体重指数与颈围联合应用对围术期困难气道的预测性分析

Predictive Analysis of the Combined Application of Body Mass Index and Neck Circumference for Difficult Airway During Perioperative Period

目的探讨体重指数与颈围联合应用对围术期困难气道的预测性。方法方便选择2014年3—9月河南理工大学一附院于全麻下气管内插管行择期手术的患者120例,麻醉前分别进行Mallampati(M氏)评分和体重指数-颈围评分来预测气管插管的困难程度,并应用Cormack and Lehane(C-L)喉头分级评分作为标准评价插管的困难程度。计算2种评估方法的敏感性、特异性、阳性预测值、阴性预测值及精确度,并在两者之间进行比较。结果体重指数-颈围评分在预测气管插管困难程度的敏感性为64.7%、特异性81.6%、阳性预测值36.7%、阴性预测值94.4%、精确度79.2%;M氏评分其对应指标分别为58.8%、86.3%、41.7%、92.6%、81.7%。结论体重指数-颈围评分对困难气道有一定预测的价值,值得临床关注。

Objective To discuss the predictability of the combined application of body mass index and neck circumference for difficult airway during perioperative period. Methods 120 cases of selective operation patients with itrachea cannula under general anesthesia in an Affiliated Hospital of Henan Polytechnic University from March 2014 to September 2014 were selected, the difficulty degree of trachea cannula was predicted by Mallampati score and body mass index-neck circumference score before anaesthesia, the difficulty degree of cannula was evaluated according to the Cormack and Lehane（C-L）larynx grading score, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of these two evaluation methods were calculated and compared. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of body mass index-neck circumference score in predicting the difficulty degree of itrachea cannula were respectively 64.7%, 81.6%, 36.7%, 94.4% and 79.2%, the corresponding indexes of M’s score were respectively 58.8%, 86.3%, 41.7%, 92.6% and 81.7%. Conclusion The body mass index-neck circumference score is of a certain predictive value to the difficult airway, which is worth clinical attention.