心脏起搏器患者围术期并发症分析及处理体会

目的为提高对心脏起搏器患者围术期并发症的认识及处理水平。方法回顾2004年1月至2008年12月共99例永久心脏起搏器置入患者，分析其围术期并发症发生的原因、处理方法和结果。结果手术成功率100％；围术期并发症发生率11．11％，其中囊袋血肿5例（5．05％），1例转院治疗，2例经加压包扎后血肿吸收，另2例加强局部消毒和换药，血肿自行吸收；电极脱位致起搏功能障碍2例，经重新调整电极位置后好转；起搏器固定螺丝松动致起搏功能障碍2例，再次手术，拧紧固定螺丝后恢复正常。结论起搏器术后并发症是影响疗效的主要问题，加强术前预防、术中规范操作、术后观察随访，可将并发症减少到最低限度，使之发挥最佳治疗效益。

Experience of peri-operational complication and their treatment in permanent cardic pacemaker implantation

Aim To promote the experience of peri-operation complication and treatment in permanent cardiac pacemaker implantation. Methods Retrospective analysis of 99 patients with permanent cardiac pacemaker implantation during January 2004 to October 2008, analysis the causes, the treatment and the results of peri-operational complication. Results All operations are successful, and the ratio of peri-operational complication was 11.11%. 5 （5.05 % ）patients with bag haematoma, including 1 patient was transferred, 2 patients＇ haematoma were absorbed after compression wrap , and the other 2 patients＇ haematoma were absorbed by disinfection and wrap. The electrode dislocation induced pacemaker dysfunction occurred in 2 patients and reversed by reposition. The actuator anchor screw becomes less crowded in 2 patients and corrected by re-operation. Conclusions The main Influence to curative effect of cardiac pacemaker is complication after implantation. Adequate preparation to prevention, skillful technique in operation and follow-up visit positively is necessary to decreasing the complication, and increasing treatment benefit.