纤维支气管镜的临VIP免费

Logo纤维支气管镜的临床应用www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo内容纲要FB简介FB诊断应用FB治疗应用FB新进展www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogoFB简介BriefIntroductionofFlexibleBronchoscopy1.1897年德国医师Killian用硬质窥镜(RigidEndoscope)取出骨性异物;2.1964年日本Olympus公司Ikeda制成标准的光导纤维支气管镜，命名为可曲式光导纤维支气管镜(FlexibleFiberopticBronchoscope)；3.硬质气管镜(RigidBronchoscope)介入气管学(InterventionalBronchology)发展史：www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo常规FB探察气管范围（27级分支）：气管0主支气管Ⅰ叶支气管Ⅱ段支气管Ⅲ100%亚段支气管Ⅳ74%www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo禁忌证(ContraindicationstoBronchoscopy)绝对禁忌证/相对禁忌证1活动性大咯血；2严重的上腔静脉阻塞综合征；3严重的肺动脉高压；4气管部分狭窄/（患侧支气管）；5支气管哮喘；www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo禁忌证(ContraindicationstoBronchoscopy)6全身情况极度衰竭；严重心、肺功能障碍；7不能纠正的出血倾向；尿毒症；8严重心律失常；新近发生的心肌梗死/不稳定心绞痛；9疑有主动脉瘤；www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo禁忌证(ContraindicationstoBronchoscopy)绝对禁忌证/相对禁忌证1咯血宜在缓解后两周再进行；2新近有较重的支气管和肺部感染伴发热，待炎症控制后再做检查；3有肺大疱的病人，应慎重检查，避免发生气胸；4较大的气管内异物，一般活检钳难以经FB取出；www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogoFB辅助设备(AccessoriesforFB)•氧气•监护www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogoFB辅助设备(AccessoriesforFB)www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo支气管病变的纤维支气管镜镜下分类(JRS分类)1.支气管管壁的异常改变2.支气管腔内异常3.支气管腔内异常物质4.呼吸动力学改变www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo1.支气管管壁的异常改变支气管黏膜肿胀（水肿）www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo1.支气管管壁的异常改变支气管黏膜充血www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo1.支气管管壁的异常改变支气管黏膜萎缩，纵行皱襞www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo1.支气管管壁的异常改变溃疡www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo2.支气管管腔的异常改变气管狭窄www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo2.支气管管腔的异常改变支气管狭窄（外压性）www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo2.支气管管腔的异常改变气管食道瘘www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo3.支气管管腔的异物肉芽肿www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogoFB诊断应用DiagnosticProceduresofFlexibleBronchoscopy适应证(IndicationsforDiagnosticBronchoscopy)1.不明原因的咯血;2.不明原因的的慢性咳嗽；3.不明原因的局限性哮鸣音(Unexplainedlocalizedwheezing)；4.不明原因的声音嘶哑；5.痰中发现癌细胞或可疑癌细胞(Roentgenographicallyoccultlungcancer)Tx；6.CXR、CT提示：肺不张、肺部肿快、阻塞性肺炎、肺炎不吸收、肺部弥漫性病变、肺门/纵隔淋巴结肿大、气管支气管狭窄、原因不明的胸腔积液等；www.themegallery.comwww.themegallery.comCompanyLogoCompanyLogoLogo适应证(IndicationsforDiagnosticBronchoscopy)7.临床已诊断肺癌的术前检查;8.胸部外伤、怀疑气管支气管挫裂/断裂、肺移植后气管支气管吻合面观察等；9.食...