论文部分内容阅读
患者女性,74岁。因高度房室传导阻滞、反复头晕需安置起搏器入院。由于患者较瘦,胸壁甚薄,上胸部埋藏起搏器有困难,而于1990年11月12日从右髂静脉插入电极。以髂动脉搏动稍内侧为中心进行局麻后,作一与腹股沟韧带平行的长约2cm的切口,钝性分离皮下脂肪达筋膜。在深部可看到髂动脉搏动,其内侧即为髂静脉。用标准Seldinger法穿刺,先后插入引导钢丝,静脉扩张管和套管,然后插入电极,在透视下将电极送达右室心尖,取得理想的心腔内电图,测起搏阚值为0.4V、0.6mA,阻抗为666Ω,随后沿电极周围筋膜作荷包式缝扎,以紧密固定电极并防止出血。然后在脐旁偏右上方作一水平切口和埋藏起搏器的囊腔及皮下隧道。使电极通过皮下隧道与起搏器连接后埋入囊腔。并将电极固定于皮
Patient female, 74 years old. Due to a high degree of atrioventricular block, repeated dizziness need to be placed pacemaker admission. Due to the thinner patient, the thin chest wall and difficulty in burying the pacemaker on the upper chest, the electrode was inserted from the right iliac vein on November 12, 1990. Iliac artery pulsation slightly medial as the center for local anesthesia, made with a parallel to the inguinal ligament about 2cm incision, blunt dissection of subcutaneous fat fascia. Can be seen in the deep iliac artery pulsation, which is the iliac vein inside. Standard Seldinger puncture, has inserted the guide wire, intravenous dilatation tube and cannula, and then insert the electrode, under the perspective of the electrode to the right apex, the ideal cardial ECG, measured pacing threshold value of 0.4V , 0.6 mA, an impedance of 666 Ω, followed by a pouch-type suture along the fascia around the electrodes to tightly secure the electrodes and prevent bleeding. Then in the upper right side of the umbilical side to make a horizontal incision and buried pacemaker capsule and subcutaneous tunnel. The electrode through the subcutaneous tunnel connected with the pacemaker buried in the cysts. And fix the electrode to the skin