腰穿提高篇醫(yī)學(xué)知識專題講座培訓(xùn)課件

腰穿提高篇醫(yī)學(xué)知識專題講座腰穿解剖一定要弄清體位一定要擺好間隙一定要摸準(zhǔn)進(jìn)針一定要垂直心理一定要穩(wěn)定2腰穿提高篇醫(yī)學(xué)知識專題講座理想與現(xiàn)實是有差距的3腰穿提高篇醫(yī)學(xué)知識專題講座體位:lateraldecubituspositionThepatientisplacedcurledonhisside,onafirmsurface,withhiskneesflexeduptothechestandneckflexedforward.Thelumbarregionshouldbeclosetotheedgeofthebedandtheplaneofthebackandshouldersasperpendiculartothebedaspossible.4腰穿提高篇醫(yī)學(xué)知識專題講座體位5腰穿提高篇醫(yī)學(xué)知識專題講座體位6腰穿提高篇醫(yī)學(xué)知識專題講座與床面的關(guān)系：兩條垂直線，一條平行線8腰穿提高篇醫(yī)學(xué)知識專題講座間隙DrawinganimaginarylinebetweenthetwoposterioriliaccrestswillallowidentificationoftheL3-4orL4-5interspaces.9腰穿提高篇醫(yī)學(xué)知識專題講座確定中點10腰穿提高篇醫(yī)學(xué)知識專題講座進(jìn)針I(yè)nsertspinalneedle,withstyletinplace,alongthemidlinewithbevelfacingupwards(assumeslateraldecubituspositioning).Directtheneedleslightlycephaladalonganimaginarylinetowardstheumbilicus.11腰穿提高篇醫(yī)學(xué)知識專題講座進(jìn)針12腰穿提高篇醫(yī)學(xué)知識專題講座理想與現(xiàn)實還是有差距的13腰穿提高篇醫(yī)學(xué)知識專題講座進(jìn)針層次14腰穿提高篇醫(yī)學(xué)知識專題講座矢狀面Sagittalsectionoflumbarvertebraeillustratingthecourseofthelumbarpunctureneedlethroughskin(1),subcutaneoustissue(2),supraspinousligament(3),interspinousligament(5)betweenthespinousprocesses(4),ligamentumflavum(6),duramater(8),intothesubarachnoidspaceandbetweenthenerverootsofthecaudaequina(7).Lumbarvertebralbodies(9),intervertebraldisc(10),andlumbarpunctureneedle(11).15腰穿提高篇醫(yī)學(xué)知識專題講座水平面Horizontalsectionoflumbarvertebraillustratingthecourseofthelumbarpunctureneedlethroughskin(1),subcutaneoustissue(2),betweenthespinousprocesses(3)andlaminae(4),ligamentumflavum(5),epiduralspace(6),duramater(7),intothesubarachnoidspaceandbetweenthenerverootsofthecaudaequina(8).Lumbarvertebralbody(9)andlumbarpunctureneedle(10).16腰穿提高篇醫(yī)學(xué)知識專題講座進(jìn)針17腰穿提高篇醫(yī)學(xué)知識專題講座心理家屬回避不要分心：不要象有些人風(fēng)一樣飄來飄去，一會接電話，一會和別人開玩笑切忌大意：有時候在給自己已經(jīng)穿過的患者再次腰穿時，由于思想上放松警惕，往往會帶來不順利18腰穿提高篇醫(yī)學(xué)知識專題講座總結(jié)19腰穿提高篇醫(yī)學(xué)知識專題講座參考文獻(xiàn)BoonJM,AbrahamsPH,MeiringJH,etal.Lumbarpuncture:an