{"id":2778,"date":"2015-02-02T18:19:00","date_gmt":"2015-02-02T17:19:00","guid":{"rendered":"http:\/\/www.zdravstvena.info\/vsznj\/?p=2778"},"modified":"2015-02-02T19:17:07","modified_gmt":"2015-02-02T18:17:07","slug":"zapleti-po-operaciji-sive-mrene-operacija-sive-mrene","status":"publish","type":"post","link":"https:\/\/www.zdravstvena.info\/vsznj\/zapleti-po-operaciji-sive-mrene-operacija-sive-mrene\/","title":{"rendered":"Zapleti po operaciji sive mrene"},"content":{"rendered":"

Operacija sive mrene je danes najpogostej\u0161a operacija na o\u010deh. Zapleti se lahko pojavijo takoj po ali leta po operaciji. Ve\u010dina zapletov je la\u017ejih, za nekaj vid ogro\u017eujo\u010dih, kot so endoftalmitis, odstop mre\u017enice, maligni glavkom idr. pa je zelo pomembna hitra prepoznava in pravilno zdravljenje.\u010clanek opisuje zgodnje in pozne zaplete po operaciji sive mrene, njihove znake in zdravljenje sive mrene je danes najpogostej\u0161a operacija na o\u010deh.<\/p>\n

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Zapleti se lahko pojavijo takoj po operaciji ali leta po operaciji. Ve\u010dina zapletov je la\u017ejih, za nekaj vid ogro\u017eujo\u010dih, kot so endoftalmitis, odstop mre\u017enice, maligni glavkom idr. pa je zelo pomembna hitra prepoznava in pravilno zdravljenje.<\/p>\n

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Zgodnji zapleti Zapleti 1. dan po operaciji<\/span><\/strong><\/p>\n

\u00a0<\/span><\/strong><\/p>\n

Pu\u0161\u010danje rane<\/strong>1<\/sup> je redkej\u0161e pri skleralnih in limbalnih, pogosteje pri \u2018clear cornea\u2019 incizijah. Pri skleralnih incizijah lahko nastane \u2018filtracijska blazinica\u2019, ko rana pu\u0161\u010da pod \u017ee zlepljeno veznico.Znaki: plitek sprednji prekat, hipotonija, lahko tudi prolaps \u0161arenice.Zdravljenje: \u0161iv rane.<\/p>\n

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Dehiscenca rane<\/strong>1<\/sup> je redek zaplet, kjer robovi rane ne prilegajo. Vzrok je slaba arhitekture incizijske rane. Terapija ni potrebna, razen v primeru visokega astigmatizma, ko rano za\u0161ijemo. Skleralne ali limbalne rane se zacelijo z vra\u0161\u010danjem episkleralnega o\u017eiljenega tkiva, ro\u017eeni\u010dne rane pa z apozicijo in vra\u0161\u010danjem epitela.<\/p>\n

\u00a0<\/strong><\/p>\n

Hifema<\/strong> = kri v sprednjem prekatu zaradi krvavitve iz incizijske rane ali \u0161arenice1,2<\/sup>. Zdravljenje: – pri manj\u0161ih krvavitvah, ki se same resorbirajo, je potrebna samo\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0kontrola intraokularnega pritiska (IOP).\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – pri ve\u010djih krvavitvah je potrebno spiranje krvi iz prekata kadar:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – IOP > 50mmHg 5 dni\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – IOP > 35mmHg 7 dni\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – totalna hifema 9 dni\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – ro\u017eenica obarvana s krvjo<\/p>\n

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Endokapsularni hematom<\/strong>1<\/sup> je kri, ujeta med intraokularno le\u010do (IOL) in zadnjo le\u010dno kapsulo. Pri malem hematomu terapija ni potrebna, pri ve\u010djem pa je potrebna YAG laserska kapsulotomija zadnje kapsule, da se kri resorbira skozi steklovino.<\/p>\n

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Akutno povi\u0161an intraokularni pritisk (IOP)<\/strong>1<\/sup>. Vzroki so lahko ostanki viskoelastika v sprednjem prekatu, obstrucija trabekularnega mre\u017eja z vnetnimi celicami ali krvjo,pa tudi glavkomski bolniki imajo pogosto akutno povi\u0161an IOP po operaciji. Zdravljenje: – pu\u0161\u010danje prekatne vodice (lahko ve\u010dkrat)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – antiglavkomske kapljice topi\u010dno\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – inhibitorji karbonske anhidraze (per os)<\/p>\n

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Edem ro\u017eenice in bulozna keratopatija<\/strong>1,2<\/sup> sta lahko posledica bolezni endotelija ali izgube endotelnih celic, mehanske travme endotelija med operacijo, <\/strong>obse\u017enega vnetje po operaciji, <\/strong>dolgotrajno povi\u0161anega IOP, <\/strong>ostankov le\u010dnega jedra po operaciji, <\/strong>nestabilne IOL v sprednjem prekatu idr.Zdravljenje: – kortikosteroidi topi\u010dno\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – zni\u017eati IOP pod 20mmHg\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – odstraniti ostanke le\u010de, \u010de so v sprednjem prekatu\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – hipertoni\u010dna raztopina topi\u010dnoPri kroni\u010dni bulozni keratopatiji je terapija zamenjava endotela (DSAEK) ali penetrantna keratoplastika (PK).<\/p>\n

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Decentracija in dislokacija IOL<\/strong>1<\/sup> v sprednji prekat, v sulkus ali v steklovino.Vzroki so lahko dislokacija ene ali obeh haptik v sulkus, v sprednji prekat ali skozi zonule, po\u0161kodovana IOL, strgana le\u010dna kapsula, strgane zonule ali dehiscenca zonul (pseudoeksfoliativni sindrom)Zdravljenje: – repozicija IOL\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – v\u0161itje IOL na \u0161arenico ali sklero<\/p>\n

– zamenjava IOL<\/p>\n

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Toksi\u010dni sindrom sprednjega segmenta (TASS)<\/strong>4,5,6<\/sup> je akutno sterilno vnetje. Vzrok: toksi\u010dna substanca, ki je pri\u0161la po pomoti v oko med operacijo in po\u0161koduje vse celice v sprednjem prekatu.Znaki: edem ro\u017eenice, gube membrane Descemete, celice v sprednjem prekatu, plegi\u010dna zenica, slab vid.Zdravljenje: intenzivno topi\u010dno s steroidi.<\/p>\n

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Zapleti od 2. dneva do 6 tednov po operaciji<\/span><\/strong><\/p>\n

Vsi zgoraj opisani in:Akutni endoftalmitis<\/strong>1,2<\/sup> se pojavlja v 0.072-0.13%, najpogosteje 2. do 5. dan, lahko pa tudi do 6 tednov po operaciji in ima fulminantni potek.Najpogostej\u0161i povzro\u010ditelj je koagulaza negativni Staphilococcus epidermidis s ko\u017ee, redkeje \u0161e Gram pozitivni Staphilococcus aureus in Gram negativni Pseudomonas sp., Proteus sp. in enterokoki.Ve\u010dje tveganje za endoftalmitis je pri pu\u0161\u010danju incizijske rane, izgubi steklovine med operacijo, dolgi operaciji, oku\u017eeni teko\u010dini, ki jo uporabljamo med operacijo.Simptomi in znaki: mo\u010dno dra\u017eeno oko, bole\u010dina, slab vid, hemoza veznice, hipopion, edem ro\u017eenice.Vedno je pred za\u010detkom zdravljenja potrebno vzeti bris in aspirat steklovne!Zdravljenje: – intravitrealno: Vancomycin 2mg\/0.1 ml in\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0 Ceftazidime 2mg\/0.1 ml ali Amikacin 0.4 mg\/0.1 ml\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dexamethasone 0.4mg \/0.1ml\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 (NE pri sumu na glivi\u010dno oku\u017ebo)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – topi\u010dno: \u00a0\u00a0\u00a0\u00a0\u00a0 Vancomycin\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0 Amikacin\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Atropin\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dexamethasone\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0– vitrektomija samo kadar je vid percepcija lu\u010di ali slab\u0161i\u010ce ni izbolj\u0161anja ponavljamo intravitrealne injekcije na 3 dni, kadar naredimo tudi vitrektomijo in na 4 dni, \u010de vitrektomije ne naredimo.<\/p>\n

Cistoidni makularni edem<\/strong> (CME)1<\/sup> je najpogostej\u0161i vzrok slabega vida po operaciji sive mrene. Pojavi se 4-8 tednov po operaciji pri 50 % bolnikov, klini\u010dno signifikanten pa je pri 3% bolnikov.Ve\u010dje tveganje je pri zapleteni operaciji, trakciji steklovine (npr. steklovina, ujeta v incizijski rani), diabeti\u010dni retinopatiji, zdravljeni z laserskimi pe\u010dati, epiretinalni membrani idr. V ve\u010dini se spontano resorbira v 6 mesecih.Zdravljenje: – odstraniti vzrok\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – topi\u010dno steroidi in NSAIDs\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – intravitrealno steroidi<\/p>\n

Ble\u0161\u010danje<\/strong>1<\/sup> zaradi gub zadnje kapsule, ker haptike raztegnejo kapsularno vre\u010do. Gube so v liniji haptik in ponavadi spontano izginejo, ko se za\u010dne kontrakcija kapsularne vre\u010de.<\/p>\n

Kroni\u010dno povi\u0161an IOP<\/strong>1<\/sup>Vzroki: – uporaba kortikosteroidov (steroidni responder)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – ostanki le\u010dnega materiala v o\u010desu (\u0161e posebej jedra)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – kroni\u010dno vnetje\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – nastanek sprednjih sinehij\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – endoftalmitisZdravljenje: vzro\u010dno.<\/p>\n

Maligni glavkom<\/strong> je nabiranje prekatne vodice za diafragmo IOL-\u0161arenica.IOL je potisnjena naprej in posledi\u010dno je plitek sprednji prekat.Zdravljenje: iridektomija, kapsulektomija (pri afakih)Pupilarni blok<\/strong> nastane, ko obsegajo sinehije med IOL in \u0161arenico vseh 360 in nastane iris bomb\u00e9. Vzrok je dolgotrajno vnetje (npr. drgnenje \u0161arenice z IOL, nezdravljen sprednji uveitis)Zdravljenje: laserska iridotomija ali kirur\u0161ka iridektomija<\/p>\n

\u2018Capsular block\u2019 sindrom<\/strong>3<\/sup>: <\/strong>viskoelastik, ujet med IOL in zadnjo le\u010dno kapsulo potisne IOL naprej \u2013 miopizacijaZdravljenje: mala YAG laserska kapsulotomija, da se viskoelastik sprosti v steklovino.<\/p>\n

Napa\u010den izra\u010dun intraokularne le\u010de<\/strong> (IOL)3<\/sup>. Posledica je pooperativna hiperopija ali miopija. Zdravljenje: zamenjava IOL ali dodatna vstavitev piggyback IOL<\/p>\n

Pozni zapleti<\/strong><\/p>\n

Zapleti ve\u010d kot 6 tednov po operaciji<\/span><\/strong><\/p>\n

Kroni\u010dni endoftalmitis1<\/sup> <\/strong> se pojavi > 6 tednov po operaciji.Pogosti povzro\u010ditelji so Propionbacterium acnes, Staph. Epidermidis in glive.Znaki: fotofobija, meglen vid, blaga bole\u010dina, zmerno dra\u017eeno zrklo, celice v sprednjem prekatu, precipitati; plak na le\u010dni kapsuli je zna\u010dilen za P. acnes.Zdravljenje: – enako akutnemu endoftalmitisu, le steroidov NE smemo dati,\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 dokler niso glive izklju\u010dene kot povzro\u010ditelj\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – sum na glivi\u010dno oku\u017ebo: intravitrealno amfotericin B 5mg \/ 0.1 m\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – vitrektomija s kapsulektomijo za odstranitev infektivnega\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 materiala pri oku\u017ebi s P. acnes<\/p>\n

Zamotnitev in fibroza zadnje le\u010dne kapsule<\/strong>2<\/sup> (PCO)Simptomi in znaki: slab\u0161i vid, ble\u0161\u010danje, dvojni vid, lahko dislokacija IOLZdravljenje: YAG laserska kapsulotomija<\/p>\n

Vra\u0161\u010danje epitela v sprednji prekat <\/strong>je zelo redek zaplet.1<\/sup> Epitel prera\u0161\u010da notranjo stran ro\u017eenice, \u0161arenico, le\u010dno kapsulo in ciliarnik. Posledica je dekompenzacija ro\u017eenice, kroni\u010dni sprednji uveitis in sekundarni glavkom.Zdravljenje: uni\u010denje intraokularnega epitelijskega tkiva s ciklodestrukcijo, iridociklektomijo ali pars plana vitrektomijo. Prognoza je zelo slaba.<\/p>\n

[wp_ad_camp_1]<\/p>\n

Odstop mre\u017enice<\/strong>1<\/sup>. <\/strong>Ve\u010dje tveganje je pri o\u010deh z visoko miopijo, lattice degeneraciji, pri mo\u0161kih, pri izgubi steklovine med operacijo in pri anamnezi odstopa mre\u017enice na drugem o\u010desu1<\/sup>.Simptomi in znaki: slab\u0161i vid, plavajo\u010de motnjave pred o\u010desom, bliskanje.Zdravljenje: kirur\u0161ko.<\/p>\n

Zaklju\u010dek<\/strong><\/p>\n

Operacija sive mrene, najpogostej\u0161a operacija na o\u010deh, ima veliko zgodnjih in poznih zapletov, vendar se huj\u0161i in vid ogro\u017eujo\u010di zapleti pojavljajo redko. Pomembna je hitra prepoznava in pravilno ukrepanje.<\/p>\n

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Literatura<\/strong>1. Yanoff M, Duker JS. Ophthalmology, Second edition; 20042. Kanski JJ. Clinical Ophthalmology, A Systematic Approach, Fifth Edition;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 20033. Henderson AB. Essentials of cataract surgery, 20074. Mamalis N et al. Toxic anterior segment syndrome. J Cataract Refract Surg\u00a0\u00a0\u00a0\u00a0 2006;32:324-335. Kutty PK et al. Multistate outbreak of toxic anterior segment syndrome. J Cataract\u00a0\u00a0 Refract Surg 2008;34(4): 585-90\u00a06. Johnston J. Toxic anterior segment syndrome \u2013 More then sterility meets the eye.\u00a0\u00a0\u00a0\u00a0 AORN 2006;84(6):967-975,977-979,981-984<\/p>\n","protected":false},"excerpt":{"rendered":"

Operacija sive mrene je danes najpogostej\u0161a operacija na o\u010deh. Zapleti se lahko pojavijo takoj po ali leta po operaciji. Ve\u010dina zapletov je la\u017ejih, za nekaj vid ogro\u017eujo\u010dih, kot so endoftalmitis, odstop mre\u017enice, maligni glavkom idr. pa je zelo pomembna hitra prepoznava in pravilno zdravljenje.\u010clanek opisuje zgodnje in pozne zaplete po operaciji sive mrene, njihove znake … Preberi ve\u010d o Zapleti po operaciji sive mrene<\/span><\/a><\/p>\n","protected":false},"author":336,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1488],"tags":[1490,1489,3307,3306,3305],"class_list":["post-2778","post","type-post","status-publish","format-standard","hentry","category-3-letnik-okulistika","tag-oftalmologija","tag-okulistika","tag-operacija-sive-mrene","tag-siva-mrena","tag-zapleti-po-operaciji-sive-mrene"],"_links":{"self":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/posts\/2778","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/users\/336"}],"replies":[{"embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/comments?post=2778"}],"version-history":[{"count":0,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/posts\/2778\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/media?parent=2778"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/categories?post=2778"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/tags?post=2778"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}