中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2009年
12期
1313-1315
,共3页
陈凤英%崔晓迎%牛君义%单鸿伟%宋威
陳鳳英%崔曉迎%牛君義%單鴻偉%宋威
진봉영%최효영%우군의%단홍위%송위
紧急%床边%心脏起搏%临时
緊急%床邊%心髒起搏%臨時
긴급%상변%심장기박%림시
Emergency bedside%Cardiac pacing%Temporary
目的 探讨床边紧急漂浮临时心脏起搏在急诊抢救中的应用价值及优越性.方法 回顾性分析内蒙占医学院第一附属医院近4年床边紧急漂浮临时心脏起搏130例和70例x线指导下临时心脏起搏抢救各种病因引起严重的缓慢型心律失常患者.结果 130例床边紧急漂浮临时心脏起搏患者成功起搏127例(97.69%),电极未到位3例(2.31%),电极脱位3例(2.36%),无严重并发症发生.从就诊到操作开始的时间为5-15 min,穿刺到成功起搏的时间为(4 4±2.5)min;70例x线指导下临时心脏起搏患者成功70例(100%),脱位6例(8.57%),下肢静脉血栓1例(1.43%),心肌穿孔致心包填塞2例(2.86%),从就诊到操作开始的时间为30-90 min,穿刺到成功起搏的时间平均为(3.5±1.5)min.结论 应用床边紧急漂浮临时心脏起搏救治严重缓慢型心律失常方法简便、并发症少,是一种及时、安全、有效的抢救措施,可在急诊急救中推广应用.
目的 探討床邊緊急漂浮臨時心髒起搏在急診搶救中的應用價值及優越性.方法 迴顧性分析內矇佔醫學院第一附屬醫院近4年床邊緊急漂浮臨時心髒起搏130例和70例x線指導下臨時心髒起搏搶救各種病因引起嚴重的緩慢型心律失常患者.結果 130例床邊緊急漂浮臨時心髒起搏患者成功起搏127例(97.69%),電極未到位3例(2.31%),電極脫位3例(2.36%),無嚴重併髮癥髮生.從就診到操作開始的時間為5-15 min,穿刺到成功起搏的時間為(4 4±2.5)min;70例x線指導下臨時心髒起搏患者成功70例(100%),脫位6例(8.57%),下肢靜脈血栓1例(1.43%),心肌穿孔緻心包填塞2例(2.86%),從就診到操作開始的時間為30-90 min,穿刺到成功起搏的時間平均為(3.5±1.5)min.結論 應用床邊緊急漂浮臨時心髒起搏救治嚴重緩慢型心律失常方法簡便、併髮癥少,是一種及時、安全、有效的搶救措施,可在急診急救中推廣應用.
목적 탐토상변긴급표부림시심장기박재급진창구중적응용개치급우월성.방법 회고성분석내몽점의학원제일부속의원근4년상변긴급표부림시심장기박130례화70례x선지도하림시심장기박창구각충병인인기엄중적완만형심률실상환자.결과 130례상변긴급표부림시심장기박환자성공기박127례(97.69%),전겁미도위3례(2.31%),전겁탈위3례(2.36%),무엄중병발증발생.종취진도조작개시적시간위5-15 min,천자도성공기박적시간위(4 4±2.5)min;70례x선지도하림시심장기박환자성공70례(100%),탈위6례(8.57%),하지정맥혈전1례(1.43%),심기천공치심포전새2례(2.86%),종취진도조작개시적시간위30-90 min,천자도성공기박적시간평균위(3.5±1.5)min.결론 응용상변긴급표부림시심장기박구치엄중완만형심률실상방법간편、병발증소,시일충급시、안전、유효적창구조시,가재급진급구중추엄응용.
Objective To study the value and feasibility of temporary emergency bedside cardiac pacing. Method Two hundred patients with severe witnessed bradycardia were treated with temporary emergency cardiac pacing. We treated 130 patients with emergency bedside pacing and 70 patients with x-ray-guided pacing. Results Emergency bedside pacing was successful in 127 patients except three patients and no postoperative complications occurred. X-ray-guided pacing was successful in all 70 patients but three patients experienced complications: one deep venous thrombosis and two cardiac tamponades due to myocardial perforation. The pacing electrodes were more likely to be displaced in X-ray-guided pacing than in emergency bedside pacing (six cases versus three cases) . The door-to-operation time was 30-90 min for x-ray-guided cardiac pacing and 5-15 min for emergency bedside pacing. Needle-to-pacing times were similar for both procedures (3.5 ± 1.5 min for x-ray guided pacing versus 4± 2.5 min for bedside pacing). Conclusions Temporary emergency bedside cardiac pacing is a rapid, efficient and safe procedure for treating severe witnessed bradycardia. The technique is easily mastered and may prove lifesaving in an emergency.
