儿童慢性胃炎课件

1、Chronic Gastritis in ChildrenChronic Gastritis in ChildrenIntroductionChronic gastritis is a chronic inflammation of the gastric mucosa caused by long-term or repeated harmful factorsChronic gastritis is a common disease of the upper digestive tract in childhoodThe main diagnosic method are gastrosc

2、opy and pathological examination IntroductionChronic gastritis Classification1. Chronic superficial gastritis (CSG): 90-95%2. Chronic atrophic gastritisClassification1. Chronic superEtiology1. Infection of Helicobacter Pylori (HP) 2. Bile reflux3. The further development of acute gastritis Bad eatin

3、g habits or improper diet Adverse reaction of medicine Non-steroidal anti-inflammatory drugs NSAIDs Cortisone, etc food allergy 4. Othersneuropsychiatric factors Stress, fatigue or overworkchronic diseasesgenetic factos Etiology1. Infection of HelicoHelicobacter Pylori(HP)Helicobacter Pylori(HP)Heli

4、cobacter Pylori(HP)Helicobacter Pylori(HP)儿童慢性胃炎课件Etiology1. Infection of Helicobacter Pylori (HP) 2. Bile reflux3. The further development of acute gastritis Bad eating habits or improper diet Adverse reaction of medicine Non-steroidal anti-inflammatory drugs NSAIDs Cortisone, etc food allergy 4. O

5、thersneuropsychiatric factors Stress, fatigue or overworkchronic diseasesgenetic factos Etiology1. Infection of HelicoThe severity is varying. The course is varying1. Recurrent abdominal pain： recurrent lack of regularity intensity location the relationship with diet2. Other dyspepsia symptoms3. Gro

6、wth stunted：4. Upper gastrointestinal bleeding：Clinical manifestationsThe younger the children, the less typical of abdominal painThe severity is varying. The c1. Gastroscope：the first choice for examinationthe basis of diagnosis2. Pathological examination of gastric mucosaChronic superficial gastri

7、tis(CSG)Chronic atrophic gastritis3. Barium meal X-ray examination4. Bacteriological examination for HP infectionbacterial culturetissue section staining Hp ureaserapid urease test13C-urea breath test urea NH4+ + CO2examination of serum Antibody against HPAuxiliary examination1. Gastroscope：Auxiliar

8、y examiNormal gastric mucosa Normal gastric mucosa Edema of gastric mucosaEdema of gastric mucosaHemorrhagic gastritisHemorrhagic gastritis with multiple intramural bleeding spots Normal gastric mucosa Hemorrhagic gastritisHemorrhagLymphatic hyperplastic nodule in antrum of stomach caused by HPLymph

9、atic hyperplastic nodule Gastritis caused by bile refluxGastritis caused by bile refluChronic antral gastritisChronic antral gastritis1. Gastroscope：the first choice for examinationthe basis of diagnosis2. Pathological examination of gastric mucosaChronic superficial gastritis(CSG)Chronic atrophic g

10、astritis3. Barium meal X-ray examination4. Bacteriological examination for HP infectionbacterial culturetissue section staining Hp ureaserapid urease test13C-urea breath test urea NH4+ + CO2examination of serum Antibody against HPAuxiliary examination1. Gastroscope：Auxiliary examiHelicobacter Pylori

11、(HP) Silver stainHelicobacter Pylori(HP) Silver1. Gastroscope：the first choice for examinationthe basis of diagnosis2. Pathological examination of gastric mucosaChronic superficial gastritis(CSG)Chronic atrophic gastritis3. Barium meal X-ray examination4. Bacteriological examination for HP infection

12、bacterial culturetissue section staining Hp ureaserapid urease test13C-urea breath test urea NH4+ + CO2examination of serum antibody against HPAuxiliary examination1. Gastroscope：Auxiliary exami1. Clinical manifestations2. Medical history3. Gastroscope and pathological examination of gastric mucosa4

13、. Bacteriological examination for HP infection Diagnosis1. Clinical manifestationsDiag Intestinal ascariasis Enterospasm Functional abdominal pain caused by psychological factorsDifferential diagnosisDifferential diagnosis1. Remove the causes 1) anti-HP infection 2) discontinuation drugs causing gas

14、tric mucosal injury3) reduce stress2. Dietotherapy3. Pharmacotherapy 1) symptomatic treatment 2) gastric mucosal protective agent: Sucralfate Bismuth potassium citrate , etc 3) antacids: H2 receptor inhibitor (H2RI) PPI Aluminum hydroxide 4) gastroprokinetic agent: Domperidone (Motilium)Treatment1.

15、Remove the causesTreatmentAnti-HP drugsAntibiotics:AmoxycillinClarithromycinMetronidazole, etc.Furazolidone Bismuth agent: Bismuth potassium citrate, etcPPI TreatmentAnti-HP drugsTreatmentAnti-HP regimen1. PPI triple therapy PPI + 2 antibiotics 1w or 2w2. bismuth agent triple therapy Bismuth potassi

16、um citrate + 2 antibiotics 4w6w 2w3. bismuth agent Quadruple therapy Bismuth potassium citrate + H2RI + 2 antibiotics 4w6w 4w8w 2w TreatmentAnti-HP regimenTreatment1. Remove the causes 1) anti-HP infection 2) discontinuation drugs causing gastric mucosal injury3) reduce stress2. Dietotherapy3. Pharmacotherapy 1) symptoma