腰椎穿刺方向对穿刺成功率及术后并发症的影响

Relation among puncture direction and the successful rate and post-puncture complications of lumbar puncture

目的观察腰椎穿刺方向对穿刺成功率及术后并发症的影响。方法采用最常用的侧卧位，将符合条件需要腰椎穿刺的104例患者，按不同腰椎穿刺方法分成A组和B组，各52例。测定腰椎穿刺术后脑脊液压力，观察腰椎穿刺成功率及术后并发症发生情况。结果A组穿刺成功率为78．8％（41／52），B组成功率为92．3％（48／52），组间腰椎穿刺成功率比较差异有统计学意义（P〈0．05）。2组穿刺成功者术后头痛、腰痛并发症发生率比较差异无统计学意义[A组分别为7．3％（3／41）、9．8％（4／41）：B组分别为8．3％（4／48）、12．5％（6／48），P〉0．05]。A组和B组穿刺成功者术后血压升高发生率比较差异无统计学意义[52．4％（22／41）比52．1％（25／48），P〉0．05]。结论正确的穿刺方法及穿刺方向可以提高穿刺成功率，不增加术后并发症。

Objective To assess the effect of puncture direction on the successful rate and complications of lumbar puncture. Methods From Jan. 2006 to Dec. 2011, 104 cases who were performed lumbar puncture were divided into A and B groups according to puncture direction, with 52 cases in each group. The success rate of lumbar puncture, the incidence of complications and the post-puncture blood pressure were recorded and compared. Results The success rate of lumbar puncture in group A was 78.8% （41/52）, lower than that in group B [92. 3% （48/52） ] （P 〈0. 05）. The incidence of headache and lumbodynia in group A and group B was 7. 3% （3/41）, 9. 8% （4/41） and 8.3 % （4/48）, 12. 5 % （ 6/48 ） （ P 〉 0. 05 ）. The incidence of increasing of blood pressure in patients with successful puncture between group A and group B was not significantly different [ 52.4% （22/41） vs 52.1% （25/48）, P 〉 0. 05 ]. Conclusion Correct puncture method and direction can achieve a high successful rate and do not increase post-puncture complications of lumber puncture.