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1、SurgicalShock外科休克DefinitionofshockShock,regardlessofthecause,maybedefinedasasyndromethatresultsfrominadequateperfusionoftissues.休克乃各种原因导致的组织灌注不足所引起的综合症群。introductionShockisasignofcardiovascular(心血管的)insufficiency（不足）.Thecardiovascularsystemismadeupofthreekeyelements:apump,tubingandafluidThepumppro
2、pels(推动)thefluidThetubingdistributesandcollectsitCausesofshockSevereofsuddenbloodlossLargedropinbodyfluidsMajorinfectionsHighspinalinjuriesMyocardialinfarctionanaphylaxisPathophysiology（病理生理学）1.Microcirculatorychanges2.Thechangesofbodyfluidmetabolism3.Mediatorsofinflammationreleaseandischemicalrep
3、erfusioninjury4.Secondarylesion1.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Microcirculatorychangescompensationofshock(1)tospeeduptheheart,cardiacoutputincreased: (2)aredistributionofblood: (3)tissuehypoxia: (4)significantlyreducedthetissuefluid（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
4、stageofshock(休克抑制期)1,indifferentmind,unresponsive,orunconsciousness,coma. 2,systemicskinmucousmembranecyanosis,coldlimbs,coldsweat 3,threadyandrapidpulseorstrokeisnotclear,bloodpressuredecreased(BP<90mmHg)orundetectable,pulsepressuresmaller. 4,decreasedurineoutputorurine(per25ml).5,metabolicaci
5、dosis. 6,bleedingtendencyoftenhinthasoccurred:DIC 7,respiratorydistresssyndrome: (1)dyspneawere. (2)althoughtoalargenumberofoxygendoesnotimprove ThesymptomsandimprovetheoxygenpartialpressureTypesofshockHypovolemicshock(低血容量性休克)Cardiogenicshock(心源性休克)Allergicshock（过敏性休克）Neurogenicshock(神经性休克)S
6、epticshock(感染性休克)HypovolemicshockInadequatebloodvolumeClinicalmanifestation(临床表现)1,hypotension. 2,heartrate. 3changes,skinandmind. 4,organdysfunction1、低血压。2、心率加快。3、皮肤和神志的变化。4、器官功能不全。Hemorrhagicshock（失血性休克）Treatment:Supplementbloodcapacity Correctionofacid-baseandelectrolyteimbalance Thecauseo
7、fdiseasetreatmentandstopthecontinuedlossofblood Andthelossoffluid治疗：补充血容量纠正酸碱及水电解质失衡病因治疗和制止继续失血和失液Traumaticshock（损伤性休克）Treatment:Inadditiontothehemorrhagicfluidshocktreatment,shouldalsostrengthenthefollowingtrea
