最新急性胰腺炎英文版 ppt课件-PPT文档
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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.
D i a g n o s i s of a c u t e pa n c r e a t i t i s
It was the best of times, it was the worst of times; it was the age of wisdom, it was the age of foolishness.
Diagnosis of acute pancreatitis
Diagnosis of acute pancreatitis (2 of the following) • Abdominal pain (acute onset of a persistent, severe, epigastric pain often radiating to the back) • Serum lipase activity (or amylase) at least 3 times greater than the upper limit of normal • Characteristic findings of acute pancreatitis on computed tomography or magnetic resonance imaging Serum lipase has a slightly higher sensitivity for detection of acute pancreatitis.One study demonstrated that at day 0–1 from onset of symptoms, serum lipase had a sensitivity approaching 100% compared with 95% for serum amylase.13 For days 2–3 at a sensitivity set to 85%, the specifcity of lipase was 82% compared with 68% for amylase. Serum lipase is therefore especially useful in patients who present late to hospital.
The guideline was developed under the auspices of the University of Toronto. They searched Medline for guidelines published between 2002 and 2014 using the Medical Subject Headings “pancreatitis” and “clinical practice guideline.” This search identifed 14 guidelines published between 2008 and 2014. Another electronic search of Medline was performed using the Medical Subject Headings “pancreatitis,”“acute necrotizing pancreatitis,” “alcoholic pancreatitis,” and “practice guidelines” to update the systematic review. The results were limited to articles published in English between January 2007 and January 2014. The references of relevant guidelines were reviewed. Up-todate articles on acute pancreatitis diagnosis and management were also reviewed for their references.
Methodology
D i a g n o s i s of acute pa n c r e a t i t i s
CO N TA N T S
AssessMent of severity
Suppor tive care
Nutrition
Prophylactic antibiotics
Management of acute gallstone pancreatitis
CO N TA N T S
Methodology
It was the best of times, it was the worst of times; it was the age of wisdom, it was the age of foolishness.
百度文库
Methodology
1 2 3
D i a g n o s i s of a c u t e pa n c r e a t i t i s
It was the best of times, it was the worst of times; it was the age of wisdom, it was the age of foolishness.
Diagnosis of acute pancreatitis
Diagnosis of acute pancreatitis (2 of the following) • Abdominal pain (acute onset of a persistent, severe, epigastric pain often radiating to the back) • Serum lipase activity (or amylase) at least 3 times greater than the upper limit of normal • Characteristic findings of acute pancreatitis on computed tomography or magnetic resonance imaging Serum lipase has a slightly higher sensitivity for detection of acute pancreatitis.One study demonstrated that at day 0–1 from onset of symptoms, serum lipase had a sensitivity approaching 100% compared with 95% for serum amylase.13 For days 2–3 at a sensitivity set to 85%, the specifcity of lipase was 82% compared with 68% for amylase. Serum lipase is therefore especially useful in patients who present late to hospital.
The guideline was developed under the auspices of the University of Toronto. They searched Medline for guidelines published between 2002 and 2014 using the Medical Subject Headings “pancreatitis” and “clinical practice guideline.” This search identifed 14 guidelines published between 2008 and 2014. Another electronic search of Medline was performed using the Medical Subject Headings “pancreatitis,”“acute necrotizing pancreatitis,” “alcoholic pancreatitis,” and “practice guidelines” to update the systematic review. The results were limited to articles published in English between January 2007 and January 2014. The references of relevant guidelines were reviewed. Up-todate articles on acute pancreatitis diagnosis and management were also reviewed for their references.
Methodology
D i a g n o s i s of acute pa n c r e a t i t i s
CO N TA N T S
AssessMent of severity
Suppor tive care
Nutrition
Prophylactic antibiotics
Management of acute gallstone pancreatitis
CO N TA N T S
Methodology
It was the best of times, it was the worst of times; it was the age of wisdom, it was the age of foolishness.
百度文库
Methodology
1 2 3