Qhov txawv ntawm Spinal Needle Tip Types Thiab Corresponding Clinical Scenarios

Kev piav qhia ntxaws los ntawm Cov Khoom Siv Kho Mob Chaw tsim khoom

16G-27G kev kho mob qib stainless hlau spinal koobmuab ob lub ntsiab lus tseem ceeb: Quincke Point thiab Pencil Point. Pom tseeb qhov tsis sib xws muaj nyob rau hauv cov qauv tsim, puncture mechanism, lub zog kho mob thiab cov neeg mob siv tau ntawm ob hom. Raws li lub luag haujlwm tseem ceeb ntawm cov koob txhaj tshuaj, cov txheej txheem tsim cov txheej txheem ncaj qha cuam tshuam rau kev raug mob hnyav, kev phais mob thiab qhov tshwm sim ntawm cov teeb meem tom qab phais. Cov kws tshaj lij txha caj qaum cov tuam txhab tsom mus rau cov thev naus laus zis thev naus laus zis thiab kev sib piv cov qauv sib txawv, cov yam ntxwv zoo thiab cov xwm txheej siv tau ntawm ob lub tswv yim, muab cov ntaub ntawv tshaj lij rau cov tsev kho mob ntawm kev xaiv kev yuav khoom thiab kev kho mob.

Lub Quincke Point yog ib qho qauv tsim qauv nrog lub ntsej muag ntse ntse uas muaj peev xwm nkag mus tau zoo. Nws cov txiaj ntsig tseem ceeb yog nyob rau hauv kev muaj zog tiv thaiv kev ua tau zoo. Thaum lub sij hawm lumbar puncture, lub supraspinous ligament, interspinous ligament thiab ligamentum flavum yog tuab thiab tawv nqaij. Lub ntsej muag ntse ntse txiav los ntawm cov ntaub so ntswg sai sai yam tsis tau rov kho qhov tob tob, ua kom lub sijhawm ua haujlwm luv thiab txo lub nra ntawm kev tuav lub cev rau cov neeg mob. Tsis tas li ntawd, lub taub hau ntse ua kom paub tseeb tias kev nce qib thiab tiv thaiv cov ncej ntog thiab sib txawv, haum rau cov rooj plaub nyuaj.

Clinically, Quincke Point koob yog dav siv rau niaj hnub cov neeg laus neuraxial tshuaj loog, puncture rau cov neeg mob uas muaj ligaments thickened, thaum muaj xwm ceev lumbar puncture thiab loj - ntim cerebrospinal kua sampling. Rau cov neeg mob rog rog, ntev - lub sij hawm ua hauj lwm lub cev los yog lumbar degeneration nrog ligament thickening, cov ntaub so ntswg tsis kam nce sharply. Cov lus qhia zoo ib yam yuav tsis nkag mus lossis ua rau cov ncej dabtsi yog khoov, thaum Quincke Point ua tau zoo dhau los ntawm cov ntaub so ntswg kom ua tiav qhov kev ua tiav ntawm thawj zaug sim. Ua ke nrog 16G-19G loj- ntsuas cov ncej tuab, nws nquag siv rau kev siv tshuaj loog ntev ntev hauv kev phais dav dav thiab kev kuaj mob xwm txheej ceev ntawm cov kab mob paj hlwb uas muaj txiaj ntsig zoo.

Pencil Point sawv cev rau qhov tshwj xeeb tsim tshwj xeeb nrog cov duab sib npaug uas tsis muaj qhov txiav ntse. Nws txoj hauv kev ua haujlwm tseem ceeb yog cais cov ntaub so ntswg ntau dua li txiav thiab lacerating lawv. Thaum lub sij hawm puncture, tus cwj mem - zoo li lub taub hau maj mam thawb ib sab subcutaneous cov ntaub so ntswg, ligament fibers, me me intraspinal cov hlab ntsha thiab cov hlab ntsha kom khaws cia ib txwm physiological qauv mus rau qhov siab tshaj plaws. Qhov kev xav "muab txoj kev" thaum dhau los ntawm ligamentum flavum yog qhov txawv dua rau cov kws kho mob kom tswj tau qhov tob tob thiab tsis txhob dhau -kev nkag mus uas yuav ua rau tus txha caj qaum.

Pencil Point koob muab qhov tseem ceeb tsawg kawg nkaus thiab muaj kev pheej hmoo tsis zoo, sib piv nruab nrab thiab me me - ntsuas qhov ntsuas (20G-27G). Lawv tau siv dav hauv kev ua kom zoo tsawg -kev kuaj mob thiab kev kho mob, tshwj xeeb tshaj yog lumbar puncture rau cov neeg mob menyuam yaus, cov neeg laus cov neeg tsis muaj zog thiab cov neeg mob rhiab heev. Cov neeg zoo li no muaj cov ntaub so ntswg txhav tsis zoo thiab tsis muaj peev xwm kho tau, yuav tsum tau ua haujlwm puncture nrog kev raug mob tsawg. Pencil Point ua rau txo qis kev pheej hmoo ntawm kev mob taub hau tom qab dural puncture, cerebrospinal kua to, hauv zos hemorrhage thiab paj hlwb. Nws kuj haum rau tus neeg mob sab nraud qhov kev kuaj xyuas cov kua cerebrospinal tsawg kawg nkaus, taug qab cov tshuaj intraspinal xa mus thiab tom qab phais mob analgesia xav tau kev phais mob siab thiab kev nplij siab ntawm tus neeg mob.

Raws li cov kws kho mob cov chaw tsim khoom, ob qho tib si cov lus qhia tau txais kev sib tsoo tshuab rau kev kho mob stainless hlau yam tsis muaj burrs lossis cov yam ntxwv tsis xws luag. Tag nrho cov gauges txhawb kev teeb tsa pub dawb ntawm cov lus qhia, thiab kho kom haum lub kaum ntse ntse thiab curvatures muaj nyob rau ntawm kev thov. Thaum lub sij hawm tswj kev ua tau zoo, peb nruj me ntsis tswj lub ntsis sharpness, radian thiab concentricity kom tshem tawm qhov tsis xws luag xws li tip deviation thiab ntug burrs, kom puncture precision thiab kev nyab xeeb ntawm txhua txhua koob. Rau kev lag luam kev lag luam thiab kev siv tshuaj kho mob, cov tsev kho mob tuaj yeem xaiv cov hom lus qhia thiab ntsuas kev sib xyaw ua ke raws li lub luag haujlwm tsom thiab tus neeg mob tus yam ntxwv kom sib npaug ntawm kev kho mob thiab kev ua haujlwm ntawm tus neeg mob.