三指宽度法选择小儿喉罩型号

目的评价三指宽度方法在小儿选择喉罩型号中的准确性.方法择期手术522例小儿,按小儿食指、中指和无名指的宽度选择最匹配的喉罩型号,与厂商提供的按体重方法选择的喉罩进行比较.采用Kappa和秩相关分析,比较两种方法所选喉罩之间的一致性.结果 Kappa系数为0.773,秩相关系数为0.917,提示两种方法所选择的喉罩之间呈高度一致性(P<0.01).其中442例(84.7%)小儿两种方法选择了相同型号的喉罩,80例(15.3%)小儿两种方法选择的喉罩相差一个型号.体重处于两个型号之间的临界值附近是引起喉罩型号差别的主要原因.结论三指宽度是小儿选择喉罩型号的可靠而简便的方法,特别在紧急情况下不知道小儿体重时尤为适用.

Selection of Laryngeal Mask Size with the Method of Three Fingers Widths in Pediatric Patients

Objective To evaluate the method of three figures width in laryngeal mask size choice. Methods(The size) of the laryngeal mask airway was determined in 522 pediatric patients by choosing the laryngeal mask that best matched the combined widths of the patient's index,middle and ring fingers.The results were compared with the standard method recommended by the manufacturer's weight-related guidelines.The patients were classified into different groups depending on the laryngeal mask airway sizes determined by both methods.A Kappa coefficient and Spearman's correlation analysis evaluated the agreement between both techniques. Results The Kappa coefficient and Spearman's correlation coefficient were 0.773 and 0.917,respectively,showing an excellent agreement between both methods(P<0.01).The size was same for both methods in 442 patients (84.7%).The disagreement between both techniques was only one size in the remaining 80 patients(15.3%).In such patients,weight was the borderline value that would indicate a change in the size of the laryngeal mask airway using the classic method.(Conclusion)This method is valid and practical in pediatric patients,particularly as an alternative in those situations where the patient's weight is unknown,such as emergency situations or in those borderline instances where an alternative measurement would be useful.