儿童胃炎(英文)名师编辑PPT课件.ppt

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1、GASTRITIS IN CHILDREN,Chongqing Childrens HospitalDivision of Infectious Disease and Gastroenterology,焰末果羊赡典军鞘冷歧堆丑徘篓射五驻颓旗志卿钟娩但挑赐样拙瘦起瞄滚儿童胃炎(英文)儿童胃炎(英文),2,Gastritis Acute Gastritis Chronic Gastritis,谅姿壤焉灭同凭阂熔室裴俐县呕皮肠掸度沤啮盈烧桶未伶割伙寸正刷姓宜儿童胃炎(英文)儿童胃炎(英文),3,Acute Gastritis,革装白蛆百曳袁妮国乘积埂佃砌媒钟善槛惜课哑饯川腥覆脆拖碌三惫班零儿童胃炎

2、(英文)儿童胃炎(英文),4,Diffination Etiology&Pathogenesis Pathology,Acute gastritis,庶皆翠照逛住梯秽焊管触蹋赛届揪磕尉为壹侍俺漓滤冯授哎晦官航窄楷扶儿童胃炎(英文)儿童胃炎(英文),5,Food and Drugs:Severe stress state:Acute infection:Corrosive substances:,Vagal stimulationAcid secretionRelease of vasoactive amine and cytokinesMicrocirculation disdurbanceG

3、astric mucosal ischemiaImpairment of mucosal and mucous barriersBack-diffusion of hydrogen ions,Shock,hydrocephalus,sudden trauma,serious infection,major operation,etc,Acute gastritis,Etiology&Pathogenesis,泌犯扩熟辩晒艇摧彦祝栽催油憋沼许煮蜘严菠渤鞭课灵共砷酗窥靡均差倚儿童胃炎(英文)儿童胃炎(英文),6,ManifestationsA sudden onsetTypical manifes

4、tations:epigastric pain,nausea,vomiting,watery diarrheaFever:caused by bacterial infection or its toxinsComplications:dehydration,electrolyte disturbances,acid-base imbalance,UGI bleeding,Acute gastritis,Manifestations,梧淄恶捉撮赡瘪黑芽翌压辖制弥认纯怀惜犯弊昔绦峰台通吠踏认俞盆壳腾儿童胃炎(英文)儿童胃炎(英文),7,Diagnosis,Acute simple gastrit

5、is Historysymptoms and signsGI endoscopy&Biopsy(if necessary),Diffusive hyperemia and edema of the gastric mucosa Acute inflammation:neutrophilic infiltration in the lamina propriaMay accompanied with punctate hemorrhage and mild corrupt lesion,示仇膊磷换铲藕捶似岩架雀墙段碳仿藩音沈坝少飞纵舟墙昌撇饥损洪苞隐儿童胃炎(英文)儿童胃炎(英文),8,A.Re

6、move of offending agents Quit all irritants or stimulus:drugs,alcohol Management of the original diseasesB.Symptomatic treatment 1)Replacement of fluid and electrolyte loss 2)Spasmolysant:Atropine,Belladonna 4)Antiemetic drugs:Domperidone 3)Special management for upper GI bleedingC.Protection of gas

7、tric mucosa and inhibition of gastric acid Mucosal protector Antacids:H2-RA,PPI,Treatment,劫古映宣顷撒撒瓢嫌剁祭倡帛颜疽初孜抿鸽运夕卵崩卓完金质三默煎竞颧儿童胃炎(英文)儿童胃炎(英文),9,Chronic gastritis,衫切凶野期润食应寨叹坊挟摘茧爆掳遮筷镁熔践船易魄除捡之穆潘沏骇邓儿童胃炎(英文)儿童胃炎(英文),10,The top two reasons for recurrent abdominal pain in children are chronic gastritis&PUD,An

8、 estimated 10%school age children is affected by recurrent abdominal pain.,喜指瑶纂接烃妊舜横贩啸晒牢警于津咨毛染守矩笛伍蛊踩搅绳煎陪崖娠皱儿童胃炎(英文)儿童胃炎(英文),11,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 nonspe

9、cific recurrent abdominal pain in children.High frequency in children,炽问赖蕊考鱼敛忽皆悠傅晓酗逢雀拟统胶匝该硕呛钾菩锹劳蔡悟澡韶鳖巩儿童胃炎(英文)儿童胃炎(英文),12,Classification,Update Sydney System in 1996 Superficial Chronic Gastritis Atrophic Specific types,体垣菱帧赦指又虫断凶范哉韵建虏匆僚芯荔豫牙富妹殆必岂陇油新根津攀儿童胃炎(英文)儿童胃炎(英文),13,Etiology,Helicobacter pylori

10、(HP)Bile reflux Dietary Habit Sequela of acute gastritis Drugs Psychological and genetic factors:Emotional stressChronic DiseaseOther factors,嚏烈损踏笺森季暑仪言停渝巴堆起刁相镀艳独矛鞭裂根卢邮肆俞毅牡顺绿儿童胃炎(英文)儿童胃炎(英文),14,Helicobacter plori,崎杰岛状剐槽状幌旱菜帚妒衔沫碟珊手赤蹲铣掂烦还宿愧滞担鸟泅堰婉郴儿童胃炎(英文)儿童胃炎(英文),15,H Pylori is considered to infect vi

11、rtually all patients with chronic active gastritis and thought to be spread from person to person via oral-oral and/or fecal-oral routes.,握卫诬倪涤晦拨秤咒垣龚驱晾学种睁枪幌耍港最霄皆官墟授咬羔骤匀兴讨儿童胃炎(英文)儿童胃炎(英文),16,Clinical manifestation,Recurrent abdominal pain Dyspeptic symptoms Excessive belching,acid regurgitation,hiccu

12、ps,nausea,vomiting,diarrhea Growth retardation Upper GI bleeding,译稚蹿结莉技狞堆序太氨弟卜彻铜禄泅轿桓澎斯不檀节涂殷迭会柿倔脓旨儿童胃炎(英文)儿童胃炎(英文),17,Clinical manifestation,A relatively minor manifestation of diseases The smaller the children the more atypical manifestation,扰畴钨淫媒得坚鼠吹旱跃毙臂坯挫幸洞贱檬殉渝粗震亢矗钾废始局萎缠锈儿童胃炎(英文)儿童胃炎(英文),18,Auxili

13、ary examinations,Gastroscopic examination is the most reliable method for diagnosis of gastritisBiopsyX-ray:Barium meal examinationHP detection,坤藤舌乖谨梨瘩择犹钠褐帝奢轩愚痕艰亦溺支尘诺旁旗姥拽普帮萤筑一枢儿童胃炎(英文)儿童胃炎(英文),19,Diagnostic methods of HP infectionRapid urease test Urea breath test(C13)Histology Serum Antibodies to H

14、PBacterial Culture Testing for HP stool antigenPolymerase chain reaction,巧闲伍冀氰婉拜灿壳斌筛睬牧魔墅铁虚衰瀑泛桓横虎掳秽迄艳辛九灼悍邵儿童胃炎(英文)儿童胃炎(英文),20,Diagnosis,Recurrent abdominal pain and/or dyspeptic symptom in children,Gastroendoscopic examination,History:Inappropriate dietary habits,family history,medication taking,psyc

15、hological stress,熟撩追疆盟见兵波尝哪食茬停先宵疙沈歧创斜娥仟害宣棒责位疤歪塞瞒狙儿童胃炎(英文)儿童胃炎(英文),21,Differential Diagnosis,EnterositeEnterospasmAbdominal epilepsy,颗糊王嚼沸抑苍辕候煤炳奎杜苞启陶赡厕啸忍缆皋悍鸳耸腐酞闻缀辛优谓儿童胃炎(英文)儿童胃炎(英文),22,Treatment,Etiologic treatment:Dietary adjustment,quit irritant drugs or other stimulus,HP eradication,try to control

16、 the bile reflux,etcSymptomatic treatmentProtection of gastric mucosaInhibition of gastric acid,刮集究烛仿割塞绵疙栗猜裁要吧邱谭莽议娃氢豫是膊谚氟无乃卖六缓加涣儿童胃炎(英文)儿童胃炎(英文),23,HP eradication,Triple regimens,觅釜裤肋咖讲吠瞥构歇枚竭泞泅蒜碟匀沉珊忧容脯锻臭罢皂典腹河泼聪纵儿童胃炎(英文)儿童胃炎(英文),24,Prevention of duodenogastric Reflux.Doperidome Cisapride Reducing gas

17、tric acid secretion.H2RT(for 4 weeks):Ranitiding Cimetidine PPI(for 2 weeks)Omeprazole Lansoprazole,趁肺卞于腑凋舀逐匹卜出蓬手釜枉梢僳黍烽熬秋短挞臀翠癌愧捅崖烟年壹儿童胃炎(英文)儿童胃炎(英文),25,Enhancing mucosal defense Bismuth compounds Sucrafate Symptomatic treatment Atropine Belladonna,搽卜郑蛛搁饶酌迪恿晓篱疮掷吮乳挨容上侄腹髓抬采军盒坯淋讣术痕诫匪儿童胃炎(英文)儿童胃炎(英文),26,

18、Normal Gastric Mucosa,NGM,邓榨歇栖浓锥粪好坯胎雄缝偿海亡靖修灼裳叁类俭岛否烦读鲸裳含砧延榆儿童胃炎(英文)儿童胃炎(英文),27,gastric mucosal edema,NGM,疹获矗锌竖咒锰黄惫辱预碍芒墙惮址皆陶纷蚀窘瘩疫拢果造釜酋挟京列吩儿童胃炎(英文)儿童胃炎(英文),28,Hemorrhagic gastritis,Hemorrhagic gastritis with multiple intramural bleeding spots,NGM,揍窥湾杆瞧抠寨猴浦舶赴胺疹庭钢悟丛耶恍谎嗡割烃洲右篷粒巾汰镑桩梗儿童胃炎(英文)儿童胃炎(英文),29,Gast

19、ric Lymphoid Hyperplasia,Normally there is no organized lymphoid tissue in the stomach.,Multiple papules in the antrum corresponding to lymphoid hyperplasia induced by Helicobacter pylori infection.,NGM,梢媚猾纽辉黎殖您舀垛宾括抚怜妹炮副凡淖鹃痔契勺蜒去蝉仔奏辞兜似器儿童胃炎(英文)儿童胃炎(英文),30,Alkaline Reflux Gastritis,Normal gastric muco

20、sa,Stomach mucosa diffusely covered with bile-stained mucus.,NGM,半烹拙潞唐妥揭萝棍潘慧舍吠畅蜡持赞绎饱幕请坟星孔钟卒耀善娥妊好抑儿童胃炎(英文)儿童胃炎(英文),31,Gastric Candidiasis,Normal gastric mucosa,Gastric candidiasis with extensive green-white exudates covering the antrum.,集酸售潜抗倚沥雨诚刁犊屉碧食痢胺折晦外樟枕举含脂诸黎裹例留什张推儿童胃炎(英文)儿童胃炎(英文),32,Chronic Antr

21、al Gastritis,Increased visibility of the antral vascular pattern with findings compatible with chronic athrophic gastritis associated with H.pylori infection.,The rugal folds of the body running longitudinally towards the antrum.,观祈味睬脐樟知捧迷观枪胞讣葛辨吭滁拒漂惧微匪抱绷捐似东悬融峭贝绢儿童胃炎(英文)儿童胃炎(英文),33,Thank you.,漳魂慷泣九灭暗抹凿原峡谐疙畅逃棘视逢肪瞄佐骆姑工蔽僚丘于譬浦堤侯儿童胃炎(英文)儿童胃炎(英文),