评估不同指标作为肥胖患者呼吸道困难的预测指标
Varun Sharma1, Himanshu P Yadav2, Abhishek Prakash3
1Cardiac Anesthesia, Chandan Hospital, Lucknow, IND.
Cureus
|February 28, 2024
概括
子周长和甲状腺的距离,以及它们的比率,是肥胖患者难以进行气管输管的可靠预测指标. 像BMI和皮肤厚度这样的标准肥胖标志物在这个人群中效果较差.
科学领域:
- 麻醉学 麻醉学
- 肥胖医学 肥胖医学
背景情况:
- 难以进行气管输管是麻醉相关的发病率和死亡率的重要原因.
- 现有的呼吸道困难预测器缺乏诊断准确性,特别是在肥胖个体中.
- 像身体质量指数 (BMI) 这样的肥胖参数尚未被独立验证为难以预测的呼吸道预测指标.
研究的目的:
- 评估肥胖患者常见难以使用的呼吸道评估工具的准确性.
- 评估BMI,马兰帕蒂分级,子周长 (NC) 和胸膜距离 (TMD) 作为肥胖患者呼吸道困难的预测指标.
- 为了验证子周长与胸膜距离 (NC/TMD) 的比率和皮肤折叠的厚度,以预测困难的气道结果 (例如,困难的口袋口罩通风或输管).
主要方法:
- 一项前性观察性研究,涉及51名肥胖患者 (ASAII级),在全身麻醉下接受选择性手术.
- 收集的数据包括患者人口统计学,BMI,修改Mallampati类 (MPG),Cormack-Lehane (CL) 级别,袋口罩通风 (BMV) 充足度,输管试验,NC,TMD,腰比 (WHR) 和皮肤折叠厚度.
- 进行了统计分析,以将这些变量与困难的呼吸道结果相关联.
主要成果:
- 子周长 (NC) 和甲状腺距离 (TMD) 与难以呼吸的气道指标 (CL等级,输管尝试,BMV充足) 显示出中度,统计学上显著的相关性.
- 该NC/TMD比率显示出强烈的,具有统计学意义的关联与困难的气道结果 (CL等级,输管试验,BMV充足).
- 身体质量指数 (BMI) 和皮肤厚度在这个队列中与难以预测的呼吸道预测因素的关联很弱或没有显著的关联.
结论:
- NC,TMD和NC/TMD比率与肥胖患者的呼吸道困难密切相关.
- 虽然肥胖是一个危险因素,但在这项研究中,特定的肥胖预测因素,如皮肤折叠厚度,与呼吸道困难没有单独相关.
- 没有一个单一的常用测试能够充分预测肥胖人口中难以输管的情况,这凸显了NC和TMD等新型测量的重要性.
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