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经锁骨下穿刺安置起搏器,穿刺成功时扩张鞘管撕开或切割后即废弃,每次均需换用扩张鞘管,扩张管则可重复多次使用。目前穿刺器具均需进口,价格昂贵。我们采用硬塑料管代替扩张鞘管安置永久性起搏器50例、临时起搏器8例,均获成功。具体方法如下:扩张管用美国 MEDAMICUS 公司产10 F 扩张管;扩张鞘管用北京美年达公司纸盒软包装橙汁饮料吸管代替(简称代用管)。后者为聚乙烯硬质白色半透明塑料,长11.8 cm,直径与10 F 扩张管正好吻合,一端为25°斜切面,硬度适中。术前用蒸馏水冲洗干净,自然凉干,再用75%酒精浸泡60 min 即可使用。我们所用58例无一例感染,并经多次细菌培养未发现细菌生长。该管比扩张管短7
The pacemaker is placed through the subclavian puncture. When the puncture is successful, the expanding sheath is torn open or discarded after cutting. Each time, the dilation sheath needs to be replaced, and the dilation tube can be used repeatedly. At present, puncture devices need to be imported and expensive. We used hard plastic tubes instead of expanding sheaths to place permanent pacemakers in 50 cases and temporary pacemakers in 8 cases. All were successful. The specific method is as follows: The expansion tube is made of 10 F dilation tube produced by MEDAMICUS of the United States; the dilation sheath is replaced with the orange juice drink straw of the carton soft packing of Beijing Midland Corporation (abbreviated as substitute tube). The latter is a polyethylene rigid white translucent plastic, 11.8 cm long, with a diameter exactly matching the 10 F dilation tube, and a 25° bevel at one end, with moderate hardness. Rinse with distilled water before surgery, dry naturally, and soak it with 75% alcohol for 60 minutes. None of the 58 cases we used had been infected and no bacterial growth was found after repeated bacterial cultures. The tube is shorter than the dilation tube 7