患者头部后仰角度对声门暴露的影响:基于CT上呼吸道矢状面图像的模拟评估方法
投稿时间:2016-09-23  修订日期:2016-10-08  点此下载全文
引用本文:柴茂,汪小海.患者头部后仰角度对声门暴露的影响:基于CT上呼吸道矢状面图像的模拟评估方法[J].医学研究杂志,2017,46(8):169-171
DOI: 10.11969/j.issn.1673-548X.2017.08.042
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作者单位E-mail
柴茂 210008 南京医科大学鼓楼临床医学院  
汪小海 210008 南京医科大学鼓楼临床医学院 519602322@qq.com 
中文摘要:目的 利用CT三维重建上呼吸道矢状面图像模拟探讨头部后仰角度对声门暴露的影响。方法 选择已在笔者医院实施头颈部上呼吸道螺旋CT扫描的患者80例,患者年龄7~78岁,利用AW4.4 workstation的3D-CT重建软件获取患者上呼吸道矢状位图像,在重建图像上选择正中矢状位并进行解剖学参数的测量:角α(A0组),即上切牙下缘、会厌根部、声门中点以会厌根部为交点所成角的度数。将得到的矢状位图像,按照人体实际尺寸以1:1的比例打印出来,以上切牙下缘为起点,会厌根部为终点,经硬腭、软腭沿弧线将图片剪开,以备用。通过顺时针方向增加角α的度数来模拟头部后仰的过程,以上切牙下缘与会厌根部的连线为基线,分别使角α增加10°(A10组)、20°(A20组)和30°(A30组),模拟使用纸质直接弯喉镜(Macintosh喉镜)模型窥视声门,根据声门暴露情况,记录各组声门暴露的成功率。结果 与A0组比较,A10组、A20组和A30组声门暴露的成功率明显升高(P<0.05);与A10组比较,A20组和A30组声门暴露的成功率明显升高(P<0.05);与A20组比较,A30组声门暴露的成功率明显升高(P<0.05)。结论 基于CT上呼吸道矢状面图像,可以直观的模拟评估患者头部后仰角度对声门暴露的影响。
中文关键词:CT三维重建  上呼吸道解剖结构  声门暴露  气道评估
 
Effect of Head Extension Angle to Glottis Exposure:A Simulation Evaluation Based on CT Reconstruction Images of Upper Airway
Abstract:Objective To investigate the effect of head extension angle to glottis exposure by using three-dimensional CT reconstruction sagittal plane images of upper airway. Methods There were 80 patients, aged 7-78 years old, who had been scanned by helical CT in the head and neck. Reconstructed images were obtained by AW4.4 workstation and the following parameter was measured:angle α(A0 group), the angle created by the upper central incisor and root of epiglottis(angular vertex) and midpoint of glottis. Reconstructed images were printed according to the actual size of human body in a ratio of 1:1, then the images were cut off from the upper central incisor to root of epiglottis by a section of arcs. Increasing the degree of angle α by clockwise to hypothetically increase the angle of head extension. The glottis was exposed by using a paper-made laryngoscope(Macintosh)model, and the success rate of glottis exposure was recorded when the degree of angle α was respectively increased 10°(A10 group), 20°(A20 group), and 30°(A30 group). Results Compared with A0 group, the success rate of glottis exposure increased significantly in A10 group, A20 group and A30 group.The success rate of glottis exposure in A20 group and A30 group was significantly higher than A10 group. Compared with A20 group, the success rate of glottis exposure obviously increased in A30 group. Conclusion Based on CT reconstruction images of upper airway, we can analog study the effect of head extension angle to glottis exposure.
keywords:Three-dimensional CT reconstruction  Anatomical feature of upper airway  Glottis exposure  Airway assessment
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