Ake sifunde nge-MELD Score, ekutshela ngempilo yesibindi sakho.

Unjani? Mhlawumbe unenkinga yezempilo ehlobene nesibindi, noma mhlawumbe othile omaziyo unayo. Ngaleso sikhathi, udokotela wakho kungenzeka ukuthi ukhulume ngento ebizwa ngokuthi amaphuzu e-'MELD'. Noma kungenzeka ukuthi uke wezwa leli gama ndawana thize. Ngakho-ke, ziyini lezi zibalo ze-'MELD'? Zihlobana kanjani nempilo yesibindi sethu? Sizokhuluma ngakho konke lokhu kalula namuhla, ngendlela ongayiqonda. Ungakhathazeki, lokhu akuyona into eyinkimbinkimbi kakhulu, uma usuyiqonda kahle.

Iyini i-MELD Score?

Kulungile, ake siqale sibheke ukuthi kusho ukuthini lokhu `MELD` score. `MELD` isifinyezo samagama esiNgisi athi `Model for End-Stage Liver Disease`. Kalula nje, kusho into efana nokuthi ``Model for End-Stage Liver Disease.`` Empeleni lolu uhlelo lokuthola amaphuzu. Kufana nokunikeza amamaki esivivinyweni sesikole, kodwa kulinganisa ukuthi isimo sakho sesibindi sibi kangakanani. Kuphinde kusize ekunqumeni ukuthi uzodinga ukufakelwa isibindi ngokushesha kangakanani ezinyangeni ezintathu ezizayo (izinsuku ezingu-90).

Izikhungo zokufakelwa isibindi zisebenzisa lesi sibalo se-'MELD' ukuze zibeke phambili ukuthi ubani odinga ukufakelwa isibindi ngokushesha okukhulu. Lokho kusho ukuthi lokhu kuyisici esisodwa nje, babheka nezinye izinto.

Manje ungase uzibuze ukuthi ngabe lolu hlelo lokufaka amamaki lufana yini kuwo wonke umuntu. Empeleni, lolu hlelo lokufaka amamaki lwe-'MELD' lusetshenziswa kuphela kubantu abangaphezu kweminyaka eyi-12. Ngisho nasezinganeni ezincane, okungukuthi, izingane ezingaphansi kweminyaka eyi-12, kukhona uhlelo lokufaka amamaki oluhlukile olufana nalolu. Lubizwa ngokuthi uhlelo lokufaka amamaki lwe-'PELD (Pediatric End-Stage Liver Disease)'. Ngakho-ke, ukufakelwa kwesibindi kwezingane ezincane kubekwa phambili ngokusekelwe kulolo phuzu lwe-'PELD'.

Lesi sibalo se-'MELD' sikunikeza inombolo. Lesi sibalo ngokuvamile singasukela ku-6 kuya ku-40. Into ebaluleke kakhulu okufanele uyikhumbule lapha ukuthi uma lesi sibalo siphezulu, isifo sesibindi siba sibi kakhulu, isibindi siba buthaka. Ngakho-ke , uma umuntu enesibalo esiphezulu se-'MELD', kungenzeka kakhulu ukuthi abe sohlwini lokulinda lokufakelwa. Ngoba, kubantu abanjalo, ngeshwa, 'ingozi yokufa' iphakeme.

Ibalwa kanjani i-MELD score?

Manje ake sibheke ukuthi lesi sibalo se-'MELD' sibalwa kanjani, okungukuthi, senziwa kanjani. Udokotela wakho ubala lesi sibalo se-'MELD' ngokusekelwe emiphumeleni yokuhlolwa kwegazi okuningana okuthathwe kusampula yegazi lakho. Kodwa-ke, lokhu akuyona indlela elula yokubala njengoba ungase ucabange. Ngaphezu kwemiphumela yokuhlolwa kwegazi, kunezinye izici eziningana ezithinta lokhu.

Izinto eziyinhloko ezibhekwa ukuhlolwa kwegazi

Ake sibheke ngokucophelela ukuhlolwa kwegazi okuyinhloko okusetshenziswe ukudala lesi sibalo se-'MELD' nokuthi bafunani:

• INR (International Normalized Ratio): Lokhu kulinganisa i-INR yakhoKuyisikhathi esithathayo ukuthi igazi lijiye. Ngokuvamile, uma isibindi singasebenzi kahle, isibindi asikhiqizi izinto ezanele ezisiza ukujiya kwegazi. Bese isikhathi esithathayo ukuthi igazi lijiye siyanda. Lokho kusho ukuthi inani le-INR liyakhuphuka.
• I-bilirubin iyonke: I-Bilirubin iyinto ephuzi. Ikhiqizwa lapho amangqamuzana abomvu egazi amadala ephuka. Isibindi sisiza ekususeni le bilirubin emzimbeni nge-bile. Ngakho-ke, uma isibindi singasebenzi kahle, le bilirubin iyaqongelela egazini, futhi izinga le-bilirubin egazini liyakhuphuka. Lokhu kukhombisa ukuthi isibindi asisebenzi kahle.
• I-Creatinine: Lokhu kulinganisa ukusebenza kwezinso . Ungase uzibuze ukuthi izinso zihlobene kanjani nesifo sesibindi. Eqinisweni, lapho isifo sesibindi siba sibi kakhulu, singathinta nokusebenza kwezinso. Ngezinye izikhathi izinso nazo ziqala ukwehluleka. Yingakho amazinga e-creatinine ehlolwa.
• I-sodium egazini: Lokhu kulinganisa inani le-sodium egazini lakho. Kungasiza futhi ekunqumeni ukuthi isibindi sakho sisebenza kahle yini. Amazinga aphansi e-sodium angabonisa ukusebenza kabi kwesibindi.
• Izinga le-Albumin: I-Albumin iyiprotheni ekhethekile eyenziwe yisibindi sakho. Omunye wemisebenzi yayo eyinhloko ukugcina inani elifanele lamanzi egazini. Uma isibindi singasebenzi kahle, ukukhiqizwa kwe-albumin kuyehla. Khona-ke izinga le-albumin egazini lingancipha. Lokhu kusho okuthile nangokusebenza kwesibindi.

Okubalulekile: Imiphumela yalokhu kuhlolwa kwegazi inquma ingxenye enkulu yesilinganiso se-MELD. Kodwa, akusikho lokho kuphela.

Izinto okufanele uzicabangele ngaphezu kokuhlolwa kwegazi

Yingakho ukubala amaphuzu e-MELD kuyinkimbinkimbi. Ngaphezu kokuhlolwa kwegazi, ithimba lakho lezokwelapha lizocabangela ezinye izici eziningana:

• Umlando wakho wezokwelapha: Lokhu kusho izinto ezifana nokuthi unesifo sesibindi esinjani, ukuthi usunesikhathi esingakanani unaso, nokuthi sibi kangakanani.
• Ubudala bakho kanye nobulili bakho ngesikhathi sokuzalwa.
• Ezinye izimo zempilo onazo: Isibonelo, ingabe unezinye izimo ezifana nesifo sikashukela noma isifo senhliziyo ezingadala izinkinga ngesikhathi sokufakelwa isibindi?
• Izici zomphakathi kanye nendlela yokuphila: Lezi nazo ziyacatshangelwa njengoba zingathinta impumelelo yokufakelwa isibindi.

Ngakho-ke ungabona, amaphuzu e-'MELD' akuwona nje umphumela wokuhlolwa kwegazi olula, angaphezulu kwalokho.

Ingabe amaphuzu engeziwe angangezwa kumaphuzu e-MELD?

Ngezinye izikhathi, ungadinga ukufakelwa isibindi ngokushesha kunalokho okushiwo yi-MELD score yakho. Lokhu kusho ukuthi i-MELD score yakho ingase ingabonakali ubukhali besimo sakho. Ezimweni ezinjalo, udokotela wakho angacela ukuthi wengeze amaphuzu engeziwe ('amaphuzu ahlukile') ku-MELD score yakho.

Nazi ezinye izimo ezingase zikuvumele ukuthola amaphuzu engeziwe:

• Ukwehluleka kwesibindi okukhulu
• Umdlavuza wesibindi - wezinhlobo ezithile kuphela
• I-Hepatopulmonary syndrome - Lesi yisimo lapho izinga lomoya-mpilo egazini lehla khona ngenxa yesifo sesibindi.
• Umfutho wegazi ophezulu we-Portopulmonary - Lesi yisimo lapho umfutho wegazi emaphashini ukhuphuka ngenxa yesifo sesibindi.
• Isifo sesibindi se-Polycystic - Lesi yisifo esingavamile, esibangelwa izakhi zofuzo.
• I-Cholangitis - ukutheleleka okuphindaphindiwe kwemigudu ye-bile

Ithimba lakho lezokwelapha lizonquma ukuthi udinga yini ukwengeza la maphuzu engeziwe kumaphuzu akho e-MELD. Ngakho-ke, kungcono ukukhuluma nodokotela wakho mayelana namaphuzu akho e-MELD, izici eziwathintayo, kanye nesimo sakho. Bangakuchazela konke futhi baphendule noma yimiphi imibuzo ongase ube nayo.

Isilinganiso se-MELD sibuyekezwa kangaki?

Isikolo sakho se-MELD asivele senzeke kanye kuphela. Udokotela wakho uzobuyekeza isikolo sakho se-MELD ngokuhlolwa kwegazi okuvamile . Ukuthi usibuyekeza kangaki kuncike kusikolo sakho sokugcina se-MELD.

Lokhu kuvame ukwenzeka:

• Uma amaphuzu engaphansi kuka-10, cishe kanye ngonyaka.
• Uma amaphuzu ephakathi kuka-11-18, cishe kanye njalo ezinyangeni ezi-3.
• Uma uphawu luphakathi kuka-19-24, cishe kanye ngenyanga.
• Uma uphawu lungama-25 noma ngaphezulu, njengokungathi kanye ngesonto.

Kodwa-ke, lokhu kumane kuyisiqondiso esijwayelekile. Udokotela wakho kuphela onganquma ukuthi udinga ukuvuselela amaphuzu akho kangaki. Kungahluka kuye ngesimo sakho.

Kusho ukuthini ukuthi isikolo sakho se-MELD sisho ukuthini?

Manje cishe ucabanga ukuthi, "Kulungile, udokotela uthe amaphuzu ami e-MELD aphezulu kangaka. Ngakho lokho kungitshelani ngempela?" Amaphuzu e-MELD anganika ithimba lakho lezokwelapha umbono wezinto ezimbili eziyinhloko:

1. Ingakanani ingozi yakho yokufa ezinyangeni ezintathu ezizayo ngenxa yesifo sesibindi ?

2. Udinga ukufakelwa isibindi ngokushesha kangakanani .

Akekho ongabikezela ukuthi umuntu uzophila isikhathi esingakanani. Sonke siyakwazi lokho. Kodwa leli phuzu elithi 'MELD' linganikeza odokotela umbono ojwayelekile ngesimo sakho. Bese, basebenzisa lelo phuzu ukusiza ekunqumeni ukuthi kufanele ube kuphi ohlwini lokulinda lokufakelwa isibindi.

Kodwa khumbula,Isilinganiso se-'MELD' akusona sodwa isici esinquma ukuthi uzofakelwa isibindi ngokushesha kangakanani. Ezinye izinto eziningi zithinta lokhu, njengohlobo lwegazi lakho kanye nenani labanikeli besibindi endaweni yakini.

Kufanele ngixhumane nini nodokotela?

Uma unemibuzo noma ukukhathazeka mayelana nesikolo sakho se-MELD, xhumana nodokotela wakho ngokushesha. Futhi, uma unemibuzo mayelana nemiphumela yokuhlolwa kwegazi lakho noma uhlelo lwakho lokwelashwa lwesikhathi esizayo, khuluma nodokotela wakho ngalokho futhi.

Isikolo sakho se-MELD simane nje siyindlela eyodwa esetshenziswa yithimba lakho lezokwelapha ukunquma ukuthi udinga ukufakelwa isibindi ngokushesha kangakanani. Kufana nengxenye eyodwa yephazili enkulu. Ngakho-ke, ungacabangi kakhulu ngezinto noma ukwethuka uze ukhulume nodokotela wakho. Bangakuchazela imiphumela yakho futhi bakunike umbono omuhle wokuthi yini ongayilindela.

Okokugcina, okufanele ukukhumbule

Kulungile, ngakho-ke sesikhulume kakhulu ngesikolo se-'MELD'. Okokugcina, nazi izinto ezibaluleke kakhulu okudingeka uzikhumbule:

• Isilinganiso se-'MELD' siyindlela esiza ekuhloleni ubucayi besifo sesibindi kanye nesidingo esiphuthumayo sokufakelwa isibindi.
• Leli phuzu libalwa ngokuyinhloko ngokucabangela imiphumela yokuhlolwa kwegazi okuningana (ikakhulukazi i-`INR`, i-`Bilirubin`, i-`Creatinine`, i-`Serum Sodium`, i-`Albumin`) kanye nezinye izici zezokwelapha.
• Njengoba amaphuzu enyuka, kubonisa ukuthi isimo sesibindi sibi kakhulu nokuthi kunesidingo esikhulu sokufakelwa isibindi.
• Leli ithuluzi elilodwa nje lokusiza odokotela ukuba benze izinqumo.
• Ungesabi ukukhuluma ngokukhululekile nodokotela wakho nganoma yikuphi ukukhathazeka onakho mayelana nesilinganiso sakho se-MELD noma impilo yesibindi.

Ngikufisela ukululama okusheshayo!

` Isilinganiso se-MELD, isifo sesibindi, ukufakelwa kwesibindi, ukuhlolwa kwegazi, i-bilirubin, i-creatinine, izikolo zempilo