paracentesis

Abdominal puncture is used to determine the nature of the ascites, to find the pathogen, and to assist in the diagnosis. When a large amount of ascites causes difficulty in breathing or abdominal pain, it can also be puncture to relieve symptoms. The commonly used puncture site for internal medicine is the intersection of the middle and outer 1/3 of the umbilical cord and the anterior superior iliac spine. Severe bloating or intestinal paralysis in patients with intestinal dilatation, a large amount of gas accumulation in the intestine, effusion, intestinal peristalsis weakened or disappeared. When the puncture needle breaks through the peritoneum and enters the abdominal cavity, the physiological reflex escape response of the intestine disappears. The puncture needle easily pierces the intestinal wall and enters the intestinal lumen, resulting in a false positive puncture result and a diagnosis error. Basic Information Specialist classification: Digestive examination classification: chest and ascites examination Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: A negative indication is normal. Positive: Positive test results suggest that it may be liver cancer or abdominal infection. Tips: People suspected of having large ovarian cysts, extensive adhesions in the abdominal cavity, and pre-hepatic coma are not suitable for this examination. Normal value The normal test result is negative. Clinical significance Abnormal results of excessive ascites, abdominal infection, cirrhosis and so on. The person in need of examination has a patient with ascites. Positive results may be disease: perforation of ulcer disease, acute abdomen in the elderly, idiopathic omental segmental infarction, colon rupture, ovarian cyst, acute diffuse peritonitis, liver trauma, secondary suppurative peritonitis, spontaneous peritoneum Post-bleeding or hematoma, secondary peritonitis considerations Inappropriate crowd: Suspected people with large ovarian cysts, extensive adhesions in the abdominal cavity, and pre-hepatic coma. Taboo before the examination: poor rest, improper diet, excessive fatigue. Requirements for inspection: Actively cooperate with the doctor's work. Inspection process 1. The patient first evacuates the urine, and the patient is seated on the backrest chair, or the reclining position is taken, the abdominal belt is laid on the back, and the plastic apron and the middle single are in the lower part of the abdomen. If the amount of ascites is small, the lateral position is taken. 2, puncture point can choose the umbilical and pubic symphysis midpoint (should avoid white line), or the outer 1/3 of the umbilical cord and the anterior superior iliac spine (usually choose the left side). 3. Regular skin disinfection. The surgeon is to be treated with sterile gloves, a sterile hole towel, and a local anesthesia to the peritoneum. Penetrate the abdominal wall with a puncture needle. After entering the abdominal cavity, you can use a syringe to pump a little ascites into a sterile test tube for inspection. 4. After the operation is completed, remove the puncture needle, partially apply iodine and ethanol, cover the sterile gauze, fix it with tape, and tie the abdomen. Not suitable for the crowd 1. Patients who have taken contraceptives, thyroid hormones, steroid hormones, etc., may affect the results of the examination and prohibit patients who have recently taken the drug history. 2, special diseases: patients with hematopoietic function to reduce disease, such as leukemia, various anemia, myelodysplastic syndrome, etc., unless the examination is essential, try to draw less blood. Adverse reactions and risks 1, subcutaneous hemorrhage: due to pressing time less than 5 minutes or blood draw technology is not enough, etc. can cause subcutaneous bleeding. 2, discomfort: the puncture site may appear pain, swelling, tenderness, subcutaneous ecchymosis visible to the naked eye. 3, dizzy 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. 4. Risk of infection: If you use an unclean needle, you may be at risk of infection.