老年患者心脏埋藏式起搏器治疗的远期随访(附122例报告)

目的:评价老年慢性心律失常患者植入心脏埋藏式起搏器的远期疗效与安全性。方法:对接受心脏埋藏式起搏治疗的122例老年患者(年龄≥70岁)术后进行长期临床随访,随访内容包括临床资料、并发症、生活质量改善情况以及死亡原因等,并与同期植入的109例非老年患者进行比较。结果:两组患者分别随访8.22±6.01和7.74±5.82年,随访成功率均为100%。老年组围手术期并发症的发生率较非老年组高(P<0.05),随访中老年组心房颤动和心力衰竭发生率均高于非老年组(P<0.05)。老年组死亡原因主要为心力衰竭,而非老年组主要为脑血管病。两组症状和生活质量均有改善。结论:老年慢性心律失常患者起搏器治疗具有确切的临床疗效、良好的安全性,并能提高患者远期生活质量;加强术前准备、术中仔细操作,注意止血彻底和术后管理,可以进一步降低围手术期并发症;应根据老年患者生理特性及心律失常类型合理选择起搏治疗模式。

Long-term Follow-up of 122 Ederly Patients with Pacemaker Implantation

Objective:To evaluate the long-term results of pacemaker implantation in 122 elderly patients.Method:A long-term follow-up survey was carried out in 122 elderly cases and 109 young cases receiving pacemaker implantation.The mean follow-up time was 8.22±6.01 and 7.74±5.82 years respectively,during which the clinical characteristics,complications and quality of life were compared each other.Results:The success rate of the follow-up was 100%.The overal1 postoperative complication occurred in elderly group was higher than that in young group.During the follow-up,the prevalence of atrial fibrillation and heart failure in elderly group was more frequently happened compared with that in young group.The heart failure was the main cause of the deaths happened in elderly group,and stroke was the main cause of the deaths in young group.Both groups possessed the improvement of the quality of life.Conclusion:The pacemaker implantation is a safe and effective therapy for treatment of elderly patients with bradycardia,and can improve the quality of elderly patients' life.The overall postoperative complication may be lowered with careful operation.Optimal mode for elderly patients will be given according to the physiological characteristics and the types of bradycardia.