{"id":3899,"date":"2026-10-12T09:31:03","date_gmt":"2026-10-12T08:31:03","guid":{"rendered":"https:\/\/wpcalc.com\/tr\/tisbi\/child-pugh-skoru-hesaplama\/"},"modified":"2026-10-12T09:31:03","modified_gmt":"2026-10-12T08:31:03","slug":"child-pugh-skoru-hesaplama","status":"publish","type":"post","link":"https:\/\/wpcalc.com\/tr\/tisbi\/child-pugh-skoru-hesaplama\/","title":{"rendered":"Child-Pugh Skoru Hesaplama"},"content":{"rendered":"<section class=\"not-prose calculator-box\" aria-labelledby=\"calculator-title\"><div class=\"flex items-baseline sm:items-center justify-between gap-2 sm:gap-3\"><div class=\"flex flex-col sm:flex-row sm:items-center gap-2\"><span class=\"icon icon-calculator text-primary-700! text-base! dark:text-primary-300!\" aria-hidden=\"true\"><\/span><h2 id=\"calculator-title\" class=\"text-lg font-display font-bold\">Child-Pugh skoru ile sirozun \u015fiddetini s\u0131n\u0131fland\u0131r\u0131n<\/h2><\/div><div class=\"calcdash-favorite group\">\n  <button type=\"button\" class=\"favorite\" id=\"favorite\" data-favorite-id=\"3899\" data-favorite-title=\"Child-Pugh Skoru\" data-favorite-url=\"https:\/\/wpcalc.com\/tr\/tisbi\/child-pugh-skoru-hesaplama\/\" data-favorite-excerpt=\"Bilirubin, alb\u00fcmin, INR veya protrombin zaman\u0131 (PT) uzamas\u0131 ile asit ve ensefalopati \u015fiddetini girin; sirozun a\u011f\u0131rl\u0131\u011f\u0131n\u0131 g\u00f6steren Child-Pugh skorunu (5\u201315 puan) ve A, B veya C s\u0131n\u0131f\u0131n\u0131 \u00f6\u011frenin.\" aria-label=\"Favorilere ekle\" data-favorite-icon=\"icon icon-flask\">\n    <span class=\"icon icon-shape-star-empty\" aria-hidden=\"true\"><\/span>\n  <\/button>\n  <div class=\"calcdash-favorite__tip\" aria-hidden=\"true\">\n   <span class=\"favorite-tooltip\" id=\"favorite-tooltip\"><\/span>\n  <\/div>\n  <span class=\"sr-only\" role=\"status\" id=\"favorite-status\"><\/span>\n<\/div><\/div><form action=\"https:\/\/wpcalc.com\/tr\/tisbi\/child-pugh-skoru-hesaplama\/\" method=\"POST\" class=\"calculator\" id=\"calculator-3899\" data-post=\"3899\"><fieldset class=\"fieldset-input is-2\"><legend class=\"sr-only\">Giri\u015f alanlar\u0131<\/legend><div class=\"field has-term\" id=\"input-1\"><label for=\"field-1\">Total bilirubin<\/label><div class=\"term\">Bil<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><div class=\"field-group\"><input type=\"text\" name=\"total_bilirubin\" id=\"field-1\" aria-describedby=\"calc-info-1\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.1\" max=\"50\" value=\"2.5\"\/><div class=\"grid grid-cols-1\"><select id=\"field-2\" name=\"birim\" aria-label=\"Birim\"><option value=\"mgdl\" selected>mg\/dL<\/option><option value=\"umol\">\u00b5mol\/L<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><small id=\"calc-info-1\">Kan tahlilinizdeki de\u011fer<\/small><\/div><div class=\"field has-term\" id=\"input-2\"><label for=\"field-3\">Serum alb\u00fcmini<\/label><div class=\"term\">Alb<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><div class=\"field-group\"><input type=\"text\" name=\"serum_albmini\" id=\"field-3\" aria-describedby=\"calc-info-3\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.5\" max=\"6\" value=\"3\"\/><div class=\"grid grid-cols-1\"><select id=\"field-4\" name=\"birim\" aria-label=\"Birim\"><option value=\"gdl\" selected>g\/dL<\/option><option value=\"gl\">g\/L<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><small id=\"calc-info-3\">Kan tahlilinizdeki de\u011fer<\/small><\/div><div class=\"field\" id=\"input-3\"><label for=\"field-5\">Koag\u00fclasyon \u00f6l\u00e7\u00fcm\u00fc<\/label><div class=\"grid grid-cols-1\"><select id=\"field-5\" name=\"koaglasyon_lm\"><option value=\"inr\" selected>INR<\/option><option value=\"pt\">PT uzamas\u0131<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><div class=\"field has-term\" id=\"input-4\"><label for=\"field-6\">INR \/ PT uzamas\u0131<\/label><div class=\"term\">INR<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><input type=\"text\" name=\"inr_pt_uzamas\" id=\"field-6\" aria-describedby=\"calc-info-6\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.5\" max=\"30\" value=\"1.8\"\/><small id=\"calc-info-6\">INR de\u011feri ya da kontrol de\u011ferine g\u00f6re saniye cinsinden protrombin zaman\u0131 uzamas\u0131<\/small><\/div><div class=\"field\" id=\"input-5\"><label for=\"field-7\">Asit<\/label><div class=\"grid grid-cols-1\"><select id=\"field-7\" name=\"asit\"><option value=\"none\">Yok<\/option><option value=\"slight\" selected>Hafif (ila\u00e7la kontrol alt\u0131nda)<\/option><option value=\"moderate\">Orta ila \u015fiddetli (kontrol alt\u0131nda de\u011fil)<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><div class=\"field\" id=\"input-6\"><label for=\"field-8\">Hepatik ensefalopati<\/label><div class=\"grid grid-cols-1\"><select id=\"field-8\" name=\"hepatik_ensefalopati\"><option value=\"none\" selected>Yok<\/option><option value=\"grade12\">Evre I\u2013II (hafif)<\/option><option value=\"grade34\">Evre III\u2013IV (\u015fiddetli)<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><\/fieldset><div class=\"buttons\"><button type=\"submit\" data-text=\"Yeniden hesapla\" id=\"calculate-button\" data-post=\"3899\">Hesapla<\/button><button type=\"reset\">S\u0131f\u0131rla<\/button><\/div><div class=\"field is-checkbox hidden!\" id=\"field-auto-calc\"><input type=\"checkbox\" id=\"auto-calc\"><label for=\"auto-calc\">Otomatik hesapla<\/label><small>Etkinle\u015ftirilirse, herhangi bir de\u011feri de\u011fi\u015ftirdi\u011finizde sonu\u00e7 otomatik olarak g\u00fcncellenir.<\/small><\/div><div class=\"fieldset-result is-hidden\" aria-labelledby=\"result-title\" aria-live=\"polite\" role=\"region\"> <h3 class=\"result-title bg-gradient-to-r from-primary-50 to-gray-50 dark:from-primary-900 dark:to-gray-800\" id=\"result-title\"><span class=\"icon icon-s-pulse\" aria-hidden=\"true\"><\/span> Child-Pugh sonucunuz<\/h3><div class=\"result-box\"><div class=\"field-result\" id=\"output-1\"><span class=\"field-title\"><span>Child-Pugh skoru<\/span><span class=\"result-term\">C-P<\/span><\/span><span class=\"field-value\" id=\"result-1\" data-unit=\"puan\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Sonucu kopyala\" aria-label=\"Sonucu kopyala\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><div class=\"field-result is-column\" id=\"output-2\"><span class=\"field-title\"><span>Child-Pugh s\u0131n\u0131f\u0131<\/span><\/span><span class=\"field-value\" id=\"result-2\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Sonucu kopyala\" aria-label=\"Sonucu kopyala\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><div class=\"field-result is-column\" id=\"output-3\"><span class=\"field-title\"><span>Bu ne anlama geliyor<\/span><\/span><span class=\"field-value\" id=\"result-3\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Sonucu kopyala\" aria-label=\"Sonucu kopyala\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><\/div><div class=\"result-actions\"><button type=\"button\" class=\"copy-link\"><svg viewBox=\"0 0 20 20\" fill=\"currentColor\" aria-hidden=\"true\"><path d=\"M12.232 4.232a2.5 2.5 0 0 1 3.536 3.536l-1.225 1.224a.75.75 0 0 0 1.061 1.06l1.224-1.224a4 4 0 0 0-5.656-5.656l-3 3a4 4 0 0 0 .225 5.865.75.75 0 0 0 .977-1.138 2.5 2.5 0 0 1-.142-3.667l3-3Z\"\/><path d=\"M11.603 7.963a.75.75 0 0 0-.977 1.138 2.5 2.5 0 0 1 .142 3.667l-3 3a2.5 2.5 0 0 1-3.536-3.536l1.225-1.224a.75.75 0 0 0-1.061-1.06l-1.224 1.224a4 4 0 1 0 5.656 5.656l3-3a4 4 0 0 0-.225-5.865Z\"\/><\/svg><span class=\"copy-link__text\">Bu hesaplaman\u0131n ba\u011flant\u0131s\u0131n\u0131 kopyala<\/span><\/button><span class=\"sr-only\" role=\"status\" id=\"copy-link-status\"><\/span><\/div><\/div><a href=\"#respond\" class=\"hidden transition-opacity duration-300 opacity-0 w-50 text-sm justify-center items-center gap-2 px-4 py-2 rounded bg-gray-200 text-gray-700 hover:bg-gray-300\" id=\"leave-comment\"><span class=\"icon icon-comments\" aria-hidden=\"true\"><\/span>Yorum b\u0131rak<\/a><\/form><\/section><section id=\"calc-reactions\" class=\"not-prose hidden my-12 bg-gradient-to-r from-primary-50 to-gray-50 border border-indigo-100 rounded-xl px-6 py-4 shadow-sm\" data-post=\"3899\" aria-live=\"polite\" aria-labelledby=\"calc-reactions-title\"><p id=\"calc-reactions-title\" class=\"text-sm text-gray-500 text-center mb-2\">Bu sonu\u00e7 hakk\u0131nda ne d\u00fc\u015f\u00fcn\u00fcyorsunuz?<\/p><div role=\"group\" aria-labelledby=\"calc-reactions-title\" class=\"grid grid-cols-3 sm:flex sm:flex-row sm:justify-around gap-4 sm:items-center sm:flex-wrap\"><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"like\"><span class=\"reaction-count\" data-reaction-count=\"like\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude00 <\/span><span class=\"reaction-description font-medium\">Be\u011fendim <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"helpful\"><span class=\"reaction-count\" data-reaction-count=\"helpful\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\udca1 <\/span><span class=\"reaction-description font-medium\">Faydal\u0131 <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"confused\"><span class=\"reaction-count\" data-reaction-count=\"confused\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude15 <\/span><span class=\"reaction-description font-medium\">Kafam kar\u0131\u015ft\u0131 <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"disappointed\"><span class=\"reaction-count\" data-reaction-count=\"disappointed\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude1e <\/span><span class=\"reaction-description font-medium\">Hayal k\u0131r\u0131kl\u0131\u011f\u0131 <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"inaccurate\"><span class=\"reaction-count\" data-reaction-count=\"inaccurate\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\u274c <\/span><span class=\"reaction-description font-medium\">Hatal\u0131 <\/span><\/button><\/div><div id=\"reaction-message\" class=\"hidden mt-8 rounded-md border border-primary-100 bg-white\/50 backdrop-blur-sm px-4 py-2 text-sm text-center shadow-sm\"><\/div><\/section><div class=\"calcdash-ad not-prose calcdash-ad--calc_result calcdash-ad--in-article\"><ins class=\"adsbygoogle\" style=\"display:block\" data-ad-client=\"ca-pub-1721569815777345\" data-ad-slot=\"6317458308\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\"><\/ins><script>(adsbygoogle = window.adsbygoogle || []).push({});<\/script><\/div>\n<style id=\"wpcoderpro-inline-1\">.formula-box {\r\n\tborder-bottom: none !important;\r\n}<\/style><section class=\"formula-box\" aria-labelledby=\"formula-title\">\r\n\t<div id=\"formula-title\" class=\"not-prose font-display mb-4\"><span class=\"icon icon-formula\" aria-hidden=\"true\"><\/span><h2>Child-Pugh Skoru Form\u00fcl\u00fc<\/h2><\/div>\r\n\t<figure class=\"not-prose formula\">\r\n\t\t<figcaption class=\"formula-title\">Form\u00fcl<\/figcaption>\r\n\t\t<div class=\"text-base text-gray-800\" id=\"formula\">\n\\[ \\text{Child-Pugh skoru} = P_{\\text{bilirubin}} + P_{\\text{alb\u00fcmin}} + P_{\\text{p\u0131ht\u0131la\u015fma}} + P_{\\text{asit}} + P_{\\text{ensefalopati}} \\]\n<\/div>\r\n\t<\/figure>\r\n\t<\/p>\n<p><strong>Buradaki de\u011fi\u015fkenler:<\/strong><\/p>\n<ul>\n<li>\\(P_{\\text{bilirubin}}\\) \u2014 total bilirubin (mg\/dL) puan\u0131: &lt;2 ise 1, 2\u20133 ise 2, &gt;3 ise 3<\/li>\n<li>\\(P_{\\text{alb\u00fcmin}}\\) \u2014 serum alb\u00fcmini (g\/dL) puan\u0131: &gt;3,5 ise 1, 2,8\u20133,5 ise 2, &lt;2,8 ise 3<\/li>\n<li>\\(P_{\\text{p\u0131ht\u0131la\u015fma}}\\) \u2014 INR puan\u0131: &lt;1,7 ise 1, 1,7\u20132,3 ise 2, &gt;2,3 ise 3 (veya PT uzamas\u0131: &lt;4 sn, 4\u20136 sn, &gt;6 sn)<\/li>\n<li>\\(P_{\\text{asit}}\\) \u2014 yok: 1 puan; hafif (t\u0131bbi olarak kontrol alt\u0131nda): 2 puan; orta ile \u015fiddetli aras\u0131 (kontrol alt\u0131na al\u0131namayan): 3 puan<\/li>\n<li>\\(P_{\\text{ensefalopati}}\\) \u2014 yok: 1 puan; derece I\u2013II: 2 puan; derece III\u2013IV: 3 puan<\/li>\n<\/ul>\n<p>Be\u015f parametrenin her biri 1, 2 veya 3 puan getirir; bu y\u00fczden toplam skor 5 ile 15 aras\u0131nda de\u011fi\u015fir. Toplam puan daha sonra bir s\u0131n\u0131fa kar\u015f\u0131l\u0131k gelir: A (5\u20136 puan), B (7\u20139) veya C (10\u201315).<\/p>\n<p>\r\n<\/section>\n<style id=\"wpcoderpro-inline-2\">.calculation-box {\r\n\tborder-bottom: none !important;\r\n}<\/style><section id=\"calculation\" class=\"calculation-box\" aria-labelledby=\"calculation-title\">\r\n\t<div id=\"calculation-title\" class=\"not-prose font-display\"><span class=\"icon icon-unordered-list\" aria-hidden=\"true\"><\/span><h2>Child-Pugh Skoru \u2013 Hesaplama \u00d6rne\u011fi<\/h2><\/div>\r\n\r\n<\/p>\n<p><strong>\u00d6rnek:<\/strong> sirozlu bir hastada total bilirubin 2,5 mg\/dL, serum alb\u00fcmini 3,0 g\/dL, INR 1,8, ila\u00e7la kontrol alt\u0131nda hafif asit ve hepatik ensefalopati yok.<\/p>\n<p>\\[ P_{\\text{bilirubin}} = 2 \\;(2.5 \\text{ mg\/dL, 2\u20133 aral\u0131\u011f\u0131nda}), \\quad P_{\\text{alb\u00fcmin}} = 2 \\;(3.0 \\text{ g\/dL, 2.8\u20133.5 aral\u0131\u011f\u0131nda}) \\]<\/p>\n<p>\\[ P_{\\text{INR}} = 2 \\;(1.8 \\text{, 1.7\u20132.3 aral\u0131\u011f\u0131nda}), \\quad P_{\\text{asit}} = 2, \\quad P_{\\text{ensefalopati}} = 1 \\]<\/p>\n<p>\\[ \\text{Skor} = 2 + 2 + 2 + 2 + 1 = 9 \\text{ puan} \\]<\/p>\n<p><strong>Sonu\u00e7:<\/strong> 9 puan \u2014 Child-Pugh S\u0131n\u0131f B; karaci\u011fer i\u015flevinin belirgin bi\u00e7imde bozuldu\u011funu g\u00f6sterir.<\/p>\n<p>\n\r\n<\/section>\n<h2>Child-Pugh Skoru Hesaplay\u0131c\u0131 Nas\u0131l Kullan\u0131l\u0131r?<\/h2>\n<ol>\n<li>Kan tahlilinizdeki <strong>total bilirubin<\/strong> de\u011ferini girin ve birimi se\u00e7in (mg\/dL veya \u00b5mol\/L).<\/li>\n<li><strong>Serum alb\u00fcmini<\/strong> de\u011ferini girin ve birimi se\u00e7in (g\/dL veya g\/L).<\/li>\n<li>Elinizdeki <strong>p\u0131ht\u0131la\u015fma \u00f6l\u00e7\u00fcm\u00fcn\u00fc<\/strong> \u2014 INR veya PT uzamas\u0131 \u2014 se\u00e7in ve de\u011feri <strong>INR \/ PT uzamas\u0131<\/strong> alan\u0131na girin. PT uzamas\u0131n\u0131 se\u00e7tiyseniz total protrombin zaman\u0131n\u0131 de\u011fil, kontrol de\u011ferinin \u00fczerindeki saniyeyi (\u00f6rn. 4,5) girin.<\/li>\n<li><strong>Asit<\/strong> \u015fiddetini se\u00e7in: yok, hafif (t\u0131bbi olarak kontrol alt\u0131nda) veya orta ile \u015fiddetli aras\u0131 (kontrol alt\u0131na al\u0131namayan).<\/li>\n<li><strong>Hepatik ensefalopati<\/strong> derecesini se\u00e7in: yok, derece I\u2013II (hafif) veya derece III\u2013IV (a\u011f\u0131r).<\/li>\n<li>Toplam skorunuzu (5\u201315 puan), Child-Pugh s\u0131n\u0131f\u0131n\u0131z\u0131 (A, B veya C) ve sonucun yorumunu g\u00f6r\u00fcn.<\/li>\n<\/ol>\n<h2>Child-Pugh Skoru Nedir?<\/h2>\n<p>Child-Pugh skoru (Child-Turcotte-Pugh skoru olarak da bilinir), kronik karaci\u011fer hastal\u0131\u011f\u0131 ve sirozun a\u011f\u0131rl\u0131\u011f\u0131n\u0131 derecelendirmek i\u00e7in kullan\u0131lan en eski ve en yayg\u0131n ara\u00e7lardan biridir. \u0130ki laboratuvar de\u011feri (bilirubin ve alb\u00fcmin), bir p\u0131ht\u0131la\u015fma \u00f6l\u00e7\u00fcm\u00fc (INR veya protrombin zaman\u0131) ve iki klinik bulguyu (asit ve hepatik ensefalopati) 5 ile 15 aras\u0131nda tek bir say\u0131da birle\u015ftirir.<\/p>\n<p>Skor, hastalar\u0131 \u00fc\u00e7 s\u0131n\u0131fa ay\u0131r\u0131r. <strong>A s\u0131n\u0131f\u0131 (5\u20136 puan)<\/strong> iyi kompanse siroza kar\u015f\u0131l\u0131k gelir \u2014 karaci\u011fer, skar dokusuna ra\u011fmen i\u015flevlerinin \u00e7o\u011funu h\u00e2l\u00e2 y\u00fcr\u00fctmektedir. <strong>B s\u0131n\u0131f\u0131 (7\u20139 puan)<\/strong> belirgin i\u015flev bozulmas\u0131n\u0131 g\u00f6sterir; <strong>C s\u0131n\u0131f\u0131 (10\u201315 puan)<\/strong> ise s\u0131v\u0131 tutulumu, kanama riski ve bilin\u00e7 bulan\u0131kl\u0131\u011f\u0131 gibi komplikasyonlar\u0131n \u00f6ne \u00e7\u0131kt\u0131\u011f\u0131 dekompanse sirozdur.<\/p>\n<p>Bu s\u0131n\u0131fland\u0131rma, sa\u011fkal\u0131m ve cerrahi riskle ili\u015fkili oldu\u011fu i\u00e7in \u00f6nemlidir. Pugh ve arkada\u015flar\u0131n\u0131n klasik 1973 veri setinde bir y\u0131ll\u0131k sa\u011fkal\u0131m A s\u0131n\u0131f\u0131nda yakla\u015f\u0131k %100, B s\u0131n\u0131f\u0131nda %80 ve C s\u0131n\u0131f\u0131nda %45 idi; perioperatif \u00f6l\u00fcm oran\u0131 ise A s\u0131n\u0131f\u0131nda yakla\u015f\u0131k %10 iken C s\u0131n\u0131f\u0131nda %80'in \u00fczerine \u00e7\u0131k\u0131yordu. Klinisyenler bu skoru bug\u00fcn de elektif cerrahinin makul \u00f6l\u00e7\u00fcde g\u00fcvenli olup olmad\u0131\u011f\u0131na karar vermek, prognozu de\u011ferlendirmek ve hastal\u0131\u011f\u0131n a\u011f\u0131rl\u0131\u011f\u0131n\u0131 standart bir bi\u00e7imde aktarmak i\u00e7in kullanmaktad\u0131r. Karaci\u011fer nakli i\u00e7in hasta \u00f6nceliklendirmesinde ise Child-Pugh yerine b\u00fcy\u00fck \u00f6l\u00e7\u00fcde <a href=\"https:\/\/wpcalc.com\/en\/medical\/meld-na-score-calculator\/\">MELD-Na skoru<\/a> kullan\u0131lmaktad\u0131r.<\/p>\n<h2>Referans Tablosu<\/h2>\n<table>\n<thead>\n<tr>\n<th>Parametre<\/th>\n<th>1 puan<\/th>\n<th>2 puan<\/th>\n<th>3 puan<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Total bilirubin (mg\/dL)<\/td>\n<td>&lt; 2<\/td>\n<td>2\u20133<\/td>\n<td>&gt; 3<\/td>\n<\/tr>\n<tr>\n<td>Serum alb\u00fcmini (g\/dL)<\/td>\n<td>&gt; 3,5<\/td>\n<td>2,8\u20133,5<\/td>\n<td>&lt; 2,8<\/td>\n<\/tr>\n<tr>\n<td>INR<\/td>\n<td>&lt; 1,7<\/td>\n<td>1,7\u20132,3<\/td>\n<td>&gt; 2,3<\/td>\n<\/tr>\n<tr>\n<td>PT uzamas\u0131 (sn)<\/td>\n<td>&lt; 4<\/td>\n<td>4\u20136<\/td>\n<td>&gt; 6<\/td>\n<\/tr>\n<tr>\n<td>Asit<\/td>\n<td>Yok<\/td>\n<td>Hafif<\/td>\n<td>Orta ile \u015fiddetli aras\u0131<\/td>\n<\/tr>\n<tr>\n<td>Hepatik ensefalopati<\/td>\n<td>Yok<\/td>\n<td>Derece I\u2013II<\/td>\n<td>Derece III\u2013IV<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>A s\u0131n\u0131f\u0131 = 5\u20136 puan, B s\u0131n\u0131f\u0131 = 7\u20139 puan, C s\u0131n\u0131f\u0131 = 10\u201315 puan.<\/p>\n<h2>Varsay\u0131mlar, S\u0131n\u0131rl\u0131l\u0131klar ve Pratik \u00d6neriler<\/h2>\n<ul>\n<li><strong>Siroz i\u00e7in ge\u00e7erlidir, akut karaci\u011fer yetmezli\u011fi i\u00e7in de\u011fil.<\/strong> Child-Pugh skoru, kronik karaci\u011fer hastal\u0131\u011f\u0131 ve portal hipertansiyonu olan hastalarda do\u011frulanm\u0131\u015ft\u0131r; akut durumlara y\u00f6nelik tasarlanmam\u0131\u015ft\u0131r.<\/li>\n<li><strong>Be\u015f parametreden ikisi klinik yarg\u0131ya dayan\u0131r.<\/strong> Asit ve ensefalopatinin derecelendirilmesi, belirtilerin tedaviyle ne kadar kontrol alt\u0131nda tutuldu\u011funa ba\u011fl\u0131d\u0131r; bu nedenle ayn\u0131 hasta zaman i\u00e7inde farkl\u0131 puanlar alabilir. Asit i\u00e7in ultrason gerektirmeyen yatak ba\u015f\u0131 de\u011ferlendirme, ensefalopati i\u00e7in dikkatli bir \u00f6yk\u00fc al\u0131nmas\u0131 gerekir.<\/li>\n<li><strong>S\u0131n\u0131r de\u011ferleri dikkatle yorumlay\u0131n.<\/strong> Skorda sabit e\u015fikler kullan\u0131l\u0131r; klinik fark \u00e7ok k\u00fc\u00e7\u00fck olsa da bilirubinin 1,9 ile 2,1 mg\/dL aras\u0131nda de\u011fi\u015fmesi puan\u0131 de\u011fi\u015ftirir. Orijinal Pugh makalesi ayr\u0131ca primer biliyer kolanjit gibi kolestatik hastal\u0131klarda bilirubin e\u015fiklerinin farkl\u0131 oldu\u011funa dikkat \u00e7ekmektedir.<\/li>\n<li><strong>Birim d\u00f6n\u00fc\u015f\u00fcmleri \u00f6nemlidir.<\/strong> \u00b5mol\/L cinsinden bilirubin \\(1 \\text{ mg\/dL} = 17.1\\ \\mu\\text{mol\/L}\\) d\u00f6n\u00fc\u015f\u00fcm\u00fcyle, g\/L cinsinden alb\u00fcmin ise 10'a b\u00f6l\u00fcnerek hesaplan\u0131r. De\u011ferleri girmeden \u00f6nce laboratuvar raporunuzdaki birimleri mutlaka kontrol edin.<\/li>\n<li><strong>Antikoag\u00fclanlar INR'yi etkiler.<\/strong> Hasta varfarin kullan\u0131yorsa INR, karaci\u011ferin sentetik i\u015flevini de\u011fil ilac\u0131n etkisini yans\u0131t\u0131r ve skoru oldu\u011fundan y\u00fcksek g\u00f6sterebilir.<\/li>\n<li><strong>Bu bilgilendirici bir ara\u00e7t\u0131r, tan\u0131 de\u011fildir.<\/strong> Sonucu mutlaka bir hepatolog veya tedavi hekiminizle g\u00f6r\u00fc\u015f\u00fcn. Fibrozis \u015f\u00fcphesinde daha kapsaml\u0131 bir karaci\u011fer risk taramas\u0131 i\u00e7in <a href=\"https:\/\/wpcalc.com\/tr\/tisbi\/fib-4-skoru-hesaplama\/\">FIB-4 skoru hesaplay\u0131c\u0131s\u0131na<\/a> bakabilirsiniz; siroz, atriyal fibrilasyonun tedavi kararlar\u0131n\u0131 etkiliyorsa <a href=\"https:\/\/wpcalc.com\/en\/medical\/has-bled-score-calculator\/\">HAS-BLED skoru hesaplay\u0131c\u0131s\u0131<\/a> kanama riskini tahmin etmede yard\u0131mc\u0131 olabilir.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Bilirubin, alb\u00fcmin, INR veya protrombin zaman\u0131 (PT) uzamas\u0131 ile asit ve ensefalopati \u015fiddetini girin; sirozun a\u011f\u0131rl\u0131\u011f\u0131n\u0131 g\u00f6steren Child-Pugh skorunu (5\u201315 puan) ve A, B veya C s\u0131n\u0131f\u0131n\u0131 \u00f6\u011frenin.<\/p>\n","protected":false},"author":3168,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[11],"tags":[33],"class_list":["post-3899","post","type-post","status-publish","format-standard","hentry","category-tisbi","tag-tani"],"acf":[],"_links":{"self":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/posts\/3899","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/users\/3168"}],"replies":[{"embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/comments?post=3899"}],"version-history":[{"count":0,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/posts\/3899\/revisions"}],"wp:attachment":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/media?parent=3899"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/categories?post=3899"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/tags?post=3899"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}