腰穿提高篇医学知识专题讲座培训课件

腰穿提高篇医学知识专题讲座腰穿解剖一定要弄清体位一定要摆好间隙一定要摸准进针一定要垂直心理一定要稳定2腰穿提高篇医学知识专题讲座理想与现实是有差距的3腰穿提高篇医学知识专题讲座体位:lateraldecubituspositionThepatientisplacedcurledonhisside,onafirmsurface,withhiskneesflexeduptothechestandneckflexedforward.Thelumbarregionshouldbeclosetotheedgeofthebedandtheplaneofthebackandshouldersasperpendiculartothebedaspossible.4腰穿提高篇医学知识专题讲座体位5腰穿提高篇医学知识专题讲座体位6腰穿提高篇医学知识专题讲座与床面的关系：两条垂直线，一条平行线8腰穿提高篇医学知识专题讲座间隙DrawinganimaginarylinebetweenthetwoposterioriliaccrestswillallowidentificationoftheL3-4orL4-5interspaces.9腰穿提高篇医学知识专题讲座确定中点10腰穿提高篇医学知识专题讲座进针Insertspinalneedle,withstyletinplace,alongthemidlinewithbevelfacingupwards(assumeslateraldecubituspositioning).Directtheneedleslightlycephaladalonganimaginarylinetowardstheumbilicus.11腰穿提高篇医学知识专题讲座进针12腰穿提高篇医学知识专题讲座理想与现实还是有差距的13腰穿提高篇医学知识专题讲座进针层次14腰穿提高篇医学知识专题讲座矢状面Sagittalsectionoflumbarvertebraeillustratingthecourseofthelumbarpunctureneedlethroughskin(1),subcutaneoustissue(2),supraspinousligament(3),interspinousligament(5)betweenthespinousprocesses(4),ligamentumflavum(6),duramater(8),intothesubarachnoidspaceandbetweenthenerverootsofthecaudaequina(7).Lumbarvertebralbodies(9),intervertebraldisc(10),andlumbarpunctureneedle(11).15腰穿提高篇医学知识专题讲座水平面Horizontalsectionoflumbarvertebraillustratingthecourseofthelumbarpunctureneedlethroughskin(1),subcutaneoustissue(2),betweenthespinousprocesses(3)andlaminae(4),ligamentumflavum(5),epiduralspace(6),duramater(7),intothesubarachnoidspaceandbetweenthenerverootsofthecaudaequina(8).Lumbarvertebralbody(9)andlumbarpunctureneedle(10).16腰穿提高篇医学知识专题讲座进针17腰穿提高篇医学知识专题讲座心理家属回避不要分心：不要象有些人风一样飘来飘去，一会接电话，一会和别人开玩笑切忌大意：有时候在给自己已经穿过的患者再次腰穿时，由于思想上放松警惕，往往会带来不顺利18腰穿提高篇医学知识专题讲座总结19腰穿提高篇医学知识专题讲座参考文献BoonJM,AbrahamsPH,MeiringJH,etal.Lumbarpuncture:an