腦脊液漿膜腔積液檢查培訓(xùn)課件

1、腦脊液漿膜腔積液檢查腦脊液漿膜腔積液檢查OutlineCSF: colourless liquid that flows through the four cerebral ventricles, subarachnoid space and spinal canal surrounding the brain and spinal cord .CSF cirlulation communicate with blood circulationAdult:90150mlNewborn:10 60ml腦脊液漿膜腔積液檢查2OutlineCSF: colourless liquid blood b

2、rain barrier 腦脊液漿膜腔積液檢查3blood brain barrier 腦脊液漿膜腔積液檢查AIMS中樞神經(jīng)感染性疾病的診斷與鑒別診斷。腦血管疾病的診斷與鑒別診斷。協(xié)助腦部腫瘤的診斷。中樞神經(jīng)系統(tǒng)疾病的治療與療效觀察。腦脊液漿膜腔積液檢查4AIMS中樞神經(jīng)感染性疾病的診斷與鑒別診斷。腦脊液漿膜腔積液Contents of examinationGeneral Properties：pressure、color、 Transparency 、 Clots and filmChemical Examination： protein、glucose、chloride Microsco

3、py Bacteriological Examination 腦脊液漿膜腔積液檢查5Contents of examinationGeneralPressure General Properties Adult(lying): 80180mmH2O， 40-50 drips/min children：40-100mmH2O。Increase：Intracranial Inflammation：meningitis, cephalitis, myelitiscerebral edema, cerebral hemorrhage, brain tumorsExtracranial：hyperten

4、sion, congestive heart failureDecrease:CSF circulation obstruction, loss or impairment in secretion腦脊液漿膜腔積液檢查6Pressure General Properties腦脊液Color changesColor of CSFConditions or causesClear, colorlessnormalMilky With WBC increasePink to yellowWith bloodYellowHyperbilirubinemiaProtein1.5g/LGreen Pur

5、ulent CSFBrown to BlackMeningeal melanoma腦脊液漿膜腔積液檢查7Color changesColor of CSFCondiTransparency Normal :Clear, colorlessClear or Cloudy：Viral Meningitis、Epidemic Encephalitis B or Syphilis in CNSGround glass opacity：Tuberculous MeningitisMilky turbid：Purulent Meningitis 腦脊液漿膜腔積液檢查8Transparency Normal

6、 :Clear, co腦脊液漿膜腔積液檢查培訓(xùn)課件Protein Qualitative ：Pandy test：-/Quantitative ：0.150.45g/L (adult,lumbar puncture)+Chemical examination腦脊液漿膜腔積液檢查10Protein Qualitative ：Pandy tesClinical significanceinflammation：PM:TM:VM:Hemorrhage in cranial or subarachnoidintracranial mass lesions ：tumor, hematomamultipl

7、e sclerosis, neurosyphilis腦脊液漿膜腔積液檢查11Clinical significanceinflammatGlucose in CSFNormal value:Adult: 2.54.5mmol/L Child: 3.14.5mmol/L GCSF/GP：0.30.9 腦脊液漿膜腔積液檢查12Glucose in CSFNormal value:腦脊液Clinical significanceInflammation ：PM:TM: VM：normalIntracranial tumor, neurosyphilisHypoglycemia 腦脊液漿膜腔積液檢查1

8、3Clinical significanceInflammatChloride in CSFAdult ：120130mmol/L TM：，102mmol/LPM：102116mmol/L。Hypochloremia，such as severe vomit、diarrhea, dehydration腦脊液漿膜腔積液檢查14Chloride in CSFAdult ：120130mNormal ValueRBC：noneWBC:adult：08106/L child：015106/L Microscopic Examination腦脊液漿膜腔積液檢查15Normal ValueMicrosco

9、pic ExaminClinical SignificanceInfectious Diseases in CNS腦脊液漿膜腔積液檢查16Clinical SignificanceInfectiouPURULENT MENINGITIS1000-2000 106/L ，segmented neutrocyte 腦脊液漿膜腔積液檢查17PURULENT MENINGITIS1000-2000 Tuberculous Meningitis 500 106/L，segment neutrocytes in early stage, and lymphocytes increase afterward

10、, plasmocyte also observed腦脊液漿膜腔積液檢查18Tuberculous Meningitis 500 1Viral Meningitis1000106/L，lymphocytes腦脊液漿膜腔積液檢查19Viral Meningitis1000106/L，lyClinical SignificanceBrain tumor：lymphocytes and tumor cellsParasitic encephalopathy :eosinophile granulocyte Hemorrhage: RBC腦脊液漿膜腔積液檢查20Clinical Significanc

11、eBrain tumNORMALPMTMVMSAHPressure mmH2O 70-180 或 Appearance Clear, colorless Milky 、greenGround Glass opacityclearbloodyClots and filmnoclotsThin film No jellyprotein 0.2-0.4g Glucose mmol/L2.5-4.5 Normal Chloride mmol/L 119-129 NormalNormalCells No neutrocytes Neutrocytes, lymphocytes and plasma ce

12、llslymphocytes RBC BACTERIALS NO pyogenic tubercle bacillusNo no腦脊液漿膜腔積液檢查21NORMALPMTMVMSAHPressure mmH2O General conceptsserous membrane fluid:pleural effussionperitoneum serouspericardial effusion Serous Membrane Fluid 腦脊液漿膜腔積液檢查22General conceptsserous membraClassification Transudate: non-inflammatoryExudate：inflammatory腦脊液漿膜腔積液檢查23Classification Transudate: nondifferential diagnosis of transudate or exudateTransudateExudatecausesIncreased capillary permeabilityInfection, malignant cancerAppearanceLight yellow, clear or cloudyBloody, purulent, milky turbidgravity1.018clotting-+C