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我院内科采用心包穿刺针连接心电导联线进行心包穿刺抽液和心电监测8例,取得了较好的效果,现介绍如下:对象本组全部为住院患者并经临床 X 线胸片、超声心动图检查确诊为心包积液,其中男性3例,女性5例。病因:结核性心包炎3例,非特异性心包炎2例,肺癌致心包积液3例。方法将常规心电图肢导联线置于四肢,用一约40厘米长的消毒电线分别与胸 V_1导联和心包穿刺针相连接,然后打开心电监测仪并记录一段心电图,按常规步骤进行心包穿刺术。穿刺过程中要求进针应缓慢,并同时密切观察心电监测的图形变化,如出现 ST 段抬高或 P-R 段抬高,表示穿刺针尖已接触到心外膜或刺入心肌,此时应再将穿刺针稍后退至 S-T 段或 P-R 段恢复到原来的心电图形,以抽出液体为止。讨论心包穿刺是治疗各种心包积液的重要方法之一,但目前大多数基层医院仍然采用常规的心包穿刺方法进行心包穿刺,这种方法虽然简单,但对于在穿刺过程中穿刺针是否接触或损伤到心肌没有客观指标,仅凭操作者手中的感觉来判定,所以此方法存
In our hospital, 8 cases of pericardiocentesis and cardiogram were performed with pericardiocentesis through the pericardiocentesis. The results were as follows: All patients were inpatients and were diagnosed by clinical X-ray, Echocardiography confirmed as pericardial effusion, including 3 males and 5 females. Etiology: 3 cases of tuberculous pericarditis, 2 cases of non-specific pericarditis, 3 cases of lung cancer caused by pericardial effusion. Methods The leads of conventional ECG leads were placed on the extremities and connected to the V_1 leads and pericardiocentesis with a sterile wire about 40 cm in length. The ECG monitor was opened and a period of electrocardiogram was recorded. Pericardium was routinely performed Puncture. Puncture process requires the needle should be slow, and at the same time close observation of ECG changes in the pattern, such as the emergence of ST segment elevation or PR segment elevation, said the puncture tip has been exposed to the epicardial or piercing the myocardium, this time should be The needle back to the ST segment or PR segment back to the original electrocardiogram to withdraw liquid. Discussion Pericardiocentesis is one of the important methods for the treatment of various pericardial effusion, but at present, most primary hospitals still use the pericardiocentesis method by the conventional pericardiocentesis. Although this method is simple, whether the puncture needle contacts or There are no objective indicators of injury to the myocardium, just by the hands of the operator to determine the feeling, so this method