Lithini iMaddrey Score futhi Kungani Libalulekile?

-Delile

• I-hepatitis emnene uma iqhathaniswa nophuzo oludakayo
• Yiziphi ezinye izikolo ezingasetshenziswa?
• Ibalwa kanjani imiphumela ye-MDF?
• Ngabe odokotela basebenzisa kanjani amaphuzu kaMaddrey?
• Uma isilinganiso sakho se-MDF singaphansi kuka-32
• Uma isilinganiso sakho se-MDF singaphezulu kwama-32
• Umbono

Incazelo

Isikolo sikaMaddrey sibizwa nangokuthi umsebenzi wokubandlulula kaMaddrey, i-MDF, i-mDF, i-DFI noma i-DF nje. Ngenye yamathuluzi noma izibalo eziningana odokotela abangazisebenzisa ukunquma isinyathelo esilandelayo sokwelapha ngokuya ngobukhulu besifo sokusha kwesibindi esidakayo.

I-hepatitis yotshwala uhlobo lwesifo sesibindi esihlobene notshwala. Kubangelwa ukuphuza utshwala obuningi.Kufika kumaphesenti angama-35 abaphuza ngokweqile abanalesi simo. Kubanga ukuvuvukala, isibazi, imali enamafutha nokuvuvukala kwesibindi. Kwenyusa nengozi yomdlavuza wesibindi futhi kubulale amangqamuzana wesibindi. Kungaba mnene, ngokulinganisela, noma kube nzima.

Isilinganiso se-MDF sithathwa njengethuluzi lokubikezela ngoba kusiza ukunquma ukuthi ngubani ongaba ngumqokelwa omuhle ukuthola ukwelashwa kwe-corticosteroid. Kubikezela namathuba okusinda enyangeni ezayo noma ezinyangeni ezimbalwa.

I-hepatitis emnene uma iqhathaniswa nophuzo oludakayo

I-hepatitis emnene yotshwala ingahlala iminyaka. Kuze kufike iphuzu elithile, ungakwazi ukubuyisela emuva ukulimala kwesibindi sakho ngokuhamba kwesikhathi uma uyeka ukuphuza. Ngaphandle kwalokho, ukulimala kwesibindi sakho kuzoqhubeka nokubi kakhulu futhi kube unomphela.

Isifo sokusha kwesibindi esidakayo singasheshe sibe nzima. Isibonelo, kungenzeka ngemuva kokuphuza ngokweqile. Kungaholela ezinkingeni ezisongela impilo. Kungaholela nasekufeni ngaphandle kokuphathwa ngonya. Ithuluzi likaMaddrey lisiza udokotela wakho abone masinyane ubunzima besifo sokusha kwesibindi esidakayo.

Yiziphi ezinye izikolo ezingasetshenziswa?

Isikolo se-MDF siyithuluzi lokushaya amagoli elisetshenziswa kakhulu. Imodeli yesilinganiso sesifo sesibindi sokugcina (MELD) elinye ithuluzi elisetshenziswa kakhulu. Ezinye zezinhlelo zokufaka amagoli zifaka:

• Isilinganiso se-Glasgow alcohol hepatitis (GAHS)
• Isikolo se-Child-Turcotte-Pugh (CTP)
• Isikolo se-ABIC
• Isikolo seLille

Ibalwa kanjani imiphumela ye-MDF?

Ukubala isilinganiso se-MDF, odokotela basebenzisa isikhathi sakho se-prothrombin. Kungenye yezivivinyo ezilinganisela ukuthi kuthatha isikhathi esingakanani igazi lakho ukuminyana.

Umphumela uphinde usebenzise izinga lakho le-serum bilirubin. Lelo yinani lama-bilirubin akhona egazini lakho. I-Bilirubin yinto etholakala enyameni. I-Bilirubin yinto eyakhekayo lapho isibindi sidiliza amaseli abomvu egazi amadala. Kumuntu onesifo sesibindi, le nombolo ivame ukuba phezulu.

Abantu abanesilinganiso se-MDF esingaphansi kuka-32 bavame ukubhekwa njengabanesifo sokusha kwesibindi esidakayo kuya esimaphakathi. Abantu abanala maphuzu babhekwa njengamathuba amancane okufa ezinyangeni ezimbalwa ezizayo. Imvamisa, cishe amaphesenti angama-90 kuye kwayi-100 abantu basaphila izinyanga ezintathu ngemuva kokuthola ukuxilongwa.

Abantu abanesilinganiso se-MDF esilingana noma esingaphezu kuka-32 bane-hepatitis enotshwala obunzima. Abantu abanala maphuzu babhekwa njengamathuba aphezulu okufa ezinyangeni ezimbalwa ezizayo. Cishe amaphesenti angama-55 kuye kwangama-65 abantu abanala maphuzu basaphila izinyanga ezintathu ngemuva kokuxilongwa. Ukuphathwa ngolaka nokuba mncane ngeminyaka kungathuthukisa umbono.

Ngabe odokotela basebenzisa kanjani amaphuzu kaMaddrey?

Udokotela wakho uvame ukunquma uhlelo lokwelashwa ngokuya ngesilinganiso sakho se-MDF nezinye izinto. Bangancoma ukulaliswa esibhedlela ukuze bakwazi ukuqapha isimo sakho eduze. Ngesikhathi sokulaliswa esibhedlela, udokotela wakho uzovame:

• Qapha eduze ukusebenza kwesibindi sakho ukubona ukuthi amazinga athuthuka yini.
• Phatha noma yiziphi izinkinga ezihlobene nezifo zesibindi ezihlobene notshwala.
• Sebenzisa amanye amathuluzi wokufaka amagoli noma ubale isikolo sakho se-MELD. Lokhu kusebenzisa umphumela wakho we-bilirubin, i-creatinine, ne-standardized standardised (INR), osuselwe esikhathini sakho se-prothrombin. Kuyasiza udokotela wakho ukuqhubeka nokuhlola isimo sakho. Isilinganiso se-MELD se-18 nangaphezulu sihlotshaniswa nombono ompofu.
• Yenza ukuhlolwa kwe-imaging njenge-ultrasound kanye ne-biopsy yesibindi uma kudingeka.
• Ukusekela ngokuhoxa utshwala, uma kunesidingo.
• Khuluma nawe ngokubaluleka kokuyeka, noma ukungaphuzi utshwala, impilo yakho yonke. Akuphephile ukuthi uphuze noma yiliphi inani lotshwala uma une-hepatitis enotshwala.
• Kukudlulisele ohlelweni lokusebenzisa kabi utshwala nezidakamizwa, uma kunesidingo.
• Khuluma nawe ngokusekelwa kwakho kwezenhlalo ngokuhlala kude notshwala.

Uma isilinganiso sakho se-MDF singaphansi kuka-32

Isilinganiso se-MDF esingaphansi kuka-32 sisho ukuthi kungenzeka ukuthi une-hepatitis yotshwala emnene ukuya kokulingene.

Ukwelashwa kwe-hepatitis yotshwala emnene noma elinganiselayo kubandakanya:

• ukwesekwa kokudla okunempilo, ngoba ukungondleki kahle kungaba inkinga yesifo sokusha kwesibindi esidakayo
• ukuyeka ngokuphelele utshwala
• ukuvala ukunakekelwa kokusekelwa nokulandelwa

Uma isilinganiso sakho se-MDF singaphezulu kwama-32

Isilinganiso se-MDF esilingana noma esingaphezu kuka-32 sisho ukuthi kungenzeka ukuthi unesifo sokusha kwesibindi kohlobo oludakayo. Ungaba yilowo ozobhekela ukwelashwa kwe-corticosteroid noma ukwelashwa kwe-pentoxifylline.

Udokotela wakho uzobheka izinto ezinobungozi ezingakwenza kungaphephi kuwe ukuthatha i-corticosteroids. Izici ezilandelayo zingakhuphula ubungozi bakho:

• Umdala kuneminyaka yobudala engama-50.
• Unesifo sikashukela esingalawuleki.
• Ube nokulimala ezinso zakho.
• Unamazinga aphezulu e-bilirubin anganciphi ngokushesha ngemuva kokulaliswa esibhedlela.
• Usabuphuza utshwala. Lapho uphuza kakhulu, ingozi yakho yokufa iyanda.
• Unomkhuhlane, ukopha okuphezulu emathunjini, i-pancreatitis, noma ukutheleleka kwezinso. Noma yikuphi kwalokhu kungasho ukuthi awukwazi ukuthatha ngokuphepha ama-corticosteroids.
• Unezimpawu ze-hepatic encephalopathy, efaka ukudideka. Lesi ngesinye sezinkinga eziyingozi kakhulu zesifo sokusha kwesibindi esidakayo.

Izincomo zokwelashwa ze-hepatitis enotshwala obukhulu zingabandakanya:

• Ukwesekwa kokudla okunomsoco ngokudla okungaphakathi, okubizwa nangokuthi ukusuthiswa kwamashubhu. Amakhemikhali asesimweni soketshezi aletha umsoco ngqo esiswini noma emathunjini amancane ngepayipi. Ukudla kwabazali kunikezwa ngumthambo. Izinkinga ze-hepatitis yotshwala zivame ukunquma ukuthi yiluphi uhlobo lokusekelwa kokudla okunempilo olungcono kakhulu.
• Ukwelashwa ngama-corticosteroids afana ne-prednisolone (Prelone, Predalone). Ungadinga ukuthatha lesi sidakamizwa isikhathi esithile.
• Ukwelashwa nge-pentoxifylline (Pentoxil, Trental), kungaba yindlela ongakhetha kuyo kuye ngesimo sakho esithile.

Umbono

Isikolo sikaMaddrey siyithuluzi udokotela wakho angalisebenzisa ukusiza ukuthuthukisa uhlelo lokwelashwa kwesifo sokusha kwesibindi kohlobo oludakayo. Lesi sici sisiza udokotela wakho ukuthi aqonde ukuthi isimo sakho sinzima kangakanani. Udokotela wakho futhi uzokuqapha ngezinye izinkinga, njengokuphuma emathunjini, i-pancreatitis, noma ukwehluleka kwezinso.

Ukuphathwa kwasekuqaleni, okunolaka kungathuthukisa umbono wabantu abakulesi simo, ikakhulukazi uma unesifo sokusha kwesibindi esinamandla.