Nervous system cytology

Neurological cytology is an examination of the morphological study of cerebrospinal fluid cells. It is a method of examining the morphology of cells in cerebrospinal fluid by microscopy after obtaining specimens from the lumbar spine (or other sites). If we consider cerebrospinal fluid as a kind of tissue, cerebrospinal fluid cytology is not only a subcutaneous subarachnoid biopsy, but also a subarachnoid lesion, so it is irreplaceable in many cerebrospinal fluid examinations. In recent years, more and more have expanded to the diagnosis, treatment, prognosis and monitoring of central nervous system tumors, leukemia, parasites, cerebrovascular diseases and neuronal immune functions, and become an indispensable helper in clinical work; Cytometry and immunohistochemistry have led to the diagnosis of some difficult neurological diseases. Basic Information Specialist classification: neurological examination classification: microscopy Applicable gender: whether men and women apply fasting: not fasting Tips: After puncture blood collection, use a sterile dry cotton swab to press the wound. At this time, pay attention to the strength and prevent the blood from being squeezed out. Normal value Normal reference value: First, the test of abnormal cells in the surrounding blood: There are no abnormal cells in normal peripheral blood. Second, the surrounding white blood cell count and classification test: Newborn: 15 ~ 20 × 109 / L. June to 2 years old: 11 to 12 × 109 / L. Adult: 4 ~ 10 × 109 / L. White blood cell classification (adult, %). Neutral rod-shaped granulocytes 1 to 5. Neutral lobular granulocytes 50-70. Eosinophils 0.5 to 5. Basophils 0 to 1. Lymphocytes 20 to 40. Monocytes 3-8. Clinical significance Abnormal result Heterotypic cell test in peripheral blood (a) Lipoidosis 50% of peripheral blood cells have vacuoles. (B) type II glycogen deposition pain (pompediease) blood smears visible foam cells. (C) β-lipoprotein deficiency disease (Bassen? Korn Weigdiesae) can be seen in a large number of red blood cells. (4) Progressive muscle dystrophy (Preogressive musclardystrophy) The shape of red blood cells is different, and the butterfly sag is obvious. Peripheral blood white cell count and classification test (1) The blood of the brain abscess (pyencephalus) has increased cells in the acute phase, and the number of neutrophils can reach 10×109/L. The latent blood picture can return to normal or only mild left leukocyte migration. White blood cells rise again when the abscess develops or collapses. (2) Purulent meningitis (purulent meningitis) increased the number of white blood cells in the acute phase, and neutrophils accounted for 80-90%. (C) Primary amoebic meningitis (primaryamoebicmenigoen-cephalitis) white blood cell counts are mostly elevated, neutrophils left shift. (4) The total number of white blood cells in epidemic encephalitis (epidemicencephalitis B) is increased, between (10 ~ 20) × 109 / L, a few can reach more than 30 × 109 / L, mainly due to the increase of neutral cells, and left shift phenomenon. Eosinophilia is reduced, unlike general viral infections. (5) The total number of white blood cells in forest encephalitis increased to (10-20)×109/L, mainly neutrophils, up to 90%. (6) Rabies virus encephalitis (rabiesviralencophaliti) increased the total number of white blood cells to (20 ~ 30) × 109 / L, mainly neutrophils. (7) Cerebral hemorrhage (cerebralhemmorrbage) increased white blood cells, and more than 10 × 109 / L accounted for 61 to 86.3%. According to statistics, (10 ~ 14) × 109 / L accounted for 27%, (10 ~ 14) × 109 / L accounted for 22%, more than 20 × 109 / L accounted for 12. (8) Acute disseminated myelitis (acutedisseminated encephalomyelitis) polymyositis (polymyositis), acute myelitis (acutemyelitis) in the acute phase can be seen in the peripheral blood picture increased white blood cell count. (9) Blood eosinophilia in cysticerosis myositis and trichinosis myositis. People who need to be examined for lipid deposition, type II glycogen deposition, β-lipoprotein deficiency, progressive muscular dystrophy, brain abscess, purulent meningitis, primary amoebic meningitis, epidemiology Japanese encephalitis, forest encephalitis, rabies virus encephalitis, cerebral hemorrhage, acute disseminated myelitis, cysticercosis. Precautions Taboo before inspection: 1. Fasting time: refers to the specimen taken on an empty stomach after fasting for 8 hours. Generally, blood is collected before morning morning. At this time, the body's material metabolism is in a stable and balanced state, which can reflect the content of the tested substance in the blood more realistically. Often used in clinical biochemical tests. 2, some anticancer drugs can lead to a reduction in whole blood cells, liver and kidney function. Glucocorticoids can raise blood sugar. Sulfonamides increase the concentration of uric acid in the blood. Antibiotics can affect the results of blood tests, so the use of such drugs is prohibited 24 hours before the test. 3, aspirin, dipyridamole, heparin, warfarin and other drugs can inhibit platelet aggregation, so should not take such drugs for a period of time before blood collection. 4, the patient should avoid strenuous exercise, running and other strenuous exercise, and should sit for more than half an hour before collecting specimens. Requirements for inspection: 1. The specimens of the abnormal blood cells in the surrounding blood should be measured within 30 minutes after collection. Peripheral white blood cell count and classification test specimens were collected and placed for 5-10 minutes. 2, if the vertigo induced by hypoglycemia, you can immediately intravenous glucose or sputum patients can take oral sugar. 3, after puncture blood collection with a sterile dry cotton swab to suppress the wound, at this time pay attention to the strength should not be too large to prevent the blood from being squeezed out. Inspection process Sample requirements: venous blood collection using EDTA-K2 anticoagulation. Capillary blood collection should wipe off the first drop of blood, so as not to mix the tissue fluid to affect the results. Specimen collection was determined after 5-10 minutes of placement. Steps: 1. One small test tube, plus 0.38 ml of white blood cell dilution. 2. Accurately absorb 20 μl of peripheral blood with a micropipette, wipe off the remaining blood from the tip of the tube, insert the pipette into the bottom of the diluent in the small tube, gently release the blood, and pipette the supernatant to clean the pipette twice and mix. 3. Fill the pool and let stand for 2 to 3 minutes until the white blood cells sink. 4. Count the number of white blood cells in the four large squares of the four corners with a low power microscope. 5. Calculation: White blood cell count / L = total number of white blood cells in 4 large squares * 10 * 20 * 106 / 4 that is the total number of white blood cells in 4 large squares * 50 * 106 = white blood cell count / L. 6. Results Enter the Shanghai New and Chinese operating system print report. Not suitable for the crowd Inappropriate people: Patients with cold fingers, cyanosis, swelling or inflammation should avoid finger pricking.

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