肥胖患者困难插管的术前视频喉镜检查
Preoperative video laryngoscopic examination for difficult intubation in obese patients.
文献信息
| PMID | 42706441 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Funda Atar |
| 作者单位 | Department of Anesthesiology and Reanimation, University of Health Sciences, Etlik City Hospital, 06100, Ankara, Turkey. fundaatar81@gmail.com. |
| 期刊 | Die Anaesthesiologie |
| SCI 分区 | Q3 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 肥胖患者常出现的解剖和生理变化会增加困难气管插管（DTI）的风险。在本研究中，我们探讨了视频辅助喉镜检查在肥胖患者中前瞻性预测DTI的潜力。
材料和方法： 研究纳入拟行全身麻醉且体重指数（BMI）高于30的患者。在常规术前床旁评估时计算El-Ganzouri风险指数（EGRI）。EGRI≥4被认为提示DTI。在气道应用局部麻醉剂后，使用术前视频喉镜检查获得声门开放百分比（POGO）评分。在POGO评分中，声门开放可见度≤50%被认为提示困难插管。使用插管困难量表（IDS）评估插管困难，IDS评分>5被认为提示困难插管。
结果： 本研究纳入104例患者，平均BMI为36.9±4.8。根据IDS，DTI发生率为30.8%（n=32）。与EGRI相比，POGO评分显示出显著更高的阳性预测值和敏感性（两者p<0.0001）。ROC分析显示，POGO评分的区分能力优于EGRI（AUC：0.868 vs. 0.436；p<0.001）。术前POGO评分与IDS相关（r=0.710，p<0.001）。
结论： 我们的研究结果表明，术前视频辅助喉镜检查获得的POGO评分与肥胖患者困难气管插管相关。
英文摘要
BACKGROUND: Anatomical and physiological changes often observed in obese patients increase the risk of difficult tracheal intubation (DTI). In this study, we explored the potential of video-assisted laryngoscopy to prospectively predict DTI in obese patients.
MATERIAL AND METHODS: Patients scheduled for general anesthesia with a body mass index (BMI) higher than 30 were included in the study. The El-Ganzouri risk index (EGRI) was calculated during routine preoperative bedside evaluations. An EGRI of ≥ 4 was considered indicative of DTI. Following the application of a local anesthetic agent to the airway, the percentage of glottic opening (POGO) score was obtained using preoperative video laryngoscopy. In the POGO score, visibility of 50% or less of the glottic opening was considered indicative of difficult intubation. Intubation difficulties were assessed using the intubation difficulty scale (IDS), with an IDS score > 5 considered indicative of difficult intubation.
RESULTS: The study included 104 patients with an average BMI of 36.9 ± 4.8. According to the IDS, the incidence of DTI was 30.8% (n = 32). The POGO score displayed a significantly higher positive predictive value and sensitivity compared to the EGRI (p < 0.0001 for both). The ROC analysis showed better discriminative performance for the POGO score than for the EGRI (AUC: 0.868 vs. 0.436; p < 0.001). The preoperative POGO score was correlated with the IDS (r = 0.710, p < 0.001).
CONCLUSION: Our findings suggest that the POGO score obtained during preoperative video-assisted laryngoscopy is associated with difficult tracheal intubation in obese patients.