心力衰竭患者行漂浮导管术的安全性评价

目的：评价漂浮导管术在心力衰竭患者中的安全性。方法：入选2013年1月—2017年7月期间行漂浮导管术的心力衰竭患者，记录操作并发症和手术不良反应。结果：278例入选，平均年龄（55.4 ± 14.3）岁，其中男188例，女90例，漂浮导管术操作的平均时间为（32.4 ± 15.6）min。共24例出现了并发症或不良反应，1例因血管鞘弯折未成功行漂浮导管术，2例因术中心衰加重停止手术未成功，其余275例均成功行漂浮导管术，其中261例经右侧颈内静脉途径，14例经右锁骨下静脉途径。并发症有穿刺误入动脉10例，气胸1例，局部血肿5例，声音嘶哑1例，3度房室传导阻滞3例，上腔静脉血肿1例。无血胸、死亡等严重并发症发生。并发症和不良反应能够自行好转或经治疗后好转，无后遗症。结论：对心力衰竭患者由有经验的医师检查漂浮导管术的安全，其结果对心力衰竭患者的治疗有指导意义。

Evaluation of the safety of floating catheterization in patients with heart failure

Objective: To evaluate the safety of floating catheterization in patients with heart failure. Methods: A prospective research of patients with heart failure between January 2013 and September 2017 was performed. The complications and side effects of floating catheterization were recorded. Result: There were 278 patients enrolled with a median age of (55.4±14.3) years, in which 188 cases were male patients and 90 cases were female patients. The median time of procedure was (32.4±15.6) minutes. Incidence of complications and side effects of floating catheterization was 8.6% (24/278). There were 3 cases failed to operation because of the vascular sheath bending (one case) and the aggravation of heart failure in the procedure (two cases). The other 275 cases of procedure were successful, in which 261 cases via right internal jugular veins and 14 cases placed the sheath by right subclavian vein. There was no hemothoraxe or death related to the procedure. The complications occurred in 21 patients (7.6%) including carotid artery mistake puncture (n=10),pneumothoraxes (n=1), hematoma (n=5), hoarseness (n=1), three degree atrioventricular block (n=3) and superior vena cava hematoma (n=1) which disappeared spontaneously without hemodynamic changes. Conclusion: Floating catheterization is safe in patients with heart failure when performed by experienced operators, and its results have a guiding significance for the treatment of heart failure.