安装心律植入装置术后静脉阻塞的发生率及危险因素分析  

Prevalence and Predictors of Venous Obstruction Following Cardiovascular Implantable Electronic Device:a Retrospective Analysis on 150 Asymptomatic Patients

作　　者：高洁[1] 李洪仕[1] 朱可佳[1] 于向东[1] 张文娟[1] GAO Jie;LI Hongshi;ZHU Kejia;YU Xiangdong;ZHANG Wenjuan(Department of Cardiology,Tianjin Medical University General Hospital,Tianjin(300052),China)

机构地区：[1]天津医科大学总医院心内科,天津市300052

出　　处：《中国循环杂志》2020年第6期599-603,共5页Chinese Circulation Journal

摘　　要：目的:研究安装心律植入装置术后患者静脉阻塞发生的危险因素。方法:连续入选因各种原因行起搏器更换术常规行术前静脉造影的患者150例。通过静脉造影确定为静脉狭窄(直径狭窄≥50%)或闭塞为阻塞组(n=38),以静脉狭窄程度<50%者为对照组(n=112)。分析心律植入装置术后静脉阻塞的危险因素。结果:38例(25.3%)发生静脉阻塞,其中12例(8.0%)患者出现静脉狭窄,26例(17.3%)患者静脉完全闭塞。在阻塞的静脉中,36例(24.0%)以锁骨下静脉狭窄及闭塞为主,仅2例(1.3%)发生腋静脉闭塞。术后感染(OR=11.475,95%CI:1.562~84.281,P=0.016)、术中静脉穿刺次数增加(OR=1.373,95%CI:1.164~1.850,P=0.019)以及植入导线数目(OR=1.270,95%CI:1.095~1.770,P=0.014)与心律植入装置术后静脉阻塞的发生相关。结论:术后感染、术中静脉穿刺次数的增加以及植入导线数目是心律植入装置后静脉阻塞发生的独立危险因素。Objectives:This study was designed to evaluate the incidence and risk factors of venous obstruction after cardiovascular implantable electronic device.Methods:A total of 150 patients who underwent routine preoperative venography for pacemaker replacement were selected.Vein stenosis(diameter stenosis≥50%)or occlusion(n=38)was determined by venography,and those with a degree of vein stenosis<50%were taken as control group(n=112).Risk factors of vein occlusion after cardiac rhythm implantation were analyzed.Results:Venous occlusion occurred in 38 cases(25.3%),including venous stenosis in 12 cases(8.0%)and complete occlusion in 26 cases(17.3%).Among the blocked veins,36 cases(24.0%)were presented as subclavian vein stenosis and occlusion,and only 2 cases(1.3%)presented as axillary vein occlusion.Multivariate regression analysis showed that postoperative infection(OR=11.475,95%CI:1.562-84.281,P=0.016),increased number of intraoperative venipuncture(OR=1.373,95%CI:1.164-1.850,P=0.019)and number of implanted wires(OR=1.270,95%CI:1.095-1.770,P=0.014)were independent risk factors of venous occlusion after cardiovascular implantable electronic device.Conclusions:Postoperative infection,the increase of the number of intraoperative venipuncture and the number of implanted wires are independent risk factors of venous occlusion after cardiovascular implantable electronic device.

关 键 词：心律植入装置 静脉阻塞 危险因素 感染 

分 类 号：R541[医药卫生—心血管疾病]