Sternary puncture ndiyo imwe yenzira dzekudzidza pfupa remapfupa, rinoitwa ne puncturing rusvingo rwekare rwe sternum. Bone marrow ndiyo nhengo inokosha ye hematopoiesis, iyo inosurupa yakazadza mumapfupa nzvimbo dzose dzisingabatanidzi nemapfupa emapfupa.
Zviratidzo zvekunze kwekunze
Sternary puncture inogadzirwa mukuongororwa kwezvirwere zvehutachiona uye inopa ruzivo rwakakosha pamusoro pekufananidzira kwechirwere. Iyi nzira inogona kuiswa kana iwe uchifungidzira:
- leukemia;
- anemia ;
- myelodysplastic syndromes;
- Gaucher's disease;
- Chirwere chaKristuen-Schuller;
- visceral leishmaniasis;
- metastases yemakumbo mumapfupa emafuta, nezvimwewo.
Inobvumira kuongorora hutano hwemamiriro emapfupa emapfupa, kuona zviduku kudarika muitiro we hematopoiesis.
Kugadzirira murwere nehana yekusingaperi
Pazuva rekudzidza, mvura yemurwere uye kudya hakufaniri kuchinjwa. Iyo nzira inoitwa kwete pasingapfuuri maawa maviri mushure mekudya nemukaka uye musumbo usina chinhu.
Usati waita chivharo, unofanirwa kurega kutora mishonga yose, kunze kwemishonga inokosha. Uyewo pane zuva rino, chero humwe hutano hwehutano uye hunoongorora hunogadziriswa.
Murwere anofanira kutsanangura chimiro uye nzira yehutano, kupa ruzivo pamusoro pezvinetso zvinogona kuitika. Mushure meizvi, kubvumirwa kwemurwere kunopiwa kwekuvhara.
Sternal puncture technique
Nguva yefupa remafupa inogona kuitwa mukati mekugadzirisa zvirongwa:- Kushandiswa kunoitwa pasi peanesthesia yepanyika munzvimbo yechiremba ari mushure make. Nokuti nzira yekusingaperi kwechigodo inokosha inoshandiswa inoshandiswa - nheyo yeKassirsky. Icho chidimbu chidiki chine mheyo ine nhu inopedza kudzika kwemvura yekudzivirira (kudzivisa kuparadza kunokonzerwa nhengo dzomuviri), mandrel (tsvimbo yekuvhara lumeni yenzono), uye kusunungura kushandiswa kunobatsira kupora.
- Nzvimbo yepaccture inobatwa nedoro uye iodine solution.
- Kuwedzera kune anesthesia inoitwa - sekutonga, 2% sarudzo ye novocaine inoshandiswa. Panguva yekufamba kwenguva, zvinogona kunge zvichishungurudzika zvishoma pakurwadziwa uye kubvarura marora muminwe, yakaenzana nejaija yakajairika.
- Iko kunoshandiswa nekufambisa kwekukurumidza kwebasa re Kassirsky (rine mandrel inowanikwa) pamwe nemuganhu wepakati pakureba kwechipiri-chechitatu nzvimbo inoputika. Apo nheyo inopfuura nepakati pechinhu che cortical uye inopinda nzvimbo ye medullar, kunzwa kwakasiyana kwekukundikana kunobuda. Kana paine kusava nechokwadi kwekuti nhare inopinda mumapfupa emapfupa, cheki nechishuvo chinoitwa.
- Sirasi yakanamatirwa nesingano mushure mokunge mandrene yabviswa uye inenge 0,2 kusvika ku3 m3 yemafuta emasora inonwa. Mushure mokunge, tsono yacho inobviswa kubva mu sternum, uye bhanhire risina kuiswa rinoshandiswa kunzvimbo yekunyura uye yakagadzirirwa nekaputi yakanamatira.
- Iko yakagadzirwa yemafupa ekumiswa kwemafuro inowanikwa mundiro yePetri, swabs inogadzirirwa pane slide, iyo inotevera
inongororwa pasi pekroscope. Kuongorora morphology uye kuverenga kwemafupa emasero masikati kunoitwa.
Matambudziko ehupenyu husingaperi
Zvakaipa zvinokonzerwa nekusingaperi kwepacture zvinogona kuva kuburikidza ne sternum puncture uye kubuda kubva panzvimbo yekunyura. Kupfurikidza nekuputika kunowanzoitika mukugadzirisa kwemwana nekuda kwesimba rakanyanya re sternum nekufamba kusingabatsiri kwomwana. Kuchenjerera kunofanira kushandiswa pakuita kushandiswa nevarwere vanotora nguva yakareba corticosteroids (nokuti vanokwanisa kuva neosteoporosis ).