休克病理生理(英文版).pptxVIP

休克病理生理ShockPathophysiology

Shockisapathologicalprocessofdecreasedeffectivecirculatingbloodvolume,tissueperfusion,cellmetabolismdisorderandimpairedfunction.Itisasyndromecausedbyavarietyofetiologies.

normalcircumstances

（1）Thearteriovenousanastomosisisclosed.

（2）Only20%ofcapillariesopenalternately,withhemoperfusion.

（3）Capillaryopeningandclosingareregulatedbytherelaxationandcontractionoftheanteriorsphincterofthecapillary.

phaseofmicrocirculationischemia：

（1）Sympatheticexcitementandadrenalin,norepinephrinesecretionincreased，

Arterioles,arterioles,posteriorarterioles,anteriorsphincterconstrictionofcapillaries

（2）Arteriovenousanastomosisisopenandbloodflowsdirectlyfromthearterioletothevenules.

（3）Insufficientcapillaryhemoperfusion,hypoxia.

（1）Arteriolesandarteriolescontract,arteriovenousanastomosesremainopen,andlittlebloodenterscapillaries.（2）Asaresultofhypoxia,histamine,bradykinin,hydrogenionandothervasomotorsubstancesincrease,afterthearterioleandcapillaryanteriorsphincterrelaxation,capillaryopening,vascularvolumeexpansion,bloodflowintothecapillaryisveryslow.Ecchymosisperiodofmicrocirculation：

（3）Asaresultofsympatheticexcitement,adrenalineandnorepinephrinesecretionincreased(andperhapshistaminerole),sovenulesandvenulescontraction,capillaryresistanceincreased,resultingintelangiectasiacongestion.Ecchymosisperiodofmicrocirculation：

（1）Duetoseverehypoxiaandacidosisoftissues,capillarywallisdamagedandpermeabilityincreases,bloodconcentrationincapillaries,bloodflowstagnation;Inaddition,bloodcoagulationincreased,resultingindisseminatedintravascularcoagulationinthemicrocirculation.Microcirculationclottingperiod：

（2）Duetotheformationofmicrothrombus,anoxiaandmetabolicdisordersaremoreseriousintissues,intracellularlysosomesr