埋藏式起搏器更换术临床分析  

Replacement of implanted pacemakers

作　　者：杨玲[1] 张仁坤[1] 许国锋[1] 周瑞珏[1] 柯海燕[1] 孙建辉[1] 

机构地区：[1]江苏省常州市第一人民医院心脏内科,213003

出　　处：《国际心血管病杂志》2006年第6期423-424,共2页International Journal of Cardiovascular Disease

摘　　要：目的：回顾性分析埋藏式起搏器更换原因,并对术中电极处理进行探讨。方法：埋藏式起搏器更换术28例,男性15例,女性13例,年龄60～98岁,17例患者为Ⅲ度房室传导阻滞,11例为病态窦房结综合征(SSS),其中更换电极11例。结果：28例起搏器更换术中,起搏器电池耗竭或使用时间已到质保期25例,电极绝缘层破裂1例,囊袋皮肤无菌性破溃1例,囊袋感染1例。心室电极在体内埋置时间为3～11年(平均8．3年)。植入起搏器时起搏阈值为(0．44±0．27)V,更换时起搏阈值为(1．08±0．53)V,两者相比有显著性差异(P＜0．01)。植入时电极阻抗为(547．52±126．35)Ω,更换时电极阻抗(723．22±103．30)Ω,两者相比无显著性差异(P＞0．05)。结论：起搏器更换原因多为电池耗竭或使用时间已到质保期。测量数据显示,心室起搏电极使用约8年后大多数的可以继续使用。Objective： To retrospectively analyse the reasons of the pacemaker replacement and investigate the treatment of pacing leads during the procedures, Methods： 28 cardiac pacemakers were replaced （15 male and 13 female, aged 60-98 years）. 17 patients were in third degree atrioven tricular block and 11 patients had sick sinus syndrome. New ventrieular lead in 11 cases was implan ted. Results：Among these 28 cases, battery exhaustion or working time of the lead reaching the service time occurred in 25, insulation defect of the lead occurred in 1, asepsis rupture of the sack skin occurred in 1 , and infection of the sack occurred in 1. The ventricular leads had been implanted for 3- 11 years （mean time 8, 3 years）. The pacing threshold of leads during pacemaker replacement were higher than initial pacing threshold（0, 44 ± 0.27）V vs （1.08 ± 0.53）V, P〈0.01, There were no significant difference in lead impedances between pacemaker replacement and initial implantation （547.52 ± 126, 35）Ω vs （723.22 ± 103. 30）Ω, P〉0.05. Conclusions： The main reason of the pacemaker replacement is battery exhaustion and the service time. The parameters of implanted ventricular leads after 8 years showed that most leads are considered to continue performing well.

关 键 词：起搏器 更换 电极 

分 类 号：R541.7[医药卫生—心血管疾病]