休克机制 shock pathogenesis 浙医一院 原发性休克 primary shock(3-7d) 1.血管通透性增加,血浆外渗,血容量下降 substantial capillary leakage leads to extravasation of plasma and hypovolemic shock characterizes 2.血液浓缩-血粘度升高-DIC,有效血容量不足 an elevated hematocrit characterizes and hemoconcentration leads to disseminated intravascular coagution
休克机制shock pathogenesis 原发性休克primary shock (3-7d) 1. 血管通透性增加，血浆外渗，血容量下降 substantial capillary leakage leads to extravasation of plasma and hypovolemic shock characterizes 2. 血液浓缩-血粘度升高-DIC，有效血容量不足 an elevated hematocrit characterizes and hemoconcentration leads to disseminated intravascular coagution
休克机制 shock pathogenesis 浙医一院 继发性休克 seconary shock( (after oliguric phase) 1.大出血 uncontrolled hemorrhage 2.水盐失衡 disturbances of hydro-dielectric 3.继发感染 secondary infection
休克机制shock pathogenesis 继发性休克seconary shock (after oliguric phase) 1. 大出血 uncontrolled hemorrhage 2. 水盐失衡 disturbances of hydro-dielectric 3. 继发感染 secondary infection
浙医一院 出血机制 bleeding pathogenesi 1.血管受损 vascular damage 2.血小板质与量异常 thrombocytopenia 3.凝血机制异常 consumption coagulopathy(DIC)
出血机制bleeding pathogenesis 1. 血管受损 vascular damage 2. 血小板质与量异常thrombocytopenia 3. 凝血机制异常consumption coagulopathy (DIC)
D)急性肾功能衰竭机制 浙医一院 acute renal failure pathogenesis 肾血流不足 insufficient blood supply 1肾免疫损伤 immune damage 肾间质水肿和出血 interstitial edema& hemorrhage ■肾缺血性坏死 necrosIs R-A-AS激活 disorder of r-A-A 肾小管管腔阻塞 renal tubules block
急性肾功能衰竭机制 acute renal failure pathogenesis 肾血流不足insufficient blood supply 肾免疫损伤immune damage 肾间质水肿和出血interstitial edema & hemorrhage 肾缺血性坏死necrosis R-A-A-S激活 disorder of R-A-A-S 肾小管管腔阻塞renal tubules block
浙医一院 >2.病理解剖 pathology (1)血管基本病变是小血管内皮细胞肿胀、变性 和坏死。 (2)肾病变最显著,充血,水肿,出血,变性。 >(3)心右心房内膜下广泛出血 >(4)脑垂体及其他脏器脑垂体肿大,充血、出血、 坏死。后腹膜、肝、胰、脑实质、肺、肠亦有病变
➢ 2． 病理解剖pathology ➢ （1）血管 基本病变是小血管内皮细胞肿胀、变性 和坏死。 ➢ （2）肾 病变最显著，充血，水肿，出血，变性。 ➢ （3）心 右心房内膜下广泛出血。 ➢ （4）脑垂体及其他脏器 脑垂体肿大，充血、出血、 坏死。后腹膜、肝、胰、脑实质、肺、肠亦有病变