rezidenturis (diplomisSemdgomi samedicino ganaTlebis ... · 2.5.1. hojkinis limfoma 2.5.2 arahojkinis limfomebi 3. 33.. 3. hemostazis darRvevebiT gamowveuli daavadebebi da hemostazis

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rezidenturis (diplomisSemdgomi samedicino ganaTlebis programa rezidenturis (diplomisSemdgomi samedicino ganaTlebis programa rezidenturis (diplomisSemdgomi samedicino ganaTlebis programa rezidenturis (diplomisSemdgomi samedicino ganaTlebis programa ““““hematologia/transfuziologiahematologia/transfuziologiahematologia/transfuziologiahematologia/transfuziologia““““

(xangrZlivoba - 3 weli (33 Tve))

Tavi I. zogadi debulebebiTavi I. zogadi debulebebiTavi I. zogadi debulebebiTavi I. zogadi debulebebi

muxli 1. zogadi gansazRvrebebimuxli 1. zogadi gansazRvrebebimuxli 1. zogadi gansazRvrebebimuxli 1. zogadi gansazRvrebebi

hematologia aris medicinis dargi, romelic Seiswavlis sisxlisa da sisxlmbadi organoebis Senebas da funqciur mdgomareobas normaSi da paTologiaSi da moicavs am organoTa embriogenezs, morfogenezs, ujredovani elementebis morfofiziologias, sisxlis sistemis daavadebaTa eTiologiis, paTogenezis, paTologiuri anatomiis, klinikis da mkurnalobis Seswavlas. hematologiis mniSvnelovan nawils transfuziologia warmoadgens, romelic Seiswavlis da moicavs organizmis sisxlwarmoqmnis darRvevebiT, sisxlis ujredovani da cilovani deficitiT an sxva paTologiuri mdgomareobebiT gamowveuli homeostazis darRvevis dros sisxlis ujredovani da cilovani komponentebis da sxva satransfuzio areebis gamoyenebis Cvenebebs, samkurnalo efeqturobas, posttransfuziul garTulebebs da maT profilaqtikas, komponenturi hemoTerapiis alternatiuli meTodebis gamoyenebas.

hematologi/transfuziologi medicinis dargis specialistia

� romelsac gaaCnia Sesabamisi Teoriuli codna da praqtikuli gamocdileba klinikur da laboratoriul hematologiaSi;

� romelsac miRebuli aqvs specialuri codna _ dauflebulia hematologiis, imunologiis da transfuziuli medicinis safuZvlebs;

� romelsac gaaCnia didi gamocdileba da sistematizirebuli Cvevebi damyarebuli sisxlis warmoqmnis, citologiis, histomorfologiis, imunologiis, citokinetikis, citogenetikis sakiTxebis Rrma codnaze;

� romelsac nebismier samkurnalo, klinikur da samecniero samedicino dawesebulebaSi SeuZlia Seasrulos kvalificiur specialist _ konsultant hematolog/transfuziologis roli diagnostikuri da Terapiuli problemebis gadawyvetaSi;

� romelsac gaaCnia maqsimaluri efeqturobis da usafrTxoebis garantirebis unari rogorc donoris, ise pacientisaTvis (recipientisaTvis) sisxlis da misi komponentebis aRebis/transfuziis dros;

� romelsac SeuZlia hematologiis da transfuziologiis dargSi monawileoba miiRos samecniero kvlevebSi;

� romelsac gaaCnia unari da survili hematologiuri da transfuziologiuri medicina Seaswavlos eqimebs, medikos-studentebs da medicinis dargSi momuSave sxva TanamSromlebs.

sarezidento programa moicavs 2 wlian swavlebas, romlis drosac umaRlesi samedicino ganaTlebis mqone piri, romelmac gaiara rezidentura Sinagan medicinaSi, eufleba specialobis safuZvlebs. msmeneli gaivlis rotaciis wesiT programiT gaTvaliswinebul Temebs. rezidenti CaerTveba klinikur muSaobaSi, gaatarebs pacientebs kuratoris meTvalyureobis qveS. rezidenturis kurss xelmZRvanelobs direqtori da uZRveba lokaluri klinikuri xelmZRvaneli. lokaluri xelmZRvaneli unda iyos gamocdili eqimi-specialisti (m.doqtori/m.m.doqtori). rezidenturis programis CatarebisaTvis samedicino-saswavlo dawesebulebas unda gaaCndes rezidenturisaTvis saWiro materialur-teqnikuri potenciali (auditoria, saswavlo oTaxebi, vizualuri da damxmare saswavlo masalebi da sxva) da kvalificiuri pedagogiuri resursi. muxli 2. muxli 2. muxli 2. muxli 2. mizani da amocanebimizani da amocanebimizani da amocanebimizani da amocanebi

sarezidento programa gankuTvnilia maTTvis, vinc gaiara rezidentura Sinagan medicinaSi.

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sarezidento programis mizania gazardos hematolog/transfuziologi, romelsac SeeZleba damoukideblad muSaoba am dargSi, pacientis marTva da strategiis gansazRvra rogorc qveynis masStabiT, aseve konkretul samedicino dawesebulebaSi.

rezidenturis damTavrebis Semdeg eqimi specialisti SeZlebs klinikuri muSaobis warmarTvas, prevenciis gansazRvras, infeqciuri komitetis muSaobaSi monawileobas, qimioTerapiis Catarebas da samecniero kvlevebSi monawileobas.

eqimi hematologi/transfuziologi SeZlebs muSaobas nebismier samkurnalo, klinikur da samecniero samedicino dawesebulebaSi. SeuZlia Seasrulos kvalificiur specialist_konsultant hematologis roli diagnostikuri da Terapiuli problemebis gadawyvetaSi;

Tavi II. ”Tavi II. ”Tavi II. ”Tavi II. ”hematologia/transfuziologiahematologia/transfuziologiahematologia/transfuziologiahematologia/transfuziologia” specialobis aRwerilo” specialobis aRwerilo” specialobis aRwerilo” specialobis aRweriloba/specifikaciaba/specifikaciaba/specifikaciaba/specifikacia

muxli 1. muxli 1. muxli 1. muxli 1. specialobisa da specialistis gansazRvreba (definicia); specialobisa da specialistis gansazRvreba (definicia); specialobisa da specialistis gansazRvreba (definicia); specialobisa da specialistis gansazRvreba (definicia);

hematologia aris medicinis dargi, romelic Seiswavlis sisxlisa da sisxlmbadi organoebis Senebas da funqciur mdgomareobas normaSi da paTologiaSi da moicavs am organoTa embriogenezs, morfogenezs, ujredovani elementebis morfofiziologias, sisxlis sistemis daavadebaTa eTiologiis, paTogenezis, paTologiuri anatomiis, klinikis da mkurnalobis Seswavlas. hematologiis mniSvnelovan nawils transfuziologia warmoadgens, romelic Seiswavlis da moicavs organizmis sisxlwarmoqmnis darRvevebiT, sisxlis ujredovani da cilovani deficitiT an sxva paTologiuri mdgomareobebiT gamowveuli homeostazis darRvevis dros sisxlis ujredovani da cilovani komponentebis da sxva satransfuzio areebis gamoyenebis Cvenebebs, samkurnalo efeqturobas, posttransfuziul garTulebebs da maT profilaqtikas, komponenturi hemoTerapiis alternatiuli meTodebis gamoyenebas.

hematologi/transfuziologi medicinis dargis specialistia

• romelsac gaaCnia Sesabamisi Teoriuli codna da praqtikuli gamocdileba klinikur da laboratoriul hematologiaSi;

• romelsac miRebuli aqvs specialuri codna _ dauflebulia hematologiis, imunologiis da transfuziuli medicinis safuZvlebs;

• romelsac gaaCnia didi gamocdileba da sistematizirebuli Cvevebi damyarebuli sisxlis warmoqmnis, citologiis, histomorfologiis, imunologiis, citokinetikis, citogenetikis sakiTxebis Rrma codnaze;

• romelsac nebismier samkurnalo, klinikur da samecniero samedicino dawesebulebaSi SeuZlia Seasrulos kvalificiur specialist _ konsultant hematologis roli diagnostikuri da Terapiuli problemebis gadawyvetaSi;

• romelsac gaaCnia maqsimaluri efeqturobis da usafrTxoebis garantirebis unari rogorc donoris, ise pacientisaTvis (recipientisaTvis) sisxlis da misi komponentebis aRebis/transfuziis dros;

• romelsac SeuZlia hematologiis da transfuziologiis dargSi monawileoba miiRos samecniero kvlevebSi;

• romelsac gaaCnia unari da survili hematologiuri da transfuziologiuri medicina Seaswavlos eqimebs, medikos-studentebs da medicinis dargSi momuSave sxva TanamSromlebs.

muxmuxmuxmuxli 2. specialistis profesiuli zogadi codnali 2. specialistis profesiuli zogadi codnali 2. specialistis profesiuli zogadi codnali 2. specialistis profesiuli zogadi codna hematologi/transfuziologihematologi/transfuziologihematologi/transfuziologihematologi/transfuziologi eqimeqimeqimeqim----specialisti unda flobdes codnas Semdegi specialisti unda flobdes codnas Semdegi specialisti unda flobdes codnas Semdegi specialisti unda flobdes codnas Semdegi kanonebis Sesabamisad: kanonebis Sesabamisad: kanonebis Sesabamisad: kanonebis Sesabamisad: specialistis profesiuli zogadi codnaspecialistis profesiuli zogadi codnaspecialistis profesiuli zogadi codnaspecialistis profesiuli zogadi codna

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hematologma unda icodes:hematologma unda icodes:hematologma unda icodes:hematologma unda icodes:

- saqarTvelos kanoni “janmrTelobis dacvis Sesaxeb”; - saqarTvelos kanoni “ saeqimo saqmianobis Sesaxeb”; - saqarTvelos kanoni “pacientTa samarTlebrivi uflebebis Sesaxeb”; - eqimisa da pacientis urTierTobebis safuZvlebi: - evrosabWos dokumentebi, romlebic sisxlis gadasxmis eTikuri, socialuri,

mecnieruli da praqtikuli aspeqtebisadmia miZRvnili da romelsac unda icnobdes, iziarebdes da iyenebdes Tavis muSaobaSi specialisti;

- rekomendacia NoR(88)4 sisxlis gadasxmis dargSi jan. dacvis oficialuri struqturebis pasuxismgeblobis Sesaxeb;

- rekomendacia NoR(95)15 sisxlis komponentebis momzadebis, gamoyenebis da xarisxis uzrunvelyofisaTvis;

- sisxlis donaciis da transfuziis eTikuri kodeqsis (ISBT-1999) ZiriTadi debulebebi;

- intensiuri Terapiis da reanimaciis principebi ambulatoriul da stacionaris pirobebSi;

- reabilitaciis da dispanseruli meTvalyureobis principebi.

muxli 3. eqimmuxli 3. eqimmuxli 3. eqimmuxli 3. eqim----specialistis zogadi unarspecialistis zogadi unarspecialistis zogadi unarspecialistis zogadi unar----CvevebiCvevebiCvevebiCvevebi hematolog/transfuziologshematolog/transfuziologshematolog/transfuziologshematolog/transfuziologs unda SeeZlosunda SeeZlosunda SeeZlosunda SeeZlos::::

1. Civilebisa da anamnezuri monacemebis Sekreba, srulfasovani Sejereba da interpretacia (anemiuri sindromi – sindromis xangrZlivoba, xarisxi, specifiuri specifiuri specifiuri specifiuri Civilebis gamovlena.Civilebis gamovlena.Civilebis gamovlena.Civilebis gamovlena. intoqsikaciis simptomebis - temperaturis momateba, oflianoba, Semcivneba, wonaSi dakleba, qavili, Zvlebis tkivili. moZraobis SezRudva, simZimis SegrZneba marcxena ferdqveSa areSi, sisxldenebi, kanis qavili da a.S.)

2. Inspectio (daxedva, daTvaliereba):

kanis da xiluli lorwovanis ferikanis da xiluli lorwovanis ferikanis da xiluli lorwovanis ferikanis da xiluli lorwovanis feri, sisxlCaqcevebi: peteqiebi, hematomebi. simsivnuri warmonaqmnebi kanze. piris Rruspiris Rruspiris Rruspiris Rrus daTvaliereba: wylulovan-nekrozuli stomatiti, sisxlcaqcevebi enaze da rbil sasaze, glositi, makroglosia, gingiviti, angularuli naxeTqebi. periferiuli limfuri kvanZebiperiferiuli limfuri kvanZebiperiferiuli limfuri kvanZebiperiferiuli limfuri kvanZebissss lokalizacia, zoma, mtkivneuloba, konsistencia, elastiuroba, simetriuloba, feri. farisebri jirkvlis inspeqcia. Zvalsaxsrovani sistemaZvalsaxsrovani sistemaZvalsaxsrovani sistemaZvalsaxsrovani sistema:::: Tavisa da saxis Zvlebis, xerxemlis svetis da sxva Zvlebis deformacia.

3. hemodinamikuri maCveneblebis Sefaseba (pulsi, arteriuli wneva sunTqva). zemo Rru venis sindromi. 4. .Pulmo et Cor – perkusia, auskultacia, Sefaseba. 5. muclis Rrus palapacia, RviZlis da elenTis palpacia (zoma, forma, zedapiris mdgomareoba, konsistencia, mtkivneuloba), Tavisufali siTxis arsebobis dadgena, moculobiTi warmonaqmnebis gamovlena. 6. pacientTan klinikuri muSaoba 7. diagnostikuri procedurebis gansazRvra 8. laboratoriasTan erTad diganostikis marTva 9. sabaziso samedicino procedurebis Catareba 10. litaraturuli wyaroebis moZieba da maTi gamoyeneba 11. urTierToba sxva specialistebTan diagnozis SemuSavebis dros 12. gamoavlinos komunikaciuri SesaZleblobebi. efeqturad da eTikis normebis dacviT iurTierTos pacientTan, misi ojaxis wevreban an momvlelebTan da samedicino personalTan.

13. sisxlis ujreduli/cilovani deficitis xarisxis gansazRvra

14. hemotransfuziis riskis da sargebelis gansazRvra

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15. pacientisagan @”informirebuli Tanxmobis” miReba

16. pacientis transfuziuli anamnezis Sekreba 17. pacientis sisxlis ujreduli antigenebis gamokvleva 18. donoris da recipientis sisxlis individualuri SeTavseba 19. eriTrocituli masis transfuzia 20. axladgayinuli plazmis transfuzia 21. Trombocituli masis transfuzia 22. koagulaciuri faqtorebis tranfuzia 23. sisxlisSemcvlelebis transfuzia 24. autologiuri sisxlis transfuzia 25. pacientis sisxlis komponentebis da sisxlis Semcvlelebis transfuziisSemdgomi monitoringi 26. sisxlis komponentebis gadasxmis garTulebebis mkurnaloba 27. sisxlis komponentebis gadasxmis dokumentaciis warmoeba 28. sisxlis recxva, leikocitur filtrSi gafiltvra (sisxlis bankSi sisxlis damzadebis dros, gadasxmis dros), sisxlis komponentebis dasxiveba. 29. Terapiuli plazma/citaferezi sisxlis fraqcionatorze da avtomatur separatorze 30. pacientis klinikuri da paraklinikuri monacemebis skriningi da monitoringi plazma/citaferezis Catarebis dros, proceduris Semdgomi monitoringi. 31. periferiuli sisxlidan Rerovani ujredebis aRebisaTvis donoris/pacientis momzadeba, “informirebuli Tanxmobis” miReba, autologiuri Rerovani ujredebis mobilizacia. muxli 4. specialoba moicavs qvemoCamoTvlili daavadebebis, paTologiuri muxli 4. specialoba moicavs qvemoCamoTvlili daavadebebis, paTologiuri muxli 4. specialoba moicavs qvemoCamoTvlili daavadebebis, paTologiuri muxli 4. specialoba moicavs qvemoCamoTvlili daavadebebis, paTologiuri mdgomareobebis klinikas, diagnostikas, mkurnalobasa da profilaqtikas: mdgomareobebis klinikas, diagnostikas, mkurnalobasa da profilaqtikas: mdgomareobebis klinikas, diagnostikas, mkurnalobasa da profilaqtikas: mdgomareobebis klinikas, diagnostikas, mkurnalobasa da profilaqtikas:

1. 1. 1. 1. anemiebianemiebianemiebianemiebi 1.1. rkinadeficituri anemiebi.

1.2. megaloblasturi anemiebi.

1.2.1 vitamin B12 deficitiT gamowveuli anemia

1.2.1 foliummJava deficituri anemia (makrocituli anemia).

1.3. porfirinebis sinTezis moSliT ganpirobebuli Tandayolili anemiebi (sideroblasturi anemiebi)

1.4. vitamin B6 deficitiT gamowveuli anemia

1.5. anemiebi qronikulad mimdinare daavedebebis dros (qronikuli infeqciuri, anTebiTi da neoplastiuri procesebi)

1.6. hemolizuri anemiebi.

1.6.1. Tandayolili hemolizuri anemiebi (membranopaTiebi, fermento-hemoglobinopaTiebi)

1.6.1.1. mikrosferocitozis (minkovski-Sofaris daavadebis), ovalocitozi. stomatocitozi..

1.6.1..2. fermentopaTiebi.

1.6.1.3. hemoglobinopaTiebi. Talasemia. homo- da heterozigotuli β-Talasemia.

1.6.2. SeZenili hemolizuri anemiebi (izoimunuri, heteroimunuri, autoimunuri hemolizuri anemiebi)

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1.6.2.1. axalSobilaTa hemolizuri anemia. Rh faqtoris SeuTavseblobiT ganpirobebuli axalSobilTa hemolizuri anemia. ABO sistemis SeuTavseblobiT gamowveuli posttransfuziuli hemolizuri anemia. Rh + ABO sistemis SeuTavseblobiT gamowveuli (plazmaferezi, CanacvlebiTi transfuziebi) hemolizuri anemia.

1.6.2.2. autoimunuri hemolizuri anemiebi.

1.6.2.3. autoimunuri hemolizuri anemiebi arasruli siTburi aglutininebiT, autoimunuri hemolizuri anemiebi siTburi aglutininebiT.

1.6.2.4. autoimunuri hemolizuri anemia sicivis aglutininebiT.

1.6.2.5. parcialuri wiTelujredovani aplazia. SeZenili da Tandayolili formebi.

1.7.. aplastiuri anemia.

1.8. sisxlwarmoqmnis depresiebi.

1.8.1. citostatiuri daavadeba. agranulocitozi. neitropeniebi. infeqciuri garTulebebi.

1.9.leikemoiduri reaqciebi.

1.9.1. neitrofiluri tipis, eozinofiluri, monocituri da limfocituri tipis. infeqciuri mononukleozi. infeqciuri limfocitozi.

1.9.2. imunoblasturi da sxva tipis limfadenitebi

1.9.3. dagrovebis daavadebebi. goSes daavadeba. niman-pikis daavadeba. hend-krisCen-Suleris daavadeba.

2. 2. 2. 2. . hemoblastozebi. hemoblastozebi. hemoblastozebi. hemoblastozebi

2.1. mwvave leikemiebi

2.2. qronikuli mieloproliferaciuli daavadebebi

2.2.1. qronikuli mieloiduri leikemia

2.2.2. WeSmariti policitemia

2.2.3. mielofibrozi

2.2.4. esenciuri Trombocitozi

2.3. qronikuli limfoproliferaciuli daavadebebi

2.3.1. qronikuli limfoiduri leikemia

2.3.2. mielomuri daavadeba

2.3.3. valdenstremis makroglobulinemia

2.4. mielodisplaziuri sindromebi

2.5. limfomebi

2.5.1. hojkinis limfoma

2.5.2 arahojkinis limfomebi

3. 3. 3. 3. hemostazis darRvevebiT gamowveuli daavadebebi da paTologiuri mdgomareobebihemostazis darRvevebiT gamowveuli daavadebebi da paTologiuri mdgomareobebihemostazis darRvevebiT gamowveuli daavadebebi da paTologiuri mdgomareobebihemostazis darRvevebiT gamowveuli daavadebebi da paTologiuri mdgomareobebi

3.1. Trombocitopeniebi da TrombocitopaTiebi 3.1.1. Trombocitopeniebi - Tandayolili da SeZenili

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3.1.2. autoimunuri Trombocitopeniuri purpura (verlhofis daavadeba) 3.1.3. izoimunuri - neonataluri antigenkonfliqturi, transimunuri - dedis autoantisxeulebiT ganpirobebuli da heteroimunuri - wamlismieri da virusuli infeqciiT gamowveuli Trombocitopeniebi; 3.1.4. TrombocitopaTiebi - Tandayolili da SeZenili, 3.1.4.1. memkvidreobiTi disagregaciuli TrombocitopaTiebi - glancmanis daavadeba, esenciuri aTrombia, parcialuri - kolagen-agregaciis, adf agregaciis da Trombin agregaciis ristocetin agregaciis izolirebuli darRvevebiT, „gamoTavisuflebis reaqciis“ darRveviT ganpirobebuli arasakmarisi dagrovebis pulis an Senaxvis daavadebebis formebi albinizmis gareSe da albinizmiT (hermansk-pudlakis sindromi), Cediak-higaSis sindromi, fon vilebrandis daavadeba, bernard-sulies hemoragiuli Trombocitodistrofia, mei-heglinis anomalia, pirson-stobis anomalia; TrombocitopaTiebi, Trombocitebis adheziis da agregaciis araarsebiTi darRvevebiT – Trombocituli faqtori 3- is deficitiT, Trombocitebis sxva difunqciebiT da anomaliebiT ganpirobebuli, uiskot-eldriCis, elers-danlos sindromebi. 3.1.4.2 SeZenili TrombocitopaTiebi, gamowveuli xarisxobrivad arasrulfasovani megakariocitebis da Trombocitebis arsebobiT - mwvave leikemiis, qronikuli mieloiduri leikemiis blasturi krizis, osteomielofibrozis, valdenstremis makroglobulinemiis, dik sindromis, da sxva paTologiuri mdgomareobebis, agreTve zogierTi wamlis an toqsinis zegavlenis dros. 3.2 koagulaciuri hemostazis darRvevebi; 3.2.1. sisxlis Sededebis memkvidreobiTi darRvevebi – sisxlis Semadedebeli plazmuri faqtorebis deficitiT da molekuluri anomaliebiT ganpirobebuli hipokoagulaciuri mdgomareobebi; 3.2.2 antihemofiluri VIII faqtoris memkvidreobiTi deficiti - hemofilia A, 5.3.1.2. fon vilebrandis faqtoris memkvidreobiTi deficiti - fon vilebrandis daavadeba 3.2.3. plazmis IX (kristmasis) faqtoris memkvidreobiTi deficiti – hemofilia B 3.2.4. plazmis XI faqtoris memkvidreobiTi deficiti – hemofilia C igive rozentalis koagulopaTia, 3.2.5. plazmis XII, hagemanis faqtoris memkvidreobiTi deficiti 3.2.6 kalikrein-kininuri sistemis memkvidreobiTi - plazmuri komponentebis, prekalikreinis da maRalmolekuluri kininogenis deficiti 3.2.7. memkvidruli hipokonvertinemia - plazmis VII faqtoris memkvidreobiTi deficiti 3.2.8. X (proTrombinuli) faqtoris deficiti 3.2.9. V faqtoris memkvidreobiTi deficiti, 3.2.10. II faqtoris memkvidreobiTi 3.211. I faqtoris memkvidreobiTi deficiti da disfibrinogenemia, 3.2.12. XIII faqtoris memkvidreobiTi deficiti, 3.3.1 SeZenili hemoragiuli koagulopaTiebi – sisxlis Semadedebel sistemaSi sxvadasxva organizmSi arsebuli sxva paTologiuri mdgomareobebiT ganpirobebuli hemoragiuli diaTezebi; 3.3.1.1. axalSobilTa hemoragiuli daavadeba 3.3.1.2. K vitamindamokidebuli faqtorebis SeZenili deficiti, gamowveuli RviZlis daavadebebiT, enteropaTiebiT da nawlavuri disbaqterioziT, meqanikuri siyviTliT; 3.3.1.3. VII, X, II da IX faqtorebis SeZenili deficiti, gamowveuli arapirdapiri moqmedebis antikoagulantebiT 3.3.1.4. hepariniT ganpirobebuli SeZenili hemoragiuli sindromi 3.3.1.5. fibrinolizuri da madefibrinirebeli moqmedebis preparatebiT ganpirobebuli hemoragiuli sindromi 3.3.1.6. Semadedebeli faqtorebis sawinaaRmdego antisxeulebis da paTologiuri antikoagulantebis moqmedebiT ganpirobebuli hemoragiuli sindromi 3.4. dik sindromi 3.5 hematogenuri da arahematogenuri Trombofiliebi

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3.5.1. SeZenili Trombofilia, SeZenili venuri Trombozi. avTvisebiani daavadebiT gamowveuli venuri Trombozi. mieloproliferaciuli darRvevebiT, mielodisplaziuri sindromiT, paroqsizmuli Ramis hemoglobinuriiT, hemolizuri anemiiT ganpirobebuli Tromboemboliebi, estorgenebiT mkurnalobiT ganpirobebuli Trombofilia. 3.5.2. Trombofiliis memkvidreobiTi faqtorebi, memkvidreobiTi Trombofiliis saxeebi, antiTrombin III-is meoradi deficiti, protein S da protein C meoradi deficiti. protein S aqtivaciis rezistentoba. memkvidreobiTi hiperhomocisteinemia, fibrinolizis memkvidreobiT defeqtebi; Trombofilia fibrinogenis memkvidruli anomaliebis dros Trombofilia dakavSirebuli antiTrombin-3-s deficitTan; 3.5.3. fibrinolizis darRveviT gamowveuli Trombofiliebi; 3.5.4. Trombocituli disfunqciiT ganpirobebuli Trombofilia – moSkovicis daavadeba 3.6. sisxlZarRvovani da Sereuli genezis hemostazis darRvevebi; 3.6.1. memkvidreobiTi hemoragiuli teleangieqtazia – randiu-osleris daavadeba 3.6.2. hemostazis darRvevebi mezenqimuri displaziebis dros 3.6.3. hemangiomebi 3.6.4. hemoragiuli vaskuliti – Senlein henoxis daavadeba 3.6.5. nevrogenuri sisxldenebi – nevropaTiuri da imitaciuri (miunhauzenis sindromi)

muxli 5. im muxli 5. im muxli 5. im muxli 5. im laboratoriullaboratoriullaboratoriullaboratoriul----instrumentuli gamokvlevebis CamonaTvali, romelTa instrumentuli gamokvlevebis CamonaTvali, romelTa instrumentuli gamokvlevebis CamonaTvali, romelTa instrumentuli gamokvlevebis CamonaTvali, romelTa Sedegebis inteSedegebis inteSedegebis inteSedegebis interpretacia da klinikuri Sefaseba unda SeeZrpretacia da klinikuri Sefaseba unda SeeZrpretacia da klinikuri Sefaseba unda SeeZrpretacia da klinikuri Sefaseba unda SeeZllllos eqim os eqim os eqim os eqim –––– specialists;specialists;specialists;specialists;

1. hemograma 2. Zvlis tvinis ujredovani Semadgenloba (mielograma) 3. Zvlis tvinis histomorfologia 4. periferiuli sisxlisa da Zvlis tvinis ujreduli elementebis citogenetikuri gamokvlevebi. kariotipis struqturuli da raodenobrivi cvlilebebi hemoblastozebis dros (translokacia, inversia, hipo- da hiperdiploidia).

5. periferiuli sisxlis, Zvlis tvinis punqtatis imunofenotipireba.

6. imunoeleqtroforezi.

7. trepanobioptatis imunohitoqimiuri gamokvlevebi

8. periferiuli sisxlisa da Zvlis tvinis citoqimiuri gamokvlevebi

9. limfuri kvanZis citologiuri da histologiuri Seswavla

10. limfuri kvanZis imunocitoqimiuri, imunohistoqimiuri gamokvlevebi da maTi diagnostikuri mniSvneloba

11. splenograma da histograma

12. elenTis histomorfologiuri Taviseburebebis Seswavla hemoblastozebis dros

13. gamokvlevis radionukliduri meTodebi

14. eriTrocitebis radionukliduri moniSvnis mniSvneloba

15. Zvlis tvinis funqciur-topografiuli mdgomareobis Sefaseba

16. kompiuteruli da magnitur-rezonansuli tomogramebis analizi

17. koagulogramis maCveneblebis interpretacia: 17.1 hemostazis I fazis maxasiaTeblebi: 17.1.1. sisxlis Seddedbis dro li da uaitiT 17.1.2. sisxldenis xangrZlivoba diukes mixedviT;

8

17.1.3. Trombocitebis raodenoba periferiul sisxlSi; 17.1.4. Trombocitebis agregacia adf-iT; 17.1.5. Trombocitebis agregacia ristocetiniT;), 17.2 hemostazis II fazis maxasiaTeblebi: 17.2.1. proTrombinis dro; 17.2.2. V faqtoris aqtivoba; 17.2.3. VII faqtoris aqtivoba; 17.2.4. II faqtoris aqtivoba. 17.3 hemostazis III fazis maxasiaTeblebi: 17.3.1. fibrinogenis koncentracia plazmaSi; 17.3.2 Trombinis dro. 17.3.3. antiTrombini III; 17.3.4. heparini; 17.3.4. sisxlis Sededebis aqtivirebuli dro: 17.3.5. proteini C; 17.3.6. proteini S. 17.3.7. plazminogeni; 17.3.8 D – dimeri. 18. antiglobulinuri testireba

19. sisxlis eriTrocituli antigenebi ABO, H da Lewis,

20. sistema Rh

21. HLA antigenebis gamovlineba

22. sisxlis serologiuri testireba

23. “krosmaC” testireba

24. pirdapiri antiglobulinuri testi

25. Rerovani ujredebis testireba

26. gamdinare citometria

27. antisxeulebis gansazRvra da SeTavseba

28. sinji SeTavsebaze: 1. eriTrokoncentratis fiziologiur xsnarSi

2. arapirdapiri antiglobulinuri testi

29. sicivis autoaglutininebis gansazRvra

30. donoris sisxlis gamokvleva: ABO da Rh kuTvnileba, serologiuri testi aTaSangze, infeqciuri daavadebebis markerebi

muxli 6. eqimmuxli 6. eqimmuxli 6. eqimmuxli 6. eqim----specialistis aucilebeli praqtikuli unarspecialistis aucilebeli praqtikuli unarspecialistis aucilebeli praqtikuli unarspecialistis aucilebeli praqtikuli unar----Cvevebi (Cvevebi (Cvevebi (Cvevebi (diagnostikuri da diagnostikuri da diagnostikuri da diagnostikuri da samkurnalo manipulaciebi);samkurnalo manipulaciebi);samkurnalo manipulaciebi);samkurnalo manipulaciebi);

hematologi/transfuziologihematologi/transfuziologihematologi/transfuziologihematologi/transfuziologi unda flobdes Semdeg diagnostikur da samkurnalo unda flobdes Semdeg diagnostikur da samkurnalo unda flobdes Semdeg diagnostikur da samkurnalo unda flobdes Semdeg diagnostikur da samkurnalo manipulaciebs:manipulaciebs:manipulaciebs:manipulaciebs:

- ujredis struqturis da ujredSida organelebis amocnoba eleqtronogramebze (birTvi, birTvaki, qromosomis fibrilebi, granularuli endoplazmaturi retikulumi, goljis aparati, mitoqondriebi, ribosomebi, lizosomebi, centrioli, plazmolema). _ periferiuli sisxlis formiani elementebis Seswavla Suqian mikroskopSi (eriTrocitebi, Trombocitebi, granulocitebi, agranulocitebi).

_ Zvlis tvinis (parenqima da misi gamokvleva), elenTis (wiTeli da TeTri pulpa), limfuri kvanZis (qerqovani da tvinovani Sre, subkafsularuli zona) struqturebis

9

Seswavla mikropreparatebis meSveobiT (damzadebis meTodebis gacnoba _ fiqsacia, SeRebva) preparatebis histomorfologiuri aRweris ZiriTadi principebi.

_ Zvlis tvinis aRebis aTviseba. sternaluri punqcia. aspiratis miReba fiqsacia, SeRebva, citologiuri Seswavla, mielogramis normebi: leiko-eriTroblasturi Sefardebis indeqsi, neitrofilebis momwifebis indeqsi, eriTroblasturi momwifebis indeqsi, mielokariocitebis raodenobis gansazRvra. _ Zvlis tvinis histomorfologiuri Seswavla (trepanobiofsia). _ trepanis aRebis daufleba. biofsiuri masalis miReba, histologiuri damuSavebis teqnika. histologiuri anaTlebis SeRebva. trepanatis histomorfologiuri aRwera Zvlovani qsovilis, Zvlis tvinis parenqimis da adipozuri qsovilis cvlilebebis gaTvaliswinebiT. _ limfuri kvanZis punqcia. punqtatis fiqsacia, SeRebva, citogenetikuri Seswavla, limfuri kvanZis bioptatis anabeWdis citologiuri Seswavla. adenogramis cvlilebebi limfadenitebis da hemoblastozebis dros. hojkinis da arahojkinis limfomebis citologiuri Taviseburebebi. _ limfuri kvanZis biofsiuri masalis fiqsacia, damuSavebis meTodika, preparatebis damzadeba da SeRebva, mikropreparatebis Seswavla saerTo Senebis da ujredovani Semadgenlobis gaTvaliswinebiT (herminatuli centri, folikuluri, mantiis zona, marginaluri zona, subkafsularuli zona). _ elenTis punqcia, SesaZlo garTulebebi (rubtura). punqtatis fiqsacia, SeRebva. normaluri splenograma. ujredovani Semadgenlobis cvlilebebi hemoblastozebis dros. - Tavzurgtvinis punqcia, intralumbalurad citostatikebis Seyvana; - periferiuli sisxlis nacxis, retikulocitebis preparatebis, Zvlis tvinis da limfuri kvanZis punqtatis, biofsiuri limfuri kvanZis anabeWdebis momzadeba; _ hemoglobinis Semcvelobis, eriTrocitebis da leikocitebis raodenobis gansazRvra, feradobis maCvenebeli, edsi, retikulocitebi _ periferiuli sisxlis nacxebis fiqsacia, SeRebva, citologiuri Seswavlis principebi. _ standartuli citogenetikuri preparatebis momzadebis meTodikis codna. diferencirebuli SeRebvis meTodebi da maTi upiratesoba. _ peroqsidazis aqtiurobis gansazRvra neitrofiluri rigis ujredebSi, tute fosfatazis aqtiuroba mwife neitrofilebSi, mJave fosfatazis Semcveloba

limfocitebsa da monocitebSi. α-naftilesTeraza _ monocitebis “specifiuri” markeri. Sik-reaqcia _ glikogenis gansazRvra granulocitebSi da limfocitebSi. SeRebva sudan-SaviT (lipidebis Semcveloba), lizocimis gansazRvra sisxlSi da SardSi. _ imunoglobulinebis Tvisobrivi cvlilebebis Sefaseba, Sardis imunoeleqtroforezi _ bens-jonsis cilis gamovlena. radialuri imunodifuzia. mocirkulire imunuri kompleqsebis gamovlenis antigenaraspecifiuri meTodi _ krioprecipitaciis meTodi. krioglobulinis gamovlena.

_ sisxlis kompomentebis damzadeba _sisxlis fraqcionireba. eriTrocituli masis damzadeba, Trombocituli masis damzadeba axladgayinuli plazmis damzadeba (centrifugireba, separireba) sisxlis komponentebis konservacia, Senaxva, transportireba. sisxlis komponentebis momzadeba gadasxmisaTvis. _ sisxlis ujreduli/cilovani deficitis xarisxis gansazRvra - hemotransfuziis riskis da sargebelis gansazRvra - pacientisagan @”informirebuli Tanxmobis” miReba - pacientis transfuziuli anamnezis Sekreba pacientis sisxlis ujreduli antigenebis gamokvleva - donoris da recipientis sisxlis individualuri SeTavseba - eriTrocituli masis transfuzia - axladgayinuli plazmis transfuzia

10

- Trombocituli masis transfuzia - koagulaciuri faqtorebis tranfuzia - sisxlisSemcvlelebis transfuzia - autologiuri sisxlis transfuzia - pacientis sisxlis komponentebis da sisxlis Semcvlelebis transfuziisSemdgomi monitoringi - sisxlis komponentebis gadasxmis garTulebebis mkurnaloba - sisxlis komponentebis gadasxmis dokumentaciis warmoeba - sisxlis recxva, leikocitur filtrSi gafiltvra (sisxlis bankSisisxlis damzadebis dros, gadasxmis dros), sisxlis komponentebis dasxiveba. - Terapiuli plazma/citaferezi sisxlis fraqcionatorze da avtomatur separatorze - pacientis klinikuri da paraklinikuri monacemebis skriningi da monitoringi plazma/citaferezis Catarebis dros, proceduris Semdgomi monitoringi. - periferiuli sisxlidan Rerovani ujredebis aRebisaTvis donoris/pacientis momzadeba, “informirebuli Tanxmobis” miReba, autologiuri Rerovani ujredebis mobilizacia. - periferiuli sisxlidan Rerovani ujredebis miReba, damzadeba, kriokonservacia. - Rerovani ujredebis transfuzia, pacientis transfuziisSemdgomi monitoringi; - Rerovani ujredebis gadasxmis garTulebebis mkurnaloba - sisxlis komponentebis gadasxmis dokumentaciis warmoeba - vena punqcia, sistemis awyoba da dayeneba; - infuzomatis da perfuzoris gamoyeneba - sisxlis komponentebis da sisxlis Semcvlelebis gadasxma.

muxli 7. im daavadebebis da paTologiuri mdgomareobebis CamonaTvali, romelTa muxli 7. im daavadebebis da paTologiuri mdgomareobebis CamonaTvali, romelTa muxli 7. im daavadebebis da paTologiuri mdgomareobebis CamonaTvali, romelTa muxli 7. im daavadebebis da paTologiuri mdgomareobebis CamonaTvali, romelTa profilaqtika, diagnostika, pirveladi daxmareba da mkurnaloba unda SeeZlos eqimprofilaqtika, diagnostika, pirveladi daxmareba da mkurnaloba unda SeeZlos eqimprofilaqtika, diagnostika, pirveladi daxmareba da mkurnaloba unda SeeZlos eqimprofilaqtika, diagnostika, pirveladi daxmareba da mkurnaloba unda SeeZlos eqim----specialists.specialists.specialists.specialists.

daavadebebis nusxa ix. muxli 5

paTologiuri mdgomareobebi:

1. mielotoqsiuri agranulocitozi 2. nekrozuli enteropaTia 3. mukoziti 4. gulisreva, Rebineba. 5. tumor-lizisis sindromi 6. onkohematologiuri avadmyofTa infeqciuri garTulebebi 7. anemiuri sindromi 8. Trombocitopenia, hemoragiuli diaTezi 9. wyal-marilovani disbalansi 10. endotoqsiuri Soki 11. hemotransfuziuli reaqciebi 12. hemotransfuziuli Soki 13. hemostazis koreqcia hemoblastozebis da sxva daavadebebis dros.

Tavi III. swavlebis/Sefasebis meTodebi. Tavi III. swavlebis/Sefasebis meTodebi. Tavi III. swavlebis/Sefasebis meTodebi. Tavi III. swavlebis/Sefasebis meTodebi.

muxli 1. swavlebis/Sefasebis principebimuxli 1. swavlebis/Sefasebis principebimuxli 1. swavlebis/Sefasebis principebimuxli 1. swavlebis/Sefasebis principebi

sarezidento programis ganxorcielebisas gamoyenebuli iqneba - leqciebi, Semovlebi, morigeobebi ufros samedicino personalTan, prezentaciebi, monawileoba konferenciebSi, diskusiebi, testebi, referatebi

muxli 2. Sefasebis meTodebimuxli 2. Sefasebis meTodebimuxli 2. Sefasebis meTodebimuxli 2. Sefasebis meTodebi

11

sarezidento programis procesSi tardeba rezidentis mier Catarebuli saqmianobis perioduli (aranakleb weliwadSi 2-3-jer) da Semajamebeli Sefaseba. perioduli Sefaseba tardeba yoveli modulis dasrulebis Semdeg, xolo Semajamebeli – programis dasrulebisas. praqtikuli unar-Cvevebis Sesafaseblad mowodebulia kompetenciis Semdegi doneebi:

kompetenciis donekompetenciis donekompetenciis donekompetenciis done

1. rezidenturis programis direqtori atarebs rezidentis mier Catarebuli saqmianobis periodul da Semajamebel Sefasebas.

2. perioduli Sefaseba tardeba rezidentis mzadebis yoveli calkeuli ciklis dasrulebis Semdeg (magram aranakleb weliwadSi erTxel), mis mier am ciklis periodSi Catarebuli muSaobis Sedegebis analizis safuZvelze. rezidentis periodul Sefasebas atarebs programis direqtori lokalur klinikur xelmZRvanelebTan erTad.

3. rezidenturis programis dasrulebis Semdeg, rezidenturis programaSi monawile dawesebulebebis lokaluri klinikuri xelmZRvanelebis da programis direqtoris mier tardeba rezidentebis Semajamebeli Sefaseba.

4. rezidenturis programiT profesiuli mzadebis Sedegebis Sefasebis procedura iTvaliswinebs rezidentis mier piradad:

_ gatarebuli avadmyofebis raodenobas da daavadebebis mravalferovnebas; _ Catarebuli diagnostikuri da samkurnalo procedurebis nairsaxeobas, raodenobasa

da xarisxs;

_ dawerili da Sevsebuli samedicino dokumentaciis (avadmyofis istoriebi, gamokvlevis daskvnebi, amonawerebi, samedicino cnobebi da sxva) raodenobasa da xarisxs;

_ samedicino konferenciebisa da seminarebis muSaobaSi misi personaluri monawileobis (gamosvlebis) sixSires da dones;

_ calkeuli samedicino dawesebulebebSi Tu ganyofilebebSi lokaluri klinikuri xelmZRvanelebisagan miRebul daxasiaTebebs.

muxli 3. Sesafasebeli kompetenciebimuxli 3. Sesafasebeli kompetenciebimuxli 3. Sesafasebeli kompetenciebimuxli 3. Sesafasebeli kompetenciebi

� Teoriuli mzadeba – refereti

� praqtikuli saqmianoba – unar-Cvevebi

� monacemTa Segrovevebisa da fiqsirebis saSualebebi – istoriis Sevseba

� Sesasrulebeli manipulaciebis/operaciebis CamonaTvali – ix. Sesabamis modulSi.

profesiuli mzadebis sxva formebi (konferenciebi, simpoziumebi, samecniero kvlevebi da sxv.)

Tavi IV. Tavi IV. Tavi IV. Tavi IV. programis xangrZlivoba.programis xangrZlivoba.programis xangrZlivoba.programis xangrZlivoba.

rezidenturis programa spacialobaSi “hematologia transfuziologia”, moicavs swavlebis 3 wels (33 samuSao Tve). es aris is minimaluri dro, rodesac rezidents/specialobis maZiebels SeuZlia Seiswavlos ZiriTadi hematologiuri daavadebebi, maTi diagnostikis da mkurnalobis Tanamedrove principebi, aseve SemdgomSi nebismier samkurnalo dawesebulebaSi SeuZlia Seasrulos kvalificiuri

1.1.1.1. asrulebs damoukidebladasrulebs damoukidebladasrulebs damoukidebladasrulebs damoukideblad

2.2.2.2. asrulebs lokalur xelmZRvanelTan erTad asrulebs lokalur xelmZRvanelTan erTad asrulebs lokalur xelmZRvanelTan erTad asrulebs lokalur xelmZRvanelTan erTad

3.3.3.3. aris damkvirvebeliaris damkvirvebeliaris damkvirvebeliaris damkvirvebeli

12

konsultant-hematologis roli diagnostikuri da Terapiuli problemebis gadawyvetaSi, hematologiis da transfuziologiis dargSi monawileoba miiRos samecniero kvlevebSi; rezidenturis programis ZiriTadi nawili (17 Tve) eTmoba onkohematologiuri daavadebebs (leikemiebi, limfomebi), anemiebsa da hemoragiuli diaTezebs. moicavs avadmyofTa gamokvlevis ,sisxlis sistemis daavadebebis eTiologiis, paTogenezis, klasifikaciis, diferencialuri diagnostikis, diagnostikis da mkurnalobis Tanamedrove meTodebis aTvisebas, laboratoriuli testebis Seswavlas. sarezidento programis mniSvnelovani nawili (5 Tve) eTmoba sisxlis samsaxuris (bankingi) safuZvlebis da klinikuri transfuziologiis ZiriTadi aspeqtebis Seswavlas.

Tavi V. rezidenturaSi profesiuli mzadebis meToduri uzrunvelyofisa da Tavi V. rezidenturaSi profesiuli mzadebis meToduri uzrunvelyofisa da Tavi V. rezidenturaSi profesiuli mzadebis meToduri uzrunvelyofisa da Tavi V. rezidenturaSi profesiuli mzadebis meToduri uzrunvelyofisa da organizaciis wesi.organizaciis wesi.organizaciis wesi.organizaciis wesi.

muxli 1.muxli 1.muxli 1.muxli 1. rezidenturaSi profesiuli mzadeba warimarTeba saqarTvelos kanonebis - `saeqimo saqmianobis Sesaxeb~, “janmrTelobis dacvis Sesaxeb” -Sesabamisad.

muxli 2. muxli 2. muxli 2. muxli 2. rezidenturaSi profesiuli mzadeba xorcieldeba diplomis Semdgomi ganaTlebisa (profesiuli mzadebis) da uwyveti profesiuli ganviTarebis sabWos mier akreditebuli rezidenturis programebiT saeqimo specialobaTa nusxis Sesabamisad.

muxli 3.muxli 3.muxli 3.muxli 3. rezidenturaSi profesiuli mzadebas srulad afinansebs saxelmwifo (stomatologiur specialobebSi dasaSvebia kerZo dafinanseba), saministros specialuri saxelmwifo programis _ `diplomisSemdgomi samedicino ganaTlebis saxelmwifo programis~ farglebSi. amave dros, arsebobs rezidenturis alternatiuli diplomisSemdgomi ganaTleba (profesiuli mzadeba), romelic gulisxmobs sarezidento programis yvela modulis gavlas calkeuli modulisa da mTlianad programis xangrZlivobis zustad gansazRvris gareSe da finansdeba kerZo piris mier moZiebuli saxsrebiT (“rezidenturi alternatiul diplomisSemdgom ganaTlebaSi (profesiul mzadebaSi) monawileobis, misi warmarTvisa da Sefasebis wesisa da im samedicino dawesebulebebis akreditaciis kriteriumebis da wesis damtkicebis Sesaxeb, romlebSic SesaZlebelia diplomisSemdgomi ganaTlebis (profesiuli mzadebis) kursis gavla” saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris 2007 wlis 18 aprilis #135/n brZanebis Sesabamisad).

muxli 4. muxli 4. muxli 4. muxli 4. rezidenturaSi Caricxvis wesi ganisazRvreba saqarTvelos Sromis, janmrTelobis da socialuri dacvis ministris brZanebiT: `erTiani diplomisSemdgomi sakvalifikacio gamocdis Catarebis wesisa da rezidenturaSi Caricxvis wesis damtkicebis Sesaxeb~ (# 295/n; 3.11.2006), xolo rezidenturis alternatiuli diplomisSemdgomi mzadebis wesi: “rezidenturis alternatiuli diplomisSemdgom ganaTlebaSi (profesiuli mzadebaSi) monawileobis, misi warmarTvisa da Sefasebis wesisa da im samedicino dawesebulebebis akreditaciis kriteriumebis da wesis damtkicebis Sesaxeb, romlebSic SesaZlebelia diplomisSemdgomi ganaTlebis (profesiuli mzadebis) kursis gavla” (#135/n; 18.04.2007).

muxli 5. muxli 5. muxli 5. muxli 5. rezidenturis programis ganxorcieleba mimdinareobs sauniversiteto klinikebsa da im samedicino dawesebulebebSi, romelTac miRebuli aqvT akreditacia kanonmdeblobiT dadgenili wesiT (`rezidenturis alternatiul diplomisSemdgom ganaTlebaSi (profesiul mzadebaSi) monawileobis, misi

13

warmarTvisa da Sefasebis wesisa da im samedicino dawesebulebebis akreditaciis kriteriumebis da wesis damtkicebis Sesaxeb, romlebSic SesaZlebelia diplomisSemdgomi ganaTlebis (profesiuli mzadebis) kursis gavla~ saqarTvelos Sromis, janmrTelobis da socialuri dacvis ministris 2007 wlis 18 aprilis #135/n brZanebis Sesabamisad).

muxli 6. muxli 6. muxli 6. muxli 6. rezidenturis kursis dasrulebis Semdeg gaicema saxelmwifo mowmoba.

muxli 7. muxli 7. muxli 7. muxli 7. rezidenturis programis xarisxis uzrunvelyofaze pasuxismgebelni arian - rezidenturis programis direqtori, programis direqtorati, lokaluri xelmZRvanelebi, rezidentebi, saministros saxelmwifo kontrols daqvemdebarebuli sajaro samarTlis iuridiuli piri.

muxli 8. muxli 8. muxli 8. muxli 8. programis direqtoris movaleobebi:

1. misaRebi gamocdis programis Sedgena da rezidenturaSi miRebis procesSi monawileoba;

2. specialobis aRwerilobis safuZvelze Sedgenil diplomis Semdgomi profesiuli mzadebis (rezidenturis) akreditebuli programis ganxorcielebas;

3. samedicino dawesebulebis da lokaluri xelmZRvanelis miTiTebiT rezidentis individualuri gegma-grafikis Sedgena da gansazRvra Tu ramden rezidents SeiZleba zedamxedvelobdes erTi lokaluri xelmZRvaneli.

4. winaswar dadgenili individualuri grafikis mixedviT rezidentis mier Sesasrulebeli samuSaos moculobasa da Casatarebeli manipulaciebis raodenobaze kontroli.

5. direqtoratis wevrebTan erTad dadgenili wesis mixedviT yovelwliurad rezidentis muSaobis Sefaseba da saministros saxelmwifo kontrols daqvemdebarebul sajaro samarTlis iuridiuli pirisaTvisangariSis Cabareba.

6. yovelwliuri Sefasebis Sedegebis gaTvaliswinebiT rezidentisaTvis rekomendacias micema programis gagrZelebis Sesaxeb.

7. rezidentis saqmianobis aradamakmoyofilebli wliuri Sefasebisas, saministros saxelmwifo kontrols daqvemdebarebul sajaro samarTlis iuridiuli pirisaTvis dasabuTebuli moxsenebiT baraTis wardgena garicxvis Sesaxeb.

8. rezidenturis kursis warmatebuli dasrulebis Semdeg rezidentis Semajamebeli atestaciis Catareba da diplomisSemdgomi ganaTlebis (profesiuli mzadebis) da uwyveti profesiuli ganviTarebis sabWos kursis gavlis damadasturebeli saxelmwifo mowmobis gacemis Sesaxeb rekomendaciis micema.

9. lokaluri xelmZRvanelebis saqmianobis zedamxedveloba da Sefaseba.

muxli muxli muxli muxli 9. 9. 9. 9. programis direqtoratis wevrebis movaleobebi:

1. rezidentebis SerCevis procesSi monawileoba; 2. program direqtorTan erTad yovelwliurad rezidentebis muSaobis dadgenili

wesis mixedviT Sefaseba; 3. program direqtorTan erTad SeimuSaveben rezidentis atestaciis formatis

SemuSaveba; 4. rezidentis Semajamebeli atestaciis procesSi monawileoba; 5. saWiroebis SemTxvevaSi, programis direqtorisaTvis rezidenturis

programasTan dakavSirebul nebismier sakiTxebze konsultaciis gaweva.

muxli 10. muxli 10. muxli 10. muxli 10. lokaluri xelmZRvanelis movaleobebi:

14

1. samedicino dawesebulebaSi rezidentis muSaobis warmarTva; 2. rezidentebTan pedagogiur muSaobisaTvis Tavisi saqmianobis gansazRvruli

drois daTmoba. 3. TiToeuli modulis dasrulebis Semdeg dadgenili wesis mixedviT, program

direqtorisaTvis rezidentis mier gaweuli samuSaos Sesaxeb angariSis wardgena;

4. rezidentis dRiurSi rezidentis mier Sesrulebuli samuSaos xelmoweriT dadastureba.

muxli 11. muxli 11. muxli 11. muxli 11. rezidentis ufleba/movaleobebi:

1. rezidenti SeiZleba garicxuli iqnas rezidenturidan erTi Tvis ganmavlobaSi gamoucxadeblobis an programis ver daZlevis SemTxvevaSi. gadawyvetilebas rezidentis garicxvis Sesaxeb iRebs programis direqtori saministros saxelmwifo kontrols daqvemdebarebuli sajaro samarTlis iuridiuli pirTan SeTanxmebiT;

2. rezidents ufleba aqvs programis kurikulumis darRvevis an Seferxebis Sesaxeb werilobiT acnobos saministros saxelmwifo kontrols daqvemdebarebul sajaro samarTlis iuridiuli pirs;

3. rezidents ufleba aqvs programis daubrkolebeli daZlevisaTvis moiTxovos Sesabamisi samuSao pirobebiT uzrunvelyofa (kvalificiuri xelmZRvaneli, Tanamedrove tipis klinikuri da sainformacio/sakomunikacio teqnologiebi, samuSao oTaxi);

4. rezidenti valdebulia Seasrulos rezidenturis programiT gansazRvruli kurikulumi;

5. rezidenti valdebulia programiT gansazRvruli da Sesrulebuli saqmianoba daafiqsiros personalur dRiurSi;

6. rezidenti valdebulia yoveli wlis bolos warudginos programis direqtors gaweuli muSaobis angariSi da gaiaros etapobrivi da damasrulebeli atestacia dadgenili wesiT;

7. rezidenti valdebulia daicvas samedicino dawesebulebis Sinaganawesi da Seasrulos dawesebulebis ganrigiT gansazRvruli saqmianoba.

Tavi VI.Tavi VI.Tavi VI.Tavi VI. programis etapobrivi ganxorcielebis aRweriloba (wlebis mixedviT) programis etapobrivi ganxorcielebis aRweriloba (wlebis mixedviT) programis etapobrivi ganxorcielebis aRweriloba (wlebis mixedviT) programis etapobrivi ganxorcielebis aRweriloba (wlebis mixedviT)

muxli 1. mzadebis pirveli wlis modulebis raodenoba muxli 1. mzadebis pirveli wlis modulebis raodenoba muxli 1. mzadebis pirveli wlis modulebis raodenoba muxli 1. mzadebis pirveli wlis modulebis raodenoba Seadgens 6.6.6.6.

1.1.1.1.1.1.1.1. eqimisa da pacientis urTierTobis samarTlebrivi da eTikuri safuZvlebi – 2 kvira;

1.2.1.2.1.2.1.2. fundamenturi medicinis Tanamedrove aspeqtebi – 2 kvira;

1.3. 1.3. 1.3. 1.3. zogadi Terapia/ambulatoriuli Terapia zogadi Terapia/ambulatoriuli Terapia zogadi Terapia/ambulatoriuli Terapia zogadi Terapia/ambulatoriuli Terapia –––– 4 Tve; 4 Tve; 4 Tve; 4 Tve;

1.3.1. zogadi Terapia – 2 Tve;

1.3.2. ambulatoriuli Terapia – 2 Tve;

1.4. Terapiuli stacio1.4. Terapiuli stacio1.4. Terapiuli stacio1.4. Terapiuli stacionari I nari I nari I nari I –––– 5 Tve; 5 Tve; 5 Tve; 5 Tve;

1.4.1. gul-sisxlZarRvTa sistemis daavadebebi – 3 Tve;

1.4.2. revmatiuli daavadebebi – 2 Tve;

1.5. 1.5. 1.5. 1.5. sazogadoebrivi jandacva da epidemiologia – 2 kvira;

1.6. 1.6. 1.6. 1.6. mtkicebiTi medicinisa da samedicino statistikis safuZvlebi – 2 kvira.

muxli 2. muxli 2. muxli 2. muxli 2. pppprofesiuli mzadebis I wlis mizani: rofesiuli mzadebis I wlis mizani: rofesiuli mzadebis I wlis mizani: rofesiuli mzadebis I wlis mizani: eqimis da pacientis urTierTobebis eTikuri da samarTlebrivi, daavadebaTa epidemiologiis da mtkicebulebiTi medicinis

15

safuZvlebis Seswava; Sinagani medicinis ZiriTadi subspecialobebis (zogadi Terapia, zogadi kardiologia da revmatiuli daavadebebi), diagnostikis, marTvisa da maTTan asocirebuli praqtikuli unar-Cvevebis aTviseba;

muxli muxli muxli muxli 3. mzadebis meore3. mzadebis meore3. mzadebis meore3. mzadebis meore wlis modulebis raodenoba wlis modulebis raodenoba wlis modulebis raodenoba wlis modulebis raodenoba ---- 4444

moduli 1moduli 1moduli 1moduli 1 - SeZenili da Tandayolili anemiebi. anemiebi sxvadasxva daavadebebis dros

moduli 2moduli 2moduli 2moduli 2 - mwvave lekemiebis diagnostikis da mkurnalobis Tanamedrove principebi

moduli 3moduli 3moduli 3moduli 3 - qronikuli mieloproliferaciuli daavadebebi moduli 4moduli 4moduli 4moduli 4 - hemostazis sitemis darRvevebi (Tandayolili da SeZenili koagulopaTiebi. hemoragiuli diaTezebi. Trombozebi da hemoragiebi klinikur praqtikaSi, dik sindromi)

muxli muxli muxli muxli 4444. profesiuli mzadebis I. profesiuli mzadebis I. profesiuli mzadebis I. profesiuli mzadebis IIIII wlis mizani: wlis mizani: wlis mizani: wlis mizani:

programis mizania eqim-klinicistebs miawodos informacia hematologiuri daavadebebis diagnostikis uaxlesi teqnologiebisa da mkurnalobis Tanamedrove meTodebis Sesaxeb.

warmodgenili programa iTvaliswinebs sisxlmbadi organoebis morfofunqciuri Taviseburebebis Seswavlas, sisxlis sistemis daavadebaTa eTiologiis, paTogenezis, paTologiuri anatomiis diagnostikis, klinikuri Taviseburebebis da mkurnalobis Tanamedrove principebis gacnobas, imunologiis da transfuziuli medicinis safuZvlebis aTvisebas. nebismieri genezis anemiis definicirebas da koreqcias, mwvave leikemiebis diagnostikis (citologiuri, citoqimiuri, citogenetikuri da imunofermentuli) uaxlesi meTodebis dauflebas, qronikuli leikemiebiT daavadebul pacientTa swor marTva-mkurnalobas, blasturi krizebis droul gamovlenas, saerTaSoriso programebisa da gaidlainebis gamoyenebas. hemostazis sistemis darRvevebis drouli gamovlena, rogorc hemoragiuli diaTezebis, ise Trombozebis mizanmimarTuli menejmentis ganxorcieleba. aRnisnul sakiTxebze uaxlesi informaciis moZieba.

muxli muxli muxli muxli 5. mzadebis mesame5. mzadebis mesame5. mzadebis mesame5. mzadebis mesame wlis modulebis raodenoba wlis modulebis raodenoba wlis modulebis raodenoba wlis modulebis raodenoba –––– 4444

moduli 1 moduli 1 moduli 1 moduli 1 ---- adenopaTiebi, splenomegaliebi, limfoproliferaciuli daavadebebi moduli 2moduli 2moduli 2moduli 2---- limfomebis (hojkinis da arahojkinis) diagnostikis da mkurnalobis Tanamedrove principebi

moduli 3 moduli 3 moduli 3 moduli 3 –––– klinikuri da sawarmoo transfuziologiis safuZvlebi (sisxlis bankingi. transfuziuli medicinis imunologia, genetika, serologia, hemokomponenturi Terapiis principebi. plazmacitaferezi, Rerovani ujredebi - miReba da gamoyeneba) moduli 4 moduli 4 moduli 4 moduli 4 ---- hemotransfuziis garTulebebi, mizezebi, mkurnaloba, profilaqtika, hemokomponenturi Terapiis alternativebi.

muxlmuxlmuxlmuxli i i i 6666. profesiuli mzadebis II. profesiuli mzadebis II. profesiuli mzadebis II. profesiuli mzadebis IIIIII wlis mizani: wlis mizani: wlis mizani: wlis mizani:

warmodgenili programa iTvaliswinebs limfomebis klasifikaciis, diagnostikis da optimaluri klinikuri taqtikis SemuSavebis ZiriTadi principebis codnas. moicavs agreTve leikemoiduri reqciebis gamijvnas sisxlis sistemuri daavadebebisagan, reaqtiuli limfadenopaTiebisa da splenomegalia-splenopaTiebis gamijvnas limfo- da mieloproliferaciuli daavadebebisagan, mielodisplaziuri sindromebis, citopeniebis, monoklonuri gamapaTiebis da paraproteinuli hemoblastozebis

16

diagnostikas, klinikuri manifestacias da mkurnalobas. programis farglebSi gaTvaliswinebuli masalis aTvisebis Semdeg eqimma droulad unda SeZlos diferencialuri diagnostikis algoriTmebze dayrdnobiT, onkohematologiuri daavadebebis gamovlena-verificireba, Sesabamisi Terapiuli taqtikis SemuSaveba (individualizaciisa da optimizaciis principebis gaTvaliswinebiT), programiT mowodebuli mkurnalobis etapebis dacva-realizacia, mielosupresiebis swori marTva.

Tavi VII. profesiuli mzadebis I wlis modulebiTavi VII. profesiuli mzadebis I wlis modulebiTavi VII. profesiuli mzadebis I wlis modulebiTavi VII. profesiuli mzadebis I wlis modulebi

moduli 1.1. moduli 1.1. moduli 1.1. moduli 1.1. ------------ Ueqimisa da pacientis urTierTobis eTikuri da samarTlebrivi Ueqimisa da pacientis urTierTobis eTikuri da samarTlebrivi Ueqimisa da pacientis urTierTobis eTikuri da samarTlebrivi Ueqimisa da pacientis urTierTobis eTikuri da samarTlebrivi aspeqtebiaspeqtebiaspeqtebiaspeqtebi

1. modulis xangrZlivobaa:modulis xangrZlivobaa:modulis xangrZlivobaa:modulis xangrZlivobaa: 2 kv. (72 sT.) 2. modulis mizania:modulis mizania:modulis mizania:modulis mizania: saeqimo saqmanobisTan dakavSirebuli saqarTvelos moqmedi

sakanonmdeblo normebis da Tanamedrove bioeTikis principebis Sesabamisi codnis SeZena da misi gamoyenebis unaris gamomuSaveba rezidentis/specialobis maZieblisaTvis

3. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: 1) saeqimo saqmianobasTan dakavSirebuli sakanonmdeblo normebi arsebuli kanonmdeblobis Sesabamisad, pacientis uflebebis dacvis samarTlebrivi sakiTxebi

2) janmrTelobis dacvis sferoSi biosamedicino eTikis sayovelTaod aRiarebuli normebi da profesiuli saqmianobis Tanamedrove samedicino eTikis principebi,

3) damoukidebeli saeqimo saqmianobis subieqtsa da saxelmwifo xelisuflebis organoebis, fizikur da iuridiul pirebs Soris urTierTobis samarTlebrivi sakiTxebi,

4) adamianze Catarebuli samedicino-biologiuri kvlevebis samarTlebrivi da eTikuri sakiTxebi,saerTaSoriso normebisa da saqarTvelos arsebuli kanonmdeblobebis Sesabamisad.

4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili # 1mocemulia cxrili # 1mocemulia cxrili # 1mocemulia cxrili # 1----is saxiT:is saxiT:is saxiT:is saxiT:

cxrili # 1cxrili # 1cxrili # 1cxrili # 1 Teoriuli kursi davaleba

kanonisa da eTikis roli samedicino momsaxureobis gawevisaskanonisa da eTikis roli samedicino momsaxureobis gawevisaskanonisa da eTikis roli samedicino momsaxureobis gawevisaskanonisa da eTikis roli samedicino momsaxureobis gawevisas -bioeTikis Seswavlis sagani, samedicno eTika,istoriuli aspeqtebi,”hipokrates fici ”, samedicino saqmianobis regulirebis istotiuli aspeqtebi

bioeTikis ZiriTadi principebibioeTikis ZiriTadi principebibioeTikis ZiriTadi principebibioeTikis ZiriTadi principebi “ar avno”, “Hhqmeni sikeTe”, “avtonomia” ,samarTlianoba, konfidencialuroba;

eqieqieqieqimisa da pacientis urTierTobis modelebimisa da pacientis urTierTobis modelebimisa da pacientis urTierTobis modelebimisa da pacientis urTierTobis modelebi prezentaciebis analizi

saeqimo saqmianobiis samarTlebrivi regulirebis istoriuli saeqimo saqmianobiis samarTlebrivi regulirebis istoriuli saeqimo saqmianobiis samarTlebrivi regulirebis istoriuli saeqimo saqmianobiis samarTlebrivi regulirebis istoriuli magaliTebimagaliTebimagaliTebimagaliTebi, -saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi ; -kanoni pacientis uflebebis Sesaxeb, saqarTvelos janmrTelobis dacvis kanoni, kanoni saeqimo saqmianobis Sesaxeb

socialuri pasuxismgeblobasocialuri pasuxismgeblobasocialuri pasuxismgeblobasocialuri pasuxismgebloba da janmrTelobada janmrTelobada janmrTelobada janmrTeloba -janmrTeloba da avadmyofoba, -eqimi, pacienti, sazogadoeba;;;;

pacientis individualuri uflebebi,pacientis individualuri uflebebi,pacientis individualuri uflebebi,pacientis individualuri uflebebi, -saqarTvelos kanonmdebloba pacientis individualuri uflebebis

17

Sesaxeb, -informaciis miRebis ufleba, samedicino personalis da samedicino dawesebulebis arCevis ufleba, informaciis konfidencialuroba; informaciuli Tanxmobainformaciuli Tanxmobainformaciuli Tanxmobainformaciuli Tanxmoba –samedicino momsaxureobis ganxorcielebis safuZveli -informaciuli Tanxmobis elementebi da aucilebeli pirobebi -informaciuli Tanxmobis ganxorcielebis meTodebi;.

pacientis qmedunarianobapacientis qmedunarianobapacientis qmedunarianobapacientis qmedunarianoba -mis mier gacnobierebuli gadawyvetilebis miRebis unari. -araqmedunariani pacienti

testireba

sicocxle da sikvdilisicocxle da sikvdilisicocxle da sikvdilisicocxle da sikvdili-------- bioeTikuri kategoriebibioeTikuri kategoriebibioeTikuri kategoriebibioeTikuri kategoriebi -biologiuri sikvdili,Tavis tvinis sikvdili, -gardacvaleba-definacia da eTikuri aspeqtebi

prezentaciebis analizi

tkivilis marTvatkivilis marTvatkivilis marTvatkivilis marTva, -ukurnebeli seniT daavadebuli pacienti, paliatiuri mkurnaloba,hospisi;

evTanazia,evTanazia,evTanazia,evTanazia, istoriuli,religiuri,eTikuri aspeqtebi -evTanaziis samarTlebrivi da eTikuri problemebi; -evTanaziis formebi; sikvdili eqimis daxmarebiT;

suicidisuicidisuicidisuicidi , masTan dakavSirebuli eTikuri aspeqtebi, masTan dakavSirebuli eTikuri aspeqtebi, masTan dakavSirebuli eTikuri aspeqtebi, masTan dakavSirebuli eTikuri aspeqtebi -eqimis daxmareba TviTmkvlelobaSi, -mkurnalobaze uaris Tqmis samarTlebrivi da eTikuri sakiTxebi,

samedicino mecnierebis progresi samedicino mecnierebis progresi samedicino mecnierebis progresi samedicino mecnierebis progresi ----axali taxali taxali taxali teqnologiebieqnologiebieqnologiebieqnologiebi -transplantacia, adamianis organoebis gadanergvis samarTlebrivi da eTikuri sakiTxebi, donoris Tanxmobis sakanonmdeblo modelebi

reproduqtolougiis samarTlebis da eTikuri sakiTxebireproduqtolougiis samarTlebis da eTikuri sakiTxebireproduqtolougiis samarTlebis da eTikuri sakiTxebireproduqtolougiis samarTlebis da eTikuri sakiTxebi ; -xelovnuri ganayofiereba, in-vitro - xelovnuri ganayofierebis eTikuri aspeqtebi,surogatuli dedoba, -adamianis reproduqciuli klonireba;.

socialurad saSiSi infeqciebi socialurad saSiSi infeqciebi socialurad saSiSi infeqciebi socialurad saSiSi infeqciebi -Sidsi, narkomania ,infeqciuri hepatitebi. maTTan dakavSirebuli samarTlebrivi da eTikuri sakiTxebi

adamianze Catarebuli kvlevebiadamianze Catarebuli kvlevebiadamianze Catarebuli kvlevebiadamianze Catarebuli kvlevebi saerTaSoriso doksaerTaSoriso doksaerTaSoriso doksaerTaSoriso dokumentebi janmrTelobis dacvis sferoSi adamianis umentebi janmrTelobis dacvis sferoSi adamianis umentebi janmrTelobis dacvis sferoSi adamianis umentebi janmrTelobis dacvis sferoSi adamianis uflebebze uflebebze uflebebze uflebebze -bioeTikis da adamianis uflebebis sayovelTao deklaracia, -msoflio samedicino asociaciis eTikis kodeqsi, -konvencia adamianis uflebebisa da biomedicinis Sesaxeb,da sxva

5. modulis Sefasebis meTodebimodulis Sefasebis meTodebimodulis Sefasebis meTodebimodulis Sefasebis meTodebi (kriteriumebi, perioduloba) _

1. profesiuli saqmianobisas konkretuli SemTxvevis samarTlebrivi da eTikuri mxareebis warmoCenis unaris gamomuSaveba rezidentis mier

2. profesiuli saqmianobisas Tanamedrove samedicino eTikis principebisa da arsebuli kanonmdeblobis Sesabamisad warmarTvis unari;

3. eTikuri dilemebis gadawyvetis unaris gamomuSaveba; 4. adamianze Catarebuli samedicino-biologiuri kvlevebis samarTlebrivi da

eTikuri sakiTxebis warmoCenis, analizis da biosamedicino eTikisa da arsebuli kanonmdeblobis Sesabamisad moqmedebis unaris gamomuSaveba rezidentisTvis.

5. aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa:

18

1. bioeTikis da adamianis uflebebis sayovelTao deklaraciabioeTikis da adamianis uflebebis sayovelTao deklaraciabioeTikis da adamianis uflebebis sayovelTao deklaraciabioeTikis da adamianis uflebebis sayovelTao deklaracia----iunesko,2005 iunesko,2005 iunesko,2005 iunesko,2005 qarTuli versiaqarTuli versiaqarTuli versiaqarTuli versia – e.giorgaZe, j.mamalaZe,l.gurgeniZe, l.korZaia – samedicino gazeTi, 2007 w.

2. samedicino eTika (bioeTika) samedicino eTika (bioeTika) samedicino eTika (bioeTika) samedicino eTika (bioeTika) – leqciebi, m.i.iarovinski. moskovi – “medicina”, 2000 3. biosamedicino eTika biosamedicino eTika biosamedicino eTika biosamedicino eTika – b.i.pokrovski. moskovi – “medicina”, 1997 w. 4. bioeTikis Sesavali bioeTikis Sesavali bioeTikis Sesavali bioeTikis Sesavali – i.ivanuSkini da sx., moskovi, progresi-tradicia, 1998 w. 5. bioeTikabioeTikabioeTikabioeTika: principebi, wesebi problemebi – b.g.iudini, moskovi, 1998 w. 6. saqarTvelos kanonmdebloba adamianis uflebebis Sesaxeb biomedicinis sferoSi saqarTvelos kanonmdebloba adamianis uflebebis Sesaxeb biomedicinis sferoSi saqarTvelos kanonmdebloba adamianis uflebebis Sesaxeb biomedicinis sferoSi saqarTvelos kanonmdebloba adamianis uflebebis Sesaxeb biomedicinis sferoSi

– g.javaSvili, g.kiknaZe, a.barkalaia. Tbilisi, 2001 w. 7. axalaZe v. bioeTika aTaswleulis mijnaze,- jurnali religia , Tb, 2002 w., #

7,8,9, gv, 82-91 8. axalaZe v.bioeTika, rogorc msoflgageba da mecniereba,biomedicines sferoSi

kacobriobis sulier-zneobrivi orientaciis Sesaxeb (jurnali rwmena da codna 2002 1 ,9, gv.82-91

9. Tanamedrove medicinis zogierTi samarTlebrivi sakiTxi , m.kvaWaZe,Tbilisi, 1995 w.

10. eqimis profesiuli saqmianobis samarTlebrivi safuZvlebi –guram kiknaZe,givi javaSvili,Tbilisi, 2002 w.

11. deontologia qirurgiaSi, n.doliZe, d. mSvenieraZe, mecniereba,1990,Tbilisi 12. adamianis uflebebi da samedicino personalis movaleobebi saerTaSoriso

dokumentebSi - Tbilisi, 1999 13. saeqimo saidumlo, saeqimo Secdoma,b.v.Sevrigini,moskovi,2000 14. saeqimo deontologia,i.i.makSanovi,1998,minski 15. Власов Василий Викторович- Невидимые проблемы медицинской этики: Медицина и

,общество-Медицинское право и этика 2002.- №1.- С. 18-28 16. Власов Василий Викторович Медицина в условиях дефицита ресурсов-Триумф, Москва, 2000 17. И.В.Силуянова. Нравственная культура врача как основание врачебного профессионализма./ ж-л

«Экономика здравоохранения»№ 1/ 42, 2000, с.5-8. 18. И.В.Силуянова Биомедицинская этика в системе медико-биологических знаний.//Медицинское

право и этика. №2, 2000 19. .И.В.Силуянова. О сущности “этического” этических проблем современной медицины. //

Медицинское право и этика,№4,2000.с. 50 20. И.В.Силуянова. В помощь преподавателю биоэтики. Программа по биоэтике. Тематические

планы лекций и семинаров.// Медицинское право и этика.№4,2001.с.84- 96. 21. И.В.Силуянова. Этическая культура как основание медицинского профессионализма или зачем

будущему врачу изучать гуманитарные науки?// Медицинское право и этика.№4, 2001, с.81-84. 22. И.В.Силуянова. Понимание этики в медицине как социальная проблема. (Этические проблемы

медицины глазами медиков).// Этика и медицина проблема взаимодействия. Медицинское право и этика.2002,№4, с.33-41

23. .И.В.Силуянова, Сабурова В.И. ,Сушко Н.А.,Першин М.С Семинарские занятия по курсу “Биомедицинская этика” для студентов лечебного, педиатрического, медико-биологического факультетов. Учебно-методич. Пособие. М. 2003.

24. И.В.Силуянова, Ляуш Л. Б., В. А. Антипенков опросы тестового контроля по биомедицинской этике. //«Медицинское право и этика», № 4, 2000, с. 79-80.

25. -http://www.bioethics.ru/rus/ - bioeTikis forumi 26. Медицина, этика, религия и право : Материалы конф. 25-26 нояб. 1999 г.. - М., 2000. - 45-56 с. 27. Биоэтика. Вопросы и ответы // Прогресс-Традиция А. Я. Иванюшкин, Л.Ф. Курило, Ю.М.

Лопухин, Н.Н. Седова, П.Д. Тищенко, Б.Г. Юдин (unesco)2005 28. http://depts.washington.edu/bioethx/topics/physpt.html#ques6 -kazusebi da pauxebi 29. -meoce saukunis qarTuli filosofiis anTologia- pirveli tomi pirveli

nakveTi 1998 weli 30. cnobili ucxoeli da qarTveli eqimebi,biografia,moRvaweoba medicinaSi da mis

farglebs gareT- z.kaxiani,s.kaxiani, 1993, gamomcemloba ganaTleba 31. bioeTikosTa bioeTikosTa bioeTikosTa bioeTikosTa saerTaSoriso asociiaciidan miRebuli masalebisaerTaSoriso asociiaciidan miRebuli masalebisaerTaSoriso asociiaciidan miRebuli masalebisaerTaSoriso asociiaciidan miRebuli masalebi,

http://bioethicsinternational.org

19

32. msoflio samedicino asociaciidan miRebuli masalebimsoflio samedicino asociaciidan miRebuli masalebimsoflio samedicino asociaciidan miRebuli masalebimsoflio samedicino asociaciidan miRebuli masalebi, http://www.wma.net/e/ethicsunit/index.htm

33. The Center for Bioethics and Human Dignity http://www.cbhd.org/ 34. Feminist Approaches to Bioethics -http://www.pdcnet.org/member-fab. 35. BioethicsWeb - http://bioethicsweb.ac.uk/ 36. http://www.unesco.org/ibc/ www.unesco.org/shs/bioethics 37. msoflios janmrTelobis organizaciis veb gvmsoflios janmrTelobis organizaciis veb gvmsoflios janmrTelobis organizaciis veb gvmsoflios janmrTelobis organizaciis veb gverdze ganTavsebuli masalebierdze ganTavsebuli masalebierdze ganTavsebuli masalebierdze ganTavsebuli masalebi----

www.who.int/ethics/topics/en/ 38. amerikis bioeTikis da humanizmis asociacia - http://www.asbh.org/ (Georgetown

University , BIOETHICS CURRICULUM UNITS FROM THE KENNEDY INSTITUTE OF ETHICS http://www.georgetown.edu/research/nrcbl

muxli 2. moduli 1.2. muxli 2. moduli 1.2. muxli 2. moduli 1.2. muxli 2. moduli 1.2. fundamenturi medicinis Tanamedrove aspeqtebifundamenturi medicinis Tanamedrove aspeqtebifundamenturi medicinis Tanamedrove aspeqtebifundamenturi medicinis Tanamedrove aspeqtebi....

1. modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa ---- 2 kv. (72 sT.) 2. modulis mizaniamodulis mizaniamodulis mizaniamodulis mizania - rezidentis/specialobis maZieblisaTvis medicinis

fundamenturi da klinikuri kvlevis Tanamedrove principebis Sesaxeb saWiro codnis SeZena da misi gamoyenebis unaris gamomuSaveba. programa kompleqsuria, Sedgeba oTxi - imunologiis, klinikuri farmakologiis, fiziologiis da paTfiziologiis - qvemodulisagan, Sesabamisi amocanebis Tanmimdevruli ganxorcielebiT.

3. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: fiziologiis qvemoduli:

1. adaminis organizmis funqciuri sistemebis organizaciisa da centralur nervul sistemaSi mimdinare neirobiologiuri procesebis bioqimiuri safuZvlebi integraciis sxvadasxva doneze;

2. calkeuli neiromediatoruli sistemis funqcionirebis (sinafsuri mediaciis) natifi molekuluri meqanizmebi; sinafsuri gadacemis sxvadasxva safexurze qimiuri preparetebis zemoqmedebis efeqturi gamovlinebebi da daavadebaTa koreqciis zogadi principebi;

3. tkivilisa da gautkivarebis funqciuri sistemis neirobiologiuri safuZvlebi; nocicepciis periferiuli da centraluri meqanizmebis neiroqimiuri safuZvlebi; endogenuri opioiduri da sxva peptidebis receptoruli sistemis roli analgeziis ganviTarebaSi;

4. motivacia da emocia. limburi sistema (hipokampi, sartylebri xveuli, nuSisebri kompleqsi), striopaliduri sistema da integraciis Talamuri done adamianis qcevis organizaciaSi. hipoTalamusis roli integraciul moqmedebaSi da ZiriTad biologiur motivaciebis formirebaSi.

5. fiziologiaSi, molekulur biologiaSi da Teoriul medicinaSi ukanasknel wlebSi (2000-2005) ganxorcielebuli mniSvnelovani kvlevis Sedegebis mimoxilva da analizi;

paTfiziologiis qvemoduli:

1. adaptaciis procesi. organizmis zogadi reaqcia endogenuri da egzogenuri faqtoris zemoqmedebaze. organizmis Seguebadoba Secvlil saarsebo garemosTan.

2. organizmis saregulacio sistemebis roli adaptaciis ganxorcielebaSi fiziologiur da eqstremalur situaciebSi. parakrinuli regulaciis molekuluri meqanizmebi. mexsierebis roli adaptaciuri qcevis realizaciaSi.

3. adapturi stres-reaqcia. stresuli da antistresuli meqanizmebi. eqstremaluri faqtoris zemoqmedebiT ganviTarebuli paTogenuri stresi. Sokuri mdgomareobis zogadi paTogenezi. organoebisa da organoTa sistemebis funqciobis da integraciis moSlis meqanizmebi Sokis dros.

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klinikuri farmakologiis qvemoduli:

1. kerZo klinikuri farmakologiis ZiriTadi sakiTxebi fundamenturi da klinikuri medicinis bolo miRwevebis Sesabamisad. farmakoTerapia mtkicebiTi medicinis poziciebidan.

2. samkurnalod praqtikaSi gamoyenebuli samkurnalo preparatebis ZiriTadi jgufebis farmakokinetikis da farmakodinamikis Seswavla. sxvadasxva samkurnalo preparatebis urTierTdamokidebulebis da arasasurveli gverdiTi efeqtebis Seswavla. agreTve, gamoyenebuli farmakologiuri preparatebis randomizebuli kontrolirebadi kvleva.

imunologiis qvemoduli:

1. fundamenturi da klinikuri imunologiis - imunuri sistemis organoebisa da ujredebis, imunoglobulinebis, antigenis gamomcnobi da warmdgeni molekulebis struqturisa da funqciis- Tanamedrove Teoriuli da praqtikuli aspeqtebi;

2. daavadebaTa ganviTarebaSi imunuri meqanizmebis rolis, rogorc axali sadiagnozo da Terapiuli strategiis safuZvlebi;

4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba

mocemulia cxrili # 2mocemulia cxrili # 2mocemulia cxrili # 2mocemulia cxrili # 2----is saxiT:is saxiT:is saxiT:is saxiT: cxrilicxrilicxrilicxrili # 2# 2# 2# 2

Teoriuli kursi davaleba organizmis funqciebis regulacia da fiziologiuri integraciaorganizmis funqciebis regulacia da fiziologiuri integraciaorganizmis funqciebis regulacia da fiziologiuri integraciaorganizmis funqciebis regulacia da fiziologiuri integracia

neironis morfologiuri specializacia da neironTaSorisi komunikaciis safuZvlebi cns-is integraciuli moqmedebis ganxorcielebaSi. neirosekrecia, rogorc ZiriTadi biologiuri kanonzomiereba da cns-is subujreduli regulaciis elementi.

neironTaSorisi komunikaciis safuZvlebineironTaSorisi komunikaciis safuZvlebineironTaSorisi komunikaciis safuZvlebineironTaSorisi komunikaciis safuZvlebi

neiroregulatorebis klasifikacia da maTi gansazRvris kriteriumebi. neiroregulatorebis mimarT mgrZnobiare receptorebis klasifikacia da maTi moqmedebis kanonzomierebani. “retrograduli mesenjeri”. sinafsis plastikuroba. neironuli integracia. calkeuli neiroregulatorebi (biogenuri aminebi, aminomJavebi, arapeptiduri kandidatebi, neiropeptidebi).


tkivilis fiziologiatkivilis fiziologiatkivilis fiziologiatkivilis fiziologia

problemis zogadi mimoxilva. nocicepturi sistema da tkivilis sensitiuri aRmavali gzebi. endogenuri opioiduri da sxva peptidebis roli. antinocicefciuri sistema, gautkivarebis biologiuri mniSvneloba. tkivilis saxeebi. tkivilis neirobiologiuri safuZvlebi. tkivilis centraluri da periferiuli meqanizmebi. endogenuri opiatebi (opioidebi). opioidebiT gamowveuli analgeziis neirofiziologiuri meqanizmebi. substancia P da misi roli tkivilis SegrZnebaSi.


motivacia da emociamotivacia da emociamotivacia da emociamotivacia da emocia

limburi sistemis anatomiis da funqciis zogadi mimoxilva. adamianis qcevis organizacia. “motivaciis” da “emociis” mniSvneloba qcevis organizaciaSi. “fsiqoanalizis” Teoria. hipoTalamusis roli integraciul moqmedebaSi da ZiriTad biologiur motivaciebis formirebaSi. limburi sistema (hipokampi, sartylebri xveuli, nuSisebri kompleqsi) striopaliduri sistema da integraciis Talamuri done.

testireba

fiziologiaSi, molekulur biologiaSi da Teoriul medicinaSi ukanasknel wlebSi (2004-2006) ganxorcielebuli mniSvnelovani kvlevis Sedegebis mniSvnelovani kvlevis Sedegebis mniSvnelovani kvlevis Sedegebis mniSvnelovani kvlevis Sedegebis

21

mimoxilva da analizi;mimoxilva da analizi;mimoxilva da analizi;mimoxilva da analizi; organorganorganorganizmis sxvadasxva funqciurizmis sxvadasxva funqciurizmis sxvadasxva funqciurizmis sxvadasxva funqciur----struqturul doneze ganviTarebuli struqturul doneze ganviTarebuli struqturul doneze ganviTarebuli struqturul doneze ganviTarebuli paTologiuri procesebis urTierTobisa da integraciis kanonzomierebani.paTologiuri procesebis urTierTobisa da integraciis kanonzomierebani.paTologiuri procesebis urTierTobisa da integraciis kanonzomierebani.paTologiuri procesebis urTierTobisa da integraciis kanonzomierebani. organizmis da garemos fiziko-qimiuri da informaciuli urTierToba. reaqtiulobis roli Secvlil saarsebo garemosTan adaptaciis ganviTarebaSi.

saregulacio sistemebis roli adaptaciuri procesebis ganviTarebaSisaregulacio sistemebis roli adaptaciuri procesebis ganviTarebaSisaregulacio sistemebis roli adaptaciuri procesebis ganviTarebaSisaregulacio sistemebis roli adaptaciuri procesebis ganviTarebaSi. parakrinul-autokrinuli regulacia. citokinebi ujredSorisi urTierTobebis peptiduri regulatorebi. azotis oqsidi da misi moqmedebis molekuluri meqanizmebi.


mexsierebis roli adaptaciuri qcevis ganxorcielebaSi. sxvadasxva tipis mexsierebis neirobiologiuri meqanizmebi. mexsierebis darRveva.


specifiuri adaptaciis meqanizmebispecifiuri adaptaciis meqanizmebispecifiuri adaptaciis meqanizmebispecifiuri adaptaciis meqanizmebi. stresstresstresstres----reaqcia. zogadi adaptaciuri reaqcia. zogadi adaptaciuri reaqcia. zogadi adaptaciuri reaqcia. zogadi adaptaciuri sindromi. sindromi. sindromi. sindromi. stresuli hormonebi. centraluri da periferiuli antistresuli meqanizmebi, stresuli cilebi.


eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis stadiebi. neiroendokrinuli regulaciisa da organoTa sistemebis integraciis moSlis meqanizmebi. Sokuri Tirkmlis, Sokuri RviZlis, Sokuri filtvis ganviTarebis meqanizmebi. mozrdilTa mwvave respiraciuli distres-sindromi.

testireba

imunuri sistemis zogadi daxasiaTeba. imunuri sistemis zogadi daxasiaTeba. imunuri sistemis zogadi daxasiaTeba. imunuri sistemis zogadi daxasiaTeba. sakuTarisa da ucxos garCeva. Tandayolili da SeZenili imunuri pasuxi. imunuri sistemis ujredebi. imunuri pasuxis mediatorebi. ujredSida da ujredgareTa paTogenis sawinaaRmdego dacva. vaqcinacia. imunopaTologia da atopia.

imunuri pasuxis regulaciaimunuri pasuxis regulaciaimunuri pasuxis regulaciaimunuri pasuxis regulacia

antigeniT imunuri pasuxis regulacia. antigenwarmdgeni ujredebi. antisxeulebiT regulacia. limfocitebiT regulacia. idiotipuri modulacia. neiroendokrinuli modulacia. imunuri pasuxis genetikuri kontroli.

tolerantobis induqcia eqsperimentSi. sakuTari antigenebisadmi centraluri Timusuri tolerantoba. sakuTari antigenebisadmi periferiuli – postTimusuri tolerantoba. sakuTari antigenebisadmi B-ujreduli tolerantoba. in vitro da in vivo xelovnurad inducirebuli tolerantoba. tolerantobis gamoyeneba TerapiaSi.


simsivnis imunologiasimsivnis imunologiasimsivnis imunologiasimsivnis imunologia

simsivne rogorc qsovilovani transplantanti. imunuri zedamxedveloba. simsivnesTan asocirebuli antigenebi. simsivnis sawinaaRmdego imunuri pasuxi. simsivnis mier imunuri pasuxis Tavidan acileba. imunodiagnostika. imunoTerapia.


autoimuniteti da autoimunuri daavadebebiautoimuniteti da autoimunuri daavadebebiautoimuniteti da autoimunuri daavadebebiautoimuniteti da autoimunuri daavadebebi

autoimunitetis kavSiri daavadebebTan. organospecifiuri da araorganospecifiuri autoimunuri daavadebebi. genetikuri faqtorebi. paTogenezi. autoimunur daavadebaTa modelebi: inducirebuli da spontanuri autoimuniteti. daavadebebi, ganpirobebuli paTogenuri autoantisxeulebiT: Tireotoqsikozi, avTvisebiani miasTenia, I tipis diabeti, mamakacis uSviloba, perniciozuli anemia, gudpasCeris sindromi, sisxlis daavadebebi. daavadebebi, ganpirobebuli paTogenuri imunuri kompleqsebiT: sistemuri wiTeli mglura, revmatoiduli poliarTriti, skleroderma,


22

antifosfolipiduri sindromi.

imunuri sistemis klinikuri da laboratoriuli Sefasebaimunuri sistemis klinikuri da laboratoriuli Sefasebaimunuri sistemis klinikuri da laboratoriuli Sefasebaimunuri sistemis klinikuri da laboratoriuli Sefaseba

humoruli imunuri pasuxis Sefaseba. ujreduli imunuri pasuxis Sefaseba.

limfocitTa raodenobisa da funqciis Sefaseba: imunofenotipireba gamWoli citofluorometriiT, in vitro limfocitebis proliferacia, citokin-maproducirebeli ujredebis gansazRvra (ELISPOT meTodi), citotoqsiurobis testi. komplementis sistemis gamokvleva. fagocitebis funqciis gamokvleva.

antigenis/antisxeulis aRmosaCeni reaqciebi: precipitaciis reaqcia, hemaglutinaciis reaqcia, komplementis SeboWvis reaqcia, pirdapiri da arapirdapiri imunofluorescenciis reaqcia, imunofermentuli reaqcia, imunoblotingi da imunoprecipitacia. antisxeulTa izolacia. monoklonuri antisxeulebis produqcia.

testireba

klinikuri farmakklinikuri farmakklinikuri farmakklinikuri farmakokinetikisa da klinikuri farmakodinamikis ZiriTadi okinetikisa da klinikuri farmakodinamikis ZiriTadi okinetikisa da klinikuri farmakodinamikis ZiriTadi okinetikisa da klinikuri farmakodinamikis ZiriTadi principebi, racionaluri farmakoTerapia.principebi, racionaluri farmakoTerapia.principebi, racionaluri farmakoTerapia.principebi, racionaluri farmakoTerapia.

arasasurveli wamlismieri reaqciebi. klinikuri farmakoekonomika, arasasurveli wamlismieri reaqciebi. klinikuri farmakoekonomika, arasasurveli wamlismieri reaqciebi. klinikuri farmakoekonomika, arasasurveli wamlismieri reaqciebi. klinikuri farmakoekonomika, farmakoepidemiologia.farmakoepidemiologia.farmakoepidemiologia.farmakoepidemiologia. samkurnalo dozebis gaTvla Tirkmlis qr. ukmarisobiT daavadebul pacientebSi. medikamentozuli saSualebebis metabolizmi, biotransformacia.


farmakoTerapia da mtkicebiTi medicina.farmakoTerapia da mtkicebiTi medicina.farmakoTerapia da mtkicebiTi medicina.farmakoTerapia da mtkicebiTi medicina. medikamentebis Sewovisa da organizmSi ganawilebis meqanizmebi


farmakoTerapiis saxeebifarmakoTerapiis saxeebifarmakoTerapiis saxeebifarmakoTerapiis saxeebi----etiotropuli, paTogenezurietiotropuli, paTogenezurietiotropuli, paTogenezurietiotropuli, paTogenezuri

farmakoTerapiis saxeebi farmakoTerapiis saxeebi farmakoTerapiis saxeebi farmakoTerapiis saxeebi ---- simptomaturi, profilaqtikuri.simptomaturi, profilaqtikuri.simptomaturi, profilaqtikuri.simptomaturi, profilaqtikuri. racionaluri antibiotikoTerapiis sakiTxebi. medikamentozuri monitoringi (Cvenebebi, klinikuri mniSvneloba da Sedegebis interpretacia).


gadaudebel mdgomareobaTa klinikaSi gamogadaudebel mdgomareobaTa klinikaSi gamogadaudebel mdgomareobaTa klinikaSi gamogadaudebel mdgomareobaTa klinikaSi gamoyenebul medikamentTa yenebul medikamentTa yenebul medikamentTa yenebul medikamentTa farmakokinetikuri da farmakodinamikuri daxasiaTebafarmakokinetikuri da farmakodinamikuri daxasiaTebafarmakokinetikuri da farmakodinamikuri daxasiaTebafarmakokinetikuri da farmakodinamikuri daxasiaTeba. arasasurveli medikamentozuri efeqtebi, maTi karcenogenoba.

testireba

5. modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi

modulis dasrulebis Semdeg rezidents/specialobis maZiebelma unda icodes/SeeZlos:

1. integraciis sxvadasxva doneze organizmis cxovelmoqmedebis zogadi kanonzomierebebis (molekuluridan-organizmulamde) da principebis Sefaseba;

2. daavadebul organizmSi mimdinare adaptaciuri procesebis, avadmyofobis aRmocenebis, mimdinareobisa da gamosavlis zogadi meqanizmebis, paTogenezuri profilaqtikis, Terapiis principebis da meTodebis Sefaseba;

3. imunopaTologiuri mdgomareobebis diagnostikuri da Terapiuli strategiis safuZvlebis Sefaseba; alergiuli daavadebebis profilaqtikisa da mkurnalobis Sesaxeb codnas;

4. farmakokinetikuri da farmakodinamikuri monacemebis Sesabamisad samkurnalo saSualebebis SerCeva. individualuri mgrZnobelobidan gamomdinare, preparatis arasasurveli efeqtebis gaTvaliswineba; datvirTvisa da SemanarCunebeli dozebis SerCeva; zogierT kategoriis avadmyofTaTvis (RviZlis funqciis darRveva, Tirkmlis qr. ukmarisoba, xandazmuli da xanSisesuli pirebi, bavSvebi) samkurnalo dozis gaTvla; arasasurveli wamlismieri reaqciis profilaqtika, diagnostika da mkurnaloba; samkurnalo preparatebis zedozirebis diagnostika da mkurnaloba.


23

1. T.naneiSvili ”sinafsi. molekulidan qcevamde” Tbilisi,2002w.

2. T.naneiSvili “”qcevis fsiqofiziologia” , Tbilisi.2003w.

3. Р,Орлов. А,Ноздрачев «Нормальная физиология». ГЕОТАР-Медия 2005 г,

4. Acta Neurobiol Exp 2004, 64; - [email protected]

5. Диффузная внесинаптическая нейропередача посредством глутамата и ГАМК .

6. http://www.biomednet.ru/content/view/47

7. http://www.brain.ru/

8. http://phynist3d.narod.ru/

9. http://www.ecclescorner.org/RUS/

10. http://www.stoppain.org/pain_medicine/content/chronicpain/

11. http://www.pbs.org/wnet/brain/3d/index.html

12. http://www.uclan.ac.uk/ldu/resources/multimedia/visualization/directions.html - brain

13. http://www.bayareapainmedical.com/nervanim.html - spinothalamic-retikulothalamic

14. http://www.painresearch.utah.edu/cancerpain/neurax.html

15. http://www.stoppain.org/pain_medicine/content/medication/opioids.asp#top

16. http://www.spine-health.com/dir/dir01.html

17. http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/NEURANCA.html#2

18. http://webschoolsolutions.com/patts/systems/nervous.htm#somatosensory

19. http://www.innerbody.com/image/nervov.html

20. П,Литвицкий. «Патофизиология». Москва. 2002 г,

21. О,Молотков. С,Ефремов. В,Решедько. «Патофизиология в вопросах и в ответах». Смоленск. 1999 г,

22. Р,Орлов. А,Ноздрачев «Нормальная физиология». ГЕОТАР-Медия 2005 г,

23. Р,Сепиащвили «Основы физиологии имунной системы». Москва. 2003 г,

24. Кукес В.Г. Клиническая фармакология. Учебник для медицинских ВУЗов.-М.ГЭОТАР-МЕД, 2004.

25. Основы клинической фармакологии и рационалъной фармакотерапии. Под общей ред. Белоусова Ю.Б., Леоновой М.В.-М., Бионика, 2002.

26. Верткин А.Л. Скорая медицинская помощъ.-М., ГЭОТАР-МЕД, 2003. 27. Михаилов И.Б. . Клиническая фармакология. С-Пт., Фолиант, 2002. 28. Лоуренс Д.Р.,Бенитт П.Н. . Клиническая фармакология. Москва «Медицина», 1993. 29. Интенсивная Терапия, реанимация, первая помощъ». Под. ред. Малышева В.Д. Москва

«Медицина», 2000. 30. n.foraqiSvili. struqturuli imunologia. gamzadebulia dasabeWdad. 31. T Ciqovani. imunologia. amonabeWdis saxiT. mzaddeba dasabeWdad. 32. g.burkaZe. imunomorfologia. norma, paTologia (I da II nawili) 33. Борисов Л.Б. Медицинская микробиология, вирусология, иммунология. Москва.

2001 34. Roitt, I., Brostoff, J. and Male, D. Immunology (7th edn.) Mosby. 2003. 35. C.A.Janeway, P.Travers, M. Walport, M.Shlomchik. Immunobiology. 6th edition., 2005 36. Supplement to The J. of Allergy and Clinical Immunology, 2003, vol.111, No.2

www.mosby.com/jaci 37. www.tsmu.edu/immuno

24

muxli 3. moduli 1.3. zogadi Terapia/ambulatoriuli Terapiamuxli 3. moduli 1.3. zogadi Terapia/ambulatoriuli Terapiamuxli 3. moduli 1.3. zogadi Terapia/ambulatoriuli Terapiamuxli 3. moduli 1.3. zogadi Terapia/ambulatoriuli Terapia (xangrZlivoba____ 4 Tve)Tve)Tve)Tve)

moduli 1.3.1. zogadi Terapiazogadi Terapiazogadi Terapiazogadi Terapia

1. modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa –––– 2 Tve2 Tve2 Tve2 Tve 2. modulis mizaniamodulis mizaniamodulis mizaniamodulis mizania - diagnistikuri TvalsazrisiT rTuli sindromebis

(anemia, febriluri mdgomareoba, limfadenopaTia) monitoringi; 3. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: rezidentis profesiuli srulyofa Semdegi daavadebebisa

da mdgomareobebis amocnobaSi, diagnostkas, mkurnalobasa da profilaqtikaSi • Sinagani daavadebebis yvela ZiriTadi sindromis diagnostika;

• Serwymuli paTologiis monitoringi da mkurnaloba;

• rezidentis mzadeba da profesiuli srulyofa Sinagani organoebis mwvave da qronikuli daavadebebis (mdgomareobebis) amocnobasa da diagnostirebaSi anamnezis Sekrebis, pacientis fizikuri kvlevis meTodebis, laboratoriuli, instrumentuli da rentgenologiuri kvlevis monacemTa interpretaciaSi daxelovnebis gziT;

• Sinagani daavadebebis marTvis adekvaturi meTodebis SerCeva, arastabiluri pacientebis marTvis Taviseburebebi, daavadebis marTvis Semdgomi taqtikis SemuSaveba, pacientisa da misi ojaxis wevrebis informireba daavadebis profilaqtikisa da reabilitaciis meTodebis dasaxvaSi;

• infuziuri Terapiis (siTxeebi, antibiotikebi da sxva farmakologiuri da Terapiuli saSualebebis) Cvenebebisa da gamoyenebis safuZvlebis Seswavla;

• qronikuli daavadebis marTvis principebis codna daavadebis nebismier etapze stacionaruli mkurnalobidan ambulatoriuli monitorirebis CaTvliT;

• dietoTerapiis mniSvnelobisa da safuZvlebis gacnoba Sinagani qronikuli daavadebebis marTvis procesSi;

• nozokomialuri (hospitaluri) infeqciebis da sxva iatrogenuli garTulebebis profilaqtikis safuZvlebis aTviseba;

Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaSesasrulebeli samuSaos moculoba da Casatarebeli manipulaSesasrulebeli samuSaos moculoba da Casatarebeli manipulaSesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba ciebis raodenoba ciebis raodenoba ciebis raodenoba mocemulia cxrili 3mocemulia cxrili 3mocemulia cxrili 3mocemulia cxrili 3----is saxiT:is saxiT:is saxiT:is saxiT:

cxrili # 3 Teoriuli kursi profesiuli unar-Cvevebi

(raodenobis miTiTebiT) davaleba

1. diferenciuli diagnozi temperaturis momatebisa da cxelebis dros; 2. diferenciuli diagnozi plevruli gamonaJonis dros; 3. diferenciuli diagnozi respiratoruli ukmarisobis dros; 4. diferenciuli diagnozi SeSupebis dros; 5. diferenciuli diagnozi filtvSi infiltraciis dros; 6. diferenciuli diagnozi siyviTlis dros; 7. diferenciuli diagnozi ascitis dros; 8. diferenciuli diagnozi hepato-splenomegaliis dros; 9. diferenciuli diagnozi Sardis sindromis dros;

anamnezis Sekreba da pacientis fizikuri kvlevis unar-Cvevebi;

klinikur-diagnostikuri kvlevis meTodebi da maTi Sedegebis interpretacia;

bioqimiuri kvlevis meTodebi da maTi Sedegebis interpretacia;

imunologiui kvlevis meTodebi da maTi Sedegebis interpretacia;

morfologiuri kvlevis meTodebi da maTi Sedegebis interpretacia;

referati an moxseneba – 1; avadmyofis damoukidebeli gasinjva da diagnozis dasma – 10; avadmyofobis istoriis damoukidebeli dawera – 4; morigeoba – TveSi 4;

25

10. diferenciuli diagnozi anemiebis da limfadenopaTiis dros; 11. diferenciuli diagnostika hemoragiuli diaTezebis da sxvadasxva etiologiis sisxldenebis dros; 12. diferenciuli diagnostika SeSupebiTi sindromisa da ascitis dros; 13.diferenciuli diagnozi arteriuli hipertenziis dros; 14.diferenciuli diagnozi arteriuli hipotenziis dros; 15. diferenciuli diagnozi gul-mkerdSi tkivilis dros; 16. diferenciuli diagnozi muclis areSi tkivilis dros; 17. diferenciuli diagnozi saxsrovani sindromis dros; 18. diferenciuli diagnozi mJava-tutovani da wyal-marilovani darRvevebis dros; 19. diferenciuli diagnozi gamonayaris dros; 20. diferenciuli diangozi cnobierebis darRvevis dros;

plevris punqcia – 10; punqtatis citologiuri, bioqimiuri maCveneblebis intepretacia; garegani sunTqvis funqciis maCveneblebis interpretacia; eleqtrokardiogramis Sefaseba da interpretacia; eleqtrokardiografia – 50; filtvebis rentgenologiuri gamoklvevis interpretacia – 50; filtvebis komputeruli tomografiis interpretacia – 20; bronqoskopiis interpretacia.

moduli 1.3.2 ambulatoriuli Terapiaambulatoriuli Terapiaambulatoriuli Terapiaambulatoriuli Terapia

1. modulis xangrZlivoba_modulis xangrZlivoba_modulis xangrZlivoba_modulis xangrZlivoba_ 2 TveTveTveTve 2. modulis mizani: modulis mizani: modulis mizani: modulis mizani: diagnistikuri TvalsazrisiT rTuli sindromebis (anemia,

febriluri mdgomareoba, limfadenopaTia) monitoringi; 3. modulis amocanebi: modulis amocanebi: modulis amocanebi: modulis amocanebi: rezidentis profesiuli srulyofa Semdegi daavadebebisa da

mdgomareobebis amocnobaSi, diagnostkas, mkurnalobasa da profilaqtikaSi

• Sinagani daavadebebis yvela ZiriTadi sindromis diagnostika;

• Serwymuli paTologiis monitoringi da mkurnaloba;

• rezidentis mzadeba da profesiuli srulyofa Sinagani organoebis mwvave da qronikuli daavadebebis (mdgomareobebis) amocnobasa da diagnostirebaSi anamnezis Sekrebis, pacientis fizikuri kvlevis meTodebis, laboratoriuli, instrumentuli da rentgenologiuri kvlevis monacemTa interpretaciaSi daxelovnebis gziT;

• Sinagani daavadebebis marTvis adekvaturi meTodebis SerCeva, daavadebis marTvis Semdgomi taqtikis SemuSaveba, pacientisa da misi ojaxis wevrebis informireba daavadebis profilaqtikisa da reabilitaciis meTodebis dasaxvaSi;

• farmakoTerapiis (antibiotikebi da sxva farmakologiuri da Terapiuli saSualebebis) Cvenebebisa da gamoyenebis safuZvlebis Seswavla;

• qronikuli daavadebis marTvis principebis codna daavadebis nebismier etapze, ambulatoriuli monitorireba;

• dietoTerapiis mniSvnelobisa da safuZvlebis gacnoba Sinagani qronikuli daavadebebis marTvis procesSi;

Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili 4mocemulia cxrili 4mocemulia cxrili 4mocemulia cxrili 4----is saxiT::is saxiT::is saxiT::is saxiT::

cxrili # 4

26

Teoriuli kursi profesiuli unar-Cvevebi (raodenobis miTiTebiT)

davaleba

1. diferenciuli diagnozi temperaturis momatebisa da cxelebis dros; 2. diferenciuli diagnozi respiratoruli daavadebebis dros; 4. diferenciuli diagnozi SeSupebis dros; 5. diferenciuli diagnozi filtvSi infiltraciis dros; 6. diferenciuli diagnozi siyviTlis dros; 7. diferenciuli diagnozi hepato-splenomegaliis dros; 8.. diferenciuli diagnozi Sardis sindromis dros; 9.. diferenciuli diagnozi anemiebis da limfadenopaTiis dros; 10. diferenciuli diagnostika hemoragiuli diaTezebis da sxvadasxva etiologiis sisxldenebis dros; 11 diferenciuli diagnozi arteriuli hipertenziis dros; 12.diferenciuli diagnozi arteriuli hipotenziis dros; 13.. diferenciuli diagnozi muclis areSi tkivilis dros; 14.. diferenciuli diagnozi saxsrovani sindromis dros; darRvevebis dros; 15. diferenciuli diagnozi gamonayaris dros; 15. diferenciuli diangozi cnobierebis darRvevis dros;

anamnezis Sekreba da pacientis fizikuri kvlevis unar-Cvevebi;

klinikur-diagnostikuri kvlevis meTodebi da maTi Sedegebis interpretacia;

bioqimiuri kvlevis meTodebi da maTi Sedegebis interpretacia;

imunologiui kvlevis meTodebi da maTi Sedegebis interpretacia;

morfologiuri kvlevis meTodebi da maTi Sedegebis interpretacia;

garegani sunTqvis funqciis maCveneblebis interpretacia; eleqtrokardiogramis Sefaseba da interpretacia; eleqtrokardiografia – 50; filtvebis rentgenologiuri gamoklvevis interpretacia – 50; filtvebis kompiuteruli tomografiis interpretacia – 20;


muxli 4. moduli 1.4. muxli 4. moduli 1.4. muxli 4. moduli 1.4. muxli 4. moduli 1.4. Terapiuli stacionari ITerapiuli stacionari ITerapiuli stacionari ITerapiuli stacionari I

(xangrZlivoba____ 5 Tve) moduli 1.4.1. gulgulgulgul----sisxlZarRvTa daavadebebisisxlZarRvTa daavadebebisisxlZarRvTa daavadebebisisxlZarRvTa daavadebebi

1. modulis xangrZlivoba modulis xangrZlivoba modulis xangrZlivoba modulis xangrZlivoba ---- 3 Tve3 Tve3 Tve3 Tve 2. modulis mizani: modulis mizani: modulis mizani: modulis mizani: gul-sisxlZarRvTa sistemis daavadebebis dignostika da

marTva. 3. modmodmodmodulis amocanebi:ulis amocanebi:ulis amocanebi:ulis amocanebi:

•••• kardiologiuri profilis pacintis anamnezis Sekreba da fizikuri kvlevis meTodebis srulyofili codna;

•••• kardiologiuri profilis pacientis dokumentaciis warmoeba;

•••• gul-sisxlZarRvTa daavadebebis farmakologia; •••• koronaruli sisxlZarRvebis daavadebebi (gulis iSemiuri daavadeba.

aucilebelia SemuSavdes diferencialuri midgomis principebi kardialgiis dros, ekg, ariTmiis Sefaseba, medikamenturi, da invaziuri mkurnalobis racionaluri SerCeva (antiTrombuli agentebi, angioplastika, aorto-koronaruli Suntireba da mkurnalobis sxva meTodebi), saswrafo angiografiis da balonuri kontrapulsaciis Cvenebebi. gulis funqciuri da hemodinamikuri

27

maCveneblebis Sefaseba (eqokardioskopia, holteruli gamokvlevebi), riskis stratifikacia. anamnezuri monacemebis Segroveba, fizikaluri gamokvleva: ekg, rentgenologiuri gamokvleva, biomarkerebis mniSvneloba, datvirTvis testebi da eqokardiografia.Ggul-sisxlZarRvTa sistemis riskis faqtorebis marTva, lipiduri profilis Sefaseba pacientis movla gulis daavadebis dros);

•••• arteriuli hipertrnzia (arteriuli hipertenziis diferencialuri diagnozi; hipertoniis marTva Tanamedrove rekomendaciebis mixedviT; (JNC-VII, ESC- ESH-2003) arteriuli hipertenziis garTulebebi); biventrikuluri resinqronizacia da implantirebadi kardioverterdefibrilatori dilataciuri kardiomiopaTiis dros; specifiuri kardiomiopaTiebi);

•••• aritmiebi (taqi da bradiaritmiebis, supraventrikuluri da ventrikuluri (farTe da viwro QRS-kompleqsiani) taqiaritmiebis diferencireba da mkurnaloba; eleqtruli kardiostimulacia, eleqtruli kardioversia da defibrilacia; eleqtrofiziologiuri gamokvlevis da transkaTeteruli ablaciis Cvenebebi;sinkope, mdgomareobis Sefaseba (holteriT, eqoskopiiT, eleqtrofiziologiuri kvleviT, maryuJovani implantatoriT da daxrili magidis testiT). Terapiuli da qirurgiuli mkurnalobis meTodebis gansazRvra; antiTrombuli Terapia winagulebis fibrilaciis dros)

•••• perikardiumis daavadebebi mdgomareobis Sefaseba da taqtikis SemuSaveba (mwvave perikarditi: eqsudaciuri, fibrinuli da restriqciuli. (fibrinuli perikarditis da miokardiumis mwvave infarqtis diferencialuri diagnozi; gulis tamponada, perikardiocentezis Cvenebebi; Terapiuli da qirurgiuli mkurnalobis taqtikis gansazRvra);

•••• filtvismieri guli da filtvismieri hipertenzia - mmmmdgomareobis Sefaseba da mkurnalobis taqtikis SemuSaveba da Terapiuli da qirurgiuli mkurnalobis taqtikis gansazRvra (dafiltvis arteriis emboliis, pirveladi da meoradi pulmonaruli hipertenziis Sefaseba);

•••• gulis sarqvlovani paTologia –––– ((((mdgomareobis Sefaseba, Terapiuli da intervenciuli mkurnalobis Cvenebebi aortuli stenozis, aortuli regurgitaciis, mitraluri stenozis da mitraluri regurgitaciis dros. qirurgiuli mkurnalobis meTodis SerCev);

•••• gulis ukmarisoba – (sistoluri da diastoluri, daqveiTebuli da SenarCunebuli gandevnis fraqciiT; gulis ukmarisobis dekompensacia, filtvebis mwvave SeSupeba, diagnostika, mkurnaloba).

Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba

mocemulia cxrili 5mocemulia cxrili 5mocemulia cxrili 5mocemulia cxrili 5----0is saxiT:0is saxiT:0is saxiT:0is saxiT: cxrili # 5

# Teoriuli kursi profesiuli unar-Cvevebi (raodenobis miTiTebiT)

davaleba

1. gulis iSemiuri daavadeba, stabiluri stenokardia, diagnostika, mkurnaloba;

eleqtrokardiografia – 50; eqokardiografiuli gamoklvevis interpretacia 20; holter-monitorirebis interpretacia – 20; gulis eleqtrofiziologiuri gamokvlevis interpretacia - 10; koronaruli angiografiis interpretacia - 10; transezofaguri eqokardioskopiis interpretacia - 5; datvirTvis testebis interpretacia - 10;


28

2222.... mwvave koronaruli sindromi – miokardiumis mwvave infarqti, arastabiluri stenokardia; miokardiumis mwvave infarqtis mqone pacientebis marTva; Trombolizuri Terapiis da angioplastikis Cvenebebi miokardiumis mwvave infarqtis dros;

gul-sisxlZarRvTa daavadebebis rwunebulebebiT gamyarebuli da kvlevis ekonomiuri meTodebis dagegmva da gamoyeneba; mwvave hemodinamikuri darRvevbis adekvaturi Sefaseba da medikamentebis koreqtuli SerCeva; mwvave kardiovaskuluri mdgomareobebis adekvaturi marTa (hemodinamiuri arastabiluroba, mwvave iSemiuri sindromi, mwvave ariTmia, kardio-fulmonuri reanimacia); mwvave gadaudebeli kardiologiuri mdgomareobebis Sefasebisa da marTvis unar-Cvevebi (mwvave koronaruli sindromi – Trombolizisi, pirveladi angioplastika da konservatuli mkurnaloba), urgentuli arteriuli hipertenzia, gulis mwvave ukmarisoba; antikoagulaciuri Terapiis srulyofili codna – varfarini, heparini, antiTrombocituli Terapia; defibrilaciis da intra-aortuli balonizaciis Cvenebebis codna;

3. gulis sarqvlovani paTologiis mqone pacientebis marTva.

4. endokarditis diagnostika, marTva da garTulebebi;

5. kardiomiopaTiebi

6. qirurgiuli pacientebis preoperaciuli Sefaseba;

7. dislipidemiis mniSvneloba, diagnostika, mkurnaloba;

8. gulis ritmis darRveva, diagnostika, mkurnaloba;

9. gulis ukmarisoba, diagnostika, mkurnaloba;

10. arteriuli hipertenzia; moduli 1.4.2. revmatiuli daavadebebirevmatiuli daavadebebirevmatiuli daavadebebirevmatiuli daavadebebi

1. modulis xangrZlivobamodulis xangrZlivobamodulis xangrZlivobamodulis xangrZlivoba ---- 2 Tve2 Tve2 Tve2 Tve 2. modulis mizani:modulis mizani:modulis mizani:modulis mizani: SemaerTebeli qsovilis sistemuri daavadebebis diagnostika,

mkurnaloba da profilaqtika. rotaciis gavlis Semdeg rezidenti

29

srulyofilad unda flobdes revmatiuli profilis daavadebebis Civilebis, simptomebis adekvaturi Sefasebis da pacientis fizikuri kvlevis unar-Cvevebs. mas unda SeeZlos revmatiul daavadebaTa laboratoriuli, instrumentuli da rentgenologiuri gamoklvevebis srulyofili interpretacia, aseve, revmatiuli daavadebebis marTva daavadebis nebismier etapze. rotaciis periodSi rezidents unda miewodos informacia aRniSnuli daavadebebis marTvis Tanamedrove rekomendaciebisa da gaidlainebis saxiT.

3. modulis amocanebi:modulis amocanebi:modulis amocanebi:modulis amocanebi:

• moxdes arTritebis paTofiziologiuri meqanizmis Sefaseba da marTva;

• Sefasdes seronegatiuri spondiloarTriti;

• moxdes SemaerTebelqsovilovani daavadebebis diagnostika da mkurnalobis taqtikis SerCeva;

• moxdes vaskuletebis diagnostika da mkurnalobis taqtikis SerCeva;

• moxdes arasaxsrovani daavadebebis diagnostika da mkurnalobis taqtikis SerCeva;

• revmatiuli daavadebebis CamonaTvali: Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili 6mocemulia cxrili 6mocemulia cxrili 6mocemulia cxrili 6----ia saxiT:ia saxiT:ia saxiT:ia saxiT:

cxrili # 6 Teoriuli kursi profesiuli unar-Cvevebi

(raodenobis miTiTebiT) davaleba

1. SemaerTebeli qsovilis sistemuri daavadebebi (sistemuri wiTeli mglura, sistemuri sklerodermia, dermatomioziti, Segrenis daavadeba, SemaerTebeli qsovilis Sereuli daavadebebi, revmatuli polimialgia, morecidive poliqondriti titces sindromis CaTvliT); 2.sistemuri vaskulitebi (kvanZovani periarteriiti, granulomuri arteriitebi – vegeneris granulomatozi, giganturujredovani temporaluri arteriiti; araspecifikuri aortoarteriiti, hipererguli angiiti, hemoragiuli vaskuliti, gudpasCeris sindromi, Sereuli krioglogulinemia, maoblitirebeli Trombagniiti, bexCetis sindromi, kavasakis sindromi. 3.revmatoiduli arTriti (serodadebiTi da seronegatiuri poliarTriti, revmatoiduli arTriti sistemuri gamovlinebebiT, feltis sindromi); 4.iuveniluri arTriti (iuveniluri revmatoiduli arTriti – stilis sindromi, iuveniluri qronikuli arTriti); 5.maankilozirebadi spondiloarTriti – bexterevis daavadeba; 5.spondiloarTritTan Serwymuli arTritebi (fsoriazuli arTriti, reiteris daavadeba, nawlavebis qronikul araspecifikur daavadebebTan asocirebuli arTritebi); 7.infeqciur daavadebebTan asocirebuli arTritebi; 8.mikrokristaluri arTritebi (podagra,

1. revmatiul daavadebaTa diangostika:

• anamnezis Segroveba

• pacientis obieqturi gamokvleva

• sisxlis da Sardis bioqimiuri da klinikur-laboratoriuli kvlevis principebi, daniSnuleba da interpretacia

• serologiuri kvlevis principebi, gansakuTrebiT sistemuri daavadebebis dros. specifikuri antisxeulebis interpretacia da marTva mkurnalobis procesSi;

• sayrden-mamoZravebeli sistemis rentgenologiuri gamokvlevis interpretacia;

• saxsarSida manipulaciebi: medikamentebis saxsarSida Seyvana – 20;

• saxsris diangostikuri punqcia – 20;

• saxsrebis sonografiuli monacemebis


30

psevdopodagra, qondrokalcinozi); 9.osteorarTrozebi; 10.saxsargareSe rbili qsovilebis daavadebebi.

interpretacia;

• osteodensitometriuli kvlevis interpretacia.

aucilebeli da rekomendirebuli literaturis nusxaaucilebeli da rekomendirebuli literaturis nusxaaucilebeli da rekomendirebuli literaturis nusxaaucilebeli da rekomendirebuli literaturis nusxa

1. d.tvildiani, b.kandelaki - "Sinagan daavadebaTa sindromuli diferenciuli diagnostika da gadaudebeli Terapia", 2000 w.

2. n.tatiSvili. g. simonia - "Sinagani sneulebani", 1998 3. Merck Manual (rusul an inglisur enebze) 4. Harrison-is mravaltomeuli Sinagan medicinaSi 5. r.heglini – Sinagan daavadebaTa diferenciuli diagnostika

damxmare literatura: monografiebi da Sesabamisi saitebi internetdamxmare literatura: monografiebi da Sesabamisi saitebi internetdamxmare literatura: monografiebi da Sesabamisi saitebi internetdamxmare literatura: monografiebi da Sesabamisi saitebi internet----SiSiSiSi muxli 5. moduli 1.5. muxli 5. moduli 1.5. muxli 5. moduli 1.5. muxli 5. moduli 1.5. mtkicebiTi medicinis da samedicino statistikimtkicebiTi medicinis da samedicino statistikimtkicebiTi medicinis da samedicino statistikimtkicebiTi medicinis da samedicino statistikis safuZvlebi. s safuZvlebi. s safuZvlebi. s safuZvlebi.

1. modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa ---- 2 kv. (72 sT.) 2 kv. (72 sT.) 2 kv. (72 sT.) 2 kv. (72 sT.) 2. modulis mizaniamodulis mizaniamodulis mizaniamodulis mizania - rezidentis/specialobis maZieblisaTvis mtkicebiTi

medicinis da samedicino statistikis codnis amaRleba da maT praqtikul saqmianobaSi aRniSnuli disciplinebis principebisa da meTodebis danergvis xelis Sewyoba.

3. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: 1) klinikur praqtikaSi gamoyenebuli mtkicebiTi medicinis ZiriTadi

principebi 2) randomizirebuli klinikuri gamocdis Sedegebi, maTi validuroba,

mniSvneloba da praqtikuli Rirebuleba 3) meta analizi meta-analizis Sedegebi, maTi validuroba, mniSvneloba da

praqtikuli Rirebuleba 4) klinikuri gaidlainis validuroba da praqtikuli Rirebuleba 5) diagnostikuri testis Sesaxeb arsebuli mtkicebulebis validuroba da

praqtikuli Rirebuleba 6) prognozis Sesaxeb arsebuli mtkicebulebis validuroba da praqtikuli

Rirebuleba 7) dadasturebuli efeqturobis mqone intervenciebis moZieba da maTi

konkretul klinikur situaciebTan misadageba 8) koxranis biblioTeka 9) internetis eleqtronuli bazebi, romlebic iZlevian informacias efeqturi

intervenciebisa da gaidlainebis Sesaxeb 10) samedicno literaturis kritikulad aRqma 11) jandacvasa da medicinaSi statistikis roli da mniSvneloba, is ZiriTadi

sferoebi, sadac gamoiyeneba statistikis meTodebi. 12) monacemTa tipebi, maTi grafikuli gamosaxva; normaluri distribuciis

daxasiaTeba, variaciis gazomva. monacemTa standartizacia 13) albaTobis principebi da kanonebi maTi misadageba populaciis

parametrebisa da sinjis distribuciis maxasiaTeblebisadmi. 14) statistikuri analizis bazisuri principebi (Sefaseba, hipoTezis testireba,

statistikuri modelireba). 15) jgufebis Sedareba. 16) or uwyvet cvlads Soris damokidebuleba, korelacia da wrfivi regresia. 17) ramdenime cvlads Soris damokidebuleba, mravlobiTi regresiis analizis. 18) kompiuteris gamoyeneba monacemTa analizisaTvis, statistikuri programebis

tipebis garCeva, kompiuteruli analizis strategia, monacemTa bazis formireba.

31

4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili # 7mocemulia cxrili # 7mocemulia cxrili # 7mocemulia cxrili # 7----is saxiT:is saxiT:is saxiT:is saxiT:

cxrili # 7 Teoriuli kursi davaleba

mtkicebiTi medicinis arsi, ZiriTadi principebi da strategia, mtkicebiTi samedicino praqtika da misi komponentebi, koxranis kolaboracia.


randomizirebuli klinikuri gamocda, klinikuri gamocdis dizaini da tipebi, klinikuri gamocdis Sedegebis validuroba, mniSvneloba, da praqtikuli Rirebuleba


meta-analizis meTodi, meta-analizis Sedegebis validuroba, mniSvneloba, da praqtikaSi gamoyenebiToba, koxranis kolaboraciis sistemuri mimoxilvis jgufebi


diagnozi da skriningi, diagnostikuri testis diagnostikuri Rirebuleba, diagnostikuri testis Sesaxeb arsebuli mtkicebulebis validuroba da praqtikuli Rirebuleba

testireba

daavadebis naturaluri istoria da prognozi, prognozis Sesaxeb arsebuli mtkicebulebis validuroba da praqtikuli Rirebuleba, klinikuri gaidlaini, misi validuroba da praqtikuli Rirebuleba

monacemTa tipebi (daTvla da gazomva), Sefardeba, proporcia, procenti, daTvladi da gazomvadi monacemebis grafikuli gamosaxva, normaluri distribucia, saSualo, moda, mediana, monacemTa variabeluroba, variaciis gazomva, populacia da sinji, populaciis parametris distribucia, sinjis saSualos distribucia, ori sinjis saSualos sxvaobis distribuci

albaToba, albaTobis kanonebi, normaluri mrudis standartizacia, normaluri standartuli mrudi, Z da misi mniSvneloba.

statistikuri analizis principebi, Sefaseba (95% sarwmunoobis intervali), hipoTezis testireba (nulovani hipoTeza, alternatiuli hipoTeza, I da II tipis Secdoma), Sefaseba Tu hipoTezis testireba

jgufebis Sedareba - uwyveti monacemebi, analizis Sesabamisi meTodis amorCeva, t distribucia, ori sinjis saSualos sxvaoba, t testi,

jgufebis Sedareba – kategoriuli monacemebi, proporcia, ori damoukidebeli jgufis proporcia, 2 x 2 cxrili – ori jgufis proporciis Sedareba, ramdenime jgufis proporciis Sedareba, riskebis Sedareba (SedarebiTi riski, Sansebis Sefardeba)

or uwyvet cvlads Soris damokidebuleba, korelacia da misi testireba, korelaciis gamoyeneba, interpretacia, martivi wrfivi regresia

ramdenime cvlads Soris damokidebuleba, mravlobiTi wrfivi regresia

monacemTa standartizacia

5. modumodumodumodulis Sefasebis meTodebi lis Sefasebis meTodebi lis Sefasebis meTodebi lis Sefasebis meTodebi

modulis dasrulebis Semdeg rezidentma/specialobis maZiebelma unda icodes/SeeZlos:

a. klinikur praqtikaSi mtkicebiTi medicinis principebis gamoyeneba

32

b. randomizirebuli klinikuri gamocdis Sedegebis interpretireba, maTi validurobis, mniSvnelobis da praqtikuli Rirebulebis dadgena

c. meta-analizis Sedegebis interpretireba, maTi validurobis, mniSvnelobis da praqtikuli Rirebulebis dadgena

d. klinikuri gaidlainis validurobisa da praqtikuli Rirebulebis dadgena

e. diagnostikuri testis Sesaxeb arsebuli mtkicebulebis validurobisa da praqtikuli Rirebulebis dadgena

f. prognozis Sesaxeb arsebuli mtkicebulebis validurobisa da praqtikuli Rirebulebis dadgena

g. dadasturebuli efeqturobis mqone intervenciebis moZieba da maTi konkretul klinikur situaciebTan misadageba

h. koxranis biblioTekiT sargebloba i. internetis eleqtronuli bazebiT sargebloba, romlebic iZlevian

informacias efeqturi intervenciebisa da gaidlainebis Sesaxeb j. samedicno literaturis kritikulad aRqma k. jandacvasa da medicinaSi statistikis rolisa da mniSvnelobis axsna, im

ZiriTadi sferoebis dasaxeleba, sadac gamoiyeneba statistikis meTodebi. l. monacemTa tipebis garCeva, maTi grafikuli gamosaxva; normaluri

distribuciis daxasiaTeba, variaciis gazomva. m. albaTobis principebisa da kanonebis misadageba populaciis

parametrebisa da sinjis distribuciis maxasiaTeblebisadmi. n. statistikuri analizis bazisuri principebis gamoyeneba (Sefaseba,

hipoTezis testireba, statistikuri modelireba). o. jgufebis Sedareba rogorc uwyveti ise kategoriuli monacemebisaTvis;

aRniSnuli analizis Sedegebis interpretacia. p. or uwyvet cvlads Soris damokidebulebis axsna korelaciisa da wrfivi

regresiis saSualebiT, maTi Sedegebis interpretacia. q. ramdenime cvlads Soris damokidebulebis axsna mravlobiTi regresiis

analizis saSualebiT, Sedegebis interpretacia. r. kompiuteris gamoyeneba monacemTa analizisaTvis, statistikuri

programebis tipebis garCeva, kompiuteruli analizis strategia, monacemTa bazis formireba.


1. Sackett DL, Straus SE, Scott Richardson W, Rosenberg W, Brian Haynes R. Evidence Based Medicine: How to Practice and Teach EBM. Churchill Livingstone, 2000.

2. letcher RH, Fletcher SW, Wagner EH. Clinical Epidemiology: the Essentials, Williams & Wilkins, 1996.

3. Rothman KJ. Epidemiology: An Introduction. Oxford University Press, 2002.

4. Rothman KJ, Greenland S. Modern Epidemiology, Lippincott Williams & Wilkins, 1998.

5. eaglehole R, Bonita R, Kjellstrom T. Basic Epidemiology, World Health Organization, Geneva, 1993.

6. Jadad AR. Randomized Clinical Trials: A User Guide, BMJ Publishing Group, 1999.

7. ltman DG. Practical Statistics For Medical Research, Chapman & Hall/CRC, 2005.

8. Last JM. A Dictionary of Epidemiology, Fourth Edition, Oxford University Press, 2006.

9. Altman DG. Practical Statistics For Medical Research, Chapman & Hall/CRC, 1999

10. Puri BK. Statistics for the Health Sciences, Sunders, 1996.

11. Castle WM, North PM. Statistics in Small Doses, Churchill Livingstone, 1995.

12. Clayton D, Hills M. Statistical Models in Epidemiology, Oxford University Press, 1998.

33

13. Breaslow NE, Day NE. Statistical Methods in Cancer Research. Volume 1, The Analysis of Case-Control.

14. Studies, IARC Scientific Publications No. 32, 1980.

15. Breaslow NE, Day NE. Statistical Methods in Cancer Research. Volume II, The Design and Analysis of Cohort Studies, IARC Scientific Publications No. 82, 1987.

16. Rothman KJ, Greenland S. Modern Epidemiology, Lippincott Williams & Wilkins, 1998.

17. Beaglehole R, Bonita R, Kjellstrom T. Basic Epidemiology, World Health Organization, Geneva, 1993.

muxli 6. moduli 1.6. muxli 6. moduli 1.6. muxli 6. moduli 1.6. muxli 6. moduli 1.6. sazogadoebrivsazogadoebrivsazogadoebrivsazogadoebrivi jandacva da epidemiologia.i jandacva da epidemiologia.i jandacva da epidemiologia.i jandacva da epidemiologia. 1. modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa - 2 kv. (72 sT.)2 kv. (72 sT.)2 kv. (72 sT.)2 kv. (72 sT.) 2. modulis mizaniamodulis mizaniamodulis mizaniamodulis mizania - modulis mizania rezidentis/specialobis maZieblisaTvis

programis mizania msmenelTa Soris sazogadoebrivi jandacvis safuZvlebis codnis amaRleba da aRniSnuli disciplinis principebisa da meTodebis praqtikul saqmianobaSi gamoyenebis SesaZleblobis xelSewyoba

3. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: 1) sazogadoebrivi jandacvis politika; 2) sazogadoebrivi jandacvis programebi da maTi prioritetebi; 3) sazogadoebrivi jandacvis programaTa dagegmva da marTva; 4) mosaxleobis janmrTelobis mdgomareobis damaxasiaTebeli ZiriTadi

maCveneblebi (daavadebis gavrceleba da sixSire, letaloba); 5) vitaluri statistikis ZiriTadi maCveneblebi (sikvdiloba, bavSvTa

sikvdiloba, dedaTa sikvdiloba, Sobadoba, sicocxlis xangrZlivoba); 6) jandacvis marTis sainformacio sistemebi 7) Tanamedrove epidemiologia, epidemiologiuri kvlevebis tipebi-

observaciuli da eqsperimentuli kvlevebi 8) infeqciur daavadebaTa epidemiologia, epidemia da endemia, transmisia, 9) epidemiologiuri kvlevebis tipebi-onservaciuli da eqsperimentuli

kvlevebi 10) epidemiologiuri kvlevebis potenciuri DSecdomebi 11) epidemiologiuri kvlevebis validurobis Sefaseba 12) mizezi da mizez-Sedegobrioba epidemiologiaSi, mizez-Sedegobriobis

kriteriumebi 13) infeqciur daavadebaTa epidemiologia,epidemia da endemia, transmisia,

bazisuri reproduqciuli ricxvi, maspinZeli da garemo pirobebi 14) epidemilogia da prevencia,prevenciis sagani da mniSvneloba. midgomabi

prevenciasa da kontrolSi. 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba

mocemulia cxrili mocemulia cxrili mocemulia cxrili mocemulia cxrili # 8# 8# 8# 8----is saxiT:is saxiT:is saxiT:is saxiT: cxrili # 8

Teoriuli kursi davaleba mosaxleobis janmrTelobis mdgomareobis maxasiaTeblebi. daavadebis gavrceleba, daavadebis sixSire, kumulaciuri sixSire da riski, letaloba

vitaluri statistika, sikvdiloba, bavSvTa sikvdiloba, dedaTa sikvdiloba, Sobadoba, sicocxlis xangrZliba, monacemTa standartizacia.

prezentaciebis ganxilva

statistikur monacemebi (tipebi, Sefardeba, proporcia, procenti, monacemebis grafikuli gamosaxva, normaluri distribucia, saSualo, moda, mediana)


statistikuri analizis principebi (jgufebis Sedareba) testireba

hipoTezis testireba da Sefaseba (sarwmonoobis intervali, statistikuri

34

sarwmunooba) saz. jandacvis koncefcia (gansazRvreba, fokusi, saz. Jandacvis determinantebi, saz. jandacvis ZiriTadi funqciebi)

saz. jandacvis praqtika (RonisZiebebi, prevenciis programebi, saz. janfacvis reforma saqarTveloSi)


Tanamedrove epidemiologia (istoriuli konteqsti, sagani, janmrTelobisa da avadmyofobis gazomva)

epidemiologiuri kvlebi. dakvirvebadi da eqsperimentuli kvlevebi

qronikul daavadebaTa epidemiologia da kontroli, gulsisxlZarRvTa daavadebebi, kibo, Saqriani diabeti

Tambaqo da alkoholi (saz. jandacvis programebi, maTi dizaini da implementacia

epidemiologia da prevencia, prevenciis doneebi, miodgomrbi prevenciasa da kontrolSi.

epidemiologiri kvlevebis potenciuri Secdomebi

mizezi da mizez Sedegobrioba epidemiologiaSi infeqciuri daavadebebis epidemiologia

epidemia da endemia, bazisuri reproduqciuli ricxvi

5. modulis Sefasmodulis Sefasmodulis Sefasmodulis Sefasebis meTodebi ebis meTodebi ebis meTodebi ebis meTodebi

- sazogadoebrivi jandacvis politikis formireba; - sazogadoebrivi jandacvis programebisaTvis prioritetebis gansazRvra; - sazogadoebrivi jandacvis programaTa dagegmva da marTva; - mosaxleobis janmrTelobis mdgomareobis daxasiaTeba ZiriTadi

maCveneblebis mixedviT (daavadebis gavrceleba da sixSire, letaloba); - vitaluri statistikis ZiriTadi maCveneblebis gamoyeneba da interpretacia

(sikvdiloba, bavSvTa sikvdiloba, dedaTa sikvdiloba, Sobadoba, sicocxlis xangrZlivoba);

- epidemiologiuri kvlevebis validurobis Sefaseba - infeqciur daavadebaTa epidemiologiis safuZvlebis praqtikaSi gamoyeneba - infeqciur daavadebaTa epidemiis gamokvlevis, zedamxedvelobis da

kontrolis bazisuri principebis praqtikaSi gamoyeneba - prevenciis potencialisa da efeqturobis Sefaseba .

6. aucilebeli aucilebeli aucilebeli aucilebeli da rekomendebuli literaturis nusxa: da rekomendebuli literaturis nusxa: da rekomendebuli literaturis nusxa: da rekomendebuli literaturis nusxa:

1. Health information systems for low income countries: An overview, Canadian Society for International Health 2. Elizabeth A. McGlynn (Editor), et al. Health Information Systems : Design Issues and Analytic Applications (Directions in Health Services Research and Policy), 2001 3. Beaglehole R, Bonita R, Kjellstrom T. Basic Epidemiology, World Health Organization, Geneva, 1993 4. Puri BK. Statistics for the Health Sciences, Sunders, 1996 5. Training manual - Reporting and recording documentation for monitoring immunization work in Georgia: Level 1 - providers of immunization services. PHRplus/ CIF 6. Training manual - Reporting and recording documentation for monitoring immunization work in Georgia: Level 2 – immunization managers, public health managers, and polyclinic managers. PHRplus/ CIF 7. Guidelines for health care providers for integrated surveillance and control of vaccine preventable diseases in Georgia. PHRplus/ CIF 8. MOH decree # 101/n, Georgi 9. 9 Rothman KJ, Greenland S. Modern Epidemiology, Lippincott Williams & Wilkins, 1998

35

10. 10 Rothman KJ. Epidemiology: An Introduction. Oxford University Press, 2002 11. 11 Beaglehole R, Bonita R, Kjellstrom T. Basic Epidemiology, World Health Organization, Geneva, 1993 12. 12 Breaslow NE, Day NE. Statistical Methods in Cancer Research. Volume 1, The Analysis of Case-Control Studies, IARC Scientific Publications No. 32, 1980 13. Breaslow NE, Day NE. Statistical Methods in Cancer Research. Volume II, The Design and Analysis of Cohort Studies, IARC Scientific Publications No. 82, 1987 14. James J. Schlesselman. Case Control Studies : Design, Conduct, Analysis , 1999 15. Elizabeth A. McGlynn (Editor), et al. Health Information Systems : Design Issues and Analytic Applications (Directions in Health Services Research and Policy) , 2001 16. Roger Webber. Communicable Disease Epidemiology and Control, 2000 17. Last JM. A Dictionary of Epidemiology, Fourth Edition, Oxford University Press, 2001 18. Rothman KJ, Greenland S. Modern Epidemiology, Lippincott Williams & Wilkins, 1998 19. Rothman KJ. Epidemiology: An Introduction. Oxford University Press, 2002 20. Beaglehole R, Bonita R, Kjellstrom T. Basic Epidemiology, World Health Organization, Geneva, 1993 21. Breaslow NE, Day NE. Statistical Methods in Cancer Research. Volume 1, The Analysis of Case-Control Studies, IARC Scientific Publications No. 32, 1980 22. Breaslow NE, Day NE. Statistical Methods in Cancer Research. Volume II, The Design and Analysis of Cohort Studies, IARC Scientific Publications No. 82, 1987 23. James J. Schlesselman. Case Control Studies : Design, Conduct, Analysis , 1999 24. Elizabeth A. McGlynn (Editor), et al. Health Information Systems : Design Issues and Analytic Applications (Directions in Health Services Research and Policy) , 2001 25. Roger Webber. Communicable Disease Epidemiology and Control, 2000 26. Last JM. A Dictionary of Epidemiology, Fourth Edition, Oxford University Press, 2001

Tavi VIIITavi VIIITavi VIIITavi VIII. profesiuli mzadebis II wlis modulebi. profesiuli mzadebis II wlis modulebi. profesiuli mzadebis II wlis modulebi. profesiuli mzadebis II wlis modulebi

muxli 1. muxli 1. muxli 1. muxli 1. moduli moduli moduli moduli 2.2.2.2.1. 1. 1. 1. SeZenili da Tandayolili anemiebi. anemiebi SeZenili da Tandayolili anemiebi. anemiebi SeZenili da Tandayolili anemiebi. anemiebi SeZenili da Tandayolili anemiebi. anemiebi sxvadasxva daavadebebis drossxvadasxva daavadebebis drossxvadasxva daavadebebis drossxvadasxva daavadebebis dros

1. modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa 2222 TveTveTveTve 2. modulis mizani:2. modulis mizani:2. modulis mizani:2. modulis mizani:

modulis mizania eqim-klininicistebs miawodos amomwuravi informacia sxvadsxva genezis anemiebis diagnostikis uaxlesi teqnologiebis da mkurnalobis Tanamedrove meTodebis Sesaxeb.

3. 3. 3. 3. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: P klinikur praqtikaSi (romelic moicavs klinikuri medicinis TiTqmis yvela dargs) didi mniSvneloba eniWeba anemiuri sindromis ZiriTadi aspeqtebis codnas. Aanemia SeiZleba iyos sxvadasxva daavadebis pirveladi gamovlineba. yoveldRiuri praqtikul saqmianobaSi klinicisti did siZneleebs awydeba anemiis genezis verificirebisa da Sesabamisi mkurnalobis SemuSavebisas. Uukanasknel wlebSi Seicvala midgoma im anemiebis mimarTac, romlebic viTardeba saxvadasxva qronikuli daavadebebis dros. AamJamad es anemiebi gamoyofilia calke jgufebad. maTi mkurnaloba moiTxovs did praqtikul gamocdilebasTan erTad diagnostikis axali teqnologiebisa da Terapiis Tanamedrove meTodebis codnas. programis farglebSi gaTvaliswinebuli masalis aTvisebis Semdeg eqimma droulad unda SeZlos anemiuri sindromis gamovlena, anemiis genezis gansazRvra diferencialuri daignostikis algoriTmebze dayrdnobiT, mkurnalobis optimaluri taqtikis SemuSaveba anemiuri sindromis kupirebis mizniT.

5.5.5.5. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili #mocemulia cxrili #mocemulia cxrili #mocemulia cxrili #9999 saxiT:saxiT:saxiT:saxiT:

cxrili # 9

Teoriuli kursi profesiuli unar-Cvevebi Sesasrulebeli

manipulaciis

raodenoba

davaleba

36

cneba eriTronis Sesaxeb (sisxlmbadi qsovilis erT-erTi mniSvnelovani sistema, romelic moicavs a) eriTropoezis winamorbed, b) morfologiurad identificirebad, g) hemoglobinis masinTezirebel ujredebs da d) mwife ujredebis klasebs). eriTrocitebis produqcia. ZiriTadi aspeqtebi. araefeqturi eriTropoezis cneba.

periferiuli sisxlis nacxis da retikulocitebis preparatis damzadeba (aReba, SeRebva). eriTrocitebis morfologiuri Taviseburebebis Sefaseba. retikulocitebis raodenobis gansazRvra. Zvlis tvinis aReba, preparatebis damzadeba, SeRebva. medulogramaSi eriTropoezis raodenobrivi da Tvisobrivi maCveneblebis gansazRvra. hematokritis gansazRvra. jgufis da rezusis gansazRvra. samkurnalo procedurebi: eriTrocituli masis transfuziisas jvaredini SeTavsebis da biologiuri cdis Catareba. sisxlis komponentebis transfuziis proceduris Catareba. posttransfuziuli garTulebebis prevencia, mkurnaloba. hemolizuri krizis gadaudebeli daxmareba anemiuri komis prevencia, mkurnaloba.

anemiebi. klasifikacia. anemiis ZiriTadi paTogenezuri faqtorebi;

rkinadeficituri anemiebi. epidemiologia. ganviTarebis ZiriTadi mizezebi; diferenciuli diagnozi. mkurnaloba.

megaloblasturi anemiebi. klasifikacia. diferenciuli diagnozi. mkurnaloba. porfirinebis sinTezis moSliT ganpirobebuli Tandayolili da SeZenili anemiebi, paTogenezi, mkurnaloba.

Tandayolili da SeZenili hemolizuri anemiebi. parcialuri wiTelujredovani aplazia. SeZenili da Tandayolili formebi. diagnostikuri kriteriumebi. prognozi. anemiebi qronikuli daavadebebis dros. etiopaTogenezi, klinikuri suraTi, diferencialuri diagnozi, mkurnaloba.

aplastiuri anemia.


diskusia, testi, referati, moxseneba, 1-jer TveSi

3. aucilebeli da rekomendebuli literaturis nusxa:aucilebeli da rekomendebuli literaturis nusxa:aucilebeli da rekomendebuli literaturis nusxa:aucilebeli da rekomendebuli literaturis nusxa:

1. Руководство по Гематологии: в 3т. Т1 под ред. А.И. Воробьева. Москва 2002г. 280с 2. Воробьев П.А. Анемический синдром в клинической практике, Москва 2001г. 168с 3. Гусева С.А., Вознюк В.П. Болезни системы крови. Справочник. Москва 2004г .489с 4. Дворецкий Л.И. Железодефицитные анемии, Москва 1998г. 37с 5. Козинец Г.И. Интерпретация анализов крови и мочи. Клиническое значение анализов, Москва 1995г. 123с 6. Новик А.А. Богданов А. Н. Анемии (от А до Я), Санкт-Петербург 2004г. 315с 7. Михаилова Е.А., Ядрихинская В. Н. Савченко В.Г. Апластические анемии и вирусные гепатиты (постгепатитные апластические анемии) // Тер. архив – 1999г. №7 С64-69 8. Михаилова Е.А., Савченко В.Г. Устинова Е.Н. Эффективность циклоспорина А в лечении больных апластической анемией // Тер. архив – 2001г. №7 С56-61 9. Румянцев А.Г. , Морщакова Е.Ф., павлов А.Д. Эритропоэтин, Москва 2002г. 397с.

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10. Шиффман Фред Дж. Патофизиология крови, Санкт-Петербург 2000г. 250с 11. Шиффман Фред Дж. Патофизиология анемии, Санкт-Петербург 2000г. 446с 12.Смирнов А.Н. «Болезни крови» Москва, 2005 13. Козинец Г.И., Погорелов В.М., Дягилева О. А., Наумова И.Н. «Кровь», Москва 2006 14.Bacigalippo A., Bruno B., Saracco P., et al. Antilymphocyte globuline, cyclophosphamide, prednisolone, and granulocyte colony-stimulating factor for severe aplastic anemia : an update of the GITMO/EBMT study of 100 patients // Blood. – 2000. –vol.95, #6- p 1931-1934. 15. Baer A. N., Dessypris E. N. krantz S. B. The pathogenesis of anemia in theumatoid arthritis: a clinical and laboratory analysis // Eur. J. Clin. Invest.-1995.Vol. 25. p383-389 16. Brown K.E. Tisdale J., Dunbar et al., Hepatitis-associated aplastic anemia// N. Engl. J. Med.-1997-vol336-p1059-1062 17. Cash J.M., Sears D.A. The Anemia of chronic diseases in series unselected hospitalized patients // Am.J. Med.- 1989 – Vol 87 – p 638-642 18. Hematology: basic principles and practice/ed BybRoland Hofman et al., 3td ed.- Churchfull livingstone, 2000. -2584p 19.Horne D.W. transport of Folates and antifolates in liver// Proc. Soc.Exp. Biol. Med.-1993.-Vol.202.- p385-390. 20. Littlewood T.j. Cella D., Nortier J.W,R., Erythropoetin o\improves quality of life // The Lancet Oncology. – 2002. –Vol.3 #8 – p235-239 21. Ludwig H., Fritz E., Leitgeb C.et al., prediction of response to erythropoetin treatment in chronic anemia of cancer// Blood. – 1994. – Vol.84.- p 1056-1059 22. Wintrope’s clinical hematology/ ed.by D.W.Pine, Jr, 11th ed. – Williams&Wilkins, 1999 23.Young N.S. Maciejewski J. The pathophysiology of acquired aplastic anemia// N. Eng. J. Med.- 1997. Vol.336.- p 1365-1370 24. Zecca M., De Stefano p., Nobeli B., Locatelli F. Anti-CD20 monoclonal antibody for the treatment of severe, immune-mediated, pure cell aplasia amd hemolitic anemia// Blood – 2001.- Vol.97.#12- p 3995-3997

muxli 2. muxli 2. muxli 2. muxli 2. moduli moduli moduli moduli 2.2.2.2.2. 2. 2. 2. mwvave lekemiebis diagnostikis da mkurnalobis mwvave lekemiebis diagnostikis da mkurnalobis mwvave lekemiebis diagnostikis da mkurnalobis mwvave lekemiebis diagnostikis da mkurnalobis Tanamedrove principebiTanamedrove principebiTanamedrove principebiTanamedrove principebi

1. modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa 3 Tve3 Tve3 Tve3 Tve 2. modulis mizaniamodulis mizaniamodulis mizaniamodulis mizania mwvave leikemiebis biologiis, diagnostikis, klasifikaciis

da mkurnalobis Tanamedrove principebis Seswavlas. 3. 3. 3. 3. modulis amocanebi:modulis amocanebi:modulis amocanebi:modulis amocanebi: modulis gavlis Semdeg rezidentma unda icodes: mwvave leikemiebis biologia, citogenetikuri, molekulur-biologiuri, imunologiuri meqanizmebi, mwvave leikemiebis Tanamedrove klasifikacia, diagnostikis kriteriumebi: klinikuri, hematologiuri, morfologiuri (citologiuri, citoqimiuri), imunologiuri, citogenetikuri. mwvave leikemiebis klinika (ZiriTadi klinikuri sindromebi), ganviTarebis dinamika, stadiebi. mkurnalobis Tanamedrove principebi, qimioTerapia, sxivuri Terapia, imunoTerapia, Rerovani ujredebis da Zvlis tvinis transplantacia. mkurnalobis alternatiuli meTodebi. rezistentuli formebis mkurnaloba. cneba wamlismieri da SedarebiTi rezistentobis Sesaxeb. dacviTi mkurnaloba. komponenturi Terapia. neiroleikemia, misi prevencia da mkurnaloba.

4. 4. 4. 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # 10101010 saxiT:saxiT:saxiT:saxiT:

cxrili # 10


manipulaciis

raodenoba

davaleba

38

mwvave leikemia - ZiriTadi debulebebi, statistikuri monacemebi, etiologia, diagnostikuri kriteriumebi, diferenciuli diagnostika, pirveladi gamokvlevebi, daavadebis bunebrivi mimdinareoba da prognozi, garTulebebi, mkurnaloba da Semdgomi dakvirveba

avadmyofis obieqturi mdgomareobis Sefaseba periferiuli sisxlis gamokvleva. periferiuli sisxlis nacxis damzadeba, Zvlis tvinis punqcia ,trepanobiofsia, qimioTerapiis procedura, mukozitebis sawinaaRmdego procedurebis Catareba, Tavzurgtvinis arxSi medikamentebis Seyvana, mJave-tutovani wonasworobis darRvevis gansazRvra da misi koreqcia

5.5.5.5.modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi


6.6.6.6. aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa:

1. Chang K.L., O’Donell M. R. ,SlovakM.L .et all “Primary mielodisplazia in adults under 50 years old: a clinicopathologic study of 52 patients. Leukemia, 2202; 16, 623-631 2. De Writte T. et all “ A recent study that evaluated 184 patients with MDS or secondory AML after MDS, who underwent induction therapy with conventional chemotherapy, folloudedby consolidation and an allogeneic or autologous transpleant depending on donor aviability” Blood, 2001, 98:2326-2331 3. Steensman d.p. et all “ Antithymocite globulin has limited efficacy and substantial toxicity in inselected anemic patients with myelodysplastic syndrome” Blood, 2003,101:2156-2158 4. Fenduse P. et all “ Cytogenetics of myelodisplastic syndromes” Semin. Hematol. , 1996, 33:127-38 5. Greenberg P. at all “Hematology (American Society Hematology Education book)” 2002, 136-61 6. Jaffe E.S., Harris N.L., Stein H, Vardiman J.W et all World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Haematopoetic and Lymphoid Tissues, Lyon< France, IARC, 2001. 7. National Comprehensne cancer Network, Clinical Practice Guidelines in oncology. 2004, vol.1 8. Cheson B.D. et all “Novel therapeutic agents for the treatment of myelodisplastic syndromes” Semin.

Oncology< 2000, 27:560-77 9. Rigolin G.M., Bigoni R et all “Clinical importance of interphase cytogenetics detecting occult

chromosome lesions in myelodisplastic syndromes with normal kariotype.” Leukemia, 2001, 15:1841-7

10. Nossilingen T., Reiser R et all “Myelodisplastic syndromes from French-American-British to World Health Organization: comparison of classification on 431 unselected patients from a single institution” Blood, 2001, 98:2435-41

muxli muxli muxli muxli 3333. . . . moduli moduli moduli moduli 2. 2. 2. 2. 3333. . . . qronikuli mieloproliferaciuli daavadebebiqronikuli mieloproliferaciuli daavadebebiqronikuli mieloproliferaciuli daavadebebiqronikuli mieloproliferaciuli daavadebebi modulis xangrZlivoba:modulis xangrZlivoba:modulis xangrZlivoba:modulis xangrZlivoba: 3 Tve 3 Tve 3 Tve 3 Tve modulis mizanimodulis mizanimodulis mizanimodulis mizania a a a qronikuli mieloiduri leikemiis, subleikemiuri mielozis, WeSmariti policitemiis biologiis, etiologiis, diagnostikisa da mkurnalobis Tanamedrove principebis Seswavla

modulis amocanebimodulis amocanebimodulis amocanebimodulis amocanebi:::: P rezidentma modulis gavlis Semdeg unda icodes: 1. qr. mieloiduri leikemiis biologia, citogenetikuri, molekulur-biologiuri, citoqimiuri Taviseburebebi. diagnostikis kriteriumebi: klinikuri, hematologiuri, morfologiuri, citogenetikuri, molekuler-biologiuri, citoqimiuri. qr.

39

mieloiduri leikemiis klinika, ZiriTadi klinikuri sindromebi, ganviTarebis dinamika, stadiebi. klinikuri formebi(bavSvTa, iuveniluri da mozrdilTa forma). mkurnalobis Tanamedrove principebi – monoqimioTerapia, imunoTerapia, poliqimioTerapia, Zvlis tvinis transplantacia. mkurnalobis axali principebi, prognozi. 2. subleikemiuri mielozis daignostikis kriteriumebi: klinikuri, hematologiuri, histomorfologiuri, citoqimiuri. Hhemopoezis funqciur-topografiuli Taviseburebebi. klinika: ZiriTad klinikuri sindromebi, ganviTarebis dinamika, stadiebi (morfogenezis formebi), imunuri garTulebebi. mkurnalobis Tanamedrove principebi: monoqimioTerapia, imunuri garTulebebs mkurnaloba, spleneqtomiis Cveneba. reducirebuli hemopoezis mkurnaloba. ImunoTerapia. blasturi krizis murnaloba. dacviTi mkurnaloba. komponenturi Terapia. 3. WeSmariti policitemiis biologia - citogenetikuri, molekulur-biologiuri darRvevebi. diagnostikis kriteriumebi: klinikuri, histomorfologiuri, citogenetikuri, radiologiuri, citoqimiuri. WeSmariti policitemiis klinika: ZiriTadi klinikri sindromebi, ganviTarebis dinamika, stadiebi. WeSmariti policitemiis garTulebebi. mkurnalobis Tanamedrove principebi: citaferezi, monoqimioTerapia, imunoTerapia, trombozebis, Trombohemoragiuli garTulebebis prevencia da mkurnaloba. WeSmariti policitemiiT daavadebulTa socialuri adaptacia da reabilitaciis problemebi 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili #mocemulia cxrili #mocemulia cxrili #mocemulia cxrili #11111111 saxiT:saxiT:saxiT:saxiT:

cxrili # 11


manipulaciis raodenoba davaleba

qronikuli mieloiduri leikemia

avadmyofis obieqturi mdgomareobis Sefaseba. periferiuli sisxlis gamokvleva. Zvlis tvinis punqciis da trepanobiofsiis Catareba Zvlis tvinis citologiuri da histologiuri gamokvleva.qimioTerapiis Catareba. daavadebis da qimioTerapiis garTulebaTa sawinaaRmdego RonisZiebaTa ganxorcieleba.Sededebis sistemis mdgomareobis Sefaseba – riskis gansazRvra.

subleikemiuri mielozi WeSmariti policitemia

modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi


aucilebeli da rekomendebuli literaturis aucilebeli da rekomendebuli literaturis aucilebeli da rekomendebuli literaturis aucilebeli da rekomendebuli literaturis nusxa: nusxa: nusxa: nusxa:

1. Vardiman J. W., Harris N.I, et all “ The World Health Organization (WHO) classiffication of the myeloid neoplasm” Blood, 2002, 100:2292-302

2. Jeferri a. “ Polysytemia vera: a compretensive revieus and clinical recomendations” Mayo Clin. Proc. 2003, 78:174-94

3. Spivak J.L. “ Polysytemia vera: myths, mechanisms and menagement” Blood, 2002,100:4272-420 4. Prchal J.T. “ Classification and molecular biology of polycytemias (erithrocytoses0 and

thrombocytosis” hematol. Oncol. Clin. North ttm. 2003, 17:1151-8

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5. Lin E., Jelinek J., Pastore Y. d. et all “Discrimination of Polysytemias and thromcytoses by novel, simple, accurante assays and comparison with PRV-I exspression and BFUO-E response to erythropoietin” Blood, 2003,101:3294-302

6. Spivak J.L., Barosi G. et all “Chronic myeloproliferation disorders” Hematology , 2003, 200-24 7. Barosi G. “Myelofibrosis with myeloid metaplasia” Hematol. Oncol. clinic. N. Am. 2003, 17:1211-26 8. Michiels J.J. at all “ Clinical and pathological criteria for the diagnosis of essential

thrombocythemia, polycythemia vera and idiopathic myelofibrosis (agrocenic myeloid metaplazia) “ hematology, 2002, 76:133-45

9. Koch C.A. et all “ Nonhepatosplenic extramedullary hematopoesis: associated diseases, pathology, clinical course and treatment” Mayo Clin. Proc. 2003, 78:1223-33

10. Deeg H.J., Gooley T.A. et all “Allogenic hematopoetic stem cell transplantation for myelofibrosis” Blood, 2003,102-3912-8

11. Melo J.V., Hughes T.P. et all “Chronic myeloid leukemia” Hematology , 2003, 132-52 12. Goldman J. , Melo J. “Chronic myeloid leukemia: advances in bilogy and new treatment approaches

ti treatment” N. Engl. J. Med. 2003, 349. 1451-64 13. O’Dwyer M.E., Mauro M. J. et all “Clonal evolution and lack of cytogenetic response are adverse

prognostic factors for hematologic relapse of chronic phase CML patints treated with imatinib mesylate” blood, 2004, 103:451-5

14. Deiminger M.W. at all “ Specific targeted therapy of chronic myeloidous leukemia with imatinib” Pharmacol Rev. 2003, 55:401-23

15. Olavarria E., Ottmamm O.G. et all “ Chronic leukemia working partyof the European group of Bone Marrow transplantation. Response to imatinib in patients who relapse after allogenic stem cell transplantation for chronic myeloid leukemia” 2003,17:1707-12

muxli muxli muxli muxli 4444. . . . moduli moduli moduli moduli 2.2.2.2.4444. . . . hemostazis sihemostazis sihemostazis sihemostazis sisssstemis darRvevebitemis darRvevebitemis darRvevebitemis darRvevebi ((((Tandayolili da SeZeniliTandayolili da SeZeniliTandayolili da SeZeniliTandayolili da SeZenili koagulopaTiebikoagulopaTiebikoagulopaTiebikoagulopaTiebi. . . . hemoragiuli hemoragiuli hemoragiuli hemoragiuli diaTezebidiaTezebidiaTezebidiaTezebi. . . . Trombozebi da hemoragiebi klinikur praqtikaSi, Trombozebi da hemoragiebi klinikur praqtikaSi, Trombozebi da hemoragiebi klinikur praqtikaSi, Trombozebi da hemoragiebi klinikur praqtikaSi, dik sindromidik sindromidik sindromidik sindromi)))) 1. 1. 1. 1. modulis xangrZlivobaa modulis xangrZlivobaa modulis xangrZlivobaa modulis xangrZlivobaa 3 3 3 3 Tve Tve Tve Tve 2. 2. 2. 2. modulis modulis modulis modulis mizania mizania mizania mizania sisxlZarRvovan-Trombocituri da plazmuri hemostazis sistemis da hemoreologiis darRvevebiT gamowveuli daavadebebis da paTologiuri mdgomareobebis paTogenezis, klinikuri gamovlinebis klinikuri mimdinareobis, profilaqtikis da mkurnalobis swavleba.

3. modulis amocanebia:3. modulis amocanebia:3. modulis amocanebia:3. modulis amocanebia: (miznis miRwevis/daZlevis saSualebebi): aRniSnuli miznis misaRwevad modulis farglebSi gaTvaliswinebulia Semdegi Teoriuli masalis aTviseba: sisxlZarRvovan-Trombocituli (pirveladi) hemostazis fiziologia da paTofiziologia; sisxlZarRvovan-Trombocituli (pirveladi) hemostazis darRvevebi, plazmuri koagulaciuri hemostazis fiziologia da paTofiziologia; SededebissawinaaRmdego meqanizmebi; pirveladi fiziologiuri antikoagulantebi fibrinolizis sistema, fiziologia da paTofiziologia, koagulogramis interpretacia, cvlilebebis klinikuri Sefaseba, heparinoTerapiis kontoli; antifosfolipiduri sindromis diagnostika - mgluras antikoagulantis da antifospilipiduri autoantisxeulebi. memkvidreobiTi da Tandayolili TrombocitopaTiebis da Trombocitebis disfunqciebis, SeZenili TrombocitopaTiebi, vilebrandis daavadebis, sisxlZarRvovani da Sereuli genezis hemostazis darRvevebis, sisxlis Sededebis plazmuri koagulaciuri faqtorebis deficitis, pirveladi fiziologiuri antikoagulantebis deficitis, fibrinolizis darRvevis anomaliebiT gamowveuli

41

daavadebebis diagnostikis Taviseburebebi, klinikuri mimdinareoba, mkurnaloba, profilaqtika.

4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba 4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili #mocemulia cxrili #mocemulia cxrili #mocemulia cxrili # 12121212 saxiT:saxiT:saxiT:saxiT:

cxrili # 12

Teoriuli kursi

profesiuli unar-Cvevebi

Sesasrulebeli

manipulaciebis

raodenoba

davaleba

sisxlZarRvovan-Trombocituli (pirveladi) hemostazis fiziologia da paTofiziologia sisxlZarRvovan-Trombocituli (pirveladi) hemostazis darRvevebis laboratoriuli diagnostikis meTodebiplazmuri koagulaciuri hemostazis fiziologia da paTofiziologia, da paTofiziologia laboratoriuli diagnostikis meTodebiSededebissawinaaRmdego meqanizmebi;pirveladi fiziologiuri antikoagulantebifibrinolizis sistema fiziologia da paTofiziologia, gamokvlevis meTodebi;koagulogramis interpretacia, cvlilebebis klinikuri Sefaseba, heparinTerapiis kontoliantifosfolipiduri sindromis diagnostika -mgluras antikoagulantis da antifospilipiduri autoantisxeulebidik sindromi – diagnostika, mkurnaloba, profilaqtika

hemostaziogramis /koagulogramis/ Catarebis teqnika specialur analizatorze da analizatoris gareSe.

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Trombocitopeniebis; TrombocitopaTiebis, Trombocitozebis, sisxlis Sededebis plazmuri koagulaciuri cilebis Tandayolili da SeZenili daficitiT gamowveuli daavadebebis, fiziologiuri antikoagulantebis deficitis, fibrinolizis darRvevis anomaliebiT gamowveuli daavadebebis , Trombofiliuri da Trombozuli mdgomareobebis, vaskulopaTiebis, diagnostika, klinikuri mimdinareoba, mkurnaloba, profilaqtika.

pacientebis miReba, anamnezis Sekreba, diagnozis dasma /hemostaziogramis garCeva/, daniSnulebis micema, dinamikis kontroli - krioplazmis, Trombocituli masis, Sededebis rekombinantuli faqtorebis, dezagregantebis da sxvadasxva sisxlisSemcvlelebis transfuzia -

5. modmodmodmodulis Sefasebis meTodebi ulis Sefasebis meTodebi ulis Sefasebis meTodebi ulis Sefasebis meTodebi


6. 6. 6. 6. aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa: aucilebeli da rekomendebuli literaturis nusxa:

1. 1. 1. 1. 3. Воробьев П.А. Актуальный гемостаз, М.,2004. Медицина, 1986. – 235 с. 2. Гаврилов О.К. Гравитационная хирургия крови М.,1994 3. Жибурт Е.Б. Трансфузиология.- СП, 2002 - 733с. 4.Зотиков Е.А., Бабаева А.Г. Путешествие в трансфузиологию. . М., 2002 – 105 с. 5. Рагимов А.А., Щербакова Г.Н., Руководство по инфузионно-трансфузионной терапии. М., 2003 – 179 с. 6. Румянцев А.Г., Аграненко В.А. Клиническая трансфузиология. – М., ГЕОТАР Медицина,1997. – 575 с. 7. “Клиническая онкогематология,” под ред. Волковой М.А, Москва, Медицина, 2001, 314- 375 8. “Руководство по ггематологии”, ппод ред. Воробъева А.И., т.2, Москва, 2002, 82-113 9. “Болезны системы крови”, Гусева С.А., Вознюк В.П., Москва, 2000,262-268 10. Гусева С.А., Вознюк В.П. Болезни системы крови. Справочник. Москва 2004г .489с 11. Robert S. Hillman, Kenneth A. Ault, Henry M. Rinder. Hematology in clinical practice, fourth edition, 2006, 440 pages. 12. “Technical manual of American Association of Blood Banks” –12 edition, Milan, 2000, 1056 pages.

13. Beul R. W., Isbister J.P., Blood component therapy in clinical practice. Melburn, Oxford, London. Bleckwell Sci. Publication, 1985. 14.Gibbs W.N., Britten A.F. Guidelines for the organization of a blood transfusion service, 1992 Geneva, WHO 15. Tomas E. at all “ Cecil essentials of medicine” Hematology Disease Philadelphia-London, 2004, 2, 403-449 16. Robert S. Hillman, Kenneth A. Ault, Henry M. Rinder. Hematology in clinical practice, fourth edition, 2006, 440 pages.

Tavi Tavi Tavi Tavi IIIIXXXX. profesiuli mzadebis II. profesiuli mzadebis II. profesiuli mzadebis II. profesiuli mzadebis IIIIII wlis modulebiwlis modulebiwlis modulebiwlis modulebi

muxli 1. muxli 1. muxli 1. muxli 1. moduli moduli moduli moduli 3.3.3.3.1. 1. 1. 1. adenopaTiebi, splenomegaliebi, adenopaTiebi, splenomegaliebi, adenopaTiebi, splenomegaliebi, adenopaTiebi, splenomegaliebi, llllimfoproliferaciuli imfoproliferaciuli imfoproliferaciuli imfoproliferaciuli daavadebebidaavadebebidaavadebebidaavadebebi modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa 3 Tve

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1. 1. 1. 1. modulis mizaniamodulis mizaniamodulis mizaniamodulis mizania – limfuri jirkvlebis hiperplaziis drouli gamovlena, diferenciuli diagnostika, etiopaTogenezuri mkurnaloba. leikemoiduri reaqciebis drouli gamovlena, diferenciuli diagnostika, etiopaTogenezuri mkurnaloba. qronikuli limfoiduri leikemiis, mravlobiTi mielomis da valdenstremis daavadebis diferencialuri diagnostika, eTiopaTogenezuri mkurnalobis Tanamedrove meTodebi, xelSmwyobi Terapiis dagmegva da ganxorcieleba. 2. 2. 2. 2. modulis amocanebimodulis amocanebimodulis amocanebimodulis amocanebi:::: maZiebelma modulis gavlis Semdeg unda icodes : limfuri jirkvlis hiperplaziis yvela mizezi, maTi diferencialuri diagnostika, etiologiis dasadgenad aucilebeli da damxmare klinikuri da paraklinikuri meTodebi, maTi interpretacia da mkurnaloba. leikemoiduri reaqciebis drouli gamovlena, etiologiis dadgena da adeqvaturi mkurnalobis SerCeva. qronikuli limfoiduri leikemiis, mr avlobiTi mielomis da valdenstremis daavadebis gamomwvevi yvela SesaZlo mizezi, maTi diferencialuri diagnostika, mkurnalobis optimaluri sqemebis gamoyeneba, qimioTerapiis periodSi SesaZlo garTulebebis drouli gamovlena da koreqcia, kliniko-laboratoriuli monacemebis swori interpretacia, prognozuli faqtorebis gaTvaliswinebiT daavadebis mimdinareobis da mkurnalobis efeqturobis gansazRvra.

4. Sesasrulebeli samuSaos moculoba da CasatarebSesasrulebeli samuSaos moculoba da CasatarebSesasrulebeli samuSaos moculoba da CasatarebSesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba eli manipulaciebis raodenoba eli manipulaciebis raodenoba eli manipulaciebis raodenoba mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # 13131313 saxiT:saxiT:saxiT:saxiT:

cxrili # 13

Teoriuli kursi


Sesasrulebe

li

manipulaciis

raodenoba

qronikuli limfoiduri leiekmia mravlobiTi mieloma valdenstremis makroglobulinemia

1.Civilebisa da anamnezuri monacemebis Sekreba, srulfasovani Sejereba da interpretacia. 2.Inspectio (daxedva, daTvaliereba) 3.hemograma. 4. Zvlis tvinis ujredovani Semadgenloba. 5. Zvlis tvinis histomorfologia 6. periferiuli sisxlisa da Zvlis tvinis ujreduli elementebis citogenetikuri gamokvlevebi. 7. periferiuli sisxlis, Zvlis tvinis punqtatis imunofenotipireba. 8. imunoglobulinebis Tvisobrivi da raodenobrivi cvlilebebis codna.

9. trepanobioptatis imunohitoqimiuri gamokvlevebi, interpretacia. 10. periferiuli sisxlisa da Zvlis tvinis histoqimiuri gamokvlevebi. 11. limfuri kvanZis citologiuri da histologiuri Seswavla. imunohistoqimiuiri gamokvleva

12.splenograma. elenTis morfologiuri da imunohistoqimiuri gamokvleva 12. gamokvlevis radionukliduri meTodebi. 13. Zvlis tvinis funqciur-topografiuli mdgomareobis Seswavla. 14. Zvlis tvinis radionukliduri vizualizaciis monacemebis praqtikuli mniSvnelobis codna 15. RviZlis da elenTis gama-scintigrafia. limfoscintigrafia. 16. kompiuteruli da magnito-rezonansuli tomografia hematologiaSi.

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5. modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi (kriteriumebi, perioduloba) _



1. “Клиническая онкогематология,” под ред. Волковой М.А, Москва, Медицина, 2001, 376-392 2M “Руководство Mпо Mгематологии”, Mпод ред. Воробъева А.И., т.2, Москва, 2002, 69-81 3M “Програмное лечение лейкозов”, Савченко В.Г. и соавт., Москва, 2002, 215-223 4. “HHematology journal”, P. Reimer et all, v-5, 2004, 132-137 5. “Hematology journal ”, Palumbo A. et all, v-5, 2004, 318-324 6. “Болезны системы крови”, Гусева С.А., Вознюк В.П., Москва, 2000,262-268 7M”Химитерапия Mопухолевых Mаболеваний”, под ред. Переводчиковой Н.И., Москва, 2000, 230-261 8. “Haematologica” Cadovsby D., v-9o, 1, 2005, 45-53

muxli 2muxli 2muxli 2muxli 2 moduli moduli moduli moduli 3.3.3.3.2. 2. 2. 2. limfomebis (hojkinis da arahojkinis) diagnostikis da limfomebis (hojkinis da arahojkinis) diagnostikis da limfomebis (hojkinis da arahojkinis) diagnostikis da limfomebis (hojkinis da arahojkinis) diagnostikis da mkurnalobis Tanamedrove principebimkurnalobis Tanamedrove principebimkurnalobis Tanamedrove principebimkurnalobis Tanamedrove principebi modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa 3 Tve3 Tve3 Tve3 Tve 1. modulis 1. modulis 1. modulis 1. modulis mizaniamizaniamizaniamizania - hojkinis da arahojkinis limfomebis citologiuri, histomorfologiuri, imunologiuri diagnostika risk-faqtorebis gaTvaliswinebiT, daavadebis mimdinareobis prognozireba, mkurnalobis Tanamedrove principebis Seswavla.

2. 2. 2. 2. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: (miznis miRwevis/daZlevis saSualebebi): maZiebelma modulis gavlis Semdeg unda icodes: hojkinis da arahojkinis limfomebis ganviTarebis gamomwvevi yvela SesaZlo mizezi, limfuri kvanZis hiperplaziis gamomwvevi yvela SesaZlo mizezi, maTi diferencialuri diagnostika, yvela aucilebeli damxmare klinikuri da paraklinikuri meTodebi, maTi interpretacia. im daavadebebis nusxa, romlebic, Zalian xSirad mimdinareoben gamoxatuli limfadenopaTiebiT praqtikulad aTvisebuli unda hqondes Semdegi unar-Cvevebi: 1. Civilebisa da anamnezuri monacemebis Sekreba, srulfasovani Sejereba da interpretacia. 2. hemograma. 3. Zvlis tvinis ujredovani Semadgenloba. 4. Zvlis tvinis histomorfologia. 5. periferiuli sisxlis da Zvlis tvinis ujreduli elementebis citogenetikuri gamokvlevebi. 6. limfuri kvanZis imunohistoqimiuri gamokvleva. 7. trepanobioptatis imunohistoqimiuri gamokvlevebi, interpretacia 8. periferiuli sisxlis da Zvlis tvinis punqtatis imunofenotipireba, interpretacia 9. trepanobioptatis morfologiuri gamokvleva 10. limfuri kvanZis citologiuri da histologiuri Seswavla. 11. kompiuteruli da magnitur-rezonansuli tomografia hematologiaSi, interpretacia. 12. Zvlebis rentgenologiuri da scintigrafiuli monacemebis interpretacia. 13. muclis Rrus ultrasonografiuli gamokvleviT miRebuli Sedegebis interpretacia 14. sisxlis bioqimiuri gamokvleva, Sedegebis interpreatcia 15. sisxlis serologiuri gamokvleva, Sedegebis interpretacia. 3. 3. 3. 3. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # 13 13 13 13 ----is saxiT:is saxiT:is saxiT:is saxiT:

cxrili # 13

45


manipulaciis

raodenoba

davaleba

limfuri kvanZis hiperplaziis gamomwvevi mizezebi. avTvisebiani limfomebis eTiologia da paTogenezi. avTvisebiani limfomebis klinikuri Taviseburebani

hojkinis da arahojkinis limfomebis citologiuri, histomorfologiuri, citogenetikuri da imunologiuri maCveneblebi.

anamnezuri monacemebis Sefaseba, srulfasovani Sejereba da swori interpretacia,. limfuri kvanZis citologiuri, histomorfologiuri da imunohisoqimiuri gamokvleva. periferiuli sisxlis da Zvlis tvinis ujreduli elementebis imunofenotipireba, citologiuri, histomorfologiuri da citogenetikuri Seswavla. trepanobioptatis morfologiuri da imunohistoqimiuri gamokvleva. mkurnalobis maqsimalurad efeqturi programis SerCeva da qimioTerapiis procesisganxorcieleba. avTvisebiani limfomebis mimdinareobis marTva remisiis fazaSi. qimioTerapiisadmi rezistentuli formebis mkurnalobalimfuri kvanZis citologiuri preparatis damzadeba. limfuri kvanZis citologiuri gamokvleva. limfuri kvanZis histologiuri gamokvleva. periferiuli sisxlis nacxis damzadeba. Zvlis tvinis punqcia. trepanobiofsia qimioTerapiis proceduris ganxorcieleba. sisxlis jgufis da rezusis gansazRvra. sisxlis komponentebis transfuziis proceduris Catareba

reaqtiuli limfadenitebis da avTvisebiani limfomebis diferencialuri diagnostika hojkinis da arahojkinis limfomebis mimdinareobis prognozireba da mkurnalobis Tanamedrove principebi

1. modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi _



1. “Клиническая онкогематология,” под ред. Волковой М.А, Москва, Медицина, 2001, 314-375 2M “Руководство Mпо Mгематологии”, Mпод ред. Воробъева А.И., т.2, Москва, 2002, 82-113 3M “Програмное лечение лейкозов”, Савченко В.Г. и соавт., Москва, 2002, 215-223 4. “Annals of Oncology”, S. Rao et all, v-15, 9, 2004, 1413-1418 5. “Annals of Oncology”, H. Bertz at all, v-15, 9, 2004, 1419-1425

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6. “Болезны системы крови”, Гусева С.А., Вознюк В.П., Москва, 2000,262-268 7M”Химитерапия Mопухолевых Mаболеваний”, под ред. Переводчиковой Н.И., Москва, 2000, 230-261

muxli 3. muxli 3. muxli 3. muxli 3. moduli moduli moduli moduli 3.3.3.3.3333. . . . klinikuri da sawarmoo transfuziologiis klinikuri da sawarmoo transfuziologiis klinikuri da sawarmoo transfuziologiis klinikuri da sawarmoo transfuziologiis safuZvlebisafuZvlebisafuZvlebisafuZvlebi (sisxlis bankingi. transfuziuli medicinis imunologia, genetika, serologia, hemokomponenturi Terapiis principebi. plazmacitaferezi, Rerovani ujredebi - miReba da gamoyeneba) modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa 3 Tve3 Tve3 Tve3 Tve modulis modulis modulis modulis mizaniamizaniamizaniamizania – rezidentebisaTvis transfuziuli medicinis, kerZod sawarmoo da klinikuri transfuziologiis Teoriuli safuZvlebis swavleba da praqtikuli unar-Cvevebis daufleba modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: (miznis miRwevis/daZlevis saSualebebi): aRniSnuli miznis misaRwevad modulis farglebSi gaTvaliswinebulia Semdegi Teoriuli masalis aTviseba:

- transfuziologiuri samsaxuris normativebi. sisxlis bankingi. donacia, sisxlis komponentebi, maTi damzadebis, Senaxvis da gamoyenebis principebi, hemokomponentebis xarisxi da usafrTxoeba. donorobis da hemotransfuziis eTikur-samarTlebrivi aspeqtebi. _ organizmis sisxlwarmoqmnis darRvevebiT, sisxlis ujreduli an cilovani deficitiT, hemostazis darRveviT an sxva mizezebiT gamowveuli daavadebebi da paTologiuri mdgomareobebis mkurnaloba sisxlis komponentebiT, maTi SemcvlelebiT an rekombinanturi koloniamastimulirebeli faqtorebiT. aRniSnuli areebis da preparatebis gamoyenebis Taviseburebebi; _ transfuziuli medicinis imunologiuri da genetikuri aspeqtebi - sisxlis ujredebis antigenebi, maTi mniSvneloba klinikur transfuziologiaSi, gadasaxmeli sisxlis komponentis recipientTan SeTavsebis ZiriTadi principebi; _ _ _ _ hemaferezi klinikur da sawarmoo transfuziologiaSi _ Rerovani ujredebi, maTi gamoyeneba klinikur praqtikaSi. hemoblastozebis da siliduri sismsivneebis maRaldozirebuli qimioTerapia hemopoeturi Rerovani ujredebis autologiuri da alogenuri transplantaciiT.

3. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # 13131313----is saxiT:is saxiT:is saxiT:is saxiT:

cxrili # 13

Teoriuli kursi


Sesasrulebeli

manipulaciebis

raodenoba

davaleba

sisxlis damzadebisa da Senaxvis dagegmvis da organizaciis principebi, xarisxis kontroli. donoroba. sisxlis komponentebis gadasxmis eTikuri sakiTxebi

donoris miReba, gamokvleva, laboratoriuli skriningi, organizmis sasicocxlo funqciebis gamokvleva

25252525

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transfuziuli medicinis imunologiis da genetikis safuZvlebi, sisxlis ujredebis antigenebi. iSviaTi antigenebi da maTi Sesabamisi antisxeulebi, maTi roli transfuziul TerapiaSi.

sisxlis eriTrocituli da leikocituri antigenebis gansazRvra. donoris da recipientis sisxlis individualuri SeTavseba.

35

transfuziuli Terapiis optimizacia paTologiuri mdgomareobis saxis, misi simZimis xarisxis, Terapiis riskis gaTvaliswinebiT. transfuziuli Terapiis moculoba sxvadasxva paTologiuri mdgomareobis, daavadebebis da sindromebis dros.

sisxlis ujreduli/cilovani deficitis simZimis xarisxis dadgena, hemotransfuziis mosalodneli riskis da sargebelis Sefaseba;pacientisaTvis mosalodneli hemotrnsfuziis Sesaxeb informaciis miwodeba da @”informirebuli Tanxmobis” miReba. pacientis transfuziuli anamnezis Sekreba.

50

satransfuzio areebis klasifikacia. sakonservacio xsnarebi eriTrocitebis masis, Trombocituli masis maxasiaTeblebi, xandazmuli eriTrocituli masis morfologiuri da bioqimiuri maxasiaTeblebi. sisxlis komponentebis damzadeba, naxva da optimaluri gamoyenebis kriteriumebi.

sisxlis komponentebis damzadeba. sisxlis fraqcionireba. eriTrocituli masis damzadeba, Trombocituli masis damzadeba axladgayinuli plazmis damzadeba. sisxlis komponentebis konservacia. transportireba. sisxlis komponentebis momzadeba gadasxmisaTvis.

50505050

sisxlis gadasxmis Cvenebebi, teqnikuri Taviseburebebi, sisxlis ujredovani da cilovani komponentebis deficitis Sevseba alogenuri sislis komponentebiT – risk faqtorebi, efeqturobis Sefaseba.

eriTrocituli masis gadasxma Trombocituli masis gadasxma Reovani ujredebis gadasxma.

80

“modificirebuli sisxli” Semadgenloba da gamoyenebis upiratesobebi.

sisxlis recxva sisxlis gafiltvra sisxlis komponentebis dasxiveba

20

sisxlis gadasxma masiuri sisxldakargviT gamowveuli anemiis mkurnalobisas – posttravmuli, qirurgiul da sameano praqtikaSi. sisxlis komponenturi Terapia dik

gadasaxmeli sisxlis da recipientis sisxlis ABO, Rh kuTvnilebis gansazRvra. individualuri SeTavsebis sinjebis

48

sindromis dros.

Catareba in vitro da in vivo; sasicocxlod mniSvnelovani funqciebis kontroli,ramdenime doza sisxlis komponentis gadasxmis dros.

sisxlze eqstrakorporuli Carevis Tanamedrove mimarTulebebi. Uujreduli Terapia. eferentuli meTodebi Terapiuli da qirurgiuli profilis pacientebis mkurnalobaSi. hemaferezis gansazRvra, saxeebi, aparatura, gamoyenebis sferoebi, gamoyeneba hematologiur praqtikaSi. hemaferezis Cvenebebi, garTulebebi. plazmaferezi mravalprofilur klinikaSi. Terapiuli hemaferezis Taviseburebebi sxvadasxva daavadebebis dros. hemaferezis garTulebebis diagnostika, mkurnaloba. hemaferezi sawarmoo transfuziologiaSi sisxlis ujredebis damzadeba, Rerovani ujredebis gamoyofis Taviseburebebi.

diskretuli plazmaferezi, eritrocitaferezi, leikaferezi, trombocitaferezi. pacientis momzadeba aferezis proceduris warmarTva proceduris Semdgomi monitoringi

30

Rerovani ujredebi da maTi klinikuri gamoyeneba. Rerovani ujredebis miRebis gzebi autologiuri da alogenuri Rerovani ujredebis transplantacia. alogenuri Rerovani ujredebis transplantaciis Semdgomi garTulebebi, profilaqtika da mkurnaloba, daavadeba “transplantati maspinZlis winaaRmdeg” – paTogenezi, klinika, mkurnaloba; transplantaciisSemdgomi gviani garTulebebi, imunitetis aRdgena; alogenuri Rerovani ujredebis transplantaciisefeqturoba, reaqcia “transplantati simsivnis winaaRmdeg”; autologiuri Rerovani ujredebis

pacientis momzadeba autologiuri Rerovani ujredebis transplantaciisaTvis periferiul sisxlSi Rerovani ujredebis mobilizeba.

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gamoyofa Senaxva, gamoyeneba; transplantacia, Cvenebebi, miRebis gzebi Wiplaris sisxli ujredebi eTikuri da iuridiuli aspeqtebi.

modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi modulis Sefasebis meTodebi

diskusia, testi, referati, seminari1-jer TveSi

aucilebeli da rekomendebuli liteaucilebeli da rekomendebuli liteaucilebeli da rekomendebuli liteaucilebeli da rekomendebuli literaturis nusxa:raturis nusxa:raturis nusxa:raturis nusxa:

1. transfuziuli samsaxuris normativebi. Tbilisi, 1999. - 431 gv 2.“Technical manual of American Association of Blood Banks” –12 edition, Milan, 2000, 1056 pages. 3. Robert S. Hillman, Kenneth A. Ault, Henry M. Rinder. Hematology in clinical practice, fourth edition, 2006, 440 pages. 4. Gibbs W.N., Britten A.F. Guidelines for the organization of a blood transfusion service, 1992 Geneva, WHO 5. Nambiar A., Leitman S. Transfusion Therapy. p.607-631 (from Michael M., Boyiadzis, Peter F. Lebowitz, James N. Frame, Tito Fojo Hematology-Oncology Therapy) McGrawHill, 2007 6. Beul R. W., Isbister J.P., Blood component therapy in clinical practice. Melburn, Oxford, London. Bleckwell Sci. Publication, 1985. 7. Гаврилов О.К. Гравитационная хирургия крови М.,1994 8. Жибурт Е.Б. Трансфузиология.- СП, 2002 - 733с. 9. Зотиков Е.А., Бабаева А.Г. Путешествие в трансфузиологию. . М., 2002 – 105 с. 10. Рагимов А.А., Щербакова Г.Н., Руководство по инфузионно-трансфузионной терапии. М., 2003 – 179 с. 11. Румянцев А.Г., Аграненко В.А. Клиническая трансфузиология. – М., ГЕОТАР Медицина,1997. – 575 с.

muxli muxli muxli muxli 4444. . . . moduli moduli moduli moduli 3. 3. 3. 3. 4. 4. 4. 4. hemotransfuziis garTulebebi, mizezebi, mkurnaloba, profilaqtika, hemotransfuziis garTulebebi, mizezebi, mkurnaloba, profilaqtika, hemotransfuziis garTulebebi, mizezebi, mkurnaloba, profilaqtika, hemotransfuziis garTulebebi, mizezebi, mkurnaloba, profilaqtika, hemokomponhemokomponhemokomponhemokomponenturi Terapiis alternatienturi Terapiis alternatienturi Terapiis alternatienturi Terapiis alternativebi.vebi.vebi.vebi. modulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaamodulis xangrZlivobaa 2 Tve2 Tve2 Tve2 Tve modulis mizania posttransfuziuli garTulebebis paTogenezis, diagnostikis, klinikuri mimdinareobis, profilaqtikis da mkurnalobis swavleba. amave modulis farglebSi ganixileba sisxlisSemcvlelebis gadasxma da sisxlis gadasxmis farmakologiuri alternativebis (eriTropoetinis, granulocituri, granulocitur-makrofaguri koloniamastimulirebebli faqtorebis) gamoyeneba klinikur praqtikaSi. modulis gavlis Semdeg rezidentma unda icodes rom alogenuri sisxlis gadasxma yovel konkretul SemTxvevaSi unda ganixilebodes rogorc alogenuri qsovilis transplantacia da mas SeiZleba Tan axldes seriozuli garTulebebi rogorc sisxlis komponentis gadasxmis dros, ise transfuziis Semdeg. aqedan gamomdinare man sworad unda Seafasos sisxlis gadasxmis mosalodnel sargebloba

50

da Seadaros igi potenciur risks. rezidentma unda icodes hemotransfuziis adreuli da gviani garTulebebis diagnostika, klinikuri mimdinareoba da mkurnaloba, hemotransfuziuli Sokis klinika da gadaudebeli daxmareba.

4. modulis amocanebia:modulis amocanebia:modulis amocanebia:modulis amocanebia: aRniSnuli miznis misaRwevad modulis farglebSi gaTvaliswinebulia Semdegi Teoriuli masalis aTviseba: - transfuziuli Terapiis optimizacia paTologiuri mdgomareobis saxis, misi simZimis xarisxis, Terapiis riskis gaTvaliswinebiT. hemotransfuziuli Terapiis, sisxlisSemcvlelebiT da hemopoezis mastimulirebeli faqtorebiT mkurnalobis moculoba sxvadasxva paTologiuri mdgomareobis, daavadebebis da sindromebis dros:

• mwvave sisxldakargviT gamowveuli anemiebis (posttravmuli, qirurgiuli, sameano da sxv);

• rkinadeficituri anemiis;

• leikemiebis da limfomebis;

• citostasiuri preparatebiT gamowveuli mielosupresiis;

• aplastiuri anemiebis;

• hemolizuri anemiebis;

• Sinagani organoebis avTvisebiani simsivneebis;

• revmatiuli daavadebebis;

• infeqciuri da parazituli daavadebebis;

• sxvadasxva mizezebiT ganpirobebuli cilovani ukmarisobis; hemostazis SeZenili darRvevebis, dsS sindromis, hematogenuri Trombofiliis, TrombocitopaTiebis da Trombocitopeniebis;

• memkvidreobiTi koagulopaTiebis - Semadedebeli faqtorebis deficitis dros. - mwvave da mogvianebiTi hemotransfuziuli reaqciebi - imunodamokidebuli da imunodamoukidebeli hemoliziT gamowveuli garTulebebi, maTi profilaqtika da mkurnaloba. - hemotransfuziiT gamowveuli sefsisi. - arahemolizuri cxelebiTi reaqciebis profilaqtika da mkurnaloba. - - anafilaqsiuri reaqcia, cirkulatoruli gadatvirTva. - citratuli intoqsikacia - paTofiziologia, profilaqtika, mkurnaloba. - hipoTermiis paTofiziologia, profilaqtika, mkurnaloba. - hiperkaliemia da hipokaliemia, haerovani embolia. mwvave hemotransfuziuli reaqciis diagnostika. -hemotransfuziuli Soki -sisxlis gadasxmis gviani garTulebebi. eriTrocitul antigenebTan aloimunizacia; leikocitur antigenebTan aloimunizacia. refraqteroba Trombocitebis transfuziasTan, - hemotransfuziiT gamowveuli daavadeba “transplantati maspinZlis winaaRmdeg” paTofiziologia, profilaqtika, mkurnaloba. - hemotransfuziuli reaqciis registracia. - sisxlis gadasxmis infeqciuri garTulebebi _ hemotransmisiuli infeqciebi; posttransfuziuli hepatitebi, aTaSangi, Sidsi,, citomegalovirusuli infeqcia, parvovirusiT, HherpesvirusiT da sxv.

infeqciuri agentebis gadacemis socialur- demografiuli da mediko-teqnologiuri risk faqtorebi - hemotransmisiuli infeqciis profilaqtika

51

- sisxlis gadasxmis farmakologiuri alternativebi. rekombinantuli zrdis faqtorebi: eriTropoetini granulocitur-makrofaguri koloniamastimulirebebli faqtori, granulocituri koloniamastimulirebebli faqtori rekombinantuli zrdis faqtorebis gamoyenebis Cvenebebi, dozebi.

hemostazis xelSemwyobi rekombinantuli preparatebi –VIII da VIIa rekombinantuli faqtorebi. - sisxlisSemcvlelebi.

sisxlisSemcvleli satransfuzio xsnarebis fiziko-qimiuri da biologiuri maxasiaTeblebi da maTi klinikuri gamoyeneba. sisxlisSemcvlelebis gamoyeneba sisxldakargvis, sxvadasxva genezis Sokuri mdgomareobis, sxvadasxva qirurgiuli Carevebis dros hemodinamikis da mikrocirkulaciis aRdgenis da hemodiluciis mizniT. dezintoqsikaciuri moqmedebis sisxlisSemcvlelebis gamoyeneba mowamvlis, damwvrobis, sxivuri daavadebis, leikozebis, soliduri simsivneebis, toqsiuri dispepsiis, RviZlis da Tirkmlis daavadebis dros. parenteraluri kvebisaTvis gamoyenebadi preparatebi. kristaloidur marilovani xsnarebi da osmodiuretuli xsnarebi.

Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba raodenoba raodenoba raodenoba mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # mocemulia cxrili # 14 14 14 14 ----is saxiT:is saxiT:is saxiT:is saxiT:

cxrili # 14

Teoriuli kursi


Sesasrulebeli manipulaciebis

raodenoba

davaleba

hemotransfuziis adreuli garTulebebis diagnostika, klinikuri mimdinareoba da mkurnaloba, hemotransfuziuli Soki klinika da gadaudebeli Terapia.

eriTrocituli masis gadasxma trombocituli masis gadasxma axladgayinuli plazmis gadasxma albuminis xsnaris gadasxma hemotransfuziuli reaqciis prevenciuli RonisZiebebi – sislis individualuri SeTavseba, sinjebi in vitro da in vivo. posttransfuziuli reaqciis mkurnaloba

100 20 30

pacientTa raodenoba ar aris winaswar gansazrvruli

hemotransfuziis gviani garTulebebis diagnostika, klinika, mkurnaloba. mravaljeradi hemotransfuziebiT gamowveuli garTuleba – daavadeba “transplantati maspinZlis winaaRmdeg”.

sisxlis komponentebis gadasxmasTan dakavsirebuli dokumentaciis Sevseba, sisxlis gadasxmis oqmis warmoeba.

100

52

sisxlis gadasxmis infeqciuri garTulebebis saxeebi, hemotransmisiuli infeqciebis gavrceleba da profilaqtika.

sisxlis konteineris utilizacia, dokumentaciis warmoeba

20

hemotransfuziis alternativebi - autohemotransfuzia, rekombinantuli koloniamastimulirebebli faqtorebi da maTi gamoyeneba klinikur praqtikaSi

autohemotransfuzia, rekombinantuli faqtorebiT mkurnaloba

30303030

sisxlisSemcveli satransfuzio xsnarebi, klasifikacia. sisxlisSemcvlelebis gamoyeneba sisxldakargvis, sxvadasxva genezis Sokuri mdgomareobis, sxvadasxva qirurgiuli Carevebis dros sisxlisSemcvlelebis gamoyeneba sxvadasxva daavadebebis dros.

sisxlisSemcveli satransfuzio xsnarebis gadasxma.

50505050


diskusia, testi, referati, seminari1-jer TveSi


1. transfuziuli samsaxuris normativebi. Tbilisi, 1999. - 431 gv 2.“Technical manual of American Association of Blood Banks” –12 edition, Milan, 2000, 1056 pages. 3. Robert S. Hillman, Kenneth A. Ault, Henry M. Rinder. Hematology in clinical practice, fourth edition, 2006, 440 pages. 4. Gibbs W.N., Britten A.F. Guidelines for the organization of a blood transfusion service, 1992 Geneva, WHO 5. Nambiar A., Leitman S. Transfusion Therapy. p.607-631 (from Michael M., Boyiadzis, Peter F. Lebowitz, James N. Frame, Tito Fojo Hematology-Oncology Therapy) McGrawHill, 2007 6. Beul R. W., Isbister J.P., Blood component therapy in clinical practice. Melburn, Oxford, London. Bleckwell Sci. Publication, 1985. 7. Гаврилов О.К. Гравитационная хирургия крови М.,1994 8. Жибурт Е.Б. Трансфузиология.- СП, 2002 - 733с. 9. Зотиков Е.А., Бабаева А.Г. Путешествие в трансфузиологию. . М., 2002 – 105 с. 10. Рагимов А.А., Щербакова Г.Н., Руководство по инфузионно-трансфузионной терапии. М., 2003 – 179 с. 11. Румянцев А.Г., Аграненко В.А. Клиническая трансфузиология. – М., ГЕОТАР Медицина,1997. – 575 с.

Tavi X. damatebiTi sakiTxebi Tavi X. damatebiTi sakiTxebi Tavi X. damatebiTi sakiTxebi Tavi X. damatebiTi sakiTxebi

muxli 1. saswavlo gegma mocemulia cxrilis saxiT:muxli 1. saswavlo gegma mocemulia cxrilis saxiT:muxli 1. saswavlo gegma mocemulia cxrilis saxiT:muxli 1. saswavlo gegma mocemulia cxrilis saxiT:

. rezidenturis programa “hematologia/transfuziologia” rezidenturis programa “hematologia/transfuziologia” rezidenturis programa “hematologia/transfuziologia” rezidenturis programa “hematologia/transfuziologia” –––– 33 Tve33 Tve33 Tve33 Tve

53

profesiuli mzadebis I weliprofesiuli mzadebis I weliprofesiuli mzadebis I weliprofesiuli mzadebis I weli

moduli ## modulis dasaxeleba xangrZlivoba moduli moduli moduli moduli 1.1.1.1.1.1.1.1. eqimisa da pacientis urTierTobis samarTlebrivi da eTikuri eqimisa da pacientis urTierTobis samarTlebrivi da eTikuri eqimisa da pacientis urTierTobis samarTlebrivi da eTikuri eqimisa da pacientis urTierTobis samarTlebrivi da eTikuri

safuZvlebi;safuZvlebi;safuZvlebi;safuZvlebi; 2 kvira2 kvira2 kvira2 kvira

moduli 1.2.moduli 1.2.moduli 1.2.moduli 1.2. fundamenturi medicinis Tanamedrove aspeqtebifundamenturi medicinis Tanamedrove aspeqtebifundamenturi medicinis Tanamedrove aspeqtebifundamenturi medicinis Tanamedrove aspeqtebi 2 kvira2 kvira2 kvira2 kvira moduli 1.3.moduli 1.3.moduli 1.3.moduli 1.3. zogadi Terapiazogadi Terapiazogadi Terapiazogadi Terapia/ambulatoriuli Terapia/ambulatoriuli Terapia/ambulatoriuli Terapia/ambulatoriuli Terapia 4 Tve4 Tve4 Tve4 Tve moduli 1.3.1 zogadi Terapia 2 Tve moduli 1.3.2 ambulatoriuli Terapia 2 Tve moduli 1.4.moduli 1.4.moduli 1.4.moduli 1.4. Terapiuli stacionari ITerapiuli stacionari ITerapiuli stacionari ITerapiuli stacionari I 6 Tve6 Tve6 Tve6 Tve moduli 1.4.1 gul-sisxlZarRvTa sistemis daavadebebi 3 Tve moduli 1.4.2 revmatiuli daavadebebi/alergologia 2 Tve

1.5.1.5.1.5.1.5. sazogadoebrivi jandsazogadoebrivi jandsazogadoebrivi jandsazogadoebrivi jandacva da epidemiologia acva da epidemiologia acva da epidemiologia acva da epidemiologia 2 kvira.2 kvira.2 kvira.2 kvira. 1.6.1.6.1.6.1.6. mtkicebiTi medicinisa da samedicino statistikis safuZvlebi mtkicebiTi medicinisa da samedicino statistikis safuZvlebi mtkicebiTi medicinisa da samedicino statistikis safuZvlebi mtkicebiTi medicinisa da samedicino statistikis safuZvlebi 2 kvira2 kvira2 kvira2 kvira

profesiuli mzadebis II weliwadi moduli

№№ modulis dasaxeleba xangrZlivoba

2.1 SeZenili da Tandayolili anemiebi. anemiebi sxvadasxva daavadebebis dros

2 Tve

2.2 mwvave lekemiebis diagnostikis da mkurnalobis Tanamedrove principebi

3 Tve

2.3 qronikuli mieloproliferaciuli daavadebebi 3Tve

2.4 hemostazis sitemis darRvevebi (Tandayolili da SeZenili koagulopaTiebi. hemoragiuli diaTezebi. Trombozebi da hemoragiebi klinikur praqtikaSi, dik sindromi)

3 Tve

profesiuli mzadebis II weliwadi moduli

№№ modulis dasaxeleba xangrZlivoba

3.1 adenopaTiebi, splenomegaliebi, limfoproliferaciuli daavadebebi

3 Tve

3.2 limfomebis (hojkinis da arahojkinis) diagnostikis da mkurnalobis Tanamedrove principebi

3 Tve

3.3 klinikuri da sawarmoo transfuziologiis safuZvlebi 3 Tve

3.4 hemotransfuziis garTulebebi, mizezebi, mkurnaloba, profilaqtika, hemokomponenturi Terapiis alternativebi.

2 Tve

Documents

rezidenturis (diplomisSemdgomi samedicino ganaTlebis ... · 2.5.1. hojkinis limfoma 2.5.2 arahojkinis limfomebi 3. 33.. 3. hemostazis darRvevebiT gamowveuli daavadebebi da hemostazis