新的"盲法"腋静脉穿刺术在起搏器植入术中的有效性和安全性  

Feasibility and safety of new"blind"axillary vein puncture technique in pacemaker implantation

作　　者：张俊蒙[1] 王泽峰 李海宴 吴永全 Zhang Junmeng;Wang Zefeng;Li Haiyan;Wu Yongquan(Department of Cardiology,Capital Medical University Affiliated Beijing Anzhen Hospital,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]北京市心肺血管疾病研究所首都医科大学附属北京安贞医院心内科,100029

出　　处：《中华心血管病杂志》2019年第9期737-741,共5页Chinese Journal of Cardiology

摘　　要：目的探索一种更简单、快捷,仅通过体表标志进行腋静脉穿刺的方法,并分析其有效性和安全性。方法回顾性分析北京安贞医院2018年1至11月接受起搏器植入的患者110例。收集患者性别、年龄、主要诊断,植入起搏器类型和是否行希浦系统起搏等基本临床信息。起搏器植入术中,采用新的"盲法"腋静脉穿刺术建立深静脉通路,观察其穿刺成功率、穿刺相关并发症以及技术参数。结果110例患者,男性58例(52.7%),年龄(70.26±10.45)岁;其中105例成功用"盲法"腋静脉穿刺术穿刺,成功率为95.5%(105/110),该穿刺法重要参数a、b两点间距离为(3.89±0.40)cm,第一个进针角度α为(25.84±5.54)°和第二个进针角度β为(66.18±10.26)°。术后未发生血肿、气胸和血胸等穿刺相关并发症。结论新的"盲法"腋静脉穿刺技术是一种简单、有效和安全的穿刺方法。Objective To explore the feasibility and safety of a newly developed simple and rapid axillary vein puncture technique based on the surface landmarks for pacemaker implantation.Methods From January to November 2018,we enrolled 110 patients who underwent pacemaker implantation in Beijing Anzhen Hospital.Basic clinical characteristics,such as gender,age,major diagnosis,type of pacemaker,and His-purkinje system pacing,were collected.The success rate of this axillary vein puncture technique,complications,and technical parameters of present puncture method were analyzed.Results There were 58(52.7%)male patients in this cohort and the average aged was(70.26±10.45)years old.This"blind"axillary vein puncture method was successful in 105 out of 110 patients(95.5%).The relevant puncture-related parameters included:the distance between points"a and b"was(3.89±0.40)cm,the first angleαwas(25.84±5.54)°and the second angleβwas(66.18±10.26)°.There were no puncture-related complications,such as hematoma,pneumothorax and hemothorax.Conclusion The new"blind"axillary vein puncture approach is a simple,effective and safe technique for pacemaker implantation,which is easy to learn and practice and suitable for promotion.

关 键 词：心脏起搏器 人工 腋静脉 穿刺术 

分 类 号：R654.2[医药卫生—外科学]