资源描述：
《急性胰腺炎acute pancreatitis（八年制）课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、AcutePancreatitisXia,ZhongshengDepartmentofGastroenterologyTheSecondAffiliatedHospitalSunYat-senUniversityTeachingObjectiveToknowtheetiologyandpathogenesisofacutepancreatitisTomastertheclinicalfeaturesandkeypointsofdiagnosisfordifferenttypesofacutepancreatitisTomasterthetherapyprinci
2、plesofacutepancreatitisDefinitionAcutepancreatitisisainflammationofthepancreasinducedbytheactivationofthepancreaticenzymesderivedfromvariouscauses.EtiologyBiliaryductdiseases:gallstone,acuteandchroniccholecystitis,ascariasisaccompaniedwithinflammatorystrictureatthelevelofthepapilla.C
3、ommonchannelhypothesisAlcoholand/orsquaremealhyperlipidemiaPostoperation:post-ERCP,abdominaloperation.EtiologyMetabolicdiseases:hyperparathyroidism,hypercalcemia,etc.Drugs:glucocorticords,diuretics,azathioprine,estrogen,etc.Autoimmunediseases:SLE,RA,vasculitis,etc.Viralinfections:mum
4、ps,coxsackievirus,HIV,etcIdiopathicpancreatitis.Pathogenesistrypsinogen→trypsintrypsin→pancreaticenzymes,complementsystemandkininsystemPathophysiologicalchanges:leukocytechemotaxis,releaseofactiveagents,oxygenicstress,microcirculationdisorderandbacteriatransposal.Trypsinactivatesothe
5、rproenzymesandresultsinproteolysis,edemaandvasculardamageLipaseproducesextrapancreaticfatnecrosisPhospholipasedegradesthelecithinintothelysolecithinwhichinducespancreaticnecrosisandhemorrhageKallikreinandelastasecausevasculardestructionBradykininpeptidaseandvasoactivesubstanceinducev
6、asodilatation,increasevascularpermeabilityandedemaCytokine,oxygenfreeradicals,plateletactivatingfactor,prostaglandins,bloodcirculationdisturbance,systemicinflammationresponsesyndrome(SIRS)PathologyMildform(interstitialoredematouspancreatitis)focalordiffusededemaslightleukocyteinfiltr
7、ationSevereform(necroticorhemorrhagicpancreatitis)markedacinardestructionwithhemorrhageextensiveleukocyteinfiltrationnecrosisofparapancreaticfatgrosslyaninflammatorytumor-likemasswithdiffusedhemorrhagicchangesecondaryinfectioninducestheformationofabscessorpseudocystsSymptomsabdominal
8、pain:located
