腰穿提高篇课件.pptx

腰穿秘笈（成人）

腰穿

n解剖一定要搞清

n体位一定要摆好

n间隙一定要摸准

n进针一定要垂直

n心理一定要稳定

理想与现实是有差距旳

体位:lateraldecubitus

position

nThepatientisplaced

curledonhisside,on

afirmsurface,withhis

kneesflexeduptothe

chestandneckflexed

forward.Thelumbar

regionshouldbeclose

totheedgeofthebed

andtheplaneofthe

backandshouldersas

perpendiculartothe

bedaspossible.

体位

体位

体位

与床面旳关系：两条垂直线，一条平

行线

间隙

nDrawinganimaginarylinebetweenthetwoposterior

iliaccrestswillallowidentificationoftheL3-4orL4-5

interspaces.

拟定中点

进针

nInsertspinalneedle,

withstyletinplace,

alongthemidlinewith

bevelfacingupwards

(assumeslateral

decubitus

positioning).Directthe

needleslightly

cephaladalongan

imaginarylinetowards

theumbilicus.

进针

理想与现实还是有差距旳

进针层次

矢状面

nSagittalsectionoflumbar

vertebraeillustratingthe

courseofthelumbarpuncture

needlethroughskin(1),

subcutaneoustissue(2),

supraspinousligament(3),

interspinousligament(5)

betweenthespinous

processes(4),ligamentum

flavum(6),duramater(8),into

thesubarachnoidspaceand

betweenthenerverootsofthe

caudaequina(7).Lumbar

vertebralbodies(9),

intervertebraldisc(10),and

lumbarpunctureneedle(11).

水平面

nHorizontalsectionoflumbar

vertebraillustratingthecourse

ofthelumbarpunctureneedle

throughskin(1),subcutaneous

tissue(2),betweenthespinous

processes(3)andlaminae(4),

ligamentumflavum(5),

epiduralspace(6),duramater

(7),intothesubarachnoid

spaceandbetweenthenerve

rootsofthecaudaequina(8).

Lumbarvertebralbody(9)and

lumbarpunctur