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。
Objective To investigate the effect of head extension angle to glottis exposure by using three - dimensional CT recon- struction sagittal plane images of upper airway. Methods There were 80 patients, aged 7 - 78 years old, who had been scanned by heli- cal CT in the head and neck. Reconstructed images were obtained by AW4.4 workstation and the following parameter was measured ： angle α（ A10 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 inci- sor to root of epiglottis by a section of arcs. Increasing the degree of angle α by clockwise to hypothetically increase the angle of head ex- tension. The glottis was exposed by using a paper- made laryngoscope（Macintosh） model, and the success rate of glottis exposure was re- corded when the degree of angle α was respectively increased 10°（AIO group）, 20°（ A20 group）, and 30°（ A30 group）. Results Com- pared 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.
出处
《医学研究杂志》
2017年第8期169-171,共3页
Journal of Medical Research
关键词
CT三维重建
上呼吸道解剖结构
声门暴露
气道评估
Three - dimensional CT reconstruction
Anatomical feature of upper airway
Glottis exposure
Airway assessment
