Bronchology. Preparation of the patient to bronchography bronchography algorithm

Bronchography -contrast method of studying air-passing ways of respiratory organs (bronchi).

Purpose: Examine the state of the lumen of the bronchial tree, detect the strength formations of communicating with bronchi.
Indications: bronchiectatic disease, developmental abnormalities
bronchial wood, chronic bronchitis, bronchopalic cysts, malignant and benign tumors bronchi and lungs, etc. Contraindications: acute diseases lungs accompanied by high mixer body; feverish states are not pulmonary etiology; heart defects; Massive pulmonary bleeding.
Complication: Allergic reactions to a contrast agent.
Bronchography conducts a doctor.
Nurse's algorithm:

2. Explain to the patient the purpose and course of the upcoming study and agree.
3. Exclude the eve of the meal, water, not smoking (the study is conducted on an empty stomach).
4. Conduct the patient in the X-ray Cabinet with the history of the disease to the appointed time.

5. Let's put the patient on the chair.
6. Prepare everything you need for the anesthesia of the upper respiratory tract Through the nose (mouth).
7. Spray the Rothoglotka anesthetic.
8. Enter a contrast substance of iodolipol into the lumen of the bronchi under local anesthesia.
9. The patient is performed a series of pictures in a radiographic office, the nurse leaves the X-ray Cabinet.
10. Scroll into the patient to the ward.
11. Ensure observation and peace.

166. Preparation of the patient to the x-ray study of the stomach and duodenum

X-ray study of the stomach and duodenal intestine is a study method based on shrying the X-ray rays of hollow organs using a contrast agent (barium sulfate).
Purpose:diagnostic: X-ray and radiography allow us to determine the form, value, position, mobility of the stomach and duodenum clarify the localization of erosion, ulcers, tumors; To study the functional state of the stomach mucosa tow the tow truck.
Indications: Diseases of the stomach and duodenum.
Contraindications: Ulcerative bleeding.
Prepare: Circle of esmark, sterile tip, vaseline, spatula, oilcloth, diaper, tripod, suspension of barium sulfate (100-150 gr.), Rubber gloves, direction forms (specify the name of the research method, Fullwritten patient, age, address or the number of the history of the disease is diagnosed with database), disinfectant solution, vessel.

X-ray study conducts a doctor.
The algorithm of the action of the wicked nurse;

3. Warning a patient about the need to exclude from the diet of gas-generating products (vegetables, fruits, milk, black bread) 2-3 days before the study for the prevention of meteorism.
4. Inform the patient that the study is conducted in the morning on an empty stomach. The last meal must be on the eve, no later than 20 pm.
5. In the case of constipation on the appointment of a doctor in the evening, the day before the study is a cleansing enema.
6. Make a patient to an x-ray office with a history of the disease to the appointed time.

Algorithm of the Nurse of the X-ray Cabinet:
7. When conducting research, give the patient to drink suspension of barium sulfate (100-150 gr. On a glass of water).
8. During the execution of pictures, the nurse leaves the X-ray Cabinet.
9. After research, spend the patient in the ward.

167. Preparation of the patient to irrigoscopy

X-ray study of a large intestine is a method of study based on shrying the X-rays of hollow organs using a contrast agent (barium sulfate).
purpose: Diagnostic: X-ray study allows you to obtain an idea of \u200b\u200bthe location of various divisions of the large intestine; On the length, position, tone, the shape of the colon, to identify violations of the motor (motor) function; Remove inflammatory processes, tumors, ulcers, erosion in the mucous membrane of the colon.
Indications: All diseases of the colon.
Contraindications: intestinal obstruction, ulcerative colitis in the period of exacerbation, intestinal bleeding.
Prepare:circle of esmark, water capacity in the amount of 1.5-2 liters, vaseline, spatula, oilcloth, diaper, tripod, rubber gloves, vessel, container with desionism, barium weightsulfate (1.5 liters at T 0 - 36 ° -37 ° C ), pelvis, tray, napkins, water thermometer, apron; FORTRANS, adsorbents, enzymatic drug form drugs (indicate the name of the study method, Full name of the patient, age, address or number of the illness, diagnosis, date of research).

Irrigoscopy conducts a doctor.
1. Install trust relationships with the patient.
2. Explain to the patient the purpose and course of the study and receive its consent.
3. Spend psychological training of the patient.
4. Warning the patient about the need to exclude from the edible ration of products causing gas formation, fermentation and provide it with plentiful drink 2-3 days before the study.
5. For the purpose of the doctor, let's enzyme preparations.
6. At 12 o'clock in the day, on the eve of the Ford Studies according to the scheme.
7. Provide a light dinner no later than 18 hours.
8. In the evening, on the eve of the study (20 and 22 hours), put the patient 2 high cleansing enemas 1.5-2 liters with an interval of 2 hours before the "clean water" effect.

9. In the morning 2 hours before the study, put the patient 2 cleansing enemas with an interval of 1 hour.
10. Provide the patient in the morning light protein breakfast 3 hours before the study (for reflex promotion of content fine intestine In the colon).
11. Take off the patient with the history of the disease in the X-ray office to the appointed time.

Algorithm of the Nurse of the X-ray Cabinet:
12. Place the patient on the left side with the legity given to the stomach.
13. Enter the patient using the bary sulfate enema to 1.5 l (T ° -36 ° C) to the x-ray.
14. When conducting a x-ray examination, the nurse leaves the X-ray Cabinet.
15. After research, escort the patient in the ward.

Note:
- In order to reduce gas formation in the intestine 3 days before the study, exclude from the diet raw vegetables, fruits. Fruit juices rye bread, dairy and yeast products, sweets;
- Assign: Porridge, Kissel, Omelets, Boiled meat and fish products, egg, cottage cheese, cheese, white bread, broth, white crumbs.

168. Preparation of the patient to intravenous (excretory)
pyelography

X-ray study of kidneys and urinary tract - based on the parenteral administration of a contrast agent (urography. Verphin, trifore, etc.).
purpose: Diagnostic: allows you to establish the location of the urinary system organs, estimate the size and form of kidneys, to determine the functional ability (on the accumulation and separation of the contrast substance), the presence of concrections in these organs, to determine the passability of ureters.
Indications: All kidney disease and urinary tract.
Contraindications: acute kidney diseases, hemorrhagic diathesis, increased sensitivity to iodine preparations, thyrotoxicosis, chronic renal failure.
Complications: Allergic reaction to iodine preparations.
Prepare: contrasting parenteral substance for the purpose of the doctor, the equipment tray for intravenous injections, a set for emergency care for an anaphylactic shock, sodium thiosulfate solution of 30% (specific antidote for iodine-containing contrast drugs), direction form (specify the name of the study method, F.I. . Patient, age, address or number of disease history, diagnosis, date of research).

A chopper conducts a doctor.
Algorithm Actions of the Western Nurse:
1. In a confidential setting, provide a patient (or members of his family) in an affordable form of basic information about the essence of the upcoming study.
2. Get the consent of the patient for research.
3. Sample on the sensitivity to the contrasting agent on the eve of 1 - 2 days before the study - introduce intravenously 1.0 ml of a contrast agent heated to T - 37 0 C.
4. Warning a patient about the need for a study in the morning on an empty stomach.
5. Put the patient a cleansing enema for 1 - 2 hours before the study.
6. Conduct the patient in the X-ray Cabinet and the history of the disease to the appointed hour.

Algorithm of the Nurse of the X-ray Cabinet:
7. Help the patient lie down on the back.
8. Enter the patient to prescribe a doctor intravenously 20-30 ml of a contrast agent heated to T ° -37 ° C slowly for 8-10 minutes.
9. Survey pictures are performed by the patient, and then a series of pictures is performed at regular intervals.
10. When conducting an X-ray study, the nurse leaves the X-ray Cabinet.
11. After research, spend the patient to the ward. Ensure observation and peace.

Note:in case of intolerance of iodine-containing drugs, the sample and the introduction of the full dose of the drug is contraindicated.

Bronchography is a radiographic method of studying the bronchial wood with a contrast agent and performing pictures.

X-rayly determined pulmonary pattern is mainly due to blood vessels and a connective tissue stroma lung. Branches of bronchial wood is almost not visible on the radiograph.

The image of large bronchi (main, and sometimes equal) can be obtained on overexposed pictures made at the height of the breath, smaller bronchi are not visible on them. The possibilities and layers are also limited - usually trachea, main and equity bronchi are determined.

A complete idea of \u200b\u200bthe state of the bronchial tree can be obtained only with the help of a contrasting x-ray study - bronchography.

The bronchography method received practical application in from 1923, when Sicar and Foresta (Sicard, Forestier) proposed to fill the bronchial wood lipiodol - an organic connection of iodine with vegetable oil. In our country, the Soviet Preparation of iodolipol is currently used at bronchography. The latter is a transparent oily liquid of brown-yellow-colored color containing 30% iodine, packaged in ampoules. Iodolipol causes a clear contrast image of the bronchi and is well tolerated by patients.

Technique bronchography

An hour before the bronchography of the patient gets inside of 0.1 g of diazepam, which, like other barbiturates, reduces the toxic effect of lidocaine used for the anesthesia of the respiratory tract, suppresses the cough reflex and causes a more superficial breathing, which contributes to the effectiveness of the study.

The study is made in the morning hours, better on an empty stomach.

Of the numerous ways to anesthetize the respiratory tract and the introduction of a contrast substance, the so-called transnasal catheterization method received the highest distribution.

The anesthesia of the respiratory tract is best to produce a mixture of Girsch. For this patient, sitting on his head trapped back. Pipette is injected into the nasal moves dropped over 5 minutes at intervals of 1-2 minutes 1-1.5 ml of a gyrsh mixture. The patient at the same time deeply inhales the injected solution.

The anesthesia of the upper respiratory tract can also be made using a special pulverizer. The same amount of anesthetic mixture is sprayed into the root area of \u200b\u200bthe tongue, zea and larynx.

After the anesthesia of the upper respiratory tract, the patient is suggested to launch a tongue and hold it with a marry napkin, and the rubber catheter in the trachea stands in front of it. After that, the patient is stacked on the table installed behind the transmission screen. On the screen check whether the catheter is in the trachea, at what level (it should be brought to the bifurcation). Then in the lumen of the catheter is introduced an additional 1-1.5 ml of a gyrsh mixture for anesthesia of the field of trachea bifurcation and large bronchi.

After 2-3 minutes after the anesthesia is completed, the patient give the position on the side according to the studied light and through the catheter is poured into the bronchial wood contrast substance - iodolipol.

The famous disadvantage of iodolipol, like each other oily contrast agent (lipiodol, iodipin), is that, penetrating into the Alveoli, it is delayed in them for many days, and sometimes weeks and months. Alveolas are known to be exempt from iodolipol not by spilling, but as a result of splitting and absorption of lipoid substance with a lung cloth.

Therefore, they were proposed for a contrasting study of the bronchial wood quickly distinguished from the body viscose aqueous solutions iodide preparations of urgent and perabrodile. However, this solution is characterized by a number of disadvantages: they are strongly irritated by the mucous membrane of the bronchi, causing a long cough, and sometimes asthmatic seizures; The contrast of the image of the bronchial tree is less than with oily substances.

In order to prevent iodolipol in the alveoli, it is recommended to increase its viscosity, mixing it with highly dispersed powders, in particular with sulfanimide. Most often, iodolipol is thoroughly mixed with the Nisulfazole in the following proportion: 3 nsulfazole per 10 ml of iodolipol. When applying said suspension in the coming days after the bronchography of the contrast agent produced in the lungs is not determined.

For an overview study of one lung in most cases, it is sufficient to introduce 20 ml of iodolypole and only with multiple large bronchootasia or cavities in an easy, the amount of iodolyipol is increased to 30 ml.

Filling the bronchial tree contrast substance Camera on the screen. Usually you have to relax the upper or low part Torso or tilt the patient forward or backward so that the contrast agent is evenly distributed throughout the bronchial tree of the lung under study.

After using the screen, an idea of \u200b\u200bthe condition of the bronchial tree or the cavities filled with the contrast agents in light, there are two overview brunchograms with a horizontal direction of X-rays: one in the patient's position on the side (in the so-called lateroposition) and the other in the patient's position back. It should be borne in mind that as soon as the patient takes vertical position, iodolipol quickly leaves the upper bronchial branches and climbs in the lower branches.

After the production of brunchograms, when the patient is positioned on the side and on the back, the x-ray is continued (and in the case of the need for additional pictures) first in the patient's lying position, and then in the vertical.

Sometimes, for example, in the diagnosis of bronchial cancer or focal forms of pneumosclerosis, there is a need for a targeted bronchonography during the dosage of the contrast agent. In these cases, the catheter under the control of the screen is introduced into the appropriate share bronchus and the bronchial branches of the ventilated share are filled with a small amount (3-5 ml) of iodolipol. The latter, spreading the thin layer along the inner surface of the bronchi wall, allows you to study it in detail its condition on the transmission screen and on the aimed pictures.

If necessary, the bronchography of the second lung should be carried out in a few days after a contrast study of the first lung.

Complications of bronchography

In the first years of the use of bronchography, poisoning anesthetic was quite often observed. Now, in connection with the change in the anesthesia technique, only light cases of poisoning sometimes occur.

Poisoning manifests itself in the form of the following symptoms: euphoria, motor arousal, difficulty swallowing, dizziness, sharp skin pallor, cold sweat, expansion of pupils, frequent and small pulse.

The phenomena of poisoning is stopped by inhalation of amylnitrite, ingestion of the solution (1: 1000) nitroglycerin (0.5 ml to once), subcutaneous administration Camphi and caffeine. It is especially effective in these cases, by observing a number of authors, intravenous infusion of 5-10 ml of 15% calcium chloride or 2 ml of 10% hexenal, or 10-15 ml of 2% of the penutal.

Another complication of the bronchographic study is the phenomenon of iodism. It is usually observed among individuals who have not been a trial on the sensitivity to iodine.

In some patients after bronchography, there is an increase in temperature in the next 2 days after the study, most of the patients are well tolerating bronchography, and many noted the decrease in sputum release after the study and the disappearance of its bad smell.

Indications for bronchography

The use of bronchography is shown primarily patients with chronic purulent lung diseases.

Signs of bronchiectasis, determined by the usual, non-contrast study, are very unreliable. In the prevailing majority of cases, only a contrast study allows you to establish or eliminate the extension of bronchial extensions.

An equally large value of a bronchographic study when recognizing chronic abscesses. With a conventional x-ray study, detect an abscess cavity is very difficult, since it is often not differentiated among the dimming due to massive infiltrative-in-industrial changes. pulmonary fabric and pleural layers. Under the bronchography of this kind, abscesses are easily filled with a contrasting agent and become clearly visible.

A contrast study in the permissive processes of lungs makes it possible to obtain an accurate idea of \u200b\u200bthe anatomical localization of the process according to the segmental structure of the lungs, which largely contributes to solving the issue of indications and scope of operational intervention.

In the diagnosis of bronchiogenic cancer, bronchography is especially valuable when bronchio is affected, inflowable for inspection by bronchoscope. However, bronchography is not a mandatory study method with lung cancer. In the prevailing majority of cases, a conventional x-ray study, supplemented by tomography, provides convincing data on the presence of a cancer tumor, its topography and prevalence, which in such cases makes it over the use of a contractual research. Bronchography should be resorted only in diagnostically difficult cases. The presence of a bronchogram of Uzura's cast of bronchi, which is a pathognomonic sign light cancerAllows you to configure the correct diagnosis with accuracy.

IN last years Bronchography received use in patients with tuberculosis with fibrous forms In order to diagnose them developing bronchootasis. Some authors recommend using a contrasting x-ray study for the diagnosis of cavity and determining the nature of pleural battles with an ineffective pneumothorax (to solve the issue, it contains a pulmonary fabric or not).

Contraindications to bronchography

Bronchography should not be made from sharply weakened, depleted patients, as well as in high-grade (with body temperature above 38 °).

Bronchography is contraindicated in diseases of the kidneys, decompensated diseases of the heart, active forms of pulmonary tuberculosis and base disease.

The article has prepared and edited: a surgeon doctor

Bronchography

Bronchography - Method of a special X-ray-contrast study, allowing you to get a distinct shadow image of the macrostructure of the tracheobronchial tree. Bronchology allows diagnosing bronchiectases, intricreen tumors, stenosis, obstruction of bronchi by a foreign body, determine the level of lesion localization for subsequent resection. Bronchography is performed by administering the X-ray-contrast substance into the lumen of the changed bronchi through the nasal catheter or the fibroidical bronchoscope with the subsequent series of targeted radiographs. Adult patients bronchography is carried out under local anesthesia, children - confiscated.

Bronchography was first used with a diagnostic purpose in 1918 by the American doctor Jackson. He spent blowing in bronchi bismuth powder. Five years later, Russian doctors Kaplan and Rainberg offered to use iodized poppy oil to contrast. For the introduction of a substance inside the bronchial tree used metal cannula, which significantly simplified the procedure and made it more affordable. Bronchography has been widely used in pulmonology, phthisiatry, oncology and other fields of medicine. In the future, the poppy oil changed the coloring substances of new generations, and the technique of bronchography was significantly improved.

In recent years, in connection with the active development of modern methods of the body survey, bronchography began to gradually go to the background. It became difficult to compete with endoscopy, as well as more informative and safe methods of computer diagnostics (magnetic resonance tomography, etc.). Nevertheless, bronchography is used to this day and in some cases can provide a sufficient amount of information. The main advantage of the study is the possibility of a detailed study of the structure of the entire bronchial tree, including even the smallest bronchi, inaccessible to the review with the help of bronchoscope.

The disadvantages of techniques include a negative effect on the organism of the patient of the ionizing radiation used during the procedure. Raduing load limits the use of research in some categories of patients (pregnant, children, etc.). The frequent assignment of manipulation is also impossible to estimate the dynamics of the process. In addition, bronchography causes a certain discomfort to the patient, and contrasting substances and anesthetics needed to conduct a study are able to cause an allergic reaction in some people.

Indications

The need for bronchography is determined individually after other types of surveys - radiography, bronchoscopy, etc. Bronchography is assigned in the event that the information obtained during other procedures does not allow verify the diagnosis. The main complaints of patients are pronounced shortness of breath (alone or with insignificant physical exertion), the extension of a large amount of sputum, the presence of blood in it or other pathological impurities.

Among the diseases that bronchography reveals, bronchiectatic disease occupies the first place. Bronchiectase is an expansion of the lumen of bronchi, which is most often complicated chronic diseases Breath organs (tuberculosis, pneumonia Ave.). Bronchography is applied to determine the location and size of bronchiectasis, on the basis of these studies, a decision is made to carry out conservative therapy or the need for surgery, a plan of operation is drawn up taking into account the localization of bronchiectasis. The procedure is quite informative in the diagnosis of congenital or acquired anomalies of the development of bronchial wood, malignant and benign neoplasms, consequences of injuries.

Contraindications

There are a number of diseases in which bronchography is categorically contraindicated. These include a myocardial infarction with a prescription of less than 6 months, an acute violation of cerebral circulation (stroke), epilepsy, cranial and brain injury in the acute period, violation of the liver and kidney function. The severe pathology of the respiratory system (pronounced stenosis of the upper respiratory tract, etc.) is also an absolute contraindication to the purpose of the study. Bronchographs do not conduct patients with allergic reactions on substances included in the contrast.

There are relative contraindications to bronchography. The feasibility of using this type of diagnosis in the presence of such contraindications is evaluated by the doctor. These include the aggravation of chronic diseases of the bronchopulmonary system ( bronchial asthma, chronic obstructive bronchitis, bronchiectatic disease), as well as acute inflammatory processes in the field of the upper respiratory tract (tracheitis, laryngitis, pharyngitis), pulmonary bleeding. Bronchology with caution is prescribed to patients with decompensated diabetes and pathology thyroid gland. In the presence of the above diseases, it is better to postpone the study to recovery or stabilization. general status. If it is impossible to delay the procedure, the doctor acts at its discretion, based on a specific clinical situation. As for pregnant women, bronchography during this period is permitted only if there is emergency testimony and not earlier than 20 weeks.

Preparation for bronchography

Before conducting the procedure, the doctor assigns a survey, which includes general blood and urine tests, the definition of the rhesv factor and blood group, coagulogram, ECG, spirometry, organ radiography chest. The need for other diagnostic methods is justified by a specific clinical case. The direction is issued by the attending physician who most often is the therapist, a pulmonologist or a phthisiar. Bronchography does not require special training. In the presence of purulent sputum, drainage is carried out using the appropriate position in bed, the appointment of expectorant and bronighting agents. The patient must abandon meals 8 hours before the study. Immediately before the procedure you need to empty bladder And remove the dental prostheses.

Methodology

Bronchography is performed in a specially equipped room. For the examination, the bronchoscope and X-ray apparatus are used. Bronchography is carried out under local or general anesthesia. In the first case through the mouth or nasal cavity An endoscope is introduced into the respiratory tract, with which anesthetic is first served, and then the coloring agent (iodine-containing preparation or barium suspension). In this case, the patient needs to change the position of the body for a uniform distribution of contrast. The final stage is the execution of a series of pictures in various projections. On this bronchography is considered completed. The patient can take conclusion and manifested radiographic film a few hours after the end of the procedure.

Bronchography is necessary to determine the state of all structures of the bronchial tree. Normally, the main bronchi will be clearly visualized on the radiograph. Right, unlike left, shorter and wide, has a more vertical location. The lumen of the bronchi is gradually narrows as divided into lower order branches. In the course of the bronchi, shadows or cavities filled with contrast should not be detected. When the pathological focus is detected, the X-ray defines its shape, homogeneity, dimensions, intensity of the shadow, clarity of contours. Based on the conclusion of a radiologist, a clinical picture and data of other diagnostic methods, the attending physician can put the final diagnosis and proceed with the treatment of pathology.

The cost of bronchography in Moscow

The cost of the diagnostic technique depends on the set of factors. In particular, this is an emergency for research - a planned procedure is usually cheaper than the urgent. The price of the characteristics of the equipment used is the price - the more modern equipment, the higher the cost of the service. Prices for bronchonia in Moscow are also associated with the form of ownership of a medical institution (private or public) and a specialist qualifications. Since bronchography is always performed using contrast, the cost of the procedure will depend on the type of coloring agent and its quantity, which is calculated taking into account the weight of the patient.

Bronchography is a study of a bronchial tree, in which a contrast substance is introduced into the lumen of the bronchi and make a series of X-ray shots. Today, such highly informative and well-portable methods of diagnosis are available in many clinics, such as computed tomography, and others, therefore, they are relatively rarely resorted to the X-ray-contrast study of the bronchi. IN medical institutionswhere access to the above studies for some reason is limited, bronchography is still applied quite wide.

Let us consider what situations it is necessary to study which categories of patients is contraindicated, whether preparations for bronchography are needed, the methodology for its implementation is needed, the interpretation of the results obtained and the complications of the procedure, which sometimes, but still happen.

The essence of the method, advantages and disadvantages

As mentioned above, the essence of bronchography is to introduce into the lumen of the bronchi contrast agent (iodine-containing or, less often, barium suspension) and the subsequent implementation of X-ray pictures in different projections.

The main plus of this method of diagnosis is the ability to explore the structure of the bronchial tree completely, even the smallest bronchi, inaccessible to the inspection of the bronchoscope.

Bronchograms and disadvantages:

• the study is unparalleled for the patient, requires a local or common (depending on age and some other factors) anesthesia;
• preparations used for diagnostics, in particular, anesthetics and contrasts containing iodine, in a number of patients cause allergies;
• a series of X-ray shots has a sufficiently large radiation burden on the body, it limits the use of the method in some categories of patients (for example, in pregnant women), and also makes it impossible to conduct a frequent study.

Indications

As a rule, bronchography is prescribed when suspected the disease of the bronchi or lungs, which could not be diagnosed with other, more gentle methods of research.

These are:

• symptoms of lung disease (pronounced, large amount of sputum, blood isolation with a mocroid), the reason for which cannot be verified by other diagnostic methods;
• suspected; with a confirmed diagnosis - determination of indications for the operation;
• suspicion of the presence of malfunction of the organs of the bronchology system;
• rapidly growing cavity in the lungs detected on the radiograph;
• suspicion of benign or malignant neoplasm in bronchi or, clarifying its prevalence;
• the upcoming light operation (based on the data of bronchography, the doctor will have a clear idea of \u200b\u200bthe structure of the patient and the peculiarities of the pathological process in them, which means it is more accurate to be determined with the tactics of operational intervention);
• after the operation on the lungs in order to control.

In each particular case, the need to perform bronchography is determined after other diagnostic methods are carried out - light radiography, bronchoscopy, computed tomography and others. If the data obtained using these methods allows you to verify the diagnosis, there is no need for bronchography. And on the contrary, if they rejected the presence of a specific pathological process, it is also not worth looking for it with the help of bronchography.

Contraindications

As the technique of bronchography improves the circle of contraindications to it gradually narrows. So, do not conduct this research method with:

• transferred over the past 6 months;
• heavy;
• heavy;
• acute CMT period;
• epilepsy;
• pronounced stenosis of the upper respiratory tract;
• on anesthetics in history;
• allergic reactions to preparations used for contrast;
• the severe condition of the patient, in which the results of bronchography will not affect the forecast.

These are absolute contraindications in which this method of diagnostics does not apply at all. There are also contraindications relative. These are:

• acute ,;
• the exacerbation of chronic inflammatory process in the lungs (for example, bronchiectatic disease);
• in the stages of exacerbation;
• progressive;
• pulmonary bleeding;
• pregnancy (in emergency cases is permissible to conduct bronchography after the 20th week);
• noncompensated;
• significant increase in thyroid gland.

The feasibility of conducting bronchography in the presence of the above states is evaluated by the doctor. If it is possible, the study is postponed to recovery / stabilize the state of the patient, in the emergency cases - at the discretion of the doctor, based on these specific clinical situations.

Does prepare need

Before the bronchography, the doctor comprehensively examines the patient, and also tells him about the research methodology, the rules for preparing for it and possible complications.

Before performing bronchography, the doctor will hold full examination Patient, including:

• general blood analysis;
• definition of blood group and rhesus factor;
• blood test for coagulation (coagulogram);
• general urine analysis;
• radiography of the chest organs;
• other diagnostic methods, depending on the clinical situation.

A few days before the study, the attending physician will tell the patient about the upcoming procedure, that, why and how to be done. If the patient agrees to the examination, he will sign the appropriate document (in the case when bronchography is necessary for a child, agree or not - parents decide).

A strong cough can prevent diagnosis, so if the patient has such a symptom, it should be reported to a doctor for him to prescribe appropriate treatment.

No special preparatory activities for research are not required. The only one should have an empty stomach - the patient should not take food at least 8 hours before bronchography.

Immediately before the start of the procedure, you should go to the toilet (so that the filled bladder does not prevent complete examination) and remove the dentures if any.

Methodology

Conduct bronchography, as a rule, in the hospital, in a special office, equipped with a table that can be given the desired configuration (so that the patient is in the middleside position), bronchoscope and radiography apparatus. Sterile conditions are observed in the office.

The patient in the diagnostic process does not feel the inconvenience, relaxed.

Research can be conducted under or general anesthesia. In the first case, before it started to the body, the patient introduces bronighting, sedatives (in order to suppress the excitement) drugs and spray in the area of \u200b\u200bthe pharynx anesthetic. In this case, the patient feels numbness treated with fabrics, light nasal congestion, it becomes difficult to swallow the saliva. If there is a need for general anesthesia, or anesthesia (as a rule, to this kind of anesthesia resorts resorted during bronchography for children or persons with mental disordersAs well, if necessary, a combination of several diagnostic methods, for example, bronchography and bronchoscopy), the patient on the nose and mouth is worn by a mask through which a anesthetizing drug is served - the patient falls asleep, the mask is removed, they intubate the trachea.

Bronchoscope is introduced through the mouth or nostril. As it has been promotion, the sensitivity (anesthetic) is fed to respiratory tract, and only then a contrast agent. Sometimes in front of the bronchography is carried out bronchoscopy.

As an x-ray content, use predominantly iodine-containing drugs, and during allergies they are aqueous barium suspension. The lack of the latter is irritation of the mucous membranes and the bronchi and the longer compared to the iodine-containing contrast to eliminate the respiratory tract.

In order for the contrast agent to spread through the mucous membrane of the bronchi walls, evenly filled their lumen, the surveyed give different positions, they ask him to turn it (or the health workers turn it on).

When the contrast is entered and distributed, several X-ray pictures are performed in different projections. After that, they consider the study performed.

Study completed. What's next?

Within 2 hours after the bronchography of a person can disturb discomfort in the larynx and difficulty swallowing. Take food, drink and smoke until these symptoms will be held, not recommended.

The doctor will prescribe a patient special breathing exerciseswhich will accelerate the process of excavation from the respiratory tract of a contrast agent. Sometimes, with the same purpose, it is carried out by postural drainage - put into oblique position, facilitating the destruction of contrast.

What does the doctor appreciate in the pictures

Healthy bronets in the pictures obtained by conducting bronchography, have the right structure:

• the left master armor goes almost horizontally, the right shorter of it, has a larger diameter and directed vertically;
• the diameter of the bronchic of the subsequent order is necessarily less than the previous one (that is, bronchi is narrowed from the center to the periphery);
• filling defects either filled with a contrasting cavity (respectively, stenosis or wall protrusion) are missing.

If a doctor detects any pathological education in bronchi, it should be described as in detail as much as possible: indicate the number of formations, accurate localization (light, share, rib level / vertebra), sizes, shape, density (it is judged on the basis of the intensity of the shadow), Uniformity, clarity contour, smooth or uneven boundaries, as well as mobility, which is determined by observing the localization of the formation when breathing. Based on these data, the specialist will conclude that it is for education, that is, will expose an estimated diagnosis. The final verdict necessarily takes into account clinical picture, results of all laboratory and instrumental, including bronchography, studies, and if necessary, biopsy data.

There are complications

If the bronchoscope traums the mucous membrane of the nose, the patient develops nasal bleeding. It is usually non-hazardous.

In some cases, when carrying out bronchography or shortly after its end, the patient's condition deteriorates. The most common complications are:

• allergic reaction to the contrast agent (the patient feels dizziness, nausea, it has vomiting, tachycardia, blood pressure is reduced, he can lose consciousness);
• bronchospasm (the surveyed suddenly feels an acute shortage of air, a pronounced shortness of breath occurs, cyanosis skin Pokrov);
• bleeding from the nose or hemoptia (if the bronchoscope damages the mucous membrane of the corresponding part of the respiratory tract);
• inflammation of the mucous membrane of the larynx, or laryngitis (as a result mechanical damage mucous membrane or infection);
• the exacerbation of the pathological process, which was carried out by bronchography.

The doctor conducting diagnostics knows about the possibility of developing these states and owns the methodology for their elimination, and they only arise in exceptional cases, therefore there is no reason to worry.

Thank you

The site provides reference information solely to familiarize yourself. Diagnosis and treatment of diseases must be under the supervision of a specialist. All drugs have contraindications. Consultation of a specialist is obligatory!

What is the lung bronchography?

Bronchography - This is a method of x-ray surveys of the lungs, allowing to study the structure of the respiratory tract in detail. The essence of the method lies in the fact that a special contrast agent is introduced into the bronchial tree of a light patient ( usually based on iodine), which is clearly visible on the pulmonary x-ray. This substance fills the respiratory tract, as a result of which they become visible on the X-ray ( what is not observed). The fact is that the respiratory tract ( trachea, bronchi) Does not contain bone tissue. During the usual X-ray study, X-rays are relatively easy to pass through them, as a result of which their structure on the radiograph ( x-ray picture) It is not possible. If before X-ray, enter into light contrast, it will make them "visible" on the x-ray.
With the help of bronchography, you can estimate the state of the trachea, large and small bronchi, as well as reveal pathological changes in the structure of respiratory tract and pulmonary fabric under various diseases.

Bronchoscopy and bronchography are the same thing?

Bronchoscopy and bronchography are two different studies, the technique of execution of which also differs.

The essence of bronchography is that a contrast substance is introduced into the patient's respiratory pathways, after which several X-ray pictures are performed in various projections. At the same time, the essence of bronchoscopy is that the patient's respiratory tract ( through the nose or through the mouth) A special apparatus is introduced - bronchoscope, which is a long flexible tube with a video camera or another optical system at the end. During bronchoscopy, the doctor can visually assess the condition of the mucous membrane of the respiratory tract ( trachea and large bronchi), identify various pathologies ( defects of mucosa, foreign bodies, accumulation of mucus) and perform diagnostic or therapeutic procedures ( remove the foreign body, take the tumor samples, remove the mucus accumulated in the respiratory tract and so on).

What is a symptom of air bronchography?

Symptom of air bronchography is diagnostic criterionused in assessing the results of computer tomography of the lungs. With ordinary bronchography ( research by research) He has nothing to do.

During computer tomography With the help of an X-ray apparatus, rotating around the lungs, get a detailed image of the pulmonary fabric and the bronchi in it. If a pathological process is developing in a certain proportion of light ( for example, pneumonia - inflammation of the lung), the affected area will be displayed on the tomogram as more dense. At the same time, some bronons in the affected area may contain air, as a result of which they will contrast ( stand out) Against the background of compacted lung fabric. This is air bronchography.

Consultation of a specialist in bronchography

How is bronchography?

Bronchography must only be performed by a doctor and only in the hospital. While doing this study Dangerous complications may develop, as a result of which the doctor should have everything necessary to provide emergency medical care to the patient.

Preparation of the patient to bronchography

To reduce the risk of developing complications and get the most informative results, the patient should be properly prepared for the study.

Preparation for bronchography includes:

• Compliance with diet. During the procedure, the patient in the respiratory tract will be introduced special equipment and contrast. At the same time, the mucous membrane of the pharynx will be called, which can provoke vomiting. If food in the patient's stomach will be food, it can lead to the falling masses in the respiratory tract and to the development of formidable, life-threatening complications. That is why the day before the study needs to abandon dinner ( if the procedure is performed in the morning, the patient should not have anything from 5 to 6 pm), And in the morning a day of study, refuse food and water. Also in the morning on the day of research, it is recommended to perform a cleansing enema.
• To give up smoking. Smoking stimulates the excretion of mucus with iron bronchi, as a result of which the lumen is narrowed. This may make it difficult to promote a contrast agent on a bronchial tree and distort the results of the study.
• Hariene oral cavity. In the morning, the teeth should be carefully cleaned before conducting research. This will remove the bacteria accumulated there for the night and prevent them from entering the airways.
• Reception of expectorant drugs. This is necessary if the patient has diseases accompanied by the release of a large amount of sputum ( mucus) In respiratory tract. At the same time, expectorant means will clear the bronchial tree, thereby improving the quality of the study.
• Removal of dentures. If the patient has prostheses that are not attached to the jaw bones ( that is, easily shifted), They should be removed immediately before the start of the procedure so that during the manipulation practiced by the doctor, they did not accidentally fall out and did not fall into the respiratory tract.
• The use of bronchosuming drugs. Bronchorants ( for example, spray Salbutamol) Promote the expansion of the bronchi and facilitate the advancement of contrast through the bronchial tree. As a result, the injected contrast will be held in smaller bronchi, which will improve the quality of the study.

Also before performing the procedure, the patient will have to pass a number of studies to eliminate the presence of pathologies in which bronchography is contraindicated.

Before bronchography should be performed:

• General blood analysis. Allows you to eliminate the presence of sharp infectious diseasesin which the study is contraindicated. In addition, the overall blood test may reveal anemia ( reducing the concentration of hemoglobin and red blood cells transporting oxygen). Heavy anemia is also a contraindication to bronchography, since the process of blood saturation may be disturbed, which will lead to oxygen starvation of the brain cells. At the same time, the patient may lose consciousness or it can develop irreversible brain damage.
• Electrocardiography. Makes it possible to eliminate the presence of severe heart pathology ( for example, myocardial infarction or heart failure).
• Conventional chest radiography in two projections. Gives general information about the state of the lungs and respiratory tract.
• Spirography. The essence of this study consists in measuring the speed and volumes of exhaled air, which gives information about functional state and compensatory lung and respiratory tract capabilities. If the results of spirographs are unsatisfactory, bronchography can be canceled.
• Pulse oximetry. This is a simple study that allows you to estimate how much blood is saturated with oxygen. To study the patient, a small clothespin is superimposed on a finger ( sensor), which after a few seconds issues results. Normally, blood must be saturated with oxygen by 95 - 100%. If this indicator is below 90%, the question of the feasibility and security of bronchography solves the attending physician. If the indicator is below 85%, bronchography is contraindicated.

Anesthesia at bronchography

Purely technically, the procedure can be performed without anesthesia, but all patients can be withstanding it. To eliminate the unpleasant sensations associated with the introduction of equipment and contrast to the respiratory tract, one of the types of anesthesia is applied ( narcosis).

Bronchography can be performed:

• Under local anesthesia. In this case, immediately before the start of the procedure, the patient is introduced into the throat and respiratory pathways ( spraying) Local anesthetic is a drug that blocks nerve endings. In this case, the patient ceases to feel anything in the drug zone. Moreover, anesthetic blocks the cough reflex ( the occurrence of cough when something in the respiratory tract). This allows you to introduce the necessary equipment and contrast to the respiratory tract. At the same time, it is worth noting that the patient remains conscious, sees and understands everything that happens around, which can be associated with certain psychological discomfort. If the patient is too emotional, and also if the bronchography is performed by the child, general anesthesia should be used ( general anesthesia).
• Under general anesthesia. The essence of this procedure is that special drugs are introduced into the patient's body, which temporarily "turn off" his consciousness. The danger of general anesthesia is that the patient can stop breathing. In this case, its respiratory tract introduces a special tube through which artificial ventilation of the lungs will be carried out at the time of the procedure. After general anesthesia, the patient will have to remain in the hospital under the supervision of doctors for at least 1 day ( for prevention and timely elimination possible complications ).

Algorithm for performing selective bronchography

It should be immediately noted that for 1 procedure, bronchography is performed only on the one hand ( that is, the contrast agent is injected into the bronchi of one lung, while the second remains unaffected - this is called selective bronchography). The fact is that if the contrast agent is immediately in both lungs, it will make it difficult for air in them. The patient will immediately begin to choke and may lose consciousness or even die if there is no emergency medical care.
The procedure is performed in a specially equipped room or in the operating room. The patient must be in a position lying on his back or on the side ( at the same time, the impaired light should be below). Most often local anesthesia is applied. For this, the doctor takes a local anesthetic solution ( usually Novocaine) and dripping a few drops to the patient in the nose. In this case, the patient should do a sharp, deep breath, which will allow anesthetic to spread through the mucous membrane of the pharynx and get into the respiratory tract. This manipulation is repeated several times, after which they begin to introduce contrast.

The contrast agent is introduced into the respiratory tract using the bronchoscope under the visual control of the doctor performing the procedure. First, through the nose or through the patient's mouth, a bronchoscope is introduced, which is moving through voice ligaments in the lumen of the trachea, and then to the right or left bronchus ( depending on how easy it is necessary to explore). Next, through a special opening of the bronchoscope, the doctor introduces the contrast, which gradually fills the respiratory tract. As soon as the contrast is introduced, a number of X-ray pictures are performed, which makes it possible to estimate the condition of the bronchial tresh and identify possible pathologies.

After the end of the procedure, the bronchoscope is removed. The contrast agent in the ability to suck from the surveyed lung with a special device ( aspirator). As soon as the anesthesia stop acting ( it usually grabs 20 - 30 minutes), the patient will begin to rejection of the contrast agent itself.

It is worth noting that the contrast can be introduced into the respiratory tract with an ordinary flexible probe ( thin tube with lumen inside). The probe consists of an X-ray-contrast material, as a result of which it should be administered under the control of X-ray radiation ( at the same time, the structure of the chest and the location of the probe doctor is watching the monitor screen in real time). Initially, the probe is introduced into the lumen of the trachea ( through nose) and moves to the place where she ( trachea) It is divided into two main bronchi ( right and left), supplying air right and left light. In this area, many nerve endings responsible for the cough reflex are concentrated. To suppress him, the doctor re-introduces several milliliters of novocaina through the probe, after which the procedure continues. The probe is introduced into the right or left lung, after which a contrast agent is supplied, which gradually fills the respiratory tract. If necessary, the probe can be introduced into smaller bronchi, which will allow to explore only certain parts of the lung. As the respiratory tract is filling, a series of X-rays is performed, which makes it possible to estimate the nature of contrast propagation and the structure of the respiratory tract. After administration of the entire contrast agent, several pictures are also performed ( from different sides), which allows you to identify possible defects of respiratory tract or pulmonary fabric.

When performing a procedure under general anesthesia, the patient is first immersed in a medical sleep, and then carry out the procedure according to the same scheme.

Sommontous double-sided bronchography

The essence of this technique lies in a one-step filling with a water-soluble contrasting agent of respiratory tract at once both lungs. This procedure is extremely dangerous, as it is conjugate with increased risk of respiratory failure ( due to violation of oxygen flow into the body). It is performed only under general anesthesia, and before the introduction of contrast, light patients are ventilated at 100% oxygen for a certain time ( which allows preventing oxygen starvation).

At the same time, it is worth noting that the information content of this study does not differ from that with selective bronchography, as a result of which today simultaneous bilateral bronchography is used extremely rarely.

Bronchography in children

Children can only be used selective ( unilateral) Bronchography. It is performed only under general anesthesia. The technique itself does not differ from those in adults. With the help of bronchoscopy or a special probe into the respiratory tract, a contrast agent is introduced, after which a series of X-ray shots is performed. After the completion of the procedure, the contrast from the respiratory tract of the child is suused, after which the baby from anesthesia is removed. As soon as he wakes up, he will also begin to spil the remnants of contrast to independently.

Indications for bronchography

As mentioned earlier, this study method is designed to assess the condition of the respiratory tract and identifying various pathologies of the respiratory tree. At the same time, it is worth noting that the bronchography procedure is conjugate with certain risks and can cause significant inconvenience to the patient, as a result of which it should be appointed only with the ineffectiveness of others ( more simple) diagnostic methods.

Bronchography can be useful in diagnosing:

Bronchiectatic disease

This pathology is characterized by deformation of small bronchi, as a result of which they expand, turning into peculiar cavities ( bronchiectase). The cavity data is badly ventilated ( or not ventilated at all), as a result of which infection can develop and accumulate pus. In this case, patients complain about a periodically arising cough, accompanied by the release of purulent sputum. In this case, patients may have an increase in body temperature, general weakness, muscle pain and other signs of the infectious process.

Periodically arising cough with purulent wets for a long time ( months or even years) It is an indication for the execution of bronchography. In this x-ray, it will be possible to observe pathologically advanced cylindrical bronons or round shapes, more often in the base of the affected lung.

Cobl

Chronic obstructive lung diseases are a group of pathologies under which a partial narrowing of the lumen of the bronchi is observed ( chronic bronchitis, bronchial asthma and others). At the same time, patients may complain about periodically arising attacks of shortness of breath ( feelings of lack of air) associated with the exacerbation of asthma or bronchitis.

A characteristic feature of COPD is the fact that, as the disease progressing, the lumens of the respiratory tract are becoming increasingly narrow, which is accompanied by an increase in the symptoms of respiratory failure. Bronchology allows you to confirm the diagnosis of COPD ( to identify the narrowed bronchi in almost all of the explored easy) and evaluate the progression of the disease in dynamics, as well as identify possible complications ( for example, bronchiectase).

Lung cancer

Bronchography is not a method of choice in the diagnosis of lung cancer, however, during the study, it is possible to detect characteristic features for this pathology. The fact is that the cancer tumor can germinate in the lumens of the bronchi ( both large and smaller). It will prevent the passage of contrast during the study, which can be noted when studying X-rays.

Tuberculosis

Bronchography will not help in confirmation of the diagnosis, but it is widely used to identify possible complications of this disease.

Patients with tuberculosis bronchography can be assigned:

• When suspected the presence of bronchiectasis. The fact is that in the development of tuberculosis in patients noted coughingwhich can sometimes persist for a long time. During cough, the pressure in the respiratory tract greatly increases, which, in combination with the development of the tuberculosis process, can lead to the deformation of the bronchi and the development of bronchiectasis.
• With cavernous form of the disease. The cavernous form of tuberculosis is characterized by the destruction of certain sections of the lung tissue and the formation of characteristic cavities in their place ( kaverne) filled with purulent masses. Over time, the walls of the cavity are destroyed, as a result of which their contents are allocated through the respiratory tract. Clinically, it can manifest itself a bout of cough, during which a large amount of purulent sputum is distinguished. When carrying out bronchography, the caverns are displayed in the form of incorrectly filled contrast zones in which there are no normal bronets.
• When suspected the presence of bronchial fistula. Svische is a pathological message ( channel), which can be formed between bronchops and pleural cavity ( surrounding light). The reason for this may be the destruction of tissues with a tuberculosis process. If such a fistin exists, the insertion substance will be passed through it and will go into pleural cavityWhat can be noted on x-ray.
• With a dubious diagnosis. If clinical or laboratory studies cause a doctor to doubt the diagnosis, the patient may be appointed bronchography to identify possible concomitant diseases.

Other readings for bronchography

Previously, bronchography was used with most chronic and "incomprehensible" diseases of the lungs when the doctor for a long time could not be diagnosed. After the invention of computed tomography, most of these problems managed to decide, but sometimes bronchography is still prescribed to patients to formulate or clarify the diagnosis.

Bronchography can be assigned:

• With prolonged ( for several months or years) The cough that is not amenable to various methods of treatment.
• With prolonged sputum release ( during coughing or without it).
• With periodically emerging attacks of shortness of breath ( if their cause fails to be installed using simpler examination methods).
• In suspected atelectasis ( freak) Light.
• When offset ( squeezing) Light detected on a conventional radiographic ( may indicate the presence of a tumor or other pathological process).
• For diagnosis congenital anomalies Development of bronchial trees.
• Before the surgical operation ( allows you to identify bronchiectases, clarify the size and localization of the tumor and so on).
• After surgery for assessing bronchial passability near the operating room.

Contraindications to bronchography

As mentioned earlier, this procedure is associated with a number of risks. Consequently, patients for bronchography must be selected and examined very carefully in order to identify contraindications.

Bronchography can be contraindicated:

• With allergies on iodine. As mentioned earlier, the composition of the contrast substance used in the bronchography includes iodine. If the patient has an allergy to iodine, the introduction of contrast into the respiratory tract will lead to a pronounced edema of the mucous membrane of the bronchi and to severe respiratory disorders. Without emergency resuscitation activities, this can lead to the death of a patient in a matter of minutes.

• With severe heart failure. In heart failure, the heart of the patient works very weakly and may not withstand the loads observed during the study. The fact is that at bronchography, the process of oxygen flow into the body is violated ( one light almost "turns off" from breathing for a while). At the same time, in order to satisfy the need of tissues in oxygen, the heart has to pump blood much faster. If a healthy person It will easily take this load, a severe shortness of breath or more terrible complications may develop in a patient with heart failure.
• With severe respiratory failure. This pathology is characterized by a violation of the processes of oxygen flow into the patient's body. If the "turn off" from the respiratory process is one easy, respiratory failure can exacerbate and decompen, which can lead to pronounced shortness, loss of consciousness or even to the death of the patient.
• With an uncontrolled increase arterial pressure. Hypertonic disease ( resistant increase in blood pressure) conjugate with the risk of development of a number of complications ( in particular, infarct, stroke and so on). If at high arterial pressure ( more than 160 - 180/100 millimeters of mercury pillar) Start performing bronchography, it can lead to a more pronounced increase in pressure and development of complications.
• During sharp respiratory infections. With viral or bacterial infection The respiratory tract marks the lesion of the mucous membrane of the trachea and bronchi, its swelling, the allocation of a large amount of mucus and so on. Also, patients enhance the body temperature, there is general weakness, chills and other signs of intoxication of the body. If at the same time try to perform bronchography, it can lead to a deterioration in the patient's condition and the development of acute respiratory failure. Moreover, in conditions of inflamed respiratory tract, the study will not give accurate results.
• With the exacerbation of chronic lung diseases. In this case, the decompensation of the respiratory function of the lungs and respiratory failure can also develop. That is why the study follows no earlier than a few weeks after the relief of exacerbations. chronic bronchitis Or after an attack of bronchial asthma.
• With the pathological narrowing of the respiratory tract. Pathological narrowing ( stenosis) Trachea or large bronchus can be worn both congenital and acquired character ( for example, a narrowing can develop after injuries, ingress of a foreign body in the respiratory tract, after operations and so on). The performance of bronchography with such patients may be complicated by respiratory failure. At the same time, the doctor may experience difficulties in the bronchoscope or probe through the narrowed respiratory tract.
• With severe anemia. As mentioned earlier, anemia is characterized by a decrease in the concentration of blood cells transporting oxygen in the body. If the oxygen delivery is disturbed through the lungs, it may lead to the development of formidable complications ( loss of consciousness, cramps, coma).
• In the third trimester of pregnancy. The implementation of the procedure is associated with the risk of a pronounced increase in blood pressure, the development of allergic reactions, oxygen starvation, and so on. Any of these situations can lead to a disruption of the delivery of oxygen to the fetus and to its damage, which may cause the development of congenital anomalies or even intrauterine death. That is why to carry out the procedure in the late period of pregnancy is strictly contraindicated. On more early time Bronchography can be carried out if the expected benefit from the study exceeds the risks described ( in this case, the need for a study is assessed by the Commission of Doctors).
• With violations of the chopping system. Under normal conditions for damage blood vessel A coagulating blood system is launched, as a result of which the bleeding quickly stops. In diseases associated with insufficient blood coagulation, even the most minor scratch can lead to pronounced and long bleeding. During the introduction of contrast with bronchography, the mucous membrane of the pharynx or trachea can be injured. If the patient has a violation of a blood coagulation system, bleeding can lead to a large amount of blood in the lungs and to the development of respiratory failure.
• In mental disorders. Procedure execution ( under local anesthesia) requires a patient a certain cooperation. If the patient is inadequate and does not give himself a report in his actions, the study will not be able to carry out ( in this case, the possibility of performing bronchography under general anesthesia).

Side effects and complications for bronchography

During the procedure and after it, various complications may develop. Their timely detection and elimination is an important task of the attending physician.

Bronchography may complicate:

• Allergic reactions. When developing the first signs of allergies ( diggers, rapid heartbeat, excitation or loss of consciousness) Immediately terminate the procedure and proceed with urgent assistance ( the introduction of antiallergic drugs, supplying high oxygen concentrations through a mask, if necessary - artificial ventilation of the lungs and so on).

• Bleeding. Bleeding can develop when injury to the mucous membrane of the nasal moves or pharynx during the introduction of the bronchoscope or probe. If the bleeding is intact, you can continue the study. If the bleeding is abundant, it is necessary to interrupt the procedure, prescribe a patient bloodstand, with nasal bleeding - to enter cotton swabs and so on in the nasal moves.
• Laryngospasm. It is an extremely dangerous complication that can develop with insufficient respiratory pain relief. In this case, administration foreign bodies (bronchoscope or probe) The larynx area can lead to a sharp and strong reduction in voice ligaments, which makes it difficult to pass the air through them. The patient's breathing instantly becomes husky or hoarse, fear and panic will be displayed on the face. After a few tens of seconds, the sinusiness of the skin and mucous membranes will appear - dangerous symptomindicating the pronounced lack of oxygen in the body. With a partial laryngospham, you can try to calm the patient, give it to breathe 100% oxygen, introduce bronchievative drugs. In the ineffectiveness of these activities and the deterioration of the patient, it should be introduced into general anesthesia, to appoint Miorosanta ( preparations relaxing all muscles in the body) And connect to the apparatus of artificial respiration.
• Bronchospasm. Also a formidable complication that can develop in response to the introduction of contrast to the respiratory tract. Unlike laryngospasm, with bronchospasm, the lumens of all small brunches are narrowed in both lungs, which leads to a pronounced disorder of the delivery of oxygen into the body. The treatment consists in breathing 100% oxygen, the use of bronchussessing agents, hormonal and non-coronal antiallergic drugs. With their ineffectiveness - the transition to artificial ventilation of the lungs.
• Vomiting and aspiration pneumonia. No less terrible complication, developing as a result of inhalation ( aspiration) Gastric juice in the respiratory tract. Being a strong acid, this juice leads to damage to the respiratory tract and pulmonary fabric, which is accompanied by respiratory failure. That is why it follows the procedure only when the patient's stomach is empty.

After performing bronchography, the patient may be observed:

• Discomfort in the throat after the study. This symptom is associated with the trauma of the mucous membrane with a bronchoscope or probe and usually passes independently within 1 - 2 days.
• Cough. The cough is associated with irritation of the nerve endings of the respiratory tract with a contrast substance, as well as with the injury to the mucous membrane during the procedure. Usually, the cough independently passes to an end of 1 - 2 days after the procedure is performed.
• Hemople ( allocation of blood streaks during coughing). This symptom is also associated with the trauma of the bronchi mucosa during the introduction of contrast. The amount of blood secured is usually small. The hemopling passes independently for 1 day after the procedure.
• Inflammatory diseases of the pharynx. The reason for this may be traumatizing the mucous membrane, as well as the infection of infection with insufficiently high-quality processing of the tools used. At the same time, patients can complain about pain and throat, cough, body temperature increase, general weakness etc. Treatment is to use anti-inflammatory drugs, antibiotics ( when attaching a bacterial infection) etc.

Where to make bronchography?

Bronchography can be made only in large clinics or hospitals, where there are necessary equipment and specialists who know how to conduct a procedure. The cost varies from 1,000 to 16,000 rubles, which is determined by the volume and complexity of the study.

Sign up for bronchography

To make an appointment to a doctor or diagnostics, you just need to call on a single phone number
+7 495 488-20-52 in Moscow

+7 812 416-38-96 in St. Petersburg

The operator listens to you and redirect the call to the desired clinic, or accept an order for writing to the specialist you need.

In Moscow

In St. Petersburg

Name of a medical institution	Address	Telephone
All-Russian Center for Emergency and Radiation Medicine. A.M. Nikiforov	Ul. Academician Lebedeva, house 4/2.	7 (812 ) 607-59-00
Computer tomography center SPb Research Institute of Physiopulmonology	Ligovsky Prospect, House 2/4.	7 (812 ) 579-24-90
FGBU "Consultative and Diagnostic Center with Polyclinic"	Sea Avenue, House 3.	7 (812 ) 325-00-03
City Hospital Saint Rev. Martyr Elizabeth	Ul. Vavilov, house 14.	7 (812 ) 555-13-25
Physiopulmonology Research Institute, Radionuclide Diagnosis Branch	Ul. Polytechnic, house 32.	7 (812 ) 297-54-46

In Krasnoyarsk

In Krasnodar

In Novosibirsk

In Vladivostok

Before use, you must consult with a specialist.