Ngaba ugqirha wakho ukuxelele ukuba unesifo sesibindi, ingakumbi isifo sesibindi? Usenokuba ukhe weva umntu esithi, "Inqaku lakho le-Child-Pugh yile." Kuqhelekile ukuba uzive usoyika xa usiva loo nto. Yintoni kanye kanye i-Child-Pugh Score? Ithini ngemeko yesibindi sakho? Ngaba kufuneka ukhathazeke ngale nkqubo yokufumana amanqaku? Namhlanje, siza kuthetha ngayo yonke le nto ngendlela elula kakhulu onokuyiqonda.
Ngamafutshane, yintoni le Child-Pugh Score?
Cinga ngayo njenge 'ikhadi lengxelo' esilinikwe esikolweni ukulinganisa inkqubela yethu, i-Child-Pugh Score ifana 'nekhadi lengxelo' elinika oogqirha umbono wempilo yesibindi sakho. Le ayisiyo inqaku elinikwa luvavanyo olunye. Yinkqubo yokufumana amanqaku ehlola iinkalo ezahlukeneyo zomzimba wakho, izinike inqaku, ize izidibanise.
Ngale nkqubo yokufumana amanqaku, ugqirha angaqonda ngokucacileyo oku:
- Isibindi sakho sisebenza kakuhle kangakanani ngoku?
- Iyintoni ingozi yokungasebenzi kakuhle kwesibindi?
- Yeyiphi indlela engcono yonyango kuwe? (Umzekelo, ngaba amayeza anele, okanye ndifanele ndicinge ngento efana nokufakelwa isibindi?)
Le nkqubo yokufumana amanqaku ivumela ugqirha naphi na emhlabeni ukuba afumane umbono ofanayo nocacileyo wemeko yesibindi sakho. Ngamanye amaxesha ibizwa ngokuba yi-Child-Turcotte-Pugh score.
Zeziphi izinto ezi-5 eziphambili ezimisela eli nqaku?
Ukuze ubale amanqaku akho e-Child-Pugh, ugqirha wakho uza kujonga izinto ezintlanu eziphambili. Ezintathu kwezi zizinto ezivavanywa ngesampulu yegazi lakho. Eminye emibini zizinto ezifunyanwa ngovavanyo lomzimba kunye neeskeni. Makhe sijonge ukuba ziyintoni na.
1. Amanqanaba eBilirubin ewonke egazini: IBilirubin yinkunkuma etyheli eveliswa xa iiseli zethu ezibomvu zegazi ziqhekeka. Isibindi esisempilweni siyayisusa le nto emzimbeni. Xa isibindi sonakele, siqala ukuqokelelana egazini. Kulapho ulusu namehlo ejika abe tyheli (i-jaundice).
2. Inqanaba le-Albumin yeSerum: I-Albumin yiproteni ebaluleke kakhulu eyenziwa sisibindi. Inceda ukugcina ulwelo kwimithambo yegazi yethu. Xa isibindi sibuthathaka, imveliso yale proteni iyancipha.
3. Ixesha leProthrombin okanye i-INR: Xa senzakele ndaweni ithile, ukopha kuyayeka ngenxa yokuba igazi liyaqhekeka. Uninzi lwezinto ezibangela ukujiya kwegazi ezifunekayo ukuze igazi lijiye zenziwa sisibindi. Xa isibindi sibuthathaka, le nkqubo iyehla. Oko kuthetha ukuba ixesha elithathwayo ukuze igazi lijiye liyanda.
4. Ukuqokelelana kolwelo esiswini (ii-Ascites):Xa isibindi singasebenzi kakuhle, ingakumbi xa amanqanaba e-albumin ephantsi, ulwelo lunokuvuza kwimithambo yegazi luze luqokeleleke kwisisu. Oku kubizwa ngokuba yi-ascites. Oku kubangela ukuba isisu sivuvuke phambili kwaye sibonakale sidumbile.
5. I-Hepatic Encephalopathy: Xa isibindi singakwazi ukususa ityhefu emzimbeni ngokufanelekileyo, ezo tyhefu ziyaqokelelana egazini zize ziye engqondweni. Oku kunokuchaphazela izinto ezifana nenkumbulo, ukuziphatha, kunye nokuqonda. Iimpawu zinokubandakanya ukozela, ukudinwa, kunye nobunzima bokugxila.
Ngokusekelwe kwiziphumo zovavanyo lwakho kwezi zinto zintlanu, uza kunikwa amanqaku ayi-1, 2, okanye ama-3 kwinto nganye. Amanqaku ayi-1 yeyona meko ilungileyo, kwaye amanqaku ayi-3 yeyona meko imbi kakhulu.
| Indawo yokujonga | Inqaku 1 (imeko engcono kakhulu) | Inqaku lesi-2 (imeko ephakathi) | Inqaku lesi-3 (imeko enzima kakhulu) |
|---|---|---|---|
| I-Bilirubin (I-Bilirubin iyonke) (mg/dL) | Ngaphantsi kwe-2 | Phakathi kwe-2 kunye ne-3 | Ngaphezulu kwe-3 |
| I-Serum Albumin (g/dL) | Ngaphezulu kwe-3.5 | Phakathi kwe-2.8 kunye ne-3.5 | Ngaphantsi kwe-2.8 |
| Ixabiso le-INR | Ngaphantsi kwe-1.7 | Phakathi kwe-1.7 kunye ne-2.3 | Ngaphezulu kwe-2.3 |
| Ulwelo esiswini (ii-Ascites) | Hayi | Kukho intwana encinci. | Kukho okuninzi. |
| I-Encephalopathy (ukungasebenzi kakuhle kwengqondo) | Hayi | Ibanga 1-2 (elincinci) | Ibanga lesi-3-4 (elinzima) |
Ungayihlela njani imeko ngokwamanqaku ewonke?
Ngoku dibanisa onke amanqaku owafumeneyo kula manqaku ma-5 akhankanyiweyo apha ngasentla. Emva koko uza kufumana amanqaku apheleleyo phakathi kwama-5 nama-15. Ngokusekelwe kweli nqaku, uza kwahlulwahlulwa ube ziindidi ezintathu eziphambili (iiKlasi).
- Iklasi A (amanqaku ama-5-6): Oku kuthetha ukuba isibindi sakho sisasebenza kakuhle . Nangona kukho umonakalo, isibindi siyakwazi ukusilawula kwaye sisebenze kwinqanaba elamkelekileyo.
- Udidi B (amanqaku 7-9): Oku kuthetha ukuba ukusebenza kwesibindi kunciphile kancinci . Kukho umonakalo othile kwisibindi.
- Udidi C (amanqaku ali-10-15): Oku kuthetha ukuba isibindi sonakele kakhulu kwaye umsebenzi waso awusebenzi kakuhle . Eli linqanaba elifuna ingqalelo enkulu.
La manqaku kunye neklasi ayisosiphelo sobomi bakho. Le yikhampasi nje yokunceda ugqirha akuncede. Ngoko ke ungakhathazeki ngala manqaku kuphela.
Kutheni le nkqubo yokufumana amanqaku ibalulekile kugqirha?
Inqaku lakho le-Child-Pugh lilulwazi olubaluleke kakhulu kugqirha wakho. Limnceda ukuba enze izigqibo ezibalulekileyo ezininzi.
- Khetha unyango olukufaneleyo: Amanqaku akho aya kugqiba ukuba unokunyangelwa ngamayeza kuphela, nokuba udinga ezinye iindlela zonyango ezikhethekileyo, okanye nokuba kufuneka ucinge ngokufakelwa isibindi.
- Vavanya umngcipheko wotyando: Ukuba umntu onesifo sesibindi udinga utyando ngesinye isizathu, la manqaku anceda ekuqinisekiseni ukuba umzimba unako na ukumelana notyando. Utyando lomntu okwiKlasi C luyingozi ngakumbi kunomntu okwiKlasi A.
- Fumana umbono wekamva:Le nkqubo yamanqaku ingakunika umbono ocacileyo (ukuxela kwangaphambili) wendlela imeko yakho eza kuqhubeka ngayo kunye namathuba akho okusinda, nokuba unyangiwe okanye awunyangwa. Kodwa khumbula, ezi ziingqikelelo nje. Ngonyango olufanelekileyo kunye notshintsho lwendlela yokuphila, ezi meko zinokutshintsha kakhulu.
Ukuba ukhe wafumanisa ngeChild-Pugh Score yakho, thetha ngokukhululekileyo nogqirha wakho malunga nokuba ithetha ukuthini kunye nento omawuyenze ngokulandelayo. Buza nayiphi na imibuzo onayo. Kubalulekile ukuba ngumthathi-nxaxheba okhutheleyo kuhambo lwakho lonyango.
Umyalezo Wokuya Ekhaya
- Inqaku le-Child-Pugh lifana 'nekhadi lengxelo' elilinganisa impilo yesibindi sakho. Ayilovavanyo olunye, kodwa yinkqubo yokufumana amanqaku esekelwe kwizinto ezi-5.
- Oku kusekelwe kwizinto ezifana ne-bilirubin egazini, i-albumin, izinga lokujiya kwegazi, ulwelo esiswini, kunye nefuthe ekusebenzeni kwengqondo.
- Ngokuxhomekeke kumanqaku akho, uza kuhlelwa ngokweCandelo A, B, okanye C. ICandelo A lelona lilungileyo kwaye iCandelo C lelona libi kakhulu.
- Ungakhathazeki ngala manqaku. Zisikhokelo nje sokunceda ugqirha wakho akunike unyango olungcono.
- Soloko uthetha ngokucacileyo nogqirha wakho malunga neempawu zakho, intsingiselo yazo, kunye namanyathelo alandelayo omawuwathathe.
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