The importance of sex, age, needle size, height and body mass index in post-lumbar puncture headache
The importance of sex, age, needle size, height and body mass index in post-lumbar puncture headache
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DOI：
10.1046/j.1468-2982.2001.00200.x
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发表时间：
2001-09-01
期刊：
影响因子：
4.9
通讯作者：
Sandvik, L
中科院分区：
文献类型：
--
作者：
Vilming, ST;Kloster, R;Sandvik, L
在这项前瞻性研究中，239例患者中有37%在诊断性腰椎穿刺后发生腰椎穿刺后头痛（PPH）。PPH在女性中的患病率高于男性（46% vs. 21%; P = 0.0003），在PPH患者中，最常见的PPH形式（64% vs. 23%; P = 0.02）和恶心（74% vs. 39%; P = 0.01）也是如此。在100 mm视觉模拟量表上，女性直立位疼痛评分比男性更严重（中位数60 mm vs. 47.5 mm; P = 0.02）。在所有患者（50% vs. 26%; P = 0.0002）、女性（57% vs. 36%; P = 0.02）和男性（38% vs. 10%; P = 0.004）中，使用20 G针的PPH发生率高于22 G针。年龄、体重、身高和体重指数（BMI）均不影响PPH的患病率，但耳鸣在高个子患者中的患病率高于小个子患者（53% vs. 17%; P = 0.02）。老年患者在起身时的中位疼痛延迟时间较长，而且，身材矮小的患者报告的中位疼痛延迟时间往往长于身材高大的患者。与BMI较低的患者相比，高BMI患者在起身和斜倚时疼痛强度的变化更慢（中位数60 s vs. 12 s; P = 0.02）。根据泄漏理论，可以预期关于身高、BMI和针尺寸的结果。在多变量分析中，性别（P = 0.0003）和针头尺寸（P = 0.0002）与PPH的发生在统计学显著水平上相关。疼痛程度与女性（P = 0.03）和年轻（P = 0.03）呈正相关。疼痛延迟时间随年龄增加而增加（P = 0.008），疼痛缓解时间随BMI增加而增加（P = 0.04）。
In this, prospective study 37% of 239 patients developed a post-lumbar puncture headache (PPH) after a diagnostic lumbar puncture. PPH was more prevalent in females than males (46% vs. 21%; P = 0.0003) as were the severest form of PPH (64% vs. 23%; P = 0.02) and nausea (74% vs. 39%; P = 0.01) in those who developed PPH. Females scored their pain in the upright position more severe on a 100-mm visual analogue scale than males (median 60 mm vs. 47.5 mm; P = 0.02). The frequency of PPH was higher with the use of a 20-gauge compared with a 22-gauge needle in all patients (50% vs. 26%; P = 0.0002) and in females (57% vs. 36%; P = 0.02) and males (38% vs. 10%; P = 0.004), separately. Neither age, weight, height, nor body mass index (BMI), influenced the prevalence of PPH, but tinnitus was more prevalent in tall compared with smaller patients (53% vs. 17%; P = 0.02). Old age was associated with a long median pain delay upon rising, and also, small patients tended to report a longer median pain delay than tall patients. The pain intensity changed more slowly upon rising and reclining in patients with a high BMI than in those with a lower BMI (median 60 s vs. 12 s; P = 0.02). The results concerning height, BMI and needle size might be anticipated according to the leakage theory. In a multivariate analysis sex (P = 0.0003) and needle size (P = 0.0002) were related to the development of PPH on a statistically significant level. Furthermore, the pain severity was positively related to female sex (P = 0.03) and young age (P = 0.03). The pain delay increased with age (P = 0.008) and the pain decrease time increased with an increasing BMI (P = 0.04).