Nemoc zk\u0159iven\u00fdch prst\u016f komplikuje u n\u00e1s \u017eivot a\u017e 300 000 lid\u00ed, zejm\u00e9na t\u011bch star\u0161\u00edch. Posti\u017een\u00e9 vazivov\u00e9 tk\u00e1n\u011b dramaticky omezuj\u00ed \u010dlov\u011bka v nejb\u011b\u017en\u011bj\u0161\u00edch ka\u017edodenn\u00edch \u010dinnostech, ke kter\u00fdm pot\u0159ebuje ruce.
\n<\/p>\n
Kdy\u017e se Tom\u00e1\u0161ovi Kocmanovi (35) objevil na dlani pod k\u016f\u017e\u00ed uzl\u00edk, nev\u011bnoval tomu moc velkou pozornost. „Je to typick\u00fd p\u0159\u00edstup v\u011bt\u0161iny pacient\u016f, kter\u00fdmi \u010dast\u011bji b\u00fdvaj\u00ed mu\u017ei,“ vysv\u011btluje MUDr. Ale\u0161 Fib\u00edr, prim\u00e1\u0159 odd\u011blen\u00ed plastick\u00e9 chirurgie na chirurgick\u00e9 klinice ve FN v Hradci Kr\u00e1lov\u00e9. \u010casem Tom\u00e1\u0161 nemohl \u00fapln\u011b nat\u00e1hnout prost\u0159edn\u00ed\u010dek a prsten\u00ed\u010dek, pozd\u011bji ani mal\u00ed\u010dek.
\nZa\u0161el proto za MUDr. Petrou Indr\u00e1kovou z ortopedick\u00e9 kliniky \u00dast\u0159edn\u00ed vojensk\u00e9 nemocnice v Praze-St\u0159e\u0161ovic\u00edch. Ta ho vy\u0161et\u0159ila a vysv\u011btlila mu, \u017ee m\u00e1 nemoc zk\u0159iven\u00fdch prst\u016f, tedy Dupuytrenovu kontrakturu. Nej\u010dast\u011bji postihuje lidi od pades\u00e1ti let v\u00fd\u0161, ale n\u011bkdy potr\u00e1p\u00ed i mlad\u0161\u00ed ro\u010dn\u00edky.
\nTom\u00e1\u0161 Kocman m\u011bl u\u017e v tu dobu probl\u00e9my se v\u0161emi aktivitami, kter\u00e9 vy\u017eadovaly pln\u011b nata\u017een\u00e9 prsty. Do sv\u00fdch motork\u00e1\u0159sk\u00fdch rukavic se dostal jen s obt\u00ed\u017eemi a vsunout ruku do \u00fazk\u00fdch prostor ve sv\u00e9 d\u00edln\u011b bylo u\u017e skoro nemo\u017en\u00e9. Kdy\u017e je \u010dlov\u011bk zdrav\u00fd, obvykle si neuv\u011bdomuje, k \u010demu v\u0161emu pot\u0159ebuje ohebn\u00e9 prsty. <\/p>\n
Nemoc se vrac\u00ed <\/p>\n
Pan Kocman si mohl vybrat jedno ze dvou \u0159e\u0161en\u00ed. Bu\u010f operaci, ta byla doned\u00e1vna nej\u010dast\u011bj\u0161\u00edm zp\u016fsobem l\u00e9\u010dby, nebo injekci se spe -ci\u00e1ln\u00edm enzymem. P\u0159edstavuje v\u00fdhodn\u011bj\u0161\u00ed a modern\u011bj\u0161\u00ed postup. Zdravotn\u00ed poji\u0161\u0165ovny ji u\u017e dnes za ur\u010dit\u00fdch podm\u00ednek hrad\u00ed, tehdy v\u0161ak za ni musel je\u0161t\u011b platit. M\u011bl d\u00e1t za dv\u011b injekce 50 000 K\u010d. Proto v\u00e1hal. L\u00e9ka\u0159ka ho nakonec p\u0159esv\u011bd\u010dila, \u017ee nov\u00e1 l\u00e9\u010dba nen\u00ed jen pro pacienta p\u0159\u00edjemn\u011bj\u0161\u00ed, ale je tak\u00e9 bezpe\u010dn\u011bj\u0161\u00ed. A obvykle se d\u00e1 bez velk\u00fdch probl\u00e9m\u016f zopakovat, pokud je to nutn\u00e9. To b\u00fdv\u00e1 d\u016fle\u017eit\u00e9, proto\u017ee choroba m\u00e1 sklon se vracet.
\nS opakov\u00e1n\u00edm operace je to slo\u017eit\u011bj\u0161\u00ed. P\u0159i n\u00ed se posti\u017een\u00e1 vazivov\u00e1 tk\u00e1\u0148 mus\u00ed bu\u010fto p\u0159etnout, nebo je nutn\u00e9 uzl\u00edky a zbytn\u011bl\u00e9 vazivov\u00e9 pruhy odstranit. „Probl\u00e9m b\u00fdv\u00e1 v tom, \u017ee t\u011bmi m\u00edsty vede spousta nerv\u016f, \u0161lach, c\u00e9v a dal\u0161\u00edch tk\u00e1n\u00ed, kter\u00e9 chirurg m\u016f\u017ee po\u0161kodit, i kdy\u017e je zru\u010dn\u00fd a d\u00e1v\u00e1 si maxim\u00e1ln\u00ed pozor,“ vysv\u011btluje doktor Fib\u00edr. „Operace p\u0159edstavuje radik\u00e1ln\u00ed \u0159e\u0161en\u00ed. N\u011bkdy je ale slo\u017eit\u00e9 ji zopakovat, nav\u00edc s ka\u017ed\u00fdm dal\u0161\u00edm z\u00e1krokem se zvy\u0161uje riziko poopera\u010dn\u00edch komplikac\u00ed.“ <\/p>\n
Enzym p\u016fsob\u00ed rychle <\/p>\n
Doktorka Indr\u00e1kov\u00e1 dala Tom\u00e1\u0161i Kocmanovi injekci nejprve do vazivov\u00fdch pruh\u016f, kter\u00e9 vedly k prost\u0159edn\u00ed\u010dku a prsten\u00ed\u010dku. Speci\u00e1ln\u00ed enzym um\u00ed selektivn\u011b rozpustit kolagen, kter\u00fd tvo\u0159\u00ed hlavn\u00ed slo\u017eku pruh\u016f, je\u017e omezuj\u00ed pohyb. Druh\u00fd den p\u0159i\u0161el do jej\u00ed ambulance znovu. L\u00e9ka\u0159ka mu v m\u00edstn\u00edm umrtven\u00ed prsty postupn\u011b napnula, a\u017e v nich jemn\u011b luplo. Z\u016fstaly narovnan\u00e9 \u2013 a vada byla pry\u010d. M\u00edrn\u00fd otok a mod\u0159iny, kter\u00e9 b\u00fdvaj\u00ed pr\u016fvodn\u00edm jevem p\u016fsoben\u00ed enzymu, b\u011bhem t\u00fddne samy od sebe zmizely.
\nTom\u00e1\u0161 Kocman musel je\u0161t\u011b rehabilitovat a na noc si d\u00e1val dlahu. Dr\u017eela mu prsty narovnan\u00e9. Pozd\u011bji zopakovali to sam\u00e9 s mal\u00ed\u010dkem. Dnes nepoci\u0165uje \u017e\u00e1dn\u00e9 pot\u00ed\u017ee a je r\u00e1d, \u017ee zvolil novou metodu. Je \u0161etrn\u011bj\u0161\u00ed, m\u00e9n\u011b rizikov\u00e1 a m\u00e1 dlouhotrvaj\u00edc\u00ed efekt. Tak\u00e9 pracovn\u00ed neschopnost po n\u00ed b\u00fdv\u00e1 v\u00fdrazn\u011b krat\u0161\u00ed, jeden a\u017e dva t\u00fddny m\u00edsto obvykl\u00fdch dvou a\u017e t\u0159\u00ed m\u011bs\u00edc\u016f, kter\u00e9 v\u011bt\u0161inou vy\u017eaduje rekonvalescence po operaci. <\/p>\n
Choroba \u010dast\u011bji tr\u00e1p\u00ed mu\u017ee <\/p>\n
Nemoc zk\u0159iven\u00fdch prst\u016f tr\u00e1p\u00ed v \u010cR odhadem 200 000 a\u017e 300 000 lid\u00ed, obvykle star\u0161\u00edch. V\u00edc postihuje mu\u017ee (pom\u011br \u017een a mu\u017e\u016f b\u00fdv\u00e1 zhruba 1:6). Co je bezprost\u0159edn\u00ed p\u0159\u00ed\u010dinou jej\u00edho vzniku, to l\u00e9ka\u0159i p\u0159esn\u011b nev\u011bd\u00ed. Ur\u010dit\u011b se na n\u00ed pod\u00edl\u00ed d\u011bdi\u010dnost, velmi pravd\u011bpodobn\u011b tak\u00e9 cukrovka a dal\u0161\u00ed vlivy.
\nPrvn\u00edmi sign\u00e1ly choroby b\u00fdvaj\u00ed uzly nebo vazivov\u00e9 pruhy na dlani, kter\u00e9 si nahmat\u00e1te pod k\u016f\u017e\u00ed. Postupn\u011b za\u010dnou omezovat pohyb posti\u017een\u00fdch prst\u016f. K l\u00e9ka\u0159i je dobr\u00e9 zaj\u00edt u\u017e p\u0159i prvn\u00edch p\u0159\u00edznac\u00edch, proto\u017ee je d\u016fle\u017eit\u00e9 neprop\u00e1st spr\u00e1vn\u00fd okam\u017eik pro zah\u00e1jen\u00ed l\u00e9\u010dby. \u010casnou formu Dupuytrenovy kontraktury, kter\u00e1 zat\u00edm neomezuje pohyb prst\u016f nebo nep\u016fsob\u00ed jin\u00e9 funk\u010dn\u00ed obt\u00ed\u017ee, nen\u00ed nutn\u00e9 n\u011bjak ovliv\u0148ovat. Obvykle sta\u010d\u00ed sledovat, jak se vyv\u00edj\u00ed. S l\u00e9\u010dbou l\u00e9ka\u0159i za\u010d\u00ednaj\u00ed ve chv\u00edli, kdy se projev\u00ed prvn\u00ed pot\u00ed\u017ee p\u0159i natahov\u00e1n\u00ed prst\u016f. Tehdy m\u00e1 nejlep\u0161\u00ed a obvykle i nejtrvalej\u0161\u00ed efekty. L\u00e9\u010dit posti\u017een\u00e9ho v pokro\u010dilej\u0161\u00edch stadi\u00edch, kdy jsou prsty hodn\u011b a trvale ohnut\u00e9, b\u00fdv\u00e1 slo\u017eit\u011bj\u0161\u00ed a v\u00fdsledky nemus\u00ed b\u00fdt tak jednozna\u010dn\u00e9.
\nD\u016fle\u017eit\u00e9 je rovn\u011b\u017e to, aby pacient podstoupil z\u00e1krok u specialisty, kter\u00fd s n\u00edm m\u00e1 dost zku\u0161enost\u00ed. T\u0159eba chirurga, jen\u017e se zab\u00fdv\u00e1 chirurgi\u00ed ruky. Nov\u00e1 metoda l\u00e9\u010d\u00ed i zak\u0159iven\u00fd penis <\/p>\n
Injekce se speci\u00e1ln\u00edm enzymem se d\u00e1 pou\u017e\u00edt i u Peyronieho choroby. U n\u00ed se vytv\u00e1\u0159ej\u00ed jizevnat\u00e1 lo\u017eiska na obalech topo\u0159iv\u00fdch t\u011bles penisu (na jejich horn\u00ed plo\u0161e nebo po stran\u00e1ch), kter\u00e1 zp\u016fsobuj\u00ed nep\u0159irozen\u00e9 zak\u0159iven\u00ed penisu p\u0159i erekci. Do stran nebo nahoru, a to dokonce a\u017e v \u00fahlu 90\u00b4. „Pr\u00e1v\u011b tyto v\u011bt\u0161\u00ed deformace b\u00fdvaj\u00ed pro mu\u017ee bolestiv\u00e9, nejen p\u0159i erekci, ale n\u011bkdy i v klidu,“ vysv\u011btluje MUDr. Libor Z\u00e1me\u010dn\u00edk, PhD., prim\u00e1\u0159 Urologick\u00e9 kliniky VFN Praha. „Nav\u00edc mu \u010dasto komplikuj\u00ed pohlavn\u00ed styk nebo mu v n\u011bm br\u00e1n\u00ed.“ To m\u016f\u017ee v\u00e1\u017en\u011b naru\u0161it pacientovu psychiku i jeho intimn\u00ed \u017eivot. Choroba obvykle postihuje mu\u017ee u\u017e kolem \u010dty\u0159ic\u00edtky a s v\u011bkem po\u010det p\u0159\u00edpad\u016f stoup\u00e1. L\u00e9ka\u0159i odhaduj\u00ed, \u017ee jich m\u016f\u017ee b\u00fdt i v\u00edc ne\u017e 50 000.
\nStejn\u011b jako u nemoci zak\u0159iven\u00fdch prst\u016f ani v tomto p\u0159\u00edpad\u011b nejsou p\u0159\u00ed\u010diny choroby jasn\u00e9. L\u00e9\u010dila se dosud jen obt\u00ed\u017en\u011b, proto\u017ee operace penisu znamenala je\u0161t\u011b v\u011bt\u0161\u00ed riziko ne\u017e u rukou a jej\u00ed efekt nebyl zaru\u010den. Injekce s enzymem rozpust\u00ed i v tomto p\u0159\u00edpad\u011b kolagenov\u00e1 lo\u017eiska, kter\u00e1 jsou p\u0159\u00ed\u010dinou pot\u00ed\u017e\u00ed. Obvykle t\u00edm v\u00fdrazn\u011b zlep\u0161\u00ed jeho stav a n\u011bkdy ho \u00fapln\u011b vyl\u00e9\u010d\u00ed. „Nov\u00e1 metoda je velmi \u0161etrn\u00e1 a p\u0159itom \u00fa\u010dinn\u00e1, zdravotn\u00ed poji\u0161\u0165ovny ji ale zat\u00edm nehrad\u00ed,“ \u0159\u00edk\u00e1 doktor Z\u00e1me\u010dn\u00edk.<\/p>\n
PETR VESEL\u00dd
\nSTYL \u2013 Pr\u00e1vo<\/p>\n","protected":false},"excerpt":{"rendered":"
Nemoc zk\u0159iven\u00fdch prst\u016f komplikuje u n\u00e1s \u017eivot a\u017e 300 000 lid\u00ed, zejm\u00e9na t\u011bch star\u0161\u00edch. Posti\u017een\u00e9 vazivov\u00e9 tk\u00e1n\u011b dramaticky omezuj\u00ed \u010dlov\u011bka v nejb\u011b\u017en\u011bj\u0161\u00edch ka\u017edodenn\u00edch \u010dinnostech, ke […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":21763,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-27300","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\/27300","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=27300"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/27300\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/21763"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27300"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27300"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27300"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}