{"id":206490,"date":"2020-10-27T18:13:25","date_gmt":"2020-10-27T17:13:25","guid":{"rendered":"http:\/\/zakrasnejsivimperk.cz\/?p=206490"},"modified":"2020-10-27T18:13:25","modified_gmt":"2020-10-27T17:13:25","slug":"vseobecna-zdravotni-pojistovna-jak-je-hrazeno-denzitometricke-vysetreni","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=206490","title":{"rendered":"V\u0160EOBECN\u00c1 ZDRAVOTN\u00cd POJI\u0160\u0164OVNA: Jak je hrazeno denzitometrick\u00e9 vy\u0161et\u0159en\u00ed"},"content":{"rendered":"

\"\"<\/p>\n

OT\u00c1ZKA T\u00ddDNE:<\/h6>\n
Za jak\u00fdch podm\u00ednek hrad\u00ed poji\u0161\u0165ovna denzitometrick\u00e9 vy\u0161et\u0159en\u00ed cel\u00e9ho t\u011bla? M\u016fj endokrinolog m\u011b poslal na denzitometrii, ale rentgenovali mi jen p\u0159edlokt\u00ed a nohy.<\/h6>\n
ODPOV\u011a\u010e:<\/h6>\n

Denzitometrick\u00e9 vy\u0161et\u0159en\u00ed (k\u00f3d v\u00fdkonu 89312 \u2013 Denzitometrie dvoufotonov\u00e1) je zam\u011b\u0159eno na stanoven\u00ed obsahu miner\u00e1l\u016f v kostech nebo v m\u011bkk\u00fdch tk\u00e1n\u00edch a v indikovan\u00fdch p\u0159\u00edpadech je pln\u011b hrazeno z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. V souladu s platn\u00fdm Seznamem zdravotn\u00edch v\u00fdkon\u016f ho mus\u00ed doporu\u010dit o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159, kter\u00fd m\u00e1 pacienta v p\u00e9\u010di pro kostn\u00ed chorobu.<\/p>\n

Nov\u011b tento v\u00fdkon pat\u0159\u00ed do odbornosti klinick\u00e9 osteologie, kde l\u00e9ka\u0159 vy\u0161et\u0159en\u00ed indikuje s\u00e1m. Nad\u00e1le v\u0161ak m\u016f\u017ee b\u00fdt po\u017eadavek na vy\u0161et\u0159en\u00ed od revmatologa, d\u011btsk\u00e9ho revmatologa a dal\u0161\u00edch z odbornost\u00ed: ortopedie, traumatologie, vnit\u0159n\u00edho l\u00e9ka\u0159stv\u00ed, gynekologie a porodnictv\u00ed, d\u011btsk\u00e9 gynekologie a endokrinologie. M\u016f\u017ee to b\u00fdt i praktick\u00fd l\u00e9ka\u0159, ale jen m\u00e1-li u konkr\u00e9tn\u00edho pacienta p\u00edsemn\u00e9 pov\u011b\u0159en\u00ed od p\u0159\u00edslu\u0161n\u00e9ho specialisty k p\u0159edpisu antiosteoporotick\u00fdch l\u00e9\u010div\u00fdch p\u0159\u00edpravk\u016f s limitac\u00ed odbornosti.<\/p>\n

Pro indikace k denzitometrick\u00e9mu vy\u0161et\u0159en\u00ed, stejn\u011b jako u ka\u017ed\u00e9ho jin\u00e9ho vy\u0161et\u0159en\u00ed plat\u00ed, \u017ee je pot\u0159ebn\u00e1 \u017e\u00e1danka, a je v\u017edy pln\u011b v kompetenci o\u0161et\u0159uj\u00edc\u00edho l\u00e9ka\u0159e, jestli vy\u0161et\u0159en\u00ed doporu\u010d\u00ed. Existuj\u00ed v\u0161ak pravidla doporu\u010den\u00ed, kter\u00e1 vyd\u00e1vaj\u00ed p\u0159\u00edslu\u0161n\u00e9 odborn\u00e9 spole\u010dnosti, tak aby mohlo b\u00fdt co nejefektivn\u011bji a nej\u00fa\u010deln\u011bji vyu\u017eito denzitometrick\u00e9ho vy\u0161et\u0159en\u00ed v osteologick\u00e9 praxi. Denzitometrie je tak\u00e9 indikovan\u00e1 u pacient\u016f na za\u010d\u00e1tku nebo v pr\u016fb\u011bhu dlouhodob\u00e9 l\u00e9\u010dby kortikoidy nebo jin\u00fdmi l\u00e9ky, kter\u00e9 sni\u017euj\u00ed mno\u017estv\u00ed kostn\u00ed hmoty.<\/p>\n

Denzitometrie umo\u017e\u0148uje stanoven\u00ed rizika vzniku zlomenin, zejm\u00e9na u \u017een v menopauze nebo po menopauze, ale vy\u0161et\u0159en\u00ed je nutn\u00e9 i u dal\u0161\u00edch onemocn\u011bn\u00ed, u kter\u00fdch jsou zn\u00e1mky pro\u0159\u00eddl\u00e9 kostn\u00ed struktury a \u010dasto jsou zji\u0161t\u011bny i dal\u0161\u00ed faktory zvy\u0161uj\u00edc\u00ed riziko zlomenin, a to u obou pohlav\u00ed. Na z\u00e1klad\u011b v\u00fdsledk\u016f denzitometrie je mo\u017en\u00e9 podstoupit c\u00edlenou l\u00e9\u010dbu, ale i jinak lze dle v\u0161eobecn\u00fdch pokyn\u016f s \u00fapravou \u017eivotospr\u00e1vy a doporu\u010dovanou b\u011b\u017en\u011b dostupnou terapi\u00ed \u00fa\u010dinn\u011b ovlivnit osteopor\u00f3zu jako jednu z nej\u010dast\u011bj\u0161\u00edch civiliza\u010dn\u00edch nemoc\u00ed.<\/p>\n

Standardn\u011b se vy\u0161et\u0159uj\u00ed 2 a\u017e maxim\u00e1ln\u011b 3 oblasti skeletu, nej\u010dast\u011bji se jedn\u00e1 o bedern\u00ed \u00fasek p\u00e1te\u0159e, ky\u010deln\u00ed klouby nebo oblast dist\u00e1ln\u00edho p\u0159edlokt\u00ed. Toto vy\u0161et\u0159en\u00ed je dosta\u010duj\u00edc\u00ed pro vyhodnocen\u00ed stavu kostn\u00ed struktury i zm\u011bn prob\u00edhaj\u00edc\u00edch v \u010dase l\u00e9\u010dby. Je nutn\u00e9 si tak\u00e9 uv\u011bdomit, \u017ee se jedn\u00e1 o vy\u0161et\u0159en\u00ed s radia\u010dn\u00ed z\u00e1t\u011b\u017e\u00ed, a vzhledem k tomu nen\u00ed \u017e\u00e1douc\u00ed organismus v\u00edce zat\u011b\u017eovat. Celot\u011blov\u00e1 denzitometrie je mo\u017en\u00e1, ale standardn\u011b se neprov\u00e1d\u00ed. Dal\u0161\u00ed dopl\u0148uj\u00edc\u00ed informace jsou uvedeny na internetov\u00fdch str\u00e1nk\u00e1ch Spole\u010dnosti pro metabolick\u00e1 onemocn\u011bn\u00ed skeletu (www.smos.cz<\/strong><\/a>).<\/p>\n

Pro dopln\u011bn\u00ed problematiky m\u016f\u017eeme informovat i o mo\u017enosti vy\u0161et\u0159en\u00ed kostn\u00ed denzity ultrazvukov\u00fdm p\u0159\u00edstrojem (k\u00f3d v\u00fdkonu 89523 \u2013 Ultrazvukov\u00e1 denzitometrie). Jedn\u00e1 se o vy\u0161et\u0159en\u00ed bez radia\u010dn\u00ed z\u00e1t\u011b\u017ee, kdy je v\u0161ak mo\u017en\u00e9 vy\u0161et\u0159it kvalitu kostn\u00ed struktury pouze v jedn\u00e9 lokalit\u011b, a to konkr\u00e9tn\u011b na patn\u00ed kosti. Vy\u0161et\u0159en\u00ed je tedy v podstat\u011b orienta\u010dn\u00ed, ale pro prevenci dosta\u010duj\u00edc\u00ed. V\u00fdkon je mo\u017en\u00fd na \u017e\u00e1danku s obdobn\u00fdmi pravidly jako u kostn\u00ed denzitometrie, ale v r\u00e1mci prevence je vhodn\u00fd i pro samopl\u00e1tce.<\/p>\n

(tzvzp)<\/strong><\/p>\n

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