胰腺（pancreas）.doc

胰腺（pancreas） Twenty pancreatic disease 481. what is the cause of acute pancreatitis? Gallstone and alcoholism. 483. what are the laboratory tests and special examinations for acute pancreatitis? Serum and urine amylase: 2~12 hours after the attack, serum amylase began to rise, peaked at 24 hours, began to decrease in 48 hours, and continued for 3~5 days. General use of Somogyi, the normal value of 100U / L, more than 200U / L to consider acute pancreatitis, more than 500U / L can be diagnosed The level of serum amylase is not absolutely proportional to the degree of pathological changes About 10% of necrotic pancreatitis has no definite elevation of serum amylase. The elevation of urinary amylase is generally 12~24 hours later, lasting 1~2 weeks. Urine amylase is more than 500U per hour, which is of diagnostic value. Ratio of amylase clearance to muscle crisp clearance Its formula is: ACR = (amylase, blood inosine) / (amylase, urine, inosine), 100% ACR, more than 5.3%, were diagnosed with acute pancreatitis. Serum lipase The normal value is 0.2 to 0.7U/dL Acute pancreatitis is more than 1.5U/L and begins to rise 72 hours after onset for more than 1 weeks. Blood calcium determination When serum calcium is lower than 1.75nmol / L, it is a sign of poor prognosis. Increased WBC Generally, neutrophils are markedly elevated between (10~20) and between 109 and a few. Other checks Serum levels of serum iron, albumin, serum albumin, serum bilirubin, serum transaminase and alkaline phosphatase Determination of amylase in peritoneal fluid The content of amylase in peritoneal fluid can reflect the extent of pancreatitis and evaluate its prognosis. Special inspection is available: Electrocardiogram: a pattern similar to myocardial infarction, Abdominal radiograph: intestinal stasis, marked inflation, stage paralysis, expansion, and even the presence of suspicious free gas. B ultrasound: edema type: pancreatic enlargement and uneven density of the pancreas parenchyma. In severe a