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我院1988年10月～1990年11月采用自制外套管经皮穿刺锁骨下静脉导引电极技术,安装了13例永久起搏器。现将操作体会作一简介。13例中,男12例,女1例,年龄32～81(平均58.4±13.7)岁,有症状的完全性房室传导阻滞7例、病态窦房结综合征6例。起搏器皆为单电极VVI型。采用壁较簿而相对较硬、内径能通过电极导管头部及相应大小扩张管的国产塑料管,制作外套管代替撕剥式电极导线导引器,其长度以能使扩张管头部外露2～3cm为宜,并用锐利刀片纵行剖开。选锁骨中内1/3交界下方约2cm处为穿刺点,针尖向上、向内、指向胸骨上窝和甲状软骨之间。局麻后先用尖刀切开皮肤约1cm,以小血管钳分离切口深部皮下组织和肌肉。穿
Our hospital from October 1988 to November 1990 using self-made percutaneous subclavian vein guiding catheter technology, installation of 13 cases of permanent pacemaker. Operation experience now make a profile. In 13 cases, there were 12 males and 1 females, ranging in age from 32 to 81 (average 58.4 ± 13.7 years), with symptoms of complete AV block in 7 cases and sick sinus syndrome in 6 cases. Pacemakers are all single-electrode VVI type. The wall than the book and relatively hard, the inner diameter of the catheter through the head and the corresponding size of the expansion of the domestic plastic tube, making the outer tube instead of peel-off electrode lead guide, the length of the dilatation in order to make the head exposed 2 ~ 3cm is appropriate, and cut open with sharp blade longitudinal. Select clavicle within 1/3 of the junction about 2cm at the puncture point, the needle up, inward, pointing to the suprasternal fossa and thyroid cartilage. After local anesthesia with a sharp knife to cut the skin about 1cm, small vascular forceps incision deep subcutaneous tissue and muscle incision. wear