心脏起搏器电极脱位的原因和处理

Discuss the cause and treatment of pacemaker lead dislocation and deal with

目的 随访安装起搏器患者 ,观察起搏电极的情况 ,探讨电极脱位的原因 ,了解和避免起搏电极的脱位。方法 总结 6例起搏器患者的临床资料 ,电极导线 7根 8次脱位 ,其中起搏器DDDR2例、DDD 2例、VVI 2例。结果 4例右锁骨下静脉穿剌、1例左锁骨下静脉穿剌 ,1例头静脉置入 ,心房导管脱位 4次、1例微脱位 ,心室导管脱位 4例、2例微脱位 ,其中 3例为老年女性 ,4根导管 5次脱位。结论 在起搏器安装时要采取必要的措施预防电极脱位 ,尤其要警惕老年女性或肥胖者。可能老年肥胖女性组织疏松 ,起搏器由于重力下坠产生遂道 ,牵拉导管会引起脱位。

Objective To follow up the patients with pacemaker, observe the condition of pacemaker lead, to explore the cause of lead dislocation, to find out and prevent its occurrence.Methods Summarizing the clinical data of 6 patients with pacemaker,7 pacemaker leads with 8 time dislocation,pacemaker 2 DDDR、2 DDD、2 VVI。 Results Four patients were punctured from right subclavian vein、one from left subclavian vein and one from right brachiocephalic vein; four leads were dislocation in atrium and one mildly dislocation; four leads dislocation in ventricle and two mildly dislocation; There were 3 old women with 4 leads and 5 times of dislocation. Conclusions