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目的 观察多普勒超声、造影定位头 -锁骨下静脉在永久型心脏起搏器植入术中的实际应用价值。方法 4 1例患者术前未进行头 -锁骨下静脉造影及多普勒头静脉定位 ,常规方法植入起搏器 (对照组 ) ,5 3例患者术前以彩色多普勒超声进行头 -锁骨下静脉定位 (多普勒组 ) ,并作体表标记 ,同时行头 -锁骨下静脉造影 (造影组 ) ,据体表标记切开头静脉植入起搏器 ,观察起搏器植入术程所需时间、术后感染、出血等并发症及各组切开方式与实际头静脉解剖位置符合情况。结果 造影及多普勒组与对照组手术时间分别为 (2 0 6± 32 )min和 (16 1± 2 9)min ,组间统计学差异有极显著性 (P <0 0 1) ,造影及多普勒组与对照组比较术后感染发生情况虽然统计学无显著性差异 (P >0 0 5 ) ,但感染发生率有下降趋势 (对照组感染发生率 7 3% ,造影及多普勒组感染发生率1 8% )。术后出血情况 ,造影及多普勒组与对照组比较统计学差异无显著性 (P >0 0 5 )。造影组与常规组比较 ,与头静脉实际解剖符合率明显提高 ,统计学差异有极显著性 (P <0 0 1)。多普勒组与常规组比较和头静脉实际解剖符合率明显提高 ,统计学差异有显著性 (P <0 0 5 )。造影组与多普勒组比较和头静脉实际解剖符合率虽然统计学差异无显著性 (P >0 0 5 ) ,但造
Objective To observe the practical value of Doppler sonography and contrast positioning head - subclavian vein in permanent pacemaker implantation. Method 4 One patient underwent preoperative-head-subclavian vein angiography and Doppler head vein positioning. The pacemaker was implanted in the conventional method (control group). Fifty-three patients underwent preoperative color Doppler ultrasound for head- The subclavian vein was located (Doppler group), and the body surface was marked. At the same time, the head-subclavian vein angiography (angiography group) was performed. Cheng required time, postoperative infection, bleeding and other complications and each group cut open with the actual location of the anatomy of the cephalic vein in line with the situation. Results The operation time was (20 ± 32) min and (16 1 ± 29) min in the contrast and Doppler group, respectively. The difference between the two groups was statistically significant (P <0.01) Compared with the control group, the incidence of postoperative infection in the Doppler group and the control group showed no significant difference (P> 0.05), but the incidence of infection was declining (the incidence of infection in the control group was 73%, contrast and Doppler Le group infection rate of 18%). Postoperative bleeding, contrast and Doppler imaging group and the control group showed no significant statistical difference (P> 0.05). Compared with the conventional group, the coincidence rate with the actual anatomy of the cephalic vein was significantly increased in the contrast group (P <0.01). Doppler group compared with the conventional group and the actual anatomy of the cephalic vein coincidence rate was significantly increased, the difference was statistically significant (P <0 05). Compared with the Doppler group and actual anatomy of the cephalic vein, the coincidence rate of the contrast group was not statistically significant (P> 0.05)