硬膜外血补丁预防硬脊膜穿刺后头痛的效果探讨  

Discussion of efficacy of prophylactic epidural blood patch in preventing post-dural puncture headache

作　　者：孟才华 冯秀珍 曹丽蓬 MENG Cai-hua;FENG X iu-zhen;CAO Li-peng(Department of Anesthesiology,Guangzhou Women and Children’s Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心麻醉科,510623

出　　处：《中国实用医药》2020年第25期1-3,共3页China Practical Medicine

摘　　要：目的探讨预防性硬膜外血补丁(EBP)预防硬脊膜穿刺后头痛(PDPH)的效果及安全性。方法 79例硬脊膜穿破患者,根据有无预防性措施分为A组(33例)和B组(46例)。A组实施EBP, B组实施对症保守治疗。比较两组患者PDPH发生率、持续时间,分析实施EBP患者的并发症发生情况。结果 A组PDPH发生率51.5%低于B组的73.9%,差异有统计学意义(P<0.05);两组PDPH持续时间比较,差异无统计学意义(P>0.05)。所有进行EBP的患者均未出现感染、发热、腰背痛、下肢放射痛、再次穿破硬膜或硬膜外血肿等并发症。结论预防性EBP可以安全有效地降低PDPH发生率,但是最佳的给予EBP的时机需要进一步的研究证实。Objective To discuss the effect and safety of prophylactic epidural blood patch(EBP) in preventing post-dural puncture headache(PDPH). Methods A total of 79 cases of dural puncture patients were divided into group A(33 cases) and group B(46 cases) according to the preventive measures. Group A received EBP, and group B received symptomatic conservative treatment. The incidence of PDPH and duration of PDPH of the two groups was compared, and the occurrence of complications of patients with EBP was analyzed. Results The incidence of PDPH 51.5% of group A was lower than that of group B 73.9%, and the difference was statistically significant(P<0.05). There was no statistically significant difference in duration of PDPH, and the difference was not statistically significant(P>0.05). All patients undergoing EBP had no complications such as infection, fever, low back pain, radiating pain in the lower limbs, re-piercing the dura mater or epidural hematoma. Conclusion Prophylactic EBP could effectively and safely prevent post-dural puncture headache, but the best EBP timing needs to be confirmed by further studies.

关 键 词：硬膜外血补丁 硬脊膜穿刺后头痛 硬脊膜意外穿破 椎管内麻醉 

分 类 号：R614[医药卫生—麻醉学]