神经疾病患者腰椎穿刺的共识指南。
Consensus guidelines for lumbar puncture in patients with neurological diseases.
作者信息
Engelborghs Sebastiaan, Niemantsverdriet Ellis, Struyfs Hanne, Blennow Kaj, Brouns Raf, Comabella Manuel, Dujmovic Irena, van der Flier Wiesje, Frölich Lutz, Galimberti Daniela, Gnanapavan Sharmilee, Hemmer Bernhard, Hoff Erik, Hort Jakub, Iacobaeus Ellen, Ingelsson Martin, Jan de Jong Frank, Jonsson Michael, Khalil Michael, Kuhle Jens, Lleó Alberto, de Mendonça Alexandre, Molinuevo José Luis, Nagels Guy, Paquet Claire, Parnetti Lucilla, Roks Gerwin, Rosa-Neto Pedro, Scheltens Philip, Skårsgard Constance, Stomrud Erik, Tumani Hayrettin, Visser Pieter Jelle, Wallin Anders, Winblad Bengt, Zetterberg Henrik, Duits Flora, Teunissen Charlotte E
机构信息
Reference Center for Biological Markers of Dementia (BIODEM), Department of Biomedical Sciences, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.
出版信息
Alzheimers Dement (Amst). 2017 May 18;8:111-126. doi: 10.1016/j.dadm.2017.04.007. eCollection 2017.
INTRODUCTION
Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as post-LP headache or back pain.
METHODS
We provide consensus guidelines for the LP procedure to minimize the risk of complications. The recommendations are based on (1) data from a large multicenter LP feasibility study (evidence level II-2), (2) systematic literature review on LP needle characteristics and post-LP complications (evidence level II-2), (3) discussion of best practice within the Joint Programme Neurodegenerative Disease Research Biomarkers for Alzheimer's disease and Parkinson's Disease and Biomarkers for Multiple Sclerosis consortia (evidence level III).
RESULTS
Our consensus guidelines address contraindications, as well as patient-related and procedure-related risk factors that can influence the development of post-LP complications.
DISCUSSION
When an LP is performed correctly, the procedure is well tolerated and accepted with a low complication rate.
引言
腰椎穿刺（LP）采集脑脊液用于多种神经性脑部疾病的诊断检查。不愿进行该操作的原因之一是缺乏将并发症风险（如腰穿后头痛或背痛）降至最低的标准和指南。
方法
我们提供腰椎穿刺操作的共识指南，以将并发症风险降至最低。这些建议基于：（1）一项大型多中心腰椎穿刺可行性研究的数据（证据级别为II-2）；（2）关于腰椎穿刺针特性及腰穿后并发症的系统文献综述（证据级别为II-2）；（3）阿尔茨海默病和帕金森病神经退行性疾病研究生物标志物联合项目以及多发性硬化症联盟内最佳实践的讨论（证据级别为III）。
结果
我们的共识指南涉及禁忌证以及可能影响腰穿后并发症发生的患者相关和操作相关风险因素。
讨论
当正确进行腰椎穿刺时，该操作耐受性良好且被广泛接受，并发症发生率较低。
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