急性胰腺炎接诊处理指南（Guidelines for management of acute pancreatitis）.docVIP

急性胰腺炎接诊处理指南（Guidelines for management of acute pancreatitis） Guidelines for the management of acute pancreatitis admissions I common knowledge I.1 non imaging clinical typing criteria: Ransons standard I.1.1 evaluation index at admission (5 items): Age 55 years and older; white blood cell 16 * 109/L; blood sugar is greater than 11.2mmol/L; serum LDH is greater than 350IU/L; GOT is greater than 250IU/L. I.1.2 was evaluated within 48 hours after admission (6 items): Hematocrit decreased by more than 10%; BUN increased by more than 1.79mmol/L; serum calcium was less than 2mmol/L; arterial blood PO2 was less than 8kPa; alkaline deficiency was greater than 4mmol/L; estimated body fluid loss was over 6000ml. I.2 clinical diagnostic words I.2.1 acute pancreatitis (acute, pancreatitis, AP) The clinical manifestation of acute and persistent abdominal pain (with or without abdominal pain) increased serum amylase activity by 3 times the normal value. Imaging findings suggest that the pancreas has / has no morphological changes and excludes other diseases. Can have / do not have other organ dysfunction. In a few cases serum amylase activity was normal or slightly increased. I.2.2 mild acute pancreatitis (mild, acute, pancreatitis, MAP) Clinical and biochemical changes of acute pancreatitis, without organ dysfunction or local complications, respond well to liquid supplement therapy. The Ranson score, 3, or CT was graded as A, B, and C. I.2.3 severe acute pancreatitis (severe, acute, pancreatitis, SAP) Have clinical and biochemical changes of acute pancreatitis, and one of the following: local complications (pancreatic necrosis, pseudocyst, pancreatic abscess); organ failure; Ranson score is more than 3 CT grade D, E. I.2.4 acute severe acute pancreatitis (early, severe, acute, pancreatitis, ESAP) The following one of the 72 h SAP: after the onset of renal failure (serum Cr 2 mg/dL); respiratory failure (PaO2 = 60, mmHg); shock (systolic blood pressure less than 80 mmHg, 15 min)