Bệnh lý học thú y_6 docx
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Ch¬ng VIII
Ch¬ng VIII
Sinh lý bÖnh hÖ h« hÊp
Sinh lý bÖnh hÖ h« hÊp
TS. NguyÔn H÷u Nam
TS. NguyÔn H÷u Nam
Bé m«n VSV TN BL – –
Bé m«n VSV TN BL – –
Th«ng khÝ
Th«ng khÝ
!"
!"
KhuÕch t¸n
KhuÕch t¸n
# !
# !
$%
$%
$"
$"
&
&
'
'
(
(
)&
)&
'
'
"
"
VËn chuyÓn
VËn chuyÓn
#%
#%
&
&
'
'
$
$
)&
)&
'
'
$*+,"
$*+,"
H« hÊp tÕ bµo:
H« hÊp tÕ bµo:
#-./%
#-./%
"012*3+-452
"012*3+-452
67
67
&
&
'
'
!879:"
!879:"
II. Rèi lo¹n h« hÊp
II. Rèi lo¹n h« hÊp
2.1. Rèi lo¹n qu¸ tr×nh th«ng khÝ
2.1. Rèi lo¹n qu¸ tr×nh th«ng khÝ
3 **8;
3 **8;
3-/32(,(
3-/32(,(
;$"
;$"
<'=(>'?&
<'=(>'?&
'
'
(=(=@?
(=(=@?
)&
)&
'
'
(A>?B"
(A>?B"
< !&
< !&
'
'
CD !
CD !
)&
)&
'
'
EF(GF3
EF(GF3
HI
HI
@
@
(I
(I
'
'
J 8KC 0L%"…
J 8KC 0L%"…
MN25C2+8O(
MN25C2+8O(
O(P3QJ(Q)%,
O(P3QJ(Q)%,
RPST"
RPST"
U38- *!VS
U38- *!VS
TL3 J&
TL3 J&
'
'
()&(
()&(
H&(H&
H&(H&
'
'
…
…
# !)&
# !)&
'
'
A W?8K12G0XW– –
A W?8K12G0XW– –
Y=?12XYZ '=?12[–
Y=?12XYZ '=?12[–
1X@=?8\9+"<
1X@=?8\9+"<
!52
!52
<
<
YA?%8KG
YA?%8KG
E"
E"
J;S;L52V:
J;S;L52V:
3,/P(:
3,/P(:
33P"
33P"
!"
!"
Giai ®o¹n hng phÊn
Giai ®o¹n hng phÊn
U<IIS9 !
U<IIS9 !
)&
)&
'
'
E( !&
E( !&
'
'
C(P0
C(P0
81(40GXU<]^_
81(40GXU<]^_
SFP(2X8
SFP(2X8
GP9,(0G(P1(
GP9,(0G(P1(
GBB12`"
GBB12`"
Giai ®o¹n øc chÕ
Giai ®o¹n øc chÕ
Sa(2(
Sa(2(
b9U<IIS[0 !)&
b9U<IIS[0 !)&
'
'
%
%
c
c
Giai ®o¹n suy sôp
Giai ®o¹n suy sôp
toµn th©n:
toµn th©n:
U<IIU<]^S[
U<IIU<]^S[
(7d(C5(BN
(7d(C5(BN
d(2C(P2(0
d(2C(P2(0
a"
a"
#$%
#$%
<F9dF1
<F9dF1
F/52_SC4(3PB
F/52_SC4(3PB
52(12+ !0
52(12+ !0
81,(8G9
81,(8G9
0818KCN
0818KCN
FSO
FSO
2C(9eL0P9,
2C(9eL0P9,
2"]P2-LfBRP3
2"]P2-LfBRP3
N0.\9eL+ !
N0.\9eL+ !
T359S52"
T359S52"
&$ '
&$ '
&()*
&()*
BÖnh g©y liÖt c¬ h« hÊp
BÖnh g©y liÖt c¬ h« hÊp
)BbB(B8 *(B
)BbB(B8 *(B
$cGRS$ B9$ B,
$cGRS$ B9$ B,
0g8-(9F912,(9$
0g8-(9F912,(9$
B-8-(+3,%
B-8-(+3,%
C(+(
C(+(
PGRS"
PGRS"
Tæn th¬ng lång ngùc
Tæn th¬ng lång ngùc
#;$ B8KC 0L;
#;$ B8KC 0L;
/; e25 B8 *(h3
/; e25 B8 *(h3
8-"MD+(9S"
8-"MD+(9S"
U;9$ B/
U;9$ B/
;(5;L*(
;(5;L*(
;1($S5h9+
;1($S5h9+
b;Bc"
b;Bc"
U9S;(9S.D9S`
U9S;(9S.D9S`
F(Db9523c
F(Db9523c
5;iOF$
5;iOF$
/$"
/$"
Trë ng¹i ®êng h« hÊp:
Trë ng¹i ®êng h« hÊp:
U0 *FSF(.(
U0 *FSF(.(
8h(9SPiO *F"
8h(9SPiO *F"
<%C(%CSF(12.8 F
<%C(%CSF(12.8 F
(hV%C(%CXF
(hV%C(%CXF
%Cd(E8hV
%Cd(E8hV
%C(12G0"
%C(12G0"
U0 *9 L/2
U0 *9 L/2
+12F$ U:2.(J2T
+12F$ U:2.(J2T
!(+F%Cj"
!(+F%Cj"
)+2VC 0L%
)+2VC 0L%
"
"
2.2. Rèi lo¹n qu¸ tr×nh khuÕch t¸n
2.2. Rèi lo¹n qu¸ tr×nh khuÕch t¸n
+ ,-./,
+ ,-./,
,
,
DiÖn tÝch khuÕch t¸n
DiÖn tÝch khuÕch t¸n
9+
9+
ND-5\L
ND-5\L
$G,
$G,
-"<03RG
-"<03RG
(0(j
(0(j
5ha(G*/
5ha(G*/
$8[END(17/
$8[END(17/
GSOd05L
GSOd05L
0(9P25ha
0(9P25ha
5-
5-
Mµng khuÕch t¸n
Mµng khuÕch t¸n
^b<Uc
^b<Uc
ZL((4f^^(
ZL((4f^^(
^^(2 BI)X
^^(2 BI)X
UC!3[!k
UC!3[!k
$92C
$92C
µ
µ
"UC
"UC
-$C9S
-$C9S
52F%ZL2RI)"
52F%ZL2RI)"
M3/)&
M3/)&
'
'
LB3/&
LB3/&
'
'
',(CE<U/)&
',(CE<U/)&
'
'
LBCE
LBCE
<U/&
<U/&
'
'
'=,( .(g+&
'=,( .(g+&
'
'
Z==,g+)&
Z==,g+)&
'
'
(9G8;
(9G8;
F+10F$
F+10F$
YI3\&
YI3\&
'
'
<U !'=(
<U !'=(
)&
)&
'
'
<U !YA"<E *CE
<U !YA"<E *CE
<UV !EF"
<UV !EF"
HiÖu sè khuÕch t¸n
HiÖu sè khuÕch t¸n
<CEV
<CEV
:38;F+;/
:38;F+;/
0$"
0$"
T¹i phæi
T¹i phæi
O
O
2
2
mmHg CO
mmHg CO
2
2
mmHg
mmHg
lY== YYZ@W Z– –
lY== YYZ@W Z– –
U'= =m m=– –
U'= =m m=– –
T¹i m« bµo:
T¹i m« bµo:
O
O
2
2
mmHg CO
mmHg CO
2
2
mmHg
mmHg
^3>Z YY=@= Z=– –
^3>Z YY=@= Z=– –
U'Z @Am=6A'–
U'Z @Am=6A'–
0(1&$2/-
0(1&$2/-
./,,
./,,
UC+n12
UC+n12
oQC8- !
oQC8- !
op2
op2
oqB$
oqB$
oU2$ !
oU2$ !
MNC 0%"
MNC 0%"
6
6
KhÝ phÕ:
KhÝ phÕ:
$ BhDr
$ BhDr
%CNGR9e"
%CNGR9e"
3,
3,
<$ Bd
<$ Bd
b32:3c"MDRR
b32:3c"MDRR
/+38-SE(3
/+38-SE(3
8-S5ha(j(
8-S5ha(j(
GsS[a(D$
GsS[a(D$
!( B[Sh(G
!( B[Sh(G
sSr(%Cj_Sr(h
sSr(%Cj_Sr(h
9[,2(/$
9[,2(/$
C"
C"
U(9+C9
U(9+C9
8-$(
8-$(
h"U0GF$GN
h"U0GF$GN
D(152C(+8-
D(152C(+8-
C"
C"
-
-
Viªm phæi:
Viªm phæi:
GRFRtDF
GRFRtDF
$tL(F$9+
$tL(F$9+
C9,SF
C9,SF
%"
%"
F8KGN9S`F92
F8KGN9S`F92
"
"
lC[_C9eL
lC[_C9eL
C+8-"
C+8-"
Phï phæi cÊp tÝnh:
Phï phæi cÊp tÝnh:
S
S
P L"
P L"
<.$9S.PV(
<.$9S.PV(
K9+Sh(
K9+Sh(
92+8-
92+8-
u="
u="
2.3. Rèi lo¹n qu¸ tr×nh vËn chuyÓn oxy
2.3. Rèi lo¹n qu¸ tr×nh vËn chuyÓn oxy
^k+n/+,
^k+n/+,
NC 0P2R52"
NC 0P2R52"
4)
4)
U(I)-I
U(I)-I
33(-(8(
33(-(8(
(vB I…
(vB I…
44CEF/
44CEF/
IL&
IL&
'
'
NC 0P2R&
NC 0P2R&
'
'
Jw(IJw I_G–
Jw(IJw I_G–
9: B;"
9: B;"
4
4
+82(
+82(
0(h x+$.$(F…
0(h x+$.$(F…
$ 12[+,NC 0L…
$ 12[+,NC 0L…
P2R&
P2R&
'
'
2.4. Rèi lo¹n qu¸ tr×nh h« hÊp tÕ bµo
2.4. Rèi lo¹n qu¸ tr×nh h« hÊp tÕ bµo
(HHTB
(HHTB
)
)
5*,&"
5*,&"
IIUx-./%
IIUx-./%
_["
_["
IIUx8;-2fBB
IIUx8;-2fBB
R !k8;5267Ux"
R !k8;5267Ux"
&52R2s
&52R2s
IIUxRI29E(E
IIUxRI29E(E
!yUl*3+-4
!yUl*3+-4
\s52 529v"–
\s52 529v"–
U9122N2%52
U9122N2%52
82FDKL
82FDKL
R2"
R2"
*,&"
*,&"
Do thiÕu c¬ chÊt
Do thiÕu c¬ chÊt
z-1/
z-1/
<488K29912
<488K29912
2N"
2N"
<v2DNC
<v2DNC
(D+0d"
(D+0d"
ThiÕu enzym h« hÊp
ThiÕu enzym h« hÊp
4v2
4v2
3*)4v2)4v2 *
3*)4v2)4v2 *
[],/
[],/
\(GxX9P2
\(GxX9P2
NC 0
NC 0
3/4v2"
3/4v2"
oUx
oUx
Y
Y
]x
]x
Y
Y
b
b
thiamin
thiamin
c
c
)4v2/4v2)52v
)4v2/4v2)52v
752/52(5
752/52(5
α
α
654
654
(9Gx
(9Gx
Y
Y
8K9e-
8K9e-
<48 -"–
<48 -"–
oUx
oUx
'
'
]x
]x
'
'
b
b
riboflavin
riboflavin
c
c
,/N4v2P2R
,/N4v2P2R
29(kw4(G!L
29(kw4(G!L
8R{^H"{yp"
8R{^H"{yp"
oUllH9 L9H
oUllH9 L9H
)4v2Hyp(HyplP
)4v2Hyp(HyplP
2R29"
2R29"
oUx
oUx
m
m
pyridoxin
pyridoxin
N4v2 )52v(
N4v2 )52v(
)8v(<4v…
)8v(<4v…
ThiÕu s¾t, thiÕu protit
ThiÕu s¾t, thiÕu protit
8r8K
8r8K
5(5 529vX8K–
5(5 529vX8K–
2F+$!4v2"
2F+$!4v2"
Enzym h« hÊp bÞ øc chÕ do ngé ®éc
Enzym h« hÊp bÞ øc chÕ do ngé ®éc
-/
-/
4[4v229"q2(
4[4v229"q2(
w[4v2P2R29X
w[4v2P2R29X
52(298w(52[
52(298w(52[
4v2P2R+7"
4v2P2R+7"
III. HËu qu¶ cña rèi lo¹n h« hÊp
III. HËu qu¶ cña rèi lo¹n h« hÊp
3.1. ThiÓu n¨ng h« hÊp vµ ®ãi oxy
3.1. ThiÓu n¨ng h« hÊp vµ ®ãi oxy
I(:879:
I(:879:
&
&
'
'
"H+:2`9$C+
"H+:2`9$C+
o<0i52"
o<0i52"
oUS$ B
oUS$ B
ox+n/32
ox+n/32
ox+n/+,
ox+n/+,
o)ST3…
o)ST3…
MN9eG&
MN9eG&
'
'
/
/
b25c"
b25c"
URE/%
URE/%
_9eG&
_9eG&
'
'
"
"
6789):7) "
6789):7) "
§ãi O
§ãi O
2
2
do cung cÊp thiÕu (hypoxic hypoxia
do cung cÊp thiÕu (hypoxic hypoxia
cL
cL
M
M
'
'
1&
1&
'
'
/M^SC(GR
/M^SC(GR
9;/&
9;/&
'
'
0SCF
0SCF
X9C(C"
X9C(C"
§ãi O
§ãi O
2
2
do thiÕu m¸u (anemic hypxia
do thiÕu m¸u (anemic hypxia
;
;
LM
LM
'
'
1&
1&
'
'
* I&
* I&
'
'
C
C
§ãi O
§ãi O
2
2
do ø trÖ (stagnant
do ø trÖ (stagnant
;
;
VkG&
VkG&
'
'
:
:
3b
3b
ischemic hypoxia
ischemic hypoxia
c(D9,&
c(D9,&
'
'
!
!
,2/(1&
,2/(1&
'
'
!I
!I
* !L:3S:(9
* !L:3S:(9
iOb(8h( c[…
iOb(8h( c[…
82C…
82C…
Đói oxy do các mô bào bị nhiễm độc (histotoxic
Đói oxy do các mô bào bị nhiễm độc (histotoxic
hypoxia):
hypoxia):
J- !52 !1-,2/
J- !52 !1-,2/
879: !SS
879: !SS
T3(3[%52
T3(3[%52
"
"
Hậu quả:
Hậu quả:
^529eL
^529eL
oz-2R(:8C|
oz-2R(:8C|
312T3
312T3
o<E85B5B[
o<E85B5B[
B%(
B%(
oHT3512F-[
oHT3512F-[
E"
E"
3. 2. Xanh tÝm
3. 2. Xanh tÝm
q+n5+
q+n5+
!Id52E
!Id52E
(R+,509(F
(R+,509(F
b
b
cyanose
cyanose
c"
c"
x *3 !d,
x *3 !d,
L52b>Z >A?c(`VC@ Z?– –
L52b>Z >A?c(`VC@ Z?– –
!d52"
!d52"
^}GCA=?I !d
^}GCA=?I !d
52(@=? !d52"
52(@=? !d52"
ë
ë
8-bZo@=c~'•
8-bZo@=c~'•
YA(Z?"b`8-2kI7c"
YA(Z?"b`8-2kI7c"
q5+ !47
q5+ !47
EF@= @Z?"–
EF@= @Z?"–
<=>"
<=>"
6
6
Xanh tÝm v× thiÕu oxy do phæi
Xanh tÝm v× thiÕu oxy do phæi
(47
(47
EC3}
EC3}
6
6
Xanh tÝm do ø trÖ tuÇn hoµn:
Xanh tÝm do ø trÖ tuÇn hoµn:
82(8-(
82(8-(
47E0}"
47E0}"
- Xanh tÝm do t¨ng hång cÇu
- Xanh tÝm do t¨ng hång cÇu
(<8- !
(<8- !
,%(4E(%$
,%(4E(%$
!52(9G !I7
!52(9G !I7
6
6
Xanh tÝm do ngé ®éc:
Xanh tÝm do ngé ®éc:
<IST3
<IST3
2R44(8w4
2R44(8w4
55+(528e
55+(528e
B"
B"
