摘要
目的根据常用气道评估指标探究困难气道的危险因素。方法选择300例拟行气管插管全麻的患者,术前测量身高、甲颏距离、颈部后仰度、张口度、改良Mallampati分级等气道评估指标。以困难插管评分〉5分为困难气管插管,结合困难面罩通气共同定义困难气道。通过logistic回归分析评估各项指标与困难气道相关性,并通过ROC曲线计算受试人群身高甲颏距离比最佳临界点。结果共8项相关因素按相对危险度估计值（OR）由大到小依次为：身高甲颏距离比3.58（1.95~8.46）、改良Mallampati分级3.34（1.82~7.14）、体质量指数3.07（1.64~6.69）、病史2.79（1.28~5.25）、颈围2.15（1.04~4.37）、颈部后仰度1.98（0.96~3.89）、下颌支长度1.46（0.67~3.04）、张口度1.01（0.49~2.54）;身高甲颏距离比最佳临界点为22.8。结论与困难气道相关的评估指标为：身高甲颏距离比、改良Mallampati分级、体质量指数、病史、颈围、颈后仰度、下颌支长度、张口度。身高甲颏距离比是困难气道危险因素,具有较高的评估效能。
Objective To analyze the risk factors for difficult airway in laryngoscopy and mask ventilation. Methods A total of300 patients receiving general anesthesia with tracheal intubation were examined preoperatively for height, thyromental and sternomental distance（TMD）, range of neck movement, inter- incisor distance, and modified Mallampati class. Intubation Difficult Score was used to identify a difficult laryngoscopy. Difficult airway was defined as either difficult laryngoscopy or difficult mask ventilation. The association between the airway characteristics and difficult airway was analyzed by logistic regression analysis, and the cut- off values for the height- to- TMD ratio was determined by the ROC curve. Results and Conclusion Eight airway characteristics were identified to contribute to a difficult airway, including（OR [95%CI]） the heightto-TMD ratio（3.58[1.95-8.46]）, modified Mallampati class（3.34 [1.82-7.14]）, BMI（3.07 [1.64-6.69]）, history of a previous difficult airway（2.79 [1.28- 5.25]）, a thick neck（2.15 [1.04- 4.37]）, range of neck movement（1.98 [0.96- 3.89]）, sternomental and angulus mandibulae distance（1.46 [0.67-3.04]）, and inter-incisor distance（1.01 [0.49-2.54]）. The optimal cut-off value for the height-toTMD ratio was 22.8 for predicting a difficult airway.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2015年第9期1352-1355,共4页
Journal of Southern Medical University
基金
卫生部国家临床重点专科建设项目(财社(2011)170号)
重庆市卫生局医学科学重点项目(2012-018)
重庆市医学重点学科(渝卫科教(2007)2号)
重庆市卫生局医学科研计划项目(2012-1-018)
关键词
困难气道
身高甲颏距离比
危险因素
difficult airway
ratio of height to thyromental distance
risk factors
