通气控制CT测量5岁以下儿童肺支气管径线  

Measurement of airway dimensions in children under 5y of age:a CT study with controlled ventilation

作　　者：刘明[1] 闫淯淳 杨洋[1] 郭红伟[1] 袁新宇[1] 

机构地区：[1]北京大学首都儿科研究所教学医院放射科,北京100020

出　　处：《放射学实践》2015年第3期275-278,共4页Radiologic Practice

摘　　要：目的：采用通气控制CT测量5岁以下儿童吸气末、呼气末呼吸道径线值,初步探讨儿童气管发育特点并为临床气管插管型号的选择提供参考。方法：本研究采用前瞻性研究,选取2011年1月-2013年8月因胸壁软组织病变来本院行胸部CT扫描的小于5岁的患儿共80例。随机将其分为吸气末扫描组与呼气末扫描组进行通气控制CT扫描,获得吸气末、呼气末图像。扫描图像由两位高年影像医师评估,将肺内及纵隔内无病变的患儿共63例纳入本研究。径线：气管隆突上2cm处的水平气管直径（TD）;气管隆突水平右主支气管直径（RBD）、左主支气管直径（LBD）;气管隆突至右中下叶支气管开口的距离作为右主支气管长度（RBL）、气管隆突至左下叶支气管开口的距离作为左主支气管长度（LBL）。角度：右主气管长轴与矢状面夹角（RA）、左主气管长轴与矢状面夹角（LA）、右上叶支气管长轴与右中下叶支气管长轴夹角（RA′）、左上叶支气管长轴与左下叶支气管长轴夹角（LA′）。分析性别、年龄、体重与径线、角度之间的关系。结果：性别、年龄、体重、径线都与角度之间不存在相关性（P〉0.05）。角度的平均值及范围：RA：34.69°±5.29°（24.43°-42.05°）,LA：45.27°±5.09°（24.43°-42.05°）,RA′：66.27°±7.71°（51.73°-84.06°）,LA′：52.12°±6.87°（37.62°-66.84°）。吸气末和呼吸末的呼吸道径线和角度间差异均无统计学意义（P〉0.05）。性别和径线之间无相关性（P〉0.05）。年龄、体重和径线间的存在相关性,并建立了相关的线性方程：TD=4.52＋0.16×体重＋0.04×月龄、RBD=3.17＋0.16×体重＋0.02×月龄、LBD=3.11＋0.11×体重＋0.03×月龄、RBL=7.07＋0.11×体重＋0.14×月龄、LBL=15.33＋0.94×体重＋0.02×月龄。结论：年龄和体重是影响5岁以下儿童呼吸道径线的重要因素,可以根据年龄、体重与径线�Objective：To measure the airway in children under 5y of age with controlled ventilation（CVCT）.The dimensions of the airway at the end phase of inspiration and expiration were measured in order to find out the development characteristics of airway trees and provide reference for selecting the appropriate trachea cannula in mechanical ventilation.Methods：80patients,who underwent chest CT for chest wall soft tissue lesions in our institute from January 2010 to August 2013,were enrolled to this prospective study.They were randomly divided into Group 1（end of inspiration）and Group2（end of expiration）for CT scan.The images were evaluated by two senior radiologists.63 patients presented no clinical respiratory symptoms and had no pulmonary and mediastinal lesions were enrolled in this study.The measurements included inner diameter of tracheal 2cm above carina（TD）,inner diameters of right and left main bronchus（RBD,LBD）at carina level,lengths of right and left main bronchus（RBL,LBL）from carina of trachea to the opening of lower lobe bronchus,angles between long dimension of main bronchus and median sagittal plane（RA,LA）,and angels between upper lobe bronchus and lower lobe bronchus（RA′,LA′）.The relationship between sex,age,body weight and airway dimensions,angles was analyzed.Results：There was no correlation between sex,age,body weight,airway dimensions and angles（P〉0.05）.The average value and range of angles of RA,LA,RA′and LA′was 34.69°±5.29°,45.27°±5.09°,66.27°±7.71°and 52.12°±6.87°respectively.There was no statistical difference in diameter,lengths and angles of the airways at the end of inspiration and expiration（P〉0.05）.There was no correlation between sex and dimensions（P〉0.05）.Interestingly,there was strong correlation between age,body weight and dimensions of the airways.The formula of the airway dimensions associated with body weight and age was TD=4.52＋0.16×weight＋0.04×age of month,RBD=3.17＋0.16×body weight＋0.02×age of mont

关 键 词：体层摄影术 X线计算机 通气控制 气管 儿童 

分 类 号：R725.6[医药卫生—儿科] R816.92[医药卫生—临床医学]