五种评估方法预测产妇困难气道准确性的比较

The predictive value of five factors to the maternal difficulty airway

目的：比较目前常用的5种评估困难气道的方法,评价其对全麻剖宫产患者困难气道预测的准确性。方法：214例行全麻剖宫产足月孕患者,术前行气道评估并记录Mallampati评分、甲颏间距、体质量指数、张口度、上唇咬合试验结果,插管后将直接喉镜下喉部显露cormack分级情况为Ⅲ~Ⅳ级的患者判定为困难气道,比较各种评估方法的准确性。结果：5种方法敏感性由高到低依次为上唇咬合试验（79.5%）、Mallampati评分（76.9%）、体质量指数（56.4%）、张口度（51.3%）、甲颏间距（35.9%）;特异性由高到低依次是上唇咬合试验（93.1%）、Mallampati评分（86.3%）、张口度（85.1%）、甲颏间距（76.6%）、体质量指数（62.3%）。结论：上唇咬合试验和Mallampati评分是预测产妇困难气道的较好指标。

Objective To research the most commonly used five method to evaluated the difficulty airway , and compare which methods were more suited for the pregnant woman in general anesthesia. Methods 214 patients with full-term pregnancy who requested emergency or elective caesarean-section were assigned. During the pre-anesthetic visit,we evaluated patients from Mallampati score, thyromental distance, body mass index （BMI）, inter-incisor gap, and upper lip bite test. After endotracheal intubation ,patients were divided into 2 groups based on Cormack classification. Results Five ways sensitivity descending order were upper lip bite test （79.5%）、Mallampati score （76.9%）、BMI （56.4%）、inter-incisor gap （51.3%）、thyromental distance （35.9%）; specificity descending order were upper lip bite test （93.1%）、Mallampati scores （86.3%）、inter-incisor gap （85.1%）、thyromental distance （76.6%）、BMI （62.3%）. Conclusions In pregnant women ,Mallampati score and the upper lip bite test are the better indicators to predict difficult airway.