A rarrabuwa na tsanani daga hanta cirrhosis bisa ga Child-Pugh

Cirrhosis na hanta - mai yaduwa daga connective nama a cikin jiki saboda dogon lokaci kumburi. A na kowa tsarin kula da rarrabuwa da wannan cuta ne ba ba, saboda babu yarjejeniya a kan abin da na samuwa mafi nasara domin bincike matsaloli da kuma lura da cirrhosis.

Nau'in hanta cirrhosis bisa ga-Child Pugh

Wannan rarrabuwa na hanta cirrhosis ake amfani da su kimanta mataki na cuta mai tsanani a cikin haƙuri.

A kan tushen da ta estimation nuna haƙuri rayuwa tare da wannan cuta da kuma yawan mace-mace bayan tiyata. M kamar yadda ake bukata ya da hanta dashi.

A cuta ne zuwa kashi uku azuzuwan. A sigogi da cewa ayyana azuzuwan nuna mataki na tsanani daga cirrhosis, kazalika da gaskiyar abin da zai zama da rai expectancy na wani mutum haƙuri wanda yana cirrhosis. Bisa ga Child-Pugh mataki na ramuwa da cutar da aka bayyana a matsayin:

1. Class A hada cika cirrhosis.
2. B - subcompensated.
3. C - decompensated cirrhosis.

Ta yaya za ka sharhi?

Kowane aji na Child-Pugh sanya wasu maki da aka lasafta bisa ga Naira Miliyan Xari da dama sigogi. Saboda haka, Class A nasa ne a kewayon 5 zuwa 6 da maki, B, bi da bi, - daga 7 zuwa 9 maki. Kuma na karshe aji - mafi girma darajar daga 10 zuwa 15 da maki.

A m mataki na tsanani daga cirrhosis saboda A. A wannan yanayin, tsowon lokacin haƙuri da rayuwa ne a wani matsakaicin - daga 15 zuwa 20 da shekaru. A na biyu, shi ne game shekaru 10. Class C yana nufin guntu rai expectancy na marasa lafiya da cirrhosis na hanta - kawai daya ko a mafi shekara uku.

Wadannan tiyata, mafi girma yawan mace-mace na aji C - shi ne 80%. 30% - da bi, da kuma A ta - kawai 10%.

Da bukatar wani hanta dashi a daban-daban digiri na tsanani ne niyya kamar haka:

• High - C;
• matsakaici - B;
• Low - A.

A sigogi ɗauke shi zuwa lissafi a cikin rarrabuwa na Child-Pugh

Abin da sigogi tasiri rarraba da azuzuwan? Da farko, da shi daukan la'akari da kasancewar:

• bilirubin.
• albumin.
• ascites.

Kazalika hanta encephalopathy, PTI, PTT da INR.

System for Child-Pugh Ba za a iya daukarsa a reference, tun da kimantawa daukan la'akari ba duk da sigogi na haƙuri. A kaifi worsening da cutar da kuma ta rikitarwa canja hoto, kuma wannan rarrabuwa da aka daina amfani da su.

Har ila yau, ya bayyana tsarin kuma daukan la'akari da morphologic da etiologic fasali a cirrhosis.

Nau'in etiologic siffofin

Akwai game da ashirin siffofin cirrhosis. Dangane da ko cikin hanyar da aka sani ko ba, cutar ne zuwa kashi uku kungiyoyin:

1. Cirrhosis shigar da (sanin) etiology.
2. A Pathology a cikin abin da etiology ne rigima (wani lokacin kira da "yiwu etiology").
3. Cirrhosis tare da m (unknown) etiology.

shigar etiology

Na san, ya kafa Sanadin cutar cewa a cikin wadannan lokuta:

• A giya cirrhosis tasowa a lokacin shafe tsawon amfani da barasa (40-60 gram ethanol) for 15 ko fiye da shekaru.
• Kwayar cewa a cikin rabin cikin lokuta ne ya sa ta a cutar da kullum hepatitis B, C da kuma G.
• Drug ko magani, wadda bayyana kanta saboda da amfani da miyagun kwayoyi da irin na dogon lokaci.
• Primary da kuma sakandare biliary cirrhosis, inda hanta nama mutuwa ya auku da kuma m tabo nama yana kafa don maye gurbin ta.
• Nakasar ko hereditary cirrhosis.
• M - shi ne daban-daban daga wasu jera siffofin da kuma tasowa a isasshe tsawon lokaci idan jinin samar da hanta da aka karya. Lura a marasa lafiya tare da general jini wurare dabam dabam.
• Lokacin da cutar da kuma-Budd Chiari ciwo - wata cuta hade tare da mai illa jini outflow daga hanta (hanta jijiya thrombosis).
• Exchange-alimentary cirrhosis a tasowa mai tsanani da ciwon sukari, kiba, a lokacin da shiga enteroapocleisis.

Zai yiwu da kuma m etiology

Zai yiwu da kuma m, unknown etiology bayyana a gaban:

• cututtuka.
• parasitic cututtuka.
• autoimmune pathologies.
• tamowa.

Unknown etiologic dalilai - shi ne sau da yawa cryptogenic cirrhosis form. A primary biliary cirrhosis da kuma Indian yara ma magana da ba a sani ba etiology.

morphological rarrabuwa

Morphological rarrabuwa na hanta lalacewar - wannan shi ne na farko samarwa da kuma amince bisa bayanai daga biopsies (jiki yanki, dauka a vivo). Ware Pathology 4 siffofin:

• MKD cirrhosis halin da kananan nodules a cikin jiki, wanda diamita ne 1-3 mm.
• krupnouzlovgo cirrhosis - hanta nodules diamita 3 ko fiye mm;
• siffofin bai cika cirrhosis, inda advantageously shafi mezhpechenochnye bangare;
• gauraye, halin da hade da duk na sama fasali.

cirrhosis magani

Fallasa aji cirrhosis na-Child Pugh bada damar ba kawai yin wani ganewar asali, to hango ko hasashen da rayuwa da marasa lafiya, amma kuma don zaɓar dace magani taimaka da kuma kula.

Saboda haka, sakamakon cutar hanta (Da aji A) ya shafi asali far da nufin kawar da tushen cutar. Bugu da kari, dole ne ka karba taimako magunguna. Manufa - don kawar da bacin. Na bayar da muhimmanci a cikin wannan enzyme ne na irin "pancreatin" "Creon", "mezim". Dosages misali, dauka sau uku a rana, zai fi dacewa da abinci. Shin sanya Darussan, wani talakawan of 2-3 makonni, wanda aka maimaita a yau da kullum jinkiri.

Lokacin da subcompensated cirrhosis (At B cirrhosis na aji na Child-Pugh) bukata m tabbatarwa far saduwa. A saboda wannan dalili da ake amfani a low gishiri rage cin abinci (ba fiye da 2 grams na gishiri a kowace rana), kara ƙuntata gina jiki. Na kwayoyi wajabta "Furosemide" da "spironolactone". Karbar diuretics constrains tasowa portal hauhawar jini da kuma rage ascites. The aiki na gastrointestinal fili za a iya inganta "lactulose" a 50-70 ml a kowace rana, amma liyafar shi ne ya zama na dindindin.

A cikin hali na decompensated cutar hanta (a lokacin da aji C bisa ga Child-Pugh) bayyana rai barazana yanayin haƙuri. Yana bukatar nan da nan m kula. Paracentesis bayar kau na ruwa daga cikin peritoneum, albumin intravenously gudanar da crystalloids, ya cika zagawa da jini girma da kuma gina jiki a cikin jiki. Rayayye amfani diuretics: guda "spironolactone" da "Furosemide". Rubũta a rage cin abinci low a gishiri. Domin daidaita parenteral abinci zo a cikin hanta encephalopathy da kuma sauran m yanayi.

ƙarshe

Prophylaxis cututtuka ne kuma bisa ga rarrabuwa na tsanani daga hanta cirrhosis na Child-Pugh.

A sakamakon cutar hanya ba ya bukatar m manufar. Lokacin da azuzuwan B da C da marasa lafiya na iya ci gaba anemia, sabili da haka sau da yawa sosai gudanar erythropoietin. Bugu da kari, cikin fiye wajabta beta-blockers (kamar "Metoprolol", "Inderal"), wanda na iya hana rata esophageal varices.