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控制性腰椎穿刺术可提高腰椎穿刺的安全性。

A controlled lumbar puncture procedure improves the safety of lumbar puncture.

作者信息

Li Chun, Li Miaomiao, Wang Yixian, Li Shaoyi, Cong Lin, Ma Weining

机构信息

Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.

Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Front Neurosci. 2023 Dec 5;17:1304150. doi: 10.3389/fnins.2023.1304150. eCollection 2023.

Abstract

BACKGROUND

In order to improve the safety of lumbar puncture (LP), we designed a new type of LP needle, that is, an integrated and controlled LP needle, which can actively and accurately control the flow rate and retention of cerebrospinal fluid (CSF) during puncture, so as to achieve a controlled LP procedure.

OBJECTIVE

To evaluate whether a controlled LP procedure can improve the comfort of LP and reduce the risk of complications associated with LP.

METHODS

Patients requiring LP (n = 63) were pierced with an integrated and controlled LP needle or a conventional LP needle. The differences in vital signs, symptom score, comfort, operation time, CSF loss, CSF pressure fluctuation and back pain before and after puncture were analyzed.

RESULTS

An integrated and controlled LP needle (n = 35) significantly improved patients' headache symptoms before and after puncture. In addition, a controlled LP procedure significantly reduced the amount of unnecessary CSF loss ( < 0.001), shortened the time of puncture ( < 0.001), improved patient comfort ( = 0.001) and reduced the incidence of back pain ( < 0.001). For patients with high intracranial pressure (HICP), the fluctuations in pressure of the CSF were also reduced while obtaining similar amounts of CSF ( = 0.009).

CONCLUSION

A controlled LP procedure avoids unnecessary CSF loss, prevents rapid fluctuations in CSF pressure in patients with HICP, and reduces the risks associated with LP.

摘要

背景

为提高腰椎穿刺(LP)的安全性,我们设计了一种新型LP针,即集成可控LP针,其在穿刺过程中可主动、准确地控制脑脊液(CSF)的流速和留取量,从而实现可控的LP操作。

目的

评估可控LP操作是否能提高LP的舒适度并降低与LP相关的并发症风险。

方法

需要进行LP的患者(n = 63)分别使用集成可控LP针或传统LP针进行穿刺。分析穿刺前后患者生命体征、症状评分、舒适度、操作时间、CSF丢失量、CSF压力波动及背痛情况的差异。

结果

集成可控LP针组(n = 35)显著改善了患者穿刺前后的头痛症状。此外,可控LP操作显著减少了不必要的CSF丢失量(<0.001),缩短了穿刺时间(<0.001),提高了患者舒适度(=0.001)并降低了背痛发生率(<0.001)。对于颅内压增高(HICP)患者,在获取相似量CSF的同时,CSF压力波动也减小了(=0.009)。

结论

可控LP操作可避免不必要的CSF丢失,防止HICP患者CSF压力快速波动,并降低与LP相关的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a604/10728282/623ac15bad84/fnins-17-1304150-g001.jpg

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