ГоловнаArchive of numbers2017Volume 25, issue 3 (92)Lumbar puncture in patients with severe alcohol delirium for diagnosis and treatment
Title of the article Lumbar puncture in patients with severe alcohol delirium for diagnosis and treatment
Authors Zadorozhnyi Volodymyr
Linskiy Igor
Yurchenko Mykola
In the section HELP TO PRACTICAL PHYSICIAN
Year 2017 Issue Volume 25, issue 3 (92) Pages 115-119
Type of article Scientific article Index UDK 616.89-02:547.262-072.5-08 Index BBK -
Abstract In patients with severe alcohol delirium (SAD), the cause for performing lumbar puncture (LP) is associated neurological and neurosurgical diseases. The aim of the study was to study the safety of the LP, as well as the evaluation of its possible therapeutic eff ect in patients with SAD. A total of 2962 observations of patients with SAD for a period of 5 years were considered. Diagnostic LP was performed in 545 cases (18.4 %). Urgent neurologic or neurosurgical pathology was detected in 5.3 % of patients. Complications associated with possible edema of the brain and the development of symptoms of its dislocation was not observed. 450 patients were selected to study the possible therapeutic eff ect of LP in SAD. LP was performed in 227 patients, in 223 persons with SAD it was not performed. To assess the psychopathological and somatic manifestations of SAD, the rating scale DRS was used. Additionally, the length of the period of mental disorders was assessed, as well as a number of neurological manifestations of SAD, primarily the meningeal syndrome. It was found that patients with SAD who underwent LP survived with signifi cantly worse psychoneurological status than patients without LP. Conclusion on the therapeutic effect of LP in patients with SAD is additionally verifi ed by creating study groups with comparable clinical manifestations. It turned out that the survival of patients with SAD with manifestations of meningeal syndrome, who underwent LP, was significantly (by 13 %) higher than in patients without LP. It was concluded that it is possible to recommend, with appropriate indications, a more extensive use of LP for diagnosis in patients with SAD. It is considered useful to perform LP, counting on its therapeutic eff ect, in patients with SAD at an early stage of inpatient treatment for transition to unfavorable course, especially in situations when manifestations of meningeal syndrome occur.
Key words severe alcohol delirium, lumbar puncture, safety, therapeutic eff ect of lumbar puncture
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