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With the widespread application of chest CT, the detection of peripheral lesions has increased, and rapid and accurate diagnosis is the prerequisite for the implementation of individualized treatment. At present, due to bronchoscopic technology through the natural cavity, the trauma of diagnosis and treatment methods has been widely used in clinical clinical. All doctors have always moved forward to all doctors in the Department of Internal Medicine of the General General Hospital (2) of the Department of Internal Medicine of the General General Hospital (2).

In terms of guidance: Peripheral Pulmonary/LUNG LESIONS (PPL/PLL) refers to the lung nodule (usually <3cm) located in the perimeter of the lungs. At present, the digital guidance method is (Image-GUIDED Bronchoscopy, IGB) biopsy. Our department conducts meticulous preoperative planning for every patient with peripheral lesions.

Step 1: Hand -painted navigation technology

Before surgery, read the CT tablets of the lungs carefully, combine the bronchial pipe combined with lesions, and plan the biopsy path by hand -drawn navigation diagram. At the same time, the bronchial level that the bronchial mirror can be reached by the bronchial mirror is required. The relationship with the lesion.

Video: hand -drawn process

Step 2: Determine the guidance method

There are branches of bronchial lesions. If the path is not large, it is estimated that the biopsy tools are easy to reach only hand -drawn navigation guidance; if the path turn is too large, the ordinary bronchial mirror is the biopsy tool that is difficult to reach. Reach more difficulty lesions. There is no bronchial lesion. According to the experience, depending on whether it can make up the syncope and confirm the surgery. When you are determined that the bronchial non -bronchial is connected, you can use the bronchial mirror to reach the BTPNA under the substantive nodules of the lungs.

Step 3: Confirm the arrival

At present, for extrateripotential lesions, we have confirmed the RadiAl EndObronchial Ultrasound (R-Ebus) through the radial probe. R-EBUS uses a miniature ultrasonic probe, which can use the working channel of bronchial mirrors, and then 360 ° to see the lung substant. The probe is smaller and can extend to the distal end of the sub -lung segment to the bronchial of the sub -lung segment, thereby seeking PPL. However, because the probe must be removed from the sheath to place a biopsy device, R-Ebus cannot provide real real-time biopsy ultrasound images. For patients with smaller lesions, we also apply perspective, which can clearly clear the position of bronchial mirrors and biopsy tools under perspective. If the lesions that cannot be seen under perspective can apply high -resolution three -dimensional CT imaging, CT image can show whether the biopsy equipment is located in the lesion. At present, after the introduction of cone bundle CT (CBCT) in our hospital, our department has a more difficult lesion or smaller lesion to get more accurate to adopt CBCT confirmation.

Fourth: Biopsy for materials

In order to ensure the positive rate, in the biopsy tool, we will also use ordinary biopsy, brush inspection, washing, guiding sheath, needle in suction biopsy, frozen lung biopsy, frozen lung biopsy, frozen lung biopsy, frozen lung biopsy, frozen lung biopsy, frozen lung biopsy, frozen lung biopsy. Multi -technical joint application.

Therefore, in the diagnosis of PPL's ​​diagnosis, the Department of Internal Medicine/Breathe and Critical Medicine 2 Department of Emergency Hospitals hopes to solve problems for more patients.

Know us, follow us

The Department of Internal Medicine of the General General Hospital (2 Department of Respiratory and Critical Medicine) is one of the key departments of the hospital. It integrates medical, teaching, and scientific research. Independent clinical departments of medical services such as intensive care, tumor treatment, and chronic disease management.

The department has a specialist clinic such as lung cancer, chronic obstructive pulmonary qi (COPD), asthma, nodules, and pneumatic fistula. In Beijing, the "green channel" of respiratory obstruction was opened in Beijing, and patients with severe air tract obstruction were observed at any time and emergency surgery at any time.

On the basis of traditional tumor internal medicine and respiratory critical condition, the department has matured early diagnosis of malignant tumors, organized biopsy for various means, formulation and implementation of chemotherapy, targeted therapy, immunotherapy plans, and focused on developing respiratory intervention diagnosis and treatment technology. In terms of lung cancer intervention treatment and respiratory endoscopic diagnosis and treatment technology and respiratory critical illness diagnosis and treatment technology, it is at the leading level in the country. The department is equipped with advanced instrument and equipment, relying on the respiratory endoscopic center, mature development of ordinary diagnostic technology and ultrasonic bronchial mirrors (EBUS-TBNA), frozen lung biopsy, bronchial electromagnetic navigation, virtual navigation, AI Advanced technologies such as auxiliary diagnosis, CBCT hybridization surgery, etc., are equipped with a hard mirror, pyrine knife, carbon dioxide frozen, laser, low -temperature plasma radio frequency, microwave and other therapeutic equipment. Treatment, blocking of various fistulas, and other treatments have a domestic leading level in the field of respiratory tumors, airway obstruction and airway fistulating therapy. For tumor patients can perform puncture biopsy and physical tumor discharge of all parts of the whole body, including technologies such as knife, microwave, radio frequency, laser, radioactive particle implantation, and inter -quality power; Vascular intervention technology and other vascular intervention technology.

The department has a mature standardized teaching system. It is a technical training such as the Chinese Physician Association's respiratory endoscopic training base, and conducting technical training such as cortex intervention technology, vascular intervention technology, respiratory tumor multi -disciplinary integration treatment, and standardized treatment of cancer pain. The department also has a comprehensive scientific research system, with drug clinical experiments and medical device clinical experimental qualifications. Adhering to the concept of people -oriented, patient first, rigorous and harmonious, and innovative development, it provides patients with high -quality and efficient medical services.

Division contact number:

010-87935395 (ward)

010-87935535 (outpatient)

Text: Gao Hong

Video: Wang Zhina

Review: Zhang Nan

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