最后审阅: 19 九月 2021
最后更新: 05 三月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 上腹痛
  • 恶心和呕吐
  • 低血容量的体征
  • 胸腔积液体征
  • 厌食
  • 危险因素

其他诊断因素

  • 器官功能障碍的征象
  • 呼吸困难
  • 黄疸
  • 低钙血症征象(Chvostek/Trousseau 征)(罕见)
  • 皮肤瘀斑和变色(Cullen/Grey-Turner/Fox 征)(罕见)

危险因素

  • 中年女性
  • 青年至中年男性
  • 结石
  • 酒精
  • 高甘油三酯血症
  • 高钙血症
  • 致病药物
  • 腮腺炎
  • 柯萨奇病毒
  • 肺炎支原体
  • 内镜逆行胰胆管造影术 (ERCP)
  • 创伤
  • 系统性红斑狼疮
  • 干燥综合征
  • 胰腺分裂
  • 胰腺癌
  • Oddi 括约肌功能障碍
  • 胰腺炎家族史

诊断性检查

首要检查

  • 血清脂肪酶或者淀粉酶
  • 全血细胞计数 (FBC) 和分类计数
  • C 反应蛋白 (CRP)
  • 尿素/肌酐
  • 脉搏血氧测量测定法
  • 肝功能检查 (LFT)
  • 胸部 X 线检查(CXR)
  • 经腹超声
  • 血清钙

需考虑的检查

  • 血清甘油三酯
  • 腹部 CT 扫描(CECT)
  • 超声内镜 (EUS)
  • 磁共振胰胆管造影术 (MRCP)
  • 动脉血气

新兴检查

  • 尿胰蛋白酶原-2
  • 血清 IL-6 和 IL-8

治疗流程

撰稿人

专家顾问

Johann Grundlingh, MBChB, FCEM, FFICM, EDICM, DFMS, DipMedTox, MMedTox, MSB, ERT, MEWI, MBA

Emergency Medicine Consultant

Royal London Hospital

Barts Health NHS Trust

London

Honorary Senior Lecturer

Queen Mary University

London

UK

利益声明

JG declares that he has no competing interests.

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Nicholas J. Zyromski MD

Associate Professor of Surgery

Department of Surgery

Indiana University

Indianapolis

IN

利益声明

NJZ is an author of a reference cited in this topic.

同行评议者

Sven van Dijk, MD

Department of Surgery

Amsterdam UMC

University of Amsterdam

Amsterdam

Department of Surgery

St Antonius Hospital

Nieuwegein

The Netherlands

利益声明

SvD declares that he has no competing interests.

Marc G Besselink, MD, PhD, MSc

Hepatopancreatobiliary Surgeon

Department of Surgery

Amsterdam UMC

University of Amsterdam

Principal Investigator

Dutch Pancreatitis Study Group

Academic Medical Center

Amsterdam

The Netherlands

利益声明

None declared

编辑

Jo Haynes,

Head of Editorial, BMJ Knowledge Centre

利益声明

JH declares that she has no competing interests.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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