CSF total cholesterol

The main components of lipids in cerebrospinal fluid are cholesterol, cholesterol esters, neutral fats, phospholipids (lecithin, myelin, etc.), fatty acids, glycolipids, etc., which are rare in nerve tissue damage, degeneration and demyelinating diseases. increase. Basic Information Specialist classification: neurological examination classification: cerebrospinal fluid examination Applicable gender: whether men and women apply fasting: fasting Tips: If the measured value is unacceptable, check the reagent expiration date, the instrument wavelength and the glassware are clean. Establish a strict laboratory management system to avoid reagent inlets, skin and splashes into the eyes. Normal value 0.01 mmol/L. Clinical significance TC can be elevated in CSF in meningitis, brain tumor, brain abscess, cerebral hemorrhage, multiple sclerosis, etc., which is markedly elevated in brain tumors and electric shocks, and moderately elevated in cerebral arteriosclerosis and multiple sclerosis. , neurotic syphilis and mild contusion in brain contusion. The level of TC is decreased when the brain and cortex atrophy. Low results may be diseases: high results of brain abscess may be diseases: brain atrophy, neurosyphilis precautions (1) In order to ensure satisfactory quality control, the normal and abnormal quality control samples to be tested are analyzed for each measurement, and the quality control value falls within the allowable range. (2) If the measured value is unacceptable, check the reagent expiration date, the instrument wavelength and the glassware are clean. (3) Establish a strict laboratory management system to avoid the entrance of reagents, stained skin and splashed into the eyes. (4) The specimen to be tested has a certain possibility of infection, so it should be properly treated. (5) The quality control value tends to increase or decrease. It is necessary to first check the serum and mass of the fixed value. (6) High concentrations of bilirubin and vitamin C can make the results lower, and high concentrations of hemoglobin can make the results higher. Inspection process First, take cerebrospinal fluid; 1. The patient lies on the hard board bed, the back is perpendicular to the table top, the head is bent as far as possible to the chest, the knees are tightly attached to the abdomen with both hands, so that the trunk is as arched as possible; or the assistant is used to hold the patient's head opposite the surgeon. The other hand pulls the lower limbs of the armpits and holds them tightly, so that the spine is as convex as possible to widen the intervertebral space, which is convenient for needle insertion. 2, determine the puncture point, usually the junction point of the highest point of the bilateral iliac spine and the posterior median line as the puncture point, here is equivalent to the third to fourth lumbar spine process, sometimes in the upper or lower lumbar spine The gap is carried out. 3, routine disinfection of the skin after wearing sterile gloves, cover the hole towel, with 2% lidocaine from the skin to the interspinous ligament for layer-by-layer local anesthesia. 4, the surgeon uses the left hand to fix the puncture point skin, the right hand holding puncture needle to the vertical back, the needle tip slightly obliquely to the direction of the head, the adult needle depth is about 4 ~ 6cm, children about 2 ~ 4cm. When the needle passes through the ligament and the dura mater, there is a sudden loss of resistance. At this point, the needle core can be slowly withdrawn (to prevent the cerebrospinal fluid from flowing out quickly, causing cerebral palsy), and the cerebrospinal fluid can be seen to flow out. 5. Connect the pressure measuring tube to measure the pressure before draining. The cerebrospinal fluid pressure in the normal lateral position is 70-180 mmH2O (0.098 Kpa=10 mmH2O) or 40-50 d/min. If you continue to do the queckstedt test, you can see if there is any obstruction in the subarachnoid space. That is, after the initial pressure is measured, the assistant first compresses one side of the carotid artery for about 10 s, then presses the other side, and finally presses both sides of the carotid artery. When the carotid artery is compressed at normal time, the pressure of the cerebrospinal fluid immediately increases by about one time, and after 10 to 20 seconds after the pressure is released, it rapidly drops to the original level, which is called negative in the obstruction test, indicating that the subarachnoid space is unobstructed; if the carotid artery is compressed, it cannot be When the pressure of the cerebrospinal fluid is raised, the obstruction test is positive, indicating that the subarachnoid space is completely blocked. If it rises slowly after applying pressure, it will slowly fall after relaxation, indicating incomplete obstruction. but. Those with increased intracranial pressure are forbidden to do this test. 6. Remove the pressure measuring tube and collect 2~5ml of cerebrospinal fluid for examination. If it is needed for cultivation, use sterile tube to keep the specimen. 7. After the operation, insert the needle core and pull out the puncture needle together, cover the sterile gauze, and fix it with tape. 8, go to the pillow for 4 to 6 hours, so as not to cause postoperative low intracranial pressure headache. Second, the method: (1) Take three test tubes, which indicate the measuring tube (U), the standard tube (S), and the blank tube (B). (2) Mix and put in a 37 ° C water bath for 15 min. (3) 510nm wavelength, 0.5cm cup, zero by blank tube, read the absorbance of each tube. Not suitable for the crowd 1. If there is obvious papilledema or cerebral palsy, contraindications are contraindicated. 2. Patients who are in shock, exhaustion or endangered state and local skin inflammation, and lesions in the posterior cranial fossa are contraindicated. Adverse reactions and risks If the patient has symptoms such as breathing, pulse, or abnormal color during puncture, stop the operation immediately and deal with it accordingly.

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