Zhang Chen, Chen Lihai, Ding Ke, Sun Bei, Zhang Xiaodan, Zhang Yong, Bao Hongguang
Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University Nanjing 210006, Jiangsu, China.
Am J Transl Res. 2023 Jun 15;15(6):4196-4202. eCollection 2023.
To investigate the diagnostic value of ultrasound for predicting occurrence of airway difficulty in patients undergoing anesthesia.
A total of 273 patients airway difficultyundergoing general anesthesia admitted to the Department of Anesthesiology, Nanjing First Hospital, Affiliated to Nanjing Medical University from January 2017 to October 2021 were selected in this prospective study. Among them, 73 suffered airway difficulty and the airway difficultyremaining 200 did not. Factors relating to the occurrence of difficulty were observed, and the hyomental distance ratio [HMDR = hyomental distance at the extreme of head extension (HMDe)/hyomental distance in the neutral position (HMDn)] combined with the distance from skin to epiglottis midway (DSEM) were further studied for the prediction of airway difficulty occurrence.
Multivariate regression analysis revealed that HMDe, HMDR, and DSEM were factors associated with the occurrence of difficulty (all P<0.05). The specificity and the sensitivity of HMDR in diagnosing airway difficulty were 0.715 and 0.918 respectively at a cutoff value of 1.245 mm. The specificity and sensitivity of DSEM in diagnosing airway difficulty were 0.959 and 0.767 respectively at a cutoff value of 22.952 nm. When HMDR was combined with DSEM, the specificity of the diagnosis of airway difficulty was 0.973, and the sensitivity was 0.904.
HMDe, HMDR and DSEM can be used to predict occurrence of airway difficultyand HMDR combined with DSEM has value in the diagnosis.
探讨超声在预测麻醉患者气道困难发生情况中的诊断价值。
本前瞻性研究选取了2017年1月至2021年10月在南京医科大学附属南京第一医院麻醉科接受全身麻醉且存在气道困难的273例患者。其中,73例发生气道困难,其余200例未发生。观察与困难发生相关的因素,并进一步研究颏下距离比值[HMDR = 头极度后仰时的颏下距离(HMDe)/中立位时的颏下距离(HMDn)]与皮肤至会厌中点距离(DSEM)对气道困难发生的预测作用。
多因素回归分析显示,HMDe、HMDR和DSEM是与困难发生相关的因素(均P<0.05)。HMDR诊断气道困难的特异性和敏感性在截断值为1.245 mm时分别为0.715和0.918。DSEM诊断气道困难的特异性和敏感性在截断值为22.952 nm时分别为0.959和0.767。当HMDR与DSEM联合时,诊断气道困难的特异性为0.973,敏感性为0.904。
HMDe、HMDR和DSEM可用于预测气道困难的发生,且HMDR与DSEM联合在诊断中具有价值。