[精华]脑脊液浆膜腔积液检查-2011.3.pptVIP

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 communicate with blood circulation Adult:90—150ml Newborn:10— 60ml blood brain barrier 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。 Contents of examination General Properties：pressure、color、 Transparency 、 Clots and film Chemical Examination： protein、glucose、chloride Microscopy Bacteriological Examination Pressure General Properties Adult(lying): 80—180mmH2O， 40-50 drips/min children：40-100mmH2O。 Increase： Intracranial Inflammation：meningitis, cephalitis, myelitis cerebral edema, cerebral hemorrhage, brain tumors Extracranial：hypertension, congestive heart failure Decrease:CSF circulation obstruction, loss or impairment in secretion Color changes Transparency Normal :Clear, colorless Clear or Cloudy： Viral Meningitis、Epidemic Encephalitis B or Syphilis in CNS Ground glass opacity：Tuberculous Meningitis Milky turbid：Purulent Meningitis Clots and film Normal: No clots or film in 24 hours Purulent Meningitis :clots observed in 1-2 hours Tuberculous Meningitis :thin film cover after 12—24 hours Subarachnoid obstruction:yellow jelly Protein Qualitative ：Pandy test：-/± Quantitative ：0.15～0.45g/L (adult,lumbar puncture) Clinical significance inflammation： PM:↑↑↑ TM:↑↑ VM:↑ Hemorrhage in cranial or subarachnoid intracranial mass lesions ：tumor, hematoma multiple 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：normal Intracranial tumor, neurosyphilis Hypoglycemia Chloride in CSF Adult ：120—130mmol/L TM：↓↓↓，102mmol/L PM：102—116mmol/L。 Hypochloremia，such as severe vomit、diarrhea, dehydration Normal Value RBC：none WBC: adult：0—8×106/L child：0—15×106/L Clinical Significance Infectious Diseases in CNS