经右颈内静脉紧急床边临时心脏起搏

nmergency bedside temporary cardiac pacing though right jugular internal vein

目的 了解经右颈内静脉紧急床边临时心脏起搏的可行性和效果.方法17例缓慢心律失常的危重患者,穿刺右颈内静脉,送入起搏电极,根据体表心电图判断起搏电极是否在右心室内.结果16例起搏成功,1例因阈值过高而改在X光透视下安置成功.从穿刺至起搏成功约需时3～5min,手术时间10min左右,电极插入深度25～30cm,临时起搏保留时间3～11天.4例急性心肌梗塞患者在溶栓后,穿刺点有出血;2例出现间歇性起搏,调整后恢复正常起搏.无严重并发症.结论 经右颈内静脉紧急床边临时心脏起搏是治疗缓慢性心律失常的一种可靠有效方法.

Objective To observe the effects of emergency bedside temporary cardiac pacing through right jugular internal vein. Methods 17 patints with acute serious bradycardia and marked haemodynamic disorder were treated by using of temporary cardiac pacing through right jugular internal vein. Right ventricular pacing electrode was localised by use of superficial ECG. Results All patients were successfully paced except 1 patient. Period from puncturing to successful pacing was 3-5min, period of Ipera-tion was about 10min. Length of indwelling catheter was 25-30cm and pacing time was 3-lldays. Complications included electrode dislocation in 2 cases,bleeding of uncture poingt in 4acute myocardial infarction patients after thrombolytic threapy. Conclusion The result indicates that this technic is reliable and effective for serious bradycardia patients.