Abstract: Background　Difficult mask ventilation （DMV） leads to oxygenation and ventilatory failure，causing complications，and fatal consequences associated with failed airway management.However，it has rarely been studied as a primary outcome in emergency patients.Objective　To determine the incidence and associated factors of DMV in emergency patients who received tracheal intubation.Methods　Adult patients who received tracheal intubation from November 1，2016 to November 1，2017 in Department of Emergency，Central South University Xiangya School of Medicine Affiliated Haikou Hospital were selected.Potential Risk Factors for Difficult Mask Ventilation Form developed by our research group was used to record and evaluate the potential risk factors of DMV，such as physical and disease characteristics，and history of diseases related to airway anatomy by the consulted physician.Logistic regression analysis was used to determine the risk factors of DMV.Results　A total of 110 cases were included，among whom 51 （46.4%） developed DMV（DMV group），other 59 （53.6%） did not（control group）．DMV group showed higher percentages of having older age，missing teeth，sunken cheeks，a double chin and a short thick neck than the control group（P<0.05）．Multivariate Logistic regression analysis showed that missing teeth 〔OR=3.41，95%CI （1.50，7.76）〕，sunken cheeks 〔OR=1.76，95%CI （1.41，2.18）〕 and double chin 〔OR=24.00，95%CI （11.53，49.90）〕 were risk factors for DMV in emergency patients with tracheal intubation （P<0.05）．The weighted predictive score showed that double chin was the strongest predictor of DMV，with a weighted score of 5，sunken cheeks of 4 and missing teeth of 2.Conclusion　The incidence of DMV is high in emergency patients.Missing teeth，sunken cheeks and double chin are independent risk factors for DMV.

Key words: Intubation, intratracheal；Face mask ventilation difficulties；Emergency treatment；Root cause analysis

摘要： 背景　面罩通气困难（DMV）会导致通气氧合失败，可引起相关并发症和气道管理的致命后果，但在急诊科中很少作为主要结果进行研究。目的　确定急诊气管插管患者DMV发生率和相关因素。方法　选取2016-11-01至2017-11-01在中南大学湘雅医学院附属海口医院急诊科接受气管插管的成年患者。设计一个记录DMV潜在危险因素的表格，评估用于确定DMV的风险因素包括身体特点和疾病特征以及与气道解剖结构有关的疾病史，均由接诊医生评估完成。采用Logistic回归分析DMV的危险因素。结果　共110例患者纳入研究，其中51例（46.4%）出现DMV，作为DMV组，其余59例（53.6%）作为对照组。DMV组年龄、缺牙、脸颊凹陷、双颏、颈部短粗所占比例均高于对照组（P<0.05）。多因素Logistic回归分析结果显示，缺牙〔OR=3.41，95%CI（1.50，7.76）〕、脸颊凹陷〔OR=1.76，95%CI（1.41，2.18）〕和双颏〔OR=24.00，95%CI（11.53，49.90）〕是急诊科气管插管患者DMV发生的独立危险因素（P<0.05）。加权预测分数显示双颏是最强的预测因子，加权预测分数为5，而脸颊凹陷为4，缺牙为2。结论　DMV在急诊科中发生率较高，缺牙、脸颊凹陷和双颏是DMV发生的独立危险因素。

关键词: 插管法, 气管内, 面罩通气困难, 急诊处理, 影响因素分析