经腋静脉和锁骨下静脉途径置入起搏器电极导线的对照研究

A comparative study on implantation of endocardial electrode via axillary vein and subclavian vein approaches

目的通过与锁骨下静脉穿刺置入起搏电极进行对照研究,探讨经腋静脉穿刺置入起搏器电极导线的可行性与安全性。方法入选118例起搏器植入患者,按简单随机法分为腋静脉组(n=66)与锁骨下静脉组(n=52),分别经腋静脉途径和经锁骨下静脉途径置入起搏导线。比较两种途径置入起搏导线的穿刺成功率和并发症。结果腋静脉组与锁骨下静脉组穿刺成功率分别为95.4%(63/66)和96.2%(50/52);两组并发症发生率分别为1.5%(1/66)和5.8%(3/52),两组患者穿刺成功率和并发症发生率均无统计学差异(P均>0.05)。其中,锁骨下静脉组发生气胸3例,腋静脉组无一例发生气胸(P<0.05)。结论经腋静脉途径置入心脏起搏器导线安全可行。

Objective To compare the safety and feasibility of axillary vein and subclavian vein approaches for im- plantation of endocardial electrode. Methods A total of 118 patients underwent placement of pacemaker via axilla- ry vein approach （axillary vein group） or subclavian vein approach （subclavian vein group）. To compare the success rate and complication of two kinds of pacemaker implantation. Results The rate of success of the axillary vein and subclavian vein puncture group were 95.4% （63/66） and 96.2% （50/52）; The incidence of complication in two groups was 1.5% （1/66） and 5.8% （3/52）, two groups of patients had no significant difference in successful punc- ture rate and complication incidence rate（P〉0.05）. Among them, 3 cases of pneumothorax occurred in the subcla- vian vein group, and there was no pneumothorax in the axillary vein group （P〈0.05）. Conclusion It is safe and feasible to put the pacemaker lead through axillary vein.