Bichel J
Ugeskr Laeger. 1989 Feb 13;151(7):442-4.
Fatal complications of sternal puncture are, as a rule, the result of penetration of the needle through the sternum followed by lesion of the pericardium and myocardium and finally pericardial tamponade and death. Thirty-four such cases are studied with a view to the technique and especially the site on the sternum where the puncture was made. It was supposed that the punctures in the sternum in the fatal cases were performed below the level of the second intercostal space and that that was the primary cause of the fatal outcome as the heart and pericardium here are very close to the sternum. Punctures at the level of the second intercostal space and higher should be reasonably safe. To the astonishment of the author, it was found that many of the fatal punctures were made in the sternum at the level of the second intercostal space or higher. The many reports in the literature were examined again and it was concluded that the complications might be due to inexperience and lack of training of the person who performed the puncture. It is concluded that puncture of the iliac crest with marrow aspiration and biopsy is preferable for better diagnostic value and a safer procedure.
胸骨穿刺的致命并发症通常是由于穿刺针穿透胸骨，继而损伤心包和心肌，最终导致心包填塞和死亡。本文研究了34例此类病例，着眼于穿刺技术，尤其是穿刺胸骨的部位。据推测，致命病例的胸骨穿刺是在第二肋间水平以下进行的，这是导致致命后果的主要原因，因为此处心脏和心包与胸骨非常接近。在第二肋间水平及以上进行穿刺应该是相当安全的。令作者惊讶的是，发现许多致命穿刺是在第二肋间水平或更高位置的胸骨处进行的。再次查阅了文献中的众多报道，得出结论：并发症可能是由于进行穿刺的人员缺乏经验和培训。结论是，为了获得更好的诊断价值和更安全的操作，髂嵴穿刺抽吸骨髓和活检更为可取。
