版權(quán)說(shuō)明：本文檔由用戶提供并上傳，收益歸屬內(nèi)容提供方，若內(nèi)容存在侵權(quán)，請(qǐng)進(jìn)行舉報(bào)或認(rèn)領(lǐng)
文檔簡(jiǎn)介
1Gastritis
AcuteGastritisChronicGastritis1Gastritis2AcuteGastritis2AcuteGastritis3DiffinationEtiology&PathogenesisPathologyAcutegastritis3Acutegastritis4FoodandDrugs:
Severestressstate:Acuteinfection:
Corrosivesubstances:VagalstimulationAcidsecretionReleaseofvasoactiveamineandcytokinesMicrocirculationdisdurbanceGastricmucosalischemiaImpairmentofmucosalandmucousbarriersBack-diffusionofhydrogenions
Shock,hydrocephalus,suddentrauma,seriousinfection,majoroperation,etcAcute
gastritisEtiology&Pathogenesis4FoodandDrugs:Vagalstimula5
ManifestationsAsuddenonsetTypicalmanifestations:epigastricpain,nausea,vomiting,waterydiarrheaFever:causedbybacterialinfectionoritstoxinsComplications:dehydration,electrolytedisturbances,acid-baseimbalance,UGIbleedingAcute
gastritisManifestations5ManifestationsAcutegastriti6DiagnosisAcutesimplegastritisHistorysymptoms
and
signsGIendoscopy&Biopsy(ifnecessary)Acute
gastritis
DiffusivehyperemiaandedemaofthegastricmucosaAcuteinflammation:neutrophilicinfiltrationinthelaminapropriaMayaccompaniedwithpunctatehemorrhageandmildcorruptlesion6DiagnosisAcutesimplegastri7A.RemoveofoffendingagentsQuitallirritantsorstimulus:drugs,alcoholManagementoftheoriginaldiseasesB.Symptomatictreatment1)Replacementoffluidandelectrolyteloss2)Spasmolysant:Atropine,Belladonna4)Antiemeticdrugs:Domperidone3)SpecialmanagementforupperGIbleedingC.ProtectionofgastricmucosaandinhibitionofgastricacidMucosalprotectorAntacids:H2-RA,PPITreatmentAcute
gastritis7A.Removeofoffendingagents8Chronicgastritis8Chronicgastritis9Thetoptworeasonsforrecurrentabdominalpaininchildrenare
chronicgastritis
&
PUDAnestimated10%schoolagechildrenisaffectedbyrecurrentabdominalpain.9Thetoptworeasonsforrecur10Bydefinition,isahistopathologicalentitycharacterizedbychronicinflammationofthestomachmucosa.Itmaypresentwithanarrayofsymptoms,themostcommonbeingnonspecificrecurrentabdominalpaininchildren.HighfrequencyinchildrenChronic
gastritis10Bydefinition,isahistopat11Classification
UpdateSydneySystemin1996
Superficial
ChronicGastritis
Atrophic
SpecifictypesChronic
gastritis11ClassificationUpdateSydne12EtiologyHelicobacterpylori(HP)BilerefluxDietaryHabitSequelaofacutegastritisDrugsPsychologicalandgeneticfactors:EmotionalstressChronicDiseaseOtherfactorsChronic
gastritis12EtiologyHelicobacterpylori13HelicobacterploriChronic
gastritis13HelicobacterploriChronicga14HPyloriisconsideredtoinfectvirtuallyallpatientswithchronicactivegastritisandthoughttobespreadfrompersontopersonviaoral-oraland/orfecal-oralroutes.Chronic
gastritis14HPyloriisconsideredtoin15Clinicalmanifestation
RecurrentabdominalpainDyspepticsymptoms
Excessivebelching,acidregurgitation,hiccups,nausea,vomiting,diarrheaGrowthretardationUpperGIbleedingChronic
gastritis15ClinicalmanifestationRecur16Clinicalmanifestation
ArelativelyminormanifestationofdiseasesThesmallerthechildrenthemoreatypicalmanifestationChronic
gastritis16ClinicalmanifestationArel17AuxiliaryexaminationsGastroscopicexaminationisthemostreliablemethodfordiagnosisofgastritisBiopsyX-ray:BariummealexaminationHPdetectionChronic
gastritis17AuxiliaryexaminationsGastro18DiagnosticmethodsofHPinfectionRapidureasetestUreabreathtest(C13)HistologySerumAntibodiestoHPBacterialCultureTestingforHPstoolantigenPolymerasechainreactionChronic
gastritis18DiagnosticmethodsofHPinf19DiagnosisRecurrentabdominalpainand/ordyspepticsymptominchildrenGastroendoscopicexaminationHistory:Inappropriatedietaryhabits,familyhistory,medicationtaking,psychologicalstressChronic
gastritis19DiagnosisRecurrentabdominal20DifferentialDiagnosisChronic
gastritisEnterositeEnterospasmAbdominalepilepsy20DifferentialDiagnosisChroni21TreatmentEtiologictreatment:Dietaryadjustment,quitirritantdrugsorotherstimulus,HPeradication,trytocontrolthebilereflux,etcSymptomatictreatmentProtectionofgastricmucosaInhibitionofgastricacidChronic
gastritis21TreatmentEtiologictreatment22HPeradicationChooseonedrugbelowPPIOmeprazoleLansoprazoleBismuthpreparationBismuthSubsalicylateBasicChoosetwoantibioticsbelowAmoxicillinClarithromycinMetronidazoleFuraxoneTripleregimensChronic
gastritis22HPeradicationChooseonedru23
PreventionofduodenogastricReflux.
DoperidomeCisapride
Reducinggastricacidsecretion.
H2RT(for4weeks):
RanitidingCimetidinePPI(for2weeks)
OmeprazoleLansoprazoleChronic
gastritis23Preventionofduodenogastri24
Enhancingmucosaldefense
BismuthcompoundsSucrafate
Symptomatictreatment
AtropineBelladonnaChronic
gastritis24EnhancingmucosaldefenseCh25NormalGastricMucosaNGM25NormalGastricMucosaNGM26gastricmucosaledemaNGM26gastricmucosaledemaNGM27HemorrhagicgastritisHemorrhagicgastritiswithmultipleintramuralbleedingspots
NGM27HemorrhagicgastritisHemor28GastricLymphoidHyperplasiaNormallythereisnoorganizedlymphoidtissueinthestomach.MultiplepapulesintheantrumcorrespondingtolymphoidhyperplasiainducedbyHelicobacterpyloriinfection.
NGM28GastricLymphoidHyperplasia29AlkalineRefluxGastritis
NormalgastricmucosaStomachmucosadiffuselycoveredwithbile-stainedmucus.
NGM29AlkalineRefluxGastritisNo30GastricCandidiasis
NormalgastricmucosaGastriccandidiasiswithextensivegreen-whiteexudatescoveringtheantrum.
30GastricCandidiasisNormalg31ChronicAntralGastritis
IncreasedvisibilityoftheantralvascularpatternwithfindingscompatiblewithchronicathrophicgastritisassociatedwithH.pyloriinfection.
Therugalfoldsofthebodyrunninglongitudinallytowardstheantrum.
31ChronicAntralGastritisInc32Thankyou.32Thankyou.33Gastritis
AcuteGastritisChronicGastritis1Gastritis34AcuteGastritis2AcuteGastritis35DiffinationEtiology&PathogenesisPathologyAcutegastritis3Acutegastritis36FoodandDrugs:
Severestressstate:Acuteinfection:
Corrosivesubstances:VagalstimulationAcidsecretionReleaseofvasoactiveamineandcytokinesMicrocirculationdisdurbanceGastricmucosalischemiaImpairmentofmucosalandmucousbarriersBack-diffusionofhydrogenions
Shock,hydrocephalus,suddentrauma,seriousinfection,majoroperation,etcAcute
gastritisEtiology&Pathogenesis4FoodandDrugs:Vagalstimula37
ManifestationsAsuddenonsetTypicalmanifestations:epigastricpain,nausea,vomiting,waterydiarrheaFever:causedbybacterialinfectionoritstoxinsComplications:dehydration,electrolytedisturbances,acid-baseimbalance,UGIbleedingAcute
gastritisManifestations5ManifestationsAcutegastriti38DiagnosisAcutesimplegastritisHistorysymptoms
and
signsGIendoscopy&Biopsy(ifnecessary)Acute
gastritis
DiffusivehyperemiaandedemaofthegastricmucosaAcuteinflammation:neutrophilicinfiltrationinthelaminapropriaMayaccompaniedwithpunctatehemorrhageandmildcorruptlesion6DiagnosisAcutesimplegastri39A.RemoveofoffendingagentsQuitallirritantsorstimulus:drugs,alcoholManagementoftheoriginaldiseasesB.Symptomatictreatment1)Replacementoffluidandelectrolyteloss2)Spasmolysant:Atropine,Belladonna4)Antiemeticdrugs:Domperidone3)SpecialmanagementforupperGIbleedingC.ProtectionofgastricmucosaandinhibitionofgastricacidMucosalprotectorAntacids:H2-RA,PPITreatmentAcute
gastritis7A.Removeofoffendingagents40Chronicgastritis8Chronicgastritis41Thetoptworeasonsforrecurrentabdominalpaininchildrenare
chronicgastritis
&
PUDAnestimated10%schoolagechildrenisaffectedbyrecurrentabdominalpain.9Thetoptworeasonsforrecur42Bydefinition,isahistopathologicalentitycharacterizedbychronicinflammationofthestomachmucosa.Itmaypresentwithanarrayofsymptoms,themostcommonbeingnonspecificrecurrentabdominalpaininchildren.HighfrequencyinchildrenChronic
gastritis10Bydefinition,isahistopat43Classification
UpdateSydneySystemin1996
Superficial
ChronicGastritis
Atrophic
SpecifictypesChronic
gastritis11ClassificationUpdateSydne44EtiologyHelicobacterpylori(HP)BilerefluxDietaryHabitSequelaofacutegastritisDrugsPsychologicalandgeneticfactors:EmotionalstressChronicDiseaseOtherfactorsChronic
gastritis12EtiologyHelicobacterpylori45HelicobacterploriChronic
gastritis13HelicobacterploriChronicga46HPyloriisconsideredtoinfectvirtuallyallpatientswithchronicactivegastritisandthoughttobespreadfrompersontopersonviaoral-oraland/orfecal-oralroutes.Chronic
gastritis14HPyloriisconsideredtoin47Clinicalmanifestation
RecurrentabdominalpainDyspepticsymptoms
Excessivebelching,acidregurgitation,hiccups,nausea,vomiting,diarrheaGrowthretardationUpperGIbleedingChronic
gastritis15ClinicalmanifestationRecur48Clinicalmanifestation
ArelativelyminormanifestationofdiseasesThesmallerthechildrenthemoreatypicalmanifestationChronic
gastritis16ClinicalmanifestationArel49AuxiliaryexaminationsGastroscopicexaminationisthemostreliablemethodfordiagnosisofgastritisBiopsyX-ray:BariummealexaminationHPdetectionChronic
gastritis17AuxiliaryexaminationsGastro50DiagnosticmethodsofHPinfectionRapidureasetestUreabreathtest(C13)HistologySerumAntibodiestoHPBacterialCultureTestingforHPstoolantigenPolymerasechainreactionChronic
gastritis18DiagnosticmethodsofHPinf51DiagnosisRecurrentabdominalpainand/ordyspepticsymptominchildrenGastroendoscopicexaminationHistory:Inappropriatedietaryhabits,familyhistory,medicationtaking,psychologicalstressChronic
gastritis19DiagnosisRecurrentabdominal52DifferentialDiagnosisChronic
gastritisEnterositeEnterospasmAbdominalepilepsy20DifferentialDiagnosisChroni53TreatmentEtiologictreatment:Dietaryadjustment,quitirritantdrugsorotherstimulus,HPeradication,trytocontrolthebilereflux,etcSymptomatictreatmentProtectionofgastricmucosaInhibitionofgastricacidChronic
gastritis21TreatmentEtiologictreatment54HPeradicationChooseonedrugbelowPPIOmeprazoleLansoprazoleBismuthpreparationBismuthSubsalicylateBasicChoosetwoantibioticsbelowAmoxicillinClarithromycinMetronidazoleFuraxoneTripleregimensChronic
gastritis22HPeradicationChooseonedru55
PreventionofduodenogastricReflux.
DoperidomeCisapride
Reducinggastricacidsecretion.
H2RT(for4weeks):
RanitidingCimetidinePPI(for2weeks)
OmeprazoleLansoprazoleChronic
gastritis23Preventio
溫馨提示
- 1. 本站所有資源如無(wú)特殊說(shuō)明，都需要本地電腦安裝OFFICE2007和PDF閱讀器。圖紙軟件為CAD,CAXA,PROE,UG,SolidWorks等.壓縮文件請(qǐng)下載最新的WinRAR軟件解壓。
- 2. 本站的文檔不包含任何第三方提供的附件圖紙等，如果需要附件，請(qǐng)聯(lián)系上傳者。文件的所有權(quán)益歸上傳用戶所有。
- 3. 本站RAR壓縮包中若帶圖紙，網(wǎng)頁(yè)內(nèi)容里面會(huì)有圖紙預(yù)覽，若沒(méi)有圖紙預(yù)覽就沒(méi)有圖紙。
- 4. 未經(jīng)權(quán)益所有人同意不得將文件中的內(nèi)容挪作商業(yè)或盈利用途。
- 5. 人人文庫(kù)網(wǎng)僅提供信息存儲(chǔ)空間，僅對(duì)用戶上傳內(nèi)容的表現(xiàn)方式做保護(hù)處理，對(duì)用戶上傳分享的文檔內(nèi)容本身不做任何修改或編輯，并不能對(duì)任何下載內(nèi)容負(fù)責(zé)。
- 6. 下載文件中如有侵權(quán)或不適當(dāng)內(nèi)容，請(qǐng)與我們聯(lián)系，我們立即糾正。
- 7. 本站不保證下載資源的準(zhǔn)確性、安全性和完整性, 同時(shí)也不承擔(dān)用戶因使用這些下載資源對(duì)自己和他人造成任何形式的傷害或損失。
最新文檔
- 保證資金風(fēng)險(xiǎn)等級(jí)分類制度
- 超市耗材管理培訓(xùn)課件
- 分子蒸餾萃取技術(shù)
- 產(chǎn)品質(zhì)量安全追溯制度
- 夢(mèng)游天姥吟留別模板
- 2025-2030細(xì)胞治療產(chǎn)品商業(yè)化生產(chǎn)質(zhì)量控制標(biāo)準(zhǔn)研究報(bào)告
- 2025-2030細(xì)胞培養(yǎng)肉生物反應(yīng)器參數(shù)優(yōu)化與規(guī)?；a(chǎn)成本測(cè)算報(bào)告
- 2025-2030細(xì)胞培養(yǎng)數(shù)據(jù)監(jiān)測(cè)與分析系統(tǒng)開(kāi)發(fā)趨勢(shì)報(bào)告
- 2025-2030紙張制造業(yè)技術(shù)創(chuàng)新及市場(chǎng)競(jìng)爭(zhēng)力發(fā)展策略深度研究
- 2025-2030箏箏行業(yè)風(fēng)險(xiǎn)投資發(fā)展分析及投資融資策略研究報(bào)告
- 黑龍江省大慶中學(xué)2025-2026學(xué)年高一（上）期末物理試卷（含答案）
- 2025年csco肝癌治療指南
- 高中生寒假安全教育主題班會(huì)
- 2025年銀行縣支行支部書(shū)記抓黨建述職報(bào)告
- 2026云南公務(wù)員考試（6146人）易考易錯(cuò)模擬試題（共500題）試卷后附參考答案
- 畜牧技術(shù)員安全培訓(xùn)效果測(cè)試考核試卷含答案
- 2026屆天津一中高三語(yǔ)文第一學(xué)期期末質(zhì)量檢測(cè)模擬試題含解析
- 2025-2026學(xué)年第一學(xué)期初中物理教研組工作總結(jié)報(bào)告
- 2025年直招軍官筆試題型及答案
- 2026年小學(xué)一二年級(jí)第一學(xué)期無(wú)紙筆化考核方案及測(cè)試題（一二年級(jí)語(yǔ)文數(shù)學(xué)）
- 2025年時(shí)事政治試題庫(kù)完整參考詳解(完整版)及答案
評(píng)論
0/150
提交評(píng)論