骨髓穿刺活檢

康爾福盛骨髓穿刺活檢產(chǎn)品培訓(xùn)解剖骨膜、皮質(zhì)骨、松質(zhì)骨所需的骨髓液及骨髓樣本就在松質(zhì)骨骨膜有豐富的血管和神經(jīng)，骨穿后疼痛就是因?yàn)榇碳ち斯悄だ锏纳窠?jīng)所致。?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.骨髓穿刺活檢的適應(yīng)癥?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.淋巴瘤急性白血病轉(zhuǎn)移癌貧血骨髓抽吸液&骨髓活檢樣本骨髓液骨髓樣本Hodgkin’s病診斷non-Hodgkin’s病診斷分期急性白血病診斷分期Hodgkin’s病診斷non-Hodgkin’s病診斷分期懷疑轉(zhuǎn)移腫瘤確診某些白血病診斷分期不明原因發(fā)熱病因骨髓液量不足?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.骨髓穿刺活檢WHAT?AspirationCore/Trephine/BMBiopsyWHERE?HaematologyLabHaematologyDayUnitsMinorproceduresPathologyOncology?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.WHO?HaematologistsPathologistsOncologistsSpecialistnurses骨髓穿刺活檢部位

髂后上嵴-最常用-髂前上嵴肥胖患者髂后上嵴不好找胸骨僅能做穿刺入路簡(jiǎn)單，有一定危險(xiǎn)需要有經(jīng)驗(yàn)髂后上嵴胸骨髂前上嵴骨髓穿刺活檢部位–兒童*Figure1六歲以下患兒Usetheflat,medialsurfaceoftheproximaltibialshaft(tibialplateau)1-2cmbelowthetibialtuberosityFigure2大于六歲患兒Usethemedialsurfaceofthetibia,proximaltothemedialmalleoluswherethecortexoftheboneandtheoverlyingtissueareboththinFigure1Figure2*如果髂嵴不可用?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.BoneMarrowProcedure?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TheProcedure麻醉–皮膚?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TheProcedure麻醉–軟組織和骨膜?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TheProcedure切口?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TheProcedure穿刺抽吸?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TheProcedure?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.穿刺抽吸TheProcedure活檢?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TheProcedure?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.活檢TheProcedure取出樣本?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TheProcedure檢查樣本長(zhǎng)度?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.康爾福盛公司產(chǎn)品268?2012CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.我們骨髓活檢產(chǎn)品市場(chǎng)占有率全球第一骨髓穿刺抽吸針?圓形把手穿刺抽吸針?DIN?T形把手穿刺抽吸針?TIN?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.康爾福盛公司產(chǎn)品康爾福盛公司產(chǎn)品骨髓活檢針?圓形把手Jamshidi針

DJ?T形把手Jamshidi針

TJC/TJM

TJM配備取樣鏟

?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.骨髓穿刺抽吸針骨髓穿刺抽吸針-TIN?髂嵴/胸骨穿刺抽吸，以及骨內(nèi)注射?人體工程學(xué)設(shè)計(jì)的T形把手?限深器可拆卸?提供成人及兒童型號(hào)?成人:?兒童:TIN3015TIN3018?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TIN–可拆卸限深器7.62cm1cm2.54cm4.76cm最小深度在位時(shí)最大深度移除限深器

移除限深器和底座?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.骨髓穿刺抽吸針-DIN?髂嵴/胸骨穿刺抽吸，以及骨內(nèi)注射?限深器?帽子可旋掉

成人:DIN1515X

兒童:DIN1518X?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.?提供成人及兒童型號(hào)骨髓液涂片?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.骨髓穿刺活檢針骨髓穿刺活檢針--DJ?業(yè)界先鋒?設(shè)計(jì)緊湊?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.DJ針尖設(shè)計(jì)?斜面切割?切割鞘刃口極其銳利

特殊設(shè)計(jì)減少對(duì)樣本結(jié)

構(gòu)的破壞?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.DJ樣本獲取及取出遠(yuǎn)端錐形設(shè)計(jì)?利于持住樣本?最大程度保留樣本的結(jié)構(gòu)不破壞TJC—T型把手骨髓活檢針

把手設(shè)計(jì)

有分量，手感好握持舒適?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.針尖設(shè)計(jì)6切割面(2betweeneachpoint)3切割嵴styletcuttingedges針芯與切割鞘的平滑過渡面3個(gè)切割點(diǎn)銳利的針尖，錨定穿透?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.Trocar針芯?金字塔形–單點(diǎn)接觸?避免骨膜上的滑動(dòng)?多出33%的切割面積?穿刺時(shí)少用25%的力量?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.冠狀設(shè)計(jì)切割鞘?冠狀設(shè)計(jì)-3點(diǎn)/6面?快速有效的入針?光滑的過渡面減少額外疼痛“減速帶”疼痛?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.骨髓取樣鏟中空的樣本推出桿把手末端膨出末端膨出，帶指向箭頭做毛的內(nèi)表面槽:2.7cm壁厚增加30%2條槽把持樣本?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.?末端帶槽以及內(nèi)壁拉毛處理把持樣本?塑料的樣本推出桿減少對(duì)樣本的損傷?推出桿長(zhǎng)1mm，利于樣本完全推出?末端膨出便于把持操作?指向箭頭避免樣本丟失

內(nèi)壁拉毛同軸設(shè)計(jì)可多次取樣尖端斜面?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.骨髓取樣鏟骨髓活檢樣本Jamshidi骨髓穿刺活檢技術(shù)TJC&DJ活檢針

操作技術(shù)?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.TJM活檢針操作技術(shù)?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.樣本質(zhì)量以及尺寸?通常需要2cm長(zhǎng)?5-6個(gè)髓腔可見，沒有明顯結(jié)構(gòu)破碎表現(xiàn)?2013CareFusionCorporationoroneofitssubsidiaries.Allrightsreserved.常見問題

皮質(zhì)骨過多原因/對(duì)策?針芯移除過早–再來一次?用之前的針道–換個(gè)角度?操作技術(shù)不過關(guān)–再培訓(xùn)一次?針太細(xì)–換粗一號(hào)樣本不夠?2013CareFusionCorporationoroneofitssub