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GLAUKOMA

glaucomaGLAUKOMA (Glaucoma; az yun. glaukos – sabzi nilgun), bemorii muzmini chashm. Nishonai asosii G. baland shudani fishori dokhili chashm meboshad. Baze boftahoi chashm (zujojiya va qarniya) dar natijai davr zadani moei daruni chashm (dar tarkibash moddahoi gizoi dorad) gizo megirand. Moei ba tozagi hosil va ba guzai chashm voridgashta bo moee, ki az dokhili chashm mebaroyad, miqdoran barobar meboshad. Az in sabab fishori dokhili chashm doimo yak khel ast (nig. CHashm). Bo sababhoi gunogun (beshtar az illati ragu asabho) gardishi moei chashm ikhtilol yofta, boisi gun shudani on dar dokhili chashm va baland gashtani fishori daruni on megardad. Az ustuvor baland shudani fishori dokhili chashm faoliyati bosira khalal yofta, illathoi zerin ba vujud meoyand: mahvi nugi torhoi asabi shabakiya; purra tagyir yoftani asabi bosira; bad shudani binish va hatto nobinoi. G. aksaran dar sinni balogat va miyonsoli, badi 45 – 55-solagi inkishof meyobad; baze kudakon va javonon ham G. meshavand. Ba nazar namudani doirahoi rangin dar girdi charogi furuzon avvalin nishonai inkishofi G. ast. CHizhoi peshi nazar khira metoband. In noqisiho, odatan, avval dar yak chashm ba vujud meoyand. Bazan (beshtar pagohi) ba muddati 1 – 3 soat fishurda shudani atrofi chakka, peshoni va khudi chashm his karda meshavad. Hangomi zuhuri chunin alomat ba dukhtur murojiat kardan zarur ast.
Fishori dokhili chashm mutadil (na beshtar az 27 mm sut. simobi), andake baland (28 – 32 mm sut. simobi) va baland (ziyoda az 32 mm sut. simobi) meshavad. Hamchunin holati khuruji shadidi bemoriro niz farq mekunand, ki dar mavridi on fishori dokhili chashm ba 50 mm sut. simobi merasad. Hangomi 27 – 28 mm sut. simobi baland shudani fishori dokhili chashm muoinai purrai oftalmologi zarur ast.
G. bazan nogahon bo khuruji shadid ogoz meyobad. Dar in asno chashm va sar sakht dard mekunad, chashm surkh shuda, pilkho varam menamoyand, quvvai bosira sust megardad. Bazan ahvoli bemor bad, dil behuzur, harorati badan baland meshavad, u qay mekunad.
Tabobati G. dar davrai avvali tashakkuli on natijai khub medihad. Tabobat az usulhoi gunoguni tasir ba chashmi bemor, hamchunin ba tamomi organizm iborat ast. Badi muoinai amiq ba har bemor tabobati alohida muqarrar mekunand. Agar zarur boshad, uro baroi muoina ba bemorkhona mekhobonand. Baroi tabobati bosamarai G. rejimi durust lozim ast. Bemor boyad har shab 7 – 8 soat khob ravad. Pesh az khob istemoli khurok mumkin nest, havoi khona boyad toza boshad, sayru gasht dar havoi toza mufid ast. Bemor boyad ba bolishti baland khobad, dar aksi hol khunu moei chashm shakh va fishori dokhili on baland megardad. Har pagoh varzishi sabuk kardan lozim. Ba shakhsoni mehnatashon fikri zarur ast, ki dar davomi ruz yagon kori jismoni namoyand, dar havoi toza sayru gasht kunand. SHakhsoni giriftori G. naboyad sakht khamu rost shavand; ba onho shustani farshi khona, khishovai poliz, jomashui, shikastani hezum, navokhtani asbobhoi nafasi, bardoshtani bori vaznin va g. mumkin nest (in hama fishori dokhili chashmro baland mekunand). Ba in qabil bemoron az had ziyod garm nigoh doshtani sar noravost. Ba onho hammomi garm, dar nazdi pechka nishastan, sari luch zeri oftob gashtan va vannahoi oftobi joiz nest. Faqat dar khonai ravshan khondanu navishtan, rasm kashidan, dukhtan mumkin ast. Toriki fishori dokhili chashmro baland mekunad. Az in ru ba bemoroni G. pushidani aynaki siyoh, nishastan dar khonai torik va dar vaqti khob pushidani pardai tirezaho mumkin nest. Hangomi tamoshoi televizor khona boyad kame ravshan boshad. Ba in qabil bemoron aynaki sabzi ravshan mufid ast (rangi sabz fishori dokhili chashmro qadre past mekunad). Onho khudro boyad az gamu anduh va hayajon dur girand. Heshu tabor va atrofiyon baroi bemor boyad osudaholi muhayyo namoyand.
Ba bemoroni giriftori G. qabuli doruhoi atropindor (fishori dokhili chashmro baland karda, hatto G.-ro sakht ba khuruj ovardanash mumkin) man ast. Bemoron dar vaqti ba dig. dukhturon murojiat kardan, boyad giriftori G. budanashonro malum namoyand.
Dar asnoi G. tagziyai murattab ahamiyati kalon dorad. Hurokro ruze 4 – 5 marotiba dar vaqti muayyan khurdan lozim ast; khuroki shomro du soat pesh az khob boyad khurd. Hurdani gizohoi duddoda, shur va tundu tez joiz nest. Huroki az ravgani rastani tahiyashuda behtar ast; gushtu mohii beravgan (gushti gov, murg, shurtan, kapur, sufmohi, ravganmohi, simmohi)-ro boyad dar ob pukhta istemol namud. SHir, jurgot, tvorog, sabzavotu meva naf dorad. Istemoli shurboi az sabzavot, tahiyashuda va haftae 2 – 3 bor istemol kardani shurboi gushtin yo zanburugi tavsiya meshavad. Bemor boyad dar yak shaboruz az 5 – 6 istakon ziyod moe (ob, choy, shurbo) nanushad; dar yak dafa az yak istakon ziyod istemol kardani choy zarar dorad. Nushidani choyi talkh, qahva, nushokihoi spirtdor, kashidani tamoku man ast. Hangomi qabziyat doruhoi mushil istemol kardan lozim.
G.-ro bo doru faqat dukhtur (oftalmolog) tabobat mekunad. Dar vaqti khuruji shadidi G. yorii tajilii tibbi zarur ast. Agar dar mavridi muoinai makhsus ba G. giriftor budani bemor muayyan karda shavad, pas to omadani dukhtur badi har 15 – 20 daq. (dar muddati yak soat), sipas badi har soat ba chashmi u pilokarpin chakkonida, dar yak vaqt dorui mushil (1 qoshuq sulfati magniy ba nim istakon ob) medihand; poyashro ba vannai garm (20 – 30 daq.) gutonida, badi on mekhobonand, ba poy garmkunak, ba gardanu pushti sar khardalkogaz meguzorand; hangomi dardi sakhti chashm 0,5 g amidopirin yo analgin medihand. Agar az tasiri doru fishori dokhili chashm past nashavad yo nokifoya past shavad, pas jarrohi noguzir ast.
Peshgiri. Har yak shakhsi sinnash az 40 bolo har sol aqallan yak marotiba (alomathoi kasalii chashm nadoshta boshad ham) boyad ba dukhturi chashm murojiat namoyad. Muoinai peshaki imkon medihad, ki bemori sarivaqt oshkor karda shavad. Agar bemoron az doruhoi tanzimgari fishori daruni chashm istifoda barand, inkishofi G.-ro peshgiri khohad kard.
Ad: Oftalmologiya, M. 2005.

Z.D. Ahrorova.

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