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Gong Liang, director of the Department of Respiratory and Critical Care Medicine of Southwest Hospital, said that after Li Ke was admitted to the hospital, the department immediately held a consultation with him, and based on the results of previous external hospital examinations, it was preliminarily determined that Li Ke might have interstitial lung diseases such as pulmonary alveolar proteinosis. However, what they did not expect was that the "milk like substance" of pulmonary alveolar proteinosis was not found in Li Ke's body in the following two fiberoptic bronchoscopy examinations. meanwhile Miss Korea free As all his other examinations were normal, Li Ke's diagnosis and treatment were at an impasse.
"In the face of such a situation, we held a consultation again." He Jian, the deputy chief physician of the department, said, "After the consultation, we decided to conduct CT guided percutaneous lung puncture for the patient, and then from a pathological point of view, determine the disease of Li Ke. Percutaneous lung puncture, referred to as lung puncture, refers to the diagnostic technology that uses a biopsy needle to puncture the lung tissue through the chest wall and pleura under the guidance of CT or B-ultrasound to obtain the tissue needed for pathological diagnosis. This method is simple, minimally invasive, with high accuracy and few complications. It is one of the important means for the diagnosis and differential diagnosis of lung masses and diffuse interstitial lung diseases. "
After consulting the patient's opinion, Li Ke received CT guided percutaneous lung puncture in late July. The pathological results showed that Li Ke did suffer from pulmonary alveolar proteinosis. "Alveolar proteinosis is a rare disease characterized by the deposition of large amounts of protein and lipid (like milk) in the alveoli and terminal respiratory bronchioles. The incidence rate reported in relevant reports is less than 1/100000, which is more common in middle-aged people than women. It may be related to smoking, occupational dust inhalation, autoimmunity, genetics and other factors." He Jian introduced, As a rare disease, the main treatment of this disease is whole lung lavage, aerosol inhalation or subcutaneous injection of granulocyte macrophage colony-stimulating factor.
After consultation and discussion, the expert team of respiratory and critical illness decided to use whole lung lavage to treat Li Ke. In early August, Li Ke was pushed into the operating room. During the operation, the Department of Respiratory and Critical Care Medicine and the Department of Anesthesia work closely together. First, double lumen endotracheal intubation is carried out and three-way pipes are connected. Then the warm physiological saline prepared in advance is poured into the lungs from the inlet, about 800ml each time, and then the milky white liquid is drawn out from the outlet. After nearly 4 hours of bilateral lung lavage, a total of 20000 ml of normal saline was irrigated, and the lung fluid washed out gradually changed from milk like to clear. Postoperative Miss Korea free Li Ke returned to the ward safely with stable vital signs. After that, with the care of medical staff, Li Ke recovered quickly and was discharged on the 27th.
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