脑脊液浆膜腔积液检查-2011.3.ppt

CerebrospinalFluid CSF Examination Outline CSF colourlessliquidthatflowsthroughthefourcerebralventricles subarachnoidspaceandspinalcanalsurroundingthebrainandspinalcord CSFcirlulationcommunicatewithbloodcirculationAdult 90 150mlNewborn 10 60ml bloodbrainbarrier AIMS 中枢神经感染性疾病的诊断与鉴别诊断 脑血管疾病的诊断与鉴别诊断 协助脑部肿瘤的诊断 中枢神经系统疾病的治疗与疗效观察 Contentsofexamination GeneralProperties pressure color Transparency ClotsandfilmChemicalExamination protein glucose chlorideMicroscopyBacteriologicalExamination Pressure GeneralPropertiesAdult lying 80 180mmH2O 40 50drips minchildren 40 100mmH2O Increase IntracranialInflammation meningitis cephalitis myelitiscerebraledema cerebralhemorrhage braintumorsExtracranial hypertension congestiveheartfailureDecrease CSFcirculationobstruction lossorimpairmentinsecretion Colorchanges Transparency Normal Clear colorlessClearorCloudy ViralMeningitis EpidemicEncephalitisBorSyphilisinCNSGroundglassopacity TuberculousMeningitisMilkyturbid PurulentMeningitis Clotsandfilm Normal Noclotsorfilmin24hoursPurulentMeningitis clotsobservedin1 2hoursTuberculousMeningitis thinfilmcoverafter12 24hoursSubarachnoidobstruction yellowjelly Protein Qualitative Pandytest Quantitative 0 15 0 45g L adult lumbarpuncture Chemicalexamination Clinicalsignificance inflammation PM TM VM Hemorrhageincranialorsubarachnoidintracranialmasslesions tumor hematomamultiplesclerosis neurosyphilis GlucoseinCSF Normalvalue Adult 2 5 4 5mmol LChild 3 1 4 5mmol LGCSF GP 0 3 0 9 Clinicalsignificance Inflammation PM TM VM normalIntracranialtumor neurosyphilisHypoglycemia ChlorideinCSF Adult 120 130mmol LTM 102mmol LPM 102 116mmol L Hypochloremia suchasseverevomit diarrhea dehydration NormalValue RBC noneWBC adult 0 8 106 Lchild 0 15 106 L MicroscopicExamination ClinicalSignificance InfectiousDiseasesinCNS PURULENTMENINGITIS 1000 2000 106 L segmentedneutrocyte TuberculousMeningitis 500 106 L segmentneutrocytesinearlystage andlymphocytesincreaseafterward plasmocytealsoobserved ViralMeningitis 1000 106 L lymphocytes ClinicalSignificance Braintumor lymphocytesandtumorcellsParasiticencephalopathy eosinophilegranulocyteHemorrhage RBC Generalconcepts serousmembranefluid pleuraleffussionperitoneumserouspericardialeffusion SerousMem