在血小板缺血的腰部穿刺:地板不坚固
Michael Kozak1, David R Hallan1, Mason Stoltzfus1
1Neurosurgery, Penn State College of Medicine, Hershey, USA.
Cureus
|August 18, 2023
概括
这项研究发现,低血小板计数 (血小板缺血) 并不会显著增加腰部穿刺后脊髓出血的风险. 然而,患有血栓塞缩症的患者更有可能需要进行血贴手术.
科学领域:
- 神经学 神经学
- 血液学 血液学 血液学
- 医疗程序 医疗程序
背景情况:
- 腰部穿刺 (LP) 是用于脑脊液 (CSF) 分析的常见诊断程序.
- 血小板减少,或血小板数量低,传统上被认为是LP并发症的危险因素,特别是脊髓出血.
- 目前的指导方针在进行LP之前推特定的血小板值,但这些值的证据仍在争论中.
研究的目的:
- 为了比较经过LP的患者的并发症率,包括和没有血小板狭窄症.
- 评估血小板减少和LP后脊柱出血,或需要脊柱减压之间的关联.
- 建立基于证据的血小板计数值,以确保LP的安全性能.
主要方法:
- 使用TrinetX多机构电子健康记录数据库进行了回顾性分析.
- 倾向性得分匹配了经过LP的有或没有血小板减少症 (10,000-50,000血小板/μL) 的患者队列.
- 评估的结果包括体内血瘤,外腔血瘤,脑下关节下出血,血块,和脊柱减压.
主要成果:
- 血栓缩和非血栓缩组之间脊髓出血率没有显著差异 (1.496%对1.09%).
- 显著更高的收到血贴在血栓塞缩小组 (OR 5.906) 的几率.
- 在率或需要脊柱减压方面没有显著差异.
结论:
- 30天内LP后脊髓出血的发生率与血小板计数低于50,000个血小板/μL并没有显著相关.
- 血小板缩不会显著增加LP后或脊柱减压的风险.
- 血小板缺血与LP后需要血块的可能性显著增加有关.
关键词:
出血的风险 发生出血的风险epidural epidural 周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周周腰部穿刺 (lp) 是指腰部穿刺.脊柱血腫 脊柱血腫 的相關搜尋血小板细胞减少症 (Thrombocytopenia) 是一种
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