CAJ | 학술논문

目的经下腔静脉(IVC)放置冠状静脉窦(CS)电极导管理论上存在减少操作者放射剂量的可能性.本文在对比经IVC可调弯电极导管与经上腔静脉(SVC)固定弯电极导管置入CS操作的可行性和操作者所受的放射剂量.方法 202例患者,经下腔静脉组(IVC组)122例、经上腔静脉组(SVC组)80例,两组患者年龄、性别、超声心动图和心律失常类型方面差异均无统计学意义.IVC组采用可控弯10极电极导管,SVC组使用固定弯10极电极导管,由同一组术者操作.记录两组患者导管放置时曝光时间,并测定操作者所受放射剂量.结果 IVC组122例患者中有2例电极导管不能到位,改经SVC途径仍未成功;SVC组80例全部放置成功.两组平均每例曝光时间相似[(105±12)s vs(108±19)s;P=0.925].单位时间所受放射剂量平均值在IVC组为0.25×10-2uGy/s,SVC组为1.38×10-2uGy/s.IVC组和SVC组操作者平均每例接受放射剂量分别为(0.30±0.04)uGy和(1.49±0.27)uGy(P＜0.001).两组皆未发现心脏和血管并发症.结论与固定弯电极导管经SVC途径比较,可控弯电极导管经IVC途径置入CS电极导管的单位时间放射量明显降低,在不增加操作时间的同时可显著减少操作者所受放射剂量.
목적 경하강정맥(IVC)방치관상정맥두(CS)전겁도관이론상존재감소조작자방사제량적가능성.본문재대비경IVC가조만전겁도관여경상강정맥(SVC)고정만전겁도관치입CS조작적가행성화조작자소수적방사제량.방법 202례환자,경하강정맥조(IVC조)122례、경상강정맥조(SVC조)80례,량조환자년령、성별、초성심동도화심률실상류형방면차이균무통계학의의.IVC조채용가공만10겁전겁도관,SVC조사용고정만10겁전겁도관,유동일조술자조작.기록량조환자도관방치시폭광시간,병측정조작자소수방사제량.결과 IVC조122례환자중유2례전겁도관불능도위,개경SVC도경잉미성공;SVC조80례전부방치성공.량조평균매례폭광시간상사[(105±12)s vs(108±19)s;P=0.925].단위시간소수방사제량평균치재IVC조위0.25×10-2uGy/s,SVC조위1.38×10-2uGy/s.IVC조화SVC조조작자평균매례접수방사제량분별위(0.30±0.04)uGy화(1.49±0.27)uGy(P＜0.001).량조개미발현심장화혈관병발증.결론 여고정만전겁도관경SVC도경비교,가공만전겁도관경IVC도경치입CS전겁도관적단위시간방사량명현강저,재불증가조작시간적동시가현저감소조작자소수방사제량.
Objective To evaluate and compare the dosages of operator-incurred-radiation during the implantation of coronary sinus (CS) catheter between the approaches through inferior vena cava (IVC) with the steerable catheter and through supra vena cava (SVC) with the fixed curve catheter. Methods Two hundred and two patients were divided into two groups according to the different approaches of CS catheter insertion. IVC group (n = 122) :a deca-polar catheter with steerable curve was placed into CS through the femoral vein and the IVC. SVC group (n =80) :a fixed curve deca-polar catheter was inserted into CS through the jugular vein and the SVC. There was no obvious difference in gender, age, and echocardiogram between the two groups. All procedures were performed by the same three operators. The exposure time of each case and the dosage of operator-incurred-radiation during the procedure were measured. Results The catheters were positioned successfully inl20 patients in the IVC group and in all patients in the SVC group. The 2 failured in the IVC group were also failed in by attempting through SVC with fixed curve catheter. There was no significant difference in the exposure time between IVC group and SVC group[( 105 ± 12)s and ( 108 ± 19)s,P =0. 925]. The per sec operator-incurred-radiation was 0. 25 × 10-2 uGy/s in WC group and 1.38 × 10 -2 uGy/s in SVC group. This lead to significant decrease in the dosage of operator-incurred-radiation in IVC group[(0. 30 ± 0. 04) uGy vs ( 1.49 ±0. 27) uGy,P ＜ 0. 001]. No cardiac or vascular complication was observed in both groups. Conclusions Insertion of coronary sinus catheter through IVC with the steerable catheter is associated with significantly less radiation than that through SVC with the fixed curve catheter without increasing time of the procedure.