摘要:
Objective To investigate the correlation between the insertion depth of the left-sided double-lumen tube (DLT) and some specific body landmarks in order to guide left-sided DLT intubation. Methods Ninety-five adult patients who underwent thoracic surgery were chosen, and the age (A), sex (S), height (H), weight (W), distance between the cricothyroid membrane and upper notch of the sternum angle (L), size of the left-sided DLT (F), and predicted depth of intubation (y) were recorded. After anesthesia induction, the final corrected insertion depth of the left-sided DLT (Y) were recorded using fiberoptic bronchoscopy. The Y and y were compared.Linear regression and Pearson's correlation analysis were used to analyze the data. Results There was no difference between the Y and y (P> 0.05). The Y was significantly correlated with H, W, and L (P < 0.01), and was not correlated with A (P> 0.05). Three linear regression equations for H, L, and Y were obtained. H and L were linearly dependent on Y, and the determination coefficients R2 were 0.43 (Y=7.285+0.128 H) and 0.41 (Y=19.305+0.866 L), respectively. Using both H and L as the independent variables, the determination coefficient R2 was 0.56 (Y=8.127+0.087 H+0.559 L). Conclusion The linear regression equation Y=8.127+0.559 H+0.087 L could be used as a rapid method to assess the insertion depth of the left-sided DLT. However, the ideal insertion depth of the left-sided DLT still needs to be confirmed using fiberoptic bronchoscopy.%目的 探讨左侧双腔支气管导管 (DLT) 插管深度与人体某些特定体表标志的相关性, 为左侧DLT插管提供指导.方法选择行胸科手术的95例成年患者, 记录患者的性别 (S) 、年龄 (A) 、身高 (H) 、体质量 (W) 、环甲膜-胸骨角上切迹的距离 (L) 、导管型号 (F) 及预计插管深度 (y) .患者麻醉诱导后, 插入左侧DLT, 应用纤维支气管镜确认最佳导管位置, 并记录插管深度 (Y) .比较预计插管深度与纤维支气管镜下实际插管深度的差异.应用线性回归和Pearson相关分析检验数据.结果 预计左侧DLT插管深度与纤维支气管镜下实际插管深度无差异 (P> 0.05) .左侧DLT插管深度与身高、体质量、环甲膜-胸骨角上切迹的距离显著相关 (P <0.01), 与年龄无相关性 (P> 0.05) .身高和环甲膜-胸骨角上切迹的距离与左侧DLT插管深度的线性回归方程分别是Y=7.285+0.128H (确定系数R2=0.43) 和Y=19.305+0.866L (确定系数R2=0.41), 以H和L同时作为自变量的线性回归方程是Y=8.127+0.087H+0.559L (确定系数R2=0.56), 较前二者线性拟合度更优.结论 以身高、环甲膜-胸骨角上切迹的距离和左侧DLT插管深度得出的线性回归方程Y=8.127+0.087H+0.559L, 可作为左侧DLT插管时一种快速评估插管深度的手段, 但是DLT最终的最优位置仍需要借助纤维支气管镜进行确认.