床边心脏临时起搏的临床应用

A Clinical Study on Bedside Emergency Temporary Cardiac Pacing

目的总结16例经锁骨下静脉、右颈内静脉途径穿刺插管,应用气囊电极导管行床边紧急心脏临时起搏的经验。方法按改良Seldinger方法行静脉穿刺置管,按Swan-Ganz球囊导管操作方法推送气囊电极导管,在无X线透视条件下,根据心电监护仪出现室性早搏或起搏心电图判断电极进入右室,调整导管位置,行右室心内膜临时起搏。结果16例全获成功,其中右颈内静脉2例、锁骨下静脉14例,两者开始穿刺至起搏成功时间为2～15分钟。起搏效果肯定,起搏时间3～13天。全部病例未发生气胸、血胸及感染等并发症,均痊愈出院。结论本法创伤小、方便快速、安全有效、无需X线引导,值得基层急救推广应用。

Objective To investigate the efficiency of bedside emergency temporary cardiac pacing with balloon-tipped floating catheter. Methods To puncture the subclavian or right jugular vein with modified Seldinger method, then set 5F balloon-tipped floating catheter guided by the QRS morphology of pacing ECG. Results There were 16 cases in this series. All patients were successfully cured . 14 of them were punctured through the subclavian vein, 2 of them were punctured through the right jugular vein. The average operation duration (from puncturing to successfully pacing) was 2～15 minutes. No complication or adverse reaction was occurred in this series. The pacing duration of this series were from 3～13 days. Conclusion Emergency bedside temporary cardiac pacing with ball-tipped floating catheter is a safe and effective method for patients with serious cardiac arrhythmia. [