经左锁骨下静脉起搏脉冲引导紧急床边临时心脏起搏

南方医科大学学报 ›› 2005, Vol. 25 ›› Issue (05): 587-588.

经左锁骨下静脉起搏脉冲引导紧急床边临时心脏起搏

马明远, 誉铁鸥, 方滨, 温伟标, 毛克江

广东佛山市第一人民医院ICU科, 广东, 佛山, 528000

出版日期:2005-05-20 发布日期:2005-05-20
基金资助:
收稿日期:2004-10-25。
作者简介:马明远(1963- ),男,副主任医师,E-mail:mmyuan@fsyyy.com

Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse

MA Ming-yuan, YU Tie-ou, FANG Bin, WEN Wei-biao, MAO Ke-jiang

广东佛山市第一人民医院ICU科, 广东, 佛山, 528000

Online:2005-05-20 Published:2005-05-20

摘要/Abstract

摘要： 目的经左锁骨下静脉途径研究起搏脉冲引导行紧急床边临时心脏起搏技术的优越性及可行性.方法以Seldinger法穿刺左锁骨下静脉置入鞘管.设置起搏器频率超过患者自主心率0次/min、输出电流为5 mA、感知电压为3mV,沿鞘管推送电极至心电监护显示脉冲信号及起搏心律.结果 18例患者获良好的起搏效果(操作时间5～10min,平均6.9 min).1例患者开始时起搏效果不良,约 h后好转;例患者起搏效果差;后3例操作时间均超0 min.1例患者术后均无并发症.结论由起搏脉冲引导、经左锁骨下静脉行紧急床边临时心脏起搏起效迅速、成功率高且较安全.

Abstract: Objective To investigate the feasibility and merits of emergency bedside temporary cardiac pacing through left subclavicular vein guided by pacemaker impulse.Methods The left subclavicular vein was punctured with Seldinger technique for insertion of a cannula. After setting the rate of pacemaker at 20 beat/min above the patients’ spontaneous heart rate with output current of 5 mA and sensing voltage of 3 mV, the electrode was inserted through the cannula until the electrocardiograph displaying pulsed signal and pacing rhythm.Results Good pacing was achieved in 18 patients with one having poor pacing, which was improved 2 h later. The pacing was not satisfactory in two cases. No postoperative complications occurred in the 21 patients.Conclusion Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse is rapid and ensures high success rate and safety.

中图分类号:

R711.750.5

马明远, 誉铁鸥, 方滨, 温伟标, 毛克江. 经左锁骨下静脉起搏脉冲引导紧急床边临时心脏起搏[J]. 南方医科大学学报, 2005, 25(05): 587-588.

MA Ming-yuan, YU Tie-ou, FANG Bin, WEN Wei-biao, MAO Ke-jiang. Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse[J]. Journal of Southern Medical University, 2005, 25(05): 587-588.

参考文献

[1] Ohta M, Inoue H, Cotticelli MG, et al. The FHIT gene, spanning the chromosome 3p14.2 fragile site and renal carcinoma associated t (3;8) breakpoint, is abnormal in digestive tract cancers[J]. Cell, 1996,84(4): 587-97.
[2] MurphyGA, HallidayD, MclennanAG, et al. The Fhit tumor suppressor protein regulates the intracellular concentration of diadenosine triphosphate but not diadenosine tetraphosphate [J].Cancer Res, 2000, 60(9): 2342-4.
[3] 蔡清萍,王强,王梁华,等.人胰腺癌细胞FHIT基因转染对肿瘤坏死因子敏感性的影响[J].中华实验外科杂志,2002,19(2):1634.Cai QP, Wang Q, Wang LH, et al. Effects of FHIT gene transfection into human pancreatic adenocarcinoma cells on tumor necrosis factor sensitivity[J]. Chin J Exp Surg, 2002, 19(2): 163-4.
[4] Sard L, Accornero P, Tornielli S, et al. The tumor-suppressor gene FHIT is involved in the regulation of apoptosis and in cell cycle control [J]. Proc Natl Acad Sci USA, 1999, 6: 8489-92.
[5] Uzawa N, Akanuma D, Negishi A, et al. Homozygous deletions on the short arm of chromosome 3 in human oral squamous cell carcinomas [J]. Oral Oncol, 2001, 37(4): 351-6.
[6] Kannan K, Munirajan AK, Bhuvarahamurthy V, et al. FHIT gene mutations and single nucleotide polymorphism in Indian oral and cervical squamous cell carcinomas[J]. Oral Oncol, 2000, 36(2): 189-93.
[7] Tanimoto K, Hayashi S, Tsuchiya E, et al. Abnormalities of the FHIT gene in human oral carcinogenesis [J]. Br J Cancer, 2000, 82(4): 838-43.
[8] van Heerden WF, Swart T J, Robson B, et al. FHIT RNA and protein expression in oral squamous cell carcinomas [J]. Anticancer Res,2001, 21 (4A): 2425-8.
[9] van Heerden WF, Swart TJ, Van Heerden MB, et al. Fhit protein expression in oral epithelium: immunohistochemical evaluation of three antisera[J]. Anticancer Res, 2001, 21 (4A): 2419-23.
[10] Chang KW, Kao SY, Tzeng RJ, et al. Multiple molecular alterations of FHIT in betel-associated oral carcinoma [J]. J Pathol, 2002, 196(3): 300-6.
[11] Lee JI, Soria JC, Hassan K. Loss of fhit expression is a predictor of poor outcome in tongue cancer[J].Cancer Res, 2001, 61(3): 837-41.