超声测定小儿环状软骨横径用于带套囊气管导管型号选择的准确性

Accuracy of ultrasonographic measurement of transverse diameter of cricoid cartilage in selecting cuffed endotracheal tube size for pediatric patients

目的 评价超声测定小儿环状软骨横径用于带套囊气管导管型号选择的准确性.方法 选择接受气管内插管全麻的患儿120例,性别不限,ASA分级Ⅰ或Ⅱ级,年龄1月-6岁,体重指数10.9 - 31.2 kg/m2,采用随机数字表法分为2组（n=60）：A组和B组.2组患儿均采用带套囊的气管导管进行气管插管,A组根据超声测定环状软骨横径的结果选择导管型号,B组根据年龄公式选择导管型号.评价所选导管型号是否合适,如导管不合适需要更换时,记录更换次数,记录气管插管相关并发症的发生情况.结果 A组首次选择带套囊气管内导管型号的准确率为95％,高于B组（60％）（P〈0.05）,2组患儿插管相关并发症发生率差异无统计学意义（P〉0.05）.结论 超声测定小儿环状软骨横径用于带套囊气管导管型号选择的准确性高,值得临床推广.

Objective To evaluate the accuracy of ultrasonographic measurement of the transverse diameter of the cricoid cartilage in selecting the cuffed endotracheal tube （ETT） size for pediatric patients.Methods A total of 120 pediatric patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 1 month-6 yr,with body mass index of 10.9-31.2 kg/m2,undergoing endotracheal intubation and general anesthesia,were divided into group A and group B,with 60 pediatric patients in each group.The pediatric patients were intubated with a cuffed ETT in two groups.The ETT size was selected based on the transverse diameter of the cricoid cartilage measured by ultrasonography in group A.The ETT size was selected according to the age-based formula in group B.A tracheal leak was detected after intubation to determine whether or not the ETT size selected was appropriate.ETTs were replaced when the actually selected ones were not appropriate,and the number of replacement was recorded.The development of intubation-related complications was also recorded.Results The accurate rate of cuffed ETT size selected at the first time was 95% in group A,and it was significantly higher than that in group B （60%） （P〈 0.05）.There was no significant difference in the incidence of intubation-related complications between the two groups （P〉0.05）.Conclusion Uhrasonographic measurement of the transverse diameter of the cricoid cartilage produces higher accuracy in selecting the cuffed ETT size for pediatric patients and is worthy of clinical application.