儿童腰椎穿刺术后垫枕平卧的效果研究

摘要

Objective To explore a safe and comfortable lying position for children undergoing lumbar puncture.Methods Totals of 80 children with normal intracranial pressure needing to undertake lumbar puncture were randomly divided into experimental group and control group.The experimental group were cushioned a pillow with a thickness of 8cm,and were free to turn over after lumbar puncture.The control group were according to conventional nursing care in horizontal position without pillow after lumbar puncture.Compared the incidence of headache and low back pain,and the seepage quantity of cerebrospinal fluid in two groups 24 h after lumbar puncture.Results The degree of headache for 0,1,2,3 level in the experimental group respectively were 32,4,2,2 cases,the control group respectively were 33,3,3,1 cases,there was no statistically significant difference (Z =-0.283,P ＞ 0.05).The degree of low back pain for 0,1,2,3,4 level in the experimental group respectively were 37,3,0,0,0 cases and control group were 27,7,3,2,1 cases,the difference was statistically significant (Z =-2.885,P ＜ 0.05).The seepage quantity of cerebrospinal fluid in the experimental group was (0.31 ±0.18) g,the control group was (0.36 ±0.21)g,there was no statistically significant difference (t =1.14,P ＞ 0.05).The unbearable,uncomfortable but can bear,doesn't matter and comfortable four levels respectively were 3,5,21,11 cases,the control group were 7,17,15,1 case,the difference was statistically significant (Z =-3.932,P ＜ 0.01).Conclusions Normal intracranial pressure children with postoperative lumbar puncture suitable cushion pillow in bed,which can reduce the incidence of back pain,and improve their comfortable.%目的 探讨儿童腰椎穿刺术后是否垫枕对头痛、腰背痛发生率以及脑脊液的渗出量的影响,为腰椎穿刺术后患儿提供安全、舒适的卧床方式.方法 将80例颅内压正常、需进行腰椎穿刺术的患儿采用随机数字表法随机分为观察组和对照组各40例.观察组患儿腰穿后给予垫枕干预,并可自由翻身,对照组腰穿后按护理常规去枕平卧.分别观察两组患儿24 h内头痛、腰背痛的发生率,脑脊液的渗出量以及患儿的舒适度.结果 观察组患儿头痛为0,1,2,3级的例数分别为32,4,2,2例,对照组分别为33,3,3,1例,两组比较,差异无统计学意义(Z=-0.283,P＞0.05)；观察组患儿腰背痛为0,1,2,3,4级的例数分别为37,3,0,0,0例,对照组分别为27,7,3,2,1例,两组比较,差异有统计学意义(Z=-2.885,P＜0.05)；观察组患儿脑脊液的渗出量为(0.31 ±0.18)g,与对照组的(0.36±0.21)g相比,差异无统计学意义(t=1.14,P＞0.05)；观察组难以忍受、不舒适但能忍受、无所谓、舒适4个等级的例数分别为3,5,21,11例,对照组分别为7,17,15,1例,两组比较,差异有统计学意义(Z=-3.932,P＜0.01).结论 儿童行腰椎穿刺后卧床采取垫枕方式对头痛的发生率和脑脊液的渗出量无影响,可减少腰背痛的发生率,同时增加了患儿的舒适性.颅内压正常的儿童腰穿术后适宜垫枕卧床.