Sternal puncture: mokhoa tshebetso, ho bonahala le mathata

Sternal puncture - le mokhoa oa ho etsa lipatlisiso tsa lesapo moko. Mokhoa ona e na le ka medullary sternal leboteng puncture ka pele le nale e khethehileng. Sternal puncture o etsoa sepetlele kapa ka mokgwa o sa outpatient motheo oa. Ho sa tsotellehe hore moo puncture e atlehe, ntho e ka sehloohong hore le hlokomeloe nakong melao lona tsa aseptic le sebolaya dikokwana-hloko.

thepa

Ho puncture hlokahala: 70º-th, joala, 5% iodine litareng e tharollo, lidocaine kapa procaine bakeng thethebatso, linale tse peli - 10 le 20 di ml, nale sternal puncture Kassirski (lekgutshwanyane nale, le nang le qetellong distal tsa nut, mandrel, 'me e mohele ntshuwang) lesela gauze le samente sekgomaretsi.

ba lokisetsa ho ba le mamello

Mokhoa ona ha a hloke ho fana ka koetliso e khethehileng. Mokuli pele 'me letsatsi la puncture ke ka le tloaelehileng fepa puso. The puncture o etsoa ka mor'a lihora tse peli kapa tse tharo ka mor'a ho ja. Lahle lithethefatsi tsohle, ntle le bakeng sa ba hlokahala ka mabaka a bophelo. Hape, etsa bonnete ba ho hlakola litokisetso nang heparin. Ka letsatsi la boitšoaro thibetsoe tse ling liteko tekotshupo, ditsamaiso ho buoa. Ho tse lakatsehang pele ho buuoa ho se nang letho le senya le mala.

Jereng sternal puncture

Setšeng puncture lokela ho tšoaroa ka joala 70º-go th le 5% iodine litareng e tharollo. Nakong e tlang, ho ke ke ho hlokahala hore ho anesthetize. Ka 10 di ml ente fumana thethefatsa - lidocaine kapa novocaine - 90º angle le nale ho e hlahiswa, obezbolivaya. Ka mor'a metsotso e 3 mora tsamaiso ea lidocaine ka qala puncture. A pele leboteng sternal puncture nale Kassirski ka III-IV molekeng oa bohareng ba bo-clavicular mola, 'me ka litlamong tsa ka sternum. The nale ho hlokahala hore ho hlahisang ka potlako rotational sisinyehang. The nale fetela le ka holim 'pel'a ntho diseke ee le sternum kena lesapo moko sebaka, moo ho na le ke ho hloleha. Lipontšo tsa ho oela sebaka sa cancellous ba ikutloa cavity opareitara e le mamello - le bohloko ka nakoana. Ka mor'a moo, tlosa stylet tloha nale sternal le khomaretse tlhokeng syringe la 20 di ml, ho o etsoang ka tsela aspiration ya dikahare masapo. Bōpa e lephaka aspirated fete 0.20-0.30 di ml. mali. Ka mor'a moo u lokela ho hula tsoa ho ente le nale e. Ka sebaka sa puncture e sebelisoa gauze lesela sekgomaretsi samente le baked. Dikahare tsa ente e sebelisoa ho khalase le smearing. Etsa bana puncture, e lokela ho a hopola hore e nale ka feta ka, sena ke ka lebaka la ho elasticity lekaneng sternum ena. Sternal puncture bakuli ba nkang corticosteroids bakeng sa nako e telele, e lokela ho etsoa ka hloko hobane ke le tsekamelo ea ho osteoporosis.

Mathata. Ho bonahala ho puncture sternal

The mathata a ka sehloohong a tsoa mali 'me puncture ka. Ka bone bone moko, sebopeho sa mali dikarolo lisele, ke hore,, sebopeho sa mali. Sternal puncture e hlokahalang bakeng sa ho tiisetsa fumanoe mafu a mangata: khaello ea mali, leukopenia kapa leukocytosis, thrombocytosis kapa thrombocytopenia, le masapo moko tshebetso insufficiency. Ho fumana sephetho ka nepo a hlahloba mosebetsi oa thulaganyou e hematopoietic, ho diphetolo mehaho ea lisele. Sternal puncture o boetse o entseng ho bakuli ba malignancy belaela le metastasis.