超声测量环状软骨横径预测气管导管型号在新生儿肠切除术麻醉中的应用

Application of Ultrasound Measurement of Transverse Diameter of the Annular Cartilage in Predicting Uncuffed Endotracheal Tube Size for Newborns Suffering from Intestinal Resection Surgery

目的探讨超声测量环状软骨横径预测无套囊气管导管型号在新生儿肠切除术麻醉中应用的可行性。方法选择2017年1月-2022年12月在全麻下行肠切除术的新生儿42例,男23例,女19例,ASAⅡ-Ⅲ级。根据插管方式随机分为超声测量组(U组)和常规组(N组),每组各21例。U组使用超声测量环状软骨横径预测无套囊气管导管型号,N组根据插管指南选择气管导管型号。记录气管插管时间、气管导管更换率;记录术后喉痉挛、声音嘶哑等不良反应;观察围术期心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_(2))等指标变化。结果与N组相比,U组气管导管更换率显著降低(P<0.05),两组患儿气管插管时间、反流换管率、插管并发症及围术期HR、MAP、SpO_(2)比较,差异无统计学意义(P>0.05)。结论超声测量环状软骨横径预测气管导管型号准确性高,能提高新生儿气管插管成功率,降低插管时气管导管更换率。

Objective To investigate the feasibility of ultrasound measurement of the transverse diameter of the annular cartilage in predicting cuffless endotracheal tube size for newborns undergoing intestinal resection surgery.Methods 42 newborns suffering from intestinal resection surgery under general anesthesia were selected from January 2017 to December 2022,including 23 males and 19 females, with ASA class II-III.They were randomly divided into two groups according to whether ultrasound was used during intubation: Ultrasound measurement group(group U) and Normal group(group N).Group U used ultrasound to measure the transverse diameter of the annular cartilage to predict the uncuffed endotracheal size, and it was selected in group N according to the intubation guidelines.The time of endotracheal intubation and the rate of endotracheal tube replacement were recorded;postoperative laryngospasm, hoarseness and other adverse reactions were noted;changes in HR,MAP and SpO_(2)during the perioperative period were also monitored.Results Compared with group N,the rate of tracheal tube replacement was significantly lower than that in group U(P<0.05).There were no statistically significant differences in intubation complications, the time of tracheal intubation and changes of perioperative HR,MAP,and SpO_(2)in the two groups.Conclusion Ultrasound measurement of the transverse diameter of the cricoid cartilage is highly accurate in predicting the size of uncuffed endotracheal tube, which can improve the success rate of neonatal tracheal intubation and reduce the rate of tracheal tube replacement during intubation.