文档介绍：Septic ShockSeptic Shock感染性休克感染性休克Surviving Sepsis Campaign: International guidelines formanagement of severe sepsis and septic shock: 2008-2012((2008-2012严重脓毒症和感染性休克治疗指南)Emergency Department, Xuanwu HospitalEmergency Department, Xuanwu Hospital,,Capital Medical University Capital Medical University :shock原意是“打击、震荡”;2.“急性循环”阶段:休克的关键是血压下降;3.“微循环学说”阶段:休克的关键不在于血压而在于血流和组织灌注。二、休克的概念?根据微循环学说,休克可定义为各种原因引起有效循环血量减少,微循环灌流障碍,引起重要生命器官血液灌流不足,从而导致细胞功能紊乱。?休克是不同病因分别或共同引起的,以微循环障碍为特征的临床综合征。休克的概念?从组织氧合角度认识, 休克的本质是细胞代谢产能过程受到组织氧供限制的状态。休克的病因和分类按病因分类?心源性休克?失血性休克?感染性休克?过敏性休克?神经源性休克………………按病理生理分类?心源性休克?低容量性休克?分布性休克?梗阻性休克Foundation of Foundation of pathophysiologypathophysiology病理生理基础病理生理基础Normal circulation based on?Normal Bood volum循环血容量正常?Normal heart pump心泵功能正常?Normal container血管容量正常Foundation of Foundation of pathophysiologypathophysiology病理生理基础病理生理基础Shock and Low Bp Shock and Low es es from??Reduction of blood Reduction of blood volumvolum血容量明显下降血容量明显下降??Failed heart pumpFailed heart pump心泵功能障碍心泵功能障碍??Enlargement of the Enlargement of the containercontainer血管容量明显扩张血管容量明显扩张?Obstructive ShockFoundation of pathophysiologyFoundation of pathophysiology?Arteriole and precapilary sphincter are more sensitive to catecholamine than postcapilery veins but less tolerant in acid surroundings.?Micro circulation ischemia →congestion 休克的发病机制保持正常血液循环的条件血容量充足心泵功能正常血管容量正常正常血液循环正常血液循环循环管路通畅休克的发病机制休克发生的始动环节血容量??心泵功能障碍血管容量??休克循环通路阻塞