左肺动脉吊带修复术后伴或不伴气管成形术的三维气管形态学改变
Three-dimensional tracheal morphologic changes after left pulmonary artery sling repair with and without tracheoplasty.
作者
作者单位
- Department of Pediatric Surgery, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan. keimorita1209@gmail.com.
- Department of Mechanical Science and Bioengineering, The University of Osaka Graduate School of Engineering Science, Suita, Japan.
- Department of Cardiovascular Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
- Department of Systems Science, The University of Osaka School of Engineering Science, Suita, Japan.
摘要
中文
对于左肺动脉吊带（LPAS）合并先天性气管狭窄的患者，同时进行滑动气管成形术的指征仍存在争议。本研究量化了LPAS修复术（伴或不伴滑动气管成形术）后三维气管形态学改变，为建立手术指征提供见解。根据13例患者（10例接受气管成形术，3例仅接受LPAS修复术）的术前和术后CT扫描重建气道几何形状，测量隆突近端30mm节段的等效直径和基于几何形状的流阻。所有结果以中位数[范围]表示。气管成形术组显示隆突周围显著扩大（3.3 [2.4-4.1]至5.2 [4.2-6.7] mm；P=0.002），阻力估计显著降低（2.30 [0.83-9.6]至0.39 [0.11-1.88] cmH2O/(L/s)；P=0.004）。在仅LPAS修复组中，两名患者术前阻力估计较低（0.92和1.52 cmH2O/(L/s)），与气管成形术组术后值相当。滑动气管成形术提供了实质性的形态和功能改善，但某些患者仅通过LPAS修复术即可获得可接受的气道阻力。计算流阻可能作为可视化或量化手术干预效果的有用工具。
English
In patients with a left pulmonary artery sling (LPAS) and congenital tracheal stenosis, indications for simultaneous slide tracheoplasty remain controversial. This study quantified three-dimensional tracheal morphologic changes after LPAS repair with and without slide tracheoplasty to provide insights into establishing surgical indications. Airway geometries were reconstructed from pre- and postoperative computed tomography scans in 13 patients (10 with tracheoplasty, three with LPAS repair alone), measuring equivalent diameter and geometry-based flow resistance in a 30-mm segment proximal to the carina. All results are expressed as median [range]. The tracheoplasty group showed significant pericarinal enlargement (3.3 [2.4-4.1] to 5.2 [4.2-6.7] mm; P = 0.002) and a marked decrease in resistance estimates (2.30 [0.83-9.6] to 0.39 [0.11-1.88] cmH2O/(L/s); P = 0.004). In the LPAS repair alone group, two patients exhibited low preoperative resistance estimates (0.92 and 1.52 cmH2O/(L/s)), comparable to postoperative values in the tracheoplasty group. Slide tracheoplasty provides substantial morphologic and functional improvements, but certain patients achieve acceptable airway resistance with LPAS repair alone. Computational flow resistance may represent a useful tool for visualizing or quantifying the effects of surgical intervention.
分类与指标
- 研究类型
- 临床研究
- 病种
- 气管疾病
- JCR 分区
- Q2
- 影响因子
- 1.8
- 新锐分区
- 3区