摘要目的 评价超声定位舌骨测量舌颏距离预测困难气道的价值.方法 拟于气管插管全麻下行择期手术患者213例,年龄18～64岁,性别不限,BMI 14～ 34 kg/m2,张口度＞3 cm,寰椎关节伸展度＞90°,Mallampati分级Ⅰ～Ⅳ级,ASA分级Ⅰ～Ⅲ级.麻醉前进行人工定位舌骨手指估测舌颏距离(HMDf)、人工定位舌骨刻度尺测量舌颏距离(HMDr)以及超声定位舌骨测量舌颏距离(HMDu).麻醉诱导后,直接喉镜下Cormack-Lehane分级3或4级定义为困难气道.以超声定位舌骨为标准,计算人工定位舌骨的错误率;应用Youden指数确定预测困难气道的最佳值,以此标准计算HMDf、HMDr和HMDu预测困难气道的灵敏度和特异度.结果 人工定位舌骨的错误率为18.8％.HMDu预测困难气道的灵敏度为64.6％、特异度为91.5％;HMDr预测困难气道的灵敏度为62.5％、特异度为84.8％;HMDf预测困难气道的灵敏度为29.2％、特异度为98.2％.结论 超声定位舌骨测量舌颏距离可准确地预测困难气道.

abstractsObjective To evaluate the value of hyomental distance (HMD) measured when the byoid was located using ultrasound in predicting the difficult airway.Methods Two hundred and thirteen patients of both sexes,aged 18-64 yr,with body mass index of 14-34 kg/m2,with interincisor distance ＞3 cm,with atlanto-axial joint mobility ＞ 90°,of Mallampati class Ⅰ-Ⅳ,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective surgery requiring endotracheal intubation under general anesthesia,were enrolled in the study.The HMD was measured by fingers (finger breaths in width,HMDf) and by rulers (HMDr) when the hyoid was located artificially and when the hyoid was viewed on ultrasound (HMDu) before anesthesia induction.After anesthesia induction,the difficult airway was defined as Cormack-Lehane grade 3 or 4 assessed under direct laryngoscope during intubation.The hyoid viewed on ultrasound was considered as the criterion,and the error rate was calculated when the hyoid was located artificially.Youden Index was used to determine the optimal value in predicting difficult airway,and the specificity and sensitivity of HMDf,HMDr and HMDu in predicting difficult airway were calculated based on this criterion.Results The error rate was 18.8％ when the hyoid was located artificially.The specificity and sensitivity of HMDu in predicting difficult airway were 64.6％ and 91.5％,respectively.The specificity and sensitivity of HMDr in predicting difficult airway were 62.5％ and 84.8％,respectively.The specificity and sensitivity of HMDf in predicting difficult airway was 29.2％ and 98.2％,respectively.Conclusion The HMD measured when the hyoid is located using ultrasound can accurately predict the difficult airway.