六大解剖因素对支撑喉镜喉部手术相关并发症的临床预测评估

Six major anatomical factors in the clinical prediction and evaluation analysis of the complications related to laryngeal surgery

目的研究六大解剖因素对支撑喉镜喉部手术术后并发症的临床预测与评估分析中的应用效果。方法选取江门市新会区中医院2015年3月至2020年6月间收治的100例行经支撑喉镜下喉部手术患者作为研究对象,利用自制颌面部六大解剖因素评估表对所有患者进行手术并发症的临床预测与评估,按照分析结果将患者分为低风险组56例、中风险组29例和高风险组15例。比较三组患者的声门暴露、术后并发症、患者治疗满意度情况。结果低风险组患者的声门暴露成功率为91.07%,明显高于中风险组的65.52%和高风险组的33.33%,中风险组又明显高于高风险组,差异均有统计学意义(P<0.05);低风险组患者的术后并发症发生率为5.36%,明显低于中风险组的37.93%和高风险组患者的53.33%,中风险组又明显低于高风险组,差异均有统计学意义(P<0.05);低风险组、中风险组、高风险组患者的综合满意率分别为92.86%、96.55%、93.33%,三组比较差异均无统计学意义(P>0.05)。结论针对支撑喉镜下喉部手术患者展开六大解剖因素术前并发症预测评估,能够让医护人员与患者家属对患者手术风险情况得到充分了解,有助于改善患者及其家属的心理预期,促进医患关系的良性发展。

Objective To explore the application effects of six major anatomical factors in the clinical prediction and evaluation analysis of postoperative complications after laryngoscope surgery.Methods A total of 100 patients who underwent laryngeal surgery under support laryngoscope were selected as the research objects in Xinhui District Hospital of Traditional Chinese Medicine from March 2015 to June 2020.Using the self-made six major anatomical factors assessment table for maxillofacial region,all patients were evaluated and analyzed for clinical prediction of surgical complications.According to the analysis results,the patients were divided into low-risk group(56 cases),medium risk group(29 cases)and high-risk group(15 cases).The patients'glottis exposure,post-operative complications,patients'satisfaction with treatment,and complaints of doctor-patient disputes between groups were observed.Results The success rate of glottis exposure in the low-risk group(91.07%)was significantly higher than that of the middle-risk group(65.52%)and the high-risk group(33.33%),the success rate of glottal exposure for patients in the medium-risk group(65.52%)was significantly higher than that of the high-risk group(33.33%);and the differences were statistically significant(P<0.05);the post-operative complication rate of patients in the low-risk group(5.36%)was significantly lower than that of the middle-risk group(37.93%)and the high-risk group(53.33%),and the postoperative complication rate of patients in the medium-risk group was(37.93%),which was significantly lower than that of the high-risk group(53.33%),with statistically significant differences(P<0.05);the comprehensive satisfaction rates of low-risk group,medium risk group and high-risk group were 92.86%,96.55%and 93.33%,respectively,and there was no significant difference among the three groups(P>0.05).Conclusion Predictive assessment of preoperative complications of six major anatomical factors for patients undergoing laryngeal surgery under support laryngoscope has a good evaluation value for the risk of preoperative complications of patients,which could allow medical staff and patients'families to fully understand the patient's surgical risk,help improve the psychological expectations of patients and their families,and promote the benign development of the doctor-patient relationship.