摘要
目的经皮腋静脉穿刺术在植入型心脏永久起搏器术中的安全性、有效性。方法方便选取该院在2013年1月—2014年12月期间首次植入心脏永久双腔起搏器的患者105例,将患者随机分为锁骨下静脉穿刺组(n=52)和腋静脉穿刺组(n=53);所有手术均由同一术者完成操作。观察术中血管穿刺时间、电极植入时间、X线曝光时间、并发症气胸、误穿动脉发生率。术后2年随访观察起搏电极磨损、断裂发生率。结果与锁骨下静脉穿刺途径相比,腋静脉穿刺途径的血管穿刺时间略长[(95.95±13.58)s vs(61.23±14.00)s](P<0.05);电极植入时间较少[(179.83±37.61)s vs(225.39±51.53)s](P<0.05;X线曝光时间较少[(129.79±26.54)s vs(152.56±36.20)s](P<0.05);并发症发生率差异无统计学意义,但锁骨下静脉穿刺途径组出现气胸;锁骨下静脉穿刺途径组术后2年出现电极磨损、断裂。结论经皮腋静脉穿刺途径植入心脏永久起搏器具有安全、可靠、易掌握等优点,减少电极植入时间、X线曝光时间,减少起搏电极磨损、断裂。
Objective This paper tries to explore the safety and efficacy of percutaneous axillary vein puncture in patients implanted permanent pacemaker.Methods During the period of January 2013 and December 2014,105 cases with first permanent cardiac pacemaker implantation were convenient selected and randomly divided into two groups： the subclavian vein puncture group（n=52） and the axillary vein puncture group（n=53）.After implantation of heart pacemaker by the same operator,the time of blood vessel puncture,the time of electrode insertion,the time of X-ray exposure,the incidence of complications of pneumothorax,and the incidence of false perforating artery were recorded,compared and analyzed.After 2 years follow-up,the rate of wear and fracture of pacing electrode was observed.Results Compared with the way of subclavian vein puncture,puncture time of axillary venous puncture was slightly longer of [（95.95±13.58） s vs（61.23±14.00）s]（P〈0.05）; the electrode implantation time was shorter of [（179.83±37.61）s vs（225.39±51.53）s]（P〈0.05）; X-ray exposure time was shorter of [（129.79±26.54）s vs（152.56±36.20）]s（P〈0.05）; and complications all were of no statistical difference between two groups; but subclavian vein puncture group had pneumothorax in operation and after 2 years follow-up,it had the electrode wear and fracture.Conclusion Percutaneous axillary vein puncture is a safe,reliable and easy to master and so on,which reduce the time of electrode implantation and of X-ray exposure,and reduce the wear and fracture of the pacing electrode.
出处
《中外医疗》
2017年第28期115-117,共3页
China & Foreign Medical Treatment
关键词
心血管病学
心脏永久起搏器
腋静脉穿刺术
锁骨挤压综合征
电极磨损、断裂
Cardiology
Cardiac permanent pacemaker
Axillary vein puncture
Clavicle crush syndrome
Pacing electrode wear and fracture
