Morishima Kuniko, Kurita Satoshi, Yamama Yoshihiro, Nakatani Keiji
Department of Anesthesia, Osaka Kosei-nenkin Hospital, Osaka 553-0003.
Masui. 2013 Dec;62(12):1406-9.
The first case was a 69-year-old woman with rheumatoid arthritis undergoing posterior occipito-cervical fusion. Although the operation was successfully performed, airway obstruction developed immediately after extubation. Her upper airway obstruction probably came from pharyngolaryngeal edema. The second case was a 59-year-old man with diabetes mellitus undergoing anterior cervical fusion. The day of surgery, he complained of dyspnea and his neck was swollen with hematoma. We used cricothyrotomy tubes (Mini-Trach II) in these two patients with postoperative upper airway obstruction and performed assist-ventilation via the tube. After starting ventilation through Mini-Trach II, we succeeded in intubation. We belive that cricothyrotomy in well-trained hands can be used safely for the management of the patient with a difficult airway.
第一例是一名69岁患类风湿性关节炎的女性，接受了枕颈后路融合术。尽管手术成功完成，但拔管后立即出现气道梗阻。她的上气道梗阻可能源于咽喉部水肿。第二例是一名59岁患糖尿病的男性，接受了颈椎前路融合术。手术当天，他主诉呼吸困难，颈部因血肿而肿胀。我们对这两名术后出现上气道梗阻的患者使用了环甲膜切开导管（Mini-Trach II），并通过该导管进行辅助通气。通过Mini-Trach II开始通气后，我们成功完成了插管。我们认为，在训练有素的人员操作下，环甲膜切开术可安全用于处理气道困难的患者。
