DORILARGA CHIDAMLI O‘PKA SIL KASALLIGI BILAN KASALLANGAN BEMORLARNI DAVOLASHNI OPTIMALLASHTIRISH
Abstrakt
Mavzuning dolzarbligi. Dorilarga chidamli o‘pka sil kasalligi (DChO‘S) — ayniqsa resurslari cheklangan va o‘tish iqtisodiyotiga ega davlatlar uchun — sog‘liqni saqlash sohasidagi eng jiddiy muammolardan biri bo‘lib qolmoqda. Mikobakteriyaning asosiy dori vositalari — izoniazid va rifampitsinga nisbatan chidamliligi tufayli an’anaviy davolash rejimlarining samaradorligi keskin pasayadi. Bu rejimlar uzoq muddatli, toksik ta’sirli va bemorlar tomonidan to‘liq o‘tab bo‘lmaydigan bo‘lishi bilan ajralib turadi. Shu sababli, zamonaviy, qisqa muddatli va individual yondashuvga asoslangan davolash rejimlarining klinik samaradorligini baholash dolzarb bo‘lib bormoqda. Tadqiqot maqsadi. Tadqiqotdan ko‘zlangan maqsad — O‘zbekiston sharoitida DChO‘Sga qarshi an’anaviy va qisqartirilgan davolash rejimlarining klinik samaradorligi va o‘zlashtirilish darajasini taqqoslashdan iborat bo‘ldi. Tadqiqot materiallari va usullari.2020–2023 yillar oralig‘ida Respublika silga qarshi dispanserida davolangan 120 nafar bemorning tibbiy hujjatlari retrospektiv tahlil qilindi. Ular ikki guruhga bo‘lindi: 65 nafar bemor 6–9 oylik individual rejim asosida (bedakvilin, delamanid, linezolid qo‘llangan holda), qolgan 55 nafar esa 18–20 oylik standart rejim asosida davolangan. Baholash mezonlariga bakteriologik konversiya muddati, davolashdan keyingi 12 oy ichida qaytalanish darajasi, nojo‘ya ta’sirlar soni va og‘irligi, shuningdek bemorlarning davoga sadoqati kiritildi. Natijalar. Qisqa muddatli rejimlar barcha ko‘rsatkichlar bo‘yicha ustunlikni namoyon etdi: bakteriologik konversiyaga erishish muddati o‘rtacha 16 hafta (standart guruhda 28 hafta), qaytalanish darajasi 7% (standart guruhda 15%), og‘ir nojo‘ya ta’sirlar 26% (standartda 42%) bo‘ldi, davoga sadoqat esa 89% ni tashkil etdi (standart guruhda 64%). Barcha farqlar statistik jihatdan ishonchli deb topildi (p < 0,05). Xulosa. Olingan natijalar shuni ko‘rsatadiki, qisqa va individual yondashuvga asoslangan DChO‘Sga qarshi davolash rejimlari yuqori klinik va epidemiologik samaradorlikka ega. Ularni amaliyotga joriy etish orqali davolash sifati yaxshilanadi, bemorlarning davoga bo‘lgan sadoqati ortadi, infektsiyaning tarqalishi xavfi kamayadi va sog‘liqni saqlash tizimidagi yuk yengillashadi. Shu sababli, bunday davolash rejimlarini O‘zbekistonning yangilangan milliy klinik protokollariga kiritish maqsadga muvofiqdir.
Nashr sanasi
Mualliflar haqida
Adabiyotlar ro'yxati
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