成年患者与喉罩置入相关咽喉部解剖的影像学研究

目的：通过咽喉部CT测量成年患者咽喉部与喉罩置入相关的解剖径线并探讨各径线与临床指标的相关性。方法：选择使用喉罩全麻行择期手术的患者121例,男性60例,女性61例。术前行CT平扫,经三维重建后测量会厌舌面长度(径线1)、会厌舌面根部宽度(径线2)、会厌舌面根部至食管入口处的距离(径线3)、两侧梨状窝外侧缘间距(径线4)。比较男、女各径线的差异并将各径线长度与年龄、身高、体重、BMI分别做Pearson相关分析。结果：各径线长度分别为径线1(1.56±0.34)cm、径线2(2.18±0.37)cm、径线3(2.15±0.34)cm以及径线4(3.79±0.43)cm。男性和女性的4条径线的差别均有统计学意义(P<0.01)。咽喉部各径线与年龄、身高、体重、BMI进行Pearson相关分析,结果显示4条径线长度与年龄的相关性无统计学意义,患者的身高与4条径线的相关性均有统计学意义(P<0.01),体重与径线1、径线3和径线4长度相关(P<0.01),而BMI只与径线3长度相关(P<0.01)。结论：本研究提供了中国人与喉罩设计相关的咽喉部解剖数据,发现性别、身高和体重是影响咽喉部解剖径线长度的重要因素,提示在设计适合中国人的喉罩和型号选择方面应综合以上三个因素。

Imaging studies of laryngeal anatomy related to laryngeal mask placement in adult patients

Objective: To measure the pharyngeal and laryngeal anatomical diameters in related to laryngeal mask placement in adult patients on CT three-dimensional reconstruction image and to explore the correlation between the diameters and clinical indicators. Methods: 121 patients, 60 males and 61 females, underwent elective surgery under laryngeal mask general anesthesia were included in the study. The length of the epiglottic tongue surface (line 1), the root width of the epiglottic tongue surface (line 2), the distance from the root of the epiglottic tongue surface to the entrance of the esophagus (line 3), and the distance between the lateral margin of piriform fossa on both sides (line 4) were measured. The differences between diameters of male and female patients were compared and Pearson correlation analysis was performed for the length of diameters with age, height, weight and BMI. Results: The lengths of each line were line 1 (1.56±0.34) cm, line 2 (2.18±0.37) cm, line 3 (2.15±0.34) cm and line 4 (3.79±0.43) cm, respectively. The difference of length of 4 lines between male and female was statistically significant (P<0.01). Pearson correlation analysis results show that the length of four lines was not significantly correlated with age. The patient"s height was significantly correlated to the length of four lines (P<0.01). The body weight was significantly correlated to the length of line 1, line 3 and line 4 (P<0.01), and BMI was only related to the length of line 3 (P<0.01). Conclusions: This study provides anatomical data of larynx and pharynx related to laryngeal mask design in Chinese people. Gender, height and weight are found to be important factors influencing the size selection of laryngeal mask.