Chong D Y C, Greenland K B, Tan S T, Irwin M G, Hung C T
Department of Anaesthesiology, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR.
Br J Anaesth. 2006 Oct;97(4):489-95. doi: 10.1093/bja/ael186. Epub 2006 Jul 27.
Previous studies have identified no strong correlation between patients' height and tracheal length in anaesthetized patients. We have attempted to compare vocal cords-carina distance (VCD) in Chinese patients with the dimensions of five commonly used tracheal tubes. In addition, we attempted to find a surface anatomy measurement that would identify patients with 'short tracheas'.
We measured VCD in 130 anaesthetized Chinese patients with a fibreoptic bronchoscope. Also measurements were obtained of the distal ends of five commonly used tracheal tubes. We undertook various surface anatomy measurements on the patients' chest and neck region to predict those patients with short tracheas.
VCD averaged 12.6 (SD 1.4) cm. In seven patients (5%) this distance was particularly short (between 8.8 and 10.4 cm). Many of the commonly used tracheal tubes would be placed close to or beyond the carina when the black intubation guide mark(s) is (are) at the level of the vocal cords. The VCD of <or=11 cm (short trachea) could be predicted by patient height of <or=167.5 cm and a thyrosternal distance of <or=28.5 cm with limited reliability.
A significant number of patients with short VCD in our study group could be at risk of endobronchial intubation with many of the tracheal tubes. Patient height and thyrosternal distance can be useful in predicting short tracheas.
既往研究未发现麻醉患者的身高与气管长度之间存在强相关性。我们试图比较中国患者的声带-隆突距离（VCD）与五种常用气管导管的尺寸。此外，我们试图找到一种体表解剖学测量方法，以识别气管“短”的患者。
我们使用纤维支气管镜测量了130例麻醉的中国患者的VCD。还测量了五种常用气管导管的远端。我们对患者的胸部和颈部区域进行了各种体表解剖学测量，以预测气管短的患者。
VCD平均为12.6（标准差1.4）cm。7例患者（5%）的这一距离特别短（在8.8至10.4 cm之间）。当黑色插管引导标记处于声带水平时，许多常用气管导管会放置在隆突附近或超过隆突。VCD≤11 cm（气管短）可通过身高≤167.5 cm和胸骨上切迹至胸骨柄上缘距离≤28.5 cm预测，但可靠性有限。
在我们的研究组中，相当数量的VCD短的患者使用许多气管导管时可能有支气管内插管的风险。患者身高和胸骨上切迹至胸骨柄上缘距离有助于预测气管短。
