Mimics软件气道重建在左侧双腔支气管导管插管中的应用价值

Application of Mimics software for airway reconstruction in left-sided double-lumen endobronchial tube intubation

目的探讨Mimics软件气道重建在左侧双腔支气管导管(LDLT)插管中的应用价值。方法选择宁波市医疗中心李惠利医院2020年1月至2021年1月需要LDLT插管行单肺通气的80例胸外科全麻患者,按随机数字表法分为观察组和对照组,每组40例。观察组麻醉前将肺部CT检查的Dicom文件导入Mimics软件,三维重建气道模型并提取气道中心曲线,测量声门上缘至隆突嵴的距离和左侧主支气管的长度,根据测得的数据进行LDLT插管;对照组按传统方法将LDLT经患者声门向支气管方向推进,出现置入阻力时停止推进,给气囊充气。两组患者插管后均用纤维支气管镜进行验证定位。记录并比较两组患者插管时间、对位满意率及LDLT调整深度、隆突及左侧支气管壁黏膜损伤情况。结果观察组患者插管时间少于对照组(P<0.05),导管开口与支气管开口对位满意率高于对照组(P<0.05),隆突及左侧支气管壁黏膜损伤发生率低于对照组(均P<0.05)。结论Mimics软件气道重建在LDLT插管应用中对位满意率高,不易移位,对患者气道损伤小,对LDLT的插管和定位有重要指导意义。

Objective To explore the clinical application of airway reconstruction using Mimics software in left-sided double-lumen endobronchial tube(LDLT)intubation.Methods Eighty patients scheduled for thoracic surgery under general anesthesia who required single-lung ventilation with left-sided double-lumen endobronchial tube intubation in Ningbo Medical Center Lihuili Hospital from January 2020 to January 2021 were randomly divided into study group and control group with 40 cases in each group.For patients in study group,before anesthesia the DICOM files of lung CT scan were imported into Mimics softw,and the airway model was reconstructed in 3D and the curve of the center of the airway was extracted;the distance from the superior glottic margin to the protrusion ridge and the length of the left main bronchus were measured.The LDLT was intubated according to the measured data.For patients in the control group,LDLT was pushed through the glottis to the bronchial direction by the traditional method,and the push was stopped when the insertion resistance appeared,and the tracheal cuff was inflated.The positioning after intubation was determined with fiberoptic bron-choscopy(FOB).Intubation time,position and accurate number,carina and mucosal damage of left bronchial wall were recorded and compared between two groups.Results The intubation time of study group was much shorter than that in control group(P<0.05).The satisfactory position of catheter opening and bronchial opening in study group was significantly better than that in control group(P<0.05).The incidence of mucosal injury of carina and left bronchial wall in study group was significantly lower than that in control group(all P<0.05).Conclusion The airway reconstruction using Mimics software in LDLT intubation has a high satisfaction rate of alignment and has less airway injury,it is of guiding significance for the intubation and positioning of LDLT.