永久起搏器植入常见并发症及防治措施

目的 回顾性分析710例永久起搏器植入术并发症的发生率及原因,以提高起搏器植入技术的安全性和有效性.方法 连续选择2005年1月至2010年6月在我院行永久起搏器植入术的患者710例,随访0.5 ～6年,观察并发症的发生率及原因.结果 起搏器植入常见的并发症分别是囊袋内积血及血肿（n=10,1.41％）、电极导线移位（n=8,1.25％）、起搏阈值升高（n=6,0.93％）及囊袋侵蚀（n=2,0.28％）.出血的发生与年龄偏大有关；电极导线的脱位主要是电极导线固定不良所致；囊袋侵蚀与患者体型偏瘦、囊袋制作偏小,或与原起搏器形状不相称引起皮肤受压缺血有关.结论 随着技术熟练及采取相应措施,可以减少并发症发生.

Complication and appropriate measures in patients with pacemarker implantation

Objective The complications in 710 patients with pacemakers implantation were analyzed in order to find causes and to avoid this situation.Methods Of these 710 patients,273 received single chamber pacemaker,437 received dual chamber pacemakers.Results The common complications related to operation were blood effusion and hematoma formation in pocket( 1.41％ ),lead dislodgement (1.25％),pacing threshold increased(0.93％ )and pocket erosion(0.28％ ).Occurrence of blood effusion was related to old age.Dislodgement of the pacing leads was related the uncompleted ligation due to the slide ligature made by the operator.Pocket erosion was especially seen in the patients with pacemaker replacement,and the reasons were considered as that original pocket' s shape or size does not fit well with later pacemaker,which caused the skin ischemia,and lead to the pocket skin rapture.Conclusion Appropriate measures could be taken to avoid these complications.