The Specific Operation Method Of Bone Marrow Acupuncture

1. Selection of puncture site ① Anterior superior iliac spine: often take 1~2cm behind and above the anterior superior iliac spine as the puncture point, where the bone surface is flat, easy to fix, convenient and safe to operate; ② posterior superior iliac spine: located in the sacral vertebra The bony protruding parts on both sides and above the buttocks; 3. Manubrium: This place is rich in bone marrow. When the above-mentioned parts fail to be punctured, the manubrium can be punctured. Penetration is dangerous, so it is less used; ④ Spinous process of lumbar spine: It is located at the protrusion of spinous process of lumbar spine and is rarely used. Infants under the age of 2 choose the anterior and inferior tibial tuberosity.

2. Posture The supine position was taken when the sternum and the anterior superior iliac spine were punctured. The lateral decubitus position should be taken during puncture of the posterior superior iliac spine. The lumbar spinous process was punctured in a sitting or lateral position.

3. Routinely disinfect the skin, wear sterile gloves, lay a sterile towel, and use 2% lidocaine for local infiltration anesthesia until the periosteum. Do "pin" shape multi-point anesthesia. Wait for about 2 minutes to allow the periosteum to be fully infiltrated and anesthetized.

4. Fix the bone marrow puncture needle fixer at an appropriate length (about 1.5cm for iliac puncture, lengthen for obese people, and about 1.0cm for sternum puncture), fix the skin at the puncture site with the thumb and index finger of the left hand, and hold the needle in the right hand. The bone surface is pierced vertically (in the case of the manubrium puncture, the puncture needle is inserted obliquely at an angle of 30-40° to the bone surface). When the resistance disappears and the puncture needle is fixed in the bone, it indicates that it has entered the marrow cavity.

5. With a dry 20ml syringe, withdraw the inner plug by 1cm, pull out the needle core, connect the syringe, and slowly aspirate with appropriate force. A small amount of red marrow fluid can be seen entering the syringe. The amount of marrow fluid aspirated is 0.1~0.2ml. If appropriate, remove the syringe, push the bone marrow fluid on the glass slide, and quickly make 5 to 6 smears by the assistant, and send them for inspection of cell morphology and cytochemical staining.

6. For bone marrow culture, connect the syringe and aspirate 2~3ml of bone marrow fluid into the culture medium.

7. If the marrow fluid cannot be extracted, it may be that the needle cavity is filled with skin, subcutaneous tissue or bone fragments, or the needle is inserted too deep or too shallow, and the needle tip is not in the medullary cavity, and the needle core should be reinserted at this time. , rotate a little or drill a little more or withdraw a little more, pull out the needle core, if you see blood on the needle core, you can expect to get bone marrow fluid by suction again.

8. After the suction is completed, insert the needle core, turn it slightly and pull out the puncture needle, then cover the needle hole with a sterile gauze, press it slightly, and fix it with adhesive tape.

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