Randell T
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
Acta Anaesthesiol Scand. 1996 Sep;40(8 Pt 2):1016-23. doi: 10.1111/j.1399-6576.1996.tb05620.x.
The incidence of a difficult laryngoscopy or intubation varies from 1.5% to 13%, and failed intubation has been identified as one of the anaesthesia-related causes of death or permanent brain damage. Problems in the airway management can be predicted based on previous anaesthesia records, the medical history of the patient and a physical examination. Several radiological measurements have been reported to be associated with a difficult intubation. The sensitivities of the commonly used bedside tests i.e. the Mallampati classification and the thyromental distance have been reported to be from 42% to 81%, and from 62% to 91%, respectively. The figures for the specificity have varied from 66% to 84% and from 25% to 82%, respectively. The other subjective assessments and objective measurements employed for the prediction of a difficult intubation reach comparable sensitivities and specificities. Evidently, the positive predictive value is improved, if combinations of tests are used.
困难喉镜检查或插管的发生率在1.5%至13%之间，插管失败已被确认为与麻醉相关的死亡或永久性脑损伤原因之一。根据既往麻醉记录、患者病史和体格检查，可以预测气道管理中存在的问题。据报道，几种影像学测量结果与困难插管有关。据报道，常用的床旁检查（即Mallampati分级和颏甲距离）的敏感性分别为42%至81%和62%至91%。特异性数据分别在66%至84%和25%至82%之间。用于预测困难插管的其他主观评估和客观测量也具有相当的敏感性和特异性。显然，如果采用多种检查相结合的方式，阳性预测值会有所提高。
