论文部分内容阅读
目的:探讨起搏电极导线引起心脏穿孔后的临床表现、影像学特点,以及处理方法。方法:连续观察应用心室起搏电极导线引起早期心脏穿孔后的临床及影像学特点,所有患者均常规采用在外科保护及超声检测下直接牵引拔除进行处理。结果:8例患者发生早期心脏穿孔,确诊时间为2~8(5.4±2.1)d,手术处理时间为4~13(7.4±3.5)d。所有患者均出现起搏或感知功能异常,其中5例出现心前区疼痛,4例出现隔肌或胸部肌肉刺激症状,2例经超声心动图检查有少量心包积液,所有患者均成功经直接牵拉拔除电极导线,未发现心包积液增加及心脏压塞表现。结论:心室电极导线导致心脏穿孔后,有其特征,在外科保护及超声检测下经静脉直接拔除电极导线通常是安全可行的。
Objective: To investigate the clinical manifestations, imaging features and treatment of cardiac pacing induced by pacemaker lead. Methods: The clinical and imaging characteristics of early cardiac perforating induced by ventricular pacing leads were observed continuously. All patients were treated by direct traction and extraction under the conventional surgical protection and ultrasonography. Results: Early perforation occurred in 8 patients. The diagnosis time was 2 to 8 (5.4 ± 2.1) days and the operative time was 4 to 13 (7.4 ± 3.5) days. All patients had pacing or cognitive dysfunction, including 5 cases of anterior area pain, 4 cases of muscle or chest muscle irritation symptoms, 2 cases of echocardiography with a small amount of pericardial effusion, all patients were successfully directly Pull pull the lead wire, no increase in pericardial effusion and cardiac tamponade performance. CONCLUSION: The ventricular lead leads to cardiac perforation and has its own characteristics. It is usually safe and feasible to directly remove the electrode lead via the vein under surgical protection and ultrasound.