Bronchography

Bronchography is a direct examination of bronchial lesions. The diagnosis is good, but the patient has some pain. Bronchography is one of the important examination methods for chest diseases, and it has a positive diagnostic value for bronchial diseases. It can determine the location, extent and nature of the lesion, and provide a basis for clinical selection of effective treatments. Congenital or acquired bronchial and pulmonary disorders such as bronchiectasis, bronchial and pulmonary tumors, organizing pneumonia, chronic lung abscesses, and atelectasis. Basic Information Specialist Category: Respiratory Examination Category: X-ray Applicable gender: whether men and women apply fasting: fasting Tips: 4 hours before angiography and 2 hours after angiography should be fasted. Normal value Normal angiography showed that the bronchial branches of each leaf segment were thick and thin, with clear classification, normal distribution, smooth tube wall, uniform filling and easy filling to the distal end. The bronchial shadows on both sides are symmetric Clinical significance The scope of application of bronchography is: (1) Congenital or acquired bronchial and pulmonary disorders, such as bronchiectasis, bronchial and pulmonary tumors, organizing pneumonia, chronic lung abscess, and atelectasis. (2) Long-term cough or hemoptysis for unknown reasons. (3) recurrent pneumonia, especially pneumonia that occurs repeatedly in the same area. (4) One-sided hilar enlargement, the nature is not certain. (5) Differential diagnosis of chronic cavities or cysts. (6) Localized emphysema or atelectasis. Analysis of inspection results: 1. If the thickness of the bronchial tube is uneven and there is partial local circumference or dilation, the bronchial fixation is stiff, the gathering is distorted, and the contrast agent is delayed, which is common in bronchiectasis. 2. If there is local bronchial stenosis or obstruction or compression deformation of the lumen, it is more common in tumors, trauma, foreign body, tuberculosis or inflammation. 3. The wall of the tube is irregular, and the contrast agent protrudes from the wall of the tube, which may be bronchopleural palsy and esophageal fistula. High results may be diseases: children with congenital pulmonary cysts, acute bronchiolitis, spherical pneumonia, mediastinal tumors, bronchogenic cysts, bronchial dilatation in children, pediatric pulmonary isolation, tracheal, bronchoconstriction, bronchiectasis in the elderly, congenital lung Cyst considerations 1. Preoperatively explain to the patient the purpose, method and possible pain of the angiography in order to obtain the patient's cooperation. 2. Fasting 4 hours before angiography and 2 hours after angiography. 3. When there is a lot of sputum, the body position should be drained before surgery. 4. The preparation of the contrast agent should be thick and appropriate, so as to prevent the contrast agent from entering the alveoli, and changing the body position when the contrast agent is injected, so that the contrast agent is evenly distributed. 5. Anesthesia should be sufficient to prevent cough from affecting the contrast effect. 6. Postoperative postural drainage to promote the discharge of contrast agents as soon as possible. Inspection process Bronchial angiography is injected directly into the trachea or bronchial lumen via the endotracheal tube. Adult unilateral 15ml ~ 20ml (40%), bilateral 30ml ~ 40ml; children reduce. The injection should be slow, and the position of the bronchus should be filled with the body position; in order to avoid the product entering the respiratory unit below the bronchiole, interfere with the diagnosis and cause granuloma, in addition to controlling the dosage and perfusion rate during perfusion, often adding grinding in the iodized oil As a fine sulfonamide powder, mix thoroughly to increase the consistency. Generally, add 5-10g per 20ml of iodized oil. Depending on the consistency of the original product and room temperature, it is forbidden to be allergic to sulfonamide preparations. Iodized oil is mild to tissue stimulation and generally does not cause local symptoms. However, entering the bronchus can stimulate the mucous membrane to cause cough, and the irritation is increased after the precipitation of free iodine, and iodine poisoning is prone to occur. After the end of the angiography, the body position is drained and the patient is encouraged to cough up the contrast agent and cannot swallow. If a large amount of iodized oil is mistakenly entered into the digestive tract, mechanical stimulation should be used to induce vomiting or gastric lavage to avoid iodine poisoning. Not suitable for the crowd 1, the body is exhausted, age is too large, heart and lung liver dysfunction. 2, bronchial, acute lung infection, invasive pulmonary tuberculosis patients. 3, 2 weeks, a large hemoptysis occurred. 4, hyperthyroidism or allergy to iodine. Adverse reactions and risks 1. Occasionally, iodine allergic reaction occurs immediately or several hours after administration, mainly manifested as angioedema, respiratory mucosal irritation, swelling and increased secretion. 2. Iodized oil is mild to tissue stimulation, generally does not cause local symptoms, but entering the bronchus can stimulate the mucous membrane to cause cough, irritating after the precipitation of free iodine, and prone to iodine poisoning. 3. Iodine can promote the deterioration of tuberculosis. 4. This product enters the alveolar, abdominal cavity and other tissues can cause foreign body reaction, resulting in granuloma.