超声引导下腋静脉穿刺术在心脏植入式电子装置植入术的应用

Application of Ultrasound-guided Axillary Vein Puncture During Cardiac Implantable Electronic Device Implantation

目的:探索实时超声引导下腋静脉穿刺在心脏植入式电子装置植入术中的应用。方法:回顾性分析我院2019年4月至2021年3月经腋静脉途径行心脏植入式电子装置植入术患者共130例。其中46例患者应用实时超声引导下腋静脉穿刺方法行心脏植入式电子装置植入术(超声组),84例患者应用解剖定位法行腋静脉穿刺行心脏植入式电子装置植入术(对照组),对比两组手术并发症发生率。结果:超声组与对照组相比,气胸发生率(0%vs.3.6%,P=0.493)、囊袋血肿发生率(2.2%vs.2.4%,P=1.000)、囊袋感染发生率(0%vs.2.4%,P=0.539)、电极脱位发生率(0%vs.2.4%,P=0.539)、电极穿孔发生率(0%vs.1.2%,P=1.000)及总体手术并发症发生率(2.2%vs.11.9%,P=0.115)差异均无统计学意义。结论:超声引导下腋静脉穿刺术在心脏植入式电子装置植入术中应用是安全、可行的。

Objectives:To evaluate the feasibility of real-time ultrasound-guided axillary vein puncture during cardiac implantable electronic device implantation.Methods:Present study enrolled 130 patients,who underwent cardiac implantable electronic device implantation by axillary vein access in our hospital from April 2019 to March 2021.Axillary vein punctures were performed under the guidance of real-time ultrasound(ultrasound group)in 46 patients and anatomy guidance(control group)in 84 patients.Results:Pneumothorax rates(0%vs.3.6%,P=0.493),pocket hematoma rates(2.2%vs.2.4%,P=1.000),pocket infection rates(0%vs.2.4%,P=0.539),electrode dislocation rates(0%vs.2.4%,P=0.539),electrode perforation rates(0%vs.1.2%,P=1.000)and total complication rates(2.2%vs.11.9%,P=0.115)were similar between the two groups.Conclusions:Ultrasound-guided puncture of axillary veins is safe and feasible in cardiac implantable electronic device implantation.