Hart Kristopher L, Thompson Stevan H
Department of Oral and Maxillofacial Surgery, Darnall Army Medical Center, Fort Hood, TX 76544, USA.
Atlas Oral Maxillofac Surg Clin North Am. 2010 Mar;18(1):29-38. doi: 10.1016/j.cxom.2009.11.002.
Establishment of an unobstructed airway and adequate oxygenation is a basic tenet of life support. Mechanical or anatomic airway obstructions can arise secondary to trauma, pathology, foreign bodies, and infection. The oral and maxillofacial surgeon is uniquely trained to provide surgical and anesthetic care, and must be prepared to provide emergency airway management. This article reviews the indications, contraindications, and techniques of surgical and needle cricothyrotomy. Fortunately, with advances in airway techniques and equipment, emergency cricothyrotomy is not a common procedure. However, in the event that a surgeon has no other means of securing an airway, this procedure may avert a catastrophe. If such a situation does occur, quick and decisive action can best be carried out if there is a thorough understanding of the anatomy and techniques involved.
建立通畅的气道和充足的氧合是生命支持的基本原则。机械性或解剖性气道梗阻可能继发于创伤、病理状况、异物和感染。口腔颌面外科医生经过专门培训,可提供外科手术和麻醉护理,并且必须做好提供紧急气道管理的准备。本文回顾了外科手术和环甲膜穿刺切开术的适应证、禁忌证及技术。幸运的是,随着气道技术和设备的进步,紧急环甲膜切开术已不是常见的操作。然而,在外科医生没有其他确保气道安全的方法时,此操作可避免灾难的发生。如果这种情况确实发生,若对相关解剖结构和技术有透彻的了解,就能最有效地采取迅速而果断的行动。