Thaum lub sij hawm dav dav "spinal needle" npog ib pawg dav, qhov tseeb yog tias cov kev kho mob sib txawv xav tau cov koob tshwj xeeb tshwj xeeb rau lawv txoj haujlwm tshwj xeeb. Kev siv hom tsis raug tuaj yeem cuam tshuam cov txheej txheem kev ua tau zoo lossis ua rau muaj kev pheej hmoo.

Hom 1: Diagnostic Lumbar Puncture Needle

Rau kev sau cov kua cerebrospinal (CSF) rau kev soj ntsuam (xws li, xav tias mob meningitis, ntau yam sclerosis, subarachnoid hemorrhage), qhov tseem ceeb yog tau txais cov qauv huv, tsis muaj paug nrog kev ntsuas siab.

• Hom nyiam:Quincke lossis Whitacre koob, feem ntau 20G txog 22G.
• Cov yam ntxwv tseem ceeb:Ib qhov loj dua (20-22G) tso cai rau CSF ntws nrawm dua thiab yooj yim dua manometer txuas rau ntsuas qhov qhib siab. Quincke lub taub hau ntse pab kom nrawm nrawm thiab huv si. Txawm li cas los xij, vim tias qhov kev pheej hmoo ntawm PDPH qis dua hauv cov neeg mob laus uas feem ntau raug kuaj xyuas cov kais dej, qhov kev pheej hmoo siab dua yog qhov ua tau.
• Tshwj xeeb Variant:Cov koob Atraumatic (Sprotte) tau nyiam dua rau kev kuaj cov kais dej hauv cov neeg mob hluas kom txo qis kev pheej hmoo mob taub hau, txawm tias ntws qeeb me ntsis.

Hom 2: Tus Kab Ntsig Spinal Anesthesia (Obstetric & Surgical)

Ntawm no, lub hom phiaj yog xa cov koob tshuaj loog hauv zos rau hauv CSF kom ua tiav qhov kev hnov ​​​​mob thiab lub cev muaj zog rau kev phais lossis kev ua haujlwm.

• Hom nyiam:cwj mem -point (Whitacre los yog Sprotte), 25G txog 27G.
• Cov yam ntxwv tseem ceeb:Cov cwj mem - taw tes taw qhia tsis yog- sib tham tau los txo PDPH, tshwj xeeb tshaj yog nyob rau hauv cov tub ntxhais hluas, poj niam, cov neeg nyob hauv obstetric. Sab - qhov tsim qauv tso cai rau kev txhaj tshuaj loog (piv txwv li, txhaj tshuaj cephalad rau qhov thaiv siab dua). Qhov ntsuas me me minimizes kev raug mob. Cov khoom siv CSE muab ib rab koob ntev ntev nrog rau ib qho epidural catheter, tso cai rau ob qho tib si pib sai thiab txuas ntxiv qhov mob.

Hom 3: Myelography koob

Myelography suav nrog kev txhaj tshuaj zoo sib xws rau hauv lub hnab thecal kom pom cov leeg txha caj qaum thiab cov paj hlwb hauv qab X-ray lossis CT.

• Hom nyiam:Quincke lossis rab koob tshwj xeeb atraumatic, feem ntau 22G txog 25G.
• Cov yam ntxwv tseem ceeb:Lub koob yuav tsum tso cai rau kev txhaj tshuaj ntawm cov kua nplaum sib txawv uas tsis muaj lub siab ntau dhau. Ib rab koob ntawm tus txha caj qaum ua haujlwm tau zoo, tab sis ib qho blunt- taub lossis rab koob atraumatic yog qee zaum nyiam los txo qhov kev pheej hmoo ntawm cov hlab ntsha hauv cov hlab ntsha los yog tom qab- txheej txheem mob taub hau. Cov koob feem ntau muab tso nrog kev taw qhia fluoroscopic.

Hom 4: Therapeutic Drainage Needle (CSF Drainage)

Siv rau kev tso dej CSF txhawm rau txo qis intracranial siab (piv txwv li, hauv pseudotumor cerebri lossis ib txwm muaj siab hydrocephalus).

• Hom nyiam:Loj bore koob (18G-20G) los yog lub lumbar ntws catheter.
• Cov yam ntxwv tseem ceeb:Rau ib qho kev kho kais dej, ib rab koob loj tso cai rau cov kua dej nrawm ntawm qhov ntim tseem ceeb (20-40mL). Rau kev tso dej tas mus li, cov khoom siv tshwj xeeb lumbar ntws yog siv. Qhov no suav nrog kev tso lub catheter hloov pauv los ntawm Tuohy koob (zoo ib yam li koob epidural) rau hauv qhov chaw subarachnoid, tso cai rau kev tswj hwm, ncua ntev CSF kev hloov pauv.

Hom 5: Kev Tshawb Fawb / Sampling Koob

Kev sau CSF rau kev tshawb fawb biomarker lossis kev txheeb xyuas ntawm tes.

• Hom nyiam:Ultra-zoo, atraumatic koob (25G-27G).
• Cov yam ntxwv tseem ceeb:Kev txo qis kev raug mob thiab ntshav paug yog qhov tseem ceeb rau kev soj ntsuam rhiab heev. Ib tug cwj mem -point koob nrog lub ntsuas me me yog qhov zoo tshaj plaws los tiv thaiv kev qhia cov khoom siv ntshav uas tuaj yeem ua rau cov txiaj ntsig tsis zoo.

Hauv kev xaus, tsis muaj universal "spinal needle." Txhua qhov chaw kho mob-kev kuaj mob kais, phais tshuaj loog, myelography, lossis kev kho cov kua dej- yuav tsum muaj kev sib xyaw tshwj xeeb ntawm ntsuas, lub hau tsim, thiab ntev. Kev nkag siab txog hom tshwj xeeb no yog qhov tseem ceeb rau txhua tus kws kho mob txhawm rau ua kom muaj kev nyab xeeb, muaj txiaj ntsig, thiab tus neeg mob- cov kev cuam tshuam tshwj xeeb.