Discussion on supine time of school-aged children with acute leukemia after first lumbar puncture / 中国实用护理杂志

ABSTRACT

Objective:To investigate the optimal lengths of supine position after first lumber puncture for school-aged children with acute leukemia.Methods:From January 2020 to December 2021, a total of 152 children with acute leukemia who underwent first lumbar puncture were randomly divided into 1h group, 2 h group, 3 h group and 4 h group, there were 38 cases in each group. The lengths of supine position after lumber puncture were 1 h, 2 h, 3 h and 4 h in the 1h group, 2 h group, 3 h group and 4 h group, respectively. The effects of different lengths of supine position on headache, low back pain, comfort and postoperative complications were observed.Results:Finally, 38 cases were enrolled in the 1 h group, 36 cases in the 2 h group, 38cases in the 3 h group and 34 cases in the 4 h group. The scores of low back pain, sleep comfort, lying position comfort, emotional comfort as well as the incidence of limb numbness in the 1 h group were (1.71 ± 0.56), (1.95 ± 0.87), (2.74 ± 1.06), (2.63 ± 0.79), 5.3%(2/38), in the 2 h group were (1.61 ± 0.27), (2.08 ± 0.81), (2.92 ± 1.34), (2.86 ± 0.80), 2.8%(1/36), which were significant lower than those of in the 3 h group (2.32 ± 1.12), (2.92 ± 1.34), (3.71 ± 1.11), (3.55 ± 1.25), 21.1%(8/38) and 4 h group(2.74 ± 1.42), (3.06 ± 1.37), (3.85 ± 1.50), (3.88 ± 0.81), 23.5%(8/34), F=6.81 to 14.06, χ2=10.84, all P<0.05. The amount of cerebrospinal fluid exudation in 1 h group was (0.33±0.09) g, which was significantly higher than that in 2 h group(0.27±0.08) g, 3 h group (0.27±0.10) g and 4 h group (0.24±0.09) g, the difference was significant ( F=5.82, P<0.05). The incidence of pressure injury in 1 h group, 2 h group and 3 h group were 0, 2.0%(1/36), 7.9%(3/38), which were significantly lower than that in the 4 h group 23.5%(8/34), χ2=15.39, P<0.05. There was no significant difference in pain scores among the 4 groups ( P>0.05). Conclusion:Two hours for supine position after first lumber puncture does not increase cerebrospinal fluid exudation in children with acute leukemia, and effectively alleviate low back pain, improve the comfort degree.