普通电极床旁临时心脏起搏治疗严重缓慢性心律失常的临床观察

Clinical observation of bedside temporary cardiac pacing with common electrodes treating severe bradyarrhythmia

目的探讨普通电极床旁临时心脏起搏治疗缓慢性心律失常的有效性和安全性。方法将115例患者分为床旁体表心电引导组（83例）和介入室X线引导组（32例）,通过穿刺左锁骨下静脉置入普通电极导管进行临时心脏起搏,观察手术成功率、操作时间、起搏参数及并发症。结果床旁体表心电引导83例即刻成功率100%,最后起搏成功率98.8%;从穿刺开始到起搏成功时间两组分别为（8.5±1.2）min和（7.4±1.6）min,起搏阈值为（0.87±0.31）V和（0.83±0.27）V,两组比较差异无统计意义。起搏电极留置时间3~15 d起搏和感知功能均正常,无并发症出现。结论紧急床旁经左锁骨下静脉置入普通电极导管进行临时心脏起搏安全有效,具有操作简便、时间短、并发症少等优点,便于急救。

[Objective] To investigate the safety with common electrodes treating severe bradyarrhythmia vided into bedside groups （n=83） and C-arm groups and effectiveness of bedside temporary cardiac pacing [Methods] One hundred and fifteen patients were di- （n ：32）. The successful rate of the method, pacing pa- rameters and complications were observed by Means of temporary cardiac pacing with implantation of common electrode catheter by puncturing the [eft subclavicular vein. [Results] The immediate success rate of bedside groups （n =83） was 100%, and the success rate of last pacing was 98.8%. The time from catheterizing to pac- ing successfully in two groups averaged （8.5 ±1.2） ＆ （7.4 ± 1.6） minutes respectively （P 〉0.05）, and pacing threshold （0.87±0,31） ＆ （0.83 ± 0.27） V （P 〉0.05）. The two groups of pacing and sensing function was nor- real in 3- 15 days when Detained pacing electrode, no complications occur. There was no significant differ- ence between the two groups in Success rate, period of indwelling catheters and pacing threshold （P 〉0.05）. [Conclusion] Bedside emergency temporary cardiac pacing by means of implantation of common electrode catheter by puncturing the left subclavicular vein is effective and safe, have many advantages, such as simple operation, short time of operation and less complications, and it is easy to first aid.