Praha, 9. 12. 2020 \u2013 Pandemie koronaviru prohnala \u010desk\u00e9 zdravotnictv\u00ed \u201eurychlova\u010dem\u201c a definitivn\u011b zm\u011bnila jeho tv\u00e1\u0159. V\u00a0n\u011bkolika m\u011bs\u00edc\u00edch muselo akceptovat a prod\u011blat zm\u011bny, na n\u011b\u017e by si za obvykl\u00fdch podm\u00ednek zvykalo je\u0161t\u011b n\u011bkolik let. P\u0159edev\u0161\u00edm v\u00a0oblasti modern\u00edch technologi\u00ed a tolik sklo\u0148ovan\u00e9 telemedic\u00edny. Zat\u00edmco n\u011bkte\u0159\u00ed l\u00e9ka\u0159i si zaveden\u00ed telemedic\u00edny pochvaluj\u00ed, jin\u00ed poukazuj\u00ed na jej\u00ed z\u00e1sadn\u00ed nedostatky \u2013 zejm\u00e9na v oblast\u00a0plic.<\/p>\n\n\n\n
\u201ePlicn\u00ed l\u00e9ka\u0159stv\u00ed je jedn\u00edm z posledn\u00edch obor\u016f, kde je nutn\u00e9 si pacienta poslechnout fonendoskopem, jen tak z\u00edsk\u00e1me informace pot\u0159ebn\u00e9 pro stanoven\u00ed diagn\u00f3zy \u2013 nap\u0159\u00edklad astmatu. Toto prvotn\u00ed vy\u0161et\u0159en\u00ed nelze ud\u011blat nad\u00e1lku. A stejn\u00e9 je to s kontrolami ji\u017e diagnostikovan\u00fdch pacient\u016f \u2013 tak\u0159ka bez v\u00fdjimky pou\u017e\u00edv\u00e1me tzv. spirometrii, kter\u00e1 n\u00e1m ukazuje, v jak\u00e9 kondici pl\u00edce jsou. P\u0159esto\u017ee nyn\u00ed b\u011b\u017e\u00ed ve sv\u011bt\u011b \u0159ada studi\u00ed, kdy se zkou\u0161\u00ed zaveden\u00ed dom\u00e1c\u00ed spirometrie, rutinn\u011b se tyto metody nepou\u017e\u00edvaj\u00ed. Nejsou p\u0159\u00edstroje a tak\u00e9 je velmi t\u011b\u017ek\u00e9 prov\u00e9st m\u011b\u0159en\u00ed v dom\u00e1c\u00edm prost\u0159ed\u00ed spr\u00e1vn\u011b,\u201c \u0159\u00edk\u00e1 MUDr. Milan Sova, Ph.D., p\u0159edseda \u010cesk\u00e9 aliance proti chronick\u00fdm respira\u010dn\u00edm onemocn\u011bn\u00edm (\u010cARO). <\/p>\n\n\n\n
Nen\u00ed pochyb o tom, \u017ee pandemie rozmetala jistoty \u010desk\u00e9ho pacienta a zasela strach, \u017ee se v m\u00edst\u011b, kde by se m\u011bl do\u010dkat pomoci, m\u016f\u017ee potkat s potenci\u00e1ln\u011b nebezpe\u010dn\u00fdm virem. \u201ePneumologov\u00e9 jsou p\u0159itom zvykl\u00ed, \u017ee do ordinace m\u016f\u017ee p\u0159ij\u00edt \u010dlov\u011bk s naka\u017elivou nemoc\u00ed typu tuberkul\u00f3za, a proto \u2013 d\u00e1vno p\u0159ed koronavirem \u2013 dodr\u017euj\u00ed p\u0159\u00edsn\u00e9 hygienick\u00e9 podm\u00ednky. V \u010dek\u00e1rn\u00e1ch obvykle sed\u00ed jen omezen\u00fd po\u010det lid\u00ed, ambulance b\u00fdvaj\u00ed vzd\u00e1len\u00e9 od ostatn\u00edch, v\u0161e se neust\u00e1le dezinfikuje. Lid\u00e9 jsou u l\u00e9ka\u0159\u016f paradoxn\u011b ve v\u011bt\u0161\u00edm bezpe\u010d\u00ed ne\u017e nap\u0159\u00edklad v pr\u00e1ci,\u201c pokra\u010duje pneumolog s t\u00edm, \u017ee pr\u00e1v\u011b u plicn\u00edch nemoc\u00ed m\u016f\u017ee ignorov\u00e1n\u00ed prvotn\u00edch probl\u00e9m\u016f dopadnou fat\u00e1ln\u011b. Nap\u0159\u00edklad u chronick\u00e9 obstruk\u010dn\u00ed plicn\u00ed nemoci pneumologov\u00e9 odhaduj\u00ed, \u017ee 300 000 lid\u00ed nemoc m\u00e1, ale nev\u00ed o n\u00ed, du\u0161nost ignoruje, k l\u00e9ka\u0159i nejde a nel\u00e9\u010d\u00ed se. Pandemie ochotu lid\u00ed zaj\u00edt za l\u00e9ka\u0159em dramaticky zbrzdila. Je\u0161t\u011b hor\u0161\u00ed je situace u rakoviny plic, kde kolem 80 % lid\u00ed p\u0159ijde pozd\u011b, v dob\u011b, kdy u\u017e nen\u00ed mo\u017en\u00e9 n\u00e1dor operovat. \u201eKa\u017ed\u00fd m\u011bs\u00edc prodlen\u00ed p\u0159edstavuje u karcinomu plic v\u00fdrazn\u011b negativn\u00ed prognostick\u00fd marker. Jin\u00fdmi slovy, \u010d\u00edm pozd\u011bji \u010dlov\u011bk p\u0159ijde, t\u00edm men\u0161\u00ed m\u00e1 \u0161ance na diagn\u00f3zu, l\u00e9\u010dbu a p\u0159e\u017eit\u00ed nebo i vyl\u00e9\u010den\u00ed. Stanovit diagn\u00f3zu po telefonu, p\u0159es e-mail nebo video by si \u017e\u00e1dn\u00fd z koleg\u016f netroufl, fyzick\u00e1 p\u0159\u00edtomnost pacienta v ordinaci je naprosto nutn\u00e1,\u201c popisuje omezen\u00ed telemedic\u00edny p\u0159edsedkyn\u011b \u010cesk\u00e9 pneumologick\u00e9 a ftizeologick\u00e9 spole\u010dnosti prof. MUDr. Martina Va\u0161\u00e1kov\u00e1, Ph.D. <\/p>\n\n\n\n
Podle\nMUDr. Sovy letos p\u0159i\u0161lo do ambulanc\u00ed plicn\u00edch l\u00e9ka\u0159\u016f odhadem o p\u011btinu lid\u00ed m\u00e9n\u011b\nne\u017e v roce 2019 \u2013 p\u0159\u00ed\u010dinu vid\u00ed pr\u00e1v\u011b ve strachu z n\u00e1kazy\nv ordinaci.<\/p>\n\n\n\n
Dal\u0161\u00edm p\u0159\u00edkladem, kdy se telemedic\u00edna ukazuje b\u00fdt dobr\u00fdm sluhou, ale \u0161patn\u00fdm p\u00e1nem, je sp\u00e1nkov\u00e1 medic\u00edna. \u201eZde m\u00e1 telemedic\u00edna sv\u00e9 nezpochybniteln\u00e9 m\u00edsto t\u0159eba u pacient\u016f s poruchami d\u00fdch\u00e1n\u00ed ve sp\u00e1nku, kdy je mo\u017en\u00e9 je na d\u00e1lku sledovat a n\u00e1sledn\u011b upravovat jejich l\u00e9\u010dbu. Na druhou stranu covid-19 na ja\u0159e zcela zmrazil \u010dinnost sp\u00e1nkov\u00fdch pracovi\u0161\u0165 a v r\u00e1mci zah\u00e1jen\u00ed l\u00e9\u010dby n\u00e1m telemedic\u00edna p\u0159\u00edli\u0161 nepom\u016f\u017ee,\u201c dopl\u0148uje MUDr. Sova, kter\u00fd je z\u00e1rove\u0148 vedouc\u00edm laborato\u0159e sp\u00e1nkov\u00e9 medic\u00edny Fakultn\u00ed nemocnice Olomouc. Podle odborn\u00edk\u016f tak vypadlo asi 20 % p\u00e9\u010de, kter\u00e1 u\u017e nebude nahrazena \u2013 nelze ji dohonit a n\u00e1sledky se projev\u00ed pozd\u011bji v podob\u011b r\u016fzn\u00fdch chronick\u00fdch onemocn\u011bn\u00ed. Covid-19 omezil tak\u00e9 \u010dinnost plicn\u00edch rehabilitac\u00ed, kter\u00e9 jsou pro zlep\u0161en\u00ed stavu pacienta z\u00e1sadn\u00ed \u2013 ani zde nelze pacienta o\u0161et\u0159it pouze vzd\u00e1len\u011b. \u201ePlicn\u00ed rehabilitace se skl\u00e1d\u00e1 p\u0159edev\u0161\u00edm z pohybov\u00e9 l\u00e9\u010dby \u2013 vytrvalostn\u00edho a silov\u00e9ho tr\u00e9ninku a z technik respira\u010dn\u00ed fyzioterapie. K nim jsou p\u0159id\u00e1v\u00e1ny i dal\u0161\u00ed koncepty, u mnoh\u00fdch z nich je nezbytn\u00e1 kontrola proveden\u00ed techniky a dopomoc s cvi\u010den\u00edm p\u0159\u00edmo od terapeuta \u2013 jako nap\u0159. manu\u00e1ln\u00ed o\u0161et\u0159en\u00ed tk\u00e1n\u00ed hrudn\u00edku pomoc\u00ed m\u011bkk\u00fdch a mobiliza\u010dn\u00edch technik \u010di n\u00e1cvik d\u00fdch\u00e1n\u00ed p\u0159es dechov\u00e9 trena\u017e\u00e9ry, co\u017e se p\u0159es obrazovku ud\u011blat ned\u00e1. Bez o\u0161et\u0159en\u00ed t\u011bchto tk\u00e1n\u00ed \u010dasto nelze zlep\u0161it dechov\u00fd vzor. Krom\u011b toho si pacient paradoxn\u011b m\u016f\u017ee \u0161patn\u011b prov\u00e1d\u011bn\u00fdm cvi\u010den\u00edm ubl\u00ed\u017eit,\u201c \u0159\u00edk\u00e1 fyzioterapeutka doc. Mgr. Kate\u0159ina Neumannov\u00e1, Ph.D., z Fakulty t\u011blesn\u00e9 kultury Univerzity Palack\u00e9ho s t\u00edm, \u017ee u plicn\u00edch pacient\u016f se nav\u00edc kontroluje b\u011bhem vytrvalostn\u00edho tr\u00e9ninku tepov\u00e1 frekvence i saturace hemoglobinu kysl\u00edkem.<\/p>\n\n\n\n
Jedinou oblast\u00ed, kde podle p\u0159edsedy \u010cARO m\u016f\u017ee telemedic\u00edna fungovat bezchybn\u011b, je p\u0159edepisov\u00e1n\u00ed medikace stabiln\u00edm pacient\u016fm.<\/p>\n\n\n\n
Tiskov\u00e1 zpr\u00e1va<\/p>\n","protected":false},"excerpt":{"rendered":"
Praha, 9. 12. 2020 \u2013 Pandemie koronaviru prohnala \u010desk\u00e9 zdravotnictv\u00ed \u201eurychlova\u010dem\u201c a definitivn\u011b zm\u011bnila jeho tv\u00e1\u0159. V\u00a0n\u011bkolika m\u011bs\u00edc\u00edch muselo akceptovat a prod\u011blat zm\u011bny, na n\u011b\u017e […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":21911,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-35517","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\/35517","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=35517"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/35517\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/21911"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=35517"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=35517"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=35517"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}