{"id":32954,"date":"2019-12-16T19:25:49","date_gmt":"2019-12-16T18:25:49","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=32954"},"modified":"2019-12-16T19:25:50","modified_gmt":"2019-12-16T18:25:50","slug":"mam-implantaty-a-spatne-se-mi-dycha-proc-jsem-nedostal-prukaz-ztp","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=32954","title":{"rendered":"M\u00e1m implant\u00e1ty a \u0161patn\u011b se mi d\u00fdch\u00e1. Pro\u010d jsem nedostal pr\u016fkaz ZTP?"},"content":{"rendered":"\n

DOTAZ: Je mi 60 let, m\u00e1m po operac\u00edch dvou kolenn\u00edch kloub\u016f – endoprot\u00e9zy, jsem pod dohledem kardiologa – ned\u00e1vno jsem prod\u011blal chirurgick\u00fd z\u00e1krok – m\u011bl jsem z\u00fa\u017eenou aortu – byla mi aplikov\u00e1na rourka. P\u0159i del\u0161\u00ed ch\u016fzi se zad\u00fdch\u00e1v\u00e1m, n\u011bkdy a\u017e k zalknut\u00ed. Nav\u0161t\u011bvuji plicn\u00ed ordinaci, pou\u017e\u00edv\u00e1m p\u011bt r\u016fzn\u00fdch tablet – medikamenty. Po\u017e\u00e1dal jsem o uzn\u00e1n\u00ed ZTP, bylo mi v\u0161e-zam\u00edtnuto. M\u016f\u017eete mi poradit – jak b\u00fdt zdrav\u00fd v dal\u0161\u00edch letech? Neb OSSZ v Karvin\u00e9 neuzn\u00e1v\u00e1 \u017e\u00e1dn\u00e9 nemoci. \u00a0<\/strong><\/p>\n\n\n\n

ODPOV\u011a\u010e<\/strong>: <\/p>\n\n\n\n

Va\u0161e \u017e\u00e1dost byla nepochybn\u011b zam\u00edtnuta proto, \u017ee v\u00e1\u0161 zdravotn\u00ed stav, jak jej popisujete, neodpov\u00edd\u00e1 indika\u010dn\u00edm krit\u00e9ri\u00edm pro p\u0159izn\u00e1n\u00ed pr\u016fkazu ZTP. To byste m\u011bl m\u00edt uvedeno v od\u016fvodn\u011bn\u00ed zam\u00edtnut\u00ed, v n\u011bm\u017e by m\u011bl posudkov\u00fd l\u00e9ka\u0159 uv\u00e9st, pro\u010d nepova\u017euje va\u0161e posti\u017een\u00ed za natolik z\u00e1va\u017en\u00e9, aby zakl\u00e1dalo n\u00e1rok na tento typ pr\u016fkazu..<\/p>\n\n\n\n

Uv\u00e1d\u00edte, \u017ee m\u00e1te kolenn\u00ed endoprot\u00e9zy, ty v\u0161ak neznamenaj\u00ed anatomickou ani funk\u010dn\u00ed ztr\u00e1tu kon\u010detin, naopak jde o implant\u00e1ty, kter\u00e9 obnovuj\u00ed funk\u010dnost kon\u010detin. Dal\u0161\u00ed implant\u00e1t m\u00e1te v aort\u011b. Op\u011bt jde o l\u00e9\u010debn\u00fd z\u00e1krok, kter\u00fd navrac\u00ed aort\u011b jej\u00ed funk\u010dnost a napravuje jej\u00ed anatomick\u00e9 abnormality. Tedy op\u011bt se nejedn\u00e1 o z\u00e1va\u017en\u00e9 anatomick\u00e9 nebo funk\u010dn\u00ed posti\u017een\u00ed. <\/p>\n\n\n\n

Nakonec uv\u00e1d\u00edte, \u017ee se p\u0159i del\u0161\u00ed ch\u016fzi zad\u00fdch\u00e1v\u00e1te. Vzhledem k tomu, \u017ee nav\u0161t\u011bvujete plicn\u00ed ordinaci, jedn\u00e1 se pravd\u011bpodobn\u011b o n\u00e1mahovou du\u0161nost plicn\u00edho typu. Pokud by se jednalo o t\u011b\u017ekou n\u00e1mahovou du\u0161nost, bylo by mo\u017en\u00e9 aplikovat krit\u00e9rium dle bodu i) „t\u011b\u017ek\u00e9 posti\u017een\u00ed pohyblivosti a celkov\u00e9 v\u00fdkonnosti ji\u017e p\u0159i lehk\u00e9m zat\u00ed\u017een\u00ed p\u0159i intern\u00edch a onkologick\u00fdch posti\u017een\u00edch“<\/strong>. Posudkov\u00fd l\u00e9ka\u0159 v\u0161ak stupe\u0148 z\u00e1va\u017enosti va\u0161\u00ed n\u00e1mahov\u00e9 du\u0161nosti nevyhodnotil jako odpov\u00eddaj\u00edc\u00ed definici dle v\u00fd\u0161e uveden\u00e9ho bodu i). Bez detailn\u011bj\u0161\u00edch informac\u00ed a vy\u0161et\u0159en\u00ed nelze va\u0161\u00ed n\u00e1mahov\u00e9 du\u0161nosti p\u0159i\u0159adit charakteristiku dle NYHA, nicm\u00e9n\u011b vzhledem k tomu, \u017ee si v t\u00e9to souvislosti st\u011b\u017eujete pouze na du\u0161nost po del\u0161\u00ed ch\u016fzi, usuzuji, \u017ee se nejedn\u00e1 o du\u0161nost IV typu dle NYHA, kdy se du\u0161nost vyskytuje ji\u017e p\u0159i minim\u00e1ln\u00ed n\u00e1maze i v klidu a je nezbytn\u00e1 pomoc druh\u00e9 osoby. P\u0159i tomto z\u00e1va\u017en\u00e9m stupni du\u0161nosti by byl n\u00e1rok na pr\u016fkaz ZTP. <\/p>\n\n\n\n

N\u00ed\u017ee uv\u00e1d\u00edme p\u0159ehled indikac\u00ed pro p\u0159izn\u00e1n\u00ed pr\u016fkazu ZTP, kde jsou kompletn\u011b pojmenov\u00e1ny v\u0161echny zdravotn\u00ed stavy, kter\u00e9 odpov\u00eddaj\u00ed t\u011b\u017ek\u00e9mu posti\u017een\u00ed, kde by m\u011bly b\u00fdt poskytnuty v\u00fdhody spojen\u00e9 s pr\u016fkazem ZTP.<\/p>\n\n\n\n

P\u0159izn\u00e1v\u00e1n\u00ed pr\u016fkazu ZTP se \u0159\u00edd\u00ed z\u00e1konem \u010d. 329\/2011 Sb. o poskytov\u00e1n\u00ed d\u00e1vek osob\u00e1m se zdravotn\u00edm posti\u017een\u00edm \u2013 HLAVA V \u2013 PR\u016eKAZ OSOBY SE ZDRAVOTN\u00cdM POSTI\u017dEN\u00cdM<\/p>\n\n\n\n

Indikace pro z\u00edsk\u00e1n\u00ed pr\u016fkazu ZTP<\/strong>
\nZa podstatn\u00e9 omezen\u00ed schopnosti pohyblivosti a orientace na \u00farovni t\u011b\u017ek\u00e9ho funk\u010dn\u00edho posti\u017een\u00ed pohyblivosti a orientace lze pova\u017eovat tyto zdravotn\u00ed stavy:<\/p>\n\n\n\n

a) anatomick\u00e1 ztr\u00e1ta doln\u00ed kon\u010detiny v kolenn\u00edm kloubu nebo v\u00fd\u0161e, exteri\u00e9rov\u00fd u\u017eivatel prot\u00e9zy,<\/p>\n\n\n\n

b) anatomick\u00e1 ztr\u00e1ta doln\u00edch kon\u010detin v n\u00e1rtech nebo v n\u00e1rtu a b\u00e9rci,<\/p>\n\n\n\n

c) funk\u010dn\u00ed ztr\u00e1ta doln\u00ed kon\u010detiny se ztr\u00e1tou op\u011brn\u00e9 funkce,<\/p>\n\n\n\n

d) anatomick\u00e1 ztr\u00e1ta doln\u00ed a horn\u00ed kon\u010detiny v \u00farovni b\u00e9rce a p\u0159edlokt\u00ed,<\/p>\n\n\n\n

e) anatomick\u00e1 ztr\u00e1ta horn\u00edch kon\u010detin v \u00farovni p\u0159edlokt\u00ed,<\/p>\n\n\n\n

f) t\u011b\u017ek\u00e9 omezen\u00ed funkce dvou kon\u010detin,<\/p>\n\n\n\n

g) posti\u017een\u00ed p\u00e1nve prov\u00e1zen\u00e9 t\u011b\u017ek\u00fdmi par\u00e9zami doln\u00edch kon\u010detin nebo z\u00e1va\u017enou nestabilitou p\u00e1nevn\u00edho prstence,<\/p>\n\n\n\n

h) posti\u017een\u00ed p\u00e1te\u0159e prov\u00e1zen\u00e9 t\u011b\u017ek\u00fdmi par\u00e9zami kon\u010detin nebo ztuhnut\u00edm t\u0159\u00ed \u00fasek\u016f p\u00e1te\u0159e nebo z\u00e1va\u017en\u00e9 deformity p\u00e1te\u0159e s omezen\u00edm exkurz\u00ed hrudn\u00edku,<\/p>\n\n\n\n

i) t\u011b\u017ek\u00e9 posti\u017een\u00ed pohyblivosti a celkov\u00e9 v\u00fdkonnosti ji\u017e p\u0159i lehk\u00e9m zat\u00ed\u017een\u00ed p\u0159i intern\u00edch a onkologick\u00fdch posti\u017een\u00edch,<\/p>\n\n\n\n

j) celkov\u00e1 ztr\u00e1ta sluchu podle Fowlera 85% a v\u00edce s neschopnost\u00ed sly\u0161et zvuky a rozum\u011bt \u0159e\u010di i p\u0159es nejlep\u0161\u00ed korekci (oboustrann\u00e1 praktick\u00e1 nebo \u00fapln\u00e1 hluchota) u osoby star\u0161\u00ed 18 let v\u011bku,<\/p>\n\n\n\n

k) kombinovan\u00e9 posti\u017een\u00ed sluchu a zraku (hluchoslepota) funk\u010dn\u011b v rozsahu oboustrann\u00e9 st\u0159edn\u011b t\u011b\u017ek\u00e9 nedosl\u00fdchavosti, kterou se rozum\u00ed ztr\u00e1ta sluchu podle Fowlera 40 a\u017e 65%, a oboustrann\u00e9 siln\u00e9 slabozrakosti, kterou se rozum\u00ed zrakov\u00e1 ostrost s nejlep\u0161\u00ed mo\u017enou korekc\u00ed na lep\u0161\u00edm oku, kdy maximum je men\u0161\u00ed ne\u017e 6\/60 a minimum rovn\u00e9 nebo lep\u0161\u00ed ne\u017e 3\/60, nebo oboustrann\u00e9 koncentrick\u00e9 z\u00fa\u017een\u00ed zorn\u00e9ho pole v rozsahu 30 a\u017e 10 stup\u0148\u016f, i kdy\u017e centr\u00e1ln\u00ed ostrost nen\u00ed posti\u017eena,<\/p>\n\n\n\n

l) oboustrann\u00e1 t\u011b\u017ek\u00e1 ztr\u00e1ta zraku, kterou se rozum\u00ed zrakov\u00e1 ostrost s korekc\u00ed, kdy maximum je men\u0161\u00ed ne\u017e 3\/60, minimum lep\u0161\u00ed ne\u017e 1\/60,<\/p>\n\n\n\n

m) psychick\u00e9 posti\u017een\u00ed s \u010dasto se opakuj\u00edc\u00edmi z\u00e1va\u017en\u00fdmi poruchami komunikace a orientace v exteri\u00e9ru v\u010detn\u011b st\u0159edn\u011b funk\u010dn\u00edho typu autismu,<\/p>\n\n\n\n

n) neurodegenerativn\u00ed posti\u017een\u00ed s mnoho\u010detn\u00fdmi hybn\u00fdmi komplikacemi typu rigidity, hypokin\u00e9zy, tremoru, ataxie, mimovoln\u00fdch pohyb\u016f.<\/p>\n\n\n\n

MUDr. Jan \u010cin\u010dura<\/p>\n","protected":false},"excerpt":{"rendered":"

DOTAZ: Je mi 60 let, m\u00e1m po operac\u00edch dvou kolenn\u00edch kloub\u016f – endoprot\u00e9zy, jsem pod dohledem kardiologa – ned\u00e1vno jsem prod\u011blal chirurgick\u00fd z\u00e1krok – m\u011bl […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":22862,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-32954","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/32954","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=32954"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/32954\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/22862"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=32954"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=32954"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=32954"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}