临时心脏起搏在急性心肌梗死中的临床应用

Clinical application of temporary cardiac pacing in the treatment of acute myocardial infarction

目的 研究在心电图引导下紧急临时心脏起搏对急性心肌梗死各种严重缓慢型心律失常和心跳骤停的临床疗效。方法 分别在床边急诊条件下由心电图引导和在导管室对37例急性心肌梗死合并各种严重缓慢型心律失常和心跳骤停患者通过普通双极心内膜临时起搏电极安置心脏临时起搏器。结果 床边急诊条件下由心电图引导的21例患者18例成功起搏。在导管室安置心脏临时起搏器16例,全部患者成功起搏,无并发症出现。两组差异无统计学意义（P〉0.05）。结论 在心电图引导下紧急临时心脏起搏是抢救治疗急性心肌梗死并发严重缓慢型心律失常和心跳骤停的有效方法 ,具有安全、快捷、并发症少等优点,特别适用于危重、不能搬动的病人及无导管室条件的医院。

Objective To investigate the feasibility of temporary cardiac pacing in the treatment of acute serious bradyeardia and cardiac arrest of acute myocardial infarction（AMI） by the guide of electrocardiogram. Methods Thirty - seven patients with acute serious bradyeardia and cardiac arrest of AMI were introduced temporary cardiac pacing through the common bi - pole temporary endocardium pacing electrode in ward by the guide of electrocardiogram and in cardiac catheterization room respectively. Results Eighteen patients of 21 were successfully introduced under the guide of electrocardiogram in ward, the other 16 patients were successfully introduced in cardiac catheterization room. All patients succeeded in pacing without any serious complication. The difference of mean was not significant between the two groups （ P 〉 0.05 ）. Conclusion Temporary cardiac pacing by the guide of electrocardiogram is an effective proeedure in the treatment of acute serious bradyeardia and cardiac arrest of AMI. It was reliable and safe and had low complications, especially for the critically ill patients which cannot be moved, or the hospitals without cardiac catheterization room.