[1]靳皓,陈萍.困难气道危险因素Logistic回归分析及身高甲颏距离比最佳临界点[J].南方医科大学学报,2015,(09):1352.
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困难气道危险因素Logistic回归分析及身高甲颏距离比最佳临界点()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2015年09期
页码:
1352
栏目:
出版日期:
2015-09-15

文章信息/Info

Title:
Logistic regression analysis of the risk factors for difficult airway and the cut-off value of
height-to-thyromental distance ratio
作者:
靳皓陈萍
关键词:
困难气道身高甲颏距离比危险因素
Keywords:
difficult airway ratio of height to thyromental distance risk factors
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。
Abstract:
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.
更新日期/Last Update: 1900-01-01