the concept of shock

Theshock is a common and serious pathological process in peacetime and wartime, and is an important subject in medicine. If it happens if it is not detected early, taking positive and correct treatment measures will miss lives and have serious consequences. In order to prevent and treat more effectively, there should be a deep understanding of the mechanism of shock and the pathophysiological changes caused by it.shock refers to acute blood circulation disorders caused by various causes (e.g. haemorrhage, trauma, burn infection, allergy, heart pump failure, etc.), and the rapid reduction of microcirculation arterial blood flow, resulting in complex systemic pathological processes of metabolic disorders and structural damage to vital organs.human understanding of shock, experienced a process of understanding from shallow to deep, from phenomenon to essence. Long ago, people gave a detailed and vivid description of the external manifestations of shock, calling the body a combination of paleness, cold limbs, cold sweats, fast and weak pulses, indifference or confusion after a strong "shock" (the word originally meant "shock"). Subsequently, it was found that shock is a serious blood circulation disorder, the above performance is due to lower blood pressure, blood pressure as a criterion to judge shock, and low blood pressure as the main contradiction in the development of shock, so the use of booster drugs as an important means of treating shock. However, it was found in medical practice that in the early stages of shock, there was often no significant reduction in blood pressure, and the use of boosters to maintain blood pressure, some not only could not save shock patients, but even aggravate the development of shock. Over the past decade or so, through the study of
tissue
microcirculation, it has been found that: (1) there are obvious microcirculation disorders (isoemia, siltation, micro blood clot formation) during shock, the function and metabolic disorder of tissue organs is caused by insufficient microcirculation artery blood perfusion; Increased, blood pressure reduction is often not obvious, but microcirculation has occurred obvious isoemia; (3) for most shock, due to insufficient circulatory blood volume, reduced heart output, coupled with stress response, has made small arteries contraction and microcirculation isoemia, inappropriate role of boosters, it seems that blood pressure temporarily maintained at a higher level, but more severe microcirculation isoemia, prompting shock further development. Therefore, it is currently believed that the sharp reduction of microcirculated blood irrigation, causing functional and metabolic disorders of important living organs due to hypoxia, regardless of the cause of shock, microcirculation arterial blood irrigation, causing important living organs due to lack of oxygen and functional and metabolic disorders, is the common law of the development of various types of shock. According to this new theory, the treatment of shock should focus on improving microcirculation as soon as possible, rather than simply pursuing a "satisfactory" blood pressure. The recovery of shock depends on the improvement of microcirculation, not simply on raising blood pressure, although there is a further understanding of the nature of shock, but there are still many debates and unconscionable areas, the current shock research has entered the molecular level of cell metabolism and function, from metabolism, function and structure of a comprehensive study. Recent studies have found that cell damage during shock can also be directly caused by the starting factors of shock, such as infectious shock, in some cases, it is not mainly due to insufficient blood perfusion, but tissue cells on oxygen or other nutrients reduced utilization capacity. It is believed that with the gradual deepening of the understanding of the essence of the ker, the level of prevention and treatment of shock will continue to improve.