{"id":105957,"date":"2017-08-15T11:49:10","date_gmt":"2017-08-15T10:49:10","guid":{"rendered":"http:\/\/zakrasnejsivimperk.cz\/?p=105957"},"modified":"2017-08-15T12:26:15","modified_gmt":"2017-08-15T11:26:15","slug":"ceske-budejovice-ocni-oddeleni-zdejsi-nemocnice-ma-jedine-vitreoretinalni-centrum-v-kraji","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=105957","title":{"rendered":"MUDr. DAVID HONNER: Lid\u00e9 chybuj\u00ed, kdy\u017e si kupuj\u00ed voln\u011b prodejn\u00e9 \u010dtec\u00ed br\u00fdle bez vy\u0161et\u0159en\u00ed o\u010dn\u00edm l\u00e9ka\u0159em"},"content":{"rendered":"

\"\"<\/p>\n

 <\/p>\n

O\u010dn\u00ed odd\u011blen\u00ed Nemocnice \u010cesk\u00e9 Bud\u011bjovice m\u00e1 jedin\u00e9 vitreoretin\u00e1ln\u00ed centrum v kraji a krom\u011b toho od nov\u00e9ho roku jako jedno z\u00a0m\u00e1la v\u00a0\u010cesk\u00e9 republice disponuje diagnostick\u00fdm p\u0159\u00edstrojem, kter\u00fd umo\u017e\u0148uje zcela novou metodu neinvazivn\u00edho vy\u0161et\u0159en\u00ed prokrven\u00ed s\u00edtnice. Nejen o tom jsme si pov\u00eddali s\u00a0MUDr. Davidem Honnerem, FEBO, z\u00e1stupcem prim\u00e1\u0159e o\u010dn\u00edho odd\u011blen\u00ed.<\/h6>\n

Na o\u010dn\u00edm\u00a0odd\u011blen\u00ed prov\u00e1d\u00edte celou \u0159adu z\u00e1krok\u016f od operac\u00ed katarakty (tzv. \u0161ed\u00fd z\u00e1kal), glaukomu (tzv. zelen\u00fd z\u00e1kal), o\u0161et\u0159en\u00ed \u00faraz\u016f oka p\u0159es korekce \u0161ilh\u00e1n\u00ed a\u017e po n\u00e1ro\u010dn\u00e9 operace s\u00edtnice. Kter\u00e9 p\u0159eva\u017euj\u00ed?<\/strong><\/p>\n

Operace \u0161ed\u00e9ho z\u00e1kalu je st\u00e1le nejroz\u0161\u00ed\u0159en\u011bj\u0161\u00edm nitroo\u010dn\u00edm z\u00e1krokem, proto i na na\u0161em pracovi\u0161ti tyto operace p\u0159eva\u017euj\u00ed. Jde o pl\u00e1novan\u00fd ambulantn\u00ed v\u00fdkon v\u00a0lok\u00e1ln\u00ed anestezii, kdy se pacientovi vym\u011bn\u00ed jeho zkalen\u00e1 biologick\u00e1 \u010do\u010dka za um\u011blou nitroo\u010dn\u00ed \u010do\u010dku. Pacient odch\u00e1z\u00ed je\u0161t\u011b t\u00fd\u017e den dom\u016f. V\u00fdkon je pln\u011b hrazen poji\u0161\u0165ovnou bez doplatku za um\u011blou nitroo\u010dn\u00ed \u010do\u010dku. P\u0159ednost\u00ed na\u0161eho pracovi\u0161t\u011b oproti priv\u00e1tn\u00edm centr\u016fm je na\u0161e st\u00e1l\u00e1 \u010dty\u0159iadvacetihodinov\u00e1 pohotovost, na kterou se pacient v\u00a0p\u0159\u00edpad\u011b pot\u00ed\u017e\u00ed m\u016f\u017ee kdykoliv obr\u00e1tit. Stejn\u011b tak z\u00e1zem\u00ed vitreoretin\u00e1ln\u00edho centra na na\u0161em pracovi\u0161ti je v\u00a0p\u0159\u00edpad\u011b mo\u017en\u00fdch komplikac\u00ed v\u00fdhodou.<\/em><\/p>\n

O\u010dn\u00ed odd\u011blen\u00ed je jedin\u00fdm pracovi\u0161t\u011bm v\u00a0Jiho\u010desk\u00e9m kraji, kter\u00e9 vitreoretin\u00e1ln\u00ed chirurgii prov\u00e1d\u00ed. Jste schopni \u201epopt\u00e1vku\u201c po t\u011bchto z\u00e1kroc\u00edch v\u016fbec pokr\u00fdt?<\/strong><\/p>\n

Vitreoretin\u00e1ln\u00ed centrum \u0159e\u0161\u00ed problematiku s\u00edtnicov\u00fdch chorob. Jde p\u0159edev\u0161\u00edm o odchl\u00edpen\u00ed s\u00edtnice, diabetickou retinopatii \u2013 o\u010dn\u00ed posti\u017een\u00ed cukrovkou, \u00farazy aj. V\u00a0ji\u017en\u00edch \u010cech\u00e1ch je na\u0161e pracovi\u0161t\u011b s\u00a0pot\u0159ebn\u00fdm vybaven\u00edm a mo\u017enostmi tyto nemoci operovat skute\u010dn\u011b jedin\u00e9. Ro\u010dn\u011b takto odoperujeme v\u00edce ne\u017e 250 pacient\u016f. St\u00e1vaj\u00edc\u00ed popt\u00e1vku kapacitn\u011b zvl\u00e1d\u00e1me a jsme p\u0159ipraveni pokr\u00fdt i\u00a0dal\u0161\u00ed jej\u00ed p\u0159\u00edpadn\u00e9 nav\u00fd\u0161en\u00ed.<\/em><\/p>\n

Po\u010det t\u011bchto operac\u00ed na zadn\u00edm segmentu oka v\u00a0posledn\u00edch letech stoup\u00e1. \u010c\u00edm je n\u00e1r\u016fst zp\u016fsoben?<\/strong><\/p>\n

Operace zadn\u00edho segmentu o\u010dn\u00edho, tedy zjednodu\u0161en\u011b operace s\u00edtnice prov\u00e1d\u00edme na na\u0161em pracovi\u0161ti v\u00edce ne\u017e dvan\u00e1ct let. O dostupnost tzv. pars plana vitrektomie (PPV) pro pacienty z Jiho\u010desk\u00e9ho kraje se v\u00fdznamn\u011b zaslou\u017eil nyn\u011bj\u0161\u00ed prim\u00e1\u0159 MUDr. Jan Sattran. Do t\u00e9 doby museli pacienti za t\u011bmito operacemi cestovat do Prahy. Jde \u010dasto o zrak zachra\u0148uj\u00edc\u00ed v\u00fdkony. Zejm\u00e9na v\u00fd\u0161e zm\u00edn\u011bn\u00e9 odchl\u00edpen\u00ed s\u00edtnice, pokro\u010dil\u00e9 stavy diabetick\u00e9 retinopatie a n\u011bkter\u00e9 \u00farazy by bez t\u00e9to operace kon\u010dily slepotou. Po\u010det v\u00fdkon\u016f stoup\u00e1 p\u0159edev\u0161\u00edm d\u00edky lep\u0161\u00edm technologi\u00edm a na\u0161im zku\u0161enostem. Zdokonalen\u00edm opera\u010dn\u00edch p\u0159\u00edstroj\u016f a p\u0159\u00edstup\u016f se sni\u017euje invazivita operace. P\u016fvodn\u00ed celkovou anestezii ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f nahradila anestezie lok\u00e1ln\u00ed, zkracuje se opera\u010dn\u00ed doba i doba rekonvalescence.<\/em><\/p>\n

Jak je to s\u00a0plastick\u00fdmi operacemi v\u00a0oblasti o\u010d\u00ed, prov\u00e1d\u00edte je na va\u0161em odd\u011blen\u00ed nebo spadaj\u00ed do operativy odd\u011blen\u00ed plastick\u00e9 chirurgie?<\/strong><\/p>\n

Prov\u00e1d\u00edme celou \u0161k\u00e1lu plastick\u00fdch operac\u00ed od drobn\u00fdch kosmetick\u00fdch v\u00fdkon\u016f, blefaroplastik (operace o\u010dn\u00edch v\u00ed\u010dek, pozn. red.) p\u0159es \u00fapravy postaven\u00ed v\u00ed\u010dek a\u017e po jejich rozs\u00e1hl\u00e9 rekonstrukce po odstran\u011bn\u00ed ko\u017en\u00edch n\u00e1dor\u016f. Mnohdy tyto operace prov\u00e1d\u00edme pr\u00e1v\u011b ve spolupr\u00e1ci s\u00a0plastick\u00fdmi chirurgy.<\/em><\/p>\n

M\u016f\u017eou lid\u00e9 onemocn\u011bn\u00edm a \u00faraz\u016fm o\u010d\u00ed p\u0159edch\u00e1zet?<\/strong><\/p>\n

Na tuto ot\u00e1zku se ned\u00e1 jednozna\u010dn\u011b odpov\u011bd\u011bt. Mnoho o\u010dn\u00edch chorob je spojeno s\u00a0v\u011bkem, kter\u00fd samoz\u0159ejm\u011b ovlivnit nelze. Mnoho onemocn\u011bn\u00ed je tak\u00e9 podm\u00edn\u011bno geneticky. Obecn\u011b lze \u0159\u00edci, \u017ee o\u010dn\u00edm chorob\u00e1m lze do ur\u010dit\u00e9 m\u00edry p\u0159edch\u00e1zet zdrav\u00fdm \u017eivotn\u00edm stylem, pestrou stravou, ochranou p\u0159ed sluncem a\u00a0pravideln\u00fdmi kontrolami u o\u010dn\u00edho l\u00e9ka\u0159e. \u010castou chybou pacient\u016f b\u00fdv\u00e1 pr\u00e1v\u011b po\u0159\u00edzen\u00ed levn\u00fdch voln\u011b prodejn\u00fdch \u010dtec\u00edch br\u00fdl\u00ed bez p\u0159edchoz\u00edho vy\u0161et\u0159en\u00ed o\u010dn\u00edm l\u00e9ka\u0159em. Takto m\u016f\u017ee doj\u00edt k\u00a0prome\u0161k\u00e1n\u00ed p\u0159\u00edpadn\u00e9 v\u00e1\u017en\u011bj\u0161\u00ed diagn\u00f3zy. Co se t\u00fd\u010de o\u010dn\u00edch \u00faraz\u016f, jsou v\u011bt\u0161inou d\u016fsledkem nepou\u017e\u00edv\u00e1n\u00ed ochrann\u00fdch pom\u016fcek \u2013 br\u00fdl\u00ed, \u0161t\u00edt\u016f, p\u0159ileb.<\/em><\/p>\n

Ned\u00edlnou sou\u010d\u00e1st\u00ed pr\u00e1ce va\u0161eho odd\u011blen\u00ed je intenzivn\u00ed p\u00e9\u010de o nedono\u0161en\u00e9 d\u011bti ohro\u017een\u00e9 slepotou a\u00a0korekce poruch postaven\u00ed o\u010d\u00ed u d\u011bt\u00ed. Co takov\u00e1 p\u00e9\u010de obn\u00e1\u0161\u00ed?<\/strong><\/p>\n

Retinopatie nedono\u0161en\u00fdch ohro\u017euje zrak d\u011bt\u00ed narozen\u00fdch p\u0159ed 30. a\u017e 32. t\u00fddnem t\u011bhotenstv\u00ed a d\u011bt\u00ed, jejich\u017e porodn\u00ed hmotnost je ni\u017e\u0161\u00ed ne\u017e 1500 gram\u016f. Je spojena s\u00a0nedokon\u010den\u00fdm v\u00fdvojem s\u00edtnicov\u00fdch c\u00e9v a\u00a0kol\u00eds\u00e1n\u00edm koncentrace kysl\u00edku b\u011bhem um\u011bl\u00e9 plicn\u00ed ventilace. S\u00edtnice t\u011bchto d\u011bt\u00ed jsou na\u0161imi d\u011btsk\u00fdmi oftalmology pravideln\u011b kontrolov\u00e1ny. Zde mus\u00edme zd\u016fraznit mimo\u0159\u00e1dnou z\u00e1sluhu na\u0161eho neonatologick\u00e9ho centra pod veden\u00edm prim. MUDr. Milana Hanzla, Ph.D., nebo\u0165 pokro\u010dil\u00e9 stavy retinopatie nedono\u0161en\u00fdch d\u011bt\u00ed vy\u017eaduj\u00edc\u00edch chirurgick\u00e9 z\u00e1kroky d\u00edky jeho p\u00e9\u010di t\u00e9m\u011b\u0159 nev\u00edd\u00e1me.\u00a0<\/em>P\u00e9\u010de o d\u011btsk\u00e9 pacienty, prevence a l\u00e9\u010dba tupozrakosti a \u0161ilhavosti p\u0159edstavuje v\u00a0Jiho\u010desk\u00e9m kraji aktu\u00e1ln\u011b probl\u00e9m. \u010cesk\u00e9 Bud\u011bjovice, pota\u017emo Jiho\u010desk\u00fd kraj se pot\u00fdk\u00e1 s\u00a0nedostatkem d\u011btsk\u00fdch oftalmolog\u016f. Do budoucna p\u0159em\u00fd\u0161l\u00edme o roz\u0161\u00ed\u0159en\u00ed na\u0161\u00ed d\u011btsk\u00e9 ambulance, nicm\u00e9n\u011b tento probl\u00e9m bude nutn\u00e9 \u0159e\u0161it komplexn\u011b na \u00farovni poji\u0161\u0165oven a jejich smluvn\u00edch l\u00e9ka\u0159\u016f.<\/em><\/p>\n

P\u0159ejd\u011bme naopak ke star\u0161\u00edm pacient\u016fm. St\u00e1le plat\u00ed, \u017ee v\u011bkem podm\u00edn\u011bn\u00e1 makul\u00e1rn\u00ed degenerace je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou nevratn\u00e9 ztr\u00e1ty zraku u osob star\u0161\u00edch pades\u00e1ti let?<\/strong><\/p>\n

Ano, v\u011bkem podm\u00edn\u011bn\u00e1 makul\u00e1rn\u00ed degenerace (VPMD) je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou slepoty v\u00a0ekonomicky vysp\u011bl\u00fdch zem\u00edch. Zaj\u00edmav\u00e9 v\u0161ak je, \u017ee v\u00a0celosv\u011btov\u00e9m m\u011b\u0159\u00edtku je jako p\u0159\u00ed\u010dina slepoty na prvn\u00edm m\u00edst\u011b uv\u00e1d\u011bna, v\u00a0na\u0161ich kon\u010din\u00e1ch pom\u011brn\u011b ban\u00e1ln\u00ed, katarakta, tedy \u0161ed\u00fd z\u00e1kal, kter\u00fd st\u00e1le p\u0159edstavuje a\u017e 50% pod\u00edl celosv\u011btov\u00e9 slepoty. L\u00e9\u010dba VPMD v\u00a0z\u00e1padn\u00edch zem\u00edch za\u017e\u00edv\u00e1 ohromn\u00fd boom. Vyv\u00edjej\u00ed se neust\u00e1le nov\u00e9 l\u00e9ky, kter\u00e9 jsou nej\u010dast\u011bji injek\u010dn\u011b aplikov\u00e1ny p\u0159\u00edmo do sklivcov\u00e9ho prostoru oka. Rapidn\u00ed v\u00fdvoj lze zaznamenat tak\u00e9 na p\u016fd\u011b diagnostick\u00fdch p\u0159\u00edstroj\u016f. Jedn\u00edm z\u00a0nich je Spectralis angio-OCT, kter\u00fd umo\u017e\u0148uje neinvazivn\u011b vy\u0161et\u0159it prokrven\u00ed s\u00edtnice. Touto metodou od za\u010d\u00e1tku tohoto roku disponuje na\u0161e odd\u011blen\u00ed jako jedno z\u00a0prvn\u00edch pracovi\u0161\u0165 v\u00a0republice.<\/em><\/p>\n

Kolik pacient\u016f ro\u010dn\u011b projde o\u010dn\u00edm odd\u011blen\u00edm?<\/strong><\/p>\n

Za lo\u0148sk\u00fd rok jsme provedli 1742 operac\u00ed a o\u0161et\u0159ili 14 698 pacient\u016f.<\/p>\n

 <\/p>\n

Text a foto: (tznem)<\/strong><\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

  O\u010dn\u00ed <\/p>\n","protected":false},"author":2,"featured_media":105958,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"gallery","meta":{"footnotes":""},"categories":[7],"tags":[],"jetpack_featured_media_url":"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2017\/08\/11\/nemocnice-cb-ocni.jpg","_links":{"self":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/105957"}],"collection":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=105957"}],"version-history":[{"count":14,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/105957\/revisions"}],"predecessor-version":[{"id":106249,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/105957\/revisions\/106249"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/media\/105958"}],"wp:attachment":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=105957"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=105957"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=105957"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}