Fiberoptic bronchoscopy is a new technology gradually applied to clinical diagnosis and treatment of pediatric respiratory diseases in recent years, which has the characteristics of soft and small mirror body. The smallest fiberoptic bronchoscope has an outer diameter of 2,2 mm and no working channel, so it can only be used for diagnosis. The bronchoscope is equipped with a biopsy sampling mechanism, which can help detect early lesions and carry out in vivo surgical procedures such as polyp removal, and is a good precision instrument for bronchial and lung disease research and postoperative examination. In addition to the great progress in the diagnosis of respiratory diseases, it is also widely used in the treatment.
I. Application of fiberoptic bronchoscopy in the investigation of respiratory tract pathogenesis
Trans-fiber bronchoscopy sampling technique: trans-fiber bronchoscopy sampling is less traumatic and can selectively and accurately take material under direct vision, which has unique superiority.
Application of fiberoptic bronchoscopy in the treatment of infectious diseases of respiratory tract
1.Clear respiratory secretions
(1) chronic respiratory failure patients with uncontrolled respiratory and pulmonary infections: use fiberoptic bronchoscopy to aspirate airway secretions under direct vision.
(2) Patients with respiratory failure caused by various reasons, after artificial ventilation by tracheal intubation: regular aspiration with fibronectomy, strengthening airway humidification management, etc.
2.Treatment of bronchoalveolar lavage (BAL)
1）BAL treatment of pulmonary infectious disorders
2）BAL treatment of pulmonary tuberculosis
3）BAL for treatment of pulmonary atelectasis
3）Treatment of endotracheobronchial tuberculosis
In addition to systemic chemotherapy, local injection (isoniazid), micro-electrodectomy, and “stent placement” are used to treat the disease (depending on the case).
4. Application of balloon dilation in inflammatory airway stenosis
Contraindications of fiberoptic bronchoscopy
1.Active hemoptysis
2.Severe cardiac and pulmonary dysfunction
3.Severe cardiac arrhythmia
4.Extreme systemic failure
5.Incorrectable hemoptysis tendency
6.Severe superior vena cava obstruction syndrome, as fibrinoscopy may lead to laryngeal edema and severe hemoptysis.
7.Newly discovered myocardial infarction, or unstable angina pectoris
8.Suspected aortic aneurysm
9, partial stenosis of the trachea, estimated that the fibrinoscope is not easy to pass, and can lead to severe obstruction of ventilation.
10, Uremia, severe bleeding may occur during biopsy
11, Severe pulmonary hypertension, severe bleeding may occur during biopsy.