心脏起搏主动与被动电极导线的拔除难度对比研究

Clinical comparative study on the difficulty of cardiac active and passive electrode leads extraction

目的 探究心脏起搏主动与被动电极导线在拔除的手术时间和并发症上是否存在差异。方法 选取新疆医科大学第一附属医院从2016年1月至2022年6月进行电极导线拔除的病人共109例,去除除颤电极导线患者8例,未使用工具拔除患者54例,剩余47例,共77根电极导线,其中主动电极导线31根,被动电极导线46根,其中22根使用锚定钢丝拔除,55根使用针眼圈套器拔除。比较两种电极导线之间的手术时间和并发症情况。结果 两组患者的年龄、性别、基础疾病、拔除原因无明显差异。在未进行电极导线使用年限匹配的情况下,主动电极导线的拔除时间明显减少[(46.74±17.95)min vs(56.41±19.61)min,P=0.031],心房主动电极导线的拔除时间较被动电极导线明显缩短[(30.42±10.84)min vs(52.90±19.82)min,P=0.009],在心室电极导线中,两种电极导线的拔除时间无明显差异[(51.50±16.89)min vs(59.36±19.34)min,P=0.137]。主动电极导线的使用年限较短[(4.60±3.64)年vs(10.27±4.26)年,P<0.001],使用锚定钢丝拔除的较多(51.60%vs 13.00%,P<0.001)。根据导线年限对进行匹配后,手术时间在心房电极导线[(32.80±10.28)min vs (48.00±18.63)min,P=0.121]和心室电极导线[(56.62±15.51)min vs (62.33±20.59)min,P=0.410]中均无明显差异。结论 主动电极导线与被动电极导线在手术难度及并发症的差异主要来自于导线使用年限,而并非本身的导线类型。

Objective To evaluate the differences between cardiac active electrode leads and passive electrode leads with operation time and complication in patients with lead extraction.Methods A total of 109patients with elec-trode lead extraction from January,2016to June,2022in center of the First Affiliated Hospital of Xinjiang Medical University,excluded 8patients of defibrillation electrode leads and 54patients without tools,remianed 47patients.Totally 77leads included 31active electrode leads and 46passive electrode leads.22leads were extracted with locking stylets,22leads were extracted with Needle′s Eye Snare.Compare the operation time and complication between ac-tive electrode leads and passive electrode leads.Results There was no significant difference in the age,sex,basic disease,and the reason of lead extraction between the two groups.In the case of no matching years,the operation time of the active electrode leads was significantly reduced[(46.74±17.95)min vs(56.41±19.61)min,P=0.031].The operation time of atrial active electrode leads was significantly shorter than that of passive electrode leads[(30.42±10.84)min vs(52.90±19.82)min,P=0.009].There was no significant difference in the ventricular electrode leads[(51.50±16.89)min vs(59.36±19.34)min,P=0.137].The age of active electrode leads was shorter than passive e-lectrode leads[(4.60±3.64)year vs(10.27±4.26)year,P<0.001],more with locking stylets(51.60%vs 13.00%,P<0.001).After according to the age of electrode leads grouping,found that the operation time of active electrode leads was no significantly reduced in whether atrial electrode leads[(32.80±10.28)min vs(48.00±18.63)min,P=0.121]or ventricular electrode leads[(56.62±15.51)min vs(62.33±20.59)min,P=0.410].Conclusion The differ-ences of surgical difficulty and complication between active electrode leads and passive electrode leads mainly come from the age of leads,rather than the types of leads.