CAJ | 학술논문

目的：探讨静脉穿刺植入临时心脏起搏器对临床抢救高度房室传导阻滞患者的临床意义。方法对我院近3年收治的各类原发或继发高度房室传导阻滞、三分支传导阻滞或有症状的严重窦性心动过缓、窦性停搏症状的患者80例，在X线透视下，将起搏导管经右颈内静脉穿刺置入右心室，根据胸部透视和心电图图形，判断导管位置和临时心脏起搏的起搏效果。结果80例均成功经颈内静脉穿刺进行临时心脏起搏器的安置，有效起搏77例，其中心脏骤停的3例患者，均起搏有效，最终2例死亡。年龄＜65岁的患者起搏器安置成功率明显高于年龄≥65岁的患者，并且并发症的发生率也显著低于年龄≥65岁的患者（P＜0.05）。结论床旁经静脉穿刺安置临时心脏起搏器是急诊处理高度房室传导阻滞患者的重要手段，并且成功率高并发症少。
목적：탐토정맥천자식입림시심장기박기대림상창구고도방실전도조체환자적림상의의。방법대아원근3년수치적각류원발혹계발고도방실전도조체、삼분지전도조체혹유증상적엄중두성심동과완、두성정박증상적환자80례，재X선투시하，장기박도관경우경내정맥천자치입우심실，근거흉부투시화심전도도형，판단도관위치화림시심장기박적기박효과。결과80례균성공경경내정맥천자진행림시심장기박기적안치，유효기박77례，기중심장취정적3례환자，균기박유효，최종2례사망。년령＜65세적환자기박기안치성공솔명현고우년령≥65세적환자，병차병발증적발생솔야현저저우년령≥65세적환자（P＜0.05）。결론상방경정맥천자안치림시심장기박기시급진처리고도방실전도조체환자적중요수단，병차성공솔고병발증소。
ObjectiveTo investigate clinical significance of bedside temporary cardiac pacemaker surgery by venipuncture for clinical rescue degree atrioventricular block patients.Methods 80 case in the past three years with all kinds of primary or secondary level atrioventricular block, three branch block or symptoms of severe sinus bradycardia, sinus arrest symptoms were put pacing catheter through the right internal jugular vein into the right ventricle under X-ray fluoroscopy. According to chest X-ray and ECG graphics, judged the effect of pacing catheter position and temporary cardiac pacing.Results 80 cases were successfully carried out by the internal jugular vein placement of a temporary pacemaker, 77 cases were effectively paced, among them, 3 patients were cardiac arrest, they were paced effectively, finally two people died. Pacemaker placement success rate of patients <65 years old was significantly higher than patients ≥65 years old, and the incidence of complications was significantly lower than patients ≥65 years old(P<0.05).ConclusionBedside placement of temporary transvenous pacemaker puncture is an important means of emergency treatment of patients with high degree atrioventricular block, it has a high success rate and less complications.