睑裂-胸骨上切迹间距在确定成人气管插管深度中的应用

目的验证睑裂-胸骨上切迹间距(SPS)可否作为成人气管导管插入深度的标准.方法选择200例无头面部解剖异常的成年全麻患者,随机分为两组各100例,两组插管前均测量SPS.观察组常规气管插管后按测得SPS长度数值,将导管平齐患者上门齿固定.对照组由麻醉医师按经验法确定深度.然后用光纤支气管镜观察导管尖端距气管隆突的距离,3～4cm表明导管位置适当,否则为过深或过浅.结果光纤支气管镜检查表明,以SPS作为气管插管深度标准,导管尖端距离气管隆突的距离均为3～4cm,97%位置满意;对照组定位深度满意率只有79%(另21%位置过浅或过深),两组差异有显著性(P＜0.05).结论用SPS定位成人气管插管深度简单、客观,且适合个体化需求,优于经验定位法.

Using of spacing between palpebral fissure and suprasternal notch in tracheal intubation in adult

Objective To evaluate the reliability of the spacing between pa lpebral fissure and suprasternal notch (SPS) as a standard of tracheal intubatio n and to provide a simple and easy method to define the depth of tracheal intuba tion.Method 200 adult patients with tracheal intubatio n,SPS was measured befor e operation and tracheal tube was fixed by SPS,then the distance between the ti p of tracheal tube and carina of trachea was observed by fibrobronchoscope,3~4 centimeter of which was considered the location of tracheal tube to be satisfact ory.In addition, the location of tracheal tube was examined by touching air p ocket and spot of light.Results Defining the depth of tracheal intubation by S PS,the incidence of clinical satisfaction was 97%.Otherwise,defin ing the dept h of tracheal intubational method,the incidence of tube difining satisfaction w as 79% only,and 21% of the depth of tracheal intubation was either too deep or too shallow.Conclusion It is simple,easy,rapid and a ccurate to define of tracheal intubation by SPS.