外科休克_英文ppt课件.ppt

Surgical Shock 外科休克 Definition of shock Shock,regardless of the cause,may be defined as a syndrome that results from inadequate perfusion of tissues. 休克乃各种原因导致的组织灌注不足所引起的综合症群。 introduction Shock is a sign of cardiovascular (心血管的) insufficiency（不足） . The cardiovascular system is made up of three key elements:a pump,tubing and a fluid The pump propels(推动) the fluid The tubing distributes and collects it Causes of shock Severe of sudden blood loss Large drop in body fluids Major infections High spinal injuries Myocardial infarction anaphylaxis Pathophysiology（病理生理学） 1. Microcirculatory changes 2. The changes of body fluid metabolism 3. Mediators of inflammation release and ischemical reperfusion injury 4. Secondary lesion 1.微循环的变化2.津液代谢的变化3.炎症介质的释放和缺血再灌注损伤 4.继发性损害 Microcirculatory changescompensation of shock (1) to speed up the heart, cardiac output increased:(2) a redistribution of blood:(3) tissue hypoxia:(4) significantly reduced the tissue fluid （1）心跳加快，心排出量增加 （2）血液重新分配 （3）组织缺氧 （4）组织液明显减 少 Inhibitory stage of shock(休克抑制期) 1, indifferent mind, unresponsive, or unconsciousness, coma.2, systemic skin mucous membrane cyanosis, cold limbs, cold sweat3, thready and rapid pulse or stroke is not clear, blood pressure decreased (BP 90mmHg) or undetectable, pulse pressure smaller.4, decreased urine output or urine (per 25ml). 5, metabolic acidosis.6, bleeding tendency often hint has occurred: DIC7, respiratory distress syndrome: (1) dyspnea were. (2) although to a large number of oxygen does not improve The symptoms and improve the oxygen partial pressure Types of shock Hypovolemic shock(低血容量性休克) Cardiogenic shock(心源性休克) Allergic shock（过敏性休克） Neurogenic shock(神经性休克) Septic shock(感染性休克) Hypovolemic shock Inadequate blood volume Clinical manifestation(临床表现) 1, hypotension.2, heart rate.3 changes, skin and mind.4, organ dysfunction 1、低血压。 2、心率加快。 3、皮肤和神志的变化。 4、器官功能不全。 Hemorrhagic sh