Sise M J, Shackford S R, Cruickshank J C, Murphy G, Fridlund P H
Ann Surg. 1984 Jul;200(1):13-7. doi: 10.1097/00000658-198407000-00002.
Cricothyroidotomy for long-term tracheal access was prospectively studied in 76 critically ill patients. Thirty patients (39%) survived and 46 (61%) died. Mean duration of follow-up computed in all survivors was 8.5 months. Postmortem examination of the airway was performed in 85% of the nonsurvivors. Five patients (7%) had major complications including one death, subglottic stenosis in two adolescent patients, reversible subglottic granulation with partial obstruction in one patient, and tracheomalacia in one patient. Minor complications occurred in 23 (30%) survivors. Eleven (28%) of the nonsurvivors examined post mortem had airway pathology, including ulceration, hemorrhage and abscess at the stoma or cuff site, subglottic erosion, and mucosal separation. There were no significant differences in any of the parameters studied between the group with and the group without airway pathology. The morbidity and mortality of cricothyroidotomy in adults are similar to that reported for tracheostomy. However, cricothyroidotomy should be avoided in children and adolescents because of the risk of subglottic stenosis.
对76例重症患者进行了前瞻性研究，以评估环甲膜切开术用于长期气管通路的情况。30例患者（39%）存活，46例（61%）死亡。所有存活患者的平均随访时间为8.5个月。85%的非存活患者进行了气道尸检。5例患者（7%）出现严重并发症，包括1例死亡、2例青少年患者出现声门下狭窄、1例患者出现可逆性声门下肉芽组织伴部分梗阻以及1例患者出现气管软化。23例（30%）存活患者出现轻微并发症。11例（28%）接受尸检的非存活患者存在气道病变，包括造口或套管部位的溃疡、出血和脓肿、声门下糜烂以及黏膜分离。在有气道病变组和无气道病变组之间，所研究的任何参数均无显著差异。成人环甲膜切开术的发病率和死亡率与气管切开术报告的相似。然而，由于存在声门下狭窄的风险，儿童和青少年应避免进行环甲膜切开术。
