螺旋CT重建成像指导全麻气管导管选择的研究

Study on the selection of tracheal catheter through general anesthesia with spiral CT reconstruction imaging

目的:探讨利用螺旋CT重建成像技术分析指导气管插管全麻病人选择合适型号气管导管的价值。方法:选择ASAⅠ-Ⅱ级择期行全麻手术患者80例,随机分2组(n=40),分别为CT指导组和经验判断组。比较两组患者气管插管的一次性成功率,气管插管困难率,插管异常率,气道正压通气状态下气道峰压值异常(大于30cmH20)率。拔管后24h内随访患者,记录气管拔管后相关并发症的发生情况。结果:试验组气管导管选择过小的比例较对照组明显减少,差异具有统计学意义(P<0.05),其他指标无明显差异。结论:参考螺旋CT重建成像分析用于气管插管全麻病人选择合适型号气管导管有一定的指导意义,可以避免经验选管带来的选管管径过小的不足,但存在费用过高,辐射较大的不足,下一步的研究中我们将采用更为方便的超声技术进行研究。

Objective:To investigate the value of spiral CT reconstruction imaging in the selection of appropriate tracheal catheters for patients with endotracheal intubation.Methods:Eighty patients with ASA I-II were randomly divided into CT guidance group(40 cases)and experience judgment group(40 cases).The one-time success rate of tracheal intubation,difficult tracheal intubation rate,abnormal intubation rate and abnormal rate of peak airway pressure(more than 30cm H20)were compared between the two groups.The patients were followed up within 24 hours after extubation,and the occurrence of related complications after tracheal extubation was recorded.Results:The proportion of undersize tracheal tube in the experimental group was significantly lower than that in the control group,(P<0.05).There was no significant difference in other indexes.Conclusion:There is a guiding significance of the spiral CT reconstruction imaging analysis for the selection of a suitable type of tracheal tube for patients with tracheal intubation.It can avoid the shortage of the pipe diameter caused by the experience selection,but has shortages of high cost and large radiation.We will use more convenient ultrasound technology for research in the next study.