The related factors analysis of difficult laryngeal exposure under retaining laryngoscope
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摘要: 目的:分析影响支撑喉镜下声门暴露困难的相关因素。方法:回顾性分析287例全身麻醉支撑喉镜手术患者的临床资料,观察性别、张口度、BMI、颈围、头颈屈伸度、甲状软骨上切迹与下颌骨颏下角距离(TMD)、舌骨下颌骨颏下角距离(HMD)、胸骨上窝至颏下角距离(SMD)与声门暴露困难之间的关系。结果:经ROC曲线分析确定TMD最佳临界值为7.35 cm,HMD最佳临界值为6.33 cm,SMD最佳临界值为14.75 cm。经单因素分析发现,性别与声门暴露无明显相关,张口度、BMI、颈围、头颈屈伸度、TMD、HMD、SMD与声门暴露相关。将影响声带暴露的单因素进一步行多因素分析,结果显示颈围、头颈屈伸度、TMD、SMD是影响支撑喉镜声门暴露的独立因素。结论:术前测量患者颈围、头颈屈伸度、TMD、SMD,对预测患者术中声门暴露情况具有重要意义。Abstract: Objective: To analyze the related factors of difficult laryngeal exposure under retaining laryngoscope.Method: We did a retrospective analysis of 287 retaining laryngoscope surgery patients' clinical datas to observe the relationship between difficult glottis exposure and patients'gender, degree of mouth opening, BMI, neck circumference,head and neck flexion, TMD, HMD and SMD.Result: By ROC curve analysis ,we determine the optimal threshold for TMD was 7.35 cm, HMD was 6.33 cm, SMD was 14.75 cm. Univariate analysis showed that gender, and glottis exposure had no significant correlation with difficult laryngeal exposure under retaining laryngoscope.Degree of mouth opening, BMI,neck circumference, head and neck flexion, TMD, HMD and SMD had correlation with difficult laryngeal exposure. Multivariate analysis showed that neck circumference, head and neck flexion, TMD, SMD were independent factors of difficult laryngeal exposure under retaining laryngoscope.Conclusion: Measurement of neck circumference, head and neck flexion, TMD, SMD before the operation is important for the prediction of difficult laryngeal exposure under retaining laryngoscope.
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Key words:
- retaining laryngoscope /
- laryngeal exposure /
- related factors
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