超声测量声门下气道横径用于小儿无囊气管导管的选择  

Prediction of uncuffed pediatric endotracheal tube size by measuring the subglottic diameter under ultrasound

作　　者：李倩[1] 张正迪[1] 蔡铁良[1] 

机构地区：[1]厦门大学附属成功医院麻醉科,361003

出　　处：《国际麻醉学与复苏杂志》2017年第8期714-717,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的探讨超声测量声门下环状软骨水平最狭窄处气道横径用于小儿无囊气管导管选择的临床效果。方法行择期手术需气管插管的6个月～6岁患儿45例，通过超声测量选择气管导管（超声测量法）；插管后视临床实际情况决定是否更换导管，至临床插管成功（临床最适）；同时应用年龄公式法计算每位患儿的气管型号。以插管成功导管型号为标准，对超声测量法与年龄公式法选择导管的准确率进行统计学分析，并分别对声门下气道横径、年龄、身高、体重与临床最适导管内径（ID）之间的相关性进行统计分析。结果超声测量法和年龄公式法的准确率分别为89％和51％，差异有统计学意义（P〈0．05）。声门下气道横径、年龄、身高、体重与ID之间均有相关性，声门下气道横径与导管ID之间的相关性更好。结论超声测量声门下环状软骨水平气道横径可以作为一种准确简便的方法用于指导小儿无囊气管导管的选择。Objective To evaluate the clinical effect of measuring pediatric subglottic diameter under ultrasound for uncuffed tracheal tube size selection in a pediatric population. Methods A total 45 pediatric patients who scheduled for surgery and undergoing tracheal intubation were enrolled. In this study, researchers determined tracheal tube sizes by ultrasound according to subglottic diameter. The final determine standard of tube size is whether a good clinical fit reached. In the meantime, calculating a tube size according to the age-based formula. We compared the accuracy of measuring the subglottic diameter under ultrasound with the accuracy of determining tracheal tube size by age-based formula. We also did the correlation analysis between different factors, which included the age, height, weight and the subglottic diameter, and the optimal tube size（ID） separately. Results The accuracy of assessing subglottic diameter under ultrasound,which is 89%, is better than the age-based formula, which is 51%. The difference was statistically significant （P〈0.05）. The subglottic diameter has a strong correlation with ID than other factors. Conclusions Predicting the uneuffed tracheal tube size according to subglottic diameter, determined by ultrasound, is a new simple way in clinic.

关 键 词：超声 声门下气道横径 无囊气管导管 小儿 

分 类 号：R726.1[医药卫生—儿科]