在安置起搏器时,常遇到下列几个问题,现就我们的临床实践结合文献予以分析讨论。一、头静脉切口的定位埋藏式起搏器电极的插入部位,在我国,首选的还是头静脉。因为:①并发症少,且比较安全。②较经济,毋须购买进口的插入导管电极的导入器。③电极不易因肢体活动牵拉而脱位。④较易达到右室。但头静脉的部位较深、难找,有时又较细小或畸形,故寻找头静脉,常是安置埋藏式心脏起搏器的第一难关。寻找头静脉时,局部表皮切口的定位很重要,我们常以下列两个方法定位:①在仰卧位时,于肱骨大结节处肩部水平面最高位置的稍内下侧,即可扪及一紧靠肱骨大结节的肩胛骨的喙突。以喙突内侧约1.5cm,下方约2cm的交 In the placement of pacemaker, often encounter the following questions, is now on our clinical practice with the literature be analyzed and discussed. First, the location of the first incision implanted pacemaker electrode insertion site, in our country, the preferred or the first vein. Because: ① less complications, and more secure. ② more economical, without the need to purchase imported catheter into the catheter guide. ③ electrodes difficult to pull and dislocation due to limb activity. ④ easier to reach the right ventricle. However, the deeper parts of the cephalic vein, hard to find, and sometimes smaller or deformity, so looking for the first vein, often placed the first difficulty of implanted pacemakers. Finding the head vein, local epidermal incision positioning is very important, we often locate the following two methods: ① in the supine position, at the humerus tuberosity at the level of the shoulder the highest position of the slightly lower side, palpable and a Close to the humerus large nodules of the scapula of the coracoid process. To the inside of the coracoid about 1.5cm, about 2cm below the pay