腰椎穿刺の技術仕様と操作手順

腰椎穿刺の技術仕様と操作手順

1.適応症

①Check the properties of cerebrospinal fluid to assist in the diagnosis of inflammatory or hemorrhagic diseases of the central nervous system.

② Determination of intracranial pressure to understand whether the subarachnoid space is blocked.

③ Do other auxiliary examinations, such as pneumoencephalography, spinal cord air angiography, radionuclide scanning of ventricles and cisterns, etc.

④ After intracranial hemorrhage, inflammation or craniocerebral surgery, the drainage of irritating cerebrospinal fluid can reduce clinical symptoms.

⑤ Perform lumbar anesthesia or intrathecal drug treatment

2.禁忌

1.明らかな鬱血乳頭または脳ヘルニアの兆候がある患者

2.ショック、倦怠感、または危険にさらされている状態の患者

3.穿刺部位またはその近くに感染者がいる

3.術前の準備：

①1 set of conventional disinfection treatment tray. There are 1 sterile tweezers (soaked in disinfectant) 2.5 percent iodine, 70 percent iodine, sterile cotton swabs, 1 dressing tank (with gauze, cotton balls) tape, 1 curved plate, 1 treatment towel and 1 rubber towel, grinding wheel, hemostatic forceps, and tourniquet.

② Sterile lumbar puncture package. There are lumbar puncture needle, pressure measuring tube and three-way tube, 5ml syringe, 7-gauge needle, 1 vascular forceps, hole towel, gauze, cotton ball, and 2 test tubes.

③Other items. Sterile gloves, 2 percent procaine, curved disc, intrathecal drug injection, alcohol lamp, matches, and 1-2 culture tubes as needed.

Fourth, the operation process: ① Explain the purpose and precautions of the puncture to the patient, eliminate tension and fear, obtain cooperation, and ask to urinate.

② Do a procaine skin test before surgery, prepare all the supplies, bring it to the patient's bed, and cover it with a screen

③ The patient lies on the side of the hard board bed, removes the pillow, puts the back on the edge of the bed, spreads rubber towels and therapeutic towels, bends the head to the chest, tucks the knees with both hands, bends the knees to the abdomen, and arches the back as far as possible. The intervertebral space is widened, which is favorable for puncture. ⑧ During the puncture process, pay attention to observe the changes in the patient's consciousness, pupils, pulse, and respiration.

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