Sternal puncture yog ib txoj hauv kev tshuaj xyuas cov pob txha. Txoj kev no muaj nyob rau hauv cov pob txha pob txha puncture ntawm lub anterior phab ntsa ntawm lub sternum siv ib tug tshwj xeeb koob. Sternal puncture yog ua ob qho tib si hauv tsev kho mob thiab chaw kho mob sab nraud. Nws tsis muaj teeb meem qhov twg qhov kev ua tiav, qhov tseem ceeb yog cov cai ntawm asepsis thiab antisepsis raug soj ntsuam thaum lub sijhawm nws.
khoom siv
Rau puncture koj xav tau: 70º cawv, 5% iodine tov, lidocaine los yog novocaine rau qhov mob nyem, ob syringes - 10 thiab 20 ml, Kassirsky's sternal puncture koob (ib tug luv luv koob uas muaj ib tug txiv ntoo ntawm lub distal kawg, mandrin thiab detachable kov), gauze ncoo thiab band-pab.
Kev npaj tus neeg mob
Cov txheej txheem no tsis tas yuav npaj tshwj xeeb. Tus neeg mob nyob rau hnub ua ntej thiab hnub ntawm qhov puncture yog nyob rau hauv ib txwm noj. Lub puncture yog nqa tawm ob mus rau peb teev tom qab noj mov. Txhua yam tshuaj raug tso tseg, tshwj tsis yog cov tsim nyog rau lub neej.lus tim khawv. Nws tseem yuav tsum tau tshem tawm cov kev npaj uas muaj heparin. Nyob rau hnub ntawm tus txheej txheem, nws yog txwv tsis pub nqa tawm lwm yam kev kuaj mob, kev phais. Nws raug nquahu kom muab zais zais zis thiab cov hnyuv ua ntej tus txheej txheem.
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Qhov chaw puncture yuav tsum tau kho nrog 70º cawv thiab 5% tshuaj iodine. Nyob rau hauv lub neej yav tom ntej, nws yog tsim nyog los tshuaj loog. Ib qho tshuaj loog - lidocaine lossis novocaine - yog kos rau hauv 10 ml syringe thiab ib rab koob yog ntxig rau ntawm lub kaum sab xis ntawm 90º, tshuaj loog. 3 feeb tom qab kev qhia txog lidocaine, koj tuaj yeem pib qhov puncture. Sab hauv phab ntsa ntawm lub sternum yog pierced nrog ib rab koob Kassirsky nyob rau theem ntawm III-IV tav nyob rau hauv nruab nrab-clavicular kab, nws kuj muaj peev xwm mus rau hauv tus tuav ntawm lub sternum. Lub koob yuav tsum tau muab tso nrog ib tug ceev twisting tsab ntawv tsa suab. Cov koob dhau los ntawm cov khoom sib txuas ntawm lub ntsej muag ntawm lub sternum thiab nkag mus rau hauv qhov chaw medullary, thiab qhov tsis ua haujlwm yog hnov. Cov tsos mob ntawm kev nkag mus rau hauv qhov chaw spongy yog qhov hnov ntawm cov kab noj hniav los ntawm tus neeg teb xov tooj, thiab tus neeg mob - qhov mob luv luv. Tom ntej no, nws yog tsim nyog los tshem tawm mandrin los ntawm lub sternal koob thiab muab ib tug 20 ml syringe rau nws, nrog kev pab los ntawm cov pob txha ntsiab lus aspirated. Tsim lub tshuab nqus tsev, aspirate tsis ntau tshaj 0.20-0.30 ml. ntshav. Tom qab ntawd, koj yuav tsum rub tawm lub syringe nrog rau rab koob. Ib daim ntaub qhwv ntsej yog siv rau ntawm qhov chaw puncture thiab cov nplaum plaster yog glued. Cov ntsiab lus ntawm syringe yog siv rau lub khob thiab npaj smear. Thaum ua rau cov menyuam yaus, nws yuav tsum nco ntsoov tias rab koob tuaj yeem dhau mus, qhov no yog vim qhov elasticity txaus ntawm sternum. Sternal puncture nyob rau hauv cov neeg mob uas noj corticosteroids mus sij hawm ntev yuav tsum tau ua nrog ceev faj vim lawv muaj feem cuam tshuam rau osteoporosis.
Kev nyuaj siab. Indications rau sternal puncture
Cov teeb meem tseem ceeb yog nkag mus thiab los ntshav. Nyob rau hauv cov pob txha pob txha, tsim ntawm cellular ntsiab ntawm cov ntshav, uas yog, hematopoiesis, tshwm sim. Sternal puncture yog tsim nyog los xyuas kom meej qhov kev kuaj mob ntawm ntau yam kab mob: anemia, leukopenia los yog leukocytosis, thrombocytosis los yog thrombopenia, raws li zoo raws li lub functional pob txha pob txha tsis ua hauj lwm. Tom qab tau txais qhov tshwm sim, nws muaj peev xwm txheeb xyuas qhov ua haujlwm ntawm cov txheej txheem hematopoietic, lub xeev thiab cov qauv kev hloov pauv ntawm cov hlwb. Sternal puncture kuj ua rau cov neeg mob uas xav tias malignant neoplasms thiab metastasis.
