《脑顺应性》PPT课件

1、BrainCompliance,邱海波东南大学附属中大医院重症医学科东南大学急诊与危重病医学研究所,Background,VTotal=Vtissue+VCSF+Vblood=constant,颅内压（IntracranialPressure，ICP）,脑组织80脑脊液CSF10脑血容量CBV10,80,10,10,成人的颅腔容积固定不变，为1400ml-1500ml,Background,临床还可以通过颅内压监护装置，进行持续地动态观察,一般以侧卧位腰椎穿刺或直接脑室穿刺测量脑脊液的静水压,ICP测量：,收缩期,呼气时,颅内压增高,舒张期,吸气时,颅内压降低,颅内压可在小范围内波动，与血压、

2、呼吸关系密切,403020100,Blood,CSF,Tissues,Masses,Compensatorymechanisms,P,V,LangfiltTWetal,JNeurosurg.1964,COMPLIANCE,ComplianceandICPnormal,403020100,Blood,CSF,Tissues,Masses,Compensatorymechanisms,P,V,LangfiltTWetal,JNeurosurg.1964,COMPLIANCE,CompliancereducedandICPnormal,颅内压的调节与代偿,当颅腔总容积超过5时，颅内压开始增高，当颅腔

3、总容积超过810时，则会产生严重的颅内压增高,颅内压增高时，有一部分脑脊液被挤入脊髓蛛网膜下腔，起下调颅内压的作用,脑脊液的总量占颅腔总容积的10，约150ml,COMPENSATION,Slow/Fast,COMPENSATION,ChangesinCSFvolume,COMPENSATION,Viciouscircle,CSFvolumeshift,403020100,Blood,CSF,Tissues,Masses,Compensatorymechanisms,P,V,LangfiltTWetal,JNeurosurg.1964,Compliance,Complianceexhauste

4、d，andICPincrease,COMPENSATION,COMPENSATION,COMPENSATION,AnatomicalCorrelatesVorICPCompensation,ICPWave,ICPWave,ActaNeurochir(Wien)(2004)146:131141,ICPWave,ICPandCVR,PVI=pressurevolumeindexcalculation,ICP=Pbrain+Pbloodvessels+PCSF,blood,CSF,Normal,Compensated,Decompensated,ICP7-15mmHg,ICP20-25mmHg,ICP30mmHg,mass,Braintissue,mass,AnatomicalCorrelatesVorICPCompensation,PV