经左锁骨下静脉起搏脉冲引导紧急床边临时心脏起搏  

Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse

作　　者：马明远[1] 誉铁鸥[1] 方滨[1] 温伟标[1] 毛克江[1] 

机构地区：[1]广东佛山市第一人民医院ICU科,广东佛山528000

出　　处：《第一军医大学学报》2005年第5期587-588,共2页Journal of First Military Medical University

摘　　要：目的经左锁骨下静脉途径研究起搏脉冲引导行紧急床边临时心脏起搏技术的优越性及可行性.方法以Seldinger法穿刺左锁骨下静脉置入鞘管.设置起搏器频率超过患者自主心率20次/min、输出电流为5 mA、感知电压为3mV,沿鞘管推送电极至心电监护显示脉冲信号及起搏心律.结果 18例患者获良好的起搏效果(操作时间5～10min,平均6.9 min).1例患者开始时起搏效果不良,约2 h后好转;2例患者起搏效果差;后3例操作时间均超20 min.21例患者术后均无并发症.结论由起搏脉冲引导、经左锁骨下静脉行紧急床边临时心脏起搏起效迅速、成功率高且较安全.Objective To investigate the feasibility and merits of emergency bedside temporary cardiac pacing through left subclavicular vein guided by pacemaker impulse. Methods The left subclavicular vein was punctured with Seldinger technique for insertion of a cannula. After setting the rate of pacemaker at 20 beat/min above the patients' spontaneous heart rate with output current of 5 mA and sensing voltage of 3 mV, the electrode was inserted through the cannula until the electrocardiograph displaying pulsed signal and pacing rhythm. Results Good pacing was achieved in 18 patients with one having poor pacing, which was improved 2 h later. The pacing was not satisfactory in two cases. No postoperative complications occurred in the 21 patients. Conclusion Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse is rapid and ensures high success rate and safety.

关 键 词：经左锁骨下静脉 起搏脉冲引导 临时心脏起搏 床边 紧急 心脏起搏技术 操作时间 起搏器频率 静脉途径 起搏心律 脉冲信号 心电监护 无并发症 患者 优越性 min 鞘管 

分 类 号：R541.7[医药卫生—心血管疾病]