超声测量舌根至甲状软骨夹角预测喉镜暴露困难的临床研究

doi:10.19438/j.cjoms.2023.02.007

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (2): 142-145.doi: 10.19438/j.cjoms.2023.02.007

超声测量舌根至甲状软骨夹角预测喉镜暴露困难的临床研究

王俊安¹, 顾海林¹, 史文涛², 孙宇³

1.上海交通大学医学院附属第九人民医院黄浦分院麻醉科,上海 200011;
2.上海交通大学医学院附属第九人民医院临床研究中心,3.麻醉科,上海 200011

收稿日期:2022-10-15 修回日期:2022-12-13 出版日期:2023-03-20 发布日期:2023-06-12
通讯作者: 孙宇,E-mail: dr_sunyu@163.com
作者简介:王俊安（1975-）,男,硕士,副主任医师, E-mail: junanw2010@126.com
基金资助:
上海市黄浦区卫生系统科研项目（HLM202013）

Clinical study of angle between base of tongue and thyroid cartilage measured by ultrasound to predict difficult laryngoscopy

WANG Jun-an¹, GU Hai-lin¹, SHI Wen-tao², SUN Yu³

1. Department of Anesthesiology, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine. Shanghai 200011;
2. Clinical Research Unit, 3.Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine. Shanghai 200011, China

Received:2022-10-15 Revised:2022-12-13 Online:2023-03-20 Published:2023-06-12

摘要/Abstract

摘要： 目的： 应用超声测量气道组织结构评估喉镜暴露困难的危险因素。方法： 选择300例在气管插管全麻下实施择期手术的患者,麻醉诱导前通过超声测量舌体宽度、舌体厚度、颏舌骨距离、甲状舌骨距离、舌根至甲状软骨夹角等评价指标,麻醉诱导后进行喉镜下声门暴露的Cormack-Lehane (C-L)分级,1、2级定义为非暴露困难组,3、4级定义为暴露困难组。分析各评价指标和C-L分级的相关性。采用SPSS 20.0软件包对数据进行统计学分析。结果： 舌根至甲状软骨夹角为预测喉镜暴露困难的独立危险因素,最佳点为43°夹角,此时敏感度为96.2%,特异度为83.6%,AUC为0.866 [95%CI: 0.769~0.962]。结论： 超声测量舌根至甲状软骨夹角可作为评估困难气道的指标。

关键词: 超声测量, 舌根至甲状软骨夹角, 喉镜暴露困难

Abstract: PURPOSE: To evaluate the risk factors of difficult laryngoscopy through structure of airway measured by ultrasound. METHODS: A total of 300 patients supposed to receive elective surgery under general anesthesia with endotracheal intubation were included. Before anesthesia induction, indicators such as tongue width, tongue thickness, mentohyoid distance, thyrohyoid distance and angle between base of tongue and thyroid cartilage were measured and recorded by ultrasound. After anesthesia induction, Cormack-Lehane (C-L) grade under laryngoscopy was conducted. One and 2 grades were defined as non-difficult laryngoscopy group and 3 and 4 grades were defined as difficult laryngoscopy group. The correlation between each evaluation index and C-L classification was analyzed by SPSS 22.0 software package. RESULTS: Angle between base of tongue and thyroid cartilage was thought as independent risk factor for predicting laryngoscopy, the cut-off point was 43°, sensibility was 96.2%, specificity was 83.6%, area under curve(AUC) was 0.866 [95%CI: 0.769-0.962]. CONCLUSIONS: Measuring angle between base of tongue and thyroid cartilage by ultrasound can be applied to predict difficult airway.

Key words: Ultrasonic measurement, Angle between base of tongue and thyroid cartilage, Difficult laryngoscopy

中图分类号:

R782.05

王俊安, 顾海林, 史文涛, 孙宇. 超声测量舌根至甲状软骨夹角预测喉镜暴露困难的临床研究[J]. 中国口腔颌面外科杂志, 2023, 21(2): 142-145.

WANG Jun-an, GU Hai-lin, SHI Wen-tao, SUN Yu. Clinical study of angle between base of tongue and thyroid cartilage measured by ultrasound to predict difficult laryngoscopy[J]. China J Oral Maxillofac Surg, 2023, 21(2): 142-145.

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超声测量舌根至甲状软骨夹角预测喉镜暴露困难的临床研究

Clinical study of angle between base of tongue and thyroid cartilage measured by ultrasound to predict difficult laryngoscopy

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