What does a bone marrow puncture needle do?

Bone marrow puncture (bone marrow puncture) is a commonly used diagnostic technique to take bone marrow fluid. The examination contents include cytology, protozoa and bacteriology. 1. Selection of the puncture site ①The anterior superior iliac spine: 1~2cm above the back of the anterior superior iliac spine is often used as the puncture point, where the bone surface is relatively flat, easy to fix, convenient and safe to operate; ②posterior superior iliac spine: located in the sacral spine Bone protruding parts on both sides and above the buttocks; ③Sternal stem: This is where the bone marrow content is rich. When the puncture fails at the above parts, the sternal stem can be punctured, but the bone here is thin, and there are atria and large blood vessels behind. Penetration is dangerous and is rarely used; ④Lumbar spinous process: Located at the protrusion of the lumbar spinous process, it is rarely used. Infants under 5.2 years old choose the anterior and inferior tibial tuberosity.　　2. Position When puncturing the sternum and anterior superior iliac spine, take the supine position. Lateral superior iliac spine puncture should be taken laterally. When puncturing the spinous process of the lumbar spine, take a sitting or lateral position.　　3. Routinely disinfect the skin, wear sterile gloves, spread a sterile towel, and use 2% lidocaine as a local infiltration anesthesia until the periosteum. 4. Fix the bone marrow puncture needle holder at an appropriate length (the iliac bone puncture is about 1.5cm, the obese people can lengthen it appropriately, and the sternum stem puncture is about 1.0cm), fix the skin of the puncture site with the thumb and index finger of the left hand, and hold the needle in Pierce the bone surface vertically (if it is a sternal stem puncture, the puncture needle is pierced obliquely at an angle of 30-40° to the bone surface). When the resistance disappears and the puncture needle has been fixed in the bone, it means that it has entered the bone marrow cavity. 5. With a dry 20ml syringe, withdraw the inner plug 1cm, pull out the needle core, connect the syringe, and slowly suck with appropriate strength. It can be seen that a small amount of red bone marrow fluid enters the syringe. The suction volume of bone marrow fluid is 0.1～0.2ml. It is advisable to remove the syringe, push the bone marrow fluid onto the glass slide, and the assistant will quickly make 5 to 6 smears, and submit them for cell morphology and cytochemical staining.　　 6. If bone marrow culture is needed, connect the syringe again, and suck 2～3ml of bone marrow fluid into the culture medium. 7. If the bone marrow fluid cannot be drawn, the needle cavity may be filled with skin, subcutaneous tissue or bone fragments, or the needle may be inserted too deep or too shallow, and the needle tip is not in the medullary cavity. At this time, the needle core should be inserted again. , Rotate it a little bit or drill a little more or withdraw a little more, pull out the needle core, if you see blood stains on the needle core, you can expect to get bone marrow fluid by aspirating again.　　 8. After the suction is completed, insert the needle core, turn slightly to pull out the puncture needle, then cover the needle hole with sterile gauze, press it slightly, and fix it with tape. Note 1. After the puncture needle enters the bone, avoid swinging too much to avoid breaking.　　2. Do not insert the needle perpendicular to the sternal stem puncture. Do not use excessive force to prevent penetration of the medial bone plate.　　3. When aspirating bone marrow fluid, gradually increase the negative pressure. When doing cell morphological examination, the aspiration volume should not be too much, otherwise it will dilute the bone marrow fluid, but it should not be too small.　　 4. Smear should be taken immediately after bone marrow fluid extraction.　　5. Bone marrow biopsy should be performed during multiple dry aspirations</SPAN></p> The significance of bone marrow aspiration Anemia has many causes, but the most common one is iron deficiency anemia. Usually after the diagnosis is diagnosed, iron supplementation is used for treatment. If it does not get better, it means that other aspects may cause anemia, such as: megaloblastic anemia, thalassemia, aplastic anemia and so on. It may also be a problem with the body's absorption of iron. These are all possible. In order to rule out the possibility, it is necessary to do bone penetration. Through the bone puncture, you can see the changes in the morphology and composition of various components in the bone marrow and cells. So as to diagnose the specific cause. Bone puncture is not to prove leukemia. Osteopuncture is the most basic diagnostic method in hematology. It is also necessary. "Bone puncture" is to penetrate the bone marrow cavity with a puncture needle to extract a small amount of bone marrow for laboratory tests. Some patients mistakenly believe that the extraction of bone marrow fluid for bone marrow puncture will damage the body’s essence, damage and vitality, and are unwilling to perform the examination. In fact, the bone marrow fluid required for bone marrow examination is very small, generally about 0.1ml, while the total amount of normal human bone marrow fluid is about 2600ml. It can be seen that the bone marrow fluid drawn during bone marrow puncture examination is insignificant compared with the total amount of human body. What's more, there is continuous regeneration of a large number of cells in the body every day. In addition, patients often think that bone marrow aspiration is painful and fearful, but in fact it is unnecessary. "Bone puncture" does not have any danger, nor does it leave anything behind. Sequelae. Some diseases, especially some blood diseases, cannot be diagnosed without this examination. If the condition requires it, you should do it without hesitation. Even if the bone marrow does not have any disease, it is a big gain, because the elimination of blood diseases can not only The mental burden is relieved, and at the same time, the pain and possible side effects of unnecessary treatments for patients and their families can be relieved.

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