支撑喉镜下声门暴露困难相关因素分析  

The related factors analysis of difficult laryngeal exposure under retaining laryngoscope

作　　者：王吉选 胡艳红[2] 王东海[2] 赵国锋[2] 李翔宇[2] 李阳阳[2] 

机构地区：[1]华北理工大学附属医院骨科,河北唐山063000 [2]唐山市协和医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第17期1519-1521,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析影响支撑喉镜下声门暴露困难的相关因素。方法:回顾性分析287例全身麻醉支撑喉镜手术患者的临床资料,观察性别、张口度、BMI、颈围、头颈屈伸度、甲状软骨上切迹与下颌骨颏下角距离(TMD)、舌骨下颌骨颏下角距离(HMD)、胸骨上窝至颏下角距离(SMD)与声门暴露困难之间的关系。结果:经ROC曲线分析确定TMD最佳临界值为7.35cm,HMD最佳临界值为6.33cm,SMD最佳临界值为14.75cm。经单因素分析发现,性别与声门暴露无明显相关,张口度、BMI、颈围、头颈屈伸度、TMD、HMD、SMD与声门暴露相关。将影响声带暴露的单因素进一步行多因素分析,结果显示颈围、头颈屈伸度、TMD、SMD是影响支撑喉镜声门暴露的独立因素。结论:术前测量患者颈围、头颈屈伸度、TMD、SMD,对预测患者术中声门暴露情况具有重要意义。Objective： To analyze the related factors of difficult laryngeal exposure under retaining laryngo- scope. Method：We did a retrospective analysis of 287 retaining laryngoscope surgery patients＇ clinical datas to ob- serve the relationship between difficult glottis exposure and patients＇gender, degree of mouth opening, BMI, neck circumference,head and neck flexion, TMD, HMD and SMD. Result： By ROC curve analysis , we determine the optimal threshold for TMD was 7.35 cm, HMD was 6.33 cm, SMD was 14.75 cm. Univariate analysis showed that gender, and glottis exposure had no significant correlation with difficult laryngeal exposure under retaining la- ryngoscope. Degree of mouth opening, BMI,neck circumference, head and neck flexion, TMD, HMD and SMD had correlation with difficult laryngeal exposure. Multivariate analysis showed that neck circumference, head and neck flexion, TMD, SMD were independent factors of difficult laryngeal exposure under retaining laryngoscope. Conclusion：Measurement of neck circumference, head and neck flexion, TMD, SMD before the operation is impor- tant for the prediction of difficult laryngeal exposure under retaining laryngoscope.

关 键 词：支撑喉镜 声门暴露 相关因素 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]