Comparative Analysis Ntawm Atraumatic Pencil Point Spinal Needle Thiab Traditional Quincke Point Spinal Needle

https://www.bmj.com/content/361/bmj.k1920

1. Taw qhia

Atraumatic mem hluav point spinal koobthiab ib txwm Quincke point spinal needles yog ob lub ntsiab lus tseem ceeb hauv kev kho mob lumbar puncture thiab spinal anesthesia. Muaj qhov sib txawv tseem ceeb ntawm ob lub hauv paus ntsiab lus, hom kev sib tsoo, kev nyab xeeb hauv chaw kho mob, tus nqi tsis zoo, thiab cov xwm txheej siv tau. Nrog kev txhim kho txuas ntxiv ntawm kev kho mob me me thiab muaj kev nyab xeeb cov tswv yim kho mob, lub atraumatic mem hluav point spinal needle, nrog nws cov kev ua tau zoo, yog maj mam hloov cov tshuaj Quincke point txiav koob thiab dhau los ua tus qauv kev lag luam tshiab.

2. Qhov tseem ceeb sib txawv hauv cov txheej txheem puncture

Qhov tseem ceeb sib txawv ntawm ob yam khoom yog nyob rau hauv lub ntsis qauv thiab cov ntaub so ntswg nkag mechanism. Cov tshuaj Quincke taw tes txha caj qaum siv lub ntsej muag ntse ntse, uas txiav hla ntawm daim tawv nqaij, cov ntaub so ntswg subcutaneous, thiab tus txha caj qaum dural fibers thaum lub sij hawm puncture. Txoj kev txiav cov ntaub ntawv tsis sib xws, jagged qhov txhab uas tsis tuaj yeem kho tus kheej - kho, ua rau cov kua cerebrospinal tsis tu ncua thiab muaj qhov tshwm sim ntawm cov teeb meem tom qab phais. Nws cov tub ntxhais tsim qauv nrhiav kev nrawm nrawm tab sis tsis quav ntsej cov ntaub so ntswg tiv thaiv thiab rov ua haujlwm tom qab.

Tus cwj mem atraumatic tus txha caj qaum siv lub cwj mem blunt - zoo li tsis yog - txiav tawm, tsis muaj qhov txiav ntse. Nws tso siab rau kev sib cais ntawm lub cev kom nkag mus rau hauv cov ntaub so ntswg, tiv thaiv kev ncaj ncees ntawm dural thiab cov nqaij mos fibers. Lub qhov txhab yog me me thiab tsis tu ncua, nrog rau tus kheej zoo - kho muaj peev xwm. Tom qab koob tshem tawm, lub qhov txhab kaw sai sai, hauv paus daws qhov teeb meem ntawm cov txheej txheem ntawm cov kua cerebrospinal to hauv cov koob txiav tsoos. Lub tshuab puncture tshiab no yog qhov tseem ceeb ntawm cov khoom lag luam me me thiab kev nyab xeeb kev ua haujlwm.

3. Kev sib piv ntawm kev soj ntsuam kev ua haujlwm zoo

Hais txog kev ua haujlwm dhau los, Quincke point koob muaj qhov nrawm nrawm tab sis kev tswj tsis tau zoo. Lub ntsej muag ntse yog ib qho yooj yim ua rau cov ntaub so ntswg ntau dhau thiab raug mob ntawm lub paj hlwb, thiab kev ua haujlwm yuav muaj kev pheej hmoo siab rau cov neeg mob uas tsis muaj zog xws li menyuam yaus thiab cov neeg laus. Cov cwj mem mem hluav taw tes txha caj qaum muaj qhov nruab nrab thiab ruaj khov puncture tsis kam, uas tuaj yeem pab cov kws kho mob kom paub meej qhov sib txawv ntawm cov ntaub so ntswg nkag mus, txhim kho qhov chaw ntawm qhov raug thiab ib qho - lub sijhawm ua tiav, thiab zam kev puas tsuaj ntau dua.

Nyob rau hauv cov nqe lus ntawm cov xwm txheej, cov tshuaj Quincke point koob tsuas yog haum rau cov neeg laus cov neeg laus uas yooj yim spinal anatomy. Lub atraumatic mem hluav point spinal needle muaj kev sib raug zoo, suav nrog txhua pab pawg hnub nyoog thiab cov neeg mob anatomical complex, thiab tuaj yeem hloov mus rau kev kuaj mob niaj hnub, kev phais mob loj, thiab kev ua haujlwm tshwj xeeb ntawm cov pej xeem, nrog rau kev siv tshuaj kho mob ntau dua.

4. Kev sib piv ntawm cov tsos mob tom qab phais

Cov ntaub ntawv pov thawj loj hauv chaw kho mob qhia tau hais tias cov koob tshuaj Quincke taw tes muaj qhov xwm txheej siab tshaj ntawm post- lumbar puncture taub hau, thiab qee tus neeg mob tau zais qhov kev pheej hmoo ntawm cauda equina paj hlwb raug mob thiab cov tshuaj tiv thaiv inflammatory. Nyob rau hauv sib piv, lub atraumatic mem hluav taw tes spinal koob zoo heev txo qhov tshwm sim ntawm ntau yam teeb meem postoperative, nrog rau post- puncture taub hau npaum li cas txo los ntawm ntau tshaj 60%, thiab yuav luag tsis muaj mob loj heev paj huam sequelae. Txawm hais tias cov txheej txheem ntau lawm yog qhov tsim nyog, nws cov txiaj ntsig kev kho mob thiab cov txiaj ntsig kev lag luam tau siab dua li cov koob tshuaj ib txwm muaj vim txo qis kev kho mob tom qab phais thiab cov nqi kho mob.

5. Cov lus xaus

Tus cwj mem mem hluav taw tes txha caj qaum tau ua tiav tag nrho -ib puag ncig kev hla dhau ib txwm Quincke point koob hauv kev tsim qauv, kev ua haujlwm ua haujlwm, kev nyab xeeb hauv chaw kho mob, thiab kev tiv thaiv teeb meem. Nws ua raws li txoj kev loj hlob ntawm cov tshuaj niaj hnub minimally invasive thiab yuav txuas ntxiv txhawb kev txhim kho tus qauv thiab kev nyab xeeb ntawm thoob ntiaj teb spinal puncture thiab anesthesia technology.