通气控制CT测量5岁以下儿童肺支气管径线

发布时间：2018-05-15 15:20

本文选题：体层摄影术 + X线计算机　；参考：《放射学实践》2015年03期

【摘要】：目的:采用通气控制CT测量5岁以下儿童吸气末、呼气末呼吸道径线值,初步探讨儿童气管发育特点并为临床气管插管型号的选择提供参考。方法:本研究采用前瞻性研究,选取2011年1月-2013年8月因胸壁软组织病变来本院行胸部CT扫描的小于5岁的患儿共80例。随机将其分为吸气末扫描组与呼气末扫描组进行通气控制CT扫描,获得吸气末、呼气末图像。扫描图像由两位高年影像医师评估,将肺内及纵隔内无病变的患儿共63例纳入本研究。径线:气管隆突上2cm处的水平气管直径(TD);气管隆突水平右主支气管直径(RBD)、左主支气管直径(LBD);气管隆突至右中下叶支气管开口的距离作为右主支气管长度(RBL)、气管隆突至左下叶支气管开口的距离作为左主支气管长度(LBL)。角度:右主气管长轴与矢状面夹角(RA)、左主气管长轴与矢状面夹角(LA)、右上叶支气管长轴与右中下叶支气管长轴夹角(RA′)、左上叶支气管长轴与左下叶支气管长轴夹角(LA′)。分析性别、年龄、体重与径线、角度之间的关系。结果:性别、年龄、体重、径线都与角度之间不存在相关性(P0.05)。角度的平均值及范围:RA:34.69°±5.29°(24.43°~42.05°),LA:45.27°±5.09°(24.43°~42.05°),RA′:66.27°±7.71°(51.73°~84.06°),LA′:52.12°±6.87°(37.62°~66.84°)。吸气末和呼吸末的呼吸道径线和角度间差异均无统计学意义(P0.05)。性别和径线之间无相关性(P0.05)。年龄、体重和径线间的存在相关性,并建立了相关的线性方程:TD=4.52+0.16×体重+0.04×月龄、RBD=3.17+0.16×体重+0.02×月龄、LBD=3.11+0.11×体重+0.03×月龄、RBL=7.07+0.11×体重+0.14×月龄、LBL=15.33+0.94×体重+0.02×月龄。结论:年龄和体重是影响5岁以下儿童呼吸道径线的重要因素,可以根据年龄、体重与径线间的线性方程选择合适的气管插管。
[Abstract]:Objective: to measure the end of air inhalation and the end respiratory tract diameter of children under 5 years of age with ventilation control CT, to discuss the characteristics of tracheal development in children and to provide reference for the selection of the type of endotracheal intubation. Methods: a prospective study was used in this study to select the small CT scan in our hospital for the chest wall soft tissue in August January 2011. A total of 80 children aged 5 years were randomly divided into the end of breath scan group and the end expiratory scan group for the ventilation controlled CT scan to obtain the end of breath and the end of expiratory image. The scanned images were evaluated by two senior image physicians. A total of 63 children with no lesions in the lung and mediastinum were included in this study. The diameter line: the horizontal trachea diameter at the 2cm of the tracheal protuberance. (TD); the diameter of the right main bronchi (RBD) and the diameter of the left main bronchus (LBD); the distance between the protuberance of the trachea to the right middle lobe bronchus as the length of the right main bronchus (RBL), the distance between the protuberance of the trachea to the left lower lobe bronchus as the length of the left main bronchus (LBL). The angle between the long axis of the tube and the sagittal plane (LA), the angle between the long axis of the right upper lobe and the long axis of the right middle lobar bronchus (RA '), the angle between the long axis of the upper left upper lobe and the long axis of the left lower lobe bronchus (LA'). The relationship between sex, age, weight and the angle were analyzed. Results: sex, age, weight, and diameter were not related to the angle (P0.05 The average value and range of the angle: RA:34.69 [5.29] (24.43 ~42.05 degrees), LA:45.27? + 5.09 [24.43], RA ': 66.27 [66.27] 7.71 (51.73 [~84.06]), LA': 52.12 + 6.87 [degree]. There was no statistical difference between the end of breath and the angle of respiratory tract (P0.05). There was no correlation between sex and diameter. (P0.05) the correlation between age, weight and diameter, and establishing a linear equation: TD=4.52+0.16 x weight +0.04 x month, RBD=3.17+0.16 x weight +0.02 month old, LBD=3.11+0.11 x weight +0.03 x month age, RBL=7.07+0.11 x weight +0.14 x month age, LBL=15.33+ 0.94 x weight +0.02 x month age. Conclusion: age and weight are 5 years old. Appropriate tracheal intubation can be selected based on the linear equation between age, weight and diameter.

【作者单位】：北京大学首都儿科研究所教学医院放射科;
【分类号】：R725.6;R816.92

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