起搏器囊袋并发症相关危险因素分析

目的探讨起搏器安置术后囊袋并发症的相关危险因素。方法回顾性分析西南医院心内科2006年3月至2011年3月期间行起搏器安置及资料完整患者的临床资料及其囊袋并发症。结果 (1)本组810例,平均年龄(68.2±8.6)岁,其中男494例,女316例。148例(18.3%)为VVI/或AAI单腔起搏器安置术患者,662例(81.7%)为双腔起搏器(DDD)、心脏同步化起搏(CRT)及心脏转复除颤器(ICD)安置术患者;(2)囊袋血肿31例(3.8%),其中年龄75岁以上、长期服用抗栓药物、合并血管疾病与囊袋血肿发生率密切相关(P<0.05);(3)囊袋皮肤破溃14例(1.7%),10例发生在术后3～12个月内,其中年龄75岁以上、起搏器更换、体质量指数22以下、手术时间与囊袋皮肤破溃密切相关(P<0.05)。结论囊袋并发症并不少见,合理使用抗栓药、尽量深埋起搏器是防治囊袋并发症的有效手段。

Analysis of relative risk factors for pocket complications after pacemaker implantation

Objective To analyze the relative risk factors of pacemaker pocket hematoma and erosion.Methods The complete clinical data of 810 patients admitted to south-west hospital between May 1,2006,and May 31,2011 were retrospectively studied,which included basic clinical data,the time of pocket complications taken place,postoperative use of antibiotics and bacterial culture results.Results(1)Median age of 810 patients(494 male and 316 female) was 68.2±8.6 years,148 patients(18.3%) were implanted by single chamber pacemaker,662 patients(81.7%) were implanted by double chamber pacemaker,or CRT or ICD.(2)Pocket hematoma was complicated within 1 weeks after pacemaker implantation in 31 cases(3.8%),and the pocket hematoma was significantly related with over 75 years old,oral anticoagulation,and combined with vascular disease(P<0.05).(3)14 patients with pocket erosion was found,in which 10 cases were occurred within 3~12 months after pacemaker implantation,the significant risk factors included over 75 years old,pacemaker replace,lower 22 of body mass index and the time of pocket implantation performed(P<0.05).Conclusion Pacemaker pocket complications are no rare.A reasonable use of anticoagulation and deep implantation of pacemaker may be a useful method away from the pocket complications.