Joshi P, Barr P
Department of Neonatology, Royal Alexandra Hospital for Children, Parramatta, New South Wales, Australia.
J Paediatr Child Health. 1998 Feb;34(1):74-8. doi: 10.1046/j.1440-1754.1998.00158.x.
To ascertain the current use of lumbar puncture (LP) and laboratory tests for possible or suspected sepsis by Australian neonatologists.
A self administered anonymous response questionnaire.
Sixty-nine (73%) of 94 neonatologists responded. None performed LP routinely in preterm infants with respiratory distress syndrome (RDS) or asymptomatic term infants with maternal Group B streptococcus (GBS) colonisation. One (1.6%) performed LP in term infants with respiratory distress, and only 35 (51%) performed LP in preterm infants with suspected late-onset sepsis (LOS). Twenty-one percent did not perform LP on all preterm infants with RDS and septicaemia and 24% did not perform LP on all preterm infants with late-onset septicaemia. Sixty-six percent and 85% did not perform LP for laboratory evidence suggestive of sepsis in preterm infants with RDS and preterm infants with LOS, respectively. Forty-nine percent investigated asymptomatic term infants with maternal GBS colonisation.
Lumbar puncture and laboratory tests for possible or suspected sepsis are not used uniformly by Australian neonatologists. The presently available information in the scientific literature is ambiguous and systematic review and further scientific study are required to determine best practice guidelines.
确定澳大利亚新生儿科医生目前对腰椎穿刺(LP)以及针对可能或疑似败血症的实验室检查的使用情况。
采用自行填写的匿名调查问卷。
94名新生儿科医生中有69名(73%)做出回应。对于患有呼吸窘迫综合征(RDS)的早产儿或母亲为B族链球菌(GBS)定植的无症状足月儿,无人常规进行LP检查。1名(1.6%)医生对有呼吸窘迫的足月儿进行了LP检查,而对于疑似晚发性败血症(LOS)的早产儿,只有35名(51%)医生进行了LP检查。21%的医生没有对所有患有RDS和败血症的早产儿进行LP检查,24%的医生没有对所有患有晚发性败血症的早产儿进行LP检查。分别有66%和85%的医生没有对患有RDS的早产儿和患有LOS的早产儿进行LP检查以获取提示败血症的实验室证据。49%的医生对母亲为GBS定植的无症状足月儿进行了检查。
澳大利亚新生儿科医生对可能或疑似败血症的腰椎穿刺和实验室检查的使用并不统一。科学文献中目前可用的信息不明确,需要进行系统综述和进一步的科学研究来确定最佳实践指南。