关键词: 新生儿窒息, 气管插管, 应用解剖

Abstract:

Objective　To provide anatomic basis for neonatal asphyxia resuscitation. Methods: 32 neonatal cadavers were used to measure about the body length, the upper part length(from corona capitis to upper border of pubic symphysis). And then, a median sagittal cut on the bodies were performed for exposing and observing of larynx, trachea and bronchus, involving the shape and position of larynx, and the slope degree of laryngeal cartilages. At the position of tracheal intubation, the lengths from oral cavity, and nasal cavity to glottis vera, from glottis vera to bifurcation of trachea, and the inner diameter of trachea were measured and analyzed.   Results (1) The body length of neonates was about (50.87±2.02）cm, the upper part length about （33.81±1.06）cm, and there were no significant difference among different cadavers. (2) The angle between aperture of larynx and vocal cords was about （46.82±1.58）°, and opened posteriorly, with an obvious difference compared to that of the adults.  (3)The length from upper incisors to the glottis was （5.95±0.51）cm, from the anterior naris to the glottis （7.06±0.47）cm, and from the glottis to the bifurcation of trachea（4.94±0.74）cm, respectively, which appeared a linear correlation with the lengths of the body and the upper part. (4) The proximal tracheal diameters and sagittal diameter were （0.50±0.12）cm and (0.38± 0.04）cm, while the distal tracheal diameter and sagittal diameter（0.49±0.14）cm and (0.35±0.06）cm, respectively, without significant difference between them.   Conclusions    According to the body length or the upper part length of the neonates, the tube length can be estimated before the intubation. For the neonates, the insertion depth has to be considered carefully, with the oral tube length about 7~9cm, the nasal tube length about 8~10cm, and diameter about 0.25~0.40cm. (2) For the neonates, laryngoscope with direct lens should be selected, and the full attention should be paid to the acute angle between the aperture of larynx and vocal cords during the trachea intubation.

Key words: Neonatal asphyxia, Trachea intubation, Applied anatomy