起搏器脉冲引导下经左锁骨下静脉紧急床边临时心脏起搏
[Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse].
作者信息
Ma Ming-yuan, Yu Tie-ou, Fang Bin, Wen Wei-biao, Mao Ke-jiang
机构信息
Intensive Care Unit, First People's Hospital of Foshan, Foshan 528000, China.
出版信息
Di Yi Jun Yi Da Xue Xue Bao. 2005 May;25(5):587-8.
OBJECTIVE
To investigate the feasibility and merits of emergency bedside temporary cardiac pacing through left subclavicular vein guided by pacemaker impulse.
METHODS
The left subclavicular vein was punctured with Seldinger technique for insertion of a cannula. After setting the rate of pacemaker at 20 beat/min above the patients' spontaneous heart rate with output current of 5 mA and sensing voltage of 3 mV, the electrode was inserted through the cannula until the electrocardiograph displaying pulsed signal and pacing rhythm.
RESULTS
Good pacing was achieved in 18 patients with one having poor pacing, which was improved 2 h later. The pacing was not satisfactory in two cases. No postoperative complications occurred in the 21 patients.
CONCLUSION
Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse is rapid and ensures high success rate and safety.
目的
探讨在起搏器脉冲引导下经左锁骨下静脉进行床旁紧急临时心脏起搏的可行性及优点。
方法
采用Seldinger技术穿刺左锁骨下静脉并置入套管。将起搏器频率设置为高于患者自身心率20次/分钟，输出电流5 mA，感知电压3 mV，然后将电极经套管插入，直至心电图显示脉冲信号及起搏节律。
结果
18例患者起搏效果良好，1例起搏效果欠佳，2小时后改善。2例起搏效果不满意。21例患者均未发生术后并发症。
结论
在起搏器脉冲引导下经左锁骨下静脉进行床旁紧急临时心脏起搏速度快，成功率高且安全。
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