Acute pancreatitis is an acute pancreatic disease. There are no typical symptoms in early clinical symptoms, the disease progresses rapidly, and the mortality rate is 20%~30%. The misdiagnosis rate is high and the demand for surveillance treatment and nursing is high. Therefore, this article popularizes science on the definition of acute pancreatitis, the causes and related nursing methods.
Severe pancreatitis definition
Acute pancreatitis is a self-digestible chemical disease, divided into two pathological types: necrotizing pancreatitis and edema pancreatitis. The former has severe symptoms and short clinical development process, which also affects the surrounding organs; the former is severe pancreatitis; acute pancreatitis may have complications and sequelae, and may be associated with pancreatic abscess, pancreatic cyst and other diseases. Some patients have sequelae such as lack of endocrine function and lack of pancreatic exocrine function after recovery, and nursing for acute pancreatitis is very important.
Causes of severe pancreatitis
1. Hepatobiliary disease
Patients with bile duct disease or cholelithiasis have a higher risk of this disease than normal people. For example, bile duct infection, bile duct roundworm and other diseases will cause acute inflammation, but acute pancreatitis is closely linked to pancreatitis and cholelithiasis. Analysis of human anatomy showed that about 70% to 80% of the pancreatic ducts can merge with the common bile duct into a unified channel, and the opening is located in the abdomen of the twelve-finger ampulla. If stones are embedded, pancreatitis and cholangitis are likely to be induced.
2. Drug factors
combined with modern drug analysis, some drugs such as tetracycline , glucocorticoid , azathioprine may damage pancreatic to varying degrees after use, increasing the secretion viscosity and amount of pancreatic juice , thereby causing acute pancreatitis, which mostly occurs within 2 months of taking the medicine, but the relationship with the dosage is not clear.
3. Daily habits
Some patients have bad habits of life, such as eating disorders, alcohol dependence, etc. They consume too much food in a short period of time, which will cause duodenal blockage, resulting in acute pancreatitis. Ethanol in alcohol can cause an increase in endocrine intestinal, gastric acid, cholecystolin, and other endocrine. This improves pancreatic exocrine and causes acute pancreatitis.
Care methods for acute pancreatitis
1. Effective life support
ensures effective circulation. Pay attention to preventing and quickly correcting shock , avoid indirect damage, closely observe changes in the patient's mental and important functions, continue to monitor electrocardiograms, and establish more than two venous channels. The patient can correct plasma, whole blood, electrolytes and other indicators in a timely, sufficient and balanced manner according to the results of venous pressure and blood pressure, pulse, electrolytes, etc.
Prevention of acute respiratory distress syndrome. Regularly inhale oxygen with an oxygen content of 231/min to increase the oxygen saturation of arterial and tissues. Use auxiliary functions such as tracheal intubation and regular ventilation as needed to correct hypoxemia according to the blood analysis results. The on-duty nursing staff and doctors are encouraged to observe the patient's symptoms such as hypoxia, shortness of breath, chest tightness, , etc. at any time, and guide the patient to breathe effectively and cough to maintain normal lung function.
Protection against acute renal exhaustion. Because hypotension and vasoactive substances cause spasm of blood vessels and trypsin coagulation function, causing fibrin to deposit in the glomerulus, resulting in the inability to filter the glomerulus and causing reduced urination and anuria. To prevent the above symptoms, the patient should be given intravenous injection of furosemide qd~bid at 20 mg each time. Observe basic characteristics such as urine volume, color, properties, etc. every hour.
blood sugar monitoring. Stable blood sugar value is very important for maintaining blood volume. Hyperglycemia not only increases hyperosmotic diuretics, but also increases bacterial infection. Real-time monitoring and observation of whether to use insulin is required, especially at night. If the patient has symptoms such as sweating and palpitations, it is suspected that it is a symptoms of hypoglycemia. Because the insulin application and the dosage of hypotonic fluid have been adjusted in time.
2. Pipe care
Usually after acute pancreatitis, patients need to indwell various pipes, and patients with surgery may also indwell multiple drainage tubes . Change the negative pressure device once a day and change the gastric tube once a week.Effective negative pressure plays an important role in slowing gastric acid, pancreatic secretion and complete pancreatic recovery.
3. Psychological care
Strong tension and extremely unstable emotions will lead to the patient's treatment resistance, which will lead to worsening of the body's adaptability and reduced resistance. Nurse needs to actively consider the different situations of the patient psychologically, use psychological theories and skills to understand what the patient needs to stabilize his emotions, comfort the overly stressed patients, and create a pleasant and calm treatment environment, so that the patient can actively cooperate with treatment and care.
4. Health education
helps patients and their families understand the causes, prevention, treatment and nursing knowledge of the disease, which shows that patients need to avoid excessive fatigue after discharge, absolutely prohibit drinking alcohol and reduce low-fat diet , gradually restore low-concentration sugar to a normal diet, and perform physical and mental labor appropriately according to the degree of physical recovery. If symptoms appear, promptly correct them to prevent the recurrence of pancreatitis. (, Department of Critical Care Medicine, Dazhou Central Hospital, Jiang Chun)
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