【摘要】 目的观察应用改良小儿腰椎穿刺术行腰椎穿刺的临床效果。方法对传统小儿腰椎穿刺方法进行改进:(1)以一次性无菌注射针为穿刺针;(2)镇静:<7岁及≥7岁评估难以配合者,使用安定镇静;(3)不做麻醉。将600例患儿随机分为传统方法组和改良方法组各300例,观察和比较传统方法组和改良方法组的临床效果、穿刺成功率、术后并发症发生率及患儿配合情况。结果传统方法组总成功率79%(一次性成功率61.3%);改良方法组总成功率90.3%(一次性成功率83.7%),2组比较差异有统计学意义(P<0.05)。并发症发生率:传统方法组中头痛为6.5%,副损伤为14%,腰背痛为13.6%;改良方法组中头痛为2%,副损伤为5.7%,腰背痛为5.8%,2组各项比较差异均有统计学意义(P<0.05)。结论改良小儿腰椎穿刺术明显提高腰椎穿刺成功率,并发症发生率低,减少患儿痛苦及紧张,配合程度高,操作易行,值得临床推广。更多还原

【Abstract】 Objective To obsewe the chinical effect of children by improved lumbar puncture.Methods The improvement of children lumbar puncture to the traditional method:(1)using single-use disposable hypodermic needle for paracente-sis;(2)sedation:<7 years old ≥7 years old appraisal with difficulty coupler,using stable sedation;(3)no anesthesia.600 children who had lumber puncture were dividedd into tradtional methods(n=300)and improved methods group(n=300)randomly.Between the two groups,puncture success rate,the incidence of postoperative complications and children cope with the situation-nation were observed and compared.Results Success rate of the tradtional methods group was 79%(one-time success tate was 61.3%),improved methods group was 90.3%(one-time success rate was 83.7%),the diffrence between the two groups was statistically significant(P<0.05);The incidence of complications :In tradtional methods heahache group was 6.5%,injure was 14%,backache was 13.6%;In improved methods group headache was 2%,injure was 5.7%,backache was 5.8%,the diffrence between the two groups was statistically significant(P<0.05).Compatible with the total rate of tradtional methods group was 79%(full compatible with the rate was 35%);the improved methods group was 95.7%(full compatible with the rate was 88%),diffrence between the two groups was statistically significant(P<0.05).Conclusion Improved lumber puncture in children markedly increased lumber success rate,the complication formation rate was low;It can reduce the child pain and tension,the coordication degree is high,operation is easy.It is worth of the clinical promotion.更多还原