I. Disease concept
Acute pancreatitis (AP) is an acute inflammation caused by the activation of pancreatic enzymes from various causes that produce digestive effects on the organ itself and its surrounding organs.
Etiology and pathogenesis
Acute pancreatitis has multiple causative factors.
1, biliary tract diseases.
2, excessive alcohol consumption.
3, duodenal reflux.
4, traumatic factors.
5, pancreatic blood circulation disorders.
6, other dietary factors, infection factors; domestic bile duct disease is the main factor, accounting for more than 50%.
When the pancreas under the action of various pathogenic factors, its own digestive defense is weakened, coupled with damage to pancreatic cells, the release of lysosomal hydrolase, this enzyme in contact with the enzymatic particles in the cell activates pancreatic enzymes, first trypsinogen is activated to form to trypsin, further activating phospholipase, elastase and pancreatic vasodilator. Phospholipase A turns lecithin into cytotoxic hemolytic lecithin, causing vascular damage, rupture, hemorrhage and necrosis; pancreatic vasorelaxin converts kininogen into kinin and bradykinin in blood, causing vasodilation and increasing vascular permeability and liquefaction. Digestive enzymes and necrotic tissue fluid can be transported to the whole body through blood circulation and lymphatic channels, causing systemic organ damage and a variety of complications and causes of death.
Third, clinical manifestations
1.Abdominal pain;
2, nausea, vomiting, abdominal distension;
3, physical signs abdominal pressure pain, rebound pain and muscle tension and other signs of peritoneal irritation;
4, shock.
5, fever.
6, hyperglycemia and hypocalcemia.
IV. Health care guidance
1. Pay attention to rest, avoid emotional excitement, and maintain a good mental state. 4~6 weeks after discharge, avoid heavy physical work and excessive fatigue and cold.
2.See a doctor promptly in case of abdominal pain, abdominal distension, fever and other maladjustments.
3.Dietary guidance Regular diet, no overeating, no smoking, no alcohol, and lipid reduction. Pay attention to a small number of meals, eat a low-fat, easy-to-digest, vitamin-rich diet, and guide patients with complications of diabetes to control their diet and follow medical advice on medication.
Inform patients of the relationship between alcohol consumption and pancreatitis, and emphasize the importance of abstaining from alcohol to prevent recurrence.