超声下胸膜滑动征在婴幼儿气管导管位置调整中的应用价值

Application Value of Pleural Sliding Sigh Under Ultrasound in the Position Adjustment of Tracheal Catheter in Infants

目的探讨利用超声观察胸膜滑动征调整不同年龄段婴幼儿气管导管位置的准确率及所需时间。方法选取郑州大学第三附属医院240例气管插管全麻手术患儿,年龄0~3岁,按照年龄分为<1岁和≥1岁2个年龄段,2个年龄段患儿根据随机数字表法分为超声组和听诊组,分别采用超声法和听诊法调整气管导管的位置,分析2种方法调整气管导管位置的准确率及所需时间。结果<1岁年龄段中,超声组调整气管导管位置的准确率及调整所需时间均优于听诊组(P<0.05)。1~3岁年龄段中,超声组调整气管导管位置的准确率优于听诊组(P<0.05),但调整位置所需时间与听诊组相比差异无统计学意义(P>0.05)。超声组不良反应发生率低于听诊组(P=0.031)。结论在对婴幼儿进行气管插管时,超声法调整气管导管位置比听诊法更准确,不良反应发生率更低,且在<1岁年龄段的患儿中用时更短。

Objective To determine the accuracy and time required to adjust the tracheal tube position in infants and young children using the pleural slide sign observed by ultrasound.Methods A total of 240 children undergoing tracheal intubation under general anesthesia in the Third Affiliated Hospital of Zhengzhou University were selected,children aged from 0 to 3 years old.They were divided into<1 year old group and≥1 year old group.According to the random number table method,the children in the two age groups were divided into ultrasound group and auscultation group,and the position of the tracheal tube was adjusted by ultrasound and auscultation,respectively.The accuracy and time required to adjust the position of the tracheal tube were analyzed.Results The accuracy of adjusting the position of the endotracheal tube by ultrasound and the time required were better than those by auscultation in the<1 year old group(P<0.05).The accuracy of adjusting the position of the endotracheal tube by ultrasound at the age of 1-3 years was better than that by auscultation(P<0.05),but the time required to adjust the position was not significantly different from that by auscultation(P>0.05),the incidence of adverse effects in the ultrasound group was less than that in the auscultation group(P=0.031).Conclusion In intubation of infants,the ultrasound method is more accurate than auscultation in adjusting the position of the endotracheal tube,has a lower incidence of adverse effects,and has a shorter duration of use in children<1 year of age.