lung examination

Pulmonary examinations are complex tests, and many items are examined, such as pulmonary function tests, pulmonary capillary wedge pressure, bronchoscopy, and so on. Pulmonary function test: Pulmonary function test includes ventilation function, ventilation function, respiratory regulation function and pulmonary circulation function. There are many inspection items and measurement indicators. This test can be used to detect lung and respiratory lesions at an early stage. It is especially important for smokers and people who work in high-pollution work. Determine what your tolerance is and what you can do. And this check does not cause any damage to the body, and the sensitivity is still high. Pulmonary capillary wedge pressure: Pulmonary capillary wedge pressure is the most commonly used and most important monitoring indicator for clinical hemodynamic monitoring. Also known as pulmonary wedge pressure (PAWP). Pulmonary wedge pressure measurement is usually performed by floating the Swan-Ganz balloon floating catheter and wedged into the pulmonary arterioles to block the forward blood flow. The pressure measured at the tip of the catheter is the pulmonary artery. Wedge pressure (PAWP). Bronchoscopy: Bronchoscopy is a method of examination 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: Other Inspections Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to normal eating habits and pay attention to personal hygiene. Normal value The normal reference value depends on the situation of each hospital, and the normal values ​​of different inspection items are also different. Pulmonary function test: ventilation function, ventilation function, respiratory regulation function and pulmonary circulation function, etc., many inspection items and measurement indicators. Different methods have different normal values, so it depends on the specific situation. Pulmonary capillary wedge pressure: pulmonary artery wedge compression (PAWP) pulmonary artery pressure or pulmonary capillary wedge pressure monitoring: normal value 6 ~ 12mmHg. Bronchoscopy: The bronchial mucosa is normal or without any other foreign body. Clinical significance Abnormal results: 1, lung function test (1) Obstructive lesions refer to changes in airflow obstruction due to various factors causing airway stenosis, with asthma being the most obvious. (2) Restrictive lesions refer to changes in pulmonary ventilation that are limited by pulmonary respiratory movements, such as emphysema, pleurisy, and pneumothorax, with varying degrees of lung ventilation. (3) mixed lesions refers to both obstructive and restrictive lesions, such as chronic obstructive pulmonary disease and advanced asthma, pneumoconiosis, pediatric bronchial pneumonia. People to be examined: repeated upper respiratory tract infections, history of smoking and long-term cough, seasonal cough attacks, regular review of chronic bronchitis, chest X-ray abnormalities, patients requiring risk assessment for anesthesia, surgery, and postoperative Recover patients who need to make predictions. 2, pulmonary capillary wedge pressure (1) Acute myocardial infarction with shock; (2) severe hypotension of unknown cause; (3) multiple organ dysfunction; (4) pulmonary hypertension; (5) low cardiac output syndrome; (6) Patients with hemodynamic instability who need to be maintained with cardiotonic or IABP. Need to check the crowd: patients with myocardial infarction with shock, severe hypotension, pulmonary hypertension and other symptoms. 3, bronchoscopy Abdominal atresia, pleural effusion, 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 showed block shadow, atelectasis, obstructive pneumonia, suspected lung cancer. (3) X-ray chest radiographs were negative, but sputum cytology-positive "hidden lung cancer". (4) Diffuse lesions of unknown nature, solitary nodules or masses need to be clamped or aspirate lung tissue for pathological section or cytology. (5) It is necessary to use a double cannula to absorb or brush the secretions of the deep bronchioles of the lungs for pathogenic culture to avoid oral contamination. (6) for the treatment of bronchial foreign body; lung sputum sucking and topical medication; sputum retention after surgery; lung cancer chemotherapy. (6) Patients with pulmonary atelectasis, pleural cavity, lung cancer, lung purulent diseases and other diseases caused by lung diseases. There are also cases to check if: 1. Cough, mostly irritating cough. 2. The blood in the sputum is mostly bloodshot. 3. Chest tightness and chest pain, the general symptoms are light and the positioning is blurred. When the cancer invades the pleura and chest wall, the pain is intensified and the positioning is clear and constant. 4. Shortness of breath, pneumonia caused by obstruction of cancer, atelectasis, malignant pleural effusion, diffuse alveolar lesions, etc. can be caused. 5. Fever, obstructive pneumonia or cancerous toxins. 6. Patients with advanced disease may have more obvious cachexia. People who need to be examined: patients with the above-mentioned irritating cough, bloody sputum, diffuse alveolar, obstructive pneumonia and other symptoms of lung disease. Precautions Forbidden before examination: Pay attention to normal eating habits and pay attention to personal hygiene. Requirements for inspection: Actively cooperate with the doctor. Inspection process First, the lung function check: the specific method of examination should be based on the content of the examination, that is, the method of checking the different functions and the specific operation is different from the requirements for the patient. 99Tcm-DTPA lung epithelial cell permeability assay: 1. Principle: The inner diameter of the alveolar capillaries is 8m on average. When the radioactive particles (99mTc-MAA) with a diameter of 10-60m are injected, the particles enter the pulmonary vascular bed with blood flow, and are transiently incarcerated in the pulmonary capillaries or lungs. In the small arteries, the distribution was proportional to the local pulmonary blood flow (r=0.97). By using a nuclear medicine imaging apparatus to photograph in vitro, an image reflecting local pulmonary blood perfusion can be obtained, so it is called lung perfusion imaging. 2. Imaging agent: 99mTc-MAA (large particle polymerized human serum albumin) suspension. Supine position slow (about 1min) intravenous injection, avoid pumping back blood (anti-particle aggregation). Multi-body planar imaging (ANT, POST, RLA, LLA, LAO, RAO, LPO, RPO) or / and tomographic imaging. Second, pulmonary capillary wedge pressure measurement method Pulmonary wedge pressure measurement is usually performed by floating the Swan-Ganz balloon floating catheter and wedged into the pulmonary arterioles to block the forward blood flow. The pressure measured at the tip of the catheter is the pulmonary artery. Wedge pressure (PAWP). When the pulmonary arterioles are blocked by wedges, the blood in the blocked pulmonary arterioles and the corresponding pulmonary venules is stagnant, becoming a static blood flow column with equal internal pressure, due to large pulmonary venous blood flow resistance. Ignore, so PAWP is equal to pulmonary venous pressure, ie left atrial pressure. Third, bronchoscopy: 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 people: depending on the item being inspected. Adverse reactions and risks Nothing.

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