心脏泵血功能.ppt

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1、心脏的泵血功能Thefunctionoftheheartasapump一、心动周期（CardiacCycle，CC）CC的概念、HR的概念Concept:Thecardiaceventsthatoccurfromthebeginningofoneheartbeattothebeginningofthenext.Iftheheartbeats75beatsperminute,theneachcardiaccycletakes0.8second.ThecardiaccycleiscomposedofdiastoleandsystoleAtrialsysto

2、le0.1secondAtrialdiastole0.7secondVentricularsystole0.3secondVentriculardiastole0.5secondAtriaVentriclesLengthofsystole&diastole2.CC中心房atrium、心室ventricle收缩systole与舒张diastole时间Atrialsystolebeginsfirst,takingabout0.1secondthenrelaxationfor0.7second.Ventricularsystolebeginsafterthe

3、endofatrialsystoleandlastsfor0.3secondandthenrelaxes.3.全心舒张期的概念AtriaVentricles射血过程和充盈过程（泵血机制）注意⑴压力变化Pressure⑵容积变化Volume⑶血流情况Bloodflow⑷瓣膜开关Valve二、心脏泵血过程pumpingevents（一）心房的初级泵血功能RoleoftheatriainheartpumpAccumulation积聚ofbloodduringventricularcontractionandprimerpump.10~30%oftotalfi

4、llingvolume.（二）心室的射血和充盈过程(以左心室LV为例)以左心室为例1.心室收缩期Ventricularsystole⑴等容收缩期:0.05S⑵射血期a.快速射血期:2/3totalejectionvolume,rapid,0.1sb.减慢射血期:1/3totalejectionvolume,0.15S.2、心室舒张期⑴等容舒张期⑵心室充盈期Periodoffillinga.快速充盈期Rapidfillingphase:2/3oftotalfillingvolumeduration:0.11sb.减慢充盈期Reducedfillingph

5、ase1/3oftotalfillingvolumeduration:0.22s3、心房收缩期Periodofatrialcontraction:（收缩期前，处于全心舒张10~30%⑴全心舒张期时⑵心房收缩时（三）CC中心室压力、容积变化、血流情况、瓣膜开关等容收缩期快速射血期减慢射血期等容舒张期快速充盈期减慢充盈期心房收缩期容积压力二尖瓣主A瓣不变急剧关关不变急剧关关达min开关开关开关达max关开关开（三）心房在心脏泵血活动中的作用心房Functionoftheatria：1.心房的接纳和初级泵作用接纳静脉回流的血液和通道作用初级泵：可使心室的充盈

6、再增加10%~30%Atriacontractcausing25%fillingoftheventricle.Beforetheatriacontract,bloodnormallyflowscontinuallyfromtheveinsintotheatria;about75%bloodflowsdirectlythroughtheatriaintotheventricles.Theatriaactasprimerpumpsfortheventricles.三、心泵功能的评定（Estimateofheartfunctionasapump）（一）心脏的

7、输出量1.每搏输出量和射血分数（1）搏出量（strokevolume,SV）：一侧心室在一次心搏中射出的血液量（60~80ml）SV=end-diastolicvolume–end-systolicvolume=125ml-55ml=70ml（2）射血分数（Ejectionfraction,EF）：搏出量和心室舒末容积的百分比。EjectionFractionistheratio比值ofSV搏出量toend-diastolicvolume舒末容积[EDC]舒末容积（end-diastolicvolume,EDV）about110to120mlforno

8、rmaladult缩末容积（end-systolicvolume,ESV）.EF=SV/EDV