The elderly diagnose that check _'s treatment in bronchiectasis

The elderly diagnose that check _'s treatment in bronchiectasis
Diagnose:As to coughing, coughing the phlegm of suppuration for a long time, there can be the disconnected patient who spat blood in the history repeatedly to and aggravate repeatedly, should consider the possibility of bronchiectasis. Flat block reveals" solicit the double track " in the chest X-ray , ring-type high density shadow or one kind of signs changed of bag, can basically make the clinical diagnosis of bronchiectasis. As to the suspicious patient, chest CT (especially HRCT) Do not have achieving one of the diagnosis means importantly. To the difficult persons who diagnose or consider the conduct surgery, the bronchus radiography of the alternative is still a gold standard diagnosed. Unless is essential for determining the healing solution, seldom consider the conduct chooses the bronchus radiography. Bronchus mirror check can't used in diagnosis, bronchiectasis of disease, to bleed, block position and remove angry way, block, have a benefit clearly; Can also make the bronchus radiography of the alternative through the bronchus mirror. In addition, it can verify whether there is abnormal state of the cilium to live and examine and organize electronic microscopic examination to the bronchus or nasal cavity mucous membrane. The sinus image learns by the nose to check that can define whether the patient of bronchiectasis accompanies sinusitis by the nose, help the cilium not to work up the diagnosis of syndrome,etc.. Other cultivation such as the phlegm or bronchus secretion, can judge the pathogenic microorganism accurately, there is directive significance on choosing to employ antibiotic.
Check in the laboratory:The phlegm slide can be seen the neutral cells of a large number of. , the false form afterbirth fungus of copper green is a common bacterium too. Other still can be seen the golden yellow staphylococcus, anaerobing is and not the branch bacillus of tuberculosis,etc..
Other auxiliary examination:
1. is X-ray flat in chest for slice It is not a peculiar inspection method of bronchiectasis. Bronchiectasis is caused by the fact that the chronic inflammation of bronchus wall causes the tube wall to increase the thick hyperplasia of connective tissue around, shown as the lamination increases, increases thickly and arranging disorderlily in the pathological change district. If there is retention of secretion in the bronchus expanded, take the form of the column to increase thickly, bronchiectasis of the heavier bag can see the curly hair shade distributed on flat sheet along the bronchus, continue, send infect, it can see short and small liquids to be flat in the the intersection of curly hair and shadowing. Because of the intersection of bronchiectasis and quality inflammation accompany often, so with netted to change while the lamination of lung increases. Patient has not obviously unusually changed on the flat sheet of chest general bronchiectasis, also without specificity, have already made the characteristic of seeing the above-mentioned bronchiectasis change, also can't determine the severity of bronchiectasis, property and pathological change range according to this.
2.Lipiodol radiography of bronchus Can make a definite diagnosis of the severity of bronchiectasis, position and range, the type of pathological change, diagnose the most important basis of bronchiectasis, have definite meaning to range that could perform the operation and excise. In order to satisfy radiography and prevent the occurrence of complication, there should be good anaesthesia results while requiring the radiography, enable patient to cooperate well. The difficult cooperation of under the age of 10 children, so unsuitable to do this inspection, sticking consistency just right of lipiodol radiography pharmaceutical, can pour into the 7- 8th bronchus, lipiodol is apt to enter the alveolus when being too rare, it is plentiful and relatively bad to cross the thick thin bronchus, will influence the exactness of reading slice. It is tempered for sulfanilamide for powder should right amount of,it is it sticks that consistency is appropriate not to could make. Bronchus although the intersection of lipiodol and radiography can diagnose, slight to plan, carry on patient that surgery excise to symptom clearly, or estimate pathological change is serious, especially dual side cases, the heart and the complete one of heart and lungs function, unsuitable to do the lipiodol radiography of bronchus, in case that the patient bears unnecessary agony and accident.
3.CT scanning Apply to the clinical high-resolution CT and can diagnose bronchiectasis more accurately in recent years, have the tendency to replace bronchus radiography gradually, the lung CT, to patient and clinical symptom model fit for the bronchus radiography, suspect the patient with a pair of side bronchiectasis, CT can offer the ranges of pathological change and pathological change while checking, synthesize some scholars' report, CT diagnoses the sensitiveness of bronchiectasis is 63.9% - 97.0%, specificity 93%-100%, layer thick to scan high-resolution, scan for 0.5mm or 1.0 thin layer regular to scan easy to find bronchiectasis, the thin layer can reduce the effect shadow of the volume, the high-resolution makes the image clearer, the lung CT can be diagnosed lung section and inferior section of bronchiectasis, less bronchiectasis is difficult to diagnose. The high-resolution CT scans and can reveal 2mm diameter bronchus,
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