基于CHANNEL流程的气道评估法对急诊困难气道的预测  

Prediction of emergency difficult airway by airway evaluation based on CHANNEL process

作　　者：戴佳原[1] 徐胜勇[1] 徐军[1] 朱华栋[1] 于学忠[1] Dai Jiayuan;Xu Shengyong;Xu Jun;Zhu Huadong;Yu Xuezhong(Department of Emergency,Peking Union Medical College Hospital,Chinese Academy of Medical Science,Beying 100730,China)

机构地区：[1]北京协和医院急诊科,北京100730

出　　处：《中华急诊医学杂志》2022年第7期948-951,共4页Chinese Journal of Emergency Medicine

摘　　要：目的评价基于CHANNEL流程的气道评估法对急诊困难气道的预测能力。方法从2016年7月至2019年12月, 选择北京协和医院急诊科行气道管理的患者, 若条件允许, 对其同时应用基于CHANNEL流程和改良Mallampati分级(modified Mallampati test, MMT)进行气道评估, 完成后予直接喉镜下显露声门继而进行Cormack-Lehane分级。以Cormack-Lehane分级Ⅲ级或Ⅳ级定义为困难气道。采用受试者工作特征(ROC)曲线分别评价应用MMT、CHANNEL流程进行气道评估时预测困难气道的能力。结果接受急诊气道管理的312例患者中有122例被纳入研究, 基于CHANNEL流程的气道评估法预测困难气道的灵敏度为100%, 特异度为90.1%, 曲线下面积(95%可信区间)为0.948(0.907~0.988)。与MMT比较, 基于CHANNEL流程的气道评估法对困难气道的预测的ROC曲线下面积更大(P<0.05)。结论基于CHANNEL流程的气道评估法可有效准确预测急诊患者的困难气道。Objective To evaluate the accuracy of CHANNEL process in predicting difficult airway of patients in emergency department.Methods From July 2016 to December 2019,we selected patients who underwent airway management in the emergency department of Peking Union Medical College Hospital.They were evaluated by CHANNEL and improved Mallampati(modified Mallampati test,MMT)classification at the same time.After completion,the glottis was exposed under direct laryngoscope,and then Cormack Lehane classification was perfonned.Difficult airway was defined as Cormack-Lehane grade Ⅲ or IV.The receiver-operating characteristics curve was used to evaluate the accuracy of MMT and CHANNEL in predicting difficult airway.Results 122 of 312 patients who underwent emergency airway management were included in the study.The sensitivity of CHANNEL in predicting difficult airway was 100%,the specificity was 90.1%,the area under the curve(95% confidence interval)was 0.948(0.907〜0.988).Compared with MMT,the area under the curve of CHANNEL in predicting difficult airway was significantly increased(P<0.05).Conclusion CHANNEL can accurately predict difficult airway of patients in the emergency department.

关 键 词：CHANNEL流程 气道管理 困难气道 评估 预测 

分 类 号：R459.7[医药卫生—急诊医学]