Brantigan C O, Grow J B
J Thorac Cardiovasc Surg. 1976 Jan;71(1):72-81.
Surgical teachings insist that cricothyroidotomy should be performed only under emergency conditions as a temporary means of securing an airway. Subsequent subglottic stenosis is thought to occur in alarming numbers of patients intubated for any length of time. The incidence of complications associated with cricothyroidotomy has not been critically examined since Jackson's classic paper in 1921, condemning the operation. A total of 655 patients with cricothyroidotomy tubes in place from hours to months were studied to determine the incidence of problems associated with this procedure. The over-all complication rate was 6.1 per cent. There was one cricothyroidotomy-associated death. Chronic subglottic stenosis did not occur, although 5 patients required resection of tracheal strictures. No additional complications occurred if the procedure was carried out at the bedside instead of in the operating room. The simplicity, absence of cross-contamination of median sternotomy incisions, and safety documented by this study recommend routine use of cricothyroidotomy in patients whose management requires tracheotomy.
外科教学强调，环甲膜切开术仅应在紧急情况下作为确保气道通畅的临时手段进行。人们认为，接受任何时长气管插管的患者中，随后发生声门下狭窄的人数惊人。自1921年杰克逊发表经典论文谴责该手术以来，与环甲膜切开术相关的并发症发生率尚未得到严格审查。对655例放置环甲膜切开管数小时至数月的患者进行了研究，以确定与该手术相关问题的发生率。总体并发症发生率为6.1%。有1例与环甲膜切开术相关的死亡病例。虽然有5例患者需要切除气管狭窄，但未发生慢性声门下狭窄。如果该手术在床边而非手术室进行，则不会出现其他并发症。本研究证明该手术操作简单、不会造成正中胸骨切开切口的交叉污染且安全，因此建议在需要气管切开术的患者中常规使用环甲膜切开术。
