The treatment of this disease should be based on the severity of disease, be selected, in principle, light non-surgical therapy can be used to deal with medical mainly on heavy gallstone pancreatitis and secondary lesions, such as pancreatic abscess, pancreatic cysts, and other pseudo be positive support and surgical treatment to save lives.
(1) Non-Surgical Treatment
1. Spasmolysis analgesics (1) pethidine, atropine injection. When severe abdominal pain to be in the application. It is not appropriate use of morphine analgesia alone, the sphincter of Oddi spasm their lead, its combination of atropine may confrontation caused cramps, yielded a good result. (2) Acupuncture Treatment: Body Acupuncture from Yang Ling-chuen, Zusanli, customs within the next giant imaginary, in, etc.. Ear acupuncture from pancreas, biliary District. (3) does not ease the pain, can be 0.1% Merino Qazi by 300 to 500 ml, intravenous drip.
2. Control diet and gastrointestinal decompression light can flow into a small amount of light juice,fat, irritating food, are required to strictly ban severe diet to reduce or inhibit secretion of pancreatic juice. Illness Shigeatsu or abdominal distension obviously, should visit gastrointestinal decompression may be out of gastric, duodenal stimulation to reduce gastric acid produced in promoting pancreatic juice, cholecystokinin, to reduce the secretion of pancreatic juice, and prevention and treatment of paralytic ileus. Infusion should be fasting period, the added calories, nutrition support. The maintenance of water and electrolyte balance, correct hypocalcemia, low magnesium, acidosis and high blood sugar, etc.. If necessary, given total parenteral nutrition (TPN) to maintain electrolyte and hot water supply cards. Advantages of pancreatic juice can reduce the secretion of digestive tract to rest, compensatory body catabolism.
3. Antibiotics commonly used penicillin, streptomycin and gentamicin, ampicillin, methyl benzyl penicillin, Pioneer Adriamycin, for the control of anaerobic infections, can be used metronidazole. Because pancreatic hemorrhage and necrosis, the protein product of decomposition is the multiplication of bacteria often a good medium, it was particularly severe in the case as soon as possible and they can play a secondary infection prevention and the prevention of complications.
4. Trypsin inhibitor used: ① aprotinin (Trasylol), and with anti-vascular ease of pancreatic role. The first volume of 200,000 μ, after 200,000 μ / 6 hours, vein. Or 200,000 μ, 2 times / day, intravenous, linked on the 5th. ② 5 - FU for the cytotoxic drug, can inhibit DNA and RNA synthesis, secretion of trypsin reduction of trypsin and phosphoric acid lipase were inhibited A daily 100 ~ 500 mg intravenous, or 250 mg in 5% glucose the infusion of 500 ml, 24 hours can repeat.
5. Give anticholinergic drug atropine 654-2, scopolamine, Propofol the digoxin to inhibit secretion of pancreatic juice, preferably early repeatedly application. Acid at the same time should be given for a cyanide microphones listening Chat 200 mg, four times / day, aluminum hydroxide gel, and sodium bicarbonate in the gastric acid to oral, inhibit secretion of pancreatic juice. Glucagon inhibited pancreatic exocrine on a certain role, can also be used.
6. Hormones can cause their application generally do not advocate the use of acute pancreatitis. But with severe pancreatitis shock; obvious symptoms of poisoning, suspected sepsis, or illness suddenly worsened serious breathing difficulties, particularly in adult respiratory distress syndrome; or some tight on the gland cortical dysfunction, should be hydrogen test 500 to 1000 mg, or dexamethasone 20 ~ 40 mg, static, linked 3, suspended by reductions to. Reduce the inflammatory response, reducing capillary permeability and edema.
7. Treatment: ① Qing Yi Tang No.1: apply to edema pancreatitis, especially suitable for liver Qi stagnation, spleen and stomach hot and humid. Prescription components: Bupleurum 15 g, 9 g, the Hu-Lien 9 g, Hang Shao 15 g, costas 9 g, Yuan Hu 9 g, Health Jun 15 g, mirabilite 9 g . One day, the fried, served at the second. ② Qing Yi Tang II: apply biliary ascariasis pancreatitis can be Shugan Qi, flooding lumbricoid the lumbricoid. Prescription components: Bupleurum 15 g, baicalin 9 g, Forsythia 9 g, costas 9 g, betel 30 g, the gentlemanly 30 g, hard-dong Paper 30 g, Asarum 3 g, mirabilite 9 g . One day, two fried, served at the second. This applies to the majority of acute pancreatitis, with clinical disease can be modified, TGA, plus two flowers, Forsythia, damp heat of re-plus Chen, Gentiana. Vomiting-plus Ruddle. Fresh and Semen Raphani plot, coke 0.53, pain Muneko, Yuan Hu cable, plus chest full Magnolol, Zhishi, pain and Gualou, Xiebai, shielding, etc..
8. Anti-shock: heavy, often a shock early stage, mainly because of the influx of humoral extravasation can cycle of loss 40 percent, it appeared hemorrhagic shock, is the cause of early death, so based on central venous pressure, blood pressure, urine output , hematocrit and electrolyte monitoring, supply balanced salt solution, plasma, fresh whole blood, human albumin, plasma, such as dextran incremental agents and electrolyte solution, in order to restore effective circulating volume and electrolyte balance, it is also necessary to maintain acid alkali balance improvement in the situation, after excluding heart failure induced hypotension, it can boost the application of vasoactive drugs, dopamine is preferred. Furthermore, it should be given broad-spectrum antibiotics and hormones to improve the ability to mobilize the body stress effect. At the same time the protection of renal function, diuretic use, if necessary, to peritoneal dialysis. Respiratory failure, arterial blood gas analysis should be high-flow oxygen, when necessary, will tracheotomy and positive pressure breathing. If cardiac dysfunction should promptly gave tonic. The rescue, should be collaboration with the College of Physicians can be successful.
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early diagnosis of pancreatic cancer

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