PDF(Pubmed)
Abstract：
Arytenoid dislocation is a rare laryngeal injury that may follow endotracheal intubation. We aimed to determine the incidence and risk factors for arytenoid dislocation after surgery under general anaesthesia.
We reviewed the medical records of patients who underwent operation under general anaesthesia with endotracheal intubation from January 2014 to December 2018. Patients were divided into the non-dislocation and dislocation groups depending on the presence or absence of arytenoid dislocation. Patient, anaesthetic, and surgical factors associated with arytenoid dislocation were determined using Poisson regression analysis.
Among the 25,538 patients enrolled, 33 (0.13%) had arytenoid dislocation, with higher incidence after anterior neck and brain surgery. Patients in the dislocation group were younger (52.6 ± 14.4 vs 58.2 ± 14.2 yrs, P = 0.025), more likely to be female (78.8 vs 56.5%, P = 0.014), and more likely to be intubated by a first-year anaesthesia resident (33.3 vs 18.5%, P = 0.048) compared to those in the non-dislocation group. Patient positions during surgery were significantly different between the groups (P = 0.000). Multivariable Poisson regression identified head-neck positioning (incidence rate ratio [IRR], 3.10; 95% confidence interval [CI], 1.50-6.25, P = 0.002), endotracheal intubation by a first-year anaesthesia resident (IRR, 2.30; 95% CI, 1.07-4.64, P = 0.024), and female (IRR, 3.05; 95% CI, 1.38-7.73, P = 0.010) as risk factors for arytenoid dislocation.
This study showed that the incidence of arytenoid dislocation was 0.13%, and that head-neck positioning during surgery, less anaesthetist experience, and female were significantly associated with arytenoid dislocation in patients who underwent surgeries under general anaesthesia with endotracheal intubation.
We reviewed the medical records of patients who underwent operation under general anaesthesia with endotracheal intubation from January 2014 to December 2018. Patients were divided into the non-dislocation and dislocation groups depending on the presence or absence of arytenoid dislocation. Patient, anaesthetic, and surgical factors associated with arytenoid dislocation were determined using Poisson regression analysis.
Among the 25,538 patients enrolled, 33 (0.13%) had arytenoid dislocation, with higher incidence after anterior neck and brain surgery. Patients in the dislocation group were younger (52.6 ± 14.4 vs 58.2 ± 14.2 yrs, P = 0.025), more likely to be female (78.8 vs 56.5%, P = 0.014), and more likely to be intubated by a first-year anaesthesia resident (33.3 vs 18.5%, P = 0.048) compared to those in the non-dislocation group. Patient positions during surgery were significantly different between the groups (P = 0.000). Multivariable Poisson regression identified head-neck positioning (incidence rate ratio [IRR], 3.10; 95% confidence interval [CI], 1.50-6.25, P = 0.002), endotracheal intubation by a first-year anaesthesia resident (IRR, 2.30; 95% CI, 1.07-4.64, P = 0.024), and female (IRR, 3.05; 95% CI, 1.38-7.73, P = 0.010) as risk factors for arytenoid dislocation.
This study showed that the incidence of arytenoid dislocation was 0.13%, and that head-neck positioning during surgery, less anaesthetist experience, and female were significantly associated with arytenoid dislocation in patients who underwent surgeries under general anaesthesia with endotracheal intubation.
摘要：
Arytenoid脱位是一种罕见的喉损伤，可能会在气管插管后发生。我们旨在确定全身麻醉下手术后关节脱位的发生率和危险因素。
我们回顾了2014年1月至2018年12月在全身麻醉下气管插管手术患者的病历。根据有无关节脱位，将患者分为非脱位和脱位组。病人,麻醉,使用泊松回归分析确定与关节脱位相关的手术因素。
在25,538名患者中，33例(0.13%)出现了节状位错，前颈部和脑部手术后发病率较高。脱位组患者较年轻（52.6±14.4vs58.2±14.2岁，P=0.025),更有可能是女性(78.8%vs56.5%，P=0.014),更有可能由第一年麻醉住院医师插管(33.3%对18.5%，P=0.048）与非位错组相比。手术期间患者的位置在组间有显著差异(P=0.000)。多变量泊松回归识别头颈部定位(发病率比[IRR]，3.10；95%置信区间[CI]，1.50-6.25,P=0.002),第一年麻醉住院医师进行气管插管(IRR，2.30；95%CI，1.07-4.64，P=0.024），和女性（IRR，3.05；95%CI，1.38-7.73，P=0.010）为关节突关节脱位的危险因素。
这项研究表明，关节脱位的发生率为0.13％，以及手术过程中头颈部的定位，更少的麻醉师经验，在气管内插管全身麻醉下接受手术的患者中，女性与蝶骨脱位显着相关。
我们回顾了2014年1月至2018年12月在全身麻醉下气管插管手术患者的病历。根据有无关节脱位，将患者分为非脱位和脱位组。病人,麻醉,使用泊松回归分析确定与关节脱位相关的手术因素。
在25,538名患者中，33例(0.13%)出现了节状位错，前颈部和脑部手术后发病率较高。脱位组患者较年轻（52.6±14.4vs58.2±14.2岁，P=0.025),更有可能是女性(78.8%vs56.5%，P=0.014),更有可能由第一年麻醉住院医师插管(33.3%对18.5%，P=0.048）与非位错组相比。手术期间患者的位置在组间有显著差异(P=0.000)。多变量泊松回归识别头颈部定位(发病率比[IRR]，3.10；95%置信区间[CI]，1.50-6.25,P=0.002),第一年麻醉住院医师进行气管插管(IRR，2.30；95%CI，1.07-4.64，P=0.024），和女性（IRR，3.05；95%CI，1.38-7.73，P=0.010）为关节突关节脱位的危险因素。
这项研究表明，关节脱位的发生率为0.13％，以及手术过程中头颈部的定位，更少的麻醉师经验，在气管内插管全身麻醉下接受手术的患者中，女性与蝶骨脱位显着相关。
