国际麻醉学与复苏杂志   2021, Issue (1): 7-7
    
强直性脊柱炎胸腰椎后凸畸形患者行后路截骨矫形术气管及气管导管位置变化的临床观察
董媛媛1()
1.南京鼓楼医院
Clinical observation on the changes of tracheal and tracheal catheter position in ankylosing spondylitis patients with thoracolumbar kyphosis treated with pedicle subtraction osteotomy
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摘要：

目的 观察经椎弓根截骨术（pedicle subtraction osteotomy, PSO）治疗强直性脊柱炎（ankylosing spondylitis, AS）胸腰椎后凸畸形患者手术前后门齿距气管隆突距离（length of incisors to carina, LIC）及气管隆突距气管导管尖端距离（length of carina to the tip of the tracheal catheter, LCT）的变化。 方法 记录86例AS行PSO患者术前及术后的身高、颈椎活动度（cervical range of motion, CROM）、全脊柱最大Cobb角（global kyphosis, GK）以及颌眉角（chin‑brow vertical angle, CBVA）；分别在术前及术后于正中仰卧位下使用纤维支气管镜（fiberoptic bronchoscope, FOB）通过气管导管测量患者的LIC和LCT。 结果 与术前比较，86例患者术后身高明显增高，术后GK、CBVA明显减小（P<0.05）；患者术后CROM与术前比较差异无统计学意义（P>0.05）；86例患者术后LIC、LCT均较术前增长（P<0.05）。 结论 AS患者行后路截骨矫形手术后，气管导管尖端在气管内向声门方向移位，可适当延长气管插管深度。
关键词： 气管导管； 移位； 强直性脊柱炎； 脊柱后凸； 截骨术
Abstract:

Objective To observe the changes in the length of incisors to the carina (LIC) and the length of carina to the tip of the tracheal catheter (LCT) in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis after pedicle subtraction osteotomy (PSO). Methods A total of 86 AS patients who underwent PSO were enrolled and their height, cervical range of motion (CROM), global kyphosis (GK), and chin‑brow vertical angle (CBVA) were recorded before and after surgery. Furthermore, LIC and LCT were measured via a tracheal tube in the median supine position under a fiberoptic bronchoscope (FOB) before and after surgery. Results Compared with those before surgery, all the patients presented remarkable increases in height and decreases in GK and CBVA after surgery (P<0.05). There were no statistical differences in CROM before and after surgery (P>0.05). All the patients presented increases in LIC and LCT after surgery, compared with those before surgery (P<0.05). Conclusions After PSO, AS patients present a shift in the tracheal catheter tip towards the glottis, and the insertion depth of tracheal tube may properly extend.
Key words: Endotracheal catheter; Displacement; Ankylosing spondylitis; Kyphosis; Osteotomy