胰腺疾病中山大學(xué)內(nèi)科學(xué)(存儲版)
【正文】 mild pancreatitis bleeding and necrotic focuses hemorrhagic focus pseudocyst Admission Age 55 yr WBC16000/mm3 Glucose 200 mg/dL LDH350 IU/L AST250 IU/L Initial 48 hrs Hct fall 10% BUN elevation 5mg/dL Ca2+ 2mmol/L PaO260mmHg Base deficit4mmol/L Fluid sequestration6L 3 or 4 signs mortality 15%, 7 or 8 signs mortality 90% Ranson’s Prognostic Signs Differential diagnosis ? acute cholangitis / cholecystitis ? perforated hollow viscus ? bowel obstruction ? mesenteric ischemia / infarction ? acute gastroenteritis ? acute myocardial infarction The stages of course ? stage of acute reaction – within 2w ? stage of systemic infection – 2w2m ? stage of residual infection later than 23m usually but not always Local plications ? acute fluid collection ? pancreatic and peripancreatic necrosis ? pancreatic pseudocyst ? pancreatic abscess Treatment nonoperative therapy 1. fasting diet, gastric suction 2. inhibition of pancreatic juice secreting somatostatin (Sandostatin， Stilamin， Uinastatin) 3. paregoric amp。 physiology ?Acute pancreatitis ?Chronic pancreatitis ?Pancreatic cyst ?Pancreatic cancer / Periampullary carcinoma ?Pancreatic endocrine tumors Location amp。 sup. mesenteric nodes
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鄂ICP備17016276號-1