小型気管内チューブの合併症例  [in Japanese] Complications of Percutaneous Cricothyrotomy  [in Japanese]

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Abstract

輪状甲状靱帯の穿刺による小型気管内チューブ留置は,気管切開術より簡便で短時間に施行することが可能である。そのため,上気道閉塞時の緊急気道確保を目的に多用される。また最近では喀痰排出を目的に施行される報告も散見され,その適応が徐々に拡大する傾向がみられている。今回われわれが経験した小型気管内チューブ留置によって,甲状軟骨を穿通したため嗄声と誤嚥をきたした症例と,皮下気腫を呈した症例から,小型気管内チューブの適応の有無やチューブ留置の際の問題点をあげた。小型気管内チューブ留置はあくまでも緊急の気道確保を目的に施行するべきであり,また本方法が適切に普及するために,耳鼻咽喉科医は他科からの依頼に応じ,状況に応じた適切なアドバイスを行うことも重要と考えられた。

Percutaneous cricothyrotomy is much simpler and less invasive than conventional tracheotomy. Therefore, this procedure has been considered a useful tool for rapidly treating progressive airway obstruction. Moreover, it has recently been reported that percutaneous cricothyrotomy can be employed to manage an excess of airway secretion.<br>We report two cases of complications due to percutaneous cricothyrotomy in order to manage pneumonia. The first patient was a 78-year-old male with hoarseness and dysphagia after percutaneous cricothyrotomy. The tube was inserted through the thyroid cartilage into the subglottic space. After removing the tube, these symptoms disappeared. The second patient was a 76-year-old male with progressive subcutaneous emphysema around the neck after the insertion of the cricothyrotomy tube. We performed a tracheotomy under general anesthesia, and his subcutaneous emphysema improved 5 days after tracheotomy.<br>Although percutaneous cricothyrotomy is an effective method for treating airway obstruction, its indications should be decided cautiously, except in cases of airway obstruction. After emergent cricothyrotomy, it is recommended the location of the cricothyrotomy tube be confirmed.

Journal

  • Nihon Kikan Shokudoka Gakkai Kaiho

    Nihon Kikan Shokudoka Gakkai Kaiho 53(3), 280-284, 2002-06-10

    The Japan Broncho-esophagological Society

References:  14

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008579655
  • NII NACSIS-CAT ID (NCID)
    AN00187474
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    00290645
  • Data Source
    CJP  CJPref  J-STAGE 
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