Kodi Maddrey Score Ndi Chiyani Ndipo Zofunika?

Zamkati

• Wofatsa vs. woopsa wa chiwindi chauchidakwa
• Ndi zina ziti zomwe zingagwiritsidwe ntchito?
• Kodi ziwerengero za MDF zimawerengedwa bwanji?
• Kodi madokotala amagwiritsa ntchito bwanji Maddrey?
• Ngati mphotho yanu ya MDF ndiyotsika kuposa 32
• Ngati mphotho yanu ya MDF iposa 32
• Chiwonetsero

Tanthauzo

Magulu a Maddrey amatchedwanso ntchito yosankha ya Maddrey, MDF, mDF, DFI kapena DF yokha. Ndi chimodzi mwazida zingapo kapena kuwerengera komwe madotolo angagwiritse ntchito kuti adziwe gawo lotsatira la mankhwala kutengera kuopsa kwa matenda a chiwindi a mowa.

Matenda a chiwindi ndi mtundu wa matenda okhudzana ndi chiwindi. Zimayambitsidwa chifukwa chomwa mowa kwambiri. Kufikira 35 peresenti ya omwa mowa mwauchidakwa amakhala ndi vutoli. Zimayambitsa kutupa, mabala, mafuta, ndi kutupa kwa chiwindi. Zimapangitsanso chiopsezo cha khansa ya chiwindi ndikupha maselo a chiwindi. Itha kukhala yofatsa, yapakatikati, kapena yayikulu.

Mulingo wa MDF umawonekeranso ngati chida cholosera chifukwa zimathandizira kudziwa yemwe angakhale woyenera kulandira chithandizo cha corticosteroid. Imaneneranso za mwayi wopulumuka m'mwezi wotsatira kapena miyezi ingapo.

Wofatsa vs. woopsa wa chiwindi chauchidakwa

Chiwindi cha chiwindi chomwa mowa mwauchidakwa chitha kukhala zaka zambiri. Mpaka pomwe, mutha kusintha kuwonongeka kwa chiwindi pakapita nthawi mukasiya kumwa. Kupanda kutero, kuwonongeka kwa chiwindi chanu kudzapitilira kukulira ndikukhazikika.

Mowa woledzeretsa umatha msanga. Mwachitsanzo, zimatha kuchitika atamwa kwambiri mowa. Zitha kubweretsa zovuta zowononga moyo. Ikhoza ngakhale kupha munthu popanda kuwongolera mwankhanza. Chida cha Maddrey chimathandiza dokotala kuzindikira msanga kuopsa kwa matenda a chiwindi a mowa.

Ndi zina ziti zomwe zingagwiritsidwe ntchito?

Mapepala a MDF ndi chida chogwiritsa ntchito kwambiri. Mtundu wamapeto a gawo la matenda a chiwindi (MELD) ndichida china chomwe chimagwiritsidwa ntchito kwambiri. Zina mwazinthu zina monga:

• Glasgow mowa woopsa wa chiwindi (GAHS)
• Mphoto ya Child-Turcotte-Pugh (CTP)
• Chiwerengero cha ABIC
• Zolemba za Lille

Kodi ziwerengero za MDF zimawerengedwa bwanji?

Kuti muwerenge kuchuluka kwa MDF, madokotala amagwiritsa ntchito nthawi yanu ya prothrombin. Ndiyeso imodzi yomwe imayeza kuti magazi anu amatenga nthawi yayitali bwanji kuti aumbike.

Zolembazo zimagwiritsanso ntchito seramu yanu ya bilirubin. Ndiwo kuchuluka kwa bilirubin komwe kumapezeka m'magazi anu. Bilirubin ndi chinthu chomwe chimapezeka mu bile. Bilirubin ndi chinthu chomwe chimapangidwa chiwindi chikasweka maselo ofiira akale. Kwa munthu yemwe ali ndi matenda a chiwindi, nambala iyi nthawi zambiri imakhala yokwera.

Anthu omwe ali ndi MDF ochepera 32 amawerengedwa kuti ali ndi chiwindi choledzeretsa pang'ono. Anthu omwe ali ndi mphambu iyi amawonedwa kuti ali ndi mwayi wochepa wakufa m'miyezi ingapo ikubwerayi. Nthawi zambiri, pafupifupi 90 mpaka 100% ya anthu amakhalabe ndi moyo miyezi 3 atalandilidwa.

Anthu omwe ali ndi MDF ofanana kapena opitilira 32 ali ndi chiwindi choopsa chomwa mowa. Anthu omwe ali ndi mphambu iyi amawonedwa kuti ali ndi mwayi wokufa miyezi ingapo ikubwerayi. Pafupifupi 55 mpaka 65 peresenti ya anthu omwe ali ndi izi adakhalabe miyezi itatu atazindikira. Kuwongolera mwankhanza komanso msinkhu wachinyamata kumatha kusintha mawonekedwe.

Kodi madokotala amagwiritsa ntchito bwanji Maddrey?

Dokotala wanu nthawi zambiri amapeza dongosolo lamankhwala molingana ndi kuchuluka kwanu kwa MDF ndi zina. Angakulimbikitseni kuti mupite kuchipatala kuti athe kuyang'anitsitsa matenda anu. Mukakhala kuchipatala, dokotala wanu nthawi zambiri amakhala:

• Yang'anirani bwino chiwindi chanu kuti muwone ngati milingo ikupita patsogolo.
• Chitani zovuta zilizonse zokhudzana ndi matenda a chiwindi okhudzana ndi mowa.
• Gwiritsani ntchito zida zina zolembera kapena kuwerengera kuchuluka kwanu kwa MELD. Izi zimagwiritsa ntchito zotsatira zanu za bilirubin, creatinine, ndi mayiko ena (INR), kutengera nthawi yanu ya prothrombin. Zimamuthandiza dokotala kuti adziwe momwe alili. Kulemba kwa MELD kwa 18 ndi kupitilira apo kumalumikizidwa ndi malingaliro osauka.
• Pangani mayeso ojambula ngati ultrasound ndi chiwindi cha chiwindi ngati kuli kofunikira.
• Kukuthandizani kudzera pakumwa mowa, ngati kuli kofunikira.
• Kulankhula nanu zakufunika kwa kudziletsa, kapena kusamwa mowa, kwa moyo wanu wonse. Si bwino kuti mumwe mowa wambiri ngati muli ndi matenda otupa chiwindi.
• Akutumizirani ku pulogalamu yogwiritsa ntchito mowa mwauchidakwa, ngati kuli kofunikira.
• Kulankhula nanu zamomwe mungathandizire anthu kuti musamamwe mowa.

Ngati mphotho yanu ya MDF ndiyotsika kuposa 32

Kulemba kwa MDF ochepera 32 kumatanthauza kuti mwina muli ndi chiwindi choledzeretsa pang'ono.

Chithandizo cha matenda opatsirana a chiwindi kapena oledzeretsa amaphatikizapo:

• chithandizo chazakudya, chifukwa kuperewera kwa zakudya m'thupi kumatha kukhala vuto la chiwindi cha mowa
• kupewa kumwa mowa kwathunthu
• chisamaliro chapafupi ndikutsatira

Ngati mphotho yanu ya MDF iposa 32

Mapepala a MDF ofanana kapena oposa 32 amatanthauza kuti mwina muli ndi chiwindi choledzeretsa. Mutha kukhala woyenera kulandira chithandizo cha corticosteroid kapena mankhwala a pentoxifylline.

Dokotala wanu angaone zoopsa zomwe zingakupangitseni kukhala zotetezeka kuti mutenge corticosteroids. Zinthu zotsatirazi zitha kukulitsa chiopsezo:

• Ndinu wamkulu kuposa zaka 50.
• Muli ndi matenda ashuga osalamulirika.
• Mwavulala ndi impso zanu.
• Muli ndi ma bilirubin ochuluka omwe samatsika mukangolowa kuchipatala.
• Mukumwabe mowa. Mukamamwa kwambiri, pamakhala chiopsezo chachikulu chofa.
• Muli ndi malungo, kutuluka magazi m'mimba, kapamba, kapena matenda a impso. Zonsezi zikhoza kutanthauza kuti simungatenge bwino corticosteroids.
• Muli ndi zisonyezo zakusokonekera kwa chiwindi, zomwe zimaphatikizapo chisokonezo. Ichi ndi chimodzi mwamavuto owopsa a chiwindi cha mowa.

Malangizo amachiritso a chiwindi chomwa mowa kwambiri atha kukhala:

• Thandizo lazakudya ndi chakudya cham'mimba, chomwe chimatchedwanso kudyetsa chubu. Zakudya zamadzimadzi zimatulutsa zakudya m'mimba kapena m'matumbo ang'onoang'ono ndi chubu. Chakudya cha makolo chimaperekedwa ndi mitsempha. Mavuto a chiwindi chomwa mowa mwauchidakwa nthawi zambiri amadziwika kuti ndi mtundu wanji wa chithandizo chamagulu abwino.
• Kuchiza ndi corticosteroids monga prednisolone (Prelone, Predalone). Mungafunike kumwa mankhwalawa kwakanthawi.
• Chithandizo cha pentoxifylline (Pentoxil, Trental), chingakhale chosankha kutengera mtundu wanu.

Chiwonetsero

Malipiro a Maddrey ndi chida chomwe dokotala angagwiritse ntchito kuti athandizire kukhazikitsa njira yothandizira odwala matenda a chiwindi. Izi zimathandiza dokotala wanu kumvetsetsa momwe matenda anu alili oopsa. Dokotala wanu amathanso kukuyang'anirani pamavuto ena, monga kutuluka m'mimba, kapamba, kapena impso kulephera.

Kuyambilira, kusamalira mwankhanza kumatha kusintha malingaliro a anthu omwe ali ndi vutoli, makamaka ngati muli ndi chiwindi chomwa mowa kwambiri.