Acute pancreasitis is common in emergency care, and is one of the diseases with a high rate of organ dysfunction and mortality. Chronic overdrinking, gruelling and gallstones are among the causes of the disease. Acute insulin is characterized by acute pancreas and biological changes, accompanied by persistent (>48 hours) organ function disorders. So, what measures are in place to prevent and disrupt acute pancreas? This paper is an important compilation for your information.
I. What is acute acute pancreas?
Clinical signs of acute pancreas and biological changes, as well as severe acute pancreas disease have been diagnosed in the following cases: APACHEII score of 8 ≥ (baseline or 72 hours); organ failure (one or more) lasting 48 hours (after recovery of sufficient liquids).
I. Screening of high-risk populations
In regular emergency care, patients at risk can be screened. In accordance with the Standardized Procedures for Emergency Medical Services issued by the National Health Board, patients with a National Early Warning Rating (NEWS) of more than four points in the UK need to pay attention to the need to focus on the screening of those at high risk of development into acute pancreas disease in the NEWS-3 patients. Including the elderly, obese (in particular BMIZ 30kg/m2), pregnant women, cholesterol, which has a history of cholesterol disease, and glycerine triester 11.1 mmol/L (1,000 mg/dL). There is a need to strengthen the observation and evaluation of these patients.
Assessment of acute pancreas
1 BISAP Rating
The BISAP rating is the rating system for the assessment of acute pancreas. The scoring system uses simple and easy-to-use clinical and laboratory parameters to enable doctors to quickly determine the severity of patients. All patients diagnosed with acute pancreas disease should be evaluated with BISAP scores, which, if over 3, are considered likely to be acute insulin. The merit of this rating is that it is easy to use and that the observation time window is small and is completed within 24 hours, allowing multiple scoring during the course of the disease.
Biochemical and biochemical markers
(1) BUN level increases, prompting a reduction in the vascular content of the patient. (2) Triester glycerine is an independent risk factor for acute pancreas. (3) CRP is a non-specific acute and reactive protein for liver synthesis, which increases when the body is infected, injured and inflammated. (4) The PCT is a precursor to calcium protein, and the PCT level is closely related to the patient ‘ s level of infection, and the response to the infection is rapid, and the infection of the PCT in the 2,3h blood rises. Thus, when the BUN rises, the trityrene glycerine 11.1 mg/L, CRP= 150 mg/L, PCT≥2.0 ng/mL is diagnosed with acute pancreasitis, suspected to be severe.
Blood and gas analysis
Blood and gas analysis is one of the important indicators of acute pancreas. Indicators such as PaCO2, aerobic pressure (PaO2), lactation acid, pH are important for determining the severity of acute pancreas. Lactate reflects the micro-circumulation and tissue infusion of the patient, and the persistence of high levels of blood lactation (>4 mmol/L) indicates poor prognosis. Normal blood lactation concentrations (≤2 mmol/L) are important for returning to normal within the first 24 hours (≤2 mmol/L).
Assessment of developments
NEWS and BISAP ratings are checked every 6-8 hours to take care of changes in ratings.
5. Visual inspection
Video screening, such as CT, not only diagnoses acute pancreas, but also identifies the state of pancreas and surrounding inflammations, local complications, etc., which are important for the patient ‘ s state and prognosis. In addition, abdominal ultrasound and CT scans were used to determine the extent of local pancreas conditions and to assess lung pathologies and chest cavity water. Balthazar et al. classified CT in A~E 5 according to pancreas and surrounding inflammation. And it’s called the CTSI. Further revisions to Mortele and others in 2004 increased the assessment of insulin complications and organ failure, made acute pancreas status and pre-assessment more comprehensive and formed MCTSI. However, the early development of acute pancreas is usually not typical of images and therefore early predictions are limited.
Summary
The timely detection of acute pancreas can increase from light to severe factors and signs, and the adoption of preventive and deterrent measures is an important task for emergency doctors in the treatment of acute pancreas. These measures are expected to reduce the incidence and mortality of acute pancreas. There are a number of assessment systems and serometric indicators to assess the severity and prognosis of acute pancreas, but each has its strengths and weaknesses. The search for rapid, economic and accurate strategies to prevent and disrupt acute pancreas is the direction of future clinical efforts.
