优化腋静脉穿刺技术应用于心脏起搏器电极植入手术的临床研究

Clinical study on the application of optimized axillary vein puncture technique in pacemaker implantation

目的探讨优化腋静脉穿刺技术应用于心脏起搏器电极植入手术的临床研究。方法选取廊坊爱德堡医院2016年11月至2019年11月收治的60例植入永久性人工心脏起搏器治疗患者,根据静脉穿刺通路不同分为锁骨下静脉组和腋静脉组,各30例。锁骨下静脉组,单腔锁骨下静脉亚组(n=19),双腔锁骨下静脉亚组(n=11);腋静脉组,单腔腋静脉亚组(n=18),双腔腋静脉亚组(n=12);记录两组患者的手术和X线曝光时间;电极参数和手术常见并发症。结果两组单双腔亚组患者手术时间和电阻参数比较,差异无统计学意义;两组单腔亚组患者X线曝光时间比较,差异无统计学意义;双腔腋静脉亚组患者的X线曝光时间高于双腔锁骨下静脉亚组患者,差异有统计学意义;腋静脉组患者并发症发生率为10.0%高于锁骨下静脉组患者3.3%,差异无统计学意义。结论优化腋窝静脉穿刺技术植入心脏起搏器不增加术后并发症,在各项指标上与锁骨下静脉植穿刺技术比较无明显差异,可作为起搏器电极导线植入的途径之一。

Objective To explore the clinical research of optimizing axillary venipuncture in the implantation of pacemaker electrode.Method From November 2016 to November 2019,60 patients with implanted permanent pacemaker were divided into subclavian vein group and axillary vein group according to different venipuncture pathways,30 cases in each group.Subclavian vein group,single subclavian vein group(n=19),double subclavian vein group(n=11);axillary vein group,single axillary vein group(n=18),double axillary vein group(n=12);record the operation and X-ray exposure time of the two groups;electrode parameters and common complications of operation.Result There was no significant difference between the two groups in terms of operation time and resistance parameters;there was no significant difference between the two groups in terms of x-exposure time;the x-exposure time of the two groups in terms of double cava axillary vein subgroup was higher than that of the double cava subclavian vein subgroup,and the difference was statistically significant;the complication rate of the axillary vein group was 10.0%higher than that of the subclavian vein group 3.3%,the difference was not statistically significant.Conclusion Optimizing the technique of axillary vein puncture and implanting pacemaker does not increase the postoperative complications,and there is no significant difference between the technique of axillary vein puncture and subclavian vein puncture.It can be used as one of the ways of pacemaker lead implanting.