创伤性与传统的腰部穿刺针:系统审查和元分析
Siddharth Nath1, Alex Koziarz1, Jetan H Badhiwala2
1Division of Neurosurgery, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.
Lancet (London, England)
|December 11, 2017
概括
与传统针相比,创伤针显著降低了穿刺后头痛率和再入院率,为腰部穿刺手术提供了更安全的选择. 这一系统审查提供了支持它们使用的高质量证据.
科学领域:
- 神经学
- 麻醉学
- 医疗器械
背景情况:
- 腰部穿刺是一种常见的诊断和治疗程序.
- 创伤针的设计是为了尽量减少像PDPH这样的并发症.
- 尽管有建议的好处,但无创性针的临床应用仍然不足.
研究的目的:
- 系统地审查和对患者的结果进行元分析,比较刺针和常规刺针.
- 评估无创针在减少PDPH和其他并发症方面的有效性和安全性.
主要方法:
- 随机对照试验的系统审查和元分析.
- 搜索了13个数据库从创建到2017年8月.
- 包括110项试验,共31412名参与者,比较部刺穿的创伤针和常规针.
主要成果:
- 创伤性针显著降低了PDPH发生率,从11. 0%降至4. 2% (RR 0. 40,P< 0. 0001).
- 与减少静脉注射液体,止痛药和外周血块的需要有关.
- 没有明显的成功率,失败率或创伤率的差异.
结论:
- 创伤性针头与PDPH的发病率较低,并减少再次入院进行额外治疗.
- 它们的疗效与传统的腰部穿刺针相似.
- 高质量的证据支持创伤性针对于经历腰部穿刺的患者来说是一个优秀的选择.
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