Health Care of Patient with Acute Pancreatitis

Učestalost pojave akutnog pankreatitisa u svijetu varira od 5 do 80 oboljelih na 100 000 stanovnika dok je učestalost akutnog pankreatitisa u europskim zemljama od 30 do 50 oboljelih na 100 000 stanovnika. Akutni pankreatitis je upala gušterače uzrokovana izlaskom pankreasnih enzima iz gušterače u okolno tkivo. Etiologija nije potpuno poznata, ali među čestim uzročnicima su bolesti žučnih putova, alkohol, žučni kamenci, uzimanje lijekova i poremećaj lučenja hormona. U kliničkoj slici dominira jaka bol najčešće lokalizirana u epigastriju koja se kasnije pomiče u gornji lijevi kvadrant i leđa. Bol se najčešće javlja nekoliko sati nakon masnog obroka ili obilne konzumacije alkohola. Dijagnozu postavljamo na temelju kliničke slike, laboratorijskih pretraga, EKG-a, RTG-a srca i pluća, nativnom snimkom abdomena te test trakicama za određivanje tripsinogena u urinu. Liječenje je u pravilu konzervativno – analgeticima, crpi se želučani sadržaj nazogastričnom sondom prvih 48-72 sata. Kirurško se liječenje poduzima samo kod pojave komplikacija. Mortalitet kod akutnog pankreatitisa ovisi o stupnju upale, odnosno zahvaćenosti gušterače upalom. Kod blagog oblika akutnog pankreatitisa iznosi manje od 5% dok kod teškog oblika varira od 10-50%. U liječenju akutnog pankreatitisa naglasak stavljamo na multidisciplinarni pristup. Važnu ulogu u tima ima medicinska sestra koja promatra stanje bolesnika, izvodi i sudjeluje pri dijagnostičkim i terapijskim postupcima, provodi zdravstvenu njegu, pruža psihološku potporu bolesniku te provodi edukaciju.The incidence of acute pancreatitis in the world varies from 5 to 80 cases per 100,000 inhabitants while the incidence of acute pancreatitis in European countries is from 30 to 50 cases per 100,000 inhabitants. Acute pancreatitis is an inflammation of the pancreas caused by the release of pancreatic enzymes from the pancreas into the surrounding tissue. The etiology is not completely known, but common causes include biliary tract diseases, alcohol, gallstones, medication, and hormone secretion disorders. The clinical picture is dominated by severe pain most often localized in the epigastrium which later moves to the upper left quadrant and back. The pain usually occurs a few hours after a fatty meal or heavy alcohol consumption. The diagnosis is made on the basis of clinical images, laboratory tests, ECG, X-ray of the heart and lungs, a native image of the abdomen and a test strip for the determination of trypsinogen in urine. Treatment is usually conservative-analgesics, the gastric contents are pumped with a nasogastric tube for the first 48-72 hours. Surgical treatment is undertaken only in case of complications. Mortality in acute pancreatitis depends on the degree of inflammation, more precisely the involvement of the pancreas with inflammation. In the mild form of acute pancreatitis it is less than 5%, while in the severe form it varies from 10-50%. In the treatment of acute pancreatitis, we place emphasis on a multidisciplinary approach. An important role in the teams is played by the nurse who observes the patient's condition, performs and participates in diagnostic and therapeutic procedures, provides health care, provides psychological support to the patient and conducts education