Department of Family Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, Bloemfontein.
S Afr Fam Pract (2004). 2022 Aug 19;64(1):e1-e8. doi: 10.4102/safp.v64i1.5435.
Previous studies have found that indications for lumbar punctures (LPs) are managed differently, which raises the question of whether all LPs performed are clinically necessary. This study aimed to determine whether unnecessary (clinically not indicated) LPs were being performed at a district hospital in the Free State, South Africa.
This was a retrospective descriptive study. A list from the National Health Laboratory Service (NHLS) was used to identify all patients on whom an LP was performed in the adult emergency department of National District Hospital (NDH) in Bloemfontein, from 1 January 2018 to 30 June 2018. Data were captured on a data sheet and included demographic information, clinical signs and symptoms the patients presented with and the cerebrospinal fluid results.
A total of 364 patients fit the inclusion criteria. Of these patients, 97 files (26.6%) could not be found, patient gender and LP results could be retrieved from the NHLS barcodes. After reviewing the presenting symptoms and signs captured on the 267 files, the primary researcher considered 150 (56.4%) of the LPs performed to have been carried out unnecessarily. From the total population of 364 patients, 246 (67.6%) of the LP results were normal. Only 118 (32.4%) of the LPs performed showed some form of central nervous system pathology. Of the 150 LPs assessed to have been unnecessarily performed, 124 (84.0%) were normal.
This retrospective review indicates that a high percentage of LPs that were clinically not indicated were performed at NDH during the study period.
先前的研究发现，腰椎穿刺（LP）的适应证存在差异，这引发了一个问题，即所有进行的 LP 是否都是临床必需的。本研究旨在确定在南非自由州的一家地区医院是否进行了不必要的（临床无指征）LP。
这是一项回顾性描述性研究。使用国家卫生实验室服务（NHLS）的清单，从 2018 年 1 月 1 日至 2018 年 6 月 30 日，确定在布隆方丹国家地区医院（NDH）成人急诊科进行 LP 的所有患者。将数据记录在数据表上，包括人口统计学信息、患者就诊时的临床症状和体征以及脑脊液结果。
共有 364 名患者符合纳入标准。其中，97 份档案（26.6%）无法找到，患者性别和 LP 结果可从 NHLS 条码中检索到。在回顾了 267 份档案中记录的就诊症状和体征后，主要研究人员认为，其中 150 例（56.4%）LP 是不必要的。在 364 名患者的总人群中，246 例（67.6%）LP 结果正常。仅 118 例（32.4%）LP 显示出某种形式的中枢神经系统病变。在评估为不必要的 150 例 LP 中，124 例（84.0%）结果正常。
本回顾性研究表明，在研究期间，NDH 进行了大量临床无指征的 LP。
