脑脊液浆膜腔积液检查.ppt

单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系本人改正。,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:90150ml,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):80180mmH,2,O，40-50 drips/min,children：40-100mmH,2,O。,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,Color of CSF,Conditions or causes,Clear,colorless,normal,Milky,With WBC increase,Pink to yellow,With blood,Yellow,Hyperbilirubinemia,Protein1.5g/L,Green,Purulent CSF,Brown to Black,Meningeal melanoma,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 1224 hours,Subarachnoid obstruction:yellow jelly,Protein,Qualitative,：Pandy test：-/,Quantitative,：0.150.45g/L(adult,lumbar puncture),+,+,+,+,Chemical examination,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:2.54.5mmol/L,Child:3.14.5mmol/L,G,CSF,/G,P,：0.30.9,Clinical significance,Inflammation：,PM:,TM:,VM：normal,Intracranial tumor,neurosyphilis,Hypoglycemia,Chloride in CSF,Adult：120130mmol/L,TM：，102mmol/L,PM：102116mmol/L。,Hypochloremia,，such as severe vomit、diarrhea,dehydration,Normal Value,RBC：none,WBC:,adult：0810,6,/L,child：01510,6,/L,Microscopic Examination,Clinical Significance,Infectious Diseases in CNS,PURULENT MENINGITIS,1000-2000,10,6,/L，segmented neutrocyte,Tuberculous Meningitis,500,10,6,/L，segment neutrocytes in early stage,and lymphocytes increase afterward,plasmocyte also observed,Viral Meningitis,100010,6,/L，lymphocytes,Clinical Significance,Brain tumor：lymphocytes and tumor cells,Parasitic encephalopathy:eosinophile granulocyte,Hemorrhage:RBC,NORMAL,PM,TM,VM,SAH,Pressure mmH,2,O,70-180,或,Appearance,Clear,colorless,Milky、green,Ground Glass opacity,clear,bloody,Clots and film,no,clots,Thin film,No,jelly,protein,0.2-0.4g,Glucose mmol/L,2.5-4.5,Normal,Chloride mmol/L,119-129,Normal,Normal,Cells,No,neutrocytes,Neutrocytes,lymphocytes and plasma cells,lymphocytes,RBC,BACTERIALS,NO,pyogenic,tubercle bacillus,No,no,General concepts,serous membrane fluid:,pleural effussion,peritoneum serous,pericardial effusion,Serous Membrane Fluid,Classification,Transudate:non-inflammatory,Exudate,：,inflammatory,differential diagnosis of transudate or exudate,Transudate,Exudate,causes,Increased capillary permeability,Infection,malignant cancer,Appearance,Light yellow,clear or cloudy,Bloody,purulent,milky turbid,gravity,1.018,clotting,-,+,Cells,10010,6,/L,different cells,bacteriology,-,+,Total protein,30g/L,Rivalta,-,+,Glucose,3.3mmol/L,3.3mmol/L,Pleural fluid/serumTP,0.5,Pleural fluid/serumLDH,0.6,LDH,200IU,