Bronchoscopy

Bronchoscopy is an examination method including electronic bronchoscopy, bronchoscopy in children, and transbronchial lung biopsy. During selective bronchoscopy, the patient should be placed in a supine or semi-recumbent position. The venous access, intermittent blood pressure monitoring, and continuous oximeter and ECG monitoring should be maintained during the examination. Perspective is not necessary but helpful in many situations. Color video imaging bronchoscopy is useful for observation and visualization of airway lesions. Basic Information Specialist Category: Respiratory Examination Category: Endoscope Applicable gender: whether men and women apply fasting: fasting Tips: Inappropriate people: pulmonary dysfunction, severe emphysema, pulmonary hypertension, bronchiectasis, coagulation disorders, pulmonary blebs around the lesions, extreme extinction should be carefully performed by bronchoscopy lung biopsy. Normal value The bronchial mucosa is normal or without any other foreign body. Clinical significance Abnormal results: atelectasis, pleural cavity, lung cancer, lung purulence, localized asthma, various pneumonia, atelectasis, bronchial asthma, lung fiber, severe emphysema, pulmonary hypertension, bronchiectasis and other abnormal lung symptoms. People who need to check: 1, unexplained hemoptysis, need to identify the bleeding site and hemoptysis reasons; or the cause and lesions are clear, but the medical treatment is ineffective or repeated hemoptysis and can not perform emergency surgery, local hemostasis treatment. 2, X-ray chest radiograph shows block shadow, atelectasis, obstructive pneumonia, suspected of lung cancer. 3, X-ray chest X-ray negative, but sputum cytology-positive "recessive lung cancer". 4, diffuse lesions of unknown nature, solitary nodules or masses need to be clamped or acupuncture lung tissue for pathological section or cytology. 5, need to use double cannula to absorb or brush the secretions of deep bronchus in the lungs for pathogenic culture to avoid oral pollution. 6, for the treatment of bronchial foreign body; lung sputum sucking and topical medication; sputum retention after surgery; lung cancer chemotherapy. 7, patients with atelectasis, pleural cavity, lung cancer, lung pus and other lung diseases and a series of diseases caused by lung diseases. Precautions Taboo before inspection: In patients with acute myocardial infarction, selective fiberoptic bronchoscopy should be postponed for 6 weeks. If the patient has unstable gas exchange, insufficient systemic oxygen delivery or frequent bronchospasm, and bronchoscopy is required, intubation ventilation should be performed to ensure safe operation. Bronchoscopy is feasible in outpatients or inpatients, mechanically ventilated patients. Fasting for at least 4 hours before surgery. Requirements for inspection: During selective bronchoscopy, the patient should be placed in a supine or semi-recumbent position. The venous access, intermittent blood pressure monitoring, and continuous oximeter and ECG monitoring should be maintained during the examination. Perspective is not necessary but helpful in many situations. Color video imaging bronchoscopy is useful for observation and visualization of airway lesions. Good intraoperative and postoperative care and timely observation are important measures to reduce intraoperative accidents and postoperative complications: (1) In addition to conventional catheter oxygen inhalation, respiratory, blood pressure and pulse changes should be closely observed, if necessary. ECG monitoring, monitoring blood oxygen saturation. (2) Continue to pay attention to the patient's breathing, blood pressure, and pulse changes within 12 hours after surgery. 1 chest per day, early complications can be found, report to the doctor in time, and deal with it accordingly. Inspection process 1. Electronic bronchoscopy: One of the important diagnostic and treatment methods for respiratory diseases, it has very much for the diagnosis and treatment of tracheal-bronchial lesions, lung occupying, especially hilar mass occupying, tuberculosis, atelectasis, lung infection, tracheal-bronchial foreign body and other diseases. Important value. 2. Children's bronchoscopy: The treatment is intuitive, safe, non-invasive, and painful. The current electronic bronchoscope has a diameter of 2.8-4.9 mm and the mirror body is soft. Not only can the observation and diagnosis of bronchopulmonary lesions be completed, but also deep respiratory secretion specimens, lavage fluid epithelial cells and lung biopsy can be used for ultrastructural, cytological and pathogenic detection by electron microscopy; Washing, injection, microwave, etc. for interventional therapy; improve clinical understanding and diagnosis of respiratory diseases, and establish a unified standard in pediatric bronchoscopy diagnosis and bronchial drug treatment. 3. Transbronchial lung biopsy: Preoperative preparation is a prerequisite for successful puncture: (1) Learn more about the patient's condition, carefully read CT, chest X-ray, and understand the lesion, nature, and depth. Estimate the possible complications, develop appropriate nursing measures, and be aware of what is right. (2) Determination of clotting time, platelet count and platelet count. Check the electrocardiogram and lung function before the operation, and master the indications for puncture. (3) Fasting 4 hours before surgery to prevent nausea and vomiting caused by puncture caused by pleural reaction. Oral administration of 60 mg of codeine phosphate 1 hour before surgery and diazepam 10 mg intramuscular injection can reduce the pleural reaction. Intravenous injection of 25% glucose in 100 ml before surgery can effectively reduce the incidence of intraoperative hypoglycemia. Not suitable for the crowd Inappropriate crowd: 1. Those who are allergic to anesthetics and those who cannot cooperate with the examination. 2, there are severe heart and lung dysfunction, severe arrhythmia, frequent angina. 3, the general condition of extreme failure can not tolerate the examiner. 4, severe blood coagulation disorders and uncontrollable bleeding quality. 5, aortic aneurysm has a risk of rupture. 6, newly had upper respiratory tract infection or high fever, asthma occlusion, and then check the symptoms. Adverse reactions and risks Nothing.

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