高频电刀对埋植起搏器影响的初步探讨

Preliminary Study of High-Frequency Electrosurgical Generator Effects on Implanted Pacemakers

高频电刀存外科手术中应用日益广泛,为探讨其对埋植起搏器的影响,在经动物实验证实高频电刀对起搏器及犬心脏无影响的前提下,对9例植入起搏器需行外科手术的患者应用了高频电刀,手术部位距起搏器最近者为心脏直视手术。结果显示:①术中、术后患者未出现新的心律失常,心电图 QRS 波、ST 段及 T 波无变化,未发生肺梗塞;②使用电刀时起搏器未因高频干扰受抑制,术后其电路无故障,电池未提前耗竭(随访4.5±2.2月);③术后起搏阈值无升高。提示高频电刀可以在起搏器植入患者中安全应用。

High-frequency electrosurgical generator(HFESG) has been widespreadly used during surgery and it has no effects on implanted pacemakers and hearts in dogs.Since March of 1994,the pacemaker performance was inves- tigated in 9 pacemakers-implanted patients during various surgical procedures,one of them with open-heart surgery.The results showed that:(1) No newly-originated arrhythmias,QRS and ST-T changes,and pulmonary in- farcts occurred during and after operations;(2) No pacemakers pulse inhibition due to high frequency interruption happened when HFESG working.After operation(4.5±2.2 months follow-up),no pacemaker electric circuit disor- ders or battery power loss was found;(3)No pace threshold increased.These suggested that pacemaker-implanted patients could safely use HFESG during surgical procedures.