急性胰腺炎合并肝损害24例

急性胰腺炎可合并多器官功能损害,其中肝功能损害最为多见,表现为丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)活性升高和(或)总胆红素(TBiL)升高。通过积极的治疗,大多可恢复正常。1994年1月～1997年7月,我院收治急性胰腺炎60例,其中合并肝损害24例(40%),报告如下。1　临床资料1.1　一般情况　本组男11例,女13例;年龄20～82岁,平均53岁。参照有关标准[1]可分为轻型胰腺炎合并肝损害14例,重型胰腺炎合并肝损害8例,暴发型胰腺炎合并肝损害2例。肝功能检查所见:TBiL升高17例,AST升高20例,ALT升高16例,其中AST和ALT同时升高16例,ALT和T…     

急性胰腺炎的肝脏损害临床分析

目的:探讨急性胰腺炎(AP)患者并发肝脏损害的临床特点以探讨其发病机制.方法:对我院近两年来收治的74例急性胰腺炎病例资料进行回顾性分析.结果:急性胰腺炎患者中有17例发生肝损害,占23％,其中轻症胰腺炎(MAP)13例,占19％,重症4例,占80％.MAP肝功能损害较SAP轻,重症者肝功能损害程度较轻症重,肝功能恢复时间延长.结论:急性胰腺炎大多伴有肝损害,其损害程度与胰腺炎病情严重程度有关.病因、各种破坏因子、炎症递质的参与、内毒素作用等因素,在AP伴肝损害的发病机制中占有重要地位.     

急性胆原性胰腺炎手术时机的选择

急性胰腺炎(Acute pancreatitis,AP)病因目前尚不十分明确,但已确认胆道疾病是引起AP的主要病因之一。1974年Acosta等就提出胆石移动学说,Houssin等分析752例胆石症病例后发现,结石越小,重症急性胰腺炎(Severe acutepancreatitis,SAP)发生率越高。以胆石症为主的胆道疾病占AP全部发病因素的55％～65％。青海高原地区系胆石症多发区,我院1991年10月～1999年6月间共收治114例急     

急性胆源性胰腺炎的临床特征和治疗分析

胆石症是引起急性胰腺炎的主要病因。据国内外文献报道，约占急性胰腺炎发病因素的58％-65％。急性胆源性胰腺炎起病急骤，临床症状复杂多变，治疗时机掌控不易。现将我院收治的急性胆源性胰腺炎107例进行回顾性分析，报道如下。     

急性胰腺炎伴肝损害56例临床分析

急性胰腺炎尤其是重症急性胰腺炎常合并多脏器功能损害,近年来研究表明,急性胰腺炎所引起的肝损害不但可加重急性胰腺炎的病情,甚至可发展成肝功能衰竭,导致病人很快死亡。本文就我院近年来收治的急性胰腺炎伴肝损害56例进行临床分析如下。     

高脂血症对急性胰腺炎发病的影响分析

急性胰腺炎是多种病因引起的胰酶激活，继以胰腺局部炎症反应为主要特征，伴或不伴其他器官功能改变的疾病。在我国．急性胰腺炎最常见的病因是胆系疾病、饮酒及高脂血症等。本研究就急性胰腺炎患者血脂水平进行临床观察，并与体检人群血脂水平比较．然后进行相关性探讨．旨在加强对高脂血症影响急性胰腺炎发病的认识，提高对这类患者的防治水平。     

急性胰腺炎对肝酶活性的影响

目的:了解急性胰腺炎对肝脏的影响。方法:采用酶速率法及酶循环法、比色法检测急性胰腺炎患者和正常人血清肝酶活性及总胆汁酸、胆红素、白蛋白水平变化。结果:急性胰腺炎(轻症组)患者血清肝酶活性及总胆汁酸水平升高,较对照组有显著性差异,P<0.001;重症胰腺炎组各指标均显著高于轻症组和对照组,P<0.001。结论:急性胰腺炎对肝脏有不同程度的损害。     

急性胰腺炎伴肝损害78例临床分析

目的探讨急性胰腺炎（AP）患者合并肝损害的发病机制、临床特点。方法对128例AP患者的临床资料进行回顾性分析。结果 128例AP中有78例合并肝损害,发生率为60.9%。其中重型急性胰腺炎（SAP）较轻症急性胰腺炎（MAP）肝损害发生率更高,损害程度更明显,差异均具有统计学意义（P〈0.05）。结论 AP大多伴有肝损害,其损害程度可反映急性胰腺炎严重程度,并与其病程有关。     

急性胰腺炎对肝脏损害的CT观察

急性胰腺炎是临床常见急腹症,因产生酶血症及胰腺解剖位置关系,常有多脏器损害,肝脏损害较常见。本文就我院2000-01—2005-03收治的43例急性胰腺炎并肝脏损害的CT表现进行分析,总结如下。1临床资料1.1一般资料43例急性胰腺炎病人中(排除原有肝炎、肝硬化、脂肪肝等肝病疾患),男25例,女18例,年龄4.5~68岁,平均38.4岁。43例患者临床分为轻型和重型,诊断标准及分型采用1973年马赛会议时胰腺炎所作的分类和定义及实用内科学制定的标准[1,2],依据此标准17例属轻型,26例属重型。1.2临床表现均表现为突发中上腹疼痛及血尿淀粉酶明显升高,大都还伴…     

急性胰腺炎诊治指南

<正>胰腺是人类体内重要的消化器官。胰腺发生的病因有哪些呢?西方国家以大量饮酒为多见,我们国家以胆道疾病为常见病因,胆石症、胆道感染、胆道蛔虫造成胆汁逆流到胰管、诱发急性胰腺炎,又称胆源性胰腺炎。此外,酗酒和暴饮暴食会导致胰腺胰液分泌增加、排出受阻,使胰管内压增加,引起急性胰腺炎。其次,与人们日常饮食习惯息息相关的一个病因就是高甘油三     

急性胰腺炎合并肝脏低密度改变的CT诊断

目的：通过对急性胰腺炎合并的肝脏低密度改变的CT表现进行分析,探讨其变化规律及可能的发生机理。方法：回顾分析资料完整的62例急性胰腺炎患者的肝脏CT表现,采用16层螺旋CT机,重建层厚为5mm。结果：62例患者中,42例CT显示肝脏低密度改变,占67.74%（42/62）;在2～20天复查CT,有61.90%（26/42）病例随病情的好转而减轻,其中45.24%（19/42）病例完全恢复为正常肝实质密度,CT值高于脾脏。最早恢复时间为发病后第5天即恢复正常。38.09%（16/42）病例无恢复。结论：多层螺旋CT特别是16层螺旋CT在清楚显示急性胰腺炎胰腺本身及其周围变化的同时亦可对继发性的肝脏低密度改变及其转归做出确切的评判,为急性胰腺炎的早期诊断增添了新的依据;结合文献认为急性胰腺炎的肝脏低密度改变主要是急性脂肪肝的形成造成的。     

Hand tendon injuries in athletics.

Hand tendon injuries may be caused by acute trauma or chronic overuse. Although these injuries are common in athletics, specific diagnoses can be difficult to make and are often delayed. Early diagnosis is the key to a good outcome. Most hand tendon injuries do well with nonoperative treatment when initiated early. Long-term disruption of the delicate balance of muscle forces in the hand will lead to secondary changes that are often difficult to correct. Delay in treatment of overuse injuries may produce chronic inflammation that does not respond to conservative care and requires operative management. A sound knowledge of hand anatomy, awareness of the differential diagnosis, and a high index of suspicion are needed for proper care of the athletic hand injury.     

Nichtokklusive Ischämie (NOI) des rechtsseitigen Kolons

BACKGROUND: Nonocclusive disease (NOD) is known to be a common cause of ischemic colitis, which is frequently underestimated. MATERIAL AND METHODS: A computer-assisted search of radiological reports at our institute over a period of 18 months, describing ischemic colitis of the ascending colon with an unimpaired perfusion of the superior mesenteric artery, was performed. RESULTS: A retrospective analysis of the clinical and radiological data of 14 patients was performed. In ten cases colonic ischemia was confirmed clinically or intraoperatively. Most of our patients needed intravenous catecholamines due to severe hypotension. However, no significant radiographic predictors could be identified. CONCLUSION: Awareness of NOD seems to be crucial. Especially in cases of acute abdominal pain associated with severe hypotension, renal insufficiency, or pancreatitis, one should include NOD as a differential diagnosis at an early stage.     

胰腺损伤及其并发症的ICU监护与治疗

目的：探讨胰腺损伤治疗中ICU监护和方法及其作用。方法：自1985年7月至2001年5月我科对78例严重胰腺损伤术后进行了ICU监护和治疗，主要包括循环，呼吸及肝，肾等脏器功能监测，容量复苏；预防和控制感染；营养支持及内脏并发症的防治。结果：发生急性呼吸窘迫综合征（ARDS）31例，多脏器功能不全综合征（MODS）21例，应激性溃疡28例，胰瘘9例，创伤性胰腺炎21例，除4例（5．1％）死于MODS外，74例（94．9％）治愈，结论：ICU监护和治疗在胰腺损伤后容量复苏，监测及维护重要脏器功能，防治内脏并发症等方面发挥重要作用。     

胰腺损伤的救治(附26例报告)

目的　探讨胰腺损伤的救治方法。方法　回顾性分析 2 6例胰腺损伤的临床资料。结果　 2 6例中合并伤 2 2例 (84 .6 % ) ,其中尤以肝、胃损伤多见。手术 2 1例 ,保守治疗 5例 ;并发症 10例 ,其中胰瘘 4例 ,外伤性胰腺炎 2例 ,腹腔脓肿 1例 ,胰腺假性囊肿 3例。治愈 2 2例 ;死亡 4例 ,其中 2例在伤后 4 8小时内分别死于急性呼吸窘迫综合征 (ARDS)和多器官功能不全综合征 (MODS)。结论　及时判明有无主胰管损伤 ,用适当的手术方式、通畅的引流、恰当的药物治疗是减少其并发症、降低死亡率、加快康复的关键。     

乌司他丁治疗急性胰腺炎临床疗效观察

目的：观察乌司他丁对急性胰腺炎的治疗作用。方法：回顾性对比分析1996－06－2001－06 72例急性胰腺炎，应用乌司他丁，生长抑素和其他方法的治疗效果。结果：应用乌司他丁治疗组体温，白细胞总数，SpO2，腹部胀痛及压痛恢复与生长抑素组和对照组有显著差异（P＜0．05），血压，心率，呼吸，肠鸣音，血，尿淀粉酶恢复明显优于对照组（P＜0．05），结论：乌司他丁对急性胰腺炎有较好的治疗作用，尽早应用能在较短时间内稳定，控制急性胰腺炎的病情发展，减少并发症的发生。     

Muscular Strength and the Knee

IN BRIEF: The diagnosis and treatment of acute ankle injuries present challenges to both primary care physicians and orthopedic specialists. Determining the position of the ankle when the injury occurred may help distinguish sprains from fractures so that unnecessary x-rays can be avoided. Stepwise rehabilitation restores function and diminishes the risk of reinjury. Physicians can stress functional measures of recovery to objectively assess readiness for return to play and balance the risks of incomplete rehabilitation against the desire for an early return to sports.     

The influence of various factors on the accuracy of gallium-67 imaging for occult infection

To examine whether the results and interpretation of gallium-67 citrate imaging may be adversely influenced by factors present in compromised patients, we reviewed our 1-year experience in 69 patients in intensive care units, renal transplants, and those on hemodialysis. Our results indicate that it is an inappropriate diagnostic procedure for acute pancreatitis since seven of nine had false-negative results. Using loglinear modeling and chi-square analysis we found that treatment with antiinflammatory steroids, severe liver disease, end-stage renal disease, and renal transplantation with immunosuppressive therapy did not interfere with gallium-67 uptake. Increased rate of true-negative results in patients with end-stage renal disease was due to a greater and earlier use of the test in the febrile transplant patient and in hemodialysis patients with infections not amenable to diagnosis with gallium-67 scan (transient bacteremia and bacteriuria). We conclude that gallium-67 imaging is a useful diagnostic tool that, with the exception of acute pancreatitis, has very few false-negative results.     

Potential role of imaging for assessing acute pancreatitis-induced acute kidney injury

Acute kidney injury (AKI) is a common complication of acute pancreatitis (AP) that is associated with increased mortality. Conventional assessment of AKI is based on changes in serum creatinine concentration and urinary output. However, these examinations have limited accuracy and sensitivity for the diagnosis of early-stage AKI. This review summarizes current evidence on the use of advanced imaging approaches and artificial intelligence (AI) for the early prediction and diagnosis of AKI in patients with AP. CT scores, CT post-processing technology, Doppler ultrasound, and AI technology provide increasingly valuable information for the diagnosis of AP-induced AKI. Magnetic resonance imaging (MRI) also has potential for the evaluation of AP-induced AKI. For the accurate diagnosis of early-stage AP-induced AKI, more studies are needed that use these new techniques and that use AI in combination with advanced imaging technologies.