{"id":1091,"date":"2023-08-14T07:57:20","date_gmt":"2023-08-14T07:57:20","guid":{"rendered":"https:\/\/new.vwdtest.com\/bo\/?page_id=1091"},"modified":"2025-10-09T12:36:21","modified_gmt":"2025-10-09T12:36:21","slug":"family-doctor-paediatrician","status":"publish","type":"page","link":"https:\/\/vwdtest.com\/ba\/family-doctor-paediatrician\/","title":{"rendered":"LJEKAR PORODI\u010cNE MEDICINE \/ PEDIJATAR"},"content":{"rendered":"
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Djeca s VWD-om tako\u0111er mogu do\u017eivjeti emocionalne probleme i probleme u pona\u0161anju u \u0161koli i u porodi\u010dnom \u017eivotu zbog straha od krvarenja, a u\u010destalo krvarenje mo\u017ee dovesti i do izostanka iz \u0161kole. 4 <\/sup>\u0160tavi\u0161e, strah od krvarenja mo\u017ee predstavljati i zna\u010dajan psiholo\u0161ki teret <\/a> za roditelje djeteta i potaknuti ih da ograni\u010de fizi\u010dke i dru\u0161tvene aktivnosti koje su va\u017ene za normalan razvoj djeteta.5<\/sup><\/h5>

<\/p>\n<\/div>\n\n\"LJEKAR\r\n\n\n

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Uloga ljekara porodi\u010dne medicine i pedijatara<\/h3>\n<\/div>\n\n
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VWD je naj\u010de\u0161\u0107i poreme\u0107aj krvarenja kod djece.6 <\/sup>\u010cesti simptomi krvarenja kod djece s VWD-om uklju\u010duju lahko stvaranje modrica<\/a>, krvarenje iz usta i nosa<\/a>, i dugotrajno krvarenje iz manjih rana i nakon operacije.2 <\/sup>Kao ljekar porodi\u010dne medicine ili pedijatar, \u010desto \u0107ete biti prvi medicinski stru\u010dnjak koji \u0107e pregledati djecu s takvim simptomima i Va\u0161 je zadatak utvrditi ima li dijete abnormalni obrazac krvarenja koji nala\u017ee daljnju stru\u010dnu obradu.7 <\/sup>I za odrasle i za djecu s mogu\u0107im poreme\u0107ajem krvarenja utvr\u0111ivanje historije krvarenja prvi je korak u dijagnozi. Pri procjeni historije krvarenja djeteta klju\u010dno je uzeti u obzir dob i razvojne sposobnosti pacijenta. Dojen\u010dad koja jo\u0161 nisu pokretna rijetko pokazuju znakove modrica, ali mo\u017ee im se pojaviti neuobi\u010dajeno krvarenje nakon obrezivanja ili va\u0111enja krvi.2,7 <\/sup>Kako djeca postaju pokretljivija, manje ogrebotine i modrice od udaraca ili padova postaju sve \u010de\u0161\u0107e. Me\u0111utim, modrice koje su ve\u0107e ili se pojavljuju \u010de\u0161\u0107e nego \u0161to bi se o\u010dekivalo mogu pobuditi sumnju u poreme\u0107aj krvarenja. Kod djece s VWD-om modrice se mogu pojaviti i na neuobi\u010dajenim mjestima, kao \u0161to su le\u0111a ili trbuh. Takve se modrice mogu pogre\u0161no protuma\u010diti kao znakovi zlostavljanja djeteta i roditelji bi se mogli zabrinuti zbog toga.8 <\/sup>Kona\u010dno, kako djevoj\u010dice ulaze u pubertet, obilno menstrualno krvarenje<\/a> postaje naj\u010de\u0161\u0107i simptom krvarenja VWD-a. Kad s pacijentima i njihovim roditeljima razgovarate o ovim simptomima, va\u017eno je obuhvatiti i porodi\u010dnu historiju krvarenja, jer se ponavljaju\u0107e abnormalno krvarenje mo\u017ee trivijalizirati unutar porodice.2,9<\/sup><\/p>\n<\/div>\n\n

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Nekada je te\u0161ko odrediti jesu li simptomi krvarenja neuobi\u010dajeni.7 <\/sup>Za prvu procjenu simptoma krvarenja, a posebno za pacijente kojima je zakazana operacija, preporu\u010dujemo Vam da s pacijentom ispunite na\u0161 test krvarenja<\/a>. Test \u0107e pokazati jesu li indicirane daljnje pretrage, a pacijentu bi mogao promijeniti \u017eivot!<\/p>\n<\/div>\n\n

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Kona\u010dna dijagnoza VWD-a rezultat je razra\u0111enog procesa.2<\/sup> Stoga Vam preporu\u010dujemo da se obratite obli\u017enjem centru za lije\u010denje hemofilije<\/a> ako je indicirana daljnja dijagnosti\u010dka obrada. Multidisciplinarni timovi u centru za lije\u010denje uz to pru\u017eaju optimalnu brigu za pacijente s poreme\u0107ajima krvarenja. VWDtest nudi i dodatne informacije o etiologiji<\/a>, dijagnosticiranju<\/a> i lije\u010denju VWD-a<\/a>, kao i uvid u tipi\u010dan put <\/a>pacijenta s VWD-om.<\/p>\n<\/div>\n\n

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Literatura<\/h6>\n<\/div>\n\n
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  1. Atiq F et al. EClinicalMedicine<\/em> 2021; 32:100726.<\/li>\n<\/div>\n\n
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  2. Corrales-Medina FF et al. Blood Rev <\/em>2023; 58:101018.<\/li>\n<\/div>\n\n
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  3. Patel PN et al. Int J Pediatr Otorhinolaryngol<\/em> 2017; 100:216-22.<\/li>\n<\/div>\n\n
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  4. de Wee EM et al. J Thromb Haemost<\/em> 2011; 9:502-9.<\/li>\n<\/div>\n\n
    \n
  5. https:\/\/www.hemophilia.org\/sites\/default\/files\/document\/files\/nurses-guide-chapter-13a-child-development-with-bleeding-disorder-transition.pdf<\/a>; posljednji put pristupljeno u o\u017eujku 2023.<\/li>\n<\/div>\n\n
    \n
  6. Klaassen R and Halton JM Paediatr Child Health<\/em> 2002; 7:245-9.<\/li>\n<\/div>\n\n
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  7. Van Ommen CH and Peters M. Eur J Pediatr<\/em> 2012; 171:1-10.<\/li>\n<\/div>\n\n
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  8. Jackson J et al. Child Abuse Negl<\/em> 2012; 36:127-34.<\/li>\n<\/div>\n\n
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  9. VanderMeulen H, et al. Hematology Am Soc Hematol Educ Program<\/em> 2022 1: 631-6.<\/li>\n<\/div><\/ol>\n<\/div>","protected":false},"excerpt":{"rendered":"

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