超声在阻塞性睡眠呼吸暂停低通气综合征患者困难气道评估中的应用价值分析  

Application value of ultrasonography in the difficult airway assessment in patients with obstructive sleep apnea hypopnea syndrome

作　　者：邓海波 梁东锋[1] 马行军[1] 蔡宁[1] DENG Haibo;LIANG Dongfeng;MAXingjun;CAI Ning(Department of Anesthesiology,Fuyang People's Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市人民医院麻醉科,安徽阜阳236000

出　　处：《长春中医药大学学报》2022年第12期1392-1395,共4页Journal of Changchun University of Chinese Medicine

基　　金：2020年阜阳市自筹经费科技计划项目(FK202081020)。

摘　　要：目的分析超声在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者困难气道评估中的应用价值。方法回顾性收集行全麻气管插管改良腭咽成形术的80例阻塞性睡眠呼吸暂停低通气综合征患者的临床资料,根据患者是否为困难气道分为困难喉镜组(26例)和非困难喉镜组(54例)。比较2组一般资料及常规测量数据、超声测量数据、上下唇咬合实验、改良Mallampanti气道分级预测困难喉镜暴露情况。结果非困难喉镜组正中位舌骨到皮肤距离、前联合到皮肤距离短于困难喉镜组,颏舌骨肌长度长于困难喉镜组(P<0.05)。困难喉镜组改良Mallampanti气道分级Ⅲ级患者占比(57.69%,15/26)高于非困难喉镜组(24.07%,13/54)(P<0.05)。结论超声和改良Mallampanti气道分级均可有效对阻塞性睡眠呼吸暂停低通气综合征患者困难气道进行评估,其中超声对阻塞性睡眠呼吸暂停低通气综合征患者困难气道具有较好的预测价值,联合改良Mallampanti气道分级可提高预测困难气道的准确性。Objective To analyze the application value of the ultrasonography in the difficult airway assessment in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods The clinical data of 80 patients with OSAHS who underwent the modified palatopharyngoplasty with tracheal intubation under general anesthesia in our hospital from August 2019 to June 2021 were retrospectively collected.They were divided into the difficult laryngoscopy group(26 cases)and the non-difficult laryngoscopy group(54 cases)according to whether the patients had a difficult airway.Their general data,conventional measurement data,ultrasonic measurement data,occlusal experiment of upper and lower lips,and modified Mallampanti airway grading were compared between the two groups to predict the difficult laryngoscopy exposure.Results The distance from the median hyoid bone to the skin,the distance from the anterior joint to the skin in the non-difficult laryngoscopy group were shorter than those in the difficult laryngoscopy group,while the length of the geniohyoid muscle was longer than that in the difficult laryngoscopy group(P<0.05).The proportion of patients with the modified Malampanti airway grade III in the difficult laryngoscopy group(57.69%,15/26)was higher than that in the non-difficult laryngoscopy group(24.07%,13/54)(P<0.05).Conclusion Both the ultrasonography and the modified Mallampanti airway grading can effectively evaluate difficult airways in patients with OSAHS,among which the ultrasonography has a better predictive value for difficult airways,and its combination with the modified Mallampanti airway grading can improve the prediction accuracy.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 超声 困难气道 上下唇咬合实验 改良Mallampanti气道分级 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]