急性胃炎课件.ppt

1、第四章第四章 胃炎胃炎GASTRITIS急性胃炎1急性胃炎2急性胃炎3急性胃炎4 Gastritis represents a nonspecific inflammation of the stomach.Clinically,the three most common and important causes of gastritis are infection of nonsteroidal anti-inflammatory drugs(NSAIDs),and stress-related mucosal changes.(5p334)急性胃炎5急性胃炎6急性胃炎7急性胃炎8急性胃炎9

2、急性胃炎10急性胃炎11急性胃炎12Clinical features Nausea and vomiting are the most likely presenting symptoms,together with indigestion.Acute gastrointestinal if gastritis is severe.Asymptomatic.(2p109)急性胃炎13急性胃炎14Diagnosis and investigation Often made on clinical grounds,e.g.History of non-steroidal anti-inflamm

3、atory drugs,heavy alcohol consumption,etc.Endoscopy appearance can vary from superficial erosions to haemorrhage secondary to acute ulceration.(2p109)急性胃炎15急性胃炎16急性胃炎17Superficial gastritis)(The inflammatory cell are confined to the pit rigion)(There is variable gland loss,which is often accompanied

4、 by intestinal metaplasia.)急性胃炎18(Intestinal metaplasia)：急性胃炎19(dysplasia)：急性胃炎20急性胃炎21急性胃炎22急性胃炎23Helicobacter pylori H.pylori is a gram-negative,curved,flagellated rod found only in gastric epithelium or in gastric metaplastic epithelium.H.pylori is a noninvasive organism that colonizes the mucus

5、layer overlying gastric epithelium.Factors important in the organisms ability to colonize the stomach to adhere to the mucus layer,and production of urease.Urease increases juxtamucosal pH,creating a more hospitable microclimate than that of the acidic stomach.(5p334)急性胃炎24急性胃炎25急性胃炎26急性胃炎27急性胃炎28急性

6、胃炎29Clinic features Most cases are asymptomatic.Symptoms are similar to those of acute gastritis,but occurring over a period of time.Pernicious anaemia due to loss of intrinsic factor secretion for vitamin B12 absorption occurs in patients with autoimmune gastritis.急性胃炎30 胃液分析胃液分析 血清学检查血清学检查 胃镜检查及活检

7、胃镜检查及活检 幽门螺杆菌检查幽门螺杆菌检查 X线检查线检查 维生素维生素B12吸收检查吸收检查急性胃炎31急性胃炎32急性胃炎33急性胃炎34急性胃炎35急性胃炎36急性胃炎37急性胃炎38急性胃炎39急性胃炎40急性胃炎41急性胃炎42急性胃炎43急性胃炎44急性胃炎45急性胃炎46 幽门螺杆菌感染的胃炎治疗幽门螺杆菌感染的胃炎治疗 无幽门螺杆菌的胃炎治疗无幽门螺杆菌的胃炎治疗急性胃炎47急性胃炎48急性胃炎49急性胃炎50急性胃炎51急性胃炎52 巨大肥厚性胃炎巨大肥厚性胃炎 痘疹样胃炎痘疹样胃炎 残胃炎残胃炎 腐蚀性胃炎腐蚀性胃炎急性胃炎53急性胃炎54急性胃炎55急性胃炎56急性胃炎57急性胃炎58急性胃炎59急性胃炎60急性胃炎61