切面超声下起搏器植入初探  

Primary Experience in Echocardiography guided Permanent Pacemaker Implantation

作　　者：郭涛[1] 赵淮[1] 顾云[1] 倪锐志[1] 赵玲[1] 韩明华[1] 李淑敏[1] 刘中梅[1] 肖践明[1] 吴昌元[1] 任国钧[1] 梁立权[1] 

机构地区：[1]昆明医学院第一附属医院心内科,650032

出　　处：《中国超声医学杂志》1999年第12期902-903,共2页Chinese Journal of Ultrasound in Medicine

摘　　要：目的： 探讨超声显像应用于心脏起搏器植入手术的方法和效果。方法： １１ 例有永久起搏指征的患者中， 选用ＶＤＤ １ 例， ＶＶＩ６ 例， ＶＶＩＲ ２ 例， 自动夺获型ＶＶＩ２ 例。穿刺左锁骨下静脉插入永久电极， 分别取剑下上下腔静脉长轴切面、剑下四腔切面、左侧位心尖四腔、胸骨旁四腔切面和剑下右室流出道长轴切面反复确认导管尖端经上腔静脉、右房、三尖瓣口抵达右室心尖部而非抵达室间隔中段或右室流出道并确保导管心房段留有足够弧度。测试验证永久电极的阈值、阻抗、感知性能等参数满意后结扎固定导管， 将起搏器与导管牢固连接、埋入胸前皮下囊袋。结果： １１ 例手术均顺利完成， 电极定位指标均满意。经最短３ 月、最长１５ 月随访， 起搏系统工作正常， 除 １ 例电极脱位外， 无其他并发症。结论： 超声引导下实施心脏起搏， 是一项高效、安全、简便、实用和经济的超声介入新技术， 似可作为Ｘ 线透视下永久起搏术的替代和补充， 采用多切面。Objective:To evaluate the efficiency and safety of two dimensional echocardiography(2DE) in monitoring transvenous pacemaker implantation.Methods:Transvenous pacemaker implantation was performed in 11 patients with bradycardia,2DE was used to locate endocardiac leads with multisection echoscan and dynamic echoscan during operation.Results:Procedure was successful in 11 cases and all of them improved quality of life,A displayed lead had to be reset under X ray fluoroscopy for the initial patient after nine days.No other complication occurred during the procedure and follow up.Conclusion:Permanent pacemaker implanted by aid of 2DE is safe and reliable with a rather higher successful rate.

关 键 词：超声心动图 心脏起搏器植入 起搏导管定位 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]