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| 超声测量舌骨-会厌距离对喉镜显露困难的预测价值 |
| Predictive value of the distance from hyoid to epiglottis measured by ultrasound in difficult laryngoscopy |
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| DOI：10.12089/jca.2021.06.014 |
| 中文关键词: 超声 喉镜显露困难 气道管理 舌骨-会厌距离 |
| 英文关键词: Ultrasound Difficult laryngoscopy Airway management Distance from hyoid to epiglottis |
| 基金项目: |
| 作者 | 单位 | E-mail | | 陈旭 | 230001,合肥市,中国科学技术大学附属第一医院麻醉科 | | | 章蔚 | 230001,合肥市,中国科学技术大学附属第一医院麻醉科 | | | 夏敏 | 230001,合肥市,中国科学技术大学附属第一医院麻醉科 | | | 吴昊 | 230001,合肥市,中国科学技术大学附属第一医院麻醉科 | | | 王胜 | 230001,合肥市,中国科学技术大学附属第一医院麻醉科 | 18935701573@163.com |
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| 中文摘要: |
目的 评估超声测量舌骨-会厌距离预测喉镜显露困难的有效性。
方法 选择择期行气管插管全身麻醉患者72例，男40例，女32例，年龄18～90岁，ASA Ⅰ—Ⅲ级。麻醉前测量张口度、甲颏距离，评估改良Mallampati分级，并在“嗅花位”下超声测量患者舌骨-会厌距离。患者麻醉后在相同体位下行气管插管，根据Cormack-Lehane分级分为两组：Ⅰ和Ⅱ级为喉镜显露容易组（n=53），Ⅲ和Ⅳ级为喉镜显露困难组（n=19）。比较常规评估气道方法和舌骨-会厌距离与喉镜显露困难的关系，采用受试者工作特征（ROC）曲线评估各项指标预测喉镜显露困难的效能。
结果 与喉镜显露容易组比较，喉镜显露困难组中男性比例、BMI值和改良Mallampati分级明显升高（P<0.05），甲颏距离和舌骨-会厌距离明显缩短（P<0.05）。BMI值、甲颏距离、张口度、Mallampati分极和舌骨-会厌距离曲线下面积（AUC）分别为0.74、0.63、0.71、0.67和0.84，舌骨-会厌距离临界值为1.4 cm，其敏感性为79.0%，特异性为83.0%。
结论 超声测量舌骨-会厌距离可较好地预测喉镜显露困难。 |
| 英文摘要: |
Objective To evaluate the effectiveness of measuring under ultrasound guidance the distance from hyoid to epiglottis in predicting difficult laryngoscopy.
Methods Seventy-two patients, 40 males and 32 females, aged 18-90 years, ASA physical status Ⅰ-Ⅲ, were enrolled in this study. Before anesthesia, thyromental distance, mouth opening and modified Mallampati classification were evaluated. The distance from hyoid bone to epiglottis was measured under ultrasound in “sniffing position”. After anesthesia, the patients were intubated in the same position. According to Cormack Lehane classification, the patients were divided into two groups: Ⅰ-Ⅱ for easy laryngoscopy group (n = 53), Ⅲ-Ⅳ for difficult laryngoscopy group (n = 19). The relationship between the distance from hyoid to epiglottis and difficult laryngoscopy was analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of each index in predicting difficult laryngoscopy.
Results Compared with the easy laryngoscopy group, the proportion of male, BMI, and modified Mallampati grade were significantly increased in the difficult laryngoscopy group (P < 0.05), and thyromental distance and distance from hyoid to epiglottis was significantly decreased (P < 0.05). The AUC of BMI, thyromental distance, mouth opening, Mallampati grade, and distance from hyoid to epiglottis were 0.74, 0.63, 0.71, 0.67, and 0.84, respectively. The cut off of distance from hyoid to epiglottis was 1.4 cm, while the sensitivity was 79.0% and the specificity was 83.0%.
Conclusion Measuring distance from hyoid to epiglottis guided under ultrasound is a good predictor of difficult laryngoscopy. |
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