Sternal puncture: hana 'ana i kūpono, nāʻikepili a me complications

Sternal puncture - he ano o ka noiʻi o ka iwi ka lolo. Kēia iaoia ninoieo ma ka medullary sternal puncture mua paia me ka kūikawā kuikele. Sternal puncture ua hana ma ka haukapila a ma ka outpatient manawa. No keia mea ma ka puncture ua haliia mai la mawaho, i ka papa kuhikuhiE mea e e malama i kona kanawai o ka aseptic a me ka antiseptic.

lako a

E puncture pono: 70º-la ka waiʻona, 5% iodine pāʻoihana, lidocaine a procaine no anesthesia, elua ohe - 10 a me 20 ml, kui kele ma sternal puncture Kassirski (pōkole kui kele, a i ma ka distal hope o ka Nut, mandrel, a me ka weheʻia i lawelawe,) lole gauze a me ka lina puna.

hoʻomanawanui hoomalolo

Kēia kaʻina hana 'Aʻole e koi kuikawa aʻo. Ke hoʻomanawanui ma mua, a me ka lā o ka puncture mea ma luna o ka maʻamau ai ana? Eia. Ke puncture ua hana i loko o elua a ekolu paha hora ma hope o kaʻaiʻana. I kāpaeʻia a pau ai ', koe wale no ka poe e pono ai ola kumu. Nō hoʻi, eʻoiaʻiʻo e ana hoʻomākaukau i loaʻa heparin. Ma ka lā o ka i pāpā 'ia' ē aʻe PalekanaEND_LINK ho'āʻo ma,ʻoki lāʻau lapaʻau kaʻina hana. He kupono ma mua i ke kaʻina hana e ninini i ka bladder a me ka naʻau liʻiliʻi.

E hali ana i sternal puncture

Ke puncture paena E e hana me ka waiʻona 70º-la a me ka 5% iodine pāʻoihana. I ka wā e hiki mai, e mea pono e anesthetize. Ma ka 10 ml 'ohe ho onui ana anesthetic - lidocaine a novocaine - 90º huina, a ua hoʻolauna i ke kuikele, obezbolivaya. Mahope o 3 minuke ma hope o aaieieno? O lidocaine hiki hoʻomaka puncture. A mua pā sternal puncture kui kele ma Kassirski ma III-IV lua penei o ka hapalua like-clavicular laina, a hiki loaʻa ka sternum. Ke kui kele ma ka pono, e hoʻolauna i kokololio rotational neʻeʻana. Ke kui kele ma kŰlń ao ma ka mua ili o ka olelo hoopomaikai waiwai, a me ka sternum komo i ka iwi lolo makahiki, kahi mea he ole. Na hoailona o ka haule ana i loko o ka cancellous makahiki e manao ana lua Aʻole a me ka hoomanawanui - he pōkole-makahiki eha. Next, wehe i ka stylet mai ka sternal kui kele, a pili ia i ka 'ohe o 20 ml, ka mea, ua lawe Via wehena o ka iwi maʻiʻo. E pili ana i ka holo aspirated i oi aku 0.20-0.30 ml. ke koko. Ma hope o ia 'oe pono e huki mai i ka' ohe a me ke kui kele ma. Ma ka paena o puncture ua noi gauze lole lina puna, a kāpili ma luna. Contents o ka 'ohe ua pili i ke aniani, a haukaʻe i. Hana puncture keiki, ka mea pono e hoomanao i ka puka o ke hele ma, keia mea ku pono i ka lawa elasticity o ka sternum. Sternal puncture i loko o nā mea maʻi i mea e lawe corticosteroids no ka lōʻihi manawa, e ke apo akuk ai me ka mālama nui, no ka mea, e prone e osteoporosis.

Complications. Nāʻikepili no ka sternal puncture

I ka papa kuhikuhiE complications e kahe ana ke koko a me ka puncture ma. I ka iwi a ka lolo, i ke kahua o ke koko ke kelepona hele eiiiiiaiou, 'o ia hoʻi, i ke kahua o ke koko. Sternal puncture ua pono e hōʻoia i kaʻike, o na maʻi: maʻi anaemia, leukopenia a leukocytosis, thrombocytosis a thrombocytopenia, a me ka iwi lolo ooieoeiiaeuiiai insufficiency. E loaa ana i ka hopena hiki pololei loiloi i ka ha awina o hematopoietic kaʻina, ke mall ka hoʻololi 'ana o ke keena. Sternal puncture ua i hana ai i nā mea maʻi i kēia malignancy a me ka metastasis.