Leibovici D, Gorfrit O N, Henig A, Blumenfeld A, Shapira S C
I.D.F. Medical Corps., Dept. of Urology, Hadassah-University Hospital, Jerusalem.
Harefuah. 1996 May 15;130(10):719-21, 727.
To assess the efficacy of prehospital coniotomy (cricothyrotomy), information regarding all coniotomies performed by military physicians during the last 3.5 years was analyzed. 26 were performed between October 1991 and May 1995, of which 23 were successful (88.4%). Failures were due to poor anatomic identification of the cricothyroid membrane. Most patients suffered head or neck injuries (in 61.5% and 19%, respectively). The main indications were anatomical distortion of the pharynx and larynx and failure to intubate. Intubation was attempted in 22 patients prior to coniotomy (multiple attempts in 17). Since coniotomy is a life-saving procedure, it should be part of the armamentarium of any physicians. Coniotomy in the field is associated with a high success rate. The procedure is recommended in trauma victims who need airway establishment and cannot be intubated or in whom intubation has failed.
为评估院前环甲膜切开术的疗效，分析了军事医生在过去3.5年中实施的所有环甲膜切开术的相关信息。1991年10月至1995年5月期间共实施了26例，其中23例成功（88.4%）。失败原因是环甲膜解剖识别不佳。大多数患者头部或颈部受伤（分别为61.5%和19%）。主要适应证为咽喉部解剖结构变形和插管失败。22例患者在环甲膜切开术前尝试过插管（17例进行了多次尝试）。由于环甲膜切开术是一种挽救生命的操作，应成为所有医生必备技能的一部分。现场环甲膜切开术成功率较高。对于需要建立气道但无法插管或插管失败的创伤患者，推荐实施该手术。
