Zhangjiagang Bailing Specimen Model Co., Ltd.
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Website:www.cnbbmx.com
Address:Bridge No. 4, Leyu Town, Zhangjiagang City, Suzhou City
Medical Human Body Model - Bronchoalveolar Lavage
Nursing person bronchoalveolar lavage is developing rapidly based on the extensive application of nursing person bronchoscopy in recent years. It is of great help to the diagnosis of diffuse diseases in both lungs. Some people call it liquid biopsy. On the basis of diagnosis and application, it has developed into treatment. It has developed from bronchial flushing to bronchoalveolar lavage by nursing staff. The lavage (200-300 mL of normal saline) develops to the whole lung lavage (thousands to 10,000 mL of normal saline). Now they are respectively introduced as follows: (1) Diagnostic nursing staff bronchoalveolar lavage and its clinical application The nursing staff bronchoalveolar lavage and the nursing staff bronchoalveolar lavage are different concepts. The former only injects a certain amount of saline into the nursing staff's bronchi; the latter When injecting saline, the tip of the fiberoptic bronchoscope needs to be inserted into the bronchial opening of the lobe segment of the nursing person, and 200-300 mL of normal saline is injected in stages, and the lavage fluid is recovered, and the recovery rate is over 40%. The cellular components of the lavage fluid, normal human alveolar phagocytic cells account for more than 90%, can be considered as successful lavage. The cellular components of the bronchial lavage of the nursing person may be the bronchial epithelium of the nursing person. The diagnostic bronchoalveolar lavage of the nursing person should include three parts: fiberoptic bronchoscopy, specimen processing and laboratory examination.
(1) The laboratory examination of bronchoalveolar lavage fluid of nursing staff can be divided into three parts:
First, the total number and classification of cells and the determination of monoclonal antibodies;
Second, non-cellular components such as immunological and biochemical assays, and the determination of some active substances cannot be carried out in peripheral blood;
Third, other such as tumor cells, mycobacteria, Pneumocystis carinii bacteria, mold and so on. However, the standardization of biochemical determination results needs to be further studied. At present, the same specimens are compared to overcome this drawback. Some scholars use albumin, potassium ion, magnesium ion, urea, etc. as indicators in the calibration of BALF.
In conclusion, the standardization of lavage fluid laboratory results requires further study. Interstitial diseases, especially sarcoidosis and allergic alveolitis, are of great value in the diagnosis of pulmonary diseases by nursing staff. Others, such as alveolar proteinosis, asbestosis, and tuberculosis, are also relatively High value, but the complex etiology of interstitial lung disease brings limitations to the diagnosis. So far, 130 kinds of interstitial diseases have been reported as "alveolitis" in the early stage and fibrosis in the later stage. In the stage of alveolitis, inflammatory and immune effector cells accumulate in the alveolar cavity, and the above-mentioned cellular components of different diseases have corresponding changes. Therefore, to a certain extent, the differential diagnosis can be made based on the classification and analysis of BALF cells. Generally, inflammatory cells are divided into medium cells. There are two types of neutrophilic type and lymphocytic type. In the former, the neutrophils in the alveolar space can reach 25%, which is more common in idiopathic pulmonary fibrosis, familial pulmonary fibrosis, pulmonary histiocytosis x, etc. The latter is characterized by a significant increase in lymphocytes, such as granulomatous diseases in the lung, tuberculosis, sarcoidosis, allergic alveolitis, beryllium poisoning, etc., which belong to this type.
(2) In allergic alveolitis, the lymphocytes are elevated as in sarcoidosis, but in allergic alveolitis, IgG/albumin is greater than 1, while in sarcoidosis it is less than 1. DKT4 is increased in sarcoidosis, and DKT8 is increased in allergic alveolitis. The proportion of lymphocytes in allergic alveolitis increases by 60%-70%, which is higher than that of sarcoidosis.
(3) Poisoning is oxidized to iron oxide dust in the air, which is very toxic. Acute poisoning can cause pneumonia and pulmonary edema. Chronic poisoning is granulomatous lesions in the lung tissue. It is regarded as a hapten in the body. It combines with protein to cause a cellular immune response. The lymphocytes in chronically poisoned BALF are 5 times higher than that of normal people, and T4/T8 is significantly increased.
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