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1984年以来,我们采用气囊漂浮起搏方法(使用Swan-Ganz双极起搏导管)床旁紧急插管抢救急性心肌梗塞伴严重房室传导阻滞6例,均获得成功,报告如下。 1 临床资料 男5例,女1例;年龄45～62岁(平均51岁);4例为急性下壁心肌梗塞,2例为急性前壁心肌梗塞。6例均合并严重房室传导阻滞,其中4例为Ⅲ度,2例为高度房室传导阻滞。其他并发症为合并低血压1例,泵衰竭(KillipⅢ级)1例,出现频发室性早搏2例;出现短暂阿斯综合征发作2例;2例心电图QRS增宽,其间期大于0.14s;6例心室率在20～38/min(平均33.5/min)。6例病人均用过阿托品及异丙肾上腺素静点,因效果不佳而行起搏治疗。
Since 1984, we used airbag floating pacing method (using Swan-Ganz bipolar pacing catheter) bedside emergency intubation rescue acute myocardial infarction with severe atrioventricular block in 6 cases, were successful, the report is as follows. 1 clinical data of 5 males and 1 female; aged 45 to 62 years (mean 51 years); 4 cases of acute inferior myocardial infarction, 2 cases of acute anterior myocardial infarction. Six cases were combined with severe atrioventricular block, of which 4 were Ⅲ degree, 2 were highly atrioventricular block. Other complications were 1 case of combined hypotension, 1 case of Killip Ⅲ grade failure, 2 cases of frequent premature ventricular contractions, 2 cases of transient Asperger syndrome, 2 cases of ECG QRS broadening, with an interval of more than 0.14s ; 6 cases of ventricular rate in 20 ~ 38 / min (average 33.5 / min). 6 patients had used atropine and isoproterenol static point, due to poor performance and pacing therapy.