超声测量皮舌厚度对小儿困难喉镜显露的预测作用  

Effect of Ultrasonic Measurement of Tongue Thickness on the Prediction of Difficult Laryngoscopy in Children

作　　者：郑镇伟[1] 王霞[2] 杜瑞明[1] 陈露[1] 马武华[2] Zheng Zhenwei;Wang Xia;Du Ruiming;Chen Lu;Ma Wuhua(Department of Anesthesiology,The Second Affiliate Hospital of Shantou University Medical College,Shantou,Guangdong 515041,China;Department of Anesthesiology,The First Affiliate Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]汕头大学医学院第二附属医院麻醉科,广东省汕头市515041 [2]广州中医药大学第一附属医院麻醉科,广州市510405

出　　处：《中国超声医学杂志》2022年第7期753-757,共5页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(No.82074357);广东省医学科研基金(No.B2020050)。

摘　　要：目的 评估超声测量皮舌厚度对小儿困难喉镜显露的预测价值。方法 选取需行气管插管全麻的择期手术患儿,年龄5~12岁。术前记录患儿的张口度、改良Mallampati分级和甲颏距离,麻醉前超声测量患儿的皮舌厚度,麻醉后对患儿进行Cormack-Lehane喉镜显露分级。结果 研究共纳入292名患儿,5~8岁组和9~12岁组各有困难喉镜显露病例6例。结果显示超声测量皮舌厚度>4.5 cm对5~8岁患儿困难喉镜显露有预测作用,灵敏度为100%、特异度为56.6%;复合指标皮舌厚度/甲颏距离比值和Mallampati分级/甲颏距离比值对5~12岁患儿困难喉镜显露的诊断价值较高。结论 超声测量皮舌厚度对5~8岁患儿、皮舌厚度/甲颏距离比值和Mallampati分级/甲颏距离比值对5~12岁患儿的困难喉镜显露有较好的预测作用。Objective To investigates the predictive value of tongue thickness eraluated by ultrasonography for difficult laryngoscopy in children. Methods Pediatric patients aged 5 to 12 years who required endotracheal intubation and general anesthesia for elective surgical procedure were enrolled. The inter-incisor distance, the modified Mallampati score(MMS) and the thyromental distance(TMD) of each pediatric patient were recorded before operation. The tongue thickness(TT) was measured by ultrasound before anesthesia, and the laryngoscopy and tracheal intubation were performed after induction of general anaesthesia. The glottic view was scored using Cormack-Lehane grades during each laryngoscopy. Grade 3 and 4 were deemed a difficult laryngoscopy. Receiver-operating characteristic curve and area under the curve were used to evaluate the predictive value of the indicators. Results A total of 292 pediatric patients were included in this study, including 6 cases in the 5-8 years group and 6 cases in the 9-12 years group. The results showed that tongue thickness >4.5 cm measured by ultrasound had a certain predictive effect on difficult laryngoscopy in children aged 5-8 years with sensitivity of 100% and specificity of 56.6%. The combined index of the increased ratio of TT to TMD and the increased ratio of MMS to TMD had high predictive values for difficult laryngoscopy in children aged 5 to 12 years. Conclusions The tongue thickness measured by ultrasound has a good predictive value for difficult laryngoscopy in children aged 5 to 8 years. And the ratio of TT to TMD and the ratio of MMS to TMD both have high predictive values for difficult laryngoscopy in children aged 5 to 12 years.

关 键 词：超声 气道管理 小儿 喉镜检查 舌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R767[医药卫生—诊断学]