Na Klinici za neurohirurgiju Univerzitetskog kliničkog centra Srbije, prvi put u Srbiji, urađeni su kompleksni zahvati kod dvoje pacijenata obolelih od Parkinsonove bolesti. Metodom elektroduboke moždane stimulacije, kod pacijenata koji su operisani, elektrode će bolest držati pod kontrolom. Ranije su na tu intervenciju naši građani upućivani u inostranstvo, gde je koštala oko 50.000 evra.
Da prvi put urade ovu intervenciju kod dvoje pacijenata, tim neurohirurga, neurologa, radiologa, psihijatara, anesteziologa i drugih, uz podršku kolega iz Praga, u sali je bio oko 15 sati. Pacijenti su sve vreme u budnom stanju. Operacije su prošle dobro, a pravi efekat procedure videće se za mesec dana.
“Pacijenti koji imaju Parkinsonovu bolest su pre svega prvi kandidati, mada i drugi sa nevoljnim pokretima. U pitanju su najteži pacijenti, kod kojih su se javile mnogobrojne komplikacije dugotrajnog lečenja. To nije definitivno izlečenje, ja uvek kažem pacijentima, to nije operacija kod koje se nešto odstrani i posle ste dobro, ali kupujete vreme, i nekako vraćate sat, četiri do pet godina unazad”, navodi dr Marina Svetel, neurolog na Klinici za neurologiju UKCS.
Profesor dr Miloš Joković, direktor Klinike za neurohirurgiju UKCS, navodi da tokom operacije treba doći do jedra u dubokim strukturama mozga, te da se zato ova intervencija naziva duboka moždana stimulacija.
“Znači, treba da dođemo do jezgra, koje je vrlo malo. Preciznim prethodnim merenjem, ciljano uđemo elektrodom u to jedro, tu elektrodu povežemo sa generatorom struje koji se nalazi najčešće na grudnom košu, i posle recimo četiri nedelje, puštamo struju da stimuliše to jedro. Obostrano se radi, i leva i desna moždana hemisfera”, objašnjava Joković.
Bolja kontrola ukočenosti, usporenosti i drhtanja
Dr Marina Svetel objašnjava da se aktivacijom jedara uspostavlja bolja kontrola ukočenosti, usporenosti i drhtanja.
“Ne mogu da se povuku svi simptomi, ne mogu da se kontrolišu poremećaji govora, stabilnosti, poremećaji hoda. Takvo stanje koje mu obezbedi njegova idealna terapija, u momentu kada ona najbolje deluje, to je stanje koje ćemo obezbediti uz hiruršku intervenciju”, dodaje dr Svetel.
Profesor dr Miloš Joković objašnjava da će pacijenti imati svoj stimulator i da će biti edukovani za njegovu upotrebu, ali da će ipak na početku lekari na neurologiji vršiti stimulaciju, određivanje i visinu doze.
Intervencija skoro tri puta skuplja u inostranom centru
U Srbiji se trenutno od Parkinsonove bolesti leči oko 20.000 osoba. Oko 1,5 odsto njih su kandidati za intervenciju.
“Ovo je zaista pomak i za same pacijente koji su obično morali da idu u pratnji neke osobe jer je takva bolest. S druge strane, intervencija je skoro tri puta skuplja u inostranom centru nego kod nas, a na kvalitetu zaista neće izgubiti. Uz podršku Ministarstva zdravlja i KCS, koji nisu osporili ovu našu ideju, mi smo uspeli ovo i da realizujemo”, dodaje Joković.
Pripreme za taj kompleksni zahvat u Srbiji trajale su dve godine, a za nju se obučavaju i naši mladi neurolozi i neurohirurzi. Želja je da mesečno, makar kod jednog pacijenta, kada medicinski kriterijumi to i dozvoljavaju, urade proceduru.
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