两种体位下行硬质喉镜检查的临床疗效分析

Clinical effect analysis of rigid laryngoscopy performed in two body positions

摘要:

目的 探讨硬质喉镜检查时患者的最佳体位。方法 选取2023年12月－2024年3月在该院耳鼻咽喉科行硬质喉镜检查的门诊患者120例，采用随机数表法分为常规体位组（58例）和前倾体位组（62例）。常规体位组采用常规体位（直立低头位）进行检查，前倾体位组采用前倾体位（身体前倾60°并抬颌）进行检查。采用Friedman评分评估患者声门暴露情况，采用视觉模拟评分法（VAS）评分来评估患者检查舒适度，比较两组患者咽反射敏感发生率和咽喉完全暴露率。结果 常规体位组中，Friedman困难暴露26例，容易暴露32例；困难暴露和容易暴露患者的VAS评分分别为：2.5（1.0，5.8）和1.0（1.0，3.0）分；咽反射敏感发生率分别为：42.3%和34.4%；咽喉完全暴露率分别为76.9%和100.0%。前倾体位组中，Friedman困难暴露28例，容易暴露34例；困难暴露和容易暴露患者的VAS评分分别为：1.5（1.0，7.0）和2.0（1.0，4.0）分；咽反射敏感发生率分别为：46.4%和29.4%；咽喉完全暴露率分别为：82.1%和91.2%；两组患者比较，差异均无统计学意义（P > 0.05）。结论 采用直立低头位或前倾位行硬质喉镜检查时，两种体位的不同声门暴露程度患者，在舒适度评分、咽反射敏感发生率和咽喉完全暴露率方面均无明显差异，检查人员可根据自身的检查习惯，选取合适的体位。

Abstract:

Objective To explore the optimal body position of patients during rigid laryngoscopy.Methods 120 outpatients who underwent rigid laryngoscopy from December 2023 to March 2024 were divided into the conventional body position group (58 cases) and the anterior tilted position group (62 cases) by the random number table method. Patients in the conventional body position group were examined in the conventional body position (upright lower head position) and patients in the anterior tilted position group were examined in the anterior tilted position (body tilted forward by 60° and jaw lifted). The vocal folds were scored on the Friedman scale, the visual analogue scale (VAS) score was used to evaluate the comfortable degree of patients during the examination, the incidence of gag reflex sensitivity and the rate of complete pharyngeal exposure were compared between the two groups of patients.Results In the conventional body position group, there were 26 cases of Friedman's difficult exposure and 32 cases of easy exposure. The VAS scores of difficult exposure and easy exposure patients were 2.5 (1.0, 5.8) and 1.0 (1.0, 3.0), respectively; The incidence of gag reflex sensitivity was 42.3% and 34.4%, respectively; and the rates of complete pharyngeal exposure were 76.9% and 100.0%, respectively. In the anterior tilted position group, there were 28 cases of Friedman difficult exposure and 34 cases of easy exposure. The VAS scores of patients with difficult and easy exposure were 1.5 (1.0, 7.0) and 2.0 (1.0, 4.0), respectively; The incidence of gag reflex sensitivity was 46.4% and 29.4%, respectively; And the rates of complete pharyngeal exposure were 82.1% and 91.2%, respectively; The differences were not statistically significant (P > 0.05).Conclusion When rigid laryngoscopy is performed in the upright lower head position or anteriorly tilted position, there is no significant difference in the comfortable degree scores, incidence of gag reflex sensitivity, and the rate of complete pharyngeal exposure in the patients in the two positions, and the examiners can choose the appropriate position according to their own examination habits.