永久性心脏起搏器植入老年患者术后起搏器囊袋感染风险因素研究  

Risk factors of pacemaker pocket infection in elderly patients after permanent pacemaker implantation

作　　者：王小鹏[1] 何丽[1] 周铭[1] 马懿[1] 杨文笔[1] 杨莉[1] WANG Xiao-peng;HE Li;ZHOU Ming;MA Yi;YANG Wen-bi;YANG Li(Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563003,China)

机构地区：[1]遵义医学院附属医院心内科

出　　处：《中华医院感染学杂志》2019年第16期2473-2477,共5页Chinese Journal of Nosocomiology

基　　金：贵州省科技计划基金资助项目(黔科合LH字[2017]7109号)

摘　　要：目的研究永久性心脏起搏器植入老年患者术后起搏器囊袋感染风险因素。方法选取2014年5月-2017年4月遵义医学院附属医院心内科收治的老年永久性心脏起搏器植入术患者289例。采用回顾性调查方法统计老年永久性心脏起搏器植入术患者临床资料。进行囊袋感染的细菌学培养及鉴定,Logistic回归分析囊袋感染风险因素。结果 289例老年永久性心脏起搏器植入术患者,术后起搏器囊袋感染27例,感染率9.34%;术后6个月感染率4.50%,高于术后1个月感染率1.38%(P<0.05);建立多因素Logistic回归模型分析,结果显示具有2型糖尿病史、手术时间、手术次数、导管室环境、囊袋大小、囊袋血肿、切口脂肪液化、贫血、白蛋白、操作人员手卫生是老年患者永久性心脏起搏器植入术后起搏器囊袋感染高风险因素,术前预防使用抗菌药物是老年患者永久性心脏起搏器植入术后起搏器囊袋感染保护性因素。结论老年患者永久性心脏起搏器植入术后起搏器囊袋感染风险因素多样,且存在地区性差异。OBJECTIVE To study the risk factors of pacemaker pouch infection after permanent pacemaker implantation in elderly patients. METHODS A total of 289 elderly patients with permanent cardiac pacemaker implantation in the Department of Cardiology, Affiliated Hospital of Zunyi Medical College from May 2014 to Apr. 2017 were enrolled. The retrospective survey method was used to analyze the clinical data of elderly patients with permanent cardiac pacemaker implantation. The bacteriological culture and identification of pacemaker pocket infection were performed, and Logistic stepwise regression analysis was used to analyze the risk factors of pacemaker pocket infection. RESULTS After the operation, 27 cases of pacemaker pocket infection occurred in the 289 elderly patients with permanent cardiac pacemaker implantation, and the infection rate were 9.34%. The infection rate of 6 months after operation was 4.50%, which was significantly higher than 1.38% of the infection rate in 1 month after the operation,(P<0.05). Analysis using the multivariate Logistic regression model suggested that history of type 2 diabetes mellitus, operation time, operation frequency, catheterization room environment, pocket size, pocket hematoma, fat liquefaction at incision, anemia, albumin, and hand hygiene of the operating personnel were high risk factors of pacemaker pocket infection in elderly patients with permanent pacemaker implantation after operation. Preventive use of antibacterials preoperatively was a protective factor for pacemaker pocket infection after permanent cardiac pacemaker implantation in elderly patients. CONCLUSION The risk factors of pacemaker bag infection in elderly patients with permanent pacemaker implantation are diverse, and there are regional differences.

关 键 词：永久性心脏起搏器植入术 老年 起搏器囊袋感染 风险 多因素 

分 类 号：R619.3[医药卫生—外科学]