From Big Medical Encyclopedia

STERNAL PUNCTURE (Greek sternon breast, breast + lat. punctio a prick) — the marrowy puncture made through a front wall of a breast; one of methods of an intravital research of functional capacity of marrow.

To page of the item it is offered by M. I. Arinkin in 1927 and it is carried out by means of Kassirsky's needle. The puncture is carried out in position of the patient on spin with the roller enclosed under shovels. The breast is pierced on the centerline (a front midline, T.) at the level of an attachment of the III—IV edge. At newborn S. items make in the handle of a breast, perpendicular to a front plate. During the passing of a needle through a layer of cortical (compact) substance of a front surface of a breast and hit in spongy (marrowy space) the feeling of a failure is noted. It must be kept in mind that at children's age the puncture of a breast through in connection with its bigger elasticity, individual distinctions in thickness and owing to involuntary movements of the child is possible. Extra care shall be observed also at patients, receiving glucocorticoid drugs since they can have an expressed osteoporosis a long time.

Kassirsky's Eagle, attached to the syringe: 1 — a needle; 2 — a safety guard; 3 — the coupling; 4 — a screw thread; 5 — a cannula; 6 — the syringe.

The place of a puncture is processed alcohol and spirit solution of iodine. Anesthesia, as a rule, is not required. The bone is pierced with a needle, making rotary motions by the handle of mandrin. After that mandrin is extracted and get the ten-gram syringe with well driven piston (fig.) by means of which aspiration of marrow is carried out.

The syringe before a puncture is processed ether (dry up). Gradually creating vacuum in the syringe, nasasyvat no more than 0,2 — 0,3 ml (before emergence in the syringe of the first drops of a marrowy suspension). Then the needle is removed from a breast.

To the place of a puncture impose a sterile sticker. Contents of a needle and the syringe squeeze out on a slide plate.

Quantification of marrowy punctate is made by the general rules of a blood analysis (see. Gemogramma , Leukocytic formula ). Define absolute quantity of yadrosoderzhashchy cells of marrow — myelocariocytes. For assessment of a condition of a marrowy hemopoiesis use calculation miyelogramm (see).

The research of marrow is of great importance in diagnosis of anemias, leukoses, hypo - and aplastic conditions of a hemopoiesis, tumors and other diseases. Punctate of marrow can be used for various biochemical, cytochemical and immunological researches. Diagnostic opportunities of a method C. of the item considerably extend during the performance gistol. researches of the marrowy particles (crumb) which are contained in aspirirovanny material that allows to make more exact idea of the general structure of marrow, of a ratio of active and fatty myeloid tissue, of its cellular structure. It is represented also possible to characterize a condition of a stroma, vessels of marrow.

Bibliography: Arinkin M. I. To a technique of a research during lifetime of marrow at patients with a disease of the hemopoietic bodies, Vestn. hir., t. 10, book 30, page 57, 1927; Voronin V. M., etc. A histologic research of marrow at hypo - and aplastic states, Probl. gematol. and modulation, blood, t. 13, No. 10, page 30, 1968; Kassirsky I. A. and Alekseev G. A. Clinical hematology, M., 1970; Sukhanov Yu. S. A method of calculation of absolute quantity of myelocariocytes in a trepanata by means of a grid Goryaeva, Laborat. business, No. 5, page 279, 1968; I r at-stovsky JI. E. K to a question of morphological structure of marrow is normal, in the same place, No. 7, page 397, 1975.

Yu. S. Sukhanov.