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目的:探讨喉显微手术影响声门暴露的相关因素,为术前评估提供参考。方法:对62例声带病变患者于术前采集可能影响声门暴露的临床数据,包括4个基本参数:年龄、性别、BMI和改良Mallampati指数(MMI);1个体表测量参数:甲状软骨夹角(TA);13个在头颈仰伸侧位X线片下测量的影像参数:上切牙夹角(UIA)、下切牙夹角(LIA)、切牙间距(IG)、下切牙颏突间距(LIMD)、下颌角(MA)、下颌骨颏-髁间距(MCD)、下颌骨高度(MH)、下颌骨深度指数(MDI)、舌颏距(HMD)、甲颏距(TMD)、胸颏距(SMD)、甲颏夹角(TMA)、上切牙甲舌夹角(THUIA)。结合患者术中声门暴露情况对这些影响因素进行统计学分析。结果:单因素分析显示,性别与声门暴露相关,差异有统计学意义(P<0.05)。Logistic逐步回归分析显示:LIMD、MA、TMA和THUIA是声门暴露困难的危险因素,临界值分别为:LIMD>4.53cm、MA>115.5°、TMA>99.2°、THUIA>152.6°。结论:术前测量LIMD、MA、TMA和THUIA对预测声门暴露困难有重要意义;性别也是预测声门暴露困难的有效指标,男性更易发生声门暴露困难。
Objective: To explore the related factors that affect the exposure of the glottic to laryngeal microsurgery and provide a reference for preoperative evaluation. Methods: Sixty-two patients with vocal cord lesions were collected preoperatively, which may affect the glottis exposure. The clinical data included four basic parameters: age, sex, BMI and modified Mallampati index (MMI). One body surface measurement parameters: (TA); 13 parameters measured under the X-ray of lateral and transverse extension of the head and neck: UIA, LIA, IG, LIMD, MA, MCD, MH, MDI, TMD, TMD, The chin distance (SMD), chin angle (TMA), upper incisor angle (THUIA). According to the patients’ glottic exposure, these influencing factors were statistically analyzed. Results: Univariate analysis showed that gender was associated with glottis exposure, the difference was statistically significant (P <0.05). Logistic stepwise regression analysis showed that LIMD, MA, TMA and THUIA were the risk factors of glottis exposure. The critical values were LIMD> 4.53cm, MA> 115.5 °, TMA> 99.2 ° and THUIA> 152.6 °. Conclusions: Preoperative measurements of LIMD, MA, TMA and THUIA are important for predicting glottis exposure. Gender is also an effective predictor of glottis exposure. Men are more likely to have glottis exposure problems.