{"id":39520,"date":"2024-10-29T12:40:14","date_gmt":"2024-10-29T09:40:14","guid":{"rendered":"https:\/\/soracamed.com\/treatment\/hluboka-zilni-tromboza\/"},"modified":"2025-05-09T17:33:18","modified_gmt":"2025-05-09T14:33:18","slug":"hluboka-zilni-tromboza","status":"publish","type":"treatment","link":"https:\/\/soracamed.com\/cs\/lecba\/hluboka-zilni-tromboza\/","title":{"rendered":"Hlubok\u00e1 \u017eiln\u00ed tromb\u00f3za"},"content":{"rendered":"\n

Hlubok\u00e1 \u017eiln\u00ed tromb\u00f3za <\/strong>je onemocn\u011bn\u00ed, kter\u00e9mu lze p\u0159edch\u00e1zet a kter\u00e9 je zp\u016fsobeno zm\u011bnami pr\u016ftoku krve, poran\u011bn\u00edm c\u00e9vn\u00ed st\u011bny a poruchami sr\u00e1\u017elivosti. Nejd\u016fle\u017eit\u011bj\u0161\u00edm faktorem hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy, kter\u00e1 m\u016f\u017ee b\u00fdt \u017eivot ohro\u017euj\u00edc\u00ed, pokud nen\u00ed l\u00e9\u010dena, je porucha koagula\u010dn\u00edho syst\u00e9mu. <\/p>\n\n

Hlubok\u00e1 \u017eiln\u00ed tromb\u00f3za, kter\u00e1 je definov\u00e1na jako ucp\u00e1n\u00ed hlubok\u00e9 \u017e\u00edly v noze sra\u017eeninou, vznik\u00e1 z r\u016fzn\u00fdch d\u016fvod\u016f. Existuj\u00ed d\u016fvody, jako je dlouh\u00e9 le\u017een\u00ed v klidu, t\u011bhotenstv\u00ed, l\u00e9\u010dba rakoviny, p\u0159ekro\u010den\u00ed ide\u00e1ln\u00ed hmotnosti nebo podstoupen\u00ed operace mozku. <\/p>\n\n

Jak\u00e9 jsou p\u0159\u00edznaky hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy?<\/strong><\/h2>\n\n

P\u0159esto\u017ee u pacienta zp\u016fsobuje vysokou hore\u010dku, mezi nejv\u00fdznamn\u011bj\u0161\u00ed n\u00e1lezy pat\u0159\u00ed n\u00e1hl\u00fd otok, zarudnut\u00ed a bolest nohy, kter\u00e1 omezuje pohyb. P\u0159\u00edznaky bolesti a otoku se v\u0161ak li\u0161\u00ed v z\u00e1vislosti na m\u00edst\u011b v\u00fdskytu probl\u00e9mu. Mezi pozdn\u00ed komplikace pat\u0159\u00ed tvorba otok\u016f a k\u0159e\u010d\u00ed a tak\u00e9 deformace struktury k\u016f\u017ee v oblasti, kde se tromb\u00f3za nach\u00e1z\u00ed. Pokud dojde k prodlen\u00ed v l\u00e9\u010db\u011b hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy, noha ztvrdne a zb\u011bl\u00e1, noha bude studen\u00e1 a za\u010dnou se tvo\u0159it vodn\u00ed puch\u00fd\u0159ky. Sou\u010dasn\u011b se zhor\u0161en\u00edm ob\u011bhov\u00e9ho syst\u00e9mu vznikaj\u00ed v\u0159edy. <\/p>\n\n

Nov\u00e9 metody l\u00e9\u010dby hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy<\/strong><\/h2>\n\n

Farmakomechanick\u00e1 l\u00e9\u010dba se v sou\u010dasn\u00e9 dob\u011b pou\u017e\u00edv\u00e1 v p\u0159\u00edpadech \u010dasn\u00e9 hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy. Tato metoda spo\u010d\u00edv\u00e1 v odstran\u011bn\u00ed sra\u017eeniny vstupem do \u017e\u00edly pomoc\u00ed intraven\u00f3zn\u00edch kat\u00e9tr\u016f na odstra\u0148ov\u00e1n\u00ed sra\u017eenin, kter\u00e9 byly v posledn\u00edch letech speci\u00e1ln\u011b vyvinuty. Po tomto z\u00e1kroku se kat\u00e9tr, kter\u00fd uvol\u0148uje l\u00e9ky rozpou\u0161t\u011bj\u00edc\u00ed sra\u017eeninu, ponech\u00e1 v \u017e\u00edle po dobu 24 hodin. <\/p>\n\n

P\u0159i l\u00e9\u010db\u011b hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy diagnostikovan\u00e9 b\u011bhem prvn\u00edch 48 hodin se sra\u017eenina viditeln\u00e1 v hlubok\u00e9<\/strong><\/a> \u017e\u00edle nad kolenem a v b\u0159i\u0161e odstran\u00ed proveden\u00edm mal\u00e9ho \u0159ezu v t\u0159\u00edsle a zaveden\u00edm speci\u00e1ln\u00edho bal\u00f3nkov\u00e9ho kat\u00e9tru. Pokud je sra\u017eenina patrn\u00e1 v oblasti pod kolenem, je do \u017e\u00edly syst\u00e9mov\u011b pod\u00e1n l\u00e9k rozpou\u0161t\u011bj\u00edc\u00ed sra\u017eeninu, kter\u00fd ji rozpust\u00ed. <\/p>\n\n

Jak\u00e9 jsou nespr\u00e1vn\u00e9 postupy p\u0159i l\u00e9\u010db\u011b hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy?<\/strong><\/h2>\n\n

Diagn\u00f3za bez dopplerovsk\u00e9ho testu nebo chybn\u00e1 diagn\u00f3za, stejn\u011b jako pou\u017eit\u00ed antibiotik nebo antikoagulanci\u00ed typu l\u00e9k\u016f na \u0159ed\u011bn\u00ed krve, jsou nespr\u00e1vn\u00e9 postupy v procesu l\u00e9\u010dby. Zejm\u00e9na pou\u017eit\u00ed l\u00e9k\u016f na \u0159ed\u011bn\u00ed krve nen\u00ed \u00fa\u010dinn\u00e9 p\u0159i odstra\u0148ov\u00e1n\u00ed existuj\u00edc\u00ed sra\u017eeniny. Pokud se spr\u00e1vn\u00e1 l\u00e9\u010dba odkl\u00e1d\u00e1, m\u016f\u017ee u pacienta doj\u00edt k otoku nohy a vzniku v\u0159ed\u016f v kotn\u00edc\u00edch. <\/p>\n\n

P\u0159\u00edznaky hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy<\/strong><\/h3>\n\n

P\u0159\u00edznaky hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy (H\u017dT) mohou b\u00fdt:<\/em><\/strong><\/p>\n\n

    \n
  • Otok nohou<\/li>\n\n\n\n
  • K\u0159e\u010de, bolest nebo bolestivost nohou, kter\u00e9 obvykle za\u010d\u00ednaj\u00ed v l\u00fdtk\u00e1ch.<\/li>\n\n\n\n
  • Barevn\u00e9 zm\u011bny na nohou, jako je fialov\u00e1 nebo \u010derven\u00e1, v z\u00e1vislosti na odst\u00ednu va\u0161\u00ed poko\u017eky.<\/li>\n\n\n\n
  • Pocit tepla na posti\u017een\u00e9 noze.<\/li>\n\n\n\n
  • Hlubok\u00e1 \u017eiln\u00ed tromb\u00f3za se m\u016f\u017ee objevit bez zjevn\u00fdch p\u0159\u00edznak\u016f.<\/li>\n<\/ul>\n\n

    Rizikov\u00e9 faktory hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy<\/strong><\/h2>\n\n

    Pravd\u011bpodobnost vzniku hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy m\u016f\u017ee zvy\u0161ovat \u0159ada faktor\u016f. (DVT). \u010c\u00edm v\u00edce rizikov\u00fdch faktor\u016f se u v\u00e1s vyskytuje, t\u00edm vy\u0161\u0161\u00ed je pravd\u011bpodobnost vzniku DVT. Mezi rizikov\u00e9 faktory vzniku DVT pat\u0159\u00ed: <\/p>\n\n

    V\u011bk<\/strong>: V\u011bk nad 60 let je faktorem zvy\u0161uj\u00edc\u00edm pravd\u011bpodobnost vzniku hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy. DVT je v\u0161ak mo\u017en\u00e1 kdykoli. <\/p>\n\n

    Nedostatek pohybu. Pokud se nohy del\u0161\u00ed dobu nepohybuj\u00ed, l\u00fdtkov\u00e9 svaly se nezat\u00e1hnou (nezkracuj\u00ed). Svalov\u00e9 kontrakce napom\u00e1haj\u00ed pr\u016ftoku krve. P\u0159i dlouh\u00e9m sezen\u00ed, nap\u0159\u00edklad p\u0159i l\u00e9t\u00e1n\u00ed nebo \u0159\u00edzen\u00ed, se zvy\u0161uje pravd\u011bpodobnost vzniku hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy. Tak\u00e9 dlouhodob\u00fd pobyt na l\u016f\u017eku, kter\u00fd m\u016f\u017ee b\u00fdt d\u016fsledkem dlouh\u00e9ho pobytu v nemocnici nebo zdravotn\u00edho stavu, jako je ochrnut\u00ed. <\/p>\n\n

    Operace nebo zran\u011bn\u00ed:<\/strong> Poran\u011bn\u00ed \u017eil nebo chirurgick\u00fd z\u00e1krok mohou zv\u00fd\u0161it riziko vzniku krevn\u00edch sra\u017eenin.<\/p>\n\n

    T\u011bhotenstv\u00ed:<\/strong> T\u011bhotenstv\u00ed zvy\u0161uje tlak v \u017eil\u00e1ch, kter\u00e9 proch\u00e1zej\u00ed nohama a p\u00e1nv\u00ed. Riziko vzniku krevn\u00edch sra\u017eenin, kter\u00e9 jsou d\u016fsledkem t\u011bhotenstv\u00ed, m\u016f\u017ee trvat a\u017e \u0161est t\u00fddn\u016f po narozen\u00ed d\u00edt\u011bte. Zvl\u00e1\u0161t\u011b n\u00e1chyln\u00e9 jsou osoby, kter\u00e9 maj\u00ed genetickou poruchu sr\u00e1\u017elivosti krve. <\/p>\n\n

    Antikoncep\u010dn\u00ed tablety (peror\u00e1ln\u00ed antikoncepce) nebo hormon\u00e1ln\u00ed substitu\u010dn\u00ed l\u00e9\u010dba. Oboj\u00ed zvy\u0161uje schopnost krve tvo\u0159it sra\u017eeniny. <\/p>\n\n

    nadv\u00e1ha nebo obezita. Nadv\u00e1ha zp\u016fsobuje tlak na \u017e\u00edly v p\u00e1nvi a na nohou. <\/p>\n\n

    Kou\u0159en\u00ed:<\/strong> Kou\u0159en\u00ed ovliv\u0148uje tok krve a jej\u00ed sr\u00e1\u017een\u00ed. To m\u016f\u017ee zv\u00fd\u0161it pravd\u011bpodobnost vzniku hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy. <\/p>\n\n

    Rakovina:<\/strong> N\u011bkter\u00e9 druhy rakoviny zp\u016fsobuj\u00ed zv\u00fd\u0161en\u00e9 mno\u017estv\u00ed l\u00e1tek v krvi, kter\u00e9 zp\u016fsobuj\u00ed tvorbu krevn\u00edch sra\u017eenin. Riziko vzniku krevn\u00edch sra\u017eenin mohou zvy\u0161ovat i n\u011bkter\u00e9 druhy l\u00e9\u010dby rakoviny. <\/p>\n\n

    Srde\u010dn\u00ed selh\u00e1n\u00ed:<\/strong> Srde\u010dn\u00ed selh\u00e1n\u00ed je rizikov\u00fdm faktorem pro vznik hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy a embolie do plicn\u00edch cest. Proto\u017ee pl\u00edce a srdce u pacient\u016f se srde\u010dn\u00edm onemocn\u011bn\u00edm nefunguj\u00ed spr\u00e1vn\u011b P\u0159\u00edznaky vyvolan\u00e9 i men\u0161\u00ed plicn\u00ed emboli\u00ed mohou b\u00fdt z\u0159eteln\u011bj\u0161\u00ed. <\/p>\n\n

    Z\u00e1n\u011btliv\u00e9 st\u0159evn\u00ed onemocn\u011bn\u00ed. Crohnova choroba nebo ulcer\u00f3zn\u00ed kolitida mohou zv\u00fd\u0161it pravd\u011bpodobnost vzniku hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy. <\/p>\n\n

    Rodinn\u00e1 nebo osobn\u00ed anamn\u00e9za hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy nebo plicn\u00ed embolie (PE). Pokud u v\u00e1s nebo u n\u011bkoho z va\u0161\u00ed rodiny bylo diagnostikov\u00e1no jedno nebo ob\u011b tato onemocn\u011bn\u00ed, m\u016f\u017eete b\u00fdt v\u00edce ohro\u017eeni vznikem DVT. <\/p>\n\n

    Genetika:<\/strong> U n\u011bkter\u00fdch lid\u00ed doch\u00e1z\u00ed ke zm\u011bn\u00e1m DNA, kter\u00e9 zp\u016fsobuj\u00ed rychlej\u0161\u00ed sr\u00e1\u017een\u00ed krve. P\u0159\u00edkladem je faktor V Leiden. Tato d\u011bdi\u010dn\u00e1 porucha m\u011bn\u00ed jeden z faktor\u016f, kter\u00e9 zp\u016fsobuj\u00ed tvorbu krevn\u00edch sra\u017eenin. Geneticky d\u011bdi\u010dn\u00e1 porucha sama o sob\u011b m\u016f\u017ee zp\u016fsobit vznik krevn\u00edch sra\u017eenin, pokud nen\u00ed spojena s dal\u0161\u00edmi faktory, kter\u00e9 zvy\u0161uj\u00ed riziko jejich vzniku. <\/p>\n\n

    N\u011bkdy m\u016f\u017ee b\u00fdt zji\u0161t\u011bno zv\u011bt\u0161en\u00ed krve v \u017e\u00edle bez rizikov\u00e9ho d\u016fvodu. Jedn\u00e1 se o tzv. nevyprovokovan\u00fd tromboembolizmus \u017eiln\u00ed krve (VTE). <\/p>\n

    \n
    \n
    \n

    Lze zachr\u00e1nit pacienta, kter\u00fd p\u0159ijde pozd\u011b?<\/strong><\/h3>\n
    \n\n

    Pacient je nejprve velmi dob\u0159e vy\u0161et\u0159en fyzik\u00e1ln\u00edm vy\u0161et\u0159en\u00edm a podrobn\u00fdm dopplerovsk\u00fdm testem. V pozdn\u00edm obdob\u00ed lze dos\u00e1hnout \u00fasp\u011b\u0161n\u00fdch v\u00fdsledk\u016f pomoc\u00ed l\u00e9k\u016f rozpou\u0161t\u011bj\u00edc\u00edch sra\u017eeniny. Zhodnot\u00ed se celkov\u00fd zdravotn\u00ed stav pacienta a stav \u017e\u00edly, ve kter\u00e9 je vid\u011bt sra\u017eenina, a pacient je hospitalizov\u00e1n a podv\u00e1z\u00e1n\u00ed odpov\u011bdn\u00fdch \u017eil i vznikl\u00e9 r\u00e1ny se rychle hoj\u00ed. <\/p>\n\n<\/div>\n<\/div>\n

    \n

    Co je t\u0159eba ud\u011blat po l\u00e9\u010db\u011b hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy?<\/strong><\/h3>\n
    \n\n

    U pacient\u016f trp\u00edc\u00edch hlubokou \u017eiln\u00ed tromb\u00f3zou by m\u011blo b\u00fdt po prvn\u00edm z\u00e1chvatu rozhodn\u011b vyhodnoceno INR a m\u011bly by b\u00fdt pou\u017eity l\u00e9ky na \u0159ed\u011bn\u00ed krve. T\u00edm se zabr\u00e1n\u00ed vzniku nov\u00e9 sra\u017eeniny.
    V dne\u0161n\u00ed dob\u011b lze neovulzivn\u00ed antikoagula\u010dn\u00ed l\u00e9ky (NAK) pod\u00e1vat bez pr\u016fb\u011b\u017en\u00e9ho krevn\u00edho testu, co\u017e pacientovi poskytuje komfort.<\/p>\n\n<\/div>\n<\/div>\n

    \n

    Co se stane, kdy\u017e se hlubok\u00e1 \u017eiln\u00ed tromb\u00f3za nel\u00e9\u010d\u00ed?<\/strong><\/h3>\n
    \n\n

    Otok nohy m\u016f\u017ee b\u00fdt trval\u00fd a mohou se otev\u0159\u00edt jizvy. M\u016f\u017ee tak\u00e9 zp\u016fsobit smrt vmeten\u00edm sra\u017eeniny do plic. Pokud m\u00e1 pacient s hlubokou \u017eiln\u00ed tromb\u00f3zou otok nohy, pot\u00ed\u017ee s d\u00fdch\u00e1n\u00edm a bolest na hrudi, m\u011bla by b\u00fdt posouzena mo\u017enost vzniku sra\u017eeniny v plic\u00edch. <\/p>\n\n<\/div>\n<\/div>\n

    \n

    \u010ceho se vyvarovat p\u0159i hlubok\u00e9 \u017eiln\u00ed tromb\u00f3ze?<\/strong><\/h3>\n
    \n\n

    Nest\u016fjte ani nese\u010fte dlouho na jednom m\u00edst\u011b. Nenoste oble\u010den\u00ed, kter\u00e9 omezuje pr\u016ftok krve nohama. Neku\u0159te. P\u0159i u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f na \u0159ed\u011bn\u00ed krve se ne\u00fa\u010dastn\u011bte kontaktn\u00edch sport\u016f, proto\u017ee hroz\u00ed riziko krv\u00e1cen\u00ed z \u00farazu.<\/p>\n\n<\/div>\n<\/div>\n

    \n

    Jak dlouho trv\u00e1 \u017eiln\u00ed tromb\u00f3za?<\/strong><\/h3>\n
    \n\n

    V\u011bt\u0161ina pacient\u016f s hlubokou \u017eiln\u00ed tromb\u00f3zou<\/strong> nebo PE se b\u011bhem n\u011bkolika t\u00fddn\u016f a\u017e m\u011bs\u00edc\u016f zcela zotav\u00ed bez v\u00fdznamn\u00fdch komplikac\u00ed nebo dlouhodob\u00fdch ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f. Mohou se v\u0161ak vyskytnout dlouhodob\u00e9 probl\u00e9my s p\u0159\u00edznaky od velmi m\u00edrn\u00fdch a\u017e po z\u00e1va\u017en\u011bj\u0161\u00ed. <\/p>\n\n<\/div>\n<\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"

    Hlubok\u00e1 \u017eiln\u00ed tromb\u00f3za je onemocn\u011bn\u00ed, kter\u00e9mu lze p\u0159edch\u00e1zet a kter\u00e9 je zp\u016fsobeno zm\u011bnami pr\u016ftoku krve, poran\u011bn\u00edm c\u00e9vn\u00ed st\u011bny a poruchami sr\u00e1\u017elivosti. Nejd\u016fle\u017eit\u011bj\u0161\u00edm faktorem hlubok\u00e9 \u017eiln\u00ed tromb\u00f3zy, kter\u00e1 m\u016f\u017ee b\u00fdt \u017eivot ohro\u017euj\u00edc\u00ed, pokud nen\u00ed l\u00e9\u010dena, je porucha koagula\u010dn\u00edho syst\u00e9mu. Hlubok\u00e1 \u017eiln\u00ed tromb\u00f3za, kter\u00e1 je definov\u00e1na jako ucp\u00e1n\u00ed hlubok\u00e9 \u017e\u00edly v noze sra\u017eeninou, vznik\u00e1 z r\u016fzn\u00fdch d\u016fvod\u016f. […]<\/p>\n","protected":false},"featured_media":39521,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","format":"standard","meta":{"_acf_changed":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}}},"class_list":["post-39520","treatment","type-treatment","status-publish","format-standard","has-post-thumbnail","hentry","treatments-dalsi-osetreni"],"acf":[],"_links":{"self":[{"href":"https:\/\/soracamed.com\/cs\/wp-json\/wp\/v2\/treatment\/39520","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/soracamed.com\/cs\/wp-json\/wp\/v2\/treatment"}],"about":[{"href":"https:\/\/soracamed.com\/cs\/wp-json\/wp\/v2\/types\/treatment"}],"replies":[{"embeddable":true,"href":"https:\/\/soracamed.com\/cs\/wp-json\/wp\/v2\/comments?post=39520"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/soracamed.com\/cs\/wp-json\/wp\/v2\/media\/39521"}],"wp:attachment":[{"href":"https:\/\/soracamed.com\/cs\/wp-json\/wp\/v2\/media?parent=39520"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}