预成型电极临时心内膜起搏在院前急救中的应用

目的 探讨心电监护下直接推送预成型电极行临时心内膜起搏在院前急救中的价值.方法 18例严重心动过缓患者均在120救护车上紧急穿刺右颈内静脉或左锁骨下静脉,采用心电监护下直接推送预成型电极行心内膜临时起搏,观察耗时长短、起搏的有效性和并发症.结果 18例患者即刻心内膜起搏均成功,其中穿刺右颈内静脉13例,左锁骨下静脉5例,电极置入深度（36.2±3.0） cm,从穿刺开始到成功起搏耗时（3.5±1.5） min,最长5 min,起搏阈值（1.1±0.4） mV,所有患者均成功持续起搏并安全转运至医院进一步治疗,所有患者均无严重并发症发生.结论 120院前急救中直接推送预成型电极临时心内膜起搏抢救严重的缓慢性心律失常安全有效、操作简便.

Application of preformed electrode temporary endocardial pacing in pre-hospital emergency

Objective To investigate the value of directly pushing preformed electrode for temporary endocardial pacing under the electrocardiogram monitoring in pre-hospital emergency. Methods All 18 patients with severe bradyarrhythmias were given emergency puncture in right internal jugular vein or left subclavian vein in 120 ambulance,and then were pushed directly preformed electrode for temporary endocardial pacing under the electrocardiogram monitoring. The duration,pacing effectiveness and complications were observed. Results The immediate endocardial pacing were all successful in 18 patients,and 13 with puncture in right internal jugular vein and 5,in left subclavian vein. The depth of electrode implantation was (36.2±3.0) cm,consumed time from puncture to success pacing was (3.5±1.5) min and the longest time was 5 minutes,and pacing threshold was (1.1±0.4) mV. All patients were given successful and continuous pacing and transported safely to hospital for further treatment,and they all had no serious complications. Conclusion Preformed electrode for temporary endocardial pacing pushed directly in 120 ambulance for rescuing severe bradyarrhythmias is safe,effective and simple in handling.