腦脊液漿膜腔積液檢查-2011.3

1、,Cerebrospinal Fluid (CSF) Examination,Outline,CSF: colourless liquid that flows through the four cerebral ventricles, subarachnoid space and spinal canal surrounding the brain and spinal cord .CSF cirlulation communica

2、te with blood circulationAdult:90—150mlNewborn:10— 60ml,blood brain barrier,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。,Contents of examination,General Properties：pressure、color、 Transparency 、

3、Clots and filmChemical Examination： protein、glucose、chloride Microscopy Bacteriological Examination,Pressure,General Properties Adult(lying): 80—180mmH2O， 40-50 drips/min children：40-100mmH2O。Increase：Intracran

4、ial Inflammation：meningitis, cephalitis, myelitiscerebral edema, cerebral hemorrhage, brain tumorsExtracranial：hypertension, congestive heart failureDecrease:CSF circulation obstruction, loss or impairment in secreti

5、on,Color changes,Transparency,Normal :Clear, colorlessClear or Cloudy：Viral Meningitis、Epidemic Encephalitis B or Syphilis in CNSGround glass opacity：Tuberculous MeningitisMilky turbid：Purulent Meningitis,Clots and

6、film,Normal: No clots or film in 24 hoursPurulent Meningitis :clots observed in 1-2 hoursTuberculous Meningitis :thin film cover after 12—24 hoursSubarachnoid obstruction:yellow jelly,Protein,Qualitative ：Pandy test：-

7、/±Quantitative ：0.15～0.45g/L (adult,lumbar puncture),+,++,+++,++++,Chemical examination,Clinical significance,inflammation：PM:↑↑↑TM:↑↑VM:↑Hemorrhage in cranial or subarachnoidintracranial mass lesions ：tumor,

8、hematomamultiple sclerosis, neurosyphilis,Glucose in CSF,Normal value:Adult: 2.5—4.5mmol/L Child: 3.1—4.5mmol/L GCSF/GP：0.3—0.9,Clinical significance,Inflammation ：PM:↓↓↓TM: ↓VM：normalIntracranial tumor, neu

9、rosyphilisHypoglycemia,Chloride in CSF,Adult ：120—130mmol/L TM：↓↓↓，<102mmol/LPM：102—116mmol/L。Hypochloremia，such as severe vomit、diarrhea, dehydration,Normal Value,RBC：noneWBC:adult：0—8×106/L child：0—1

10、5×106/L,Microscopic Examination,Clinical Significance,Infectious Diseases in CNS,PURULENT MENINGITIS,1000-2000 ×106/L ，segmented neutrocyte,Tuberculous Meningitis,< 500 ×106/L，segment neutrocytes in ear

11、ly stage, and lymphocytes increase afterward, plasmocyte also observed,Viral Meningitis,<1000×106/L，lymphocytes,Clinical Significance,Brain tumor：lymphocytes and tumor cellsParasitic encephalopathy :eosinophile

12、granulocyte Hemorrhage: RBC,General concepts,serous membrane fluid:pleural effussionperitoneum serouspericardial effusion,Serous Membrane Fluid,Classification,Transudate: non-inflammatory,Exudate：inflammatory,diffe