摘要
目的根据Arne气道评估体系建立一种较为准确的新预测系统。方法选择113例全麻后插管困难的患者（病例组）,按年龄与性别1：1配对,选择全麻后喉镜暴露正常患者113例（对照组）,分别记录有无困难插管史、困难插管相关疾病、气道疾病等病史,记录张口度、颞颌关节活动度、身高、甲颏距离、头颈活动度、Mallampati分级等指标的数值。以条件Logistic回归筛选出相关危险因素建立新预测体系,并分别用新系统和Arne评估气道。结果 1Arne系统的8项指标中经条件Logistic回归分析得出有5项为相关危险因素,其相对危险度估计值（OR）及95%可信区间（95%CI）按OR由大到小依次为：气道疾病（19.57,1.28～94.33）、Mallampati分级（15.39,1.14～87.74）、身高甲颏距离比（11.62,1.06～75.41）、困难插管史（5.45,0.97～46.23）、张口度（2.78,0.91～12.50）2新预测体系灵敏度、特异性、阳性预测值、阴性预测值分别为85.8%、70.8%、74.6%和83.3%。结论新预测系统可较准确地评估困难气道。
Objective To evaluate the effect of a new system based on Arne system for predicting difficult laryngoscopy. Methods A total of 113 patients who suffered from difficult laryngoscopy were selected as the case group. According to principles of the same sex, similar age, 113 patients with easy laryngoscopy（the control group）were paired with those of the case group. Airway characteristics such as knowledge by the patients of previous difficult laryngoscopy, pathologies associated with difficult laryngoscopy, clinical symptoms of airway pathology, height,thyromental distance（TMD）, maximum range of the head and neck movement, inter-incisor gap and mandible luxation were recorded. Logistic regression analysis was applied to screen the risk factors for establishing a new system.Arne system and new system was used for evaluating airway. Results 1 Risk factors of difficult laryngoscopy were clinical symptoms of airway pathology, Mallampati test, ratio of height and TMD, knowledge of difficult laryngoscopy and inter-incisor gap. The odd radios were（19.57, 1.28～94.33）,（15.39, 1.14～87.74）,（11.62, 1.06～75.41）,（5.45,0.97～46.23）,（2.78, 0.91～12.50）, respectively. 2 The new system got the sensitivity, specificity, positive predictive value and negative predictive value of 85.8%, 70.8%, 74.6% and 83.3%, respectively. Conclusion The new system could predict difficult laryngoscopy appropriately.
出处
《海南医学》
CAS
2015年第23期3458-3460,共3页
Hainan Medical Journal
基金
卫生部国家临床重点专科建设项目[编号:财社(2011)170号]
重庆市卫生局医学科研计划项目(编号:2012-1-018)
关键词
困难插管
Arne
身高
甲颏距离比
Difficult laryngoscopy
Arne
Height
Thyromental distance（TMD）
