颈外体表标志环颏距与喉罩型号选择的临床研究  

Relationship between cricoid-mental distance based on external neck landmarks and laryngeal mask size selection

作　　者：刘宝芸 黄浩贤 黄敏贞 盛恒炜 Liu Baoyun;Huang Haoxian;Huang Minzhen;Sheng Hengwei(Department of Anesthesiology,Sanshui District People's Hospital,Foshan 528100,China;Guangdong Medical University,Zhanjiang 524023,China;Department of Anesthesiology,First Hospital,Jinan University,Guangzhou 510000,China)

机构地区：[1]佛山市三水区人民医院麻醉科,佛山528100 [2]广东医科大学,湛江524023 [3]暨南大学附属第一医院麻醉科,广州510000

出　　处：《国际医药卫生导报》2024年第15期2574-2578,共5页International Medicine and Health Guidance News

基　　金：广东省医学科研基金(2020111195224883);佛山市医学科研基金(20210230)。

摘　　要：目的本研究通过对颈外体表标志环颏距进行测量,旨在探讨喉罩型号选择的新方法。方法前瞻性研究,选取2019年11月至2020年10月在佛山市三水区人民医院使用经典喉罩全身麻醉行择期手术的98例患者,其中有4例患者因自身原因取消手术,共有94例患者进入数据分析,男36例、女58例,年龄18~65岁。术前访视时,测量和记录数据,包括性别、年龄、身高、体质量、改良的Mallampti分级、张口度等。在麻醉前,测量并记录环颏距。将喉罩置入成功患者按不同喉罩型号进行分组,对比3组患者一般资料及环颏距差异,采用logistics回归分析喉罩型号的影响因素。统计学方法采用方差分析、χ^(2)检验。结果3种型号喉罩患者年龄、体质量、环颏距比较[(37.75±9.05)岁比(33.62±11.98)岁比(29.11±9.80)岁、(46.74±3.58)kg比(57.26±6.52)kg比(70.86±10.61)kg、(7.85±0.83)cm比(9.34±0.74)cm比(11.64±0.65)cm],差异均有统计学意义(F=7.643、51.126、156.135,均P<0.05)。logistic回归分析显示,喉罩型号选择与体质量、环颏距存在相关关系(均P<0.05)。通过绘制小提琴图和计算3种型号喉罩患者环颏距的95%可信区间,可得到环颏距推荐适用范围为环颏距7.87~10.81 cm选择4号(占53.19%,50例),环颏距<7.87 cm选择3号(占17.02%,16例),环颏距>10.81 cm选择5号(占29.79%,28例)。结论环颏距可以作为选择喉罩大小的指标,在临床操作上更为简便快速,可有效提高手术过程,具有较强的临床实用性。Objective To explore a new method for selecting laryngeal mask sizes measuring the cricoid-mental distance(CMD)based on external neck landmarks.Methods This was prospective study.Ninety-eight patients undergoing selective surgery under general anesthesia with classic laryngeal masks at Sanshui District People's Hospital from November 2019 to October 2020 were selected,and 4 cases cancelled the surgery because of their personal reasons.Ninety-four patients were included,including 36 males and 58 females who were 18-65 years old.During the preoperative visit,their gender,age,height,body weight,modified Mallampati classification,and degree of mouth opening were recorded.The CMD was measured before the anesthesia.The patients with successful laryngeal mask insertion were grouped according to the laryngeal mask sizes.The general data and CMD were compared between the three groups.The logistic regression analysis was used to identify the factors influencing laryngeal mask size selection.The analysis of variance andχ^(2) test were applied.Results There were statistical differences in age,body weight,and CMD between the patients using 3 different laryngeal mask sizes[(37.75±9.05)years vs.(33.62±11.98)years vs.(29.11±9.80)years,(46.74±3.58)kg vs.(57.26±6.52)kg vs.(70.86±10.61)kg,and(7.85±0.83)cm vs.(9.34±0.74)cm vs.(11.64±0.65)cm;F=7.643,51.126,and 156.135;all P<0.05].The logistic regression analysis revealed correlation of laryngeal mask size selection with weight and CMD(both P<0.05).The 95%confidence intervals for CMD of the three laryngeal mask sizes were as below:laryngealmask3'sCMD6.19-9.51cm(17.02%,16cases);laryngealmask4'sCMD7.87-10.81cm(53.19%,50 cases);laryngeal mask 5's CMD 10.34-12.94 cm(29.79%,28 cases).Conclusions CMD can serve as an indicator for selecting laryngeal mask sizes.If the CMD is 7.87~10.81 cm,laryngealmask4isrecommended;CMD<7.87cm,laryngealmask3;CMD>10.81cm,laryngealmask 5.

关 键 词：喉罩 气道管理 环状软骨 颏 LOGISTIC回归 

分 类 号：R614[医药卫生—麻醉学]