Bendable bronchoscopy (including fiberoptic bronchoscopy and electronic bronchoscopy; hereinafter referred to as bronchoscopy) is an important tool for clinical diagnosis and treatment of respiratory diseases, and has been widely used in clinical practice. The Guidelines for the Application of Diagnostic Bendable Bronchoscopy (2008 Edition) (hereinafter referred to as the Guidelines) are revised and supplemented on the basis of the Guidelines for the Clinical Application of Fiberoptic Bronchoscopy (Bendable Bronchoscopy) (Draft) published by the Chinese Medical Association, Respiratory Diseases Branch in 2000. Based on the addition of bronchoscopic cleaning and disinfection and medical personnel protection, this guideline integrates relevant domestic and international literature and grades the relevant contents according to the principles of evidence-based medicine (Table 1), with the aim of further standardizing the operation of bronchoscopy, improving the detection rate of diseases, and reducing the occurrence of related adverse events and complications. In view of the wide range of bronchoscopic treatment areas and the relatively complex technical requirements, the relevant contents are not covered in this guideline. Wang Xiaoping, Department of Respiratory Medicine, Shandong Provincial Chest Hospital I. Indications and contraindications for bronchoscopy (I) Indications 1. Chronic cough of unknown origin. Bronchoscopy is of great value in the diagnosis of bronchial tuberculosis, foreign body aspiration and benign and malignant airway tumors. 2. Unexplained hemoptysis or blood in sputum. Especially in patients over 40 years old, hemoptysis or blood in sputum lasting for more than 1 week. Bronchoscopy can help to clarify the site of bleeding and the cause of bleeding. 3. Unexplained restricted croup. Bronchoscopy helps to identify the cause, location and nature of airway obstruction. 4. Unexplained hoarseness. It may be caused by vocal cord paralysis due to laryngeal nerve involvement and neoplasia in the airway, etc. 5. Cancer cells or suspected cancer cells are found in sputum. 6. X-ray chest radiograph and/or CT examination suggest abnormal changes such as pulmonary atelectasis, nodules or masses in the lungs, obstructive pneumonia, non-resolution of inflammation, diffuse lung lesions, enlarged hilar and/or mediastinal lymph nodes, tracheobronchial stenosis, and pleural effusion of unknown origin. 7.Pre-surgical examination of the lung is useful for guiding the site and extent of surgical resection and estimating prognosis. 8.Bronchoscopy can often provide a definitive diagnosis in cases of chest trauma, suspected tracheobronchial laceration or rupture. 9.Etiological diagnosis of infectious lung or bronchial diseases (including bronchopulmonary infections in immunosuppressed patients), such as obtaining specimens for culture by tracheal suction, protective specimen brushing or bronchoalveolar lavage (BAL). 10. airway management during mechanical ventilation. 11. confirmation of the diagnosis of suspected tracheal and bronchial fistulae. (B) Contraindications Bronchoscopy has accumulated a wealth of experience so far, and the scope of contraindications has been narrowing, or is only a relative contraindication. However, the risk of complications from bronchoscopy is significantly higher than that of the general population in the following cases, and the pros and cons should be carefully weighed before deciding whether to perform the examination. 1. Active hemoptysis. If bronchoscopy is necessary, it should be performed after the establishment of an artificial airway to reduce the risk of asphyxia. 2. Severe hypertension and cardiac arrhythmias. 3. Recent myocardial infarction or history of unstable angina attack. 4. Severe cardiac and pulmonary dysfunction. 5. Uncorrectable bleeding tendencies, such as severe coagulation disorders, uremia and severe pulmonary hypertension. 6. Severe superior vena cava obstruction syndrome, as fiberoptic bronchoscopy may lead to laryngeal edema and severe bleeding. 7. suspected aortic aneurysm. 8. Multiple pulmonary blisters. 9. Extremely debilitated systemic condition.