摘要
目的:评价张口度的实测方法与手指估测方法在预测困难气道中的价值区别。方法:对符合纳入标准的患者全麻气管插管的择期手术患者,术前进行张口度的实测方法评估,张口度是否<2指和是否<3指的手指估测方法评估。记录患者是否困难喉镜暴露及是否困难气管插管。应用受试者工作特征曲线(ROC)及曲线下面积(AUC)来分析不同张口度的评估方法预测困难喉镜暴露及困难插管的能力。结果:共732位患者纳入研究,困难喉镜暴露患者67位,困难插管患者25位。预测困难喉镜暴露时,实测张口度的标准为<3.9 cm,AUC为0.718,张口度<2指和张口度<3指的AUC分别为0.569、0.631。低于实测张口度的预测能力(P<0.001)。预测困难插管时,实测张口度的标准为<3.8 cm,受试者工作特征曲线下面积(AUC)为0.821,张口度<2指和张口度<3指的AUC分别为0.669、0.646,低于实测张口度的预测能力(P<0.001)。结论:与实测评估张口度的方法相比,无论是张口度<2指还是张口度<3指的手指估测方法均降低了张口度预测困难气道的能力。
Objective： To compare the outcomes of real interincisor distance measurement and finger measurement in predicting the difficult airways. Methods ： Eligible patients undergone selective surgery by general endotracheal intubation anesthesia were included and preoperatively estimated on the dif- ficult airways by real interincisor distance measurement and finger measurement. Difficult laryngoscopy and difficult intubation were documented, and re- ceiver operating characteristic curves （ROC） and the area under the curve （AUC） were utilized to analyze the capacity of different assessment methods for estimation of difficult airways. Results： A total of 732 patients were finally included,in whom 67 had difficult laryngoscopy and 25 had difficult intubation. In predicting difficult laryngoscopy,the criterion of actually measured interlneisor distance was 〈 3.9 cm,wlth AUC of 0.718. The AUC for breadth 〈 two fingers and 〈 three fingers was 0. 569 and 0. 631, respectively, which was different from the results of actually measured interincisor distance （P 〈 0. 001 ）. In predicting difficult intubation, actually measured interincisor distance was 〈 3.8 cm, and breadth of finger measurement was 〈 two fingers and 〈 three fingers. The AUC was 0.821 for the former and 0.669 and 0.646, respectively for the latter. The difference was significant （P 〈0. 001 ）. Conclusion ： Compared with actually measured interincisor distance, whatever mouth opening less than 2 finger breadths or 3 finger breadths may diminish the ability to predict difficult airways.
出处
《皖南医学院学报》
CAS
2015年第5期489-492,共4页
Journal of Wannan Medical College
关键词
困难气道
张口度
实测
手指估测
全身麻醉
difficult airway
interincisor distance
actual measurement
finger measurement
general anesthesia
