气管插管后狭窄27例的CT影像特征及其临床指导意义  

Computed tomography imaging feature of post-intubation tracheal stenosis and its clinical significance

作　　者：张科[1] 魏宁[1] 徐浩[1] 祖茂衡[1] 王文亮[1] 肖晋昌[1] 王珣[1] 

机构地区：[1]徐州医学院附属医院介入放射科,221006

出　　处：《介入放射学杂志》2014年第5期418-421,共4页Journal of Interventional Radiology

基　　金：江苏省临床医学科技专项-新型临床诊疗技术攻关(BL2013011);徐州医学院"振兴计划"(XZMC2012-2015)

摘　　要：目的探讨气管插管后狭窄(PITS)的螺旋CT影像学特征及其临床指导意义。方法回顾性分析27例PITS患者,分别收集其临床资料及螺旋CT影像资料,观察气管狭窄部位、程度、形态,总结其影像特点;并根据不同的影像特点分析狭窄原因及其对PITS病情评估和临床处理的影响。结果 27例患者,共检出气管狭窄部位35处,分别位于气管切开水平10例、气囊水平5例和套管末端20例,狭窄程度均大于30%;其中局限性狭窄15例,影像特征为"沙漏状、束腰状"狭窄;节段性狭窄4例,影像特征为"带状、哑铃状"狭窄;复合狭窄8例。参考相应的影像特征,所有患者均得到了及时、个体化的治疗。结论PITS具有典型的影像特征,螺旋CT检查可作为PITS影像学检查的首选。相关科室可根据不同的影像特征评估患者病情,制订个体化的治疗方案,对麻醉科气管插管及相关科室医护人员认识并及时预防、处理该症具有一定的临床指导意义。Objective To explore the spiral computed tomography intubation tracheal stenosis （PITS） and to discuss its clinical significance. （CT） imaging feature of post- Methods The clinical data and CT imaging findings of 27 patients with PITS were retrospectively analyzed. The location, degree and shape of PITS were analyzed, and the imaging features were summarized. Based on the imaging features the etiology of PITS was suggested, and the role of imaging feature in assessing PITS condition and in planning clinical management was evaluated. Results A total of 35 tracheal strictures were detected in the 27 patients. The location of the strictures included trachea incision site （n = 10）, balloon level （n = 5） and distal end of tube （n = 20）. In all patients the degree of stenosis was 〉 30%. Localized stenosis was seen in 15 cases, which presented as ＂hourglass＂ or ＂girdle＂ shape. Segmental stenosis was found in 4 cases, which was characterized by a ＂ribbon＂ or ＂dumbbell＂ stricture on CT scans. Complex stenosis was found in 8 cases. With the help of imaging findings, all patients got timely, proper and individualized treatment. Conclusion PITS has typical imaging characteristics. Spiral CT scanning should be regarded as the imaging examination of first choice. Based on the different imaging characteristics, the relevant departments can evaluate patient＇s condition and make individualized treatment plan. The imaging finding is very helpful for anesthesiologists and other clinicians in recognizing and in managing the post- intubation tracheal stenosis. （J Intervent Radiol, 2014, 23： 418-421）

关 键 词：气管插管 气管狭窄 气管切开 影像 螺旋CT 

分 类 号：R816.4[医药卫生—放射医学] R562.12[医药卫生—临床医学]