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目的为新生窒息复苏术提供应用解剖学基础。方法新生儿尸体32具,测身长及上部量(从头顶至耻骨联合上缘);将标本头颈部正中矢状切开,暴露喉、气管及支气管,观察测量喉形态、软骨倾斜度;将头部置气管插管体位,测量自口腔和鼻腔至声门的长度、声门至气管杈的长度及气管内径。结果 (1)新生儿身长(50.87±2.02)cm,上部量(33.81±1.06)cm,与总体均数相比无显著性差异;(2)喉口平面与声带平面形成向后开放的角,角度为(46.82±1.58)°,与成人差别较大;(3)上中切牙至声门长(5.95±0.51)cm,鼻前孔至声门长(7.06±0.47)cm,声门至气管杈长(4.94±0.74)cm,与身长及上部量呈直线相关;(4)气管起始端横径为(0.50±0.12)cm,矢状径为(0.38±0.04)cm,气管末端横径为(0.49±0.14)cm,矢状径为(0.35±0.06)cm,始、末端管径无明显差别。结论 (1)新生儿插管前可以其身长或上部量为依据估算插管长度,插入不能过深,自口腔插管长度约7～9cm,自鼻腔插管长度约8～10cm,管径以0.25～0.40cm为宜;(2)选择喉镜时采用直镜片效果好,插入时要充分注意喉口平面与声带平面的锐角。
Objective To provide anatomical basis for neonatal asphyxia resuscitation. Methods 32 neonatal cadavers, body length and upper part (from the top of the head to the upper edge of the pubic symphysis) were obtained. The sagittal section of the head and neck was opened and the throat, trachea and bronchus were exposed. The laryngeal morphology and cartilage inclination were observed. Head tracheal intubation body position, measured from the mouth and nasal cavity to glottis length, glottis to tracheal twig length and tracheal diameter. Results (1) Neonatal body length (50.87 ± 2.02) cm, the upper part (33.81 ± 1.06) cm, no significant difference compared with the overall mean; (2) the throat plane and vocal fold plane to form a backward angle, The angle was (46.82 ± 1.58) °, which was significantly different from that of adults. (3) The distance between the maxillary incisor to the glottis (5.95 ± 0.51) cm and the anterior nasolabial to the glottis (7.06 ± 0.47) cm, (4.94 ± 0.74) cm, which was linearly correlated with the length and the upper part of the trachea. (4) The transverse diameter at the beginning of the trachea was (0.50 ± 0.12) cm and the sagittal diameter was (0.49 ± 0.14) cm, and the sagittal diameter was (0.35 ± 0.06) cm. There was no significant difference between the beginning and the end of the diameter. Conclusion (1) Neonatal intubation can be based on their length or upper part of the estimated intubation length, the insertion can not be too deep, since the oral intubation length of about 7 ~ 9cm, nasal intubation length of about 8 ~ 10cm, diameter 0.25 ~ 0.40cm is appropriate; (2) the choice of laryngoscope with a direct lens effect is good, insert the full attention to the throat plane and vocal plane acute angle.