摘要
313例次起搏器安置和更换术后共发生12例次皮袋内出血,发生率为3.8％。主要出血原因为术中伤及胸大肌纤维后止血困难,纤维袋因更换起搏器大小不一而留有残腔,全身凝血机制不良,用扩血管及抗凝药。处理包括哲保留引流皮条继续引流;局部体征轻者予加强压迫;局部体征典型者早期可抽取血液,晚期局部体征剧者切开止血,去除瘀血并用抗生素液冲洗伤口。
Twelve times of bleeding in subcutaneous pouch occurred after 313 procedures of pacemaker implantation and replacement. The rate of occurrence was 3.8％. The causes of bleeding included difficulty of stanching blood after injury of pectoralis major muscle,incompatibility of size of fiber pouch after repacement of pacemaker, general bleeding tendency,administration of vasodilators and anticoagulants. Managements included remaining drainage to drain the blood, reinforcing pressure on pouch in the patients with mild sign,drawing the blood from pouch in early stage,reopersting and irrigating the wounds with antibiotics and removing clots in patients with severe sign.
关键词
起搏器
皮袋
出血
Pacemaker
subcutaneous pouch
Bleeding
