三点连线法指导床边经左锁骨下静脉快速心脏起搏

将78例患者分为2组，A组40例床边经左锁骨下静脉临时心脏起搏，应用“三点连线法”指导床边经左锁骨下静脉快速心脏起搏；B组38例在X线透视下穿刺左或右侧锁骨下静脉进行临时起搏。结果示2组患者手术成功率均为100％，电极操作时间及起搏阈值无差异（P〉0．05），总抢救时间A组明显短于B组（P〈0．01）。成功后电极平均深度为“三点间连线长度＋9．0cm”。提示利用三点连线法指导床边经左锁骨下静脉快速心脏起搏时能有效缩短手术时间，适用于不同年龄、身高和体形的患者，对无自主心律和有自主心律的严重缓慢性心律失常同样有效。

Through left subclavian vein emergent cardiac pacing guided by "three-peint measurement" method

Seventy eight patients who need bedside temporary cardiac pacing through left subclavian vein were divided into 2 groups. In group A (n=40) the "three-point measurement" method was applied: a was set for puncture point of left subclavian vein, b was the middle point of angulus sterni, c was the right edge of the sternum at the 4th intercostal space, the length of ab + bc was used to estimate the depth of right atrium for electrode to reach until the success of right ventricular pacing. In group B (n=38) the puncture to the right or the left subclavian vein for temporary pacing was performed with X-ray guidance in catheter lab. Total rescuing time, procedure time and the threshold voltage of cardiac pacing was recorded in each groups. All cases were successful paced without complication related emergency cardiac pacing with a successful rate of 100% in both groups. There was not difference between two groups in the procedure time and the threshold voltage of cardiac pacing (P > 0. 05). The total rescuing time of A group was (10.0± 2.2) min, and that of B group was (30.5±3.5) min (P<0.01). The average depth of the electrode was ab + bc +9.0 cm. The results suggest that "three-point measurement" method is valuable in the guiding of bedside emergent cardiac pacing through the left subclavian vein.