高龄老年人安置永久心脏起搏器临床分析

The analysis of pacemaker complications in aged patients with permanent pacemaker implantation

目的分析高龄老年人安置心脏永久起搏器的临床特点及并发症治疗。方法12例高龄老年患者，年龄80～96岁。心律失常类型分别为快-慢综合征6例，Ⅱ度Ⅱ型以上房室传导阻滞4例，窦性停搏2例。安置起搏器类型：DDDR 1例，DDD 5例，VVIR 4例，VVI 2例。结果（1）高龄老年患者心内膜阻抗增高。12例高龄老年患者心内膜阻抗870～1460Ω。（2）3例85岁以上高龄老年患者术后1周后活动上肢导致起搏器囊袋内出血皮下血肿，发现后局部压迫和上肢制动，均自行吸收痊愈。（3）4例发生术中恶性心律失常。结论高龄老年人由于生理性衰老变化，在安置心脏永久起搏器的过程中及术后易发生手术并发症，临床治疗中应加以重视。

Objective To analysis the clinical characteristics and complications of aged patients with permanent pacemaker implantation. Methods 12 aged patients from 80 to 96 years old who were planted the permanent pacemaker. Among the 12 patients, 6 had bradycardia-tachycardia syndrome and 4 had second to third degree atrioventricular block and 2 had sinus pause. In these patients, 1 patient with DDDR pacemaker, 5 patients with DDD pacemaker, 4 patients with VVIR, 2 patients with VVI. Results （1）Endocardial impedance increased in aged patients. Endocardial impedance of the 12 patients were 870- 1460Ω. （2） Three aged patients whose age above 85 years old had the pacemaker pocket hematoma after the operation in the first week. After founding it,patients were asked to brake the upper limb and suppressed the pocket hematoma. The pocket hematoma could be cured. （3） Vicious ventricular arrhythmi occured among four patients during the operation. Conclusion The complications is easy to occur during the operation and post - operation of permanent pacemaker implantation in aged patients ,which may be related to their physiological aging.