{"id":194,"date":"2021-05-28T08:34:42","date_gmt":"2021-05-28T08:34:42","guid":{"rendered":"http:\/\/80.233.182.142\/?page_id=194"},"modified":"2021-12-10T20:13:51","modified_gmt":"2021-12-10T17:13:51","slug":"rekonstruktiva-kirurgija","status":"publish","type":"page","link":"https:\/\/logina.lv\/index.php\/rekonstruktiva-kirurgija\/","title":{"rendered":"Rekonstrukt\u012bv\u0101 \u0137irur\u0123ija"},"content":{"rendered":"\n<p><strong>Rekonstrukt\u012bv\u0101s oper\u0101cijas veic jebkur\u0101 \u0137erme\u0146a da\u013c\u0101, ja nepiecie\u0161ama audu formas, apjoma un funkcijas uzlabo\u0161ana vai atjauno\u0161ana. Visbie\u017e\u0101k \u0161\u0101das oper\u0101cijas nepiecie\u0161amas traumu, traumu seku, k\u0101 ar\u012b ieg\u016btu vai iedzimtu saslim\u0161anu vai defektu gad\u012bjumos.<\/strong><\/p>\n\n\n\n<p class=\"has-vivid-green-cyan-color has-text-color has-medium-font-size\"><strong>Transplant\u0101ti un l\u0113veri<\/strong><\/p>\n\n\n\n<p><strong>Transplant\u0101ts<\/strong> &#8211; audi, kas tiek transplant\u0113ti vai p\u0101rvietoti no vienas \u0137erme\u0146a da\u013cas uz otru, bet <strong>bez savas asins apg\u0101des.<\/strong> Piem\u0113ri \u2013 \u0101da, c\u012bpslas, kauli, skrimslis, asinsvadi (galvenok\u0101rt, v\u0113nas). \u0160aj\u0101 gad\u012bjum\u0101 nepiecie\u0161ama labi sagatavota un apasi\u0146ota gultne, kur\u0101 transplant\u0101tu ievieto. P\u0101rvietotie audi izdz\u012bvo sa\u0146emot bar\u012bbas vielas, asinsriti no apk\u0101rt\u0113jiem audiem.<br><strong>L\u0113veris<\/strong> &#8211; audi, kas tiek transplant\u0113ti vai p\u0101rvietoti no vienas \u0137erme\u0146a da\u013cas uz otru, bet kop\u0101 ar visu<strong> savu asins apg\u0101di.<\/strong><br>L\u0113veri uz <strong>asinsvadu k\u0101ji\u0146as<\/strong> \u2013 var b\u016bt nejau\u0161i izv\u0113l\u0113ti asinsvadi, vai prec\u012bzi zin\u0101mi asinsvadi uz kuriem veido l\u0113veri, un rot\u0113jot uz izdal\u012btajiem asinsvadiem izmanto sal\u012bdzino\u0161i tuvu eso\u0161u rajonu defektu sl\u0113g\u0161anai. Reiz\u0113m asinsvadi tiek \u013coti s\u012bki izdal\u012bti, bet reiz\u0113m audus var p\u0101rvietot izmantojot sal\u012bdzino\u0161i platu \u201ck\u0101ji\u0146u\u201d, kas satur ne tikai asinsvadus, bet ar\u012b zem\u0101das audus, musku\u013cus. \u0160ajos gad\u012bjumos izveidotajiem audiem asinsrite netiek p\u0101rtraukta, k\u0101 ar\u012b netiek veikta asinsvadu vai nervu sa\u0161\u016b\u0161ana. <\/p>\n\n\n\n<p><strong>Br\u012bvi l\u0113veri <\/strong>\u2013 izdala nepiecie\u0161amos audus (l\u0113veri) ar savu asins apg\u0101di. Tad asinsrite audos tiek uz neilgu laiku p\u0101rtraukta \u2013 audi tiek p\u0101rvietoti uz vietu, kur tas nepiecie\u0161ams un p\u0113c tam p\u0101rvietotajos audos asinsriti atjauno sa\u0161ujot asinsvadus. \u0160aj\u0101 gad\u012bjum\u0101 audus var p\u0101rvietot \u013coti t\u0101lu no vienas vietas uz otru \u2013 piem\u0113ram no kakla uz v\u0113deru vai no v\u0113dera uz k\u0101ju. Lai audi cit\u0101 viet\u0101 var\u0113tu labi sadz\u012bt oblig\u0101ti ir j\u0101veido asinsvadu \u0161uves (anastomozes) \u2013 tiek atjaunota uz laiku p\u0101rtraukta asinsrite. L\u0113verus p\u0113c nepiecie\u0161am\u012bbas var veidot tikai no \u0101das un zem\u0101das, taukaudiem, vai ar\u012b iek\u013caut musku\u013cus, kaulus, c\u012bpslas. <\/p>\n\n\n\n<p>Lai veidotu l\u0113verus, speci\u0101listam ir \u013coti labi j\u0101zina \u0137erme\u0146a uzb\u016bve, asinsrite, k\u0101 ar\u012b tehniski j\u0101sp\u0113j \u0101tri un prec\u012bzi veikt gan da\u017e\u0101du audu izdal\u012b\u0161anu, gan ar\u012b s\u012bku strukt\u016bru \u2013 asinsvadu un nervu \u0101tru sa\u0161\u016b\u0161anu. Ir j\u0101b\u016bt lielai paciet\u012bbai un pieredzei, lai \u0161\u0101das oper\u0101cijas var\u0113tu veikt.Transplant\u0101tu un l\u0113veru veido\u0161anas oper\u0101cij\u0101s var notikt da\u017e\u0101da veida sare\u017e\u0123\u012bjumi, taj\u0101 skait\u0101 ar\u012b t\u0101di, kurus nevar paredz\u0113t un ietekm\u0113t ne pacients pats, ne \u0137irurgs.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p class=\"has-vivid-green-cyan-color has-text-color has-medium-font-size\"><strong>C\u012bpslu p\u0101rvieto\u0161anas (transpoz\u012bcijas) oper\u0101cijas tetrapl\u0113\u0123ijas gad\u012bjumos<\/strong><\/p>\n\n\n\n<p>Mugurkaula trauma un t\u0101s izrais\u012btas sekas var b\u016btiski ietekm\u0113t un pat piln\u012bgi main\u012bt konkr\u0113t\u0101 cilv\u0113ka dz\u012bvi. Sekas var b\u016bt gan vieglas un man\u0101mas tikai pie izteiktas slodzes \u2013 s\u0101pes mugur\u0101, sp\u0113ka tr\u016bkums, reiz\u0113m galvas s\u0101pes vai reibo\u0146i, gan b\u016btiskas &#8211; mugurkaula traumu un l\u016bzumu gad\u012bjumos, kad tiek boj\u0101tas muguras smadzenes. Traumas smagums nosak\u0101ms p\u0113c mugurkaula l\u012bme\u0146a, kur\u0101 ir boj\u0101tas muguras smadzenes. Vissmag\u0101k\u0101s sekas ir gad\u012bjumos, ja boj\u0101ta mugurkaula aug\u0161\u0113j\u0101 da\u013ca \u2013 kakla l\u012bmen\u012b. \u0160ajos gad\u012bjumos rodas \u013coti ierobe\u017eots vai piln\u012bgs kust\u012bbas un ju\u0161anas iztr\u016bkums ab\u0101s k\u0101j\u0101s un rok\u0101s, ko d\u0113v\u0113 par tetrapl\u0113\u0123iju, k\u0101 ar\u012b multiplu iek\u0161\u0113jo org\u0101nu (piem\u0113ram, zarnas, ur\u012bnp\u016bslis, plau\u0161as) funkciju trauc\u0113jumi.<br>Vai p\u0113c tik smagas traumas past\u0101v iesp\u0113ja atka\u013c k\u013c\u016bt patst\u0101v\u012bgam un neatkar\u012bgam? J\u0101, past\u0101v! Visbie\u017e\u0101k cilv\u0113ks nek\u013c\u016bs piln\u012bgi vesels, jo neprotam atjaunot boj\u0101to nervu sist\u0113mu un visas iepriek\u0161\u0113j\u0101s \u0137erme\u0146a funkcijas, bet varam b\u016btiski uzlabot atsevi\u0161\u0137as funkcijas, kas pal\u012bdz k\u013c\u016bt neatkar\u012bgam un br\u012bvam. Ir iesp\u0113jams veikt kvalitat\u012bvu un m\u0113r\u0137tiec\u012bgu rehabilit\u0101ciju, piel\u0101got da\u017e\u0101da veida pal\u012bgier\u012bces (ortozes), k\u0101 ar\u012b ir iesp\u0113jams veikt oper\u0101cijas roku funkciju uzlabo\u0161anai vai atjauno\u0161anai.<\/p>\n\n\n\n<p><strong>Roku funkcijas uzlabo\u0161ana<\/strong><br>Mugurkaula aug\u0161\u0113j\u0101s da\u013cas traumu rezult\u0101t\u0101, kad tiek boj\u0101tas mugurkaula smadzenes, rodas \u013coti ierobe\u017eots vai piln\u012bgs kust\u012bbas un ju\u0161anas iztr\u016bkums ab\u0101s k\u0101j\u0101s un rok\u0101s, ko d\u0113v\u0113 par tetrapl\u0113\u0123iju. \u0136irur\u0123isk\u0101 tehnika, ko d\u0113v\u0113 par \u201ec\u012bpslu transpoz\u012bciju\u201d, var pal\u012bdz\u0113t uzlabot vai atjaunot roku funkciju. \u0160aj\u0101s oper\u0101cij\u0101s musku\u013ciem, kas sp\u0113j darboties, tiek uztic\u0113ta cita, jauna funkcija, kas b\u016btiski uzlabo cilv\u0113ka funkcion\u0101lo st\u0101vokli. Oper\u0101ciju m\u0113r\u0137is ir uzlabot visb\u016btisk\u0101k\u0101s rokas funkcijas, t\u0101 cilv\u0113kam pal\u012bdzot k\u013c\u016bt daudz patst\u0101v\u012bg\u0101kam un neatkar\u012bg\u0101kam. Ir iesp\u0113jams veikt da\u017e\u0101das musku\u013cu transpoz\u012bcijas oper\u0101cijas atkar\u012bb\u0101 no t\u0101, k\u0101di musku\u013ci str\u0101d\u0101 un k\u0101di nestr\u0101d\u0101.<\/p>\n\n\n\n<p><strong>\u0136irur\u0123ijas pamatprincipi<\/strong><br>C\u012bpslas ir veidotas no sp\u0113c\u012bga kolag\u0113na \u0137\u0113d\u0113m, kuras muskuli piesaista kaulam. C\u012bpsla sav\u0101 gait\u0101 parasti \u0161\u0137\u0113rso vienu vai vair\u0101kas loc\u012btavas un kop\u0101 ar muskuli pal\u012bdz veidot kust\u012bbas. C\u012bpslu transpoz\u012bcijas gad\u012bjum\u0101 str\u0101d\u0101jo\u0161a musku\u013ca c\u012bpsla tie p\u0101rvietota t\u0101, lai t\u0101 var\u0113tu veikt vairs nestr\u0101d\u0101jo\u0161\u0101 vai paraliz\u0113t\u0101 musku\u013ca funkciju. Tas dod iesp\u0113ju veselajam muskulim veikt t\u0101du funkciju, k\u0101du paraliz\u0113tais muskulis vairs nesp\u0113j veikt.<br>Piem\u0113rs. Tricepsa muskulis veic rokas iztaisno\u0161anu elko\u0146a loc\u012btav\u0101. Deltveida muskulis veic rokas kust\u012bbu uz mugurpusi un uz s\u0101nu prom no \u0137erme\u0146a. Ja tricepsa muskulis ir paraliz\u0113ts, bet deltveida muskulis str\u0101d\u0101, tad rokas \u0137irurgs var sadal\u012bt deltveida muskuli un ar papildus c\u012bpslas pal\u012bdz\u012bbu to pievienot tricepsa c\u012bpslai. \u0160\u0101das oper\u0101cijas rezult\u0101t\u0101, nepasliktinot rokas citas funkcijas, b\u016bs pan\u0101kta iesp\u0113ja veikt rokas atliek\u0161anu elko\u0146a loc\u012btav\u0101.<br>T\u0101l\u0101k ir uzskait\u012btas funkcijas, kuras iesp\u0113jams atjaunot, veicot rok\u0101s c\u012bpslu transpoz\u012bcijas oper\u0101cijas:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Iesp\u0113ja iztaisnot un saliekt elko\u0146a loc\u012btavu.<\/li><li>Iesp\u0113ja iztaisnot un saliekt plaukstas loc\u012btavu.<\/li><li>Iesp\u0113ja satvert ar \u012bk\u0161\u0137i un pirkstiem.<\/li><li>Iesp\u0113ja atv\u0113rt plaukstu.<\/li><li>Iesp\u0113ja rot\u0113t apak\u0161delmu.<\/li><li>Iesp\u0113ja ieg\u016bt labu \u012bk\u0161\u0137a un pirkstu kust\u012bbu kontroli atsevi\u0161\u0137os gad\u012bjumos.<\/li><\/ul>\n\n\n\n<p>Atsevi\u0161\u0137i izdal\u0101mas oper\u0101cijas spasticit\u0101tes mazin\u0101\u0161anai.<\/p>\n\n\n\n<p>C\u012bpslu transpoz\u012bcijas oper\u0101cijas veic tikai speci\u0101li apm\u0101c\u012bti profesion\u0101\u013ci, jo c\u012bpslu \u0161\u016b\u0161anas, p\u0101rvieto\u0161anas tehnika, musku\u013cu izv\u0113le un rokas funkcijas izmekl\u0113\u0161ana \u0161ajos gad\u012bjumos ir specifiska. Rokas \u0137irurgam, kas v\u0113las veikt \u0161\u0101das oper\u0101cijas, ir j\u0101b\u016bt ar \u012bpa\u0161\u0101m zin\u0101\u0161an\u0101m un interesi attiec\u012bb\u0101 uz tetraple\u0123ijas pacientiem, k\u0101 ar\u012b j\u0101b\u016bt zino\u0161am rehabilit\u0101cij\u0101, jo rokas \u0137irurgam ar\u012b akt\u012bvi j\u0101iesaist\u0101s rehabilit\u0101cijas proces\u0101.<\/p>\n\n\n\n<p><strong>Elko\u0146a iztaisno\u0161ana<\/strong><br>Sp\u0113ja iztaisnot elkoni b\u016btiski ietekm\u0113 cilv\u0113ka mobilit\u0101ti. \u0160\u012bs funkcijas atjauno\u0161anai visbie\u017e\u0101k tiek izmantots deltveida muskulis un papildus c\u012bpsla \u2013 deltveida muskulis ir sam\u0113r\u0101 \u012bss, un l\u012bdz ar to cit\u0101di nav iesp\u0113jams to savienot ar triceps muskuli. Veicot oper\u0101ciju visbie\u017e\u0101k izmanto k\u0101jas muskuli \u2013 tibialis anterior, k\u0101 ar\u012b reiz\u0113m iesp\u0113jams izmantot bicepsa muskuli. P\u0113c oper\u0101cijas roka l\u012bdz pat \u010detr\u0101m ned\u0113\u013c\u0101m tiek imobiliz\u0113ta taisn\u0101 st\u0101vokl\u012b, bet p\u0113c tam pak\u0101peniski tiek uzs\u0101ktas kust\u012bbas. Elko\u0146a iztaisno\u0161ana b\u016btiski uzlabo rokas funkciju \u2013 iesp\u0113jams samazin\u0101t pal\u012bgier\u012b\u010du skaitu, viegl\u0101k p\u0101rvietoties ar rati\u0146kr\u0113slu, p\u0101rvietoties no gultas kr\u0113sl\u0101 un no kr\u0113sla gult\u0101, aizsniegt t\u0101l\u0101k eso\u0161us priek\u0161metus.<\/p>\n\n\n\n<p><strong>Pirkstu satv\u0113riens<\/strong><br>Atjaunot pirkstu satv\u0113rienu ir \u013coti svar\u012bgi &#8211; ietekm\u0113 t\u0101das patst\u0101v\u012bgi veicamas aktivit\u0101tes k\u0101 \u0113\u0161ana, mobilo ier\u012b\u010du, telefona, datora izmanto\u0161ana, rakst\u012b\u0161ana un citas. \u0160\u0101das \u0137irur\u0123ijas laik\u0101 viens no apak\u0161delma musku\u013ciem (m.brachioradialis) tiek novirz\u012bts t\u0101, lai b\u016btu iesp\u0113jams veikt \u012bk\u0161\u0137a saliek\u0161anu, un cits muskulis (veic rokas atliek\u0161anu) tiek novirz\u012bts pirkstu saliek\u0161anai. \u0160\u0101du oper\u0101ciju gad\u012bjumos bie\u017ei vien nepiecie\u0161ams papildus stabiliz\u0113t \u012bk\u0161\u0137a pamatnes loc\u012btavu.<\/p>\n\n\n\n<p><strong>Kombin\u0113ta saliek\u0161anas un atliek\u0161anas funkcijas atjauno\u0161ana<\/strong><br>Ilg\u0101ku gadu p\u0113t\u012bjumi ir devu\u0161i iesp\u0113ju secin\u0101t, ka kompleksa saliek\u0161anas\/atliek\u0161anas funkcijas atjauno\u0161ana vienas oper\u0101cijas laik\u0101 dod lab\u0101kus rezult\u0101tus sal\u012bdzinot ar oper\u0101cij\u0101m divos etapos \u2013 atsevi\u0161\u0137i atjaunojot saliek\u0161anu un atliek\u0161anu. \u0160\u0101das oper\u0101cijas realiz\u0101cijai iesp\u0113jams izmantot da\u017e\u0101das tehnikas. \u0160obr\u012bd izmanto 7 da\u017e\u0101das proced\u016bras:<br>\u012bk\u0161\u0137a pamatnes loc\u012btavas stabiliz\u0113\u0161ana (artrod\u0113ze),<br>c\u012bpslu transpoz\u012bcija akt\u012bvas kust\u012bbas veik\u0161anai \u2013 pirkstu saliek\u0161ana un \u012bk\u0161\u0137a atliek\u0161ana,<br>\u012bk\u0161\u0137a gala loc\u012btavas stabiliz\u0101cija (tenod\u0113ze),<br>c\u012bpslu transpoz\u012bcija pas\u012bvas kust\u012bbas veik\u0161anai \u2013 pirkstu atliek\u0161ana,<br>plaukstas stabiliz\u0113\u0161ana,<br>\u012bk\u0161\u0137a atliek\u0161ana.<\/p>\n\n\n\n<p><strong>Rehabilit\u0101cija<\/strong><br>Roku rehabilit\u0101cija p\u0113c mugurkaula traumas (s\u0101kot no pirm\u0101s dienas kop\u0161 traumas) ir pirmais priek\u0161noteikums n\u0101kotn\u0113 iesp\u0113jamai oper\u0101cijai, lai atjaunotu roku kust\u012bbu funkciju. M\u0113r\u0137is \u2013 izstr\u0101d\u0101t br\u012bvas kust\u012bbas visas loc\u012btav\u0101s, nepie\u013caut kontrakt\u016bru vai st\u012bvu un nekust\u012bgu loc\u012btavu veido\u0161anos, iesp\u0113ju robe\u017e\u0101s tren\u0113t musku\u013cu sp\u0113ku. Ir j\u0101c\u012bn\u0101s par katra musku\u013ca sp\u0113ju str\u0101d\u0101t, jo jebkur\u0161 muskulis v\u0113l\u0101k var\u0113tu b\u016bt noder\u012bgs k\u0101das svar\u012bgas kust\u012bbas atjauno\u0161anai.<br>Rehabilit\u0101cija p\u0113c rekonstrukt\u012bv\u0101m rokas oper\u0101cij\u0101m ir sare\u017e\u0123\u012bta, jo vienas oper\u0101cijas laik\u0101 bie\u017ei vien tiek veiktas vair\u0101kas darb\u012bbas \u2013 stabiliz\u0113tas loc\u012btavas, p\u0101rvietotas c\u012bpslas. Lai rehabilit\u0101cija b\u016btu veiksm\u012bga, ir nepiecie\u0161ams gan motiv\u0113ts pacients, gan zino\u0161s rehabilit\u0101cijas speci\u0101lists.<br>P\u0113c oper\u0101cijas viss svar\u012bg\u0101kais ir p\u0101rvietot\u0101 musku\u013ca jaun\u0101s funkcijas apzin\u0101\u0161an\u0101s. Jau otraj\u0101 dien\u0101 p\u0113c oper\u0101cijas veik\u0161anas pacients rehabilit\u0101cijas speci\u0101lista kl\u0101tb\u016btn\u0113 tiek apm\u0101c\u012bts, k\u0101 apzin\u0101ties un aktiviz\u0113t jauno musku\u013ca funkciju. Protams, \u013coti svar\u012bgi, lai oper\u0101cijas laik\u0101 izveidot\u0101s jaun\u0101s saist\u012bbas (\u0161uves) starp c\u012bpsl\u0101m b\u016btu iztur\u012bgas \u2013 to nodro\u0161ina speci\u0101la c\u012bpslu \u0161uvju tehnika. S\u0101kotn\u0113ji p\u0113c oper\u0101cijas pacientam \u013cauj tikai aktiviz\u0113t muskuli jaun\u0101s kust\u012bbas veik\u0161anai, bet pati kust\u012bba tiek izdar\u012bta pavisam minim\u0101li, nepie\u013caujot nek\u0101du kust\u012bbas pretest\u012bbu. Svar\u012bgi pirms oper\u0101cijas izrun\u0101t, tie\u0161i k\u0101da kust\u012bba oper\u0101cijas rezult\u0101t\u0101 tiks atjaunota \u2013 tas pal\u012bdz\u0113s p\u0113coper\u0101cijas rehabilit\u0101cijas gait\u0101 pacientam viegl\u0101k apzin\u0101ties jauno kust\u012bbu.<br>Rehabilit\u0101cijas laik\u0101 jaun\u0101s kust\u012bbas lab\u0101kai apguvei bie\u017ei tiek izmantots t\u0101 saucamais \u201ebioffeedback\u201d princips.<br>P\u0113c oper\u0101cijas pacienta rehabilit\u0101cijas protokols sast\u0101v no vair\u0101kk\u0101rt\u012bg\u0101m viz\u012bt\u0113m pie rehabilit\u0101cijas speci\u0101lista un rokas \u0137irurga. Parasti 2-3 dienu treni\u0146i ir pietiekami, lai pacients var\u0113tu turpin\u0101t p\u0113coper\u0101cijas procesu m\u0101j\u0101s. Svar\u012bgas ir bie\u017eas un neilgas viz\u012btes. Pacientam izsniedz individu\u0101lo vingrin\u0101jumu pl\u0101nu uz 3-4ned\u0113\u013c\u0101m. P\u0113c tam pacients v\u0113lreiz iziet rehabilit\u0101cijas kursu pie rehabilit\u0101cijas speci\u0101lista, kura laik\u0101 jaunieg\u016bt\u0101 musku\u013cu funkcija jau m\u0113r\u0137tiec\u012bgi tiek izmantota ikdienas aktivit\u0101\u0161u veik\u0161anai un modific\u0113\u0161anai. P\u0113c tam, tiek tren\u0113ts musku\u013ca sp\u0113ks \u2013 palielinot rezistenci un p\u0113c tr\u012bs m\u0113ne\u0161iem pacientam \u013cauj, neierobe\u017eojot un papildus nesarg\u0101jot, veikt ikdienas aktivit\u0101tes. Parasti ilgsto\u0161i ir j\u0101turpina lietot nakts ortozes. \u0160\u0101dos gad\u012bjumos ir j\u0101veido individu\u0101las ortozes.<\/p>\n\n\n\n<p><strong>Oper\u0101cijas rezult\u0101ts<\/strong><br>Pirms oper\u0101cijas ir nepiecie\u0161ams izvirz\u012bt konkr\u0113tus m\u0113r\u0137us \u2013 k\u0101du funkciju paredz\u0113ts uzlabot vai atjaunot. To nosaka gan pa\u0161a pacienta v\u0113lmes, gan ar\u012b iesp\u0113jas \u2013 k\u0101di musku\u013ci ir str\u0101d\u0101jo\u0161i un var tikt izmantoti funkciju atjauno\u0161an\u0101. Visbie\u017e\u0101k pacienti izvirza t\u0101dus m\u0113r\u0137us k\u0101 \u2013 lab\u0101k veikt ikdienas aktivit\u0101tes, p\u0101rvietoties ar rati\u0146kr\u0113slu, iztaisnot roku, bet j\u0101respekt\u0113 katra konkr\u0113t\u0101 pacienta v\u0113lmes veikt k\u0101du noteiktu darb\u012bbu, kas var\u0113tu b\u016bt noz\u012bm\u012bga \u0146emot v\u0113r\u0101 ikdienas paradumus vai hobiju. Protams, izv\u0113l\u0113tajam m\u0113r\u0137im ir j\u0101b\u016bt re\u0101listiskam \u2013 tas noz\u012bm\u0113, vai to ir iesp\u0113jams tehniski konkr\u0113t\u0101 situ\u0101cija veikt.<br>J\u0101atceras, ka rokas funkcija turpin\u0101s pak\u0101peniski uzlaboties vismaz v\u0113l vienu gadu p\u0113c oper\u0101cijas.<\/p>\n\n\n\n<p><strong>Svar\u012bga inform\u0101cija<\/strong><br>2007.gad\u0101 pasaules kongres\u0101 par rokas rekonstrukciju tika pie\u0146emts pazi\u0146ojums, ka jebkurai personai, kurai ir notikusi mugurkaula trauma ar muguras smadze\u0146u boj\u0101jumu un t\u0101 rezult\u0101t\u0101 radusies tetrapl\u0113\u0123ija, ir j\u0101sa\u0146em \u012bpa\u0161i apm\u0101c\u012bta rokas \u0137irurga izmekl\u0113\u0161ana, lai savlaic\u012bgi izv\u0113rt\u0113tu rokas kust\u012bbu atjauno\u0161anas iesp\u0113jas. \u0160is m\u0113r\u0137is ir \u013coti gr\u016bti sasniedzams, bet m\u0113s esam ce\u013c\u0101.<br>Ir vair\u0101kas pamatv\u0113rt\u012bbas, kas j\u0101iev\u0113ro \u0161\u0101du pacientu \u0101rst\u0113\u0161an\u0101:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Nepiecie\u0161amas regul\u0101ras zino\u0161a rokas \u0137irurga konsult\u0101cijas. Pirm\u0101 konsult\u0101cija rekomend\u0113jama v\u0113l\u0101kais p\u0113c 3-6m\u0113ne\u0161iem kop\u0161 traumas, p\u0113c tam 8-9m\u0113ne\u0161os p\u0113c traumas, ~1gadu kop\u0161 traumas.<\/li><li>Oper\u0101cija nedr\u012bkst b\u016bt eksperiment\u0101la un neatgriezeniska. Oper\u0101cijai j\u0101balst\u0101s uz zin\u0101\u0161an\u0101m un apm\u0101c\u012bta rokas \u0137irurga prasm\u0113m. Ja gad\u012bjum\u0101 oper\u0101cijas rezult\u0101ts nav apmierino\u0161s, ir j\u0101b\u016bt iesp\u0113jai atjaunot iepriek\u0161\u0113jo st\u0101vokli.<\/li><li>C\u012bpslu transpoz\u012bcij\u0101 dr\u012bkst izmantot tikai t\u0101dus musku\u013cus, kas atbilst 4-5pak\u0101pei (skat\u012bt tabulu), nav boj\u0101ti, traum\u0113ti vai re-inerv\u0113ti.<\/li><\/ul>\n\n\n\n<p><strong>Pak\u0101pe  &#8211; Musku\u013ca atbilde<\/strong><br>5.pak\u0101pe &#8211;  Norm\u0101ls sp\u0113ks pret rezistenci, pilns akt\u012bvu kust\u012bbu apjoms<br>4.pak\u0101pe &#8211;  Labs (bet samazin\u0101ts) sp\u0113ks pret rezistenci, pilns akt\u012bvu kust\u012bbu apjoms<br>3.pak\u0101pe &#8211;  Pilns akt\u012bvu kust\u012bbu apjoms, nav, v\u0101ja musku\u013cu rezistence<br>2.pak\u0101pe &#8211;  Samazin\u0101ts akt\u012bvo kust\u012bbu apjoms \u2013 pret gravit\u0101ti un rezistenci<br>1.pak\u0101pe &#8211;  Nav iesp\u0113jams veikt akt\u012bvas kust\u012bbas, ir taust\u0101mas musku\u013cu kontrakcijas<br>0.pak\u0101pe &#8211;  Nav akt\u012bvas kust\u012bbas, nav taust\u0101mas musku\u013cu kontrakcijas<\/p>\n\n\n\n<p><strong>Atkar\u012bb\u0101 no funkcion\u0101liem musku\u013ciem pacienti tiek iedal\u012bti grup\u0101s 0-10.<\/strong><br>Grup\u0101 zem\u0101kai musku\u013cu atbildei ir j\u0101b\u016bt >4<br>0 grupa =    Neviena musku\u013ca zem elko\u0146a<br>1  grupa =   Brachioradialis<br>2  grupa =   ECRL<br>3  grupa =   ECRBr<br>4  grupa =   Protanor (PT)<br>5  grupa =   FCR<br>6  grupa =   ExDigitorum II-V<br>7  grupa =   Ex Poll<br>8  grupa =   Da\u013c\u0113ji FDP et FDS<br>9  grupa =   Iztr\u016bkst tikai intrinsic<br>10  grupa = Iz\u0146\u0113mumi<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Spasticit\u0101tes mazin\u0101\u0161ana ir tetrapl\u0113\u0123ijas rokas \u0137irur\u0123ijas sast\u0101vda\u013ca un no oper\u0101cijas taktikas ieteicams izmantot tikai c\u012bpslu pagarin\u0101\u0161anu, atbr\u012bvo\u0161anu. Tikai \u013coti retos gad\u012bjumos rekomend\u0113 veikt musku\u013cu p\u0101rdal\u012b\u0161anu.<\/li><li>C\u012bpslu \u0161uv\u0113m j\u0101b\u016bt labi veidot\u0101m, sp\u0113c\u012bg\u0101m \u2013 lieto \u012bpa\u0161u \u0161uvju tehniku.<\/li><li>Oper\u0101cijas rokas kust\u012bbu atjauno\u0161anai veic ne \u0101tr\u0101k k\u0101 8-10m\u0113ne\u0161us kop\u0161 traumas, optim\u0101li \u2013 1gadu p\u0113c traumas.<\/li><\/ul>\n\n\n\n<p>Loginas Mikro\u0137irur\u0123ijas un Rehabilit\u0101cijas centra plastikas un rokas \u0137irur\u0123e Dr.med. Laura Logina ir veikusi sertific\u0113tu apm\u0101c\u012bbu un kompetenta veikt tetrapl\u0113\u0123ijas rokas rekonstrukt\u012bv\u0101s \u0137irur\u0123ijas oper\u0101cijas. Dr.med.L.Logina 2011. gad\u0101 ir veiksm\u012bgi nok\u0101rtojusi tetrapl\u0113\u0123ijas rokas \u0137irur\u0123ijas teor\u0113tisko un praktisko apm\u0101c\u012bbu profesora Jan Friden vad\u012bb\u0101, nok\u0101rtojusi eks\u0101menu un ieguvusi Eiropas rokas \u0137irur\u0123ijas apvien\u012bb\u0101 apstiprin\u0101tu sertifik\u0101tu, k\u0101 ar\u012b 2012.gad\u0101 papildus sta\u017e\u0113jusies \u0160veices Nottwil kl\u012bnik\u0101 \u2013 Schweizer Paraplegiker-Zentrum.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rekonstrukt\u012bv\u0101s oper\u0101cijas veic jebkur\u0101 \u0137erme\u0146a da\u013c\u0101, ja nepiecie\u0161ama audu formas, apjoma un funkcijas uzlabo\u0161ana vai atjauno\u0161ana. Visbie\u017e\u0101k \u0161\u0101das oper\u0101cijas nepiecie\u0161amas traumu, traumu seku, k\u0101 ar\u012b&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_mi_skip_tracking":false,"footnotes":""},"class_list":["post-194","page","type-page","status-publish","hentry"],"aioseo_notices":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Rekonstrukt\u012bv\u0101 \u0137irur\u0123ija - Loginas Mikro\u0137irur\u0123ijas un Rehabilit\u0101cijas centrs<\/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:\/\/logina.lv\/index.php\/rekonstruktiva-kirurgija\/\" \/>\n<meta property=\"og:locale\" content=\"lv_LV\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Rekonstrukt\u012bv\u0101 \u0137irur\u0123ija - Loginas Mikro\u0137irur\u0123ijas un Rehabilit\u0101cijas centrs\" \/>\n<meta property=\"og:description\" content=\"Rekonstrukt\u012bv\u0101s oper\u0101cijas veic jebkur\u0101 \u0137erme\u0146a da\u013c\u0101, ja nepiecie\u0161ama audu formas, apjoma un funkcijas uzlabo\u0161ana vai atjauno\u0161ana. 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