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《儿童胃炎英》幻灯片本课件PPT仅供大家学习使用学习完请自行删除，谢谢！本课件PPT仅供大家学习使用学习完请自行删除，谢谢！《儿童胃炎英》幻灯片本课件PPT仅供大家学习使用Gastritis
AcuteGastritisChronicGastritisGastritisAcuteGastritisAcuteGastritisDiffinationEtiology&PathogenesisPathologyAcutegastritisAcutegastritisFoodandDrugs:
Severestressstate:Acuteinfection:
Corrosivesubstances:VagalstimulationAcidsecretionReleaseofvasoactiveamineandcytokinesMicrocirculationdisdurbanceGastricmucosalischemiaImpairmentofmucosalandmucousbarriersBack-diffusionofhydrogenions
Shock,hydrocephalus,suddentrauma,seriousinfection,majoroperation,etcAcute
gastritisEtiology&PathogenesisFoodandDrugs:Vagalstimulat
ManifestationsAsuddenonsetTypicalmanifestations:epigastricpain,nausea,vomiting,waterydiarrheaFever:causedbybacterialinfectionoritstoxinsComplications:dehydration,electrolytedisturbances,acid-baseimbalance,UGIbleedingAcute
gastritisManifestationsManifestationsAcutegastritisDiagnosisAcutesimplegastritisHistorysymptoms
and
signsGIendoscopy&Biopsy(ifnecessary)Acute
gastritis
DiffusivehyperemiaandedemaofthegastricmucosaAcuteinflammation:neutrophilicinfiltrationinthelaminapropriaMayaccompaniedwithpunctatehemorrhageandmildcorruptlesionDiagnosisAcutesimplegastritA.RemoveofoffendingagentsQuitallirritantsorstimulus:drugs,alcoholManagementoftheoriginaldiseasesB.Symptomatictreatment1)Replacementoffluidandelectrolyteloss2)Spasmolysant:Atropine,Belladonna4)Antiemeticdrugs:Domperidone3)SpecialmanagementforupperGIbleedingC.ProtectionofgastricmucosaandinhibitionofgastricacidMucosalprotectorAntacids:H2-RA,PPITreatmentAcute
gastritisA.RemoveofoffendingagentsTChronicgastritisChronicgastritisThetoptworeasonsforrecurrentabdominalpaininchildrenare
chronicgastritis&PUDAnestimated10%schoolagechildrenisaffectedbyrecurrentabdominalpain.ThetoptworeasonsforrecurrBydefinition,isahistopathologicalentitycharacterizedbychronicinflammationofthestomachmucosa.Itmaypresentwithanarrayofsymptoms,themostcommonbeingnonspecificrecurrentabdominalpaininchildren.HighfrequencyinchildrenChronic
gastritisBydefinition,isahistopathoClassification
UpdateSydneySystemin1996
Superficial
ChronicGastritis
Atrophic
SpecifictypesChronic
gastritisClassificationUpdateSydneyEtiologyHelicobacterpylori(HP)BilerefluxDietaryHabitSequelaofacutegastritisDrugsPsychologicalandgeneticfactors:EmotionalstressChronicDiseaseOtherfactorsChronic
gastritisEtiologyHelicobacterpylori(HelicobacterploriChronic
gastritisHelicobacterploriChronicgastHPyloriisconsideredtoinfectvirtuallyallpatientswithchronicactivegastritisandthoughttobespreadfrompersontopersonviaoral-oraland/orfecal-oralroutes.Chronic
gastritisHPyloriisconsideredtoinfeClinicalmanifestation
RecurrentabdominalpainDyspepticsymptoms
Excessivebelching,acidregurgitation,hiccups,nausea,vomiting,diarrheaGrowthretardationUpperGIbleedingChronic
gastritisClinicalmanifestationRecurreClinicalmanifestation
ArelativelyminormanifestationofdiseasesThesmallerthechildrenthemoreatypicalmanifestationChronic
gastritisClinicalmanifestationArelatAuxiliaryexaminationsGastroscopicexaminationisthemostreliablemethodfordiagnosisofgastritisBiopsyX-ray:BariummealexaminationHPdetectionChronic
gastritisAuxiliaryexaminationsGastroscDiagnosticmethodsofHPinfectionRapidureasetestUreabreathtest(C13)HistologySerumAntibodiestoHPBacterialCultureTestingforHPstoolantigenPolymerasechainreactionChronic
gastritisDiagnosticmethodsofHPinfecDiagnosisRecurrentabdominalpainand/ordyspepticsymptominchildrenGastroendoscopicexaminationHistory:Inappropriatedietaryhabits,familyhistory,medicationtaking,psychologicalstressChronic
gastritisDiagnosisRecurrentabdominalpDifferentialDiagnosisChronic
gastritisEnterositeEnterospasmAbdominalepilepsyDifferentialDiagnosisChronicTreatmentEtiologictreatment:Dietaryadjustment,quitirritantdrugsorotherstimulus,HPeradication,trytocontrolthebilereflux,etcSymptomatictreatmentProtectionofgastricmucosaInhibitionofgastricacidChronic
gastritisTreatmentEtiologictreatment:CHPeradicationChooseonedrugbelowPPIOmeprazoleLansoprazoleBismuthpreparationBismuthSubsalicylateBasicChoosetwoantibioticsbelowAmoxicillinClarithromycinMetronidazoleFuraxoneTripleregimensChronic
gastritisHPeradicationChooseonedrug
PreventionofduodenogastricReflux.
DoperidomeCisapride
Reducinggastricacidsecretion.
H2RT(for4weeks):
RanitidingCimetidinePPI(for2weeks)
OmeprazoleLansoprazoleChronic
gastritisPreventionofduodenogastric
Enhancingmucosaldefense
BismuthcompoundsSucrafate
Symptomatictreatment
AtropineBelladonnaChronic
gastritisEnhancingmucosaldefenseChroNormalGastricMucosaNGMNormalGastricMucosaNGMgastricmucosaledemaNGMgastricmucosaledemaNGMHemorrhagicgastritisHemorrhagicgastritiswithmultipleintramuralbleedingspots
NGMHemorrhagicgastritisHemorrhGastricLymphoidHyperplasiaNormallythereisnoorganizedlymphoidtissueinthestomach.MultiplepapulesintheantrumcorrespondingtolymphoidhyperplasiainducedbyHelicobacterpyloriinfection.
NGMGastricLymphoidHyperplasiaNoAlkalineRefluxGastritis
NormalgastricmucosaStomachmucosadiffuselycoveredwithbile-stainedmucus.
NGMAlkalineRefluxGastritisNormGastricCandidiasis
NormalgastricmucosaGastriccandidiasiswithextensivegreen-whiteexudatescoveringtheantrum.
GastricCandidiasisNormalgasChronicAntralGastritis
IncreasedvisibilityoftheantralvascularpatternwithfindingscompatiblewithchronicathrophicgastritisassociatedwithH.pyloriinfection.
Therugalfoldsofthebodyrunninglongitudinallytowardstheantrum.
ChronicAntralGastritisIncreThankyou.Thankyou.《儿童胃炎英》幻灯片本课件PPT仅供大家学习使用学习完请自行删除，谢谢！本课件PPT仅供大家学习使用学习完请自行删除，谢谢！《儿童胃炎英》幻灯片本课件PPT仅供大家学习使用Gastritis
AcuteGastritisChronicGastritisGastritisAcuteGastritisAcuteGastritisDiffinationEtiology&PathogenesisPathologyAcutegastritisAcutegastritisFoodandDrugs:
Severestressstate:Acuteinfection:
Corrosivesubstances:VagalstimulationAcidsecretionReleaseofvasoactiveamineandcytokinesMicrocirculationdisdurbanceGastricmucosalischemiaImpairmentofmucosalandmucousbarriersBack-diffusionofhydrogenions
Shock,hydrocephalus,suddentrauma,seriousinfection,majoroperation,etcAcute
gastritisEtiology&PathogenesisFoodandDrugs:Vagalstimulat
ManifestationsAsuddenonsetTypicalmanifestations:epigastricpain,nausea,vomiting,waterydiarrheaFever:causedbybacterialinfectionoritstoxinsComplications:dehydration,electrolytedisturbances,acid-baseimbalance,UGIbleedingAcute
gastritisManifestationsManifestationsAcutegastritisDiagnosisAcutesimplegastritisHistorysymptoms
and
signsGIendoscopy&Biopsy(ifnecessary)Acute
gastritis
DiffusivehyperemiaandedemaofthegastricmucosaAcuteinflammation:neutrophilicinfiltrationinthelaminapropriaMayaccompaniedwithpunctatehemorrhageandmildcorruptlesionDiagnosisAcutesimplegastritA.RemoveofoffendingagentsQuitallirritantsorstimulus:drugs,alcoholManagementoftheoriginaldiseasesB.Symptomatictreatment1)Replacementoffluidandelectrolyteloss2)Spasmolysant:Atropine,Belladonna4)Antiemeticdrugs:Domperidone3)SpecialmanagementforupperGIbleedingC.ProtectionofgastricmucosaandinhibitionofgastricacidMucosalprotectorAntacids:H2-RA,PPITreatmentAcute
gastritisA.RemoveofoffendingagentsTChronicgastritisChronicgastritisThetoptworeasonsforrecurrentabdominalpaininchildrenare
chronicgastritis&PUDAnestimated10%schoolagechildrenisaffectedbyrecurrentabdominalpain.ThetoptworeasonsforrecurrBydefinition,isahistopathologicalentitycharacterizedbychronicinflammationofthestomachmucosa.Itmaypresentwithanarrayofsymptoms,themostcommonbeingnonspecificrecurrentabdominalpaininchildren.HighfrequencyinchildrenChronic
gastritisBydefinition,isahistopathoClassification
UpdateSydneySystemin1996
Superficial
ChronicGastritis
Atrophic
SpecifictypesChronic
gastritisClassificationUpdateSydneyEtiologyHelicobacterpylori(HP)BilerefluxDietaryHabitSequelaofacutegastritisDrugsPsychologicalandgeneticfactors:EmotionalstressChronicDiseaseOtherfactorsChronic
gastritisEtiologyHelicobacterpylori(HelicobacterploriChronic
gastritisHelicobacterploriChronicgastHPyloriisconsideredtoinfectvirtuallyallpatientswithchronicactivegastritisandthoughttobespreadfrompersontopersonviaoral-oraland/orfecal-oralroutes.Chronic
gastritisHPyloriisconsideredtoinfeClinicalmanifestation
RecurrentabdominalpainDyspepticsymptoms
Excessivebelching,acidregurgitation,hiccups,nausea,vomiting,diarrheaGrowthretardationUpperGIbleedingChronic
gastritisClinicalmanifestationRecurreClinicalmanifestation
ArelativelyminormanifestationofdiseasesThesmallerthechildrenthemoreatypicalmanifestationChronic
gastritisClinicalmanifestationArelatAuxiliaryexaminationsGastroscopicexaminationisthemostreliablemethodfordiagnosisofgastritisBiopsyX-ray:BariummealexaminationHPdetectionChronic
gastritisAuxiliaryexaminationsGastroscDiagnosticmethodsofHPinfectionRapidureasetestUreabreathtest(C13)HistologySerumAntibodiestoHPBacterialCultureTestingforHPstoolantigenPolymerasechainreactionChronic
gastritisDiagnosticmethodsofHPinfecDiagnosisRecurrentabdominalpainand/ordyspepticsymptominchildrenGastroendoscopicexaminationHistory:Inappropriatedietaryhabits,familyhistory,medicationtaking,psychologicalstressChronic
gastritisDiagnosisRecurrentabdominalpDifferentialDiagnosisChronic
gastritisEnterositeEnterospasmAbdominalepilepsyDifferentialDiagnosisChronicTreatmentEtiologictreatment:Dietaryadjustment,quitirritantdrugsorotherstimulus,HPeradication,trytocontrolthebilereflux,etcSymptomatictreatmentProtectionofgastricmucosaInhibitionofgastricacidChronic
gastritisTreatmentEtiologictreatment:CHPeradicationChooseonedrugbelowPPIOmeprazoleLansoprazoleBismuthpreparationBismuthSubsalicylateBasicChoosetwoantibioticsbelowAmoxicillinClarithromycinMetronidazoleFuraxoneTripleregimensChronic
gastritisHPeradicationChooseonedrug
PreventionofduodenogastricReflux.
DoperidomeCisapride
Reducinggastricacidsecretion.
H2RT(for4weeks):
RanitidingCimetidinePPI(for2weeks)
OmeprazoleLansopraz
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