急诊室休克诊断及处理1(急诊学)

)?梗阻性(Obstructive)?分布性(Distributive)Р低血容量性?心源性?感染性?过敏性?神经源性?肺栓塞?心包填塞?腔静脉综合症?……Р电池Р电阻2Р电阻1Р≈Р循环系统与欧姆定律Р休克机制РObstruction?or?DilationРHeart Rate?ArrhythmiaРPreload?Afterload?ContractilityР容量?心肌Р梗阻或分布Р心脏结构Р=РU=IRР动力系统Р心率与心律Р心肌收缩力Р循环回路РCardiac Output=Stroke Volume×Heart RateР有效血容量Р阻力系统Р血管张力决定循环阻力和血流分配Р不同脏器具有不同的调节机制Р殊途同归РType of ShockРInsultРPhysiologic EffectРCompensationРCompensation?Heart RateРCompensation?ContractilityРCardiogenicРHeart fails to pump blood outР↓COРBaroRc?↑SVRР↑Р↑РObstructiveРHeart pumps well, but the outflow is obstructedР↓COРBaroRc?↑SVRР↑Р↑РHemorrhagicРHeart pumps well, but not enough blood volume to pumpР↓COРBaroRc?↑SVRР↑Р↑РDistributiveРHeart pumps well, but there is peripheral vasodilationР↓SVRР↑COР↑РNo Change - in neurogenic shockР↑РNo Change - in neurogenic shockР不同休克特点