The Influence of the Endotracheal Tube on the Vocal Cord by the Change of Head Position

头位改变气管插管对声带的影响

• 批准号: 07672168
• 负责人: SHIBUTANI Tohru
• 金额: $ 1.34万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07672168/
• 关键词: Hed rotation; Vocal cord; Endotracheal tube; MRI; Morphological change; 声門; 核磁気共鳴像

We investigated the influence of the endotracheal tube on the vocal cord by head rotation.1.The airway from the nasal and oral cavity to the trachea was imaged with magnetic resonance imaging (MRI) in two head position ; ordinary head position and head rotation. The life sized airway model was made of acrylic plate based on MR images. Various types and sizes of endotracheal tubes (ETT) were intubated in the model and the pressure between the ETT and the vocal cord was measured with pressure transducer. The ETT was pressed on the opposite side of the vocal cord. The strength of the pressure was varied by the type and size of the ETT.2.Mongrel dogs were intubated and the ETT was pressed to the larynx with the pressure obtained in the model. The morphological changes of the larynx were observed macroscopically and microscopically with scanning Electron Microscopy. Laryngeal ruber was seen after 6 hours with a pressure of 25 mmHg and after 2 hours of 50mmHg.Microscopical changes such as desquamation of stratified squamous epithelium, partial lack and disarrangement of micriridge, and lack and fusion of cilia, appeared before the macroscopical changes.Consequently, in operation which require head rotation, we have to select sutable ETT and pay attention to prevent postoperative complications such as laryngeal edema and granuloma.

研究了气管插管通过头部旋转对声带的影响。1.在两种头位、普通头位和头部旋转状态下，对鼻腔和口腔至气管的呼吸道进行磁共振成像。真人大小的气道模型由基于MR图像的亚克力平板制作而成。在模型中插入不同类型和大小的气管导管(ETT)，用压力传感器测量ETT与声带之间的压力。ETT被压在声带的对侧。压力强度因ETT的类型和大小而异。2.杂种犬插管后，将ETT按模型所获得的压力按压至喉部。用扫描电子显微镜大体和显微观察喉的形态变化。在25 mm Hg6 h和50 mm Hg 2 h后可见喉部皱纹，肉眼可见复层鳞状上皮脱屑、微突部分缺失和排列紊乱、纤毛缺失和融合，因此，在需要转头的手术中，应选择合适的ETT，注意预防喉部水肿、肉芽肿等术后并发症。

项目成果

堀 智範: "頭位回旋による各種気管内チューブの声門に対する影響" 日本歯科麻酔学雑誌. 24(1). 13-31 (1996)

Tomonori Hori：“由于头部旋转，各种气管插管对声门的影响”《日本牙科麻醉学杂志》24(1) (1996)。

Tomonori HORI: "The Effect of Head Rotation on the Pressure of the Endotracheal Tube on the Vocal Cords" Jap.J.Dental Anesthesiolgy. 24(1). 13-31 (1996)

Tomonori HORI：“头部旋转对气管插管对声带压力的影响”Jap.J.Dental Anesthesiolgy。