Bendable bronchoscopy examination and treatment technique is a minimally invasive diagnostic and treatment technique in which a bendable bronchoscope (fiberoptic bronchoscope, electronic bronchoscope) is used to enter the trachea and bronchus through the oral cavity, nasal cavity, tracheal tube or tracheotomy cannula to examine and treat lung diseases.
So, under what circumstances is bronchoscopy and treatment necessary?
In general, as long as there are no contraindications to bronchoscopy, electronic bronchoscopy and treatment should be considered when the following conditions occur
1. Unexplained hoarseness, hemoptysis, blood in sputum and frequent cough, especially if the original cough and sputum of the smoking patient have changed in nature.
2, Chest film or CT shows limited emphysema, obstructive pneumonia or pulmonary atelectasis, etc., suggesting bronchial obstruction and limited dry montanus on physical examination
3.Clinical symptoms or chest X-ray or CT examination are suspected to be lung cancer, but lack of pathological basis.
4.Difficult to diagnose or bronchial or pulmonary diseases of unknown cause or diffuse lung diseases that require bronchoscopy, pathology and bacteriological examination through lung biopsy, brush examination, lavage and other examinations.
5.The degree and extent of tracheal and bronchial stenosis will be further clarified through examination in order to provide the basis for subsequent transbronchial treatment (stent placement, balloon dilation, cryo, electrokinetic, etc.).
6.Routine examination before general thoracic surgery to evaluate the extent of the lesion in order to select the appropriate surgical modality and determine the scope of surgical resection, etc.
7.Patients with mediastinal and hilar lymph node enlargement that are difficult to diagnose and lung cancer patients who need to clarify whether the lymph nodes have metastases before surgery can undergo ultrasound bronchoscopy-guided transbronchial needle aspiration biopsy (EBUS-TBNA); patients with peripheral lung nodal lesions that are difficult to diagnose can undergo transbronchial ultrasound-guided sheath-guided transbronchial lung biopsy (EBUS-GS-TBLB) and other advanced Bronchoscopic diagnostic techniques to confirm the diagnosis.
8.Take out foreign bodies that fall into the bronchus, remove pus sputum and bleeding in the airways; perform microscopic drug injection and flushing, drainage and other treatments for infectious lung diseases such as bronchial dilatation and lung abscess; perform bronchoalveolar lavage treatment for pneumoconiosis and alveolar protein deposition.
9.Treatment of respiratory system diseases by advanced transbronchial interventional techniques, such as transbronchial lung decompression for severe non-homogeneous emphysema; transbronchial balloon exploration + blocking for refractory pneumothorax; transbronchial thermoplasty for severe or refractory asthma; transbronchial laser, argon knife, high-frequency electric knife, microwave, stent placement, particle implantation, balloon expansion, freezing, drug injection, etc. Treatment of benign and malignant airway stenosis. Improve quality of life and prolong survival time.
If a bendable bronchoscopy or treatment is indeed required, what should be noted?
1. In order to prevent accidental aspiration due to vomiting during the examination, patients should fast and drink 4 hours before the procedure, and those with movable denture should be removed in advance.
2. Because bronchoscopy is an invasive operation, patients may feel pain and discomfort during the procedure, so some sedative and anesthetic drugs will be used before the procedure.
3. Patients are often placed in a supine position during fiberoptic bronchoscopy, with shoulders slightly padded, head positioned slightly back and nostrils facing upward. In this position, the patient’s muscles are relaxed and more comfortable. During the examination, patients should avoid violent coughing, and when the endoscope enters the vocal cavity, they should inhale deeply under the doctor’s guidance, not to strain and hold their breath.
When done with the bronchoscopy or treatment, what other situations need to be noted?
1.Patients will usually have a small amount of blood in the sputum after the examination, especially patients who undergo biopsy will have more hemoptysis, which will usually stop on its own within a few hours. If the hemoptysis is significantly more than before, medical staff should be notified immediately.
2.Some patients may experience cough, coughing and nasopharyngeal discomfort or pain, hoarseness, fever, chest pain, etc. after the operation, which can generally heal on their own within a short period of time or within a few days.
3.Eating should be allowed 2 hours after the examination, starting with warm and cool semi-liquid, and it is advisable to take small sips of water before eating, without choking and coughing.
4.Avoid smoking, talking and coughing for a few hours after the examination so that the vocal cords can have sufficient rest, which can reduce the discomfort caused by hoarseness and pain in the throat.
5.After the transbronchoscopic biopsy, attention should be paid to the presence of pneumothorax or active bleeding. When there is a change in the condition, it is necessary to promptly inform the doctor or nurse or promptly consult the doctor so that timely treatment can be obtained.