Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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소아에서 척수액 검사 후 발생한 두통에 대한 연구

A study for post-diagnostic lumbar puncture headache in children

  • 장국찬 (조선대학교 의과대학 소아과학교실) ;
  • 양은석 (조선대학교 의과대학 소아과학교실) ;
  • 문경래 (조선대학교 의과대학 소아과학교실) ;
  • 박영봉 (조선대학교 의과대학 소아과학교실) ;
  • 노영일 (조선대학교 의과대학 소아과학교실)
  • Jang, Gook Chan (Department of Pediatrics, College of Medicine, Chosun University) ;
  • Yang, Eun Seok (Department of Pediatrics, College of Medicine, Chosun University) ;
  • Moon, Kyung Rye (Department of Pediatrics, College of Medicine, Chosun University) ;
  • Park, Young Bong (Department of Pediatrics, College of Medicine, Chosun University) ;
  • Rho, Young Il (Department of Pediatrics, College of Medicine, Chosun University)
  • 투고 : 2007.03.12
  • 심사 : 2007.06.14
  • 발행 : 2007.08.15
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초록

목 적 : 소아에서 진단 목적으로 척수액 검사를 시행한 환아에서 천자 후 부작용으로 발생하는 두통의 발생 빈도와 영향을 끼치는 인자들에 대해 알아보고자 본 연구를 하였다. 방 법 : 2005년 3월부터 2006년 2월까지 조선대학교 병원 소아과에서 진단 목적으로 요추천자를 시행한 4세에서 13세 사이의 환아 중 뇌수막염이 의심되었던 44명을 대상으로 하였다. 요추천자 후 두통의 발생빈도와 성별, 연령, 요추 천자 횟수, 척수액 양, 두통의 과거력, 척수액 압력, 척수액내 백혈구 수의 각 인자들과 두통 발생사이의 상관성, 두통의 발생 시작시간과 지속시간 및 치료에 대해서 조사하였다. 결 과 : 천자 후 두통의 발생빈도를 보면 전체 44명 중 16명(36.4%)에서 발생했으며, 남녀가 각 39.4%(13명), 27.2%(3명)로 성별에서는 유의한 차이는 없었다. 두통의 과거력이 있는 6명중 50%(3명)에서 두통이 발생하였고, 과거력이 없는 38명 중 36.1 %(13명)에서 발생하여 두통의 과거력이 있는 경우 두통이 의의 있게 많이 발생하였다(P=0.037). 척수액내 백혈구 세포수가 많을수록 요추 천자 후 두통의 발생은 통계학적으로 의의 있게 많았다(P=0.012). 그 외 연령, 척수액 검사 횟수, 척수액 양, 척수액 압력과 천자 후 두통 발생 사이에는 통계학적 상관성이 없었다. 결 론 : 요추 천자 후에 두통은 기존의 다른 연구에서 보다 발생 빈도가 더 높았으며 두통의 과거력이 있는 경우와 척수액내 백혈구 세포수는 소아에서 척수액 검사 후 발생한 두통에 영향을 주는 인자로 생각된다.

Purpose : Post-lumbar puncture headache is common complaint. A study of post-diagnostic lumbar puncture headache in children is rare. Various factors that might influence the occurrence of postdiagnostic lumbar puncture headache in children exist. The purpose of this prospective study was to assess the frequency and risk factors for post-diagnostic lumbar puncture headache in children. Methods : From March 2005 to February 2006, 44 patients with suspected meningitis were enrolled. Patients were received diagnostic lumbar puncture at the Chosun University Hospital, Gwangju, Korea. We evaluated age, sex, previous headache history, number of puncture attempts, volume of cerebrospinal fluid (CSF), pressure of CSF, cell count in CSF, final diagnosis, and the frequency and duration of headaches. Results : Of the 44 patients (mean age $7.36{\pm}2.04$, range 4-13 years), 16 patients (36.4%, male 13/33, 39.4%, female 3/11, 27.2%) had headache. The frequency of headaches was significantly higher in patients with previous headache history compare to those without previous headache history (P= 0.037). The mean of cell count of CSF was significantly higher in patients with post-lumbar puncture headache (P=0.012). The other factors did not influence the post-diagnostic lumbar puncture headache. Conclusion : Post-diagnostic lumbar puncture headache in children was more common than other studies. The factors that influence post-diagnostic lumbar puncture headache in children are previous headache history and cell count in CSF.

키워드

참고문헌

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