术前不同CT测量方式对指导双腔支气管插管效果的影响  

Effect of Different CT Measurement Methods Before Operation on Guiding Double Lumen Bronchial Intubation

作　　者：赵振儒 王馨[1] 胡杰[1] 彭印明[1] 孙艳斌[1] 王本奇[1] ZHAO Zhenru;WANG Xin;HU Jie;PENG Yinming;SUN Yanbin;WANG Benqi(Department of Anesthesiology,Chengde Central Hospital,Chengde Hebei 067000,China)

机构地区：[1]承德市中心医院麻醉科

出　　处：《中国医疗设备》2020年第1期78-81,共4页China Medical Devices

摘　　要：目的探讨CT平扫及重建分别应用于指导患者双腔支气管插管的效果,并分析气管内径与患者一般资料的相关性。方法选择2015年6月至2018年6月于我院行择期肺叶切除的患者53例,按照随机数字表法分为平扫组(n=27)和重建组(n=26),两组患者均于麻醉前行CT检查支气管情况,平扫组采用CT平扫法进行测量,而重建组则采用CT重建法进行测量,而后根据测量结果行双腔支气管插管。比较两组患者导管合适程度评价指标情况,插管并发症之间的差异。对患者通过重建测量出的气管内径与其身高、体重、年龄和BMI等一般资料进行相关性分析。结果重建组LT1、PT1及APP显著低于平扫组,插管1次成功率显著高于平扫组(P<0.05),重建组患者插管并发症总发生率显著低于平扫组(P<0.05);重建组胸廓入口处、主动脉弓处以及气管最狭窄处气管内径值显著高于平扫组(P<0.05);Pearson相关分析显示,身高与气管四个位置的内径呈正相关(P<0.05)。结论CT重建应用于指导双腔支气管导管型号的选择,能有效提升术前气管导管选择型号合适程度,并有效减少插管并发症;患者身高与气管内径呈显著正相关。Objective To explore the effect of CT plain scan and reconstruction in guiding dual lumen bronchial intubation,and to analyze the correlation between endotracheal diameter and general data of patients.Methods A total of 53 patients who underwent elective pulmonary lobectomy surgery in our hospital from June 2015 to June 2018 were selected and divided into two groups according to random number table:plain scan group(n=27)and reconstruction group(n=26).CT bronchoscopy was performed before anesthesia in both groups.The plain scan group was measured by CT plain scan method,while the reconstruction group was measured by CT reconstruction method.Then double-lumen bronchial intubation was performed according to the measurement results.The difference of catheter suitability and complications between the two groups was compared.The correlation between tracheal diameter measured by reconstruction and general data such as height,weight,age and BMI was analyzed.Results The LT1,PT1 and APP in the reconstruction group were significantly lower than those in the plain group,and the one-time success rate of intubation was significantly higher than that in plain scan group(P<0.05).The total incidence of intubation complications in reconstruction group was significantly lower than that in plain scan group(P<0.05).The endotracheal diameter at thoracic entrance,aortic arch and tracheal stenosis in reconstruction group was significantly higher than that in plain scan group(P<0.05).Pearson correlation analysis showed that height was positively correlated with endotracheal diameter at four locations of trachea(P<0.05).Conclusion CT reconstruction can be used to guide the selection of double-lumen bronchial catheter model,which can effectively improve the appropriateness of the selection of preoperative tracheal catheter model and reduce the complications of intubation.There is a significant positive correlation between the height of patients and the diameter of trachea.

关 键 词：双腔支气管插管术 CT重建 肺叶切除术 气管内径 

分 类 号：R445.3[医药卫生—影像医学与核医学] R655[医药卫生—诊断学]