Barrachina F, Guardiola J J, Añó T, Ochagavia A, Mariné J
Intensive Care Unit, Hospital Universitari Joan XXIII, Tarragona, Spain.
Intensive Care Med. 1996 Sep;22(9):937-40. doi: 10.1007/BF02044119.
To assess the value of the percutaneous dilatational technique in elective cricothyroidotomy.
Forty-four consecutive patients requiring prolonged mechanical ventilation.
The general 14-bed intensive care unit of a university hospital.
Fourty-four percutaneous dilatational cricothyroidotomies using a multiple-dilator wire-guided procedure.
The average duration for the procedure was 11 min in 37 patients. No significant complications occurred intraoperatively except for one paratracheal cannula insertion. Postoperative complications were one case of stoma infection, three cases of transient phonatory changes, two cases of a small peristomal granuloma, and one case of persistent stoma. Of 21 decannulated patients, 16 survived to discharge. Long-term follow-up was possible in 14 surviving patients. All were asymptomatic several months after decannulation.
Percutaneous dilatational cricothyroidotomy can be a quick, safe technique, as good as the percutaneous subcricoidal approach in ventilated, critically ill patients.
评估经皮扩张技术在择期环甲膜切开术中的价值。
连续纳入44例需要长期机械通气的患者。
一所大学医院设有14张床位的普通重症监护病房。
采用多扩张器导丝引导法进行44例经皮扩张环甲膜切开术。
37例患者手术平均时长为11分钟。术中除1例气管旁插管外，无显著并发症发生。术后并发症包括1例造口感染、3例短暂发声改变、2例造口周围小肉芽肿和1例持续性造口。在21例拔管患者中，16例存活出院。14例存活患者得以进行长期随访。拔管数月后，所有患者均无症状。
经皮扩张环甲膜切开术是一种快速、安全的技术，对于需要通气的危重症患者，其效果与经皮环甲膜下切开术相当。
