A puncture is a puncture of the organ. The procedure is carried out for diagnostic or therapeutic purposes.
Bone marrow puncture
Patients produced for his research,donors - in order to obtain healthy biological material. Such bones as ileal, epiphysis of tibial, heel and sternum are exposed to puncture. In adults, the iliac crests and the sternum are most commonly involved in the study. Puncture of the bone marrow can be made even in the spinous process of the lumbar vertebra. Due to the smaller thickness and density of the sternum in children, its puncture in this area is very dangerous. In childhood (including the earliest), bone marrow puncture should preferably be carried out in the tibia (its upper third).
The procedure is performed with anesthesia, inaseptic conditions of the operating room. Puncture of the bone marrow is carried out in the position of the patient lying on his back. With the help of a hollow needle, the sternum is pierced at the level of the third rib. A special puncture needle is equipped with a limiter disc to regulate the depth of puncture.
Под микроскопом осуществляется изучение colored smear taken material. This allows you to detect the presence of atypical cells and other changes. In the presence of bloody impurities in punctate, blood is removed using filter paper or sucked off with a pipette. This need is related to the fact that excessive admixture in the material of peripheral blood does not allow to obtain an accurate understanding of the composition of the bone marrow. In case the biological material is too liquid, the leucoconcentration method is used. After separation of the cells from the plasma, smears are made from the precipitate.
Пункция (биопсия) костного мозга осуществляется в purposes of diagnostic confirmation of metastases, elucidation of the causes of thrombocytosis, leukocytosis, anemia. This procedure also allows you to evaluate the effectiveness of the applied drug therapy for blood diseases.
Rare enough in medical practice.complications with diagnostic puncture. As a rule, they can be associated with infection in the bone marrow cavity. When conducting sternal puncture there is no likelihood of damage to large vessels. Only in the case of gross noncompliance with the research technique are possible violations of the integrity of the internal organs.
Spinal puncture
This procedure is used for extraction and subsequent research of liquor or for the purpose of infusion of radiopaque or medicinal substances.
During the procedure, the needle is inserted into the subarachnoidspace. Puncture can be made at different levels of the spine. More often the puncture is carried out in the lumbar region, in rare cases in the thoracic region, in the region of the large opening.
Lumbar (lumbar) puncture gives a veryvaluable diagnostic data. Liquor obtained during the procedure may contain bloody or purulent impurities. This suggests meningitis or subarachnoid hemorrhage. Cerebrospinal fluid may be clear. With the help of a manometer (a glass tube bent at an angle, with the existing centimeter divisions), it is determined under what pressure the liquor flows out of the needle: increased, normal or reduced.
Brain puncture for hematomas
As practice shows, today, compared toIn past years, this procedure has few indications. In particular, the need for a puncture in order to detect intracerebral hematoma (in the absence of CT) has significantly decreased. According to some specialists, puncture should not be performed for this purpose, since the procedure contributes to the aggravation of the damage, while hematomas are usually not detected.
