以血液貼片治療自發性低腦壓頭痛之護理

近年因醫學影像進步使低腦壓頭痛的診斷能快速明確。低腦壓頭痛常因姿位改變而引起頭痛，且伴隨噁心、嘔吐、頭頸僵硬，尤其是坐姿或站立時頭痛症狀加劇。臨床多利用影像學及腰椎穿刺，再合併理學檢查來做鑑別診斷，只要其中一項證實低腦壓或腦脊髓液外漏即需治療。經由醫師確立診斷後，多臥床休息並飲用含咖啡因的飲料，及服類固醇之藥物來增加體液容積，有些人可在一到數個月症狀因此而緩解。但約有五分之一低腦壓頭痛病患未能改善而出現硬腦膜下腔出血的嚴重症狀，故早期接受治療可縮短病程減少合併症發生。神經科專家一致認為「硬腦膜外血液貼片」(Epidural blood patch, EBP)是腦脊髓液外漏所導致低腦壓頭痛最有效的治療方式。此類病人蒙受嚴重頭痛之苦，甚至影響日常生活作息，故病患在接受各項檢查及治療時，需提供心理支持、情緒安撫並協助遵循返家後正確居家照護，能使病患早日脫離頭痛陰霾，希望藉由本文分享相關臨床照護重點，提供臨床照護病人參考。

關鍵字

低腦壓頭痛；硬膜外血液貼片

並列摘要

Medical imaging had advanced in recent years due to ”Spontaneous Intracranial Hypotension, SIH” which provide quick and accurate diagnosis, and cause postural changes. Associated symptoms include nausea, vomiting, and neck stiffness. More diagnostic uses of clinical imaging and then combined lumbar puncture, are required to confirm cerebral spinal fluid leakage for treatment purpose. Adjuvant treatment options which have helped some people to relive symptoms include bed rest, and drinking caffeinated and oral fludrocortisones to increase fluid volume. But about one-fifth of patients with low intracranial pressure headache have not improved still with subdural hemorrhage, Early treatment may shorten the course to reduce complications. Today, the epidural blood patch, EBP is recognized as the most effective treatment. These patients suffered severe headaches and the pain had affected their everyday life. Therefore they accepted the examination and treatment. Psychological support, emotional comfort and proper home care after discharge were provided to these patients to shorten their recovery process from headaches. We hope to share this article focusing on clinical care and patient in formation with orther nursing staff.

並列關鍵字

low pressure headache ； epidural blood patch

國際替代計量

以血液貼片治療自發性低腦壓頭痛之護理

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