Sempere A P, Berenguer-Ruiz L, Lezcano-Rodas M, Mira-Berenguer F, Waez M
Servicio de Neurología, Hospital General Universitario de Alicante, Spain.
Rev Neurol. 2007;45(7):433-6.
Although first described over 100 years ago, lumbar puncture is still an important tool in the diagnosis of neurological diseases. In this article we review its indications, contraindications, the technique for carrying it out, the analysis of the cerebrospinal fluid and possible complications.
The lumbar puncture has diagnostic and therapeutic indications. The chief diagnostic indications include infectious, inflammatory and neoplastic diseases affecting the central nervous system. Complications are infrequent, except for headaches and low back pain, but can be severe. Analysis of the cerebrospinal fluid must include a cell count and determination of the glucose and protein concentrations. The other analytical studies of cerebrospinal fluid must be conducted according to the diagnostic suspicion.
The lumbar puncture in expert hands is a safe test. The health professional should be suitably familiar with its contraindications, the regional anatomy and the technique used to perform it.
尽管腰椎穿刺在100多年前就首次被描述,但它仍是诊断神经疾病的一项重要工具。在本文中,我们将回顾其适应证、禁忌证、操作技术、脑脊液分析及可能的并发症。
腰椎穿刺具有诊断和治疗适应证。主要诊断适应证包括影响中枢神经系统的感染性、炎症性和肿瘤性疾病。除头痛和腰痛外,并发症并不常见,但可能很严重。脑脊液分析必须包括细胞计数以及葡萄糖和蛋白质浓度的测定。其他脑脊液分析研究必须根据诊断怀疑进行。
由专业人员操作的腰椎穿刺是一项安全的检查。卫生专业人员应充分熟悉其禁忌证、局部解剖结构及操作所用技术。