医学
胰腺炎
指南
急性胰腺炎
腹痛
优势比
内科学
死亡率
入射(几何)
重症监护医学
病理
光学
物理
作者
Georg Beyer,Albrecht Hoffmeister,Pia Lorenz,Petra Lynen,Markus M. Lerch,Julia Mayerle
出处
期刊:Deutsches Arzteblatt International
[Deutscher Arzte-Verlag GmbH]
日期:2022-07-25
被引量:6
标识
DOI:10.3238/arztebl.m2022.0223
摘要
Acute pancreatitis (AP) is among the commonest non-malignant admission diagnoses in gastroenterology. Its incidence in Germany lies between 13 and 43 per 100 000 inhabitants and is increasing. In 2017, 24 per 100 000 inhabitants were hospitalized for chronic pancreatitis.From October 2018 to January 2019, we systematically searched the literature for original articles, meta-analyses, and evidence-based guidelines that were published in German or English between 1960 and 2018.30-50% of cases of acute pancreatitis are caused by gallstone disease, and another 30-50% are due to alcohol abuse. The diagnosis is made when at least two of the following three criteria are met: typical abdominal pain, elevation of serum lipase, and characteristic imaging findings. If those criteria are ambiguous, transabdominal sonography is indicated. The early initiation of food intake lowers the rate of infected pancreatic necrosis, organ failure, or death (odds ratio 0.44; 95% confidence interval [0.2; 0.96]). In AP, Ringer's lactate solution should be preferred for fluid resuscitation, at 200-250 mL/hr for 24 hours. Severe pain should be treated with opiates.The current German clinical practice guideline reflects the developments in the diagnosis and treatment of pancreatitis that have taken place over the past few years. The long-term care and monitoring of patients with complication-free pancreatitis is the responsibility of primary care physicians and gastroenterologists.
科研通智能强力驱动
Strongly Powered by AbleSci AI