显微支撑喉镜手术声门区暴露困难的相关因素分析  

An analysis of the related factors of difficult laryngeal exposure in microsurgical laryngoscope surgery

作　　者：刘言军 庞秀红 储九圣[1] 毛明荣[1] 徐六英 LIU Yanjun;PANG Xiuhong;CHU Jiusheng;MAO Mingrong;XU Liuying(Department of Otolaryngology,Jiangsu Taizhou People's Hospital,Jiangsu,Taizhou 225300,China)

机构地区：[1]江苏省泰州市人民医院耳鼻咽喉科,江苏泰州225300

出　　处：《中国医药科学》2021年第24期156-158,163,共4页China Medicine And Pharmacy

基　　金：国家自然科学基金(81700920)。

摘　　要：目的分析显微支撑喉镜手术中声门区暴露困难的相关因素,为术前评估提供依据。方法采取前瞻性研究设计的方法,直接抽样法收集2020年1月至2021年1月江苏省泰州市人民医院收治的150例显微支撑喉镜下各类外科手术(包括声带息肉、声带肉芽、声带囊肿、声带白斑、喉乳头状瘤、早期喉癌等)患者的临床资料,统计分析相关因素与声门区暴露困难(DLE)的关系。结果经单因素分析发现体重指数(BMI)、头颈屈伸度、颈围、舌颏距(HMD),甲颏距(TMD)、胸颏距(SMD)、改良Mallampati(MMT)3、4级及Yamamoto 3、4级与支撑喉镜声门区暴露困难有关。logistic回归分析显示,头颈屈伸度<90°、TMD<7.75 cm和HMD<6.35 cm是DLE的独立危险因素。结论术前测量患者头颈屈伸度、TMD和HMD对评估DLE具有重要意义。Objective To analyze the related factors of difficult laryngeal exposure(DLE)in microsurgical laryngoscope surgery to provide basis for preoperative evaluation.Methods With the method of prospective research design being adopted,the clinical data of 150 patients with operations under micro-laryngoscope(against vocal cord polyps,vocal cord granulation,vocal cord cyst,vocal cord leukoplakia,laryngeal papilloma,early laryngeal cancer,etc.)admitted to and treated in Jiangsu Taizhou People's Hospital from January 2020 to January 2021 were collected through direct sampling,and the relationships between the related factors and DLE were statistically analyzed.Results According to univariate analysis,the factors related to DLE under self-retaining laryngoscope included height and body mass index(BMI),head and neck flexion and extension,neck circumference,hyoid-mental distance(HMD),thyroid-mental distance(TMD),sternum-mental distance(SMD),the modified Mallampati test(MMT)class III and class IV and Yamamoto class III and class IV.Logistic regression analysis showed that head and neck flexion and extension<90°,TMD<7.75 cm and HMD<6.35 cm were independent risk factors of DLE.Conclusion Preoperative measurement of the patients'head and neck flexion and extension,TMD and HMD is of great significance for evaluating DLE.

关 键 词：支撑喉镜 外科手术 声门暴露 相关因素 

分 类 号：R767.44[医药卫生—耳鼻咽喉科]