Bronchoscopy

Bronchoscopy ndiyeso yoyang'ana njira zowuluka komanso kuzindikira matenda am'mapapo. Itha kugwiritsidwanso ntchito pochiza matenda ena am'mapapo.

Bronchoscope ndi chida chomwe chimagwiritsidwa ntchito kuwona mkatikati mwa njira zam'mlengalenga ndi m'mapapu. Kukula kwake kumatha kukhala kosasintha kapena kolimba. Kukula kosinthika kumagwiritsidwa ntchito nthawi zonse. Ndi chubu chosakwana theka la inchi (1 sentimita) mulifupi komanso kutalika kwake ngati 60 sentimita. Nthawi zambiri, bronchoscope yolimba imagwiritsidwa ntchito.

• Mutha kupeza mankhwala kudzera mumtsempha (IV, kapena kudzera m'mitsempha) kukuthandizani kupumula. Kapena, mwina mukugona pansi pa anesthesia, makamaka ngati mukugwiritsa ntchito zovuta.
• Mankhwala osokoneza bongo (opha ululu) adzakupopera m'kamwa ndi mmero. Ngati bronchoscopy yachitika kudzera m'mphuno mwako, dzira losungunula lidzaikidwa pamphuno chubu chimadutsamo.
• Kukula kwake kumalowetsedwa mokoma. Zitha kukupangitsani kutsokomola poyamba. Kutsokomola kudzaleka pamene mankhwala osokoneza bongo ayamba kugwira ntchito.
• Wothandizira zaumoyo wanu amatha kutumiza yankho la saline kudzera mu chubu. Izi zimatsuka mapapu ndikulola omwe amakupatsani kuti asonkhanitse zitsanzo zam'mapapu, madzi, tizilombo tating'onoting'ono ndi zinthu zina mkati mwamatumba ampweya. Gawo ili la njirayi limatchedwa kutsuka.
• Nthawi zina, maburashi ang'onoang'ono, singano, kapena forceps amatha kudutsa mu bronchoscope kuti atenge timatumba tating'onoting'ono m'mapapu anu.
• Wothandizira anu amathanso kuyika stent panjira yanu kapena kuwona mapapu anu ndi ultrasound panthawiyi. Stent ndi kachipangizo kakang'ono ngati mankhwala. Ultrasound ndi njira yopanda zowawa yomwe imalola wothandizira wanu kuwona mkati mwa thupi lanu.
• Nthawi zina ma ultrasound amagwiritsidwa ntchito kuwona ma lymph node ndi zopindika kuzungulira mpweya wanu.
• Pamapeto pa ndondomekoyi, kukula kwake kumachotsedwa.

Tsatirani malangizo amomwe mungakonzekerere mayeso. Muyenera kuti mudzauzidwa:

• Osadya kapena kumwa chilichonse kwa maola 6 kapena 12 musanayezedwe.
• Osamwa ma aspirin, ibuprofen, kapena mankhwala ena ochepetsa magazi musanachitike. Funsani omwe akukuthandizani omwe angakupangireni bronchoscopy ngati angaleke kumwa mankhwalawa ndi nthawi yanji.
• Konzani zoti mukwere ndi kuchipatala.
• Konzani chithandizo chantchito, kusamalira ana, kapena ntchito zina, chifukwa mungafunikire kupumula tsiku lotsatira.

Kuyesaku kumachitika nthawi zambiri ngati kuchipatala, ndipo mupita kunyumba tsiku lomwelo. Nthawi zambiri, anthu ena angafunike kugona mchipatala.

Mankhwala oletsa ululu am'deralo amagwiritsidwa ntchito kupumula ndikumafewetsa minofu yanu yapakhosi. Mpaka pomwe mankhwalawa ayambe kugwira ntchito, mutha kumva kuti madzi akuyenda kumbuyo kwanu. Izi zingakupangitseni kutsokomola kapena kutsamwa.

Mankhwalawa atayamba kugwira ntchito, mutha kumva kukakamizidwa kapena kukoka pang'ono pomwe chubu chimadutsa pamphepo yanu. Ngakhale mutha kumva kuti simungathe kupuma pomwe chubu ili pakhosi panu, palibe chiopsezo cha izi. Mankhwala omwe mumalandira kuti musangalale amathandizira ndi izi. Mwinamwake mudzaiwala zambiri za njirayi.

Mankhwala oletsa kupweteka akatha, pakhosi panu pamakhala papaka masiku angapo. Pambuyo pa mayeso, kuthekera kwanu kutsokomola (chifuwa reflex) kumabwereranso mu 1 mpaka 2 maola. Simudzaloledwa kudya kapena kumwa mpaka chifuwa chanu chibwerere.

Mutha kukhala ndi bronchoscopy yothandizira omwe amakuthandizani kuzindikira mavuto am'mapapo. Yemwe amakupatsani mwayi azitha kuyendera mayendedwe anu kapena kutenga zitsanzo za biopsy.

Zifukwa zambiri zopangira bronchoscopy kuti mupeze matenda ndi awa:

• Kuyesa kujambula kunawonetsa kusintha kwamapapu anu, monga kukula kapena chotupa, kusintha kapena mabala am'mapapo, kapena kugwa kwa gawo limodzi lamapapu anu.
• Ku biopsy lymph node pafupi ndi mapapu anu.
• Kuti muwone chifukwa chake mukutsokomola magazi.
• Kufotokozera kupuma pang'ono kapena kuchuluka kwa oxygen.
• Kuti muwone ngati pali chinthu chachilendo panjira yanu.
• Muli ndi chifuwa chomwe chatenga miyezi yopitilira 3 popanda chifukwa chomveka.
• Muli ndi matenda m'mapapu anu komanso mawayilesi akuluakulu (bronchi) omwe sangapezeke mwanjira ina iliyonse kapena amafunikira mtundu wina wamatenda.
• Munapumira mpweya woipa kapena mankhwala.
• Kuti muwone ngati kukanidwa kwamapapu pambuyo poumba mapapu kukuchitika.

Muthanso kukhala ndi bronchoscopy yochiza vuto lamapapu kapena mayendedwe apandege. Mwachitsanzo, zitha kuchitidwa kuti:

• Chotsani mapulagi amadzimadzi kapena ntchofu m'mayendedwe anu
• Chotsani chinthu chachilendo panjira zanu
• Lonjezani (yambitsani) njira yapaulendo yomwe imatsekedwa kapena kuchepetsedwa
• Sungani chotupa
• Chitani khansa pogwiritsa ntchito njira zingapo zosiyanasiyana
• Sambani njira yapaulendo

Zotsatira zabwinobwino zimatanthauza kuti maselo abwinobwino ndi madzi amadzuwa amapezeka. Palibe zinthu zakunja kapena zotchinga zomwe zimawoneka.

Matenda ambiri amatha kupezeka ndi bronchoscopy, kuphatikizapo:

• Matenda ochokera ku mabakiteriya, mavairasi, bowa, tiziromboti, kapena chifuwa chachikulu.
• Kuwonongeka kwa mapapo komwe kumakhudzana ndi zovuta zina.
• Matenda am'mapapo momwe m'mapapo mwake mumatupa chifukwa cha chitetezo chamthupi, kenako nkuwonongeka. Mwachitsanzo, kusintha kwa sarcoidosis kapena nyamakazi kungapezeke.
• Khansa ya m'mapapo, kapena khansa mdera lamapapo.
• Kupondereza (stenosis) ya trachea kapena bronchi.
• Kukanidwa kwakukulu pambuyo poumba mapapu.

Zowopsa zazikulu za bronchoscopy ndi:

• Kutuluka magazi kuchokera kumalo osanthula
• Matenda

Palinso chiopsezo chochepa cha:

• Nyimbo zosadziwika bwino zamtima
• Mavuto opumira
• Malungo
• Matenda a mtima, mwa anthu omwe ali ndi matenda amtima omwe alipo
• Mpweya wotsika magazi
• Mapapu atagwa
• Chikhure

Zowopsa pakagwiritsidwe ka anesthesia ndi monga:

• Kupweteka kwa minofu
• Sinthani kuthamanga kwa magazi
• Kugunda kwa mtima pang'ono
• Nseru ndi kusanza

Fiberoptic bronchoscopy; Khansa ya m'mapapo - bronchoscopy; Chibayo - bronchoscopy; Matenda a m'mapapo - bronchoscopy

• Bronchoscopy
• Bronchoscopy

Christie NA. Ogwira ntchito otolaryngology: bronchoscopy. Mu: Myers EN, Snyderman CH, olemba. Opaleshoni ya Otolaryngology Mutu ndi Khosi Opaleshoni. Wachitatu ed. Philadelphia, PA: Elsevier; 2018: mutu 18.

Kupeli E, Feller-Kopman D, Mehta AC. Kuzindikira bronchoscopy. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 22.

Weinberger SE, Cockrill BA, Mandel J. Kuunika kwa wodwala yemwe ali ndi matenda am'mapapo. Mu: Weinberger SE, Cockrill BA, Mandel J, olemba. Mfundo za Pulmonary Medicine. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: chaputala 3.