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甲状腺手术对女性患者基于触诊的环甲膜识别准确性的影响:一项前瞻性观察队列研究。

The Effect of Thyroid Surgery on the Accuracy of Palpation-Based Cricothyroid Membrane Identification in Female Patients: A Prospective Observational Cohort Study.

机构信息

Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

出版信息

Medicina (Kaunas). 2024 Mar 13;60(3):471. doi: 10.3390/medicina60030471.

Abstract

: This study examined how a history of thyroid surgery impacts the precision of cricothyroid membrane (CTM) identification through palpation (validated by ultrasound) in female patients visiting the operating room for surgeries unrelated to neck procedures. : This prospective observational cohort study enrolled adult female patients undergoing elective non-neck surgery, dividing them into control (no thyroid surgery history; = 40) and experimental (with thyroid surgery history; = 40) groups. CTM identification was performed by palpation and confirmed via ultrasound. : There were no significant differences between two groups in the demographic characteristics of the patients. The success rate and accuracy of CTM identification through palpation were significantly higher in the control group compared to the experimental group (90% vs. 42.5%, respectively; < 0.001). For female patients with a history of thyroid surgery, the sensitivity of successful CTM palpation was 42.5%, and the specificity was 10%. These figures are based on the calculated true positives (17), false positives (36), true negatives (4), and false negatives (23). : Thyroid surgery history in female patients may hinder the accurate palpation-based identification of the CTM, suggesting a need for enhanced clinical practices and considerations during airway management training.

摘要

这项研究旨在探讨甲状腺手术史对女性患者经触诊(经超声验证)识别环甲膜(CTM)的准确性的影响,这些女性患者因与颈部手术无关的手术而就诊于手术室。

这是一项前瞻性观察性队列研究,纳入了接受择期非颈部手术的成年女性患者,将其分为对照组(无甲状腺手术史;n=40)和实验组(有甲状腺手术史;n=40)。通过触诊进行 CTM 识别,并通过超声确认。

两组患者的人口统计学特征无显著差异。与实验组相比,对照组通过触诊识别 CTM 的成功率和准确性明显更高(分别为 90%和 42.5%;<0.001)。对于有甲状腺手术史的女性患者,成功触诊 CTM 的敏感度为 42.5%,特异度为 10%。这些数据基于计算得出的真阳性(17)、假阳性(36)、真阴性(4)和假阴性(23)。

甲状腺手术史可能会阻碍女性患者基于触诊的 CTM 准确识别,这提示在气道管理培训中需要加强临床实践和考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ab/10971964/c8b3b84c91f7/medicina-60-00471-g001.jpg

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