COMPLICATIONS OF LUMBAR PUNCTURE FOLLOWED BY ANTICOAGULATION
COMPLICATIONS OF LUMBAR PUNCTURE FOLLOWED BY ANTICOAGULATION
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DOI：
10.1161/01.str.12.6.879
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发表时间：
1981-01-01
期刊：
影响因子：
8.3
通讯作者：
DOUGHERTY, JH
中科院分区：
文献类型：
--
作者：
RUFF, RL;DOUGHERTY, JH
比较了两组342例患者的腰椎穿刺（LP）相关并发症。第1组患者在LP后抗凝，第2组患者未抗凝。两组轻微头痛或背痛的发生率相似（第1组，62%;第2组，64%）。抗凝组患者下肢轻瘫发生率较高（第1组5例，第2组0例; P < 0.05），严重的背部或腰骶神经根疼痛持续时间超过48 h（第1组18例，第2组6例; P < 0.025）。7例抗凝患者出现脊髓血肿（5例下肢轻瘫，2例重度背痛）。在抗凝治疗的患者中，创伤性LP（P < 0.001）、LP后1小时内开始抗凝治疗（P < 0.001）或LP时阿司匹林治疗（P < 0.001）增加了重大并发症的风险。如果进行LP，延迟抗凝治疗至少1小时，避免同时使用阿司匹林治疗可能会降低发生脑实质外脊髓血肿的风险。
The complications associated with lumbar puncture(LP) were compared in 2 groups of 342 patients. The 1st group of patients was anticoagulated after the LP, and the 2nd was not. The incidence of minor headache or back pain was similar in the 2 groups (group 1, 62%; group 2, 64%). The anticoagulated patients had a higher incidence of paraparesis (group 1, 5 patients, group 2, no patients; P < 0.05) and severe back or lumbosacral radicular pain lasting more than 48 h (group 1, 18 patients; group 2, 6 patients; P < 0.025). Seven of the anticoagulated patients developed spinal hematomas (5 with paraparesis, 2 with severe back pain). Among the anticoagulated patients the risk of a major complication was increased by a traumatic LP (P < 0.001), starting anticoagulation within 1 h of the LP (P < 0.001), or aspirin treatment at the time of the LP (P < 0.001). If LP is done, delaying anticoagulation for at least 1 h and avoiding concurrent aspirin therapy may decrease the risk of developing an extraparenchymal spinal hematoma.