应用多层螺旋CT重建技术提高气管狭窄患者麻醉质量及安全性的可行性研究

Feasibility Study on Improving Anesthesia Quality and Safety of Tracheal Stenosis Patients with Multi-slice Spiral CT Reconstruction

目的旨在探讨应用多层螺旋CT重建技术提高气管狭窄患者麻醉质量及安全性的可行性。方法选取我院2017年2月-2018年1月收治的甲状腺疾病患者32例,所有患者入院后均经X线平片检查提示气管出现不同程度的受压狭窄,对患者进行多层螺旋CT,进行CT模拟支气管镜及后处理技术处理,收集整理32例患者的临床及影像学资料,分析多层螺旋CT重建技术对气管狭窄患者麻醉质量的影响及安全性。结果经整理32例患者影像学资料发现,32例患者中,气管狭窄程度分级Ⅰ级者24例,气管狭窄程度分级Ⅱ级者8例。经CT模拟支气管镜图像测量,32例患者中气管狭窄最严重出直径3.1~9.1mm,平均直径(6.71±1.21)mm;气管狭窄最严重处横截面积:0.80~1.26cm^2,平均横截面积(1.00±0.69)cm^2。以CT图像资料为根据,气管插管全身麻醉中,32例患者均成功完成了麻醉诱导,第一次气管插管成功率为100%。氧饱和度:95~100%,呼气末二氧化碳:3.50~5.51kPa,术中、拔管后未发生气管插管并发症。结论麻醉前应用多层螺旋CT重建技术,气管狭窄患者第一次插管成功率高,多层螺旋CT重建技术对提高气管狭窄患者气管插管安全性、麻醉质量意义重大。

Objective To explore the feasibility of multi-slice spiral CT reconstruction in improving the anesthesia quality and safety of patients with tracheal stenosis.Methods 32 patients with thyroid diseases admitted to our hospital from February 2017 to January 2018 were selected.After admission,all patients were examined by X-ray plain film,which indicated that the trachea had different degrees of compression stenosis.Multi-slice spiral CT was used to simulate bronchoscopy and post-processing technology.Clinical and imaging data of 32 patients were collected and collated.The effect and safety of MSCT reconstruction technology on anesthesia quality of patients with tracheal stenosis were analyzed.Results According to the imaging data of 32 patients,24 cases were classified as grade I of tracheal stenosis and 8 cases as grade II of tracheal stenosis.The most severe tracheal stenosis in 32 patients was 3.1-9.1 mm in diameter,with an average diameter of(6.7±1.21)mm.The cross-sectional area of the most severe tracheal stenosis was 0.80-1.26 cm^2,with an average cross-sectional area of(1.00±0.69)cm^2.Based on CT image data,32 patients successfully completed anesthesia induction during general anesthesia with tracheal intubation.The success rate of first tracheal intubation was 100%.Oxygen saturation:95-100%,end-expiratory carbon dioxide:3.50-5.51 kPa.No complications of endotracheal intubation occurred during and after extubation.Conclusion Multi-slice spiral CT reconstruction before anesthesia has a high success rate in the first intubation of patients with tracheal stenosis.Multi-slice spiral CT reconstruction technology is of great significance to improve the safety of tracheal intubation and the quality of anesthesia for patients with tracheal stenosis.