Н.Нансалмаа: Эрэгтэйчүүдийн эрүүл мэндийн асуудал манай улсад гээгдсэн салбар
- 2012-10-14
- Эрүүл мэнд
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Манай
сайтын энэ удаагийн ярилцлага эрэгтэйчүүдэд зориулагдаж байгаа юм.Манай
сайтын энэ удаагийн ярилцлага эрэгтэйчүүдэд зориулагдаж байгаа юм.
Ингээд Адам эмнэлгийн эмч Найдангийн Нансалмаатай эрэгтэйчүүдэд зонхилон
тохиолдох өвчин эмгэг хийгээд тэдгээрийг хэрхэн эмчлэх, урьдчилан
сэргийлэх талаар ярилцсанаа хүргэе.
Өөрийнхөө талаар танилцуулахгүй юу?
Би 1996 онд АУИС төгсөөд бөөрний мэс заслын буюу урологийн эмчийн мэргэжил эзэмшсэн. Анагаах Ухааны Үндэсний хүрээлэнд Бөөр шилжүүлэн суулгах төсөл, УКТЭмнэлэг болон Ачтан эмнэлэгт бөөрний мэс заслын эмчээр, 2010 оноос АДАМ эмнэлэгтээ ажиллаж байна.
Эрэгтэйчүүдийн бэлгийн үйл ажиллагаа, ахимаг насны эрэгтэйчүүдийн бэлгийн дааврын өөрчлөлтийн талаар 2009 оноос хойш Монгол Улсын Төрийн соёрхолт, гавьяат эмч АУ доктор М. Намсрай, АУ-ны доктор, Дэд профессор Ж.Мөнхцэцэг нарынхаа удирдлаганд судалгаа, эрдмийн ажил хийж байна.
АДАМ эмнэлгийнхээ үйлчилгээ оношлогооны талаар танилцуулах уу? Урологи андрологийн эмнэлэг гэхээр ямар төрлийн шинжилгээнүүд хийдэг вэ?
Манайх зөвхөн эрэгтэйчүүдийн эмнэлэг биш юм. Урологи буюу шээс судлал, андрологи буюу эрэгтэйчүүдийн даавар судлалд хамаардаг эмгэгүүдйин оношлож эмчилдэг гэсэн үг. Урологийн салбар нь бөөр, давсаг, шээсний замын эмгэгүүдийг эрэгтэй эмэгтэй хүмүүст ялгаагүй оношилж эмчилнэ. Бөөрний далд үрэвслийг илрүүлэх сэдээлт шинжилгээ, шээсний замын халдвар, бөөрний үйл ажиллагааны өөрчлөлт байна уу гээд олон талаас нь оношлогоо хийдэг.
Бөөр, давсаг, түрүү булчирхайн, төмсөгний эхо оношлогоо хийдэг. Бөөрний усжилт, уйланхай, хавдар, чулуу, төмсөгний хавдар, хуухнагны усжилт, төмсөгний судасны өргөсөлт, төмсөгний дайвар булчирхайн уйланхай, түрүү булчирхайн хортой хоргүй хавдар, шохойжилт, үрийн цэврүүний өөрчлөлт, шээс давсагт үлдэх, эмгэгүүдийг мэргэжлийн түвшинд оношилдог.
Мөн бэлгийн замын халдварууд, хламидиоз, шээсний замын уреаплазмоз, микоплазмоз, гарднереллез гээд олон эмгэгүүдийг молекул биологийн арга гэж ярьдаг PCR-ийн шинжилгээгээр хийдэг. Бэлгийн дааврын эмгэгүүд, үргүйдэл, үр тогтоох чадвартай эсэхийг шинжилж оношлож эмчилдэг. Түрүү булчирхай, төмсөгний дайвар, үр дамжуулах сувгийн архаг үрэвсэл нь аажимдаа хоёрдогч үргүйдлийг үүсгэдэг гэдгийг олон хүмүүс мэдэхгүйгээс дахин хүүхэдтэй болохгүй үед эмэгтэйчүүдийг буруутгах нь олонтоо тохиолддог.
Манай сайтын энэ удаагийн ярилцлага эрэгтэйчүүдийн эрүүл мэндэд зориулагдсан. Ямар тулгамдсан асуудал энэ салбарт байгаа гэж та боддог вэ?
Эрэгтэйчүүдийн эрүүл мэндийн асуудал манай улсад гээгдсэн салбар. Мэргэжлийн эмч нар цөөхөн тул заримдаа доторын эмч нар ч эрэгтэйчүүдийн эмгэгийг оношлож эмчилж байна гэж бизнес хийх болсонд мэргэжлийн хүний хувьд харамсдаг. Эрэгтэйчүүдэд зориулсан нийгмийн бодлого, хөтөлбөрүүд хэрэгжүүлэх, төрийн бус байгууллагууд, мэргэжлийн нийгэмлэгүүдтэй хамтран ажиллах, ард түмнийг эрүүл мэндийн мэдээллээр хангах гээд нийгмийн эрүүл мэндийн олон асуудлуудыг хийж эхлүүлмээр.
Ер нь түрүү булчирхай гэж ямар үүрэгтэй эрхтэн бэ? Энэ өвчлөл ямар насны хүмүүст голчлон тохиолддог вэ?
Түрүү булчирхай нь үрийн шингэний 2/3-ыг ялгаруулдаг, эр бэлгийн эсийн амьдрах орчинг хэвийн нөхцлийг хангах, шээсний сүв дундуур нь байрладаг 20 грам хүртэл жинтэй булчирхайлаг хос биш эрхтэн. Шээх үед шээсийг нөхөн үржихүйн хэсгээс тусгаарладаг. Түрүү булчирхайн үрэвсэл залуу хүмүүст илүү, түрүү булчирхайн томролт 45-аас дээш болон ахимаг насныханд тохиолддог. Түрүү булчирхай томрох нь настай хамааралтай ихэсдэг. Түрүү булчирхайн хортой хавдар 65-аас дээш насныханд илүү түгээмэл тохиолддог ч оношлохгүй зөвхөн томролт гэж явах нь ч бий.
Шээс задгайрах эмгэг эрэгтэй хүмүүст их тохиолддог уу?
Шээс задгайрах өвчин эрэгтэй эмэгтэй аль алинд нь тохиолдоно. Ялангуяа 40-өөс дээш насны эмэгтэйчүүдэд дааврын өөрчлөлт, бага аарцгийн ёроолын булчин суларсан, таргалалт, төрөх үеийн зарим эмгэгүүдтэй холбоотой гарна. Эрэгтэй хүнд түрүү булчирхайн үрэвсэл, томролттой холбоотой гардаг. Нугасны эмгэгийн шалтгаантай ч бас байж болно .
Эрэгтэйчүүд цэвэршдэг үү? Хэрэв тийм бол хэрхэн явагддаг вэ?
Эрэгтэйчүүд цэвэршихэд бэлгийн дур сонирхол буурах, ядрах, яс сийрэгжиж нуруугаар өвдөх, нойргүйдэх, мартамхай уцаартай болох шинжүүд гарна. Бас булчингийн хэмжээ бууран өөхний хэмжээ нь ихэсч, хэвлийгээр өөхлөх, хөх томрох шинжүүд илэрнэ. Өвөрмөц шинжээр илэрдэггүй учраас эрэгтэйчүүд эмчид хандахаа тэр бүр мэддэггүй. Таргалалт, буруу хооллолт, чихрийн шижин, элэгний өөрчлөлт зэрэг хүчин зүйлс хавсарсан үед 45-аас доош идэр насны эрэгтэйчүүд илүү эрт цэвэршиж дааврын дутагдал эрт эхлэж болно. Үүнийг Германы Байер Шеринг компанийн цэвэр эр бэлгийн дааврын бэлдмэл NEBIDO тарилга, бэлгийн сулралыг Levitra гэх өндөр хөгжилтэй орнуудад хэрэглэдэг эмээр эмчлэх боломжтой болсон. Харин тухайн хүнд тохирох эсэх, ямар тунгаар хэдий хугацаанд хэрэглэхийг эмч тухайн хүнд нь тохируулж зөвлөнө. Хэрэглэж болохгүй заалт гэж байдаг.
Эрчүүддээ хандаж эдгээр өвчин эмгэгээс хэрхэн сэргийлэх зөвлөгөө өгнө үү?
Бэлгийн замын халдвараар өвчлөхгүй, зөв хооллон илүүдэл жингүй, идэвхтэй хөдөлгөөнтэй амьдрах нь чухал. Ялангуяа тамхи судас хатууруулж бэлгийн сулралд хүргэдэг. Архи, дарсыг тохируулан, зохистой хэрэглэх нь олон төрлийн эмгэгүүдээс сэргийлдэг.
Танд баярлалаа.
Т.Оюунсүрэн
Өөрийнхөө талаар танилцуулахгүй юу? Би 1996 онд АУИС төгсөөд бөөрний мэс заслын буюу урологийн эмчийн мэргэжил эзэмшсэн. Анагаах Ухааны Үндэсний хүрээлэнд Бөөр шилжүүлэн суулгах төсөл, УКТЭмнэлэг болон Ачтан эмнэлэгт бөөрний мэс заслын эмчээр, 2010 оноос АДАМ эмнэлэгтээ ажиллаж байна.
Эрэгтэйчүүдийн бэлгийн үйл ажиллагаа, ахимаг насны эрэгтэйчүүдийн бэлгийн дааврын өөрчлөлтийн талаар 2009 оноос хойш Монгол Улсын Төрийн соёрхолт, гавьяат эмч АУ доктор М. Намсрай, АУ-ны доктор, Дэд профессор Ж.Мөнхцэцэг нарынхаа удирдлаганд судалгаа, эрдмийн ажил хийж байна.
АДАМ эмнэлгийнхээ үйлчилгээ оношлогооны талаар танилцуулах уу? Урологи андрологийн эмнэлэг гэхээр ямар төрлийн шинжилгээнүүд хийдэг вэ?
Манайх зөвхөн эрэгтэйчүүдийн эмнэлэг биш юм. Урологи буюу шээс судлал, андрологи буюу эрэгтэйчүүдийн даавар судлалд хамаардаг эмгэгүүдйин оношлож эмчилдэг гэсэн үг. Урологийн салбар нь бөөр, давсаг, шээсний замын эмгэгүүдийг эрэгтэй эмэгтэй хүмүүст ялгаагүй оношилж эмчилнэ. Бөөрний далд үрэвслийг илрүүлэх сэдээлт шинжилгээ, шээсний замын халдвар, бөөрний үйл ажиллагааны өөрчлөлт байна уу гээд олон талаас нь оношлогоо хийдэг.
Бөөр, давсаг, түрүү булчирхайн, төмсөгний эхо оношлогоо хийдэг. Бөөрний усжилт, уйланхай, хавдар, чулуу, төмсөгний хавдар, хуухнагны усжилт, төмсөгний судасны өргөсөлт, төмсөгний дайвар булчирхайн уйланхай, түрүү булчирхайн хортой хоргүй хавдар, шохойжилт, үрийн цэврүүний өөрчлөлт, шээс давсагт үлдэх, эмгэгүүдийг мэргэжлийн түвшинд оношилдог.
Мөн бэлгийн замын халдварууд, хламидиоз, шээсний замын уреаплазмоз, микоплазмоз, гарднереллез гээд олон эмгэгүүдийг молекул биологийн арга гэж ярьдаг PCR-ийн шинжилгээгээр хийдэг. Бэлгийн дааврын эмгэгүүд, үргүйдэл, үр тогтоох чадвартай эсэхийг шинжилж оношлож эмчилдэг. Түрүү булчирхай, төмсөгний дайвар, үр дамжуулах сувгийн архаг үрэвсэл нь аажимдаа хоёрдогч үргүйдлийг үүсгэдэг гэдгийг олон хүмүүс мэдэхгүйгээс дахин хүүхэдтэй болохгүй үед эмэгтэйчүүдийг буруутгах нь олонтоо тохиолддог.
Манай сайтын энэ удаагийн ярилцлага эрэгтэйчүүдийн эрүүл мэндэд зориулагдсан. Ямар тулгамдсан асуудал энэ салбарт байгаа гэж та боддог вэ?
Эрэгтэйчүүдийн эрүүл мэндийн асуудал манай улсад гээгдсэн салбар. Мэргэжлийн эмч нар цөөхөн тул заримдаа доторын эмч нар ч эрэгтэйчүүдийн эмгэгийг оношлож эмчилж байна гэж бизнес хийх болсонд мэргэжлийн хүний хувьд харамсдаг. Эрэгтэйчүүдэд зориулсан нийгмийн бодлого, хөтөлбөрүүд хэрэгжүүлэх, төрийн бус байгууллагууд, мэргэжлийн нийгэмлэгүүдтэй хамтран ажиллах, ард түмнийг эрүүл мэндийн мэдээллээр хангах гээд нийгмийн эрүүл мэндийн олон асуудлуудыг хийж эхлүүлмээр.
Ер нь түрүү булчирхай гэж ямар үүрэгтэй эрхтэн бэ? Энэ өвчлөл ямар насны хүмүүст голчлон тохиолддог вэ?
Түрүү булчирхай нь үрийн шингэний 2/3-ыг ялгаруулдаг, эр бэлгийн эсийн амьдрах орчинг хэвийн нөхцлийг хангах, шээсний сүв дундуур нь байрладаг 20 грам хүртэл жинтэй булчирхайлаг хос биш эрхтэн. Шээх үед шээсийг нөхөн үржихүйн хэсгээс тусгаарладаг. Түрүү булчирхайн үрэвсэл залуу хүмүүст илүү, түрүү булчирхайн томролт 45-аас дээш болон ахимаг насныханд тохиолддог. Түрүү булчирхай томрох нь настай хамааралтай ихэсдэг. Түрүү булчирхайн хортой хавдар 65-аас дээш насныханд илүү түгээмэл тохиолддог ч оношлохгүй зөвхөн томролт гэж явах нь ч бий.
Шээс задгайрах эмгэг эрэгтэй хүмүүст их тохиолддог уу?
Шээс задгайрах өвчин эрэгтэй эмэгтэй аль алинд нь тохиолдоно. Ялангуяа 40-өөс дээш насны эмэгтэйчүүдэд дааврын өөрчлөлт, бага аарцгийн ёроолын булчин суларсан, таргалалт, төрөх үеийн зарим эмгэгүүдтэй холбоотой гарна. Эрэгтэй хүнд түрүү булчирхайн үрэвсэл, томролттой холбоотой гардаг. Нугасны эмгэгийн шалтгаантай ч бас байж болно .
Эрэгтэйчүүд цэвэршдэг үү? Хэрэв тийм бол хэрхэн явагддаг вэ?
Эрэгтэйчүүд цэвэршихэд бэлгийн дур сонирхол буурах, ядрах, яс сийрэгжиж нуруугаар өвдөх, нойргүйдэх, мартамхай уцаартай болох шинжүүд гарна. Бас булчингийн хэмжээ бууран өөхний хэмжээ нь ихэсч, хэвлийгээр өөхлөх, хөх томрох шинжүүд илэрнэ. Өвөрмөц шинжээр илэрдэггүй учраас эрэгтэйчүүд эмчид хандахаа тэр бүр мэддэггүй. Таргалалт, буруу хооллолт, чихрийн шижин, элэгний өөрчлөлт зэрэг хүчин зүйлс хавсарсан үед 45-аас доош идэр насны эрэгтэйчүүд илүү эрт цэвэршиж дааврын дутагдал эрт эхлэж болно. Үүнийг Германы Байер Шеринг компанийн цэвэр эр бэлгийн дааврын бэлдмэл NEBIDO тарилга, бэлгийн сулралыг Levitra гэх өндөр хөгжилтэй орнуудад хэрэглэдэг эмээр эмчлэх боломжтой болсон. Харин тухайн хүнд тохирох эсэх, ямар тунгаар хэдий хугацаанд хэрэглэхийг эмч тухайн хүнд нь тохируулж зөвлөнө. Хэрэглэж болохгүй заалт гэж байдаг.
Эрчүүддээ хандаж эдгээр өвчин эмгэгээс хэрхэн сэргийлэх зөвлөгөө өгнө үү?
Бэлгийн замын халдвараар өвчлөхгүй, зөв хооллон илүүдэл жингүй, идэвхтэй хөдөлгөөнтэй амьдрах нь чухал. Ялангуяа тамхи судас хатууруулж бэлгийн сулралд хүргэдэг. Архи, дарсыг тохируулан, зохистой хэрэглэх нь олон төрлийн эмгэгүүдээс сэргийлдэг.
Танд баярлалаа.
Т.Оюунсүрэн
Сэтгэгдэл (200)
cEBElZJfpRnK (31.184.238.180)
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