甲颏距离作为成人喉罩型号选择依据的可行性分析  

Feasibility analysis on the thyromental distance as a criterion to identify laryngeal mask airway size for adults

作　　者：程慧娴 王业芹 王斌 鲁美静 CHENG Huixian;WANG Yeqin;WANG Bin;LU Meijing(Department of Anesthesiology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院麻醉科,安徽芜湖241001

出　　处：《皖南医学院学报》2024年第2期161-164,共4页Journal of Wannan Medical College

基　　金：安徽省卫生健康科研项目(AHWJ2022b021)。

摘　　要：目的:探讨超声定位甲状软骨切迹测量甲颏距离作为成人喉罩(LMA)型号选择依据的可行性。方法:选取2022年7~9月择期进行腹腔镜胆囊切除术的患者184例,按照随机数字表法分为甲颏距离组(n=92)和标准体质量组(n=92)。甲颏距离组超声定位甲状软骨切迹测量甲颏距离,标准体质量组依据公式计算标准体质量,作为LMA型号选择依据。记录LMA首次置入成功率、置入时间、口腔漏气压、囊内压、置入成功时气道峰压、留置时间、喉罩染血、术后24 h LMA相关并发症。结果:甲颏距离组首次置入成功率、口腔漏气压均高于标准体质量组(P<0.05),囊内压、置入时间均低于标准体质量组(P<0.05)。两组患者置入成功时气道峰压、留置时间、喉罩染血、术后24 h LMA相关并发症差异均无统计学意义(P>0.05)。结论:依据甲颏距离选择LMA型号,首次置入成功率高,置入时间短,能提供好的气道密封压。Objective:To explore the feasibility of thyromental distance measured by ultrasound-detected incision of thyroid cartilage as a reference to identify the size of laryngeal mask airway(LMA)for adult patients.Methods:In total,184 patients undergoing laparoscopic cholecystectomy were included from July to September of 2022,and were divided into thyromental distance group and standard weight group(n=92 for each group)according to the random number table method.The thyromental distance was measured by ultrasound-detected incision of thyroid cartilage,and the standard weight was calculated according to a formula,which served as the basis for selecting LMA sizes.The following data,including the success rate of first LMA insertion,insertion time,oral leak pressure,intracapsular pressure,peak airway pressure at successful insertion,retention time,LMA stained with blood and LMA-related complications 24 hours after surgery,were recorded.Results:The success rate of first LMA insertion and oral air leak pressure of the thyromental distance group were significantly higher than those of the standard weight group(P<0.05).However,the intracapsular pressure and insertion time of the thyromental distance group were significantly lower(P<0.05).There was no statistical difference in peak airway pressure,retention time,LMA stained with blood,and LMA-related complications between groups(P>0.05).Conclusion:Choosing LMA size based on thyromental distance measurement can improve success rate of initial LMA placement,shorten the placement time and provide better airway sealing pressure.

关 键 词：超声 甲状软骨切迹 甲颏距离 SUPREME喉罩 

分 类 号：R445.1[医药卫生—影像医学与核医学] R614.2[医药卫生—诊断学]