床旁无X线无漂浮球囊电极安置临时起搏器的效果

目的评价床旁无X射线导引安置临时起搏器的安全性及有效性。 方法选择云南师范大学医院2013年4月至2017年12月期间有安置临时起搏器指征的患者，主要纳入病态窦房结综合征的患者，根据患者及家属意愿分为X线导引组（A组）157例，床旁无X线无漂浮球囊电极组（B组）157例，采用t检验比较2组患者的手术时间及起搏阈值的差异，采用χ²检验比较2组患者手术成功率及并发症的差异。 结果A组与B组患者手术时间［（22±12）min vs （23±14）min］、成功率（100% vs 99.3%）及起搏阈值［（0.97±0.32）V vs（0.97±0.35）V］比较，差异均无统计学意义（t=0.050、χ²=1.003、t=0.000，P均>0.05）。B组1例患者右心房显著增大伴三尖瓣畸形者未成功置管，改导管室X线引导下成功安装。 结论床旁无X射线无漂浮球囊电极安置临时起搏器一样安全高效，但极少数特殊疑难病例，如右心房显著增大、三尖瓣狭窄及畸形等宜选用X射线定位下安装临时起搏器。

Clinical application of bedside temporary pacemaker without X-ray guidance and balloon-tipped floating catheter

ObjectiveTo evaluate the safety and efficacy of temporary pacemaker without X-ray guidance. MethodsPatients with indications for temporary pacemaker (mainly those with sick sinus syndrome) treated at Department of Internal Medicine of Yunnan Normal University Hospital from April 2013 to December 2017 were studied. The patients were divided into two groups: 157 cases using temporary pacemaker with X-ray guidance (group A) and 157 cases using temporary pacemaker without X-ray and balloon-tipped floating catheter (group B). The t-test was used to compare the difference in operation time and pacemaker threshold between the two groups, and χ² test was used to compare the success rate and complications between the two groups. ResultsThere was no statistical difference (t=0.050、χ²=1.003、t=0.000, P all>0.05) between groups A and B in operation time (22±12) min vs (23±14) min], success rate (100% vs 99.3%), and pacing threshold (0.97±0.32)V vs (0.97±0.35)V]. Failed operation occurred in one patient in group B with right atrium dilation and Ebstein′s anomaly, but a success was achieved under the guidance of X-ray. ConclusionBedside temporary pacemaker without X-ray guidance is as safe and efficient as that guided by X-ray, but the latter is better for patients with special difficulties, namely, enlarged right atrium, tricuspid stenosis, and Ebstein′s anomaly.