环甲膜的解剖学测量及其临床意义

Anatomical measurement of cricothyroid membrane and its clinical significance

目的 通过测量环甲膜的解剖学数据 ,为经环甲膜穿刺呼吸急救提供依据 .方法 10 0例成人在超声波下进行环甲膜观察 ,对具有临床意义的数据进行解剖学测量 ,并结合2 0具成人尸体标本的环甲膜测量比较 ,测量有关数据并在标本上摹拟环甲膜穿刺 .结果 裸露于两环甲肌内侧缘之间的环甲膜近似于长方形 ,超声波测量环甲膜中线处上下径为(4.4± 1.0 ) mm,宽度为 (11.9± 3.2 ) mm ,皮肤至环甲膜内侧气管面为 (3.9± 0 .6 ) m m,成人尸体标本测量分别为 (4.0±1.0 ) ,(10 .2± 2 .2 )和 (3.3± 0 .7) mm.环甲膜上下径在 4 mm者占 71.2 % .结论 环甲膜空间可提供直径为 3m m的穿刺针通过 ,经皮环甲膜穿刺一般穿刺深度为 5 mm即可到达气管内 .当进行环甲膜穿刺抢救上呼吸道梗阻时 ,经环甲膜穿刺套管针直径最好不要大于 3m m。

AIM To measure the cricothyroid membrane for percutaneous trans tracheal ventilation as a temporary lifesaving procedure during upper respiratory tract obstruction. METHODS 100 adults underwent ultrasound to measure the cricothyroid membrane and 20 corpses were observed. RESULTS The shape of cricothyroid membrane was like a rectangle. In ultrasound, the distance between crico and thyroid is (4.4±1.0) mm, the broadth of crocothyroid membrane ( 11.9 ±3.2) mm, and the thickness of skin to inferior membrane (3.9±0.6) mm. In the corpses, the result was (4.0±1.0), (10.2±2.2), and (3.3±0.7) mm respectively. CONCLUSION The space of cricothyroid membrane is enough for a needle 3 mm in diameter to trans tracheal and the distance of trans tracheal is about 3.87 mm. Percutaneous trans tracheal ventilation (PTJV) should be inserted between the inferior thyroid cartilage and superior circled cartilage, and it is safe for cricothyroid muscle and larynx cartilage.