中切牙到胸骨角距离指导气管插管深度的可行性探索

Using the Distance between Upper Incisor and the Manubriosternal Joint to Adjust the Depth of the Endotracheal Tube

目的找到一种快速、经济、实用、简单易行的方法,对气道长度进行评估,进而指导气管导管插入深度。方法采用前瞻性自身对照设计。纳入ASAⅠ或Ⅱ全麻患者100例,术前于颈部过伸位测量中切牙到胸骨角距离。入室后常规诱导插管,使用纤支镜测量中切牙到隆突距离。分析两段距离的相关性和一致性,并计算出回归方程。结果中切牙到胸骨角距离与中切牙到隆突距离高度相关(r=0.944,P=0.000)。Bland-Altman检验提示二者具有较好的一致性[偏倚:-0.266,一致性界限:(0.28,-1.32),百分误差:8.3%]。回归方程:中切牙到隆突距离=0.983×中切牙到胸骨角距离+0.689。结论中切牙到胸骨角距离可用于评估气道长度并指导插管深度。

Objective To explore an economic,faster and more reliable approach to adjust the depth of the eudotracheal tube. Methods 100 patients underwent general anesthesia were included. They were asked to extend the neck before the induc-tion, the distance between upper incisor and the manubriosternal joint（ UM） were measured and recorded. After inducing,the dis-tance between upper incisor and the carina（UC） was measured by fibrotic bronchoscope（FOB）. The correlation between the two distances was calculated. Formula for the regression line was obtained and Bland-Altman test was made. Results There was sig-nificant correlation between the two distance（r=0. 944,P=0. 000）. Formula for the regression line was UC =0. 983 ＆#215; UM ＋0. 689. Bland-Altman test revealed bias was-0. 266,the agreement of limitation was（0. 28,-1. 32）,percentage error was 8. 3%. Conclusion UM could be used to guide the depth of the ETT.