普通电极床旁临时起搏78例治疗体会  

Experience of temporary cardiac pacing by using ordinary electrode catheter at bedside in 78 patients

作　　者：李泽华[1] 关贤颂[1] 

机构地区：[1]长沙市中心医院心内科,长沙410004

出　　处：《岭南心血管病杂志》2014年第4期460-463,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的分析普通电极床旁临时心脏起搏对于心动过缓患者的应用效果及其安装过程中的注意事项及并发症处理。方法 78例缓慢型心律失常患者均在床旁非X线条件下,以改良的Seldinger法穿刺左锁骨下静脉或右锁骨下静脉或右颈内静脉,留置血管鞘。经鞘管送入6 F普通起搏电极导管到达右心室,行床旁临时起搏。结果 78例患者完全置入成功,达到有效起搏。所有患者均无血、气胸,心肌穿孔,血栓形成,心包填塞,膈肌跳动等并发症。术后2例患者发生电极脱位,1例患者植入术中发生心室颤动并术后发热,1例患者死于非起搏因素,其他患者均安全度过危险期。结论普通电极床旁临时心脏起搏在床旁操作,无需X线引导,普通电极即可达到有效起搏,患者痛苦小、创伤小、并发症发生率低,是抢救缓慢性心律失常患者的有效措施。Objectives To analyze the efficacy of temporary cardiac pacing by using ordinary electrode catheter at bedside in patients with bradyeardia, the announcements of installment process and the treatment of complications. Methods Without bedside X-ray, left subclavian vein, fight subclavian vein or internal carotid vein in 78 patients with bradycardia were punctured to input vagina vasorum by modified Seldinger technique. 6 F normal pacing electrode was posted into fight ventricle through sheathing canal to perform temporary cardiac pacing at bedside. Results Temporary cardiac pacemaker was implanted successfully in 78 patients and worked effectively. No haemothorax,aerothorax, myocardial perforation, thrombopoiesis, cardiac tamponade or beating in diaphragma occurred. All the patients survived the crises except 2 patients loosed electrode placement after surgery, 1 patient had ventricular fibrillation during surgery and had a fever after implantation, and 1 patient died of non-pacing factors. Conclusions Temporary cardiac pacing by using ordinary electrode catheter at bedside can achieve effective pacing without X-ray guidance. It is an effective measure with less pain, less trauma and lower incidence of complication to rescue patients with bradycardia.

关 键 词：心动过缓 临时起搏 锁骨下静脉 

分 类 号：R541.7[医药卫生—心血管疾病]