1.1 Kev npaj ua ntej puncture yog ib qho tseem ceeb ntawm kev txhim kho txoj kev vam meej ntawm qhov ua kom tus me nyuam nqos, thaum niam txiv tuav lub hauv caug ntawm tus me nyuam. Tus niam txiv kuj tuav lub hau ntawm ob sab tes, thiab ob txhais caj npab maj mam nias thiab khawm tus me nyuam Lub xub pwg ua kom nws zoo, thiab lwm daim kab xev uas ntev txaus rau ntawm tus menyuam lub taub hau tuaj yeem siv los tiv thaiv cov menyuam uas nplaum tsis tau tawm 10 cm ntawm ob hnub ntawm cov plaub hau thiab so feem ntau ntawm nruab nrab folds ua ke.
1.2 Cov Cim Ntawm Cov Hloov Ntawm Cov Hloov Pediatric Cov hlab plaub hau muaj ntau thiab yooj yim pom. Cov nkoj yuav tsum muab tso rau hauv ib qho reticular pattern. Ntshav yuav kis tau los ntawm cov chaw ntiav. Yog li ntawd, cov kev siv tshuaj tua kab mob thiab cov koob txhaj tshuaj tsis tuaj yeem cuam tshuam txog kev rov qab pleev xim dua. Tus nqi ntawm nruab nrab venous tuab, ncaj, tsis nplawm, yooj yim kho thiab yooj yim kho, tsis cuam tshuam rau cov dej num ntawm cov me nyuam, yooj yim kom sov, feem ntau dua; qhov ncauj hlab ntsha thiab pob ntseg ntawm sab nqaij tawv, ncaj, pom tseeb, tsis txhob xaub, vim muaj cov hlab ntsha me me Cov txheej txheem nrawm tsis yooj yim; cov leeg hauv qab pob ntseg yog me ntsis tuab, tab sis cov roj ntsha yog tuab heev, thiab nws tsis yooj yim los ntsuas qhov tob thiab qhov tob ntawm rab koob, thiab nws tsis zoo rau kev kho mob; cov leeg ntawm cov skulls yog tuab thiab ncaj tiamsis yooj yim los xaub.
1.3 Xaiv cov tawv taub hau, sim kom tsis txhob lub hauv paus ntawm cov pob txha ntawm lub hauv pliaj ntawm lub hauv siab, tus nqi ntawm cov hlab ntsha tawg, qhov tob hauv lub cev ib txwm yog 5 ° ~ 15 °, tom qab nkag rau ntawm daim tawv nqaij, mus tib seem mus rau tom qab tho, saib cov ntshav, koj kho tau. Cov leeg pob tsaig ntawm pob ntseg thiab cov sab phlu siab dawb yog 15 ° txog 30 °. Cov menyuam pob txha taub hau nrog rau lub taub hau, lub cev nqaij daim tawv, lub qhov muag ntawm daim tawv nqaij, qhov muag ntawm lub cev yog qhov khiav, tho lub pob yas nrig, lub kaum sab xis ntawm 30 ° ~ 60 °. Rau cov ntshiab tsis meej lossis tsis paub tseeb cov hlab ntsha, siv cov ntiv tes tawm mus rau hauv cov leeg, xav tias cov kev taw qhia ntawm cov hlab ntsha, qhov tob, lub thickness, thiab cov qib ntawm kev sib txeeb, thiab ces thim lawv. Lub ntsiab lus tseem ceeb yog tias tom qab rab koob slanting ntws nkag ntawm daim tawv nqaij, rab koob yog muab tso rau pem hauv ntej thiab downward ntawm ntiav mus tob, thiab cov ntshav yuav kho tom qab pom ntshav. Cov kws tu mob yuav tsum yog lub teeb, khov kho, qeeb, thiab muaj tseeb. Lawv yuav tsum xaiv cov hlab ntsha uas lawv xav tias muaj kev ntseeg siab txog. Thaum tus menyuam quaj qw, cov hlab ntsha hauv cov hlab ntsha hauv lub plab yuav ua raws li cov txheej txheem luv luv vim tias qhov nce ntawm kev rov tuaj ntawm kev rov qab veneous. Lub sij hawm no, lub sij hawm tsim nyog yuav tsum tau ntes nplua thiab lub puncture yuav tsum ua kom tiav.
1.4 Ua Ib Txoj Haujlwm Zoo rau Cov Niam Txiv Tau txais kev txhawb nqa ntawm cov niam txiv thiab kho cov me nyuam kom lawv tsis txhob sib thab.
1.5 Raws li qhov tob ntawm daim tawv nqaij yuav tsum siv qhov tsim nyog Siv cov hlab ntsha uas feem ntau pom muaj qhov muag liab qab yog ntiav, thiab cov hlab ntsha uas tsis pom los yog kov raug tob. Thaum cov hlab ntsha nqaj raug nplua, tsis txhob siv lub tsho ntev. Muaj tsis muaj qhov sib txawv nruab nrab ntawm ob sab ntawm phab ntsa venous, thiab tsis muaj kev tsis pom zoo rau ntshav khiav rov qab rau hauv lub plawv. Yog li ntawd, lub hlab ntsha nqaj yog qhov qeeb qeeb thiab tsis tshua mob heev dua cov leeg nyob rau hauv cov tawv nqaij. Yog li, thaum koj xav tias koob tau nkag mus rau hauv cov hlab ntsha thiab lub pob muaj qhov tsis zoo thiab tsis tuaj yeem rov mus rau cov ntshav, tsis txhob khiav tawm rab koob. Koj yuav tsum nres thiab tos, los sis rub tus ceg hmab hose nyob rau sab qis dua ntawm kev tso dej los yog hloov qhov chaw ntawm rab koob. Lub kaum ntse ntse yog feem ntau pom ntshav.
1.6 Cov Kev Xav Tau Cov Koob Tsheej Ntsuas Zoo siab pom zoo tias ntshav rov qab los. Nws yog ib qho tseem ceeb heev uas yuav tsum tau kho lub koob tshuaj rau lub sijhawm. Tom qab zoo tiav, kho lub koob ntiv tes nrog tus ntiv tes ntawm sab tes laug thiab nruab nrab ntiv tes thiab txhim kho nrog 3 mus rau 4 caj dab. Kho cov tawv taub hau nrog daim ntaub nplaum thiab taub hau. Koob rau lub voj voos yuav tsum tsim nyog, loj thiab yooj yim kom tau rub los yog kov tus kab mob hauv lub plab, dhau me me mus quav, ua rau muaj kev cuam tshuam. Cov lus tshwj xeeb yuav tsum tau ua kom txav tawm ntawm cov plaub hau ncig ntawm qhov teeb meem ua ntej puncture los pab txhawb cov kab xev kho. Yog hais tias tus me nyuam muaj kev nyuaj siab vim kev quaj los yog siv cov tshuaj yeeb tshuaj tiv thaiv thiab cuam tshuam rau qhov txhim kho ntawm daim kab xev, nws tuaj yeem tsau rau ntawm daim nplaum nplaum ntawm qhov taw qhia ntawm lub taub hau ntawm lub taub hau ntawm lub taub hau kom tsis txhob poob ntawm daim kab xev tawm. Thaum cov lus pom zoo lawm, yuav tsum mloog zoo rau kev koom tes ntawm tes, sab tes xis los tuav daim kab xev sab laug ntiv tes nrog muab tshuaj, thiab sim ntxig rau daim kab xev, kom ruaj thiab ntev ntev rau ntawm qhov ruaj, nyob ntawm qhov teeb meem tuaj yeem tsau ncaj nraim los yog kab ntu txav ntawm kab ntawv saum toj.
1.7 Lub puncture tseem yuav tsum tau them sai sai rau ntau cov ntsiab lus los kho tus kab mob hauv lub plhaub taum rov qab los ntawm lub lauj kaub, vim hais tias tus tswj nyob ze rau ntawm lub lauj kaub, lub me me siab nyob rau hauv lub infusion tube, siab dua tus nqi ntawm cov ntshav rov qab; vascular bifurcation at cautious hnav, Lub koob raug tso me ntsis ntxiv ntawm cov hlab ntsha. Tom qab rab koob tau tso, tus koob txhaj rau ntawm lub plab hlaub ntshav; cov hlab ntsha ntawd tau kov nrog cov ntiv tes me ntsis, thiab cov hlab ntsha tseem tseem ntsia xiav thiab ncaj thaum ntiv tes tawm. Yog tias koj kov koj cov ntiv tes, cov hlab ntsha uas pom tsis tau yog tsis muaj; transverse cov hlab ntsha tuaj yeem raug muab pov tseg. Cov kev taw qhia qhov taw qhia yog rub tawm hauv cov kev taw qhia centripetal. Vim hais tias cov hlab ntsha hauv cov hlab ntsha ntawm cov hlab plawv tuaj yeem muab faib ua ib qho qauv zoo, lawv tuaj yeem mus sab laug thiab sab xis. Yog li ntawd, nyob rau hauv cov kev taw qhia cov lus taw qhia hnoos yuav hnav tau, cov tshuaj yuav tsum muab coj los siv. Yog hais tias cov hlab ntsha twb tau raug nplua lawm lawm, lub iav tau muab tso rau hauv pem hauv ntej ntawm qhov taw tes. Muaj cov hlab ntsha hauv cov hlab ntsha hauv cov pos hniav los sis cov sab nraud ntawm cov hlab ntsha thiab qhov elasticity zoo, thiab cov kev taw qhia ntawm txoj hlua yuav kho tau. Cov kua tsis kis ntawm lub qhov muag tsis pom thiab tsis yog nws xau.
1.8 Feem xyuam ntawm kev puas siab puas ntsws Txhaum cov kws saib xyuas neeg mob yuav tsum tuav lub dag zog, kev ruaj ntseg ntawm kev kho mob lub xeev, kom txo tau qhov tsis ua hauj lwm. Kev vam meej ntawm lub plab hlaub menyuam hauv plab tsis muaj nyob ntawm theem ntawm kev siv tshuab, tab sis kuj rau lub hlwb, phom sij, cuam tshuam thiab cuam tshuam ntawm ib puag ncig ib puag ncig, yog tias tsim nyog, niam txiv yuav tsum zam.
1.9 Yog vim li cas rau cov neeg pluag uas tsis muaj dej nyob hauv cov hlab ntsha, tab sis thaum muaj pes tsawg tus drips tsis muaj, muaj ntau yam: qhov ntxeev ntawm rab koob ntawm rab koob phab ntsa hauv cov hlab ntsha, thiab lub koob ncoo yuav kho nrog cotton swab; lub siab nyob rau hauv lub raj mis infusion yog tsawg, thiab qhov infusion sawv yog tsa; Cia tus me nyuam nyob ntsiag to thiab khaws nws los ntawm quaj; thaum tsis muaj lwm yam, qhov hno rab koob yuav tuaj yeem nrawm nrog lub pob caus ntawd.
