daunis

sindromi

samedicino
meTvalyureoba

kavSiri `Cveni bavSvebi~

 Sesavali

yovel sam wuTSi qveynad erTi daunis sindromis mqone

bavSvi ibadeba _ yovel 800 bavSvSi - erTi. dRes msoflioSi
daaxloebiT 5 milioni am sindromis mqone adamiani cxovrobs.
igi erT-erTi yvelaze metad gavrcelebuli Tandayolili
genetikuri maxasiaTebelia. daunis sindromis mqone adamian-
ebi yvelgan gvxvdebian, msoflios nebismier kuTxeSi, nebis-
mier eTnikur, kulturul Tu socialur jgufSi.
1866 wels ingliselma eqimma jon landom daunma pirve-
lad aRwera am sindromisaTvis damaxasiaTebeli niSnebi. 1959
wels ki frangma mecnierma Jerom leJenim aRmoaCina, rom
daunis sindromis mqone adamianebs yovel ujredSi ormoc-
daeqvsis magivrad, 47 qromosoma aqvT, radgan 21-e qromoso-
ma dawyvilebis nacvlad samdeba. aqedan momdinareobs am sin-
dromis sxvagvari dasaxelebac: trisomia 21.
meoce saukunis 70-ian wlebamde daunis sindromis mqone
mravali adamiani ver iRebda Sesabamis samedicino daxmare- jon landom daunma
bas. iSviaTad xdeboda gulis Tandayolili daavadebebis, in- pirvelad aRwera daunis
feqciuri, endokrinologiuri, ZvalkunTovani sistemis daa- sindromis maxasiaTeblebi
vadebaTa da sensoruli sistemis darRvevebis mkurnaloba.
daunis sindromis mqone pirTaTvis, umeteswilad, praqtiku-
lad miuwvdomeli iyo Sesabamisi specialuri ganaTleba, ino-
vaciuri gamajansaRebeli momsaxureba da adreuli ganviTa- sarCevi
rebis programebi. sabednierod, 70-iani wlebidan moyole- Sesavali 1
buli, mniSvnelovani winsvla SeiniSneba daunis sindromis
mqone adamianebis ganaTlebisa da maTi janmrTelobis dac- gulis Tandayolili
vis sferoSi. daavadeba 3
daunis sindromis mqone adamianebi Zalian gansxvavdebian kuW-nawlavis traqtis
erTmaneTisagan rogorc maTTvis damaxasiaTebeli samedici- anomaliebi 4
no problemebis xasiaTis, ise maTi simwvavis TvalsazrisiT.
miuxedavad imisa, rom maTs organoebze SesaZloa uaryofiT- farisebri jirkvlis
ad imoqmedos qromosomulma darRvevam da daunis sindromis disfunqcia 5
mqone zogierT adamians ufro meti problema axasiaTebdes, imunuri sistema 6
vidre am sindromis armqone individebs, saWiro samedicino
da stomatologiuri momsaxurebiT sargeblobis SemTxvevaSi mxedvelobis problemebi 7
am tipis adamianTa umravlesobis janmrTelobis zogadi md- yel-yur-cxviri 8
gomareoba damakmayofilebelia.
sxva bavSvebis msgavsad, daunis sindromis mqone bavSvma orTopedia 12
garkveuli sixSiriT unda gaiaros samedicino Semowmeba zr- dentaluri (piris Rrus)
disa da ganviTarebis kontrolis mizniT. Semowmebisas pedi- problemebi 13
atrma an ojaxis eqimma, mSoblebTan erTad, unda ganixilos
ganviTarebasTan dakavSirebuli problemebi da bavSvis kve- daunis sindromis mqone
basTan dakavSirebiT konsultacia gauwios maT. regularuli bavSvi da leikemia 13
samedicino kontroli sWirdeba acrebis mimdinareobas, ker- nevrologiuri problemebi 14
Zod, imunizacias (acra) B hepatitze, poliomielitze, tet-
samedicino problemebi
anussa da difteriaze, yivanaxvelaze, hemofilus influen-
zrdasrul asakSi 15
caze, pnevmokokiT gamowveul daavadebebze, ybayuraze, wiTe-
lasa da wiTuraze da sxv. daculi unda iqnas regularuli daskvna 16
acris grafiki.


me-20 saukunis dasawyisi dromis mqone adamianTa swavle- bavSvebma Cveulebrivi bavSvebis
daunis sindromis mqone adami- ba-ganviTareba SeuZlebelia. gverdiT unda iswavlon.
anis sicocxlis saSualo xan- Tumca am dros ukavSirdeba daunis sindromis mqone bavS-
grZlivoba cxra welia. TavianTi bevri pirveli sareabilitacio vebis mSoblebi bevr qveyanaSi
sicocxlis xanmokle periods centris daarsebac. adamianebi arian am moTxovnis wamoyenebis
bavSvebi, ZiriTadad, Sin gamo- xvdebian, ramdenad mniSvnelova- iniciatorebi. Sedegad am wlebSi
ketilni atareben, sadac isini, nia, rac SeiZleba adre dawye- daunis sindromis mqone mravali
ojaxis wevrebis mzrunvelobis bul iqnas daunis sindromis bavSvi integrirebul sabavSvo
garda, araviTar sxva daxmare- mqone bavSvTa gansakuTrebuli baRsa Tu skolaSi dadis.
bas ar iReben. ar arsebobs ara- xelSewyoba. TandaTan izrdeba integracia vrceldeba
viTari interesi am sindromis sareabilitacio centrebs Soris Tavisufali drois gatarebis

1950
mqone adamianebis mimarT. kavSirebi. axla ukve daunis sin- obieqtebzec: sul ufro meti
dromis mqone bavSvs sicocxlis integrirebuli sacekvao klu-
daunis sindromis mqone ada- pirvelsave wels ramdenime gan- bi, Teatri, musikaluri ansambli
mianis sicocxlis saSualo xan- maviTarebel Terapiul meTods da sportuli gaerTianeba ixsne-

1980
grZlivoba 20 welia. rogorc sTavazoben. ba SezRuduli SesaZleblobebis

2000
wesi, bavSvebs dabadebisTanave mqone adamianebisaTvis.
bavSvTa saxlebSi aTavseben, sa- daunis sindromis mqone
dac isini TiTqmis araviTar dax- bavSvebi, rogorc wesi, ramden- sul ufro meti daunis sin-
marebas ar iReben. sayovelTaod imewliani sareabilitacio kur- dromis mqone axalgazrda pou-
miRebuli azris mixedviT, maT- sis gavlis Semdeg, specialur lobs samsaxurs Tavisufal ba-
Tvis raimenairi daxmarebis gaw- sabavSvo baRebsa da skolebSi da- zarze da damoukideblad cxov-
evas azri arc aqvs. samedicino dian. aq maT praqtikul, cxovre- robs Cveulebriv binaSi da

1960
saSualebebi arasakmarisia. baSi gamosayenebel unar-Cvevebs ara specializebul saerTo
uviTareben. am bavSvebisaTvis sacxovrebelSi.
daunis sindromis mqone bavS- kognituri sagnebis swavleba daunis sindromis mqone ada-
vTa mSoblebi TandaTan zrunaven zedmetad, an aramniSvnelovnad mianTa sasicicxlo pirobebis
Svilebis ganaTlebaze. yalibdeba ganixileba. gaumjobesebas xels uwyobs med-
mSobelTa iniciativiT daarse- am periodSi Zalian bevri icinis miRwevebi tvinisa da gene-
buli moZraobebi, romlebic daculi tipis saxelosno iqmne- tikis kvlevis sferoebSi.
SezRuduli SesaZlebleblobebis ba, sadac, skolis periodis das- axali samecniero, Terapiuli
mqoneTa interesebs icaven. es rulebis Semdeg, daunis sindro- da pedagogiuri Sedegebis gaT-
organizaciebi momdevno 30 wlis mis mqone mozrdilebi saqmdebi- valiswinebiT, daunis sindromis
ganmavlobaSi am adamianebisaTvis an. axla ukve daunis sindro- mqone adamianebis individualuri
sabavSvo baRebs, skolebs, sax- mis mqone bevri adamiani saerTo SesaZleblobebi unda viTarde-
elosnoebsa da saerTo sacxovre- sacxovreblebSi cxovrobs, rom- bodes, raTa maT damoukide-

1970
blebs aarseben. lebic specialurad SezRuduli beli da Rirseuli cxovrebis
SesaZleblobebis mqone adamian- gagrZeleba SeZlon.

1990
ukve fiqroben, rom dau- ebisaTvis igeba. daunis sindromis mqone ada-
nis sindromis mqone adamianebi- mianebi, dRes karg samedicino
saTvis garkveuli tipis swavle- integraciis survili kidev momsaxurebas iReben da bevrad
ba da ganviTareba SesaZlebelia. ufro Zlierdeba. mas Semdeg, rac ukeTesi sasicocxlo pirobe-
magram, amasTanave miaCniaT, rom saerTaSoriso normebisa da mra- bi aqvT, vidre adre. amis gamo,
isini garkveuli drois Semdeg val qveyanaSi miRebuli kanoniT, bolo wlebSi daunis sindromis
TavianT “mwvervals” aRweven, SezRuduli SesaZleblobebis mqone adamianTa sicocxlis xan-
Semdeg Cerdebian da isev de- mqone adamianebi ganaTlebis grZlivoba sagrZnoblad gaizar-
gradirebas iwyeben. es mosazre- uflebas moipoveben, bevr mSo- da da dRes ukve danarCeni ada-
ba imiTaa gamowveuli, rom ped- bels ukve aRar surs misi Svili mianebis sicocxlis xangrZlivo-
agogebis mxridan ar arsebobs specializebul sabavSvo baRsa bisagan bevrad aRar gansxvavde-
saTanado interesi special- Tu skolaSi ataros. isini inter- ba. sicocxlis xangrZlivobis
uri ganmaviTarebeli meTodebis graciis uflebisaTvis ibrZvian: saSualo maCvenebeli 60 wels
Seqmnaze. iTvleba, rom gonebri- SezRuduli SesaZleblobebis zeviTaa.
vi TvalsazrisiT, daunis sin-


 gulis gaxSireba, xSiri avadoba, wonaSi
cudi mateba, zeda sasunTqi gze-
Tandayolili bis infeqcia. Tumca arsebobs is-
daavadeba eTi saxis Tandayolili mankebi,
romlebic Tavidan usimptomod
mimdinareobs, xolo aRniSnuli
simptomebi SeiZleba mogvianebiT
gulis Tandayolili daa- gamovlindes, rodesac qirur-
vadeba daunis sindromis mqone giuli koreqcia SesaZlebelia
bavSvebis daaxloebiT 40%‑50%‑s dagvianebulic ki aRmoCndes.
aReniSneba. yvelaze xSirad aseT SemTxvevaSi mniSvnelova-
gvxvdeba gulis centraluri nia pediatris konsultacia da
nawilis anomaliebi: xvrelis ar- mankis drouli diagnostika,
seboba gulis Rruebs Soris da ris safuZvelzec moxdeba mankis
gulis sarqvelis anomaliuri drouli qirurgiuli koreqcia.
struqtura. aseT darRvevebs, daunis an viliamsis sindromebs
Cveulebriv, atrioventriku- xSir SemTxvevaSi gul-sisxl-
luri Zgidis defeqts uwode- ZarRvTa sistemis paTologiac
ben. SesaZloa arsebobdes gulis erTvis Tan. amitom aseTi sin-
sxva Tandayolili anomaliebic dromebis arsebobis SemTxvevaSi,
– parkuWTaSua Zgidis an wina- pediatri, gulis mankis simp-
gulTaSua Zgidis defeqti. tomebis ar arsebobis drosac,
radgan gulis Tandayolili pacients diagnostikis mizniT
mankis mravali saxeoba arsebobs, kardio-qirurgiul klinikaSi
Sesabamisad sxvadasxvaa maTi agzavnis.
gamovlenis niSnebi da mimdin- mniSvnelovania, rom saWiroe-
areoba. zogadad mankis simptom- bis SemTxvevaSi, gulis mankis ga-
ebia: cianozi (silurje), kvebis mosworeba gadaudebeli qirur-
dros daRla, uaris Tqma sakve- giuli Carevis gziT optim-
bze, gulis aCqareba, sunTqvis alur periodSi ganxorcieldes.
amgvari qirurgiuli Careva mniS-
 dRes eqimebi bWoben, Seitanon Tu vnelovnad gaaumjobesebs bavSvis
ara, Tirkmlis Tandayolili proble-
janmrTelobasa da sicocxlis
mebi daunis sindromisaTvis damaxasi-
aTebel daavadebaTa ricxvSi. radgan, xarisxs. gulis Tandayolili
Tu am saxis problemebi danarCeni popu- mankis qirurgiaSi arsebuli
laciis mxolod 1% aris damaxasiaTebe- miRwevebiT, SesaZlebelia ise-
li, daunis sindromis SemTxvevaSi, pro- Ti saxis gulis mankebis koreq-
centuli maCvenebeli 17%-mde izrdeba.
cia, romlis gankurnebac adre
amitom sasurvelia, daunis sindromis
mqone Cvils Tirkmlis eqografiuli ar xdeboda.
daTvalierebac Cautardes.


 kuW-nawlavis traqtis anomaliebi

daunis sindromis mqone muSaobaSi metyvelebisa da oku- bali maCvenebeli aqvT. aqedan
bavSvebis 5%-12%-s aReniSne- paciuri Terapevtebic CaerTon, gamomdinare, maT esaWiroebaT
ba kuW-nawlavis traqtis mrava- radgan sakvebis miRebasTan da- 10%-20%-iT naklebi kaloria,
li Tandayolili anomalia, ro- kavSirebuli problemebis mogva- vidre igive wonisa da simaRlis
goricaa saylapavi milis bloka- reba maTi saqmianobis sferoSic mqone sxva bavSvebs.
da, saylapavi milis dakavSireba Sedis. radganac Warbi wona janmr-
sasunTq gzasTan (fistula), ku- TelobasTan dakavSirebul mra-
Wis sarqvelis Seviwroeba (pi- val problemas warmoSobs, mniS-
lorusis stenozi), Tormetgoja vnelovania, rom daunis sin-
nawlavis gadaketva, msxvili naw- kvebasTan dromis mqone adamanebs ar aR-
lavis zogierT monakveTSi ner- dakavSirebuli eniSnebodes wonis Warbi mate-
vuli ujredebis ararseboba problemebi ba. Sesabamisad, swori kvebis
(hirSsprungis daavadeba), anal- Taobaze konsultireba adreuli
uri spinqteris ararseboba da asakidan unda daiwyos. mSobleb-
sxva. am Tandayolil anomaliaTa Cvilobis asakSi daunis sin- ma unda miiRon informacia daba-
umravlesoba saswrafo qirurgi- dromis mqone bavSvebSi aRin- lansebuli dietis ZiriTadi el-
ul Carevas saWiroebs, raTa aR- iSneba kvebasTan dakavSirebu- ementebis Sesaxeb. isini unda er-
dges nawlavis normaluri fun- li problemebi da arasakmari- idon bavSvisaTvis zedmeti kal-
qcia – sakvebi nivTierebisa da si mateba wonaSi. aseTi viTare- oriebis micemas da xels unda
siTxis Sewova. ra Tqma unda, ba gansakuTrebiT damaxasiaTe- uwyobdnen bavSvis fizikur aq-
daunis sindromis mqone bavS- belia gulis Tandayolili daa- tivobas. amasTan, regularulad
vebi igive saxis mkurnalobas vadebis mZime SemTxvevebisaTvis. unda xdebodes zrdis maxasiaTe-
saWiroeben, rasac qromosomuli Sesabamisad, SesaZloa moxdes blebis Semowmeba (wona da simaR-
darRvevis armqone bavSvebi. Seferxeba zrdasa da wonis mate- le) da miRebuli maCveneblebis
aqve unda aRiniSnos, rom baSi. gulis Tandayolili daa- zrdis diagramaze aRricxva.
daunis sindromis mqone bavS- vadebis mqone bvSvebs sWirdebaT rodesac bavSvs zeWarbi
vebs celiakiiT daavadebis ufro damatebiTi kaloriebis miRe- wona aqvs, wonaSi dakleba xSir-
meti Sansi aqvT. celiakiis dros, ba, rasac uzrunvelyofs sakve- ad sakmaod rTulia. qcevis mod-
bavSvi ver inelebs burRuleu- bi racionis gazrda, xSiri kveba ifikacia, SezRuduli raodeno-
lis konkretuli cilis we- da racionSi cximovani an naxSir- bis sakvebis miRebasa da aqtiur
bogvaras, rac wonasa da ganvi- wylovani danamatebis Semotana. varjiSTan erTad, wonaSi klebis
TarebaSi CamorCenas iwvevs. daa- gulis Tandayolili mankis ga- racionaluri programis mTavari
vadebis identificireba xSirad mosworebis Semdeg, bavSvebi, elementia.
rTulia, radgan misi klinikuri Cveulebriv, normalurad iwye- Tu daunis sindromis mqone
niSnebi (neli zrda, ganviTarebis ben wonaSi matebas. adamianebi daicaven raodeno-
Seferxeba) daunis sindroms miew- amave dros, daunis sindro- brivad da Tvisobrivad dabalan-
ereba xolme. Tu celiakia dadg- mis mqone mraval mozards da sebul dietas, romelic Seicavs
inda, bavSvebs ugliadino dietas zrdasruls Warbi wona aReniS- oTxi ZiriTadi jgufis sakvebs
uniSnaven. neba, rac, albaT, gamowveulia (1. xorceuli, Tevzeuli da
radgan daunis sindromis dabali fizikuri aqtivobiT, kvercxi; 2. xili da bostneuli;
mqone bavSvs, SesaZloa, sxvadasx- Warbi kvebiTa da energiis ara- 3. xorbleuli da puri; 4. rZe da
va tipis samedicino problema sakmarisi xarjviT. daunis sin- rZis produqtebi), isini miiReben
erTdroulad hqondes, kargia, dromis mqone zogi adamiani wo- vitaminebs, aminomJavebs, minera-
Tu am sakiTxebis mogvarebaze eq- naSi Zalian imatebs “normaluri” lebsa da sxva sakveb nivTierebas,
imTa gundi (pediatri, qirurgi, raodenobis kaloriebis miRebis romelic swori zrdisa da ganvi-
radiologi, dietologi) erT- SemTxvevaSic ki. kvlevam daadgi- TarebisaTvis aris aucilebeli.
droulad da urTierTSeTanx- na, rom daunis sindromis mqone
mebiT imuSavebs. sasurvelia am bavSvebs nivTierebaTa cvlis da-


 farisebri jirkvlis disfunqcia

miuxedavad imisa, rom dau- SeirCes Sesabamisi medikamenti.

nis sindromis mqone bavSvebis Tu medikamentebiT mkurnaloba
umetesobas farisebri jirkvlis sasurvel Sedegs ver iRebs, ma-
normaluri funqcia axasiaTebs, Sin ori alternatiuli gza rCe-
sxva bavSvebTan SedarebiT, am ba: Tiroidis radioaqtiuli io-
TvalsazrisiT, maT mainc gac- diniT mospoba, an qirurgiu-
ilebiT meti problema aqvT. li operacia. aRsaniSnavia, rom
farisebri jirkvlis disfunq- daunis sindromis mqone pirebis
cia SeiZleba gamowveuli iyos SemTxvevaSi, sjobs qirurgiul
farisebri jirkvlis hormo- gzas mivmarToT, radgan radio-
nis donis aweviT (hiperTire- aqtiuli iodiniT mkurnalobis
ozi) an am hormonis donis daw- grZelvadiani Sedegebi jer kar-
eviT (hipoTireozi). hiperTir- gad Seswavlili ar aris. es ki
eozTan SedarebiT hipoTireozi gansakuTrebiT safrTxiloa dau-
ufro gavrcelebulia da daunis nis sindromis mqone bavSvebisaT-
sindromis mqone pirebis daax- vis, radgan maTSi leikemiis gan-
loebiT 15%-20%-s aReniSneba. viTarebis riski ufro maRalia,
farisebri jirkvlis funqcias- vidre sxva bavSvebSi.
Tan dakavSirebul problemebs farisebri jirkvali mniS-
ufro xSirad daunis sindromis vnelovan funqcias asrulebs
mqone ufrosi asakis individebT- adamianis organizmSi. misi hor-
an vxvdebiT. monis nakleboba uaryofiT-
hiperTireozis SemTxvevaSi, ad moqmedebs bavSvis zrdasa da
pacients, romelic iRebs me- inteleqtualur ganviTareba-
Tiomazols an propilTioura- ze. amitom aucilebelia xSir-
cils da mas baqteriuli (ara vi- ad Semowmdes bavSvis farisebri
rusuli) infeqciebi uviTardeba, jirkvlis funqcia. Tu drou-
aucileblad unda Seumowmdes lad ar moxda farisebri jirkv-
leikocitebis da neotrofi­ lis disfunqciis dadgena, aman
lebis maCveneblebi. yuradRe- SesaZloa SemdgomSi uaryofiT-
ba unda mieqces, rom medika- ad imoqmedos bavSvis central-
mentma seriozuli baqteriu- uri nervuli sistemis funqci-
li infeqciebis riski ar gazar- aze. Tu daunis sindromis mqone
dos. medikamentebis SecvliTa pirs hipoTireozi an hiperTire-
da antibiotikebis gamoyenebiT ozi daudginda, saswrafod unda
SesaZloa am problemis Tavidan dawyebul iqnas misi mkurnalo-
acileba. SesaZloa iyos sxva ba. drouli da swori mkurnalo-
gverdiTi efeqtebi: wamowiTle- bis SemTxvevaSi mas aRudgeba
ba, kunTebis tkivili, umado- farisebri jirkvlis normaluri
ba, siyviTle, rac RviZlis an- funqcia da swavla-ganaTlebisa
Tebis niSania. mniSvnelovania, Tu zogadi Semecnebis procesi-
rom nebismieri amgvari simpto- saTvis saWiro Sesabamisi pirobe-
mis dros mivmarToT eqims, raTa bic Seeqmneba.


 imunuri sistema

daunis sindromis mqone siaTdeba. mkvlevarebi amboben, uli (sasunTqi gzebis) infeqcie-
bavSvebs xSirad emarTebaT sa- rom daunis sindromis mqone zo- bi. immunoglobulin G (IgG) srul
sunTqi gzebis infeqciuri daa- gierT bavSvs aqvs SedarebiT mc- ararsebobas seriozuli prob-
vadebebi. sasunTqi gzebis in- ire raodenobis leikocitebi, lemebis gamowveva SeuZlia.
feqcia ufro xSirad gulis romelic mniSvnelovan rols as- Tumca (IgG) ramdenime varianti,
Tandayolili daavadebebis mqone rulebs organizmis dacvis saqme- qve-klasi, arsebobs da Tu misi
bavSvebs aReniSnebaT. garda ami- Si. zogierTi am saxis ujredis romelime umniSvnelo qve-kla-
sa, daunis sindromis mqone bavS- funqcia (gansakuTrebiT B da T si ar moipoveba organizmSi, es
vebSi, adreul asakSi, yuris in- limfocitebis funqcia) anoma- SedarebiT umniSvnelo sirTu-
feqciebia gavrcelebuli. zog liuria daunis sindromis mqone leebs iwvevs. daunis sindromis
mozards aReniSneba ganmeo- bavSvebTan. mqone bavSvebs SesaZlebelia IgG
rebiTi xasiaTis mqone kanis in- me-2 da me-4 qve-klasis defici-
feqciebi, ZiriTadad barZayisa ti hqondeT. radgan IgG mTliani
da dundulis kunTze. infeqcias, maCvenebeli SesaZloa normaSi
Cveulebriv, spobs Sesabamisi antisxeulebi iyos, amitom es deficiti mx-
mkurnaloba antibiotikebiT. olod Sesabamisi qveklasebis an-
mniSvnelovania, rom zogi- aliziT unda gamovlindes. IgG-s,
erTi tipis imunuri problemis specialuri individualuri an romelime misi qveklasis def-
dros, (ujreduli imunitetis Semowmebis gareSe SeuZlebelia icitis SemTxvevaSi, bavSvs ada-
problemebi) bavSvebi ar avcraT dadgindes, aqvs Tu ara dau- mianis imuno-globuliniT in-
cocxali virusuli vaqcinebiT, nis sindromis mqone an armqone travenur, an intramuskulur
rogoricaa poliomelitis pirSi bavSvs imunuri problemebi. ro- mkurnalobas uniSnaven. zogi-
CasawveTebeli vaqcina da wiTel- gorc cnobilia, antisxeulebi, erT SemTxvevaSi, SesaZlebelia
as, wiTurasa da yba-yuris cocx- romlebic organizms daavade- agresiuli antibiotikoTerapi-
ali vaqcinebi. bebisagan icaven, xuTi tipis ac. miuxedavad imisa, rom Terapia
ismis kiTxva, aqvT Tu ara imunoglobulinisagan Sedgeba. umravles SemTxvevaSi warmate-
daunis sindromis mqone bavSvebs organizmSi romelime maTganis bulia, pacients mainc sWirdeba
tipiuri imunuri sistema, ro- Warbi an naklebi doziT arsebo- perioduli Semowmeba mTeli si-
melic maT organizms infeqciis- ba, SesaZlebelia imunur prob- cocxlis manZilze. am procesze
agan icavs? miuxedavad imisa, rom lemebs iwvevdes. immunoglobu- meTvalyureobas sasurvelia at-
daunis sindromis mqone bavSveb- lin AA-s simcire (IgA), an ararse- arebdes specialisti, romelic
Si ar SeiniSneba imunuri siste- boba, marTalia, sicocxlisaTvis icnobs axlebur teqnologiebsa
mis seriozuli anomalia, maTi saSiSi ar aris, magram amis gamo, da meTodebs da qveklasebis do-
organizmis damcavi meqanizmebi bavSvs SesaZlebelia Zalian gax- nis gamovlenis axlebur gzebs.
mainc umniSvnelo anomaliiT xa- Sirebuli hqondes respirator-


 mxedvelobis problemebi

Tandayolili kataraqta bis darRvevebi. arsebuli mo- CamorCeniloba axasiaTebs, ro-

nacemebis mixedviT, bavSvebis gorc es umetesad daunis sin-
daaxloebiT 40% axlomxedve- dromis arsebobis SemTxvevaSi
daunis sindromis mqone lia da 20% Sorsmxedveli. zogi- xdeba, damatebiTi sensoru-
Cvilebis 3%-s Tandayolili erTs aReniSneba sacremle milis li darRveva kidev ufro zRu-
kataraqta aReniSneba. radgan blokireba, xolo bevr maTgans davs bavSvis zogad funqcias
kataraqtuli cvlilebebis gamo – sielme, quTuTos kidis anTe- da xels uSlis swavlis pro-
sinaTle ver aRwevs Tvalis ba- ba (blefariti), aseve, zogjer, cesSi mis CarTvas. daunis sin-
duraSi, mniSvnelovania am daa- Tvalis swrafi moZraobebi (ni- dromis mqone bavSvebs ar axasi-
vadebis identificireba adreul stagmi. nistagmis gakontroleba aTebT Tvalis iseTi disfuqncia,
asakSive. Tu kataraqtas eqstraq- bavSvs ar ZaluZs da amitom mas rac danarCeni populaciisaTvis
cia ar gakeTda dabadebidan rac es ar unda movTxovoT). zemoT ar aris damaxasiaTebeli. dRes
SeiZleba mokle droSi, bavSvi aRniSnul Tandayolil kata- Tvalis movlisa da mxedvelobis
SeiZleba dabrmavdes. kataraq- raqtas garda, daunis sindro- xarisxis gaumjobesebis mravali
tas eqstraqcia kargi pediatr- mis mqone adamianebs SeiZleba SesaZlebloba arsebobs, romle-
oftalmologisaTvis SedarebiT kataraqta zrdasrul asakSic bic aucileblad unda gamovi-
martivi operaciaa. amis Semdeg, CamouyalibdeT. rqovanas da- yenoT daunis sindromis mqone
saTvalis an kontqaturi linze- zianeba Tavs iCens daunis sin- bavSvis SemTxvevaSic. Tu bavSvs
bis gamoyeneba normalur mxedv- dromis mqone pirebis daaxloe- saTvalis tarebis an operaciis
elobas uzrunvelyofs. biT 2%-5%-Tan. gakeTebis fsiqologiuri, an sxva
imis gamo, rom daunis sin- tipis problema gauCndeba, dax-
dromis mqone bavSvebSi xSiria marebisaTvis, eqimis garda, unda
Tvalis disfunqcia, maT regu- mivmarToT fsiqologsa da ok-
mxedvelobis darRvevebi laruli Semowmeba unda gaiar- upaciur Terapevts. nebismieri
on pediatr-ofTalmologTan. problemis gadaWrisas, sasarge-
normaluri mxedveloba nebism- bloa gunduri midgoma.
daunis sindromis mqone ieri bavSvisaTvis mniSvnelova-
bavSvebs xSirad aqvT mxedvelo- nia, magram Tu bavSvs gonebrivi


 yel-yur-cxviri

smeniTi darRvevebi mis arxebi aqvT, SesaZlebelia vebSi Sua yuris infeqciebi
am procedurisaTvis msubuqi ufro xSiria da am infeqciebi-
damamSvidebeli dainiSnos. ami- sgan gamowveuli yurSi Camdgari
daunis sindromis mqone bavS- tom, sasurvelia, amgvari pro- siTxis mkurnaloba ufro Zneli,
vebis umravlesobas msubuqi an ceduris win eqims gaesaubroT am dros ufro agresiuli an-
saSualo simZimis smeniTi dar- da gasinjvis strategiaze er- tibiotikoTerapia iniSneba, vi-
Rvevebi aqvs, rac gamowveulia: Tad SeTanxmdeT. Tu gasinjvisas, dre daunis sindromis armqone
yuris gogirdis Warbi odenobiT an raime procedurisas bavSvi bavSvis SemTxvevaSi dainiSnebo-
sasmen milebSi, yuris xSiri in- bevrs itirebs da gaRiziandeba, da. Tu antibiotikebiT Sedegi
feqciiT, Sua yurSi siTxis dag- SesaZloa mas saxeze patara zo- ar miiRweva, maSin yurSi saven-
rovebiT an, Sua yuris mcire mis wiTeli winwklebi gauCndes. tilacio drenaJis Cadgma (mir-
Zvlebis, romlebic bgeras yuris es kapilaruli sisxlCaqcevaa, ingotomia) xdeba saWiro. es xan-
apkidan Sida yurs gadascemen, saSiSi ar aris da ramdenime dRe- mokle qirurgiuli operaciia,
anomaliuri formiT. zogjer, Si TavisiT gaivlis. Tu pirveli romelic, rogorc wesi, sruli
daxSobis gamo, Semcirebulia an gasinjvisas bavSvs gadaxra ar anesTeziis qveS keTdeba.
blokirebulia siTxis drenaJi aRmoaCndeba, es ar niSnavs, rom Sua yuris anTebis preven-
Sua yuridan yelSi, rac zeda sa- mas SemdgomSi yuris problema ciisaTvis, rasac xSirad strep-
sunTqi gzebis infeqciis, didi ar eqneba. Tanac mniSvnelovania, tokokuli baqteria iwvevs, sa-
zomis adenoidebis arsebobis rom subieqtur STabeWdilebebs survelia bavSvi pnevmokokis vaq-
an evstaqis milis (akavSirebs ar vendoT. SesaZlebelia Cveni ciniT (PVC) aicras. es acra dau-
yels Sua yurTan) disfuqnciis varaudebi mcdari iyos. amitom nis sindromis mqone bavSvebisaT-
Sedegad viTardeba. smenis regularuli Semowmeba vis gansakuTrebiT rekomendire-
sasurvelia, daunis sindro­ daunis sindromis mqone bavS- bulia, radgan igi zeda sasunTqi
mis mqone bavSvebs, ­ smena da­ vebisaTvis aucilebelia. gzebis mravali daavadebisa-
badebis pirvel TveebSive Seu­ Tu smeniTi darRveva Sua gan icavs maT. saqarTveloSi
mowmdeT, Semdeg ki sul mci- yuriT aris gamowveuli, bavS- es vaqcina savaldebulo acra-
re weliwadSi erTxel unda ga- vs unda daeniSnos Sesabamisi Ta rigSi ar Sedis. Tumca misi
iaron Semowmeba. radgan pata- mkurnaloba, rac SeiZleba gu- Camotana (specialuri wesebis
ra bavSvebis sasmeni arxebis sa- lisxmobdes antibiotikebis dacviT) SesaZlebelia amerikis
guldagulo Semowmeba Znelia, miRebas, an Sua yurSi saventi- SeerTebuli Statebidan an evro-
miTumetes daunis sindromis lacio drenaJis Cadgmas. radgan pis qveynebidan.
mqone bavSvebs ufro mcire zo- daunis sindromis mqone bavS-


 smenis saSualo an mZime dar- Zilis apnoe (ZilSi CamouyalibdeT maRali sisxlis
Rvevis dros, sasmeni aparati sunTqvis droebiT wneva filtvis sisxlZarRvebSi,
gamoiyeneba. daunis sindromis Sewyveta) rac gamoiwvevs gulis ukmari-
mqone bavSvs SesaZloa zemgrZno- sobis ganviTarebas. Tu Zilis
beloba hqondes Tavis midamoe- apnoes gaCenis mizezi zeda sa-
bSi Sexebaze da amitom yuris ukanasknel wlebSi, samedi- sunTqi gzis gadaketvaa, xSir-
sasmen aparatTan Segueba gau- cino literaturaSi, gamoqveyn- ad misi mkurnaloba – didi zo-
Wirdes. am problemis mogvareba- da mravali statia, romlebSic mis tonzilebisa da adenoidebis
Si okupaciuri Terapevti dagex- saubaria Zilis apnoes Sesaxeb, moSoreba qirurgiuli Carevis
marebaT. mniSvnelovania sasmeni romelic daunis sindromis mqone gziT, Zilisas haeris nakadis
aparatis regularuli Semowmeba, adamianebs SeiZleba hqondeT. wnevis gamoyeneba da sxva pro-
raTa darwmunebuli iyoT, rom Zilis apnoes gaCenas ZiriTadad cedurebi – sasurvel Sedegs
igi ­ kargad muSaobs. Sida yuris ganapirobebs yelis ukana mxares iZleva.
an sasmeni nervis problemebiT sasunTqi gzis gadaketva, rac,
gamowveuli smeniTi darRveva Tavis mxriv, xSirad gamowveulia
(smenis sensonervuli daqveiTe- tonzilebiTa da adenoidebiT,
ba), daunis sindromis mqone yelis siviwroviT, an, Warbi wo- tonzileqtomia
bavSvebSi ufri naklebi sixSiriT nis mqone adamianebTan, cximovani
gvxvdeba. qsovilis didi odenobiT.
smeniTma darRvevebma SeiZ­ Zilis apnoes mqone bavSvebi Tu Tqvens bavSvs sunTqvas-
leba zegavlena moaxdinos dau- Cveulebriv xmaurianad sunTqa- Tan dakavSirebuli problemebi
nis sindromis mqone umcro- ven, xvrinaven, Zilisas aReniSne- aqvs, SesaZlebelia tonzileqto-
si asakis bavSvebis fsiqolo- baT sunTqvis Sekavebis xanmokle mia da adenoidoqtomia, (glan-
giur da emociur mdgomareoba- epizodebi, dRisiT axasiaTebT debisa da adenoidebis amokveTa)
ze. amitom, Zalian mniSvnelova- Zilianoba da yuradRebis sus- girCion.
nia, rom sworad Semowmdes bavS- ti koncentracia. Zilis apno- daunis sindromis mqone bevr
vis smena da smenis daqveiTebis em SeiZleba gamoiwvios sisxlSi bavSvs gadidebuli glandebi
SemTxvevaSi saswrafod dainiS- Jangbadis Semcvelobis Semcireba, an adeniodebi aqvs. Tumca dau-
nos mkurnaloba. cnobilia, rom rac uaryofiTad imoqmedebs cen- nis sindromis mqone bavSvebi-
smenis umniSvnelo daqveiTe- traluri nervuli sistemis muS- saTvis am operaciebis gakeTeba
bamac ki SesaZloa Seaferxos me- aobaze. iSviaT SemTxvevaSi Zilis garkveul riskTanaa dakavSire-
tyvelebis ganviTareba. apnoes mqone bavSvebs SeiZleba buli. radgan daunis sindromis


mqone bavSvebis sasunTqi gze- tonzileqtomiisa da adeno­ lic am mdgomareobas axlavs, hip-
bi isedac SedarebiT pataraa, idoqtomiis gadawyvetisas, aseve ernazaloba hqvia. am dros bavS-
operaciis Semdgomma SeSupebam unda vicodeT, rom am operaciis vi TiTqos „cxvirSi laparakobs“.
SesaZloa sunTqvis seriozuli Semdeg daunis sindromis mqone metyvelebis Terapevtis daxmare-
garTuleba gamoiwvios. amitom, bavSvs SesaZloa metyveleba ufro biT, SesaZlebelia hipernazalo-
operaciis Semdeg, sxva bavSvebi- gauWirdes. saqme imaSia, rom bis nel-nela gaumjobeseba. ma-
sagan gansxvavebiT, daunis sin- rodesac adamiani laparakobs, gram sirTuleebis Tavidan asac-
dromis mqone bavSvebi klinika- misi sasis ukana nawili moZraobs ileblad umjobesia adenoidebis
Si SedarebiT xangrZlivad unda da gzas uketavs haers, romelic mxolod wina nawili amoiWras.
darCnen, raTa sunTqvis gar- xaxidan nestoebisaken miedineba. tonzileqtomiisa da adenoido-
Tulebis SemTxvevaSi maT sas- kunTi amas adenoidis baliSze qtomiis meore gavrcelebuli
wrafo daxmareba aRmouCinon. zewoliT akeTebs. rodesac ad- riski sisxldenaa, romelic yove-
Zneli saTqmelia, gamos- enoidi mocilebulia, bavSvs am li 30-50 pacientidan erTs uvi-
wordeba Tu ara, an ramdenad kunTis ufro metad (Sors) amoZ- Tardeba xolme.
gamoswordeba sunTqviTi prob- raveba uwevs, raTa nestoebisken radgan glandebisa da ade-
lemebi operaciis Semdeg. dau- gza Caiketos. daunis sindromis noidebis operacia da Sedegebi
nis sindromis mqone zogierTma mqone bavSvebisaTvis, romlebsac garkveul riskTanaa dakavSireb-
bavSvma, romelsac Zalian patara pir-xaxis kunTebis hipotonia uli, igi mxolod im SemTxvevaSi
sasunTqi arxebi aqvs, operaci- (moduneba) da Seferxebuli mo- unda gakeTdes, Tu seriozu-
is Sedegad SesaZloa sunTqviTi toruli ganviTareba aqvT, amis li sunTqviTi darRvevebi ap-
problemebi ver moigvaros. gar- gakeTeba ufro rTulia. Tu gas- noes iwvevs, an Tu saqme Zalze
da amisa, piriT sunTqvis Cveva asvleli bolomde ar Caiketeba, xSirad ganmeorebad, rTul in-
Zneli mosacilebelia, operaciis es haeris gaJonvas iwvevs. amis feqciebTan gvaqvs. saSualo do-
gakeTeba am Cvevisagan ganTavi- aRmniSvneli samedicino termi- nis sasunTqi gzebis obstruq-
suflebis erTaderTi winapiroba nia velofaringsis ukmarisoba ciis SemTxvevaSi didi Sansia,
ar aris. cxviriT sunTqvas swav- (Velopharyngeal insufficiency). met­ rom bavSvi zrdasTan erTad am
la sWirdeba. yvelebis Taviseburebas, rome­ problemas gadalaxavs, anu asak-

10
Tan erTad, misi sasunTqi gze- ciasTan gvaqvs. am SemTxvevaSi
bi adenoidebTan da glandebTan Sesabamisi antibiotikoTera-
SedarebiT gaizrdeba. pia unda dainiSnos, (sasurvelia
gamonadenis baqteriuli anal-
izis gakeTebac, optimaluri an-
tibiotikis dasaniSnad). Tu wam-
sinusiti lis miRebis dasrulebis Semdeg
cxviridan dena maleve isev iwye-
ba, SesaZloa eqimma antibioti-
daunis sindromis mqone bavS- kis mcire doza xangrZlivi peri-
vebSi xSiria sinusitic (wiaRebis odiT (Tveebi, wlebi) daniSnos.
anTeba). daunis sindromis mqone gverdiTi efeqtebi minimaluria,
aTidan rva bavSvs cxviridan magram am iSviaT SemTxvevaSi an-
permanentuli gamonadeni aqvs tibiotikma SesaZloa gamoiwvios
xolme. miuxedavad imisa, rom diarea kuW-nawlavis floraze
surdo nebismieri bavSvisaTvis zemoqmedebis gamo, alergiuli
Cveulebrivi movlenaa, daunis reaqcia, an veRar imoqmedos in-
sindromis mqone bavSvs SeiZleba feqciis gamomwvev baqteriaze.
igi ufro xSirad da ufro xan- operaciuli Careva (romelic
grZlivi droiT emarTebodes. sruli anesTeziiT unda gakeT-
magram, asakis matebasTan erTad des), mizanSewonilia mxolod
es problema mcirdeba. ukidures SemTxvevaSi, rodesac
Tu cxviridan gamonadeni antibiotikebi veRar moqmede-
Sesqelebuli da moyviTalo-mom- ben da pacients mudmivad gan-
wvano ferisaa, es niSnavs, rom meorebadi sicxiani haimoritis
saqme SesaZlo baqteriul infeq- Setevebi aqvs.

11
 orTopedia

daunis sindromis mqone bavS- daunis sindromis mqone Careva gaxdes aucilebeli.
vebTan gavrcelebulia orTope- Zalian cota bavSvs aqvs kis- daunis sindromis mqone im
diuli problemebi. isini sxeu- ris seriozuli problemebi (1%- adamianebma, romelTac surT mi-
lis mraval nawilSi iCens Tavs. 2%) – xerxemlis nervebis da- iRon monawileoba SezRuduli
ZiriTadi problemebi myesebs zianeba kisris meore malis ze- SesaZleblobebis adamianebisa­
ukavSirdeba. myesebi Seicavs wolis Sedegad, rasac simptom- Tvis gankuTvnil sportul Ro­
gansakuTrebiT didi raodeno- atur atlantoaqsilur arasta- nis­ZiebebSi, eqimTan unda ga-
bis kolagens. isini erTmaneTTan bilurobas uwodeben. aseT bavS- iaron Semowmeba. maT unda Cau­
akavSirebs Zvlebs da Zvlebze vebs SesaZloa uWirdeT siaruli, tardeT nevrologiuri gamo­
amagrebs kunTebs. daunis sindro- da SeiZleba axasiaTebdeT une- kvleva. aucilebelia rentgenis
mis mqone bavSvebis did umravle- blie Sardva da defekacia, gan- gadaReba imis gasarkvevad, aRin-
sobas zeelastiuri saxsrebi aqvT icdidnen diskomforts kisris iSneba Tu ara kisris seriozuli
(myesis sisuste), rasac zogjer areSi, da avlendnen nevrolo- problemebi.
moSvebul saxsrianobas an orsax- giur simptomebs, rac samedici- daunis sindromis mqone ada-
srianobas uwodeben. es SeiZleba no Semowmebisas iCens Tavs. aseT mianebTan rac SeiZleba adre
iwvevdes saxsris amovardnilo- SemTxvevaSi, xerxemlis stabili- unda gamovlindes atlantoaqsi-
bas (srul an nawilobriv dislo- zaciisaTvis SesaZloa qirurgiu- luri da atlantooqsipitaluri
kacias) da kviristavisa da TeZos li Careva iyos aucilebeli. arastabiluroba. es imitom, rom
Zvlis dislokacias. rodesac atlantoaqsilur maTTan es darRvevebi Zalian xSi-
daunis sindromis mqone ada- arastabilurobas specifikuri ria da adreul etapze maTi gamo-
mianebTan, Cveulebrivi ganviTa- simptomebi ar axasiaTebs, rent- sworeba SesaZlebelia. arastabi-
rebis adamianebTan SedarebiT, geni aCvenebs did manZils kis- lurobis dagvianebuli dadgeni-
ufro xSirad gvxvdeba kisris ris pirvel or malas Soris xe- sas SesaZloa xerxemali gamous-
malebis problemebi. farTo- rxemlis nervebze dawolis gar- woreblad daziandes. daunis sin-
masStabiani gamokvleviT dadg- eSe. aseT SemTxvevaSi, individi dromis mqone yvela bavSvma, or-
inda, rom daunis sindromis dakvirvebis qveS unda imyofe- naxevridan sam wlamde, unda ga-
mqone adamianebis did umravle- bodes da sagangebo profilaq- daiRos kisris malebis rentgeni.
sobas axasiaTebs atlantoaqsi- tikuri zomebs unda iRebdes. radgan ar aris cnobili xseneb-
luri (kisris pirveli da meore atlantoaqsiluri da atlan- uli darRvevis Camoyalibebis
malis Sorisi) da atlantooqsip- tooqsipitaluri arastabilu- anamnezi, SeiZleba aucilebeli
italuri (kisris pirveli malis robis mqone adamianebi ar unda gaxdes rentgenis ganmeorebiT
da Tavis qalis fuZis Sorisi) misdevdnen sportis im saxeobas, gadaReba, savaraudod, mozard-
arastabiluroba. daunis sin- romelic kisris dazianebis ris- obis asakis gviandel period-
dromis mqone adamianebis daax- kis Semcvelia. maT unda gaiaron Si, maSin, rodesac bavSvebi iwye-
loebiT 15% axasiaTebs atlan- regularuli Semowmeba am sfer- ben monawileobis miRebas spe-
toaqsiluri arastabiluroba da oSi kompetentur eqimTan. nev- cialur sportul varjiSebSi da
daaxloebiT 8%-s – atlantooq- rologiuri simptomebis gamo- SejibrebebSi.
sipitaluri arastabiluroba. Cenisas, SesaZloa qirurgiuli
orive viTareba kisris myesebis
sisustiTaa gamowveuli.

12
 dentaluri (piris daunis sindromis mqone
Rrus) problemebi bavSvi da leikemia

miuxedavad imisa, rom dau- daunis sindromis mqone davi nabijebi gadaidga am daa-
nis sindromis mqone bavSvebs bavSvebs ufro xSirad aReniS- vadebis mkurnalobis saqmeSi.
kbilebi gvian amosdiT, kbi- nebaT xolme darRvevebi sisxl- dRes ukve leikemiis am tipis
lebs SeiZleba anomaliuri for- sa da imunur sistemaSi. ker- mqone bavSvebis 70% aqvs gankur-
ma hqondeT. zogjer aRiniSneba Zod, bavSvobis garkveul mon- nebisa da gaxangrZlivebuli re-
kbilebis Tandayolili nakle- akveTSi leikemiis riski maTTan misiis Sansi. daunis sindromis
boba an Sezrda. yvelaze tipi- ufro maRalia, vidre sxva bavS- mqone bavSvebi, romlebsac ALL
uri stomatologiuri problema vebSi. Tumca maTTan simsivnuri aqvT, intensiur Terapiul kurss
mainc RrZilebis daavadebaa (gin- daavadebis sxva formebi ufro unda gadiodnen. mkurnalobis es
givitebi da paradontaluri daa- maRali procentuli maCveneble- kursi iseTive efeqturia dau-
vadebebi). samedicino da stoma- biT ar gvxvdeba. nis sindromis mqone bavSvebi-
tologiur literaturaSi xSir- bavSvobis adreul asakSi maT saTvis, rogorc danarCenebi-
ad aRiniSneba, rom daunis sin- SesaZloa daemarToT mielopro- saTvis, magram, gverdiTi mov-
dromis mqone adamianebisaTvis liferaciuli daavadeba, an gar- lenebi, am SemTxvevaSi SesaZloa
RrZilebis daavadebebia damaxa- damavali leikemia; es aris md- ufro Zlieri iyos. kerZod, dau-
siaTebeli. amitom mniSvnelova- gomareoba, romelic leikemi- nis sindromis mqone bavSvebs
nia, rom aseTma adamianebma da- is msgavsia, magram TavisTavad uWirT metotreqsatTan Segueba,
icvan piris Rrus higiena, ga- swordeba xolme. Tumca am romelic qimioTerapiisas gam-
iaron regularuli Semowmeba problemagadatanili bavSvebis oyenebuli erT-erTi prepara-
stomatologTan da sistemat- oc procents SesaZloa Semdeg tia. amitom am wamlis gamoyene-
urad Caitaron ftoridebiT leikemia ganuviTardes. bas gansakuTrebuli yuradReba
mkurnaloba, SeimuSaon swori genetikis Tanamedrove gamo­ unda mieqces.
kvebiTi Cvevebi, da, saWiroebis kvlevebma 21-e qromosomis im daunis sindromis mqone pa-
SemTxvevaSi, gaiaron aRdgeniTi monakveTis identificireba moax- tara bavSvebSi leikemiis ufro
procedurebi. Sesabamisi stoma- dines, romelic daunis sindro- gavrcelebuli forma AML-ia.
tologiuri mkurnaloba, pro- mis maxasiaTeblebs apirobebs. AML transientuli leikemiisa-
filaqtika da piris Rrus saTa- es moankveTi aseve Seicavs genis gan unda ganvasxvavoT. daunis
nado movla agvaridebs paradon- tips, romelsac proto-onkoge- sindromis mqone bavSvebs meti
talur daavadebebsa da kbilis ni ewodeba. proto-ontogenisa midrekileba aqvT ganuviTar-
kariess. da 21-e qromosomis am monakve- deT AML-is M7 an megakario-
Tis Seswavla mecnierebs, albaT, tikuli leikemiis tipi. AML-is
male miscems saSualebas daadgi- mkurnalobis progresi bavSveb-
non, ratom aqvT daunis sindro- Si ufro nelia, magram am bolo
mis mqone bavSvebs leikemiisa da wlebis ganmavlobaSi intensiuri
sisxlis sxva tipis daavadebaTa Terapis meTodebma da Zvlis tvi-
ufro maRali riski. nis gadanergvam gaumjobesebaTa
ALL (mwvave limfoblasturi ricxvi gazarda. daunis sindro-
leikemia) bavSvebSi gavrcele- mis mqone bavSvebi qimioTerapias
buli leikemiaa, romelic aseve iseve itanen, rogorc sxva bavS-
yvelaze xSirad gvxvdeba daunis vebi da maT mkurnalobas kargi
sindromis mqone mozrdil bavS- Sedegebi aqvs.
vebSi. bolo periodSi STam­beW­

13
 nevrologiuri problemebi

gulyra sxva tipis TavSi da ugulebelyon mravali

nevrologiuri ram, rac maT garSemo xdeba. amJa-
problemebi mad ar arsebobs autizmis mqone
gamokvlevebis Tanaxmad, bavSvebis efeqturi samedicino
daunis sindromis mqone pirebis mkurnaloba. radganac ar moiZe-
daaxloebiT 8%-s sxvadasxva sax- daunis sindromis mqone zo- bneba autizmis mqone ori erT-
is gulyrebi SeiZleba hqondes. gierT bavSvs axasiaTebs yur- nairi individi, yoveli adamianis
gulyrebis konkretuli formaa adRebis deficiti da hiperaq- specifikuri saWiroebebis sapa-
e.w. Cvilobis periodis spazmebi, tiuloba. aseTi bavSvebi xSirad suxod unda Sedges mkurnalo-
romlebic 5-10 Tvis bavSvebs aRe- uyuradRebo, zeaqtiuri, impul- bis individualuri gegma. spe-
niSnebaT da romelTa mkurnalo- suri da gafantulni arian. am cialuri meTodebi, rogoricaa,
ba aseT bavSvebSi, daunis sin- maxasiaTeblebis sixSire daunis magaliTad, qceviTi procedure-
dromis armqone bavSvebisgan gan- sindromis mqone bavSvebTan ms- bi, SeiZleba efeqturi gamodg-
sxvavebiT, sakmaod Znelia. amave gavsia maTi gavrcelebis xarisxi- es komunikaciis daswavlisa da
dros, adrenokortikotropu- sa zogad populaciaSi. xsenebuli urTierTobisaTvis saWiro unar-
li hormoniT mkurnaloba xSir- Tvisebebis mqone mravali bavSvi Cvevebis SemuSavebis saqmeSi.
ad efeqturia daunis sindro- dadebiTad reagirebs stimula- Cveulebriv, bavSvebisaTvis sa-
mis mqone bavSvebTan. maTi mdgo- tori medikamentebiT mkurnalo- sargebloa specialuri sagan-
mareoba, Cveulebriv, sagrZno- baze (ritalini, deqsdrini, cil- manaTleblo programebi, rom-
blad umjobesdeba am hormoniT erti). garda amisa, saWiroa ga- lebic, miuxedavad imisa, rom
mkurnalobis Semdeg. gulyris naTlebis procesis adaptacia. mkacrad aris struqturirebu-
sxva formebia tonur-klon- qcevis marTvis teqnika da qcevis li, mainc moicavs individualur
uri da rTuli gulyrebi, rac modifikacia, yuradRebis defi- swavlebas da mcire jgufebSi
zogjer Tavs iCens bavSvobisa da citis mqone hiperaqtiuli bavS- swavlebis SesaZleblobas.
mozardobis asakSi. ufrosi asa- vebis mkurnalobis komponentebs garda amisa, daunis sindro-
kis individebi, romelTac al- warmoadgens. mis mqone zogierT bavSvs ax-
cheimeris daavadeba uyalibde- daunis sindromis mqone zo- asiaTebs qcevis darRveva da
baT, gansakuTrebiT midrekilni gierT bavSvs SeiZleba autiz- opoziciuri qceva. amis movla
arian gulyrebis mimarT. Zalze mi axasiaTebdes, rac Tavs iCens Cveulebriv SesaZlebelia qcev-
mniSvnelovania, rom, saWiroe- SegrZnebebSi, metyvelebaSi, ko- is modifikaciis Sesatyvisi mid-
bis SemTxvevaSi, daunis sindro- munikaciaSi da socialur urT- gomis gamoyenebiT. warmatebu-
mis mqone adamianebs davudginoT ierTobebSi. aseTi bavSvebisaT- li Careva, Tu es SesaZlebelia,
gulyris konkretuli forma da vis tipiuria ritualuri da gulisxmobs dadebiTi ganmt-
saswrafod daviwyoT mkurnalo- TviT-mastimulirebeli qceva. kicebisa da TviTregulaciis
ba Sesabamisi preparatiT. isini SeiZleba Caiketon sakuTar gamoyenebas.

14
 samedicino problemebi zrdasrul asakSi

bavSvobis xanisaTvis damax- monacemebis mixedviT, igi ufro

asiaTebeli mravali samedicino xSirad iCens Tavs, vidre es wi-
problema (infeqciebi, kvebiTi naT iyo miCneuli. fsiqiatriu-
xasiaTis problemebi, RrZilebis li darRvevis diagnozis dasmi-
daavadeba, krunCxvebi, mxedv- sas unda dainiSnos specialuri
elobiTi da smeniTi darRvevebi, mkurnaloba da konsultacia.
farisebri jirkvlis disfuqn-
cia, orTopediuli probleme-
bi) SeiZleba Tavs iCendes dau-
nis sindromis mqone zrdasru- alcheimeris daavadeba
li asakis pirebTanac. ase mag-
aliTad, maTTan xSirad gvxvde-
ba smeniTi darRvevebi, kataraq- daunis sindromis mqone ad-
ta da hipoTireozi. garda ami- mianebTan daberebis proce-
sa, maT SeiZleba aReniSnebodeT si gansakuTrebul yuradRebas
fsiqiatriuli darRvevebi da saWiroebs. samedicino liter-
alcheimeris daavadeba. aturaSi gamoqveynda mravali
werili, romelic miuTiTebs dau-
nis sidromis mqone zrdasruli
asakis adamianebTan alcheimeris
fsiqiatriuli daavadebis sixSires. miuxeda-
darRvevebi vad imisa, rom daunis sidromis
mqone 40 da ufro maRali asa-
kis adamianebis tvinSi aRiniSne-
bolo wlebSi dadginda, rom ba anomaliuri cvlilebebi, rom-
daunis sindromis mqone adami- lebic, Cveulebriv, alcheimeris
anebs aReniSnebaT fsiqiatriu- daavadebis mqone adamianebs axa-
li darRvevebi da qceviTi da siTebT, dabejiTebiT mainc ver
SeguebiTi xasiaTis problemebi. davamtkicebT, rom 40 wlisa da
daunis sindromis mqone zogi- am asaks gadacilebul daunis
erTi mozardi mZime danakargis sidromis mqone yvela individs
Semdeg gamZafrebulad dardobs alcheimeris daavadeba aqvs. dau-
da depresiaSi vardeba. rode- nis sidromis mqone adamianTa um-
sac axalgazrda ver umklavde- ravlesoba iSviaTad amJRavnebs
ba stresis gamomwvev konkre- alcheimeris daavadebisaTvis
tul faqtors, misTvis gansa- tipiur mexsierebis daqveiTe-
kuTrebiT problemuri SeiZleba bas, pirovnul cvlilebebsa da
gaxdes konkretul situacias- fsiqologiur problemebs. wi-
Tan Segueba. darRvevaTa umrav- naswari Sefasebis mixedviT al-
lesoba, gansakuTrebiT ki Rrma cheimeris daavadebis klinikuri
depresia adre iSviaTad aRiniS- niSnebi daunis sindromis mqone
neboda daunis sindromis mqone asakovani individebis 15%-25%-
adamianebTan, magram ukanaskneli Tan iCens Tavs.

15
 daskvna

miuxedavad imisa, rom dau- ase magaliTad, uaRresad mniS- SemTxvevaSi, skriningisas sxva
nis sindromis mqone adamian- vnelovania, rom Seumowmon sme- testebic unda iqnes gamoy-
ebTan, ufro xSiria samedicino na, mxedveloba da farisebri enebuli, raTa adreul etapze
problemebi, vidre am sindromis jirkvlis funqcia, gadauRon gamovlindes janmrTelobis
armqmone adamianebTan, am sin- kisris malebis rentgeni. gar- problemebi da droulad iq-
dromis mqone mraval bavSvs ar da amisa, maT unda CautardeT nas dawyebuli maTi mkurnalo-
axasiaTebs zemoT aRwerili vi- skriningi organizmSi TuTiisa ba. Tu daunis sindromis mqone
Tarebebi da kargi janmrTelo- da selenis Semcvelobaze (ori adamianebi maTi keTildReobis
bis mdgomareoba aqvs. Tumca elementi, romlis nakleboba- xelSewyobis mizniT miiReben
Zalian mniSvnelovania, rom eq- sac SeiZleba ganicdidnen dau- optimalur samedicino mom-
imebma da stomatologebma dau- nis sindromis mqone individe- saxurebas, maT gauumjobesde-
nis sindromis mqone adamianebs bi), da SeumowmdeT endomiziu- baT cxovrebis xarisxi da isi-
garkveuli diagnostikuri te- mis sawinaaRmdego antisxe- ni SeZleben mniSvnelovani wv-
stirebis gavlis garda, regu- ulebis titri. gazrdili titri lilis Setanas sazogadoebriv
laruli Semowmeba Cautaron. celiakias miuTiTebs. Cvenebis cxovrebaSi.

broSura Sedgenilia
Medical and Surgical Care for Children
with Down Syndrome, Woodbine
House 1995, Down Syndrome Toward
a Brighter Future, Brookes Publishing
2001, Down-Syndrom Was bedeutet
das? Deutshes Down-Syndrom InfoCenter,
Januar 2000 wignebis mixedviT

redaqtori:
irakli rcxilaZe
redkolegia:
ia TevzaZe, nino doborjginiZe,
xaTuna doliZe, nino cincaZe
gamocemulia daunis
sindromis mqone
bavSvebis mSoblebisa
da profesionalebis
kavSiris
`Cveni bavSvebi~ mier.
www.downsyndrome.ge

proeqtis mxardaWerisaTvis
kavSiri `Cveni bavSvebi~ madlobas
uxdis organizacias `globaluri
iniciativa fsiqiatriaSi~


saxeli bevrad gansazRvravs
Cvens damokidebulebas da
Sexedulebebs sag­nebisa da
adamianebisadmi. rodesac im
adamianebze vsaubrobT, visac
erTiT meti qromosoma aqvs,
unda vTqvaT, daunis sindromis
mqone bavSvi, axalgazrda,
kaci an qali. arasworia daun
bavSvebze, an daun adamianebze
saubari. ufro marTebulia,
daunis sindromis mqone
adamianze visaubroT, Tan
ar unda dagvaviwydes, rom,
pirvel rigSi, es adamianebi
adamianebi arian.

rodesac daunis sindromis

mqone adamians gavicnobT,
bunebrivia, mas saxeliT
unda mivmarToT, zrdasrul
adamianebs TqvenobiT unda
vesaubroT. daunis sindromis
mqone adamianebi individebi
arian da maT surT, rom
aseTebad iyvnen aRqmulebi.

daunis sindromi daavadeba

ar aris, Sesabamisad misi
gankurnebac SeuZlebelia.
daunis sindromi tkivilebs
ar iwvevs, Sesabamisad maT
es arc “awuxebT”. Tu isini
rameze wuxan es garSemomyofTa
araswori damokidebuleba
da gariyulobaa.