摘要
目的建立猪环甲膜穿刺和切开模型,供临床医师学习环甲膜穿刺和切开技术,提高紧急气道的应急处理能力,降低麻醉气道相关的死亡率和脑损伤发生率。方法选取会厌、声门、甲状软骨、环甲膜、环状软骨和气管等完整的猪喉做环甲膜穿刺和切开模型。在隆凸上方离断气管,注射器针筒连接气管和模拟肺。利用食指、中指和拇指触摸确定环甲膜的位置,然后依据流程行穿刺或切开建立有创气道并通气。结果猪喉环甲膜定位明确,穿刺后建立的气道连接喷射通气装置。环甲膜切开后置入气管导管,连接呼吸皮囊进行通气,以上操作均获得理想的通气效果。结论猪喉结构和人喉结构非常相似,能够模拟真实的环甲膜穿刺和切开,为临床医师教学提供良好的动物模型。
Objective To establish porcine model for needle cricothyroidotomy and scalpel cricothyroidotomy for practitioners to train,maneuver techniques of needle cricothyroidotomy and scalpel cricothyroidotomy,improve the ability of emergency surgical airway management,and reduce the mortality and the incidence of brain injury peri-anesthesia. Methods Porcine larynx with integrated epiglottis,glottis,thyroid cartilage,cricothyroid membrane,cricoid cartilage and trachea was selected to establish the model for needle cricothyroidotomy and scalpel cricothyroidotomy.The trachea was detached above the carina,the trachea and a simulated lung were connected by a 20 mL syringe cylinder.Cricothyroid membrane was positioned with the thumb,middle and index fingers,and then needle cricothyroidotomy and scalpel cricothyroidotomy were performed according to the process to establish an invasive airway and observe the effect of ventilation. Results Positioning of porcine cricothyroid membrane was clear.An invasive airway established by puncture was connected with manual jet ventilation device.The endotracheal tube was intubated after scalpel cricothyroidotomy,and the simulated lung was ups and downs visibly.The above performances obtained satisfactory effect. Conclusions The structure of porcine larynx is very similar to that of human.Porcine model is good for practitioners to train needle cricothyroidotomy and scalpel cricothyroidotomy.
作者
伍金红
李文献
范庆
陆艺
WU Jin-hong;LI Wen-xian;FAN Qing;LU Yi(Department of Anesthesiology,Eye and ENT Hospital,Fudan University,Shanghai 200031,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2019年第4期524-528,共5页
Fudan University Journal of Medical Sciences
基金
上海市卫计委基金(20174Y0125)~~
关键词
困难气道
紧急外科气道
环甲膜
环甲膜穿刺术
环甲膜切开术
猪模型
difficult airway
emergency surgical airway
cricothyroid membrane
needle cricothyroidotomy
scalpel cricothyroidotomy
porcine model
