McIntyre P, Isaacs D
Department of Pediatrics, Westmead Hospital, New South Wales, Australia.
J Paediatr Child Health. 1995 Feb;31(1):1-2. doi: 10.1111/j.1440-1754.1995.tb02899.x.
The importance of lumbar puncture (LP) as part of the evaluation of suspected neonatal sepsis is assessed, as it may be the only positive diagnostic test in about 10% of septic babies with meningitis but negative blood cultures. However, LP may compromise respiratory function, and the interpretation of cerebrospinal fluid (CSF) may not be straightforward.
The clinical setting and the probability of meningitis are important determinants of the likely value of LP. For asymptomatic neonates with obstetric risk factors for sepsis, and for babies with early-onset respiratory distress alone, LP may be delayed and only performed later if blood cultures are positive. This is because hundreds of LP will be needed to diagnose a single case. However, infants with suspected late-onset sepsis should have an immediate LP because finding Gram-negative bacilli or fungi in the CSF will affect treatment choices.
评估腰椎穿刺（LP）作为疑似新生儿败血症评估一部分的重要性，因为在约10%患有脑膜炎但血培养阴性的败血症婴儿中，它可能是唯一的阳性诊断测试。然而，LP可能会损害呼吸功能，并且脑脊液（CSF）的解读可能并不简单。
临床情况和患脑膜炎的可能性是LP可能价值的重要决定因素。对于有败血症产科危险因素的无症状新生儿，以及仅患有早发性呼吸窘迫的婴儿，LP可能会延迟进行，只有在血培养呈阳性时才在之后进行。这是因为诊断一例病例需要进行数百次LP。然而，疑似晚发性败血症的婴儿应立即进行LP，因为在脑脊液中发现革兰氏阴性杆菌或真菌会影响治疗选择。
