424例永久心脏起搏器治疗患者并发症回顾性分析

Retrospective analysis on complication of 424 patients with permanent cardiac pacemaker implantation

目的探讨永久性心脏起搏器植入术中及术后并发症发生的原因、处理方法及其预防措施。方法回顾性分析我院2001年1月～2011年6月424例永久性心脏起搏器患者的临床资料。结果发生起搏器并发症41例(9.7%)。其中,术中气胸5例,误穿锁骨下动脉10例,术后起搏器囊袋血肿18例,起搏器囊袋破溃1例,电极移位2例,导线断裂1例,起搏综合征3例,起搏器介导的心动过速1例。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。

Objective To investigate the causes, the appropriate remedies and the preventions of the complication in the patients with implanted cardiac pacemaker during implanting operation and after implantation. Methods The clinical and follow-up data of 424 patients with implanted cardiac pacemaker were analyzed retrospectively from the January in 2001 to the June 2011 in this hospital. Results There were 41 patients with complications,with 5 patients with pneumothorax, 10 patients with puncturing into subclavical artery, 18 patients with blood .effusion and hematoma formation in pacemaker sac, 1 patient with broken pacemaker sac, 2 patients with lead dislocation, 1 patient with lead fracture, 3 patients with pacemaker syndrome, 1 patient with pacemaker mediated tachycardia. Conclusions The complications after cardiac pacemaker implantation are main influence factors of curative effect of cardiac pacemaker. Adequate preparation to prevention, skillful technique in operation and follow-up visit positively are necessary to decrease the complication and increase treatment benefit.