epiduraalruumi punktsioon
Feb 14, 2022
Epiduraalruumis on kahte tüüpi punktsioon: sirge ja külgne. Kuna vöökoha ogajätked on paralleelsed, soovitatakse üldiselt sirge{0}}meetodit.
Lateraalset lähenemist kasutatakse ainult siis, kui otsene läbitungimine on raskendatud, eakad, seljaajuline side on lupjunud, lülisamba kõverus on piiratud või vahet ei saa puudutada.
0. Select the correct lumbar intervertebral space for the direct insertion method, remove the local skin, lay a sterile towel on the upper and lower sides, and use local anesthetic to moisten the skin and various layers of tissue through the midline of the waist. It is round and blunt, so the range of infiltration block should be wide enough. Then use a skin incision needle to poke a hole in the skin mound, and then use an epidural piercing needle to insert the person, hold the needle body with one hand against the back, and push the needle slowly with the other hand. The ligaments of the ligaments are completely parallel to each other to avoid excessive damage to the ligament fibers. During the whole puncture process, the level of the ligament should be understood according to the change of resistance. After the supraspinous ligament is passed, the interspinous ligament is relatively loose, and the resistance of needle insertion is small at this time. > Continue to advance to encounter the dense and thick ligamentum flavum. When the needle tip passes through the ligamentum flavum and enters the epidural space, the resistance can increase to disappear suddenly, that is, there is a "feeling of failure". It is preliminarily judged that the needle tip has reached the epidural space.
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