๊ธ‰์„ฑ ์ทŒ์žฅ์—ผ / Acute pancreatitis

์ •์˜

์ทŒ์žฅ์˜ ๊ธ‰์„ฑ ์—ผ์ฆ์œผ๋กœ epigastric pain ๋ฐ back-radiating pain, ์ทŒ์žฅํšจ์†Œ ์ƒ์Šน, ์˜์ƒ ์†Œ๊ฒฌ์œผ๋กœ ์ง„๋‹จํ•˜๋Š” ์งˆํ™˜.

์ž„์ƒ ํ•ต์‹ฌ

์œ„ํ—˜ ์ธ์ž๋Š” gallbladder stone, alcohol, hypertriglyceridemia, hypercalcemia๊ฐ€ ๊ธฐ๋ก๋˜์–ด ์žˆ๋‹ค. Cullen sign์€ ๋ฐฐ๊ผฝ ์ฃผ์œ„ ์ฒญ์ƒ‰ ๋ณ€ํ™”, Grey-Turner sign์€ ์˜†๊ตฌ๋ฆฌ ๋ณด๋ผ/์ ๊ฐˆ์ƒ‰ ๋ณ€ํ™”์ด๋‹ค.

์ง„๋‹จ

์ž„์ƒ์ฆ์ƒ, amylase/lipase 3๋ฐฐ ์ด์ƒ ์ƒ์Šน, ์˜์ƒ์—์„œ peripancreatic fluid collection ์ค‘ 2๊ฐœ ์ด์ƒ์ด๋ฉด ๊ธ‰์„ฑ ์ทŒ์žฅ์—ผ์„ ์‹œ์‚ฌํ•œ๋‹ค. Lipase๋Š” pancreatitis rule-out์„ ์œ„ํ•ด ์ถ”๊ฐ€ํ•˜๋ฉฐ amylase๋ณด๋‹ค ์˜ค๋ž˜ ์ง€์†๋œ๋‹ค. TG, cholesterol series, calcium, phosphorus, ์Œ์ฃผ๋ ฅ, ํก์—ฐ๋ ฅ, GB stone ํ‰๊ฐ€๊ฐ€ ํ•„์š”ํ•˜๋‹ค.

์น˜๋ฃŒ

Demerol ๋“ฑ ์ง„ํ†ต์ œ, aggressive hydration(Hartmann 1000), NPO๊ฐ€ ๊ธฐ๋ก๋˜์–ด ์žˆ๋‹ค. ์ž๋ฃŒ์—๋Š” ulinastatin 1A + NS 100 ์ฒ˜๋ฐฉ๋„ ์–ธ๊ธ‰๋œ๋‹ค.

์ถœ์ฒ˜

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๋ณธ ๋ฌธ์„œ๋Š” ํ•™์Šตยท์ฐธ๊ณ ์šฉ์ด๋ฉฐ ์‹ค์ œ ์ง„๋ฃŒ ๊ฒฐ์ •์€ ์ž„์ƒ์˜์˜ ํŒ๋‹จ์ž…๋‹ˆ๋‹ค.