peritoneal puncture

Ascites refers to ascites exceeding normal values and retention, complications such as fever, proteinuria, and decreased urine output. In general, bacterial infections, tumors, tuberculous peritonitis, perforation of the digestive tract, and cirrhosis of the liver may cause ascites. Discharge should not be too fast, too much, cirrhosis patients usually do not exceed 3000ml once aspiration, excessive discharge can induce hepatic encephalopathy and electrolyte imbalance; but on the basis of maintaining a large amount of imported albumin, it can also be discharged in large quantities. If it is a diagnostic puncture, a small amount of ascites can be taken for examination and can be pulled out; if it is for treatment, it should not exceed 5000ml at most. Treatment of diseases: pelvic fluid Indication 1. Pumping for laboratory or pathological examination to assist in diagnosis. 2, a large amount of ascites caused by severe chest tightness, shortness of breath, moderate amount of fluid to relieve symptoms. 3, artificial gas abdomen as a means of diagnosis and treatment. 4, intraperitoneal injection of drugs. 5, a diagnostic puncture to determine whether there is empyema or hemorrhage in the abdominal cavity. Contraindications 1, severe intestinal flatulence. 2, pregnancy. 3, due to previous surgery or inflammation in the abdominal cavity has a wide range of adhesions. 4. Instigation, inability to cooperate and aura of hepatic encephalopathy. 5. Those who have bleeding tendency, 6. Those who have local infection at the puncture site Surgical procedure 1, sputum patients urinating, so as not to stab the bladder. 2. Take the lying position or the reclining position. If the abdomen is placed, the abdomen is placed on the back. 3, puncture point selection: 1. The intersection of the 1/3 and the middle 1/3 of the umbilical cord and the anterior superior iliac spine is used as the puncture point. When the ascites is used, the left puncture point is usually used. 2, about 1CM above the midpoint of the umbilical cord and pubic symphysis, left or right 1~1. 5CM. 3. If a diagnostic peritoneal lavage is performed, the puncture site is taken on the midline of the abdomen. 4, routine disinfection of the skin, the surgeon with sterile gloves, a hole towel, 1 to 2% procaine layer by layer anesthesia to the peritoneal wall layer (deep into the peritoneum), when the needle tip has a feeling of falling and back pumping ascites Pull out the needle. 5. As a diagnostic fluid, connect the syringe with a long needle of 17~18, and directly enter from the upper and lower oblique points by the puncture point. When the resistance suddenly disappears, it means to enter the abdominal cavity. After the liquid is pumped, the puncture needle is pulled out, the pinhole is squeezed, and the iodine is partially applied, covered with sterile gauze, and fixed with a tape. 6. When the abdominal cavity is discharged and decompressed, the long needle of the thoracic puncture is connected with a long sterile plastic tube, and the rubber tube is clamped by the blood vessel. The puncture needle is obliquely entered from the top to the bottom, and the ascites naturally flows out after entering the abdominal cavity. Discharge the latex tube in the container. The liquid should not be too much, too fast, generally not more than 3000ml each time. After the liquid is discharged, pull out the puncture needle and press the part with force. After disinfection, cover the sterile gauze, fix it with gauze, and tighten the bandage. 6, the intra-abdominal effusion is not much, abdominal puncture is unsuccessful, for the diagnosis, feasible diagnostic abdominal lavage, using the same method as diagnostic abdominal puncture.

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