影响显微支撑喉镜下声门暴露的相关因素研究

Study on affect factors related to laryngeal exposure in selfretaining microscopic surgery

摘要:

摘要：目的探讨影响显微支撑喉镜下声门暴露的相关因素，为术前评估提供参考。方法收集58例行支撑喉镜下喉显微手术患者的可能影响声门暴露的资料，包括年龄、性别、身高、体质指数（BMI）、颈周长、头颈最大仰伸度、张口度（IG）、舌骨-下颌骨颏下角距离（HMD）、胸骨上窝-颏下角距离（SMD）、甲状软骨上切迹-下颌骨颏下角距离（TMD）、上切牙-甲状软骨距离（UITD），上切牙-胸骨距离（UISD）和Friedman 舌根分级（FTP），再根据患者术中声门暴露分级的结果将患者分为声门暴露困难组（试验组6例）和非声门暴露困难组（对照组52例），比较两组患者以上资料是否存在差异，再将有组间差异的指标用Logistic回归分析筛选出可以用于预测声门暴露困难的危险因素。结果经Logistic逐步回归分析，TMD和FTP为声门暴露困难的独立危险因素（P<0.05）。结论术前测量患者的TMD和FTP，对预测患者是否为支撑喉镜下声门暴露困难有重要临床意义。

关键词:支撑喉镜|声门暴露困难|预测因素

Abstract:

Abstract:ObjectiveTo investigate the factors influencing laryngeal exposure in selfretaining microscopic surgery, therefore to provide references for preoperative assessment.Methods58 patients were included in this prospective study. Their data including age, gender, height, weight, body mass index, neck circumference and the angel of neutral to extension (NEA), the size of full mouth opening, hyoidmental distance(HMD),sternummental distance(SMD), thyroidmental distance(TMD), thyroidupper incisor distance(UISD),sternumupperincisor distance(UITD) and the Friedman grade(FTP) were collected. According to the results of glottis exposure, they were divided into two groups, i.e. difficult exposure group and normal group. The differences of abovementioned indexes between the two groups were analyzed by logistic stepwise regression analysis. The risk factors for predicting difficult exposure were screened out.ResultsLogistic stepwise regression analysis demonstrated TMD and FTP were independent risk factors for difficult laryngeal exposure (P<0.05). ConclusionPreoperative measurement of patients’ TMD and FTP is important for prediction of difficulty in glottis exposure during selfretaining microscopic surgery.

Key words:Selfretaining laryngoscope| Difficult laryngeal exposure|Predictive factor