急性胰腺炎的临床处理美国胃肠病学.pptxVIP

急性胰腺炎的临床处理美国胃肠病学第1页/共55页第2页/共55页1Center for Pancreatic Care, Southern California Permanente Medical Group, Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California （南加州,凯萨医疗机构） ; and 2 Center for Pancreatic Disease, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts（波士顿，哈佛医学院)Keywords: Clinical Management; Fluid Resuscitation; Necrosis; Quality Improvement.第3页/共55页Abstract Acute pancreatitis is the leading cause of hospitalization for gastrointestinal disorders in the US, with more than 280,000 hospitalizations each year. The average length of stay at US hospitals in 2010 was estimated to be 5 days, at an aggregate cost of $2.9billion. 高发病率；平均住院时间：5天；治疗费用高昂 Mortality ranges from 3% for patients with interstitial (edematous) pancreatitis to 15% for patients who develop necrosis. 死亡率：3%（间质水肿性AP）-15%(坏死性AP) As the rate of hospitalization for acute pancreatitis continues to increase, so does the demand for effective management. This demand has resulted in publication of at least 14 clinical practice guidelines in the past decade. An update to the American Pancreas Association and International Association of Pancreatology guidelines is forthcoming. 急性胰腺炎诊治指南需进一步规范1. Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology 2012;143:1179–1187.2. Singh VK, Bollen TL, Wu BU, et al. An assessment of the severity of interstitial pancreatitis. Clin Gastroenterol Hepatol 2011;9:1098–1103.3. van Santvoort HC, Bakker OJ, Bollen TL, et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology 2011;141:1254–1263 第4页/共55页Diagnosis1Risk and Prognostic Factors 2Treatment3Prevention4Contents第5页/共55页Diagnosis The diagnosis of acute pancreatitis requires at least 2 of the following: 1.typical upper abdominal pain 典型的上腹部疼痛 2.serum levels