Yintoni iMaddrey Score kwaye kutheni ibalulekile?

Umxholo

• Ubumnene xa kuthelekiswa ne-hepatitis enxilisayo
• Ngawaphi amanye amanqaku anokusetyenziswa?
• Libalwa njani inqaku le-MDF?
• Oogqirha basebenzisa njani amanqaku eMaddrey?
• Ukuba amanqaku akho e-MDF angaphantsi kwama-32
• Ukuba amanqaku akho e-MDF aphezulu kune-32
• Imbonakalo

Ingcaciso

Amanqaku kaMaddrey abizwa ngokuba ngumsebenzi wokucalucalulo waseMaddrey, MDF, mDF, DFI okanye iDF nje. Sesinye sezixhobo ezininzi okanye izibalo oogqirha abanokuzisebenzisa ukumisela inyathelo elilandelayo lonyango olusekwe kubukrakra besifo sokudumba kwesibindi.

Utywala i-hepatitis luhlobo lwesifo sesibindi esinxulumene notywala. Kubangelwa kukusela utywala kakhulu. Ukuya kuthi ga kwiipesenti ezingama-35 zabantu abasela kakhulu bayiphuhlisa le meko. Kubangela ukudumba, amanxeba, amanqatha, kunye nokudumba kwesibindi. Ikwonyusa umngcipheko womhlaza wesibindi kwaye ibulale iiseli zesibindi. Inokuba nobulali, ukumodareyitha, okanye ubunzima.

Inqaku le-MDF likwajongwa njengesixhobo sokuxela kwangaphambili kuba iyanceda ukufumanisa ukuba ngubani onokuba ngumgqatswa ofanelekileyo wokufumana unyango lwe-corticosteroid. Ikwaxela kwangaphambili amathuba okusinda kwinyanga ezayo okanye kwiinyanga ezininzi.

Ubumnene xa kuthelekiswa ne-hepatitis enxilisayo

I-hepatitis encinci yotywala inokuhlala iminyaka. Ukufikelela kwinqanaba elithile, unokukwazi ukuguqula umonakalo kwisibindi sakho ngokuhamba kwexesha xa uyeka ukusela. Ngaphandle koko, umonakalo kwisibindi sakho uya kuqhubeka ukhula ngakumbi kwaye ube sisigxina.

I-hepatitis enotywala inokukhawuleza ibe qatha. Umzekelo, inokwenzeka emva kokusela kakhulu. Ingakhokelela kwiingxaki ezisongela ubomi. Ingakhokelela nasekufeni ngaphandle kolawulo olunoburharha. Isixhobo sikaMaddrey sinceda ugqirha wakho ukuba abuqonde ngokukhawuleza ubuzaza besifo sokudumba kwesibindi.

Ngawaphi amanye amanqaku anokusetyenziswa?

Amanqaku e-MDF sisixhobo esisetyenziselwa amanqaku. Imodeli yesiphelo sesigaba sesifo sesibindi (MELD) esinye isixhobo esisetyenziswa rhoqo. Ezinye zeenkqubo zokufumana amanqaku zibandakanya:

• Amanqaku e-Glasgow alcohol hepatitis (GAHS)
• Amanqaku omntwana-iTurcotte-Pugh (CTP)
• Amanqaku eABIC
• Amanqaku eLille

Libalwa njani inqaku le-MDF?

Ukubala amanqaku e-MDF, oogqirha basebenzisa ixesha lakho leprothrombin. Olunye lovavanyo olulinganisa ukuba lithatha ixesha elingakanani igazi lakho ukuba lijiye.

Amanqaku asebenzisa inqanaba lakho le-serum bilirubin. Elo lixabiso le-bilirubin ekhoyo egazini lakho. IBilirubin yinto efumaneka kwi-bile. I-Bilirubin yinto eyenza xa isibindi sichitha iiseli ezibomvu zegazi ezindala. Kumntu onesifo sesibindi, eli nani lihlala liphezulu.

Abantu abanamanqaku e-MDF angaphantsi kwama-32 bahlala bethathelwa ingqalelo ukuba banesifo sokudumba kwesibindi. Abantu abanamanqaku athathwa njengamathuba asezantsi okusweleka kwiinyanga ezimbalwa ezizayo. Ngokwesiqhelo, malunga neepesenti ezingama-90 ukuya kwi-100 zabantu basaphila iinyanga ezi-3 emva kokufumana isifo.

Abantu abanamanqaku e-MDF alinganayo okanye angaphezu kwama-32 bane-hepatitis enxilisayo. Abantu abanamanqaku athathwa njengamathuba aphezulu okufa kwiinyanga ezimbalwa ezizayo. Phantse iipesenti ezingama-55 ukuya kuma-65 zabantu abanala manqaku basaphila iinyanga ezi-3 emva kokuxilongwa. Ulawulo olundlongondlongo kunye nokuba mncinci kunokuthi kuyiphucule imbonakalo.

Oogqirha basebenzisa njani amanqaku eMaddrey?

Ugqirha wakho uhlala egqiba isicwangciso sonyango esekwe kumanqaku akho e-MDF kunye nezinye izinto. Banokucebisa ngokulaliswa esibhedlele ukuze bajonge imeko yakho. Ngexesha lokulaliswa esibhedlele, ugqirha wakho uhlala:

• Jonga ngokusondeleyo umsebenzi wakho wesibindi ukuze ubone ukuba amanqanaba aphuculwe.
• Phatha naziphi na iingxaki ezinxulumene nezifo zesibindi ezinxulumene notywala.
• Sebenzisa ezinye izixhobo zokufumana amanqaku okanye ubale amanqaku akho e-MELD. Oku kusebenzisa iziphumo zakho zebilirubin, i-creatinine, kunye ne-INR) esekwe kwilizwe lonke, esekwe kwixesha lakho leprothrombin. Inceda ugqirha ukuba aqhubeke nokuvavanya imeko yakho. Amanqaku e-MELD ye-18 nangaphezulu enxulunyaniswa nembono ehlwempuzekileyo.
• Yenza uvavanyo lwe-imaging njenge-ultrasound kunye nesibindi se-biopsy xa kufuneka njalo.
• Kukuxhasa ngokurhoxisa utywala, ukuba kukho imfuneko.
• Thetha nawe malunga nokubaluleka kokuziyeka, okanye ukungaseli tywala, ubomi bakho bonke. Akukhuselekanga ukuba usele naliphi na inani lotywala ukuba unesifo sokudumba kwesibindi.
• Ukuthumela kwinkqubo yokusetyenziswa gwenxa kotywala neziyobisi, ukuba kukho imfuneko.
• Thetha nawe malunga nenkxaso yakho ekuhlaleni utywala.

Ukuba amanqaku akho e-MDF angaphantsi kwama-32

Amanqaku e-MDF angaphantsi kwama-32 athetha ukuba unokuba nesifo sokudakumba hepatitis.

Unyango lwe-hepatitis enxilisayo okanye elinganiselweyo ibandakanya:

• inkxaso yesondlo, kuba ukungondleki kunokuba yingxaki yesifo sokudumba kwesibindi
• ukuyeka ngokupheleleyo utywala
• Inkxaso ekufutshane nenkxaso yokulandela

Ukuba amanqaku akho e-MDF aphezulu kune-32

Amanqaku e-MDF alinganayo okanye angaphezulu kwama-32 kuthetha ukuba unokuba nesifo sokudumba kwesibindi. Unokuba ngumgqatswa kunyango lwecorticosteroid okanye unyango lwepentoxifylline.

Ugqirha wakho uyakuthathela ingqalelo umngcipheko onokuthi wenze ukuba kungakhuselekanga kuwe ukuba uthathe iicorticosteroids. Ezi zinto zilandelayo zinokunyusa umngcipheko wakho:

• Umdala kuneminyaka eyi-50.
• Unesifo seswekile esingalawulekiyo.
• Uye wenzakala kwizintso zakho.
• Unamanqanaba aphezulu ebilirubin anganciphi ngokukhawuleza emva kokuba ungeniswe esibhedlele.
• Usasela utywala. Okukhona usela, kokukhona uphezulu umngcipheko wokufa.
• Unomkhuhlane, ukuphuma kwegazi eliphezulu, i-pancreatitis, okanye isifo sentso. Nayiphi na kwezi inokuthetha ukuba awukwazi ukuthatha i-corticosteroids ngokukhuselekileyo.
• Unemiqondiso ye-hepatic encephalopathy, equka ukudideka. Le yenye yeengxaki ezinobungozi kwi-hepatitis enotywala.

Iingcebiso zonyango kwi-hepatitis enxilisayo inokubandakanya:

• Inkxaso yezondlo ngokutya okungaphakathi, okwabizwa ngokuba kukutyisa ityhubhu. Izakhamzimba ezikwimo yolwelo zihambisa isondlo ngqo kwisisu okanye amathumbu amancinci ngombhobho. Isondlo sabazali sinikezelwa ngumthambo. Iingxaki ze-hepatitis enotywala zihlala zichonga ukuba loluphi uhlobo lwenkxaso yesondlo efanelekileyo.
• Unyango nge-corticosteroids enjenge-prednisolone (Prelone, Predalone). Kuya kufuneka ulithathe eli chiza ixesha elininzi.
• Unyango nge-pentoxifylline (Pentoxil, Trental), inokuba lukhetho ngokuxhomekeke kwimeko ethile.

Imbonakalo

Amanqaku kaMaddrey sisixhobo ugqirha anokusisebenzisa ukunceda ukuphuhlisa isicwangciso sonyango se-hepatitis enotywala. Amanqaku anceda ugqirha wakho ukuba aqonde ukuba imeko yakho inzima kangakanani. Ugqirha wakho uya kuthi abeke esweni ezinye iingxaki, njengokuphuma kwesisu, ipancreatitis, okanye ukusilela kwezintso.

Kwangoko, ulawulo olungqongqo lunokuyiphucula imbonakalo yabantu abakule meko, ngakumbi ukuba unesifo sokudumba kwesibindi.