超声在气道管理中的应用VIP免费

上海交通大学附属第六人民医院麻醉科赵达强超声在气道管理中的应用2016-5-27上海市第六人民医院ShanghaiSixthPeople’sHospital颈部气道解剖上海市第六人民医院ShanghaiSixthPeople’sHospital定位喉上神经Thethyrohyoidmembraneasatargetforultrasonography-guidedultrasonography-guidedblockoftheinternalbranchofthesuperiorlaryngealnerveStopar-PintaricT,VlassakovK,AzmanJ.JClinAnesth.2015Nov;27(7):548-52.Inconclusion,weareproposingananatomicalconceptforanew,new,simpler,consistentlyreproduciblesimpler,consistentlyreproducibleUS-guidediSLNblocktechniqueusingthethyrohyoidmembranetodefinethetargetplaneforlow-volumelocalanestheticinjection.上海市第六人民医院ShanghaiSixthPeople’sHospital外侧舌骨外侧舌骨超声影像——舌骨、喉上神经外侧过拱桥，甲舌膜里寻喉上上海市第六人民医院ShanghaiSixthPeople’sHospital定位环甲膜Theconventionalmethod,inspectionandpalpation,hasalowsuccessrate,especiallyinwomen(24–35%).ElliottDS,BakerPA,ScottMR,etal.Accuracyofsurfacelandmarkidentificationforcannulacricothyroidotomy.Anaesthesia2010;65:889–94LambA,ZhangJ,HungO,etal.AccuracyofidentifyingthecricothyroidmembranebyanesthesiatraineesandstaffinaCanadianinstitution.CanJAnaesth2015;62:495–503上海市第六人民医院ShanghaiSixthPeople’sHospitalBarbeN,MartinP,PascalJ,etal.AnnFrAnesthReanim.2014Mar;33(3):163-6.定位环甲膜Locatingthecricothyroidmembraneinlearningphase:Valueofultrasonography?TheCTMwasaccuratelyidentifiedbypalpationandultrasoundby46%46%and100%and100%ofresidentsrespectively(P<0.05).上海市第六人民医院ShanghaiSixthPeople’sHospitalKristensenMS,TeohWH,RudolphSS,etal.BrJAnaesth.2015Jun;114(6):1003-4.定位环甲膜Structuredapproachtoultrasound-guidedultrasound-guidedidentificationofthecricothyroidmembrane:arandomizedcomparisonwiththepalpationmethodinthemorbidlyobesemorbidlyobeseWhenusingtheconventionaldigitalpalpationmethod,13of35anaesthetists(37%)wereabletolocatethecricothyroidmembranesuccessfullywithin2min,whereasthesuccessratewas29of35(83%)whenthestructuredstepwiseultrasonographymethodwasapplied(P=0.0008,McNemar’stest).上海市第六人民医院ShanghaiSixthPeople’sHospitalSiddiquiN,ArzolaC,FriedmanZ,etal.Anesthesiology.2015Nov;123(5):1033-41.定位环甲膜UltrasoundUltrasoundImprovesCricothyrotomySuccessinCadaverswithPoorlyDefinedNeckAnatomy•Ultrasoundguidancesignificantlydecreasedtheincidenceofinjuriestothelarynxandtrachea•Increasedtheprobabilityofcorrectinsertionby5.6timesincadaverswithdifficultandimpossiblelandmarkpalpation.上海市第六人民医院ShanghaiSixthPeople’sHospital外侧甲状软骨声带声带环甲膜外侧超声影像——甲状软骨、环甲膜外侧越尖峰，缺口伪影环甲膜甲状软骨声带声带伪影上海市第六人民医院ShanghaiSixthPeople’sHospital超声影像环状软骨外侧气管软骨甲状腺峡部外侧气管软骨外侧上海市第六人民医院ShanghaiSixthPeople’sHospitalUltrasound-guidedsuperiorlaryngealnerveblockandtranslaryngealblockforawaketrachealintubationinapatientwithlaryngealabscessIidaT,SuzukiA,KunisawaT,etal.JAnesth(2013)27:309–310临床应用1—清醒插管上海市第六人民医院ShanghaiSixthPeople’sHospitalSonographicallySonographicallyGuidedSuperiorLaryngealNerveBlockDuringAwakeFiberopticIntubationSawkaA,TangR,VaghadiaH.AACaseRep.2015Apr15;4(8):107-10.Sonographicallyguidedsuperiorlaryngealnerveblockmaybeusefulusefulinpatientswhereidentificationoflandmarksintheneckisdifficultdifficultasaresultofpatientanatomy临床应用1—清醒插管上海市第六人民医院ShanghaiSixthPeople’sHospital...