老年患者床旁快速临时起搏器安置术路径的研究

目的探讨老年患者床旁快速临时起搏器安置术路径。方法回顾性分析2009年7月至2013年2月收治于本院ICU行床旁快速临时起搏器安置术的老年患者(≥70岁)128例,其中右颈内静脉组25例、左锁骨下静脉组37例、右锁骨下静脉组27例和股静脉组39例,比较各组间植入时间、起搏器电极脱落例数、并发症等情况。结果各组间穿刺失败和起搏器电极脱落例数比较均无统计学差异。左锁骨下静脉组成功植入时间明显短于其余3组,右颈内静脉组总并发症多于股静脉组。结论从穿刺的并发症方面、起搏失败和起搏器电极脱落来说更趋向于经股静脉植入起搏器,如果出现植入困难或失败后建议行左锁骨下静脉途径。

Study on implantation path of rapid bedside temporary pacemaker in elderly patients

Objective To investigate the implantation path of rapid bedside temporary pacemaker for elderly patients. Methods Retrospective analysis of the clinical data of 128 elderly patients（age≥70 years） who were implanted with temporary pacemaker in ICU from July 2009 to February 2013 was conducted. 25 patients were implanted via right internal jugular vein（RIJV）,37 patients were implanted via left subclavian vein（ LSV）,27 cases and 39 patients were implanted via right subclavian vein（RSV）and femoral vein（FV） respectively. We evaluated the difference of operating time,the number of failure cases and complication rate between the four groups. Results No difference was found in the number of puncture failure and pacemaker shedding cases between four groups. Implanting time of LSV group was shorter than that in the other three groups. More complications occurred in the right internal jugular vein group than the femoral vein group. Conclusions Pacemaker implantation via femoral vein has the inclination of less occurrence of puncture complication,pacing failure and pacemaker shedding. Left subclavian vein path is recommended when the implantation is difficult or fails.