喉部超声能否在机械辅助咳嗽期间检测喉部运动？
Can laryngeal ultrasound detect laryngeal movements during mechanically assisted cough?
文献信息
| PMID | 42741617 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Tiina Maarit Andersen |
| 作者单位 | Thoracic Department, Haukeland University Hospital, Bergen, Norway. |
| 期刊 | ERJ open research |
| SCI 分区 | Q1 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 机械吹气-排气（MI-E）用于增强无效咳嗽，但治疗效果取决于上气道的适当反应。经鼻柔性喉镜检查（TFL）是评估喉部反应的金标准，但具有侵入性。本研究评估了喉部超声（US）能否在MI-E期间评估喉部反应。
方法： 在这项横断面研究中，健康志愿者在被动和主动咳嗽用力下接受MI-E，同时进行TFL和US检查。喉部US采用前入路和侧入路。记录由两名设盲评估者逐帧回顾性分析。可评估性定义为声带或杓会厌襞的适当可视化。在预先设定的MI-E周期中计算可视化成功率和喉部US与TFL结果之间的一致性。在部分样本中评估US判读的评估者间信度。
结果： 共纳入30名成年参与者和875个MI-E周期。至少一种喉部US入路在所有参与者中均获得可评估数据，但男性中可评估性较低。在MI-E周期中，TFL的可视化成功率高于喉部US（93.5%对68%）。在被动和主动吹气期间，US与TFL的一致性分别为78%和79%；在被动和主动排气期间分别为80%和88%；在主动咳嗽压缩期间为92%。评估者间信度为高度一致（κ=0.62）。
结论： 这项探索性研究表明，喉部US可能提供一种可行的非侵入性方法来评估MI-E期间的喉部反应，但TFL仍是金标准。需要在患者人群中进行进一步验证。
英文摘要
BACKGROUND: Mechanical insufflation-exsufflation (MI-E) is used to augment ineffective cough, but treatment efficacy depends on appropriate upper airway response. Transnasal flexible laryngoscopy (TFL) is the reference standard for assessing laryngeal responses, but is invasive. This study evaluated whether laryngeal ultrasonography (US) can assess laryngeal responses during MI-E.
METHODS: In this cross-sectional study, healthy volunteers underwent MI-E with both passive and active cough efforts, while TFL and US were performed simultaneously. Laryngeal US was applied using anterior and lateral approaches. Recordings were analysed retrospectively frame-by-frame by two blinded raters. Assessability was defined as appropriate visualisation of the vocal folds or aryepiglottic folds. Visualisation success rates and concordance between laryngeal US and TFL findings were calculated across pre-specified MI-E cycles. Inter-rater reliability for US interpretation was assessed in a subset.
RESULTS: 30 adult participants and 875 MI-E cycles were included. At least one laryngeal US approach yielded assessable data in all participants, with lower assessability in males. Across MI-E cycles, visualisation success rates were higher for TFL than for laryngeal US (93.5% versus 68%). Concordance between US and TFL was 78% and 79% during passive and active insufflation, 80% and 88% during passive and active exsufflation, and 92% during active cough compression. Inter-rater reliability was substantial (κ=0.62).
CONCLUSION: This exploratory study suggests that laryngeal US may offer a feasible noninvasive approach to assess laryngeal responses during MI-E, but TFL remains the reference standard. Further validation in patient populations is required.