Injani impilo yesibindi sakho? Thola ulwazi nge-Child-Pugh Score!

Ngezinye izikhathi lapho odokotela besitshela amagama amasha noma izivivinyo ezintsha zezokwelapha, siba novalo kancane, akunjalo? Lokho kuvamile. Namuhla sizokhuluma ngento okungenzeka ukuthi uyizwile, noma ongase uyizwe esikhathini esizayo. Ibizwa ngokuthi i-Child-Pugh Score . Ungakhathazeki uma uzwa leli gama, ngoba liyindlela nje yokusiza odokotela baqonde isimo sesibindi sakho. Ake sixoxe ngayo kalula nangokucacile.

Iyini i-Child-Pugh Score? Kalula nje...

Cabanga ngakho njengokuthi uma uyisa imoto yakho esikhungweni senkonzo, uchwepheshe uhlola izinto ezahlukene futhi akutshele ngesimo semoto yakho. Isilinganiso se-Child-Pugh siyindlela yokuhlola ukuthi isibindi sisebenza kahle kangakanani kumuntu onesifo sesibindi sesikhathi eside , ikakhulukazi i-cirrhosis, isimo lapho amafutha anqwabelana khona esibindini futhi asenze sibe lukhuni.

Kalula nje, lolu hlelo lokuthola amaphuzu luvumela odokotela ukuthi baqonde okulandelayo:

• Isibindi sakho sisebenza kahle kangakanani?
• Ingabe ikhona ingozi yokwehluleka kwesibindi? Kungenzeka kangakanani lokho?
• Uhlobo luni lokwelashwa olungcono kakhulu kuwe?

Lokhu kwenza okunye. Kusiza odokotela emhlabeni wonke ukuthi bakhulume ngesimo sesibindi sakho ngendlela efanayo. Ngezinye izikhathi kubizwa ngokuthi i-"Child-Turcotte-Pugh (CTP) calculator." Kodwa khumbula, nakuba lesi sibalo sibalulekile, asisho yonke indaba ngempilo yakho. Siyingxenye eyodwa nje.

Yiziphi izinto ezi-5 ezibhekwayo kulokhu?

Odokotela babheka izici ezinhlanu eziyinhloko ukudala amaphuzu e-Child-Pugh. Lezi yizi:

1. Izinga eliphelele le-bilirubin egazini: I-Bilirubin iyinhlanganisela ephuzi etholakala enyongweni yomzimba wethu. Isetshenziselwa ukukala ukuthi isibindi sisebenza kahle yini. Uma sanda, amehlo nesikhumba kuba phuzi (njenge-jaundice).

2. Izinga le-albumin egazini: I-Albumin iyiprotheni eyenziwe yisibindi sakho. Isiza ekuthutheni izakhamzimba emzimbeni wakho wonke. Uma isibindi sakho sibuthakathaka, senza le protheni encane.

3. Ukuthi igazi lakho liqina ngokushesha kangakanani (Isikhathi se-Prothrombin noma i-INR): Isibindi sihilelekile nokuthi igazi lakho liqina ngokushesha kangakanani. Lokhu kungenxa yokuthi ezinye zezinto ezidingekayo ukuze igazi liqine zenziwa esibindini. Ukwanda kwalesi sikhathi kusho ukuthi kuthatha isikhathi eside ukuthi igazi liqine.

4. Ama-Ascites: Lokhu kubhekisela ekuqongeleleni okungavamile koketshezi ngaphakathi esiswini sakho (umgodi wesisu). Lokhu kungenzeka uma izifo zesibindi ezifana ne-cirrhosis zinzima.

5. Ingabe ukusebenza kobuchopho kuthinteka yisifo sesibindi (i-Encephalopathy):Uma isibindi sonakele, ubuthi obuthile okufanele bususwe emzimbeni bunganqwabelana egazini. Lokhu kungahamba kuye ebuchosheni futhi kuthinte ukusebenza kobuchopho. Lokhu kungabangela izinguquko ezintweni ezifana nenkumbulo, ukunaka, kanye nokuziphatha.

Ngayinye yalezi zici ezinhlanu inikezwa amaphuzu ngokusekelwe emiphumeleni yakho yokuhlolwa. Bese, zonke zihlanganiswa ndawonye ukuze uthole amaphuzu aphelele. Ngakho-ke, uhlukaniswa ngesinye sezigaba ezintathu: A, B, noma C.

Ngingalungiselela kanjani i-Child-Pugh Score?

Ukuze ubale lesi sibalo se-Child-Pugh, kuzodingeka wenze izivivinyo eziningana. Lokhu kungafaka ukuhlolwa ngokomzimba , ukuhlolwa kwegazi , kanye nokuhlolwa kwezithombe .

Udokotela uzokucela isampula yegazi ukuze ahlole lezi zinto:

• Izinga le-Bilirubin: Njengoba kushiwo ngaphambili, lokhu kuyindlela yokusebenza kwesibindi.
• Izinga le-Albumin: Iphrotheni ekhiqizwa yisibindi ethwala izakhamzimba.
• Isikhathi se-Prothrombin (PT) noma i-INR: Isivinini lapho igazi ligoba khona.

Udokotela wakho angenza i-ultrasound yesisu noma i-CT scan ukuhlola ukwakheka koketshezi esiswini sakho (ama-ascites). Ama-Ascites ukuqongelela koketshezi olwengeziwe esiswini. I-Cirrhosis iyimbangela eyinhloko yalokhu.

Ukuhlolwa ngokomzimba kanye/noma ukuhlolwa kwengqondo kungenziwa ukuze kuhlolwe umonakalo wesibindi othinta ubuchopho (i-encephalopathy). Lesi simo singase senzeke lapho isibindi sonakele futhi ubuthi buqongelela egazini.

Okubalulekile: Ukuze uthole imiphumela enembile kakhulu kulezi zivivinyo, ungase ucelwe ukuthi ungadli noma uphuze amahora ambalwa ngaphambi kokuhlolwa (ukuzila ukudla). Ngakho-ke, buza udokotela wakho ukuthi yimaphi amalungiselelo okudingeka uwalungiselele.

Lezi zivivinyo kungenzeka zingenziwa ngosuku olufanayo noma endaweni efanayo. Kulungile lokho. Ngemva kokuba udokotela ethole imiphumela yazo zonke lezi zivivinyo, uyayihlanganisa yonke ukuze abale amaphuzu akho e-Child-Pugh.

Ibalwa kanjani i-Child-Pugh score?

Kulula kakhulu. Odokotela babheka izici ezinhlanu okukhulunywe ngazo ngenhla ezihlobene nempilo yesibindi sakho. Ngayinye yalezo zinto inganikwa amaphuzu angu-1, 2, noma 3, kuye ngesimo sakho. (Imaphuzu 1 awona anzima kakhulu, amaphuzu 3 awona anzima kakhulu).

Ngemva kokuthola amaphuzu wonke amahlanu, udokotela uwahlanganisa wonke. Uthola amaphuzu aphelele phakathi kuka-5 no-15. Leso yisibalo sakho se-Child-Pugh.

Nasi ishadi elibonisa ukuthi amaphuzu anikezwa kanjani ngokusekelwe emiphumeleni yalezo zici ezinhlanu:

| Isici | Isilinganiso 1 | Isilinganiso 2 | Isilinganiso 3 |

| :- ...

| I-Bilirubin `(I-bilirubin ephelele)` (mg/dL) | < 2 | 2 - 3 | > 3 |

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

| INR (ukujiya kwegazi) | < 1.7 | 1.7 - 2.3 | > 2.3 |

| Ama-Ascites | Akukho | Okuncane/Okulawulwe Kancane | Okumaphakathi/Okungalawulwa Kahle |

| I-Encephalopathy | Akukho | Ibanga 1-2 (Elincane/Eliphakathi) | Ibanga 3-4 (Elinzima) |

Kuye ngokuthi uthola amaphuzu aphelele, uzohlukaniswa ngezigaba ezintathu eziyinhloko:

• Isigaba A: Isibindi sakho sisebenza kahle. Isibalo sakho sisonke siphakathi kuka-5 no-6.
• Isigaba B: Kukhona ukulimala kwesibindi okumaphakathi. Isilinganiso sakho siphakathi kuka-7 no-9.
• Isigaba C: Ukulimala kwesibindi okukhulu noma isifo esiqhubekele phambili. Isilinganiso sakho siphakathi kuka-10 no-15.

Ake sibone isibonelo?

Cabanga ngemiphumela yokuhlolwa komuntu ilandelayo:

• I-Bilirubin - 3 mg/dL (amaphuzu ama-2)
• I-Albumin - 2.9 g/dL (amaphuzu ama-2)
• INR - 1 (iphuzu eli-1)
• Uketshezi esiswini (ama-Ascites) - okuncane (amaphuzu ama-2)
• I-Encephalopathy - Cha (iphuzu eli-1)

Isilinganiso salo muntu se-Child-Pugh singu-2 + 2 + 1 + 2 + 1 = amaphuzu angu-8 . Lokhu kusho ukuthi usekilasini B.

Kusho ukuthini ukuthi i-Child-Pugh Score yakho?

Leli phuzu linikeza isithombe sesifo sakho sesibindi ngaleso sikhathi. Litshela udokotela wakho ukuthi isibindi sakho sisebenza kahle kangakanani ngokusekelwe kulezi zici ezinhlanu. Iphuzu le-Child-Pugh lisiza udokotela wakho:

• Yenza uhlelo lwakho lokwelashwa: Lokhu kuzokusiza ukuthi unqume ukuthi uzokwelashwa ngemithi, ukuhlinzwa, noma ukufakelwa isibindi , nokuthi ngabe lezo zindlela zokwelashwa zizophumelela yini.
• Hlola ingozi:Uma uhlinzwa, lokhu kuzokusiza ukuthi ubone ukuthi kuyingozi futhi kunenzuzo kangakanani empilweni yakho iyonke. Uma ukuhlinzwa kuphumelele, kungabikezela nokuthi ikhwalithi yempilo yakho izoba njani ngemva kokuhlinzwa.
• Linganisela ukusinda kwakho: Nakuba izibikezelo zesikhathi sokusinda ziyizilinganiso nje ezingacacile, udokotela wakho angasebenzisa lokhu ukubikezela ukuthi ungaphila isikhathi esingakanani, ngokwelashwa noma ngaphandle kokwelashwa, ngokusekelwe kumaphuzu akho.

Khumbula, konke lokhu kunqunywa udokotela. Leli khadi lamaphuzu limane nje liyisiqondiso kubo.

Kufanele ngimbone nini udokotela wami?

Uma unemibuzo mayelana nesikolo sakho se-Child-Pugh noma ukuthi sibalwa kanjani, qiniseka ukuthi ukhuluma nodokotela wakho . Uma unemibuzo mayelana nemiphumela yokuhlolwa kwakho noma ukuthi kuzokwenzekani ngokulandelayo ohlelweni lwakho lokwelashwa, tshela udokotela wakho ngalokho.

Manje usunamaphuzu akutshela ngempilo yesibindi sakho. Ngakho-ke wenzani manje? Okokuqala, ungagcini nje ngokuhlala kula maphuzu noma imiphumela yokuhlolwa ngaphandle kokukhuluma nodokotela wakho. Bangakuchazela imiphumela yakho nokuthi isho ukuthini. Amaphuzu akho e-Child-Pugh ayabasiza ukuthi banqume ngohlelo lwakho lokwelashwa. Kodwa nawe uyingxenye yaleso sinqumo. Ngakho-ke, khuluma nethimba lakho lezokwelapha mayelana nokuthi amaphuzu akho asho ukuthini nokuthi bancoma ini. Ungakhathazeki, balapha ukuzokusiza.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Child-Pugh Score iyithuluzi elibalulekile lokulinganisa impilo yesibindi, kodwa ayilandi yonke indaba.

• Lokhu kunganikeza odokotela umbono omuhle ngempilo yesibindi sakho.
• Lokhu kusiza ukuhlela ukwelashwa nokuhlola izingozi.
• Ungakhathazeki ngamamaki kuphela. Xoxa ngakho konke nodokotela wakho.
• Thatha indima ebonakalayo ekwenzeni izinqumo mayelana nempilo yakho.

Isibindi siyisitho esibaluleke kakhulu emzimbeni wethu. Kungumsebenzi wethu ukusivikela. Uma unenkinga yesibindi, landela imiyalelo kadokotela wakho ngqo. Phila impilo enempilo. Khona-ke ngeke kudingeke ukhathazeke ngezimpawu ezinjalo. Konke kuzolunga!

Isilinganiso se - Child-Pugh, isibindi, i-cirrhosis, isifo sesibindi, i-bilirubin, i-albumin, ukusebenza kwesibindi