安置心脏起搏器患者行乳腺癌手术的安全性分析

Safety analysis of breast cancer surgery for patients with cardiac pacemaker implantation

目的:探讨安置心脏起搏器患者行乳腺癌手术围手术期的安全性。方法:回顾性分析2013年1月至2017年12月复旦大学附属中山医院普通外科收治的13例安置心脏起搏器患者行乳腺癌手术的临床资料,以同期52例无心脏疾病、应用单极电凝的乳腺癌患者作为对照,分析并探讨安置心脏起搏器患者围手术期的安全性。结果:起搏器组13例患者术中生命体征均平稳,未出现起搏器工作异常状态,未出现新的心律失常,术后顺利康复。起搏器组与对照组的住院时间及术后引流情况无显著性差异。结论:对安置心脏起搏器的乳腺癌患者做好围手术期管理,术前对起搏器的型号和功能进行详细的了解,制定个体化的手术方案,术中密切监护,手术操作时尽量使用解剖刀锐性分离,使用双极电凝、Ligasure止血,避免使用单极高频电刀,手术的安全性是可以保证的。

Objective:To investigate perioperative safety of breast cancer surgery for patients with cardiac pacemaker implantation.Methods:The clinical data of 13 patients undergoing breast cancer surgery from January 2013 to December 2017 were retrospectively collected and analyzed.A total of 52 breast cancer patients without cardiac diseases were continuously collected at the same time as the control group.Results:In pacemaker group,all of the 13 patients recovered smoothly postoperatively without abnormal state of implanted pacemakers or newly occurrences of arrhythmia.There were no significant differences in length of stay in hospital or postoperative drainage between the two groups.Conclusions:The safety of the operation can be guaranteed for breast cancer patients with pacemaker implantation based on individualized therapy and good perioperative managements including full knowledge about models and functions of pacemakers,strict intraoperative monitoring,the use of anatomical scalpels,bipolar electric scalpels,and Ligasure vessel sealing system instead of unipolar high-frequency electric scalpels.