患者,男,18岁。因外伤致左手、左前臂肿痛,活动受限2 h入院。患者入院前2 h工作时不慎被机器绞伤左上肢,当即感左手、左前臂疼痛,活动受限,病程中无肢体麻木。刻下症:左前臂及左手肿胀畸形,左腕关节旋转受限。至我院门诊就诊,行X线片检查示（图1a,1b）:左尺骨骨折,左桡骨可塑性弯曲,左第1掌骨、第5指骨近节骨折。门诊以"左尺骨骨折,左桡骨可塑性弯曲,左第1掌骨、第5指骨近节

Study Objective: A novel pressure bladder indicator was developed, and this study aimed to evaluate the clinical application of the pressure bladder indicator by measuring the epidural space pressure and bladder working pressure on patients undergoing lumbar epidural puncture.Design: Randomized, prospective, double-blinded studyPatients: 130 patientsSetting: The Second Hospital of Shandong UniversityInterventions: In this study, 60 patients undergoing surgical procedures under lumbar epidural anesthesia were enrolled to detect epidural pressure, and other 70 patients who were undergoing lumbar epidural anesthesia or combined spinal-epidural anesthesia were enrolled to evaluate the pressure bladder indicator.Measurements: After successful breakthrough of ligamentum flavum by traditional methods, a pressure transducer was connected to an epidural needle tail and a monitor to measure the epidural pressure at L1-L5 in 60 patients. The working pressure of the bladder was also measured by a transducer. Then lumbar epidural puncture was performed with the pressure bladder indicator in other 70 patients.Main Results: The lumbar epidural pressure of the 60 patients was 9.8 +/- 4.3 mm Hg, and the bladder working pressure of the pressure bladder indicator was 122 +/- 15 mm Hg. All these 70 patients were confirmed with successful bladder indication and lumbar epidural puncture. Thus, the coincidence ratio was 100%.Conclusions: The novel developed pressure bladder indicator was a reliable and useful technique to conduct successful lumbar epidural puncture. (C) 2015 Elsevier Inc. All rights reserved.

Objective To evaluate the efficacy of pressure bladder indicator in guiding epidural puncture.Methods Test Ⅰ Thirty-two patients scheduled for epidural puncture were studied. After successful epidural puncture, the end of the epidural needle was connected to a pressure sensor to measure the epidural space pressure. Test Ⅱ Seventy patients scheduled for epidural puncture were studied. The epidural puncture was performed using the pressure bladder indicator. The successful condition of the pressure bladder indicator in guiding epidural puncture was recorded. Results The epidural space pressure was ( 10 ± 4) cm H2O. Seventy patients completed epidural pucture under the guidance of the pressure bladder indicator. The success rate was 100%.Conclusion The pressure bladder indicator can serve as an assistance for epidural puncture and has clinical application value.