Obulamu bw’ekibumba kyo buli butya? Manya n'obubonero bwa Child-Pugh!

Oluusi abasawo bwe batubuulira ebigambo ebipya oba okukeberebwa kw’abasawo okupya, tufuna akatyabaga katono, nedda? Ekyo kya bulijjo. Leero tugenda kwogera ku kintu osanga ky'owuliddeko, oba ky'oyinza okuwulira mu biseera eby'omu maaso. Kiyitibwa Child-Pugh Score . Totya ng’owulira erinnya lino, kubanga ngeri yokka ey’okuyamba abasawo okutegeera embeera y’ekibumba kyo. Ka twogere ku nsonga eno mu ngeri ennyangu era mu ngeri entegeerekeka.

Obukodyo bwa Child-Pugh kye ki? Mu ngeri ennyangu...

Kilowoozeeko nga bw’otwala mmotoka yo mu kifo awaweebwa saaviisi, omukugu n’akebera ebintu eby’enjawulo n’akubuulira embeera y’emmotoka yo. Obukodyo bwa Child-Pugh nkola ya kwekenneenya engeri ekibumba gye kikola obulungi mu muntu alina obulwadde bw’ekibumba obw’ekiseera ekiwanvu , naddala cirrhosis, embeera ng’amasavu gazimba mu kibumba ne kikaluba.

Mu ngeri ennyangu, enkola eno ey’okugaba obubonero esobozesa abasawo okutegeera bino wammanga:

• Ekibumba kyo kikola bulungi kitya?
• Waliwo akabi k’ekibumba okulemererwa? Kiyinzika kitya?
• Bujjanjabi bwa ngeri ki obusinga okukusinga?

Kino kikola ekirala. Kiyamba abasawo okwetoloola ensi yonna okwogera ku mbeera y’ekibumba kyo mu ngeri y’emu. Oluusi kiyitibwa ``Child-Turcotte-Pugh (CTP) calculator.'' Naye jjukira, wadde ng'obubonero buno bukulu, tebunyumya mboozi yonna ku bulamu bwo. Kitundu kimu kyokka.

Bintu ki 5 ebitunuuliddwa mu kino?

Abasawo batunuulira ensonga ttaano enkulu okutondawo obubonero bwa Child-Pugh. Bino bye bino:

1. Omuwendo gwa bilirubin gwonna mu musaayi: Bilirubin kirungo kya kyenvu ekisangibwa mu ntuuyo z’omubiri gwaffe. Kikozesebwa okupima oba ekibumba kikola bulungi. Bwe gweyongera, amaaso n’olususu bifuuka bya kyenvu (nga jaundice).

2. Serum albumin level: Albumin ye puloteyina ekolebwa ekibumba kyo. Ayamba okutambuza ebiriisa mu mubiri gwo gwonna. Ekibumba kyo bwe kiba kinafu, kikola ekitono ku puloteyina ono.

3. Engeri omusaayi gwo gye guzimba amangu (Prothrombin time oba INR): Ekibumba nakyo kyenyigira mu ngeri omusaayi gwo gye guzimba amangu. Kino kiri bwe kityo kubanga ebimu ku bintu ebyetaagisa omusaayi okuzimba bikolebwa mu kibumba. Okwongera mu budde buno kitegeeza nti kitwala ekiseera ekiwanvu omusaayi okuzimba.

4. Ascites: Kino kitegeeza okukuŋŋaanyizibwa kw’amazzi mu ngeri etaali ya bulijjo munda mu lubuto lwo (abdominal cavity). Kino kiyinza okubaawo ng’endwadde z’ekibumba nga cirrhosis za maanyi.

5. Enkola y’obwongo ekosebwa obulwadde bw’ekibumba (Encephalopathy):Ekibumba bwe kyonoonese, obumu ku butwa obulina okuggyibwa mu mubiri busobola okuzimba mu musaayi. Bino bisobola okugenda mu bwongo ne bikosa enkola y’obwongo. Kino kiyinza okuleeta enkyukakyuka mu bintu ng’okujjukira, okufaayo, n’enneeyisa.

Buli emu ku nsonga zino ettaano eweebwa obubonero okusinziira ku bivudde mu bigezo byo. Olwo, zonna zigattibwa wamu okufuna obubonero bwonna awamu. Okusinziira ku kino, ogabanyizibwa mu kimu ku biti bisatu: A, B oba C.

Nneetegeke ntya obubonero bwa Child-Pugh?

Okubala obubonero buno obwa Child-Pugh, ojja kwetaaga okukola ebigezo ebiwerako. Mu bino biyinza okuli okwekebejjebwa omubiri , okukeberebwa omusaayi , era oboolyawo n’okukeberebwa ebifaananyi .

Omusawo ajja kukusaba omusaayi okukebera ebintu bino:

• Omuwendo gwa bilirubin: Nga bwe kyayogeddwako emabegako, kino kipimo ky’enkola y’ekibumba.
• Albumin level: Puloteeni ekolebwa ekibumba etambuza ebiriisa.
• Prothrombin time (PT) oba INR: Sipiidi omusaayi gye guzimba.

Omusawo ayinza okukola ultrasound mu lubuto oba CT scan okukebera oba amazzi gakuŋŋaanye mu lubuto (ascites). Ascites kwe kukuŋŋaanyizibwa kw’amazzi ag’enjawulo mu lubuto. Obulwadde bwa Cirrhosis bwe businga okuvaako kino.

Okukebera omubiri ne/oba okukebera okutegeera kuyinza okukolebwa okukebera oba ekibumba kyonoonese ekikosa obwongo (encephalopathy). Embeera eno esobola okubaawo ng’ekibumba kyonoonese n’obutwa ne buzimba mu musaayi.

Ekikulu: Okusobola okufuna ebituufu ebisinga okuva mu kukeberebwa kuno, oyinza okusabibwa okwewala okulya oba okunywa okumala essaawa ntono nga tonnaba kukeberebwa (okusiiba). N’olwekyo, buuza omusawo wo enteekateeka ki ddala z’olina okukola.

Ebigezo bino biyinza obutakolebwa ku lunaku lumu oba mu kifo kye kimu. Ekyo si kibi. Omusawo bw’amala okufuna ebyava mu kukeberebwa kuno kwonna, byonna babigatta okubala obubonero bwo obwa Child-Pugh.

Obukodyo bwa Child-Pugh bubalirirwa butya?

Kyangu nnyo. Abasawo batunuulira ensonga ttaano ezoogeddwako waggulu ezikwata ku bulamu bw’ekibumba kyo. Buli emu ku nsonga ezo esobola okuweebwa obubonero 1, 2, oba 3 okusinziira ku mbeera gy’olimu. (Obubonero 1 bwe businga obutono, obubonero 3 bwe businga okuba obw’amaanyi).

Oluvannyuma lw’okuteeba ensonga zonna ettaano, omusawo azigatta zonna. Ofuna obubonero bwonna wakati wa 5 ne 15. Obwo bwe bubonero bwo obwa Child-Pugh.

Wano waliwo ekipande ekiraga engeri obubonero gye buweebwamu okusinziira ku bivudde mu nsonga ezo ettaano:

| Ensonga | Obukodyo 1 | Obukodyo 2 | Obukodyo 3 |

| :--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- :------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ :------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ :---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| Bilirubin `(Bilirubin yonna)` (mg/dL) | < 2 | 2 - 3 | > 3 |

| Albumin mu musaayi `(Albumin mu musaayi)` (g/dL) | > 3.5 Obubaka bwa Kabaka | 2.8 - 3.5 | < 2.8 |

| INR (okuzimba omusaayi) | < 1.7 | 1.7 - 2.3 | > 2.3 Obubaka bwa Kabaka |

| Obulwadde bwa Ascites | Tewali | Ekitono/Ekifugibwa | Ekigero/Ekifugibwa Obubi |

| Obulwadde bw'obwongo | Tewali | Ekibiina 1-2 (Eky’ekigero/Eky’ekigero) | Ekibiina 3-4 (Eky'amaanyi) |

Okusinziira ku bubonero bwonna bw’ofuna, ojja kugabanyizibwa mu biti bisatu ebikulu:

• Kiraasi A: Ekibumba kyo kikola bulungi. Omugatte gw’obubonero bwo buli wakati wa 5 ne 6.
• Kiraasi B: Waliwo okwonooneka kw’ekibumba okw’ekigero. Omugatte gw’obubonero bwo buli wakati wa 7 ne 9.
• Class C: Ekibumba okwonooneka ennyo oba obulwadde obw’amaanyi. Obukodyo bwo buli wakati wa 10 ne 15.

Ka tulabe ekyokulabirako?

Teebereza ebyava mu kukeberebwa kw’omuntu biri bwe biti:

• Bilirubin - 3 mg/dL (obubonero 2) .
• Albumin - 2.9 g/dL (obubonero 2) .
• INR - 1 (obubonero 1)
• Amazzi mu lubuto (Ascites) - matono (obubonero 2) .
• Obulwadde bw'obwongo - Nedda (obubonero 1) .

Omuntu ono obubonero bwa Child-Pugh buli 2 + 2 + 1 + 2 + 1 = 8 obubonero . Kino kitegeeza nti ali mu Class B.

Child-Pugh Score yo etegeeza ki?

Obukodyo buno buwa ekifaananyi ky’obulwadde bwo obw’ekibumba mu kiseera ekyo. Kitegeeza omusawo wo engeri ekibumba kyo gye kikola obulungi okusinziira ku nsonga zino ettaano. Obukodyo bwa Child-Pugh buyamba omusawo wo:

• Kola enteekateeka yo ey’obujjanjabi: Kino kijja kukuyamba okusalawo oba ojja kujjanjabwa n’eddagala, okulongoosebwa, oba okukyusibwa ekibumba , era oba obujjanjabi obwo bujja kuba buwanguzi.
• Weekenneenye akabi akali mu:Bw’oba ​​olongoosebwa, kino kijja kukuyamba okuzuula engeri gye kiri eky’akabi era eky’omugaso eri obulamu bwo okutwalira awamu. Singa okulongoosebwa kugenda bulungi, era kiyinza okulagula omutindo gw’obulamu bwo bwe gunaaba oluvannyuma lw’okulongoosebwa.
• Teebereza obulamu bwo: Wadde ng’okuteebereza obudde bw’okuwangaala kuba kuteebereza kwokka, omusawo wo asobola okukozesa kino okulagula ebbanga ly’oyinza okuwangaala, ng’olina obujjanjabi oba nga tolina bujjanjabi, okusinziira ku bubonero bwo.

Jjukira nti bino byonna omusawo y’asalawo. Kaadi eno ey’obubonero eba bulagirizi bwokka gye bali.

Ddi lwe nnina okulaba omusawo wange?

Bw’oba ​​olina ekibuuzo kyonna ku bubonero bwo obwa Child-Pugh oba engeri gye bwabalirirwamu, kakasa nti oyogera n’omusawo wo . Bw’oba ​​olina ekikweraliikiriza ku bivudde mu kukeberebwa kwo oba ekiddako mu nteekateeka yo ey’obujjanjabi, ekyo nakyo kibuulire omusawo wo.

Kati olina obubonero obukubuulira ku bulamu bw’ekibumba kyo. Kale kati okola ki? Ekisooka, tomala gakoma ku bubonero buno oba ebyava mu bigezo nga toyogedde na musawo wo. Basobola okukunnyonnyola ebivuddemu byo ne kye bitegeeza. Obukodyo bwo obwa Child-Pugh bubayamba okusalawo ku nteekateeka yo ey’obujjanjabi. Naye era oli kitundu ku kusalawo okwo. Kale, yogerako ne ttiimu yo ey’abasawo ku bubonero bwo kye butegeeza ne bye bakuwa amagezi. Teweeraliikiriranga, bali wano kuyamba.

N’ekisembayo, ebintu by’olina okujjukira (Obubaka bw’okutwala awaka) .

Obukodyo bwa Child-Pugh Score kikulu nnyo mu kupima obulamu bw’ekibumba, naye tebyogera ku nsonga yonna.

• Kino kiyinza okuwa abasawo endowooza ennungi ku bulamu bw’ekibumba kyo.
• Kino kiyamba okuteekateeka obujjanjabi n’okukebera akabi akali mu kukola.
• Tofaayo ku bubonero bwokka. Teesa ku buli kimu n’omusawo wo.
• Faayo nnyo mu kusalawo ku bulamu bwo.

Ekibumba kitundu kikulu nnyo mu mubiri gwaffe. Buvunaanyizibwa bwaffe okubukuuma. Bw’oba ​​olina ekizibu ky’ekibumba, goberera ddala ebiragiro by’omusawo. Beera mu bulamu obulungi. Olwo tojja kweraliikirira bubonero ng’obwo. Buli kimu kijja kuba kirungi!

` Child-Pugh score, ekibumba, cirrhosis, obulwadde bw’ekibumba, bilirubin, albumin, enkola y’ekibumba