Ukuhlolwa kwendawo yangaphakathi, okwenzelwe izinhloso zokuxilonga noma zokwelapha, kwenziwa ngosizo lwendlela yokugcina, lapho i-bronchoscopy isebenza khona. Kuyini i-bronchoscopy, inqubo enjalo kanjani nokuthi kungani-umbuzo odinga ukucatshangelwa okuningiliziwe.
Kuyini i-bronchoscopy?
Okokuqala, kufanele ucabangele leyo ncazelo yomqondo we-bronchoscopy, yimuphi uhlobo lwenqubo futhi uma kunqunywe. Igama layo eligcwele yi-tracheobronchoscopy. Lena indlela yesimanje evumela ukuthi uhlole ngokubukeka i-trachea ne-bronchi. Yenza i-bronchoscopy isebenzisa i-fibrobronhoscope yedivayisi ekhethekile, equkethe ikhebula elikhethekile elinemifanekiso noma ikhamera ekugcineni. Ukulawula ukusebenzisa idivaysi isibambo esikhethekile esinezikhwama.
Yini ekhombisa ukuthi i-bronchoscopy ibonisa?
Ukuthola ukuthi yiyiphi i-bronchoscopy nokuthi ungayenza kanjani le nqubo, kufanele wazi ngamanye amaphuzu abalulekile. I-tracheobronchoscopy ivame ukuqhutshwa ngokufakela idivayisi ngempumu, kaningi kancane emlonyeni. Isazi ngaphambi kwenkambiso sisebenzisa izidakamizwa kanye nama-anesthetics wendawo ukukhipha injabulo ngokweqile, ukuphazamiseka nokunciphisa ubuhlungu. Ezimweni ezinzima kakhulu, i-anesthesia jikelele isetshenziswa. Khona-ke idivayisi ingena engxenyeni ngaphansi kophenyo. Ngaphandle kokuhlola okubukwayo, i-bronchoscope ivumela i-biopsy ukuba yenziwe ukuhlolwa okwengeziwe.
Yini ezoboniswa yi-bronchoscopy ebonakalayo kulesi sifundo:
- isikhukhula, ipus kanye ne-mucus;
- izinqubo zokuvuvukala;
- ukutholakala kwezidumbu zangaphandle;
- amathumbu amapulmoni;
- ama-cysts;
- lumen encane ye-bronchi noma ukwandiswa okungavamile kwe-bronchi;
- ukutholakala kwezidumbu;
- i-fistula, ukuvuvukala, ukuguguleka kwamanzi;
- ukuphuma.
I-bronchoscopy - izinkomba
Inqubo enzima kangaka njenge-bronchoscopy ye-bronchi kanye ne-trachea inezinkomba zayo, ezingasetshenziswa ukuxilongwa noma zokwelapha. Uma umbuzo, i-bronchoscopy - esiyicabangile lokhu, bese ulandela ukuqonda nokuvumelana kokucubungula le nkinga, umuntu kufanele acabangele izinkomba eziyinhloko zokusetshenziswa kwe-bronchoscope.
Izinkomba ze-tracheobronchoscopy ngezinhloso zokwelapha:
- ukutholakala kwezidumbu zangaphandle ezithombeni zokuphefumula, ngenhloso yokususwa kwazo;
- ukususwa kwezicubu ezinobungozi ezinobuthi nezimbi, nezinye iziphuzo eziphuzayo kanye nama-plug mucous.
- ukufakwa kwe-stent ekhethekile lapho ucindezela izindiza zomoya ngezinambuzane.
- ukususwa kwe-mucus kanye ne-pus.
Ngezinhloso zokuxilonga, izinkomba ze-bronchoscopy zilandelayo:
- ama-abscesses emaphashini;
- i-pneumonia ivame ukuvama;
- ukuphalaza igazi;
- i-neoplasm ecatshangelwayo;
- ukuthola izimbangela zezifo ezinzima zokuphefumula;
- isifo sofuba;
- ukubhema ugwayi;
- ukukhwehlela okungaqapheli.
I-bronchoscopy - ukuphikisana
Inqubo ye-bronchoscopy inezinamba eziningi zokuphikisana nokusebenza, okubaluleke kakhulu ukwazi. Ngokuvamile, ochwepheshe baqoqa umlando ophelele ngaphambi kokubeka inqubo yokukhipha imiphumela engadingeki futhi ngezinye izikhathi eyingozi ye-bronchoscopy eyenziwa ngaphandle kokucatshangelwa okungahambisani nanoma yikuphi.
Ukuphikisana okungaqondile:
- ukuhlaselwa kwenhliziyo, kwaphela ezinyangeni ezingaphansi kwezinyanga eziyisithupha edlule;
- ukuphazamiseka kwamapayipi kanye nenhliziyo yezinga lesithathu;
- isisu esibi;
- ukungahambisani ne-anesthetics;
- i-asthma ye-bronchial ngendlela elula;
- ubuhlungu ku-peritoneum;
- stenosis ye-larynx ne-trachea;
- izifo ze-neuropsychic;
- i-arrhythmia.
Uhlobo:
- isifo sikashukela mellitus;
- isigamu sesibili sokukhulelwa;
- umjikelezo wesisindo;
- i-degree yesithathu ye-goiter;
- I-IHD;
- I-ARI;
- ukuphuza utshwala ngesimo esingapheli.
I-bronchoscopy yenziwa kanjani?
Umbuzo wokuthi i-bronchoscopy yenziwa kanjani kubalulekile kulabo abelwe le nqubo. I-tracheobronchoscopy kufanele yenziwe ngemuva kokulungiselela, futhi indlela yokuqhuba kwayo inqunywe ochwepheshe, ngokususelwa kuleso sizathu kanye nokuyinkimbinkimbi kokuhlelwa okuhleliwe. I-bronchoscopy, indlela yokwenza ngayo nokuthi ungayilungiselela kanjani - inkinga ebalulekile lapho kuxhomeke khona umphumela ophumelelayo wenqubo.
Ukulungiselela i-bronchoscopy
Ukulungiswa okufanelekile kwesiguli nge-bronchoscopy kuhlanganisa ukuhlaziywa okuningi:
- ECG;
- X-ray yamaphaphu ;
- ukuhlolwa kwegazi nge-HIV, i-syphilis, i-hepatitis kanye jikelele;
- i-coagulogram.
Ngaphandle kokuhlolwa, isiguli kumele sithobele izidingo ezithile ngaphambi kwenqubo:
- Ungadla isikhathi esidlule ngaphambi kuka-8 kusihlwa futhi hhayi ngokuqinile kakhulu.
- Ngesonto ngaphambi kokulala, kuyadingeka ukuthatha izidakamizwa.
- Ngosuku lwenqubo, kufanele uyeke ukubhema.
- I-tracheobronchoscopy yenziwa ngesisu esingenalutho.
- Ngaphambi kwenqubo, kuyisifiso sokungenalutho isisu nesisu.
I-bronchoscopy ene-biopsy
Ukwazi ukuthi i-bronchoscopy idlula kanjani nge-biopsy, ungalungisa ngokomzwelo kule nqubo engavamile. Nakuba, incazelo yokuphathwa okunjalo ayijabulisi futhi imininingwane yokuziphatha kwayo ingethusa noma ubani. Ngakho, ukulandelana kwezinyathelo yilokhu:
- I-tube ye-apparatus ifakwa ngokusebenzisa i-bronchi eya endaweni engaphansi kophenyo (lapho isampuli sokwaziswa kuhlelwe khona).
- Ngokulawula inqubo ngokusebenzisa i-X-ray ithelevishini, cindezela i-forceps ekhethekile kuze kube sekugcineni.
- Ekuphumuleni, amaphuzu e-forceps agxila emaphandleni futhi athathe ukulandelwa kwecala.
- Uma ngalesi siguli isiguli sizwa ubuhlungu, ukuthi i-forceps kufanele isuswe masinyane futhi indaba ethathwe kwenye indawo.
- Le ndlela ithatha amasampula amathathu kuya kwayisishiyagalombili.
- Le nqubo igcwaliswe kuphela ngemuva kokuqiniseka ukuthi i-stop ephelele yokuphuma kwezindawo ezimele. Igazi elivela ku-bronchi ne-trachea lifisa.
I-bronchoscopy ngaphansi kwe-anesthesia
Kwezinye izimo, i-tracheobronchoscopy yenziwa ngaphansi kwe-anesthesia ejwayelekile. Akuyona yonke imitholampilo enekhono lobuchwepheshe kulokhu, ngakho-ke kufanele wazi kusengaphambili mayelana nokutholakala kwezixhobo ezidingekayo ngenqubo. Izinzuzo eziyinhloko zalolu daba ziphezu kokuzwa esikhathini esilandelayo, ezibonakaliswa ubuhlungu obukhulu nokukhwehlela okubuhlungu, okungakuvumeli ngisho nokuhamba. I-bronchoscopy, esetshenziselwa noma yikuphi, kwenzeka kuphela ngaphandle kokungezwani komzimba ku-anesthetics.
Umyalelo we-bronchoscopy owenziwa kanje:
- Amaphaphu wesiguli aphefumula ngamaminithi ambalwa.
- Isixazululo se-1% se-sodium thiopental senziwa ngokuqondile.
- Ngemuva kokuqala kwezinga lesithathu le-anesthesia, lesi sidakamizwa simisiwe futhi iziphumuli zesampula zokuqothula ziqaliswa futhi kwenziwa umoya wokuphuza umoya.
- Ngemuva kokuqala kokuzilibazisa, i-mask isuswe futhi iqhubekela phambili kwinqubo ye-tracheobronchoscopy, umyalelo wayo ochazwe ngenhla.
- Akunakwenzeka ngaso sonke isikhathi ukuqhuba umoya ogcwele nge-mask (i-anesthesia apparatus), ngakho-ke uma izibonakaliso ze-hypoxia zivela, isiguli kumele sithunyelwe futhi siqhubeke sivuselela amaphaphu ngokusebenzisa ithubhu.
I-bronchoscopy - izinkinga
Ngeshwa, izinkinga zingenzeka ngemuva kwe-bronchoscopy, nakuba le ndlela ibhekwa njengokuphepha ngangokunokwenzeka. Ingozi yokubukeka kwayo ayifanele, kodwa akekho ongalinika isiqinisekiso esiphelele sokuphepha okuphelele.
- ubuhlungu esifubeni;
- ukushisa komzimba okwandisiwe;
- isicanucanu, ngokuvamile sihambisana nokuhlanza;
- ukudonsa nokugubha;
- ukuphalaza kwegazi isikhathi eside.
Emva kwe-bronchoscopy, eyenziwa ngaphansi kwe-anesthesia, izinkinga zingaba kanje:
- i-bronchospasm ne-loringospasm;
- ukungezwani komzimba kanye ne-hyperthermia;
- ukuguqulwa kwe-bronchus (okungavamile kakhulu);
- i-aspiration pneumonia.
Imiphumela ye-bronchoscopy
Ngemuva kokuthi i-bronchoscopy yenziwe, ukuthi ukukhishwa kwemiphumela kwemiphumela kwenziwa kanjani nokuthi yini engaba yiyo, umbuzo uyaknomerny. Kuncike ekubonisweni kokuqala kwenqubo, kanye nendlela okwenziwe kuyo, ukuqhutshelwa phambili kwezifundo zendaba (uma kwenzeka kube yi-biopsy) kuzoxhomeka. I-bronchoscopy, emva kwalokho okuhlolwayo okwenziwe ebhokisatri, kungasiza ekwakheni ukuxilongwa okunembile. Izifo ezivame ukuxilongwa, okuyinto esiteji sokuqala kwakuyizinkomba zenqubo.
Iziphetho ezivame kakhulu emva kwe-tracheobronchoscopy zilandelayo:
- i-fistula ewuphawu lwesifo sofuba ;
- lumen encane kanye ne-sputum yezingqinamba ezinzima angakwazi ukukhuluma kanye ne- cystic fibrosis ;
- endobronchitis;
- izibonakaliso zesifo sokuphefumula kwesibindi: iningi le-sputum ngaphandle kwe-pus, ukubomvu kwe-mucosa nokukhukhumeza kwayo;
- ukwehla kwe-lumen nokuvuvukala kodonga kungakhuluma ngokukhula kwesisu;
- ama-contours amakhulu, amaphethelo angalingani, ukutholakala kwezilonda ze-necrotic - izimpawu ze-oncology;
- Isifo se-bronchoectatic sihambisana ne-sputum e-purulent ne-pus kanye ne-dilonal bronchial.