置入心脏起搏器患者施行妇产科手术的体会  

Clinical Analysis of Cesarean Sections and Gynecological Operations in Women after Implanting Cardiac Pacemakers

作　　者：秦晓莉[1] 谢建华[1] 杜为平[1] 邱朝晖[2] 

机构地区：[1]宁波市第一医院,浙江宁波315010 [2]上海华东医院,上海200000

出　　处：《实用妇产科杂志》2006年第11期691-693,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨缓慢心律失常患者置入心脏起搏器后经历妇产科手术的临床情况。方法:回顾分析37例伴有缓慢心律失常的孕产妇及妇科患者置入人工心脏起搏器后施行剖宫产或妇科手术的围手术期情况及术中高频手术器械对心脏起搏器的影响。结果:总计在已置入31例临时和6例永久性起搏器的患者中,10例孕产妇顺利施行剖宫产,27例妇科患者顺利施行经腹全子宫加附件切除、宫腹腔镜等手术;32例使用高频双极电刀电凝或双极切割套圈对起搏器无干扰,5例单极电刀干扰或抑制起搏器。结论:置入心脏起搏器可使患有严重缓慢心律失常的妇产科患者安全度过围手术期;妇产科手术中应用高频手术器械应尽可能选用对起搏器无影响的双极电刀电凝。Objective： To investigate the clinical therapeutic effect of cesarean section and gynecological operations experienced with brady-arrhythmia after implanting cardiac pacemakers, Methods： Retrospectively analyze the perioperative manifestations of cesarean sections and gynecological operations in 37 patients with brady-arrhythmia after implanting artificial cardiac pacemakers and the impacts to the pacemakers of high-frequency operative devices used in the operations. Results： Among implanted 31 temporary pacemakers and 6 permanent pacemakers, 10 pregnant woman successfully experienced cesarean sections and 27 gynecological patients with total abdominal hysterectomy, hysteroscopy,and laparoscopy operations. No interferences were observed in 32 cases when using high-frequency bipolar electro-cutting or coagulation or collar, but with interferences or inhibitions of pacemakers using monopolar cutting. Conclusions： Cardiac pacemakers are helpful to patients with serious brady-arrhythmia to safely pass through the perioperative period. Bipolar electro cutting or coagulation without interferences to pacemakers is preferred in obstetrical and gynecological operations.

关 键 词：心脏起搏器 剖宫产 妇科手术 

分 类 号：R71[医药卫生—妇产科学]