休克病人的病情监测和护理.pptVIP

休克病人的病情监测及护理 何君君 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 1773年法国医生拉杜蘭(LeDran)描述枪伤病患的临床表征所用的 事实上休克并不是一个疾病的名词，而是由许多不同原因所引起的生理病理变化 身体的循环系统无法维持细胞的灌流及功能的需要 休克造成的最终结果是：细胞膜功能丧失、细胞代谢异常及细胞的死亡 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 机体在各种有害因素侵袭下引起的以有 效循环血容量锐减，致组织血液灌注不足、细胞 代谢紊乱受损、微循环障碍为特点的病理过程 。 充足的血容量 有效的心排出量 良好的周围血管张力 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 低血容量性休克 感染性休克 心源性休克 神经源性休克 过敏性休克 失血性休克 失液性休克 外科常见 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 微循环收缩期（休克代偿期） 微循环扩张期（休克抑制期） 微循环衰竭期（休克失代偿期） Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 微循环收缩期（休克代偿期） 血容量↓ BP↓ 压力感受器 交感肾上腺髓质系统兴奋 儿茶酚胺大量释放 选择性地外周和内脏微血管收缩 （微动脉和cap前括约肌为著） 保证重要 器官供血 微循环缺血 回心血量↑ 心跳↑ 心输出量↑ Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 微循环扩张期（休克抑制期） 微循环内缺血 组织细胞缺血、缺氧 无氧酵解↑出现代谢性酸中毒 微动脉和cap前括约肌对儿茶酚胺的敏感性↓ 微动脉和cap前括约肌收缩减弱 血液涌如cap网、微循环瘀血 血浆外渗 血液浓缩、回心血量↓、BP↓ Evaluation only