比较超声波和表面地标引导的腰椎穿刺在患有肥胖和难以解剖的患者;一个随机对照试验
Pitsucha Sanguanwit1, Phantakan Tansuwannarat2,3, Chinnarat Bua-Ngam4
1Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Archives of academic emergency medicine
|September 6, 2023
概括
超声指导显著改善肥胖或难以解剖的患者的腰椎穿刺 (LP) 成功率. 与传统的里程碑技术相比,这种方法还可以减少手术时间和创伤并发症.
科学领域:
- 医疗成像医学成像
- 干预程序 干预程序
- 紧急医疗 紧急医疗
背景情况:
- 腰部穿刺 (LP) 的成功率在患有肥胖或难以解剖的患者中可能具有挑战性.
- 在之前的研究中,超声指导已经显示出改善LP结果的潜力.
研究的目的:
- 为了比较超声导向LP的第一次尝试成功率与使用可触摸的脊柱地标的盲人技术.
- 评估在特定患者群体中两种技术之间的手术持续时间和并发症率.
主要方法:
- 一项前性随机对照研究在一个学术三级大学医院进行.
- 招募了40名患者,并随机分为表面地标指导或超声波指导的LP组.
- 收集的数据包括首次尝试成功率,程序持续时间和创伤性刺穿的发生率.
主要成果:
- 超声波引导的LP表现出明显更高的第一次尝试成功率 (80%) 与地标引导的LP (35%) 相比.
- 超声组经历了更短的中位数程序持续时间 (5分钟对13.5分钟).
- 虽然在超声组中创伤性刺伤的频率较低,但这种差异在统计学上并不显著.
结论:
- 超声指导提高了肥胖或难以解剖的患者的腰部穿刺的第一次尝试成功率.
- 超声波的使用还缩短了程序的持续时间,并减少了创伤性触摸的发生率.
- 超声波引导的LP在具有挑战性的患者病例中提供了更好的结果和效率.
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