高龄患者永久心脏起搏器植入术41例临床分析

Clinical analysis of permanent cardiac pacemaker implanted in 41 elderly patients

目的分析高龄患者植人永久心脏起搏器的临床特点及并发症发生情况。方法对植入永久心脏起搏器的41例高龄（≥80岁）患者临床资料进行回顾性分析，观察临床症状、缓慢心律失常的类型、起搏模式、术中起搏参数、术中和术后并发症等。结果41例患者手术均成功完成。起搏模式：心室单腔起搏器VVI29例、VⅥR2例、房室双腔起搏器DDD9例，房室双腔频率适应性起搏器DDDRI例；心室电极位于右室心尖部，心房电极位于右心耳。术中无心脏穿孔、恶性心律失常等严重并发症发生；术后发生电极脱位I例、囊袋血肿1例，经治疗后治愈，无感染、起搏器综合征发生。随访中死亡6例，死于术后2月至6年。结论高龄患者植入心脏起搏器，手术风险并不增加，治疗效果较好。

Objective To analyse the clinical characteristics of elderly patients with permanent cardiac pace- maker implanted. Methods To retrospectively analyze 41 elderly patients（ ~〉80 years） with permanent pacemakers implantation. Observing the clinical symptoms, bradyarrhythmia category, pacing mode, intraoperative pacing parame- ters,intraoperative and postoperative complications. Results All patients were operated successfully. Pacing modes were,VVI 29 cases,VVIR 2 cases,DDD 9 cases and DDDR 1 case. Ventricular electrode located in right ventricular apical pacing. Atrial electrode located right heart ear. During the operateing, severe complications did not happen such as heart perforation, malignant arrhythmia. One case of postoperative dislocation electrode and one case of pocket hem- atocele were observed. After treatment, they were cured, no infection and pacemaker syndrome happened. 6 patients died during follow-up,postoperative from two months to 6 years. Conclusion Pacing therapy in elderly patients is good. Surgical risk was not increased.