最新脑脊液浆膜腔积液检查-.3.ppt课件.ppt

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1、脑脊液浆膜腔积液检查-2011.3.OutlineCSF:colourlessliquidthatflowsthroughthefourcerebralventricles,subarachnoidspaceandspinalcanalsurroundingthebrainandspinalcord.CSFcirlulationcommunicatewithbloodcirculationAdult:90—150mlNewborn:10—60mlbloodbrainbarrierColorchangesColorofCSFConditionsorcausesClear,c

2、olorlessnormalMilkyWithWBCincreasePinktoyellowWithbloodYellowHyperbilirubinemiaProtein≥1.5g/LGreenPurulentCSFBrowntoBlackMeningealmelanomaTransparencyNormal:Clear,colorlessClearorCloudy：ViralMeningitis、EpidemicEncephalitisBorSyphilisinCNSGroundglassopacity：TuberculousMeningitisMilkyturbid

3、：PurulentMeningitisClotsandfilmNormal:Noclotsorfilmin24hoursPurulentMeningitis:clotsobservedin1-2hoursTuberculousMeningitis:thinfilmcoverafter12—24hoursSubarachnoidobstruction:yellowjellyProteinQualitative：Pandytest：-/±Quantitative：0.15～0.45g/L(adult,lumbarpuncture)++++++++++Chemicalexami

4、nationClinicalsignificanceinflammation：PM:↑↑↑TM:↑↑VM:↑Hemorrhageincranialorsubarachnoidintracranialmasslesions：tumor,hematomamultiplesclerosis,neurosyphilisGlucoseinCSFNormalvalue:Adult:2.5—4.5mmol/LChild:3.1—4.5mmol/LGCSF/GP：0.3—0.9ClinicalsignificanceInflammation：PM:↓↓↓TM:↓VM：normalIntr

5、acranialtumor,neurosyphilisHypoglycemiaChlorideinCSFAdult：120—130mmol/LTM：↓↓↓，<102mmol/LPM：102—116mmol/L。Hypochloremia，suchasseverevomit、diarrhea,dehydrationNormalValueRBC：noneWBC:adult：0—8×106/Lchild：0—15×106/LMicroscopicExaminationClinicalSignificanceInfectiousDiseasesinCNSPURULENTMENIN

6、GITIS1000-2000×106/L，segmentedneutrocyteTuberculousMeningitis<500×106/L，segmentneutrocytesinearlystage,andlymphocytesincreaseafterward,plasmocytealsoobservedViralMeningitis<1000×106/L，lymphocytesClinicalSignificanceBraintumor：lymphocytesandtumorcellsParasiticencephalopathy:eosinophilegran

7、ulocyteHemorrhage:RBCNORMALPMTMVMSAHPressuremmH2O70-180↑↑↑或↑↑↑↑AppearanceClear,colorlessMilky、greenGroundGlassopacityclearbloodyClotsandfilmnoclotsThinfilmNojellyprotein0.2-0.4g↑↑↑↑↑↑Glucosemmol/L2.5-4.5↓↓Normal↓Chloridemmol/L119-129↓↓↓NormalNormalCellsNoneutrocytes