I ētahi wā ka kōrero mai ngā tākuta i ngā kupu hou, i ngā whakamātautau hauora hou rānei, ka paku mataku tātou, tika? He mea noa tēnā. I tēnei rā ka kōrero tātou mō tētahi mea kua rongo pea koe, ka rongo pea rānei koe mōna ā muri ake nei. Ko te ingoa o tēnei ingoa ko te Kaute Child-Pugh . Kaua e mataku ina rongo koe i tēnei ingoa, he huarahi noa iho tēnei hei āwhina i ngā tākuta ki te mārama ki te āhua o tō ate. Me kōrero tātou mō tēnei mea, kia māmā noa iho, kia mārama hoki.
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He aha te Kaute Child-Pugh? He māmā noa iho...
Whakaarohia tēnei me te mea kei te haria e koe tō waka ki tētahi pokapū ratonga, ka tirohia e te tohunga hangarau ngā mea maha, ka kōrero atu ki a koe mō te āhua o tō waka. Ko te kaute Child-Pugh he tikanga aromatawai i te pai o te mahi a te ate i roto i te tangata he mate ate roa tōna , inā koa ko te cirrhosis, he āhuatanga e pupū ake ai ngā putunga ngako i roto i te ate, ā, ka whakapakeke.
Ki te kī ngāwari, mā tēnei pūnaha whakatauranga ka taea e ngā tākuta te mārama ki ngā mea e whai ake nei:
- Kei te pēhea te pai o te mahi a tō ate?
- He tūponotanga kei te ngoikore te ate? He aha te tūponotanga?
- He aha te momo maimoatanga e pai ana mōu?
He mahi anō tā tēnei. Ka āwhina i ngā tākuta o te ao katoa ki te kōrero mō tō mate ate i te ara kotahi. I ētahi wā ka kiia ko te "tātaitai Child-Turcotte-Pugh (CTP).'' Engari kia maumahara, ahakoa he mea nui tēnei kaute, kāore e kōrerotia te kōrero katoa mō tō hauora. He wāhanga kotahi noa iho.
He aha ngā mea e rima e tirohia ana i roto i tēnei?
E rima ngā āhuatanga matua e tirohia ana e ngā tākuta hei tatau i te kaute Child-Pugh. Ko ēnei:
1. Te taumata bilirubin katoa i roto i te toto: He matū kōwhai te bilirubin e kitea ana i roto i te au o te tinana. Ka whakamahia hei ine mēnā kei te mahi tika te ate. Ina piki ake, ka kōwhai ngā kanohi me te kiri (pērā i te jaundice).
2. Te taumata o te albumin i roto i te toto: He pūmua te albumin i hangaia e tō ate. Ka āwhina i te kawe i ngā matūkai puta noa i tō tinana. Ina ngoikore tō ate, ka iti ake te hanga o tēnei pūmua.
3. Te tere o te totoka (te wā Prothrombin, te INR rānei): Kei roto hoki i te ate te tere o te totoka. Nā te mea ko ētahi o ngā mea e hiahiatia ana mō te totoka ka hangaia i roto i te ate. Mā te roa o tēnei wā ka roa ake te totoka.
4. Te Ascites: E pā ana tēnei ki te kohikohinga rerekē o te wai i roto i tō puku (kōhao puku). Ka puta pea tēnei ina he kino ngā mate ate pērā i te cirrhosis.
5. Kei te pāngia te mahi a te roro e te mate ate (Encephalopathy):Ina pakaru te ate, ka taea e ētahi o ngā paitini e tika ana kia tangohia mai i te tinana te kohikohi ki roto i te toto. Ka taea e ēnei te haere ki te roro, ka pā ki te mahi a te roro. Ka taea e tēnei te whakaputa i ngā huringa ki ngā mea pēnei i te mahara, te aro, me te whanonga.
Ka hoatu he kaute ki ia o ēnei āhuatanga e rima i runga i ngā hua o tō whakamātautau. Kātahi ka tāpirihia katoatia kia whiwhi ai i te kaute katoa. Nō reira, ka whakarōpūhia koe ki tētahi o ngā wāhanga e toru: A, B, C rānei.
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Check Availability →Me pēhea taku whakarite mō te Kaute Child-Pugh?
Hei tatau i tēnei kaute Child-Pugh, me whai koe i ētahi whakamātautau. Kei roto pea i ēnei he whakamātautau tinana , he whakamātautau toto , me ētahi whakamātautau whakaahua pea.
Ka tono te tākuta kia tangohia he tauira toto hei tirotiro i ēnei mea:
- Te taumata bilirubin: E ai ki te kōrero i mua ake nei, he ine tēnei mō te mahi a te ate.
- Te taumata o te albumin: He pūmua i hangaia e te ate e kawe ana i ngā matūkai.
- Te wā prothrombin (PT) te INR rānei: Te tere o te toto e piri ai.
Tērā pea ka whakahaerehia e tō tākuta he tirotiro i te puku mā te whakamahi i te ultrasound , i te CT scan rānei hei tirotiro mēnā kei te puta he wai i roto i tō puku (ascites). Ko te ascites te putunga o te wai tāpiri i roto i te puku. Ko te cirrhosis te tino take o tēnei.
Tērā pea ka whakahaerehia he whakamātautau tinana, he whakamātautau hinengaro rānei, hei tirotiro mēnā he kino te ate e pā ana ki te roro (encephalopathy). Ka puta pea tēnei āhuatanga ina pakaru te ate, ā, ka nui haere ngā paitini i roto i te toto.
He mea nui: Hei whiwhi i ngā hua tino tika mai i ēnei whakamātautau, ka tonoa pea koe kia kaua e kai, e inu rānei mō ētahi haora i mua i te whakamātautau (nohopuku). Nō reira, pātai atu ki tō tākuta he aha ngā whakaritenga e tika ana kia mahia e koe.
Kāore pea ēnei whakamātautau e mahia i te rā kotahi, i te wāhi kotahi rānei. Kāore he aha. Kia whiwhi te tākuta i ngā hua o ēnei whakamātautau katoa, ka tāpirihia katoatia e rātou hei tatau i tō kaute Child-Pugh.
Me pēhea te tatau i te kaute Child-Pugh?
He tino māmā noa iho. Ka tirohia e ngā tākuta ngā āhuatanga e rima kua whakahuatia ake nei e pā ana ki te hauora o tō ate. Ka taea te hoatu i tētahi kaute 1, 2, 3 rānei ki ia āhuatanga, i runga i tō āhua. (Ko te kaute 1 te mea tino kino, ko te kaute 3 te mea tino kino).
I muri i te tātaitanga i ngā āhuatanga e rima, ka tāpirihia katoatia e te tākuta. Ka whiwhi koe i te tapeke o ngā kaute i waenga i te 5 me te 15. Koinā tō kaute Child-Pugh.
Anei tētahi tūtohi e whakaatu ana i te tukunga o ngā kaute i runga i ngā hua o aua āhuatanga e rima:
| Tauwehe | Kaute 1 | Kaute 2 | Kaute 3 |
| :------------------------------------------------------- | :--------------------------------------- | :------------------------------------- | :------------------------------------------ |
| Pirirupini (Bilirupini katoa) (mg/dL) | < 2 | 2 - 3 | > 3 |
| Serum albumin (Serum albumin) (g/dL) | > 3.5 | 2.8 - 3.5 | <2.8 |
| INR (te toto totoka) | < 1.7 | 1.7 - 2.3 | > 2.3 |
| Ngā Ascites | Kāore | Iti/Whakahaeretia | Waenga/Whakahaeretia Kino |
| Te Matepukupuku o te Ao | Kāore | Taumata 1-2 (Ngawari/Waenga) | Taumata 3-4 (Nui) |
I runga i te tapeke o te kaute ka riro i a koe, ka whakarōpūtia koe ki ngā wāhanga matua e toru:
- Akomanga A: Kei te mahi pai tō ate. Kei waenga i te 5 me te 6 tō kaute katoa.
- Akomanga B: He paku kino te ate. Kei waenga i te 7 me te 9 tō kaute katoa.
- Akomanga C: He kino nui ki te ate, he mate kua horapa rānei. Kei waenga i te 10 me te 15 tō kaute.
Kia kite tātou i tētahi tauira?
Whakaarohia ko ngā hua o te whakamātautau a tetahi e whai ake nei:
- Pirirupini - 3 mg/dL (2 ngā tohu)
- Pūmua - 2.9 g/dL (2 ngā tohu)
- INR - 1 (1 tohu)
- He wai i roto i te puku (Ascites) - iti (2 ngā tohu)
- Te mate pukupuku roro - Kāore (1 tohu)
Ko te kaute Child-Pugh a tēnei tangata ko 2 + 2 + 1 + 2 + 1 = 8 ngā tohu . Ko te tikanga kei roto ia i te Akomanga B.
He aha te tikanga o tō Kaute Child-Pugh?
Mā tēnei kaute ka kitea te āhua o tō mate ate i taua wā tonu. Ka whakamōhio atu ki tō tākuta te pai o te mahi a tō ate i runga i ēnei āhuatanga e rima. Mā te kaute Child-Pugh tō tākuta e āwhina:
- Hangaia tāu mahere maimoatanga: Mā tēnei koe e āwhina ki te whakatau mēnā ka rongoatia koe ki te rongoā, ki te pokanga, ki te whakawhitinga ate rānei, ā, mēnā ka angitu aua maimoatanga.
- Aromatawaihia te mōrearea:Mena kei te pokanga koe, mā tēnei koe e āwhina ki te whakatau i te mōrearea me te whai hua mō tō hauora whānui. Mena ka angitu te pokanga, ka taea hoki te matapae i te kounga o tō oranga i muri i te pokanga.
- Whakatau tataitia tō oranga: Ahakoa he whakatau tatai noa iho ngā matapae mō te roa o te oranga, ka taea e tō tākuta te whakamahi i tēnei hei matapae i te roa o tō oranga, me te kore maimoatanga, i runga i tō kaute.
Kia maumahara, nā te tākuta tēnei katoa i whakatau. He aratohu noa iho tēnei kāri kaute mā rātou.
Āhea ahau me toro atu ki taku tākuta?
Mena he pātai āu mō tō kaute Child-Pugh, mō te āhua rānei o te tatau, me kōrero ki tō tākuta . Mena he āwangawanga āu mō ngā hua o tō whakamātautau, mō ngā mea rānei ka whai ake i roto i tō mahere maimoatanga, me kōrero anō hoki ki tō tākuta.
Kei a koe he kaute e whakaatu ana i te hauora o tō ate. Nā, me aha koe ināianei? Tuatahi, kaua e noho noa ki ēnei kaute, ki ngā hua rānei o te whakamātautau me te kore e kōrero ki tō tākuta. Ka taea e rātou te whakamārama i ō hua ki a koe me ō rātou tikanga. Mā tō kaute Child-Pugh rātou e āwhina ki te whakatau i tō mahere maimoatanga. Engari he wāhanga anō hoki koe o taua whakatau. Nō reira, kōrero ki tō tīma hauora mō te tikanga o tō kaute me ā rātou taunakitanga. Kaua e manukanuka, kei konei rātou hei āwhina.
Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)
He taputapu nui te Kaute Child-Pugh mō te ine i te hauora o te ate, engari kāore e taea te whakaatu i te pūrākau katoa.
- Ka taea e tēnei te hoatu he whakaaro pai ki ngā tākuta mō te hauora o tō ate.
- Mā tēnei ka āwhina i te whakamahere maimoatanga me te aromatawai i ngā mōrearea.
- Kaua e manukanuka ki ngā kaute anake. Kōrerohia ngā mea katoa ki tō tākuta.
- Whakauru atu ki te whakatau kaupapa mō tō hauora.
He tino nui te ate i roto i tō tātou tinana. Ko tā tātou kawenga he tiaki i a ia. Ki te pāngia koe e te mate ate, me whai i ngā tohutohu a tō tākuta. Kia ora tō āhua noho. Kātahi ka kore koe e manukanuka ki ēnei tohu. Ka pai ngā mea katoa!
Kaute Child-Pugh, ate, cirrhosis, mate ate, bilirubin, albumin, mahi ate
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