摘要
目的：总结经右股静脉插入导管床边紧急心脏临时起搏经验。方法：在心腔内心电图或起搏心电图的引导下，经右股静脉穿刺床边无Ｘ线显示插入起搏导管抢救危重症患者。结果：８例患者均获得成功。到达有效起搏的时间为１０～２０分钟，起搏效果恒定，持续起搏时间２～２０天。结论：此法简单、安全、效果恒定。适用于使用其它临时起搏方法后，再改用经静脉起搏方法者；病情进展稍缓慢者和无条件进行其它临时起搏方法的危重病患者；急性心肌梗塞早期或伴有室性早搏患者。操作者应特别轻柔、缓慢，术前预先注射利多卡因，以防出现心肌穿孔和室性心动过速、心室颤动等并发症。选择紧急床边心脏临时起搏方式，应根据患者病情。
Objective:To summarize the experience of bedside emergency cardiac pacing by catheterization through the right femoral vein.Methods:Directed by the intra cardiac ECG(or pacing ECG),the pacing catheter was inserted through the right femoral vein without Xray monitoring for the emergency treatment of the eight critically ill patients.Results:The emergency procedures were successfully performed in eight patients.The time of effective pacing was 10￣20 min and the effectiveness was fairly stable.Paing lasted for 2￣20days.Conclusions:This method is simple,safe and its effect is fairly stable,it is suitable for the critically ill patients who have to use the pacing after other temporary measures of pacing,as well as the patients in imminent danger whose disease evolution is slightly slow and in whom no other temporary measures of cardiac pacing are available.In the early stage of acute myocardial infarction with ventricular premature beats,the manipulation should be very gentle,and the injection of lidocaine should be given to avoid the occurrence of complications,such as myocardial perforation,ventricular tarchycardia and ventricular fibrillation.The choice of bedside emergency temporary cardiac pacing should base on multiple determinants including the disease condition of the patient,the facilities of the hospital and the technical levels of the physicians.
出处
《中国危重病急救医学》
CAS
CSCD
1997年第2期88-89,共2页
Chinese Critical Care Medicine
关键词
心脏起搏
右股静脉
插管
cardiac pacing
right femoral vein
catheterization
