Na Mea Maluna o ka oolea o ke akepaʻa cirrhosis e like me Child-Pugh

Cirrhosis o ke akepaʻa - i ka hoʻonuiʻana o connective'aʻaʻa i loko o ke kino ma muli o ka loa-makahiki li nui. A e like me ka hiki i ka Mea Maluna o keia maʻi mea ole, no ka mea,ʻaʻohe kona manaʻo ma ma i o ka loaʻa loa holomua no PalekanaEND_LINK pilikia a me ka hana o ka cirrhosis.

Mea Maluna o ke akepaʻa cirrhosis e like me Child-Pugh

Kēia Mea Maluna o ke akepaʻa cirrhosis ua hoʻohana 'ia e ke kiÿeleo i ka degere o ka maʻi i loko o ka oolea o ka hoʻomanawanui.

Ma ke kumu o kona manaʻo paka hoʻomanawanui ola i kēia maʻi, a me ka pakeneka o ka make ma hope oʻoki kino. Hooponoponoia ia mea, e like me ka pono i ake transplant.

I ka maʻi ua maheleia i ekolu papa. Nā mea kiko'î e hoakaka i ka papa hōʻike i ke degere o ka oolea o ke cirrhosis, e like me ka mea mea e ia i ke ola expectancy o kekahi kanaka hoomanawanui ka mea cirrhosis. E like me ka Child-Pugh degere o ka uku o ka maʻi ua hoakakaia e like me:

1. Class A nā compensated cirrhosis.
2. B - subcompensated.
3. C - decompensated cirrhosis.

Pehea oe kākau manaʻo?

Kēlā me kēia papa o Child-Pugh ia kekahi mau heluʻai i ka pōpilikia ma muli o ka huina o kekahi mau mea kiko'î. Penei, Class A no ia i ka laulā o ka 5 me 6 kumu, B, niioaaonoaaiii, - mai ka 7 a hiki i 9 puan. A me ka mea hope papa - ka waiwai nui mai ka 10 a hiki i 15 heluʻai.

Ka palena iki degere o ka oolea o ka cirrhosis ma muli o ka A. Ma keia hihia, no ka lōʻihi like 'ole o ka hoʻomanawanui ka ola mea ma ka i kā mākou - mai ka 15 a hiki i 20 makahiki. Ma ka lua, ia mea ma kahi o 10 makahiki. Class C o ia hoʻi, ka shortest ola expectancy o nā mea maʻi me ka cirrhosis o ke akepaʻa - wale kekahi a ma ka hapanui ekolu makahiki.

Ma hope o kaʻoki kino, ka mea kiʻekiʻe loa pakeneka o ka make ana o ka papa C - ka mea, o 80%; 30% - pakahi, a me ka A mau - wale 10%.

Ka nele i ke akepaʻa transplant ma kekahi mau degere o ka oolea o ka manao o lakou e like me penei:

• High - C;
• lōpū - B;
• Low - A.

Nā mea kiko'î ia i moolelo i loko o ka Mea Maluna o Child-Pugh

He aha kiko'î a ololi i ka puunaue ana o ka papa? Mua o nā mea a pau, e lawe i ka mooolelo o ka alo ana o:

• bilirubin;
• albumin;
• ascites.

Like pono me hepatic encephalopathy, ili n, PTT a me INR.

System no ka Child-Pugh hiki ole ke manao like me ka olua, mahope mai o ka loiloi 'ana i loko o helu ole a pau o na mea kiko'î o ka hoʻomanawanui. Kaʻoi worsening o ka maʻi a me kona complications hoʻololi i ke kiʻi, a me keia Mea Maluna ua hou i hoʻohana.

I ho'ākāka 'ia ma ka'ōnaehana i lawe i loko o no ka morphologic a etiologic hiʻona ma cirrhosis.

Mea Maluna o etiologic hiʻona

Aia nō ma kahi o iwakalua ano o ka cirrhosis. Ke kaumaha ma muli paha o ka hihia ua ike paha ole, i ka maʻi ua maheleia i ekolu pūʻulu.

1. Cirrhosis hoʻouka kekahi (ike) etiology.
2. Ke pathology ma i ka etiology mea controversial (kekahi manawa kapaia "He hiki etiology").
3. Cirrhosis me unclear (unknown) etiology.

hoʻouka kekahi etiology

O ka ike, hoʻokumu i nā kumu o ka maʻi i ka i ana i loko o ka kēia hihia.

• I kanakaʻona mau cirrhosis i kupu mai ma hooloihi ae i hoʻohana o ka waiʻona (40-60 gram ethanol) no 15 a oi makahiki.
• Mea hoʻomaʻi i loko o ka hapalua o ka hihia ua kauoha ae la ia e kekahi mea hoʻomaʻi o ka maʻi hepatitis B, C a me G.
• Lāʻau a me ka lapaʻauʻia, i hoike mai ai ia ia iho no i ke ano o ka ai 'o ka ua' ano no ka lōʻihi manawa.
• N, a kiʻekiʻe biliary cirrhosis, kahi hepatic'aʻaʻa make ia lŘlŘ a me ka lohi loa me ka makaʻu no'aʻaʻa ua hanaʻia e puku ia.
• Congenital a hereditary cirrhosis.
• Stagnant - ia mea okoa mai ka'ē aʻe papa inoa pepa a me ka hoʻomōhala ana i ka wā i lawa lōʻihi o ka manawa i ka wa a ke koko lako i ke akepaʻa ua wawahiia. Mālama i nā mea maʻi me ka mau koko holo.
• I ka maʻi a me Budd-Chiari maʻi pale - he maʻi pili me kaʻole koko outflow mai ke akepaʻa (hepatic aa koko thrombosis).
• Mail-alimentary cirrhosis i kupu mai ma ka loa mimikō, obesity, ka wā hui enteroapocleisis.

Hiki a me ka unclear etiology

Hiki a me ka hoʻohoka, i ike ole etiology hoikeia mai ma ke alo o ka:

• infectious maʻi;
• parasitic maʻi;
• autoimmune pathologies;
• malnutrition.

Unknown etiologic kumumea - Ua pinepine cryptogenic cirrhosis palapala. Ma iniiaiie biliary cirrhosis a me ka Mauna keiki hoi olelo a ike etiology.

morphological Mea Maluna

Morphological Mea Maluna o ke akepaʻa poho - keia mea i ka i manaoia, a i aponoia ma muli maʻikepili mai biopsies (kino apana, ia ma ka vivo) mua. Līkaia pathology 4 'ano apau loa.

• MKD cirrhosis wehewehe aku ma nodules uuku i loko o ke kino, ao kona anawaena o 1-3 mm o;
• krupnouzlovgo cirrhosis - ake nodules anawaena o 3 mm o a oi;
• ano kāpili cirrhosis, hiki ia advantageously loli mezhpechenochnye paku;
• kawili, wehewehe aku ma ka hui malu pu ana o nā mea a pau i ka luna hiʻona.

cirrhosis lapaʻau

I hooleiiaʻi mawaho papa cirrhosis o Child-Pugh i haawi mai i ka manawa i wale no e i kaʻike,, e wńnana i ke ola o nā mea maʻi, akā, no hoi e koho i kūpono lapaau a me ka hope malama.

Penei, ka compensated ake maʻi (Me ke kūlana A) kŰia kumu o Inc nona ma ke kāpaeʻana i ke kumu kumu o ka maʻi. Eia hou kekahi, e pono e koho i ke kākoʻo lāʻau. Kā lākou huakaʻi - e hoʻopau indigestion. O ka nui i loko o kēia'ūhū mea o ke 'ano "pancreatin" "Creon", "mezim". Dosages hae, ia ekolu manawa i ka lā, kaʻoi loa ma muaʻai. He ia papa, he awelika o ka 2-3 pule, a ua hai hou i mauʻanuʻu.

I ka subcompensated cirrhosis (At B cirrhosis o ka papa o Child-Pugh) koi 'ia mālama nui mālama' ana i Inc hookohu. No keia mea ua hoʻohana 'ia i ka haʻahaʻa paakaiʻai (i hou aku 2 nā huna o ka paʻakai o ka lā), hou pūʻulu kumuʻiʻo. O ka ai 'hoakaka ia "Furosemide" a me ka "spironolactone". Loaa ana diuretics a koi aku i ka ulu 'ka puka hypertension a me ka ho'ēmi i kā ascites. I ka hana o ka gastrointestinal'āpana hiki ke hou "lactulose" i loko o 50-70 ml no ka lā, akā, i ka hiki aku o ia e mau.

Ma ka hihia o decompensated akepaa mai (ka wā o ka papa C e like me Child-Pugh) hoikeia mai ke ola-na olelo hooweliweli e ana o ka hoʻomanawanui. Ua pono koke mālama nui malama. Paracentesis i nā wehe 'ana o ka loli, mai ka peritoneum, albumin intravenously lawelawe a me crystalloids, hoolako mai ai hoʻolahaʻia ke koko ka leo a me ka kumuʻiʻo i loko o ke kino. 'Imi hoʻohana diuretics:ʻo ia "spironolactone" a me ka "Furosemide". I hoakaka ia i kaʻai haʻahaʻa i ka paakai. No ke koena aku hoi parenteral kino e hele mai i loko o hepatic encephalopathy a me nā loa aku ana.

ka hopena

Prophylaxis o ka maʻi ua i ka nānā 'ana ma luna o ka Mea Maluna o ka oolea o ke akepaʻa cirrhosis o Child-Pugh.

Ma compensated maʻi papa 'aʻole i koi kāohi manao. I ka papa B a me C nā mea maʻi i ulu anaemia, a no ia mea, nui pinepine lawelawe erythropoietin. Eia hou, i ka mau hoakaka Hoʻokolohua-blockers (e like me "Metoprolol", "Inderal"), a e pale aku i ka nahā i esophageal varices.