外科休克英文

1、外科休克英文第一張，PPT共二十四頁，創(chuàng)作于2022年6月Definition of shockShock,regardless of the cause,may be defined as a syndrome that results from inadequate perfusion of tissues.休克乃各種原因?qū)е碌慕M織灌注不足所引起的綜合癥群。第二張，PPT共二十四頁，創(chuàng)作于2022年6月introductionShock is a sign of cardiovascular (心血管的) insufficiency（不足） .The cardiovascular syst

2、em is made up of three key elements:a pump,tubing and a fluidThe pump propels(推動) the fluidThe tubing distributes and collects it第三張，PPT共二十四頁，創(chuàng)作于2022年6月Causes of shock Severe of sudden blood lossLarge drop in body fluids Major infectionsHigh spinal injuries Myocardial infarctionanaphylaxis 第四張，PPT共二

3、十四頁，創(chuàng)作于2022年6月Pathophysiology（病理生理學）1. Microcirculatory changes2. The changes of body fluid metabolism3. Mediators of inflammation release and ischemical reperfusion injury4. Secondary lesion 1.微循環(huán)的變化2.津液代謝的變化3.炎癥介質(zhì)的釋放和缺血再灌注損傷 4.繼發(fā)性損害 第五張，PPT共二十四頁，創(chuàng)作于2022年6月Microcirculatory changescompensation of sh

4、ock (1) to speed up the heart, cardiac output increased:(2) a redistribution of blood:(3) tissue hypoxia:(4) significantly reduced the tissue fluid （1）心跳加快，心排出量增加 （2）血液重新分配 （3）組織缺氧（4）組織液明顯減 少第六張，PPT共二十四頁，創(chuàng)作于2022年6月Decompensation of shockprogressive stage of shock( 休克進展期) (1) is larger than the flow

5、of irrigation(灌大于流);(2) the tissue edema（組織水腫） Refractory stage of shock(休克難治期） (1) the formation of DIC（DIC形成）(2) cell autolysis, tissue necrosis;（細胞自溶，組織壞死）(3) the bleeding tendency （出血傾向）第七張，PPT共二十四頁，創(chuàng)作于2022年6月Clinical manifestation(臨床表現(xiàn))Compensatory of shock1, mental tension, irritability.2, pal

6、e, cold clammy skin.3, thready and rapid pulse, systolic blood pressure, diastolic blood pressure rise high, pulse pressure smaller.4, normal or decreased urine volume 第八張，PPT共二十四頁，創(chuàng)作于2022年6月Inhibitory stage of shock(休克抑制期) 1, indifferent mind, unresponsive, or unconsciousness, coma.2, systemic skin

7、 mucous membrane cyanosis, cold limbs, cold sweat3, thready and rapid pulse or stroke is not clear, blood pressure decreased (BP 90mmHg) or undetectable, pulse pressure smaller.4, decreased urine output or urine (per 25ml). 第九張，PPT共二十四頁，創(chuàng)作于2022年6月 5, metabolic acidosis.6, bleeding tendency often hin

8、t has occurred: DIC7, respiratory distress syndrome: (1) dyspnea were. (2) although to a large number of oxygen does not improve The symptoms and improve the oxygen partial pressure 第十張，PPT共二十四頁，創(chuàng)作于2022年6月Types of shockHypovolemic shock(低血容量性休克)Cardiogenic shock(心源性休克)Allergic shock（過敏性休克）Neurogenic

9、 shock(神經(jīng)性休克)Septic shock(感染性休克)第十一張，PPT共二十四頁，創(chuàng)作于2022年6月Hypovolemic shockInadequate blood volume第十二張，PPT共二十四頁，創(chuàng)作于2022年6月Clinical manifestation(臨床表現(xiàn))1, hypotension.2, heart rate.3 changes, skin and mind.4, organ dysfunction 1、低血壓。2、心率加快。3、皮膚和神志的變化。4、器官功能不全。第十三張，PPT共二十四頁，創(chuàng)作于2022年6月Hemorrhagic shock（失血

10、性休克）Treatment: Supplement blood capacityCorrection of acid-base and electrolyte imbalanceThe cause of disease treatment and stop the continued loss of bloodAnd the loss of fluid 治療：補充血容量糾正酸堿及水電解質(zhì)失衡 病因治療和制止 繼續(xù)失血和失液第十四張，PPT共二十四頁，創(chuàng)作于2022年6月Traumatic shock（損傷性休克）Treatment:In addition to the hemorrhagic

11、fluid shock treatment, should also strengthen the following treatment:1, anti infection2, analgesia, sedation3, the treatment of wounds 治療：除按失血失液性休克治療外，還應(yīng)加強以下治療： 1、抗感染 2、鎮(zhèn)痛、鎮(zhèn)靜 3、處理創(chuàng)傷第十五張，PPT共二十四頁，創(chuàng)作于2022年6月Septic shock(感染性休克)Treatment： 1 supplement blood capacity.2 control of infection.3 correcting

12、acid-base imbalance.Application of 4 cardiovascular drugs.5 cortical hormone therapy.6 other nutritional support, complications 治療： 1 補充血容量。 2 控制感染。 3 糾正酸堿失衡 4 心血管藥物的 應(yīng)用。 5 皮質(zhì)激素治療 6 其他營養(yǎng)支持、處并發(fā)癥等第十六張，PPT共二十四頁，創(chuàng)作于2022年6月Infection control（控制感染）Antibacterial drugs（抗菌藥物）Operation （手術(shù)）第十七張，PPT共二十四頁，創(chuàng)作于202

13、2年6月SIRST38 or 36Rate of heart90times/minR20times/min or above, PaCO24.3kPaNo.of Leukocyte12109/L or 4109/L， or unadult Leukocyte10%第十八張，PPT共二十四頁，創(chuàng)作于2022年6月Diagnosis(診斷)1. History: serious injury, bleeding, severe infection, allergy, history of heart disease2 .shock aura: sweating, rapid heart rate,

14、 pulse excited, reduce or Niaoshao symptoms 3. shock signs: indifferent mind, unresponsive, pale skin rapid shallow breathing, systolic blood pressure below 90mmHg and oliguria, sign the patient has entered the inhibitory stage of shock.第十九張，PPT共二十四頁，創(chuàng)作于2022年6月Monitors(監(jiān)測) of shockgeneral monitoring

15、1, state of mind 2, skin temperature, color 3, blood pressure 4, the pulse 5, the amount of urine is reaction 第二十張，PPT共二十四頁，創(chuàng)作于2022年6月(b) special monitoring1, central venous pressure (CVP):The normal value: 510cmH2O 2, pulmonary capillary wedge pressure (PCWP): 615mmHg 3, cardiac output (CO) and cardiac index (CI):Adult CO: 46L/min; CI:2.53.5L/ (min M2). 第二十一張，PPT共二十四頁，創(chuàng)作于2022年6月4, artery blood gas analysis (動脈血氣分析)5, artery blood lactate determination （動脈血乳酸鹽測定） The normal value is :12mmol/L. 6，Laboratory examination of DIC第二十二張，P