脑顺应性课件

BrainCompliance

脑顺应性BrainComplianceBackground

VTotal

=Vtissue+VCSF+Vblood=constant脑顺应性BrainCompliance

颅内压（IntracranialPressure，ICP）

脑组织

80％脑脊液CSF10％脑血容量CBV10％

80％10％10％成人的颅腔容积固定不变，为1400ml-1500ml脑顺应性BrainComplianceBackground脑顺应性BrainCompliance临床还可以通过颅内压监护装置，进行持续地动态观察一般以侧卧位腰椎穿刺或直接脑室穿刺测量脑脊液的静水压ICP测量：脑顺应性BrainCompliance收缩期呼气时颅内压增高舒张期吸气时颅内压降低颅内压可在小范围内波动，与血压、呼吸关系密切

脑顺应性BrainCompliance403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfiltTWetal,JNeurosurg.1964COMPLIANCE

ComplianceandICPnormal脑顺应性BrainCompliance403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfiltTWetal,JNeurosurg.1964COMPLIANCE

CompliancereducedandICPnormal脑顺应性BrainCompliance颅内压的调节与代偿当颅腔总容积超过5％时，颅内压开始增高，当颅腔总容积超过8％～10％时，则会产生严重的颅内压增高颅内压增高时，有一部分脑脊液被挤入脊髓蛛网膜下腔，起下调颅内压的作用脑脊液的总量占颅腔总容积的10％，约150ml脑顺应性BrainComplianceCOMPENSATIONSlow/Fast脑顺应性BrainComplianceCOMPENSATIONChangesinCSFvolume脑顺应性BrainComplianceCOMPENSATIONViciouscircleCSFvolumeshift脑顺应性BrainCompliance403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfiltTWetal,JNeurosurg.1964Compliance

Complianceexhausted，andICPincrease脑顺应性BrainComplianceCOMPENSATION脑顺应性BrainComplianceCOMPENSATION脑顺应性BrainComplianceCOMPENSATION脑顺应性BrainComplianceAnatomicalCorrelatesVorICPCompensation

脑顺应性BrainComplianceICPWave脑顺应性BrainComplianceICPWaveActaNeurochir(Wien)(2004)146:131–141脑顺应性BrainComplianceICPWave脑顺应性BrainComplianceICPandCVR脑顺应性BrainCompliancePVI=pressurevolumeindexcalculation脑顺应性BrainComplianceICP=Pbrain+Pbloodvessels+PCSF

bloodCSFNormalCompensatedDecompensatedICP7-15mmHgICP20-25mmHgICP30mmHgmassBraintissuemass脑顺应性BrainComplianceAnatomicalCorrelatesVorICPCompensation脑顺应性BrainCompliancePVI=pressurevolumeindexcalculation脑顺应性BrainCompliancePVIafterTBI脑顺