腰椎穿刺术后垫枕与去枕对颅内压的影响  

Effect of Ad-Pillow or De-Pillow on the Intracranial Pressure After Lumbar Puncture

作　　者：米凯 杨霞锋 陈团芝 

机构地区：[1]聊城市脑科医院神经内科,山东聊城252000

出　　处：《护理学杂志》2008年第13期5-6,共2页

基　　金：2007年聊城市卫生局医学科研立项项目(14)

摘　　要：目的为腰椎穿刺术后患者提供安全、舒适的体位。方法选择脑出血行侧脑室引流的患者90例，测定颅内压后分为高颅压组、正常颅压组和低颅压组各30例；腰穿后每组均分别予以垫枕与去枕干预各15例．接受垫枕干预者腰穿后于枕下垫软枕（厚7～8cm），并每2小时翻身1次；接受去枕干预者按护理常规去枕平卧6h，每2小时将手伸至患者背部按摩皮肤。各组均在腰穿前，腰穿后30min、60min、2h、4h、6h分别监测脑室颅内压变化。结果高颅压和低颅压组患者垫枕和去枕对颅内压影响显著（均P〈0．05）；正常颅压组患者垫枕和去枕对颅内压影响无显著性意义（均P〉0．05）；接受去枕干预者皮肤反应发生率显著高于接受垫枕干预者（P〈0.01）。结论高颅压患者腰穿后采取垫枕位更合适，正常颅压患者腰穿后可以垫枕，低颅压患者腰穿后不宜垫枕。Objective To explore a safe and comfortable body position for patients after undergoing lumbar puncture. Methods The intracranial pressure （ICP） of 90 cerebrohemorrhage patients who were going to receive ventricular drainage through lumbar puncture were measured. And according to the results of ICP, the cases were divided into a high ICP group, a normal ICP group and a low ICP group, with each group having 30 cases. After lumbar puncture, 15 cases in each group were cushioned under the head by a pillow with a thickness of 7-8 cm and were asked to turn over every 2 h, while the other 15 lay supine without a pillow and received back massage by nurses every 2 h. The ICP values of 3 groups were measured before lumbar puncture and 30 min, 60 min, 2 h, 4 h, and 6 h after the procedure. Results Significant changes in the ICP values in the high ICP group and the low ICP group after ad-pitlow and de-pillow interventions （P〈0.05 for all）, while no significant changes in the ICP values were noted in the normal ICP group （P〉0. 05 for all）. Skin reaction rate in patients receiving ad-pillow intervention was significantly lower than that in their counterparts （P〈0.01）. Conclusion Patients with high ICP are more recommended to have a pillow under the head after lumbar puncture, that will also work in patients with normal ICP, but should be prohibited in patients with low ICP.

关 键 词：腰椎穿刺 体位 垫枕 去枕 颅内压 

分 类 号：R473.74[医药卫生—护理学]