床边经股静脉临时起搏器抗心律失常的应用分析

目的探讨床边经股静脉心脏临时起搏器植入在危重症急救中的应用意义。方法床边经股静脉植入心脏临时起搏器患者55例,男42例,女13例,年龄17～81岁。其中,冠心病心肌梗死20例,病毒性心肌炎9例,扩张型心肌病11例,心外科术后6例,脑外伤9例。心律失常分类：病窦综合征15例,显著窦性心动过缓13例,Ⅲ度房室传导阻滞9例,恶性室性心律失常8例,室性自主心搏2例,心肺复苏心脏电复律后5例,心脏术后顽固性室上性心动过速发作药物治疗无效3例。全部患者行床边经股静脉植入心脏临时起搏器。结果所有患者心脏临时起搏器植入均获得成功,无并发症。5例患者心电监护可见起搏脉冲信号,其后未见心室电活动,心脏听诊无心音,血压测不出,心肺复苏失败。结论在危重症急救中床边经股静脉植入心脏临时起搏器,方法便捷,可提高抢救成功率,不影响其他抢救措施进行,无严重并发症,值得在各种急救场合推广应用。

The application analysis of urgently bedside temporary pacemaker implanted through femoral vein for arrhythmia

Objective To discuss the clinical application of urgently bedside temporary pacemaker implanted through femoral vein for arrhythmia in critical patients. Methods Fifty-five patients （ male 42, female 13, aged 17 - 81 years） were received urgent implantation of bedside temporary pacemaker through femoral vein, including 20 patients with myocardial infarction （MI） , 9 with viral myocarditis （VM） , 11 with dilated cardiomyopathy, 6 with pro-cardiosurgery and 9 with cerebral trauma respectively. Classification of arrhythmias in the patients included： sick sinus syndrome 15, severe bradycardia 13, atrioventricular heart-block type III 9, malignant ventricular arrhythmias 8, idio-ventricular rhythm 2, post-resuscitation 5 and refractory supraventricular tachycardia with no medicine treatment after heart operation 3 respectively. All patients were received bedside temporary pacemaker implantation via femoral vein urgently. Results The implantations performed successfully in all patients with no complication. Five cases got failure treatment because of no ventricular electrical activity, no heart sound of cardiac auscultation, and blood pressure could not be determined. Conclusion The implantation of urgently bedside temporary pacemaker through femoral vein in critical patients was safety and convenient with higher survival rate, has no affect on the other rescues and no serious complications. We suggested that urgently bedside temporary pacemaker implanted through femoral vein apply on various first aid situations.