https://radiologykey.com/essential- khoom siv- xuas nrig ntaus- koob/

Lumbar puncture muaj keeb kwm ntau dua ib puas xyoo, thiab kev hloov pauv ntawm nws cov cuab yeej tseem ceeb -tus txha caj qaum- qhia txog keeb kwm ntawm kev phais me me. Los ntawm cov hlau tuab thaum ntxovkoobcuam ​​tshuam nrog cov teeb meem nyuaj rau niaj hnub no kev siv dav dav ntawm ultra-cov cwj mem nyias-point koob, txoj kev mus rau miniaturization tau tsis tu ncua nyob ib ncig ntawm ob qhov kev sib tw hauv nruab nrab:"ua tiav txoj hauv kev meej"thiab"minimizing cov ntaub so ntswg puas,"tau tsav los ntawm kev nce qib tsis tu ncua hauv cov ntaub ntawv tshawb fawb thiab kev tsim qauv.

Lub Sij Hawm Thaum Ntxov: Lub Caij Nplooj Ntoos Hlav thiab Kev Mob ntawm Cov Teeb Meem

Nyob rau hauv thawj ib nrab ntawm lub xyoo pua 20th, lumbar puncture koob feem ntau yog ua los ntawm stainless hlau, nrog loj gauges (feem ntau 18-20G) thiab ib txwm beveled ntsis (Quicke hom). Txawm hais tias tus qauv tsim no tau yooj yim rau cov ntaub so ntswg nkag mus thiab nrawm nrawm, lub ntsej muag ntse tau ua tiav cov fibers ntawm dura mater thiab arachnoid membrane, tawm hauv qhov loj, kho tsis zoo. Qhov no ncaj qha coj mus rau cerebrospinal cov kua dej tsis tu ncua los ntawm cov koob txhaj tshuaj tom qab cov txheej txheem, ua rau txo qis intracranial siab thiab mob taub hau loj heev, uas tshwm sim hauv ntau dua 30% ntawm cov neeg mob. Thaum lub sij hawm ntawd, koob tsim thawj txheej txheem"kev ruaj ntseg"thiab sampling"efficiency,"thaum tus neeg mob kev nplij siab thiab kev nyab xeeb coj lub rooj zaum rov qab.

Thawj kiv puag ncig: Yug ntawm koob zoo thiab cwj mem tswv yim tsim

Nyob rau xyoo 1970 thiab 1980s, thawj qhov kev hloov pauv tau tshwm sim nrog kev nkag siab zoo dua ntawm cov txheej txheem tom qab- mob taub hau dural. Qhov kev hloov pauv tseem ceeb yog qhov kev siv dav dav ntawm cov koob ntsuas zoo tshaj plaws (22–25G) thiab xaum -taw tes lossis tapered- cov qauv tsim xws li Whitacre thiab Sprotte hom. Cwj mem-point koob muaj lub ntsej muag zoo nkauj nrog lub ntsej muag qhib uas maj mam sib cais thiab tshem tawm cov fibers dural es tsis yog txiav los ntawm lawv thaum nkag mus rau dura mater. Qhov no ho txo ​​qhov loj ntawm lub dural kua muag. Nyob rau tib lub sijhawm, txoj kab uas hla me dua- kwv yees li 0.7 hli rau 22G thiab tsuas yog 0.5 hli rau 25G-ntau ntxiv rau qhov puncture channel. Ua ke, cov kev nce qib no txo ​​qhov tshwm sim tom qab- mob taub hau ib ntus kom qis dua 5%. Nyob rau ntawm lub sijhawm no, lub tswv yim ntawm kev txo qis kev cuam tshuam los ntawm kev txo cov koob loj tau ruaj khov: qhov me me ntawm txoj kab uas hla thiab ntau dua."blunt"cov lus qhia, qhov zoo dua - muab cov txheej txheem kev cai yooj yim tau ua tiav.

Kev hloov pauv thib ob: Cov Khoom Siv Kev Tshawb Fawb Kev Tshawb Fawb thawb qhov txwv ntawm qhov loj

Txawm li cas los xij, kev nrhiav kev yooj yim"zoo"thiab"blunt"tau tsoo lub cev tsis muaj zog: cov koob hlau zoo tshaj plaws yuav khoov thiab nyuaj rau kev tswj xyuas thaum nkag mus rau cov tawv nqaij interlaminar thiab supraspinous ligaments, thaum cov lus qhia ntau dhau yuav tsum muaj zog ntau dua, uas ua rau cov ntaub so ntswg tawg. Daim ntawv thov ntawm cov ntaub ntawv polymer tau tawg qhov kev tuag no. Cov ntaub ntawv xws li polyether ether ketone (PEEK) thiab cov khoom siv hluav taws xob muaj zog tau pib siv los tsim cov koob txhaj tshuaj. Cov no muaj rigidity piv rau steel koob, yog sib dua nyob rau hauv qhov hnyav, thiab tuaj yeem molded los ntawm kev txhaj tshuaj molding rau hauv ntau txoj hau kev thiab cov gauges zoo dua. Tsis tas li ntawd, kev siv cov duab- nco alloys zoo li nitinol ua rau cov koob txhaj tshuaj kom tswj tau lawv cov duab preset raws txoj kev nkhaus anatomical, txhim kho navigability. Kev nce qib hauv cov ntaub ntawv tau ua kom ua tiav cov koob uas yog"zoo dua, muaj zog dua, thiab tswj tau ntau dua,"ua kom ntseeg tau kev kho mob siv 26G thiab txawm koob zoo dua.

Qhov thib peb kiv puag ncig: Precise Matching thiab Functional Integration

Tam sim no, minimally invasive phais tau nkag mus rau lub sijhawm ntawm"precise matching,"characterized los ntawm:

• Customizable Length:Muab qhov ntev ntev ntawm 1.5 txog 7 ntiv tes, haum rau cov neeg tshwj xeeb xws li cov neeg mob rog thiab cov menyuam yaus. Ua ke nrog kev ntsuas ultrasound ua ntej, nws ua rau kev xaiv meej, zam dhau - nkag lossis qhov tob tsis txaus.
• Integrated Functional Design:Muab cov fibers kho qhov muag, me me ultrasound probes, los yog biosensors nyob rau hauv lub zoo koob ncej, ua tiag tiag - lub sij hawm cov ntaub so ntswg txheeb xyuas thaum lub sij hawm puncture - txawv ligaments, epidural qhov chaw, thiab subarachnoid qhov chaw- los tiv thaiv kev rov sim dua vim qhov muag tsis pom kev. Qhov no tso cai rau txawm tias 25G koob zoo kom ua tiav qhov kev tso kawm raug nyob hauv ib qho kev sim.
• Txheej thiab Kev Hloov Kho Nto:Siv hydrophilic txheej rau ntawm rab koob nto, txo kev sib txhuam ntawm rab koob thiab cov ntaub so ntswg. Qhov no ua rau smoother insertion, yuav tsum tau tsawg zog thiab txo cov ntaub so ntswg tshem tawm raug mob.

Yav tom ntej Outlook: "Tus kheej-Kho" thiab "Samless Puncture"

Lub hom phiaj ntawm miniaturizing interventional txheej txheem yog"tsis yog-invasive."Nyob rau hauv lub neej yav tom ntej, ultra- cov koob txhaj tshuaj zoo ua los ntawm biodegradable polymers yuav dhau los ua cov lus cog tseg. Tom qab ua tiav lawv txoj haujlwm, cov koob no tuaj yeem maj mam txo qis ntawm qhov chaw ntxig thaum muab kev kho kom zoo - txhawb cov tshuaj los qhia kev kho qhov nyiam ntawm dura mater, ua rau"tus kheej- kho."Ntawm qhov tod tes,"needle-pub dawb"technologies-xws li tsim micrometer- teev cov kab hauv cov ntaub so ntswg siv lasers lossis microjets rau kev kuaj lossis xa tshuaj- tuaj yeem hloov kho lub tswv yim ntawm kev sib tsoo.

Los ntawm coarse steel koob mus rau ntse microsystems, txhua qhov kev txo qis hauv lumbar puncture koob loj tau nrog rau kev dhia mus rau hauv cov ntaub ntawv, tsim, thiab lub tswv yim. Txoj kev evolutionary no qhia meej meej rau yav tom ntej uas cov txheej txheem kho mob yuav tsis tsuas yog kho tus kab mob xwb tab sis kuj sawv cev tsawg kawg nkaus, kwv yees, thiab txawm tias"tus phooj ywg"kev cuam tshuam rau hauv cov qauv physiological.