Nov\u00fd l\u00e9\u010debn\u00fd postup p\u0159in\u00e1\u0161\u00ed skv\u011bl\u00e9 v\u00fdsledky u nemocn\u00fdch po d\u011btsk\u00e9 mozkov\u00e9 obrn\u011b. Ro\u010dn\u011b se u n\u00e1s narod\u00ed a\u017e 300 d\u011bt\u00ed s mozkovou obrnou. V\u011bt\u0161inu z nich cel\u00fd \u017eivot prov\u00e1z\u00ed bolesti, mnoh\u00e9 z\u016fstanou na invalidn\u00edch voz\u00edc\u00edch a pozd\u011bji kon\u010d\u00ed v soci\u00e1ln\u00edch \u00fastavech. Speci\u00e1ln\u00ed baclofenov\u00e1 pumpa jim v\u0161ak m\u016f\u017ee z\u00e1sadn\u011b zm\u011bnit \u017eivot.<\/p>\n
Nikole Murkov\u00e9 bylo dvan\u00e1ct let. Zat\u00edmco jej\u00ed kamar\u00e1dky mohou b\u011bhat po h\u0159i\u0161ti, ona je odk\u00e1zan\u00e1 na invalidn\u00ed voz\u00edk. Bez n\u011bj se nepostav\u00ed, plaz\u00ed se po \u010dty\u0159ech. Um\u00fdvat i obl\u00e9kat ji mus\u00ed m\u00e1ma. Nikola se narodila p\u0159ed\u010dasn\u011b, v 29. t\u00fddnu t\u011bhotenstv\u00ed. „Do jej\u00edch dvou let jsem netu\u0161ila, \u017ee m\u00e1 n\u011bjak\u00fd probl\u00e9m. Jen le\u017eela, neh\u00fdbala se. Pozd\u011bji se za\u010dala i plazit, ale nohy tahala za sebou. Tenkr\u00e1t ale l\u00e9ka\u0159i tvrdili, \u017ee to v\u0161echno do\u017eene,“ vypr\u00e1v\u011bla Nikol\u010dina matka Martina Murkov\u00e1.<\/p>\n
A\u017e v l\u00e1zn\u00edch se pan\u00ed Murkov\u00e1 dozv\u011bd\u011bla, \u017ee jej\u00ed dvoulet\u00e1 dcera m\u00e1 mozkovou obrnu. Z\u00e1hy prod\u011blala prvn\u00ed operaci nohou na uvoln\u011bn\u00ed svalov\u00e9ho nap\u011bt\u00ed. Pak n\u00e1sledovaly dal\u0161\u00ed a dal\u0161\u00ed operace: prav\u00e9 ruky, kolene, kotn\u00edku, pod kolenem… „P\u0159i sedm\u00e9m nebo osm\u00e9m z\u00e1kroku jsem p\u0159estala po\u010d\u00edtat, kolik jich celkem bylo,“ \u0159ekla pan\u00ed Murkov\u00e1.<\/p>\n
Operace m\u011bly Nikole pomoci od spasm\u016f, co\u017e jsou \u010dasto velmi bolestiv\u00e9 k\u0159e\u010de a neovladateln\u00e9 pohyby sval\u016f. „Po ka\u017ed\u00e9 operaci sice p\u0159i\u0161lo zlep\u0161en\u00ed, ale i kdy\u017e jsme poctiv\u011b cvi\u010dily, \u010dasem se spasmy vr\u00e1tily. Bylo to, jako by Nikola ud\u011blala t\u0159i kroky vp\u0159ed a pak zase jeden zp\u011bt,“ popisovala v\u00fdsledky operac\u00ed Martina Murkov\u00e1.<\/p>\n
Z\u00e1sadn\u00ed pokrok v l\u00e9\u010db\u011b d\u011btsk\u00e9 mozkov\u00e9 obrny ale p\u0159edstavovalo voperov\u00e1n\u00ed baclofenov\u00e9 pumpy. Pr\u00e1v\u011b tu dostala i Nikola. V\u00fdsledky l\u00e9\u010dby si d\u00edvka ani matka nemohly vynachv\u00e1lit. Ustoupily bolesti a k\u0159e\u010de, d\u00edky tomu Nikola byla mnohem pohybliv\u011bj\u0161\u00ed. „Mohu oh\u00fdbat nohy a zvedat ruce, nic m\u011b nebol\u00ed,“ \u0159ekla \u0161\u0165astn\u011b.<\/p>\n
„Nikolka byla v\u017edycky takov\u00e1 skr\u010den\u00e1 a kdy\u017e jsem ji vid\u011bla potom, p\u0159ipadala mi stra\u0161n\u011b velik\u00e1,“ \u0159ekla jej\u00ed matka a vysv\u011btluje, \u017ee d\u00edky l\u00e9\u010db\u011b baclofenovou pumpou m\u016f\u017ee dcera sed\u011bt vzp\u0159\u00edmen\u011b, a vypad\u00e1 tak mnohem v\u011bt\u0161\u00ed ne\u017e p\u0159ed p\u00e1r m\u011bs\u00edci. „Je taky komunikativn\u011bj\u0161\u00ed, proto\u017ee povolilo nap\u011bt\u00ed sval\u016f v obli\u010deji a Nikolka dok\u00e1\u017ee l\u00e9pe artikulovat,“ \u0159ekla.<\/p>\n
Pumpa se implantuje do vytvo\u0159en\u00e9 kapsy v podko\u017e\u00ed, na ni pak navazuje katetr. V\u0161e je ovl\u00e1d\u00e1no program\u00e1torem, a to bezbolestn\u011b p\u0159es k\u016f\u017ei. Pomoc\u00ed tohoto syst\u00e9mu je l\u00e9k v naprogramovan\u00fdch minid\u00e1vk\u00e1ch dopravov\u00e1n p\u0159\u00edmo do p\u00e1te\u0159n\u00edho kan\u00e1lu a p\u016fsob\u00ed tak p\u0159\u00edmo na m\u00edchu.<\/p>\n
Samotn\u00e1 operace, p\u0159i kter\u00e9 se pumpa implantuje do t\u011bla pacienta, se prov\u00e1d\u00ed v celkov\u00e9 anestezii a trv\u00e1 n\u011bkolik hodin. Neurochirurg speci\u00e1ln\u00ed jehlou zavede silikonov\u00fd katetr do p\u00e1te\u0159n\u00edho kan\u00e1lu, do prostoru, kde mozkom\u00ed\u0161n\u00ed mok om\u00fdv\u00e1 m\u00edchu. Do podko\u017e\u00ed b\u0159i\u0161n\u00ed st\u011bny voperuje pumpu. Na z\u00e1v\u011br prot\u00e1hne katetr vrstvou podko\u017e\u00ed k pump\u011b a navz\u00e1jem je propoj\u00ed.<\/p>\n
Po operaci n\u00e1sleduje rekonvalescence, n\u00e1sledn\u011b rehabilitace, kontroly pumpy a dopl\u0148ov\u00e1n\u00ed l\u00e9ku. Jak \u010dasto je pot\u0159eba \u00fa\u010dinnou l\u00e1tku dod\u00e1vat, z\u00e1vis\u00ed na pot\u0159eb\u00e1ch ka\u017ed\u00e9ho pacienta. Dopl\u0148uje se pomoc\u00ed jehly zaveden\u00e9 p\u0159es k\u016f\u017ei do pumpy, \u017eivotnost pumpy, respektive baterie uvnit\u0159, je a\u017e osm let; pak je nutn\u00e9 ji vym\u011bnit.
\nN\u011bkdy je nutn\u00e9 kv\u016fli opakovan\u00fdm infekc\u00edm pumpu odstranit. Po \u010dase ji lze ale znovu implantovat. A v\u011bt\u0161ina pacient\u016f o jej\u00ed navr\u00e1cen\u00ed stoj\u00ed.<\/p>\n
Pumpa m\u00e1 m\u00e9n\u011b ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f <\/strong> Je-li baclofen pod\u00e1v\u00e1n v tabletov\u00e9 form\u011b, dost\u00e1v\u00e1 se do krve p\u0159es \u017ealudek. V krvi pak cirkuluje, ale t\u011b\u017eko p\u0159ekon\u00e1v\u00e1 rozhran\u00ed mezi c\u00e9vn\u00edm \u0159e\u010di\u0161t\u011bm a nervovou tk\u00e1n\u00ed. Aby tuto „bari\u00e9ru“ p\u0159ekonal, je nutn\u00e9 pacientovi pod\u00e1vat velk\u00e9 d\u00e1vky l\u00e9ku. Ty maj\u00ed ale \u010dasto ne\u017e\u00e1douc\u00ed \u00fa\u010dinky. Nap\u0159\u00edklad z\u00e1vra\u0165, zvracen\u00ed, \u00fatlum, ospalost, zmatenost, probl\u00e9my s pam\u011bt\u00ed a pozornost\u00ed.<\/p>\n Cesta k baclofenov\u00e9 pump\u011b za\u010d\u00edn\u00e1 u d\u011btsk\u00e9ho l\u00e9ka\u0159e. Pokud ten u d\u00edt\u011bte odhal\u00ed p\u0159\u00edznaky d\u011btsk\u00e9 mozkov\u00e9 obrny, je pacient v p\u00e9\u010di d\u011btsk\u00e9 neurologie, rehabilitace a dal\u0161\u00edch odborn\u00edk\u016f. Pokud u n\u011bj sel\u017ee klasick\u00e1 l\u00e9\u010dba formou tablet, nebo se nemoc zhor\u0161uje, m\u011bl by b\u00fdt pacient odesl\u00e1n na specializovan\u00e9 vy\u0161et\u0159en\u00ed do motolsk\u00e9 nemocnice. To je jedin\u00e9 pracovi\u0161t\u011b v \u010cesku, kde d\u011bti t\u00edmto zp\u016fsobem l\u00e9\u010d\u00ed. Zde prob\u00edh\u00e1 dal\u0161\u00ed testov\u00e1n\u00ed, kter\u00e9 sleduje neurolog, neurochirurg, fyzioterapeut a rodi\u010de d\u00edt\u011bte.<\/p>\n Vhodn\u00fdm pacientem je kvadruplegik se zv\u00fd\u0161en\u00fdm svalov\u00fdm nap\u011bt\u00edm horn\u00edch i doln\u00edch kon\u010detin. Operaci zvl\u00e1dne u\u017e t\u0159\u00edlet\u00e9 d\u00edt\u011b. Ne\u017e se rozhodne o implantaci pumpy, je nutn\u00e9 prov\u00e9st takzvan\u00fd baclofenov\u00fd test, kdy doktor zaveden\u00edm do\u010dasn\u00e9ho katetru do p\u00e1te\u0159n\u00edho kan\u00e1lu ov\u011b\u0159\u00ed, jak pacient reaguje na l\u00e9k. Pot\u00e9 n\u00e1sleduje mnohdy zdlouhav\u00e1 administrativa mezi nemocnic\u00ed a poji\u0161\u0165ovnou. Kdy\u017e ta n\u00e1klady na operaci schv\u00e1l\u00ed, pacient je operov\u00e1n. Pokud jde v\u0161e dob\u0159e, m\u016f\u017ee se pacient do\u010dkat operace za t\u0159i a\u017e \u0161est m\u011bs\u00edc\u016f. Velk\u00e1 \u010d\u00e1st pacient\u016f, kte\u0159\u00ed jsou v ran\u00e9m v\u011bku pohybliv\u00ed, ale l\u00e9\u010d\u00ed se konzervativn\u00edmi postupy, kon\u010d\u00ed pozd\u011bji v soci\u00e1ln\u00edch \u00fastavech s t\u011b\u017ek\u00fdm pokroucen\u00edm t\u011bla. Pokud se s l\u00e9\u010dbou za\u010dne v\u010das, je mo\u017en\u00e9 p\u0159edej\u00edt pok\u0159iven\u00ed kon\u010detin, nebo alespo\u0148 v\u00fdrazn\u011b zpomalit takov\u00fd v\u00fdvoj.<\/p>\n Proto \u010d\u00edm d\u0159\u00edve se s touto l\u00e9\u010debnou metodou za\u010dne, t\u00edm l\u00e9pe, pumpu je mo\u017en\u00e9 implantovat i velmi mal\u00fdm d\u011btem, a to u\u017e od t\u0159\u00ed let. Velk\u00fd probl\u00e9m je slo\u017eit\u00e9 financov\u00e1n\u00ed operace. Jedn\u00e1 se o n\u00e1kladnou l\u00e9\u010dbu pro poji\u0161\u0165ovny i pro zdravotnick\u00e9 za\u0159\u00edzen\u00ed, kter\u00e9 l\u00e9\u010dbu prov\u00e1d\u00ed. Poji\u0161\u0165ovnu operace p\u0159ijde na p\u016fl milionu korun, dal\u0161\u00ed \u0159\u00e1dov\u011b tis\u00edce korun ro\u010dn\u011b stoj\u00ed dopl\u0148ov\u00e1n\u00ed l\u00e9\u010div\u00e9 l\u00e1tky. D\u00edky operaci se v\u0161ak v\u00fdrazn\u011b zlep\u0161\u00ed kvalita \u017eivota nejen pacienta, ale i cel\u00e9 rodiny. D\u00edt\u011b se m\u016f\u017ee d\u00e1l rozv\u00edjet a nap\u0159\u00edklad nastoupit do \u0161koly. Rodi\u010de, kte\u0159\u00ed se dosud o nemocn\u00e9ho starali, se mohou vr\u00e1tit do pr\u00e1ce. Pozd\u011bji m\u016f\u017ee pracovat i samotn\u00fd pacient. Podle zahrani\u010dn\u00edch studi\u00ed zlep\u0161en\u00ed kvality \u017eivota pacienta a jeho rodiny jednozna\u010dn\u011b ospravedl\u0148uje n\u00e1klady na l\u00e9\u010dbu p\u0159i srovn\u00e1n\u00ed s konzervativn\u00edm postupem.<\/p>\n –<\/p>\n","protected":false},"excerpt":{"rendered":" Nov\u00fd l\u00e9\u010debn\u00fd postup p\u0159in\u00e1\u0161\u00ed skv\u011bl\u00e9 v\u00fdsledky u nemocn\u00fdch po d\u011btsk\u00e9 mozkov\u00e9 obrn\u011b. Ro\u010dn\u011b se u n\u00e1s narod\u00ed a\u017e 300 d\u011bt\u00ed s mozkovou obrnou. V\u011bt\u0161inu z […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":459,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-456","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/456","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=456"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/456\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/459"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=456"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=456"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=456"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nV \u010dem spo\u010d\u00edv\u00e1 v\u00fdhoda pumpy oproti klasick\u00e9 l\u00e9\u010db\u011b? Pokud je l\u00e9k do t\u011bla p\u0159iv\u00e1d\u011bn katetrem p\u0159\u00edmo do m\u00ed\u0161n\u00edho kan\u00e1lku, sta\u010d\u00ed k terapii a\u017e tis\u00edckr\u00e1t ni\u017e\u0161\u00ed d\u00e1vky, p\u0159itom \u00fa\u010dinnost je nesrovnateln\u011b vy\u0161\u0161\u00ed.<\/p>\n
\nKrom\u011b toho se pacient zbav\u00ed bolestiv\u00fdch k\u0159e\u010d\u00ed. No\u010dn\u00ed bolesti vymiz\u00ed, zlep\u0161\u00ed se sp\u00e1nek, p\u0159\u00edpadn\u011b \u0159e\u010d a pacient se o s\u00e1m o sebe dok\u00e1\u017ee l\u00e9pe postarat.<\/p>\n