X线透视骨性标志定位穿刺腋静脉置入永久起搏器导线的研究

Implantation of permanent pacemaker wire by puncturing axillary vein guided by bone landmark under X-ray

目的探讨骨性标志法的可行性、安全性及实用价值。方法将125例永久起搏器植入术的患者分为骨性标志法穿刺腋静脉组(骨性标志法组,=63)和造影定位法穿刺腋静脉组(造影法组,=62),比较两组穿刺方法的穿刺次数、所用时间、成功率及并发症。结果骨性标志法组的穿刺次数及所用时间均较造影定位法组多(均<0.01),但计入造影用时后骨性标志法耗时较造影法少(<0.01)。骨性标志法组成功率及并发症发生率与造影定位法组差异均无统计学意义(均>0.05)。结论 X线透视下骨性标志定位直接穿刺腋静脉无需预先穿刺静脉造影,可节省手术时间及费用,且操作简便、安全。

Objective To investigate the feasibility, safety and practical value of bone landmark in implantation of permanent pacemaker wire by puncturing axillary vein under X-ray. Methods One hundred and twenty-five pati- ents who needed implantation of permanent pacemakers were divided into two groups： group A （puncturing axillary vein by bone landmark, n=63） and group B （puncturing axillary vein by venography, n=62）. Number of times of punc- ture, time, success rate and complications were compared.Results In group A, the number of times of puncture and the puncturing time were more than those in group B（P 〈 0.01）.However, including the time ofvenography, the total time of puncture was significantly more in group B than in group A（P 〈 0.01）.There were no differences of success rate and cornplieations between the two groups（P 〉 0.05）. Conclusions The methods of puncture axiUary vein un- der X-ray is simple, safe and reliable with high success rate.