Mil\u00ed \u010ditatelia, prin\u00e1\u0161ame v\u00e1m s\u00e9riu \u010dl\u00e1nkov, v ktor\u00fdch postupne predstavujeme jednotliv\u00e9 oddelenia Nemocnice s poliklinikou v Brezne. Pokra\u010dujeme neurologick\u00fdm oddelen\u00edm, pri\u010dom v tomto \u010d\u00edsle v\u00e1s obozn\u00e1mime s jednotkou intenz\u00edvnej starostlivosti.<\/p>\n\n\n\n
BREZNO. Neurol\u00f3gia v Brezne je rozdelen\u00e1 na nemocni\u010dn\u00fa \u010das\u0165, zlo\u017een\u00fa z neurologickej jednotky intenz\u00edvnej starostlivosti (JIS) neurologick\u00e9ho oddelenia, neurologick\u00e9ho urgentn\u00e9ho pr\u00edjmu a ambulantn\u00fa, zlo\u017een\u00fa z dvoch neurologick\u00fdch ambulanci\u00ed a elektrofyziologick\u00e9ho laborat\u00f3ria.<\/strong><\/p>\n\n\n\n Kompletn\u00e9 vybavenie JIS-ky Na neurologickej JIS-ke hospitalizuj\u00fa pacientov so z\u00e1va\u017en\u00fdmi, resp. \u017eivot ohrozuj\u00facimi ochoreniami mozgu, miechy, nervov, svalov, tie\u017e po oper\u00e1ci\u00e1ch a poraneniach hlavy, mozgu a miechy. Ako pop\u00edsal prim\u00e1r oddelenia Ivan Droppa, jednotka je vybaven\u00e1 \u0161tyrmi polohovate\u013en\u00fdmi poste\u013eami s antidekubitov\u00fdmi matracmi. \u201eL\u00f4\u017eka s\u00fa vybaven\u00e9 komplexn\u00fdm monitorovac\u00edm syst\u00e9mom \u017eivotn\u00fdch funkci\u00ed a pri ka\u017edom je automatick\u00fd d\u00e1vkova\u010d liekov \u2013 tzv. perf\u00fazor, ako i automatick\u00e1 pumpa s riaden\u00fdm d\u00e1vkovan\u00edm inf\u00faznych roztokov, st\u00e1ly pr\u00edvod kysl\u00edka s kysl\u00edkovou maskou. Na JIS-ke je i EKG pr\u00edstroj, mobiln\u00e1 ods\u00e1vacia stanica a v pr\u00edpade zlyhania \u017eivotn\u00fdch funkci\u00ed je st\u00e1le k dispoz\u00edcii defibril\u00e1tor a resuscita\u010dn\u00fd kufr\u00edk.\u201c<\/p>\n\n\n\n O ka\u017edom pacientovi ved\u00fa podrobn\u00fd z\u00e1znam Doh\u013ead nad pacientmi 24 hod\u00edn kontinu\u00e1lne zabezpe\u010duje kvalifikovan\u00e1 sestra, ktor\u00e1 m\u00e1 k dispoz\u00edcii asistentku a sanit\u00e1ra. \u201eCelkov\u00fd mana\u017ement chor\u00fdch je v ruk\u00e1ch lek\u00e1ra \u2013 neurol\u00f3ga s atest\u00e1ciou a minim\u00e1lne 6-ro\u010dnou praxou \u2013 ved\u00faceho lek\u00e1ra JIS. O ka\u017edom pacientovi vedieme podrobn\u00fd z\u00e1znam \u2013 JIS dekurz, kde minim\u00e1lne trikr\u00e1t denne je z\u00e1pis lek\u00e1ra, v \u010dase \u00fastavnej no\u010dnej slu\u017eby a cez v\u00edkend slu\u017ebukonaj\u00faceho lek\u00e1ra.\u201c<\/p>\n\n\n\n Pod\u013ea slov prim\u00e1ra, ro\u010dne hospitalizuj\u00fa 250 a\u017e 280 chor\u00fdch \u013eud\u00ed s priemernou d\u013a\u017ekou pobytu 3 a\u017e 5 dn\u00ed. \u201eChor\u00fdch s cievnou mozgovou pr\u00edhodou evidujeme 150 \u2013 160, s krv\u00e1can\u00edm do mozgu 5 \u2013 8, s ubarachnoid\u00e1lnym krv\u00e1can\u00edm 2 \u2013 3, tranzit\u00f3rnymi ischemick\u00fdmi atakmi 16, n\u00e1dorom mozgu 3 \u2013 4, s nahromaden\u00edm epileptick\u00fdch z\u00e1chvatov 5 \u2013 10, z\u00e1va\u017en\u00fdmi poraneniami hlavy a mozgu 6 \u2013 10, ochoreniami miechy, neroinfekciami (z\u00e1paly mozgu, mozgov\u00fdch bl\u00e1n) 3 \u2013 6, z\u00e1va\u017en\u00fdmi z\u00e1palmi a autoim\u00fannymi ochoreniami perif\u00e9rnych nervov, svalov, nervovosvalov\u00e9ho prechodu 3 \u2013 4.<\/p>\n\n\n\n Dobr\u00e1 spolupr\u00e1ca je na nezaplatenie Neurol\u00f3gia spolupracuje aj s pracoviskami, odborn\u00edkmi v in\u00fdch mest\u00e1ch, s Neurochirurgickou klinikou FNFDR v B. Bystrici, kde smeruj\u00fa a pripravuj\u00fa pacientov pred opera\u010dn\u00fdm rie\u0161en\u00edm. Ako pokra\u010doval prim\u00e1r Ivan Droppa, ve\u013emi dobr\u00fa spolupr\u00e1cu maj\u00fa s oddelen\u00edm invaz\u00edvnej radiol\u00f3gie Stredoslovensk\u00e9ho \u00fastavu srdcovocievnych ochoren\u00ed v B. Bystrici. \u201eNa mechanick\u00fa trombekt\u00f3miu odosielame pacientov do centra pre invaz\u00edvnu r\u00e1diol\u00f3giu v NFDR v B. Bystrici. Zriedkav\u00e9, ale z\u00e1va\u017en\u00e9 ochorenia nervov, svalov a nervovo-svalov\u00e9ho prechodu, hlavne autoim\u00fannej povahy, kde je ve\u013emi drah\u00e1 a n\u00e1ro\u010dn\u00e1 lie\u010dba, rie\u0161ime v Centre pre nervovosvalov\u00e9 ochorenia v Bratislave Ru\u017einove. Nie jednozna\u010dn\u00e9 a komplikovan\u00e9 pr\u00edpady konzultujeme asi dvakr\u00e1t do roka s neurologickou klinikou v Martine,\u201c vysvet\u013euje prim\u00e1r Droppa.<\/p>\n\n\n\n Neodmyslite\u013enou met\u00f3dou je magnetick\u00e1 rezonancia V r\u00e1mci neurol\u00f3gie v SR je tzv. imunomodula\u010dn\u00e1 lie\u010dba ur\u010den\u00e1 len na vy\u0161\u0161\u00edch pracovisk\u00e1ch, t. j. vo fakultn\u00fdch a v krajsk\u00fdch nemocniciach. \u201eTo znamen\u00e1, \u017ee na na\u0161om oddelen\u00ed definit\u00edvne ur\u010d\u00edme diagn\u00f3zu sclerosis multiplex pomocou MR, evokovan\u00fdch potenci\u00e1lov, anal\u00fdzy CSL, imunol\u00f3gie a potom odo\u0161leme do centra pre roztr\u00fasen\u00fa skler\u00f3zu.\u201c Neodmyslite\u013enou diagnostickou zobrazovacou met\u00f3dou pri stanovovan\u00ed neurologick\u00fdch diagn\u00f3z je magnetick\u00e1 rezonancia. \u201eNa\u0161a spolupr\u00e1ca je dlhodobo stabiln\u00e1 s pracoviskami v Banskej Bystrici, kde m\u00e1me denne dva term\u00edny, s\u00farne pr\u00edpady v no\u010dnej slu\u017ebe, \u010di cez v\u00edkend cestou MR pracoviska vo FNFDR v B. Bystrici.\u201c Ako zhodnotil Ivan Droppa, vy\u0161etrenia z t\u00fdchto pracov\u00edsk s\u00fa v popisoch i realiz\u00e1cii sn\u00edmkovej dokument\u00e1cie vysoko profesion\u00e1lne.<\/p>\n\n\n\n Urgentn\u00e9 diagn\u00f3zy pru\u017ene diagnostikuje CT pracovisko Neoddelite\u013enou s\u00fa\u010das\u0165ou starostlivosti o pacientov na neurologickej JIS-ke a oddelen\u00ed je rehabilita\u010dn\u00e1 lie\u010dba. \u201eV spolupr\u00e1ci s oddelen\u00edm rehabilit\u00e1cie zabezpe\u010dujeme u chor\u00fdch s ochrnut\u00edm dvojf\u00e1zov\u00fa rehabilit\u00e1ciu. V pr\u00edpade nutnosti stav pacientov konzultujeme aj so psychiatrom, ophtalmol\u00f3gom, pneumol\u00f3gom, kardiol\u00f3gom, chirurgom a pod.\u201c Denn\u00fa a naju\u017e\u0161iu spolupr\u00e1cu maj\u00fa s intern\u00fdm oddelen\u00edm a oddelen\u00edm dlhodobo chor\u00fdch. \u201eV r\u00e1mci nemocnice je najd\u00f4le\u017eitej\u0161ie CT pracovisko, kde n\u00e1m t\u00edm radiol\u00f3gov pru\u017ene pom\u00e1ha definit\u00edvne diagnostikova\u0165 urgentn\u00e9 diagn\u00f3zy i pl\u00e1novan\u00e9 vy\u0161etrenia,\u201c uzavrel prim\u00e1r Ivan Droppa.<\/p>\n\n\n\n Neurologick\u00e9 oddelenie a ambulantn\u00fa zlo\u017eku person\u00e1lne zabezpe\u010duje prim\u00e1r Ivan Droppa, jeho z\u00e1stupca Bronislav Zlevsk\u00fd a \u010fal\u0161\u00ed siedmi lek\u00e1ri \u2013 Jana Fischerov\u00e1, Janka Tapaj\u010d\u00edkov\u00e1, Franti\u0161ek Pelik\u00e1n, Miriama Chovancov\u00e1, Pavlo Kostyschak, Lucia Luk\u00e1\u010dov\u00e1 a Ivana Moj\u017ei\u0161ov\u00e1. Vrchnou sestrou oddelenia je Martina Gracov\u00e1.<\/p>\n\n\n\n Najv\u00e4\u010d\u0161ie zast\u00fapenie maj\u00fa ochorenia chrbtice a pohybov\u00e9ho apar\u00e1tu Neurologick\u00e9 oddelenie zabezpe\u010duje \u0161pecializovan\u00fa starostlivos\u0165 v oblasti ak\u00fatnej a chronickej neurologickej problematiky. Ako povedal prim\u00e1r Ivan Droppa, ro\u010dne hospitalizuj\u00fa asi 1250 pacientov, 70 % pre neodkladn\u00fa, ak\u00fatnu starostlivos\u0165 a 30 % pre pl\u00e1novan\u00fa hospitaliz\u00e1ciu. \u201eNaj\u010dastej\u0161\u00edmi diagn\u00f3zami s\u00fa cievna mozgov\u00e1 pr\u00edhoda, tranzit\u00f3rna ischemick\u00e1 ataka, epilepsia, demencia, Parkinsonova choroba, polyneuropatia, myopatia, tumory mozgu, Lymsk\u00e1 boreli\u00f3za, neuroinfekcie, at\u010f. Najv\u00e4\u010d\u0161ie zast\u00fapenie maj\u00fa v\u0161ak ochorenia chrbtice a pohybov\u00e9ho apar\u00e1tu, \u010do je z celkov\u00e9ho po\u010dtu pacientov na oddelen\u00ed 65 %.\u201c<\/p>\n\n\n\n Na izola\u010dke hospitalizuj\u00fa pacientov s infek\u010dn\u00fdmi ochoreniami Na oddelen\u00ed sa nach\u00e1dza 22 l\u00f4\u017eok, ktor\u00e9 s\u00fa vyu\u017eit\u00e9 na 80 a\u017e 90 %. \u201eIzby s\u00fa vybaven\u00e9 \u0161tandardn\u00fdmi, niektor\u00e9 elektricky polohovate\u013en\u00fdmi poste\u013eami, niektor\u00e9 s mo\u017enos\u0165ou antidekubitov\u00e9ho matraca. V izola\u010dnej izbe umiest\u0148ujeme pacientov s infek\u010dn\u00fdm ochoren\u00edm, resp. s poruchami spr\u00e1vania ohrozuj\u00facimi seba a okolie. Ochrnut\u00fdch pacientov pravidelne polohujeme a umiest\u0148ujeme na antidekubitov\u00fd matrac, pri zmen\u00e1ch polohy a pri hygiene v k\u00fape\u013eni ich pres\u00favame elektrick\u00fdm prenosn\u00fdm zdv\u00edhac\u00edm zariaden\u00edm,\u201c uviedol Ivan Droppa.<\/p>\n\n\n\n V ambulanci\u00e1ch vy\u0161etria ro\u010dne v priemere 10 000 pacientov. Pr\u00edstrojov\u00e1 technika v laborat\u00f3riu sa pohybuje do 150 tis\u00edc eur Pod\u013ea slov prim\u00e1ra, s\u00fa\u010das\u0165ou ambulantnej \u010dasti je aj elektrofyziologick\u00e9 laborat\u00f3rium, ktor\u00e9 tvor\u00ed vy\u0161etrovanie elektrickej aktivity mozgov\u00fdch buniek a tie\u017e perif\u00e9rnych nervov, svalov, nervovosvalov\u00fdch spojen\u00ed, ALT a pod. \u201eVysokokvalifikovan\u00fd atestovan\u00fd lek\u00e1r s praxou a za\u0161kolen\u00edm vykon\u00e1va aj ultrasonografiu mozgov\u00fdch tepien. Pr\u00edstrojov\u00e1 technika v elektrofyziologickom laborat\u00f3riu a sonografickom laborat\u00f3riu sa pohybuje od 120 do 150 tis\u00edc eur.\u201c<\/p>\n\n\n\n Jednou z v\u00edzi\u00ed je denn\u00fd stacion\u00e1r na lie\u010dbu bolesti pohybov\u00e9ho syst\u00e9mu Ako ka\u017ed\u00e9 oddelenie aj neurologick\u00e9 m\u00e1 svoje v\u00edzie do bud\u00facnosti. Pod\u013ea slov Ivana Droppu, okrem in\u00e9ho k nim patr\u00ed rekon\u0161trukcia oddelenia (vn\u00fatorn\u00e9 priestory, k\u00fape\u013ene, toalety, izby s maximom dvaja chor\u00ed na izbe, vr\u00e1tane vybavenia izieb), v\u00fdmena a znovu obnovenie parku rehabilita\u010dn\u00fdch pom\u00f4cok, invalidn\u00fdch voz\u00edkov, chod\u00edtok, zdv\u00edhac\u00edch zariaden\u00ed. \u201eTie\u017e obnova technick\u00e9ho vybavenia JIS, elektrofyziologick\u00e9ho laborat\u00f3ria, rozvinutie starostlivosti o bolestiv\u00e9 stavy, otvorenie \u0161pecializovanej poradne a denn\u00fd stacion\u00e1r so zameran\u00edm na lie\u010dbu bolesti pohybov\u00e9ho syst\u00e9mu, stabiliz\u00e1cia lek\u00e1rov a sestier, zlep\u0161enie publika\u010dnej a predn\u00e1\u0161kovej \u010dinnosti. V spolupr\u00e1ci s rehabilita\u010dn\u00fdm oddelen\u00edm chceme dotiahnu\u0165 komplexn\u00fa starostlivos\u0165 o pacientov s ochrnut\u00edm,\u201c uzavrel prim\u00e1r neurologick\u00e9ho oddelenia.<\/p>\n","protected":false},"excerpt":{"rendered":" Na neurologickej jednotke intenz\u00edvnej starostlivosti ro\u010dne hospitalizuj\u00fa 250 a\u017e 280 pacientov \u010cl\u00e1nok zverejnen\u00fd v novin\u00e1ch My Horehronie 5.3.2019 a v novin\u00e1ch My Horehronie 12.3.2019. Autor: MONIKA DOL\u0147ANOV\u00c1. Foto: Luk\u00e1\u0161 P\u0161en\u010d\u00edk. Mil\u00ed \u010ditatelia, prin\u00e1\u0161ame v\u00e1m s\u00e9riu \u010dl\u00e1nkov, v ktor\u00fdch postupne predstavujeme jednotliv\u00e9 oddelenia Nemocnice s poliklinikou v Brezne. Pokra\u010dujeme neurologick\u00fdm oddelen\u00edm, pri\u010dom v tomto \u010d\u00edsle v\u00e1s […]<\/p>\n","protected":false},"author":1,"featured_media":1987,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[7],"tags":[],"class_list":["post-2102","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-onas"],"_links":{"self":[{"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/posts\/2102","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/comments?post=2102"}],"version-history":[{"count":5,"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/posts\/2102\/revisions"}],"predecessor-version":[{"id":2143,"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/posts\/2102\/revisions\/2143"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/media\/1987"}],"wp:attachment":[{"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/media?parent=2102"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/categories?post=2102"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nspbr.sk\/web\/wp-json\/wp\/v2\/tags?post=2102"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"http:\/\/nspbr.sk\/web\/wp-content\/uploads\/2019\/03\/prim\u00e1r_Neurologick\u00e92-1024x683.jpg\")
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<\/figure>\n\n\n\n V dvoch neurologick\u00fdch ambulanci\u00e1ch vy\u0161etria denne asi 50 pacientov <\/h4>\n\n\n\n
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V r\u00e1mci urgentn\u00e9ho pr\u00edjmu pri vstupe do nemocnice sa nach\u00e1dza neurologick\u00fd urgentn\u00fd pr\u00edjem. \u201eV tejto ak\u00fatnej ambulancii v \u00fastavnej pohotovostnej slu\u017ebe slu\u017ebukonaj\u00faci lek\u00e1r po\u010das pracovnej doby zabezpe\u010duje vy\u0161etrenia ak\u00fatnych pacientov, so z\u00e1va\u017en\u00fdmi pr\u00edznakmi, resp. privezen\u00fdch pos\u00e1dkou RZP \u010di RLP. Denne ich v priemere vy\u0161etr\u00edme 8 -10.\u201c V poliklinickej \u010dasti s\u00fa aj dve neurologick\u00e9 ambulancie s dvoma lek\u00e1rmi a kvalifikovanou zdravotnou sestrou, ktor\u00ed denne vy\u0161etria v priemere 50 pacientov, do roka a\u017e 10 000.<\/p>\n\n\n\n![\"\"](\"http:\/\/nspbr.sk\/web\/wp-content\/uploads\/2019\/03\/P1050791-1024x683.jpg\")
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