最新妇产科学精品课件-妊娠高血压疾病-药学医学精品资料.ppt

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1、最新妇产科学精品课件-妊娠高血压疾病-药学医学精品资料HypertensiveDisorderscomplicatingPregnancyGestationalHypertensionPreeclampsiaPreeclampsiaSuperimposedonChronicHypertensionChronicHypertensionEclampsiaAGroupofRelatedDiseasesCharacteristicsSystemicsmallarteriesspasmEndothelialcellinjuryHypertensionProteinu

2、riaMultipleorgansdysfunctionConvulsionMaternalmortalityFetalmortalityGestationalHypertension;ChronichypertensionEclampsiaPreeclampsia;PreeclampsiaSuperimposedonChronicHypertensionPathophysiologyfluidproteinHypertensionEdemaProteinuriaHemoconcentrationSmallarterialspasmEndothelialce

3、llinjuryMultipleorgansdysfunctionIschemiaEdemamalfunctionSystemicDiseaseBrainHydrocephalusHyperemia/ischemiaThrombosiscerebralhemorrhagecerebralherniaheadachedazzlenauseavomitHypopsiaretinaldetachmentCorticalblindnessDysesthesiaConfusionofthinkingEclampsiaconvulsioncomabrain：Vasosp

4、asmpermeability↑kidneyrenalvasospasmrenalbloodflow↓glomerularfiltrationrate↓pathology：Glomerularexpansionswollenvascularendothelialcellcellulosedepositionrenocorticalnecrosis——renalirreversibledamageclinicalmanifestation：albuminuriahypoproteinemiarenaldysfunctioncreatinineureanitro

5、genuricacidoliguriarenalfailureliverhepaticvasospasm;hepaticischemia;hepaticedemaliverenlargement;hepaticdysfunctionelevatedliverenzymejaundicehypoproteinemiacoagulationfunctionchangedsevere：PeriportalnecrosishepaticsubcapsularhematomahepatorrhexisHELLPsymdrome:Elevatedhepaticenzym

6、esDecreasedbloodplateletCardiovascularSystemBloodPressure↑VasospasmVascularResistance↑CardiacLoad↑heartfailurevasospasmMyocardialIschemiaInterstitialEdemaSpottyNecrosispulmonaryvasospasmPulmonaryHypertensionPulmonaryEdemaOliguriawater-sodiumretentionRelativeBloodVolumeExcessIatroge

7、nicBloodVolumeExcessHighburdenPoorabilitybloodsystemRelativehypovolemiaAnemiaDecreasedbloodplateletHypercoagulabilitybloodclottingfactor↓placenta-fetusplacentaPlacentalhypoperfusionSpiralarteriessclerosisPlacentalInfarctionPlacentalAbruptionPlacentalfunctiondecreasesfetusIUGRfetald

8、istressoligohydramniosfeta