I thin hriselna engtin nge a awm? Child-Pugh Score hmangin zawng chhuak rawh!

A chang chuan Doctor ten thu thar emaw, medical test thar emaw min hrilh hian kan hlauthawng deuh thin a ni lawm ni? Chu chu thil pangngai a ni. Vawiin hian i hriat tawh mai thei, nakin lawkah i hriat tawh mai thei thil kan sawi dawn a ni. Child-Pugh Score tih a ni. He hming i hriat hian hlauthawng suh, a chhan chu doctor-te’n i liver dinhmun an hriatthiam theihna tur kawng khat chauh a nih vang a ni. A awlsam leh chiang takin sawi ila.

Child-Pugh Score hi eng nge ni? A awlsam zawngin...

Service center-a i car i hruai hian technician chuan thil chi hrang hrang a check a, i car dinhmun a hrilh che ang maiin han ngaihtuah teh. Child-Pugh score hi hun rei tak chhunga liver natna vei tawh , a bik takin cirrhosis, liver-a thau awmkhawm a, a khauh phah thinte liver a thawh that dan tehna hmanraw a ni.

A awlsam zawngin sawi ila, he scoring system hian doctor-te chu a hnuaia mite hi a hrethiam thei a ni:

• I liver hian engtiang chiahin nge hna a thawh?
• Liver failure hlauhawmna a awm em? Engtiang chiahin nge a nih?
• Eng ang enkawlna nge i tan a tha ber?

Hei hian thil dang a ti a ni. Khawvel hmun hrang hranga doctor te pawhin i liver dinhmun chungchang chutiang bawka sawi turin a pui thin. A chang chuan ``Child-Turcotte-Pugh (CTP) calculator'' an ti bawk.Mahse, hre reng ang che, he score hi a pawimawh laiin, i hriselna chungchang zawng zawng a sawi vek lo. A then khat chauh a ni.

Hemi kawngah hian eng thil 5 nge thlir a nih?

Doctor-te chuan Child-Pugh score siam nan hian thil pawimawh panga an en a. Chungte chu:

1. Thisen a bilirubin level zawng zawng: Bilirubin hi kan taksa bile-a awm, yellow compound a ni. Liver hian hna a thawk tha em tih tehna atan hman a ni. A lo pun chuan mit leh vun chu a sen (jaundice ang) a lo ni ta a ni.

2. Serum albumin level: Albumin hi i thin (liver) atanga siam protein a ni. I taksa pum puiah nutrients a phurh luh theih nan a pui thin. I liver a chak loh chuan he protein hi a siam tlem zawk thin.

3. I thisen zam chak dan (Prothrombin time or INR): I thisen zam chak danah hian thin (liver) hian a inrawlh bawk. Hei hi a chhan chu thisen zawrhna atana thil tul thenkhat chu thin (liver)-a siam a nih vang a ni. Hemi hun a pun chuan thisen a hrual theih nan hun a duh rei zawk tihna a ni.

4. Ascites: Hei hian i pum chhunga tui awm dan pangngai lo (abdominal cavity) a kawk a ni. Hei hi thin natna, cirrhosis ang chi a nasat chuan a thleng thei a ni.

5. Thin natna (Encephalopathy) hian thluak hnathawh a nghawng em:Liver a chhiat chuan taksa atanga toxin lak chhuah tur thenkhat chu thisenah a lo awm khawm thei a ni. Chungte chuan thluak lamah a kal thei a, thluak hnathawh a nghawng thei bawk. Hei hian hriatrengna, ngaihsakna, leh nungchang ang chi thilte a tidanglam thei a ni.

Heng thil panga te hi i test result a zirin score pek vek a ni. Tichuan, an vai hian an inzawm khawm a, total score an hmu ta a ni. Chutiang chuan category pathum zinga pakhatah i in\hen a, chungte chu A, B, C.

Child-Pugh Score atan engtin nge ka inbuatsaih ang?

He Child-Pugh score hi chhut tur chuan test eng emaw zat i neih a ngai dawn a ni. Chûng zîngah chuan taksa enfiahna , thisen test , leh imaging test pawh a tel thei.

Doctor chuan hengte hi enfiah turin thisen sample a dil ang che:

• Bilirubin level: A hmaa kan sawi tawh ang khan hei hi thin (liver function) tehna a ni.
• Albumin level: Liver atanga protein siam, nutrients phurtu.
• Prothrombin time (PT) emaw INR: Thisen zam chakna.

I doctor chuan i pum chhunga tui awm leh awm loh (ascites) enfiah turin abdominal ultrasound emaw CT scan emaw a ti thei ang. Ascites chu pum chhunga tui tam zawk awmkhawmna a ni. Cirrhosis hi a chhan ber a ni.

Thluak tichhe thei liver chhiatna (encephalopathy) enfiah nan taksa enfiahna leh/ emaw hriatna enfiahna neih theih a ni . Hetiang dinhmun hi thin (liver) a chhiat a, thisenah toxins a lo pungkhawm hian a lo awm thei a ni.

Pawimawh: Heng test atanga result dik ber hmuh theih nan test (fasting) hma darkar engemaw zat ei leh in loh turin an ti thei che a ni. Chuvangin i doctor hnenah eng inbuatsaihna nge i siam tur tih chiang takin zawt la.

Heng test te hi ni khatah emaw, hmun khatah emaw tih loh theih a ni. Chu chu a pawi lo. Doctor chuan heng test zawng zawng result a dawn hnu hian i Child-Pugh score chhiar nan an dah khawm vek a ni.

Engtin nge Child-Pugh score hi chhut a nih?

A awlsam khawp mai. Doctor-te chuan i liver hriselna nena inzawm thil panga kan sawi tawhte hi an en thin. Chutiang thil pakhat zel chu i dinhmun azirin score 1, 2, emaw 3 emaw pek theih a ni. (Score 1 hi a na lo ber a, score 3 hi a na ber).

Factor pangate chu a score vek hnuah doctor chuan a belhkhawm vek a ni. Total score 5 leh 15 inkar i hmu a, chu chu i Child-Pugh score a ni.

Chu thil panga result atanga score pek dan tur chart chu hetiang hi a ni:

| Factor | Score 1 a ni | Score 2 a ni | Score 3 a ni |

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

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

| Serum albumin `(Serum albumin)` (g/dL) | > 3.5 | 2.8 - 3.5 | < 2.8 a ni |

| INR (thisen chhuak) | < 1.7 a ni | 1.7 - 2.3 | > 2.3 |

| Ascites natna | Engmah lo | Slight/Control theih a ni | Moderate/Control tha lo |

| Encephalopathy natna a awm | Engmah lo | Pawl 1-2 (Mild/Moderate) | Pawl 3-4 (Severe) |

Score i hmuh zawng zawng a zirin chi thum ah then i ni ang:

• Class A: I liver chu a thawk tha hle. I score zawng zawng hi 5 leh 6 inkar a ni.
• Class B: Liver chhiatna tlemte a awm. I score zawng zawng hi 7 leh 9 inkar a ni.
• Class C: Liver chhiatna nasa tak emaw, natna zual zel emaw. I score hi 10 leh 15 inkar a ni.

Entirna pakhat han en teh ang?

Mi pakhat test result chu hetiang hi han ngaihtuah teh:

• Bilirubin - 3 mg/dL (point 2) a ni.
• Albumin - 2.9 g/dL (point 2) a ni.
• INR - 1 (point 1) a ni.
• Pum chhunga tui (Ascites) - tlem (point 2) .
• Encephalopathy - No (point 1) a awm lo.

He mipa Child-Pugh score hi 2 + 2 + 1 + 2 + 1 = 8 points a ni . Chumi awmzia chu Class B-ah a awm tihna a ni.

I Child-Pugh Score hian eng nge a awmzia?

He score hian chutih laia i liver natna chu snapshot a pe a ni. Heng thil panga hmang hian i doctor hnenah i liver hnathawh that dan a hrilh thin. Child-Pugh score hian i doctor chu a pui a:

• I enkawl dan tur ruahmanna siam rawh: Hei hian damdawi hmanga enkawl i nih dawn leh dawn loh, operation hmanga enkawl i nih dawn leh dawn loh, leh chu enkawlnate chu a hlawhtling dawn em tih ngaihtuah turin a ṭanpui ang che.
• Risk awm dan tehfung siam rawh:Surgery i neih chuan hei hian i hriselna zawng zawng tana a hlauhawmna leh a hlawkpui dan tur a hriat theih nan a pui ang che. Surgery a hlawhtlin chuan operation hnua i nunphung chu eng ang nge a nih dawn tih pawh a sawi lawk thei bawk.
• I dam khawchhuah hun tur chhut rawh: Dam hun tur sawi lawk chu chhut dan tlangpui chauh ni mah se, i doctor chuan hei hi hmangin i score a zirin i dam rei theih dan tur, enkawlna i neih leh neih loh pawh a sawi thei ang.

Hei hi doctor-in a rel vek tih hre reng ang che. He scorecard hi an tan chuan kaihhruaina mai a ni.

Engtikah nge ka doctor ka hmuh ang?

I Child-Pugh score emaw, a chhut dan emaw chungchanga zawhna i neih chuan i doctor nen inbiakna neihpui ngei ang che . I test result emaw, i treatment plan-a thil thleng tur emaw chungchangah ngaihtuahna i neih chuan chu pawh chu i doctor hnenah hrilh bawk ang che.

Tunah chuan i liver hriselna chungchang hrilh thei tur score i nei ta. Chuti a nih chuan tunah hian engtin nge i tih? Pakhatnaah chuan, i doctor nen inbiakna nei lovin heng score emaw, test result emaw hi ngaihtuah mai mai suh. I result leh a awmzia chu an hrilhfiah thei che a ni. I Child-Pugh score hian i enkawlna tur ruahmanna siam turin a pui a ni. Mahse, chu thutluknaah chuan nang pawh i tel ve tho. Chuvangin, i score awmzia leh an rawtna chungchang chu i medical team te nen sawiho rawh. Lungngai suh, tanpui turin an rawn kal a ni.

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

Child-Pugh Score hi thin hriselna tehna atana hmanraw pawimawh tak a ni a, mahse a chanchin kimchang erawh a sawi lo.

• Hei hian doctor te hnenah i liver hriselna chungchangah ngaihtuahna tha tak a pe thei a ni.
• Hei hian enkawlna ruahmanna siam leh hlauhawmna tehna atan a pui a ni.
• Score chauh ngaihtuah buai suh. I doctor nen engkim sawipui rawh.
• I hriselna chungchanga thutlukna siamnaah active takin tel ve rawh.

Liver hi kan taksa peng pawimawh tak a ni. Kan humhalh hi kan mawhphurhna a ni. Liver lama harsatna i neih chuan doctor thupek dik takin zawm tur a ni. Nun hrisel takin nung rawh. Tichuan chutiang symptoms chu i ngaihtuah buai a ngai tawh lovang. Engkim a tha vek ang!

` Child-Pugh score, thin, cirrhosis, thin natna, bilirubin, albumin, thin hnathawh