{"id":25182,"date":"2016-04-08T12:21:12","date_gmt":"2016-04-08T10:21:12","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=25182"},"modified":"2016-04-08T12:21:12","modified_gmt":"2016-04-08T10:21:12","slug":"velka-cast-pacientu-s-hemeroidy-lekarskou-peci-nevyhledava","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=25182","title":{"rendered":"Velk\u00e1 \u010d\u00e1st pacient\u016f s hemeroidy l\u00e9ka\u0159skou p\u00e9\u010di nevyhled\u00e1v\u00e1"},"content":{"rendered":"

Nemocnice v Havl\u00ed\u010dkov\u011b Brod\u011b zakoupila p\u0159\u00edstroj, kter\u00fd nab\u00edz\u00ed bezbolestn\u00e9 vy\u0161et\u0159en\u00ed<\/strong> <\/p>\n

Havl\u00ed\u010dk\u016fv Brod \u2013 Aktu\u00e1ln\u011b chirurgick\u00e9 odd\u011blen\u00ed brodsk\u00e9 nemocnice zakoupilo a pou\u017e\u00edv\u00e1 nov\u00fd p\u0159\u00edstroj, kter\u00fdm roz\u0161i\u0159uje nab\u00eddku l\u00e9\u010dby hemoroid\u016f. Jde o metodu u\u017eit\u00ed infra\u010derven\u00e9 fotokoagulace, kterou velice rychle, bezbolestn\u011b a snadno m\u016f\u017eeme \u0159e\u0161it a l\u00e9\u010dit semiinvazivn\u00ed hemerodi\u00e1ln\u00ed nemoci. P\u0159\u00edstroj jsme m\u011bli zap\u016fj\u010den\u00fd na podzim 2015 a nyn\u00ed jsme jej zakoupili. K dne\u0161n\u00edmu dni jsme od \u0159\u00edjna 2015 o\u0161et\u0159ili 25 pacient\u016f infra\u010dervenou fotokoagulac\u00ed.<\/p>\n

Infra\u010derven\u00fd koagul\u00e1tor IRK 1513 jsme po\u0159\u00eddili za 67 tis\u00edc K\u010d. „P\u0159\u00edstroj zaji\u0161\u0165uje tepeln\u00e9 destrukce tk\u00e1n\u011b a zastaven\u00ed krv\u00e1cen\u00ed. Infra\u010derven\u00e9 z\u00e1\u0159en\u00ed vznik\u00e1 ve speci\u00e1ln\u00ed halogenovenov\u00e9 lamp\u011b, fokusuje se ve sv\u011btlovodi\u010di a\u017e do kontaktn\u00ed polymerov\u00e9 plo\u0161ky pro o\u0161et\u0159en\u00ed tk\u00e1n\u011b,“ popsal jeho fungov\u00e1n\u00ed Adam Fila, vedouc\u00ed odd\u011blen\u00ed zdravotnick\u00e9 techniky. Na n\u011bkolik ot\u00e1zek souvisej\u00edc\u00edch s l\u00e9\u010dbou hemeroid\u016f odpov\u011bd\u011bl l\u00e9ka\u0159 Jaroslav B\u011blehr\u00e1dek, kter\u00fd se tomuto t\u00e9matu v havl\u00ed\u010dkobrodsk\u00e9 nemocnici intenzivn\u011b v\u011bnuje .<\/p>\n

– Proktologick\u00e1 ambulance v lo\u0148sk\u00e9m roce roz\u0161i\u0159ovala ordina\u010dn\u00ed hodiny z d\u016fvodu n\u00e1r\u016fstu pacient\u016f. Je tedy problematika hemoroid\u016f st\u00e1le \u010dast\u011bj\u0161\u00ed diagn\u00f3zou?<\/p>\n

P\u0159edev\u0161\u00edm je nutno p\u0159ipomenout, \u017ee proktologick\u00e1 ambulance nen\u00ed jenom l\u00e9\u010dba hemoroid\u016f, ale starostlivost o mno\u017estv\u00ed onemocn\u011bn\u00ed, o kter\u00fdch se nerado hovo\u0159\u00ed, ale kter\u00e1 jsou, anebo v budoucnu mohou b\u00fdt velmi z\u00e1va\u017en\u00e1. V celospole\u010densk\u00e9m konceptu se v\u011bnuje pozornost r\u016fzn\u00fdm program\u016fm a j\u00e1 m\u00e1m tak trochu dojem, \u017ee na tuto choulostivou \u010d\u00e1st lidsk\u00e9ho t\u011bla se docela zapom\u00edn\u00e1. Obecn\u011b m\u016f\u017eeme \u0159\u00edci, \u017ee hemoroidy trp\u00ed velk\u00e9 procento populace, ale pouze ur\u010ditou \u010d\u00e1st pacient\u016f m\u016f\u017eeme vid\u011bt v klinick\u00e9 praxi. Mysl\u00edm si, \u017ee v\u011bt\u0161\u00ed \u010d\u00e1st pacient\u016f s pot\u00ed\u017eemi l\u00e9ka\u0159skou p\u00e9\u010di z r\u016fzn\u00fdch d\u016fvod\u016f nevyhled\u00e1. Proktologickou ambulanci nav\u0161t\u011bvuj\u00ed pacienti s benign\u00edm \u010di malign\u00edm onemocn\u011bn\u00edm kone\u010dn\u00edku. Pacienti s hemoroid\u00e1ln\u00ed nemoc\u00ed p\u0159edstavuj\u00ed nej\u010dast\u011bj\u0161\u00ed diagn\u00f3zu z benign\u00edch onemocn\u011bn\u00ed. Co je dle m\u00e9ho soudu v\u0161ak je\u0161t\u011b d\u016fle\u017eit\u011bj\u0161\u00ed ne\u017e samotn\u00e1 l\u00e9\u010dba hemoroid\u016f, je v\u016fbec ur\u010den\u00ed, \u017ee se jedn\u00e1 „jen“ o hemoroidy, tedy o benign\u00ed onemocn\u011bn\u00ed. To je d\u016fle\u017eit\u011bj\u0161\u00ed ne\u017e v\u0161echno ostatn\u00ed.<\/p>\n

– Jak\u00e9 jsou p\u0159\u00ed\u010diny vzniku hemoroid\u016f?<\/p>\n

Hemoroidy mohou vzniknout z r\u016fzn\u00fdch p\u0159\u00ed\u010din, kter\u00e9 se mohou i kombinovat. M\u016f\u017ee se nap\u0159. jednat o genetickou predispozici, chronickou z\u00e1cpu, pr\u016fjmovitou stolici, nedostatek vl\u00e1kniny ve strav\u011b, t\u011bhotenstv\u00ed, v\u011bt\u0161\u00ed fyzickou z\u00e1t\u011b\u017e, obezitu, ale i v\u011bk. N\u011bkter\u00e9 p\u0159\u00ed\u010diny lze ovlivnit a ur\u010dit\u00fdm zp\u016fsoben p\u0159edch\u00e1zet vzniku hemoroid\u016f, n\u011bkter\u00e9 p\u0159\u00ed\u010diny ovlivnit prost\u011b nelze. D\u016fle\u017eit\u011bj\u0161\u00ed v\u0161ak jsou jejich projevy. Tady je t\u0159eba upozornit, \u017ee zm\u011bny rytmu stolice, zm\u011bna charakteru stolice, zm\u011bna pocit\u016f p\u0159ed a zejm\u00e9na po stolici, krev ve stolici, hlen ve stolici a dal\u0161\u00ed projevy jsou jednozna\u010dn\u00fdm d\u016fvodem k n\u00e1v\u0161t\u011bv\u011b proktologa. Toto upozorn\u011bn\u00ed by m\u011bla vz\u00edt ve\u0159ejnost velmi v\u00e1\u017en\u011b.<\/p>\n

– Mus\u00ed se pacienti do ambulance objedn\u00e1vat?<\/p>\n

Ano, do na\u0161\u00ed ambulance se pacienti objedn\u00e1vat mus\u00ed. Objedn\u00e1vaj\u00ed se v chirurgick\u00e9 kartot\u00e9ce osobn\u011b \u010di telefonicky. B\u011bhem ordina\u010dn\u00ed doby v proktologick\u00e9 ambulanci vy\u0161et\u0159\u00edme okolo 20 pacient\u016f. Na vy\u0161et\u0159en\u00ed a l\u00e9\u010dbu ka\u017ed\u00e9ho pacienta je pot\u0159eba m\u00edt dostatek \u010dasu a proto tedy pacienty objedn\u00e1v\u00e1me na \u010das. Pokud to lze, tak se sna\u017e\u00edme vyj\u00edt v\u0161em maxim\u00e1ln\u011b vst\u0159\u00edc. Nutno dodat, \u017ee roz\u0161\u00ed\u0159en\u00edm ordina\u010dn\u00edch hodin se \u010dekac\u00ed doba zkr\u00e1tila.<\/p>\n

– V\u011bt\u0161ina pacient\u016f se domn\u00edv\u00e1, \u017ee pro l\u00e9\u010dbu hemoroid\u016f je nutn\u00e9 absolvovat \u0159adu nep\u0159\u00edjemn\u00fdch l\u00e9ka\u0159sk\u00fdch vy\u0161et\u0159en\u00ed a \u017ee operace je nevyhnuteln\u00e1. Jak\u00e1 je realita?<\/p>\n

Aby mohl b\u00fdt pacient s hemoroidy l\u00e9\u010den je t\u0159eba jej nejprve dostate\u010dn\u011b vy\u0161et\u0159it, n\u011bkter\u00e1 vy\u0161et\u0159en\u00ed nap\u0159. anoskopii mohou pacienti vn\u00edmat nep\u0159\u00edjemn\u011b. Nem\u011bla by b\u00fdt v\u0161ak bolestiv\u00e1. L\u00e9\u010dba hemoroid\u016f je d\u00e1na stupn\u011bm posti\u017een\u00ed a m\u011bla by b\u00fdt komplexn\u00ed. L\u00e9\u010dbu lze rozd\u011blit na konzervativn\u00ed, semiinvazivn\u00ed a chirurgickou. Konzervativn\u00ed l\u00e9\u010dba nevede k vyl\u00e9\u010den\u00ed. Je indikov\u00e1na v po\u010d\u00e1te\u010dn\u00edm st\u00e1diu hemoroid\u016f a p\u0159edev\u0161\u00edm zm\u00edr\u0148uje pot\u00ed\u017ee pacienta. Semiinvazivn\u00ed a chirurgick\u00e1 l\u00e9\u010dba je l\u00e9\u010dbou kauz\u00e1ln\u00ed. Jde o celou \u0159adu rozd\u00edln\u00fdch metod. Semiinvazivn\u00ed metody jsou pacienty dob\u0159e sn\u00e1\u0161eny, maj\u00ed mal\u00e9 mno\u017estv\u00ed komplikac\u00ed a lze je prov\u00e1d\u011bt ambulantn\u011b. T\u011bmito metodami lze \u0159e\u0161it velkou \u010d\u00e1st nemocn\u00fdch. K chirurgick\u00e9 l\u00e9\u010db\u011b je pak indikov\u00e1no cca 5\u00ad-10% nemocn\u00fdch.<\/p>\n

– Jak\u00e9 mo\u017enosti l\u00e9\u010dby aktu\u00e1ln\u011b nab\u00edz\u00edte?<\/p>\n

Ze semiinivazivn\u00edch metod m\u016f\u017eeme pacient\u016fm nab\u00eddnout \u2013 o\u0161et\u0159en\u00ed hemoroid\u016f Barronovou ligaturou, l\u00e9\u010dbu hemoronem a nov\u011b tak\u00e9 o\u0161et\u0159en\u00ed uzl\u016f infra\u010dervenou fotokoagulac\u00ed. Z opera\u010dn\u00edch metod, krom klasick\u00e9 hemoroidektomie, hemoroid\u00e1ln\u00ed arteri\u00e1ln\u00ed ligaci a radiofrekven\u010dn\u00ed ablaci uzl\u016f.<\/p>\n

– Aktu\u00e1ln\u011b jsme d\u00edky nov\u00e9mu p\u0159\u00edstroji roz\u0161\u00ed\u0159ili nab\u00eddku \u0159e\u0161en\u00ed probl\u00e9mu s hemoroidy. P\u0159ibli\u017ete n\u00e1m, co je to infra\u010derven\u00e1 fotokoagulace ?<\/p>\n

Infra\u010derven\u00e1 fotokoagulace je semiinvazivn\u00ed metoda slou\u017e\u00edc\u00ed k o\u0161et\u0159en\u00ed hemoroid\u016f. Principem metody je koagulace tk\u00e1n\u011b infra\u010derven\u00fdm sv\u011btlem respektive z\u00e1\u0159en\u00edm. Koagulac\u00ed u b\u00e1ze hemoroidu vznikne nekr\u00f3za, kter\u00e1 omez\u00ed tok krve do hemoroid\u00e1ln\u00edho uzlu a z\u00e1rove\u0148 uzel fixuje v\u00fd\u0161e do anorekta. Je indikov\u00e1na u I. a II. st\u00e1dia onemocn\u011bn\u00ed. Je to metoda bezpe\u010dn\u00e1, bezbolestn\u00e1 a rychl\u00e1, prov\u00e1d\u00ed se ambulantn\u011b a nevy\u017eaduje pracovn\u00ed neschopnost, lze ji kombinovat i s jin\u00fdmi metodami.<\/p>\n

PETRA \u010cERNO
\nHavl\u00ed\u010dkobrodsk\u00fd den\u00edk
\nhttp:\/\/havlickobrodsky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Nemocnice v Havl\u00ed\u010dkov\u011b Brod\u011b zakoupila p\u0159\u00edstroj, kter\u00fd nab\u00edz\u00ed bezbolestn\u00e9 vy\u0161et\u0159en\u00ed<\/p>\n<\/div>","protected":false},"author":1,"featured_media":14888,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-25182","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\/25182","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=25182"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25182\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14888"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25182"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25182"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25182"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}