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2013 | OriginalPaper | Buchkapitel

3. Klinische Klassifikationssysteme und prognostische Marker der akuten Pankreatitis: Wie hoch ist der Nutzen im Alltag?

verfasst von : Prof. Dr. med. Bettina M. Rau

Erschienen in: Erkrankungen des Pankreas

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Zur Schweregradstratifizierung der akuten Pankreatitis steht eine umfangreiche Palette an Klassifikationssystemen, Multiparameter-Scores und laborchemischen Variablen zur Verfügung, von denen sich jedoch nur wenige in der klinischen Routine durchgesetzt haben. Jedes einzelne Klassifikationssystem hat Vor- und Nachteile, sodass häufig eine Kombination derselben im Gesamtverlauf der Erkrankung zur Anwendung kommt. Im Frühverlauf der Pankreatitis stehen zur Differenzierung von leichter und schwerer Pankreatitis sowohl klinische Multiparameter-Scores als auch laborchemische Variablen zur Verfügung, von denen das CRP bis heute der wichtigste Vertreter ist. Zum Verlaufsmonitoring eignen sich bei schweren Verläufen intensivmedizinische Scores wie der APACHE II-, SOFA- und Marshall-Score, unter den laborchemischen Variablen stellt das PCT zur Vorhersage von infektiösen Komplikationen und der Gesamtprognose eine wertvolle Bereicherung dar.
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Metadaten
Titel
Klinische Klassifikationssysteme und prognostische Marker der akuten Pankreatitis: Wie hoch ist der Nutzen im Alltag?
verfasst von
Prof. Dr. med. Bettina M. Rau
Copyright-Jahr
2013
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-642-37964-2_3

Update Chirurgie

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S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.