Sternal puncture - njira za kafukufuku wa mafupa. Njira imeneyi imakhala mu medullary sternal khoma puncture kutsogolo ndi singano wapadera. Sternal puncture imagwiridwa kuchipatala kapena pa outpatient maziko. Ziribe kanthu kumene puncture imachitidwa, chinthu chachikulu chakuti akuoneni pa malamulo ake a aseptic ndi antiseptic.
zida
Kuti puncture zofunika: 70º-TH mowa, 5% ayodini yothetsera, lidocaine wa kapena procaine kwa mankhwala, syringes awiri - 10 ndi 20 ml, singano sternal puncture Kassirski (lalifupi singano, amene ali kumapeto wapotalikira wa mtedza, mandrel, ndi chogwirira zochotseka) nsalu gauze ndi pulasitala zomatira.
kukonzekera mtima
njirayi sikutanthauza maphunziro apadera. Wodwala patsogolo ndi tsiku puncture ndi pa wabwinobwino kudya boma. The puncture imagwiridwa maola awiri kapena atatu mutadya. Kutaya mankhwala onse, kupatula kwa omwe kofunika chifukwa cha matenda. Komanso, onetsetsani kuti muletse kukonzekera munali heparin. Pa tsiku khalidwe zoletsedwa ena mayesero matenda, popanga munthu opaleshoni. Ndi zofunika isanafike ndondomeko wopanda tanthauzo chikhodzodzo ndi matumbo.
Kunyamula sternal puncture
The malo puncture ayenera kusonyezedwa mowa 70º-TH ndi 5% ayodini yothetsera. M'tsogolo, m'pofunika anesthetize. Mu 10 ml syringe kupeza mankhwala ochititsa - lidocaine wa kapena novocaine - 90º ngodya ndi singano umayamba, obezbolivaya. Patapita mphindi 3 pambuyo makonzedwe ya lidocaine angayambe puncture. A kutsogolo khoma sternal puncture singano Kassirski pa III-IV m'mbali mwa m'ma clavicular mzere, ndipo mungathe nsinga za sternum. The singano m'pofunika kuti atchule mofulumira rotational kuyenda. The singano chimafikira kudzera kutsogolo padziko thunthu yaying'ono ndi sternum akulowa mafupa malo, mmene pali kulephera. Zizindikiro za kugwera danga cancellous tikumva M'mimbamo woyendetsa ndi mtima - ululu yochepa. Kenako, kuchotsa stylet ku singano sternal ndi Ufumuyo thereto ndi syringe 20 ml, izo ikuchitika kudzera chiyembekezo cha zili fupa. Kujambula zingalowe aspirated zosaposa 0.20-0.30 ml. magazi. Pambuyo kuti muyenera tinyamuke ndi syringe ndi singano. Pamalo a puncture umagwiritsidwa gauze nsalu zomatira pulasitala ndi kuzilemba. Zamkatimu wa syringe ndi umagwiritsidwa ntchito pa galasi ndi Kupaka. Kuchita ana puncture, tiyenera kukumbukira kuti singano akhoza kudutsa, ichi ndi chifukwa elasticity okwanira sternum lapansi. Sternal puncture odwala amene akutenga corticosteroids kwa nthawi yaitali, ayenera kukwatiwa ndi kusamala chifukwa sachedwa kufooka kwa mafupa.
Zosokonezeka. Zikuonetsa kuti puncture sternal
Mavuto chachikulu ndi magazi ndi puncture kupyolera. M'kati mwa mafupa, mapangidwe magazi zigawo ma, ie, mapangidwe magazi. Sternal puncture chofunika kuti atsimikizire matenda a matenda ambiri: magazi, leukopenia kapena leukocytosis, thrombocytosis kapena thrombocytopenia, ndi mafupa zinchito insufficiency. Kulandira chifukwa molondola kuunikira ntchito za ndondomeko hematopoietic, ndi zosintha structural maselo. Sternal puncture ndi zinkachitikanso odwala chotupa chija amaganiziridwa ndi metastasis.