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BARNOMAI MILLII RUSHDI DONORII HUN VA JUZHOI ON DAR TOJIKISTON

 BARNOMAI MILLII RUSHDI DONORII HUN VA JUZHOI ON DAR JUMHURII TOJIKISTON BAROI SOLHOI 2015-2019

Bo qarori Hukumati Jumhurii Tojikiston  az 2 iyuli soli 2015, № 422 tasdiq shudaast 

  1. Mukaddima
  1. Barnomai minlii rushdi donorii khun va juzhoi on dar Jumhurii Tojikiston baroi solhoi 2015-2019 (minbad – “Barnoma”) mutobiqi moddai 5 Qonuni Jumhurii Tojikiston “Dar borai donorii khun va juzhoi on”, qarori Hukumati Jumhurii Tojikiston az 4 marti soli 2002, № 94 “Dar borai tasdiq namudani Konsepsiyai islohoti tandurustii Jumhurii Tojikiston” tahiya gardida, baroi andeshidani chorahoi takhirnopazir oid ba takmil va rushdi donorii khun dar mamlakat ravona karda shudaast.
  2. Hadamoti khun yake az qismhoi muhimi tarkibii sohai tandurusti mahsub yofta, maqsadi on tamin namudani sifat, bekhatari va dastrasii mahsuloti khuni donori ba bemoron va osebdidagon dar zamoni osoishta va hangomi holathoi favqulodda ravona shudaast. On khususiyati strategii umumidavlati doshta, ba masalahoi bekhatarii millii davlat dakhl dorad.
  3. Dar Barnomai mazkur mafhumhoi asosii zerin istifoda meshavand:

– akkreditatsiya – rasmiyoti etirof namudani maqomi makhsus va sohibhuquqii shakhsoni voqei va huquqi baroi amali namudani faoliyati tibbiyu farmasevti, inchunin baroi guzaronidani arzyobii mustaqili ekspertii faoliyati subekthoi tandurusti mutobiqi standarthoi muqarrarshudai akkreditatsiya;

– albumin – safedai plazmai khuni odam buda, dar organizm funksiyahoi jabbanda intiqoli va gemodinamikiro ijro namuda, zakhirai asosii safedai organizm meboshad;

– plazmai ziddistafilokokki (PZS) – plazmai ziddistafilokokkii ba tozagi yakhkunonidashuda, ki dar tarkibi khud jismhoi begonai makhsusi ziddistafilokokkiro bo titri baland dorad. Az donorhoe tayyor karda meshavad, ki bo anatoksini stafilokokki em karda shudaand. On dar muolijai bemorihoi rimdoru taaffunii paydoishashon stafilokokki istifoda burda meshavad. Muhlati nigohdori dar harorati pasttar az 25°S to 3 sol meboshad;

– konnektori aseptiki – dastgoh baroi payvastkunii besiroyati magistralhoi konteynerhoi plastiki bo khun yo juzhoi on meboshad. Prinsipi sistemai pushidaro tamin menamoyad;

– autogemotransfuziya – transfuziyai (bargardonidani) khuni khudi yo juzhoi onro ba resipient (bemor) dar nazar dorad, ki az on peshaki tayyor karda shudaast;

– juzhoi autologii khun – juzhoi khun, ki az shakhsi voqei bo maqsadi dar holati zaruri ba khudi vay guzaronidan tayyor karda shudaand;

– aferez – az khuni davrzananda giriftani juzhoi alohidai khun va tayyor namudani on bo istifodai separatorhoi makhsusi hujayrahoi khun;

– validatsiya – amale, ki tibqi prinsiphoi tajribai zarurii istehsoli isbot menamoyad, ki yagon khel metodika, ravand, tajhizot, ashyoi khom, faoliyat yo sistema dar voqe boisi natijahoi peshbinishavanda megardad;

– immunoglobulini dokhilivaridi (IGDV) – dorui khun, ki dar tarkibi khud fraksiyai immunoglobulinii khunro doshta, baroi tazriqi dokhilivaridi peshbini shudaast;

– tarozu-omekhtakunanda – dastgohest, ki baroi nazorati miqdori zarurii khuni az donor giriftashavanda va omekhtakunii barobari on bo mahluli konservakunandai konteyner (gemakon) hangomi tayyor namudani khun peshbini karda shudaast;

– virushoi leykozi T-hujayravi – virushoi T-limfotropii navhoi I va II-i odam (NTLV-I), ki boisi bemorihoi badsifati sistemai khun va illati sistemai markazii asab megardand NTLV-I ba retrovirusho, NTLV-II boshad, ba onkovirusho dokhil meshavand. Onho doroi limfotropiyat va neyrotropiyati zohirshavanda meboshand;

– virusinaktivatsiya – usule meboshad, ki gayrifaol namudani virushoro dar juzho va doruhoi khun tamin menamoyad. Gayrifaolinamoii virus kimiyovi va harorati meshavad;

– homili virus-odami bo in yo on virus siroyatshuda be alomathoi klinikii in bemori, ki virus ba vujud meovarad;

– nazorati dokhili laboratorii sifat (NDS)-majmui chorabinihoe, ki az tarafi kormandoni ozmoishgoh baroi arzyobii doimii sifati korhoi ozmoishgohi va natijahoi hosilshuda andeshida meshavand;

– arzyobii berunii sifat (ABS)-in usuli sanjishi voqeii tahqiqoti ozmoishgohi meboshad, ki az tarafi tashkiloti beruna guzaronida meshavad. Barnomai arzyobii berunii sifat baroi giriftani ittiloot oid ba mushkiloti imkonpaziri sifat dar har yak ozmoishgohi alohida imkoniyat medihad;

– gemofiliya – in ikhtiloli genetiki meboshad, ki bo norasoi yo nabudani yake az safedahoi (yo omilhoi) plazmai khun, ki baroi lakhtashavii on javobgar meboshad, vobastagi dorad. Darajai pasti yake az safedahoi plazma boisi khunravi va dushvorii lakhtashavii khuni bemor megardad. Norasoii az hama pahnshudai safedai lakhtashavii khun norasoii omili VIII meboshad, garchande har yake az in omilho metavonand mavjud naboshand yo nokifoya boshand. Norasoii omili IX az rui basomad joi duyumro ishgol mekunad. Norasoii omili VIII – gemofiliyai Agemofiliyai muqarrari meboshad. Norasoii omili IX – gemofiliyai V bemorii Kristmas meboshad. Baroi muolijai in du namudi gemofiliya doruhoi khun – konsentrathoi omilhoi VIII va IX istifoda burda meshavand;

– donatsiya – chorabinii az jonibi donor dodani khun yo plazma;

– funksiyai donori – iqdomi ikhtiyorii donor, ki muoinai tibbi va ijroi chorabinii dodani khun va juzhoi onro bo maqsadhoi tibbi dar bar megirad;

– markazi yagonai ittilootii donori – sokhtori markazi khun, ki vazifai asosii on jamovarii malumot oid ba shakhsoni bo VNMO siroyat yofta, zardparvinhoi virusi, otashak, ki dar qaydi muassisahoi makhsusgardondashudai tibbi ba maqsadi roh nadodani in doirai odamon baroi ishtirok dar donori qaror dorand, inchunin malumoti boygoni oid ba donorho meboshad;

– kafsherkunandai magistralho – asbobi baroi kafsherkunii magistralhoi konteynerhoi plastikii khun va juzhoi on peshbini shudaast. Prinsipi sistemai pushidaro tamin menamoyad;

– tahqiqoti izoimmunologi (immunogematologi) – ba guruhho judo namudani khun az rui antigen va jismhoi begonai gunoguni guruhi (tahqiqi mansub budani khuni donori ba sistemai AVO va rezus hatmi meboshad);

– zardobhoi izogemaglyutinatsiyakunanda (standarti)standarthoi tashkhisi, ki az khun va baze moehoi digari organizmi odam tayyor karda shuda, mansubiyati muayyani guruhi dorand va baroi muayyan namudani guruhi khuni odam peshbini karda shudaand;

– immunoglobulini odami mutadil – fraksiyai az jihati immunologi faoli zardobi khuni odam, ki az zardob yo plazmai odam judo karda shudaast. Konsentratsiyai safeda – 100 mg/ml; stabilizator – glitsin (22,5 +/- 7,5 mg/ml).

– infuziya – ba majroi khunguzar rekhtani khunivazkunandaho va doruho;

– karantinizatsiyai juzhoi donorii khun – az nigohdorii onho dar davomi vaqti muayyan pas az donori to vaqte meboshad, ki donorhoi munosib takroran baroi nishonahoi (markerhoi) siroyati muoina karda nashavand. Hangomi natijai manfii tahlilho, juzhoi khuni qablan tayyorkardashuda baroi maqsadhoi tibbi istifoda burda meshavand;

– juzhoi khun – qismhoi tarkibii khun, ki az on bo usulhoi gunogun dar shakli hujayrahoi khun va be muhiti hujayravi judo karda shudaand. Bo rohi poloish (filtratsiya), sentrifugakunoni va yakhkunoni bo usulhoi dar tashkilothoi khadamoti khun qabulkardashuda judo karda meshavand. Namoyandagoni asosi: vazni eritrositi, konsentrati trombositho, plazmai ba tozagi yakhkunonidashuda, kriopresipitat, fraksiyai plazmai supernatanti, plazmai ziddistafilokokki va gayra;

– tabobati juzi – usuli muolija, ki bo transfuziyai juzhoi khun asosnok karda shudaast;

– konsentrati trombositho – in trombosithoi qobili hayot va az jihati gemostatiki faol dar plazma meboshand, ki bo usuli silsilavii sentrifugakunonii khuni nigohdoshtashuda yo bo rohi trombositaferezi khuni yak donor tayyor karda meshavad. Muhlati nigohdori dar harorati +22°S dar sharoiti omekhtakunii doimi az 3 to 5 shabonaruz;

– kriokonservakunonii juzhoi khun – daroz namudani vaqti nigohdorii juzhoi khun bo rohi yakhkunoni;

– kriopresipitat – juzi doroi fraksiyai krioglobulini omilhoi plazmavii lakhtashavii khun, ki to hajmi 20 ml jam karda shudaast. Dar muolijai bemoriho va holathoi bo norasoii omili VIII lakhtashavi asosnokshuda (gemofiliyai A, bemorii Villebrand), hangomi muolijai DVS-sindrom (lakhtashavii disseminii dokhilivaridi) istifoda burda meshavad. Muhlati nigohdori az lahzai tayyor namudani khun az donor bo harorati pasttar az -25°S to 3 sol meboshad;

– leykofiltratsiya (leykodeplesiya) – giriftani leykositho az khun va juzhoi on bo yorii poloishhoi makhsusi leykositari;

– eritrosithoi sof – juze, ki hangomi sentrifugikunonii khun va giriftani plazma bo minbad sofkunii eritrositho dar mahluli izotoni hosil karda meshavad;

– davrai darichai immunologi – davrae, ki dar davomi on ozmoishhoi ayni zamon baroi siroyat istifodashavanda oshkor namudani nishonahoi siroyatshavii insonro imkoniyat namedihand, to on vaqte ki siroyat dar organizmi vay mavjud ast;

– plazmaferez – rasmiyoti donatsiyai khun, ki tayyor namudani plazmaro az donor bo transfuziyai bozpasi hujayrahoi khun ba vay peshbini menamoyad;

– aksulamali polimerazi zanjiri (APZ) – sintezi “in vitro” nuskhai makhsusi qitai kislotai dezoksiribonukleini (KDN) yo kislotai ribonukleini (KRN) dar davomi yakchand soat bo yorii fermenti KDN (KRN) polimeraz meboshad. APZ baroi oshkor namudani daleli dar mavodi tahqiqshavanda vujud doshtani mikroorganizmi bemoriovar dar davrai darichai immunologi imkoniyat medihad;

– retsipient – shakhsi voqei (bemor), ki ba u khuni donori yo juzhoi on guzaronida meshavad;

– plazmai ba tozagi yakhkunonidashuda (PTYA) – juzi az khuni kholis yo plazma istehsolkardashuda, ki bo usuli plazmaferez tayyor karda shudaast, ba chunin muhlatho va bo chunin harorate yakh kunonida meshavad, ki dar holati funksionali hamai omilhoi lakhtashavii khunro nigoh medorad. Hangomi vayronshavii sistemai lakhtashavii khun, makhsusan dar on holathoe istifoda burda meshavad, ki norasoii sistemai lakhtashavi az rui yakchand omilho vujud dorad. Vaqti yakhkunoni to harorati – 30°S  dar yadroi konteyner bo plazma na ziyodtar az yak soat meboshad. Muhlati nigohdori dar harorati pasttar az – 25°S  to 3 sol ast;

– fraksiyai plazmai supernatanti (FPS) – juze, ki az plazma badi giriftani kriopresipitat hosil karda shudaast. On nazar ba PTYA faolnokii balandi ziddilakhtashavi dorad. Dar muolijai bemorihoi bo lakhtashavii balandi khun aloqamand istifoda burda meshavad. Muhlati nigohdori dar harorati pasttar az – 25°S to 3 sol az lahzai tayyor kardani khun az donor ast;

– test – sistema – majmu baroi tahlili immunofermenti;

– tippikunonii khun – muayyan kardani tarkibi antigenii khun;

– transfuziya – ba shakhsi voqei (retsipient) guzarondani juzho yo doruhoi khuni donori;

– tabobati transfuzioni – usuli muolija, ki hangomi on juzho va doruhoi khuni donori istifoda burda meshavand;

– vositahoi transfuzioni – juzho va doruhoi khuni donori;

– siroyathoi transfuzioni (transmissivi) – bemorihoi siroyati, ki hangomi guzarondani khuni donori va juzhoi on ba retsipient meguzarand. Namudhoi nisbatan ahamiyatnoki onhoVNMO, gepatithoi gayrirudagi, otashak, siroyati sitomegalovirusi va gerpesi;

– trombositaferez – chorabinii donatsiyai khun, ki tayyor namudani trombosithoi dar plazma halshudaro bo transfuziyai bozpasi eritrositho va plazmahoi vay ba donor peshbini menamoyad;

– omili VIII – safedai sistemai lakhtashavii khun;

– omili IX – safedai sistemai lakhtashavii khun;

– sitaferez – usuli hosil namudani juzhoi hujayravii khun az yak donor bo istifodai separatorhoi avtomatikii hujayrahoi khun;

– sitomegalovirus (SMV) – KDN-i virus bo tropizmi zohirshavanda ba leykositho. SMV bo rohi aloqai jinsi, inchunin tavassuti moehoi biologi hangomi allotransplantatsiyaho va guzarondani juzhoi khun meguzarad;

– khuni kholis – in khune meboshad, ki az donor bo istifodai antikoagulyanti besiroyatu apirogeni va konteyner girifta shudaast.

Hamchun mavodi avvaliya baroi tayyor namudani juzhoi khun istifoda burda meshavad;

– moddai kholisi eritrositi – in juzi khun meboshad, ki az khuni nigoh doshtashuda badi sentrifugakunoni va giriftani qismi plazma bo minbad ba vazni eritrositi ilova namudani mahluli gizlatkunanda bo maqsadi ziyod namudani muhlati nigokhdori va behtar namudani khususiyathoi reologi hosil qarda shudaast;

– vazni eritrositi – juze, ki badi az khun giriftani qismi plazma hosil meshavad. Baroi jubron namudani talafyobii khun va muolijai kamkhuni istifoda burda meshavad. Mukhdati nigohdori dar harorati +4°S az 21 to 42 shabonaruz vobasta ba tarkibi mahluli nigokhdoshtashuda, hangomi istifodai tekhnologiyai yakhkunoni to 10 sol meboshad.

  1. Rushdi muosiri tibbi tajili, rasonidani kumaki takhirnopaziri akusheri va tajribai pediatri, muolijai bemoroni saratoniyu khun, guzaronidani amaliyoti jarrohii dil tavassuti tekhnologiyahoi peshrafta, osebshinosi, muolijai bemoron bo sukhtagii badanro be istifodai durusti juzhoi khun tasavvur namudan dushvor ast.
  2. Talabot ba sifatu bekhatarii juzhoi khun khususiyati istehsol va istifodai onhoro muayyan mesozad. Manbai ba dast ovardani onho inson (donor) meboshad. Binobar in, az vazi salomatii donor sifatu bekhatarii juzhoi tayyorshudai khun vobasta ast.
  3. Dar barobari in, nigohdorii miqdori muassisahoi khadamoti khun, tajhizonidani onho bo dastgohhoi muosir, mavodi sarfshavandai istifodaashon yakdafaina va test-sistemahoi balandsifat boyad az hisobi mablaghoi peshbinishudai sohai tandurusti marhila ba marhila tamin karda shavad. Dar sharoiti iqtisodi bozargoni guzaronidani monitoringi muntazami kharojoti mablaghoi moliyavi, istifodai tajhizot, ijroi nishondihandahoi naqshavi, ravandi sarivaqtii kharidi reagentho va mavodi sarfshavanda baroi tamin namudani sifati mahsulot va ustuvorii kori muassisahoi khadamoti khun ahamiyati avvalindaraja paydo kardaast.

2. Tahlili vaziyat

  1. Sokhtori tashkilii khadamoti khuni jumhuri dar asosi prinsipi mamuriyu mintaqavi sozmon doda shuda, tavassuti Markazi jumhuriyavii ilmii khun bo 3 filial va 63 hujrahoi tabobati transfuzioni dar jumhuri iborat buda, dar onho 102 tabibon va 132 kormandoni miyonai tibbi faoliyat dorand. Rohbarii tashkiliyu metodi az tarafi Markazi jumhuriyavii ilmii khun amali karda meshavad.
  2. Tibqi qarori Hukumati Jumhurii Tojikiston az 2 mayi soli 2013, № 215 “Dar borai mutamarkazonidani faoliyati khadamoti khun”, bo maqsadi tamin namudani dastrasi va bekhatarii sifati khun va juzhoi on ba aholii Jumhurii Tojikiston, inchunin mutobiq budan ba standarthoi Tashkiloti umumijahonii tandurusti khadamoti khun mutamarkazonida shud. Bo darnazardoshti jori namudani tajribai peshraftai davlathoi Avrupo va Osiyo tavassuti mutamarkaz tamin namudani khadamoti khun bo mavodi sarfshavandai yakdafainai khuntayyorkuni va bo test-sistemahoi balandsifat hamai muassisahoi khadamoti khuni viloyathoi Hatlon va Sugd bo guzarish ba mablagguzori az bujeti jumhuriyavi ba filialhoi Markazi jumhuriyavii ilmii khun tabdil doda shudand.
  3. Tahlili guzaronidashudai nishondihandahoi asosii faoliyati khadamoti khun nishon dod, ki dar davomi solhoi okhir hajmi mahsuloti az khun tayyorkardashuda az tarafi markazhoi khun to 30 foiz ziyod shudaast. In padida tamoyuli musbi buda ba tavsiyaho oid ba mutamarkazonidani jam namudan, guzaronidani test, ba juzho taqsim namudan va dar makhzanhoi markazhoi khun nigoh doshtan, ki baroi giriftani juzhoi bosifatu bekhatari khun sharoit faroham meovarad, muvofiq ast.
  4. Nishondihandaho oid ba tayyor namudani khun va korkardi juzhoi on dar solhoi 2010-2013 bo sababi kam budani shumorai donorho dar markazhoi khun past meboshad (4-5 ba 1000 nafar aholi) va on talaboti bemoronro ba mahsuloti khuni donori qone namegardonad. Bo vujudi in, nishondihandahoi pasti tayyor namudani khun dar viloyathoi Hatlon – 6 nafar (ba 1000 nafar aholi), Sugd – 5 nafar (ba 1000 nafar aholi) va shahru nohiyahoi tobei jumhuri – 1 nafar, khususan dar vodii Rasht mushohida karda meshavad. Dar shahri Dushanbe in nishondihanda 25 ba 1000 nafar aholi meboshad, ki az kori qanoatbakhshi Markazi jumhuriyavii ilmii khun dar jalb namudani aholi ba qatori donorho shahodat medihad.
  5. Hujrahoi tabobati transfuzioni, ki vohidhoi muassisahoi tabobatiyu profilaktiki meboshand, az jihati sokhtor az markazhoi khun judo meboshand. Vazifai asosii hujrahoi mazkur az nigohdori va tamin namudani bemoron bo mavodi khun iborat ast.
  6. Sokhtori tashkilii khadamoti khun dar Tojikiston hanuz solhoi 70-umi asri guzashta tahiya shudaast. Zaminai moddiyu tekhnikii hujrahoi tabobati transfuzioni va markazhoi khun dar imorathoi kuhna joygir shudaast, ki dar onho korkardi khun sari vaqt guzaronida nameshavad. Testikunonii khun bo nishonahoi siroyati gemotranmissivi odatan dar 4 markazhoi viloyatii khun guzaronida meshavad. SHubai khunguzaronii Bemorkhonai viloyatii Horug va muassisahoi tabobatiyu profilaktikii vodii Rasht berun az nazorati markazi khun faoliyat menamoyand. Binobar narasidani vositahoi naqliyot baroi intiqoli khuni donori, dar mintaqahoi nombarshuda mushkilot ba miyon meoyand, ki dar majmu ba sifati bekhatarii mavodi khun tasir merasonad. Baroi khungiri dar sharoiti sayyor dar markazhoi khun az hisobi Fondi globali naqliyothoi makhsus kharidori karda shud, vale baroi intiqoli juzhoi khun ba muassisahoi tabobatiyu peshgirikunanda chunin naqliyotho vujud nadorand.
  7. Vazifai afzaliyatnoki rushdi khadamoti khun in faolona jalb namudani doirahoi vasei aholi ba donorii ikhtiyorii roygoni muntazami khun bo dastgirii vositahoi akhbori umum va tashkilothoi davlatiyu gayrihukumati amali gardonida meshavad.
  8. Nabudani nizomi yagonai mablagguzorii bujeti dar khadamoti khun, ki bo prinsiphoi jubron namudani kharojoti khizmatrasoniho asos megirad, ba pastravii sistemavii sifati kor va tamini aholi bo juzhoi bekhatari khun tasir merasonad.
  9. Tibqi standarthoi baynalmilali, iqtidori haddi aqali amaliyotii markazhoi khun, ki ba talaboti samarabakhshi iqtisodi va darajai sifat muvofiq buda, bo tajribai khubi istehsoli javobgu meboshad, boyad na kamtar az 50000 khunsupori dar yak solro tashkil dihad. Jamovarii harruzai khun az 60-70 nafar donorhoi ikhtiyorii roygon tavassuti dastahoi sayyori naqliyoti va hamzamon bo jamovarii 100150 vohidi khun dar markazhoi mintaqavii khun, ba tavri nazarras kharojotro baroi istifodai tajhizot kam namuda, vaqti testikunoniro az hisobi pepshihodi yakvaqtainai miqdori kaloni namunaho sarfa menamoyad va baroi samaranok istifoda burdani zakhirahoi insoni imkoniyat medihad.
  10. Jori namudani tekhnologiyahoi muosir dar khadamoti khun, daromadnoki va samaranokii iqtisodii muassisahoro baland bardoshta, baroi purzur namudani nazorati ijroi nishondihandahoi naqshavi, sarfai mablaghoi moliyavi, istifodai tajhizot, ravandi sarivaqtii kharidi reagentho va mavodi kharojoti va az hama muhim kafolat dodani sifatu bekhatarii mahsuloti istehsolshavanda imkoniyat medihad. Soli 2012 az tarafi Hazinai globali 20000 khaltachahoi duqabatai khungiri, vositahoi naqliyoti makhsus baroi jamovarii khun dar sharoiti sayyor, tajhizoti hozirazamona va yakhdonhoi sanoati bo maqsadi tahkimi khadamoti khun dar Markazi jumhuriyavii ilmii khun dar hamai, filialhoi viloyatii on, inchunin yakhdonhoi sanoati baroi hujrahoi tabobati transfuzioni kharidori karda shud.
  11. Markazi jumhuriyavii ilmii khun va baze az hujrahoi tabobati transfuzioni dar binohoi mutobiqgardondashudae joygirand, ki az rui loihahoi solhoi 30-um, 60-um va 70-umi asri guzashta sokhta shudaand va holo ba talaboti hujrahoi tayyorkunii khun va nigohdorii juzhoi on javobgu nestand.
  12. Zaminai meyorni huquqii mavjudbuda, ki tamomi janbahoi faoliyati khadamoti khunro faro girifta nametavonad, nokifoya buda, tekhnologiyahoi muosirro dar tamin namudani bekhatarii immunologi va siroyatii juzhoi donorii khun ba nazar namegirad va rushdi onro bozdoshta, ba takmildihi niyoz dorad. Masalai donorii khun va juzhoi on baroi davlat muhim va baroi tandurustii mamlakat asosi mahsub meyobad. Mahz baroi hamin, mushkiloti mazkurro metavon ba qatori masalahoi bekhatarii dokhilii mamlakat dokhil namud.
  13. Huni donori, juzho va doruhoi on molikiyati milli meboshand. SHarti asosii ishtirok baroi donori – in mutobiq budani vazi salomatii donor ba meyorhoi talabotii tibbi meboshad. Donori dar inson prinsiphoi balandi akhloqii bashardustona, gamkhori, khayrkhohi va vatandustiro tarbiya menamoyad. Munosibati musbii jomea va ishtiroki faolonai aholi dar donori ba maqsadhoi davlat dar sohai bekhatari va siyosati ijtimoii tashakkuli nasli solim, jomeai az jihati jismoni va ruhi purquvvat mutobiqat menamoyad.
  14. Donorii ikhtiyorii roygon, ki az tarafi Tashkiloti umumijahonii tandurusti va digar tashkilothoi baynalmilali hamchun bekhatar etirof gardidaast, zaminai khadamoti khun meboshad. Hamin tavr, tibqi malumoti Tashkiloti umumijahonii tandurusti (soli 2005) dar mamlakathoi darajai daromadnokiashon baland 94 foizi khuni donori dar asosi ikhtiyori va roygon suporida meshavad. Dar mamlakathoi darajai daromadnokiashon past yo miyona besh az 43 foizi khuni az tarafi donorhoi nav suporidashavanda hanuz ba donorhoi pardokhtshavanda yo donorho-kheshovandon (yo shakhsoni ivazkunandai kheshovandon) rost meoyad va tanho dar 39 mamlakat nishondihandai suporidani 100 foizi khuni donori dar asosi ikhtiyorii roygon mushohida shudaast. Dar hamai mamlakatho, ba andozai on, ki hissai aholii doroi bemorihoi siroyati (ba monandi VNMO-siroyat va gepatit) meafzoyad, mutanosiban hissai aholie, ki metavonad khun suporad, kam meshavad. Binobar in, talabot ba donorhoi ikhtiyori va roygoni doroi khatari pasti siroyat boz ham ziyodtar shuda istodaast.
  15. Soli 2013 bo dastgirii moliyavii Hazinai globali testsistemaho baroi tashkhisi siroyathoi transmissivi (gepatiti V va S, VNMO) kharidori shud. Dar davomi du soli okhir afzoishi shumorai donorhoi ikhtiyori dar jumhuri 15 foiz ba mushohida merasad. Vale az rui mintaqaho in raqamho khele past meboshand.
  16. Soli 2013 – 35000 donatsiyai khun va juzhoi on ba qayd girifta shudaast, ki qarib 5 donoriro ba 1000 nafar aholi dar yak sol tashkil medihad va tanho ba 12,5 foiz ba sathi haddi aqali tavsiya namudai Tashkiloti umumijahonii tandurusti muvofiqat mekunad (baroi muqoisa dar SHMA in nishondihanda – 109,9; dar Daniya – 67,2; Olmon – 52,6; Federatsiyai Rossiya – 25,3; Britaniyai Kabir – 42,5; Faronsa – 38,0, Qazoqiston-18,0, Eron – 21,0 foizro tashkil medihad).
  17. Sathi pasti donori va tagyir yoftani sokhtori on asosan bo vaziyati murakkabi ijtimoiyu iqtisodii mamlakat, barham dodani sistemai qablii naqshavii tashkil namudani donori dar vasoiti akhbori umum, nokifoya budani mablagguzorii khadamoti khun, ishtiroki gayrikofii maqomoti hokimiyati davlati va tashkilothoi gayrihukumati dar halli in masala vobastagi dorad. Mamuriyati muassisavu korkhonahoe, ki qablan safarho bo maqsadi tayyor namudani khun amali karda meshudand, dar guzaronidani chunin sahmiyaho mavqei gayrifaolro ishgol mekunand va bazan baroi ishtiroki kollektivi mehnati dar suporidani khun monea megardand.
  18. Harakati donori ba dastgirii doimii namoyandagoni maqomoti hokimiyati davlati dar tamomi sathho, siyosatmadoron, hunarmandon va sohibkoron ehtiyoj dorad.
  19. Sathi pasti donori dar jumhuri nomutanosibiro dar tamin namudani muassisahoi tabobatiyu peshgirikunanda bo juzhoi asosii khun, narasidani hamai namudhoi juzhoi khun dar mintaqahoi mamlakat hangomi tamini qanoatbakhshi ehtiyojoti bemoroni shahri Dushanbe ba vujud ovard.
  20. Mushkiloti jori namudani tekhnologiyahoi muosiri istehsoli juzho va doruhoi khun bo nokifoya budani mablagguzorii tashkilothoi khadamoti khun asosnok gardidaast. Dar jumhuri ba hajmi purra hanuz usulhoi muosiri tamini bekhatarii siroyati va immunologii khun tatbiq karda nashudaast. Sistemai donorii muntazami khun, gayrifaol gardonidani virusho, karantinkunoni va leykofiltratsiya ba roh monda nashudaast. Usulhoi samaranoki dastgohi tayyor namudani plazma (zardobi khun) ba tavri nokifoya istifoda burda meshavad. Tayyorkunii dastgohii juzhoi hujayravii khun (trombositho, granulositho, hujayrahoi nihoii tanagi) umuman vujud nadorad. Tekhnologiyai nigohdorii durudarozi khun dar sharoiti harorati past tatbiq karda nashudaast, ki imkoniyati tashkil namudani makhzanhoi juzhoi khudii khunro istisno menamoyad.
  21. Sistemai kompyuterikunonii tashkilothoi khadamoti khun – yake az unsurhoi muhimi tamin namudani bekhatari va sifati tabobati transfuzioni ba roh monda shudaast. Fazoi yagonai ittilooti dar khadamoti khun baroi sarivaqt mubodila namudani malumot oid ba shakhsoni guruhi khatar ba muassisaho imkoniyat medihad. Dar mintaqahoe, ki markazi yagonai ittilootii donori tashakkul yoftaast, malumoti donor oid ba muhiti epidemiologi girifta meshavad. Bo vujudi in, ehtimoliyati ba donori roh nadodani shakhsoni guruhi khatar kam megardad. Ayni zamon, dar jumhuri Fehristi millii donorhoi khun va juzhoi on tashkil karda shudaast. Gayr iz in, fazoi yagonai ittilooti baroi samaranok idora namudani zakhirahoi juzhoi khun imkoniyat medihad. Jori namudani sistemai ittilooti boisi kam namudani mahsulot bo sababi anjom yoftani muhlati istifodabari az yak taraf va az tarafi dagar kam namudani mushkiloti narasidani juzhoi khun, makhsusan baroi bemoroni doroi guruhi nodiri khun yo bo anamnezi transfuzioni gardid.
  22. Tahiyai standarti ittilootii khadamoti khun va jori namudani fazoi yagonai ittilootii khadamoti khuni jumhuri baroi tashkil namudani Fehristi millii donorhoi khun va juzhoi on, baqaydgirii shakhsoni guruhi khatar, sistemai jumhuriyavii ittilootii idorakunii zakhirahoi juzhoi khun imkoniyat medihad.
  23. Markazi jumhuriyavii ilmii khun bo tashkilothoi baynalmilali, az qabili Hazinai globali va Tashkiloti umumijahonii tandurusti hamkori menamoyad. Az jonibi Hazinai globali bo maqsadi tashkil namudani Fehristi millii donorhoi khun va sistemai jumhuriyavii idorakunii zakhirahoi juzhoi khun, dar asosi tatbiqi sistemai yagonai ittilooti, baroi hamai markazho tajhizoti kompyuteri kharidori karda shud.
  24. Tayi solhoi 2011-2013 bo dasttirii tashkiloti baynalmilalii SBS/ZAK dar Markazi jumhuriyavii ilmii khun (az mohi sentyabri soli 2011) va dar hamai filialhoi viloyatii on (az mohi mayi soli 2013) usuli shtrikh-kod namudani juzhoi khunro jori namudand, yane ba tavri dasti vorid namudani malumot dar borai donorho dar gemakonho vujud nadorad va boyad qayd namud, ki jori namudani nizomi mazkur nakhustin dar bayni davlathoi Osiyoi Markazi ba hisob meravad.
  25. Jihati istifodabarii vasei sistemai yagonai ittilooti, az jumla tahiya va jori namudani barnomahoi gunogun, bo dastgirii moliyavii tashkiloti baynalmilalii SDC/SAR baroi guzaronidani kurshoi omuzishi kormandoni sohai tib va kormandoni tekhnikii khadamoti khun, mutakhassison az shahri Moskva davat karda shudand.
  26. Istehsoli mavjudai doruhoi khun dar solhoi 70-80 asri guzashta tashkil shuda, ba hissahoi taqsim namudani plazma bo usuli laboratori dar mizhoi ba hissaho taqsimkuni asosnok shuda bud va in tekhnologiya az mushobehi khorijii khud khele qafo monda, ba talaboti tajribai khubi istehsolii GMP javobgu nest. Az in sabab ba hissahoi doruhoi khun taqsim namudani plazma dar zaminai markazhoi khun qat karda shudaast.

Baroi khudtaminkunii jumhuri bo doruhoi muosiri khun kor karda baromadani 25 hazor litr plazma dar yak sol zarur ast. Holo talaboti muassisahoi tibbi ba albumin na besh az 15 foizi az tarafi Tashkiloti umumijahonii tandurusti tavsiyashuda, qanoatmand karda meshavad. Istehsoli yak qator doruhoi muhimi khun (albumin, immunoglobuliihoi tasiri samtnok, omilhoi lakhtashavii khuni VIII va IX, immunoglobulinhoi dokhilivaridi) ba roh monda nashudaast. Az jonibi davlat mushkiloti kharidani doruhoi garoni khun az khoriji kishvar hal nagardidaast.

  1. Istemolkunandagoni asosii omilhoi lakhtashavii khun bemoroni giriftori gemofiliya meboshand. Az rui malumoti soli 2012 dar Tojikiston 400 nafar bemoronn giriftori gemofiliya va bemorii Villebrandi az rui padidahoi kliniki ba on monand ba qayd girifta shuda bud, az jumla besh az 75 nafar kudakoni sinni to 8 sola, 175 nafar noboligon va 150 nafar kalonsolon, Boyad qayd namud, ki bemorii gemofiliya dar Tojikiston nazar ba davlathoi Avrupo 1,5 marotiba az nishondihandai miyona ziyod ast. Har sol ba hisobi miyona besh az 700 nafar bemoroni giriftori leykozhoi shadid va muzmin muolija karda meshavand, ki 90 foizi onho ba guzaronidani juzho va doruhoi khun ehtiyoj dorand. Vale to hol dar jumhuri siyosati davlatii tamin namudani in doirai bemoron bo doruhoi muosiri khun kor karda baromada nashudaast.
  2. Narasidani doruhoi balandsifat va samaranoki khun tashkilothoi muolijaviyu profilaktikiro baroi istifoda burdani usulhoi kuhnashudai tabobati transfuzioni vodor mesozad. To imruz dar Tojikiston usuli az tarafi umum qabul shudai muolijai khunravihoi gemofili, in guzaronidani bisyorkaratai (az 20 to 100 va besh az on) kriopresipitat-juzi donorii khun meboshad. CHi tavre ki amaliya nishon dod (dar davlathoe, ki chunin muolija ba roh monda shudaast), hangomi istifodai in usul, az 60 foiz to 80 foizi bemoroni gemofiliya bo virusi gepatiti V va S siroyat megirand.
  3. Bekhatarii siroyatii mahsuloti khun, pesh az hama bo tashkhisi etimodnok va sifatnoki laboratorii siroyathoi transmissivi (VNMO, gepatitho, sifilis) tamin karda meshavad.
  4. YAke az masalahoi mubrami khadamoti khun in tamin namudani nazorati muntazami sifat dar faoliyati onho meboshad. Binobar in, nazorati sifat boyad on chorabinihoero dar bar girad, ki arzyobii hamai qismhoi tekhnologiyai yagonai tahlilro (arzyobii faoliyati kormandoni laboratoriya va natijai testho) peshbini menamoyad.
  5. Arzyobii berunai sifat in usuli taftishi voqeii tahqiqoti laboratorii tashkilothoi beruna meboshad. Barnomai arzyobii berunai sifat baroi ba dast ovardani malumot oid ba mushkiloti imkonpaziri sifat dar har yak laboratoriyai alohida imkoniyat medihad.
  6. Barnomai arzyobii berunai sifat baroi arzyobii siroyathoi transmissivi bo dastgirii Tashkiloti umumijahonii tandurusti guzaronida meshavad. Ozmoishgohi referensii Tashkiloti umumijahonii tandurusti arzyobii berunai sifati ozmoishgohi Markazi jumhuriyavii ilmii khunro guzaronid va az rui natijahoi sifat muayyan shud, ki tahlilhoi guzaronidashuda ba standarthoi baynalmilali javobgu meboshand, yane khatari siroyatshavii retsipientho bo virushoi transmissivi khele past meboshad.
  7. Gayr az in, guzaronidani tahlili khun ba tavri genetikii zanjirai polimerazi yake az qismhoi muhimi tahlili 100 foizai khuni donoron buda, iqdomi buzurg ba hisob meravad va baroi kam gardidani siroyatshavi musoidat namuda, bekhatarii juzhoi khunro tamin menamoyad.
  8. Zarurati tajhizoti navi garon va kormandoni ilovagii balandikhtisos, justuju namudani imkoniyati mutamarkazonidani tahqiqoti namunai khuni donorhoro baroi oshkor namudani siroyat az rui prinsipi zerin asosnok menamoyad: intiqol dodani namunaho nazar ba tashkil kardan va nigohdorii laboratoriyahoi nav osontar ast.
  9. Ravandi mutamarkazonidani laboratoriyahoi khadamoti khun dar tamomi jahon guzashta istodaast, Masalan, dar SHMA ba 12 mln. donorii khun dar yak sol 15 laboratoriya, dar Niderlandiya ba 700 hazor donori 4 laboratoriya, dar Finlyandiya ba 300 hazor 1 laboratoriya rost meoyad.
  10. Holati khadamoti laboratorii markazhoi khun va tashkil namudani sistemai skriningi namunahoi khuni donori takmildihiro talab mekunad. Masalai digari haltalab in purra guzashtan ba tahqiqoti khuni donori bo reagentho baroi muayyan namudani guruhhoi khun az rui sistemai AV0, zerguruhhoi onho, muayyan namudani fenotipho (BDS, s, e), Kell meboshad.
  11. Vazi imruzai epidemiologii donorho dar mamlakat andeshidani chorabinihoi daqiqi profilaktikiro ba misli sifati intikhobi donorho va istifodai test-sistemahoi balandhassosi ba standarthoi jahoni muvofiqro baroi muoinai onho talab mekunad. Hissiyot hamchun khususiyati testho dar skriningi khuni donori ahamiyati avvalindaraja dorad. Az tarafi digar, dar khadamoti khun istifoda burdani testhoi hassos, vale makhsusiyatashon past boisi talafoti ziyodi moliyavi az sababi bekorkunii beasosi khun megardad. Raqamhoi ovardashuda talafoti kadrii donorho, bekorkunii beasosi khun hangomi karantinkuni, inchunin kharojoti ilovagiro, ba monandi az nav testikuni va mushohidai dispanseriro dar nazar nadorad. Az tarafi digar, az dast dodani donorhoi kadri jihati vase jalb namudani donorhoi avvaliya megardad, ki dahho marotiba khatari siroyatshavii bemoronro ziyod mekunad.
  12. Intikhobi namunahoi khuni donorho baroi tahqiqot dar probirkahoi istifodaashon bisyorkaratai shishagi girifta meshavand, ki dar yagon laboratoriyai khadamoti khun usulhoi avtomatii tahqiqi khuni donori baroi siroyat tatbiq karda nashudaast. Hatari roh dodan ba khatogi, ki bo omili insoni aloqamandi dorad, makhsusan dar sokhtori khun ahamiyati kalon dorad. Az in sabab tatbiq namudani tekhnologiyai avtomatikunonii tahqiqoti laboratori dar zaminai sistemai yagonai ittilootii markazi khun, ki ba haddi aqal kam kardani tasiri manfii omili insoni ravona karda shudaast, boyad yake az samthoi afzaliyatnok dar tashkil namudani khadamoti muosiri laboratorii markazhoi khun gardad.
  13. Tahqiqoti immunogematologi (guruhi khun, rezus-omil) dar aksariyati tashkilothoi tibbii jumhuri tibqi usuli kuhnashuda bo istifodai reagenthoi doroi hassosiyatu makhsusiyati past guzaronida meshavad, ki metavonad boisi natijahoi bargalat va intikhobi nodurusti vositahoi transfuzioni baroi khun qabulkunanda gardad. Usulhoi muosiri guruhhoi khunro judokuni bo usuli agglyutinatsiya dar gel guzaronida meshavad, ki na tanho bo makhsusiyati balandi reagentho va soddagii guzoshtani aksulamalho, balki bo spektri nisbatan vasei antigenhoi muayyanshavandai khun, ki baroi tashkil namudani makhzani donorhoi fenotipikardashuda imkoniyat medihad, tatbiq karda nashudaand.
  14. Talabot ba juzhoi khun bo ivazshavii protokolhoi tabobati bemoron tagyir yofta istodaast. Dar sharoithoi jarrohii muosir talabot ba eritrositho past shuda, ehtiyojot ba plazmai ba tozagi yakhkardashuda ziyod meshavad. Dar tabobati bemoroni saratoni khun bo istifodai miqdori ziyodi massai trombositari nomumkin ast.
  15. Mushkiloti transfuziologiyai kliniki bo monitoringi nokifoyai asosnokkunii istifodai juzhoi donorii khun aloqamand ast, ki boisi istifodai besamar va be in ham mahdudi zakhirahoi donori megardad.
  16. Sanjishi asosnokii tajribai transfuzioni (yo audit) yake az rohhoi tasirbakhshi past namudani istifodai juzhoi donorii khun meboshad. CHi tavre, ki malumoti adabiyoti ilmi shahodat medihad, 10 soli okhir hangomi guzaronidani auditi tajribai transfuzioni dar davlathoi gunogun hangomi namudhoi gunoguni bemori, uslub va hajmi tahqiqot to 55 foiz istifodabarii eritrositho, 67 foiz plazmai ba tozagi sardkardashuda va 78 foiz konsentrati trombositho beasos shumorida meshavad. Alomathoi zarur budani audit ba tavri bovaribakhsh nishon doda shudaand, zero badi tatbiqi on miqdori tazriqhoi zaruri past meshavad. Odatan, natijahoi sanjishi asosnokii tajribai transfuzioni, takmil dodani dasturho oid ba guzaronidani juzhoi khun, talim dodani tabibon, muayyan namudani samthoi minbadai tahqiqot meboshad.
  17. Ayni zamon, problemai mubram in judogii sokhtori va tashkilii zinahoi kliniki va istehsolii sokhtori khuni jumhuri meboshad, ki natijai on nabudani aloqai bozpas bayni klinika va markazi khun meboshad. Dar natijai in, markazi khun malumoti sarivaqti va mutamadro oid ba orizahoi baditransfuzioni dar retsipienthoi (khunqabulkunandahoi) juzhoi donorii khun namegirad.
  18. Mushkiloti taminoti kadrii khadamoti khun bo nokifoya budani mablagguzori va khususiyati soha asosnok gardidaast. Muzdi mehnati kam, nabudani mekhanizmhoi voqeii havasmandgardonii moddii kormandon dar solhoi guzashta boisi ba sokhtorhoi tijorati guzashtani mutakhassisoni balandikhtisos gardid.
  19. Mubodilai muntazami tajriba ham dar dokhili jumhuri va ham bo mutakhassisoni digar mamlakatho vujud nadorad. Korho oid ba takmili ikhtisosi mutakhassisoni sokhtori khun dar muassisahoi asosii khoriji duru nazdiki kishvar ba tavri purra guzaronida nameshavand. Dar sistemai talimoti miyona va olii tibbi (tayyorkunii badidiplomi) to hol barnomahoi muosiri talim muvofiqi tavsiyahoi Tashkiloti umumijahonii tandurusti oid ba transfuziologiya tatbiq karda nashudaand.
  20. Rushdi bosurati tibbi transfuzioni, paydo shudani tekhnologiyahoi nav dar khadamoti khun zarurati takmil dodani sistemai tayyorkunii kasbii mutakhassison, tashakkul va inkishofi zaminai khudii ilmiro dar sohai transfuziologiyai kliniki va istehsoli ba vujud ovardaast.
  21. Rushdi bosurati khadamoti khun dar tamomi samtho, az jumla purzur namudani zaminai meyorii huquqi, tatbiqi tekhnologiyai muosir, tayyorii kasbii mutakhassison, rushdi donorii ikhtiyorii roygon va tatbiqi sistemai nazorati sifat zarur meboshad. Inchunin mablagguzori az hisobi bujeti davlati va bujethoi mahallii shahr va tainoti nohiyavi zarur ast.

3. Maqsad va vazifahoi Barnoma

  1. Maqsadi Barnoma az tamin namudani bekhatari, sifat va dastrasii kumaki transfuzioni dar Jumhurii Tojikiston iborat meboshad.
  2. Vazifahoi asosii Barnoma inho meboshand:

– takmil dodani zaminai meyorii huquqi va sokhtori tashkilii khadamoti khun;

– tatbiqi tekhnologiyahoi muosir dar asosi tajdidi zaminai moddiyu tekhniki;

– baland bardoshtani takhassusi mutakhassisoni khadamoti khun;

– rushdi donorii khun va juzhoi on dar asosi tajribai peshraftai baynalmilali;

– tashkili sistemai nazorati sifati mahsuloti khuni donori.

4. Mablagguzorii Barnoma

  1. Jihati tatbiqi Barnoma bujet, ki baroi sohai tandurusti peshbini shudaast, mablaghoi tashkilothoi baynalmilali, inchunin digar manbahoe, ki qonunguzorii Jumhurii Tojikiston man nakardaast, amali karda meshavad.

5. Natijahoi peshbinishavandai Barnoma

  1. Sistemai bosamari mutamarkazi khadamoti khun tashkil karda shudaast va halli mushkiloti tamin namudani aholi bo juzhoi khuni donori, ki ba standarthoi sifati baynalmilali muvofiq ast, az hisobi chorabinihoi zerin tamin karda meshavand:

– takmil dodani zaminai qonunguzori, meyori, huquqi va tashkilii sokhtori Muassisai davlatii “Markazi jumhuriyavii ilmii khun”, filialhoi viloyatii on va hujrahoi tabobati transfuzioni dar muassisahoi tibbiyu profilaktikii jumhuri tibqi standarthoi baynalmilali;

– dar solhoi 2016-2019 takmil va tahkimi mutamarkazii sohai khun dar yakjoyagi, inchunin fazoi yagonai ittilootiyu kompyuteri dar sathi milli (dar zaminai Markazi jumhuriyavii ilmii khun);

– dar davomi solhoi 2016-2019 tashkil namudani laboratoriyahoi zanjirai polimerazi bo maqsadi paydo namudani virusi seronegativi dar filialhoi Muassisai davlatii “Markazi jumhuriyavii ilmii khun” bo tamini minbadai muassisahoi tibbiyu profilaktikii jumhuri bo juzhoi khuni bekhatar;

– tatbiqi marhila ba marhilai tekhnologiyai muosir va tamin namudani muassisaho bo tajhizoti zamonavi baroi tahlili khuni donori;

– dar solhoi 2016-2018 tahiya namudani standartu talaboti yagona ba tajhizot va mavodi sarfashavanda, tamin namudani laboratoriyahoi nazorati sifat dar filialhoi Muassisai davlatii “Markazi jumhuriyavii ilmii khun”;

– mutobiqi moddai 10 Qonuni Jumhurii Tojikiston “Dar borai donorii khun va juzhoi on” donoron dar ruzi suporidani khun az hisobi mablaghoi bujeti dakhldor bo khuroki roygon tamin karda meshavand;

– dar davomi solhoi 2016-2019 tamin namudani markazhoi khun bo naqliyoti makhsusgardonidashuda baroi intiqoli mutamarkazi juzhoi khun az markazhoi khun ba muassisahoi tibbiyu profilaktiki;

– tain namudan bo tajhizoti makhsus baroi istehsol, nigohdorii juzhoi khun, guzaronidani tadqiqoti laboratorii namunahoi khuni donorho dar solhoi 2016-2019;

– dastras namudani mavodi istifodaashon yakdafaina baroi tayyor namudani khun va juzhoi on, leykofiltratsiya, probirkahoi istifodaashon yakdafaina test-sistemahoi balandsifat baroi tahqiqi khuni donoron baroi siroyathoi transmissivi bo usulhoi immunofermenti va taboduli zanjirii polimerazi, reagenthoi monoklonali va bisyorklonali;

– takmili ikhtisosi mutakhassisoni khadamoti khun dar markazhoi khuni peshrafta va talimgohhoi khorijii duru nazdik va davat namudani mutakhassisoni varzidai khadamoti khun baroi tayyor namudan va bozomuzii mutakhassisoni khadamoti khun dar zaminai Muassisai davlatii “Markazi jumhuriyavii ilmii khun”;

– rushdi shaklhoi gunoguni donorii khun, juzhoi on va dar asosi tatbiqi tajribai baynalmilalii tashkil namudani on, jalb namudani Kumitai markazii Jamiyati Hiloli Ahmari Tojikiston, peshvoyoni siyosi, dini, ashkhosi mashhuri davlat, tashkilothoi gayrihukumati va digar ittihodiyahoi jamiyati baroi tashviqu targibi donorii roygon.

6. Samthoi asosi va mekhanizmhoi tatbiqi Barnoma

  1. Takmili zaminai meyorii huquqi va tashkilii sokhtori khadamoti khun dar Jumhurii Tojikiston peshbini menamoyad:

– takmil dodani sanadhoi meyorii huquqi oid ba masalahoi rushdi khadamoti khun tavassuti ba standarthoi baynalmilali mutobiq kardani onho;

– tahiya va tatbiqi standarti sistemai ittilootii markazi khun.

  1. Tatbiqi tekhnologiyahoi muosir dar asosi tajdidi zaminai moddiyu tekhniki peshbini menamoyad:

– tahiyai standartu talaboti yagona baroi tajhizonidani khadamoti khun va tamin namudani on bo mavodi sarfshavanda;

– tamin namudani markazhoi khun bo tajhizoti makhsusgardondashudai tayyor kardan, istehsol, nigohdori va intiqoli juzhoi khun, tahqiqi laboratorii namunai khuni donorho;

– tajhizondani khadamoti khun bo kompyuterhoi shakhsi va tajhizoti serveri jihati tahkimi sistemai ittilootii khadamoti khun;

– tamin namudani markazhoi khun bo naqliyoti makhsusgardonidashuda baroi tayyor namudani khun va juzhoi on dar sharoithoi sayyor vobasta ba doirai markazi khun va shumorai aholie, qi khizmatrasoni peshbini menamoyad, tajhizonidan bo avtoprisep-modulho (dar majmu bo tajhizot) baroi tayyor namudani khun dar sharoiti sayyor va modulho baroi tayyor namudani plazma (dar majmu bo tajhizot va yadak);

– tamin namudani markazhoi khun bo test-sistemahoi balandsifat va mavodi sarfshavandai istifodaashon yakkarata baroi tahqiqi siroyathoi transfuzioni;

– tamin namudani markazhoi khun bo reagenthoi monoklonali va mavodi sarfshavandai istifodaashon yakkarata baroi guzaronidani tahqiqoti immunogematologii donorho, khunqabulkunandaho va homiladoron;

– tatbiqi tekhnologiyai agglyutinatsiya dar gel va tippikunonii avtomatikardashudai khun;

– tamin namudani markazhoi khun bo mavodi sarfshavandai tayyor namudani khun va juzhoi on, leykofiltratsiya bo darnazardoshti tajhizoti mavjuda va miqdori bahisobgiriftashudai donorii khun va juzhoi on;

– tamin namudani shubahoi khunguzaroni va hujrahoi tabobati I, transfuzioni bo tajhizoti makhsusgardondashudai nigohdorii juzhoi khun;

– ziyod namudani hajmi ba hissaho taqsim namudani plazma dar kriopresipitat va plazmai krionatanti.

  1. Takmili ikhtisosi mutakhassisoni khadamoti khun peshbini menamoyad:

– takmili ikhtisosi mutakhassison dar zaminai Markazi jumhuriyavii ilmii khun: inchunin dar markazhoi peshraftai davlathoi khoriji duru nazdik;

– davat namudani mutakhassisoni khorijii sohai tibbi transfuzioni baroi guzaronidani kursho, treningu seminarho bo maqsadi dar zaminai Markazi jumhuriyavii ilmii khun tayyor namudani mutakhassisoni khadamoti khun.

  1. Rushdi donorii khun va juzhoi on dar asosi tatbiqi tajribai baynalmilalii tashkil namudani on peshbini menamoyad:

– rushdi donorii ikhtiyorii roygon, tavassuti ittihodiyahoi jamiyati va tashkilothoi gayrihukumati bo rohi joygirkunonii farmoishi ijtimoi dar sathi maqomoti ijroiyai mahallii hokimiyati davlati;

– jalbi tashkilothoi gayrihukumati va digar ittihodiyahoi jamiyati baroi ishtirok dar targibu tashviqi donori bo mablagguzorii chorabiniho tavassuti bujethoi jumhuriyaviyu mahalli az rui prinsipi farmoishi ijtimoi;

– ba donori jalb namudani khizmatchiyoni harbii vohidhoi Vazorati mudofiai Jumhurii Tojikiston, Kumitai holathoi favqulodda va mudofiai grajdanii nazdi Hukumati Jumhurii Tojikiston, Vazorati korhoi dokhilii Jumhurii Tojikiston va digaron;

– tashkil namudani donorii ikhtiyorii roygon dar sharoiti sayyor;

– tamin namudani gizoi donorii roygon mutobiqi Qonuni Jumhurii Tojikiston “Dar borai donorii khun va juzhoi on” amali karda meshavad.

  1. Tashkil namudani sistemai idorakunii sifati mahsuloti khun peshbini menamoyad:

– tahiyai standarthoi sifati juzhoi, donori va doruhoi khun, standarthoi tahqiqoti laboratori va standarthoi nishondihandahoi istifodai kliniki vositahoi transfuzioni va usulhoi transfuziologiyai kliniki;

– tahiyai nizomnoma oid ba akkreditatsiyai tashkilotu vohidhoi khadamot.

Naqsha

Bo qarori Hukumati

Jumhurii Tojikiston _

2 iyuli soli 2015, № 422 tasdiq shudaast

Naqshai chorabiniho oid ba tatbiqi Barnomai millii rushdi donorii khun va juzhoi on dar Jumhurii Tojikiston baroi solhoi 2015-2019

CHorabiniho Ijrokunandagon Muhlati ijro Bo solho Mablagi umumi (oomoni) Sarchashmahoi mablagguzori
 

 

 

 

 

 

 

 

2016 2017 2018 2019    
1 Takmil dodani sanadhoi meyorii huquqi va tavsiyahoi talimiyu metodi oid ba masoili rushdi khadamoti khun Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston 2016           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston peshbini shudaast
2 Tashkil namudani guruhi kori oid ba masalahoi istifodai juzhoi khun Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston 2016           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston peshbini shudaast
3 Takmil dodani khadamoti markazonidashudai khun dar – jumhuri.

Tamin namudani sharoit baroi 50000 khunsupori dar yak sol dar Markazi jumhuriyavii ilmii khun (25000) va filialhoi on

Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassichai davlatii “Markazi jumhuriyavii ilmii khun” 2016-2019           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston peshbini shudaast
4 Tamin namudani khadamoti khun bo reagenthoi monoklonali va bo mavodi yakdafainai sarfshavanda baroi guzaronidani tadqihoti immunologii khun Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassioai davlatii “Markazi jumhuriyavii ilmii khun” 2016-2017 150000 150000     300000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
5 Tamin namudani Markazi jumhuriyavii ilmii khun va filialhoi viloyatii on bo khaltachahoi khungiri Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2017-2019   2000000 2000000 4000000 8000000 Az hisobi mablaghoi Bujegi davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston peshbini shudaast  
6 Tamin namudani Markazi jumhuriyavii ilmii khun va filialhoi viloyatii on bo tajhizoti ozmoishii genetikii zanjirai polimerazi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “”Markazi jumhuriyavii ilmii khun” 2018-2019     400000 600000 1000000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
7 Tamin namudani Markazi chumhuriyavii ilmii khun va filialhoi viloyatii on bo dastgohi davrzanonii refrejeratorii khun Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2019       2500000 2500000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
8 Tamin namudani Markazi jumhuriyavii ilmii khun va filialhoi viloyatii on bo dastgohi payvastkunii naychahoi khaltachahoi khun Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikioton, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2019       500000 500000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
9 Tamin namudani Markazi jumhuriyavii ilmii khun va filialhoi viloyatii on bo yakhdonhoi sanoati baroi nigohdorii khun Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2017-2019   150000 150000 300000 600000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
10 Tamin namudani Markazi jumhuriyavii ilmii khun va filialhoi viloyatii on bo naychashishaho baroi tahlili khun Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassioai davlatii “Markazi jumhuriyavii ilmii khun” 2019       600000 600000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
11 Tashkil namudani Vazorati tandurusti 2016 100000       100000 Az hisobi mablaghoi  
  davrhoi omuzishi baroi kormandoni khadamoti khun va muassisahoi tabobatiyu profilaktiki mutobiqi tavsiyahoi navi talimiyu metodi oid ba transfuziologiya va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun”             Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
12 Dar barnomai talimii Donishgohi davlatii tibbii Tojikiston, kollejho va omuzishgohhoi tibbi va inchunin dar Donishkadai takmili ikhtisosi badidiplomii kormandoni tibbi Tojikiston jori namudani kurohoi omuzishi oid ba masalahoi mubrami tibbi transfuziologi Vazorati maorif va ilmi Jumhurii Tojikiston, Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Donishgohi davlatii tibbii Tojikiston, Donishkadai takmili ikhtisosi badidiplomii kormandoni tibbi Tojikiston 2016           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
13 Guzaronidani takmili ikhtisosi mutakhassisoni khadamoti khun dar zaminai Markazi jumhuriyavii ilmii khun, khorijai nazdik va dur Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii khun” 2017-2019   200000 200000 100000 500000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
14 Tamin namudani Vazorati tandurusti 2016-2018 40000 30000 30000   100000 Az hisobi mablaghoi  
  davati mutakhassisoni varzidai khoriji baroi tayyor namudani mutakhassisoni khadamoti khun dar zaminai Markazi

Jumhuriyavii ilmii

khun

va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun”             Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
15 Tahkimi zaminai moddiyu tekhnikii shubai talimiyu metodii Muassisai davlatii “Markazi jumhuriyavii ilmii khun” Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2018     100000   100000 Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
16 Tamin namudani rushdi donorii ikhtiyorii khun va juzhoi on Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2016-2019           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
17 Purzur namudani targibu tashviqi donorii ikhtiyorii roygon: bo istifoda az VAO, kumaki sozmonhoi jamiyati va Jamiyati Hiloli Ahmari Tojikiston Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muasrisai davlatii “Markazi jumhuriyavii ilmii khun” 2016-2019           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini  
  purzur namudani faoliyati targibu korho oidi az bayn burdani shumorai donoroni pulaki va ziyod namudani shumorai donorhoi ikhtiyorii roygon               shudaast  
18 Tamini hifzi salomatii donorho az jonibi maqomoti tandurusti va bo in maqsad amali namudani majmui tadbirhoi zerin:

– jam kardani donorho;

– rioyai sharoiti behdoshtiyu epidemiologii khungiri;

– dar sathi zaruri tayyor namudani kormandoni tib;

– nazorati donorho dar markazhoi salomati.

Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassioai davlatii “Markazi jumhuriyavii ilmii    khun” 2016           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
19 Mustahkam gardonidani imkonoti tamini bekhatarii khun, az jumla kharidorii tajhizoti zaruri, mavodi sarfshavanda, guzaronidani Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tbjikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2018-2019           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbnni  
  seminarho oid ba amali namudani tavsiyaho               shudaast  
20 Tashkili markazi yagonai donori baroi jamovarii ittiloot az mintaqahoi jumhuri oid ba vazi epidemiologii donorhoi ehtimoli, vazi salomatii donorho Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii    khun” 2017           Az hisobi mablaghoi Bujeti davlagi, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
21 Tashkil namudani Referens-laboratoriya dar nazdi Markazi jumhuriyavii ilmii khun baroi nazorati sifati mahsuloti istehsolshavanda az tamomi filialhoi “Markazi jumhuriyavii ilmii khun” Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2017-2019           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
22 Takmil dodani sistemai yagonai monitoring va arzyobi dar nazdi “Markazi jumhuriyavii ilmii khun” Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston, Muassisai davlatii “Markazi jumhuriyavii ilmii khun” 2018-2019           Az hisobi mablaghoi Bujeti davlati, ki baroi Vazorati tandurusti va hifzi ijtimoii aholii Jumhurii Tojikiston va Muassisai davlatii “Markazi jumhuriyavii ilmii khun” peshbini shudaast  
  Hamagi     290000 2530000 2880000 8600000 14300000    
                                                                                       

 

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