心外膜电信号引导技术在心包穿刺置管中的应用价值  

Application value of epicardial electrical signal guidance technology in pericardial paracentesis and catheterization

作　　者：蔡磊 尹春颖 CAI Lei;YIN Chunying(Department of Heart Care Unit,Daqing Longnan Hospital,the Fifth Affiliated Hospital of Qiqihar Medical University,Qiqihar,Heilongjiang,163453,China;Department of Cardiothoracic Surgery,Daqing Longnan Hospital,the Fifth Affiliated Hospital of Qiqihar Medical University)

机构地区：[1]齐齐哈尔医学院附属第五医院、大庆龙南医院心脏监护室,黑龙江齐齐哈尔163453 [2]齐齐哈尔医学院附属第五医院大庆龙南医院心胸外科

出　　处：《临床急诊杂志》2023年第7期374-376,共3页Journal of Clinical Emergency

基　　金：黑龙江省卫生健康委科研课题(No:20210303010047)。

摘　　要：目的:评价床旁在无B超引导下利用心外膜电信号引导心包穿刺置管的安全性及有效性。方法:回顾性分析2021年1月—2022年6月期间在我院急诊科和重症监护室实施紧急临时心包穿刺的60例中-大量心包积液患者的临床资料。随机分为2组:对照组30例,实验组30例。实验组以赛丁格技术穿刺剑突下,利用心包穿刺针的导电性与心电机电极相连接,穿刺过程中用穿刺针头端电信号的图形变化,利用“损伤电流”判断是否接触到心外膜或刺入心肌,以抽出液体为止。同期与传统的超声引导穿刺方法(对照组)在安全性、操作时间、便捷性等方面进行差异性比较。结果:60例患者均一次性穿刺引流成功,成功率100%。实验组穿刺成功平均操作时间(8.5±2.7)min,对照组在等待超声设备及人员到场后行超声引导穿刺,穿刺成功平均操作时间(38.5±22.4)min。结论:相对于超声引导穿刺,利用心外膜电信号引导技术在心包穿刺置管中具有耗时短的特点,是抢救心包积液压塞患者的有效措施。Objective:To evaluate the safety and effectiveness of bedside pericardiocentesis and catheterization guided by epicardial electrical signals without B-ultrasound guidance.Methods:A retrospective analysis was conducted on data from patients who underwent emergency cardiac puncture in our hospital from January 2021 to June 2022.They were randomly divided into 2 groups:30 cases in control group and 30 cases in experimental group.The Seidinger technique was used to puncture the xiphophidium,and the electrical conductivity of the pericardial puncture needle was connected to the electrode of the cardiac motor.During the puncture process,the electrical signal at the end of the puncture needle was changed by the pattern,and the"damage current"was used to determine whether it contacted the epicardial membrane or penetrated the myocardium to extract the fluid.At the same time,the differences of traditional ultrasound-guided puncture methods in safety,operation time and convenience were compared.Results:All 60 patients underwent successful pericardiocentesis and drainage in a single puncture,with a 100%success rate and no complications.The average operation time of successful puncture(8.5±2.7)min,the control group performed ultrasound guidance puncture after waiting for the arrival of ultrasound equipment and personnel,and the average operation time of successful puncture(38.5±22.4)min.Conclusion:Compared with ultrasound-guided puncture,the technique of epicardial electric signal guidance technology is efficient and time-consuming.It is an effective measure to rescue the hydraulic plug of pericardial effusion.

关 键 词：无B超引导 心外膜电信号 心包穿刺 定位 

分 类 号：R542.12[医药卫生—心血管疾病]