{"id":41705,"date":"2023-06-15T07:00:34","year":"2023","link":"https:\/\/rigasveseliba.lv\/lv\/aktualitates\/rehabilitacija-pacientiem-pec-covid-19-infekcijas\/","type":"aktualitates","slug":"rehabilitacija-pacientiem-pec-covid-19-infekcijas","featured_image":"https:\/\/rigasveseliba.lv\/wp-content\/uploads\/2023\/06\/PecCovid2023.jpg","title":"Rehabilit\u0101cija pacientiem p\u0113c Covid-19 infekcijas","content":"
Kop\u0161 Covid-19 pand\u0113mijas s\u0101kuma vesel\u012bbas apr\u016bpes speci\u0101listi ir uzkr\u0101ju\u0161i pieredzi un medi\u0137i uzskata, ka Covid-19 infekcija kl\u012bniski var norit\u0113t k\u0101:<\/span><\/p>\n Par\u0101d\u0101s arvien vair\u0101k zi\u0146ojumu par ieilgu\u0161as Covid-19 infekcijas sek\u0101m gan b\u0113rnu, gan pieaugu\u0161o popul\u0101cij\u0101, nor\u0101dot uz \u0161o ilgtermi\u0146a simptomu b\u016btisko ietekmi uz p\u0101rslimoju\u0161o fizisko un psihisko vesel\u012bbu.\u00a0\u00a0 <\/span><\/p>\n Ir pier\u0101d\u012bts, ka garais Covid-19 var att\u012bst\u012bties infekciju p\u0101rslimoju\u0161iem jebkur\u0101 vecuma grup\u0101, neatkar\u012bgi no ak\u016bt\u0101s\u00a0 slim\u012bbas kl\u012bnisk\u0101s ainas (asimptom\u0101tiska, vid\u0113ji smaga vai smaga) vai hospitaliz\u0101cijas statusa ak\u016btaj\u0101 slim\u012bbas etap\u0101. Ir noteikts, ka t\u0101di riska faktori k\u0101 hroniskas saslim\u0161anas (aler\u0123ijas, aptauko\u0161an\u0101s, respiratoras saslim\u0161anas, iedzimta\/ieg\u016bta im\u016bnsupresija), k\u0101 ar\u012b citas v\u012brusinfekcijas var veicin\u0101t ilgtermi\u0146a Covid-19 simptomu att\u012bst\u012bbu.<\/span><\/p>\n <\/p>\n Vienlaic\u012bgi ar pas\u0101kumiem ak\u016btas Covid-19 infekcijas \u0101rst\u0113\u0161anai svar\u012bgi ir pal\u012bdz\u0113t daudzajiem koronavirusa infekciju p\u0101rslimu\u0161ajiem cilv\u0113kiem atg\u016bt fizisko un gar\u012bgo vesel\u012bbu. L\u012bdz \u0161im apkopot\u0101 pieredze r\u0101da, ka atvese\u013co\u0161an\u0101s process p\u0113c infekcijas ir individu\u0101ls un bie\u017ei vien ilgsto\u0161s. Pacientiem ilgsto\u0161i var saglab\u0101ties s\u016bdz\u012bbas par v\u0101jumu, \u0101tru nogurumu, elpas tr\u016bkumu, klepu, r\u012b\u0161anas trauc\u0113jumiem, s\u0101p\u0113m kr\u016bt\u012bs, galvass\u0101p\u0113m, \u0137erme\u0146a s\u0101p\u0113m, l\u012bdzsvara trauc\u0113jumiem, izzi\u0146as un miega trauc\u0113jumiem un ikdienas nodarbju veik\u0161anas ierobe\u017eojumiem. Ir zin\u0101ms, ka daudzi pacienti atvese\u013co\u0161an\u0101s laik\u0101 atz\u012bm\u0113 psihoemocion\u0101lus simptomus, tai skait\u0101 depresiju un trauksmi.<\/span><\/p>\n Augst\u0101k min\u0113tais nor\u0101da, ka pacientiem p\u0113c Covid- 19 infekcijas, ir nepiecie\u0161ama \u00a0savlaic\u012bga multidisciplin\u0101ra \u00a0un individu\u0101laj\u0101m vajadz\u012bb\u0101m atbilsto\u0161a rehabilit\u0101cija.<\/span><\/p>\n SIA \u201cR\u012bgas vesel\u012bbas centrs\u201d pied\u0101v\u0101 \u00a0\u00a0ambulatorus medic\u012bnisk\u0101s rehabilit\u0101cijas pakalpojumus atbilsto\u0161i koronavirusinfekciju p\u0101rslimojo\u0161o pacientu\u00a0 individu\u0101laj\u0101m vajadz\u012bb\u0101m.<\/span><\/p>\n SIA \u201cR\u012bgas vesel\u012bbas centrs\u201d pied\u0101v\u0101 gan valsts apmaks\u0101tu, gan maksas rehabilit\u0101cijas pakalpojumu programmu ambulatori fili\u0101l\u0113s \u201cImanta\u201d, \u201cI\u013c\u0123uciems\u201d, \u201c\u0136engarags\u201d, \u201cBolder\u0101ja\u201d, \u201cZiepniekkalns\u201d un \u201cTor\u0146akalns\u201d un multiprofesion\u0101lu rehabilit\u0101cijas programmu dienas stacion\u0101r\u0101 fili\u0101l\u0113s \u201cImanta\u201d, \u201cI\u013c\u0123uciems\u201d, \u201c\u0136engarags\u201d, \u201cBolder\u0101ja\u201d, \u201cZiepniekkalns\u201d.\u00a0 Fili\u0101l\u0113s multidisciplin\u0101r\u0101 speci\u0101listu komand\u0101 fizik\u0101l\u0101s un rehabilit\u0101cijas medic\u012bnas \u0101rsta vad\u012bb\u0101 pakalpojumus nodro\u0161ina fizioterapeiti, ergoterapeiti, audiologop\u0113di\/logop\u0113di, fizik\u0101l\u0101s medic\u012bnas m\u0101sas, uztura speci\u0101listi, psihologi, masieri:<\/span><\/p>\n <\/p>\n \u0100rsts nov\u0113rt\u0113 pacienta vesel\u012bbas st\u0101vokli, funkcion\u0113\u0161anu, rehabilit\u0101cijas potenci\u0101lu un nos\u016bta uz valsts apmaks\u0101tu ambulatoru monoprofesion\u0101lu\u00a0 rehabilit\u0101cijas pakalpojumu, ja pacients vienlaikus\u00a0 atbilst visiem trim krit\u0113rijiem<\/strong><\/u>:<\/span><\/p>\n Lai pacients p\u0113c laboratoriski apstiprin\u0101tas SARS-CoV-2 \u00a0jeb Covid-19 infekcijas p\u0101rslimo\u0161anas sa\u0146emtu valsts apmaks\u0101tus ambulatorus rehabilit\u0101cijas pakalpojumus, ir nepiecie\u0161ams \u0123imenes \u0101rsta vai \u0101rsta speci\u0101lista nos\u016bt\u012bjums \u00a0\u00a0ar nor\u0101d\u012btu, atbilsto\u0161i \u00a0\u00a0SSK10, \u00a0diagnozes kodu: \u201cU08 \u2013<\/strong>\u00a0Covid-19 anamn\u0113z\u0113 vai \u201cU09<\/strong> \u2013 St\u0101voklis p\u0113c p\u0101rslimota Covid-19.<\/span><\/p>\n I\u00a0 \u00a0Atbilsto\u0161i Ministru kabineta noteikumu Nr. 555 punktam 104.4. \u0123imenes \u0101rsts vai \u0101rsts speci\u0101lists pacientu p\u0113c p\u0101rslimotas Covid-19 infekcijas var nos\u016bt\u012bt l\u012bdz piec\u0101m reiz\u0113m pie funkcion\u0101l\u0101 speci\u0101lista (fizioterapeits, ergoterapeits, audiologop\u0113ds), ja:<\/span><\/p>\n Funkcion\u0101lais speci\u0101lists, atbilsto\u0161i savai kompetencei, nov\u0113rt\u0113 pacientu pirms un p\u0113c nodarb\u012bbu uzs\u0101k\u0161anas. Ja p\u0113c piec\u0101m nodarb\u012bb\u0101m funkcion\u0101l\u0101\u00a0 speci\u0101lista vad\u012bb\u0101 ir v\u0113rojama pozit\u012bva dinamika un FS izvirz\u012btie m\u0113r\u0137i ir sasniegti, tad kursu neturpina. Ja m\u0113r\u0137i nav sasniegti, tad FS sniedz atgriezenisko saiti (veidlapa Nr. 027\/u) par pacienta terapijas rezult\u0101tiem \u0123imenes \u0101rstam vai \u0101rstam speci\u0101listam, kur\u0161 pacientu nos\u016bt\u012bjis, un tas lemj par nos\u016bt\u012b\u0161anu pie FRM \u0101rsta rehabilit\u0101cijas pas\u0101kumu turpin\u0101\u0161anai.<\/em><\/span>\u00a0<\/span><\/p>\n II\u00a0 \u00a0Lai pacients p\u0113c p\u0101rslimotas Covid-19 infekcijas sa\u0146emtu ambulatorus rehabilit\u0101cijas pakalpojum, gimenes \u0101rsts vai \u0101rsts speci\u0101lists, izrakstot nos\u016bt\u012bjumu (veidlapa 027\/u) uz FRM \u0101rsta konsult\u0101ciju, nos\u016bt\u012bjum\u0101 nor\u0101da diagnozes kodu p\u0113c SSK-10 klasifikatora: \u201cU08 \u2013<\/strong>\u00a0Covid-19 anamn\u0113z\u0113\u201d vai\u00a0 \u201cU09<\/strong> \u2013 St\u0101voklis p\u0113c p\u0101rslimota Covid-19\u201d.<\/span><\/p>\n III\u00a0 \u00a0Pacients p\u0113c p\u0101rslimotas Covid-19 infekcijas var sa\u0146emt ambulatorus monoprofesion\u0101lus rehabilit\u0101cijas pakalpojumus iesniedzot citas iest\u0101des FRM \u0101rsta atbilsto\u0161i noform\u0113tu nos\u016bt\u012bjumu \u2013 veidlapa 027\/u.<\/span><\/p>\n Lai pacients p\u0113c p\u0101rslimotas Covid-19 infekcijas sa\u0146emtu medic\u012bnisk\u0101s rehabilit\u0101cijas pakalpojumus dienas stacion\u0101r\u0101 ir nepiecie\u0161ams FRM \u00a0\u0101rsta nos\u016bt\u012bjums uz \u0161o pakalpojumu.<\/span><\/p>\n Lai pacients p\u0113c p\u0113c iesp\u0113jamas vai laboratoriski apstiprin\u0101tas SARS-CoV-2 \u00a0jeb Covid-19 infekcijas sa\u0146emtu valsts apmaks\u0101tus medic\u012bnisk\u0101s rehabilit\u0101cijas pakalpojumus dienas stacion\u0101r\u0101, ir nepiecie\u0161ams \u0123imenes \u0101rsta vai \u0101rsta speci\u0101lista nos\u016bt\u012bjums FRM \u0101rstam\u00a0 ar nor\u0101d\u012btu diagnozes kodu: U08<\/strong> (Covid-19 anamn\u0113z\u0113) vai U09<\/strong> (St\u0101voklis p\u0113c p\u0101rslimota Covid-19) atbilsto\u0161i \u00a0\u00a0SSK -10. \u00a0<\/span><\/p>\n FRM \u0101rsts nov\u0113rt\u0113 pacienta vesel\u012bbas st\u0101vokli, funkcion\u0113\u0161anu, rehabilit\u0101cijas potenci\u0101lu un nos\u016bta uz valsts apmaks\u0101tu pakalpojumu medicinisk\u0101s rehabilit\u0101cijas dienas stacion\u0101r\u0101 \u00a0(nos\u016bt\u012bjum\u0101 \u00a0nor\u0101dot diagnozes kodu: U08<\/strong> (Covid-19 anamn\u0113z\u0113) vai U09<\/strong> (St\u0101voklis p\u0113c p\u0101rslimota Covid-19) atbilsto\u0161i \u00a0\u00a0SSK -10), ja pacients vienlaikus \u00a0atbilst visiem pieciem krit\u0113rijiem<\/strong>:<\/span><\/p>\n Nos\u016btot pacientu p\u0113c p\u0101rslimota Covid-19 rehabilit\u0101cijas pakalpojuma sa\u0146em\u0161anai ambulatori vai dienas stacion\u0101r\u0101, j\u0101v\u0113rt\u0113 ne tikai pacienta visp\u0101r\u0113jais vesel\u012bbas st\u0101voklis un funkcion\u0113\u0161ana, bet ar\u012b iesp\u0113jam\u0101s kontrindik\u0101cijas medic\u012bniskai rehabilit\u0101cijai.<\/span><\/p>\n Kontrindik\u0101cijas medic\u012bniskai rehabilit\u0101cijai ambulatori un dienas stacion\u0101r\u0101 pacientiem p\u0113c Covid-19:<\/span><\/p>\n 1) nestabils medic\u012bniskais st\u0101voklis:<\/span><\/p>\n 2) nepietiekams rehabilit\u0101cijas potenci\u0101ls.<\/span><\/p>\n Rehabilit\u0101cijas potenci\u0101ls \u2013 pacienta sp\u0113ja (gan \u0137ermeniska, gan gar\u012bga) iztur\u0113t un realiz\u0113t pl\u0101n\u0101 ietvertos\u00a0 rehabilit\u0101cijas pas\u0101kumus, \u00a0pacienta l\u012bdzdal\u012bba rehabilit\u0101cijas programm\u0101. Pacientam ir v\u0113lme mazin\u0101t funkcion\u0113\u0161anas ierobe\u017eojumus, kas radu\u0161ies Covid-19 d\u0113\u013c.<\/span><\/p>\n Dinamisk\u0101 nov\u0113ro\u0161ana[1]<\/a>[2]<\/a> (turpm\u0101k \u2013 DN) PostCovid kontekst\u0101 ir regul\u0101ras vesel\u012bbas st\u0101vok\u013ca p\u0101rbaudes pacientiem, kuriem noteikts PostCovid statuss, ar m\u0113r\u0137i savlaic\u012bgi to diagnostic\u0113t un \u0101rst\u0113t. DN tiek iek\u013cauti pacienti, kuriem ne maz\u0101k k\u0101 pirms 5 m\u0113ne\u0161iem laboratoriski verific\u0113ta SARS-CoV-2 infekcija vai Covid-19. Galven\u0101 \u0101rstniec\u012bbas persona DN organiz\u0101cij\u0101 un \u012bsteno\u0161an\u0101 PostCovid pacientam \/ personai ir \u0123imenes \u0101rsts (turpm\u0101k \u2013 \u0122\u0100).\u00a0<\/span><\/p>\n Pirms do\u0161an\u0101s pie \u0123imenes \u0101rsta, iesak\u0101m aizpild\u012bt ieilgu\u0161u Covid-19 simptomu izv\u0113rt\u0113\u0161anas testu:<\/span><\/p>\n [1]<\/a> Covid-19 p\u0101rslimoju\u0161o pacientu dinamisk\u0101s nov\u0113ro\u0161anas kl\u012bniskie algoritmi un kl\u012bniskie ce\u013ci pieaugu\u0161ajiem.\u00a0 https:\/\/www.spkc.gov.lv\/lv\/media\/17978\/download<\/a><\/p>\n [2]<\/a> Covid-19 p\u0101rslimoju\u0161o pacientu dinamisk\u0101s nov\u0113ro\u0161anas kl\u012bniskie algoritmi un kl\u012bniskie ce\u013ci b\u0113rniem. https:\/\/www.spkc.gov.lv\/lv\/media\/17981\/download<\/a><\/p>\n <\/p>\n\n
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Nosac\u012bjumi nos\u016bt\u012b\u0161anai uz valsts apmaks\u0101tu ambulatoru monoprofesion\u0101lo medic\u012bnisko rehabilit\u0101ciju p\u0113c Covid-19 izslimo\u0161anas<\/strong><\/span><\/h1>\n
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Nosac\u012bjumi nos\u016bt\u012b\u0161anai uz valsts apmaks\u0101tu medic\u012bnisko rehabilit\u0101ciju dienas stacion\u0101r\u0101 p\u0113c Covid-19 izslimo\u0161anas\u00a0 <\/strong><\/span><\/h1>\n
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Kontrindik\u0101cijas ambulatorai medic\u012bniskajai rehabilit\u0101cijai <\/strong><\/span><\/h1>\n
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Dinamisk\u0101 nov\u0113ro\u0161ana p\u0113c Covid-19 infekcijas<\/strong><\/span><\/h1>\n
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