MDCT及后处理技术在儿童呼吸道异物患者中的应用探讨

发布时间：2018-03-06 09:02

  本文选题：呼吸道异物　切入点：排螺旋CT三维成像　出处：《临床耳鼻咽喉头颈外科杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的:探讨64排螺旋CT三维成像(MDCT)及后处理技术在儿童可疑呼吸道异物中的临床应用价值。方法:对200例可疑呼吸道异物患儿行MDCT及仿真内镜成像,并与支气管镜术中所见对比,比较MDCT及后处理的结果和术中所见情况符合度。结果:经MDCT后处理技术检出184例阳性患儿经支气管镜检查,结果179例为外源性异物,5例为痰栓(内源性异物)阻塞。经MDCT后处理技术诊断为无异物的16例患儿,经支气管镜检查,1例有异物,其异物位于声门裂(西瓜子壳),其余15例亦无异物;MDCT及后处理技术对儿童呼吸道异物诊断的灵敏性99.4%,特异性75%。经统计学分析处理,MDCT及后处理技术与支气管镜检查术对异物的检出率差异无统计学意义(P0.05)。结论:虽然MDCT及后处理技术不能用于治疗支气管异物,但在支气管异物的诊断上与支气管镜相当。对于异物吸入史不明确、疑似气道异物时间长的患儿可在支气管镜检查之前行MDCT检查并做后处理,可指导支气管镜检查术中操作的关注点,提高诊疗水平。
[Abstract]:Objective: to evaluate the clinical value of 64-slice spiral CT 3D imaging and post-processing in children with suspicious respiratory foreign bodies. Methods: 200 children with suspected respiratory foreign bodies were treated with MDCT and virtual endoscopy. The results of MDCT and post treatment were compared with those of bronchoscopy. Results: 184 cases of positive children were detected by MDCT. Results there were 5 cases of phlegm embolism (endogenous foreign body) obstruction in 179 cases of foreign body, 16 cases were diagnosed as no foreign body by MDCT postprocessing technique, and 1 case had foreign body by bronchoscopy. The foreign body was located in the glottic fissure (Puca sunflower), and the other 15 cases had no foreign body MDCT and post-processing technique. The sensitivity and specificity of the foreign body in the diagnosis of respiratory foreign body in children were 99.4 and 75.After statistical analysis, the MDCT and post-processing technique and bronchoscopy were analyzed. Conclusion: although MDCT and post-processing techniques can not be used to treat foreign bodies in bronchus, there is no significant difference in the detection rate of foreign bodies. However, the diagnosis of foreign bodies in the bronchoscope is similar to that of bronchoscopy. For children with long suspected airway foreign bodies, the history of foreign bodies inhalation is not clear, and children with suspected foreign bodies of long time may undergo MDCT examination before bronchoscopy and do post-treatment. It can guide the operation of bronchoscopy and improve the level of diagnosis and treatment.
【作者单位】： 安徽医科大学第一附属医院耳鼻咽喉头颈外科;安徽省儿童医院耳鼻咽喉科;
【分类号】：R768.13
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本文编号：1574178