病理学血液循环系统障碍.pptVIP

原因 动脉阻塞或静脉回流不畅 Occlusion of arterial supply or venous drainage Thrombosis, embolism, athermanous plaques, external compression 功能性细动脉痉挛 Functional spasm of arteriole 类型 White infarcts (anemic infarcts) 白色梗死（贫血性梗死） Red infarcts (hemorrhagic infarcts) 红色梗死（出血性梗死） Septic infarcts 败血性梗死 INFARCTION INFARCTION White infarction Arterial occlusion 动脉阻塞 Solid, compact organs 质实组织或脏器 Few collateral circulation 缺乏侧支循环 spleen, kidney, heart, brain, etc. Morphology Gross Dull pale, dry, wedge-shaped necrotic lesion，with a hemorrhagic zone surrounding 灰白，干燥，大致呈楔形，尖端指向门部，底部紧邻包膜；病灶周围可见充血出血带。 新鲜时病灶肿胀，略隆起于脏器表面，浆膜外可见絮状纤维蛋白性渗出；陈旧时病灶收缩，质实。 INFARCTION LM Ischemic coagulative necrosis （kidney） Necrotic core Inflammatory and granulation tissue. Hyperemic and hemorrhagic zone Most undergo organization and scarring in the end. INFARCTION Spleen Infarction INFARCTION Cardiac Infarction INFARCTION Brain Infarction ( liquefied necrosis) INFARCTION Red infarction ? Arterial occlusion 动脉阻塞 ? Venous occlusion 静脉阻塞/淤滞 ? Loose tissue 组织疏松 ? Dual circulations: lung , small intestine 双重血供 previously congested re-established blood flow to a site of previous arterial occlusion and necrosis INFARCTION Hemorrhagic infarction of the lung 肺出血性梗死 Gross Roughly wedge shaped Dark red, solid area Base beneath the pleura Fibrin exudation LM Coagulative necrosis Large amounts of RBC filled in alveolar space Obscure structure INFARCTION Hemorrhagic infarction of the intestine INFARCTION Septic Infarction Bacteria containing emboli May form abscess and pus INFARCTION Fate of Infarct ? Enzymatic lysis, liquefaction and absorption ? Organization with scar formation ? Encapsulation and Calcification INFARCTION Factors that influence development of an infarct 影响梗死形成和发展的要素 Nature of the vascular supply Rate of development of occlusion Vulnerability to hypoxia Oxygen content of blood Case Study A 59-year old man was admitted to the hospital after a fall, complaining of hip pain an