Mr. Chen, Haizhu District, Guangzhou: The child had fever, vomiting and headache these two days. The doctor suspected meningitis after seeing the doctor. He suggested lumbar puncture for diagnosis. The child was only 5 years old and didn't want her to suffer. Is it necessary to have lumbar puncture? Is there an alternative?

Answer: This method is the first choice for diagnosis

Kuang Zonghe, a physician in the Department of Neurology of the 421 Hospital of the PLA, said that "cerebrospinal fluid examination (lumbar puncture) for lumbar puncture is a necessary examination for diagnosing intracranial infectious diseases (such as encephalitis, meningitis, etc.), except for clear contraindications (such as those with suppurative infection at the puncture site, and those with bleeding tendency for blood system diseases, etc.) EEG, CT/MRI and other examinations can be carried out first. For patients with high suspicion of intracranial infection, it is better to improve cerebrospinal fluid examination as soon as possible to avoid delay in diagnosis and treatment ".

In clinical practice, there are often patients who are nervous, anxious or even afraid because they do not know about lumbar puncture. Some of them will refuse to perform surgery because they mistakenly believe that the surgery will cause great damage to the body and the cerebrospinal fluid is rare. Especially some parents, who cannot see their children suffer a little, sometimes delay the best time for disease diagnosis and treatment, In fact, following the doctor's advice for regular operation, there are few cases of postoperative discomfort.

Kuang Zonghe suggested that parents should first adjust their emotions to reduce anxiety so as not to give bad hints to their children; Secondly, it is necessary to pacify the children and eliminate their nervousness so as to gain understanding and cooperation and make the procedure more smooth. In addition, strictly follow the principle of lying flat without pillow 4~6 hours after operation, which can avoid the occurrence of postoperative headache to the greatest extent.

He said that before lumbar puncture surgery, doctors should have a detailed understanding of the patient's condition and do necessary physical examination. After confirming that there are indications but no contraindications, surgery can be performed. If the condition permits, non-invasive examinations (such as head CT/head MRI) can also be performed first. However, because of the high cost of MRI, CT has a certain amount of radiation, so lumbar puncture cerebrospinal fluid examination is still the first choice for the most direct and definite diagnosis.

Information Times reporter Zhou Weilong intern Chen Mingjian Correspondent Liu Tingting