Banik D, Ray L, Akhtaruzzaman A K, Bhowmick D K, Hossain M S, Islam M S, Haque M F
Dr Debasish Banik, Associate Professor, Department of Anaesthesia, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mymensingh Med J. 2017 Apr;26(2):395-405.
This study was aimed at finding the parameters for prediction of difficulty in endotracheal intubation, that are easy to examine and that could better predict difficulty. The current observational prospective, cross sectional study was conducted in the department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2015 to September 2015 comprising 180 patient of both sexes requiring endotracheal intubation were arranged into two groups, Group A: Modified Mallampati test Group and Group B: Modified Mallampati & upper lip bite test group (combined) Assessment of difficulty in intubation was done by Cormack & Lehane direct Laryngoscopic grading. Outcome was measured as no difficulty or difficulty in intubation. In Group A 33 cases were true positive, 15 false negative, 26 false positive, 16 true negative. In Group B 53 cases were true positive, 1 false positive, 8 false negative, 28 true negative. The validity tests for Group A for evaluation of difficult intubation were indicated by sensitivity 55.9%, Specificity 51.6%, Accuracy 54.41%, Positive predictive value 68.8% and Negative predictive value 38.1%. The values for Group-B were 86.9%, 96.6%, 90.0%, 98.1% and 77.8% respectively. Combined modified Mallampati & Upper Lip Bite Test has definite value in the diagnosis of difficulty in intubation and can be regarded as sensitive & specific test for operative discrimination of the patient.
本研究旨在寻找易于检查且能更好预测困难程度的气管插管困难预测参数。2015年3月至2015年9月，在孟加拉国达卡的班加班杜·谢赫·穆吉布医科大学（BSMMU）麻醉、镇痛与重症医学科进行了一项当前的观察性前瞻性横断面研究，180例需要气管插管的男女患者被分为两组，A组：改良马兰帕蒂试验组；B组：改良马兰帕蒂试验与上唇咬合试验联合组（联合组）。通过科马克和莱汉直接喉镜分级评估插管困难程度。结果以插管无困难或有困难来衡量。A组中，33例为真阳性，15例为假阴性，26例为假阳性，16例为真阴性。B组中，53例为真阳性，1例为假阳性，8例为假阴性，28例为真阴性。A组评估困难插管的有效性测试结果为：敏感性55.9%，特异性51.6%，准确性54.41%，阳性预测值68.8%，阴性预测值38.1%。B组的相应值分别为86.9%、96.6%、90.0%、98.1%和77.8%。改良马兰帕蒂试验与上唇咬合试验联合在插管困难诊断中具有一定价值，可被视为对患者进行手术鉴别诊断的敏感且特异的试验。
