择期颈椎手术患者困难气道的研究  

Investigation of difficult airway in patients for elective cervical vertebral operation

作　　者：王英伟[1] 赵璇[1] 沈赛娥[1] 吴韬[1] 陈锡明[1] 尤新民[1] 

机构地区：[1]上海交通大学医学院附属新华医院麻醉科,200092

出　　处：《临床麻醉学杂志》2007年第3期193-195,共3页Journal of Clinical Anesthesiology

摘　　要：目的对择期颈椎手术患者困难气道的发生率以及困难气道和颈椎疾病的相关性进行前瞻性研究。方法172例拟在全身麻醉下择期行颈椎手术的患者于手术前日或麻醉诱导前进行气道评估。困难气道评估指标为：张口度、颈部活动度、甲颏距离、Mallampati分级和Cormack分级等。结果颈椎择期手术的患者中困难气道的比例为30．2％。张口度较差的占2．4％，甲颏距离较短的占7．2％，Mallampati分级为Ⅲ～Ⅳ级的占19．8％，Cormack分级为Ⅲ级的占12．2％。困难气道的发生与患者的年龄和性别无显著相关；但与患者的颈部活动度密切相关，颈椎滑脱和颈椎骨折的患者困难气道的发生率显著升高。结论颈椎择期手术患者困难气道的发生率要远高于普通人群，并且与颈部活动度、颈椎滑脱和颈椎骨折密切相关。Objective To investigate prospectively the relationship between difficult airway and cervical vertebral diseases. Methods One hundred and seventy-two patients scheduled for selective cervical vertebral operation were evaluated for airway condition before induction of anesthesia. The difficult airway grade was determined by evaluating the degree of mouth opened, neck activity, thyromental distance, Mallampati classification, and Cormack classification. Results The morbidity of difficult airway was 30.2% in 172 patients for elective cervical vertebral operation. The ratio of poor mouth opened was 2.4%, and short thyromental distance 7.2%. 19. 8% of the patients had Mallampati classification of Ⅲ or Ⅳ, and the ratio of Cormack grade Ⅲ was 12. 2%. The morbidity of difficult airway had no any relationship to age or sex, but was associated with neck activity, cervical vertebral surge, and cervical vertebral fracture statistically. Conclusion The morbidity of difficult airway for the elective cervical vertebral operation population is higher than that of normal population, which is associated with neck activity, cervical vertebral surge, and cervical vertebral fracture.

关 键 词：颈椎手术 困难气道 气管插管 颈部活动度 颈椎滑脱 

分 类 号：R614[医药卫生—麻醉学]