上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

瓣膜术后患者起搏器植入术后囊袋相关并发症的临床研究

李艳杰 1, 2，张魏巍 1，杨潇潇 1，黄婧娟 1，叶茂青 3，曲新凯 1，杨奕清 1, 2，李若谷 1   

  1. 1.上海交通大学附属胸科医院心内科，上海 200030；2.上海交通大学附属胸科医院心血管研究室，上海 200030；3.上海交通大学 医学院附属瑞金医院，上海市高血压研究所，上海 200025
  • 出版日期:2016-11-28 发布日期:2016-11-29
  • 通讯作者: 李若谷，电子信箱：lrgchest@yahoo.com。
  • 作者简介:李艳杰（1990—），男，硕士生；电子信箱：liyanjie6666@126.com。
  • 基金资助:

    国家自然科学基金（81400244）；上海市科学技术委员会基金（14140903601，14140903602）

Clinical study on pocket-related complications in patients undergoing pacemaker implantation after valvular surgery

LI Yan-Jie1, 2, ZHANG Wei-Wei1, YANG Xiao-Xiao1, HUANG Jing-Juan1, YE Mao-Qing3, QU Xin-Kai1, YANG Yi-Qing1, 2, LI Ruo-Gu1   

  1. 1. Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China; 2. Cardiovascular Research Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China;3. Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2016-11-28 Published:2016-11-29
  • Supported by:

    National Natural Science Fund of China, 81400244; Project of Science and Technology Committee of Shanghai, 14140903601，14140903602

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摘要：

目的 ·探讨心脏瓣膜术后患者行永久性心脏起搏器植入后囊袋相关并发症的危险因素及防治策略。方法 ·收集 115例瓣膜术后永久性心脏起搏器植入患者的临床资料，回顾性分析术后囊袋相关并发症的发生情况及长期服用华法林对囊袋相关并发症的影响。结果 ·共有12例患者（10.43%）出现囊袋相关并发症，其中囊袋血肿8例（6.96%），囊袋感染或破溃4例（3.48%）；12例患者首次植入平均年龄为（66.5±7.1）岁，男性患者5例（41.7%），其中华法林组囊袋血肿6例（9.23%），囊袋感染或破溃4例（6.15%）。结论 ·瓣膜术后患者永久性心脏起搏器植入后囊袋相关并发症的发生率较高，长期服用华法林是其危险因素；提高患者对起搏器早期并发症的认识并及时就诊，可降低并发症的发生率。

关键词: 永久性心脏起搏器, 并发症, 囊袋血肿, 囊袋感染, 瓣膜手术

Abstract:

Objective · To investigate risk factors for pocket-related complications in patients undergoing permanent pacemaker implantation after valvular surgery, as well as prevention and treatment strategies. Methods · The clinical data of 115 patients undergoing permanent pacemaker implantation after valvular surgery were collected. Postoperative pocket-related complications and the effects of long term administration of warfarin on them were retrospectively analyzed. Results · A total of 12 patients (10.43%) had pocket-related complications, including 8 cases (6.96%) of capsular hematoma and 4 cases (3.48%) of capsular infection or rupture. The average age of 12 patients at their first implantation was 66.5±7.1 years, among whom five are male (41.7%). For the warfarin group, 6 patients (9.23%) had capsular hematoma and 4 patients had capsular infection or rupture (6.15%). Conclusion · The incidence of pocket-related complications in patients undergoing permanent pacemaker implantation after valvular surgery is high. Long term administration of warfarin is a risk factor. Enhancing the awareness of pocket-related complications and prompt treatment can decrease the incidence of complications.

Key words: permanent cardiac pacemaker, complication, capsular hematoma, capsular infection, valvular surgery