非創傷性針頭應用於腰椎穿刺後頭痛之成效

Effectiveness of Atraumatic Needles in Preventing Post-Lumbar Puncture Headache

腰椎穿刺後頭痛（post-dural puncture headache，PDPH）為腰椎穿刺後常見併發症。過往文獻已證實合適的針頭類型及大小可降低PDPH發生率。然而臨床採用仍不普遍，且缺乏整合性文獻進行全面性成效評估，因此本研究欲探討非創傷性針頭於腰椎穿刺後頭痛之成效。依照PRISMA指引進行文獻回顧，搜尋Cochrane Library、MEDLINE、CINAHL、PubMed、Embase、Airiti library華藝線上圖書館等資料庫。納入截至2025年9月前符合納入與排除條件之中英文原著研究，並以QualSyst工具進行文獻品質評讀。共納入10篇研究，因研究間異質性大，故未進行統合分析。多數研究指出，使用非創傷性及較小口徑針頭可顯著降低PDPH風險。顯示非創傷性針頭具降低PDPH之效益，並減少額外醫療資源使用。建議加強臨床教育與推廣，以提升使用率並改善照護品質。

Post-dural puncture headache (PDPH) is a common complication after lumbar puncture. Although previous studies have demonstrated that proper needle type and size can reduce the incidence of PDPH, clinical adoption remains limited, and a comprehensive synthesis of these findings is still lacking. To investigate the effectiveness of atraumatic needles in reducing post-lumbar puncture headache (PDPH).This systematic literature review was conducted in accordance with PRISMA guidelines, utilizing databases such as the Cochrane Library, MEDLINE, CINAHL, PubMed, Embase, and the Airiti library. Original Chinese and English studies that met the inclusion and exclusion criteria before September 2025 were reviewed, and the quality of the literature was assessed using the QualSyst tool. A total of 10 studies were included. Due to high heterogeneity, a meta-analysis was not performed. Most studies reported that the use of atraumatic needles significantly reduced the incidence of PDPH, and smaller needle sizes were also associated with a lower risk of PDPH. Atraumatic needles are effective in reducing PDPH and decreasing the use of additional healthcare resources. Strengthening clinical education and promotion is recommended to increase their adoption and improve the quality of care.