Dhibcaha Child-Pugh

Qiimaynta Xumaanta Cudurka Beerka (Liver Cirrhosis)

Bilirubin Guud (Total Bilirubin) *

< 2 mg/dL (dhibic 1) 2–3 mg/dL (2 dhibcood) > 3 mg/dL (3 dhibcood)

Albumin Seerumka (Serum Albumin) *

> 3.5 g/dL (dhibic 1) 2.8–3.5 g/dL (2 dhibcood) < 2.8 g/dL (3 dhibcood)

INR (International Normalised Ratio) *

< 1.7 (dhibic 1) 1.7–2.3 (2 dhibcood) > 2.3 (3 dhibcood)

Ascites (Biyo Caloosha) *

Ma jiro (dhibic 1) Xoogaa yar ilaa dhexdhexaad — lagu xakameeyo daawooyinka kaadida (diuretics) (2 dhibcood) Daran — aan la xakamayn karin ama adag in la maareeyo (3 dhibcood)

Hepatic Encephalopathy (Saameynta Beerka ee Maskaxda) *

Ma jiro (dhibic 1) Heerka I–II — yar ilaa fudud (2 dhibcood) Heerka III–IV — dhexdhexaad ilaa daran (3 dhibcood)

Fasiraadda

Dhibcaha Child-Pugh waxay qiimeeyaan xumaanta cudurka beerka (cirrhosis) iyagoo ku salaysan shan cabbir oo caafimaad iyo shaybaar ah. Dhibcaha guud waxay u dhexeeyaan 5 ilaa 15, waxayna bukaanka u kala saaraan saddex heer (A, B iyo C) oo leh saamayn kala duwan oo qiyaas iyo daaweyn ah.

Dhibcaha	Heerka	Xumaanta	Nolosha sanad 1	Nolosha 2 sano	Dhimashada qalliinka*
5–6	Class A	Cudur si fiican u xakamaysan	100%	85%	~10%
7–9	Class B	Hoos u dhac muhiim ah oo shaqada beerka ah	81%	57%	~30%
10–15	Class C	Cudur aan xakamaysnayn	45%	35%	~80%

* Qiyaasta dhimashada qalliinka caloosha ee lagu qorsheeyay bukaanada cirrhosis-ka qaba.

† Xogta nolosha waxay ku salaysan tahay falanqayn (Cholongitas et al., 2005). Ilo qaar ayaa xisaabiya qiimayaal yar oo ka duwan Heerka B (80%/60%), taasoo muujineysa is-badal u dhexeeya kooxaha kala duwan.

Macnaha caafimaad: Dhibcaha Child-Pugh waxaa si weyn loo isticmaalaa qiimaynta ka hor qalliinka, kala saarida khatarta, iyo saadaasha cirrhosis-ka. Bukaanada Class C waa musharraxiinta ugu horreysa ee ku-dhaqanka beerka (liver transplantation). Dhibcahan waxaa markii hore soo saaray Child iyo Turcotte (1964), waxaana wax ka beddelay Pugh iyo saaxiibadiis (1973), kuwaas oo ku beddelay xaaladda nafaqada waqtiga prothrombin (hadda loo yaqaan INR). Marka lagu daro dalalka badankood ee caalamka, MELD ayaa beddeshay Child-Pugh marka la go'aaminayo qaybinta xubnaha maxaa yeelay waxay isticmaashaa oo keliya tirooyin shaybaar oo hufan — si kastaba ha ahaatee, Child-Pugh weli ayaa si weyn loogu isticmaalaa qiimaynta khatarta qalliinka iyo kala soocidda caafimaad ee cirrhosis-ka.

⚠️ Xayiraadaha muhiimka ah

Qaybaha shakhsiga ah: Qiimaynta ascites iyo encephalopathy waxay ku tiirsan tahay baaritaanka caafimaad waxayna ku xiran tahay farqiga u dhexeeya dhakhaatiirta — waa xaddid caan ah oo qoraalladu ku qeexaan.
Waxaa loogu talagalay kaliya cudurka beerka ee joogtada ah: Dhibcahan waxaa loo soo saaray oo loo hubiyay bukaanada qaba cirrhosis. Kama ay ekayn in loo isticmaalo xaaladaha degdegga ah ee beerka (acute liver failure), halkaas oo nidaamyo kale oo dhibco ah ay ku habboon yihiin (tusaale, King's College Criteria).
Waxaa lagu beddelay MELD marka la qaybinayo xubnaha ku-dhaqanka: Sababtoo ah cabbirradiisa shakhsiga ah iyo 10 heer oo dhibco ah oo keliya — taasoo xaddidaysa kala soocidda bukaanada — Child-Pugh waxaa lagu beddelay MELD dalal badan marka la qaybinayo beerka ku-dhaqanka.

⚠️ Fiiro gaar ah: Kalkuleytarkani waa aalad taageero waxbarasho ah. Dhibcaha Child-Pugh kama beddelayaan qiimeynta caafimaad ee dhamaystiran ee kooxda caafimaad ee mas'uulka ka ah, gaar ahaan go'aannada ku saabsan ku-dhaqanka beerka iyo maareynta qalliinka bukaanada cirrhosis qaba.

Tixraacyada

1. Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. "Transection of the oesophagus for bleeding oesophageal varices." Br J Surg. 1973;60(8):646–649. PubMed ↗
2. Cholongitas E, Papatheodoridis GV, Vangeli M, Terreni N, Patch D, Burroughs AK. "Systematic review: The model for end-stage liver disease — should it replace Child–Pugh's classification for assessing prognosis in cirrhosis?" Aliment Pharmacol Ther. 2005;22(11–12):1079–1089. PubMed ↗

Calculamedica