非X线指导下经左锁骨下静脉紧急临时心脏起搏

Emergency Temporary Pacing Through Subclavicular Vein Without the Direction of X Ray

对１８例急性重症缓慢心律失常合并严重血液动力学障碍患者，施行非Ｘ线透视指导下经左锁骨下静脉床边紧急临时心脏起搏，以体表心电图判定起搏情况及电极在右室的位置。１８例起搏均获成功，平均手术时间１６．９±２．５ｍｉｎ、平均穿刺至起搏成功时间６５±５０ｓ、平均电极留置长度２９．９±２．７ｃｍ。对提高穿刺成功率、防止误穿锁骨下动脉、防止电极误入颈内静脉等进行了讨论。

By using bedside emergency temporary cardiac pacing through left subclavicular vein without the direction of X ray,18 patients suffered from acute serious bradycardia and marked haemodynamic discorder were treated.The pacemaker electrode position in right ventricle and cardiac pacing could be estimated by use of superficial ECG.All patients were successfully paced.Period of operation was 16.9±2.5 min,period from puncturing to successful pacing was 65±50 s and length of indwelling catheter was 29.9±2.7 cm.In this paper,how to improve the success rate of puncture,prevent misleading the catheter into subclavicular artery of vein were discussed.