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onkoinkurabeluri pacientebis paliatiuri movla

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Presentation on theme: "onkoinkurabeluri pacientebis paliatiuri movla"— Presentation transcript:

1 onkoinkurabeluri pacientebis paliatiuri movla

2 Sexvedris mizani: zogad saeqimo praqtikaSi onkoinkurabeluir terminaluri pacientebis paliatiuri movlis organizaciuli aspeqtebis ganxilva amocanebi: zogad saeqimo praqtikaSi paliatiuri movlis organizebis ZiriTadi etapebis Camoyalibeba konkretuli klinikuri SemTxvevebis ganxilvis magaliTze pjd gundis rolis gacnobiereba paliatiuri movlis procesSi

3 ganmarteba paliatiuri movla samedicino momsaxurebaa, romliTac pacientis mdgomareoba radikalurad ar umjobesdeba, ar icvleba arakeTilsaimedo prognozi, da romlis mizani pacientis mdgomareobis droebiTi Semsubuqebaa. paliatiuri movla yovlismomcveli, interdisciplinaruli samedicino daxmarebaa, romlisaTvisac amosavali wertili terminaluri pacientisa da misi axloblebis TanagrZnoba, mxardaWera da maTTvis maqsimalurad komfortuli mdgomareobis Seqmnaa.

4 paliatiuri movlis umTavresi aspeqtebi
paliatiuri movla uzrunvelyofs terminaluri pacientebisaTvis tkivilisa da sxva simptomebis optimalur kontrols; ganamtkicebs sicocxles, xolo sikvdils ganixilavs, rogorc Cveulebriv, normalur movlenas; ar cdilobs sikvdilis gadavadebas an daCqarebas; uzrunvelyofs pacientis movlis fsiqologiuri da sulieri aspeqtebis integrirebas; pacients sTavazobs sistemas, romelic mas aqtiuri cxovrebis unaris maqsimalurad didxans SenarCunebis saSualebas miscems

5 paliatiuri movlis umTavresi aspeqtebi
uzrunvelyofs ojaxze orientirebul daxmarebas, rac pacientis gardacvalebis Semdeg kidev ufro intensiuri unda gaxdes; mTavar miznad isaxavs pacientis cxovrebis xarisxis gaumjobesebas, ramac, SesaZloa, dadebiTad imoqmedos daavadebis mimdinareobazec; gamoyenebadia daavadebis mimdinareobis SedarebiT adreul etapebzec, sxva samkurnalo RonisZiebebTan erTad, romelTa mizani pacientis sicocxlis gaxangrZlivebaa (mag. qimio da sxivuri Terapia). am etapze paliatiuri movla miznad isaxavs aRmocenebuli klinikuri garTulebebis gamovlenasa da kontrols; avTvisebiani simsivneebis fonze aRmocenebuli qronikuli tkivilis marTvisaTvis saWiroa analgeziuri saSualebebis, maT Soris opioiduri preparatebis, farTod gamoyeneba. amas garda, droulad unda Sefasdes tkivilis neiropaTiuri xasiaTi, risTvisac mkurnalobis sqemaSi unda CairTos antikonvulsiuri preparatebi an tricikluri antidepresantebi.

6 paliatiuri movlis umTavresi aspeqtebi
aucileblad unda gaumjobesdes sxva simptomebis kontroli, rogoricaa gastrointestinuri simptomebi, qoSini, konfuzia da depresia. gansakuTrebuli yuradReba unda mieqces momakvdavi pacientis movlis gegmis winaswar SemuSavebas. terminalur fazaSi pacientebs xSirad uqveiTdebaT gadawyvetilebis miRebis unari, amdenad, misi avtonomiis dacvisa da arCevnis pativiscemis TvalsazrisiT, terminaluri daxmarebis gegma, pacientis informirebuli Tanxmobis safuZvelze, winaswar unda Sedges. saTanadod unda Sefasdes momakvdavi pacientisaTvis xelovnuri kvebis mniSvneloba. miRweulia konsensusi sicocxlis SemanarCunebeli RonisZiebebis Sewyvetisa da ormagi efeqtis wesis Taobaze.

7 klinikuri SemTxveva 1 onkoinkurabeluri pacienti, romelic paliatiur movlas saWiroebs
saojaxo medicinis centrSi aRricxvaze imyofeba 59 wlis mamakaci, romelsac erTi wlis win dausves prostatis adenokarcinomis diagnozi. mTeli am periodis ganmavlobaSi pacienti itarebda saTanado mkurnalobas, ris fonzec mkveTrad gamoxatuli tkivili an sxva raime simptomi ar aReniSneboda. dilis miRebaze ojaxis eqimTan movida pacientis meuRle, romelmac eqims Seatyobina, rom misi mdgomareoba damZimda. ras gaakeTebT? CamoayalibeT mdgomareobis marTvis gegma. ra roli daekisreba eqims da ra roli daekisreba eqTans am situaciaSi.

8 klinikuri SemTxveva 2 87 wlis avTvisebiani simsivniT daavadebuli terminaluri pacienti, romlisTavisac eqims misi mdgomareobis Sesaxeb araferi uTqvams 87 wlis qalbatons axlaxan dausves kolinjis araoperabeluri kibos diagnozi. eqTanma pacientis qaliSvilsa da vaJiSvils uTxra ~dedaTqvens kibo aqvs~. qaliSvilma amis Semdeg maSinve dagirekaT da daJinebiT gTxovaT- `araferi uTxraT dedaCems amis Taobaze~. Tqven am ojaxs didi xania icnobT, da maTTvis daxmareba araerTxel gagiweviaT. axla ki sakmaod rTul mdgomareobaSi aRmoCndiT. rogor moiqceviT?

9 klinikuri SemTxveva 3 ojaxis eqims mimarTavs pacienti, romelsac tkivilis kontrolis mizniT daniSnuli hqonda gaxangrZlivebuli moqmedebis morfini orjer dReSi da damatebiT, Sualeduri tkivilis kupirebisaTvis xanmokle moqmedebis morfinis preparatebi. pacienti aRniSnavs, rom ukve erTi kviraa, rac Zalian xSirad uxdeba xanmokle moqmedebis preparatebis gamoyeneba da es TiTqmis samjer aRemateba adre moxmarebul raodenobas. rogor moiqceviT aseT SemTxvevaSi?


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