用于心脏起器下静脉穿刺的标准化程序
Bing Ji1, Yu Mao1, Xue-Bo Liu1
1Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
BMC cardiovascular disorders
|April 15, 2025
概括
用光镜引导的腹静脉穿刺用于心脏起器植入是可行的和安全的,成功受到患者解剖学 (如BMI和关节骨角) 的影响. 这种技术提供了一个可行的选择,特别是在资源有限的环境中.
科学领域:
- 心血管干预 心血管干预
- 医疗成像医学成像
- 解剖学研究 解剖学研究
背景情况:
- 关静脉接入是用于心脏起器植入的下静脉接入的有希望的替代方案,可能降低感染风险并提高成功率.
- 目前还没有用于光学引导下静脉穿刺的标准化方案.
研究的目的:
- 评估一项简化光镜技术的可行性,用于腹静脉穿刺.
- 为了确定手术成功的解剖学和临床预测因子为静脉接入.
主要方法:
- 对178名接受心脏起器植入的患者进行了回顾性队列研究.
- 通过光镜穿刺技术分层的患者:RAO 30°,尾部35°或静脉引导.
- 对人口统计数据,并发症,吸烟状况和放射性参数 (关节骨下脂肪厚度,关节骨-第一个肋骨角) 的分析.
主要成果:
- 94.9%的高成功率 (169/178) 在没有静脉检查的情况下进行尾静脉穿刺.
- 成功的预测因素包括性别特异性解剖学,BMI≥23.84 kg/m2和关节骨-第一个肋骨角.
- 低并发症率为1.69%,没有肺胸炎或脱落等严重事件.
结论:
- 光学引导的静脉穿刺的成功取决于患者特定的解剖学 (性别,BMI,关节骨-第一个肋骨关系,吸烟状况).
- 标准化协议在没有超声波的情况下证明了高效率和安全性,在资源有限的环境中证明有用.
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