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休克微循环研究中尚有若干问题值得探讨。国内一般把休克微循环变化分为缺血期、淤血期、凝血期。作者提出凝血期作为合并症看待为宜。淤血期的发生与血液细胞流变学的改变有关。在观察血管口径时应考虑到,微血管的舒缩既有血管平滑肌主动的作用,也有充盈压和血流阻力变化被动的影响。在判断微循环功能时重要的是观察血流量。休克时微血管口径与流量的变化有时并不一致。细胞流变学(cytorheology)的研究查明,休克时出现白细胞变形力下降和毛细血管嵌塞,细静脉中自细胞附壁粘着,红细胞和血小板聚集,以及微血栓形成等。它们带来微循环阻力增加和灌流量减压,在休克的发病中有重要意义,值得重视。
Shock microcirculation research there are a number of issues worth exploring. The domestic general microcirculation changes in shock is divided into ischemia, congestion period, clotting period. The authors suggest that coagulation as a complication is appropriate. The occurrence of congestion period is associated with changes in blood cell rheology. In the observation of vascular caliber should be taken into account, both the vasomotor and vasoconstriction of both vascular smooth muscle active role, but also filling pressure and blood flow resistance changes in passive effect. In determining the microcirculation function is important to observe the blood flow. Shock when the changes in micro-vascular caliber and flow are not always consistent. Studies of cytorheology have shown that there is a decrease in leukocyte deformability and capillary embolism in shock, self-cell adhesion in the fine veins, aggregation of red blood cells and platelets, and formation of microthrombi. They bring increased resistance to microcirculation and perfusion decompression, in the pathogenesis of shock is of great significance, it is worth attention.