在肥胖患者中基于超声波的呼吸道评估作为预测呼吸道困难的有价值工具:一项观察性研究
Ozan Tasdemir1, Nazan Kocaoglu2, H Fisun Demir2
1Balikesir Atatürk City Hospital, Department of Anesthesiology and Intensive Care Medicine, Altieylul, Balikesir, Türkiye.
Brazilian journal of anesthesiology (Elsevier)
|July 12, 2024
概括
对部软组织的超声波测量可以预测肥胖患者难以进行喉腔镜. 这些前宫测量显示,与难以输入管道的相关性比与面具通风挑战更强.
科学领域:
- 麻醉学 麻醉学
- 医疗成像医学成像
- 肥胖医学 肥胖医学
背景情况:
- 肥胖患者经常经历呼吸道困难,使麻醉诱导复杂化,面具通风和输管方面存在挑战.
- 在这个人群中预测困难的呼吸道对于手术过程中的患者安全至关重要.
研究的目的:
- 评估超声波测量前宫软组织参数,以预测肥胖手术患者的呼吸道困难.
- 为了比较这些超声波测量对困难的口罩通风和喉腔镜的预后效率.
主要方法:
- 一项前性观察性研究包括157名接受手术的肥胖患者 (BMI ≥30 kg/m2).
- 超声波测量了前宫软组织的距离:口腔骨与皮肤 (DSHB),表皮与皮肤 (DSE) 以及声带与皮肤 (DSV).
- 使用汉级 (口罩通风) 和科马克-莱汉级 (喉腔镜) 评估困难的呼吸道.
主要成果:
- 在困难喉腔镜组中,DSHB,DSE和DSV的平均值分别为18.5±3.5,18.3±3.8和18.6±3.4毫米.
- 对DSHB,DSE和DSV的曲线下面面积 (AUC) 值为0.845,0.827和0.850,表明具有良好的预测值.
- 之前的宫测量表明,与难以通风的口罩相比,难以进行喉腔镜的预测价值更高.
结论:
- 前宫软组织的超声波测量是难以预测喉腔镜的有效预测器.
- 在肥胖患者中,这些超声波参数与难以进行喉腔镜检查的相关性比与难以进行口罩通风的相关性更强.
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