老年患者植入心脏埋藏式起搏器的远期随访（附122例报告）  

Long-term follow-up of elderly patients with pacemaker implantation （a report of 122 cases）

作　　者：王学忠[1] 章萍[1] 王岳松[1] 吾柏铭[2] 

机构地区：[1]安徽省马鞍山市人民医院心内科,243000 [2]苏州大学附属第二医院心内科

出　　处：《中国医师进修杂志（内科版）》2008年第9期32-35,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价老年慢性心律失常患者植入心脏埋藏式起搏器的远期疗效和安全性。方法对植入心脏埋藏式起搏器且年龄≥70岁的122例老年患者（老年组）术后进行长期随访，随访内容包括症状、心电图或动态心电图检查，必要时行胸部X线片及超声心动图检查等，并与同期植入心脏埋藏式起搏器的109例非老年患者（非老年组）进行比较。结果两组患者分别随访（8．22±6．01）、（7．74±5．82）年，随访率均为100％。老年组囊袋相关并发症和心房颤动的发生率较非老年组高（4．10％与0比较，21.31％与10．09％比较，P〈0．05）。老年组死亡原因主要为心力衰竭，而非老年组主要为脑血管病和尿毒症。两组患者生活质量均有改善，但差异无统计学意义（P〉0．05）。结论老年慢性心律失常患者植入心脏埋藏式起搏器具有确切的临床疗效和良好的安全性，并能提高患者远期生活质量；临床上应该根据老年患者生理特性及心律失常类型，合理选择起搏治疗模式。Objective To evaluate the long-term results of pacemaker implantation in 122 elderly patients. Methods A long-term follow-up was carried out in 122 elderly patients （ ≥70 years old, elderly group）and 109 non-elderly patients （ 〈 70 years old,non-elderly group ）who received pacemaker implantation. The clinical characteristics, complications and quality of life were compared. Results The mean follow-up time was （8.22 ± 6.01 ） years and （7.74 ± 5.82） years respectively. The successful rate of the follow-up was 100%. The overall postoperative complications about pacemaker pocket and the prevalence of atrial fibrillation occurred in elderly group were higher than those in non-elderly group （4.10% vs 0, 21.31% vs 10.09%, P 〈 0.05 ）.The heart function failure was the main cause of the death in elderly group. The stroke and uremia were the main causes of the death in non-elderly group. There was no significant difference in theimprovement of the life quality in both groups （ P 〉 0.05 ）. Conclusions The pacemaker implantation is a safe and effective therapy for treatment of elderly patients with bradycardia, and can improve the quality of elderly patients＇ life. Optimal mode for elderly patients will be given according to the physiological characteristics and the types of bradycardia.

关 键 词：老年人 心脏起搏器 人工 随访研究 

分 类 号：R654.2[医药卫生—外科学] R473.6[医药卫生—临床医学]