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1、护理学杂志2008年7月第23卷第13期(综合版)·5·腰椎穿刺术后垫枕与去枕对颅内压的影响米凯,杨霞锋,陈团芝摘要:目的为腰椎穿刺术后患者提供安全、舒适的体位。方法选择脑出血行侧脑室引流的患者90例,测定颅内压后分为高颅压组、正常颅压组和低颅压组各30例;腰穿后每组均分别予以垫枕与去枕干预各15例,接受垫枕干预者腰穿后于枕下垫软枕(厚7～8cm),并每2小时翻身1次;接受去枕干预者按护理常规去枕平卧6h,每2小时将手伸至患者背部按摩皮肤。各组均在腰穿前,腰穿后30min、60min、2h、4h、6h分别
2、监测脑室颅内压变化。结果高颅压和低颅压组患者垫枕和去枕对颅内压影响显著(均P<0.05);正常颅压组患者垫枕和去枕对颅内压影响无显著性意义(均P>0.05);接受去枕干预者皮肤反应发生率显著高于接受垫枕干预者(P<0.01)。结论高颅压患者腰穿后采取垫枕位更合适,正常颅压患者腰穿后可以垫枕,低颅压患者腰穿后不宜垫枕。关键词:腰椎穿刺;体位;垫枕;去枕;颅内压中图分类号:R473.74文献标识码:A文章编号:1001-4152(2008)13-0005-02EffectofAd2PilloworDe2Pil
3、lowontheIntracranialPressureAfterLumbarPuncture∥MIKai,YANGXiafeng,CHENTuanzhi∥(DepartmentofNeurology,LiaochengBrainHospital,Liaocheng252000,China)Abstract:ObjectiveToexploreasafeandcomfortablebodypositionforpatientsafterundergoinglumbarpuncture.MethodsThe
4、intracranialpressure(ICP)of90cerebrohemorrhagepatientswhoweregoingtoreceiveventriculardrainagethroughlum2barpunctureweremeasured.AndaccordingtotheresultsofICP,thecasesweredividedintoahighICPgroup,anormalICPgroupandalowICPgroup,witheachgrouphaving30cases.A
5、fterlumbarpuncture,15casesineachgroupwerecushionedundertheheadbyapillowwithathicknessof728cmandwereaskedtoturnoverevery2h,whiletheother15laysupinewithoutapillowandreceivedbackmassagebynursesevery2h.TheICPvaluesof3groupsweremeasuredbeforelumbarpunctureand3
6、0min,60min,2h,4h,and6haftertheprocedure.ResultsSignificantchangesintheICPvaluesinthehighICPgroupandthelowICPgroupafterad2pillowandde2pillowinterventions(P<0.05forall),whilenosignificantchangesintheICPvalueswerenotedinthenormalICPgroup(P>0.05forall).Skinre
7、actionrateinpatientsreceivingad2pillowinter2ventionwassignificantlylowerthanthatintheircounterparts(P<0.01).ConclusionPatientswithhighICParemorerecom2mendedtohaveapillowundertheheadafterlumbarpuncture.thatwillalsoworkinpatientswithnormalICP,butshouldbepro
8、hibitedinpatientswithlowICP.Keywords:lumbarpuncture;position;ad2pillow;de2pillow;intracranialpressure传统护理常规一直认为,腰椎穿刺(下称腰穿)术颅内压的数值分为高颅压组(颅内压>180mmH2O)、[1]后,为预防低颅压头痛需去枕平卧4～6h,但患者正常颅压组(80～180mmH2O)和低颅压组(<80常感觉难以忍受,特别是小
