{"id":28181,"date":"2017-05-11T14:39:37","date_gmt":"2017-05-11T12:39:37","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=28181"},"modified":"2017-05-11T14:39:37","modified_gmt":"2017-05-11T12:39:37","slug":"mam-cirhozu-jater-na-jaky-stupen-id-mam-narok","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=28181","title":{"rendered":"M\u00e1m cirh\u00f3zu jater. Na jak\u00fd stupe\u0148 ID m\u00e1m n\u00e1rok?"},"content":{"rendered":"

Dotaz:<\/strong>
\n Jak\u00fd stupe\u0148 invalidity bych p\u0159\u00edpadn\u011b mohla dostat p\u0159i cirh\u00f3ze jater? I m\u00e1 praktick\u00e1 l\u00e9ka\u0159ka mi doporu\u010duje, abych si za\u017e\u00e1dala, ale po\u0159\u00e1d si nejsem jist\u00e1, jestli bych m\u011bla v\u016fbec n\u00e1rok.<\/strong>
\n
\nOdpov\u011b\u010f:<\/p>\n

Bohu\u017eel neuv\u00e1d\u00edte, v jak\u00e9 f\u00e1zi Va\u0161e cirh\u00f3za jater je, jak moc V\u00e1s omezuje apod., nen\u00ed proto mo\u017en\u00e9 jednozna\u010dn\u011b \u0159\u00edci, zda n\u00e1rok na ID m\u00e1te \u010di ne.<\/p>\n

Pravdou ale je, \u017ee lid\u00e9 s posti\u017een\u00edm jater z pravidla m\u00edt n\u00e1rok na n\u011bkter\u00fd ze t\u0159\u00ed stup\u0148\u016f invalidn\u00edho d\u016fchodu mohou.<\/p>\n

Pro \u00faplnost uv\u00e1d\u00edm v\u0161echny t\u0159i stupn\u011b invalidn\u00edho d\u016fchodu a k nim p\u0159i\u0159azen\u00e9 poklesy pracovn\u00ed schopnosti v procentech a z\u00e1rove\u0148 tak\u00e9 v\u0161echny posti\u017een\u00ed jater s procentu\u00e1ln\u00edm poklesem. Jedn\u00e1 se o zdravotn\u00ed krit\u00e9ria, na z\u00e1klad\u011b kter\u00fdch L\u00e9ka\u0159sk\u00e1 posudkov\u00e1 slu\u017eba \u010cSSZ rozhoduje o n\u00e1roku na invalidn\u00ed d\u016fchod:<\/p>\n

Poji\u0161t\u011bnec je invalidn\u00ed, jestli\u017ee z d\u016fvodu dlouhodob\u011b nep\u0159\u00edzniv\u00e9ho zdravotn\u00edho stavu nastal pokles jeho pracovn\u00ed schopnosti nejm\u00e9n\u011b o 35 %.
\nJestli\u017ee pracovn\u00ed schopnost poji\u0161t\u011bnce poklesla
\na. nejm\u00e9n\u011b o 35 %, av\u0161ak nejv\u00edce o 49 %, jedn\u00e1 se o invaliditu prvn\u00edho stupn\u011b,
\nb. nejm\u00e9n\u011b o 50 %, av\u0161ak nejv\u00edce o 69 %, jedn\u00e1 se o invaliditu druh\u00e9ho stupn\u011b,
\nc. nejm\u00e9n\u011b o 70 %, jedn\u00e1 se o invaliditu t\u0159et\u00edho stupn\u011b.<\/p>\n

POSTI\u017dEN\u00cd JATER<\/p>\n

Polo\u017eka
\nDruh zdravotn\u00edho posti\u017een\u00ed
\nM\u00edra poklesu pracovn\u00ed schopnosti v %<\/p>\n

1
\nAutoimunitn\u00ed hepatitida, hepatopatie jin\u00e9 ne\u017e virov\u00e9 etiologie, nealkoholick\u00e1 steatohepatitida, prim\u00e1rn\u00ed bili\u00e1rn\u00ed cirh\u00f3za, prim\u00e1rn\u00ed sklerotizuj\u00edc\u00ed cholangoitida, alkoholick\u00e9 posti\u017een\u00ed jater, jatern\u00ed steat\u00f3za, jatern\u00ed steatofibr\u00f3za, jatern\u00ed cirh\u00f3za, toxick\u00e9 po\u0161kozen\u00ed jater, po\u0161kozen\u00ed chemick\u00fdmi l\u00e1tkami
\nPosudkov\u00e9 hledisko:
\nP\u0159i stanoven\u00ed m\u00edry poklesu pracovn\u00ed schopnosti je nutno zhodnotit funk\u010dn\u00ed kapacitu jater (podle biochemick\u00e9 a histologick\u00e9 aktivity z\u00e1n\u011btliv\u00e9 a fibrotick\u00e9), pokro\u010dilost a aktivitu procesu, rychlost progrese, poruchy metabolismu, p\u0159\u00edpadn\u00e9 mimojatern\u00ed projevy, stav v\u00fd\u017eivy, \u00fanavu, toleranci z\u00e1t\u011b\u017ee, dopad na celkovou v\u00fdkonnost a schopnost vykon\u00e1vat denn\u00ed aktivity. Pro hodnocen\u00ed jatern\u00ed cirh\u00f3zy se vyu\u017e\u00edv\u00e1 Child Pughova klasifikace, pro alkoholickou hepatitidu DF diskrimina\u010dn\u00ed funkce nebo Glasgow Alcoholic Hepatitis score.<\/p>\n

1a
\nlehk\u00e9 poruchy,
\nbez komplikac\u00ed, bez mimojatern\u00edch projev\u016f, s lehce sn\u00ed\u017eenou v\u00fdkonnost\u00ed, s \u00fanavou
\n15-20%<\/p>\n

1b
\nst\u0159edn\u011b t\u011b\u017ek\u00e9 poruchy,
\nse sn\u00ed\u017eenou funk\u010dn\u00ed kapacitou jater, kompenzovan\u00e1 jatern\u00ed cirh\u00f3za, leh\u010d\u00ed mimojatern\u00ed projevy, v\u00fdznamn\u00e1 dlouhodob\u00e1 \u00fanava, se zna\u010dn\u00fdm sn\u00ed\u017een\u00edm celkov\u00e9 v\u00fdkonnosti p\u0159i obvykl\u00e9m zat\u00ed\u017een\u00ed, n\u011bkter\u00e9 denn\u00ed aktivity vykon\u00e1v\u00e1ny s obt\u00ed\u017eemi nebo omezeny, podle rozsahu poruch a omezen\u00ed
\n30-45%<\/p>\n

1c
\nt\u011b\u017ek\u00e9 poruchy,
\nt\u011b\u017ek\u00e1 porucha kapacity jater, metabolismu, v\u00fd\u017eivy, rozvoj jatern\u00ed cirh\u00f3zy – klasifikace Child-Pugh A, funk\u010dn\u011b v\u00fdznamn\u00e9 mimojatern\u00ed projevy, podstatn\u00e9 omezen\u00ed celkov\u00e9 v\u00fdkonnosti p\u0159i lehk\u00e9m zat\u00ed\u017een\u00ed, neschopnost vykon\u00e1vat n\u011bkter\u00e9 denn\u00ed aktivity
\n60%<\/p>\n

1d
\nzvl\u00e1\u0161\u0165 t\u011b\u017ek\u00e9 poruchy,
\ndekompenzov\u00e1n\u00e1 jatern\u00ed cirh\u00f3za – klasifikace Child-Pugh B, C, t\u011b\u017ek\u00e9 mimojatern\u00edmi projevy nebo kone\u010dn\u00e1 stadia, jatern\u00ed insuficience, termin\u00e1ln\u00ed f\u00e1ze jatern\u00edho selh\u00e1n\u00ed
\n70-80%<\/p>\n

2
\nWilsonova choroba
\nPosudkov\u00e9 hledisko:
\nP\u0159i stanoven\u00ed m\u00edry poklesu pracovn\u00ed schopnosti je nutno zhodnotit, zda jde o formu neurologicko-psychiatrickou, kde se m\u00edra poklesu pracovn\u00ed schopnosti stanov\u00ed podle kapitoly V. nebo VI., nebo formu jatern\u00ed, kde se m\u00edra poklesu pracovn\u00ed schopnosti stanov\u00ed srovnateln\u011b podle polo\u017eky 1, odd\u00edl F, kapitola XI.<\/p>\n

3
\nHeredit\u00e1rn\u00ed hemochromat\u00f3za
\nPosudkov\u00e9 hledisko:
\nP\u0159i stanoven\u00ed m\u00edry poklesu pracovn\u00ed schopnosti je nutno zhodnotit formy manifestace. U formy jatern\u00ed se m\u00edra poklesu pracovn\u00ed schopnosti stanov\u00ed srovnateln\u011b podle polo\u017eky 1, odd\u00edl F, kapitola XI, u formy s manifestac\u00ed diabet\u016f podle polo\u017eky 2, kapitola IV, u formy s p\u0159eva\u017euj\u00edc\u00edmi p\u0159\u00edznaky kardiomyopatie podle kapitoly IX.<\/p>\n

4
\nPorfyrie
\nPosudkov\u00e9 hledisko:
\nP\u0159i stanoven\u00ed m\u00edry poklesu pracovn\u00ed schopnosti je nutno zhodnotit pokro\u010dilost a t\u00ed\u017ei jatern\u00edho po\u0161kozen\u00ed. M\u00edra poklesu pracovn\u00ed schopnosti se stanov\u00ed srovnateln\u011b podle polo\u017eky 1, odd\u00edl F, kapitola XI.<\/p>\n

5
\nTransplantace jater<\/p>\n

5a
\ndo stabilizace zdravotn\u00edho stavu a jatern\u00edch funkc\u00ed
\n70%<\/p>\n

5b
\npo dosa\u017een\u00ed stabilizace zdravotn\u00edho stavu, p\u0159i stabilizaci jatern\u00edch funkc\u00ed, podle omezen\u00ed celkov\u00e9 v\u00fdkonnosti, rozsahu a stupn\u011b p\u0159\u00edpadn\u00fdch komplikac\u00ed
\n40-60%<\/p>\n

5c
\nselh\u00e1v\u00e1n\u00ed transplantovan\u00e9ho org\u00e1nu
\n70-80%<\/p>\n

Ji\u0159\u00ed Marek
\ninvArena<\/p>\n","protected":false},"excerpt":{"rendered":"

Dotaz: Jak\u00fd stupe\u0148 invalidity bych p\u0159\u00edpadn\u011b mohla dostat p\u0159i cirh\u00f3ze jater? I m\u00e1 praktick\u00e1 l\u00e9ka\u0159ka mi doporu\u010duje, abych si za\u017e\u00e1dala, ale po\u0159\u00e1d si nejsem jist\u00e1, […]<\/a><\/p>\n<\/div>","protected":false},"author":3,"featured_media":14888,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18,9],"tags":[],"class_list":["post-28181","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28181","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\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28181"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28181\/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=28181"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28181"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28181"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}