Introduction to bronchoalveolar lavage (BAL).
Bronchoalveolar lavage (BAL) is performed at the level of the lung segments or sub-pulmonary segments below the bronchus through fiberoptic bronchoscopy, repeatedly lavaged with sterile saline, recovered, and subjected to a series of tests and analyses to obtain the characteristics of the nature and activity of the lower respiratory tract lesions and help establish the diagnosis.
Normal values for bronchoalveolar lavage (BAL): Normal.
Bronchoalveolar lavage (BAL) Clinical significance.
Indications.
1, Pathogenetic diagnosis of lung infections, especially immune compromised, immunodeficient lung infections;
2, cytologic diagnosis of diffuse and peripheral lung tumors;
3, diagnosis, treatment, efficacy and prognosis estimation of interstitial lung diseases, such as nodular disease, idiopathic interstitial fibrosis, exogenous allergic alveolitis, alveolar protein deposition, collagen vascularity with pulmonary fibrosis, etc.
4, silicosis, etc.
Contraindications
Contraindications to performing BAL examinations are.
①Severe impairment of pulmonary function;
②Patients with recent acute myocardial infarction;
③Recently coughing up blood;
(iv) patients with untreated active tuberculosis, etc.
The technique of repeated lavage and recovery with sterile saline at the level of lung segments or sub-pulmonary segments below the bronchus by fiberoptic bronchoscopy, and the recovered fluid is subjected to a series of tests and analysis such as cytology, biochemistry, enzymology and immunology.
1. Whole lung lavage.
Used for the treatment of alveolar protein deposition, silicosis, alveolar microlithiasis, persistent asthma, etc.
2.Lung segmental lavage.
It is mainly used for the diagnosis of diffuse interstitial pulmonary fibrosis, asbestosis and Pneumocystis carinii pneumonia, and is also valuable for the diagnosis of diffuse alveolar carcinoma.
BAL is more and more widely used, although its operation is complicated, with some physiological changes and mild complications, but as long as the evidence of adaptation is selected and the operation is correct, it is still a safe and effective examination method.