{"?xml":{"@version":"1.0"},"edm:RDF":{"@xmlns:dc":"http://purl.org/dc/elements/1.1/","@xmlns:edm":"http://www.europeana.eu/schemas/edm/","@xmlns:wgs84_pos":"http://www.w3.org/2003/01/geo/wgs84_pos","@xmlns:foaf":"http://xmlns.com/foaf/0.1/","@xmlns:rdaGr2":"http://rdvocab.info/ElementsGr2","@xmlns:oai":"http://www.openarchives.org/OAI/2.0/","@xmlns:owl":"http://www.w3.org/2002/07/owl#","@xmlns:rdf":"http://www.w3.org/1999/02/22-rdf-syntax-ns#","@xmlns:ore":"http://www.openarchives.org/ore/terms/","@xmlns:skos":"http://www.w3.org/2004/02/skos/core#","@xmlns:dcterms":"http://purl.org/dc/terms/","edm:WebResource":[{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-N0JN99O5/f2da7121-a311-4151-a001-8521519d5da8/PDF","dcterms:extent":"292 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-N0JN99O5/719a988d-efd0-40ee-a9af-3abf59b22640/TEXT","dcterms:extent":"0 KB"}],"edm:TimeSpan":{"@rdf:about":"2008-2025","edm:begin":{"@xml:lang":"en","#text":"2008"},"edm:end":{"@xml:lang":"en","#text":"2025"}},"edm:ProvidedCHO":{"@rdf:about":"URN:NBN:SI:doc-N0JN99O5","dcterms:isPartOf":[{"@rdf:resource":"https://www.dlib.si/details/URN:NBN:SI:spr-FQ9JBKO1"},{"@xml:lang":"sl","#text":"Rehabilitacija (Ljubljana)"}],"dcterms:issued":"2023","dc:creator":"Grabljevec, Klemen","dc:format":[{"@xml:lang":"sl","#text":"letnik:22"},{"@xml:lang":"sl","#text":"str. 7-10"},{"@xml:lang":"sl","#text":"številka:supl. 1"}],"dc:identifier":["COBISSID_HOST:152729347","ISSN:2232-545X","URN:URN:NBN:SI:doc-N0JN99O5"],"dc:language":"sl","dc:publisher":{"@xml:lang":"sl","#text":"Univerzitetni rehabilitacijski inštitut Republike Slovenije - Soča"},"dc:subject":[{"@xml:lang":"en","#text":"baclofen pump"},{"@xml:lang":"sl","#text":"baklofenska črpalka"},{"@xml:lang":"sl","#text":"intratekalni baklofen"},{"@xml:lang":"en","#text":"intrathecal baclofen"},{"@xml:lang":"sl","#text":"Muscle Spasticity"},{"@xml:lang":"sl","#text":"okvara zgornjega motoričnega nevrona"},{"@xml:lang":"sl","#text":"rehabilitacija"},{"@xml:lang":"sl","#text":"rehabilitation"},{"@xml:lang":"en","#text":"spasticity"},{"@xml:lang":"sl","#text":"spastičnost"},{"@xml:lang":"en","#text":"upper motor neuron lesion"}],"dcterms:temporal":{"@rdf:resource":"2008-2025"},"dc:title":{"@xml:lang":"sl","#text":"Indikacije in učinkovitost zdravljenja spastičnosti z intratekalno črpalko| Indications for and effectiveness of spasticity treatment with intrathecal pump implant|"},"dc:description":[{"@xml:lang":"sl","#text":"In some patients severe spasticity of cerebral or spinal origin cannot be treated succesfully with conventional oral medication or physical modalities. Intrathecal baclofen therapy with implanted pump has been an effective treatment since mid-80s. Baclofen (Lioresal) is a muscle relaxant and potent GABA agonist that acts via GABAb receptors at the posterior columns of spinal cord level, to inhibit the release of excitatory neurotransmitters by inhibiting the influx of calcium ions into presynaptic terminals. Such direct binding on spinal cord receptors leads to higher efficiency compared to peroral therapy, in which baclofen does not pass the brain-blood barrier. In Slovenia, there are currently 86 patients with an intrathecal pump implanted; five of those are receiving morphium sulfate as intractable pain therapy. We describe indications and contraindications for intrathecal baclofen therapy, selection and preparation of patients for surgery, the surgical procedure of pump implantation, long term follow-up with pump refill procedure, and possible complications of intrathecal baclofen therapy. In addition, the experiences of the Centre for Spasticity Treatment at the University Rehabilitation Institute Republic of Slovenia in Ljubljana are presented"},{"@xml:lang":"sl","#text":"Pri nekaterih pacientih z okvaro osrednjega živčevja generalizirane spastičnosti ne zmoremo obvladati s konvencionalnim zdravljenjem z zdravili in fizikalnimi načini zdravljenja. Zdravljenje z dovajanjem intratekalnega baklofena z metodo podkožno vstavljene črpalke predstavlja učinkovitejšo metodo zdravljenja generalizirane izrazite spastičnosti že od sredine 80-ih let prejšnjega stoletja; prvi pacientki iz Slovenije so črpalko vstavili leta 1993. Baklofen (Lioresal) je mišični relaksant in GABA agonist, ki z vezavo na GABAb receptorje v zadnjih stebričkih hrbtenjače zavira sproščanje ekscitatorih nevrotransmiterjev z inhibicijo kalcijevih kanalčkov na presinaptični membrani. Taka neposredna vezava v hrbtenjači pomeni bistveno večjo učinkovitost baklofena, ki sicer ne prestopa krvno-možganske pregrade v primerjavi z zdravljenjem v obliki tablet. V Sloveniji trenutno zdravimo 81 pacientov z metodo vstavljene programirljive črpalke, še pet pacientov pa s pomočjo črpalke v intratekalni prostor prejema morfijev sulfat za lajšanje močne bolečine v obliki mono- ali dodatnega zdravljenja. V nadaljevanju prispevka so predstavljene indiciranosti in kontraindiciranosti za zdravljenje z intratekalnim baklofenom, postopek izbire in priprave pacienta za kirurški poseg oz. vstavitev črpalke, polnjenje črpalke, vodenje pacientov po vstavitvi črpalke ter možni zapleti zdravljenja. Predstavljene so tudi izkušnje centra za zdravljenje spastičnosti na Univerzitetnem rehabilitacijskem inštitutu Soča v Ljubljani"}],"edm:type":"TEXT","dc:type":[{"@xml:lang":"sl","#text":"znanstveno časopisje"},{"@xml:lang":"en","#text":"journals"},{"@rdf:resource":"http://www.wikidata.org/entity/Q361785"}]},"ore:Aggregation":{"@rdf:about":"http://www.dlib.si/?URN=URN:NBN:SI:doc-N0JN99O5","edm:aggregatedCHO":{"@rdf:resource":"URN:NBN:SI:doc-N0JN99O5"},"edm:isShownBy":{"@rdf:resource":"http://www.dlib.si/stream/URN:NBN:SI:doc-N0JN99O5/f2da7121-a311-4151-a001-8521519d5da8/PDF"},"edm:rights":{"@rdf:resource":"http://rightsstatements.org/vocab/InC/1.0/"},"edm:provider":"Slovenian National E-content Aggregator","edm:intermediateProvider":{"@xml:lang":"en","#text":"National and University Library of Slovenia"},"edm:dataProvider":{"@xml:lang":"sl","#text":"Univerzitetni rehabilitacijski inštitut RS – Soča"},"edm:object":{"@rdf:resource":"http://www.dlib.si/streamdb/URN:NBN:SI:doc-N0JN99O5/maxi/edm"},"edm:isShownAt":{"@rdf:resource":"http://www.dlib.si/details/URN:NBN:SI:doc-N0JN99O5"}}}}