临床见习前理论课件：胃炎.ppt

Gastritis Injury of gastric mucosa Injury of Epithelium Mucosal inflammation Regeneration of epithelial cell Gastritis: acute gastritis、 chronic gastritis Gastropathy Gastritis Acute gastritis Acute gastritis  ? Acute stress ?Acute erosion hemorrhagic gastritis Chemical injury ?Acute corrosive gastritis ?NSAID-related gastritis ? Acute bacterial infection ?Acute purulent gastritis Arachidonic acid COX COX-1 COX-2 (Architectonic enzyme） （Induced enzyme） PG Protect and regulate gastrointestinal cells、kidney、blood vessel Cause inflammation and ache Charge basic PG composition Charge pathological PG composition NSAIDs _ _ COX-2 inhibitors _ NSAIDs--“an two-blade knife” First used drugs for bone and articular muscle ache Anti-inflammation and alleviate pain Thirty? million patients use everyday in the world, the olders accounts 40% In the course of use，especially long-time and high-dose usage, it can always causes Injury of GI In UK, the side-effect caused by NSAIDs accounts 25% of all drugs High risk patients for toxic action of GI tract Risk factors Evidences High-age（>70yers） +++ History of peptic ulcer +++ Hp infection +/- Combined medication Other NSAIDs or Aspirin ++ Steroid + Decoagulant + Smoking + Drinking + Serious burn Curling ulcer Serious CNS changes Cushing ulcer Mucosal microcirculation disturbance ! Acid, pepsine How does stress leads to mucosa damage? Clinical manifestation Symptoms ?primary disease manifestation：shock、burn、 trauma…… ?upper GI symptoms: upper abdominal pain 、 nausea、vomiting…… ? upper GI hemorrhage：hematemesis 、melena ?Signs Electronic gastroscope X-ray check Change position Swallow barium Treatment of acute gastritis Eliminate etiopathogenisis Inhibit gastric acid Protect gastric mucosa Hemorrhage therapy Swallow NE Symptomatic treatment chronic gastritis chronic gastritis Chronic、non-specific gastric mucosal inflammation caused by var