{"id":6350,"date":"2020-05-15T14:30:22","date_gmt":"2020-05-15T13:30:22","guid":{"rendered":"https:\/\/euromedic.rs\/pregledi\/pulmologija-hemioterapija-u-lecenju-plucnih-tumora-copy\/"},"modified":"2020-10-07T10:47:13","modified_gmt":"2020-10-07T09:47:13","slug":"pulmologija-pleuralni-izliv","status":"publish","type":"post","link":"https:\/\/euromedic.rs\/pregledi\/specijalisticki-pregledi\/pulmologija\/pulmologija-pleuralni-izliv\/","title":{"rendered":"Pulmologija – Pleuralni izliv"},"content":{"rendered":"

\u0160ta je to pleuralni izliv?<\/strong><\/p>\n

Predstavlja pojavu te\u010dnosti u prostoru izmedju dva lista plu\u0107ne maramice koji okru\u017euje plu\u0107a \u2013 pleuralni prostor.\u00a0<\/span><\/p>\n

U tom prostoru ina\u010de postoji negativan atmosferski pritisak kojim se na\u0161a plu\u0107a odr\u017eavaju u\u00a0 ra\u0161irenom stanju ispunjena vazduhom.<\/span><\/p>\n

U fiziolo\u0161kim uslovima u pleuralnom prostoru uvek postoji oko 20 ml te\u010dnostikoja je ultrafiltrat na\u0161e krvi I njen tok ide od spolja\u0161njeg lista \u2013 parijetalne pleure do unutra\u0161njeglista-visceralne pleure.<\/span><\/p>\n

Svako nakupljanje te\u010dnosti ve\u0107e od fiziolo\u0161kih\u00a0 20 ml predstavlj apleuralni izliv.<\/span><\/p>\n

Posto se plu\u0107a sastoje od dva plu\u0107na krilapo sto je I dva pleuralna prostora papleuralni izliv moze biti jednostran I obostran.<\/span><\/p>\n

U kojimstanjima\/bolestima se javlja pleuralni izliv?<\/strong><\/p>\n

Pleuralni izliv je \u010desto patolo\u0161ko stanje. Javlja se kao posledica patolo\u0161kih stanja pluca, plu\u0107ne maramice, ali I udaljenih organa I bolesti koje nisu primarno plu\u0107ne.<\/span><\/p>\n

Najce\u0161\u0107astanja u kojima se javlja\u00a0 pleuralni izliv su sr\u010dana slabost, upala plu\u0107a, maligne bolesti \u2013 karcinomi plu\u0107a ili drugih organa(debelo greva, dojke, jajnika)<\/span><\/p>\n

Pleuralni izliv moze biti jedina\u00a0 manifestacija\u00a0 nekih bolesti kao \u0161to su maligne bolesti ili infekcije \u2013 tuberkuloza.<\/span><\/p>\n

Koji su simptomi pleuralnog izliva?<\/strong><\/p>\n

Kako \u0107e se manifestovat I pleuralni izliv zavisi od brzine kojim se stvara, kao I njegove veli\u010dine.<\/span><\/p>\n

Bolest mo\u017ee biti bez simptoma kada se registruje uzgredno prilikom nekih dijagnosti\u010dkih procedura koje su ra\u0111ene iz nekog\u00a0 drugog razloga \u2013 radiografija grudnog ko\u0161a,ultrazvuk stomaka, skenerom ili magnetom rezonancom trbuha ili ku\u010dmenog stuba.\u00a0<\/span><\/p>\n

Kada postoje, simptomi su: ote\u017eano I ubrano disanje, ka\u0161alj, bol I pritisak u predelu grudnog ko\u0161a. Ako je koli\u010dina u pleuralnom prostoru velika, to mo\u017ee ugroziti \u017eivot pacijenta.<\/span><\/p>\n

Koji je postupak?<\/strong><\/p>\n

Ako te\u0161ko di\u0161ete, zamarate se, ose\u0107ate pritisak ili bol u grudima, ka\u0161ljete , ne mo\u017eete da legnete javite se odmah lekaru.<\/span><\/p>\n

Lekar \u0107e vas pregledati I auskultacijom grudnog ko\u0161a \u0107e \u010duti da je disanje iznad izliva slabije \u010dujno ili ne\u010dujno.<\/span><\/p>\n

Slede\u0107i postupak je radiografija plu\u0107a i srca gde \u0107e se izliv videti \u2013 kolika je veli\u010dina, da li je jednostran ili obostran.<\/span><\/p>\n

Kao dopunski pregledi u\u00a0 cilju sagledavanja izgleda izliva, mogu\u0107e\u00a0 postojanja patolo\u0161kih procesa na plu\u0107ima i drugim organima lekar moze da preporu\u010di ultrazuk i skener grudnog ko\u0161a.<\/span><\/p>\n

Da bi se sagledalo celokupno stanje organizma naj\u010des\u0107e se rade i laboratorijske analize krv i gde se gledaj umarkeri infekcije, sr\u010dane slabosti,stanja bubrega, jetre, tumor marker\u2026<\/span><\/p>\n

\u0160ta je torakocenteza?<\/strong><\/p>\n

Da bi se pacijentu olak\u0161alo disanje i ispitala tecnost koja se nakupIja u pleuri potrebno je da lekar uradi pleuralnu punkciju (torakocentezu).\u00a0<\/span><\/p>\n

Bolesnik sedi naslonjen napred na svoje ruke dok lekar na zadnjoj strani grudnog ko\u0161a ispod lopatice iglom ulazi u pleuralni prostor. Kroz tu iglu uzima uzorke za biohemijski, citolo\u0161ki I mikrobiolo\u0161ki pregled. Tako\u0111e ispu\u0161ta te\u010dnost,obi\u010dno ne vise od 1000 ml. Bolesnik u par minuta ose\u0107a olak\u0161anje disanja.Pregledom te\u010dnosti na vedenim analizama se razja\u0161njava uzrok pleuralnog izliva.Dalje le\u010denje zavisi upravo od uzroka nastanka pleuralnog izliva. Infekcija se le\u010di antibioticima, maligni tumori operacijom, zra\u010denjem, hemioterapijom, tuberkuloza antituberkuloznim lekovima, sr\u010dana slabost lekovima za stimulaciju mokrenja\u2026<\/span><\/p>\n

Nekad se pleuralna te\u010dnost stvara ponovo i vi\u0161e puta, \u0161to se najce\u0161\u0107e vidja kod malignih tumora i tada se radi pleurodeza- kroz iglu za pleuralnu punkciju se ubacuju sredstva koja izazivaju hemijsku reakciju pleure i posledi\u010dno smanjenje daljeg stvaranja izliva.<\/span><\/p>\n

Za pleuralnu punkciju nije potrebna posebna priprema osim podatka o uzimanju lekova koji spre\u010davaju trombozu i agregaciju trombocita (antikoagulativna i antiagregaciona terapija\u2013 Farin, Sintrom, Sincum, Xarelto, Pradaxa, Eliqius, Plavix, Aspirin, Brilique). Ove lekove je neophodno ako ih uzimate prekinuti sto \u0107e Vam lekar re\u0107i ta\u010dno koliko pre pleuralne punkcije. Procedura se izvodi u lokalnoj anesteziji.<\/span><\/p>\n

Ukoliko je uzrok pleuralnog izliva nepoznat radi se biopsija plu\u0107ne maramice ili operativne procedure kojima se direktno sagledava plu\u0107na maramica i uzimaju biopsije na analizu (pleuroskopija, video asistirana torakoskopija – VATS).<\/span><\/p>\n

U Op\u0161toj bolnici Euromedik mo\u017eete da obavite kompletnu dijagnostiku. Od pregleda pulmologa<\/a>, radiografije (RTG) pluca, ultrazvuka, skener grudnog ko\u0161a, pleuralnu punkciju sa svim pregledima pleuralne te\u010dnosti, biopsiju pleure, VATS. Neke preglede je mogu\u0107e obaviti ambulantno, a za neke je potrebno boravak u bolnici (VATS). Takodje je mogu\u0107e zapo\u010dinjanje i sprovo\u0111enje le\u010denja shodno rezultatima ura\u0111enih ispitivanja.<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

\u0160ta je to pleuralni izliv? Predstavlja pojavu te\u010dnosti u prostoru izmedju dva lista plu\u0107ne maramice…<\/p>\n","protected":false},"author":1,"featured_media":6352,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[480],"tags":[394,370],"class_list":["post-6350","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pulmologija","tag-pleuralni-izliv","tag-pulmologija"],"yoast_head":"\nPulmologija - Pleuralni izliv - Dijagnostika i le\u010denje u Euromediku<\/title>\n<meta name=\"description\" content=\"Predstavlja pojavu te\u010dnosti u prostoru izmedju dva lista plu\u0107ne maramice koji okru\u017euje plu\u0107a \u2013 pleuralni prostor.\u00a0U tom prostoru ina\u010de postoji negativan...\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/euromedic.rs\/pregledi\/specijalisticki-pregledi\/pulmologija\/pulmologija-pleuralni-izliv\/\" \/>\n<meta property=\"og:locale\" content=\"sr_RS\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pulmologija - 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