临床带教医学英语会话｜骨髓穿刺术（有音频）

小白老师说：A bone marrow puncture is used for diagnosing diseases and their spread in the bone marrow and the hematopoietic system.A bone marrow biopsy is performed under local anesthesia. To puncture the medullary cavity of a flat bone and to extract tissue, a special hollow needle is employed.

Resident**:** Mrs. Blake, please prepare for the marrow puncture. It’s your turn next.

Blake 太太，请准备一下，接下来就轮到你做骨髓穿刺了。

**Patient：**OK. What should I do?

好的，我该准备些什么呢？

Resident： Don’t be so nervous. It won’t be painful. It will be algetic, when I’m injecting the anesthetic. But you may feel sore during the bone puncture.

别紧张，不会很痛的。只是打麻药的时候有点痛，穿刺时只会有点酸胀感觉。

**Patient：**Well, I get it. 好的，我明白了。

A few minutes later.

Resident： Pull down your pants and explore your ilium, please. Then, lie on the left side and curl up your legs. Very good. It will be finished in a moment. Please take it easy. (Turn to Doctor B) Please give a hand, Dr. Shepherd Open a puncture pack for me.

请脱下裤子，露出髂骨。向左边侧卧，把腿蜷起来。很好，别紧张，一会儿就好了。（转向实习医生）帮一下忙，Shepherd 医生，帮我打开穿刺包。

**Intern：**OK. Shall I sterilize the ilium?

好的，要我消毒髂骨部位的皮肤吗？

Resident: Fine. Please describe the exact puncture position first.

好的，请你先描述一下确切的穿刺部位。

**Intern：**Yes. We can puncture the sternum, the front and back thorn of the ilium, and the fibula if the patient is younger than two years old. However, usually we take the back thorn of the ilium.

好的。我们可以选择胸骨、髂骨前后上棘做骨髓穿刺。此外，2岁以下幼儿可以选择腓骨。但是通常我们选用髂后上棘。

Resident： Very good. I hope that you can also grip the skill of practice. The sterilization is very important. You can touch the back thorn of the ilium first and mark it. Then use atlansil and sterilize the puncture range from inside to the outside.

很好！你已经掌握了理论知识，我希望你也能掌握实践技能。对穿刺部位的消毒十分重要。摸准髂骨后上棘后，做好记号，然后用胺碘酮从里到外消毒穿刺部位。

**Intern：**I see. I will be indeed careful.

明白，我会很小心的。

After sterilizing, the Intern flattens the puncture cloth.

消毒后，实习医生铺巾。

Resident： What shall we do next?

接下来我们该做什么呢？

**Intern：**Puncture, I suppose.

我想应该穿刺了吧。

Resident： Don’t forget to inject the anesthetic. This process can be divided into two procedures. Firstly, inject it into the skin and muscle. Secondly, the acicula should be perforate the periosteum and be pushed into the bone with anaesthetic being injected. After a few minutes the anaesthetic will play the role.

可别忘记打麻药了。麻醉的过程可以分成两步。首先，在皮肤和肌肉下注射，然后针穿透骨膜，打入麻药。等几分钟，让麻药发挥作用。

**Intern：**Oh, it is so complicated.

噢，还真复杂。

**Resident：**Ok. We can puncture now. When the puncture acicula perforates the periosteum, you can feel it clearly. Take out 1 ml marrow and make into marrow smear as soon as possible. Will you send them to the clinical laboratory for me?

现在我们可以做穿刺了。当穿刺针突破骨膜的时候，你会有明显的感觉。抽出1毫升骨髓，尽快推片制成骨髓片。你帮我把它送到检验科，好吗？

Intern： OK. I will do it right now.

好的，我马上就去。

**Resident：**Thank you. (Turn to the patient.) Mrs. Blake, it is finished. Don’t wash the puncture position for a week. Let me send you to the ward.

谢谢。（转向病人）Blake太太，骨髓穿刺做好了。一周内骨髓穿刺部位不要浸水。我送你到病房吧。

Patient： I get it. Thanks a lot. When can I get the report?

好，谢谢！我什么时候可以看到报告？

Resident： About a week. 大约一周。