肠炎病情说明指导书

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中毒性巨结肠病情说明指导书

中毒性巨结肠病情说明指导书一、中毒性巨结肠概述中毒性巨结肠（toxic megacolon，TMC）又称中毒性结肠扩张，是各种炎症性肠病、细菌性肠病和病毒性肠病等的一种致命并发症，常见于溃疡性结肠炎患者。

患者常有腹痛、腹泻、血便、发热、心动过速等表现。

该病起病急，发展快，如不及时诊断及处理，预后不良，病死率高。

英文名称：toxic megacolon，TMC。

其它名称：中毒性结肠扩张。

炎症性肠病指南.pdf_1699215832.8027055说明书

A teen’s guideto inflammatory bowel diseaseStart your journey towards understanding inflammatory bowel diseaseIMPORTANT NOTICE:The information in this booklet does not replace any of the information or advice provided by a medical practitioner and other members of your healthcare team. If you have any further questions about inflammatory bowel disease, please contact your doctor.CONTENTSIN RODUC ION 2WHAT IS INFLAMMATORY BOWEL DISEASE? 4Crohn’s disease 5 Ulcerative colitis 5 Symptoms 6 Causes 6 Medical tests 8TREATMENT OPTIONS 10TOM’S STORY: LIVING WITH CROHN’S DISEASE 12TIPS FOR AN ACTIVE LIFE 13Involving your family and friends 13Social life 13Playing sport 13Food and nutrition 14 Bathroom dash 14 School life14Feeling sad?OLIVIA’S STORY: LIVING WITH ULCERATIVE COLITIS 15RESOURCES 162INTRODUCTIONWe hope you find this booklet useful. If there is anything you don’t understand, please ask your parents or your healthcare team for further help.You may have just found out that you have inflammatory bowel disease (IBD). You are probably worried, as you may never have heard of this illness before. This booklet is designed to ease your worries and help you learn more about your illness and how you can carry on enjoying your daily life.It can be difficult to deal with inflammatory bowel disease as a teenager but you are not alone, and with a little help you will be able to carry on with your everyday life. It is important to talk to your doctor and ask any questions you may have about your illness or how it might affect your life.This booklet has been prepared to help you:• Learn about your illness • U nderstand what treatmentsare available• G et some real-life tipsfor your day-to-day life.Dealing with inflammatory bowel disease as a teenager can be challenging. The good news is that you’re not alone.3Inflammatory bowel disease is the name given to a group of illnesses including Crohn’s disease and ulcerative colitis. These illnesses,the two most common types of inflammatory bowel diseases, affect around 85,000 people in Australia and this number is expected to exceed 100,000 by 2022.1 In New Zealand, an estimated 20,000 people are living with IBD, with this figure expected to increase by 2026.2Do not confuse inflammatorybowel disease with irritable bowel syndrome as they are quite different! Inflammatory bowel disease can develop at any age, though most people get this illness duringtheir 20s–30s.3People with inflammatory bowel disease have some periods, known as ‘remission’, when the illness seems to disappear (remission can lastfor months or even years) and other periods, known as ‘flare ups’, when the illness seems to get worse. Inflammatory bowel disease affects certain parts of your digestive tract, the system of organs that normally‘digest’ or break down the food you eat to extract the nutrients you need to stay healthy. Ulcerative colitis only affects the colon (also called the large intestine) whereas Crohn’s disease can affect any part of the digestive tract (from the mouth to the anus).WHAT IS INFLAMMATORY BOWEL DISEASE?Around 85,000people in Australiaand 20,000 peoplein New Zealandhave IBD.1,24Ulcerative colitisPatients with ulcerative colitis have sores called ulcers that form in the inner lining of the large intestine. It normally affects the lower large intestine and rectum but sometimes may involve the entire large intestine. People suffering with ulcerative colitis get diarrhoea often mixed with blood, abdominal pain and may occasionally present with other symptoms not related to the gastrointestinal tract such as pain in the joints.Crohn’s diseaseIn Crohn’s disease, the full thickness of the wall of the intestine becomes sore, inflamed and swollen. Crohn’s disease can cause abdominal pain, diarrhoea, fever and loss of weight. Some people may even have symptoms that occur outside of the intestinal tract such as pains in the knees, ankles or other joints.Areas of the gastrointestinal tract affected by inflammatory bowel disease5Ulcerative colitisCrohn’s diseaseSymptomsThe symptoms of Crohn’s disease and ulcerative colitis can be very similar and vary depending on how severe your illness is. Most people respond well to treatment and never develop more severe complications. However, serious complications can occur over a short period of time and normally require immediate medical attention. CausesInflammatory bowel disease isan autoimmune-related condition, meaning that the immune system, which normally defends the body against disease, attacks the body’s own tissues. However, whythis happens is not yet known. Some people believe that the immune system may actually be damaging the intestine and causing inflammation (a normal protective biological process in responseto harm). Other researchers think that viruses or bacteria may be causing the inflammation. Inflammatory bowel disease is not contagious (you can’t catch it from someone else) and is not causedby nerves or certain types of food.It is a combination of your genetics, environmental and lifestyle factors that may trigger your illness.The most common symptoms of inflammatory bowel disease• Fever, fatigue, low iron• Mouth ulcers• Skin rash• Stomach pain• Weight loss•Diarrhoea, blood, mucus67163 genetic locations have been identified which increase the risk of inflammatory bowel disease.4Smoking makes it at least twice as likely for you to develop Crohn’s disease.5Eating too much unsaturated fat may increase the chance of you developing ulcerative colitis.6Key causes8Medical testsYour doctor will likely carry out a series of tests to work out exactly what your illness is. These tests may include:A questionnaire about your healthColonoscopyImagingBlood testsStool sampleTemperaturePhysical examination of your abdomenWeight9After these tests, your doctor may send you to see other medical specialists who will help look after you and your illness. It may take a couple of months until your doctor can confirm what illness you are suffering from. Some tests will be repeated regularly, even when you are taking medication, to check that your illness is improving.Your healthcare team responsible for looking after your illness and your overall wellbeing may include a:• Gastroenterologist • Colorectal surgeon • General practitioner • Nurse • Radiologist • Dietitian • Psychologist.There are multiple treatmentsand surgeries available to treat the symptoms of inflammatory bowel disease, but given that this is a chronic illness, you may require lifelong treatment.Treating inflammatory bowel disease depends on how severe your illness is and whether you are in remission or experiencing a disease flare up. Your doctor will tell you about the medications available that are suitable for you. There are many different types of drugs for inflammatory bowel disease that are generally given in several different ways.TREATMENT OPTIONSDrug class When usedHow givenOral(by mouth)Intravenous(into your vein)Subcutaneous(under your skin)Rectal(into your anus)Anti-inflammatory drugs (to reduce inflammation)•F or mild to moderate illness •For relapseCorticosteroids(to block inflammation and allergic responses)•F or moderateto severe illness •To treat flare ups •F or short-term useImmunosuppressants (to suppressthe immune system)•F or moderate to severe illness •F or ongoing treatmentBiologics(to target proteins involved in inflammation)•F or patients who do not respond to other drugs10Medications can sometimes cause unpleasant side effects; your doctor will tell you about these. Always askif you have any questions or if you don’t understand something that your doctor has told you. Always talk to your doctor before taking food supplements and take your medication as your doctorhas prescribed to avoid a flare up. Sometimes, if your illness gets worse, you may need to go into hospital;for example, if you have severe bleeding or severe diarrhoea. Your doctor will manage this and will monitor your illness closely to help you recover. For patients with inflammatorybowel disease who do not respond well to medication, surgery is sometimes required to remove the diseased digestive area. Your doctor will talk to you about this if surgeryis necessary to treat your illness.Talk to your healthcareteam about your worries.11TOM’S STORY: LIVING WITH CROHN’S DISEASE My name is Tom and I am 13 yearsold. Last September, I was havingbad pains in my stomach. I wasalways tired and slept through theday. One day at school I got reallybad pains that I never had before, somy teacher called my mum to comeand get me. Later that day, I had topack a bag and go and stay in hospital.I had a good doctor but I couldn’teat so I had to have this nasty broth!And drank water and Gatorade… I hadbeen in and out of hospital before,but this time I was there for a week.The hospital helped me though – Ihad many tests and then, in April,I found out I had Crohn’s. I hadto have all these different drugsat the start but now I’m ona biologic. Sometimes I worrythat I won’t be OK but thedoctor says I can lead anormal life as long as I keephaving regular check upsand treatment.12TIPS FOR AN ACTIVE LIFESome things to think aboutwhen considering your daily lifewith inflammatory bowel disease: Involving your family and friendsIt is up to you who you tell aboutyour condition. A lot of people feel embarrassed, but really it is nothingto feel bad about. Decide how best you can tell the people you are close to and don’t let your illness take control of you or your life.Social lifeDeciding whether or not to go out when you’re feeling sick can be a really tough choice. The truth is that you can’t stop diarrhoea or stomach cramps so sometimes you just have to deal with it. You don’t have to decide alone – talking to a parent, siblingor friend can really help you to figure out the best choice and prepareyou for an outing. Try to do as many things as possible so you don’t feel isolated from your friends and your social circle. Playing sportPlaying sport may not be an optionfor you right now because of your illness. However, there may be something else you can do to keep you involved with your team and sport; for example, help the coach and keep track of scores and records. One low-impact exercise that does seem to be popular with young people suffering from inflammatory bowel disease is swimming. Swimming isa great all-round activity, but it’s also one sport that most people can still do even when they have stomach pain.Handy hint: Make yourselfa rice sock for comfort whenyour stomach’s hurting.Take a long sock, fill withrice and tie the end in a knot.Heat in the microwave fora great heating pad for whenyou have a stomach ache.1314Food and nutritionWhen you are first diagnosed, it’s normal to feel worried about what you can and can’t eat. Keep in mind that learning to eat what is right for you and your illness takes some time. Try to be patient and test out lots of different foods along the way. There may be some foods you shouldn’t eat – ask your parents, doctor and dietitian if there are any tasty substitutes for foods you have to go without. Pay attention to how certain foods (e.g. heavy carbohydrates such as pasta, sugary and spicy foods) make you feel. Keeping a diary may help you keep track of foods that make you feel unwell.Bathroom dashEveryone has to dash to the bathroom sometimes! Be prepared as much as possible and also realise that, now and again, you may have an accident if you don’t make it to the toilet in time.School lifeTalk to the teachers so theyunderstand what your illness is and how it might affect your needs at school. Carry a letter from your doctor that explains the drugs you take (dose and time that they should be given and potential side effects) and work with school staff to set up a system for taking your medication that easily fits into your school day.Feeling sad?Your doctor and healthcare team care about your complete wellbeing and not just what goes on with you physically. If you’re feeling stressed, depressed, having trouble at school with your friends, or even your parents, talk to your healthcare team. Your team can help you deal with the emotions your illness may cause as well as looking after your physical health.Handy hint: Pack a change of clothes to carry with you in case of a bathroom emergency.Handy hint: Carry your doctor’s and healthcare team’s contact information with you at all times!If you need to talk to someone immediately,call Lifeline on 13 11 14 in Australiaor 0800 543 354 in New Zealand .If you need to talk to someone immediately,call Lifeline on 13 11 14 in Australia or 0800 543 354 in New Zealand.OLIVIA’S STORY: LIVING WITH ULCERATIVE COLITISI’m Olivia and I’m 16 years old. I wasdiagnosed with ulcerative colitis when Iwas 7. Back then, I worried and cried a lot,as I was ashamed that I had really runnydiarrhoea. One day, my mum noticed thatmy stool had blood in it and took me to thedoctor. I had also lost weight and neededthe toilet a lot even if I couldn’t go. I went tothe hospital and drank one of those horribledrinks before they did several tests to workout what was wrong with me. It took a whileand my mum was really worried as she alsohad some bowel problems a while ago.The doctor said it was ulcerative colitis –I didn’t even know what that was! I wasscared to go to school and tell myteachers but the tablets they gaveme helped a lot.Now I’m used to taking mymedication every day and I do allthe things my friends do. I wasworried that having ulcerativecolitis might affect me at schooland time with my friends butI only have to think a bit moreabout my diet now and again.1516RESOURCESCrohn’s and Colitis Australia*.auProvides information on Crohn’s disease and ulcerative colitis and support programs that provide education, advocacy, counselling, awareness and fundraising for research.IBD Support Australia*.auResources include an online forum where you can share your experiences and learn from others who are also living with inflammatory bowel disease.Beyond Blue*.auProvides information about depression and its symptoms.Crohn’s and Colitis New Zealand*Crohn’s and Colitis New Zealand is a charitable trust which aims to provide support, advice, resources and information about Crohn’s disease and ulcerative colitis.Living Beyond IBDProvides you with easy to understand information on IBD, its impacts and practical tips on how to manage it in everyday life. The website also includes videos of people sharing their experiences of living with IBD.* T he websites above are provided for information only. The websites may contain content that the sponsor of thisbooklet does not endorse. The sponsor is not responsible for the validity of the information on these sites. The websites may contain or link to information that is not consistent with the way medicines are used in Australia or New Zealand. Always discuss any issues relating to your treatment with your doctor or a member of your healthcare team.GastroCentral Australia and New Zealand.au | This website is an informative portal, created by Janssen, about inflammatory bowel disease for patients and healthcare professionals. The patient portal provides information and videos to help you understand your condition and treatmentjourney. Shared patient experiences, the latest news in the field and other useful links and resources are also available.Use the QR code to access GastroCentral AustraliaUse the QR code to accessGastroCentral New ZealandNOTESUse this space to write down the name of your doctor and nurses or write down any questions or concerns you may have about your condition.17References: 1. Crohn’s and Colitis Australia. About Crohn’s & Colitis. Available at: .au/about-crohns-colitis (accessed June 2021).2. Crohn’s and Colitis New Zealand. Reducing the growing burden of inflammatory bowel disease in New Zealand. Available at: https:///static/59c9a99bf14aa1faebdc9469/t/5b5a399103ce642 3d9189069/1532639643871/ CCNZ+Burden+of+Disease+Report.pdf (accessed June 2021). 3. Duricova D et al.J Crohns Colitis 2014;8:1351–61. 4. Jostins L et al. Nature 2012;491:119–24. 5. Lakatos P et al. World J Gastroenterol 2007;13:6134–39. 6. Ananthakrishnan A. Dig Dis Sci 2015;60:290–98.©Janssen-Cilag 2021. Janssen-Cilag Pty Ltd. ABN 47 000 129 975.1–5 Khartoum Road, Macquarie Park NSW 2113. Ph: 1800 226 334./australia. Janssen-Cilag (New Zealand) Ltd,507 Mount Wellington Hwy, Mount Wellington, Auckland 1060,New Zealand. /newzealand. Ph: 0800 800 806 / +64 (9) 588 1343. CP-47203. JANS3326/EMBC. July 2021.。

慢性肠炎病历模板

资料范本本资料为word版本，可以直接编辑和打印，感谢您的下载慢性肠炎病历模板地点：__________________时间：__________________说明：本资料适用于约定双方经过谈判，协商而共同承认，共同遵守的责任与义务，仅供参考，文档可直接下载或修改，不需要的部分可直接删除，使用时请详细阅读内容患者李明，男性，43岁，汉族，已婚，农民，，主诉：间断性腹泻，腹痛22年，加重伴乏力，纳差一周。

于2016/01/16 08:57以“慢性肠炎”收住入院。

一、病例特点：1.病史：患者自述于入院22年前因饮食不慎出现腹痛，腹泻，大便一日3-5次，呈稀水样便，伴恶心，无呕吐，食欲差，进食后腹痛加重，无发烧、头痛、头晕，无咳嗽，咳痰，无心慌气短、呼吸困难，即在当地村卫生所诊治（具体用药用量不详）后，腹痛腹泻好转，大便一日一次或隔日一次，量少，但出现腹部胀满不适，时轻时重，进食后明显加重，肛门排气或嗳气后减轻，伴食欲不佳，进食量少，疲乏无力，一直清淡饮食，口服中药等对症治疗，症状时轻时重，于本次入院前1周前因吃牛肉后以上症状加重，在当地卫生院诊治（具体诊断及用药用量不祥），疗效不佳，今来我院就诊，准备进一步检查治疗，门诊既以“慢性肠炎”收入院。

患者自发病以来，神志清楚，精神差，饮食差，睡眠欠佳，小便正常，体重明显减轻。

2.查体：T 36.3℃ P 76次/分 R 18次/分 BP 135/80mmHg发育正常，营养中等，神志清楚，精神差，慢性病容，表情淡漠，步入病房，查体合作，对答切题。

全身皮肤粘膜有黄染，无皮疹及出血点，无肝掌、蜘蛛痣、皮下结节或肿块，全身表浅淋巴结未扪及肿大，头颅五官端正，无畸形，眼睑无浮肿，巩膜无黄染，双侧瞳孔等大等圆，直径约2.5mm，对光反射灵敏。

乳突区无压痛，耳郭无畸形，外耳道无异常分泌物，鼻中隔居中，鼻通气良好，无脓性分泌物，口唇无明显发绀，咽无充血水肿，扁桃体不肿大，颈软无抵抗，气管居中，甲状腺无肿大。

胃肠炎门诊病历书写范文

胃肠炎门诊病历书写范文日期：[具体年月日]姓名：[患者姓名]性别：[男/女]年龄：[X]岁。

主诉：哎哟，大夫啊，我这肚子可难受了，一阵一阵地疼，还老是跑厕所，拉得我都快没力气了。

感觉胃里也翻江倒海的，吃啥吐啥，这罪受的呀，都快一天了。

现病史：患者昨天晚上吃了顿火锅，那可没少吃，什么毛肚、鸭肠、肥牛的，还喝了好几瓶冰啤酒呢。

吃完后没多久，就开始觉得肚子有点胀，当时没太在意。

到了半夜，肚子就开始疼起来了，就像有人在里面拧着劲似的。

然后就往厕所跑，拉的都是稀水样的大便，一晚上跑了四五趟。

今天早上起来呢，胃里也跟着凑热闹，喝了口水都给吐出来了，吐完了还是觉得恶心。

这一天啥也没敢吃，就怕吃了又吐又拉的。

既往史：以前身体还不错呢，没得过啥大病。

就是偶尔有点小感冒，吃点药就好了。

没有什么慢性的胃病、肠道疾病啥的，也没有做过什么手术。

过敏史：没有发现对啥过敏的，平时吃药啥的都没出过问题。

体格检查：患者看起来有点虚弱，精神不太好，脸色有点发白。

测了个体温，[X]℃，有点低热。

肚子摸起来有点软，但是一按肚脐周围就喊疼，尤其是右下腹部，不过麦氏点没有明显的反跳痛（跟患者解释了下这个是排除阑尾炎的一个检查）。

肠鸣音很活跃，咕噜咕噜响个不停，就像里面在开小火车似的。

初步诊断：急性胃肠炎。

诊断依据：有不洁饮食史（那顿火锅和冰啤酒），这是很重要的诱发因素。

腹痛、腹泻、呕吐这些典型的胃肠炎症状都有啊，再加上低热，肠鸣音活跃，综合起来看很像是急性胃肠炎闹的。

治疗计划：首先呢，这几天得让肚子休息休息，先禁食几个小时，等不吐了，可以喝点清淡的米粥啥的。

开点药，给开了口服补液盐，这玩意可重要了，拉了那么多次，身体里的水分和电解质都丢了不少，得补补。

还有黄连素，这是专门对付肠道炎症的。

再加上胃复安，能止吐的。

嘱咐患者回家一定要多休息，这几天就别吃那些油腻、辛辣、生冷的东西了，要是症状加重了，或者出现了便血、高烧不退这些情况，可得赶紧回来。

急性胃肠炎健康教育处方

**市**区人民医院
健康教育处方
急性胃肠炎
急性胃肠炎是胃肠粘膜的急性炎症，临床表现主要为恶心、呕吐、腹痛、腹泻、发热等。

(一）出院指导
1.如药物引起，应告诫今后禁止用此药；如疾病需要必须用该药，必须遵医嘱
配合服用制酸剂以及胃黏膜保护剂。

2.嗜酒者应戒酒。

3.进食要有规律，避免食生、冷、硬及刺激性食物和饮料。

4.了解本病为急性病，应及时治疗及预防复发，防止发展成慢性胃炎。

5、上吐下泻除了流失水分，还流失电解质，因此最好喝些‘补液盐’，而非纯粹的白开水。

6、应遵医嘱按时给药，如有不适，及时来院就诊。

祝您健康！
地址：**市**区**路**巷38号
邮编：334100
电话：- 转9120。

慢性胃肠炎的病历范文

慢性胃肠炎的病历范文
这里是一份慢性胺肠炎的病历范文:
慢性胃肠炎的病历范文
姓名:
年龄:岁
性别:女
就诊日期:年月日
主诉:经常腹泻,有时会有小便急迫感,伴有腹胀不适。

现病史:近3年来,病人常会出现腹泻症状,每次腹泻次数多,粪便颜色偏淡,有时伴有粘液或血丝,腹胀不适。

近1年症状加重,每个月大概会腹泻3-4次,持续1-2天。

小便时会感觉急迫。

既往史:无特殊既往史。

个人史:食品没有明显避忌食物。

女性生理史正常。

身体检查:腹软,未觉肝脾肿大。

全身其他各系统检查未见明显改变。

辅助检查:
1. 粪 :次肥乎乎,未见虫卵。

2. 肠镜:粘膜表现为嗜酸性细胞增生,脱落程度轻-中度,诊断为慢性胃肠炎。

诊断:慢性非感染性胃肠炎
说明:根据病人近3年来反复出现的腹泻、腹胀等症状,及肠镜表现为粘膜程度轻-中度的嗜酸性细胞增生及脱落,符合慢性胃肠炎的诊断标准。

治疗方案:治疗措施包括用药治疗及生活调理两方面。

用药方面按时口服孟斯片;生活方面注意饮食规律,少饮刺激性饮料,多水分补液,适当运动等调理。

疾病预后:通过药物控制和生活调理,症状应可获得缓解。

随访观察病情的变化。

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肠炎病情说明指导书一、肠炎概述肠炎是由于各种原因引起的肠道炎症反应，如肠道细菌、病毒等病原维生素感染或受到免疫损害、放射线损害、饮食刺激、药物刺激等因素。

临床表现主要有发热、恶心、呕吐、腹痛、腹泻、稀水便或黏液脓血便，部分患者还可有里急后重感。

肠炎按发病原因不同，分为感染性和非感染性两类。

按病程长短不同，分为急性肠炎和慢性肠炎两类。

肠炎严重时可引起脱水和电解质紊乱，甚至威胁生命。

英文名称：enteritis。

其它名称：无。