超声引导下床边起搏器植入术：心脏急症的救命技术。
Ultrasound-guided pacemaker implantation at the bedside: A lifesaving technique for cardiac emergencies.
机构信息
Department of Ultrasound Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Ultrasound Medicine, National RegionalMedical Center, Binhai Campus of the First Affiliated Hospital Fujian Medical University, Fuzhou, China.
出版信息
Ann Noninvasive Electrocardiol. 2023 Sep;28(5):e13071. doi: 10.1111/anec.13071. Epub 2023 Jul 19.
OBJECTIVE
To investigate the safety and effectiveness of implanting temporary pacemakers using ultrasound-guidance at the bedside for rescuing patients in case of cardiac emergencies.
METHODS
We enrolled 194 patients with cardiac emergencies requiring temporary pacemakers in this study, and randomly assigned them to either a bedside ultrasound-guided installation group or an electrocardiogram-guided installation group. There were 105 cases in the bedside ultrasound-guided installation group, aged approximately 66.3 ± 10.2 years, and 89 cases in the electrocardiogram-guided installation group, aged approximately 65.8 ± 9.5 years old, and disease composition was similar between the two groups. We then compared the duration of the procedure, success rates, and occurrence of adverse events between the two groups.
RESULTS
The two groups showed similar clinical characteristics. The success rates of venipuncture and temporary pacemaker electrode placement were both 100% in the bedside ultrasound-guided installation group, compared to 87.8% and 96.7% respectively, in the electrocardiogram-guided installation group, with a statistically significant difference between the two groups. The duration of puncture was significantly shorter in the bedside ultrasound-guided installation group than in the electrocardiogram-guided installation group, with statistically significant differences. Moreover, no adverse events such as hematoma, pneumothorax and electrode dislodgement occurred in the bedside ultrasound-guided installation group, while 13 cases in the electrocardiogram-guided installation group experienced adverse events, and the difference was statistically significant.
CONCLUSIONS
The bedside installation of temporary pacemakers using ultrasound guidance is a simple, safe, effective, and cost-efficient procedure that boasts a high success rate, does not involve radiation, and enables accurate placement of the electrode catheter.
目的
研究使用床边超声引导植入临时起搏器抢救心脏急症患者的安全性和有效性。
方法
本研究共纳入 194 例需要临时起搏器的心脏急症患者，随机分为床边超声引导安装组和心电图引导安装组。床边超声引导安装组 105 例，年龄约 66.3±10.2 岁；心电图引导安装组 89 例，年龄约 65.8±9.5 岁，两组疾病构成相似。比较两组手术时间、成功率及不良事件发生情况。
结果
两组患者临床特征相似。床边超声引导安装组的静脉穿刺和临时起搏器电极放置成功率均为 100%，明显高于心电图引导安装组的 87.8%和 96.7%，差异有统计学意义。床边超声引导安装组穿刺时间明显短于心电图引导安装组，差异有统计学意义。床边超声引导安装组无血肿、气胸、电极脱位等不良事件发生，心电图引导安装组发生 13 例不良事件，差异有统计学意义。
结论
床边超声引导临时起搏器安装操作简单、安全、有效、经济，成功率高，无辐射，电极导管定位准确。
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