Typicky se projevuje pocitem studen\u00fdch nohou a bolest\u00ed l\u00fdtek p\u0159i ch\u016fzi. Pr\u00e1v\u011b chlad pat\u0159\u00ed k prvn\u00edm p\u0159\u00edznak\u016fm ischemick\u00e9 choroby doln\u00edch kon\u010detin (ICHDK), tedy jejich \u0161patn\u00e9ho prokrven\u00ed. O tom hovo\u0159ila angiolo\u017eka MuDr. Hana Mischkov\u00e1.<\/p>\n
– M\u016f\u017eete p\u0159ibl\u00ed\u017eit prvn\u00ed p\u0159\u00edznaky chronick\u00e9 ischemick\u00e9 choroby doln\u00edch kon\u010detin?<\/p>\n
P\u0159\u00edznak typick\u00fd pro toto onemocn\u011bn\u00ed je bolest, kter\u00e1 je zp\u016fsobena nedostate\u010dnou dod\u00e1vkou kysl\u00edku a energie do sval\u016f, kter\u00e9 jsou z\u00e1sobeny posti\u017eenou tepnou. \u010casto se projevuje v l\u00fdtku, ale m\u016f\u017ee b\u00fdt p\u0159\u00edtomna v cel\u00e9 doln\u00ed kon\u010detin\u011b, nebo postihovat ob\u011b nohy. Pacienta nut\u00ed nejprve zpomalit tempo ch\u016fze, na kter\u00e9 byl dosud zvykl\u00fd, nebo jej p\u0159inut\u00ed zcela zastavit, po\u010dkat n\u011bkolik minut, a pot\u00e9 pokra\u010dovat v pohybu. A tato bolest se v dan\u00e9m intervalu opakuje \u2013 hovo\u0159\u00edme o tzv. klaudika\u010dn\u00edm intervalu, tedy vzd\u00e1lenosti, kterou pacient ujde do projev\u016f bolesti. V n\u011bkter\u00fdch p\u0159\u00edpadech, zejm\u00e9na u diabetick\u00fdch pacient\u016f, kte\u0159\u00ed trp\u00ed posti\u017een\u00edm perifern\u00edch nerv\u016f a sn\u00ed\u017een\u00fdm vn\u00edm\u00e1n\u00edm bolesti, m\u016f\u017ee b\u00fdt prvn\u00edm p\u0159\u00edznakem a\u017e nehoj\u00edc\u00ed se defekt na noze.<\/p>\n
– Jak\u00e9 jsou nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010diny t\u00e9to nemoci?<\/p>\n
Nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou chronick\u00e9 ICHDK je ateroskler\u00f3za, z\u00e1n\u011btliv\u011b degenerativn\u00ed posti\u017een\u00ed tepenn\u00e9 st\u011bny, a to a\u017e v 90 % p\u0159\u00edpad\u016f.<\/p>\n
– Co tuto nemoc zhor\u0161uje?<\/p>\n
N\u011bkter\u00e9 faktory souvisej\u00edc\u00ed s progres\u00ed ateroskler\u00f3zy neovlivn\u00edme \u2013 m\u00e1me na mysli v\u011bk a pohlav\u00ed. Onemocn\u011bn\u00ed m\u00e1 vy\u0161\u0161\u00ed v\u00fdskyt ve vy\u0161\u0161\u00edch v\u011bkov\u00fdch skupin\u00e1ch, a \u010dast\u011bji postihuje mu\u017ee. Dal\u0161\u00ed faktory je mo\u017en\u00e9 ovlivnit farmakoterapeuticky, jedn\u00e1 se nap\u0159\u00edklad o l\u00e9\u010dbu hypertenze, kompenzaci diabetu. Z\u00e1sadn\u00edm rizikov\u00fdm faktorem je kou\u0159en\u00ed. U ku\u0159\u00e1k\u016f m\u00e1 toto onemocn\u011bn\u00ed \u0161estin\u00e1sobn\u00fd v\u00fdskyt oproti neku\u0159\u00e1k\u016fm, a vylou\u010den\u00ed tohoto rizika m\u00e1 pln\u011b ve sv\u00e9 moci s\u00e1m pacient.<\/p>\n
– P\u0159edstavuje velk\u00e9 zdravotn\u00ed riziko? V \u010dem?<\/p>\n
Nejen m\u016f\u017ee, ale skute\u010dn\u011b p\u0159edstavuje velk\u00e9 zdravotn\u00ed riziko! U pacient\u016f bez p\u0159\u00edznak\u016f, nebo s m\u00edrn\u00fdmi p\u0159\u00edznaky ICHDK, bylo prok\u00e1z\u00e1no v\u00fdznamn\u00e9 zv\u00fd\u0161en\u00ed kardiovaskul\u00e1rn\u00edho onemocn\u011bn\u00ed a ischemick\u00fdch mozkov\u00fdch p\u0159\u00edhod. Rovn\u011b\u017e je u nich zv\u00fd\u0161ena \u00famrtnost na kardiovaskul\u00e1rn\u00ed onemocn\u011bn\u00ed. Pacienti v pokro\u010dil\u00fdch stadi\u00edch onemocn\u011bn\u00ed, tedy III. a IV., jsou ohro\u017een\u00ed ztr\u00e1tou kon\u010detiny amputa\u010dn\u00edm v\u00fdkonem, se v\u0161emi d\u016fsledky do dal\u0161\u00edho \u017eivota.<\/p>\n
– D\u00e1 se tomuto onemocn\u011bn\u00ed p\u0159edch\u00e1zet? Jak?<\/p>\n
Nekou\u0159it, nebo p\u0159estat kou\u0159it, d\u016fle\u017eit\u00fd je aktivn\u00ed pohyb a kontrola rizikov\u00fdch faktor\u016f nebo ji\u017e p\u0159\u00edtomn\u00fdch v\u00fd\u0161e uveden\u00fdch onemocn\u011bn\u00ed.<\/p>\n
– Kolik procent lid\u00ed tr\u00e1p\u00ed tato forma onemocn\u011bn\u00ed, a hlavn\u011b, co s t\u00edm?<\/p>\n
V\u00fdskyt tohoto onemocn\u011bn\u00ed v na\u0161\u00ed populaci roste, stoup\u00e1 s v\u011bkem, a je vy\u0161\u0161\u00ed v mu\u017esk\u00e9 populaci ve srovn\u00e1n\u00ed se \u017eenami, zejm\u00e9na v mlad\u0161\u00edch v\u011bkov\u00fdch kategori\u00edch. Odhaduje se, \u017ee po\u010det nemocn\u00fdch, kter\u00fdm je amputov\u00e1na kon\u010detina z d\u016fvodu tohoto onemocn\u011bn\u00ed, je 300 z jednoho milionu obyvatel, tedy v na\u0161\u00ed republice asi t\u0159i tis\u00edce netraumatick\u00fdch amputac\u00ed ro\u010dn\u011b.<\/p>\n
– Za jak\u00fdm l\u00e9ka\u0159em s takov\u00fdm probl\u00e9mem vyrazit, a jak\u00e1 vy\u0161et\u0159en\u00ed \u010dlov\u011bka \u010dekaj\u00ed?<\/p>\n
Prvotn\u00ed vy\u0161et\u0159en\u00ed provede praktick\u00fd l\u00e9ka\u0159, kter\u00fd zhodnot\u00ed obt\u00ed\u017ee pacienta v kontextu s objektivn\u00edm n\u00e1lezem a vyhodnocen\u00edm rizikov\u00e9ho profilu. Pot\u00e9 je doporu\u010deno vy\u0161et\u0159en\u00ed c\u00e9vn\u00edm specialistou (angiologem, nebo c\u00e9vn\u00edm chirurgem). Jsou provedena nejprve neinvazivn\u00ed vy\u0161et\u0159en\u00ed, kter\u00e9 p\u0159edstavuje dopplerovsk\u00e9 vy\u0161et\u0159en\u00ed tok\u016f v tepn\u00e1ch, n\u00e1sledn\u011b v indikovan\u00fdch p\u0159\u00edpadech zobrazovac\u00ed vy\u0161et\u0159en\u00ed CT angiografie, na jej\u00edm\u017e z\u00e1klad\u011b je stanoven dal\u0161\u00ed l\u00e9\u010debn\u00fd postup. Vy\u0161et\u0159en\u00ed je provedeno ambulantn\u011b, a ve srovn\u00e1n\u00ed s klasickou angiografi\u00ed, kter\u00e1 byla d\u0159\u00edve vy\u0161et\u0159en\u00edm volby, a dnes je indikov\u00e1na jen ve speci\u00e1ln\u00edch p\u0159\u00edpadech, jen pro pacienta velmi komfortn\u00ed.<\/p>\n
– Kdy\u017e n\u00e1s studen\u00e9 nohy bud\u00ed i ze span\u00ed… m\u00e1te n\u011bjakou radu, jak si pomoci?<\/p>\n
Pokud nen\u00ed p\u0159\u00ed\u010dinou onemocn\u011bn\u00ed, a\u0165 u\u017e ischemick\u00e9, neurologick\u00e9, nebo metabolick\u00e9, proto\u017ee tento p\u0159\u00edznak nen\u00ed typick\u00fd jen pro onemocn\u011bn\u00ed tepen, pak je nep\u0159\u00edjemn\u00fd pocit vyvol\u00e1n nej\u010dast\u011bji tepeln\u00fdm dyskomfortem a stresem. Zcela na m\u00edst\u011b je aplikace such\u00e9ho tepla, t\u0159eba v podob\u011b termoforu na\u0161ich babi\u010dek, nebo elektrick\u00e9 de\u010dky, zateplit nohy vhodn\u00fdmi pono\u017ekami nebo podkolenkami i na span\u00ed, a relaxace.<\/p>\n","protected":false},"excerpt":{"rendered":"
Typicky se projevuje pocitem studen\u00fdch nohou a bolest\u00ed l\u00fdtek p\u0159i ch\u016fzi. Pr\u00e1v\u011b chlad pat\u0159\u00ed k prvn\u00edm p\u0159\u00edznak\u016fm ischemick\u00e9 choroby doln\u00edch kon\u010detin (ICHDK), tedy jejich \u0161patn\u00e9ho […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":29185,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-15080","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/15080","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15080"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/15080\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/29185"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15080"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15080"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15080"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}