Ncej -Lumbar Puncture Headache Mechanism Thiab Txhim Kho Qhov Zoo Ntawm Atraumatic Pencil Point Spinal Needle

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

1. Taw qhia

Post- lumbar puncture headache yog qhov teeb meem tshwm sim tom qab kev phais feem ntau ntawm cov txheej txheem lumbar puncture thiab txha nraub qaum, cuam tshuam rau ntau tus neeg mob thiab txo qis kev kho mob thiab kev ua haujlwm rov qab ua haujlwm. Qhov tshwm sim ntawmatraumatic mem hluav point spinal koobhauv paus txhim kho qhov tshwm sim tom qab- mob taub hau los ntawm cov qauv tsim kho tshiab, dhau los ua cov txheej txheem tseem ceeb los txo cov teeb meem tom qab kev kho mob. Tsab ntawv xov xwm no tshawb xyuas cov kab mob ntawm cov kab mob tom qab- lumbar puncture mob taub hau thiab txheeb xyuas qhov kev tiv thaiv zoo heev ntawm tus cwj mem mem hluav taw tes txha caj qaum hauv daim ntawv thov kho mob.

2. Pathogenesis thiab Clinical Manifestations of Post-Puncture Headache

Cov ntaub ntawv kho mob tau lees paub tias feem ntau cov neeg mob raug kev txom nyem los ntawm kev sib txawv ntawm kev mob taub hau tom qab kev phais lumbar puncture. Qhov laj thawj tseem ceeb ntawm qhov teeb meem no yog qhov poob ntawm cerebrospinal kua thaum lub sij hawm puncture txheej txheem, uas ua rau ib ntus thiab tsis tu ncua ntawm intracranial cerebrospinal kua siab. Tsoos Quincke taw tes txiav rab koob ua rau tsis tuaj yeem tsim kua muag ntawm dural fibers, ua rau tsis muaj qhov txhab me me thiab cov kua dej cerebrospinal tsis tu ncua tom qab kev phais, uas yog lub hauv paus ua rau muaj kev cuam tshuam tsis zoo - mob taub hau.

Hom mob taub hau no muaj cov yam ntxwv ntawm kev ua haujlwm zoo heev uas paub qhov txawv ntawm qhov mob taub hau. Thaum tus neeg mob pw tiaj tus, qhov sib txawv ntawm cov kua dej cerebrospinal yog sib npaug, thiab mob taub hau zoo heev los yog ploj mus; Thaum tus neeg mob zaum los yog sawv ntsug, lub intracranial siab hloov pauv heev, thiab mob taub hau yog sharply aggravated. Hauv cov mob me me, cov neeg mob tuaj yeem ua kom rov zoo li qub hauv 1 mus rau 2 hnub los ntawm kev ntxiv dej txaus thiab so hauv txaj yam tsis muaj kev cuam tshuam tshuaj tshwj xeeb. Txawm li cas los xij, rau cov neeg mob uas mob taub hau tsis tu ncua, nws yuav qhia tau tias muaj peev xwm ua rau lub paj hlwb, xav tau kev kuaj mob hauv tsev kho mob raws sij hawm thiab tsom mus rau kev kho mob kom tsis txhob ncua kev kuaj mob thiab kev kho mob.

3. Core Anti-Headache Mechanism of Atraumatic Pencil Point Spinal Needle

Lub atraumatic mem hluav point spinal needle ua tiav lub hom phiaj tiv thaiv kev tshaj tawm -mob taub hau los ntawm nws qhov tshwj xeeb blunt- ntsis tsis yog - txiav tsim. Sib txawv ntawm cov koob ntse ntse uas rhuav tshem dural fiber ntau kev ncaj ncees, mem hluav taw tes blunt tip cia siab rau lub cev sib cais kom tiav cov ntaub so ntswg nkag, tiv thaiv tag nrho cov qauv ntawm tus txha caj qaum dural fibers yam tsis muaj kev puas tsuaj. Lub qhov txhab raug tsim los ntawm hom no yog me me, tsis tu ncua, thiab tus kheej zoo heev - kho tau. Tom qab koob tshem tawm, cov elastic dural fibers rov qab sai sai los kaw lub qhov txhab, zoo thaiv cov kua dej cerebrospinal thiab tswj kom ruaj khov intracranial siab.

Ntau qhov kev tshawb fawb soj ntsuam pom tau hais tias qhov atraumatic mem hluav point spinal needle tuaj yeem txo qhov tshwm sim ntawm post-lumbar puncture taub hau ntau dua 60% piv nrog cov tsoos txiav koob. Txawm hais tias cov neeg mob me me muaj cov tsos mob mob taub hau me ntsis tom qab kev phais, lub sij hawm luv luv, thiab kev rov qab los sai dua, tsis tas yuav muaj kev kho mob ntxiv. Qhov kev tiv thaiv kev cuam tshuam zoo heev no yog tag nrho los ntawm cov khoom lag luam kev ua kom zoo dua qub, ua kom muaj kev cuam tshuam me me thiab nyab xeeb los ntawm qhov ntsuas ntsuas.

4. Daim Ntawv Thov Kev Kho Mob Tus nqi txo qhov mob taub hau

Kev txo qis tom qab- ntuav mob taub hau ua rau muaj ntau yam kev txhim kho tus nqi kho mob. Ua ntej, nws ua kom zoo dua rau cov neeg mob kev kho mob, txo cov mob tom qab lub cev thiab kev ntxhov siab, thiab ua rau lub tsev kho mob luv luv thiab rov qab mus. Qhov thib ob, nws txo qis kev ua haujlwm hauv tsev laus ntxiv ntawm cov neeg ua haujlwm kho mob thiab zam kev rov ua haujlwm tom qab ua raws li - nce thiab kho cov tsos mob. Thib peb, nws txo cov nqi kho mob ntxiv los ntawm kev kho mob sequelae, txhim kho tus nqi tag nrho -kev ua haujlwm ntawm kev kho mob lumbar puncture thiab tshuaj loog phais. Rau cov tsev kho mob, qhov nrov ntawm atraumatic mem hluav point spinal needle standardizes minimally invasive diagnosis and treatment and reduces the risk of medical problems los ntawm postoperative complications.

5. Cov lus xaus

Los ntawm kev daws qhov teeb meem ntawm cov cuab yeej siv tshuaj tua kab mob uas yooj yim ua rau cov kua cerebrospinal to, lub atraumatic mem hluav point spinal needle txhim kho cov teeb meem kho mob tom qab- lumbar puncture mob taub hau. Nws cov txiaj ntsig kev tiv thaiv tsis zoo, kev ua haujlwm ruaj khov, thiab kev hloov pauv ntawm tus neeg mob siab ua rau nws yog ib qho tseem ceeb ntawm cov khoom siv rau niaj hnub siab -zoo txha caj qaum thiab tshuaj loog kuaj thiab kho.