Bronchoscopy

Definition

支气管镜检查是一种检查气道和诊断肺部疾病的检查. 它也可用于治疗某些肺部疾病.

Alternative Names

Fiberoptic bronchoscopy; Lung cancer - bronchoscopy; Pneumonia - bronchoscopy; Chronic lung disease - bronchoscopy

How the Test is Performed

支气管镜是一种用来观察气道和肺部内部的设备. The scope can be flexible or rigid. A flexible scope is almost always used. 它是一个不到半英寸(1厘米)宽，大约2英尺(60厘米)长的管子. In rare cases, a rigid bronchoscope is used.

• You will likely get medicines through a vein (IV, or intravenously) to help you relax. Or, you may be asleep under general anesthesia, especially if a rigid scope is used.
• 一种麻药(麻醉剂)会喷在你的口腔和喉咙里. If bronchoscopy is done through your nose, 麻醉果冻将被放置在管子经过的鼻孔里.
• The scope is gently inserted. It will likely make you cough at first. 当麻醉药开始起作用时，咳嗽就会停止.
• 你的医疗保健提供者可能会通过管子输送生理盐水. 这样可以清洗肺部，让十大赌博平台排行榜收集肺细胞样本, fluids, microbes and other materials inside the air sacs. This part of the procedure is called a lavage.
• Sometimes, tiny brushes, needles, 或者钳可以通过支气管镜从肺部取出非常小的组织样本(活检).
• Your provider can also place a stent in your airway or view your lungs with ultrasound during the procedure. A stent is a small tube-like medical device. 超声波是一种无痛的成像方法，可以让十大赌博平台排行榜看到你的身体内部.
• 有时用超声波来检查呼吸道周围的淋巴结和组织, 小针头可以插入那里获取组织并做出某些诊断.
• At the end of the procedure, the scope is removed.

How to Prepare for the Test

Follow instructions on how to prepare for the test. You will likely be told:

• 在考试前6到12小时内不要吃或喝任何东西.
• 手术前不要服用阿司匹林、布洛芬或其他血液稀释药物. 询问十大赌博平台排行榜谁将为你做支气管镜检查，以及何时停止服用这些药物.
• Arrange for a ride to and from the hospital.
• 安排别人帮忙工作、照顾孩子或其他任务，因为第二天你可能需要休息. 

该测试通常作为门诊程序进行，您将在当天回家. 很少，有些人可能需要在十大赌博平台排行榜过夜.

How the Test will Feel

局部麻醉是用来放松和麻痹你的喉部肌肉. 在这种药开始起作用之前，你可能会感到有液体从喉咙后面流下来. This may cause you to cough or gag.

Once the medicine takes effect, 当管子穿过你的气管时，你可能会感到压力或轻微的牵拉. 虽然你可能会觉得你不能呼吸时，管在你的喉咙, there is no risk of this happening. 你服用的放松药物将有助于缓解这些症状. You will likely forget most of the procedure.

麻醉剂消失后，你的喉咙可能会痒几天. 测试后，您的咳嗽能力(咳嗽反射)将在1至2小时内恢复. 在你的咳嗽反射恢复之前，你不能吃东西或喝水.

Why the Test is Performed

你可以做支气管镜检查来帮助十大赌博平台排行榜诊断肺部问题. 你的十大赌博平台排行榜会检查你的呼吸道或做个检查 biopsy sample.

进行支气管镜检查诊断的常见原因有:

• 影像学检查显示你的肺部有异常变化, such as a growth or tumor, changes or scarring of lung tissue, or collapse of one area of your lung.
• To biopsy lymph nodes near your lungs.
• To see why you are coughing up blood.
• 来解释呼吸短促或低氧水平.
• 看看你的呼吸道里是否有异物.
• 你的咳嗽持续了3个多月，没有任何明确的原因.
• 你的肺部和主要气道(支气管)感染，不能用其他方法诊断或需要某种类型的诊断.
• You inhaled a toxic gas or chemical.
• 看看肺移植后是否发生了排斥反应.

你也可以做支气管镜检查来治疗肺部或呼吸道问题. For example, it may be done to:

• Remove fluid or mucus plugs from your airways
• Remove a foreign object from your airways
• 拓宽(扩张)阻塞或变窄的气道
• Drain an abscess
• 治疗癌症有很多不同的方法
• Wash out an airway

Normal Results

正常结果是指发现正常的细胞和液体. No foreign substances or blockages are seen.

What Abnormal Results Mean

支气管镜检查可诊断许多疾病，包括:

• 由细菌、病毒、真菌、寄生虫或肺结核引起的感染.
• Lung damage related to allergic-type reactions.
• Lung disorders 在这种情况下，由于免疫系统的反应，肺深部组织会发炎，然后受损. 例如，可能会发现结节病或类风湿性关节炎的变化.
• Lung cancer, or cancer in the area between the lungs.
• Narrowing (stenosis) of the trachea or bronchi.
• 肺移植后的急性排斥反应或感染.

Risks

Main risks of bronchoscopy are:

• 活检部位出血(极少数情况下最危险的并发症)
• Infection

There is also a small risk for:

• Abnormal heart rhythms
• Breathing difficulties
• Fever
• 心脏病发作，在已有心脏病的人
• Low blood oxygen
• Collapsed lung
• Sore throat

Risks when general anesthesia is used include:

• Muscle pain
• Change in blood pressure
• Slower heart rate
• Nausea and vomiting

References

Christie NA. Operative otolaryngology: bronchoscopy. In: Myers EN, Snyderman CH, eds. Operative Otolaryngology Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 18.

Kupeli E, Mehta AC. Diagnostic bronchoscopy. In: Broaddus VC, Ernst JD, King TE, et al, eds. 默里和纳德尔的呼吸医学教科书. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 26.

Weinberger SE, Cockrill BA, Mandel J. Evaluation of the patient with pulmonary disease. In: Weinberger SE, Cockrill BA, Mandel J, eds. Principles of Pulmonary Medicine. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 3.