Epidural puncture anesthesia koob siv txoj kev

(1) Pw rau sab, khawm lub hauv caug sib koom tes nrog ob txhais tes, thiab lub puab tsaig sab hauv yuav tsum nyob ze rau ntawm lub hauv siab nyob rau hauv ib tug flexed zoo.

(2) Xaiv qhov chaw txha nraub qaum ntawm cov txheej txheem ntawm tus txha caj qaum ntawm 10th thoracic vertebra mus rau 4th lumbar vertebra raws li qhov yuav tsum tau ua ntawm kev ua haujlwm, ua ntej ua tshuaj loog hauv zos, thiab xuas nrig nrog rab diav zoo li rab koob. Muaj ob txoj kev puncture: ① puncture qhov chaw epidural perpendicular rau tus txha nraub qaum, hu ua txoj kev ncaj-hauv puncture; ② puncture tus txha nraub qaum obliquely, hu ua side-in puncture method.

(3) Cov theem ntawm qhov puncture yog tsuas yog txiav txim raws li qhov kev hloov ntawm kev tiv thaiv. Thaum ntsib ligamentum flavum, qhov tsis kam nce thiab muaj kev nkag siab ntawm toughness. Nyob rau lub sijhawm no, rub tawm lub koob tseem ceeb, txuas lub koob txhaj tshuaj nrog ib qho me me ntawm huab cua (lossis saline), thiab txuas ntxiv mus ntxig rau rab koob kom zoo. Hollowness", siv lub siab tsis zoo ntawm qhov chaw epidural los kos cov huab cua hauv cov koob txhaj tshuaj rau hauv cov kab noj hniav, thiab saib xyuas cov kev hloov ntawm cov kua theem ntawm lub taub hau ntawm lub syringe. Yog tias nws hloov pauv nrog cov kev hloov pauv hauv qhov tsis zoo, nws txhais tau hais tias nws tau nkag mus rau hauv qhov tawv nqaij. Extramembranous kab noj hniav. Yog tias tsis muaj qhov tsis zoo siab, txuas ntxiv mus ntxiv rau rab koob. Yog tias pom cov kua cerebrospinal, nws txhais tau hais tias nws tau dhau los ntawm qhov chaw epidural thiab nkag mus rau qhov chaw subarachnoid. Qhov puncture ua tsis tiav thiab yuav tsum tau tso tseg.

(4) Yog tias nws tau ua pov thawj tiag tiag hauv qhov chaw epidural, cov tshuaj loog yog txhaj rau hauv cov khoom siv. Feem ntau siv tshuaj loog yog 2% lidocaine (tseem hu ua xerocaine) lossis 2% decaine, ntxiv rau 0.1% epinephrine 0.1 ~ 0.2mL. Lidocaine feem ntau tsis ntau tshaj 500mg ib tus neeg laus rau ib koob, thiab dicaine tsis ntau tshaj 60mg ib koob. Nruam tshuaj loog epidural tuaj yeem muab faib ua cov koob tshuaj raws li kev phais. Thaum lub sij hawm tag nrho cov txheej txheem ntawm tshuaj loog, yuav tsum tau them nyiaj mloog zoo rau tus neeg mob' cov lus teb thiab kev hloov pauv ntawm cov tshuaj loog.

(5) Yog tias yuav tsum tau txhaj tshuaj loog epidural tas li, ua ntej siv lub ureteral catheter sib haum rau qhov loj ntawm rab diav-zoo li rab koob, sim ua ntej seb nws tsis muaj kev cuam tshuam, thiab ntsuas qhov ntev. Muab qhov chaw sloping ntawm rab diav-zoo li rab koob nce (los yog nqes, nyob ntawm qhov yuav tsum tau ua), ntxig lub ureteral catheter rau hauv qhov chaw epidural los ntawm rab koob kab noj hniav, rub tawm rab koob, thiab maj mam thawb lub catheter mus rau hauv qhov chaw epidural. Lub catheter tuaj yeem tso rau hauv qhov chaw epidural rau 3 mus rau 5 cm, tsis ntev. Tsis txhob nqa lub catheter tawm ntawm kab noj hniav thaum rub tawm rab diav zoo li rab koob. Sim txhaj me me ntawm cov tshuaj loog txog 2mL ntawm lub catheter. Yog tias tsis muaj kev tiv thaiv, tsis muaj lub pob hauv zos, thiab tsis muaj cov kua dej nchuav, nws txhais tau hais tias lub catheter tseem nyob hauv cov kab noj hniav. Thaum kawg, lub catheter sab laug sab nraum lub cev yog tsau rau sab nraum qab nrog daim kab xev los tiv thaiv nws los ntawm protruding thiab khoov rau hauv lub kaum sab xis los xyuas kom meej lub smoothness ntawm lub catheter thiab intraoperative tshuaj xa.

Yog tias koj muaj lus nug, thov hu rau peb. Peb lub tuam txhab tuaj yeem tsim ntau yam koob txhaj tshuaj, koob tshuaj kho mob, koob txhaj tshuaj, koob tshuaj hypodermic, koob txhaj tshuaj, koob tshuaj tiv thaiv kab mob, koob txhaj tshuaj, koob txhaj tshuaj, koob tshuaj tua tsiaj, koob xaum koob, koob ovum khaws koob, koob txhaj tshuaj, thiab lwm yam Yog tias koj xav tau kev kho. koob cov khoom, thov hu rau peb. Peb tos ntsoov rau koj qhov kev nug! Qhov zoo ntawm cov khoom tsim nyob rau hauv peb lub Hoobkas yuav txaus siab rau koj!

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