床旁球囊漂浮电极导管心脏临时起搏的临床观察  

A clinical study on temporary cardiac pacing using balloon-tipped floating catheter

作　　者：李淑敏[1] 刘中梅[1] 韩明华[1] 郭涛[1] 赵玲[1] 代青原[1] 

机构地区：[1]昆明医学院第一附属医院心内科,650032

出　　处：《实用心脑肺血管病杂志》2004年第1期10-12,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的　对床旁应用球囊漂浮电极导管行心脏临时起搏 176例进行总结分析 ,探讨床旁心脏临时起搏的方法学和可行性。　方法　男性 10 8例 ,女性 6 8例 ,年龄 6 1 7岁± 9 8岁 ,安置临时起搏器原因为 :Ⅱ度以上房室传导阻滞 97例 ,病窦综合征 4 8例 ,因心动过缓外科手术中保护性起搏 31例 ,所有病例选择锁骨下静脉入路安置临时起搏器 ,通过分析起搏心电图图形特点和测量导管深度 ,并对需要植入永久起搏器的 93例患者的X线透视进行研究 ,判定该起搏方法的可行性和成功率。　结果　床旁心脏临时起搏适用于各年龄组人群 ,起搏部位经左锁骨下静脉入路植入者 ,两种起搏点的导管深度分别为 36 8cm± 2 7cm及 34 8cm± 3 3cm ,5例右锁骨下静脉入路者为右心室心尖部。其起搏点的导管深度 31 5cm± 3 1cm ,通过起搏心电图图形和导管深度指导下 ,应用球囊漂浮电极导管即刻成功率 10 0 %。 1例发生左侧气胸 ,发生率 1 7%。　结论　体表心电图和导管深度指导下应用球囊漂浮电极导管进行床旁心脏临时起搏是一项安全有效、可行的起搏方法 ,只要操作方法正确 ,可替代X线指导下的临时起搏 ,值得临床推广。Objective To investigate the methodology and feasibility of bedside temporary cardiac pacing with balloon tipped floating catheter Methods One hundred and seventy six patients(male 108,female 68,mean age 61 7±9 8 years old) in this study were treated with bedside temporary cardiac pacing for arrhythmias Among them there were 97 cases with atrioventricular block(overⅡ°),48 cases with sick sinus syndrome and 31 cases with bradycardia who conducted protective pacing for operation A balloon tipped floating catheter was inserted through the left subclavine vein in right ventricle,guided by the length of catheter in body and the QRS morphology of pacing electrocardiogram(ECG) After that,the pacing site was identified by X ray fluoroscopy in 93 patients Then,the feasibility and successful rate of this bedside temporary cardiac pacing were analyzed Results Guided by length of catheter and the QRS morphology of pacing ECG,the instant successful rate of balloon tipped floating catheter putted into right ventricle was 100% The most successful pacing site were located at the right ventricular apex(RVA) and right ventricular outflow tract(RVOT) The length of catheter from the puncture sites to RVA and RVOT were 37 53cm±3 52cm and 34 21cm±3 15cm,respectively One patient occur left pneumothorax,the rate of complication was 1 7% Conclusion Guided by the length of catheter and QRS morphology of pacing ECG,the balloon tipped floating catheter can be safety used for bedside temporary cardiac pacing for patients with different age with a higher successful rate

关 键 词：球囊漂浮电极导管 心脏临时起搏 方法学 可行性 心律失常 锁骨下静脉 

分 类 号：R654.2[医药卫生—外科学]