Bódis Fruzsina, Orosz Gábor, Szabó Marcell, Molnár Viktória, Tóth T József, Élő László Gergely, Tamás László, Élő Gábor
1 Semmelweis Egyetem, Általános Orvostudományi Kar, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika Budapest, Szigony u. 36., 1083 Magyarország.
2 Semmelweis Egyetem, Általános Orvostudományi Kar, Aneszteziológiai és Intenzív terápiás Klinika Budapest Magyarország.
Orv Hetil. 2023 Apr 23;164(16):630-635. doi: 10.1556/650.2023.32746.
For patients requiring prolonged mechanical ventilation, tracheostomy becomes necessary, which may be performed through surgical or percutaneous methods. In this study, we used three different methods of percutaneous dilatational tracheostomy. Our goal was to identify anthropometric parameters relevant for the correct position of the tracheostomy tube.
Randomized, controlled observational study was performed on 118 cadavers. Three different tracheostomy methods were used: the Griggs (n = 37), the Griggs modified by Élő (n = 45), and the Ciaglia's Blue Rhino (n = 36). The neck circumference, jugulomental distance, and mid-upper arm circumference were measured on each cadaver. We assessed whether the aforementioned parameters related with the appropriate positioning of the tracheostomy tube Results: Significant correlation was found (p = 0.0287) between mid-upper arm circumference and incorrect tracheostomy tube position (below the fourth tracheal cartilage ring). We identified the value of 30 cm of mid-upper arm circumference as the ideal cut-off for predicting tube malposition (sensitivity: 63.63%, specificity: 60.22%).
When planning percutaneous tracheostomy, it is important to measure the anthropometric parameters. If mid-upper arm circumference is 30 cm or higher we recommend other tests and/or ENT (ear, nose, and throat) consultation. Orv Hetil. 2023; 164(16): 630-635.
对于需要长期机械通气的患者，气管切开术变得必要，可通过手术或经皮方法进行。在本研究中，我们使用了三种不同的经皮扩张气管切开术方法。我们的目标是确定与气管切开管正确位置相关的人体测量参数。
对118具尸体进行了随机对照观察研究。使用了三种不同的气管切开术方法：格里格斯法（n = 37）、埃洛改良的格里格斯法（n = 45）和恰利亚蓝犀牛法（n = 36）。在每具尸体上测量了颈围、下颌至颏下距离和上臂中段周长。我们评估了上述参数是否与气管切开管的正确定位有关。结果：上臂中段周长与气管切开管位置不正确（低于气管第四软骨环）之间存在显著相关性（p = 0.0287）。我们确定上臂中段周长30 cm为预测导管位置异常的理想临界值（敏感性：63.63%，特异性：60.22%）。
在计划经皮气管切开术时，测量人体测量参数很重要。如果上臂中段周长为30 cm或更高，我们建议进行其他检查和/或咨询耳鼻喉科医生。《匈牙利医学周报》。2023年；164(16): 630 - 635。
