Özdamar Emre, Özkaya Ahmet Kağan, Güler Ekrem, Cantay Burcu, Karabel Nihal, Göksügür Yalçin, Çetinkaya Ahmet, Emre Özcan
From the Departments of *Pediatrics, and †Pediatric Emergency, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras; ‡Department of Pediatric Emergency, Faculty of Medicine, Gazi University, Ankara; and §Department of Radiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Pediatr Emerg Care. 2017 Aug;33(8):e21-e23. doi: 10.1097/PEC.0000000000000593.
Lumbar puncture (LP) is one of the essential diagnostic tools in pediatric emergency services. Recently, ultrasound-assisted LP was reported to be beneficial in the emergency service by facilitating the procedure and improving the successful procedure rates. In addition, this method may be effective in reducing patient and parent anxiety due to the LP procedure.
The aim of this study was to investigate the effect of ultrasound-assisted LP on the outcomes of puncture procedures and traumatic LP.
The study included patients younger than 18 years, who were admitted to the pediatric emergency service and underwent LP because of suspected central nervous system infection. The patients requiring LP were randomly divided into 2 groups designated as odd and even. One group received LP using the conventional method, whereas the other group had LP after spinal space measurement by ultrasound. The patients who did and who did not undergo ultrasound-assisted LP were compared for demographics, number of puncture attempts, and traumatic LP. Statistical analysis was performed using the Mann-Whitney U test and the Student t test. The χ test was used when nominal data were compared between the 2 groups.
Ultrasound-assisted LP was performed in 56 patients, and LP by using conventional method was performed in 55 patients. There was traumatic LP in 5 (8.9%) of the patients who underwent ultrasound-assisted LP and 9 (16.3%) of the patients who underwent LP using the conventional method (P > 0.05). The number of puncture attempts was 2 or more in 2 (3.5%) of the patients who underwent ultrasound-assisted LP and 5 (9%) of the patients who had LP using the conventional method (P > 0.05).
Ultrasound-assisted LP reduced traumatic LP and the number of puncture attempts in pediatric patients; however, the results were not statistically significant.
腰椎穿刺（LP）是儿科急诊服务中的重要诊断工具之一。最近，有报道称超声引导下的LP在急诊服务中有助于简化操作并提高成功率。此外，该方法可能有效减轻患者及其家长因LP操作而产生的焦虑。
本研究旨在探讨超声引导下LP对穿刺操作结果及LP所致创伤的影响。
本研究纳入年龄小于18岁、因疑似中枢神经系统感染入住儿科急诊并接受LP的患者。需要进行LP的患者被随机分为奇数组和偶数组。一组采用传统方法进行LP，另一组在超声测量椎间隙后进行LP。比较接受和未接受超声引导下LP的患者的人口统计学特征、穿刺尝试次数及LP所致创伤。采用Mann-Whitney U检验和Student t检验进行统计学分析。两组间比较名义数据时使用χ检验。
56例患者接受了超声引导下LP，55例患者采用传统方法进行LP。接受超声引导下LP的患者中有5例（8.9%）发生LP所致创伤，采用传统方法进行LP的患者中有9例（16.3%）发生LP所致创伤（P>0.05）。接受超声引导下LP的患者中有2例（3.5%）穿刺尝试次数为2次或更多，采用传统方法进行LP的患者中有5例（9%）穿刺尝试次数为2次或更多（P>0.05）。
超声引导下LP可减少儿科患者LP所致创伤及穿刺尝试次数；然而，结果无统计学意义。
