实用医学杂志2026，Vol.42Issue(9)：1635-1641,7.DOI:10.3969/j.issn.1006-5725.2026.09.019
超声两点预定位辅助腋静脉穿刺在心脏起搏器植入中应用的有效性和安全性
The effectiveness and safety of ultrasound-assisted axillary vein puncture with two-point pre-positioning in cardiac pacemaker implantation
摘要
Abstract
Objective To explore the efficacy and safety of ultrasound-guided two-point pre-localization-assisted axillary vein puncture in cardiac pacemaker implantation.Methods Sixty-three patients who needed cardiac pacemaker implantation between May 2022 and December 2023 were included in the study and randomly allocated into a conventional surgery group(n=31)and an ultrasound two-point pre-localization group(n=32).The conventional surgery group underwent preparation following routine surgical procedures.In the ultrasound two-point pre-localization group,preoperative ultrasound was employed to conduct a two-point localization of the axillary vein.One point was designated as the skin puncture site,and the other indicated the puncture direction.Additionally,the ultrasound probe was positioned at an angle of 30°to the skin to measure the puncture depth,thus determining the puncture site,direction,and depth.During the surgery,ultrasound was not utilized,and the puncture was carried out based on the preoperative localization.The differences in parameters such as the first-attempt puncture success rate,puncture time,number of punctures,X-ray exposure time and dose,surgical time,pacing threshold,sensitivity,and impedance were compared to evaluate the efficacy.Safety was evaluated by comparing the incidence of pneumothorax,hemothorax,arterial injury,pocket hematoma,infection,electrode dislodgement,and wear.Results There were no statistically significant differences in baseline clinical characteristics,CIED implantation indications,and device types between the two groups(P＞0.05).When compared with the conventional surgery group,the ultrasound two-point pre-localization group exhibited a higher first-attempt puncture success rate(38.2％vs.63.2％,P=0.008),a shorter puncture time[36.0(17.5,79.0)s vs.20.0(9.0,34.0)s,P=0.004],fewer puncture attempts[2(1,4)vs.1(1,3),P=0.005],less X-ray exposure time and dose[12.4(7.1,20.3)minvs.6.2(5.5,9.4)min,P=0.003;60.0(24.7,168.1)mGy vs.29.0(16.6,46.4)mGy,P=0.010].However,there was no significant difference in the total surgical time[(149.19±41.81)min vs.(131.90±40.05)min,P=0.099].Additionally,there were no statistically significant differences in pacemaker parameters and adverse event rates between the two groups(P＞0.05)Conclusion Ultrasound-guided two-point pre-localization assisted axillary vein puncture is a safe,effective,and highly practical method in cardiac pacemaker implantation.关键词
超声预定位/腋静脉/心脏起搏器植入Key words
ultrasound pre-positioning/axillary vein/cardiac pacemaker implantation分类
医药卫生引用本文复制引用
陈钢彬,郑海生,马贵洲,倪楚民,何新界,蔡典煜,蔡志雄..超声两点预定位辅助腋静脉穿刺在心脏起搏器植入中应用的有效性和安全性[J].实用医学杂志,2026,42(9):1635-1641,7.基金项目
广东省医学科研基金项目(编号:A2022229) （编号:A2022229）
