气管狭窄及支架置入后气流动力学参数改变及意义  

The changes of aerodynamic parameters in the tracheal stenosis before and after stent implantation and their clinical significance

作　　者：张科 魏宁 徐浩 高传举 ZHANG Ke WEI Ning XU Hao GAO Chuan-ju(Deportment of Medical Imaging, Jiawang Hospital, Affiliated Hospital Group of Xuzhou Medical University. Xuzhou, Jiangsu Province 221006, China)

机构地区：[1]徐州医科大学附属医院集团贾汪医院影像科 [2]徐州医科大学附属医院介入科,江苏221006

出　　处：《介入放射学杂志》2017年第1期35-39,共5页Journal of Interventional Radiology

基　　金：江苏省临床医学科技专项项目(新型临床诊疗技术攻关)(BL2013011);徐州市科技计划项目(KC14SH096)

摘　　要：目的探讨气管狭窄及支架置入术后气流动力学参数的改变及意义。方法收集20例气管狭窄并行气管支架置入术患者的临床资料,总结其临床特点及影像学征象。应用计算机流体力学分析软件对狭窄气道支架置入前后进行气流动力学模拟,记录感兴趣区气流动力学参数进行统计学分析,定量资料均数间比较采用t检验,以P<0.05认为差异具有统计学意义。结果 20例气管狭窄均为恶性狭窄,病因为肿瘤压迫及侵犯。其中狭窄程度>50%者18例;狭窄部位以气管中段为主,为10例;狭窄范围以节段型为主,为15例;狭窄形态以偏心性为主,为17例。气管狭窄处支架置入后管腔截面积为(2.03±0.32)cm2,大于置入前管腔截面积(0.96±0.18)cm2;气管支架置入前狭窄处流速为(1764±1484)cm/s,大于支架置入后管腔内流速(688±434)cm/s;支架置入前左主支气管入口流速及流量分别为(308±209)cm/s、(359±255)ml/s,均小于右主支气管入口处流速(464±246)cm/s及流量(526±283)ml/s,均P<0.05。气管支架置入后左右主支气管入口流速及流量差异无统计学意义。结论气管狭窄气流动力学参数以狭窄处出现气流高流速为特点,同时气管狭窄会对左右主支气管入口流速及流量产生一定影响。气管支架置入后能显著增加狭窄处管腔面积,降低狭窄处高流速使气流平顺,并使两侧支气管气流分布均匀。气管狭窄支架置入前后的气流动力学参数模拟对该症病理生理学研究及疗效评估具有一定的价值。Objective To explore the changes of the aerodynamic parameters in tracheal stenosis before and after stent implantation, and to discuss the significance of these changes. Methods The clinical data of 20 patients with tracheal stenosis, who were treated with stent implantation, were collected, and the clinical features as well as imaging findings were summarized. Using the computer fluid dynamics analysis software, the airflow dynamics simulation study on tracheal stenosis before and after stent implantation was conducted. The aerodynamic parameters of the region of interest were recorded and statistically analyzed. The mean values of quantitative data were compared by using t-test, and P〈O.05 was considered to be statistically significant. Results The nature of tracheal stenosis was malignant in all 20 patients, which was caused by tumor compression and invasion. Stenosis degree 〉50% was seen in 18 patients, the stenosis was located in the middle of trachea in 10 patients, segmental stenosis was observed in 15 patients, and eccentric stenosis was found in 17 patients. After stent implantation, the lumen area at previous tracheal stenosis site became （2.03±0.32） cm2, which was larger than （0.96±0.18） cm2 measured before stent implantation. The pre-stenting velocity at the stenotic site of trachea was （1764±1484） cm/s, which was higher than （688±434） cm/s of the post-stenting velocity. The pre-stenting velocity and volume flow measured at the left main bronchus entrance were （308±209） cm/s and （359±255） ml/s respectively, both of them were smaller than those measured at the right main bronchus entrance, which were （464±246） cm/s and （526±283） ml/s respectively, the differences were statistically significant （both P〈0.05）. After tracheal stent implantation,the differences in the velocity and volume flow between the left main bronchus entrance and the right main bronchus entrance were not statistically significant. Conclusion The aerodynamic parameters in tracheal ste

关 键 词：气管狭窄 支架 呼吸 影像学 气流动力学 

分 类 号：R56[医药卫生—呼吸系统]