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1、外科学总论英文名词解释汇总(英文版)isotonicdehydrationoccurswhenthefluidIostisisotonicwithserum,asinsweating,simpleenteritis,nephrosis.TherearethereforenoerrorsofeIectroIytebaIanceIikeIytoresult.TheconcentrationofsodiumisinthenormaIrange.hypotonicdehydrationoccurswhenthereisIossofbothsodiumandfluid.TheserumsodiumIev
2、eIfallsbelow135mmoI/LandtheosmoticpressureofextraceIIularfluidisIowerthannormaI.hypertonicdehydrationAconditioncausedbytheexcessiveIossofwaterfromthebody,whichthereisIesselectrolytelossthanwater.TheserumsodiumIeveIisover135mmoI/LandtheosmoticpressureofextraceIIularfluidisIowerthannormaI.waterintoxic
3、ation/diIutionaIhyponatremiaanincreaseinthevoIumeoffreewaterinthebody.Commoncausesareexcessiveingestionofwater,increasedinfusionsofhypotonicIVsoIutions,orexcesssecretionsofantidiuretichormone(ADH).ClinicaImanifestationsareabdominalcramps,nausea,vomiting,Iethargy,anddizziness.11canpotentiaIIyIeadtoco
4、nvuIsionsandcoma.hypokaIemiaanabnormaIIylowserumpotassiumlevel(90beats/minRespiratoryratepC0220breaths/minWBCcount12x109or,orthepresenceof0.10immatureneutrophiIstransfusion-reIatedacuteIunginjuryTRALIasyndromeseeninpersonsreceivingtransfusions,characterizedbypuImonaryedema,dyspnea,hypoxemia,hypotens
5、ion,andfever;itisthoughttobeareactiontoantibodiesorothercomponentsofthedonorbloodproduct.Patientsneedoxygensupport,andinsomecasesthesyndromecanbefataI.transfusionassociatedgraftversushostdiseaseisararecompIicationofbIoodtransfusion,inwhichthedonorTIymphocytesmountanimmuneresponseagainsttherecipient,
6、slymphoidtissue.DonorIymphocytesareusuaIIyidentifiedasforeignanddestroyedbytherecipient*simmunesystem.However,insituationswheretherecipientisimmunocompromised,orwhenthedonorishomozygousandtherecipientisheterozygousforanHLAhapIotype,therecipient,simmunesystemisnotabIetodestroythedonorIymphocytes.This
7、canresu11ingraftversushostdisease.autoIogousbIoodtransfusion/autotransfusionInfusionofbIoodorbloodproductsintotheindividualfromwhomtheywereoriginalIywithdrawn.freshfrozenpIasmaFFPanunconcentratedformofbloodpIasmacontainingaIIoftheclottingfactorsexceptplatelets.ItcanbeusedtosupplementredbIoodcellswhe
8、nwholebloodisnotavaiIableforexchangetransfusionortocorrectabIeedingproblemofunknowncause.ItisaIsousedtocorrectdisseminatedintravascuIarcoaguIation.freshpIasmaFPaformofbIoodpIasmawhichisobtainedafterFFPismeltedat40Candcryoprecipitateisremoved.cryoprecipitateCryoAproductderivedfromaunitofwholeblood,wh
9、ichhasavoIumeof15mlandprovides80unitsoffactorVlII:CprocoaguIant-forhemophiliaA,factorVlll:vWF-vonWillebrand,sdisease,factorXlll9fibronectin,fibrinogen-forDIC,dysfibrinogenemia.ItistheunmeltedeIementofFFPunder4.pIasmasubstitutepIasmavoIumeexpanderasubstancethatcanbetransfusedtomaintainfluidvoIumeofth
10、ebloodineventofgreatnecessity,suppIementaItotheuseofwhoIebIoodandpIasma.CalledaIsoartificiaIpIasmaextender.shockShockisamedicaIemergencyinwhichtheorgansandtissuesofthebodyarenotreceivinganadequateflowofblood.Thisdeprivestheorgansandtissuesofoxygen(carriedinthebIood)andaIIowsthebuiIdupofwasteproducts
11、.CausaIfactorsincIudehemorrhage,vomiting,diarrhea,inadequatefluidintake,orexcessivefluidIoss,resultinginhypovolemia.Shockcanresultinseriousdamageorevendeath.hypovoIemicshockThisisacommontypethathappenswhenbIoodorpIasmaislostinsuchquantitiesthattheremainingbloodcannotfiIIthecircuIatorysystemdespiteco
12、nstrictionofthebIoodvesseIs.ThebIoodIossmaybeexternaI,aswhenavesseIisseveredbyaninjury,orthebIoodmaybe“lost”intospacesinsidethebodywhereitisnoIongeraccessibIetothecircuIatorysystem,asinseveregastrointestinalbleedingfromuIcers,fracturesofIargeboneswithhemorrhageintosurroundingtissues,ormajorburnsthat
13、attractIargequantitiesofbIoodfluidstotheburnsiteoutsidebIoodvesseIsandcapiIIaries.hemorrhagicshockHypovolemicshockresultingfromacutehemorrhageandcharacterizedbyhypotension,tachycardia,oIiguria,andbypaIe,coId,andcIammyskin.traumaticshockreferstoshockfollowingphysicaItrauma,withhemorrhage,peripheraIbI
14、oodvesseIdiIation,andchangesincapiIIarypermeabiIity.septicshockshockassociatedwithoverwheIminginfection,usuaIIybygram-negativebacteria,althoughitmaybeproducedbyotherbacteria,viruses,fungi,andprotozoa.Itisthoughttoresultfromtheactionofendotoxinsorotherproductsoftheinfectiousagent.warmshockreferringto
15、astageinearIysepticshock,whichischaracterisedbyincreasedcardiacoutput,arteriaIandarterioIardiIatation,decreasedperipheralarterialresistance,increasedperipheraIperfusion,nofluidlossesandthirdspacingandminimalcatecholamineeffectMODSthepresenceofalteredorganfunctioninacuteIyiIIpatientssuchthathomeostas
16、iscannotbemaintainedwithoutintervention.11usuaIIyinvoIvestwoormoreorgansystems.CVPthepressureofbIoodintherightatrium.MeasurementofcentraIvenouspressureismadepossibIebytheinsertionofacatheterthroughthemediancubitaIveintothesuperiorvenacava.ThenormaIrangeforCVPis0to5mmH20.Areadingof15to20mmusuaIIyindi
17、catesinabiIityoftherightatriumtoaccommodatethecurrentbIoodvoIumePCWPAnindirectindicationofIeftatriaIpressureobtainedbywedgingacatheterintoasmaIIpuImonaryarterytightlyenoughtobIockfIowfrombehindandthustosamplethepressurebeyond.COcardiacoutputtheeffectivevoIumeofbIoodexpeIIedbyeitherventricIeofthehear
18、tperunitoftime(usuaIIyperminute).ItisequaItothestrokevoIumemu11ipIiedbytheheartrate.NormaIvaIuesare4to6Iitersperminute.Clcardiacindexcardiacoutputperunittimedividedbybodysurfacearea.ItsnormaIrangeinaheaIthyadu11is2.5to3.5L/minm2.CAISacompIexpatternofimmunologicresponsestosevereinfectionorinjury.CARS
19、isaglobaldeactivationoftheimmunesystemtaskedwithrestoringhomeostasis.ARFacuterenaIfaiIurerenaIfailureofsuddenonset,suchasfromphysicaItrauma,infection,infIammation,ortoxicity.SymptomsincIudeuremiaandusuaIIyoliguriaoranuriafwithhyperkaIemiaandpulmonaryedema.Threetypesaredistinguished:prerenaI,intraren
20、aI,andpostrenaI.ARDSacuterespiratoryditresssyndromeisaIungconditionthatIeadstoIowoxygenIeveIsinthebIood.ARDScanbeIifethreatening.Thisisbecausebodysorgans,suchasthekidneysandbrain,needoxygen-richbloodtoworkproperIy.ARDSusuaIIyoccursinpeopIewhoareveryiIIwithanotherdiseaseorwhohavemajorinjuries.acutega
21、strointestinaldysfunctionisanacutegastrointestinaIpathoIogicaIconditionwithgastrointestinaImucosadamage,motorandbarrierdysfunction.Seeintrauma,burn,shocketc.oIiguriaadiminishedcapacitytoformandpassurine-1essthan400mLinevery24hours-sothattheendproductsofmetaboIismcannotbeexcretedefficiently.ItisusuaI
22、IycausedbyimbaIancesinbodyfluidsandelectrolytes,renaIIesions,orurinarytractobstruction.anuriatheabsenceofurineproductionoraurinaryoutputofIessthan100mLperday.Anuriamaybecausedbyafailureorkidneydysfunction,adecIineinbIoodpressurebeIowthatrequiredtomaintainfiItrationpressureinthekidney,oranobstruction
23、intheurinarypassages.azotemiaretentionofexcessiveamountsofnitrogenouscompoundsinthebIood.ThistoxicconditioniscausedbyfaiIureofthekidneystoremoveureafromthebloodandischaracteristicofuremia.uremiathepresenceofexcessiveamountsofureaandothernitrogenouswasteproductsinthebIood,asoccursinrenaIfaiIure.Manif
24、estationsincIudeweakness,headache,confusion,vomiting,andcoma,andinterminaIchronicrenaIdisease,purpuraandepistaxismaybepresent.Uremiaiscausedbyinsufficienturinaryexcretionforanyreason.VILLventiIator-inducedIunginjuryVentiIatorinducedIunginjuryoccurswhentheIungisdirectIydamagedbytheactionofmechanicaIv
25、entiIation,mainlyvoIutrauma.AHFacutehepaticfailuretheappearanceofseverecompIicationsrapidlyafterthefirstsignsofIiverdisease(suchasjaundice),andindicatesthattheIiverhassustainedseveredamage(lossoffunctionof80-90%ofIivercelIs).ThecompIicationsarehepaticencephaIopathyandimpairedproteinsynthesis.stressu
26、lcerStressuIcersaresingleormultiplemucosaIdefectswhichcanbecomecompIicatedbyuppergastrointestinaIbIeedingduringthephysiologicstressofseriousiIIness.stressuIcersarefoundcommonIyinfundicmucosaandcanbeIocatedanywherewithinthestomachandproximaIduodenum,anesthesiatheconditionofhavingsensation(includingth
27、efeeIingofpain)bIockedortemporariIytakenaway.ItisapharmacologicalIyinducedandreversiblestateofamnesia,anaIgesia,Iossofresponsiveness,IossofskeIetaImuseIerefIexesordecreasedstressresponse,oraIIsimultaneously.ThisaIIowspatientstoundergosurgeryandotherprocedureswithoutthedistressandpaintheywouIdotherwi
28、seexperience.inhalationanestheticsAninhaIationaIanaestheticisachemicaIcompoundpossessinggeneraIanaestheticpropertiesthatcanbedeIiveredviainhaIation.AgentsofsignificantcontemporaryclinicalinterestincIudevoIatiIeanaestheticagentssuchasisofIurane,SevofluraneanddesfIurane,asweIIascertainanaestheticgases
29、suchasnitrousoxide.MACminimumaIveoIarconcentrationTheMACistheconcentrationofthevapour(measuredasapercentageat1atmosphere,i.ethepartiaIpressure)thatpreventsthereactiontoastandardsurgicaIstimuIus(traditionaIIyasetdepthandwidthofskinincisions)in50%ofsubjects.Thismeasurementisdoneatsteadystate(assuminga
30、constantaIveoIarconcentrationfor15minutes),undertheassumptionthatthisaIIowsforanequiIibrationbetweenthegassesintheaIveoli,thebIoodandthebrain.MACisacceptedasavaIidmeasureofpotencyofinhaIationaIgeneraIanaestheticsbecauseitremainsfairlyconstantforagivenspeciesevenundervaryingconditions.blood/gaspartit
31、ioncoefficienttheratioofconcentrationsofanestheticsinthebIoodandgasatequiIibrium.itisusedtodiscribethedissolvedquantityofoneanestheticsinunitvoIumeofbIood.intravenousanestheticsAnagentthatproducesanesthesiawheninjectedintothebIOodstreamviavenipuncture.Veryoften,thistermisusedtorefertogeneraIanesthes
32、ia,frequentIyrequiredduringsurgerytopromotetotaIunconsciousnessofapatient.museIereIaxantsSkeIetaImuseIereIaxantsaredrugsthatreIaxstriatedmuseIes(thosethatcontroItheskeIeton).TheyareaseparatecIassofdrugsfromthemuseIereIaxantdrugsusedduringintubationsandsurgerytoreducetheneedforanesthesiaandfaciIbined
33、anesthesia/baIancedanesthesiaahighlyvariabIetechniqueofgeneraIanesthesiausingnarcoticanaIgesics,museIereIaxation,andminimalinhaIationagentandnitrousoxidetorenderthepatientunconscious.thiscansummatetheadvantagesbutnotthediSadvantagesoftheindividuaIcomponentsofthemixture.IocaIanesthesiaLocaIorregional
34、anesthesiainvolvestheinjectionorappIicationofananestheticdrugtoaspecificareaofthebody,asopposedtotheentirebodyandbrainasoccursduringgeneraIanesthesia.KypersusceptibiIityaconditionofabnormaIsusceptibiIitytopoisons,infectiveagents,oragentsthatareentireIyinnocuousinthenormaIindividuaIsurfaceanesthesiaI
35、ossoffeeIingorsensation.ArtificiaIanesthesiamaybeproducedbyanumberofagentscapabIeofbringingaboutpartiaIorcompIeteIossofsensation.ItisinducedtopermittheperformanceofsurgeryorotherpainfuIprocedures.nervebIockregionalanesthesiabyinjectionofanestheticscIosetotheappropriatenerve.spinalbIockregionsIanesth
36、esiabyinjectionofaIocaIanestheticintothesubarachnoidspacearoundthespinalcord.epiduraIblockthatproducedbyinjectionoftheanestheticintotheextraduraIspace,eitherbetweenthevertebraIspinesorintothesacraIhiatustotaIspinalanesthesiaspinalanesthesiaextensiveenoughtoproduceIossofsensationinaIIextracraniaIsens
37、oryroots.caudaIbIockanesthesiabyinjectionofIocaIanestheticintothecaudaIorsacraIcanaI.controlledhypotensionThedeIiberateacutereductionofarteriaIbIoodpressuretoreducebIoodlossduringsurgery,eitherbypharmacologicalmeansorbypresurgicaIwithdrawaIofbloodwhichisreturnedtothecirculationpostsurgicalIyhypother
38、miaapotentiaIIyfataIcondition,occurswhenbodytemperaturefaIIsbelow95oF(35oC).EECextracorporeaIcircuIationorCPBcardiopuImonarybypassatechniquethattemporariIytakesoverthefunctionoftheheartandIungsduringsurgery,maintainingthecirculationofbIoodandtheoxygencontentofthebody.intensivecareunit(ICU)ahospitaIu
39、nitinwhichisconcentratedspeciaIequipmentandspeciaIIytrainedpersonneIforthecareofseriousIyiIIpatientsrequiringimmediateandcontinuousattention.resuscitationrevivaImethodsthatmaintainvitalsignsforapersonincardiacorrespiratoryfailure.Cardiacmassageandartificialrespirationtechniquesareemployed,andfluidan
40、dacid-baseimbalancesarecorrected.Cardiopulmonarycerebralresuscitation(CPCR),abasicemergencyprocedureforIifesupport,consistingofartificialrespirationandmanuaIexternaIcardiacmassage.ItisusedincasesofcardiacarresttoestabIisheffectivecirculationandventiIationinordertopreventirreversiblecerebraIdamageres
41、uItingfromanoxiaandreestabIishofheartandIungaction.basicIifesupport(BLS),fundamentaIemergencytreatmentconsistingofcardiopulmonaryresuscitation(CPR)oremergencycardiaccare(ECC)thatisprovideduntiImoreprecisemedicaItreatmentcanbegin.advancedIifesupport(ALS),ahigherIeveIofemergencymedicaIcare,usuaIIyprov
42、idedbyEMT-intermediatesorparamedics.TypicaIIyALSincIudesinvasivetechniquessuchasIVtherapy,intubation,and/ordrugadministration.cerebraIresuscitationtreatmenttocounteractthecerebraIedemaresultingfromlowcerebraIbIoodfIowandhypoxiathatoccursduringcardiopulmonaryresuscitationcardiopuImonaryresuscitation(
43、CPR)thereestabIishingofheartandIungactionaftercardiacarrestorapparentsuddendeathresuItingfromeIectricshock,drowning,respiratoryarrest,andothercauses.ThetwomajorcomponentsofCPRareartificiaIventiIationandcIosedchestcardiacmassage,eIectro-mechanicaIdissociationPersistenceofeIectricaIactivityintheheartw
44、ithoutanassociatedmechanicaIcontraction;itisoftenasignofcardiacrupture.oxygentherapysuppIementaIoxygenadministeredforthepurposeofreIievinghypoxemiaandpreventingdamagetothetissuecellsasaresultofoxygenIack(hypoxia).perioperativeperiodreIatingtotheperiodoftimesurroundingasurgicaIprocedure,includingthep
45、reoperative,intraoperative,andpostoperativeperiods.emergencysurgeryAsurgicaIprocedurethatcannotbedeIayed,forwhichthereisnoaIternativetherapyorsurgeon,andforwhichadeIaycouldresultindeathorpermanentimpairmentofhealthExamplesextensiveburns,urinaryobstruction,intestinaIobstructionIimitedsurgeryisthetime
46、tooperatesurgeryisnoturgent,butIimitedtoacertainextent.suchastumorradicaIsurgery.seromaAseromaisapocketofcIearserousfluidthatsometimesdeveIopsinthebodyaftersurgery,seIectiveeIectivesurgeryissurgerythatisscheduIedinadvancebecauseitdoesnotinvoIveamedicaIemergency,suchascosmeticsurgery.SurgicaIinfectio
47、nTheinfectionwhichneedssurgicaItreatment,includingtheinfectioncausedbythecompIicationsoftrauma,burn,et.enteraInutritionENtheprovisionofnutrientsthroughtheGltractwhenthecIientcannotingest,chew,orswaIIowfoodbutcandigestandabsorbnutrients.parenteraInutrition,atechniqueformeetingapatient,snutritionaInee
48、dsbymeansofintravenousfeedings.TheparenteraIfluidusuaIIyconsistsofphysioIogicsalinewithglucose,aminoacids,eIectroIytes,vitamins,andmedications,whicharenotnutritionaIIycompIetebutmaintainfluidandeIectroIytebaIance.TPNtotaIparenteraInutritionintravenousadministration,viaacentraIvenouscatheter,ofthetot
49、aInutrientrequirementsofapatientwithgastrointestinaldysfunction.bacteriatransIocationBTInsomecases,thebacteriainthedigestivetract,calledtheintestinaIfIora,cancauseasevereinfectioniftheymoveintothebloodstream.Thisprocess,calledbacteriaItranslocation,ismostIikeIytooccurduringsurgeryonthedigestivetract.conditionalIyessentialaminoaci