congestion淤血-吉林大学基础医学院.ppt

肉眼：组织器官体积轻度肿胀，颜色鲜红，温度升高，代谢功能亢进 镜下：动脉和毛细血管扩张、充满血液 后果：暂时性变化，去除原因即可恢复正常，因而影响小 但血管本身有病变时，充血可以是血管破裂的诱因 Dilatation of local venules and capillaries 局部静脉和毛细血管扩张 Congestive edema 淤血性水肿 Congestive hemorrhage，hemosiderin–laden macrophage 淤血性出血 Parenchyma cell: atrophy, reversible injury, necrosis 实质细胞萎缩、变性、坏死 Interstitial hyperplasia: fibrosis, congestive sclerosis 间质纤维组织增生 Lung congestion 肺淤血 ---肝淤血 Liver congestion Right-sided heart failure Acute hepatic congestion: Gross: dusky red, tense, slightly heavy; LM: central vein and sinusoids are distended with blood There may be central hepatocyte necrosis Chronic hepatic congestion: Gross: nutmeg liver LM: centrilobular necrosis and peri-lobular fatty change; hemorrhage; atrophy long standing congestion—hepatic fibrosis Dilatation of local venules and capillaries Congestive edema Congestive hemorrhage Parenchyma cell: atrophy,degeneration, necrosis Interstitial hyperplasia: fibrosis, congestive sclerosis Thrombosis 血栓形成 动脉粥样硬化溃疡 风湿性或细菌性内膜炎 心肌梗死 结节性多动脉炎 同一静脉经过多次注射 缺氧、休克、败血症等，全身广泛内皮损伤，弥散性血管内凝血 血流缓慢、停滞或涡流形成。 为什么静脉比动脉更易发生血栓？ 静脉血栓常见于心衰、久病和术后卧床患者 原因：静脉瓣，不搏动，壁薄易受压，血液粘滞性增加 指血液的高凝状态。血小板数量或粘度增加，凝血因子增多 发生于心血管系统的任何部位 心脏或主动脉壁上血栓 --层状血栓（lines of Zahn),为混合血栓（mixed thrombi) ：由灰白色的血小板和纤维素层以及暗红色的红细胞层相间而成，并混有变性的白细胞 --附壁血栓（mural thrombi)—底部与心壁、血管壁相连 -- 球形血栓（ball thrombi)—左心房内血栓 静脉—红色血栓 Morphology of thrombi Hemostasia 自行止血 obstruct vessel 阻塞血管 Embolism 栓塞 deformed valves 心瓣膜变形 disseminated intravascular coagulation 广泛性出血 出血 (Hemorrhage) 血液从血管或心腔逸出,称出血. 破裂性出血 漏出性出血 Loss of blood from the vascular compartment, usually as a result of trauma or disease of the vessel wall. This can involve large vessels, e.g, aorta or small vessels, e.g., capillaries. 外出血-- 鼻出血，咯血，呕血，血便，血尿 淤点，紫癜，淤斑 内出血 体腔积血: (心包腔,胸腔,腹腔,关节腔) 软组织血肿: (硬脑膜下血肿，腹膜后血肿，皮下血肿) 出血 (Hemorrhage) petechia 淤点(1-2mm) purpura 紫癜(3