心脏起搏系统感染因素的回顾性分析

Retrospective Analysis of the Susceptibility Factors of the Cardiac Pacing System Infection

目的分析心脏起搏系统感染的发生情况及高危因素。方法选取江苏省人民医院溧阳分院心血管内科2005~2016年行心脏起搏器植入患者631例。平均随访1年。其中感染组24例,非感染组607例。收集患者的基本临床资料、起搏器囊袋位置、起搏器品牌、起搏器类型、起搏器导线类别、手术排序及手术用时等信息。比较感染组患者的感染特征,进行logistic回归分析,得出起搏系统感染的高危因素。结果我院心脏起搏系统感染率为3.8%,主要为切口/线头感染。感染组患者空腹血糖、血清肌酐明显高于非感染组,差异均有统计学意义(P <0.05)。感染组患者年龄、糖尿病史、起搏器类型、起搏器导线类型、手术排序、手术用时与非感染组比较,差异均有统计学意义(P <0.05)。将这些因素导入logistic回归分析,得出年龄、糖尿病史、起搏器类型、起搏器导线类型、手术排序、手术用时是心脏起搏系统感染的高危因素。结论起搏系统感染受年龄、糖尿病史、起搏器类型、起搏器导线类型、手术排序、手术用时多种因素影响,避免高龄手术,合理手术排序,减少手术用时是避免心脏起搏系统感染的主要措施。

Objective To analyze the incidence and risk factors of cardiac pacing system infection.Methods 631 patients with pacemaker implantation were selected from 2005 to 2016 in Liyang Branch of Jiangsu Provincial People's Hospital.The mean follow-up was 1 year.The patients were divided into the infected group(24 cases)and non-infected group(607 cases).Basic clinical data of patients,pacemaker pouch location,pacemaker brand,type of pacemaker and pacemaker lead,operation sequencing and operation time were documented.The infection characteristics of patients in the infected group were investigated.Logistic regression analysis was conducted to obtain the high risk factors of pacemaker infection.Results The incidence of cardiac pacing system infection was 3.8%,mainly incision/thread infection.The levels of fasting blood glucose and serum creatinine in the infected group were significantly higher than those in the non-infected group,and there were significant differences between the two groups(P<0.05).There were significant differences in the age,history of diabetes,type of pacemaker,type of pacemaker lead,operation sequencing and operation time between the two groups(P<0.05).Logistic regression analysis showed that the age,history of diabetes,type of pacemaker,type of pacemaker lead,operation sequencing and operation time were high risk factors for cardiac pacing system infection.Conclusion Cardiac pacing system infection might be associated with the age,history of diabetes,type of pacemaker,type of pacemaker lead,operation sequencing and operation time.