心脏永久置入起搏器患者医院感染的临床研究  

Clinical study of hospital infections in patients after implantation of permanent cardiac pacemaker

作　　者：黄荫浩[1] 顾青青[1] 陆齐[1] 黄荣[1] 吴翔[1] 

机构地区：[1]南通大学附属医院心内科,江苏南通226001

出　　处：《中华医院感染学杂志》2015年第22期5212-5214,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(1400521498)

摘　　要：目的探讨心脏永久置入起搏器患者的医院感染与病原学特征,旨在为临床提供一定的指导。方法回顾性分析2011年1月-2014年6月240例实施永久起搏器置入术患者的临床资料,统计其感染的发生、临床表现、病原学特征、治疗方法,并采用单因素方差分析和多因素logistic回归分析,分析心脏永久置入起搏器装置患者感染的危险因素。结果 240例心脏永久置入起搏器装置的患者中6例发生起搏器囊袋感染,感染率为2.5%,其中4例为首次置入时发生感染,2例为更换起搏器后感染;6例患者中4例经分泌物培养呈阳性,均为表皮葡萄球菌感染,其对万古霉素的敏感率为100.0%;高龄、手术时间≥2h、手术次数≥2次、囊袋血肿是心脏永久置入起搏器装置患者感染的危险因素。结论心脏永久置入起搏器装置患者感染病原菌以表皮葡萄球菌为主,其对万古霉素敏感,根据患者感染的危险因素,合理的治疗。OBJECTIVE To investigate the hospital infection and pathogenic characteristics of patients undergoing implantation of permanent cardiac pacemaker so as to provide certain clinical guidance .METHODS Retrospective a‐nalysis was conducted on clinical data of 240 patients undergoing permanent pacemaker implantation from Jan . 2011 to Jun .2014 .T he infection incidence ,clinical manifestations ,pathogenic characteristics and treatment meth‐ods were statistically summarized ,and the single factor analysis of variance and the multiple logistic regression a‐nalysis were used to analyze risk factors of infections in patients with permanent cardiac pacemaker .RESULTS A‐mong the 240 patients with permanent cardiac pacemaker ,pacemaker pocket infection occurred in 6 cases ,the in‐fection rate was 2 .5% ,including 4 cases （66 .7% ） with infections occurring at the first time of implantation and 2 cases （33 .3% ） after the replacement of pacemaker .In the 6 patients ,4 cases had the secretion culture positive for Staphylococcus epidermidis infection and the sensitivity to vancomycin was 100 .0% .Advanced age ,operation time ≥ 2 h ,operation frequency ≥ 2 times ,and pocket hematoma were risk factors of infection in patients with permanent pacemaker .CONCLUSION The main pathogen for infection in patients with permanent cardiac pacemak‐er was S .epidermidis ,sensitive to vancomycin .It is recommended to conduct reasonable treatment according to the risk factors of the patients .

关 键 词：心脏起搏器 感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]