经静脉电极拔除浅谈  

Transvenous lead removal and treatment of surgery-related problems

作　　者：黎明 毛小香 LI Ming;MAO Xiaoxiang(Department of Cardiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China;Hubei Key Laboratory of Biological Targeted Therapy,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology;Hubei Engineering Research Center for Immunological Diagnosis and Therapy of Cardiovascular Diseases,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology)

机构地区：[1]华中科技大学同济医学院附属协和医院心内科,武汉430022 [2]生物靶向治疗研究湖北省重点实验室 [3]心血管疾病免疫诊疗湖北省工程研究中心

出　　处：《临床心血管病杂志》2024年第11期876-879,共4页Journal of Clinical Cardiology

摘　　要：随着心血管植入型电子装置(CIED)植入量增多,脉冲发生器囊袋感染、上腔静脉综合征、电极损伤退化或功能障碍等问题日益突出。囊袋清创并电极拔除是根本性解决问题的办法。充分的术前准备、高精准的术中操作以及严密的术后监测,对降低经静脉导线拔除(transvenous lead removal, TLR)术中心脏破裂、大血管撕裂等严重手术并发症至关重要。本文就目前国内外的TLR临床指征、危险因素预测及管理的临床研究进展进行论述,以期降低手术风险,提高电极拔除成功率,为患者带来更多的临床获益。With the increasing implantation of cardiovascular implantable electronic devices(CIED),prob-lems such as pulse generator pocket infection,superior vena cava syndrome,electrode damage and degeneration or dysfunction have become increasingly prominent.Pocket debridement and electrode removal is the only way to fundamentally solve this problem.Adequate preoperative preparation,highly accurate intraoperative operation and strict postoperative monitoring are essential to reduce serious surgical complications such as cardiac rupture and large vessel tear during transvenous lead removal(TLR).This article reviews the current research progress of TLR clinical indications,risk factors prediction and management,aiming to reduce the risk of surgery,improve the success rate of electrode removal,and bring more clinical benefits to patients.

关 键 词：经静脉电极拔除术 囊袋感染 埋藏式心律转复除颤器 

分 类 号：R541.7[医药卫生—心血管疾病]