蛛网膜下腔阻滞医疗模板.pptVIP

PunctureRelatedInfectionInfectionHematomaNerveRootSpinalBleedMeningitisArachnoiditisAbscess1.Backorvertebralpain2.Nerverootpain3.Motor/sensorydeficitsorsphincterdysfunction.4.Paraplegiaorparalysis.Bloodculture,CT,MRIAntibioticsPunctureRelatedSpinalcordInfectionHematomaNerveRootSpinalBleedPunctureRelatedNerverootInfectionNerveRootHematomaSpinalBleedPreventionObservationPunctureRelatedBleedInfectionHematomaNerveRootSpinalBleed1.Venousplexus2.Pregnancy/AVM3.SubarachnoidhemorrhagePunctureRelatedHematomaInfectionHematomaNerveRootSpinalBleed1.Spinal1:220,0002.Epidural1:150,0003.AbnormalcoagulationDrugInjection心血管效应呼吸抑制马尾综合征恶心呕吐DrugInjectionCardiacarrestLowBPDrugInjectionAPostoperativeBPostduralPunctureHeadache(PDPH)CTransientneurologicsymptoms(TNS)DUrinaryRetentionEBackachePostduralPunctureHeadache(PDPH)Treatment1.OralAnalgesics2.Bedrest3.Hydration4.Caffeineinfusion5.Epiduralbloodpatch1.Frontal/Occipital2.Tinnitus/Diplopia3.UprightpositionPage***蛛网膜下腔：前面解剖我们已经讲解过了又叫腰麻或者脊麻*WhenDrAugustBierpioneeredspinalanaesthesiainthe1890sheobservedthathispatients,allapparentlypain-freeduringtheprocedure,sufferedfromvomitingandsevereheadachesfordaysafterwards.TheGermandoctor,concernedaboutthesecomplications,decidedhemustexperiencetheeffectshimselftotrulyunderstand,andhopefullyprevent,them.Hepersuadedhiscolleague,DrAugustHildebrandt,toassist.TheplanwasforHildebrandttoinjecthalfamillilitreofcocaineintoBiersspine.HildebrandtwouldthenassessBierssensitivitytopainanddeterminehowlongittookfortheanaestheticeffecttosetin.Thefirstattemptproveddisastrous.AfterinsertingtheneedleintoBiersspine,Hildebrandtstruggledtoconnectthesyringe.Asaresul