永久性起搏器植入术121例相关并发症分析

The causes and treatment strategies of the complications in 121 patients implanted by permanent cardiac pacemaker

目的:讨论永久性心脏起搏器植入术常见并发症发生原因、处理策略及防治措施。方法:对121例植入永久性心脏起搏器患者的随访资料进行分析,其中病态窦房结综合征53例,Ⅲ度房室传导阻滞23例,Ⅱ度房室传导阻滞16例,病态窦房结综合征合并房室传导阻滞15例,持续性心房颤动伴缓慢心室率或3 s以上长间歇14例。结果:121例中发生并发症15例,其中气胸1例,囊袋内积血及血肿5例,起搏器囊袋感染5例(1例合并囊袋血肿),电极导线脱位2例,导线尾端与脉冲发生器连接不紧1例,起搏器综合征1例,上肢深静脉血栓1例;经相应处理后均治愈或缓解。结论:深入对心脏起搏器植入术常见并发症的了解,重视术前预防及术中规范操作,加强术后随访及起搏器知识教育,早期发现并积极处理各种并发症,可将并发症减少到最低。

Objective：To explore the causes,treatment strategies and prevention measures of the complications in permanent cardiac pacemaker implantation. Methods： The data of 121 patients with permanent cardiac pacemaker implantation were retrospectively analyzed. One hundred and twenty-one patients included 53 cases of athological sinoatrial node syndrome, 23 cases of Ⅲ degree atrioventricular block, 16 cases of Ⅱ degree atrioventricular block, 15 cases of pathological sinoatrial node syndrome complicated with atrioventricular block and 14 cases of persistent atrial fibrillation complicated with slow ventricular rate or more than 3 second long interval. Results ：The complications occurred in 15 cases, including 1 case of pneumothorax, 5 cases of capsule bag hemorrhage and hematoma,5 cases of capsule bag infection（ 1 cases complicated with capsule bag hematoma） ,2 cases of electrode dislocation, 1 case of wire electrode connection fail, 1 case of pacemaker syndrome and 1 case of upper extremity deep vein thrombosis. The complications of 15 cases cured or alleviated after the corresponding treatment. Conclnsions：Thoroughly understanding of the common complications, paying attention to preoperative prevention, standardizing operation procedure, strengthening following up and the education of pacemaker knowledge and early discovering and handling complication can reduce the complications.