病理生理学第八版配套13休克汇编.ppt

二、发病学防治 （一）改善微循环 1.纠酸 2.及时补足血容量，防治缺血-再灌注损伤 3.合理使用血管活性药物 * 人民卫生出版社 病理生理学 二、发病学防治 （二）防止细胞损伤保护细胞功能 （三）阻断炎症介质的作用 （四）防止DIC与MOSF * 人民卫生出版社 病理生理学 * Enjoy Pathophysiology ! This conceptual framework shows the interrelationships between infection, non-infectious disorders, SIRS, sepsis and severe sepsis. Components of the process not discussed on the following slides include: Infection: a microbial phenomenon characterized by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by those organisms Bacteremia: the presence of viable bacteria in the bloodstream Septic shock: sepsis-induced hypotension despite adequate fluid resuscitation along with the presence of perfusion abnormalities that may include, but are not limited to, lactic acidosis, oliguria or an acute alteration in mental status Multiple organ dysfunction syndrome (MODS): presence of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992;101:1644-55. Opal SM, Thijs L, Cavaillon JM, et al. Relationships between coagulation and inflammatory processes. Crit Care Med 2000;28:S81-2. * In the study by Angus et al described on the previous slide, the national estimate of severe sepsis was 750,000 cases. Since this figure was based on 1995 data, it is estimated that there will be more than 750,000 cases this year. Based on data from the US census, Angus et al estimate that the number of cases of severe sepsis will increase steadily at 1.5% per annum. This increase in the incidence of severe sepsis is greater than the anticipated population growth. The disproportionate growth is due to the high incidence of sepsis in older patients and a disproportionate increase in the number of elderl