改良LEMON评分与创伤急诊手术患者气管插管困难的相关性研究  

Study on the correlation between modified LEMON score and tracheal intubation difficulty in patients undergoing emergency trauma surgery

作　　者：温福腾 肖笑雨[2] 董师武 修雪莉 刘凤妍 李小华 WEN Futeng;XIAO Xiaoyu;DONG Shiwu;XIU Xueli;LIU Fengyan;LI Xiaohua(Anesthesia Department,Heshan People's Hospital of Guangdong Province,Jiangmen 529700;Anesthesiology Department,the Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China)

机构地区：[1]广东省鹤山市人民医院麻醉科,广东江门529700 [2]中山大学附属第五医院麻醉科,广东珠海519000

出　　处：《临床医学研究与实践》2022年第11期5-8,共4页Clinical Research and Practice

基　　金：江门市卫生健康局科研立项项目(No.20A188)。

摘　　要：目的探讨改良LEMON评分与创伤急诊手术患者气管插管困难的相关性,明确改良LEMON评估法预测困难气道的独立危险因素。方法纳入300例气管插管全麻的创伤急诊手术患者,术前给予改良LEMON评估及麻醉诱导气管插管,并进行困难气管插管量表(IDS)评分。根据IDS评分将300例患者分为气管插管困难组(D组,IDS评分≥5分)和非气管插管困难组(ND组,IDS评分<5分)。分析改良LEMON评分与IDS评分的相关性;采用多因素Logistic回归分析探讨改良LEMON评估法预测困难气道的独立危险因素。结果D组的改良LEMON评分、IDS评分及张口度<3指、舌甲间距<2指及颈部活动受限的患者占比均高于ND组(P<0.05)。改良LEMON评分与IDS评分呈显著正相关(r=0.590,P<0.05)。多因素Logistic回归分析结果显示,张口度<3指、舌甲间距<2指及颈部活动受限均为预测创伤急诊手术患者困难气道的独立危险因素(P<0.05)。结论改良LEMON评分与创伤急诊手术患者气管插管困难呈显著相关性,张口度<3指、舌甲间距<2指及颈部活动受限均为预测困难气道的独立危险因素。Objective To investigate the correlation between modified LEMON score and tracheal intubation difficulty in patients undergoing emergency trauma surgery,and to identify the independent risk factors of modified LEMON assessment method in predicting difficult airway.Methods A total of 300 emergency trauma surgery patients under general anesthesia with endotracheal intubation were included and given modified LEMON assessment and anesthesia induction endotracheal intubation before operation,and scored with intubation diffculty scale(IDS).According to the IDS score,300 patients were divided into tracheal intubation difficulty group(group D,IDS score≥5 points)and non tracheal intubation difficulty group(group ND,IDS score<5 points).The correlation between modified LEMON score and IDS score was analyzed;multivariate Logistic regression analysis was used to investigate the independent risk factors for difficult airway by the modified LEMON assessment method.Results The modified LEMON score,IDS score and the proportions of patients with mouth opening<3 fingers,hyoid thyroid cartilage spacing<2 fingers and limited neck movement in the group D were higher than those in the group ND(P<0.05).There was a significant positive correlation between modified LEMON score and IDS score(r=0.590,P<0.05).Multivariate Logistic regression analysis showed that mouth opening<3 fingers,hyoid thyroid cartilage spacing<2 fingers and limited neck movement were independent risk factors for predicting difficult airway in patients undergoing emergency trauma surgery(P<0.05).Conclusion The modified LEMON score is significantly correlated with the tracheal intubation difficulty in patients undergoing emergency trauma surgery.Mouth opening<3 fingers,hyoid thyroid cartilage spacing<2 fingers and limited neck movement are independent risk factors for predicting the difficult airway.

关 键 词：改良LEMON评分 气管插管困难 困难气管插管量表 困难气道 创伤急诊手术 

分 类 号：R614[医药卫生—麻醉学]