Шунтирование сердца инвалидность после операции

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 3 минуты Ирина Смирнова 6746

Оперативное хирургическое вмешательство на сердце дает шанс больному человеку начать жить полноценной жизнью. После проведения коронарного шунтирования функция кровоснабжения сосудов начинает восстанавливаться, самый важный орган – «мотор» – организма возобновляет свою продуктивную работу. Человек становится более активным, симптоматика уходит или уменьшается. Но не нужно считать, что операция – это панацея от всех проблем. После шунтирования сердца бывает тяжело восстановиться и вернуться к обычной жизни, начать работать так, как раньше. В этом случае больной проходит медицинскую комиссию, после которой решается вопрос: присваивать инвалидность после шунтирования сосудов сердца или нет.

Группы инвалидности

Существует три группы инвалидности. Чем меньше порядковый номер, тем тяжелее показатель. Больные, которым выставляется третья группа инвалидности, трудоспособны, выполняют обязанности пусть не в полном объеме, но так, как допускает их состояние здоровья. Такой пациент способен сам себя обслужить и передвигается без посторонней помощи. Третья группа инвалидности считается самой «легкой», если сравнивать с остальными. В народе ее называют «рабочая». Больные, которым положена вторая группа инвалидности, работать не в состоянии, чтобы себя обслужить, им порой требуется посторонняя поддержка. При первой группе пациент зависим, ему необходима помощь практически постоянно. Самостоятельно передвигаться для них проблематично.

АКШ – не приговор

После произведенной операции по аортокоронарному шунтированию сердца совершенно не обязательно присвоение группы. Перенесенное хирургическое вмешательство не является для этого критерием. После проведенной операции делается УЗИ, результат должен показать, насколько восстановились сердечные функции. Если пациент чувствует себя хорошо, обследование не выявило отклонений или они минимальны и незначительны, то выставление инвалидности после операции не обязательно. Статистика показывает, что всего лишь 10 процентов больных, которым была произведена хирургическая процедура АКШ, получают группу. И все же после коронарного шунтирования пациента направляют на МРЭК (медико-реабилитационная комиссия).

Если у вас возникнут вопросы, можете бесплатно проконсультироваться в чате с юристом внизу экрана или позвонить по телефону 8 800 350-81-94 (консультация бесплатно), работаем круглосуточно.

 Врачи-эксперты дают окончательную оценку состоянию прооперированного и выносят свой вердикт – давать группу инвалидности или нет.

Как присваивается инвалидность, какие для этого показания

Исследуется полностью история болезни, показатели анализов, общее состояние пациента. Показанием может быть сохранение частых стенокардических приступов, наличие сердечной недостаточности. Важные факторы, на которые смотрят специалисты при возможном выставлении группы:
  • каков ответ на аортокоронарное шунтирование сердечно-сосудистой системы и как реагирует организм;
  • какие были сердечные патологии и были ли они отягощены иными заболеваниями до хирургического вмешательства.

Операция на сердце, в частности, коронарное шунтирование, во многих случаях позволяет человеку вернуться к нормальной жизни. Восстановление функции кровоснабжения сосудов помогает организму работать более продуктивно, возникает состояние активности, а симптомы уменьшаются или полностью исчезают. Конечно, хирургическое вмешательство не является панацеей, так как некоторым пациентам сложно восстанавливаться после шунтирования. А если в результате возникают ограничения жизнедеятельности, имеет смысл обратиться к кардиологу за направлением на МСЭ для назначения инвалидности.

Когда направляют на освидетельствование после шунтирования

Аортокоронарное шунтирование сердца как таковое не позволяет претендовать на группу и сопутствующие льготы. Прежде всего, хирургическая манипуляция должна нормализовать работу сердца. Для того, чтобы дать послеоперационный прогноз, специалисты проводят УЗИ органа и смотрят на уровень его функциональных возможностей.
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Хорошее самочувствие, отсутствие (или минимум) отклонений не позволяют получить инвалидность. Как отмечают врачи, всего 10% пациентов, перенёсших хирургическую процедуру АКШ, проходят МСЭ и получают справку о присвоении статуса «инвалид». При всём этом рекомендуется посетить МРЭК или медико-реабилитационную комиссию, где врачи дают наиболее полную оценку здоровья и принимают решение о необходимости назначения группы.

Группы инвалидности при шунтировании

Всего существует три группы, указывающие на тяжесть состояния в порядке уменьшения номера (чем он меньше, тем сильнее развилась патология). Например, инвалидность 3 группы означает способность её обладателя к труду, к выполнению обычных обязанностей (иногда не в полном объёме), к самостоятельному передвижению и тд.

Если у вас возникнут вопросы, можете бесплатно проконсультироваться в чате с юристом внизу экрана или позвонить по телефону 8 800 350-81-94 (консультация бесплатно), работаем круглосуточно.

 Более серьёзная в сравнении с указанной выше «лёгкой» – 2 группа. Лица данной категории считаются нетрудоспособными, могут нуждаться в поддержке со стороны, так как самообслуживание для них затруднительно. При 1 группе подразумевается зависимость больного от чьей-то помощи, причём практически на постоянной основе. Передвижение и осуществление привычных дел для них проблематично.

Шунтирование сосудов сердца и критерии присвоения группы

Экспертная комиссия изучает данные анализов, историю болезни, учитывает общее состояние потенциального инвалида. К примеру, показаниями для назначения группы являются наличие сердечной недостаточности, сохранение часто повторяющихся стенокардических приступов. Помимо этого учитываются некоторые значимые факторы: – реакцию организма и ответ сердечно-сосудистой системы на АКШ; – присутствие патологий сердца и их отягощённость до вмешательства хирургов другими заболеваниями. Чаще всего инвалидность приходится подтверждать на переосвидетельствовании каждый год (3 и 2 группы) или раз в два года (1 категория). Подобная мера необходима ввиду наступления возможных изменений, то есть улучшения состояния и наоборот. При позитивной динамике инвалидность снимают или уменьшают категорию. В противном случае фиксируется нетрудоспособность, происходит утяжеление группы. А при выявлении стойких изменений в негативную сторону группу могут дать бессрочно. Особенно это актуально для женщин от 55 лет и для мужчин за 60.

Что нужно для назначения инвалидности после АКШ

Прежде всего, прооперированному необходимо запросить у кардиолога посыльной лист для сдачи требуемых анализов и прохождения инструментального обследования. Важно посетить всех указанных специалистов и получить от них медзаключения. Как правило, предоставляемый в экспертную комиссию пакет документов включает в себя:

Если у вас возникнут вопросы, можете бесплатно проконсультироваться в чате с юристом внизу экрана или позвонить по телефону 8 800 350-81-94 (консультация бесплатно), работаем круглосуточно.

 – заявление на освидетельствование; – паспорт и трудовую книжку (плюс их копии); – медицинскую карту и иные сведения о здоровье; – выданные в стационаре и заверенные эпикризы. Важно. Папка может дополняться необходимыми бумагами, так как каждый случай уникален. Если получено заключение о присвоении конкретной группы инвалидности, а также на руках ИПР и справка, подтверждающая статус, можно обращаться в Пенсионный фонд за выплатами. Обжаловать принятое решение в случае несогласия пациент вправе в центральной комиссии на вышестоящем уровне или через суд (эта инстанция действует в последнюю очередь, когда во всех бюро отказались давать инвалидность).

Операция шунтирования на сердце проводится достаточно часто. Связано это, прежде всего, с увеличением числа больных, страдающих проблемами кровоснабжения сердечной мышцы и эффективностью данного метода лечения. Этот вид хирургического вмешательства дает высокие шансы на полноценную жизнь в дальнейшем и снижает риск возникновения инфаркта миокарда. Однако, возникают вопросы, сможет ли больной после шунтирования работать на прежнем месте, какие возможны осложнения и дают ли инвалидность после шунтирования сосудов сердца. Рассмотрим эти вопросы.

Осложнения, возникающие в результате проведения операции шунтирования на сердце

Практически каждая хирургическая манипуляция несет в себе риск развития осложнений у больного, тем более – операция на сердце.
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Несмотря на положительную динамику проведения аортокоронарного шунтирования (АКШ), у пациентов могут наблюдаться следующие осложнения:

  • кровотечения в области операционной раны;
  • кровотечения и инфицирование раны в месте разреза вены (как правило, зона бедер);
  • нарушение функций шунта вследствие его сужения;
  • раскрытие швов;
  • боли и жар в зоне грудной клетки;
  • ухудшение когнитивных процессов;
  • тромбоз венозных русел;
  • появление приступов стенокардии;
  • нарушение кровоснабжения мозга;
  • общая ослабленность организма.

Если у вас возникнут вопросы, можете бесплатно проконсультироваться в чате с юристом внизу экрана или позвонить по телефону 8 800 350-81-94 (консультация бесплатно), работаем круглосуточно.

 Важно! Для исключения вероятности развития осложнений необходимо придерживаться строгих правил послеоперационного периода восстановления, данных врачом.

Шунтирование сердца — инвалидность после операции

Многие пациенты, перенесшие операцию, полагают, что в дальнейшем у них появятся отклонения и ограничения физических возможностей. Однако группа инвалидности присваивается только 7-8% пациентов. В большинстве случаев (85%) дают временную инвалидность (6-12 месяцев) с присвоением третьей группы инвалидности. Для получения группы инвалидности пациент проходит врачебную комиссию. Для принятия решения комиссия учитывает следующие факторы:
  • возраст пациента;
  • заболевания сердца до операции;
  • присутствие хронических заболеваний, сердечной недостаточности;
  • высокая вероятность сердечного приступа;
  • состояние организма до и после операции;
  • серьезные проблемы мышления и ухудшение памяти.
Первая группа инвалидности присваивается пациентам при следующих обстоятельствах:
  • стенокардия с частыми приступами (несколько раз в день);
  • симптомы хронической сердечной недостаточности;
  • тяжелые нарушения ритма сердца.
Вторая группа присваивается в следующих случаях:
  • нарастающая сердечная недостаточность;
  • ежедневные приступы стенокардии.
Инвалидность после АКШ сердца третьей группы присваивается при:
  • периодических приступах стенокардии;
  • умеренных нарушениях работы сердца;
  • постоянном общем недомогании;
  • нарушении процессов памяти и мышления.
Только при наличии нескольких симптомов человеку после операции шунтирования дадут 1, 2 или 3 группу инвалидности.

Где не работают инвалиды

Имея группу инвалидности, человек работает с определенными ограничениями. Разумеется, необходимо учитывать профессию больного и режим работы.
Важно! Как и любой другой сотрудник организации, инвалид не может быть ограничен в трудовых правах.
После шунтирования сердца человеку дают группу инвалидности, и он не сможет работать на вредных производствах, в ночные смены или посуточно, разгружать грузы и поднимать тяжести. Также ограничения распространяются на военную службу и работу в ОВД.

Какие возможности/льготы дают группы инвалидности

Если у вас возникнут вопросы, можете бесплатно проконсультироваться в чате с юристом внизу экрана или позвонить по телефону 8 800 350-81-94 (консультация бесплатно), работаем круглосуточно.

 Группы инвалидности подразумевают собой получение льготных пенсий и выплату пособий.

Третья группа

Группы инвалидности подразумевают собой получение льготных пенсий и выплату пособий. При этом третья группа инвалидности предусматривает следующие льготы:
  • скидки на проезд в общественном транспорте;
  • скидки на медицинское обслуживание, покупку медтехники и лекарств;
  • льготное санаторно-курортное лечение;
  • льготы, касающиеся налоговых платежей;
  • льготы по оплате ЖКХ;
  • устройство на работу с неполным графиком;
  • право самостоятельного выбора времени отпуска.

Вторая группа

Вторая группа инвалидности дает следующие льготы:
  • бесплатные проезды на общественном транспорте;
  • предоставление выписанных доктором медикаментов;
  • льготное санаторно-курортное лечение;
  • предоставление медтехники;
  • протезирование зубов;
  • право внеочередного поступления в учебные заведения высшего и среднего образования;
  • право на повышенную стипендию;
  • укороченная до 35 часов рабочая неделя для работающего инвалида второй группы;
  • получение отпуска до 60 дней;
  • освобождение от налога на имущество, доставшегося по наследству;
  • другие послабления налоговых выплат.

Первая группа

Люди с первой группой инвалидности пользуются следующими льготами:
  • бесплатный проезд на общественном транспорте;
  • бесплатные лекарства, медтехника и перевязочные материалы, показанные врачом;
  • бесплатное санаторно-курортное лечение и отдых 1 раз в год на протяжении 3 лет с момента получения группы;
  • бесплатное протезирование, в т.ч. и зубное;
  • бесплатная ортопедическая обувь;
  • внеочередное поступление в учебные заведения высшего и среднего образования;
  • повышенная стипендия;
  • для работающих инвалидов укороченная рабочая неделя до 35 часов;
  • получение отпуска до 60 дней;
  • освобождение от налога на имущество, доставшегося по наследству;
  • другие послабления налоговых выплат.

Порядок оформления группы инвалидности по сердцу

Для начала человеку после АКШ обращаются к кардиологу для получения посыльного листа, направления на сдачу анализов и инструментальное обследование.
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Далее больной совершает обход требуемых врачей, сдает анализы и проходит обследование. Для получения группы больному требуется:

  • совершить полное обследование сердечно-сосудистой системы;
  • совершить обследование на выявление других системных заболеваний;
  • подойти с результатами к лечащему врачу и получить направление на комиссию;
  • пройти медико-социальную экспертизу, медицинскую комиссию, на которой определят обоснование присвоения той или иной группы инвалидности и установят сроки инвалидности.
Также готовят следующий список документов:
  • копия трудовой книжки, в случае если человек работал до операции;
  • паспорт;
  • амбулаторная карта;
  • заявление больного на освидетельствование;
  • заверенные эпикризы из стационаров.
Далее проходит заседание медицинской комиссии и выносится заключение. Если группа инвалидности присвоена, человеку выдают необходимые справки и программу реабилитации.

Если у вас возникнут вопросы, можете бесплатно проконсультироваться в чате с юристом внизу экрана или позвонить по телефону 8 800 350-81-94 (консультация бесплатно), работаем круглосуточно.

 Внимание! Если пациент не согласен с решением, оно обжалуется в вышестоящей комиссии или через суд.

Медико-социальная экспертиза

Аортокоронарное шунтирование

АКШ представляет собой хирургическое вмешательство по проведению операции на сосудах сердца с целью восстановления кровотока в коронарном русле. Одно из основных показаний для проведения операции — ишемическая болезнь сердца. Дополнительные показания для проведения АКШ пациенту:
  • постоянные проявления стенокардии, которые невозможно скорректировать медикаментозным лечением;
  • значительное сужение коронарного русла;
  • высокий риск инфаркта миокарда.
В классическом варианте операция аортокоронарного шунтирования довольно сложное и опасное для больного хирургическое вмешательство, состоящее из основных этапов:
  1. Для начала пациента подвергают общему наркозу
  2. Далее вскрывается грудная клетка с помощью срединной стернотомии.
  3. Вскрывается полость перикарда, параллельно процессу производится забор сосуда, который в дальнейшем будет использоваться в роли шунта.
  4. После проведения ряда мероприятий сердце подключается к аппарату искусственного кровообращения;.
  5. Далее накладывают шунт и сердце выводится из искусственного кровоснабжения и в условиях сокращающегося органа шунтом соединяют аорту и межжелудочковую артерию.
  6. Кровоснабжение миокарда восстанавливается, грудную клетку сшивают.

Инвалидность после шунтирования сердца

Перенесенная операция шунтирования на сердце — вовсе не обязательный повод для выставления инвалидности. АКШ позволяет сердцу восстановить функционирование, а пациенту — вернуться к привычному образу жизни. Если после проведения операции работа сердца восстанавливается, УЗИ не выявляет отклонений или они незначительны, а состояние пациента хорошее, человек не считается инвалидом. Однако, шунтирование — повод для назначения прохождения медико-реабилитационной комиссии (МРЭК), которая включает в себя освидетельствование врачами-экспертами во главе с председателем. Комиссия анализирует историю болезни, результаты обследований, состояние пациента и выносит решение о наличии или отсутствии симптомов, указывающих на инвалидность. При наличии выраженных нарушений в работе сердечно-сосудистой системы, сложностях в осуществлении трудовой деятельности и выполнении необходимых действий для самообслуживания человеку присваивается группа инвалидности. При стойких и необратимых изменениях в работе сердца и возрасте пациента (у женщин старше 55 лет, у мужчин старше 60 лет) могут присвоить пожизненную группу. Но это бывает достаточно редко.

Нужна ли перекомиссия для продления инвалидности

Чаще всего после АКШ присваивается временная инвалидность сроком на 1-2 года, и в дальнейшем требуется пройти переосвидетельствование. Для 1 группы инвалидности, перекомиссию проходят 1 раз в 2 года, для 2 и 3 групп 1 раз в год. Такое правило связано с тем, что состояние сердечно-сосудистой системы пациента с течением времени может измениться, причем как в лучшую, так и в худшую сторону. При улучшении состояния больного группа может быть снижена, а если наблюдается ухудшение состояния пациента и прогрессивное течение болезни сердца — утяжелена или дана пожизненно. Таким образом, при наличии серьезных последствий для здоровья пациента, ухудшении состояния после операции шунтирования на сердце, невозможности вести трудовую деятельность, может быть присвоена инвалидность. Группа определяется в зависимости от тяжести выявленных патологий.

Если у вас возникнут вопросы, можете бесплатно проконсультироваться в чате с юристом внизу экрана или позвонить по телефону 8 800 350-81-94 (консультация бесплатно), работаем круглосуточно.

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