Inspection of the internal cavity, produced for diagnostic or therapeutic purposes, is performed with the help of an endoscopic method, to which bronchoscopy also applies. What is bronchoscopy, how do such a procedure and why - a question that requires detailed consideration.
What is bronchoscopy?
To begin with, you should consider the very definition of the concept of bronchoscopy, what kind of procedure and when it is prescribed. Its full name is tracheobronchoscopy. This is a modern method that allows you to visually examine the trachea and bronchi. Perform bronchoscopy using a special device fibrobronhoscope, which consists of a special cable that has a video or camera at the end. To control the device use a special handle equipped with a manipulator.
What does the bronchoscopy show?
Finding out what bronchoscopy is and how to do this procedure, you should know about some important points. Tracheobronchoscopy is often performed by inserting the device through the nose, less often through the mouth. The specialist before the procedure applies sedatives and local anesthetics to exclude excessive excitement, spasms and reduce pain. In particularly difficult cases, general anesthesia is used. Then the device penetrates into the organ under investigation. In addition to visual inspection, the bronchoscope allows a biopsy to be performed for additional examination.
What will the bronchoscopy show visually in the study:
- sputum, pus and mucus;
- inflammatory processes;
- presence of foreign bodies;
- pulmonary abscesses;
- cysts;
- a narrow lumen of the bronchi or an abnormal enlargement of the bronchi;
- presence of tumors;
- fistula, swelling, erosion;
- bleeding.
Bronchoscopy - indications
Such a complicated procedure as bronchoscopy of the bronchi and trachea has its own indications, which can be diagnostic or therapeutic. If the question, bronchoscopy - that we have considered this, then following the logicality and consistency in considering this issue, one should consider the main indications for the use of a bronchoscope.
Indications for tracheobronchoscopy for medicinal purposes:
- presence of foreign bodies in respiratory organs, with the purpose of their removal;
- removal of tumors of benign and malignant, other neoplasms and mucous plugs.
- installation of a special stent when squeezing the airways with tumors.
- removal of mucus and pus.
For diagnostic purposes, the indications for bronchoscopy are as follows:
- abscesses in the lungs;
- pneumonia is frequent;
- spitting blood;
- suspected neoplasm;
- finding out the causes of serious respiratory diseases;
- tuberculosis;
- tobacco smoking;
- causeless cough.
Bronchoscopy - contraindications
The procedure of bronchoscopy has a number of contraindications to the exercise, of which it is very important to know. Typically, specialists collect a complete history before prescribing the procedure to exclude the unwanted and sometimes dangerous consequences of bronchoscopy performed without taking into account contraindications that can be relative and absolute.
Absolute contraindications:
- a heart attack, suffered less than six months ago;
- pulmonary and cardiac insufficiency of the third degree;
- acute stroke;
- intolerance to anesthetics;
- bronchial asthma in acute form;
- pain in the peritoneum;
- stenosis of larynx and trachea;
- neuropsychic diseases;
- arrhythmia.
Relative:
- diabetes;
- second half of pregnancy;
- menstrual cycle;
- third degree of goiter;
- IHD;
- ARI;
- alcoholism in a chronic form.
How is bronchoscopy performed?
The question of how bronchoscopy is done is important for those who are assigned this procedure. Tracheobronchoscopy should be carried out after preparation, and the method of its conducting is determined by a specialist, based on the reason and complexity of the planned manipulation. Bronchoscopy, how to do it and how to prepare for it - an important issue on which depends the successful outcome of the procedure.
Preparation for bronchoscopy
Obligatory preparation of the patient for bronchoscopy includes a number of analyzes:
- ECG;
- X-ray of the lungs ;
- blood test for HIV, syphilis, hepatitis and general;
- coagulogram.
In addition to the tests, the patient must comply with certain requirements before the procedure:
- You can have dinner no later than eight in the evening and not too tightly.
- On the eve before going to bed it is desirable to take sedatives.
- On the day of the procedure, you should stop smoking.
- Tracheobronchoscopy is done on an empty stomach.
- Before the procedure, it is desirable to empty the bladder and intestine.
Bronchoscopy with biopsy
Knowing how the bronchoscopy passes with a biopsy, you can prepare emotionally for this unpleasant procedure. Although, the description of such manipulation is unpleasant and the details of its conduct can frighten anyone. So, the sequence of actions is:
- The tube of the apparatus is inserted through the bronchi to the site under investigation (at which the sampling of the material is planned).
- By controlling the process through X-ray television, push the special forceps up to the stop.
- On exhalation, the ends of the forceps are immersed in the parenchyma of the lungs and take a trial traction.
- If at this point the patient feels pain, that the forceps should be immediately removed and the material taken in the other site.
- This method takes from three to seven samples.
- The procedure is completed only after they are convinced of the complete stop of the bleeding of the damaged areas. Blood from the bronchi and trachea is aspirated.
Bronchoscopy under anesthesia
In some cases, tracheobronchoscopy is done under general anesthesia. Not all clinics have the technical capabilities for this, so you should know in advance about the availability of the necessary apparatus for the procedure. The main advantages of this method overshadow the sensations in the postoperative period, which are manifested by severe pain and painful cough, which does not even allow you to move. Bronchoscopy, which is used in any case, is carried out with the exception of allergy to anesthetics.
The order of the bronchoscopy performed is as follows:
- The patient's lungs are ventilated for a couple of minutes.
- A 1% solution of sodium thiopental is intravenously administered.
- After the onset of the third degree of anesthesia, the drug is stopped and the relaxants of the depolarizing sample are introduced and ventilation is performed.
- After the onset of relaxation, the mask is removed and proceeds to the very procedure of the tracheobronchoscopy, the order of which is described above.
- It is not always possible to conduct full-fledged ventilation with a mask (anesthesia apparatus), so if signs of hypoxia appear, the patient must be intubated and continue to ventilate the lungs through the tube.
Bronchoscopy - complications
Unfortunately, complications can occur after bronchoscopy, although this method is considered as safe as possible. The risk of their appearance is minimal, but no one can give an absolute guarantee of complete safety.
- pain in the chest;
- increased body temperature;
- nausea, often accompanied by vomiting;
- choking and wheezing;
- prolonged spitting of blood.
After bronchoscopy, performed under anesthesia, complications can be as follows:
- bronchospasm and loringospasm;
- allergy and hyperthermia;
- perforation of the bronchus (very rare);
- aspiration pneumonia.
Results of bronchoscopy
After the bronchoscopy was done, how the decoding of the results is done and what they can be, the question is zaknomerny. Depending on the initial indications for the procedure, as well as on the way in which it was performed, further studies of the material (in the case of a biopsy) will depend. Bronchoscopy, after which tests are performed in the laboratory, can help in the formulation of an accurate diagnosis. More often diagnose diseases, which at the initial stage were indications for the procedure.
The most frequent conclusions after the tracheobronchoscopy are as follows:
- fistulas that are a sign of tuberculosis ;
- narrow lumen and sputum of thick consistency can speak and cystic fibrosis ;
- endobronchitis;
- signs of bronchial asthma: a lot of sputum without pus, redness of the mucosa and its puffiness;
- a decrease in lumen and swelling of the wall can talk about the growth of the tumor;
- wide contours, uneven edges, presence of necrotic lesions - symptoms of oncology;
- Bronchoectatic disease is accompanied by purulent sputum with pus and bronchial dilations.