胰腺炎治疗策略1__培训课件.pptVIP

营养方法的选择 当肠道不能应用时，从肠外给予营养。 当肠道有功能，且能安全使用时，应用它。 Thank you ! 谢 谢 ! * Gallstone-induced pancreatitis in a 27-year-old woman. (a) Transverse CT scan obtained with intravenous and oral contrast material reveals a large, edematous, homogeneously attenuating (73-HU) pancreas (1) and peripancreatic inflammatory changes (white arrows). Although the attenuation values are low, there is no pancreatic necrosis. Calcified gallstones are seen in gallbladder (black arrow). 2 = liver (140 HU). (b) Follow-up transverse CT scan obtained 7 days later reveals total resolution, with a normal pancreas (P, arrows) with CT number of 104 HU. * Figure 1a. Gallstones, acute pancreatitis, and gland necrosis in a 47-year-old man with four Ranson grave signs. (a) Early transverse nonenhanced CT scan obtained at the time of admission to the hospital shows a homogeneously enlarged pancreas (solid arrows). There are large heterogeneous peripancreatic fluid collections (open arrows). Gland necrosis cannot be ruled out. K = kidney, L = liver, P = pancreas, Sp = spleen, St = stomach. (b) Follow-up transverse contrast-enhanced CT scan obtained 13 days after a reveals two zones (straight arrows) of liquefied pancreatic necrosis in the neck and tail of the gland. There are residual nodular areas adjacent to the tail of the pancreas, consistent with fat necrosis (curved arrow). P = pancreas. (c) Follow-up transverse contrast-enhanced CT scan obtained 10 days after b reveals development of large pseudocysts (P) in the neck and tail of the pancreas. * Follow-up transverse contrast-enhanced CT scan obtained 13 days after a reveals two zones (straight arrows) of liquefied pancreatic necrosis in the neck and tail of the gland. There are residual nodular areas adjacent to the tail of the pancreas, consistent with fat necrosis (curved arrow). P = pancreas. * Follow-up transverse contrast-enhanced CT scan obtained 10 days after b reveals development of large pseudocysts (P) in the neck and tail of the p