Yin Jiyya na Cirrhosis Gishiri
An san sunayen Maddrey Score da sunayen da yawa, ciki harda aikin Madrrey Discrimination Function, MDF, DF ko DFI. Yana da kayan aiki da masu amfani da kiwon lafiya suke amfani da shi don sanin irin nauyin kulawa da ya kamata ga mai haƙuri wanda yake da irin nau'in hanta na hanta wanda ake kira giro cirrhosis .
Ana amfani dashi kayan aiki na asibiti a asibiti, saboda waɗannan mutane suna da rashin lafiya a lokacin da suke fuskantar yanayin cutar wanda ya bukaci amfani da Maddrey Score.
A takaice, madadin Maddrey yana taimaka wajen ƙayyade yadda mugun lalata hanta ne, don haka za'a iya tsara shirin kulawa.
Wa ke Bukata Maddrey Score?
Mutane da ke fama da hepatitis giya ne marasa lafiya wadanda aka yi amfani da Maddrey Score. Wadannan marasa lafiya ne da ke da lahani ga hanta da aka haifar da shan giya, ko yin amfani da barasa da yawa, kuma suna fuskantar matsananciyar cututtuka lokacin da ake amfani da Maddrey.
Wasu daga cikin wadannan mutane za su kasance a asibiti, wasu kuma za a gani a kan asibiti. A cikin waɗannan lokuta, ya kamata su sami kulawa daga mai bada sabis wanda ke ƙwarewa a gastroenterology ko hepatology. Masu binciken gine-ginen suna kula da dukkanin hanyoyin narkewa, ciki har da hanta, yayin da masu ilimin cututtuka ke mayar da hankali ga hanta.
Mene ne Tsarin Gishiri?
Magunguna na cirrhosis irin nau'in cutar hanta ne da aka yi amfani da barasa mai yawa. Zai iya zamawa daga m zuwa mai tsanani kuma zai iya haifar da matsaloli masu yawa-ciki har da mutuwa.
Cirrhosis zai sa ciwon hawan kumburi mai haɗari, haɓo mai yawa kuma zai iya haifar da abin da zai sa ya zama haɗari ga hanta ya yi aiki yadda ya kamata. A wasu lokuta, hanta zai kara girma.
Alamun da aka saba da alamomin cututtuka na Cirrhosis
Akwai nau'o'in cirrhosis iri daban-daban, wanda mai yiwuwa ko bazai haifar da shan barasa ba.
Ko da kuwa ma'anar dalili, marasa lafiya da cirrhosis suna da alamun da alamun sunaye iri ɗaya, wadanda suke da yawa a cikin matakai na farko na cutar kuma suna cike da mummunan cuta.
- Abun ciki na ciki na dama: Hanta yana cikin ƙananan ƙananan dama kuma wasu marasa lafiya sun nuna cewa suna jin ciwo akan hanta da ke ƙarawa da mummunar cuta.
- Nausea: wasu marasa lafiya suna shan wuka, amma tashin hankali yafi kowa kuma yana iya buƙatar magani don ba da damar mai haƙuri ya ci abinci na yau da kullum.
- Sauƙaƙewa sauƙi: hanta yana taka muhimmiyar rawa wajen taimakawa jinin jini bayan rauni ko rauni. Yayin da cirrhosis ke damuwa, raunuka yana faruwa sau da sauƙi kuma a wasu lokuta, zub da jini yana faruwa ba zato ba tsammani, ba tare da wani rauni kamar yadda ya haifar.
- Rashin hankali na tunanin tunani : Lokacin da hanta bai iya yin aikinsa ba, ammonia zai iya gina cikin jini, yana haifar da rikicewa, gajiya, girgizawar tunanin mutum, da rashin iyawa don kula da ayyuka na yau da kullum.
- Lalacewa: Lokacin da hanta ke da cututtuka har zuwa inda ba zai iya yin aikinsa gaba daya ba, bayyanar cututtuka zai bayyana kuma ya tsananta kamar yadda cutar take. Ana iya amfani da magungunan don inganta bayyanar cututtuka.
- Rashin wuya / rauni: Rashin wahala yana da yawa kuma sau da yawa shine abin da ke haifar da ganewar asalin cirrhosis.
- Jaundice (yellowing of skin): Lokacin da hanta ba zai iya tsaftace jinin ba sai fata da sauran kayan jiki na jiki zasu iya daukar nauyin launin rawaya. Wannan an fara gani a cikin fata na idanu, inda sauƙi mai sauƙi shine mafi mahimmanci.
- Gyaran ƙarar daji a cikin ciki: Yayi ta ƙara yawan karfin jini da kwantar da hankali a cikin tasoshin jini kusa da hanta, jini a cikin ciki ya zama ya fi girma kuma mafi bayyane a karkashin fata.
- Ƙunƙarar daɗaɗɗa a cikin esophagus ( banda bambanci): Bugu da ƙari da ciwon daji a cikin ciki yana cike da kuma kara girman girmansa, wannan zai iya faruwa a cikin tasoshin a cikin esophagus. Lokacin da aka kara girman wa annan nau'o'in akwai haɗari na zub da jinin rai, saboda haka magani yana da mahimmanci don rage wannan hadarin.
- Abinci mara kyau, asarar nauyi: Mutane da yawa marasa lafiya zasu sami nauyi saboda kulawa da ruwa, amma wasu sun ga cewa suna fama da rashin nauyi saboda rashin ci abinci da gajiya. Jiɗa kuma iya haifar da asarar nauyi.
- Hanyar daɗaɗɗa a cikin maza da mata: Yayinda ainihin ma'anar wannan ba a fahimta ba, cirrhosis zai kai ga rashin daidaito na hormon wanda zai haifar da canji a cikin ƙirjin jikin.
- Gas (flatulence)
- Bleeding: Za a iya ganin jini ko a'a. A wasu, zub da jini yana iya zama a matsayin "kofi na kofi" wanda aka gani a yayin da ake yin zubar da jini. Wasu na iya lura da cewa ɗakunansu ba su da launin ruwan kasa amma sun zama duhu ko ma baki, kuma suna da tsalle ko kamar tar. Dukansu sune alamun zub da jini a cikin tsarin narkewa kuma ya kamata a ba da rahoton zuwa ga likita.
- Rigawar ruwa ( hawan ): Wasu marasa lafiya suna ɗauke da ruwa mai mahimmanci, musamman a cikin ciki, yanayin da zai iya haifar da buƙatar samun hanya don cire ruwa.
- Tsara: Wannan zai iya zama alamar cewa hanta baya tsaftace jinin da zai iya dandanawa kamar yadda yake.
- Kusawa a kafafu, idon kafa, da ƙafa: Wani alamar alamar riƙewar ruwa, busawa a cikin ƙananan ƙananan iya zama alamar al'amurran da hanta tare da wasu mutane.
- Cikakken numfashi: Rawancin numfashi zai iya zama matsala idan maida hankali a cikin ciki yana da wuya a dauki numfashi mai zurfi ko kara ƙaruwa cikin ciki.
Yadda aka kirkiro Maddrey Score
Maɗaukaki Maddrey yayi amfani da gwaje-gwaje biyu na jini don tantance yawan lalata hanta, bilirubin da lokacin prothrombin.
Bilirubin wata alamar orange ne cewa hanta yana yin lokacin da ya rushe hemoglobin (wani ɓangare na jini) kuma an cire shi a bile. Yawanci, an cire wannan jiki daga jiki amma a cikin yanayin hasara mai cutar bilirubin zai iya ginawa a cikin jini wanda ya haifar da jaundice.
Lokaci na Prothrombin shine ma'auni na yadda sauri yaduwar jini a seconds. Daya daga cikin ayyukan hanta shine don taimakawa da jini, don haka ana tsammanin kwancen kafa lokacin da hanta ya lalace.
Control ne lissafin cewa Lab yana amfani da shi don sanin abin da sakamakon "al'ada" yake a wannan makamancin, kuma ba sakamakon sakamakon jini daga jini ba.
Halin da ake amfani dashi don lissafin Maddrey Score shine:
- Bilirubin (MG / DL) + 4.6 sau (prothrombin lokaci a cikin gajeren minti kadan)
Yaya ake amfani da Sakamakon Maddrey?
Lokacin da mai ciwo da cirrhosis ya yi rashin lafiya, ana amfani da Maddrey Score don sanin ko za su amfana daga amfani da steroid a matsayin ɓangare na tsarin magani. Har ila yau yana iya hango hasashen yiwuwar rayuwa, musamman a cikin watanni uku bayan an ƙidaya yawan.
Idan Maddrey ci gaba da kasa da 32, ana ganin mai haƙuri yana da mici ga madarar cirrhosis kuma bazai amfana da amfani da steroid ba. Kimanin kashi 90 cikin dari na marasa lafiya da suke da wannan za su tsira cikin watanni nan da nan nan bayan da aka kammala.
Abin baƙin ciki shine, cike da sama da 32 yana nuna cutar mai haɗari mai haɗari, yana nufin cewa hanta ya cike hanta. A cikin wadannan lokuta, kimanin kashi 60-65 cikin dari na marasa lafiya suna da rai watanni uku bayan zato. Wadannan marasa lafiya sune 'yan takara mafi kyau don yin amfani da kwayoyin steroid kamar wani ɓangare na maganin su. Ga waɗannan marasa lafiya, haɗarin mummunar magani suna nuna damuwa daga sakamakon da ake samu na rayuwa mai tsawo.
Yana da muhimmanci a tuna cewa Maddrey Score kayan aiki ne, ba cikakke ba. Wannan yana nufin cewa kashi ɗaya ne kawai likita ko likitocin kiwon lafiya suka dubi lokacin da suka yanke shawara mafi kyau na aikin. A saboda wannan dalili, za ka iya ganin mai haƙuri da kashi 30 da ke karbi steroids kuma za ka iya ganin wani mai haƙuri daban da kashi sama da 32 wanda baya. Tumatir suna da tasiri mai mahimmanci, kamar karuwa da jini, wanda zai buƙaci a guje masa a wasu marasa lafiya.
Yadda za a inganta Maddrey Score
Maganin Maddrey ba a kafa shi a dutse ba, kuma ba maganar karshe ce game da yadda cutar mai lafiya za ta amsa maganin ba. Sakamakon shine kayan aiki da aka yi amfani da shi don hango sakamakon sakamakon, amma mai haƙuri zai yiwu har yanzu ya canza yanayin cutar su a wasu lokuta.
Ga marasa lafiya da rashin lafiya, canji a cikin salon zai iya haifar da canji mai kyau a cikin hakin hanta don aiki kuma zai iya kawar da mummunan cutar. A wasu marasa lafiya tare da m cuta daina dakatar da barasa zai iya haifar da cikakkiyar juyawa daga cutar. Ga marasa lafiya da matsanancin matsananciyar cuta, zai yiwu a ga ciwon hanta don inganta wasu. Ga wasu, sauye-sauye na rayuwa baya haifar da inganta amma yana hana cutar daga ciwo-yana da wahala a hango ko wane irin darajar zai faru.
- Tsaya duk abincin barasa. Idan mutum ya cigaba da shan giya, hanyar da ta dace ta dakatar da cututtukan cututtuka da kuma yiwuwar samun cigaba a hanta aikin shine dakatar da shan barasa gaba daya. Wannan yana nufin babu barasa, banda ma'anar ruwan inabi ko giya. Wannan shararwa na shan barasa zai iya zama da wuya, amma zai zama mahimmanci ga lafiyar mai haƙuri, kamar yadda mai amfani da barasa ya yi amfani da bayan ganewar asirin cirrhosis zai kara yawan gudun da wanda yake ci gaba ya ci gaba zuwa matakan karshe na cirrhosis kuma ƙarshe mutuwa.
- Low mai / sodium rage cin abinci. Diet zai iya taimakawa wajen sarrafa cirrhosis. Abincin da ke cikin mai da sodium zai iya taimakawa wajen rage mummunar cuta kuma zai iya rage jigilar ruwa da hanta ke ciki. Ga mutanen da suke buƙatar cire ruwa daga ciki, hanyar da ake kira paracentesis, rage cin abinci zai iya tasiri yadda sau da yawa yawan hanya ya zama dole ta rage rage riƙewar ruwa.
- Karin bayani. Wasu mutanen da ke dauke da cirrhosis na giya suna fama da mummunan abinci kuma zasu ga cigaba a yanayin su tare da kara yawan bitamin da kuma ma'adanai da aka kara zuwa abinci kamar yadda ma'aikatan kiwon lafiya suka tsara. Maganar rashin abinci mai gina jiki na iya zama rashin adadin kuzari a cikin abincin, kamar yadda wasu mutane da ke shan barasa masu cin nama suna cin abinci kadan kuma suna daukar yawancin adadin kuzari a cikin irin barasa. Ga wasu, rashin abinci mara kyau ko wasu batutuwa na iya haifar da rashin abinci mai gina jiki.
- Daidai calories. Ga marasa lafiya da cututtuka mai tsanani da rashin abinci mara kyau, yana iya zama dole don kariyar abincin tare da sha kamar su Tabbatar ko Boost. Idan mai haƙuri ba zai iya cinye adadin adadin kuzari don ƙoshi da bukatun jiki ba, sau da yawa calories 2,000 ko fiye, zasu iya buƙatar buƙata ta ciyar da su don ƙara yawan adadin kuzari da suke shiga. ga wasu marasa lafiya duk wani abincin yana maraba idan suna ƙoƙari su ɗauki calories adadin.
- Gwanar dabbar. Gaskiya guda daya don maganin cirrhosis, duk da ma'anar dalili, shine haɗuwa da hanta. Gyarawa yana da wuyar gaske ga mutanen da ke da cirrhosis na giya saboda dole ne su guje wa barasa na tsawon lokaci - yawanci watanni 6 ko ya fi tsayi - don cancantar yin dashi. Wannan yana da wuyar gaske, kuma mutane da yawa ba su iya isa ga dashi ba saboda sun kasa samun nasarar maye gurbin shan barasa.
Mai haɗuri dole ne ya guje wa barasa bayan ya sami sabon hanta, kamar yadda sabon kwayoyin zai iya lalacewa tare da barasa fiye da yadda hanta ke ciki saboda magunguna da ake buƙatar hana ƙin yarda.
Kalma Daga
Matsayin Maddrey shine kayan aiki guda daya da masu samarwa suke amfani da su wajen kula da marasa lafiya da aka gano da cutar cutar hanta. Hakan yana taimakawa wajen gane ƙananan cirrhosis kuma ya ba da alamar ko ya kamata a yi amfani da suturar don amfani da shi. Duk da yake wannan muhimmin bangare ne na kulawa da aka bayar, wasu dalilai suna da mahimmanci ko ma fi mahimmanci, irin su ko mai haƙuri ya ci gaba da shan barasa, yadda suke so su bi umarnin da sauran dalilan da basu iya canza ba, kamar su shekaru.
> Sources:
> Cirrhosis. Medscape. https://emedicine.medscape.com/article/185856-overview
> Menene cirrhosis? NIDDK. https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis