lung biopsy

Lung biopsy is a percutaneous lung biopsy. It is used for the diagnosis and differential diagnosis of peripheral lung lesions or diffuse lung lesions. Its indications are: (1) examination of inferior pulmonary mass lesions by fiberoptic bronchoscopy, X-ray, sputum, microbial blood, etc., especially suitable for diagnosing a mass located in the surrounding area. (2) Peritoneal lung biopsy can be performed in patients with unexplained diffuse lung disease under conditions of pleural adhesions. (3) Localized pulmonary infiltration. (4) Mediastinal masses of unknown cause. Basic Information Specialist classification: Respiratory examination classification: pathological examination Applicable gender: whether men and women apply fasting: fasting Tips: severe cardiopulmonary dysfunction, pulmonary vascular disease with bleeding tendency, acute respiratory infections. Patients who do not cooperate or have a cough that cannot be controlled are not suitable for examination. Normal value Normal lung tissue. Clinical significance Abnormal results: 1. Lung biopsy pathological examination see tumor cells, can be diagnosed as tumors. 2. Lung biopsy pathological examination see tuberculosis granuloma, can be diagnosed as tuberculosis. 3. Lung biopsy pathological examination see inflammatory lesions, considered as pulmonary infection. Need to check the crowd: Patients with severe lung disease who need to be very prepared to check for verification. Precautions Preparation before inspection: 1. Preoperative preparation: "fiberoptic bronchoscopy" and "pleural biopsy". 2. The location of the preoperative lesion should be as accurate as possible. In principle, bilateral TBLB is not performed to prevent bilateral pneumothorax and severely impair lung function. Note when checking: 1. Try not to carry out in the middle or the tongue, so as not to damage the pleura between the leaves, and pneumothorax occurs. 2. Anesthesia requirements are higher than conventional fiberoptic bronchoscopy, and it is required to ensure that patients can be examined quietly. Therefore, pethidine should be used before surgery instead of phenobarbital. 3. Instruct patients to cooperate with the examination, such as deep inhalation, exhalation, breath holding, etc., and keep the operation safe. 4. Once the biopsy forceps reach the surrounding area and the patient complains of pain, stop the operation immediately and change the direction of the biopsy to avoid damage to the pleura. 5. Close observation and treatment of bleeding, pneumothorax and other complications. Inspection process 1. Take the incision between the sixth intercostal space and the anterior line of the ankle to the posterior iliac crest. The length is about 10cm. Cut the skin, subcutaneous tissue, and muscle layer layer by layer, and cut the intercostal muscle along the upper edge of the rib into the chest. 2. Use a small chest opener to slightly retract the ribs 4 to 5 cm, explore and find the lesions, use two large curved clamp wedge clamps to clamp the lung tissue containing the lesions, use an electric knife to cut the lungs to be taken along the large bending forceps Specimens are sent for pathological examination. 3. Use a small needle with a No. 1 silk thread "U" nest to suture the lung section. Thoroughly stop bleeding, rinse with saline, place a closed drainage tube between the 7th and 8th intercostals, and close the chest layer by layer. Not suitable for the crowd (1) severe cardiopulmonary dysfunction. (2) pulmonary vascular disease. (3) Those with bleeding tendency. (4) Those with acute respiratory infections and fever. (5) The patient does not cooperate or has a cough that cannot be controlled. Adverse reactions and risks May cause lung infections and bleeding.

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