Measurement Of Central Airway In Healthy Subject And Application Of The Judgment For The Treatment Of Airway Disease

Background The central airway refers to the trachea and long axon, or so the main bronchi and middle section bronchus.The central airway lesions oppression or the airway obstruction lumen itself lesions can cause severe breathing difficulties, the patient died of respiratory failure even.The central airway narrow can seriously affect ventilation function, breathing difficulties caused by patients, affect the patient's quality of life, and even cause suffocation deaths.Therefore, the central airway tumor therapy intervention was very important in one of the means.In recent years around the central airway narrow processing, there are many interventional treatment methods, including laser ablation, electrotome burning, frozen, light dynamic therapy, stent placement, balloon expansion and close illuminate, etc.With the rapid development of science and technology, these technologies and methods will also improving continuously, and can derive new treatments.Domestic more by bronchoscopy application reported in the literature of high-frequency electrotome trachea bronchial malignancy, low-grade malignant tumor, benign tumor, inflammatory granulation is swollen and tracheal bronchial amyloid treatment, has obtained the certain recent curative effect, after treatment significantly improved lung function [1-7].Improved lung function mainly embodied in the central airway narrow degree of improvement, at present, in the central airway narrow degree of judgment, judging by the airway volume increase the curative effect of patients with narrow central airway relatively small lesions research how to alleviate breath away let difficulties, improve the quality of life.The central airway measurements are not uniform diameter line, existence many problems of regional variations,â‘ The figure in Asia than commonly crowd Europe, according to Europe and the small crowd measured crowd standard size line between Asia and may not be appropriate value americans, may affect curative effect judge effect.â‘¡The measurement methods are different.The domestic existing various data about the central airway's records, a measurement data inconsistencies, many from by the corpse anatomical measurement, can't reflect live normal data.â‘¢Different measuring range.Always measuring range from the sternum choice clavicle middle position began, but at present the central airway narrow site near the subglottic, always, measurement range and may not apply to the current efficacy judgment.â‘£By measuring the patients at home and abroad to central central airway volume of airway curative effect, especially through judge relatively less in multislice CT 3d reconstruction technique determination of airway lesions trachea volume to judge less effect.Objective In view of the above questions, to normal persons were central airway reconstruction, get normal trachea and main bronchi diameter line each measurement data and volume, analysis trachea and the main bronchi measuring data and the crowd the relationship between relative factors. Airway lesions with central patients in before and after the treatment of 3d reconstruction on airway, compare and analyse tracheal interventional treatment for central trachea volume change the curative effect of airway lesions judgment. The study is based on the 200 cases of no into the chest disease patients, and CT scan and measurement by airway intervention treatment evaluation 120 cases of patients with benign airway narrow the curative effect.Methods Choose between October 2009 in Beijing in March 2010 chest CT scan coal general hospital, no chest disease, are from Beijing, the han nationality for 200 cases of personnel as the research object.With 64-slice CT ( spiral CT, slice 64-64 - SCT) image post-processing reconstruction technique: many plane MPR) and rebuild (volume reconstruction (VR) determine the sternum trachea clavicle diameter, cricoid cartilage level 2cm long axon level to the length of the trachea, left, right mainstem diameter and length, and left and right mainstem long axis and the Angle sagittal airway volume; central airway volume.Check-in our chest CT, trachea by endoscopy and pathological diagnosed with central airway benign stricture 120 cases of patients with 64 - SCT image post-processing technology: volume reconstruction (vr-cnc) trachea and main bronchi determined, and the volume of normal regression equations are obtained for calculating 100 patients airway sicken time capacity.Statistical analysis: data using S P S S 13.0 software statistics, data to mean + standard deviation says, compared between the two groups using the grouping t test, analysis of variance between groups, compares the with multiple linear regression analysis method is each height, weight and age and trachea and left and right mainstem length and diameter correlation, and left and right mainstem inner diameter of relevancy. With the trachea. P < 0.05 for difference have statistical significance.Results1The basic characteristics of the object of study(1) The normal group: male 110 cases, female 90 cases, age 18 80 years, mean age 2 + 2.41 years old, height, weight 182cm 150 ^, 40 91.8 kg BMI15.99 31.25 kg/m2.(2) Positive airway patients with narrow: male 64 cases of 56 cases, women, age 18 80 years, mean age 42.76 + 3.80 years old, height, weight 156cm 180cm 45 81kg, body mass index 18.34 29.18 kg/m2.2 Measurement results and its influencing factors(1) In addition to LA, RA two indexes women than men, TD, LBD LBL, TL, RBL, central, CAV1 airway volume wait for an indexes for men than women, with statistical significance.Most is that airway index with normal gender.(2) The refers to the measured value of the basic agreement between in all age groups, difference was statistically significant that normal adult airway index and regardless of age.(3) The measured value of the indexes in different height groups are different, besides between two indexes LA, RA with the increase of the height, other diminishing each index all along with height increases, with statistical significance.Airway index majority is that normal with height about.(4) The measured value of the indexes in different weight group are different, besides between two indexes LA, RA with weight gain degressive outside, other all indexes as weight increases, with statistical significance. Airway index majority is that normal with height about.(5) Measurements of each indicator between groups in different body mass index is basically the same not statistically significant difference that normal adult airway index has nothing to do with body mass index.(6) CAV₂ and CAV₃ in scar group, granulation group, benign tumor with differences between groups, with benign tumor group CAV₂ supreme, granulation group minimum;And CAV₃ supreme, scar by granulation group, difference of minimum was statistically significant.(7) Each main bronchi with trachea inner diameter and tracheal volume diameter and height are tending to high correlation between.(8) Scar group, granulation group, benign tumor group APC that first ablation range similar, in combination of the airway APC freezing the treatment effect of various benign stricture similar.(9) Scar group, granulation group, benign tumor groups before treatment within narrow airway both promote score similar degree, after treatment, both within narrow airway degree greup promote score.After treatment, the three groups both promote score more narrow degree preoperative will be improved obviously, scar treatment group is significantly better than the other two groups effect, the other two groups was not statistically significant, show the APC combination of the treatment of benign stricture frozen better effects, especially for scar treatment group effect is rather strong.Conclusion(s)(1)Through MDCT 3d imaging method for normal adult tracheal, left and right mainstem diameter line value and central airway volume than X-ray and ordinary CT.(2)Left, right mainstem inner value, the central airway volume diameter with height and trachea patients with measured values into highly correlation.(3) The APC combined with CO2 cryotherapy central airway narrow short-term relief of symptoms can be used for breathing difficulties, especially on high safety, and relief.