First of all, I'm sorry to say that I don't have the book in my hand at the moment, so I can't give the page number~~
Intuitively, I tell you: about lumbar puncture, it should be easier to find it in the anesthesiology textbook (Clinical Anesthesiology?).
The clinical significance of lumbar puncture:
1. Diagnostic value: (1) Determination of cerebral pressure; (2) the presence of subarachnoid hemorrhage and intracranial infection; (3) lumbar puncture injection of gas to perform pneumoencephalography, injection of contrast medium to perform vertebral canalography; (4) Quiessel's test to check for vertebral canal obstruction.
2 . Therapeutic value: (1) discharge of cerebrospinal fluid to treat high cranial pressure, injection of saline to treat low cranial pressure; (2) discharge of hemorrhagic cerebrospinal fluid, injection of 5-10 ml of oxygen, can reduce the blood stimulation, promote the absorption of blood, and can prevent the occurrence of the subarachnoid space adhesions and traffic hydrocephalus; (3) lumbar puncture can be injected with effective antibiotics to treat the person who has central nervous system infection; (4) lumbar anesthesia injection.
Lumbar puncture mainly has the following purposes:
1, to understand the intracranial pressure and cerebrospinal fluid circulation pathway is smooth
2, retained cerebrospinal fluid sent to the test: routine, biochemistry, bacteriology, tumor cytology, and so on
3, the release of blood cerebrospinal fluid or high-protein cerebrospinal fluid
4, intrathecal injection
(I) Indications
1. Determine the nature of the cerebrospinal fluid to assist in the diagnosis of inflammatory or hemorrhagic diseases of the central nervous system (PS: personal understanding of "cerebral hemorrhage").
2. Determine the cerebrospinal fluid pressure, in order to understand the intracranial pressure and subarachnoid space patency.
3. For intracranial (or spinal cord) subarachnoid hemorrhage, inflammation, prevention of subarachnoid adhesions or hydrocephalus.
4. Perform lumbar spinal anesthesia or inject drugs slightly internally.
5. Oxygen is injected to treat adhesive arachnoiditis.
6. Perform other tests by lumbar puncture, such as vertebral angiography, pneumoencephalography, and radionuclide scanning of the ventricles and brain pools.
7. Diagnosis and differential diagnosis of inflammatory diseases of the central nervous system: including purulent meningitis, tuberculous meningitis, viral meningitis, mycobacterial meningitis, encephalitis B, and so on.
8. Diagnosis and differential diagnosis of cerebrovascular accidents: including cerebral hemorrhage, cerebral infarction, subarachnoid hemorrhage and so on.
9. Diagnosis and treatment of oncological diseases: for the diagnosis of meningeal leukemia and the treatment of meningeal leukemia by intrathecal injection of chemotherapeutic drugs through lumbar puncture.
(II) Contraindications
1. Posterior cranial recess occupational lesions, especially those with markedly increased intracranial pressure or suspected of early cerebral herniation, should be used with caution or prohibited.
2. Infected lesions in the skin or subcutaneous tissue at the puncture site.
3. Spinal tuberculosis and other spinal inflammatory diseases.
4. Critical patients with shock, sepsis, systemic infections, and other critical patients, failing or endangered patients.
5. Complications of lumbar puncture include impaired cardiopulmonary function and hemorrhage, so it is used with caution in patients with cardiopulmonary insufficiency and bleeding tendency.
6. Those with localized skin (near the puncture point) inflammation.