Dialyza\u010dn\u00ed st\u0159edisko Nemocnice Prachatice stoj\u00ed v\u00edce ne\u017e t\u0159i desetilet\u00ed. Vedouc\u00ed pracovnice a nefrolo\u017eka Eva Pauchov\u00e1 v podcastu Den\u00edku z ji\u017en\u00edch \u010cech p\u0159ibli\u017euje, jak se k medic\u00edn\u011b dostala, jak se dialyza\u010dn\u00ed p\u00e9\u010de vyv\u00edjela a co mohou lid\u00e9 d\u011blat pro to, aby sv\u00e9 ledviny chr\u00e1nili co nejd\u00e9le.<\/p>\n\n\n\n
Cesta Evy Pauchov\u00e9 k medic\u00edn\u011b za\u010dala u\u017e v d\u011btstv\u00ed. Maminka pracovala jako zdravotn\u00ed sestra a mal\u00e1 Eva ob\u010das tr\u00e1vila odpoledne v z\u00e1vodn\u00edm st\u0159edisku \u010cZ ve Strakonic\u00edch. \u201ePom\u00e1hala jsem zakl\u00e1dat zdravotn\u00ed karty nebo skl\u00e1dat \u010dtverce z g\u00e1zy. To prost\u0159ed\u00ed mi bylo bl\u00edzk\u00e9,\u201c vzpom\u00edn\u00e1 dnes vedouc\u00ed l\u00e9ka\u0159ka hemodialyza\u010dn\u00edho st\u0159ediska Nemocnice Prachatice.<\/p>\n\n\n\n
Do prachatick\u00e9 nemocnice nastoupila na intern\u00ed odd\u011blen\u00ed. Kdy\u017e veden\u00ed nemocnice v roce 1994 zakl\u00e1dalo nov\u00e9 dialyza\u010dn\u00ed st\u0159edisko, dostala nab\u00eddku b\u00fdt u jeho zrodu \u2013 a u\u017e z\u016fstala. \u201eTehdy jsme p\u0159evzali dev\u011bt pacient\u016f z \u010cesk\u00fdch Bud\u011bjovic a m\u011bli p\u011bt dialyza\u010dn\u00edch l\u016f\u017eek. Dnes m\u00e1me t\u0159i dialyza\u010dn\u00ed s\u00e1ly, dvan\u00e1ct l\u016f\u017eek a modern\u00ed technologie. Pacient\u016fm se zkr\u00e1tila dojezdov\u00e1 vzd\u00e1lenost, co\u017e je z\u00e1sadn\u00ed,\u201c vysv\u011btluje.<\/p>\n\n\n\n
Co dial\u00fdza vlastn\u011b znamen\u00e1<\/p>\n\n\n\n
Jedn\u00e1 se o metodu n\u00e1hrady funkce vlastn\u00edch ledvin, kter\u00e9 nedok\u00e1\u017eou ji\u017e o\u010dis\u0165ovat krev a zbavit t\u011blo odpadn\u00edch l\u00e1tek, a to pomoc\u00ed p\u0159\u00edstroje (um\u011bl\u00e9 ledviny). Krev se odv\u00e1d\u00ed z t\u011bla pacienta mimot\u011bln\u00edm ob\u011bhem p\u0159es speci\u00e1ln\u00ed filtr, polopropustnou membr\u00e1nu, kde se krev zbavuje odpadu, p\u0159ebyte\u010dn\u00e9 vody. Z\u00e1rove\u0148 se upravuje porucha elektrolytov\u00e9 a acidobasick\u00e9 rovnov\u00e1hy. P\u0159echod l\u00e1tek se d\u011bje pomoc\u00ed difuse a konvekce. Difuse p\u0159es membr\u00e1nu se naz\u00fdv\u00e1 dial\u00fdza. Konvekce je pak splavov\u00e1n\u00ed rozpu\u0161t\u011bn\u00fdch l\u00e1tek spolu s rozpou\u0161t\u011bdlem, kter\u00e9 p\u0159estupuje p\u0159es membr\u00e1nu filtrac\u00ed. Krev koluje p\u0159es filtr (membr\u00e1nu) 4-5 hodin, po o\u010di\u0161t\u011bn\u00ed se vrac\u00ed krev zp\u011bt do t\u011bln\u00edho ob\u011bhu a pacient po odpojen\u00ed od p\u0159\u00edstroje odj\u00ed\u017ed\u00ed sanitou dom\u016f, aby v t\u00fddnu si l\u00e9\u010dbu t\u0159ikr\u00e1t zopakoval. Dial\u00fdza slou\u017e\u00ed pro pacienty s akutn\u00edm \u010di chronick\u00fdm selh\u00e1n\u00edm ledvin.<\/p>\n\n\n\n
Vedle hemodial\u00fdzy existuje i peritone\u00e1ln\u00ed dial\u00fdza, kdy krev o\u010di\u0161\u0165uje tekutina zaveden\u00e1 do dutiny b\u0159i\u0161n\u00ed p\u0159es pob\u0159i\u0161nici. N\u011bkte\u0159\u00ed pacienti maj\u00ed v\u00fdm\u011bny b\u011bhem noci prov\u00e1d\u011bn\u00e9 automatizovan\u00fdm p\u0159\u00edstrojem, co\u017e umo\u017e\u0148uje \u017e\u00edt aktivn\u011bji a bez \u010dast\u00e9ho doj\u00ed\u017ed\u011bn\u00ed.<\/p>\n\n\n\n
Nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou selh\u00e1n\u00ed ledvin je podle Pauchov\u00e9 diabetick\u00e1 nefropatie, d\u00e1le \u0161patn\u011b l\u00e9\u010den\u00fd vysok\u00fd tlak, z\u00e1n\u011bty mo\u010dov\u00fdch cest \u010di d\u011bdi\u010dn\u00e1 onemocn\u011bn\u00ed. V posledn\u00edch letech p\u0159ib\u00fdv\u00e1 pacient\u016f s posti\u017een\u00edm ledvin kv\u016fli ateroskler\u00f3ze.<\/p>\n\n\n\n
\u201eNe zcela \u010derstvou novinkou je dom\u00e1c\u00ed hemodial\u00fdza. Princip je stejn\u00fd, jen odpad\u00e1 doj\u00ed\u017ed\u011bn\u00ed na st\u0159edisko. Hemodial\u00fdzu si pak pacient prov\u00e1d\u00ed s\u00e1m, pop\u0159\u00edpad\u011b bl\u00edzk\u00e1 osoba, v ur\u010dit\u00fdch p\u0159\u00edpadech oslovujeme i agenturu, kter\u00e1 zajist\u00ed l\u00e9\u010dbu specializovan\u00fdm t\u00fdmem, kter\u00fd je p\u0159\u00edtomen po celou dobu dial\u00fdzy. Dial\u00fdzy jsou ale \u010dast\u011bj\u0161\u00ed, by\u0165 krat\u0161\u00ed,“ popisuje Eva Pauchov\u00e1.<\/p>\n\n\n\n
Dial\u00fdza v\u0161ak nen\u00ed kone\u010dnou mo\u017enost\u00ed. \u201eTransplantace ledviny je obrovsk\u00fd dar. Pacient se m\u016f\u017ee vr\u00e1tit k plnohodnotn\u00e9mu \u017eivotu v\u010detn\u011b pr\u00e1ce,\u201c zd\u016fraz\u0148uje l\u00e9ka\u0159ka prachatick\u00e9 nemocnice. \u010cekac\u00ed doba je p\u0159itom r\u016fzn\u00e1 \u2013 n\u011bkter\u00fdm se vhodn\u00fd org\u00e1n najde za p\u016fl roku, jin\u00ed \u010dekaj\u00ed i dva roky.<\/p>\n\n\n\n
St\u0159edisko dnes zaji\u0161\u0165uje l\u00e9\u010dbu akutn\u00edm a zhruba 45 chronick\u00fdm pacient\u016fm a ro\u010dn\u011b provede okolo 6500 procedur. Krom\u011b kvalitn\u00edho p\u0159\u00edstrojov\u00e9ho vybaven\u00ed jsou podle Evy Pauchov\u00e9 kl\u00ed\u010dov\u00e9 i vztahy. \u201ePacienty v\u00edd\u00e1me t\u0159ikr\u00e1t t\u00fddn\u011b m\u011bs\u00edce, roky. Vznik\u00e1 mezi n\u00e1mi opravdu bl\u00edzk\u00e1 vazba,,\u201c \u0159\u00edk\u00e1.<\/p>\n\n\n\n
Hlavn\u00edm poselstv\u00edm l\u00e9ka\u0159ky je podle n\u00ed jednozna\u010dn\u00e1 v\u00fdzva: \u201ePrevence, prevence, prevence.\u201c \u010casn\u00e9 stadium onemocn\u011bn\u00ed ledvin toti\u017e nebol\u00ed, pacient ho tak nemus\u00ed ani rozpoznat. V\u010dasn\u00e9 zachycen\u00ed, n\u00e1sledn\u011b l\u00e9\u010dba zejm\u00e9na u cukrovky nebo hypertenze, v\u0161ak m\u016f\u017ee nemoc v\u00fdrazn\u011b zpomalit a t\u00edm odd\u00e1lit kone\u010dn\u00e9 selh\u00e1n\u00ed ledvin.<\/p>\n\n\n\n
Doporu\u010duje tak\u00e9 dostatek tekutin, zdrav\u00fd \u017eivotn\u00ed styl (kvalitn\u00ed strava, sp\u00e1nek, aktivn\u00ed pohyb), opatrnost p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f na bolest typu nesteroidn\u00edch antiflogistik jako je ibuprofen, diclofenac. \u201eA p\u00e1r sklenek alkoholu? To nemohu doporu\u010dit,\u201c dod\u00e1v\u00e1 s \u00fasm\u011bvem.<\/p>\n\n\n\n
V osobn\u00edm \u017eivot\u011b relaxuje u knih, v p\u0159\u00edrod\u011b se sv\u00fdm psem, v zahrad\u011b a nov\u011b i v roli babi\u010dky. \u201eEmoce k t\u00e9to pr\u00e1ci pat\u0159\u00ed, ale \u010dlov\u011bk mus\u00ed um\u011bt vypnout,\u201c \u0159\u00edk\u00e1.<\/p>\n\n\n\n
Kl\u00e1ra Sk\u00e1lov\u00e1<\/p>\n\n\n\n
Prachatick\u00fd den\u00edk<\/p>\n\n\n\n
https:\/\/prachaticky.denik.cz<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Dialyza\u010dn\u00ed st\u0159edisko Nemocnice Prachatice stoj\u00ed v\u00edce ne\u017e t\u0159i desetilet\u00ed. Vedouc\u00ed pracovnice a nefrolo\u017eka Eva Pauchov\u00e1 v podcastu Den\u00edku z ji\u017en\u00edch \u010cech p\u0159ibli\u017euje, jak se k […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":58354,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-62340","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\/62340","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=62340"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/62340\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/58354"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=62340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=62340"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=62340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}