关于局部血液循环障碍处理方式.ppt

recanalization 影响：“弊大于利” 1.阻塞血管 2.栓塞 3.心瓣膜变形 4.广泛性出血:DIC Effects of thrombosis： Ischemia 局部缺血 ／ Congestion Embolism Heart valve disease DIC Embolism Embolus An embolus is a detached intravascular solid,liquid,or gaseous mass that is carried by the blood to a site distant from its point of origin 栓 塞 栓子 在循环血液中出现的不溶于血液的异常物质，随血流运行阻塞血管腔的现象称为栓塞。 布道军师网/ashajk/ Motional pathway of embolus: Embolus from left heart cavity or arterial system Embolus from right heart cavity or venous system Embolus from portal veins Paradoxical embolism Retrograde ethrombus 栓子运行的途径： 动脉系统及左心栓子 静脉系统及右心栓子 门静脉系统栓子 交叉性栓塞 逆行性栓塞 运行途径 Thromboembolism Pulmonary thromboembolism Systemic thromboembolism 血栓栓塞 肺动脉栓塞 体循环动脉栓塞:下肢.脑.肠.肾 pulmonary embolism 肺动脉主干及 分支血栓栓塞 这里是位于通向左肺的肺动脉内一个大的肺血栓。这类血栓发源于不能走动的病人的大腿静脉或骨盆静脉。 布道军师网/ashajk/ Congestive liver cirrhosis Thrombosis ／Thrombus Thrombosis is the process of formation of a solid from the blood within living blood vessels or the heart, the resultant is termed a thrombus. 血栓形成/血栓 在活体的心脏和血管内，血液发生凝固或血液中某些有形成分凝集形成固体质块的过程. Three primary influences predispose to thrombus formation: Endothelial injury most important Alone can induce thrombosis Stasis or turbulence of blood flow Blood hypercoagulability 血栓形成的三个条件: 心血管内皮细胞的损伤 血流状态的改变 缓慢,涡流 血液凝固性增高 抗凝 Protective screen PGI2,NO,ADP酶 Thrombomodulin Membrane-associated heparin-like molecules Protein S t-PA 促凝 组织因子 Von Willebrand factor PAIs 布道军师网/ashajk/ On contact with extracellular matrix ECM , platelets undergo three general reactions: Adhesion reaction Release reaction Aggregation reaction 血小板的活化 粘附反应 释放反应 粘集反应 布道军师网/ashajk/ Ulcerative atherosclerosis 溃疡性的动脉粥样硬化 Transmural myocardial infarction 透壁的心肌梗塞 Vasculitis 脉管炎,血管炎 Trauma 创伤,外伤,损伤 Radiation 辐射,放射 Bacterial toxins 细菌毒素 血流状态的改变 缓慢,涡流 Platelets activated by contact with endothelium. Slowed flow retards dilution of activated clotting factors and hepatic clearance. Turbulence may induce endothelial injury 布道军师网/ashajk/ 血液