不同体位对腰穿后头痛的影响  

Influence of Different Postures on Incidence of Headache after Lumbar Puncture

作　　者：付菊芳[1] 张玉莲[2] 孟春静[3,4] 宣力[3,4] 王小芳[1] 李蕊[1] 白燕妮[1] 李武平[1] 

机构地区：[1]第四军医大学西京医院血液科 [2]陕西省人民医院神经内科 [3]第四军医大学唐都医院神经内科 [4]陕西 西安 710032

出　　处：《解放军护理杂志》2003年第10期28-30,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的 评价不同体位对腰穿后头痛的影响,为临床选择最佳腰穿后体位提供依据。方法 用随机单盲法将符合条件的164例患者分成4组:A组(去枕平卧6h)、B组(平行位头抬高5cm平卧6h)、C组(头低脚高俯卧1h,左右交替侧卧或平卧5h)、D组(头低脚高俯卧1h,左右交替侧卧或平卧2h),观察其在腰穿术后6、24、48、72h头痛发生率、头痛程度、头痛持续时间及不适指标。结果 4组体位头痛发生率分别是23.80％、22.50％、27.50％、19.05％,头痛发生率、头痛程度、持续时间无显著差异(P>0.05);B组舒适率显著低于其他3组(P<0.05)。结论 D组体位为最佳腰穿后体位。Objective To investigate the influence of different body positions on the incidence of headache after lumbar puncture so as to provide evidence for selecting a most suitable position in clinical lumbar puncture. Methods 164 patients were divided into four groups randomly: group A (dorsal position without pillows for 6 hours), group B (fiat position with heads horizontally elevated by 5era for 6 hours), group C ( prone position with heads lower than feet for 5 hours), and group D ( prone position with heads lower than feet for 2 hours). Pain index and other uncomfortable complaints were observed at 6h, 24h and 72h after lumbar puncture. Results Headache incicence rate of the four groups postures was 23. 80% 、22.50% 、27.50% and 19.05% ( P>0.05 ) respectively. The incidence, degree and duration of headache were not significantly different between the four groups ( P>0.05 ). The rate of comfortable sensation of Group B was significantly lower than that of the other three groups( P <0.01 ), though there was no significant difference between groups A, C and D ( P>0.05 ). Conclusion The posture of group D is the most suitable body position for lumbar puncture.

关 键 词：不同体位 头痛 硬脊膜穿刺 并发症 麻醉 

分 类 号：R614.4[医药卫生—麻醉学] R741.041[医药卫生—外科学]