{"id":51873,"date":"2024-09-11T11:21:06","date_gmt":"2024-09-11T09:21:06","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=51873"},"modified":"2024-09-11T11:21:07","modified_gmt":"2024-09-11T09:21:07","slug":"lidem-se-jizvi-plice-k-lekari-chodi-pozde","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=51873","title":{"rendered":"Lidem se jizv\u00ed pl\u00edce \u2013 k\u00a0l\u00e9ka\u0159i chod\u00ed pozd\u011b"},"content":{"rendered":"\n

Fibr\u00f3zy berou plochu k d\u00fdch\u00e1n\u00ed a bez l\u00e9\u010dby zab\u00edj\u00ed<\/em><\/p>\n\n\n\n

Mu\u017e, ve v\u011bku kolem 70 let, b\u00fdval\u00fd ku\u0159\u00e1k, kter\u00fd se \u010d\u00edm d\u00e1l v\u00edce zad\u00fdch\u00e1v\u00e1 \u2013 to je typick\u00fd pacient s\u00a0idiopatickou plicn\u00ed fibr\u00f3zou (IPF). Smrtelnou nemoc\u00ed, kter\u00e1 sv\u00fdm nositel\u016fm jizv\u00ed pl\u00edce, bere plochu k\u00a0d\u00fdch\u00e1n\u00ed a postupn\u011b znemo\u017e\u0148uje fungovat. P\u0159esto\u017ee slovo idiopatick\u00e1 znamen\u00e1, \u017ee l\u00e9ka\u0159i neznaj\u00ed p\u0159\u00ed\u010dinu vzniku, v\u00a0tomto p\u0159\u00edpad\u011b ji dle nich m\u00e1 a\u017e 80 % sou\u010dasn\u00fdch \u010di b\u00fdval\u00fdch ku\u0159\u00e1k\u016f. A st\u00e1le plat\u00ed, \u017ee na nemoc se p\u0159ich\u00e1z\u00ed pozd\u011b \u2013 \u010dasto ve chv\u00edli, kdy u\u017e nen\u00ed pacient\u016fm pomoci. Pneumologov\u00e9 na to upozor\u0148uj\u00ed u p\u0159\u00edle\u017eitosti m\u011bs\u00edce plicn\u00edch fibr\u00f3z, kter\u00fd p\u0159ipad\u00e1 na z\u00e1\u0159\u00ed.<\/strong><\/p>\n\n\n\n

\u201eI p\u0159es informa\u010dn\u00ed kampan\u011b u odborn\u00e9 i laick\u00e9 ve\u0159ejnosti n\u00e1m bohu\u017eel st\u00e1le chod\u00ed do ordinace lid\u00e9 v tak pokro\u010dil\u00e9m stadiu, \u017ee u\u017e jim nem\u00e1me jak pomoci. P\u0159itom u zav\u010das objeven\u00e9 nemoci m\u00e1me \u0159adu mo\u017enost\u00ed, jak jej\u00ed postup zpomalit, nebo dokonce zastavit. Nap\u0159\u00edklad antifibrotickou l\u00e9\u010dbu, n\u011bkdy transplantaci plic. Nej\u010dast\u011bji se IPF myln\u011b zam\u011b\u0148uje za chronickou obstruk\u010dn\u00ed plicn\u00ed nemoc,\u201c <\/em>\u0159\u00edk\u00e1 doc. MUDr. Martina \u0160terclov\u00e1, Ph.D., p\u0159edsedkyn\u011b Sekce pro interstici\u00e1ln\u00ed plicn\u00ed procesy (SIPP) \u010cesk\u00e9 pneumologick\u00e9 a ftizeologick\u00e9 spole\u010dnosti (\u010cPFS) \u010cLS JEP.<\/p>\n\n\n\n

P\u0159ipom\u00edn\u00e1, \u017ee se na vzniku onemocn\u011bn\u00ed pod\u00edl\u00ed i dal\u0161\u00ed faktory, dominantn\u011b se v\u0161ak vyskytuje u ku\u0159\u00e1k\u016f, a\u0165 u\u017e b\u00fdval\u00fdch, nebo sou\u010dasn\u00fdch. Upozor\u0148uje tak\u00e9, \u017ee mezi \u010dasn\u00e9 projevy IPF pat\u0159\u00ed pocit nedostatku kysl\u00edku a ka\u0161el. \u201eNemoc lze pom\u011brn\u011b snadno rozeznat u\u017e p\u0159i poslechu fonendoskopem \u2013 v plic\u00edch sly\u0161\u00edme zvuk, kter\u00fd p\u0159ipom\u00edn\u00e1 ch\u016fzi po zmrzl\u00e9m sn\u011bhu nebo rozep\u00edn\u00e1n\u00ed such\u00e9ho zipu. Pacienti \u010dasto m\u00edvaj\u00ed pali\u010dkovit\u00e9 prsty s vyklenut\u00fdmi nehty ve tvaru hodinov\u00fdch skl\u00ed\u010dek,\u201c <\/em>vysv\u011btluje doc. \u0160terclov\u00e1 s t\u00edm, \u017ee pokud na sob\u011b lid\u00e9 n\u011bkter\u00e9 z p\u0159\u00edznak\u016f zpozoruj\u00ed, m\u011bli by se obr\u00e1tit na praktika nebo pneumologa. Seznam plicn\u00edch l\u00e9ka\u0159\u016f naleznou nap\u0159\u00edklad zde<\/a>.<\/p>\n\n\n\n

Jak uv\u00e1d\u00ed prof. MUDr. Martina Koziar Va\u0161\u00e1kov\u00e1, Ph.D., p\u0159ednostka Pneumologick\u00e9 kliniky 1. LF UK a Fakultn\u00ed Thomayerovy nemocnice, z\u00e1m\u011bna nemoc\u00ed funguje i opa\u010dn\u011b. Pro plicn\u00ed fibr\u00f3zy ob\u010das l\u00e9ka\u0159i v plic\u00edch nevid\u00ed zhoubn\u00fd n\u00e1dor. \u201eV ter\u00e9nu tzv. interstici\u00e1ln\u00edch zm\u011bn je bohu\u017eel mo\u017en\u00e9 n\u00e1dor p\u0159ehl\u00e9dnout. A\u017e u 20 % lid\u00ed s IPF se p\u0159itom vyv\u00edj\u00ed v pr\u016fb\u011bhu nemoci karcinom plic \u2013 d\u016fvodem je jizven\u00ed plicn\u00ed tk\u00e1n\u011b, kter\u00e9 s sebou nese vy\u0161\u0161\u00ed riziko vzniku n\u00e1dorov\u00e9ho bujen\u00ed. Pokud se mal\u00fd n\u00e1dor v ter\u00e9nu fibr\u00f3zy p\u0159ehl\u00e9dne, nen\u00ed u\u017e pak mo\u017en\u00e9 jej operovat a mo\u017enosti jin\u00e9 l\u00e9\u010dby (oz\u00e1\u0159en\u00ed, c\u00edlen\u00e1 \u2013 biologick\u00e1 l\u00e9\u010dba) jsou u pacient\u016f s plicn\u00edmi fibr\u00f3zami velmi omezen\u00e9, ne-li p\u0159\u00edmo kontraindikovan\u00e9,\u201c<\/em> uv\u00e1d\u00ed prof. Koziar Va\u0161\u00e1kov\u00e1. Apeluje proto na v\u0161echny l\u00e9ka\u0159e, aby p\u0159i diagn\u00f3ze plicn\u00edch fibr\u00f3z p\u00e1trali i po tom, zda pacient nem\u00e1 z\u00e1rove\u0148 n\u00e1dor, a sledovali meziro\u010dn\u00ed zm\u011bny na plic\u00edch. \u201ePokud zachyt\u00edme karcinom, kdy\u017e je mal\u00fd, m\u016f\u017eeme je operativn\u011b odstranit nebo lok\u00e1ln\u011b stereotakticky oz\u00e1\u0159it,\u201c <\/em>dod\u00e1v\u00e1 prof. Koziar Va\u0161\u00e1kov\u00e1.<\/p>\n\n\n\n

I to je d\u016fvod, pro\u010d l\u00e9ka\u0159i v r\u00e1mci ned\u00e1vno spu\u0161t\u011bn\u00e9ho programu \u010dasn\u00e9ho z\u00e1chytu rakoviny plic p\u00e1traj\u00ed nejenom po n\u00e1dorech, ale tak\u00e9 po dal\u0161\u00edch plicn\u00edch nemocech \u2013 fibr\u00f3zy nevyj\u00edmaje. Plicn\u00edch fibr\u00f3z je v\u00edce druh\u016f, ne v\u0161echny jsou tak fat\u00e1ln\u00ed jako IPF. N\u011bkter\u00e9 se poj\u00ed s dal\u0161\u00edmi autoimunitn\u00edmi chorobami, jako je nap\u0159\u00edklad syst\u00e9mov\u00e1 sklerodermie nebo revmatoidn\u00ed artritida. Antifibrotickou l\u00e9\u010dbu, hrazenou zdravotn\u00edmi poji\u0161\u0165ovnami, l\u00e9ka\u0159i nasazuj\u00ed v celkem 16 centrech pro interstici\u00e1ln\u00ed plicn\u00ed procesy.<\/p>\n\n\n\n

O idiopatick\u00e9 plicn\u00ed fibr\u00f3ze<\/strong><\/p>\n\n\n\n

Idiopatick\u00e1 plicn\u00ed fibr\u00f3za po\u0161kozuje plicn\u00ed skl\u00edpky, jizv\u00ed je \u2013 bere plochu k d\u00fdch\u00e1n\u00ed, pl\u00edce tuhnou a \u010dlov\u011bk se nem\u016f\u017ee nadechnout. Postup nemoci zpomaluje l\u00e9\u010dba, kter\u00e1 je v tuzemsku hrazena zdravotn\u00edmi poji\u0161\u0165ovnami. Pacienti se k n\u00ed v\u0161ak \u010dasto nedostanou, proto\u017ee je nemoc odhalena pozd\u011b. Projevy idiopatick\u00e9 plicn\u00ed fibr\u00f3zy l\u00e9ka\u0159i \u010dasto zam\u011b\u0148uj\u00ed za chronickou obstruk\u010dn\u00ed plicn\u00ed nemoc \u010di srde\u010dn\u00ed selh\u00e1n\u00ed. Nemoc se ohla\u0161uje zprvu nen\u00e1padn\u011b, \u010dlov\u011bk se za\u010dne zad\u00fdch\u00e1vat do schod\u016f, pozd\u011bji i p\u0159i ch\u016fzi \u010di hovoru, v pokro\u010dil\u00e9m stadiu m\u00e1 pocit nedostatku vzduchu p\u0159i b\u011b\u017en\u00fdch denn\u00edch \u010dinnostech a v z\u00e1v\u011bru v\u011bnuje ve\u0161kerou energii tomu, aby se nadechl. Bez spr\u00e1vn\u00e9 l\u00e9\u010dby idiopatick\u00e1 plicn\u00ed fibr\u00f3za v\u00fdrazn\u011b zkracuje \u017eivot pacienta. Pokud je nemoc odhalena co nejd\u0159\u00edve, pak m\u016f\u017ee v\u010dasn\u00e1 l\u00e9\u010dba zpomalit rozvoj onemocn\u011bn\u00ed, zlep\u0161it kvalitu \u017eivota pacient\u016f, sn\u00ed\u017eit riziko v\u00fdskytu akutn\u00edch komplikac\u00ed a prodlou\u017eit d\u00e9lku p\u0159e\u017eit\u00ed. V\u00edce informac\u00ed o nemoci, v\u010detn\u011b seri\u00e1lu o plicn\u00ed fibr\u00f3ze obsahuj\u00edc\u00edho 12 eduka\u010dn\u00edch vide\u00ed s plicn\u00ed l\u00e9ka\u0159kou z FN Brno<\/a> lze nal\u00e9zt na www.zivotsplicnifibrozou.cz<\/a>.<\/p>\n\n\n\n

O plicn\u00ed fibr\u00f3ze<\/strong><\/p>\n\n\n\n

Plicn\u00ed fibr\u00f3za (PF) je z\u00e1va\u017en\u00e9 onemocn\u011bn\u00ed, p\u0159i n\u011bm\u017e doch\u00e1z\u00ed ke zjizven\u00ed p\u016fvodn\u011b zdrav\u00e9 plicn\u00ed tk\u00e1n\u011b a k jej\u00edmu ztlu\u0161t\u011bn\u00ed a ztuhnut\u00ed. PF m\u016f\u017ee b\u00fdt pr\u016fvodn\u00edm jevem v\u00edce ne\u017e 200 plicn\u00edch onemocn\u011bn\u00ed, kter\u00e1 se ozna\u010duj\u00ed souhrnn\u00fdm n\u00e1zvem interstici\u00e1ln\u00ed plicn\u00ed procesy. V sou\u010dasn\u00e9 dob\u011b jimi na cel\u00e9m sv\u011bt\u011b trp\u00ed p\u0159ibli\u017en\u011b 3 miliony lid\u00ed.<\/p>\n","protected":false},"excerpt":{"rendered":"

Fibr\u00f3zy berou plochu k d\u00fdch\u00e1n\u00ed a bez l\u00e9\u010dby zab\u00edj\u00ed Mu\u017e, ve v\u011bku kolem 70 let, b\u00fdval\u00fd ku\u0159\u00e1k, kter\u00fd se \u010d\u00edm d\u00e1l v\u00edce zad\u00fdch\u00e1v\u00e1 \u2013 to je […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":27673,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-51873","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\/51873","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=51873"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/51873\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/27673"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=51873"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=51873"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=51873"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}