Ingabe udokotela wakho ukutshelile ukuthi unesifo sesibindi, ikakhulukazi i-cirrhosis? Kungenzeka ukuthi uke wezwa othile ethi, "I-Child-Pugh Score yakho yilokhu." Kuvamile ukuzizwa wesaba uma uzwa lokho. Iyini ngempela i-Child-Pugh Score? Ithini ngesimo sesibindi sakho? Ingabe kufanele ukhathazeke ngalolu hlelo lokuthola amaphuzu? Namuhla, sizoxoxa ngakho konke lokhu ngendlela elula kakhulu ongayiqonda.
Kalula nje, iyini le Child-Pugh Score?
Cabanga ngakho 'njengekhadi lombiko' esilinikwe esikoleni ukuze silinganise intuthuko yethu, i-Child-Pugh Score ifana 'nekhadi lombiko' elinikeza odokotela umbono wempilo yesibindi sakho. Lokhu akuyona amaphuzu anikezwa ukuhlolwa okukodwa. Kuyisistimu yokulinganisa ehlola izici eziningana zomzimba wakho, izinike amaphuzu, bese izihlanganisa ndawonye.
Ngalesi simiso sokuthola amaphuzu, udokotela angaqonda ngokucacile:
- Isibindi sakho sisebenza kahle kangakanani njengamanje?
- Iyini ingozi yokwehluleka kwesibindi?
- Iyiphi indlela yokwelapha engcono kakhulu kuwe? (Isibonelo, ingabe imithi yanele, noma kufanele ngicabangele into efana nokufakelwa isibindi?)
Lolu hlelo lokuhlola luvumela udokotela noma kuphi emhlabeni ukuthi athole umbono ofanayo nocacile ngesimo sesibindi sakho. Ngezinye izikhathi lubizwa ngokuthi isikolo se-Child-Turcotte-Pugh.
Yiziphi izici ezi-5 eziyinhloko ezinquma leli phuzu?
Ukuze abale i-Child-Pugh Score yakho, udokotela wakho uzobheka izici ezinhlanu eziyinhloko. Ezintathu zalezi zinto zihlolwa ngesampula yegazi lakho. Ezinye ezimbili izinto ezitholakala ngokuhlolwa ngokomzimba kanye nokuskena. Ake sibheke ukuthi ziyini.
1. Amazinga E-Bilirubin Egazini: I-Bilirubin iwumkhiqizo ophuzi okhiqizwa lapho amangqamuzana ethu abomvu ephuka. Isibindi esinempilo siyawususa lo mkhiqizo emzimbeni. Lapho isibindi sonakele, siqala ukunqwabelana egazini. Yilapho isikhumba namehlo ephenduka aphuzi (i-jaundice).
2. Izinga le-Albumin egazini: I-Albumin iyiprotheni ebaluleke kakhulu eyenziwe yisibindi. Isiza ukugcina uketshezi emithanjeni yegazi yethu. Uma isibindi sibuthakathaka, ukukhiqizwa kwale protheni kuyancipha.
3. Isikhathi se-Prothrombin noma i-INR: Uma silimala ndawana thize, ukuphuma kwegazi kuyayeka ngoba igazi liyagoba. Iningi lezinto ezibangela ukugoba kwegazi ezidingekayo ukuze igazi ligobe lenziwe yisibindi. Uma isibindi sibuthakathaka, le nqubo iyehla. Lokho kusho ukuthi isikhathi esithathayo ukuze igazi ligobe siyanda.
4. Ukuqongelela koketshezi esiswini (ama-Ascites):Uma isibindi singasebenzi kahle, ikakhulukazi lapho amazinga e-albumin ephansi, uketshezi lungavuza emithanjeni yegazi bese luqoqana emgodini wesisu. Lokhu kubizwa ngokuthi i-ascites. Lokhu kubangela ukuthi isisu sivuvuke phambili futhi sibonakale sivuvukele.
5. I-Hepatic Encephalopathy: Uma isibindi singakwazi ukususa ubuthi emzimbeni ngendlela efanele, labo buthi buqoqana egazini bese buya ebuchosheni. Lokhu kungathinta izinto ezifana nenkumbulo, ukuziphatha, kanye nokuqonda. Izimpawu zingase zihlanganise ukozela, ukudinwa, kanye nobunzima bokugxilisa ingqondo.
Ngokusekelwe emiphumeleni yakho yokuhlolwa kwalezi zici ezinhlanu, uzonikezwa amaphuzu angu-1, 2, noma 3 ngesici ngasinye. Amaphuzu angu-1 yisimo esihle kakhulu, kanti amaphuzu angu-3 yisimo esibi kakhulu.
| Indawo yokuhlola | Isikolo 1 (isimo esingcono kakhulu) | Isikolo 2 (isimo esimaphakathi) | Isilinganiso 3 (isimo esibucayi kakhulu) |
|---|---|---|---|
| I-Bilirubin (I-Bilirubin Ephelele) (mg/dL) | Ngaphansi kuka-2 | Phakathi kuka-2 no-3 | Ngaphezu kwe-3 |
| I-Albumin ye-Serum (g/dL) | Ngaphezu kuka-3.5 | Phakathi kuka-2.8 no-3.5 | Ngaphansi kuka-2.8 |
| Inani le-INR | Ngaphansi kuka-1.7 | Phakathi kuka-1.7 no-2.3 | Ngaphezu kuka-2.3 |
| Uketshezi esiswini (ama-Ascites) | Cha | Kukhona okuncane. | Kuningi. |
| I-Encephalopathy (ukungasebenzi kahle kobuchopho) | Cha | Ibanga 1-2 (elincane) | Ibanga 3-4 (elinzima kakhulu) |
Ungasihlela kanjani isimo ngenani eliphelele lamaphuzu?
Manje hlanganisa wonke amaphuzu owatholile ngamaphuzu ama-5 okukhulunywe ngawo ngenhla. Ngemuva kwalokho uzothola amaphuzu aphelele aphakathi kuka-5 no-15. Ngokusekelwe kulo maphuzu, uzohlukaniswa ngezigaba ezintathu eziyinhloko (Amakilasi).
- Isigaba A (amaphuzu angu-5-6): Lokhu kusho ukuthi isibindi sakho sisasebenza kahle . Ngisho noma kukhona umonakalo, isibindi siyakwazi ukusiphatha futhi sisebenze ezingeni elamukelekayo.
- Isigaba B (amaphuzu 7-9): Lokhu kusho ukuthi ukusebenza kwesibindi kuncishisiwe ngokulinganisela . Kukhona umonakalo othile esibindini.
- Isigaba C (amaphuzu ayi-10-15): Lokhu kusho ukuthi isibindi sonakele kakhulu futhi ukusebenza kwaso kubi kakhulu . Leli yizinga elidinga ukunakwa okukhulu.
Leli phuzu kanye nekilasi akusona isiphetho sempilo yakho. Leli yikhampasi nje yokusiza udokotela akusize. Ngakho ungakhathazeki ngalezi phuzu zodwa.
Kungani lolu hlelo lokuthola amaphuzu lubalulekile kudokotela?
I-Child-Pugh Score yakho iwulwazi olubaluleke kakhulu kudokotela wakho. Lumsiza ukuthi enze izinqumo eziningana ezibalulekile.
- Khetha ukwelashwa okufanele wena: Amaphuzu akho azonquma ukuthi ungelashwa ngemithi yodwa, ukuthi udinga ezinye izindlela zokwelapha ezikhethekile, noma ukuthi kufanele ucabangele ukufakelwa isibindi.
- Hlola ingozi yokuhlinzwa: Uma umuntu onesifo sesibindi edinga ukuhlinzwa ngesinye isizathu, la maphuzu asiza ekunqumeni ukuthi umzimba ungakwazi yini ukubhekana nokuhlinzwa. Ukuhlinzwa komuntu osesigabeni C kuyingozi kakhulu kunomuntu osesigabeni A.
- Thola umbono wesikhathi esizayo:Lolu hlelo lokuhlola lungakunikeza umbono oqondile (ukubikezela) ukuthi isimo sakho sizoqhubeka kanjani kanye namathuba akho okusinda, ngokwelashwa nangaphandle kokwelashwa. Kodwa khumbula, lokhu kumane kuyizilinganiso. Ngokwelashwa okufanele kanye nezinguquko zendlela yokuphila, lezi zimo zingashintsha kakhulu.
Uma kwenzeka uthola ulwazi nge-Child-Pugh Score yakho, khuluma ngokukhululekile nodokotela wakho ngokuthi kusho ukuthini nokuthi yini okufanele uyenze ngokulandelayo. Buza noma yimiphi imibuzo onayo. Kubalulekile ukubamba iqhaza ohambweni lwakho lokwelashwa.
Umlayezo Wokuya Nawe Ekhaya
- I-Child-Pugh Score ifana 'nekhadi lombiko' elilinganisa impilo yesibindi sakho. Akuyona isivivinyo esisodwa, kodwa uhlelo lokuthola amaphuzu olusekelwe ezintweni ezi-5.
- Lokhu kusekelwe ezicini ezifana ne-bilirubin egazini, i-albumin, izinga lokujiya kwegazi, uketshezi esiswini, kanye nomthelela ekusebenzeni kobuchopho.
- Kuye ngesikolo sakho, uzohlukaniswa ngeSigaba A, B, noma C. Isigaba A yisimo esihle kakhulu kanti iSigaba C yisona esibi kakhulu.
- Ungakhathazeki ngalezi zibalo. Zimane nje ziyisiqondiso sokusiza udokotela wakho akunike ukwelashwa okungcono kakhulu.
- Khuluma nodokotela wakho ngokucacile njalo ngezimpawu zakho, ukuthi zisho ukuthini, kanye nezinyathelo ezilandelayo okufanele uzithathe.
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