心脏植入电子装置感染的临床表现和治疗措施  

The clinical manifestation and treatment of cardiac implantable electronic device infection

作　　者：方丹红[1] 黄伟剑[1] 李海鹰[1] 林捷[1] 吴高俊[1] FANG Danhong;HUANGWeijian;LI Haiying(Department of Cardiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院心内科,325000

出　　处：《心电与循环》2018年第6期406-409,共4页Journal of Electrocardiology and Circulation

基　　金：温州市科技计划项目(Y20140490)

摘　　要：目的分析心脏植入电子装置(CIED)感染的发生率,临床表现和处理方法。方法回顾分析2000年1月至2012年12月心脏中心植入CIED病例资料、感染类型、感染组患者的血培养结果、感染处理方法及预后。结果 1 817例植入CIED者中16例发生CIED相关感染,其中15例为起搏器囊袋感染,1例为感染性心内膜炎,11例检测到葡萄球菌,其中10例为凝固酶阴性葡萄球菌。保留导管11例,拔除导管4例,取出原起搏器12例。随访(8.9±2.6)年,无感染复发及拔管相关并发症和死亡。结论 CIED感染以囊袋感染为主,病原菌以凝固酶阴性葡萄球菌为主,非导管相关感染者可保留导管。Objective To analyze the incidence, clinical features and management strategy of cardiac implantableelectronic device（CIED） related infection. Methods The clinical data of cases implanted with CIED from January 2000 toDecember 2012, infection pattern, blood culture results, management methods and prognosis were analyzedretrospectively. Results Of 1817 cases implanted with CIED, 16 cases suffered from CIED related infection. Of them,15 cases were generator pocket infection, and 1 case was diagnosed as infective endocarditis. Staphylococcus wasdetected in 11 cases.Of them, 10 cases were coagulase negative Staphylococcus. Pacing leads were retained in 11 casesand extracted in 4 cases. Pacemakers were removed in 12 cases. During （8.9±2.6） years of follow-up, there was norecurrent infection and no lead extraction related complication and death. Conclusion The most of CIED relatedinfection is pocket infection and the most of pathogen is coagulase-negative Staphylococcus. Pacing lead may beretained in patients without catheter related infection.

关 键 词：心脏植入电子装置 起搏器囊袋 感染 凝固酶阴性葡萄球菌 

分 类 号：R541.7[医药卫生—心血管疾病]