chapter 12shock分析课件

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1、Chapter12.Shock1ThetermwasoriginatedfromGreece,itsinitialmeaningwas:About200yearsago,itwasusedfirsttimebyaFrancedoctortodescribeShockApathologicprocessCausedbytraumaAviolentcollisionoraheavyblow；Theeffectofsuchacollisionorblow2Introduction2AcutecirculatoryfailureIntr

2、oduction3Microcirculationdisturbanceandtheeffectsofpro-inflammatorymediatorsandanti-inflammatorymediatorsShockReductionofECBVInadequateperfusionofvitalorgansCellularmetabolismdisturbanceDysfunctionoforgansThepathogeniciscomplex,involving:Shockisageneralpathologicproc

3、ess,charactrizedby:Including:3ShocksyndromeClassicclinicalpresentationofshock:5IntroductionShockperipheralvasoconstrictionseverelydiminishedCOinadequatebloodflowtothebrainandkidneysrespiratorycompensationformetabolicacidosispaleandcoldclammyskinhyperventilationoligur

4、iadulledsensoriumrangingfromagitationtostupororcomatachycardiawithathreadypulsehypotensionwithanarrowedpulsepressure4Section1.EtiologyandClassificationofShock5Hypovolemicshock6Section1.1.EtiologyandClassificationofshock(1)Accordingtocauses1)LossofbloodorfluidBlo

5、odlossHemorrhagicshockFluidlossDehydrationshock2)BurnBurnshock3)TraumaTraumicshock4)InfectionInfectious(endotoxic,septic)shock5)AnaphylaxisAnaphylacticshock6)AcuteheartfailureCardiogenicshock7)StrongstimulationonnervesystemNeurogenicshock6(2)Accordingtotheini

6、tialchangesofshockdevelopmentSufficientbloodvolumeheartpumpNormalfunctionVascularbedvolumeNormalvasoconstrictionandvasodilation3majordeterminantsofeffectiveperfusion:Perfectperfusion2Section1.Anyofthesedeterminantsmayinfluencetheeffectperfusion7Conditionsnecessaryfor

7、effectiveperfusionShocktypeInitialchanges×3213Section1.3typesofshockaccordingtodifferentinitialchangesSufficientbloodDecreasedHypovolemicvolumeshockAdequatecapacityIncreasedVasogenicofvascularbedshockNormalfunctionDisturbedCardiogenicofheartpumpshock8Section2.Stages

8、andPathogenesisofShock9MicrocirculationTheory3Section2.012345678910BPPRCABFPresentedbyLilleheiin1964.Shockisasyndromemainlyofmicroc