Bronchoscopy

I-Bronchoscopy luvavanyo lokujonga iindlela zomoya kunye nokufumanisa isifo semiphunga. Inokusetyenziswa kwakhona kunyango lweemeko ezithile zemiphunga.

I-bronchoscope sisixhobo esisetyenziselwa ukubona ngaphakathi kwindlela yomoya kunye nemiphunga. Ubungakanani bunokuba buguquke okanye buqine. Umda oguqukayo uhlala uhlala usetyenziswa. Yityhubhu engaphantsi kwesiqingatha se-intshi (isentimitha enye) ububanzi kwaye ikumalunga ne-2 yeenyawo (60 iisentimitha) ubude. Kwiimeko ezinqabe kakhulu, kusetyenziswa bronchoscope engqongqo.

• Uya kufumana amayeza nge-vein (IV, okanye nge-intravenous) ukukunceda uphumle. Okanye, usenokuba ulele phantsi kweanesthesia ngokubanzi, ngakumbi ukuba kusetyenziswa umda oqinileyo.
• Iyeza elenzakalisayo (i-anesthetic) liya kutshizwa ngomlomo nasemqaleni. Ukuba i-bronchoscopy yenziwe ngeempumlo, i-jelly ye-numbing iya kufakwa kwimpumlo ityhubhu edlula kuyo.
• Ubungakanani bufakwe ngobunono. Kuya kukwenza ukuba ukhohlele ekuqaleni. Ukukhohlela kuya kuyeka njengoko isiyobisi esidikidiki siqala ukusebenza.
• Umboneleli wakho wezempilo unokuthumela isisombululo se-saline ngombhobho. Oku kuhlamba imiphunga kwaye kuvumela umboneleli wakho ukuba aqokelele iisampulu zeeseli zemiphunga, ulwelo, iintsholongwane kunye nezinye izinto ngaphakathi kweengxowa zomoya. Le nxalenye yenkqubo ibizwa ngokuba lugeza.
• Ngamanye amaxesha, iibrashi ezincinci, iinaliti, okanye i-forceps zinokudlula kwi-bronchoscope ukuthatha iisampulu ezincinci kakhulu (ii-biopsies) kwimiphunga yakho.
• Umboneleli wakho unokubeka i-stent kwindlela yakho yomoya okanye ujonge imiphunga yakho nge-ultrasound ngexesha lenkqubo. I-stent sisixhobo esincinci setyhubhu esinjengonyango. I-Ultrasound yindlela yokucinga engenabuhlungu evumela umboneleli wakho ukuba abone ngaphakathi komzimba wakho.
• Ngamanye amaxesha i-ultrasound isetyenziselwa ukubona ii-lymph node kunye nezicubu ezijikeleze umoya wakho.
• Ekupheleni kwenkqubo, umda uyasuswa.

Landela imiyalelo yendlela yokulungiselela uvavanyo. Uya kuxelelwa:

• Ukungatyi okanye usele nantoni na iiyure ezi-6 ukuya kwezi-12 phambi kovavanyo lwakho.
• Ungathathi i-aspirin, ibuprofen, okanye ezinye iziyobisi zokucoca igazi ngaphambi kwenkqubo yakho. Buza umboneleli oza kwenza i-bronchoscopy yakho ukuba uyeke nini ukuthatha la machiza.
• Lungiselela ukukhwela ukuya nokubuya esibhedlele.
• Lungiselela uncedo ngomsebenzi, ukukhathalelwa kwabantwana, okanye eminye imisebenzi, njengoko kuya kufuneka uphumle ngosuku olulandelayo.

Uvavanyo luhlala lwenziwa njengenkqubo yokugula, kwaye uya kugoduka kwangolo suku. Rhoqo, abanye abantu banokufuna ukulala esibhedlele.

I-anesthetic yendawo isetyenziselwa ukuphumla kunye nokuqaqamba izihlunu zomqala wakho. Kude kube eli yeza liqale ukusebenza, unokuziva ulwelo lubaleka luye emva komqala wakho. Oku kunokubangela ukuba ukhohlele okanye uqumbe.

Emva kokuba iyeza liqalise ukusebenza, unokuziva uxinzelelo okanye ukutsala kancinci njengoko ityhubhu ihamba ngombhobho wakho. Nangona ungaziva ngathi awukwazi ukuphefumla xa ityhubhu isemqaleni wakho, akukho bungozi bokwenzeka kwale nto. Amayeza owafumanayo ukuze uphumle aya kukunceda kwezi mpawu. Uyakulibala uninzi lwenkqubo.

Xa i-anesthetic iphela, umqala wakho unokukrakra iintsuku eziliqela. Emva kovavanyo, amandla akho okukhohlela (okhohlela reflex) aya kubuya emva kweeyure eziyi-1 ukuya kwezi-2. Awuyi kuvunyelwa ukuba utye okanye usele de ubuye umkhuhlane.

Unokuba ne-bronchoscopy ukunceda umboneleli wakho afumanise iingxaki zemiphunga. Umboneleli wakho uya kuba nakho ukujonga i-airways yakho okanye athathe isampulu ye-biopsy.

Izizathu eziqhelekileyo zokwenza i-bronchoscopy yokufumanisa isifo zezi:

• Uvavanyo lokucinga lubonisa utshintsho olungaqhelekanga emiphungeni yakho, njengokukhula okanye ithumba, utshintsho okanye ukonakala kwethishu yemiphunga, okanye ukuwa kwendawo enye yomphunga.
• Kwii-lymph node ezikufutshane nemiphunga yakho.
• Ukubona ukuba kutheni ukhohlela igazi.
• Ukuchaza ukuphefumla okufutshane okanye amanqanaba eoksijini asezantsi.
• Ukujonga ukuba kukho into yelinye ilizwe kwindlela yakho yomoya.
• Unesikhohlela esiye sahlala ngaphezulu kweenyanga ezintathu ngaphandle kwesizathu esicacileyo.
• Unosulelo kwimiphunga yakho kunye neendlela ezinkulu zomoya (i-bronchi) ezingenakufunyaniswa nayiphi na enye indlela okanye zifuna uhlobo oluthile lokufumanisa isifo.
• Uphefumle irhasi enetyhefu okanye imichiza.
• Ukujonga ukuba ukwaliwa kwemiphunga emva kokufakelwa komphunga kwenzeka.

Unokuba ne-bronchoscopy yokunyanga ingxaki yemiphunga okanye yomoya. Umzekelo, inokwenziwa:

• Susa iiplagi ezinamanzi okanye ezirholayo kwiindlela zakho zomoya
• Susa into yelinye ilizwe kwiindlela zakho zomoya
• Yandisa (yandisa) indlela yomoya evaliweyo okanye emxinwa
• Khupha ithumba
• Phatha umhlaza usebenzisa iindlela ngeendlela ezahlukeneyo
• Hlamba indlela yomoya

Iziphumo eziqhelekileyo zithetha ukuba iiseli eziqhelekileyo kunye namanzi afunyenweyo. Akukho zinto zangaphandle okanye izithintelo zibonwayo.

Iingxaki ezininzi zinokufunyanwa nge-bronchoscopy, kubandakanya:

• Usulelo olusuka kwiibhaktheriya, ii-virus, i-fungi, i-parasites, okanye i-tuberculosis.
• Umonakalo wemiphunga onxulumene nezinto ezingahambelaniyo komzimba.
• Ukuphazamiseka kwemiphunga apho izicwili ezinzulu zemiphunga ziye zitshise ngenxa yokuphendula kwenkqubo yomzimba yokuzikhusela, emva koko zonakaliswe. Umzekelo, utshintsho olusuka kwi-sarcoidosis okanye i-rheumatoid arthritis lunokufumaneka.
• Umhlaza wemiphunga, okanye umhlaza kwindawo ephakathi kwemiphunga.
• Ukunciphisa (stenosis) yetrachea okanye i-bronchi.
• Ukwalelwa okungafunekiyo emva kokufakwa komphunga.

Umngcipheko ophambili webronchoscopy zezi:

• Ukopha kwiindawo ze-biopsy
• Usulelo

Kukho umngcipheko omncinci woku:

• Isingqisho sentliziyo esingaqhelekanga
• Ubunzima bokuphefumla
• Ifiva
• Ukuhlaselwa yintliziyo, kubantu abanesifo sentliziyo esele sikhona
• Ioksijini yegazi ephantsi
• Umphunga owileyo
• Umqala obuhkungu

Iingozi xa kusetyenziswa ianesthesia ngokubanzi zibandakanya:

• Intlungu yezihlunu
• Guqula uxinzelelo lwegazi
• Ukubetha kwentliziyo kancinci
• Isicaphucaphu nokugabha

I-fiberoptic bronchoscopy; Umhlaza wemiphunga - bronchoscopy; Inyumoniya - i-bronchoscopy; Isifo esinganyangekiyo semiphunga - i-bronchoscopy

• Bronchoscopy
• Bronchoscopy

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UKupeli E, uFeller-Kopman D, Mehta AC. Uxilongo bronchoscopy. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 22.

I-Weinberger SE, Cockrill BA, Mandel J.Uvavanyo lwesigulana esinesifo se-pulmonary. Ku: Weinberger SE, Cockrill BA, Mandel J, ii-eds. Imigaqo yePulmonary Medicine. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2019: isahluko 3.