超声辅助气管插管深度定位的应用价值  

Discussion on the Application Value of Ultrasound Assisted Deep Localization of Tracheal Intubation

作　　者：杨广宇 郑重 郭强 夏海燕 朱小平 史文澄 YANG Guangyu;ZHENG Zhong;GUO Qiang;XIA Haiyan;ZHU Xiaoping;SHI Wencheng(Department of Anesthesiology,Taicang Hospital Affiliated to Suzhou University,Taicang Jiangsu 215400,China)

机构地区：[1]苏州大学附属太仓医院麻醉科,江苏太仓215400

出　　处：《中国卫生标准管理》2023年第20期103-106,共4页China Health Standard Management

基　　金：2020年度太仓市科技计划项目(TC2020JCYL25)。

摘　　要：目的探讨超声辅助气管插管深度定位的应用价值。方法选择2020年9月—2022年12月苏州大学附属太仓医院收治的要进行气管插管的50例患者,进行常规气管插管后,运用听诊结合呼气末二氧化碳(positive end expiratory pressure CO_(2),PetCO_(2))和超声辅助确认导管所处位置,记录以上不同方法下的导管位置确认结果及耗时。结果将听诊结合PetCO_(2)监测结果作为标准,超声辅助下确认气管导管位置的灵敏度、特异度、准确率、阴性及阳性预测值分别是97.62%(47/48)、100%(2/2)、98.00%(49/50)、66.67%(2/3)、100%(47/47)。超声和听诊结合PetCO_(2)监测在确认气管插管位置方面表现出较高的一致性(Kappa=0.86,P<0.01)。超声探测平均用时为(20.14±5.47)s,短于听诊结合PetCO_(2)监测(25.51±7.44)s,差异有统计学意义(P<0.05)。结论超声辅助评估气管内插管定位准确性较高,操作方便、迅速,可有效提升插管效率。Objective To explore the application value of ultrasound assisted depth positioning of tracheal intubation.Methods A total of 50 patients who will undergo tracheal intubation in Taicang Hospital Affiliated to Suzhou University from September 2020 to December 2022 were selected.After routine Tracheal intubation,auscultation combined with positive end expiratory pressure CO_(2)(PetCO_(2))and ultrasound were used to assist in confirming the position of the catheter,and the results and time consumption of the catheter position confirmation under the above different methods were recorded.Results Using auscultation combined with PetCO_(2) monitoring results as the standard,the sensitivity,specificity,accuracy,negative and positive predictive values of ultrasound assisted confirmation of tracheal catheter position were 97.62%(47/48),100%(2/2),98.00%(49/50),66.67%(2/3)and 100%(47/47),respectively.Ultrasound and PetCO_(2) monitoring showed high consistency in confirming the position of tracheal intubation(Kappa=0.86,P<0.01).The average time taken for ultrasound detection was(20.14±5.47)s,which was shorter than that of auscultation combined with PetCO_(2) monitoring(25.51±7.44)s,and the difference was statistically significant(P<0.05).Conclusion Ultrasound assisted assessment of tracheal intubation positioning has high accuracy,convenient and rapid operation,and can effectively improve intubation efficiency.

关 键 词：气管插管 深度定位 超声探查法 PetCO_(2)监测法 效果观察 操作用时 

分 类 号：R614[医药卫生—麻醉学]