支气管镜检查

定义

支气管镜检查 is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.

选择的名字

Fiberoptic bronchoscopy; 肺癌 - bronchoscopy; Pneumonia - bronchoscopy; Chronic lung disease - bronchoscopy

如何执行测试

A bronchoscope is a device used to see the inside of the airways and lungs. 范围可以是柔性的，也可以是刚性的. 几乎总是使用灵活的作用域. It is a tube less than one half inch (1 centimeter) wide and about 2 feet (60 centimeters) long. 在极少数情况下，使用刚性支气管镜.

• 你可能会得到 静脉用药 (静脉注射)来帮助你放松. 或者，你可能睡着了 全身麻醉特别是在使用刚性作用域的情况下.
• A numbing drug (anesthetic) will be sprayed in your mouth and throat. 如果通过鼻子进行支气管镜检查, numbing jelly will be placed in the nostril the tube goes through.
• 将瞄准镜轻轻插入. 一开始可能会让你咳嗽. The coughing will stop as the numbing drug begins to work.
• Your health care provider may send saline solution through the tube. This washes the lungs and allows your provider to collect samples of lung cells, 液体, 气囊内的微生物和其他物质. 这部分过程被称为洗胃.
• 有时, 小刷子, 针, or forceps may be passed through the bronchoscope to take very small tissue samples (biopsies) from your lungs.
• 您的提供者也可以放置一个 支架 在你的气道里或者用 超声波 在手术过程中. 支架是一种小的管状医疗设备. Ultrasound is a painless imaging method that allows your provider to see inside your body.
• 有时 超声波 is used to see the lymph nodes and tissues around your airways, and small 针 can be inserted there to obtain tissue and make certain diagnoses.
• 在手术结束时，取出瞄准镜.

如何准备考试

Follow instructions on how to prepare for the test. 你可能会被告知:

• Not to eat or drink anything for 6 to 12 hours before your test.
• Not to take aspirin, ibuprofen, or other blood-thinning drugs before your procedure. Ask the provider who will do your bronchoscopy if and when to stop taking these drugs.
• 安排接送你往返十大赌博平台排行榜.
• Arrange for help with work, child care, or other tasks, as you will likely need to rest the next day. 

The test is most often done as an outpatient procedure, and you will go home the same day. Rarely, some people may need to stay overnight in the hospital.

考试的感觉如何

Local anesthetic is used to relax and numb your throat muscles. Until this medicine begins to work, you may feel fluid running down the back of your throat. 这可能会导致你咳嗽或呕吐.

一旦药物生效, you may feel pressure or mild tugging as the tube moves through your windpipe. Although you may feel like you are not able to breathe when the tube is in your throat, 没有发生这种情况的风险. The medicines you receive to relax will help with these symptoms. 你可能会忘记大部分的步骤.

When the anesthetic wears off, your throat may be scratchy for several days. After the test, your ability to cough (cough reflex) will return in 1 to 2 hours. You will not be allowed to eat or drink until your cough reflex returns.

为什么要进行测试

You may have a bronchoscopy to help your provider diagnose lung problems. Your provider will be able to inspect your airways or take a 活检样本.

Common reasons to do a bronchoscopy for diagnosis are:

• An imaging test showed abnormal changes of your lung, 如生长或肿瘤, 肺组织的变化或疤痕, 或者你肺的某个部位塌陷.
• 对你肺附近的淋巴结进行活检.
• 看看你为什么咳血.
• To explain shortness of breath or low oxygen levels.
• 看看你的呼吸道里是否有异物.
• You have a cough that has lasted more than 3 months without any clear cause.
• You have an infection in your lungs and major airways (bronchi) that cannot be diagnosed any other way or need a certain type of diagnosis.
• 你吸入了有毒气体或化学物质.
• To see if a lung rejection after a lung transplant is occurring.

You may also have a bronchoscopy to treat a lung or airway problem. 例如，可以这样做:

• 清除呼吸道中的液体或粘液塞
• 清除呼吸道中的异物
• Widen (dilate) an airway that is blocked or narrowed
• 流失的 脓肿
• Treat cancer using a number of different techniques
• 冲洗呼吸道

正常的结果

Normal results mean normal cells and 液体 are found. 未见异物或堵塞.

异常结果意味着什么

Many 障碍 can be diagnosed with bronchoscopy, including:

• 感染s from bacteria, viruses, fungi, parasites, or tuberculosis.
• 与过敏型反应有关的肺损伤.
• 肺 障碍 in which the deep lung tissues become inflamed due to the immune system response, and then damaged. For example, changes from sarcoidosis or rheumatoid arthritis may be found.
• 肺癌或者是两肺之间的癌症.
• 气管或支气管的狭窄.
• Acute rejection or infection after a lung transplant.

风险

支气管镜检查的主要风险有:

• Bleeding from biopsy sites (most dangerous complication in very rare occasions)
• 感染

还有一个小风险是:

• 心律失常
• 呼吸困难
• 发热
• Heart attack, in people with existing heart disease
• 低血氧
• 肺功能衰竭,
• 喉咙痛

使用全身麻醉的风险包括:

• 肌肉疼痛
• 血压变化
• 心率变慢
• 恶心和呕吐

参考文献

克里斯蒂纳. 手术耳鼻喉科:支气管镜检查. 见:Myers EN, Snyderman CH，编. 外科耳鼻咽喉头颈外科. 3日艾德. Philadelphia, PA: Elsevier; 2018:chap 18.

Kupeli E, Mehta AC. 诊断支气管镜检查. 见:broadus VC, Ernst JD, King TE等编. Murray and Nadel's Textbook of Respiratory Medicine. 6日艾德. Philadelphia, PA: Elsevier; 2022:chap 26.

Weinberger SE, Cockrill BA, Mandel J. 肺部疾病患者的评价. In: Weinberger SE, Cockrill BA, Mandel J, eds. 肺医学原理. 7日艾德. Philadelphia, PA: Elsevier; 2019:chap 3.