Mallampati和Wilson综合评分预测肥胖患者插管困难诊断的准确性：一项描述性横断面研究

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Mallampati和Wilson综合评分预测肥胖患者插管困难诊断的准确性：一项描述性横断面研究

贵州医科大学  麻醉与心脏电生理课题组

翻译：安丽   编辑：潘志军   审校：曹莹

0 1 背景、目的

麻醉期间在处理肥胖患者时，麻醉医师最关心的问题通常是气道管理，而由于患者常合并呼吸暂停、缺氧和呼吸力学受损的有害影响，因此围术期气道的管理是较为困难的。

本研究的主要目的是以直接喉镜和插管的Cormack-Lehane评分为金标准，确定Mallampati和Wilson联合评分来预测肥胖手术患者插管困难诊断的准确性。

0 2 方法

该项研究共对体重指数>29.9 kg/m2的肥胖患者300名进行描述性横断面研究。主要研究者在术前记录每位患者坐位时的改良Mallampati和Wilson评分。并同时记录气管插管等级，根据Cormack-Lehane插管分级，将IIb、III和IV级视为困难插管。

0 3 结果

平均年龄46.76±15.57岁。Mallampati和Wilson联合评分检测喉镜检查困难和插管困难的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为75.0、98.8、92.9、95.0和94.6%。

0  4 结论  

Mallampatti和Wilson联合评分在肥胖患者插管困难风险的初始诊断中具有较高的准确性。易于计算并可降低插管相关并发症和失败的风险。

0  5 原始文献来源  

Khalid Maudood Siddiqui , Faruq Hameed and Muhammad Asghar Ali.Diagnostic Accuracy of Combined Mallampati and Wilson Score to Predict Diffiffifficult Intubation in Obese Patients: A Descriptive Cross-sectional Study.Anesth Pain Med. 2021 December; 11(6):e118626. Doi:10.5812 /aapm. 118626. 

英文原文  

Diagnostic Accuracy of Combined Mallampati and Wilson Score to Predict Diffiffifficult Intubation in Obese Patients: A Descriptive Cross-sectional Study

Abstract

Background: Airway protection during anesthesia is often the primary concern of anesthetists when working with obese patients and always is a difficult task due to increased exposure to harmful effects of apnea, hypoxia, and impaired respiratory mechanics. 

Objectives: The primary goal of this research was to determine the diagnostic accuracy of combined Mallampati and Wilson score in detecting difficult intubation in obese patients undergoing surgery by taking the Cormack-Lehane grading on direct laryngoscopy and intubation as the gold standard.

Methods: This descriptive cross-sectional study was done in 300 obese patients with BMI > 29.9 kg/m2 . Modifified Mallampati and Wilson score was recorded preoperatively for each patient in the sitting position by the primary investigator. Endotracheal intubation grades were also recorded, and grades IIb, III, and IV were regarded as difficult intubation according to the Cormack-Lehane intubation classifification. 

Results: The mean age was 46.76 ± 15.57 years. The sensitivity, specifificity, positive predictive value, negative predictive value, and diagnostic accuracy of the combined Mallampati and Wilson score for detecting difficult laryngoscopy and difficult intubation were 75.0, 98.8, 92.9, 95.0, and 94.6%, respectively. 

Conclusions: Combined Mallampatti and Wilson score is highly accurate in the initial diagnostic workup of obese patients at risk of difficult intubation. It is easy to calculate and lower the risk of intubation-related complications and failure. 

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