超声测定小儿环状软骨横径在全麻时最适加强型气管导管选择的应用

Application of ultrasound measurement of the transverse diameter of children's cricoid cartilage in the selection of the most suitable reinforced tracheal duct during general anesthesia

目的探究超声测定小儿环状软骨横径在全麻时最适加强型气管导管选择的应用效果。方法前瞻性选取2022年1月-2023年9月南昌大学第二附属医院收治的80例拟施行气管插管全身麻醉的患儿为研究对象。通过随机数字表法分为研究组与对照组,每组40例。所有患儿均采取相同带套囊加强型气管导管,对照组采用年龄公式预评估选择气管导管型号,研究组采用超声测量环状软骨横径选择气管导管型号。比较两组加强型气管导管选择准确率,换管情况,插管后即刻心率、平均动脉压(MAP)与并发症发生情况(包括喉头水肿、喉痤、气道黏膜损伤),并通过Pearson相关性分析超声测量环状软骨横径与最适加强型气管导管内径、外径相关性。结果等级资料秩和检验结果显示,两组全麻时最适加强型气管导管选择情况比较,差异存在统计学意义(Z=1.918,P<0.05),且研究组全麻时最适加强型气管导管选择准确率高于对照组(97.50%VS60.00%)(P<0.05)。两组插管后即刻心率、MAP比较,差异无统计学意义(P>0.05),但研究组换管例数与换管次数均低于对照组(P<0.05)。Pearson相关性显示,超声测量环状软骨横径与最适加强型气管导管内径、外径存在显著正相关(r=0.980、0.982,P<0.05)。两组喉头水肿发生率、喉李发生率、气道黏膜损伤发生率、并发症总发生率比较,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应用于选择全麻时最适加强型气管导管具有较高准确性,且可有效降低换管率与并发症发生率。

Objective To explore the application effect of ultrasound measurement of the transverse diameter of cricoid cartilage in children during general anesthesia for the optimal selection of reinforced tracheal catheters.Method A prospective study was conducted on 80 pediatric patients who were admitted to our hospital from January 2022 to September 2023 and planned to receive general anesthesia through tracheal intubation.Divide into a study group and a control group of 40 cases each using a random number table method.All patients were treated with the same reinforced tracheal catheter with a cuff.The control group was selected for tracheal catheters based on age formula pre evaluation,while the study group was selected for tracheal catheters based on ultrasound measurement of the transverse diameter of the cricoid cartilage.Compare the accuracy of selecting two groups of reinforced tracheal catheters,the situation of tube replacement,immediate heart rate,mean arterial pressure(MAP)after intubation,and the incidence of complications(including laryngeal edema,laryngeal spasm,and airway mucosal injury).Use Pearson correlation analysis to measure the correlation between the transverse diameter of cricoid cartilage measured by ultrasound and the optimal inner and outer diameter of reinforced tracheal catheters.Result The rank sum test of grade data showed that there was a statistically significant difference(Z-1.918,P<0.05)in the selection of the most suitable reinforced tracheal catheter between the two groups under general anesthesia,and the accuracy of the selection of the most suitable reinforced tracheal catheter in the study group was higher than that in the control group(97.50%VS 60.00%)(P<0.05).There was no statistically significant diference in heart rate and MAP between the two groups immediately after intubation(P>0.05),but the number and frequency of tube replacement in the study group were lower than those in the control group(P<0.05).Pearson correlation showed that there was a significant positive correlation(r=0.980,0.982,P<0.05)between the transverse diameter of the cricoid cartilage measured by ultrasound and the inner and outer diameters of the most suitable reinforced tracheal duct.There was no statistically significant difference in the incidence of laryngeal edema,laryngeal spasm,airway mucosal injury,and total complications between the two groups(P>0.05).Conc lusion Ultrasound measurement of the transverse diameter of the cricoid cartilage in children has high accuracy in selecting the most suitable reinforced tracheal catheter during general anesthesia,and can effectively reduce the rate of tube replacement and the incidence of complications.