瓣膜术后患者起搏器植入术后囊袋相关并发症的临床研究  

Clinical study on pocket-related complications in patients undergoing pacemaker implantation after valvular surgery

作　　者：李艳杰[1,2] 张魏巍[1] 杨潇潇[1] 黄婧娟[1] 叶茂青[3] 曲新凯[1] 杨奕清[1,2] 李若谷[1] 

机构地区：[1]上海交通大学附属胸科医院心内科,上海200030 [2]上海交通大学附属胸科医院心血管研究室,上海200030 [3]上海交通大学医学院附属瑞金医院,上海市高血压研究所,上海200025

出　　处：《上海交通大学学报（医学版）》2016年第11期1628-1631,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81400244);上海市科学技术委员会基金(14140903601,14140903602)~~

摘　　要：目的·探讨心脏瓣膜术后患者行永久性心脏起搏器植入后囊袋相关并发症的危险因素及防治策略。方法·收集115例瓣膜术后永久性心脏起搏器植入患者的临床资料,回顾性分析术后囊袋相关并发症的发生情况及长期服用华法林对囊袋相关并发症的影响。结果·共有12例患者(10.43%)出现囊袋相关并发症,其中囊袋血肿8例(6.96%),囊袋感染或破溃4例(3.48%);12例患者首次植入平均年龄为(66.5±7.1)岁,男性患者5例(41.7%),其中华法林组囊袋血肿6例(9.23%),囊袋感染或破溃4例(6.15%)。结论·瓣膜术后患者永久性心脏起搏器植入后囊袋相关并发症的发生率较高,长期服用华法林是其危险因素;提高患者对起搏器早期并发症的认识并及时就诊,可降低并发症的发生率。Objective · To investigate risk factors for pocket-related complications in patients undergoing permanent pacemaker implantation after valvular surgery, as well as prevention and treatment strategies. Methods · The clinical data of 115 patients undergoing permanent pacemaker implantation after valvular surgery were collected. Postoperative pocket-related complications and the effects of long term administration of warfarin on them were retrospectively analyzed. Results · A total of 12 patients （10.43%） had pocket-related complications, including 8 cases （6.96%） of capsular hematoma and 4 cases （3.48%） of capsular infection or rupture. The average age of 12 patients at their first implantation was 66.5±7.1 years, among whom five are male （41.7%）. For the warfarin group, 6 patients （9.23%） had capsular hematoma and 4 patients had capsular infection or rupture （6.15%）. Conclusion · The incidence of pocket-related complications in patients undergoing permanent pacemaker implantation after valvular surgery is high. Long term administration of warfarin is a risk factor. Enhancing the awareness of pocket-related complications and prompt treatment can decrease the incidence of complications.

关 键 词：永久性心脏起搏器 并发症 囊袋血肿 囊袋感染 瓣膜手术 

分 类 号：R654.2[医药卫生—外科学]