CAJ | 학술논문

目的：探讨气管插管后狭窄（PITS）的螺旋CT影像学特征及其临床指导意义。方法回顾性分析27例PITS患者，分别收集其临床资料及螺旋CT影像资料，观察气管狭窄部位、程度、形态，总结其影像特点；并根据不同的影像特点分析狭窄原因及其对PITS病情评估和临床处理的影响。结果27例患者，共检出气管狭窄部位35处，分别位于气管切开水平10例、气囊水平5例和套管末端20例，狭窄程度均大于30%；其中局限性狭窄15例，影像特征为“沙漏状、束腰状”狭窄；节段性狭窄4例，影像特征为“带状、哑铃状”狭窄；复合狭窄8例。参考相应的影像特征，所有患者均得到了及时、个体化的治疗。结论 PITS具有典型的影像特征，螺旋CT检查可作为PITS影像学检查的首选。相关科室可根据不同的影像特征评估患者病情，制订个体化的治疗方案，对麻醉科气管插管及相关科室医护人员认识并及时预防、处理该症具有一定的临床指导意义。
목적：탐토기관삽관후협착（PITS）적라선CT영상학특정급기림상지도의의。방법회고성분석27례PITS환자，분별수집기림상자료급라선CT영상자료，관찰기관협착부위、정도、형태，총결기영상특점；병근거불동적영상특점분석협착원인급기대PITS병정평고화림상처리적영향。결과27례환자，공검출기관협착부위35처，분별위우기관절개수평10례、기낭수평5례화투관말단20례，협착정도균대우30%；기중국한성협착15례，영상특정위“사루상、속요상”협착；절단성협착4례，영상특정위“대상、아령상”협착；복합협착8례。삼고상응적영상특정，소유환자균득도료급시、개체화적치료。결론 PITS구유전형적영상특정，라선CT검사가작위PITS영상학검사적수선。상관과실가근거불동적영상특정평고환자병정，제정개체화적치료방안，대마취과기관삽관급상관과실의호인원인식병급시예방、처리해증구유일정적림상지도의의。
Objective To explore the spiral computed tomography (CT) imaging feature of post-intubation tracheal stenosis (PITS) and to discuss its clinical significance. Methods The clinical data and CT imaging findings of 27 patients with PITS were retrospectively analyzed. The location, degree and shape of PITS were analyzed, and the imaging features were summarized. Based on the imaging features the etiology of PITS was suggested, and the role of imaging feature in assessing PITS condition and in planning clinical management was evaluated. Results A total of 35 tracheal strictures were detected in the 27 patients. The location of the strictures included trachea incision site (n=10), balloon level (n=5) and distal end of tube (n = 20). In all patients the degree of stenosis was > 30%. Localized stenosis was seen in 15 cases, which presented as “hourglass”or “girdle”shape. Segmental stenosis was found in 4 cases, which was characterized by a “ribbon” or “dumbbell” stricture on CT scans. Complex stenosis was found in 8 cases. With the help of imaging findings, all patients got timely, proper and individualized treatment. Conclusion PITS has typical imaging characteristics. Spiral CT scanning should be regarded as the imaging examination of first choice. Based on the different imaging characteristics, the relevant departments can evaluate patient’s condition and make individualized treatment plan. The imaging finding is very helpful for anesthesiologists and other clinicians in recognizing and in managing the post-intubation tracheal stenosis.