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采用泰勒入路成功进行腰椎穿刺，用于强直性脊柱炎患者脑膜炎的诊断性检查。

Successful lumbar puncture with Taylor's approach for the diagnostic workup of meningitis in a patient with Ankylosing spondylitis.

作者信息

Shrestha Gentle Sunder, Acharya Subhash Prasad, Keyal Niraj, Paneru Hem Raj, Shrestha Pramesh Sunder

机构信息

Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.

Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.

出版信息

Indian J Crit Care Med. 2015 Oct;19(10):618-20. doi: 10.4103/0972-5229.167053.

DOI:10.4103/0972-5229.167053
PMID:26628829
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4637964/
Abstract

Meningitis and encephalitis are the neurological emergencies. As the clinical findings lack specificity, once suspected, cerebrospinal fluid (CSF) analysis should be performed and parenteral antimicrobials should be administered without delay. Lumbar puncture can be technically challenging in patients with ankylosing spondylitis due to ossification of ligaments and obliteration of interspinous spaces. Here, we present a case of ankylosing spondylitis where attempts for lumbar puncture by conventional approach failed. CSF sample was successfully obtained by Taylor's approach.

摘要

脑膜炎和脑炎是神经系统急症。由于临床表现缺乏特异性，一旦怀疑，应立即进行脑脊液（CSF）分析并给予胃肠外抗菌药物。对于强直性脊柱炎患者，由于韧带骨化和棘突间隙闭塞，腰椎穿刺在技术上可能具有挑战性。在此，我们报告一例强直性脊柱炎患者，采用传统方法进行腰椎穿刺失败，最终通过泰勒入路成功获取脑脊液样本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8548/4637964/c6464e29f7ff/IJCCM-19-618-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8548/4637964/3183f5790cc7/IJCCM-19-618-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8548/4637964/c6464e29f7ff/IJCCM-19-618-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8548/4637964/3183f5790cc7/IJCCM-19-618-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8548/4637964/c6464e29f7ff/IJCCM-19-618-g002.jpg

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本文引用的文献

1
Subarachnoid block with Taylor's approach for surgery of lower half of the body and lower limbs: A clinical teaching study.泰勒入路蛛网膜下腔阻滞用于下半身及下肢手术的临床教学研究
Anesth Essays Res. 2012 Jan-Jun;6(1):38-41. doi: 10.4103/0259-1162.103370.
2
Ultrasound imaging for lumbar punctures and epidural catheterisations: systematic review and meta-analysis.超声引导下腰椎穿刺和硬膜外导管置管术的影像学研究：系统评价和荟萃分析。
BMJ. 2013 Mar 26;346:f1720. doi: 10.1136/bmj.f1720.
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Emergency neurologic life support: meningitis and encephalitis.
紧急神经生命支持：脑膜炎和脑炎。
Neurocrit Care. 2012 Sep;17 Suppl 1:S66-72. doi: 10.1007/s12028-012-9751-8.
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Ultrasound imaging facilitates spinal anesthesia in adults with difficult surface anatomic landmarks.超声成像有助于在体表解剖标志困难的成人中进行脊髓麻醉。
Anesthesiology. 2011 Jul;115(1):94-101. doi: 10.1097/ALN.0b013e31821a8ad4.
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Ultrasound guidance for neuraxial analgesia and anesthesia in obstetrics: a quantitative systematic review.超声引导在产科中的神经轴阻滞镇痛和麻醉中的应用：一项定量系统评价。
Ultraschall Med. 2012 Dec;33(7):E132-E137. doi: 10.1055/s-0029-1245724. Epub 2010 Nov 15.
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Taylor's approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists.针对拟行经皮肾镜取石术的强直性脊柱炎患者的泰勒方法：给麻醉医生带来的一项挑战。
Saudi J Anaesth. 2009 Jul;3(2):87-90. doi: 10.4103/1658-354X.57879.
7
Effect of delayed lumbar punctures on the diagnosis of acute bacterial meningitis in adults.延迟腰椎穿刺对成人急性细菌性脑膜炎诊断的影响。
Emerg Med J. 2010 Jun;27(6):433-8. doi: 10.1136/emj.2009.075598. Epub 2010 Apr 1.
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Antibiotic treatment delay and outcome in acute bacterial meningitis.急性细菌性脑膜炎的抗生素治疗延迟与预后
J Infect. 2008 Dec;57(6):449-54. doi: 10.1016/j.jinf.2008.09.033. Epub 2008 Nov 9.
9
How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis?我如何进行腰椎穿刺并分析结果以诊断细菌性脑膜炎？
JAMA. 2006 Oct 25;296(16):2012-22. doi: 10.1001/jama.296.16.2012.
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