Ischemick\u00e1 choroba doln\u00edch kon\u010detin za\u010d\u00edn\u00e1 nen\u00e1padn\u011b. P\u0159i ch\u016fzi v\u00e1s bol\u00ed l\u00fdtka, i kdy\u017e jste p\u0159edchoz\u00edho dne ur\u010dit\u011b neub\u011bhli p\u00e1r kilometr\u016f. Pocit studen\u00fdch nohou je nep\u0159\u00edjemn\u00fd, ale \u010demu se divit, kdy\u017e u\u017e v\u00e1m nen\u00ed dvacet. Pomalou ch\u016fzi a ob\u010dasn\u00e9 zastavov\u00e1n\u00ed pova\u017eujete za p\u0159irozenou sou\u010d\u00e1st st\u00e1rnut\u00ed. Lid\u00e9 se s nebezpe\u010dnou ischemickou chorobou doln\u00edch kon\u010detin k l\u00e9ka\u0159i mnohdy dostanou, a\u017e kdy\u017e je onemocn\u011bn\u00ed v pokro\u010dil\u00e9m st\u00e1diu. P\u0159itom u posledn\u00ed f\u00e1ze nemoci hroz\u00ed a\u017e amputace kon\u010detiny. \u0160patn\u00e9 prokrven\u00ed nohou se proto vyplat\u00ed rozpoznat a \u0159e\u0161it zav\u010das.<\/p>\n\n\n\n
P\u0159i ischemick\u00e9 chorob\u011b doln\u00edch kon\u010detin (ICHDK) doch\u00e1z\u00ed k jejich nedostate\u010dn\u00e9mu prokrvov\u00e1n\u00ed. Hlavn\u00ed p\u0159\u00ed\u010dinou je ateroskler\u00f3za, tedy takzvan\u00e9 \u201ekornat\u011bn\u00ed\u201c tepen. Ateroskler\u00f3za postihuje v\u0161echny tepny v t\u011ble, nejen ty v kon\u010detin\u00e1ch. Ale pr\u00e1v\u011b u nich lid\u00e9 riziko \u010dasto podce\u0148uj\u00ed. P\u0159itom jde o stejn\u00e9 onemocn\u011bn\u00ed, kter\u00e9 p\u0159i posti\u017een\u00ed mozkov\u00fdch tepen zp\u016fsobuje mozkovou mrtvici a v p\u0159\u00edpad\u011b koron\u00e1rn\u00edch tepen zap\u0159\u00ed\u010di\u0148uje srde\u010dn\u00ed infarkt.<\/p>\n\n\n\n
Co je ischemick\u00e1 choroba doln\u00edch kon\u010detin<\/p>\n\n\n\n
V\u00fdskyt ischemick\u00e9 choroby doln\u00edch kon\u010detin roste s v\u011bkem. \u201ePostihuje 13 % populace ve v\u011bku mezi 55 a 75 lety, p\u0159i\u010dem\u017e vrchol je u mu\u017e\u016f kolem 70 let v\u011bku,\u201c uv\u00e1d\u00ed pra\u017esk\u00e1 Nemocnice Na Homolce.<\/p>\n\n\n\n
Na vnit\u0159n\u00edch st\u011bn\u00e1ch tepen se za\u010dnou tvo\u0159it tukov\u00e9 pl\u00e1ty, tak\u017ee c\u00e9va se zu\u017euje a pr\u016ftok okysli\u010den\u00e9 krve zmen\u0161uje. Hroz\u00ed tvorba krevn\u00edch sra\u017eenin, kter\u00e9 mohou tepnu n\u00e1hle uzav\u0159\u00edt.<\/p>\n\n\n\n
\u201ePod pojmem ICHDK zahrnujeme krom\u011b b\u0159i\u0161n\u00ed aorty tak\u00e9 p\u00e1nevn\u00ed tepenn\u00e9 \u0159e\u010di\u0161t\u011b, stehenn\u00ed tepnu a podkolenn\u00ed tepnu s b\u00e9rcov\u00fdm tepenn\u00fdm \u0159e\u010di\u0161t\u011bm. Nej\u010dast\u011bji, z 90 procent, se setk\u00e1v\u00e1me s ateroskler\u00f3zou tepen doln\u00edch kon\u010detin,\u201c \u0159ekl pro Den\u00edk v \u010dl\u00e1nku Nejz\u00e1va\u017en\u011bj\u0161\u00ed komplikac\u00ed je ztr\u00e1ta kon\u010detiny chirurg Milan Bart\u00e1\u0161ek.<\/p>\n\n\n\n
P\u0159\u00ed\u010diny vzniku ICHDK<\/p>\n\n\n\n
Hlavn\u00edmi rizikov\u00fdmi faktory ischemick\u00e9 choroby doln\u00edch kon\u010detin jsou kou\u0159en\u00ed, cukrovka, vysok\u00e1 hladina tuk\u016f a cholesterolu v krevn\u00edm \u0159e\u010di\u0161ti, vysok\u00fd krevn\u00ed tlak a svoji roli hraje i genetika.<\/p>\n\n\n\n
\u201eObezita tak\u00e9 nep\u0159\u00edmo pat\u0159\u00ed mezi rizikov\u00e9 faktory sv\u00fdm spojen\u00edm s vysok\u00fdm krevn\u00edm tlakem a poruchou metabolismu tuk\u016f,\u201c uv\u00e1d\u00ed l\u00e9ka\u0159i z Homolky.<\/p>\n\n\n\n
Z v\u00fd\u010dtu rizikov\u00fdch faktor\u016f je tedy z\u0159ejm\u00e9, \u017ee a\u017e na genetiku je mo\u017en\u00e9 tomuto onemocn\u011bn\u00ed p\u0159edch\u00e1zet.<\/p>\n\n\n\n
\u201eSna\u017ete se dos\u00e1hnout a udr\u017eet optim\u00e1ln\u00ed hmotnost pro v\u00e1\u0161 typ posty a v\u011bk. Pravideln\u011b cvi\u010dte, minimalizujte stres a udr\u017eujte sv\u016fj krevn\u00ed tlak i cholesterol ve zdrav\u00fdch mez\u00edch. V p\u0159\u00edpad\u011b onemocn\u011bn\u00ed typu diabetes nezanedb\u00e1vejte l\u00e9\u010dbu,\u201c rad\u00ed, jak sn\u00ed\u017eit rizikov\u00e9 faktory, web akademick\u00e9ho l\u00e9ka\u0159sk\u00e9ho centra Cleveland Clinic.<\/p>\n\n\n\n
P\u0159\u00edznaky ischemick\u00e9 choroby doln\u00edch kon\u010detin<\/p>\n\n\n\n
Existuj\u00ed \u010dty\u0159i stupn\u011b nemoci. ICHDK je nejprve bez klinick\u00fdch projev\u016f, tak\u017ee o n\u00ed nemocn\u00fd nemus\u00ed v\u016fbec v\u011bd\u011bt.<\/p>\n\n\n\n
1. stupe\u0148: Tepenn\u00e9 posti\u017een\u00ed bez klinick\u00fdch projev\u016f. Prov\u00e1z\u00ed ho pocit chladn\u00fdch nohou a ztr\u00e1ta ochlupen\u00ed na kon\u010detin\u00e1ch.<\/p>\n\n\n\n
2. stupe\u0148: K\u0159e\u010dovit\u00e1 bolest svalstva se objev\u00ed po ur\u010dit\u00e9m intervalu ch\u016fze. Po zastaven\u00ed bolest b\u011bhem p\u00e1r sekund a\u017e minut odezn\u00edv\u00e1. Je z\u00e1visl\u00e1 na ch\u016fzi nebo cvi\u010den\u00ed.<\/p>\n\n\n\n
3. stupe\u0148: Stadium klidov\u00fdch bolest\u00ed, kter\u00e9 b\u00fdvaj\u00ed nejhor\u0161\u00ed v noci. Ru\u0161\u00ed sp\u00e1nek nemocn\u00e9ho. \u010c\u00e1ste\u010dnou \u00falevu p\u0159in\u00e1\u0161\u00ed sv\u011b\u0161en\u00ed kon\u010detiny z l\u016f\u017eka.<\/p>\n\n\n\n
4. stupe\u0148: Doch\u00e1z\u00ed k odum\u00edr\u00e1n\u00ed tk\u00e1n\u00ed, tvo\u0159\u00ed se v\u0159edy, odum\u00edraj\u00ed prsty na nohou. Tento proces m\u016f\u017ee postihnout postupn\u011b celou doln\u00ed kon\u010detinu a ohrozit ji amputac\u00ed.<\/p>\n\n\n\n
\u201eVyhledat l\u00e9ka\u0159e je nutn\u00e9 p\u0159i akutn\u00edm tepenn\u00e9m uz\u00e1v\u011bru, d\u00e1le nejl\u00e9pe ve II. stadiu, kdy nen\u00ed p\u0159\u00edtomna klidov\u00e1 bolest a porucha ko\u017en\u00edho krytu,\u201c doporu\u010dil chirurg Milan Bart\u00e1\u0161ek.<\/p>\n\n\n\n
L\u00e9\u010dba ischemick\u00e9 choroby doln\u00edch kon\u010detin<\/p>\n\n\n\n
L\u00e9\u010dba ICHDK 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 zvolena terapie konzervativn\u00ed nebo interven\u010dn\u00ed.<\/p>\n\n\n\n
Konzervativn\u00ed l\u00e9\u010dba je farmakologick\u00e1. Pat\u0159\u00ed k n\u00ed re\u017eimov\u00e1 opat\u0159en\u00ed, z nich\u017e nejd\u016fle\u017eit\u011bj\u0161\u00ed je intervalov\u00fd tr\u00e9nink ch\u016fz\u00ed.<\/p>\n\n\n\n
\u201eInterven\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 (chirurgick\u00fd z\u00e1krok, kter\u00fd zpr\u016fchod\u0148uje zablokovanou c\u00e9vu; pozn. red.) prost\u00e1 nebo se stentem \u010di s pou\u017eit\u00edm rotabl\u00e1toru. Chirurgick\u00e9 revaskularizace (l\u00e9ka\u0159sk\u00e9 procedury pou\u017e\u00edvan\u00e9 k obnoven\u00ed pr\u016ftoku krve; pozn. red.) zahrnuj\u00ed rekonstrukce tepen, endarterektomie \u010di bypassy,\u201c popsali postup l\u00e9ka\u0159i z Homolky.<\/p>\n\n\n\n
\u201eNavzdory sou\u010dasn\u00e9 p\u00e9\u010di podstoup\u00ed u n\u00e1s ro\u010dn\u011b netraumatickou amputaci (amputace, kter\u00e1 nen\u00ed zap\u0159\u00ed\u010din\u011bna \u00farazem; pozn. red.) asi 3000 nemocn\u00fdch. U diabetik\u016f je riziko 10-20kr\u00e1t vy\u0161\u0161\u00ed ne\u017e u nediabetik\u016f,\u201c uv\u00e1d\u00ed smutnou statistiku Nemocnice Na Homolce.<\/p>\n\n\n\n
Olga Tu\u0161icov\u00e1<\/p>\n\n\n\n
Blanensk\u00fd den\u00edk<\/p>\n\n\n\n
https:\/\/blanensky.denik.cz<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Ischemick\u00e1 choroba doln\u00edch kon\u010detin za\u010d\u00edn\u00e1 nen\u00e1padn\u011b. P\u0159i ch\u016fzi v\u00e1s bol\u00ed l\u00fdtka, i kdy\u017e jste p\u0159edchoz\u00edho dne ur\u010dit\u011b neub\u011bhli p\u00e1r kilometr\u016f. Pocit studen\u00fdch nohou je nep\u0159\u00edjemn\u00fd, […]<\/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-51300","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\/51300","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=51300"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/51300\/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=51300"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=51300"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=51300"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}