Ukuhlolwa kwesigxina sangaphakathi, esenzelwe iinjongo zokuxilonga okanye zonyango, senziwa ngoncedo lweendlela endoscopic, apho i-bronchoscopy isebenza khona. Yiyiphi i-bronchoscopy, yintoni inqubo enjalo kwaye kutheni-umbuzo ofuna ukucatshungulwa ngokubanzi.
Yintoni i-bronchoscopy?
Okokuqala, kufuneka uqwalasele ngokwenene inkcazo ye-bronchoscopy, yintoni uhlobo lwenkqubo kwaye xa imiselwe. Igama elipheleleyo li-tracheobronchoscopy. Le ndlela yindlela yanamhlanje ikuvumela ukuba uhlolisise i-trachea kunye ne-bronchi. Yenza i-bronchoscopy isebenzisa i-frobronhoscope ekhethekileyo, eneefayile ekhethekileyo enevidiyo okanye ikhamera ekupheleni. Ukulawula ifowuni isebenzise isibambo esikhethekileyo esineenkcukacha zesikhombisi.
Yintoni ibonisa i-bronchoscopy?
Ukufumanisa ukuba yiyiphi i-bronchoscopy kunye nendlela yokwenza le nkqubo, kufuneka ukwazi malunga namanye amanqaku abalulekileyo. I-tracheobronchoscopy idla ngokufakela ngokufaka ifowuni ngeempumlo, kaninzi kunomlomo. Iingcali ngaphambi kokuba inkqubo isebenzise i-sedatives kunye ne-anesthetics yendawo ukuze ingabandakanyi uvuyo olugqithiseleyo, i-spasms kunye nokunciphisa intlungu. Kwiimeko ezithile ezinzima, i-anesthesia jikelele isetyenziswa. Emva koko ifowuni ingena kwiqumrhu phantsi kophando. Ukongeza kokuhlola okubonakalayo, i-bronchoscope ivumela ukuba i-biopsy iqhutyelwe uviwo olongezelelweyo.
Yintoni eyenza i-bronchoscopy ibonakale ngokubonakalayo kwisifundo:
- i-sputum, i-pus kunye ne-mucus;
- iinkqubo ezivuthayo;
- kubakho kwamanye amazwe;
- iifom
- maqhekeza;
- i-lumen encinci ye-bronchi okanye ukwandiswa okungavumelekanga kwe-bronchi;
- ubukho beentlungu;
- i-fistula, ukuvuvukala, ukuguguleka komhlaba;
- kuphuma.
Iibhonchoscopy - izibonakaliso
Inkqubo enzima njengokuba i-bronchoscopy ye-bronchi ne-trachea inezibonakaliso zayo, ezinokuthi zifumane ukuxilonga okanye unyango. Ukuba umbuzo, i-bronchoscopy-esiyiqwalasele oku, emva koko kulandelelaniswa nokuqikelela kokuqwalasela le ngxaki, umntu kufuneka aqwalasele iimpawu eziphambili zokusetyenziswa kwe-bronchoscope.
Iimpawu ze-tracheobronchoscopy ngenjongo yokwelapha:
- ubukho bamaziko angaphandle kumaziko okuphefumula, ngenjongo yokususwa kwabo;
- ukususwa kweemvumi eziphathekayo ezinobungozi kunye nezibi, ezinye iipoplasms kunye neepucks.
- ukufakela i-stent ekhethekileyo xa ucima i-airways ngeesisu.
- ukususwa kwe-mucus kunye ne-pus.
Ngeenjongo zokuxilonga, izibonakaliso ze-bronchoscopy zilandelayo:
- iimfumba kwimiphunga;
- i-pneumonia idla rhoqo;
- igazi lokuphalaza;
- krokrela i-neoplasm;
- ukufumanisa izizathu zezifo ezinzulu zokuphefumula;
- isifo sofuba;
- utshaya;
- ukukhwehlela okungenangqondo.
Bronchoscopy - ingqinano
Inkqubo ye-bronchoscopy inobungqina benkcazo ekusebenziseni, okubaluleke kakhulu ukuba ukwazi. Ngokuqhelekileyo, iingcali ziqokelela imbali epheleleyo ngaphambi kokumisela inkqubo yokukhuphela ngaphandle imiphumo engafunekiyo kunye neyezinye iingozi ze-bronchoscopy eyenziwa ngaphandle kokuqwalasela ingqinisiso enokuba yinto ehambelana nayo.
Iingqinisiso ezingapheliyo:
- ukuhlaselwa intliziyo, kwagqithwa ngaphantsi kweenyanga ezintandathu ezedlulileyo;
- i-pulmonary and cardiac insufficiency ye-degree yesithathu;
- uhlangothi olubi;
- ukunyamezela kwi-anesthetics;
- I-asthma ye-bronchial ifom elula;
- intlungu e-peritoneum;
- i-stenosis ye-larynx ne-trachea;
- izifo ze-neuropsychic;
- i-arrhythmia.
Uhlobo:
- isifo sikashukela;
- isiqingatha sesibini sokukhulelwa;
- umjikelezo wesini;
- isigaba sesithathu se-goiter;
- IHD;
- ARI;
- ukusela utywala ngesimo esingapheliyo.
I-bronchoscopy eyenziwa njani?
Umbuzo wendlela i-bronchoscopy eyenziwa ngayo kubalulekile kulabo banikwe le nkqubo. I-Tracheobronchoscopy kufuneka iqhutywe emva kokulungiswa, kwaye indlela yokuqhuba kwayo ichongiwe yingcali, ngokusekelwe kwisizathu kunye nobunzima bezinto ezicwangcisiweyo. I-bronchoscopy, indlela yokwenza ngayo nendlela yokuyilungiselela ngayo - umba obalulekileyo apho kuxhomekeke kwisiphumo esiyimpumelelo kwenkqubo.
Ukulungelelwa kwe-bronchoscopy
Ukulungelelaniswa kwesigulane nge-bronchoscopy kufaka inani lokuhlalutya:
- ECG;
- X-ray yemiphunga ;
- ukuhlolwa kwegazi nge-HIV, i-syphilis, i-hepatitis kunye jikelele;
- coagulogram.
Ukongeza kwiimvavanyo, isigulane kufuneka sithobele iimfuno ezithile phambi komgaqo:
- Ungadla isidlo kungekudala emva kweesibhozo ngokuhlwa kwaye ungagcini kakhulu.
- Ebusuku ngaphambi kokulala, kuyinqweneleka ukuthabatha.
- Ngomhla wenkqubo, kufuneka uyeke ukutshaya.
- I-tracheobronchoscopy yenziwa kwisisu esingenalutho.
- Ngaphambi kwenkqubo, kuyinqweneleka ukukhupha isisu kunye nesisu.
Bronchoscopy nge-biopsy
Ukwazi indlela i-bronchoscopy idlulayo ngayo i-biopsy, unokuyilungiselela ngokomoya kule nkqubo engathandekiyo. Nangona, inkcazo yokuphathwa okunjalo ayimnandi kwaye iinkcukacha zendlela yokuziphatha ziloyikisa umntu. Ngoko, ukulandelelana kwezenzo kuku:
- I-tube ye-apparatus ifakwe kwi-bronchi ukuya kwisiza phantsi kophando (apho isampuli sezinto ezicwangcisiweyo).
- Ngokulawula inkqubo ngokusebenzisa i-X-ray ithelevishini, chukumisa i-forceps ekhethekileyo ukuya kwindawo.
- Ekuphumeni komzimba, iziphelo ze-forceps zibhaptizwa kwi-parenchyma yemiphophu kwaye zithatha i-traction traction.
- Ukuba kule ndawo isigulane siva intlungu, ukuba i-forceps kufuneka isuswe ngokukhawuleza kunye nezinto ezithathwe kwenye indawo.
- Le ndlela ithatha kwiisampuli ezintathu ukuya kwezixhenxe.
- Inkqubo igqityiwe kuphela emva kokuba baqinisekiswe ngokuyeka ngokupheleleyo ukuphuma kweendawo eziwonakalisiweyo. Igazi ukusuka kwi-bronchi kunye ne-trachea ifanelwe.
Bronchoscopy phantsi kwe-anesthesia
Kwezinye iimeko, i-tracheobronchoscopy yenziwa phantsi kwe-anesthesia jikelele. Akuzona zonke iikliniki ezinokukwazi ukwenza lobu buchule, ngoko kufuneka uwazi kwangaphambili malunga nokufumaneka kwezixhobo ezifunekayo kule nkqubo. Iinjongo eziphambili zalolu hlobo lugqithise ukuvakalelwa kwithuba elisebenza emva kwexesha, elibonakaliswa yintlungu ebuhlungu kunye nokukhwehlela okubuhlungu, okukuthi akuvumeli ukuba uhambe. I-bronchoscopy, esetyenziselwa nayiphi na imeko, iqhutyelwa ngaphandle ngaphandle kokungabikho komzimba kwi-anesthetics.
Umyalelo we-bronchoscopy eyenziwe ngolu hlobo lulandelayo:
- Imiphunga yesigulane iphefumle imitha emibini.
- Isisombululo se-1% se-sodium thiopental senziwa ngokufanelekileyo.
- Emva kokuqala kwesantya sesithathu se-anesthesia, isicatshulwa sagqitywa kwaye i-sampuli yesampula yokugqithisa isetyenziswe kwaye umoya womoya usebenza.
- Emva kokuqala kokuphumla, i-mask isuswe kwaye iqhutyelwa kwinkqubo ye-tracheobronchoscopy, umyalelo ochazwe ngasentla.
- Akusoloko kunokwenzeka ukuqhuba umoya ogcweleyo kunye ne-mask (i-anesthhesia devices), ngoko ke ukuba imbonakalo ye-hypoxia ibonakala, isigulane kufuneka senze i-intubated kwaye iqhubeke nokuphucula imiphunga nge-tube.
Bronchoscopy - iingxaki
Ngelishwa, iingxaki ezinokuthi zenzeke emva kwe-bronchoscopy, nangona le ndlela ithathwa njengekhuselekile kunokwenzeka. Umngcipheko wokubukeka kwawo uyingcipheko, kodwa akukho bani unokunika isiqinisekiso esipheleleyo sokukhuselwa ngokupheleleyo.
- intlungu esifuba;
- ukwanda kweqondo lomzimba;
- isicongconi, esivame ukuhamba nokuhlanza;
- ukukhawula nokuhamba;
- ukuphalaza kwegazi ixesha elide.
Emva kwe-bronchoscopy, eyenziwa phantsi kwe-anesthesia, iingxaki ezinokuthi zinoku:
- bronchospasm kunye ne-loringospasm;
- ukungabikho komzimba kunye ne-hyperthermia;
- ukugqithiswa kwe-bronchus (kakhulu engaqhelekanga);
- isifo somphefumlo.
Iziphumo ze-bronchoscopy
Emva kokuba i-bronchoscopy yenziwe, indlela yokuqulunqwa kwemiphumo yenziwe ngayo kwaye ingaba yintoni na, umbuzo u-zaknomerny. Ngokuxhomekeke kwiimpawu zokuqala zenkqubo, kunye nendlela eya kwenziwa ngayo, uphando olongezelelweyo lwezinto eziphathekayo (kwimeko ye-biopsy) kuya kuxhomekeka. I-bronchoscopy, emva koko iimvavanyo zenziwa kwibhubhoratri, zinokukunceda ekuqulunqweni kwe-diagnostic echanekileyo. Ngokuqhelekileyo ukuxilonga izifo, eyokuqala kwinqanaba elibonisa iinkqubo.
Izigqibo eziqhelekileyo emva kwe-tracheobronchoscopy zilandelayo:
- i-fistula engumqondiso wesifo sofuba ;
- i-lumen encinci kunye ne-sputum yoxinano oluqinileyo unokuthetha kunye ne- cystic fibrosis ;
- endobronchitis;
- imiqondiso ye-asthma ye-bronchial: i-sputum eninzi ngaphandle kwe-pus, ukubomvu kwe-mucosa kunye nokukhukhuma kwayo;
- ukuhla kwe-lumen kunye nokuvuvukala kodonga kunokuthetha ngokukhula kwe-tumor;
- intambo ebanzi, iingxube ezingafaniyo, ubukho bezilonda zesifo se-necrotic - iimpawu ze-oncology;
- Isifo se-brronchoectatic sihamba kunye ne-sputum e-purulent ne-pus kunye ne-bronchial dilations.