{"id":1091,"date":"2023-08-14T07:57:20","date_gmt":"2023-08-14T07:57:20","guid":{"rendered":"https:\/\/new.vwdtest.com\/cz\/?page_id=1091"},"modified":"2025-10-09T12:21:31","modified_gmt":"2025-10-09T12:21:31","slug":"family-doctor-paediatrician","status":"publish","type":"page","link":"https:\/\/vwdtest.com\/cz\/family-doctor-paediatrician\/","title":{"rendered":"PRAKTICK\u00dd L\u00c9KA\u0158 \/ D\u011aTSK\u00dd L\u00c9KA\u0158"},"content":{"rendered":"
\n

V\u011bt\u0161ina pacient\u016f s vrozen\u00fdmi poruchami krv\u00e1cen\u00ed, jako je von Willebrandova choroba<\/a> (VWD), poci\u0165uje prvn\u00ed p\u0159\u00edznaky krv\u00e1cen\u00ed b\u011bhem d\u011btstv\u00ed. Bohu\u017eel kv\u016fli nedostate\u010dn\u00e9 informovanosti, slo\u017eit\u00e9 diagn\u00f3ze a m\u00edrn\u00fdm symptom\u016fm doch\u00e1z\u00ed u pacient\u016f k n\u011bkolikalet\u00e9 prodlev\u011b mezi prvn\u00edmi krv\u00e1civ\u00fdmi p\u0159\u00edznaky a diagn\u00f3zou krv\u00e1civ\u00e9 poruchy. Toto zpo\u017ed\u011bn\u00ed je je\u0161t\u011b v\u00fdrazn\u011bj\u0161\u00ed u \u017een ne\u017e u mu\u017e\u016f. Bez diagn\u00f3zy a adekv\u00e1tn\u00ed l\u00e9\u010dby maj\u00ed d\u011bti s nediagnostikovanou krv\u00e1civou poruchou zv\u00fd\u0161en\u00e9 riziko v\u00e1\u017en\u00e9ho krv\u00e1cen\u00ed i po men\u0161\u00edm traumatu<\/a> nebo b\u011b\u017en\u00fdch operac\u00edch<\/a> , jako jsou zubn\u00ed z\u00e1kroky<\/a> nebo tonzilektomie.1\u20133<\/sup><\/strong><\/h5><\/p>\n<\/div>\n\n\"PRAKTICK\u00dd\r\n\n\n
\n

D\u011bti s vWch mohou tak\u00e9 za\u017e\u00edvat emocion\u00e1ln\u00ed probl\u00e9my a probl\u00e9my v chov\u00e1n\u00ed ve \u0161kole a v rodinn\u00e9m \u017eivot\u011b kv\u016fli strachu z krv\u00e1cen\u00ed a \u010dast\u00e9 krv\u00e1cen\u00ed m\u016f\u017ee v\u00e9st k absenci ve \u0161kole.4 <\/sup> Strach z krv\u00e1cen\u00ed m\u016f\u017ee nav\u00edc p\u0159edstavovat zna\u010dnou psychickou z\u00e1t\u011b\u017e<\/a> pro pe\u010dovatele d\u00edt\u011bte a p\u0159im\u011bt je k omezen\u00ed fyzick\u00fdch a soci\u00e1ln\u00edch aktivit, kter\u00e9 jsou d\u016fle\u017eit\u00e9 pro norm\u00e1ln\u00ed v\u00fdvoj jejich d\u00edt\u011bte. 5<\/sup><\/p>\n<\/div>\n\n

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Role praktick\u00fdch l\u00e9ka\u0159\u016f a pediatr\u016f<\/h3>\n<\/div>\n\n
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VWch je nej\u010dast\u011bj\u0161\u00ed krv\u00e1civ\u00e1 porucha u d\u011bt\u00ed.6 <\/sup>\u010cast\u00e9 krv\u00e1civ\u00e9 p\u0159\u00edznaky u d\u011bt\u00ed s vWch zahrnuj\u00ed snadnou tvorbu mod\u0159in<\/a>, krv\u00e1cen\u00ed z \u00fast a nosu<\/a> a prodlou\u017een\u00e9 krv\u00e1cen\u00ed z drobn\u00fdch ran a po operac\u00edch.2 <\/sup>Jako praktick\u00fd l\u00e9ka\u0159 nebo pediatr budete \u010dasto jako prvn\u00ed l\u00e9ka\u0159 vid\u011bt d\u011bti nebo dosp\u011bl\u00e9 s takov\u00fdmi p\u0159\u00edznaky a va\u0161\u00edm \u00fakolem bude ur\u010dit, zda m\u00e1 tato osoba abnorm\u00e1ln\u00ed typ krv\u00e1cen\u00ed, kter\u00fd si zaslou\u017e\u00ed dal\u0161\u00ed vy\u0161et\u0159en\u00ed odborn\u00edkem.7 <\/sup>U dosp\u011bl\u00fdch i d\u011bt\u00ed s mo\u017enou poruchou krv\u00e1civosti, je anamn\u00e9za krv\u00e1cen\u00ed prvn\u00edm krokem v diagnostice. P\u0159i hodnocen\u00ed anamn\u00e9zy krv\u00e1cen\u00ed u d\u00edt\u011bte je z\u00e1sadn\u00ed vz\u00edt v \u00favahu v\u011bk a v\u00fdvojov\u00e9 schopnosti pacienta. Kojenci, kte\u0159\u00ed je\u0161t\u011b nejsou pohybliv\u00ed, z\u0159\u00eddka vykazuj\u00ed zn\u00e1mky mod\u0159in, ale po ob\u0159\u00edzce nebo odb\u011brech krve mohou zaznamenat neobvykl\u00e9 krv\u00e1cen\u00ed.2,7 <\/sup>Jak se d\u011bti st\u00e1vaj\u00ed pohybliv\u011bj\u0161\u00edmi, \u010dast\u011bj\u0161\u00ed jsou drobn\u00e9 \u0161kr\u00e1bance a mod\u0159iny zp\u016fsoben\u00e9 n\u00e1razy nebo p\u00e1dy. Av\u0161ak mod\u0159iny, kter\u00e9 jsou v\u011bt\u0161\u00ed nebo se vyskytuj\u00ed \u010dast\u011bji, ne\u017e se o\u010dek\u00e1valo, mohou vyvolat podez\u0159en\u00ed na poruchu krv\u00e1civosti. U d\u011bt\u00ed s vWch se mohou objevit mod\u0159iny na neobvykl\u00fdch m\u00edstech, jako jsou z\u00e1da nebo b\u0159icho. Takov\u00e9 mod\u0159iny mohou b\u00fdt myln\u011b pova\u017eov\u00e1ny za zn\u00e1mky t\u00fdr\u00e1n\u00ed d\u011bt\u00ed a rodi\u010de mohou m\u00edt z t\u00e9to mo\u017enosti obavy.8 <\/sup>Kdy\u017e d\u00edvky vstoup\u00ed do puberty, za\u010dne siln\u00e9 menstrua\u010dn\u00ed krv\u00e1cen\u00ed<\/a>, nej\u010dast\u011bj\u0161\u00ed krv\u00e1civ\u00fd p\u0159\u00edznak vWch. P\u0159i diskusi o t\u011bchto p\u0159\u00edznac\u00edch s pacienty a jejich pe\u010dovateli je d\u016fle\u017eit\u00e9 zahrnout tak\u00e9 rodinnou krv\u00e1civou anamn\u00e9zu, proto\u017ee opakuj\u00edc\u00ed se abnorm\u00e1ln\u00ed krv\u00e1cen\u00ed m\u016f\u017ee b\u00fdt v rodin\u011b bagatelizov\u00e1no.2,9<\/sup><\/p>\n<\/div>\n\n

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Rozhodnut\u00ed, zda jsou p\u0159\u00edznaky krv\u00e1cen\u00ed neobvykl\u00e9, m\u016f\u017ee b\u00fdt n\u00e1ro\u010dn\u00e9.7 <\/sup>Pro prvn\u00ed posouzen\u00ed p\u0159\u00edznak\u016f krv\u00e1cen\u00ed, a zejm\u00e9na u pacient\u016f, u kter\u00fdch je pl\u00e1nov\u00e1na operace, doporu\u010dujeme prov\u00e9st n\u00e1\u0161 test krv\u00e1cen\u00ed<\/a> s va\u0161\u00edm pacientem. Test uk\u00e1\u017ee, zda jsou indikov\u00e1na dal\u0161\u00ed vy\u0161et\u0159en\u00ed \u2013 a m\u016f\u017ee zm\u011bnit \u017eivot va\u0161eho pacienta!<\/p>\n<\/div>\n\n

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Kone\u010dn\u00e1 diagn\u00f3za vWch je v\u00fdsledkem slo\u017eit\u00e9ho procesu.2<\/sup> Proto v\u00e1m doporu\u010dujeme, abyste se obr\u00e1tili na nejbli\u017e\u0161\u00ed centrum pro l\u00e9\u010dbu hemofilie<\/a>, pokud je indikov\u00e1no dal\u0161\u00ed diagnostick\u00e9 hodnocen\u00ed. Multidisciplin\u00e1rn\u00ed t\u00fdmy centra poskytnou optim\u00e1ln\u00ed p\u00e9\u010di tak\u00e9 o pacienty s krv\u00e1civ\u00fdmi poruchami. VWDtest tak\u00e9 nab\u00edz\u00ed dal\u0161\u00ed informace o etiologii<\/a>, diagn\u00f3ze<\/a> a l\u00e9\u010db\u011b vWch<\/a> a tak\u00e9 nahl\u00e9dnut\u00ed do typick\u00e9 situace <\/a> pacient\u016f s vWch.<\/p>\n<\/div>\n\n

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References<\/h6>\n<\/div>\n\n
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  1. Atiq F et al. EClinicalMedicine<\/em> 2021; 32:100726.<\/li>\n<\/div>\n\n
    \n
  2. Corrales-Medina FF et al. Blood Rev <\/em>2023; 58:101018.<\/li>\n<\/div>\n\n
    \n
  3. Patel PN et al. Int J Pediatr Otorhinolaryngol<\/em> 2017; 100:216-22.<\/li>\n<\/div>\n\n
    \n
  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>; posledn\u00ed p\u0159\u00edstup v b\u0159eznu 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
    \n
  7. Van Ommen CH and Peters M. Eur J Pediatr<\/em> 2012; 171:1-10.<\/li>\n<\/div>\n\n
    \n
  8. Jackson J et al. Child Abuse Negl<\/em> 2012; 36:127-34.<\/li>\n<\/div>\n\n
    \n
  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":"

    V\u011bt\u0161ina pacient\u016f s vrozen\u00fdmi poruchami krv\u00e1cen\u00ed, jako je von Willebrandova choroba (VWD), poci\u0165uje prvn\u00ed p\u0159\u00edznaky krv\u00e1cen\u00ed b\u011bhem d\u011btstv\u00ed. Bohu\u017eel kv\u016fli nedostate\u010dn\u00e9 informovanosti, slo\u017eit\u00e9 diagn\u00f3ze a m\u00edrn\u00fdm symptom\u016fm doch\u00e1z\u00ed u pacient\u016f k n\u011bkolikalet\u00e9 prodlev\u011b mezi prvn\u00edmi krv\u00e1civ\u00fdmi p\u0159\u00edznaky a diagn\u00f3zou krv\u00e1civ\u00e9 poruchy. Toto zpo\u017ed\u011bn\u00ed je je\u0161t\u011b v\u00fdrazn\u011bj\u0161\u00ed u \u017een ne\u017e u mu\u017e\u016f. Bez diagn\u00f3zy a adekv\u00e1tn\u00ed […]<\/p>\n","protected":false},"author":1,"featured_media":1095,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false},"acf":[],"yoast_head":"\nPRAKTICK\u00dd L\u00c9KA\u0158 \/ D\u011aTSK\u00dd L\u00c9KA\u0158 - Czech Republic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/vwdtest.com\/cz\/family-doctor-paediatrician\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PRAKTICK\u00dd L\u00c9KA\u0158 \/ D\u011aTSK\u00dd L\u00c9KA\u0158 - Czech Republic\" \/>\n<meta property=\"og:description\" content=\"V\u011bt\u0161ina pacient\u016f s vrozen\u00fdmi poruchami krv\u00e1cen\u00ed, jako je von Willebrandova choroba (VWD), poci\u0165uje prvn\u00ed p\u0159\u00edznaky krv\u00e1cen\u00ed b\u011bhem d\u011btstv\u00ed. 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