臨床醫(yī)學(xué)專業(yè)04級八年制內(nèi)科學(xué)教案

臨床醫(yī)學(xué)專業(yè)04級八年制《內(nèi)科學(xué)204一、教學(xué)目的（掌握、熟悉、了解的具體內(nèi)容masterthecommoncausesofacutemastertheclinicalclassificationofacutemastertheclinicfeaturesandthelaboratorydataofacutemasterthediagnosisandtreatmentofofacutemastertheranson`stohaveanintimateknowledgeofthe monandrarecausesofcutepancreatitis tohaveanintimateknowledgeofactivationofpancreaticenzymesinthepathogenesisofacutepancreatits.tohaveanintimateknowledgeofBalthazar-Ranson`s tohaveanintimateknowledgeofinfectedpancreaticnecrosisandsomecomplicationsofacutepancreatitis，e.g.pancreaticabscessandpseudocyst,pancreaticascitesandpancreaticpleuraleffusion.(General1theclassificationofacute2commoncausesofacutepancreatitisand monandrarecausesofacute(Etiologyand1etiologyofacutepancreatitis,e.g.gallstone,alcohol,hypertrilyceridemiaandso2pathogenesisofacutepancreatitis:intrapancreaticdigestiveenzymeactivation;activation,chemoattraction,sequestrationofneutrophilanddevelopmentofacutepancreatitis;distantansareaffected.(Clinical1symptoms:pain,nauseaandvomiting,abdominal2.signs:low-gradefever,tachycardia,hypotension,jaundice,erythematousskinnodules,pleuraleffusion,abdominaltendernessandmusclerigidity,diminishedorabsentbowelsounds,themassoftheupperabdomen,Cullen`ssignandTurner`s3others:1serumamylase:threefoldormoreaboveofupperlimitofnormalserumperitonealorpleuralbloodroutine:leukocytosis,hemoconcentration(elevatedhematocrit hyperbilirubinemia,serumALT,AST,andLDH,serumalbumin.ECGexamination,conventionalX-rayexaminations,B-us,1diagnosis:elevatedlevelofserumamylaseorlipase;severeacuteabdominalpain;leukocytosisandsoon.2differential(Courseofthediseaseand1Ranson`scriterionandBalthazar-Ranson`sriskfactorsthatadverselyaffectsurvivalinacutecomplications:localandsystemic.4recurrentpancreatitis.1conventionalmeasures:(1) gesicsforpain,(2)intravenousfluidsandcolloidstomaintainnormalintravascularvolume,(3)avoidfood,(4)nasogastricsuction. antibioticprophylaxis:(1)thereisnotbenefitfromantibioticuseinacutepancreatitisofmildtomoderateseverity,(2)prophylacticantibioticsmaybeusedinsevereacutepancreatitis,(3)current mendationistheuseofasystemicsomedrugsisnoeffectiveinthetreatmentofacutepancreatitis.Thelistincludesglucagon,calcitonin.somatostatin,octreotide;gabexate(FOY).thecriteriaofreintroduceoralparenteraloperations:debridement(necrosectomy),laparotomywithdrainageandremovalofnecrotictissue.endoscopicaltreatment:papillotomybyurgenttreatmentforpatientswith sociated(Infectedpancreaticnecrosis,Abscess,andinfectedpancreaticpancreaticpancreatic(PancreaticAscitesandPancreaticPleural1pancreatic2pancreaticpleural(一)內(nèi)容及時間分 1GeneralConsiderations、EtiologyandPathogenesis、Clinical2LaboratoryData、Diagnosis、Treatment、(二)重點和難Etiology、ClinicalFeatures、LaboratoryData、(三)中文和英文急性胰腺 acute急性輕型胰腺 mildacutepancreatitis急性重型胰腺 severeacutepancreatitis膽石 酗 alcohol淀粉 serum脂肪 serum C-r