多排螺旋CT成像评价双相气道正压无创机械通气下上呼吸道状态  

Evaluation of functional state of upper respiratory tract under duplex positive airway pressure non-invasive mechanical ventilation by multi-slice spiral CT imaging

作　　者：李汉文[1] 叶素贞[1] 王卓丹[1] 叶显智[1] 刘炳烦[1] 

机构地区：[1]广州医学院附属第二医院放射科,510260

出　　处：《重庆医学》2008年第12期1331-1332,1335,共3页Chongqing medicine

摘　　要：目的应用16排螺旋CT评价不同通气状态下上呼吸道状态。方法选择拟实施全身麻醉的择期手术患者10例,分别对患者清醒自主呼吸、麻醉诱导后自主呼吸停止、BiPAP无创通气时头颈部正位和侧位等4种状态作螺旋CT扫描,监测扫描过程的无创血压、脉搏氧饱和度、心率、自主呼吸频率,测量上呼吸道各软组织区的最窄气道横截面径线长度及横截面积。结果螺旋CT扫描能在解剖学上充分反映各种状态下上气道软组织区的径线及横截面积,头部正位BiPAP通气时各截面径线和面积与清醒期比较差异有统计学意义(P<0.05,P<0.01)。头部侧位BiPAP通气时各径线和截面积与清醒时比较差异无统计学意义(P>0.05)。结论利用16排螺旋CT扫描能客观评价麻醉后各种通气状况下气道状态,证实头部侧位BiPAP无创通气能克服上呼吸道阻力,实施有效的机械通气。Objective To explore the application of multi-slice spiral CT in assessing the functional state of the upper respiratory tract under different ventilated conditions. Methods Ten patients receiving operation under general anaesthesia participated in this study were performed multi-slice spiral CT scan under spontaneously breathing, the cessation of spontaneously breathing induced by anaesthesia,as well as the BiPAP non-invasive ventilation in the supine and lateral position conditions. Simultaneously, the blood pressure,peripheral oxygen saturation,heart rate and respiratory frequency were monitored along the scans. The diameters and cross section area of the narrowest upper airway were measured. Results Multi slice spiral CT could reflect the diameters and cross section area of the upper airway accurately. There was significant difference in the diameters and cross section area between the BiPAP non-invasive ventilation in the supine position and spontaneously breathing condition（P〈0.05, P〈0.01）. No significant difference was found between the BiPAP non-invasive ventilation in the lateral position and spontaneously breathing condition（P〉 0.05）. Conclusion 16-slice spiral CT can assess the functional state of the upper respiratory tract under different ventilated conditions accurately. BiPAP non-invasive ventilation in the supine position can overcome the upper air way resistance and implement the effective mechanical ventilation.

关 键 词：双相气道正压通气 体层摄影术 X线计算机 全身麻醉 

分 类 号：R816.4[医药卫生—放射医学]