外科学总论英文名词说明Word文档下载推荐.docx

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anincreaseinthevolumeoffreewaterinthebody.Commoncausesareexcessiveingestionofwater,increasedinfusionsofhypotonicIVsolutions,orexcesssecretionsofantidiuretichormone(ADH).Clinicalmanifestationsareabdominalcramps,nausea,vomiting,lethargy,anddizziness.Itcanpotentiallyleadtoconvulsions抽搐andcoma.

hypokalemia

anabnormallylowserumpotassiumlevel(<

L).Hypokalemiamayoccurinmetabolicalkalosis,chronicdiarrhea,Cushingsyndrome,primaryaldosteronism,andexcessiveuseofcortisone,orACTH.

hyperkalemia

abnormallyhighpotassiumconcentrationintheblood(aboveL),mostoftenduetodefectiverenalexcretion,asinkidneydisease,severeandextensiveburns,intestinalobstruction,diabetesmellitus,acuterenalfailureandhypoadrenocorticism.

metabolicacidosis

DecreasedpH(belowandbicarbonateconcentrationofthebodyfluidscausedeitherbytheaccumulationofexcessacidsstrongerthancarbonicacidorbyabnormallossesofbicarbonatefromthebody.

metabolicalkalosis

Anincreaseinthealkalinityofbodyfluidsduetoanincreaseinalkaliintakeoradecreaseinacidconcentration,asfromvomiting.pHisover.

respiratoryacidosis

Acidosisthatiscausedbyretentionofcarbondioxide,duetoinadequatepulmonaryventilationorhypoventilation,andthatresultsinadecreaseinbloodpHunlesscompensatedforbyrenalretentionofbicarbonate.

respiratoryalkalosis

anabnormalconditioncharacterizedbyahighplasmapH(overresultingfromincreasedalveolarventilation.Theconsequentaccelerationofcarbondioxideexcretionlowerstheplasmalevelofcarbonicacid,thusraisingplasmapH.Thehyperventilationmaybecausedbypulmonaryandnonpulmonaryproblems.Somepulmonarycausesareacuteasthma,pulmonaryvasculardisease,andpneumonia.Somenonpulmonarycausesareaspirintoxicity,anxiety,feveretc.

acepsis

theexclusionofallmicroorganismsbeforetheycanenteranopensurgicalwoundorcontaminateasterilefieldduringsurgery

sterilization

theprocessofdestroyingallmicroorganismsandtheirpathogenicproducts.Itisaccomplishedbyheat(wetsteamordryheat)orbybactericidalchemicalcompounds.

disinfection

Theprocessoractofdestroyingpathogenicmicroorganisms.However,certainbacterialsporesmaysurviveandgerminatewhichcouldleadtocontamination.

bloodtransfusion

theadministrationofwholebloodoracomponent,suchaspackedredcells,toreplacebloodlostthroughtrauma,surgery,ordisease,inordertosupplementbloodvolume,improvecirculatoryfunctionandoxygen-carryingability,increasetheplasmaproteinandenhanceimmunityandcoagulationfunction.

hematocritHCT

ameasureofthepackedcellvolumeofredcells,expressedasapercentageofthetotalbloodvolume.Thenormalrangeisbetween43%and49%inmenandbetween37%and43%inwomen.

tansfusionreaction

agroupofclinicalsignsduetoantibodyintherecipient'

sbloodreactingwiththetransfusedredbloodcellswhenbloodfortransfusionisincorrectlymatched,orwhentherecipienthasanadversereactiontosomeelementofthedonorblood.

SIRS

aninflammatorystateaffectingthewholebody,frequentlyaresponseoftheimmunesystemtoinfection,butnotnecessarilyso.Itisrelatedtosepsis,aconditioninwhichindividualsbothmeetcriteriaforSIRSandhaveaknownorhighlysuspectedinfection.

Temperature<

36oCor>

38oC

Heartrate>

90beats/min

RespiratoryratepCO2<

32mmHgor>

20breaths/min

WBCcount<

4x109or>

12x109or,orthepresenceof>

immatureneutrophils

transfusion-relatedacutelunginjuryTRALI

asyndromeseeninpersonsreceivingtransfusions,characterizedbypulmonaryedema,dyspnea,hypoxemia,hypotension,andfever;

itisthoughttobeareactiontoantibodiesorothercomponentsofthedonorbloodproduct.Patientsneedoxygensupport,andinsomecasesthesyndromecanbefatal.

transfusionassociatedgraftversushostdisease

isararecomplicationofbloodtransfusion,inwhichthedonorTlymphocytesmountanimmuneresponseagainsttherecipient'

slymphoidtissue.Donorlymphocytesareusuallyidentifiedasforeignanddestroyedbytherecipient'

simmunesystem.However,insituationswheretherecipientisimmunocompromised,orwhenthedonorishomozygousandtherecipientisheterozygousforanHLAhaplotype,therecipient'

simmunesystemisnotabletodestroythedonorlymphocytes.Thiscanresultingraftversushostdisease.

autologousbloodtransfusion/autotransfusion

Infusionofbloodorbloodproductsintotheindividualfromwhomtheywereoriginallywithdrawn.

freshfrozenplasmaFFP

anunconcentratedformofbloodplasmacontainingalloftheclottingfactorsexceptplatelets.Itcanbeusedtosupplementredbloodcellswhenwholebloodisnotavailableforexchangetransfusionortocorrectableedingproblemofunknowncause.Itisalsousedtocorrectdisseminatedintravascularcoagulation.

freshplasmaFP

aformofbloodplasmawhichisobtainedafterFFPismeltedat4℃andcryoprecipitateisremoved.

cryoprecipitateCryo

Aproductderivedfromaunitofwholeblood,whichhasavolumeof15mlandprovides80unitsoffactorVIII:

Cprocoagulant–forhemophiliaA,factorVIII:

vWF–vonWillebrand'

sdisease,factorXIII,fibronectin,fibrinogen–forDIC,dysfibrinogenemia异样纤维蛋白原血症.ItistheunmeltedelementofFFPunder4℃.

plasmasubstitute/plasmavolumeexpander

asubstancethatcanbetransfusedtomaintainfluidvolumeofthebloodineventofgreatnecessity,supplementaltotheuseofwholebloodandplasma.Calledalsoartificialplasmaextender.

shock

Shockisamedicalemergencyinwhichtheorgansandtissuesofthebodyarenotreceivinganadequateflowofblood.Thisdeprivestheorgansandtissuesofoxygen(carriedintheblood)andallowsthebuildupofwastefactorsincludehemorrhage,vomiting,diarrhea,inadequatefluidintake,orexcessivefluidloss,resultinginhypovolemia.Shockcanresultinseriousdamageorevendeath.

hypovolemicshock

Thisisacommontypethathappenswhenbloodorplasmaislostinsuchquantitiesthattheremainingbloodcannotfillthecirculatorysystemdespiteconstrictionofthebloodvessels.Thebloodlossmaybeexternal,aswhenavesselisseveredbyaninjury,orthebloodmaybe“lost”intospacesinsidethebodywhereitisnolongeraccessibletothecirculatorysystem,asinseveregastrointestinalbleedingfromulcers,fracturesoflargeboneswithhemorrhageintosurroundingtissues,ormajorburnsthatattractlargequantitiesofbloodfluidstotheburnsiteoutsidebloodvesselsandcapillaries.

hemorrhagicshock

Hypovolemicshockresultingfromacutehemorrhageandcharacterizedbyhypotension,tachycardia心动过速,oliguria少尿,andbypale,cold,andclammyskin.

traumaticshock

referstoshockfollowingphysicaltrauma,withhemorrhage,peripheralbloodvesseldilation,andchangesincapillarypermeability.

septicshock

shockassociatedwithoverwhelminginfection,usuallybygram-negativebacteria,althoughitmaybeproducedbyotherbacteria,viruses,fungi,andprotozoa.Itisthoughttoresultfromtheactionofendotoxinsorotherproductsoftheinfectiousagent.

warmshock

referringtoastageinearlysepticshock,whichischaracterisedbyincreasedcardiacoutput,arterialandarteriolar小动脉的dilatation扩张,decreasedperipheralarterialresistance阻力,increasedperipheralperfusion灌注,nofluidlossesandthirdspacingandminimalcatecholamine儿茶酚胺effect

coldshock

MODS

thepresenceofalteredorganfunctioninacutelyillpatientssuchthathomeostasiscannotbemaintainedwithoutintervention.Itusuallyinvolvestwoormoreorgansystems.

CVP

thepressureofbloodintherightatrium.MeasurementofcentralvenouspressureismadepossiblebytheinsertionofacatheterthroughthemediancubitalveintothesuperiorvenanormalrangeforCVPis0to5mmH2O.Areadingof15to20mmusuallyindicatesinabilityoftherightatriumtoaccommodatethecurrentbloodvolume

PCWP

Anindirectindicationofleftatrialpressureobtainedbywedgingacatheterintoasmallpulmonaryarterytightlyenoughtoblockflowfrombehindandthustosamplethepressurebeyond.

COcardiacoutput

theeffectivevolumeofbloodexpelledbyeitherventricleoftheheartperunitoftime(usuallyperminute).Itisequaltothestrokevolumemultipliedbytheheartrate.Normalvaluesare4to6litersperminute.

CIcardiacindex

cardiacoutputperunittimedividedbybodysurfacenormalrangeinahealthyadultisto3.5L/min/m2.

CAIS

acomplexpatternofimmunologicresponsestosevereinfectionorinjury.CARSisaglobaldeactivationoftheimmunesystemtaskedwithrestoringhomeostasis.

ARFacuterenalfailure

renalfailureofsuddenonset,suchasfromphysicaltrauma,infection,inflammation,ortoxicity.Symptomsincludeuremiaandusuallyoliguriaoranuria,withhyperkalemiaandpulmonaryedema.Threetypesaredistinguished:

prerenal,intrarenal,andpostrenal.

ARDSacuterespiratoryditresssyndro

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