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| Application of Ultrasound-guided Cricothyroidotomy in Difficult Tracheal Intubation |
| ZHANG Liangcheng, LIU Dan, WU Yu |
| Department of Ultrasound,Zhenba County People's Hospital,Hanzhong Shaanxi 723600 |
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Abstract 【Objective】To explore the effect of cricothyroid membrane puncture (cricothyroidotomy) in difficult tracheal intubation guided by ultrasound. 【Methods】A total of 76 patients with intractable tracheal intubation who were hospitalized in Zhenba County People's Hospital and Zhenba Hospital of Traditional Chinese Medicine from January 2018 to January 2020 were selected in the study. According to the random number table method, patients were divided into the control group and the observation group (with 38 cases each). The control group was treated with cricothyroid membrane puncture by body surface positioning method, while the observation group was applied with ultrasound-guided cricothyroidotomy. The success rate of one-time puncture of cricothyroid membrane, intubation comfort and tracheal tube tolerance scores in the two groups of patients were compared. The blood oxygen saturation (SpO2), heart rate (HR), mean arterial pressure (MAP) in both groups, at pre-anesthesia (T0), anesthesia (T1), tracheal intubation (T2) and 5 minutes after intubation (T3) were recorded and postoperative complications was analyzed. 【Results】The success rate of cricothyroid membrane puncture in the observation group was 100%. The observation group had a higher success rate of puncture of the cricothyroid membrane than the control group (100% vs 84.21%) (χ2=6.514, P=0.011). The SpO2, HR, and MAP indexes of T1, T2, and T3 in both groups were higher than those of T0, and those parameters of the observation group were lower than those of the control group (P<0.05).The SpO2, HR, and MAP indexes at T3 were lower than those at T1 and T2 (P<0.05). The observation group's intubation comfort score and tracheal tube tolerance score were lower than the control group (P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (18.42% vs 47.37%) (χ2=7.213,P=0.007). 【Conclusion】Ultrasound-guided cricothyroid membrane puncture can better meet the needs of difficult tracheal intubation patients, improve the success rate of cricothyroid membrane puncture, intubation comfort and tolerance, and reduce the occurrence of complications.
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Received: 21 November 2022
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2024, Vol. 41 
