ʻO Bronchoscopy

ʻO Bronchoscopy kahi hoʻāʻo e nānā i nā alaloa a ʻike i nā maʻi maʻi. Hiki ke hoʻohana ʻia ia i ka wā o ka mālama ʻana i kekahi mau kūlana māmā.

ʻO ka bronchoscope kahi mea i hoʻohana ʻia e ʻike i ka loko o nā alaloa a me nā akemāmā. Hiki ke maʻalahi a paʻakikī paha ke ākea. ʻAneʻane hoʻohana ʻia kahi pae maʻalahi. ʻO ia kahi pahu i emi iho ma mua o hoʻokahi hapalua iniha (1 kenimika) ākea a ma kahi o 2 kapuaʻi (60 kenimika) ka lōʻihi. I nā hihia kakaikahi, hoʻohana ʻia kahi bronchoscope ʻoʻoleʻa.

• E loaʻa paha iā ʻoe nā lāʻau i loko o ke aa (IV, a i ʻole intravenously) e kōkua ai iā ʻoe e hoʻomaha. A i ʻole, hiamoe paha ʻoe ma lalo o ka anesthesia ākea, keu hoʻi inā hoʻohana ʻia kahi pae ʻoʻoleʻa.
• E kāpīpī ʻia kahi lāʻau numbing (anesthetic) i kou waha a me kou puʻu. Inā hana ʻia ka bronchoscopy ma kou ihu, e hoʻokomo ʻia ka jelly numbing i loko o ka puka ihu e hele ai ka paipu.
• Hoʻokomo mālie ʻia ka pae. E hōʻeha paha ʻoe iā ʻoe i ka mua. E kū ka uha i ka hoʻomaka ʻana o ka lāʻau numbing e holo.
• Hiki i kāu mea mālama ola ke hoʻouna i ka hopena saline ma o ka paipu. Holoi kēia i nā akemāmā a ʻae i kāu mea e hōʻiliʻili e ʻohiʻohi i nā laʻana o nā huna puʻupuʻu, nā wai, nā microbes a me nā mea ʻē aʻe i loko o nā ʻeke ea. Kapa ʻia kēia ʻāpana o ke kaʻina he lavage.
• I kekahi manawa, hala ʻia nā palaki liʻiliʻi, nā nila, a i ʻole nā ​​forceps ma o ka bronchoscope e lawe i nā mea liʻiliʻi liʻiliʻi (biopsies) mai kou mau māmā.
• Hiki i kāu mea hāʻawi ke kau i kahi stent i kāu ala ʻāpana a i ʻole nānā i kāu mau māmā me ka ultrasound i ke kaʻina hana. ʻO kahi stent kahi kīkī liʻiliʻi e like me ka lāʻau lapaʻau. ʻO Ultrasound kahi ʻano kiʻi ʻehaʻeha ʻole e hiki ai i kāu mea hāʻawi ke ʻike i loko o kou kino.
• I kekahi manawa hoʻohana ʻia ka ultrasound e ʻike i nā lymph node a me nā ʻaʻa a puni kou mau kahawai.
• I ka hopena o ke kaʻina hana, hemo ka laulā.

E hāhai i nā ʻōkuhi pehea e hoʻomākaukau ai no ka hōʻike. E haʻi ʻia paha iā ʻoe:

• ʻAʻole e ʻai a inu paha i kekahi mea no 6 a 12 mau hola ma mua o kāu hoʻāʻo.
• ʻAʻole e lawe i ka aspirin, ibuprofen, a i ʻole nā ​​lāʻau ʻokiʻoki koko aʻe ma mua o kāu kaʻina hana. E noi i ka mea nāna e hāʻawi i kāu bronchoscopy inā a i ka manawa hea e haʻalele ai i ka lawe ʻana i kēia mau lāʻau.
• Hoʻonohonoho no kahi holo i a mai ka haukapila.
• E hoʻonohonoho no ke kōkua me ka hana, mālama keiki, a i ʻole nā ​​hana ʻē aʻe, no ka mea, pono ʻoe e hoʻomaha i ka lā aʻe.

Hana pinepine ʻia ka hoʻāʻo ma ke ʻano he hana ma waho, a e hoʻi ʻoe i ka hale i ka lā like. Kākaʻikahi, pono paha kekahi poʻe e noho pō i ka haukapila.

Hoʻohana ʻia ka anesthetic kūloko e hoʻomaha ai a hōʻino ai i kou ʻāʻī puʻupuʻu. A hiki i ka hoʻomaka ʻana o ka hana ʻana o kēia lāʻau, manaʻo paha ʻoe e holo ana ka wai i hope o kou puʻu. ʻO kēia paha ka mea e ʻū ai a i ʻole pūpū ai ʻoe.

Ke holo pono ka lāʻau, ʻike paha ʻoe i ke kaomi a i ʻole ka ʻūlū mālie ʻana i ka neʻe ʻana o ka pahu i loko o kāu puka makani. ʻOiai manaʻo paha ʻoe ʻaʻole hiki iā ʻoe ke hanu i ka wā o ka paipu i loko o kou puʻu, ʻaʻohe pilikia o kēia hana. ʻO nā lāʻau i loaʻa iā ʻoe e hoʻomaha e kōkua i kēia mau ʻōuli. Poina paha ʻoe i ka hapa nui o nā kaʻina hana.

Ke pau ka anesthetic, ʻeha paha kou puʻu i mau lā. Ma hope o ka hoʻāʻo, e hoʻi ana kou hiki i ka uha (reflex batū) i 1 a 2 mau hola. ʻAʻole ʻoe e ʻae ʻia e ʻai a inu a hoʻi mai kāu reflex bat.

Loaʻa paha iā ʻoe kahi bronchoscopy e kōkua i kāu mea nāna e kuhikuhi i nā pilikia o ka maʻi. Hiki i kāu mea hāʻawi ke nānā i kāu mau kahawai a lawe paha i kahi laʻana biopsy.

ʻO nā kumu maʻamau e hana i kahi bronchoscopy no ka hōʻoia ʻana:

• Ua hōʻike ʻia kahi hoʻokolohua kiʻi i nā loli maʻamau o kou ake, e like me ka ulu ʻana a i ʻole ka tumo, nā hoʻololi ʻana a i ʻole nā ​​ʻili ʻana o kaʻiʻo māmā, a i ʻole ka hāʻule ʻana o kahi ʻāpana o kou māmā.
• I ka biopsy lymph nodes kokoke i kou mau ake māmā.
• E ʻike ai i ke kumu o kou hāmau ʻana i ke koko.
• E wehewehe i ka pōkole o ka hanu a i ʻole nā ​​pae oxygen haʻahaʻa.
• E ʻike ai inā aia kekahi mea haole i kāu alaloa.
• Loaʻa iā ʻoe kahi maʻi kahe i ʻoi aku ma mua o 3 mau mahina me ke kumu ʻole.
• Loaʻa iā ʻoe kahi maʻi i loko o kou mau māmā a me nā alaloa nui (bronchi) ʻaʻole hiki ke ʻike ʻia i kekahi ala ʻē aʻe a i ʻole pono i kekahi ʻano o ka hōʻailona.
• Hoʻomoe ʻoe i kahi kinoea ʻona a i ʻole kemika.
• E ʻike ai inā hōʻole ʻia kahi māmā ma hope o kahi transplant lung e hana ʻia.

Loaʻa paha iā ʻoe kahi bronchoscopy e mālama ai i kahi pilikia o ke akemāmā a i ʻole ke ala ea. ʻO kahi laʻana, hiki ke hana ʻia i:

• Wehe i nā wai a i ʻole nā ​​mucus mai kāu alaloa
• Wehe i kahi mea haole mai kāu mau kahawai
• ʻO Widen (dilate) kahi ala kaʻa i ālai ʻia a i ololi paha
• E hoʻopau i kahi abscess
• E mālama i ka maʻi ʻaʻai me ka hoʻohana ʻana i nā ʻano hana like ʻole
• E holoi i kahi alaloa

ʻO nā hopena maʻamau ke ʻike ʻia nā hunaola maʻamau a me nā wai. ʻAʻole ʻike ʻia nā mea haole a i ʻole nā ​​palaka.

Hiki ke ʻike ʻia nā maʻi he nui me ka bronchoscopy, me:

• Nā maʻi mai nā koʻohune, nā mea hoʻomaʻi, fungi, parasites, a i ʻole tuberculosis.
• ʻO ka hōʻino ʻia o ka lepa e pili ana i nā hopena maʻi ʻaʻano maʻi.
• Nā maʻi o ka puʻuwai kahi e wela ai nā mākala hohonu ma muli o ka pane o ka ʻōnaehana immune, a laila ʻino. ʻO kahi laʻana, ʻike ʻia nā hoʻololi ʻana mai sarcoidosis a i ʻole rheumatoid arthritis.
• Ka maʻi ʻaʻai pūpū, a i ʻole ka maʻi ʻaʻai ma ka wahi ma waena o nā māmā.
• Pahu (stenosis) o ka trachea a i ʻole ka bronchi.
• Hoʻowahāwahā koʻikoʻi ma hope o ka hoʻoliʻi ʻana o ka hanu.

ʻO nā pilikia nui o ka bronchoscopy:

• Kahe mai nā pūnaewele biopsy
• Maʻi kīnā

Aia kekahi pilikia iki no:

• Nā ritme naʻau maʻamau
• Nā pilikia hanu
• Fiva
• Ka hōʻeha puʻuwai, i ka poʻe me ka maʻi puʻuwai e kū nei
• Ka oxygen liʻiliʻi o ke koko
• Pulupā naha
• Eha ka 'ā'ī

Nā pilikia inā hoʻohana ʻia ka anesthesia laulā:

• ʻEha ʻeha
• Hoʻololi i ke kahe o ke koko
• Lōʻihi ka helu o ka naʻau
• ʻO Nusea a me ka luaʻi

Fiberoptic bronchoscopy; Kanesa maʻi ʻaʻai - bronchoscopy; Poniaikona - bronchoscopy; Maʻi maʻi maʻi maʻi - bronchoscopy

• ʻO Bronchoscopy
• ʻO Bronchoscopy

Christie NA. ʻO ka otolaryngology hana: bronchoscopy. I: Myers EN, Snyderman CH, eds. ʻO ke keʻoki Otolaryngology Operative a me ka ʻoki ʻāʻī. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2018: chap 18.

Kupeli E, Feller-Kopman D, Mehta AC. ʻO Bronchoscopy diagnostic. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 22.

Weinberger SE, Cockrill BA, Mandel J. Loiloi ʻia o ka mea maʻi me ka maʻi pulmonary. I: Weinberger SE, ʻo Cockrill BA, Mandel J, eds. Nā Kumu o ka lāʻau lapaʻau pulmonary. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 3.