实用医学杂志 ›› 2021, Vol. 37 ›› Issue (7): 909-913.doi: 10.3969/j.issn.1006⁃5725.2021.07.016

• 临床研究 • 上一篇    下一篇

Pierre Robin 序列征婴儿下颌骨牵引成骨术后声门暴露分级的改变及相关因素分析

徐颖怡, 张娜, 邱倩琪, 毛喆, 梁宇峰, 区信栩, 谭永红1   

  1. 广州医科大学附属广州市妇女儿童医疗中心 1 麻醉科与围术期科,2 口腔颌面外科, 3 重症监护室(广州 510623)

  • 出版日期:2021-04-10 发布日期:2021-04-10
  • 通讯作者: 谭永红 E⁃mail:yonghongtandoctor@yeah.net

Changes of glottic exposure classification and related factors in infants with Pierre Robin sequence after mandibular distraction osteogenesis

XU Yingyi*,ZHANG Na,QIU Qingqi,MAO Zhe,LIANG Yufeng,OU Xingxu,TAN Yonghong   

  1. Department of Anaesthesia and Prioperative Medicine,Guangzhou Women and Chil⁃dren′s Medical Center,Guangzhou Medical University,Guangzhou 510623,China
  • Online:2021-04-10 Published:2021-04-10
  • Contact: TAN Yonghong E⁃mail:yonghongtandoctor@yeah.net

摘要:

目的 分析 Pierre Robin 序列征患儿下颌骨牵引成骨术后声门暴露分级的改变及其相关因素。方法 回顾 2016⁃2019 年在我院全麻下行下颌骨牵引成骨术的 Pierre Robin 序列征患儿 95 例,比较下颌骨牵引成骨术前后 Cormack⁃Lehane 分级结果及上气道各 CT 指标测量值的差异。并应用 Spearman 关性分析评价 CT 测量指标与 Cormack⁃Lehane 分级评分的相关性。结果 与下颌骨牵引成骨术术前相比, 术后患儿 Cormack⁃Lehane 评分与声门暴露困难发生率降低(P<0.05),D1、D2、D3、D4、D5、D6、D7、D8、D9 D10、D11 长度均增加(P<0.05);角 1、角 2 和角 5 增大;角 3、角 4 和角 6 均减小(P<0.05);会厌尖端的气道 截面积及腭咽腔容积增加(P<0.05),并与 Cormack⁃Lehane 分级呈负相关。结论 随着气道截面积及腭咽 腔容积增加,Pierre Robin 序列征婴儿下颌牵张成骨术后声门暴露分级明显改善。

关键词:

Abstract:

Objective To analyze the changes of glottic exposure classification and related factors in Pierre Robin sequence pediatric patients after mandibular distraction osteogenesis. Methods Ninety five pediatric patients with Pierre Robin sequence,scheduled for elective mandibular distraction osteogenesis under general anes⁃ thesia in our hospital from 2016 to 2019,were enrolled in this study. The results of Cormack Lehane classification and CT parameters of upper airway were compared before and after mandibular distraction osteogenesis. Pearson correlation analysis was used to evaluate the correlation between CT measurement indexes and Cormack Lehane grading score. Results The Cormack Lehane score and the incidence of glottic exposure difficulty were decreased compared with that before mandibular distraction osteogenesis(P < 0.05),the length of D1,D2,D3,D4,D5 D6,D7,D8,D9,D10,D11 were increased(P < 0.05);angle 1,angle 2 and angle 5 were increased;angle 3 angle 4 and angle 6 were decreased(P < 0.05);airway cross⁃sectional area and palatopharyngeal cavity volume at the tip of epiglottis were increased(P < 0.05). It was negatively correlated with Cormack Lehane classification. Conclusion Preoperative maxillofacial and upper airway CT can play an important role in the judgment of laryngo⁃ scope exposure classification in PRS patients. With the increase of airway cross⁃sectional area and velopharyngeal cavity volume,glottic exposure classification of infants with Pierre Robin sequence sign after mandibular distrac⁃ tion osteogenesis was significantly improved.

Key words:

Pierre Robin syndrome, mandible distraction osteogenesis, upper airway morphology, glottic exposure