Division of Hematology, University Hospital Basel, CH-4031 Basel, Switzerland.
Ann Hematol. 2010 Jun;89(6):619-24. doi: 10.1007/s00277-010-0934-0. Epub 2010 Mar 24.
Bone marrow examination (BME) represents an essential tool for diagnosis and monitoring of haematological disorders. It remains associated with morbidity and discomfort; repeat examinations are frequent. We made a single-centre prospective survey on 700 BME between July 2007 and July 2008 with a structured anonymized questionnaire for patients undergoing and physicians performing BME, which includes at our institution always aspiration and trephine. All procedures were performed according to institutionalised standard operating procedures; 412 patients' (58.9%) and 554 physicians' (79.1%) questionnaires were returned. Pain was the only procedure-related complication; no pain was reported in 149 (36.7%), bearable pain in 242 (59.6%) and unbearable pain in 15 (3.7%) cases. Premedication associated complications were reported by 110 (32.7%) of the 336 (65.4%) patients with premedication before BME. None of these were > WHO grade 2; most frequently reported were tiredness (76 patients; 22.6%), dizziness (19 patients; 5.7%) and nausea (15 patients; 4.5%). Only two factors were significantly associated with unbearable pain: "pain during prior BME" (seven of 94 with versus one of 198 without previous pain; p < 0.01) and "information before BME" (four of 11 without versus 12 of 372 with adequate information before BME; p < 0.01). Inadequate information at any time showed a trend towards an association with unbearable pain (p = 0.08). No other factor was associated with unbearable pain. Good and adequate information appears to be the best way to reduce pain, even for a future BME.
骨髓检查（BME）是诊断和监测血液系统疾病的重要工具。它仍然与发病率和不适有关；重复检查很频繁。我们在 2007 年 7 月至 2008 年 7 月期间对 700 例 BME 进行了单中心前瞻性调查，为接受 BME 的患者和进行 BME 的医生设计了一份结构化的匿名问卷，其中包括我们机构始终进行的抽吸和钻取。所有程序均按照既定的标准操作程序进行；共收回 412 名患者（58.9%）和 554 名医生（79.1%）的问卷。疼痛是唯一与操作相关的并发症；149 例（36.7%）患者报告无疼痛，242 例（59.6%）患者报告可忍受的疼痛，15 例（3.7%）患者报告无法忍受的疼痛。在接受 BME 前进行预处理的 336 例（65.4%）患者中，有 110 例（32.7%）报告了预处理相关并发症。这些并发症均未达到 WHO 2 级以上；最常报告的是疲倦（76 例；22.6%）、头晕（19 例；5.7%）和恶心（15 例；4.5%）。只有两个因素与无法忍受的疼痛显著相关：“之前的 BME 期间疼痛”（94 例中有 7 例，198 例中无之前疼痛的患者中只有 1 例；p<0.01）和“BME 前信息”（11 例中无信息的患者中有 4 例，372 例中有足够信息的患者中有 12 例；p<0.01）。任何时候信息不足都与无法忍受的疼痛呈趋势相关（p=0.08）。没有其他因素与无法忍受的疼痛相关。良好和充分的信息似乎是减轻疼痛的最佳方法，即使是未来的 BME。
