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    腰穿和超聲
    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
    題目:腰穿和超聲
    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.? ?
    上個月Lo等人發表了一項研究,看是否這一現象在嬰兒中也是成立的。
    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.
    這項研究對50個健康的小于4個月的嬰兒在L3-L4之間的蛛網膜下腔的大小用超聲在3個不同的位置:側臥,45度傾斜,正坐位進行了測量。
    This study found that the size of the subarachnoid space did not differ significantly between the 3 positions.
    這項研究發現,蛛網膜下腔的大小在3個位置之間沒有顯著不同。
    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.
    作者推測,麻醉雜志報到的坐位可增加腰穿成功率,可能是由于其他因素,如腦脊液壓力增高,脊突間間隙增寬或表面標記更明顯。
    References參考文獻:
    Sitting or Tilt Position for Infant Lumbar Puncture Does Not Increase Ultrasound Measurements of Lumbar Subarachnoid Space Width. PediatrEmer Care 2013;29: 588-591.

    文章來源:《中華急診醫學雜志》編輯部

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