气管插管后狭窄27例的CT影像特征及其临床指导意义

发布时间：2019-04-10 11:11

【摘要】：目的探讨气管插管后狭窄(PITS)的螺旋CT影像学特征及其临床指导意义。方法回顾性分析27例PITS患者,分别收集其临床资料及螺旋CT影像资料,观察气管狭窄部位、程度、形态,总结其影像特点;并根据不同的影像特点分析狭窄原因及其对PITS病情评估和临床处理的影响。结果 27例患者,共检出气管狭窄部位35处,分别位于气管切开水平10例、气囊水平5例和套管末端20例,狭窄程度均大于30%;其中局限性狭窄15例,影像特征为"沙漏状、束腰状"狭窄;节段性狭窄4例,影像特征为"带状、哑铃状"狭窄;复合狭窄8例。参考相应的影像特征,所有患者均得到了及时、个体化的治疗。结论PITS具有典型的影像特征,螺旋CT检查可作为PITS影像学检查的首选。相关科室可根据不同的影像特征评估患者病情,制订个体化的治疗方案,对麻醉科气管插管及相关科室医护人员认识并及时预防、处理该症具有一定的临床指导意义。
[Abstract]:Objective to investigate the spiral CT imaging features of (PITS) stenosis after endotracheal intubation and its clinical significance. Methods 27 cases of PITS were analyzed retrospectively. The clinical data and spiral CT images were collected, the position, degree and shape of trachea stenosis were observed, and the imaging features were summarized. According to different imaging features, the causes of stenosis and its influence on the evaluation and clinical management of PITS were analyzed. Results there were 35 stenosis sites in 27 patients, which were located at tracheotomy level in 10 cases, airbag level in 5 cases and end of casing in 20 cases. The degree of stenosis was more than 30%. 15 cases with localized stenosis were characterized by "hourglass-shaped, lumber-shaped" stenosis, 4 cases with segmental stenosis, 8 cases with "banded, dumbbell-like" stenosis and 8 cases with compound stenosis. Referring to the corresponding imaging features, all patients were treated in a timely and individualized manner. Conclusion PITS has typical imaging features and spiral CT can be used as the first choice for imaging examination of PITS. The related departments can evaluate the patient's condition according to different imaging characteristics, and make individual treatment plan, which has certain clinical guiding significance to understand and prevent the trachea intubation in anaesthesia department and doctors and nurses in related departments in time, and to deal with the disease.
【作者单位】：徐州医学院附属医院介入放射科;
【基金】：江苏省临床医学科技专项-新型临床诊疗技术攻关(BL2013011) 徐州医学院“振兴计划”(XZMC2012-2015)
【分类号】：R816.4;R562.12

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