- 期刊
使用21號頭皮針施行兒科病人骨髓抽吸術
Bone Marrow Aspiration with a 21-Gauge Scalp Vein Needle
摘要
從民國71年10月到72年5月，共歷8個月，我們以21號頭皮針代替Turkel骨髓抽液針，試行12歲以下小兒病患骨髓抽吸術，期間住於三軍總醫院小兒科患童，以須要接受骨髓檢查者爲對象，經徵得家屬同意後進行骨髓抽吸抹片檢查。另外對高度懷疑血液病患童同時進行本法及傳統標準之法於不同位置取得之標本抹片互作對照比較，其結果如下：接受檢查之64名患童中，男童佔34名，女童佔30名，只有5名行第1次抽吸時因針孔阻塞而告失敗，第2次抽吸時全部成功。失敗的5名中，無特殊男女之別，失敗的傾向隨年齡而增加。我們抽樣將不同之抹片交由血液科不同醫師鑑定，其結果並無出入，同時亦將本法及標準抽吸所得之抹片做雙重檢查，兩者之間幾於差別，白血病抹片診斷亦和細胞表面標志相符合。因此，我們推介這是一簡單、快速、安全又準確之方法，除可減低兒童疼痛之外（由臨床觀察及成人自願者口述），又可去除其恐懼心理，69次穿刺，沒有發生流血，感染或針軸斷裂於骨髓中。應可廣泛適用於小兒科病人。
關鍵字
無資料並列摘要
Bone marrow aspiration is a painful procedure, in part because of the large size of the needle, which is usually of the size of 14- to 17-gauge. Recently, we have substituted a 21-gauge scalp vein needle in an effort to reduce the trauma to children undergoing this procedure. The records of 64 patients, on whom the procedure was used, were reviewed. The volume of aspirate obtained varied from 0.1 to 0.2ml. In all instances, the need for injection of a local anesthetic agent was eliminated. Bone marrow morphology appeared to be comparable to that of ordinary procedure and the volume of marrow blood obtained was sufficient for all studies. 59 out of 64 scalp vein needle bone marrow aspirations were successful on the first puncture. There were five dry taps in the beginning of the study, probably due to the blockage of the needles. In such cases only the second and no third puncture were needed to get adequate specimens. In two children, 21-gauge needle aspiration failed to obtain spicules of the marrow on the slides but there were adequate cells for evaluation. In leukemic patients, the marrow aspirates obtained with a 21-gauge scalp vein needle were as satisfactory as with Turkel's needles. This technique is simple to master, and needles are disposable. Because the procedure causes little pain and distress, it seems to be a useful procedure. We are now using this technique routinely in pediatric patients with satisfactory results.