体表触诊法与超声双平面法对环甲膜定位差异的影响因素  

Factors influencing difference in location of cricothyroid membrane between surface palpation and ultrasonic biplane

作　　者：步桂清[1] 任珊[2] 赵浩天[3] 龙玲[2] 申丽旻[2] Bu Guiqing;Ren Shan;Zhao Haotian;Long Ling;Shen Limin(Department of Otolaryngological,Hebei General Hospital,Shijiazhuang 050051,China;Intensive Care Unit,Hebei General Hospital,Shijiazhuang 050051,China;Department of Ultrasound,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院耳鼻喉科,石家庄050051 [2]河北省人民医院重症医学科,石家庄050051 [3]河北省人民医院超声科,石家庄050051

出　　处：《中华麻醉学杂志》2022年第4期444-446,共3页Chinese Journal of Anesthesiology

基　　金：河北省医学科学研究课题计划项目(20211264)。

摘　　要：目的分析传统体表触诊法和超声双平面法对环甲膜定位差异的影响因素。方法选取本院2021年8月至2021年12月期间住院或门诊接受颈部超声检查的受试者107例,性别不限,年龄>18岁,使用超声观察颈部气道结构,选取超声下可清晰显示环甲膜结构的受试者,分别由耳鼻喉科医师使用体表触诊法、超声科医师使用超声双平面法对环甲膜中点位置定位。使用直尺测量两种方法定位之间的距离,将受试者分为准确组(两点间距≤3 mm)和差异组(两点间距>3 mm)。使用超声测量环-甲间距(环状软骨与甲状软骨距离)、环甲膜-皮肤间距(环甲膜中点与皮肤间距离),使用直尺测量平视时颈部长度、仰头时最大颌下间距。采用多因素logistic回归分析两种定位方法差异的影响因素。结果选取清晰显示环状软骨和环甲膜的受试者104例。2组性别比例、BMI、环甲膜-皮肤间距、颈部长度、最大颌下间距比较差异有统计学意义(P<0.05)。多因素logistic回归分析显示:女性(OR=9.091,P<0.001)、BMI>28.0 kg/m^(2)(OR=11.214,P=0.001)、环甲膜-皮肤间距增大(OR=5.649,P=0.015)为两种环甲膜定位方法出现差异的影响因素。结论女性、肥胖(BMI>28.0 kg/m^(2))、环甲膜-皮肤间距增大是超声双平面法与体表触诊法定位环甲膜出现差异的影响因素,对存在上述因素者,建议使用床旁超声定位。Objective To analyze the factors influencing the difference in location of cricothyroid membrane between traditional surface palpation and ultrasonic biplane.Methods One hundred and seven subjects of both sexes,aged 18 yr,underwent neck ultrasound examination in our hospital from August 2021 to December 2021,were selected.The structure of cervical airway was observed by ultrasound.The subjects in whom the structure of cricothyroid membrane was clearly shown were selected.The middle point of cricothyroid membrane was located by otorhinolaryngologist using surface palpation method and by ultrasonic doctor using ultrasonic biplane method.The distance between two positioning points was measured by a ruler.The subjects were divided into accurate group(distance between two points≤3 mm)and difference group(distance between two points>3 mm).The distance between cricoid cartilage and thyroid cartilage(spacing of cricoid cartilage and thyroid cartilage)and distance between the midpoint of cricothyroid membrane and skin(spacing of cricothyroid membrane and skin)were measured by ultrasound.The neck length and the maximum submaxillary distance in head up were measured by a ruler.The factors influencing the difference in location between the two methods were analyzed by multivariate logistic regression.Results One hundred and four subjects with clear cricoid cartilage and cricothyroid membrane under ultrasound were selected.There were significant differences in the ratio of gender,body mass index(BMI),cricothyroid membrane-skin distance,neck length,and maximum submandibular distance between the two groups(P<0.05).Multivariate logistic analysis showed that female(OR=9.091,P<0.001),BMI(OR=11.214,P=0.001)and increased cricothyroid membrane-skin distance(OR=5.649,P=0.015)were the factors influencing the difference in location between the two cricothyroid membrane localization methods.Conclusions Female,obesity(BMI>28.0 kg/m^(2))and increased distance between cricothyroid membrane and skin are the factors affecting the difference

关 键 词：环状软骨 超声检查 体表触诊法 

分 类 号：R445.1[医药卫生—影像医学与核医学]