枕颈融合术后患者枕颈角度与困难气道的关系
Relationship between occipitocervical angle and difficult airway after occipitocervical fusion surgery
毋楠 1张林忠 1宋文慧 2张毓婧 3王利利 1梁凯恒 2殷昊1
作者信息
- 1. 山西医科大学第二医院麻醉科,太原 030001
- 2. 山西医科大学第二医院骨科,太原 030001
- 3. 山西医科大学第二医院影像科,太原 030001
- 折叠
摘要
目的 评价枕颈融合术后患者颅底枢椎角(O-C2角)、颌-咽夹角(M-P角)和颈椎活动度(CROM)与困难气道的关系.方法 本研究为回顾性研究.回顾性收集2018年3月至2023年3月于本院行枕颈融合术患者的临床资料.记录患者术前以及末次随访时气道评估资料和颈椎侧位X线片,测量O-C2角、M-P角和CROM.根据末次随访改良Mallampati分级将患者分为阴性组(Mal-lampati分级Ⅰ或Ⅱ级,无气管插管困难)和阳性组(Mallampati分级Ⅲ或Ⅳ级,可能造成气管插管困难).结果 共纳入53例患者,阳性组18例,阴性组35例.53例患者术前与末次随访时O-C2角和CROM比较差异无统计学意义(P＞0.05),末次随访时M-P角较术前减小(P＜0.05).与阴性组比较,阳性组末次随访时O-C2角和M-P角减小(P＜0.05),CROM差异无统计学意义(P＞0.05).与术前比较,2组末次随访时M-P角减小,阳性组末次随访时O-C2角减小(P＜0.05).O-C2角、M-P角和CROM预测困难气道的受试者工作特征曲线下面积分别为0.895、0.888和0.519.结论 枕颈融合术后患者o-C2角和M-P角减小可增加困难气道风险,两者可用于该类患者气道评估.
Abstract
Objective To evaluate the relationship between the occipitocervical angle(basilar ver-tebral angle[O-C2 angle],mento-pharyngeal angle[M-P angle],and cervical range of motion[CROM])and difficult airway after occipitocervical fusion surgery in the patients.Methods This was a retrospective study.The clinical data from patients who underwent occipitocervical fusion surgery at our hospital from March 2018 to March 2023 were retrospectively collected.Preoperative and last follow-up airway assessment data and cervical lateral X-rays were collected to measure the O-C2 angle,M-P angle and CROM.Patients were divided into negative group(Mallampati grade Ⅰ or Ⅱ,suggesting no difficulty in intubation)and positive group(Mallampati grade Ⅲ or Ⅳ,suggesting possible difficulty in intubation)based on the last follow-up modified Mallampati classification.Results A total of 53 patients were finally included,with 18 cases in positive group and 35 in negative group.There were no statistically significant differences in the O-C2 angle and CROM between preoperative and last follow-up in the 53 patients(P＞0.05),and the M-P angle was significantly decreased at the last follow-up compared with that before operation(P＜0.05).Com-pared with negative group,O-C2 angle and M-P angle were significantly decreased at the last follow-up(P＜0.05),and no significant change was found in CROM in positive group(P＜0.05).Compared with that be-fore operation,the M-P angle was significantly decreased at the last follow-up in both groups,and the O-C2 angle was significantly decreased at the last follow-up in positive group(P＜0.05).The areas under the re-ceiver operating characteristic curves of O-C2 angle,M-P angle and CROM in predicting difficult airway were 0.895,0.888 and 0.519 respectively.Conclusions The decrease in the O-C2 angle and M-P angle af-ter occipitocervical fusion surgery can increase the risk of difficult airway,and both can be used for airway assessment in the patients undergoing this kind of surgery.
关键词
脊柱融合术/枕骨/颈椎/困难气道Key words
Spinal fusion/Occipital bone/Cervical vertebrae/Difficult airway引用本文复制引用
基金项目
山西省高等学校科技创新计划(2022L153)
出版年
2024
NETL
NSTL
万方数据