慢性胰腺炎Chapter 10 Chronic pancreatitis
学习目标
1.慢性胰腺炎疼痛的原因
2.如何缓解慢性胰腺炎疼痛
3.掌握以下词汇
intermittent 间歇的；间断的
upper abdominal pain 上腹痛
diarrhea 腹泻
pancreatic duct hypertension 胰管高压
analgesic 止痛剂；止痛的
extracorporeal shock wave lithotripsy （ESWL） 体外冲击波碎石术
Zhang Jun suffers from intermittent upper abdominal pain for two years accompanied by diarrhea and weight loss.The pain has been getting worse recently.The purpose of this hospitalization is to manage the pain.Xiao Ran is his primary nurse.They are having a conversation.
Xiao Ran: Good morning, Zhang Jun.Did you have a good sleep last night?
Zhang Jun: Good morning, Xiao Ran.I did not sleep well last night.The pain has been bothering me and kept me awake.
Xiao Ran: I am sorry to hear that.
Zhang Jun: Xiao Ran, why is chronic pancreatitis painful?
Xiao Ran: Abdominal pain caused by chronic pancreatitis is mainly the result of pancreatic duct hypertension, or increased pancreatic parenchyma/interstitial tension.The other major cause could be peripancreatic and celiac plexus inflammation.
Zhang Jun: Oh, I see.How to deal with it?
Xiao Ran: First, avoid alcohol, quit smoking, and choose proper diet.Second, use medications such as pancreatic enzyme supplementation, antioxidant, somatostatin and analgesic.Third,ESWL treatment may also help to remove stones and reduce pain.
Zhang Jun: Ok, thank you.
Xiao Ran: You're welcome.Wish you a speedy recovery.
译文
患者张军有间歇性上腹部疼痛，反复持续2年，伴腹泻、体重下降，最近疼痛症状加重，这次住院的目的是控制疼痛，小冉是他的责任护士，他们正在交谈。
小冉：早上好，张军，昨晚休息得怎样？
张军：早上好，小冉，我昨晚睡得很不好，疼痛一直困扰着我，使我难以入睡。
小冉：很抱歉听到这些。
张军：小冉，慢性胰腺炎为什么会疼痛？
小冉：慢性胰腺炎引起腹痛的原因主要为胰管高压，胰腺实质 / 间质张力升高；另一个主要原因可能是胰腺周围和腹腔神经丛炎症。
张军：哦，我明白了。如何处理呢？
小冉：首先要禁酒、戒烟、控制饮食，其次要用药物治疗，包括胰酶制剂、抗氧化剂、生长抑素及止痛药的应用。此外，体外冲击波碎石术也有助于清除结石及缓解疼痛。
张军：好的，谢谢你。
小冉：不客气，祝你早日康复。