otorinolaringologia - TSMU...3 2. specialobis aRweriloba specialobis da specialistis gansazRvra...
Transcript of otorinolaringologia - TSMU...3 2. specialobis aRweriloba specialobis da specialistis gansazRvra...
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diplomisSemdgomi samedicino ganaTlebis programa
otorinolaringologia
______________________________________________________________________ xangrZlivoba – 4 weli (44 Tve)
1. programis mizani da amocanebi
sarezidento programis mizans rezidentis mier otorinolaringologiis specialobiT damoukidebeli saqmianobisTvis aucilebeli klinikuri gamocdilebis miReba warmoad-gens. momavali otorinolaringologi yuris, cxviris, xaxis, xorxis da nawilobriv kisris paTologiaTa diagnostikis da mkurnalobisaTvis aucilebel Teoriul da praq-tikul codnas unda daeuflos. rezidenturis programis msvlelobis procesSi momavali specialisti lor organoe-bis inspeqtirebis Tanamedrove meTodebsaiTvisebs, laboratoriuli, sxivuri da his-topaTologiuri gamokvlevis meTodebsgaecnobadiagnozis dazustebisaTvis maTi ga-moyenebarom SeZlos, lor organoebis damuSavebis meTodebsdaeufleba, romlebic am-latoriul praqtikaSi pouloben gamoyenebas. momavalma specialistma etapobrivad un-da aiTvisos martivi, saSualo sirTulis da rTuli operaciebi, Seiswavlos lor on-kologiis Taviseburebebi, iswavlos samedicino dokumentaciis gaformeba. rezidents lor praqtikaSi gadaudebeli mdgomareobebis dros pirveladi daxmarebis gaweva da Semdgom mkurnalobis Catarebaunda SeeZlos. rezidenturis programa audiologiis da vestibulologiis safuZvlebis Seswavlasacmoicavs, rac specialists smenis da ves-tibuluri organos daavadebaTa Tanamedrove doneze interpretaciaSi da mkurnalobis da/an reabilitaciis meTodTa SerCevaSi daexmareba. praqtikuli muSaobis paralelu-rad rezidentma Teoriuli codna unda gaiRrmavos.amisaTvismas multimediuri saSua-lebebis gamoyenebacunda xelewifebodes. sarezidento programis Sesrulebis procesSi rezidentma Teoriuli da praqtikuli xasiaTis swavlebis adekvaturi kursi unda gaiaros, raTa poliklinikisTu stacio-narispirobebSi eqim-otorinolaringologaddamoukideblad muSaoba SeZlos.
ra unda icodes otorinolaringologiis specialobiT rezidenturis programis kursdamTavrebulma
1. avadmyofis anamnezis swori da sruli Sekreba, ambulatoriuli da stacionaruli istoriebis Sevseba;
2. avadmyofis momzadeba saoperaciod da postoperaciuli periodis sworad warmarT-va;
3. saoperacio riskis gansazRvra da Sesabamisi taqtikis SerCeva; 4. sxvadasxva saxis Sokis diagnostika, diferencialuri diagnostika, mkurnaloba; 5. transfuziuli Terapiis optimaluri moculobis da dozirebis SerCeva; 6. xelovnuri sunTqvis Catareba: a) stacionaruli aparatiT; b) ambus aparatiT; 7. oqsigenoTerapia; 8. eleqtrodefibrilacia; 9. traqeis punqcia; 10. periferiuli venis kaTeterizacia; 11. zondiT kveba; 12. parenteraluri kveba; 13. Sereuli kveba; 14. sedacia; 15. sisxlis jgufobriobis dadgena;
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16. intubacia; 17. antibaqteriuli Terapiis optimaluri moculobis da dozirebis SerCeva, antibaqte-
roTerapiis kontroli; 18. antimikozuri Terapiis optimaluri moculobis da dozirebis SerCeva; 19. sxvadasxva saxis da lokalizaciis sisxldenis diagnostika, diferencialuri diag-
nostika, mkurnalobis taqtikis SerCeva da Catareba; 20. cxviris da misi danamati wiaRebis anatomia, topografiuli anatomia, fiziologia; 21. cxiris da misi danamati wiaRebis daavadebebis diagnostika, diferencialuri diag-
nostika, mkurnaloba, mkurnalobis axlo da Soreuli Sedegebis Sefaseba; 22. xaxis anatomia, topografiuli anatomia, fiziologia; 23. xaxis daavadebebis diagnostika, diferencialuri diagnostika, mkurnaloba, mkurna-
lobis axlo da Soreuli Sedegebis Sefaseba; 24. xorxis anatomia, topografiuli anatomia, fiziologia; 25. xorxis daavadebebis diagnostika, diferencialuri diagnostika, mkurnaloba; 26. xorxis da traqeis sxvadasxva genezis stenozebis diagnostika, mkurnalobis kon-
servatiuli da qirurgiuli meTodebi; 27. yuris anatomia, topografiuli anatomia, fiziologia; 28. yuris daavadebebis diagnostika, diferencialuri diagnostika, mkurnaloba,mkurna-
lobis axlo da Soreuli Sedegebis Sefaseba; 29. saylapavi milis anatomia, topografiuli anatomia, fiziologia; 30. saylapav milSi ucxo sxeulis arsebobis verifikacia, mkurnaloba; 31. rinogenuli qalasSida da orbitaluri garTulebebi, diagnostika, diferencialuri
diagnostika, mkurnaloba; 32. otogenuri qalasSida garTulebebi, diagnostika, diferencialuri diagnostika,
mkurnaloba; 33. lor organoebis onkologiuri daavadebebis diagnostika, diferencialuri diagnos-
tika, mkurnalobis taqtikis SerCeva; 34. klinikuri audiologiis da vestibulologiis safuZvlebi; 35. lor organoebis mimoxilviTi rentgenogramebis da kompiuteruli tomogramebis
ganxilva da analizi; 36. otoskopia, mikroskopiuli otoskopia, wina rinoskopia, ukana rinoskopia, lor or-
ganaoebis endoskopia, cxvir-xaxis manualuri gamokvleva, faringoskopia, ezofago-skopia, arapirdapiri laringoskopia;
37. sxvadasxva lor organodan ucxo sxeulebis amoReba; 38. sxvadasxva lor organodan sisxldenis SeCereba, cxviris wina da ukana tamponada,
tonzileqtomiis Semdgomi sisxldenis ligireba, kerva, tamponada, lor organoebi-dan sisxldenis SeCereba koagulaciiT, wina da ukana eTmoiduri arteriebis, gareTa saZile arteriis gadakvanZviT;
39. paratonzilaruli da retrofaringealuri abscesebis kveTa-drenireba; 40. parafaringealuri abscesebis kveTa-drenireba; 41. konikotomia, traqeotomia, traqeostomia; 42. cxviris da misi danamati wiaRebis travmebis dros Zvlebis repozicia, Sesabamisi
taqtikis SerCeva; 43. cxviris danamati wiaRebis punqcia, trepanopunqcia; 44. cxviris danamati wiaRebidan Cirqis evakuacia arapunqciuri meTodebiT; 45. dafis apkis pmevmomasaJi, evstaqis milis kaTeterizacia, policeris baloniT tim-
panaluri Cabervebi; 46. dafis apkis paracentezi; 47. sxvadasxva tipis smenis daqveiTebis diagnostika; 48. smenadaqveiTebulTa reabilitaciis taqtikis SerCeva; 49. lor organoebis anTebiTi daavadebebis mkurnalobaSi fizioTerapiuli meTodebis
gamoyeneba, mkurnalobis axlo da Soreuli Sedegebis Sefaseba da Sesabamisi taqti-kis SerCeva.
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2. specialobis aRweriloba
specialobis da specialistis gansazRvra (definicia)
otorinolaringologiaqirurgiuli medicinis dargia, romelic yuris, cxviris, xa-xis, xorxis da nawilobriv kisris daavadebebis diagnostikas da mkurnalobas moicavs.
otorinolaringologi movalea yuris, cxviris, xaxis, xorxis da nawilobriv kisris paTologiis mqone pacientebSi swori diagnozi dasvas, konservatiuli Tu qirurgiuli mkurnalobis taqtika gansazRvros, kritikul situaciebSi avadmyofs gadaudebeli daxma-reba gauwios.
momavali specialisti 4-wliani rezidenturis kurss gaivlis da sasertifikacio ga-mocdas Caabarebs, ris Semdegac eqim-otorinolaringologis statuss moipovebs. eqimi-otorinolaringologiuwyveti samedicino ganaTlebis principebs emorCileba.sakvali-fikacio kursis gavla mas sxva qveynebis klinikebSic SeuZlia.
specialistis zogadi unar-Cvevebi 1. cxviridan ucxo sxeulis amoReba; 2. cxviris Zvlebis repozicia; 3. cxviris Zgidis abscesis gakveTa; 4. evstaqis milis kaTeterizacia, timpanaluri Cabervebi; 5. haimoris wiaRis punqcia; 6. cxviris danamati wiaRebidan arapunqciuri meTodebiT Cirqis evakuacia; 7. cxviris wina tamponada; 8. cxviris ukana tamponada; 9. saylapavidan ucxo sxeulebis amoReba ezofagoskopiT; 10. paratonzilaruli abscesis kveTa; 11. retrofaringealuri abscesis kveTa, drenireba; 12. adenotomia; 13. tonzileqtomia; 14. endonazaluri polipotomia; 15. endonazaluri polipotomia eTmoidis gaxsniT; 16. rinofimis operacia; 17. cxviris qvemo konxotomia; 18. cxviris qvemo niJarebis ultrabgeriTi dezintegracia; 19. cxviris qvemo niJarebis turbinoplastika; 20. cxviris qvemo niJarebis submukozuri rezeqcia; 21. cxviris Zgidis rezeqcia; 22. cxviris plastika; 23. Sublis wiaRis trepanopunqcia; 24. frontotomia; 25. eTmoidotomia; 26. haimorotomia; 27. sfenoidotomia; 28. cxviris danamat wiaRebze endoskopiuri operaciebi; 29. kisris midamos kisteqtomia; 30. kamertonuli gamokvleva; 31. tonaluri audiometria, timpanometria; 32. transmeataluri polipotomia; 33. dafis apkis paracentezi; 34. dafis Rrus Suntireba; 35. gareTa sasmeni milis egzostozis operacia; 36. antromastoideqtomia; 37. yuris radikaluri operacia; 38. traqeotomia; 39. xelovnuri sunTqvis ganxorcieleba: a) stacionaruli aparatiT; b) ambus aparatiT;
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40. oqsigenoTerapia; 41. eleqtrodefibriliacia; 42. traqeis punqcia; 43. periferiuli venis kaTeterizacia; 44. zondiT kveba; 45. parenteraluri kveba; 46. Sereuli kveba; 47. sedacia; 48. sisxlis jgufobriobis dadgena; 49. intubacia.
specialoba qvemoCamoTvlili daavadebebis da paTologiuri mdgomareobebis klinikas, diagnostikas, mkurnalobas da profilaqtikas Semdegi moculobiTmoicavs: 1. cxviris da misi danamati wiaRebis travmebi; 2. cxviris Tandayolili anomaliebi, cxviris Rrus atrezia, sineqiebi; 3. cxviris Rrus da misi danamati wiaRebis ucxo sxeulebi; 4. cxviris wiTeli qari, egzema, sikozi, furunkulozi, rinofima; 5. cxviris Zgidis deformacia, hematoma, abscesi; 6. rinitebi, ozena; 7. cxviris da misi danamati wiaRebis polipozi; 8. cxviridan sisxldena; 9. mwvave da qronikuli sinusitebi; 10. cxviris danamati wiaRebis cistiseburi gaganiereba; 11. cxviris da misi danamati wiaRebis simsivneebi; 12. xaxis dazianebebi, ucxo sxeulebi xaxaSi; 13. cxvir-xaxis adenoidebis da sasis tonzilebis hiperplazia; 14. mwvave da qronikuli faringitebi; 15. banaluri da specifikuri anginebi; 16. paratonzilaruli, parafaringealuri, retrofaringealuri abscesebi; 17. qronikuli tonziliti; 18. xorxis travmebi; 19. xorxis ucxo sxeulebi; 20. xorxis SeSupeba; 21. xorxis anTebiTi daavadebebi; 22. xorxis mwvave da qronikuli stenozi; 23. yuris travmebi, ucxo sxeulebi; 24. wiTeli qari, periqondriti; 25. gareTa sasmeni milis egzema da anTebiTi daavadebebi; 26. Sua yuris mwvave da qronikuli anTebiTi daavadebebi; 27. labirinTiti; 28. otosklerozi; 29. menieris daavadeba; 30. smenis sensonevraluri daqveTeba; 31. smenis daqveiTeba, sruli smenaClungoba, yrumunjoba; 32. smenadaqveiTebul avadmyofTa reabilitaciis meTodebi; 33. cxvir-xaxis avTvisebiani simsivneebi; 34. nuSura jirkvlis da pir-xaxis avTvisebiani simsivneebi; 35. xorxis kiboswinare daavadebebi da avTvisebiani simsivneebi; 36. zeda ybis, cxviris da misi danamati wiaRebis avTvisebiani simsivneebi; 37. piris Rrus organoebis avTvisebiani simsivneebi.
otorinolaringologs Semdegi laboratoriul-instrumentuli gamokvlevis Sedegebis interpretacia da klinikuri Sefasebaunda SeeZlos:
1. sisxlis saerTo analizi ujreduli Semadgenlobis gaTvaliswinebiT; 2. koagulogramis analizi; 3. sisxlis jgufobriobisdadgena,rezus-faqtoris gansazRvra;
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4. Sardis saerTo analizi; 5. biofsiuri da operaciuli masalis histologiuri gamokvlevebismonacemTa Se-
faseba; 6. punqtatis da nacxis citologiuri da baqteriologiuri gamokvlevis monacemTa
Sefaseba; 7. cilebis, naxSirwylebis da cximebis metabolizmis, azotovani cvlis, eleqtro-
litebis da fermentuli gamokvlevebis monacemTa Sefaseba; 8. rentgenoskopiis, rentgenografiis, ultrabgeriTi gamokvlevis, kompiuteruli
tomografiis, eleqtro-magnituri rezonansuli gamokvlevis monacemTa Sefaseba; 9. endoskopiurigamokvlevis monacemTa adekvaturi Sefaseba.
otorinolaringologs Semdegi diagnostikuri da samkurnalo manipulaciebisganxor-cieleba unda SeeZlos: * otoskopia, mikrootoskopia; * wina da ukana rinoskopia; * faringoskopia; * arapirdapiri da pirdapiri laringoskopia; * lor organoebis inspeqtirebaendoskopiT; * evstaqis milis kaTeterizacia; * miringotomia; * cxviris danamati wiaRebidan arapunqciuri meTodebiT Cirqis evakuacia; * haimoris wiaRis punqcia; * Sublis wiaRis punqcia; * cxviris wina da ukana tamponada; * lor sistemis Rru organoebidan ucxo sxeulis amoReba; * cxviris Zvlebis repozicia; * cxviris Zgidis abscesis gakveTa; * smenis gamokvleva kamertoniT; * tonaluri zRurblovani audiometria; * timpanometria, impedansometria.
otorinolaringologsSemdegi gadaudebeli mdgomareobebis profilaqtika, diagnosti-ka, pirveladi daxmareba da mkurnaloba unda SeeZlos: * cxviridan sisxldena; * cxviris Ria da daxuruli motexilobebi; * xorx-xaxis da cxvir-xaxis ucxo sxeulebi; * xorxis ucxo sxeulebi, xorxis stenozi; * xorxis Ria da daxuruli dazianebebi; * xaxisa da rbili sasis dazianebebi; * peritonzilaruli da parafaringealuri abscesebi; * yuris niJaris Wrilobebi da dazianebebi; * gareTa sasmeni milis dazianebebi; * safeTqlis Zvlis motexilobebi; * dafis apkis dazianebebi; * Sua yuris mwvave anTeba; * paracentezi; * subperiostaluri abscesi, mastoiditi; * akustikuri travma; * uecari siyrue; * xelovnuri sunTqvis ganxorcieleba: a) stacionaruli aparatiT; b) ambus aparatiT; * periferiuli venis kaTeterizacia; * intubacia.
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3. saswavlo programis Sinaarsi
otorinolaringologiis specialobiT rezidentis momzadebisaTvis sarezidento prog-ramis minimaluri xangrZlivoba oTxi welia.
programiszogad nawils Semdegi modulebiganekuTvneba:
programis zogadi nawili profesiuli mzadebis I weli mod.# modulis dasaxeleba xangrZlivoba 1.1 zogadi qirurgia 6 Tve 1.2 otorinolaringologiuri profilis avadmyofe-
bis ambulatoriuli miRebis da mkurnalobis aT-visebis kursi
5Tve
programis specifiur nawils Semdegi modulebiganekuTvneba:
programis specifiuri nawili profesiuli mzadebis II weli mod.# modulis dasaxeleba xangrZlivoba 2.1 stacionarSi momuSave otorinolaringologisaT-
vis aucilebeli diagnostikuri meTodebis asaT-visebeli treningis kursi
5 Tve
2.2 yelis, yuris da cxviris daavadebebis staciona-ruli mkurnalobis asaTvisebeli treningis kur-si
6 Tve
profesiuli mzadebis III weli mod.# modulis dasaxeleba xangrZlivoba 3.1 yelis, yuris da cxviris topografiuli anato-
miis klinikuri xedviT Seswavla da msubuqi ope-ciebis aTvisebis kursi
5 Tve
3.2 otorinolaringologiaSi saSualo sirTulis operaciebis aTvisebis kursi
6 Tve
profesiuli mzadebis IV weli
mod. # modulis dasaxeleba xangrZlivoba 4.1 audiologia, vestibulologia 1.5 Tve 4.2 Tavis, kisris, zeda sasunTqi gzebis onkologiu-
ri daavadebebi 4.5 Tve
4.3 otorinolaringologiis IV da V xarisxis sir-Tulis operaciebis aTvisebis kursi
5 Tve
4. akademiuri personali, kvalifikacia da saganmanaTleblo resursebi
rezidenturis programis Catareba im samedicino-saswavlo dawesebulebas an dawesebu-baTa jgufs SeuZlia, romelic rezidentebis srulyofili profesiuli mzadebisaTvis saWiro adamianur sakadro resursebs da saTanado materialur-teqnikur bazas flobs da romelsac Sesabamisi saxelmwifo akreditacia aqvs mopovebuli.
rezidenturis programis akademiuri personali:
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a) rezidenturis programaSi monawile dawesebulebis TanamSromlebidan progra-mis direqtori rezidentebis mzadebis modulze pasuxismgebel pirs an pirebsSearCevs da SerCevas dokumenturad adasturebs;
b) modulze pasuxismgebeli piris funqcia konkretul klinikur bazaze reziden-tis mzadebis procesis warmarTva da programis moTxovnilebebis Sesabamisadproce-siskontrolia;
g) modulze pasuxismgebeli piri rezidenturis programis direqtoris winaSe aris angariSvaldebuli;
d) modulze pasuxismgebeli piri profesiuli saqmianobis mniSvnelovan nawils (kviraSi sami dRis jamSi aranakleb 15 saaTs) uTmobsprofesiuli swavlebis programis realizacias;
e) rezidenturis xelmZRvanels oficialurad unda hqondes gamoyofili dro re-zidentTan Teoriuli da praqtikuli xasiaTis pedagogiuri muSaobisaTvis. xelmZRvane-lis mier rezidentisaTvis Catarebuli treiningis dro ZiriTadad stacionarul da am-bulatoriul pirobebSi pacientebTan praqtikul saqmianobas,gadaudebeli da saswrafo samedicino daxmarebis proceduraTa aprobacias unda daeTmos da otorinolarin-gologiis specialobiT profesiuli saqmianobisaTvis saWiro unar-Cvevebis, diagnosti-kis, mkurnalobis da profilaqtikis principebis da meTodebis srulyofilad aTvisebi-saken unda iyos mimarTuli.
rezidenturis programaSi CarTuli samedicino dawesebulebis stacionarul da ambulatoriul ganyofilebebSi avadmyofebis raodenoba da daavadebebis speqtri oto-rinolaringologiis specialobiT rezidentisTvis mniSvnelovani klinikuri gamocdi-lebis miRebis saSualebas unda iZleodes.
saswavlo gegmis da programis meti wili praqtikul mzadebas anu rezidentis xelmZRvanelis meTvalyureobiT rezidentis klinikur-diagnostikuri, samkurnalo-pro-filaqtikuli xasiaTis samedicino muSaobas eTmoba. saswavlo gegmaSi swavlebis sxva-dasxva formis (leqciebi, seminarebi, Tematiuri konferenciebi, asistirebuli da damo-ukidebeli profesiuli saqmianoba da a.S.) xangrZlivobakonkretulad ar aris miTiTe-buli.
otorinolaringologis profesiuli mzadebis ZiriTadi meTodi rezidenturis xelmZRvanelis meTvalyureobis pirobebSi rezidentis mier samkurnalo, diagnostikuri da profilaqtikuri xasiaTis muSaobis uSualo Sesrulebaa.
rezidentebis, maZieblebis Teoriuli mzadebisaTvis gamoyofilia oTaxi kompiute-riT da Sida biblioTekiT.iqarsebuli literatura programiT gaTvaliswinebuli Te-oriuli da praqtikuli sakiTxebis swavlebas da Sesabamisi unar-Cvevebis gamomuSavebas uzrunvelyofs.
5. xarisxis uzrunvelyofis meqanizmebi
rezidenturis programis xarisxis uzrunvelyofaze rezidenturis programis xelmZRvaneli damodulis realizaciaSi CarTuli yvela sxva piriaris pasuxismgebeli.
1. rezidentze zedamxedvelobis formebi sarezinteto klinikaSi an mis romelime konkretul departamentSi SinaganawesiT an romelime sxva proceduruli nor-miT ganisazRvreba;
2. rezidentze zedamxedvelobis formebi da wesebi xarisxis uzrunvelyofis samsa-xuris mierkontroldeba periodulad;
3. rezidenturobasTan dakavSirebul damoukidebel gadawyvetilebaTa miRebas sa-Tanado zedamxedveloba ar unda uSlides xels.zedamxedvelobis tipi kliniku-ri situaciebis da rezidentis momzadebis etapis da donis Sesabamisadicvleba. centraluri mmarTveli Tu zedamxedveli rCevis micemis, daxmarebis, rekomenda-ciebis, saTanado konsultaciebis micemisaTvis samuSao drois nebismier peri-odSi unda iyos xelmisawvdomi.
6. programis xangrZlivoba
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amerikis SeerTebul StatebSi,EkanadaSi, evropiscentralur qveynebSi moqmedi msgavsi programebis xangrZlivoba 3-5 welia. aRniSnulis da saqarTveloSi otorinolaringo-logiis specialobiT rezidentis mzadebis gamocdilebis da dRes moqmedi programis gaTvaliswinebiT, winamdebare programis xangrZlivobis optimalur vadad 4 weli undaiqnes miCneuli.
7. programis ganaxlebis perioduloba
otorinolaringologiaSi sarezidento programis oTxwliani xangrZlivobis gaTva-liswinebiT, misi ganaxleba oTx weliwadSi erTxelunda miviCnioT mizanSewonilad.
II. programis zogadi nawili
profesiuli mzadebis I weli
moduli 1.1
1. modulis dasaxeleba, xangrZlivoba: zogadi qirurgia, 6 Tve.
2. modulis mizani: modulis sawyisi etapis mizania rezidents is bazisuriqirurgiuli Cvevebi ganuviTaros, romlebic yvela qirurgiuli specialobisaTvis aris saerTo. saorientacio programis Semdeg rezidents zogadi qirurgiis yvela ZiriTadi kom-ponentiunda hqondes aTvisebuli. rezidenti pre-, intra- da postoperaciuli marT-vis sakiTxebs unda gaecnos. man qirurgiuli infeqciebis da klinikuri mikrobiolo-giis Taviseburebebis, qirurgiuli da nozokomiuri infeqciebis prevenciis gzebisSesaxebacunda miiRos sruli informacia. praqtikul nawilSi rezidentma mcire qirurgiuli manipulaciebis Sesruleba unda daiwyos. unda gaecnos, kerZod,Wrilobis pirveladiqirurgiuli damuSavebis specifikas midamoebis mixedviT. postoperaciuli intensiuri Terapiis palataSi rezidenti qirurgiuli avadmyofis statusis Sefasebis unars unda flobdes. yuradReba unda gamaxvildespaTologiis hemodinamikur da homeostazur maCveneblebze da maTi darRvevis koreqciis gzebze. ramdenime Tvis Semdeg rezidentipoliklinikuri masStabis tipiur qirurgiul manipulaciebsTavad unda asrulebdes. modulis bolos rezidentsgadaudebeli samedicino daxmarebis qirurgiuli komponentebis, maT Soris, traqeotomiis da traqeis intubaciis teqnika unda hqondes aTvisebuli da Catarebul proceduraTa Teoriul safuZvlebsunda flobdes.
3. rekomendebuliliteraturis nusxa:
1. grigolia n. qirurgiuli sneulebebi. Tbilisi, 2000. 2. kuzini m. qirurgiuli sneulebebi. Tbilisi,2004. 3.kikaliSvili l., yifiani e., korZaia d. topografiuli da klinikuri anatomia.
Tbilisi, 2005. 4. Schwartz, Shires, Spencer. Principles of Surgery. 8th Ed. 2004. 5. Bailey, Love's.Short Practice of Surgery (A Hodder Arnold Publication).By Norman S Williams(Author),
Christopher J.K. Bulstrode (Author), Ronan O'ConnellP. (Author), 25thEd. 2006. 6. Sarrel B.E., Carabasi R.A.Surgery.National Medical Series for Independent Study.1995. 7. Silverberg S.C.Principles and Practice of Surgical Pathology. 8. Speciality Review in General Surgery. The National Center for Advanced Medical Education. 2001. 9. Way L.W. Surgical Diagnosis and Treatment. 1994. 10. Way L.W., Doherty G.M.Current Surgical Diagnosis and Treatment. 2004. 11. Kant X.Scientific Basic for the Selection of Surgical Needles and Sutures.1999.
9
12. Кузин М.И. Хирургические болезни. Москва, 2003. http://www.medtrng.com/tutorials_and_simulators_part_8.htn (clinical surgery, surgical videos) www.surgical-tutur.org.uk http://www.surgicalcourses.org.uk./ www.dundee.ac.uk./surgicalskills/index.htm http://www.update-software.com/publications/cochrane/ http://www.ncepod.org.uk/ http://www.intumed.com/
4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi (ix. cxrili 1.1)
cxrili 1.1
Teoriuli kursi profesiuli unar-Cvevebi
Ses
-srul
.man
ipul. Sefasebis meTodebi
zogadi qirurgiuli Cvevebi usafrTxo qirurgiis principebi:
qirurgis momzadeba opera-ciisaTvis
xelis dabanis, damuSavebis da xelTaTmanis Cacmis principebi
qirurgebisaTvis da avad-myofebisaTvis imunizaciis protokolebi
adgilobrivi anesTeziis daniSvna:
saanesTezio preparatis SerCeva
qirurgiuli Wrilobebi:
qirurgiuli Wrilobebis klasifikacia
Wrilobis marTvis princi-pebi
Wrilobis Sexorcebis paTo-fiziologia
nawiburebi da kontraqtu-rebi
kanisa da kanqveSa qsovilis gakveTa:
o langeris xazebi o instrumentis SerCeva o usafrTxo praqtika
kanisa da kanqveSa qsovilis Wrilobis daxurva:
o Wrilobis yrud ga-kervis Cvenebebi
o sakeravi Zafisa da nemsis SerCeva
qirurgis momzadeba operaciisaT-vis:
efeqturi da saimedo xe-lis dabana, xelTaTmanis Cacma, steriluri xala-Tis Cacma
4 adgilobrivi anesTeziis teq-nika, saanesTezio agentis swori da usafrTxo gamoyeneba 4 kanisa da kanqveSa qsovilis kveTa:
skalpelis, diaTermiis, ma-kratlis gamoyeneba
4 kanisa da kanqveSa qsovilis Wrilobis daxurva:
Wrilobis kideebis zusti da dauWimavi Sepirispi-reba
4 kvanZis dadeba:
erTi xeliT
ori xeliT
instrumentiT
zedapiruli
Rrma 3 hemostazi:
sisxlmdeni sisxlZarRvis (zedapiruli) kontroli
diaTermia
ligireba nakeriT
ligireba kvanZiT
klipireba
30 10 20 20
100 50
modulis mimdinareo-bis dros, modulze pasuxismgebeli piri, ufrosi rezidenti da zedamxedveli, eqimi rezidentis praqtiku-li momzadebis dones afaseben. Teoriuli masala klinikis Tana-mSromelTa mier kon-ferenciebis bolos fasdeba. Sefaseba saregistracio Jur-nalSi fiqsirdeba.
10
kvanZis dadeba: o nakerisa da ligatu-
ris masala da maTi SerCeva
o qirurgiuli nakere-bis da ligaturebi-saTvis kvanZebis usafrTxo gamoyeneba
hemostazi: o qirurgiuli teqnika o diaTermiis princi-
pebi o instrumentebis Ser-
Ceva
biofsiis teqnika aspiraci-uli citologiuri masalis aRebis CaTvliT
drenaJis gamoyeneba: o Cveneba o tipebi o menejmenti
anastomozis formirebis principebi
qirurgiuli endoskopiis principebi
transfiqsiuri nakeri 4 qsovilis retraqcia:
qirurgiuli pinceti
WrilobaSi retraqtoris moTavseba
3 drenaJis gamoyeneba:
Cadgma
fiqsacia
amoReba 3 qsovilis damuSaveba:
instrumentebis saTanado gamoyeneba da qsovilebTan faqizi mopyroba
biofsiis teqnika 4 asistentobis Cvevebi:
asistenciis dros opera-toris moTxovnilebebis amocnoba
20 20 20 20
presaoperacio marTva intraoperaciuli marTva postoperaciuli marTva presaoperacio Sefaseba da menejmenti:
kardiorespiratoruli fiziologia
Saqriani diabeti da sxva endokrinuli dar-Rvevebis winasaoperacio koreqcia
siTxis balansi da ho-meostazi
Tirkmlis ukmarisoba
sefsisis paTofiziolo-gia, prevencia, profi-laqtika
Tromboprofilaqtika
laboratoriuli anali-zebi da instrumentuli kvlevebi
operaciis risk-faqtore-bi da qulobrivi siste-mebi
premedikacia da sxva preoperaciuli daniSnu-
3 preoperaciuli Sefaseba da menejmenti:
avadmyofis gasinjva da istoriis Sevseba
winasaoperacio kvlevebis Sedegebis interpretacia
Tanmxlebi daavadebebis menejmenti
reanimacia
Sesabamisi preoperaciuli daniSnuleba premedika-ciis CaTvliT
3 intraoperaciuli mzrunveloba:
intraoperaciuli mzrun-velobis usafrTxo war-moeba
avadmyofis swori pozicia
nervis dazianebis preven-cia
basri instrumentebiT da-zianebis prevencia
diaTermuli dazianebis prevencia
venuri Trombozis preven-cia
3 postoperaciuli mzrunveloba:
saoperacio Canawerebis
20 20
modulis mimdinareo-bis dros modulze pa-suxismgebeli piri, uf-rosi rezidenti da ze-damxedveli, eqimi re-zidentis praqtikuli momzadebis dones afa-seben. Teoriuli masa-lis aTvisebis done klinikis TanamSromel-Ta mier konferencie-bis bolos fasdeba. Sefaseba saregistra-cio JurnalSifiqsir-deba.
11
leba
operaciis dRis daniSv-nis principebi
intraoperaciuli mzrunvelo-ba:
usafrTxoeba saoperaci-oSi, raSic saoperacio magidaze avadmyofis swori pozicia Se-dis,nervis dazianebis Tavidan acileba
usafrTxoeba basri in-strumentebis mimarT
diaTermia, lazeris ga-moyeneba
infeqciis riskebi
radiaciis gamoyeneba da riskebi
laxtis gamoyeneba misi Cvenebis, efeqtebis da garTulebebis gaTva-liswinebiT
adgilobrivi, regiona-luri da zogadi anes-Teziis principebi
invaziuri da arainvazi-uri monitoringis prin-cipebi
venuri Trombozis pre-vencia
operacia hepatitis da Sidsis virusis mata-reblebSi
siTxis balansi da ho-meostazi
postoperaciuli mzrunveloba:
postoperaciuli moni-toringi
kardiorespiratoruli fiziologia
siTxis balansi da ho-meostazi
Saqriani diabeti, sxva endokrinuli darRve-vebi
Tirkmlis ukmarisoba
sisxlis danakargis pa-Tofiziologia
sefsisis paTofiziolo-
gia SIRS-is da Sokis CaTvliT
multiorganuli dis-
gakeTeba
avadmyofis mdgomareobis Sefaseba da monitoringi
postoperaciuli analge-zia
siTxeebisa da eleqtro-litebis menejmenti
organoTa mosalodneli ukmarisobis gamovlena
organoTa ukmarisobis sa-wyisi menejmenti
dializis principebi da Cvenebebi
postoperaciuli garTu-lebebis amocnoba, preven-cia da mkurnaloba
3 hemostazi da sisxlis produq-tebi:
im mdgomareobaTa amocno-ba, romebmac hemoragiuli diaTezi SeiZleba gamoiw-vion
operaciis dros koagulo-paTiuri sisxldenis amocnoba
sisxlis produqtebis sa-Tanado gamoyeneba
sisxlis produqtebis transfuziis garTulebe-bis menejmenti
3 koagulacia, Rrma venebis Trombozi da embolia:
riskis qveS myofi avadmyo-febis amocnoba
pulmonaruli emboliis da Rrma venebis Trombo-zis amocnoba da diagnozi
dupleqs-skanirebis, veno-grafiis da D-dimeris maC-veneblis roli
venuri Trombozis da pulmonaruli emboliis sawyisi da monitoruli mkurnaloba-profilaqti-kis dawyeba
3 antibiotikebi:
antibiotikebis daniSnu-leba
3 preoperaciuli kvebiTi mkur-nalobis Sefaseba da dagegmva:
20 20 20
12
funqciis sindromi
zogadi postoperaciuli garTulebebi
postoperaciuli anal-geziis meTodebi
kvebis menejmentis Sefaseba da dagegmva:
postoperaciuli kveba
malnutriciis efeqtebi _ Warbi kveba, kvebis ukmarisoba
dazianebaze metaboluri pasuxi
kvebis statusis skrinin-gis da Sefasebis meTo-debi
enteraluri da parente-raluri kvebis meTodebi
hemostazi da sisxlis kompo-nentebi:
hemostazis meqanizmi, maT Soris, Sededebis kaskadi
darRveuli hemostazis paTologia _ hemofilia, RviZlis daavadebebi, ma-siuri hemoragia
sisxlis komponentebi
sisxlis produqtebis gamoyenebis alternativa
sisxlis produqtebis daniSvnis principebi
sisxlis produqtebis gamoyenebasTan dakavSi-rebuli avadmyofis usafrTxoeba
koagulacia, Rrma venebisTrom-bozi da embolia:
Sededebis meqanizmi (virxovis triada)
operaciis da travmis zemoqmedeba koagula-ciis procesze
testebi Trombofiliaze da koagulaciis sxva darRvevebze
Tromboemboliuri daa-vadebiskvlevis meTo-debi
venuri Trombozis da filtvis emboliis mkur-
xelovnuri kvebis uzrun-velyofis organizeba,Zi-riTadi sakvebi danamatebi, enteraluri da parente-raluri kveba
3 metaboluri da endokrinuli darRvevebi:
endokrinuli da eleq-trolituri dazianebis mqone avadmyofebSi anam-nezi da maTi analizi
Tireotoqsikozis da hipo-Tireoidizmis diagnostika da menejmenti
hiper- da hipokalciemiis diagnostika da menejmenti
steroidul Terapiaze myofi avadmyofebis peri-operaciuli menejmenti
Saqriani diabetis mqone avadmyofebis periopera-ciuli menejmenti
hiponatriemiis diagnos-tika da menejmenti
hiper- da hipokaliemiis diagnostika da menejmenti
centralur venaSi kaTete-ris Cadgma
ureTris kaTeterizacia
20 10 10 10 5 10 10 10 5 20
13
nalobis principebi an-tikoagulaciis CaTvliT
ventilacia/perfuziis skanirebis, kt pulmona-ruli angiografiis, D-dimeris da Tromboli-zis roli
pulmonaruli emboleq-tomia
Tromboemboliis profi-laqtika
Rrma venebis Trombozis riskis klasifikacia da menejmenti
Rrma venebis Trombozis prevenciis meqanikuri da farmakologiuri me-Todebi
Aantibiotikebi:
qirurgiul avadmyofeb-Si ZiriTadi paTogenuri infeqciebi
antibiotikebisadmi mgrZnobeloba
antibiotikebis gverdi-Ti movlenebi
profilaqtikis da mkur-nalobis principebi
periopraciul menejmentTan dakavSirebuli metaboluri da endokrinuli darRvevebi:
Tireoiduli hormonis siWarbisa da deficitis paTofiziologia da masTan asocirebuli operaciuli riskebi
hiper- da hipokalciemi-is mizezebi da Sedegebi
kortikosteroiduli Terapiis garTulebebi
steroiduli ukmariso-bis mizezebi da Sedege-bi
Saqriani diabetis gar-Tulebebi
hiponatriemiis mizezebi da Sedegebi
hiper- da hipokaliemiis mizezebi da Sedegebi
qirurgiuli teqnika da teqnologia
Wrilobis pirveladi qirurgiu-li damuSaveba,
20
modulis mimdinareo-bis dros modulze pa-
14
barZayis amputacia, TiTis falangebis amputacia, TiTis falangebis amosaxsvra, winamxris amputacia, terfis amputacia Sarpis meTo-diT, terfSorisi amosaxsvra lis-frankis wesiT, wvivis Zval-plastikuri amputa-cia, barZayis Zval-plastikuri ampu-tacia, suprakondiluri amputacia, sisxlZarRvTa ligacia, nevrorafia, tendorafia, laparotomia, laparotomiuli Wrilobis daxurva, RviZlis biofsia, laparoskopuli teqnikis aTvise-ba traqeotomia, traqeis intubacia
2 2 2 2 2 2 2 2 2 20 5 5 30 5 5 5 5
suxismgebeli piri, uf-rosi rezidenti da ze-damxedveli, eqimi re-zidentis praqtikuli momzadebis dones afa-seben. Teoriuli masa-lis aTvisebis done kli-nikis TanamSromelTa mier konferenciebis bolosfasdeba. Sefa-seba saregistracio JurnalSi fiqsirdeba.
ZiriTadi qirurgiuli daavadebebi arsebuli simptomebi da sindro-mebi:
abdominuri tkivili
abdominuri Seberiloba
nawlavTa peristaltikis cvlilebebi
gastrointestinuri sisxldena
reqtaluri sisxldena
disfagia
dispefsia
siyviTle moicavs Semdeg daavadebebs:
apendiciti
gastrointestinuri avTvise-biani simsivne
nawlavis anTebiTi daava-deba
nawlavisTa divertikuli
nawlavis obstruqciuli gauvaloba
Sexorcebebi muclis RruSi
muclis Tiaqari
peritoniti
nawlavis perforacia
saylapavi milis keTilTvi-sebiani simsivneebi
kuWis peptiuri wylulovani
modulis mimdinareo-bis dros modulze pasuxismgebeli piri, ufrosi rezidenti da zedamxedveli, eqimi rezidentis praqti-kuli momzadebis do-nes afaseben. Teoriuli masalis aT-visebis done kli-nikis TanamSromelTa mier konferenciebis bolos fasdeba. Sefa-faseba saregistracio Jur-nalSi fiqsirdeba.
15
daavadeba
RviZlis, naRvlis buStis, pankreasis keTilTvisebiani da avTvisebiani simsivneebi
hemoroiduli da periana-luri daavadebebi
muclis kedlis stoma sarZeve jirkvlis daavadebebi:
ZuZus simsivneebi da dvri-lis gamonadeni
ZuZus mwvave tkivili Semdeg daavadebebs moicavs:
ZuZus keTilTvisebiani da avTvisebiani simsivneebi
mastiti da ZuZus abscesi
periferiuli sisxlZarRvebis daa-vadebebi warmodgenili simptomebi da sin-dromebi:
kiduris qronikuli da mwvave iSemia
sisxlZarRvTa anevrizma
tranzitoruli iSemia
venebis varikozuli gaganie-reba
qveda kiduris dawyluleba
Semdeg paTologiebs moicavs:
arteriebis aTerosklero-zuli daavadeba
arteriebis embolia d Trmbozi
venuri ukmarisoba
diabeturi dawyluleba endokrinuli daavadebebi simptomebi da sindromebi:
kisris simsivneebi
mwvave endokrinuli krizi Semdeg daavadebebs moicavs:
Tiroiduli da paraTireoi-duli daavadebebi
Tirkmelzeda jirkvlis daavadebebi
Saqriani diabeti
politravma zogadi informacia:
Zogadi sakiTxebi: 4 anamnezi da gasinjva 3 kvleva
5 5
modulis mimdinareo-bis dros modulze pasuxismgebeli piri,
16
avadmyofobaTa Sefasebis qulobrivi sistema
Taviseburebebi bavSvTa asakSi
Soki:
Sokis paTogenezi
Soki da kardiovaskula-ruli fiziologia
travmul dazianebaze meta-boluri pasuxi
respiratoruli distres-sindromi
arajvaredini SeTavsebis sisxlis gamoyenebis Cveneba
Wrilobebi da rbili qsovilebis dazianebebi:
cecxlsasroli iaraRiT da WurviT miyenebuli daziane-bebi
daniT miyenebuli daziane-bebi
adamianisa da cxovelTa nakbeni
rbili qsovilebis daziane-bis buneba da meqanizmebi
rbili qsovilebis daziane-bisas menejmentis princi-pebi
travmuli Wrilobebis me-nejmentis principebi
kompartment-sindromi damwvroba:
damwvrobis klasifikacia
menejmentis principebi damwvrobisas
motexilobebi:
motexilobebis klasifika-cia
motexilobebis paTofizi-ologia
menejmentis principebi mo-texilobebis
motexilobebis garTule-bebi
saxsrebis dazianebebi organo-specifiuri travma:
Torakaluri travmis paTo-fiziologia
3 Sesabamisi qirurgiuli subspe-cialobisaken gadamisamarTeba 4 im avadmyofTa reanimacia da adreuli menejmenti, romlebmac gulmkerdis, Tavis, xerxemlis, muclis an kidurebis dazianebebi miiRes (ATLS, APLS gaidlainebis mixedviT) 4 mravlobiTi dazianebis mqone avadmyofTa reanimacia da adreu-li menejmenti 3 specifiuri problemebi:
ugono mdgomareobaSi myofi avadmyofis menej-menti
kanis danakargvisas (de-ficitisas) avadmyofis sa-wyisi menejmenti
damwvrobis mqone avad-myofis sawyisi menejmenti
2 kaTeteris Cadgmacentralur venaSi 3 gulmkerdSi drenaJis Cadgma 2 diagnostikuri peritonealuri lavaJi 4 ureTraluri kaTeterizacia 2 suprapubikuri kaTeterizacia (epicistostomia)
5 5 5 5 2 5 5 5 20 5
ufrosi rezidenti da zedamxedveli, eqimi rezidentis praqtiku-li momzadebis dones afaseben. Teoriuli masalis aT-visebis done klinikis TanamSromelTa mier konferenciebis bolos fasdeba. Sefafaseba sa-registracio JurnalSi fiqsirdeba.
17
pnevmoToraqsi
Tavisqalas dazianebebi in-trakranialuri travmuli hemoragiis da Tavis tvinis dazianebis CaTvliT
xerxemlis svetis dazianeba
periferiuli nervuli sis-temis dazianeba
muclis blagvi da Semavali travma
elenTis dazianeba
sisxlZarRvTa dazianeba, maT Soris, iatrogenuli genezis da intravaskula-ruli narkotikuli moxma-rebiT gamowveuli
kraS-dazianeba
kanis deficitisas menejmentis principebi, maT Soris kanis transpalntantebi da kanis naf-leTebi
qirurgiuli infeqcia da misi prevencia
abscesis (flegmonis) gaxsna
Wrilobis pirveladi qirurgiuli damuSaveba.
hidradenitis drenireba
20 30 20
modulis mimdinareo-bis dros modulze pasuxismgebeli piri, ufrosi rezidenti da zedamxedveli, eqimi rezidentis praqti-kuli momzadebis do-nes afaseben. Teoriuli masalis aT-visebis doneklinikis TanamSromelTa mier konferenciebis bolos fasdeba. Sefafaseba saregistracio Jur-nalSi fiqsirdeba.
moduli 1.2
1. modulis dasaxeleba, xangrZlivoba:
otorinolaringologiuri profilis avadmyofebis ambulatoriuli miRebisda
mkurnalobis kursი, i.5 Tve
2. modulis mizani:
rezidentma lor organoebis inspeqciis yvela Tanamderove meTodi unda aiTvisos. modulis damTavrebisas man damoukideblad unda SeZlos ambulatoriul pirobebSi daavadebis diagnozis dasma, medikamentozuri mkuranlobis daniSvna da Sedegebze dakvirveba. otorinolaringologiaSi sertifikatis maZiebelma mimdinare periodSi rinoskopia, otoskopia, faringoskopia, arapirdapiri laringoskopia unda Seiswav-los. lor organoebis rentgeno- da kompiuteruli kvlevis monacemebis analizi un-
18
da aiTvisos. razidents iseTi laboratoriuli kvlevebis interpretacia unda SeeZ-los, rogoricaa sisxlis saerTo analizi, koagulogramis, Sardis saerTo analizi, biofsiuri masalis histologiuri gamokvleva, nacxis citologiuri da baqterio-logiuri gamokvleva.
3. aucilebeli da rekomendebuli literaturis nusxa:
1. ToxaZe T. otorinolaringologia. Tbilisi, 1995. 2. БартонМ. Болезни уха, горла и носа. Москва, Санкт-Петербург, 2002.
3. Пальчун В.Т., Преображенский Т.А. Болезни уха, горла и носа. М., 1980. 4. Солдатов И.Б. Лекции по оториноларингологии. М., 1994. 5. Belaites E., Gudziol H. Restoring Methods of Functional Defects in Head and Neck. 2005. 6. Hall, Colman. Diseases of the Ear, Nose and Throat. 1999. 7. Meyerhoff R. Otolaringology, Head and Neck Surgery. Philadelphia, 1992. 8. Schultz-Coulon H. Enviromental and Occupational Health Disorders. Germany, 2004. 9. www.earallergy.com 10. www.nlm.nih.gov (aSS nacionaluri samedicino biblioTeka) 11. www.medinfo.ufl.edu 12. www.lor.ru 13. www.augie.edu 14. www.earsurgery.org 15. www.archotol.ama-assn.org 16. www.nature.com 17. www.medexplorer.com 18. www.karger.com
4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix.cxrili 1.2)
cxrili 1.2
Teoriuli kursi profesiuli unar-Cvevebi
Ses
asax
vevi.
Mmanipu
l.
rao
denoba
davaleba
yuris anatomia, yuris gamokvlevis meTodebi, yuris daavadebebi. cxvi-ris anatomia, cxviris gamokvlevis meTodebi, cxviris daavadebebi. xa-xis anatomia, xaxis gamokvlevis me-Todebi, xaxis daavadebebi. xorxis anatomia, xorxis gamokvlevis meTo-debi, xorxis daavadebebi.
otoskopia. mikrootoskopia. yuris mwvave daavade-bebis diagnostika da mkurnaloba. wina da ukana rino-skopia. cxvirisdanamati wia-Rebis rentgenogramis Sefaseba. faringoskopia. xaxidan nacxis aReba. anginis diagnozi da mkurnaloba. arapirdapiri larin-goskopia.
100 50 30 80 20 20 120 10 15 30
Teoriuli kursis gamo-kiTxva. avadmyofobis istoriis warmodgena da garCeva
modulis Sefasebis meTodebi: - mimdinare gamokiTxva yoveldRiurad Catardeba.
19
- kviraSi erTxel gaimarTeba koloqviumi, romelsac orive modulze pasuxismgebe-li piri Caatarebs da romelzec kviris ganmavlobaSi miRebuli codna Sefasde-ba.
- diagnostikuri manipulaciebis Sesrulebis xarisxi yoveli gasinjvis Semdeg Se-fasdeba.
- modulis damTavrebis Semdeg diagnostikuri manipulaciebis Sesrulebis xaris-xi 10-baliani skaliT Sefasdeba.
- kviraSi erTxel rezidenti saintereso SemTxvevasTan dakavSirebiT moxsenebas gaakeTebs;
- TveSi erTxel modulze pasuxismgebeli piris mier winaswar SerCeul Temaze rezidenti referats daamuSavebs. referatis xarisxi 5-baliani skaliTSefasde-ba.
- modulis damTavrebisas ganvlili Teoriuli masalis aTvisebis donetestire-biT da zepiri gamokiTxviT Semowmdeba.
- Teoriuli codnis, praqtikuli unar-Cvevebis, referatis damuSavebis xarisxis da klinikur muSaobaSi zogadi CarTulobis gaTvaliswinebiT modulis bolos rezidentis moswrebis done10-quliani skaliT Sefasdeba.
programis specifiuri nawili
profesiuli mzadebis meore wlis modulebi
moduli2.1 1. modulis dasaxeleba, xangrZlivoba:
stacionarSi momuSave otorinolaringologisaTvis aucilebeli diagnostikuri meTodebis asaTvisebeli treningis kursi, 5 Tve
2. modulis mizani: otorinolaringologiaSi sertifikatis maZiebelma praqtikulad unda aiTvisos da modulis damTavrebisas damoukideblad unda SeZlos stacionarSi myofi avadmyo-febisaTvis aucilebeli diagnostikuri kvlevebis Catareba. sertifikatis maZie-belma mimdinare periodSi unda Seiswavlos da damoukideblad unda SeZlos wina da ukana rinoskopiis, pirdapiri da arapirdapiri laringoskopiis, ezofagoskopi-is Catareba. unda gamoiyenos cxviris danamati wiaRebis damuSavebis arapunqciuri meTodebi: iamikis kaTeteriT mkurnalobis meTodi, protsis siTxeTa gadanacvlebis meTodi, fleceqteris meTodi. unda Seasrulos haimoris wiaRis punqcia,cxviris danamati wiaRebis damuSaveba, cxviris da misi danamati wiaRebis endoskopiuri diagnostika, antroskopia, evstaqis milis kaTeterizacia, toinbisa da valsalvas cdebi, dafis apkis paracentezi. unda iswavlos yuris mikroskopuli kvlevis pro- cedurebi, yuris rentgeno- da kompiuteruli tomografiis monacemebis analizi. maZiebelma unda Seiswavlos cxviris danamati wiaRebis rentgenografia da kompiuteruli tomografia. unda gamoimuSavos rentgenogramemebis da kompiuteru-li tomogramebis damoukidebeli xedvis unari.
3. aucilebeli da rekomendebuli literaturis nusxa: ToxaZe T. otorinolaringologia. Tbilisi, 1995. АльтманЯ.А.,ТаварткиладзеГ.А. Руководствопоаудиологии.М., 2003. Бартон М. Болезни уха, горла и носа. Москва, Санкт-Петербург, 2002. Пальчун В.Т., Преображенский Т.А. Болезни уха, горла и носа. М., 1980. Солдатов И.Б. Лекции по оториноларингологии. М., 1994.
20
Belaites E., Gudziol H. Restoring Methods of Functional Defects in Head and Neck. 2005. Hall, Colman.Diseases of the Ear, Nose and Throat. 1999. Meyerhoff R. Otolaringology, Head and Neck Surgery.Philadelphia, 1992. Schultz-Coulon H. Enviromental and Occupational Health Disorders.Germany, 2004.
4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix. cxrili 2.1)
cxrili 2.1
Teoriuli kursi profesiuli unar-
Cvevebi
Sesasrulebeli manipulaciis raodenoba
Ddavaleba
dafis apki normaSi da yuris sxvadasxva paTo-logiisas
otoskopia, mikro-otoskopia 200
otoskopiis sura-Tis aRwera da diagnozis dasma
smenis gamokvlevis me-Todebi
smenis gamikvleva ka-mertonebiT 50
smenis daqveiTe-bis lokalizaci-is dadgena
miringotomiis Cvenebe-bi da teqnika
miringotomia, perfo-rirebuli yuris da-muSaveba
15 Teoriuli cod-nis Sefaseba
yuris rentenologiu-ri gamokvlevis meTo-debi
safeTqlis Zvlebis
rentgenogramebis, CT da MRImonacemTa ana-lizi
30
SemTxvevebis gar-Ceva
cxviris gamokvlevis meTodebi
wina da ukana rino-skopia, fibroskopia
80 prezentaciis gan-xilva
cxviris wiaRebis damu-Savebis arapunqciuri meTodebi: iamikis kaTe-teriT mkurnalobis me-Todi, haimoris wiaRis punqcia; protsis siT-xeTa gadanacvlebis meTodiT, fleceqteris meTodiT cxviris dana-mati Rruebis damuSave-ba
Sesabamisi manipula-ciebis teqnikis da-ufleba
30
Teoriuli cod-nis Sefaseba
pirdapiri da arapir-dapiri laringosko-piis teqnika
arapirdapiri da pir-dapiri laringosko-pia
25 prezentaciis gan-xilva
modulis Sefasebis meTodebi:
- mimdinare gamokiTxva yoveldRiuradCatardeba; - kviraSi erTxel, paraskevs, gaimarTeba koloqviumi, romelsac orive modulze pa-
suxismgebeli piriCaatarebs da romelzec kviris ganmavlobaSi miRebuli codna-Sefasdeba.
- diagnostikuri manipulaciebis Sesrulebis xarisxi yoveli gasinjvis SemdegSe-fasdeba.
- modulis damTavrebis Semdeg diagnostikuri manipulaciebis Sesrulebis xarisxi 10-baliani skaliTSefasdeba.
- kviraSi erTxel rezidenti saintereso klinikur SemTxvevasTan dakavSirebiT mox-senebasgaakeTebs.
- TveSi erTxel modulze pasuxismgebeli piris mier winaswar SerCeul Temaze re-zidenti referatsdaamuSavebs. referatis xarisxi 5-baliani skaliT Sefasdeba.
21
- modulis damTavrebisas testirebiT da zepiri gamokiTxviT ganvlili Teoriuli masalis aTvisebis done Semowmdeba.
- Teoriuli codnis, praqtikuli unar-Cvevebis, referatis damuSavebis xarisxis da klinikur muSaobaSi zogadi CarTulobisgaTvaliswinebiT, modulis bolos rezi-dentis moswrebis done 10-quliani skaliT Sefasdeba.
. moduli 2.2
1. modulis dasaxeleba, xangrZlivoba: yelis, yurisa da cxviris daavadebaTa stacionaruli mkurnalobis asaTvisebeli treningis kursi,6 Tve
2. modulis mizani: wina modulebis gavlisas miRebuli codnis gaRrmaveba, otorinolaringologiu-ri daavadebebis samkurnalo manipulaciebis da qirurgiuli Carevebis aTviseba, ezofagoskopiis, pirdapiri laringoskopiis, endoskopiuri rinoskopiis, mikro-otoskopiis meSveobiT lor organoebidan ucxo sxeulebis amoReba, cxviridan sisxldenis SeCereba, wina da ukana tamponada, paratonzilaruli da parafarin-gealuri abscesis kveTa da drenireba. yuris damuSaveba Semdegi daavadebebis dros: otohematoma, yuris niJaris abscesi, qondroperiqondriti, yuris niJaris travmebi da Wrilobebi.xorxisa da traqeis medikamentozuri destenozireba. seqciur masalaze konikotomiis da traqeotomiis aTviseba. cxvirisa da misi da-namati wiaRebis travmebis dros Zvlebis repoziciis gansazRvra da misi reabi-litaciis praqtikuli ganxorcieleba. cxviris danamati wiaRebis punqciuri da arapunqciuri mkurnalobis meTodebis aTviseba. fragmentuli Careva adenotomii-sas da tonzileqtomiisas.
3. aucilebeli da rekomendebuli literaturis nusxa: ToxaZe T. otorinolaringologia. Tbilisi, 1995. АльтманЯ.А.,ТаварткиладзеГ.А. Руководствопоаудиологии.М., 2003. Бартон М. Болезни уха, горла и носа. Москва, Санкт-Петербург, 2002. Пальчун В.Т., Преображенский Т.А. Болезни уха, горла и носа. М., 1980. Солдатов И.Б. Лекции по оториноларингологии. М., 1994. Belaites E., Gudziol H. Restoring Methods of Functional Defects in Head and Neck. 2005. Hall, Colman.Diseases of the Ear, Nose and Throat. 1999. Meyerhoff R. Otolaringology, Head and Neck Surgery.Philadelphia, 1992.
Schultz-Coulon H. Enviromental and Occupational Health Disorders.Germany, 2004.
4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix. cxrili 2.2)
cxrili 2.2 Teoriuli kursi profesiuli unar-
Cvevebi Sesasrulebeli manipulaciis raodenoba
davaleba
gareTa yuris daavade-bebi
yuris damuSaveba otohematomis, peri-qondritis, travmis, gareTa otitis dros, gogirdis sacobis amorecxva
80 referati
Sua yuris Cirqovani daavadebebi
Sua yuris damuSave-ba, miringotomia, perforirebuli yu-ris damuSaveba
70 koloqviumi
otogenuri qalaSida garTulebebi
diagnozis dasazus-teblad damatebiTi
5 referati
22
gamokvlevebis daniS-vna
Sua yuris araCirqova-ni daavadebebi
diagnozis dasma da mkurnalobis swori taqtikis SerCeva
50 koloqviumi
cxviris daavadebebi cxviris Rrus damu-Saveba
60 referati
cxviridan sisxldena cxviris wina da uka-ana tamponada
40
cxviris danamati wia-Rebis daavadebebi
haimoris wiaRis punq-qcia
10 koloqviumi
xaxis daavadebebi parafaringealuri abscesis gaxsna, tonzileqtomiis procesSi CarTva
20 referati
xorxis anTebiTi daa-vadebebi
arapirdapiri larin-goskopia
45 referati
xorxis simsivneebi biofsiuri masalis analizi
5 koloqviumi
modulis Sefasebis meTodebi:
- mimdinare gamokiTxva yoveldRiuradCatardeba. - kviraSi erTxel, paraskevs, gaimarTeba koloqviumi, romelsac orive modulze pa-
suxismgebeli piriCaatarebs da romelzec kviris ganmavlobaSi miRebuli codna-Sefasdeba.
- diagnostikuri manipulaciebis Sesrulebis xarisxi yoveli gasinjvis SemdegSe-fasdeba.
- modulis damTavrebis Semdeg diagnostikuri manipulaciebis Sesrulebis xarisxi 10-baliani skaliTSefasdeba.
- kviraSi erTxel rezidenti saintereso SemTxvevasTan dakavSirebiT moxsenebasgaa-keTebs.
- TveSi erTxel modulze pasuxismgebeli piris mier winaswar SerCeul Temaze re-zidenti referatsdaamuSavebs. referatis xarisxi 5-baliani skaliT Sefasdeba.
- modulis damTavrebisas testirebiT da zepiri gamokiTxviT ganvlili Teoriuli masalis aTvisebis done Semowmdeba.
- rezidentisTeoriuli codna, praqtikuli unar-Cvevebi, mis mierdamuSavebuli re-feratis xarisxi, klinikur muSaobaSi zogadi CarTuloba modulis bolos 10-qu-liani skaliT Sefasdeba.
profesiuli mzadebis III wlis modulebi
moduli 3.1
1. modulis dasaxeleba, xangrZlivoba: yelis, yurisa da cxviris topografiuli anatomiis klinikuri xedviT Ses-wavla da mcire operaciebis aTvisebis kursi, 5 Tve
2. modulis mizani: wina modulebis gavlis dros miRebuli codnis gaRrmaveba. lor organoebis topografiis klinikuri xedviT Seswavla. mcire lor operaciebis aTviseba. sa-samarTlo eqspertizis saseqcioSi umeTvalyuro gvamebis lor organoebis to-pografiuli anatomiis klinikuri xedviT Seswavla. seqciur masalaze cxvirze, cxviris danamat wiaRebze, yurze operaciuli teqnikis daxvewa. Semdeg etapze
23
mcire lor operaciebis Seswavla da Catareba. gareTa sasmeni milis furunku-lis gaxsna. yuris niJaris daCirqebuli hematomis gaxsna da drenireba. miringo-tomia mikroskopis qveS. cxviris furunkulis, hematomis da abscesis gaxsna da drenireba. parafaringealuri abscesis gaxsna da drenireba. tonzileqtomiis da adenotomiis damoukidebeli Sesruleba.
3. rekomendebuli literaturis nusxa: ВульштейнХ. Слухоулучщающиеоперации. М., 1972. Гельфанд С.А. Слух. Нью-Йорк, 1984. Люлько В.Л., Марченко В.М. Атлас операций на ухе. Киев, 1989. Пальчун В.Т., Преображенский Т.А. Болезни уха, горла и носа. М., 1980. Солдатов И.Б. Лекции по оториноларингологии. М., 1994. Belaites E., Gudziol H. Restoring Methods of Functional Defects in Head and Neck. 2005. DeWeese D.D. et al.Otolaryngology,Head and Neck Surgery. Washington, 1988. Hall, Colman.Diseases of the Ear, Nose and Throat, 1999. Meyerhoff R. Otolaringology, Head and Neck Surgery.Philadelphia, 1992. Schultz-Coulon H. Enviromental and Occupational Health Disorders.Germany, 2004. www.nlm.nih.gov (aSS nacionaluri samedicino biblioTeka) www.medinfo.ufl.edu www.lor.ru www.augie.edu www.earsurgery.org www.nature.com www.medexplorer.com www.karger.com
4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix. cxrili 3.1)
cxrili 3.1
Teoriuli kursi profesiuli unar-
Cvevebi
Sesasrulebeli manipulaciis raodenoba
Ddavaleba
yuris, cxviris, xaxis, xorxis topografiuli anatomia
muSaoba seqciur ma-salaze
qirurgiuli teq-nikis Sefaseba
yurze operaciebis teqnikis aTviseba
yurze operaciis ad-gilobrivi anesTezi-iT Catareba. pirveli ganakveTis gakeTeba. operaciis Semdeg Wrilobis damuSaveba
25 referatis ward-gena operaciuli teq-nikis, Teoriuli codnis Sefaseba
cxvirze operaciebis teqnikis aTviseba
cxviris Rrus anesTe-zia
50 koloqviumi
yuris Cirqovani daava-debebi
gareTa sasmeni milis furunkulis gaxsna, yuris daCirqebuli hematomis gaxsna da drenireba
25
cxviris abscesebis gaxsna
cxviris furunkulis, hematomis, abscesis gaxsna da drenireba
25 referatis ward-gena
adenotomia operaciis damouki-deblad Catareba
50 operaciis teqni-kis Sefaseba
tonzileqtomia operaciis damouki-deblad Catareba
30 operaciis teqni-kis Sefaseba
24
modulis Sefasebis meTodebi (kriteriumebi, perioduloba): - mimdinare gamokiTxva yoveldRiuradCatardeba; - kviraSi erTxel, paraskevs, gaimarTeba koloqviumi, romelsac orive modulze pa-
suxismgebeli piriCaatarebs da romelzec kviris ganmavlobaSi miRebuli codna-Sefasdeba.
- qirurgiuli manipulaciebis Sesrulebis xarisxi yoveli manipulaciis SemdegSe-fasdeba.
- modulis damTavrebis Semdeg qirurgiuli manipulaciebis Sesrulebis xarisxi 10-baliani skaliTSefasdeba.
- kviraSi erTxel saintereso SemTxvevasTan dakavSirebiT rezidenti moxsenebasgaa-keTebs;
- TveSi erTxel modulze pasuxismgebeli piris mier winaswar SerCeul Temaze re-zidenti referats daamuSavebs. referatis xarisxi 5-baliani skaliT Sefasdeba.
- modulis damTavrebisas testirebiT da zepiri gamokiTxviT ganvlili Teoriuli masalis aTvisebis done Semowmdeba.
- Teoriuli codnis, praqtikuli unar-Cvevebis, referatis damuSavebis xarisxis da klinikur muSaobaSi zogadi CarTulobis gaTvaliswinebiT rezidentis moswrebis done modulis bolos 10-quliani skaliT Sefasdeba.
moduli 3.2
1. modulis dasaxeleba, xangrZlivoba: saSualo sirTulis otorinolaringologiurioperaciebis aTvisebis kursi,6 Tve
2. modulis mizani: wina modulis gavlisas miRebuli codnis gaRrmaveba. me-2 da me-3 sirTulis lor operaciebis daufleba. wina modulebis gavlisas miRebuli codnis praqti-kuli ganxorcielebis fonze mocemuli modulis miznis misaRwevad Semdegi operaciebis aTviseba da maTi praqtikuli ganxorcieleba: polipotomia, cxviris qvemo niJarebis turbinoplastika, submukozuri rezeqcia, lateralizacia, ult-rabgeriTi dezintegracia, qvemo konxotomia, cxviris Zgidis rezeqcia, adenoto-miis da tonzileqtomiis Semdgomi sisxldenis kupireba, konikotomiis da traqe-otomiis aTviseba, wina da ukama eTmoidotomia, gareTa saZile arteriis gadak-vanZva.
3. rekomendebuli literaturis nusxa: ToxaZe T. otorinolaringologia. Tbilisi, 1995. БартонМ. Болезни уха, горла и носа. Москва, Санкт-Петербург, 2002. Пальчун В.Т., Преображенский Т.А. Болезни уха, горла и носа. М., 1980. Солдатов И.Б. Лекции по оториноларингологии. М., 1994. Belaites E., Gudziol H. Restoring Methods of Functional Defects in Head and Neck. 2005. Hall, Colman.Diseases of the Ear, Nose and Throat. 1999. Meyerhoff R. Otolaringology, Head and Neck Surgery.Philadelphia, 1992. Schultz-Coulon H. Enviromental and Occupational Health Disorders.Germany, 2004. www.earallergy.com www.nlm.nih.gov (aSS nacionaluri samedicino biblioTeka) www.medinfo.ufl.edu www.lor.ru www.augie.edu www.archotol.ama-assn.org www.nature.com www.medexplorer.com
25
4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix. cxrili 3.2)
cxrili3.2
Teoriuli kursi profesiuli unar-Cvevebi Sesasrulebeli manipulaciebis
raodenoba davaleba
cxviris qirur-gia
polipotomia, cxviris qvemo niJa-rebis turbinoplastika, submuko-zuri rezeqcia
50 pacientebis kurireba
cxviris qvemo niJare-bislateralizacia,ultrabgeriTi dezintegracia, qvemo konxotomia
50 pacientebis kurireba
cxviris Zgidis rezeqcia 70 pacientebis kurireba
traqeotomia: Cvenebebi, teqnika
traqeotomia 10 referatis wardgena
modulis Sefasebis meTodebi: - mimdinare gamokiTxva yoveldRiuradCatardeba; - kviraSi erTxel, paraskevs, gaimarTeba koloqviumi, romelsac orive modulze pa-
suxismgebeli piriCaatarebs da romelzec kviris ganmavlobaSi miRebuli codna-Sefasdeba.
- qirurgiuli manipulaciebis Sesrulebis xarisxi yoveli gasinjvis SemdegSefas-deba.
- modulis damTavrebis Semdeg qirurgiuli manipulaciebis Sesrulebis xarisxi 10-baliani skaliTSefasdeba.
- kviraSi erTxel saintereso SemTxvevasTan dakavSirebiT rezidenti moxsenebasgaa-keTebs.
- TveSi erTxel modulze pasuxismgebeli piris mier winaswar SerCeul Temaze re-zidenti referatsdaamuSavebs. referatis xarisxi 5-baliani skaliT Sefasdeba.
- modulis damTavrebisas testirebiT da zepiri gamokiTxviT ganvlili Teoriuli masalis aTvisebis done Semowmdeba.
- Teoriuli codnis, praqtikuli unar-Cvevebis, referatis damuSavebis xarisxis da klinikur muSaobaSi zogadi CarTulobis gaTvaliswinebiTmodulis bolos rezi-dentis moswrebis done 10-quliani skaliT Sefasdeba.
profesiuli mzadebis IV wlis modulebi
moduli 4.1
1. modulis dasaxeleba, xangrZlivoba: audiologia, vestibulologia, 1.5 Tve
2. modulis mizani: smenis da vestibuluri organos gamokvlevis meTodebi. kvlevis Sedegebis ana-lizi. smenis da vestibuluri organos foziologiis da paTologiis Seswavla. wina modulebis gavlis dros miRebuli codnis gaRrmaveba da gafarToeba. mo-dulis msvlelobaSi rezidenti kvlevis rogorc subieqtur, ise obieqtur meTo-debs aiTvisebs. Seswavlili iqneba, kerZod, tonaluri zRurblovani da zezRur-blovani audiometria, timpanometria/impedansometria, rekruitmentis gamosavli-nebeli testebi, gamowveuli da distorziuli produqtis otoakustikuri emisi-is, smenis gamowveuli potencialebis kompiuteruli registraciis meTodebi. re-
26
zidenti daeufleba gamokvlevaTa Catarebis teqnikas da Taviseburebebs.is SeZ-lebs agreTve miRebuli Sedegebis analizs da Sesabamis daskvnaTa Camoyalibe-bas. gansazRvravs smena-vestibuluri sistemis mkurnaloba-reabilitaciis stra-tegias.
3. rekomendebuli literaturis nusxa: ToxaZeT. otorinolaringologia.Tbilisi, 1995. Альтман Я.А., Таварткиладзе Г.А. Руководство по аудиологии.М., 2003. Вульштейн Х. Слухоулучщающие операции. М., 1972. Гельфанд С.А. Слух. Нью-Йорк, 1984. Хечинашвили С.Н., Кеванишвили З.Ш. Слуховые вызванные потенциалы человека.Тбилиси, 1985. Belaites E., Gudziol H. Restoring Methods of Functional Defects in Head and Neck. 2005. Schultz-Coulon H. Enviromental and Occupational Health Disorders.Germany, 2004.
4. modulis dasrulebis Semdeg rezidentma unda icodes da mas unda SeeZlos: smenis gamokvleva metyvelebiT, kamertonebiT; tonaluri zRurblovani audio-metriis Catareba da audiogramis gaSifvra; intra- da retrokoxlearuli paTo-logiebis diferencirebis mizniT zezRurblovani audiotestebis Catareba; impe-dansometria; smenis gamowveuli potencialebis kompiuteruli registraciis me-TodiT smenis zRurblTa da retrokoxlearul paTologiisdadgena; nistagmo-grafia, brunviTi, kaloriuli cdebi.
5. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix. cxrili 4.1):
cxrili4.1
Teoriuli kursi profesiuli unar-
Cvevebi
Sesasrulebeli manipulaciis raodenoba
davaleba
smenis da vestibuluri organos fiziologia
- smenis da vesti-
buluri sistemis kvlevis Sedege-bis safuZvelze diagnozis dasma da mkurnalobis dagegmva
smenis gamokvlevis subieqturi meTodebi
subieqturi tonalu-ri zRurblovani da zezRurblovani au-diometria
50
smenis gamokvlevis ob-ieqturi meTodebi
impedansometria, otoakustokuri emi-siis registraciis meTodi, smenis gamow-veuli potencialebis registraciis meTodi
50
vestibuluri organos gamokvlevis meTodebi
nistagmogra-fia,brunviTi, kalo-riuli cda
10
modulis Sefasebis meTodebi (kriteriumebi, perioduloba): - mimdinare gamokiTxva yoveldRiuradCatardeba. - kviraSi erTxel, paraskevs, koloqviumi gaimarTeba da kviris ganmavlobaSi miRe-
buli codnaSefasdeba. - audiologiuri gamokvlevebis Sesrulebis xarisxi yoveli kvlevis SemdegSefas-
deba. - modulis damTavrebis Semdeg audiologiuri gamokvlevebis Sesrulebis xarisxi
10-baliani skaliT Sefasdeba. - kviraSi erTxel saintereso SemTxvevasTan dakavSirebiT rezidenti moxsenebasgaa-
keTebs.
27
- or kviraSi erTxel modulze pasuxismgebeli piris mier winaswar SerCeul Te-maze rezidenti referatsdaamuSavebs. referatis xarisxi 5-baliani skaliT Se-fasdeba.
- modulis damTavrebisas testirebiT da zepiri gamokiTxviT ganvlili Teoriuli masalis aTvisebis done Semowmdeba.
- Teoriuli codnis, praqtikuli unar-Cvevebis, referatis damuSavebis xarisxis da klinikur muSaobaSi CarTulobis gaTvaliswinebiT, modulis bolos rezidenti 10-quliani skaliT miiRebs Sefasebas.
moduli 4.2
1. modulis dasaxeleba: Tavis, kisrisa da zeda sasunTqi gzebis onkologiuri daavadebebi, 4.5 Tve.
2. modulis mizani da Sesasrulebeli samuSaos moculoba: kursis procesSi otolaringologiis rezidentebma is onkologiuri daavadebe-bi unda Seiswavlon, romlebic zeda sasunTq gzebsa da Tavisa da kisris orga-noebSi gvxvdeba. problemas is garemoebaxdis aqtualurad, rom bolo wlebSi Tavis, kisris da piris Rrus organoebis onkologiuri daavadebebis procentu-li maCvenebeli mniSvnelovnad gaizarda.zogadi profilis samedicino dawese-bulebebSi diagnostikur SecdomaTa mizeziT mniSvnelovnad moimata agreTve araradikaluri operaciebis raodenobamac. rezidentebma unda icodnen Tavis, kisris da piris Rrus organoebis kiboswinare daavadebebis da avTvisebiani sim-sivneebis gamovlenis sawyisi formebi, unda SeZlon maTi swori diagnostika. Se-iswavlian ra cnebas onkologiuri sifrTxile, ar dauSveben zusti diagnosti-rebis gareSe xangrZlivi da araradikaluri mkurnalobis Catarebas, rasac da-avadebebis progresireba sdevs Tan. rezidentebma aRniSnuli kursi specializi-rebuli onkologiuri klinikis bazaze unda gaiaron da onkologiur daavadeba-Ta mimdinareobis Taviseburebebi, diagnostikuri kvlevis algoriTmebi, dakvir-vebis meTodebi adgilzeve unda Seiswavlon. yuradReba unda mieqces onkologi-uri avadmyofebisaTvis daxmarebis ganxorcielebis Taviseburebebs. medikamento-zuri da sxivuri mkurnalobis dros unda gaiTvaliswinebodes daavadebebis spe-cifiuroba.
3. modulis amocanebi: modulisprocesis mimdinareobisas rezidentma Semdegi sakiTxebi unda Seiswav-los: 1. avTvisebiani simsivneebis cneba. onkologiuri daavadebebis epidemiologia, ma-
Ti ganviTarebis ZiriTadi principebi, etiopaTogenezi, klasifikacia, klinika, diagnostika, mkurnaloba, dispanserizaciis cneba.
2. cxvir-xaxis avTvisebiani simsivneebis etiologia, paTogenezi, klasifikacia, klinika, diagnostika, mkurnaloba.
3. nuSura jirkvlis da pir-xaxis avTvisebiani simsivneebis etiologia, paToge-nezi, klasifikacia, klinika, diagnostika, mkurnaloba.
4. xorxis kiboswinare daavadebebis da avTvisebiani simsivneebis etiologia, pa-Togenezi, klasifikacia, klinika, diagnostika, mkurnaloba.
5. zeda ybis, cxviris da misi danamati wiaRebis avTvisebiani simsivneebis etio-logia, paTogenezi, klasifikacia, klinika, diagnostika, mkurnaloba.
6. piris Rrus organoebis avTvisebiani simsivneebis etiologia, paTogenezi, klasifikacia, klinika, diagnostika, mkurnaloba.
7. mcire da didi sanerwyve jirkvlebis avTvisebiani simsivneebis etiologia, pa-Togenezi, klasifikacia, klinika, diagnostika, mkurnaloba.
8. sxvadasxva lokalizaciis avTvisebiani simsivneebis metastazebi Tavis, kisris da piris Rrus organoebsa da qsovilebSi: klinika, diagnostika, mkurnaloba.
28
modulis dasrulebis Semdeg rezidentma unda icodesdamas unda SeeZlos: sxvadasxva lokalizaciis simsivneebis rutinuli gamokvlevebi. anamnezis Sekreba, pi-ris Rrus daTvaliereba, laringoskopia (pirdapiri da arapirdapiri), cxvir-xaxis daT-valiereba, rinoskopia, zeda sasunTqi gzebis fibroskopia, saxis Zvlebis rentgenogra-fiis, kompiuteruli tomografiis, citologiuri da morfologiuri gamokvlevebis Se-degTa analizi. sxvadasxva lokalizaciis simsivneebisas biofsiuri kvlevis Catarebis Cvenebebis gansazRvra da misi ganxorcieleba. zeda, Sua da qveda traqeostomiis Cvene-bebis dadgena. gareTa saZile arteriis gadakvanZvis Cvenebebi. rekomendebuliliteraturis nusxa:
1. nemsaZe o., oqropiriZeT. Terapiruli stomatologia. Tbilisi, 2001. 2. zarqua z. oficialuri miTiTebebi, debulebebi, meToduri rekomendaciebi, diag-
nostikisa da mkurnalobis algoriTmebi onkologiaSi. Tbilisi, 2005. 3. avTvisebian simsivneTa saerTaSoriso ТНМklasifikacia.kibos winaaRmdeg brZo-
lis saerTaSoriso kavSiri (UICE, Geneva, 2005). 4. БернадскийЮ.И. Основычулюстно-лицевойхирургииихирургическойстоматологии. Витебск,
1998. 5. Хирургическаястоматология (под ред. РобустовойГ.Г.).М., 2000. 6. Пачес Л.И. Опухоли головы и шеи. М., Медицина, 1983. 7. Струков А.М., Серов В.В. Патологичкская анатомия. М., 1995. 8. Патофизиология (под. ред. Литвицкого П.Ф.). М., Медицина, 1995. 9. Петров С.В. Обшая хирургия. СПБ, 1999. 10. Пропедевтика хирургической стоматологии (под ред. Матроса-ТаранцаИ.Н.). Донецк, 2000. 11. Фармакология (под ред. КомиссароваИ.В.).Донецк, 1999. 12. Рентгендиагностика заболеваний челюстно-лицевой области (под ред. РабухинойН.А.,
ЧупринойН.М.).М., Медицина, 1991. 13. ArchievesofOtolaryngology,HeadandNeckSurgery: http:/archotol.ama-assn.org 14. OtolaryngologyandFacial-PlastikSurgery:http://www.emadicine.com 15. American Dental Association: http://www.ada.org
4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix.
cxrili 4.2) cxrili4.2
Teoriuli kursi profesiuli unar-
Cvevebi
Sesasrulebeli manipulaciis minimaluri raodenoba
davaleba
kisrisa da ybisqvSa mi-damos palpacia, rino-skopia, arapirdapiri laringoskopia,mcire zomis simsivneebis amokveTa, biofsia
damoukidebeli Sesruleba
20
pacientebis kuri-reba,operaciuli teqnikis aT-viseba, Teoriuli codnis Sefaseba
traqeostomia, gareTa saZile arteriis gada-kvanZva
asistireba
10
pacientebis kuri-reba
minimaluri masStabis operaciebi farisebr jirkvalze; operaciebi farisebri jirkvlis keTilTvisebianisimsiv-neebisas; operaciebi di-fuzur-toqsiur Ciy-visas; operaciebi fa-risebri jirkvlis av-Tvisebiani simsivneebi-
asistireba
10
pacientebis kuri-reba,operaciuli teqnikis aTvise-ba, Teoriuli codnis Sefaseba
29
sas xorxis rezeq-cia,laringeqtomia, xorxis nawilobrivi rezeqcia, kisris mod-ificirebuli limfodi-seqcia, krailis opera-cia, Tireoideqtomia.
asistireba
10
pacientebis kuri-reba,operaciuli teqnikis aTvise-ba, Teoriuli codnis Sefaseba
haimorotomia, polipo-tomia, cxvir-xaxis, pa-rafaringealuri sim-sivneebis amokveTa, fa-ringostomis plastika
asistireba
10
pacientebis kuri-reba
ybayura jirkvlis sub-totaluri rezeqcia, parotideqtomia, ybis-qveSa jirkvlis rezeq-cia
asistireba
10
pacientebis kuri-reba, operaci-uli teqnikis aT-viseba, Teoriuli codnis Sefaseba
moduli 4.3 1. modulis dasaxeleba, xangrZlivoba:
otorinolaringologiis IV da V xarisxis sirTulis operaciebis aTvisebis kursi,5 Tve
2. modulis mizani da Sesasrulebeli samuSaos moculoba: wina modulebisrealizacisasmiRebuli codnis ganmtkiceba.axlis moculobiT gaTva-liswinebuli operaciebis aTviseba da ZiriTadad damoukideblad ganxorcieleba.wi-na modulebis gavlisas miRebuli codnis ganmtkiceba. me-4 sirTulis Semdegi ope-raciebis daufleba: cxviris plastika, haimorotomia, eTmoidotomia, frontotomia, kisris midamos kisteqtomia, traqeostomia, yuris midamos subperiostaluri absce-sis gakveTa. me-5 sirTulis operaciebze asistireba da fragmentuliSesrule-ba: an-tromastoideqtomia, orkameriani antromastoideqtomia, yuris radikaluri ope-racia, miringoplastika, timpanoplastika. cxviris da misi danamati wiaRebis endo-skopiuri operaciebis, antromastoideqtomiis, yurze radikaluri operaciebis, timpa-notomiis da Suntirebis damoukidebeli Sesruleba. modulis mimdinareobis period-Si seqciur masalaze mudmivi treningi.
3. rekomendebuli literaturis nusxa:
АльтманЯ.А.,ТаварткиладзеГ.А. Руководствопоаудиологии.М., 2003. Бартон М. Болезни уха, горла и носа. Москва, Санкт-Петербург, 2002. Вульштейн Х. Слухоулучщающие операции. М., 1972. Гельфанд С.А. Слух. Нью-Йорк, 1984. Люлько В.Л., Марченко В.М. Атлас операций на ухе. Киев, 1989. Пальчун В.Т., Преображенский Т.А. Болезни уха, горла и носа. М., 1980. Солдатов И.Б. Лекции по оториноларингологии. М., 1994. Хечинашвили С.Н., Кеванишвили З.Ш. Слуховые вызванные потенциалы человека. Тбилиси, 1985. BelaitesE., GudziolH. RestoringMethodsofFunctionalDefectsinHeadandNeck. 2005. DeWeeseD.D. etal.Otolaryngology,Head and Neck Surgery.Washington, 1988. Hall, Colman.Diseases of the Ear, Nose and Throat. 1999. Meyerhoff R. Otolaryngology, Head and Neck Surgery.Philadelphia, 1992.
30
Schultz-Coulon H. Enviromental and Occupational Health Disorders.Germany, 2004.
4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba (ix. cxrili 4.3)
cxrili4.3
Teoriuli kursi profesiuli unar-
Cvevebi
Sesasrulebeli manipulaciis minimaluri raodenoba
davaleba
cxviris plastika, haimo-rotomia, eTmoidotomia, frontotomia
damoukidebeli Ses-ruleba
20 pacientebis ku-rireba referatebis wardgena
kisris midamos kisteqto-mia, traqeostomia, yuris midamos subperiostalu-ri abscesis gakveTa
damoukidebeli Ses-sruleba
20
antromastoideqtomia, yu-ris radikaluri opera-cia, miringoplastika, timpanoplastika
asistireba 25
timpanotomia da Suntire-ba
damoukidebeli Ses-ruleba
30
modulis Sefasebis meTodebi: - mimdinare gamokiTxva yoveldRiuradCatardeba; - kviraSi erTxel, paraskevs, gaimarTeba koloqviumi, romelsac orive modulze
pasuxismgebeli piriCaatarebs da romelzec kviris ganmavlobaSi miRebuli cod-na Sefasdeba.
- qirurgiuli operaciebis Sesrulebis xarisxi avadmyofis yoveli gasinjvis Sem-degSefasdeba.
- modulis damTavrebis Semdeg qirurgiuli operaciebis Sesrulebis xarisxi10-ba-liani skaliTSefasdeba.
- kviraSi erTxel rezidenti saintereso SemTxvevasTan dakavSirebiT moxsenebas-gaakeTebs.
- TveSi erTxel modulze pasuxismgebeli piris mier winaswar SerCeul Temaze rezidenti referats daamuSavebs. referatis xarisxi 5-baliani skaliT Sefasde-ba.
- modulis damTavrebisas Teoriuli masalis aTvisebis done testirebiT da zepi-ri gamokiTxviT Semowmdeba.
- rezidentisTeoriuli codnis done, praqtikuli unar-Cvevebi, referatis damu-Savebis xarisxi da klinikur muSaobaSi CarTulobis xarisxi modulis bolos 10-quliani skaliT Sefasdeba.
rekomendebuli literaturis nusxa:
1. ToxaZeT. otorinolaringologia. Tbilisi, 1995. 2. Альтман Я.А., Таварткиладзе Г.А. Руководство по аудиологии. М., 2003. 3. Бартон М. Болезни уха, горла и носа. Москва, Санкт-Петербург, 2002. 4. Вульштейн Х. Слухоулучщающие операции. М., 1972. 5. Гельфанд С.А. Слух. Нью-Йорк, 1984. 6. Люлько В.Л., Марченко В.М. Атлас операций на ухе. Киев, 1989. 7. Пальчун В.Т., Преображенский Т.А. Болезни уха, горла и носа. М., 1980. 8. Солдатов И.Б. Лекции по оториноларингологии. М., 1994. 9. Хечинашвили С.Н., Кеванишвили З.Ш. Слуховые вызванные потенциалы человека. Тбилиси,
1985. 10. Belaites E., Gudziol H. Restoring Methods of Functional Defects in Head and Neck. 2005. 11. DeWeese D.D. et al. Otolaryngology,Head and Neck Surgery. Washington, 1988.
31
12. Hall, Colman. Diseases of the Ear, Nose and Throat. 1999. 13. Meyerhoff R. Otolaryngology, Head and Neck Surgery. Philadelphia, 1992. 14. Schultz-Coulon H. Enviromental and Occupational Health Disorders. Germany, 2004. 15. www.earallergy.com 16. www.nlm.nih.gov (aSS nacionaluri samedicino biblioTeka) 17. www.medinfo.ufl.edu 18. www.lor.ru 19. www.augie.edu 20. www.earsurgery.org 21. www.archotol.ama-assn.org 22. www.nature.com 23. www.medexplorer.com 24. www.karger.com