1、如何预测困难气管插管?How to Predict Difficult Intubation四川大学华西医院麻醉科Trouble with Airway DefinitionTests to determine difficult intubation are for laryngoscopy and may not apply to all devicesDifficult intubation vs Difficult laryngoscopyMay not see cords yet be able to intubationMay see cords and not be able t
2、o intubationCormack & Lehane 喉镜暴露分级未预计的困难气管插管对麻醉医生是一种挑战。是否可以通过简单的床旁体检来预测困难气管插管?LEMON 法则 Look externally. Evaluate the 3-3-2 rule. Mallampati. Obstruction? Neck mobility.Look Externally(外观检查)肥胖(Obesity)颈短粗(Short bull neck)高腭弓(High arching palate)上门牙突出(Prominent Upper Incisors,Buck Teeth)小下颌(Receding
3、mandible,Dentures)无牙(Edentulous mouth)面部畸形(Abnormal facial shape)面部创伤(Facial trauma)Evaluate the 3-3-2 rule(3-3-2法则)3 fingers between the patients teeth (patients mouth should open adequately to permit three fingers to be placed between the upper and lower teeth)3 fingers between the tip of the jaw and the beginning of the neck (under the chin)2 fingers between the thyroid notch and the floor of the mandible (top of the neck)改良Mallampati分级Obstruction?(是否存在梗阻因素)肿瘤脓肿血肿会厌炎甲状腺肿大Neck Mobility(颈椎活动度)