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Barshagha ayan, tuberkulez, qazaqy úghymda qúrt auruy býgingi tanda densaulyq saqtau salasynyn ózekti mәselelerinin birine aynalyp otyr. Mәselen, DDÚ-nyn mәlimetteri boyynsha tórtkýl dýniyede kýn sayyn 9 milliongha juyq adam tuberkulezge shaldyqsa, 2 mln-gha tayau nauqas odan kóz júmady eken. Tuberkulez - búl tek qana medisinalyq emes, sonymen qatar qoghamdyq problema. Endeshe, búl jaghday Qazaqstanda qalay, ony emdeu, aldyn alu joldary jayynda keninen maghlúmat alu maqsatynda býginde seksen jyldyq tarihy bar elimizdegi bayyrghy emdeu oryndarynyng birinen sanalatyn Tuberkulez mәseleleri Últtyq ortalyghynyng diyrektory, medisina ghylymdarynyng doktory, professor Tileuhan ÁBILDAEVQA jolyqqan edik.
Barshagha ayan, tuberkulez, qazaqy úghymda qúrt auruy býgingi tanda densaulyq saqtau salasynyn ózekti mәselelerinin birine aynalyp otyr. Mәselen, DDÚ-nyn mәlimetteri boyynsha tórtkýl dýniyede kýn sayyn 9 milliongha juyq adam tuberkulezge shaldyqsa, 2 mln-gha tayau nauqas odan kóz júmady eken. Tuberkulez - búl tek qana medisinalyq emes, sonymen qatar qoghamdyq problema. Endeshe, búl jaghday Qazaqstanda qalay, ony emdeu, aldyn alu joldary jayynda keninen maghlúmat alu maqsatynda býginde seksen jyldyq tarihy bar elimizdegi bayyrghy emdeu oryndarynyng birinen sanalatyn Tuberkulez mәseleleri Últtyq ortalyghynyng diyrektory, medisina ghylymdarynyng doktory, professor Tileuhan ÁBILDAEVQA jolyqqan edik.
- Ádilhan Tileuhanúly, ótkensiz býgingige bagha beru qiyndau bolar, aldymen seksenning sengirine shyqqan mekemening tarihy, yaghny negizi qalay qalandy, alghashqy úiymdastyrushylary, basshylary jayly qysqasha toqtalyp ketseniz...
- Qazaqstanda tuberkulez instituty 1932 jyly 9 nauryzda KASSR Halyq komissariatynyng sheshimimen qúrylghan. Alghashqyda bar bolghany 25 tósek-oryndy qamtysa, sol uaqytta respublikada 790 auruhanalyq tósek-oryn bolatyn. Instituttyng alghashqy diyrektory medisina ghylymdarynyng doktory, professor V.IY.Zuzin bolsa, Otan soghysy jyldary QazKSR-dyng enbek sinirgen dәrigeri A.M.Zadvornyh, keyinnen G.M. Varshavskiy, D.U.Tólemisov, 1963-1982 jyldary ghylymgha enbegi singen qayratker, professor Ayqan Terlikbaev, 1982-1997 jyldary professor Áldesh Jýnisbekov, 1997-2012 jyldary professor A.A. Jәngireev, Sh.Sh.Ismailov, Gh.B. Raqyshev basqardy. Býginde ortalyqta 400 tósek-oryn, al jalpy elimizde 13498 tósek qory bar. Ortalyqta 7 ghylym doktory, 5 professor, 19 medisina ghylymdarynyng kandidaty júmys jasaydy.
- Derekterdi sóiletip kórinizshi, býginde Qazaqstanda qansha adam esepte túr? 1991-2000 jyldary Qazaqstan tuberkulezge shaldyghushylyqtan dýnie jýzi boyynsha 12-shi, al TMD elderi arasynda aldynghy oryndy iyemdenuining ózi talay jaydy aighaqtasa kerek...
- Últtyq ortalyq qazirgi tanda Qazaqstan tuberkulez ghylymy zertteu instituty bastaghan óte әleumettik manyzdy mindetterdi sheshudi nәtiyjeli atqaryp keledi. Instituttyng naqty tәjiriybelik, ghylymy izdenisterinin, ozyq tәjiriybeni barlyq ónirlerge endiruge jetekshiligining nәtiyjesinde 60-jyldardaghy ushyqqan epiydemiyalogiyalyq jaghdaydy túraqtandyryp, jaghdaydyng edәuir jaqsaruyna qol jetkizildi. Institut Kenes Odaghy kezindegi odaqtas respublikalar arasynda nәtiyjeli júmystarmen erekshelendi. 60-shy jyldardyng basynda tuberkulezding alghashqy syrqattanu kórsetkishteri 100 myng adamgha shaqqanda 300-di, al ólim kórsetkishi 60-ty qúraghan. 80-shi jyldary jaghday aitarlyqtay jaqsarghan edi. Alayda, tәuelsizdik alghan jyldardaghy әleumettik- ekonomikalyq túraqsyzdyqtar taghy da tuberkulezden ahualdyng nasharlauyna yqpal etti. 2002 jyly syrqattanu kórsetkishi 165,5, ólim kórsetkishi 24,4 qúrady. 1998 jyly Elbasynyng Jarlyghymen qabyldanghan maqsatty is-sharalar, tuberkulezben kýres mәselelerine sony pәrmen berdi. Nәtiyjesinde 10 jyl ishinde syrqattanu kórsetkishi 1,9 esege, ólim 3 esege azaydy.
- Býginde ortalyqta qansha nauqas emdeledi? Últtyq ortalyq bolghandyqtan respubliykadaghy jaghdaydy da ýilestirip otyratyn shygharsyzdar? Endeshe, aimaqtaghy ahual qanday, qay oblysta auru kórsetkishi basym? Qanday týrleri kóbirek beleng alghan?
- Qazirgi tósek qorymen Últtyq ortalyq jylyna 1300-1400 aurudy emdep shygharady. Ortalyqta negizinen aurudyng kýrdeli týrleri - kóptegen dәrige tózimdi tuberkulez emdeledi. Ókpe hirurgiyasy bólimshesinde terapiyalyq emge kónbegen, ókpe tesigi bar aurulargha ota jasalady. Statiystiykagha sýiensek 85 payyz jaghdayda ókpe tuberkulezi, al 15 payyzynda ókpeden tys tuberkulez kezdesedi.
Ortalyq elimizdegi barlyq oblystargha ýilestiru, әdistemelik, jetekshilik, kenes beru mindetterin atqarady. Osynday qyzmettik kómekti qylmystyq atqaru jýiesine de kórsetedi. Nәtiyjesinde jyl ótken sayyn jaghday jaqsaryp, syrqattanu jәne ólim kórsetkishteri tómendep keledi. Degenmen de Aqmola, Atyrau, Shyghys Qazaqstan oblystary men Astana qalasynda syrqattanu kórsetkishteri respublikalyq orta kórsetkishten joghary. Ortalyq barlyq ónirlerde jylyna 2 ret monitoringtik baqylau jasap, keshendi is-sharalar barysyna bagha berumen, normatiyvti qújattardy uaqyt talabyna sәikestendirumen ainalysady.
- Mulitiyrezistenttik tuberkulez - qúrt auruynyng óte qauipti, emge kónbeytin týri songhy kezderi túraqty ósip kele jatqan kórinedi. Oqyrmandargha týsinikti bolsyn, kenirek toqtalsanyz?
- Kóptegen dәrige tózimdi tuberkulez (mulitiyrezistentti) ókinishke oray, respublikamyzda alghash syrqattanghandar arasynda - 19, qaytalap auyrghandar arasynda 53 payyzdy qúraydy. Emdelip jazylu nәtiyjeligi elimizde 73 payyzdan joghary. Emdelu nәtiyjesi aurudyng úzaq emdelu kursyna shydauyna, ýzbey emdi jalghastyrugha tútastay baylanysty. Bir qauipti jeri, aurudyng osy týrimen auyratyn adamdar qauipsizdik sharalaryn saqtamasa, basqalar osy qauipti aurudy júqtyrady. Sondyqtan sanitarlyq aghartu, psihologiyalyq qoldau júmystary qatar jýrgizilude. Emdeu nәtiyjesine basqa da qosymsha aurulardyng qosarlanuy (qant auruy, basqa da sozylmaly aurular) óz әserin tiygizip jatady. Qazaqstanda tuberkulezding kóptegen dәrige tózimdi týrimen auyrghandardy emge alu dengeyi 85 payyzgha jetti, búl DDÚ standartyna say, 2011 jyldyng qorytyndysy boyynsha aurudyng búl týrimen syrqattanu 3,8 payyzgha azaydy. Búl jaghday túraqtana bastaghannyng kórinisi deuimizge bolady.
- Ortalyq respublikadaghy osy baghyttaghy ghylymy zertteuler jýrgizetin biregey mekeme bolghandyqtan ghylymda qol jetkizgen qanday janalyq, jetistikterinizben bólise alasyz?
- Ortalyqta ghylymy júmystar údayy jýrgizilip keledi. Tiyimdi nәtiyjeleri is-tәjiriybede qoldanysqa engizilude. Últtyq ortalyq joghary kәsiby mamandar dayarlau mәselesine ýlken kónil bólip keledi. 80 jyl ishinde 40 ghylym doktoryn, 168 ghylym kandidatyn dayarlap shyghardy. 67 ghylymy jinaqtama, 8565 ghylymy maqala, 135 emdeu diagnostiykalyq әdisti jetildiru isi boyynsha qújattar jaryq kórdi.
Ortalyqta aurudyng asqynghan týrlerine ota jasau, plastiykalyq qayta qúrylymdau otalary jýzege asyrylady. Songhy uaqyttarda Resey hirurgtarymen birlesip az jaraqat keltiretin bronhoskopiyalyq otalardy jasau qolgha alyndy. 80 jyldyng ayasynda ótkizilgen konferensiyada jana tehnologiyalardy paydalanu, jana zerthanalyq tәsilderdi engizu, hirurgiyalyq emdeu tәsilderin talqylap, tәjiriybe almasu mәselelerine ýlken mәn berildi.
- Tuberkulez órkeniyetting damuymen birge kelgen әleumettik auru. Sondyqtan olargha memleket jaghdayynda jenildikter qarastyrylghan. Solardy atap kórsetseniz... Jәne ózderinizding taraptarynyzdan emdelushilerge qanday jaghday jasalyp otyr. Óitkeni, búl kesel tez arada aiyghyp ketetin auru emes, nauqastargha ailap, jyldap emdeluge tura keledi...
- Tuberkulez әleumettik manyzy bar júqpaly auru. Sondyqtan memleket tarapynan býginde aurudy anyqtau, emdeu tolyqtay tegin. Biylghy jyly tek qana arnayy tuberkulezge qarsy dәri- dәrmekterdi ortalyqtan satyp alugha 4 milliard tenge qarjy bólindi. Tuberkulezge qarsy emdeu mekemelerining materialdyq- tehnikalyq bazasy jyl ótken sayyn jaqsaruda. 2000 jyldan beri 46 jana tiptik tuberkulezben kýres auruhanalary iske qosyldy. Jergilikti atqarushy biylikting kómegimen 2011 jyly 258 mln. tengening kóleminde aurulargha ambulatorlyq emdeu kezinde jol aqysyna, tamaghyna qosymsha kómek kórsetildi. 34 pәter berildi. Búl baghyttaghy júmystardy jandandyra týsu qajet dep sanaymyn.
- Eger jýreginiz, bolmasa ayaghynyz auyryp emdelmeseniz - ol әrkimning jeke basynyng sharuasy, al eger siz júqpaly tuberkulez dertine shaldyghyp emdelmeseniz - keshiriniz, ol mening de, ózgening de, memleketting de sharuasy. Óitkeni, onday kesapatty keseldi kez kelgen jerde, kez kelgen jaghdayda ózinizge júqtyryp qoymay, ózgege de júqtyruynyz mýmkin. Yaghniy...
- Aurudyng aldyn alu, auyryp qalghan jaghdayda ýzdiksiz emdelip, jaqsy nәtiyjege jetu әrbir adamnyng óz jauapkershiliginde bolu kerek. Sonda ghana búl iste joghary nәtiyjege jetuge bolady. Búl iste medisina qyzmetkerining aurudyng jan dýniyesin týsine bilu, minez-qúlqyna әser etu qabileti qajet-aq. Al kerekti aldyn alu sharalary: balalar arasynda egu júmystary jýrgiziledi. Auru qaupi joghary toptardy jylyna keminde bir ret tekseru sharalary atqarylady. Al qylmystyq atqaru jýiesinde jylyna 2 ret profilaktikalyq tekseruler jýrgiziledi. Jasóspirimder arasynda búiryqqa sәikes jylyna keminde 1 ret flurografiyalyq tekseruden ótkiziledi. Al әrbir eresek túrghyn óz qalauymen jylyna 1 ret tekseruden ótui abzal.
Jalpy, tuberkulez auruymen kýres mәselesi dúrys baghytta. Osynday memlekettik qoldau ayasynda jaqyn jyldary syrqattanu jәne ólim kórsetkishterin tómendetude ýlken jetistikterge jetuge tolyq mýmkindikter bar.
- Ádilhan Tileuhanúly, ortalyqtyng seksen jyldyq mereyli jasyna oray halyqaralyq konferensiya ótkizip jatyr ekensizder...
- Konferensiyanyng maqsaty basqa memleketterding ozyq is-tәjiriybesin Qazaqstanda jýrgizilip jatqan tuberkulezge qarsy is-sharalarmen salystyrmaly týrde talqylau, aurugha diagnostika qoi jәne emdeu tiyimdiligin jogharylatu maqsatynda jana tehnologiyany qoldanu arqyly emdeu sapasyn kóteru joldaryn qarastyru bolyp tabylady. Al jiynnyng negizgi mәseleleri: azamattyq jәne qylmystyq atqaru jýiesindegi kóptegen dәrige tózimdi tuberkulez mәselelerin taldau; ambulatoriyalyq emdi paydalanu ayasyn keneytu; aurulardyng ýzdiksiz emdeluge yntasyn jogharylatu; aurudyng kýrdeli týrlerin anyqtau; býgingi tanda ózekti mәselege ainalyp jatqan tuberkulez jәne adamnyng immundy tapshylyq virusy aurularynyng qatar kezdesuin anyqtau bolyp tabylady. Konferensiyagha Resey, Ázerbayjan, Ózbekstan, Gruziya, Qyrghyzstan, Kolumbiya uniyversiytetterinen әlemge tanymal ghalymdar men professorlar shaqyryldy.
Tuberkulez problemalarynyng Últtyq ortalyghynda 31 qazan men 1 qarasha kýnderi sheberlik synyptary ótkizilip, 10-nan astam adamgha kýrdeli otalar jasaldy. Arnayy bilimin jetildiru sabaqtary jýrgizildi. Búl is-sharalargha barlyq oblys pen qalalardan mamandar qatysty. Bolashaqta mamandardyng kәsiby sheberligin kóteru maqsatynda osynday is-sharalar údayy jýrgiziletin bolady.
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