Kalezić Nevena, Lakićević Mirko, Miličić Biljana, Stojanović Marina, Sabljak Vera, Marković Dejan
School of Medicine, University of Belgrade.
Bosn J Basic Med Sci. 2016 Aug 2;16(3):232-6. doi: 10.17305/bjbms.2016.1217. Epub 2016 Jun 14.
The hyomental distance ratio (HMDR) is the ratio between the hyomental distance (HMD) (the distance between the hyoid bone and the tip of the chin) at the extreme of head extension (HMDe) and the one in the neutral position (HMDn). The objective of the study was to examine the predictive value, sensitivity, and specificity of HMDe, HMDn, and HMDR in predicting difficult endotracheal intubation (DI). A prospective study included 262 patients that underwent elective surgical operations. The following parameters were observed as possible predictors of DI: HMDR, HMDe, HMDn, Mallampati score, and body mass index (BMI). The cut-off points for the DI predictors were HMDe <5.3 cm, HMDn ≤5.5 cm, and HMDR ≤1.2. The assessment that DI existed was made by the anesthesiologist while performing laryngoscopy by applying the Cormack-Lehane classification. DI was present in 13 patients (5%). No significant difference was observed in the frequency of DI with regard to the sex, age, and BMI of the patients. Our research indicated HMDR as the best predictor of DI with a sensitivity of 95.6% and specificity of 69.2%. HMDR can be used in the everyday work of anesthesiologists because HMDR values ≤1.2 may reliably predict DI.
下颌舌骨距离比（HMDR）是头部极度后仰时（HMDe）下颌舌骨距离（HMD，即舌骨与下巴尖端之间的距离）与中立位时下颌舌骨距离（HMDn）的比值。本研究的目的是检验HMDe、HMDn和HMDR在预测困难气管插管（DI）方面的预测价值、敏感性和特异性。一项前瞻性研究纳入了262例行择期外科手术的患者。观察了以下参数作为DI的可能预测指标：HMDR、HMDe、HMDn、马兰帕蒂评分和体重指数（BMI）。DI预测指标的截断点为HMDe <5.3 cm、HMDn≤5.5 cm和HMDR≤1.2。麻醉医生在进行喉镜检查时采用科马克-莱汉内分级法来评估是否存在DI。13例患者（5%）存在DI。在患者的性别、年龄和BMI方面，DI的发生率未观察到显著差异。我们的研究表明，HMDR是DI的最佳预测指标，敏感性为95.6%，特异性为69.2%。由于HMDR值≤1.2可可靠地预测DI，因此其可用于麻醉医生的日常工作中。
