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我如何进行腰部穿刺并分析结果以诊断细菌性脑膜炎?
Sharon E Straus1, Kevin E Thorpe, Jayna Holroyd-Leduc
1Division of General Internal Medicine, University of Calgary, Alberta. sharon.straus@utoronto.ca
在诊断腰部穿刺 (LPs) 期间使用创伤针和重新插入笔可能会降低头痛风险. 脑脊液 (CSF) 分析可以准确诊断细菌性脑膜炎.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 医疗程序 医疗程序
背景情况:
- 诊断性腰部穿刺 (LPs) 对于排除脑膜炎至关重要,但会带来不良事件的风险.
- 对LP技术和脑脊液 (CSF) 分析准确性的证据的系统审查.
研究的目的:
- 审查诊断LP技术,尽量减少不良事件.
- 为了评估成年人细菌性脑膜炎的CSF分析的测试准确性.
主要方法:
- 随机试验和诊断准确性研究的系统审查.
- 搜索了科克兰图书馆,MEDLINE和EMBASE数据库.
- 数据提取和质量评估由两名独立调查人员进行.
主要成果:
- 创伤性针在减少LP后头痛方面表现出不显著的趋势.
- 在取出针头之前重新插入针头显著降低了头痛风险.
- 脑流中的葡萄糖比≤0.4,白细胞计数≥500/μL,乳酸≥3.5 mmol/L,准确诊断出细菌性脑膜炎.
结论:
- 小尺寸的无创针可以降低诊断LP后头痛的风险.
- 建议重新插入笔;不需要LP后的常规床上休息.
- 未来的研究应该专注于优化LP成功和程序培训.
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