超声评估颈部占位致颈段气管狭窄移位的可行性研究  

Feasibility of ultrasound to evaluate cervical tracheal with tracheal stenosis and displacement from neck mass

作　　者：何艳 姚卫东 金孝岠 HE Yan;YAO Weidong;JIN Xiaoju(Department of Anesthesiology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院麻醉科,安徽芜湖241001

出　　处：《皖南医学院学报》2020年第5期462-465,共4页Journal of Wannan Medical College

基　　金：皖南医学院中青年科研基金项目(KY23600316);安徽省重点研究与开发计划项目(201904b11020014)。

摘　　要：目的:探讨超声评估颈段气管狭窄移位的可行性。方法:纳入拟在全身麻醉气管插管下行择期手术且术前已明确颈段气管狭窄移位的患者27例,使用超声观察患者颈部气管前壁形态结构,并分析超声和CT分别测量颈段气管最狭窄内径、气管最大移位距离的差异性及一致性。结果:当颈段气管受压狭窄移位时,超声仍能够较清晰地显示气管前壁形态结构;超声测量最狭窄处气管内径及气管最大移位距离分别为(10.52±2.10)mm、(13.11±8.41)mm,CT测量结果为(10.95±1.94)mm、(12.84±8.10)mm,差异均无统计学意义;两种方法测量最狭窄处气管内径及最大移位距离的相关系数(r)分别为0.84和0.97;最狭窄处气管内径的一致性界限(LoA)为-1.6~2.9 mm,最大移位距离的一致性界限(LoA)为-3.7~4.4 mm。两种测量方法一致性较高。结论:超声可准确评估因颈段占位所致的颈段气管狭窄移位情况,有望成为评估颈段气管异常的一种有价值的辅助手段。Objective:To investigate the feasibility of ultrasound in evaluating the degree of tracheal stenosis and displacement of cervical tracheal caused by neck mass.Methods:Twenty-seven patients diagnosed as cervical tracheal compression,scheduled for elective surgery requiring endotracheal intubation under general anesthesia,were enrolled in the study.Ultrasound was used to observe the structure of the anterior wall of the cervical trachea,and the inner diameter at the narrowest cervical trachea and the maximum deviation distance of the trachea measured by ultrasound and CT were analyzed.Results:Ultrasound could exhibit the shape and structure of the anterior wall of the cervical tracheal compressed by cervical mass.The inner diameter at the narrowest cervical trachea and the maximum deviation distance of the trachea measured were(10.52±2.10)and(13.11±8.41)by ultrasound,and(10.95±1.94)and(2.84±8.10)mm by CT,respectively.The paired t-test showed no significant difference between the two techniques.The correlation coefficient of the two methods for the inner diameter of the narrowest cervical trachea and the maximum deviation distance of the trachea were 0.84 and 0.96,respectively.The consistency limit(LoA)of the inner diameter of the narrowest cervical trachea and the maximum deviation distance of the trachea was-1.6 and 2.9 mm,-3.7 and 4.4 mm,respectively.There was a strong correlation between the two methods.Conclusion:Ultrasound can be accurate in evaluating degree of tracheal stenosis and displacement of cervical tracheal caused by neck mass,and is expected to be auxiliary means to evaluate tracheal anomalies of cervical airway.

关 键 词：超声 气管狭窄 气管移位 颈部占位 

分 类 号：R614[医药卫生—麻醉学] R445.1[医药卫生—外科学]