兩歲以下小兒鼻聲帶距離與口聲帶距離差值之測量

The Difference between Nasotracheal and Orotracheal Lengths in Pediatric Patients Younger Than Two Years Old

古昆岳(Kun-Yueh Ku) ； 李國森(Kuo-Sheng Lee) ； 楊政謙(Cheng-Chien Yang) ； 陳昱君(Yu-Chun Chen)

《台灣耳鼻喉頭頸外科雜誌》 43卷6期 (2008/12) Pp. 155-159

https://doi.org/10.6286/2008.43.6.155

摘要

背景：藉由臨床測量自前鼻孔至聲帶的距離（鼻聲帶距）與自上門牙至聲帶的距離（口聲帶距），來推測鼻聲帶距與口聲帶距的差值（鼻口差距），提供小於2歲的小兒患者經鼻氣管內插管深度的參考值。
方法：利用回溯分析病歷的方式，收集馬偕紀念醫院耳鼻喉科自1998年3月至2006年7月，小於2歲並接受通氣式支氣管鏡術檢查後，同時接受經鼻插管的小兒患者共24例，測量其鼻聲帶距與口聲帶距，並藉此獲得鼻口差距。
結果：24例中男性19名，女性5名，平均年齡爲8.79±1.52個月，平均體重爲5.98±0.61kg，鼻聲帶距爲9.44±0.29cm，口聲帶距爲6.41±0.17cm，鼻口差距的平均值爲3.03±0.19cm；年齡、體重，與鼻口差距之間並無顯著相關。
結論：本研究提供小於2歲小兒的鼻口差距數據，發現鼻口差距在此年齡層的小兒變異不大。此項結果對於需經鼻插管的小兒患者，可利用一般經口插管時的深度，加上鼻口差距約3cm，來作爲插管深度的參考並可提高小兒插管的安全性與準確性。

關鍵字

經鼻插管 ； 經口插管 ； 差距

並列摘要

BACKGROUND: To provide reference standards for nasotracheal intubation in pediatric patients younger than 2 years old by the clinical measurement of the nostril to cord distance (NCD), the upper incisor to the vocal cords distance (ICD) and the difference between the NCD and ICD.
METHODS: From March 1998 to July 2006, we used a video rigid ventilation bronchoscope under general anesthesia to measure the length from upper incisor to the vocal cords and that from the nostril to the vocal cords in 24 patients younger than 2 years old.
RESULTS: The study group was composed of 19 boys and 5 girls. The average age was 8.79±1.52 (month). The average body weight was 5.98±0.61 (kg). The mean value for the difference between the NCD and ICD was 3.03±0.19 (cm). On comparing the NCD and ICD difference against age and body weight, no significant correlation was found to exist for the group used in this study.
CONCLUSION: For optimal placement of an endotracheal tube in infants and small children younger than 2 years old, when changing an oral ETT to a nasal ETT, we can use the results of this study as a baseline. However, clinical judgement remains the essence of proper placement in such circumstances.

並列關鍵字

nasal intubation ； oral intubation ； difference