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    原作者: Jennifer Guyther,肖鋒譯 文章來源: 《中華急診醫學雜志》編輯部 發布日期:2013-06-14

    Title: Lumbar punctures and ultrasound
    Author作者: Jennifer Guyther

    Infant lumbar puncture is often difficult and may require repeated attempts. The traditional body positioning is lateral decubitus. Previous studies have examined the safety of having the patient in a sitting position, and neonatal studies have suggested that the subarachnoid space increases in size as the patient is moved to the seated position.
    嬰兒腰椎穿刺往往是困難的,可能需要多次嘗試。傳統的身體姿勢是側臥。以往的研究已經檢查了讓病人坐著安全性; 同時新生兒研究表明,新生兒蛛網膜下腔隨病人移動到坐在而增加。
    A study by Lo et al published last month looked to see if the same held true in infants.? ?
    50 healthy infants less then 4 months old had the subarachnoid space measured by ultrasound between L3-L4 in 3 positions: lateral decubitus, 45 degree tilt and sitting upright.
    This study found that the size of the subarachnoid space did not differ significantly between the 3 positions.
    Authors postulated that a reason for increase sitting LP success rate that had been reported in anestesia literature with tilt position could be due to other factors such as increased CSF pressure, intraspinous space widening or improved landmark identification.
    Sitting or Tilt Position for Infant Lumbar Puncture Does Not Increase Ultrasound Measurements of Lumbar Subarachnoid Space Width. PediatrEmer Care 2013;29: 588-591.