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[腰椎穿刺——穿刺后综合征。使用“无创伤性”穿刺针预防及临床观察]

[Lumbar puncture--the post-puncture syndrome. Prevention with an "atraumatic" puncture needle, clinical observations].

作者信息

Jäger H, Krane M, Schimrigk K

机构信息

Neurologische Klinik des Bundesknappschaftskrankenhauses Püttlingen/Saar.

出版信息

Schweiz Med Wochenschr. 1993 Oct 23;123(42):1985-90.

PMID:8259481
Abstract

Postlumbar puncture syndrome (PPS) is caused by continuous leakage of CSF through the dural puncture defect. While it has long been known that the symptoms are dependent on the diameter of the puncture needle, the influence of the needle point on the frequency of PPS has now also been examined. Following diagnostic and/or therapeutic lumbar puncture (LP) with Sprotte's "atraumatic" needle, the symptoms in 600 patients during a period of 8 days were recorded. In 92% of the patients LP involved no problems. In 7% the puncture was successful only at the second or third attempt. In 4 cases it was necessary to carry out the procedure under X-ray control. While the literature shows that PPS following lumbar puncture with a 21 G needle occurs in 30-40% of cases, only 3.6% of the patients complained about position-dependent headaches where the Sprotte needle was used. Nausea, dizziness and tinnitus were extremely rare (< 1%).--The "atraumatic" puncture needle reduces the frequency and the degree of PPS to the minimum and makes the lumbar puncture procedure possible on an outpatient basis.

摘要

腰穿后综合征(PPS)是由于脑脊液通过硬脊膜穿刺缺损持续漏出所致。虽然长期以来人们都知道症状取决于穿刺针的直径,但现在也研究了针尖对PPS发生率的影响。在使用Sprotte“无创”针进行诊断性和/或治疗性腰椎穿刺(LP)后,记录了600例患者在8天内的症状。92%的患者腰椎穿刺未出现问题。7%的患者仅在第二次或第三次尝试时穿刺成功。4例患者需要在X线引导下进行操作。虽然文献表明使用21G针进行腰椎穿刺后PPS的发生率为30%-40%,但使用Sprotte针的患者中只有3.6%抱怨与体位有关的头痛。恶心、头晕和耳鸣极为罕见(<1%)。——“无创”穿刺针将PPS的发生率和程度降至最低,并使腰椎穿刺操作可以在门诊进行。

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