Study On The Evaluation Of Difficult Intubation In Diabetic Patients By Palmprint Test And Prayer Sign

Objective: To explore the difference between the incidence of difficult airway in patients with diabetes and the common patients and its related influencing factors,and to screen out more accurate predictors of difficult intubation(DI)in diabetic patients.Methods: A total of 104 patients with diabetes mellitus and 80 cases of non-diabetics who underwent elective surgery under general anesthesia in the operating room of the First Affiliated Hospital of Guangxi Medical University from February 2018 to February 2019 were randomly selected.Inclusion criteria:18-85 year old adults without sex exclusion,ASA grade I~III,except for patients who do not prefer general laryngoscope intubation and patients with abnormal airway ?head and face anatomy due to congenital or acquired diseases.Patients were assessed by using pre-operative thyromental distance,the modified Mallampati Degree,bite upper lip test,interincisor distance,neck circumference,neck mobility,Prayer sign,and palm print test and so on for airway assessment,and compared with the classification of glottis exposed by Macintosh common laryngoscope.Non-diabetic patients only recorded the level of glottis exposed by Macintosh common laryngoscope,and calculated the incidence of difficult intubation and compared with the diabetic group.Finally,thel collected datawere calculated by SPSS22.0 statistical software for final statistical analysis.Results: Among the 104 diabetic patients recorded,29(27.88%)of them were difficult to intubate,9(11.25%)intubation difficulties in 80 non-diabetic patients,and the difference between the two groups was statistically significant..Compared with laryngoscope exposure grading methods,the P values of thyromental distance,the modified Mallampati Degree,bite upper lip test,interincisor distance,neck circumference,neck mobility in the diabetes group were all P>0.05,which did not have judgment consistency.The sensitivity(75.90%)and the specificity(86.70%)of the palm print test were higher than other indexes,and the P value <0.01(0.00)compared with the laryngoscope exposure grading method was consistent.At the same time,the degree of good glycemic control was compared with the laryngoscopy exposure grading method,and the P value <0.01(0.00)also had evaluation consistency.The sensitivity of the prayer sign is second at 62.10%,but its specificity is the worst among all the above indicators(only 45.3%).When the intubation difficulty group was compared with the non-difficult intubation(NDI)group diabetes duration,the final calculated P value <0.01(0.00)showed statistically significant differences,indicating that the length of diabetes history in the difficult group was significantly higher than non-difficult group.Conclusions: 1.The incidence of difficult intubation in diabetic patients is higher than in ordinary patients.2.Diabetes patients with long history of diabetes and poor glycemic control have a high incidence of intubation.3.The palm print test is of great clinical significance for predicting difficult intubation in diabetic patients.