotikur gardaqmnebsa da                  da WeSmaritma moqalaqeebad dagvitoves
ekonomikur siduxWires. mZimed, magram gar-        optimizmi, rac gvasuldgmulebs da imeds
egnuli emociuri gamoxatvis gareSe itan-           ar gvakargvinebs, viciT ra, rom namdvili
da batoni oTari mraval gaWirvebas - qveya-        patriotizmi da qveynisadmi siyvaruli
naSic, samsaxurSic da, bunebrivia, piradi,        sam veSaps eyrdnoba - patiosnebas, ga-
yofiTi xasiaTisasac. ver gauZlo misma fa-         naTlebulobas da Sromismoyvareobas.
qizma, mgrZnobiare, upatiosnesma gulma               aseTi iyo batoni oTar SalamberiZe,
amgvar rTul daZabulobas da, samwuxarod,           romelmac Tavis cxovrebis wesiT pirnaT-
man 75 wlis zRurblsac ki ver miaRwia...           lad moixada vali yvelas winaSe da rwmena
   wels mas 85 weli Seusruldeboda...              Cagvinerga - ‘kidevac daizrdebian!..~
   batoni oTari moaklda, upirvelesad,                naTelSi amyofos misi suli maradiul
Tavis SesaniSnav ojaxs. ojaxs, romlis             sasufevelSi.


                                                  saqarTvelos medicinis mecnierebaTa,
                                                  medikur-biologiur mecnierebaTa,
                                                  profilaqtikuri medicnis mecnierebaTa,
                                                  afxazeTis mecnierebaTa akademiebis wevri,
                                                  profesori vadim saakaZe
                                             43



                                       xsovna




                           giorgi kereseliZe
   qarTulma samedicino sazogadoebri-              lis samedicino dawesebulebebTan, sadac
obam, saqarTvelos profesiuli kavSirebis           asrulebda erT-erTi xelmZRvanelisa da
gaerTianebam mZime danaklisi ganicada:            mkurnali eqimis movaleobas.
gardaicvala janmrTelobis, socialuri                  ukanaskneli TiTqmis ori aTeuli weli
dacvisa da profkavSiruli moZraobis                giorgi kereseliZis saeqimo, organiza-
gamoCenili organizatori, sazogado moR-            toruli saqmianoba mTlianad dakavSirebu-
vawe, medicinis akademiuri doqtori gior-          li iyo saqarTvelos medicinis muSakTa
gi kereseliZe.                                    profesiul kavSirebTan. misi xelmZRv-
   batonma giorgim, misi arcTu ise xangr-         anelobiT, droTa ganmavlobaSi, es orga-
Zlivi sicocxlis manZilze, qveynis samedi-         nizacia gadaiqca samedicino dargis muSak-
cino da profesiul dargSi moRvaweobis as-          Ta zrunvis, socialuri keTildReobis,
parezze Tavi gamoiCina rogorc Rirseul-            SromiTi pirobebis gaumjobesebis mZlavr
ma xelmZRvanelma da niWierma muSakma.             centrad, ramac misi moRvaweobisadmi say-
   giorgi kereseliZe daibada 1949 wels            ovelTao mxardaWera hpova.
TbilisSi. saSualo skolis damTavrebi-                 batoni giorgi, rogorc moqalaqe da
sTanave saeqimo profesias daeufla lenin-          qveynis WeSmariti patrioti, mudmivad iRv-
gradis saxelmwifo samedicino institut-            woda Tavisi xalxis sasikeTod, TansakuTre-
Si, romlis damTavrebis Semdeg, praqtikul          biT STambeWdavi iyo misi damokidebuleba
saeqimo saqmianobas iwyebs m. winamZRvriS-        qveyanaSi mimdinare procesebisadmi.
vilis saxelobis kardiologiis samecnie-               is gansakuTrebuli mondomebiT zrunav-
ro-kvleviT institutSi.                            da axalgazrda saeqimo kadrebis profesi-
   perspeqtiuli, niWieri axalgazrdis mo-          uli daxelovnebisaTvis. man mraval axal-
mavali saeqimo kariera SeumCneveli ar dar-        gazrda specialists gauwia Tanadgoma da
CeniaT mis mecnierul xelmZRvanelebs. ma-          mxardaWera.
Tive rekomendaciiT axalgazrda eqimi gaig-            giorgi kereseliZis mravalmxrivi moR-
zavna moskovis meore saxelmwifo samedici-         vaweoba saTanadod dafasda. mas miniWebu-
no institutis aspiranturaSi. muyaiTi da           li hqonda Cveni qveynis maRali jildo -
gamrje mkvlevari warCinebiT amTavrebs as-         Rirsebis ordeni.
piranturas da amave umaRlesi samedicino              gulistkiviliT veTxovebiT Cvens me-
saswavleblis samedicino sabWos sxdomaze           gobarsa da kolegas, Tanamoazres, romel-
warmatebiT icavs sakandidato disertacias.         mac icxovra da iRvawa qveynisaTvis mam-
   batoni giorgis Semdgomi saeqimo saqmi-         uliSviluri erTgulebiT da amiT Rirseu-
anoba dakavSirebulia Tbilisisa da marneu-         li magaliTi dautova momaval Taobas.

                                                  saqarTvelos janmrTelobis, socialuri
                                                  dacvis, samedicino da qimiuri mrewvelobis
                                                  muSakTa damoukidebeli profesiuli kavSiri
                                           44



                             redaqtoris gverdi




                                 tradicia
   odiTganve profesiis arCeva ojaxis            fesiuli moRvaweobis Sedegad moepovebi-
tradiciidan gamomdinare, ar warmoad-            na mTavari - xalxis upirobo mzadyofna -
gens iSviaT movlenas. kacobriobis isto-         andon mas yvelaze Zvirfasi bavSvis sic-
riaSi mravlad moiZebneba saxelganTqmu-          ocxle da janmrTeloba.
li ojaxuri dinastiebi, Taobidan Taoba-             batoni irakli qarTuli pediatriuli
Si gadasuli profesiuli memkvidreobiTi           skolis Rirseuli warmomadgenelia. klin-
principebiT. aseTi ojaxebi Zlieri fes-          icisti, pedagogi, Tbilisis saxelmwifo
vebidan arian aRmocenebuli da inteleq-          samedicino universitetis bavSvTa sneule-
tis maRali doniT xasiaTdebian, vinaidan         baTa kaTedris profesori. is qarTvel pe-
tradiciuloba, rogorc movlena Tavisi             diatrTa im pleadis warmomadgenelia,
arsiT gulisxmobs axali Taobis wina Tao-         romelsac miekuTvnebodnen: irakli rcx-
bis Rvawlisadmi Tayvaniscemas, mzadyof-         ilaZe, meri gelovani, irakli faRava,
nas ganagrZos da srulyos winaparTa pro-         vladimer ToxaZe, ioseb kvaWaZe da bevri
fesiuli saqmianoba drois moTxovnaTa             sxva. batoni irakli dResac nayofierad
Sesabamisad.                                    moRvaweobs da mdidar gamocdilebas
   saqarTveloSi bevri sxva qveynisagan          uziarebs axalgazrda kolegebs.
gansxvavebiT, profesiuli tradiciis                 gasul wels saqveynod cnobilma far-
memkvidreobiToba vrceldeba inteleq-             macevtulma firmam ‘pfaizerma~ saqarTve-
turluri saqmianobis sxvadasxva sfroze,          los samedicino sazogadoebam didi for-
maT Soris medicinazec.                          matis ilustrirebuli kalendriT
   saqarTveloSi eqimoba ramdenime Tao-          daasaCuqra. kalendris Tormet gverdze
bis tradiciaa. STamomavlobiT eqimTa             gamosaxuli iyo saqarTvelos sxvadasxva
CamonaTvali Sors wagviyvanda. maT               dargis Tormeti cnobili moRvawe. kalen-
Sorisaa ojaxebi, romlebic gansakuTre-           dris pirveli gverdi ixsneba batoni irak-
biT dafasebulia sazogadoebis mier.              lis foto-portretiT. suraTidan miRe-
   Tqveni yuradReba gvinda SevaCeroT            buli STabeWdilebiT mnaxveli eziareba im
eqimTa brwyinvale gvaris or warmomad-           realobas, Tu rogori unda iyos eqimi am
genelze: mamaSvil irakli da daviT               sityvis WeSmariti gagebiT.
ciciSvilebze. ciciSvilebis gvari, rom              yovelive amis Semdeg, gasakviri ar unda
ucxo ar aris qarTuli medicinis istori-          yofiliyo, rom batoni iraklis vaJis, davi-
aSi, amas didi mkurnalisa da sazogado           Tis momavali profesia winaswarve iyo gan-
moRvawis zaza fanaskerteli-ciciSvilis           sazRvruli. Tbilisis 53-e saSualos skolis
ukvdavi saxelic metyvelebs. Tavad bato-         dasrulebis Semdeg, daviTma swavla mosko-
ni irakli ciciSvili saerTo saxalxo siy-         vis pirvel saxelmwifo samedicino insti-
varuliTa da pativiscemiT garemoculi             tutSi ganagrZo. institutis damTavrebis
eqimia. man SeZlo moqalaqeobrivi da pro-        Semdeg, daviT ciciSvili muSaobas iwyebs
                                             45



moskovis botkinis saxelobis klinikuri             niSvnelovanesia mxatvruli xedvis niWi,
saavadmyofos zogadi profilis qirur-               rac gulisxmobas imis aucileblobas, rom
gad. 1989 wels Camodis TbilisSi da xe-            eqimma individualurad aRiqvas pacientis
lovndeba otolaringologiis profiliT.               monacemebi da mravalTagan SearCios esTe-
specializaciis kurss maSin akademikosi            tikuri koreqciis is erTaderTi varianti,
simon xeCinaSvili xelmZRvanelobda,                romelic optimaluria.
romelic im periodSi eqimTa daxelovneb-               daviT ciciSvili srulyofilad flobs
is Tbilisis institutis yel-yur-cxviris            Tanamedrove plastikuri qirurgiis yve-
daavadebaTa kaTedris gamge iyo. 1990 wl-          la dargs. is medicinis mecnierebaTa doq-
idan daviTi iwyebs muSaobas baton vaxtang         toria. sadoqtoro sakvalifikacio naS-
xurciZesTan, romlis xelSewyobiT xvews             romi exeba cxviris kompleqsuri opera-
ostatobas plastikur qirurgiaSi. aRsani-           ciebis Temas. praqtikuli saqmianobi-
Snavia, rom daviT ciciSvili vaxtang xur-          saTvis, metad mniSvnelovnad miiCnevs pa-
ciZes Tavis maswavleblad miiCnevs. 1991           cientis fsiqologiur mdgomareobas,
wlidan daviTi ukve rogorc damoukidebe-            gansakuTrebiT operaciis mosamzadebel
li eqimi iwyebs muSaobas im xanad TbilisSi        periodSi. daviT ciciSvili rogorc
erTaderT profilirebul samedicino                  pirovneba - gulTbili da saurTierTod
dawesebulebaSi, plastikuri qirurgiisa             gaxsnili pirovnebaa. xasiaTis es Tvisebe-
da kosmetologiis klinikaSi. 1992 wels             bi uadvilebs mas pacientebTan urTier-
daviTi tovebs Tbiliss da gadadis mosk-            Tobas. hyavs sami Svili: ana, marina da irak-
ovSi. aq iwyeba misi cxovrebisa da samedi-        li. meuRle profesiiT fsiqologia.
cino saqmianobis axali etapi. ra sirTu-              daviTi moskovis or prestiJul klini-
leebs ukavSirdeba misi profesiuli moR-            kaSi ‘lantansa~ da ‘laiv-taimSi~ moR-
vaweoba iseT konkurentul qalaqSi,                 vaweobs. Tumca ar iviwyebs Tbilissac da
rogoric moskovia, advili warmosadgenia.           yoveli Camosvlisas uamravi pacientis
miuxedavad amisa, sakmaod mokle xanSi dav-        guliTad madlobas imsaxurebs, amJamad is
iTma moskovis erT-erTi warmatebuli                samedicino centr ‘qali da janmrTelo-
plastikuri qirurgis saxeli daimkvidra.            bis~ maRalkvalificiuri koleqtivis
kiTxvaze - Tu ra aris plastikuri qirurgi-         TanadgomiT, romelsac gamocdili mene-
is warmatebis saidumlo, daviTma xazi gaus-        jeri, qalbatoni marina sayvareliZe xe-
va im faqts, rom operaciis teqnikurad             lmZRvanelobs, warmatebiT eweva konsul-
srulyofisaTvis, codnasaTan erTad, um-             taciebs da operaciul mkurnalobas.
                                            46




                                    rCeuli


   maTes saxarebaSi vkiTxulobT: ‘esreT              adamianebTan, moqalaqeebTan piradi
iyvnen winani da ukanani wina, rameTu            urTierTobis erT-erT saukeTeso qmede-
mravalni arian Cinebul da mciredi                bad baton iraklis miaCnda maTTan
rCeuln rCeulTa xvedri gamorCeulia sa-            yoveldRiuri kontaqti Tbilisis quCeb-
zogadoebriv asparezze. isini cxovrebi-           Si fexiT mosiarule baton iraklis miaCn-
seuli avanscenidan amdidreben adamianTa          da maTTan yoveldRiuri kontaqti Tbili-
sulier Tu yofiT procesebs da amiT xels           sis quCebSi fexiT mosiarule baton irak-
uwyoben warmatebiT warmarTon maTi                lis xvdebodnen misi Tayvanismcemlebi,
yoveldRiuri qmedeba sazogadoebis sam-            uamravi nakadi qalaqelebisa. mas SekiTx-
saxurSi.                                         viT mimarTavdnen usmendnen mis mo-
   rCrulTa Soris gansakuTrebiT misaba-           sazrebebs, ixiblebodnen batoni iraklis
Zi iyo saxelovani mecnieris, pedagogis,          mWermetyvelobiT, siRrmiseuli logi-
sazogado moRvawis, WeSmaritad saxalxo            kiT, ubraloebiT.
eqimis baton irakli faRavas Rvawli                  wilad mxvda pativi, ramdenime weli me-
erovnuli pediatriuli skolis ganvi-               gobruli da SemoqmedebiTi urTierToba
Tarebisa da aRmavlobis mamuliSvilur              mqonoda baton iraklisTan. samedicino
saqmeSi.                                         Jurnalis redaqciaSi misi stumroba yve-
   batoni irakli misabaZi iyo aramarto           las gvaxarebda. TiToeuli CvenTagani ak-
rogorc mecnieri da pedagogi, aramed              ademiuri SekiTxvebis garda, vcdilobdiT
rogorc moqalaqe, qveynis patrioti da             aqtiur saubarSi CagveTria da siam-
qomagi. misabaZi iyo agreTve misi yoveld-        ovnebiT vismendiT mis mosazrebebs, vixi-
Riuri cxovrebis kredo. moqalaqeebTan             blebodiT misi xedviT rogorc erovnul,
urTierToba da maT mimarT Tanadgoma, sa-          ise yofiT, profesiul da sxva sakiTebze.
jaro gamosvlebis dros myari erovnuli                batoni irakli Cinebulad iyo gaTviTc-
poziciebi, momavali Taobisadmi erTguli           nobierebuli Cveni qveynis istoriaSi,
samsaxuri da Tavdadeba.                          eamayeboda misi gmiruli warsuli, wina-
   adamianTa mimarT batoni iraklis               parTa saqmeni sagmironi. ‘istoriuli fes-
pirovnuli xibli, ganwyoba, komunikabe-           vebi amdidrebs da aZlierebs adamianis
loba, sisadave izidavda yvelas - patara          ulierebas~ - ityoda saubarSi. misi say-
pacientebidan dawyebuli, Rrmad asakovan          ovelTaod momxibvleli leqciebi da sa-
pirovnebebze.                                    jaro gamosvlebi gajerebuli iyo warsu-
                                         47



lis istoriuli faqtebiT, saxelovan             rTulebiT sazogadoebas warudgina maTi
winapraTa mier Cvendami moRweuli fr-          pozicia. aseTi iyo misi moxseneba
Tiani gamoTqmebiT da mecnieruli Tu            saqarTvelos pediatrTa yrilobaze 1987
praqtikuli koncefciebiT da rac yve-           wels - ‘ilia WavWavaZe bavSvTa aRzrdisa
laze mniSvnelovania, STambeWdavi iyo          da janmrTelobis sakiTxebis Sesaxeb~.
miseuli paralelebis gavlena da urT-              sabednierod, batoni iraklis mecnier-
ierTkavSiri warsulTan da dRevandelo-          uli, saeqimo, pedagogiuri tradiciebis
basTan.                                       sasaxelod grZeldeba. mis memkvidreTa
  `aRvzardoT srulfasovani pirovneba~          sanaqebod unda iTqvas, rom erovnuli pe-
- aseTi iyo misi profesiuli da mo-            diatriuli skolis dRevandeli Taba amdi-
qalaqeobrivi pozicia, romelic saTaves         drebs da amravlebs maTi TvalsaCino
warsulidan iRebda, rac imaSi mdgomare-        winapris naanderZevs, mis mier Seqmnil da
obda, rom batonma iraklim safuZvlianad        danergil mecnierul da klinikur mima-
Seiswavla warsulSi gamoCenil erovnul          rTulebaTa formebsa da meTodebs, rac
moRvaweTa xedva momavali Taobis janm-         WeSmariti garantiaa misi amqveyniuri ukv-
rTelobis dacvis Taobaze da am mima-           davebisa.
                                             48



                                  gamosaTxovari




   batoni kote barqaias udroo                     damamkvidrebel Zalad misTvis wigni da
sikvdilma mTeli Cveni sazogadoebriobis            wignisadmi siyvaruli iyo.
mwvave gancda da gulistkivili gamoiwvia.             axalgazrdobas - qveynis saimedo da
   misi pirovnuli Tvisebebi, adamianTa mi-        sasikeTo momavlad miiCnevda. maTi yove-
marT miseuli komunikabeloba gan-                  li winsvla da warmateba did siamayes gvr-
sakuTrebul xibls iwvevda yvela CvenTa-            ida da mTeli arsebiT cdilobda gamoexa-
ganSi.                                            ta maTdami siyvaruli da Tanadgoma.
   cxovrebisadmi erTgulebiT aRsavse                  naTeli cxovrebiT icxovrad kote bar-
mTeli SemarTebiT grZnobda qveynisadmi,            qaiam. sadac ki umoRvawia: jandacvis, sa-
sazogadoebisadmi did pasuxismgeblobas,            gareo saqmeTa saministroebSi, saqarTve-
TiToeuli pirovnebisadmi movaleobasa               los parlamentSi Tu sxvagan mamuliSvil-
da Tanadgomas.                                    uri TavdadebiT emsaxureboda erovnul
   siyvarulze siyvaruliTve pasuxobda.             saqmes da miuxedavad arc Tu xangrZlivi
yvelgan keTili guli Seqonda, aseve                cxovrebisa da valmoxdili wavida amqvey-
keTili ganwyobiT xvdebodnen mas.                  niuri yofidan.
   uyvardaT misi mosmena da masTan                   mas SeeZlo eTqva: ‘me vcxovrobdi ise,
saubari. sikeTesa da adamianur keTilSo-           rogorc vgrZnobdi da vgrZnobdi ise,
bilebas aravis ar daukargavda da Tavisi           rogorc vcxovrobdi. me Cemi rwmenis
gulis siTbosac zed daamatebda.                    erTguli davrCi~.
   qveynis, xalxis warsulisa da awmyos is-           samomavlod darCa kvali naTeli Sesani-
toriaze, mis kulturaze, literaturaze,             Snavi pirovnebisa, megobrisa, moqalaqisa,
xelovnebaze uzomod Seyvarebuls                    romelmac Rirseulad iRvawa. samagaliTo
saubris dros uamravi konkretuli faqte-            mogonebad darCeba yvelasTvis, vinc ic-
bis citireba SeeZlo mdidari bib-                  nobda da axloblobda masTan.
liografiuli wyaroebis moSveliebiT.                   msubuqi iyos misTvis mSobliuri,
sulieri silaRisa da simSvidis erT-erT             qarTuli miwa.




  3. saqarTvelos samedicino Jurnali, 2, 2008 w.
                                          49




                                 axali wignebi




  1. zurab xelaZe - kritikuli medicina. gamomcemloba ‘universali~. 2007 w.
  2. n. lebaniZe, s. qajaia - anesTeziologia da reanimatologia kiTxvebsa da
pasuxebSi.
  3. lin s. bikli - beitsis klinikuri gamokvlevis safuZvlebi.
  4. jon p. klosherti - neonatologia
  5. 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 SegiZliaT
                Tbilisis saxelmwifo samedicino universitetis
             administraciuli korpusis jixurSi, vaJa-fSavelas 33.




                   konsultanti inglisur enaSi maka tatiSvili

redaqciis misamarTi: Tbilisi, vaJa-fSavelas gamz. 33
АДРЕС РЕДАКЦИИ: ТБИЛИСИ, ПРОСПЕКТ              ВАЖА-ПШАВЕЛА 33

xelmowerilia dasabeWdad: 22.07.08 w., formati 70 X 108 1/16
fizikuri nabeWdi Tabaxi 3.0
saaRricxvo-sagamomcemlo Tabaxi 3,5, tiraJi 300,
fasi saxelSekrulebo
                                                  50




      indeqsi              76184

   saqarTveloSi latviuri farmaciis kompania “Grindeks” (grindeqsis) warmomadgen-
lobis xelmZRvaneli, eqimi Tea sxirtlaZe Cveni Jurnalis mkiTxvels sTavazobs rCe-
va-darigebas, romelic efuZneba misi saeqimo saqmianobis praqtikul gamocdilebas.

                                  uZiloba da misi mkurnaloba
                                         ra aris uZiloba?
   uZiloba - Zilis darRvevis erT-erTi yvelaze gavrcelebuli formaa.
   uZiloba moicavs CaZinebasTan dakavSirebul siZnleebs, xSir gamoRviZebas RamiT da naadrev
gamoRviZebas diliT. uZiloba mniSvnelovnad auaresebs adamianis cxovrebis ritms da moqmedebs
mis Sromisunarianobaze.
   uZilobis yvelaze xSiri mizezebia:
   stresebi _ ojaxuri problemebi, samsaxureobrivi usiamovnebebi, SfoTva mniSvnelovani movle-
nebis win, avadmyofoba, tkivili, xmauri, amindis cvlileba. cxovrebis wesi _ mZime fizikuri Sroma
saRamos saaTebSi, Ramis cvlaSi muSaoba, Zilis win Warbi kveba, yavis an alkoholis miReba, Tambaqos
moweva. 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 medikament-
ebTan da 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 igrZnobT
uZilobas 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.
                                                       51



saredaqcio kolegiisa da                   ПРЕДСЕДАТЕЛЬ РЕДАКЦИОННОЙ              THE CHAIRMAN OF EDITORIAL
sabWos Tavmjdomare -                      КОЛЛЕГИИ И СОВЕТА -                    BOARD AND COUNCIL -
giorgi menabde                            Г.Т. МЕНАБДЕ                           G. MENABDE
mTavari redaqtori -                       ГЛАВНЫЙ РЕДАКТОР -                     CHIEF EDITOR -
jangir mamalaZe                           ДЖ.А. МАМАЛАДЗЕ                        J. MAMALADZE

saredaqcio kolegia:                       РЕДАКЦИОННАЯ КОЛЛЕГИЯ:                 EDITORIAL BOARD:
zaza beriSvili,                           З.Л. Беришвили,                        Z. Berishvili,
nodar baqraZe,                            Н.Д. Бакрадзе,                         N. Bakradze
klara gelaSvili,                          К.Д. Гелашвили,                        D. Chavchanidze,
oTar gerzmava,                            О.Х.Герзмава,                          G. Chapidze,
SoTa gogoxia,                             Ш.Д. Гогохия,                          T. Dekanosidze,
Tamar dekanosiZe (mTavari                 З.Г. Гугунишвили,                      K. Gelashvili,
redaqtoris moadgile),                     Т.И. Деканосидзе (зам.                 O. Gerzmava,
fridon Todua,                             гл.редактора),                         Sh. Gogokhia,
paliko kintraia,                          М.Н. Кавтарадзе,                       Z.Gugunishvili,
dimitri korZaia,                          Э.П. Кемертелидзе,                     M. Kavtaradze,
gia lobJaniZe,                            П.Я. Кинтраиа,                         E. Kemertelidze,
vadim saakaZe (mTavari                    Н.Н. Кипшидзе,                         S. Khechinashvili,
redaqtoris moadgile),                     Д.Дж. Кордзаиа,
                                                                                 R. Khetsuriani,
irakli favleniSvili,                      Л.С. Курцикашвили,
                                                                                 P. Kintraia,
merab qavTaraZe,                          Г.В. Лобжанидзе,
                                                                                 N. Kipshidze,
eTer qemerteliZe,                         И.В. Павленишвили,
levan qurcikaSvili,                       В.П. Саакадзе (зам. главного.          D. Kordzaia,
zezva RuRuniSvili,                        редактора),                            L. Kurtsikashvili,
nodar yifSiZe,                            Ф.И. Тодуа,                            G. Lobjanidze,
roman SaqariSvili,                        Р.Г. Хецуриани,                        I. Pavlenishvili,
ramaz Sengelia,                           С.Н. Хечинашвили,                      V. Saakadze,
gulnara CafiZe,                           Д.Г. Чавчанидзе,                       R. Shakarishvili,
daviT WavWaniZe,                          Г.Э. Чапидзе,                          R. Shengelia,
simon xeCinaSvili,                        Р.Р. Шакаришвили,                      P. Todua
ramaz xecuriani                           Р.М. Шенгелиа




                                      saredaqcio sabWo:
             a. aladaSvili       (Tbilisi)                       a. koWlamazaSvili          (Tbilisi)
           m. apostolovi         (bulgareTi)                                l. managaZe     (Tbilisi)
                     i. beraZe   (Tbilisi)                         v. margvelaSvili         (Tbilisi)
                     m. boxua    (Tbilisi)                                i. megrelaZe      (Tbilisi)
                      r. gagua   (Tbilisi)                                    m. mixaili    (israeli)
                  g. gegeSiZe    (samtredia)                             g. muxaSavria      (Tbilisi)
                l. gujabiZe      (Tbilisi)                            i. mWedliSvili        (Tbilisi)
                j. gujabiZe      (Tbilisi)                                     q. nemsaZe   (Tbilisi)
     a. diamandopulosi           (saberZneTi)                             T. sanebliZe      (marneuli)
               i. eliaSvili      (tyibuli)                              r. sefiaSvili       (moskovi)
                 n. emuxvari     (Tbilisi)                                r. surmaniZe      (baTumi)
                     g. vasaZe   (Tbilisi)                                m. tatiSvili      (Tbilisi)
                      g. vekua   (Tbilisi)                                    a. tuveidi    (vaSingtoni)
                  n. vefxvaZe    (Tbilisi)                                      i. faRava   (Tbilisi)
          o. zurabiSvili         (parizi)                          e. qarTveliSvili         (Tbilisi)
                     o. ToiZe    (Tbilisi)                                   b. qobulia     (Tbilisi)
                 z. Tofuria      (Tbilisi)                                     v. yifiani   (Tbilisi)
                  s. kapanaZe    (Tbilisi)                               r. yuraSvili       (Tbilisi)
                    i. kvaWaZe   (Tbilisi)                               a. CarTolani       (mestia)
     a. kvezereli-kopaZe         (Tbilisi)                                   T. CxikvaZe    (Tbilisi)
         r. kverenCxilaZe        (Tbilisi)                                    l. WeliZe     (Tbilisi)
                    v. kiknaZe   (Tbilisi)                               n. xatiaSvili      (Tbilisi)
                 n. kintraia     (Tbilisi)                              a. xomasuriZe       (Tbilisi)
                   z. kirtava    (Tbilisi)                             n. javaxiSvili       (Tbilisi)
                                            52




                        avtorTa sayuradRebod!

     `saqarTvelos samedicino Jurnali~ ganTavsebulia internetis veb-gverdze, referirebulia
ВИНИТИ-is referatul Jurnalsa da monacmeTa bazebSi, vrceldeba sazRvargareTis sxvadasxva qvey-
anaSi.
     Jurnali, ZiriTadad, qarTulenovania, inglisuri da rusuli vrceli anotaciebiT. avtorTa
surviliT Sromebi qveyndeba ucxo enebzec, Sesabamisi anotaciebiT.
     sadReisod, Jurnalis prioritetul mimarTulebis umaRles mizans kvlav warmoadgens: mec-
nieruli azrisa da praqtikis erTianobis principi, rogorc samamulo, aseve msoflio samedicino
da fundamentur gamokvlevaTa mkiTxvelamde mitana da mecnieruli codnis popularizacia.
     Tbilisis saxelmwifo samedicino universitetis xelmZRvanelobas ganzraxuli aqvs Jurnalis
samedicino universitetis periodul samecniero-praqtikul da meTodologiur organod gadaqceva.
     Cveni azriT, es faqti Jurnalis mesveurebs udides pasuxismgeblobas akisrebs, rom Jurnali
gaxados Tanamedrove akademiuri donis periodul gamocemad, gaaumjobesos misi dizaini da poli-
grafiuli xarisxi.
     gvinda gauwyoT, rom JurnalSi gamoqveynebuli masalebis prioriteti gaTvaliswinebuli iqne-
ba sakvalifikacio Tematikis damtkicebis, sakonkurso ganxilvis da sxvaTa dros.
     migvaCnia, rom Jurnalis mkiTxvelTa Tanadgoma sasikeTod waadgeba fundamenturi qarTuli
samedicino periodikis gamocemas, mis popularobas da saerTaSoriso aRiarebas.


                                                                       saredaqcio kolegia

				
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