电灼术在永久起搏器植入术中的应用

Application of Electrocautery in Hemorrhagic Tendency Patients during Permanent Pacemaker Implantation

目的研究对有出血倾向患者(正在进行抗凝和(或)抗血小板治疗)施行电灼术在永久起搏器植入术中的安全性及可靠性。方法比较有出血倾向电灼术应用组(A组,n=47)和非电灼术应用组(B组,n=42);无出血倾向电灼术应用组(C组,n=95)和非电灼术应用组(D组,n=91),4组止血效果及术中、术后并发症。结果无论有出血倾向组还是无出血倾向组,电灼术可明显降低囊袋渗血、血肿并发症,且有出血倾向组应用电灼术有更明显的优势(P=0.004)。使用电灼术组术中无心肌穿孔、大出血、电极脱位和起搏器系统故障。随访1年起搏参数与程控参数一致,无囊袋感染。结论电灼术止血在永久起搏器植入术中的应用安全、有效。

Objective To investigate the safety and efficacy of electrocautery in hemorrhagic tendency patients （being treated with anti-coagulant and anti-platelet） during permanent pacemaker implantation. Methods We Compared the hemostasis effectiveness, and complications during and after operation within four groups group A （hemorrhagic tendency patients with electocautery, n = 47）, group B （hemorrhagic tendency patients without eclectrocautery, n=42）, group C （non-hemorrhagic tendency patients with eclectrocautery, n=95） and group B （non-hemorrhagic tendency patients without eclectrocautery, n=91）. Results Regardless patients with hemorrhagic tendency or without hemorrhagictendency the incidence of hemorrhage and hematoma was lower in the electrocautery groups. Especially, the electrocautery therapy proved more benefit in the hemorrhagic tendency patients（P=0.04）. There were no complications of myocardial perforation, hemorrhoea, electrode dislodge and pacemaker system failure. There were no pocket erosion and the pacing parameters were coincident with program parameters during 1 year follow-up. Conclusion The electrocautery is safe and effective in permanent pacemaker implantation.