心脏永久起搏器安置术后囊袋血肿临床诊治

Clinical treatment of postoperative pocket hematoma after permanent cardiac pacemaker implantation

目的总结分析32例心脏永久起搏器安置术后患者囊袋血肿形成的原因及治疗。方法回顾性分析我院自2008年01月份开始至2012年06月份期间32例行心脏永久起搏器安置术后患者囊袋血肿形成的原因及其治疗,总结起搏器安置术后囊袋血肿的治疗经验。结果32例患者中早期囊袋血肿[1](起搏器植入术后1周内出现的囊袋内出血称为中早期囊袋血肿)22例,迟发性囊袋血肿10例,(起搏器植入术后1周以上出现的囊袋内出血称为迟发性囊袋血肿),均取囊袋内液体行细菌培养结果为阴性。所有患者均予抗生素预防感染并积极治疗原发病,均未发生起搏器囊袋感染,32例患者术口均愈合出院。结论早期发现囊袋血肿,及时进行正确的治疗,有利于术口愈合。

Objective To investigate the causes and treatment of postoperative pocket hematoma in 32 patients implanted with permanent cardiac pacemaker. Methods A retrospective analysis was performed on 32 patients with postoperative pocket hematoma after permanent cardiac pacemaker implantation, who were hospitalized in our hospital from January 2008 to June 2012, to investigate the causes and treatment of this condition, and the experiences in the treatment of postoperative pocket hematoma after permanent cardiac pacemaker implantation were summarized. Results Among the 32 cases of postoperative pocket hematoma, 22 had early postoperative pocket hematoma （pocket hematoma occurring within 1 week after implantation）, and 10 had delayed postoperative pocket hematoma （pocket hematoma occurring over 1 week after implantation）. Moreover, the fluid in pocket hematoma was collected for bacterial culture, and negative results were found in all 32 cases. All patients received antibiotic treatment for preventing infection and active treatment of the primary disease, and none of them had pacemaker pocket infection; the 32 cases were discharged with anastomotic healing. Conclusion Early detection of pocket hematoma and timely proper treatment are very helpful for anastomotic healing.