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სასუნთქი გზების ინფექციების განვითარების რისკ-ფაქტორები (რინიტი, ლარინგიტი, ბრონქიტი) | სიახლეები | vidal.ge
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სასუნთქი გზების ინფექციების განვითარების რისკ-ფაქტორები (რინიტი, ლარინგიტი, ბრონქიტი)
სასუნთქი გზების ინფექციების განვითარების რისკ-ფაქტორები (რინიტი, ლარინგიტი, ბრონქიტი)


თარიღი: 07/11/2018

სასუნთქი გზების ინფექციების განვითარების რისკ-ფაქტორები (რინიტი, ლარინგიტი, ბრონქიტი)

 

ჰაერის დაბინძურება (მტვერი, აირები, კვამლი)

მავნე ჩვევები (თამბაქოსა და სპირტიანი სასმელების გამოყენება)

ინფექციური აგენტები (ვირუსები, ბაქტერიები, სოკოები)

ალერგენები (საკვებისმიერი, მცენარეული, ქიმიური, მედიკამენტოზური)

ადგილობრივი იმუნიტეტის დაქვეითება (ხშირი გაციება ან ქრ. პათოლოგია)

ცივი და ცხელი ჰაერის ზემოქმედება (ცენტრალური გათბობა და კონდიციონერი)

სახმო აპარატის ექსპლუატაცია* (მომღერლები, პედაგოგები, ექიმები)

პირით სუნთქვა

* ეხება მხოლოდ ლარინგიტს

 

ზემოთ ჩამოთვლილი აგრესიული ფაქტორების გახანგრძლივებული ზემოქმედება იწვევს როგორც ნაზალურ, ისე ბრონქიალურ სეკრეტში ბალანსის დარღვევას. ზოლის შრეში მცირდება წყლის კონცენტრაცია და მატულობს ცილა. შედეგად ზოლის შრის მოძრაობა ფერხდება, აგრესორი ვერ ტოვებს სასუნთქ სისტემას და იწყებს აქტიურ გამრავლებას. ცილა შესანიშნავი ნიადაგია მათი გამრავლებისთვის. ყოველივე ზემოხსენებულის ფონზე ყალიბდება დაავადებები, როგორიცაა რინიტი, ლარინგიტი, ბრონქიტი.

 

ცხვირი

ცხვირის ღრუ რესპირატორული ტრაქტის მთავარი კარიბჭეა. ცნობილია, რომ ადამიანი საკვების გარეშე ცოცხლობს 4 კვირა, წყლის გარეშე 14 დღე, მაშინ, როცა ჰაერის გარეშე - რამდენიმე წუთი. სწორედ ამიტომ, სუნთქვა ადამიანისთვის უმნიშვნელოვანესი პროცესია. ცხვირის ლორწოვან გარსში განთავსებულია ნერვული დაბოლოებანი, რომლებიც უზრუნველყოფენ ცხვირის შიდა ნაწილის რეფლექტორულ კავშირს სხვა ორგანოებთან. მეცნიერების მიერ დამტკიცებულია ცხვირით სუნთქვის უდავო უპირატესობა პირით სუნთქვასთან შედარებით. გამოვლენილია მრავალი ორგანული დარღვევა ცხვირით სუნთქვის საერთო სასუნთქი სისტემიდან გამოთიშვის დროს. პირით მუდმივად სუნთქვა არღვევს გაზების ცვლას ფილტვებში, ჟანგბადის რაოდენობა მცირდება 25-30%-ით.

 

ცხვირის ფუნქცია

ჰაერის ფილტრაცია - ბაქტერიები, მიკრობები, ალერგენები, მტვერი, თავისუფლად მოხვდებოდნენ ფილტვებში, რომ არა ცხვირის ღრუში არსებული ეპითელური უჯრედების წამწამები. ისი-ნი სინქრონულად ირხევიან და ზემოთ ჩამოთვლილი აგენტების ევაკუაციას ახდენენ ცხვირის ღრუდან.

ჰაერის დატენიანება - ცხვირის ლორწოვანი გარსის მეშვეობით ხორციელდება ფილტვებისკენ მიმავალი ჰაერის დატენიანება, რისთვისაც ცხვირის ღრუში 500 მლ წყალი ორთქლდება დღეში.

ჰაერის გათბობა - ცხვირის ღრუ დაფარულია სისხლძარღვოვან-კაპილარული ქსელით, რომელიც ჰაერს ათბობს 37 გრადუსამდე, ანუ ჰაერი ფილტვებში ხვდება უკვე გაწმენდლი, დატენიანებული და გამთბარი.

ყნოსვა - ცხვირის გაჭედილობა იწვევს ყნოსვის დაქვეითებას, ვერ აღიქვავთ საყვარელი სუნამოს თუ ყვავილის არომატს, ამ დროს უგემოვნო გეჩვენებათ საკვებიც. ცხვირის ღრუში მდებარე ყნოსვის რეცეპტორების მეშვეობით ადამიანს შეუძლია აღიქვას დაახლო-ებით 4000-მდე სახეობის სურნელი. … საფოსტო მტრედები ორიენ-ტაციისთვის იყენებდნენ ყნოსვას. ისინი იმახსოვრებდნენ სუნს გადაფრენის მომენტში და ადგენდნენ „სუნის რუკას“.

ხმის წარმოქმნა - ცხვირი იღებს მონაწილეობას ხმის წარმოქმნაში. დავახშოთ ცხვირი და ვთქვათ „მიმიკა.“ ვნახავთ, როგორ შეიცვლე-ბა ხმა, ის გახდება არა მკაფიო, არათანაბარი, და მოგუდული.

 

რა არის რინიტი? 

რინიტი - ცხვირის ღრუს ლორწოვანი გარსის ანთებაა, რომელსაც ახასიათებს:

ლორწოვანის შეშუპება, გაგუდულობა, გაჭედილობა

ცხვირიდან გამონადენი (რინორეა)

ქავილი და ცემინება

ყნოსვის დაქვეითება 

როგორ ვუმკურნალოთ?

რინიტის მკურნალობაში უდიდესი როლი ენიჭება მუკოცილიარული ტრანსპორტის შეუფერხებელ მუშაობას. უპირველეს ყოვლისა, უნდა მოხდეს იმ შინაგანი თუ გარეგანი ფაქტორების ლიკვიდაცია, რომლებიც იწვევენ რინიტს. რინიტის მკურნალობა უნდა დაიწყოს მისი გამოვლენისთანავე. სამკურნალოდ გამოიყენება მედიკამენტების რამდენიმე ჯგუფი:

ანტიბაქტერიული (ანტიბიოტიკი) და ანტივირუსული პრეპარატები

სისხლძარღვების შემავიწროებელი საშუალებები (დეკონგენსტანტები)

ლეიკოტრიენების ინჰიბიტორები (მონტელუკასტი)

ტოპიკური ნაზალური სტეროიდები (ადგილობრივი მოქმედების სტეროიდები)

ცხვირის ლორწოვანი გარსის გაღიზიანების შემამცირებელი და დამატენიანებელი საშუალება (ნიზიტა)

რინიტის ეტიოლოგიიდან გამომდინარე პაციენტის სამკურნალოდ ხდება ზემოთ ჩამოთვლილი ჯგუფებიდან პრეპარატების კომბინირებული გამოყენება. ყველა შესაძლო კომბინაციაში მნიშვნელოვანია ნიზიტას მალამოს ან სპრეის ჩართვა.

 

რატომ ნიზიტა?

მიუხედავად თაობისა, ზემოთ ჩამოთვლილი სამკურნალო მედიკამენტები (ცხვირის ლორწოვანი გარსის გაღიზიანების შემამცირებელი და დამატენიანებელი საშუალებების გარდა) იწვევენ ცხვირის ლორწოვანი გარსის ძლიერ გამოშრობას.
სწორედ ამიტომ, გერმანელმა ფარმაცევტებმა შექმნეს ისეთი პრეპარატი, როგორიც არის ნიზიტა. ნიზიტას მალამო და სპრეი უალტერნატივოა თავისი შემადგენლობით. ის არის A დონის რეკომენდაციის მატარებელი მწვავე რინოსინუსიტის მკურნალობის ეროვნულ გაიდლაინში. ნიზიტას შემადგენელი კომპონენტები უზრუნველყოფენ ცხვირის ღრუში pH-ის შენარჩუნებას, ნაზალურ სეკრეტში წყლისა და ცილის ბალანსს, რაც არის გარანტი მუკოცილიარული კლირენსის შეუფერხებელი მუშაობისა.

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