The marrow puncture


Needle - trocar Abramova (left - assembled nom)

The marrow puncture - method lifetime extraction of bone tissue (mostly bone to bone marrow. The marrow puncture has a certain advantage over sternal puncture (see), which gives the opportunity to study only scattered cells in the bone marrow mixed with blood cells. If trepanobiopsy remove a piece of the bone marrow with preservation of its structure, that allows to correctly estimate the ratio of active and fat, bone marrow, to identify focal and diffuse changes in it. The marrow puncture produce a special needle-trocar design Professor M. G. Abramov (Fig). Needle-trocar consists of a needle length of 4 cm and an inner diameter of 2 mm, plate, allowing to establish the necessary depth of a puncture, mandrel and handle. The end of the needle sharpened so that the needle when rotating cuts column of bone and bone marrow tissue.
The puncture is performed in the iliac crest bone 2-3 cm posterior to the front of the upper spine after anesthesia soft tissues and of periosteum with a 2% solution novokaina. When the needle penetration into the bone that is known by the feeling commit needles, remove the handle, take the rod, again put on the handle and the rotational motion promote the needle deep into. The same rotational motion pull the needle and mandrin away from the glass piece of bone tissue 6-10 mm in length, which is then transferred into a solution for fixing. In the future the obtained sample is processed according to the rules of histological techniques. Remaining on the glass, the mandrel and the needle of the material make the strokes, painted and study how the sternal punctat.
The study of the histological preparations to differentiate hyperplastic, gipoplasticheskaya or aplastic bone marrow is normal. Valuable information gives the marrow puncture, and for the diagnosis of such lesions of blood-forming tissue such as retikulez, myeloma, eritremia, chronic mielolakoz, etc.
The marrow puncture performed by a physician. The role of nurses is to help the doctor to sterilize needle-free article by dry heat or boiling with the subsequent drying alcohol and ether, preparing the puncture site and laying on him sterile stickers after the biopsy.