中指长度预测不同年龄段患者经口气管插管深度的准确性

Accuracy of middle finger length in predicting depth of placement of oral endotracheai tubes in pa-tients of different ages

目的评价中指长度预测不同年龄段患者经口气管插管深度的准确性。方法择期行气管插管全身麻醉手术患者120例，ASA分级Ⅰ-Ⅲ级，性别不限，根据年龄分为成年（18-84岁）组（n=98）和儿童（5-14岁）组（n=22）。麻醉诱导后使用纤维支气管镜经口测量主气管长度，并完成气管插管术；以3倍左手中指长度为气管插管深度，固定导管后测量导管尖端距隆突距离，计算最佳气管插管深度，计算气管插管深度合适率，3倍左手中指长度与最佳气管插管深度行直线相关分析。结果成年组气管插管深度合适率88％，气管插管过深7％，气管插管过浅5％；儿童组气管插管深度合适率90％，气管插管过深10％，无气管插管过浅发生。2组气管导管尖端和套囊亦均位于主气管内。成年组最佳气管插管深度与3倍左手中指长度呈正相关（r=0.774，P〈0．01），儿童组最佳气管插管深度与3倍左手中指长度亦呈正相关（r=0．911，P〈0．01）。结论3倍左手中指长度可预测18—84岁、5-14岁患者经口气管插管深度。

Objective To evaluate the accuracy of the middle finger length in predicting the depth of placement of oral endotracheal tube （ETr） in patients of different ages. Methods One hundred and twenty patients of both sexes, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, undergoing e-lective surgery under general anesthesia requiring insertion of ETT, were divided into adult (18-84 yr） group （n= 98） and children （5-14 yr） group （n = 22） according to age. After anesthesia induction, the length of trachea was measured through mouth with a fiberoptic bronchoscope, and the patients were endo-tracheally intubated with the depth of three times the length of the left middle finger. The length from ETT tip to carina was measured after positioning. The optimal depth of placement of ETT was calculated, and the rate of appropriate placement depth of ETF was calculated. Linear correlation of three times the length of the middle finger with the optimal placement depth of ETT was analyzed. Results The rate of appropriate placement depth of ETF was 88%, the excessively deep placement of ETT was 7%, and the excessively shallow placement of ETF was 5% in adult group. The rate of appropriate placement depth of ETF was 90%, the excessively deep placement of ETT was 10%, and no excessively shallow placement of ETT was found in children group. The tip and cuff of ETT were all in the main trachea in the two groups. The optimal placement depth of ETT was positively correlated with three times the length of the left middle finger (r = 0. 774, P〈0. 01） in adult group and （r = 0. 911, P〈0. 01） in children group. Conclusion Three times the length of the left middle finger can predict the appropriate placement depth of oral ET＇F in patients of 18-84 yr and 5-14 yr.