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1、hypoxia王婧婧山東大學醫(yī)學院病理生理學教研室氧氣的獲得和利用:ventilationgasexchangeinternalrespirationexternalrespirationairalveoliAlveolarcapillaryGastransportTissuecellsConcept運送氧或利用氧發(fā)生障礙時，機體發(fā)生功能、代謝、形態(tài)結構改變的病理過程.Tissuecellscan’tobtainenoughoxygenorcan’tfullyutilizeoxygen→metabolic,functionalandstructuralchangesParameters
2、ofbloodgas1.PartialpressureofO2（PO2）2.O2capacity（CO2max）3.O2content（CO2）4.O2saturation（SO2）1.PartialpressureofO2（PO2）溶解在血液中的氧所產(chǎn)生的張力。ThepressureortensionproducedbyphysicallydissolvedO2intheblood.Normal:PaO2:100mmHg吸入氣氧分壓Influencedby:theoxygenpressureintheinhaliedairextra-respirationNormal:PvO2:40
3、mmHgInfluencedbyintra-respiration2.O2capacity（CO2max）100ml血液中的Hb被氧充分飽和時的最大攜氧量MaximumamountofO2thatcanbecombinedchemicallywiththeHbin100mlblood.Normal:20ml/dl(15gHb/100mlblood)InfluencedbytheamountofqualityandquantityofHb100mlHb的實際攜氧量TheconcentrationofO2inabloodsampleNormal:CaO2:19ml/dl,CvO2:14ml
4、/dl3.O2content（CO2）InfluencedbythePO2andCO2maxThedifferencebetweenCaO2andCvO2動靜脈血氧差:動脈血氧含量-靜脈血氧含量19ml/dl14ml/dl5ml/dlO2O2O2O2O2AVCaO2--CvO2Reflecttheoxygenconsumptionrateofthetissue.4.O2saturation（SO2）Normal：SaO295%SvO275%InfluencedbythePO2指Hb結合氧的百分數(shù)AmountofoxygenactuallycombinedwithHb,expressed
5、asapercentageofoxygencapacity.CO2–O2ofphysicalsolutionCO2max?100%=2,3-DPG2,3-DPGP50HypoxiaIntroductionClassification,etiologyandpathogenesisFunctionalandmetabolicchangesFactorsinvolvedintolerancetohypoxiaOxygentreatmentandoxygentoxicityAirGastransport+HbcirculationTissuecellsExternalrespirationC
6、lassification血液性缺氧Hemichypoxia循環(huán)性缺氧Circulatoryhypoxia低張性缺氧Hypotonichypoxia組織性缺氧Histogenoushypoxia低張性缺氧Hypotonichypoxia血液性缺氧Hemichypoxia循環(huán)性缺氧Circulatoryhypoxia組織性缺氧Histogenoushypoxia1.Hypotonichypoxia—PaO2↓Causes:1)PiO2↓:highaltitude(3000~4000m)海拔高度大氣壓PiO2PAO2SO2(m)(mmHg)(mmHg)(mmHg)%海平面760159105
7、9510006801409094200060012570923000530110629050004058545753667440708000270563050氧分壓與氧飽和度的關系——氧離曲線2040608010020406080100氧飽和度%氧分壓(mmHg)pH↓2,3-DPG↑Temp↑NO↑3000m呼吸中樞抑制脊髓高位損傷脊髓前角細胞受損運動神經(jīng)受損呼吸肌無力彈性阻力增加胸壁損傷氣道狹窄或阻塞Hypoventilation2)Dys
