经皮床旁漂浮电极导管心脏临时起搏的临床观察

Clinical comparison between bedside percutaneous floating catheter temporary cardiac pacing and X-ray guided temporary cardiac pacing

目的探讨应用经皮床旁球囊漂浮起搏电极导管心脏临时起搏(非透视下起搏)的临床疗效,比较其与X线透视下普通起搏电极导管心脏临时起搏(透视下起搏)在成功率、安全性及操作时间上的差异。方法21例应用非透视下起搏,全部选择左锁骨下静脉途径置入起搏电极导管至右心室;透视下起搏24例,其中,14例选择左锁骨下静脉路径,10例选择右侧股静脉途径。结果非透视下起搏21例成功20例,透视下起搏24例全部成功,无一例出现血管损伤、血气胸、栓塞、心脏穿孔等并发症。两种方法在成功率、室性心律失常发生率及操作时间上差异均无统计学意义(P>0.05)。结论与透视下起搏相比,非透视下起搏无需X线引导,也不需要特殊器械,具有床旁、快速、微创、插管时间短、术中室性心律失常发生率低,不受环境条件限制等众多优点,可实施现场急救,是一项安全有效、可行的起搏方法。

Objective To compare the clinical values in success rate, safety and procedure time between bedside percutaneous floating catheter temporary cardiac pacing and X-ray guided temporary cardiac pacing. Methods Forty-five patients were included in this study, of whom, 21 patients received bedside percutaneous floating catheter temporary cardiac pacing via left subclavian vein. 24 patients underwent X-ray guided temporary cardiac pacing, of whom, 14 via the left sabelavian vein approach and 10 through the right femoral vein approach. Results Twenty of 21 patients in bedside pacing group and all patients in X-ray guided pacing group were successfully paced. No blood vessel damage, haemopneumothorax, embolism or cardiac perforation occurred in both groups. The success rate and procedure time were similar in two groups （P 〉 0. 05 ）. Conclusion Bedside pereutaneous floating catheter temporary cardiac pacing is safe, effective and feasible.