老年患者永久起搏器植入的临床疗效评价

目的 探讨不同年龄组老年患者植入心脏永久起搏器的安全性及可行性。方法 对2020年1月至2021年1月初诊于陕西省人民医院心内二科初次植入永久起搏器的老年患者74例的临床及随访资料进行回顾性分析,依据世界卫生组织的老年标准分为高龄组和低龄组。分析气胸、电极脱位、囊袋出血等并发症发生率及起搏器阈值、感知、电极阻抗等数据。结果 两组患者在性别和BMI,以及冠心病、高血压和2型糖尿病患病占比差异均无统计学意义（P>0.05）。高龄组年龄以及心力衰竭和肺部疾病的占比均显著高于低龄组,差异有统计学意义（P<0.05）。高龄组气胸和囊袋出血发生率显著高于低龄组,差异有统计学意义（P<0.05）;高龄组心室和心房的起搏阈值均显著高于低龄组,差异有统计学意义（P<0.05）。结论 高龄及超高龄患者植入心脏永久起搏器安全且可行,关注老年患者生理特性并注重围术期管理十分重要。

Clinical efficacy evaluation of permanent pacemaker implantation in elderly patients

Objective To investigate the safety and feasibility of implantation of permanent cardiac pacemakers in elderly patients of different age groups.Methods From January 2020 to January 2021, the clinical and follow-up data of 74 elderly patients with permanent pacemakers initially implanted in the Second Department of Cardiology of Shaanxi Provincial People's Hospital were retrospectively analyzed. They were divided into the elderly group and the younger group according to World Health Organization standards for aging. The incidence of complications such as pneumothorax, electrode dislocation, bag hemorrhage and the data of pacemaker threshold, perception and electrode impedance were observed and analyzed.Results There was no significant difference between the two groups in gender and BMI, as well as the prevalence of coronary heart disease, hypertension and type 2 diabetes （P>0.05）. The age and the proportion of heart failure and pulmonary diseases in the elderly group were significantly higher than those in the younger group （P<0.05）. The incidence of pneumothorax and bag hemorrhage in the elderly group was significantly higher than that in the younger group （P<0.05）; The pacing thresholds of ventricle and atrium in the elderly group were significantly higher than those in the younger group （P<0.05）.Conclusion It is safe and feasible to implant permanent cardiac pacemakers in elderly and ultra-elderly patients. It is important to pay attention to the physiological characteristics of elderly patients and perioperative management.