山东大学基础医学院：《病理生理学 Pathophysiology》课程PPT教学课件（7年制）09 Shock 休克

Introduction 1. 1731. Le dran: french e first used shock te describe the severe condition of the patient of hurt

一、Introduction ： 1. 1731. Le Dran : French He first used ‘shock’ to describe the severe condition of the patient of hurt

2。1895 Warren describe the clinical manifestations of shock

2. 1895 Warren describe the clinical manifestations of shock

the face is pale or cyanosis cold and clammy skin rapid and thready pulse oliguria apath ★ hypotension( Crile)

• the face is pale or cyanosis • cold and clammy skin • rapid and thready pulse • oliguria • apathy ★hypotension (Crile)

Mechanism peripheral circulatory failure Vascular center- paralysis Treatment: pressor

Mechanism: peripheral circulatory failure Vascular center — paralysis Treatment: pressor

1960s The theory of microcirculation: Sympathetic adrenal medulla- hypersympathetic 7Os: Cellular metabolic disturbance 80s: septic shock

1960s: The theory of microcirculation: Sympathetic￾adrenal medulla — hypersympathetic 70s : Cellular metabolic disturbance 80s: septic shock

三、 Concept: Causes disturbance blood fow of microcirculation t functional and meta bolic disorders of the vital organs Inadequate tissue perfusion

二、Concept: Causes disturbance blood flow of microcirculation functional and metabolic disorders of the vital organs Inadequate tissue perfusion

三、 Etiology and classification of shock ( Etiology 1. Blood loss and body fluid loss SIHR/SBP SI Blood loss 0.5 10% compensation 1.0 20%30%shock 1.5 50% death

三、Etiology and classification of shock ㈠ Etiology 1. Blood loss and body fluid loss SI=HR/SBP SI Blood Loss 0.5 10% compensation 1.0 20% ~ 30% shock 1.5 50% death

fluid loss vomit. diarrhea collapse 2. Burn/trauma: pain, plasma loss burn shock, infection shock(late)

fluid loss vomit. diarrhea collapse 2.Burn/trauma: pain, plasma loss burn shock, infection shock(late)