经腋静脉远段穿刺植入起搏电极导线的可行性分析  

Feasibility analysis of distal axillary vein puncture to implant pacemaker electrode wire

作　　者：张楠[1] 范晓玲 曲丽娟 郭敏[1] 孙萌[1] 王睿[1] ZHANG Nan;FAN Xiao-ling;QU Li-juan;GUO Min;SUN Meng;WANG Rui(The First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第一医院,山西太原030001

出　　处：《中国心脏起搏与心电生理杂志》2022年第1期12-14,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的依据腋静脉走行及透视下腋静脉影像定义腋静脉近远段,利用静脉造影法分别穿刺腋静脉近、远段,探索腋静脉远段穿刺植入起搏电极的安全性及可行性。方法选取于2019年5月至2020年5月于山西医科大学第一医院行心脏永久性起搏器植入的患者136例。根据起搏电极导线血管入路随机分为远段组、近段组,分别记录两组患者穿刺成功率、穿刺耗时、穿刺次数、并发症发生率等。结果远段组中68例患者,首针穿刺成功48例(70.59%),二次穿刺成功15例(22.06%),总穿刺成功63例(92.65%),穿刺次数(2.62±1.77)次,穿刺耗时29.0(20.3,38.8)s;近段组中68例患者,首针穿刺成功50例(73.53%),二次穿刺成功14例(20.59%),总穿刺成功64例(94.12%),穿刺次数(2.48±1.70)次,穿刺耗时27.0(19.3,38.5)s。两组患者首针穿刺成功率、穿刺总成功率、穿刺次数及穿刺耗时无差异。两组各有1例误入动脉;术后随访半年均无电极磨损、电极脱位等并发症发生。结论穿刺腋静脉远段作为起搏电极导线的血管入路安全可行。Objective The proximal and distal end of the axillary vein was defined according to the axillary vein route and the X-ray image of the axillary vein.Venography was used to puncture the proximal and distal of the axillary vein to explore the safety and feasibility of pacemaker electrode wire implantation by puncture at the distal axillary vein.Methods One hundred and thirty-six patients who received permanent pacemaker implantation in the First Hospital of Shanxi Medical University from March 2019 to March 2020 were selected.According to the vascular approach of pacemaker electrodes wire,the patients were randomly divided into the distal group and the proximal group.The puncture success rate,puncture time,number of puncture and incidence of complications were recorded in the two groups.Results Among the 68 patients in the distal group,48(70.59%)cases were successful in the first puncture,15(22.06%)cases were successful in the second puncture,and 63(92.65%)cases were successful in the total puncture.The number of puncture was 2.62±1.77,and the puncture time was 29.0(20.3,38.8)s.Among the 68 patients in the proximal group,50(73.53%)cases were successful in the first puncture,14(20.59%)cases in the second puncture,and 64(94.12%)cases in the total,with puncture times of 2.48±1.70 and puncture time of 27.0(19.3,38.5)s.There was no statistically significant difference between the two groups in the success rate,total success rate and time consuming of first-needle puncture,all P>0.05.There was one patient strayed into the artery in each group.There were no electrode wear,electrode dislocation and other complications in the postoperative follow-up for half a year.Conclusion It is safe and feasible to puncture the distal axillary vein to implant pacemaker electrode wire.[Chinese Journal of Cardiac Pacing and Electrophysiology,2022,36(1):12-14]

关 键 词：心血管病学 腋静脉穿刺 起搏器 电极导线 成功率 

分 类 号：R318.11[医药卫生—生物医学工程]