《病理生理学教研室》演示PPT

1、1 病理生理学教研室病理生理学教研室 刘俊昌刘俊昌 2 休克是各种强烈致病因子作 用于机体引起的急性循环衰竭， 其特点是微循环障碍,重要脏器 的灌流不足和细胞功能代谢障碍， 由此引起的全身性危重的病理过 程. 3 1. 按病因分类按病因分类 (By etiology): 失血性休克失血性休克 (Hemorrhagic Shock) 烧伤性休克烧伤性休克(Burn Shock) 感染性休克感染性休克 (Infectious Shock) 过敏性休克过敏性休克(Anaphylactic Shock) 心源性休克心源性休克(Cardiogenic Shock) 神经源性休克神经源性休克(Neurog

2、enic Shock) 4 Clinical Signs of Acute Hemorrhagic Shock % Blood lossClinical Signs 50Refractory hypotension, refractory acidosis, death 5 Changes in CO and MAP in haemorrhage 6 Cardiogenic Shock The impaired ability of the heart to pump blood Pump failure of the right or left ventricle Most common c

3、ause is LV MI (Anterior) Occurs when 40% of ventricular mass damage Mortality rate of 80 % or 7 Neurogenic Shock Caused by: Spinal cord injury Certain drugs Brain stem, spinal or torso trauma Venous pooling and arteriolar dilatation Signs and Symptoms: Hypotension without tachycardia Warm pink skin

4、Low blood pressure 钙 拮抗剂有降低胞浆游离Ca2+浓度，能减轻细胞 各种膜结构损伤. 损伤性体液因子拮抗剂的应用 (自由基清除剂, TNF-的单克隆抗体、酶抑制剂拮抗损伤性 因子作用, 可的松类制剂抑制细胞因子的过 量生成) 47 问问 题：题： 1 1、治疗休克时为什么要贯彻、治疗休克时为什么要贯彻需多少，需多少， 补多少补多少的原则？的原则？ 2 2、如何正确使用血管活性药物？、如何正确使用血管活性药物？ 48 ShockShock Hypovolemic Shock, Cardiogenic Shock, Hypovolemic Shock, Cardiogenic

5、Shock, Vasogenic Shock Vasogenic Shock Compensated shock, Decompensated shock, Compensated shock, Decompensated shock, Irreversible shock, Irreversible shock, Ischemic hypoxic phase, Stagnant hypoxic Ischemic hypoxic phase, Stagnant hypoxic phase, Refractory shock, phase, Refractory shock, Shock Kidney, Shock Kidney, Shock LungShock Lung Acute Respiratory Distress Syndrome, ARDSAcute Respiratory Distress Syndrome, ARDS