Zdravstvena Biblioteka

Odgovore na Vaša pitanja o zdravlju i korake za zdrav život možete pronaći u našoj biblioteci.

Tehnologije

HIFU

<p>Rak prostate jedan je od najče&scaron;ćih karcinoma kod mu&scaron;karaca u svijetu i kod nas. Kao i kod ostalih vrsta raka, rana dijagnostika ima važno mjesto u liječenju ove bolesti. Metoda HIFU, koja je posljednjih godina postala istaknuta kao nehirur&scaron;ko liječenje u slučajevima raka prostate, može pružiti velike prednosti. Najnovija verzija HIFU tehnologije primijenjena&nbsp; je u bolnici Memorial Bah&ccedil;elievler i&nbsp; osigurava da se liječi samo oboljelo područje prostate, a okolna tkiva ostaje ne&nbsp; o&scaron;tećena.</p> <p>HIFU uklanja rizike poput urinarne inkontinencije ili seksualne disfunkcije, koji su među mogućim nuspojavama klasične hirurgije.</p> <p>&Scaron;TA JE HIFU METODA?</p> <p>Tretmani poput hirurgije i radioterapije koriste se kod raka prostate. Mogu se javiti mnoge nuspojave ovih metoda liječenja. Kao rezultat toga, razvijena je High IntensityFocusedUltrasound ili HIFU metoda. Najsavremenija verzija HIFU tehnologije primijenjenjuje se&nbsp; u&nbsp; Memorial Bah&ccedil;elievler bolnici , koja se naziva terapijom žari&scaron;ta,&nbsp; i uklanja rizike poput urinarne inkontinencije ili seksualne disfunkcije osiguravajući da se liječi samo oboljelo područje prostate i da okolna tkiva nisu o&scaron;tećena. Ovaj novi uređaj primjenjuje se samo u jednom centru u Istanbulu a to je&nbsp;&nbsp; Memorijal&nbsp; Bah&ccedil;elievler bolnica .</p> <p>Na&scaron;e stručno osoblje u&nbsp; centru:</p> <p>&nbsp;</p> <p><strong>Urolozi </strong></p> <ul> <li>Prof. Dr. Volkan Tuğcu</li> <li>Op. Dr. İlker &Ccedil;&ouml;mez</li> </ul> <p><strong>Radijolozi &nbsp;</strong></p> <ul> <li>Prof. Dr. Barış Bakır</li> <li>Do&ccedil;. Dr. Selim Bakan</li> </ul> <p><strong>Nuklearna medicina </strong></p> <ul> <li>Prof. Dr. Akın Yıldız</li> <li>Uz. Dr. Aria Forouz</li> </ul> <p><strong>KOJI PACIJENTI SU&nbsp; PODOBNI&nbsp; ZA HIFU METODU?</strong></p> <p>HIFU metoda se najvi&scaron;e koristi u ranim fazama raka prostate, kod malih i neza&scaron;tićenih pacijenata.</p> <p>&bull; HIFU metoda je prikladnija opcija liječenja jer pruža prednosti mlađim pacijentima koji ne žele imati urinarne probleme i imaju aktivan seksualni život.</p> <ul> <li>&nbsp;</li> <li>&bull; HIFU metoda je prikladnija opcija liječenja jer pruža prednosti mlađim pacijentima koji ne žele imati urinarne probleme i imaju aktivan seksualni život.</li> <li>&bull; Pacijenti sa karcinomom prostate u ranoj fazi, T1 ili T2,</li> <li>&bull; Rak je u početnoj fazi,</li> <li>Pacijenti čija dob ili opće stanje nije pogodno za operaciju raka prostate</li> <li>Pacijenti koji traže minimalno invazivne sklonosti liječenju prema radikalnim operativnim metodama liječenja</li> </ul> <p><strong>KOLIKO TRAJE&nbsp;&nbsp; HIFU PROCEDURA?</strong></p> <p>Trajanje postupka HIFU-a izravno je proporcionalno veličini područja koje se mora spaliti.&nbsp; Postupak spaljivanja u prosjeku traje između 1-2 sata, a &nbsp;može biti &nbsp;i duže.</p> <p><strong>KAKVE SU PREDNOSTI&nbsp; U ODNOSU NA&nbsp; DRUGE METODE LIJEČENJA&nbsp; RAKA&nbsp; PROSTATE ?</strong></p> <p>&nbsp;</p> <p>&bull; Nudi važnu prednost u za&scaron;titi seksualnog života i kontrole mokraće.</p> <p>&bull; U otvorenim operacijama pacijent ostane u bolnici 3-4 dana. Kako liječenje radioterapijom traje 30 dana, pacijent mora svakodnevno dolaziti u bolnicu. HIFU operacija je aplikacija za jednu sesiju. Samo pacijenti koji su primili HIFU mogu se vratiti svojoj kući nakon &scaron;to ostanu u bolnici 1 noć. Ili ako se postupak primjenjuje ujutro, pacijenti se mogu otpustiti uvečer istog dana.</p> <p>&bull; Rizik od komplikacija je vrlo nizak.</p> <p>&bull; Može se lako primjeniti u slučajevima recidiva nakon otvorene hirurgije, zatvorene hirurgije, radioterapije ili HIFU.</p> <p>&bull; Daje priliku za intervenciju u tkivu raka bez o&scaron;tećenja okolnih organa i tkiva.</p> <p>&bull; nije izložen &scaron;tetnim uticajima zračenja.</p> <p>&bull; Pacijenti koji nisu podobni za operaciju mogu imati koristi od HIFU-a.</p> <p>&bull; Prag boli razlikuje se za sve, ali postupak HIFU-a definiran je kao bezbolna primjena.</p> <p>&bull; Može se primeniti kod pacijenata starije životne dobi koji ne mogu primiti anesteziju.</p>

PET/CT

<p>&nbsp;<strong>Pozitronska emisijska tomografija</strong>&nbsp;(PET/CT) je metoda kojom se pomoću radiofarmaka prikazuje funkcionalno stanje tkiva i organa, odnosno metabolička aktivnost stanica. To je najosjetljivija molekularna slikovna metoda dana&scaron;njice, te je standardna metoda u praćenju bolesnika sa različitim tumorima. PET/CT je osobito koristan za lokalizaciju tumora, procjenu učinka provedene terapije, uznapredovalosti bolesti, detekciju lokalnog recidiva i udaljenih metastaza,a u novije vrijeme ova dijagnostika ima sve veći značaj u preciznijem planiranju radioterapije.</p> <p>PET i&nbsp; PET/CT dijagnostika se koristi za :</p> <ul> <li>Detekciju kancera.</li> <li>Procjenu da li se kancer pro&scaron;irio po tijelu</li> </ul> <p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Procijenu učinkovitosti&nbsp; plana liječenja, kao &scaron;to je terapija protiv kancera</p> <ul> <li>Procjenu da li je kancer recidivirao ( da li se vratio)</li> <li>Određuje protok krvi u srčani mi&scaron;ić</li> <li>Utvrđuje učinke infarkta miokarda na različitim djelovima srca</li> </ul> <p>Identifikaciju &nbsp;područja srčanog mi&scaron;ića koji će imati koristi od postupaka, kao &scaron;to angioplastika ili bypass operacije</p> <p>&nbsp;Procijenu &nbsp;abnormalnosti mozga, kao &scaron;to su tumori, poremećaji pamćenja, napada i drugih poremećaja sredi&scaron;njeg živčanog sustava.</p> <p>Kako se trebate pripremiti za PET/CT dijagnostiku</p> <p>&nbsp;Za PET/CT snimanje potrebno je da bar&nbsp; 6 sati prije istoga prestanete da konzumirate hranu ,budući da obroci mogu izazvati&nbsp; poremećaj u raspodjeli&nbsp; PET Tracera u tijelu &scaron;to&nbsp; može dovesti do suboptimalnog &nbsp;skeniranja .Ne smijete konzumirati bilo koju tečnost koja sadrži &scaron;ećere ili kalorije,umjesto toga treba unositi samo vodu.Ako ste dijabetičar ,dobićete posebna upustva.Žene trebaju uvijek prije snimanja da informi&scaron;u doktora o tome da li postoji mogućnost da su gravidne ili da li doje Takođe dužni ste da obavjestite doktora o tome da li koristite neke lijekove,vitamine ili suplemente.Takođe doktori prije PET CT dijagnostike moraju biti upoznati sa tim da li imate neke alergije, i druge bolesti kako bi dobili uvid u kompletno stanje va&scaron;eg organizma.</p> <p>Dobićete posebna upustva u zavisnosti koju vrstu PET CT dijagnostike radite.Metalni predmeti uključujući nakit,naočale,proteze i ukosnice mogu uticati na snimanje i trebate ih odstraniti prije ispitivanja.</p> <p>Kako se izvodi postupak</p> <p>Prije samog postupka pacijentu se izmjeri visina &scaron;ećera u krvi. Kada je &nbsp;razina glukoze u krvi na željenoj razini, radioaktivni materijal se ubrizgava &nbsp;intravenozno, ovisno o vrsti pregleda&nbsp; kojeg pacijent prolazi. Postoji nekoliko radioaktivnih tvari, ali najče&scaron;će kori&scaron;tena je F-18 fluorodeoxyglukoza. Ovaj materijal se naziva jo&scaron; &nbsp;fluor-18,temeljen&nbsp; je na&nbsp; molekuli &scaron;ećera &nbsp;koja se veže na radioaktivnim tvarima.</p> <p>Nakon injekcije, pacijent leži &nbsp;oko sat vremena kako bi&nbsp; radiooaktivni materijal se apsorbovao &nbsp;u organima&nbsp; ili tkivima koja &nbsp;se proučavaju. Tokom ovog postupka pacijent treba da leži u ti&scaron;ini&nbsp; izbjegavajući kretanje i druženje. Zatim će se poduzeti PET-CT. Ukupno vrijeme skeniranja je oko 30 minuta.</p>

Sav sadržaj Tehnologije

Metode liječenja

POEM

<p><strong>&Scaron;ta je POEM?</strong></p> <p>Postupak peroralne endoskopske miotomije (POEM) je napredna metoda endoskopskog liječenja koja se koristi kod ahalazije ili nekih bolesti jednjaka. POEM metoda se koristi tek u nekoliko centara na svijetu , i koristi se kad&nbsp; problematični mi&scaron;ići jednjaka se smanjuju ulaskom kroz usta i kada konvencionalna endoskopija nije moguća .</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>Kod kojih se bolesti koristi POEM?</strong></p> <p>To je metoda liječenja bolesti achalasia, koja ima simptome poput te&scaron;koće pri gutanju nakon jela, osjećaj zaglavljene hrane i začepljenja u grudima, nelagode u grudima, hrane koja se vraća iz usta, infekcije pluća, lo&scaron;eg zadaha i bolova u grudima.</p> <p>&nbsp;</p> <p><strong>Kako se vr&scaron;i POEM? Kako se primjenjuje POEM</strong>?</p> <p>Problematični mi&scaron;ići jednjaka se režu ulazeći kroz usta kao da se klasična endoskopija izvodi POEM metodom primenjenom u nekoliko centara u svijetu. Nakon dijagnoze bolesti ahalazije, pacijentima je omogućeno da ponovo jedu .</p> <p>&nbsp;</p> <p><strong>Koje su odlike POEM metode?</strong></p> <p>Kod nas se danas uspje&scaron;no primjenjuju najnaprednije endoskopske metode liječenja koje su zastupljene &nbsp;u svijetu. Budući da se postupak vr&scaron;i endoskopski, u tijelu nema ureza i pacijent se u kratkom vremenu otpu&scaron;ta kući. Pacijenti počinju jesti 1 dan nakon POEM-a, koji traje oko 1-1,5 sati, i nastavljaju svoj život 2. dan na zdrav način. Dugoročno gledano, stopa uspjeha je prilično visoka. U na&scaron;em centru za &nbsp;bolest achalasia može se liječiti pomoću naprednih endoskopskih sistema.</p> <p>&nbsp;</p> <p><strong>Često postavljena pitanja </strong></p> <p>&nbsp;</p> <p>1.<strong>POEM</strong> je &nbsp;endoskopski zahvat kojim se liječi ahalazija jednjaka. Napretkom endoskopskih tehnika i alata do&scaron;lo je do mogućnosti da se bez&nbsp;ikakvoga vanjskog reza endoskopskim putem odstrani zloćudna promjena probavne cijevi, bilo da je riječ o jednjaku, želucu ili debelom crijevu. Poput drugih tehnika u gastrointestinalnoj endoskopiji i ove metode imaju rizik od komplikacija poput krvarenja, perforacije i postproceduralnih striktura.</p> <p><strong>.</strong></p> <p>&nbsp;</p> <p>&nbsp;2.<strong>&Scaron;ta je manometrija jednjaka?</strong></p> <p>Radni raspored jednjaka i kontrakcijski pokreti tokom gutanja ispituju se manometrijom. U endoskopskim procjenama kod pacijenata koji se liječniku predstavljaju s poremećajem gutanja, dijagnoza ahalazije potvrđuje se manometrijskim metodama ako se ne utvrdi stanje tumora i nema simptoma refluksa.</p> <p>&nbsp;<br /> &nbsp;<br /> <strong>&nbsp;&nbsp;3. Kolika je stopa uspeha POEM metode, a to je lečenje bolesti ahalazije?</strong></p> <p>Najveća prednost POEM metode je ta &scaron;to je stopa uspjeha bolesti ahalazije visoka u usporedbi s drugim endoskopskim metodama. S obzirom na petogodi&scaron;nje rezultate, poznato je da je stopa uspjeha preko 90 posto.</p> <p><br /> &nbsp;<br /> <strong>4.&nbsp;&nbsp;&nbsp;4. Da li je POEM, lečenje bolesti ahalazije, rizičan postupak?</strong></p> <p>S&nbsp; obzirom da je stopa komplikacija niska, to je prva poželjna metoda liječenja u primarnom liječenju bolesti ahalazije u svijetu<strong>.</strong><br /> <br /> &nbsp;5. <strong>Mogu li se pacijenti s prethodnim botoksom, balonom ili hirur&scaron;kim liječenjem bolesti ahalazije liječiti i POEM metodom</strong>?</p> <p>POEM metoda može se sigurno primijeniti kod pacijenata koji su liječeni od bolesti ahalazije, ali čije se žalbe nisu umanjile ili se ponovo nisu pojavile.<br /> &nbsp;</p>

Moždana baterija

<p><strong>&Scaron;ta je moždana baterija?</strong></p> <p>Pejsmejker je uspje&scaron;na metoda liječenja kod nekih neurolo&scaron;kih bolesti koje uzrokuju nehotične poremećaje kretanja u tijelu.</p> <p><strong><em>Kod kojih bolesti se primenjuje pejsmejker?</em></strong></p> <p>1. Parkinsonova bolest</p> <p>2. distonija (skupina bolesti kod kojih se tijelo neprestano nehotice vrti i uvija)</p> <p>3. Tremor</p> <p>4. Epilepsija</p> <p>5. Huntington-ova bolest (genetska bolest kod koje je koordinacija pokreta progresivno naru&scaron;ena)</p> <p><strong><em>Kako se primjenjuje?</em></strong></p> <p>U ovom procesu; Tanki kablovi postavljaju se u &bdquo;moždane jezgre&ldquo; koje se nalaze u srednjem dijelu mozga vrlo osjetljivom metodom i kontinuirana električna stimulacija se daje baterijom postavljenom u grudima ili trbuhu. Na taj se način reorganiziraju nervne ćelije čija je električna aktivnost oslabljena zbog bolesti i &nbsp;ti simptomi bolesti nestaju.</p> <p>Osobito pacijenti s Parkinsonom i tremorom mogu se za kratko vrijeme rije&scaron;iti pote&scaron;koća poput drhtanja, nesposobnih da hodaju i govore u &nbsp;godinama kada imaju priliku živjeti normalan život.</p> <p>Da bi se umetnuo pejsmejker, potrebno je obaviti niz detaljnih ispitivanja, snimanja i neuropsihijatrijske procjene, te dokazati podobnost pacijenta za ovo liječenje.</p> <p>Operacija pejsmejkera mozga može se primijeniti samo na pacijente za koje je vjerovatno da će imati koristi od liječenja.</p> <p>Operacija se obično izvodi &nbsp;u budnom stanju . Prije operacije na uređaj se postavlja aparat nazvan &quot;stereotaktični okvir&quot;, zatim se izrađuje film i izrađuju koordinatni ciljevi. Ciljevi se određuju kao rezultat vrlo osjetljivih izračuna s naprednim računarskim programima i kablovi se postavljaju na ove točke s lokalnom anestezijom.</p> <p><strong>ČESTO POSTAVLJANA PITANJA O KUTIJI ZA BATERIJU</strong></p> <p><strong><em>Da li se baterija zamenjuje?</em></strong></p> <p>Trajanje baterije je otprilike 5-6 godina. Na kraju ovog perioda, staru bateriju možete zamijeniti novom u 15-minutnom procesu bez ometanja kablova u mozgu.</p> <p>Kako pejsmejker utječe na svakodnevni život?</p> <p>Nakon operacije pacijent se može vratiti na posao i dru&scaron;tveni život onako kako liječnik to smatra prikladnim. Dok osoba lako ispunjava svoje svakodnevne potrebe, može živjeti kao zdrav pojedinac.</p> <p>Mogu li oni koji imaju bateriju mozga proći kroz sigurnosne uređaje?</p> <p>U redu je da pacijenti sa baterijom mozga uđu u rendgenske, sigurnosne skrining uređaje.</p> <p>Mogu li pacijenti sa pejsmejkerom napraviti tomografiju ili MRI?</p> <p>Ne preporučuje se MR tijela, ali MR se može uzimati kako bi se mozak pravilno vizualizirao.</p> <p>Je li protivno da pacijenti sa pejsmejkerima vježbaju ili vježbaju?</p> <p>Pacijenti mogu pravilno vježbati, čak je i aktivan život vrlo važan. Ipak, treba izbjegavati sportove koji zahtijevaju bliski kontakt i mogu prouzrokovati traume.</p>

Transplantacija jetre

<p>Transplantacija ili presađivanje organa je&nbsp; uspje&scaron;na metoda liječenja bolesnika kod kojih je do&scaron;lo do nepovratnog gubitka funkcije vitalnih organa.</p> <p>Organi koji mogu biti transplantirani u dana&scaron;njoj medicini su : srce,pluća, srce i pluća zajedno,jetra, bubrezi,pancreas,crijeva i rožnjača.Transplantacija jetre,srca, rožnjače i bubrega se uspje&scaron;no obavlja u Turskoj,a u poslednje vrijeme počela se izvoditi i transplantacija pankreasa i pluća.</p> <p>Pored komponente&nbsp; pacijent-doktor-bolnica ,nezaobilazna komponenta u transplantaciji organa jeste donor organa.</p> <p>Memorial Zdravstvena Grupacija&nbsp; &nbsp;&nbsp;je prva privatna zdravstvena ustanova odobrena i licencirana od strane Ministarstva Zdravlja Republike Turske za transplantaciju organa &nbsp;(jetre , bubrega ,ko&scaron;tane srži )&nbsp; i srodne laboratorijske usluge.</p> <p>Najče&scaron;ći razlog za transplantaciju jetre kod&nbsp; odraslih jeste&nbsp; ciroza jetre-</p> <p>&nbsp;U&nbsp; Memorial bolnicama se&nbsp; uspje&scaron;no&nbsp; obavljaju transplantacije jetre ,bubrega rožnjače, &nbsp;ko&scaron;tane srži i pluca. Statistički gledano pozicionirani su među top 5 zemalja svijeta. Samo u pro&scaron;loj godini u Memorial bolnicama urađeno je 250 transplantacija jetre ( 85% je bilo transplantacija sa živog donora a uspje&scaron;nost je iznosila&nbsp; 93%) ,&nbsp; takođe &nbsp;preko 352 transplantacija bubrega čija uspje&scaron;nost je bila 99%, dok kada govorimo o transplantaciji ko&scaron;tane srži ta brojka&nbsp; je iznosila 156 transplantacija .</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>Transplantacija jetre</strong></p> <p><strong>&nbsp;</strong></p> <p>Najče&scaron;ći razlog za transplantaciju jetre kod&nbsp; odraslih jeste&nbsp; ciroza. Ciroza je hronična bolest jetre koju obilježava o&scaron;tećenje jetrenog tkiva&nbsp; (uglavnom uzrokovano hepatitisom B). Ostali uvjeti koji uzrokuju nastanak ciroze su: neke urođene bolesti, i neke metaboličke bolesti</p> <p>Ako neko zbog zatajenja jetre ne moze da obavlja&nbsp; svakodnevne životne&nbsp; aktivnosti ;onda je on kandidat za trasplantaciju jetre.</p> <p>Postoje izvori donora jetre. Obično jetra se dobija od kadaveričnih donora (osoba kod kojih je dijagnosticirana &quot;moždana&nbsp; smrt&quot;, ali čiji drugi organi i sistemi funkcioniraju ispravno).</p> <p>Usljed kontinuiranog nedostatka donora jetre i s obzirom na visoku učestalost bolesti jetre, vrijeme čekanja na ovaj organ &nbsp;se povećava svake godine.Stotine ljudi umiru svake godine dok su u procesu čekanja na organ.</p> <p>Donori &nbsp;jetre također&nbsp; mogu biti i &nbsp;članovi&nbsp; porodice ili prijatelji koji doniraju dio svoje &nbsp;jetre pacijentu .</p> <p>Kompatibilnost obje krvne grupe i veličine jetre su od su&scaron;tinskog značaja za transplantaciju jetre.</p> <p>&nbsp;Ako postoji član obitelji ili prijatelj voljan donirati dio njegove / njene jetre moguće je spasiti život pacijenta uklanjanjem dijela&nbsp; jetre sa živog&nbsp; donora&nbsp; i presađivanjem istoga u primaoca,tj. pacijenta.</p> <p>Živi donor ne mora biti u krvnom srodstvu sa primaocom jetre,ali krvne grupe moraju biti kompatibilne.Donor mora biti zdrav i motiviran za doniranje organa iz altruističkih razloga.</p> <p>Ako je živi donor odgovarajuća opcija za pacijenta ,pristupa se evaluaciji donora i testiranju donora nakon čega transplantacijski tim odlućuje da li će se pristupiti transplantaciji ili ne.Živi donori su obično i jedina &scaron;ansa za djecu.Idealno bi bilo da se transplantacija obavlja između osoba čije krvne grupe se podudaraju.Međutim, u hitnim&nbsp; slučajevima ,kako bi se spasio život pacijenta transplantacija se može obaviti i među ne kompatibinim krvnim grupama,ali veličina jetre mora biti&nbsp; podudarna.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>&nbsp;Često postavljana pitanja</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>&Scaron;ta je transplantacija jetre ?</strong></p> <p>&nbsp;</p> <p>To je operacija kojom se otklanja oboljela jetra i zamjenjuje sa zdravom .</p> <p><strong>Koje su indikacije za transplantaciju jetre ?</strong></p> <p>Indikacije za translantaciju jetre su mnogobrojne bolesti jetre kao &scaron;to su cioza, neka kongenitalna oboljenja i tumori jetre.</p> <p><strong>Odakle dolazi jetra za transplantacju ?</strong></p> <p>Cijele jetre dolaze od osoba koje su upravo preminule (osoba kod kojih je dijagnosticirana &lsquo;moždana smrt&rsquo; ali čiji ostali&nbsp; organ ili sistemi funkcionisu normalno).Ovaj tip donora nazivano kadaverični donor.Da bi se uzela jetra sa mrtvog tijela ; ova osoba treba da je potpisala donorsku karticu za donaciju njenin/njegovih organa ili njeni/ njegovi rođaci trebaju da daju pristanak za doniranje organa nakon &scaron;to osoba premine. Organi ne smiju biti prodavani, to je ilegalno.</p> <p>&nbsp;</p> <p><strong>Da li je &nbsp;moguće izvr&scaron;iti transplantacija jetre sa živog donora?</strong></p> <p>&nbsp;</p> <p>Da,moguće je . Ako postoji član obitelji ili prijatelj voljan donirati dio njegove / njene jetre moguće je spasiti život pacijenta uklanjanjem dijela&nbsp; jetre sa živog&nbsp; donora&nbsp; i presađivanjem istoga u primaoca,tj. pacijenta. Živi donor ne mora biti u krvnom srodstvu sa primaocom jetre,ali krvne grupe moraju biti kompatibilne.Donor mora biti zdrav i motiviran za doniranje organa iz altruističkih razloga.Prednost kod transplantacije sa živog donora je to sto vrijeme čekanja na listi za transplantaciju je relativno kraće,a jetra koja je presađena sa živog donora je sa dužim vijekom trajanja.Darivanje dijela jetre je sa puno manjim rizikom za zdravlje donora zbog detaljnih ispitivanja koje se radi kod donora sa kojim se isključuje mogućnost pojave kasnijih zdravstvenih problema i zbog karakteristike jetre da se skoro u potpunosti regeneri&scaron;e 6-8 sedmica nakon transplantacije.</p> <p>Ako je živi donor odgovarajuća opcija za pacijenta ,pristupa se evaluaciji donora i testiranju donora nakon čega transplantacijski tim odlućuje da li će se pristupiti transplantaciji ili ne.</p> <p>Živi donori su obično i jedina &scaron;ansa za djecu.Idealno bi bilo da se transplantacija obavlja između osoba čije krvne grupe se podudaraju.Međutim, u hitnim&nbsp; slučajevima ,kako bi se spasio život pacijenta transplantacija se može obaviti i među ne kompatibinim krvnim grupama,ali veličina jetre mora biti&nbsp; podudarna.</p> <p>&nbsp;</p> <p><strong>Može li bilo koja jetra biti donirana svakome ?</strong></p> <p>Ne,ne može.Postoje određene kvalifikacije koje se moraju ispo&scaron;tovati kako bi se sigurno obavila translanatacija jetre.</p> <p>Donor mora biti:</p> <p>Približno iste težine i veličine kao primaoc</p> <ul> <li>Mora biti bez oboljenja ,infekcija i povreda koje utiču na jetru</li> <li>Obično iste ili kompatibilne krvne grupe</li> </ul> <p>U veoma hitnim slučajevima transplantacija jetre se može obaviti između ne kompatibilnih krvnih grupa&nbsp; kako bi se spasio život pacijenta.</p> <p>&nbsp;</p> <p><strong>Da li je transplantacija jetre rizična ?</strong></p> <p>&nbsp;</p> <p>Da. Transplantacija jetre kao i bilo koja druga operacija ima svoje rizike koji su zajednički svim velikim operativnim zahvatima.Situacije kao &scaron;to su ;krvarenje, slaba funkcija presađene jetre i infekcije su glavni rizici koji se pojavljuju nakon operacije.</p> <p>Ponekad nova jetra ne funkcioni&scaron;e kako bi trebalo&nbsp; i kada se to dogodi infekcije su najveći problem za te pacijente.</p> <p><strong>&Scaron;to je odbacivanje?</strong></p> <p>Odbacivanje transplantata dolazi kada imuni sistem &nbsp;primaoca napadne transplantirani organ ili tkivo.Imuni sistem ljudskog tijela se sam &scaron;titi od potencijalno &scaron;tetnih tvari, kao &scaron;to su mikroorganizmi, toksini, i ćelije raka. Ove &scaron;tetne tvari na svojim povr&scaron;inama&nbsp;&nbsp; imaju proteine zvani antigeni. Ako &nbsp;imunolo&scaron;ki sistem prepoznaje antigene koji su strani, on će ih napasti.</p> <p>Na isti način, strana krv ili tkivo može izazvati reakciju na transfuziju krvi ili &nbsp;odbacivanje transplantata. Da bi se ovo sprječilo rade se testovi&nbsp; tipizacije prije transplantacije.</p> <p>Iako tipizacija tkiva osigurava da organ ili tkivo budu &nbsp;&scaron;to je sličnije moguće tkivu primaoca, mečing&nbsp; obično nije savr&scaron;en. Ne postoje &nbsp;dvije osobe (osim jednojajčanih blizanaca) &nbsp;koje imaju identične antigene tkiva.</p> <p>Imunosupresivni lijekovi su potrebni za sprećavanje odbacivanja organa, u suprotnom , organ i tkivo će izazvati imuni odgovor i dovesti do uni&scaron;tenja stranih tkiva.</p> <p>Cilj lijećenja je osigurati&nbsp; da presađeni organi ili tkiva funkcijoni&scaron;u ispravno, te istovremeno suzbiti imuni odgovor primaoca. Suzbijanje imunolo&scaron;kog odgovora može tretirati i spriječiti&nbsp; odbacivanje transplantata.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>Da li nakon transplantacije jetre se moraju doživotno koristiti lijekovi?</strong></p> <p>&nbsp;</p> <p>Da, pacijent mora uzimati lijekove cijeli život kako bi sprječio reakcije. Redovno uzimanje lijekova je bitno da bi&nbsp; transplantacija bila uspje&scaron;na. U slučaju da se ne koriste lijekovi, imuni sistem pacijenta odmah će prepoznati&nbsp; strani organ i on će se boriti protiv njega. To može dovesti do zatajenja organa ili smrt.</p> <p><strong>Koji je procenat uspje&scaron;nosti transplantacije jetre?</strong></p> <p>Prosječna stopa uspje&scaron;nosti transplantacije jetre u Memorial bolnici je &nbsp;93,8% .</p> <p><strong>Može li&nbsp; pacijent nakon transplantacije jetre se vratiti normalnim životnim aktivnostima?</strong></p> <p>Da. Nakon uspje&scaron;ne transplantacije jetre, večina ljudi se može vratiti u svoje normalne dnevne aktivnosti. To je u stvari i svrha postupka. Trudnoća i porod djeteta su također mogući nakon transplantacije jetre. Večina ljudi mogu se&nbsp; baviti fizičkim aktivnostima&nbsp; i vježbama unutar godinu dana.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>Za vi&scaron;e informacija molimo kontaktirajte na&scaron;e predstavni&scaron;tvo u Sarajevu</p> <p>Memorial office Sarajevo<br /> tel.:+38733 260 050<br /> Gsm.:+38762 311 911<br /> ili na adresi Branilaca Sarajeva 16/1</p>

Zamjena srčanog ventila

<p><strong>Srce ima dvije pretklijetke i dvije klijetke.</strong></p> <p>Svaka klijetka ima valvulu, jednosmjerni otvor (ventil) kroz koji ulazi krv te valvulu kroz koju krv izlazi. Ponekad se&nbsp;<strong>ventilni otvori ne otvaraju i zatvaraju ispravno te naru&scaron;avaju protok krvi</strong>&nbsp;kroz srce i tijelo.</p> <p>Srčani zalisci složene su strukture koje imaju funkciju ventila, a smje&scaron;tene su između pretklijetke i klijetke, odnosno između klijetke i arterije koja izlazi iz srca.</p> <p><strong>Postoje četiri srčana zaliska:</strong></p> <ul> <li><strong>mitralni zalistak</strong>&nbsp;&ndash; koji onemogućuje vraćanje krvi iz lijeve klijetke u lijevu pretklijetku,</li> <li><strong>aortni zalistak</strong>&nbsp;&ndash; koji zadržava krv u aorti nakon istiskivanja iz klijetke,</li> <li><strong>trikuspidalni zalistak</strong>&nbsp;&ndash; koji onemogućuje vraćanje krvi iz desne klijetke u desnu pretklijetku,</li> <li><strong>pulmonalni (plućni) zalistak</strong>&nbsp;&ndash; koji zadržava krv u pulmonalnoj arteriji nakon istiskivanja iz desne klijetke.</li> </ul> <p>Stanje koje nazivamo&nbsp;<strong>stenoza (suženje zalistaka)</strong>&nbsp;jest ono u kojem se ventil ne može ispravno otvoriti.</p> <p><strong>Regurgitacija</strong>&nbsp;<strong>(insuficijencija)</strong>&nbsp;je stanje kada se ventil ne zatvara ispravno te<strong>&nbsp;propu&scaron;ta krv</strong>.</p> <p>Također, bolesti mogu biti mije&scaron;ane (i stenoza i regurgitacija).</p> <p><strong>Bolesti srčanih zalistaka su:</strong></p> <ul> <li>aortna stenoza i regurgitacija,</li> <li>mitralna stenoza i regurgitacija,</li> <li>trikuspidalna stenoza i regurgitacija,</li> <li>pulmonalna (plućna) stenoza i regurgitacija.</li> </ul> <p>Za normalnu funkciju srčanih zalistaka nužna je i normalna struktura i funkcija ostalih dijelova srca.</p> <p><img alt="Zdravlje srca" 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" style="height:330pt; width:495pt" /></p> <p><strong>Bolesti aortnih zalistaka</strong></p> <p><strong>Bolesti aortnih zalistaka</strong>&nbsp;su stanja u kojem ventil između glavne crpne komore srca (lijeve klijetke) i glavne arterije u tijelu (aorte) ne funkcionira ispravno.</p> <p>Budući da srce zbog toga radi pod većim opterećenjem i da se o&scaron;tećenje zalistaka pogor&scaron;ava, s vremenom dolazi do srčanog popu&scaron;tanja i pro&scaron;irivanja srca.</p> <p><strong>Aortna stenoza &ndash; uzroci, simptomi i liječenje</strong></p> <p><strong>Uzroci aortne stenoze</strong></p> <p><strong>Kada je aortni zalistak sužen</strong>, kroz lijevu se klijetku srca u aortu&nbsp;<strong>pumpa manje krvi</strong>. Tako dolazi i do smanjene količine krvi koju srce pumpa kroz čitavo tijelo.</p> <p>Posljedično, lijeva klijetka pro&scaron;iruje svoju mi&scaron;ićnu stijenku kako bi istisnula &scaron;to vi&scaron;e krvi kroz zalistak. Stijenka klijetke traži sve vi&scaron;e krvi kako bi opskrbila svoju povr&scaron;inu kisikom.</p> <p><strong>Najče&scaron;ći uzroci u starijih bolesnika</strong>&nbsp;su skleroza aorte i zadebljanje aortnog zaliska zbog fibroze (formiranje vi&scaron;ka vlaknastog vezivnog tkiva u organu) i kalcifikacija (kalcijeve soli u tjelesnim tkivima).</p> <p><strong>Najče&scaron;ći uzrok aortne stenoze kod osoba mlađih od 70 godina</strong>&nbsp;je kongenitalna bikuspidna aortna valvula &ndash;&nbsp;<strong>prirođena&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/kreni-sa-srcem/srcane-mane-razvoj-simptomi-i-lijecenje">srčana mana</a></strong><strong>.</strong></p> <p><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/reumatska-groznica-uzrok-simptomi-i-lijecenje">Reumatska groznica</a></strong>&nbsp;koja je povezana s drugim gre&scaron;kama zalistaka &ndash;&nbsp;<strong>često može uzrokovati aortnu stenozu</strong>. Aortni zalistak o&scaron;tećen je kod gotovo 40% osoba koje imaju nekakvu gre&scaron;ku srčanih zalistaka nakon napadaja&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/reumatska-groznica-uzrok-simptomi-i-lijecenje">reumatske groznice</a>.</p> <p>Ako bolesnik ima samo aortnu stenozu i nema dokaza o drugim poremećajima &ndash; vrlo vjerojatno se radi o&nbsp;<strong>kongenitalnom poremećaju</strong>.</p> <p><strong>Mu&scaron;karci su gotovo 3 puta skloniji aortnoj stenozi od žena.</strong></p> <p><img alt="Prikaz aortne stenoze" 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" style="height:330pt; width:495pt" /></p> <p><strong>Aortna stenoza &ndash; simptomi</strong></p> <p>Kod aortne stenoze&nbsp;<strong>u samom početku nema</strong>&nbsp;<strong>nikakvih simptoma,&nbsp;</strong>a kasnije se simptomi počinju vrlo brzo razvijati.&nbsp;</p> <p>Kako se stanje pogor&scaron;ava, može se javiti<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/nedostatak-zraka-otezano-disanje-dispneja-uzroci-dijagnoza-i-lijecenje">&nbsp;gubitak daha</a></strong>&nbsp;tijekom tjelesne aktivnosti (<a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/dispneja-zaduha-znacenje-vrste-i-lijecenje">dispneja</a>). U konačnici dolazi i do&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/sinkopa-uzroci-simptomi-lijecenje">sinkope</a></strong><strong>&nbsp;kod napora</strong>&nbsp;(iznenadni, prolazni gubitak svijesti koji nastaje uslijed poremećaja prokrvljenosti mozga).</p> <p>Može doći i do razvijanja<a href="https://www.krenizdravo.rtl.hr/zdravlje/angina-pektoris-uzroci-simptomi-i-lijecenje">&nbsp;angine pektoris</a>&nbsp;i napadaja&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/vrtoglavica-uzroci-simptomi-i-lijecenje">vrtoglavice</a>.</p> <p>S vremenom se mogu javiti i simptomi dekompenzacije lijevog srca.</p> <p>Aortna stenoza može izazvati probleme s disanjem, tzv. &rdquo;te&scaron;ko disanje&rdquo; posebno dok osoba leži.&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/nedostatak-zraka-otezano-disanje-dispneja-uzroci-dijagnoza-i-lijecenje">Otežano disanje</a></strong>, ponekada može biti praćeno &rdquo;sviranjem&rdquo; u prsima.</p> <p>Aortna stenoza često dovodi do nedovoljnog dotoka krvi u koronarne arterije. Upravo zbog toga postoji&nbsp;<strong>veća opasnost od iznenadne smrti koju većinom uzrokuje srčani zastoj.</strong></p> <p>Ako se aortna stenoza ne liječi, tekućina u plućima može dovesti do<a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/upala-pluca-pneumonia-uzroci-simptomi-i-lijecenje">&nbsp;upale pluća</a>, odnosno smanjene otpornosti na infekciju.</p> <p><strong>Aortna stenoza &ndash; liječenje</strong></p> <p>Prilikom&nbsp;<strong>rutinskog liječničkog pregleda&nbsp;</strong>može se utvrditi o&scaron;tećenje zaliska, vjerojatno ćete morati napraviti rendgensku snimku grudnog ko&scaron;a te&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/pretrage/ekg-snimanje-elektrokardiograma-sto-ocekivati-i-kako-se-pripremiti">elektrokardiogram</a>. Koristi se&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/pretrage/ultrazvuk-srca-kako-se-pripremiti">ehokardiogram</a></strong>&nbsp;&ndash; ultrazvučna pretraga srca.</p> <p><strong>Dijagnoza</strong>&nbsp;se poslije može potvrditi ostalim pretragama, kao &scaron;to su kateterizacija srca, koronarna arteriografija i ultrazvučno snimanje.</p> <p>Ako ste upoznati s tim da imate blaži oblik aortne stenoze,&nbsp;<strong>izbjegavajte jače tjelesne napore</strong>. Isto se podrazumijeva i za spolno općenje, budite umjereni.</p> <p>Jedino moguće liječenje u slučaju te&scaron;ke aortne stenoze je&nbsp;<strong>operacija,</strong>&nbsp;točnije zamjena zalistaka.</p> <p>Ako se kirurg odluči za ugradnju umjetnog zaliska, morat ćete&nbsp;<strong>doživotno</strong>&nbsp;<strong>uzimati antikoagulanse</strong>. Izgledi za potpuno ozdravljenje su uglavnom isti kao i kod ostalih bolesti srčanih zalistaka.</p> <p><img alt="aortna regurgitacija" 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" style="height:250.8pt; width:450pt" /></p> <p><strong>Aortna regurgitacija &ndash; uzroci, simptomi i liječenje</strong></p> <p><strong>Aortna regurgitacija &ndash; uzroci</strong></p> <p>Do aortne regurgitacije, odnosno insuficijencije aorte, dolazi zbog toga &scaron;to aortni zalistak ne funkcionira onako kako bi trebao, točnije, krv se može vratiti iz aorte u lijevu klijetku. To je<strong>&nbsp;neadekvatno zatvaranje aortne valvule koja uzrokuje povrat krvi iz aorte u lijevu klijetku u dijastoli</strong>.</p> <p>Uzrok tom poremećaju je najvjerojatnije&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/reumatska-groznica-uzrok-simptomi-i-lijecenje">reumatska groznica</a></strong>. Aortni zalistak može biti o&scaron;tećen i zbog&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/spolne-bolesti-zdravlje/sifilis-uzroci-simptomi-dijagnoza-i-lijecenje">sifilisa</a>, ali danas uzrokuje svega 1% svih slučajeva insuficijencije aorte.</p> <p><strong>Ostali uzroci su:</strong></p> <ul> <li>degeneracija valvule,</li> <li>endokarditis (infekcija endokarda i srčanih valvula),</li> <li>kongenitalna bikuspidna aortna valvula (prirođena&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/kreni-sa-srcem/srcane-mane-razvoj-simptomi-i-lijecenje">srčana mana</a>),&nbsp;</li> <li>upalne bolesti vezivnih tkiva.</li> </ul> <p>Zbog bakterijskog endokarditisa ponekad može doći do pucanja dijela zaliska.</p> <p><strong>Simptomi aortne regurgitacije</strong></p> <p>Nakon pojave insuficijencije aorte,&nbsp;<strong>mogu proći godine prije pojavljivanja prvih značajnijih simptoma.</strong>&nbsp;Međutim, simptomi se vrlo brzo razvijaju ako dođe do pucanja zalistaka. Uzrok su simptomi&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/kreni-sa-srcem/kongestivno-zatajenje-srca-uzroci-simptomi-nyha-klasifikacija-i-lijecenje">zatajivanja srca</a>&nbsp;i kardiogenog &scaron;oka.</p> <p>Glavni simptom je&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/nedostatak-zraka-otezano-disanje-dispneja-uzroci-dijagnoza-i-lijecenje">gubitak daha</a></strong><strong>,&nbsp;</strong>odnosno zaduhe u naporu.</p> <p>Često se javljaju i svi simptomi&nbsp;<strong>dekompenzacije srca</strong>. Javlja se ortopneja (<a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/dispneja-zaduha-znacenje-vrste-i-lijecenje">dispneja</a>&nbsp;prilikom mirovanja) te&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/preskakanje-srca-palpitacije-uzroci-simptomi-i-lijecenje">palpitacije</a>&nbsp;(neugodan osjećaj ubrzanog ili nepravilnog srčanog rada).</p> <p>Insuficijencija, tj. aortna regurgitacija, danas nije toliko česta bolest.</p> <p><strong>Aortalna regurgitacija &ndash; liječenje</strong></p> <p>Pregled i dijagnostičke pretrage slične su ostalim dijagnostičkim metodama kada su u pitanju srčane gre&scaron;ke. Dijagnoza se temelji na&nbsp;<strong>anamnezi i fizikalnom pregledu</strong>, a potvrđuje se&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/pretrage/ultrazvuk-srca-kako-se-pripremiti">ehokardiografijom</a></strong><strong>.</strong></p> <p>Ako se sumnja na aortnu regurgitaciju, ba&scaron; kao i kod aortne stenoze, bit će&nbsp;<strong>potrebno regulirati aktivnosti.</strong>&nbsp;Liječnik će na kraju odlučiti jeste li kandidat za presađivanje zalistaka. Liječenje ovisi o simptomima i stupnju disfunkcije.</p> <p><img alt="mitralni zalisci " src="data:image/jpeg;base64,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" style="height:303.6pt; width:489.6pt" /></p> <p><strong>Bolesti mitralnih zalistaka</strong></p> <p>Kod bolesti mitralnih zalistaka, mitralni ventil, koji se nalazi između lijeve srčane komore (lijevi atrij i lijeva klijetka), ne radi ispravno.</p> <p><strong>Mitralna stenoza &ndash; uzroci, simptomi i liječenje</strong></p> <p><strong>Mitralna stenoza &ndash; uzroci</strong></p> <p><strong>Mitralna stenoza</strong>&nbsp;pojam je koji opisuje&nbsp;<strong>suženje mitralnog zaliska koji se nalazi između lijeve pretklijetke i klijetke</strong>. Sužavanje mitralnog u&scaron;ća ometa protok krvi iz lijevog atrija u lijevi ventrikul. Kako bi potisnula krv kroz uski otvor, mi&scaron;ićna stijenka klijetke zadeblja, a tlak u toj komori postepeno raste.</p> <p>Taj tlak se povratno prenosi kroz plućne vene u pluća te dolazi do njihove zasićenosti krvlju.</p> <p>Mitralna stenoza se razvija kod 60% osoba&nbsp;<strong>nakon pojave&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/reumatska-groznica-uzrok-simptomi-i-lijecenje">reumatske groznice</a></strong>.</p> <p><strong>Simptomi mitralne stenoze</strong></p> <p>Mnoge osobe su bez simptoma sve do npr. trudnoće ili razvoja fibrilacije atrija (<a href="https://www.krenizdravo.rtl.hr/zdravlje/kreni-sa-srcem/aritmija-srca-uzroci-simptomi-i-lijecenje">aritmija</a>).&nbsp;</p> <p>Glavni simptom mitralne stenoze je&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/nedostatak-zraka-otezano-disanje-dispneja-uzroci-dijagnoza-i-lijecenje">gubitak daha</a></strong>, a uzrokuje ga kongestija pluća (pluća prepunjena krvlju). Gubitak daha je najizraženiji nakon naporne tjelesne aktivnosti, a može se javiti i tijekom mirovanja. Javlja se&nbsp;<strong>opća slabost i mogući razvoj&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/plucni-edem-uzroci-simptomi-prva-pomoc-lijecenje-i-caj">plućnog edema</a></strong><strong>.</strong></p> <p>Možete postati osjetljiviji i na napade<a href="https://www.krenizdravo.rtl.hr/mame-i-bebe/zdravlje-djece/bronhitis-kod-djece-uzroci-simptomi-i-lijecenje">&nbsp;akutnog bronhitisa</a>, a mogu se javiti i bolovi u prsima nalik onima kod&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/angina-pektoris-uzroci-simptomi-i-lijecenje">angine pektoris</a>.</p> <p>Kao simptom dekompenzacije srca može se javiti i učestalo<strong>&nbsp;noćno mokrenje</strong>.&nbsp;</p> <p><strong>Najveća opasnost je treperenje klijetki zbog čega dolazi do stvaranja embolusa</strong>.</p> <p><img alt="Ljudsko srce" 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" style="height:330pt; width:495pt" /> Foto: Photospin</p> <p><strong>Mitralna stenoza &ndash; liječenje</strong></p> <p>Liječnik će dijagnozu mitralne stenoze moći postaviti&nbsp;<strong>oslu&scaron;kujući</strong>&nbsp;<strong>srce stetoskopom</strong>, ali će vas uputiti specijalistu za srčane bolesti radi provođenja ostalih pretraga &ndash;&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/pretrage/ultrazvuk-srca-kako-se-pripremiti">ehokardiografija</a></strong><strong>.</strong></p> <p>Ako vas mitralna stenoza nije fizički onesposobila, moći čete živjeti normalnim životom.</p> <p><strong>Ako</strong>&nbsp;<strong>te&scaron;ko di&scaron;ete,</strong>&nbsp;liječnik vam može propisati&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/prehrana/prirodni-diuretici?utm_source=terms&amp;utm_campaign=terms&amp;utm_medium=prirodni-diuretici">diuretik</a></strong>, koji će vam omogućiti da se oslobodite vi&scaron;ka tekućine iz tijela. Liječnik vam može propisati i tablete kalija&nbsp;s obzirom na to da djelovanjem nekih diuretika dolazi i do gubitka kalija koji je potrebno nadomjestiti.</p> <p><strong>Fibrilacija</strong>&nbsp;<strong>atrija</strong>&nbsp;(treperenje) može se uspje&scaron;no kontrolirati<strong>&nbsp;beta-blokatorima</strong>, a možete dobiti i&nbsp;<strong>antikoagulanse</strong>&nbsp;kako bi se spriječilo nastajanje&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/krvni-ugrusci">ugru&scaron;aka</a>.</p> <p>Ako mitralna stenoza&nbsp;<strong>utječe na va&scaron;e svakodnevne aktivnosti ili ste trudni</strong>&nbsp;pa se simptomi stenoze pogor&scaron;avaju, liječnik će vam najvjerojatnije predložiti&nbsp;<strong>operaciju.</strong></p> <p>Uobičajena operacija se naziva&nbsp;<strong>valvulotomijom</strong>&nbsp;te kod takve vrste operacije ipak postoji određeni rizik. Nakon operacije, simptomi se ne moraju vratiti godinama.</p> <p>Ako se simptomi ponovno jave, možete zatražiti drugu valvulotomiju ili će vam liječnik predložiti presađivanje zalistaka.</p> <p>Kod 80% operiranih slučajeva zabilježeno je preživljavanje od najmanje 5 godina nakon operacije.</p> <p><img alt="Mitralna insuficijencija" 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" style="height:330pt; width:495pt" /></p> <p><strong>Mitralna insuficijencija &ndash; uzroci, simptomi i liječenje</strong></p> <p><strong>Mitralna insuficijencija &ndash; uzroci</strong></p> <p>Ako se mitralni zalistak ne zatvara potpuno, krv koja je već pre&scaron;la iz lijeve pretklijetke u lijevu klijetku, može se vraćati u lijevu pretklijetku. Tada srce mora intenzivnije kucati kako bi istisnulo zaostalu krv koja se nakuplja u lijevoj pretklijetki. To je zapravo&nbsp;<strong>neadekvatno zatvaranje mitralnog zaliska.&nbsp;</strong></p> <p>Stijenka srca se pro&scaron;iruje kako bi svladala dodatno opterećenje. Kao i kod ranije navedenih stanja &ndash; uzrok mitralne insuficijencije jest&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/reumatska-groznica-uzrok-simptomi-i-lijecenje">reumatska groznica</a></strong><strong>,</strong>&nbsp;međutim insuficijencija ponekad može biti&nbsp;<strong>prirođena</strong>.</p> <p>Također, mitralnu regurgitaciju uzrokuju i prolaps mitralne valvule (zalisci valvule izbočuju se u lijevu pretklijetku za vrijeme kontrakcije), disfunkcija papilarnih mi&scaron;ića te dilatacija mitralnog prstena (pro&scaron;irenje).</p> <p><strong>Mitralna insuficijencija &ndash; simptomi</strong></p> <p>Kod mitralne insuficijencije&nbsp;<strong>simptoma obično nema</strong>. Kada dođe do simptoma &ndash; isti su kao i kod&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/kreni-sa-srcem/kongestivno-zatajenje-srca-uzroci-simptomi-nyha-klasifikacija-i-lijecenje">zatajenja srca</a>&nbsp;i kardiogenog &scaron;oka.</p> <p>Mitralna insuficijencija je praćena&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/nedostatak-zraka-otezano-disanje-dispneja-uzroci-dijagnoza-i-lijecenje">gubitkom daha</a></strong>, kao i gore navedena stanja, stoga je osobi iznimno te&scaron;ko razlikovati ta stanja. Kao i kod svih drugi gre&scaron;aka vezanih za srčane zaliske, mogu se javiti simptomi&nbsp;<strong>dekompenzacije srca</strong>. Može se javiti i<strong>&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi-zdravlje/otezano-gutanje-disfagija?utm_source=terms&amp;utm_campaign=terms&amp;utm_medium=otezano-gutanje-disfagija">otežano gutanje</a></strong>&nbsp;&ndash; &scaron;to je posljedica pritiska na jednjak.</p> <p>Simptomi su jo&scaron; i&nbsp;<strong>slabost</strong>&nbsp;(uslijed srčanog zatajivanja) te&nbsp;<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/preskakanje-srca-palpitacije-uzroci-simptomi-i-lijecenje">palpitacije</a></strong><strong>.</strong></p> <p>Mitralna insuficijencija može biti trajna ako je zalistak o&scaron;tećen ili privremena ako je u pitanju<strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/bolesti-zdravlje/reumatska-groznica-uzrok-simptomi-i-lijecenje">&nbsp;reumatska groznica</a></strong>.</p> <p>Najveća opasnost mitralne insuficijencije je&nbsp;<strong>bakterijski endokarditis</strong>&nbsp;kojem ćete, ako patite od ovog poremećaja, biti znatno skloniji.</p> <p><strong>Liječenje mitralne insuficijencije</strong></p> <p>Dijagnoza se postavlja klinički, a&nbsp;<strong>potvrđuje&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/pretrage/ultrazvuk-srca-kako-se-pripremiti">ehokardiografijom</a></strong><strong>.&nbsp;</strong></p> <p>Ako nema simptoma, liječenje kao i kod mitralne stenoze, najvjerojatnije neće biti potrebno.</p> <p>Ako imate mitralnu insuficijenciju,&nbsp;<strong>preporučuje se uzimanje antibiotika</strong>&nbsp;prije postupaka kao &scaron;to su vađenje zuba ili drugih operativnih zahvata.</p> <p>Ako imate&nbsp;<strong>veće komplikacije, liječnik će vam predložiti operaciju</strong>&nbsp;kojom će se postojeći zalisci zamijeniti novima. Akutna mitralna insuficijencija zahtijeva hitan popravak ili zamjenu zaliska.&nbsp;</p> <p>Terapija lijekovima je jednaka kao i kod ranije navedenih stanja.</p> <p><strong>Ako bilo kada nakon operacije osjetite&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/nedostatak-zraka-otezano-disanje-dispneja-uzroci-dijagnoza-i-lijecenje">gubitak daha</a></strong><strong>, potražite hitnu liječničku pomoć</strong>&nbsp;jer se može raditi o mehaničkoj gre&scaron;ci zamijenjenog zaliska.</p> <p><img alt="Bolesti plućnih zalistaka" 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" style="height:330pt; width:495pt" /></p> <p><strong>Bolesti plućnih zalistaka</strong></p> <p>Bolesti plućnih zalistaka se odnose na bilo koji<strong>&nbsp;poremećaj plućnog ventila</strong>, koji je odgovoran za čuvanje krvi te&nbsp;<strong>pravilan protok iz srca prema plućima.</strong></p> <p>Bolesti se mogu odnositi na&nbsp;<strong>propu&scaron;tanje ventila</strong>&nbsp;(plućno&nbsp;<a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi-zdravlje/mucnina-i-povracanje?utm_source=terms&amp;utm_campaign=terms&amp;utm_medium=mucnina-i-povracanje">povraćanje</a>) i&nbsp;<strong>suženje ventila</strong>&nbsp;(pulmonalna stenoza).</p> <p>Pulmonalna stenoza najče&scaron;će pogađa djecu. Prognoza bez liječenja je općenito dobra.</p> <p>Liječenje ovisi o vrsti bolesti te njenoj težini.</p> <p><strong>Bolesti trikuspidalnih zalistaka</strong></p> <p>Bolesti trikuspidalnih zalistaka su stanja u kojem ventil između desne klijetke i desne pretklijetke ne funkcionira ispravno. Često se javlja kod drugih problema srčanih zalistaka.</p> <p><strong>Trikuspidalna stenoza</strong></p> <p><strong>Trikuspidalna stenoza</strong>&nbsp;&ndash; u tom stanju, trikuspidalni ventil je sužen, smanjuje količinu krvi koja može teći kroz njega iz desne pretklijetke u desnu klijetku.</p> <p><strong>Jedini te&scaron;ki simptomi su:</strong></p> <ul> <li>osjećaj treperenja u vratu,</li> <li>opća slabost,</li> <li>hladna koža,</li> <li>osjećaj nelagode u gornjem desnom kvadrantu abdomena.</li> </ul> <p>Prilikom ležanja lice može postati tamnije, a bolesniku žile na glavi mogu postati izraženije.</p> <p>Dijagnoza se postavlja na temelju&nbsp;<strong>anamneze</strong>&nbsp;i<strong>&nbsp;fizikalnog pregleda</strong>, a potvrđuje se&nbsp;<strong>doppler&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/pretrage/ultrazvuk-srca-kako-se-pripremiti">ehokardiografijom</a></strong>.</p> <p>Obično je benigna te ne zahtijeva posebno liječenje, no u simptomatskih bolesnika dolazi do pobolj&scaron;anja simptoma nakon kirur&scaron;kog zahvata.</p> <p>Sve bolesnike koji pokazuju izraženije simptome potrebno je podvrgnuti prehrani s niskim unosom soli, propisati diuretike te ACE inhibitore.</p> <p>Opcije su balonska vulvoplastika ili&nbsp;<strong>otvorena reparacija</strong>&nbsp;ili zamjena zaliska.&nbsp;</p> <p><img alt="https://www.krenizdravo.rtl.hr/wp-content/uploads/2015/02/trikuspidalna-atrezija.jpg?x34873" src="https://www.krenizdravo.rtl.hr/wp-content/uploads/2015/02/trikuspidalna-atrezija.jpg?x34873" style="height:228.6pt; width:450pt" /></p> <p><strong>Trikuspidalna atrezija</strong></p> <p>Prilikom trikuspidalne atrezije&nbsp;<strong>nema komunikacije između desne pretklijetke i desne klijetke.</strong></p> <p>Trikuspidalna atrezija čini 3% prirođenih poremećaja. Djeca pri porodu obično imaju&nbsp;<strong>te&scaron;ku&nbsp;</strong><strong><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/cijanoza-znacenje-vrste-dijagnoza-i-lijecenje">cijanozu</a></strong>, dok se u dobi od 4 &ndash; 6 mjeseci manifestiraju znakovi popu&scaron;tanja srca, kao i&nbsp;<strong>slabo dobivanje na težini</strong>.</p> <p>Za liječenje je obično potrebna&nbsp;<strong>kateterizacija</strong>&nbsp;srca koja se obavlja prije kirur&scaron;kog zahvata.</p> <p><strong>Ebsteinova anomalija</strong></p> <p><strong>Ebsteinova anomalija</strong>&nbsp;predstavlja&nbsp;<strong>urođenu manu trikuspidalnih zalistaka</strong>. Ebsteinova anomalija spada u grupu opstruktivnih valvularnih i vaskularnih malformacija s desno-lijevim &scaron;antom, odnosno&nbsp;<strong>skretanjem toka krvi</strong>.</p> <p><strong>Najče&scaron;ći simptomi su:</strong></p> <ul> <li><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/cijanoza-znacenje-vrste-dijagnoza-i-lijecenje">cijanoza</a>,</li> <li><a href="https://www.krenizdravo.rtl.hr/zdravlje/simptomi/nedostatak-zraka-otezano-disanje-dispneja-uzroci-dijagnoza-i-lijecenje">otežano disanje</a>,</li> <li><a href="https://www.krenizdravo.rtl.hr/vitalnost/najcesci-uzroci-umora-i-kako-povecati-energiju">lako umaranje</a>,</li> <li><a href="https://www.krenizdravo.rtl.hr/zdravlje/kreni-sa-srcem/aritmija-srca-uzroci-simptomi-i-lijecenje">supraventrikularna aritmija</a>.</li> </ul> <p>Kada nema izraženih simptoma, potrebno je tek pratiti simptome oboljelog, kod težih slučajeva je potrebno&nbsp;<strong>liječenje lijekovima</strong>&nbsp;<strong>ili operacija.</strong></p> <p><strong>Operacija valvule</strong>&nbsp;&ndash; Operacija aortnog ili mitralnog zaliska je operacija na otvorenom srcu koju izvode kardio hirurzi radi liječenja suženja (stenoze) ili popu&scaron;tanja (regurgitacije) zaliska.</p> <p><strong>Uzroci</strong></p> <p>Zalisci obolijevaju na vi&scaron;e načina. U nekih osoba, nakon infekcije ždrijela specifičnom bakterijom (streptokok, streptococcus), povremeno se desi i o&scaron;tećenje valvula, do kojih bakterija dospije krvotokom. Ovo se de&scaron;ava u sklopu sindroma koji se zove Reumatska groznica U drugih osoba neke druge bakterije mogu ući u krvotok i napraviti upalu na unutra&scaron;njim slojevima srca (tzv endokarditis, endocarditis), o&scaron;tećujući valvule. Obično osobe sa već o&scaron;tećenim valvulama budu prijemčivije za endokarditis. U nekih pacijenata postoji urođena mana na valvulama, koja ih čini ranivim za nastanak endokarditisa, ili sama mana s godinama napreduje i dodatno o&scaron;tećuje valvulu.Također, u nekih starijih osoba valvule se postupno mijenjaju s godinama, postaju krute i zadebljale (degeneriraju), &scaron;to također stvara o&scaron;tećenja valvula</p> <p><strong>Oblici</strong></p> <p>Oboljenje valvula može se manifestirati nemogućno&scaron;ću da se valvula u cijelosti zatvori onda kada treba (insuficijencija valvule, ili regurgitacija), ili nemogućno&scaron;ću da se valvula u cijelosti otvara onda kada treba (stenoza valvule).</p> <p><img alt="https://mib.institute/wp-content/uploads/2017/12/valvuel-oboljele-320x242.jpg" src="https://mib.institute/wp-content/uploads/2017/12/valvuel-oboljele-320x242.jpg" style="height:219.6pt; width:291pt" /></p> <p>Dakle, ako se mitralna valvula ne može potpuno zatvoriti, već propusti dio krvi natrag iz lijeve komore u lijevu pretkomoru, govori se o mitralnoj insuficijenciji (regurgitaciji). Pri tome srce dio zapremine krvi koju bi trebalo goniti naprijed pomalo vraća nazad ka pretkomori, &scaron;to rad srca čini neefikasnim. Stoga srce poku&scaron;ava raditi jače, a ovo ga s godinama iscrpljuje i oboljenje na valvuli se pogor&scaron;ava, pa pacijent se lako zamara, ima ojsećaj nedostatka zraka i sl. Ali, ako se mitralna valvula ne može otvoriti (mitralna stenoza), onda lijeva pretkomora s naporom istiskuje krv ka lijevoj komori. Srce se ponovno napreže i s godinama slabi.</p> <p>Ako se aortna valvula ne može potpuno zatvoriti, već propusti dio krvi natrag iz aorte u lijevu komoru, govori se o aortnoj insuficijenciji (regurgitaciji). Pri tome srce dio zapremine krvi koju bi trebalo goniti naprijed pomalo vraća nazad ka komori, &scaron;to rad srca čini neefikasnim. Stoga srce poku&scaron;ava raditi jače, a ovo ga s godinama iscrpljuje i oboljenje na valvuli se pogor&scaron;ava. Ali, ako se aortna valvula ne može otvoriti (aortna stenoza), onda lijeva komora s naporom istiskuje krv ka aorti. Srce se ponovno napreže i s godinama slabi. Pacijent može osjećati zamaranje, gu&scaron;enje, bol u prsima, imati nesvjestice, omaglice, čak i gubitak svijesti, kao i te&scaron;ku srčanu slabost.</p> <p>Ako se trikuspidna valvula ne može potpuno zatvoriti, već propusti dio krvi natrag iz desne komore u desnu pretkomoru, govori se o trikuspidnoj insuficijenciji (regurgitaciji). Pri tome srce dio zapremine krvi koju bi trebalo goniti naprijed pomalo vraća nazad ka pretkomori, &scaron;to rad srca čini neefikasnim. Stoga srce poku&scaron;ava raditi jače, a ovo ga s godinama iscrpljuje i oboljenje na valvuli se pogor&scaron;ava. Ali, ako se trikuspidna valvula ne može otvoriti (trikuspidna stenoza), onda desna pretkomora s naporom istiskuje krv ka desnoj komori. Srce se ponovno napreže i s godinama slabi.</p> <p>Ako se pulmonalna valvula ne može potpuno zatvoriti, već propusti dio krvi natrag iz plućne arterije u desnu komoru, govori se o pulmonalnoj insuficijenciji (regurgitaciji). Pri tome srce dio zapremine krvi koju bi trebalo goniti naprijed pomalo vraća nazad ka komori, &scaron;to rad srca čini neefikasnim. Stoga srce poku&scaron;ava raditi jače, a ovo ga s godinama iscrpljuje i oboljenje na valvuli se pogor&scaron;ava. Ali, ako se pulmonalna valvula ne može otvoriti (pulmonalna stenoza), onda desna komora s naporom istiskuje krv ka plućnoj arteriji. Srce se ponovno napreže i s godinama slabi.</p> <p><strong>Kada operisati</strong></p> <p>Nisu sva oboljenja valvula indikacija za operaciju. Postoje blage i umjerene forme oboljenja valvula koje ne zahtijevaju hirur&scaron;ki tretman, već se mogu držati pod kontrolom lijekovima. Te&scaron;ka oboljenja valvula, koja se definiraju nakon urađenog ultrazvučnog pregleda srca, te koja uzrokuju značajne tegobe pacijentima su indikacija za operaciju.</p> <p>Operacije valvula su teže nego koronarni bypass (bajpas, premosnice) i rizičnije, te mora postojati dobro opravdanje da se pacijent podvrgne takvom zahvatu.</p> <p><strong>&Scaron;ta se radi operacijom</strong></p> <p>Operacijom se valvula može reparirati (popraviti), ili zamijeniti.</p> <p>Reparacija (popravka) valvule je procedura u kojoj se otavlja valvula pacijenta, ali se na njoj prave hirur&scaron;ki &scaron;avovi i rezovi, koji nakon operacije poprave funkciju valvule i vrate je u normalu. Pacijent zadržava svoju valvulu, ona se ne vadi iz srca.</p> <p>Zamjena valvula vr&scaron;i se biolo&scaron;kom ili mehaničkom valvulom. Pacijentova oboljela valvula se isiječe i vadi iz srca, a na njeno mjesto u&scaron;iva se zamjenska valvula. Biolo&scaron;ka potiče od biolo&scaron;kog, živog tkiva, a mehanička je napravljena od vje&scaron;tačkih materijala.</p> <p><img alt="https://mib.institute/wp-content/uploads/2017/12/valvule-320x116.png" src="https://mib.institute/wp-content/uploads/2017/12/valvule-320x116.png" style="height:112.2pt; width:310.8pt" /></p> <p>Prednosti biolo&scaron;ke alvule: pacijent nije vezan za antikoagulantnu terapiju (lijekovima Marivarin, Warfarin, Marcoumar, Sintrom, Farin itd) i ne treba česte kontrole stupnja razrijeđenosti krvi (kontrole INR). Mane biolo&scaron;ke valvule : vremenom degenerira, te je nakon nekoliko godina neophodna reoperacija, kada se i ta valvula zamijeni novom.</p> <p>Prednosti mehaničke valvule: znatno trajnija, reoperacija radi zamjene novom valvulom može se značajno odgoditi (vi&scaron;e godina) u odnosu na biolo&scaron;ku. Mane mehaničke valvule: neophodna antikoagulantna terapija za razrjeđivanje krvi (lijekovima Marivarin, Warfarin, Marcoumar, Sintrom, Farin itd) i neophodne česte kontrole stupnja razrijeđenosti krvi (kontrole INR). Ovisno o tipu valvule, ciljne vrijednosti INR određuje Va&scaron; kardiolog.</p> <p><strong>&Scaron;ta poslije operacije</strong></p> <p>Redovno uzimati lijekove. Obavezno apsolutno pridržavanje uputa Va&scaron;eg kardiologa. Neophodna prevencija bakterijskog endokarditisa (profilaktičko uzimanje antibiotika prije nekih medicinskih procedura) da se spriječi o&scaron;tećenje nove valvule. Postupno vraćanje u normane životne aktivnosti ovisi o ukupnom stanju srca i organizma. Postupajte u skladu s uputama Va&scaron;eg kardiologa.</p>

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