輪状甲状間膜切開を要した上気道閉塞の3症例

Three cases of upper respiratory tract obstruction treated by cricothyroid membrane incision

はじめに

　輪状甲状間膜切開は緊急気道確保に重要な方法の1つである^1,2）。当科では輪状甲状間膜切開の適応を，①上気道狭窄または閉塞，②換気困難または挿管困難，③進行する低酸素血症または徐脈，④より低侵襲な気道確保が不可能，⑤延命拒否の提示のない場合，としている。今回，上気道狭窄による気道緊急を呈した急性喉頭蓋炎，下咽頭進行癌，気道熱傷の3症例に対して輪状甲状間膜切開により緊急気道確保を行ったので，若干の文献的考察を加えて報告する。

　In case of upper respiratory tract obstruction, there are cricothyroid membrane puncture, cricothyroid membrane incision, and tracheostomy for surgical respiratory securing.

　In 3 patients, who fell into upper respiratory tract obstruction caused by acute epiglottitis, advanced hypopharyngeal cancer, and severe inhalation burn, cricothyroid membrane incision was performed to save their lives.

　Even if they are experienced anesthesiologists or ER doctors, there is a case having difficulty with airway maintenance by the tracheal intubation. Cricothyroid membrane incision is regarded as usefull airway maintenance in emergency.