超声测定先天性心脏病患儿声门下横径用于带气囊气管导管型号选择的准确性  

Accuracy of ultrasonographic measurement of subglottic airway diameter in selecting cuffed endotracheal tube size for pediatric patients with congenital heart disease

作　　者：张侃[1] 陈华林 但颖之 陈怡绮[1] 郑吉建 白洁[1] 张马忠[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心麻醉科,200127

出　　处：《中华麻醉学杂志》2017年第7期796-799,共4页Chinese Journal of Anesthesiology

基　　金：中国医师协会麻醉学医师分会青年麻醉医师科研基金（220160900008）;上海市科委西医引导类课题基金（16411967500）;上海卫生计生系统重要薄弱学科（2015ZB0106）

摘　　要：目的 评价超声测定先天性心脏病患儿声门下横径用于带气囊气管导管型号选择的准确性.方法 择期行先天性心脏病手术患儿60例,性别不限,ASA分级Ⅱ-Ⅳ级,年龄1月-7岁,诱导后床边超声测量患儿声门下横径,选择外径与声门下横径相匹配的气管导管.依据漏气试验判断超声选择的气管导管是否合适.如最终选择的气管导管内径和Motoyama公式计算结果相差小于0.2 mm,则认为Motoyama公式选择气管导管尺寸合适.年龄公式、超声测量声门下横径与实际选择气管导管外径的一致性和相关性分析采用Bland-Alrman和Passing-Bablok图分析.结果 根据超声和Motoyama公式选择气管导管的准确率分别为80％和55％,差异有统计学意义（P〈0.05）.结论 超声测定先天性心脏病患儿声门下横径用于带气囊气管导管选择的准确性高于经典的Motoyama公式.Objective To evaluate the accuracy of ultrasonographic measurement of the subglottic airway diameter in selecting the cuffed endotracheal tube （ETT） size for the pediatric patients with congenital heart disease.Methods Sixty pediatric patients of both sexes with congenital heart disease,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,aged 1 month-7 yr,undergoing elective open heart surgery,were included in this study.The subglottic airway diameter was measured by bedside ultrasonography after induction of anesthesia.The outer diameter of the cuffed ETT was determined according to the subglottic airway diameter.The air leak test was performed after intubation to determine whether or not the ETT size selected based on ultrasonography was appropriate.When the difference between the inner diameter of the finally selected ETT and the result calculated by the Motoyama formula was less than 0.2 mm,the ETT size selected based on the Motoyama formula was considered appropriate.The agreement and correlation between the subglottic airway diameter measured by age-based formula and ultrasonography and the outer diameter of the actually selected ETT were analyzed using Bland-Altman plot and Passing-Bablok regression analysis.Results The accurate rate of the ETT selected based on the ultrasonic measurement and Motoyama formula were 80% and 55%,respectively,and there was significant difference （P〈0.05）.Conclusion Ultrasonographic measurement of the subglottic airway diameter produces higher accuracy than the classical Motoyama formula in selecting the cuffed ETT size for the pediatric patients with congenital heart disease.

关 键 词：超声检查 儿童 声门 插管法 气管内 

分 类 号：R726.1[医药卫生—儿科]