《脑脊液浆膜腔积液检查》由会员分享，可在线阅读，更多相关《脑脊液浆膜腔积液检查（24页珍藏版）》请在金锄头文库上搜索。
1、Cerebrospinal Fluid (CSF) Examination2021/3/111OutlinevCSF: colourless liquid that flows through the four cerebral ventricles, subarachnoid space and spinal canal surrounding the brain and spinal cord .vCSF cirlulation communicate with blood circulationvAdult:90150mlNewborn:10 60ml2021/3/112blood br
2、ain barrier 2021/3/113AIMSv中枢神经感染性疾病的诊断与鉴别诊断。中枢神经感染性疾病的诊断与鉴别诊断。v脑血管疾病的诊断与鉴别诊断。脑血管疾病的诊断与鉴别诊断。v协助脑部肿瘤的诊断。协助脑部肿瘤的诊断。v中枢神经系统疾病的治疗与疗效观察。中枢神经系统疾病的治疗与疗效观察。2021/3/114Contents of examinationvGeneral Properties：pressure、color、 Transparency 、 Clots and filmvChemical Examination： protein、glucose、chloride vMicro
3、scopy vBacteriological Examination 2021/3/115Pressure General Properties Adult(lying): 80180mmH2O， 40-50 drips/min children：40-100mmH2O。vIncrease：Intracranial Inflammation：meningitis, cephalitis, myelitiscerebral edema, cerebral hemorrhage, brain tumorsExtracranial：hypertension, congestive heart fai
4、lurevDecrease:CSF circulation obstruction, loss or impairment in secretion2021/3/116Color changesColor of CSFConditions or causesClear, colorlessnormalMilky With WBC increasePink to yellowWith bloodYellowHyperbilirubinemiaProtein1.5g/LGreen Purulent CSFBrown to BlackMeningeal melanoma2021/3/117Trans
5、parencyTransparency vNormal :Clear, colorlessvClear or Cloudy：Viral Meningitis、Epidemic Encephalitis B or Syphilis in CNSvGround glass opacity：Tuberculous MeningitisvMilky turbid：Purulent Meningitis 2021/3/118Clots and filmvNormal: No clots or film in 24 hoursvPurulent Meningitis :clots observed in
6、1-2 hoursvTuberculous Meningitis :thin film cover after 1224 hoursvSubarachnoid obstruction:yellow jelly2021/3/119Protein vQualitative ：Pandy testPandy test：-/-/vQuantitative ：0.150.150.45g/L (adult,lumbar 0.45g/L (adult,lumbar puncture)puncture)+ +Chemical examination2021/3/1110Clinical significanc
7、evinflammation：PM:TM:VM:vHemorrhage in cranial or subarachnoidvintracranial mass lesions ：tumor, hematomavmultiple sclerosis, neurosyphilis2021/3/1111Glucose in CSFNormal value:vAdult: 2.54.5mmol/L Child: 3.14.5mmol/L vGCSF/GP：0.30.9 2021/3/1112Clinical significancevInflammation ：PM:TM: VM：normalvIn
8、tracranial tumor, neurosyphilisvHypoglycemia 2021/3/1113Chloride in CSFvAdult ：120130mmol/L TM：，102mmol/LPM：102116mmol/L。Hypochloremia，such as severe vomit、diarrhea, dehydration2021/3/1114Normal ValuevRBC：nonevWBC:vadult：08106/L child：015106/L Microscopic Examination2021/3/1115Clinical SignificanceI
9、nfectious Diseases in CNS2021/3/1116PURULENT MENINGITIS1000-20001000-2000 10106 6/L /L ，segmented neutrocytesegmented neutrocyte 2021/3/1117Tuberculous Meningitis 500 106/L，segment neutrocytes in early stage, and lymphocytes increase afterward, plasmocyte also observed2021/3/1118Viral Meningitis1000
10、101000106 6/L/L，lymphocyteslymphocytes2021/3/1119Clinical SignificancevBrain tumor：lymphocytes and tumor cellsvParasitic encephalopathy :eosinophile granulocyte vHemorrhage: RBC2021/3/1120NORMALNORMALPMPMTMTMVMVMSAHSAHPressure mmHPressure mmH2 2O O 70-180 70-180 或或 Appearance Appearance Clear, Clear
11、, colorless colorless Milky Milky 、greengreenGround Glass Ground Glass opacityopacityclearclearbloodybloodyClots and Clots and filmfilmnonoclotsclotsThin film Thin film No No jellyjellyprotein protein 0.2-0.4g 0.2-0.4g Glucose Glucose mmol/Lmmol/L2.5-4.52.5-4.5 Normal Normal Chloride Chloride mmol/L
12、 mmol/L 119-129119-129 NormalNormalNormalNormalCells Cells No No neutrocytes neutrocytes Neutrocytes, Neutrocytes, lymphocytes lymphocytes and plasma and plasma cellscellslymphocytlymphocytes es RBC RBC BACTERIALS BACTERIALS NO NO pyogenicpyogenic tubercle tubercle bacillusbacillusNo No nono2021/3/1
13、121General conceptsvserous membrane fluid:pleural effussionperitoneum serouspericardial effusion Serous Membrane Fluid 2021/3/1122Classification vTransudate: non-inflammatoryvExudate：inflammatory2021/3/1123differential diagnosis of transudate or exudateTransudateTransudateExudateExudatecausescausesI
14、ncreased capillary Increased capillary permeabilitypermeabilityInfection, malignant cancerInfection, malignant cancerAppearanceAppearanceLight yellow, clear or Light yellow, clear or cloudycloudyBloody, purulent, milky Bloody, purulent, milky turbidturbidgravitygravity1.0181.0181.018clottingclotting
15、- -+ +CellsCells1001010010100106 6/L, different cells /L, different cells bacteriology bacteriology - -+ + Total proteinTotal protein25g/L30g/L30g/LRivaltaRivalta- -+ +Glucose Glucose 3.3mmol/L3.3mmol/L3.3mmol/L3.3mmol/LPleural Pleural fluid/serumTP fluid/serumTP 0.5 0.5 0.5 Pleural Pleural fluid/serumLDH fluid/serumLDH 0.6 0.6 0.6 LDH LDH 200IU 200IU 200IU 2021/3/1124
