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通过学习和临床观察,我们对流行性脑脊髓膜炎(以下简称流脑)并发弥漫性血管内凝血(以下简称DIC)和休克的关系有些粗浅的认识,提出来共同探讨。我们认为流脑后的DIC应分为以下两型: 一、继发于休克后的DIC:特点是在休克基础上发生出血倾向。其主要发病因素为流脑引起的小血管挛缩和微循环淤滞,使有形成份聚集,加以心肌功能障碍等,使组织细胞缺氧和酸中毒,从而血液浓缩而易凝,终致发生微栓阻滞(图1)。由于这些微栓是在淤滞的静态下,在微血管里形成的,无路可去,只能像淤泥样阻塞于微循环处,故其对微血管的机械作用较弱。临床常不易有栓塞性出血斑,而多以休克和消耗性出血为其特点。
Through learning and clinical observation, we have some superficial understanding of the relationship between meningococcal meningitis (hereinafter referred to as meningitis) and disseminated intravascular coagulation (hereinafter referred to as DIC) and shock, put forward to jointly explore. We think DIC after meningitis should be divided into the following two types: First, DIC secondary to shock: It is characterized by bleeding tendency based on the shock. The main risk factors for the cerebellar caused by small blood vessel contracture and microcirculation stasis, so that the accumulation of visible ingredients, such as myocardial dysfunction, so that cells hypoxia and acidosis, which concentrated to easy blood coagulation, and eventually cause microthrombus Hysteresis (Figure 1). Since these microthrombi are formed in the microvasculature in a static state of stagnation, there is no way to go and they can only clog at the microcirculation like a sludge, so their mechanical effect on the microvasculature is weak. Clinical often difficult to have embolic bleeding spots, and more to shock and consume bleeding for its characteristics.