Indications and contraindications for lumbar puncture?

Purpose of piercing:

(1) For diagnosis: 1. Take cerebrospinal fluid for testing. 2. Measure brain pressure to understand the level of intracranial pressure. 3. Perform cerebrospinal fluid dynamic examination. 4. Perform spinal cord or pneumoencephalography.

(2) For treatment: 1. Drainage of bloody cerebrospinal fluid. 2. Remove cerebrospinal fluid and reduce intracranial pressure. 3. Intrathecal injection of drugs to treat inflammation or tumors. complication

(1) Bloody cerebrospinal fluid problems:

The bloody cerebrospinal fluid problem caused by the accidental injury of the internal spinal venous plexus by the lumbar puncture needle is one of the most common complications of lumbar puncture. Its occurrence is often due to lack of experience, the needle is too deep, and the venous plexus in the spinal canal is accidentally injured. If not identified immediately, it is easy to be confused with pathological bloody cerebrospinal fluid. Bleeding due to accidental puncture injury can often stop quickly on its own, but individual patients with more bleeding may experience transient low back and leg pain due to blood stimulation, and only need to be given general symptomatic treatment.

(2) Low intracranial pressure syndrome:

Low intracranial pressure syndrome is usually caused by too much lumbar puncture needle used, or too early to get out of bed after operation, which causes too much outflow of cerebrospinal fluid from the lumbar puncture needle on the meninges, resulting in low intracranial pressure. The diagnosis can be made based on the fact that the patient's headache is significantly aggravated when sitting, and may be accompanied by nausea, vomiting or dizziness in severe cases, and the headache can be relieved or relieved when the patient is lying down or with the head lowered. Strictly requiring the patient to lie on his back for 6 hours after puncture can often prevent the occurrence of such complications.

(3) Sudden aggravation of the original spinal nerve root and spinal cord symptoms:

After the lumbar puncture, the buoyancy and cushioning effect of the cerebrospinal fluid is reduced, which promotes the compression of the nearby spinal cord or spinal nerve roots, resulting in sudden symptoms such as radicular pain, paraplegia, and bowel and bladder disorders. It is more likely to occur in patients with spinal cord compression. For high cervical spinal cord compression lesions, we should be more alert to the occurrence of serious complications such as dyspnea and even sudden respiratory arrest. Therefore, when cooperating with doctors for lumbar puncture, nurses should closely observe the patient. breathing and pulse.

(4) Formation or exacerbation of brain herniation:

Such complications are more likely to occur when intracranial pressure is increased, more and faster fluid discharge is performed during lumbar puncture, or the bed rest system is not strictly adhered to after lumbar puncture. Severe cases may suddenly stop breathing, unconsciousness or convulsions, and even cardiac arrest immediately. This is due to a sudden change in the dynamics of the cerebrospinal fluid pressure between the cranial and spinal canal after lumbar puncture. This complication can occur at the time of the puncture or within a few hours after the puncture. If the intracranial pressure is found to be high during the operation, the fluid should be stopped, and only the cerebrospinal fluid stored in the cerebrospinal fluid pressure tube can be tested. Patients were instructed to strictly abide by the bed rest system after surgery, and to observe changes in consciousness, respiration, pulse, blood pressure, pupil and limb movements within 12 to 24 hours. If necessary, prophylactic hypertonic dehydrating diuretics can be given as appropriate to prevent the formation or aggravation of brain herniation. If it happens, emergency measures should be taken immediately, and the doctor should be reported to the doctor. Quickly assist the doctor to rescue and reset the brain herniation.

(5) Injury to the cauda equina nerve root:

Such complications are rare clinically, and are mostly related to the deviation of the needle tip from the midline of the human body or accidental injury to the spinal nerve root. Symptoms such as lower extremity numbness, pain, or transient urination disturbance may occur, which often resolve spontaneously.

(6) Postoperative infection:

Postoperative infections were all caused by lax sterilization of lumbar push puncture instruments and items. It is completely avoidable if the aseptic technique is strictly followed.

(7) Deficiency meningitis:

This complication is fairly rare. It mostly occurs after injecting irritating drugs into the spinal cord subarachnoid space, and the patient can be distinguished from intracranial infection except for headache and mild meningeal irritation. It usually subsides on its own within 2-3 days after surgery.

If you have any questions, please contact us. Our company can produce various customized needles, medical needles, puncture needles, hypodermic needles, biopsy needles, vaccine needles, injection needles, syringe needles, veterinary needles, pencil point needle, ovum pick up needles, spinal needles, etc. If you need customized needle products, please contact us. We look forward to your inquiry! The quality of the products manufactured in our factory will surely satisfy you!

Please contact us if you need: zhang@sz-manners.com