Analysis Of 5 Cases Of Hemorrhage And Hematoma In Axilliary Artery Branch Caused By Axillary Vein Puncture

Objective:To investigate the causes and preventive measures of hemorrhage and hematoma in axillary artery branch injury during axillary vein puncture.Methods: The clinical features and puncture techniques of five patients with hemorrhage and hematoma in the mid-to-after implantation of pacemaker were analyzed retrospectively,to explore the prevention and treatment measures in the department of cardiology,first affiliated hospital of nanjing medical university.xinghua people's hospital and yancheng hospital of traditional chinese medicine.To observe the occurrence of hematoma after changes in the puncture site of 304 patients in the department of cardiology,the first affiliated hospital of nanjing medical university from July 2016 to December 2017.Results:Three out of five cases occurred in the department of cardiology,first affiliated hospital of nanjing medical university from January 2014 to June 2016,accounting for 0.55%(3/547)of the total number of pacemakers implanted with axillary vein puncture.The other two cases occurred in 2017,respectively in the yancheng hospital of traditional chinese medicine(the annual implantation amount <100)and the xinghua people's hospital(the annual implantation amount is about 200).The puncture sites of the 5 patients were all laterally,belonging to the second part of the axillary vein.Two patients showed continuous pulsatile bleeding after removal of the sheath.Hemostasis was invalid after compression and achieved after surgical separation of the axillary artery branch..Three patients showed postoperative pectoralis major hematoma.Two of them were treated with conservative treatment.The other case failed to find a bleeding point and was improved after the interventional occlusion.From July 2016 to December 2017,304 patients underwent the third stage of axillary vein puncture and did not experience arterial hemorrhage and hematoma in the first affiliated hospital of nanjing medical university.Conclusion: Hemorrhage and haematoma caused by injury of axillary artery branches in axillary venipuncture is a rare complication.Selecting the third segment of axillary vein puncture and strengthening intraoperative observation can reduce the incidence of bleeding and hematoma caused by arterial branch injury.