Apakah kegunaan jarum penyedut sumsum tulang?
Mar 18, 2022
Bone marrow puncture (bone marrow puncture) is a commonly used diagnostic technique to take bone marrow fluid, and its inspection contents include cytology, protozoa and bacteriology. 1. Selection of puncture site ① Anterior superior iliac spine: The puncture point is usually 1 to 2 cm behind and above the anterior superior iliac spine, where the bone surface is flat, easy to fix, and the operation is convenient and safe; ② Posterior superior iliac spine: located in the sacral vertebra The bony protruding parts on both sides and above the buttocks; 3. Manubrium: The bone marrow is rich here. When the puncture of the above-mentioned parts fails, the manubrium can be punctured. Penetration is dangerous, so it is less used; ④ Spinous process of lumbar spine: It is located at the protrusion of spinous process of lumbar spine and is rarely used. 5. Infants under the age of 2 choose the anterior and inferior tibial tuberosity. 2. Posture The supine position was taken during puncture of the sternum and the anterior superior iliac spine. The lateral decubitus position should be taken during puncture of the posterior superior iliac spine. The lumbar spinous process was punctured in a sitting or lateral position. 3. Routinely disinfect the skin, wear sterile gloves, lay a sterile hole towel, and use 2 percent lidocaine for local infiltration anesthesia until the periosteum. 4. Fix the needle holder for bone marrow puncture at an appropriate length (about 1.5cm for iliac puncture, lengthen for obese patients, and about 1.0cm for sternum puncture), fix the skin at the puncture site with the thumb and index finger of the left hand, and hold the needle in the right hand. Perpendicularly penetrate the bone surface (in the case of manubrium puncture, the puncture needle and the bone surface should be punctured at an angle of 30 to 40 degree ), when the puncture needle touches the bone, rotate it left and right, and slowly pierce the bone. When the resistance disappears and the puncture needle is fixed in the bone, it indicates that it has entered the marrow cavity. 5. With a dry 20ml syringe, withdraw the inner plug by 1cm, pull out the needle core, connect the syringe, and slowly aspirate with appropriate force. A small amount of red marrow fluid can be seen entering the syringe. The amount of marrow fluid aspirated is 0.1-0.2ml. If appropriate, remove the syringe, push the bone marrow fluid on the glass slide, and quickly make 5 to 6 smears by the assistant, and send them for examination of cell morphology and cytochemical staining. 6. For bone marrow culture, connect the syringe and aspirate 2-3ml of bone marrow fluid into the culture medium. 7. If the marrow fluid cannot be extracted, it may be that the needle cavity is filled with skin, subcutaneous tissue or bone fragments, or the needle is inserted too deep or too shallow, and the needle tip is not in the medullary cavity, and the needle core should be reinserted at this time. , rotate a little or drill a little more or withdraw a little more, pull out the needle core, if you see blood on the needle core, you can expect to get bone marrow fluid by suction again. 8. After the suction is completed, insert the needle core, turn it slightly and pull out the puncture needle, then cover the needle hole with sterile gauze, press it a little, and fix it with adhesive tape. Matters needing attention 1. After the puncture needle enters the bone, avoid swinging too much to avoid breaking. 2. The puncture of the manubrium should not be inserted vertically, and excessive force should not be used to prevent penetration of the medial bone plate. 3. When aspirating bone marrow fluid, gradually increase the negative pressure. When doing cytomorphological examination, the suction volume should not be too much, otherwise the bone marrow fluid will be diluted, but it should not be too small. 4. The smear should be smeared immediately after bone marrow fluid extraction. 5. Bone marrow biopsy should be performed during multiple dry aspirations
Significance of bone marrow aspiration There are many causes of anemia, but iron deficiency is the most common one. It is usually treated with iron supplementation after diagnosis. If there is no improvement, it may be caused by other aspects of anemia, such as: megaloblastic anemia, thalassemia, aplastic anemia and so on. There may also be a problem with the body's absorption of iron. These are all possible. In order to rule out the possibility, it is necessary to do bone piercing. The morphological changes and compositional changes of various components and cells in the bone marrow can be seen through bone puncture. to diagnose the specific cause. Bone perforation is not intended to prove leukemia. Osteotomy is the most basic diagnostic technique in hematology. Also necessary. "Bone puncture" is for the purpose of diagnosis. A puncture needle is used to penetrate the bone marrow cavity, and a small amount of bone marrow is extracted for testing. Some patients mistakenly believe that the extraction of bone marrow fluid by bone marrow aspirate will damage the essence of the human body and damage the vitality, and are reluctant to carry out the examination. In fact, the bone marrow fluid required for bone marrow examination is a very small amount, generally about 0.1ml, while the normal amount of bone marrow fluid in the human body is about 2600ml. It can be seen that the bone marrow fluid extracted during bone marrow biopsy is insignificant compared with the total amount of the human body. What's more, there is a lot of cell regeneration in the body every day. In addition, patients often think that the bone marrow biopsy is very painful and has a sense of fear, in fact, this is unnecessary. "Bone puncture" does not have any danger, and will not leave any Sequelae. Some diseases, especially some blood diseases, are difficult to diagnose without this test. If the condition requires it, it should be done without hesitation. Even if the bone marrow does not have any lesions, it is a great gain, because excluding blood diseases can not only It can relieve the mental burden, and also relieve the pain and possible side effects of patients and their families receiving unnecessary treatment.Jika anda mempunyai sebarang pertanyaan, sila hubungi kami. Syarikat kami boleh menghasilkan pelbagai jarum tersuai, jarum perubatan, jarum tusukan, jarum hipodermik, jarum biopsi, jarum vaksin, jarum suntikan, jarum picagari, jarum veterinar, jarum mata pensil, jarum pengambilan ovum, jarum tulang belakang, dll. Jika anda memerlukan disesuaikan produk jarum, sila hubungi kami. Kami menantikan pertanyaan anda! Kualiti produk yang dikeluarkan di kilang kami pasti akan memuaskan hati anda!
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