上海交通大学：《病理生理学》课程教学资源（PPT课件讲稿）第十三章 休克

休克 Shock

休 克 Shock

History of shock Circulation failure Up Microcirculation obstruction

History of shock Description Circulation failure Microcirculation obstruction Present

Concept 【 Shock】 休克是指机体在受到各种有害因子作用后发生的,以 组织灌流量急剧降低为特征,并导致细胞功能、结构损伤 和各重要器官机能代谢紊乱的复杂的全身性病理过程。 Shock is a clinical condition and pathophysiologic process haracterized, regardless of cause, by inadequate blood flow to vital organs and inability of body cell mass to metabolize nutrients normally

【Shock】 休克是指机体在受到各种有害因子作用后发生的，以 组织灌流量急剧降低为特征，并导致细胞功能、结构损伤 和各重要器官机能代谢紊乱的复杂的全身性病理过程。 Shock is a clinical condition and pathophysiologic process haracterized, regardless of cause, by inadequate blood flow to vital organs and inability of body cell mass to metabolize nutrients normally. Concept

【 Shock】 休克是多病因、多发病环节、多种体液因子参与的 种全身性病理过程,其始动环节是有效循环血量急剧 减少,其主要特征是微循环功能障碍,其后果是器官功 能衰竭

【Shock】 休克是多病因、多发病环节、多种体液因子参与的 一种全身性病理过程，其始动环节是有效循环血量急剧 减少，其主要特征是微循环功能障碍，其后果是器官功 能衰竭

10O Arterial pressure 品号 Cardiac outpUt 5O 10 20 30 40 50 Percentage of total blood removed 10%o of total blood volume can be removed without this effect Further blood loss reduces cardiac output, then arterial pressure Cardiac output and arterial pressure fall to zero when 35-45% of total blood volume removed

Etiology and Classification 1. Etiology 失血一 Hemorrhagic shock 大面积烧伤一— Burn shock 重创伤— Traumatic shock 感染— Infective shock 过敏一 Anaphylactic shock 急性心力衰竭— Cardiogenic shock 强烈的神经刺激— Neurogenic shock

1．Etiology 失血 Hemorrhagic shock 严重创伤 Traumatic shock 感染 Infective shock 过敏 Anaphylactic shock 大面积烧伤 Burn shock 急性心力衰竭 Cardiogenic shock 强烈的神经刺激 Neurogenic shock Etiology and Classification

2. Classification (1)病因分类( Classification of etiology (2)休克的始动环节分类 (Classification by initial changes of shock) A Hypovolemic shock A Vasogenic shock , Cardiogenic shock

（2）休克的始动环节分类 （Classification by initial changes of shock） Hypovolemic shock Vasogenic shock Cardiogenic shock 2．Classification （1）病因分类（Classification of etiology）

Hypovolemic Shock (Hemorrhage, Dehydration, Trauma, Plasma Loss) Decreased Circulating Blood Volume Inadequate Tissue Perfusion

Acidosis. Infection Neurogenic shock Anaphylactic Shock Increased vascular capacity Increased Capillary permeability Reduced Circulating Blood Volume Inadequate Tissue Perfusion

Acidosis, Infection

Cardiogenic shock Myocardial factor Non-myocardial factor Decreased Cardiac Output Inadequate Tissue Perfusion (共同的发病环是有效循环血量减少)

(共同的发病环节是有效循环血量减少） Myocardial factor Non-myocardial factor