南方医科大学学报
南方醫科大學學報
남방의과대학학보
Journal of Southern Medical University
2015年
9期
1352-1355
,共4页
困难气道%身高甲颏距离比%危险因素
睏難氣道%身高甲頦距離比%危險因素
곤난기도%신고갑해거리비%위험인소
difficult airway%ratio of height to thyromental distance%risk factors
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。
目的：根據常用氣道評估指標探究睏難氣道的危險因素。方法選擇300例擬行氣管插管全痳的患者，術前測量身高、甲頦距離、頸部後仰度、張口度、改良Mallampati分級等氣道評估指標。以睏難插管評分＞5分為睏難氣管插管，結閤睏難麵罩通氣共同定義睏難氣道。通過logistic迴歸分析評估各項指標與睏難氣道相關性，併通過ROC麯線計算受試人群身高甲頦距離比最佳臨界點。結果共8項相關因素按相對危險度估計值(OR)由大到小依次為：身高甲頦距離比3.58（1.95~8.46）、改良Mallampati分級3.34（1.82~7.14）、體質量指數3.07（1.64~6.69）、病史2.79（1.28~5.25）、頸圍2.15（1.04~4.37）、頸部後仰度1.98（0.96~3.89）、下頜支長度1.46（0.67~3.04）、張口度1.01（0.49~2.54）；身高甲頦距離比最佳臨界點為22.8。結論與睏難氣道相關的評估指標為：身高甲頦距離比、改良Mallampati分級、體質量指數、病史、頸圍、頸後仰度、下頜支長度、張口度。身高甲頦距離比是睏難氣道危險因素，具有較高的評估效能。
목적：근거상용기도평고지표탐구곤난기도적위험인소。방법선택300례의행기관삽관전마적환자，술전측량신고、갑해거리、경부후앙도、장구도、개량Mallampati분급등기도평고지표。이곤난삽관평분＞5분위곤난기관삽관，결합곤난면조통기공동정의곤난기도。통과logistic회귀분석평고각항지표여곤난기도상관성，병통과ROC곡선계산수시인군신고갑해거리비최가림계점。결과공8항상관인소안상대위험도고계치(OR)유대도소의차위：신고갑해거리비3.58（1.95~8.46）、개량Mallampati분급3.34（1.82~7.14）、체질량지수3.07（1.64~6.69）、병사2.79（1.28~5.25）、경위2.15（1.04~4.37）、경부후앙도1.98（0.96~3.89）、하합지장도1.46（0.67~3.04）、장구도1.01（0.49~2.54）；신고갑해거리비최가림계점위22.8。결론여곤난기도상관적평고지표위：신고갑해거리비、개량Mallampati분급、체질량지수、병사、경위、경후앙도、하합지장도、장구도。신고갑해거리비시곤난기도위험인소，구유교고적평고효능。
Objective To analyze the risk factors for difficult airway in laryngoscopy and mask ventilation. Methods A total of 300 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 height-to-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-to-TMD ratio was 22.8 for predicting a difficult airway.
