Mazzon D, Di Stefano E, Dametto G, Nizzetto M, Cippolotti G, Bosco E, Conti C, Giuliani G
2nd Department of Anesthesia and Intensive Care, S.M. dei Battuti City Hospital, Treviso, Italy.
J Neurosurg Anesthesiol. 1996 Oct;8(4):293-5. doi: 10.1097/00008506-199610000-00006.
After spinal cord injury, quadriplegic patients generally require tracheostomy for ventilatory support and airway clearance. Early tracheostomy has several advantages over translaryngeal intubation, but in patients who undergo anterior surgical fixation of the spine, it is often delayed until after recovery of the surgical wound. We report the case of a quadriplegic patient who underwent a successful percutaneous dilational tracheostomy with the Ciaglia technique after surgical fixation of the spine. The percutaneous dilational technique minimizes the injury to the adjacent structures of the neck and the risk of stomal infection. Therefore, it should be considered the technique of choice when an early tracheostomy is indicated for quadriplegic patients who have undergone anterior surgical fixation of the cervical spine.
脊髓损伤后，四肢瘫痪患者通常需要气管切开术来进行通气支持和气道清理。早期气管切开术相较于经喉插管有若干优势，但对于接受脊柱前路手术固定的患者，气管切开术往往会推迟到手术伤口愈合之后。我们报告一例四肢瘫痪患者的病例，该患者在脊柱手术固定后采用Ciaglia技术成功实施了经皮扩张气管切开术。经皮扩张技术可将对颈部相邻结构的损伤以及造口感染风险降至最低。因此，对于接受颈椎前路手术固定的四肢瘫痪患者，若有早期气管切开术的指征，应将该技术视为首选技术。
