Kuyang'anitsitsa mkati, kumapangidwira kafukufuku kapena mankhwala, kumachitidwa mothandizidwa ndi njira yosatha, yomwe bronchoscopy imagwiranso ntchito. Kodi bronchoscopy, kodi njira yotereyi ndichifukwa chiyani - funso lomwe limafunikanso kulingalira mwatsatanetsatane.
Kodi bronchoscopy ndi chiyani?
Poyambira, muyenera kuganizira tanthauzo lenileni la bronchoscopy, mtundu wanji wa ndondomeko komanso ngati atayikidwa. Dzina lake lonse ndi tracheobronchoscopy. Imeneyi ndi njira yamakono yomwe imakulolani kuti muwone bwinobwino ma trachea ndi bronchi. Chitani bronchoscopy pogwiritsa ntchito chipangizo chapadera cha fibrobronhoscope, chomwe chiri ndi chingwe chapadera chomwe chili ndi kanema kapena kamera kumapeto. Kulamulira chipangizochi kumagwiritsira ntchito chipangizo chapadera chokhala ndi manipulator.
Kodi bronchoscopy amasonyeza chiyani?
Kuti mudziwe zomwe bronchoscopy ndizochita komanso momwe mungachitire zimenezi, muyenera kudziwa za mfundo zofunika. Kawirikawiri tracheobronchoscopy imachitidwa mwa kuika chipangizo kudzera m'mphuno, mobwerezabwereza kudzera pakamwa. Katswiri asanayambe kugwira ntchitoyi amagwiritsa ntchito mankhwala osokoneza bongo komanso mankhwala osokoneza bongo am'derali kuti asatenge chisangalalo chochulukirapo, kuchepetsa kupweteka komanso kuchepetsa ululu. Pa milandu yovuta kwambiri, amagwiritsa ntchito anesthesia. Kenaka chipangizocho chilowetsa mu limba lofufuzidwa. Kuphatikiza pa kuyang'anitsitsa maso, bronchoscope imalola kuti biopsy ichitike kuti ipitirire kufufuza.
Kodi bronchoscopy ikuwonetseratu chiyani mu phunziroli:
- sputum, pus ndi moscus;
- njira yotupa;
- kupezeka kwa matupi achilendo;
- zoperekera zamapapo;
- chithunzi;
- chotupa chaching'ono cha bronchi kapena kuwonjezera kwina kwa bronchi;
- kukhalapo kwa zotupa;
- fistula, kutupa, kukokoloka kwa nthaka;
- magazi.
Zojambulajambula - zizindikiro
Njira yovuta kwambiri monga bronchoscopy ya bronchi ndi trachea ili ndi zizindikiro zake, zomwe zingathe kupezetsa kapena kuchiritsidwa. Ngati funsoli, bronchoscopy - lomwe talingalira izi, potengera tsatanetsatane ndi kulingalira kosatha pankhaniyi, wina ayenera kulingalira zizindikiro zazikulu zogwiritsira ntchito bronchoscope.
Zizindikiro za tracheobronchoscopy kwa mankhwala zolinga:
- kukhalapo kwa matupi achilendo m'magulu opuma, ndi cholinga chochotsamo;
- kuchotsa zotupa zowonongeka ndi zopweteka, zina zotsekemera ndi mapulogi a mucous.
- Kuika stent wapadera pofikira mpweya ndi zotupa.
- kuchotsedwa kwa mucus ndi pus.
Pofuna kupeza matenda, zizindikiro za bronchoscopy ndi izi:
- zoperewera m'mapapo;
- chibayo ndifupipafupi;
- magazi;
- chokayikitsa cha neoplasm;
- kupeza zomwe zimayambitsa matenda aakulu;
- chifuwa chachikulu;
- kusuta fodya;
- chifuwa chopanda pake.
Bronchoscopy - zotsutsana
Ndondomeko ya bronchoscopy ili ndi zosiyana zotsutsana ndi zochitika, zomwe ndizofunikira kudziwa. Kawirikawiri, akatswiri amapeza mbiri yakale asanafotokoze njirayi kuti asawononge zotsatira zosafunika komanso zina zoopsa za bronchoscopy zomwe sizichitika popanda kulingalira zotsutsana zomwe zingakhale zogwirizana.
Zotsutsa zosamveka:
- matenda a mtima, anavutika miyezi yosachepera sikisi yapitayo;
- kuperewera kwa pulmonary ndi mtima wa digiri yachitatu;
- kupweteka kwakukulu;
- kusalana kwa anesthetics;
- kupweteka kwa mphumu mwachiwonekedwe;
- ululu mu peritoneum;
- stenosis ya khosi ndi trachea;
- matenda a neuropsychic;
- arrhythmia.
Chibale:
- shuga;
- theka lachiwiri la mimba;
- kusamba;
- digiri yachitatu ya goiter;
- IHD;
- ARI;
- uchidakwa mu mawonekedwe osatha.
Kodi bronchoscopy imachitanji?
Funso la momwe bronchoscopy likuyendera ndi lofunikira kwa omwe apatsidwa njirayi. Tracheobronchoscopy iyenera kuchitika pambuyo pokonzekera, ndipo njira yophunzitsirayo imatsimikiziridwa ndi katswiri, chifukwa cha chifukwa chake ndi zovuta zowonongeka. Bronchoscopy, momwe mungachitire ndi momwe mungakonzekere - nkhani yofunikira yomwe imadalira zotsatira za njirayi.
Kukonzekera kwa bronchoscopy
Kuyenera kukonzekera wodwalayo chifukwa cha bronchoscopy kumaphatikizapo zochitika zingapo:
- ECG;
- X-ray ya mapapo ;
- kuyesa magazi kwa kachirombo ka HIV, syphilis, chiwindi cha matenda a shuga ndi wamba;
- coagulogram.
Kuwonjezera pa mayesero, wodwalayo ayenera kutsatira zinthu zina asanayambe kuchita izi:
- Mungathe kudya chakudya chamadzulo pasanafike eyiti madzulo komanso osati molimba kwambiri.
- Usiku usanakagone ndi zofunika kuti mutenge.
- Patsikuli, muyenera kusiya kusuta.
- Tracheobronchoscopy yachitidwa pamimba yopanda kanthu.
- Musanayambe ndondomekoyi, ndizofunika kutaya chikhodzodzo ndi matumbo.
Bronchoscopy yokhala ndi chidziwitso
Podziwa momwe bronchoscopy ikudutsa ndi chidziwitso, mukhoza kukonzekera m'malingaliro kuti izi zitheke. Ngakhale, kufotokozedwa kwa kusokoneza koteroko sikusangalatsa ndipo mwatsatanetsatane wa makhalidwe ake akhoza kuopseza aliyense. Choncho, zotsatirazi ndizo:
- Chipangizo cha injini chimayikidwa kudzera mwa bronchi kupita ku malo omwe akufufuza (pomwe sampuli ya nkhaniyo ikukonzekera).
- Poyendetsa njirayi kudzera pa TV, yanikitsani mapepala apadera payimira.
- Popuma, mapeto a forceps amamizidwa mu parenchyma ya mapapo ndikuyesa kuyesera.
- Ngati pakadali pano wodwala akumva ululu, kuti forceps ayambe kuchotsedwa pomwepo ndi zinthu zomwe zimatengedwa kumalo ena.
- Njira imeneyi imatenga kuchokera ku zitsanzo zitatu kapena zisanu ndi ziwiri.
- Ndondomekoyi imatsirizidwa pokhapokha atatsimikizika za kuyima kwathunthu kwa kutuluka magazi kwa malo owonongeka. Magazi ochokera ku bronchi ndi trachea amafunidwa.
Bronchoscopy pansi pa anesthesia
Nthaŵi zina, tracheobronchoscopy imachitika mwachibadwa anesthesia. Osati ma kliniki onse ali ndi luso lothandizira izi, choncho muyenera kudziwiratu za kupezeka kwa zipangizo zoyenera kuti zitheke. Ubwino waukulu wa njirayi umapangitsa kuti mukhale ndi nthawi yowonjezera, yomwe imawonetsedwa ndi ululu wowawa komanso kupweteka kovuta, zomwe sizikulolani kuti musamuke. Bronchoscopy, yomwe imagwiritsidwa ntchito mulimonsemo, ikuchitika kupatulapo zovuta zowonongeka kwa anesthetics.
Malangizo a bronchoscopy ndi awa:
- Mapapo a wodwalayo ali mpweya wabwino kwa mphindi zingapo.
- Njira imodzi yokha ya sodium thiopental imayendetsedwa bwino.
- Pambuyo pa kuyambira kwa digiri yachitatu ya anesthesia, mankhwalawa amaletsedwa ndipo otsitsimula a zowonongeka zimayambitsidwa ndipo mpweya wabwino ukuchitidwa.
- Pambuyo pa kusungulumwa, chigoba chimachotsedwa ndipo chimapita ku ndondomeko ya tracheobronchoscopy, yomwe ikufotokozedwa pamwambapa.
- Sizingatheke kuti pakhale mpweya wabwino (masewera a anesthesia), kotero ngati zizindikiro za hypoxia zikuwoneka, wodwalayo ayenera kuti atsimikizidwe ndikupitiriza kupuma mapapu kudzera mu chubu.
Bronchoscopy - mavuto
Mwamwayi, mavuto akhoza kuchitika pambuyo pa bronchoscopy, ngakhale kuti njirayi imaonedwa ngati yotetezeka. Kuopsa kwa maonekedwe awo ndi kochepa, koma palibe amene angakhale otsimikiza kuti ali ndi chitetezo chokwanira.
- ululu m'chifuwa;
- kutentha kwa thupi;
- kunyozetsa, nthawi zambiri kumatsatana ndi kusanza;
- kumangirira ndi kuwomba;
- kupopera kwa magazi kwa nthawi yaitali.
Pambuyo pa bronchoscopy, yomwe imagwira pansi pa matenda a anesthesia, mavuto amatha kukhala motere:
- bronchospasm ndi loringospasm;
- zowopsa ndi hyperthermia;
- kuperewera kwa bronchus (kawirikawiri);
- aspiration chibayo.
Zotsatira za bronchoscopy
Pambuyo pa bronchoscopy itatha, momwe kufotokoza kwa zotsatira zachitidwa ndi zomwe zingakhale, funso ndi zaknomerny. Malingana ndi zizindikiro zoyambirira za ndondomekoyi, komanso njira yomwe inachitikidwira, kufufuza kwina kwa nkhaniyi (panthawi ya biopsy) idzadalira. Bronchoscopy, pambuyo pake mayesero amachitidwa mu labotale, ingathandize kuthandizira kudziwa bwino. Kawiri kawiri amadziwa kuti matendawa, omwe pachiyambi choyamba anali zizindikiro zowonongeka.
Zomwe zimachitika kawirikawiri pambuyo pa tracheobronchoscopy ndi izi:
- fistula omwe ali chizindikiro cha chifuwa chachikulu ;
- Chimake chofewa ndi chotupa chokhazikika chingathe kulankhula ndi cystic fibrosis ;
- endobronchitis;
- Zizindikiro za mphumu yowonongeka: nthenda zambiri zopanda pus, kuphulika kwa mucosa ndi kudzikuza kwake;
- kuchepa kwa lumen ndi kutupa kwa khoma kungathe kuyankhula za kukula kwa chotupa;
- zotsalira zazikulu, mapiri osagwirizana, kukhalapo kwa zilonda zam'mimba - zizindikiro za oncology;
- Bronchoectatic matenda ikuphatikiza ndi purulent sputum ndi pus ndi bronchial kuchepetsa.