移动CT监测肺不张的临床应用

目的应用电子计算机体层摄影(CT)观察全身麻醉诱导前后肺不张的变化。方法8例择期行神经外科手术的患者,于麻醉前、麻醉诱导插管后行全肺CT扫描,选择肺尖、肺门、右膈顶上1cm三个层面的CT图像分析观察肺不张的变化。结果三个层面中,右膈顶上1cm层面的图像麻醉前后变化最明显,麻醉诱导插管后监测到明显的肺不张。结论全麻导致患者肺不张的面积和百分比增加,围术期肺部CT扫描能有效地监测到肺不张的发生,有助于优化术中机械通气,减少肺损伤。

Clinical study on mobile CT monitoring atelectasis during general anesthesia

Objective To observe the changes of atelectasis by CT before and after induction of general anesthesia. Methods Eight patients scheduled for elective neurosurgery were examined with CT scaning of the thorax before and after intubation. The images at three levels of the apex, hilum and 1 cm above the top of the right diaphragm were selected to analysize the changes of atelectasis. Results The areas and ratios of atelectasis after intubation were remarkably increased after induction at the level of 1 cm above the top of the right diaphragm. Conclusion Atelectasis was remarkably increased after intubation and could effectively examined with CT scan, especially at the level of dome of diaphragm, which can be beneficial to selecting mechanical ventilation during general anesthesia.