床旁心脏临时起搏术在ICU的临床应用

目的探讨并总结床旁临时心脏起搏成功救治危重症患者心脏急症的经验。方法对340例伴发多种类型心律失常的患者在动态心电监测下采用床旁经锁骨下静脉穿刺法行心脏临时起搏器安置术。评估临床可操作性、适应症、起搏后疗效、术中及术后并发症及处理等。结果 318例次经床旁盲插导管成功,成功率93.5%。平均操作时间3~15 min。应用于心脏疾病及心脏疾病以外因素导致的心律失常的急救,导管置入都能成功起搏心脏。起搏器安置术中、起搏应用过程中发生室颤、心脏穿孔、血气胸、导管脱落以及感知起搏不良等相关并发症25例,占7.35%。结论床旁临时心脏起搏术在心脏急症的治疗中具有快捷、损伤小、灵活性高、疗效好以及并发症少等特点,为危重症患者的综合救治成功的基础。

The bedside temporary cardiac pacing in the clinical application of ICU

【Objective】 To investigate and summarize bedside temporary cardiac pacing with successful treatment of critically ill patients with cardiac emergency experience.【Methods】 340 cases associated with many types of arrhythmias in patients with Holter monitoring bedside through the subclavian vein puncture the temporary cardiac pacemaker implantation.To assess clinical operability and indications for pacing efficacy,intraoperative and postoperative complications and treatment.【Results】 318 cases by the bedside blind intubation catheter success,the success rate is 93.5%.The average operating time is 3~ 15min.First-aid applied to factors other than heart disease and heart disease caused by arrhythmia,the catheter can be successful pacing the heart,pacemaker implantation,ventricular fibrillation,pacing applications,cardiac perforation,pneumothorax,catheter loss,perceived adverse pacing-related complications in 25 cases,accounting for 7.35%.【Conclusion】 The bedside temporary cardiac pacing in the treatment of acute heart is a successful treatment for critically ill patients based.It has quick,little injury,high flexibility,good curative effect,less complications and other characteristics.