实用临床医药杂志2026,Vol.30Issue(4):59-64,71,7.DOI:10.7619/jcmp.20255963
基于中国人群的声门暴露困难预测模型的前瞻性研究
A prospective study on predictive model for difficult laryngeal exposure based on Chinese population
摘要
Abstract
Objective To construct a simplified predictive model for difficult laryngeal exposure(DLE)during laryngomicrosurgery in Chinese population and evaluate its clinical value.Methods A total of 384 patients with laryngomicrosurgery from January 2022 to December 2023 were selected.DLE was defined as Cormack-Lehane grades Ⅲ to Ⅳ.Univariate analysis and multivariate Logistic regression were used to screen independent risk factors.A predictive model was constructed incorporating 5 pa-rameters:body mass index(BMI)≥28 kg/n2,neck circumference ≥40 cm,thyromental distance<6.5 cm,modified Mallampati classification grades Ⅲ to Ⅳ,and moderate-to-severe restriction of neck mobility.The area under the curve(AUC)of the receiver operating characteristic(ROC)curve and the Bootstrap method were employed to validate the performance of the model.Results The model demonstrated a negative predictive value of 95.3%,good discriminatory performance(AUC=0.876,95% CI,0.835 to 0.917),and stable internal validation(adjusted AUC=0.862).When the cut-off value was ≥3 points,the model exhibited a sensitivity of 86.0% and a specificity of 82.6%.Con-clusion This model can accurately identify patients at high risk of DLE before surgery,providing a reference for individualized surgical preparation.关键词
声门暴露困难/喉显微手术/预测模型/体质量指数/颈围/甲颏距离/颈部活动度/改良Mallampati评分Key words
difficult laryngeal exposure/laryngomicrosurgery/predictive model/body mass in-dex/neck circumference/thyromental distance/neck mobility/modified Mallampati classification分类
医药卫生引用本文复制引用
杜娟,杨亚灵,王德超,康伟,孙双..基于中国人群的声门暴露困难预测模型的前瞻性研究[J].实用临床医药杂志,2026,30(4):59-64,71,7.基金项目
2025年度河北省医学科学研究课题计划(20250277) (20250277)