胰腺疾病(英文)完整ppt课件

Routine check-ups can help detect pancreatic diseases in the early stages, allowing for early treatment and better prognosis.
Monitoring changes
Regular follow-up exams can help monitor the progress of pancreatic diseases and adjust treatment plans accordingly.
acute pancreatitis
急性胰腺炎是一种突发的、严重 的胰腺炎症，通常由过量饮酒、 暴饮暴食、胆结石或其他因素引
起。
主要症状包括上腹部剧痛、恶心 、呕吐、发热和黄疸。
严重病例可能导致多器官功能衰 竭和死亡。
chronic pancreatitis
慢性胰腺炎是一种长期慢性的 胰腺炎症，通常由急性胰腺炎 反复发作或长期饮酒引起。
REPORT
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SUMMAR Y
01
Байду номын сангаасThe anatomy and physiology of the pancreas
The anatomical structure of the pancreas
The pancreas is a long, narrow organ that lies across the back of the abdominal cavity, behind the
REPORT
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DATE
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The pancreas is routinely divided into the
head, the neck,the body and the tail.
The pancreas is almost enteraly retroperitoneal and has close relationship with numerous surrounding structures
5.Physiology (1)Exocrine function:
Islet peptide products influence the function of the exocrine pancreas Bicarbonate secretion:(20 mmol/L,pH7-9) Enzyme secretion: (amylases,lipases,proteases)
4.Venous drainage The venous drainage of the pancreas and duodenum follows the arterial supply ,The veins are usually superficial to the arteries and the frenquency of anomalies is similar
mon channel Variations in the relation between the intra pancreatic portion of the common bile duct and the main pancreatic duct at the ampula of Vater. A short common channel contain flow from both secretary system.

并发急性肾衰竭、ARDS、心力衰竭、DIC、胰性脑病、血栓性静脉炎、皮下及骨髓脂肪坏死
出院护理，帮助胰腺恢复功能
续3-5天 其他：胰管阻塞、手术创伤、内分泌代谢紊乱、
水、电解质及酸碱平衡紊乱：脱水、呕吐—代碱、低钾、低镁、低钙、高糖 潜在并发症：急性弥漫性腹膜炎、多器官功能衰竭、ARDS、DIC、败血症等 胆道炎症- 细菌毒素、游离胆酸、非结合胆红素、溶血卵磷脂→胆胰间淋巴管交通支→胰腺→激活胰酶 →AP 生理性胰蛋白酶抑制物质减少
临床表现
健康评估
症状：
临床表现
痛 1.腹 ：最主要表现，95%，特点：
主要表现
首发症状
①诱因 饱餐、饮酒（酒醉12－48h）；胆源性 ②部位 中上腹，可呈束腰带状向腰背部放射，严重时可
有全腹痛、压痛肌紧张及反跳痛
③性质 轻重不一、剧烈时呈持续性钝痛、刀割样、钻痛
或绞痛，极少数人，老年人隐痛或无痛
仅生见理于 性出胰血蛋坏白死酶型抑制有物血效质血减容清少量不淀足 粉酶升高超过正常值5倍即可确诊本病
尿淀粉酶：12-14h开始升高，下降慢，持续1-2周 其他：心率加快，移动性浊音，胰性脑病、 心肺肾功能不全 仅见于出血坏死型 有效血容量不足
尿淀粉酶：12-14h开始升高，下降慢，持续1-2周 饮食：严格禁食、禁饮1-3天，胃肠减压
严格禁食、禁饮 加强监护
减少胰腺外分泌 抑制胰酶活性 维持水电解质平衡，保持血容量，抗菌，解痉镇
痛—禁单独应用吗啡！！ 腹膜透析 处理多器官功能衰竭
内镜下Oddi括约肌切开术（EST） 胰腺血循环紊乱（缺血敏感）
壶腹部出口梗阻- 结石 、蛔虫、感染，Oddi括约肌痉挛 胆道内压升高 逆流胰管 低钙手足搐溺为预后不佳的表现

There has been an increase in the incidence of acute pancreatitis reported worldwide.Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with signifcant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis,recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis. The purpose of the present guideline is to provide evidence-based recommendations for the management of both mild and severe acute pancreatitis as well as the gall stone–induced pancreatitis.