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Indikacije in učinkovitost zdravljenja spastičnosti z intratekalno črpalko [Elektronski vir] = Indications for and effectiveness of spasticity treatment with intrathecal pump implantGrabljevec, KlemenPri nekaterih pacientih z okvaro osrednjega živčevja generalizirane spastičnosti ne zmoremo obvladati s konvencionalnim zdravljenjem z zdravili in fizikalnimi načini zdravljenja. Zdravljenje z ... dovajanjem intratekalnega baklofena z metodo podkožno vstavljene črpalke predstavlja učinkovitejšo metodo zdravljenja generalizirane izrazite spastičnosti že od sredine 80-ih let prejšnjega stoletja; prvi pacientki iz Slovenije so črpalko vstavili leta 1993. Baklofen (Lioresal) je mišični relaksant in GABA agonist, ki z vezavo na GABAb receptorje v zadnjih stebričkih hrbtenjače zavira sproščanje ekscitatorih nevrotransmiterjev z inhibicijo kalcijevih kanalčkov na presinaptični membrani. Taka neposredna vezava v hrbtenjači pomeni bistveno večjo učinkovitost baklofena, ki sicer ne prestopa krvno-možganske pregrade v primerjavi z zdravljenjem v obliki tablet. V Sloveniji trenutno zdravimo 81 pacientov z metodo vstavljene programirljive črpalke, še pet pacientov pa s pomočjo črpalke v intratekalni prostor prejema morfijev sulfat za lajšanje močne bolečine v obliki mono- ali dodatnega zdravljenja. V nadaljevanju prispevka so predstavljene indiciranosti in kontraindiciranosti za zdravljenje z intratekalnim baklofenom, postopek izbire in priprave pacienta za kirurški poseg oz. vstavitev črpalke, polnjenje črpalke, vodenje pacientov po vstavitvi črpalke ter možni zapleti zdravljenja. Predstavljene so tudi izkušnje centra za zdravljenje spastičnosti na Univerzitetnem rehabilitacijskem inštitutu Soča v Ljubljani.Source: Pogosti klinični problemi v rehabilitaciji [Elektronski vir] : zbornik predavanj = Common clinical problems in rehabilitation : proceedings (Letn. 22, supl. 1, 2023, str. 7-10)Type of material - conference contribution ; adult, seriousPublish date - 2023Language - slovenianCOBISS.SI-ID - 152729347
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source: Pogosti klinični problemi v rehabilitaciji [Elektronski vir] : zbornik predavanj = Common clinical problems in rehabilitation : proceedings (Letn. 22, supl. 1, 2023, str. 7-10)
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Grabljevec, Klemen | 18897 |
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