脑顺应性课件.pptVIP

BrainCompliance

脑顺应性BrainCompliance

Background

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BrainCompliance

Background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BrainCompliance

403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfiltTWetal,JNeurosurg.1964COMPLIANCEComplianceandICPnormal脑顺应性BrainCompliance

403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfiltTWetal,JNeurosurg.1964COMPLIANCECompliancereducedandICPnormal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BrainCompliance

COMPENSATIONSlow/Fast脑顺应性BrainCompliance

COMPENSATIONChangesinCSFvolume脑顺应性BrainCompliance

COMPENSATIONViciouscircleCSFvolumeshift脑顺应性BrainCompliance

403020100BloodCSFTissuesMassesCompensatorymechanismsPVLangfiltTWetal,JNeurosurg.1964ComplianceComplianceexhausted，andICPincrease脑顺应性BrainCompliance

COMPENSATION脑顺应性BrainCompliance

COMPENSATION脑顺应性BrainCompliance

COMPENSATION脑顺应性BrainCompliance

AnatomicalCorrelatesVorICPCompensation

脑顺应性BrainCompliance

ICPWave脑顺应性BrainCompliance

ICPWaveActaNeurochir(Wien)(2004)146:131–141脑顺应性BrainCompliance

ICPWave脑顺应性BrainCompliance

ICPandCVR脑顺应性BrainCompliance

PVI=pressurevolumeindexcalculation脑顺应性BrainCompliance

ICP=Pbrain+Pbloodvessels+PCSF

bloodCSFNormalCompensatedDecompensatedICP7-15mmHgICP20-25mmHgICP30mmHgmassBraintissuemass脑顺应性BrainCompliance

AnatomicalCorrelatesVorICPCompensation脑顺应性BrainCompliance

PVI=pressurevolumeindexcalculation脑顺应性BrainCompliance

PVIafterTBI脑顺应性BrainCompliance

Conclusion脑顺应性BrainCompliance

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