Brain or spinal puncture is used to diagnose or treat the following:

subdural puncture

Often used in infants and young children. When the anterior fontanelle is not closed or the coronal suture is enlarged, a lumbar puncture needle is inserted into the subdural layer from the lateral angle of the anterior fontanelle or from the coronal suture to extract the subdural effusion in traumatic chronic subdural hematoma and suppurative meningitis, and then Inject an appropriate amount of antibiotics.

Ventricular puncture

Can be divided into anterior angle puncture, lateral angle puncture and posterior angle puncture three. Use a cranial cone to quickly drill through the skull 2 cm behind the anterior hairline and 2.5 cm next to the midline, and then use a lumbar puncture needle or a ventricle drainage tube to penetrate the anterior horn of the lateral ventricle. When the cerebral pressure is too high, the patient is in a coma, the pupil is dilated, the breathing is superficial, and the brain herniation is formed, a rapid ventriculocentesis is performed to release the ventricular fluid, and the brain herniation can be relieved immediately. Ventricular pressure can also be measured, or a drainage bottle can be connected for continuous ventricular drainage, and the ventricular fluid can be taken for testing. Methylene blue can also be injected to understand the circulation of cerebrospinal fluid. Air, oxygen, and contrast agents can also be injected from the puncture needle to diagnose intracranial space-occupying lesions and ventricular system obstruction. People who are allergic to iodine should not do angiography. Ventricular fluid discharge over Shaanxi, occasional epidural and subdural hematoma.

Cerebral vascular puncture

The common carotid artery or vertebral artery can be punctured, and the contrast agent can be injected for cerebral angiography, and the common carotid artery angiography can display the blood vessels of the cerebral hemisphere. Vertebral artery angiography can show infratentorial vessels.

lumbar puncture

Using lumbar puncture needle to puncture the subarachnoid space of the lumbar spinal cord is an important clinical auxiliary examination method in neurology. It can be used to measure cerebral pressure, collect cerebral effusion for routine, biochemical and bacteriological examination, tumor cell and enzymatic examination, and provide the basis for the diagnosis of intracranial inflammation, tumor, hemorrhage and cerebral white matter demyelination disease. However, when the intracranial pressure is too high, the lumbar puncture should be careful, it is best not to discharge the fluid, and only use the cerebrospinal fluid in the hose connected to the brain pressure gauge for testing to avoid brain herniation. Contrast can also be injected into the subarachnoid space for descending or ascending angiography. Air (or oxygen) can also be injected into the subarachnoid space, directional flow into the brain, do spinal lesions angiography, ventriculo-encephalography and cisternography.

Thoracic cavity puncture

pleural puncture

The puncture point is between the 7th to 9th intercostal space under the scapula or the 6th and 7th intercostal space in the midaxillary line. Air can be extracted to treat pneumothorax, inflammatory exudate from the pleural cavity can also be extracted, or drugs can be injected to treat pleurisy and relieve symptoms of respiratory distress. The extracted liquid can be used for testing and bacterial culture.

pericardiocentesis

The pericardial cavity was punctured from the 5th and 6th intercostal space of the left midclavicular line with a thoracic needle, outside the border of cardiac dullness. Draw out the inflammatory fluid to relieve the pressure on the heart. When replacing the needle tube during operation, the tube should be clamped to prevent air from entering. Antibiotics can also be injected into the pericardium for treatment.

Abdominal cavity and organ puncture

paracentesis

1 cm above the midpoint of the line connecting the umbilicus to the pubic bone, and 1 to 1.5 cm laterally to puncture the abdominal cavity. Used to diagnose unexplained ascites and release ascites to relieve dyspnea. It can also be injected into the abdominal cavity.

Liver puncture

Can be used for biopsy (see Liver biopsy).

kidney puncture

Using No. 9 and No. 10 lumbar puncture needles, the kidneys were punctured at the lower border of the 12th rib, 6 to 6.5 cm next to the dorsal midline, and biopsies were taken for examination. For unclear primary glomerulonephritis, pyelonephritis, nephrotic syndrome, multiple myeloma involving the kidney, renal tumor, nephrosclerosis, etc. Patients with muscle tendency, high blood pressure, perirenal abscess, and renal tuberculosis should not be punctured.

bladder puncture

The bladder is punctured above the midpoint of the pubis for patients with urinary retention due to enlarged prostate and failure of catheterization.

uterine puncture

The uterus is punctured above the pubic bone, and the amniotic fluid is removed to measure the lecithin/nitrophospholipid ratio, which is helpful to determine the fetal lung maturity, whether it is suffering from hyaline membrane disease after birth, and to predict the best time and best way of pregnancy.