belstaff bolsas Diagnosis and treatment of severe

lin06900 · Wysłany: Śro 8:17, 23 Mar 2011

Diagnosis and treatment of severe acute pancreatitis

. 2.1 Non-SAP treatment of gallstone disease should be based on the principles of the various stages, using different treatment. 3.2.1.1 acute reaction of (1) first non-surgical treatment,[link widoczny dla zalogowanych], the treatment focus is: ① to strengthen monitoring; ② to correct electrolyte imbalance and imbalance of the acid-base balance; ③ nutritional support; ④ control shock,[link widoczny dla zalogowanych], pulmonary edema, ARDS ,[link widoczny dla zalogowanych], acute renal failure, pancreatic encephalopathy fatal and other serious complications. The main principle of non-surgical treatment are: ① Anti-shock; ② pancreatic rest methods: such as fasting, gastrointestinal decompression, H,-blockers, somatostatin Sandostatin, 5 ~ FU; ③ prophylactic antibiotics : such as quinolones, ceftazidime, imipenem, metronidazole, etc.; ④ calm spasm, pain treatment; ⑤ integrative medicine, traditional Chinese medicine using the 15g (post below), Glauber's salt 6 ~ 30g (blunt), Angelica 1O ~ 12g, white peony 10 ~ 12g, citrus aurantium 12 ~ 15g, Magnolia 12-15g, Toosendan 12 ~ 15g, wide wood 1Og, peach kernel 1Og, Burnet 30g, Patrinia 30g, Pinellia 1Og, Chai Hu 15g; suffering, 1 day, 3 times within the gastrointestinal decompression injection. Syndrome differentiation, addition and subtraction with the disease. To improve the microcirculation, Qi Yin, improve immunity, promote the recovery of the pancreas, the routine use of Pulse Health, Danshen injection of the 4oIIll, adding 5% GS500ml intravenously, day 1. ⑥ prevention of fungal infections: fluconazole can be used. ⑦ nutritional support: parenteral nutrition to the main. (2) the treatment of infection in the transfer operation should be decisive. 24h formal non-surgical treatment where disease progression, and a CT review should be extended pancreatic necrosis and early surgical treatment, surgery is the complete removal of necrotic lesions in the program, backed by effective decompression and drainage. (3) the rapid development of the disease, non-surgical treatment of 24h unstable vital signs, and signs of multiple organ dysfunction, abdominal drainage should be timely, and its methods are: ① abdominal drainage; ② peritoneal lavage; ③ laparoscopic drainage. 3.2.1.2 the treatment of systemic infection of the main principles are: (1) According to the results of blood culture + sensitivity of antimicrobial agents used very sensitive; (2) combined with signs of bed do I Miss CT monitoring, to determine which parts of foci, surgery for treatment of active infection focus; (3) Note whether the associated infection; (4) strengthening systemic support treatment. 3.2.1.3 peritoneal treatment of residual infection (1) clear the infection of residual cavity by imaging the location, extent and adjacent relationship,[link widoczny dla zalogowanych], watch for pancreatic fistula and gastrointestinal fistula; (2) strengthening systemic support therapy enhance nutrition, improve nutritional status; (3) timely debridement for drainage of residual cavity. 3.2.2 The principle of treatment of gallstone SAP should first identify whether the bile duct obstruction. (1) if biliary obstruction: emergency surgery should first aim is to relieve biliary obstruction, the surgical option Fiber duodenoscopy and Oddi's sphincter cut stone and nasal biliary drainage, or open surgery; (2) No biliary obstruction: first non-surgical treatment, to be SAP stable condition, cure elective biliary tract surgery. No matter what kind of procedure,[link widoczny dla zalogowanych], and were advised to line cholangiography, biliary picture to know to avoid lead to biliary stones left over from SAP recurrence.
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