{"id":32556,"date":"2019-10-30T19:55:58","date_gmt":"2019-10-30T18:55:58","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=32556"},"modified":"2019-10-30T19:55:58","modified_gmt":"2019-10-30T18:55:58","slug":"bolest-lytek-je-prvni-varovani-s-pribyvajicim-vekem-hrozi-riziko-vazne-choroby","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=32556","title":{"rendered":"Bolest l\u00fdtek je prvn\u00ed varov\u00e1n\u00ed: S p\u0159ib\u00fdvaj\u00edc\u00edm v\u011bkem hroz\u00ed riziko v\u00e1\u017en\u00e9 choroby"},"content":{"rendered":"

Bolest nohou nen\u00ed dobr\u00e9 zanedb\u00e1vat. Pokud jste nesportovali a opakovan\u011b v\u00e1s bol\u00ed l\u00fdtka, m\u011bli byste zaj\u00edt k l\u00e9ka\u0159i, proto\u017ee oby\u010dejn\u00e1 bolest nohou m\u016f\u017ee signalizovat nebezpe\u010dnou ischemickou chorobu doln\u00edch kon\u010detin. P\u0159esn\u011b takov\u00fd probl\u00e9m za\u017eil 48let\u00fd Radek.<\/strong><\/p>\n

ilustra\u010dn\u00ed foto<\/em><\/p>\n

Byl jsem opravdu aktivn\u00ed, chodil na ryby, pat\u0159il jsem k myslivc\u016fm, tak\u017ee jsem \u010dasto chodil na hony. Prvn\u00ed v\u011bc, kterou jsem zaznamenal a kv\u016fli kter\u00e9 jsem si za\u010dal \u0159\u00edkat, \u017ee mo\u017en\u00e1 nen\u00ed v\u0161e v po\u0159\u00e1dku, byla bolest sval\u016f na nohou, kdy\u017e jsem \u0161el po ulici. Musel jsem se zastavit a odpo\u010d\u00edvat ka\u017ed\u00fdch p\u00e1r des\u00edtek metr\u016f. To se postupn\u011b hor\u0161ilo, pak u\u017e to bylo kolikr\u00e1t i po p\u00e1r kroc\u00edch. Nev\u011bd\u011bl jsem, co se d\u011bje.<\/p>\n

Jednoho dne, kdy jsem \u0161el na ryby, jsem musel dol\u016f k \u0159ece sej\u00edt hodn\u011b schod\u016f. Kdy\u017e jsem se po t\u011bch schodech vracel zp\u011bt, vy\u0161el jsem p\u011bt schod\u016f \u2013 a konec. Nohy p\u0159estaly fungovat. Musel jsem si odpo\u010dinout, a a\u017e pak jsem ud\u011blal dal\u0161\u00ed kroky. Nejsp\u00ed\u0161 u\u017e svaly v t\u00e9 chv\u00edli nem\u011bly dostatek krve, ale to jsem v t\u00e9 dob\u011b je\u0161t\u011b netu\u0161il.<\/p>\n

Nejsem typ \u010dlov\u011bka, kter\u00fd jenom f\u0148uk\u00e1 nebo hned s ka\u017ed\u00fdm \u0161kr\u00e1bnut\u00edm b\u011b\u017e\u00ed k l\u00e9ka\u0159i, ale tohle m\u011b docela tr\u00e1pilo. B\u00e1l jsem se, \u017ee se d\u011bje n\u011bco \u0161patn\u00e9ho, a proto jsem \u0161el na vy\u0161et\u0159en\u00ed. Dostal jsem se na intravaskul\u00e1rn\u00ed ultrazvuk obou nohou, d\u00edky \u010demu\u017e mohl l\u00e9ka\u0159 prozkoumat tepny. Nebylo to nijak bolestiv\u00e9, ale ultrazvuk bohu\u017eel prok\u00e1zal, \u017ee jsou tepny ucpan\u00e9 a lev\u00e1 noha je na tom h\u016f\u0159e ne\u017e prav\u00e1. L\u00e9ka\u0159 mi \u0159ekl, \u017ee bude pot\u0159eba c\u00e9vy vy\u010distit chirurgick\u00fdm zp\u016fsobem, tedy endarterektomi\u00ed, p\u0159i n\u00ed\u017e se zpr\u016fchodn\u00ed tepny posti\u017een\u00e9 ateroskler\u00f3zou. Ta zp\u016fsobila kornat\u011bn\u00ed tepen.<\/p>\n

Byl jsem z toho nerv\u00f3zn\u00ed, ale l\u00e9ka\u0159 m\u011b ujistil, \u017ee to bude bezpe\u010dn\u00e9 a pom\u016f\u017ee mi to. M\u011bl pravdu. Od t\u00e9 chv\u00edle moje nohy ka\u017ed\u00fdm dnem s\u00edlily. Pokud by m\u011bl n\u011bkdo podobn\u00e9 p\u0159\u00edznaky, rozhodn\u011b bych mu \u0159ekl, a\u0165 neodkl\u00e1d\u00e1 n\u00e1v\u0161t\u011bvu l\u00e9ka\u0159e. Po\u0159\u00e1d jsem si myslel, \u017ee se to zlep\u0161\u00ed, ale jen se to zhor\u0161ovalo. L\u00e9ka\u0159 \u0159\u00edkal, \u017ee pot\u00e9 n\u00e1sleduje f\u00e1ze, kdy nohy bol\u00ed i v klidu, hlavn\u011b v noci, a m\u016f\u017ee to skon\u010dit ztr\u00e1tou kon\u010detiny. Te\u010f u\u017e se ale c\u00edt\u00edm mnohem l\u00e9pe, tak snad to vydr\u017e\u00ed.<\/p>\n

Jak se nemoc l\u00e9\u010d\u00ed?<\/p>\n

C\u00edlem je zlep\u0161en\u00ed pr\u016ftoku tepnami a zachov\u00e1n\u00ed kon\u010detiny. L\u00e9\u010dba je zam\u011b\u0159ena na odstran\u011bn\u00ed nebo alespo\u0148 zm\u00edrn\u011bn\u00ed rizikov\u00fdch faktor\u016f a zlep\u0161en\u00ed prokrven\u00ed kon\u010detiny. V z\u00e1vislosti na stupni posti\u017een\u00ed je terapie konzervativn\u00ed nebo interven\u010dn\u00ed. Konzervativn\u00ed l\u00e9\u010dba zahrnuje intervalov\u00fd tr\u00e9nink, medikamentozn\u00ed l\u00e9\u010dbu, vasodilata\u010dn\u00ed infuze.<\/p>\n

Typ interven\u010dn\u00ed revaskulariza\u010dn\u00ed terapie z\u00e1vis\u00ed na typu a rozsahu posti\u017een\u00ed tepen. Jsou pou\u017e\u00edv\u00e1ny interven\u010dn\u00ed radiologick\u00e9 metody, jako je balonkov\u00e1 angioplastika prost\u00e1 nebo se stentem \u010di s pou\u017eit\u00edm rotabl\u00e1toru. Chirurgick\u00e9 revaskularizace zahrnuj\u00ed rekonstrukce tepen, endarterektomie \u010di by-passy.<\/p>\n

P\u0159i selh\u00e1n\u00ed terapie doch\u00e1z\u00ed bohu\u017eel ke ztr\u00e1t\u011b kon\u010detiny. Navzdory sou\u010dasn\u00e9 p\u00e9\u010di podstoup\u00ed u n\u00e1s ro\u010dn\u011b netraumatickou amputaci asi 3000 nemocn\u00fdch. U diabetik\u016f je riziko 10\u201320x vy\u0161\u0161\u00ed ne\u017e u nediabetik\u016f.<\/p>\n

(Zdroj: Nemocnice Na Homolce)<\/p>\n

Informace o nemoci<\/p>\n

*Ischemick\u00e1 choroba doln\u00edch kon\u010detin (ICHDK) je spole\u010dn\u00e9 ozna\u010den\u00ed pro zhor\u0161en\u00e9 prokrven\u00ed tk\u00e1n\u00ed doln\u00edch kon\u010detin.<\/p>\n

*Nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou nemoci je ateroskler\u00f3za (kornat\u011bn\u00ed tepen). Je zodpov\u011bdn\u00e1 p\u0159ibli\u017en\u011b za 90 % p\u0159\u00edpad\u016f chronick\u00e9 ICHDK.<\/p>\n

*P\u0159i nemoci se m\u011bn\u00ed c\u00e9vn\u00ed st\u011bny a tvo\u0159\u00ed se tukov\u00e9 pl\u00e1ty na vnit\u0159n\u00edch st\u011bn\u00e1ch tepen. Jejich zv\u011bt\u0161ov\u00e1n\u00edm se postupn\u011b uzav\u00edr\u00e1 tepna a zmen\u0161uje pr\u016ftok okysli\u010den\u00e9 krve. Vnit\u0159n\u00ed povrch tepny p\u0159est\u00e1v\u00e1 b\u00fdt hladk\u00fd a ztr\u00e1c\u00ed svou nesm\u00e1\u010divost, co\u017e vede k usazov\u00e1n\u00ed krevn\u00edch desti\u010dek a mo\u017enosti tvorby krevn\u00edch sra\u017eenin, kter\u00e9 mohou tepnu n\u00e1hle uzav\u0159\u00edt.<\/p>\n

*Mezi rizikov\u00e9 faktory pat\u0159\u00ed kou\u0159en\u00ed, cukrovka, vysok\u00e1 hladina tuk\u016f a cholesterolu v krevn\u00edm \u0159e\u010di\u0161ti a vysok\u00fd krevn\u00ed tlak.<\/p>\n

*Probl\u00e9my s tepnami nohou se zpo\u010d\u00e1tku projevuj\u00ed pouze pocitem chladn\u00fdch nohou, pot\u00e9 se p\u0159id\u00e1 ob\u010dasn\u00e9 kulh\u00e1n\u00ed. P\u0159i ch\u016fzi se dostav\u00ed svalov\u00e1 a\u017e k\u0159e\u010dovit\u00e1 bolest v l\u00fdtku, ob\u010das i ve stehn\u011b. Kdy\u017e se \u010dlov\u011bk zastav\u00ed, bolest zmiz\u00ed.<\/p>\n

*Okysli\u010den\u00e1 krev se nedok\u00e1\u017ee dostat k pracuj\u00edc\u00edm sval\u016fm a nesta\u010d\u00ed kr\u00fdt jejich zv\u00fd\u0161enou pot\u0159ebu kysl\u00edku, a proto svaly bol\u00ed. Jakmile p\u0159estane sval pracovat, zmen\u0161\u00ed se jeho metabolismus a bolest ustoup\u00ed. Je to podobn\u00e9 jako bolest na hrudi p\u0159i ischemick\u00e9 chorob\u011b srdce (angina pectoris). V dal\u0161\u00ed f\u00e1zi bol\u00ed nohy i v klidu.<\/p>\n

*V posledn\u00ed f\u00e1zi je stav prokrven\u00ed posti\u017een\u00e9 kon\u010detiny u\u017e kritick\u00fd, objevuj\u00ed se svalov\u00e9 z\u00e1\u0161kuby a k\u0159e\u010de. Nemocn\u00fd je ohro\u017een odum\u0159en\u00edm tk\u00e1n\u00ed. V t\u00e9to f\u00e1zi m\u016f\u017ee doj\u00edt a\u017e k amputaci.<\/p>\n

Den\u00edk.cz
\nhttps:\/\/www.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Bolest nohou nen\u00ed dobr\u00e9 zanedb\u00e1vat. Pokud jste nesportovali a opakovan\u011b v\u00e1s bol\u00ed l\u00fdtka, m\u011bli byste zaj\u00edt k l\u00e9ka\u0159i, proto\u017ee oby\u010dejn\u00e1 bolest nohou m\u016f\u017ee signalizovat nebezpe\u010dnou […]<\/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":[9],"tags":[],"class_list":["post-32556","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\/32556","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=32556"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/32556\/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=32556"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=32556"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=32556"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}