Surely many do not know what it is - a puncture. It is a specific procedure used to diagnose various pathologies, as well as to treat biological cavities and internal organs. Before the patient agrees to this procedure, he must study more carefully what it is - a puncture. This is what we will talk about in our article. In addition, here you will find information on when this procedure is prescribed.
What is this?
A puncture is a special puncture of the tissues of blood vessels, internal organs, various cavities, neoplasms for the purpose of diagnosis or for the collection of fluids. In addition, this procedure is sometimes also necessary for the administration of drugs. Speaking about what it is - a puncture, it should be noted that it is used to diagnose diseases of the liver, lungs, bone marrow, and bone tissue. In most cases, this method is used to detect oncological diseases. In order to clarify the diagnosis, the material is takendirectly from the tumor itself.
If we talk about blood vessels, then here the puncture is used to take biological fluid, as well as to install catheters. Women can be assigned a puncture during IVF.
Varieties
There are several varieties of this procedure. The main ones are as follows:
- P leftal puncture. It is necessary when fluid has accumulated between the pleural sheets in the form of blood or exudate.
- Sternal puncture. This procedure is performed on patients who are suspected to have hematopoietic diseases such as leukemia, aplastic anemia, and myelodysplastic syndrome.
- Biopsy. Patients are prescribed for suspected malignant neoplasms, as well as various pathologies. Most often, doctors biopsy the liver, lungs, kidneys, prostate, thyroid, ovaries, and other internal organs.
- Spinal puncture. The procedure is indicated for patients with meningitis, neuroleukemia, subarachnoid hemorrhage, brain neoplasm.
- Cordocentesis. This procedure is a puncture of the umbilical vein, in which the blood of the fetus is taken for analysis.
In addition to all the varieties described above, women are also often prescribed a puncture of the follicles, which is done during IVF. This is an important and crucial moment on the way to motherhood. Reviews say that after the puncture of the follicles, as well as duringthis procedure, patients experience only an unpleasant sensation.
How is it done?
But how is this procedure carried out? As mentioned earlier, a puncture is a puncture using a special thin needle and syringe, as well as their penetration into the internal organ to take away fluid or other material. The procedure can be carried out in different ways: by the method of local anesthesia, without painkillers, under general anesthesia. Everything will depend on the organ, the localization of education and other nuances.
This event is carried out only in stationary mode. The patient should choose the most comfortable position for the doctor. The duration of the procedure is about 15 minutes. Before the puncture itself, the place is treated with an antiseptic. During the taking of the material, you can not move so that the needle does not touch nearby vessels and tissues. After taking the material, the patient must lie still for some time. For example, if a bone marrow puncture is done, the patient should lie on his side for about 30 minutes.
In what cases is it prescribed? Sensations during manipulation
Reviews of the puncture suggest that the procedure is painless, but may cause discomfort. And now let's look at the specific cases in which this event can be assigned.
For splicing
Such a puncture is used when it is required to bring together and hold in mutual contact until the fused tissues. For example, such a puncture is used for skin incisions,aponeurosis, serous membranes, renal tissue, intestinal, cardiac, vascular wall or parenchyma of organs, as well as cut muscles, tendons, etc. These are, in fact, indications of a surgical suture in general.
For drug administration
When one or another anesthetic, indifferent substance is introduced into tissues or cavities. Of the indifferent substances for cosmetic purposes, they are injected into the subcutaneous tissue, for example, silicone into the mammary gland or molten paraffin into the back of the nose when it retracts to eliminate the defect. Finally, intradermal administration of drugs is also used. Deeper punctures are also performed, for example, the abdominal wall with ascites.
To take material
Puncture is also used if necessary to obtain the safest way for biopsy material (abdominal or tissue fluid and pieces of tissue in order to subject them to chemical, bacteriological or microscopic analysis). This is mainly done to obtain additional data for diagnosis and for a more correct choice of therapy up to surgery.
The puncture makes it possible to probe directly with the end of the instrument any dense pathological formation or foreign object hidden in the depths of the organ and only a suspect before the puncture. Such trial punctures are used for pleurisy, pericarditis, meningitis. This matters when there is doubt about the presence of a subperiosteal or even deep in the tissues of the located focuspurulent inflammation when other research data are inconclusive. In a word, such a puncture, without representing a great danger to the patient, subject to well-known rules and precautions, is an indispensable diagnostic tool in the hands of a doctor.
For removing substances
A puncture is shown for releasing a large amount of liquid and even gaseous products of activity from various organs of the human body or accumulation of products of pathological contents of one of its departments. So, with urinary retention, a puncture of the bladder above the pubis is indicated, with ascites - a puncture of the anterior abdominal wall, with acute exudative, traumatic pericarditis or pneumonia, hemothorax, thoracocentesis is indicated. For testicular hydrocele or dropsy of the knee, a puncture is performed to remove pathological fluid.
The listed four categories of indications can be divided essentially into 4 groups of punctures:
- surgical sutures, referring to surgical techniques for joining human body tissue;
- therapeutic punctures for the introduction of medicinal or indifferent substances;
- injection punctures, to empty retained fluids or gases - evacuation puncture;
- diagnostic punctures to make a diagnosis by obtaining fluid or tissue for examination, or by direct probing deep into the tissues of underlying pathological formations.
Currently, according to some authors, the need for diagnosticpunctures. This is due, on the one hand, to the use in surgery of a wider opening of the surgical field and work under visual control. On the other hand, the emergence of new diagnostic equipment and research methods (ultrasound diagnostics, computed tomography, nuclear magnetic resonance, angiography and other methods of X-ray and electronic diagnostics).
Despite this, diagnostic punctures still enjoy their well-deserved right of citizenship in surgical practice, not to mention the fact that the field of application for surgical and therapeutic punctures is increasing. Operations have come into use for wounds of the heart, blood vessels, the central nervous system, and for transplantation of organs and tissues, where vascular sutures are used, for example, the vascular suture according to Carrel. To the above, punctures should be added, which provide both a diagnostic and a therapeutic effect. These include the use of various types of abdominal endoscopes.
