Masifunde nge-MELD Score, ekuxelela ngempilo yesibindi sakho.

Unjani? Mhlawumbi unengxaki yempilo enxulumene nesibindi, okanye mhlawumbi umntu omaziyo unayo. Ngelo xesha, ugqirha wakho usenokuba wayethethe ngento ebizwa ngokuba yi-'MELD' score. Okanye usenokuba ukhe weva eli gama ndaweni ithile. Ngoko ke, zeziphi ezi `MELD' score? Zihambelana njani nempilo yesibindi sethu? Siza kuthetha ngazo zonke ezi zinto ngokulula namhlanje, ngendlela onokuyiqonda. Ungakhathazeki, le ayiyonto inzima kakhulu, wakuba uyiqonde kakuhle.

Yintoni i-MELD Score?

Kulungile, masiqale sijonge ukuba eli nqaku elithi `MELD` lithetha ukuthini. `MELD` sisifinyezo samagama esiNgesi athi `Model for End-Stage Liver Disease`. Ngamafutshane, lithetha into efana nelithi `Model for End-Stage Liver Disease.`` Le yinkqubo yokufumana amanqaku. Kufana nokunika amanqaku kuvavanyo lwesikolo, kodwa ilinganisa ukuba imeko yesibindi sakho imbi kangakanani. Ikwanceda ekumiseleni ukuba uza kuyidinga nini i-isibindi sokufakelwa kwinyanga ezintathu ezizayo (iintsuku ezingama-90).

Iziko lokufakelwa isibindi lisebenzisa eli nqaku elithi 'MELD' ukuze libeke phambili abo bafuna ukufakelwa isibindi ngokukhawuleza. Oko kuthetha ukuba le yinto enye, bajonga nezinye izinto.

Ngoku usenokuba uzibuza ukuba le nkqubo yokufumana amanqaku iyafana na kuye wonke umntu. Enyanisweni, le nkqubo yokufumana amanqaku ethi 'MELD' isetyenziswa kuphela kubantu abaneminyaka engaphezu kwe-12 ubudala. Kwanabantwana abancinci, oko kukuthi, abantwana abangaphantsi kweminyaka eyi-12 ubudala, kukho inkqubo yokufumana amanqaku eyahlukileyo efana nale. Ibizwa ngokuba yinkqubo yokufumana amanqaku ethi 'PELD (Pediatric End-Stage Liver Disease)'. Ngoko ke, ukufakelwa kwesibindi kubantwana abancinci kubekwa phambili ngokusekelwe kuloo manqaku ethi 'PELD'.

Eli nani le-'MELD' likunika inani. Eli nani lidla ngokuqala kwi-6 ukuya kwi-40. Eyona nto ibalulekileyo ekufuneka uyikhumbule apha kukuba okukhona eli nani liphezulu, kokukhona isifo sesibindi sinzima, kokukhona isibindi sibuthathaka. Ngoko ke , ukuba umntu unenani eliphezulu le-'MELD', kusenokwenzeka ukuba abe kuluhlu lokulinda 'lokufakelwa'. Kuba, kubantu abanjalo, ngelishwa, 'umngcipheko wokufa' uphezulu.

Ibalwa njani inqaku le-MELD?

Ngoku makhe sijonge indlela ebalwa ngayo le `MELD`, oko kukuthi, indlela eyenziwa ngayo. Ugqirha wakho ubala le `MELD` ngokusekelwe kwiziphumo zovavanyo oluthile lwegazi oluthathwe kwisampulu yegazi lakho. Nangona kunjalo, oku akulula njengoko unokucinga. Ukongeza kwiziphumo zovavanyo lwegazi, kukho nezinye izinto ezininzi ezichaphazela oku.

Izinto eziphambili ezijongwa kuvavanyo lwegazi

Makhe sijonge ngokusondeleyo uvavanyo oluphambili lwegazi olusetyenzisiweyo ukwenza eli nqaku le-'MELD' kunye noko bakufunayo:

• INR (International Normalized Ratio): Oku kulinganisa i-INR yakhoYindlela ethatha ngayo ixesha ukuze igazi lijiye. Ngokuqhelekileyo, xa isibindi singasebenzi kakuhle, isibindi asivelisi ngokwaneleyo izinto ezinceda ekujiyeni kwegazi. Emva koko ixesha elithathayo ukuze igazi lijiye liyanda. Oko kuthetha ukuba ixabiso le-INR liyanyuka.
• I-bilirubin iyonke: I-Bilirubin yinto etyheli. Iveliswa xa iiseli ezibomvu zegazi ezindala ziqhekeka. Isibindi sinceda ekususeni le bilirubin emzimbeni nge-bile. Ngoko ke, ukuba isibindi asisebenzi kakuhle, le bilirubin iqokelelana egazini, kwaye amanqanaba e-bilirubin egazini ayanda. Oku kubonisa ukuba isibindi asisebenzi kakuhle.
• I-Creatinine: Oku kulinganisa umsebenzi wezintso . Usenokuba uzibuza ukuba izintso zinxulumene njani nesifo sesibindi. Enyanisweni, xa isifo sesibindi siba sibi kakhulu, sinokuchaphazela nomsebenzi wezintso. Ngamanye amaxesha nezintso nazo ziqala ukungasebenzi kakuhle. Yiyo loo nto amanqanaba e-creatinine ejongwa.
• I-serum sodium: Oku kulinganisa ubungakanani be-sodium egazini lakho. Kunokunceda ekuqinisekiseni ukuba isibindi sakho sisebenza kakuhle na. Amanqanaba aphantsi e-sodium anokubonisa ukusebenza kakubi kwesibindi.
• Inqanaba le-Albumin: I-Albumin yiproteni ekhethekileyo eyenziwe sisibindi sakho. Omnye wemisebenzi yayo ephambili kukugcina umlinganiselo ofanelekileyo wamanzi egazini. Ukuba isibindi asisebenzi kakuhle, ukuveliswa kwe-albumin kuyehla. Emva koko inqanaba le-albumin egazini linokwehla. Oku kuthetha into ethile malunga nokusebenza kwesibindi.

Kubalulekile: Iziphumo zolu vavanyo lwegazi zimisela uninzi lwamanqaku e-MELD. Kodwa, akuphelelanga apho.

Izinto ekufuneka ziqwalaselwe ukongeza kuvavanyo lwegazi

Yingakho ukubala amanqaku e-MELD kunzima. Ukongeza kuvavanyo lwegazi, iqela lakho lezonyango liza kuqwalasela ezinye izinto ezininzi:

• Imbali yakho yezonyango: Oku kuthetha izinto ezifana nohlobo lwesifo sesibindi onaso, ixesha osifumene ngalo, kunye nokuba sibi kangakanani.
• Ubudala bakho kunye nesini sakho ekuzalweni.
• Ezinye iimeko zempilo onazo: Umzekelo, ngaba unezinye iimeko ezifana nesifo seswekile okanye isifo sentliziyo ezinokubangela iingxaki ngexesha lokufakelwa isibindi?
• Izinto ezichaphazela uluntu nendlela yokuphila: Ezi zikwaqwalaselwa kuba zinokuchaphazela impumelelo yokufakelwa kwesibindi.

Ngoko ke ungabona, amanqaku e-'MELD' ayisiyiyo nje isiphumo sovavanyo lwegazi esilula, kodwa angaphezulu koko.

Ngaba amanqaku ongezelelweyo anokongezwa kumanqaku e-MELD?

Ngamanye amaxesha, unokufuna ukufakelwa isibindi ngaphambi kokuba amanqaku akho e-MELD abonise. Oku kuthetha ukuba amanqaku akho e-MELD asenokungabonisi ubunzulu bemeko yakho. Kwiimeko ezinjalo, ugqirha wakho unokucela ukuba wongeze amanqaku ongezelelweyo ('amanqaku angaqhelekanga') kumanqaku akho e-MELD.

Nazi ezinye iimeko ezinokukufanelekela amanqaku ongezelelweyo:

• Ukungasebenzi kakuhle kwesibindi
• Umhlaza wesibindi - kuphela kwiintlobo ezithile
• Isifo seHepatopulmonary - Le yimeko apho inqanaba leoksijini egazini liyehla ngenxa yesifo sesibindi.
• Uxinzelelo lwegazi oluphezulu oluvela kwimiphunga - Le yimeko apho uxinzelelo lwegazi oluphezulu emiphungeni ngenxa yesifo sesibindi.
• Isifo sesibindi sePolycystic - Esi sisifo esingaqhelekanga, esibangelwa lufuzo.
• I-Cholangitis - usulelo oluphindaphindayo lwemibhobho yenyongo

Iqela lakho lezonyango liza kugqiba ukuba ufuna ukongeza la manqaku ongezelelweyo kumanqaku akho e-MELD okanye cha. Ngoko ke, kungcono ukuthetha nogqirha wakho malunga namanqaku akho e-MELD, izinto ezichaphazela wona, kunye nemeko yakho. Banokukuchazela yonke into baze baphendule nayiphi na imibuzo onokuba unayo.

Inqaku le-MELD lihlaziywa kangaphi?

Amanqaku akho e-MELD awakhe enzeke kube kanye. Ugqirha wakho uza kuhlaziya amanqaku akho e-MELD ngovavanyo lwegazi oluqhelekileyo . Ukuba uwahlaziya kangaphi kuxhomekeke kumanqaku akho okugqibela e-MELD.

Oku kwenzeka rhoqo:

• Ukuba amanqaku angaphantsi kwe-10, amalunga nokuba kube kanye ngonyaka.
• Ukuba amanqaku aphakathi kwe-11-18, ngoko malunga kanye kwiinyanga ezi-3.
• Ukuba uphawu luphakathi kwe-19-24, malunga kanye ngenyanga.
• Ukuba uphawu luyi-25 nangaphezulu, njengokuba kube kanye ngeveki.

Nangona kunjalo, esi sisikhokelo nje esiqhelekileyo. Ngugqirha wakho kuphela onokumisela ukuba kufuneka uhlaziye amanqaku akho kangaphi. Ingahluka ngokuxhomekeke kwimeko yakho.

Ithetha ukuthini inqaku lakho le-MELD?

Ngoku mhlawumbi ucinga, "Kulungile, ugqirha uthe amanqaku am e-MELD aphezulu kangaka. Ngoko ke oko kundixelela ntoni ngokwenene?" Amanqaku e-MELD anokunika iqela lakho lezonyango umbono wezinto ezimbini eziphambili:

1. Ingakanani ingozi yakho yokufa kwiinyanga ezi-3 ezizayo ngenxa yesifo sesibindi ?

2. Udinga ukufakelwa isibindi ngokukhawuleza kangakanani ?

Akukho mntu unokuqikelela ngokuthe ngqo ukuba umntu uza kuphila ixesha elingakanani. Sonke siyayazi loo nto. Kodwa eli nqaku elithi 'MELD' linokunika oogqirha umbono opheleleyo ngemeko yakho. Emva koko, basebenzisa elo nqaku ukunceda ekumiseleni apho ufanele ube khona kuluhlu lokulinda lokufakelwa isibindi.

Kodwa khumbula,Amanqaku e-'MELD' ayilonto yodwa egqiba ukuba uza kufumana utyando lwesibindi kungekudala kangakanani. Zininzi nezinye izinto ezichaphazela oku, njengohlobo lwegazi lakho kunye nenani labanikeli besibindi kwindawo okuyo.

Ndingaqhagamshelana nini nogqirha?

Ukuba unemibuzo okanye iinkxalabo malunga nenqaku lakho le-MELD, nxibelelana nogqirha wakho ngoko nangoko. Kwakhona, ukuba unemibuzo malunga neziphumo zovavanyo lwakho lwegazi okanye isicwangciso sakho sonyango lwexesha elizayo, thetha nogqirha wakho ngaloo nto.

Inqaku lakho le-MELD lisixhobo esinye nje esisetyenziswa liqela lakho lezonyango ukugqiba ukuba ufuna ukufakelwa isibindi ngokukhawuleza kangakanani. Kufana neqhekeza elinye lephazili enkulu. Ngoko ke, musa ukucinga kakhulu ngezinto okanye uloyiko ude uthethe nogqirha wakho. Banokukuchazela iziphumo zakho baze bakunike umbono olungileyo wento omawuyilindele.

Okokugqibela, yintoni ekufuneka uyikhumbule

Kulungile, ngoko ke sithethe kakhulu ngamanqaku e-'MELD'. Okokugqibela, nazi izinto ezibalulekileyo ekufuneka uzikhumbule:

• Inqaku elithi `MELD` yindlela enceda ekuvavanyeni ubukhali besifo sesibindi kunye nesidingo esingxamisekileyo sokufakelwa isibindi.
• Eli nqaku libalwa ngokuyintloko ngokuqwalasela iziphumo zovavanyo lwegazi oluliqela (ngokukodwa i-`INR`, i-`Bilirubin`, i-`Creatinine`, i-`Serum Sodium`, i-`Albumin`) kunye nezinye izinto zonyango.
• Njengoko amanqaku enyuka, oko kubonisa ukuba imeko yesibindi imbi kakhulu kwaye kukho imfuneko enkulu yokufakelwa isibindi.
• Esi sisixhobo esinye nje sokunceda oogqirha benze izigqibo.
• Musa ukoyika ukuthetha ngokukhululekileyo nogqirha wakho malunga nazo naziphi na izinto ezikuxhalabisayo malunga nenqaku lakho le-MELD okanye impilo yesibindi.

Ndikunqwenelela ukuchacha ngokukhawuleza!

Amanqaku e - MELD, isifo sesibindi, ukufakelwa kwesibindi, uvavanyo lwegazi, i-bilirubin, i-creatinine, amanqaku ezempilo