Gillespie M B, Eisele D W
Department of Otolaryngology--Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21203-6402, USA.
Laryngoscope. 1999 Nov;109(11):1766-9. doi: 10.1097/00005537-199911000-00008.
To review the circumstances, complications, and outcomes of emergency surgical airway procedures and to compare the relative merits of cricothyroidotomy and tracheotomy for airway control in a hospital-wide patient population.
Retrospective review.
Patient data were obtained from the inpatient charts and electronic patient records of 35 patients who required an emergency surgical airway over a 6-year period at an urban medical center.
Emergency cricothyroidotomy and tracheotomy were successfully performed in 34 of 35 patients (97%). Orotracheal intubation was successfully achieved in one patient with a failed cricothyroidotomy. The overall complication rates for emergency cricothyroidotomy and tracheotomy were similar (20% and 21%, respectively). Inpatients requiring an emergency surgical airway had a higher complication rate (32% vs. 0%) but better overall survival (91% vs. 46%) than patients treated in the emergency department. No long-term complications were observed from emergency cricothyroidotomies that were not converted to tracheotomies.
The establishment of an emergency surgical airway by either tracheotomy or cricothyroidotomy is effective with low overall morbidity. The need to convert every emergency cricothyroidotomy to a tracheotomy should be reevaluated.
回顾紧急外科气道手术的情况、并发症及结果，并比较环甲膜切开术和气管切开术在全院患者群体中控制气道的相对优点。
回顾性研究。
从一家城市医疗中心6年间35例需要紧急外科气道手术的患者的住院病历和电子病历中获取患者数据。
35例患者中有34例（97%）成功实施了紧急环甲膜切开术和气管切开术。1例环甲膜切开术失败的患者成功实现了经口气管插管。紧急环甲膜切开术和气管切开术的总体并发症发生率相似（分别为20%和21%）。与急诊科治疗的患者相比，需要紧急外科气道手术的住院患者并发症发生率更高（32%对0%），但总体生存率更高（91%对46%）。未转为气管切开术的紧急环甲膜切开术未观察到长期并发症。
通过气管切开术或环甲膜切开术建立紧急外科气道是有效的，总体发病率较低。应重新评估将每例紧急环甲膜切开术都转为气管切开术的必要性。
