Accurate and robust navigation in complex surgical environments is crucial for bronchoscopic surgeries.This study purposes a bronchoscopic lumen feature matching network(BLFM-Net)based on deep learning to address the ...Accurate and robust navigation in complex surgical environments is crucial for bronchoscopic surgeries.This study purposes a bronchoscopic lumen feature matching network(BLFM-Net)based on deep learning to address the challenges of image noise,anatomical complexity,and the stringent real-time requirements.The BLFM-Net enhances bronchoscopic image processing by integrating several functional modules.The FFA-Net preprocessing module mitigates image fogging and improves visual clarity for subsequent processing.The feature extraction module derives multi-dimensional features,such as centroids,area,and shape descriptors,from dehazed images.The Faster RCNN Object detection module detects bronchial regions of interest and generates bounding boxes to localize key areas.The feature matching module accelerates the process by combining detection boxes,extracted features,and a KD-Tree(K-Dimensional Tree)-based algorithm,ensuring efficient and accurate regional feature associations.The BLFM-Net was evaluated on 5212 bronchoscopic images,demonstrating superior performance compared to traditional and other deep learning-based image matching methods.It achieved real-time matching with an average frame time of 6 ms,with a matching accuracy of over 96%.The method remained robust under challenging conditions including frame dropping(0,5,10,20),shadowed regions,and variable lighting,maintaining accuracy of above 94%even with the frame dropping of 20.This study presents BLFM-Net,a deep learning-based matching network designed to enhance and match bronchial features in bronchoscopic images.The BLFM-Net shows improved accuracy,real-time performance,and reliability,making a valuable tool for bronchoscopic surgeries.展开更多
Objective:To analyze the treatment effect of standardized bronchoscopic interventional therapy(i.e.,interventional therapy)on airway stenosis.Methods:Forty patients with airway stenosis admitted to the hospital betwee...Objective:To analyze the treatment effect of standardized bronchoscopic interventional therapy(i.e.,interventional therapy)on airway stenosis.Methods:Forty patients with airway stenosis admitted to the hospital between September 2022 and September 2024 were selected and randomly divided into two groups using a random number table.The experimental group received interventional therapy,while the reference group received conventional treatment.The total effective rate,degree of airway stenosis,shortness of breath score,and lung function indicators were compared.Results:The total effective rate in the experimental group was higher than that in the reference group.The proportion of mild stenosis in the degree of airway stenosis was higher in the experimental group than in the reference group.The shortness of breath score was lower in the experimental group than in the reference group.The lung function indicators were better in the experimental group than in the reference group(P<0.05).Conclusion:Interventional therapy is effective for patients with airway stenosis,as it can reduce the degree of stenosis,improve symptoms of shortness of breath,and protect patients’lung function.展开更多
Objective:Fluoroscopy guidance is generally required for endobronchial ultrasonography with guide sheath(EBUS-GS)in peripheral pulmonary lesions(PPLs).Virtual bronchoscopic navigation(VBN)can guide the bronchoscope by...Objective:Fluoroscopy guidance is generally required for endobronchial ultrasonography with guide sheath(EBUS-GS)in peripheral pulmonary lesions(PPLs).Virtual bronchoscopic navigation(VBN)can guide the bronchoscope by creating virtual images of the bronchial route to the lesion.The diagnostic yield and safety profiles of VBN without fluoroscopy for PPLs have not been evaluated in inexperienced pulmonologist performing EBUS-GS.Methods:Between January 2016 and June 2017,consecutive patients with PPLs referred for EBUS-GS at a single cancer center were enrolled.The diagnostic yield as well as safety profiles was retrospectively analyzed,and our preliminary experience was shared.Results:A total of 109 patients with 109 lesions were included,99(90.8%)lesions were visible on EBUS imaging.According to the procedure time needed to locate the lesion on EBUS,24.8%(27/109)were deemed technically difficult procedures;however,no significant relationships were identified between candidate parameters and technically difficult procedures.The overall diagnosis yield was 74.3%(81/109),and the diagnostic yield of malignancy was 83.7%(77/92).Lesions larger than 20 mm[odds ratio(OR),2.758;95%confidence interval(95%CI),1.077-7.062;P=0.034]and probe of within type(OR,3.174;95%CI,1.151-8.757,P=0.026)were independent factors leading to a better diagnostic yield in multivariate analysis.About 30 practice procedures were needed to achieve a stable diagnostic yield,and the proportion of technically difficult procedures decreased and stabilized after 70 practice procedures.Regarding complications,one patient(0.9%)had intraoperative hemorrhage(100 mL)which was managed under endoscopy.Conclusions:VBN without fluoroscopy guidance is still useful and safe for PPLs diagnosis,especially for malignant diseases when performed by pulmonologist without previous experience of EBUS-GS.VBN may simplify the process of lesion positioning and further multi-center randomized studies are warranted.展开更多
BACKGROUND The advent of molecular targeted agents and immune checkpoint inhibitors has greatly improved the treatment of advanced renal cell carcinoma(RCC), thus significantly improving patient survival. The incidenc...BACKGROUND The advent of molecular targeted agents and immune checkpoint inhibitors has greatly improved the treatment of advanced renal cell carcinoma(RCC), thus significantly improving patient survival. The incidence of rare drug-related adverse events has gained increased attention.CASE SUMMARY We report a patient with advanced RCC treated with multiple lines of molecular targeted agents and immune checkpoint inhibitors, who developed a pulmonary infection after treatment with everolimus in combination with lenvatinib. Determining the pathogenic organism was difficult, but it was eventually identified as Pneumocystis jirovecii by next-generation sequencing(NGS) of bronchoscopic alveolar lavage fluid(BALF) and successfully treated with trimethoprim-sulfamethoxazole.CONCLUSION Rare pulmonary infections caused by molecular targeted agents are not uncommon in clinical practice, but their diagnosis is difficult. Evaluating BALF with NGS is a good method for rapid diagnosis of such infections.展开更多
Objective: Exploration for chronic obstructive pulmonary disease with branched air lumen hamartoma by bronchoscoptic treatment. Material and Method: An old man was referred to our hospital with shortness of breath for...Objective: Exploration for chronic obstructive pulmonary disease with branched air lumen hamartoma by bronchoscoptic treatment. Material and Method: An old man was referred to our hospital with shortness of breath for many years. Clinical evidence emphysema on respiratory examination, lung function and chest X-ray gave rise to concern. He was diagnosed as COPD and treated with ICS + LABA. But the shortness of breath is still existed. Initial assessment by CT suggested a left lower lobe collapse. Then bronchoscope identified a solid abnormality in main left bronchus. The pathology showed a benign neoplasm. Because of intolerance of operation, the patient was treated by brochoscopic intervention. The endoscopic intervention included resection by electrosurgical snare, electrocautery, argon plasma coagulation (APC). Result: After intervention, the neoplasm was partly removed and the pathological result was endobrochial hematoma. After treatment, the patient’s panting had taken a turn for the better. After one month later, the patient’s lung function improved a lot. Conclusion: In conclusion, endobronchial hamartomas are one of benign neoplasms. It can cause persistent bronchial obstruction and recurrent pneumonias. In this case, invasive endoscopic treatment provides an excellent outcome.展开更多
BACKGROUND Takotsubo cardiomyopathy(TTC),a syndrome of acute left ventricular(LV)dysfunction,is characterized by transitory hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.The symptoms o...BACKGROUND Takotsubo cardiomyopathy(TTC),a syndrome of acute left ventricular(LV)dysfunction,is characterized by transitory hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.The symptoms of TTC mimic acute myocardial infarction,without significant coronary stenoses on coronary angiography.Echocardiogram plays a key role in the diagnosis and prognosis of TTC.New indicators from echocardiograms may be helpful in disease evaluation.CASE SUMMARY A 67-year-old man with a 10-year history of non-small cell lung cancer was admitted to our hospital for emerging facial edema and dry cough.Bronchoscopic lavage,brushing,and biopsy were performed to evaluate tumor progression.During this procedure,he complained of left chest pain,nausea,and vomiting,with elevated troponin levels.Electrocardiogram showed sinus bradycardia with ST-segment elevation in I,AVL,and V4 to V6 leads.Coronary angiography revealed mild stenosis in the right coronary artery.Echocardiography showed hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.At the 7-d follow-up,echocardiographic pressure-strain analysis showed a normal LV ejection fraction,but partial recovery of LV myocardial work,which fully recovered 5 mo later.CONCLUSION This is a case of TTC caused by bronchoscopic operation.We strongly recommend noninvasive myocardial work measured by echocardiographic pressure-strain analysis as a necessary supplementary test for the long-term follow-up of TTC.展开更多
Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and par- ticularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in Case lesions are...Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and par- ticularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in Case lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bron- choscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormali- ties undetectable to the naked eye. Methods We retrospectively analyzed 109 cases between January 2008 and December 2012. The in- clusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of visible endobronchial manifestations, brushing, and bronchoalveolar lavage （BAL） according to the images obtained from high-resolution computed tomography （HRCT）. Data regarding age, sex, pathology, tumor stage; the method of diagnosis; location of primary lesion （central, peripheral, or intermediate）; tumor size, mediastinal lymph node metastasis, and the serum carcinoembryonic antigen （CEA） value were collected. The Pearson chi-square test or Fisher＇s exact and McNemar tests were used in the univadate analysis. Results Among the 109 patients, the diagnosis of 37 （33.9%） patients was confirmed through bronchos- copy. Brushing and BAL had higher positive detection rates than biopsy （P = 0.004）. There were no differ- ences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node metastasis, and the serum CEA value （P〈 0.05 for all groups）. Conclusion Despite the normal appearance of the endobronchial manifestations, lesions undetectable by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that brushing and BAL might increase the positive detection rate of bronchoscepic examination.展开更多
Objective:To study the effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection.Methods:100 patients with bronchiectasis complicated by i...Objective:To study the effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection.Methods:100 patients with bronchiectasis complicated by infection who were treated in our hospital between May 2012 and January 2016 were divided into the control group (n=54) who received conventional treatment and the observation group (n=46) who received intravenous anti-infection combined with bronchoscopic ambroxol lavage after the therapies were reviewed. The contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were compared between the two groups.Results: Before treatment, the differences in contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were not statistically significant between two groups of patients. After treatment, inflammatory factors IL-4, IL-6, IL-10 and TNF-α contents in lavage fluid of observation group were lower than those of control group;adhesion molecules sICAM-1 and VCAM-1 contents in lavage fluid were lower than those of control group;acute phase proteins CRP, AAG, HPT and CER contents in lavage fluid were lower than those of control group.Conclusion:Bronchoscopic ambroxol lavage can reduce airway inflammation in patients with bronchiectasis complicated by infection.展开更多
BACKGROUND Primary tracheobronchial mucoepidermoid carcinoma(MEC),derived from salivary mucus glands,is an uncommon neoplasm in adults.At present,surgery is still the preferred treatment for adult bronchial MEC,althou...BACKGROUND Primary tracheobronchial mucoepidermoid carcinoma(MEC),derived from salivary mucus glands,is an uncommon neoplasm in adults.At present,surgery is still the preferred treatment for adult bronchial MEC,although it may cause significant trauma and loss of lung function.Here,we report a patient with endobronchial MEC who received the interventional bronchoscopic therapy to remove the neoplasm and no recurrence occurred during follow-up.CASE SUMMARY A 28-year-old man was admitted to our unit with mild hemoptysis for 3 d.Physical examination did not show any abnormal signs,and the serological indexes were all in the normal range.Chest computed tomography(CT)indicated an intraluminal nodule in the bronchus intermedius with homogeneous density and a well-defined margin.Upon fiberoptic bronchoscopy,an endobronchial pedunculated polypoid was discovered without submucosal involvement.As the neoplasm was confined to the bronchus,interventional bronchoscopy was performed to remove the mass by high-frequency electric knife and laser resection.Tissue was sampled and histopathological examination confirmed the diagnosis of low-grade MEC.As the proliferation index was low,no further treatment was given.During 2 years of follow-up,the patient’s condition was good and no relapse was discovered under fluorescence bronchoscopy or CT scan.CONCLUSION Interventional bronchoscopy can be considered for treatment of low-grade bronchial MEC,with few complications and preserved lung function.展开更多
BACKGROUND End-stage chronic obstructive pulmonary disease(COPD)is one of the common lung diseases referred for lung transplantation.According to the international society of heart and lung transplantation,30%of all l...BACKGROUND End-stage chronic obstructive pulmonary disease(COPD)is one of the common lung diseases referred for lung transplantation.According to the international society of heart and lung transplantation,30%of all lung transplantations are carried out for COPD alone.When compared to bilateral lung transplant,singlelung transplant(SLT)has similar short-term and medium-term results for COPD.For patients with severe upper lobe predominant emphysema,lung volume reduction surgery is an excellent alternative which results in improvement in functional status and long-term mortality.In 2018,endobronchial valves were approved by the Food and Drug Administration for severe upper lobe predominant emphysema as they demonstrated improvement in lung function,exercise capacity,and quality of life.However,the role of endobronchial valves in native lung emphysema in SLT patients has not been studied.CASE SUMMARY We describe an unusual case of severe emphysema who underwent a successful SLT 15 years ago and had gradual worsening of lung function suggestive of chronic lung allograft dysfunction.However,her lung function improved significantly after a spontaneous pneumothorax of the native lung resulting in auto-deflation of large bullae.CONCLUSION This case highlights the clinical significance of native lung hyperinflation in single lung transplant recipient and how spontaneous decompression due to pneumothorax led to clinical improvement in our patient.展开更多
Objective: to explore the application value of whole-course nursing in the treatment of pneumoconiosis patients with whole lung lavage by bronchoscope. Methods: 30 patients with pneumoconiosis admitted to our hospital...Objective: to explore the application value of whole-course nursing in the treatment of pneumoconiosis patients with whole lung lavage by bronchoscope. Methods: 30 patients with pneumoconiosis admitted to our hospital from January 2017 to January 2022 were selected as the research object. According to the implementation of the nursing plan, they were divided into the whole-course group and the routine group, with 15 patients in each group. The lung function, arterial blood oxygen partial pressure index, postoperative recovery and psychological state of the two groups were compared. Results: the comparison of pulmonary function and arterial oxygen partial pressure index before treatment between the whole course group and the conventional group had statistical significance (P > 0.05). After treatment, it was better than before, and the whole course group was better than the control group (p < 0.05). Compared with the control group, the ambulation time, extubation time and hospitalization time of the whole group were lower. Compared with the conventional group, the pain score was higher (p < 0.05). Compared with the normal group, the psychological state score was higher (p < 0.05). Conclusion: during the period of treating pneumoconiosis with bronchoscope whole lung large volume lavage, complete nursing can improve the disease index of patients, accelerate the recovery of patients' symptoms, and reduce patients' negative emotions.展开更多
Objective:To observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.Methods:A total of 60 patients undergoing painless...Objective:To observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.Methods:A total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group,30 cases in each one.In the wrist-ankle acupuncture group,wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room.In the control group,no any intervention was provided.The patients in two groups all received venous administration of midazolam,nalorphine and lidocaine and target controlled infusion of propofol.When the patient’s consciousness was lost and the eyelash reflex disappeared,bronchoscopy was performed and the propofol dosage was increased accordingly during operation.Propofol dosage,vital signs and occurrence of adverse reactions,bronchoscopist satisfaction,operation time and recovering time were recorded in the patients of two groups.Results:Propofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group,indicating the statistical differences(both P<0.05).The vital signs were stable during bronchoscopy in patients of two groups.The occurrence rates of hypoxemia and choking in the wrist-ankle acupuncture groups were lower than those in the control group,indicating the statistical differences(both P <0.05).Bronchoscopist satisfaction in the wrist-ankle acupuncture group was higher than that of the control group,and the operation time and recovering time were lower than the control group,indicating the statistical differences(all P<0.05).Conclusion:In painless bronchoscopy,wrist-ankle acupuncture may effectively reduce propofol dosage,alleviate respiratory suppression,reduce adverse reaction and shorten the recovering time in elderly patients.展开更多
Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operat...Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operator needs to be in close proximity to the patient’s face during the procedure,which increases the risk of droplet exposure.Therefore,we simulated fiberoptic endotracheal intubation on a mannequin representing the patient,using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope,in order to maintain distance from the patient during the procedure.We performed this procedure 10 times and measured the time required;the median procedure time was 6.4 s(interquartile range,5.7-8.1 s).The advantage of this method is the short procedure time and distance maintained from the patients.The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients.In addition,this method can handle difficult airways without risk of misplacement of the endotracheal tube.However,it is necessary to consider the risk of aerosol generation associated with this procedure.In the pandemic setting of coronavirus disease 2019,this approach may be useful when a gastrointestinal endoscopist is in charge of endotracheal intubation of patients with coronavirus disease 2019.展开更多
Objective: To investigate the effect of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia. Methods: From January 2017 to...Objective: To investigate the effect of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia. Methods: From January 2017 to June 2018, 82 patients with severe pneumonia were randomly divided into observation group and control group (all 41 cases). Patients in the control group received conventional anti-infective treatment, and the observation group was treated with fiberoptic bronchoscopy combined with mucosolvan on the basis of the control group. Respiratory function, inflammatory response and stress status were compared between the two groups. Results: Before treatment, there was no significant difference in Cdyn, WOB and PaO2/FiO2 between the two groups. After treatment, Cdyn and PaO2/FiO2 in the observation group were (36.28±4.28) mL/cmH2O and (376.23±24.21) mmHg respectively, while those in the control group were (26.89±3.76) mL/cmH2O and (322.12±23.16) mmHg, respectively. The levels of Cdyn and PaO2/FiO2 in the observation group were higher than those in the control group. After treatment, the WOB in the observation group was (7.81±0.72) J/L, and the WOB in the control group was (8.33±1.23) J/L. WOB of both groups was lower than that before treatment, and in observation group WOB was lower than that of control group, the difference was statistically significant. In CRP, PCT and sTREM-1 levels, there was no significant difference between the two groups before treatment. After treatment, CRP, PCT and sTREM-1 in the observation group were (39.10±6.03) mg/L, (14.57±2.05) ng/L, (15.02±3.02) ng/L respectively, while those in the control group were (59.72±8.81) mg/L, (20.03±3.09) ng/L, (34.21±5.28) ng/L, respectively. CRP, PCT, sTREM-1 in both groups were lower than those before treatment, and CRP, PCT, sTREM-1 in observation group were lower than those in control group. Before treatment, there was no significant difference with Cor, Ang-I and Ang-II in two groups. After treatment, the levels of Cor, Ang-I and Ang-II in the observation group were (114.76±15.85) ng/mL, (6.72±0.64) ng/mL, (27.28±3.43) ng/mL respectively, while those in the control group were (193.15±22.64) ng/mL, (12.10±1.68) ng/mL, (43.02±5.57) ng/mL, respectively. In the observation group, the levels of Cor, Ang-I and Ang-II were lower than those in the control group. Conclusion: Mucosolvan combined with fiberoptic bronchoscopy can effectively improve the respiratory function of patients with severe pneumonia, and reduce inflammation and stress state of the body.展开更多
Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection....Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection.Methods:A total of 78 patients with lung cancer who received surgical treatment in our hospital between August 2013 and January 2015 and were with postoperative infection were selected as the research subjects and randomly divided into two groups, control group received mechanical ventilation therapy, observation group received bronchoalveolar lavage by bronchoscope combined with mechanical ventilation, and the inflammatory factor levels, RAAS system activity and respiratory mechanics indexes of two groups were determined after treatment.Results:3 d after treatment, serum hs-CRP, TNF-α, IL-8, PCT, renin, angiotensin II and aldosterone levels of observation group were lower than those of control group, and PIP, Raw and WOB values were lower than those of control group while Cdyn value was higher than that of control group.Conclusion:For lung cancer patients with postoperative pulmonary infection, bronchoalveolar lavage by bronchoscope combined with mechanical ventilation can optimize patients' condition, relieve systemic inflammatory response and improve respiratory function, and it has positive clinical significance.展开更多
Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe p...Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.展开更多
Objective To evaluate the diagnostic value of transbronchial lung biopsy(TBLB)via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions.Methods The results of TBLB were retrospectively analyzed from 2...Objective To evaluate the diagnostic value of transbronchial lung biopsy(TBLB)via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions.Methods The results of TBLB were retrospectively analyzed from 256 diagnoses of unknown patients with lung diffuse lesions or peripheral lung lesions.Results Eighty-nine final diagnosis cases via TBLB only once,the diagnostic rate of double lung diffuse lesions was the highest,[51.06%(24/47)],local non-nodule lesions,nodule lesions,cavity lesions were 33.33%(23/69),29.91%(35/117),and 28.57%(4/14),respectively.Among 24 diagnostic cases of double lung diffuse lesions,there were 6 cases of pneumonia of pulmonary tuberculosis,9 cases of lung carcinoma,7 cases of adenocarcinoma;6 cases of pneumonia,2 cases of fungous infection,and 1 case of lung hemosiderosis.The diagnostic yield about 58 cases of local lesions was low,among which non-nodule lesions accounted for 33.33% and nodule lesions accounted for 29.91%.In 89 cases of peripheral lung lesions with histological diagnosis,lung carcinoma and pulmonary tuberculosis were frequent diseases,which accounted for 86.52%.Conclusion TBLB is a reliable,safe,effective and repeatable operation method in diagnosis of lung diffuse lesions and peripheral pulmonary lesions.展开更多
Objective:Placement of self expanding metallic stents(SEMS) is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope.There have been few reports published on use o...Objective:Placement of self expanding metallic stents(SEMS) is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope.There have been few reports published on use of flexible bronchoscope(FB) for the removal.This article summarizes the indications,methods and complications of SEMS removal by FB.Methods:We reviewed our experience with removal of SEMS using FB retrospectively.The clinical data on 29 patients with average age of(39.0±13.2) years was analyzed who underwent removal of SEMS using FB between April 2002 and August 2008.Results:Thirty-seven procedures were performed in 29 consecutive patients to remove 37 stents.The average duration of stent placement was(55± 94.7) d(0-472 d).Twenty-two procedures(59.4%) were performed under local anesthesia.The percentage of procedures under general anesthesia was 13%(3/24),67%(4/6) and 100%(7/7) for the short-term(≤30 d),medium-term(31-90 d) and long-term(>90 d) of stents placement,respectively.Indications for stents removal included migration in 15(40.6%),scar restenosis in 11(29.7%),airway shaping in 5(13.5%),stent fracture in 2(5.4%),stent incomplete expansion in 2(5.4%),improper size in 1(2.7%),mucus plugging with chest pain in 1(2.7%).And 85.7% of long-term stents were removed due to scar restenosis.The total success rate was 92%.There was no significant difference in success rate between the uncovered and covered group(82.3% and 100%,P>0.05).Complications were encountered in 13 patients,bleeding being the most common(53.8%).Conclusion:Operation by FB may be an alternative method to remove SEMS effectively and safely based on the proper anesthesia chosen.展开更多
Objective In order to achieve immediate relief of central airway obstruction caused by malignant tumor after interventional therapy, we observed the efficacy and safety of cryorecanalization after cryosurgery via fle...Objective In order to achieve immediate relief of central airway obstruction caused by malignant tumor after interventional therapy, we observed the efficacy and safety of cryorecanalization after cryosurgery via flexible bronchoscope.展开更多
Background and Aims： Since our rural institution has liamted resources we always choose econoamcal options. Recently, indigenous technique of pleuroscopy is gaining popularity due to various advantages. We developed ...Background and Aims： Since our rural institution has liamted resources we always choose econoamcal options. Recently, indigenous technique of pleuroscopy is gaining popularity due to various advantages. We developed indigenous technique of medical thoracoscopy has been developed and done by using set of patented conduits and fiberoptic bronchoscope （FOB）.Therefore, we have used this technique for undiagnosed pleural effusions. Methods： An observational study was conducted in 79 undiagnosed cases of exudative pleural effusion from June 2016 to Jmmary 2017. Indigenous technique consists of use of fiber optic bronchoscope through various metallic conduits to be used in specified order for medical thoracoscopy. Procedure is done under conscious sedation and conduits are passed one after another in a specified order, through the chest stoma. The visualization of pleural cavity and various procedures were done with FOB （fiberoptic bronchoscope）. Results： Out of the 79 cases, the appearance of pleura showed, inflamed/reddened pleura in 16 （20.2%） cases, thin transparent adhesions in 18 （22.7%）, thin transparent loculations in 16 （20.2%） cases, thick loculations in 6 （7.6%） cases, hard pleural surface in 5 （6.3%）, large nodule/masses in 6 （7.6%）, small amlliary seedlings or sago grain appeoxmlce in 6 （7.6%）, scattered masses or nodules in 5 （6.3%） and, broncho-pleural fistula was observed in 1 （1.2%） case. Histopathological analysis showed chronic inflammation in 34.1% （27）, tubercular lesions in 24.05% （19） of patients. Primary aspergillosis and mesothelioma each has 1 case, and the rest 29.11% （23） were pleural metastasis. Thus, diagnostic yield of pleuroscopy pleural biopsy was 89.9% （71）. Conclusion： Indigenous technique appears to be an efficient and relatively safe procedure with good diagnostic yield in undiagnosed pleural effusions.展开更多
基金funded by the National Natural Science Foundation of China(Grant No.52175028).
文摘Accurate and robust navigation in complex surgical environments is crucial for bronchoscopic surgeries.This study purposes a bronchoscopic lumen feature matching network(BLFM-Net)based on deep learning to address the challenges of image noise,anatomical complexity,and the stringent real-time requirements.The BLFM-Net enhances bronchoscopic image processing by integrating several functional modules.The FFA-Net preprocessing module mitigates image fogging and improves visual clarity for subsequent processing.The feature extraction module derives multi-dimensional features,such as centroids,area,and shape descriptors,from dehazed images.The Faster RCNN Object detection module detects bronchial regions of interest and generates bounding boxes to localize key areas.The feature matching module accelerates the process by combining detection boxes,extracted features,and a KD-Tree(K-Dimensional Tree)-based algorithm,ensuring efficient and accurate regional feature associations.The BLFM-Net was evaluated on 5212 bronchoscopic images,demonstrating superior performance compared to traditional and other deep learning-based image matching methods.It achieved real-time matching with an average frame time of 6 ms,with a matching accuracy of over 96%.The method remained robust under challenging conditions including frame dropping(0,5,10,20),shadowed regions,and variable lighting,maintaining accuracy of above 94%even with the frame dropping of 20.This study presents BLFM-Net,a deep learning-based matching network designed to enhance and match bronchial features in bronchoscopic images.The BLFM-Net shows improved accuracy,real-time performance,and reliability,making a valuable tool for bronchoscopic surgeries.
文摘Objective:To analyze the treatment effect of standardized bronchoscopic interventional therapy(i.e.,interventional therapy)on airway stenosis.Methods:Forty patients with airway stenosis admitted to the hospital between September 2022 and September 2024 were selected and randomly divided into two groups using a random number table.The experimental group received interventional therapy,while the reference group received conventional treatment.The total effective rate,degree of airway stenosis,shortness of breath score,and lung function indicators were compared.Results:The total effective rate in the experimental group was higher than that in the reference group.The proportion of mild stenosis in the degree of airway stenosis was higher in the experimental group than in the reference group.The shortness of breath score was lower in the experimental group than in the reference group.The lung function indicators were better in the experimental group than in the reference group(P<0.05).Conclusion:Interventional therapy is effective for patients with airway stenosis,as it can reduce the degree of stenosis,improve symptoms of shortness of breath,and protect patients’lung function.
基金This study was supported by Beijing Municipal Hospital Scientific Research Cultivation Program(No.PX2016057).We thank Xiaoping Kang for her help in data analysis.
文摘Objective:Fluoroscopy guidance is generally required for endobronchial ultrasonography with guide sheath(EBUS-GS)in peripheral pulmonary lesions(PPLs).Virtual bronchoscopic navigation(VBN)can guide the bronchoscope by creating virtual images of the bronchial route to the lesion.The diagnostic yield and safety profiles of VBN without fluoroscopy for PPLs have not been evaluated in inexperienced pulmonologist performing EBUS-GS.Methods:Between January 2016 and June 2017,consecutive patients with PPLs referred for EBUS-GS at a single cancer center were enrolled.The diagnostic yield as well as safety profiles was retrospectively analyzed,and our preliminary experience was shared.Results:A total of 109 patients with 109 lesions were included,99(90.8%)lesions were visible on EBUS imaging.According to the procedure time needed to locate the lesion on EBUS,24.8%(27/109)were deemed technically difficult procedures;however,no significant relationships were identified between candidate parameters and technically difficult procedures.The overall diagnosis yield was 74.3%(81/109),and the diagnostic yield of malignancy was 83.7%(77/92).Lesions larger than 20 mm[odds ratio(OR),2.758;95%confidence interval(95%CI),1.077-7.062;P=0.034]and probe of within type(OR,3.174;95%CI,1.151-8.757,P=0.026)were independent factors leading to a better diagnostic yield in multivariate analysis.About 30 practice procedures were needed to achieve a stable diagnostic yield,and the proportion of technically difficult procedures decreased and stabilized after 70 practice procedures.Regarding complications,one patient(0.9%)had intraoperative hemorrhage(100 mL)which was managed under endoscopy.Conclusions:VBN without fluoroscopy guidance is still useful and safe for PPLs diagnosis,especially for malignant diseases when performed by pulmonologist without previous experience of EBUS-GS.VBN may simplify the process of lesion positioning and further multi-center randomized studies are warranted.
文摘BACKGROUND The advent of molecular targeted agents and immune checkpoint inhibitors has greatly improved the treatment of advanced renal cell carcinoma(RCC), thus significantly improving patient survival. The incidence of rare drug-related adverse events has gained increased attention.CASE SUMMARY We report a patient with advanced RCC treated with multiple lines of molecular targeted agents and immune checkpoint inhibitors, who developed a pulmonary infection after treatment with everolimus in combination with lenvatinib. Determining the pathogenic organism was difficult, but it was eventually identified as Pneumocystis jirovecii by next-generation sequencing(NGS) of bronchoscopic alveolar lavage fluid(BALF) and successfully treated with trimethoprim-sulfamethoxazole.CONCLUSION Rare pulmonary infections caused by molecular targeted agents are not uncommon in clinical practice, but their diagnosis is difficult. Evaluating BALF with NGS is a good method for rapid diagnosis of such infections.
文摘Objective: Exploration for chronic obstructive pulmonary disease with branched air lumen hamartoma by bronchoscoptic treatment. Material and Method: An old man was referred to our hospital with shortness of breath for many years. Clinical evidence emphysema on respiratory examination, lung function and chest X-ray gave rise to concern. He was diagnosed as COPD and treated with ICS + LABA. But the shortness of breath is still existed. Initial assessment by CT suggested a left lower lobe collapse. Then bronchoscope identified a solid abnormality in main left bronchus. The pathology showed a benign neoplasm. Because of intolerance of operation, the patient was treated by brochoscopic intervention. The endoscopic intervention included resection by electrosurgical snare, electrocautery, argon plasma coagulation (APC). Result: After intervention, the neoplasm was partly removed and the pathological result was endobrochial hematoma. After treatment, the patient’s panting had taken a turn for the better. After one month later, the patient’s lung function improved a lot. Conclusion: In conclusion, endobronchial hamartomas are one of benign neoplasms. It can cause persistent bronchial obstruction and recurrent pneumonias. In this case, invasive endoscopic treatment provides an excellent outcome.
文摘BACKGROUND Takotsubo cardiomyopathy(TTC),a syndrome of acute left ventricular(LV)dysfunction,is characterized by transitory hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.The symptoms of TTC mimic acute myocardial infarction,without significant coronary stenoses on coronary angiography.Echocardiogram plays a key role in the diagnosis and prognosis of TTC.New indicators from echocardiograms may be helpful in disease evaluation.CASE SUMMARY A 67-year-old man with a 10-year history of non-small cell lung cancer was admitted to our hospital for emerging facial edema and dry cough.Bronchoscopic lavage,brushing,and biopsy were performed to evaluate tumor progression.During this procedure,he complained of left chest pain,nausea,and vomiting,with elevated troponin levels.Electrocardiogram showed sinus bradycardia with ST-segment elevation in I,AVL,and V4 to V6 leads.Coronary angiography revealed mild stenosis in the right coronary artery.Echocardiography showed hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.At the 7-d follow-up,echocardiographic pressure-strain analysis showed a normal LV ejection fraction,but partial recovery of LV myocardial work,which fully recovered 5 mo later.CONCLUSION This is a case of TTC caused by bronchoscopic operation.We strongly recommend noninvasive myocardial work measured by echocardiographic pressure-strain analysis as a necessary supplementary test for the long-term follow-up of TTC.
文摘Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and par- ticularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in Case lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bron- choscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormali- ties undetectable to the naked eye. Methods We retrospectively analyzed 109 cases between January 2008 and December 2012. The in- clusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of visible endobronchial manifestations, brushing, and bronchoalveolar lavage （BAL） according to the images obtained from high-resolution computed tomography （HRCT）. Data regarding age, sex, pathology, tumor stage; the method of diagnosis; location of primary lesion （central, peripheral, or intermediate）; tumor size, mediastinal lymph node metastasis, and the serum carcinoembryonic antigen （CEA） value were collected. The Pearson chi-square test or Fisher＇s exact and McNemar tests were used in the univadate analysis. Results Among the 109 patients, the diagnosis of 37 （33.9%） patients was confirmed through bronchos- copy. Brushing and BAL had higher positive detection rates than biopsy （P = 0.004）. There were no differ- ences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node metastasis, and the serum CEA value （P〈 0.05 for all groups）. Conclusion Despite the normal appearance of the endobronchial manifestations, lesions undetectable by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that brushing and BAL might increase the positive detection rate of bronchoscepic examination.
文摘Objective:To study the effect of bronchoscopic ambroxol lavage on inflammatory factors in lavage fluid of patients with bronchiectasis complicated by infection.Methods:100 patients with bronchiectasis complicated by infection who were treated in our hospital between May 2012 and January 2016 were divided into the control group (n=54) who received conventional treatment and the observation group (n=46) who received intravenous anti-infection combined with bronchoscopic ambroxol lavage after the therapies were reviewed. The contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were compared between the two groups.Results: Before treatment, the differences in contents of inflammatory factors, adhesion molecules and acute phase proteins in lavage fluid were not statistically significant between two groups of patients. After treatment, inflammatory factors IL-4, IL-6, IL-10 and TNF-α contents in lavage fluid of observation group were lower than those of control group;adhesion molecules sICAM-1 and VCAM-1 contents in lavage fluid were lower than those of control group;acute phase proteins CRP, AAG, HPT and CER contents in lavage fluid were lower than those of control group.Conclusion:Bronchoscopic ambroxol lavage can reduce airway inflammation in patients with bronchiectasis complicated by infection.
基金Supported by the National Natural Science Foundation of China,No.81870018.
文摘BACKGROUND Primary tracheobronchial mucoepidermoid carcinoma(MEC),derived from salivary mucus glands,is an uncommon neoplasm in adults.At present,surgery is still the preferred treatment for adult bronchial MEC,although it may cause significant trauma and loss of lung function.Here,we report a patient with endobronchial MEC who received the interventional bronchoscopic therapy to remove the neoplasm and no recurrence occurred during follow-up.CASE SUMMARY A 28-year-old man was admitted to our unit with mild hemoptysis for 3 d.Physical examination did not show any abnormal signs,and the serological indexes were all in the normal range.Chest computed tomography(CT)indicated an intraluminal nodule in the bronchus intermedius with homogeneous density and a well-defined margin.Upon fiberoptic bronchoscopy,an endobronchial pedunculated polypoid was discovered without submucosal involvement.As the neoplasm was confined to the bronchus,interventional bronchoscopy was performed to remove the mass by high-frequency electric knife and laser resection.Tissue was sampled and histopathological examination confirmed the diagnosis of low-grade MEC.As the proliferation index was low,no further treatment was given.During 2 years of follow-up,the patient’s condition was good and no relapse was discovered under fluorescence bronchoscopy or CT scan.CONCLUSION Interventional bronchoscopy can be considered for treatment of low-grade bronchial MEC,with few complications and preserved lung function.
文摘BACKGROUND End-stage chronic obstructive pulmonary disease(COPD)is one of the common lung diseases referred for lung transplantation.According to the international society of heart and lung transplantation,30%of all lung transplantations are carried out for COPD alone.When compared to bilateral lung transplant,singlelung transplant(SLT)has similar short-term and medium-term results for COPD.For patients with severe upper lobe predominant emphysema,lung volume reduction surgery is an excellent alternative which results in improvement in functional status and long-term mortality.In 2018,endobronchial valves were approved by the Food and Drug Administration for severe upper lobe predominant emphysema as they demonstrated improvement in lung function,exercise capacity,and quality of life.However,the role of endobronchial valves in native lung emphysema in SLT patients has not been studied.CASE SUMMARY We describe an unusual case of severe emphysema who underwent a successful SLT 15 years ago and had gradual worsening of lung function suggestive of chronic lung allograft dysfunction.However,her lung function improved significantly after a spontaneous pneumothorax of the native lung resulting in auto-deflation of large bullae.CONCLUSION This case highlights the clinical significance of native lung hyperinflation in single lung transplant recipient and how spontaneous decompression due to pneumothorax led to clinical improvement in our patient.
文摘Objective: to explore the application value of whole-course nursing in the treatment of pneumoconiosis patients with whole lung lavage by bronchoscope. Methods: 30 patients with pneumoconiosis admitted to our hospital from January 2017 to January 2022 were selected as the research object. According to the implementation of the nursing plan, they were divided into the whole-course group and the routine group, with 15 patients in each group. The lung function, arterial blood oxygen partial pressure index, postoperative recovery and psychological state of the two groups were compared. Results: the comparison of pulmonary function and arterial oxygen partial pressure index before treatment between the whole course group and the conventional group had statistical significance (P > 0.05). After treatment, it was better than before, and the whole course group was better than the control group (p < 0.05). Compared with the control group, the ambulation time, extubation time and hospitalization time of the whole group were lower. Compared with the conventional group, the pain score was higher (p < 0.05). Compared with the normal group, the psychological state score was higher (p < 0.05). Conclusion: during the period of treating pneumoconiosis with bronchoscope whole lung large volume lavage, complete nursing can improve the disease index of patients, accelerate the recovery of patients' symptoms, and reduce patients' negative emotions.
基金Supported by Scientific Research Program of Hebei Administration of Traditional Chinese Medicine:2020006。
文摘Objective:To observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.Methods:A total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group,30 cases in each one.In the wrist-ankle acupuncture group,wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room.In the control group,no any intervention was provided.The patients in two groups all received venous administration of midazolam,nalorphine and lidocaine and target controlled infusion of propofol.When the patient’s consciousness was lost and the eyelash reflex disappeared,bronchoscopy was performed and the propofol dosage was increased accordingly during operation.Propofol dosage,vital signs and occurrence of adverse reactions,bronchoscopist satisfaction,operation time and recovering time were recorded in the patients of two groups.Results:Propofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group,indicating the statistical differences(both P<0.05).The vital signs were stable during bronchoscopy in patients of two groups.The occurrence rates of hypoxemia and choking in the wrist-ankle acupuncture groups were lower than those in the control group,indicating the statistical differences(both P <0.05).Bronchoscopist satisfaction in the wrist-ankle acupuncture group was higher than that of the control group,and the operation time and recovering time were lower than the control group,indicating the statistical differences(all P<0.05).Conclusion:In painless bronchoscopy,wrist-ankle acupuncture may effectively reduce propofol dosage,alleviate respiratory suppression,reduce adverse reaction and shorten the recovering time in elderly patients.
文摘Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operator needs to be in close proximity to the patient’s face during the procedure,which increases the risk of droplet exposure.Therefore,we simulated fiberoptic endotracheal intubation on a mannequin representing the patient,using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope,in order to maintain distance from the patient during the procedure.We performed this procedure 10 times and measured the time required;the median procedure time was 6.4 s(interquartile range,5.7-8.1 s).The advantage of this method is the short procedure time and distance maintained from the patients.The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients.In addition,this method can handle difficult airways without risk of misplacement of the endotracheal tube.However,it is necessary to consider the risk of aerosol generation associated with this procedure.In the pandemic setting of coronavirus disease 2019,this approach may be useful when a gastrointestinal endoscopist is in charge of endotracheal intubation of patients with coronavirus disease 2019.
文摘Objective: To investigate the effect of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia. Methods: From January 2017 to June 2018, 82 patients with severe pneumonia were randomly divided into observation group and control group (all 41 cases). Patients in the control group received conventional anti-infective treatment, and the observation group was treated with fiberoptic bronchoscopy combined with mucosolvan on the basis of the control group. Respiratory function, inflammatory response and stress status were compared between the two groups. Results: Before treatment, there was no significant difference in Cdyn, WOB and PaO2/FiO2 between the two groups. After treatment, Cdyn and PaO2/FiO2 in the observation group were (36.28±4.28) mL/cmH2O and (376.23±24.21) mmHg respectively, while those in the control group were (26.89±3.76) mL/cmH2O and (322.12±23.16) mmHg, respectively. The levels of Cdyn and PaO2/FiO2 in the observation group were higher than those in the control group. After treatment, the WOB in the observation group was (7.81±0.72) J/L, and the WOB in the control group was (8.33±1.23) J/L. WOB of both groups was lower than that before treatment, and in observation group WOB was lower than that of control group, the difference was statistically significant. In CRP, PCT and sTREM-1 levels, there was no significant difference between the two groups before treatment. After treatment, CRP, PCT and sTREM-1 in the observation group were (39.10±6.03) mg/L, (14.57±2.05) ng/L, (15.02±3.02) ng/L respectively, while those in the control group were (59.72±8.81) mg/L, (20.03±3.09) ng/L, (34.21±5.28) ng/L, respectively. CRP, PCT, sTREM-1 in both groups were lower than those before treatment, and CRP, PCT, sTREM-1 in observation group were lower than those in control group. Before treatment, there was no significant difference with Cor, Ang-I and Ang-II in two groups. After treatment, the levels of Cor, Ang-I and Ang-II in the observation group were (114.76±15.85) ng/mL, (6.72±0.64) ng/mL, (27.28±3.43) ng/mL respectively, while those in the control group were (193.15±22.64) ng/mL, (12.10±1.68) ng/mL, (43.02±5.57) ng/mL, respectively. In the observation group, the levels of Cor, Ang-I and Ang-II were lower than those in the control group. Conclusion: Mucosolvan combined with fiberoptic bronchoscopy can effectively improve the respiratory function of patients with severe pneumonia, and reduce inflammation and stress state of the body.
文摘Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection.Methods:A total of 78 patients with lung cancer who received surgical treatment in our hospital between August 2013 and January 2015 and were with postoperative infection were selected as the research subjects and randomly divided into two groups, control group received mechanical ventilation therapy, observation group received bronchoalveolar lavage by bronchoscope combined with mechanical ventilation, and the inflammatory factor levels, RAAS system activity and respiratory mechanics indexes of two groups were determined after treatment.Results:3 d after treatment, serum hs-CRP, TNF-α, IL-8, PCT, renin, angiotensin II and aldosterone levels of observation group were lower than those of control group, and PIP, Raw and WOB values were lower than those of control group while Cdyn value was higher than that of control group.Conclusion:For lung cancer patients with postoperative pulmonary infection, bronchoalveolar lavage by bronchoscope combined with mechanical ventilation can optimize patients' condition, relieve systemic inflammatory response and improve respiratory function, and it has positive clinical significance.
文摘Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.
文摘Objective To evaluate the diagnostic value of transbronchial lung biopsy(TBLB)via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions.Methods The results of TBLB were retrospectively analyzed from 256 diagnoses of unknown patients with lung diffuse lesions or peripheral lung lesions.Results Eighty-nine final diagnosis cases via TBLB only once,the diagnostic rate of double lung diffuse lesions was the highest,[51.06%(24/47)],local non-nodule lesions,nodule lesions,cavity lesions were 33.33%(23/69),29.91%(35/117),and 28.57%(4/14),respectively.Among 24 diagnostic cases of double lung diffuse lesions,there were 6 cases of pneumonia of pulmonary tuberculosis,9 cases of lung carcinoma,7 cases of adenocarcinoma;6 cases of pneumonia,2 cases of fungous infection,and 1 case of lung hemosiderosis.The diagnostic yield about 58 cases of local lesions was low,among which non-nodule lesions accounted for 33.33% and nodule lesions accounted for 29.91%.In 89 cases of peripheral lung lesions with histological diagnosis,lung carcinoma and pulmonary tuberculosis were frequent diseases,which accounted for 86.52%.Conclusion TBLB is a reliable,safe,effective and repeatable operation method in diagnosis of lung diffuse lesions and peripheral pulmonary lesions.
文摘Objective:Placement of self expanding metallic stents(SEMS) is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope.There have been few reports published on use of flexible bronchoscope(FB) for the removal.This article summarizes the indications,methods and complications of SEMS removal by FB.Methods:We reviewed our experience with removal of SEMS using FB retrospectively.The clinical data on 29 patients with average age of(39.0±13.2) years was analyzed who underwent removal of SEMS using FB between April 2002 and August 2008.Results:Thirty-seven procedures were performed in 29 consecutive patients to remove 37 stents.The average duration of stent placement was(55± 94.7) d(0-472 d).Twenty-two procedures(59.4%) were performed under local anesthesia.The percentage of procedures under general anesthesia was 13%(3/24),67%(4/6) and 100%(7/7) for the short-term(≤30 d),medium-term(31-90 d) and long-term(>90 d) of stents placement,respectively.Indications for stents removal included migration in 15(40.6%),scar restenosis in 11(29.7%),airway shaping in 5(13.5%),stent fracture in 2(5.4%),stent incomplete expansion in 2(5.4%),improper size in 1(2.7%),mucus plugging with chest pain in 1(2.7%).And 85.7% of long-term stents were removed due to scar restenosis.The total success rate was 92%.There was no significant difference in success rate between the uncovered and covered group(82.3% and 100%,P>0.05).Complications were encountered in 13 patients,bleeding being the most common(53.8%).Conclusion:Operation by FB may be an alternative method to remove SEMS effectively and safely based on the proper anesthesia chosen.
文摘Objective In order to achieve immediate relief of central airway obstruction caused by malignant tumor after interventional therapy, we observed the efficacy and safety of cryorecanalization after cryosurgery via flexible bronchoscope.
文摘Background and Aims： Since our rural institution has liamted resources we always choose econoamcal options. Recently, indigenous technique of pleuroscopy is gaining popularity due to various advantages. We developed indigenous technique of medical thoracoscopy has been developed and done by using set of patented conduits and fiberoptic bronchoscope （FOB）.Therefore, we have used this technique for undiagnosed pleural effusions. Methods： An observational study was conducted in 79 undiagnosed cases of exudative pleural effusion from June 2016 to Jmmary 2017. Indigenous technique consists of use of fiber optic bronchoscope through various metallic conduits to be used in specified order for medical thoracoscopy. Procedure is done under conscious sedation and conduits are passed one after another in a specified order, through the chest stoma. The visualization of pleural cavity and various procedures were done with FOB （fiberoptic bronchoscope）. Results： Out of the 79 cases, the appearance of pleura showed, inflamed/reddened pleura in 16 （20.2%） cases, thin transparent adhesions in 18 （22.7%）, thin transparent loculations in 16 （20.2%） cases, thick loculations in 6 （7.6%） cases, hard pleural surface in 5 （6.3%）, large nodule/masses in 6 （7.6%）, small amlliary seedlings or sago grain appeoxmlce in 6 （7.6%）, scattered masses or nodules in 5 （6.3%） and, broncho-pleural fistula was observed in 1 （1.2%） case. Histopathological analysis showed chronic inflammation in 34.1% （27）, tubercular lesions in 24.05% （19） of patients. Primary aspergillosis and mesothelioma each has 1 case, and the rest 29.11% （23） were pleural metastasis. Thus, diagnostic yield of pleuroscopy pleural biopsy was 89.9% （71）. Conclusion： Indigenous technique appears to be an efficient and relatively safe procedure with good diagnostic yield in undiagnosed pleural effusions.
