Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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소아에서 척수액 검사 후 발생하는 두통과 요통에 대한 연구

A study for headaches and backaches occurrence after diagnostic lumbar puncture in children

  • 투고 : 2006.03.27
  • 심사 : 2006.05.04
  • 발행 : 2006.07.15
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초록

목 적 : 소아에서 척수액 검사 후에 부작용으로 발생하는 두통과 요통에 대한 발생 빈도와 영향을 주는 인자를 알아보기 위하여 연구를 시작하였다. 방 법 : 2004년 10월부터 2006년 2월까지 1년 5개월 동안 전주예수병원 소아과에서 진단 목적으로 척수액 검사를 실시한 만2세에서 15세 환아 148명을 대상으로, 연령, 성별, 검사 횟수, 척수액 양, 검사 바늘 방향, 척수액내 백혈구 수, 절대 침상안정시간과 두통, 요통의 발생 빈도 및 지속 기간에 대해서 조사하였다. 결 과 : 남녀 분포 및 발생 빈도 : 두통은 8명(5.4%)으로 이중자세성 두통은 4명(2.7%)이었으며, 요통은 40명(27.0%)으로 이중 하지로 전파된 경우는 8명(5.4%)이었으며, 남녀 차이는 없었다. 각 인자별 발생 빈도 : 10세 미만에서 두통이 4명(3.3%), 10세 이상에서 4명(14.8%)이 발생하여, 10세 이상에서 의의 있게 많이 발생하였으며(P=0.017), 요통은 33명(27.3%), 7명(25.9%)으로 차이가 없었다. 검사 횟수, 척수액 양, 검사 바늘 경사면 방향, 척수액내 백혈구 세포 수, 절대 침상안정 시간과 두통 및 요통의 차이가 없었다. 연령군 내에서 성별에 따른 발생 빈도 : 10세 미만과 10세 이상 각각에서 두통과 요통의 성별 차이가 없었다. 두통과 요통의 지속 기간 : 검사 바늘 방향이 상부일 때 측면보다 두통의 지속 기간이 더 길었으며, 요통의 차이는 없었다. 검사 횟수, 척수액 양, 척수액내 백혈구 세포 수, 절대 침상안정시간과 두통 및 요통의 차이가 없었다. 연령군 내에서 성별에 따른 지속 기간 : 남자에서 요통의 지속 기간은 더 길었으나, 10세 미만과 10세 이상 각각에서 두통과 요통의 성별 차이는 없었다. 결 론 : 척수액 검사 후에 두통은 5.4%로 10세 이상에서 많았으며, 요통은 27.0%이었다. 검사 바늘 경사면이 상부 방향일 때 두통이 오랫동안 지속되었으며, 남자에서 요통의 지속 기간이 길었다. 따라서 10세 이상에서 요추 천자를 하는 경우에는 검사 후 발생하는 통증에 대한 교육 및 주의가 필요할 것으로 사료되었다.

Purpose : Our goals were to determine the frequency of headaches and backaches occurring as a side effect following lumbar puncture in children, and to investigate various factors that might influence the frequency of headaches and backaches. Methods : From October 2004 to February 2006, we enrolled 148 patients aged 2 to 15 years who received diagnostic lumbar puncture at the Presbyterian Medical Center, Chonju, Korea. Patient data were collected for age, sex, number of puncture attempts, volume of cerebrospinal fluid(CSF), bevel orientation of puncture needle, cell count in CSF, periods of absolute bed rest, and the frequency and duration of headaches and backaches. Results : Headaches occurred in 8 patients and backaches occurred in 40 patients. Headaches were found both to occur significantly more frequently in patients over age 10 and to last longer when the bevel orientation of the puncture needle was inserted toward the cranium rather than laterally. Backaches lasted longer in males than in females. The other factors evaluated showed no relationship at all to the frequency and duration of headaches and backaches. Conclusion : Following lumbar puncture, headaches were common in patients over age 10, and lasted longer when the bevel orientation was toward the cranium. Backaches lasted longer in males than in females. In light of these findings, we recommend taking special care when performing lumbar puncture for CSF examination in patients over age 10.

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참고문헌

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