bone marrow nucleated cell count

Based on the examination of the degree of proliferation of bone marrow cells, the proportion of cells in each major hematopoietic system in the bone marrow was further analyzed. Basic Information Specialist classification: cardiovascular examination classification: microscopy Applicable gender: whether men and women apply fasting: fasting Tips: hemophilia and diffuse intravascular coagulation, if there is no special need, do not do bone marrow puncture examination. Normal value (10 to 180) × 109 / L (1 to 180,000 / mm3). Clinical significance (1) Increased bone marrow hyperplasia, such as leukemia, hemolytic anemia, hypersplenism and so on. (2) Reduce the dysfunction of hematopoietic tissue, such as aplastic anemia. Low results may be diseases: macroglobulinemia, congestive splenomegaly, high results may be diseases: acute neutropenia, pediatric restricted cardiomyopathy considerations Preoperative preparation: The patient is placed in accordance with the doctor's instructions. Inspection process (1) Bone marrow material: There are sternum, spinous processes, anterior or posterior tibia, etc. It is best to use the humerus for children under the age of two, and the upper iliac spine is often taken by adults. This part is convenient for puncture and easy for patients to accept. Strict disinfection is required before puncture to eliminate bacterial infection. In addition to UV disinfection and skin disinfection in the puncture chamber, it should also be noted whether the puncture bag and glove disinfection time have expired. Wear gloves to be proficient and avoid contact with unsterilized items. When the puncture needle enters the medullary cavity, there is often a feeling of detachment. There should be about 1 ml of void in the sputum before the suction, otherwise the medullary fluid will quickly enter the space of the syringe and cannot be taken out. If there is water in the syringe, wipe it with sterile gauze to avoid lysis of cells. The amount of liquid absorption is generally controlled at about 0.2 ml. Due to excessive absorption, it is easily diluted by peripheral blood. When some patients dry or suck too little, do not pull out the needle immediately. You can adjust the depth of the needle while pulling, or slowly move the needle while pulling. Finally, the residual marrow fluid in the needle should be pushed out and produced as much as possible. Reduce patient suffering. (2) Smear: After the bone marrow is taken out, it should be immediately placed on a pair of obliquely placed slides, so that the excess peripheral blood naturally flows down, and the medullary fluid with more small granules on the upper part is scraped by a pusher to push the piece on another clean slide. The slides are preferably immersed in dilute nitric acid solution, rinsed with water, and then immersed in distilled water. Avoid baking in a rust oven or using a wire basket to reduce false positive iron staining caused by iron contamination. At the same time, slides that have been tested for bacteria are best not to be used for bone marrow examination. (3) Dyeing: Two pieces of bone marrow with more small particles and uniform thickness were selected. After natural drying, the patient's name, date and "BM" mark were written on the thick head membrane. 8 to 12 drops of Gareth's staining solution, suck with a suction ball and make it cover the entire smear. After about half a minute, add 5 to 10 drops of the Giemsa dilution, and then inhale with a suction ball to make two The liquid is thoroughly mixed, and if a golden oil film appears, the dyeing effect is better. The dyeing time is generally 10 to 20 minutes, which can be shortened in summer and extended in winter. Slide the slides gently to allow the running water to rinse slowly. In addition, there may be dye residue at the hand slide, and the hand position should be replaced and rinsed. The smear stained too lightly can be counterstained with Giemsa dilution for 3 min; when the staining is too deep, it can be applied to the smear with Wright stains and rinsed immediately. It is best for each laboratory to explore its own dyeing experience and try to achieve a one-time dyeing success. Units without Giemsa dye solution can be replaced with distilled water plus a small amount of azure (or methylene blue), but the dyeing effect is not as good as the former. The dyed smear should be naturally dry, and should not be heated and dried, otherwise the cells will fade and affect the observation. Not suitable for the crowd Hemophilia and disseminated intravascular coagulation, if there is no special need, do not do bone marrow puncture. Adverse reactions and risks 1, dizziness or fainting: in the blood draw, due to emotional overstress, fear, reflex caused by vagus nerve excitement, blood pressure decreased, etc. caused by insufficient blood supply to the brain caused by fainting or dizziness. 2. Risk of infection: If you use an unclean needle, you may be at risk of infection.