CAJ | 학술논문

[目的]分析经鼻留置胃管不同体位下胃管路径的影像变化,为改良经鼻留置胃管技术提供影像解剖依据。[方法]26例需留置胃管的病人以垫肩颈仰头体位经鼻留置胃管后,分别取垫肩颈仰头体位及平卧位行 CT 扫描,通过多平面重组(MPR)及最大密度投影(MIP)等后处理观察胃管走行路径,在正中矢状位测量各观察指标。[结果]垫肩颈仰头位时：鼻尖至食管入口连线长度(A1)(118.71±6.66) mm,寰椎前弓至 A1的垂直距离(A2)(42.35±7.81)mm ,颚骨上缘与第2颈椎椎体后缘的角度(A3)(91.17±7.90)°及颚骨上缘与第5颈椎椎体后缘的角度(A4)(97.99±8.79)°；平卧位时：A1为(114.58±9.07)mm,A2为(38.72±7.44)mm,A3为(95.15±8.78)°,A4为(94.42±10.58)°。[结论]垫肩颈仰头仰卧位留置胃管技术具有明显的解剖学优势,使胃管走行曲度变大,更有利于临床置管并减轻病人副反应。
[목적]분석경비류치위관불동체위하위관로경적영상변화,위개량경비류치위관기술제공영상해부의거。[방법]26례수류치위관적병인이점견경앙두체위경비류치위관후,분별취점견경앙두체위급평와위행 CT 소묘,통과다평면중조(MPR)급최대밀도투영(MIP)등후처리관찰위관주행로경,재정중시상위측량각관찰지표。[결과]점견경앙두위시：비첨지식관입구련선장도(A1)(118.71±6.66) mm,환추전궁지 A1적수직거리(A2)(42.35±7.81)mm ,악골상연여제2경추추체후연적각도(A3)(91.17±7.90)°급악골상연여제5경추추체후연적각도(A4)(97.99±8.79)°；평와위시：A1위(114.58±9.07)mm,A2위(38.72±7.44)mm,A3위(95.15±8.78)°,A4위(94.42±10.58)°。[결론]점견경앙두앙와위류치위관기술구유명현적해부학우세,사위관주행곡도변대,경유리우림상치관병감경병인부반응。
Obj ective:To analyze and compare the imaging changes of gastric tube path under different positions of nasal gastric tube indwell-ing,so as to provide imaging and anatomy evidences for improving na-sal gastric tube technology.Methods:A total of 26 cases of patients who need indwelling gastric tube were selected,and they were exam-ined by CT respectively with shoulder and pillow pad upward position and supine after the nasal gastric tube indwelling in shoulder pads neck upward position.The gastric tube traveling path was observed af-ter MIP and MPR treatment and all indicators were measured in the median sagittal plane.Results:Shoulder and pillow pad upward posi-tion A1(118.71±6.66)mm,Supine A2(42.35±7.81)mm;shoulder and pillow pad upward position A3(91.17±7.90)°;shoulder and pil-low pad upward position A4(97.99±8.79)°,Supine position:A1 was (114.58±9.07)mm,A2 was (38.72±7.44)mm,A3 was (95.15±8.78)°, A4 was (94.42 ± 10.58 )°.Conclusion:Gastric tube technology in shoulder pads neck upward in a supine position has obvious anatomical advantages,so that the curvature of gastric tube traveling is larger,and it is more conducive to clinical catheterization and reduce the side effects of patients.