【摘要】 目的探讨新型拐弯喉镜声门显露情况,在此基础上提出气道分类新标准。方法选择2016年9月至2018年9月期间深圳龙岗中心医院收治的90例患者为研究对象,其中男性43例,女性47例,年龄32～76岁。术前均行颈椎侧位X线检查,测量影像学参数,包括颈椎曲率指数、C2～C7矢状垂直轴、会厌与椎体前缘夹角。全凭静脉麻醉诱导后,根据随机数表法将患者分为三组,每组30例,分别应用3种不同角度的新型拐弯喉镜声门显露,A组为拐弯喉镜I型,小角度;B组为拐弯喉镜Ⅱ型,中角度;C组为拐弯喉镜Ⅲ型,大角度。比较三组间影像学资料的差异。结果 B组患者的颈椎曲率指数为(9.8±0.8),C2～C7矢状垂直轴为(62.3±16.7) mm,会厌与椎体前缘夹角为(43.3±4.6)°,与A组的(9.8±0.8)、(79.0±19.3) mm、(60.7±7.9)°及C组的(6.1±0.7)、(44.2±18.9) mm、(40.6±4.3)°比较差异均有统计学意义(P<0.05)。结论结合颈椎影像学特点,选择使用合适角度的新型拐弯喉镜片,可达到充分声门显露目的,并可以据此将气道分为不同类型,作为新的气道分类标准。更多还原

【Abstract】 Objective To explore the glottis exposure of a new type of laryngoscope and to propose a new criterion for airway classification. Methods A total of 90 patients, including 43 males and 47 females, aged 32 to 76 years, who admitted to Longgang Central Hospital of Shenzhen from September 2016 to September 2018, were selected as the study group. All patients underwent lateral cervical X-ray examination before operation, and the imaging parameters were measured, including cervical curvature index, C2-C7 sagittal vertical axis, epiglottis and anterior edge of vertebral body angle. After induction of total intravenous anesthesia, according to the random number table method, the patients were divided into three groups(30 cases in each group), in which three different angles of the new laryngoscope were used to expose the glottis: group A(turning laryngoscope type Ⅰ, small angle); group B(turning laryngoscope typeⅡ, medium angle); group C(turning laryngoscope type Ⅲ, large angle). The differences of imaging data between the three groups were compared. Results The curvature index of cervical spine, and C2-C7 sagittal vertical axis, the angle between the epiglottis and the anterior edge of the vertebral body in group B were 9.8±0.8,(62.3±16.7) mm,(43.3±4.6)°,as compared with 9.8±0.8,(79.0±19.3) mm,(60.7±7.9)° in group A(P<0.05) and 6.1±0.7,(44.2±18.9) mm,(40.6±4.3)°in group C(P<0.05). Conclusion According to the imaging characteristics of cervical spine, a new type of curved laryngoscope with suitable angle can achieve the goal of full glottis exposure, and the airway can be divided into different types according to it, as a new airway classification standard.更多还原