喉显微手术声门暴露困难患者头颈部影像测量参数的研究  

A study on the X-ray measurement predictors of difficult laryngeal exposure in patients undergoing microlaryngosurgery

作　　者：马艳利[1] 徐新林[1] 周莉[1] 王睿卿[2] 庄佩耘[1] 

机构地区：[1]厦门大学附属中山医院耳鼻咽喉科福建,厦门361004 [2]厦门大学医学院

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第13期1042-1046,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金(No:81371080)资助

摘　　要：目的:探讨喉显微手术影响声门暴露的相关因素,为术前评估提供参考。方法:对62例声带病变患者于术前采集可能影响声门暴露的临床数据,包括4个基本参数:年龄、性别、BMI和改良Mallampati指数(MMI);1个体表测量参数:甲状软骨夹角(TA);13个在头颈仰伸侧位X线片下测量的影像参数:上切牙夹角(UIA)、下切牙夹角(LIA)、切牙间距(IG)、下切牙颏突间距(LIMD)、下颌角(MA)、下颌骨颏-髁间距(MCD)、下颌骨高度(MH)、下颌骨深度指数(MDI)、舌颏距(HMD)、甲颏距(TMD)、胸颏距(SMD)、甲颏夹角(TMA)、上切牙甲舌夹角(THUIA)。结合患者术中声门暴露情况对这些影响因素进行统计学分析。结果:单因素分析显示,性别与声门暴露相关,差异有统计学意义(P<0.05)。Logistic逐步回归分析显示:LIMD、MA、TMA和THUIA是声门暴露困难的危险因素,临界值分别为:LIMD>4.53cm、MA>115.5°、TMA>99.2°、THUIA>152.6°。结论:术前测量LIMD、MA、TMA和THUIA对预测声门暴露困难有重要意义;性别也是预测声门暴露困难的有效指标,男性更易发生声门暴露困难。Objective：This paper seeks to identify useful and reliable indicators for predicting the occurrence of difficult laryngeal exposure（DLE）in microlaryngosurgery.Method：Sixty-two patients were given physical examinations,including 4general parameters：age,sex,BMI,and MMI,and 14 physical measurement parameters（TA,UIA,LIA,IG,LIMD,MA,MCD,MH,MDI,HMD,TMD,SMD,TMA,THUIA）.Univariate analysis,stepwise regression analysis and ROC curve analysis were employed to identify parameters with the potential to predict DLE.Result：We found sex（P〈0.05）showed significant correlation with the laryngeal exposure score（P〈0.05）.We also found LIMD,MA,TMA and THUIA to be reliable DLE predictors.The cutoff values for predicting DLE were LIMD〉4.53 cm,MA〉115.5°,TMA〉99.2°,and THUIA〉152.6°.Conclusion：X-ray measurement predictors of LIMD,MA,TMA,and THUIA before operation are important for the prediction of DLE.Sex is also the reliable DLE predictor.Males were prone to DLE.

关 键 词：声门暴露困难 影像学测量 性别 预测指标 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]