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ID:19532223
大小:669.50 KB
页数:53页
时间:2018-10-03
《妇产科学精品课件妊娠高血压疾病_1》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、HypertensionDisordersComplicatingPregnancy妊娠期高血压疾病HypertensiveDisorderscomplicatingPregnancyGestationalHypertensionPreeclampsiaPreeclampsiaSuperimposedonChronicHypertensionChronicHypertensionEclampsiaAGroupofRelatedDiseasesCharacteristicsSystemicsmallarteriesspasmEndothelialcellinjuryHype
2、rtensionProteinuriaMultipleorgansdysfunctionConvulsionMaternalmortalityFetalmortalityGestationalHypertension;ChronichypertensionEclampsiaPreeclampsia;PreeclampsiaSuperimposedonChronicHypertensionHypertensiondisorderscomplicatingpregnancyPathophysiologyCategoryandclinicalmanifestationDiagn
3、osisanddifferentialdiagnosisManagementandprevention病理生理临床表现诊断治疗EpidemiologyIncidence:6-9%Preeclampsia-eclampsia:70%ChronicHypertension:30%Eclampsia0.5%-1%China1.0%Overseas0.5%ReflectionofmedicallevelThesecondcauseofmaternaldeath(20%)Causeofprematuredelivery(10%)UnknownoriginPathophysiolog
4、yBasicpathologicalchangesSpasmofsystemicsmallarteriesVascularendothelialcellinjuryPathophysiologyfluidproteinHypertensionEdemaProteinuriaHemoconcentrationSmallarterialspasmEndothelialcellinjuryMultipleorgansdysfunctionIschemiaEdemamalfunctionSystemicDiseaseBrainHydrocephalusHyperemia/isch
5、emiaThrombosiscerebralhemorrhagecerebralherniaheadachedazzlenauseavomitHypopsiaretinaldetachmentCorticalblindnessDysesthesiaConfusionofthinkingEclampsiaconvulsioncomabrain:Vasospasmpermeability↑kidneyrenalvasospasmrenalbloodflow↓glomerularfiltrationrate↓pathology:Glomerularexpansionswolle
6、nvascularendothelialcellcellulosedepositionrenocorticalnecrosis——renalirreversibledamageclinicalmanifestation:albuminuriahypoproteinemiarenaldysfunctioncreatinineureanitrogenuricacidoliguriarenalfailureliverhepaticvasospasm;hepaticischemia;hepaticedemaliverenlargement;hepaticdysfunctionel
7、evatedliverenzymejaundicehypoproteinemiacoagulationfunctionchangedsevere:PeriportalnecrosishepaticsubcapsularhematomahepatorrhexisHELLPsymdrome:ElevatedhepaticenzymesDecreasedbloodplateletCardiovascularSystemBloodPressure↑VasospasmVascularResistance↑CardiacLoad↑hear
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