骨髓穿刺（Bone marrow puncture）.docVIP

骨髓穿刺（Bone marrow puncture） 1. Bone marrow puncture is applicable to: 1. Diagnose the cell morphology of anemia and observe the effect after treatment. 2. Establish the diagnosis of hematopoietic system diseases, such as aplastic anemia, megaloblastic anemia, leukemia, primary thrombocytopenic purpura, etc. 3. Establish the cytological type of leukemia, decide the treatment plan, observe the therapeutic effect, determine the condition and prognosis. 4. Assist in the diagnosis of abnormal cell diseases that can occur in the bone marrow, such as myelopathy, lymphoma, malignant cell growth, and metastasis. 5. Clear reasons for unexplained fever, liver and spleen enlargement, etc. 6. Differential diagnosis of leukemia, chronic myelogenous leukemia, and bone marrow fibrosis. Bone marrow puncture does not apply to hemophilia. Bone marrow collection: 1. Bone marrow fluid collection site: It is commonly used in the posterior superior iliac spine. The anterior superior iliac spine. Bone marrow is safe here. The sternal puncture is not necessary when necessary. 2. Suction volume: in the syringe, the bone marrow fluid (0.2-0.3 ml) is just seen in the syringe, which is not too much, to avoid the effects of peripheral blood dilution. The bone marrow solution should be taken immediately to prevent solidification. To observe the condition of the smear, the bone marrow granule and lipid droplet should be seen in the satisfactory smear. If it is diluted by blood, the film is thin and smooth, and the surface light feels like blood. Bone marrow smear: 1. Smear staining: ritz staining method. Low magnification: To observe the smear, the dyeing is satisfactory. To observe the number of nuclear cells and to determine the extent of bone marrow hyperplasia. The proliferation is generally divided into 5 levels. To observe large cells or specific cells, such as metastatic cancer cells, lymphoma cells, high snow cells, and niem-pickerocytes. We have to count megakaryocytes. The selection of th