دراسة تحليلية لحالات التنظير القصبي للمرضى المراجعين لمشفى الأسد باللاذقية خلال عام 2016
Abstract
خلال سنة 2016 قمنا بإجراء 167 تنظيرا قصبياً استقصائياً ( 101 ذكور – 66 أنثى ) وأجريت بمنظار ليفي مرن ماركة pentax قطر رفيع slim , وتم تحضير المرضى للتنظير بالتخدير الموضعي للأنف والبلعوم والحنجرة بالليدوكائين .
وفي حالات قليلة وخاصة تم التركين الوريدي بالـ Midazolam 5مغ.
وكان تحمل التنظير جيداً ولم تحدث اختلاطات تستدعي الاستشفاء.
كانت استطبابات التنظير هي:
- الاشتباه بالخباثة حيث تم تشخيص 49 حالة بنسبة 56,3% وشخصت وعزلت الإمراضيات في حال الاشتباه بالأخماج عند 11 مريض بنسبة 45,8% وتم تشخيص السل لدى 9 مرضى بنسبة 42,8% من الحالات المشتبهة.
- وفي حالات نفث الدم: تم تحديد موقع النزف ومعرفة العامل المسبب لدى 12 مريض بنسبة 63%.
- وفي حالات السعال المزمن تم تأكيد التشخيص لدى 4 مرضى بنسبة 50%
- وفي حالات الآفات الرئوية الخلالية تم تشخيص 4 مرضى بنسبة 50%
ونؤكد بعد الدراسة على أهمية التنظير القصبي كوسيلة استقصائية تشخيصية وخاصة في حالات الخباثة , وعند سلبية الفحوصات الأخرى : دم , قشع عند الشبهة بالأخماج والسل وفي حالات نفث الدم والإمراضياتالخلالية وخاصةً أنه إجراء خارجي جيد التحمل واختلاطاته نادرة.
During 2016 we have made 167 survey bronchoscopy (101 males & 66 females),they had been done by flexible fibroscope (pentaxTM) slim diameter .
Patients has prepared for the endoscopy by local anesthesia on nose ,pharynx and larynx using Lidocaine .In few particular cases , the sedation has been done by Midazolam (5mg) intravenous .
The endoscopy's tolerance was good and no complication that require recovery occurred .
The indications of the endoscopy were suspected malignancy, 49 cases had diagnosed in the rate of 56.3%. The disorders had been diagnosed and isolated in the case of suspected infections in 11 patients in the rate of 45.8%.The tuberculosis had been diagnosed in 9 patients in the rate of 42.8%.
In hemoptysis cases ,bleeding site and causing factor had causing factor had been detected in 12 patients in rate of 63%.
In chronic cough cases, the diagnosis had been confirmed in 4 patients in the rate of 50%.
In case of interstitial pulmonary lesions , the diagnosis had been confirmed in 4 patients in the rate of 50%.
After the study ,we emphasize the importance of broncoscopy as survey diagnostic instrument especially in malignancy cases , other negative tests (blood, sputum ), suspected infections , tuberculosis ,hemoptysis cases and interstitial lesions .Especially it is external good tolerances procedure with rare complication.
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