I-Bronchoscopy

I-Bronchoscopy isivivinyo sokubuka imigwaqo yomoya nokuthola isifo samaphaphu. Ingasetshenziswa futhi ngenkathi ukwelashwa kwezimo ezithile zamaphaphu.

I-bronchoscope iyithuluzi elisetshenziselwa ukubona ingaphakathi lemigwaqo yomoya namaphaphu. Ububanzi bungaguquguquka noma buqinile. Ububanzi obuguquguqukayo buhlala busetshenziswa njalo. Iyishubhu elingaphansi kwesentimitha elilodwa ububanzi futhi lingaba ngamamitha angu-60 ubude. Ezimweni ezingavamile, i-bronchoscope eqinile isetshenziswa.

• Kungenzeka uthole imishanguzo ngomthambo (IV, noma ngemithambo yegazi) ukukusiza uphumule. Noma, kungenzeka ukuthi ulele ngaphansi kwe-anesthesia ejwayelekile, ikakhulukazi uma kusetshenziswa umugqa oqinile.
• Isidakamizwa esiyindikindiki (i-anesthetic) sizofuthwa emlonyeni nasemphinjeni. Uma i-bronchoscopy yenziwa ngamakhala akho, i-jelly ebulalayo izobekwa emakhaleni ithubhu idlula.
• Ububanzi bufakwe ngobumnene. Kungenzeka kukwenze ukhwehlele ekuqaleni. Ukukhwehlela kuzoma lapho umuthi onamafutha uqala ukusebenza.
• Umhlinzeki wakho wezokunakekelwa kwempilo angathumela isisombululo sikasawoti ngepayipi. Lokhu kugeza amaphaphu futhi kuvumela umhlinzeki wakho ukuthi aqoqe amasampula amaseli wamaphaphu, uketshezi, amagciwane nezinye izinto ngaphakathi kwezikhwama zomoya. Le ngxenye yenqubo ibizwa ngokuthi ukuhlanza.
• Kwesinye isikhathi, amabhlashi amancane, izinaliti, noma i-forceps kungadluliselwa kwi-bronchoscope ukuthatha amasampula amancane kakhulu (ama-biopsies) emaphashini akho.
• Umhlinzeki wakho angabeka futhi i-stent ku-airway yakho noma abuke amaphaphu akho nge-ultrasound ngesikhathi senqubo. I-stent iyithuluzi lezokwelapha elincane elinjengeshubhu. I-Ultrasound iyindlela yokuthwebula engenabuhlungu evumela umhlinzeki wakho ukuthi abone ngaphakathi komzimba wakho.
• Kwesinye isikhathi i-ultrasound isetshenziselwa ukubona ama-lymph node kanye nezicubu ezizungeze umoya wakho.
• Ekupheleni kwenqubo, ubukhulu buyasuswa.

Landela imiyalo yokuthi ungasilungiselela kanjani isivivinyo. Uzotshelwa:

• Ukungadli noma uphuze noma yini amahora ayisithupha kuya kwayi-12 ngaphambi kokuhlolwa kwakho.
• Hhayi ukuthatha i-aspirin, ibuprofen, noma ezinye izidakamizwa zokuncipha kwegazi ngaphambi kwenqubo yakho. Buza umhlinzeki ozokwenza i-bronchoscopy yakho ukuthi uyeke nini ukusebenzisa le mithi.
• Hlela ukugibela ukuya nokubuya esibhedlela.
• Hlela usizo ngomsebenzi, ukunakekelwa kwengane, noma eminye imisebenzi, njengoba kuzodingeka uphumule ngosuku olulandelayo.

Ukuhlolwa kuvame ukwenziwa njengenqubo yokugula, futhi uzobuyela ekhaya ngalo lolo suku. Akuvamile, abanye abantu bangadinga ukulala esibhedlela.

I-anesthetic yendawo isetshenziselwa ukukhululeka nokuqaqamba imisipha yomphimbo wakho. Kuze kube yilapho lo muthi uqala ukusebenza, ungazizwa uketshezi lwehla ngomphimbo wakho. Lokhu kungadala ukuthi ukhwehlele noma uvale umlomo.

Lapho umuthi uqala ukusebenza, ungazizwa ucindezelekile noma udonsa kancane lapho ithubhu idlula ku-windpipe yakho. Yize ungazizwa sengathi awukwazi ukuphefumula lapho ishubhu lisemphinjeni wakho, ayikho ingozi yalokhu okwenzekayo. Imithi oyithola uphumule izosiza ngalezi zimpawu. Cishe uzokhohlwa iningi lenqubo.

Lapho i-anesthetic iphela, umphimbo wakho unganwaya izinsuku ezimbalwa. Ngemuva kokuhlolwa, ikhono lakho lokukhwehlela (ukukhwehlela i-reflex) lizobuya emahoreni angu-1 kuya kwangu-2. Ngeke uvunyelwe ukudla noma ukuphuza kuze kubuye i-reflex yakho yokukhwehlela.

Ungaba ne-bronchoscopy ukusiza umhlinzeki wakho ukuthi ahlole izinkinga zamaphaphu. Umhlinzeki wakho uzokwazi ukuhlola izindiza zakho noma athathe isampula le-biopsy.

Izizathu ezijwayelekile zokwenza i-bronchoscopy yokuxilongwa yilezi:

• Ukuhlolwa kwe-imaging kubonise izinguquko ezingajwayelekile zamaphaphu akho, njengokukhula noma isimila, izinguquko noma isibazi sezicubu zamaphaphu, noma ukuwa kwendawo eyodwa yamaphaphu akho.
• Ukuze uthole ama-lymph node eduze kwamaphaphu akho.
• Ukubona ukuthi kungani ukhwehlela igazi.
• Ukuchaza ukuphefumula okuncane noma amazinga e-oxygen aphansi.
• Ukubona ukuthi ngabe kukhona okuthile kwangaphandle ku-airway yakho.
• Unesifo sokukhwehlela esidonse izinyanga ezingaphezu kwezingu-3 ngaphandle kwesizathu esicacile.
• Unesifo emaphashini akho nasemigwaqeni yomoya emikhulu (bronchi) engatholakali nganoma iyiphi enye indlela noma edinga uhlobo oluthile lokuxilongwa.
• Uhogele igesi enobuthi noma ikhemikhali.
• Ukubona ukuthi ukwenqatshwa kwamaphaphu ngemuva kokufakelwa kwamaphaphu kuyenzeka yini.

Ungase futhi ube ne-bronchoscopy yokwelapha inkinga yamaphaphu noma yomoya. Isibonelo, kungenziwa ku:

• Susa ama-plugs oketshezi noma amafinyila ezindleleni zakho zomoya
• Susa into yangaphandle kusuka ezindleleni zakho zomoya
• Nweba (yandisa) indlela yomoya evinjiwe noma encishisiwe
• Khipha ithumba
• Phatha umdlavuza usebenzisa amasu amaningi ahlukene
• Geza indlela yomoya

Imiphumela ejwayelekile isho ukuthi amaseli ajwayelekile kanye noketshezi kuyatholakala. Azikho izinto zangaphandle noma izivimbelo ezibonakalayo.

Izinkinga eziningi zingatholakala nge-bronchoscopy, kufaka phakathi:

• Ukutheleleka okuvela kubhaktheriya, amagciwane, isikhunta, izimuncagazi, noma isifo sofuba.
• Ukulimala kwamaphaphu okuhlobene nokusabela kohlobo lomzimba.
• Ukuphazamiseka kwamaphaphu lapho izicubu ezijulile zamaphaphu zivutha ngenxa yokuphendula kwamasosha omzimba, bese kulimala. Isibonelo, izinguquko ezivela ku-sarcoidosis noma i-rheumatoid arthritis zingatholakala.
• Umdlavuza wamaphaphu, noma umdlavuza endaweni ephakathi kwamaphaphu.
• Ukunciphisa (stenosis) kwe-trachea noma i-bronchi.
• Ukwenqatshwa okukhulu ngemuva kokufakelwa kwamaphaphu.

Izingozi eziyinhloko ze-bronchoscopy yilezi:

• Ukopha kusuka kumasayithi we-biopsy
• Ukutheleleka

Kukhona nengozi encane yoku:

• Isigqi senhliziyo esingajwayelekile
• Ubunzima bokuphefumula
• Imfiva
• Ukuhlaselwa yinhliziyo, kubantu abanesifo senhliziyo esivele sikhona
• I-oxygen ephansi yegazi
• Iphaphu eliwile
• Umphimbo obuhlungu

Izingozi lapho kusetshenziswa i-anesthesia ejwayelekile zifaka:

• Ubuhlungu bemisipha
• Shintsha umfutho wegazi
• Ukushaya kwenhliziyo kuhamba kancane
• Isicanucanu nokuhlanza

I-fiberoptic bronchoscopy; Umdlavuza wamaphaphu - i-bronchoscopy; Inyumoniya - i-bronchoscopy; Isifo samaphaphu esingapheliyo - i-bronchoscopy

• I-Bronchoscopy
• I-Bronchoscopy

UChristie NA. I-otolaryngology esebenzayo: i-bronchoscopy. Ku: Myers EN, Snyderman CH, eds. I-Operative Otolaryngology Head kanye ne-Neck Surgery. 3rd ed. IPhiladelphia, PA: Elsevier; 2018: isahluko 18.

UKupeli E, uFeller-Kopman D, Mehta AC. I-bronchoscopy yokuxilonga. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 22.

I-Weinberger SE, i-Cockrill BA, i-Mandel J. Ukuhlolwa kwesiguli esine-pulmonary disease. Ku: Weinberger SE, Cockrill BA, Mandel J, ama-eds. Izimiso zePulmonary Medicine. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 3.