【摘要】 目的探讨紧急床边临时心脏起搏器安装术快速有效的电极静脉入路,分析不同静脉入路的优缺点。方法选择150例严重缓慢心律失常伴血流动力学障碍,阿-斯综合征发作的患者分为左锁骨下静脉组(A组)、右颈内静脉组(B组)和右股静脉组(C组),在无X线透视下行紧急床边临时心脏起搏术,比较三组起搏成功率、起搏操作总时间、起搏耗时、成功起搏的置管次数和并发症等方面的差异。结果 A组起搏成功率(98%)明显高于B组(82%)和C组(64%)(P<0.01);操作总时间A组(5.01±0.34)min最短,B组(10.93±0.26)min次之,C组(15.26±2.51)min最长;A组起搏耗时、成功起搏的置管次数明显优于B组和C组(P<0.01);A组并发症发生率低于C组(P<0.01)。结论紧急床边临时心脏起搏器安置术经左锁骨下静脉入路起搏成功率高,减少置管次数及并发症,缩短手术时间,提高抢救成功率,在临床中可首选。更多还原

【Abstract】 Objective To investigate the disavantege and advantage of different venous access for planting electrode of cardiac pacemaker on emergent beside.Methods Selected 150 patients with severe chonic arrhythmia associated with hemodynanmics disorders,with the attack of Adams-Stokes Syndrome.All the patiens underwent planting electrode of cardiac pacemaker on emergent beside without X-ray fluoroscopy,on the basis of these all the patients were randomized allocated to three groups,i.e.through the pathways of the left clavian vein(group A),the right jugular vein(group B) and the right femoral vein(group C),respectively.Compared of the successful pacing rates,the overall time of operation pacing,pacing time-consuming,the frequency of catheter placement and the complication among the three groups.Results The successful pacing rate in group A(98%) was obviously higher than those in group B(82%) and higher than those in group C(64%)(P<0.01).The overall time of operation pacing in group A was(5.01±0.34)min,which was the shortest among the three groups;group B followed it,which was(10.93±0.26) min;group C was the lasted,which was(15.26±2.51)min,in group A,pacing time-consuming,the frequency of catheter placement were superior to those in group B and group C(P<0.01).The complication rate in group A was lowred than that in group C(P<0.01).Conclusion Urgent beside cardiac pacemaker implantation via left subclavian vein is preferred in the clinical.It is a highly successful rate,less complication,less frequency of catheter placement,shortened the operation time so to improve the survival rates.更多还原