Bronchoscopy - how to do it? See that show until the end

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The site provides additional information, including for information. It is necessary to go through the diagnosis of that likuvannya ill under the supervision of a fahіvtsya. Usі drugs and mayut contraindications. Consultation fahіvtsya є obov'yazkovaya!

What is bronchoscopy?

Bronchoscopy- This is the method of follow-up, for the help of which the enlightenment and mucous membrane of the bronchi are looked at. Bronchoscopy endoscopic methods further investigation can be carried out both with a likuval and with a diagnostic method.

Endoscopic methods of follow-up - these are the methods that allow you to look at the organs, even if you want to have a minimal empty space. "endo" means in the middle, and skopiya - doslidzhuvati) In such a rank, by the method of endoscopic methods - a look at the internal empty body. When carrying out these methods of diagnostics, there are hard and soft fittings ( endoscopy). Metal tubes of various diameters can be seen to the first ones, and fiber optic fittings to the others. At the endoscope endoscope there is a light bulb that hangs until the empty tube, that video camera, as it was brought to the monitor. When bronchoscopy is performed, endoscopy gnats are observed ( synonym - fiberscope), as if they celebrated the right revolution in medicine. The stench is made up of faceless glassy fibers ( svіtlodіodіv), by which the image is transmitted. For the phenomenon of repeated reflection on the border between two mediums, the picture is given great information. During bronchoscopy, the fiberscope is inserted into the bronchi through the opening, then through the nis abor.

How to perform bronchoscopy?

Bronchoscopy allows revealing pathologies that are localized on the lower level. wild ways- trachea, head bronchi and bronchioles. In order to understand how to do bronchoscopy itself, it is necessary to know the nature of the bronchial tree.

Anatomy of bronchi and bronchial tree
The lower dichal paths of a person are formed from the trachea, cephalic ( right and left) bronchi and bronchial tree. The trachea and dichal throat divide into the right and left head bronchus. In them, the secondary bronchi enter, yak, with their own blackness, subdivided into small throats, and those - more small. The constriction of all secondary bronchi and other bronchi is called the bronchial tree. In this manner, mentally, the lower dichal paths can be turned in such a way. Trachea - left and right head bronchus - secondary bronchi - bronchial tree. During the first hour of bronchoscopy, the fiberscope looks at the trachea, smut and secondary bronchi, let the veins pass at the middle and flanks of the bronchi. However, the fiberscope cannot penetrate into other bronchioles through their small diameter. Other methods of diagnostics, for example, such as virtual bronchoscopy, are required to follow up on other bones.

Bronchoscopy method

When conducting bronchoscopy, the patient is obliged to rest in the supine position. Most often, under the shoulders, additionally put a roller from a towel. Planned lіkuvalna bronchoscopy to be carried out vranci, now. If bronchoscopy is carried out for emergency indications, then, obviously, the hour of doby does not matter. For 5 - 10 quills per cob, anesthesia is carried out, so that pain relief. Anesthesia as an obov'azkovy point as a planned, and emergency bronchoscopy. Vaughn knows better more clearly in a patient, ale and ignoring the cough reflex, which is the moment to stop the procedure. Most often, the anesthetic vicorates like a spray or aerosol.

A fibroscope is inserted through the nis orifice, which passes at the throat, and from it into the trachea and bronchi. Through the arrival at the other end, the eyepiece of the doctor looks at the paths to pass. Away tactics lie down in the form of bronchoscopy. For aspiration ( ventilation) pathological rіdini in the bronchi and sanitation ( washing) purulent empties into the lumen of the bronchi, a special aspiration tip is introduced, from which the stool is examined. As a method of bronchoscopy, i.e. the bronchial tree is passed through, an opening is introduced forward along the fiberscope tube to instill the bronchial tree ( ce can buti rozchin furacilin). Motherland is introduced in small portions, after which it is seen. For the additional help of the process of introducing the rіdini and її aspiration, sanitation is being established ( Promivannya) bronchi.

When third party body from the bronchial tubes, special forceps are drawn, yak tse mozhe buti pea, kvassola) and do yoga. With bronchial bleeding, the procedure is called tamponade of the bronchi. In this way, a piece of foam rubber is taken, which may increase the diameter of the bronchi. Yogo schіlno sgortayut, soak at the rozchinі antiseptic and pom_shchayut at the empty bronchus, in such a rank, zakryvayuchi yogo enlightenment. In order to introduce this foam rubber at the bronchus, a pair of forceps is used, which is passed through a fiberscope. If the fiberscope reaches the bleeding point, the forceps are squeezed, and the foam rubber is straightened and filled with enlightenment. In such a “rammed” steel, foam rubber is found near the enlightenment of the bronchial tree of the doti, the doki does not bleed.

Even if the bleeding is small, then the replacement of the tamponade can be delayed by the judge, to bleed with adrenaline. Adrenaline is a speech, yak calling a sharp ringing of the vessels and a bloody bleed ( like the vessel is small).

Preparation before bronchoscopy and the procedure

Proper preparation before bronchoscopy allows you to conduct an informative procedure with minimal negative consequences. By the method of forward entry and adoption as emotional, and physiological officials, as they can cross over to this duty.

Preparation before bronchoscopy includes the following steps:

• medical treatment;
• early medical consultation;
• psychological preparation of the patient;
• dotrimanya special diet;
• acceptance of calm benefits;
• vikonannya low diy bezposeredno before the procedure.

Carrying out medical treatment

Schob turn off possible contraindications and choose the best way for the patient to conduct bronchoscopy, before the procedure, go through a low ventilation.

Preparing for bronchoscopy before passing the following steps:

• X-ray sign of legends. To take the sign of legen ( radiography) a beam of X-ray changes is passed through the thoracic clitina, which then looks like a swimmer. So, like brushes, they swear at the vibrancy, at the sign of the stench you see a white color, and when you look at the empty ones, you look like a black one. Soft tissues on radiography are marked with a gray color. Orienting on the sign, the doctor treats the growth of pathological cavities and during bronchoscopy gives them special respect.
• Cardiogram. The obstezhennya is carried out in order to take care of the graphic visualization of the work of the heart. On the chest, arms and legs of the patient, special electrodes are installed, as if they record the heart rhythm and transmit it to the computer, so it is possible to get cardiograms. The obstezhennya passed as informative as possible, 2-3 years before the procedure, the patient did not have a trace. According to the cardiogram, the doctor determines what is the risk negative experiences heart for bronchoscopy
• Blood test. In order to reduce the severity of infectious processes and other illnesses, which can become an obstacle for bronchoscopy, blood tests are prescribed to the patient. For biochemical analysis of blood, it is taken from a vein, for a cold one - from a finger or from a vein. In order for the results to be reliable, the analysis should be carried out in the future, for which it is necessary not to eat 8 years before the procedure. Also, for 1 - 2 days, it is recommended to drink alcohol and fatty foods.
• Coagulogram. For carrying out this follow-up, blood is taken from the patient's vein, so that we can then change it to laryngeal. A coagulogram is prescribed to rule out risk of bleeding during the hour after bronchoscopy. So, just like for other blood tests, the patient must not eat for 8 years before the procedure and do not live for 1-2 days of alcohol and high fat products.

Early medical consultation
After reviewing these data, the patient is referred to a doctor who will perform bronchoscopy. Before the procedure, a previous consultation is shown, in the course of which the ailing person should be explained that he needs to work up to that next appointment. Lyudina, who is indicated for bronchoscopy, is obliged to tell the doctor about those who take the same medications, who suffer from allergies, and who have undergone anesthesia earlier. Tsya іnformatіya podpomozhe likarevі pіdіbrati optimal for the patient method of carrying out the procedure.

Psychological preparation of the patient
The emotional state is more dependent on the quality of the bronchoscopy and the results. Under the hour of the procedure, ailments can be relaxed and calm, so that it is easy to carry out the necessary manipulations with a bronchoscope in a proliferative patient. The best way to help the sick person to calm down is to be aware of the usual aspects of the procedure. In order to put together outside information about those, how to conduct bronchoscopy, the patient should follow the hour before the consultation, put the doctor on all the nutrition that he needs to be turbulent. Trivality of the procedure, the nature of the findings before the next bronchoscopy, the type of planned anesthesia - q and other nutrition, which can be blamed on the sick, it is necessary to discuss with the doctor.

Let's get medical advice, the patient can also independently improve his emotional state. To calm down, it is recommended to think about those who will significantly speed up the process of bronchoscopy, regardless of the way it is carried out. diagnostic and licuval). Also, take into account the fact that there are pain receptors in the mucous membrane of the bronchi. Therefore, the discomfort during bronchoscopy is greater than the confusion of psychological and physical factors. It is not recommended to watch films with a negative character before the obstezhennyam. Also, according to the feasibility of following the surroundings, adding various other professional stress factors.

Doing a special diet before bronchoscopy

Bronchoscopy is carried out on a daily basis, so the rest of the meal can be no less than 8 years before the procedure. Most of the time, the rest of the day is assigned to the morning, then the last meal of the evening, after which you have a light snack. The Supper is due to the accumulation of products, which are quickly overwhelmed and easily conquered. It is recommended to give priority to vegetables, meat, chi ribi. In order to avoid discomfort during the first hour of the procedure, it is necessary to move in the air, as a spray of supra-world gas in the intestines.

Іsnuyut taksі kharchovі commodities, yakі provokuyut gazootvorennya:

• be-like legumes;
• all varieties of cabbage;
• radish, rapa, radish;
• mushrooms, artichokes;
• apples, pears, peaches;
• milk is like a new one;
• all napoї, scho avenge gas.

Obov'yazkovoy umovoy є vіdmova vіd alcoholic drinks for doba before bronchoscopy. On the day of the obstezhennya, the following is observed in the chicken, the shards of the implantation of tyutyunov virobiv raise a risk of vindication. So you can’t drink kava, cocoa and be drunk with caffeine.

During bronchoscopy, the patient's intestines may be empty. In the proliferative fall through the intracranial vice, the procedure may be mimoly delayed. To that lie before the examination of the clinic should empty the intestines. In some patients, through hvilyuvannya, or the peculiarities of the mucosal-intestinal tract, the folding is blamed on the early act of defecation. In such cases, the sick person is shown to clean the enema.

Acceptance of calm benefits
To reduce anxiety, more patients are prescribed sedative drugs before bronchoscopy. calm) dії. Take such faces as necessary in the evening ahead of the obstezhennaya. In a number of cases of indications, a repeated intake of calm, 1-2 years before the procedure.

Vikonannya low diy without intermediary before the procedure
Before bronchoscopy, the patient is guilty of seeing the toilet to empty the sieve mikhur. Like on the shiї or on such parts of the body, like nіs, tongue, ruin, embellish the person, it is necessary to remove them, stink shards to make the doctor carry out the necessary manipulations. Braces and other attachments can be used for a bronchoscope, as they are fastened to the teeth, so, if possible, they can be removed.

Results of bronchoscopy

Diagnostic bronchoscopy allows to reveal more than endobronchial manifestations of the ignition process, so that changes, like rotting in the middle of the bronchial tree. The manifestations of one’s own change are most often referred to by the term “endobronchitis” ( endo - mean middle). Fallow in the step and the vastness of the changes, one sees a sprat seen in endobronchitis.

Types of endobronchitis є:

• catarrhal endobronchitis- characterized by less redness and swelling of the mucous membrane of the bronchi;
• atrophic endobronchitis- it manifests itself in thinning and dryness of the mucous membrane, and in case of cartilaginous little settlements;
• hypertrophic endobronchitis- characterized by sweating of the mucous membrane, which leads to equal ringing of the bronchial tubes;
• purulent endobronchitis- the main symptom is purulent vision that accumulates in the bronchial cavity;
• fibrous-virazkovy endobronchitis- characterized by the formation of virazkovyh lesions on the mucosal membranes, which are replaced by fibrous tissue throughout the year.

Behind the grapes I’m dying of vipadkiv ( cancer, fistulas and third-party bodies) during bronchoscopy, inflammation of the bronchi is diagnosed. In order to evaluate them, the doctor respectfully looks at the mucous membrane through a fiberscope, or rather, through a camera brought to him. As a rule, the data that are collected during the hour of bronchoscopy are transmitted to a video monitor. The picture on the screen gives a better assessment of the mucous membrane. Also, which is not less important, you can increase the number of times and take a closer look at the image. In order to accurately assess the nature of the ignition injury, the doctor can take a small piece of the mucous membrane for further analysis in the laboratory. This procedure is called a biopsy.

Bronchoscopy can diagnose damage to the tone of the bronchial tree. As a rule, hypotonic dyskinesia is diagnosed, which is characterized by an increase in dyhalal fragility and a decrease in bronchial tubes on the vidia.

Through the growth of puffy tissue or part of the ignition changes, the lumen of the bronchi can sound. It is also visible from bronchoscopy. With which drug, which is to conduct bronchoscopy, you can evaluate the world of sounding. At the first stage, the enlightenment of sounds is no more lower by one eighth, at the other stage - by half, and at the third stage - more lower by two thirds.

See bronchoscopy

As indicated, bronchoscopy may be performed as a diagnostic test. At the first stage, the doctor can carry out a bronchial tree washing, introduce faces and see third-party objects. In another case, bronchoscopy is carried out using the method of assessing the mucous membrane or taking a biopsy.

Before seeing bronchoscopy to lie:

• local bronchoscopy;
• diagnostic bronchoscopy;
• Virtual bronchoscopy.

Licuval bronchoscopy legen

Lіkuvalny bronchoscopy legen - tse type of vtruchannya, in which case, whether pathology is used, chi is introduced into the likarsky speech. How and before any follow-up, before bronchoscopy may be indicated. As a rule, ce pidozra on a third-party body, flushing, bronchial hemorrhage.

Before the indication to lіkuvalnoї bronchoscopy lie:

• flushing of the bronchial tree;
• washing and draining rotten empty;
• exclusion of third-party bodies - most often in children;
• Usunennya blockage of the dyhal passages, which may be caused by mucus or pus;
• scowl.

Also, luteal bronchoscopy can be carried out with the method of bronchial bleeding, or for the introduction of liquor directly into the empty bronchi. The rest maneuver, as a rule, is carried out in case of mild bronchial asthma.

As always, in case of lacuval bronchoscopy, there is also a contraindication.

Contraindications prior to lacuval bronchoscopy:

• other and third stage of arterial hypertension;
• heavy camp of the patient;
• exudative pleurisy;
• aortic aneurysm;
• pathology of the larynx ( e.g. tuberculosis);
• swelling of the middle.

At the same time, the doctor is guilty of correcting both indications and contraindications. For example, if the patient has a third-party object in dyhalnye paths, then bronchoscopy will be carried out in any case, shards in the other case will lead to death.

Diagnostic bronchoscopy

Diagnostic bronchoscopy is performed to reveal pathology. For the help of this method of diagnosis, it is possible to reveal a fuse or a cicatricial lesion of the mucous membrane of the bronchial tree. Bronchoscopy also reveals swelling, stenosis ( buzzing), norici. At the end of the hour, you can also take a biopsy. piece of fabric, which was further examined under a microscope).

Indications for diagnostic bronchoscopy are:

• suspect cancer of the leg;
• tuberculosis;
• persistent, trivial cough;
• pathological changes in the tissues of the leg, which were revealed on x-rays;
• chicken over 5 years;
• fall ( atelectasis) legends.

However, it is a contraindication for diagnostic bronchoscopy, as well as for licuval. As a rule, stinks are interspersed with pathologies of the heart and vessels. It is explained, that at the hour of the bronchoscopy, the arterial pressure rises sharply, which can aggravate the underlying pathology.

Prior to contraindication for diagnostic bronchoscopy:

• zagostrennya bronchial asthma;
• recent transfer of myocardial infarction;
• disruption of the heart rhythm in the form of blockade or arrhythmia;
• cardiac insufficiency or legenev insufficiency;
• mental and neurological illness, for example, epilepsy;
• became post craniocerebral injury.

Conducted diagnostic bronchoscopy, as well as likuvalna. Obov'zkovym point - anesthesia, which allows you to relax the mucus of the bronchi, reduce the cough reflex and relieve sickness in the patient. After anterior anesthesia and the correct positioning of the patient ( vin lie on your back) A fiberscope is inserted through the empty mouth into the throat. Dali veins with smooth hands proshtovhuєtsya into the trachea, the same way from it - into the left chi of the right bronchus.

Virtual bronchoscopy

Virtual bronchoscopy is the same method that extends to the bronchi, without going into it until the probe is used. For this reason, virtual bronchoscopy is not used as an endoscopic diagnostic method, but as a variant of computed tomography.

The basis of virtual bronchoscopy is the X-ray method. Wrapping around, the X-ray tube gives an image, as if far away, it transforms into a trivier world. In this way, for the help of special programs, the outside of the image of the entire bronchial tree is reconstructed. head and small bronchi). With this, all the balls of the bronchi, including the mucous membrane, appear visible in the picture. The advantage of this method is the ability to continue to find more bronchial tubes, so that you can always take advantage of primary bronchoscopy.

Cons and pros of virtual bronchoscopy

Minusi	Plusy
The diagnostic value is lower, lower at primary bronchoscopy - it is impossible to take a biopsy ( piece of material for follow-up).	Highly informative - virtual bronchoscopy allows you to pump bronchi of a small caliber, in the range of 1 to 2 millimeters.
It is impossible to perform the procedure with a jubilant method, so that it is not possible to pull a third-party object, or to stop bleeding.	Nabagato is less contraindicated. Before the contraindication, it is seen that the obesity of the third stage is less than the degree of vaginess.
Variation of the procedure in 2-3 times, lower bronchoscopy.	Painless, non-traumatic.
Carrying out virtual bronchoscopy of obstruction in case of claustrophobia ( fear of closed spaces) that early child vіtsі.	Without special training, trivality becomes 5 to 15 hvilin ( The usual procedure borrows approximately 30 credits and more).
During a virtual bronchoscopy, the patient receives the first dose of the prescription.	It is possible to carry out diagnostics for severe illnesses.

Bronchoscopy in children

Bronchoscopy in children can be carried out as a curative and diagnostic procedure. Modern preparations for anesthesia allow painless and non-invasive procedures. It is important to increase the list of pathologies in small patients, in which indications for lung follow-up by a bronchoscope.

The procedure is carried out to establish the correct causes of quiet and other illnesses dichal system. For additional help, the doctor can take away the secret ( slime) from glucocorrosive veins of the bronchial tree for further bacteriological investigation. Also, during this procedure, it is possible to carry out parkan textiles ( biopsy) for distant analyses, visualization of third-party subjects or a new creation. Bronchoscopy makes it possible to deliver preparations directly to the follicles of the wound, to see pathological mucus and to carry out other surgical procedures with a high therapeutic effect.

Indications for bronchoscopy in children

One of the most common reasons for carrying out manipulations in children is the penetration of a third-party body at the dychal passage. Details of toys, letter cases, tassels, rhymes, coins - these and other other items are often consumed by small patients near the respiratory system.

Tuberculosis is another widespread cause of recognition of bronchoscopy. The procedure is prescribed in order to confirm or reveal the presence of changes in the bronchi or in the lungs characteristic of tuberculosis. Bronchoscopy is indicated for the removal of mucus with the method of introducing an ailment alarm. In older children, tuberculosis can cause bleeding in the legs, and in such cases, the procedure is prescribed to complete this process. Investigate other pathological conditions, in which bronchoscopy is indicated in children.

There are such indications for bronchoscopy in children:

• anomalies in the development of the bronchogenetic system;
• legeni atelectasis ( pathology, when such a disease ceases to take part in gas exchange);
• cystic fibrosis ( ailments of organs that produce mucus, including legen);
• abscess legheni ( molding at the light empty, filled with pus);
• haemorrhage and/or mild bleeding;
• newborn at the legenia;
• bronchial asthma ( chronic inflammation in the dichal system);
• ailments of the legen and bronchi of an unexplained trip.

Preparing the child for bronchoscopy

In order for the endoscopic procedure to be successful, it is necessary for the fathers to prepare the child according to the lowest rules. So, as bronchoscopy is carried out under general anesthesia, and the patient does not know what to expect, in some cases we are mature enough to recommend not explaining the details of the procedure. Tim is not less than that, even as a child he allows, it is necessary to emotionally prepare for anesthesia, so that she does not panic immediately before the introduction of an anesthetic.

Perelik front lining ( blood test, radiography, cardiogram) is appointed as a doctor, who accepts to the vіdoma vіk children, її zagalny camp and other factors. For 6-8 years before bronchoscopy, children cannot be born, and for 3-4 years, they should be seen and taken care of. Children who are breastfeeding can be born 4 years before the procedure.

Features of bronchoscopy in children

The most common procedure for small patients is carried out under general anesthesia. For children up to 3 years of age, inhalation anesthesia is indicated ( mask anesthesia), when the drug is administered through a special mask, which is worn on the mouth and not. Patients older than 3 years old can be given mask and traditional anesthesia, which is administered internally. Bronchoscopy in children is carried out most importantly with a flexible bronchoscope, the diameter of which is chosen stalely in children. So, patients for a century to one rock are fitted with an attachment, the tube of which does not exceed 3 mm in diameter. For children of age up to 3 years of bronchoscope indications, the diameter of which does not exceed 6 mm.

Under the hour of the procedure, the child is resting in a horizontal position, which increases the severity of bronchial spasm. Therefore, before carrying out a child's bronchoscopy, medical personnel prepare the necessary adjustment of piece ventilation of the lungs. After manipulation of the bronchoscope, children are prescribed antibiotics to prevent the development of infection.

Indications for bronchoscopy

Bronchoscopy is invasive ( destroying the ranks of the barriers to the body - skin, slime) by the follow-up method, and to that, regardless of її perevaga, carried out for suvori indications. The main indications for bronchoscopy are tuberculosis of the leg, cancer of the bronchi, as well as third-party bodies in the distal passages.

Bronchoscopy for tuberculosis

In case of tuberculosis, bronchoscopy is carried out as a diagnostic, and lіkuvalna. The first option is carried out only if the bacteriological results are negative, or if it is impossible to remove sputum for follow-up. In times of bronchoscopy, it is possible to make a correct diagnosis, and to indicate adequate treatment. Another important advantage of bronchoscopy in tuberculosis is the possibility of taking a biopsy. Taking the material for further investigation to allow the diagnosis of chemo-resistant forms of tuberculosis ( forms that do not fall for the jubilation of vikoristannyam chemopreparations). Bronchoscopy also allows you to control the bronchi after or before surgery. Thus, tuberculosis often ends with resection. to the distant) parts of the legend, if you need to be careful. As it has already been said above, bronchoscopy in case of tuberculosis is always accompanied by taking a piece of mucus for follow-up, so that a biopsy is taken. The biopsy is carried out with special forceps or with an additional scarifier. For the first time, the material for the follow-up simply looks good ( does it take a few seconds), and in another way the material is lost ( brush biopsy method).

Bronchoscopy for leg cancer

In case of suspected cancer of the leg, additional visualization is carried out for additional bronchoscopy. looking around) trachea and bronchi, including secondary bronchi. Virtual bronchoscopy is performed to look at the small veins by measuring the number of sprats. In obov'yazkovuyu order to carry out the collection of material for histological and cytological follow-up. Only for an additional biopsy can confirm the diagnosis of cancer, and also look at it.

Other steps may include insertion of catheters ( tubule) in the other bronchi for taking a smear. This procedure is called catheterization and is necessary for the diagnosis of peripheral cancer. If the cancer has already been confirmed, bronchoscopy should be carried out with caution, and a biopsy of the lymph nodes should also be performed. It is necessary to identify metastases.

Bronchoscopy in bronchial asthma

Bronchoscopy in bronchial asthma may be indicated for diagnosis or treatment of illness. In the acute stages of the disease, the procedure is not carried out;
As a child who suffers from bronchial asthma, thoughts about the dotality of bronchoscopy are being raised. A number of fahivtsіv classify the endoscopic procedure to the category of obov'yazykovyh, oskolki for help can be carried out various highly effective manipulations. Others rarely go to bronchoscopy;

Regardless of the heterogeneity of thoughts, it is obvious that at the moment bronchoscopy of the leg is one of the most accurate methods for establishing the correct diagnosis in cases of suspected bronchial asthma. Also, in some cases, bronchoscopy is the only possible method for carrying out this or that other surgical procedure.

Indications for bronchoscopy in bronchial asthma

This procedure is prescribed for us in order to confirm or ask for a clear admission about the presence of a patient with bronchial asthma. Also, bronchoscopy will help to establish the nature of the disease. So, as a strong bulge was revealed from the penetration of the exudate ( rare parts of blood) deep into the walls of the bronchi, the severity of atopic bronchial asthma is great. In cases of depression, if sputum is coughed up during asthma, bronchoscopy is carried out with a method of sampling and further mucus collection. The presence of sputum white secretion without pus, in which there is a lot of eosinophils ( singly type of leukocytes) can tell about the allergic nature of the disease. An endoscopic procedure is also performed to rule out other causes of asthma-specific symptoms.

Licuval bronchoscopy is indicated to improve symptoms and polypshitis of the patient's self-esteem.

There are such indications for lacuval bronchoscopy in asthma:

• vіdsutnіst result vіd lіkuvannya;
• clear vision of the mucus, if the possibility of development of bronchial obstruction is great;
• coughing up a purulent mixture;
• zblizhennya that embossment of legenevyh walls, in the wake of which the bulbous bulbs of legenity are known more and more, and the organ is affected by gas exchange.

Likuvalny bronchoscopy is carried out to relieve bronchial obstruction, as well as to reduce the ignition process by way of injection into the mucous membrane with various drugs. For active patients, with the help of a bronchoscope, a wash should be carried out with the onset of breaths together.

Features of bronchoscopy in asthma

Before bronchoscopy, a patient with asthma is prescribed sedatives ( calm) preparations, as they are taken in the evening, ahead of the procedure. For 40 minutes before the procedure, intravenous administration of drugs with anti-seizure and anti-inflammatory drugs. Tse mozhe buti atropin, diphenhydramine or seduxen. After 20 minutes, the ailment should be given Eufilin, or another drug that expands the bronchi and relieves spasms. Without intermediary before the procedure, the sick person should wipe the aerosol ( berotek, salbutamol) to prevent bronchial spasm. Nadali procedure was carried out by the standard method.

Effects and complications of bronchoscopy

After bronchoscopy, the patient may experience low inability to respond, the reason for which is the transfer of anesthesia and manipulation. In those who have rare symptoms of endoscopy, the leg is accompanied by complications, which may appear like a half hour of the procedure, so after that.

Effects of bronchoscopy
Sound ailment to complain about difficulties that are blamed on the process of forging, seeing a third-party body at the throat, the name of the throat. In some cases, after the procedure, the presence of loose blood clots in the mucus may be present, which is coughing up. The blood is blamed for the fact that the first hour of bronchoscopy is an attachment for traumatizing the mucous membrane of the dycal passages. Also, some ailments have timchasov nasal congestion. In order to reduce discomfort and avoid the development of more serious complications, people should follow the current rules after bronchoscopy.

• take water and drink water, don’t follow doty, don’t pass the anesthetic ( specific hour tell the doctor);
• the docks of anesthesia continue the child, it is necessary to spit the slough, and not to coddle it, so that the patient can choke in the protivolezhnoy type;
• for a period of 24 years after the procedure, the next step was taken in the chicken;
• before the first meal, it is necessary to make a small bowl of water, to turn it over, so that the sensitivity of the throat was aroused;
• until the end of the day, the patient is not recommended to sit at the kermo;
• by protyag dobi after bronchoscopy it is fenced to live in whether it is alcohol or hot drinks;
• frosty and іnshi see cold fears/drinking not a trace to live through the coming 24 years.

Complicated bronchoscopy

The complexity that provokes bronchoscopy can be mentally subdivided into two groups. The first category includes negative changes in the patient, which develops under the hour of the procedure. The other group includes complications that are to be blamed after bronchoscopy.

The reason for the aggravation that occurs under the hour of the procedure may be preparations that are used for anesthesia. In case of allergy to mіstseviy or severe anesthesia in a patient, a case can be blamed or an anaphylactic shock develops. It is also possible to reduce the pressure, viniknennya problems іz dyhannyam, disruption of the heart rhythm.
It should be noted that an allergic reaction to anesthesia manifests itself in a few episodes, and the uninterrupted presence of a doctor allows you to quickly normalize the state of the sick. Another reason for the aggravation of the hour of the procedure may be poor blood-bearing judges, through which bleeding develops. Bleeding is most likely to occur if a biopsy is missed during bronchoscopy. pluck a fragment of legenia or bronchitis with forceps).

Factors that provoke complication after the procedure can be different infections or allow pardons at the hour of bronchoscopy.

There are such complications that develop after bronchoscopy:

• Pneumothorax. With this pathology in the empty pleural space ( expanse under the golden shell of the legen) appears repeatedly, as if crushing the leg, as a result, the body ceases to take part in the process of breathing. It develops through the ear of the pleura with a bronchoscope and forceps, which are used to biopsy. Pneumothorax is manifested by a sharp pain in chest clitz as it becomes stronger when you breathe in and you can breathe in the shoulder. The patient's breath becomes quicker and superficial, a dry cough is possible. The heart rhythm is more frequent, the stitches appear on the ridges, a severe weakness develops.
• Bacteremia. Due to the presence of an infectious process in the dyhal passages and the occasional bronchial integrity during the procedure, the pathogens of infection penetrate the blood, and bacteria develop. The pathology is manifested by such signs as chills, boredom, vomiting, severe weakness and apathy.
• Perforation of the bronchial wall. To lay down to one of the most complicated conditions and blame them, if from the wildest paths of the patient there are various hospital objects. drit, flowers, hairpins). Symptoms of impaired bronchial integrity are coughing, coughing up blood. don't wait), strong bіl at the breasts.
• Inflammation of the bronchi and leg. With penetrating infection in the dychalny tract, the patient may develop such complications as bronchitis, pneumonia. Signs of inflammation are pain in the chest, fever, cough.

Prices for bronchoscopy

The variability of bronchoscopy is determined by the method used for the procedure, if not, if not carried out.

There are such factors that determine the type of bronchoscopy:

• The method of the procedure. So, the standard endoscopic examination cost is significantly less, lower virtual. computer) bronchoscopy. In case of extreme bronchoscopy, the price can also be varied depending on the type of device ( zhorstky chi gnuchki) to be followed up.
• Install. Rotation of the clinic, and the very distance to the center of the city or the grains of the public transport, sometimes play a great role in the molding of the vartost of this procedure. Also, the quality of possession, the competence of fahivtsiv and other officials, which signify the prestige of the likuval mortgage, are poured in.
• Additive manipulations. The degree of anesthesia, which is victorious, may determine the price of bronchoscopy. For more patients, the procedure due to the need for anesthetics is cheaper for patients. Prior to additional manipulations, a biopsy and follow-up of an advanced cytological follow-up should also be carried out.

The average variant of standard bronchoscopy varies from 2000 to 6000 rubles. The price of virtual bronchoscopy can be 7000 - 9000 rubles. In other settings, the price of such a procedure shifts the average value into a kilka times. So, at the capital's European Medical Center on Shchepkina Street, bronchoscopy costs 23,000 rubles. The difference in prices is explained by foreign owners, such as equipping the center and other factories that reinforce the prestige and professionalism of the clinic.
For the sake of transparency on the Internet, catalog sites have been created, which provide detailed information about various clinics that specialize in the procedures performed. Krіm addresses, hours of work on rich resources are also indicated approximately the variance of the procedure, which allows you to choose the best option from the minimum hourly rates.

Sign up for follow-up

To make an appointment with a doctor or for diagnostics, you just need to call for a single phone number
+7 495 488-20-52 near Moscow

+7 812 416-38-96 near St. Petersburg

The operator will listen to you and redirect the call to the clinic, or I will accept an appointment for an appointment until you need it.

Prices for bronchoscopy in Moscow and other places in Russia

Such a procedure, like endoscopy in the capital, is promoted by a lot of different mortgages. Detailed information about the clinics of the capital and other settlements was collected from special Internet catalogs. On such sites, prices, addresses, schedule of work and other data are indicated for the selection of a suitable diagnostic center. On some resources, including basic information, they show real observations of people who have undergone bronchoscopy, as well as photographs of the interior, and special data on fahivtsiv.

Find out who can undergo bronchoscopy

Misto	Install name	Addresses	Telephone	Website
Moscow	Clinic "Be healthy"	Komsomolsky prospect, budinok 28	(495 ) 782-88-82	clinicbudzdorov.ru
	Medical center "MEDLUX"	Buzkoviy Boulevard, Budinok 32a	(499 ) 704-49-26
	Center "Best Clinic"	street Nyzhnya Krasnosilska, budinok 15/17	(499 ) 519-34-75
Saint Petersburg	Clinic "Admiralty Shipyards"	Sadova street, budinok 126	(812 ) 409-90-18
	Petrov Scientific Institute of Oncology	Settlement Pisochniy, street Leningradska, budinok 68	(812 ) 243-19-60
	Clinic named after Peter the Great	Piskarevsky prospect, budinok 47	(812 ) 303-50-60
Novosibirsk	Medical center "Almitu"	street Zaliznichna, budinok 12/1	(383 ) 363-06-31
	Medical Center "A"	Rimskogo-Korsakova street, budinok 19	(383 ) 346-00-70
	Clinic "Sanitas"	Street Vokzalna magistral, budinok 16	(383 ) 233-66-00
Kazan	Republican likarnya	Orenburg tract, budinok 138	(843 ) 231-21-09
	Likarnya №7	Marshala Chuikov street, budinok 54	(843 ) 237-91-71
	Sloping booth of the clinic No. 16	street Gagarina, budinok 54	(843 ) 560-66-52
Ufa	Health care service	Batyrska street, budinok 39/2	(347 ) 255-66-71	bsmp-ufa.rf
	Clinic of the Bashkir State Medical University	street Shafieva, budinok 2	(347 ) 223-11-92
	Republican likarnia named after Kuvatov	Dostoyevsky street, 132 budinok	(347 ) 279-03-97

The most widely used method of follow-up, which allows to reveal the pathology of the dycal pathways, is bronchoscopy. Bronchoscopy is a method, for the help of which, the mucous membrane of the trachea and bronchi are checked, and the device itself, which is victorious for looking around, is called a bronchoscope. A tube is placed through the middle of the patient's mouth, which can be a special device - a camera that sends a light. Effektivnіst kogo outweighs 97%. Such a pokaznik to rob the Danes is the best way of the most recent on this day. Bronchoscopes can be equipped with surgical instruments or laser devices. At this time, the stench vikoristovuyutsya in jubilant purposes.

General information about bronchoscopy

The first known type was dated back to 1897. At that time, the process itself was rather unsafe and painful, and cocaine was injected into that patient like an anesthetic. Spatula bronchoscope serving as a third-party tel.

In 1956, the roci bronchoscope, we can say, was blamed again, becoming absolutely safe, but at the same time, the wine did not fill up with a more pronounced form for us, we keep repeating. The first flexible bronchoscope was presented in twelve years. And after a decade of modern investigations, they allowed me to take away the picture for revealing illness at the early stages.

Bronchoscopy is a name that comes from two Greek words: “look around” and “distal throat”. An attachment is a singing system, for the help of which the dihal organs are twisted. Its diameter is 3 to 6 mm, and the length is close to 60 cm. As described above, a modern bronchoscope can have special attachments for viewing images on a monitor, as well as additional equipment. The video from the bronchoscope can be saved for further investigations for the development of illness or pathology.

Indication before bronchoscopy

Endoscopic obstruction of respiratory pathways may be two methods - diagnostics and exaltation.

The main indications for decontamination are:

• symptoms of swelling on the wild ways and organs
• the presence of third-party objects is possible
• often despite the fact that you have not shown either
• vodharkuvannya with blood
• pustules or brushes in legenia
• inflammation of the dichal organs
• repeated
• non-standard type of bronchi
• definition of the causes that called asthma in the bronchi
• taking material for follow-up response to
• preparation for surgical intervention.

How to perform bronchoscopy

In order for the algorithm of the procedure to be carried out without becoming an inconsistency for you, the next step is to familiarize yourself with it.

The following may include the following items:

• Patients, if they want to undergo bronchoscopy, stay at a specially owned office (endoscopic room), all can go under the strange care of a specially trained doctor
• A patient with goiter should be given a bronchoconstriction preparation in order to ensure that the device can safely reach the month to be treated.
• Under the hour of bronchoscopy, the patient is guilty of being in a sitting or lying position on his back. It is important to take care of the safety technique in order to avoid injuries
• Under the hour of the procedure, breathing can be partial and superficial, so you can avoid vomiting
• The bronchoscope can also be inserted through the lower mouth. Don’t worry about it, even if it’s not in the line for the possibility of going wild, the shards of the pipe itself are richly smaller, lower wild ways.
• You can feel the pressure at the singing missions, but I’m in pain, like this, there won’t be
• Looking around starts from the larynx and the vocal fold, then look at the trachea and bronchi. Zavdyaki small roses, the pipe will not harm your health
• During bronchoscopy, it is possible to take a part of the necessary material, to remove external bodies from the bronchi, or to use a special rozchin.
• If you wait until the end of the procedure, you may lose your name. For a period of two years after the procedure, there was no time to smoke or live
• Preparations that are victorious to stifle anxiety, change the speed of the reaction, it is not recommended for him to sit for a kermo for eight years
• Do not deprive doctors of joy medical establishment well, after the constriction, only in such a time the medical staff can prostrate behind your camp

Give respect:under the hour of conducting bronchoscopy with a flexible tube, one is guilty of medical anesthesia, and for solid variations of the apparatus - severe pain relief.

Preparation for bronchoscopy

Preparation before the procedure includes two obov'yazkovі points: the presence of additional consequences and immediate preparation of the body.

For maximum information and safety, you will have to go through a series of additional refreshments.

People to enter:

• . This result may increase the doctor's respect for a specific case under the hour of the bronchoscopy.
• . This method will help to turn off the imovirnist viniknennya folded from the side of the heart.
• Build shelter
• Check the ribcage of the blood

Your body can also be prepared before the procedure.

In order to avoid unacceptable situations during the hour and after the endoscopy, the following rules are clumsy:

On a bronchoscopy, you should bring a towel, to the one who knows the imovirnist of the fact that one day after the procedure you have blood. For bronchial asthma, bring an inhaler.

When should I go to the doctor after bronchoscopy?

A number of symptoms after bronchoscopy may be complicated. Golovnya, do not let them out of respect and for an hour take advice from a tradesman.

Symptoms after endoscopy, which may lead to a referral to a doctor:

• blood sampling
• chest discomfort
• wheezing
• increased body temperature

Contraindication

Bronchoscopy is contraindicated in the following conditions:

• ringing of the larynx and trachea II and III stage,
• dychal insufficiency III stage,
• acute bronchial asthma,
• aortic aneurysm,
• і (as long as the stink was not less than six months before the procedure),
• broken blood coagulation,
• intolerance to drugs for anesthesia; mental illness.

It is not possible to undergo bronchoscopy for these people, who suffer from:

• heart rate disorder is higher than the third stage
• strongly
• past infarction, transferred for the first time and less before the procedure
• dilation of the aorta

For people with heart disease, bronchoscopy can be performed, but only after special preparation.

Won go to:

• stabilization of heart rate
• administering to the drug, which improves the eating of my heart
• normalization of the vice
• taking sedative speeches

Ailments of wild ways to the current world trapyayutsya douche often. For їхної diagnostics, there are different methods of vicariousness. One of them is bronchoscopy of legends - follow-up, for an hour of some kind of fahivets looking at the mucosa of the trachea and bronchi, vicarious special attachment - a bronchoscope. Tse tube, at the end of which there is a video camera. Everything that is running the device is displayed on the computer monitor. The accuracy of this result should be over 97%.

The most common procedure is victorious as a method for diagnosing chronic bronchitis, pneumonia, cancer of the leg, tuberculosis. So, when you have pneumonia, show you how much fluff is in the wild ways.

Indications before bronchoscopy are most often the following signs:

• presence at the wild ways of a third-party body;
• hemoptysis;
• brushes in legenia;
• preparation before surgery;
• Trival zadishka, tied up with ailments of the dichal system.

In this way, for additional similar manipulations, it is necessary to carry out not only the diagnosis of illnesses, but also liquor procedures, for example, remove from the bronchi in the external body, cleanse the pus and thick mucus; rinse and administer, if necessary, antibiotics; zdіysnyuyut zabіr zrazkіv tissue for additional follow-up (biopsіyu); expand the lumen of the bronchi and navіt remove loose swelling.

The most important method of bronchoscopy is to supplement it with such devices as a laser for removing puffs or with forceps for taking material.

History of bronchoscopy

Previously, a bronchoscopy of the leg was carried out in 1897, and for 50 years after the help of a bronchoscope, we could see other parts of the body. Cocaine was most often used as anesthesia, so the procedure was even more painful. The old models of the bronchoscope often injured the dichal passages and caused complication.

The first safe for the ailing apparatus of wines Fridel in 1956 roci. That's right, a zhorstky bronchoscope. Gnuchkiy came up with 1968 rock. With the development of electronic technologies, it became possible to improve the image and take a more detailed picture of the changes in legenia.

Different procedures

Bronchoscopy has two types: female and female.

1. Gnuchkiy (fibrobronchoscope) zastosovuetsya for the diagnosis of dyhal passages; visualization of the mucosal bronchi and in case of visible other third-party bodies. A flexible bronchoscope is less traumatic to the mucosa, the shards may be small in diameter, vicorous when children are obese.
2. Zhorstky, or rigid, zastosovuєtsya for expansion of the lumen of the bronchi, the distance of third-party bodies, as a way to cross the dyhal channels. Vykoristovuєtsya during resuscitation of the thin, ill with cystic fibrosis (with the help of yogo, they remove the mother's leg from the leg); reinforce the passage of the distal paths (for the presence of scars and fluff); when fighting with bleeding; promyvannya bronchial tubes and the introduction of medical rozchiniv.

How is bronchoscopy performed?

Dosledzhennya zdijsnyuyut at a special office, de mayut to the minds of sterility. Sickness to sit or lie on your back. Insert the tube through the mouth of the patient. To suppress the vomit reflex, which is due to the hour of the introduction of the bronchoscope, the patient should be asked to breathe often and superficially. You don't have to be afraid that the tubes sound like a breath, the stench is much less from the bronchi and trachea, that does not respect the breath.

The procedure is performed under anesthesia. It should be carried out with a flexible bronchoscope, vicorous anesthesia with a 2-5% dose of lidocaine. When you feel the palate, you see the breasts at the throat, and you notice a slight stuffiness in the nose. When the tube of the bronchoscope is inserted, the mucus is sprayed with an analgesic spray.

When vikoristannye zhorstkih models carried out general anesthesia, it is recommended not only for children, but also for people with a mental illness. Even more than an hour of general anesthesia, the patient does not feel fear. After two years have passed, you can smoke that їsti.

In order to make it difficult to develop, it’s better to stay out of the sight of medical practitioners for a day, at the connection with the work of those who are on the camp, do not sit at the kermo on the day of the procedure.

Preparing for delivery

When preparing for the procedure, it is most common to carry out such follow-ups, such as x-rays, electrocardiography, blood tests. To appoint a doctor for a sign, for some part of the leg it is necessary to learn in more detail, to follow the heart, show the risk of a more complicated development.

In advance, it is necessary to tell the doctor about allergies to faces, chronic illness and drugs that are taken. Like be-like medical care take carelessly, then goiter ahead of the doctor about the patient.

Before going ahead, it is necessary to pay full attention, it is possible to stop the calm ahead of the procedure.

In order not to suffocate with excess during the first hour of bronchoscopy, it is necessary not less than 8 years before the procedure, and chickens cannot smoke on the day of follow-up.

Before proceeding, it is necessary to cleanse the intestines for additional enemas or glycerin suppositories and it is recommended to urinate before the procedure.

At the beginning, after the procedure, hemoptysis fluctuates, prepare a towel, a servlet or a pelushka for scalding.

Like and be-like else medically obstezhennya bronchoscopy may be contraindicated. At any time, it is not possible to carry out the procedure, as if to wash the place:

• acute bronchial asthma;
• allergy to pain medications;
• myocardial infarction;
• severe arterial hypertension;
• empty oral ailments;
• naslіdki craniocerebral trauma and іn;
• strong cough.

Conducted bronchoscopy may be but timchasovo vіdkladeno:

• pid hour of pregnancy (2nd and 3rd trimester);
• during menstruation in women;
• under the hour of circulatory diabetes, with alcoholism and increased thyroid disease.

What traces can be blamed?

It is impossible to say that bronchoscopy of the leg does not reveal daily complications. In single episodes, after diagnosis, bronchospasm, allergy and bleeding, the development of pneumonia, and the most common occurrence were bronchospasm. To follow all the orders of the doctor, who is to carry out the follow-up, you can omit any traces.

Bronchoscopy of the leg is a procedure of little acceptance, but it is considered the most effective medium for diagnosing various diseases of the respiratory paths. Before that, anesthesia is often used as an inability to take it, depending on the hour of the procedure.

Bronchoscopy, as a result, I give as an assessment I will become ill, and I can carry out a song of the likuvalny, come in, vikonati, in a wonderful way, do not go into it.

Bronchoscopy- a method for examining the mucous membranes of the trachea and bronchi with the help of a special tool - a bronchoscope. A tube is inserted through the throat into the distal path, it is secured by illumination with a video camera. Today, it is safe to have an accuracy of over 97%, which makes yoga indispensable in the diagnosis of various pathologies: chronic bronchitis, pneumonia, which recur, cancer of the legenivs.

The bronchoscope is often victorious with a jubilant method. For whom it is necessary to equip with a surgical set of instruments, biopsy forceps, laser devices.

History of bronchoscopy.

The first bronchoscopic examination was carried out in 1897. The procedure was sickly and traumatic, so cocaine was used for pain relief. For the first 50 years, the bronchoscope was victorious for the removal of other third-party bodies from the bronchi.

The early models were equipped with a warm dzherel of light. The light bulb, behind the help of the mirror system and the lens, transmitted a beam of light from the bronchi, which led to the light of the likar bachiv usi change from the wild roads.

The first models of the bronchoscope were incomplete. The stench traumatized the dichal system and called out a serious aggravation. The first rigid (zhorstky), but safe for patients, apparatus for finding faults in 1956 by Friedel. The flexible fiber bronchoscope appeared in 1968. After 10 years, electronic technologies have made it possible to improve the image in dozens of times and to take a detailed picture of the changes in legenia.

What is bronchoscopy

Bronchoscopy- Vivchennya wild ways. The term looks like two Greek words: “look around” and “distal throat”. Myself bronchoscope- a special optical system for looking at the mucous membrane of the larynx, trachea and bronchi to their other vision. Vin with a system of flexible or hard tubes with a diameter of 3-6 mm and a length of about 60 cm.

Modern bronchoscopy is equipped with photo and video equipment, as well as a cold light lamp, as placed on the end of the tube. The image appears on the screen of the monitor, which can be enlarged dozens of times. In addition, it is possible to save a record, which is needed later for equalizing that assessment of the dynamics of the pathological process.

Indication of bronchoscopy. Bronchoscopy is carried out as a way to diagnose diseases of the dichal system. For the help of a bronchoscope, it is possible to carry out low-level procedures:

• removal from bronchial third-party tіl
• purification from pus and thick mucus
• administration and administration of antibiotics, glucocorticoids, mucolytics, nitrofurans
• taking specimens of tissue for biopsy
• expanding the lumen of the bronchi
• removal of fluffy puffs

For this bronchoscopy, equip with various devices: a laser for removing the newborn, forceps for taking biopsy material, an electric and mechanical surgical instrument.

How is bronchoscopy performed?

• The follow-up is carried out at a specially equipped endoscopic room, where they are treated themselves to sterility, like in the operating room. The procedure is carried out by the doctor, which is a special training for the follow-up of the bronchi.
• Injection of Atropine sulfate, Eufilin, Salbutamol Voni may be used in the presence of aerosols in order to induce bronchoconstriction and to administer the bronchoscope without interruption.
• Dosledzhennya to spend in a sitting position or lying on your back. With this, it is not possible to pull the head forward and regenerate the chest cavity, so that the apparatus does not injure the mucous membrane of the dycal passages.
• With the introduction of a bronchoscope, it is recommended to dihati often superficially, not to ignore the vomit reflex.
• The bronchoscope is inserted through the nostril through the mouth. At the moment of deep inhalation, the tube is passed through the glottis. Dali with overt ruhi її zaglyuyut near the bronchi. The tubes are richly thin behind the deep channels;
• In case of obstezhenni, you may notice a vice in different cases of the dichal system, but you will not feel pain.
• Dosledzhennya start from looking around the larynx and the vocal folds, farther around the trachea and bronchi. Thin bronchioles and alveoli of the leg become inaccessible through their small diameter.
• Under the hour of the procedure, you can take a piece of tissue for a biopsy, remove it from the bronchial tubes, clean it with a medical tool, take a piece of tissue for follow-up.
• After the procedure, it is almost like the name is filled with a stretch of the year. It is not recommended to smoke and live for 2 years, so as not to provoke bleeding.
• Sedative measures that cause a change in anxiety, reduce the severity of the reaction. Tom is not recommended to sit at the kermo for 8 years.
• For a long time, it is recommended to stay at the hospital. The medical personnel will keep watch over your camp, so as to prevent the development of complications.

Pain during bronchoscopy.

The main rule is to note: when using a flexible bronchoscope to instill general anesthesia, when using multiple models, general anesthesia is necessary.

• Mistseve pain relief. For anesthesia, 2-5% of the amount of lidocaine is used. Vіn vyklyaє nіmіnnya pіdnebіnnya, vіdchuttya thorax in the throat, difficulties in forging and easy stuffiness of the nose. Anesthesia will also help to stifle the cough and vomit reflex. When introduced through the tube of the bronchoscope, gradually spray the mucosa of the larynx with an analgesic spray, voice calls, trachea and bronchi.
• Hot anesthesia. This procedure is recommended for children and people with an unstable mentality. To introduce a sick person at the camp of a medical sleep, and I see absolutely nothing.

See bronchoscopy

Modern bronchoscopy is divided into two groups: females and females. The skin of the models may have its own advantage and the sphere of congestion.

Indications for bronchoscopy

Indication before bronchoscopy

• signs of disseminated pathological processes on x-rays (dry pustules, cysts, voids)
• suspicion of swelling of the trachea and bronchi
• suspicion of the presence of a third-party body
• trivala zadishka (because of bronchial asthma and heart failure)
• hemoptysis
• multiple abscesses of the leg
• brushes at legenia
• chronic inflammation of the bronchi in an unknown cause
• recurrent pneumonia
• anomalous budova and bronchial expansion
• explanation of the causes of the diagnosis of bronchial asthma
• take away for the purpose of determining the susceptibility of flora to antibiotics
• preparation before surgery on legs

Purpose of recognition of bronchoscopy- Reveal signs of ailment and, if possible, pinpoint the cause.

Pathology	Signs of this illness, which may be revealed during bronchoscopy
Tuberculosis	Infiltrate and thin consistency. The borders of pale-erysipelas swollen dilyanki, which hang over the mucous membrane of the bronchi. At the last stages of illness, the stinks become red, plump, covered with bleeding erosions.
	Bronchial ringing. Enlightenment becomes narrow, slit-like, for the rahunok the mucus membrane of the distal paths
	Fistulas - open at the bronchial wall
Endobronchitis - inflammation of the mucous membrane of the bronchi	Mucus swelling
	Sudini in the mucosal membranes are nasty visible
	Thinning of the mucous bronchi. Vaughn red, on contact it is easy to bleed
	With hypertrophic form of the disease, the mucous membrane is evenly sweated. Enlightenment of bronchial sounds
	Clearly seen pus
cystic fibrosis	Damage to the tone of the membranous part of the trachea and bronchi - sounding of the lumen more lower by 1/2 of the diameter
	Bleeding of the bronchial wall
	Squeezing thick sputum
Cancer - exophytic swellings that grow near the lumen of the bronchus	Clearly christened the newly created on a broad basis
	Contours are wrong
	The surface is humpbacked, covered with erosions, to bleed, with necrosis (death).
	Colour: white to bright red
	The mucosal membrane around the swelling may be unchanged, or there is hyperemia (blackening) at the sight of half a day
Cancer swellings with infiltrating growths	On the walls of the bronchus, smooth infiltrate, sweating
	Edges can be clear and clear
	The top is smooth abo shorts, covered with rotten sludge
	Pale erysipelas to bluish color
	The mucus has become slightly blackened, covered with a yellowish rotting incrustation, and erosions are seen on the surface.
	The cartilaginous base of the bronchus is not visible through the swelling of the mucous membrane.
	Clearance of the bronchus signifi cantly sounds
Cancer tumors that grow near the bronchi (peribronchially)	Vipinannya walls of the bronchus, or sounding of yoga enlightenment for the swelling of the swelling, as it grows.
	Sweating of bronchial spurs
	The mucous membrane is not changed
	The wall of the bronchi is hard and swollen
Alien body	Clearance of the bronchi in the upper part of the body, or often overlapping with a different third-party body.
	Like the subject of a trivaly hour, having changed at the tіlі, the wine is overgrown with fibrin
	Slime swollen around the alien body and turned black
bronchoectatic ailment	Cylindrical or mouse-like expansion of bronchial lumen
	Thinning of the walls of the bronchi, erosion, yaki can cause bleeding
	Accumulation of thick purulent sputum on the expansion of the gap due to impaired drainage function of the bronchi
Congenital vadi of the tracheobronchial tree	Dilyanki expansion of chi ringing in the bronchi
	Vitonchennya okremyh bronchus
	Empty, napovnenі povіtryam chi home
	Fistulas at the walls of the bronchi
Bronchial asthma	Mucus bronchial congestion and other signs of endobronchitis
	Vibration of the walls of the bronchial tree
	A brighter vision of a bright, transparent motherland without a house of pus
	The color of the mucus is pale with a bluish tinge to bright red.

Preparation for bronchoscopy

What do you need to do before bronchoscopy?

• X-ray leg. It is a sign that, as a child of a legen, it is necessary to take special care during bronchoscopy.
• Electrocardiography. This method will help you to develop a risky development from the side of the heart.
• Coagulogram– blood test for larynx
• Riven gas rozchinenikh in the blood (sour, carbon dioxide and nitrogen)
• Riven sechovini at the blood

How to prepare for bronchoscopy?

• Before an hour later, talk to the doctor about allergies to drugs, chronic illness (heart failure, blood diabetes) and drugs that are taken (antidepressants, hormones, anticoagulants). If it is not recommended to be accepted by a doctor, the doctor will inform you about it.
• Tranquilizers (Elenium, Seduxen) will help to change anxiety in the evening ahead of the next day. Їх you can go from snodіynym (Luminal), sob povnotsіnno vіdpochiti before slіdzhennyam.
• The rest of the appointment is due no later than 8 years before the procedure. Tse profilaktika potraplyannya zalishkіv їzhі to dyhalnyh slyahіv pіd h bronchoscopy.
• Stopped smoking at the day of follow-up.
• Before the procedure, it is necessary to clean the intestines. For whom you can win an enema and glycerin candles.
• It is recommended to empty the sieve mіkhur without intermediary before the procedure.
• If necessary, immediately before the procedure, sedatives can be applied to reduce anxiety.

What to take with you?

On obstezhennya when you need a mother towel, because after the procedure it is possible to avoid hemoptysis. If you suffer from bronchial asthma, then do not forget the inhaler.

Preparation for bronchoscopy of people with pathology of the cardiovascular system

It is contraindicated to carry out bronchoscopy in sick people, as there may be such pathologies:

• disruption of the heart rhythm is higher than the third stage
• movement of the lower (diastolic) blood pressure over 110 mm Hg
• myocardial infarction, transferred less than 6 months ago

In other cases, in ailments with pathologies of the heart, further follow-up is carried out after special training. It starts 2-3 days before bronchoscopy. The training is aimed at compensating for impaired functions and includes the following steps:

• normalization of heart rhythm (Ritmonorm, Nekvitok)
• the use of beta-blockers, to reduce the ingestion of heart meat (Carvedigamma Celiprolol)
• lowering arterial vice(Anaprilin, Monopril, Enap)
• taking calming drugs, tranquilizers (Phenazepam, Mebicar)
• administration of Heparin and Aspirin for the prevention of thrombosis

In some cases, is it necessary to contact a doctor after bronchoscopy?

There is a small risk of complications after bronchoscopy (bleeding, development of infection). It is important not to miss these symptoms and immediately turn to the doctor. You may be alert:

• trivale hemoptysis
• wheezing
• elevated temperature, chills.

Contraindications for bronchoscopy

The number of contraindications to bronchoscopy is often reduced by doctors. Ale, with certain pathologies of obstezhennia, you can have more shkodi, lower crusty.

• Stenosis of the larynx and trachea II and III stage. Severe ringing of the lumen complicates the introduction of the bronchoscope and may cause respiratory distress.
• Dychal insufficiency III stage. Accompanying sharp broncho sounds. To that, for doslidzhennya, a high risk of their ushkodzhennya.
• The acute period of bronchial asthma. Carrying out the procedure at the same time can potentiate bronchospasm and potentiate sickness.
• Aortic aneurysm. Nerve stress and manipulation of the bronchoscope may cause aneurysm rupture.
• Myocardial infarction and cerebral infarction (stroke), transferred less than before. Stress and spasm of the vessels and the deaceria of sourness during the first hour of the procedure can cause a recurrence of circulatory disorders.
• Impaired pharynx- small damage to the mucous membrane of the bronchi can cause bleeding, unsafe for life.
• Intolerance to drugs for anesthesia– Nebezpeka development of serious allergic reactions, which can cause poison.
• Mental illness: schizophrenia, epilepsy, after craniocerebral injury. Stress and a decrease in the concentration of sour in the blood can provoke an attack by a court.

• hostile infectious disease
• monthly
• attacks of bronchial asthma
• on the other half of the vacancy

However, in emergency situations, bronchoscopy is carried out, regardless of contraindications.

Bronchoscopy and Bronchography (Video)

Bronchoscopy in children, indications, contraindications, measles and rhizomes, unsafe

Children should also undergo bronchoscopy and an indication for this procedure to milk the bagato. I realized that it was important for the fathers to dare to give their permission for such a manipulation for their child. But there are situations, if bronchoscopy cannot be replaced by anything, and in view of the diagnostic method, it is possible to lay the life of a baby.

Indications for bronchoscopy in children:

What does bronchoscopy give us in treating tuberculosis?

1. Appointment of adequate therapy to relieve congestion and bronchospasm (Ventolin, Berodual, eufilin, glucocorticoids, Spiriva and so on), as a result - improved effectiveness of anti-tuberculosis therapy;
2. diagnosis of tuberculosis in steep depressions in children and grown-ups;
3. showing that dynamic caution for bronchial tuberculosis;
4. withdrawal biopsy material for histological follow-up;
5. manifestation of chemoresistant forms tuberculosis;
6. dispersal of atelectasis legen;
7. bronchial control before the operation (bezpeka narcosis, appointment of the possible obligation of the operative introduction then) and after it;
8. removal of granulation bronchi, vinicles due to bronchial tuberculosis;
9. legenevous bleeding і hemoptysis with a path of tamponing of a bleeding blood-bearing judge;
10. vimivannya caseous mas from the bronchi;
11. removal of bronchial tubes from tuberculosis-affected lung tissue, intrathoracic lymph nodes;
12. sanitation of the bronchial tree with chronic purulent diseases of the bronchi, after chronic bleeding;
13. insertion into the bronchi anti-tuberculosis and other medicinal preparations, antibiotics.

How to perform bronchoscopy with biopsy?

A biopsy of the bronchi is necessary in the diagnosis of ailments, the most relevant is cancer of the lungs and bronchi. A bronchus biopsy can be performed only after additional bronchoscopy or under the hour of a complete operation on the empty chest.

It is practically impossible to make a diagnosis of bronchus cancer without a biopsy, even if the symptoms of this illness become wider and with other pathologies of the bronchogenetic system (cough, backache, increased body temperature, pain in the chest cleft).

What is a biopsy?

Biopsy - taking a cloth or a cloth for further їх dolіdzhennya, like being carried out for the life of an ailing person. Removing the material is called biopsy or biopsy material.

How is the biopsy material wrapped?

1. Histological follow-up of the biopsy material- Vivchennya fabric under a microscope. With this, it is possible to determine which process has damaged the normal tissue of the bronchus, the warehouse and the cell of the removed material, the reaction of the immune system to the whole process. Such follow-up is carried out by pathologists and pathologists. The biopsy can be carried out terminovo, at the hour of the bronchoscopy or surgery on the legs. If so, the pathomorphologist is in the operating room in order to assess the question of nutrition: cancer or cancer. As the histological picture is typical for cancer, surgeons in the field are working out food about the new development and further operational tactics. This investigation allows you to establish a diagnosis with an accuracy of 95%.
2. cytological method- Vivchennya clitin under a microscope. For this follow-up, take not a part of the affected tissue, but a smear, a smear or a bronchus wash from the changed surface of the mucous membrane of the bronchus. This type of follow-up is screening, it is practical to carry out it during skin bronchoscopy. The result of cytological follow-up allows the detection of cancerous cells, cells of the immune system, which indicate those ignition processє at bronze.
3. Microbiological method of follow-up biopsy- The manifestation of microorganisms in the tissue of the changed bronchus, which led to the development of bronchial pathology. This method is relevant in case of suspected tuberculosis process, if in sputum, when conducting various follow-up methods, the cause of tuberculosis is not detected. For this biopsy preparation, an additional histochemical follow-up (preparation by various methods) should be given. For some forms of tuberculosis, histology does not give a typical picture for this disease (miliary, VIL-associated tuberculosis and others), so it is important in this situation to reveal the sick person himself.

How to conduct a bronchial biopsy?

In principle, the preparation and technique of conducting bronchoscopy with biopsy is not considered as a typical endoscopic bronchoscopy. If it is revealed that the doctor is guilty of taking a biopsy material.

Biopsy material can be taken in different ways:

1. Sniffing of suspected tissue with special forceps,
2. Brush biopsy - taking a biopsy material for an additional special shield-scarifier, such a biopsy method is relevant for extended bronchi in a smaller caliber, where forceps cannot pass.

It is also important to take the material correctly, so that the histological follow-up was informative.

For biopsy of the bronchi, additional bronchoscopy can be used to take leg tissue. When this is done, the bronchoscope is brought to the segmental bronchus, then a special catheter is inserted through it, and it is inserted directly into the newborn, where the biopsy material is taken, all under fluoroscopy control.

The moment of taking a biopsy, the patient is not aware, it is painless. After such a procedure, short-term hemoptysis is often suspected.
When taking the great obsyagu material, the surgeon puts sutures to prevent bleeding from the poshkogennoy blood-bearing vessel.

Photo bronchoscopy, how do you look at ailments on the bronchi?

This is how healthy bronchi look on bronchoscopy.

And on this photo, the picture of bronchoscopy with cancer legend(Central cancer).

And such changes are characteristic for bronchial tuberculosis

For additional bronchoscopy, the trachea is examined. The photo shows the results of bronchoscopy for benign swelling of the trachea.

Vision of a third-party body from wild ways.

And this is how the bronchi look in chronic obstructive ailment legenia (COPD) - the most common ailment of the dichal system of malignant curves.

Bronchoscopy is an examination of the mucous organs of the dichal system (nis, throat, voice box, trachea, bronchi) with the help of a special endoscope (bronchofiberscope). If you want to say today it’s more correct to say not a fiber bronchoscope, but a video bronchoscope (“fibro” should be replaced by “video”). Bronchoscopy is considered to be one of the most informative methods for diagnosing newly formed dyspepsia. Zavdyaki їy you can take a piece of fabric from the summative place. Such a biopsy is carried out for cytological and histological analysis.

Bronchoscopy - does it hurt?

Evenings ahead of the day before ailments receive calm zasib, appointments as a doctor. Without intermediary before the manipulation of the drug vikoristovu for the expansion of the pharynx, a special spray, which suppresses the vomit reflex. There are no pain receptors in the mucous membrane of the bronchi, so the hand of the bronchoscope does not indicate sickness in the patient. Doctors proponuyat pіd hour poduvannya apparatus dihati often and on top of the memory - the tube of the apparatus is thin, so it does not affect the breath. When the bronchoscope tube is obstructed, it may break, discomfort may be felt, but taking a biopsy will not cause pain. Depending on the needs of the patient and the indications of the doctor, it is possible to perform bronchoscopy with higher sleep. Sound medical sleep is prescribed for children and people because of emotional lability. But in German clinics, bronchoscopy, as a rule, has long been carried out under anesthesia. Therefore, the procedure for the patient is painless and well tolerated.

Preparing the patient for bronchoscopy

The preparation of the ailing person before bronchoscopy is divided into the main and without the middle.

Algorithm for the general preparation of a patient for bronchoscopy.

1. Psychological preparation of the patient for bronchoscopy.

The patient is obliged to understand the essence of the possible manipulation and to give a year for yoga. For the TSOO LIKARA, the accessible forms about the post -di -diye at the bronchoscope, and Patzinta is the VSI Pitannya, the Khviluyu Yogo, Zokrem, Chi Rabi bronchoscope, Yaki anesthesia, Skirki is not about the hour ? If the patient suffers from allergies, may have concomitant illness, take anticoagulants or insulin, he is guilty of obov'yazkovo rozpovіst about the purpose of the medicine.

2. Required to undergo obstezhennya (X-ray examination, detection of coagulograms, blood tests, ECG)

3. The day before the due date, alcohol is not allowed.

4. There is no special diet before bronchoscopy, but the procedure is more difficult.

5. Ahead of the evening, for the confession of the doctor, it is necessary to take calm preparations.

6. Odyag pіd hour of the procedure is guilty but comfortable and vіlnim.

Algorithm for immediate preparation of the patient for bronchoscopy.

1. Do not smoke before bronchoscopy.
2. For 1-1.5 years on the ear of bronchoscopy, premedication with tranquilizers is carried out.
3. Before proceeding, it is necessary to remove embellishments for piercings, dental prostheses, orthodontic dressings for correcting bite and correction of teeth, contact lenses.
4. Without intermediary before the next patient, the patient is guilty of sich mikhur.

Why bronchoscopy?

Bronchoscopy is carried out in an endoscopic room, in which all the norms of a sterile operating room are met. Follow-ups can be carried out on an outpatient basis.

How is bronchoscopy performed?

1. Ask the patient to sit on the bed, put your hands between your legs and tilt your head slightly.
2. Before going to the hospital, a spray for pain relief of the pharynx (due to the presence of a new allergy) is treated with a spray for such anesthesia, the vomiting reflex during the passage of a bronchoscope is treated.
3. If the patient's throat is expanded, it can be placed on the endoscopic steel-transformer horizontally on the back. Throw your head back slightly. It is not possible to viginate and work sharply. You need to relax and calmly breathe.
4. Then the patient can be administered an intravenously narcotic preparation of a short duration, so that in case of extended wines, nothing is observed, but only rests in the bed of insomnia.
5. Introduce the bronchoscope through the lower nasal passage at the nasopharynx, and then at the trachea. If the nose is ringing, swollen, in the patient part of the nose is bleeding, the bronchoscope tube is inserted through the mouth. A hard bronchoscope is less likely to be inserted through the mouth, but a female bronchoscope is more rarely crusted at the same time.
6. The doctor looks at the mucous membrane of the deep paths, as if it were possible to see it as a "bronchial tree" with needles - splitting. The endoscopist will reach all the bronchi as much as possible. Riven look around to lie down in the field of the bronchoscope and become a bronchial tree. For friendly minds, the doctor can look like a great bronchi, and th їх vіdgaluzhennya. Dihal passages themselves are insensitive to pain, so the biopsy procedure is painless.
7. If necessary, bronchial lavage, the drug should be injected at the lower dychal tract with approximately 20-100 ml of sterile root and then swiped. So we take away bacteria and cells from the surface of the dychal pathways for further investigation at the laboratory. In addition, during the first hour of bronchoscopy in case of viscous sputum, it is possible to clear the bronchi and introduce medicinal products.

How long does a bronchoscopy take?

An hour, for which a bronchoscopy is carried out, to lie down in the name of the procedure - likuvalno chi diagnostic. Bronchoscopy sound three times from 10-15 minutes to 1st year.

What should be done after bronchoscopy?

After the manipulation, the patient is guilty not to eat or drink until the anesthesia of the pharynx has passed step by step. Sound the anesthetic effect for about two years. In another fall, your risk will choke. Navіt slina is required to be splovuvati, not to be shoveled. Before the first dose, drink some trochs of water and perverity, chi discomfort. You can't smoke for two years either. If the patient has taken a calm zasib or a short anesthesia, and bronchoscopy is carried out on an outpatient basis, then this day it is not possible to carry it out by car. Before the completion of the procedure, the patient is obliged to check with the doctor if he can accept the medication.

The results of bronchoscopy are observed quickly. Bajannya coughs up sometimes for the coming day. Hoarseness in voice and pershinnya at the throat can turbulate the patient for many days after bronchoscopy. Then let us pass the unacceptable appearances.