起搏器植入术并发神经系统功能障碍的探讨

目的分析起搏器植入术中并发脑神经功能障碍的因素,探讨预防和临床处置的相关对策。方法记录2006年1月至2009年3月在我院进行起搏器植入术的患者术中发生神经系统功能障碍时的临床情况,分析其基础临床资料,探讨该并发症的可能因素及对策。结果所有367例患者中共有7例并发了神经系统功能障碍,发生率为1.91%。年龄78±6.8岁。主要表现为言语不利、恶心呕吐、意识淡漠。手术即刻收缩压、舒张压均较术前升高(P均0.0001)。结论神经系统功能障碍在老年起搏器植入患者中并非少见,症状多为一过性,精神紧张、血压升高及异常波动是导致其发生的主要原因。

Nervous dysfunction in the procedure of pacemaker implantation

Objective To analyze the possible reasons which induce nervous dysfunction during the implantation of cardiac pacemaker. Method An analysis was performed in the patients with abnormalities of neural dysfunction in the procedure of pacemaker implantation in our hospital from January 1,2006 to March 1, 2009. Results Seven patients had the complication of neural dysfunction in the procedure of implanting pacemaker, whose incidence was 1.91%. The average age was 78 ±6.8 years, and the major presentations included anarthria, nausea, vomiting, and faint consciousness. The systolic and diastolic blood pressure was 190± 15.4/102 ±15.6 mmHg at the beginning of procedure,which was much more higer than before （ P 〈 0. 000 1 ）. Conclusion Nervous dysfunction may be a transient symptom, and is mostly induced mainly by stress, blood pressure fluctuation, and pain.