{"id":21077,"date":"2015-09-28T00:15:15","date_gmt":"2015-09-27T22:15:15","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=21077"},"modified":"2015-09-28T12:38:13","modified_gmt":"2015-09-28T10:38:13","slug":"nemocne-klouby-potiz-ktera-se-dnes-da-lecit","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=21077","title":{"rendered":"Nemocn\u00e9 klouby? Pot\u00ed\u017e, kter\u00e1 se dnes d\u00e1 l\u00e9\u010dit"},"content":{"rendered":"

Osteoartr\u00f3za je chronick\u00e9 degenerativn\u00ed onemocn\u011bn\u00ed kloub\u016f. Jak vypad\u00e1 l\u00e9\u010dba?<\/strong><\/p>\n

Jedn\u00e1 se o nejb\u011b\u017en\u011bj\u0161\u00ed onemocn\u011bn\u00ed perifern\u00edch kloub\u016f u na\u0161\u00ed populace. Charakteristick\u00e1 pro n\u011bj je postupn\u00e1 degenerace kloub\u016f, zejm\u00e9na kloubn\u00edch chrupavek, av\u0161ak doch\u00e1z\u00ed k posti\u017een\u00ed cel\u00fdch kloubn\u00edch tk\u00e1n\u00ed v\u010detn\u011b p\u0159ilehl\u00fdch struktur. Stav vede k deformac\u00edm a postupn\u00e9 ztr\u00e1t\u011b biomechanick\u00e9 funkce kloub\u016f. P\u0159edstavuje hlavn\u00ed p\u0159\u00ed\u010dinu invalidity u star\u0161\u00ed populace. Pro osteoartr\u00f3zu je typick\u00fd progresivn\u00ed \u00fabytek chrupavky a z\u00e1rove\u0148 tvorba nov\u00fdch kost\u00ed zejm\u00e9na ve form\u011b kostn\u00edch v\u00fdr\u016fstk\u016f – osteofyt\u016f. Jak choroba postupuje, vytv\u00e1\u0159en\u00ed osteofyt\u016f je st\u00e1le z\u0159eteln\u011bj\u0161\u00ed a kloubn\u00ed \u0161t\u011brbina se zu\u017euje. U pokro\u010dil\u00fdch stadi\u00ed je na rentgenov\u00fdch sn\u00edmc\u00edch patrn\u00e1 v\u00fdrazn\u00e1 skler\u00f3za a jasn\u00e1 deformace kontur kost\u00ed.<\/p>\n

L\u00e9\u010dba osteoartr\u00f3zy by m\u011bla b\u00fdt komplexn\u00ed a sest\u00e1vat z nefarmakologick\u00fdch a farmakologick\u00fdch metod. Nefarmakologick\u00e1 l\u00e9\u010dba zahrnuje edukaci pacienta, sn\u00ed\u017een\u00ed t\u011blesn\u00e9 hmotnosti, cvi\u010den\u00ed a r\u016fzn\u00e9 pom\u016fcky, jako je speci\u00e1ln\u00ed obuv a podp\u016frn\u00e9 prost\u0159edky. Pou\u017e\u00edvaj\u00ed se rovn\u011b\u017e r\u016fzn\u00e9 fyzioterapeutick\u00e9 metody.
\nFarmakologick\u00e1 l\u00e9\u010dba se zam\u011b\u0159uje zejm\u00e9na na zm\u00edr\u0148ov\u00e1n\u00ed bolesti. Doporu\u010den\u00fdm l\u00e9\u010divem prvn\u00ed volby v p\u0159\u00edpadech, kdy se choroba projevuje m\u00edrn\u00fdmi a\u017e st\u0159edn\u00edmi bolestmi, b\u00fdv\u00e1 paracetamol, kter\u00e9mu se d\u00e1v\u00e1 jako dlouhodob\u00e9mu analgetiku p\u0159ednost, proto\u017ee m\u00e1 podle v\u00fdzkum\u016f dobr\u00fd bezpe\u010dnostn\u00ed profil.
\nNesteroidn\u00ed antirevmatika se pou\u017e\u00edvaj\u00ed bu\u010f syst\u00e9mov\u011b, nebo lok\u00e1ln\u011b. Or\u00e1ln\u011b pod\u00e1van\u00e1 antirevmatika dnes p\u0159edstavuj\u00ed nej\u010dast\u011bji pou\u017e\u00edvanou farmakologickou l\u00e9\u010dbu bolesti souvisej\u00edc\u00ed s osteoartr\u00f3zou a v tomto ohledu jsou u mnoha pacient\u016f \u00fa\u010dinn\u011bj\u0161\u00ed ne\u017e paracetamol. Jejich kr\u00e1tkodob\u00e9 pou\u017eit\u00ed pat\u0159\u00ed k b\u011b\u017en\u00e9 praxi, av\u0161ak dlouhodob\u00e9 pou\u017e\u00edv\u00e1n\u00ed se pova\u017euje za nevhodn\u00e9 z d\u016fvodu rizika z\u00e1va\u017en\u00fdch gastrointestin\u00e1ln\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f. Nesteroidn\u00ed antirevmatika se mohou aplikovat rovn\u011b\u017e lok\u00e1ln\u011b a p\u0159i tomto zp\u016fsobu pou\u017eit\u00ed jsou velmi bezpe\u010dn\u00e1.<\/p>\n

Nebezpe\u010d\u00ed vedlej\u0161\u00edch \u00fa\u010dink\u016f na za\u017e\u00edvac\u00ed trakt je ni\u017e\u0161\u00ed u nov\u00e9 generace COX-2. Opioidn\u00ed analgetika jsou vhodnou alternativou zm\u00edrn\u011bn\u00ed bolesti u pacient\u016f, u kter\u00fdch jsou nesteroidn\u00ed antirevmatika kontraindikov\u00e1na, ne\u00fa\u010dinn\u00e1 \u010di \u0161patn\u011b sn\u00e1\u0161en\u00e1. Do skupiny pomalu p\u016fsob\u00edc\u00edch l\u00e9k\u016f u osteoartr\u00f3zy (symptomatic slow acting drugs in osteoarthritis – SYSADOA) spad\u00e1 glukosamin sulf\u00e1t, chondroitin sulf\u00e1t, diacerein, ASU a kyselina hyaluronov\u00e1. V\u011bt\u0161ina t\u011bchto l\u00e9\u010div p\u016fsob\u00ed na \u00farovni metabolismu chrupavky. V posledn\u00edch letech byla zkoum\u00e1na v mnoha studi\u00edch a bylo zji\u0161t\u011bno, \u017ee vedle symptomatick\u00e9ho \u00fa\u010dinku mohou rovn\u011b\u017e modifikovat strukturu chrupavky.<\/p>\n

V p\u0159\u00edpad\u011b, \u017ee farmakologick\u00e9 metody nejsou schopn\u00e9 dostate\u010dn\u011b zm\u00edrnit projevy osteoartr\u00f3zy, zejm\u00e9na bolest, je indikov\u00e1na chirurgick\u00e1 l\u00e9\u010dba a prov\u00e1d\u00ed se tot\u00e1ln\u00ed n\u00e1hrada posti\u017een\u00e9ho kloubu.<\/p>\n

Metro<\/p>\n","protected":false},"excerpt":{"rendered":"

Osteoartr\u00f3za je chronick\u00e9 degenerativn\u00ed onemocn\u011bn\u00ed kloub\u016f. Jak vypad\u00e1 l\u00e9\u010dba?<\/p>\n<\/div>","protected":false},"author":1,"featured_media":22868,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-21077","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/21077","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=21077"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/21077\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/22868"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21077"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21077"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21077"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}