儿童胃炎英文课件

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,#,1,Gastritis,Acute Gastritis,Chronic Gastritis,1 Gastritis,2,Acute Gastritis,2Acute Gastritis,3,Diffination,Etiology&Pathogenesis,Pathology,Acute gastritis,3Acute gastritis,4,Food and Drugs:,Severe stress state:,Acute infection:,Corrosive substances:,Vagal stimulation,Acid secretion,Release of vasoactive amine and cytokines,Microcirculation disdurbance,Gastric mucosal ischemia,Impairment of mucosal and mucous barriers,Back-diffusion of hydrogen ions,Shock,hydrocephalus,sudden trauma,serious infection,major operation,etc,Acute,gastritis,Etiology&Pathogenesis,4Food and Drugs:Vagal stimula,5,Manifestations,A sudden onset,Typical manifestations:epigastric pain,nausea,vomiting,watery diarrhea,Fever:caused by bacterial infection or its toxins,Complications:dehydration,electrolyte disturbances,acid-base imbalance,UGI bleeding,Acute,gastritis,Manifestations,5 ManifestationsAcute gastriti,6,Diagnosis,Acute simple gastritis,History,symptoms,and,signs,GI endoscopy&Biopsy(if necessary),Acute,gastritis,Diffusive hyperemia and edema of the gastric mucosa,Acute inflammation:neutrophilic infiltration in the lamina propria,May accompanied with punctate hemorrhage and mild corrupt lesion,6Diagnosis Acute simple gastri,7,A.,Remove of offending agents,Quit all irritants or stimulus:drugs,alcohol,Management of the original diseases,B.,Symptomatic treatment,1)Replacement of fluid and electrolyte loss,2)Spasmolysant:Atropine,Belladonna,4)Antiemetic drugs:Domperidone,3)Special management for upper GI bleeding,C.,Protection of gastric mucosa and inhibition of gastric acid,Mucosal protector,Antacids:H2-RA,PPI,Treatment,Acute,gastritis,7A.Remove of offending agents,8,Chronic gastritis,8Chronic gastritis,9,The top two reasons for recurrent abdominal pain in children are,chronic gastritis,&,PUD,An estimated 10%school age children is affected by,recurrent abdominal pain,.,9The top two reasons for recur,10,By definition,is a histopathological entity characterized by,chronic inflammation,of the stomach mucosa.,It may present with an array of symptoms,the most common being,nonspecific recurrent abdominal pain,in children.,High frequency in children,Chronic,gastritis,10By definition,is a histopat,11,Classification,Update Sydney System in 1996,Superficial,Chronic Gastritis,Atrophic,Specific types,Chronic,gastritis,11Classification Update Sydne,12,Etiology,Helicobacter pylori(HP),Bile reflux,Dietary Habit,Sequela of acute gastritis,Drugs,Psychological and genetic factors:Emotional stress,Chronic Disease,Other factors,Chronic,gastritis,12Etiology Helicobacter pylori,13,Helicobacter plori,Chronic,gastritis,13Helicobacter ploriChronic ga,14,H Pylori is considered to infect virtually all patients with chronic active gastritis and thought to be spread from person to person via oral-oral and/or fecal-oral routes.,Chronic,gastritis,14H Pylori is considered to in,15,Clinical manifestation,Recurrent abdominal pain,Dyspeptic symptoms,Excessive belching,acid regurgitation,hiccups,nausea,vomiting,diarrhea,Growth retardation,Upper GI bleeding,Chronic,gastritis,15Clinical manifestation Recur,16,Clinical manifestation,A relatively minor manifestation of diseases,The smaller the children the more atypical manifestation,Chronic,gastritis,16Clinical manifestation A rel,17,Auxiliary examinations,Gastroscopic examination,is the most reliable method for diagnosis of gastritis,Biopsy,X-ray,:Barium meal examination,HP detection,Chronic,gastritis,17Auxiliary examinationsGastro,18,Diagnostic methods of HP infection,Rapid urease test,Urea breath test(C,13,),Histology,Serum Antibodies to HP,Bacterial Culture,Testing for HP stool antigen,Polymerase chain reaction,Chronic,gastritis,18Diagnostic methods of HP inf,19,Diagnosis,Recurrent abdominal pain and/or dyspeptic symptom in children,Gastroendoscopic examination,History:,Inappropriate dietary habits,family history,medication taking,psychological stress,Chronic,gastritis,19DiagnosisRecurrent abdominal,20,Differential Diagnosis,Chronic,gastritis,Enterosite,Enterospasm,Abdominal epilepsy,20Differential DiagnosisChroni,21,Treatment,Etiologic treatment:,Dietary adjustment,quit irritant drugs or other stimulus,HP eradication,try to control the bile reflux,etc,Symptomatic treatment,Protection of gastric mucosa,Inhibition of gastric acid,Chronic,gastritis,21TreatmentEtiologic treatment,22,HP eradication,Choose,one,drug below,PPI,Omeprazole,Lansoprazole,Bismuth preparation,Bismuth Subsalicylate Basic,Choose,two,antibiotics below,Amoxicillin,Clarithromycin,Metronidazole,Furaxone,Triple regimens,Chronic,gastritis,22HP eradicationChoose one dru,23,Prevention of duodenogastric Reflux,.,Doperidome,Cisapride,Reducing gastric acid secretion,.,H2RT(for 4 weeks):,Ranitiding,Cimetidine,PPI (for 2 weeks),Omeprazole,Lansoprazole,Chronic,gastritis,23 Prevention of duodenogastri,24,Enhancing mucosal defense,Bismuth compounds,S