{"id":300338,"date":"2024-03-11T12:38:58","date_gmt":"2024-03-11T11:38:58","guid":{"rendered":"https:\/\/zakrasnejsivimperk.cz\/?p=300338"},"modified":"2024-03-11T12:38:58","modified_gmt":"2024-03-11T11:38:58","slug":"vseobecna-zdravotni-pojistovna-lecba-endometriozy","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=300338","title":{"rendered":"V\u0160EOBECN\u00c1 ZDRAVOTN\u00cd POJI\u0160\u0164OVNA: L\u00e9\u010dba endometri\u00f3zy"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-201756 size-full\" src=\"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2020\/08\/31\/vzp-logo.png\" alt=\"\" width=\"646\" height=\"223\" srcset=\"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2020\/08\/31\/vzp-logo.png 646w, https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2020\/08\/31\/vzp-logo-300x104.png 300w\" sizes=\"(max-width: 646px) 100vw, 646px\" \/><\/p>\n<h4 style=\"text-align: center;\">OT\u00c1ZKA:<\/h4>\n<h4 style=\"text-align: center;\"><strong>Je z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed hrazena l\u00e9\u010dba endometri\u00f3zy?<\/strong><\/h4>\n<h4 style=\"text-align: center;\">ODPOV\u011a\u010e:<\/h4>\n<h6 class=\"-wm-MsoNoSpacing\">Endometri\u00f3za je chronick\u00e9 onemocn\u011bn\u00ed, kter\u00e9 se t\u00fdk\u00e1 nej\u010dast\u011bji \u017een ve v\u011bku 15-49 let. Toto z\u00e1va\u017en\u00e9 gynekologick\u00e9\u00a0<strong>onemocn\u011bn\u00ed se ned\u00e1 zcela vyl\u00e9\u010dit, ale jeho diagnostika a\u00a0n\u00e1sledn\u00e1 l\u00e9\u010dba m\u016f\u017ee pacientce zv\u00fd\u0161it kvalitu \u017eivota a ovlivnit plodnost. Prvotn\u00ed vy\u0161et\u0159en\u00ed by m\u011bla pacientka absolvovat u\u00a0gynekologa<\/strong>, p\u0159\u00edpadn\u011b se tak\u00e9 m\u016f\u017ee obr\u00e1tit na praktick\u00e9ho l\u00e9ka\u0159e, kter\u00fd ji ode\u0161le na\u00a0vy\u0161et\u0159en\u00ed ke specialistovi.<\/h6>\n<h6 class=\"-wm-MsoNoSpacing\"><strong>Co je to endometri\u00f3za?<\/strong><\/h6>\n<p class=\"-wm-MsoNoSpacing\">Onemocn\u011bn\u00ed postihuje v\u0161echny tk\u00e1n\u011b a org\u00e1ny v\u00a0lidsk\u00e9m t\u011ble, s\u00a0v\u00fdjimkou srdce a sleziny. Vyzna\u010duje se\u00a0vytv\u00e1\u0159en\u00edm lo\u017eisek tk\u00e1n\u011b endometria (sliznice dutiny d\u011blo\u017en\u00ed) mimo d\u011blohu \u2013 mohou vznikat na\u00a0vaje\u010dn\u00edc\u00edch, na povrchu d\u011blohy, st\u0159ev, mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e. Tato lo\u017eiska reaguj\u00ed na kol\u00eds\u00e1n\u00ed hormon\u016f v\u00a0\u010dase menstrua\u010dn\u00edho cyklu \u00fapln\u011b podobn\u011b jako sliznice v\u00a0d\u011bloze, narostou a krv\u00e1cej\u00ed \u2013 stejn\u011b jako sliznice v d\u011bloze, ale ta v\u00a0\u010dase menstruace odejde a v\u00a0pr\u016fb\u011bhu cyklu u\u017e o n\u00ed \u017eena nev\u00ed. Tk\u00e1\u0148 mimo dutinu d\u011blohy ale vytv\u00e1\u0159\u00ed cysty, sr\u016fsty, m\u016f\u017ee doch\u00e1zet k\u00a0pror\u016fst\u00e1n\u00ed lo\u017eisek i do okoln\u00edch org\u00e1n\u016f a\u00a0rovn\u011b\u017e ke\u00a0vzniku chronick\u00fdch z\u00e1n\u011bt\u016f. Projevy endometri\u00f3zy jsou zpravidla p\u0159etrv\u00e1vaj\u00edc\u00ed bolest v\u00a0p\u00e1nevn\u00ed oblasti, siln\u011b bolestiv\u00e1 menstruace, bolesti v\u00a0podb\u0159i\u0161ku mimo menstrua\u010dn\u00ed cyklus, bolestiv\u00fd pohlavn\u00ed styk, mo\u017en\u00e9 pot\u00ed\u017ee s\u00a0ot\u011bhotn\u011bn\u00edm, za\u017e\u00edvac\u00ed pot\u00ed\u017ee, pop\u0159\u00edpad\u011b krev v\u00a0mo\u010di \u010di stolici. N\u011bkter\u00e9 pacientky mohou b\u00fdt asymptomatick\u00e9, tzn. nemus\u00ed poci\u0165ovat \u017e\u00e1dn\u00e9 projevy onemocn\u011bn\u00ed a\u00a0zdravotn\u00ed obt\u00ed\u017ee.<\/p>\n<h6 class=\"-wm-MsoNoSpacing\"><strong>Existuje v\u00edce forem endometri\u00f3zy?<\/strong><\/h6>\n<p class=\"-wm-MsoNoSpacing\">Ani v sou\u010dasn\u00e9 dob\u011b medic\u00edna nen\u00ed schopna zji\u0161t\u011bn\u00ed, jak p\u0159esn\u011b doch\u00e1z\u00ed ke vzniku tohoto onemocn\u011bn\u00ed.\u00a0<strong>Ka\u017ed\u00e1 forma endometri\u00f3zy m\u00e1 jin\u00e9 projevy a p\u0159\u00ed\u010diny, li\u0161\u00ed se rovn\u011b\u017e postupy p\u0159i jej\u00ed diagnostice a\u00a0p\u0159i l\u00e9\u010db\u011b.<\/strong><\/p>\n<p class=\"-wm-MsoNoSpacing\">Zn\u00e1me n\u011bkolik klasifikac\u00ed a d\u011blen\u00ed onemocn\u011bn\u00ed podle lokalizace, vzniku, klinick\u00fdch projev\u016f \u010di\u00a0druh\u016f l\u00e9\u010dby:<\/p>\n<ul type=\"disc\">\n<li class=\"-wm-MsoNoSpacing\">endometri\u00f3za p\u00e1nevn\u00ed pob\u0159i\u0161nice (peritone\u00e1ln\u00ed) \u2013 jde o drobn\u00e1 lo\u017eiska na povrchu sliznice v\u00a0p\u00e1nvi<\/li>\n<li class=\"-wm-MsoNoSpacing\">endometri\u00f3za ovari\u00e1ln\u00ed \u2013 tzv. \u201e\u010dokol\u00e1dov\u00e9\u201c cysty na vaje\u010dn\u00edc\u00edch<\/li>\n<li class=\"-wm-MsoNoSpacing\">endometri\u00f3za d\u011blohy (adenomy\u00f3za) \u2013 tk\u00e1\u0148 vyst\u00fdlaj\u00edc\u00ed d\u011blohu pror\u016fst\u00e1 do svalov\u00e9 st\u011bny d\u011blohy<\/li>\n<li class=\"-wm-MsoNoSpacing\">endometri\u00f3za hlubok\u00e1 (tzv. hluboce infiltruj\u00edc\u00ed) \u2013 nejz\u00e1va\u017en\u011bj\u0161\u00ed forma zasahuje do\u00a0okoln\u00edch org\u00e1n\u016f v\u010detn\u011b t\u011bch \u017eivotn\u011b d\u016fle\u017eit\u00fdch<\/li>\n<\/ul>\n<h6 class=\"-wm-MsoNoSpacing\"><strong>Jak se stanovuje diagn\u00f3za?<\/strong><\/h6>\n<p class=\"-wm-MsoNoSpacing\"><strong>Pokud trvaj\u00ed zdravotn\u00ed obt\u00ed\u017ee\u00a0<\/strong>(viz v\u00fd\u0161e)<strong>\u00a0n\u011bkolik m\u011bs\u00edc\u016f bez zlep\u0161en\u00ed, m\u011bla by se pacientka obr\u00e1tit na\u00a0sv\u00e9ho gynekologa. Ten s pacientkou nejprve projde podrobn\u011b jej\u00ed anamn\u00e9zu<\/strong>\u00a0(osobn\u00ed, rodinnou, soci\u00e1ln\u00ed, pracovn\u00ed)<strong>, aktu\u00e1ln\u00ed zdravotn\u00ed obt\u00ed\u017ee, u\u017e\u00edvan\u00e9 l\u00e9ky, alergie\u00a0<\/strong>atd. N\u00e1sleduje\u00a0<strong>gynekologick\u00e9\u00a0<\/strong>vy\u0161et\u0159en\u00ed (s gynekologick\u00fdmi zrcadly)\u00a0<strong>a vy\u0161et\u0159en\u00ed<\/strong>\u00a0pohmatem.\u00a0<strong>Sou\u010d\u00e1st\u00ed vy\u0161et\u0159en\u00ed by\u00a0m\u011blo b\u00fdt i z\u00e1kladn\u00ed ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed.<\/strong>\u00a0Dopl\u0148kem m\u016f\u017ee b\u00fdt tak\u00e9 odb\u011br krve \u2013 laboratorn\u00ed krevn\u00ed testy mohou prok\u00e1zat zv\u00fd\u0161en\u00e9 zn\u00e1mky specifick\u00fdch l\u00e1tek pro toto onemocn\u011bn\u00ed.<\/p>\n<p class=\"-wm-MsoNoSpacing\"><strong>K\u00a0diagnostice je mo\u017en\u00e9 vyu\u017e\u00edt i dal\u0161\u00ed zobrazovac\u00ed metodu \u2013 tzv. \u201eexpertn\u00ed ultrazvuk\u201c<\/strong>\u00a0ve\u00a0specializovan\u00e9m centru, kter\u00fd umo\u017e\u0148uje zobrazit p\u0159\u00edtomnost a rozsah endometri\u00f3zy. Po vyhodnocen\u00ed n\u00e1lezu m\u016f\u017ee l\u00e9ka\u0159 pacientku tak\u00e9 odeslat na\u00a0magnetickou rezonanci \u010di na vy\u0161et\u0159en\u00ed st\u0159ev.\u00a0<strong>K\u00a0potvrzen\u00ed \u010di\u00a0up\u0159esn\u011bn\u00ed diagn\u00f3zy m\u016f\u017ee b\u00fdt pacientka indikov\u00e1na k\u00a0laparoskopick\u00e9mu vy\u0161et\u0159en\u00ed, kter\u00e9 je\u00a0pou\u017e\u00edv\u00e1no jak pro diagnostiku, tak l\u00e9\u010dbu i pro biopsii<\/strong>\u00a0(odebr\u00e1n\u00ed vzork\u016f tk\u00e1n\u011b pro dal\u0161\u00ed vy\u0161et\u0159en\u00ed) a\u00a0odstran\u011bn\u00ed jednotliv\u00fdch lo\u017eisek endometri\u00f3zy.<\/p>\n<p class=\"-wm-MsoNoSpacing\"><strong>V\u00a0p\u0159\u00edpad\u011b podez\u0159en\u00ed na endometri\u00f3zu m\u016f\u017ee l\u00e9ka\u0159 pacientku odeslat k\u00a0dal\u0161\u00edmu specializovan\u00e9mu vy\u0161et\u0159en\u00ed do centra pro l\u00e9\u010dbu endometri\u00f3zy, a to na z\u00e1klad\u011b posouzen\u00ed celkov\u00e9ho zdravotn\u00edho stavu pacientky.<\/strong><\/p>\n<h6 class=\"-wm-MsoNoSpacing\"><strong>Specializovan\u00e1 pracovi\u0161t\u011b<\/strong><\/h6>\n<p class=\"-wm-MsoNoSpacing\"><strong>Na diagnostiku a l\u00e9\u010dbu endometri\u00f3zy se zam\u011b\u0159uj\u00ed tzv. centra pro l\u00e9\u010dbu endometri\u00f3zy<\/strong>. Jedn\u00e1 se\u00a0o\u00a0specializovan\u00e1 pracovi\u0161t\u011b, ve kter\u00fdch je zaji\u0161t\u011bna spolupr\u00e1ce l\u00e9ka\u0159\u016f z\u00a0r\u016fzn\u00fdch l\u00e9ka\u0159sk\u00fdch obor\u016f \u2013 gynekologie, urologie, analgesie (l\u00e9\u010dba bolesti), neurologie, gastroenterologie, chirurgie, psychologie, fyzioterapie, asistovan\u00e1 reprodukce atd. Pacientk\u00e1m je v\u00a0t\u011bchto centrech\u00a0poskytov\u00e1na komplexn\u00ed p\u00e9\u010de.\u00a0<a name=\"-wm-_Hlk160786511\"><\/a><strong>Objedn\u00e1n\u00ed do tohoto centra je na z\u00e1klad\u011b doporu\u010den\u00ed<\/strong>\u00a0(\u017e\u00e1danky)<strong>\u00a0ambulantn\u00edho gynekologa. Pacientku m\u016f\u017ee doporu\u010dit tak\u00e9 praktick\u00fd l\u00e9ka\u0159, kter\u00fd m\u00e1 ve\u0161kerou pot\u0159ebnou zdravotn\u00ed dokumentaci\u00a0<\/strong>(od\u00a0gynekologa, ide\u00e1ln\u011b i<strong>\u00a0<\/strong>n\u00e1lez, kopie z\u00a0p\u0159edchoz\u00edch vy\u0161et\u0159en\u00ed) pro vytvo\u0159en\u00ed \u017e\u00e1danky.<\/p>\n<h6 class=\"-wm-MsoNoSpacing\"><strong>L\u00e9\u010dba<\/strong><\/h6>\n<p class=\"-wm-MsoNoSpacing\"><u>Farmakologick\u00e1 l\u00e9\u010dba<\/u><\/p>\n<p class=\"-wm-MsoNoSpacing\"><strong>Ke zm\u00edrn\u011bn\u00ed obt\u00ed\u017e\u00ed se pou\u017e\u00edv\u00e1 \u010dasto konzervativn\u00ed typ l\u00e9\u010dby l\u00e9\u010div\u00fdmi p\u0159\u00edpravky<\/strong>. L\u00e9ka\u0159 pacientce m\u016f\u017ee p\u0159edepsat nap\u0159. hormon\u00e1ln\u00ed l\u00e9ky, r\u016fzn\u00e9 druhy antikoncep\u010dn\u00edch pilulek nebo jin\u00fdch druh\u016f hormon\u016f, d\u00e1le l\u00e9ky proti bolesti (analgetika, protiz\u00e1n\u011btliv\u00e9 l\u00e9ky skupiny NSAID), kter\u00e9 v\u0161ak nejsou l\u00e9kem prvn\u00ed volby.<\/p>\n<p class=\"-wm-MsoNoSpacing\"><u>Chirurgick\u00e1 l\u00e9\u010dba<\/u><\/p>\n<p class=\"-wm-MsoNoSpacing\">I p\u0159es farmakologickou l\u00e9\u010dbu m\u016f\u017ee doch\u00e1zet u \u017een k op\u011btovn\u00e9mu n\u00e1stupu zdravotn\u00edch obt\u00ed\u017e\u00ed zp\u016fsoben\u00fdch endometri\u00f3zou \u2013 lo\u017eiska endometri\u00f3zy se mohou d\u00e1l roz\u0161i\u0159ovat \u010di vznikat nov\u00e1.\u00a0<strong>Chirurgick\u00e1 l\u00e9\u010dba m\u00e1 n\u011bkolik podob a odv\u00edj\u00ed se od konkr\u00e9tn\u00edho typu endometri\u00f3zy.<\/strong>\u00a0<strong>Spr\u00e1vn\u00e1 diagnostika umo\u017e\u0148uje l\u00e9ka\u0159i minimalizovat nutnost opakovan\u00fdch opera\u010dn\u00edch z\u00e1krok\u016f a vybrat ide\u00e1ln\u00ed l\u00e9\u010debn\u00fd postup \u010di jejich kombinaci \u2013 a t\u00edm zv\u00fd\u0161it \u00fasp\u011b\u0161nost terapie v\u00a0budoucnosti.<\/strong><\/p>\n<p class=\"-wm-MsoNoSpacing\"><strong>Rozhoduj\u00edc\u00edm a z\u00e1rove\u0148 nej\u0161etrn\u011bj\u0161\u00edm vy\u0161et\u0159en\u00edm je diagnostick\u00e1 laparoskopie, kter\u00e1 je\u00a0miniinvazivn\u00edm chirurgick\u00fdm v\u00fdkonem.<\/strong>\u00a0Vyu\u017e\u00edvan\u00e1 je tak\u00e9 pro diagnostiku tohoto onemocn\u011bn\u00ed. V\u00a0p\u0159\u00edpad\u011b, \u017ee pacientka trp\u00ed z\u00e1va\u017en\u011bj\u0161\u00ed formou endometri\u00f3zy, b\u00fdv\u00e1 n\u011bkdy nutn\u00e1 i\u00a0tzv.\u00a0laparotomie (otev\u0159en\u00e1 operace). Chirurgicky se odstran\u00ed lo\u017eiska endometri\u00f3zy a cysty, v\u00a0n\u011bkter\u00fdch p\u0159\u00edpadech je\u00a0pot\u0159eba i p\u0159eru\u0161it sr\u016fsty, vazy a nervov\u00e9 pleten\u011b, a t\u00edm dos\u00e1hnout \u00falevy od bolesti. U\u00a0nejt\u011b\u017e\u0161\u00edch forem tohoto onemocn\u011bn\u00ed m\u016f\u017ee b\u00fdt\u00a0p\u0159istupov\u00e1no i k\u00a0hysterektomii (odstran\u011bn\u00ed d\u011blohy) a sou\u010dasn\u011b mohou b\u00fdt odstran\u011bny i vaje\u010dn\u00edky.\u00a0<strong>V\u0161e ale vy\u017eaduje p\u0159\u00edsn\u011b individu\u00e1ln\u00ed p\u0159\u00edstup, ka\u017ed\u00e1 pacientka je\u00a0jedine\u010dn\u00e1.<\/strong><\/p>\n<h6 class=\"-wm-MsoNoSpacing\"><strong>\u00dahrada z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed<\/strong><\/h6>\n<p class=\"-wm-MsoNoSpacing\"><strong>Z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed jsou hrazena ve\u0161ker\u00e1 vy\u0161et\u0159en\u00ed indikovan\u00e1 o\u0161et\u0159uj\u00edc\u00edm l\u00e9ka\u0159em. Vy\u0161et\u0159en\u00ed a odb\u011bry je nutn\u00e9 prov\u00e9st ve\u00a0smluvn\u00edch zdravotnick\u00fdch za\u0159\u00edzen\u00edch\u00a0<\/strong>(tzn.\u00a0u\u00a0poskytovatele zdravotn\u00edch slu\u017eeb, kter\u00fd m\u00e1 uzav\u0159enou smlouvu se zdravotn\u00ed poji\u0161\u0165ovnou pacienta).<\/p>\n<p><strong>(vzp)<\/strong><\/p>\n<hr \/>\n","protected":false},"excerpt":{"rendered":"<p>OT\u00c1ZKA: Je <\/p>\n","protected":false},"author":2,"featured_media":300343,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"gallery","meta":{"footnotes":""},"categories":[88],"tags":[],"jetpack_featured_media_url":"https:\/\/zakrasnejsivimperk.cz\/wp-content\/uploads\/2024\/03\/11\/ram-vzp.jpg","_links":{"self":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/300338"}],"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=300338"}],"version-history":[{"count":5,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/300338\/revisions"}],"predecessor-version":[{"id":300344,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/posts\/300338\/revisions\/300344"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=\/wp\/v2\/media\/300343"}],"wp:attachment":[{"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=300338"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=300338"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zakrasnejsivimperk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=300338"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}