Tiyeni tiphunzire za MELD Score, yomwe imakuuzani za thanzi la chiwindi chanu.

Muli bwanji? Mwina muli ndi vuto la thanzi lokhudzana ndi chiwindi, kapena mwina munthu amene mumamudziwa ali nalo. Panthawiyo, dokotala wanu mwina analankhula za chinthu chotchedwa `MELD` score. Kapena mwina munamvapo mawu awa kwinakwake. Ndiye, kodi `MELD` score izi ndi ziti? Kodi zikugwirizana bwanji ndi thanzi la chiwindi chathu? Tikambirana zonsezi mosavuta lero, mwanjira yomwe mungamvetse. Musadandaule, izi sizovuta kwambiri, mukangomvetsa bwino.

Kodi MELD Score ndi chiyani?

Chabwino, choyamba tiyeni tiwone tanthauzo la mawu akuti 'MELD' awa. `MELD` ndi chidule cha mawu achingerezi akuti `Model for End-Stage Liver Disease`. Mwachidule, amatanthauza chinthu chonga `Model for End-Stage Liver Disease`. Iyi ndi njira yopezera zigoli. Zili ngati kupereka zigoli pa mayeso a kusukulu, koma zimayesa momwe chiwindi chanu chilili choopsa. Zimathandizanso kudziwa nthawi yomwe mudzafunikire kuikidwa chiwindi mkati mwa miyezi itatu ikubwerayi (masiku 90).

Malo oika chiwindi amagwiritsa ntchito chiŵerengero cha `MELD` ichi posankha omwe akufunikira kuyika chiwindi mwachangu momwe angathere. Izi zikutanthauza kuti ichi ndi chinthu chimodzi chokha, amaonanso zinthu zina.

Tsopano mwina mukudabwa ngati njira iyi yopezera zigoli ndi yofanana kwa aliyense. Kwenikweni, njira iyi yopezera zigoli ya `MELD` imagwiritsidwa ntchito kwa anthu azaka zopitirira 12 zokha. Kwa ana aang'ono, ndiko kuti, ana osakwana zaka 12, pali njira yopezera zigoli yosiyana ngati iyi. Imatchedwa njira yopezera zigoli ya `PELD (Pediatric End-Stage Liver Disease)`. Chifukwa chake, kuyika chiwindi kwa ana aang'ono kumayikidwa patsogolo kutengera zigoli za `PELD`.

Chiwerengero cha `MELD` ichi chimakupatsani nambala. Chiwerengerochi nthawi zambiri chimakhala kuyambira 6 mpaka 40. Chofunika kwambiri kukumbukira apa ndichakuti chiwerengerochi chikakhala chachikulu, matenda a chiwindi amakhala oopsa, chiwindi chimakhala chofooka. Chifukwa chake , ngati wina ali ndi chiwerengero cha `MELD` chapamwamba, amakhala pa mndandanda wa 'kuyembekezera kuikidwa kwa odwala ena'. Chifukwa, mwatsoka, kwa anthu otere, 'chiwopsezo cha imfa' chimakhala chachikulu.

Kodi chiwerengero cha MELD chimawerengedwa bwanji?

Tsopano tiyeni tiwone momwe chiwerengero cha `MELD` ichi chimawerengedwera, kutanthauza momwe chimapangidwira. Dokotala wanu amawerengera chiwerengero cha `MELD` ichi kutengera zotsatira za mayeso angapo a magazi omwe atengedwa kuchokera ku chitsanzo chanu cha magazi. Komabe, izi si zowerengera zosavuta monga momwe mungaganizire. Kuwonjezera pa zotsatira za mayeso a magazi, palinso zinthu zina zingapo zomwe zimakhudza izi.

Zinthu zazikulu zomwe mayeso a magazi amafufuza

Tiyeni tiwone bwino mayeso akuluakulu a magazi omwe amagwiritsidwa ntchito popanga chiŵerengero cha `MELD` ichi ndi zomwe amayang'ana:

• INR (International Normalized Ratio): Izi zimayesa kuchuluka kwa shuga m'magazi anu.Ndi nthawi yomwe magazi amaundana. Nthawi zambiri, chiwindi chikapanda kugwira ntchito bwino, sichipanga zinthu zokwanira zomwe zimathandiza magazi kuundana. Kenako nthawi yomwe magazi amaundana imawonjezeka. Izi zikutanthauza kuti INR imawonjezeka.
• Bilirubin yonse: Bilirubin ndi chinthu chachikasu. Chimapangidwa maselo ofiira akale a magazi akale akawonongeka. Chiwindi chimathandiza kuchotsa bilirubin iyi m'thupi kudzera mu ndulu. Choncho, ngati chiwindi sichikugwira ntchito bwino, bilirubin iyi imasonkhana m'magazi, ndipo kuchuluka kwa bilirubin m'magazi kumawonjezeka. Izi zikusonyeza kuti chiwindi sichikugwira ntchito bwino.
• Creatinine: Izi zimayesa ntchito ya impso . Mwina mukudabwa kuti impso zimagwirizana bwanji ndi matenda a chiwindi. Ndipotu, matenda a chiwindi akakula kwambiri, amathanso kukhudza ntchito ya impso. Nthawi zina impso zimayambanso kulephera kugwira ntchito. Ichi ndichifukwa chake kuchuluka kwa creatinine kumayesedwa.
• Sodium m'magazi: Izi zimayesa kuchuluka kwa sodium m'magazi mwanu. Zingathandizenso kudziwa ngati chiwindi chanu chikugwira ntchito bwino. Kuchepa kwa sodium m'magazi kungayambitse kusagwira bwino ntchito kwa chiwindi.
• Mulingo wa Albumin: Albumin ndi puloteni yapadera yopangidwa ndi chiwindi chanu. Ntchito yake yayikulu ndikusunga madzi okwanira m'magazi. Ngati chiwindi sichikugwira ntchito bwino, kupanga albumin kumachepa. Kenako kuchuluka kwa albumin m'magazi kumatha kuchepa. Izi zikusonyezanso zinazake zokhudza momwe chiwindi chimagwira ntchito.

Chofunika: Zotsatira za mayeso a magazi awa ndi zomwe zimatsimikiza kuchuluka kwa MELD score. Koma, si zokhazo.

Zinthu zofunika kuziganizira kuwonjezera pa kuyezetsa magazi

Ichi ndichifukwa chake kuwerengera zigoli za MELD n'kovuta. Kuwonjezera pa kuyezetsa magazi, gulu lanu lachipatala lidzaganizira zinthu zina zingapo:

• Mbiri yanu ya matenda: Izi zikutanthauza zinthu monga mtundu wa matenda a chiwindi omwe muli nawo, nthawi yomwe mwakhala nawo, komanso kuopsa kwake.
• Zaka zanu ndi jenda lanu pobadwa.
• Matenda ena omwe muli nawo: Mwachitsanzo, kodi muli ndi matenda ena monga matenda a shuga kapena matenda a mtima omwe angayambitse mavuto poika chiwindi?
• Zinthu zokhudzana ndi chikhalidwe cha anthu komanso moyo: Izi zimaganiziridwanso chifukwa zingakhudze kupambana kwa kuyika chiwindi.

Kotero mutha kuwona, chiwerengero cha `MELD` si zotsatira zongoyerekeza za magazi, koma ndi zambiri kuposa zimenezo.

Kodi mfundo zina zitha kuwonjezeredwa ku chigoli cha MELD?

Nthawi zina, mungafunike kuikidwa chiwindi msanga kuposa momwe chiwerengero chanu cha MELD chikusonyezera. Izi zikutanthauza kuti chiwerengero chanu cha MELD sichingasonyeze kuopsa konse kwa vuto lanu. Zikatero, dokotala wanu angakupempheni kuti muwonjezere mfundo zina ('mfundo zosiyana') ku chiwerengero chanu cha MELD.

Nazi zina mwa zinthu zomwe zingakuthandizeni kupeza mfundo zina:

• Kulephera kwa chiwindi mwachangu
• Khansa ya chiwindi - ya mitundu ina yokha
• Matenda a Hepatopulmonary - Iyi ndi matenda omwe mpweya m'magazi umachepa chifukwa cha matenda a chiwindi.
• Kuthamanga kwa magazi m'mapapo (Portopulmonary hypertension) - Iyi ndi vuto lomwe kuthamanga kwa magazi m'mapapo kumawonjezeka chifukwa cha matenda a chiwindi.
• Matenda a chiwindi a Polycystic - Iyi ndi matenda osowa, obadwa nawo.
• Cholangitis - matenda obwerezabwereza a ndulu

Gulu lanu lachipatala lidzasankha ngati mukufunika kuwonjezera zigoli zina izi ku zigoli zanu za MELD. Chifukwa chake, ndi bwino kulankhula ndi dokotala wanu za zigoli zanu za MELD, zinthu zomwe zimakhudza, ndi vuto lanu. Akhoza kukufotokozerani zonse ndikuyankha mafunso aliwonse omwe mungakhale nawo.

Kodi chigoli cha MELD chimasinthidwa kangati?

Zigoli zanu za MELD sizimangochitika kamodzi kokha. Dokotala wanu adzasintha zigoli zanu za MELD ndi mayeso a magazi nthawi zonse . Kangati mumazisintha zimadalira zigoli zanu zomaliza za MELD.

Izi nthawi zambiri zimachitika:

• Ngati zigolizo zili zosakwana 10, zimakhala pafupifupi kamodzi pachaka.
• Ngati chiwerengerocho chili pakati pa 11-18, ndiye kuti kamodzi pa miyezi itatu iliyonse.
• Ngati chizindikirocho chili pakati pa 19-24, pafupifupi kamodzi pamwezi.
• Ngati chizindikirocho chili 25 kapena kupitirira apo, monga kamodzi pa sabata.

Komabe, izi ndi malangizo wamba. Dokotala wanu yekha ndi amene angadziwe nthawi yeniyeni yomwe muyenera kubwereza mayeso anu. Zingasinthe malinga ndi momwe zinthu zilili.

Kodi chigoli chanu cha MELD chimatanthauza chiyani?

Tsopano mwina mukuganiza kuti, "Chabwino, dokotala anati zigoli zanga za MELD zinali zapamwamba chonchi. Ndiye zimenezo zikundidziwitsa chiyani kwenikweni?" Zigoli za MELD zingapatse gulu lanu lachipatala lingaliro la zinthu ziwiri zazikulu:

1. Kodi chiopsezo chanu chomwalira mkati mwa miyezi itatu ikubwerayi chifukwa cha matenda a chiwindi ndi chotani ?

2. Kodi muyenera kuikidwa chiwindi nthawi yanji ?

Palibe amene anganeneretu nthawi yeniyeni yomwe munthu adzakhala ndi moyo. Tonsefe tikudziwa zimenezo. Koma chiwerengero cha `MELD` ichi chingapatse madokotala lingaliro la matenda anu. Kenako, amagwiritsa ntchito chiwerengero chimenecho kuti athandize kudziwa komwe muyenera kukhala pamndandanda woyembekezera kuikidwa chiwindi.

Koma kumbukirani,Chiwerengero cha `MELD` sichokhacho chomwe chimatsimikizira nthawi yomwe mudzalandire chiwindi. Zinthu zina zambiri zimakhudza izi, monga mtundu wa magazi anu ndi chiwerengero cha opereka chiwindi m'dera lanu.

Ndiyenera kulankhula ndi dokotala liti?

Ngati muli ndi mafunso kapena nkhawa zokhudzana ndi chigoli chanu cha MELD, funsani dokotala wanu nthawi yomweyo. Komanso, ngati muli ndi mafunso okhudza zotsatira za mayeso anu a magazi kapena dongosolo lanu la chithandizo chamtsogolo, lankhulani ndi dokotala wanu za zimenezo.

Chigoli chanu cha MELD ndi chida chimodzi chomwe gulu lanu lachipatala limagwiritsa ntchito posankha nthawi yomwe mukufuna kuikidwa chiwindi. Zili ngati chidutswa chimodzi cha puzzle yayikulu. Chifukwa chake, musaganize kwambiri kapena kuchita mantha mpaka mutalankhula ndi dokotala wanu. Angakufotokozereni zotsatira zanu ndikukupatsani lingaliro labwino la zomwe mungayembekezere.

Pomaliza, zomwe muyenera kukumbukira

Chabwino, takambirana zambiri za chigoli cha `MELD`. Pomaliza, nazi zinthu zofunika kwambiri zomwe muyenera kukumbukira:

• Chigoli cha `MELD` ndi njira yomwe imathandiza kuwunika kuopsa kwa matenda a chiwindi komanso kufunikira kwachangu kwa kuyika chiwindi.
• Chiwerengerochi chimawerengedwa makamaka poganizira zotsatira za mayeso angapo a magazi (makamaka `INR`, `Bilirubin`, `Creatinine`, `Serum Sodium`, `Albumin`) ndi zina zokhudzana ndi matenda.
• Pamene chiwerengerocho chikukwera, zimasonyeza kuti vuto la chiwindi ndi lalikulu ndipo pakufunika kwambiri kuti chiwindi chiikidwenso.
• Ichi ndi chida chimodzi chokha chothandizira madokotala kupanga zisankho.
• Musaope kulankhula momasuka ndi dokotala wanu za nkhawa zilizonse zomwe muli nazo zokhudza MELD score yanu kapena thanzi la chiwindi.

Ndikukufunirani kuchira mwachangu!

` Chiwerengero cha MELD, matenda a chiwindi, kusamutsa chiwindi, kuyezetsa magazi, bilirubin, creatinine, ziwerengero zaumoyo