新的盲法腋静脉穿刺("两点两线"法)与锁骨下静脉穿刺在心脏植入装置植入手术中的对比研究
A comparative study of new blind axillary vein puncture(the"two points and two lines")method and subclavian vein puncture in implantation of cardiac implantable electronic device
张艺民 1陈梦娜 1史婧 1张旭 1戈晓珍 1张俊蒙2
作者信息
- 1. 清华大学第一附属医院心内科(北京 100016)
- 2. 清华大学附属垂杨柳医院心内科(北京 100022)
- 折叠
摘要
目的 通过与锁骨下静脉穿刺进行对照研究,探讨新的盲法腋静脉穿刺技术("两点两线"法)在心脏植入装置植入手术中的可行性与安全性.方法 根据《2013 ESC心脏起搏和心脏再同步化治疗指南》植入指征入选接受心脏植入装置植入患者(年龄≥18岁),分为腋静脉组与锁骨下静脉组,分别采用新的盲法腋静脉穿刺法("两点两线"法)和锁骨下静脉穿刺法建立血管通路并置入起搏导线.比较两种穿刺方法的成功率、穿刺次数、穿刺时间和并发症发生率.盲法腋静脉穿刺法首先确定沿肌间沟走行的A线,再确定与之平行的B线,最后在B线上确定穿刺点,在操作过程中记录腋静脉穿刺进针角度α、β.结果 共纳入90例患者,其中男性50例,年龄(74.61±12.29)岁,其中腋静脉组45例,锁骨下静脉组45例.两组穿刺成功率分别为93.3％和95.6％;两组穿刺成功所需次数分别为(1.35±0.66)次和(1.30±0.64)次,两组穿刺成功所需时间分别为(44.5±15.8)s和(46.1±15.3)s,两组并发症发生率分别为4.5％和6.7％,两组间成功率、穿刺成功所需次数、穿刺成功所需时间及并发症发生率无差异(P＞0.05).腋静脉穿刺进针角度α为(25.79±3.95)°,进针角度β为(65.02±9.14)°.结论 新的盲法腋静脉穿刺法("两点两线"法)在心脏植入装置植入手术中是安全可行的.
Abstract
Objective To compare the feasibility and safety of new blind axillary vein puncture(the"two points and two lines")method and subclavian vein puncture for implantation of cardiac implantable electronic device.Methods Accord-ing to the 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy,patients(aged ≥18 years)under-going cardiac implantable electronic device implantation were divided into axillary vein group and subclavian vein group.The new bland axillary vein puncture-the"two points and two lines"method and subclavian vein puncture were used to estab-lish vascular access respectively.To compare the succes rate,number of successful puncture,puncture time and complica-tion of two kinds of puncture technique.In the process of axillary vein puncture,line A along the intermuscular groove was first determined,then the line B parallel to line A was determined,and the puncture point was finally determined on line B,and the insertion angle α and β were recorded.Results A total of 90 patients were enrolled,including 50 males,with an average age of(74.61±12.29)years,including 45 in the axillary vein group and 45 in the subclavian vein group.The rate of success in two groups were 93.3％and 95.6％;The number of successful puncture in two groups were(1.35±0.66)times and(1.30±0.64)times;The mean puncture time in two groups were(44.5±15.8)s and(46.1±15.3)s;The incidence of complication in two groups were 4.5％and 6.7％.Two groups of patients had no significant difference in successful puncture rate,number of successful puncture,puncture time and complication incidence rate(P＞0.05).The injection angle α was(25.79±3.95)°,and the angle β was(65.02±9.14)°.Conclusion It is safe and feasible for the implantation of cardiac implantable electronic device by the new bland axillary vein puncture-the"two points and two lines"method.
关键词
心血管病学/腋静脉/锁骨下静脉/心脏植入装置Key words
Cardiology/Axillary vein/Subclavian vein/Cardiac implantable electronic device引用本文复制引用
出版年
2024
NETL
NSTL
万方数据