I-sternary puncture iyindlela yokutadisha umongo wethambo. Le ndlela iqukethe umthambo wamathambo wesibhakabhaka sangaphakathi sternum enaliti ekhethekile. I-Sternary puncture yenziwa kokubili izilungiselelo zesibhedlela kanye neziguli. Akunandaba ukuthi kukhishwa nini, into eyinhloko ukuthi imithetho ye- asepsis ne-antiseptics iyabonakala ngesikhathi sayo .
Izinsiza
Ukuze uthole i-puncture, udinga: 70º utshwala, isisombululo se-iodine esingu-5%, i-lidocaine noma i-novocaine ukuze uthole ukuphumula ubuhlungu, izinwele ezimbili - 10 no-20 ml, inaliti yokupaka okungapheli uKassirsky (inaliti emfushane ene-nut endal distal, I-Napkin ye-gauze ne-adhesive plaster.
Ukulungiselela isiguli
Le nqubo ayidingi ukulungiselela okukhethekile. Isiguli esontambama kanye nosuku lokugcoba kudla okujwayelekile. Isikhathi senziwa amahora amabili kuya kwamathathu ngemva kokudla. Zonke izidakamizwa zikhanseliwe, ngaphandle kwalezo ezidingekile ezibonisweni zokuphila. Kudingeka futhi ukukhansela amalungiselelo aqukethe i-heparin. Ngosuku lokuqhuba ngalo akuvunyelwe ukuqhuba ezinye izinqubo zokuhlola, izinqubo zokuhlinzwa. Kunconywa ukuthi ungenalutho isisu nesisu ngenxa yenqubo.
Ukukhipha i-puncture yangaphandle
Indawo yokuphumula kufanele iphathwe nge-70 ° utshwala nesisombululo se-5% se-iodine. Esikhathini esizayo, kudingekile ukuba u-anesthetize. I-anesthetic - lidocaine noma i-novocaine - ijojowe ibe yindilinga engu-10 ml kanti inaliti ijojowe engxenyeni engama-90 °, i-anesthetizing. Ngemuva kwemizuzu emithathu emva kokuphathwa kwe-lidocaine, kungenziwa iqhwa. Ingxenyeni yangaphambili ye-sternum ihlonywe inaliti yeKassirsky ezingeni lezintambo ze-III-IV eceleni komugqa ophakathi, futhi kungenzeka ukufaka i-sternum kwisibambo. Izinaliti zidinga ukujova ngokunyakaza okusheshayo kokujikeleza. Inaliti idlula nge-compact substance ye-frontal surface of the sternum futhi ingena isikhala medullar, ngenzwa ukuhluleka. Izibonakaliso zokuwela esikhala esiphepheni kukhona inzwa yi-opharetha wesigxobo, kanye neziguli - zobuhlungu besikhathi esifushane. Ngokulandelayo, susa i-mandril enaliti yangaphandle bese unamathisela iseringana engu-20 ml kuyo, ukuyisebenzisa ukuze ufise isifuba. Uma udala i-vacuum, i-aspirate ayikho ngaphezu kuka-0.20-0.30 ml. Igazi. Ngemuva kwalokhu, kubalulekile ukukhipha isirinji kanye nenaliti. Esikhathini sendawo yokugcoba, kusetshenziswe i-napze ye-gauze bese ukhonta okunamathela. Okuqukethwe kwe-syringe kusetshenziselwa ingilazi futhi isilonda senziwe. Ukwenza i-puncture kubantwana, kubalulekile ukukhumbula ukuthi inaliti ingahamba ngqo, lokhu kungenxa yokuqina okwanele kwe-sternum. I-sternary yokugcoba iziguli ezithatha i-corticosteroids yesikhathi eside kufanele iqashwe ngokucophelela, ngoba inesifiso sokwelapha i-osteoporosis.
Izinkinga. Izinkomba zokukhishwa kwangaphandle
Izingqinamba eziyinhloko zikhona ngokugwedla nokuphuma kwegazi. Emnothweni wethambo kukhona ukwakheka kwezakhi zamaselula zegazi, okungukuthi, i-hematopoiesis. I-sternary puncture iyadingeka ukuqinisekisa ukutholakala kwezifo eziningi: i-anemia, i-leukopenia noma i-leukocytosis, i-thrombocytosis noma i-thrombopenia, kanye nokwehluleka komnyoko wethambo. Uma sithole umphumela, kungenzeka ukuba uhlole ngokunembile umsebenzi wenqubo ye-hematopoiesis, izinguquko zombuso nezakhi emasethini. I-sternary puncture nayo yenziwa iziguli ezinomsoco ongenayo okusobala kanye ne-metastasis.