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急性胰腺炎

最后审阅: 22 Nov 2024
最后更新: 05 Mar 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 腹痛
  • 恶心和呕吐
  • 厌食
  • 低血容量的体征
完整详情

其他诊断因素

  • Grey-Turner 征
  • Cullen 征
  • Fox 征
  • Chvostek 征
  • 低血压
  • 腹胀
完整详情

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
  • 肺炎支原体肺炎
  • 经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
完整详情

诊断性检查

首要检查

  • 血清脂肪酶或者淀粉酶
  • 天冬氨酸氨基转移酶/丙氨酸氨基转移酶
  • 全血细胞和分类计数
  • C 反应蛋白 (CRP)
  • 血细胞比容
  • 动脉血气
  • 腹部平片检查
  • 胸部 X 线检查
  • 经腹部超声
  • 血清脂肪酶与淀粉酶的比值
完整详情

需考虑的检查

  • 腹部 CT 扫描
  • 磁共振胆管胰腺造影 (MRCP)
  • 超声内镜(endoscopic ultrasound,EUS)
完整详情

新兴检查

  • 尿胰蛋白酶原-2
  • 血清白介素-6
  • 血清白介素-8

治疗流程

急症处理

所有患者

撰稿人

作者

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.

鸣谢

Dr Nicholas J. Zyromski would like to gratefully acknowledge Dr Brian Daley, Dr Catherine Lindsay McKnight, and Dr Fernando Aycinena, previous contributors to this topic. He would also like to thank Dr Camille Blackledge for her contribution to this topic. BD, CLM, FA, and CB declare that they have no competing interests.

同行评议者

Tamas A. Gonda, MD

Assistant Professor of Medicine

Attending Physician and Director of Research

Columbia University Medical Center

New York

NY

利益声明

TAG declares that he has no competing interests.

Alan Moss, MD

Harvard Medical Faculty Physician

Division of Gastroenterology

Beth Israel Deaconess Medical Center

Boston

MA

利益声明

AM declares that he has no competing interests.

Derek O'Reilly, MD

Consultant Hepatobiliary & Pancreatic Surgeon

Department of Surgery

North Manchester General Hospital

Manchester

UK

利益声明

DOR is an author of a reference cited in this topic. He declares that he has no other competing interests.

Eric Frykberg, MD

Professor

Department of Surgery

Division General Surgery

Shands Jacksonville Medical Center

FL

利益声明

At the time of the peer review, Dr E. Frykberg declared no competing interests. We were made aware that Dr Frykberg is now deceased.

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