急性胰腺炎知识介绍.ppt

inhibit excrine of pancreas and pancreatic enzymes: No oral alimentation and continuous nasogastric suction H2RA or PPI Somatostatin and its long-acting analogue (Sandostatin) protease inhibitors: gabexate, aprotinin, etc. Prevention and treatment of enteral failure oral antibiotics enteral microecological preparations glutamine enteral feeding Treatment of multiple organs failure Traditional Chinese medicine: 生大黄、清胰汤 Endoscopic therapy: ERCP+EST+ENBD Surgical operation: indications necrotic pancreatitis with infection pancreatic abscess early severe acute pancreatitis (ESAP) abdominal compartment syndrome (ACS) pancreatic pseudocyst: 6cm diagnosis remain unclear and GI perforation is suggested Acute Pancreatitis Teaching Objective To know the etiology and pathogenesis of acute pancreatitis To master the clinical features and key points of diagnosis for different types of acute pancreatitis To master the therapy principles of acute pancreatitis Definition Acute pancreatitis is a inflammation of the pancreas induced by the activation of the pancreatic enzymes derived from various causes. Etiology Biliary duct diseases: gallstone, acute and chronic cholecystitis, ascariasis accompanied with inflammatory stricture at the level of the papilla. Common channel hypothesis Alcohol and/ or square meal hyperlipidemia Postoperation: post-ERCP, abdominal operation. Etiology Metabolic diseases: hyperparathyroidism, hypercalcemia, etc. Drugs: glucocorticords, diuretics, azathioprine, estrogen, etc. Autoimmune diseases: SLE, RA, vasculitis, etc. Viral infections: mumps, coxsackie virus , HIV, etc Idiopathic pancreatitis. Pathology Mild form (interstitial or edematous pancreatitis) focal or diffused edema slight leukocyte infiltration Severe form (necrotic or hemorrhagic pancreatitis) marked acinar destruction with hemorrhage extensive leukocyte infiltration necrosis of parapancreatic fat grossly an in