Kuriloff D B, Setzen M, Portnoy W, Gadaleta D
Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary/New York Medical College, NY.
Laryngoscope. 1989 Feb;99(2):125-30. doi: 10.1288/00005537-198902000-00002.
Airway complications following elective cricothyroidotomy were reviewed in 48 adult cardiothoracic surgery patients. A 52% incidence of airway complications was found and manifested by failed or delayed decannulation, extensive subglottic granulation tissue, stenosis, vocal cord paralysis, and aspiration pneumonia. The most common cause for decannulation difficulty was subglottic stenosis (50%). Several risk factors were specifically identified, including a period of cricothyroid cannulation exceeding 30 days, the presence of diabetes, and advanced age. These findings suggest that airway sequelae following cricothyroidotomy in cardiothoracic surgery patients is higher than previously reported. Indications and risk factors for cricothyroidotomy are discussed.
对48例成年心胸外科手术患者择期环甲膜切开术后的气道并发症进行了回顾。发现气道并发症发生率为52%，表现为拔管失败或延迟、声门下广泛肉芽组织、狭窄、声带麻痹和吸入性肺炎。拔管困难最常见的原因是声门下狭窄（50%）。具体确定了几个危险因素，包括环甲膜插管超过30天、糖尿病的存在和高龄。这些发现表明，心胸外科手术患者环甲膜切开术后的气道后遗症高于先前报道。讨论了环甲膜切开术的适应症和危险因素。
