无X线指导经颈外静脉漂浮球囊电极临时心脏起搏研究

目的探讨无X线透视指导下经右颈外静脉球囊漂浮电极紧急临时心脏起搏的疗效。方法 58例严重心动过缓的患者,分为A、B两组。A组,28例应用无X线透视指导下经右颈外静脉球囊漂浮电极、B组,30例应用X线透视指导下经右锁骨下静脉普通电极进行临时心脏起搏。观察两组间置管操作时间、起搏阈值、并发症等。结果右颈外静脉组(A)从穿刺开始至鞘管置入时间(置鞘时间)明显小于右锁骨下静脉组(B)(0.79±0.21)min vs(1.18±0.45)min,P0.01],从而在从穿刺开始至成功起搏的总操作时间也显著少于右锁骨下静脉组(B),另外右颈外静脉组(A)无须转运患者消耗时间。而两组的一次穿刺成功率、穿刺次数、穿刺相关并发症有显著差异。两组的起搏阈值、QRS振幅和ST段抬高水平差异无统计学意义(P0.05)。结论无X线透视指导下经右颈外静脉球囊漂浮电极的临时心脏起搏有良好起搏疗效,其操作简单、节省时间、更少穿刺相关并发症。

An investigation on the temporary cardiac pacing with Balloon - tipped floating catheter via right external jugular vein sparing X - ray

Objective To investigate the effect of urgent cardiac pacing with Balloon-tipped floating catheter,via right external jugular vein sparing X-ray. Methods A total of 58 patients diagnosed as serious bradycardia and scheduled for urgent cardiac pacing were divided into two groups:group A with balloon-tipped floating electrode leading through right external jugular vein sparing X-ray(n=28),group B with common electrode leading through right subclavian vein with the direction of X-ray(n=30).The duration of the operation,the pacing threshold,and complications were observed. Results It was shorter in group A than Group B,for the time from puncture to sheath placed(0.79±0.21 min vs 1.18±0.45 min,P<0.01),and the time from puncture to successful pacing.Group A also spared the time for patient transportation.Furthermore,Group A was superior to group B for the rate of successful first puncture,the puncture number,and the complications relating puncture.There was no significant difference between two groups according to the pacing threshold,QRS wave amplitude and ST segment elevation. Conclusion The technique of temporary cardiac pacing with Balloon-tipped floating catheter via the right external jugular vein sparing X-ray is effective,easy-operated,time-saving and safety.