【摘要】 目的:研究头后仰角度差与改良Mallampati分级,上下切牙间距三参数结合对困难气道预测的准确性。方法:选择200例拟行气管插管全麻的患者,术前测量头后仰角度差值、上下切牙间距、改良Mallampati分级,以Cormack-Lehane 3~4级定为困难气管插管。结果:以头后仰角度差<15°能较准确的预测困难气道(P<0.05)。结合头后仰角度差与改良Mallampati分级,上下切牙间距三参数以总分≥5认为存在困难气道的综合评估指标,与传统的单项改良Mallampati分级试验比较实际插管困难发生率,得出三参数结合评估法敏感度(81.3%)、阳性预测值高(75%)(P<0.05),漏诊率低(18.8%)(P<0.05)。结论:在拟行气管插管全麻的患者中头后仰角度差能较准确的预测困难气道;若结合头后仰角度差、改良Mallampati分级、上下切牙间距三项评估指标,可提高困难气道预测的准确性。更多还原

【Abstract】 Objective:The object of this study was to determine the diagnostic accuracy of a combination with the difference backward extension degree of neck,modified Mallampati classification and upper-lower incisor teeth distance for predicting difficult intubation.Methods:Two-hundred patients who would undergo general anesthesia with endotracheal intubation were evaluated pre-operatively for difficult intubation using neck backward degree,upper-lower incisor teeth distance and modified Mallampati classification.And the standard of difficult intubation was Cormack-Lehane classes Ⅲ-Ⅳ.Results:Used alone,the difference of neck upward degree <15°had best predictive value(P<0.05).Combining the difference of neck backward degree with modified mallampati classification and upper-lower incisor,the score ≥5 suggested the likelihood of a difficult airway,and the sensitivity(81.3%)and the positive predictive values(75%)were higher than the traditional modified Mallampati classification,and the misdiagnosis rate(18.8%)was lower than the traditional modified Mallampati classification(P<0.05).Conclusion:The difference of neck backward degree was an effective method for predicting difficult intubation,and if combined with modified Mallamptati and upper-lower incisor teeth distance,it would improve the accuracy of prediction.更多还原