起搏器囊袋反复感染临床分析  

Rrepeated infection of permanent pacemaker implantation:clincial analysis

作　　者：何姗姗 郭涛 郭金锐 He Shanshan;Guo Tao;Guo Jingrui(Department of Arrhythmia,Yunnan fuwai cardiovascular hospital,Yunnan,650000,China)

机构地区：[1]云南省阜外心血管病医院

出　　处：《云南医药》2019年第6期496-500,共5页Medicine and Pharmacy of Yunnan

摘　　要：目的起搏器囊袋感染为心脏起搏器植入术后最为常见的并发症,也是影响其治疗效果的主要原因。对永久起搏器植入术后囊袋反复感染相关因素进行分析,探讨相关预防措施,为临床防治提供参考。方法回顾性研究了2017年10月-2019年6月因起搏器囊袋反复感染至我院诊疗的患者5例,分析其原因并对症处理。结果 5例患者目前均取得较满意结局。通过分析患者临床资料,明确患者有囊袋及植入系统感染,即使患者尚处在无全身感染症状的囊袋感染时,拔个植入系统也是不可避免的,但是对于特殊原因不愿更换囊袋或拔出电极困难的极少数囊袋感染患者,可以先明确感染的原因,予以清创后仔细换药及抗感染等保守治疗可能防止囊袋破溃后的进一步感染。结论提高对心脏起搏器植入后囊袋感染的鉴别能力,采取针对个体化的治疗措施,加强术前预防、规范术中操作、重视术后随访,可降低起搏器感染风险,从而发挥其最大治疗效益。Objective Pacemaker pocket infection is the most common complication after cardiac pacemaker implantation, and it is also the main reason affecting its therapeutic effect. The purpose of the study is to analyze the repeated infection of the pocket associated with permanent pacemaker implantation and the related influencing factors, and then provide reference for clinical prevention and treatment. Methods This paper retrospectively studies 5 patients with repeated infection of the Pacemaker pocket from other hospitals who were treated in our hospital from October 2017 to June 2019.We summarized and analyzed the related reasons,and symptomatic treatment was conducted. Results All the 5 patients achieved satisfactory results,it is inevitable for patents with pacemaker pocket infection to pull out the implantation system, even though without Symptoms of systemic infection of pocket infection.but for some special reasons,the patients with bladder infection didn’t want to change the pacemaker pocket or it is handly to pull out electrode, after make clear the cause of the infection, Conservative treatment such as debridement and careful dressing-changing and antibiotics may prevent further infection after the rupture of the pouch. Conclusion To reduce the risk of cardiac pacemaker pocket infection and play the greatest therapeutic benefits,it is necessary to improve the ability of identifying pacemaker pocket infection,strengthen preoperative prevention,standardize operation,pay attention to follow-up.

关 键 词：起搏器 囊袋反复感染 并发症 

分 类 号：R540.47[医药卫生—心血管疾病]