腋静脉入路与锁骨下静脉入路起搏器植入应用比较研究  

Comparison of clinical application of axillary vein puncture and subclavian vein puncture in pacemaker implantation

作　　者：司晓云 蒋先文 吴志涛 张姝 侯艳平 李伟 李勇兵 SI Xiaoyun;JIANG Xianwen;WU Zhitao;ZHANG Shu;HOU Yanping;LI Wei;LI Yongbing(Department of Cardiology,Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550004,China;Department of Cardiology,Panzhou People′s Hospital,Panzhou,Guizhou 561601,China)

机构地区：[1]贵州医科大学附属医院心血管内科,贵州贵阳550004 [2]盘州市人民医院心血内科,贵州盘州561601

出　　处：《现代医药卫生》2020年第19期3052-3055,共4页Journal of Modern Medicine & Health

基　　金：国家自然科学基金项目(81960047);贵州省科技厅科技计划项目(黔科合平台人才〔2018〕5608);贵州省科技厅科技计划项目(黔科合支撑〔2018〕2800);贵州省科技厅科技计划项目(黔科合基础〔2019〕1260);贵州省教育厅普通高等学校科技拔尖人才支持计划项目(黔教合KY字〔2016〕070);贵州省贵阳市科技局科技计划(GY2017-34)。

摘　　要：目的基于倾向性评分匹配(PSM),比较腋静脉入路与锁骨下静脉入路起搏器植入临床应用效果。方法采用PSM方法,按1∶2最近邻居匹配法进行匹配,将2017年12月至2019年12月于盘州市人民医院行起搏器植入的患者分为腋静脉入路组(33例)和锁骨下静脉组(61例)。记录并比较患者一般信息、手术信息及回访信息等。结果匹配前,除高血压病史外,其他协变量组间标准差异绝对值均大于10%,年龄、性别、高血压病史、吸烟史数据组间差异均有统计学意义(P<0.05);匹配后,各协变量因素组间标准差异绝对值均小于10%,且协变量数据组间差异均无统计学意义(P>0.05)。手术穿刺时间组间比较差异无统计学意义(P>0.05);腋静脉组电极植入时间及X线暴露时间均短于锁骨下静脉组(P<0.05);腋静脉组并发症发生例数少于锁骨下静脉组(P<0.05);电极磨损及断裂发生例数组间比较差异无统计学意义(P>0.05)。结论腋静脉入路起搏器植入具有并发症少、X线暴露时间少等优势,值得推广应用。Objective To compare the clinical application effect of pacemaker implantation between axillary vein puncture and subclavian vein puncture based on the propensity score matching(PSM)method.Methods From Dec.2017 to Dec.2019,patients receiving pacemaker implantation in Panzhou People′s Hospital were divided into axillary vein group(33 cases)and subclavian vein group(61 cases)by using PSM method and and the nearest neighbor matching method.The patient′s baseline characteristics,surgical information and follow-up information were recorded and compared.Results The absolute value of the standard difference between the two groups of covariant was greater than 10%except for the history of hypertension patients before propensity matching,and the differences of age,gender,history of hypertension and smoking history were significantly between the two groups(P<0.05).After propensity matching,the absolute value of the standard difference of all covariant were less than 10%,and the difference of each factor was not significant between the two groups(P>0.05).The puncture time was without significant difference between the two groups(P>0.05),but the actual electrode implantation and X-ray exposure time of the axillary vein group were shorter than subclavian vein group(P<0.05).The cumulative complications in axillary vein group were lower than subclavian vein group(P<0.05).There was no significant difference in electrode wear and fracture between the two groups(P>0.05).Conclusion Pacemaker implantation via axillary vein puncture could be with advantages of fewer complication and less X-ray exposure time,which might be worthy of clinical application.

关 键 词：腋静脉 起搏器植入 并发症 

分 类 号：R459.7[医药卫生—急诊医学]