Xisaabiyayaashayagu waa aalado waxbarasho ah oo aan beddelin baaritaanka ama daaweynta dhakhtarka. Had iyo jeer la tashii dhakhtar shati leh.

Calculamedica

Aaladaha bilaashka ah ee shaqaalaha caafimaadka adduunka oo dhan

MELD / MELD-Na

Model for End-Stage Liver Disease — waxay qiimeysaa ba'idda cudurka beerka ee heerka ugu dambeeya iyo mudnaanta beddelka beerka.

Caadi: 0.3 – 1.2 mg/dL · Qiimaha ugu yar ee la isticmaalo xisaabinta: 1.0

aan qiyaas lahayn

Caadi: 0.8 – 1.2 · Qiimaha ugu yar ee la isticmaalo xisaabinta: 1.0

Caadi: 0.7 – 1.3 mg/dL · Qiimaha ugu badan ee la isticmaalo xisaabinta: 4.0 mg/dL

Caadi: 136 – 145 mEq/L · MELD-Na ahaan, qiimayaal < 125 waxaa loola dhaqmayaa sida 125 iyo > 137 sida 137

Fasiraadda MELD-Na

Dhibcaha MELD-Na Dhimasho 3 bilood Fasiraadda
< 10 ≈ 1.9% Ba'id hooseysa
10 – 19 ≈ 6% Ba'id dhexdhexaad ah
20 – 29 ≈ 19.6% Ba'id sareysa
30 – 39 ≈ 52.6% Ba'id aad u sareysa
≥ 40 ≈ 71.3% Ba'id aad u xagjir ah

* Dhimasho la qiyaasay bukaannada ku jira liiska sugitaanka beddelka beerka. Kala-duwanaanta MELD: Kamath et al., 2001; xaqiijinta MELD-Na: Kim et al., 2008.

Xaalada Caafimaad

MELD (Model for End-Stage Liver Disease) waxaa la sameeyay sanadkii 2001 si loo saadaaliyo dhimashada bukaannada TIPS ku jira, waxaana ka dib la xaqiijiyay kala-soocidda liisaska sugitaanka beddelka beerka, isaga oo beddelay Child-Pugh Score sida qodobka qaybinta ee Maraykanka sanadkii 2002.

MELD-Na, kaas oo lifaaqaya sodium-ka dhiigga, wuxuu muujiyay saadaalin ka fiican MELD-ga asalka ah, waxaana loo qaatay dhibcaha rasmiga ah ee mudnaanta ee liisaska sugitaanka beddelka beerka Maraykanka sanadkii 2016. Isticmaalkeedu wuxuu si weyn u fidiyay wadamada iyo nidaamyada beddelka beerka adduunka.

Fomulada MELD waxay isticmaashaa logaritmka dabiiciga ah ee saddex qodob, iyada oo qiimayaasha ugu yar loo dejiyay 1.0 si looga hortago natiijooyin negative ah. Creatinine-ku wuxuu leeyahay xad 4.0 mg/dL; bukaannada dialysis-ka haysta si toos ah waxay helaan qiimahan ugu badan.

Kalkuleytarkani waa mid dheeraad ah Child-Pugh: intii MELD ay si buuxda ku tiirsan tahay qodobbo shaybaar oo dhab ah, Child-Pugh wuxuu lifaaqaa natiijooyin caafimaad oo shakhsi ah (ascites, encephalopathy). MELD waxay leedahay saxnaan ka fiican saadaalinta dhimashada muddada gaaban ee cudurka beerka daran.

⚠ Xaddidaadaha

  • MELD si fiican uma saadaalinayso cirrhosis-ka khamriga xagjirka ah, hepatitis khamri oo daran, ama cudurka hepatopulmonary — xaaladaha leh qodobbo mudnaan gaar ah oo iyaga u gaar ah.
  • Bukaannada leh hepatocellular carcinoma (HCC) waxay helaan dhibco dheeraad ah oo MELD ah iyadoo la eegayo qodobbada barnaamijka beddelka, kuwaas oo aan lagu xisaabin aaladan.
  • Creatinine-ku wuxuu noqon karaa mid been-abuur ah oo sarreeya bukaannada leh xad-dhaaf dareere (bukaannada cirrhosis-ka leh ascites weyn), taasoo yareysa shaqada kelyaha dhabta ah.
  • MELD-Na waxay yareyn kartaa khatarta dumarka sababtoo ah janjeerka qiimayaasha creatinine ee hooseeya — noocyo sida MELD 3.0 ayaa la soo jeediyay si loo saxo eexdaan.
  • Kalkuleytarkani ma beddesho qiimeyn caafimaad oo dhamaystiran ama go'aanka kooxda beddelka.

Ilaha

  • 1. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33(2):464–470. PubMed ↗
  • 2. Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008;359(10):1018–1026. PubMed ↗
  • 3. Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130(6):1652–1660. PubMed ↗
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