新生儿胃管插管的应用解剖

Applied anatomy on stomach intubation of neonates

目的:为新生儿胃管插管提供应用解剖学基础。方法:对32具新生儿尸体标本采取正中矢状切面的方法暴露鼻腔、口、咽、食管及胃,分别从鼻孔及口腔插入胃管标记到腭、喉口、食管3个狭窄及贲门的长度,同时也测量了贲门经胃小弯侧和胃大弯侧到幽门的距离,食管3个生理狭窄处的横径及食管壁的厚度。结果:鼻孔到咽后壁的长度约为(4.86±0.51)cm,鼻孔到喉口的长度为(7.32±1.56)cm,鼻孔到贲门的长度为(15.86±2.15)cm,从贲门沿小弯到幽门的长度为(4.51±0.91)cm,从贲门沿胃大弯到幽门的长度为(10.52±2.21)cm,食管3个狭窄处的内径分别为(3.2±1.0)mm,(3.5±1.1)mm,(3.7±0.8)mm,食管最大内径为(4.2±1.0)cm,食管壁最大厚度为(1.6±2.3)mm。结论:新生儿经鼻孔插入胃管的长度以18～22cm为宜,从口腔插入胃管的长度以15～17cm为宜,胃管的直径不能大于4.0mm。

Objective： To furnish the applied anatomy foundation about neonates＇stomach intubation. Methods： 32 specimens of neonates＇corpse were dissected to expose nasal cavity, mouth, pharynx, gullet,and stomach under paramedian sagittal section,and then measure the distances from the front nostril and the mouth to the palate,opening of the larynx,gullet and the cardia of stomach respectively. Meanwhile, the distances from the cardia of stomach to the pylorus via the lesser curvature of stomach and the greater ones were measured. The diameters of the three narrowest physiological parts of the gullet and the thickness of the gullet wall were also achieved. Results： The length from the nares to the back wall of the pharynx, laryngeal aperture and the cardia of stomach is （4.86±0.51 ）cm, （7.32± 1.56）cm, （ 15.86±2.15）cm respectively.The distance from the cardia of stomac to the pylorus via the lesser curvature was （4.51 ±0.91 ）cm, （10.52±2.21 ）cm was the greater curvature. The inner diameters of the three narrowest parts of the gullet were （3.2±1.0）mm,（3.5±1.1）mm, and （3.7±0.8）mm respectively,while the largest inner diameter was （4.2±1.0）cm and the thickest wall of the gullets was （1.6±2.3） mm. Conclusions： The proper length of the pipe for neonates＇ stomach intubation was （18-22）cm from the front nostril, and （15-17）cm from the cavity of the mouth.The diameter of the pipe should not exceed 4.0 mm.