Kodi thanzi la chiwindi chanu lili bwanji? Dziwani zambiri pogwiritsa ntchito Child-Pugh Score!

Nthawi zina madokotala akatiuza mawu atsopano kapena mayeso atsopano azachipatala, timachita mantha pang'ono, eti? Zimenezo ndi zachilendo. Lero tikambirana za chinthu chomwe mwina mudamvapo, kapena chomwe mungamve mtsogolo. Chimatchedwa Child-Pugh Score . Musachite mantha mukamva dzinali, chifukwa ndi njira yongothandiza madokotala kumvetsetsa momwe chiwindi chanu chilili. Tiyeni tikambirane momveka bwino.

Kodi Child-Pugh Score ndi chiyani? Mwachidule...

Taganizirani izi monga momwe mukapita ndi galimoto yanu ku malo operekera chithandizo, katswiri amafufuza zinthu zosiyanasiyana ndikukuuzani za momwe galimoto yanu ilili. Chiwerengero cha Child-Pugh ndi njira yowunikira momwe chiwindi chikugwira ntchito bwino mwa munthu amene ali ndi matenda a chiwindi kwa nthawi yayitali , makamaka matenda a chiwindi otchedwa cirrhosis, matenda omwe mafuta amasonkhana m'chiwindi ndikuchipangitsa kukhala cholimba.

Mwachidule, njira iyi yopezera zigoli imathandiza madokotala kumvetsetsa zotsatirazi:

• Kodi chiwindi chanu chikugwira ntchito bwino bwanji?
• Kodi pali chiopsezo cha kulephera kwa chiwindi? Kodi pali mwayi wotani?
• Ndi mtundu wanji wa chithandizo chomwe chili chabwino kwa inu?

Izi zimachitanso china. Zimathandiza madokotala padziko lonse lapansi kulankhula za vuto la chiwindi chanu mwanjira yomweyo. Nthawi zina zimatchedwa ``Child-Turcotte-Pugh (CTP) calculator.'' Koma kumbukirani, ngakhale kuti mfundo iyi ndi yofunika, siifotokoza nkhani yonse yokhudza thanzi lanu. Ndi gawo limodzi lokha.

Ndi zinthu ziti zisanu zomwe zikuganiziridwa apa?

Madokotala amafufuza zinthu zisanu zazikulu kuti awerengere kuchuluka kwa Child-Pugh. Izi ndi izi:

1. Mulingo wonse wa bilirubin m'magazi: Bilirubin ndi chinthu chachikasu chomwe chimapezeka mu ndulu ya thupi lathu. Chimagwiritsidwa ntchito poyesa ngati chiwindi chikugwira ntchito bwino. Chikawonjezeka, maso ndi khungu zimakhala zachikasu (monga jaundice).

2. Kuchuluka kwa albumin m'magazi: Albumin ndi puloteni yopangidwa ndi chiwindi chanu. Imathandiza kunyamula zakudya m'thupi lonse. Chiwindi chanu chikakhala chofooka, chimapanga puloteni yochepa.

3. Kuchuluka kwa magazi anu omwe amaundana mofulumira (Prothrombin time kapena INR): Chiwindi chimakhudzidwanso ndi kuchuluka kwa magazi omwe amaundana mofulumira. Izi zili choncho chifukwa zinthu zina zofunika kuti magazi aziundana zimapangidwa m'chiwindi. Kuwonjezeka kwa nthawi imeneyi kumatanthauza kuti zimatenga nthawi yayitali kuti magazi aziundana.

4. Mafinya: Izi zikutanthauza kusonkhana kwa madzi m'mimba mwanu (m'mimba). Izi zitha kuchitika matenda a chiwindi monga cirrhosis akakula kwambiri.

5. Kodi ntchito ya ubongo imakhudzidwa ndi matenda a chiwindi (Encephalopathy):Chiwindi chikawonongeka, poizoni wina amene ayenera kuchotsedwa m'thupi amatha kudziunjikira m'magazi. Izi zimatha kupita ku ubongo ndikukhudza momwe ubongo umagwirira ntchito. Izi zingayambitse kusintha kwa zinthu monga kukumbukira, chidwi, ndi khalidwe.

Chilichonse mwa zinthu zisanuzi chimapatsidwa chigoli kutengera zotsatira za mayeso anu. Kenako, zonsezo zimawonjezedwa pamodzi kuti mupeze chigoli chonse. Chifukwa chake, mumagawidwa m'magulu atatu: A, B, kapena C.

Kodi ndiyenera kukonzekera bwanji Child-Pugh Score?

Kuti muwerengere kuchuluka kwa Child-Pugh kumeneku, muyenera kuyesedwa kangapo. Izi zingaphatikizepo kuyezetsa thupi , kuyezetsa magazi , komanso mwina kuyezetsa zithunzi .

Dokotala adzakufunsani kuti muyese magazi kuti muwone ngati pali zinthu izi:

• Mlingo wa Bilirubin: Monga tanenera kale, uwu ndi muyeso wa momwe chiwindi chimagwira ntchito.
• Mulingo wa Albumin: Puloteni yopangidwa ndi chiwindi yomwe imanyamula zakudya.
• Nthawi ya Prothrombin (PT) kapena INR: Liwiro limene magazi amaundana.

Dokotala wanu angachite ultrasound ya m'mimba kapena CT scan kuti aone ngati madzi akuchulukana m'mimba mwanu (ascites). Ascites ndi kuchulukana kwa madzi owonjezera m'mimba. Cirrhosis ndiye chifukwa chachikulu cha izi.

Kuyezetsa thupi ndi/kapena kuyezetsa ubongo kungachitike kuti muwone ngati chiwindi chawonongeka chomwe chimakhudza ubongo (encephalopathy). Matendawa amatha kuchitika chiwindi chikawonongeka ndipo poizoni amasonkhana m'magazi.

Chofunika: Kuti mupeze zotsatira zolondola kwambiri kuchokera ku mayesowa, mungapemphedwe kuti musadye kapena kumwa kwa maola angapo mayeso asanayambe (kusala kudya). Chifukwa chake, funsani dokotala wanu kukonzekera komwe muyenera kuchita.

Mayeso awa sangachitike tsiku lomwelo kapena pamalo omwewo. Palibe vuto. Dokotala akalandira zotsatira za mayeso onsewa, amawaphatikiza onse kuti awerengere kuchuluka kwa mayeso anu a Child-Pugh.

Kodi chiwerengero cha Child-Pugh chimawerengedwa bwanji?

Ndi zophweka kwambiri. Madokotala amaona zinthu zisanu zomwe zatchulidwa pamwambapa zokhudzana ndi thanzi la chiwindi chanu. Zinthu zonsezi zitha kupatsidwa chigoli cha 1, 2, kapena 3, kutengera matenda anu. (Chigoli 1 ndi chocheperako, chigoli 3 ndi choopsa kwambiri).

Dokotala akamaliza kulemba mfundo zonse zisanu, amawaphatikiza onse. Mumapeza mfundo zonse pakati pa 5 ndi 15. Imeneyo ndiye mfundo yanu ya Child-Pugh.

Nayi tchati chosonyeza momwe zigoli zimaperekedwera kutengera zotsatira za zinthu zisanu izi:

| Chinthu | Zigoli 1 | Zigoli 2 | Zigoli 3 |

| :- ...

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

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

| INR (kuundana kwa magazi) | < 1.7 | 1.7 - 2.3 | > 2.3 |

| Ascites | Palibe | Yochepa/Yolamulidwa | Yocheperako/Yosalamulirika Bwino |

| Matenda a Encephalopathy | Palibe | Giredi 1-2 (Yofatsa/Yapakati) | Giredi 3-4 (Yoopsa) |

Kutengera ndi zigoli zonse zomwe mwalandira, mudzagawidwa m'magulu atatu akuluakulu:

• Kalasi A: Chiwindi chanu chikugwira ntchito bwino. Chiwerengero chonse cha zigoli zanu chili pakati pa 5 ndi 6.
• Kalasi B: Pali kuwonongeka pang'ono kwa chiwindi. Chiwerengero chonse cha zigoli zanu chili pakati pa 7 ndi 9.
• Kalasi C: Kuwonongeka kwakukulu kwa chiwindi kapena matenda opitirira muyeso. Zigoli zanu zili pakati pa 10 ndi 15.

Tiyeni tiwone chitsanzo?

Tangoganizani kuti zotsatira za mayeso a munthu wina ndi izi:

• Bilirubin - 3 mg/dL (mapointi awiri)
• Albumin - 2.9 g/dL (mapointi awiri)
• INR - 1 (mfundo imodzi)
• Madzi m'mimba (Ascites) - pang'ono (mapointi awiri)
• Encephalopathy - Ayi (mfundo imodzi)

Chigoli cha Child-Pugh cha munthu uyu ndi 2 + 2 + 1 + 2 + 1 = mapointi 8. Izi zikutanthauza kuti ali mu kalasi B.

Kodi Child-Pugh Score yanu imatanthauza chiyani?

Zigoli izi zikuwonetsa momwe chiwindi chanu chikugwirira ntchito panthawiyo. Zimauza dokotala wanu momwe chiwindi chanu chikugwira ntchito bwino kutengera zinthu zisanu izi. Zigoli za Child-Pugh zimathandiza dokotala wanu:

• Konzani dongosolo lanu la chithandizo: Izi zikuthandizani kusankha ngati mudzalandira chithandizo ndi mankhwala, opaleshoni, kapena kuikidwa chiwindi , komanso ngati chithandizocho chidzapambana.
• Unikani zoopsa:Ngati mukuchitidwa opaleshoni, izi zikuthandizani kudziwa momwe zimakhalira zoopsa komanso zothandiza pa thanzi lanu lonse. Ngati opaleshoniyo yapambana, ingathenso kuneneratu momwe moyo wanu udzakhalire mukatha opaleshoniyo.
• Yerekezerani kupulumuka kwanu: Ngakhale kuti kuneneratu nthawi yopulumuka ndi kungoyerekeza chabe, dokotala wanu angagwiritse ntchito izi kuti aneneretu nthawi yomwe mungakhale ndi moyo, ndi chithandizo kapena ayi, kutengera zigoli zanu.

Kumbukirani, zonsezi zimasankhidwa ndi dokotala. Khadi la zigoli ili ndi chitsogozo kwa iwo.

Ndiyenera kupita liti kwa dokotala wanga?

Ngati muli ndi mafunso okhudza chigoli chanu cha Child-Pugh kapena momwe chinawerengedwera, onetsetsani kuti mwalankhula ndi dokotala wanu . Ngati muli ndi nkhawa iliyonse yokhudza zotsatira za mayeso anu kapena zomwe zidzachitike pambuyo pake mu dongosolo lanu la chithandizo, uzani dokotala wanu za zimenezo.

Tsopano muli ndi zigoli zomwe zimakuuzani za thanzi la chiwindi chanu. Ndiye kodi mukuchita chiyani tsopano? Choyamba, musamangoganizira za zigoli izi kapena zotsatira za mayeso popanda kulankhula ndi dokotala wanu. Angakuuzeni zotsatira zanu ndi tanthauzo lake. Zigoli zanu za Child-Pugh zimawathandiza kusankha dongosolo lanu la chithandizo. Koma inunso muli mbali ya chisankho chimenecho. Chifukwa chake, lankhulani ndi gulu lanu lachipatala za tanthauzo la zigoli zanu ndi zomwe amalimbikitsa. Musadandaule, ali pano kuti akuthandizeni.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Child-Pugh Score ndi chida chofunikira poyesa thanzi la chiwindi, koma sichifotokoza nkhani yonse.

• Izi zingapatse madokotala lingaliro labwino la thanzi la chiwindi chanu.
• Izi zimathandiza kukonzekera chithandizo ndikuwunika zoopsa.
• Musadandaule za zigoli zokha. Kambiranani zonse ndi dokotala wanu.
• Chitani nawo mbali popanga zisankho zokhudzana ndi thanzi lanu.

Chiwindi ndi chiwalo chofunikira kwambiri m'thupi lathu. Ndi udindo wathu kuchiteteza. Ngati muli ndi vuto la chiwindi, tsatirani malangizo a dokotala wanu molondola. Khalani ndi moyo wathanzi. Mukatero simudzadandaula ndi zizindikiro zotere. Zonse zikhala bwino!

Chiwerengero cha Child -Pugh, chiwindi, cirrhosis, matenda a chiwindi, bilirubin, albumin, ntchito ya chiwindi