Birch C D, Fischer S, Zibell A, Jensen M E
Acta Pathol Microbiol Immunol Scand A. 1982 Jul;90(4):229-34. doi: 10.1111/j.1699-0463.1982.tb00086_90a.x.
The value of routinely including biopsy of the iliac crest in the haematological diagnostic programme in medical departments of haematology is elucidated by analysis of 129 biopsies. At the same time, imprints of the biopsies and aspirate smears were compared as regards diagnostic efficacy, which proved 15% greater for imprints and biopsies. The frequency of an inadequate bone biopsy was 7.7%, often because the biopsies were less than 5 mm in length (16%). The individual categories, bone biopsy, imprint, and aspiration smears were of equal diagnostic efficacy in 76%. Guidance for the haematological diagnosis was obtained in 80% of the cases. The incidence of dry tap was 1.6% and the complication rate 1.6%. The optimal result, viz. sufficiently long biopsies (54% over 10 mm in length), is obtained by taking the biopsy with a conically tipped needle (the Jamshidi or Schaadt-Fischer needle) and by making imprints before embedding the biopsies in methacrylate JB IV. The preparation and safety measures in embedding in JB IV and subsequent special staining, including cytochemical studies, are described. By the technique used, it is possible, with some practice, to obtain adequate biopsies in 80-90% of all patients and to take a biopsy and perform aspiration in one session. The patient's position, lying on his side, seems to make him less apprehensive.
通过对129例活检病例的分析，阐明了在血液科医学诊断程序中常规进行髂嵴活检的价值。同时，对活检印片和抽吸涂片的诊断效能进行了比较，结果表明印片和活检的诊断效能高出15%。骨活检不充分的频率为7.7%，通常是因为活检长度小于5mm（占16%）。在76%的病例中，骨活检、印片和抽吸涂片这几种检查方法的诊断效能相当。80%的病例获得了血液学诊断指导。干抽发生率为1.6%，并发症发生率为1.6%。通过使用锥形头针（Jamshidi针或Schaadt-Fischer针）进行活检，并在将活检组织包埋于甲基丙烯酸酯JB IV之前制作印片，可获得最佳结果，即足够长的活检组织（54%长度超过10mm）。文中描述了将组织包埋于JB IV及后续特殊染色（包括细胞化学研究）的制备方法和安全措施。采用该技术，经过一定练习后，80%至90%的患者都能获得足够的活检组织，且能在一次操作中完成活检和抽吸。患者侧卧的体位似乎能减轻其焦虑情绪。
