床边紧急心脏起搏与导管室内紧急心脏起搏对比观察

摘要

Objective：To compare the results of emergency tempo rary cardiac pacing via femoral vein between bedside without X-rays and in cath eter lab with X-ray.Methods：Sixty-four patients with serious bradyarrhythmia were treated temporary pacing. Webster catheter electrode was inserted into right ven tricular using Seldinger and general right heart catheter procedure, 24 cases we re urgently paced by on bedside without X-rays as bedside cardiac pacing group (BCP group);40 cases were urgently paced in catheter lab with X-ray as normal car diac pacing group (NCP group).Cardiac pacing was determine by means of provide premature, introcardiac mapping electrocardiograph and superficial pacing elect rocardiograph.Total rescuing time, procedure time, length of electroed inserted and threshold voltage of cardiac pacing in 64 was separately collected.Results：All cases were successfully paced without complication related temporary cardiac pacing. The rate of success in BCP gruop is 83%, in N CP group is 100%. The procedure time of BCP group was 10.6±3.3 min, longer tha n that of NCP group of 5.8±3.2 min (P＜0.05); the total rescuing time of B C P group was 14.6±8.7 mim, shorter than that of NCP group of 35.9±14.2 min ( P＜0.05).There was not difference between two groups in length of electrode i nserted and threshold voltage of cardiac pacing (P＞0.05).Conclusion：Under certain circumstance, bedeside emergency card iac pacing without X-ray would achieve more beneficial result.%目的：比较床边紧急心脏起搏与导管室内紧急心脏起搏对心脏聚停及过缓型心律失常抢救结果的影响，以提高临床抢救水平。方法：经右侧股静脉途径行右心室心内膜起搏，比较床边无X-线紧急起搏与导管室内紧急起搏的抢救时间、导管操作时间、置管深度、起搏阈值、并发症及成功率等结果。结果：床边起搏组的成功率为83%，导管室内起搏组为1 00%，均无发生与起搏有关的并发症。导管操作时间，床边起搏组为10.6±3.8 min长于导管室内起搏组的5.8±3.2 min(P＜0.05)；总抢救时间床边起搏组为14.6±8.7 m in；明显短于导管室内起搏组的35.9±14.2 min(P＜0.05)。置管深度、起搏阈值两组均无差异。结论：在某些条件下，经股静脉床边紧急心脏起搏可能获得更大的效益。