在患有病态肥胖症的患者中,难以预测喉腔镜和/或输管术的预测:上唇咬伤测试与修改的Mallampati分类对比
Freda Richa1,2, Christine El-Hage1,2, Viviane Chalhoub1,2
1Department of Anaesthesia, Critical Care and Pain Management, Hotel-Dieu de France Hospital, Beirut, Lebanon.
Journal of perioperative practice
|December 19, 2023
概括
上唇咬伤测试比修改后的Mallampati测试更有效,用于预测患有致病肥胖症的患者难以进行喉腔镜和输管检查. 这种测试为这个人群的气道评估提供了更高的准确性和可靠性.
科学领域:
- 麻醉学 麻醉学
- 航空航道管理的管理.
- 肥胖医学 肥胖医学
背景情况:
- 患有致病性肥胖症的患者对呼吸道管理提出了独特的挑战.
- 预测困难的喉腔镜和输管术对于患者的安全至关重要.
研究的目的:
- 为了比较上唇咬伤测试 (ULBT) 和修改的Mallampati测试 (MMT) 在预测困难的喉腔镜和输管术中的有效性.
- 为了评估这些测试在病态肥胖患者的队列.
主要方法:
- 一项前性观察性研究,涉及500名患有致病性肥胖症的患者 (BMI>40 kg/m2).
- 使用ULBT和MMT进行手术前的气道评估.
- 使用Cormack和Lehane的分类来评估喉腔镜难度;使用输管难度度表 (IDS) 来评估输管难度.
主要成果:
- 难以进行喉腔镜检查 (Cormack和Lehane III/IV) 和输管检查 (IDS ≥ 5) 的发生率分别为9.4%和11.8%.
- 与MMT相比,ULBT表现出更高的特异性,积极的预测值和准确性.
- 结合ULBT和MMT进一步改善了预测措施.
结论:
- 上唇咬伤测试是一种敏感和特定的预测器,可以预测严重肥胖患者难以进行喉腔镜检查和输管.
- 在这种患者群体中,ULBT是术前呼吸道评估的有利工具.
- 结合ULBT和MMT可以提高预测准确度.
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