{"id":2143,"date":"2020-03-18T21:20:37","date_gmt":"2020-03-18T21:20:37","guid":{"rendered":"https:\/\/www.slovhep.sk\/verejnost\/clanok?uid=e6debba2eabb4646bbcd76d96cedf096"},"modified":"2026-07-20T22:35:41","modified_gmt":"2026-07-20T20:35:41","slug":"odborne-e6debba2eabb4646bbcd76d96cedf096","status":"publish","type":"post","link":"https:\/\/slovhep.sk\/en\/odborne-e6debba2eabb4646bbcd76d96cedf096","title":{"rendered":"Usmernenie pre pacientov s ochoren\u00edm pe\u010dene v s\u00favislosti s epid\u00e9miou COVID-19"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><strong>Ofici&aacute;lne Stanovisko Slovenskej Hepatologickej spolo\u010dnosti&nbsp; a&nbsp;pracovnej skupiny pre transplant&aacute;cie pe\u010dene<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>Na z&aacute;klade&nbsp; s&uacute;\u010dasne dostupn&yacute;ch epidemiologick&yacute;ch &uacute;dajov o &scaron;&iacute;ren&iacute;&nbsp; koronav&iacute;rusu COVID-19 aj cestou asymptomatick&yacute;ch jedincov, s potvrdenou cestou prenosu kvap&ocirc;\u010dkovou infekciou, stolicou ako i mo\u010dom, odpor&uacute;\u010dame pozastavi\u0165 d\u0148om 16.3.2020 pl&aacute;novan&eacute; ambulantn&eacute; hepatologick&eacute; vy&scaron;etrenia ako aj vy&scaron;etrenia na transplanta\u010dn&yacute;ch hepatologick&yacute;ch ambulanci&aacute;ch.&nbsp; S&uacute;vis&iacute; to s vysok&yacute;m rizikom prenosu n&aacute;kazy na zdravotn&iacute;cky person&aacute;l ako aj na in&yacute;ch pacientov.<\/p>\n<p>&nbsp;<\/p>\n<p>Usmernenie v&nbsp;typick&yacute;ch situ&aacute;ci&aacute;ch pacientov s&nbsp;ochoren&iacute;m pe\u010dene.<\/p>\n<ol>\n<li><strong>V&scaron;etci pacienti<\/strong>\n<ol>\n<li>Pokia\u013e m&aacute;te \u0165a\u017ekosti typick&eacute; pre v&iacute;rusov&uacute; infekciu d&yacute;chac&iacute;ch ciest(telesn&aacute; teplota vy&scaron;&scaron;ia ako 37,5 st. C, ka&scaron;e\u013e, boles\u0165 hrdla, \u0165a\u017ekosti s&nbsp;d&yacute;chan&iacute;m)<\/li>\n<li>mali ste vy, alebo V&aacute;&scaron; rodinn&yacute; pr&iacute;slu&scaron;n&iacute;k v posledn&yacute;ch 14 d\u0148och kontakt s pacientom pozit&iacute;vne testovan&yacute;m na COVID-19<\/li>\n<li>boli ste vy, ale niekto z&nbsp;Va&scaron;ich bl&iacute;zkych za posledn&yacute;ch 14 dn&iacute; v krajine s vysok&yacute;m v&yacute;skytom n&aacute;kazy, \u010di v&nbsp;akejko\u013evek cudzej krajine? V&nbsp;s&uacute;\u010dasnej dobe sa d&aacute; ka\u017ed&aacute; krajina pova\u017eova\u0165 za vysokorizikov&uacute;.\n<p> Kontaktuje svojho praktick&eacute;ho lek&aacute;ra <strong><u>telefonicky<\/u><\/strong> a&nbsp;ozn&aacute;mte mu tieto skuto\u010dnosti, odporu\u010d&iacute; v&aacute;m \u010fal&scaron;&iacute; postup.<\/p>\n<\/li>\n<\/ol>\n<\/li>\n<li><strong>Pacienti s&nbsp;cirh&oacute;zou pe\u010dene<br \/> <\/strong>&#8211; v&nbsp;pr&iacute;pade stabiln&eacute;ho zdravotn&eacute;ho stavu bez n&aacute;hlej zmeny alebo vzniku \u0165a\u017ekost&iacute; (bod \u010d. 3) nie je toho \u010dasu potrebn&eacute; fyzick&eacute; vy&scaron;etrenie na ambulancii<br \/> &#8211; ambulantn&eacute; kontroly a&nbsp;term&iacute;ny s&uacute; zru&scaron;en&eacute;, po ukon\u010den&iacute; karant&eacute;ny sa pacienti objednaj&uacute; na kontroln&eacute; vy&scaron;etrenie znova.<strong> <br \/> &#8211; <\/strong>v pr&iacute;pade potreby predpisu medik&aacute;cie, kontaktuje ambulanciu telefonicky, lieky V&aacute;m bud&uacute; predp&iacute;san&eacute; elektronicky.<br \/> &#8211; je vhodn&eacute; pod\u013ea mo\u017enost&iacute; dodr\u017ea\u0165 pravidelnos\u0165 ultrazvukov&eacute;ho vy&scaron;etrenia 1x za 6 mesiacov, vy&scaron;etrenie je vhodn&eacute; realizova\u0165 tam kde zvy\u010dajne a&nbsp;so \u017eiadankou od v&scaron;eobecn&eacute;ho lek&aacute;ra na odpor&uacute;\u010danie hepatol&oacute;ga\/gastroenterol&oacute;ga. v&yacute;sledok sonografick&eacute;ho vy&scaron;etrenia brucha je mo\u017en&eacute; zasla\u0165 na ambulanciu emailom\/po&scaron;tou\n<\/li>\n<li><strong>Pacienti v&nbsp;dispenz&aacute;ri s&nbsp;dekompenzovanou cirh&oacute;zou pe\u010dene<br \/> <\/strong>&#8211; pacient sa dostav&iacute; na kontroln&eacute; vy&scaron;etrenie v&nbsp;pr&iacute;pade, \u017ee spozoruje prejavy krv&aacute;cania, n&aacute;rast obvodu bruchu, spozoruje zn&iacute;\u017eenie mo\u010denia, v&yacute;raznej&scaron;ie o\u017eltnutie, alebo rodina zaznamen&aacute; poruchy v&nbsp;sp&aacute;van&iacute;, zv&yacute;&scaron;en&uacute; spavos\u0165. <br \/> &#8211; Osobitou situ&aacute;ciu s&uacute; <br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &#8211; porucha vedomia<br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &#8211; vracanie \u010derstvej alebo natr&aacute;venej krvi, \u010di \u010dierna koloma\u017eovit&aacute; stolica<br \/> &#8211; tieto situ&aacute;cie si vy\u017eaduj&uacute; neodkladn&eacute; vy&scaron;etrenie cestou urgentn&eacute;ho pr&iacute;jmu\/pr&iacute;jmovej ambulancie sp&aacute;dovej nemocnice.\n<\/li>\n<li><strong>Pacienti so stabiln&yacute;m ochoren&iacute;m pe\u010dene, sledovan&iacute;\/kontrolovan&iacute; v&nbsp;hepatologickej ambulancii BEZ zmeny zdravotn&eacute;ho stavu<br \/> <\/strong>&#8211; ide najm&auml; o&nbsp;pacientov s&nbsp;chronick&yacute;m stukovaten&iacute;m pe\u010dene, alkoholovou chorobou pe\u010dene, ale aj v&nbsp;lie\u010dbe, alebo po ukon\u010den&iacute; lie\u010dby hepatit&iacute;dy C<br \/> <strong>&#8211; <\/strong>pl&aacute;novan&eacute; kontroly a&nbsp;term&iacute;ny s&uacute; zru&scaron;en&eacute;, po ukon\u010den&iacute; karant&eacute;ny sa pacienti objednaj&uacute; na kontroln&eacute; vy&scaron;etrenie znova. <br \/> <strong>&#8211; <\/strong>v pr&iacute;pade potreby predpisu medik&aacute;cie, kontaktuje ambulanciu telefonicky, lieky V&aacute;m bud&uacute; predp&iacute;san&eacute; elektronicky\n<\/li>\n<li><strong>Pacienti so stabiln&yacute;m ochoren&iacute;m pe\u010dene na imunosupres&iacute;vnej lie\u010dbe<br \/> <\/strong>&#8211; najm&auml; pacienti s&nbsp;autoimunitnou hepatit&iacute;dou <br \/> &#8211; t&iacute;to pacienti maj&uacute; zv&yacute;&scaron;en&eacute; riziko \u0165a\u017ek&eacute;ho priebehu ochorenia, preto je nevyhnutn&eacute; dodr\u017eiavanie pr&iacute;snej soci&aacute;lnej izol&aacute;cie. Rovnako je v&scaron;ak d&ocirc;le\u017eit&eacute; pokra\u010dova\u0165 v&nbsp;lie\u010dbe a&nbsp;nevynech&aacute;va\u0165 imunosupresiu pre vysok&eacute; riziko aktiv&aacute;cie ochorenia pe\u010dene.<br \/> &#8211; ambulantn&eacute; kontroly a&nbsp;term&iacute;ny s&uacute; zru&scaron;en&eacute;, po ukon\u010den&iacute; karant&eacute;ny sa pacienti objednaj&uacute; na kontroln&eacute; vy&scaron;etrenie znova.<strong> <br \/> &#8211; <\/strong>v pr&iacute;pade potreby predpisu medik&aacute;cie, kontaktuje ambulanciu telefonicky, lieky V&aacute;m bud&uacute; predp&iacute;san&eacute; elektronicky\n<\/li>\n<li><strong>Pacienti s&nbsp;nezhubn&yacute;mi lo\u017eiskami pe\u010dene &ndash; cysty, hemangi&oacute;my, fok&aacute;lne nodul&aacute;rne hyperpl&aacute;zie, aden&oacute;my<br \/><\/strong>&#8211; pokia\u013e V&aacute;m bola pri sonografickom vy&scaron;etren&iacute; ozn&aacute;men&aacute; zmena ve\u013ekosti lo\u017eiska, za&scaron;lite v&yacute;sledok sonografick&eacute;ho vy&scaron;etrenia na ambulanciu, budete vyrozumen&yacute; rovnako p&iacute;somnou formou<\/li>\n<\/ol>\n<ol start=\"7\">\n<li><strong>Pacienti s&nbsp;nejasn&yacute;mi a mal&iacute;gnymi lo\u017eiskov&yacute;mi l&eacute;ziami &ndash; hepatocelul&aacute;rny karcin&oacute;m<br \/> <\/strong>&#8211; postup je na rozhodnut&iacute; konkr&eacute;tneho poskytovate\u013ea zdravotnej starostlivosti. Odpor&uacute;\u010dame pacientom sa informova\u0165 o&nbsp;platnosti objednan&yacute;ch term&iacute;nov. <br \/> &#8211; v&nbsp;niektor&yacute;ch zariadeniach v&scaron;etky pl&aacute;novan&eacute; v&yacute;kony, ako TACE, \u010di RFA a chirurgick&eacute; v&yacute;kony u&nbsp;onkologickej indik&aacute;cie aktu&aacute;lne pokra\u010duj&uacute;, v&yacute;nimo\u010dne bud&uacute; pacientom pridelen&eacute; nov&eacute; term&iacute;ny.<br \/> &#8211; V&nbsp;FNsP Bansk&aacute; Bystrica pod\u013ea na&scaron;ich inform&aacute;ci&iacute; s&uacute; pl&aacute;novan&eacute; z&aacute;kroky, ako TACE, \u010di RFA aktu&aacute;lne \u010diasto\u010dne pozastaven&eacute; a&nbsp;prehodnocovan&eacute; individu&aacute;lne, informujte sa pros&iacute;m vopred ak m&aacute;te v&nbsp;tomto obdob&iacute; pl&aacute;novan&yacute; nejak&yacute; z&aacute;krok.\n<\/li>\n<li><strong>Pacienti s chronickou hepatit&iacute;dou B vo virostatickej lie\u010dbe (Viread, Zeffix, Baraclude)<br \/> <\/strong>&#8211; recepty bud&uacute; v pr&iacute;pade platnej schv&aacute;lenej \u017eiadosti predpisovan&eacute; elektronicky po telefonickej \u017eiadosti.<br \/> &#8211; v pr&iacute;pade skon\u010denia platnosti v&yacute;nimky je potrebn&eacute; realizova\u0165 odber krvi bu\u010f cestou obvodn&eacute;ho lek&aacute;ra &#8211; Krvn&yacute; obraz, bioch&eacute;mia &#8211; bilirub&iacute;n celkov&yacute;, konjugovan&yacute;, album&iacute;n, AST, ALT, ALP, GGT, celkov&eacute; bielkoviny, Na,K, urea, kreatin&iacute;n, INR, PT, aPTT alebo pr&iacute;padne hepatologickej ambulancie. Ak nedo&scaron;lo k vzniku alebo v&yacute;razn&eacute;mu zhor&scaron;eniu \u0165a\u017ekost&iacute; bude \u017eiados\u0165 po doru\u010den&iacute; v&yacute;sledkov odoslan&aacute; do pois\u0165ovne bez nutnosti fyzick&eacute;ho vy&scaron;etrenia pacienta.&nbsp;<\/li>\n<\/ol>\n<ol start=\"9\">\n<li><strong>Pacienti po transplant&aacute;cii pe\u010dene<br \/><\/strong>&#8211;&nbsp; najrizikovej&scaron;ia skupina, pros&iacute;m dodr\u017eiava\u0165 striktn&eacute; karant&eacute;nne opatrenia!!!<br \/>&#8211; v&nbsp;pr&iacute;pade potreby opustenia bydliska &ndash; noste ochrann&eacute; pom&ocirc;cky &ndash; r&uacute;&scaron;ky, respir&aacute;tory, rukavice, pokia\u013e nie je potrebn&eacute; bydlisko z&nbsp;v&aacute;\u017enych d&ocirc;vodov opusti\u0165, osta\u0148te v&nbsp;dom&aacute;com prostred&iacute;, vyh&yacute;bajte sa ak&eacute;muko\u013evek kontaktu s&nbsp;rizikov&yacute;mi osobami.&nbsp;<br \/><strong>1) stabilizovan&iacute; pacienti po transplant&aacute;cii pe\u010dene<\/strong> &ndash; v&nbsp;pr&iacute;pade potreby predpisu medik&aacute;cie, kontaktuje ambulanciu telefonicky, lieky V&aacute;m bud&uacute; predp&iacute;san&eacute; elektronicky, po stabiliz&aacute;cii situ&aacute;cie V&aacute;m bude po telefonickom dohovore, alebo prostredn&iacute;ctvom email stanoven&yacute; nov&yacute; kontroln&yacute; term&iacute;n<br \/><strong>2) pacienti prepusten&iacute; z&nbsp;hospitaliz&aacute;cie po transplant&aacute;cii pe\u010dene<\/strong> &ndash; pokia\u013e V&aacute;m lek&aacute;r nariadi ambulantn&uacute; kontrolu, je potrebn&eacute; dostavi\u0165 sa na vy&scaron;etrenie, nezab&uacute;dajte na nutnos\u0165 ochrann&yacute;ch pom&ocirc;cok!!!<br \/><strong>3) Pacienti po transplant&aacute;cii pe\u010dene s&nbsp;novovzniknut&yacute;mi \u0165a\u017ekos\u0165ami<\/strong> &ndash; kontaktuje lek&aacute;ra transplanta\u010dn&eacute;ho centra telefonicky po\u010das pracovn&eacute;ho \u010dasu, ktor&yacute; V&aacute;s n&aacute;le\u017eite usmern&iacute; <br \/>&#8211; HEGITO, 2. Intern&aacute; klinika SZU, FNsP FDR Bansk&aacute; Bystrica tel. \u010d. &ndash; 0917 643&nbsp;483<br \/>&#8211; 1. Intern&aacute; klinika SZU, Bratislava, Kram&aacute;re tel. \u010d. &#8211;&nbsp;02\/59542439 al. 02\/59542438\n<\/li>\n<li><strong>\u010cakatelia na transplant&aacute;ciu pe\u010dene (pacienti s&nbsp;dekompenzovanou cirh&oacute;zou) a pacienti v pr&iacute;prave na zv&aacute;\u017eenie transplant&aacute;cie pe\u010dene&nbsp;v&nbsp;FNsP Bansk&aacute; Bystrica<br \/><\/strong>&#8211; pokia\u013e ste v&nbsp;medzi\u010dase absolvovali nejak&eacute; odpor&uacute;\u010dan&eacute; vy&scaron;etrenia, za&scaron;lite ich v&yacute;sledok (scan) na adresu transplanta\u010dn&eacute;ho koordin&aacute;tra <a href=\"mailto:adropcova@nspbb.sk\">adropcova@nspbb.sk<\/a> (v s&uacute;lade s&nbsp;odpor&uacute;\u010dan&iacute;m GDPR prekryte pros&iacute;m Va&scaron;e identifika\u010dn&eacute; &uacute;daje &ndash; meno a priezvisko)<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><span style=\"background-color: #ffcc00;\"><strong>Ak mus&iacute;te pr&iacute;s\u0165 osobne na hepatologick&uacute; ambulanciu, pr&iacute;\u010fte v\u017edy s ochrannou r&uacute;&scaron;kou, s ochrann&yacute;mi rukavicami.<\/strong><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>V&aacute;\u017een&iacute; pacienti,<\/p>\n<p>v s&uacute;vislosti s epid&eacute;miou ochorenia COVID-19 zapr&iacute;\u010dinenou nov&yacute;m koronav&iacute;rusom SARS-CoV-2 do&scaron;lo 13.3.2020 k vyhl&aacute;seniu mimoriadneho stavu na &uacute;zem&iacute; SR a 15.3.2020 aj k vyhl&aacute;seniu n&uacute;dzov&eacute;ho stavu pre zdravotn&iacute;cke zariadenia, \u010d&iacute;m do&scaron;lo prakticky k ukon\u010deniu poskytovania elekt&iacute;vnej zdravotnej starostlivosti. Napriek tomu nem&ocirc;\u017ee d&ocirc;js\u0165 k tomu \u017ee pre opatrenia v s&uacute;vislosti s koronav&iacute;rusom d&ocirc;jde k po&scaron;kodeniu zdravia na z&aacute;klade in&yacute;ch chronick&yacute;ch alebo ak&uacute;tnych ochoren&iacute;. Preto Slovensk&aacute; hepatologick&aacute; spolo\u010dnos\u0165 pripravila pre pacientov usmernenie ako sa zachova\u0165 v typick&yacute;ch situ&aacute;ci&aacute;ch do ktor&yacute;ch sa m&ocirc;\u017ee dosta\u0165 pacient s ochoren&iacute;m pe\u010dene.<\/p>\n","protected":false},"author":2,"featured_media":2326,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"categories":[78,5],"tags":[23],"class_list":["post-2143","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guidelines","category-pre-clenov","tag-covid-19"],"_links":{"self":[{"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/posts\/2143","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/comments?post=2143"}],"version-history":[{"count":1,"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/posts\/2143\/revisions"}],"predecessor-version":[{"id":3394,"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/posts\/2143\/revisions\/3394"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/media\/2326"}],"wp:attachment":[{"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/media?parent=2143"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/categories?post=2143"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/slovhep.sk\/en\/wp-json\/wp\/v2\/tags?post=2143"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}