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本文引用的文献

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Ultrasound for airway management: An evidence-based review for the emergency clinician.超声在气道管理中的应用:急诊临床医生的循证评价。
Am J Emerg Med. 2020 May;38(5):1007-1013. doi: 10.1016/j.ajem.2019.12.019. Epub 2019 Dec 11.
2
Use of a Combined Laryngo-Bronchoscopy Approach in Difficult Airways Management: A Pilot Simulation Study.联合喉镜-支气管镜检查法在困难气道管理中的应用:一项初步模拟研究
Turk J Anaesthesiol Reanim. 2019 Dec;47(6):464-470. doi: 10.5152/TJAR.2019.99234. Epub 2019 Sep 2.
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Airway Management in Critical Illness: An Update.危重病患者的气道管理:更新。
Chest. 2020 Apr;157(4):877-887. doi: 10.1016/j.chest.2019.10.026. Epub 2019 Nov 9.
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The Difficult Airway.困难气道
Otolaryngol Clin North Am. 2019 Dec;52(6):1115-1125. doi: 10.1016/j.otc.2019.08.009. Epub 2019 Sep 25.
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Will This Patient Be Difficult to Intubate?: The Rational Clinical Examination Systematic Review.患者是否难以插管?:理性临床检查系统评价。
JAMA. 2019 Feb 5;321(5):493-503. doi: 10.1001/jama.2018.21413.
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The hyoid bone: an overview.舌骨:概述
Cranio. 2020 Jan;38(1):6-14. doi: 10.1080/08869634.2018.1487501. Epub 2018 Oct 5.
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Thyromental height test as a new method for prediction of difficult intubation with double lumen tube.甲状舌骨高度测试作为预测双腔管插管困难的新方法。
PLoS One. 2018 Sep 13;13(9):e0201944. doi: 10.1371/journal.pone.0201944. eCollection 2018.
8
Upper lip bite test for prediction of difficult airway: A systematic review.用于预测困难气道的上唇咬试验:一项系统评价
Pak J Med Sci. 2018 Jul-Aug;34(4):1019-1023. doi: 10.12669/pjms.344.15364.
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Ultrasound-based assessment of hyomental distances in neutral, ramped, and maximum hyperextended positions, and derived ratios, for the prediction of difficult airway in the obese population: a pilot diagnostic accuracy study.基于超声评估中立位、斜坡位和最大伸展位时的下颌至胸骨上切迹距离及其衍生比值,用于预测肥胖人群困难气道:一项初步诊断准确性研究。
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10
Relationships among retropalatal airway, pharyngeal length, and craniofacial structures determined by magnetic resonance imaging in patients with obstructive sleep apnea.磁共振成像评估阻塞性睡眠呼吸暂停患者的后咽气道、咽腔长度和颅面结构的关系。
Sleep Breath. 2019 Mar;23(1):103-115. doi: 10.1007/s11325-018-1667-x. Epub 2018 May 5.

超声对预测麻醉患者气道困难发生情况的诊断价值

Diagnostic value of ultrasound for predicting the occurrence of airway difficulty in patients undergoing anesthesia.

作者信息

Zhang Chen, Chen Lihai, Ding Ke, Sun Bei, Zhang Xiaodan, Zhang Yong, Bao Hongguang

机构信息

Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University Nanjing 210006, Jiangsu, China.

出版信息

Am J Transl Res. 2023 Jun 15;15(6):4196-4202. eCollection 2023.

PMID:37434828
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10331644/
Abstract

OBJECTIVE

To investigate the diagnostic value of ultrasound for predicting occurrence of airway difficulty in patients undergoing anesthesia.

METHODS

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.

RESULTS

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.

CONCLUSION

HMDe, HMDR and DSEM can be used to predict occurrence of airway difficultyand HMDR combined with DSEM has value in the diagnosis.

摘要

目的

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。

方法

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。

结果

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。

结论

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。