腰穿提高篇醫(yī)學知識專題講座培訓課件

腰穿提高篇醫(yī)學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進針一定要垂直心理一定要穩(wěn)定2腰穿提高篇醫(yī)學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)學知識專題講座體位:lateraldecubituspositionThepatientisplacedcurledonhisside,onafirmsurface,withhiskneesflexeduptothechestandneckflexedforward.Thelumbarregionshouldbeclosetotheedgeofthebedandtheplaneofthebackandshouldersasperpendiculartothebedaspossible.4腰穿提高篇醫(yī)學知識專題講座體位5腰穿提高篇醫(yī)學知識專題講座體位6腰穿提高篇醫(yī)學知識專題講座與床面的關系：兩條垂直線，一條平行線8腰穿提高篇醫(yī)學知識專題講座間隙DrawinganimaginarylinebetweenthetwoposterioriliaccrestswillallowidentificationoftheL3-4orL4-5interspaces.9腰穿提高篇醫(yī)學知識專題講座確定中點10腰穿提高篇醫(yī)學知識專題講座進針I(yè)nsertspinalneedle,withstyletinplace,alongthemidlinewithbevelfacingupwards(assumeslateraldecubituspositioning).Directtheneedleslightlycephaladalonganimaginarylinetowardstheumbilicus.11腰穿提高篇醫(yī)學知識專題講座進針12腰穿提高篇醫(yī)學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)學知識專題講座進針層次14腰穿提高篇醫(yī)學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)學知識專題講座進針17腰穿提高篇醫(yī)學知識專題講座心理家屬回避不要分心：不要象有些人風一樣飄來飄去，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)學知識專題講座總結19腰穿提高篇醫(yī)學知識專題講座參考文獻BoonJM,AbrahamsPH,MeiringJH,etal.Lumbarpuncture:an